Evidence for Negative Effects of Elevated Intra-Abdominal Pressure on Pulmonary Mechanics and Oxidative Stress

Objective. To compare the effects of pneumoperitoneum on lung mechanics, end-tidal CO2 (ETCO2), arterial blood gases (ABG), and oxidative stress markers in blood and bronchoalveolar lavage fluid (BALF) during laparoscopic cholecystectomy (LC) by using lung-protective ventilation strategy. Materials and Methods. Forty-six patients undergoing LC and abdominal wall hernia (AWH) surgery were assigned into 2 groups. Measurements and blood samples were obtained before, during pneumoperitoneum, and at the end of surgery. BALF samples were obtained after anesthesia induction and at the end of surgery. Results. Peak inspiratory pressure, ETCO2, and pCO2 values at the 30th minute were significantly increased, while there was a significant decrease in dynamic lung compliance, pH, and pO2 values in LC group. In BALF samples, total oxidant status (TOS), arylesterase, paraoxonase, and malondialdehyde levels were significantly increased; the glutathione peroxidase levels were significantly decreased in LC group. The serum levels of TOS and paraoxonase were significantly higher at the end of surgery in LC group. In addition, arylesterase level in the 30th minute was increased compared to baseline. Serum paraoxonase level at the end of surgery was significantly increased when compared to AWH group. Conclusions. Our study showed negative effects of pneumoperitoneum in both lung and systemic levels despite lung-protective ventilation strategy

Biochemical Analysis of Germinal Membrane and Cyst Fluid by Raman Spectroscopy in Echinococcosis

Amaç: Hydatidosis, Echinococcus granulosus’un larva evresinin neden olduğu zoonotik paraziter bir enfeksiyondur. Çalışmada, karaciğer tutulumu olan hastaların cerrahi sırasında elde edilen germinal membran ve kist sıvılarının Raman spektroskopisi ile moleküler düzeyde biyokimyasal yapılarının incelenmesi amaçlanmıştır. Yöntemler: Çalışmada, germinal membran ve kist sıvılarının mitokondriyal gen bölgesine göre moleküler karakterizasyonları belirlenmiş ve filogenetik analizleri yapılmıştır. Örneklerde Raman spektroskopisi kullanılarak 300-1800 cm-1 arasındaki spektral bantlar incelenmiştir. Bulgular: PZR analizleri sonucunda hastalardan elde edilen germinal membranlarda ve kist sıvılarında yaklaşık 400 bç büyüklüğünde DNA bandı elde edilmiştir. Germinal membranda 780, 880, 970, 1151, 1200, 1270 cm-1’de, kist sıvısında 780 ve 1200 cm-1’de farklı pikler gözlenmiştir. 1333-1335 cm-1’de elde edilen en şiddetli spektral bantların CH3CH2 kollajen ve polinükleotit zincirini gösteren modlar olduğu belirlenmiştir. Bu ise, E. granulosus’un moleküler düzeyde biyokimyasal yapısını gösteren spesifik pik olarak değerlendirilmiştir. Sonuç: Mikroorganizmaların tanımlanmasında ve biyolojik dokuların biyokimyasal analizlerinde; moleküler, serolojik ve konvansiyonel farklı tanı yöntemleri kullanılmaktadır. Bu yöntemlere ek olarak Raman spektroskopisinin hızlı, tahribatsız ve noninvaziv bir yöntem olduğu yapılan çalışmada gösterilmiştir. Dolayısıyla mikroorganizmaların temel biyokimyasal bileşenlerinin moleküler düzeyde analiz edilebilmesi bakımından alternatif bir yöntem olacağı düşünülmektedir.Objective: Hydatidosis is a zoonotic parasitic infection caused by the larval stage of Echinococcus granulosus. The aim of this study was to investigate the biochemical structures of germinal membrane and cyst fluids obtained from patients with liver involvement during surgery, by Raman spectroscopy at the molecular level. Methods: Molecular characterization of germinal membrane and cyst fluid according to mitochondrial gene region was determined and phylogenetic analysis was performed. Raman spectroscopy was used in samples and spectral bands between 300 and 1800 cm-1 were examined. Results: As a result of PCR, approximately 400 bp DNA band was obtained from germinal membranes and cyst fluids gathered from patients. Peaks were observed at 780, 880, 970, 1151, 1200, 1270 cm-1 for germinal membrane and at 780 and 1200 cm-1 for cyst fluid. The highest spectral bands were obtained at 1333-1335 cm-1 and were determined to be modes indicating the CH3CH2 collagen and polynucleotide chain. Conclusion: In the identification of microorganisms and biochemical analysis of biological tissues; different diagnostic methods such as molecular, serological and conventional methods are used. In addition to these methods, Raman spectroscopy has been shown in studies to be a fast, non-destructive and noninvasive method. Therefore, it is thought to be an alternative method for analyzing the basic biochemical components of microorganisms at molecular level

Comparison of the Protoscolocidal Effectiveness of Hypertonic Saline, Povidone-Iodine and Albendazole Solutions in an Experimental Lung Hydatid Cyst Model

