Zoledronic acid aggravates kidney damage during ischemia reperfusion injury in rat.

INTRODUCTION: Zoledronic acid (ZA), a bisphosphonate, increases the levels of cytokines, such as interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α), and reactive oxygen species (ROS) in subjects without cancer. Increased production of ROS, TNF-α, and IL-6 during ischemia and reperfusion (I/R) injury stimulates apoptosis that leads to renal injury. We aimed to investigate whether ZA treatment has a protective effect on renal tissues during I/R. MATERIALS AND METHODS: Twenty-four Sprague-Dawley rats were used in this study, and they were subdivided randomly into three groups, each containing eight rats. Infrarenal abdominal aortic cross ligation was performed on the I/R group. After 2 h of ischemia, 2 h of reperfusion was applied. A single dose of 100 µg/kg ZA was administered intraperitoneally to the ZA group. I/R was performed after 48 h. RESULTS: Whereas TNF-α, IL-6, and nitric oxide (NO) levels of the I/R group were higher than those of the control group, TNF-α, IL-6, and NO levels of the ZA group were higher than those of the I/R group [TNF-α (p=0.038), IL-6 (p=0.012), NO (p=0.002), and caspase-3 (p=0.037)] and the control group [TNF-α (p<0.001), IL-6 (p<0.001), NO (p<0.001), and caspase-3 (p<0.001)]. Whereas the carbonic anhydrase II (CA-II) level of the ZA group was lower than that of the control group (p=0.040), the CA-II level of the I/R group was higher than that of the control group (p=0.020). CONCLUSION: ZA may aggravate renal injury during I/R by increasing cytokine production and apoptosis. It may also increase renal injury and metabolic acidosis during I/R by suppressing CA-II enzyme activities.

Effect of infliximab on acute hepatic ischemia/reperfusion injury in rats.

This study aimed to investigate the hepatoprotective and antioxidant effects of infliximab (IFX) against liver ischemia/reperfusion (I/R) injury in rats. A total of 30 male Wistar albino rats were divided into three groups: sham, I/R, and I/R+IFX. IFX was given at a dose of 3 mg/kg for three days before I/R. Rat livers were subjected to 60 min of ischemia followed by 90 h of reperfusion. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), TNF-α, malondialdehyde (MDA), and glutathione peroxidase (GSH-Px) levels were measured in the serum. The liver was removed to evaluate the histopathologic changes. The I/R group had a significant increase in AST, ALT, MDA, and TNF-α levels, and a decrease in GSH-Px activity compared with the sham group. The use of IFX significantly reduced the ALT, AST, MDA and TNF-α levels and significantly increased GSH-Px activity. IFX attenuated the histopathologic changes. IFX has a protective effect on liver I/R injury. This liver protective effect may be related to antioxidant and anti-TNF-α effects. We propose that, for the relief of liver injury subsequent to transplantation, liver resection, trauma, and shock, tentative treatments can be incorporated with IFX, which is already approved for clinical use.

A novel model approach for esophageal burns in rats: A comparison of three methods.

BACKGROUND: Corrosive esophageal injury causes serious clinical problems. We aimed to create a new experimental esophageal burn model using a single catheter without a surgical procedure. MATERIALS AND METHODS: We conducted the study with two groups of 12 male rats that fasted for 12 h before application. A modified Foley balloon catheter was inserted into the esophageal lumen. The control group was given 0.9% sodium chloride, while the experimental group was given 37.5% sodium hydroxide with the other part of the catheter. After 60s, esophagus was washed with distilled water. The killed rats were examined using histopathological methods after 28 days. RESULTS: In comparison with the histopathological changes experienced by the study groups, the control groups were observed to have no pathological changes. Basal cell degeneration, dermal edema, and a slight increase in the keratin layer and collagen density of submucosa due to stenosis were all observed in the group subjected to esophageal corrosion. CONCLUSION: A new burn model can thus, we believe, be created without the involvement of invasive laparoscopic surgery and general anesthesia. The burn in our experiment was formed in both the distal and proximal esophagus, as in other models; it can also be formed optionally in the entire esophagus.

A rare stoma-related complication: parastomal evisceration.

Defunctioning stoma is a commonly used colorectal surgical procedures. The stomal complications recorded are usually classified as early and late complications. Parastomal hernia is a common complication of stomal surgery. We present a very rare stoma-related complication developed after parastomal hernia and described parastomal evisceration.

