Efficacy of diffusion-weighted magnetic resonance imaging in the evaluation of extrahepatic cholestasis-related hepatic fibrosis.

BACKGROUND/AIM: To investigate the efficacy of diffusion-weighted magnetic resonance imaging (DWI) in the diagnosis and staging of fibrosis induced by experimental bile duct ligation (BDL). MATERIALS AND METHODS: Twenty-four rats were divided randomly into four groups: control, BDL--3 days, BDL--2 weeks, and BDL--4 weeks. DWI was performed with b-values of 100 and 500 on the rats from control group at day zero, on the rats from the BDL--3 days group at the end of day 3, on the rats from the BDL--2 weeks group at the end of day 14, and on the rats from the BDL--4 weeks at the end of day 28. RESULTS: When fibrosis scores generated in all groups were evaluated together, a strong negative correlation was detected between fibrosis scores and apparent diffusion coefficient (ADC) values measured using b 100 and b 500. ADC values obtained using b 100 were found to be significantly higher compared to the fibrosis observed in both the BDL--2 weeks and BDL--4 weeks groups (P < 0.003 and P < 0.001, respectively). CONCLUSION: We think that DWI may be an alternative to liver biopsy for the diagnosis and staging of hepatic fibrosis with underlying extrahepatic cholestasis.

A novel approach for preventing esophageal stricture formation: olmesartan prevented apoptosis.

Accidentally ingested corrosive substances can cause functional and structural damage to the esophageal tissue resulting in stricture formation. It has been reported that the administration of olmesartan (OLM) can have anti-inflammatory, antifibrotic and antiapoptotic effects on injured tissue. The aim of our study was to check if OLM could prevent formation of scars in the corrosive esophageal burn model. Fifty-one Wistar Albino rats were divided into six groups: Control, Sham, OLM, Sham + OLM, Burn, and Burn + OLM. Olmesartan (5 mg/kg) was given by gavage once per day for 21 consecutive days after injury. The morphology of the esophagus was assessed after Masson trichrome staining, and apoptosis was evaluated using the terminal deoxynucleotidyl transferased UTP nick end labeling (TUNEL) method. The serum nucleosomes (as an indicator of apoptosis), serum p53 protein, and esophageal tissue p53 protein levels of each group were measured by immunoassays. Muscularis mucosa damage, submucosal collagen deposition, and tunica muscularis injury in the Burn + OLM group decreased significantly compared with the Burn group (p < 0.05). Similarly, the number of apoptotic cells in the Burn + OLM group decreased compared with the Burn group (p < 0.05). Serum levels of nucleosomes and p53 and tissue of p53 protein did not differ between the groups. Exogenously administered OLM can effectively prevent the occurrence of esophageal strictures caused by corrosive esophageal burns.

Desferrioxamine effectively attenuates testicular tissue at the end of 3 h of ischemia but not in an equal period of reperfusion.

OBJECTIVE: To investigate the effect of desferrioxamine (DFX) on ipsilateral and contralateral testis damage caused by experimental testis torsion and detorsion. MATERIALS AND METHODS: Forty rats were divided into five groups (n = 8): control, torsion (T), torsion + desferrioxamine (T + DFX), torsion/detorsion (T/D), and torsion/detorsion + desferrioxamine (T/D + DFX). The right testes of the rats were subjected to torsion and detorsion for 3 h each. Thirty minutes before the application of torsion and detorsion, DFX (100 mg/kg) was administered intramuscularly. Blood samples and testicular tissues were examined using specific biochemical and histopathological methods. RESULTS: Ipsilateral and contralateral testis tissue glutathione levels in the T group decreased compared with the control and T + DFX groups. Plasma glutathione peroxidase activity in the T, T/D, and T/D + DFX groups was lower than in the control group. Plasma catalase activity in the T and T/D groups decreased compared with the control group. Ipsilateral mean seminiferous tubule diameter of the T group was lower than that of the T + DFX group. The ipsilateral mean testis biopsy scores in the T and T/D groups were lower than in the control group. CONCLUSION: The administration of DFX prior to torsion may be useful only for preventing ischemic damage in ipsilateral and contralateral testes.

Desferrioxamine reduces oxidative stress in the lung contusion.

Our hypothesis in this study is that desferrioxamine (DFX) has therapeutic effects on experimental lung contusions in rats. The rats were divided into four groups (n = 8): control, control+DFX, contusion, and contusion+DFX. In the control+DFX and contusion+DFX groups, 100 mg/kg DFX was given intraperitoneally once a day just after the contusion and the day after the contusion. Contusions led to a meaningful rise in the malondialdehyde (MDA) level in lung tissue. MDA levels in the contusion+DFX group experienced a significant decline. Glutathione levels were significantly lower in the contusion group than in the control group and significantly higher in the contusion+DFX group. Glutathione peroxidase (GPx) and superoxide dismutase (SOD) levels in the contusion group were significantly lower than those in the control group. In the contusion+DFX group, SOD and GPx levels were significantly higher than those in the contusion group. In light microscopic evaluation, the contusion and contusion+DFX groups showed edema, hemorrhage, alveolar destruction, and leukocyte infiltration. However, histological scoring of the contusion+DFX group was significantly more positive than that of the contusion group. The iNOS staining in the contusion group was significantly more intensive than that in all other groups. DFX reduced iNOS staining significantly in comparison to the contusion group. This study showed that DFX reduced oxidative stress in lung contusions in rats and histopathologically ensured the recovery of the lung tissue.

