Yucel Gonul

Variations in the intracranial vertebrobasilar system

AimThe aim of our study was to demonstrate some possible variations in the vertebrobasilar system (VBS) in the Turkish population and to compare our results with the literature.Materials and methodsThe VBS samples were taken from 109 fresh forensic autopsies and one anatomic cadaver. The widths of the vertebral artery (VA), the basilar artery (BA) and their branches were measured; dominancy and hypoplastic arteries, as well as the types of variations and their locations, were determined.ResultsHypoplastic VA was observed at rates of 20.2% on the right, 14.4% on the left and 4.8% bilaterally. The vertebrobasilar junction was found to be either at the level of bulbopontine sulcus (20%), below the sulcus (67%) or above the sulcus (12%). BA variations were observed as duplications of the proximal (0.9%) and distal segments (1.8%). Anterior spinal artery (ASA) originated as a single trunk in 12.5% of the cases. ASA arose from a transverse anastomosis connecting VAs in 6.3% of the cases. Furthermore, 15.6% of ASAs were double. The observed variations in the superior cerebellar artery were early bifurcation (7.2% on the right, 12.7% on the left), fenestration (4.5% on the right, 7.2% on the left), duplication (14.5% on the right, 12.7% on the left) and origin as a common trunk (6.3% on the right, 10% on the left).ConclusionOur results show that a high percentage of variations can be seen even in a small number of cases. We believe that our data are clinically important because, for example, variations are a factor which increases the incidence of aneurism and thrombus. We also think our results will contribute to the demography of our country and to clinical medicine.

Anti-inflammatory and Antiapoptotic Effect of Interleukine-18 Binding Protein on the Spinal Cord Ischemia-Reperfusion Injury

We investigated the anti-inflammatory and antiapoptotic effects of interleukin-18 binding protein (IL-18BP) on spinal cord ischemia/reperfusion (I/R) injury in rats. Twenty-one adult male rats were divided into three groups: sham, I/R, and I/R+IL-18BP. Proinflammatory cytokines were determined in rat blood samples by using ELISA, while apoptosis was immunohistochemically evaluated in spinal cord tissue using caspase 3. Both IL-18 and TNF-α were significantly decreased in the IL-18BP group compared to that in the sham group. The highest caspase 3 levels were observed in the I/R group, while the lowest levels were found in the sham group. The mean Tarlov score of the I/R group was significantly lower than that of the sham group. However, the mean Tarlov score of the IL-18BP group was significantly higher than that of the I/R group. The results of the current study demonstrate that IL-18BP plays both anti-inflammatory and antiapoptotic roles in spinal cord I/R injury.

Effect of IL-18 binding protein on hepatic ischemia-reperfusion injury induced by infrarenal aortic occlusion

Purpose Severe local and systemic tissue damage called ischemia/reperfusion (IR) injury occurs during the period of reperfusion. Free oxygen radicals and proinflammatory cytokines are responsible for reperfusion injury. IL-18 binding protein (IL-18BP) is a natural inhibitor of IL-18. The balance between IL-18 and IL-18BP has an important role in the inflammatory setting. The present study aimed to investigate whether IL-18BP had a protective role in remote organ hepatic IR injury. Methods Wistar-Albino rats were divided into three groups that contained seven rats. Group I (sham): Laparotomy and infrarenal abdominal aorta (AA) dissection were done but no clamping was done. Group II (I/R): The infrarenal AA was clamped by atraumatic microvascular clamp for 30 minutes and then was exposed to 90 minutes of reperfusion. Group III (IR + IL-18BP): 75 µg/kg of IL-18BP in 0.9% saline (1 mL) was administered 30 minutes before infrarenal AA dissection and clamping; 30 minutes of ischemia was applied and then was exposed to 90 minutes of reperfusion. Results Serum AST, ALT, and LDH levels were remarkably higher in IR group and returned to normal levels in treatment group. The proinflammatory cytokine levels had decreased in treatment group, and was statistically significant compared with the IR group. Serum levels of total oxidant status and oxidative stress index decreased and levels of total antioxidant status increased by IL-18BP. Conclusion This study suggested that IL-18BP has antioxidant, anti-inflammatory and hepatoprotective effects in cases of IR with infrarenal AA induced liver oxidative damage.

