Deneysel özofagus atrezisi modelinde özofagus ile trakea arası destek dokudaki farklılıklar
Küçük Resim Yok
Tarih
2003
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Deneysel özofagus atrezisi modelinde, cerrahi tedavi sonrası özofagus fonksiyonlarında yetersizliğe neden olabilecek, özofagus ile trakea arası destek dokudaki yapısal farklılıkları ortaya koymak. Gereç ve Yöntem : Çalışmamızda, 200-250 gr ağırlığında, 18 adet Sprague-Dawley cinsi dişi sıçan ve bunlardan kontrollü olarak elde edilen fetusler kullanıldı. Özofagus atrezisi ve trakeo-özofagial fistüllü fetusleri elde etmek için, koitus günü vajinal tıkaç yöntemi ile belirlenen 1 1 dişi sıçana, hamileliklerinin 6.-9. günleri arası 4 gün, 2ml serim fizyolojik içinde sulandırılan 2 mg/kg adriamisin intraperitoneal olarak verildi. Çalışmadaki kontrol ve sham grublannı oluşturmak üzere, yine koitus günü vajinal tıkaç yöntemi ile belirlenen 7 dişi sıçandan 4'üne hamileliklerinin 6.-9. günleri arası 4 gün 2ml serum fizyolojik intraperitoneal olarak verildi ve diğer 3 'üne ise herhangi bir medikasyon uygulanmadı. Hamileliklerinin 21. gününde tüm anne sıçanlara, 50 mg/kg İM ketamin hidroklorür ile anestezi sonrası, seksiyo yapılarak fetusler alındı. Adriamisin verilerek ÖA modelini oluşturması beklenen hamile sıçanlardan 13 fetus, konrol grubunu oluşturması beklenen hamile sıçanlardan 1 1 fetus ve sham grubunu oluşturması beklenen hamile sıçanlardan ise 1 1 fetus elde edildi. 30 fetus %10'luk formaldehid solüsyonundan alınıp mandibulalannın altından ve ksifoidlerinin hizasından horizontal planda kesilerek üçe ayrıldı ve bloklandı. Fetusler dört gruba ayrılarak çalışıldı: Grup 1; annelerine gebeliklerinde hiç bir müdahale yapılmayan ve özofagus atrezisi gelişmeyen fetusler. (Kontrol grubu, n= 10) Grup 2; annelerine hamileliklerinin 6.-9. günleri arası 4 gün, intraperitoneal, 2 ml serum fizyolojik verilen ve özofagus atrezisi gelişmeyen fetusler. (Sham grubu, n= 10) Grup 3 ; annelerine hamileliklerinin 6.-9. günleri arası 4 gün, intraperitoneal 2 mg/kg adriamisin verilen ve özofagus atrezisi oluşmayan fetusler (n= 4) Grup 4; annelerine hamileliklerinin 6.-9. günleri arası 4 gün, intraperitoneal 2 mg/kg adriamisin verilen ve özofagus atrezisi oluşan fetusler (n=6) Grup 4'deki ÖA'li fetuslerden, Grup 4 D; distal TÖF seviyesindeki ve Grup 4 P; proksimal poş seviyesindeki histopatolojik incelemeleri ifade eden, iki alt grup oluşturuldu. Histopatolojik çalışma için bloklardan 5 u kalınlığında kesitler alınıp, hemotoksilen eozin boyama ve bağ dokusu boyalarından, Masson's Trichorome ve Van Gieson's ile boyandı. Trakeanın bifürkasyonu seviyesinde, özofagus ile trakeayı içine alan kesitlerde, iki 39yapı arasındaki alanda fibroblastlar, kollajen lifleri, nöronal aksonal uzantılar sayıldı. Sayım işlemi 40'lık büyütme ile 4 farklı alanda yapıldı. Grup 4 P'deki incelemeler, proksimaldeki atrezik özofagus lümeninin tam olarak görüldüğü, en distal preperatlardan yapıldı. Bulgular: Masson's Trichorome ve Van Gieson's boyamalarına göre sırası ile, Grup l'deki kesitlerinde fibroblast sayıları, 11.30±1.70 ve 10.30±2.67; kollajen lif sayılan 7.8±2.10 ve 10.30±2.50; ve nöronal aksonal uzantı sayıları 0.5±0.67 ve 0.6 ±0.66 idi. Grup 2'deki fibroblast sayılan sırası ile 10.70±3.77 ve 12.30±2.31, kollajen lif sayılan 9.50±3.21 ve 10.10±1.73; ve nöronal aksonal uzantı sayıları 0.6±0.66 ve 0.6±0.48 idi. Grup 3'deki fibroblast sayılan