Kemal Altunatmaz

Pathologic Alterations Detected in Acute Pancreatitis Induced by Sodium Taurocholate in Rats and Therapeutic Effects of Curcumin, Ciprofloxacin and Metronidazole Combination

Background and Aims: Secondary bacterial infections and free radical injury have been known to play an important role in the pathogenesis and clinical outcome of acute pancreatitis. Despite the therapy models developed in recent years, the mortality rate is still reported to be higher than expected. The objective of this study therefore was to investigate the effectiveness of ciprofloxacin and metronidazole combination and curcumin together in the treatment of acute pancreatitis. Methods: Acute pancreatitis was induced in rats by sodium taurocholate (n = 60). Starting 6 h after the induction of acute pancreatitis, groups I and II were injected 200 mg/kg ciprofloxacin and 500 mg/kg metronidazole intraperitoneally every 12 h for 6 days. Groups II and III received 100 mg/kg curcumin since day 20 prior to the initiation of acute pancreatitis. On day 6, animals of all groups were killed. Blood and tissue samples were taken for biochemical, pathologic and bacteriologic examination. Results: No statistical difference in the treatment groups versus the non-treatment group has been detected in the pancreatic tissue on the basis of histopathological scoring results. Prevalences of bacterial translocation were significantly lower in the treatment groups (groups I–III) than in the non-treatment group (group IV) (p < 0.001, p < 0.001, p < 0.05, respectively). Serum amylase, lipase, malon dialdehyde and nitric oxide (except for nitric oxide level in group I), levels of groups I, II and III were significantly lower than those of group IV (p < 0.05). Conclusions: The administration of ciprofloxacin and metronidazole in combination and curcumin in acute pancreatitis failed to provide a preventive effect on the occurrence of tissue injury, whereas free radical injury and prevalence of bacterial translocation were reduced significantly.

The Use of Platelet-Rich Fibrin in Combination With Biphasic Calcium Phosphate in the Treatment of Bone Defects: A Histologic and Histomorphometric Study

Background Platelet-rich fibrin (PRF) is a leukocyte and platelet concentrate containing many growth factors. Its potential for hard tissue augmentation as a sole grafting material or in combination with other grafting materials has been investigated in many studies. Objective The aim of this histologic study was to evaluate the efficacy of PRF mixed with biphasic calcium phosphate (BCP) on bone regeneration in surgically created bone defects. Methods Defects 5 mm in diameter were created in both tibias of 6 sheep. The defects were left empty or grafted with BCP, PRF, or BCP+PRF. Animals were killed at 10, 20, and 40 days. The specimens underwent histologic and histomorphometric analysis. Results None of the groups displayed any signs of necrosis. Inflammation was observed in all groups at 10 days; 2 specimens of PRF+BCP and all empty defects showed inflammatory cell infiltration at 20 days. During the 40-day evaluation period, the PRF+BCP group showed the highest ratios of new bone. The other 3 groups showed statistically similar results. In the BCP and PRF+BCP groups, the residual graft ratios were decreased at consecutive time intervals. The difference between the 2 groups was not statistically significant during follow-up. Conclusions The current study revealed a histomorphometric increase in bone formation with the addition of PRF to BCP in surgically created defects in sheep tibia.

Effects of curcumin on proinflammatory cytokines and tissue injury in the early and late phases of experimental acute pancreatitis

