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Biomedical subjects

N Kale

Publications and source records attributed to N Kale.

16 recordsLinked to original sources

Effects of amrinone on bilateral renal ischemia/reperfusion injury.

Renal ischemia/reperfusion injury could arise as a consequence of clinical conditions such as renal transplantation, shock, cardiac arrest, hemorrhage and renal artery surgery. In this experimental study, we aimed to determine the preventive effects of amrinone on bilateral renal ischemia/reperfusion injury in rats. A total of 60 Wistar-albino rats were divided into six groups ( n=10). Midline laparotomies were made under ketamine anesthesia. In the sham, amrinone1 and amrinone2 without ischemia (AWI1 and AWI2) groups saline, 5 and 10 mg/kg of amrinone was infused, respectively. In the ischemia, ischemia plus amrinone1 (IPA1) and ischemia plus amrinone2 (IPA2) groups, saline and 5 and 10 mg/kg of amrinone was infused, respectively, at the beginning of reperfusion, subsequent to 45 min of bilateral renal artery occlusion. Following 6 h of reperfusion, blood was drawn to study serum BUN and creatinine and a bilateral nephrectomy was done to determine tissue malonyldialdehyde ( MDA) and myeloperoxidase (MPO) levels. The results were analysed by Mann-Whitney U-test. The parameters studied were statistically higher in the ischemia group compared with the other groups ( P<0.05 for each comparison), indicating renal I/R injury. These parameters were lower in the amrinone without ischemia groups (AWI1 and AWI2) than in the sham group, however there were no significant differences between the groups ( P>0.05, for each comparison). The treatment groups IPA1 and IPA2 had statistically similar results compared with the sham group, showing the preventive effect of amrinone on renal I/R injury at the given doses. We conclude that amrinone prevented experimental renal ischemia/reperfusion injury in rats, independently of the administered doses. This preventive effect of the agent could depend on its effect of regulating the microcirculation, in decreasing intracellular calcium and in preventing neutrophil activation. We propose that this preventive effect of amrinone - which has gained clinical application especially in cases of cardiac insufficiency - could also be exploited in clinical conditions related with renal ischemia/reperfusion.

Amrinone↗

Diffuse fibrous proliferation of tunica vaginalis associated with testicular infarction: a case report.

Fibrous pseudotumor of the tunica vaginalis testis is an uncommon lesion of unknown pathogenesis. Although this reactive process of testicular tunics is benign, this usually is diagnosed after radical orchiectomy. The authors describe a case of fibrous pseudotumor of the tunica vaginalis testis associated with testicular infarction. To our knowledge, this is the first case presented with similar association, second case consisting predominantly of myofibroblasts and the fourth reported case encountered in childhood.

Adolescent↗

Effect of bilirubin in ischemia/reperfusion injury on rat small intestine.

PURPOSE: The aim of this study was to determine the effects of bilirubin in experimental small intestinal ischemia/reperfusion (I/R) injury in rats. METHODS: Thirty rats were divided into 5 groups (n = 6). In group S, saline and in group B, bilirubin, 20 mg/kg were infused via the jugular vein without an additional procedure. In groups S-IR, saline, B(1)-IR and B(2)-IR, 10 and 20 mg/kg/h of bilirubin were infused for 2 hours, respectively. In these groups, an I/R procedure was done after infusions by occluding the superior mesenteric artery for 45 minutes followed by 1 hour of reperfusion. After reperfusion, the small intestines were resected for histopathologic and malondialdehyde (MDA) assessments. Mucosal lesions were scored between 0 and 5. Malondialdehyde levels and histopathologic grades were analyzed statistically. RESULTS: Mucosal injury was severe in S-IR (grade 4 to 5), mild in B(1)-IR (grade 0 to 3) and none in B(2)-IR group (grade 0). Grades of group S-IR were higher than those of B(1)-IR and B(2)-IR statistically (P <.05). Tissue MDA levels of the S-IR group were significantly higher than those of B(1)-IR and B(2)-IR groups (U = 36, P <.05). Bilirubin levels correlated inversely with MDA levels (r = -0.94). CONCLUSIONS: Bilirubin effectively prevents intestinal I/R injury in rat. This observation is consistent with the hypotheses regarding bilirubin as an antioxidant, having a role in the body defense. J Pediatr Surg 36:1764-1767.

Animals↗

Colon interposition for esophageal stenosis in a patient with epidermolysis bullosa.

Epidermolysis bullosa (EB) is a disease with 3 forms, most hereditary, characterized by spontaneous blistering lesions. The autosomally inherited form, epidermolysis bullosa dystrophica recessive (EBDR), is responsible for esophageal lesions consisting of web or stenosis. The authors could find only 9 cases treated by various esophageal replacement procedures in the literature, and the experience with 1 case treated by colon interposition is presented. J Pediatr Surg 36:1861-1863.

