Pre-operative atorvastatin therapy to decrease the systemic inflammatory response after coronary artery bypass grafting.

The effect of pre-operative atorvastatin on systemic inflammatory response syndrome (SIRS), often seen after coronary artery bypass grafting (CABG) was evaluated in 40 patients undergoing elective CABG. Patients were divided into two groups: group I (pre-operative LDL cholesterol > or = 100 mg/dl; n = 20) received 20 mg/day atorvastatin for at least 15 days pre-operatively; group II (pre-operative LDL cholesterol < 100 mg/dl; n = 20) did not receive antihyperlipidaemic agents. All patients underwent CABG with cardiopulmonary bypass. Blood samples were taken pre-operatively and 24 h post-operatively. There were no significant differences between the two groups in terms of demographic, pre-operative or operative parameters. At 24 h post-operatively, median high-sensitivity C-reactive protein and mean interleukin-6 levels were significantly lower in group I compared with group II. There were no other significant differences in post-operative parameters between the two groups, except for duration of stay in the intensive care unit, which was shorter in group I patients. In conclusion, pre-operative atorvastatin treatment in patients undergoing elective CABG decreased inflammation parameters and could be effective in preventing SIRS.

Erdosteine ameliorates neurological outcome and oxidative stress due to ischemia/reperfusion injury in rabbit spinal cord.

OBJECTIVE: Oxygen-derived free radicals have been suggested as important in degeneration after spinal cord ischemia. The aim of this study was to investigate whether erdosteine has a protective effect against spinal cord ischemia during aortic cross clamping. MATERIALS AND METHODS: New Zealand White rabbits (n=21) were divided into three groups. In the ischemia/reperfusion group (I/R) (n=8), the infrarenal aorta of rabbits was cross clamped for 21 min and then reperfused. In erdosteine group, the administration of erdosteine solution (50 mg/kg) was started two days before aortic cross-clamping and rabbits (n=8) were subjected to ischemia and reperfusion. Animals in control group (n=5) underwent a surgical procedure similar to the other groups but the aorta was not clamped. The animals were sacrificed at 72 h and histopathological, and biochemical analyses were carried out on the lumbar spinal cords. RESULTS: Erdosteine treatment was associated with improved neurological function in the postoperative period. Histopathological examination of spinal cord tissues in erdosteine group revealed changes consistent with mild ischemic injury, but rabbits in I/R group with paraplegia had total destruction of the motor neurons. Biochemical analyses of spinal cord tissues, in the I/R group, revealed a significant increase in the superoxide dismutase, xanthine oxidase, adenosine deaminase and myeloperoxidase activities, and a significant depletion in glutathione peroxidase activity when compared to that of control rabbits. Erdosteine treatment prevented the increase of all these enzymes except adenosine deaminase. Ischemia/reperfusion produced a significant increase in the tissue malondialdehyde levels. Ischemia/reperfusion-induced increments in malondialdehyde content of the spinal cord were significantly prevented by erdosteine treatment. CONCLUSIONS: The present study demonstrated that erdosteine treatment before aortic cross clamping ameliorates neurological outcome, neuronal injury and oxidative stress in the rabbit spinal cord.

Chromosomal fragile sites and relationship between genetic predisposition to small cell lung cancer.

Fragile sites are non-staining gaps and breaks on mammalian chromosomes. Several investigators have pointed out that these sites may act as factors that predispose to specific chromosomal rearrangements that are present in some cancer cases. The expression of common fragile sites induced by aphidicolin (Apc) was evaluated on prometaphase chromosomes obtained from the peripheral blood lymphocytes of 15 patients with lung cancer, 20 of their clinically healthy family members, and 20 age-matched normal controls. As a result of cytogenetic evaluation carried out by the High Resolution Banding (HRB) technique, 1q21, 2q33, 3p14, 7q32, 13q13, 16q23, 17q21, and 22q12 are defined as fragile sites in patients and relatives. The rate of total fragile sites and 2q33, 3p14, and 16q23 are statistically significant in both patients and relatives when compared with the control group. Therefore, our results showed that common fragile sites might be unstable factors in the human genome and they can be used as suitable markers for genetic predisposition to lung cancer.

