Effects of L-Theanine on Hepatic Ischemia-Reperfusion Injury in Rats.

OBJECTIVES: The effects of L-theanine on hepatic microcirculation during hepatic ischemia-reperfusion injury have not yet been investigated. The aim of this study was to investigate the influence of L-theanine on hepatic ischemia-reperfusion injury in rats. MATERIALS AND METHODS: Thirty-two male Sprague Dawley rats weighing 250 to 300 g were used. Rats were divided into 4 groups: sham + saline, sham + L-theanine, hepatic ischemia-reperfusion injury + saline, and hepatic ischemia-reperfusion injury + L-theanine. Hepatic ischemia-reperfusion injury in rats was induced by 60 minutes of 70% ischemia and 4 hours of reperfusion. The extent of hepatic cell injury, functional capillary density, hepatic functions, and changes in some enzyme markers in hepatic tissue were investigated in the 4 groups. RESULTS: The induction of hepatic ischemia-reperfusion injury resulted in significant increases in hepatic necrosis; serum activity of alanine aminotransferase, lactate dehydrogenase, gamma-glutamyltransferase, and tumor necrosis factor alpha; tissue activity of inducible nitric oxide synthase, myeloperoxidase, and malondialdehyde, and oxide glutathione; and H score for hypoxia-inducible factor 1-alpha in the liver. In the liver, there were significant reductions in reduced glutathione, ratio of reduced glutathione-to-oxide glutathione, and functional capillary density. The use of L-theanine improved these changes. CONCLUSIONS: L-theanine demonstrated protective effects on hepatic injury after ischemia-reperfusion injury in rats. However, new studies are needed to confirm the preventive or reducing effects of L-theanine on hepatic ischemia-reperfusion injury.

Open adrenalectomy: A 20-year review of our experience in a developing country.

Introduction: The aim of this study was to present our 20-year experience regarding open adrenalectomy (OA) during laparoscopic era in a developing country Turkey. Materials and Methods: A retrospective and descriptive study of patients with adrenal mass undergoing OA in the surgery department of our hospital, between January 1993 and January 2013, was carried out. All operations were performed by two surgeons. Results: Ninety patients who underwent OA in our clinic were reviewed retrospectively. The mean number of adrenal operations per month during this period was 0.38 ± 0.12. The patient included 35 men (38.8%) and 55 women (61.2%), with a mean age of 46.4 ± 17 years. The mean body mass index was 28.4 ± 5.25, and the mean American Society of Anesthesiologists score was 2.6 ± 0.57. The mean operative time was 88 ± 27 min. The mean maximum diameter of all the lesions was 4.8 ± 1.3 cm (range: 1.2-21 cm). The mean blood loss was 118 ± 23 ml during the operations. Postoperative complications were observed in four patients (5.5%). There was no mortality. The length of hospital stay was 6.2 ± 2.1 days. The most frequent type of the histological type was benign adenoma (48.8%). Conclusion: OA in a developing country is a safe method as an alternative for laparoscopic adrenalectomy which has a difficult learning curve.

RésuméIntroduction: Le but de cette étude est de présenter nos 20 ans dæexpérience de læadrénalectomie ouverte (OA) lors de la laparoscopie dans un pays en développement. Matériaux et méthodes: Une étude rétrospective et descriptive a été prévue dans le service de chirurgie générale de notre hôpital, incluant des patients ayant subi entre janvier 1993 et janvier 2013 une adrénalectomie ouverte pour une masse adrrénalienne. Toutes les opérations ont été effectuées par 2 chirurgiens. Résultats: Quatre-vingt-dix patients qui ont subi une adrénalectomie ouverte dans notre clinique ont été évalués rétrospectivement. Le nombre moyen dæopérations adrénaliennes par mois au cours de cette période était de 0,38 ± 0,12. Læâge moyen des patients était de 46,4 ± 17 ans: 35 (38,8%) étaient des hommes et 55 (61,2%) étaient des femmes. Læindice de masse corporelle (IMC) moyen était de 28,4 ± 5,25 et le score moyen de læAmerican Society of Anesthesiologists (ASA) était de 2,6 ± 0,57. La durée moyenne d'opération était de 88 ± 27 minutes. Le diamètre moyen de toutes les lésions était de 4,8 ± 1,3 cm (entre 1,2 et 21 cm). La quantité moyenne de saignements rencontrés au cours des opérations était de 118 ± 23 ml. Des complications postopératoires ont été observées chez quatre patients (5,5%). La mortalité næa été observée chez aucun des patients. La durée moyenne dæhospitalisation était de 6,2 ± 2,1 jours. Le type histologique le plus courant était læadénome bénin (48,8%). Conclusion: Dans un pays en développement, læadrénalectomie ouverte est une alternative sûre à læadrénalectomie laparoscopique qui a une courbe dæapprentissage difficile.

