Investigating of the effects of iloprost?s over lung injury caused by reperfusion which develops on lower limp experimental ischaemia/reperfusion model

Tıpta Uzmanlık TeziBu deneysel çalışmada, sıçan infrarenal abdominal aortunda oklüzyon-reperfüzyon sonrası akciğerlerde oluşan iskemi-reperfüzyon hasarı üzerine iloprostun etkisi araştırıldı. 24 adet Sprague Dawley cinsi dişi sıçan randomize olarak, eşit sayıda (n=8) dört gruba ayrıldı. Kontrol grubuna median laporotomi ve diseksiyon uygulandı. Diğer gruplara uygulanan toplam deney süresi sonunda total bilateral pulmonektomi uygulandı. İskemi-reperfüzyon grubuna median laporotomi ardından infrarenal aortaya mikrovasküler klemp konularak 60 dakika iskemi oluşturuldu, ardından klemp kaldırılarak 120 dakika reperfüzyon uygulandı. Reperfüzyon süresinin sonunda total bilateral pulmonektomi yapıldı. İloprost grubuna, iskemi-reperfüzyon grubuna ek olarak klemp kaldırılmadan 15 dakika önce iloprost 0,45 µg/kg/h infüzyonu başlandı ve reperfüzyon süresince devam edildi. Reperfüzyon süresinin sonunda total bilateral pulmonektomi yapıldı. Akciğer dokuları formaldehit ile fikse edildi. Ardından kesitler hazırlanarak Hematoksilen-Eozin ile boyandı. Preparatlar ışık mikroskobunda değerlendirildi. Histopatolojik incelemede, kontrol grubu ile iskemi-reperfüzyon grubu arasında ve iskemi-reperfüzyon grubu ile iskemi-reperfüzyon +iloprost grubu arasında, iloprost lehine anlamlı patolojik değişiklik tespit edildi. Sonuç olarak çalışmamızda, iloprostun vazodilatatör, trombosit adezyon ve agregasyon inhibisyonu, nötrofil aktivasyon ve akümülasyon inhibisyonu ile inflamatuar sitokinlerin inhibisyonu etkileri ile mikrosirkülasyonu koruyarak akut alt ekstremite iskemilerinde reperfüzyon sonrası akciğerde gelişecek hasarı azaltabileceği düşüncesindeyiz.AbstractIn this experimental study, we investigated the effect of iloprost on ischaemia-reperfusion injury in lung occuring in rats after occlusion-reperfusion of infrarenal abdominal aorta. Spraque-Dawley female rats(28 pieces) were randomly divided into three groups (n=8). Median laporotomy and dissection were performed on control group. Totally bilateral pneumonectomy operation were performed on rats in other groups at the end of the total experimental period. In group of ischaemia/reperfusion, micro vascular clamps were put on infrarenal aorta and after 60 minutes of ischaemia period, 120 minutes of reperfusion was applied. Unlike ischaemia/reperfusion group, 0,45 µg/kg/h iloprost infusion was started 15 minutes before the clamp was removed and was continued during reperfusion in ischaemia/reperfusion+iloprost group. Totally bilateral pulmoectomia was performed at the end of the reperfusion period. Pulmonary tissues were fixed with formaldehyde. Then pulmonary tissue samples were prepaired and stained with hematoxylin-eosin. Samples were examined by light microscopy. Significant pathological alterations were found between ischaemia and reperfusion group - control group and between ischaemia and reperfusion group - ischaemia and reperfusion + iloprost group as the benefit of iloprost. As a result, regarding our study; iloprost defends microcirculation and lung, with vasodilatory effect, inhibition of platelet adhesion and aggregation effect, inhibition of neutrophil activation and acculumation effect and inhibition of inflammatory cytokine effect. We consider, that it may reduce the injury which might occur in lung, following the reperfusion in the acute lower extremity ischaemias

Primary School Students’ Conditions that Using of School Librarys and Class Bookshelves (Erzurum City Sampling)

Okuma, bireyin insanlarla iletişim kurmasını, bilgiye ulaşmasını ve hayatına yön verebilmesini sağlayan temel araçlardan biridir. Okuma alışkanlığı ve kitap sevgisinin kazanılmasında, dikkat edilmesi gereken gelişim dönemleri ilk ve orta öğrenimdir. Resmi ve özel kurumlarda, kültürel gelişimi destekleme, bireysel okuma gereksinimlerine cevap verme, okuma alışkanlığını yaratma ve alışkanlık haline getirme, kitabı ve kütüphaneyi kullanmayı öğretme gibi amaçlarla kütüphane ve kitaplıklar oluşturulur. Bu çalışmada, ilköğretim sınıf kitaplıkları ve okul kütüphanelerinin durumunu ve öğ- rencilerin kütüphaneleri kullanma düzeylerini tespit etme amaçlanmıştırReading is one of the basic means that enables the individuals to communicate with people, reach people and shape his/her life. In the gaining of reading habit and sympathy for the books, the degree development that should be best regarded are primary and secondary terms. In formal and private associations, the libraries and the bookshelves are made up with the aim of teaching the use of the book and the library in order to support the cultural development, respond to individual reading needs, create reading habit and change it into a habit. In our study, it has been aimed to find out primary school bookshelves and the condition of the of the libraries and students’ use level of the libraries