Echinococcal hydatid cyst at the right ventricle outlet with leakage to the pulmonary artery outflow causing follicular airway disease and sudden death.

Postmortem examination of a 35-year-old parous woman who died suddenly revealed a hydatid cyst mass located at the right ventricular outlet, with a grossly discernible defect opening to the pulmonary outflow tract. Pulmonary hemorrhage, follicular bronchitis, and bronchiolitis also were present, with severe acute purulent exudation in the airways. Hydatid cyst complications must be kept in mind when dealing with sudden deterioration and death in patients who are residents of regions where echinococcosis is endemic.

Injuries of large vessels in high stage neuroblastoma surgery. A case report.

Complete resection of the primary lesion in stage III neuroblastoma improves survival Neuroblastoma has a tendency towards surrounding and infiltrating the large vessels, leading to injuries during tumor resection. We operated on a stage III neuroblastoma, which resulted in the right and left common iliac artery and vein damage. The right common iliac artery and, veins were repaired by end to end anastomosis. There was a long gap between the two ends of the left common iliac artery and it was repaired using a mesenteric vein (marginal vein of the colon) graft. Digital subtraction angiography performed 6 months after the operation did not reveal any stenosis or aneurysmatic changes in the anastomoses. We conclude that short segments of large vessels may be sacrificed during the resection of neuroblastomas invading the vessel wall, and the resulting defects may be repaired by end to end anastomosis, or even by substituting mesenteric vein grafts, for the purpose of total or near total removal

Cardiac hydatid cyst causing massive pulmonary embolism.

Cardiac hydatid cyst is a rare parasitic disease. Since it may be associated with fatal complications, early diagnosis and treatment of a cardiac hydatid cyst is very important. We present a case with hydatid cyst localized in the right atrium and bilaterally in the lungs, and embolized pulmonary arteries bilaterally. The right atrial cyst localized on the interatrial septum was removed using cardiopulmonary bypass and the cyst in the right pulmonary artery was extracted by an embolectomy catheter. The patient died of pulmonary hypertension and pulmonary insufficiency three months postoperatively.

Active and passive mechanical properties of isolated arterioles from STZ-induced diabetic rats. Effect of aminoguanidine treatment.

Studies were performed to examine the effect of experimental diabetes (4-6 weeks duration) on both the passive elastic and active myogenic properties of isolated skeletal muscle arterioles. Studies were conducted on untreated streptozotocin (60 mg/kg)-induced diabetic rats and in similar rats treated daily with either amino-guanidine (25 mg/kg) or methylguanidine (25 mg/kg). First-order cremaster muscle arterioles were isolated, cannulated, and pressurized in the absence of intraluminal flow. Video microscopy was used to determine relationships between arteriolar diameter and intraluminal pressure both in the active and passive (o mmol/l Ca(2+)-2 mmol/l EGTA superfusated) tes. The measurements were used to calculate active myogenic responses, arteriolar distensibility, and stress-strain relationships. Under passive conditions, arterioles from untreated diabetic animals appeared to be stiffer and less distensible compared with similar arterioles from control animals. Under active conditions, i.e., in the presence of extracellular Ca2+, arterioles from the untreated diabetic group showed impaired myogenic reactivity as evidenced by a significant (P < 0.001) reduction in the negative slope of the pressure-diameter relationship over a physiological range of intraluminal pressures. Chronic treatment with aminoguanidine prevented the diabetes-induced changes in the active and passive properties of the isolated arterioles while treatment with methylguanidine appeared ineffective. Vasodilator responses to topically applied acetylcholine (10(-8) to 5 x 10(-6) mol/l) were significantly impaired in diabetic animals irrespective of treatment with aminoguanidine. The data indicate that experimental diabetes is associated with a decreased passive distensibility, or stiffening, of skeletal muscle arterioles that, in addition, may contribute to impaired active myogenic responses.