Gastrointestinal quality of life in patients with asymptomatic cholelithiasis after laparoscopic cholecystectomy

To assess the outcome of laparoscopic cholecystectomy for asymptomatic cholelithiasis before and after laparoscopic cholecystectomy using a specific quality of life instrument for gastrointestinal disorders in adults : The Gastrointestinal Quality of Life Index (GIQLI) was used to study the quality of life in patients before and after laparoscopic cholecystectomy : Seventy one patients completed the GIQLI questionnaire both preoperatively and after a minimum postoperative follow-up of three months. Mean preoperative score was 126.8±14.07 out of a theoretical maximum score of 144.After three months, the score had significantly improved to 136.6±9.31, close to the range for the normal population. Not only items assessing gastrointestinal symptoms but also the domains of physical, social, and emotional function improved significantly. The most marked improvements were achieved in patients with the lowest preoperative scores. Laparoscopic cholecystectomy significantly improves the quality of life in patients with cholelithiasis who are asymptomatic or have nonspecific gastrointestinal symptoms that cannot be explained by another gastrointestinal pathology.Bu çalısmada asemptomatik kolelitiyazis olgularının ameliyat öncesi ve ameliyat sonrası hayat kalitesi degerlendirilmistir. Hastaların ameliyat öncesi ve sonrası hayat kalitelerinin ölçümü gastrointestinal hayat kalitesi indeksi parametreleri kullanılarak belirlenmistir. Çalısmaya alınan 71 hasta ameliyat öncesi ve ameliyattan en az 3 ay sonra gastrointestinal hayat kalitesi indeksine göre sorgulanmıstır. Preoperatif dönemde ortalama skor 126.8±14.07, 3 ay sonra yapılan sorgulamada ise ortalama 136.6±9.31 olup normal populasyona yakın bir oranda saptanmıstır. (toplam skor 144). Gastrointestinal semptomlarının yanı sıra fiziksel, sosyal ve duygusal durumlarında da anlamlı düzelme gözlenmistir.Düsük skorlu hastalarda bu iyilesmedaha belirgindir. Asemptomatik kolelitiyazisli hastalarda baska gastrointestinal patolojilerle açıklanamayan nonspesifik semptomların laparoskopik kolesistektomiyle iyilesme gösterdigi, hastaların hayat kalitelerinde anlamlı bir artıs oldugu görülmektedir

Hepatoprotective effects of B-1,3-(D)-Glucan on bortezomib-induced liver damage in rats

The aim of this study was to evaluate the effects of beta -1,3-(D)-glucan as an antioxidant and tissue protective agent and study the biochemical, histopathologic, and immunohistochemical effects of first therapeutic proteasome inhibitor bortezomib on the liver for treating relapsed multiple myeloma. The experiment included 36 adult male rats, which were divided into four treatment groups: control (healthy); bortezomib-treated; beta-1,3-D-glucan-treated; and bortezomib + beta-1,3-(D)-glucan-treated. Each group was subdivided into two subgroups based on time of sacrifice (48 or 72 h). After the experiments, superoxide dismutase (SOD) activity and lipid peroxidation (LPO) amounts were determined, and immunohistochemical and histopathological changes were examined in all rat liver tissues. beta -1,3-(D)-Glucan treatment normalized changes of LPO and stimulated an over activity of endogenous SOD. The results of the histopathologic parameters showed that treatment with beta -1,3-(D)-Glucan in the bortezomib group ameliorated the development of non-specific reactive hepatitis (NSRH) and Kupffer cell activation via NF-kB. Administration of beta -1,3-(D)-Glucan is effective in reversing tissue damage induced by bortezomib in rat livers.Bu çalışmanın amacı, relaps multiple miyelom tedavi etmek için kullanılan ilk terapötik proteazom inhibitörü olan bortezomibin karaciğer üzerine immunohistokimyasal, histopatolojik ve biyokimyasal etkilerini araştırmak ve bir antioksidant ve doku koruyucu ajan olarak B-1,3-(D)-glukanın etkilerini değerlendirmekdi. Deney; kontrol (sağlıklı), bortezomib ile tedavi, B-1,3-(D)-glukan ile tedavi ve bortezomib + B-1,3-(D)-glukan ile tedavi olmak üzere dört tedavi grubuna bölünen 36 yetişkin erkek sıçan içerdi. Her bir grup sakrifikasyon zamanına (48 veya 72 saat) göre iki alt gruba ayrıldı. Deneylerin bitiminden sonra, süperoksit dismutaz (SOD) aktivitesi ve lipid peroksidasyon (LPO) miktarları ölçüldü ve tüm sıçan karaciğer dokularında immünohistokimyasal ve histopatolojik değişiklikler incelendi. B-1,3-(D)-glukan ile tedavi LPO değişikliğini normalize etti ve endojen SOD aktivitesi aşırı uyardı. Histopatolojik parametrelerin sonuçları, bortezomib grubunda B-1,3-(D)-glukan ile tedavi NF-kB yoluyla Kupffer hücre aktivasyonunu ve non-spesifik reaktif hepatit (NSRH) gelişimini regüle ettiğini gösterdi. B-1,3-(D)-glukan uygulaması, sıçan karaciğerinde bortezomibin neden olduğu geri döndürülebilir doku hasarında efektifdir

