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The organ that is affected first and most severely in intraabdominal sepsis is the lung. Oxygen radicals and active neutrophils in the lung are important sources for severe pulmonary inflammation leading to acute lung injury (ALI)/acute respiratory distress syndrome. The aim of this study was to investigate the effects of leflunomide, an immunomodulatory agent, on oxidant/antioxidant status with nitric oxide (NO) level and myeloperoxidase (MPO) activity in rats with sepsis-induced ALI. Fifty male Wistar albino rats were divided into five groups: control, sham, sepsis, leflunomide (10 mg/kg, intragastrically for two doses with an 8 h interval prior to the experiment) and sepsis + leflunomide. After the animals were anesthetized with ketamine and xylazine, the abdominal cavity was opened and ligated just below the ileocaecal valve with 3–0 silk. The antimesentric surface of the cecum was perforated and the cecum was gently compressed until fecal matter was extruded to induce sepsis. None of the rats received antibiotics during the experimental procedures. The experiment was ended 24 h after cecal ligation puncture (CLP) with the cervical dislocation under anesthesia. The lung tissues were removed for analysis of biochemical parameters and light microscopic investigation. The lung superoxide dismutase (SOD), catalase and glutathione peroxidase activities were decreased in the sepsis group as compared to the group control, sham, leflunomide and sepsis + leflunomide ( P < 0.05), and SOD activity were significantly higher in group sepsis + leflunomide than sham, control, leflunomide and sepsis group ( P < 0.05). The lung MPO, malondialdehyde (MDA), protein carbonyl and NO levels were higher in the sepsis group when compared to group control, sham, leflunomide and sepsis + leflunomide ( P < 0.05), and MPO, MDA and NO levels were higher in the sepsis + leflunomide group than in the sham, control and leflunomide group ( P < 0.05). The light microscopic evaluation showed that pulmonary architecture was preserved, and infiltration of neutrophil and edema decreased in sepsis + leflunomide group. The grade of alveolar damage was significantly decreased in sepsis + leflunomide group in comparison with sepsis group ( P < 0.05). Our findings suggested that leflunomide attenuated the lung injury after CLP-induced sepsis by inhibition of neutrophils accumulation and increasing endogenous antioxidant capacity. [ABSTRACT FROM AUTHOR]

In this randomized, double-blind study, we aimed to compare the effectiveness of lornoxicam and ondansetron for the prevention of intrathecal fentanyl-induced pruritus in patients undergoing cesarean section. One hundred and eight parturients (American Society of Anesthesiologists [ASA] I-II status) requesting neuraxial analgesia by a combined spinal-epidural (CSE) technique were recruited for this study. A CSE technique was performed and anesthesia was achieved with fentanyl 25 µg and hyperbaric bupivacaine 12 mg. Patients were randomly allocated to three groups, each with 36 participants. Immediately following delivery, patients received either lornoxicam 8 mg IV (group L; n = 36), ondansetron 8 mg IV (group O; n = 36), or normal saline 2 ml IV (group P; n = 36). Pruritus, pain, and nausea and vomiting scores were recorded during the initial 24 h postoperatively. The incidence of pruritus was significantly lower in group O from 4 to 12 h postoperatively when compared to that in group L and group P. According to the pruritus grading system we used, the number of patients without pruritus was significantly higher in group O when compared to that in group L and group P. The number of patients experiencing moderate pruritus was significantly lower in group O when compared to that in group P. We observed that the administration of 8 mg IV lornoxicam failed to prevent intrathecal fentanyl-induced pruritus in parturients. Also, our data confirmed that ondansetron is likely to attenuate intrathecal fentanyl-induced pruritus. [ABSTRACT FROM AUTHOR]

This study aims to determine the microscopic anatomy of the layers of the lateral wall of the cavernous sinus (CS) and, in particular, intends to examine the location and relations of the dural openings on the deep layer. Forty sides of 20 formalin-fixed and fresh cadavers were dissected and their CS examined. In 12 cases we found an opening on the deep dural layer; however, in four of them the inferolateral trunk of the internal carotid artery (ICA) was identified through these dural openings. We noticed the trochlear nerve making a curve (5% of cases) or lying close to the ophthalmic nerve (12.5%) on the lateral wall. In one case, the triangular area described by Parkinson could not be exposed surgically. Our findings indicate the importance of the heterogeneous courses of the cranial nerves lying on the lateral wall and point to the significance of the dural openings, which can influence the etiology of neoplastic invasions originating from the CS. [ABSTRACT FROM AUTHOR]

The main purpose of this study was to investigate the effectiveness of the DSM-IV diagnostic criteria and the South Oaks Gambling Screen (SOGS) in identifying Turkish pathological gamblers. Fifty-nine subjects participated in the study. The subjects were diagnosed as either pathological gamblers or not (comparison group) through the use of the DSM-IV criteria and were given the Turkish version of the SOGS. Four of the ten DSM-IV criteria were found to be problematic in the diagnosis of Turkish pathological gamblers. The data concerning reliability and validity of the Turkish version of the SOGS suggested that the SOGS can be used as a reliable and valid instrument in identifying Turkish pathological gamblers. Most (16 out of 20) of the items of the SOGS appear to work well in discriminating pathological gamblers from the subjects in the comparison group. In the case of the two DSM-IV criteria and the four SOGS items that failed to discriminate, cultural factors seemed to be responsible for the failure. [ABSTRACT FROM AUTHOR]

An anatomical study was performed to assess the course of the dorsal branches of superficial radial nerve and to investigate potential clinical applications in hand surgery. Eight upper extremities were dissected, using an operating microscope. All branching points of the superficial radial nerve were noted and the distances from the radial styloid process were recorded. Their proximity to neighboring vascular structures was noted. The superficial branches of the radial nerve can vascularize axial neurofasciocutaneous flaps via their paraneural arterial network. In addition, various reverse neurofasciocutaneous flaps may be harvested, based on dorsal branches of the superficial radial nerve. The nerve can be anastomosed with a suitable nerve in the recipient area. The dorsal branches of the superficial radial nerve can easily be added to the reverse first dorsal metacarpal artery flap and other reverse dorsal metacarpal artery flaps, thus making it possible to form a sensate flap. These branches may be anastomosed with nerves in the recipient site, such as dorsal branches of digital nerve stump, without significant donor site morbidity. A free sensate first dorsal artery flap can be prepared with a combination of dorsal branches of the superficial radial nerve and used with the same indications as a free digital artery flap. It has some advantages over the free digital artery flap, because the main neurovascular structures of the finger are kept intact. Finally, a dorsal nerve branch which accompanies the first dorsal metacarpal artery may be harvested with this artery and a subcutaneous dorsal vein as vascularized nerve graft. It can be used to repair a digital nerve defect in dense scar tissue. [ABSTRACT FROM AUTHOR]