Ethyl pyruvate treatment ameliorates pancreatic damage: evidence from a rat model of acute necrotizing pancreatitis.

INTRODUCTION: Ethyl pyruvate (EP), a natural flavoring and fragrance agent, has been shown to exert anti-inflammatory and antioxidant actions. We tested the potential beneficial effects of EP in a rat model of acute necrotizing pancreatitis (ANP), a serious condition with a significant inflammatory explosion and oxidative stress. MATERIAL AND METHODS: Fifty-two adult male Sprague-Dawley rats were divided into four groups: sham + saline, sham + EP, ANP + saline, and ANP + EP. The ANP was induced by glycodeoxycholic acid and cerulein. Animals were sacrificed at 48 h and biochemical, hematological, and histological markers of ANP and inflammation were assessed. The extent of mortality, systemic cardiorespiratory variables, pancreatic microcirculation, renal/hepatic functions, acinar cell injury and enzyme markers for pancreas and lung tissues were investigated. RESULTS: The EP-treated ANP group presented significantly lower mortality than the untreated ANP group (44% (7/16) vs. 19% (3/16), respectively, p < 0.05). Administration of EP resulted in significantly lower levels of IL-6 (ANP + saline: 5470 ±280 vs. ANP + EP: 2250 ±180 pg/ml, p < 0.05). Compared with the ANP group, the ANP + EP group had a lower pancreatic necrosis score (1.45 ±0.2 vs. 0.96 ±0.2, p < 0.05). Moreover, intraperitoneal EP administration had a positive effect on most indices of pancreatitis (amylase and alanine transaminase levels) and lung damage (except lung malondialdehyde levels) as they decreased towards baseline values. CONCLUSIONS: The results from this experimental study indicate that EP, a nontoxic chemical approved by the Food and Drug Administration as a food additive, provides positive effects on the course of pancreatitis, suggesting potential usefulness in management of ANP.

The anti-inflammatory effect of hydrogen sulphide on acute necrotizing pancreatitis in rats.

OBJECTIVE: The aim of this study was to investigate the dose-dependent anti-inflammatory effect of the Hydrogen sulfidedonor sodiumhydrosulphide on acute necrotizing pancreatitis in rats. MATERIAL AND METHODS: A total of 42 male Sprague-Dawley rats were divided into 4 groups: sham+saline (group 1), sham+NaHS (group 2), acute necrotizing pancreatitis+saline (group 3), and acute necrotizing pancreatitis+NaHS (group 4). Acute pancreatitis was induced in rats in groups 3 and 4 with the infusion of glycodeoxycholic acidinto the biliopancreatic canal and infusion of cerulein parenterally. In group 4, 10 mg/kg NaHS was administered intraperitoneally after cerulein infusion. Tests for liver and kidney function, interleukin-6, lactate dehydrogenase in bronchoalveolar lavage, and malonyaldehyde and myeloperoxidase activities in pancreas and lung tissue were performed, and histopathologic examination of pancreas was conducted. RESULTS: In groups 3, a significant increase in amylase, alanine aminotransferase, urea, interleukine-6, lungmalondialdehyde and myeloperoxidase activities, pancreas myeloperoxidase activity, edema, and necrosis in pancreas tissue and a significant decrease in serum calcium levels were detected (p<0.05). In group 4, addition of NaHS resulted in a significant decrease in lactate dehydrogenase level in bronchoalveolar lavage, amount of urea, lung myeloperoxidase activity, and pancreatic edema (p<0.05). CONCLUSION: Although not in pancreatic necrosis, hydrogen sulphide has an anti-inflammatory effect especially in the inflammatory process in lung and edema in pancreasin acute necrotizing pancreatitis at particular doses. With further studies evaluating the anti-inflammatory effects of hydrogen sulphide, we believe it can be used in the treatment of edematous acute pancreatitis and the related complications in lungs.

