Şükrü Oğuz Özdamar

Comparison of the effects of bupivacaine, lidocaine, and tramadol infiltration on wound healing in rats

BACKGROUND AND OBJECTIVES The aim of this study was to investigate the effects of saline solution, bupivacaine, lidocaine and tramadol infiltration on wound healing in rats. METHOD Thirty-two male Wistar Albino rats were randomly separated into four groups, receiving 3 mL saline solution in control group (Group C, n=8), 3 mL of 2% lidocaine in lidocaine group (Group L, n=8), 3 mL of 0.5% bupivacaine in bupivacaine group (Group B, n=8), and 3 mL of 5% tramadol in tramadol group (Group T, n=8). Breaking-strength measurements, collagen bundle counting, and histopathologic evaluation were evaluated in the tissue samples taken from the rats. RESULTS Comparing the control group with the groups where bupivacaine and lidocaine were used for wound infiltration, collagen production was lower, breaking-strength measurements showed reduced resistance while significantly high edema, vascularity, inflammation scores were found (p<0.0125). Between the control and the tramadol group there were no significant differences in collagen production, breaking-strength measurements, and edema, vascularity, inflammation scores (p>0.0125). CONCLUSION In our study, we found bupivacaine and lidocaine reduced the collagen production, wound breaking strength, and caused significantly high scores for edema, vascularity, and inflammation when compared to the control group. There was no significant difference between the control and the tramadol group. Results of this experimental preliminary study on rats support the idea that tramadol can be used for wound infiltration anesthesia without adverse effect on the surgical healing process. These results need to be verified in humans.

Comparação dos efeitos da infiltração com bupivacaína, lidocaína e tramadol na cicatrização de feridas em ratos

JUSTIFICATIVA Y OBJETIVOS: El objetivo de este estudio fue investigar los efectos de la solucion salina, de la bupivacaina, lidocaina y de la infiltracion de tramadol en la cicatrizacion de heridas en ratones. METODOS: Treinta y dos ratones Wistar machos albinos fueron ubicados aleatoriamente en cuatro grupos que recibieron 3 mL de solucion salina en el grupo control (grupo C, n = 8); 3 mL de lidocaina al 2% (grupo L, n = 8); 3 mL de bupivacaina al 0,5% (grupo B, n = 8) y 3 mL de tramadol al 5% (grupo T, n = 8). Las medidas de tension de ruptura, conteo de fibras de colageno y evaluacion histopatologica se evaluaron en las muestras de tejido retiradas de los ratones. RESULTADOS: La comparacion del grupo control con los grupos donde la bupivacaina y la lidocaina fueron usadas para la infiltracion de la herida mostro que en esos ultimos, la produccion de colageno fue menor, junto con la resistencia en la tension de ruptura, mientras se observo un edema mas intenso, vascularizacion y puntajes de inflamacion significativos (p 0,0125). CONCLUSION: En este estudio, verificamos que tanto la bupivacaina como la lidocaina redujeron la produccion de colageno, la resistencia a la ruptura de la cicatriz y causaron edema, vascularizacion e inflamacion significativas cuando se les comparo con el grupo control. No hubo diferencia significativa entre los grupos control y tramadol para estas variables. Los resultados de este estudio experimental preliminar en ratones indican que el tramadol puede ser utilizado para la anestesia por infiltracion en incisiones, sin efectos adversos sobre el proceso de cicatrizacion quirurgica. Esos resultados necesitan ser verificados en los seres humanos.

Histopathological analysis of vesicular and bullous lesions in Kaposi sarcoma

BackgroundIn this study, the clinical and morphological features of vesiculobullous lesions observed in Kaposi sarcoma are analyzed, and the features of bullous Kaposi sarcoma cases are emphasized.MethodsA total of 178 biopsy materials of 75 cases diagnosed as classic-type cutaneous Kaposi sarcoma were reviewed. Twenty-five cases showing vesiculobullous features were included in the study. Tumor, epidermis, dermis, and clinical data regarding these cases was evaluated.ResultsVesicular changes were observed in 21 (12%) out of 178 lesions of the 75 cases, while bullous changes were present in only 4 (2%). In all cases where vesicular and bullous changes were detected, tumor, epidermis, and dermis changes were similar. All cases were nodular stage KS lesions, whereas hyperkeratosis and serum exudation in the epidermis, marked edema in the dermis, and enlarged lymphatic vessels and chronic inflammatory response were observed.ConclusionsOur findings suggest that changes in vascular resistance occurring during tumor progression are the most important factors comprising vesiculobullous morphology.Virtual slidesThe virtual slide(s) for this article can be found here:http://www.diagnosticpathology.diagnomx.eu/vs/1646397188748474

