Resveratrol, a red wine polyphenol, protects spinal cord from ischemia-reperfusion injury

OBJECTIVE: The cardioprotective effect of red wine has been attributed to resveratrol. The resveratrol-induced protection against ischemia-reperfusion (I/R) injury has been documented in heart, kidney, and brain. Resveratrol scavenges free O(2) radicals and upregulates nitric oxide (NO). However, the presence of resveratrol-induced spinal cord protection against I/R injury has not been reported in the literature. The objective of this study was to evaluate the effects of resveratrol on neurologic functions, histopathologic changes, and NO metabolism following temporary spinal cord ischemia (SCI) in rabbits.Material and methods SCI was induced with occlusion of the infrarenal aorta in rabbits. In addition to the sham group (group S, n = 7), group C (n = 7) received vehicle 30 minutes before ischemia. Group R1 (n = 7) and R10 (n = 7) received 1 mg/kg and 10 mg/kg resveratrol instead of vehicle, respectively. Blood samples were taken to obtain nitrite/nitrate levels during the surgical procedure. After neurologic evaluation at the 48th hour of reperfusion, lumbar spinal cords were removed for histopathologic examination and malondialdehyde measurement as a marker of oxidative stress. RESULTS: Five animals in group C had paraplegia while 5 in group R10 had normal neurologic functions. The average Tarlov score of group R10 was significantly higher than that the score of group C (4.1 +/- 1.2, vs 1.2 +/- 2.2; P =.014). Histopathologic examination revealed higher neuronal viability index in group R10 compared with that of group C (0.82 +/- 0.24 vs. 0.46 +/- 0.34; P =.018). Nitrite/nitrate levels decreased in group C (from 357 +/- 20.15 micromol/L to 281 +/- 47.9 micromol/L; P <.01) whereas they increased both in group R1 and group R10 (from 287+/-28 micromol/L to 310 +/- 33.9 micromol/L and from 296 +/- 106 micromol/L to 339 +/- 87 micromol/L, respectively) during SCI. Malondialdehyde levels of group R10 was lower than those of group C (55 +/- 12.9 nmol/mg protein vs 83.9 +/- 15.1 nmol/mg protein; P =.001, respectively). CONCLUSIONS: In this model of SCI, resveratrol decreased oxidative stress, increased NO release, and protected spinal cord from I/R injury. Resveratrol-induced neuroprotection is probably mediated by its antioxidant and NO promoting properties. Before considering the clinical use of this natural antioxidant, further research is warranted about its mechanism of effects, timing, and optimum dose. CLINICAL RELEVANCE: Paraplegia that results from spinal cord ischemia is a catastrophic complication of thoracic and thoracoabdominal aorta surgical procedures. Despite several surgical modifications and pharmacologic approaches, paraplegia has not been totally eliminated. On clinical grounds, the efficiency of currently used pharmacologic agents to prevent spinal cord injury during thoracic and thoracoabdominal aorta surgery is very limited and their benefit is controversial. Preischemic infusion of resveratrol protects the spinal cord from ischemia reperfusion injury in rabbits. Following clarification of the underlying protective mechanism, optimal dose, and timing, resveratrol may used in humans as an adjunct to eliminate this catastrophic complication.     

Binding of polychlorinated biphenyls/metabolites to hemoglobin

Polychlorinated biphenyls (PCBs) may form reactive electrophiles that can bind covalently to hemoglobin in vivo. Female C57/BL6 mice, pretreated with phenobarbital and P-naphthoflavone, were injected with either radiolabeled 4-chlorobiphenyl, 3,3',4.4'-tetrachlorobiphenyl, benzo[a]pyrene (B[a]P) or the corresponding non-labeled 4-chlorobiphenyl, 3.3',4.4'-tetrachlorobiphenyl, B[a]P or vehicle. Blood was collected at different time points. At 24 h a greater presence of 4-chlorobiphenyl and 3,3',4.4'-tetrachlorobiphenyl in the plasma, compared with the erythrocytes, was observed. For all three treatment groups the radioactivity in the hemolysate was found to be greater than the vehicle-treated group, except at 2 h after dosing, suggesting an association with hemoglobin. Covalent binding with globin was 10-fold greater for 4-chlorobiphenyl-treated animals compared with 3,3',4,4'-tetrachlorobiphenyl-treated animals. Liquid chromatography-mass spectral analysis of globin was used to identify adducts. Our preliminary data show an increase in mass corresponding to adducts of oxidized metabolites of PCBs. Detection of adducts of PCBs with hemoglobin could provide a valuable tool to evaluate acute exposure of a population.     