sırası ile 10.25±3.30 ve 10.25il.50; kollajen lif sayıları 10.50±2.38 ve 9.25±5.06; ve nöronal aksonal uzantı sayılan 1±0.81 ve 1±0.81 idi. Grup 4 D'deki fibroblast sayılan sırası ile 4.17±2.14 ve 3.83±1.83; kollajen lif sayılan 19.50±6.35 ve 21.17i5.91; ve nöronal aksonal uzantı sayılan 0.5±0.5 ve 0.83±0.68 idi. Grup 4 P'deki fibroblast sayıları sırası ile 8.83±2.71 ve 9.50±2.88; kollajen lif sayılan sırası 10.50±3.15 ve 9.33±2.50; ve nöronal aksonal uzantı sayılan 0.5±0.76 ve 0.66±0.47 idi. Grup 4 D' deki fetuslerden alınan kesitler Grup 1, Grup 2, ve Grup 3 'den alınan kesitlerle karşılaştırıldığında, fibroblast sayılarında azalma (P<0.05) ve kollajen lif sayılannda artma (p<0.05) saptandı. Grup 4 D'deki kesitler Grup 4 P'dekilerle karşılaştırıldığında fibroblast sayılannda azalma (P<0.05) ve kollajen lif sayılarında artma (p<0.05) saptandı. Nöronal aksonal uzantı sayılan açısından gruplar arasında anlamlı fark yoktu. Sonuç: Trakea-özofageal fıstül seviyesinde fibroblast sayılarının az, kollajen liflerinin sayıca artmış olması, embriyonel gelişim sürecinde burada bir enflamatuar olayın geliştiğini düşündürmektedir. Bu enflamatuar kollajen birikiminin doğum sonrasında da devam etmesi, özofagusun fonksiyonlannı olumsuz yönde etkileyeceği kanatindeyiz. Anahtar Kelimeler: Özofagus atrezisi, adriamisin, fibroblast, kollajen, dismotilite
To discount differences in the structural changes in the connection tissues between esophagus and trachea after surgical treatment of esophageal atresia (OA) of experimental models that may be responsible for insufficient esophageal functions. Material and Method: 18 Sprague-Dawley female rats weighting 200-250 gr and controlled fetuses were used in this study. For deandloping of esophageal atresia and tracheo esophageal fistula, 2mg/kg intraperitoneal adriamycin diluted with 2 ml of serum physiologic solution was giandn to 1 1 rats in the 6-9 days of pregnancy for 4 days via vaginal plug method. For control and sham groups 2 ml of serum physiologic solution was giandn to 4 rats of total of 7 rats in the 6 - 9 days of pregnancy for 4 days via vaginal occluding method and no medication applied to the remaining 3 rats. Fetuses were obtained by performing section using 50 mg/kg ketamin anesthesia to all mother rats at 21st day of pregnancy. Then fetuses were obtained: 13 fetuses from adriamycin giandn group with OA, 1 1 fetus from control group and 1 1 fetus from sham group. 30 fetuses were taken out from 10% formaldehyde solution and opened by a horizontal incision from jaw to xiphoid process. Three blocks were obtained. Fetuses were divided in to 4 groups: Group 1 ; no any interandntion to pregnancy and no esophageal atresia. (Control group, n= 10) Group 2; 2 ml of serum physiologic solution was giandn intraperitoneally in the 6-9 days of pregnancy for 4 days and no OA deandloped in the fetuses. (Sham grup, n= 10) Group 3; 2 mg/kg of adriamycin was giandn intraperitoneally in the 6-9 days of pregnancy for 4 days and no OA deandloped in the fetuses (n= 4 Group 4; 2 mg/kg of adriamycin was giandn intraperitoneally in the 6-9 days of pregnancy for 4 days and OA deandloped in the fetuses (n=6). For histopathological examination two subgroups were obtained from Group 4 with OA fetuses, Group 4 D; distal TOF leandl and Group 4 P; proximal pouch level. For histopathologic examination 5u thickness section were taken from the blocks and painted with hemotoxilen eozin (Masson's Trichorome and Van Gieson's paint). Numbers of fibroblasts, collagen fibers and neural axons were measured from at the leandl of tracheal bifurcation from sections containing esophagus and trachea. Messurment process was carried out by 40 fold increment within 4 different fields. Examination of Group 4 P carried out from the most distal part of operand proximal atresic esophagus. 