Gastroprotective effects of CoQ10 on ethanol-induced acute gastric lesions.

INTRODUCTION: Alcohol consumption is frequently associated with gastric mucosal lesions. The purpose of this study was to determine the effect of Coenzyme-Q10 (CoQ10) supplementation on the ethanol-induced gastric mucosal damage in a rat model. MATERIAL AND METHOD: Sixty-four female wistar albino rats were randomly divided into 8 groups (n = 8). Studies were performed in ethanol induced gastric ulcer model in Wistar albino rats. Famotidine at a dose of 5 mg/kg or 20 mg/kg and CoQ10 at a single dose of 10 mg/kg or 20 mg/kg and 30 mg/kg for 7 days were administered as pretreatment. All the rats in study groups received 2 ml/kg ethanol 95 % intragastrically, 30 minutes after pretreatment. Four hour after ethanol administration, all rats were sacrificed and their stomachs were removed under ketamin anaesthesia. Gastric protection was evaluated by measuring the ulcer index, MDA concentrations, and histopathological studies. RESULTS AND DISCUSSION: Rats pretreated either with famotidine or CoQ10 had significantly diminished gastric mucosal damage which was assessed with gross and microscopic analysis (p < 0.00625). MDA levels were significantly lower in famotidine 20 mg/kg and CoQ10 pretreatment for 7 days group (p < 0.00625).

Experimental obstructive jaundice results in oxidized low-density-lipoprotein accumulation in surgical wound of rats.

INTRODUCTION: Mounting evidence suggests that impaired wound healing is a well-defined consequence in obstructive jaundice and, as redox-regulated processes are relevant to wound healing, it is not unreasonable to suppose that oxidative stress associated with lipid peroxidation in cholestasis might be a systemic phenomenon probably comprising all tissues and organs, including wounds. The aim of the present investigation was to analyse the lipid peroxidation status of surgical wounds, in terms of oxidized low-density-lipoprotein (oxLDL) accumulation in experimental obstructive jaundice. METHODS: Sixteen Wistar-Albino rats weighing 200-230 gr were randomly divided into two groups. Group I (n = 8) was designed as the prolonged obstructive jaundice group and was subjected to bile duct ligation. Group II (Sham-control, n = 8) rats underwent laparotomy alone and bile duct was just dissected from the surrounding tissue. Histopathological evaluation, immunohistochemical screening and immunoflourescent staining of the surgical wound was conducted to the bile-duct ligated rats and control group on the 21st postoperative day. RESULTS: Wound healing was found to be impaired in jaundiced rats histopathologically. When compared with the control group, significant positive oxLDL staining and intracellular accumulation of TNF-alpha, IL-2 and IL-6 was detected in the wound sections of the prolonged obstructive jaundice group. CONCLUSION: Our present data is the first in the literature, indicating significant oxLDL accumulation in surgical wounds of cholestatic rats, which might be one of the results of systemic oxidative stress leading to deficient healing capacity as a consequence of persistent inflammation.

Retroperitoneal localization of hydatid cyst disease.

In this study we discuss a rare case; hydatid cyst disease that is located in the retroperitoneum. Two cases were treated in our department with hydatid cyst disease located in the retroperitoneum; one of the cysts was in the minor pelvis and the other was on the left psoas muscle. Diagnosis was confirmed with blood tests, and radiological examinations. The cyst wall was excised partially and was oversewn. Following the operation both of the patients were given albendasole tablets for 10 weeks with blood count and liver enzyme monitorization. Hydatic cysts located in retroperitoneum were treated successfully. Especially in the endemic areas hydatid cyst should be remembered when evaluating cystic masses in the retroperitoneum. It can be treated successfully with surgery.

A rare cause of acute abdomen: splenic infarction.

Splenic infarction is a rare disorder. We have treated 4 patients during the last year. Abdominal pain in the left upper quadrant was the common complaint. Other complaints were fever, nausea and vomiting. Computed tomography showed infarcted areas in the spleen in all of the patients. Splenectomy was applied to three of the patients with recurring symptoms. The other patient had the first episode treated medically. Pulmonary embolism in one and surgical wound infection occurred in another patient during postoperative follow-up for nine (range: 4-14) months.

The effects of resveratrol on the healing of left colonic anastomosis.

INTRODUCTION: Resveratrol (RSV) is a natural polyphenolic compound found in grape skins and the red wine which improves histological reorganization of the regenerating tissue in dermal wound healing. Since anastomotic healing possesses paramount importance to prevent complications in colorectal surgery, the present study is aimed to evaluate the effect of RSV on the healing of experimental left colonic anastomoses. METHODS: Thirty-two male Wistar albino rats were randomized into two groups and subjected to colonic anastomosis. The study group was treated with RSV and the control group received tap water instead. The rats were sacrificed 3 and 7 days postoperatively. Wound complications, intra-abdominal abscesses, and anastomotic leaks and stenosis were recorded. Four types of assessment were performed: bursting pressure, hydroxyproline (OHP) content, histopathology, and biochemical analysis. RESULTS: Compared to the control group, the RSV-treated rats displayed a higher bursting pressure (p < .001) and anastomotic OHP content (p < .05)]. RSV treatment leads to significant increase in PON activity at both time points and decrease in malondialdehyde levels on postoperative day 3 (p < .001). Histopathological analysis revealed that RSV administration leads to a better anastomotic healing in terms of mucosal ischemia, neovascularization, reepithelialization, fibroblast, and lymphocyte infiltration. CONCLUSION: The study results suggest that exogenous RSV administration exerts a positive effect on experimental colonic wound healing in the rat. Although the precise cellular mechanisms by which RSV enhances anastomotic wound healing is not clear, stimulation of neovascularization, generation of collagen synthesis, inhibition of over inflammation, and restriction of oxidative injury seems to be of paramount importance.

