Oxidative stress and DNA damage due to one-lung ventilation.

AIM: One-lung ventilation (OLV) is an anesthesia technique used to provide visualization in thoracoscopic lung surgeries and increase surgical site visibility during operation. In OLV, atelectasis occurs and blood from the lung participates in circulation without receiving oxygen. We designed a prospective study on patients we implemented surgery in order to research whether OLV leads to oxidative stress and DNA damage or not. METHODS: It was taken 5cc blood samples 4 times from these patients in the postoperative preparatory stage (T1), on the 60th minute after the start of OLV (T2), on the 60th minute after the termination of OLV (T3) and 24 hours after surgery (T4). Total antioxidant capacity (TAC), total oxidant status (TOS), oxidative stress index (OSI) values were examined with regards to DNA damages in the blood samples taken. RESULTS: DNA damage was statistically increased with OLV compared to baseline level (p<0.05) and statistically decreased in 24 hour (p<0.05). TAC level was statistically decreased with OLV compared to baseline level and statistically increased in 24 hour (p<0.05 ). TOS level was statistically increased with OLV compared to baseline level (p<0.05) and statistically decreased in 24 hour (p<0.05 ). OSI level was statistically increased with OLV compared to baseline level (p<0.05) and statistically decreased in 24 hour (p<0.05 ). CONCLUSION: To the best of our knowledge this is the first study showing DNA damage in thoracic surgery which was operated with OLV. This DNA damage found to be decreased in first postoperative day and might be related to changes in oxidative status of this patient group. KEY WORDS: Oxidative stress, lung ventilation, DNA damage.

The Efficacy of Platelet-Rich Plasma in the Treatment of Rib Fractures.

Background Rib fracture is the most common result of thoracic traumas. Intrapulmonary shunt, alveolar capillary membrane damage, intra-alveolar hemorrhage, and hypoxia may develop following rib fractures. Therefore, prompt treatment is important. The aim of this experimental study was to analyze the effects of platelet-rich plasma (PRP) on rib fractures to secure a speedier and more efficient treatment method. Materials and Methods The study involved 18 New Zealand white rabbits, randomly divided into three groups as Group 1, the sham group with no surgical intervention; Group 2, the control group in which simple rib fractures were applied and no treatment; and Group 3, in which rib fractures were applied and then PRP treatment was administered. Results The mean recovery plate thickness measurements were found to be statistically significantly higher in the PRP group compared with the other groups (p < 0.005). A thicker fibrotic cell proliferation and the formation of many capillaries were observed around the growth plate in the PRP group compared with the other groups. These structures were lesser in the control group compared with the PRP group and at the lowest level in the sham group. Larger and distinct callus formation was observed and a new intramedullary field in the PRP group. Conclusions PRP is a reliable and effective autologous product with minimal side effects, which can be considered as an alternative treatment in patients with rib fractures and used easily in pseudoarthrosis, surgical fracture, or flail chest.

Intraperitoneal Administration of Silymarin Protects End Organs from Multivisceral Ischemia/Reperfusion Injury in a Rat Model.

Objective: To determine whether intraperitoneal silymarin administration has favorable effects on the heart, lungs, kidney, and liver and on oxidative stress in a rat model of supraceliac aorta ischemia/reperfusion injury. Methods: Thirty male Wistar albino rats were divided equally into three groups: sham, control, and silymarin. The control and silymarin groups underwent supraceliac aortic occlusion for 45 min, followed by a 60 min period of reperfusion under terminal anesthesia. In the silymarin group, silymarin was administered intraperitoneally during ischemia at a dose of 200 mg/kg. Rats were euthanized using terminal anesthesia, and blood was collected from the inferior vena cava for total antioxidant capacity, total oxidative status, and oxidative stress index measurement. Lungs, heart, liver and kidney tissues were histologically examined. Results: Ischemia/reperfusion injury significantly increased histopathological damage as well as the total oxidative status and oxidative stress index levels in the blood samples. The silymarin group incurred significantly lesser damage to the lungs, liver and kidneys than the control group, while no differences were observed in the myocardium. Furthermore, the silymarin group had significantly lower total oxidative status and oxidative stress index levels than the control group. Conclusion: Intraperitoneal administration of silymarin reduces oxidative stress and protects the liver, kidney, and lungs from acute supraceliac abdominal aorta ischemia/reperfusion injury in the rat model.

