248 research outputs found
POSSUM, P-POSSUM, CR-POSSUM ve ACPGBI-CRC skorlama sistemlerinin, kolorektal karsinomlu hastalarda mortalite tahminindeki duyarlılıklarının karşılaştırılması (Retrospektif çalşıma)
Full text linkKolorektal kanser cerrahi operasyon sonrası gelişecek sonuçları tahmin etmek için skorlama sistemleri geliştirilmiştir. Bizim amacımız kolorektal kanser nedeniyle opere edilen hastaların, postoperatif mortalite değerlendirmede kullanılan POSSUM, P- POSSUM, CR- POSSUM ve ACPGBI-CRC skorlama sistemlerinin postoperatif mortaliteyi belirlemede hangisinin daha duyarlı olduğunu karşılaştırmaktır. Materyal ve metod: Çalışmamızda Ocak 2002 ile Haziran 2007 tarihleri arasında Dicle Üniversitesi Tıp Fakültesi Genel Cerrahi Kliniği'nde kolorektal kanser nedeniyle ameliyat edilen 130 hasta vardı. . POSSUM, P-POSSUM, CR-POSSUM ve ACPGBI-CRC skorlama sistemlerinin postoperatif mortalitenin doğruluğunu belirlemede Receiver Operator Characteristic (ROC) eğri analizi ve Hosmer-Lemeshow testi kullanıldı. Bulgular: Postoperatif 30 günlük gözlenen mortalite yüzdesi 13.07 (%95 CI 8.32-19.93) idi. Mortalite tahmin güçleri POSSUM için 6.15 (3.14-11.66) p=0.0925 ; P-POSSUM için 5.38 (2.62 10.69) p=0.0538; CR-POSSUM için 8.44 (4.78-14.51), p=0.3178; ACPGBI-CRC için 9.23 (5.35- 15.44), p=0.4315 idi. Ve doğruluklarını değerlendirmek için ROC eğri analizi yapıldığında AUC değerleri CR-POSSUM için 0.969 (0.922-0.991), p=0.270; P-POSSUM için 0.959 (0.909-0.986), p=0.232; POSSUM için 0.949 (0.896-0.980), p=0.167. olarak bulundu. Sonuç: Tüm skorlama sistemleri postoperatif mortaliteyi belirlemede anlamlıdır. Ancak tüm hastaları değerlendirmede mortaliteyi en az tahmin eden skorlama sistemi P-POSSUM olarak bulundu. Postoperatif mortaliteyi belirlemede CR-POSSUM ve ACPGBI-CRC skorlama sistemlerinin daha anlamlı olduğu görüldü. CR-POSSUM ve ACPGBI-CRC skorlama sistemleri karşılaştırıldığında istatistiksel olarak anlamlı bir fark saptanmadı. ROC eğri analizinde de skorlama sistemleri arasında anlamlı bir fark saptanmamıştır.Scoring systems was developed to predict outcomes after surgical operation for colorectal carcinomas. Our aim was to compared POSSUM, P- POSSUM, CR- POSSUM and ACPGBI-CRC scoring systems to detirmine which one is the most predictive factor for mortality in patients undergoing colorectal cancer surgery. Material and method: 130 patients with colorectal cancer surgery operated at Dicle university medical faculty general surgical clinic between january 2002 and july 2007 were included in this study. Receiver Operator Characteristic (ROC) curve analyz and Hosmer-Lemeshow test were used to determine accuracy of postoperative mortality for POSSUM, P- POSSUM, CR- POSSUM and ACPGBI-CRC scoring systems. Findings: Overall observed mortality rate for postoperative 30 days was 13.07 (95% CI 8.32-19.93). The predictive impatc of mortality for POSSUM 6.15 (3.14-11.66) p=0.0925 ; for P-POSSUM 5.38 (2.62 10.69) p=0.0538; for CR-POSSUM 8.44 (4.78-14.51), p=0.3178; and for ACPGBI-CRC 9.23 (5.35- 15.44), P=0.4315. to determine accuracy of scoring systems Receiver Operator Characteristic (ROC) curve analyz was used and the following AUC values were found: CR-POSSUM 0.969 (0.922-0.991), p=0.270; P-POSSUM 0.959 (0.909-0.986), p=0.232; POSSUM 0.949 (0.896-0.980), p=0.167. Results: POSSUM, P- POSSUM, CR- POSSUM and ACPGBI-CRC scoring systems were found significant to pedict postoperative mortality. However , P-POSSUM scoring was the least predictive in all patients. CR-POSSUM and ACPGBI-CRC scorings were more significant to predict postoperative mortality. Statisticaly there was no significant difference between CR-POSSUM and ACPGBI-CRC when compared. There was no significant difference between POSSUM, P- POSSUM, CR- POSSUM and ACPGBI-CRC scoring systems in ROC curve analysiz
Simvastatin attenuates cisplatin-induced kidney and liver damage in rats
