The effects of caffeic acid phenethyl ester (CAPE) on bacterial translocation and inflammatory response in an experimental intestinal obstruction model in rats.

OBJECTIVE: Intestinal obstruction (IO) is a disease which generates approximately 20% of emergency surgery and tends to with high mortality. Prevention of oxidative stress, bacterial translocation and tissue damage caused by IO is an important medical issue. Caffeic acid phenethyl ester (CAPE) is an anti-inflammatory, antioxidant, anti-bacterial and immunomodulatory agent. In this experimental study, we aimed to investigate the effects of CAPE on bacterial translocation, inflammatory response, oxidative stress and tissue injury caused by intestinal obstruction in a rat model. MATERIALS AND METHODS: Breafly, thirty Wistar albino rats divided into three groups as Sham (n=10), IO (n=10) and IO + CAPE (10 µmol/kg day, intraperitoneal) (n=10). The tissues from the study groups were examined biochemically, microbiologically and histopathologically. RESULTS: In CAPE treated group, decreased serum levels of proinflammatory cytokines (TNF-α, IL-6, IL-1ß) and CRP (p < 0.05), additionally increased serum levels of antioxidant parameters (PONS, TAS) (p < 0.05), were observed after IO. Microbiologically, the rates of positive cultures of the lymph node, spleen, liver and blood were significantly decreased in CAPE treated group compared to the IO group. Also histopathological examination showed that the intestinal mucosal injury score and hepatic portal inflammation score were significantly decreased in the CAPE treated group (p < 0.05). CONCLUSIONS: It is suggested that intraperitoneal administration of CAPE might has potential antibacterial, anti-inflammatory, antioxidant and immunomodulatory effects in IO. So, further studies on IO are needed to evaluate exact antibacterial, antiinflammatory, antioxidant and immunomodulatory effects of CAPE.

The value of liver and spleen ADC measurements in the diagnosis and follow up of hepatic fibrosis in chronic liver disease.

AIMS: To evaluate the value of spleen and liver apparent diffusion coefficients (ADC) in chronic liver disease patients, with and without hepatocellular carcinoma (HCC), and to investigate the use of diffusion-weighted imaging (DWI) in the diagnosis and follow-up of hepatic fibrosis. MATERIALS AND METHODS: This study population comprised 68 chronic liver disease patients (Group 1) and 70 healthy volunteers as controls (Group 2). In Group 1, 40 patients had chronic hepatitis-B, 20 had chronic hepatitis-C, 5 had non-alcoholic steatohepatitis and 3 had alcoholic steatohepatitis. Diagnosis of chronic liver disease was made by percutaneous liver biopsy and the degree of fibrosis (stage) was determined using the METAVIR scoring system. HCC diagnosis was made with a lesion biopsy. The patient group was subdivided based on the degree of fibrosis (F1, F2, F3 and F4) and presence of HCC. After patient and control groups underwent b-value 600 s/mm(2) DWI examination, liver and spleen ADC values were mapped and measured. The ADC values of the patient groups (F1, F2, F3, F4; with HCC, without HCC) were compared with each other and with the control group. RESULTS: Liver ADC values were lower in Group 1 compared to Group 2 (P<0·001). There was a statistically significant difference between the patient and control groups liver right lobe, left lobe and caudate lobe ADC values (P<0·001). Comparing the F1, F2, F3 and F4 groups, there was no statistically significant difference found in terms of ADC values (P>0·05). However, as degree of fibrosis increased there was a reduction in ADC values, though not statistically significant. Comparing the groups with HCC and without HCC, there was no statistically significant difference in ADC values (P>0·05). There was no statistical difference in average spleen ADC values between patient and control groups (P>0·05). CONCLUSIONS: In chronic liver disease, ADC values were lower. As the degree of liver fibrosis increased, ADC levels decreased, though the relationship between ADC values and fibrosis degree was not statistically significant. Quantitative DWI may help in the diagnosis of fibrosis in chronic liver disease patients, however as it does not show the degree of fibrosis, its use in treatment planning and follow-up is controversial. Spleen DWI measurement is not a sufficient method to diagnose and determine the degree of fibrosis in chronic liver disease patients.

The effect of propofol lipuro with and without lidocaine on injection pain in children.

OBJECTIVE: Despite advantages of propofol use such as providing a good anesthesia and rapid recovery; pain due to intravenous propofol injection continues to be a problem. The aim of this study was to compare the effects of generic propofol and propofol lipuro with and without lidocaine on injection pain in children. MATERIALS AND METHODS: This study performed between 01 December 2009 and 16 May 2010. A total of 120 children, who planned to undergo elective surgery under general anesthesia, were included in four groups of 30 in a prospectively, randomized and double-blind study. Generic propofol was given to first and second groups and propofol lipuro was given to third and fourth groups. In addition to propofol, lidocaine was given to second and fourth groups. Injection pain was assessed using Ontario Children's Hospital Pain Scale (mCHEOPS). RESULTS: No differences were found in the mean age, weight and given dose of propofol administered between all groups (P>0.05). Double comparison of groups revealed no significant difference in pain scores between Group 1 and 2 (mean pain scores, 1.34 ± 1.42 vs. 1.22 ± 1.31 points, respectively; P>0.05). However, significant difference was found between propofol lipuro groups with or without lidocaine (3.20 ± 2.10 vs. 0.95 ± 1.21 points, respectively; P<0.001). CONCLUSION: The highest pain scores were found in the propofol lipuro without lidocaine use while propofol lipuro plus lidocaine had the lowest pain scores. Because adding lidocaine to propofol lipuro decreased injection pain scores to minimum levels, this practice seems to be the most appropriate alternative in order to diminish propofol injection pain during anesthesia in children.