Abdominal ultrasonographic findings in patients with thalassemia

AMAÇ: Bu çalışmanın amacı, Denizli Devlet Hastanesi Talasemi Merkezinde izlenen talasemi major ve talasemi intermedia hastalarının rutin abdominal ultrasonografik incelemeleri seyrinde görülen hepatosplenomegali dışındaki abdominal solid organlar ile ilgili bulgularını değerlendirmektir. GEREÇ veYÖNTEMLER: Bu çalışmaya, 73'ü talasemi major, 5'i talasemi intermedia olmak üzere, yaşları 2 ile 30 yıl arasında, 40 kız, 38 erkek hasta alınmıştır. BULGULAR: Safra kesesinde taş ve çamur (%8.9) en sık görülen bulgu idi. Aksesuar dalak 6 hastada (%7.7), karaciğerde ekojenite artısı 2 hastada (%2.6), karaciğerde hemanjiom 1 hastada(%1.3), portal ven trombozu 1 hastada(%1.3) saptandı. Bir talasemi major hastasında, bilateral renal kist ve sag renal tas ve beraberinde safra kesesinde taş görüldü. SONUÇ: Talasemi hastalarında abdominal ultrasonografik inceleme, komplikasyonların önlenmesi ve etkili klinik izlem için düzenli aralıklar ile yapılmalıdır.OBJECTIVE: The aim of this study was to evaluate the type and prevalance of abdominal ultrasonographic abnormalities except hepatosplenomegaly in patients with thalassemia major and thalassemia intermedia. MATERIAL and METHODS: Seventy-eight patients; 73 thalassemia major, 5 thalassemia intermedia followed in Denizli State Hospital Thalassemia Center were included in the study. The patients' ages ranged from 2 to 30 years, with 40 females, 38 males. RESULTS: The most frequent ultrasonografic findings were cholelithiasis (8.9%), accesory spleen (7.7%), hepatic grade I-II echogenity (2,6%), hepatic hemangioma (1.3%) and portal vein thrombosis (1.3%). One case was diagnosed with polycystic kidney disease with coexisting nephrolitiasis and cholelithiasis. CONCLUSION: Abdominal ultrasonographic imaging of patients with thalassemia patients should be done regularly to prevent complications and for effective clinical observation

Effects of Systemic and Local Interferon Beta-1a on Epidural Fibrosis

Study DesignLevel 1 randomized controlled study.PurposeTo investigate the effects of systemic and local interferon-beta-1a (IFN-β-1a) on prevention of epidural fibrosis using histopathological parameters.Overview of LiteratureEpidural fibrosis involves fibroblastic invasion of nerve roots into the epidural space. Formation of dense fibrous tissue causes lumbar and radicular pain. Many surgical techniques and several materials have been proposed in the literature, but no study has assessed the effect of IFN-β-1a on prevention of epidural fibrosis.MethodsForty-eight adult female Sprague-Dawley rats were divided into six groups of eight: sham group, control group, systemic 44 μg IFN-β-1a group and 22 μg IFN-β-1a group (after laminectomy and discectomy, 0.28 mL and 0.14 mL IFN-β-1a applied subcutaneously three times for a week, respectively), local 44 μg IFN-β-1a group (laminectomy and discectomy, followed by 0.28 mL IFN-β-1a on the surgical area), and local 22 μg IFN-β-1a group (laminectomy and discectomy, followed by 0.14 mL IFN-β-1a on the surgical area). All rats were sacrificed after 4 weeks and groups were evaluated histopathologically.ResultsCompared with sham and control groups, significantly less epidural fibrosis, dural adhesion, and fibroblast cell density were observed in the local and systemic 44 μg IFN-β-1a groups. No other differences were evident between the local and systemic groups.ConclusionsIFN-β-1a is effective in preventing epidural fibrosis with systemic and local application

Effects of crosslinked high molecular weight hyaluronic acid on epidural fibrosis: Experimental research

