The effects of erdosteine on lung injury induced by the ischemia-reperfusion of the hind-limbs in rats

BACKGROUND: [corrected] The goal of this experimental study was to investigate whether erdosteine has a protective effect against lung injury as a remote organ after hind-limb ischemia-reperfusion (I/R). MATERIALS AND METHODS: The rats were divided into three groups: control, I/R, and I/R + erdosteine. After the experimental procedure, nitric oxide (NO) levels, myeloperoxidase (MPO), adenosine deaminase (ADA), and the activities of xanthine oxidase (XO) were determined on the lung tissue. The levels of NO and activities of MPO were also measured on the bronchial alveolar lavage (BAL). In addition, the lung tissue was examined by histopathology. RESULTS: The lung tissue ADA and XO activities were increased in the I/R group compared with the control group (P < 0.05). In the I/R group, the levels of NO were higher than the control group (P < 0.05), whereas the erdosteine treatment did not alter the NO levels (P < 0.05). The MPO activities increased after I/R in the I/R group compared to both control and I/R + erdosteine group (P < 0.05). The activity of MPO increased in the IR group in comparison with the control group in BAL (P < 0.05). The activity of MPO in the I/R + erdosteine group was significantly lower than the I/R group in BAL (P < 0.05). NO levels increased in all I/R groups compared to control group in BAL (P < 0.05). However, treatment of erdosteine significantly decreased NO levels compared to I/R group (P < 0.05). The animals of the I/R group had total destruction of normal alveolar structure with the intense presence of infiltrating neutrophils and mononuclear phagocytes in histopathological examination. The rat lung exhibited mild degrees of destruction in the erdosteine group. CONCLUSIONS: As a result, erdosteine may be a protective effect for lung injury, decreasing oxidative stress and neutrophil accumulation after hind-limb I/R in rats.     

Comparison of the 2000 and 2005 outbreaks of tularemia in the Duzce region of Turkey

Tularemia caused by Francisella tularensis, which is considered a biological warfare agent, is a widely distributed zoonosis. In this study, we aimed to compare a 2005 outbreak of tularemia that was confirmed as waterborne by PCR to outbreak of tularemia that was reported as waterborne in 2000 and to investigate the changes of epidemiological characteristics between these two outbreaks occurring in the same region. In the present study, a total of 11 patients were diagnosed with tularemia. In the 2000 outbreak, oropharyngeal type was observed 19 patients, and ulceroglandular type in 3 patients. In the 2005 outbreak, oropharyngeal type was observed in 8 patients, and oculoglandular type in 3 patients. However, our cases are not sufficient to make a conclusion that the characteristics of tularemia seem to be changing.     

N-acetylcysteine protects the rats against phrenic nerve dysfunction in sepsis

This study investigates the association of oxidative stress with the function of the phrenic nerve and inquires whether N-acetylcysteine (NAC) may counteract the possible detrimental effects. Thirty rats were divided into three groups: sham, cecal ligation and puncture (CLP), and CLP plus NAC treatment. Sepsis was produced by the CLP procedure. NAC was administered at 70 mg/day for 7 days. Electrophysiology was evaluated by the needle electromyography of the diaphragm and phrenic nerve conduction study. Oxidative stress was evaluated by malondialdehyde (MDA), nitrite/nitrate (NN), and reduced-glutathione (ReGSH) levels and myeloperoxidase (MPO) and catalase (CAT) activities in the phrenic nerve. In the CLP group, ReGSH and CAT were decreased (P = 0.0001, P = 0.07, respectively); and MDA, MPO, and NN were increased (P = 0.02, P = 0.0001, P = 0.043, respectively), compared with the sham group. NAC administration increased the ReGSH (P = 0.036) and decreased the MDA, MPO, and NN (P = 0.008, P = 0.01, P = 0.032, respectively), compared with the CLP group. In the CLP group, electrophysiology revealed reductions in the number of motor unit action potentials (P = 0.0001) and prolongations in the latency of the compound nerve action potential (P = 0.0001), indicating phrenic nerve neuropathy. NAC administration significantly ameliorated these electrophysiological alterations (P = 0.011, P = 0.0001, respectively), compared with the CLP group. The present results showed that intraabdominal sepsis is closely associated with phrenic nerve neuropathy. In addition, NAC administration protects the rats against the detrimental events of sepsis.     

