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    Comparison of hyperbaric oxygen, ozone, and dexpanthenol therapies in rats with acute lung injury
    (Kare Publ, 2022) Yilmaz, Merve; Mutlu, Pinar; Mirici, Nihal Arzu; Kapicibasi, Hasan Oguz; Bagla, Aysel Guven; Gulen, Meltem Ickin; Korpinar, Sefika
    BACKGROUND AND AIM: Acute respiratory distress syndrome (ARDS) is a fatal disease pre-senting with respiratory failure. Patients with ARDS account for a considerable portion of patients staying in the intensive care unit (ICU). Therefore, advances in the treatment of these patients are of great importance. Direct or indirect injury to the lung initiates an inflammatory process. This results in impaired integrity of the alveolar-capillary membrane, pulmonary edema, and severe hy-poxia. The present study compared hyperbaric oxygen (HBO), ozone, and dexpanthenol therapies administered to rats with experimentally induced ARDS, as well as the efficacy of these therapies. METHODS: Thirty-two male Wistar Albino rats were used in the study. The rats were divided into four groups. All groups were administered antibiotherapy for 5 days after administering live Escherichia coli. Group 1 (control group) rats received intraperitoneal saline. Group 2 rats were treated with HBO. Group 3 rats received an oxygen + ozone mixture. Group 4 rats received dex-panthenol. After 5 days, anesthesia was administered to all rats, blood gases were collected from the abdominal aorta, and then the rats were sacrificed. Some of the collected blood was used for cytokine assays. The right lung tissues were used for histopathological examination. The left lung tissues were used to measure enzyme levels. RESULTS: Histopathologically, there were intra-alveolar hemorrhage, edema, intensive inflam-matory cell infiltration, fibrosis, collapse, type 2 alveolar cells, and macrophage accumulation in all groups. In terms of fibrosis/alveolar septal thickening, the dexpanthenol group had a sig-nificantly lower mean score than the control and HBO groups. In terms of alveolar collapse, the dexpanthenol group had a significantly lower mean score than all other groups. In terms of increased macrophage and type II alveolar cell counts, the ozone group had a significantly lower mean score than all other groups. There was no significant difference in immunohistochemical staining between the groups. In terms of superoxide dismutase levels, the dexpanthenol group had a significantly lower score than the control group. Regarding IL-10 levels, the ozone group had a significantly higher score than the control and HBO groups. The dexpanthenol group had a significantly higher score only than the HBO group. Regarding PaO2 levels, the ozone group had a significantly higher score than all groups. The ozone group had a significantly lower score on PaCO2 levels than all groups. CONCLUSIONS: Among the treatments, the HBO therapy increased cell injury. The ozone therapy produced anti-inflammatory effect and histopathologically positive outcomes. The ozone therapy provided significant improvement in arterial oxygenation. The dexpanthenol therapy produced antioxidant effect and histopathologically positive outcomes. The antifibrotic effect was prominent in the dexpanthenol therapy. Further studies are needed to generalize the use of these treatments in ARDS.
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    Could Hyperbaric Oxygen Be a Solution in the Treatment of Spinal Infections?
    (Mdpi, 2019) Korpinar, Sefika
    Background and Objective: Pyogenic spinal infections are rare and potentially devastating, requiring prompt recognition and management. Parallel to the ever-increasing number of invasive spinal procedures, its incidence is on a steady rise, particularly in an expanding elderly population. The aim of this study was to evaluate the efficacy of hyperbaric oxygen (HBO2) therapy in the treatment of this heterogeneous group of disorders. Materials and Methods: Nineteen patients who were referred to our center for HBO2 with a clinical diagnosis of spinal infections (vertebral osteomyelitis, pyogenic spondylitis, spondylodiscitis, surgical site infection following spine surgery, epidural abscess) were retrospectively reviewed. Results: Infection resolution was adequately achieved in 12 of 13 patients (92.3%) on magnetic resonance imaging at the end of HBO2 treatment or during the first month of follow-up. The mean follow-up period was 11 months (range 1 month to 3 years). Conclusions: This study suggests that HBO2 therapy is efficacious in patients with pyogenic spinal infections complicated by primary therapy failure or by medical comorbidities that may impede the eradication of microbial infection and delay wound healing. HBO2 therapy may be useful for reducing long hospital stays, repeated surgeries, and morbidities.
