Renal Ischemia/Reperfusion Injury in Diabetic Rats: The Role of Local Ischemic Preconditioning

Background. The aim of this study was to evaluate the effects of local ischemic preconditioning using biochemical markers and histopathologically in the diabetic rat renal IR injury model. Methods. DM was induced using streptozotocin. Rats were divided into four groups: Group I, nondiabetic sham group (n=7), Group II, diabetic sham group (n=6), Group III, diabetic IR group (diabetic IR group, n=6), and Group IV, diabetic IR + local ischemic preconditioning group (diabetic IR + LIPC group, n=6). Ischemic renal injury was induced by clamping the bilateral renal artery for 45 min. 4 h following ischemia, clearance protocols were applied to assess biochemical markers and histopathologically in rat kidneys. Results. The histomorphologic total cell injury scores of the nondiabetic sham group were significantly lower than diabetic sham, diabetic IR, and diabetic IR + LIPC groups. Diabetic IR group scores were not significantly different than the diabetic sham group. But diabetic IR + LIPC group scores were significantly higher than the diabetic sham and diabetic IR groups. Conclusion. Local ischemic preconditioning does not reduce the risk of renal injury induced by ischemia/reperfusion in diabetic rat model

Successful Treatment of Herpes Esophagitis With Ganciclovir in a Liver Transplant Patient

The presence of Herpes Simplex Virüs-1 (HSV-1) esophagitis in patients with liver transplantation has been reported rarely. Among the reports that are accessible in the literature, none could have shown tissue positivity for Herpes virus-1 DNA via Polymerase Chain Reaction (PCR) in patients with liver transplantation. This case is presented as the patient was diagnosed with herpes esophagitis based on the histopathological findings and HSV-1 DNA positivity (detected by PCR) in the biopsy material and was treated with Ganciclovir. Due to the specific action of Ganciclovir against CMV infections, it is natural that the drug cannot use in the treatment of HSV infections. However it is reported that ganciclovir has been reduced the incidence of symptomatic HSV infections after liver transplantation. We report on a patient after liver transplantation with HSV-1 esophagitis, who was successfully treated with Ganciclovir. We assume that most transplant centers according to their protocols use ganciclovir for CMV prophylaxis, which may contribute to avoid HSV infection

A Novel Technique for Managing Pancreaticojejunal Anastomotic Leak after Pancreaticoduodenectomy

Pancreaticoduodenectomy (Whipple's procedure) remains the only definitive treatment option for tumors of the periampullary region. The most common and life-threatening complications following the procedure are pancreatic anastomotic leakage and subsequent fistula formation. When these complications occur, treatment strategy depends on the severity of anastomotic leakage, with patients with severe leakages requiring reoperation. The optimal surgical method used for reoperation is selected from among different options such as wide drainage, definitive demolition of the pancreaticojejunal anastomosis and performing a new one, or completion pancreatectomy. Here we present a novel, simple technique to manage severe pancreatic leakage via ligamentum teres hepatis patch

Evaluation of the Effectiveness of Sugammadex for Verapamil Intoxication

Previous studies have shown that medications from the cyclodextrin family bind to verapamil. The aim of our study was to determine whether sugammadex could bind to verapamil and prevent the cardiovascular toxicity of that drug. Twenty-eight sedated Wistar rats were infused with verapamil at 37.5mg/kg/h. Five minutes after the start of infusion, the animals were treated with a bolus of either 16mg/kg, 100mg/kg or 1000mg/kg sugammadex. The control group was treated with an infusion without sugammadex. The heart rate and respiratory rate were monitored, and an electrocardiogram was recorded. The primary end-point was the time to asystole. The verapamil infusion continued until the animals arrested. The asystole time for the S16 group was significantly longer compared to those for the control and S1000 groups (p<0.05). The asystole time for the S1000 group was significantly shorter than those for all of the other groups (p<0.05). Reflecting these data, there was a near doubling of the mean lethal dose of verapamil from 13.57mg/kg (S.D. +/- 8.1) in the saline-treated rats to 22.42mg/kg (S.D. +/- 9.9) in the sugammadex 16 group (p<0.05). However, for the sugammadex 1000 group, the mean lethal dose was found to be 6.28 +/- 1.11mg/kg. This dose is significantly lower than those for all of the other groups (p<0.05). We found that treatment with 16mg/kg sugammadex delayed verapamil cardiotoxicity in rats. However, 1000mg/kg sugammadex accelerated verapamil cardiotoxicity in rats. Further studies must be conducted to investigate the interaction between verapamil and sugammadex

Intestinal perforation due to ingestion of fish bone

Perforation of the gastrointestinal tract by accidently ingested foreign bodies is rare, occurring in less than 1% of the patients. Fish bones are the most common foreign bodies leading gastrointestinal tract perforation due to their elongated shape end sharp ends. Preoperative diagnosis of the gastrointestinal tract perforation by foreign body is challenging since the patients present with a wide and nonspecific spectrum of symptoms and usually don't recall ingestion of the foreign body. It should always be kept in mind in cases with acute abdominal complaint. Herein, we present multidetector computed tomography findings of a case with bowel perforation due to fish bone. Thus, computed tomography scan revealed the foreign body with perforated intestinal segment, led prompt diagnosis and optimal surgical treatment even in a patient with no preoperative history of foreign body ingestion. [Cukurova Med J 2016; 41(0.100): 1-4

