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The effects of immunosuppressive agents on inflammatory response in septic rats

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Filiz A., Ozturk A., Kurt Y., Sucullu I., Akin M., Yildiz M.
Open Medicine
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2010
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vol. 5
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issue 6
683-690
EN
Sepsis remains a serious clinical problems resulting in high morbidity and mortality. We aimed to investigate the inflammatory response in a septic rat model treated with immunomodulator agents. We used the cecal ligature and puncture model to establish septic peritonitis in rats. Male Wistar-Albino rats were randomized into groups of seven rats each and assigned different regimens: Tacrolimus 1 mg/kg/day, cyclosporin-A 5 mg/kg/day and methylprednisolone 15 mg/kg/day. These immunsuppressive agents were applied at the 6 and 48 hour intraperitoneally. The animals were euthanized after 6 and 48 hours and systemic parameters including, IL-2, IL-6, TNF-a, CRP, AST and creatinine were examined. Our study demonstrated that the experimental peritonitis model caused a meaningful rise in the values of systemic parameters. This was especially apparent for early-applied cyclosporin A; in addition, tacrolimus significantly decreased the levels both at the 6 and 48 hour. The excess immune response in complex sepsis treatment might be restrained using immunosuppressive agents administered early. Although additional supportive, comprehensive, experimental and clinical studies are still needed, this therapy model may prove to be an alternative for the future.
2
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Seminoma presented with acute abdomen due to ileum perforation

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Filiz A., Sücüllü İ., Kurt Y., Okul O., Küçükodaci Z., Karagöz B.
Open Medicine
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2010
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vol. 5
|
issue 5
636-639
EN
Germ cell tumors presenting with an acute abdomen are not common. We present a case of seminoma with ileum perforation, which presented in a 48-year-old man. who had been admitted to hospital with a right lower abdominal palpable mass measuring approximately 16 cm. Before an exploratory laparotomy was performed, acute abdomen with signs of hollow viscus perforation had occurred. An ileum perforation was detected and a right hemicolectomy and ileal resection were performed. The pathological examination showed a classic seminoma of undescended testis. In conclusion, this case is interesting with respect to its clinical picture of acute abdomen due to ileal perforation. The possibility of a germ cell tumor should always be kept in mind in male patients with acute abdomen.
3
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Coexistence of pancreatic tuberculosis with systemic brucellosis: a case report

84%
Acar A., Sücüllü İ., Baylan O., Filiz A., Diktaş H., Kıvanc M., Öncül O., Görenek L.
Open Medicine
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2010
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vol. 5
|
issue 5
573-576
EN
Isolated pancreatic tuberculosis is an extremely rare clinical entity and is difficult to diagnose particularly in immunocompetent individuals. Clinical findings and symptomatology of brucellosis are often similar to tuberculosis thus making the differentiation amongst the two entities difficult. We report a case of pancreatic tuberculosis with systemic brucellosis in a 29 year old veterinarian who presented with epigastric pain and loss of appetite. Initial investigations revealed leukocytosis with moderately elevated transaminase, gamma glutamyl transferase, amylase and lipase levels. Imaging studies revealed an anechoic multiloculated cyst in the body and tail of the pancreas. Given the patient’s occupational risk coupled with the presence of a positive Brucella agglutination test (with a titer of 1:320); a diagnosis of pancreatitis secondary to brucellosis was given. In addition to standard pancreatitis therapy of bowel rest with intravenous fluid/electrolyte replacement, anti-brucellosis therapy was also administered. The patient’s initial response to therapy was positive however, 6 weeks into therapy, his abdominal pain recurred and repeat CT scan revealed the development of a pseudocyst in the pancreas. After failing a second attempt at conservative supportive therapy, the patient underwent an explorative laparotomy. Histological examination of the resected pancreatic specimen showed necrosis and was positive for tuberculosis by polymerase chain reaction. Herein, we describe the first case reported in the medical literature of the coexistence of systemic brucellosis with pancreatic tuberculosis. We suggest that the possibility of the coexistence of brucellosis with tuberculosis be kept in mind when assessing pancreatitis patients in endemic regions and in individuals with occupational risk hazards.
4
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Platelet indices in patients with colorectal cancer

68%
Karagöz B., Sücüllü İ., Sayan Ö., Bilgi O., Tuncel T., Filiz A., Yücel E., Ozgun A., Erikçi A., Alacacioğlu A., Kandemir E.
Open Medicine
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2010
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vol. 5
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issue 3
365-368
EN
The interaction between cancer cells and platelets has been known for a long time. Although platelet indices have been also investigated in several clinical settings, it has not been exactly demonstrated in cancer patients. We investigated platelet indices in colorectal cancer patients and compared with healthy subjects. Two hundred and twenty-one colorectal cancer patients and 110 healthy subjects were enrolled into the retrospective study. Data were obtained from computerized medical records of our hospital. Medical record review was performed for all patients regarding thrombocyte indices. Platelet count (325.000/mm3 ± 265.000/mm3 vs 267.000/mm3 ± 67.000/mm3; p=0.025; respectively) and plateletcrit (Pct) (0.25% ± 0.10 vs 0.21 ± 0.05; p<0.001; respectively) were increased in patients compared with healthy subjects while mean platelet volume (MPV) and platelet distribution width (PDW) were similar. The platelet indices were not related to existence of metastasis or acute abdomen. Platelet count and Pct, but not MPV and PDW, are elevated in colorectal cancer patients. Future studies that investigate platelet morphology, function, and putative role of platelets in tumorigenesis and metatasis should be established.
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