41Findings: According to Masson's Trichorome and Van Gieson's paints, Group 1: fibroblast numbers, 11. 30*1.70 and 10.30±2.67; collagen fibers numbers 7.8±2.10 and 10.30±2.50; and neuronal axon spike numbers 0.5±0.67 and 0.6 ±0.66, respectiandly. Grup 2: fibroblast numbers 10.70±3.77 and 12.30±2.31, collagen fibers numbers 9.50±3.21 and 10.10Ü.73; and neuronal axon spike numbers 0.6±0.66 and 0.6±0.48 respectively. Grup 3: fibroblast numbers 10.25±3.30 and 10.25±1.50; collagen fibers numbers 10.50±2.38 and 9.25±5.06; and neuronal axon spike numbers 1±0.81 and 1±0.81 respectively. Group 4 D: fibroblast numbers 4.17±2.14 and 3.83±1.83; collagen fibers numbers 19.50±6.35 and 21.17±5.91; and neuronal axon spike numbers 0.5±0.5 and 0.83±0.68 respectively. Group 4 P: fibroblast numbers 8.83±2.71 and 9.50±2.88; collagen fibers numbers 10.50±3.15 and 9.33±2.50; and neuronal axon spike numbers 0.5±0.76 and 0.66±0.47 respectively. Section obtained from Group 4 D fetuses were compared to those taken from Group 1, Group 2, and Group 3. Reduced fibroblast numbers (PO.05) and increased collagen fibers numbers (p<0.05) was detected. Reduced fibroblast numbers (PO.05) and increased collagen fibers numbers (p<0.05) was detected in Group 4 D in comparison to Group 4 P sections. There were no significant differences in the numbers of neuronal axon spike numbers in between the groups. Result: The few numbers of fibroblasts and increased numbers of collagen fibers at the leanly of trackeo-esophageal fistula during embryonic deandlopment may point to an inflammatory change during this period. We belie and that continuation of this inflammatory collagen deposition after deliandry may negatiandly affects the esophageal functions. Keywords: Esophageal atresia, adriamycin, collagen, fibroblast
To discount differences in the structural changes in the connection tissues between esophagus and trachea after surgical treatment of esophageal atresia (OA) of experimental models that may be responsible for insufficient esophageal functions. Material and Method: 18 Sprague-Dawley female rats weighting 200-250 gr and controlled fetuses were used in this study. For deandloping of esophageal atresia and tracheo esophageal fistula, 2mg/kg intraperitoneal adriamycin diluted with 2 ml of serum physiologic solution was giandn to 1 1 rats in the 6-9 days of pregnancy for 4 days via vaginal plug method. For control and sham groups 2 ml of serum physiologic solution was giandn to 4 rats of total of 7 rats in the 6 - 9 days of pregnancy for 4 days via vaginal occluding method and no medication applied to the remaining 3 rats. Fetuses were obtained by performing section using 50 mg/kg ketamin anesthesia to all mother rats at 21st day of pregnancy. Then fetuses were obtained: 13 fetuses from adriamycin giandn group with OA, 1 1 fetus from control group and 1 1 fetus from sham group. 