Evaluation of the Macular and Choroidal Perfusion in Healthy Turkish Population Using Optical Coherence Tomography Angiography

PurposeTo investigate the effect of age- and sex-related differences on macular and choroidal perfusion in healthy Turkish individuals by optical coherence tomography angiography (OCTA).MethodsTwo hundred-eight eyes of 116 healthy Turkish individuals (60 females and 56 males, mean age 40.35 ± 12.64 years) were included in this study. OCTA was performed on a 3 × 3-mm region on the macula. The superficial macula whole-image vessel density (wiVD), foveal VD and parafoveal VD vessel density, foveal avascular zone (FAZ) as well as choriocapillaris flow index (CFI) were quantified.ResultsThe mean vessel density was 53.1% ± 2.8% in superficial macula wiVD, 31.7% ± 6.9% in superficial foveal VD and 55.2% ± 3.4% in superficial parafoveal VD for 3 × 3-mm OCTA images. Analysis of 3 × 3-mm scan has revealed a mean value of FAZ area was 0.313 ± 0.112 mm². The mean CFI for 3 × 3-mm scan was 1.937 ± 0.059. A significant decrease was observed in the mean values of wiVD, parafoveal VD and CFI with age (p < 0.001, p = 0.001, and p < 0.001, respectively), with average yearly reductions of 0.3%, 0.4% and 0.4%, respectively. However, there was no correlation between age and foveal VD (p > 0.05). The FAZ area has shown an age-dependent annual increment, showing an average of 1.26%. The parafoveal VD and FAZ area were significantly higher in females than males (p = 0.027 and p = 0.015, respectively) while other parameters seemed similar (p > 0.05 for all).ConclusionsOur results suggest that age- and sex-related variations were effective on macular and choroidal perfusion. These normative values obtained using OCTA may be clinically useful to the evaluation of retinal and choroidal disorders.     

Early oral hydration after cesarean delivery performed under regional anesthesia

OBJECTIVE: To establish an early, safe, and well-tolerated time to start oral hydration after cesarean delivery. METHODS: A prospective randomized trial of women delivered by cesarean under regional anesthesia at Alanya Research and Medical Center, Turkey, between 2005 and 2006. A clear liquid drink was given to 100 women in the early oral intake (EOI) group 2 hours after surgery, and to 100 women in the delayed oral intake (DOI) group 8 hours after surgery. If the drink was tolerated, solid foods were then given gradually. RESULT: In the EOI and DOI groups, respectively, the mean time for the return of bowel movements was 4.4+/-1.9 h vs 6.3+/-2.4 h; mean time elapsed until initial passage of flatus was 12.1+/-5.5 h vs 24.1+/-6.0 h; and mean duration of hospitalization was 29.6+/-5.5 h vs 44.6+/-6.8 h (P<0.05). CONCLUSION: Following cesarean delivery under regional anesthesia, oral hydration given as early as 2 hours after the operation is safe and well tolerated.     

Health-related quality of life of Turkish stroke survivors

Stroke is a major, chronically disabling neurological disease, which often radically and permanently changes the lives of the victims. Improvement of motor coordination and the degree of independence achieved in activities of daily living have been the usual criteria used to measure outcome in stroke rehabilitation. The objective of our study is to compare health-related quality of life (HRQOL) between stroke patients 6 months after rehabilitation and a control group who did not have any major illness. The associations of several factors with the quality of life were also examined. Sixty consecutive stroke patients and 58 healthy control participants were included in the study. Functional independence measure (FIM), Nottingham health profile (NHP) and demographic variables were used as the main outcome measures. There were significant improvements in both motor coordination and functional status as measured by FIM at discharge and also 6 months after stroke and these variables were significantly associated with the HRQOL. The NHP, which is a validated quality-of-life measurement in Turkish patients, was used and the scores were compared with the healthy control participants. The scores of NHP domains (energy level, emotional reactions, sleep, social isolation and physical mobility) of the stroke patients were higher than those of the healthy group (P<0.01). Age, marital status, lesion side and multiple stroke history showed no significant correlation with NHP scores. Being a woman, lower educational status, tendency to depression and the presence of several comorbidities were significantly correlated with the NHP scores. Stroke survivors in our society have lower HRQOL than healthy individuals. HRQOL is correlated with the functional status in the stroke population. Additionally, the reduced HRQOL after stroke appears to be related to several demographic properties such as sex, education, comorbidities and psychological factors.     