BACKGROUND & AIMS Acute pancreatitis (AP) varies from mild to severe necrotizing changes with high mortality. The objective of the current study was to investigate the effects of curcumin on tissue injury and proinflammatory cytokines in the early and late phases of AP. METHODS AP was induced by sodium taurocholate in rats (n = 140). First group was left untreated. Group II received 100 mg/kg curcumin daily starting 20 days before AP induction. The rats were allocated into 7 sub-groups (n:5) and were sacrificed at 2, 6, 12, 24, 72, 144 and 288 h following the induction of AP. Blood and pancreatic tissue samples were collected for biochemical and histopathologic evaluations and the assessment of protein and mRNA levels, as well. RESULTS Curcumin decreased total histopathologic scores in comparison with those of the taurocholate group (P < 0.05). Curcumin increased Caspase-3 activity and decreased trypsin activity, while inhibited nuclear factor-κ (NF-κB) at all time points (P < 0.05) and moreover reduced activator protein-1 (AP-1). Curcumin decreased chemokine (except for 288 h), TNF-α (except for 2 and 24 h), IL-6 (except for 2, 6 and 288 h) and iNOS (except for 144 and 288 h) mRNA levels (P < 0.05). Curcumin serum nitric oxide (NO) (except for 144 and 288 h) levels were reduced, as well. CONCLUSIONS In conclusion, curcumin reduced tissue injury, trypsin activation and inhibited NF-κB and AP-1. However TNF-α, IL-6 and iNOS and NO were not inhibited at all time points. Therefore no direct correlation was detected in the subgroups between tissue injury, proinflammatory cytokines and oxidative enzymes.

Use of intramedullary fully-threaded pins in the fixation of feline and canine humeral, femoral and tibial fractures

Intramedullary fully-threaded pins were manufactured from an alloy of titanium, aluminium and vanadium in a fully-threaded style. Pins were produced in various diameters, ranging from 4 mm to 11 mm. Pin lengths varied from 5 cm to 22 cm. The proximal end of the pins was designed to fit into a hexagonal screwdriver, while the distal end was slightly tapered to allow for ease of entry into cancellous bone. Treatment using the fully-threaded intra- medullary pin was carried out in a total of 175 fractures of the humerus, femur, and tibia in 95 cats (bilateral femur in 1 case) and 77 dogs (bilateral femur in 2 cases). Radiographic follow-up for the cases was performed at monthly intervals. Non-union developed in one dog with a femoral fracture in which cerclage wire had also been used. Delayed healing and lameness were observed in two other dogs. Healing with excessive callus formation was observed in 16 dogs. However, there were not any problems noted in these dogs in regards to limb usage. Clinical and radiological results obtained for the remaining cases were found to be very good. Normal, complete fracture healing occurred between four to 14 weeks in dogs, and between four to 12 weeks in cats. Pins were removed upon observation of satisfactory functional and radiographic recovery. Pins could not be removed from 26 cats and 21 dogs as the owners had declined pin removal, or because the owners were lost to follow-up.

Bilateral pes valgus in an Anatolian Sheepdog.

A 15-month-old, male, Anatolian Sheepdog weighing 45 kg, was admitted with uneven stance in both hindlegs, a condition it had had since the age of six months. Radiographs of both hindlimbs revealed lateral deviation of 26 degrees in the distal metaphysis of the left tibia and 32 degrees in the distal metaphysis of the right tibia. Corrective osteotomy was used to treat the deformity. Both tibias were aligned with the closed wedge osteotomy and a suitably curved plate was placed on both bones. In the assessment prior to the removal of both plates, it was determined that a valgus deformation of 6 degrees was still present. However, this did not affect the gait, nor did it have an abnormal effect on the cosmetic appearance. It was concluded that if corrective osteotomy is performed before any degenerative changes have taken place, the outcome will be successful.

The treatment of supracondylar and diaphyseal femoral fractures incats using intramedullary two-way stacked Kirschner wire application

* Correspondence: didaraydin@hotmail.com

KÖPEKLERDE EKLEM İÇİ HASTALIKLARIN TANISINDA DİREKT VE İNDİREKT RADYOGRAFİLER (ARTROGRAFİ) İLE ARTROSKOPİ'NİN KARŞILAŞTIRILMASI