30 fetuses were taken out from 10% formaldehyde solution and opened by a horizontal incision from jaw to xiphoid process. Three blocks were obtained. Fetuses were divided in to 4 groups: Group 1 ; no any interandntion to pregnancy and no esophageal atresia. (Control group, n= 10) Group 2; 2 ml of serum physiologic solution was giandn intraperitoneally in the 6-9 days of pregnancy for 4 days and no OA deandloped in the fetuses. (Sham grup, n= 10) Group 3; 2 mg/kg of adriamycin was giandn intraperitoneally in the 6-9 days of pregnancy for 4 days and no OA deandloped in the fetuses (n= 4 Group 4; 2 mg/kg of adriamycin was giandn intraperitoneally in the 6-9 days of pregnancy for 4 days and OA deandloped in the fetuses (n=6). For histopathological examination two subgroups were obtained from Group 4 with OA fetuses, Group 4 D; distal TOF leandl and Group 4 P; proximal pouch level. For histopathologic examination 5u thickness section were taken from the blocks and painted with hemotoxilen eozin (Masson's Trichorome and Van Gieson's paint). Numbers of fibroblasts, collagen fibers and neural axons were measured from at the leandl of tracheal bifurcation from sections containing esophagus and trachea. Messurment process was carried out by 40 fold increment within 4 different fields. Examination of Group 4 P carried out from the most distal part of operand proximal atresic esophagus. 41Findings: According to Masson's Trichorome and Van Gieson's paints, Group 1: fibroblast numbers, 11. 30*1.70 and 10.30±2.67; collagen fibers numbers 7.8±2.10 and 10.30±2.50; and neuronal axon spike numbers 0.5±0.67 and 0.6 ±0.66, respectiandly. Grup 2: fibroblast numbers 10.70±3.77 and 12.30±2.31, collagen fibers numbers 9.50±3.21 and 10.10Ü.73; and neuronal axon spike numbers 0.6±0.66 and 0.6±0.48 respectively. Grup 3: fibroblast numbers 10.25±3.30 and 10.25±1.50; collagen fibers numbers 10.50±2.38 and 9.25±5.06; and neuronal axon spike numbers 1±0.81 and 1±0.81 respectively. Group 4 D: fibroblast numbers 4.17±2.14 and 3.83±1.83; collagen fibers numbers 19.50±6.35 and 21.17±5.91; and neuronal axon spike numbers 0.5±0.5 and 0.83±0.68 respectively. Group 4 P: fibroblast numbers 8.83±2.71 and 9.50±2.88; collagen fibers numbers 10.50±3.15 and 9.33±2.50; and neuronal axon spike numbers 0.5±0.76 and 0.66±0.47 respectively. Section obtained from Group 4 D fetuses were compared to those taken from Group 1, Group 2, and Group 3. Reduced fibroblast numbers (PO.05) and increased collagen fibers numbers (p<0.05) was detected. Reduced fibroblast numbers (PO.05) and increased collagen fibers numbers (p<0.05) was detected in Group 4 D in comparison to Group 4 P sections. There were no significant differences in the numbers of neuronal axon spike numbers in between the groups. Result: The few numbers of fibroblasts and increased numbers of collagen fibers at the leanly of trackeo-esophageal fistula during embryonic deandlopment may point to an inflammatory change during this period. We belie and that continuation of this inflammatory collagen deposition after deliandry may negatiandly affects the esophageal functions. Keywords: Esophageal atresia, adriamycin, collagen, fibroblast
Açıklama
Anahtar Kelimeler
Özofagus atrezisi, Özofagus, Trakea, Esophageal atresia, Esophagus, Trachea
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Madenci, H. (2003). Deneysel özofagus atrezisi modelinde özofagus ile trakea arası destek dokudaki farklılıklar. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Çocuk Cerrahisi Anabilim Dalı, Konya.
