Fatih Albayrak

Mean Platelet Volume: A New Predictor in Confirming Acute Appendicitis Diagnosis

Objective: The purpose of this study was to investigate the diagnostic value of mean platelet volume (MPV) in acute appendicitis (AA). Methods: Our study was carried out in 206 healthy control groups and 226 patients who had a preliminary diagnosis of AA. Results: A statistically significant decrease in MPV was noted in patients with AA compared with healthy controls (P < .001). The best MPV level cutoff point for AA was 7.6 fL, with a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 73%, 84%, 84%, and 74%, respectively. Conclusions: As the MPV value is included in the complete blood count (CBC) analysis, it increases the sensitivity and NPVs of white blood cell (WBC) in AA diagnosis without the need for extra analyses, loss of time, or cost increase. Therefore, we believe that the MPV value should also be taken into consideration along with the WBC in every patient with suspected AA.

Antiulcer activity of fluvoxamine in rats and its effect on oxidant and antioxidant parameters in stomach tissue

BackgroundAlthough many drugs are available for the treatment of gastric ulcers, often these drugs are ineffective. Many antidepressant drugs have been shown to have antiulcer activity in various models of experimental ulcer. One such drug, the antidepressant mirtazapine, has been reported to have an antiulcer effect that involves an increase in antioxidant, and a decrease in oxidant, parameters. To date, however, there is no information available regarding the antiulcer activity for a similar antidepressant, fluvoxamine. This study aimed to investigate the antiulcer effects of fluvoxamine and to determine its relationship with antioxidants.MethodsGroups of rats fasted for 24 h received fluvoxamine (25, 50, 100 and 200 mg/kg), ranitidine (50 mg/kg) or distilled water by oral gavage. Indomethacin (25 mg/kg) was orally administered to the rats as an ulcerative agent. Six hours after ulcer induction, the stomachs of the rats were excised and an ulcer index determined. Separate groups of rats were treated with the same doses of fluvoxamine and ranitidine, but not with indomethacin, to test effects of these drugs alone on biochemical parameters. The stomachs were evaluated biochemically to determine oxidant and antioxidant parameters. We used one-way ANOVA and least significant difference (LSD) options for data analysis.ResultsThe 25, 50, 100 and 200 mg/kg doses of fluvoxamine exerted antiulcer effects of 48.5, 67.5, 82.1 and 96.1%, respectively, compared to the control rat group. Ranitidine showed an 86.5% antiulcer effect. No differences were observed in the absence of indomethacin treatment for any dose of fluvoxamine or for ranitidine. The levels of antioxidant parameters, total glutathione and nitric oxide, were increased in all fluvoxamine groups and in the ranitidine group when compared with the indomethacin-only group. In addition, fluvoxamine and ranitidine decreased the levels of the oxidant parameters, myeloperoxidase and malondialdeyhyde, in the stomach tissues of the rats when compared to indomethacin group.ConclusionWe conclude that fluvoxamine has antiulcer effects, and that these occur by a mechanism that involves activation of antioxidant parameters and inhibition of some toxic oxidant parameters.

Does telmisartan prevent hepatic fibrosis in rats with alloxan-induced diabetes?

BACKGROUND/AIMS This study evaluated the effect of telmisartan on the livers of diabetic rats and also aimed to determine the hepatic distribution and role of transforming growth factor beta (TGF-beta) in diabetes-related hepatic degeneration while taking into account the possible protective effects of telmisartan. METHODS Fifteen adult male rats were used and divided into three groups: the non-diabetic healthy group, alloxan-induced diabetic control group, and the alloxan-induced diabetic telmisartan group. The non-diabetic healthy group and the diabetic control group were exposed to saline for 30 days, while the group treated with diabetic drugs was orally administered telmisartan for 30 days (10 mg/kg/day). At the end of the experiment, the rats were sacrificed and the livers were dissected and transferred into the fixation solution. The livers were then evaluated using stereological and histopathological methods. RESULTS Our study of the numerical density of hepatocytes shows a significant difference between the diabetic control group and diabetic rats treated with telmisartan. Immunohistochemical staining for TGF-beta in liver sections of the diabetic rats treated with telmisartan showed no immunoreactivity. The diabetic control group was determined to be strongly immunoreactive to TGF-beta. CONCLUSION Results suggest that telmisartan may reduce type-I diabetes mellitus-induced hepatic injury by suppressing activated hepatic stellate cells through concomitant TGF-beta1 down-regulation.