The antioxidant and antiapoptotic effects of crocin pretreatment on global cerebral ischemia reperfusion injury induced by four vessels occlusion in rats

AIMS Cerebral ischemia reperfusion (IR) injury is a process in which oxidative and apoptotic mechanisms play a part. Neuroprotective agents to be found could work out well for the efficient and safe minimization of cerebral IR injury. Crocin is a strong antioxidant agent; however the influence of this agent on the experimental cerebral ischemia model has not been studied extensively and thus it is not well-known. The objective of our study was to investigate the antioxidant, antiapoptotic and protective effects of crocin on the global cerebral IR induced by four-vessel occlusion. MAIN METHODS A total of 30 adult female Sprague-Dawley rats were equally and randomly separated into three groups as follows: sham, IR and IR+crocin (40mg/kg/day orally for 10days). 24h after electrocauterization of bilateral vertebral arteries, bilateral common carotid arteries were occluded for 30min and reperfused for 30min. Oxidative stress parameters (TAS, TOS, OSI), haematoxylin and eosin staining, caspase-3 and hypoxia-inducible factor-1 alpha (HIF-1α) expressions and TUNEL methods were investigated. KEY FINDINGS There was a significant difference between the IR and sham groups by means of OSI level, histopathological scoring, caspase-3, HIF-1α and TUNEL-positive cell parameters. We have also observed that pre-treatment with crocin reduced these parameter levels back to the baseline. SIGNIFICANCE The data obtained from the present study suggest that crocin may exert antiapoptotic, antioxidant and protective effects in IR-mediated brain injury induced by four-vessel occlusion. To the best of our knowledge, this would be the first study to be conducted in this field.

Protective Effect of Melatonin on Infrarenal Aortic Occlusion: This Effect Is Related to Anti-inflammatory Effect and Antioxidant Effect

Aortic cross-clamping is frequently exerted during surgery of the abdominal aorta (AA). Ischemia–reperfusion (IR) damage, which is observed in the surgery of AA, is a complex situation and is considered not only in lower extremities but also in remote tissues and organs like the lungs, kidneys, heart, and liver [1–6]. IR damage leads to important morbidity and mortality because of its systemic complications [7, 8]. Acute renal dysfunction, which is one of the most important complications following elective surgery of AA, is still a frequently seen condition (15– 22%), but acute kidney injury (AKI) is relatively rare (1.8– 4 %) [9, 10]. Infrarenal clamping of the aorta has been shown to decrease renal blood flow especially in patients who postoperatively developed renal failure [11–13]. This clamping procedure can cause vasoconstriction in renal arteries by forming turbulent flow in the aorta at the level of renal arteries [13]. The mechanisms underlying IR-induced organ damage are likely multifactorial and interdependent, involving hypoxia, inflammatory responses, and free radical damage [14–17]. Two of the most important factors in the pathophysiology of IR injury are reactive oxygen species (ROS) andmassive secretion of systemic inflammatorymediators, which especially increase in the reperfusion phase [18–20]. The endogenous antioxidants which are responsible for protecting against ROS during reperfusion have an important role in decreasing IR injury [18]. Melatonin, the main indolamine produced by the pineal gland, has been demonstrated to be an effective antioxidant and free radical scavenger [21–24]. Additionally, it has also shown an anti-inflammatory effect, which is suppression of proinflammatory cytokines like tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6 [25– 30]. Melatonin has a small size and high lipophilicity; therefore, it crosses biological membranes easily and reaches all sections of the cell [22, 31, 32]. In this study, we aimed to investigate the anti-inflammatory, antioxidant, and protective effects of melatonin in IR damage developing in kidneys following infrarenal aortic occlusion–reperfusion in rat models and in preventing kidneys from this kind of damage.

