Myeloperoxidase induces monocyte migration and activation after acute myocardial infarction.

Introduction: Myocardial infarction (MI) is a significant contributor to morbidity and mortality worldwide. Many individuals who survive the acute event continue to experience heart failure (HF), with inflammatory and healing processes post-MI playing a pivotal role. Polymorphonuclear neutrophils (PMN) and monocytes infiltrate the infarcted area, where PMN release high amounts of the heme enzyme myeloperoxidase (MPO). MPO has numerous inflammatory properties and MPO plasma levels are correlated with prognosis and severity of MI. While studies have focused on MPO inhibition and controlling PMN infiltration into the infarcted tissue, less is known on MPO's role in monocyte function. Methods and results: Here, we combined human data with mouse and cell studies to examine the role of MPO on monocyte activation and migration. We revealed a correlation between plasma MPO levels and monocyte activation in a patient study. Using a mouse model of MI, we demonstrated that MPO deficiency led to an increase in splenic monocytes and a decrease in cardiac monocytes compared to wildtype mice (WT). In vitro studies further showed that MPO induces monocyte migration, with upregulation of the chemokine receptor CCR2 and upregulation of inflammatory pathways identified as underlying mechanisms. Conclusion: Taken together, we identify MPO as a pro-inflammatory mediator of splenic monocyte recruitment and activation post-MI and provide mechanistic insight for novel therapeutic strategies after ischemic injury.

Stamp2 Protects From Maladaptive Structural Remodeling and Systolic Dysfunction in Post-Ischemic Hearts by Attenuating Neutrophil Activation.

The six-transmembrane protein of prostate 2 (Stamp2) acts as an anti-inflammatory protein in macrophages by protecting from overt inflammatory signaling and Stamp2 deficiency accelerates atherosclerosis in mice. Herein, we describe an unexpected role of Stamp2 in polymorphonuclear neutrophils (PMN) and characterize Stamp2's protective effects in myocardial ischemic injury. In a murine model of ischemia and reperfusion (I/R), echocardiography and histological analyses revealed a pronounced impairment of cardiac function in hearts of Stamp2-deficient- (Stamp2-/- ) mice as compared to wild-type (WT) animals. This difference was driven by aggravated cardiac fibrosis, as augmented fibroblast-to-myofibroblast transdifferentiation was observed which was mediated by activation of the redox-sensitive p38 mitogen-activated protein kinase (p38 MAPK). Furthermore, we observed increased production of reactive oxygen species (ROS) in Stamp2-/- hearts after I/R, which is the likely cause for p38 MAPK activation. Although myocardial macrophage numbers were not affected by Stamp2 deficiency after I/R, augmented myocardial infiltration by polymorphonuclear neutrophils (PMN) was observed, which coincided with enhanced myeloperoxidase (MPO) plasma levels. Primary PMN isolated from Stamp2-/- animals exhibited a proinflammatory phenotype characterized by enhanced nuclear factor (NF)-κB activity and MPO secretion. To prove the critical role of PMN for the observed phenotype after I/R, antibody-mediated PMN depletion was performed in Stamp2-/- mice which reduced deterioration of LV function and adverse structural remodeling to WT levels. These data indicate a novel role of Stamp2 as an anti-inflammatory regulator of PMN and fibroblast-to-myofibroblast transdifferentiation in myocardial I/R injury.

[Publication rates of audiology master and doctoral theses in peer-reviewed journals]. / Odyoloji alaninda yapilan yüksek lisans ve doktora tezlerinin bilimsel dergilerde yayinlanma oranlari.

OBJECTIVES: Theses are the prime indicators of the scientific productivity of a country and one of the main and strongest resources for the emergence of scientific articles. This study aims to examine, by using the survey method, how many of the audiology master and/or doctoral theses in Turkey were turned into a scientific work. PATIENTS AND METHODS: Individuals who received a master's degree in audiology were surveyed whether their theses had been reviewed as a paper or publication. RESULTS: Forty-five of the 230 audiology specialists and 22 audiologists with a doctorate degree working in Turkey participated in the study by answering the survey questions. In general, while 45.4% of master theses were presented orally or as a poster presentation in a national convention, 20.4% were presented orally or as a poster presentation in an international convention. While 18.1% of theses were published as an article in a national journal, 15.9% were published as an article in an international SCI or SCI-E journal. The distribution of the doctoral theses is 26.6%, 33.3%, 13.3% and 26.6%, respectively. CONCLUSION: We found the rate of theses in audiology turning into a scientific article to be below the desired level, as in other fields. The reasons for this should be emphasized and efforts should be made to raise these rates to the desired level.

