The effects of erdosteine on experimental acute pancreatitis model

YÖK Tez No: 319234ÖZETAkut pankreatit kendi kendini sınırlayan hafif semptomlardan multiorgan yetmezliği ile seyreden fulminant gidişe kadar oldukça geniş klinik sunum gösterebilen bir hastalıktır.Bu çalışmada 30 adet erkek Wistar albino rat her birinde 10 adet olacak şekilde 3 gruba ayrılmıştır. Grup 1'de herhangi bir işlem yapılmamıştır. Grup 2 ve Grup 3' teki ratlara birer saat ara ile 6 kez toplam 80 ?g/kg olacak şekilde subkutan cerulein enjekte edilerek deneysel pankreatit modeli oluşturulmuş ve bu durumun teyidi için kan amilaz ve lipaz değerlerine bakılmıştır. Grup 3'teki ratlara 10 mg/kg Erdostein orogastrik yol ile verilmiştir. Bu tedaviye 2 gün daha devam edilmiş ve ratlar 3. gün sakrifiye edilmiştir. Ratlardan çıkarılan pankreas dokusunda ödem, inflamasyon, yağ nekrozu, asiner nekroz ve vakuolizasyon histopatolojik olarak araştırılmış ve 0 ile 4 arasında skorlar verilerek değerlendirme yapılmıştır.Cerulein kullanımıyla amilaz ve lipaz gibi biyokimyasal tetkiklerin sonuçları ve pankreas dokularının histopatolojik olarak incelenmesi sonucunda ratlarda akut pankreatit gelişmiş ve pankreas dokusunda ciddi boyutlarda ödem, inflamasyon, asiner nekroz, yağ nekrozu ve vakuolizasyon gözlenmiştir. Grup 3'teki ratlarda Erdosteinin beklenilen antiinflamatuar etkisi elde edilmiş ve oluşan pankreatit şiddetinin azaldığı histopatolojik olarak gösterilmiştir. Çalışmanın istatistiksel sonuçları incelendiğinde ise Erdosteinin akut pankreatit dokusunda inflamasyon, asiner nekroz, yağ nekrozu ve vakuolizasyon skorlarında anlamlı azalmalara yol açtığı ortaya çıkmıştır.Sonuç olarak Cerulein ile ratlarda ağır pankreatit oluşturulmuş ve Erdostein kullanımı ile pankreatit şiddeti azalmış olarak bulunmuştur. Erdostein ile elde ettiğimiz bu olumlu sonuçlar daha kapsamlı deneysel ve klinik çalışmalar ile desteklenebildiği takdirde Erdostein akut pankreatit tedavisinde olumlu etkileri olan yeni bir tedavi yöntemi olarak kullanılabilecektir.ABSTRACTAcute pancreatitis is a disease which can manifest itself with a wide range of clinical presentations from self-limiting mild symptoms to fulminant course with multiorgan failure.In this study, 30 male Wistar albino rats were divided into 3 groups, with 10 rats in each group. No action was taken in Group 1. An experimental pancreatitis model was formed with the rats in Groups 2 and 3, which were given subcutaneous cerulean injection of 80 ?g/kg in total administered in 6 doses every one hour, and blood amylase and lipase values were assessed for confirmation. Erdosteine 10 mg/kg was administered via orogastric route in the rats in Group 3. This treatment was continued for another 2 days and the rats were sacrificed on the 3rd day. The pancreas tissues removed from the rats were examined histopathologically for edema, inflammation, fat necrosis, acinar necrosis and vacuolization, and the evaluation was made by scoring between 0 and 4.At the end of the biochemical examination of amylase and lipase values and the histopathological examination of pancreas tissues, it was concluded that the rats developed acute pacreastitis by cerulean use, and serious edema, inflammation, acinar necrosis, fat necrosis and vacuolization were observed in the pancreas tissue. In the rats in Group 3, Erdosteine had the expected anti-inflammatory effect, and the histopathological results showed a reduction in pancreatitis severity. According to the statistical results of the study, Erdosteine resulted in significant reductions in the inflammation, acinar necrosis, fat necrosis and vacuolization scores in acute pancreatitis tissues.Consequently, severe pancreatitis was created by cerulein in the rats, and pancreatitis severity was reduced by the use of Erdosteine. If these favorable results obtained by Erdosteine are supported by more comprehensive experimental and clinical studies, Erdosteine can be used as a new treatment method with favorable effects in the treatment of acute pancreatitis