The Effects of Diabetes and/or Polymicrobial Sepsis on the Status of Antioxidant Enzymes and Pro-Inflammatory Cytokines on Heart, Liver, and Lung of Ovariectomized Rats

BACKGROUND The rat sepsis model in the present study was used to understand the role of sustained hyperglycemia and ovariectomy, either separately or together, on the response of pro-inflammatory mediators and oxidative response. MATERIALS AND METHODS Polymicrobial sepsis was induced using cecal ligation and two-hole puncture. Diabetes was induced in the female Wistar albino rats using intraperitoneal administration of aqueous alloxan monohydrate at a single dose of 150 mg/kg body weight. The rats were divided into five groups: sham control: group 1, ovariectomy: group 2, ovariectomy + sepsis: group 3, ovariectomy + diabetes: group 4, and ovariectomy + diabetes + sepsis: group 5. RESULTS In lung, heart, and liver tissues, the levels of myeloperoxidase (MPO) and lipid peroxidation (LPO) were higher for the groups 3, 4, and 5 than in control group. In heart and liver tissues, superoxide dismutase (SOD) and catalase (CAT) activities were higher for the groups 3, 4, and 5 than control group. In lung tissue SOD activities were higher for the groups 3, 4, and 5 than in control group. Diabetes + ovariectomy caused a significant increase in serum levels of tumor necrosis factor-alpha (TNF-α) and interleukin 6 (IL-6) in comparison to the sham group. The strongest production of TNF-α and IL-6 in serum was observed in the group 5. CONCLUSIONS Hyperglycemia and ovariectomy (postmenopausal period) severely increased serum cytokines and oxidant levels with the stages of our sepsis model. The lung tissue was most affected by diabetes and ovariectomy under sepsis conditions. Ovariectomy leading to estrogen deficiency results in general changes in metabolism, which are seen in the liver, lungs, and heart with diabetes under sepsis conditions.

Biochemically and histopathologically comparative review of thiamine's and thiamine pyrophosphate's oxidative stress effects generated with methotrexate in rat liver

Summary Background Oxidative liver injury occurring with methotrexate restricts its use in the desired dose. Therefore, whether or not thiamine and thiamine pyrophosphate, whose antioxidant activity is known, have protective effects on oxidative liver injury generated with methotrexate was comparatively researched in rats using biochemical and histopathological approaches. Material/Methods Thiamine pyrophosphate+methotrexate, thiamine+methotrexate, and methotrexate were injected intraperitoneally in rats for 7 days. After this period, all animals’ livers were excised, killing them with high-dose anesthesia, and histopathologic and biochemical investigations were made. Result Biochemical results demonstrated a significant elevation in level of oxidant parameters such as MDA and MPO, and a reduction in antioxidant parameters such as GSH and SOD in the liver tissue of the methotrexate group. Also, the quantity of 8-OHdG/dG, a DNA injury product, was higher in the methotrexate group with high oxidant levels and low antioxidant levels, and the quantity of 8-OHdG/dG was in the thiamine pyrophosphate group with low oxidant levels and high antioxidant levels. In the thiamine and control groups, the 8-OHdG/dG rate was 1.48±0.35 pmol/L (P>0.05) and 0.55±0.1 pmol/L (P<0.0001). Thiamine pyrophosphate significantly decreased blood AST, ALT and LDH, but methotrexate and thiamine did not decrease the blood levels of AST, ALT and LDH. Histopathologically, although centrilobular necrosis, apoptotic bodies and inflammation were monitored in the methotrexate group, the findings in the thiamine pyrophosphate group were almost the same as in the control group. Conclusions Thiamine pyrophosphate was found to be effective in methotrexate hepatotoxicity, but thiamine was ineffective.

