The effect of preventive use of alanyl-glutamine on diaphragm muscle function in cecal ligation and puncture-induced sepsis model

BACKGROUND: Low muscle glutamine levels during sepsis are associated with reduced protein synthesis and elevated protein breakdown, in particular myofibrillar protein breakdown. Thus, in a cecal ligation and puncture (CLP)-induced sepsis model in the rat, we hypothesized that glutamine pretreatment would protect the diaphragm muscle function. METHODS: Eighty-four male Wistar rats weighing between 180 g and 200 g received standard amino acid solution 1.2 g kg(-1) per day intraperitoneally (IP) or standard amino acid solution 1.2 g kg(-1) per day plus alanyl-glutamine (GLN) 0.25 g kg(-1) per day (IP) during the first 6 days of the experiment. On the seventh day, CLP or sham procedures were applied. The sham and CLP groups were equally divided into 3 subgroups according to the termination of the experiment, which took place at either the 24th hour, 48th hour, or 72nd hour. After the compound muscle action potentials (CMAP) were recorded from the diaphragms of the rats at these selected times, they were decapitated under ketamine/xylazine anesthesia, and diaphragms were harvested for biochemical and histopathological examination. RESULTS: The mean area and amplitude of CMAP were significantly larger in sham+GLN groups when compared with CLP and CLP+GLN groups at all times (p < .05). Diaphragm Ca+2 -ATPase levels were found to be significantly decreased in CLP group at all times compared to sham groups (p < .05). Diaphragm reduced glutathione levels were significantly higher in sham+GLN groups when compared with CLP and CLP+GLN groups at all times (p < .05). In histopathologic assessment, moderate neutrophil infiltration, which was observed in CLP48, was significantly reduced with alanyl-glutamine supplementation in CLP+GLN48 group (p < .05). CONCLUSIONS: This study showed that glutamine pretreatment did not improve diaphragm muscle function, but prevented the biochemical and histopathological changes in diaphragmatic muscle in CLP-induced sepsis. However, further studies are needed to clarify whether a higher dose of glutamine supplementation might protect the diaphragmatic muscle functions.     

Mitomycin C prevents strictures in caustic esophageal burns in rats

BACKGROUND: Caustic esophageal injuries lead to stricture formation. Although a number of agents have been tried experimentally to prevent strictures, few have gained clinical application. The purpose of this study was to investigate the effectiveness of Mitomycin C (MMC), which inhibits fibroblastic proliferation in preventing caustic esophageal strictures. MATERIAL AND METHODS: Fifty-six rats were allocated into four groups. Caustic esophageal burns were created as described by Gehanno. Group A was instilled only with saline. Group B was injured and untreated. Groups C and D were injured and received topical MMC at 0.02 and 0.04% concentrations, respectively. At 28 days, stenosis index (SI), collagen deposition, and hydroxyproline content (HP) were determined in distal esophageal segments. Statistical analyses were done. RESULTS: Mean SI in Group B was significantly higher than others (P < 0.05). Mean SI was statistically higher in Group C than A and D and similar between groups A and D. The greatest accumulation of collagen was found in Group B, followed by Group C, D, and A, respectively. Collagen deposition in Group D was statistically lower than Group B (P < 0.01) and similar to Group C. Mean HP in Group B was statistically higher than others (P < 0.05), significantly higher in Group C than Group D (P = 0.047), and similar between Groups A and D (P = 0.73). CONCLUSION: MMC was effective in preventing strictures following experimental caustic esophageal injury, in a dose-dependent manner. We consider that it can gain clinical utilization with the establishment of effective mode, dose, and timing of therapy.     

Impact of haemodialysis on QTc dispersion in children

BACKGROUND: The purpose of the present paper was to investigate the corrected QT (QTc) interval and QTc dispersion value, and the impact of haemodialysis on these parameters in children with chronic renal failure. METHODS: Nineteen patients with chronic renal failure receiving haemodialysis were included in the present study. Electrocardiography (ECG), echocardiography and serum biochemistry were performed in all patients. Serum electrolyte levels were measured before and after haemodialysis, at the time of the ECG. Nineteen healthy age- and sex-matched children served as the control group. RESULTS: Patients with chronic renal failure had greater QTc interval and QTc dispersion compared to control subjects. The patients' sex, age and presence of hypertension or left ventricular hypertrophy (LVH) were not related to QTc interval/dispersion. However, the patients with left ventricular (LV) systolic dysfunction had significantly greater QTc dispersion value. After haemodialysis session, both QTc interval and QTc dispersion values significantly increased. Serum potassium levels significantly decreased, whereas the calcium level significantly increased after the haemodialysis session. The changes in electrolyte values were not associated with the changes in both QTc interval and QTc dispersion. CONCLUSION: Children receiving haemodialysis may be at greater risk of ventricular arrhythmia and sudden death because QTc dispersion reflects heterogeneous recovery of ventricular excitability.     