Outcomes of Incisional Hernia Repair Following Liver Transplantation

Objective: In this case series, the risk factors, types of repair and outcomes for the development of incisional hernias following liver transplantation are presented. Material and Methods: The medical records of 362 patients who underwent orthotopic liver transplantation were analyzed retrospectively. This study was designed as a descriptive study and statistical methods were not used. Results were given as mean +/- standard deviation and number (%). Patients who were followed up for at least one year after liver transplantation were included in the study. Fiftyseven (15.7%) patients who died within the first six months were excluded. The risk factors, defect size, meshes used and types of repair were analyzed in nine patients who developed incisional hernia. Results: Incisional hernia was detected in nine (2.9%) out of 305 patients included in the study. The most common indication for liver transplantation was cirrhosis due to chronic viral hepatitis C. Complications (duodenal ulcer perforation, bleeding from hepatic artery anastomosis, bleeding from duodenal ulcer and mechanical intestinal obstruction) developed in four (44.4%) of these nine patients after liver transplantation. Relaparatomy was performed in three of nine patients. The mean largest diameter of defect was 27.9 +/- 10.1 (6-40) cm. Expanded polytetrafluoroethylene mesh was used most frequently for incisional hernia repair. Early or late complications did not develop except one patient who developed recurrent incisional hernia. Conclusion: In cirrhotic patients who have additional risk factors for incisional hernia development, the risk of hernia development may be reduced by using appropriate closure technique and materials after liver transplantation. A safe hernia repair may be performed by using an appropriate technique and meshes if the patient develops an incisional hernia

Renal Ischemia/Reperfusion Injury in Diabetic Rats: The Role of Local Ischemic Preconditioning

WOS: 000369669400001PubMed ID: 26925416Background. The aim of this study was to evaluate the effects of local ischemic preconditioning using biochemical markers and histopathologically in the diabetic rat renal IR injury model. Methods. DM was induced using streptozotocin. Rats were divided into four groups: Group I, nondiabetic sham group (n = 7), Group II, diabetic sham group (n = 6), Group III, diabetic IR group (diabetic IR group, n = 6), and Group IV, diabetic IR + local ischemic preconditioning group (diabetic IR + LIPC group, n = 6). Ischemic renal injury was induced by clamping the bilateral renal artery for 45 min. 4 h following ischemia, clearance protocols were applied to assess biochemical markers and histopathologically in rat kidneys. Results. The histomorphologic total cell injury scores of the nondiabetic sham group were significantly lower than diabetic sham, diabetic IR, and diabetic IR + LIPC groups. Diabetic IR group scores were not significantly different than the diabetic sham group. But diabetic IR + LIPC group scores were significantly higher than the diabetic sham and diabetic IR groups. Conclusion. Local ischemic preconditioning does not reduce the risk of renal injury induced by ischemia/reperfusion in diabetic rat model

Outcomes of Incisional Hernia Repair Following Liver Transplantation

Objective: In this case series, the risk factors, types of repair and outcomes for the development of incisional hernias following liver transplantation are presented. Material and Methods: The medical records of 362 patients who underwent orthotopic liver transplantation were analyzed retrospectively. This study was designed as a descriptive study and statistical methods were not used. Results were given as mean +/- standard deviation and number (%). Patients who were followed up for at least one year after liver transplantation were included in the study. Fiftyseven (15.7%) patients who died within the first six months were excluded. The risk factors, defect size, meshes used and types of repair were analyzed in nine patients who developed incisional hernia. Results: Incisional hernia was detected in nine (2.9%) out of 305 patients included in the study. The most common indication for liver transplantation was cirrhosis due to chronic viral hepatitis C. Complications (duodenal ulcer perforation, bleeding from hepatic artery anastomosis, bleeding from duodenal ulcer and mechanical intestinal obstruction) developed in four (44.4%) of these nine patients after liver transplantation. Relaparatomy was performed in three of nine patients. The mean largest diameter of defect was 27.9 +/- 10.1 (6-40) cm. Expanded polytetrafluoroethylene mesh was used most frequently for incisional hernia repair. Early or late complications did not develop except one patient who developed recurrent incisional hernia. Conclusion: In cirrhotic patients who have additional risk factors for incisional hernia development, the risk of hernia development may be reduced by using appropriate closure technique and materials after liver transplantation. A safe hernia repair may be performed by using an appropriate technique and meshes if the patient develops an incisional hernia

Five years with a rectal foreign body: Acasereport

INTRODUCTION: Rectal foreign bodies are rare colorectal emergencies. They are important for the com-plications that may occur. Delayed response causes a wide range of complications or may even result in death