Evidence that osteogenic and neurogenic differentiation capability of epidural adipose tissue-derived stem cells was more pronounced than in subcutaneous cells

Background/aim

The management of dura-related complications, such as the repairment of dural tears and reconstruction of large dural defects, remain the most challenging subjects of neurosurgery. Numerous surgical techniques and synthetic or autologous adjuvant materials have emerged as an adjunct to primary dural closure, which may result in further complications or side effects. Therefore, the subcutaneous autologous free adipose tissue graft has been recommended for the protection of the central nervous system and repairment of the meninges. In addition, human adipose tissue is also a source of multipotent stem cells. However, epidural adipose tissue seems more promising than subcutaneous because of the close location and intercellular communication with the spinal cord. Herein, it was aimed to define differentiation capability of both subcutaneous and epidural adipose tissue-derived stem cells (ASCs).

Materials and methods

Human subcutaneous and epidural adipose tissue specimens were harvested from the primary incisional site and the lumbar epidural space during lumbar spinal surgery, and ASCs were isolated.

Results

The results indicated that both types of ASCs expressed the cell surface markers, which are commonly expressed stem cells; however, epidural ASCs showed lower expression of CD90 than the subcutaneous ASCs. Moreover, it was demonstrated that the osteogenic and neurogenic differentiation capability of epidural adipose tissue-derived ASCs was more pronounced than that of the subcutaneous ASCs.

Conclusion

Consequently, the impact of characterization of epidural ASCs will allow for a new understanding for dural as well as central nervous system healing and recovery after an injury.

Can Intra-articular 1α, 25-Dihydroxyvitamin D3 Administration Be Therapeutical in Joint Cartilage Damage?

INTRODUCTION Vitamin D-deficiency is known to cause nerve conduction impairments, cancer and chronic diseases, as well as the pathogenesis of osteoarthritis. Our goal with this study is to evaluate the cartilage healing by applying intraarticular 1α, 25 (OH) 2D3 at different doses in rats with normal vitamin D levels and metabolism, which we made focal chondral damage model in the knee joint. MATERIAL AND METHODS 35 male Sprague-Dawley rats aged 20-24 weeks were used in our study. Both knees of rats were cartilage defected surgically on day 0. Joint injections performed at 06:00 am on 0th and 2nd days and after second injection others performed on days 9-16 and 23 following a weekly period. RESULTS In the fourth week, hematoxylin eosin staining measurements showed statistically significant difference according to the groups (p < 0.01) Metalloproteinase-13 (MMP-13) in histological staining for evaluating cartilage healing and healing levels showed statistically significant differences between the groups at first week and fourth week (p < 0.05). DISCUSSION Vitamin D, which affects many tissues through its receptors, is believed to be chondroprotective and neuroprotective by decreasing the expression of MMP in cartilage fibroblast, macrophage, lymphocyte through its intracellular receptors. To the best of our knowledge, this is the first study known to be intraarticular use of 1α, 25-dihydroxyvitamin D3. Our study has been found to be safe and successful in terms of weight, systemic PTH and 1α, 25-dihydroxyvitamin D3 levels in rats during treatment as well as better healing of cartilage damage. Key words: vitamin D3 receptor, articular cartilage, orthopedics, nerve conduction.

Is Intraarticular Antibiotic Administration Effective in the Treatment of Methicillin-Resistant Staphylococcus aureus?