No full textStatins have anti-inflammatory effects that are not directly related to their cholesterol-lowering activity. This study aimed to investigate the effect of simvastatin on the extent of tissue damage in cisplatin-induced nephrotoxicity and hepatotoxicity. The rats received a single intravenous injection of 2.5 mg kg(-1) cisplatin. Other groups received either simvastatin (1 mg kg(-1)) or the vehicle (ethanol: saline) intraperitoneally for 10 days beginning 5 days prior to cisplatin injection. All animals were decapitated 5 days after cisplatin administration. Trunk blood was collected and analyzed for blood urea nitrogen (BUN), creatinine, alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), albumin, and total bilirubin levels. The urine samples were used for the calculation of creatinine clearance levels. The kidney and liver samples were stored for the measurement of malondialdehyde (MDA) and glutathione (GSH) levels, myeloperoxidase (MPO) activity and collagen content or were processed for histopathological examinations. Formation of reactive oxygen species in tissue samples was monitored by using chemiluminescence method. Simvastation reduced the extent of both kidney and liver damage and preserved both kidney and liver functions (p < 0.01-0.001). Increase in liver MDA level with a concomitant reduction in GSH in the cisplatin group was attenuated by simvastatin treatment (p < 0.05-0.01). Increase in tissue collagen content and chemiluminescence levels in the kidney and liver samples of the cisplatin group was also reversed by simvastatin (p < 0.001). In conclusion, simvastatin is beneficial in cisplatin-induced kidney and liver dysfunction and organ damage in rats via prevention of lipid peroxidation and tissue fibrosis, preservation of antioxidant glutathione, and suppression of neutrophil infiltration. (c) 2006 Elsevier Ireland Ltd. All rights reserved
2-mercaptoethane sulfonate (MESNA) protects against biliary obstruction-induced oxidative damage in rats
No full textThe aim of this study was to assess the antioxidant and antifibrotic effects of chronic administration of 2-mercaptoethane sulfonate (MESNA) on oxidative liver damage and fibrosis induced by biliary obstruction in rats. Liver fibrosis was induced in male Wistar albino rats by bile duct ligation and scission (BDL). MESNA (150 mg/kg, i.p.) or saline was administered for 28 days. At the end of the experiment, rats were killed by decapitation. Serum aspartate aminotransferase (AST), and alanine aminotransferase (ALT) levels were determined to assess liver function. Tumor necrosis factor-alpha (TNF-alpha) and lactate dehidrogenase (LDH) were also assayed in serum samples. Liver tissues were taken for determination of the free radicals, hepatic malondialdehyde (MDA) levels, an end product of lipid peroxidation; glutathione (GSH) levels, a key antioxidant; myeloperoxidase (MPO) activity, as an indirect index of neutrophil infiltration. Hepatic collagen content, as a fibrosis marker was also determined. Serum AST, ALT, LDH and TNF-alpha levels were elevated in the BDL group as compared to control group, while this increase was significantly decreased by MESNA treatment. BDL caused a significant (p < 0.05-0.001) decrease in GSH levels while MDA levels and MPO activity were increased in the liver tissue. These changes were reversed by MESNA treatment. Collagen contents of the liver tissue was increased by BDL (P < 0.001), and reversed back to the control levels with MESNA. Since MESNA administration alleviated the BDL-induced oxidative injury of the liver and improved the hepatic functions, it seems likely that MESNA with its antioxidant and antifibrotic properties, may be of potential therapeutic value in protecting the liver fibrosis and oxidative injury due to biliary obstruction. (c) 2006 Published by Elsevier Ireland Ltd
Protective role of adrenomedullin in burn-induced remote organ damage in the rat
