Fusun Baba

Melatonin protects from ischemia/reperfusion‐induced renal injury in rats: this effect is not mediated by proinflammatory cytokines

Abstract:  The pathophysiologic mechanisms leading to acute ischemic renal failure are not completely understood. Melatonin, a compound with well‐known antioxidant properties, reduces IR‐induced renal injury. The purpose of the present study was to investigate the changes in levels of tumor necrosis factor (TNF)‐α, IL‐β, and IL‐6 in postischemic reperfused renal tissue, and to determine whether the protective effect of melatonin is related the modulation of the production of these inflammatory molecules. Male Wistar albino rats were unilaterally nephrectomized and subjected to 1 hr of renal pedicle occlusion followed by 2 hr or 24 hr of reperfusion. Melatonin (10 mg/kg, i.p.) or vehicle was administrated at 10 min prior to ischemia. After 24 hr of the reperfusion, following decapitation, kidney samples were taken both for histologic examination and for the determination of malondialdehyde (MDA), myeloperoxidase (MPO) activity, total antioxidant capacity (TAC), total oxidative stress (TOS), creatinine, and blood urea nitrogen (BUN). These were measured in serum samples. TNF‐α, IL‐β, and IL‐6 were measured in kidney samples after 2 hr of reperfusion. IR caused a significant increase in renal MDA, MPO, TOS, creatinine, and BUN while decrease TAC without any change in TNF‐α, IL‐β, and IL‐6 levels. Melatonin treatment reduced the biochemical indices without any change in the cytokine levels and ameliorated histopathologic alterations induced by IR. The protective effect of melatonin on IR‐induced renal injury is related to its antioxidant properties but not to proinflammatory cytokines.

Case Report: A Dramatic Response to Ketotifen in a Case of Eosinophilic Gastroenteritis Mimicking Abdominal Emergency

Eosinophilic gastroenteritis (EGE) is an uncommon benign disease characterized by eosinophilic infiltration of the gastrointestinal (GI) tract. It affects adults as well as infants and children (1). It commonly involves the antrum of the stomach and proximal small bowel (2). However, the large bowel may occasionally be involved (3). The etiology of the disease is unknown, but tissue injury in EGE has been shown to correlate with the presenting number of activated degranulated eosinophils (4). The usual symptoms in EGE are abdominal pain, altered bowel habits, diarrhea, nausea and vomiting, and weight loss (5). Although steroid treatment is associated with a high relapse rate, it is the mainstay of therapy, which usually reveals a good response (6). We report a 30-year-old female who presented with symptoms of an acute abdominal picture and was diagnosed with EGE that responded dramatically to ketotifen therapy.

Melatonin improves methanol intoxication‐induced oxidative liver injury in rats

Abstract:  This study was performed to evaluate the effect of melatonin on methanol‐induced liver injury. We evaluated the levels of malondialdehyde (MDA), protein carbonylation (PC), myeloperoxidase (MPO) activities and to assess lipid peroxidation, protein oxidation, neutrophil accumulation and nitrite which is a stable end product of nitric oxide respectively. We also studied superoxide dismutase, catalase, and glutathione peroxidase activities of liver tissue to evaluate the changes in the antioxidant status. Histopathological alterations were also determined. The experiment was performed on Wistar rats, which received intragastric 3 g/kg methanol as a 50% solution in isotonic saline once. After 6 and 24 hr all the drug received and intoxicated rats were killed under anesthesia. Pretreatment with melatonin (10 mg/kg) decreased the MDA levels significantly, restored the PC levels to the control, prevented the increase of nitrite level and MPO activity significantly and reversed to the control levels, prevented the reduction in all of the antioxidant enzyme activities. Additionally in melatonin treated group piecemeal necrosis, lobular lytic necrosis, and portal inflammation returned to normal histologic appearances when compared with methanol administration. In conclusion, melatonin has protective effects against methanol‐induced hepatic injury.

