Irfan Bayram

Hepatoprotective effect of Foeniculum vulgare essential oil

Hepatoprotective activity of Foeniculum vulgare (fennel) essential oil (FEO) was studied using carbon tetrachloride (CCl(4)) induced liver injury model in rats. The hepatotoxicity produced by acute CCl(4) administration was found to be inhibited by FEO with evidence of decreased levels of serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and bilirubin. The results of this study indicate that FEO has a potent hepatoprotective action against CCl(4)-induced hepatic damage in rats.

Anti-fibrogenic effects of captopril and candesartan cilexetil on the hepatic fibrosis development in rat: The effect of AT1-R blocker on the hepatic fibrosis

BACKGROUND/AIM Angiotensin converting enzyme (ACE) and angiotensin II (AT-II) have been suggested to play an important role in liver fibrogenesis. There is a significant relationship between inheritance of hightened expression of transforming growth factor beta1 (TGF-beta1) and AT-II and the development of progressive hepatic fibrosis. The purpose of this study was to investigate the effects of captopril, an ACE inhibitor and candesartan cilexetil, an AT-II type 1 receptor (AT1-R) blocker, on liver fibrosis induced in rats by carbon tetrachloride (CCl4) administration. METHODS rats were divided into 4 experimental groups: The first group was given CCl4 alone; the second was given both CCl4 and captopril (100 mg x kg(-1) x day(-1)); the third was given both CCl4 and candesartan cilexetil (8 mg x kg(-1) x day(-1)); fourth group was given 0.9% NaCl only. Seven weeks after initiating the treatment, indices of fibrosis were assessed. RESULTS Candesartan cilexetil treatment significantly reduced the fibrosis development. These inhibitory effects were not observed in the captopril-treated group. The mean fibrosis score was significantly lower in the CCl4/candesartan group compared with the group applied to CCl4 alone and the group applied to CCl4/captopril. Similarly, the number of alpha-smooth muscle actin positive cells was markedly suppressed by candesartan treatment. CONCLUSIONS The results suggest that AT-II plays a pivotal role in hepatic fibrogenesis and candesartan significantly attenuates the progression of liver fibrosis. This drug may provide an effective new strategy for prevention of liver fibrosis. Its effectiveness should be investigated in chronic liver disease associated with progressive fibrosis.

Three-year review of bacteriological profile and antibiogram of burn wound isolates in Van, Turkey.

The risk of infection in burns is well-known. In recent decades, the antimicrobial resistance of bacteria isolated from burn patients has increased. For this reason, a retrospective study was conducted at Van Training and Research Hospital to analyze the bacterial isolates from the wounds of patients admitted to the Burn Unit and to determine the susceptibility patterns of the commonly cultured organisms over a 3-year period, January 2009 to December 2011. A total of 250 microorganisms were isolated from burn wounds of 179 patients. Our results revealed that the most frequent isolate was Acinetobacter baumannii (23.6%), Pseudomonas aeruginosa (12%), Staphylococcus aureus (11.2%), Escherichia coli (10%) respectively. Multidrug-resistance has emerged as an important concern in our burn unit. Tigecycline, and colistin were found to be the most active drugs against Acinetobacter baumannii. Carbapenems and amikacin, were found to be the most active drugs against other gram negative bacteria. Vancomycin and linezolid were active against gram positive bacteria. Aggressive infection control measures should be applied to limit the emergence and spread of multidrug-resistant pathogens.

Comparison of the effects of melatonin and pentoxifylline on carbon tetrachloride-induced liver toxicity in mice

The purpose of the study was to determine whether along and in combination melatonin (MLT) and pentoxlfylline (PTX) exerted beneficial effects on histopathological changes and changes in oxidant and antioxidant systems in liver caused by CCl4-induced liver toxicity in mice. Mice were randomly divided into six groups: control, olive oil, toxicity, MLT, PTX, PTX+MLT. MLT 10 mg/kg/day, PTX 50 mg/kg/day, and the same individual doses in MLT+PTX combination were given intraperitoneally to mice for 7 day. CCl4 0.8 mg/kg/day was administered on the 4th, 5th, and 6th days of therapy in all groups except the control and olive oil groups. In the toxicity group, increased concentrations of malondialdehyde (MDA) and lipid hydroperoxides (LOOH) and decreased glutathione peroxidase (GSH-Px) and catalase (CAT) activities were found compared to the control and olive oil groups (p < 0.05). Compared to the toxicity group, both the PTX group and the PTX+MLT group had decreased MDA and LOOH levels, whereas MLT reduced only LOOH levels (p < 0.01). MLT, PTX and MLT+PTX increased the GSH-Px and CAT activities compared to the toxicity group (p < 0.05). MLT increased CAT activity compared to PTX and MLT+PTX (p < 0.05). Superoxide dismutase enzyme activity did not change in any group (p < 0.05). Histopatholically, ballooning, degeneration, apoptosis, and bridging necrosis were seen in the toxicity group. MLT, PTX and MLT+PTX decreased the apoptosis and bridging necrosis (p < 0.01), and PTX and MLT+PTX decreased balloon degeneration compared to the toxicity group (p < 0.01). These results indicate that administration of PTX and MLT alone and in combination before onset of liver toxicity might prevent the oxidative damage by reducing oxidative stress and increasing antioxidant enzyme levels.