N-acetylcysteine amid reduces pancreatic damage in a rat model of acute necrotizing pancreatitis.

BACKGROUND: Inflammatory explosion and oxidative stress are important mechanisms of injury in acute necrotizing pancreatitis (ANP). This study investigated the effects of N-acetylcysteine amid (NACA), a novel cell-permeant antioxidant with anti-inflammatory activity, on experimental ANP in rats. MATERIALS AND METHODS: Fifty-two adult male Sprague-Dawley rats were used, and ANP was induced by cerulein. The animals were divided into four groups which were sham + saline, sham + NACA, ANP + saline, and ANP + NACA. NACA (2.2 mg/kg, i.p) was administered for 6 h, after the induction of ANP. The extent of acinar cell injury, mortality, systemic cardiorespiratory variables, functional capillary density, renal/hepatic functions, and changes in some enzyme markers for pancreas and lung tissues were investigated. RESULTS: Induction of ANP increased mortality from 0% in the sham group to 43.75% in the ANP + saline group (P < 0.05), and administration of NACA significantly reduced mortality to 12.5% (P < 0.05). Induction of ANP also caused increases in pancreatic necrosis, serum amylase, alanine aminotransferase (ALT), interleukin-6, LDH in bronchoalveolar lavage fluid, serum urea, tissue myeloperoxidase in pancreas and lung tissues and malondialdehyde. There was less pronounced increase in these parameters in NACA treated group. Compared with ANP group, ANP + NACA group had lower levels of pancreatic necrosis (0.5 ± 0.2 versus 1.45 ± 0.2, P < 0.05) and inflammation (0.6 ± 0.2 versus 1.29 ± 00.3, P < 0.05) scores. CONCLUSIONS: Administration of NACA significantly decreased the ANP-induced mortality and also provided significant improvements in hemodynamic changes. The obtained positive effects of NACA on the course of pancreatitis indicates its potential usefulness in the management of ANP.

A 20-year study on 190 patients with primary hyperparathyroidism in a developing country: Turkey experience.

The aim of this study was to present our 20-year experience regarding primary hyperparathyroidism (PHPT). PHPT patients who underwent parathyroidectomy in our clinic were reviewed retrospectively. There were 190 PHPT patients, of whom 137 were asymptomatic (72%). The mean serum calcium at the time of diagnosis was 11.9 ± 2.2 mg/dL. The mean parathyroid hormone (PTH) level was 467 ± 78 pg/mL. Ultrasonography (USG) identified all abnormal glands accurately (82.6%) and Technetium-99m sestamibi scintigraphy (MIBI) was used in 89.4% of the patients and magnetic resonance imaging (MRI) in 61%. The common use of USG and MIBI detected 92% of the lesions. Bilateral neck exploration (BNE) was performed in 12.2% of the patients and focused unilateral neck exploration (FUNE) in the remaining 87.8%. Surgical intervention was unsuccessful in 1 patient (0.5%). The conversion ratio from FUNE to BNE was 5.2%. The mean operation time and mean hospital stay decreased significantly in patients with FUNE. Pathologic examination revealed single adenoma in 93% of the patients. New imaging techniques result in the conversion of surgical treatments of PHPT. FUNE in parathyroidectomy performed by an experienced surgeon may provide successful treatment rates.

Effects of glutamine alone on the acute necrotizing pancreatitis in rats.