The effects of IL-18BP on mRNA expression of inflammatory cytokines and apoptotic genes in renal injury induced by infrarenal aortic occlusion

BACKGROUND Renal injury is an important complication of infrarenal aortic occlusion (IAO), which is mainly encountered during the postoperative period. Aortic clamping procedure may lead to turbulent blood flow and eventually vasoconstriction at renal arterial level of the abdominal aorta. IL-18BP has well-known antioxidant and anti-inflammatory properties. In this study, we aimed to determine whether IL-18BP has anti-inflammatory, antiapoptotic, antioxidant, and protective effects on acute kidney damage induced by IAO rat model. MATERIALS AND METHODS A total of 30 adult male Wistar-Albino rats were equally and randomly separated to three groups as follows: SHAM laparotomy, ischemia-reperfusion (IR), and IR + IL-18BP. We applied 30-min IAO and 2-h reperfusion. Inflammatory cytokine levels (TNF-α, IL-1β, IL-18, IL-6, and IFN-γ) and oxidative stress parameters (TAS, TOS, and OSI) were measured. In addition to this, urea and creatinine levels, histopathology of kidney, mRNA expression levels of inflammatory cytokines, and apoptotic genes were investigated. RESULTS Urea and creatinine, tissue and serum levels of TNF-α, IL-6, IL-18, IFN-γ, and TOS, and oxidative stress index (OSI) were found significantly lower in IR + IL-18BP group, when compared to the IR group. Moreover, mRNA expression levels of inflammatory cytokines and apoptotic genes were prominently depressed in IR + IL-18BP pre-treatment group in histopathologic examination, there was a significant difference between the IR and other three groups (P < 0.001). These improvements were demonstrated with a total score of histopathologic damage. In our previous studies, we have demonstrated that IL-18BP has antioxidant, inflammatory, and protective effects on liver and spinal cord IR injury. Data established from the present study suggest that IL-18BP may exert anti-inflammatory, antiapoptotic, antioxidant, and protective effects on IAO-induced acute kidney injury in rats, and this would be the first study to be conducted in this field. CONCLUSIONS Data established from the present study suggest that IL-18BP may exert anti-inflammatory, antiapoptotic, antioxidant, and protective effects on IAO-induced acute kidney injury in rats.

The effects of amlodipine and platelet rich plasma on bone healing in rats.

Aim The aim of this study was to evaluate the effects of calcium channel blocker (CCB) amlodipine (AML), platelet rich plasma (PRP), and a mixture of both materials on bone healing. Materials and methods Fifty-six male Wistar rats were randomly divided into four groups: group A, tibia defect model with no treatment; group B, tibia defect model treated with AML, 0.04 mg daily by oral gavage; group C, tibia defect model treated with local PRP; group D, tibia defect model treated with local PRP and AML, 0.04 mg daily by oral gavage. Results At day 21, bone healing was significantly better in groups C and D compared to group A (P<0.05), but comparisons showed no statistically significant difference in group B (P>0.05). At day 30, groups B and C showed no statistically significant difference (P>0.05) compared to group A, but bone healing in group D was significantly better than in group A (P<0.05). Statistically, AML did not affect alkaline phosphatase (ALP) activity at 21 and 30 days (P>0.05), but PRP and AML + PRP increased ALP activity statistically (P<0.05). Conclusion It can be concluded that AML had neither a positive nor a negative effect on bone healing, but when used in combination with PRP, it may be beneficial.

Interleukin-18 Binding Protein Pretreatment Attenuates Kidney Injury Induced by Hepatic Ischemia Reperfusion ☆ ☆☆ ★