Testosterone- and cortisol-secreting adrenocortical oncocytoma: an unusual cause of hirsutism.

Objective. Oncocytomas of the adrenal cortex are usually benign and nonfunctional. They are rarely seen as the cause of hirsutism. Therefore, we aimed to report a case of adrenocortical oncocytoma presenting with hirsutism. Methods. We report a testosterone- and cortisol-secreting adrenal oncocytoma in a 23-year-old female patient presenting with hirsutism. Results. The patient had the complaint of hirsutism for the last year. Laboratory tests revealed total testosterone level of 4.2 ng/mL, free testosterone of >100 pg/mL, and DHEAS level of 574 µg/dL. There was no suppression in cortisol levels with 2 mg dexamethasone suppression test (5.4 µg/dL). Adrenal MRI revealed a 27 × 25 mm isointense solid mass lesion in the left adrenal gland and the patient underwent laparoscopic left adrenalectomy. Pathological examination confirmed the diagnosis of benign adrenocortical oncoyctoma. Conclusion. This well-characterized case describes a testosterone- and cortisol-secreting adrenocortical oncocytoma as a possible cause of hirsutism. To our knowledge, this is the second report in the literature. Adrenal oncocytomas should always be considered in the differential diagnosis of hirsutism.

Antral hyperplastic polyp: A rare cause of gastric outlet obstruction.

INTRODUCTION: Gastric polyps are usually found incidentally during upper gastrointestinal endoscopic examinations. These polyps are generally benign, with hyperplasia being the most common. While gastric polyps are often asymptomatic, they can cause gastric outlet obstruction. PRESENTATION OF CASE: A 64 years-old female patient presented to our polyclinic with a history of approximately 2 months of weakness, occasional early nausea, vomiting after meals and epigastric pain. A polypoid lesion of approximately 25mm in diameter was detected in the antral area of the stomach, which prolapsed through the pylorus into the duodenal bulbus, and subsequently caused gastric outlet obstruction, as revealed by upper gastrointestinal endoscopy of the patient. The polyp was retrieved from the pyloric canal into the stomach with the aid of a tripod, and snare polypectomy was performed. DISCUSSION: Currently, widespread use of endoscopy has led to an increase in the frequency of detecting hyperplastic polyps. While most gastric polyps are asymptomatic, they can cause iron deficiency anemia, acute pancreatitis and more commonly, gastric outlet obstruction because of their antral location. Although there are no precise principles in the treatment of asymptomatic polyps, polyps >5mm should be removed due to the possibility of malignant transformation. CONCLUSION: According to the medical evidence, polypectomy is required for gastric hyperplastic polyps because of the risks of complication and malignancy. These cases can be successfully treated endoscopically.

Adalimumab ameliorates abdominal aorta cross clamping which induced liver injury in rats.

The aim of this study was to investigate the possible protective effects of adalimumab (ADA) on cell damage in rat liver tissue during ischemia/reperfusion (I/R) injury of infrarenal abdominal aorta. Thirty male Wistar-albino rats were divided into three groups: control, I/R, and I/R+ADA, each group containing 10 animals. Laparotomy without I/R injury was performed in the control group animals. Laparotomy in the I/R group was followed by two hours of infrarenal abdominal aortic cross ligation and then two hours of reperfusion. ADA (50 mg/kg) was administered intraperitoneally as a single dose, to the I/R+ADA group, five days before I/R. The tumor necrosis factor-alpha (TNF-α) (pg/mg protein) and nitric oxide (NO) (µmol/g protein) levels in the I/R group (430.8 ± 70.1, 8.0 ± 1.1, resp.) were significantly higher than those in the I/R+ADA group (338.0 ± 71.6, P = 0.006; 6.3 ± 1.2, P = 0.008) and the control group (345.5 ± 53.3, P = 0.008; 6.5 ± 1.5, P = 0.010, resp.). I/R causes severe histopathological injury to the liver tissue, but ADA leads to much less histopathological changes. ADA treatment significantly decreased the severity of liver I/R injury. ADA pretreatment may have protective effects on experimental liver injury.

A rare cause of acute abdomen: jejunal diverticulosis with perforation.

Jejunal diverticulosis is generally asymptomatic and is associated with high morbidity and mortality secondary to complications, especially in elderly patients. We present a case report of a 74-year-old female patient with jejunal diverticulosis and perforation due to diverticulitis.

Gastric Necrosis due to Acute Massive Gastric Dilatation.

