Cagatay Daphan

Effects of Laparotomy, and Carbon Dioxide and Air Pneumoperitoneum, on Cellular Immunity and Peritoneal Host Defences in Rats

OBJECTIVE To assess the effects of laparotomy, and insufflation of carbon dioxide and air, on the immune system in rats. DESIGN Randomised laboratory study. SETTING Teaching hospital, Turkey. ANIMALS 77 Wistar rats randomly allocated to 2 groups one of which was sensitised with dinitrofluorobenzene (DNFB, n = 43) and one of which was not (n = 34). INTERVENTIONS The DNFB group was sensitised and subdivided into control (n = 8), laparotomy alone (n = 7), and insufflation with carbon dioxide (CO2) for 30 and 60 mins (n = 7 in each) or room air for 30 and 60 mins (n = 7 in each). A week later DNFB was reapplied to the ears. In the group not sensitised with DNFB the animals were subdivided similarly, the corresponding numbers in each group being, 6, 6, 6, 6, 5, and 5. MAIN OUTCOME MEASURES Delayed type hypersensitivity (DTH) measured by ear swelling in the DNFB group, and peritoneal bactericidal activity, total free peritoneal cell counts (TPC), and cell types in the non-sensitised group. RESULTS There were significant differences in the degree of ear swelling in the DNFB group between control and laparotomy groups (p = 0.0001) and between control and both insufflations of air (p = 0.002 and p = 0.0003, respectively). In the non-sensitised group peritoneal bactericidal activity was significantly increased after 7 hours in the 60 mins air insufflation group (p = 0.04). At 24 hours there were no differences among the groups. TPC were not affected. The number of peritoneal polymorphonuclear leucocytes (PMN) was significantly higher in the laparotomy alone group than in the control or any of the insufflation groups (p < 0.05). CONCLUSIONS Laparotomy and air insufflation depressed cell-mediated immunity. Peritoneal bactericidal activity was affected only after 60 minutes of air insufflation.

Similar effects of general and spinal anaesthesia on perioperative stress response in patients undergoing haemorrhoidectomy.

Surgery induces release of neuroendocrine hormones (cortisol), cytokines (interleukin-6: IL-6, tumour necrosis factor-α: TNF-α), acute phase proteins (C-reactive protein: CRP, leptin). We studied the effects of general and spinal anaesthesia on stress response to haemorrhoidectomy. Patients were assigned to general and spinal anaesthesia groups (n = 7). Blood samples were drawn before induction and 24 hours after surgery. Perioperative levels of IL-6, TNF-α, CRP, cortisol, and leptin were comparable among the groups. Twenty four hours after surgery, TNF-α and cortisol did not change; IL-6 and CRP increased significantly in all patients. Significant increase in leptin levels was found in patients undergoing spinal anaesthesia. Except for the increase in leptin levels, there was no significant difference related to the effects of general and spinal anaesthesia.

Effect of Carnitine on Cutaneous Wound Healing in Immunosuppressed Rats

BACKGROUND The wound is ischemic in nature. Chronic steroid administration impairs wound healing by changing enzymes in the glycolytic pathway. Carnitine supplementation may help to restore the energy deficiency caused by chronic steroid administration in the wound. The aim of this study was to evaluate the effect of carnitine on impaired wound healing. METHODS The study was conducted in three groups. Surgical intervention was a 4 cm long midline skin incision at the back. In Group A, eight rats received methylprednisolone for 7 d prior to surgical intervention, and it was continued until the end of the experiment. In Group B, 12 rats received methylprednisolone for 7 d prior to surgical intervention. After surgery, methylprednisolone injection was continued and carnitine was supplemented until the end of the experiment. In Group C, eight rats received no medication. The wound of half of the animals in each group was harvested on the seventh day after surgical intervention and the remaining on the 14th d. Tensile strength and hydroxyproline content were measured in all groups. RESULTS There was no significant difference in parameters in any of the groups on day seven. On day 14, all parameters were statistically different between methylprednisolone and control groups (P < 0.05). Values for tensile strength were higher in the methylprednisolone/carnitine group compared with methylprednisolone group (P < 0.05). Carnitine administration had also increased hydroxyproline levels in the methylprednisolone/carnitine group compared with the control group (P < 0.05). CONCLUSIONS Carnitine is shown to increase tensile strength of the wound when supplemented to immunosuppressed rats in which wound healing is impaired by methylprednisolone.

The effects of anesthetic techniques on acute phase response at delivery (anesthesia and acute phase response).

OBJECTIVES To investigate the effects of anesthetic techniques and delivery types on stress response during uncomplicated delivery. DESIGN AND METHODS Forty pregnant women at term were divided into four groups. Group-I, cesarean section with general anesthesia; Group-II, section with spinal anesthesia; Group-III, section with epidural anesthesia; and Group-IV, vaginal delivery with epidural analgesia. C-reactive protein and albumin were measured on hospital admission, immediately after delivery and 24 h later. RESULTS Albumin and CRP levels decreased significantly in Group-II and Group-III, just after delivery. CRP increased significantly in all groups at the 24(th) hour of delivery. The effect of hemodilution on CRP and Albumin, due to volume loading, during spinal and epidural anesthesia disappeared after 24 h. CONCLUSION We found no influence of anesthetic techniques on acute phase response except hemodilution effect. In the view of delivery types, vaginal delivery caused less stress response than section.

