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BACKGROUND AIMS: Wound healing is a multistage process that requires a concerted effort of various cell types. The intricate processes involved in the healing of wounds result in high energy requirements. Furthermore, mitochondria play a crucial role in the healing process because of their involvement in neo angiogenesis, growth factor synthesis, and cell differentiation. It is unclear how mitochondria transplantation, a promising new approach, influences wound healing. METHODS: In this study, healthy autologous mitochondria obtained from skeletal muscle were injected into chronic pressure wounds as an intervention to promote wound healing. RESULTS: Mitochondrial transplantation accelerated wound healing by reducing wound size, increasing granulation tissue, and hastening epithelialization. CONCLUSIONS: This study is the first to demonstrate the therapeutic efficacy of mitochondrial transplantation in wound healing.
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Cicatrização , Humanos , Mitocôndrias/metabolismo , Mitocôndrias/transplante , Masculino , Úlcera por Pressão/terapia , Pessoa de Meia-IdadeRESUMO
PURPOSE: Taurine, the major intracellular free amino acid found in high concentrations in mammalian cells, is known to be an endogenous antioxidant and a membrane-stabilizing agent. It was hypothesized that taurine may be effective in reducing ischemia-reperfusion injury after lung transplantation and an experimental study was conducted in a rat model. METHODS: The number of Sprague-Dawley rats used in the study was 35. Animals were randomized into five groups of 7 rats each, including control, donor I, donor II, ischemia-reperfusion injury, and treatment groups. All animals were exposed to the same experimental conditions in the preoperative period. Rats were fixed in a supine position after the induction. After the rats were shaved, a left pneumonectomy was performed following sternotomy in control, donor I, and donor II groups. The harvested grafts in donor I and donor II groups were transplanted to the rats of the ischemia-reperfusion group and treatment group, respectively. However, taurine was administered intraperitoneally for 3 days before the harvesting procedure in donor II. All harvested lungs were kept in a Euro-Collins solution at +4 °C for 24 h in a half-inflated manner. After harvesting and transplantation, lungs were sampled for histopathological and biochemical analysis. RESULTS: Malondialdehyde and superoxide dismutase, glutathione peroxidase, and catalase levels were lower in the treatment group than the other groups (p < 0.05). Histopathological findings were better in treatment group than the ischemia-reperfusion group (p < 0.05). CONCLUSION: It was demonstrated that donor treatment with taurine resulted in preservation of transplanted lung tissue in respect to histopathological and biochemical findings.
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Antioxidantes/uso terapêutico , Pulmão/efeitos dos fármacos , Pulmão/patologia , Traumatismo por Reperfusão/tratamento farmacológico , Traumatismo por Reperfusão/patologia , Taurina/uso terapêutico , Animais , Modelos Animais de Doenças , Soluções Hipertônicas , Pulmão/irrigação sanguínea , Pulmão/metabolismo , Transplante de Pulmão/métodos , Masculino , Malondialdeído/análise , Malondialdeído/metabolismo , Ratos , Ratos Sprague-Dawley , Traumatismo por Reperfusão/metabolismo , Superóxido Dismutase/análise , Superóxido Dismutase/metabolismoRESUMO
Background: This study aims to evaluate the feasibility, safety, and efficacy of transthoracic robot-assisted surgery for diaphragmatic plication and to describe our surgical approach in detail. Methods: Between January 2014 and January 2020, a total of 13 patients (11 males, 2 females; median age: 55 years; range, 24 to 70 years) who underwent diaphragmatic plication with the robotic system were retrospectively analyzed. The changes in the Medical Research Council dyspnea scale, forced expiratory volume in 1 sec, body mass index, and quality of life scale scores of the patients before the operation and at the first year of follow-up were examined. Results: Twelve of the operations were performed on the left side. The median pre- and postoperative Medical Research Council dyspnea scores were 2 (range, 1 to 4) and 1 (range, 1 to 4), respectively, indicating a statistically significant improvement (p=0.008). A significant improvement was detected in the forced expiratory volume in 1 sec of the patients in the first year after surgery (p=0.036). In terms of quality of life parameters, only, in the physical health subscale, the scores were statistically significantly different in the pre- and postoperative first-year follow-up (p=0.002). Median time to chest tube removal was 1 (range 1-5, IQR=0,5) days. Median total length of hospital stay was 2 (range 2-18, IQR=3) days. Conclusion: Owing to its technical dexterity, the robot enables the plication to be performed easily and safely. Late improvement in respiratory functions is reflected in quality of life.
