Comparison of extraperitoneal and intraperitoneal laparoscopic procedures for intracranial pressure increase: a prospective clinical study.

OBJECTIVE: According to the literature, higher levels of both intracranial pressure (ICP) and intraabdominal pressure (IAP) are related in a way that suggests a causal relationship. An increase in ICP can cause major neurological problems both during and after laparoscopic surgery. In this study, we aimed to examine the increase in ICP between totally extraperitoneal (TEP) inguinal hernia repair and laparoscopic cholecystectomy. PATIENTS AND METHODS: We investigated 52 individuals who underwent laparoscopic surgery for the treatment of inguinal hernia (n = 26) or had a laparoscopic cholecystectomy (n = 26). The optic nerve sheath diameter (ONSD) was assessed before the procedure (T0), 10 minutes after carbon dioxide insufflation (T1), and immediately before extubation (T2). RESULTS: There were significant differences in the ONSD values between the two groups as a function of time (p = 0.001). In terms of ONSD, the laparoscopic cholecystectomy value (LV) group showed a greater shift from T0 to T1 and T2 than the inguinal hernia value (HV) group. At T1, the ONSD values of both groups were considerably higher than those of T0 and T2. The impact of the extraperitoneal and transperitoneal laparoscopic methods on ICP was investigated. The ONSD value reached its maximum at T1 in both groups. At all measurement periods, the ONSD values of the LV group were noticeably higher than those of the HV group. CONCLUSIONS: The diagnostic accuracy of ONSD ultrasonography is an important approach for determining the ICP level. During the decision-making process of TEP inguinal hernia repair, this study can guide medical professionals in the evaluation of elevated ICP.

Magnetic Resonance Imaging of Mouse Cerebral Cavernomas Reveal Differential Lesion Progression and Variable Permeability to Gadolinium.

BACKGROUND: Cerebral cavernous malformations, also known as cavernous angiomas, are blood vessel abnormalities comprised of clusters of grossly enlarged and hemorrhage-prone capillaries. The prevalence in the general population, including asymptomatic cases, is estimated to be 0.5%. Some patients develop severe symptoms, including seizures and focal neurological deficits, whereas others remain asymptomatic. The causes of this remarkable presentation heterogeneity within a primarily monogenic disease remain poorly understood. METHODS: We established a chronic mouse model of cerebral cavernous malformations, induced by postnatal ablation of Krit1 with Pdgfb-CreERT2, and examined lesion progression in these mice with T2-weighted 7T magnetic resonance imaging (MRI). We also established a modified protocol for dynamic contrast-enhanced MRI and produced quantitative maps of gadolinium tracer gadobenate dimeglumine. After terminal imaging, brain slices were stained with antibodies against microglia, astrocytes, and endothelial cells. RESULTS: These mice develop cerebral cavernous malformations lesions gradually over 4 to 5 months of age throughout the brain. Precise volumetric analysis of individual lesions revealed nonmonotonous behavior, with some lesions temporarily growing smaller. However, the cumulative lesional volume invariably increased over time and after about 2 months followed a power trend. Using dynamic contrast-enhanced MRI, we produced quantitative maps of gadolinium in the lesions, indicating a high degree of heterogeneity in lesional permeability. MRI properties of the lesions were correlated with cellular markers for endothelial cells, astrocytes, and microglia. Multivariate comparisons of MRI properties of the lesions with cellular markers for endothelial and glial cells revealed that increased cell density surrounding lesions correlates with stability, whereas denser vasculature within and surrounding the lesions may correlate with high permeability. CONCLUSIONS: Our results lay a foundation for better understanding individual lesion properties and provide a comprehensive preclinical platform for testing new drug and gene therapies for controlling cerebral cavernous malformations.

Supplementary dietary nitric oxide donor (sodium nitroprusside) or inhibitor (NG-nitro-L-arginine methyl ester) depressed growth performance and ovarian primordial and primary follicles in Japanese quail (Coturnix coturnix japonica) in a dose-dependent manner.

1. The aim of the study was to determine the effects of dietary supplementation with sodium nitroprusside (SNP), a nitric oxide (NO) exogenous donor, and N(G)-nitro-L-arginine methyl ester (l-NAME), a NO inhibitor, on growth performance, some biochemical parameters and ovarian primordial and primary follicles of quail. 2. A total of 480 Japanese quail (Coturnix coturnix japonica), one-day-old, including both males and females, were randomly allocated into one control group and 4 treatment groups each consisting of 96 birds. The control group was fed on the basal diet, whereas the experimental groups were fed on the basal diet supplemented with 50 mg SNP/kg, 200 mg SNP/kg, 50 mg L-NAME/kg or 200 mg L-NAME/kg. In the group receiving 200 mg SNP/kg, BW was lower on d 28 and d 42 compared to the control group and body weight gain (BWG) was lower between weeks 2 and 4 compared to the control group. In the same group, BWG and feed consumption were lower compared with the control group. 3. In the group receiving 200 mg L-NAME/kg, BW on d 42 and BWG were lower, whereas feed consumption and FCR was higher than in the control group. 4. In the groups supplemented with SNP at 50 and 200 mg/kg, serum total protein and albumin were higher than the control group; however, serum lipid profile, and liver and kidney enzymes were not affected by supplementation with SNP or l-NAME. 5. The numbers of ovarian primordial and primary follicles were greater in the group fed on the diet supplemented with 200 mg SNP/kg compared with the control group. Supplementation at 200 mg L-NAME/kg diet reduced the number of primary follicles compared to the controls, whereas the diameter of primordial and primary follicles increased. 6. In conclusion, supplementation with SNP and L-NAME depressed quail growth. Furthermore, the increase in NO following dietary supplementation with the NO-donor SNP delayed the growth process from primordial to primary and primary to secondary follicle transition in quail.