Secondary hydatidosis is an important problem encountered during the surgical treatment of hydatid cysts. This study describes an experimental model of secondary hydatidosis by cyst inoculation, used to explore whether simultaneous inoculation of protoscolocidal agents could prevent secondary hydatidosis. Fertile cyst fluid was injected into the pleural space of rabbits alone (group 1, n = 8), and in combination with 2% albendazole solution (group 2, n = 8), 20% hypertonic saline (group 3, n = 8) or 10% povidone-iodine (group 4, n = 8). Computed tomography imaging of the thorax, indirect haemagglutination (IHA) titres and eosinophil counts were used to determine cyst development. After 16 months, three control rabbits had pneumothorax, seven had cysts and four had parenchymal nodules. Histopathological investigation of nodules revealed 87.5% cyst formation. Pleural thickening was observed in rabbits from all groups. Cyst formation rates, IHA titres and eosinophilia counts were higher in group 1 than in groups 2 - 4. This study demonstrated the experimental formation of secondary hydatidosis and found that topical protoscolocidal agents were beneficial in preventing cyst recurrence

Dual treatment of albendazole in hepatic hydatidosis: New therapeutic modality in 52 cases

Background: Hepatic hydatidosis still remains as a serious problem in general surgery. Recurrence and/or secondary hydatidosis rates are up to 25% in the cases treated with surgery alone. Albendazole is the most commonly used drug in the medical treatment of echinococcosis. The aim of the present study was to evaluate the effect of albendazole using the intraoperative and perioperative periods as dual therapy

Relation of Serum ADMA, Apelin-13 and LOX-1 Levels with Inflammatory and Echocardiographic Parameters in Hemodialysis Patients

PubMedID: 29205940Cardiovascular diseases are the leading causes of mortality in patients with chronic kidney disease. Nitric oxide has a critical role in both endothelial dysfunction and the atherosclerosis process. We aimed to investigate the relationships between serum asymmetric dimethyl arginine (ADMA), LOX-1, and Apelin-13 levels, which are known to act over nitric oxide with endothelial dysfunction and cardiac morphology as well as with each other in hemodialysis patients. The study comprised a total of 120 patients (53 females and 67 males) receiving hemodialysis three times a week for at least 6 months and an age-gender matched control group (55 females and 58 males). Serum ADMA, LOX-1, and Apelin-13 levels were measured using the ELISA technique. Echocardiography, 24-h blood pressure monitoring by the Holter and carotid artery intima-media thickness (CIMT) measurement was performed on all of the included subjects. The associations between serum ADMA, LOX-1, and Apelin-13 levels with CIMT, echocardiographic parameters [left ventricular mass (LVM) and left ventricular mass index (LVMI)], and inflammatory markers [high sensitive C-reactive protein (hsCRP) and neutrophil lymphocyte ratio (NLR)] were evaluated by correlation analysis. Serum ADMA, Apelin-13, and LOX-1 levels were significantly higher in the hemodialysis group than the controls (P < 0.001, P < 0.001, and P < 0.001, respectively). CIMT, hsCRP, and NLR levels were also significantly higher in the hemodialysis group (P < 0.05, P < 0.001, P < 0.001, respectively). Significant correlations were observed among the serum ADMA, Apelin-13, and LOX-1 levels. Moreover, notably positive correlations were found between these three biochemical markers and LVM, LVMI, hsCRP, and CIMT. Serum ADMA, Apelin-13, and LOX-1 levels can be indicators not only for the inflammatory process but also for the pathogenesis of cardiovascular diseases in hemodialysis patients. © 2017 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therap

Videolaparoscopic treatment of hepatic hydatid cyst

Background/Aims: Unroofing, cystopericyst.ectomy, or cystic evacuation and omentoplasty have been used in videolaparoscopic treatment in hepatic hydatidosis since 1992. Currently it is shown that videolaparoscopic treatment has been carried out successfully in selected cases

Relation of serum spondin-2 levels with cardiac morphology and inflammatory parameters in hemodialysis patients

PubMedID: 30276603Purpose: Cardiovascular diseases are the leading causes of mortality in chronic kidney disease. Spondin-2 (SP-2), an intrinsic cardio-protective factor, prevents maladaptive remodeling. We aimed to determine the relation between serum SP-2 levels and cardiac morphology along with inflammatory parameters in hemodialysis (HD) patients. Method: The study comprised a total of 95 patients (61 females) receiving HD treatment three times a week for at least 6 months, and a control group consisting of age and gender matched 62 subjects (34 females). SP-2 levels were determined by ELISA. Echocardiography, 24-h ambulatory blood pressure monitoring, and carotid artery intima-media thickness (CIMT) measurement were performed in all subjects. The relation of serum SP-2 levels with CIMT, echocardiographic parameters, CRP, and absolute neutrophil-to-lymphocyte count ratio (NLR) was evaluated by correlation analysis. Results: SP-2 levels were found to be significantly higher in the HD group than the control group (16.660 [8.719–20.938] vs. 3.988 [2.702–8.042] ng/L; P < 0.001). CIMT, CRP, and NLR were also higher in HD group (P < 0.005, P < 0.001, and P < 0.001, respectively). Significantly positive correlation was found between SP-2 and left ventricular mass, left ventricular mass index, CRP, and NLR, but no correlation was determined between SP-2 and CIMT. SP-2 was not statistically significant variable for the determination of LVH in univariate logistic regression analysis [Wald = 2.375; OR (95% CI) = 1.000 (0.999–1.000), P = 0.123]. Conclusion: Serum SP-2 levels were higher in HD patients compared to the population with normal renal functions. The results suggest that SP-2, an uremic toxin, might be effective over a complex pathway in the inflammatory process and in the pathogenesis of cardiovascular diseases of patients under HD treatment. © 2018, Springer Nature B.V