Evaluation of Transforming Growth Factor Beta-1 in the vein wall of males with varicocele.

OBJECTIVE: This study aims to investigate potential differences in the presence of Transforming Growth Factor-Beta 1 (TGF-ß1) between the vein walls of patients with varicocele and those of healthy individuals. PATIENTS AND METHODS: The study comprised a total of 40 participants, divided into two groups. The control group (Group 1) consisted of 20 patients who underwent coronary bypass surgery, while the varicocele group (Group 2) included 20 patients scheduled for varicocelectomy. The cytoplasmic and nuclear staining patterns of TGF-ß1 immunohistochemistry were assessed in tissue samples under light microscopy, identifying any differences in TGF-ß1 presence between varicocele patient vein walls and normal (saphenous) veins. RESULTS: The varicocele group demonstrated lower nuclear and cytoplasmic TGF-ß1 staining rates compared to the control group. After controlling for the independent factor of age, significantly lower nuclear and cytoplasmic staining was still observed in the varicocele group. CONCLUSIONS: This study is the first of its kind to compare TGF-ß1 staining in the vein walls of varicocele patients and healthy individuals. Previous studies focusing on varicose veins reported elevated TGF-ß1 expression. Contrarily, our study observed lower TGF-ß1 expression in varicocele patient veins, marking a unique contribution to the field.

Survival of root canal-treated teeth adjacent to an implant: A retrospective case-control study.

OBJECTIVES: To evaluate the survival of root canal treated (RCT) teeth adjacent to an implant compared with that of RCT teeth of the same patient non-adjacent to an implant. MATERIALS AND METHODS: RCT tooth of each patient adjacent to an implant were included in the test group. The control group consisted of another RCT tooth of the same patient; the control RCT tooth was not adjacent to an implant and selected to be of the same type of the RCT tooth in the test group. 72 teeth of 36 patients with at least 4-year follow-up were included. In addition to survival, other clinical and demographic parameters investigated were age, sex, tooth type and position, presence of a crown, presence of retreatment, presence of a post-core, presence of adjacent edentulous area, presence of implant-supported fixed prosthetic restoration on the antagonist tooth and periapical health status. Pearson Chi-Square and Fisher Exact tests were used to compare the test and the control groups with categorical variables (α=0.05). Survival curves were obtained by the Kaplan-Meier method, and the Log-rank test was performed to compare the survival probabilities (α=0.05). RESULTS: No significant difference in survival rates was observed between the test and the control groups (p = 0.72). Similarly, no significant relationship was found between the investigated clinical variables and the survival rates of RCT teeth (p>0.05). Survival times differed depending on the presence of an adjacent edentulous area (p<0.001) and the periapical health status (p = 0.026). CONCLUSIONS: RCT teeth with unhealed periapical tissues had a shorter cumulative survival time. Similarly, those adjacent to an edentulous area had shorter cumulative and complication-free survival times. CLINICAL SIGNIFICANCE: This is the first study to determine the survival outcome of a RCT tooth adjacent to an implant compared to a non-adjacent one in the same patient. Being adjacent to an implant did not have a detrimental effect on the survival time and rate of RCT teeth.

Array-Based Comparative Genomic Hybridization Analysis in Children with Developmental Delay/Intellectual Disability.

Developmental delay (DD) is a condition wherein developmental milestones and learning skills do not occur at the expected age range for patients under 5 years of age. Intellectual disability (ID) is characterized by limited or insufficient development of mental abilities, including intellectual functioning impairments, such as learning and cause-effect relationships. Isolated and syndromic DD/ID cases show extreme genetic heterogeneity. Array-based comparative genomic hybridization aCGH) can detect copy number variations (CNVs) on the whole genome at higher resolution than conventional cytogenetic methods. The diagnostic yield of aCGH was 15.0-20.0% in DD/ID cases. The aim of this study was to discuss the clinical findings and aCGH analysis results of isolated and syndromic DD/ID cases in the context of genotype-phenotype correlation. The study included 139 cases (77 females, 62 males). Data analysis revealed 38 different CNVs in 35 cases. In this study, 19 cases with pathogenic CNVs (13.6%) and five cases with likely pathogenic CNVs (3.5%) were found in a total of 139 cases diagnosed with DD/ID. When all pathogenic and likely pathogenic cases were evaluated, the diagnosis rate was 17.1%. The use of aCGH analysis as a first-tier test in DD/ID cases contributes significantly to the diagnosis rates and enables the detection of rare microdeletion/microduplication syndromes. The clear determination of genetic etiology contributes to the literature in terms of genotype-phenotype correlation.