Evaluation of the Effect of Bosentan-Mediated Endothelin Receptor Blockade on Flap Survival in Rats: An Experimental Study.

Local skin flaps are important tools for performing plastic surgery. Skin flaps are used for closure of defects after tumor excision or in tissue losses after trauma. However, problems associated with these flaps are commonly encountered, particularly in areas of marginal necrosis. Bosentan is a vasodilator that exerts its effect through endothelin receptor blockade, and has been shown to prevent ischemic tissue damage. However, no reports have addressed the effect of bosentan on skin flaps. The aim of the study was to investigate the effects of bosentan, which may be applied clinically to promote survival of ischemic skin flaps. A modified McFarlane flap was elevated in the dorsum of 20 Albino Wistar rats with a width-to-length ratio of 3 to 10 cm, respectively, with the caudal base. Perioperatively, 0.9% of physiologic NaCl and injectable distilled water of identical volume were injected into rats in Group 1 (n = 10), and 5 mg/kg bosentan was injected intraperitoneally into rats in Group 2 (n = 10). All of the rats were followed up for 7 days postoperatively. The surviving parts of the flaps were measured at the end of day 7. Acute and chronic inflammation, amount of granulation tissue, fibroblast maturation, amount of collagen, and amounts of reepithelialization and neovascularization present in the ischemic zones of the distal parts of the flaps were evaluated histopathologically, and results were compared statistically. The mean flap survivals were 61.1% in Group 1 and 91.1% in Group 2; the percentage of the surviving flap area in Group 2 was higher than that in Group 1 (p < 0.005). In both groups, there was significantly less acute inflammation in the ischemic zones in Group 2 than in Group 1 (p < 0.005). No significant difference was found in the amounts of chronic inflammation and granulation tissue between the two groups (p > 0.005). Fibroblast maturation, amount of collagen, and amounts of reepithelialization and neovascularization investigated in Group 2 were statistically significantly higher than those in Group 1 (p < 0.005). We believe that bosentan may be used prophylactically to increase survival in risky skin flaps because it decreases ischemic necrosis distal to skin flaps, thus exerting favorable effects on flap survival.

A fast, easy circumcision procedure combining a CO2 laser and cyanoacrylate adhesive: a non-randomized comparative trial.

BACKGROUND: Circumcision is performed as a routine operation in many countries, more commonly for religious and cultural reasons than for indicated conditions, such as phimosis and balanitis. There are many techniques available, and recently electrocautery and both Nd:YAG and CO2 lasers, instead of blades, have been used for skin and mucosal incisions. However, the infection risk in circumcisions performed using a CO2 laser was 10% higher. There are also reports of sutureless procedures using cyanoacrylate, but these have higher risks of hematoma and hemorrhage. We combined a CO2 laser and cyanoacrylate to shorten the operation time and to decrease bleeding complications. MATERIALS AND METHODS: Circumcisions were performed under general anesthesia with CO2 laser and cyanoacrylate combination in 75 6-9-year-old boys between May 2013 and August 2014 only for religious reasons. As a control, we compared them retrospectively with 75 age-matched patients who were circumcised using the conventional guillotine method in our clinic. RESULTS: No hematomas, bleeding, or wound infections were observed. One wound dehiscence (1.33%) occurred during the early postoperative period and healed without any additional procedures. The median operating time was 7 (range 6-9) minutes. The conventional guillotine group comprised one hematoma (1.3%), two wound dehiscences (2.6%), and two hemorrhages (2.6%), and the median operating time was 22 (range 20-26) minutes. The difference in surgical time was significant (p<0.001), with no significant difference in the rate of complications between the two groups. CONCLUSION: The combined CO2 laser and cyanoacrylate procedure not only decreased the operating time markedly, but also eliminated the disadvantages associated with each individual procedure alone.

Effects of ozone gas on skin flaps viability in rats: an experimental study.

