Comparison of Adhesive Properties of Five Different Prosthetic Materials Used in Hernioplasty

This experimental study was designed to assess and to compare intra-abdominal adhesions following the use of five commercially available prosthetic mesh grafts in the repair if abdominal wall defects. Sixty Wistar albino rats were randomly divided into six groups (n = 10). A 2 × 1 cm defect at abdominal wall was created and defects were closed either primarily or with one of the following prosthetic mesh grafts: monofilament polypropylene, polytetrafluoroethylene, sodium hyaluronate/carboxymethylcellulose-coated polypropylene, polypropylene/polyglactin 910 composite, or resorbable hydrophilic collagen-coated multifiber polyester. The severity of adhesions was graded, tensile strengths of adhesions were measured, and histopathological grades of inflammation and fibrosis were evaluated. Polypropylene mesh resulted in more adhesion formation in comparison to primary repair and other grafts used in this study, except polypropylene/polyglactin 910 composite mesh. In addition, the highest tensile strength of omental adhesions was detected in the polypropylene group (χ² = 26.249; p =. 0001). Polyester composite mesh caused the least adhesion formation among the groups. Sodium hyaluronate/carboxymethylcellulose-coated polypropylene and polyester composite meshes revealed the highest fibrosis scores (χ² = 50.776; p =. 0001). The highest inflammatory activity was detected in the polytetrafluoroethylene mesh group (χ² = 16.564; p =. 005). Thus, sodium hyaluronate/carboxymethylcellulose-coated polypropylene and polytetrafluoroethylene meshes following polyester composite mesh were the minimal adhesion-forming grafts in this study. Disadvantages of the polytetrafluoroethylene mesh were lower fibrotic activity and higher inflammatory reaction to the graft.     

Curcumin ameliorates impaired insulin/IGF signalling and memory deficit in a streptozotocin-treated rat model

Increased serum insulin levels and reduced peripheral insulin activities seen in insulin resistance syndrome are associated with age-dependent cognitive impairment and Sporadic Alzheimer’s Disease (SAD), suggesting a disturbance in the insulin signalling system in the brain and possibly being one of the causes of dementia. Therefore, the streptozotocin (STZ)-induced animal may be an appropriate model for the investigation of SAD and related dementia. This study was designed to investigate the beneficial effect of Curcumin (CUR), a neuroprotective agent, on intracerebroventricular (ICV) STZ-induced cognitive impairment in rats. For this purpose, adult male Wistar rats were bilaterally ICV injected with STZ (3 mg/kg). An artificial cerebrospinal fluid (aCSF) was given to the control group (SHAM) instead of STZ on days 1 and 3. Learning and memory performance were assessed using the “passive avoidance task” and the “Morris water maze test”. After confirmation of acquisition impairment with these tests, the STZ group was divided into two subgroups: STZ + vehicle (Vh) and STZ + CUR. The rats in the SHAM and STZ + Vh groups were administered intraperitoneally with 0.5 ml Vh and the rats in the STZ + CUR group were treated intraperitoneally with CUR (300 mg kg⁻¹ day⁻¹ in Vh) for 10 days starting from the 25th day after STZ injection. The Morris water maze test was reapplied on the 35th day after STZ injection and all of the rats were sacrificed on day 36 for quantitation of IGF-1 and for histopathological evaluation. Rats in the STZ + CUR group were found to have a higher performance in cognitive tests than rats in the STZ + Vh group (P < 0.01). In parallel with the cognitive tests, IGF-1 levels were decreased in all of the STZ-injected groups (1.78 ± 0.34) compared to the SHAM group (3.46 ± 0.41). In contrast, CUR treatment significantly increased IGF-1 levels (P < 0.001). The degree of neuronal loss decreased after CUR treatment compared to the SHAM group (P < 0.02). These results clearly indicate that CUR treatment is effective in reducing the cognitive impairment caused by STZ in rats, and may be a potential therapeutic agent for altering neurodegeneration in SAD.     

Plasma Concentrations of Isoniazid and Rifampin Are Decreased in Adult Pulmonary Tuberculosis Patients with Diabetes Mellitus

Plasma isoniazid and rifampin concentrations, but not pyrazinamide and ethambutol concentrations, were decreased by about 50% (P < 0.05) in diabetic pulmonary tuberculosis patients. The prevalences of subnormal plasma isoniazid, rifampin, pyrazinamide, and ethambutol concentrations were 49% or 100% (P < 0.01), 66% or 100% (P < 0.05), 30% or 50% (P = 0.198), and 32% or 21% (P = 0.742) in nondiabetic or diabetic tuberculosis patients, respectively. These data show that plasma concentrations of isoniazid and rifampin were greatly reduced in diabetic tuberculosis patients.     

Unusual Manifestations of Bilateral Carotid Artery Dissection: Dysphagia and Hoarseness

Dissection of the carotid artery can occur intracranially or extracranially, although dissections tend to affect extracranial segments of the arteries much more commonly than intracranial segments. Carotid artery dissection (CAD) is most common in middle-aged women. Although not completely known, the main risk factors related to carotid artery dissection are genetic and environmental factors, traumatic events, cervical manipulation, migraine, recent infections, hyperhomocysteinemia, and hereditary connective tissue disorders. Although some cases of bilateral internal CAD have been reported, spontaneous bilateral dissections are rare. Prolonged hoarseness is usually due to using the voice either too much, too loudly, or improperly over an extended period of time. Disorders leading to dysphagia may affect the oral, pharyngeal, or esophageal phases of swallowing. In this study we report on a patient with bilateral CAD who presented to our clinic with dysphagia and hoarseness.     