The effects of hyperbaric oxygen application against cholestatic oxidative stress and hepatic damage after bile duct ligation in rats.

BACKGROUND: The aim of this study was to evaluate the preventive and therapeutic potential of hyperbaric oxygen therapy (HBO) on the liver tissue against bile duct ligation (BDL)-induced oxidative damage and fibrosis in rats. MATERIALS AND METHODS: We divided 32 adult male Sprague Dawley rats into four groups: sham, sham plus HBO, BDL, and BDL plus HBO; each group contained eight animals. We placed the sham plus HBO and BDL plus HBO groups in an experimental hyperbaric chamber in which we administered pure oxygen at 2.5 atmospheres absolute 100% oxygen for 90 min on 14 consecutive days. RESULTS: The application of BDL clearly increased the tissue malondialdehyde level, myeloperoxidase activity, and hydroxyproline content and decreased the antioxidant enzymes (superoxide dismutase and catalase activities) and glutathione level. Hyperbaric oxygen therapy treatment significantly decreased the elevated tissue malondialdehyde level, myeloperoxidase activity, and hydroxyproline content and increased the reduced superoxide dismutase and catalase activities and glutathione level in the tissues. The changes demonstrating the bile duct proliferation and fibrosis in expanded portal tracts include the extension of proliferated bile ducts into lobules, mononuclear cells, and neutrophil infiltration into the widened portal areas were observed in BDL group. Treatment of BDL with HBO attenuated alterations in liver histology. Alpha smooth muscle actin, cytokeratin-positive ductular proliferation, and the activity of terminal deoxynucleotidyl transferase 2'-deoxyuridine, 5'-triphosphate nick end labeling in the BDL decreased with HBO treatment. CONCLUSIONS: The data indicate that HBO attenuates BDL-induced oxidative injury, hepatocytes damage, bile duct proliferation, and fibrosis. The hepatoprotective effect of HBO is associated with antioxidative potential.

Preventive effects of hyperbaric oxygen treatment on glycerol-induced myoglobinuric acute renal failure in rats.

Myoglobinuric acute renal failure (ARF) is a uremic syndrome caused by traumatic or non-traumatic skeletal muscle breakdown and intracellular elements that are released into the bloodstream. We hypothesized that hyperbaric oxygen (HBO) therapy could be beneficial in the treatment of myoglobinuric ARF caused by rhabdomyolysis. A total of 32 rats were used in the study. The rats were divided into four groups: control, control+hyperbaric oxygen (control+HBO), ARF, and ARF+hyperbaric oxygen (ARF+HBO). Glycerol (8 ml/kg) was injected into the hind legs of each of the rats in ARF and ARF+HBO groups. 2.5 atmospheric absolute HBO was applied to the rats in the control+HBO and ARF+HBO groups for 90 min on two consecutive days. Plasma urea, creatinine, sodium, potassium, calcium, aspartate aminotransferase, alanine aminotransferase, lactic dehydrogenase, creatinine kinase and urine creatinine and sodium were examined. Creatinine clearance and fractional sodium excretion could then be calculated. Superoxide dismutase, catalase, glutathione and malondialdehyde (MDA) levels were assessed in renal tissue. Tissue samples were evaluated by Hematoxylin-eosin, PCNA and TUNEL staining histopathologically. MDA levels were found to be significantly decreased whereas SOD and CAT were twofold higher in the ARF+HBO group compared to the ARF group. Renal function tests were ameliorated by HBO therapy. Semiquantitative evaluation of histopathological findings indicated that necrosis and cast formation was decreased by HBO therapy and TUNEL staining showed that apoptosis was inhibited. PCNA staining showed that HBO therapy did not increase regeneration. Ultimately, we conclude that, in accordance with our hypothesis, HBO could be beneficial in the treatment of myoglobinuric ARF.

The effects of N-acetylcysteine on intestinal ischemia/reperfusion injury in rats.

OBJECTIVE: To evaluate the effects of N-acetylcysteine NAC on the injury of intestinal ischemia-reperfusion. METHODS: Forty-eight Wistar-Albino rats were divided into 6 groups: as control, ischemia, ischemia-reperfusion, ischemia + N-acetylcysteine, ischemia-reperfusion + N-acetylcysteine (IRN), and reperfusion + N-acetylcysteine (RN). Histopathologic examination was performed to all groups. In the tissue and plasma, and erythrocyte samples, malondialdehyde, superoxide dismutase, glutathione, and nitric oxide NO levels were evaluated. The present study was carried out in Trakya and Istanbul University, Edirne, Turkey between December 2002 and July 2003. RESULTS: The most severe histopathological damage was seen in the intestinal ischemia-reperfusion group, and this damage was observed to be reduced by NAC administration. Lowest plasma malondialdehyde levels were observed in RN group. The tissue glutathione levels were found to be higher in RN group than those in IRN group. CONCLUSION: It was found that administration of NAC has important effects on the injury of intestinal ischemia, as well as, reperfusion in rats. N-acetylcysteine administration causes an improvement in the histopathologic findings of ischemia/reperfusion damages. The N-acetylcysteine treatment protects the antioxidant enzymes in the tissue, plasma, and the erythrocytes, which are crucially important in the intestinal ischemia/reperfusion injury in rats.

