Seasonal effects of the fatty acid composition of phospholipid and triacylglycerol in the muscle and liver of male Salmo trutta macrostigma

The seasonal effects on the fatty acid composition of triacylglycerol (TAG) and phospholipid (PL) in the muscle and liver of male Salmo trutta macrostigma were determined using the gas chromatographic (GC) method. The fatty acid (FA) compositions of total lipid, PL and TAG fractions were determined in muscle and liver tissues of S. trutta macrostigma. The phospholipids contained a higher proportion of 16:0 compared to the TAG in the muscle tissue of S. trutta macrostigma. Docosahexaenoic acid (22:6 ω-3) and eicosapentaenoic acid (20:5 ω-3) contents were high in both muscle and liver tissues. The total lipid contents in the muscle and liver were 1.07-2.45 and 3.00-4.64%, respectively. S. trutta macrostigma is a rich source of ω-3 and ω-6, polyunsaturated fatty acids (PUFA) with numerous benefits to human health.

Diagnostic utility of oxidative and non-oxidative markers for spontaneous bacterial peritonitis in non-malign ascites

OBJECTIVE

In this study, we aimed to investigate the diagnostic availability of oxidant and antioxidant parameters in ascites for spontaneous bacterial peritonitis (SBP).

MATERIAL AND METHODS

This study was carried out between July and October 2018 with 25 patients with SBP and 24 patients without SBP. Patients with acute infection, those taking vitamin supplements and antioxidant medication, smoking and drinking alcohol, and patients without ascites culture were excluded from the study.

RESULTS

In patients with SBP compared those without SBP median paraoxonase (3.1 vs 15.6 ; p <0.001), median stimulated paraoxonase (12.6 vs 53.1 ; p <0.001), median arylesterase (769,9 vs 857,5 ; p = 0,003) and median catalase (10 vs 22,2 ; p = 0,003) were found to be lower and median myeloperoxidase (8.1 vs 1.1 ; p <0.001) were found to be higher. There was a positive correlation between paraoxonase levels and stimulated paraoxonase levels, arylesterase levels and catalase levels, there was a negative correlation between paraoxonase levels and myeloperoxidase levels. Paraoxonase levels 3.7 and lower, stimulated paraoxonase levels 25.8 and lower, arylesterase levels 853.4 and lower, catalase levels 11.8 and lower and myeloperoxidase levels 2.7 and more predicted the the presence of SBP with high specificity and high sensitivity. Paraoxonase and stimulated paraoxo-nase levels were found to have superior performance in predicting the presence of SBP compared to arylesterase levels (p <0.05).

CONCLUSION

In this study it was shown that paraoxonase, stimulated paraoxonase, arylesterase, catalase and myeloperoxidase activities can be used for the diagnosis and severity of SBP.

Prognostic Utility of Hypokalemia in Cirrhotic Patients

BACKGROUND AND AIM

We researched the relationships between serum potassium level and prognostic scores and complications of cirrhosis, and mortality.

METHODS

This study was performed retrospectively in Turkish High Specialty Training and Research Hospital between 2009 and 2015. Patients who had missing patient files and electrolyte disorder for another reason, showed complications at the time of application and were using diuretics were excluded from the study.

RESULTS

218 patients were included in the study. During the follow-up period, 23.4% (n: 51) of the entire population passed away. Compared to the patients who survived, the patients who passed away had higher HCC and HES development rate, mean Child-Pugh and MELD score and lower mean blood potassium level. The stepwise multivariable Cox regression model which included significant independent predictors showed that ChildPugh score (HR: 1.29; p <0.001), MELD score (HR:1.13; p= 0.006), and potassium level (HR: 0.18; p< 0.001) were independent predictors of mortality. The cut off value for potassium level in predicting mortality was found to be ≤ 3.4 mmol/L with 80.4% sensitivity and 100% specificity. Compared to the patients with a potassium level > 3.4 mmol/L, the patients with a potassium level ≤ 3.4 mmol/L had higher mortality rate, HCC and HES development rate, mean Child-Pugh and mean MELD scores.

CONCLUSION

Hypokalemia is an important prognostic factor in cirrhotic patients.

