Purpose
Reactive oxygen species (ROS) and reactive nitrogen species (RNS), generated during tissue reperfusion, are characteristic of ischemia/reperfusion (I/R) injury. We conducted this study to ...evaluate the protective effect of α-lipoic acid (α-LA) and ebselen against intestinal I/R injury.
Methods
Forty Sprague-Dawley rats were divided into five groups: a sham-operated group; an I/R group, subjected to intestinal ischemia for 45 min and reperfusion for 3 days; an I/R+α-LA group; an I/R+ebselen group; and an I/R+α-LA+ebselen group. We collected ileal specimens, to measure the tissue levels of malondialdehyde (MDA), protein carbonyl content (PCC), superoxide dismutase (SOD), and glutathione peroxidase (GPx), and to evaluate the histologic changes.
Results
There was a significant decrease in SOD and GPx levels, with an increase in MDA and PCC levels and intestinal mucosal injury in the intestinal I/R group (
P
< 0.05). Superoxide dismutase and GPx levels were significantly higher, MDA and PCC levels were significantly lower, and intestinal injury was significantly less severe in the I/R+α-LA+ebselen group than in the I/R group (
P
< 0.05). Although shortened villi and epithelial lifting were seen in the I/R group, only slight mucosal injury was seen in the treatment groups.
Conclusion
α-Lipoic acid and ebselen played an important role in attenuating I/R injury of the intestine by scavenging ROS and RNS.
: Pancreatitis is a rare manifestation of Henoch Schonlein purpura (HSP). Herein we report a 3‐year‐old girl presented with acute pancreatitis that developed characteristic rash for HSP at the fifth ...day of clinical onset. Abdominal pain which is the most frequent sign of gastrointestinal involvement can be also explained by acute pancreatitis. Although clinical features of pancreatitis may be encountered after the onset of the typical rash, pancreatitis can also occur as a presenting feature. This rare presentation of HSP is discussed to emphasise the clinical features, presentation and outcome of pancreatic involvement.
Isolated torsion of fallopian tubes should be considered even at premenarcheal ages in cases of acute pelvic pain, and prompt surgery can preserve the tube and thus fertility. It is an uncommon ...emergency event and a difficult condition to evaluate clinically. This report focuses on a 12‐year‐old premenarcheal girl who presented with acute pelvic pain of 2 days. Pelvic ultrasound showed an adnexal mass on the left side. Laparoscopy was performed and an isolated tubal torsion was discovered. The tube was necrotic and salpingectomy was performed. The appendix appeared to be hyperemic and erectile. Appendectomy was also performed to rule out appendicitis. It's our recommendation that in the differential diagnosis of acute lower abdominal pain of girls, isolated torsion of the fallopian tubes should be considered. Also, preservation of the tube and fertility should be possible with prompt surgical intervention.
Acute gastric volvulus in the newborn period is a rare condition requiring surgery. The association of gastric volvulus with congenital bands is extremely rare and unreported previously. A ...one-day-old male neonate was diagnosed to have acute gastric obstruction in the neonatal intensive care unit. Mesenteroaxial gastric volvulus due to dense gastrocolic bands was detected during laparotomy. Band excision and anterior gastropexy were performed. The clinical features, radiologic findings, treatment modes and possible mechanisms of gastric volvulus due to congenital bands are discussed.
Abstract Purpose Necrotizing enterocolitis (NEC) remains a major cause of morbidity and death in neonates. Evidence suggests that an imbalance between activated proinflammatory response with ...inadequate antiinflammatory protection results in NEC. Ozone has been proposed as an antioxidant enzyme activator, immunomodulator, and cellular metabolic activator. Therefore, this study was designed to investigate whether medical ozone therapy is effective on neonatal rat model of NEC. Materials and Methods Thirty-eight newborn Sprague-Dawley pups were randomly divided into 3 groups of NEC, NEC + ozone, and control (left to breast feed). Necrotizing enterocolitis was induced by enteral formula feeding and exposure to 100% carbon dioxide inhalation for 10 minutes after +4°C cold exposures for 5 minutes and 97% oxygen for 5 minutes 2 times daily. The NEC + ozone group received 0.7 mg/kg per day ozone/oxygen mixture intraperitoneally for a total of 3 days after first day of NEC procedure. The pups were killed at fourth day, and their intestinal tissues were harvested for biochemical and histopathologic analysis. Blood sample from pups were also obtained. Results The mortality rate and the weight loss were significantly higher in NEC group than control and treatment groups. Oxidative stress markers (malondialdehyde and protein carbonyl content) significantly increased and antioxidant enzyme activities (superoxide dismutase and glutathione peroxidase) were significantly decreased in NEC group. All these biochemical changes were ameliorated in NEC + ozone group. Nitrate plus nitrite levels and serum tumor necrosis factor α were elevated in NEC group and reduced in treatment group. In addition, histopathologic injury score of NEC group was significantly higher than NEC + ozone group. Conclusion Ozone treatment significantly reduced the severity of NEC by modulating antioxidative defense and antiinflammatory protection in our experimental animal model.
The aim of this study was to evaluate the safety and efficacy of nonoperative treatment of esophageal perforation (EP) in children. Between 1999 and 2004, 13 episodes in 12 patients were evaluated. ...The treatment program consisted of broad-spectrum antibiotics, nasopharyngeal aspiration, parenteral and/or enteral nutrition by gastrostomy, and pleural effusion or mediastinal abscess drainage when required. Mean age of the patients was 3.75 ± 1.13 (range 3-7 years). Two patients (16.7%) were girls and 10 patients (83.3%) were boys. Chest pain was found 76.9% of all EP episodes (10 of 13 perforations), followed by dyspnea in 69.2% (9 of 13), vomiting in 46.1% (6 of 13), fever in 46.1% (6 of 13), and epigastric pain in 7.6% (1 of 13). No deaths occurred. In children, in contrast with the adults, EP can be treated safely by nonoperative methods.