BACKGROUND: The main purpose of this study was to assess the effects of ozone gas on the viability of flaps for reconstruction and to determine the optimum application method. The antioxidant, immunomodulatory, and reperfusion effects of ozone gas have been previously assessed, and successful results have been reported. However, only one study has investigated the effect of ozone gas on flap viability. In the present study, it was hypothesised that the antioxidant and reperfusion effects of ozone gas would enhance flap viability. METHODS: Forty female Wistar rats were randomly divided into four groups of 10 rats each. A cranial-based, 3 × 11 cm modified McFarlane flap including the panniculus carnosus was raised from the dorsum of a rat and re-sutured to its own bed using 3/0 sharp propylene. Group 1 (n = 10): no pharmacological agent was used after the operation. Group 2 (n = 10): vegetable (olive) oil group; vegetable-oil-impregnated gauze was used as a dressing for 7 days. Group 3 (n = 10): Vegetable (olive) oil with ozone peroxide group; vegetable oil with ozone peroxide-impregnated gauze was used as a dressing for 7 days. Group 4 (n = 10): Hemo-ozone therapy group; hemo-ozone therapy was applied rectally once every day for 7 days. All rats were sacrificed at the end of week 1 and assessed macroscopically and histopathologically. RESULTS: The proportion of substantive necrosis was less in group 4 than in the other three groups. Survival area ratios were better in groups 2 and 3 than in group 1; however, there was no significant difference between groups 2 and 3. No significant differences in the histopathological scores were observed among the groups. CONCLUSION: Ozone gas enhanced flap viability. No differences in flap viability were observed between the vegetable oil and vegetable oil with ozone peroxide groups. The greatest benefit ratios were found in the hemo-ozone therapy group.

A cause of severe thigh injury: Battery explosion.

INTRODUCTION: In parallel with technological improvements, humankind encounter with equipments/devices transforming chemical energy to electrical energy. Especially automobile batteries, watch and mobile phone batteries are the most encountered ones. In the literature, there are mainly facial burn cases due to mobile phone battery explosion. On the other hand very few examples of serious lower limb. injury is present. PRESENTATION OF CASE: 12-year-old female patient referred to emergency room with skin and soft tissue injuries on bilateral anteromedial thigh area as a result of battery explosion. The widest axis of skin defect was approximately 16 × 8 cm on the right side, and 17 × 4 cm on the left side. In addition, there were tattooing caused by chemical injury and multiple pin-point like lesions extending to dermal level on anterior region of thigh. Chemically dirty and necrotized dermal and subdermal tissues were debrided and foreign materials were removed from regions with multiple tattooing. Left thigh was closed primarily. In order to close the defect on right anterior thigh, skin flap from right medial thigh is advanced in Y-V fashion. DISCUSSION: Battery explosion causing lower extremity tissue defect is a type of injury that is rarely seen in the literature. Regardless of battery size and energy level, they should be considered as potential explosive material and protector masks, clothing should be worn during contact with this type of material.

A fast, easy circumcision procedure combining a CO2 laser and cyanoacrylate adhesive: a non-randomized comparative trial

ABSTRACT Background Circumcision is performed as a routine operation in many countries, more commonly for religious and cultural reasons than for indicated conditions, such as phimosis and balanitis. There are many techniques available, and recently electrocautery and both Nd:YAG and CO2 lasers, instead of blades, have been used for skin and mucosal incisions. However, the infection risk in circumcisions performed using a CO2 laser was 10% higher. There are also reports of sutureless procedures using cyanoacrylate, but these have higher risks of hematoma and hemorrhage. We combined a CO2 laser and cyanoacrylate to shorten the operation time and to decrease bleeding complications. Materials and Methods : Circumcisions were performed under general anesthesia with CO2 laser and cyanoacrylate combination in 75 6–9-year-old boys between May 2013 and August 2014 only for religious reasons. As a control, we compared them retrospectively with 75 age-matched patients who were circumcised using the conventional guillotine method in our clinic. Results No hematomas, bleeding, or wound infections were observed. One wound dehiscence (1.33%) occurred during the early postoperative period and healed without any additional procedures. The median operating time was 7 (range 6–9) minutes. The conventional guillotine group comprised one hematoma (1.3%), two wound dehiscences (2.6%), and two hemorrhages (2.6%), and the median operating time was 22 (range 20–26) minutes. The difference in surgical time was significant (p<0.001), with no significant difference in the rate of complications between the two groups. Conclusion The combined CO2 laser and cyanoacrylate procedure not only decreased the operating time markedly, but also eliminated the disadvantages associated with each individual procedure alone.

Application of N-Butyl Cyanoacrylate to Split-Thickness Skin Grafts in Rats: An Experimental Study.