Effect of season on the fatty acid profile of total lipids, phospholipids and triacylglycerols in

The present study investigated the lipid content and FA profiles of total lipids, phospholipids (PL) and triacylglycerols (TAG) of Mastacembelus mastacembelus from the Atatürk Dam Lake (Turkey). The results showed that the total lipid content of the dorsal muscle varied seasonally from 0.50% to 3.59%. Wide ranges of saturated fatty acids (SFAs) (36.21 to 50.52%) and polyunsaturated fatty acids (PUFAs) (25.22 to 42.02%) were found in the PL fraction. However, higher monounsaturated fatty acids (MUFAs) (37.63 to 45.07%) and SFA (34.71 to 38.82%) were found in TAG (triacylglycerol). The ratios of ω-3 to ω-6 PUFA ranged from 0.65 to 1.32 and 1.07 to 3.48 in PL (phospholipid) and TAG fraction, respectively. The results also showed that the major components were palmitic acid (C16:0), stearic acid (C18:0), oleic acid (C18:1ω-9), palmitoleic acid (C16:1ω-7), docosahexaenoic acid (DHA, C22:6ω-3), arachidonic acid (AA, C20:4ω-6) and docosapentaenoic acid (C22:5ω-3) in total lipid, C16:0, C18:1ω-9, AA and DHA in PL, C16:0, C16:1ω-7, C18:1ω-9, linoleic acid (LA, C18:2ω-6), and DHA in TAG extracted from the muscle of M. mastacembelus in all seasons.

Pre-operative radiochemotherapy for rectal cancer. A prospective randomized trial comparing pre-operative vs. postoperative radiochemotherapy in rectal cancer patients

PURPOSE

The aim of the study was to find out whether pre-operative radiochemotherapy had any survival advantage over postoperative radiochemotherapy for rectal carcinoma patients without distant metastasis or peritoneal carcinomatosis.

MATERIAL AND METHODS

Between January 1998 and December 2003, 51 rectal carcinoma patients without distant metastasis or peritoneal carcinomatosis were randomly divided into pre-operative (PRE) and postoperative (POST) radiochemotherapy groups. Twenty-six were assigned to the PRE group and were operated on 5 to 8 weeks after the completion of radiotherapy. The other 25 patients were operated on immediately and received radiotherapy postoperatively 2 to 4 weeks after surgery. The patients were followed up for between 4 to 51 months.

RESULTS

In the PRE group the rates of disease-free survival were 92%, 70%, 56% and 56% at the end of the 1t, 2d, 3"r and 4th years, respectively. In the POST group those percentages were 83%, 68%, 51% and 51% at the 1S", 2nd, 3r and 4th years, respectively (p = 0.707). One-year and 4-year overall survival rates in the PRE group were 100% and 86% respectively and 100% and 60% in the POST group (p = 0.520).

CONCLUSION

No statistical difference was found between the survival rates of the rectal carcinoma patients receiving radiotherapy either pre-operatively or postoperatively. However, the disease-free survival rates of the PRE group were higher than the POST group's during each year and overall survival rates were higher after the third and fourth years. We conclude that pre-operative radiotherapy is at least as effective as postoperative radiotherapy.

Pre-operative radiochemotherapy for rectal cancer. A prospective randomized trial comparing pre-operative vs. postoperative radiochemotherapy in rectal cancer patients

PURPOSE

The aim of the study was to find out whether pre-operative radiochemotherapy had any survival advantage over postoperative radiochemotherapy for rectal carcinoma patients without distant metastasis or peritoneal carcinomatosis.

MATERIAL AND METHODS

Between January 1998 and December 2003, 51 rectal carcinoma patients without distant metastasis or peritoneal carcinomatosis were randomly divided into pre-operative (PRE) and postoperative (POST) radiochemotherapy groups. Twenty-six were assigned to the PRE group and were operated on 5 to 8 weeks after the completion of radiotherapy. The other 25 patients were operated on immediately and received radiotherapy postoperatively 2 to 4 weeks after surgery. The patients were followed up for between 4 to 51 months.

RESULTS

In the PRE group the rates of disease-free survival were 92%, 70%, 56% and 56% at the end of the 1st, 2nd, 3rd and 4th years, respectively. In the POST group those percentages were 83%, 68%, 51% and 51% at the 1st, 2nd, 3rd and 4th years, respectively (p = 0.707). One-year and 4-year overall survival rates in the PRE group were 100% and 86% respectively and 100% and 60% in the POST group (p = 0.520).

CONCLUSION

No statistical difference was found between the survival rates of the rectal carcinoma patients receiving radiotherapy either pre-operatively or postoperatively. However, the disease-free survival rates of the PRE group were higher than the POST group's during each year and overall survival rates were higher after the third and fourth years. We conclude that pre-operative radiotherapy is at least as effective as postoperative radiotherapy.