Effects of 2-arylbenzimidazoles on rat hepatic microsomal monooxygenase system

1. The effects of eight newly synthesized 2-aryl substituted benzimidazole derivatives on control and phenobarbital (PB) treated rat liver microsomal aniline 4-hydroxylase and ethylmorphine N-demethylase activities, and their binding to control and PB-treated rat liver microsomal oxidized cytochrome P-450 are presented. 2. All compounds inhibited ethylmorphine N-demethylase activity with I50 values ranging from 8.50 × 10−4 M to 27.83 × 10−4 M in control and ranging from 2.80 × 10−4 M to 15.79 × 10−4 M in PB-treated rats. 3. Aniline 4-hydroxylase activity was inhibited by all of the compounds tested having I50 values in the range of 7.04 × 10−4 M-31.37 × 10−4 M in PB-treated rats, but only five of the compounds showed inhibitory activity in control rats. 4. Only a few significant regression coefficients could be found between the parameters of the chemicals studied and their inhibitory patterns. 5. No correlation has been observed between the binding of the derivatives and their inhibitory pattern.Publisher's Versio

Body mass index as a determinant of postoperative morbidity

BACKGROUND: The impact of obesity on postoperative mortality and morbidity in coronary artery bypass grafting (CABG) operations is a widely studied but poorly defined topic. OBJECTIVE: To investigate the effect of body mass index (BMI) on in-hospital mortality and morbidity after isolated CABG surgery. METHODS: Prospectively collected data of a series of 1057 consecutive patients who underwent on-pump isolated CABG surgery were retrospectively analyzed. Patients were divided into five groups according to WHO BMI categorization (defined as underweight [BMI = 20 kg/m(2) to = 25 kg/m(2) to = 30 kg/m(2) to = 35 kg/m(2)]). RESULTS: Of 1057 patients, 13 patients (1.2%) were underweight, 298 (28.2%) were normal weight, 462 (43.7%) were overweight, 218 (20.6%) were obese and 66 (6.2%) were morbidly obese. The mean age was significantly lower in underweight patients, who were also more likely to be male. In contrast, obese and morbidly obese patients were older, and more likely to have comorbidities such as diabetes and hypertension. The incidence of postoperative bronchodilator use (P<0.001), leg wound infection (P=0.038), sternal dehiscence (P=0.039) and development of new-onset atrial fibrillation (P<0.001) was significantly higher in obese and morbidly obese groups. In contrast, postoperative prolonged ventilation (P<0.001), need for blood transfusions (P<0.001) and revision for bleeding (P=0.041), as well as gastrointestinal complications (P<0.001), were significantly higher in underweight patients. Multivariate logistic regression analysis showed that not BMI but female sex, older age and diabetes mellitis were independent risk factors for early mortality after CABG surgery. CONCLUSION: No effect of BMI on early postoperative mortality after CABG surgery could be demonstrated. However, in terms of morbidity, postoperative bleeding and revision for bleeding were increased in underweight patients while sternal dehiscence, wound infections and occurrence of atrial fibrillation were increased in obese and morbidly obese patients

Investigation the effects of cilostazol and rosuvastatin on kidney and heart: An experimental acute kidney and heart injury model