Skin grafts are a standard option for closing skin defects that cannot be closed primarily. A split -thickness skin graft entirely transfers the epidermis and a part of the dermal layer to the wound site. Using conventional techniques, the skin graft is fixed to the wound using sutures and kept closed for 3 to 7 days with a pressed bolster dressing. Continued care includes applying routine graft dressings after the bolster dressing has been removed. The use of fibrin glue and cyanoacrylate derivatives-which shortens the duration of surgery and improves graft fixation to the recipient bed-has become widespread. However, applying fibrin glue during skin graft surgery is limited because there are considerable disadvantages in terms of preparation and cost. Many studies have been conducted on the use of cyanoacrylate derivatives during skin grafting; however, few reports have investigated the effects of cyanoacrylate derivatives on skin graft survival and related histopathologic changes.In this study, the authors used n-butyl cyanoacrylate to prepare split-thickness skin grafts that were subsequently applied to Wistar albino rats, and the authors evaluated the results both histopathologically and macroscopically. The authors also statistically analyzed the effects of graft fixation according to surgical duration. The findings of authors suggest that n-butyl cyanoacrylate can be safely applied during split-thickness skin graft surgery because it significantly reduces surgical duration, demonstrates substantial advantages in terms of graft fixation and monitoring, and, most importantly, demonstrates no notable disadvantages in comparison with conventional methods.

Fast and Painless Skin Tag Excision with Ethyl Chloride.

Skin tags (acrochordon) are skin colored or hyperpigmented, usually pedunculated benign skin lesions and often occur on the neck, axilla, and groin regions. It is difficult choice to excise these multiple, widespread, and pedinculated lesions with or without local anesthesia. One option is to infiltrate local anesthesia to every single skin tag, while cutting pedicle with single move is another option. However, both of these options are painful to some degree. We routinely use ethyl chloride spray anesthesia for skin tag excision with micro-scissor and micro-forceps. We received positive feedback from patients, who underwent skin tag excision before with conventional techniques. They declare that ethyl chloride procedure is more comfortable and painless.

A cause of severe sacral injury, sledding with a plastic bag: Case report.

INTRODUCTION: Various injuries are associated with winter sports, of which the most frequently encountered are traumas to the extremities. Sledding on hills using plastic-based materials appears to be one of the major forms of entertainment for children living in cities during winter. However, this can lead to injury because such areas are inappropriate for winter sports. PRESENTATION OF CASE: We herein document a case of a 32-year-old male who presented to the emergency department following severe injury to the sacral region, caused by contact with a metal object while sledding with plastic bags. Patient had sacral defect including coccyx and sacral vertebrae and soft tissue. Primary closure, vacuum assisted closure and reconstruction with de-epithelized skin flap techniques were performed in 35 days period after injury. DISCUSSION: Winter sports are associated with a wide variety of injuries, but tissue defects are rare. Seroma formation due to dead spaces can occur in traumas causing bony and soft tissue loss in sacral region as seen in our case. In order overcome this problem primary closure can be delayed or defect can be filled with a bulky flaps. CONCLUSION: This case represents the first report of this particular combination of injury and treatment.

Electroencephalographic and behavioral effects of intracerebroventricular or intraperitoneal injections of toxic honey extract in adult Wistar rats and GAERS.

Toxic honey, containing grayanotoxin, is obtained from nectar and polen of rhododendron. Consumed in excess it produces seizures and convulsions. In order to investigate whether the toxic honey extract can be used as a seizure model, we examined the electroencephalographic (EEG) and motor effects of intracerebroventricular (icv) or intraperitoneal (ip) injection of toxic honey extract in Wistar rats or in genetic absence epilepsy rats from Strasbourg (GAERS). Male Wistar rats or GAERS were stereotaxically implanted with bilateral cortical recording electrodes in all ip groups and cannula in the icv groups. Based on the previous study, an extract was obtained from the non-toxic and toxic honey. After the injection of the non-toxic or toxic honey extract, seizure stages and changes in EEG were evaluated from 9 am to noon. The icv administration of toxic honey extract produced stage 4 seizures and bilateral cortical spikes within 30-60 min and these effects disappeared after 120 min in Wistar rats or GAERS. The mean of bilateral cortical spike acitivity in EEG of Wistar rats was 804.2 ± 261.0 s in the 3-h period. After the icv administration of toxic honey extract to GAERS, the mean duration of spike-and-wave discharges (SWDs) in GAERS significantly decreased during the first 60 min and then returned to baseline level. Ip injection of toxic honey extract caused no seizure and no change in EEG in either GAERS or Wistars. These results suggest that the icv administration of toxic honey extract can be used as a seizure model.