Gastric necrosis due to acute massive gastric dilatation is relatively rare. Vascular reasons, herniation, volvulus, acute gastric dilatation, anorexia, and bulimia nervosa play a role in the etiology of the disease. Early diagnosis and treatment are highly important as the associated morbidity and mortality rates are high. In this case report, we present a case of gastric necrosis due to acute gastric dilatation accompanied with the relevant literature.

Obturator hernia: a rare case of acute mechanical intestinal obstruction.

Obturator hernia is a rare type of pelvic hernia which generally occurs in elderly patients with accompanying diseases. Because it is difficult to diagnose before surgery, the morbidity and mortality rates for obturator hernia are high. The most common symptom is strangulation combined with mechanical intestinal obstruction.

Distribution of Thyroid Cancer in the Eastern Part of Turkey 27 Years After the Chernobyl Accident.

BACKGROUND: The Chernobyl accident caused widespread effects across Europe and huge areas where radiocontaminated. The effects of the Chernobyl accident on thyroid cancer have been investigated in most European countries. According to the data of the Turkish Atomic Energy Authority, the eastern part of the Black Sea region was the most radiocontaminated area in Turkey at the time of Chernobyl accident. We therefore aimed to examine the data of thyroid cancers at our center, Rize city which is located in the eastern Black Sea region. METHODS: This retrospective study included the patients with histologically proven thyroid cancer at our center between January 2008 and May 2012. Pathologic examinations of thyroidectomy materials were reviewed. We evaluated patients' age, gender, size of the primary tumor (all sizes, < 1 cm, 1 - 2.9 cm, 3 - 3.9 cm and ≥ 4 cm), multicentricity, histologic subtypes of thyroid cancer, the presence of lymphatic, vascular, capsule and the extrathyroidal invasion. RESULTS: Five hundred and forty-seven of the 3,556 patients were diagnosed with thyroid cancer. The mean age of the patients was 49.31 ± 0.49 years. The histopathologic diagnosis of patients was papillary carcinoma in 533 (97.4%) and the tumor size was < 1 cm in 53.6% of the patients. The presence of multicentricity was detected in 47% of the patients. CONCLUSION: The portion of thyroid carcinomas in all thyroidectomies was 15.4% in our institution 27 years after the Chernobyl accident.

Protective effect of curcumin on acute lung injury induced by intestinal ischaemia/reperfusion.

The aim of this study is to evaluate the role of curcumin on acute lung injury induced by intestinal ischaemia/reperfusion (I/R). A total of 30 male Wistar albino rats were divided into 3 groups: sham, I/R, and I/R + curcumin; each group contains 10 animals. Sham group animals underwent laparotomy without I/R injury. After I/R groups animals underwent laparotomy, 1 h of superior mesenteric artery ligation were followed by 1 h of reperfusion. In the curcumin group, 3 days before I/R, curcumin (100 mg/kg) was administered by gastric gavage. All animals were killed at the end of reperfusion and lung tissue samples were obtained for biochemical and histopathological investigation in all groups. To date, no more biochemical and histopathological changes on intestinal I/R injury in rats by curcumin treatment have been reported. Curcumin treatment significantly decreased the elevated tissue malondialdehyde levels and increased reduced superoxide dismutase, and glutathione peroxidase enzyme activities in lung tissue samples. Intestinal I/R caused severe histopathological injury including oedema, haemorrhage, increased thickness of the alveolar wall, and infiltration of inflammatory cells into alveolar spaces. Curcumin treatment significantly attenuated the severity of intestinal I/R injury. Furthermore, there is a significant reduction in the activity of inducible nitric oxide synthase and increase in the expression of surfactant protein D in lung tissue of acute lung injury induced by intestinal I/R with curcumin therapy. It was concluded that curcumin treatment may have beneficial effects in acute lung injury, and therefore has potential for clinical use.

Laparoscopic treatment of a phytobezoar in the duodenal diverticulum - Report of a case.

