Effects of trimetazidine in acute pancreatitis induced by L-arginine.

BACKGROUND: In acute pancreatitis, oxygen free radicals (OFRs) and cytokines have been shown to play a role in the failure of pancreatic microcirculation and the development of local tissue damage. We studied the effects of trimetazidine (TMZ), a potent antioxidant and anti-ischemic agent, on acute pancreatitis. METHODS: Rats were randomized into 3 groups: a control group (n = 15), a study group (n = 15) in which acute pancreatitis was induced with with L-arginine, and a treatment group (n = 15) in which pancreatitis was induced and treated with TMZ intraperitoneally. The rats were followed for 24 hours. At the 24th hour we determined serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), amylase, lactate dehydrogenase (LDH), interleukin 1-β (IL-1β), interleukin 6 (IL-6) and tumour necrosis factor-α (TNF-α), and the pancreatic tissues were analyzed histopathologically. RESULTS: The AST (p < 0.001), ALT (p < 0.01), amylase (p < 0.001), LDH (p < 0.01), TNF-α (p < 0.01), IL-1ß (p < 0.001) and IL-6 (p < 0.001) levels, and pancreatic tissue edema (p < 0.01), hemorrhage (p < 0.05), acinar cell necrosis (p < 0.001) and level of perivascular inflammation (p < 0.01), were significantly lower in the treatment group than the study group. CONCLUSION: Trimetazidine markedly decreases biochemical and histopathologic changes during the early stages of acute pancreatitis, thus preserving the pancreas histologically.

CONTEXTE: Dans la pancréatite aiguë, les radicaux libres de l'oxygène et les cytokines contribuent à l'insuffisance de la microcirculation pancréatique et à l'endommagement des tissus localement. Nous avons étudié les effets de la trimétazidine (TMZ), un puissant agent antioxydant et anti-ischémique, sur la pancréatite aiguë. MÉTHODES: Des rats ont été assignés aléatoirement à 1 de 3 groupes : un groupe témoin (n = 15), un groupe (n = 15) dans lequel la pancréatite aiguë a été induite au moyen de L-arginine et un groupe (n = 15) dans lequel la pancréatite a été induite, puis traitée par TMZ par voie intrapéritonéale. Les rats ont été suivis pendant 24 heures. À la 24e heure, nous avons mesuré les taux sériques d'aspartate aminotransférase (AST), d'alanine aminotransférase (ALT), d'amylase, de lacticodéshydrogénase (LDH), d'interleukine 1-ß (IL-1ß), d'interleukine 6 (IL-6) et de facteur de nécrose tumorale α (TNF-α), et les tissus pancréatiques ont été soumis à un examen histopathologique. RÉSULTANTS: Les taux d'AST (p < 0,001), d'ALT (p < 0,01), d'amylase (p < 0,001), de LDH (p < 0,01), de TNF-α (p < 0,01), d'IL-1ß (p < 0,001) et d'IL-6 (p < 0,001), de même que l'oedème tissulaire (p < 0,01), les saignements (p < 0,05), la nécrose des cellules acineuses (p < 0,001) et le degré d'inflammation périvasculaire (p < 0,01) pancréatiques,étaient significativement moindres dans le groupe traité que dans le groupe non traité. CONCLUSIONS: La trimétazidine atténue nettement les modifications biochimiques et histopathologiques qui accompagnent les premiers stades d'une pancréatite aiguë, ce qui permet de préserver le pancréas au plan histologique.

The results of surgical treatment for hepatic hydatid cysts in an endemic area.

BACKGROUND/AIMS: Hydatid cyst remains an important public health problem in endemic areas. METHODS: This study retrospectively reviewed medical records of 63 patients treated for hepatic cyst hydatidosis in Frat University, Medical School, Department of General Surgery between January 1994 and December 2002. RESULTS: There were 96 cysts in total in 63 patients, with 67 (69%) of them located in the right lobe of the liver. Of 96 hepatic cysts, 41 (45%) were treated with partial cystectomy and drainage, 25 (26%) with partial cystectomy and capitonnage and 15 (15%) with partial cystectomy and omentoplasty. Thirty-two patients (51%) received treatment with albendazole while 31 (49%) received no medical therapy. The postoperative complication rate was 19% and there was no significant difference in the early post-operative complications between surgical procedures (p>0.05). Cysts recurred in 6 patients (11%) and no correlation was found between recurrence of cysts and albendazole use, type of surgical procedure, number and size of the cysts, Gharbi classification as determined by ultrasound examination or the relation of the cyst with the biliary tract (p>0.05). CONCLUSION: It was concluded that there was no significant difference in the rates of complications and recurrences among different surgical procedures when performed with basic rules of the surgical principles.