Effect of levosimendan on erythrocyte deformability during myocardial ischaemia-reperfusion injury

Diabetes mellitus (DM) is a chronic metabolic disorder accompanied by an increase in oxidative stress. Ischaemia-reperfusion (IR) injury is a cascade of events initiated by tissue ischaemia. The cellular damage produced by reperfusion leads to an active inflammatory response. Erythrocyte deformability and plasma viscosity are of crucial importance for the perfusion of tissues and organs. The aim of this study was to evaluate the effect of levosimendan on erythrocyte deformability during IR myocardial injury in diabetic rats.

METHODS

Twenty-four Wistar albino rats were included in the study after streptozocin (55 mg/kg) treatment for 4 weeks to observe the existence of diabetes. The animals were randomly assigned to one of four experimental groups. In Group C and DC (sham-control group), the coronary artery was not occluded or reperfused in the control rats. Myocardial IR was induced by ligation of the left anterior descending coronary artery for 30 min, followed by 2 h of reperfusion in the diabetes-IR (DIR) and diabetes-IR-levosimendan (DIRL) group. Deformability measurements were performed in erythrocyte suspensions containing Htc 5 % in a phosphate-buffered saline (PBS) buffer.

RESULTS

The deformability index was significantly increased in the diabetic rats. It was similar in Group DC and DIRL It was significantly increased in the DIR group compared to Group C, DIRL and DC. The relative resistance was increased in the IR models.

CONCLUSION

Erythrocyte deformability was decreased in rats with diabetes and IR injury. This injury might lead to further problems in microcirculation. Levosimendan may be useful in enhancing the adverse effects of this type of injury (Fig. 2, Ref. 41).

KEYWORDS

erythrocyte deformability, myocardial ischaemia reperfusion, experimental diabetes, levosimendan, rat.

Effect of dexmedetomidine on erythrocyte deformability during ischaemia-reperfusion injury of heart in diabetic rats

The aim of this study is to evaluate the effect of dexmedetomidine on erythrocyte deformability during IR heart injury in diabetic rats.

METHODS

Eighteen Wistar Albino rats were included in the study after streptozocin (55 mg/kg) treatment for four weeks. In the Group C and DC (sham-control group), the coronary artery was not occluded or reperfused in the control rats. In the Group DIR, a branch of the left coronary artery was occluded for 30 minutes followed by two hours of reperfusion to produce IR. In the Group DIRD, a branch of the left coronary artery was occluded for 30 minutes followed by two hours of reperfusion to produce IR, and dexmedetomidine was administrated via 100 µg/kg IP route 30 minutes before ligating the left coronary artery. Deformability measurements were performed in erythrocyte suspensions containing Htc 5 % in a PBS buffer.

RESULTS

The deformability index was significantly increased in diabetic rats; however, it was similar in the Group DC and DIRD. It was significantly increased in the Group DIR when compared to the Group C, DIRD and DC. The relative resistance was increased in IR models.

CONCLUSION

Erythrocyte deformability was decreased in rats having diabetes and IR injury. This injury might lead to further problems in microcirculation. It was shown that dexmedetomidine might be useful in enhancing the adverse effects of this type of injury (Fig. 1, Ref. 39).

The effects of iloprost on lung injury induced by skeletal muscle ischemia-reperfusion

PURPOSE

The aim of this study was to investigate the effects of iloprost (I) on lung injury as a remote organ following skeletal muscle ischemia-reperfusion injury in a rat model.

MATERIALS AND METHODS

Twenty-four Wistar Albino rats were randomized into four groups (n = 6). Laparotomy was performed in all groups under general anesthesia. Only laparotomy was applied in Group S (Sham). Ischemia reperfusion group (Group I/R) underwent ischemia and reperfusion performed by clamping and declamping of the infrarenal abdominal aorta for 120 minutes. Group iloprost (Group I) received intravenous infusion of iloprost 0.5 ng/kg/min, without ischemia and reperfusion. Group I/R/I received intravenous infusion of iloprost 0.5 ng/kg/min immediately after 2 hours of ischemia. At the end of the study, lung tissue was obtained for determining total oxidant status (TOS) and total antioxidant status (TAS) levels, histochemical and immunohistochemical determination.

RESULTS

Diffuse lymphocyte infiltration was detected in immunohistochemical examination of lung tissue in Group I/R. The connective tissue around bronchi, bronchioles and vessel walls was found to be increased. Although minimal local lymphocyte infiltration was detected in some fields in Group I/R/I, the overall tissue was found to be similar to Group S. iNOS expression was significantly higher in Group I/R, when compared with Group S and significantly lower in Group I/R/I compared to Group I/R.TOS levels were significantly higher in Group I/R, when compared with groups S and I (p = 0.028, p = 0.016, respectively) and significantly lower in group I/R/I, when compared with Group I/R (p = 0.048). TAS levels were significantly higher in Group I/R, when compared with groups S, I (p = 0.014, p = 0.027, respectively) and significantly lower in Group I/R/I, when compared with Group I/R (p = 0.032).

CONCLUSION

These results indicate that administration of iloprost may have protective effects against ischemia reperfusion injury (Fig. 8, Tab. 1, Ref. 30)

The protective effects of dexmedetomidine on liver injury-induced myocardial ischemia reperfusion

PURPOSE

The aim of this study was to evaluate the effect of dexmedetomidine (100 µg/kg-ip) on liver injury-induced myocardial ischemia and reperfusion (IR) in rats.

