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Aim of this experimental study is to verify the protective effect of molsidomine on the renal function and structural modifications in the ischemia-reperfusion rat kidney. Sixty-eight male Sprague-Dawley rats, which were right nephrectomized and occluded left renal artery for 60 minutes were used. Group I (n = 10) Sham-Operated animals, which only underwent right nephrectomy. Group II (n = 20) Untreated ischemic rats, which underwent left renal ischemia by occlusion of the renal artery for 60 minutes before blood flow was restored. Group III (n = 18) Molsidomine treated ischemic rats, Group IV (n = 20) L-NAME (N(G)-nitro-L-arginine methyl ester) treated ischemic rats. Serum creatinine and blood urea nitrogen (BUN) were measured daily and biopsies were obtained from the remaining left kidneys. At seventh day, 55% and 50% of the rats remained alive at the G-II and G-IV respectively. Molsidomine treated rats (G-III) were alive and healthy at day 7. The serum creatinine and BUN levels were significantly higher in G-II and G-IV when compared with the sham-operated group (G-I). G-III rats showed a rapid return to the normal serum creatinine and BUN values on postoperative days 1, 2, 3 and 4. The obtained values in G-II were significantly lower in comparison to the values of G-II and G-IV. The most severe damage (grade 3 to 4) was determined in the kidneys of rats from GII or GIV. The degree of renal tubular damage in GIII was evaluated as grade 1 or 2 tubular damage according to Jablonkski's scale. Our findings suggested that the administration of molsidomine may vanquish the pernicious effects of warm ischemia on kidney structure and function.

Background/Purpose: Colonic injuries are rare in childhood, but when they do occur, they are mostly associated with penetrating abdominal injuries. The primary repair of colon injuries without stoma is still controversial within surgical experience, and the potential risk factors affecting morbidity and mortality is not sufficiently known. Methods: Between 1985 and 1997, 34 children presenting with traumatic colonic perforations were reevaluated by analyzing the relationship between the overall morbidity and mortality and the potential risk factors. Results: Of the 34 children in the case study, 27 boys and 7 girls, there were 7 (21%) isolated colonic injuries. The remaining 27 (79%) patients showed colonic injuries most frequently associated with the small bowel, the liver, and the bladder. Localization of injury was distributed thus: 21% in the right colon, 29% in the transverse colon, and 50% in the left colon. Primary repair, with or without intestinal resection, was performed in 27 (79%) of the patients. In total, postoperative complications occurred in 10 (29%) of the patients. Risk factors such as age, abdominal contamination, and associated abdominal organ injuries were found significant in these complications, however, the mechanism of injury, shock, blood transfusion, and localization of injury were not correlated significantly to postoperative complications. "`Flint's Colon Grading System" was used to ascertain the sensitivity of trauma scoring systems for postoperative complications. Conclusion: Colonic wounds can be repaired primarily without the need of colostomy in the majority of cases in children when the required selections are established. J Pediatr Surg 35:1799-1804. Copyright © 2000 by W.B. Saunders Company.

We analysed the inter-relationships of the cause and the type of trauma, the presence of pelvic fracture, the associated intraabdominal organ injuries,and the morbidity and mortality rates in 154 patients presenting and being treated for UGT between 1983 and 1997.The cause of injury was blunt in 77% of cases and penetrating in 13%. The most frequently injured organs were kidney followed by urethra and bladder. Bowels, liver and spleen were the most frequently associated injured organs. Moreover, bladder injuries were strongly associated with bowel injuries (p < 0.0001). Hemodynamically normal 49 children with minor or major kidney injuries were managed conservatively. Hemodynamically non-stable 11 patients were explored.The majority of urogenital injuries can be managed conservatively evenwhen associated with intraabdominal organ injuries. Solid genitourinary organ injuries may accompany more frequently to intraperitoneal solidorgan injury. Whereas, non-solid genitourinary organ injuries may more frequently associated with injuries of intraperitoneal hollow viscus.

Objective To evaluate the protective effect of interleukin 10 (IL-10) on biochemical and histopathologic changes in experimental testicular ischemia or reperfusion injury (RI) in rats. Methods Sprague-Dawley rats were randomly divided into 3 groups, each containing 7 rats; sham-control, I-R/untreated group, and I/R treated with IL-10. The ischemia period was 6 hours, and orchiectomy was performed after 1 hour of detorsion. IL-10 was given intraperitoneally in a period of 10 minutes before reperfusion. In all groups, ipsilateral orchiectomies were performed to make histologic examination and biochemical analysis such as malondialdehyde, glutathione peroxidase, and myeloperoxidase (MPO). Results IL-10 treatment significantly decreased the I-R–induced elevation in testes malondialdehyde levels. In the I-R/IL-10–treated group, testes glutathione peroxidase levels were increased compared with the I-R/untreated group rats. MPO activities were significantly increased in the testes tissues of the I-R/untreated group. However, in the I-R/IL-10–treated group, MPO levels significantly decreased. Histopathologically, in the I-R/untreated group rats, edema, congestion, hemorrhage among seminiferous tubules, and necrosis of the germinal cells were predominant features in sections. The testicular injury score was lower in the IL-10–treated group rats compared with the I-R/untreated group. Conclusion IL-10 might play a protective role in reducing reperfusion injury.

Intestinal ischemia and reperfusion (I-R) injury of different causes, including cardiac insufficiency, sepsis, vasodepressant and cardiodepressant drugs, and complications of long-lasting surgery, represents a major clinical problem.The purpose of the present study was to investigate whether lithospermic acid (LA) can reduce oxidative stress and histological damage in the rat small bowel subjected to mesenteric I-R injury.The study was performed on three groups of animals, each composed of 7 rats: the SO (sham operation) group, the I-R/Untreated group and the I-R/LA (I-R plus LA pretreatment) group. Intestinal ischemia for 45 minutes and reperfusion for 60 minutes were applied. Ileum specimens were obtained to determine the tissue level of malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (CAT) and myeloperoxidase (MPO) activities and histological changes.Untreated intestinal I-R resulted in increased tissue MDA and MPO levels and diminished SOD and GPx activities. These changes were found to be almost reversed in the LA treatment group. Histopathologically, the intestinal injury in rats treated with LA was less than the untreated I-R group.Lithospermic acid attenuates mesenteric ischemia reperfusion injury in rat intestines by increasing tissue SOD and GPx activities and decreasing MDA and MPO levels. Lithospermic acid also improves morphological alterations which occurred after periods of reperfusion.

Magnetic compression anastomoses (magnamosis) have been previously described for gastrointestinal, biliary, urinary, and vascular anastomoses. Objectives. Herein, the authors report the creation of a magnetic compression colostomy (magnacolostomy) using a simple technique in rats.Animals were randomized into two groups (n = 8, each): a magnetic colostomy (MC) group and a control surgical tube colostomy (SC) group. In the MC group, the first magnetic ball (3 mm) was rectally introduced into the rat colon. The second magnetic ball (4 mm) was placed subcutaneously into the left quadrant, and the two magnetic balls strongly coupled. On postoperative day 20 for the MC group and postoperative day 10 in the SC group, the rats were sacrificed and the colostomies evaluated macroscopically, histopathologically, and for mechanical burst testing.From the macroscopic evaluation, two rats failed to form the colostomy canal due to colostomy catheter and magnetic ball removal. In the remaining rats, evidence of complications were not observed. Two rats in the MC group displayed mild adhesion and all rats in the SC group displayed moderate adhesion. No significant differences between the burst pressures were observed. However, a significant difference (p0.001) between the procedure times of the MC (4.13 +/- 1.00 minutes) and SC groups (14.25 +/- 2.05 minutes) was evident.Magnacolostomy is an easy and effective procedure in the rat model and presents a safe, minimally invasive alternative to current tube colostomy procedures such as antegrade continence enemas, percutaneous endoscopic, and colostomy/cecostomy in humans.