No full textClinical and experimental research findings suggest that a local burn insult produces oxidant-induced organ changes as evidenced by increased lipid peroxidation in lung, liver and gut. Adrenomedullin (AM), a potent vasodilator, was originally isolated from pheochromocytoma cells, and has been identified in other tissues. In this study, we investigated the potential role of AM in burn-induced remote organ damage in rats. Sprague-Dawley rats (250-300 g) were treated with either AM (100 ng/kg, subcutaneously) or saline 10 min before burn insult which covers 30% of total body surface area and were decapitated 24 It after the burn insult. Trunk blood was collected and analyzed for liver and kidney functions and for determination of TNF-alpha levels. The liver, lung and kidney samples were taken for histologic evaluation and for measurement of malondialdehyde (MDA) level, myeloperoxidase (MPO) activity and chemiluminescence levels. The data revealed that AM treatment resulted in a significant protection in tissues tested against burn injury via suppression of lipid peroxidation, tissue neutrophil infiltration, oxidant generation and via decreasing circulating levels of the pro-inflammatory cytokine TNF-alpha. AM treatment was also effective in attenuating hepatic and kidney dysfunction due to burn injury, suggesting that peripherally AM administration may protect the tissues against burn-induced injury. (c) 2007 Elsevier B.V. All rights reserved
The effect of angilotensin-converting enzyme inhibitors on experimental colitis in rats
No full textThe present study was aimed to investigate the effect of ACE inhibition on trinitrobenzene sulphonic acid (TNBS)-induced colonic inflammation in rats by using captopril and lisinopril. In treatment groups, the rats were treated with ACE inhibitors, captopril or lisinopril (0.1 and I mg/kg/day; intraperitoneally). The drugs were given 5 min after induction of colitis and the treatment was continued for 3 days. Three days after the induction of colitis, all rats were decapitated. The distal colon was weighed and the mucosal lesions were scored at both macroscopical at microscopic levels. Malondialdehyde (MDA) and glutathione (GSH) levels, myeloperoxidase (MPO) activity and collagen content were assessed in tissue samples. Formation of reactive oxygen species in colonic samples was monitored by using chemiluminescence technique. Serum TNF-alpha level was assessed in trunk blood. Captopril treatment was found to be beneficial in all parameters, except colonic glutathione content. On the other hand, although stimulation of lipid peroxidation and increase in serum TNF-a level were successfully prevented by lisinopril, the morphology of the lesions remained unchanged. In conclusion, sulphydryl and non-sulphydryl ACE inhibitors, captopril and lisinoptil do not seem to be similarly effective in TNBS-induced colitis model at least at the doses tested in our study. (c) 2005 Elsevier B.V. All rights reserved
Ghrelin alleviates biliary obstruction-induced chronic hepatic injury in rats
No full textBackground: Reactive oxygen species and oxidative stress are implicated in hepatic stellate cell activation and liver fibrosis, which are initiated by recruitment of inflammatory cells and by activation of cytokines. Objective: The possible anti-oxidant and anti-inflammatory effects of ghrelin were evaluated in a hepatic fibrosis model in rats with bile duct ligation (BDL). Methods: Under anesthesia, bile ducts of Sprague Dawley rats were ligated, and half of the rats were subcutaneously administered with ghrelin (10 ng/kg/day) and the rest with saline for 28 days. Sham-operated control groups were administered saline or ghrelin. On the 28th day of the study, rats were decapitated and malondialdehyde (NIDA) content - an index of lipid peroxidation, and myeloperoxidase (MPO) activity - an index of neutrophil infiltration - were determined in the liver tissues. Oxidant-induced tissue fibrosis was determined by collagen contents, while the hepatic injury was analyzed microscopically. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) levels and lactate dehydrogenase (LDH) levels were determined to assess liver function and tissue damage, respectively. Pro-inflammatory cytokines; TNF-alpha, IL-1 beta and IL-6 were also assayed in plasma samples. Results: In the saline-treated BDL group, hepatic NIDA levels, MPO activity and collagen content were increased (p < 0.001), suggesting oxidative organ damage, as confirmed histologically. In the ghrelin-treated BDL group, however, all of the oxidant responses were reversed significantly (p < 0.05-p < 0.001). Serum AST, ALT, LDH levels, and cytokines were elevated in the BDL group as compared to the control group, while this increase was significantly decreased by ghrelin treatment. Conclusion: Owing to the anti-inflammatory and anti-oxidant effect as demonstrated in our study, it is possible to speculate that exogenously administered ghrelin may possess an antifibrotic effect against biliary obstruction-induced liver fibrosis. Thus, it seems likely that ghrelin may be of potential therapeutic value in protecting the liver fibrosis and oxidative injury due to biliary obstruction. (c) 2007 Elsevier B.V. All rights reserved
Erdosteine treatment attenuates oxidative stress and fibrosis in experimental biliary obstruction
No full textOxidative stress, in particular lipid peroxidation, induces collagen synthesis and causes fibrosis. The aim of this study was to assess the antioxidant and antifibrotic effects of erdosteine on liver fibrosis induced by biliary obstruction in rats. Liver fibrosis was induced in Wistar albino rats by bile duct ligation (BDL). Erdosteine (10 mg/kg, orally) or saline was administered for 28 days. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and lactate dehydrogenase (LDH) levels were determined to assess liver functions and tissue damage, respectively. Pro-inflammatory cytokines, TNF-alpha, IL-1 beta and IL-6 and antioxidant capacity (AOC) were assayed in plasma samples. Liver tissues were taken for determination of malondialdehyde (MDA) and glutathione (GSH) levels, myeloperoxidase (MPO) activity and collagen content. Production of reactive oxidants was monitored by chemiluminescence assay. Serum AST, ALT, LDH, and plasma cytokines were elevated in the BDL group as compared to controls and were significantly decreased by erdosteine treatment. Hepatic GSH level and plasma AOC, depressed by BDL, were elevated back to control level with erdosteine treatment. Furthermore, hepatic luminol and lucigenin chemiluminescence (CL), MDA level, MPO activity and collagen content in BDL group increased dramatically compared to control and reduced by erdosteine treatment. Since erdosteine administration alleviated the BDL-induced oxidative injury of the liver and improved the hepatic functions, it seems likely that erdosteine with its antioxidant and antifibrotic properties, may be of potential therapeutic value in protecting the liver fibrosis and oxidative injury due to biliary obstruction
Resveratrol alleviates bleomycin-induced lung injury in rats
No full textAntioxidant therapy may be useful in diseases with impaired oxidant-antioxidant balance such as pulmonary fibrosis. This study was designed to examine the effects of resveratrol, an antioxidant agents, against bleomycin-induced pulmonary fibrosis and oxidative damage. Wistar albino rats were administered a single dose of bleomycin (5 mg/kg; via the tracheal cannula) followed by either saline or resveratrol (10 mg/kg; orally) for 14 days. The effect of resveratrol on pulmonary oxidative damage was studied by cell count and analysis of cytokine levels (TGF-beta, TNF-alpha, IL-1 beta and IL-6) in the bronchoalveolar lavage fluid (BALF) and biochemical measurements of malondialdehyde (MDA), an end product of lipid peroxidation; glutathione (GSH), a key antioxidant; and myeloperoxidase (MPO) activity, an index of neutrophil infiltration, in the lung tissue. Bleomycin-induced lung fibrosis was determined by lung collagen contents and also microscopically. Bleomycin caused a significant decrease in lung GSH, which was accompanied with significant increases in MDA level, MPO activity, and collagen contents