Farklı kortikosteroidlerin yenidoğan ratlarda hipokampusta nöron kaybına ve beyin ağırlığına etkisi

Amaç: Kronik akciğer hastalığı riski olan mekanik ventilatöre bağlı düşük doğum ağırlıklı yenidoğanlara steroid tedavisi uygulanmaktadır. Çalışmamızda neonatal dönemde eşit etkin dozda deksametazon, betametazon ve metilprednizolon tedavisinin, ayrıca yüksek doz deksametazon tedavisinin hipokampusta nöron kaybına etkisi ve beyin ağırlığının vücut ağırlığına oranı karşılaştırıldı. Gereç ve Yöntem: Pamukkale Üniversitesi Tıp Fakültesi Deney Hayvanları Laboratuvarı'nda üretilmiş olan Sprague-Dawley ratlar (Denizli, Türkiye) çalışmaya alındı. 1. Grup, kontrol; 2. grup betametazon; 3. grup, metilprednizolon; 4. grup, düşük doz deksametazon; 5.grup, yüksek doz deksametazon grubu Postnatal 3., 4. ve 5. günlerde kontrol grubuna serum fizyolojik, ikinci gruba betametazon, üçüncü gruba metilprednizolon, dördüncü gruba düşük doz deksametazon, beşinci gruba yüksek doz deksametazon tedavisi azaltılan dozlarda subkutan verildi. Vücut ağırlıkları ilaçlar verilmeden önce postnatal 1., postnatal 3-5 günlerde ve postnatal 7. günde dekapitasyon öncesinde ölçüldü. Postnatal 7. günde beyin kraniyotomi ile çıkarıldı. Beyin ağırlıkları ölçüldü. Beyin dokusu simetrik olarak ikiye bölünerek bir yarısı TUNEL boyama için hazırlandı. Bulgular: Yüksek doz deksametazon grubunda hipokampusta Aİ sayısı diğer gruplardan anlamlı olarak fazlaydı (p0.001). Ayrıca, metilprednizolon grubunda Aİ sayısı kontrol, betametazon ve düşük doz deksametazon grubuna göre anlamlı olarak fazlaydı (p0.001). Yüksek doz deksametazon grubunda, hipokampusun hem CA1 hem de CA3 alt bölgelerinde Aİ sayısı diğer grupların CA1 ve CA3 alt bölgelerine göre anlamlı olarak yüksekti (p 0.001). Aİ sayısı metilprednizolon grubunun CA1 alt bölgesinde, betametazon (p0.001) ve kontrol (p0.02) gruplarının CA1 alt bölgelerine göre anlamlı olarak yüksekti. Düşük doz deksametazon grubunun CA1 alt bölgesinde Aİ sonucu betametazon grubunun CA1 alt bölgesine göre anlamlı olarak yüksekti (p0.03). Metilprednizolon grubunun CA3 alt bölgesinde Aİ sayısı kontrol, betametazon ve düşük doz deksametazonun CA3 alt bölgelerine göre anlamlı olarak yüksekti (p0.001). Ayrıca, kontrol, betametazon, metilprednizolon ve yüksek doz deksametazonun CA3 alt bölgelerinde Aİ sonucu, bu grupların CA1 alt bölgelerindekine göre anlamlı olarak yüksekti (p0.001). Beyin ağırlığının vücut ağırlığına oranı yüksek doz deksametazon grubunda diğer gruplara göre anlamlı olarak düşük bulunurken (p0.02), betametazon, metilprednizolon, düşük doz deksametazon ve kontrol grubu arasında istatistiksel olarak fark bulunmadı (p>0.05). Sonuç: Sonuç olarak betametazonun hipokampusta nöron kaybına yol açmadığı ve beyin ağırlığını sadece yüksek doz deksametazonun etkilediği sonucuna varılmıştır.Purpose: Dexamethasone has been applied to ventilator-depended premature infants with chronic lung disease to improve lung function. In this study, the effects of the equivalent doses for antiinflammatory potency of neonatal dexamethasone, betamethasone and methylprednisolone have been evaluated on in situ cell death in hippocampus and on ratio of brain weight to body weight in rats. Same comparision has also been performed with high and low dose dexamethasone treatment. Material and Method: Groups were prepared as follows: Group 1, control; group 2:,betamethasone; group 3, methylprednisolone; group 4, low dose dexamethasone; group 5, high dose dexamethasone group At postnatal 3rd, 4th and 5th days pups at first, second, third, fourth and fifth groups were injected with saline, betamethasone, methylprednisolone, low and high dose dexamethasone respectively. The treatments were given subcutaneously with tapering doses. Body weight was measured on PD1, PD 3-5 before the treatment was given and on PD 7 before the decapitation. On PD 7 brain weights were measured and divided into two hemisphers. One hemisphere was processed for TUNEL method. Results: AI was significantly higher in high dose dexamethasone group than the other groups (p0.001). It was also significantly higher in methylprednisolone group than betamethasone, low dose dexamethasone and control groups (p0.001). AI in CA1 and CA3 subregions of high dose dexamethasone group were the highest among the five groups (p0.001). AI in CA1 subregion of methylprednisolone group was significantly higher than that in control (p0.02), and betamethasone (p0.001) groups. AI in CA1 subregion of low dose dexamethasone group was significantly higher than that in betamethasone (p0.03) group. AI in CA3 subregion of methylprednisolone group was significantly higher than that in control, betamethasone, and low dose dexamethasone groups (p0.001). AI of CA3 subregion was significantly higher than that of CA1 subregion in control, betamethasone, methylprednisolone and high dose dexamethasone groups (p0.001). High dose dexamethasone caused significant decrease in the ratio of brain weight to body weight (p0.02), there was no significant difference among other groups. Conclusion: Betamethasone treatment has no effect on hippocampal neuronal loss. High dose dexamethasone treatment decreases the ratio of brain weight to body weight

