Öz
Objective: Corrosive burns of the esophagus are some reports demonstrating that the stricture ratio exceeds 50% in the case of a severe burn. In this experimental animal study of rats, we aimed to investigate the effects of the anti-inflammatory agents in esophageal alkali burns.Methods: Twenty-eight Wistar albino rats, weighing from 220 to 250 gr, were used in the study. And following a starving period of 12 hours, we provided general anesthesia with intramuscular ketamin HCL (90 mg/kg) and xylazine (10mg/kg). A corrosive burn just like the corrosive esophagitis was done under general anesthesia. The rats were divided into four groups (7 rats for each). The intraluminal area of 1cm in the esophagus of the rats of the first group was washed using serum physiologic (1 ml). Group II received parenteral antibiotic treatment. Group III received antibiotic and dexamethasone regiment, while the Group IV received antibiotic and prednisolone. Each animal was sacrificed on the 21st day, and their abdominal esophagus was resected for histopathological investigation. The submucosal increase in the collagen, damage to the muscularis mucosa and to the tunica muscularis were three parameters demonstrating the injury histopathologically.Results: There was no injury in the Group I. There was injury in each parameter in the Group II, III, and IV compared with Group I. In the comparison between Group II and III, there was less injury in the Group III. In comparison with Group II there was also significant injury in the muscularis mucosa and the tunica muscularis in the Group I (p<0.05).Conclusion: Prednisolone may decrease the new collagen synthesis that progresses up to muscularis mucosa, but the effect on the lowering the stricture formation is not better than dexamethasone
Anahtar Kelimeler
Dexamethasone collagen corrosive burns of the esophagus prednisolone
Kaynakça
- Koltuksuz U, Mutus HM, Kutlu R, et al. Effects of caffeic acid phenethyl ester and epidermal growth factor on the development
- of caustic esophageal stricture in rats. J Pediatr Surg 2001; 36:1504-1509.
- Ocakcı A, Kanter M, Cabuk M, Büyükbas S. Role of caffeic acid phenenthyl ester, an active component of propolis, against NAOH- induced esophageal burns in rats. Int J Pediatr Otorhinolaryngol 2006; 70:1731-1739.
- Adam JS, Brick HG. Pediatric caustic ingestion. Ann torhinolaryngol
- ; 91:656-658.
- Günel E, Cağlayan O, Canbilen A, Tosun M: Effect of antioxidant
- theraphy on collagen synthesis in corrosive esophageal burns. Pediatr Surg Int 2002; 18:24-27.
- Berthet B, Costanzo J, Arnaud C, et al. Influence of epidermal growth factor and interferon gamma on healing of esophageal burns in the rat. British J Surg 1994; 81:395-398.
- Ashcraft KW, Padula RT. The effect of dilute corrosives on
- esophagus. Pediatrics 1974; 53:226-232.
- Kasap E, Ozütemiz A. Pet şişedeki tehlike. Korozif özefajit.Güncel Gastroenteroloji 2006; 10:29-35.
- Kayaalp O. Tıbbi Farmakoloji. Kortikosteroidler, Kortikosteroid Antagonistleri ve ACTH. 12. Baskı, Ankara: Pelikan yayınları 2009:1079-1107.
- Gehanno P, Guedon C. Inhibition of experimental esophageal lye strictures by pensilamin. Arch Otolaryngol 1981;107:145-147.
- Güven A, Gündogdu G, Sadir S, et al. The efficacy of ozone therapy in experimental caustic esophageal burn. J Pediatr
- Surg 2008; 43:1679-1684.
- Naharcı I, Tüzün A. Kostik özefagus yaralanmaları. Güncel Gastroenteroloji 2005; 9:226-233.
- Greiner C, Wolfer J, Hulsmann S, et al. Bioelectrical behavior of hipoxic human neocortical tissue under the influence of nimodipine and dimethyl sulfoxide. Brain Research 2003; 959:199-205.
- Güven A, Demirbağ S, Uysal B, et al. Effect of 3- amino benzamide, a poly (adenosine diphosphate- ribose) polymerase inhibitor, in experimental caustic esophageal burn. J Pediatr Surg 2008; 43:1474-1479.
- Anderson KD, Rouse TM, Randalph JG. A controlled trial of corticosteroids in children with corrosive injury of the esophagus. N Engl J Med 1990; 323:637-640.
- Keskin E, Okur H, Koltuksuz Y. Effect of steroid treatment on corrosive esophageal burns in children. Eur J Pediatr Surg 1991; 1:335-338.
- BautistaA, Tojo R, Varela R. Effects of prednisolone and dexamethasone on alkali burns of the esophagus in children.
- Eur J Pediatr Surg 1996; 6:198-203.
- Baurista A, Tojo R, Varela R, et al. Effects of prednisolone and dexamethasone on alkali burns of the esophagus in rabbit. J Pediatr Gastroenterol Nutrition 1996; 22:275-283.
- Rafeey M, Shoaran M. Clinical characteristics in oral caustic ıngestion in children. Pakistan Journal of Biological Sciences 2008; 11:2351-2355.
- Osman M, Russel J, Shukla D, et al. Responses of the murine
- esophageal microcirculation to acute exposure to alkali, acid, or hypochlorite. J Pediatr Surg 2008; 43:1672-1678.
Öz
Amaç: Korozif özofagus yanıkları (KÖY) hastalarda striktür oranının %50‘nin üzerine çıktığını gösteren çalışmalar mevcuttur. Çalışmamızda rat özofagus alkali yanık modelinde antienflamatuar ajanların etkisini araştırmayı amaçladık.