The evaluation of renal parenchymal scarring using static renal scintigraphy after percutaneous nephrolithotomy operations.

OBJECTIVE: To analyze whether operative techniques and other variables related to patient and renal stone characteristics affect potential renal parenchymal damage. MATERIALS AND METHODS: The study population comprised 64 patients who underwent percutaneous nephrolithotomy operations (PCNL). Data of the operated renal units, renal stone burden, route and number of entries, dilation techniques, duration of surgery, preoperative and postoperative glomerular filtration rate (GFR) and relative dimercaptosuccinic acid (DMSA) uptakes, as well as the changes in hemoglobin values, were recorded and analyzed for all patients. RESULTS: The mean age of the patients was 44 years. In 11 (17.1%) cases, renal cortical defects in the 3rd month were detected on DMSA scintigraphy. When the patients with and without renal cortical defect were compared regarding their preoperative and postoperative GFR values, no statistically significant difference was noticed between the groups (P > 0.05). Similarly, when postoperative relative DMSA uptakes were compared with preoperative relative DMSA uptakes of the same kidneys, no statistical significance was seen. When preoperative relative DMSA uptake values between groups with and without renal scarring were compared, no statistically significant difference was observed (P > 0.05). CONCLUSION: We did not observe any significant difference in scintigraphic parameters and GFR values. Hence, in the current trial, significant loss in renal function after PCNL operations was not observed. Thus, PCNL operations should be regarded as safe, but still, the risk of loss of kidney function should always be considered.

Determination of fusarium mycotoxins in wheat, maize and animal feed using on-line clean-up with high resolution mass spectrometry.

An automated method involving on-line clean-up and analytical separation in a single run using TurboFlow™ reversed phase liquid chromatography coupled to a high resolution mass spectrometer has been developed for the simultaneous determination of deoxynivalenol, T2 toxin, HT2 toxin, zearalenone and fumonisins B1 and B2 in maize, wheat and animal feed. Detection was performed in full scan mode at a resolution of R = 100,000 full width at half maximum with high energy collision cell dissociation for the determination of fragment ions with a mass accuracy below 5 ppm. The extract from homogenised samples, after blending with a 0.1% aqueous mixture of 0.1% formic acid/acetonitrile (43:57) for 45 min, was injected directly onto the TurboFlow™ (TLX) column for automated on-line clean-up followed by analytical separation and accurate mass detection. The TurboFlow™ column enabled specific binding of target mycotoxins, whereas higher molecular weight compounds, like fats, proteins and other interferences with different chemical properties, were removed to waste. Single laboratory method validation was performed by spiking blank materials with mycotoxin standards. The recovery and repeatability was determined by spiking at three concentration levels (50, 100 and 200% of legislative limits) with six replicates. Average recovery, relative standard deviation and intermediate precision values were 71 to 120%, 1 to 19% and 4 to 19%, respectively. The method accuracy was confirmed with certified reference materials and participation in proficiency testing.

Preconditioning-like amelioration of erythropoietin against laparoscopy-induced oxidative injury.