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Although hydatid cysts are an endemic infestation, experience in surgical management of pregnant women is quite limited. This report aims to share the results and experiences gained from the management and surgery of a woman with a second trimester pregnancy who presented with asphyxia because of the rupture of a giant bilateral hydatid cyst.
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Equinococose , Equinococose/diagnóstico por imagem , Equinococose/cirurgia , Feminino , Humanos , Gravidez , Segundo Trimestre da Gravidez , RupturaRESUMO
Traumatic pulmonary pseudocysts (TPPs) are rare sequelae of blunt chest trauma. Young adults and adolescents are predominantly affected. In this study, two cases of TPPs in young patients are presented. Chest radiographs are usually insufficient for the diagnosis, and the imaging modality of choice is computed tomography (CT). TPPs are self-limiting, benign lesions that usually require no specific therapy. Surgical treatment is indicated in rare instances and only when complications occur.
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Cistos/diagnóstico , Pneumopatias/diagnóstico , Traumatismos Torácicos/complicações , Ferimentos não Penetrantes/complicações , Adulto , Cistos/diagnóstico por imagem , Cistos/etiologia , Cistos/terapia , Diagnóstico Diferencial , Humanos , Pneumopatias/diagnóstico por imagem , Pneumopatias/etiologia , Pneumopatias/terapia , Masculino , Radiografia Torácica , Traumatismos Torácicos/diagnóstico por imagem , Ferimentos não Penetrantes/diagnóstico por imagemRESUMO
Spontaneous pneumothorax is defined as the rupture of bleb or emphysematous bullae that develop just beneath the pulmonary pleura. Weather changes may influence the incidence of spontaneous pneumothorax. The aim of this study was to examine the influence of rainfall, temperature and atmospheric pressure changes on the onset of spontaneous pneumothorax. The study involved 669 spontaneous pneumothorax admissions to three reference hospitals in Ankara, Turkey between 1996 and 2006 (612 males and 57 females with the mean age of 34.0 +/- 15.5 years). The meteorological data were obtained from Turkish State Meteorological Services for temperature, atmospheric pressure, and rainfall. The correlation between these values and spontaneous pneumothorax clusters, which was defined as the admission of at least two patients with pneumothorax within three days of each other, was evaluated. Among 669 episodes of spontaneous pneumothorax, 472 (70.5%) occurred in 188 clusters. When compared to days without spontaneous pneumothorax, the amount of average rainfall on the day of admission with spontaneous pneumothorax, one day before and two days before the admission was significantly high. Similarly, the atmospheric pressure on one day and two days before the admission of spontaneous pneumothorax patients was significantly low. In addition, maximum temperature level was significantly lower on admission day of spontaneous pneumothorax patients compared to those on the days without spontaneous pneumothorax. This largest series of the literature shows that spontaneous pneumothorax occurs in clusters and suggests that rainfall, temperature and falls in atmospheric pressure might play a role in the pathophysiology of spontaneous pneumothorax.
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Pneumotórax/epidemiologia , Pneumotórax/etiologia , Tempo (Meteorologia) , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Estatísticas não Paramétricas , Turquia/epidemiologiaRESUMO
AIM: Nitrogen Mustard (NM) is an alkylating agent that damages cellular nuclear DNA after penetrating tissue. This results in cytostatic, mutagenic and cytotoxic effects. We used the electron microscope to investigate the effect of NM gas administered through the dermal and respiratory routes to rats on the brain cortex and also tried to show whether the antioxidant Proanthocyanidin (PC) could decrease this effect. MATERIAL AND METHODS: A total of 32 rats were randomized into four groups: Group I: Control group, Group II: PC group, Group III: NM group, Group IV: NM + PC group. The rats were sacrificed 3 days after NM gas exposure. A segment of the cortical tissue was prepared for electron microscopy. RESULTS: We used the electron microscope for cellular analysis of NM on cortical neural cells. These investigations revealed degeneration of the cortical neural cell nuclei together with oedema and axonal degeneration in the subcortical neural tissue. The group receiving antioxidants was found to have less oedema and degeneration. CONCLUSION: These findings imply that structural changes induced by mustard gas can be prevented and restored by proanthocyanidin treatment.