WOS:000310828400003 PubMed: 23175922 Background : To examine the clinico-epidemiological details of paediatric caustic substance ingestion (CSI) accidents in Turkey. To present the new DROOL Score (DS), which the authors developed based on the severity and duration of initial signs and symptoms (ISSs) to predict oesophageal stricture (OS) without endoscopy, and to present our management protocol based on immediate feeding, early detection, and oesophageal balloon dilatation (OBD) of OS with no barium study. Methods : We prospectively reviewed the records of 202 children admitted with a history of CSI within 48 hours. Patient, parent, caustic substance, and accident characteristics were noted in detail. Patients were fed as soon as they could swallow saliva. Diagnoses of OS were made earlier via timely endoscopy (mean, 10-14 days after CSI) for patients with persistent dysphagia and OBD was started earlier. ISSs and DSs were analyzed. OS treatment results were compared between early (10-14 days) and late (>= 21 days) dilatation patients who were referred for OBD by other hospitals. Results : In total, 144 (71%) incidents occurred within the parents' home and 44 (22%) occurred at another individual's home. The caustic substances were frequently sold in non-original containers (68.8%). Most patients' parents had low incomes and were poorly educated. Ninety-six children had no ISSs, whereas 106 patients had ISSs. Seventeen symptomatic patients had persistent dysphagia after 10-14 days. Timely endoscopy was performed within 10-14 days for these patients only, and OS was diagnosed and successfully treated. DSs were significantly lower in patients with OS than those without (p < 0.001). A DS = 21 days). OBD can then also be started earlier in these patients.

Splenic hemangiopericytoma is a very rare tumor. So far only 10 patients (9 adults, 1 child) have been reported in the literature and all of them were treated with total splenectomy. Herein, we report the first infant case of the splenic hemangiopericytoma in a 10-month-old girl and the first case that was treated with partial splenectomy for splenic hemangiopericytoma.

Magnetic compression anastomosis is used for gastrointestinal, biliary, and urinary anastomoses. We have developed a simple magnetic compression gastrostomy technique in rats.Animals were randomized into two groups (n = 12 each): magnetic gastrostomy (MG) and surgical gastrostomy (SG) (control). In the MG group, a magnetic insertion catheter was coupled with the first magnetic ball and introduced transorally into the stomach. A second magnetic ball was placed subcutaneously into the left upper quadrant. The two magnetic balls (4 mm) were strongly coupled together. On postoperative day (PD) 20 (MG group) and PD10 (SG group), rats were killed, gastrostomies were evaluated macroscopically and histopathologically, and mechanical burst testing was performed.Two animals died due to suspected leaks. Macroscopic evaluation indicated no gastrostomy canal in one rat in each group. Mild adhesion was observed in two rats in the MG group. Moderate adhesion was observed in all rats in the SG group. No significant differences were observed in burst pressure between the two groups (means: MG group, 143 mmHg, n = 9; SG group, 159 mmHg, n = 8).Magnetic compression gastrostomy can be performed easily in rats, and may be developed in future as a simple alternative to some gastrostomy procedures in humans.

Primary gastric adenocarcinoma is extremely rare in children. Here, we report an additional case of primary adenocarcinoma, located at the lesser curvature in a girl at the age of 2.5 years. She had no family history and no apparent underlying cause for the tumor. She died 4 months after admission despite complete resection of the mass and chemotherapy.

PURPOSE: Peripherally inserted central catheters (PICC) have been extensively used in neonates. However, insertion of these thinnest catheters is a very delicate procedure associated with a high failure rate. In our Neonatal Surgical Intensive Care Unit, we developed a very easy new PICC insertion and evaluated the neonates treated with PICCs which were inserted by using our technique as well as catheter features such as success rate, number of insertion attempts, reason for removal and complications. METHODS: Information was retrospectively collected on all 40 PICCs inserted at Kutahya Evliya Celebi Goverment Hospital and Dicle University Hospital during a 6-years period from September 2004 to September 2010. RESULTS: A total of 40 PICCs were inserted in 37 patients (26, 70% males, 11, 30% females) by using new technique. The median age of patients was 8.3 days (range 1 to 66 days) and the median weight of patients was 2365 g (range 600 to 5000 g). The vein most commonly accessed was long saphenous vein (85%). The length of PICCs in the body was 19.6 cm (range 5 cm to 30 cm). The tip was located in a central vein in all patients. Surgical abdomen was the most common cause for PICC insertion (38%). Duration of catheterization was 7.7±5.6 days (1-F 5.5 days, 2-F 8.6 days). Almost all of the PICCs were inserted successfully (40/42, success rate 95%) and in the first venipucture (36/42, 86%). Completion of therapy and removed after death were achieved with 87% of PICCs. Three minor complications were noted. Minor bleeding in the insertion site which was stopped via compression occurred in two neonates. Major complication was not seen. No deaths were directly attributed to PICCs use. CONCLUSION: The new insertion technique of the neonatal peripherally inserted central catheters may be one of the easiest and safest techniques, in comparison to previous techniques reported in the literature. OBJETIVO: Cateteres centrais de inserção periférica (PICC) têm sido usados extensivamente em neonatos. Entretanto, a inserção destes cateteres tão finos é um procedimento muito delicado associado a uma elevada taxa de falha. Em nossa Unidade de Cuidado Intensivo Neonatal, nós desenvolvemos uma técnica muito fácil de inserção de PICC e avaliamos os neonatos tratados com PICCs que foram inseridos usando nossa técnica assim como características relacionadas ao cateter tais como taxa de sucesso, número de tentativas de inserção, razão de remoção e complicações. MÉTODOS: Informações foram coletadas retrospectivamente de todos os 40 PICCs inseridos no Kutahya Evliya Celebi Goverment Hospital e Dicle University Hospital durante um período de seis anos, desde Setembro de 2004 até Setembro de 2010. RESULTADOS: Um total de 40 PICCs foi inserido em 37 pacientes (26 homens, 70%, 11 mulheres, 30%) usando a nova técnica. A idade media dos pacientes foi de 8,3 dias (variando entre 1 e 66 dias) e a mediana do peso dos pacientes foi 2365g (variando entre 600g e 5000g). A veia mais comumente acessada foi a veia safena magna (85%). O comprimento mediano do PICC no corpo foi 19,6 cm (variando entre 5 cm e 30 cm). A ponta foi alocada em uma veia central em todos os pacientes. Cirurgia abdominal foi a causa mais comum de uso do PICC (38%). A duração do cateterismo foi 7,7±5,6 dias. Quase todos os PICCs foram inseridos com sucesso (40/42, taxa de sucesso de 95%) e na primeira venopunção (36/42, 86%). O término da terapia e a remoção após morte ocorreu em 87% dos PICCs. Foram observadas três complicações menores. Pequeno sangramento no local da inserção, que parou com compressão, ocorreu em dois neonatos. Complicações importantes não foram observadas. Nenhuma morte foi diretamente atribuída ao uso do PICC. CONCLUSÃO: A nova técnica de inserção periférica de cateteres centrais em neonatos pode ser um procedimento seguro e fácil, comparando com as técnicas previamente relatadas na literatura.

