Nurettin Kahramansoy

A combination of plasma DAO and citrulline levels as a potential marker for acute mesenteric ischemia

Introduction There is no valid and reliable diagnostic test for early diagnosis of acute mesenteric ischemia (AMI). The aim of this study was to measure the plasma levels of diamine oxidase (DAO) and citrulline in AMI to gain insight into its early diagnosis. Material and methods A total of 21 Wistar albino rats were divided into three groups, that is, control group, short-term ischemia group, and prolonged ischemia group. The superior mesenteric artery was occluded for 15 min in the short-term ischemia group and for 12 h in the prolonged ischemia group. Twelve hours later, the experiment was terminated and plasma DAO and citrulline levels were measured. Intestinal tissue was evaluated for the histopathological changes. Results Compared to the control group, the short-term and prolonged ischemia groups showed significant increases in the plasma levels of DAO, whereas the plasma citrulline levels decreased significantly. Prolonged ischemia caused a larger increase in the plasma DAO levels and a larger decrease in the plasma citrulline levels compared to the short-term ischemia (p=0.011 and p=0.021, respectively). Intestinal damage was shown to develop more in the prolonged ischemia group (p=0.001). Conclusion In the early period of AMI, the plasma DAO levels increase while citrulline levels decrease, and the extent of these changes depends on the duration of ischemia.Introduction There is no valid and reliable diagnostic test for early diagnosis of acute mesenteric ischemia (AMI). The aim of this study was to measure the plasma levels of diamine oxidase (DAO) and citrulline in AMI to gain insight into its early diagnosis. Material and methods A total of 21 Wistar albino rats were divided into three groups, that is, control group, short-term ischemia group, and prolonged ischemia group. The superior mesenteric artery was occluded for 15 min in the short-term ischemia group and for 12 h in the prolonged ischemia group. Twelve hours later, the experiment was terminated and plasma DAO and citrulline levels were measured. Intestinal tissue was evaluated for the histopathological changes. Results Compared to the control group, the short-term and prolonged ischemia groups showed significant increases in the plasma levels of DAO, whereas the plasma citrulline levels decreased significantly. Prolonged ischemia caused a larger increase in the plasma DAO levels and a larger decrease in the plasma citrulline levels compared to the short-term ischemia (p=0.011 and p=0.021, respectively). Intestinal damage was shown to develop more in the prolonged ischemia group (p=0.001). Conclusion In the early period of AMI, the plasma DAO levels increase while citrulline levels decrease, and the extent of these changes depends on the duration of ischemia.

The effect of erythropoietin to pulmonary injury and mast cells secondary to acute pancreatitis

BackgroundAcute pancreatitis is a life-threatening necroinflammatory disease that is characterized by systemic inflammatory response syndrome and acute lung injury even in its very first days. Erythropoietin (EPO) is a hormone considered as an antiapoptotic and cytoprotective with observed receptors of anti-inflammatory effect on organs apart from the liver and the kidneys. In this study, the effects of EPO on pulmonary mast cells and on secondary injury caused by acute pancreatitis are investigated.MethodsTwenty one Wistar Albino rats were divided into three groups—sham, control, and EPO groups—with 7 rats per group. Pancreatitis was induced by administering 4.5% sodium taurocholate into the pancreatic duct. A 1000 U/kg/day dosage (three times) of EPO was administered to the EPO group. Blood urea nitrogen (BUN), creatinine, amylase, and troponin I in the serum were studied; and lung, kidney, brain, and heart tissues were examined histopathologically.ResultsThere were no histopathological changes in the other organ tissues except for the lung tissue. Compared to the control group, the EPO group showed significantly reduced alveolar hemorrhage, septal neutrophil infiltration, lung wall thickness score, and mast cell count in the lung tissue.ConclusionsAdministration of EPO reduces the mast cell count and lung wall thickness, and it reduces the alveolar hemorrhage and septal infiltration induced by acute pancreatitis.

Gender differences in trauma mechanisms, and outcomes in a rural hospital which is not designed as trauma centre

Objectives This study aimed to investigate how trauma characteristics and outcomes differ between genders in a rural hospital. Methods Records of trauma patients admitted to a state emergency department (ED) in eastern Turkey, between January 2006 and December 2007 were reviewed and data were analysed based on gender. Results In total, 5379 (87.0%) men and 806 (13.0%) women, totalling 6185 patients, were assessed. Mean age was 26.5 (1 month – 80 years) years for men and 24.7 (2 month – 81 years) years for women. Men comprised 90.2%, 81.3% and 77.3% of the patients injured by assault, motor vehicle incidents and falls, respectively. Women comprised a significantly larger share of suicide attempts (70.8%) than men. Of the men injured, 90.6% were discharged after treatment in the ED. The per cent of hospitalised women (5.8%) was increased compared with the per cent of hospitalised men (p=0.011). There was a higher frequency of transfer among women (8.6%) when compared with men (p<0.001). Women had a mortality frequency of 1.2%, which was similar to the mortality per cent calculated for men. Conclusions Men were at an increased risk for trauma, especially assault. The percentage of women injured and admitted to the ED due to assault was low compared with statistics reported in the literature. However, assault is the most common cause of trauma among women. The high per cent of hospitalisation and transfer among women may indicate that women are exposed to more severe trauma, and therefore experience increased morbidity compared with men.