MATERIALS AND METHODS

Twenty-four Wistar Albino rats were separated into four groups. There were four experimental groups (Group C (Control; n = 6), Group IR (ischemia-reperfusion, n = 6), Group D (Dexmedetomidine; n = 6) that underwent left thoracotomy and received ip dexmedetomidine without IR administered via 100 µg/kg ip route 30 minutes before ligating the left coronary artery, and Group IR-D (IR-Dexmedetomidine; n = 6). A small plastic snare was threaded through the ligature and placed in contact with the heart. To produce IR, a branch of the left coronary artery was occluded for 30 min followed by two hours of reperfusion. However, after the above procedure, the coronary artery was not occluded or reperfused in the control rats. At the end of the study, liver tissue was obtained for histochemical and immunohistochemical determination.Some part of tissue samples were stained with Masson-trichrome for the evaluation of ultrastructural changes and inducible nitric oxide synthase (iNOS) expression was evaluated in other part of samples for immunohistochemical examination.

RESULTS

Histopathological changes were detected in Group IR when compared with Group C. iNOS expression was found to be increased and stronger particularly in the vascular wall, perisinusoidal space and hepatocytes around vena centralis in this group compared to the control group. Perivascular oedema was detected to be decreased in Group IR-D compared to Group IR. It was also observed that the impairment in the radial arrangement of hepatocytes significantly recovered in Group IR-D. The immunoreactivity was found to be significantly decreased in the assessment of iNOS expression in the same group when compared with Group IR.

CONCLUSION

Administration of dexmedetomidine ameliorates liver injury induced by myocardial ischemia and reperfusion (Fig. 8, Ref. 33).

The effects of dexmedetomidine on pulmonary artery pressure in experiment

AIM

The primary purpose of this study is to assess the effects of dexmedetomidine (DEX) infusion on pulmonary artery pressures (PAP), heart rate (HR), and mean arterial pressure (MAP) in pigs. The secondary purpose is to evaluate whether DEX infusion via the pulmonary artery has any beneficial effect over the peripheral IV route.

MATERIALS AND METHODS

Sixteen healthy male pigs (25-35 kg) scheduled for laparoscopy training were used in this study. The animals were randomly allocated into two groups: Group I (n = 9): A loading dose of 1 μg/kg DEX was administered over 10 minutes followed by an infusion of 0.5 μg/kg/hr for one hour via the pulmonary artery catheter. Group II (n = 7): A loading dose of 1 μg/kg DEX was administered over 10 minutes followed by an infusion of 0.5 μg/kg/hr for one hour via the peripheral venous catheter. Mean PAP, HR, MAP, SpO2, and ETCO2 were recorded at 5, 10, 15, 30, 45, and 60 minutes after the initiation of the DEX infusion.

RESULTS

Heart rate and MAP were similar in both groups at all time points. Also, neither the HR nor the MAP deviated from the basal values in Groups I and II at any time point. The mean PAP values were similar in Groups I and II, and in Group I, the mean PAP values were similar to Group I's basal value at all time points. However, in Group II, the mean PAP values at 5, 45, and 60 minutes were significantly lower than Group II's basal value (p = 0.023, p = 0.041, p = 0.015, respectively).

CONCLUSION

DEX infusion did not elevate the mean PAP and the results from the administration of DEX through the peripheral vein and pulmonary artery were similar (Tab. 3, Ref. 13).

Investigation of the effects of propofol and vitamin C administration on erythrocyte deformability in rats with streptozotocin-induced diabetes mellitis

PURPOSE

In the current study we aim to investigate the effects of vitamin C and profol on red blood cell deformability in diabetic rats.

MATERIALS AND METHODS

Twenty- eight Wistar Albino rats were included in the study after streptozocin (60 mg/kg) treatment for 4 weeks of observation for diabetes presence. Twenty-eight rats were allocated to 4 groups. In group DP (n = 7) 150 mg.kg-1 of propofol was injected intraperitoneally. In group DP-vit C (n = 7) rats 100 mg/kg of vitamin C (Ascorbic acid, Redoxon® 1000 mg/5 mL - Roche) were applied one hour before administrating 150 mg.kg-1 of propofol, while rats in control group (n = 7), and diabetic control group (n = 7) received intraperitoneally physiological saline. Deformability measurements were achieved by using erythrocyte suspensions with hematocrit level of 5 % in PBS buffer.

RESULTS

Erythrocyte deformability was significantly higher in diabetic control group than in control and vitamin C plus propofol groups (p = 0.00, p = 0.025, respectively). Erythrocyte deformability indexes were found similar in control group and vitamin C plus propofol group (p = 0.949). Relative resistance was increased in diabetic rat model.

CONCLUSIONS

Erythrocyte deformability was damaged in rats with diabetes. This injury might lead to further problems in microcirculation. Application of propofol did not alter red cell deformability in diabetic rats. Vitamin C supplementation seems to reverse those negative effects and variations in erythrocyte deformability (Fig. 2, Ref. 57).