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    Hyperbaric oxygen treatment in a rare complication of intramuscular injection: four cases of Nicolau syndrome
    (South Pacific Underwater Med Soc, 2022) Korpinar, Sefika
    Intramuscular injections are one of the most common clinical procedures. The objectives of this case series are to analyse the role, timing and efficacy of hyperbaric oxygen treatment (HBOT) in the management of Nicolau syndrome (NS), an extremely rare complication of this common intervention. Clinical, demographic, laboratory and microbiological data extraction were performed through retrospective analysis of the medical records of all patients with NS who were referred for HBOT over a 10-year period with wounds, ischaemia, infection or necrosis at the injection site following drug injection; four patients with NS were included. All injections were made via the intramuscular route; three adult cases followed a non-steroidal anti-inflammatory drug, diclofenac sodium and one in a child followed penicillin injection. The time between diagnosis/injection and HBOT ranged from five to 33 days. NS can develop despite all preventive measures based on injection technique guidelines. HBOT appeared beneficial to healing of NS when administered with other therapeutic approaches. Due to the missing pieces of the puzzle in pathogenesis, NS is rarely completely reversible; keeping the awareness high for undesirable complications stands out as the most effective approach.
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    Patent Foramen Ovate and Diving
    (Bezmialem Vakif Univ, 2019) Korpinar, Sefika
    Although patent foramen ovale (PFO) was anatomically depicted in 1513 by Leonardo da Vinci and described as a thromboembol ism route in 1877, it has been ignored for a long time as a potential way to produce pathological conditions. The unifying hypothesis associated with multiple clinical issues, such as cryptogenic stroke, migraine and decompression sickness is that a particle, inert gas bubbles or chemical substance in the venous circulation bypasses the lungs and enters to the systemic circulation via PFO. In this review, current data on the status of PFO in diving medicine arc discussed.
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    Pulmonary barotrauma during hookah diving: a case report
    (Undersea & Hyperbaric Medical Soc Inc, 2020) Korpinar, Sefika; Gonlugur, Ugur; Kapicibasi, Oguz; Gonlugur, Tanseli; Toklu, Akin Savas
    When commercial sea harvesters have dive accidents, it is sometimes difficult to obtain an accurate dive history and make a definitive diagnosis. We report a sea harvest diver who dived to collect sea snails (Rapana venosa) by using a hookah dive system. He experienced mediastinal and subcutaneous emphysema due to interruption of breathing airflow. Thoracic computed tomography performed one year prior to the accident revealed paramediastinal subpleural blebs on both lung apices. Emphysema was resolved by administering normobaric oxygen.
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    The Effects of Hyperbaric Oxygen at Different Pressures on Oxidative Stress and Antioxidant Status in Rats
    (Mdpi, 2019) Korpinar, Sefika; Uzun, Hafize
    Background: The optimal use of oxygen at greater than atmospheric pressures in any operational or therapeutic application (hyperbaric oxygen, HBO2) requires awareness of the fact that the beneficial effects of oxygen coexist with toxic effects depending on the pressure and duration of exposure. In this study, we aimed to investigate the effect of HBO2 therapy on oxidative stress and antioxidant status in commonly used protocol for acute HBO2 indications, such as carbon monoxide intoxication, central retinal artery occlusion, crush injury, gas gangrene, and to compare it with normobaric oxygen (NBO2) in healthy rats. Materials and Methods: Fifty-six male, young adult Wistar albino rats were randomly divided into seven groups and named as Group I through Group VII. Plasma malondialdehyde (MDA), superoxide dismutase (SOD), and erythrocyte glutathione (GSH) levels in control group were compared to the levels in other groups. Results: The increases in MDA levels and the decrease in SOD activities were statistically significant in HBO2 groups at the end of the first 24 h when compared to the control group, and the significant decrease in erythrocyte GSH level was only at 2.4 atmospheres absolute. Conclusions: The present study showed that pressure and frequency of exposure are important factors to consider when investigating HBO2-induced oxidative stress and antioxidant response.