BACKGROUND: Laparoscopic surgery has gained wide acceptance for almost every kind of surgical procedure, although it has produced significant oxidative injury to intraabdominal organs depending on the pressure level and the kind of the gas used. The literature describes several preventive measures for decreasing the postlaparoscopic oxidative injury such as low intraabdominal pressure, gasless laparoscopy, and laparoscopic preconditioning. Erythropoietin was shown previously to decrease ischemia-reperfusion injury to the liver. The current study evaluated the effect of erythropoietin against laparoscopy-induced oxidative injury, as compared with laparoscopic preconditioning. METHODS: For this study, 64 male Spraque-Dawley rats were randomly assigned to one of the following groups. The control group was subjected to a sham operation. The laparoscopy group was subjected to 60 min of pneumoperitoneum. The laparoscopic preconditioning plus laparoscopy group was subjected to 5 min of insufflation and 5 min of desufflation followed by 60 min of pneumoperitoneum. The erythropoietin plus laparoscopy group was subjected to a subcutaneous injection of erythropoietin as a single 1,000-U/kg dose followed by 60 min of pneumoperitoneum. After 45 min of desufflation subsequent to cessation of pneumoperitoneum, blood, liver, and kidney samples were obtained from half of the rats. The other half of the rats were observed for a reperfusion period of 24 h. Tissue and blood samples also were obtained after this period. RESULTS: Laparoscopy produced significant oxidative injury, as compared with the sham treatment. Laparoscopic preconditioning produced significant amelioration of the ischemic injury. Although erythropoietin administration during the prelaparoscopic period decreased the pneumoperitoneum-induced oxidative injury, the beneficial effect of laparoscopic preconditioning was more pronounced. CONCLUSION: Laparoscopic preconditioning is more effective than the preischemic administration of erythropoietin in reducing laparoscopy-induced oxidative injury.

Perioperative immunonutrition ameliorates the postoperative immune depression in patients with gastrointestinal system cancer (prospective clinical study in 42 patients).

Cancer surgery is a major challenge for patients to develop immune depression in postoperative period. Several cytokines can depress immune cell subpopulations. Increased cytokine response after surgery is assumed to arise mainly from lipooxygenase pathway acting on membrane arachidonic acid. Therefore; investigators focused their efforts to alter the membrane fatty acid profile by changing the nutritional regimen with epsilon-3 fatty acid supplementation and encouraging results were obtained after surgery. Despite the theoretical and clinical advantage of enteral nutrition many surgeons remain committed to parenteral nutrition for feeding of patients due to maintain bowel rest and fear of anastomosis leakage at the postoperative period. Several studies investigating role of the postoperative immunonutrition reported that beneficial immunological changes were associated with reduction of infectious complications. Interestingly; these findings were observed at least five days after the surgery in which the highest incidence of complications was seen. In this prospective study including 42 patients eligible for curative gastric or colon cancer surgery; we investigated the beneficial effect of enteral immunonutrition (EEN) compared to total parenteral hyperalimentation (TPN) beginning from the preoperative period. Cortisol and CRP levels as stress parameters significantly increased one day after surgery in both groups but they rapidly returned to (on POD1) preoperative baseline level in EEN group whereas these values remained high in the TPN group. Additionally a significant decrease in natural killer (NK) cells and CD8+ levels were observed in both groups. However they recovered on POD3 in EEN group and on POD6 in TPN group. CD4+ subset remained almost same as preoperative value in the TPN group whereas it increased from (%) 40.14 to 46.40, 51.29 and 54.7 on PO 6th hr, POD3 and POD6 in the EEN group. Our findings suggest that preoperative nutrition via the enteral route provided better regulation of postoperative immune system restoration than parenteral nutrition. On the basis of our findings we recommend enteral immunonutrition to be started at the preoperative period rather than postoperatively before a major operation whenever the enteral route is feasible.

Effect of leptin on renal ischemia-reperfusion damage in rats.

Tumor necrosis factor-alpha (TNF-alpha) has been established as an important mediator in renal ischemia-reperfusion (I/R) injury. Leptin, a product of the ob gene, has been known to exhibit cytoprotective effects on renal tissue, but its effect on renal tissue TNF-alpha level after renal I/R injury in rats remains unknown. The purpose of the study was to evaluate the effects of leptin on renal tissue TNF-alpha, malondialdehyde (MDA), protein carbonyls (PCs) and total sulfydryl group (SH) levels, and plasma nitrite levels after renal I/R injury in rats. The animals were divided into three groups: control, I/R and I/R+leptin. Rats were subjected to renal ischemia by clamping the left pedicle for 45 min, and then reperfused for 1 h. The I/R+leptin group was pretreated intraperitoneally with leptin (10 microg/kg) 30 min before the induction of ischemia. Our results indicate that MDA, TNF-alpha levels, and PCs were significantly higher in the I/R group than those in the control group (p < 0.05). The administration of leptin decreased these parameters (p < 0.05) significantly. The SH level was observed to significantly decrease after I/R injury when compared to the control group (p < 0.05). Leptin treatment significantly increased tissue SH and plasma nitrite levels when compared to the I/R group (p < 0.05). Plasma nitrite levels did not change significantly in I/R when compared to the control. These results suggest that leptin could exert a protective effect on I/R induced renal damage by decreasing TNF-alpha levels and increasing nitrite level.