Comparison of flunixin meglumine and meloxicam influence on postoperative and oxidative stress in ovariohysterectomized bitches.

The aim of this study was to compare the effect of flunixin meglumine (FM) and meloxicam (M) on postoperative and oxidative stress in ovariohysterectomized bitches. Twenty four bitches were divided into three groups (n = 8 in each) and treated during premedication as follows: FM (2.2 mg/kg, iv, Fluvil, Vilsan, Turkey), M (0.2 mg/kg, sc, Maxicam, Sanovel, Turkey) or 0.9% saline (1 ml, iv, IE, Turkey)--control (C) group. The concentrations of serum cortisol, nitric oxide (NO), malondialdehyde (MDA), antioxidant potential (AOP) and glutation (GSH) were measured in blood samples collected during incision (0 h), closure of incision line (0.5 h) and 1, 2.5, 12 and 24 hours after incision. It was observed that cortisol level was higher at 0.5, 1 and 2.5 h in group C (p < 0.05), 0.5 h in group FM (p < 0.001), and 1 and 2.5 h in group M (p < 0.01), as compared to that determine at 0 h. Group C showed higher cortisol level during 0.5 h (p < 0.05) than that found in the other groups. Group FM displayed lower levels during 1 h (p < 0.01) and 2.5 h (p < 0.05) as compared to those observed in other groups. Concentrations of MDA, AOP and GSH between all the groups did not show any significant differences. MDA level was higher at 0.5 and 1 h in group M (p < 0.05) than that found in group C and it was the lowest at 2.5 h in group C (p < 0.05). AOP was higher at 2.5 h in group FM and M (p < 0.05) than that observed in group C, and at 12 and 24 h in group M than that found in group C and FM. GSH did not show any significant differences between the groups. NO level in group FM after 12 h was higher (p < 0.05) than that at 0.5, 1 and 24 h. Moreover, NO level was lower at 0.5 (p < 0.01), 1 (p < 0.05) and 24 h (p < 0.05) in group FM than that observed in group C and M. In conclusion, flunixin meglumine decreases cortisol and NO levels more efficiently than meloxicam. Therefore, it is suggested that postoperative stress following ovariohysterectomy may be prevented by flunixin meglumine in bitches.

The effect of dietary L-arginine intake on the level of antibody titer, the relative organ weight and colon motility in broilers.

This study was carried out to determine the effect of L-arginine (L-Arg) levels in diet at the starter, grower and finisher phases on immune response, organ development, nitric oxide (NO) metabolism and colon motility in broilers. A total of 500 one-day-old Ross-308 broiler chickens of mixed sex were separated into one Arg-deficient group and four experimental groups. Each group was then divided into five subgroups of 20 birds each. Arginine deficient group for all phases was fed a basal diet which contained 10% less L-Arg than optimum Arg requirement recommended by the breeder. Experimental groups were fed a basal diet supplemented with L-Arg which was progressively 10% increased in groups. Thus, the diet contained 90, 100, 110, 120 and 130% of optimum Arg requirement for each phases in groups, respectively. The highest serum infectious bursal disease antibody titer (IBD) was observed in the experimental group which was fed the diet containing 110% L-Arg at grower phase (P < 0.05), whereas Newcastle disease antibody titer did not differ between groups. The relative weight of spleen increased in groups which were fed the diet containing 120 and 130% L-Arg at starter phase as compared to Arg-deficient group (P < 0.05). The group which was fed the diet containing 110% L-Arg showed highest relative weight of bursa Fabricii at grower (P < 0.05) and finisher (P < 0.01) phases. It was observed that serum nitric oxide (NO) concentration decreased in Arg-deficient group (P < 0.05). The amplitude of spontaneous colon contractility did not differ between groups at the end of all three phases. However, the frequency of spontaneous colon contractility in the Arg deficient group was higher at starter (P<0.05), grower (P < 0.01) and finisher (P < 0.05) phases. These results suggest that the supplementation of L-Arg at higher level than optimum Arg requirement in broiler diet has minimal effect on parameters investigated in the study. However, L-Arg-deficiency may negatively affect immune response and the motility of gastrointestinal system due to disruption of NO metabolism at three phases.