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Encefalopatias/induzido quimicamente , Encefalopatias/tratamento farmacológico , Substâncias para a Guerra Química/toxicidade , Mecloretamina/toxicidade , Proantocianidinas/farmacologia , Animais , Antioxidantes/farmacologia , Encefalopatias/patologia , Edema Encefálico/induzido quimicamente , Edema Encefálico/tratamento farmacológico , Edema Encefálico/patologia , Córtex Cerebral/efeitos dos fármacos , Córtex Cerebral/patologia , Masculino , Degeneração Neural/induzido quimicamente , Degeneração Neural/tratamento farmacológico , Degeneração Neural/patologia , RatosRESUMO
BACKGROUND: This study aims to investigate the demographic characteristics and familial inheritance of pectus deformities across Turkey. METHODS: Demographic characteristics of a total of 5,098 patients (5,028 males, 70 females, mean age 23.6 years; range, 1 to 56 years) with pectus excavatum and pectus carinatum admitted to our outpatient clinic between January 1996 and December 2018 were retrospectively analyzed. The distribution of the patients across the country was made according to seven regions and 81 provinces. Familial inheritance was investigated using patients" data obtained from the clinical records and telephone calls. RESULTS: Of all patients, 3,330 (65.3%) had pectus excavatum and 1,768 (34.7%) had pectus carinatum deformity with a pectus excavatum-to-pectus carinatum ratio of 1/1.9. In the Southeast Anatolia region, the rate of pectus excavatum was lower than the overall average and higher in the Marmara region (p=0.009 and p=0.037, respectively). In the Southeast Anatolia region, the rate of pectus carinatum was higher than the general average and lower in the Marmara region (p=0.001 and p=0.003, respectively). Kastamonu, Çankiri, Karabük, and Sinop were the most common provinces for pectus deformity cases. Family history was positive in 39% of pectus excavatum and 43% of pectus carinatum patients. All regions showed a similar distribution in terms of the presence of family history. CONCLUSION: This is the first study to report the distribution of pectus deformities in Turkey and the high frequency of pectus deformities in certain regions and provinces of Turkey indicates familial inheritance.
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BACKGROUND: This study aims to investigate the preventive effect of proanthocyanidin against ischemia-reperfusion injury after lung transplantation. METHODS: The study included 12 swines (weighing 35±5 kg) and separated into four groups. Groups 1 and 3 were identified as control groups and left upper lobectomy was performed. Groups 2 and 4 were identified as transplantation groups and left lower lobectomy and heterotransplantation were performed. Proanthocyanidin was only given to groups 3 and 4. Tissue samples were analyzed under light microscope and histopathological findings were recorded. RESULTS: There was no statistically significant difference between control groups in terms of the numerical values of histopathological findings that include congestion (p=0.565), alveolar edema (p=0.197) and peribronchial inflammation (p=0.444). However, numerical values of acute cellular rejection were statistically significantly different between transplantation groups (p=0.048). Mean oxidative stress enzyme levels were higher in group 2 compared to group 4; however, the difference was not statistically significant (p>0.05). CONCLUSION: According to the findings of our experimental study, proanthocyanidin can be safely used in lung transplantation based on its preventive effect in ischemia-reperfusion injury that may lead to morbidity and mortality.