Ischemic preconditioning decreases laparoscopy-induced oxidative stress in small intestine.

BACKGROUND/AIMS: Laparoscopy is advantageous but its adverse effects have not yet been completely elucidated. Pneumoperitoneum performed to facilitate laparoscopy causes the organ perfusion decrease such as in the intestine. Oxidative stress reflects the tissue injury related to ischemia and reperfusion. We previously showed that laparoscopy causes oxidative stress in intestinal tissues. To assess whether the preconditioning phenomenon could be taken advantage of during laparoscopy we designed this randomized, controlled, experimental study with blind outcome assessment. We evaluated the effect of preconditioning, including sequential periods of pneumoperitoneum and desufflation on laparoscopy-induced tissue injury of small bowel with the help of two important markers of oxidative stress, thiobarbituric acid reactive substances and reduced glutathione. METHODOLOGY: Forty Sprague-Dawley male rats were used. After anesthesia, an intraperitoneal catheter was inserted. Pneumoperitoneum was created in all except controls, by CO2 insufflation under a pressure of 15 mmHg. The rats were randomized into the groups below: Group P was subjected to 60 minutes of pneumoperitoneum; Group P/D was subjected to 60 minutes of pneumoperitoneum followed by 45 minutes of desufflation; Group IP + P was subjected to 10 minutes of pneumoperitoneum, 10 minutes of desufflation and 60 minutes of pneumoperitoneum; Group IP + P/D was subjected to 10 minutes of pneumoperitoneum, 10 minutes of desufflation, 60 minutes of pneumoperitoneum and 45 minutes of desufflation; Group C (Control) was subjected to a sham operation, without pneumoperitoneum. Small bowel tissue malondialdehyde and reduced glutathione activities were measured, as applicable, by investigators blinded to the study design. The results were decoded and statistically analyzed with Kruskal-Wallis test. Mann-Whitney U test was used to compare the paired groups. p < 0.05 was considered significant. RESULTS: Small bowel tissue malondialdehyde levels were increased, whereas glutathione values were decreased in Groups P and P/D, as compared to Groups PRE/P and PRE/P/D; the latter two groups had results similar to the Control Group. CONCLUSIONS: Laparoscopic preconditioning may reduce the oxidative injury in intestine following laparoscopic procedures.

Lidocaine-containing Euro-Collins solution prevents renal injury in the isolated perfused canine kidney exposed to prolonged cold ischemia.

Previous studies have reported a decreased incidence of delayed graft function after cadaveric transplantation with the use of lidocaine pretreatment of the donor. We evaluated the effects of lidocaine on prolonged cold ischemia and reperfusion injury in a canine model of isolated kidney perfusion (IPK). The purpose of this study was to evaluate the renal function of isolated perfused canine kidneys after 48 h of cold storage with Euro-Collins (EC) solution or EC solution plus lidocaine. Isolated perfused canine kidneys were randomized into four groups which contained six kidneys: I) cold flush with EC solution and immediately reperfused, II) cold flush with EC solution plus lidocaine and immediately reperfused, III) 48 h of cold storage with EC and reperfusion, IV) 48 h of cold storage with EC solution plus lidocaine and reperfusion. The measured renal functions were glomerular filtration rate, urine production, perfusate flow, urinary lactic dehydrogenase (ULDH), Na reabsorptive capacity, and tissue MDA levels. Histological examination was performed after reperfusion. The tubular functions of kidneys preserved with EC solution containing lidocaine were better when compared with the kidneys preserved with EC alone. Tubular injury marker levels (ULDH) in group IV were significantly lower than in group III and lidocaine also reduced lipid peroxidation during reperfusion. This is in agreement with the histological results. The results of the present study can be taken as evidence of the cytoprotective effect of lidocaine, which may therefore be accepted as a useful agent for kidney preservation.

