L-carnitine protects the lung from radiation-induced damage in rats via the AMPK/SIRT1/TGF-1ß pathway.

Radiotherapy (RAD) is a common cancer treatment method, but it can have unintended lung side effects. L-carnitine (LCAR) is an amino acid with antioxidant and anti-inflammatory properties. This study aims to demonstrate the effects of LCAR against radiation-induced acute lung injury and to elucidate its possible protective molecular mechanisms. A total of 32 Wistar albino rats were separated into four groups: control, RAD (10 Gy once on 1st day), RAD + LCAR (intraperitoneally, 200 mg/kg/d, for 10 days), and LCAR. At the end of the experiment, the rats were euthanized, and the lung tissues were collected for histopathological, immunohistochemical, biochemical, and genetic analysis. Emphysema, pronounced hyperemia, increased total oxidant status, and increased caspase-3 and TNF-α immunostainings were all seen in the lung tissues of the RAD group. LCAR treatment reduced these negative effects. In addition, AMPK and SIRT1 gene expressions increased in the RAD + LCAR group compared to the RAD group, while TGF-1ß gene expression decreased. While RAD caused major damage to the lungs of rats, LCAR application reduced this damage through antioxidant, anti-inflammatory, and anti-apoptotic mechanisms. Specifically, LCAR reduced fibrosis while attenuating RAD-induced inflammation and oxidative stress via the AMPK/SIRT1/TGF-1ß pathway. Therefore, LCAR can be considered a supplement to reduce complications associated with RAD.

Management of life-threatening tracheal emergencies.

OBJECTIVE: Tracheal pathologies are life-threatening in all age groups and may result in death if urgent action isn't taken. The aim of this study was to present cases of rare and life-threatening tracheal pathologies and discuss the management of these in the light of literature. METHODS: A retrospective analysis was made of 8 patients who underwent surgery for emergency tracheal pathologies in our clinics between 2013 and November 2018. The patients were evaluated in terms of age, gender, etiology, symptoms, location of pathology, surgical approach, treatment technique, and length of hospital stay. RESULTS: Of the 8 cases with tracheal pathology, 4(50%) had tracheal rupture, 3(37.5%) had tracheal stenosis due to prolonged post-intubation, and one (12.5%) had a tracheal tumor. The cases with tracheal rupture comprised 2 females and 2 males with a mean age of 28.5 years (range, 16-48 years). The cases with tracheal stenosis were 2 females and 1 male with a mean age of 29.3 years (range, 25-36 years). The patient with a tracheal tumor was 34 years old and had been diagnosed late. Preoperative mortality as a result of hypoxia was seen in one case with carina rupture. No postoperative morbidity or mortality were observed in all 7(87.5%) cases who underwent surgery. CONCLUSION: Early diagnosis, treatment, determination of the location and form of the pathology is very important in tracheal pathologies. In surgical treatment, wide resection should be avoided as much as possible, and the surgical approach should be determined according to the shape of the pathology, wiht end-to-end anastomosis and/or primary repair applied when possible. KEY WORDS: Surgery, Tacheal tumor, Tracheal stenosis, Tracheal rupture.

Diagnostic significance of biochemical markers and pentraxin-3 in the differential diagnosis of malign, benign pleural effusion and empyema.

OBJECTIVE: To investigate the diagnostic significance of biochemical markers and pentraxin-3 in the differential diagnosis of pleural effusions. METHODS: The prospective clinical study was conducted at the Suleyman Demirel University, Isparta, Turkey, from January 2013 to June 2014, and comprised patients with pleural effusion. Pleural effusions were tested for glucose, protein, lactate dehydrogenase, and pentraxin 3 while simultaneous C-reactive protein and white blood cell levels were studied in the serums. Data was analysed using SPSS 22. RESULTS: Of the 96 patients, 48(50%) had malignant disease, 33(34%) had benign pleural effusion, and 15(16%) had empyema. In terms of glucose, protein, lactate dehydrogenase in the pleural effusions and C-reactive protein values in serums, significant differences were observed among the three groups (p<0.05). The pentraxin-3 levels in the empyema group was significantly higher than in the benign cases (p<0.033). No significant difference was observed in terms of the other variables between the groups (p>0.05). CONCLUSIONS: Serum C-reactive protein and pentraxin-3 levels were not found to be individually conclusive in the differential diagnosis of pleural effusion. Also, lactate dehydrogenase levels were higher and glucose levels were lower in empyema.