An MRI study of age-related changes in the dimensions related temporal lobe

The aim of this study was to determine the effect age-related changes on the MRI-based parameters related to several measurement of temporal lobe in the lifespan of adult persons. MRI scans of head (n=236) were reviewed retrospectively to identify abnormalities of temporal lobe, third ventricle, and temporal horn of lateral ventricle. Patients were divided into 3 study groups according to their age. Using axial and coronal views of the cerebral hemispheres, interuncal distance, thickness of temporal lobe, Evans' ratio, and the width of third ventricle, height of hippocampus, width of choroid fissure, and width of the temporal horn were measured. The mean age of study group was 44.2±17.7 (18 to 86). The gender ratio (F/M) of study group was 129/107. There is mild-moderate significant correlation between age and Evans' ratio (r=0.35, p<0.05). There is mild significant correlation between age and interuncal distances (r=0.24, p<0.05). There was no correlation between age and third ventricle widths, temporal lobe widths, and temporal horn widths of left and right sides of brain (p>0.05). A mild and significant correlation was present between these variables (r=0.14 and r=0.17, respectively; p<0.05). There was a mild and significant correlation between these variables. (r=-0.14 and r=-0.19, respectively; p<0.05). Although several parameters including our measurements were developed for the assessment of size and structure of temporal lobe. It is not ease to determine MRI-based markers for the prediction, diagnosis, and follow-up of mild cognitive impairment and Alzheimer's disease in the elderly.

Cyclodextrin mediated polymer coupling via thiol–maleimide conjugation: facile access to functionalizable hydrogels

Fabrication of well-defined chemically cross-linked poly(ethylene glycol) (PEG)-based hydrogels using the thiol–maleimide addition reaction is reported.

Antioxidative effects of adrenomedullin and vascular endothelial growth factor on lung injury induced by skeletal muscle ischemia-reperfusion

PURPOSE

The aim of this study was to investigate the effects of adrenomedullin (AM) and vascular endothelial growth factor (VEGF) on lung injury as a remote organ following skeletal muscle ischemia-reperfusion injury in a rat model.

MATERIALS AND METHODS

Thirty-six Wistar rats were randomized into six groups (n=6). Laparotomy was performed in all groups under general anesthesia. Nothing else was done in Group S (Sham). Ischemia reperfusion group (Group I/R) underwent ischemia and reperfusion performed by clamping and declamping of the infrarenal abdominal aorta for 120 minutes, respectively. Group VEGF and Group AM received intravenous infusion of VEGF (0.8 μg/kg) or AM (12 μg /kg) respectively, without ischemia and reperfusion. Group IR+VEGF and Group IR+AM received intravenous infusion of VEGF (0.8 μg/kg) or AM (12 μg /kg) respectively immediately after 2 hours period of ischemia. At the end of reperfusion period. Lung tissue samples were taken for biochemical examination. Total oxidant status (TOS) and total antioxidant status (TAS) levels in lung tissue were determined by using a novel automated method. p<0.05 was considered as statistically significant.

RESULTS

TOS levels were significantly higher in Group I/R, when compared with groups S, AM and VEGF (p=0.004, p=0.011, p=0.017, respectively) and significantly lower in groups I/R+AM and I/R+VEGF, when compared with Group I/R (p=0.018, p=0.006, respectively). TAS levels were significantly higher in Group I/R, when compared with groups S, AM and VEGF (p=0.006 p=0.016, p=0.016, respectively) and significantly lower in Group I/R+AM, when compared with Group I/R (p=0.016).

CONCLUSION

These findings indicate that AM and VEGF acted effectively on the prevention of lung injury induced by skeletal muscle ischemia-reperfusion injury in a rat model (Fig. 2, Ref. 30).

Cardiac structure and functions in patients with asymptomatic primary hyperparathyroidism

BACKGROUND

The data about cardiovascular (CV) changes in patients with asymptomatic primary hyperparathyroidism (PHPT) are scarce.

AIM

The aim of this study is to compare cardiac structure and functions in patients with asymptomatic PHPT and controls by using tissue Doppler echocardiography.

SUBJECTS AND METHODS

Thirty-eight patients with asymptomatic PHPT and 31 sex- and age-matched controls with similar cardiac risk factors were evaluated.

RESULTS

There was no significant difference in ejection fraction (EF) between the patients and the controls [64±5.95 vs 62±3.25% (p=0.094)]. Left ventricular mass index (LVMI) was significantly higher in patients than controls [105.96 (66.45-167.24) vs 93.79 (64.25- 139.25) g/m2, p=0.014]. There was a significant correlation between LVMI and serum calcium (Ca) (r=0.240, p<0.005). Myocardial performance index (MPI) was significantly higher in patients than controls [0.49 (0.35-0.60) vs 0.39 (0.33-0.62), p<0.001]. There was positive correlation between theMPI and serumCa levels (r=0.505, p<0.001), parathyroid hormone (PTH) levels (r=0.464, p<0.001) and LVMI (r=0.270, p<0.005). When the normotensive patients and controls were evaluated, the difference between the groups remained statistically significant considering LVMI and MPI [109 (66.45-167.24) g/m2 vs 94.17 (64.25-75.10) g/m2, p=0.03; and 0.49 (0.35-0.60) vs 0.39 (0.33-0.62), p<0.01, respectively]. There were significant correlations between MPI and Ca (r=0.566, p<0.001), and PTH (r=0.472, p<0.001).