Objective To report the first creation of magnetic compression cystostomy (magnacystostomy) using an easy and simple new technique in rats. Magnetic compression anastomoses (magnamosis) have been previously described for gastrointestinal, biliary, urinary, and vascular anastomoses. Methods Female rats were randomized into 2 groups (n = 10 each): a magnetic cystostomy group and a formal surgical cystostomy group as the control group. In the magnetic cystostomy group, a very small cylindrical magnet was inserted into the bladder. The external magnetic ball was placed subcutaneously into the suprapubic region, and the 2 magnets were coupled together strongly. On postoperative day 20 in the magnetic cystostomy group and day 10 in the surgical cystostomy group, the rats were killed, and the cystostomies were evaluated macroscopically, histopathologically, and by mechanical burst testing. Results In the surgical cystostomy group, 3 rats died. In the remaining rats, no evidence of complications was observed. However, mild adhesion in 1 rat in the magnetic cystostomy group and moderate adhesions in all the rats in the surgical cystostomy group were observed. No significant difference was found in burst pressure between the 2 groups (mean 162 mm Hg in the magnetic cystostomy group [n = 6] and 185 mm Hg in the surgical cystostomy [n = 5] group). However, the procedure time between the magnetic cystostomy group (7.70 ± 1.64 minutes) and surgical cystostomy group (18.50 ± 2.01 minutes) was significantly different (P Conclusion Magnacystostomy is easy and safe in the rat model and could be useful for some suprapubic cystostomy procedures in humans.

A two years old boy presented with a transanal protrusion of the ventriculoperitoneal (VP) shunt catheter. A VP shunt was inserted when the boy was six-month-old for congenital hydrocephalus. He was active and neurologically normal, with no signs of meningitis and peritoneal irritation. During laparotomy, the tube was seen entering the sigmoid colon, so the tube was cut at the point where it entered the sigmoid colon. The distal end of the protruding tube was pulled out from the anus. The sigmoid colon was repaired, and a delayed shunt revision was completed. The patient was discharged without abdominal and neurological deterioration.

Introduction: In this study, we investigate the effect of montelukast on histologic damage induced by testicular torsion-detorsion in rats. Methods: Twenty-one male Sprague-Dawley rats were separated into 3 groups, each containing 7 rats. A sham operation was performed in group 1 (control). In group 2 (ischemia-reperfusion [IR]/ untreated), 1-hour detorsion of the testis was performed after 6 hours of unilateral testicular torsion. In group 3 (I-R/dextroamphetamine), after performing the same surgical procedures as in group 2, montelukast was given intraperitoneally. In all experimental rats, ipsilateral orchiectomies were performed for histological examination and tissue malondialdehyde (MDA), glutathione and myeloperoxidase assays. Results: Montelukast treatment significantly decreased the I-Rinduced elevation in testes tissue MDA and glutathione levels were found to be preserved. The level of myeloperoxidase (MPO) activity was significantly increased in the testes tissue of the IR/ untreated group. However, in I-R/montelukast treatment group significantly decreased testes tissue MPO level. Histopathologically, the in the group 2 rats, edema, congestion, hemorrhage between seminiferous tubules and necrosis of the germinal cells were predominant features in sections. However, most of the specimens in the montelukast treated group 3 showed grades-I and II injury. Additionally, the testicular injury score was lower in group 3 rats compared with group 2. Conclusion: The current findings demonstrate that the montelukast decreased the severity of testicular injury by reversing the oxidative effects of testes I-R. Introduction : Dans cette etude, nous examinons l’effet du montelukast sur les lesions tissulaires provoquees par torsion-detorsion testiculaire chez le rat. Methodologie : Vingt-et-un rats Sprague-Dawley mâles ont ete repartis en trois groupes de 7 rats. Une operation fictive a ete realisee dans le groupe 1 (groupe temoin). Dans le groupe 2 (ischemie-reperfusion / non traite), une detorsion testiculaire d’une heure a ete realisee apres 6 heures de torsion testiculaire unilaterale. Dans le groupe 3 (ischemie-reperfusion / dextroamphetamine), on a administre du montelukast par voie intraperitoneale apres les memes interventions chirurgicales que pour le groupe 2. Chez tous les rats, une orchidectomie homolaterale a ete effectuee en vue d’un examen histologique et de mesures du malonaldehyde, du glutathion et de la myeloperoxidase dans les tissus. Resultats : Le traitement par montelukast a significativement reduit l’elevation dans les tissus testiculaires provoquee par l’ischemiereperfusion, mais les taux de malonaldehyde et de glutathion sont demeures les memes. Le niveau d’activite de la myeloperoxidase (MPO) a significativement augmente dans les tissus testiculaires du groupe ayant subi l’ischemie-reperfusion sans traitement subsequent. Cependant, dans le groupe ayant subi l’ischemiereperfusion avec traitement par montelukast, le taux de MPO dans les tissus testiculaires avait significativement diminue. Selon les examens d’histopathologie, dans le groupe 2, de l’oedeme, de la congestion, des hemorragies entre les tubules seminiferes et une necrose des cellules germinales etaient les caracteristiques predominantes observees dans les coupes. Par comparaison, la plupart des echantillons du groupe 3 (traite par montelukast) presentaient des lesions de stade I et II. En outre, le score de lesions testiculaires etait plus faible dans le groupe 3 que dans le groupe 2. Conclusion : Les observations actuelles montrent que l’administration de montelukast diminue la gravite des lesions testiculaires en annulant les effets oxydatifs de l’ischemie-reperfusion des testicules.

This study was aimed to evaluate the analgesic efficacy duration of analgesia, and side effects of two different doses of caudal neostigmine used with levobupivacaine in children.Sixty boys, between 5 months and 5 years, undergoing genitourinary surgery were allocated randomly to one of three groups (n =20 each). Group I patients received caudal 0.25% levobupivacaine (1 ml.kg(-1)) alone. Groups II and III patients received neostigmine (2 and 4 microg.kg(-1) respectively) together with levobupivacaine used in the same does as Group I. Pain scores were assessed using Children's and Infant's Postoperative Pain Scale (CHIPPS) at 15th (t(1)) min after arrival to postanesthetic care unit, and 1st (t(2)), 2nd (t(3)), 3rd (t(4)), 4th (t(5)), 8th (t(6)), 16th (t(7)), and 24th (t(8)) hour postoperatively. Duration of analgesia, amount of additional analgesic (paracetamol), score of motor blockade and complications were recorded for 24 h postoperatively, and compared between groups.CHIPPS scores were higher during t(2), t(3), t(6), t(7), and t(8) periods, duration of analgesia was shorter, and total analgesic consumption was higher in Group I compare to neostigmine groups (P0.05). Duration of postoperative analgesia and total analgesic consumption were similar in Groups II and III (P0.05). Adverse effects were not different between three groups.Caudal neostigmine in doses of 2 and 4 microg.kg(-1) with levobupivacaine extends the duration of analgesia without increasing the incidence of adverse effects, and 2 microg.kg(-1) seems to be the optimal dose, as higher dose has no further advantages.

A 22-year-old man was admitted with abdominal pain, nausea and vomiting secondary to ingestion of multiple foreign bodies. He was found to be in increasing distress with an increase in abdominal pain and distention and no passage of foreign bodies. Patient underwent a laparotomy. Foreign bodies removed from perforated distal ileum included 8 big size (10 cm) plastic clothes pegs, a 10 cm pencil, couple of stones, a 10 cm wood nail, nail scissors and a small size battery. In case of foreign body ingestion, especially in mentally-ill patients, the patient should be carefully examined because of the potential risk of obstruction and bowel perforation, more so, if the foreign body is a battery which can puncture causing corrosive injury as well.

