The Effect of Udenafil on Stasis Zone in an Experimental Burn Model

BACKGROUND

Management of the burn injuries is still a problematic issue because the stasis zone may become necrotic. We hypothesized that udenafil, a potent phospodiesterase inhibitor, can be beneficial in burn treatment by enhancing the viability of the stasis zone.

METHODS

Fifteen Wistar rats were randomly divided into 3 groups. Comb burn injury model was conducted bilaterally on the back of rats in each subject. Group 1 received 1 mL/d of saline orally for 7 days. Group 2 received 10 mg/kg per day of udenafil for 7 days. Group 3 received 20 mg/kg per day of udenafil for 7 days. At the end of seventh day, gross morphological and histopathological samples of stasis zone survival were evaluated.

RESULTS

Histopathological examination of groups 2 and 3 revealed that the stasis zone was mostly viable. The mean necrotic area and severity of inflammation was significantly higher in the control group compared with the treatment groups. Significant differences were determined in treatment groups compared with control group in terms of vital stasis zone area and histopathological parameters.

CONCLUSIONS

Udenafil treatment improved tissue survival on zone of stasis in. Future experimental studies should be conducted to develop zone of stasis treatment protocols combining udenafil with potent anti-inflammatory and antioxidant drugs.

Investigation of sensory nerve endings in pulvinar, ligamentum teres, and hip joint capsule: A prospective immunohistochemical study of 36 cases with developmental hip dysplasia

OBJECTIVE

The aim of this study was to immunohistochemically identify and characterize the presence of sensory nerve endings (SNEs) in pulvinar, ligamentum teres (LT), and hip joint capsule (HJC) of children with developmental dysplasia of the hip (DDH).

METHODS

Pulvinar, LT, and HJC specimens were obtained from 38 hips of 36 children (31 girls, five boys; mean age=49 months; age range=18-132 months) during open reduction surgery for DDH. All specimens underwent subsequent routine tissue processing (formalin fixation and paraffin embedding). To determine tissue morphology, haematoxylin and eosin staining was used. SNEs were analyzed immunohistochemically using a mouse monoclonal antibody against S-100 Beta Protein based on the classification of Freeman and Wyke including four types of SNEs including mechanoreceptors: type I Ruffini corpuscles, type II Pacini corpuscles, type III Golgi organs, and type IVa unmyelinated free nerve endings (FNEs). Additionally, children were sorted into three groups based on their age at the time of surgery: Group 1 (age <3 years; 19 hips of 18), Group 2 (age: 3-5 years; 10 hips of 10 children), and Group 3 (age >5 years; 9 hips of 8 children).

RESULTS

Although no Type I, II, or III SNEs were identified in any specimen, type IVa mechanoreceptor (FNEs) was immunohistochemically characterized in 13 (34%) pulvinar, 19 (50%) LT, and 16 (42%) HJC specimens. The total density of FNEs was 3.31±5.70)/50 mm2 (range 0-21) in pulvinar specimens, 3.18 ± 5.92)/50 mm2 (range 0-24) in HJC specimens, and 4.51±6.61/50 mm2 (range 0-22) in LT specimens. Furthermore, the operated side, gender, and the number of FNEs in specimens did not differ significantly among the age groups (p>0.05 for all), and the number of FNEs was not significantly correlated with age, gender, or the operated side (p>0.05 for all).

CONCLUSION

Evidence from this study revealed that pulvinar, LT, and HJC include only FNEs, which play a role in pain sensation, among mechanoreceptors. Surgical excision of these tissues may not cause a significant loss of sensory function in the hip joint of children with DDH.

LEVEL OF EVIDENCE

Level II, Therapeutic Study.

Comparison of the effects of thymoquinone and silymarin on the brain of rats having ischemia-reperfusion in the lower extremities

AIM

We aimed to show whether ischemia reperfusion (I/R) injury causes damage on brain or not, and whether thymoquinone and silymarin, as antioxidant and anti-inflammatory herbs, have beneficial effects on this damage or not.

METHODS

Forty Wistar albino rats were carried out and were randomized to 4 groups with equal numbers (n=10): sham group, implemented of only anesthesia; control group, implemented of anesthesia and I/R injury; silymarin group, implemented of anesthesia and I/R injury and treated with a dose of 200 milligram/kg silymarin ip and thymoquinone group, implemented of anesthesia and I/R injury and treated with a dose of 20 mg/kg thymoquinone. Serum lipid hydroperoxide (LOOH) and total free sulfhydryl (Sh) levels were determined. Light microscopy was used to evaluate histological changes in brain tissue.

RESULTS

Serum LOOH levels (0.21 ± 0.04 for control group, 0.29 ± 0.01 for sham group, 0.23 ± 0.09 for silymarin group, 0.29 ± 0.09 for thymoquinone group) were significantly higher and Sh levels (10.74 ± 1.71 for control group, 6.82 ± 0.24 for sham group, 9.12 ± 1.04 for silymarin group, 8.41 ± 1.12 for thymoquinone group) were significantly lower in control, silymarin and thymoquinone groups compared to control group (p<0.05 for all). According to the histopathologic damage score assessment, it was seen that the damage decreased significantly in the silymarin and the thymoquinone groups.

CONCLUSION

We showed that tissue damage also occurs in brain following the ischemia reperfusion. It was shown that thymoquinone and silymarin is quite effective in preventing this damage.

KEY WORDS

Brain, Hydroperoxide levels, Ischemia reperfusion injury, Sulfhydryl levels, Silymarin, Thymoquinone.