CONCLUSIONS

Our study results showed that cardiacmorphology and diastolic functions are altered in the patients with asymptomatic PHPT. High serum PTH and Ca levels may have an impact on these CV changes. Whether these subtle CV changes would affect cardiac systolic functions and mortality in patients with asymptomatic PHPT should be investigated in further prospective studies.

Intensive pulmonary care after liver surgery: a retrospective survey from a single center

BACKGROUND

Prevention from postoperative pulmonary complications (PPCs) has been an important topic. The aims of this study were to determine the risk factors for PPC after liver surgery and to analyze the efficacy of postoperative pulmonary care on PPC prevention.

MATERIALS AND METHODS

We retrospectively analyzed variables of 81 patients who underwent hepatectomy and 4 transplantations between January 2007 and March 2012.

RESULTS

Nineteen patients suffered PPCs (22.4%). Bivariate analysis identified four risk factors: preoperative anemia (odds ratio [OR] = 5.69), the American Society of Anesthesiologists (ASA) score of 3 or 4 (OR = 5.36), blood transfusion (OR = 2.81), and prolonged operative time (OR = 1.01). Upon multivariate analysis, only prolonged operative time was an independent risk factor for PPC (OR = 1.01). Pulmonary function test (PFT) was performed for 22 of 41 patients with an ASA score ≥ 2 (53.7%); there was no significant relationship between abnormal PFTs (n = 13) and the development of PPCs (P = .12).

CONCLUSIONS

The elimination of risk factors may reduce the incidence of PPCs. Postoperative intensive pulmonary care should be given to all patients after liver surgery but particularly to patients with high ASA scores and those with abnormal PFTs irrespective of age.

Effect of iloprost on erythrocyte deformability in rat's lower extremity undergoing an ischemia reperfusion injury

AIM

Ischemia reperfusion injury (I/R) in lower extremity is a frequent and important clinical phenomenon. The protective effect of iloprost on local and distant organ injury due to I/R has been well documented but its effect on erythrocyte deformability needs further investigation. Our aim was to investigate the effect of iloprost on erythrocyte deformability in the infrarenal aorta of rats undergoing I/R.

MATERIALS AND METHODS

Our study was conducted with 18 Wistar albino rats. Rats were divided into the 3 groups; the randomized control group (group C; n=6), I/R group without iloprost (group I/R; n=6) and I/R group with iloprost - 10 mcg.kg-1, 30 min infusion (group I/R-I; n=6). Packs of erythrocytes were prepared from heparinized blood samples and deformability measurements were done.

RESULTS

The comparisons of the control and I/R-I groups revealed similar results (p=0.951). The values of the IR group were significantly higher than those of the control and IR-I groups (p=0.006, p=0.011, respectively).

CONCLUSION

In our study, we detected the unfavourable effects of I/R on erythrocyte deformability, which may lead to disturbance in blood flow and hence tissue perfusion in the infrarenal rat aorta. We also found that Iloprost had beneficial effects by reversing the undesirable effects of I/R (Fig. 1, Ref. 15).

Oxidative stress and antioxidant activity of female rat liver tissue after sevoflurane anaesthesia: young versus old

AIM

The aim of our study was to assess the evidence of oxidative stress in the rat liver tissue by studying enzymes, such as nitric oxide synthase (NOS), superoxide dismutase (SOD), glutathione-S transferase (GST) activity, and thiobarbutiric acid-reactive substances (TBARS) levels in young versus old female rats after sevoflurane anaesthesia.

MATERIAL AND METHOD

The study involved 28 female Wistar Albino rats. The rats were divided into the two groups [(Group I, n=14): Young sevoflurane group (Group I-YS, n=7); Young control group (Group I-YC, n=7)], [(Group II, n=14): Old sevoflurane group (Group II-OS, n=7); Old control group (Group II-OC, n=7)]. Sevoflurane was administered at 2 % volume inspiratory concentration, 6 L.min-1 in 100 % O2 for 2 hours. The control groups were not subjected to any procedures. Accordingly, GST, SOD, and NOS enzyme activity and TBARS level, were studied in the liver tissue samples of the rats to determine the presence of oxidative stress (OS) and antioxidant activity.

RESULTS

Following administration of sevoflurane anaesthesia; GST, SOD enzyme activity and TBARS level was significantly higher in the Group I-YS than in the Group I-YC and in the Group II-OS than in the Group II-OC. There was no difference between the groups when the mean NOS levels were compared.

CONCLUSION

Although the results of our study are similar to the previous indicating that sevoflurane has the capacity to induce the oxidative stress; a new data has been recorded that sevoflurane has a similar effect on the OS level in aged and young female rat (Tab. 1, Fig. 4, Ref. 48).

Can cardiac surgery be performed safely on patients with haematological malignancies

Introduction

Surgical strategy in patients with haematological malignancies must be planned and carried out with the specific aim of decreasing postoperative complications. The aim of this study was to present our experience on patients previously diagnosed with haematological malignancies who subsequently underwent cardiac surgery. We include data to assist other surgeons predict factors affecting postoperative morbidity and mortality in this group of patients.

Methods

Fifteen patients diagnosed with haematological malignancies who had cardiac surgery were retrospectively analysed. Eight patients had chronic lymphocytic leukaemia, six had non-Hodgkin’s lymphoma and the rest had chronic myelocytic leukaemia. Coronary artery bypass graft surgery was performed on all of them.