Ozet Calismada; toplam 36 kopegin degisik eklemlerinin radyografik ve artroskopik degerlendirmesi yapildi. Olgularin tamaminda direkt radyografi ve artroskopik muayene, omuz eklemlerine de indirekt radyografik muayene (artrografi) yapilarak ilgili bolgelerdeki hastaliklarin tanisinda kullanilan yontemler karsilastirildi. Calismada 29 diz, 19 omuz ve 1 i dirsek eklemi olmak uzere toplam 59 ekleme artroskopi ve direk radyografi. 19 omuz eklemine de artrografi yapildi. Diz eklemlerinin artroskopik incelemesinde 14 (Tinde bilateral), omuz eklemlerinde 6 ve dirsek eklemlerinin artroskopik muayenesinde de 5 olguda lezyon saptandi. Artroskopik inceleme yapilan diger diz, omuz ve dirsek eklemleri saglikliydi. Sonuc alarak, artrografik muayenenin butun eklemlerde yapilamiyacagi gerceginden hareketle modem bir goruntuleme teknigi olan artroskopik muayenenin, tereddute yer birakmadan taniyi kesinlestirdigi ve sagaltima yon verdigi gorulmustur. Ayrica eklem hastaliklarinin tanisinda direkt ve indirekt radyografiye gore daha guvenil bil yontem oldugu kanisina varilmistir. Anahtar Kelimeler: Artroskopi, radyografi, artrografi, eklem, kopek. COMPARISON OF DIRECT AND INDIRECT RADIOGRAPHICS (ARTHROGRAPHY) WITH ARTHROSCOPY IN DIAGNOSIS OF INTRA ARTICULAR DISEASES IN THE DOG Abstract In this study; radiographic and arthroscopic evaluations of different joints were made in 36 dogs. Direct radiography and arthroscopic examinations was carried out In all cases and indirect radiography (Arthrography) in shoulder joints, in order to determine the differences between diagnostic methods for diseases in this region. Direct radiography and arthroscopic examinations was carried out in all cases, as well as indirect radiography of the shoulder joints, and 29 stifle, 19 shoulder and 11 elbow joints, making a total of 59 joints, were examined arthroscopicaly. Fourteen (1 bilateral) lesions were arthroscopicaly observed In the stifle. 6 in the shoulder and 5 in the elbow joint. The remaining stifle, shoulder, and elbow joints were sound. As a result, in view of the fact that arthrographic examination cannot be made in all joints, It was seen that the modem imaging technique of arthroscopic examination presented definitive diagnosis and directed treatment. Arthroscopic examination was also considered to be more reliable method in diagnosis of joint diseases compared to direct and indirect radiography. Key words: Arthroscopy, radiography, arthrography, joint, dog.

BİR MİDİLLİ KISRAĞINDA MONTEGGİA KIRIĞI VE OPERATİF SAĞALTIMI

Ozet Bu gozlemde, 10 yasindaki bir Midilli kisraginda karsilasilan distal olekranon kirigi ile komplike dirsek eklemi cikigi (Monteggia kirigi) ve parsiyel radius kmgmin, plaka osteosentezi ile operatif sagaltimi ve gec donem klinik sonuclan rapor edilmektedir. Operasyondan 20 gun sonra plakayi tutan vidalardan bir kismi kirilarak fiksasyonun stabilitesi bozulmustur. Bunun sonucunda eklemde osteoartrit ve ankiloz geliserek, karpal eklemde fleksiyon ve orta derecede bir topalliga neden olmustur. Bu durumun duzeltilmesi icin, sumbugu gagali ozel bir nal cakilarak hayvanin genis alanda hareket etmesine imkan verilmistir. Bu uygulamalardan 4 ay sonra yapilan klinik ve radyolojik muayenelerde belirgin bir duzelme gorulmedigi ve atin halen sumbugu ile basarak ve topallayarak yurudugu belirlenmistir. Anahtar kelimeler: Midilli, Monteggia kirigi, plaka osteosentezi. MONTEGGIA FRACTURE AND OPERATIVE TREATMENT IN A PONY MARE Summary In this case report, distal olecranon fracture complicated with elbow luxation (Monteggia fracture) and partial radial fracture, encounter in a 10 years old Pony mare, treatment with plate osteosynthesis and late stage clinical result is reported. Some of screws, which were holding plate, broken 20 days after surgery and fixation were failed. According to this, carpal flexion and mild lameness has formed. Because of osteoarthritis, ankylosis occurred. To eliminate this problem a toe lengthen shoe applied and animal left in a large open space. Four month after this application, in clinical and radiological check-ups, there were no significant recovery and the horse were still step on toe and lamed. Key words: Pony, Monteggia fracture, plate osteosynthesis