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The main method of fighting against colon cancer is targeted treatment. BRAF inhibitors, which are accepted as standard treatment for V600E mutant malign melanomas, are the newest approach for targeted treatment of V600E mutant colorectal cancers. In this case report, we share our experience about the use of BRAF inhibitor vemurafenib on a V600E mutant metastatic right colon adenocarcinoma patient. A 59-year-old male with only lung multiple metastatic V600E mutant right colon cancer presented to our clinic. The patient was evaluated and FOLFOX + bevacizumab treatment was initiated, which was then continued with vemurafenib. A remarkable response was achieved with vemurafenib treatment in which the drug resistance occurred approximately in the sixth month. Even though the patient benefited majorly from vemurafenib, he died on the 20th month of the diagnosis. The expected overall survival for metastatic V600E mutant colon adenocarcinoma patients is 4.7 months. BRAF inhibitors provide new treatment alternatives for V600E mutant colorectal cancers, with prolonged overall survival. BRAF inhibitors in combination with MEK inhibitors are reported as feasible treatment to overcome BRAF inhibitor drug resistance on which phase studies are still in progress. To conclude, BRAF inhibitors alone or in combination with other drugs provide a chance for curing BRAF V600E mutant colorectal cancer patients.
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Bronchobiliary fistula caused by liver echinococcosis is a relatively unusual but severe complication of hydatid disease. Optimal management of cases is crucially important in establishing rapid recovery and avoiding additional complications. The use of an algorithmic guide is essential because of an ongoing dilemma that involves a large variety of therapeutic options. We present four patients with bronchobiliary fistulas caused by liver hydatid disease to discuss the management of therapeutic options through a case-based approach and an extent review to finally generate an algorithm. In this series, two patients were treated surgically, and the remaining were treated with conservative methods. To date, they have developed neither recurrence nor need for additional intervention. Although treatment of bronchobiliary fistulas is traditionally thought to be surgical, most of the less severe cases can be treated nonoperatively. Making an accurate selection among less invasive methods and/or open surgical interventions seems to be a key component of management.
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Fístula Biliar/cirurgia , Fístula Brônquica/cirurgia , Equinococose Hepática/complicações , Adulto , Idoso , Algoritmos , Fístula Biliar/diagnóstico , Fístula Biliar/etiologia , Fístula Brônquica/diagnóstico , Fístula Brônquica/etiologia , Colangiopancreatografia Retrógrada Endoscópica , Equinococose Hepática/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: The most common congenital chest wall deformities are pectus excavatum and pectus carinatum. Various techniques have been described for correction of pectus deformities. We describe our experience with surgical repair of pectus deformity (PD) in adults, including our new technique, which uses a resorbable plaque for fixation of the sternum. METHODS: We reviewed the records of 317 patients who underwent surgical correction of PD between October 1997 and December 2005. RESULTS: All of the patients were male and the median age was 21.3 years (range, 16-32 years). Of 317 patients, the type of deformity was a pectus excavatum in 230 patients and a pectus carinatum in 87 of the patients. Four different operative techniques were used. There were no intraoperative deaths or major perioperative morbidity. The complications rate was 17%. Overall mean hospital stay was 14.25 days. In 208 patients who underwent a mid-term outpatient follow up (mean, 8 months), there was no recurrence. Patient satisfaction was excellent in 234 patients, good in 79 patients and fair in 4 patients. CONCLUSION: The majority of patients with pectus deformity had been operated on during childhood; therefore there is limited published information about the correction of pectus excavatum and pectus carinatum deformities in adults. The most important point in pectus correction is to achieve proper and long-term stability of the sternum following osteotomy. Various techniques can be used for this purpose.