Results

There were no hospital mortalities. The average follow-up period was 35 ± 11 (23–56) months. Three patients required early postoperative re-operation because of excessive bleeding. No mortalities were seen in the early postoperative period. There were five (33%) deaths during the late follow-up period. Three patients were lost due to intracranial bleeding (confirmed by autopsy) in the 16th, 23rd and 38th months after surgery. The remaining two patients had sudden death in the eighth and 55th months from non-detectable causes.

Conclusion

Conclusion: Cardiac surgery can be performed with acceptable early postoperative outcomes in patients with haematological malignancies. Intracranial bleeding is an important factor contributing to late mortality and patient selection and risk stratification are crucial to improving surgical benefits.

[The efficacy and toxicity of gemcitabine and cisplatin chemotherapy in advanced/metastatic bladder urothelial carcinoma]

OBJECTIVE

Many new agents have been introduced as an alternative to standard MVAC therapy with improved efficacy and lower toxicity profile in advanced bladder carcinoma. The aim of this study is to evaluate the response rate and toxic side effects of gemcitabine-cisplatin (GC) in patients with advanced/metastatic bladder carcinoma.

METHODS

Between January 2001 and April 2006, 58 patients with histologically confirmed advanced/metastatic transitional cell carcinoma (TCC) were enrolled in the study. All patients received 1,000 mg/m(2) gemcitabine administered via intravenous infusion of 30-60 minutes on days 1, 8 and 15, and 70 mg/m(2) cisplatin as an infusion of 60-min on day 2. All toxicities were graded using the WHO scale and the National Cancer Institute scale.

RESULTS

The average number of cycles was 4.1. Neutropenia and thrombocytopenia were clinically significant treatment-related side-effects. Hematologic toxicity included mainly grade 3-4 neutropenia in 56%, grade 3-4 thrombocytopenia in 59%, and grade 3- 4 anemia in 33% of patients. There was only one death from neutropenic sepsis. Complete response and partial response were obtained in 13 (22.4%) and 17 (29.3%) of patients, respectively, 17 (29.3%) of patients were found to have stable disease, and progression was observed in 11 patients (18.9%). Median survival for the whole group was 14.7 months (2-67).

CONCLUSIONS

GC therapy is an effective regimen owing to its high tumor response and long survival with a low incidence of toxicity in advanced or metastatic patients.

The evaluation of effects of lornoxicam on blood flow and erythrocyte deformability in comparison with iv paracetamol in rats

BACKGROUND

Lornoxicam and iv paracetamol are commonly preferred to be used for postoperative analgesia. Although Aspirin is a well known non-steroid anti-inflammatory drug that decreases the erythrocyte deformability, there is no study comparing lornoxicam and iv paracetamol regarding their effects on erythrocyte deformability recorded in literature. The aim of this study was to compare the effects of lornoxicam and IV paracetamol on blood perfusion and erythrocyte deformability on rats.

METHODS

Twenty male Wistar Albino rats were randomly divided into three groups as Lornoxicam group (Group L), IV paracetamol group (Group P), and control group (Group C). Intraperitoneal administrations were done in all groups except Group C. Liver and renal blood flows were conducted by laser Doppler and euthanasia was performed via intraabdominal blood uptake. Erythrocyte deformability was measured using a constant flow filtrometer system.

RESULTS

Lornoxicam increased the relative resistance which shows the erythrocyte deformability in rats (p<0.05). The comparison of Groups C and P revealed no statistically different results (p=0.731) while Group L revealed statistically higher results than Group C (p=0.022). No statistically significant differences were found between groups L and P (p=0.073). Liver and renal blood flow values in Group L were just numerically decreased not statistically whilst no statistically significant difference was found between the three groups.

CONCLUSIONS

Lornoxicam have lead to functional disorders related to tissue perfusion as a result of both decreased blood flow and erythrocyte deformability (Fig. 3, Ref. 21). Full Text in PDF www.elis.sk.

Does vitamin C prevent the effects of high dose dexmedetomidine on rat erythrocyte deformability?

PURPOSE

Dexmedetomidine is an anesthetic agent frequently used for sedation at the intensive care units and during general anesthesia. The purpose of our study was to investigate whether vitamin C prevents the effect of high dose dexmedetomidine on erythrocyte deformability in rats.

METHODS

The study was performed on 21 male rats, with 7 rats in each study groups and the control group. The rats in the study groups were treated with intraperitoneal dexmedetomidine (10 µg/kg) and intraperitoneal dexmedetomidine plus Vitamin C (ascorbic acid) (100 mg/kg ascorbic acid administered 1 hour before administration of 10 µg/kg dexmedetomidine), respectively. Intraperitoneal physiological saline was administered in the control group. Erythrocyte packs were prepared using heparinized total blood samples. Deformability measurements were done by erythrocyte suspensions in phosphate buffered saline (PBS) buffer. A constant flow filtrometer system was used to measure erythrocyte deformability and the relative resistance was calculated.

RESULTS

Erythrocyte deformability was significantly higher in dexmedetomidine group than in control and vitamin C plus dexmedetomidine groups (p=0.003, p=0.013, respectively). Erythrocyte deformability indexes were found similar in the control group and in the vitamin C plus dexmedetomidine group (p=0.383).