To evaluate the effects of N-acetylcysteine NAC and vitamin C on pulmonary histological alterations in bile duct-ligated (BDL) rats.The current study was conducted in the Department of Pediatric Surgery, Medical School of Abant Izzet Baysal University, Bolu, Turkey between May 2007 and July 2007. Thirty-five males Sprague-Dawley rats, weighing 210-240 grams, were used. Group 1 rats (n=7) underwent only laparotomy. Group 2 rats (n=7) were subjected to BDL. Group 3 rats (n=7) were subjected to BDL and given vitamin C. Group 4 rats (n=7) were subjected to BDL and given NAC. Group 5 rats (n=7) were subjected to BDL and received NAC plus vitamin C. At the end of the 3 week period, biochemical and histological evaluations were processed.Total bilirubin values were decreased in group 5 compared to group 2, 3, and 4. Group 2 showed massive interstitial infiltration with inflammatory cells. Interstitial edema, focal cuboidal metaplasias of alveolar lining cells, and severely damaged pulmonary architecture were noted. Treatment of rats with NAC and vitamin C produced a significant reduction in the histopathological score compared to groups 2, 3, and 4.The combination of NAC and vitamin C reduced lung histological alterations in BDL rats with afforded by each drug individually.

H, Ozturk/0000-0001-5608-5742; Tuncer, Mehmet Cudi/0000-0001-7317-5467; WOS: 000263508000016 PubMed: 18787973 This study was designed to determine the effect of molsidomine (MO), a precursor of nitric oxide (NO) donor, on hypoxia inducible factor alpha (HIF-1 alpha) and Sonic hedgehog (Shh) levels considered to be involved in the development of testes ischemia/reperfusion (I-R) injury. Torsions were created by rotating ipsilateral testes 720A degrees in a clockwise direction for 6 h and 1-h detorsion of the testis was performed. A sham operation was performed in group 1 (control, n = 7). In group 2 (I-R/Untreated, n = 7), following 6 h of unilateral testicular torsion, 1-h detorsion of the testis was performed. No drug was given. In group 3 (I-R/MO), after performing the same surgical procedure as in group 2, a NO donor MO was given at the starting time of reperfusion. In group 4 (I-R/L-NAME), after performing the same surgical procedure as in group 2, L-NAME was given at the starting time of reperfusion. Testes malondialdehyde (MDA) levels were determined as well as examining the testes histologically. Treatment of rats with MO produced a significant reduction in the levels of MDA and histopathological score compared to testes I-R groups. The Sonic hedgehog (Shh) expression in the basement membrane of the tubuli seminiferi, and sertoli and germinal cells in testicular tissue, were greatly increased in the I-R/MO group compared to groups 1, 2 and 4. Additionally, the HIF-1 alpha expression in the interstitial spaces in testicular tissue were greatly increased in the I-R/MO group. The results suggest that MO has a protective effect against ischemia/reperfusion injury in rat testes and may affect Shh and HIF-1 alpha signaling pathway.

BACKGROUND: We evaluated the effect of continuous fluid resuscitation on the hemodynamic response and survival following massive splenic injury (MSI) in rats. METHODS: Uncontrolled hemorrhagic shock was produced in 70 rats by sharp transaction. The animals were randomized into 7 groups: group 1 (n = 10), sham-operated; group 2 (n = 10), MSI was untreated and splenectomy was performed after 45 min; group 3 (n = 10), MSI treated after 15 min with 7.5 ml/kg/h of 7.5% NaCl (HTS-7.5) and splenectomy after 45 min; group 4 (n = 10), MSI treated with 35 mL/kg/h Ringers lactate (RL) solution (RL-35) and splenectomy; group 5 (n = 10), MSI treated with 70 mL/kg/h RL (RL-70) and splenectomy; group 6 (n = 10), MSI treated with 35 mL/kg/h of 0.9% NaCl (NaCl-35) and splenectomy; and group 7 (n = 10), MSI treated with 70 mL/kg/h of 0.9% NaCl (NaCl-70) and splenectomy. RESULTS: Small and high volume ringer lactate (RL-35, RL-70) infusion increased MAP, pulse rate, and hematocrit level compared to untreated group (p < 0.001); however, best response was inquired by RL-35. TBL with RL-35 (22% of blood volume) was less than RL-70 and other groups (p < 0.01). High rate of early mortality (33.4% at 30 min) with HTS infusion was noticed. TBL was moderately increased in NaCl-70 (32% of blood volume) compared to NaCl-35 (30% of blood volume). Survival time was better with RL-35 and RL-70 at 60 min and 120 min, respectively, compared to other groups (p < 0.05). CONCLUSIONS: In conclusion, continuous infusion of HTS, RL-70, NaCl-35 and NaCl-70 following massive splenic injury in uncontrolled hemorrhagic shock resulted in a significant increase in intra-abdominal bleeding compared to lower dose RL-35 and greatest survival time was noticed with RL-35 and RL-70 at 60 and 120 min, respectively.

The purpose of the present study was to determine whether a correlation exits between the main trauma scoring systems and the activation of inflammatory cells and mediators such as interleukin-(IL-) 1beta, IL-6, IL-8 and tumor necrosis factor alpha (TNF-alpha) after trauma, and moreover to assess if any of these can be used to predict the outcome in patients under care at a trauma center. Forty-seven children (37 boys, 10 girls) presenting with blunt trauma, were evaluated by an analysis of the relationship between overall mortality and potential risk factors. Admission data, including serum IL-1beta, IL-6, IL-8, TNF-alpha, pediatric trauma score (PTS), and injury severity score (ISS), were collected and analyzed. In descriptive statistics for independent variables, some prognostic factors such as IL-8 (P = 0.04), and ISS (P = 0.004) were significant in their relationship to mortality. In the univariate statistical analysis some other risk factors such as IL-8 (P = 0.004),20 TNF-alpha (P = 0.04), and ISS (P = 0.007) were significant in their relationship to mortality. The relative risk of developing mortality was higher than two for each of the following risk factors:10 ages,25 IL-6, 10-20 TNF-alpha,20 TNF-alpha, PTSor= 8, and ISS15. There was a positive correlation between IL-8 (r = 0.31, P = 0.33), ISS (r = 0.31, P = 0.0001), and mortality. There was also a correlation with ISS and IL-8 (r = 0.32, P = 0.02). ISS, and the serum IL-8 level are the most important determinants of clinical outcome in critically injured patients. A correlation exits between IL-8 and mortality and between ISS and IL-8.

An enlarged accessory spleen, 10 x 8 x 6 cm in diameter, adjoining the spleen appearing as a mass on CT and ultrasonography is reported herein. Accessory spleen is an ectopic mass of healthy splenic tissue separate from the main body of the spleen. It should be considered the differential diagnosis of an enlarged mass in the left upper quadrant.

To determine contemporary patterns of presentation and trends in the management and outcome of 51 newborn infants with intestinal atresia.We retrospectively reviewed 51 cases of intestinal atresia between January 1983 and February 2003. Clinical data included antenatal history, age, gender, weight, presenting symptoms and signs, diagnostic procedures, location and type of atresia, associated abnormalities, surgical treatment, associated problems, morbidity, mortality and plans of treatment.Twenty children had duodenal obstruction, 24 had jejunoileal atresia, and 7 had colonic atresia. Approximately one-fourth of patients associated with duodenal atresia had preterm delivery and all patients with jejunoileal and colonic atresia were full term. Clinical features such as vomiting, abdominal distention, delayed meconium passage and jaundice were more frequent in jejunoileal atresia patients. Other associated organ anomalies particularly Down's syndrome were more frequent in duodenal atresia patients. A duodeno-duodenostomy was preferred in most of the patients with duodenal atresia and annular pancreas; duodenotomy and web excision for those with duodenal webs; and resection with end-to-end anastomosis for those with jejunoileal atresia. In all patients with colonic atresia, colostomy procedure was performed as the first step of surgery.Experienced neonatal care and prompt total parenteral nutrition by placing central line during surgery may improve the outcome of such patients.

