Paraoxonase and Arylesterase Activities, Lipid Profile, and Oxidative Damage in Experimental Ischemic Colitis Model

Objective. In the present study, since PON1 is known as an HDL-associated antioxidant enzyme that inhibits the oxidative modification of LDL and oxidative stress plays a role in the pathogenesis of mesenteric ischemia, we investigated the changes in PON1 activity and lipid profile in an experimental ischemic colitis model. Methods. Forty male Wistar albino rats were divided into two groups: the control group (N = 15) and the experimental group (N = 25). All animals were anesthetized with ether and ketamine anesthesia to undergo a midline laparotomy. Ischemic colitis was induced by marginal vessel ligation in the splenic flexura (devascularization process). A sham laparotomy was performed in the control group. All animals were sacrificed on the seventh postoperative day. Oxidative stress marker (malonyldialdehyde, MDA), lipid profile, and paraoxonase (PON-1) and arylesterase activities were determined. Histopathological evaluation was done under light microscopy, after sectioning and staining with hematoxyline and eosin. Statistical analysis was conducted using Student's t-test and Mann-Whitney U test, and P 0.05).Conclusions. PON1 and arylesterase play an important role in the pathophysiology of ischemic colitis

The outcome of kidney transplants with multiple renal arteries

BACKGROUND: The use of grafts with multiple renal arteries has been considered a relative contraindication because of the increased incidence of vascular and urologic complications The aim of this study is to determine whether the kidney grafts with multiple arteries have any adverse effect upon post-transplant graft and patient survival. METHODS: We reviewed the records of 225 adult kidney transplants done consecutively at our institution. Twenty-nine patients (12.8%) had grafts with multiple renal arteries. We analyzed the incidence of post-transplant hypertension and vascular complications, mean creatinine levels, patient and graft survival. In 17 cases reconstruction was done as conjoined anastomosis between two arteries of equal size, and in 6 cases as end-to-side anastomosis of smaller arteries to larger arteries. Multiple anastomoses were performed in 6 cases. RESULTS: In one patient postoperative bleeding occurred. Mean systolic blood pressures, creatinine levels at first year and last follow-up and complication rates were all in acceptable ranges. There was no significant difference in graft and patient survival between multiple and single renal artery allografts. CONCLUSION: Although the kidney grafts with multiple renal arteries have been considered a relative contraindication because of the increased risk of complications, in our study allografts with multiple arteries were used successfully in kidney transplantation

Does the Change in the Indications of Endoscopic Sinonasal Surgery Continue? Data between 1994-2018

Objective: Endoscopic sinonasal surgery (ESS) has changing over the years in parallel with the developments in endoscopy devices, video-imaging techniques, and surgical instruments. In the present study we investigated whether the indications of patients who underwent surgery over a period of 25 years have accommodated to these changes.Methods: We retrospectively evaluated 1173 patients who underwent surgery in our clinic from 1994 through 2007, and 954 patients who underwent surgery from 2008 through 2018. The patients were divided into three groups as follows: chronic rhinosinusitis with polyps (CRSwNP), chronic rhinosinusitis without polyps (CRSsNP), and others. The changes in the indications during the first 14 years and the following 11 years were compared, and the results were statistically evaluated.Results: A significant decrease was observed in the number of patients who underwent surgery following the diagnosis of CRSsNP (p<0.001). In addition, a statistically significant increase was found in CRSwNP (p<0.001) and other (p<0.001) indications.Conclusion: When ESS indications identified in our clinic were reviewed, it was observed that the increasing trend in CRSwNP rate in the first 14 years continued, there was a significant increase in non-CRS indications in the last 11 years, and there has been an increase in patients with fungal sinusitis, especially in this group

The Priority Structure of Bank Regulatory Capital: The Case of Subordinated Debt

The aftermath of a crisis often brings reflections on the adequacy of regulatory capital against financial shocks. Accordingly, succeeding regulatory interventions focus on strengthening the resilience of the banking system by improving the quality and quantity of capital, and subordinated debt (sub-debt) remains key to these reforms. Whether, however, the regulatory motive underpins the decision of banks to issue sub-debt is unclear. Moreover, the perceptions of shareholders on the regulatory function of sub-debt are less understood. This thesis attempts to answer these questions by first reviewing other roles of sub-debt then testing if regulation drives its issuance and finally revealing shareholder incentives that weaken its regulatory function. Contrasting capital requirement motives with other explanations, and accounting for equity issuance, we find that banks issue sub-debt primarily to improve their regulatory capital buffer. While a few non-regulatory factors, related to easier entry conditions to debt market, influence the issuance decision, their economic impact is smaller than the impact of the buffer. By exploring how variations in tail risk and size influence the sub-debt and equity issuance decisions by banks with low buffers, we show that issuance choices do not reflect risk-shifting incentives. Next, we review shareholders’ perceptions of the regulatory value of sub-debt vis-a-vis the risk-shifting and wealth-expropriation incentives associated with senior debt by comparing the reaction of stocks to these security announcements. We find that senior debt incentives are more valuable than the regulatory benefit of sub-debt. Contrary to regulatory expectations, announcement of sub-debt (capital-improving) offers are valueless even when undertaken by risky or less-capitalized banks; rather, senior debt offered by these vulnerable banks generate significant shareholder value. Pursuant to these risk-shifting motives, senior debt issuers get riskier post-issuance. These findings suggest that the broader debt priority structure harbours perverse incentives that dilute the regulatory effectiveness of sub-debt