BACKGROUND: The effects of the glutamine on the acute pancreatitis are controversial in the clinical and experimental studies. The aim of this study was to investigate the influence of glutamine alone on acute necrotizing pancreatitis (ANP) induced by glycodeoxycholic acid in rats. MATERIAL AND METHODS: Fifty-two male Sprague-Dawley rats weighing 300-350 g were used. Rats were divided into four groups as sham + saline, sham + glutamine, ANP + saline and ANP + glutamine. ANP in rats was induced by glycodeoxycholic acid. The extent of acinar cell injury, mortality, systemic cardiorespiratory variables, functional capillary density, renal/hepatic functions, and changes in some enzyme markers for pancreatic and lung tissue were investigated during ANP in rats. RESULTS: The induction of ANP resulted in a significant increase in the mortality rate, pancreatic necrosis, and serum activity of amylase, alanine aminotransferase, interleukin-6, lactate dehydrogenase in bronchoalveolar lavage fluid, serum concentration of urea, and tissue activity of myeloperoxidase and malondialdehyde in the pancreas and lung, and a significant decrease in concentrations of calcium, blood pressure, urine output, pO2, and functional capillary density. The use of glutamine alone improved these changes. CONCLUSIONS: Glutamine demonstrated beneficial effect on the course of ANP in rats. Therefore, it may be used by itself in the treatment of acute pancreatitis.

Diagnostic efficacy of the diffusion weighted imaging in the characterization of different types of breast lesions.

PURPOSE: To evaluate the diagnostic efficacy of quantitative Diffusion-weighted imaging (DWI) in the characterization of breast lesions of mass and non-mass enhancement (NME) types. MATERIALS AND METHODS: After the institutional review board gave approval, DWI exams of 267 women with 212 suspicious masses, 73 NMEs were retrospectively analyzed. Apparent diffusion coefficients (ADCs) of benign and malignant lesions were compared. Cutoff values were obtained by receiver operating characteristics analysis. Diagnostic accuracies of DWI for masses and NMEs were compared with the use of Chi-square test. The effect of the lesions histologic subtypes and size on diagnostic accuracies was evaluated. RESULTS: ADCs were significantly lower in malignants than in benigns for both masses (0.75 versus 1.21 × 10(-3) mm(2) /s,) and NMEs (0.79 versus 1.06 × 10(-3) mm(2) /s)(P < 0.001). Cutoff value was 0.90 × 10(-3) mm(2) /s for both lesion types. The accuracy of DWI was lower in NMEs (76.7%) than masses (89.2%) (P = 0.008) unrelated to lesion size. There was more overlap in ADCs of the benign and malignant NMEs due to the lower ADCs of the benign histologies of this group. CONCLUSION: Despite the lower diagnostic accuracy of DWI in NMEs, it could be helpful in the characterization of suspicious breast lesions of both mass and NME types.

Hormone-secreting large adrenal ganglioneuroma in an adult patient: a case report and review of literature.

BACKGROUND. Ganglioneuromas (GNs) are neural crest cell-derived tumors and rarely occur in the adrenal gland. They are usually asymptomatic and hormonally silent. The majority of cases are detected incidentally during work-up for unrelated conditions. Hormone-secreting pure adrenal GNs in adults are extremely rare. To date, only four cases have been reported in the English literature. CASE REPORT. We describe an adult case of endocrinologically active adrenal GN incidentally diagnosed in a 64-year-old male patient with history of uncontrolled hypertension. On physical examination, he had a blood pressure (BP) of 160/100 mmHg. Abdominal computed tomography and magnetic resonance imaging showed a large solid tumor (8.5 × 7.5 × 7 cm) in the right adrenal gland. Urinary levels of norepinephrine, normetanephrine, vanillylmandelic acid and dopamin were elevated, although urinary level of epinephrine was suppressed. Right adrenalectomy was performed for treatment purposes. The histological diagnosis of the resected tumor was adrenal GN. CONCLUSIONS. Hormone-secreting pure adrenal GN occurs very rarely in adults and preoperative diagnosis is difficult. Adrenal GN may present with hormonal activity such as increased secretion of catecholamines and their metabolites. There are no specific diagnostic signs and symptoms discriminating GN and pheochromocytoma. Therefore, histopathological examination need for a definitive diagnosis of adrenal GN. The prognosis after completed surgical resection without further therapy seems to be excellent. To our knowledge, the present case is the second report that describes hormone-secreting pure adrenal GN in an adult from Turkey in the English literature. We discuss this case and review the literature on this unusual entity.