Yöntemler: Çalışmada vücut ağırlıkları 220–250 gr arasında değişen Wistar Albino türü 28 adet rat kullanıldı. Bütün gruplara korozif özofajitine benzer şekilde KÖY oluşturuldu. Rat'lar 12 saat aç bırakılarak kas içi ketamin HCL (90 mg/kg) ve xylazine (10mg/kg) ile genel anestezi sağlandı. Her grupta 7 rat olacak şekilde 4 gruba ayrıldı. Grup I’ deki rat'ların 1 cm özofagus segmenti lümen içi 1ml serum fizyolojik ile yıkandı. Grup II rat'lara KÖY oluşturulduktan sonra parenteral antibiyotik verildi. Grup III rat’lara KÖY oluşturulduktan sonra antibiyotik ve deksametazon, grup IV rat'lara ise prednizolon ve antibiyotik tedavisi verildi. Rat'ların tümü 21. günde sakrifiye edilerek abdominal özofagusları histopatolojik inceleme için çıkarıldı. Submukoza kollajen artışı, muskularis mukoza hasarı ve tunika muskularis hasarı histopatolojik olarak belirlendi.
Bulgular: Yapılan inceleme ile Grup I’ de hasar olmadığı görüldü. Grup I ile Grup II, III, IV karşılaştırıldığında Grup II, III ve IV’ de her üç parametrede hasar saptandı. Grup II, Grup III ile karşılaştırıldığında Grup III’ de hasar daha az saptandı. Grup II, Grup IV ile karşılaştırıldığında muskularis mukoza ve tunika muskularis hasarı açısından istatistiksel olarak anlamlı farklılık saptandı (p<0.05).
Sonuç: Sonuç olarak prednizolon muskularis mukozaya kadar ilerleyen yeni kollojen sentezini azaltabilir ancak darlık oluşumunu azaltıcı etkisi deksametazona göre farklı değildir.
Anahtar kelimeler: Deksametazon, kollojen, korozif özofagus yanığı, prednizolon.
Anahtar Kelimeler
Kaynakça
- Koltuksuz U, Mutus HM, Kutlu R, et al. Effects of caffeic acid phenethyl ester and epidermal growth factor on the development
- of caustic esophageal stricture in rats. J Pediatr Surg 2001; 36:1504-1509.
- Ocakcı A, Kanter M, Cabuk M, Büyükbas S. Role of caffeic acid phenenthyl ester, an active component of propolis, against NAOH- induced esophageal burns in rats. Int J Pediatr Otorhinolaryngol 2006; 70:1731-1739.
- Adam JS, Brick HG. Pediatric caustic ingestion. Ann torhinolaryngol
- ; 91:656-658.
- Günel E, Cağlayan O, Canbilen A, Tosun M: Effect of antioxidant
- theraphy on collagen synthesis in corrosive esophageal burns. Pediatr Surg Int 2002; 18:24-27.
- Berthet B, Costanzo J, Arnaud C, et al. Influence of epidermal growth factor and interferon gamma on healing of esophageal burns in the rat. British J Surg 1994; 81:395-398.
- Ashcraft KW, Padula RT. The effect of dilute corrosives on
- esophagus. Pediatrics 1974; 53:226-232.
- Kasap E, Ozütemiz A. Pet şişedeki tehlike. Korozif özefajit.Güncel Gastroenteroloji 2006; 10:29-35.
- Kayaalp O. Tıbbi Farmakoloji. Kortikosteroidler, Kortikosteroid Antagonistleri ve ACTH. 12. Baskı, Ankara: Pelikan yayınları 2009:1079-1107.
- Gehanno P, Guedon C. Inhibition of experimental esophageal lye strictures by pensilamin. Arch Otolaryngol 1981;107:145-147.
- Güven A, Gündogdu G, Sadir S, et al. The efficacy of ozone therapy in experimental caustic esophageal burn. J Pediatr
- Surg 2008; 43:1679-1684.
- Naharcı I, Tüzün A. Kostik özefagus yaralanmaları. Güncel Gastroenteroloji 2005; 9:226-233.
- Greiner C, Wolfer J, Hulsmann S, et al. Bioelectrical behavior of hipoxic human neocortical tissue under the influence of nimodipine and dimethyl sulfoxide. Brain Research 2003; 959:199-205.
- Güven A, Demirbağ S, Uysal B, et al. Effect of 3- amino benzamide, a poly (adenosine diphosphate- ribose) polymerase inhibitor, in experimental caustic esophageal burn. J Pediatr Surg 2008; 43:1474-1479.
- Anderson KD, Rouse TM, Randalph JG. A controlled trial of corticosteroids in children with corrosive injury of the esophagus. N Engl J Med 1990; 323:637-640.
- Keskin E, Okur H, Koltuksuz Y. Effect of steroid treatment on corrosive esophageal burns in children. Eur J Pediatr Surg 1991; 1:335-338.
- BautistaA, Tojo R, Varela R. Effects of prednisolone and dexamethasone on alkali burns of the esophagus in children.
- Eur J Pediatr Surg 1996; 6:198-203.
- Baurista A, Tojo R, Varela R, et al. Effects of prednisolone and dexamethasone on alkali burns of the esophagus in rabbit. J Pediatr Gastroenterol Nutrition 1996; 22:275-283.
- Rafeey M, Shoaran M. Clinical characteristics in oral caustic ıngestion in children. Pakistan Journal of Biological Sciences 2008; 11:2351-2355.
- Osman M, Russel J, Shukla D, et al. Responses of the murine
- esophageal microcirculation to acute exposure to alkali, acid, or hypochlorite. J Pediatr Surg 2008; 43:1672-1678.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 24 Ekim 2015 |
| Gönderilme Tarihi | 24 Ekim 2015 |
| Yayımlandığı Sayı | Yıl 2015 Cilt: 42 Sayı: 3 |