Laboratuvardan Kliniğe Transplantasyon Pratiği

Transplantasyon; Temel Tıbbi Bilimler, Moleküler Tıp, Genetik ve İmmünolojiden klinik uygulamalardan destek alan multidisipliner bir tıp dalıdır. Temel bilimlerdeki başarılı çalışmaların kliniğe uygulanması, klinikte karşılaşılan sorunların da, oluşturulan deneysel hayvan modellerinde irdelenmesi, elde edilen bilgilerin klinik uygulamalara aktarılması; diğer deyişle tecrübelerin “Translational” özellikli olması günümüz transplantasyon çalışmalarında bir gerekliliktir. İmmün sistemin bileşenlerinin ve reaksiyonlarının iyi bilinmesi, hücreler arası ilişkilerde greftin reddi ya da kabul edilmesinin şartlarını doğru anlamak ve uygun laboratuvar yöntemleri ile klinik durumun aydınlatılması transplantasyonda stratejik önemdedir. Bu nedenle, klinik transplantasyon çalışmaları yapanlar temel bilimler bilgileri ile de donanımlı olmalıdırlar. Multidisipliner bir dal olma bilinci ile yapılan klinik transplantasyon çalışmalarında başarı yakalanmaktadır. Laboratuvardan Kliniğe Transplantasyon kitabımızda tüm yönleri ile transplantasyonun organizmaya etkileri ve bunların klinik sonuçlarını, çalışmalarımızın ışığında sunmayı ve tartışmayı hedefledik. Editör: Prof.Dr. Mesut İzzet TİTİZ Yardımcı Editör: Doç.Dr. Pınar AT

Mortal bilateral psoas abscess caused by urogenital infection in geriatric age

Psoas apsesi nadir rastlanan, tanısı zor ve geç konulan bir durumdur. Primer ve sekonder olarak sınıflandırılır. Erişkin hastalarda üriner sistem enfeksiyonlarına sekonder psoas apsesi gelişmesi nadir bir durumdur. Olgumuz 79 yaşında erkek hasta, ürosepsis tanısıyla yatırıldı. Uygun antibiyotik tedavisine rağmen genel düşkünlük hali, hipotansiyon ve ateş kliniği devam etti. Çekilen batın bilgisayarlı tomografide bilateral iliopsoas kasında retroperitoneal alana kadar uzanım gösteren apseler izlendi. İliopsoas apselerine perkütan yolla drenaj kateteri yerleştirildi. Kontrol tomografide batın içinde yaygın kistik-apse odakları saptandı. Cerrahi drenaj için hazırlanırken gelişen ani kardiak arrest nedeniyle hasta exitus oldu. Psoas apsesi özgün olmayan klinik bulguları ve nadir görülen bir durum olması nedeniyle tanısı geciken, yanlış tanılar ile mortalite oranı yükselen ve apse drenajı yapılmayan vakalarda mortalite oranı %100'e ulaşan bir durumdur.Psoas abscess (PA) is a rare condition which is difficult to diagnose, so its diagnosis may be delayed. It is classified as primary and secondary psoas abscess. In adult patients, PA caused by urinary tract infections is a rare entity. Our case, a 79 year old male patient was hospitalized with a diagnosis of urosepsis. In his follow-up despite the appropriate antibiotic therapy the symptoms of fever, hypotension and general weakness persisted. Abdominal computed tomography, showed bilateral iliopsoas muscle abscesses extending to the retroperitoneal area. Percutaneous drainage catheters were inserted into iliopsoas abscesses. Control computed tomography revealed disseminated cystic-abscess centers in the abdomen. During preoperative management for surgical drainage of abscesses, the patient died due to a sudden cardiac arrest. Psoas abcesess is an entity, with delayed diagnosis because of its nonspecific clinical features and infrequency. Its mortality rate is high due to misdiagnosis and may even reach upto 100% in the absence of abscess drainage

Yoğun bakim ünitesindeki hastane enfeksiyonlu geriatrik ve non-geriatrik hastalarda, anemi ve eritrosit transfüzyonunun mortaliteye etkisi

Introduction: This study aimed to investigate the effects of anemia and red blood cell transfusion on the risk of mortality in geriatric and non-geriatric Intensive Care Unit patients with Hospital- Acquired Infection. Materials and Method: This study included 546 patients aged ?18 years, from these, 112 patients had Hospital-Acquired Infection. Results: Among the patients aged ?65 years with Hospital-Acquired Infection who were treated in the medical Intensive Care Unit, the risk of mortality was significantly increased in patients with anemia or history of diabetes, in patients who were intubated or in patients with neurological disorders or respiratory failure. Although the abovementioned factors increased the risk of mortality in the elderly, the same relationship was not observed in patients aged<65 years. In addition, blood transfusion did not increase the risk of mortality in patients belonging to both the age groups. Conclusion: We conclude that in geriatric Intensive Care Unit patients with Hospital-Acquired Infection, anemia increases the risk of mortality but red cell transfusion does not affect the risk of mortality. © 2015, Geriatrics Society. All rights reserved