CONCLUSIONS

High dose dexmedetomidine may cause functional deterioration in blood flow and tissue perfusion with negative effects in erythrocyte deformability. Vitamin C supplementation seems to reverse those negative effects and variations in erythrocyte deformability. However, our preliminary results should be confirmed in wider serious of experimental and clinical trials (Fig. 1, Ref. 27).

Magnetic resonance imaging of the clivus and its age-related changes in the bone marrow

Background

The clivus is a bone region between dorsum cella and foramen magnum. It can be evaluated very clearly in routine brain magnetic resonance imaging (MRI) dueto its central location.

Objectives

Quantitative and qualitative evaluation of the clivus and its changes according to age in a group of healthy people.

Patients and Methods

The transition of clival bone marrow to fatty marrow by the increasein age is examined by MRI in 105 men and 105 women who had no clival and bone marrow pathology on MRI. The clivus/pons, clivus/CSF intensity values and clival bone marrow imaging patterns according to age groups were prospectively evaluated using a 1.5 Tesla MR device.

Results

When age groups were individually compared, there were meaningful statistical differences both in men and women in terms of clivus/CSF and clivus/pons intensity ratios (both Ps < 0.05). Clivus/pons and clivus/CSF intensity ratios were found to be increased with age in all cases. The distribution of age groups according to stages in all individuals was statistically meaningful (P < 0.05). When the appearance patterns of both genders in every ten-fold age were examined, stage III bone marrow was observed more in elder ages.

Conclusions

As a result, besides the fact that standard ranges determined for clivus/CSF, clivus/pons intensity ratios according to age may be used in the assessment of potential pathological cases involving bone marrow; they can also be leading in the diagnosis of bone marrow diseases when taken into consideration together with clinical and laboratory data.

First Report of a Root Rot Caused by Phytophthora palmivora on Lavandula angustifolia in Turkey

English Lavender (Lavandula angustifolia Mill.) has been considered an alternative crop to tobacco in Hatay Province of Turkey because of its great production potential. As a new, nonnative crop, diseases and pests of lavender are not well known in the region. In summer 2010, root rot symptoms were observed with an average incidence of 45% in a 2-year-old lavender nursery in Hatay. Initial symptoms of chlorosis and wilting were followed by progressive death of the plants starting at the shoot tips. An oomycetous species was isolated consistently from the stems and roots of diseased plants on potato dextrose agar (PDA) amended with several fungicides and antibiotics. The culture of the single-zoospore isolate produced arachnoid growth on PDA. Chlamydospores of the isolate were approximately 35.0 μm in diameter. The isolate produced papillate, caduceus, hyaline sporangia in different shapes ranging from spherical to ellipsoidal. Sporangia with short pedicels (5 μm) were 35.0 to 57.5 × 27.5 to 42.5 μm with a length/width ratio of 1.2 to 1.8. On the basis of symptoms and morphology of the organism, the pathogen was identified as Phytophthora palmivora (E.J. Butler) E.J. Butler (3). Identification of the isolate was also confirmed by comparison of the sequence of the nuclear ribosomal internal transcribed spacer (ITS) region with reference isolates. The ITS region of rDNA was amplified by PCR with primers ITS1/ITS4 and sequenced (GenBank Accession No. JF777117). BLAST analysis of the sequence obtained showed a 99 to 100% homology with P. palmivora. Pathogenicity tests were performed on 12 greenhouse-grown 2-year-old lavender plants in 2-liter pots containing a steamed sand/peat/soil mixture. After rooting, the plants were inoculated by placing mycelial plugs from a 1-week-old culture of the isolate into an incision made at the base of each plant. Control plants were treated with plugs of sterile PDA. Inoculated plants were kept at 27°C for 5 weeks. Similar symptoms developed on the inoculated plants within 4 weeks after inoculation. P. palmivora was consistently reisolated from symptomatic plants. No symptoms developed on control plants. P. palmivora attacks a wide range of crop species including lavenders (1,2,4). To our knowledge, this is the first report of a root rot caused by P. palmivora, a new pathogen of lavender in Turkey. References: (1) S. Davino et al. Plant Dis. 86:561, 2002. (2) D. C. Erwin and O. K. Ribeiro. Phytophthora Diseases Worldwide. The American Phytopathological Society, St Paul, MN, 1996. (3) D. J. Stamps. C.M.I. Descr. Fungi Bact. 831:1, 1985. (4) G. A. Torres et al. Plant Dis. 94:1163, 2010.

Evaluation of erythrocyte deformability in experimentally induced osteoporosis in female rats and the effects of vitamin C supplementation on erythrocyte deformability

OBJECTIVE

The aim of this study was to evaluate the possible variations in antioxidant enzymes, lipid peroxidation and erythrocyte deformability in experimentally induced osteoporosis in female rats and to assess the effects of vitamin C supplementation on those variations.

MATERIAL

A total of 20 female Wistar Albino Rats were randomized into the three groups as controls (Group C, n = 6), ovariectomized rats (Group O, n = 7) and ovariectomized rats receiving vitamin C supplementation (Group OVC, n = 7). After the surgical procedure of ovariectomy, group OVC received 1 g ascorbic acid in 500 mL water daily. After 100 days following the ovariectomy, bone mineral density (BMD) was measured by using dual-energy X-ray absorptiometry.

