Tamer Sagiroglu

Protective effect of curcumin on cyclosporin A-induced endothelial dysfunction, antioxidant capacity, and oxidative damage

Cyclosporin A (CsA) is the most widely used immunosuppressive drug for preventing graft rejection and autoimmune disease. However, the therapeutic treatment induces several side effects such as nephrotoxicity, cardiotoxicity, hypertension, and hepatotoxicity. Curcumin has been successfully used as a potent antioxidant against many pathophysiological states. This experimental study was performed to test, during CsA treatment, the alterations of curcumin antioxidant properties against CsA-induced endothelial dysfunction. Rats were divided into four groups: control, curcumin alone, CsA, and CsA + curcumin; each group containing eight animals. The animals in the CsA + curcumin group were treated with CsA (10 days, 25 mg/kg, orally) and curcumin (15 days, 200 mg/kg, orally, starting 5 days before CsA administration). At the end of the treatments, the animals were killed; serum and aorta tissue were treated for biochemical and morphological analyses. The results indicate that CsA-induced aortic endothelial dysfunction was characterized by morphological and ultrastructural alterations in tissue architecture, changes in malondialdehyde and ferric reducing/antioxidant power levels, and increase in endothelial nitric oxide synthase and terminal-deoxynucleotidyl-transferase mediated dUTP nick end labeling (TUNEL) expression. In conclusion, our data suggest that the imbalance between production of free oxygen radicals and antioxidant defence systems, due to CsA administration, is a mechanism responsible for oxidative stress. Moreover, we show that curcumin plays a protective action against CsA-induced endothelial dysfunction and oxidative stress, as supported by biochemical, ultrastructural, immunohistochemical, and TUNEL results.

Protective effect of everolimus on renal ischemia reperfusion injury in rats.

The aim of this study was to determine the effect of everolimus and tacrolimus pretreatments on renal morphology and function in a rat ischemia reperfusion (I/R) model. Twenty-eight male Sprague-Dawley rats were randomly assigned to saline + sham operation, saline + I/R (IR), tacrolimus + I/R (TRL + I/R) and everolimus + I/R (ERL + I/R) groups. Saline and active treatments were administered intraperitoneally for seven consecutive days before the surgery. The suprarenal aorta was clamped to achieve warm ischemia, except in the sham group. Right nephrectomy was performed in all animals and histology was examined. Renal function was assessed on post-operative Day 7 by Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy, glomerular filtration rate (GFR) and serum biochemistry. Both everolimus and tacrolimus preserved serum creatinine and blood urea nitrogen levels, but only everolimus preserved GFR (0.74 ± 0.36, 1.20 ± 0.37 and 2.24 ± 0.32 mL/min for I/R, TRL + I/R and ERL + I/R, respectively, P < 0.001). %ID values for sham, I/R, TRL + I/R and ERL + I/R were 55 ± 3, 47 ± 4, 45 ± 6 and 62 ± 7 (P < 0.001). On histologic evaluation, ERL + I/R showed less tubular damage and necrosis than I/R, as well as TRL + I/R. Within the confines of this rat warm ischemia model, everolimus pre-treatment was useful in preserving renal function following I/R injury. The possibility of using everolimus as a pre-conditioning agent for I/R injury in kidney transplantation should be further explored.

Combined effects of tauroursodeoxycholic Acid and glutamine on bacterial translocation in obstructive jaundiced rats

BACKGROUND Bacterial Translocation is believed to be an important factor on mortality and morbidity in Obstructive Jaundiced. AIMS We investigated the probable or estimated positive effects of tauroursodeoxycholic acid, which has antibacterial and regulatory effects on intestinal flora, together with glutamine on BT in an experimental obstructive jaundiced rat model. STUDY DESIGN Animal experimentation. METHODS Forty adult, male, Sprague Dawley rats were used in this study. Animals were randomised and divided into five groups of eight each: sham (Sh); control (common bile duct ligation, CBDL); and supplementation groups administered tauroursodeoxycholic acid (CBDL+T), glutamine (CBDL+G), or tauroursodeoxycholic acid plus glutamine (CBDL+TG). Blood and liver, spleen, MLN, and ileal samples were taken via laparotomy under sterile conditions for investigation of bacterial translocation and intestinal mucosal integrity and hepatic function tests on the tenth postoperative day. RESULTS There were statistically significant differences in BT rates in all samples except the spleen of the CBDL+TG group compared with the CBDL group (p=0.041, p=0.026, and p=0.041, respectively). CONCLUSION It is essential to protect hepatic functions besides maintaining intestinal mucosal integrity in the active struggle against BT occurring in obstructive jaundice. The positive effect on intestinal mucosal integrity can be increased if glutamine is used with tauroursodeoxycholic acid, which also has hepatoprotective and immunomodulatory features.

The effects of apelin on mesenteric ischemia and reperfusion damage in an experimental rat model.