PURPOSE OF THE STUDY Septic arthritis is an infection of joints caused by a pathogenic microorganism. Septic arthritis has a mortality rate of 11-40% when it's not treated properly. The mortality rate with methicillin-sensitive Staphylococcus aureus (MSSA)is 5-7%, while the rate with methicillin-resistant Staphylococcus aureus (MRSA)is 13-20%. The aim of this study is to evaluate the effects of intraarticular vancomycin and teicoplanin on joint cartilage in in vivo settings and its utility in routine MRSA treatment. MATERIALS AND METHODS In our study, 35 male Sprague-Dawley rats aged 28 days were used. Rats were obtained from the Regenerative and Restorative Medicine Research Center (REMER) of Istanbul Medipol University. Rats were randomly divided into 5 groups each containing 7 rats. Joint injections were administered with isoflurane analgesia every day at 6 am. Three rats (15 rats) from each group were sacrified in seventh day and evaluated immunohistologically to evaluate acute healing in articular cartilage. All remaining rats were sacrificed on day 28 and their knees were evaluated by immunohistochemical examination. RESULTS In our study, there were no complications in any rat during injection and the study period. Hematoxylin eosin (H & E) histological staining for evaluating cartilage healing and healing levels did not show statistically significant differences between the groups at first week (p > 0.05). Matrix metalloproteinase-13 (MMP-13) staining did not show any statistically significant difference between the groups. (p > 0.05). DISCUSSION MRSAseptic arthritis, diagnosed for the first time in 1960, has recently been responsible for 6-22% of all septic arthritis and is increasing day by day. The use of systemic vancomycin or teicoplanin is the first-line treatment method in MRSA septic arthritis. Serum levels reach the desired level, especially with intravenous infusion dose. On the other hand, it has been shown that intraarticular concentration does not reach a sufficient level in studies conducted. The use of intraarticular antibiotics during treatment can lead to more effective and early disease control by turning this negative situation into favor of the patient. As a result, intraarticular vancomycin and teicoplanin maximale tolerable and maintenance doses can be safely used beside surgery and intravenous antibiotics to increase efficacy of treatment, reduction of recurrence rates and reduction of mortality in MRSAseptic arthritis. CONCLUSIONS Intraarticular vancomycin and teicoplanin maximale tolerable and maintenance doses can be safely used beside surgery and intravenous antibiotics to increase efficacy of treatment, reduction of recurrence rates and reduction of mortality in MRSA septic arthritis. Key words:arthritis, infectious; methicillin-resistant Staphylococcus aureus; mortality.

A Machine Learning Approach for the Association of ki-67 Scoring with Prognostic Factors

ki-67 score is a solid tumor proliferation marker being associated with the prognosis of breast carcinoma and its response to neoadjuvant chemotherapy. In the present study, we aimed to investigate the way of clustering of prognostic factors by ki-67 score using a machine learning approach and multiple correspondence analysis. In this study, 223 patients with breast carcinoma were analyzed using the random forest method for classification of prognostic factors according to ki-67 groups (<14% and >14%). Also the relationship between subgroups of prognostic factors and ki-67 scores was examined by multiple correspondence analysis. There was a clustering of molecular classification LA, 0-3 metastatic lymph node, age <50, absence of LVI, T1 tumor size with ki-67 <14% and grade III, 10 or more metastatic lymph nodes, and presence of LVI and molecular classification LB, age >50, and T3-T4 tumor size categories with ki-67 >14%. The fact that the low scores of ki-67 correlate with early stage diseases and high scores with advanced disease suggests that 14% threshold value is crucial for ki-67 score.

The protective effects of pomegranate on liver and remote organs caused by experimental obstructive jaundice model

OBJECTIVE

We aimed to investigate the protective potential of pomegranate extract on the liver and remote organs in rats with obstructive jaundice.

MATERIALS AND METHODS

The rats were split into 4 groups. In Group 1 (G1) (sham group) rats, the common bile duct was mobilized without any ligation. Group 2 (G2) received a combination of the sham operation and synchronous treatment with pomegranate. Group 3 (G3) received common bile duct ligation (CBDL). Group 4 (G4) were subjected to CBDL and treatment with pomegranate. After 8 days, we measured total oxidative status (TOS) and antioxidant capacity in the rats' liver tissue and remote organs, and evaluated blood levels of malondialdehyde and total antioxidant capacity (TAC).

RESULTS

G3 rats showed significantly raised malondialdehyde level as compared to G1 rats (p < 0.001). Following the pomegranate therapy, a decrease in malondialdehyde was observed (p = 0.015). TAC levels were significantly raised in the G3 rats compared to the G1 rats (p = 0.004). TAC levels dropped after pomegranate therapy (p = 0.011). CBDL caused elevated TOS levels in the liver and remote organs, with a statistically significant increase in the lung tissue (p = 0.002). TOS levels in the CBDL groups decreased after pomegranate treatment (p < 0.001).