The Protective Effect of Silymarin on Cholestatic Liver Injury

Introduction: Medical and surgical problems caused by obstructive jaundice is an important problem for surgeons and gastroenterologists. Silymarin prevents liver damage by maintaining the integrity of the plasma membrane. Purpose: The aim of this study was to evaluate whether silymarin administration would protect against cholestatic liver injury in rats with bile duct ligation. Methods: Thirty male Sprague-Dawley rats with a weight of 200-240 g were used in the study. They were randomly divided into three groups (n = 10 for each group): sham group only operated (Group I), control group was bile duct ligation (BDL) (Group II), and treatment group was IR+ BDL+silymarin (Group III) Silymarin 200 mg/kg/day was given by orally to the Silymarin group for 10 days. After 10 days, all rats were sacrificed, plasma and liver samples were obtained. Blood parameters were measured and tissue level of Glutathione (GSH), malondialdehyde (MDA) and copper/zinc superoxide dismutase (Cu / Zn SOD) were determined. The degree of portal inflammation, necrosis, vacuolar degeneration, sinusoidal dilatation, vascular congestion and fibrosis were evaluated histopathologically. Results: In the silymarin treated rats, MDA levels and liver tissue Cu-Zn SOD levels were significantly lower, while GSH levels were significantly higher than that of the BDL group (p = 0.001, p = 0.05, p = 0.001, respectively). In the BDL+silymarin group, the levels of LDH were significantly lower than that of the BDL group (p = 0.01). Conclusions: Our results supported indicate that silymarin exerts a protective and therapeutic effect on cholestatic liver injury in bile duct ligated rats

The effect of silymarin on hepatic regeneration after partial hepatectomy: is silymarin effective in hepatic regeneration?

Aim: Silymarin from Silybum marianum was found to reduce liver injury. The aim of the present study was to investigate the effects of silymarin on hepatic regeneration in partially hepatectomized rats. Methods: Thirty Wistar-Albino rats were divided into 3 groups of 10 animals as sham, control and experimental groups. In the sham group (n= 10) abdominal incision was closed after laparotomy. In the control group (n= 10), the rats underwent 70% hepatectomy after laparotomy. In the experimental group (n= 10) after partial 70% hepatectomy, silymarin (200 mg/kg/d) were given to rats for 10 days. Rats in three groups were sacrificed on 10 days. Aspartate (AST) and alanine transaminase (ALT), gamma glutamyl transferase (GGT), ALP, LDH and total bilirubin levels were measured using intracardiac blood samples. Tissue malondialdehyde (MDA) and tissue glutathion (GSH) and Superoxide dismutase (SOD) levels were measured. To reveal the increase in the mass of the remnant liver tissue in the control and experimental groups relative weight of the liver was calculated. Histopathological analysis of the liver was performed using a semi-quantitative scoring system. Results: A statistically significant difference among three groups was not shown for AST and ALT levels. A statistically significant difference was found between the groups as for total bilirubin and gamma glutamyl transferase levels. Increases in relative liver weights were seen with time in Groups 2 and 3. A statistically significant difference was not found for tissue malondialdehyde, Glutathion and Superoxide dismutase levels between hepatectomy and hepatectomy + silymarin groups. On liver tissue sections of the rats in the hepatectomy + silymarin group, increased regeneration and lipid peroxidation were observed accompanied by decreased antioxidant response. Conclusion: It has been observed that silymarin with many established functions such as antiproliferative, anti-inflammatory and energy antioxidant effects, does not contributed to proliferative regeneration of the liver-which has very important metabolic functions -after partial hepatectomy; instead it will decrease serum levels of transaminases

Protective role of heparin in the injury of the liver and kidney on the experimental model of ischemia/reperfusion

PubMed ID: 24533613Background: Surgery of thoracoabdominal aortic aneurysms (TAAA) is associated with high incidence of serious complications. Ischemia/reperfusion (I/R) injury may be responsible for these complications. We investigated the effect of degree of anticoagulation on remote organ I/R injuries and whether heparin is protective against I/R injury in addition to its anticoagulant properties.Methods: Spraque Dawley rats were used to determine both liver and kidney concentrations of HSP-70,IL-6, MPO in four groups: ischemic control (operation with cross-clamping and intraperitoneal administration of 0.9% saline, n = 7), sham (operation without cross-clamping, n = 7), heparin (ACT level about 200), and high dose heparin (ACT level up to 600). Histological analyses of the organs were performed.Results: Histopathological evaluation of kidney presented significant differences between groups with regards to the cytoplasmic vacuole formation, hemorrhage, tubular cell degeneration and tubular dilatation while heparinized group had best results. The kidney MPO and HSP-70 levels significantly decreased (p 0.05) in heparinized group when compared to ischemic control group. No statistically significant intergroup differences were detected in the tissue samples of liver. Immunohistochemical markers of the liver were compared and no statistically significant difference was found among the groups.Conclusion: Heparin is an important anticoagulation agent in TAAA surgical procedures but the use of higher levels of heparin in the present study revealed no beneficial effects. Bleeding complications is much less when heparin is used in the real-world clinical practice as ACT levels of 200. © 2014 Yener et al.; licensee BioMed Central Ltd

Real-world data on efficacy and safety of first-line alectinib treatment in advanced-stage, ALK-positive non-small-cell lung cancer patients: A Turkish Oncology Group study

Aims: In this multicenter study, the authors aimed to determine the real-life efficacy and safety of first-line alectinib. Materials & methods: This retrospective trial included advanced-stage, ALK-positive non-small-cell lung cancer patients who were treated with first-line alectinib in terms of ALK-tyrosine kinase inhibitors, regardless of previous chemotherapy. The co-primary end points were progression-free survival both for all patients and for the treatment-naive population. The secondary end points were overall response rate, overall survival, rate of CNS progression and safety. Results & conclusion: A total of 274 patients (n = 177 for treatment-naive patients) were enrolled in the study. The median progression-free survival was 26 and 28.8 months for all patients and the treatment-naive group, respectively. The overall response rate, CNS progression rate and 1-year overall survival ratio were 77.9, 12.4 and 77%. Alectinib is a highly effective therapy with a favorable safety profile