Genotype–Phenotype Correlation in Patients with Familial Mediterranean Fever in East Anatolia (Turkey)

AIMS Familial Mediterranean fever (FMF) is an autosomal recessive hereditary disease. Clinical symptoms and findings (phenotypes) seen in this disease are generally fever, abdominal pain, and arthritis. Amyloidosis is also a significant complication. Phenotype-genotype correlations in FMF have not been conclusively resolved. The aims of this study were to find the most frequent mutation/genotype of FMF, as well as to investigate the role of genetic factors on the phenotype and on the development of amyloidosis in a population living in East Anatolia (Turkey). This study included 105 adult patients with FMF. DNA samples were obtained from peripheral blood lymphocytes of the patients. Mutations of the Mediterranean fever (MEFV) gene were analyzed with an FMF Strip Assay test kit (ViennaLab Labordiagnostika GmbH, Vienna, Austria). Patients were separated according to genotypes, and phenotypes were compared statistically by the chi-square test. RESULTS The most frequent mutation was M694V (53%) and the most frequent genotype was M694V/M694V (26%). In total, 81% of the patients experienced abdominal pain, 76% had fever, and 22% had arthritis. Fever and arthritis were determined in similar ratios to other genotypes (76% and 19%, respectively) in the M694V/M694V genotype (74% and 29%, respectively) (p > 0.50 and p > 0.20, respectively). However, the patients without the M694V/M694V genotype (86%) had a higher abdominal pain ratio than did the patients with the M694V/M694V genotype (67%) (p <0.05). Renal amyloidosis was determined in 33% of both M694V/M694V and M680I(G/C)/M680I(G/C) homozygous groups and in 12% of the heterozygous groups (p < 0.02 and p < 0.00002, respectively). In other words, homozygous groups had higher ratios of renal amyloidosis. CONCLUSIONS The most frequent mutation in FMF was M694V and the most frequent genotype was M694V/M694V. Fever, abdominal pain, arthritis, and renal amyloidosis were determined not only in patients with M694V/M694V genotype but also in other genotypes. Therefore, genotypes may not predict phenotypes in FMF. Renal amyloidosis was seen more frequently in homozygous genotypes.

Role of α-2 adrenergic receptors in anti-ulcer effect mechanism of estrogen and luteinising hormone on rats

Objective. To evaluate anti-ulcer effect of estrogen and luteinising hormone (LH) on indomethacin-induced ulcer model in female rats. Study design. Ovariectomy in healthy adult famale rats. Acute administration of estradiol to ovariectomised rats. Acute administration of LH to intact rats. Combined administration of tamoxifen with estradiol or LH to intact rats. Combined administration of yohimbin with estradiol or LH to intact rats. Combined administration of piperoxan with estradiol or LH to intact rats. Indomethacin administration to all rats. Results. Results have shown that LH exerted anti-ulcer activity at all doses we used but estradiol at 5 and 10 mg/kg. In rats administered yohimbine and piperoxan estradiol and LH could not prevent indomethacin-induced ulcers. In rats administered tamoxifen, estradiol and LH could prevent indomethacin-induced ulcers. Conclusions. LH is a very potent endogen anti-ulcer factor, and the anti-ulcerative activities of estrogen and LH are mediated via α-2 adrenergic receptors, but not es receptors. The resistance of gastric mucosa to aggressive factors may decrease as a result of LH inhibition when estrogen is secreted chronically in the human body.

