Pioglitazone Attenuates Ischemia/Reperfusion–Induced Liver Injury in Rats

Introduction

Hepatic ischemia/reperfusion (I/R) injury leads to free radical generation and acute inflammatory responses that cause liver damage, an important problem for liver transplantation. Pioglitazone is known to protect I/R injury in various tissues; however, the mechanism of cytoprotection is not well understood. This study investigated the effects of pioglitazone administration in a warm hepatic I/R model on tumor necrosis factor (TNF)-α level, tissue injury, and antioxidant enzyme activity.

Materials and Methods

Eighty wistar strain rats were divided into 4 groups (n = 20): Group 1 sham hosts; Group 2 hepatic I/R; Group 3 hepatic I/R + pioglitazone (10 mg/kg); and Group 4 hepatic I/R + vehicle. Rat livers were subjected to 30 minutes of ischemia followed by 6 hours of reperfusion. After reperfusion rats were humanely killed to obtain liver tissue to study glutathione peroxidase (GPx), superoxide dysmutase (SOD), malondialdehyde (MDA) levels and for histopathologic assessment. TNF-α, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were measured in serum.

Results

Pioglitazone pretreatment significantly reduced liver enzyme content (ALT, 176.80 ± 13.75 vs 235.28 ± 31.92 and AST, 748.20 ± 79.29 vs 944.85 ± 101.87) and TNF-α level (9:8.60 ± 8.67 vs 138.28 ± 9.99) after I/R compared with the control group. MDA level (3.02 ± 0.37 vs 4.36 ± 0.38) and hepatocytic degeneration were reduced in the pioglitazone-treated group. GPx (2.40 ± 0.25 vs 1.36 ± 0.31) and SOD activity (2.22 ± 0.30 vs 1.40 ± 0.35) were significantly higher in the pioglitazone-treated group compared with the control group.

Conclusion

The present study showed that pioglitazone administration improved hepatic I/R injury that was associated with enhanced antioxidant enzyme activities and suppression of TNF-α, ALT, and AST levels. Because peroxisome proliferator-activated receptor-γ agonists are widely used to treat diabetic patients, it may be relatively easy to expand their clinical indication. However, further investigations will be required to delineate protective mechanisms by which pioglitazone attenuates hepatic tissue injury after I/R.     

Knowledge and practice of foot care in Iranian people with type 2 diabetes

The aim of this study was to determine the knowledge and practice of foot care in people with type 2 diabetes. We carried out a cross-sectional study. A questionnaire was completed by 148 patients with type 2 diabetes in Tehran, Iran. Knowledge score was calculated and the current practice was determined. The mean knowledge score was 6.6 (standard deviation +/-3.0) out of a possible 16. Illiterate patients were the least knowledgeable (P= 0.008). Lack of adequate knowledge includes the following: 56% not aware of the effect of smoking on the circulation to the feet, 60% failed to inspect their feet and 42% did not know to trim their toenails. High risk practices including use of irritants to water (66.5%) and walking barefoot (62%). The results of this study highlight the patients' inadequate knowledge of self-care about their foot and lack of optimal podiatry service in Iran. These findings have implications for further evaluation, planning and management of patient care in diabetic foot disease.     

217. Technik der Lezius-Herzer-Nagelung

ZusammenfaBung Die intramedulläre Fixation mit dem Rundnagel nach Lezius-Herzer bei trochanteren Frakturen ist eine stabile Osteosynthese mit sofortiger Belastbarkeit. Es ist eine relativ leichte Methode bei Benutzung des Bildwandlers zur Bestimmung der Länge und Form des Nagels, sowie der Höhe der Incision und des Bohrloches. Der Nagel unterstützt die architektonische Struktur des Femur. Die NachuntersuchungsergebniBe von 130 Überlebenden 1–16 Jahre nach der Operation waren: sehr gut bis gut bei 121, mäBig bei 6 und schlecht bei 3 Patienten. Operationserfahrung haben wir bei 600 Frakturen.     

Post-operative quadriplegia as the initial manifestation of tumefactive multiple sclerosis

Post-operative quadriplegia is a rarely encountered complication and not previously reported as the initial presentation of tumefactive multiple sclerosis. We present an unusual case of a patient with such manifestation and atypical lesions on brain magnetic resonance imaging. The patient was treated with methyl prednisolone pulse therapy and showed a dramatic response. Uncommon neurologic diseases can have very unusual presentations, which should be taken into consideration when encountered with such patients. Considering this fact will help physicians in better decision-making and proper treatment planning.     

Predictive value of neutrophil-to-lymphocyte ratio in diabetic wound healing

Objective

The neutrophil-to-lymphocyte ratio (NLR) has been used as a surrogate marker of systemic inflammation. We sought to investigate the association between NLR and wound healing in diabetic wounds.