The role of osteopontin in the pathogenesis of placenta percreta

OBJECTIVE

This study aims to determine how the expression of osteopontin is altered in the placenta percreta by compar-ing osteopontin expression in normal placentas and placenta percreta tissues.

MATERIAL AND METHODS

Placental tissues from hysterectomy materials which were histopathologically diagnosed with placenta percreta (study group, n = 20) and placental tissues obtained from normal term pregnancies (control group, n = 20) were immunohistochemically stained with osteopontin antibody. The groups were compared with respect to the intensity of cytoplasmic staining for osteopontin.

RESULTS

The study and control groups were similar with respect to age, gravidity, parity, gestational age at birth, number of previous cesarean deliveries and curettages and (p > 0.05 for all). Immediate postoperative hemoglobin was significantly lower and the need for blood transfusion was significantly higher in the study group (p = 0.001 for both). Placental osteo-pontin expression was significantly altered in the study group (p = 0.020). Negative staining for placental osteopontin was significantly more frequent in the placenta percreta group than the control group (9/20 vs 0/20, 45.0% vs 0%, p = 0.037).

CONCLUSION

As reduced placental osteopontin expression was determined in the placenta percreta cases compared to the normal term placenta tissues, osteopontin can be considered to have a role in morbidly adherent placentation. This study is of value as the first study to investigate the changes in osteopontin expression in placenta percreta cases.

Giant renal metastasis from prostate cancer mimicking renal cell carcinoma

The most common sites for prostate cancer metastasis include bone, distant lymph nodes, liver and lungs. Renal metastasis of prostate cancer is a rarely seen pattern of invasion. In the current study, we described an 83-year-old male with a history of prostate cancer. He was admitted because of edema, hyperemia, warm and pain at left leg and inguinal region. In the further evaluation, a mass lesion at prostate region and conglomerate lymphadenopathy at left iliac vascular trajectory and a mass lesion at left kidney with heterogeneous contrast-enhancement were observed on contrast-enhanced magnetic resonance imaging and computerized tomography scan. Fine-needle aspiration biopsy was performed in the lesion with radiologically suspect renal cell carcinoma. By evaluating histopathological features and immunohistochemical staining of the tumor, we decided that the lesion was metastasis from prostate cancer.

Intraperitoneal Administration of Silymarin Protects End Organs from Multivisceral Ischemia/Reperfusion Injury in a Rat Model

Objective

To determine whether intraperitoneal silymarin administration has favorable effects on the heart, lungs, kidney, and liver and on oxidative stress in a rat model of supraceliac aorta ischemia/reperfusion injury.

Methods

Thirty male Wistar albino rats were divided equally into three groups: sham, control, and silymarin. The control and silymarin groups underwent supraceliac aortic occlusion for 45 min, followed by a 60 min period of reperfusion under terminal anesthesia. In the silymarin group, silymarin was administered intraperitoneally during ischemia at a dose of 200 mg/kg. Rats were euthanized using terminal anesthesia, and blood was collected from the inferior vena cava for total antioxidant capacity, total oxidative status, and oxidative stress index measurement. Lungs, heart, liver and kidney tissues were histologically examined.

Results

Ischemia/reperfusion injury significantly increased histopathological damage as well as the total oxidative status and oxidative stress index levels in the blood samples. The silymarin group incurred significantly lesser damage to the lungs, liver and kidneys than the control group, while no differences were observed in the myocardium. Furthermore, the silymarin group had significantly lower total oxidative status and oxidative stress index levels than the control group.

Conclusion

Intraperitoneal administration of silymarin reduces oxidative stress and protects the liver, kidney, and lungs from acute supraceliac abdominal aorta ischemia/reperfusion injury in the rat model.

Clinical and histopathological characteristics of cutaneous Leishmaniasis in Sanliurfa City of Turkey including Syrian refugees

BACKGROUND

The aim of our study was to investigate the clinical and histopathological characteristics of cutaneous leishmaniasis (CL) in the city of Sanliurfa in Turkey, where Syrian refugees also reside.

MATERIALS AND METHODS

At the Harran University Hospital outpatient clinics between 2012 and 2013, 54 CL cases, including 24 Syrian patients, underwent punch biopsy of the skin and/or a touch imprint. Patients in whom leishmania parasites were detected were included in the study. The clinical and histopathological data of the patients were obtained by a review of the patients' medical records. All the slides of each patient were re-evaluated histopathologically.

RESULTS

Fifty-four cases (mean age; 17 ± 12 years), consisting of 32 males (59.3%) and 22 females (40.7%), were examined. The most common site of involvement was the face (63%). The most common presentation was noduloulcerative lesions (57.4%). Histopathologically, the majority of the cases exhibited hyperkeratosis, follicular plugging of the epidermis, chronic inflammatory infiltration, leishmania amastigotes and non-caseating granulomatous inflammation in the dermis.

CONCLUSION

CL presents with a wide spectrum of expression, both clinically and histologically, and may mimic other inflammatory and neoplastic diseases. The diagnosis of CL relies on the identification of leishmania amastigotes in either a direct smear of the lesion or in a tissue section.

Leser-Trélat sign: does it really exist?

Leser-Trélat sign is a rare cutaneous disorder that manifests with sudden emergence of seborrheic keratoses and increase in their numbers and size within weeks or months. Its concurrence with many types of malignancies, especially adenocarcinoma and lymphoma, has been reported in the literature. In this case report, a patient having Leser-Trélat sign, without any detected malignancy in spite of detailed examination and 18 months of follow up, is presented. Current literature is reviewed in relation to the debate whether Leser-Trélat is a paraneoplastic syndrome or not.