Anastomosis, Surgical↗

Hydatid cysts of the lung in childhood: is capitonnage advantageous?

In the treatment of thoracal hydatid cysts, there is not an agreement whether the cyst cavity to be capitonnaged or not. In this retrospective study, it was aimed to compare the cases of capitonnaged and not capitonnaged thoracal hydatid cysts with regard to hospital stay and post-operative chest tube removal day. Documents of 15 patients operated for pulmonary hydatid cysts in our clinic were reviewed. In 7 cases pericystectomy and removal of germinative membrane was performed whereas in 8 patients capitonnage was added to the procedure. In all cases open airways were suture controlled and pleural cavity was drained with chest tube connected to waterseal system. Average hospital stay of capitonnaged cases was 8 days and of uncapitonnaged ones was 12 days. Thoracal drainage tubes were removed in an average of 4 post-operative days in capitonnaged cases and of 7 days in the others. Statistical analysis were made by Mann-Whitney U test. Difference between the hospital stays of the 2 groups were not significant, whereas it was significant statistically between chest tube removal days (p<0.05). Capitonnage shortens postoperative chest tube drainage period in pulmonary hydatid cysts, resulting in lower morbidity compared with the uncapitonnaged cases.

Adolescent↗

Comparison of consequent small bowel anastomoses after transient ischemia: an experimental study in rats.

BACKGROUND/PURPOSE: The role of ischemia/reperfusion (I/R) damage on intestinal anastomotic healing remains to be precisely determined. The objective of this study was to investigate healing of small bowel anastomoses performed at different times after transient ischemia. METHODS: Thirty male Wistar-Albino rats were investigated in five groups (four study and one control). Under general anesthesia, the superior mesenteric artery (SMA) was occluded for 40 minutes in the study rats. Biopsy specimens, to document I/R histopathology, were obtained before small intestinal anastomoses at 20 minutes (group 1), 90 minutes (group 2), 6 hours (group 3), and 24 hours (group 4) after reperfusion. In a control group, biopsy and intestinal anastomoses were performed after SMA dissection without occlusion. The rats were relaparotomized on the fifth day to determine in situ bursting pressures and to obtain specimens for hydroxyproline content and histopathologic evaluation. RESULTS: Hydroxyproline content and bursting pressures were compared statistically with Mann-Whitney U test. Although there was no statistical difference between the control group and group 1, there were significant differences (P < .05) between groups 2, 3, and 4, with both parameters decreasing as the duration after reperfusion increased. CONCLUSION: Anastomosis are less likely to leak when performed sooner rather than later after an ischemia/reperfusion event.

Anastomosis, Surgical↗

Assessment of anastomotic reliability with pulse oximetry in graded intestinal ischemia: an experimental study in dogs.

BACKGROUND/PURPOSE: Pulse oximetry has been proposed as an appropriate and feasible technique in the assessment of intestinal ischemia in recent years. In this study the authors aimed to assess the reliability of anastomoses in the dog small intestine in which there is graded irreversible ischemia as measured by pulse oxymeter. METHODS: In a control group of four dogs, without any devascularization, three small bowel anastomoses were formed in each dog. The study group consisted of 12 dogs. In each animal three intestinal segments with different levels of ischemia were created by ligating the marginal vessels proximally and distally in sequence beginning from the midpoint of the segmental vascular arcade. Preanastomotic pulse oximeter readings between 80% and 90% were assigned to mild ischemia, 70% and 80% to moderate, and 60% and 70% to severe ischemia group. Pulse oximetry measurements were obtained from probes applied to the antimesenteric serosal surfaces at the midpoint of small intestinal segments. A total of 48 intestinal segments (12 nonischemic in the control group and 36 with three different levels of ischemia in the study group) were transected in the midpoint and anastomosed in double layers. Postanastomotic SaO2 values were also noted. The anastomoses were evaluated 48 hours later macroscopically if there was any leakage, and biopsy specimens were obtained for histopathologic ischemic gradings. All results were studied statistically. RESULTS: Histopathologic grades between each group were statistically different (P < .01 for each comparison) except for control and mild ischemia groups (P > .05), worsening as the level of ischemia increased. Pre- and postanastomotic pulse oximetry measurements correlated very well with the histological gradings (r = -0.90, P < .001 and r = -0.93, P < 0.001 respectively). Number of anastomotic leakages were none in control, one in mild, nine in moderate, and 12 (all of the anastomoses) in severe ischemia groups. In the moderate ischemia group with an average preanastomotic pulse reading of 76.75%, each of the leaking anastomoses had a postanastomotic pulse measurement of lower than 70%. The finding that the difference between histopathologic grades of control and mild ischemia groups with average preanastomotic pulse measurements of 96% and 85%, respectively is not statistically significant enables us to suggest that a saturation of at least 85% is necessary for a reliable anastomosis. CONCLUSION: These results suggest clearly that anastomotic reliability can be predicted objectively with pulse oximetry.

