Cumhur Yegen

Estrogens ameliorate remote organ inflammation induced by burn injury in rats

Abstract.Objective and design: The present study was designed to investigate the role of sex steroids in burn-induced remote organ injury.¶Material or subjects: Male Wistar albino rats were given burn trauma (n=39), and underwent castration or sham operation at 2 h following the burn injury.¶Treatment: Rats were injected sc with either 17β estradiol benzoate (E2, 10 mg/kg) or an androgen receptor blocker cyproterone acetate (CPA, 25 mg/kg) or vehicle, immediately after burn and at 12 h.¶Methods: At 24 h of burn insult, rats were decapitated. Blood samples for RIA of testosterone, estradiol and tumor necrosis factor (TNF)-α and the tissue samples for myeloperoxidase activitiy (MPO) were taken. ANOVA students t test was used for statistical analysis.¶Results: Castration, antiandrogen and E2 treatments increased plasma estradiol levels and depressed burn-induced elevation in serum TNF-α levels. In the liver and lung, burn-induced increase in MPO was reduced by E2 and castration, while CPA was effective in reducing neutrophil infiltration only in the liver.¶Conclusion: We propose that treatment with estrogens or antiandrogens might be applicable in clinical situations to ameliorate systemic inflammation induced by burn.

Oxytocin alleviates hepatic ischemia–reperfusion injury in rats

Various mechanisms have been proposed for the pathogenesis of postischemic hepatic injury, including the generation of reactive oxygen metabolites. Oxytocin (OT) possesses antisecretory, antiulcer effects, facilitates wound healing and has anti-inflammatory properties. Hepatic ischemia-reperfusion (I/R)-injury was induced by inflow occlusion to median and left liver lobes ( approximately 70%) for 30 min of ischemia followed by 1h reperfusion in female Sprague-Dawley rats under anesthesia. I/R group (n=8) was administered intraperitoneally either OT (500 microg/kg) or saline at 24 and 12 h before I/R and immediately before reperfusion. Sham-operated group that underwent laparotomy without hepatic ischemia served as the control. Rats were decapitated at the end of reperfusion period. Hepatic samples were obtained for the measurement of myeloperoxidase (MPO) activity, malondialdehyde (MDA), glutathione (GSH) and collagen levels and histopathological analysis. Tumor necrosis factor-alfa (TNF-alpha) and transaminases (SGOT, SGPT) were assayed in serum samples. I/R injury caused significant increases in hepatic microscopic damage scores, MPO activity, collagen levels, transaminase, serum TNF-alpha levels. Oxytocin treatment significantly reversed the I/R-induced elevations in serum transaminase and TNF-alpha levels and in hepatic MPO and collagen levels, and reduced the hepatic damage scores. OT treatment had tendency to abolish I/R-induced increase in MDA levels, while GSH levels were not altered. These results suggest that OT has a protective role in hepatic I/R injury and its protective effect in the liver appears to be dependent on its inhibitory effect on neutrophil infiltration.

Melatonin protects against pancreaticobiliary inflammation and associated remote organ injury in rats: role of neutrophils

Abstract:  Although the role of oxidative stress in acute pancreatitis (AP) has been studied in several animal models, little data are available regarding AP induced by pancreatic duct obstruction. We characterized the protective effects of melatonin on pancreaticobiliary inflammation and associated remote organ injury. In Sprague–Dawley rats, either the common pancreaticobiliary duct (PBDL; n = 28) or bile duct (BDL; n = 28) was ligated or a sham operation was applied (n = 14). Either melatonin (10 mg/kg) or vehicle (saline; 1 mL/kg) was administered intraperitoneally (i.p.) immediately before the surgery and twice a day until the rats were decapitated at 6 or 72 h. The pancreas, liver, kidneys and lungs were removed and tissue samples were stored for the determination of malondialdehyde (MDA) and glutathione (GSH) levels and myelopreoxidase activity. The results demonstrate that pathogenesis of acute obstructive pancreatitis involves not only the oxidative damage of the pancreatic and hepatic tissues, as assessed by increased MDA and reduced GSH levels, but the lungs and kidneys are also challenged by oxidant injury. Similarly, hepatic oxidative injury caused by cholestasis was also accompanied by pulmonary, renal and even pancreatic damage. The biochemical findings were also verified histologically. Melatonin, probably because of its free‐radical scavenging and antioxidant activity, which involves an inhibitory effect on tissue neutrophil infiltration, protected all the affected tissues.

Early Prediction of Normocalcemia after Thyroid Surgery

Hypocalcemia is the principal factor that determines length of hospital stay after thyroid surgery. Seventy-nine patients who underwent thyroidectomy were prospectively evaluated in order to define risk factors for postoperative hypocalcemia. Serum samples were taken postoperatively at 8, 14, 24, and 48 hours to measure total calcium levels. The slope of change in serum calcium level between each sample time was calculated. Patients were also examined for age, gender, surgical indications, type and extension of surgery, thyroid function, presence of substernal extension, initial operation versus reoperation, and application of parathyroid autotransplantation. All comparisons were made between hypocalcemic and normocalcemic groups. Hypocalcemia occured in 15 (19%) patients. In univariate analysis, type and extent of thyroidectomy, serum calcium levels at each time point, as well as the slope of change in serum total calcium levels between 8 and 14 hours were found to be significantly predictive of normocalcemia. All patients who underwent hemithyroidectomy and who had a positive or neutral slope of calcium change after surgery remained normocalcemic. By multivariate logistic regression analysis, only the slope of change in calcium levels within the first 14 postoperative hours independently predicted calcium status after thyroidectomy. All patients who undergo unilateral thyroid surgery who have a positive/neutral slope of change in serum total calcium levels within the first 14 hours after surgery can be safely discharged early if they have no other risks.