Epidural fibrozis; epidural mesafe ile birlikte sinir köklerinin fibroblastik invazyona uğramasıdır. Bu yoğun fibröz doku, cerrahi sonrası bel ağrısı, radiküler ağrı semptomlarına neden olmasının yanı sıra, sonradan gerekebilecek bir operasyonda intraspinal yapıların diseksiyonunu da zorlaştırmaktadır.Epidural fibrozis gelişimini önlemek için, cerrahi teknikler ve çeşitli tıbbı tedaviler uygulanmıştır. Bir glikozaminoglikan olan hiyalüronik asid oligomerlerinin oto-çapraz bağlanması ile elde edilen derive edilmiş yüksek viskoziteli hiyalüronik asidin; obstetrik, jinekolojik ve abdominal cerrahide yapışıklık ve sikatris oluşumunun engellenmesi ile yara iyileşmesinin erken fazlarında rolü olduğu gösterilmiştir.Oluşturduğumuz deneysel laminektomi - diskektomi modeli ile derive edilmiş yüksek viskoziteli hiyalüronik asidin epidural fibrozisi önlemede histopatolojik ve biyokimyasal etkilerinin incelenmesi ve araştırılması amaçlandı.Çalışmamıza 60 adet, Sprague-Dawley dişi sıçan alındı. Ancak cerrahi sırasında dural yaralanma meydana gelen 3 denek ile hematom gelişen 1 denek çalışma dışı bırakıldı. Son değerlendirme 56 denek ile yapıldı. Denekler; 1. grup (Sham grubu, n=14); laminektomi ve diskektomi yapılıp mesafeye herhangi bir madde uygulanmayan, 2. grup (Kontrol grubu, n=14); laminektomi ve diskektomi yapılıp mesafeye topikal % 0,9 NaCl uygulanan, 3. grup [Hiyalüronik asid (HA) deney grubu, n=14 ], laminektomi ve diskektomi yapılıp operasyon sahasına topikal hiyalüronik asid uygulanan ile 4. grup [Derive edilmiş yüksek viskoziteli hiyalüronik asid (HA gel) deney grubu, n=14]; laminektomi ve diskektomi yapılıp operasyon sahasına topikal derive edilmiş yüksek viskoziteli hiyalüronik asid uygulanan grup olarak dört gruba ayrıldı. Tüm denekler 4. haftanın sonunda dekapite edilip epidural fibröz dokunun biyokimyasal ve histopatolojik incelemeleri yapıldı. Sonuçlar istatistiksel olarak karşılaştırıldı.iiiDerive edilmiş yüksek viskoziteli hiyalüronik asidin uygulandığı grupta sham ve kontrol grubuna oranla epidural fibrozis, dural adezyon, fibroblast hücre yoğunluğu ile doku hidroksiprolin düzeylerinin belirgin olarak az olduğu izlendi (p 0,05).Sonuç olarak; derive edilmiş yüksek viskoziteli hiyalüronik asidin laminektomi sonrası gelişen epidural fibrozis ile oluşan fibrotik doku yoğunluğunun azaltılmasında olumlu etkileri gözlenmiştir. Bu çalışmanın öncülüğünde yapılacak daha ileri deneysel ve klinik çalışmalar ile elde edilecek sonuçların klinik pratikte uygulama alanları bulması ile epidural fibrozisin önlenmesinde önemli yol alınacağı kanaatindeyiz.Epidural fibrosis is fibroblastic invasion of nerve roots into the epidural space. Formation of dense fibrous tissue causes lumbar and radicular pain. In addition to radicular symptoms, scar tissue may cause problems during redo surgery.Several surgical techniques and medical treatments have been extensively studied to prevent epidural fibrosis development. Crosslinkedhigh molecular weight hyaluronic acid, a glucosaminoglican which is obtained by auto-crosslinking of hyaluronic acid oligomers, has been shown to play a role in prevention of fibrosis and scar formation, therefore early phases of wound healing in obstetrics, gynecology and abdominopelvic surgery. By this laminectomy - discectomy model we aimed to investigate effects of crosslinked high molecular weight hyaluronic acid on prevention of epidural fibrosis, by using histopathological and biochemical parameters.A total of 60 adult female Sprague-Dawley rats were used in this study. However, 4 rats were excluded due to peroperative dural tear or hematoma formation. The final evaluation was done by 56 rats. They were divided into four groups; group 1 (Sham group, n=14); underwent laminectomy and discectomy, and was not given any treatment, group 2 (Control group, n=14); were laminectomized and discectomized, and 0.9 % NaCl was applied on the surgical area, group 3 [Hyaluronic acid (HA) group, n=14]; hyaluronic acid was applied to surgical area after identical surgical procedure, group 4 [crosslinked high molecular weight hyaluronic acid (HA gel) group, n=14]; underwent laminectomy and discectomy, and crosslinkedhigh molecular weight hyaluronic acid was applied to surgical area. All ras were decapitated after 4 weeks and groups were evaluated vhistopathologically and biochemically. Results were statistically compared with Mann-Whitney U test.Compared with sham and control groups, significantly less epidural fibrosis, dural adhesion, fibroblast cell density, and tissue hidroxyprolin concentrations were observed in the group treated with topical crosslinkedhigh molecular weight hyaluronic acid (p 0.05).In conclusion, positive effects of crosslinked high molecular weight hyaluronic acid in prevention of epidural fibrosis and reduction of fibrotic tissue density were observed. The efficacy of this agent should also be supported with further experimental and clinical studie