Amaç: Bu çalışmada, deneysel bir modelde ameliyat öncesi silostazol ve rosuvastatin tedavisinin böbrek iskemi/reperfüzyon hasarına olan etkisi ve uzak kalp reperfüzyon hasarı üzerine olan etkisi araştırıldı.Ça lış ma pla nı: Toplam 35 adet dişi Sprague-Dawley sıçan rastgele beş gruba ayrıldı (n=7). Median laparotomi yapılarak, her iki böbreğe 45 dakika süren iskemi uygulandı. Cerrahi girişimin üç gün öncesinden başlayarak oral tedavi uygulandı (20 mg/kg silostazol, 10 mg/kg rosuvastatin ve 20 mg/kg cilostazol + 10 mg/kg rosuvastatin). Cerrahi girişimden bir gün sonra ise kan örnekleri ve böbrek ve kalp doku örnekleri alındı.Bul gu lar: değerlendirmesinde tümör nekroz faktör-alfa ve hipoksi ile indüklenebilir faktör-1 alfa immünreaktivitesinin silostazol, rosuvastatin ve silostazol + rosuvastatin grubunda, iskemi/reperfüzyon hasarı grubuna kıyasla anlamlı düzeyde daha düşük olduğu tespit edildi (p<0.05). Kalp dokularının immünhistokimyasal değerlendirmesinde tümör nekroz faktör-alfa immünreaktivitesi, iskemi/reperfüzyon hasarı grubuna kıyasla silostazol grubunda anlamlı düzeyde daha düşüktü. Hipoksi ile indüklenebilir faktör-1 alfa immünreaktivitesi, silostazol, rosuvastatin ve silostazol + rosuvastatin grubunda, iskemi/reperfüzyon hasarı grubuna kıyasla, anlamlı düzeyde daha düşüktü (p<0.05). İskemi/reperfüzyon hasarı grubuna kıyasla, silostazol, rosuvastatin ve silostazol + rosuvastatin grubunda, serum üre, kreatinin, kreatin kinaz-kas ve beyin ve troponin düzeyleri anlamlı düzeyde daha düşüktü (p<0.05).So nuç: Silostazol ve rosuvastatinin böbrek iskemi/reperfüzyon ve uzak kardiyak reperfüzyon hasarı üzerinde koruyucu etkileri olmakla birlikte, bu etki kombine tedaviye kıyasla silostazol tedavisi ile artabilir.Background: In this study, we aimed to assess the effects of preoperative cilostazol and rosuvastatin therapy on kidney ischemia/reperfusion injury and remote cardiac reperfusion injury in an experimental model.Methods: A total of 35 female Sprague-Dawley rats were randomly divided into five groups (n=7). Median laparotomy and a 45-min bilateral kidney ischemia were performed. Oral medications were administered three days before the surgical intervention (20 mg/kg cilostazol, 10 mg/kg rosuvastatin and 20 mg/kg cilostazol + 10 mg/kg rosuvastatin). Blood samples and kidney and heart tissue samples were extracted one day after surgery.Results: Immunohistochemical examination of the kidney samples revealed that tumor necrosis factor-alpha and hypoxia-inducible factor-1 alpha immunoreactivities in the cilostazol, rosuvastatin, and cilostazol + rosuvastatin groups were found to be significantly lower, compared to ischemia/reperfusion injury group (p&lt;0.05). Immunohistochemical examination of the heart samples revealed that tumor necrosis factor-alpha immunoreactivity was significantly lower in the cilostazol group, compared to ischemia/reperfusion injury group. Hypoxia-inducible factor-1 alpha immunoreactivities were significantly lower in the cilostazol, rosuvastatin, and cilostazol + rosuvastatin groups, compared to ischemia/reperfusion injury group (p&lt;0.05). Serum urea, creatinine, creatine kinasemuscle and brain, and troponin levels were significantly lower in the cilostazol, rosuvastatin, and cilostazol + rosuvastatin groups, compared to ischemia/reperfusion injury group (p&lt;0.05).Conclusion: Cilostazol and rosuvastatin have protective effects on kidney ischemia/reperfusion and remote cardiac reperfusion injury, and the protective effect can be augmented with cilostazol monotherapy, compared to combined therapy

The impact of body mass index on mortality and morbidity in patients undergoing isolated valve surgery

Background: This study aims to investigate the impact of body mass index (BMI) on early mortality and morbidity in patients undergoing isolated valve surgery. Methods: Between January 2004 and December 2012, medical records of 196 patients (115 males, 81 females; mean age 62.0 years; range 28 to 81 years) who underwent isolated valve surgery in our clinic with prospective follow-up data were retrospectively analyzed. The patients were divided into three groups according to their BMI values. Group 1 consisted of patients with a BMI = 25 kg/m(2) to = 30 kg/m(2). Obesity was defined as a BMI of >= 30 kg/m(2). Groups were compared in terms of morbidity parameters including bleeding, respiratory, renal, neurological and sternal complications and in-hospital mortality. Results: Increased BMI was associated with increased diabetes prevalence and use of bronchodilator. According to postoperative data, there was no significant difference in duration of extubation, postoperative renal functions, neurological complications such as stroke and transient ischemic attack, length of intensive care unit or hospital stay among three groups. Obese patients in group 3 had significantly higher rates of respiratory complications including re-intubation (p=0.011) and postoperative bronchodilator need (p=0.034), sternal dehiscence and sternal infections (p=0.023) and in-hospital mortality (p=0.021). The bleeding complications were significantly higher in group 1 (p=0.004). Conclusion: Our study results suggest that obesity results in increased 30-day mortality and several morbidity parameters such as respiratory and sternal complications in patients undergoing isolated valve surgery

Paratesticular Leiomyosarcoma Accompanying to Strangulated Inguinal Hernia

Sarcomas arising from spermatic cord are rare malignant tumors that constitute 2.1% of soft tissue sarcomas and that are seen in the genitourinary system at the rate of 1-2%. A 74-year-old male patient was admitted to our emergency unit with the complaints of inguinal pain and swelling going on for the last 3 days. In the physical examination, an approximately 5x5 cm hard non-reducible mass in the right inguinal region and right inguinal hernia were detected. The computed tomography revealed a large hernia sac in the right inguinal region and a 77x55 mm mass inside it. The patient was performed radical orchiectomy and hernia repair. In the pathological evaluation of the mass, the diagnosis of paratesticular leiomyosarcoma was established. Postoperative local recurrence or distant metastasis was not observed in the 7th month. In conclusion, although paratesticular leiomyosarcomas are rarely encountered, they should be kept in mind in the elderly patient group, especially with inguinal mas