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Tórax em Funil/cirurgia , Procedimentos Cirúrgicos Torácicos/métodos , Parede Torácica/anormalidades , Parede Torácica/cirurgia , Adolescente , Adulto , Cartilagem Articular/transplante , Seguimentos , Humanos , Tempo de Internação , Masculino , Dispositivos de Fixação Ortopédica , Satisfação do Paciente , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Esterno/anormalidades , Esterno/cirurgia , Procedimentos Cirúrgicos Torácicos/instrumentação , Titânio/uso terapêutico , Resultado do TratamentoRESUMO
OBJECTIVE: In clotted hemothorax, both thoracocentesis and closed tube thoracostomy will not be able to evacuate the pleural cavity especially if it is minimal. The aim of this study was to assess the effectiveness of intrapleural administered streptokinase on minimal clotted hemothorax without drainage, in order to accelerate the spontaneous resolution and absorption in blunt thoracic trauma. METHODS: Thirteen adult ewes were used for this experiment. The animals were divided into two groups. First group served as the control group (Group C) (n=5) and did not receive any intrapleural fibrinolytic treatment. In both groups, 200 ml of blood was taken from the left jugular vein and injected into the pleural cavity with a serum line through the scope after pleural abrasion. Streptokinase (150.000 U) was diluted in 100 ml of saline and applied to the second group (Group S) (n=5) in second postoperative day. One ewe in each group was sacrificed with a lethal dose of sodium thiopental in postoperative 2nd, 4th, 6th, 8th, and 10th weeks, respectively. When a left posterolateral thoracotomy was performed, pleural thickening and adhesion were evaluated. The lung and pleural tissue samples were taken for histopathologic examination. The slides were examined in a blinded manner. RESULTS: Thoracentesis was performed in all ewes in the second postoperative day and no fluid was detected. There was no allergic reaction in group S after the injection of streptokinase into the pleural cavity. During postmortem macroscopic evaluation, we observed clot in one of the ewes in group C in second postoperative week. A statistically significant difference was found between Group C and S regarding pleural thickening and adhesion (P=0.05). The ewes of Group S had less pleural thickening and adhesion compared to those of Group C. These results were confirmed with histopathological examination. CONCLUSION: We conclude that intrapleural streptokinase increases resolution of clot in the pleural space and decreases pleural thickening and adhesion in experimental minimal clotted hemothorax in ewes. This study has also demonstrated that intrapleural streptokinase can be used without drainage. Use of intrapleural streptokinase without drainage can be a novel therapeutic option for trauma patients with minimal clotted hemothorax after haemorrhage of other organs was excluded.
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Fibrinolíticos/uso terapêutico , Hemotórax/tratamento farmacológico , Estreptoquinase/uso terapêutico , Terapia Trombolítica/métodos , Animais , Feminino , Hemotórax/etiologia , Hemotórax/patologia , Pleura/patologia , Índice de Gravidade de Doença , Ovinos , Traumatismos Torácicos/complicações , Ferimentos não Penetrantes/complicaçõesRESUMO
OBJECTIVE: Bronchiectasis is defined permanent dilatations of bronchi with destruction of the bronchial wall. It is still a major cause of morbidity and mortality in developing countries. The aim of this retrospective study is to present our surgical experiences, the early and long-term results of 238 patients with bronchiectasis during a 10-year period. METHODS: We reviewed the medical records of 238 patients who underwent surgical resection for bronchiectasis between January 1992 and December 2001, at Gülhane Military Medical Academy (GMMA) Thoracic Surgery Department. Variables of age, sex, symptoms, etiology, and type of operation, mortality, morbidity and the result of surgical therapy were analyzed. RESULTS: There were 205 (86.13%) male and 33 (13.87%) female patients with an average age of 23.7 and a range of 15-48 years. The presenting symptoms were productive cough in 133 (55.88%), fetid sputum in 116 (48.73%), recurrent infections in 84 (35.29%), and hemoptysis in 39 (12.18%) patients. The disease was bilateral in 31 patients (13.02%) and mainly confined to the lower lobes in 162 (68.06%). The surgical treatment was as follows: pneumonectomy in 13 patients (5.46%), lobectomy in 189 (79.40%), lobectomy+segmentectomy in 31 (13.02%), and wedge resection or segmentectomy in five (2.1%). Staged bilateral thoracotomy was used in 14 patients. There was no operative mortality. Complications occurred in 21 patients and the morbidity rate was 8.82%. Complete resection was achieved in 154 (64.7%) patients. Follow-up data were obtained for 229 (96.21%) of the patients. Nine patients were lost to follow-up. The mean follow-up of these patients was 9 months (range, 3 months to 4 years). The symptoms disappeared in 189 patients (79.41%) and 29 patients (12.18%) had improved, whereas 11 patients (4.62%) had no improvement. Significantly better results were obtained in patients who had undergone a complete resection. CONCLUSIONS: Surgical resection for bronchiectasis can be performed with acceptable morbidity and mortality at any age. The involved bronchiectatic sites should be resected completely for the optimum control of symptoms.