Treatment of Recurrent Perforating Intestinal Ulcers with Thalidomide in Behçet's Disease

OBJECTIVE To report the beneficial effects of thalidomide on recurrent perforating intestinal ulcers in a patient with Behçets disease (BD). CASE SUMMARY A 24-year-old Turkish woman with BD was admitted to our hospital because of severe abdominal pain and vomiting. She had been receiving colchicine 1.5 mg/day and azathioprine 150 mg/day for treatment of BD for 2 years. During emergency laparatomy, 2 perforating ulcers were detected in the anterior cecum, which were treated with debridement and primary repair. She experienced 2 more episodes of intestinal perforations during the second and fifth weeks despite intense immunosuppressive treatment with methylprednisolone and cyclophosphamide. New intestinal perforations were found in the posterolateral cecum and transverse colon during the second operation and in the terminal ileum during the third one. Thalidomide 100 mg/day was then started, and the symptoms disappeared within 2 weeks. The woman experienced no other intestinal perforation during the follow-up period of 4 months. DISCUSSION The mode of action of thalidomide in BD is still unclear. In BD, various cytokines have been shown to be abnormally expressed and neutrophils are overactive. This is a possible mechanism of action with thalidomide reducing both tumor necrosis factor and the neutrophil migration. CONCLUSIONS Thalidomide may be an effective alternative treatment for BD patients with recurrent and perforating intestinal ulcers despite intense immunosuppressive therapy.

Prognostic factors and COX-2 expression in advanced stage esophageal squamous cell carcinoma.

Cyclooxygenase-2 (COX-2) is overexpressed in various types of human malignancies, including squamous cell carcinomas of the esophagus, but its clinicopathologic role in esophageal squamous cell carcinoma (ESCC) remains unclear. The aim of this study was to analyze expression of COX-2 in ESCC and to correlate this expression with clinicopathologic parameters and survival. From 1999 to 2003, endoscopic tissue samples from 110 patients with ESCC were collected for analysis. COX-2 expression was examined through immunohistochemical staining. Clinicopathologic data were analyzed to verify significance. COX-2 expression was detected in 50 of 110 ESCC specimens (45%). COX-2 expression was negative to weak in 73% (COX-2 low) and moderate to strong in 27% (COX-2 high) of tumors. Statistical differences between COX-2 high and COX-2 low were found according to status of the stage (stage IVM1a/IVM1b) (P=.001): cancer antigen (CA) 19-9 (normal/high) (P=.011), CA 12-5 (normal/high) (P=.011), and CA 15-3 (normal/high) (P=.035). Survival was significantly reduced among patients with high COX-2 expression (median overall survival, 3 mo) when compared with the COX-2 low group (median overall survival, 6 mo) (P=.0001). In the univariate analysis, age, body mass index, stage, COX-2, lactate dehydrogenase, CA 12-5, and CA 15-3 were significant factors for survival. With the use of COX regression analysis, only stage (P=.000), COX-2 (P=.000), lactate dehydrogenase (P=.023), and CA 15-3 (P=.002) were independent prognostic factors. Results showed that in patients with ESCC, COX-2 overexpression was significantly correlated with visceral metastases (IVM1b). COX-2 overexpression is an unfavorable prognostic factor in ESCC.

Renal involvement in Brucella infection.

