Uğur Kandilci

Propylthiouracil-Lnduced Hepatic Damage

OBJECTIVE: To report a case of propylthiouracil-induced hepatic damage. CASE SUMMARY: A 64-year-old white woman with hyperthyroidism received propylthiouracil 250 mg/d for 1 year. She developed hepatitis after 1 year of therapy. Alcohol and drug abuse were ruled out and all serologic tests for hepatitis A, B, and C were negative. Cytomegalovirus and Epstein-Barr virus infection were also ruled out. Antinuclear antibody, antimitochondrial antibody, and antismooth muscle antibody were negative. The clinical picture was similar to that of viral hepatitis characterized by nausea, vomiting, and jaundice. Histologic examination of a liver biopsy specimen showed chronic active hepatitis. The patient developed cirrhosis during follow-up. DISCUSSION: Propylthiouracil is widely used in the treatment of hyperthyroidism. Despite its widespread use, there have been only a few reported cases of propylthiouracil-induced hepatotoxicity. The precise mechanism of the injury is unknown, although immunologic factors are suggested. CONCLUSIONS: Hepatic damage induced by propylthiouracil is a rare complication. However, the danger of permanent hepatic damage should be kept in mind. The best way of preventing propylthiouracil hepatotoxicity is careful screening of patients considered for treatment.

Evaluation of apoptosis along with BCL-2 and Ki-67 expression in patients with intestinal metaplasia.

The primary aim is to compare individuals with intestinal metaplasia (IM), chronic active gastritis (CAG), and normal gastric mucosa (NGM) in terms of apoptosis, proliferation, and Bcl-2 expression. The secondary aim is to determine whether these parameters are different between patients with and without gastric cancer in first-degree relatives. We enrolled 106 patients whose histopathological results were consistent with IM (n: 42), CAG (n: 51), or NGM (n: 13). Antral biopsies were immunohistochemically stained for Bcl-2 and Ki-67 expression. Apoptosis was detected using TUNEL assay. While no significant difference was determined between three groups with regard to apoptosis and Bcl-2 expression (p>0.05), Ki-67 expression was significantly higher in the IM group when compared with the CAG and NGM groups (29.90±22.87 vs. 18.18±16.22 vs. 18.54±20, respectively; p=0.012). Helicobacter pylori was determined to increase apoptosis (49.3% vs. 25.7%, p<0.05), nevertheless, it had no significant effect on proliferation and Bcl-2 expression. Bcl-2 and Ki-67 expression and apoptosis were not different among patients with and without a history of gastric cancer in first degree relatives. Although intestinal metaplasia cases demonstrate an increase in proliferation, no elevation is observed in apoptosis. This can be an important factor in the progression to gastric cancer.

Comparison of the efficacy of the somatostatin analogue SMS 201-995 and electromagnetic fields in cerulein-induced pancreatitis in rats

Abstract Background: Despite known protocols, acute pancreatitis still has mortality rates of 10% and morbidity rates of 30%, and research continues into alternative therapeutic models for preventing both the inflammation and the complications of pancreatitis. Objective: This study was undertaken to investigate the effect of electromagnetic field therapy in acute pancreatitis and to compare the effect of electromagnetic fields with that of the somatostatin analogue SMS 201-995 in the treatment of cerulein-induced acute pancreatitis in rats. Methods: Male Wistar rats were divided into 4 equal groups. In group I, cerulein administration was followed by electromagnetic field therapy; group II received only cerulein. In group III (the control group), saline administration was followed by electromagnetic field therapy. In group IV, cerulein administration was followed by SMS 201-995 administration. After the procedure, serum amylase activity was determined for all rats and the pancreas of each rat was assessed histopathologically based on a scoring system in which 0=no change and 7=maximum change. A score ≥3 indicates cerulein-induced pancreatitis. Significance was set at P Results: Each group contained 12 rats. Statistically significant differences in pathologic pancreatitis scores were noted between groups I and II ( P P Conclusions: Electromagnetic field therapy appears to be as effective as somatostatin therapy in cerulein-induced acute pancreatitis in this study. It can thus be considered an alternative to somatostatin therapy in the treatment of acute pancreatitis in rats.