Mehmet Cabuk

Pharmacological preconditioning with erythropoietin reduces ischemia-reperfusion injury in the small intestine of rats.

AIMS Considering the implications that arose from several recent experimental studies using recombinant human erythropoietin in rodents, erythropoietin has been regarded as a pharmacological preconditioning agent. The purpose of the present study was to evaluate whether erythropoietin has a preconditioning effect against ischemia and reperfusion injury in the small intestine of the rat. MAIN METHODS Intestinal ischemia was induced in male Wistar rats by clamping the superior mesenteric artery for 30 min, followed by reperfusion for 180 min. Recombinant human erythropoietin (1000 or 3000 U/kg) or vehicle was administered intraperitoneally 24 h prior to ischemia. After collection of ileal tissue, evaluation of damage was based on measurements of the accumulation of polymorphonuclear neutrophils by technetium-99m-labeled leukocyte uptake, content of malondialdehyde, reduced glutathione, contractile responses to agonists, and an evaluation of histopathological features in intestinal tissue. KEY FINDINGS Treatment with erythropoietin 24 h before ischemia significantly reduced the tissue content of malondialdehyde and increased that of reduced glutathione. Pretreatment also significantly suppressed leukocyte infiltration into the postischemic tissue, as evidenced by the lower content of myeloperoxidase and technetium-99m-labeled leukocytes. Physiological and histopathological improvements were also significant with the rHuEpo treatment. SIGNIFICANCE Results of the present study indicate that rHuEpo is an effective preconditioning agent in ischemic injury of the small intestine. Protection provided by recombinant human erythropoietin is closely related to the inhibition of oxidative stress and leukocyte infiltration, which might be among the possible protective mechanisms of erythropoietin in intestinal ischemia and reperfusion.

Helicobacter pylori Eradication Lowers Serum Asymmetric Dimethylarginine Levels

Introduction. Microbial pathogens, one of them is Helicobacter pylori (H. pylori), have frequently been implicated in the atherogenesis. Endothelium-derived nitric oxide (NO) is synthesized from L-arginine by nitric oxide synthase (NOS) and plays a pivotal role in the regulation of vascular tone. Asymmetric dimethylarginine (ADMA) is the most potent endogenous NOS inhibitor. Elevated levels of ADMA have been reported in many circumstances associated with a high cardiovascular risk. The aim of the present study was to investigate whether the eradication of H. pylori infection affects serum ADMA levels. Materials and Methods. Forty-two H. pylori-positive patients were enrolled in the study. Triple therapy for 14 days were given to all patients. Serum ADMA levels were measured at baseline and 2 months after therapy. Results. Eradication was achieved in 34 (81%) patients. The mean serum ADMA levels before and after therapy were 1, 77 ± 0, 30 and 1, 67 ± 0, 29 ng/mL in the group with H. pylori eradicated and 1, 63 ± 0, 28 and 1, 56 ± 0, 32 ng/mL in the noneradicated, respectively. We detected statistically significant decreased serum ADMA levels after therapy in H. pylori eradicated group. Conclusion. These findings have indicated that eradication of H. pylori infection may decrease the risk of atherosclerosis and cardiovascular events.

Evaluation of Nasal Mucociliary Functions with Rhinoscintigraphy in Coal Workers’ Pneumoconiosis

Objective: To compare nasal mucociliary clearance (NMC) functions in coal workers with pneumoconiosis, coal workers without pneumoconiosis and healthy controls by using technetium-99m-labeled macroaggregated albumin rhinoscintigraphy. Methods: Sixty-five of the 86 coal workers were clinically documented as suffering from coal workers’ pneumoconiosis (CWP group). CWP workers were divided into two groups according to smoking status: 44 smokers (CWP-S) and 21 nonsmokers (CWP-NS). Twenty-one workers without pneumoconiosis (NCWP group) were similarly divided into two groups: 12 smokers (NCWP-S) and 9 nonsmokers (NCWP-NS). Thirty-three healthy male volunteers were selected for the control group [15 smokers (control-S), 18 nonsmokers (control-NS)]. The half-time (t½) value for the clearance of the radiopharmaceutical was calculated for each patient. Results: Mean t½ values for CWP-S, CWP-NS, NCWP-S, NCWP-NS, control-S and control-NS were 25.10 ± 7.75, 10.97 ± 3.24, 14.68 ± 4.98, 9.17 ± 3.71, 19.15 ± 5.04 and 15.08 ± 5.11, respectively (p < 0.001, Kruskal-Wallis variance analysis). Further, mean t½ values of smokers versus nonsmokers in CWP, NCWP and control groups were compared, and it was found that although smoking prolonged nasal transport time in all three groups, the difference was significant only in the CWP group (p < 0.001, p < 0.023 and p < 0.027, respectively, Bonferroni-adjusted Mann-Whitney test). Conclusion: Our findings demonstrated a synergistic detrimental effect of smoking with coal dust exposure on nasal transport time.