RESULTS

BMD was significantly lower in the group O than in the group C (p = 0.015), whereas it was significantly higher in the group OVC than in the group O (p = 0.003). MDA activity was significantly higher in the group O than in the group C (p = 0.032), whereas it was significantly lower in the group OVC than in the group O (p = 0.025). SOD activity was significantly higher in the group O than in the group C (p = 0.032). Erythrocyte deformability was significantly higher in the group O than in the group C and OVC (p = 0.008, p = 0.021, respectively).

CONCLUSION

Erythrocyte deformability may show negative variations, suggesting a causative role in disruption of blood flow and tissue perfusion, which also negatively affect bone metabolism. Vitamin C supplementation seems to reverse those negative effects of variations in erythrocyte deformability. However, our preliminary results should be confirmed in more experimental studies and clinical trials (Tab. 3, Ref. 28).

Prevention of postoperative nausea and vomiting with a small dose of propofol combined with dexamethasone 4 mg or dexamethasone 8 mg in patients undergoing middle ear surgery: a prospective, randomized, double-blind study

OBJECTIVE

Postoperative nausea and vomiting (PONV) is a common complication after middle ear surgery. We have aimed to compare the administration of a subhypnotic dose of propofol with dexamethasone 4 mg or 8 mg and placebo in prevention of postoperative nausea and vomiting (PONV) after middle ear surgery.

METHOD

This clinical research was performed at Yüksek Ihtisas Hospital Kirikkale. The study included 105 adult patients scheduled for a middle ear operation. The patients were randomly assigned into three groups. The patients in Group I received propofol in a dose of 0.5 mg x kg(-1) plus 4 mg of dexamethasone while Group II was administered with propofol in a dose of 0.5 mg x kg(-1) plus 8 mg of dexamethasone, and Group III was given 0.9% saline solution. Within the framework of the study we evaluated the number of patients suffering from nausea and vomiting at 0-4, 4-12, and 12-24 hours postoperatively, and the necessity to use additional antiemetics.

RESULTS

The comparison of data showed that at up to four hours, the incidence of vomiting was 28.6% in Group 1, 22.9% in Group II, and 65.7% in Group III. The incidence rates in Group I and Group II were significantly lower than that in Group III (p < 0.05), while the rate of antiemetic drug usage was higher in Group III than in Group I and Group II (p < 0.05). The Nausea Vomiting Scale scores were also significantly higher in Group III than in Group I and Group II (p < 0.05). There were no significant differences between the values at 4-12 and 12-24 hours.

CONCLUSION

The administration of a subhypnotic dose of propofol plus 4 mg of dexamethasone at the end of surgery was found to be at least as effective as propofol plus 8 mg of dexamethasone in preventing the PONV in the early postoperative period in adult patients undergoing middle ear surgery (Tab. 4, Ref. 34).

Association of polymorphisms in the IL-18 and IL-12 genes with susceptibility to Type 1 diabetes in Turkish patients

BACKGROUND

Recent studies have indicated that polymorphisms of the interleukin-18 (IL-18) and interleukin- 12 (IL-12) genes are associated with the development of Type 1 diabetes mellitus (T1DM) in some populations, but not all.

AIM

The present study was designed to examine the roles of polymorphisms in the IL-18 promoter and IL-12p40 with respect to susceptibility to T1DM in Turkish patients.

SUBJECTS AND METHODS

Ninety-one patients with T1DM and 87 unrelated healthy subjects were included in the study. The IL-18 polymorphisms at positions -607 and -137 were detected by a sequence-specific PCR method. The single nucleotide polymorphism in the IL-12p40 3' untranslated region (3'-UTR) at position +1188 was analyzed by the PCR-restriction fragment length polymorphism (RFPL) method.

RESULTS

The allelic and genotypic frequencies of the IL-18 and IL-12p40 polymorphisms did not differ significantly between subjects with T1DM and the controls (p>0.05). However, diabetic patients with the -137 (CC) genotype showed a younger onset age compared to patients with the -137 (GG) genotype (p=0.02). In addition, patients with the -607 (CC) genotype had higher levels of glycated hemoglobin (HbA1c) than patients with the -607 (AC) genotype (p=0.004). Furthermore, patients with the IL-12p40 (AC) genotype had higher HbA(1c) levels than patients with the IL-12p40 (AA) genotype (p=0.01).

CONCLUSIONS

The results of the present study show that the IL- 18 and IL-12p40 polymorphisms may have some effect on the onset age and deterioration of glycemic control in Turkish patients with T1DM.

An Unusual Cause of Haematuria: Renal Arteriovenous Malformation Mimicking Caliceal Dilatation at Ultrasonography

We report a 37-year-old woman admitted to the emergency service with macroscopic haematuria and flank pain due to renal arteriovenous malformation (AVM). Ultrasonography showed apparent dilatation of the left renal caliceal system, whereas intravenous pyelography (IVP) demonstrated multinodular pelvicaliceal impressions with no caliceal dilatation. The final diagnosis was established with conventional angiography. Renal AVM may mimic caliceal dilatation on ultrasonography. Demonstration of multinodular pelvicaliceal impressions at IVP and lack of caliceal dilatation are clues for the correct diagnosis in this particular situation.

