Effect of growth hormone, hyperbaric oxygen and combined therapy on the gastric serosa.

AIM: To investigate the role of growth hormone (GH), hyperbaric oxygen therapy (HBOT) and combined therapy on the intestinal neomucosa formation of the gastric serosa. METHODS: Forty-eight male Wistar-albino rats, weighing 250-280 g, were used in this study. The rats were divided into four groups (n = 12): Group 1, control, gastric serosal patch; Group 2, gastric serosal patch + GH; Group 3, gastric serosal patch + HBOT; and Group 4, gastric serosal patch + GH + HBOT. Abdominal access was achieved through a midline incision, and after the 1-cm-long defect was created in the jejunum, a 1 cm × 1 cm patch of the gastric corpus was anastomosed to the jejunal defect. Venous blood samples were taken to determine the insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3) basal levels. HBOT was performed in Groups 3 and 4. In Groups 2 and 4, human GH was given subcutaneously at a dose of 2 mg per kg/d for 28 d, beginning on the operation day. All animals were sacrificed 60 d after surgery. The jejunal segment and the gastric anastomotic area were excised for histological examination. The inflammatory process, granulation, collagen deposition and fibroblast activity at the neomucosa formation were studied and scored. Additionally, the villus density, villus height, and crypt depth were counted and recorded. The measurements of villus height and crypt depth were calculated with an ocular micrometer. New vessel growth was determined by calculatingeach new vessel in a 1 mm(2) area. RESULTS: In the histological comparison of groups, no significant differences were observed between the control group and Groups 2 and 3 with respect to epithelialization, granulation, fibroblastic activity and the inflammatory process, but significant differences were present between the control group and all others groups (Groups 2-4) with respect to angiogenesis (P < 0.01) and collagen deposition (P < 0.05, P < 0.01). Significant differences between the control group and Group 4 were also observed with respect to epithelialization and fibroblastic activity (P < 0.01 and P < 0.05, respectively). There were significant differences in villus density in all of groups compared with the control group (P < 0.05). Crypt depth was significantly greater in Group 4 than in the control group (P < 0.05), but no other groups had deeper crypts. However, villus height was significantly longer in Groups 2 and 4 than in the control group (P < 0.05). The comparison of groups revealed, significant difference between control group and Groups 2 and 4) with respect to the levels of IGF-1 and IGFBP-3 (P < 0.01) 3 wk after the operation. CONCLUSION: HBOT or GH and combined therapy augmented on neomucosal formation. The use of combined therapy produced a synergistic effect on the histological, morphological and functional parameters.

The effects of melatonin on postoperative intraabdominal adhesion formation.

PURPOSE: Postoperative intraabdominal adhesion formation is a major clinical problem. No previous study was found, reporting the relationship between adhesion formation and melatonin administration, but melatonin, a strong antioxidant, is recognized to have certain effects on the progression of adhesion formation mechanism. It was therefore decided to investigate the effects of melatonin on postoperative adhesion formation. MATERIALS AND METHODS: A total number of 24 Sprague-Dawley rats were utilized. Three groups, described as: Group A, sham laparatomy (n=8), Group B, rats that underwent only ischemia-reperfusion (n=8) and Group C, rats that underwent ischemia- reperfusion and were given 10 mg/kg melatonin solution i.v. (n=8). For Groups B and C, the ileocolic vessels were clamped. Blood glutathione peroxidase levels of all study groups were assessed, then microscopic and macroscopic adhesion scores were evaluated. RESULTS: Glutathione peroxidase levels of the melatonin-treated group were significantly higher and fibroblast proliferation and macroscopic adhesion scores were significantly lower, than in the melatonin-free group. CONCLUSION: The results of this study supported the hypothesis, that melatonin administration may prevent intraabdominal adhesions resulting from surgery.

Evaluation of pulmonary alveolo-capillary permeability in Type 2 diabetes mellitus: using technetium 99mTc-DTPA aerosol scintigraphy and carbon monoxide diffusion capacity.