CONCLUSIONS

This study reveals the marked protective effect of pomegranate on the liver and remote organs in obstructive jaundice.

Effects of paricalcitol and aliskiren combination therapy on experimental diabetic nephropathy model in rats

BACKGROUND/AIMS

The aim of the present study was to investigate the effect of combination of aliskiren with paricalcitol on experimental diabetic nephropathy (DN) model in rats.

METHODS

Forty male Sprague Dawley rats were divided into 5 groups of 8 rats each, namely the control (Group C), diabetes (Group D), aliskiren (Group A), paricalcitol (Group P), and aliskiren plus paricalcitol (Group A+P) groups. Aliskiren was given by oral-gavage at a dose of 50 mg/kg/day once daily for 12 weeks. Paricalcitol was given by intraperitoneally at a dose of 0,4 µg/kg/three day of week for 12 weeks. Renal function parameters, oxidative stress biomarkers, mRNA expression of renin-angiotensin system parameters and kidney histology were determined.

RESULTS

Group A+P had lower mean albümin-to-creatinine ratio (ACR) (p=0.004) as well as higher creatinine clearance (CCr) (p<0.005) than the diabetic rats (Group D). Combination therapy significantly increased CCr (Group A+P vs. Group A, p<0.005; Group A+P vs. Group P, p=0.022) and reduced ACR (Group A+P vs. Group A, p=0.018; Group A+P vs. Group P, p<0.005) when compared to monotherapy. Serum malondialdehyde levels were significantly lower (p=0.004); glutathion levels (p=0.003), glutathion peroxidase (p=0.004) and superoxide dismutase (p<0.005) activities were significantly higher in group A+P than in group D. The mean scores of mRNA expression of renin (p<0.005), angiotensin II (p=0.012) and angiotensin type 1 receptor (p=0.018) in group A+P were significantly lower. Although combination therapy showed no additional effect on oxidative system, renin-angiotensin system and renal histology, aliskiren plus paricalcitol significantly decreased interstitial fibrosis volume when compared to monotherapy (Group A+P vs. Group A, p<0.005; Group A+P vs. Group P, p=0.002).

CONCLUSION

Our data seem to suggest a potential role of aliskiren plus paricalcitol acting synergystically for reducing the progression of diabetic nephropathy in an experimental rat model.

Electrochemistry of moexipril: experimental and computational approach and voltammetric determination

The electrochemistry of moexipril (MOE) was studied by electrochemical methods with theoretical calculations performed at B3LYP/6-31 + G (d)//AM1. Cyclic voltammetric studies were carried out based on a reversible and adsorption-controlled reduction peak at -1.35 V on a hanging mercury drop electrode (HMDE). Concurrently irreversible diffusion-controlled oxidation peak at 1.15 V on glassy carbon electrode (GCE) was also employed. Potential values are according to Ag/AgCI, (3.0 M KCI) and measurements were performed in Britton-Robinson buffer of pH 5.5. Tentative electrode mechanisms were proposed according to experimental results and ab-initio calculations. Square-wave adsorptive stripping voltammetric methods have been developed and validated for quantification of MOE in pharmaceutical preparations. Linear working range was established as 0.03-1.35 microM for HMDE and 0.2-20.0 microM for GCE. Limit of quantification (LOQ) was calculated to be 0.032 and 0.47 microM for HMDE and GCE, respectively. Methods were successfully applied to assay the drug in tablets by calibration and standard addition methods with good recoveries between 97.1% and 106.2% having relative standard deviation less than 10%.

Attitudes and behavior regarding organ donation and transplantation on the part of religious officials in the Eastern Black Sea region of Turkey

AIM

This study evaluated the opinions and attitudes toward organ donation and transplantation on the part of religious officials in the Eastern Black Sea region of Turkey.