o-Benzenedisulfonimido-sulfonamides are potent inhibitors of the tumor-associated carbonic anhydrase isoforms CA IX and CA XII

By using phthalimido-substituted aromatic sufonamides as lead molecules, a series of new sulfonamides incorporating ortho-benzenedisulfonimide moieties have been synthesized and tested against the human (h) cytosolic carbonic anhydrase (CA, EC 4.2.1.1) isozymes hCA I and hCA II and the transmembrane, tumor-associated isozymes hCA IX and hCA XII. All these compounds showed K-i values lower than 100 nM and many of them showed better K(i)s than the reference compound acetazolamide, a clinically used sulfonamide. The tumor-associated isozymes were better inhibited than the cytosolic ones. A molecular docking within the active site of some CA isoforms, such as hCA I, explained these findings, as the benzenedisulfonimide moiety makes favorable interactions (hydrogen bonds) with amino acid residues involved in binding of inhibitors, such as Gln92, His67, and His64. (C) 2012 Elsevier Ltd. All rights reserved

The relationship between the Trendelenburg position and cerebral hypoxia inpatients who have undergone robot-assisted hysterectomy and prostatectomy

Background/aim: This study aimed to evaluate the relationship between the Trendelenburg position and cerebral hypoxia in robotassisted hysterectomy and prostatectomy. Materials and methods: A standardized mini-mental state examination was administered to 50 patients enrolled in the study 1 h before and after surgery. Near infrared spectroscopy (NIRS) values and hemodynamic and respiratory parameters were recorded after induction of anesthesia (baseline) and once every 20 min in the Trendelenburg position and supine positions. The relationship between the development of cerebral desaturation and the patient’s position was examined. Results: For all patients, the baseline mean cerebral oxygen saturation (RSO2 ) on the right and left were 70.5 ± 7.3% and 70.6 ± 6.7%, respectively. Right RSO2 values at 20 min and 60 min in the Trendelenburg position decreased significantly, but they increased at 120 min. A significant positive correlation was found between right RSO2 and EtCO2 in the supine period following surgery, and between left RSO2 and EtCO2 at 60 min in the Trendelenburg and supine positions. The relationship between NIRS values and cognitive dysfunction was not significant. Conclusion: We found that cerebral saturation decreases as age increases, and cerebral desaturation may occur owing to the Trendelenburg position. There was no correlation between patients’ cognitive function and NIRS values.Background/aim: This study aimed to evaluate the relationship between the Trendelenburg position and cerebral hypoxia in robotassisted hysterectomy and prostatectomy. Materials and methods: A standardized mini-mental state examination was administered to 50 patients enrolled in the study 1 h before and after surgery. Near infrared spectroscopy (NIRS) values and hemodynamic and respiratory parameters were recorded after induction of anesthesia (baseline) and once every 20 min in the Trendelenburg position and supine positions. The relationship between the development of cerebral desaturation and the patient’s position was examined. Results: For all patients, the baseline mean cerebral oxygen saturation (RSO2 ) on the right and left were 70.5 ± 7.3% and 70.6 ± 6.7%, respectively. Right RSO2 values at 20 min and 60 min in the Trendelenburg position decreased significantly, but they increased at 120 min. A significant positive correlation was found between right RSO2 and EtCO2 in the supine period following surgery, and between left RSO2 and EtCO2 at 60 min in the Trendelenburg and supine positions. The relationship between NIRS values and cognitive dysfunction was not significant. Conclusion: We found that cerebral saturation decreases as age increases, and cerebral desaturation may occur owing to the Trendelenburg position. There was no correlation between patients’ cognitive function and NIRS values

