The effect of early tranexamic acid administration on hemoglobin levels after unstable pelvic fracture: An experimental study in rats

Aim: To investigate the effect of early systemic tranexamic acid (TRA) administration on hemoglobin (Hb) levels in rats with pelvic fracture. Method: In our study, 30 Wistar Albino rats were randomly divided into 3 groups in equal numbers and their hemoglobin levels were measured by taking blood samples from each. No trauma was applied to the first group and it was taken as the main control group of the study. Closed bilateral unstable pelvic fractures were created in all rats in groups 2 and 3. Fracture creation time is considered as minute 0. 10 minutes after the fracture was formed, TRA was given to the 1st group, TRA to the 2nd group and saline solution to the 3rd group systemically. Hemoglobin levels were measured by taking blood samples from all rats at 30th minute and 24th hour. The initial Hb values ​​obtained were normalized to 100 and the percentages of 30th minute and 24th hour values ​​were calculated. The initial, 30th minute and 24th hour values ​​of all groups were compared statistically with each other. The 30th minute and 24th hour values ​​were compared statistically between the groups. Results: No death was observed within 24 hours in all three groups. When the first Hb values ​​of each group are normalized to 100, the mean Hb percentages were calculated in the first group as 99.54 and 99.84 at 30 minutes and 24 hour, respectively; 92.95 and 87.73 in the second group; and 87.95 and 73.16 in the third group. When these values ​​obtained were compared statistically within the groups (initial, 30th minute, 24th hour Hb percentages), there was no significant difference between the initial, 30th minute and 24th hour values ​​in group 1. However, a statistically significant difference was found between the initial, 30th minute and 24th hour values ​​in group 2 and 3 (p<0.01). In the comparison between the groups, a statistically significant difference was found between group 1-2, group 1-3 and group 2-3 between both 30th minute and 24th hour values (p<0.01). Conclusion: In rats with bilateral unstable pelvic fractures due to blunt pelvis trauma, early administration of TRA after trauma significantly reduced the first 24-hour decrease in Hb value. Our study supports the early and prehospital use of TRA in traumas that are predicted to progress with acute bleeding, such as unstable pelvic fractures

Is combined therapy more effective than growth hormone or hyperbaric oxygen alone in the healing of left ischemic and non-ischemic colonic anastomoses?

OBJECTIVE: Our aim was to investigate the effects of growth hormone (GH), hyperbaric oxygen and combined therapy on normal and ischemic colonic anastomoses in rats. METHODS: Eighty male Wistar rats were divided into eight groups (n = 10). In the first four groups, non-ischemic colonic anastomosis was performed, whereas in the remaining four groups, ischemic colonic anastomosis was performed. In groups 5, 6, 7, and 8, colonic ischemia was established by ligating 2 cm of the mesocolon on either side of the anastomosis. The control groups (1 and 5) received no treatment. Hyperbaric oxygen therapy was initiated immediately after surgery and continued for 4 days in groups 3 and 4. Groups 2 and 6 received recombinant human growth hormone, whereas groups 4 and 8 received GH and hyperbaric oxygen treatment. Relaparotomy was performed on postoperative day 4, and a perianastomotic colon segment 2 cm in length was excised for the detection of biochemical and mechanical parameters of anastomotic healing and histopathological evaluation. RESULTS: Combined treatment with hyperbaric oxygen and GH increased the mean bursting pressure values in all of the groups, and a statistically significant increase was noted in the ischemic groups compared to the controls (

Testicular Polyarteritis Nodosa Mimicking Testicular Neoplasm

Polyarteritis nodosa (PAN) presents mostly as a systemic disease characterized by necrotizing vasculitis affecting small- and medium-sized arteries. Rarely, the inflammatory process is isolated and involves a single organ without systemic manifestations. We described the case of a 57-year-old patient with isolated testicular PAN who presented with a testicular mass mimicking a primary testicular tumor

Clinical Study Laparoscopic Treatment of Adrenal Tumors: A Single-Center Experience with 58 Patients

