The effects of antitrombin ııı on lung injury in a model of experimental acute pancreatitis

Acute pancreatitis, especially in the severe form, is a well-known disease causing both local intraabdominal and remote organ disturbances, including lungs. As a natural inhibitor of serine proteases, antithrombin was previously shown to attenuate the tissue damage after ischemia-reperfusion, sepsis, and shock in several organ systems. Here, we examined the effects of antithrombin on pulmonary injury in a rat acute pancreatitis model. Thirty male Wistar-Albino rats underwent median laparotomy and randomized into three groups: group I (control) bilio-pancreatic duct was dissected but not ligated (n=10), group II (acute pancreatitis group) bilio-pancreatic duct was ligated (n=10), and group III (AT treated group) AT III 250 U/Kg was injected following bilio-pancreatic duct ligation (n=10). After observation time (48 hours) animals were sacrificed and myeloperoxidase activity together with tissue wet/dry ratio in the lung parenchyma were assessed and compared. There was a statistically significant increase in the quantity of myeloperoxidase activity and tissue wet/dry ratio of lungs in the acute pancreatitis group when compared to the control group. Treatment of animals with antithrombin partly reduced the pulmonary injury characterized by increased tissue wet/dry ratio and myeloperoxidase activity. But this reduction was not found to be statistically significant. Beneficial effects of AT in preventing pulmonary injury following experimental models of sepsis and ischemia-reperfusion have been reported previously. In our model of experimental acute pancreatitis, AT showed some attenuating effect on pulmonary injury despite it was limited when compared to that of ischemiareperfusion and sepsis models. This result suggests that some other confounding factors may be involved in the mechanisms of pulmonary injury related to acute pancreatitis. We believe that further detailed studies are needed to elucidate the exact mechanisms of that injury.Akut pankreatitte gelişen akciğer hasarına Antitrombin III'ün etkisi araştırıldı. 30 adet rat üç gruba ayrıldı ( n=10). Grup I (Kontrol grubu): Laparotomi ve bilio-pankreatik kanal hazırlığı yapıldı. Grup II (Akut pankreatit grubu):Bilio-pankreatik kanal bağlanarak akut pankreatit ve akciğer hasarı oluşturuldu. Grup III (Tedavi grubu): Bilio-pankreatik kanal bağlandı ve Antitrombin III verilerek akciğer dokusunun ıslak/kuru ağırlık oranı ve miyeloperoksidaz aktivitesindeki değişimler ölçüldü. Grup II ve III de miyeloperoksidaz aktivitesi ve ıslak/kuru ağırlık oranındaki artış kontrol grubuna göre anlamlı derecede yüksek saptandı (p<0.0001). Grup III de miyeloperoksidaz ve ıslak/kuru oranında azalma görüldü. Fakat bu değişim istatistiksel olarak anlamlı bulunmadı. Literatürde deneysel iskemi-reperfüzyon ve sepsis modellerinde gelişen akciğer hasarı üzerine olumlu etkileri bildirilen Antitrombin III'ün, çalışmamızda oluşturulan pankreatite bağlı akciğer hasarını kısmen azalttığı, fakat bu etkinin iskemi-reperfüzyon ve sepsis modellerine göre çok daha sınırlı kaldığı görülmektedir. Bu da pankreatite bağlı akciğer hasarının oluşum mekanizmasında etkili başka faktörlerin olabileceğini düşündürmektedir. Bu konuda altta yatan mekanizmaları aydınlatmak için ileri çalışmalara ihtiyaç vardır

Lumbar single-level dynamic stabilization with semi-rigid and full dynamic systems: A retrospective clinical and radiological analysis of 71 patients

WOS: 000411033200008PubMed ID: 28861198Background: This study compares the clinical and radiological results of three most commonly used dynamic stabilization systems in the field of orthopedic surgery. Methods: A total of 71 patients underwent single-level posterior transpedicular dynamic stabilization between 2011 and 2014 due to lumbar degenerative disc disease. Three different dynamic systems used include: (1) the Dynesys system; (2) a dynamic screw with a PEEK rod; and (3) a full dynamic system (a dynamic screw with a dynamic rod; BalanC). The mean patient age was 45.8 years. The mean follow-up was 29.7 months. Clinical and radiological data were obtained for each patient preoperatively and at 6, 12, and 24 months of follow-up. Results: Clinical outcomes were significantly improved in all patients. There were no significant differences in the radiological outcomes among the groups divided according to the system used. Screw loosening was detected in 2 patients, and 1 patient developed screw breakage. All patients with screw loosening or breakage underwent revision surgery. Conclusions: Each procedure offered satisfactory outcome regardless of which system was applied

Complications of 2-level dynamic stabilization: A correlative clinical and radiological analysis at two-year follow-up on 103 patients

WOS: 000443444000010PubMed ID: 30192368AIM: To investigate the postoperative complications, such as screw loosening, screw breakage and adjacent segment disease (ASD), in patients who underwent surgery with 2-level dynamic stabilization systems. MATERIAL and METHODS: Postoperative complications, clinical improvements and radiological parameters in patients who underwent surgery using a dynamic system for 2-level lumbar stabilization were retrospectively reviewed. A total of 103 patients with lumbar degenerative spinal instability underwent 2-level dynamic stabilization. Clinical findings were reviewed at 2-year follow-up. Screw breakage and loosening were evaluated during this duration together with clinical findings. RESULTS: Visual analog scale (VAS) and Oswestry Disability Index (ODI) scores were significantly decreased at the four-month evaluation, and they were also decreased at the 1-year follow up and at the 24th postoperative month. ASD was diagnosed in twelve (8 females, 4 males) of the 103 patients in the follow-up radiological and clinical controls. There were 9 screw breakages and 4 screw loosening cases. The complication rate of 2-level dynamic stabilization was high in this study. CONCLUSION: Our results showed that complications (screw loosening or breakage and adjacent segment disease) are not rare after 2-level dynamic stabilization, unlike the acceptable results with the single-level dynamic system. The most probable explanation is that the instrument system behaves more rigidly with every additional segment