Erol Erden Ünlüer

The effect of agmatine on the vascular reactivity in streptozotocin-diabetic rats

AIM We investigated the vascular effects of agmatine (decarboxylated arginine=AGM), an endogenous ligand for alpha(2)-adrenoceptors and imidazoline receptors, present in endothelium and smooth muscle, using the diabetic rat aortae. MATERIALS AND METHODS Studies were performed in control group (0.2 ml i.p. saline, n=10), streptozotocin (STZ)-diabetic control group (60 mg kg(-1) STZ i.p., n=10), agmatine (AGM)-control group (5 mg kg(-1)day(-1) i.p. AGM for 1 month, n=10), citrate-control group (0.2 ml 0.01 M, n=10), insulin-treated diabetic group ((3 U kg(-1) NPH+1 U kg(-1) regular insulin) twice per day, for 1 month, n=10) and AGM-treated diabetic group (5 mg kg(-1)day(-1) i.p. for 1 month, n=10). All values are expressed as means+/-S.E.M. Statistical analysis of the data was performed using ANOVA followed by Tukey multiple comparisons test. RESULTS One-month AGM-treatment significantly decreased the blood glucose levels of diabetic rats (502+/-44 mg dl(-1) to 343+/-31 mg dl(-1), P<0.001). Fast, slow and total components of responses to noradrenaline in all the experimental groups were not significantly affected by AGM-treatment. AGM reversed the decreased responses of acetylcholine (pD(2) and Inh.%, P<0.001 and P<0.05) in diabetic rats although it did not affect the responses of sodium nitroprusside in all groups. The contraction values of KCl in all groups were not affected by AGM-treatment. CONCLUSION AGM-treatment could improve the increased blood glucose level, reverse the endothelial dysfunction and normalize the endothelium-dependent relaxation responses in STZ-diabetic rats.

Bedside assessment of central venous pressure by sonographic measurement of right ventricular outflow-tract fractional shortening.

Objectives We aimed to assess the suitability of right ventricular outflow tract (RVOT) fractional shortening for estimating low central venous pressure (CVP). To the best of our knowledge, there have been no similar studies in the English language literature. Methods In this cross-sectional study, the emergency physicians measured the RVOT fractional shortening on parasternal short-axis view. A receiver operating characteristic curve analysis was conducted to identify the threshold that maximized the sensitivity and specificity for discriminating normal and low CVPs by the RVOT fractional shortening value. The sensitivity, specificity, and the positive and the negative likelihood ratios of RVOT fractional shortening to truly estimate CVP were calculated. Results Fifty-eight consecutive patients had invasive CVP monitoring. Nine patients with high CVP and eight for other reasons were excluded. Forty-one patients were enrolled in the study, of whom 21 were in low CVP group and 20 were in normal CVP group. RVOT diastolic diameters, RVOT systolic diameters, and RVOT fractional shortening were lower in low CVP group and this difference was statistically significant (P<0.001). The cutoff value for RVOT fractional shortening to differentiate the low and normal CVPs using the highest sensitivity and specificity was 26.44%. Area under the receiver operating characteristic curve was 0.933 (0.810–0.987) with a P value of less than 0.001. The sensitivity and specificity of RVOT fractional shortening to truly estimate CVP were 95 (75–99) and 80% (58–94), respectively. Conclusion In the hands of emergency physicians, a RVOT fractional shortening measurement is a good predictor of low CVP.

Do we routinely need cranial computed tomography for mild head injuries in Turkey

The objectives of this study were to determine the role of clinical parameters in detecting intracranial injury and to find out whether cranial computed tomography (CT) is routinely needed for mild head injury (MHI) in Turkey. This retrospective study was conducted by reviewing the records of patients with MHI who underwent cranial CT in our emergency department. We carried out multiple logistic regression analysis, and odds ratios with 95% confidence intervals were calculated by using SPSS 15.0. This study included 923 patients. Positive cranial CT findings were determined in 17 patients (1.8%) and six of them (0.6%) underwent surgery. Statistically significant correlations were found among headache, presence of clinical findings of skull fracture, focal neurological deficit and positive cranial CT findings. Although the incidence of the intracranial lesions, especially those requiring surgery, is low in MHI, the liberal use of CT scanning in MHI seems to be justified in countries such as Turkey.

Role of Bombesin and Cholecystokinin Receptors in Gastric Injury Induced by Hemorrhagic Shock in the Rat

Bombesin has been shown to have trophic effects on the gastrointestinal tissue. Bombesin has direct mitogenic effects besides stimulating release of gastric hormones. The aim of this study was to investigate the effect of bombesin in hemorrhagic shock-induced stress ulcers in rats, and the role of cholecystokinin (CCK) receptors in this activity. Hemorrhagic shock was created by withdrawing 3 ml blood/200 g b.w. of rats. At the end of the 1-hour hypovolemic shock period, histological analysis, gastric ulcer index, gastric myeloperoxidase activity and gastric protein oxidation levels were determined. When given before the hemorrhage, subcutaneous bombesin (10 µg/kg) reduced macroscopically gastric ulcer index (p < 0.05). Blockade of CCK-A receptors with intraperitoneal MK-329 (1 mg/kg) did not reverse bombesin-induced gastroprotection. Blockade of CCK-B receptors with intraperitoneal L-365,260 (25 mg/kg) reversed bombesin-induced gastroprotection. Blockade of the two receptors resulted in no gastroprotection at all. It is concluded that bombesin treatment attenuated hemorrhagic shock-induced stress ulcers in rats via CCK receptors.