The effect of interleukin-10 on acute pancreatitis induced by cerulein in a rat experimental model.

To investigate whether interleukin-10, a potent anti-inflammatory cytokine, could have a therapeutic effect on rats on that were made pancreatitis by cerulein. Thirty Wistar Albino rats were randomized into sham, pancreatitis, and therapy groups (n = 10 in each). Nothing was applied to the sham group; pancreatitis by inject-ing cerulein (50 micro/g/kg/h) was induced in the pancreatitis and therapy groups. Interleukin-10 (10.000 U) was injected at 1 and 4 h after pancreatitis inductions in the therapy group. The rats were sacrificed at postoperative hour 24. The following parameters were investigated: the leukocyte count, blood glucose, amylase, lipase and tumor necrosis factor-alpha levels in the blood samples; histopathological search, and wet/dry weight ratios of the pancreas tissues. The ratio of wet/dry pancreatic tissue weight, serum tumor necrosis factor-alpha, amylase and lipase lev-els, and histologic damage scores in the pancreatitis and therapy groups were significantly higher when they were compared with the sham group(p < .01). However, all of these values were significantly lower in the therapy groups than in the pancreatitis group (p < .01). Interleukin-10 decreases pancreatic tissue injury induced by cerulein-induced pancreatitis in rats. Nevertheless, more experimental studies are needed to compare endogenous interleukin-10 with exogenous interleukin-10 effects before clinical usage of this drug.

Effects of recombinant platelet activating factor acetylhydrolase in obstructive jaundice.

BACKGROUND/AIMS: The aim of this study was to investigate effects of recombinant PAH (platelet activating factor acetylhydrolase), on tissue damage and on antioxidant response. METHODOLOGY: A total of 30 Wistar-Albino type rats were used in this PAH treatment, and the subjects were divided into 3 groups namely sham, ligation and PAH treatment groups, each containing 10 rats. In PAH treatment and ligation groups, laparotomy was made; common bile duct was ligated and incised. Following ligation, blood and liver tissue were taken. In the sham group, the common bile duct was turned but no other procedure was applied. The subjects in the ligation group were given intraperitoneal placebo on the 2nd to 6th days; and those in the PAH treatment group were applied PAH at a 5-mg/kg dose. Blood and liver tissue were taken on postoperative day 7. The parameters examined in the blood sample included, liver function tests, superoxide dismutase, glutathione peroxidase, tumor necrosis factor-alpha and interleukin-6. In liver tissue, histopathologic examination was made. RESULTS: Levels of AST, ALT, GGT, ALP, tumor necrosis factor-alpha and interleukin-6 were significantly higher than the levels in the sham group. These parameters, measured on the 7th day in the PAH treatment group were found to be significantly lower than the ligation group. Portal inflammation in the PAH given group was significantly lower than the ligation group. CONCLUSIONS: Administration of PAH in experimental jaundice has produced improvement in liver functions, significant reductions in serum GGT and ALP, tumor necrosis factor-alpha and interleukin-6, and in liver damage whereas it has brought about an increase in the levels of antioxidant enzymes.

Surgical management of spontaneous intrabiliary rupture of hydatid liver cysts.

PURPOSE: The most common complication of hydatid liver cysts is spontaneous rupture into the biliary tract. This study was conducted to evaluate the surgical management of spontaneous intrabiliary rupture of a hydatid liver cyst in 41 patients. METHODS: The preoperative diagnosis was confirmed by ultrasound in all 41 patients, 37 of whom were jaundiced. RESULTS: According to Gharbi's classification, 39% of the cysts were type III and they ranged from 3 to 18 cm in diameter, with a mean diameter of 9 cm. The mean total bilirubin and alkaline phosphatase values were 6.3 mg/dl and 450 IU, respectively. Partial cystectomy, cholecystectomy, and common bile duct exploration were performed in all patients. In seven patients, the visible biliary duct within the cyst cavity was sutured with 2/0 silk. Intraoperative cholangiography was performed in all patients, and choledochoscopy was performed in 11 patients. A T-tube was inserted after the biliary tract content was thought to have been totally cleaned out in 38 patients (93%), and a choledochoduodenostomy was performed in 3 patients (7%). An external biliary fistula developed in five patients, persisting for 11-25 days. The fistulae healed within a mean period of 5 days after endoscopic sphincterotomy (EST). For patients without a fistula the mean hospitalization time was 8 days and there was no mortality. CONCLUSION: These results suggest that when a hydatid liver cyst ruptures into the biliary tract, common bile duct exploration should be conducted using intraoperative cholangiography and choledochoscopy. If the biliary tract is cleaned of all cystic content, T-tube drainage should be sufficient, but EST is an effective technique for treating persistent extended external biliary fistulae.