Subacute effects of methyl parathion on antioxidant defense systems and lipid peroxidation in rats

In this study we aimed to examine how methyl parathion (MP) at sublethal dosages affects on malondialdehyde (MDA) content and antioxidant defense system (ADS) such as reduced glutathione (GSH), glutathione reductase (GR), superoxide dismutase (SOD) and glutathione-S-transferase (GST) in various tissues of rats exposed to 19 and 38 millimole (mM) MP dosages as drinking water ad libitum for 28 days continuously. MDA significantly increased in all the tissues except for in the lungs of rats treated with both dosages of MP. With regard to the ADS, SOD significantly decreased in the lungs tissue whereas increased in the erythrocytes with two dosages of MP. GR activity significantly decreased in the erythrocytes treated with both dosages of MP, but decreased in the lungs and liver tissues with 38 mM MP treatment. GST activity significantly elevated in all the tissues except for in the liver treated with 38 mM dosage but did not change with 19 mM. Meanwhile, GSH depletion in all the tissues except lungs of rats treated with both dosages of MP was found to be significant. The observations presented led us to conclude that after the administrations of MP promote MDA content and fluctuate in the ADS in rats.     

A life-threatening infection: Fournier's gangrene

Fournier's gangrene is a life-threateningdisorder in which infection of the perineum andscrotum spreads along fascial planes, causingsoft tissue necrosis. If urgent surgery isdelayed, the disease will soon result in septicshock, multiorgan failure, and death. In thisstudy, we present 21 patients with Fournier'sgangrene who were treated in period between1994 and 2001. Patients' charts were reviewedretrospectively and are discussed in the lightof literature.All patients received aggressive surgicaldebridment. Penicillin or Ceftriaxone,aminoglicoside and metronidazole wereadministered intravenously. Of the 21 patients,5 had scrotal carbuncle, 1 had urethralstricture, 1 had chronic indwelling urethralcatheterization, 2 had perirectal abscess, and1 had hemorrhoidectomy. In eleven patients wecouldn't identify any cause. Twelve patientshad diabetes mellitus, and two had chronicalcoholism. Escherichia coli was isolatedin 12 purulent tissue cultures, and Bacteroides fragilis in eight. Seventeenpatients survived, whereas four died.Fournier's gangrene is considered a surgicalemergency. Early surgical intervention isessential, as the gangrene can spread rapidlyat rates reaching 2 mm per hour. So thatFournier's gangrene is an abrupt, rapidlyprogressive, gangrenous infection of theexternal genitalia and perineum and is a realurologic emergency.     

L-carnitine in experimental retinal ischemia-reperfusion injury

The effect of L-carnitine on retinal ischemia-reperfusion injury was evaluated in guinea pigs. 90 min of pressure-induced retinal ischemia followed by 24 h of reperfusion was established in both eyes of 2 groups of animals receiving either L-carnitine (100 mg/kg repeated in 5 doses) or saline intraperitoneally. After enucleation of all the eyes, including those of a control group, malonyldialdehyde (MDA) levels and the thickness of the retinal tissue were measured in 3 groups. The mean MDA value and the tissue thickness of the L-carnitine-treated group were statistically insignificant versus the control group (p > 0.05 and p > 0.05, respectively). However, these values were significantly different in the group receiving saline versus the control group and that receiving L-carnitine (p < 0.001, p < 0.001 and p < 0.001, p < 0.001 respectively). L-Carnitine might be an alternative drug for ischemia-reperfusion injury of the retina.     

The effects of the incision types in myringoplasty operations on cosmesis

There is no study based on objective measurements about the cosmetic results of myringoplasty operation in medical literature. This study aims to show the differences in the auriculomastoid angle between the operations which were done with postauricular and endaural incisions. The auriculomastoid angle of 20 patients having had postauricular myringoplasty operation were measured both preoperative and postoperative periods. The auriculomastoid angles of 17 patients having had endaural myringoplasty operation were also measured in both preoperative and postoperative periods. Also, the patients were asked whether there was a change in the shape of their ears. It was observed that the increase of the auriculomastoid angles of the patients who had myringoplasty by postauricular incision was statistically significant when compared to the ones having had the operation by endaural incision. Also, the patients who had myringoplasty operation by postauricular incision realized the change in their ears significantly when compared to the other group. In this study, esthetically better results were observed in the myringoplasty operations done by endaural incision than the ones done by postauricular incision. When deciding on the incision type, this should be considered.     

Ethmomaxillary sinus

Ethmomaxillary sinus is a variation of the posterior ethmoid cells. It is formed by the extension of the posterior ethmoid cells into the maxillary sinus and drains into superior nasal meatus. It is incidentally seen on paranasal sinus computerized tomography (CT) scans. Its prevalence has been reported as 0.7 and 2% in two studies. In this study, paranasal CT scans of 466 patients were investigated for the presence of ethmomaxillary sinus. The patients had paranasal CT with the preliminary diagnoses of septal deviation, chronic inflammatory paranasal sinus disease and nasal turbinate disorders. The ethmomaxillary sinus was present in nine of those patients (1.93%). It was septated in one of them. The CTs were further investigated for other anatomical variations and co-existent mucosal disease of the paranasal sinuses.