A Rare Cause of Abdominal Pain: Scar Endometriosis

Introduction. Scar endometriosis (SE) is a rare pathology that develops in the scar tissue formed on the anterior abdominal wall usually after a cesarean section. There have been instances of women presenting to emergency or general surgery clinics with abdominal pain due to SE. Materials and Methods. This study retrospectively reviews 19 patients who were operated on in our clinic between January 2010 and January 2017 with a prediagnosis of SE and were reported to have SE based on their pathology results. Results. The mean age of the patients was 30.8 years (range: 20-49 years). The body mass indexes of 12 (63.2%) patients were ≥ 25. All patients had a history of cesarean section and 9 (47.4%) patients had undergone cesarean section once. With the exception of one patient who had her SE localized in her inguinal region, all patients had a mass localized on their anterior abdominal wall neighboring the incision and complained about cyclic pain starting in their premenstrual periods. The complaints began 2 years after their cesarean section in 10 (52.6%) patients. Mostly abdominal ultrasonography was used for diagnostic purposes. The lesions were totally excised and the SE diagnosis was made through a histopathological examination in all patients. No postoperative complications or recurrences were seen in any of the patients. Conclusion. Suspicion of SE is essential in women of reproductive age who have a history of cesarean section and complaints of an anterior abdominal wall mass and a pain at the scar site that is associated with their menstrual cycle. An accurate and early diagnosis can be established in such patients through a careful history and a good physical examination and possible morbidities can be prevented with an appropriate surgical intervention

Primary Hydatid Cyst of the Chest Wall

WOS: 000308968400015PubMed: 22249910

Bilaterally recurrent spontaneous pneumothorax due to lymphangioleiomyomatosis

Pulmoner lenfanjiyoleiomyomatozis oldukça nadir görülen bir interstisyel akciğer hastalığıdır. Klinik tablo genellikle nüks spontan pnömotoraks ve progresif dispne şeklindedir. Kesin bir tedavi seçeneği olmamakla birlikte, yıllar içerisinde akciğer parankiminde oluşan multikistik destrüksiyonla solunum yetmezliğine neden olmaktadır. Otuz dokuz yaşında kadın hasta ani başlayan nefes darlığı ve yaygın göğüs ağrısı yakınmaları ile kliniğimize başvurdu. Oskültasyonda her iki akciğerde solunum seslerinde azalma tespit edildi. Akciğer grafisinde iki taraflı pnömotoraks gözlenmesi üzerine iki taraflı tüp torakostomi uygulandı. Toraks tomografisinde sağda daha fazla olmak üzere her iki akciğerde yerleşmiş birkaç ince duvarlı kistik yapı tespit edildi. Hastaya sağ posterolateral torakotomi ile büllektomi, apikal kama rezeksiyonu, apikal parietal plörektomi ve geri kalan plevral alanlara mekanik plevral abrazyon yapıldı. Hastada bir ay sonra oluşan sol nüks pnömotoraks nedeni ile sol posterolateral torakotomi ile büllektomi, bül ligasyonu, apikal kama rezeksiyonu, apikal parietal plörektomi ve geri kalan plevral alanlara mekanik plevral abrazyon uygulandı. Histopatolojik inceleme ile hastaya lenfanjiyoleiomyomatozis tanısı konuldu. İki yıllık takip süresinin sonunda pnömotoraks nüksü gözlenmedi. İki taraflı nüks spontan pnömotoraks gelişen premenopozal kadınlarda lenfanjiyoleiomyomatozis mutlaka akılda tutulmalıdır. Bu hastalarda konservatif yöntemlerle pnömotoraksın sıklık ile nüks etmesi nedeni ile erken dönemde cerrahi tedavi yapılmalıdır.Pulmonary lymphangioleiomyomatosis is an extremely rare interstitial lung disease. The clinical presentation is generally recurrent spontaneous pneumothorax and progressive dyspnea. No definitive treatment option is available and it leads to respiratory failure due to multicystic destruction of the lung parenchyma in the following years. A 39-year- old female patient was admitted to our clinic with the complaints of sudden onset dyspnea and diffuse chest pain. Auscultation revealed decreased respiratory sounds in both lungs. Chest X-ray showed bilateral pneumothorax and bilaterally tube thoracostomy was performed. Thoracic tomography demonstrated a few thin-wall cystic structures in both lungs with a higher number on the right side. We performed bullectomy, apical wedge resection, apical parietal pleurectomy and mechanic pleural abrasion on residual pleural spaces through right posterolateral thoracotomy. One month later, we performed bullectomy, bulla ligation, apical wedge resection, apical parietal pleurectomy and mechanic pleural abrasion on residual pleural spaces through left posterolateral thoracotomy due to the left recurrent pneumothorax. The patient was diagnosed with lymphangioleiomyomatosis based on the histopathological examination. No recurrent pneumothorax was observed at the end of the two-year follow- up period. Lymphangioleiomyomatosis should be kept in mind in premenopausal women who have bilaterally recurrent spontaneous pneumothorax. Early surgical treatment should be planned in these patients due to multiple pneumothorax recurrences with conservative procedures