Open versus laparoscopic donor nephrectomy in live related renal transplantation

BACKGROUND

This analysis sought to evaluate the efficiency and safety of laparoscopic nephrectomy (LDN) for the donor, the recipient, and the graft. LDN seems to have advantages over the open donor nephrectomy (ODN) in length of hospital stay, postoperative comfort, and pain control.

METHODS

The results of 40 patients who underwent LDN between October 2000 and September 2003 were compared to those of 40 ODN patients just preceding the LDN patients. Eight laparoscopy patients required conversion to an open procedure due to bleeding (4; two major and two minor), technical problems with the instrument (n = 1) and difficulty in the dissection (n = 3).

RESULTS

The demographic data, percentages of right and left nephrectomy, number of vessels, rates of acute rejection episodes, as well as the rates of urologic and vascular complications were similar between the two groups. The time of hospital stay was shorter, and the duration of the operation and of the warm ischemia time were significantly longer for the LDN group. The postoperative decline in serum creatinine levels were similar for the two groups. Graft survival rates were 91.7% at both the first and third years in the LDN group; 92.5% and 87.0% for the ODN group, a difference that was not statistically significant.

CONCLUSION

LDN is as efficient and safe as ODN for donors, recipients, and grafts.

Influence of tacrolimus plus mycophenolate mofetil regimens on acute rejection rate and diabetes mellitus development in renal transplant recipients

In this study we investigated the influence of a tacrolimus (TAC) plus mycophenolate mofetil (MMF) immunosuppressive regimen on the acute rejection rate and side effect profile in renal transplant recipients. The study included 80 living-related and 40 cadaveric donor renal transplant recipients (82 men, 38 women) of mean age 35 +/- 10 years (range, 16 to 58) who were operated between August 1999 and September 2002. The mean HLA mismatches was 3 +/- 1 (range, 0 to 5). All patients received prednisolone, MMF (2 g/d for the first 14 days posttransplant and then 1 g/d) plus TAC (0.2 mg/kg/d). They were followed for the development of rejection attacks and side effects. Diabetes mellitus developed in 13 patients (9 men, 4 women; 10.8%). Initially, patients required insulin therapy but after 6 months, 5 recipients no longer needed insulin therapy and were switched to oral hypoglycermic agents and diet control. Hypertension was diagnosed in 58 patients (48.3%). Neither gender nor donor origin (P =.14; P =.79, respectively) produced a significant difference in diabetes mellitus development. Biopsy proven acute rejection episodes were observed in 16 out of 120 patients (13.3%). Six out of 120 patients lost their grafts throughout the study period including one death because of suicide, one because of cytomegalovirus disease and hemophagocytic syndrome, one due to posttransplant lymphoproliferative disease and two to a cardiac arrhythmia. Only one patient lost his graft due to acute accelerated vascular rejection. Biopsy-proven chronic rejection appeared in one patient. In conclusion, although the incidence of insulin-dependent diabetes mellitus during posttransplant 6 months, seems high it decreased to 1.6% upon reduction of the TAC dosage. TAC plus MMF immunosuppression seems effective and safe in terms of acute rejection rates and side effect profiles.

Do multiple renal arteries restrict laparoscopic donor nephrectomy?

Laparoscopic donor nephrectomy is a new technique. For anatomical and technical reasons, many transplant centers restrict laparoscopic donor nephrectomy to kidneys with a single artery. However, we believe that with increased experience, laparoscopic donor nephrectomy in cases of multiple renal arteries does not affect donor or recipient outcomes. Among 115 living related renal transplantations performed between January 1996 and December 2002, 31 nephrectomies were performed via laparoscopy including eight with multiple arteries and 84 via an open approach, including nine with multiple arteries. The 17 patients with multiple arteries at the two procedures were compared in terms of donor and recipient outcomes. All the patients received the same immunosuppressive regimen. The demographic data were similar in the two groups. Mean durations of the donor operations (223 vs 247 minutes), side of nephrectomy (left/right, 5/4 vs 7/1), mean warm ischemia times (230 vs 432 seconds), mean serum creatinine levels at the end of 1 year follow-up, were statistically similar for the open versus the laparoscopy groups. Urological (11.1% vs 25%) and vascular complication rates (22.2% vs 25%), acute rejection rates (11.1% vs 12.5%) were also statistically similar for open versus laparoscopy groups, respectively. One-year patient and graft survival rates were 87.5% for both groups. Laparoscopic donor nephrectomy was as safe a procedure as open surgery even in the presence of multiple renal arteries in the hands of experienced transplants surgeons.