Effects of beta-glucan on hepatic damage caused by obstructive jaundice

BACKGROUND Beta-glucans are known as macrophage stimulators and antioxidants. This study aimed to investigate the effects of beta-glucans on oxidative damage to the liver during obstructive jaundice. METHODS Sham, control and treatment groups (7 Wistar Albino rats in each) were designed. In the treatment group, beta-glucan was given through gavages for 10 days after bile duct ligation. All groups were sacrificed on the 11th day. Liver function tests, superoxide dismutase (SOD), myeloperoxidase (MPO), malondialdehyde (MDA), lipid peroxide (LPO), glutathione (GSH), and histopathological examination of the liver were investigated. RESULTS In the treatment group, the levels of alanine and aspartate aminotransferases (AST, ALT), gamma glutamyl transpeptidase (GGT), lactate dehydrogenase (LDH), total and direct bilirubin, MPO in the serum, and the levels of MDA and LPO in the liver tissue were significantly lower when compared with the control group. Moreover, SOD and GSH levels were relevantly high in the treatment group. Histopathological examination of the liver revealed less damage in the treatment group. CONCLUSION These results show that beta-glucan induced the phagocytic and anti-oxidative effects and also reduced the liver damage and oxidative stress in obstructive jaundice. Advanced studies are required for the clinical use of beta-glucan in obstructive jaundice.

The Effects of Ankaferd Blood Stopper on the Recovery Process in an Experimental Oesophageal Perforation Model

BACKGROUND Oesophageal perforation is a life-threatening pathology that is generally treated conservatively; however, surgical procedures are frequently performed. A topical haemostatic agent, Ankaferd Blood Stopper (ABS), also has beneficial wound-healing effects. AIMS This study aimed to determine the effects of ABS following experimental oesophageal perforations. STUDY DESIGN Animal experiment. METHODS The experimental rats were classified into 6 groups (with 7 rats in each group). Pairs of groups (primary repair alone and primary repair + ABS) were terminated in the 1(st), 2(nd), and 3(rd) weeks following injury. The oesophageal perforations, which were 8-10 mm in length, were created using a nasogastric tube. The perforation sites were repaired with a 6-0 polyglactine thread in the primary repair groups. Additionally, ABS was sprayed over the perforation site in the treatment groups. Each oesophagus was evaluated histopathologically. RESULTS There were fewer microabscesses and areas of necrosis in the ABS groups compared with the primary repair groups. The histopathological evaluation revealed that the ABS groups had less inflammation and more re-epithelisation compared to the primary repair groups (p=0.002 and p=0.003, respectively). Fibrosis in the ABS groups was moderate in the 2(nd) week and mild in the 3(rd) week. Comparing the groups with respect to the time intervals, only the 1(st) week groups showed a significant difference in terms of re-epithelialisation (p=0.044). CONCLUSION Topical ABS application on the repaired experimental oesophageal perforation regions led to positive wound-healing effects compared with the rats that were administered the primary repair alone.

İleri yaş hastalarda lokal anestezi altında kasık fıtığı tamiri

Objectives: The incidence of inguinal hernia and the frequency of comorbidity increase in the elderly. Therefore, in operations of these patients, anesthesia methods are important. The aim of our study was to investigate the feasibility of local anesthesia in the operation of the elderly. Materials and methods: The patients operated for inguinal hernia were analyzed retrospectively. They were divided into two groups: the elderly (>60 years) and the younger. Anesthesia methods, additional anesthesia requirement and complications were compared. Results: Of totally 177 patients, 30.5% were elderly. Operation type, anesthesia method and score of operational risk differed between groups. The percentage of co morbidity (55.6%) in the elderly was significantly high (p< 0.001). Among elderly, the frequency of co morbidity was slightly higher in patients who had local anesthesia compared to spinal and general anesthesia. Patients in young and middle ages preferred to be operated less under local anesthesia (34.1%) compared to elderly (70.4%). There was one case (2.6%) converted to general anesthesia as an additional anesthesia in the elderly group. Postoperative complications were slight more frequent in elderly. These cases were five in number (31.3%) and were oper ated under spinal or general anesthesia (p=0.002). Conclusions: The frequency of co morbidity and risk score of operation (ASA category) rise in the elderly. However, inguinal hernioraphy can be performed under local anesthesia without complication and conversion to general anesthesia.