Incidental Papillary Thyroid Microcarcinoma in an Endemic Goiter Area

Clinical and pathological characteristics of incidental papillary thyroid microcancer cases, surgical, medical, and nuclear treatment methods, and patients’ outcome were studied during follow-up period of 102 months. We studied 37 patients with incidental papillary thyroid microcancer (I-PTM). The surgical procedure was total thyroidectomy in 29 and hemithyroidectomy in 8 patients. Size, multifocality, and bilateralism of PTM foci, thyroid capsule invasion, and presence of lymphovascular invasion were histopathological parameters. We analysed adjuvant medical and nuclear treatment and patients’ outcome during follow-up period of 102 (61–144) months. The prevalence rates of I-PTM were 9.4% in 395 thyroidectomy cases. Histopathological examination reported unifocal disease in 30 and multifocal disease in 7 (18%) patients. Multifocal disease was bilateral in 6 (20.1%) patients. The mean size of the PTM foci was 4.88 mm. The rate of thyroid capsule invasion was 5.4%. All patients received a suppressive dose of LT4 to achieve a low serum TSH level. Adjuvant surgical and nuclear treatment was not performed in our cases. We did not find any negative changes in blood chemistry and ultrasound imaging, and any unfavourable events as locoregional and systemic recurrence. In conclusion, diagnosis of I-PTM is common that multifocality and bilateralism appear as pathologic features. The prognosis is excellent after surgical treatment and TSH suppression. Routine adjuvant nuclear treatment is unnecessary in majority of patients

Prevention of Pulmonary Complications of Pneumoperitoneum in Rats

Saritas, Ayhan/0000-0002-4302-1093;WOS: 000287657700001PubMed: 21303502Background: Carbon dioxide (CO(2)) pneumoperitoneum facilitates the visualization of abdominal organs during laparoscopic surgery. However, the associated increase in intra-abdominal pressure causes oxidative stress, which contributes to tissue injury. Objective: We investigated the ability of the antioxidant and anti-inflammatory drug Erdosteine to prevent CO(2) pneumoperitoneum-induced oxidative stress and inflammatory reactions in a rat model. Methods: Fourteen female adult Wistar albino rats were divided into a control group (Group A, n = 7) and an Erdosteine group (Group B, n = 7). Group A received 0.5 cc/day 0.9% NaCl, and Group B received 10 mg/kg/day Erdosteine was administered by gavage, and maintained for 7 days prior to the operation. During the surgical procedure, the rats were exposed to CO(2) pneumoperitoneum with an intra-abdominal pressure of 15 mmHg for 30 min. The peritoneal gas was then desufflated. The rats were sacrificed following 3 h of insufflation. Their lungs were removed, histologically evaluated, and scored for intra-alveolar hemorrhage, alveolar edema, congestion, and leukocyte infiltration. The results were statistically analyzed. A value of P < 0.05 was considered statistically significant. Results: Significant differences were detected in intra-alveolar hemorrhage (P < 0.05), congestion (P < 0.001), and leukocyte infiltration (P < 0.001) in Group A compared with Group B. However, the differences in alveolar edema were not statistically significant (P = 0.698). Conclusions: CO(2) pneumoperitoneum results in oxidative injury to lung tissue, and administration of Erdosteine reduces the severity of pathological changes. Therefore, Erdosteine may be a useful preventive and therapeutic agent for CO(2) pneumoperitoneum-induced oxidative stress in laparoscopic surgery

Glutamine administration enhances the healing of lung parenchymal injuries and reduces air leakage in rats

Beneficial effects of glutamine on wound healing are well known. Parenchymal injuries in the lung cause air leakage that resolves with wound healing. We aimed to determine the effect of glutamine on the healing of lung injuries. Wistar albino female rats were randomized in three groups. One group (control, n = 7) received intraperitoneal injection of 0.9% sodium chloride (1.5 ml/day), while other group (GLN, n = 7) received glutamine (1.5 g/kg/day), beginning two days prior to the operation for total four days. After thoracotomy, a lung parenchymal lesion was made with a scalpel in the right upper lobe. Only thoracotomy was performed to sham group (n = 4). Air leakage was observed in the isolated lungs of control group, but not GLN and sham groups, at 5 cm H2O of positive airway pressure (p < 0.001). The threshold of positive airway pressure for air leakage was 4.85 +/- 0.37 and 19.42 +/- 4.54 cm H2O for control and GLN groups, respectively (p < 0.001). For measurement of collagen content in the healing parenchyma, digital images were processed to calculate the stained area percentage (SAP). SAP for immature collagen, a marker for wound healing, was 0.36 +/- 0.18% and 1.48 +/- 0.83% (p = 0.02) in control and GLN groups, respectively, but no significant difference was noted in SAP for mature collagen. The grade of inflammation was not significantly different between control and GLN groups. We conclude that glutamine enhances lung parenchymal healing by increasing immature collagen secretion

Chest-wall metastasis in a patient who underwent liver transplantation due to hepatocellular carcinoma

Hepatocellular carcinoma is a common malignancy. It may cause extrahepatic metastases through haematogenous or lymphatic dissemination or direct invasion. Furthermore, methods such as fine-needle aspiration biopsies performed to obtain a diagnosis or percutaneous ethanol injection and radiofrequency hyperthermia performed for treatment may also cause tumour dissemination