Porphyridium cruentum (Rhodophyceae) yağ asitleri kompozisyonuna kurutma yöntemlerinin etkisi

The marine Rhodophyte Porphyridium cruentum (S. F. Gray) Naegeli was cultured in thin glass panel bioreactors in outdoor. The algal biomass was dried using different methods and their effects on the fatty acids compositions off. cruentum was investigated. The results of the present study showed that the sample which were dried in etuve contain 31.01% total saturated fatty acids (TSAT), 14.83% total polyunsaturated fatty acids (PUFA) and 54.16% total monounsaturated fatty acids (MUFA), the samples dried in room temperature contain 36.61% TSAT, 17.41 % PUFA and 45.98% MUFA. Although the content of PUFA and TSAT were found to be higher in the samples dried in room temperature, Alphalinoleic acid (18:3w3, ALA), gammalinoleic acid(18:3w6, GLA) and eicosapentaenoic acid (20:5w3, EPA) were found to be higher in the samples dried in oven and they were 1.76%, 0.51% and 7.42%, respectively. There was a significant decrease in EPA from group of PUFA which is obtained from algal pasta dried in room and oven temperature. In all samples, arachidonic asit (20:4w6, ARA) wasn't determined. In the study it was reported that the drying methods used for P. cruentum caused low PUFA content.Porphyridium cruentum (S.F.Gray) Naegeli'un dış ortamda ince cam panel biyoreaktörlerde yığın kültürleri yapıldı. Elde edilen algal biyomas farklı kurutma işlemlerinden geçirildikten sonra yağ asitleri içerikleri bakımından karşılaştırıldı. Etüvde kurutulan örneklerde toplam doymuş yağ asitleri (TSAT) %31.01, toplam çok doymamış yağ asitleri (PUFA) %14.83, toplam tek doymamış yağ asitleri (MUFA) %54.16 idi. Oda sıcaklığında kurutulanlarda TSAT %36.61, PUFA %17.41, MUFA %45.98 olarak saptandı. PUFA ve TSAT oda sıcaklığında kurutulan örneklerde'daha yüksek değerler vermesine rağmen, etüvde kurutma ile PUFA grubundan alfalinoleik asit (18:3w3,ALA) %1.76, gammalinoleik asit (18:3w6,GLA) %0.51, eicosapentatenoik asit (20:5w3, EPA) %7.42 ile daha yüksek değerler verdi. Oda sıcaklığında ve etüvde kurutularak elde edilen algal pastanın PUFA grubundan EPA içeriğinde önemli bir azalmanın meydana geldiği ve örneklerde ARAMn ise hiç tespit edilemediği görüldü. Bu çalışmada P. cruentum için denenmiş olan kurutma işlemlerinin, PUFA grubu yağ asitleri kaybına neden olduğu görüldü