Objective: Acute kidney injury (AKI) is a serious condition that can be induced by liver transplantation, major hepatic resection or prolonged portal vein occlusion. AKI can increase the frequency of postoperative complications. In the current study, we aimed to investigate whether interleukin‐18 binding protein (IL‐18BP) pretreatment has a protective effect against possible kidney injury following liver ischemia‐reperfusion (IR) achieved by Pringle maneuver in an experimental rat model. Materials and Methods: A total of 24 male Wistar albino rats were included in this study. Animals were equally and randomly separated into 3 groups as follows: I, Sham group, II, IR group (1‐hour ischemia and 4‐hour reperfusion) and III, IR + IL‐18BP group (50 &mgr;g/kg IL‐18BP was intraperitoneally administered 30 minutes before surgery). Blood, liver and kidney samples were collected for histopathological and biochemical (hepatic and renal function, nitric oxide, malondialdehyde and glutathione levels) analysis. In addition, proinflammatory cytokines including tumor necrosis factor &agr;, IL‐1&bgr; and IL‐6 levels were measured in kidney tissues. Results: IL‐18BP has improved kidney functions in acute kidney damage, restored structural changes, exhibited anti‐inflammatory effects by decreasing proinflammatory cytokines and regulated the oxidative stress parameters by antioxidant effect. Conclusions: Current study would be the first to evaluate the protective, antioxidant and anti‐inflammatory effects of IL‐18BP on renal damage induced by liver ischemia (1 hour) and reperfusion (4 hours). As a result, we have demonstrated that AKI may develop after hepatic IR with Pringle maneuver and IL‐18BP pretreatment can attenuate this damage. By this way, complications related to liver IR could be minimized and also postoperative hospitalization durations, treatment costs and healing periods could be decreased.

Interleukin 18–binding protein ameliorates liver ischemia–reperfusion injury

BACKGROUND The aim of this study was to investigate the possible protective effect of interleukin 18-binding protein (IL-18BP) on ischemia-reperfusion (I/R)-induced liver injury in experimental rat models. Liver is one of the most affected organs from I/R process. IL-18 is an important proinflammatory cytokine, which may induce some events such as production of reactive oxygen substances and release of various cytokines. IL-18BP acts as an inhibitor of IL-18. The relationship between IL-18 and IL-18BP has an important place in inflammatory process. MATERIALS AND METHODS Rats were equally divided into three groups as follows: sham: Hepatic pedicle dissection was done, but hepatic pedicle clamping was not used. I/R: Sixty minutes of ischemia and 2 h of reperfusion were applied. IR + IL-18BP: Recombinant human IL-18BP (100 μg/kg) was administered 30 min before the surgery. Hepatic pedicle was clamped during 60 min of ischemia and 2 h of reperfusion was achieved. RESULTS Liver enzyme levels were significantly lower in the IR + IL-18BP group, when compared with the I/R group. Serum and tissue levels of tumor necrosis factor-α, IL-6, and IL-18 were considerably lower in the IR + IL-18BP group, when compared with the I/R group, but hepatic interferon-γ and IL1β levels were not significant. Serum oxidative stress index level was significantly higher in the I/R group, when compared with the IR + IL-18BP group. In immunostaining, it was observed that pathologic changes were lower in IR + IL-18BP group than the I/R group. CONCLUSIONS IL-18BP exhibited anti-inflammatory, antioxidant, and protective effects in I/R-mediated hepatic injury via regulating some liver enzyme activities and cytokine levels. Additionally, these effects have been verified by histomorphologic examination and oxidative stress markers.

Assessment of pulmonary functions and anthropometric measurements in women with polycystic ovary syndrome

Objectives. The aims of this study were to compare pulmonary function tests of patients with polycystic ovary syndrome (PCOS) versus healthy women, and to investigate correlations between pulmonary function tests and anthropometric measurements of them. Materials and Methods. A total of 31 women with PCOS and 29 controls matched for age and body mass index (BMI) were enrolled into the study. Pulmonary function tests were performed with spirometer. Body fat percentage was calculated from the skinfold thicknesses using the formula. Biacromial, chest antero-posterior and lateral diameter measurements were carried out with anthropometric set. Results. There were no significant differences between patients with PCOS and healthy controls in the pulmonary function tests, body fat %, chest and abdomen region anthropometric measurements. There were moderate negative correlations only between forced expiratory volume per 1 s and BMI, abdomen circumference, body fat percentage in patients with PCOS. In the control group, however, there were moderate or strong negative correlations between anthropometric measurements (BMI, body fat percentage, abdominal circumference, chest lateral diameter) and at least three different pulmonary function tests. Conclusion. These results suggest that the upper body anthropometry and respiratory function relations might have impaired in patients with PCOS. We think that this situation might support the increased tendency for poor health status in patients with PCOS.