An evaluation of five different dressing materials on split-thickness skin graft donor site and full-thickness cutaneous wounds: an experimental study.

The objective of this study was to investigate the healing effect of five different products on split-thickness skin graft (STSG) donor sites and full-thickness cutaneous wounds (FTCWs) using an occlusive dressing model. Six groups were included: 1 control and 5 experimental groups, with a total of 24 rats, using an occlusive dressing model. STSG donor sites and FTCWs were established in two separate areas, to the right and left on the animals' backs. Wound sites were dressed with one of the following materials: fine mesh gauze, microporous polysaccharide hemosphere (MPH), clinoptilolite, alginate, hydrogel or biosynthetic wound dressing (Biobran(®) ). These materials were compared in terms of healing rate, healing quality and histopathological findings. Occlusive dressings were applied to each wound on days 0, 3, 5, 7, 10 and 14. Area measurements were taken using images of each dressing. The alginate and clinoptilolite groups gave the best healing rate results for both STSG donor sites (P = 0·003) and FTCWs (P = 0·003). MPH came third in each group. The alginate group produced better results in terms of healing quality criteria, followed by hydrogel, MPH, clinoptilolite and Biobran(®) , in that order. Statistically significant results were obtained in all groups compared to the control group (P < 0·0007). Rapid and good healing quality for both the STSG donor sites and FTCWs were obtained with alginate. Healing with clinoptilolite and MPH was rapid, but poor quality, while slower but good healing quality was obtained with hydrogel. Slower and worse quality healing was obtained with Biobran(®) .

Effects of clotrimazol on the acute necrotizing pancreatitis in rats.

This study aims to investigate the influence of clotrimazol (CLTZ) on acute necrotizing pancreatitis (ANP) induced by glycodeoxycholic acid in rats. Rats were divided into five groups as sham + saline, sham + CLTZ, sham + polyethylene glycol, ANP + saline, and ANP + CLTZ. ANP in rats was induced by glycodeoxycholic acid. The extent of acinar cell injury, mortality, systemic cardiorespiratory variables, functional capillary density (FCD), renal/hepatic functions, and changes in some enzyme markers for pancreatic and lung tissue were investigated during ANP in rats. The use of CLTZ after the induction of ANP resulted in a significant decrease in the mortality rate, pancreatic necrosis, and serum activity of amylase, alanine aminotransferase, interleukin-6, lactate dehydrogenase in bronchoalveolar lavage fluid, serum concentration of urea, and tissue activity of myeloperoxidase, and malondialdehyde in the pancreas and lung and a significant increase in concentrations of calcium, blood pressure, urine output, pO2, and FCD. This study showed that CLTZ demonstrated beneficial effect on the course of ANP in rats. Therefore, it may be used in the treatment of acute pancreatitis.

A study on 107 patients with acute mesenteric ischemia over 30 years.

Acute mesenteric ischemia (AMI) is a life threatening cause of acute abdomen. The purpose of this study is to define risk factors that predict the adverse outcome of AMI and to present our experience in the last 30 years. Hospital records and clinical data of 107 patients undergoing surgical intervention for AMI during the last 30 year period were reviewed and clinical outcomes as well as factors influencing mortality were analyzed. Mesenteric arterial thrombosis, arterial embolism and nonocclusive mesenteric ischemia (NOMI) were the cause of AMI in 68 (63.6%), 28 (26%), and 11 patients (10.2%), respectively. Abdominal pain was the most common presenting symptom (90.6%). Peritonitis was observed in 96 patients (89.7%) and 24 patients (22.4%) were in shock. Abdominal ultrasonography was performed in 46 patients (42%), abdominal CT angiography in 36 patients (33%) and mesenteric angiography in 12 patients (10.5%). All patients were operated and 11 (10%) patients underwent a second-look operation. Bowel resection was necessary in 101 patients (93.4%) during the initial operation and in seven patients (6.5%) during the second-look operation. The hospital mortality was 55.1%. Mortality was mainly due to multiorgan failure (43%). Diabetes mellitus, use of digoxine and antiplatelet drugs, duration of the symptoms until before surgery, existence of shock, low levels of the pH and bicarbonate and re-laparotomy were found to be negative predictors of the perioperative mortality. The use of total parenteral nutrition and CT angiography was found to be a protective factor against mortality. A high index of suspicion with prompt diagnostic evaluation with CT angiography may reduce time prior to surgical intervention which may lead to improved patient survival.