Tissue and Flow Myocardial Performance Index Measurements Taken During Dobutamine Stress Echocardiography for Early Diagnosis of Late Anthracycline Cardiotoxicity

The purpose of this study was to define the role of tissue and flow myocardial performance index (MPI) measured during dobutamine stress and tissue Doppler echocardiography in the early diagnosis of late cardiotoxicity among patients with childhood cancer treated with anthracycline. The study included 20 patients (14 male and 6 female; mean age 18.4 ± 3.2 years) as the study group and 18 healthy volunteers (14 female and 4 male, mean age: 19.2 ± 4.0) as the control group. The mean cumulative dose of anthracycline treatment was 282.1 ± 125.9 mg/m², and the mean time period after the last dose of anthracycline was 10.2 ± 4.0 years. Echocardiography was performed during rest and at infusions of 5, 10, 15, and 20 μ/kg/min dobutamine. Although only isovolumetric relaxation and contraction times of the patient group were prolonged at rest, dobutamine infusion showed significant differences in % left ventricle (LV) posterior wall thickening, LV end-systolic wall stress, LV diastolic and systolic diameter, mitral acceleration, and deceleration time in the patient group compared with the control group. Tissue and flow MPI of the LV, tissue MPI of the right ventricle (RV), and interventricular septum of the patient group were higher than the control group throughout the test. LV tissue MPI increased much more than LV flow MPI when stress was increased. In conclusion, LV tissue MPI value during stress is more valuable than LV flow MPI in the early diagnosis of late cardiotoxicity. RV function can be assessed by tissue Doppler MPI.     

Bilateral facial nerve enhancement demonstrated by magnetic resonance imaging in Guillain–Barre Syndrome

Guillain–Barré syndrome (GBS) is an acute inflammatory demyelinating peripheral nerve disorder. It is known that gadolinium enhancement on magnetic resonance imaging (MRI) reflects alteration of the blood–nerve barrier secondary to inflammation. Enhancement of the cauda equina roots with gadolinium on lumbosacral magnetic resonance imaging have been demonstrated in several reports. Although about 50% of GBS patients clinically exhibit facial nerve involvement, it has never been demonstrated on MRI. We aimed to observe facial nerve involvement in a GBS patient who has prominent facial diplegia. With the guidance of the literature, we predict that MRI in selected GBS patients may be an adjunct tool for the clinician in both diagnosis and monitoring the treatment response.     

Is there any relationship between streptococcal infection and multiple sclerosis?

BACKGROUND: Multiple sclerosis (MS) is an immune-mediated inflammatory demyelinating disease of uncertain etiology. Although the mechanisms of inducting autoimmunity by some of the infectious agents have been investigated, there is not yet enough research on streptococcal infections. MATERIAL/METHODS: To understand the effect of past group A streptococcal infection on MS, antistreptolysin O (ASO) and antideoxyribonuclease B (ADNase B) were measured in 21 patients with relapsing-remitting MS and 21 healthy blood donors by nephelometric assay. RESULTS: ADNase B levels in the patients with MS were found to be significantly higher than in the controls (p<0.001); however, ASO levels were similar in both groups. CONCLUSIONS: These findings indicate that a relationship between multiple sclerosis and streptococcal infections may exist, but to acquire a better understanding of the role of group A streptococci in the pathogenesis of multiple sclerosis, more studies with animal models are necessary.     

Late effects of treatment on growth in childhood non-Hodgkin's lymphoma

Growth impairment is one of the most important late sequelae in childhood malignancies. In the last few years, the contribution of cytotoxic agents to growth retardation has been a subject of investigation. The aim of this study was to evaluate the growth impairment in children treated for non-Hodgkin's lymphoma (NHL). The study group comprised 41 children (eight girls, 33 boys) treated for NHL with three different chemotherapy protocols. All patients were in remission at the last visit. The control group consisted of 41 healthy age- and sex-matched children. All patients' standing heights and body weights were measured regularly from the time of diagnosis. Growth parameters were measured both at the time of diagnosis and at the end of treatment (median treatment time: 6 months). Height and weight velocities were calculated at 6 month intervals after the diagnosis until the last visit. The mean height SDS of the patients was -0.66 ± 1.42 at the diagnosis and 0.29 ± 1.21 at the last visit. Height SDS of the patients showed a significant improvement at the end of the 2nd year after the diagnosis (p = 0.005) and at the last visit (p = 0.022) (median follow-up time: 48 months after diagnosis). The height velocity SDS increase at the end of the 2nd year was particularly remarkable in short-term protocols such as BFM-90 B-NHL. The sitting height, the sitting height/height ratio and serum insulin-like growth factor-I (IGF-I) levels were found to be lower in the patients than those of control group at the last visit. One can conclude that chemotherapy might cause a reduction in growth velocity during treatment. The cumulative dosages of anti-neoplastic agents and serum IGF-I levels could have been implied in the pathogenesis of growth retardation.