Background. The aim of this study is to discuss the laparoscopic approach and assess the immunohistochemical expression profiles of synaptophysin, Ki-67, and inhibin and patient outcomes in adrenal masses through a series of cases treated at our institution. Method. The study was conducted on 58 patients who were diagnosed with adrenal masses. All cases were operated on laparoscopically for adrenal masses. Results. Both inhibin and synaptophysin were found positive in 45 patients (77,6%). Ki-67 was negative in 11 patients, whereas it was found positive in 42 with a rate of 1%. The size of the masses ranged from 1 up to 9 cm (mean 4,3 ± 1,5). Urine hormone excretion was measured within normal ranges in 47 out of 58 patients (81%). Most of the diagnosed patients were harboring Cortical Adenoma ( : 38; 65,5%). All of the masses were successfully resected without complication except 3 patients. Because of complications of bleeding, the operation was converted to open surgery for 2 patients. Conclusion. Morbidity, mortality, and healing were comparable, regardless of tumor size, yet involvement in both laparoscopic and adrenal surgery was required. Our results suggested that laparoscopic adrenalectomy should replace open surgery as the standard treatment for most adrenal masses

Molecular cloning and biotic elicitation response of phenylalanine ammonia-lyase gene of Astragalus chrysochlorus.

Phenylalanine ammonia lyase (PAL) is the first enzyme of the phenylpropanoid pathway, and it is necessary to upregulate flavonoid biosynthesis in most of the plant species. In this study, we have cloned PAL gene from endemic Astragalus chrysochlorus which is a producer of phenolic nicotiflorin (kaempferol-3-O-rutinoside). The cDNA encoding PAL was cloned from A. chrysochlorus using RT-PCR (reverse transcription-polymerase chain reaction) with conserved primer pairs. Amino acid sequence alignments showed that AcPAL (2160 bp, Accession number: KM189182) has more than 95% amino acid identity with their homologues in other Astragalus species. The coding sequence for the protein of AcPAL is 720 amino acids with a calculated molecular weight of 78.53 kDa. Full length AcPAL was cloned and expressed in Escherichia coli. qPCR (quantitative real-time PCR) analysis of the expression of PAL gene of A. chrysochlorus suggested that maximum transcript level was observed in 3 h yeast extract elicited suspension cells. Our findings suggest that AcPAL plays role in early response for yeast extract treatment. The isolation of AcPAL gene could be result in further studies for overproduction of secondary metabolite, nicotiflorin

Prospective Randomized Trial to Determine Whether Inhalational Anesthetics Have Any Effects on Hearing Function

WOS: 000273634500012PubMed: 19755091Objective: The purpose of this study was to investigate and compare the effects of inhalation anesthetics (sevoflurane and isoflurane) on hearing function by using an audiometric test battery. Design: A prospective, randomized, double-blind, clinical trial. Setting: University hospital. Patients: Fifty-three adult patients (American Society of Anesthesiologists I-II) scheduled for sinonasal surgery with intratracheal general anesthesia were enrolled in the study. The patients were premedicated with diazepam intramuscularly. Propofol 2 mg/kg (Diprivan, AstraZeneca, Wilmington, DE) was given intravenously (IV) for induction of general anesthesia. After endotracheal intubation with vecuronium IV (1 mg/kg), in group 1 (n = 27) sevoflurane 2% and in group 2 (n = 26) isoflurane 1.2% were used to maintain general anesthesia. All patients received nitrous oxide during maintenance. Main Outcome Measures: The patients' hearing function was measured before anesthesia and 24 hours after surgery by means of pure-tone audiometry, high-frequency pure-tone audiometry, and transient evoked otoacoustic emissions (TEOAEs) by the same clinician. Results: There were no statistically significant differences between the demographic data and the hemodynamic and respiratory parameters of the groups. No significant differences were found between groups in hearing thresholds of conventional pure-tone audiometry and extended high frequency (p > .05). For TEOAE responses, no statistically significant differences were determined between pre- and postoperative measurements (p > .05). Conclusion: It was audiometrically demonstrated that general anesthesia did not affect the hearing function in any of the patients undergoing sinonasal surgery. These findings encourage the use of sevoflurane or isoflurane as a safe agent without any ototoxic effects in otorhinolaryngologic surgery with general anesthesia