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Bronquiectasia/cirurgia , Pneumonectomia/métodos , Adolescente , Adulto , Infecções Bacterianas/complicações , Bronquiectasia/diagnóstico por imagem , Bronquiectasia/microbiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonectomia/efeitos adversos , Recidiva , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do TratamentoAssuntos
Equinococose/diagnóstico , Doenças Torácicas/diagnóstico , Adulto , Diafragma/fisiopatologia , Equinococose/cirurgia , Feminino , Coração/fisiopatologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Mediastino/fisiopatologia , Pessoa de Meia-Idade , Doenças Torácicas/cirurgia , Parede Torácica/fisiopatologia , Toracotomia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
BACKGROUND: Chemical pleurodesis is widely recommended in the treatment of refractory pleural effusion or pulmonary air leak of different etiologies. Although several agents have been used, many questions have remained unanswered about their toxicity. Talc is the most commonly used agent for the treatment, with rare, serious complications reported. Oxytetracycline pleurodesis in clinical practice has been described in a few studies, but literature reveals no experimental studies using this agent. We performed a prospective, randomized, observer-blinded, controlled study to evaluate the changes in lung histology and systemic response to pleurodesis with oxytetracycline and talc in acute and subacute phases in a rat model. METHODS: Forty-two male albino Wistar rats were divided into three groups and 3 subgroups with 7 animals in each. Group 1 was given oxytetracycline, 35 mg/kg; Group 2 was given talc slurry, 60 mg/kg in 0.5 mL saline solution, and Group 3 was given only 0.5 mL saline intrapleurally. In subgroups "a" the nimls were sacrificed at the postoperative 72nd hour and, in subgroups "b", on the postoperative day 7. The surfaces were graded by microscopic examination. RESULTS: Oxytetracycline produced alveolar collapse, hemorrhage, edema, inflammation at the postoperative 72nd hour and hemorrhage on the postoperative day 7, while talc produced significant edema, inflammation, proliferation, fibrosis at the postoperative 72nd hour and hemorrhage, edema, inflammation, proliferation, and fibrosis on the postoperative day 7 (p < 0.0042). Talc produced significant edema compared to oxytetracycline on the postoperative day 7. On contralateral side, oxytetracycline and talc produced significant hemorrhage on the postoperative day 7 (p < 0.0042). CONCLUSIONS: Both agents were shown to produce pulmonary lesions. In acute phase, the pulmonary side effects of oxytetracycline were more pronounced, whereas the side effects of talc were prolonged to subacute phase. We propose that the occasional side effects in humans may be related to these changes as were observed in our rat model, and like talc, oxytetracycline must be used cautiously in patients with limited respiratory function.
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Antibacterianos/efeitos adversos , Antiperspirantes/efeitos adversos , Pulmão/efeitos dos fármacos , Oxitetraciclina/efeitos adversos , Pleurodese/efeitos adversos , Talco/efeitos adversos , Animais , Antibacterianos/administração & dosagem , Pulmão/patologia , Masculino , Oxitetraciclina/administração & dosagem , Ratos , Ratos Wistar , Talco/administração & dosagemRESUMO
INTRODUCTION: We investigated the role of oxidative stress in the pathogenesis of reexpansion pulmonary edema (RPE) and effect of alpha-lipoic acid (ALA) in the prevention of RPE. MATERIAL AND METHODS: There were 4 groups consisting of 10 rats in each group; control group (CG), α-lipoic acid group (ALAG), reexpansion pulmonary edema group (RPEG), reexpansion pulmonary edema plus α-lipoic acid group (RPE + ALAG). In all the groups, all rats were sacrificed 2 hours after the reexpansion of lungs. To indicate oxidative stress malondialdehyde (MDA), and to indicate antioxidant status superoxide dismutase (SOD), catalase (CAT) and glutathione peroxides (GPx) were measured in the lungs of rats. RESULTS: Mean MDA value was lower in CG (7.02 ±0.14) and in ALAG (6.95 ±0.11) than the other groups (p = 0.001). It was highest in RPEG (8.89 ±0.21) (p = 0.001). It was lower in RPE + ALA G (7.21 ±0.32) than RPEG (p = 0.001). Antioxidant levels: GPx (37.21 ±3.01), CAT (2.87 ±0.14) and SOD (100.12 ±12.39) were lowest in RPEG among all groups (p = 0.001). These values were GPx (45.21 ±3.54), CAT (3.24 ±0.21) and SOD (172.36 ±15.48) in RPE + ALA G and were greater than those of RPEG (p = 0.001). While normal pulmonary parenchyma was seen in 2 rats in RPE + ALAG, it was not seen in RPEG. Pulmonary edema was seen in 1 rat in RPE + ALAG; however, it was seen in 3 in RPEG. CONCLUSIONS: Oxidative stress might have an important role in the pathogenesis of RPE. In addition, ALA treatment might contribute in preventing RPE.