METHOD

This descriptive study was performed between December 2008 and November 2009 with 550 among Muslim religious officials, including 541 males and 9 females, who attended educational seminars on the subject arranged in collaboration with Mufti Offices in the provinces of Trabzon, Rize, Gümüşhane, and Giresun in the Eastern Black Sea region of Turkey. A supervised questionnaire administered before the seminars contained questions investigating whether subjects have volunteered to donate organs, reasons for not volunteering, whether they would donate the organs of a close relative in the event such a death, and what they would think in the event they required an organ transplantation themselves. Questions were also asked regarding permission for organ transplantation and donation in 5 main religions.

RESULTS

Although no female religious officials had previously volunteered to donate organs, 4 men (0.7%) had done so. After attending seminars, 32 (5.9%) volunteered to donate. The main reasons cited for not volunteering to donate organs were lack of sufficient knowledge of the procedures involved (30.6%) and lack of interest (17.4%). Three hundred five religious officials stated they would not agree to organ donation in the event of the death of a close relative. When asked "What would you think about organ donation and transplantation if you needed an organ transplant now?", 46.0% replied "I would want an organ transplant." Finally, 83.3% of religious officials stated that Islam permits organ donation and transplantation, whereas 13.6% stated that Christianity permits it, other figures being 7.3% for Judaism, 2.5% for Buddhism, and 2.0% for Hinduism.

CONCLUSIONS

Religious views affect organ donation. The fact that religious officials agreed to donate organs after appropriate education emphasized that Islam is the most sensitive faith on the subject, indicating that the issues can be improved through collaboration with religious officials.

Information, attitude, and behavior toward organ transplantation and donation among health workers in the eastern Black Sea region of Turkey

AIM

We sought to evaluate the information, attitude, and behaviors toward organ donation among health workers in the eastern Black Sea region of Turkey.

METHOD

This descriptive study was performed between December 2008 and November 2009. It involved 1,545 health personnel in 8 state hospitals in the eastern Black Sea region of Turkey, excluding the university hospitals in the towns of Trabzon, Rize, Gümüşhane, and Giresun. Educational seminars regarding organ transplantation and donation were arranged for the hospitals in the study. Questionnaires on the subject distributed to the participants were collected before the seminars began. They contained questions about occupation, gender, age, previous organ donation, whether the person would consider donating if they had not already volunteered (if not, the reasons why), whether any relatives had volunteered to donate organs, whether anyone close to them had volunteered to donate organs, whether they would donate organs in the event of a relative's death, and what they might think if they were to require an organ transplant. Following the seminars, participants were given the opportunity to obtain organ donation cards from a stand on site. Data were analyzed using the chi-square test.

RESULTS

Eighty-one participants (5.2%), including 46 women (5.2%) and 35 men (5.3%), had previously officially volunteered to donate organs (P = .875). One hundred thirty-seven health personnel were willing to donate organs by visiting the donation stand after the seminars. The main reasons for participants who had not volunteered to donate organs failing to do so were lack of information about donation and procedures (28.4%), lack of interest in the subject (23.2%), and Islamic religious beliefs and/or traditions (19.6%). One hundred eighty health personnel (11.7%) had family members or relatives who had volunteered to donate organs. Asked whether they would donate that person's organs in the event of the death of a relative, 93 doctors (67.6%), 225 nonphysician health personnel (41.1%), and 345 other participants (43.1%) stated that they would not (P < .0005).

CONCLUSIONS

Health workers play a key role to overcome the difficulties encountered regarding organ donation. This study showed the need for constant effective education seminars to enhance knowledge and sensitivity on the part of health workers.

Cervical spinal cord stimulation increases cerebral cortical blood flow in an experimental cerebral vasospasm model

BACKGROUND

Cerebral microcirculatory changes during cerebral vasospasm after aneurysmal subarachnoid haemorrhage (SAH) are still controversial and uncertain. The aim of our study is to demonstrate that spinal cord stimulation (SCS) augments cerebral cortical microcirculatory blood flow in an experimental cerebral vasospasm model by using Laser Doppler Flowmetry (LDF).

