ABSTRACT
BACKGROUND: Local anesthetic infiltration along the incision may be used to provide surgical anesthesia or postoperative analgesia. However, the effect of local anesthetics on wound healing remains controversial. In this investigation, we evaluated the effects of levobupivacaine on wound healing. METHODS: Sixty Wistar albino female rats weighing 230±20 g were included, with 10 rats in each group: group early c (early control): 3 mL isotonic saline; group early l1.25 (early levobupivacaine 1.25): 1.25 mg/kg per 3 mL levobupivacaine; group early l2.5 (early levobupivacaine 2.5): 2.5 mg/kg per 3 mL levobupivacaine; group late c (late control): 3 mL isotonic saline; group late l1.25 (late levobupivacaine 1.25): 1.25 mg/kg per 3 mL levobupivacaine; and group late l2.5 (late levobupivacaine 2.5): 2.5 mg/kg per 3 mL levobupivacaine. Rats in groups early c to early l2.5 were euthanized on the 8th day. Rats in groups late c to late l2.5 were euthanized on the 21st day. Wound tension strength, tissue hydroxyproline, and fibrotic index levels of the tissue samples from the early c and early l2.5 and late c and late l2.5 groups, respectively, on the 8th and 21st days were examined. RESULTS: Levobupivacaine decreased wound tension strength on the 8th day, especially a 2.5 mg/kg dose (P<0.001), and increased it on the 21st day (P<0.001). It also increased the inflammatory response (P<0.001) and collagen synthesis (8th day, P=0.109; 21st day, P=0.103) on both the 8th and 21st days. CONCLUSIONS: While levobupivacaine had a positive effect on wound healing during the early period, negative effects were observed thereafter. Additional studies at the molecular level are necessary to determine the cause of these apparently opposite effects.
Subject(s)
Anesthetics, Local/therapeutic use , Wound Healing/drug effects , Wounds and Injuries/pathology , Anesthetics, Local/adverse effects , Animals , Biopsy , Bupivacaine/adverse effects , Bupivacaine/analogs & derivatives , Bupivacaine/therapeutic use , Cell Proliferation , Female , Fibrosis , Hydroxyproline/analysis , Hydroxyproline/metabolism , Levobupivacaine , Postoperative Period , Rats , Rats, Wistar , Skin/chemistry , Sutures , Tensile Strength , Wounds and Injuries/metabolismABSTRACT
OBJECTIVE: The aim of this study is to compare possible protective effects of zofenopril, enalapril and valsartan against both ischaemia/reperfusion injury as well as acute doxorubicin cardiotoxicity. All three agents have never been compared in this setting before. METHODS AND RESULTS: Sixty-four male rats were divided into eight groups by computer-generated random numbers and each group included 8 rats. Groups 1, 2, 3 and 4, respectively, received 0.5 ml distilled water, 15 mg/kg/day zofenopril, 2 mg/kg/day enalapril, and 30 mg/kg/day valsartan intragastrically for 7 days. Groups 5, 6, 7, and 8 underwent the same procedures as groups 1, 2, 3 and 4. On the 7th day, groups 1-4 and groups 5-8, respectively, were injected with serum saline or 20 mg/kg doxorubicin intraperitoneally. On the 9th day, isolated rat hearts were perfused in the Langendorff perfusion system. At the end of each Langendorff experiment, the rat hearts were kept for histological analysis. Left ventricular systolic pressures were negatively affected by doxorubicin with ischaemia (group 5 initially: 61.4 +/- 13.6 mmHg--post-ischaemic (PI): 20.7 +/- 17.5 mmHg (P = 0.0002), group 6 initially: 63 +/- 18.2 mmHg--PI: 24.2 +/- 24.3 mmHg (P = 0.0135), group 7:82 +/- 26 mmHg--PI: 14.3 +/- 12.1 mmHg (P < 0.0001), group 8:73.1 +/- 27.8 mmHg--PI: 20.4 +/- 27.3 mmHg (P < 0.0001). The lowest troponin I levels (group 2: 0.3 +/- 0.2 ng/ml, group 6:0.2 +/- 0.1 ng/ml (P = 0.003) versus the groups' baseline value) were recorded in the groups of zofenopril in the coronary perfusate during post-ischaemic period. Light microscopic evaluation revealed marked cardiac damage with doxorubicin, since zofenopril treatment prevented a doxorubicin induced increase in the histopathological scores. CONCLUSIONS: In respect of our results zofenopril could be considered more effective than enalapril and valsartan in protecting against both ischaemia/reperfusion injury as well as doxorubicin induced-cardiotoxicity.