OBJECTIVE Intestinal ischemia-reperfusion (I/R) injury is associated with high morbidity and mortality rates. There is ongoing research to find an effective preventive or treatment agent. We aimed to evaluate the effects of apelin 13 (AP) on intestinal I/R injury in a rat model. MATERIAL AND METHODS Twenty-four male Sprague-Dawley rats aged 6-8 weeks and weighing 280±20 g were equally divided into three groups (control, I/R and I/R+AP). The control group underwent superior mesenteric artery (SMA) mobilization alone without any clamping. In the I/R and I/R+AP groups, an atraumatic microvascular bulldog clamp was placed across the SMA at its point of origin from the aorta. In the I/R+AP group, 2 μg/kg/d apelin was administered intraperitoneally. After 60 minutes of ischemia, relaparotomy was performed to remove the microvascular clamp on the SMA for 3 hours of reperfusion. After 3 hours, tissue samples were obtained for biochemical [malondialdehyde (MDA) and glutathione (GSH) levels] and histopathological analyses. RESULTS MDA levels were significantly higher in the I/R group compared to the control group. Although MDA levels were lower in the I/R+AP group compared tothe I/R group, the difference was not statistically significant. There was also no significant difference between the I/R+AP and I/R groups regarding GSH levels. The median histopathological grade was significantly lower in the I/R+AP group compared to the I/R group (p=0.001). CONCLUSION Apelin appeared to have a positive effect on oxidative injury; this did not reach statistical significance. Thus, the role of apelin and associated findings in the initial treatment of intestinal ischemia needs further large-scale animal studies before human use.

Comparison of Sirolimus and Colchicine Treatment on the Development of Peritoneal Fibrozis in Rats Having Peritoneal Dialysis

BACKGROUND Continuous ambulatory peritoneal dialysis is a successful treatment modality for patients with end-stage renal disease. Peritoneal fibrosis (PF) is the most critical complication of long-term peritoneal dialysis (PD). AIMS In our study, we aimed to compare the effects of colchicine and sirolimus on PF induced by hypertonic peritoneal dialysis solutions in rats. STUDY DESIGN Animal experiment. METHODS Twenty-four rats were randomly divided into three groups. The control group received an intraperitoneal injection (ip) of saline. The sirolimus group received the PD solution, plus 1.0 mg/kg/day Rapamune®. The colchicine group received the PD solution ip plus 1.0 mg/kg/day of colchicine. Blood samples were taken to measure the serum levels of VEGF, TGF-β, and TNF-α. Peritoneal tissue samples were taken for histopathological evaluation. RESULTS TGF-β and TNF-α values in the sirolimus group were found to be statistically significantly lower than in the control and colchicine groups, but the differences between the control and colchicine groups were not statistically significant. No statistically significant differences were found between the groups regarding the VEGF values. Vascular neogenesis and peritoneal thickness were compared; the values in the sirolimus group were statistically reduced compared to the values in the control group. Mild fibrosis developed in 75% of all animals in the sirolimus group; there was no moderate or severe fibrosis observed. Fibrosis developed to varying degrees in 100% of the animals in the control and colchicine groups. CONCLUSION The present study demonstrates that sirolimus might be beneficial for preventing or delaying the progression of PF and neoangiogenesis. These alterations in the peritoneal membrane may be connected with reduced TNF-α and TGF-β levels.

Is Flow Cytometry Crossmatch Analysis Using Sera with Different Dilutions Important for Pretransplant Analysis? A Case Report

The most effective form of treatment for chronic renal failure is kidney transplantation from a cadaver or a living donor. For a kidney transplant to be successful, tissue compatibility and a lack of donor-specific anti-human leukocyte antigen (HLA) antibodies in the circulation of the patient are vital, in addition to ABO blood group compatibility. The presence of anti-HLA antibodies is assayed before transplantation using various methods, but because organ rejections have been observed in previous studies, different techniques are required to detect anti-HLA antibodies. Today, flow cytometry crossmatching is one of the most important and effective techniques in testing for donor-specific anti-HLA antibodies (DSAs). If weakly positive serum is assayed after serial dilution, it can yield high positivity. Herein, we describe the differences between the results for diluted and undiluted weakly positive sera studied using the flow cytometry crossmatch (FCXM) technique. In a recent study, the sera of weakly FCXM-positive patients were diluted 1/50, and the FCXM test was repeated. The use of diluted serum eliminated the effect of the prozone so that the DSAs could be detected.