Effects of different corticosteroids on the brain weight and hippocampal neuronal loss in rats

Equivalent antiinflammatory doses of steroids including betamethasone, methylprednisolone and dexamethasone were administered in the neonatal period in a rat model. In situ cell death in hippocampus quantified by Terminal Deoxynucleated Transferase Nick-End Labeling and on ratio of brain to body weight was investigated. Apoptotic index (AI) was significantly higher in methylprednisolone, and high dose dexamethasone groups than the other groups. AI in "Cornu ammonis 1" (CA1) and "Cornu ammonis 3" (CA3) subregions of high dose dexamethasone group was the highest among the five groups tested. AI in CA3 subregions of methylprednisolone group was also significantly higher than the control, betamethasone and low dose dexamethasone groups. AI in CA1 subregion were not different among control, betamethasone, methylprednisolone and low dose dexamethasone groups. In addition, high dose dexamethasone resulted significant decrease in the ratio of brain weight to body weight in comparison to all other groups tested. In conclusion, betamethasone and low dose dexamethasone may be better alternative treatments among agents tested in this study for chronic lung disease (CLD). © 2008

Transient pulmonary perfusion abnormality after massive exchange transfusion: Case report

The principal indications for exchange transfusion are hemolytic diseases of the newborn with hyperbilirubinemia. However, there are some potential complications of exchange transfusion such as infection, coagulopathies (i.e., thrombocytopenia), electrolyte abnormalities (i.e., hypocalcemia), metabolic acidosis, hypoglycemia, and necrotizing enterocolitis. Stored blood develops some platelet-white cell microaggregates. These microaggregates or blood debris have been found to produce changes in pulmonary hemodynamics in animals and have been implicated in post-traumatic pulmonary insufficiency in man. Authors suggested that pulmonary gas exchange alterations following blood transfusion were primarily due to increased dead-space ventilation secondary to vasoconstriction and occlusion of the pulmonary microvasculature because of microaggregates. In this article, a newborn with transient pulmonary perfusion abnormality who had massive exchange transfusion for Rh isoimmunization and hyperbilirubinemia was reported. © 2010 by Türkiye Klinikleri

Transient pulmonary perfusion abnormality after massive exchange transfusion: Case report

The principal indications for exchange transfusion are hemolytic diseases of the newborn with hyperbilirubinemia. However, there are some potential complications of exchange transfusion such as infection, coagulopathies (i.e., thrombocytopenia), electrolyte abnormalities (i.e., hypocalcemia), metabolic acidosis, hypoglycemia, and necrotizing enterocolitis. Stored blood develops some platelet-white cell microaggregates. These microaggregates or blood debris have been found to produce changes in pulmonary hemodynamics in animals and have been implicated in post-traumatic pulmonary insufficiency in man. Authors suggested that pulmonary gas exchange alterations following blood transfusion were primarily due to increased dead-space ventilation secondary to vasoconstriction and occlusion of the pulmonary microvasculature because of microaggregates. In this article, a newborn with transient pulmonary perfusion abnormality who had massive exchange transfusion for Rh isoimmunization and hyperbilirubinemia was reported. © 2010 by Türkiye Klinikleri

The Prevalence of Asthma Diagnosis and Symptoms is Still Increasing in Early Adolescents in Turkey

Background: : This study was performed to evaluate the time trends in prevalence of asthma and related factors in Denizli, Turkey. Methods: : Two cross-sectional surveys were performed, 6 years apart (2002 and 2008) using the ISAAC protocol, in the 13-14 age groups and comparisons were made between the results. Results: : Lifetime prevalence of wheeze, 12 month prevalence of wheeze, and the prevalence of wheeze after exercise in the previous 12 months were significantly increased respectively from 10.2% to 13.4% (POR = 1.37, 95%CI = 1.18-1.58, p < 0.001), from 5.0% to 6.2% (POR = 1.26, 95%CI = 1.02-1.55, p = 0.016) and from 9% to 10.2% (POR = 1.15, 95%CI = 0.98-1.35, p = 0.046) in 2008 study. Doctor diagnosed asthma prevalence also increased significantly from 2.1% to 12.9 (POR = 6.80, 95%CI =5.22-8.85, p < 0.001). Prevalence of sleep disturbed by wheeze in the last 12 months; but, never woken with wheezing (POR = 1.62, 95%CI = 1.26-2.09, p = < 0.001) and less than one night per week (POR = 1.58, 95%CI = 1.06-2.36, p = 0.013) were significantly increased in 2008 study. Severe attacks of wheeze limiting speech in the last year was increased from 1.3% to 2.2% (POR = 1.67, 95%CI = 1.14-2.43, p = 0.004). The number of wheeze attacks in the previous 12 months was increased significantly for 4-to-12 attacks (POR = 1.54, 95%CI = 1.03-2.32, p = 0.02) in 2008 study. However, prevalence of waking with cough in the last 12 months did not change. While history of family atopy and domestic animal at home were found as significant risk factors for asthma in 2002 study, male gender, history of family atopy and stuffed toys were found significant in 2008. Conclusions: : The prevalence of asthma symptoms were increased in Denizli. History of family atopy, male gender and stuffed toys were important risk factors for asthma in 2008