Nasal polyp diseases in allergic and nonallergic patients and steroid therapy

Objective To investigate widespread disease causes, cellular-structural differences, and steroid response of nasal polyps (NPs). Method Study group consisted of NPs, allergic-NPs, NPs with steroid therapy (ST), antrochoanal polyp (ACP), and controls. We investigated stromal eosinophil, mast cell, CD4+ and CD8+ cell counts and presence of squamous metaplasia, Ki-67 expression, intraepithelial eosinophils-mast cells, epithelial damage, edema, fibrosis, hyalinization, polymorphonuclear leukocyte, and glandular hyperplasia. Results In allergic-NPs, intraepithelial eosinophils and epithelial damage CD4+ were significantly higher than NPs and also, eosinophils, mast cells, intraepithelial eosinophils, and epithelial damage were significantly higher than ACP. Only stromal eosinophilic infiltration was significantly higher in NPs than ACP. There was significant increased glandular hyperplasia and decreased intraepithelial eosinophils, mast cells, CD4+ cells, squamous metaplasia, and epithelial damage with ST in allergic-NPs. There were no significant differences with ST in NPs. Conclusion NPs in allergic and nonallergic patients may differ in their histology and in their histologic responses to ST. EBM rating: B-3b

Proliferating Active Cells, Lymphocyte Subsets, and Dendritic Cells in Recurrent Tonsillitis: Their Effect on Hypertrophy

OBJECTIVE To investigate the causes of hypertrophy in recurrent tonsillitis with hypertrophy (RTTH). DESIGN An immunohistochemical study of recurrent tonsillitis with or without hypertrophy and adenoid tissue. SETTING Academic medical center. PATIENTS The study population comprised 15 patients with RTTH, 15 patients with recurrent tonsillitis (RT), 9 patients with adenoid vegetation, and 6 controls. MAIN OUTCOME MEASURES The following outcome measures were investigated: follicle number and follicular area and circumference; degree of papillary arrangement and keratin cyst in crypts; fibrosis; and density of S-100(+) cells, CD20(+) cells, CD45RO(+) cells, lymphocytes and plasma cells, and cyclin D(1)(+) cells in surface epithelium, crypt epithelium, extrafollicular area, and follicles. RESULTS In the RTTH group, follicle number and follicular area and circumference, S-100(+) cell density in crypt and surface epithelium, and CD20(+) cell density in crypt epithelium were higher than in the RT group. The other measures were lower in the RTTH group than in the RT group. In patients with RTTH, the increase in follicle number and S-100(+) cell density in surface epithelium and decrease in cyclin D(1)(+) cell density in surface epithelium were significant. The number of CD45RO(+) cells was unchanged, while S-100(+) cell density increased in surface epithelium; however, in the RTTH group, CD20(+) cell density, together with cyclin D(1)(+) cell density, decreased in surface epithelium when compared with the RT group. Also, there was a 50% decrease in cyclin D(1)(+) cell density in follicles, but CD20(+) cell density decreased minimally in follicles. In the RTTH group, the increase or decrease in the number of cyclin D(1)-expressing cells was parallel with the increase or decrease in the number of CD20(+) cells in the areas without follicles. CONCLUSIONS Tonsil hypertrophy occurred with follicular hyperplasia and hypertrophy. There is a deficiency of proliferating active cells in response to mitogenic stimulation in RTTH. New follicles might have formed with B cells supplied from other sites because of the deficiency of proliferating active cells.