Subject(s)
Angiotensin II Type 1 Receptor Blockers/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Captopril/analogs & derivatives , Doxorubicin/adverse effects , Enalapril/therapeutic use , Heart Diseases/chemically induced , Heart Diseases/prevention & control , Reperfusion Injury/prevention & control , Tetrazoles/therapeutic use , Valine/analogs & derivatives , Animals , Captopril/therapeutic use , Hemodynamics/drug effects , Humans , Male , Rats , Rats, Wistar , Valine/therapeutic use , ValsartanABSTRACT
Cardiovascular disease is one of the leading causes of mortality and morbidity in postmenopausal women. Menopausal changes have been shown to be related with an atherogenic lipid profile. The efficiency of statins in reducing the incidence of cardiovascular diseases has been well-documented in a variety of randomized, placebo-controlled trials. This review outlines the effectiveness of statins both in cardiac events and in some noticeable indications in postmenopausal women.
Subject(s)
Cardiovascular Diseases/prevention & control , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Primary Prevention , Cardiovascular Diseases/mortality , Female , Humans , Postmenopause , Randomized Controlled Trials as TopicABSTRACT
Several human diseases have been associated with the overproduction of reactive oxygen species (ROS) and subsequently various antioxidants emerged as potential therapeutic agents that scavenge ROS. As an oxidative stress model of human disease, we used hydrogen peroxide (H2O2) to study effect of ROS on C6 glioma cells as a surrogate for astrocytes. H2O2 induced dose- and time-dependent apoptotic cell death which was preceded by growth arrest, and transiently activated the signalling proteins ATF-2, ERK1/2 and AKT in C6 glioma cells. While several antioxidants failed to block H2O2-induced apoptosis of these cells, Ginkgo biloba extract (EGb) totally prevented the cell death and growth inhibition induced by H2O2. Interestingly, EGb did not prevent the activation of ATF-2, ERK1/2 and AKT induced by H2O2 excluding the role of these factors in the pro-apoptotic effect of H2O2. We have previously shown that the lipid-lowering drug, simvastatin, causes apoptotic cell death in C6 glioma cells [Koyuturk M, Ersoz M, Altiok N. Simvastatin induces proliferation inhibition and apoptosis in C6 glioma cells via c-jun N-terminal kinase. Neurosci Lett 2004;370(2-3):212-7]. However, in parallel experiments with H2O2, EGb was unable to prevent cell death induced by simvastatin suggesting the involvement of separate signalling pathways between H2O2 and simvastatin. Thus, EGb and other plant flavonoids might have potential as protective agents against apoptosis through scavenging ROS upon cerebral or myocardial diseases associated with free radical generation.