Spontaneous Fistulization of a Pancreatic Abscess to Colon and Duodenum Treated With Percutaneous Drainage

Pancreatic fistulas are rare clinical entities associated with severe pancreatitis. A 39-year-old man who had been diagnosed and treated for severe pancreatitis 2 months ago presented with abdominal pain, fever, and vomiting. The abdominal computed tomography (CT) demonstrated a peripancreatic abscess and a duodenal fistula communicating the first part of duodenum, which was also verified with fluoroscopy. A size 14-French catheter with pig-tail tip was inserted primarily with a Seldinger 2-step technique through percutaneous route under CT-guidance to avoid intervening bowels or solid organs. The patients clinic improved and treatment was stopped on the 18th day. On the 26th day of the first intervention, the patient had fever and abdominal pain and his clinic was deteriorated. A second fluoroscopic examination revealed that the duodeno pancreatic fistula was closed while a new 1 has developed into the ascending colon. With aggressive nutrition support, antibiotics and repeated drainage of the abscess pouch a dramatic clinical improvement was observed. Control abdominal CT demonstrated the resolution of pancreatic abscess on the 62nd day.

Ruhsal bozuklukların psikobiyolojisinde nitrik oksit

The articles about various pneumoconiosis in dental technicians who work in inconvenient conditions have been increasing in recent years. Exposure to dust and fume that occur during the dental procedure may play role in pneumoconiosis of dental technicians. A 53 years old male patient conveyed that he has worked in dental prosthesis procedures for 22 years (1968-1990).Environmental asbestosis was not established in the history of the case but there were calcified pleural plaques in the chest x-ray graphy.There were appearance of calcific asbest plaques in many section of thorax CT.A case of pneumoconiosis in dental technician who work in unadequate preventive conditions was reported in this paper. Probably ,exposure to the asbest fibers that occurs during the procedure of dental prosthesis were the main reason for developing calcific pleural lesions.The aim of this study was to investigate the efficacy of occlusion treatment on different age group patients with anisometropic amblyopia. Occlusion treatment was applied to 34 patients, 15 preschool children (age between 4-6 years), and 19 school age children (7-11 years). Daily duration of occlusion was minimum 6 hours. Best corrected visual acuity of patients was measured initially, at the end of 1st, 3rd and 6th months. Data belonging to amblyopia groups was compared with one another and with the controls. Initial visual acuity of two amblyopia groups were similar, however there was a significant difference between the amblyopia groups and the controls (PChest pain is a frequently encountered problem in childhood. In this study we aimed to asses the relationship between exertional chest pain and asthma by using the peek expiratory flow rate measurements. For this study, 64 otherwise healthy children with chest pain (chest pain group), 9-16 years of age (mean 11.9) and 58 healthy (control group), 8-11 years (mean 11.5) were compared with the use of peak flow-meter. Ages, weights, heights, systolic-diastolic blood pressures, pulses recorded. Preexertional and postexertional peak flow measurements (PEFR) at 2, 5 and 10 minutes determined. There was a decrease more than 15% in PEFR measures in 7 (10.9%) of chest pain group and in 1 (1.7%) of control group children (p

Akut Üst Gastrointestinal Kanama Şikâyeti ile Başvuran Yaşlı Hastaların Klinik Özellikleri ve Risk Faktörlerinin Değerlendirilmesi

Departments of Emergency Medicine, General Surgery, Internal Medicine, Public Health, Trakya University Faculty of Medicine, Edirne; Department of Emergeny Medicine, Ankara Numune Training and Research Hospital, Ankara, all in Turkey Mustafa Burak SAYHAN,1 Serhat OĞUZ,2 Hasan ÜMİT,3 Esin SECGİN SAYHAN,4 Mustafa Onur ERALP,1 Gökhan AKDUR,1 Cemil KAVALCI,5 Tamer SAĞIROĞLU2 Evaluation of Risk Factors and Clinical Characteristics of Elderly Patients with Acute Upper Gastrointestinal HemorrhageDepartments of Emergency Medicine, General Surgery, Internal Medicine, Public Health, Trakya University Faculty of Medicine, Edirne; Department of Emergeny Medicine, Ankara Numune Training and Research Hospital, Ankara, all in Turkey Mustafa Burak SAYHAN,1 Serhat OĞUZ,2 Hasan UMIT,3 Esin SECGIN SAYHAN,4 Mustafa Onur ERALP,1 Gokhan AKDUR,1 Cemil KAVALCI,5 Tamer SAĞIROĞLU2 Evaluation of Risk Factors and Clinical Characteristics of Elderly Patients with Acute Upper Gastrointestinal Hemorrhage

Intestinal invagination secondary to intestinal adenocarcinoma in coeliac disease

Invagination is defined as a medical condition in which a part of the gastrointestinal tract has entered into another section. Intestinal invagination is a rare clinical entity among adults and there is an underlying structural lesion in most of the cases. Coeliac disease is considered as a risk factor for intestinal invagination, because of the associated inflammatory processes and motility disorders as well as the increased risk for secondary malignancies. We report a case of intestinal invagination secondary to intestinal adenocarcinoma in a woman with coeliac disease, whose adherence to a gluten-free diet was poor.