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OBJECTIVE: Tuberculosis remains one of the most fatal diseases in the world. Extrapulmonary tuberculosis increases in parallel fashion with the rise of incidence of pulmonary tuberculosis. Tuberculosis of the chest wall is rare. METHODS: Our study retrospectively evaluated 10 patients with tuberculosis of the chest wall who were treated with surgery in addition to antituberculous chemotherapy in the last 8 years. Seven of the lesions were located on the anterior chest wall, and three of the lesions were on the lateral chest wall. RESULTS: Surgical therapy consisted of evacuation of the cold abscess material from the cavities and wide débridement of the soft tissue planes in all patients. Partial rib resections were performed in six patients owing to costal or chondral involvement. CONCLUSIONS: Chest wall tuberculosis must be considered in the differential diagnosis of chest wall lesions, especially in endemic areas.
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Parede Torácica , Tuberculose Osteoarticular/cirurgia , Adulto , Idoso , Desbridamento , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Tuberculose Osteoarticular/diagnóstico , Adulto JovemRESUMO
BACKGROUND: We aimed to investigate the preventive effect of Proanthocyanidine (PC) in the prevention of RPE formation. METHODS: Subjects were divided into four groups each containing 10 rats. In the Control Group (CG): RPE wasn't performed. Then subjects were followed up for three days and they were sacrificed after the follow up period. Samplings were made from tissues for measurement of biochemical and histopathologic parameters. In the Second Group (PCG): The same protocol as CG was applied, except the administration of PC to the subjects. In the third RPE Group (RPEG): Again the same protocol as CG was applied, but as a difference, RPE was performed. In the Treatment Group (TG): The same protocol as RPEG was applied except the administration of PC to the subjects. RESULTS: In RPEG group, the most important histopathological finding was severe pulmonary edema with alveolar damage and acute inflammatory cells. These findings were less in the TG group. RPE caused increased MDA levels, and decreased GPx, SOD and CAT activity significantly in lung tissue. CONCLUSION: PC decreased MDA levels. Oxidative stress plays an important role in pathophysiology of RPE and PC treatment was shown to be useful to prevent formation of RPE.
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Antioxidantes/uso terapêutico , Proantocianidinas/uso terapêutico , Edema Pulmonar/prevenção & controle , Animais , Catalase/análise , Protocolos Clínicos , Glutationa Peroxidase/análise , Malondialdeído/análise , Ratos , Prevenção Secundária , Estatísticas não Paramétricas , Superóxido Dismutase/análise , Resultado do TratamentoRESUMO
Re-expansion pulmonary edema (RPE) is an acute, rare and potentially lethal complication. Its beginning is sudden and dramatic. The mechanism is not yet fully understood. Some authors suggest that it may occur after rapid re-inflation of a collapsed lung. It was reported by other authors that it may relate to surfactant depletion or may result from hypoxic capillary damage, leading to increased capillary permeability. In RPE, unilateral lung injury is initiated by cytotoxic oxygen metabolites and temporally associated with an influx of polymorphonuclear neutrophils. These toxic oxygen products are the results of re-oxygenation of a collapsed lung. Treatment of re-expansion pulmonary edema is basically preventive.