Anastomosis, Surgical↗

Neovascularization of the testicle through spermatic vessels by omental pedicle flap: a new experimental model.

The aim of this experimental study in rats was to consider the supplementary role of an omental pedicle flap on the neovascularization of the testicle through the spermatic vessels, for which a Fowler-Stephens procedure had been planned. To compare results, 12 animals had only the spermatic vessels ligated, without an additional procedure (Fowler-Stephens procedure [FS group]), and 12 others had omentopexy of the spermatic vessels of the left testes, with ligation of the vessels 4 weeks later (Fowler-Stephens procedure plus omentopexy [FSO group]). In the sham group (n = 8), only omentopexy of the left spermatic vessels was performed. Six rats served as controls. In each rat, both testes were evaluated by color Doppler ultrasonography to assess capsular and intratesticular blood flow, followed by orchiectomy to determine testicular weights, testicular biopsy scores, and mean seminiferous tubule diameters. Data were analyzed statistically. According to the color Doppler ultrasonography, the testicular blood flow in the FSO group was better than that of the FS group, but was less sufficient than that of the sham and control groups. The testicular weights and biopsy scores for the FSO group were statistically greater than those of the FS group, and less than those of the sham and control groups. There was no significant difference in the mean seminiferous tubule diameters of the FSO and FS groups. The contralateral tests of the four groups did not differ significantly for any parameter. In light of the data available, it is suggested that the omental pedicle flap neovascularizes the testicle through spermatic vessels. Given the high incidence of testicular atrophy associated with Fowler-Stephens orchiopexies, it might be beneficial to perform laparoscopic orchiopexy of testicles neovascularized with omental pedicle flaps as the first-stage procedure.

Animals↗

Hungry bone syndrome in a child following parathyroid surgery.

The rare hungry bone syndrome was encountered in a 15-year-old child after the removal of a parathyroid adenoma. Contrary to the hypocalcemias caused by the removal of all parathyroid glands or transient ischemia after parathyroid surgery, in which the serum inorganic phosphorus level is usually normal, both serum calcium and inorganic phosphorus levels are decreased in hungry bone syndrome in the early postoperative period. Vigorous calcium supplementation and vitamin D are required for prolonged periods.

Adenoma↗

Polyorchidism.

Polyorchidism, defined as the presence of more than two histologically proven testes, is a rare entity. A review of the literature has yielded 46 cases of true polyorchidism suitable for consideration in this review, and we add two more, one of them being the 12th case of complete duplication of the testis reported in the literature.

Child↗

Experience with childhood urolithiasis. Report of 196 cases.

A total of 196 children with urinary calculi were treated surgically. Their ages ranged from 1 to 14 years. The male:female ratio was 3:1. Stones were located in the kidney in 96 patients, in the bladder in 52 and in the ureters in 32. Multiple organ involvement was present in 16 patients and associated urinary tract anomalies were found in 11. Stone analysis revealed calcium oxalate and phosphate stones in 121 patients, struvite stones in 60 and uric acid stones in 15.

Adolescent↗

Effects of polyethyleneglycol-superoxide dismutase (PEG-SOD) and pentoxifylline on small intestinal anastomoses established in the 24th hour of reperfusion: an experimental study in rats.

In a previous study, we had shown that anastomoses established in the 24th hour of reperfusion healed less than the ones established in earlier periods. In this study, we aimed to assess the impacts of polyethyleneglycol-superoxide dismutase (PEG-SOD), a free oxygen radical scavenger and of pentoxyfilline, a methyl-xanthine derivative on anastomotic healing at 24th hour of reperfusion. 18 Wistar-albino rats were divided into 3 groups (n = 6). In all groups superior mesenteric artery was occluded for 40 minutes and the intestine was reperfused for 24 hours. Rats were relaparotomized in the 24th hour and small intestinal anastomoses were established. In Sham group, saline (0.5ml); in Group PTX, pentoxyfilline (25mg/kg); and in Group PGS, PEG-SOD (1,500U/kg) was administered intravenously 20 minutes before anastomoses. In the 5th day, anastomotic healing was evaluated by bursting pressures and hydroxyproline contents. Results were analized by Mann-Whitney U test, p < 0.05 was considered significant. Both of average bursting pressures and average hydroxyproline contents were highest in Group PGS (240 mmHg +/- 23.9; 7.71 +/- 0.68 micromol/g-tissue), followed by sham group (168.3 +/- 18.3 mmHg; 5.94 +/- 0.62 micromol/g-tissue) and Group PTX (83.8 +/- 9.2 mmHg, 5.94 +/- 0.62 micromol/g-tissue). Differences of these two parameters between all groups were statistically significant (p < 0.05). Best anastomotic healing in the 24th hour of reperfusion was achieved by PEG-SOD administration, whereas pentoxyfilline did not favor the healing.

Anastomosis, Roux-en-Y↗