Oguzhan Karatepe, Suleyman Kokdas, Sedat Kamali, Timucin Aydın, Ahu Kemik, Gulcin Kamali, Gokhan Adas and Enis Yuney
Introduction: The etipathogenesis of inflammatory bowel disease (IBD) includes immunologic, genetic and environmental factors. In addition to the colon, frequent extra-intestinal alterations related to pancreas and hepatobiliary system are evaluated in several studies. A minimally invasive approach was applied to the IBD, with the expectation of earlier recovery, fewer postoperative complications. The aim of the study is to compare the effects of laparoscopic and open techniques applied for the surgical treatment of ulcerative colitis on the gastrointestinal system and pancreas, and related systemic consequences. Methods: Colitis was induced in 20 rats by rectal injection of a 5% 0.25mL 10mg/kg TNBS (Sigma, USA) in 50% ethanol. The rats were randomly divided into two groups: rat control, laparotomy was made for two-hour duration (n=10), a pneumoperitoneum was applied for a two-hour duration (n=10). Following the surgical procedures, samples were drawn for biochemical and histopathologic examinations. TNF-?, IL-6, MDA, NO, MPO and PAP levels were evaluated in serum and in tissues of pancreas and colon. Results: Except the MDA and NO levels in colonic tissues, all the parameters indicating the oxidative injury and inflammation were found significantly lower in a pneumoperitoneum group. There was no difference in histopathologic examinations of the both groups. Discussion: The results revealed that despite the pathophysiologic effects of pneumoperitoneum laparoscopic surgery in patients with ulcerative colitis elicited less oxidative damage and inflammation compared to conventional surgery. Regarding the findings we concluded that laparoscopic procedures are safe in patients with IBD but to comment on the effects of pneumoperitoneum related to the longer surgery duration further studies with variable operation times are required.
Oguzhan Karatepe, Idris Kurtulus, Orcun Unal, Orhan Yalcin, Ahu Kemik, Gulcin Kamali, Gokhan Adas, Muharrem Battal, Mine Adas, Hale Ozgun and Murat Aksoy
Background: Erythropoietin (Epo), a hormone produced by the kidney that promotes the formation of red blood cells in the bone marrow, is considered anti-inflammatory,anti-apoptotic, angiogenetic and sitoprotective. In this study, high dose erythropoietin is examined on an animal model for ischemic colitis (IC) to detect its possible potential benefits. Methods: Thirty female Wistar albino rats weighing 250-300 g were randomized into three experimental groups as follows: in Group 1, animals were sham operated (n = 10) and received distilled water; in Groups 2 and 3, the rats underwent a standardized surgical procedure to induce IC (n = 10 in each group). Group 2 animals served as the controls, receiving only tap water, while Group 3 animals received 3000 IU/kg eritropoetin as a single high dose. All animals were sacrificed 72 h after devascularization. Colonic malondialdehyde (MDA) levels, glutathione (GSH), myeloperoxidase (MPO), and caspase 3 activities of the sacrified rats were measured. CD-34 was evaluated by the immunohistochemical examination of the colonic tissue. Results: Colonic ischemia significantly increased the colonic MDA levels, caspase 3 activity, and TNF alfa in comparison to the control group. Epo treatment was associated with increased GSH levels, decreased MDA, and caspase 3 activity. Histopathological examination revealed that the intestinal mucosal structure was preserved in the Epo treated group. Moreover, treatment with Epo significantly increased CD-34 (stem cell) when compared to the ischemic colitis group. Conclusion: Epo reduced colonic damage in ischemic colitis. The mechanism of the protection associated with Epo was due to its mobilization of the stem cells as well as its anti-apoptotic and anti-inflammatory effects.
E. JayaShankar, B. Pavani, Eshwar Chandra, Ravinder Reddy, M. Srinivas and Ashwin Shah
A prospective and retrospective hospital based descriptive study was done to know the pathological spectrum of thoracic lesions and to correlate the radiological findings with cytological findings obtained from computed tomography guided percutaneous transThoracic fine needle aspiration of lung and mediastinum. The clinical, radiological and cytological data of 60 patients were studied who underwent CT guided FNAC from January 2008- June 2009. Diagnostic accuracy of FNAC is more than 90%. Out of 60 cases 19 cases are non malignant and 41 cases were malignant. The Diagnostic sensitivity of Bronchogenic carcinoma is 84% and Specificity is 76%. Male to Female ratio is 2.3:1. Majority of cases were seen in 5th and 6th decade. Apart from Non small cell carcinoma cases like small cell carcinoma, Carcinoid tumor, Chondroid hamartoma, SFT were also noted. Cytological diagnosis is correlated with cell block sections in available cases. Post procedural complications like Pneumothorax, Pulmonary hemorrhage and hemoptysis were noted in few cases. CT guided FNAC is a simple and safe procedure with high diagnostic accuracy in the evaluation of chest lesions. Pneumothorax, hemorrhage and hemoptysis are usually encountered complication. Very few cases require active management.