of the lung tissue concomitant with increased levels of the pro-inflammatory mediators and cell count in BALF. On the other hand, resveratrol treatment reversed all these biochemical indices as well as histopathological alterations induced by bleomycin. The results demonstrate the role of oxidative mechanisms in bleomycin-induced pulmonary fibrosis, and resveratrol, by its antioxidant properties, ameliorates oxidative injury and fibrosis due to bleomycin. Thus, an effective supplement with resveratrol as an adjuvant therapy may be a very promising agent in alleviating the side effects of bleomycin, an effective chemotherapeutic agent. (C) 2006 Elsevier Ltd. All rights reserved
Pomegranate peel extract prevents liver fibrosis in biliary-obstructed rats
No full textPunica granaturn L. (pomegranate) is a widely used plant that has high nutritional value. The aim of this study was to assess the effect of chronic administration of pomegranate peel extract (PPE) on liver fibrosis induced by bile duct ligation (BDL) in rats. PPE (50 mg kg(-1)) or saline was administered orally for 28 days. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and lactate clehydrogenase (LDH) levels were determined to assess liver function and tissue damage. Proinflammatory cytokines (tumor necrosis factor-alpha and interleukin 1 beta) in the serum and antioxidant capacity (AOC) were measured in plasma samples. Samples of liver tissue were taken for measurement of hepatic malondialdehyde (MDA) and glutathione (GSH) levels, myeloperoxidase (MPO) activity and collagen content. Production of reactive oxidants was monitored by chemiluminescence assay. Serum AST, ALT, LDH and cytokines were elevated in the BDL group compared with the control group; this increase was significantly decreased by PPE treatment. Plasma AOC and hepatic GSH levels were significantly depressed by BDL but were increased back to control levels in the PPE-treated BDL group. Increases in tissue MIDA levels and MPO activity due to BDL were reduced back to control levels by PPE treatment. Similarly, increased hepatic collagen content in the BDL rats was reduced to the level of the control group with PPE treatment. Thus, chronic PPE administration alleviated the BDL-induced oxidative injury of the liver and improved the hepatic structure and function. It therefore seems likely that PPE, with its antioxidant and antifibrotic properties, may be of potential therapeutic value in protecting the liver from fibrosis and oxidative injury due to biliary obstruction
Geçici batın kapama tekniklerinden bogota bag ile cilt kapatılmasının karşılaştırılması
No full textAmaç; GBK teknikleri yüksek İAB, AKS, İBH veya şüphesi olan ve reoperasyon gerekecek hastalarda sık kullanılmaktadır. Açık abdomen sonrası uygulanan GBK teknikleri son 20 yılda travma, İBH ve şüphesi olanlar ayrıca yaygın intraabdominal sepsis gibi durumlarda hayat kurtarıcı bir durum olarak gelişmiştir. Günümüzde GBK teknikleri olarak farklı teknikler kullanılmaktadır. Bu tekniklerin birbirine üstünlükleri ve dezavantajları olsa da henüz hangi yöntemin en uygun olduğuna dair ortak bir görüş yoktur. Bu çalışmamızda DÜTF Genel Cerrahi anabilim dalı yoğun bakım ünitesinde takip edilen ve çeşitli nedenlerle dekompresif laparatomi yapılıp, GBK tekniği uygulanan hastalarda iki farklı GBK yöntemi olan Bogota bag ile cilt kapama tekniklerini karşılaştırmayı amaçladık. Materyal metod; Bu çalışmamızda Ocak 2006 ile Mart 2011 tarihleri arasında Dicle Üniversitesi Tıp Fakültesi Genel Cerrahi Kliniğinde abdominal operasyon geçiren hastalarda GBK tekniklerinden Bogota bag veya ciltile kapatılan 109 hastanın dosyaları retrospektif olarak incelendi. Hastalarda yaş, cinsiyet, tanı, İAB, GKS, MPİ, APACHE II skoru, CRP değeri, WBC sayısı, HCT değeri, PLT sayısı, serum albumin değeri, organ yetmezliği, morbidite ve mortaliteleri retrospektif olarak incelendi. Bulgular; Bu çalışmamızda GBK tekniklerinden 85 hastanın batını grup 1 ile, kalan 24 hastanın batını grup 2 ile kapatıldı. Her iki hasta