Subject(s)
Cell Death/drug effects , Ginkgo biloba/chemistry , Hydrogen Peroxide/toxicity , Hydroxymethylglutaryl-CoA Reductase Inhibitors/toxicity , Neuroglia/drug effects , Oxidants/toxicity , Simvastatin/toxicity , Activating Transcription Factor 2/physiology , Apoptosis/drug effects , Blotting, Western , Brain Neoplasms/pathology , Cell Line, Tumor , Cell Survival/drug effects , Extracellular Signal-Regulated MAP Kinases/physiology , Glioma/pathology , Humans , Immunohistochemistry , Immunoprecipitation , Oxidative Stress/drug effects , Plant Extracts/pharmacology , Proto-Oncogene Proteins c-akt/physiology , Signal Transduction/drug effectsABSTRACT
Recently, it has been reported that identifying nuclear membrane irregularities with anti-emerin antibody is useful for papillary thyroid carcinoma diagnosis. However, literature regarding the significance of emerin immunohistochemistry in thyroid is limited. We evaluated the diagnostic accuracy of the well-established nuclear alterations, nuclear protrusions and recently described nuclear shapes (garlands and star-like shapes) with emerin immunohistochemistry and hematoxylin- eosin stain in thyroid lesions. We further evaluated the diagnostic accuracy measures of tissue microarrays evaluated with both stains, to detect whether emerin immunohistochemistry improves the diagnostic accuracy for papillary thyroid carcinoma. For papillary thyroid carcinoma, pseudo- inclusions were best performers with emerin (diagnostic accuracy: 0.91), whereas with hematoxylin- eosin diagnostic accuracy of grooves was the highest (0.92). For follicular variant of papillary thyroid carcinoma, with both stains, predominately oval nuclear shape had the best diagnostic performance (diagnostic accuracy: 0.95). Nuclear protrusions were poor identifiers for papillary thyroid carcinoma. However, with emerin immunohistochemistry, they could successfully identify malignancy in 83% of the cases. Using emerin immunohistochemistry, in addition to hematoxylin- eosin improved the diagnostic accuracy for papillary thyroid carcinoma when compared to hematoxylin- eosin evaluation only (sensitivity: 0.70 vs 0.86, negative predictive value: 0.81 vs. 0.94, diagnostic accuracy: 0.87 vs. 0.94). Consistent with the previous literature, our findings indicate that emerin immunohistochemistry may be used as an adjunct diagnostic method to identify papillary thyroid carcinoma. Additionally, we suggest that nuclear protrusions detected with emerin imunohistochemistry may be used as indicators of malignant behavior in small tissue samples of thyroid.
Subject(s)
Adenocarcinoma/diagnosis , Biomarkers, Tumor/metabolism , Carcinoma/diagnosis , Gene Expression Regulation, Neoplastic/physiology , Membrane Proteins/metabolism , Nuclear Proteins/metabolism , Thyroid Neoplasms/diagnosis , Adenocarcinoma/metabolism , Adenocarcinoma/pathology , Carcinoma/metabolism , Carcinoma/pathology , Carcinoma, Papillary , Cell Differentiation/physiology , Epithelial Cells/pathology , Humans , Immunohistochemistry/methods , Predictive Value of Tests , Retrospective Studies , Sensitivity and Specificity , Thyroid Cancer, Papillary , Thyroid Neoplasms/metabolism , Thyroid Neoplasms/pathologyABSTRACT
Heart tumors can be primary in origin, can develop from direct extension of a neighboring tumor or they can be the manifestation of metastasis of a distant tumor. Myxomas are the most frequently encountered primary benign cardiac tumors. Primary malignant tumors of the heart are rare, and they are mostly sarcomatous in structure. Secondary heart tumors constitute a wide spectrum, nevertheless they most frequently originate from lung cancer, breast cancer and hematological malignancies. Heart tumors may involve myocardium, endocardium, epicardium, pericardium, or any combination of the aforementioned layers. On the other hand, the usual site for metastasis to the heart is the pericardium. These tumors do not have a well- established classification. Clinical findings are usually non-specific and transient in nature and frequently present late in the disease process. Transthoracic and transesophageal echocardiography are the most widely used diagnostic modalities. Magnetic resonance imaging and computerized tomography may be helpful for selected cases. Surgery is the principal therapeutic option in benign tumors and when recurrences are not taken into account, they have favorable prognoses. Since surgical resection is usually incomplete in malignant tumors, therapy must be individualized for each patient; even with adjuvant chemotherapy, postoperative survival is usually short. Metastases to the heart are usually approached symptomatically except for exceptional cases.