The cytoprotective effects of verapamil and iloprost (zk-36374) on ischemia reperfusion injury of kidneys

We investigated the cytoprotective effects of verapamil, a Ca channel blocker, and of iloprost (ZK 36374), a stable prostacyclin analogue, on ischemia/reperfusion (I/R) injury in Wistar albino rat kidneys that were subjected to 60 min of warm ischemia and reperfusion. The groups included sham, ischemia-untreated (ISCH), verapamil-treated (VER), iloprost-treated (ILO), and verapamil + iloprost (VER+ILO)-treated rats. The 7-day survival of all the treated groups was better than that of the ISCH group. The creatinine concentration on the 3rd day was significantly lower in the VER+ILO group than in the ISCH group. Serum creatinine on day 3 was also low in the VER+ILO groups compared to the ISCH group, although the differences were not significant. The creatinine values on day 7 were significantly lower in the VER and ILO group than in the control, VER, or ILO groups. The malondialdehyde (MDA) concentrations of the kidney cortex tissue after reperfusion in all groups were higher than normal. The tissue-reduced glutathione (GSH) concentrations of the kidneys sampled immediately after reperfusion were significantly lower in the ISCH group than in all of the other treated groups. These results indicate that although verapamil and iloprost have independent cytoprotective effects on 60-min warm ischemia/reperfusion injury of rat kidneys, the protection afforded when both drugs are combined is synergistic. The mechanism of cytoprotection is not limited to the suppression of lipid peroxidation, and a nearly complete protection of reperfusion injury can be obtained by such an intervention.

Bombesin Ameliorates Colonic Damage in Experimental Colitis

In the present study we investigated thepossible therapeutic effects of bombesin on anexperimentally induced colitis model in rats.Inflammation of the colon was induced by a singleintracolonic administration of 30 mg of 2,4,6-trinitrobenzene sulfonic acid(TNBS) at 8 cm from the anus. Immediately after theinduction of colitis, some rats were given bombesin (10μg/kg; subcutaneously) three times a day for 14 days, while another group received vehicletreatment. On day 14, the rats were decapitated andplasma carbonyl content and tissue myeloperoxidaselevel, as an index of granulocyte infiltration intointestinal tissue, were determined in order to obtain anobjective evaluation of colonic injury. In the colitisgroup, increased macroscopic damage score, elevated MPOlevel and high plasma carbonyl content, together with the microscopic appearance revealed severeinflammatory changes resembling IBD. Bombesin treatmentattenuated the TNBS-induced colonic damage andstimulated histopathologically apparent mucosalproliferation, suggesting that bombesin may play a role inprotecting gut integrity.

Primary Torsion of the Omentum Mimicking Acute Appendicitis: Report of a Case

A case of primary omental torsion seen in a 26-year-old man is discussed. All signs and symptoms mimicked acute apendicitis. The patient underwent emergency laparotomy in which a normal appendix and serohemorrhagic fluid in the pelvis were observed. The pathological diagnosis was a primary torsioned omentum which was thus excised. This case helps to emphasize the importance of a routine exploration of the abdomen when serohemorrhagic fluid is found at the time of laparotomy in the absence of any pathological condition in the pelvis.

The Use of Bonewax to Control Massive Presacral Bleeding

Abstract.Massive presacral bleeding during retroperitoneal resection is unusual, and can be difficult to control. We describe a technique for managing this complication whereby bonewax is pushed through the presacral fascia and periosteum directly into the bleeding point in the sacrum, followed by abdominal packing. This maneuver proved successful for achieving hemostasis when we recently encountered this intraoperative complication.

Bombesin improves burn-induced intestinal injury in the rat.

This study was designed to determine the effect of exogenous bombesin (10 microg/kg/day, subcutaneously, three times a day) on intestinal hypomotility and neutrophil infiltration in the early and late phases of burn injury (partial-thickness, second-degree burn of the skin). In acute (2 h after burn injury) or chronic (3 days after) burn groups, intestinal transit was delayed, which was reversed by bombesin treatment. In the acute burn group, but not in the chronic group, increased MPO activity was also reduced by bombesin treatment. The results demonstrate that bombesin ameliorates the intestinal inflammation due to burn injury, involving a neutrophil-dependent mechanism.

The effect of iloprost and NDGA in ischemia reperfusion injury in rat liver

In this study, the effects of iloprost (ZK 36374) and NDGA on warm ischemia and reperfusion injury in rat liver were investigated. Rats were given isotonic saline (control group), iloprost 25 micrograms/kg i.v. (group II) just before warm ischemia or NDGA 10 micrograms/kg i.v. (group III) 5 min before reperfusion or the same drugs were given together (group IV). Serum SGOT, SGPT, and LDH values and tissue malondialdehyde (MDA), glutathione (GSH), prostaglandin (PG)E2, and leukotriene (LT)C4 levels were determined after ischemia-reperfusion injury. Histopathologic examination of the liver was carried out under the light microscope. The serum SGOT, SGPT and LDH levels improved significantly in groups II, III, and IV when compared with the control group (p < 0.05). There was a significant decrease (p < 0.05) in tissue MDA levels and significant increase (p < 0.05) in tissue GSH levels in group I, when compared with group IV and the control groups. The values did not differ significantly in group IV when compared to controls. The LTC4/PGE2 ratio was low and histologic findings were worse in group III. In conclusion, iloprost was found to be beneficial in preventing the ischemia-reperfusion injury in the rat livers. NDGA, either by direct toxic effect or by shifting the arachidonic acid metabolism to the cyclooxygenase route, was not found to be as effective. Iloprost and NDGA did not exert a synergist effect.