Cavernous Hemangioma-Like Kaposi Sarcoma: Histomorphologic Features and Differential Diagnosis

Aim. Cavernous hemangioma-like Kaposi sarcoma is a rare morphologic type of Kaposi sarcoma. So far there are no cases in the literature defining the histological features of this morphologic spectrum in detail. In this study we presented two classical-type cutaneous Kaposi sarcoma cases with histologic findings resembling cavernous hemangioma in company with clinical and histopathological data. Cases. One hundred and eighty-five classical-type cutaneous Kaposi sarcoma lesions in 79 patients were assessed retrospectively in terms of histopathological features. Findings of two cases showing features of cavernous hemangioma-like Kaposi sarcoma whose clinical data could be accessed were presented in accompany with the literature data. Both cases were detected to have bluish-purple, protruded, irregularly bordered cutaneous lesions. Histopathological examination revealed a lesion formed by cavernous hemangioma-like vascular structures organized in a lobular pattern that became dilated and filled with blood. Typical histological findings of early-stage KS, consisting of mononuclear inflammation, extravasated erythrocytes, and a few immature vascular structures in superficial dermis, were observed. All cases were serologically HIV-1 negative. A positive reaction with HHV-8, CD31, CD34, and D2-40 monoclonal antibodies was identified at both cavernous hemangioma-like areas and in immature vascular structures. Results. Cavernous hemangioma-like Kaposi sarcoma is a rare Kaposi sarcoma variant presenting with diagnostic challenges, that may be confused with hemangioma. As characteristic morphological features may not be observed in every case, it is important for diagnostic purposes to show immunohistochemical HHV-8 positivity in this variant.

Sitomorfolojik Bulgularla Pelvis Renalisin Üroteryal Neoplazmı

Idrar sitolojisi, siklikla mesanede izlenen uroteryal neoplaziler icin kullanilan onemli bir tanisal tekniktir. Pelvikaliksiyel sistem ve ureter tumorlerinin tanisinda sitopatolojik kanitlari ortaya koymak daha zor olmakla beraber sitolojik materyalde tumorun tanisi ve derecelendirilmesi, tedavi planlanmasinda onemli avantaj saglar. Gross hematuri etyolojisi arastirilan 55 yasinda erkek hastanin, abdomen bilgisayarli tomografisinde “sag pelvis renalisde tumor?” saptanmasi uzerine yapilan ureterorenoskopisinde, pelvis renalisde multipl papiller kitle gorunumu izlenmistir. Bu islem sirasinda alinan idrar sitolojisi “malignite suphesi” gosteren yayma olarak rapor edilmistir. Doku ornekleri kesitlerinde, fibrovaskuler kor cevresinde dizilim gosteren 6–7 epitel hucre tabakasindan olusan papiller yapilar ile karakterize tumoral olusum izlenmistir. Tumor, pleomorfik, iri, nukleolleri belirgin, hiperkromatik nukleuslu, eozinofilik sitoplazmali atipik epitelyal karakterde hucrelerden olusmaktadir. Lamina propriada invazyon saptanmayan olgu “dusuk malign potansiyelli papiller uroteryal neoplazi (WHO/ISUP 98)” tanisi almistir. Olgumuz diyagnostik sitolojik ozellikleri nedeniyle sunulmaya deger bulunmustur. Urothelial neoplasm of pelvis renalis with cytomorphology findings Urine cytology is an important diagnostic technique for urothelial neoplasia. Although it is difficult to demonstrate the cytopathological clues in the diagnos are of pelvicalicial system and urothelial tumors, tumor grading and diagnosis with cytology provides important advantages for treatment. After “right pelvis renalis tumor?” determination in abdominal computerized tomography of a 55 year old male patient for gross hematuria etiology search, multiple milimetric papillary mass appearance was observed at pelvis renalis in ureterorenoscopy. In examination of urine sample obtained during this procedure reported as “suspicious of malignancy”. A tumoral mass characterized with papillary structures composed of 6-7 epithelial cells layer lined around fibrovasculary core, is designated in cross sections. Tumor was composed of atypical epithelial cells with pleomorphic, coarse, apparent nucleoli, hyperchromatic nuclei and eosynophilic cytoplasm features. Tumor with no lamina propria invasion reported as “papillary urothelial neoplasm with low malignancy potential (WHO/ISSUP 98)” Our case was worth presentation because of its diagnostic cytological features.