WOS:000246884800001 PubMed: 17497436 This study was designed to determine the effect of L-arginine on hypoxia inducible factor alpha (HIF-1 alpha) and Sonic hedgehog (Shh) levels considered to be involved in the development of ischemia/reperfusion (I/R) injury. Unilaterally nephrectomized Sprague-Dawley rats were subjected to 60 minutes of left renal ischeMia followed by 45 minutes of reperfusion. Group I were sham-operated animals; group 2, I-R/Untreated animals; and group 3, I-R/L-Arg-treated animals. Serum creatinine, blood urea nitrogen (BUN), and kidney malondialdehyde (MDA eve were determined as well as examining the kidneys histologicall The treatment of rats with L-Arg produced a significant reduction in the levels of BUN, creatinine, MDA, and histopathological score compared to renal I/R groups. The Shh expression in the tubulus epithelia were intensely increased in the I-R/L-Arg group when compared to that of the Sham-control and the I-R/ untreated groups. Additionally, the HIF-fix expression in the tubulus epithelia and the interstitial spaces were intensely increased in the I-R/L-Arg group. These findings suggest that NO reduces the renal dysfunction associated with I/R of the kidney and may act as a trigger to induce Shh and HIF-1 activity.

The aim of this study was to investigate the role of adhesion molecules in epididymal injury induced by ischemia-reperfusion (I-R) in the rats. About 20 male Sprague-Dawley rats were separated into two groups. A sham operation was performed in group 1 (control). In group 2 (I-R), following 6 h of unilateral spermatic cord torsion, 1-h detorsion of the testis was performed. Then, epididymides were removed to measure the tissue levels of malondialdehyde (MDA) and to make histological examination. Malondialdehyde values increased in group 2. In group 2, the rats demonstrated significant disorganization of the epithelium and loss of microvilli in the epididymal tissue. No abnormal microscopic findings of the epididymis of the rats in the control group. The tenascin expression in the interstitial area of the epididymis was intense in group 2. Intercellular adhesion molecule-1 (ICAM-1) expression by intense brown staining was seen along the basement membrane in epididymal tissue from I-R group rats. The microvillus sites of the epithelia in I-R group were stained mildly by lectin. The increased expression of adhesion molecules found in epididymal injury induced during of postischemic reperfusion may implicate importance of inflammatory infiltration.

The aim of this study was to determine the effects of a synthetic serine protease inhibitor, gabexate mesilate (GM), in rats with ischemia-reperfusion (I-R) damage due to unilateral testicular torsion. Thirty male Sprague-Dawley rats were separated into three groups, each containing ten rats. A sham operation was performed in group 1 (control). In group 2 (I-R/untreated), 1 h detorsion of the testis was performed after 6 h of unilateral testicular torsion. In group 3 (I-R/GM), after performing the same surgical procedures as in group II, gabexate mesilate was given intravenously. In all experimental rats, ipsilateral orchiectomies were performed for histological examination and measuring the tissue levels of malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px). MDA values and the testicular injury score decreased and SOD, CAT and GSH-Px values increased in the GM-treated group compared to the I-R/untreated group. The Tc-99m pertechnetate uptake ratio and the perfusion index were significantly decreased in the group 2 compared to the group 1 and 3 rats. In group 3, these values were significantly increased compared to group 2. Most of the specimens in the GM-treated group showed grade-I testicular injury. However, the injuries in the I-R/untreated rats varied between grade-III and grade-IV. The results of this study show that GM may play a role in reducing the injury caused by I-R.

This study was designed to determine the possible protective effect of mibefradil on renal ischemia/reperfusion (I/R) injury. Unilaterally nephrectomized Sprague-Dawley rats were subjected to 60 min of left renal ischemia followed by 45 min of reperfusion. Group 1 were sham-operated animals; group 2, I/R/untreated animals; and group III, I/R/mibefradil-treated animals. A 99mTc-DTPA scan was taken to measure kidney perfusion, glomerular filtration rate (GFR) and the time elapsed from isotope injection to the maximum of the curve. Serum creatinine, blood urea nitrogen (BUN), kidney malondialdehyde (MDA) level were determined as well as examining the kidneys histologically. Treatment of rats with mibefradil produced a significant reduction in the serum levels of creatinine and urea nitrogen. T-max-sec (renal perfusion) was significantly lower in group 2 than in groups 1 and 3. The GFR was markedly greater in group 3 than in the group 2. The Tmax-min was significantly greater in group 2 than in group 3. Mibefradil treatment significantly decreased the MDA levels. The histopathologic score was significantly less in the group 3 rats compared with group 2 rats. Kidneys of group 2 rats showed tubular cell swelling, cellular vacuolization, pyknotic nuclei, medullary congestion, and moderate to severe necrosis. Treatment with mibefradil preserved the normal morphology of the kidney and shows normal glomeruli and slight edema of the tubular cells. These findings suggest that mibefradil reduces the renal dysfunction associated with I/R of the kidney.

The aim of this study was to evaluate the relation between severity of injury and the early activation of interleukins in multiple-injured patients. Ninety-nine patients with multiple injuries were included in this prospective study. Plasma levels of interleukin (IL)-1, IL-2, IL-6, IL-8 and TNF-α were measured. Injury Severity Score (ISS), Revised Trauma Score (RTS), Glasgow Coma Score (GCS) and the Acute Physiology and Chronic Health Evaluation II (APACHE-II) were all recorded. Of the 99 patients, 82 were male and 17 were female. The mean age was 26.6 ± 20.7 years. The mortality rate for this series was 17%. Patients who died from trauma exhibited a significant increase for IL-2, IL-6 and IL-8 in comparison with patients who survived. Significant differences for ISS, RTS and GCS were found between survivors and non-survivors. Values in all patients with ISS >16 were increased and these increases were significant for IL-6 and IL-2. These data show that the initial increase of IL-2, IL-6 and IL-8 might predict the patients with a high possibility of mortality and a significant increase of IL-2 and IL-6 in patients with ISS >16 might be used in a new developed trauma score combined with ISS as an indicator for the injury severity.

To determine the effect of continuous limited fluid resuscitation on the hemodynamic response and survival in rats in a model of uncontrolled hemorrhage shock due to massive splenic injury (MSI) and head injury (HI).An experimental study.Dicle University Animal Research Laboratory, Turkey, between January and February 2005.Seventy Sprague-Dawley rats were used in this study. Group 1 rats (n=10) was sham-operated. In group 2 (n=10), only Massive Splenic Injury (MSI) was performed and untreated. In group 3 (n=10), only head injury (HI) was performed and untreated. In group 4 (n=10), HI and MSI were performed and were untreated. In group 5 (n=10), HI and MSI were performed and 15 minutes later treated with 7.5% NaCl. In group 6 (n=10), HI and MSI were performed, and rats were treated with Ringer's Lactate (RL) solution. In group 7 (n=10), HI and MSI were performed, rats were treated with 0.9 % NaCl. In groups 2,4,5,6 and 7 midline incision was reopened and splenectomy was performed at 45 minutes.In group 4 rats, Mean Arterial Pressure (MAP) was decreased from 104 +/- 6.1 mmHg to 75 +/- 19.5 mmHg at 15 minutes; heart rate decreased from 357 +/- 24.9 beats/min to 321 +/- 62.1 beats/min and hematocrit decreased from 46 +/- 1.3 % to 43 +/- 2.5 % (p0.01). Similar early changes in MAP, heart rate and hematocrit were observed in groups 5, 6, and 7, at 15 minutes. At 45,60 and 120 minutes, in fluid resuscitated rats (group 5,6,7) MAP, heart rate and hematocrit values were measured higher than group 2 and 4 (p0.01 for all). At 120 min. in group 6, hematocrit was higher than group 4, 5 and 7, in group 6, total blood loss after splenectomy was calculated at 20 +/- 2.4% of blood volume and was the best value compared to other fluid resuscitated group 5 and 7 (28% and 27% of blood volume) (p0.01). Mortality was lower in all fluid resuscitated groups when compared to group 3 and 4 (p0.05). The median survival time was again higher in fluid resuscitated groups.Continuous infusion of 7.5% NaCl, RL and 0.9 % NaCl following uncontrolled hemorrhagic shock with massive splenic injury and combined head injury resulted in better survival and RL did not increase abdominal bleeding before splenectomy was performed.