The effects of methylene blue on renal scarring due to pyelonephritis in rats.

The aim of this study was to evaluate the efficiency of methylene blue (MB) in preventing renal scar formation after the induction of pyelonephritis (PNP) in a rat model with delayed antimicrobial therapy. An inoculum of the K-12 strain of Escherichia coli was injected into both kidneys. Control groups received isotonic saline instead of bacterial solution. Four equal groups were then formed: the PNP group was untreated and the PNP ciprofloxacin (CIP) treated group was treated only with CIP intraperitoneally (i.p.) starting on the third day following bacterial inoculation. In the PNP (MB)-treated group, MB was given i.p., and in the PNP MB + CIP-treated group, MB + CIP were administered i.p.. In the sixth week following bacterial inoculation, all rats were sacrificed, and both kidneys of the rats in all groups were examined biochemically and histopathologically for renal scarring. Renal scar was significant in the groups treated with MB alone or MB + CIP combination compared with untreated or antibiotic only groups. Delayed treatment with antibiotics had no effect on scarring. These results suggest that the addition of MB to the delayed antibiotic therapy might be beneficial in preventing PNP-induced oxidative renal tissue damage.

[Diagnostic value of pediatric trauma score in blunt abdominal injuries]. / Pediatrik travma skorunun künt karin travmalarindaki tanisal degeri.

BACKGROUND: It was reported that pediatric trauma score (PTS) is an important tool for the initial assessment of injury severity and could help in the triage of injured children as well. The aim of this study is to investigate the prognostic value of PTS in blunt abdominal traumas. METHODS: Between 1997 and 2003, children with blunt abdominal trauma who treated in the Department of Pediatric Surgery, Trakya University Medical Faculty were evaluated with retrospective analysis. PTS was designated for each case. Individual morbidity and mortality were correlated with PTS. Data analysis were performed with Mann Whitney U test and ROC curve statistically. RESULTS: Seventy five patients were included in this study. The mean age of children was 7.5+/-4.2 years (10 months-15 years). Mechanisms of injury were as follows: automobile versus pedestrian 30, falls 18, motor vehicle crashes 14, bicycle accidents 7 and others 6. Forty two abdominal organ injuries were found.. PTS of the patients who had abdominal injuries were different statistically from others (p<0.05). On the ROC curve sensitivity and specificity were found as %74 and %12 respectively in those with PTS scores of 8. CONCLUSION: PTS was found to be of low sensitivity and specificity for blunt abdominal trauma patients.

Waugh's syndrome: report of two cases.

The association of intussusception and intestinal malrotation has been reported rarely in the literature. This association is called Waugh's syndrome. The authors report 2 cases of Waugh's syndrome and discuss diagnostic features and treatment methods.

Prenatally closed gastroschisis with midgut atresia.

Spontaneous prenatal closure of gastroschisis (GS) is rare and usually associated with atresia of the midgut. We describe a case of GS diagnosed at 20 weeks' gestation that resolved spontaneously in utero. At delivery the infant had an ileus. A laparotomy with a jejunocolostomy was performed, but she died at 2 months of age due to complications of total parenteral nutrition.

Congenital fibrous epulis in the infant.

Congenital fibrous epulis is an extremely rare tumor of infancy. It is a benign gingival tumor and generally seen in maxillary alveolar crest and its etiology remains the subject of debate. Congenital fibrous epulis could be considered a hamartomatous lesion. Histologically it does not show the closely packed large granular cells necessary for the diagnosis of an ordinary congenital epulis. Instead, it consists of irregular bundles of collagenous connective tissue, varying numbers of fusiform cells with oval or fusiform shaped nuclei and mild subepithelial inflammatory infiltration with tiny blood vessels and in this case a woven bone spicule in the deep area. Recommended treatment for this tumor is simple excision. We report upon a case of congenital fibrous epulis in a male infant and discuss the clinical features, histopathologic findings, and surgical treatment.

Acute gastric volvulus due to deficiency of the gastrocolic ligament in a newborn.

UNLABELLED: Gastric volvulus is rare in the neonatal period. Only three cases of gastric volvulus due to deficiency of gastrocolic ligament have been reported until now in the literature. We describe a neonatal case due to absence of the gastrocolic ligament. Stamm gastrostomy was performed for fixation and there has been no recurrence of his symptoms during a 13-month post-operative period. CONCLUSION: Stamm gastrostomy is a viable treatment of gastric volvulus due to lack of the gastrocolic ligament.