MDCT with multiplanar reconstruction in the preoperative local staging of rectal tumor.

OBJECTIVE: To evaluate the accuracy of MDCT with multiplanar reconstruction in the preoperative local staging of rectal tumor. MATERIALS AND METHODS: Thirty-seven patients with rectal tumor underwent preoperative MDCT. Two radiologists evaluated the depth of tumor invasion (T staging), regional lymph node involvement (N staging) and mesorectal fascia involvement on axial, sagittal, and coronal multiplanar reconstruction images in consensus. MDCT findings were compared with pathologic results, which served as the reference standard. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were assessed. RESULTS: Overall accuracy was 86% in T staging, 84% in N staging, 89% in International Union Against Cancer (UICC) Staging, and 94.5% in the prediction of mesorectal fascia involvement. CONCLUSION: MDCT with multiplanar reconstruction is an accurate technique in the preoperative local staging of rectal tumor.

Contribution of diffusion-weighted imaging to dynamic contrast-enhanced MRI in the characterization of breast tumors.

OBJECTIVE: The purpose of our study was to evaluate the diagnostic value of an imaging protocol that combines dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI) in patients with suspicious breast lesions and to determine if additional information provided by DWI improves the diagnostic value of breast MRI. MATERIALS AND METHODS: Eighty-four patients with breast tumors (37 benign, 47 malignant) underwent DCE-MRI and DWI before biopsy. Morphologic and kinetic analyses were performed on DCE-MRI and findings were classified according to the BI-RADS lexicon. Apparent diffusion coefficient (ADC) values were calculated from the DWI. The ADCs of the benign and malignant lesions were compared. For the combined MRI protocol, morphologic kinetic features and ADCs were evaluated together. Diagnostic values of DCE-MRI, DWI, and combined MRI were calculated. RESULTS: Median ADCs of the benign and malignant lesions were 1.26 × 10(-3) mm(2)/s and 0.75 × 10(-3) mm(2)/s, respectively. Cutoff value of 0.92 × 10(-3) mm(2)/s for ADC provided 91.5% sensitivity and 86.5% specificity. DCE-MRI alone showed 97.9% sensitivity and 75.7% specificity. The combination of DCE-MRI with DWI provided 95.7% sensitivity and 89.2% specificity. The specificity of breast MRI improved by 13.5% (p = 0.063) without a significant decrease in the sensitivity (p = 1.000). CONCLUSION: The combination of DWI and DCE-MRI has the potential to increase the specificity of breast MRI.

Contrast-enhanced MR angiography of the breast: Evaluation of ipsilateral increased vascularity and adjacent vessel sign in the characterization of breast lesions.

OBJECTIVE: The purpose of this study was to investigate the role of evaluation of breast vascularity with contrast-enhanced MR angiography in the differentiation of malignant from benign lesions. MATERIALS AND METHODS: Contrast-enhanced 3D MR angiograms of the breasts of 102 patients with unilateral and histopathologically confirmed breast lesions were evaluated retrospectively. All images were evaluated for both ipsilateral increased vascularity and adjacent vessel sign, and the values of these signs in the diagnosis of malignancy were assessed. RESULTS: Histopathologic analysis of 102 patients revealed 50 malignant and 52 benign results. In 31 of the 50 patients with breast cancer and in 11 of the 52 patients with benign lesions, ipsilateral breast vascularity was increased. The resulting sensitivity and specificity of ipsilateral increased vascularity were 62% and 79%. The adjacent vessel sign was present in 37 of the 50 patients with breast cancer and six of the 50 patients with benign lesions. The resulting sensitivity and specificity of the adjacent vessel sign were 74% and 89%. The overall accuracies of ipsilateral increased vascularity and the adjacent vessel sign were 71% and 81%. CONCLUSION: Both ipsilateral increased vascularity and the adjacent vessel sign were found to be associated with breast cancer in a significant percentage of patients. The adjacent vessel sign is more practical and generally applicable. There is a borderline significance in favor of the higher accuracy of the adjacent vessel sign in comparison with ipsilateral increased vascularity (p = 0.043).