Objective Hypospadias is an increasingly common condition, and many procedures have been described for operative correction. We reviewed our experience of different techniques of one-stage hypospadias repair. Materials and methods We retrospectively reviewed 107 hypospadic boys who were younger than 15 years between January 1986 and June 2003. We included all patients who underwent one-stage hypospadias repair. All patients were evaluated for age, type of hypospadias, associated anomalies, surgical technique, and morbidity rate. The functional and cosmetic results were evaluated at 1 month, 6 months and 1 year postoperatively. Univariate analysis was done to identify those variables that might serve as interdependent predictors of postoperative complications. Results The median age was 7 years (6 months to 13 years). Severe chordee was observed in 15 patients. The majority of cases were anterior hypospadias (53%), while the majority of complications were observed in the middle group (62%). Cosmetic and functional results were satisfactory in the majority of the patients. Complications included 16 fistulae (15%) and 11 meatal stenoses (10%). Some prognostic factors such as age, insertion of a suprapubic cystostomy tube, suture structure, and time of catheter removal did not significantly affect the risk of complication, whereas some other factors such as associated anomalies, severe chordee, middle and posterior hypospadias, and use of a pedicle island flap were significant in their relation to the complication rate. Conclusion Such possible risk factors as severe chordee, middle and posterior localized hypospadias, and use of a pedicle island flap may increase the postoperative complication rate. There is no gold-standard technique for hypospadias repair; the procedure of choice should depend on the individual anatomy of the penis. The long-term outcome after puberty has to be awaited.

Objectives To evaluate the long-term outcome of posterior urethral rupture due to pelvic trauma. Methods We retrospectively reviewed the records of 49 children with posterior urethral rupture from 1986 to 2000. The urologic evaluation at the last follow-up visit was made by the same surgeon and included physical examination, ultrasonography, simultaneous retrograde urethrography, and voiding cystourethrography, as well as cystourethroscopy in some cases. The long-term urologic results were determined by voiding function, continence and erectile function, and semen analysis. Results The mean follow-up was 12 years (range 4 to 17). The average age was 8 years at the time of trauma and 20 years at the last follow-up visit. Primary realignment (22 patients), immediate repair (8), and delayed repair (16) were performed for posterior urethral rupture. Urethral continuity was achieved in 97.9% of patients, and 30 (61.2%) were free of symptoms. The overall rate of long-term complications was significantly greater in patients with a prostatic urethra location injury, and it was similar for the three surgical procedures. Conclusions The results of our study have shown that, apart from partial injury, all types of surgical treatment are equally problematic, with similar complication rates and long-term morbidity. The procedure of choice should be individualized, depending on the anatomy and the extent of the urethral injury, stability of the patient, and presence of additional injuries.

The purpose of this study was to evaluate essential prerequisites for a selective non-operative approach in children with solid organ injuries due to blunt abdominal trauma, and to determine the predictive value of two different trauma scoring systems: the Injury Severity Score (ISS) and the Paediatric Trauma Score (PTS). A retrospective review of children who were admitted with blunt abdominal solid organ injuries to a paediatric trauma centre between January 1986 and September 2001 was performed. Hepatic, splenic, and renal injuries were graded, based on the American Association for the Surgery of Trauma (AAST) Organ Injury Scale (ranged from grade I to IV). The patients were treated non-operatively or operatively and the two groups were compared for variables such as age, blood transfusion, ISS, PTS, length of hospitalisation, morbidity and mortality rate. Two hundred and five patients (147 boys and 58 girls) entered in this study. Median age was 7 years (1 - 15 yrs). The most common cause of trauma was falls (50%). Abdominal organ injuries were present in all patients with the spleen as the most commonly injured organ (111 patients). Fifty-one patients (32%) had additional extra-abdominal organ injuries. Thirty-five (17%) patients were treated operatively, while 170 (83%) were treated non-operatively. Post-traumatic complications developed in 10 patients treated operatively versus 4 patients treated non-operatively. Four patients died due to multiple organ failure (2 non-operative, 2 operative). When compared to the non-operative group, higher transfusion requirements (p < 0.05), a higher ISS (p < 0.01), lower PTS values (p = 0.0001), a longer hospitalisation period (p = 0.0001), and a higher complication rate (p < 0.05) were observed in the operative group. In addition, the non-operative treatment approach was more common in the last five years compared to the previous ten years (p = 0.002). In conclusion, the appropriate non-operative management of injured children reduces the risks of blood transfusion and decreases the length of hospital stay compared with a surgical approach. The use of physiological parameters and radiological findings may be sufficient criteria for observing haemodynamically stable patients with isolated abdominal organ injuries, and thus intensive care unit costs may be avoided. In addition, a careful and close follow-up is essential in injured patients with a low PTS or high ISS.

WOS: 000186565200012, PubMed: 14614712, Background/Purpose: The aim of this study was to determine the effects of nitric oxide (NO) on the expression of adhesion molecules in the early course of testicular I-R injury in rats. Methods: Forty male Sprague-Dawley rats were separated into 4 groups, each containing 10 rats. A sham operation was performed in group 1 (control). In group 2 (I-R), after 6 hours of unilateral testicular torsion, 1 -hour detorsion of the testis was performed. In group 3 (I-R/L-NAME), after performing the same surgical procedures as in group 11, L-NAME was given for 30 minutes. In group 4 (I-R/Mol), after performing the same surgical procedure (torsion and detorsion) as in group 11, molsidomine, an NO donor, was infused for 30 minutes. Then, ipsilateral orchiectomies were performed to measure the tissue levels of malondialdehyde (MDA) and NO and to make histologic examination. Results: MDA values and the testicular injury score decreased and NO values increased in the I-R/Mol-treated group compared with other experimental groups. The tenascin expression in the interstitial space and basement membrane of the tubuli seminiferi were milder in the I-R/Mol group compared with that of the I-R and the I-R/L-NAME. The acrosomes of the spermatids in I-R and I-R/L-NAME groups were stained mildly by lectin. In the I-R and I-R/L-NAME groups, the interstitial spaces, basement membrane of the tubuli seminiferi, and sertoli and germinal cells in testicular tissue were stained intensely by ICAM-1. Conclusions: The expression of adhesion molecules such as tenascin, lectin, and ICAM-1 in the totted testicular tissue may be a pathophysiologic sign of inflammation. NO regulates adhesion molecules expression.