Effect of re-use of a disposable micro-polisher on the surface of a microhybrid resin composite

PURPOSE: To evaluate the surface roughness of Esthet-X resin-based composite with the multi-use of a one-step disposable diamond micro polisher PoGo with profilometer and scanning electron microscope (SEM). METHODS: 35 discs were obtained by condensing Esthet-X in an 8x2 mm plexiglass mold covered with a Mylar strip. The specimens were polymerized 40 seconds on both sides. Five Mylar strips' surfaces were used as a control. Six groups of five discs were formed by reusing the same PoGo disc 1, 2, 3, 4, 5 and 6 times. The surfaces of the 30 discs were ground wet with a 1200 grit silicon carbide paper and then polished 30 seconds with PoGo. The surface roughness was measured with Surtronic 4. One representative sample of each group was selected to visualize the surfaces morphology by SEM. The results were statistically evaluated by one-way ANOVA (P< 0.01). RESULTS: There were no statistical differences with the Mylar-created surfaces and one, two and three times' use of PoGo. Furthermore, reusing PoGo one to four times was not found to affect the surface roughness (P> 0.01). There were no differences with four and five re-uses of PoGo while using the same disc six times exhibited more roughness than single use and Mylar strip (P< 0.01). The SEM and the profilometer revealed similar results.     

Increased nitric oxide is accompanied by lipid oxidation in adolescent varicocele

Summary One of the mechanisms of injury in varicocele has been proposed to be elevated nitric oxide (NO). We aimed to determine the association between the elevation of NO and lipid oxidation in varicocele compared with peripheral venous levels of these two substances as it has not been studied before. The study group consisted of 13 adolescents with left idiopathic varicocele of grades II-III. Blood specimens were obtained from dilated spermatic and peripheral veins simultaneously. Peripheral samples were also collected from 13 healthy children as controls. Nitrite/nitrate levels (NO(x)) and levels of malonedialdehyde (MDA) were determined using Griess reaction and thiobarbituric acid test, respectively. Results were compared with Kruskal-Wallis and Mann-Whitney tests. Peripheral NO(x) and MDA were the same in the study and control groups (p = 0.069 and p = 0.27, respectively). Spermatic vein NO(x) and MDA levels were elevated significantly compared with the peripheral levels in the study group (p = 0.005 and p = 0.048, respectively). Increased NO(x) levels with lipid oxidation occur locally in adolescent varicocele, implying that these events could be reversed by early treatment.     

Candida albicans endocarditis and a review of fungal endocarditis: case report

Endocarditis due to fungal etiology is rare, but it is the most severe form of infective endocarditis. Fungal endocarditis is commonly complicated by systemic embolizations, and the difficulty in isolating the fungi with routine blood cultures complicates the diagnostic process. In these culture-negative cases of endocarditis, etiologic diagnosis is made with histopathologic examination of the cardiac valve, embolic materials, and systemic ulcers. In this case report, the presented patient with fungal endocarditis and its neurologic complications was treated with a surgical and medical approach.     

Serum nitric oxide metabolite levels and the effect of antipsychotic therapy in schizophrenia

BACKGROUND: Recently it was proposed that nitric oxide metabolites (NO) may have a role in the pathophysiology of schizophrenia and major depressive disorders. The present study was performed to assess changes in serum nitric oxide metabolite levels in schizophrenic patients compared with healthy controls. Our secondary aim was to further evaluate the impact of psychopharmacologic treatment on circulating NO levels not assessed previously. METHODS: Serum NO levels of patients with schizophrenia (n=20) before and after 6 weeks of treatment were compared with those of healthy controls (n=20). Severity of schizophrenia and response to treatment were assessed with positive and negative symptoms of schizophrenia. NO levels were estimated by Griess method in serum samples. RESULTS: In patients with schizophrenia, pre-treatment serum NO levels were higher than those of control subjects (39.15 +/- 18.24 vs. 25.40 +/- 5.83 micromol/L, p=0.036) and also of post-treatment values (34.41 +/- 16.35 vs. 25.40 +/- 5.83 micromol/L, p=0.049), respectively. However, no significant difference was found between serum NO levels in pre- and post-treatment values. CONCLUSIONS: Our findings of increased serum NO levels in schizophrenic patients confirmed the role of NO in the pathophysiology of schizophrenia. However, we found that antipsychotic drugs do not reveal significant effects on serum levels of NO in schizophrenia in a 6-week treatment regimen. Further studies with longer therapy periods may suggest some new clues for novel treatment strategies employing antioxidants and NOS inhibitors in schizophrenia.