The thickening of alveolar basement membrane is found in autopsies, along with microvascular pathologies, in Type 1 and 2 diabetes mellitus (DM). To detect the function and permeability of alveolar basement membrane, carbon monoxide diffusion capacity (DLCO) and technetium 99m-diethyltriaminepentaaceticacid ((99m)Tc-DTPA) aerosol scintigraphy methods can be used. The aim of this study was to determine alveolar basement membrane damage using these two methods. Nineteen women and 6 men, nonsmoking, Type 2 DM cases, without any lung and/or heart disease and who had neither anemia nor obesity, made up the patient group. They were compared with six female and nine male healthy cases who had the same characteristics with the diabetes cases. All of the cases DLCO were measured by single-breath method and (99m)Tc-DTPA aerosol scintigraphy was performed. DLCO showed no difference between the two groups. Aerosol scintigraphy was significantly decreased in the diabetic group (P=.01). In cases with >5 years of diabetic duration (P<.01), in cases with glycolized hemoglobin (HbA(1c)) 8% (P<.05), and in microangiopathic cases (P<.01), alveolo-capillary permeability was significantly decreased than in the control group. Among the same groups, no significant difference could be detected for DLCO. The permeability of alveolar basement membrane can reduce in respect to diabetes duration and poor metabolic control. According to our investigation, (99m)Tc-DTPA aerosol scintigraphy method is more sensitive than DLCO method for determining these pathologies.

Melatonin administration acutely decreases the diffusing capacity of carbon monoxide in human lungs.

BACKGROUND: Most physiological measurements of the pulmonary diffusing capacity use carbon monoxide (CO) as a tracer gas. Similar to CO, melatonin binds the hemoglobin in the blood. OBJECTIVE: The present study was designed to assess the effect of exogenous melatonin administration on pulmonary functions including diffusing capacity for carbon monoxide (DL(CO)) in healthy subjects. METHODS: The study was performed in a randomized, double-blind, placebo-controlled manner. DL(CO) was measured in 22 healthy male volunteers (age 18-25 years) who were randomized to melatonin (n = 11) and placebo administration (n = 11). At baseline, DL(CO), alveolar volume (V(A)) and other spirometric parameters such as forced expiratory volume in 1 s (FEV(1)), forced vital capacity (FVC), peak expiratory flow (PEF) and maximal voluntary ventilation (MVV) were measured. DL(CO) was then corrected for the hemoglobin concentration. Measurements were repeated in a double-blind fashion 60 min after the administration of melatonin (1 mg) or placebo. RESULTS: DL(CO) was significantly decreased (39.31 +/- 4.75 vs. 34.82 +/- 6.18 ml/min/mm Hg) 60 min after the melatonin administration (p = 0.01), while FEV(1), FVC, FEV(1)/FVC, PEF and MVV values did not demonstrate significant differences. Placebo administration did not result in significant alteration in any of these parameters. CONCLUSIONS: In healthy subjects, oral administration of melatonin acutely influences the DL(CO) without affecting other pulmonary function test results. We conclude that melatonin may have a reducing effect on the DL(CO) in the lungs.

Evaluation of alveolo-capillary permeability in thyrotoxicosis using Tc-99m DTPA aerosol scintigraphy.

Surfactant secreted from type II pneumocytes plays an important role in alveolo-capillary permeability. In thyrotoxicosis, high levels of T3 receptors detected at these cells might affect the alveolo-capillary permeability due to increased serum thyroid hormone levels. The results by CO-diffusion capacity measurement in thyrotoxicosis are conflicting. Changes in alveolo-capillary membrane permeability resulting from thyrotoxicosis are not well established yet. This prompted us to investigate the alveolo-capillary permeability in thyrotoxic patients in comparison with CO-diffusing capacity. For this aim twenty-two non-smoking thyrotoxic patients (before treatment) and fifteen healthy voluntary controls underwent 99mTc-DTPA aerosol scintigraphy. CO-diffusing and pulmonary function tests were performed in all subjects. After ventilation of radiotracer through a nebulizer for 15 minutes, 30 dynamic images (1 frame/minute) were taken from both lungs. ROI's were drawn over both lung areas, and the time-activity curves were generated. Then clearance half time (CT1/2) for radioaerosol was obtained. CT1/2 of thyrotoxic patients did not differ from that of the controls: 77.9 +/- 25.9 min vs. 79.4 +/- 22.3 min; p > 0.05. Similar result was found for CO-diffusion parameters. Also there was no significant correlation between CT1/2 and CO-diffusion parameters. We concluded that in patients with thyrotoxicosis, the alveolo-capillary permeability is unaffected. Further experimental research is needed to establish the possible effects of thyroid hormones on alveolo-capillary membrane.