The effect of lateral osteotomy of septorhinoplasty on nasolacrimal duct functions: a radionuclide imaging study.

Background The aim of this study was to evaluate the effects of lateral osteotomy of septorhinoplasty on nasolacrimal duct functions by dacryoscintigraphy. Methods The study group comprised 60 nasolacrimal systems of 30 consecutive patients who underwent septorhinoplasty. Dacryoscintigraphy images were taken in the preoperative period and postoperative 1st week and 3rd month. After Tc-99m pertechnetate instillation, dynamic images were obtained every 15 seconds. For cases of normal drainage, the study was terminated after 10 minutes but when obstruction was suspected, external ocular massage and rapid nasal inspiration were applied and the test was extended for an additional 10 minutes. Systems were classified either as passage without massage (normal nasolacrimal test), passage with massage (physiological obstruction), or presac or postsac obstruction (partial or complete obstruction) according to test results. Transit time was determined for cases with normal test or physiological obstruction. Results In the preoperative period eight systems (two presac and six postsac) had obstruction. There were a total of 11 (18.3%) additional systems with obstruction (4 presac and 7 postsac) in the 1st postoperative week and patient symptoms were not in complete agreement with the test results in this period. By the 3rd month, nine systems (three presac and six post sac) had obstruction. Transit time was prolonged in both the postoperative 1st week and the postoperative 3rd month tests compared with the preoperative tests (p = 0.000 and p = 0.023, respectively). Conclusion We did not encounter any permanent obstructions after lateral osteotomy of rhinoplasty. Temporary obstructions in the 1st postoperative week improved to normal preoperative status by the postoperative 3rd month.

Evaluation of the protective effect of agmatine against cisplatin nephrotoxicity with 99mTc-DMSA renal scintigraphy and cystatin-C.

Abstract Background: The aim of the current study was to investigate whether agmatine (AGM) has a protective effect against cisplatin-induced nephrotoxicity. Materials and methods: Thirty-two rats were randomly divided into four groups: (1) Saline (control); (2) Cisplatin (CDDP; 7.5 mg/kg intraperitoneally); (3) Agmatine (AGM; 10 mg/kg intraperitoneally); (4) Cisplatin plus agmatine (CDDP + AGM). Agmatine was given before and two consecutive days after cisplatin injection. All the animals underwent renal scintigraphy with 99mTc-DMSA. The levels of serum creatinine, cystatin C, and blood urea nitrogen (BUN) were measured in addition to examination of the tissue samples with light microscopy. Acute renal injury was assessed with biochemical analyses, scintigraphic imaging, and histopathological evaluation. Results: In the cisplatin group, the levels of BUN, creatinine, and cystatin C were significantly higher than that of the controls. Histopathological examination showed remarkable damage of tubular and glomerular structures. Additionally, cisplatin caused markedly decreased renal 99mTc-DMSA uptake. AGM administration improved renal functions. Serum creatinine, BUN, and cystatin C levels had a tendency to normalize and, scintigraphic and histopathological findings showed significantly less evidence of renal toxicity than those observed in animals receiving cisplatin alone. Conclusions: Our data indicate that AGM has a protective effect against cisplatin-induced nephrotoxicity. Therefore, it may improve the therapeutic index of cisplatin. In addition, the early renal damage induced by cisplatin and protective effects of AGM against cisplatin nephrotoxicity was accurately demonstrated with 99mTc-DMSA renal scintigraphy.

Bilateral generalised synovial chondromatosis of the knee: Bone scintigraphic demonstration with radiologic correlation.

A 67-year-old woman with a history of bilateral progressive knee pain and swelling was referred for 99mTc-methyl diphosphonate bone scintigraphy. Flow and blood pool images showed bilateral heterogeneous increased uptake and delayed phase revealed mass-looking lobulated heterogeneous increased activity in both of knees extending distal part of the femoral shaft, but no other pathologic uptake was found in rest of the body. A.diagnosis of synovial chondromatosis was made when correlated with X-ray and computed tomography.(CT) images. This is a rare presentation of generalized synovial chondromatosis involving both knees which demonstrated on bone scintigraphy with X-ray and CT correlation.

Disseminated nocardia infection mimicking malignancy on FDG PET/CT

A 39-year-old male patient was admitted to our hospital with recurrent fever and coughing up purulent sputum for two months. The symptoms were suppressed by a course of 14-day antibiotherapy (ampicillin sulbactam and clarithromycin) but relapsed after he stopped using antibiotics. The patient’s past medical history included immunosuppressive therapy for Neuro-Behc et’s disease 2 months ago. Laboratory work-up showed increased white blood cell count [20 × 109 L–1 (N: 4–11 × 109 L–1)], C-reactive protein (CRP) concentration [128 mg/L (N: <3 mg/L)] and erythrocyte sedimentation rate (ESR) [44 mm/h (N: <5 mm/h)]. Thorax computed tomography (CT) revealed a mass in the apical segment of the upper lobe of the right lung and multiple parenchymal nodules in both lungs (not shown). Infection and malignancy