Effects of caffeic acid phenethyl ester on pancreatitis in rats.

BACKGROUND: This study investigated the effect of caffeic acid phenethyl ester (CAPE) on acute necrotizing pancreatitis (ANP) induced by glycodeoxycholic acid in rats. CAPE, an active component of honeybee propolis, has previously been determined to have antioxidant, anti-inflammatory, antiviral, and anticancer activities. MATERIALS AND METHODS: Forty-eight rats were divided into four groups of 12. Group 1 animals received intraductal saline and intravenous saline infusion treatment. Group 2 was given intraductal saline and intraperitoneal CAPE infusion treatment. ANP was induced in the animals in group 3 (ANP with saline infusion), and group 4 had induced ANP plus CAPE infusion treatment (ANP with CAPE infusion). Sampling was performed 48 h after treatment. RESULTS: ANP induction significantly increased mortality rate, pancreatic necrosis, and bacterial infection in pancreatic and extrapancreatic organs. ANP also increased levels of amylase and alanine aminotransferase (ALT) in serum, increased levels of urea and lactate dehydrogenase in bronchoalveolar lavage fluid (BAL LDH), increased the activities of myeloperoxidase (MPO) and malondialdehyde (MDA) in pancreas and lung tissue, and decreased the serum calcium levels. The use of CAPE did not significantly reduce the mortality rate but significantly reduced the ALT and BAL LDH levels, the activities of MPO and MDA in the pancreas, the activity of MDA in the lungs, and pancreatic damage. The administration of CAPE did not reduce the bacterial infection. CONCLUSIONS: These results indicate that CAPE had beneficial effects on the course of ANP in rats and suggest that CAPE shows promise as a treatment for ANP.

Effects of enalaprilat on acute necrotizing pancreatitis in rats.

The aim of this study was to investigate the influence of enalaprilat on acute necrotizing pancreatitis (ANP) induced by glycodeoxycholic acid in rats. The induction of ANP resulted in a significant increase in the mortality rate, pancreatic necrosis, serum activity of amylase, alanine aminotransferase (ALT), and interleukin-6 (IL-6), lactate dehydrogenase (LDH) in bronchoalveolar lavage (BAL) fluid, serum concentration of urea, and tissue activity of myeloperoxidase (MPO) and maondialdehyde (MDA) in the pancreas and lung, and a significant decrease in concentrations of calcium, blood pressure, urine output and p0(2). The use of enalaprilat inhibited the changes in urine output, blood pressure, serum concentration of urea, p0(2), and tissue activity of MPO and MDA in the pancreas and lungs. It reduced the mortality and pancreatic damage. Enalaprilat demonstrated a beneficial effect on the course of ANP in rats; therefore, it may be used in the treatment of acute pancreatitis.

The effects of pentoxifylline on liver regeneration after portal vein ligation in rats.

AIM: To determine the effects of pentoxifylline, a methyl xanthine derivative on hepatic cell production of uninterferred lobe after portal vein branch ligation. METHODS: Sixty-six rats were randomly allocated into 9 groups with 8 rats in PVL groups and 6 rats in sham operation groups. The portal branches of the median and the lateral liver lobes, corresponding to approximately 70% of the liver volume were ligated in the PVL groups. The control group received 0.9% NaCl solution. The rats in the treatment groups received pentoxifylline at the dose of 50 mg/kg/dy. After 1, 2, 4 days of portal vein ligation in both PVL and PVNL lobes the levels of adenine nucleotides were determined and flowcytometric analysis of cell cycles were performed. RESULTS: On the first day of portal branch ligation energy charge was significantly lower, in pentoxifylline treated group comparing to pentoxifylline untreated group, both in PVL and PVNL lobes (P<0.05). Proliferative indexes were 0.38 and 0.29 in pentoxifylline treated and pentoxifylline untreated PVNL lobes respectively (P<0.05). CONCLUSION: Pentoxifylline treatment resulted in an increase of percentage of calls entering mitosis phase on the first day after PVL, somehow accelerating the regeneration process.