METHOD

The experiments were carried out on 24 New Zealand rabbits. Three experimental groups were designed. In group 1, Cerebral cortical blood flow (CCoBF) was evaluated by LDF in 8 rabbits. In group 2, Intracisternal saline injection and cervical epidural electrode placement without SCS were performed in 8 animals before LDF. In group 3, LDF was performed before and after SCS on the 4th day of SAH in 8 rabbits. CCoBF parameters obtained from LDF data were compared.

FINDINGS

The occurrence of vasospasm after SAH was demonstrated with significant changes in LDF values. In all SAH animals, SCS resulted in significant increase (approximately 30%) in CCoBF. This increase was observed to continue even after the cessation of the stimulation.

CONCLUSIONS

These results indicate that SCS improves cortical ischemia due to vasospasm after induced SAH. The cervical SCS may constitute a new therapeutic modality in treating disturbed CCoBF due to vasospasm.

Paired transcranial magnetic stimulation in hemifacial spasm

OBJECTIVES

The aim of this study was to investigate the changes in cortical excitability in patients with hemifacial spasm (HFS) in order to examine the physiological state of facial nerve nucleus.

METHODS

Nineteen patients with HFS and 13 control subjects were examined at rest. The procedure was repeated during voluntary contraction in 6 of control subjects. By paired transcranial magnetic stimulation, conditioning and test motor evoked potentials (MEP) were recorded from bilateral orbicularis oris muscles at interstimulus intervals (ISI) of 20, 25, 30, 50, 75 and 100 ms.

RESULTS

In control subjects at rest, ISI's of 20, 25, 30 ms evealed facilitation of the test MEP and inhibition developed at ISI's of 75 and 100 ms. Test MEP facilitation in the contracting controls and on the symptomatic sides of HFS patients was significantly less than the resting controls. Asymptomatic sides of HFS patients behaved similar to the corresponding symptomatic sides and to the contracting controls, although the values were not statistically significant when compared to the resting controls.

CONCLUSION

The lessening of facilitation found in this study can be interpreted as an abnormal finding that reflects the changes in the excitability of facial motoneuronal system in patients with HFS. However it is difficult to exclude the possibility that this finding can occur due to the normal behavior of cortex during voluntary or involuntary contraction.

Transposition of the sacrotuberous ligament for the treatment of coxofemoral luxation in dogs

A surgical technique is described for transposition of the sacrotuberous ligament to replace the teres ligament in the treatment of coxofemoral luxation in dogs. Ten dogs with coxofemoral luxation were treated using this technique and all animals regained full limb function within two months of surgery. It is suggested that the technique could be employed in dogs suffering from all types of hip luxations.

Electrochemical behaviour of 3,8-difluorobenzo[c]cinnoline at mercury electrode

Voltametric and coulometric methods have been used to study the electroanalytical behaviour of 3,8-difluorobenzo[c]cinnoline. The number of electrons transferred, the wave characteristics, diffusion coefficient and reversibility of the reactions have been investigated in ethyl alcohol-BR. Adsorption of the molecule on the surface of the mercury drop electrode was analyzed and this phenomena was exploited to calculate the diffusion coefficient of 3,8-difluorobenzo[c]cinnoline. A mechanism for the electrode reaction was proposed.

The stability constants of copper(II) complexes with some alpha-amino acids in dioxan-water mixtures

In this study, the overall stability constants of copper(II) complexes with some alpha-amino acids (glycine, dl-alanine, dl-valine, l-leucine, l-asparagine, l-glutamine) were determined by potentiometric titration in water, 25% dioxan-75% water, 35% dioxan-65% water, 50% dioxan-50% water, and 60% dioxan-40% water. The titrations were performed at 25 degrees C, under nitrogen atmosphere, and the ionic strength of the medium was maintained at 0.10 M by using sodium perchlorate. The formation curves of their complexes (n-p[L]) were obtained by means of the titration data. Then the stability constants were determined in relation to these curves. The mol ratio of copper(II) to alpha-amino acid was also determined and it was found that the complexes were CuL(2) type. Another important result obtained was that the tendency of amino acids to form complexes with copper(II) was greater in dioxan-water mixtures compared to water.