Thyroid fine needle aspiration biopsy: is topical local anaesthesia beneficial?

OBJECTIVE

Thyroid fine needle aspiration biopsy (TFNAB) is the gold standard in the differential diagnosis of the thyroid nodules. In general, no analgesia is needed before this procedure. However, it is usually believed that the patients may be more comfortable if the procedure is performed under local anaesthetics. In this study, we examined the impact of the use of dermal anaesthetic on the patient's level of discomfort during palpation-guided TFNAB.

METHODS

Fifty female patients with nodular goitre were enrolled in this study. Patients were randomised into two groups: a placebo cream was applied to group 1 patients (25 females; mean age 47.45 +/- 11.61 years), and local anaesthesia (EMLA 5% cream) was applied to group 2 patients (25 females; mean age 50.89 +/- 12.01 years) approximately 1 h before TFNAB. All patients were asked to mark the pain they felt during the TFNAB on Visual Analogue Scale.

RESULTS

The pain scores during TFNAB were 27.73 +/- 20.01 mm and 24.79 +/- 21.98 mm in the placebo group and in the EMLA group respectively. There was no significant difference between the groups (p = 0.496).

CONCLUSIONS

Topical anaesthesia before palpation-guided TFNAB provides no benefit.

CA 72-4 levels in patients with type 2 diabetes mellitus

OBJECTIVE

CA 72-4 is one of the blood group carbohydrate antigens which can be used as a tumour marker in ovarian, pancreatic and gastrointestinal carcinomas. It can also be elevated in various benign conditions including pancreatitis. Diabetes mellitus is a chronic disorder related with the pancreas. In this study, we investigated CA 72-4 levels in patients with type 2 diabetes and its relation to the metabolic status.

METHODS

Sixty-nine patients with type 2 diabetes mellitus (female/male = 40/29) and 60 healthy subjects (female/male = 35/25) participated in this study. The levels of serum CA 72-4 were measured and faecal occult blood tests (following 3 days of white diet were obtained for three consecutive days) were performed in all patients. Patients had a pathological finding for any of these two parameters were further investigated with upper gastrointestinal endoscopy, colonoscopy and computerised tomography.

RESULTS

The mean levels of CA 72-4 was 1.89 +/- 2.61 U/ml in the study group and 1.4 +/- 0.98 U/ml in the control group (p > 0.05). There was no association between CA 72-4 levels and age and sex of the patients, duration of diabetes, body mass index, biochemical indicators of metabolic control (the levels of HbA(1c), fasting and postprandial glucose, serum lipids), the presence of microvascular complications (retinopathy, nephropathy, neuropathy) or treatment modalities.

CONCLUSIONS

Elevated levels of CA 72-4 in diabetic patients are not related to diabetes and it should be interpreted as evaluated in a non-diabetic patient.

Intermittent Microwave-convective Air Drying of Oregano

Effectiveness of intermittent microwave-convective air drying (IMWC) was investigated and compared to continuous microwave-convective air drying (CMWC) and convective air drying for oregano. Both CMWC and IMWC increased the drying rate of oregano compared to convective drying. The CMWC and IMWC were 12.7-14.0 and 4.7-11.2 times more energy efficient in drying than convective drying, respectively. The highest essential oil contents were obtained from convective drying at 40 °C and 45 °C. However, these treatments had the longest drying time and the highest energy consumption. The CMWC yielded the lowest essential oil content and resulted in an extreme change in the essential oil composition. The IMWC, except with the pulse ratio of 3.0, resulted in similar essential oil content compared to convective drying at 50 °C and shade drying. No identical result was found among the prevailing compounds of essential oil of oregano obtained from shade drying, convective drying and IMWC. Both CMWC and IMWC did not yield acceptable results of product color. However, in terms of essential oil content and quality, the IMWC at 25 °C room temperature with the pulse ratio of 5.0 was judged as the most suitable drying method for oregano due to its rational drying time and energy consumption compared to CMWC drying, convective air dying, and shade drying.

Testicular development and establishment of spermatogenesis in Nili-Ravi buffalo bulls

Fifteen longitudinally reared Nili-Ravi buffalo bulls (Bubalus bubalis) were slaughtered at 1, 6, 12, 18, and 24 mo of age (n=3 per group) to observe testicular development and to examine qualitatively the establishment of spermatogenesis. With the age held constant, scrotal circumference and testes weight were correlated (0.95; P<0.05). Testes weight increased from 3.5+/-0.7 at 1 mo of age to 185+/-30g at 24 mo of age. Seminiferous tubules diameter developed in a linear fashion (57microm at 1 mo and 178microm at 24 mo), and the lumen formed at 12 mo of age. Differentiation of basal indifferent supporting cells to Sertoli cells started at 6 mo, and formation of Sertoli cells completed near 12 mo of age. Gonocytes predominated at 1 mo, but by 12 mo, most had been replaced by spermatogonia, thus rapid proliferation of tubular contents occurred at 12 mo (testes weight=75g). Spermatocytes were first observed at 12 mo, and their number increased through 18 and 24 mo. Establishment of spermatogenesis, as reflected by appearance of significant number of spermatids, occurred by 18 mo of age (testes weight 122g). Thus, the establishment of spermatogenesis was progressive from birth, and marked changes were observed during the last 6 mo.