The main purpose of this study was to investigate whether in vivo freezing and mannitol administration can protect the small intestine against ischaemia-reperfusion (I-R) injury.Fifty male Sprague-Dawley rats (200-225 g) were divided into 5 groups each containing 10 rats; group SO, sham operation group; group I, mesenteric ischaemia group; group R, ischaemia-reperfusion (I-R); group FR, I-R plus in vivo freezing; group MR, I-R plus mannitol treatment. Intestinal ischaemia for 30 min and reperfusion for 60 min were applied. Ileum specimens were obtained to determine the tissue levels of malondialdehyde (MDA) and histological changes.The mucosal injury scores of group R were significantly higher than those of the group I (P0.0001). The mucosal injury scores in the groups FR and MR were significantly lower than the group R (P0.0001 and P0.0001, respectively). In the group FR, mucosal injury scores were not significantly different from those of group I (P=0.123). However, mucosal injury scores of group MR were significantly less when compared to those of group I (P=0.01). Mean MDA levels of group R were significantly higher than those of the group I (P0.0001). Mean MDA levels of groups FR and MR were significantly lower than those of group R (P0.0001 and P0.0001, respectively). In addition, MDA levels of group FR were significantly higher than those of group MR (P0.0001).In conclusion, these observations suggest that the in vivo freezing of SMA and the pre-treatment with mannitol before reperfusion period may be useful in preventing intestinal reperfusion injury.

Objectives To determine the functional effects of methoctramine as an M 2 muscarinic receptor antagonist on isolated detrusor strips in vitro and bladder overactivity in vivo in rats. Methods A total of 114 Sprague-Dawley rats were used in the present study. Isolated rat detrusor strips were contracted by depolarizing the preparations with carbachol. Methoctramine was added to the tissue bath in increasing concentrations, and contraction inhibition was assessed. Isovolumetric contractions were evoked by electrical stimulation using a bipolar electrode. Efficacy against bladder instability was evaluated using the obstructed hypertrophied bladder model in the rat. The acetic acid bladder cystometry model was used to assess the efficacy of methoctramine in neurogenic detrusor overactivity. Results Methoctramine inhibited carbachol-induced bladder contractions significantly in isolated rat detrusor strips in a concentration-dependent manner. The amplitude of electrically evoked isovolumetric contractions was decreased significantly after methoctramine exposure. In vivo methoctramine administered intravenously significantly increased the voiding interval and bladder compliance. In addition, a decrease occurred in the number of spontaneous contractions during the filling phase in a model of neurogenic and obstruction-induced detrusor overactivity. Conclusions M 2 antagonists in general may represent a new useful class of drug worth considering in the treatment of bladder overactivity.

The role of cytokines in the pathogenesis of hemodynamic instability or tissue destruction in patients with necrotizing enterocolitis (NEC) remains undefined. The aim of this study was to determine the effects of recombinant human interleukin-102 (rhIL-10) on intestines of hypoxia-induced necrotizing enterocolitis in immature rats.The study was performed on 1-day-old Sprague Dawley rat pups. Group 1 (n = 8) served as nonhypoxic controls. Group 2 (untreated, n = 11) rats were subjected to hypoxia-reoxygenation (H/O) and then were returned to their mothers. Group 3 (rhIL-10 treated, n = 10) rats were subjected to H/O, were returned to their mothers, and were treated with rhIL-10 (75 microgram/kg subcutaneously) for the next 3 days. All animals were killed on day 4, and intestine specimens were obtained to determine the tissue level of malondialdehyde (MDA) and histologic changes.The microscopic lesions in the untreated rats were virtually the same as those seen in neonatal NEC, with destruction of villi and crypts, and in some cases extension to the muscularis. In contrast, in the rats treated with rhIL-10, lesions were limited essentially to the very tips of the villi. Intestinal injury score was significantly less in the rhIL-10-treated rats than in the untreated rats (P.05). In the rhIL-10-treated group, Malondialdehyde (MDA) levels were not significant in comparison to the control group. In the untreated group, MDA levels were significantly increased when compared with the control and the rhIL-10-treated groups (P.001 and P.05, respectively).RhIL-10 has a protective effect on intestinal injury in NEC in an experimental model.

We examined the fact that 12 years old obese girl who applied to our clinic with acute abdomen symptoms and we determined primer omental torsion (POT) at laparotomy in this case. This disease is rare in childhood and imitates the signs of acute appendicitis. Obesity and anatomic variations ofthe omentum are predisposingfactorsfor POI ln this study we wanted to share our experiences in diagnosis and treatment ofPOI

This study aimed to evaluate the effects of the nitric oxide donor molsidomine on the early stages of liver damage and biochemical changes in rats with bile duct ligation (BDL). Forty prepubertal male Sprague-Dawley rats weighing 125–140 g were studied. Group 1 rats (sham-control, n = 10) were not subjected to any surgical manipulation. Group 2 rats (BDL/untreated, n = 10) were subjected to BDL but no drug was administered. Group 3 rats (BDL/L-NAME, n = 10) received a daily dose of NG-nitro-L-arginine methyl ester (L-NAME) intraperitoneally for 7 days after BDL. Group 4 rats (BDL/molsidomine, n = 10) received a daily dose of molsidomine by gastric tube for 7 days after BDL. After 1 week, biochemical and histological evaluations were performed and the liver hydroxyproline content was measured. Serum bilirubin and liver enzymes were significantly increased in the BDL/untreated, BDL/L-NAME and BDL/molsidomine groups in comparison with the sham-control group 1 week after BDL. However, the liver enzymes were significantly decreased in the BDL/molsidomine group in comparison with the BDL/untreated and BDL/L-NAME groups. In the BDL/L-NAME group, proliferation of portal and periportal biliary ductules with disorganization of the hepatocyte plates, dilated portal spaces and areas of polymorphonuclear leukocyte infiltration, fibrosis and hepatocyte necrosis were observed. In the BDL/molsidomine group, polymorphonuclear leukocyte infiltration, hepatocyte necrosis and fibrosis were rarely seen. The hydroxyproline content in the liver was increased 1 week after obstruction in the BDL/untreated and BDL/L-NAME groups when compared to BDL/molsidomine group. Collagen type-IV expression was not observed in the BDL/molsidomine group in contrast to the BDL/untreated and BDL/L-NAME groups. In conclusion, during 1 week of treatment, the nitric oxide donor molsidomine improved hepatic fibrosis in the hepatic parenchyma and did not affect serum bilirubin values, but positively affected the serum aspartate aminotransferase and alanine aminotransferase values.

Postoperative intra-abdominal adhesion formation is a major clinical problem. We aimed to examine the preventive effect of treatment with the platelet-activating factor (PAF) antagonist (lexipafant, BB-882) on experimentally induced intra-abdominal adhesion formation in rats. Twenty male Sprague-Dawley rats weighing 250 and 290 g were studied. Generation of adhesions in rats by brushing a 1-cm2 area of the cecum and the peritoneum on the right side of the abdominal wall was followed by intra-abdominal administration of saline and 5 mg/kg in a volume of 0.2 ml PAF receptor antagonist BB-882. After 45 days, formation of adhesions was graded and histological evaluation was processed. The severity of adhesions was significantly less in the BB-882 group than in the control group (p < 0.001, p < 0.05). The average adhesion scores in the control and BB-882 groups were 3.2 ± 0.6 and 0.6 ± 0.6, respectively, and the difference between both groups was found to be significant (p < 0.0001). The number of polymorphonuclear leukocytes and fibrotic areas was significantly decreased in the BB-882 group when compared to the control group (p < 0.001, p < 0.002). In conclusion, this study confirms the efficacy of BB-882 in the prevention of postoperative intra-abdominal adhesions in a rat model.