OBJECTIVES To examine our patients with brucellosis and renal involvement. Although brucellae have been recovered from the urine of patients with brucellosis, renal involvement is uncommon. METHODS The data from 15 patients (8 males and 7 females, mean age 43 +/- 18.9 years, range 16 to 80), who had been admitted to our hospital with the diagnosis of brucellosis with renal involvement from 1998 to 2006, were retrospectively evaluated. RESULTS In almost all cases, urinalysis revealed hematuria and variable amounts of proteinuria; some of the patients had pyuria. Of the 15 patients, 14 had renal failure. The etiology of renal failure was prerenal azotemia in 1, acute tubular necrosis because of nonsteroidal anti-inflammatory drug use in 1, anuric tubulointerstitial nephritis due to rifampin use in 1, nephritis accompanied by brucellar endocarditis in 3, brucellar endocarditis and tubulointerstitial nephritis-associated vasculitis in 1, brucellar membranoproliferative glomerulonephritis in 1, and brucellar tubulointerstitial nephritis clinically in 6 patients. Hemodialysis was required in 5 patients. Chronic renal failure developed in 1 patient, 2 patients were lost to follow-up, and renal function completely recovered in 11 patients. Two patients underwent renal biopsy and membranoproliferative glomerulonephritis with intraglomerular infiltration of histiocytes was identified in 1 patient and chronic tubulointerstitial nephritis associated with vasculitis and immune complex nephritis features was identified in the other. CONCLUSIONS In areas endemic for brucellosis, this infection can be associated with hematuria, proteinuria, and renal failure. In addition, many diverse etiologies can play a role in the renal involvement associated with Brucella infection.

Lipid peroxidation in patients with brain tumor.

Molecular and genetic signatures may predict brain tumor behavior and may soon guide tumor classification, diagnosis, and tumor-specific treatment strategies. Free oxygen radicals (FOR) are thought to take part in oncogenesis and cellular differentiation. This article explored the state of FORs and antioxidant system in patients with cerebral tumor. The serum concentrations of malondialdehyde (MDA), catalase, and glutathione peroxidase (GSH-Px) enzyme activities were measured in the serum of 35 patients with cerebral tumors (21 glioma, 14 meningioma) and 11 controls. MDA measurement was done with fluorometric method and catalase and GSH-Px enzyme activities were done with photometric method. Mean serum MDA levels, catalase, and GSH-Px enzyme activities were significantly higher for both glial and meningiomal tumor cases when compared to controls (p < .05). There is no significant difference between glioma and meningioma groups in terms of the aforementioned parameters (p > .05). In conclusion, lipid peroxidation and antioxidant enzymes as assessed by MDA, catalase, and GSH-Px were increased in patients with brain tumors, for this respect there is no difference between gliomas and meningiomas.

Asymmetrical nonscalp aplasia cutis congenita: a case report.

Aplasia cutis congenita or congenital absence of the skin is a rare and serious congenital disease; its etiopathogenesis remains unclear. In this condition, localized or widespread areas of skin are absent at birth. A newborn suffering from an unusual aplasia cutis congenita located asymmetrically on the nonscalp, without blistering, was presented. This patient was completely healed with conservative treatment.

Cavernous haemangioma of the mitral valve in a child: report of a case and review of the literature.

Sir, Among primary tumours of the heart, haemangiomas account for 5–10% of benign tumours. Only five cases (three tricuspid, two mitral) of haemangiomas arising from the heart valves had been reported in English literature as of March 2005. We describe a case of surgically resected cavernous haemangioma arising from the anterior mitral valve leaflet in a 8-year-old male. An 8-year-old male child was admitted to hospital with palpitation and exertional dyspnoea for 6 months on August 2003. On auscultation, he had a systolic murmur (2/ 6) over the precordium. Cardiac computed tomography (CT) and echocardiogram (ECG) demonstrated an immobile left atrial mass positioned along the septal border. In left atriotomy, a white, polypoid, round mass was seen adjacent to the annulus, raised over the anterior leaflet of mitral valve. There was no involvement of subvalvular structure or posterior leaflet by tumoural formation. A lobulated, grey-white mass measuring 2.361.561.1 cm was resected completely and the excised anterior leaflet was re-attached to the mitral annulus without patch. Grossly, the tumour was 263 cm in diameter, lobulated, grey-white in colour and with an irregular surface (Fig. 1). On cross section, focal haemorrhagic areas were observed. Histopathological diagnosis was a cavernous haemangioma with thick-walled vessels and large cavernous vascular spaces separated by fibrous septa, partly filled with blood and lined by a flattened typical endothelium. The endothelial cells of these vessels did not show any cellular atypia, mitoses or necroses (Fig. 2). After operation, an ECG showed evidence of atrioventricular block. Therefore, a pacemaker was implanted. He has been followed up for 19 months without any recurrence. Haemangiomas of the heart are rare, with only 40 reported cases involving surgical treatment. These were located throughout the heart, including the pericardium,