Effects of dual inhibitor of cyclooxygenase and 5-lipoxygenase on acute necrotizing pancreatitis in rats.

BACKGROUND/AIMS: The aim of this study was to investigate the influence of dual inhibitor of cyclooxygenase and 5-lipoxygenase (ER-34122) on acute necrotizing pancreatitis (ANP) induced by glycodeoxycholic acid in rats. METHODOLOGY: ANP was induced in 96 rats by standardized intraductal glycodeoxycholic acid infusion and intravenous cerulein infusion. Rats were divided into six groups (6 rats in each group): Sham + saline, sham + ER-34122, which was dissolved in hydroxypropylmetylcellulose (TC-5RW), sham + TC-5RW, ANP + saline, ANP + ER-34122 and ANP + TC-5RW. Six hours after ANP induction ER-34122 (30 mg/kg), saline or TC-5RW was given by feeding tube. At the 12th hour, routine cardio-respirator, renal parameters were monitored to assess organ function. Serum amylase, alanine amino transferase (ALT), interleukin 6 (IL-6), lactate dehydrogenase (LDH) in bronchoalveolar lavage (BAL) fluid, serum concentration of urea, tissue activity of myeloperoxidase (MPO) and malondialdehyde (MDA) in pancreas and lung were measured. Pancreas histology was examined. In the second part of the study 60 rats were studied in four groups similar to first part. Survival of all rats was monitored for 24 hours. RESULTS: The induction of ANP resulted in significant increase in mortality rate, pancreatic necrosis and serum activity of amylase, ALT, IL-6, LDH in BAL fluid, serum concentration of urea, tissue activity of MPO and MDA in pancreas and lung, and significant decrease of serum concentrations of calcium, blood pressure, urine output and pO2. NAC did not change serum activity of amylase. The use of ER-34122 inhibited the changes in blood pressure, pO2, serum activity of ALT, pancreatic MPO and MDA levels, partially urine output, LDH level in BAL fluid and pancreatic damage. But ER-34122 could not effect the changes, such as serum activity of amylase, IL-6, serum concentration of urea and calcium, MPO and MDA levels in lung and the mortality rate. CONCLUSIONS: The use of ER-34122 has a limited value on the course of ANP. It has no role in the treatment of ANP.

MDCT cholangiography with volume rendering for the assessment of patients with biliary obstruction.

OBJECTIVE: We sought to evaluate the diagnostic utility of MDCT cholangiography with volume rendering in the evaluation of patients with suspected biliary tree obstruction. SUBJECTS AND METHODS: MDCT was performed in 34 patients who were thought to have biliary obstruction. Portal venous phase scanning was initiated 70 sec after the IV infusion of 150 mL of contrast agent, and no cholangiographic contrast agent was administered. Three-dimensional MDCT cholangiographic images were produced using volume rendering. ERCP was performed in 26 patients, and percutaneous transhepatic cholangiography (PTC) was performed in five patients; 17 patients underwent biopsy or surgery. The findings on MDCT cholangiography were compared with those of ERCP, PTC, biopsy, or surgery. RESULTS: The correct diagnosis was made on MDCT cholangiography for 14 (93%) of the 15 patients with a biliary stone and in 16 (94%) of the 17 patients with malignant biliary obstruction. Microlithiasis in one patient could not be detected on MDCT cholangiography. One patient with polypoid adenocarcinoma and one patient with normal findings were incorrectly diagnosed with a biliary stone on the basis of MDCT cholangiography. In one of the two patients with a benign stricture, the stricture was incorrectly diagnosed as malignant. For the diagnosis of biliary stone, sensitivity and specificity of MDCT cholangiography were 93% and 89%, respectively. For the diagnosis of malignant obstruction, sensitivity and specificity were both 94%. The accuracy of the technique for the diagnosis of the cause of biliary obstruction was 83.3%. CONCLUSION: MDCT cholangiography with volume rendering is a noninvasive and fast imaging technique with high sensitivity and specificity for the diagnosis of the cause of biliary tree obstruction. It is a promising diagnostic tool for the assessment of patients with bile duct obstructions.