Background/Purpose: Risk factors that may independently predict morbidity in children with penetrating abdominal wounds (PAW) have not been elucidated fully. The aim of this study was to identify not only correlated risk factors for morbidity in children with PAW, but also to evaluate the independent predictive value of 3 different trauma scoring systems: the Injury Severity Score (ISS), the Penetrating Abdominal Trauma Index (PATI), and the Pediatric Trauma Score (PTS). Methods: Between January 1983 and November 2000, 119 children (99 boys, 20 girls) presenting with PAW were reevaluated by an analysis of the relationship between overall morbidity and potential risk factors. Results: Wounds were caused by firearm trauma in 85 children and stabbing in 34. Univariate analysis found that age greater than 10 years, trauma mechanism, number of intraabdominal organs injured (NOI) greater than 2, presence of penetrating injury, and ISS and PATI score were associated with greater than 3-fold increased incidence of morbidity (P , .05). The relative risk of a postoperative septic complication was higher than 2 for the following risk factors: age greater than 10 years, shotgun injury, number of organs injured greater than 2, presence of colon injury, ISS greater than 15, and PATI score greater than 15. Multivariate analysis showed that only ISS (P 5 .02), and PATI score (P 5 .03) were independently significant in predicting morbidity. Conclusion: ISS and PATI score were the most important indicators found to be independently associated with morbidity.

In cases with incomplete ureteric duplication, lower pole ureteropelvic junction obstruction (UPJO) may occur as an unusual entity. Surgical reconstruction of UPJO can be with different techniques such as pyeloplasty, pyeloureterostomy or ureteroureterostomy. In our case, the connecting segment distal to the pelvioureteric junction was found short and we performed direct pyeloureteral side-to-side anastomosis, with a double j catheter. It is helpful to determine prior to reconstruction of a short lower pole ureteral length.

Crossed testicular ectopia (CTE) is a rare congenital anomaly of testicular descent in which migration of one testis towards the opposite inguinal canal. The ordinary presentation is that of ipsilateral inguinal hernia and contralateral cryptorchidism. Here, a 2-year-old boy presented in surgical outpatient department with right inguinal hernia and impalpable testis in left scrotum and inguinal canal. Right herniotomy was performed. Left testis was brought to the left scrotum through transceptal window.

It is suggested that gastrointestinal mucosal blood flow depends on a balanced release of vasoactive substances from the endothelium. The present study investigated the effects of molsidomine on the small intestine after ischemia-reperfusion (I/R) injury in four groups of 10 rats each composed: (1) SO, sham operation; (2) untreated I/R; (3) ML, I/R plus molsidomine pretreatment; (4) L-NAME, I/R plus N-omega-nitro-L-arginine methyl ester pretreatment. Intestinal ischemia for 45 min and reperfusion for 60 min were applied. Ileum specimens were obtained to determine the tissue level of malondialdehyde (MDA) and histologic changes. Mean MDA levels in the SO, untreated I/R, ML, and L-NAME groups were 95.60 +/- 2.59, 136.90 +/- 4.35, 121.10 +/- 3.38, and 137.40 +/- 4.42 nmol/g wet tissue, respectively. Although the MDA level in the ML group was higher than in the SO group ( P < 0.0001), it was significantly lower compared to the untreated I/R and L-NAME groups ( P < 0.0001, P < 0.0001). Mucosal injury scores (MIS) in groups 1-4 were 0.2 +/- 0.42, 3.9 +/- 0.73, 1.5 +/- 0.70, and 4.1 +/- 0.56, respectively. In group 3 the MIS was significantly lower than in groups 2 and 4 ( P < 0.0001, P < 0.0001). Molsidomine plays a role in attenuating reperfusion injury of the small intestine by depression of tissue MDA levels and MIS and regulates post-ischemic intestinal perfusion while restoring the intestinal microcirculatory blood flow and histologic injury.

The purpose of this study is to show whether selective (celecoxib) and non-selective (piroxicam) inhibitors of COX-2 can alter the morphological and functional changes after the release of a 24 h complete ureteric obstruction in tissue from solitary rat kidney. Forty male Sprague-Dawley rats weighing 225–250 g were used. The animals were divided into four groups. In group 1 rats (control, n=10), only right nephrectomy was performed. Group 2 rats (untreated, n=10) underwent right nephrectomy and the left ureter was completely obstructed. In group 3 rats (celecoxib), the same operation was performed as described for group 2 and than celecoxib was administered by gavage for a period of 24 h. Group 4 rats (piroxicam) underwent the same operation as described for group 2, then piroxicam was administered intramuscularly at least 1 h before the release of the for 24 h complete ureteric obstruction. All animals were then prepared for functional and histopathological studies. The administration of celecoxib produced a significant decrease in blood urea nitrogen levels when compared to the animals receiving piroxicam and the animals with no treatment. Moreover, celecoxib caused a significant decreased in creatinine levels when compared to the untreated group. Urine volume and the urinary sodium values were increased in the celecoxib group when compared with the other groups. The administration of celecoxib and piroxicam caused a significant decrease in the number of interstitial macrophages when compared to the untreated group. The Bowman space was significantly increased in the untreated group when compared with the celecoxib and the piroxicam groups. These studies indicate that celecoxib may be an important factor affecting renal morphological and functional changes after the release of a 24 h complete ureteric obstruction.

Zenker's diverticulum (ZD) is a very rare pathology in childhood and to date only few pediatric cases have been reported in literature. Herein we report on a case of ZD with cervical abscess formation and oral purulent drainage in a 6-year old girl with severe malnutrition. Diverticulectomy was performed as surgical treatment. The patient is free of symptoms after two years' follow-up.

Objective To evaluate the efficacy of Rhodiola rosea (R. rose) extract in terms of preventing tissue injury induced by testicular torsion and subsequent ischemia/reperfusion (I/R). Methods Twenty-one Wistar albino male rats were divided into 3 groups: group 1 = control group, group 2 = I/R group, and group 3 = I/R + extract group. After 2 hours of ischemia and 4 hours of reperfusion, testes were removed and evaluated histologically by hematoxylin and eosin staining. Apoptosis in spermatogonial cells of seminiferous tubules was determined by transferase biotin-2′-deoxyuridine, 5′-triphosphate nick end labeling (TUNEL). To assess oxidative damage, serum malondialdehyde (MDA) and glutathione (GSH) levels were measured. Results Median MDA and GSH levels were, respectively, 12 ± 3 pmol/mL and 24.8 ± 3.8 μM in group 1, 38 ± 11 pmol/mL and 10.3 ± 1.7 μM in group 2, and 19 ± 5 pmol/mL and 17.6 ± 1.3 μM in group 3 (P

WOS: 000261768200008 PubMed: 19084917 AIM: To investigate the effects of resveratrol on liver ischemia/reperfusion (I/R) injury in rats. METHODS: A total of 40 male Sprague-Dawley rats weighing 240-290 g were randomized into four groups of ten: (1) controls: data from unmanipulated animals; (2) sham group: rats subjected to the surgical procedure, except for liver I/R, and given saline; (3) I/R group: rats underwent liver ischemia for 45 min followed by reperfusion for 45 min; (4) I-R/Resveratrol group: rats pretreated with resveratrol (10 mu mol/L, iv). Liver tissues were obtained to determine antioxidant enzyme levels and for biochemical and histological evaluation. RESULTS: Plasma aminotransferase activities were higher in the I/R group than in the I-R/Resveratrol group. Malondialdehyde levels and the hepatic injury score decreased, while superoxide dismutase, catalase, and glutathione peroxidase levels increased in group 4 compared to group 3. In group 4, histopathological changes were significantly attenuated in resveratrol-treated livers. CONCLUSION: These results suggest that resveratrol has protective effects against hepatic I/R injury, and is a potential therapeutic drug for ischemia reperfusionrelated liver injury. (C) 2008 The WIG Press. All rights reserved.