Curcumin protects against ischemia/reperfusion injury in rat kidneys

OBJECTIVES: Renal ischemia followed by reperfusion leads to acute renal failure in both native kidneys and renal allograft. We investigated the effect of curcumin on ischemia-reperfusion (I/R) injury and the antioxidant effects of curcumin in rats. METHODS: Thirty rats were randomly divided into five experimental groups (control, sham, curcumin, I/R and I/R+curcumin, n=6 each). Curcumin was administered (200 mg kg(-1)) orally to curcumin and I/R+curcumin groups for 7 days. Then, the rats were subjected to bilateral renal ischemia for 45 min and followed by reperfusion for 24 h. All rats were killed and kidney function tests, serum and tissue nitric oxide (NO), protein carbonyl (PC), malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels were determined. Histopathological examinations were also performed. RESULTS: Curcumin significantly improved the urea and cystatin C levels in I/R+curcumin group compared to I/R group (p<0.05). Reduction of serum GSH-Px was significantly improved by curcumin (p<0.001), but SOD enzyme activity did not alter (p>0.05). Treatment with curcumin also resulted in significant reduction in serum and tissue MDA, NO and PC and for tissue that were increased by renal I/R injury (p<0.001 for serum and p<0.05 for tissue, respectively). In histological examination, the rats treated with curcumin had nearly normal morphology of the kidney. CONCLUSIONS: Based on our results, it can be concluded that curcumin protects the kidneys against I/R injury via its antioxidant effects.     

Unusual complications and presentations of intracranial abscess: experience of a single institution

BACKGROUND: Complicating events and unusual presentations associated with intracranial abscess are rare but potentially fatal conditions. This study was undertaken to shed light on the unusual complications and presentations of intracranial abscess treated at a single institution. METHODS: We retrospectively reviewed 116 cases of intracranial abscesses that were treated at our institution over the last 10 years and identified 11 (9.4%) cases with unusual complications. RESULTS: These complications consisted of (1) rupture within the abscess, (2) hemorrhage into the abscess, (3) hemispheric infarction due to ICA thrombosis, (4) acute visual loss due to pituitary abscess, (5) acute neurologic deterioration due to rapid gas formation within the abscess, (6) acute hydrocephalus, (7) trigeminal neuralgia, (8) fungal abscess developing secondary to intracranial extension of a temporal bone tumor, (9) Cryptococcus abscess with different morphology, (10) pontine infarction, and (11) sigmoid sinus thrombosis. Sinusitis accompanied 8 (72.7%) of the cases, and there were 5 (45.4%) mortalities. Culture results were unyielding in 4 patients, whereas Streptococcus species were identified in 4 and fungi in the rest. CONCLUSION: Intracranial abscesses and their complications still continue to be challenging entities in the neurosurgical practice. Our experience may provide an informational source for those who are taking care of patients with intracranial abscess.     

Does glomerular hyperfiltration in pregnancy damage the kidney in women with more parities?

Objectives  

We aimed to investigate the glomerular hyperfiltration due to pregnancy in women with more parities.     

Augmented Reality: A New Tool To Improve Surgical Accuracy during Laparoscopic Partial Nephrectomy? Preliminary In Vitro and In Vivo Results

Background

Use of an augmented reality (AR)–based soft tissue navigation system in urologic laparoscopic surgery is an evolving technique.

Objective

To evaluate a novel soft tissue navigation system developed to enhance the surgeon's perception and to provide decision-making guidance directly before initiation of kidney resection for laparoscopic partial nephrectomy (LPN).

Design, setting, and participants

Custom-designed navigation aids, a mobile C-arm capable of cone-beam imaging, and a standard personal computer were used. The feasibility and reproducibility of inside-out tracking principles were evaluated in a porcine model with an artificially created intraparenchymal tumor in vitro. The same algorithm was then incorporated into clinical practice during LPN.

Interventions

Evaluation of a fully automated inside-out tracking system was repeated in exactly the same way for 10 different porcine renal units. Additionally, 10 patients underwent retroperitoneal LPNs under manual AR guidance by one surgeon.

Measurements

The navigation errors and image-acquisition times were determined in vitro. The mean operative time, time to locate the tumor, and positive surgical margin were assessed in vivo.