Intraperitoneal curcumin decreased lung, renal and heart injury in abdominal aorta ischemia/reperfusion model in rat.

BACKGROUND: Previous studies have demonstrated that curcumin (CUR) has protective effects against ischemia reperfusion injury to various organs. We aimed to determine whether CUR has favorable effects on tissues and oxidative stress in abdominal aorta ischemia-reperfusion injury. MATERIALS AND METHODS: Thirty rats were divided into three groups as sham, control and treatment (CUR) group. Control and CUR groups underwent abdominal aorta ischemia for 60 min followed by a 120 min period of reperfusion. In the CUR group, CUR was given 5 min before reperfusion at a dose of 200 mg/kg via an intraperitoneal route. Total antioxidant capacity (TAC), total oxidative status (TOS), and oxidative stress index (OSI) in blood serum were measured, and lung, renal and heart tissue histopathology were evaluated with light microscopy. RESULTS: TOS and OSI activity in blood samples were statistically decreased in sham and CUR groups compared to the control group (p < 0.001 for TOS and OSI). Renal, lung, heart injury scores of sham and CUR groups were statistically decreased compared to control group (p < 0.001 for all comparisons). Histopathological examination revealed less severe lesions in CUR group than in the control group. CONCLUSION: CUR administered intraperitoneally was effective in reducing oxidative stress and histopathologic injury in an acute abdominal aorta I/R rat model.

Surgical approach for patients with unusually located hydatid cyst.

INTRODUCTION: Hydatid cyst is a parasitic disease caused by Echinococcus granulosus whose people is the intermediate host. Although this parasite can settle in any part of the human body, it is frequently seen in liver and lungs. The rate of unusual located hydatid cyst outside of liver and lungs is 13,9%. In this study, we aimed presenting unusual located hydatic cysts regarding 51 patients. MATERIAL AND METHOD: In this retrospective study, the files of the patients operated in our department between 2005 and 2012 with the diagnosis of hydatid cyst, characterized be an additional location besides liver and lung involvement and located outside of liver and lung were controlled. FINDINGS: We had a total of 51 patients between the ages of 6-79 (average age 35,34), 20 of them were men (39%) and the others were women (61%) (men/women = 1.56). The cysts outside of liver and lung were frequently seen in spleen (24/51), ovarium (9/51), intraabdominal (8/51), brain (8/51), kidney (6/51), psoas muscle (1/51), bladder (1/51), cervical lymph node (1/51), the heart(1/51) respectively. The most frequent symptom in our patients was stomachache. Besides, symptoms of cough, fever, respiratory disorder were present; only one patient suffered from hemophtysis. While 32 patient out of 51 were treated by laparotomy, 8 patients were operated with laparotomy and thoracotomy in the same session; the patient with 2 ovarian cysts was submitted to cystectomy through laparoscopic surgery. As a patient had a cyst both in brain and liver, he was submutted to laparotomy and craniotomy. 46 cysts in 9 patients with lung involvement were treated with lung resections: 7 wedges resection and 2 segmentectomies. The other lung cysts of the analysed patients were treated by cystectomy and capitonnage. Bile leakage was detected in a total of 7 patients: 3 of them were treated with T tube drainage and the others were endoscopically healed by means of ERCP. CONCLUSION: The incidence of hydatid cyst, which is an important health problem in endemic areas, can be reduced by means of simple preventive measures. Its basic treatment is surgery. Main objective of the surgery should be parenchyma sparing while taking off completely the cysts. Although the disease is frequently seen in liver and lung, other organ involvements should be considered. Thus, it does not matter where hydatid cyst is seen, abdomen and thorax should be attentively controlled by the simplest imaging method also outside of clinical symptoms. Abdomen and thorax imaging should be carried out at least once in the two following years to have an early detection of an eventual recurrence.