Umbilical hernia is one of the most common congenital pathologies of the anterior abdominal wall in children. Umbilical hernia in children has a high tendency for spontaneous closure. Surgical ...treatment is performed only for rarely occurring complications. Appendicitis within an umbilical hernia sac is a previously unreported complication for umbilical hernias. We report here the first case in the current English language literature.
AIM:To investigate the role of triamcinolone in the management of acute and chronic enteritis caused by pelvic radiotherapy.METHODS:Twenty-eight patients with rectum adenocarcinoma or endometrium ...adenocarcinoma were studied.We compared the results of 14 patients treated with injected triamcinolone acetonide(TA)with those of 14 patients who were not treated with TA.For the TA group,40 mg of TA was injected intramuscularly on the 1st,11th and 21st d of radiotherapy;the control group received no injections.All of the study participants had a median age of 65 years,had undergone postoperative radiotherapy and were evaluated weekly using Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer Acute Morbidity Score Criteria,and complete blood counts for every 10 d.RESULTS:Triamcinolone was found to effectively prevent and treat radiation-induced acute gastrointestinal(enteritis)and genitourinary(cystitis)side effects(P=0.022 and P=0.023).For the lower GI side effect follow up,11 patients in the control group had Grade 2toxicity and 3 patients had Grade 1 toxicity.In the TA group,5 patients had Grade 2 toxicity and 9 patients had Grade 1 toxicity.For the genitourinary system side effect follow up,4 patients had Grade 2 toxicity and 6patients had Grade 1 toxicity.Additionally,2 patients had Grade 2 toxicity and 2 patients had Grade 1 toxicity.The neutrophil counts did not differ between the TA group and the control group.There was no meaningful difference between age groups and primary cancers.At the 12th mo of follow up,there were no differences between groups for chronic side effects.CONCLUSION:Triamcinolone is a moderately potent steroid,that is inexpensive and has a good safety profile.It would be beneficial for reducing medical expenses related to treatment of radiation induced enteritis.
Abstract Introduction Ozone has been proposed as an antioxidant enzyme activator, immunomodulator and cellular metabolic activator. This study was designed to investigate the efficacy of ozone ...therapy in the prevention of esophageal damage and stricture formation developed after esophageal caustic injuries in the rat. Materials and Methods Forty-five rats were allocated into three groups; sham-operated, un-treatment and treatment groups. Caustic esophageal burn was created by instilling 15% NaOH in the distal esophagus. The rats were left untreated or treated with 1 mg/kg/day ozone intraperitoneally. All rats were sacrificed at 28 days. Efficacy of the treatment was assessed by measuring the stenosis index (SI) and histopathologic damage score, and biochemically by determining tissue hydroxyproline content (HP), superoxide dismutase (SOD), glutathione peroxidase (GPx), malondialdehyde (MDA) and protein carbonyl content (PCC) in esophageal homogenates. Results Whereas seven (47%) rats died in the un-treatment group, all rats in the sham-operated and the treatment group survived during the study. SI, the histopathologic damage score, was significantly lower in the ozone-therapy group than the un-treatment group. HP levels were significantly higher in the un-treatment group than the group treated with ozone. Caustic esophageal burn increased MDA and PCC levels and also decreased SOD and GPx enzyme activities. In contrast, ozone therapy decreased the elevated MDA and PCC levels and also increased the reduced SOD and GPx enzyme activities. Conclusion Ozone has a preventive effect in the development of fibrosis by decreasing tissue damage and increasing the antioxidant enzyme activity in an experimental model of corrosive esophageal injury.
Abstract Introduction Hyperbaric oxygen (HBO) therapy is known to increase oxygen concentration in tissues leading to induction of an adaptive increase in antioxidants, stimulation of angiogenesis, ...improvement of white blood cell action, and regulation of inflammatory process. Therefore, we tested the potential beneficial effect of HBO in neonatal rat model of necrotizing enterocolitis (NEC). Materials and Methods Thirty newborn Sprague-Dawley rats, provided by the Experimental Research Council, Gulhane Military Medical Academy, Ankara,Turkey, were randomly divided into 3 groups as follows: NEC, NEC + HBO, and control. Necrotizing enterocolitis was induced by enteral formula feeding and exposure to hypoxia after cold stress at 4°C and oxygen. The NEC + HBO group received HBO at 2.8 atmosphere absolute (ATA) for 90 minutes daily for 3 days. The pups were killed on the fourth day, and their intestinal tissues were harvested for biochemical and histopathologic analysis. Blood samples were also obtained from the pups. Results The mortality rate was highest in the NEC group (3 pups in the NEC group vs 1 pup in the NEC + HBO group). Malondialdehyde and protein carbonyl content were significantly increased, whereas superoxide dismutase and glutathione peroxidase were significantly decreased in the NEC group. All these changes were similar to control levels in the NEC group by HBO treatment. Nitrate plus nitrite (NOx ) levels and serum tumor necrosis factor α were increased in the NEC group and histopathologic injury score and apoptosis index in the NEC group were significantly higher than in the NEC + HBO group. Conclusion Hyperbaric oxygen significantly reduced the severity of NEC in our study.
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