The Effect of G-CSF in an Experimental MRSA Graft Infection in Mice

Wound infection after prosthetic material implantation is a troublesome complication with an incidence of 2% to 10%. The effect of granulocyte colony-stimulating factor (G-CSF) was studied in an experimental methicillin-resistant Staphylococcus aureus (MRSA) graft infection model. Eighty adult mice were used. Under general anesthesia an abdominal incision of 2 cm in length was performed. A subcutaneous cavity of 2 × 2 cm in size was created. Polypropylene mesh pieces of 2 × 1 cm and MRSA solution of 0.1ml of 108 CFU/mL were used. G-CSF was applied systemically or locally in a dosage of 0.02 MU/30 g body weight. There were 8 groups: group I, wound + MRSA; group II, wound + mesh + MRSA; group III, wound + mesh + MRSA + G-CSF (ip, 48 h before operation); group IV, wound + mesh + MRSA + G-CSF (ip, 24 h before operation); group V, wound + mesh + MRSA + G-CSF (locally, into the cavity); group VI, wound + mesh (incubated in G-CSF solution for 4 h) + MRSA; group VII, wound + mesh + MRSA + G-CSF, ip, 24 h from operation; and group VIII (positive control group), wound + mesh + MRSA + Teicoplanin (0.03 mg/30 g body weight, ip, 1/2 h before operation). Three days after, animals were killed and incisions were examined for possible infection or abscess formation and wound failure. Meshes were removed; after vortexing and dilution, samples were incubated with 5% agar media. Results of bacterial incubation were evaluated 24 h and 48 h later. There were symptoms of wound infection and abscess formation in all groups except group VIII. In group VIII, MRSA was isolated in 7 events with a colony count below 103. Bacterial counts were above 106 (106–108) in all other groups. Thus, it was observed that wound infection could be created with this model, but G-CSF could not prevent the development of wound infection, whether it was administered systemically or locally. Teicoplanin decreased the number of colony-forming units of MRSA, and prevents wound infection in this MRSA wound infection model.

Healing of Ischemic Colon Anastomosis in Rats Could Be Provided by Administering Dexpanthenol or Coenzyme Q10

Background: In this study, the effectiveness of dexpanthenol and coenzyme Q10 (CoQ10) on the healing of ischemic colon anastomosis was investigated. Methods: Forty eight male Wistar Albino rats were divided into four equal groups (Sham-S, Sham-I, DXP, Q10). Following full layer colon resection, single layer colon anastomosis, without creating ischemia, was performed on the Sham-S group. The same experimental model was performed on remaining groups after ischemia was created. Intraperitoneal dexpanthenol and CoQ10 was administered to the DXP and Q10 groups once a day for three days. Ten days later, all colon anastomoses were investigated histopathologically and biochemically, as well as their burst pressure values, in all sacrificed rats. Results: The highest burst pressure value was observed in the Sham-S group, decreasing from high to low in the DXP, Q10, and Sham-I groups, respectively (p = 0.008). Furthermore, tissue hydroxyproline (p = 0.001) level values were significantly different among the groups. Additionally, histopathological analysis revealed a significant difference among groups regarding reepithelization (p = 0.027) and polymorphonuclear leukocyte density (p = 0.022). Conclusions: This preliminary study has shown that ischemia-reperfusion injury may impair the healing of colon anastomosis and it has been concluded that dexpanthenol and CoQ10 may have positive effects on the healing of ischemic colon anastomosis in rat, although re-epithelization may be adversely affected using CoQ10.

Ultrasonografide Rastlantısal Olarak Saptanan Polipoid Gastrointestinal Sistem Lezyonları: Ultrasonografi, Bilgisayarlı Tomografi ve Kolonoskopi Bulguları

406 eknolojik gelişmeler sayesinde manyetik rezonans ve bilgisayarlı tomografi (BT) inceleme sonuçları, gastrointestinal sistemin değerlendirilmesinde, konvansiyonel baryumlu tetkikler ve endoskopik incelemelerin başarı oranlarına yaklaşmaya başlamıştır. Her iki inceleme yöntemi, kanserler dışında küçük boyutlu poliplerin bulunmasında da başarılı sonuçlar vermektedir. Ayrıca BT, kolonografi küçük kolorektal poliplerin tanısında non invaziv bir yöntem olarak kullanılabilir.1 Ultrasonografi (USG) ise, geliştirilen sono-enterokolonografi ve hidrokolonik USG teknikleri ile, kanserleri ve 7 mm’den büyük polipleri, diğer iki yönteme oranla daha düşük oranlarda olmakla birlikte saptayabilmektedir. HidrokoUltrasonografide Rastlantısal Olarak Saptanan Polipoid Gastrointestinal Sistem Lezyonları: Ultrasonografi, Bilgisayarlı Tomografi ve Kolonoskopi Bulguları