The combined effects of controlled breathing techniques and ventilatory and upper extremity muscle exercise on cardiopulmonary responses in patients with spinal cord injury

This study investigated the effects of controlled breathing techniques and ventilatory and upper extremity muscle exercise on cardiopulmonary and metabolic functions and exercise tolerance in patients with spinal cord injury (SCI). The design of the study was prospective and was a before-after trial. Twenty patients with SCI were included in the study. Resting pulmonary functions were assessed spirometrically. Cardiopulmonary and metabolic responses to maximum exercise were determined with an electronically braked arm crank ergometer. The expired gases during this exercise were collected and analysed using a computerized gas analysis system. Patients with SCI participated in a 6-week ventilatory and upper extremity muscle exercise program for 1 h, three times per week. At the end of the exercise program, we observed significant improvement in spirometric values, peak oxygen uptake, time to fatigue, peak power output and minute ventilation compared with pre-training values for the patients.     

Primary cervical lymphoma: report of two cases and review of the literature

BACKGROUND: Primary lymphoma arising from the female genital tract has been rarely encountered. Primary cervical lymphoma is even rarer in gynecologic oncology practice and accounts for approximately only 1% of extranodal lymphomas. In this article, two cases of cervical lymphoma are presented with a review of the available literature. CASE HISTORIES: A 51-year-old woman presented with abnormal vaginal discharge. On pelvic examination, cervix was apparently normal; however, a solid and mobile pelvic mass was palpated. Pap smear was reported as HSIL at another institution. Radiological evaluation revealed a cervical mass with a 3 cm diameter. Histopathological evaluation of LEEP material was reported as diffuse large B cell lymphoma. We performed abdominal hysterectomy plus bilateral salphingo-oopherectomy and the patient was treated with adjuvant 6 cycles of CHOP chemotherapy. A second case was a 49-year-old postmenopausal woman who had undergone a routine gynecologic follow-up examination without any complaint at another institution. Routine cytological smear revealed HSIL. Punch biopsy under colposcopic examination presented no remarkable pathology except for a benign inflammation. Due to discordance between cytology and histology, LEEP was performed under colposcopic examination, which revealed follicular lymphoma grade III. This patient was treated with 6 cycles CHOP chemotherapy without any surgery. CONCLUSION: Primary cervical lymphoma is a rare disorder. Although most reported cases in the literature have a normal Pap smear, some may represent with co-existent cytological abnormalities. Therefore, cervical lymphomas should be kept in mind in patients with cytological abnormalities.     

Alprazolam significantly improves the efficacy of granisetron in the prophylaxis of emesis secondary to moderately emetogenic chemotherapy in patients with breast cancer

BACKGROUND: Alprazolam, a newer benzodiazepine, may be useful in the control of nausea and vomiting in breast cancer patients. METHODS: Nineteen operable breast cancer patients were included in this randomized prospective crossover open-label trial. Patients received either granisetron (G) alone, or in combination with alprazolam (A). Group A patients received G+A first and then crossed over to G-alone after the 2nd or 3rd cycle. Group B patients received the reverse order. Eighty-four cycles were evaluated. RESULTS: In group A, complete remission (CR) plus major response (MR) was higher (93.9%) with G+A than with G-alone (83.3%; p = 0.0001) in the first 24-hour period. In group B, CR plus MR was higher in G+A cycles (100%) than in G-alone cycles (85.7%; p = 0.035) in the 24-hour period and in the 25- to 129-hour period (92 vs. 90.5%, respectively; p = 0.022). CONCLUSION: Alprazolam increases the efficacy of granisetron in patients with breast cancer treated with an anthracycline-containing regimen.     

The effect of stimulated microglia conditioned media on BDNF gene expression of striatal astrocytes: quantification by real-time PCR

It is well accepted that there is mutual relation between glia-glia and glia-neuron in the central nervous system. In the present study, the authors aimed to evaluate the effect of microglia conditioned medium (MCM) on brain derived neurotrophic factor (BDNF) gene expression of astrocytes by quantitative real-time polymerase chain reaction (PCR). Real-time PCR is one of the most recent techniques for determination of gene expression. It is the first choice when sensitivity, specifity and cost effectiveness are concerned. The authors present, for the first time, the settings of real-time PCR for quantification of BDNF gene expression of rat strital astrocytes. Astrocytes that cultured- from the striatum were incubated with conditioned medium of either Zymosan A stiumulated or unstimulated microglia which were cultured from striatum and cortex of the rat pups. Our results have shown that incubation with stimulated striatal MCM induced BDNF gene expression of striatal astrocytes (1.33 fold) when compared to astrocytes treated with regular medium or unstimulated striatal MCM. We have also seen the similar effect with cortical MCM implying that effect of MCM does not change with regionally different microglia.