Results and limitations

The system was able to navigate and superpose the virtually created images and real-time images with an error margin of only 0.5 mm, and fully automated initial image acquisition took 40 ms. The mean operative time was 165 min (range: 135–195 min), and mean time to locate the tumor was 20 min (range: 13–27 min). None of the cases required conversion to open surgery. Definitive histology revealed tumor-free margins in all 10 cases.

Conclusions

This novel AR tracking system proved to be functional with a reasonable margin of error and image-to-image registration time. Mounting the pre- or intraoperative imaging properties on real-time videoendoscopic images in a real-time manner will simplify and increase the precision of laparoscopic procedures.     

Oncostatin M regulates secretoglobin 3A1 and 3A2 expression in a bidirectional manner

Secretoglobin (SCGB) 3A1 and 3A2 are members of the small molecular weight secretoglobin gene superfamily. SCGB3A1 is a tumor suppressor gene, whereas SCGB3A2 has anti-inflammatory properties. Both genes are mainly expressed in the lung and trachea in mice. Whether the expression and/or function of these two genes are related is not known. Here we show that the expression of SCGB3A1 and SCGB3A2 are bidirectionally regulated by oncostatin M (OSM) when examined in a mouse transformed Clara cell line (mtCC); SCGB3A1 is up-regulated by OSM, while SCGB3A2 is down-regulated in a time- and dose-dependent manner. OSM-activated STAT3/5, through binding to the STAT-binding element located at -201 to -209 bp in the mouse Scgb3a1 gene promoter, and the extracellular signal-regulated kinase (ERK)- and p38-mitogen-activated protein kinase (MAPK) pathways are responsible for the OSM-induced up-regulation of SCGB3A1 expression. On the other hand, the -113 to -273 bp region in the Scgb3a2 promoter appears to be responsible for the OSM induced down-regulation of the gene. No significant differences in the levels or patterns of specific DNA-binding proteins were found in the -113 to -273 bp region as determined by electrophoretic mobility shift assays. Neither the ERK- nor p38-MAPK pathways were involved in the OSM-induced reduction of Scgb3a2 promoter activity. These results suggest that OSM-induced suppression of SCGB3A2 expression is an indirect effect of OSM. Expression of the Clara cell marker, CYP2F2, was markedly decreased upon OSM treatment in parallel with the decrease of SCGB3A2 expression in mtCC cells. The differential regulation of Scgb3a1 and Scgb3a2 gene expression by OSM may explain the unique functions of these genes in the lung.     

Are sinus-track cultures reliable for identifying the causative agent in chronic osteomyelitis?

Purpose  

The infection of bone that contains bone marrow called osteomyelitis, and is caused by different microorganisms. In this study, we aimed to determine the diagnostic value and accuracy of cultures of material from a sinus track compared with those of cultures of bone specimens that have been controversial.     

Prognosis of patients with seizures occurring in the first 2 years

The aim of this study is to determine the prognosis of patients with seizure onset from 1 to 24 months of age in respect to epilepsy, developmental outcome, and neurological status. It also aims to determine predictive factors regarding an unfavorable prognosis. Seventy-five patients were retrospectively analyzed. Univariate analysis revealed the following findings: (1) mental retardation at initial admission, abnormal neurological finding, infantile spasm, use of more than 1 antiepileptic drug, epileptic activity on electroencephalography (EEG) of neonatal seizure, and perinatal anoxia were significant risk factors with regard to developmental outcome; (2) mental retardation at initial admission, abnormal neurological finding, infantile spasm, use of more than 1 antiepileptic drug, epileptic activity on EEG, symptomatic etiology, history of neonatal seizure, and perinatal anoxia were significant risk factors regarding neurological status; and (3) mental retardation at initial admission, neurological abnormality, infantile spasm, use of more than 1 antiepileptic drug, epileptic activity on EEG, status epilepticus, symptomatic etiology, seizure frequency of more than once per week, history of perinatal anoxia, and neonatal seizure were significant risk factors regarding epilepsy prognosis. In addition, multivariate analysis revealed that neurological abnormality and use of more than 1 antiepileptic drug were significant for developmental outcome, that epileptic activity on EEG and use of more than 1 antiepileptic drug were significant for neurological status, and that perinatal anoxia, infantile spasm, and status epilepticus were significant for epilepsy prognosis. These findings suggest that neurological abnormality, use of more than 1 antiepileptic drug, infantile spasm, status epilepticus, and perinatal anoxia are unfavorable predictive risk factors regarding the prognosis of patients with seizures that have an onset from 1 to 24 months of age.