Simvastatin improves wound strength after intestinal anastomosis in the rat.

BACKGROUND: Simvastatin is a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor commonly known as a cholesterol-lowering drug with additional pleiotropic effects. Also, it is demonstrated that it prevents postoperative peritoneal adhesions in rat. This study was designed to assess its effects on the healing process of colonic anastomosis. METHODS: Thirty-two male Wistar albino rats were randomized into two groups and subjected to colonic anastomosis. The study group was treated with simvastatin and the control group received only tap water instead. The rats were killed 3 and 7 days postoperatively. Wound complications, intra-abdominal abscesses, and anastomotic leaks and stenosis were recorded. Four types of assessment were performed: bursting pressure, hydroxyproline content, histopathology, and biochemical analysis. RESULTS: Compared to the control group, simvastatin-treated rats displayed a higher bursting pressure (p < 0.001) and anastomotic hydroxyproline content (p < 0.05). Simvastatin treatment leads to a significant decrease in malondealdehyde levels (p < 0.05) and increase in paraoxonase activity (p < 0.001) at both time points. Histopathological analysis revealed that simvastatin administration leads to a better anastomotic healing in terms of reepithelialization, decreased granuloma formation, reduced ischemic necrosis, and inflammatory infiltration to muscle layer. CONCLUSION: Clinically relevant doses of simvastatin do not have a negative impact on colonic anastomosis but improve intestinal wound healing in rats.

Inadvertent parathyroidectomy and temporary hypocalcemia: an adverse natural outcome or a true complication during thyroidectomy?

OBJECTIVE: The aim of this study was to assess the factors that might predict patients at increased risk for inadvertent parathyroidectomy and postoperative symptomatic hypocalcemia during thyroidectomy. METHODS: Demographic data as well as the data on preoperative diagnosis, preoperative ultrasonography reports, operation reports, histological findings, and postoperative symptomatic hypocalcemia were collected. A total of 273 (83 male and 190 female patients) thyroid operations were included in this study. RESULTS: Histopathological examination identified inadvertent parathyroidectomy in 10 (3.7%) cases. Statistical analysis identified the presence of cervical lymphadenopathy as detected by preoperative ultrasonography as a risk factor for inadvertent parathyroidectomy. In 57 patients (20.9%) clinically symptomatic postoperative hypocalcemia was observed. However, the difference in the frequency of such hypocalcemia between the patients with and without inadvertent parathyroidectomy was not significant. Statistical evaluation identified total thyroidectomy as a risk factor for postoperative hypocalcemia (p<0.005). CONCLUSION: Due to our experience, inadvertent parathyroidectomy is not a rare entity during thyroidectomy and the presence of cervical lymphadenopathy, as observed by preoperative ultrasonography, is the only risk factor for inadvertent parathyroidectomy. In contrast, no association between inadvertent parathyroidectomy and postoperative hypocalcemia was detected. Total thyroidectomy was found to be the sole risk factor for symptomatic temporary hypocalcemia.

[Nine years of trauma cases]. / Dokuz yillik travma olgularimiz.

Trauma is one of the major cause of death in the young population. The patients treated due to trauma were evaluated retrospectively during the last nine years. 212 cases with trauma were hospitalised in our clinic, between 1.7.1990-11.4.1999. 190 (89.6%) of them were operated and 22 (10.4%) of them were observed selectively. 36 (17%) of the cases were female and 176 (83%) of them were male. The mean age was 32.4 (16-81). 93 (43%) of them were hospitalized following traffic accidents; 56 (26.4%) of them stab wounds, 33 (15.6%) of them gunshots and 30 (14.1%) of them blunt trauma. The diagnosis was done through the diagnostic peritoneal lavage 95.1% of the traffic accident cases. The diagnosis was performed through diagnostic peritoneal lavage 76.9% of the after blunt trauma cases. After gunshots the diagnosis was done by 59.4% of the cases with physical examination. Local lesion exploration helped us to establish the diagnosis 51.4% of the stab wound cases. The most frequent organ injury following traffic accidents is splenic injury and injury of small intestine following penetrating trauma. The amount of our negative laparotomy was more than in literature and 47 (24.7%) cases were accepted as negative exploration. Negative laparotomy was seen mostly by stab wounds (49%). 17 (77.3%) of the 22 cases observed selectively were the cases of the last two years. In the recent two years the amount our negative laparotomy was six and our negative laparotomy ratio is 14%. Our mortality and the morbidity rates were at the acceptable level.