Studies on the protonation constants and solvation of alpha-amino acids in dioxan-water mixtures

To gain more information about the effect of solvent on alpha-amino acids, the stoichiometric protonation constants of 10 alpha-amino acids (glycine, DL-alanine, DL-valine, L-leucine, L-isoleucine, DL-phenylalanine, L-serine, L-threonine, L-asparagine, and L-glutamine) in different dioxan-water mixtures have been determined potentiometrically using a combined pH electrode system calibrated in concentration units of hydrogen ion at 25 degrees C with an ionic strength of 0.10 M. For all amino acids studied, it was observed that the log K(1) values relating to the protonation equilibria of the anionic form are almost unaltered by the change in solvent composition. However, the log K(2) values corresponding to the formation equilibria of cationic form increase with the increase in dioxan content. The variation of these constants is discussed on the basis of specific solute-solvent interactions and structural changes of amino acids from water to dioxan-water media. The zwitterionic to neutral form ratio of these acids in dioxan-water mixtures is also discussed.

The non-aqueous titrimetric assay of the selected anti-inflammatory agents using tetra-n-butylammonium hydroxide as titrant

A potentiometric titration method in non-aqueous media is proposed for the determination of some commonly used anti-inflammatory agents. The direct potentiometric titration of three anti-inflammatory agents, namely mefenamic acid, fenbufen and ibuprofen; and the indirect potentiometric titration of diclofenac sodium was carried out in acetonitrile solvent using tetra-n-butylammonium hydroxide as titrant, at 25 degrees C and under a nitrogen atmosphere. The method was found to be highly accurate and precise, having a relative standard deviation of <1.0% for all anti-inflammatory agents studied. Also, it was shown that the method could be successfully applied to the assay of commercial pharmaceuticals containing the above-mentioned anti-inflammatory agents. The validity of the method was tested by the recovery studies of standard addition to pharmaceuticals and the results were found to be satisfactory. The proposed method is simple, rapid and sufficiently precise for quality control purposes.

Conductimetric titrimetry for assay of selected antibiotics in non-aqueous media

In this study, a conductimetric titration method is proposed for the determination of some commonly used antibiotics. The conductimetric titration of three antibiotics, namely ampicillin, amoxycillin trihydrate and rifampin, was carried out in acetic acid using perchloric acid as titrant. Ciproflaxacin hydrochloride, however, was titrated after being dissolved in acetic acid containing an excess of mercury(II) acetate. For the titration of netilmicin sulphate, barium acetate prepared in acetic acid was used as titrant. The method was found to be highly accurate and precise, having a relative standard deviation of less than 1.0% for all antibiotics studied. It was also shown that the conductimetric titrimetry could be successfully applied to the assay of commercial preparations containing the above-mentioned antibiotics. The validity of the method was tested by the recovery studies of standard addition to pharmaceuticals and the results were found to be satisfactory.

The non-aqueous titrimetric assay of selected antibiotics using tetra-N-butylammonium hydroxide as titrant

This study was carried out to develop a potentiometric titration method in non-aqueous media for the determination of some commonly used antibiotics. For this purpose, five antibiotics, namely ampicillin, amoxycillin trihydrate, rifampin, netilmicin sulphate and ciproflaxacin hydrochloride, were potentiometrically titrated using pyridine as solvent and tetrabutylammonium hydroxide as titrant, at 25 degrees C and under a nitrogen atmosphere. The method was found to be highly accurate and precise having a relative standard deviation of less than 1.0%. Also it was shown that the method could be successfully applied to assay of commercial pharmaceuticals containing the above-mentioned antibiotics. The results of recovery studies for standard additions in pharmaceutical preparations were satisfactory. The proposed method is simple, rapid and sufficiently precise for quality control purposes.