Gastric anti-ulcerative and anti-inflammatory activity of metyrosine in rats

In this study, the anti-inflammatory and anti-ulcerative effects of metyrosine, a selective tyrosine hydroxylase enzyme inhibitor, were investigated in rats. For ulcer experiments, indomethacin-induced gastric ulcer tests and ethanol-induced gastric ulcer tests were used. For these experiments, rats were fasted for 24 h. Different doses of metyrosine and 25 mg/kg doses of ranitidine were administered to rats, followed by indomethacin at 25 mg/kg for the indomethacin-induced ulcer test, or 50% ethanol for the ethanol-induced test. Results have shown that at all of the doses used (50, 100 and 200 mg/kg), metyrosine had significant anti-ulcerative effects in both indomethacin and ethanol-induced ulcer tests. Metyrosine doses of 100 and 200 mg/kg (especially the 200 mg/kg dose) also inhibited carrageenan-induced paw inflammation even more effectively than indomethacin. In addition, to characterize the anti-inflammatory mechanism of metyrosine we investigated its effects on cyclooxygenase (COX) activity in inflammatory tissue (rat paw). The results showed that all doses of metyrosine significantly inhibited high COX-2 activity. The degree of COX-2 inhibition correlated with the increase in anti-inflammatory activity. In conclusion, we found that metyrosine has more anti-inflammatory effects than indomethacin and that these effects can be attributed to the selective inhibition of COX-2 enzymes by metyrosine. We also found that adrenalin levels are reduced upon metyrosine treatment, which may be the cause of the observed gastro-protective effects of this compound.

Comparative study of three angiotensin II type 1 receptor antagonists in preventing liver fibrosis in diabetic rats: stereology, histopathology, and electron microscopy

The presence of liver disease in patients with progressively worsening insulin resistance may not be recognized until patients develop manifestations of the metabolic syndrome such as diabetes, hypertension, hyperlipidemia, and vascular disease. It was aimed to investigate whether three angiotensin II type 1 receptor antagonists (ARBs) (olmesartan, losartan, and valsartan) had preventive effect against hepatic fibrosis and this was a common characteristic among ARBs. In current study, 25 adult male rats were used and divided into five groups: the non-diabetic healthy group, alloxan induced diabetic (AID) control group, AID losartan group, AID valsartan group and AID olmesartan group. According to numerical density of hepatocytes, significant difference was found between the non-diabetic healthy group and diabetic control group. All treatments groups were significant when compared to diabetic control group. In diabetic control group it was examined swelling, irregular cristae arrangement in some of mitochondria. It was also determined mitochondria membrane degeneration in some areas of section profiles. In diabetic rats treated with losartan group, there were necrotic hepatocytes. In diabetic rats treated with valsartan group, predominantly, findings were similar to losartan group. In diabetic rats treated with olmesertan group, plates of hepatocytes were quite regular. There were hardly necrotic cells. Not only other organelles such as RER, SER and lysosom but also mitochondrial structures had normal appearance. In the diabetic control group electron microscopy revealed edema in both the cytoplasm and perinuclear area and the nuclear membranes appeared damaged. In conclusion, it was established that the most protective ARB the liver in diabetic rats was olmesartan, followed by losartan.

Inflammatory myofibroblastic tumor of the stomach in an adult woman: a rare intermittent cause of gastric outlet obstruction.

BACKGROUND Inflammatory myofibroblastic tumor is a neoplasm of intermediate biological potential that frequently recurs and rarely metastasizes. CASE REPORT We report a rare case of intermittent gastric outlet obstruction by an inflammatory myofibroblastic tumor of the cardia. RESULTS A 56-year-old woman presented at the gastroenterology department with a two-day history of hematemesis and melena. She had intermittent nausea and vomiting complaints, which had manifested periodically for about five months. Upper gastrointestinal endoscopy demonstrated a mass of 6 cm in diameter, which was resected. Histological examination revealed ulcerated mucosal granulation-like tissue with myofibroblastic spindle cell proliferation in a storiform pattern. CONCLUSIONS In order to avoid unnecessary aggressive therapy, gastric IMT should be taken into account when a gastric mass accompanied by the various clinical manifestations of IMT is found in an adult.