INTRODUCTION: Primer small intestine bezoar is seen rarely. It frequently arises from underlying small intestine pathologies (diverticle, tumor, stricture etc.). We report a very rare case of disopyrobezoar in the duodenal diverticulum, a kind of phytobezoar caused by persimmons, which was treated laparoscopically. PRESENTATION OF CASE: The 47-year-old patient applied to polyclinic with complaints of epigastric tenderness, occasional distension, and acid regurgitation. In endoscopical examination, impacted bezoar was determined in the diverticulum in the duodenum. Because it is too hard, it was unable to remove endoscopically. On the abdominal tomography, a smooth-bounded non-homogeneous mass including gas and soft tissue areas in the 2nd portion of the duodenum was detected. A barium meal confirmed the presence of a 5cm diameter diverticulum on the lateral wall of the second portion of the duodenum. It also showed an intraluminalfilling defect as well as the mottled appearance of the bezoar. Learned from history of the patient, that the patient consumed over persimmon in childhood. DISCUSSION: Generally, duodenal diverticles are asymptomatic. Surgical treatment is rarely necessary because of complications such as bleeding, perforation, abdominal pain, bezoar formation. As well as using methods such as gastric lavage, enzymatic dissolution, endoscopical fragmentation in the treatment of phytobezoar, their chances of success are low because its structure is rigid. Usually, surgical intervention is required. CONCLUSION: For the treatments of bezoar cases located in the small intestine, laparoscopic surgical method is a safe and feasible method in selected cases.

Anti-inflammatory and antioxidant effects of infliximab in a rat model of intestinal ischemia/reperfusion injury.

The aim of this study was to investigate the possible protective effects of infliximab on oxidative stress, cell proliferation and apoptosis in the rat intestinal mucosa after ischemia/reperfusion (I/R). A total of 30 male Wistar albino rats were divided into three groups: sham, I/R and I/R+ infliximab; each group comprised 10 animals. Sham group animals underwent laparotomy without I/R injury. I/R groups after undergoing laparotomy, 1 hour of superior mesenteric artery ligation occurred, which was followed by 1 hour of reperfusion. In the infliximab group, 3 days before I/R, infliximab (3 mg/kg) was administered intravenously. All animals were killed at the end of reperfusion and intestinal tissues samples were obtained for biochemical and histopathological investigation in all groups. To date, no biochemical and histopathological changes have been reported regarding intestinal I/R injury in rats due to infliximab treatment. Infliximab treatment significantly decreased the elevated tissue malondialdehyde levels and increased reduced superoxide dismutase and glutathione peroxidase enzyme activities in intestinal tissues samples. I/R caused severe histopathological injury including mucosal erosions, inflammatory cell infiltration, necrosis, hemorrhage, and villous congestion. Infliximab treatment significantly attenuated the severity of intestinal I/R injury, inhibiting I/R-induced apoptosis, and cell proliferation. Because of its anti-inflammatory and antioxidant effects, infliximab pretreatment may have protective effects on the experimental intestinal I/R model of rats.

Relationship between the levels of oxidative stress in mesenteric and peripheral serum and clinicopathological variables in colorectal cancer.

OBJECTIVE: To explore the differences existing between the levels of oxidative stress in peripheral and mesenteric serum in patients with colorectal cancer. MATERIAL AND METHODS: One hundred fifty patients with colorectal cancer who underwent surgery between May 2005 and March 2010 were prospectively analyzed. The differences between oxidative stress parameters in their peripheral and mesenteric blood were measured. The associations between peripheral and mesenteric levels and the staging and clinicopathological variables were investigated. RESULTS: Oxidative stress parameters were higher in patients with advanced tumor staging (p<0.01), lymph node invasion (p<0.01), and venous invasion (p<0.01). Differences between oxidative stress parameters in peripheral and mesenteric blood samples were also observed. CONCLUSIONS: The mesenteric levels of the oxidative stress markers were higher than the peripheral levels in these colorectal cancer patients. Higher levels of these oxidative stress markers are associated with an advanced state of cancer.

Lipid Peroxidation and Transforming Growth Factor-ß1 Levels in Gastric Cancer at Pathologic Stages.

OBJECTIVE: High levels of TGF-ß1 and enhanced TGF-ß1 receptor signaling are related to the pathology of gastric cancer. This effect is caused by oxidative stress and lipid peroxidation products. The aim of this study was to investigate the levels of TGF-ß1 and lipid peroxidation products in gastric cancer patients and their correlation with pathologic stage. MATERIAL AND METHODS: Lipid peroxidation products and TGF-ß1 levels were studied in the serum samples of 50 gastric cancer patients and 18 control subjects. RESULTS: HNE-protein adducts and TGF-ß1 levels were significantly higher in T2, T3 and T4 gastric cancers than in either the T1 stage or controls (p<0.001). Pathologic stage was correlated with TGF-ß1 levels (r=0.702, p<0.05). CONCLUSION: These markers production may contribute to tumor angiogenesis and aid in the prognosis of the gastric cancer.