Ultrastructural view of a promising anti TNF-α agent on hepatic ischaemia reperfusion injury.

BACKGROUND: Ischemia reperfusion causes injury to the liver cells during transplantation, trauma and emergency surgery. We investigated whether the anti TNF-α agent, etanercept, can reduce injury in an animal model of ischemia reperfusion owing to the fact that TNF-α plays a critical role in the process of inflammation. MATERIALS AND METHODS: Thirty rats were divided into three groups: sham (Group 1), control (Group 2), etanercept (5 mg/kg) treatment (Group 3). Ischemia-reperfusion model was carried out by clamping the hepatic pedicle for 45 min and then reperfusing the liver for 60 min. Etanercept (5 mg/kg) was injected intraperitoneally 5 min prior to reperfusion. At the end of the procedures, blood and liver tissue samples were obtained for biochemical and histopathological assessment. RESULTS: Control and treatment groups showed significant differences in hepatic function tests, plasma and tissue oxidative stress parameters. Samples in the control group histopathologically showed morphologic abnormalities specific to ischemia reperfusion. Histomorphologic findings in the treatment groups showed similar features as the sham group. CONCLUSIONS: Our evidence suggests that TNF-α plays a key role in liver ischemia reperfusion injury and etanercept may provide a novel therapeutic approach for patients undergoing liver surgical procedure (Tab. 3, Fig. 4, Ref. 22).

Effects of Ankaferd Blood Stopper and calcium alginate in experimental model of hepatic parenchymal bleeding.

BACKGROUND: This experimental study compared the hemostatic effects of calcium alginate and Anka-ferd Blood Stopper in hepatic parenchymal bleedings. MATERIAL AND METHOD: The study comprised 39 male Wistar albino rats (weight 230±30 g). Laceration model was created in the left lateral lobe of the liver. Standard cotton gauze that was impregnated 0.9% NaCl solution and Calcium alginate cover was compared to ABS tampon. The amount of preoperative bleeding, preoperative and postoperative Day 1 hematocrit levels, and the difference between them were assessed and statistically analyzed. RESULTS: Comparing the hematocrit levels between the groups, we found that the amount of bleeding was significantly higher in the control group versus the study groups (p<0.001). Histopathological examination revealed the portal area enlargement and biliary canaliculi proliferation. In the Ca2+ Alginate group, it was observed that the fibres were still present in the incision line with massive fibrotic area around. In the Ankaferd group, examination of the preparations revealed patchy focal necrosis areas but no fibrotic area. CONCLUSION: With this study, we demonstrated that both calcium alginate and Ankaferd have hemostatic effect in preventing hepatic parenchymal bleeding and that calcium alginate causes fibrosis in the liver, where ABS causes focal necrosis areas(Tab. 2, Fig. 4, Ref. 19).

The effect of diosmin on pancreatic injury induced by hepatic ischemia reperfusion in rats.

PURPOSE: This experimental study aimed at comparing the cyanoacrylate abdomen closure to the effectiveness of triclosan coated polidioxanone abdomen closure. METHODS: The abdomen layers were closed with 3/0 polidioxanone suture in the first group. In the second group, the layers were closed with triclosan coated polidioxanone suture in a single layer. The abdomen layers of rats in the third group were attached with cyanoacrylates without sutures. The rats were sacrificed on the 14th day and the adhesive level was recorded. The incision resistance strength was measured. The tissue was examined blindly in the terms of inflammatory cell infiltration, capillary proliferation, fibrosis and micro-abscess by the pathologist. RESULTS: No significant difference was determined between the 1st and 2nd groups in the terms of inflammatory cell infiltration, capillary proliferation, collagen deposition, fibroblast activity, adhesive and tissue distension strength. The fibrosis and adhesive rate of the 3rd group was significantly higher than the 1st and 2nd groups statistically. The tissue distension strength was lower than in the other groups and the differences between the groups were found to be significant (p < 0.05). No significant difference was determined between the groups in the term of micro-abscess. CONCLUSIONS: Antibacterial suture is not superior to the conventional suture. It is concluded that cyanoacrylate is not an appropriate molecule for abdomen closure (Tab. 1, Fig. 3, Ref. 17).

Evaluation of incidental thyroid cancer in patients with thyroidectomy.

OBJECTIVES: Variations such as communications between median nerve and musculocutaneous nerve or in their abnormal branching pattern constitute a major concern in clinical and surgical field. Knowledge of these variations not only provides the clinician with a proper interpretation of the case, but also minimizes the complication in surgical approaches in this region. METHOD: We examined 50 isolated upper limbs to investigate the possible incidences of various types of communications between these two neighbouring peripheral nerves. RESULT: Twenty-eight per cent of limbs were found to have communication between these two nerves. When categorized according to Venieratos and Anagnostopoulou's classification method, 11 out of 14 cases (79%) showed type I communications, two out of 14 (14%) showed type II and the remaining one (7%) showed type III communication pattern. CONCLUSION: Prior knowledge of communications between these two neighbouring nerves, both in terms of their incidences and pattern of communications, may be of considerable significance to neurologists and orthopaedicians in dealing with nerve entrapment syndromes in the upper limb of patients.