Use of Homologous Acellular Dermal Matrix for Abdominal Wall Reconstruction in Rats

Homologous acellular dermal matrix graft (HADMG) has been used for the reconstructions of bowel, bladder, or urethra, but its suitability in the reconstruction of abdominal wall has not been tested. Therefore an experimental study was performed to evaluate the use of HADMG for the reconstruction of abdominal wall defects in weanling rats. Thirty weanling Wistar rats were used. A patch of abdominal wall 20 × 20 mm in dimension was removed. The defects were reconstructed with HADMGs that were derived from rat skin and prepared through a detergent enzymatic method. The reconstructed abdominal walls were evaluated as hernia rate and graft take ratio, excised and prepared for histological examination at 21 (n = 10), 40 (n = 10), and 90 (n = 10) days postoperation. The healing of repaired abdominal walls was uneventful. Histological evaluation demonstrated the migration of fibroblasts and neovascularization within the HADMG. Hernia in four rats were developed at 90 days. Neither significant wound contraction nor inflammation was seen at 21, 40, and 90 days after surgery in wounds receiving HADMGs. Thus, the use of a HADMG for reconstructing the abdominal wall in weanling rats has not given rise to any complications. HADMG has progressively remodeled into fibrous tissue. It appears to represent an important alternative substitute for the reconstruction of abdominal wall.

Effect of lycopene on caspase-3 enzyme activation in liver of methanol-intoxicated rats: comparison with fomepizole.

Lycopene is one of the major carotenoids and is found almost exclusively in tomatoes and tomato products. This study was performed to evaluate the effect of lycopene on methanol-induced liver injury and to compare the results with those after fomepizole, which is used in treatment of methanol intoxication. Experiments were carried out with 30 female Wistar rats weighting 180-200 g. Rats were injected with a intraperitoneally dose of 3 g/kg methanol as a 50% solution in isotonic saline once for intoxication. Rats were pretreated with fomepizole (50 mg/kg) and/or lycopene (10 mg/kg) before methanol. After 24 hours all the drug-treated and intoxicated rats were sacrificed under anesthesia. Malondialdehyde (MDA) levels were determined in order to assess lipid peroxidation, and caspase-3 activity was determined by immunostaining of liver tissues to evaluate apoptosis. Methanol administration significantly increased the MDA level and caspase-3 activity in liver. Pretreatment with lycopene and/or fomepizole decreased the MDA levels significantly. Similarly, lycopene and fomepizole decreased methanol-induced caspase-3 activity. The findings of the present study demonstrate that methanol intoxication causes hepatic toxicity in rats and that this is likely a result of reactive oxygen species and apoptosis induction. Lycopene has protective effects against methanol-induced hepatic injury similar to fomepizole. It was demonstrated for the first time that both lycopene and fomepizole prevent methanol-induced hepatic injury by reducing the increase of lipid oxidation and caspase-3 activation.

Effects of Benzalkonium Chloride Application on the Rat Bladder A Functional and Histopathological Study

Aim: To establish a new bladder denervation model for bladder augmentation, using benzalkonium chloride (BCl) treatment, and to characterize the normal and treated rat bladder both urodynamically and immunohistochemically. Methods: Adult Wistar rats were divided into two groups, and the bladders were treated with a local application of 0.3% BCl for 30 min in the denervation group and saline in the control group. Before and at the 8th week after treatment, cystometry was performed in all rats, and results were recorded. The bladders were removed and whole-mount sections were prepared, and also evaluated by immunohistochemistry. Results: BCl-treated rats showed a significant increase in bladder capacity (p < 0.05), but no significant change was observed in other cystometric parameters (p > 0.05) when compared with control rats. Immunohistochemistry revealed none or very few nerve fibers within the BCl-treated bladders. Conclusions: The present study showed that denervation caused by BCl is useful for augmentation of the rat bladder. Bladder capacity was increased by the local application of BCl without impairing bladder functions. This method with a better understanding of the effects of BCl may be useful for augmentation in patients who have neurogenic bladder with low capacity.

Abdominal wall mucocele: a late complication of colostomy closure.

We present a case of incisional enteric mucocele formation 10 years following colostomy closure. The patient was admitted to the hospital with the symptoms of an abdominal wall mass lying on previously closed colostomy incision. Clinical presentation, diagnostic work up and pathology of the case were discussed. To our knowledge, this is the first abdominal wall mucocele after colostomy closure reported in the literature.