grubunda yaş, cinsiyet, tanı, İAB, GKS, MPİ, APACHE 2 skoru, CRP değeri, WBC sayısı, HCT değeri, PLT sayısı, serum albumin değeri, organ yetmezliği, morbidite ve mortalite açısından istatistiksel olarak anlamlı bir fark olmadığı gözlendi. Ancak hastaların hastanede ortalama kalış süreleri ve ortalama operasyon sayısı açısından anlamlı fark olduğu gözlendi. Batını cilt ile kapatılan hastaların ortalama hastanede kalış süresi 20,38 gün iken batını Bogota bag ile kapatılan hastaların ortalama hastanede kalış süresi 34,46 gün olduğu gözlendi. Batını cilt ile kapatılan hastaların ortalama operasyon sayısı 1,92 iken, batını Bogota bag ile kapatılan hastaların ortalama operasyon sayısı 2,50 olduğu gözlendi. Sonuç; Bu bulgulara dayanılarak bogota bag ve cilt kapama arasında mortalite ve morbidite açısından anlamlı bir fark saptanmadı. GBK yöntemi uygulanan hastalarda; seçici vakalarda bogota bag uygulamaktayız, diğer uygun vakalarda ise cilt kapamasını önermekteyiz. Anahtar kelimeler; Bogota bag, Cilt kapatılması, Batın kapama tekniği, İntraabdominal hipertansiyon.Purpose The TAC techniques are used very often for the patients with high intraabdominal pressure (IAP), abdominal compartment syndrome (ACS) and ischemic enteropathy (IE) which is suspected or needed a reoperation. The techniques (TAC), applied after open abdominal surgery, was developed as lifesaving techniques in situations such as trauma, diagnosed or suspected ischemic enteropathy (IE) and prevalent intraabdominal sepsis (IAS) in recent two decades. Today, the different techniques are used as TAC. Despite the fact that these techniques have disadvantages or superiorities to one another, yet; there has been no common agreement about which technique the best is. In this study, two different techniques of TAC, Bogota Bag and Skin Closure, were compared on the patients, followed up in the Intensive Care Unit, Department of General Surgery, the Faculty of Medicine, at Dicle University and underwent decompressive laparotomy because of various reasons. Material and Method In this study the records of 109 patients, underwent abdominal surgery with two techniques of TAC; Bogota Bag and Skin Closure; in the Department of General Surgery, the Faculty of Medicine, at Dicle University were scrutinized retrospectively between Jenuary 2006 and March 2011. The age, gender, diagnosis, IAP, Glasgow Coma Scale (GCS), Mannheim Peritonitis Index (MPI), APACHE II Score, C-reactive protein value (CRP), White Blood Cell count (WBC), hematocrit value (HCT), platelet count (PLT),serum albumin levels, organ failure, morbidity and mortality rates of the patients were investigated retrospectively. Results and Discussion While the abdomens of 85 patients were enclosed with Skin Closure (i.e., group 1), the other 24 were treated with Bogota Bag (i.e., group 2). In each group there was no statistically significance in point of IAP, GCS, MPI, APACHE II Score, CRP value, WBC count, HCT value, PLT count, serum albumin levels, organ failure, and morbidity and mortality rates. Nonetheless, it was found that there was statistically significant difference between average number of surgeries and average length of stay in hospital of the patients.The length of stay in hospital for the first group was found as 20,38 days while it was established as 34,46 days for the second group. As for average number of surgeries, they were found 1,92 and 2,50 for the patients underwent Skin Closure and Bogota Bag treatments respectively. Conclusion: By relying on the results above, it was established that there was no statistical difference between Skin Closure and Bogota Bag techniques from the point of mortality and morbidity rates. Consequently, it can be suggested that Bogota Bag is appropriate for the selective cases whereas Skin Closure fits better in other appropriate cases for the patients that TAC applied. Keywords; Bogota bag, Skin Closure, Abdominal Closure Technique, Intra abdominal hypertension
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