Diagnostic value of interleukin-6 and C-reactive protein in acute appendicitis.

The aim of this study is prospectively to evaluate the serum C-reactive protein (CRP) and interleukin-6 (IL-6) levels in detection of acute appendicitis in patients with right iliac fossa pain. Data were collected in prospective manner on 102 consecutive patients with right iliac fossa pain. Laparotomy was performed for suspected acute appendicitis for 55 of the 102 patients, of whom 49 patients had appendicitis, 6 patients non-appendicitis (NA), and the other 47 patients had nonspecific abdominal pain (NSAP) and they did not undergo operation. Among those with appendicitis 31 had acute appendix (AA), 8 had gangrenous appendix (GA), and 10 had perforated appendix (PA). The WBC and CRP the mean (SEM) values were significantly different in AA, GA, and PA groups compared with NSAP and NA groups (P < 0.05). Although the mean IL-6 levels were significantly different only in PA group than the others groups (P < 0.05). The sensitivity and specificity of serum CRP measurements were calculated as 96% and 87%, respectively whereas these were 33% and 83% for IL-6 levels for the diagnosis of the acute appendicitis. As a result, measurement of the CRP levels and WBC have an additional diagnostic value on the diagnosis of the acute appendicitis but determination of IL-6 levels which added to the test combination of WBC and CRP, the sensitivity for the diagnosis of the acute appendicitis was not changed whereas the specificity was decreased to 66%.

L-Arginine-enriched preservation solution decreases ischaemia/reperfusion injury in canine kidneys after long-term cold storage.

BACKGROUND: Kidneys stored hypothermically for transplantation show varying degrees of tissue injury, depending on the duration of preservation. The causes of injury are not entirely clear. We investigated the quality of renal functional recovery in canine kidneys after 72 h hypothermic preservation in custodiol solution or custodiol solution plus L-arginine. METHODS: Kidneys obtained from mongrel dogs, weighing 18-25 kg, were subjected to 72-h cold ischaemia after flushing. Animals were divided into two groups (n=18/group). A flush solution of either custodiol solution or custodiol solution plus L-arginine 1 mmol/l was used for each group. After 72-h cold storage all animals had a contralateral nephrectomy, and autotransplantation was performed to external iliac artery and vein. Survivals were evaluated at 3 days. RESULTS: Renal damage was assessed by kidney function tests, serum creatinine (SCr), blood urea nitrogen (BUN) and light histology. Malondialdehyde (MDA) was measured as an index of lipid peroxidation. SCr and BUN (24, 48 and 72 h) were significantly different from the control and L-arginine groups. Histological damage was less in the L-arginine group. MDA levels were significantly different with the lower levels in the L-arginine group. CONCLUSIONS: On the basis of these data, we concluded that exogenous L-arginine (a substrate for NO synthesis) has a beneficial and protective effect on long-term (72 h) hypothermic ischaemical damage in canine kidneys.

Characterization and COD fractionation of domestic wastewaters.

Results of a comprehensive study are reported for wastewater characterization in relation to modelling and design of biological nutrient removal systems for the Metropolitan Area of Istanbul. Domestic sewage quality was experimentally assessed in terms of major polluting parameters. Size distribution and calculation of significant ratios such as BOD5:COD and COD:N were used to evaluate the merit of candidate physical, chemical and biological treatment alternatives. COD fractionation was effected to assess biological treatability and to yield the necessary process components to the recent modelling approaches.

The HLA phenotype in slipped capital femoral epiphysis.

The HLA genotypes of six patients with acute grade I slipped capital femoral epiphysis as determined by microlymphocytotoxic technique revealed HLA-DR4 as their phenotypes. These results contradict the previously reported HLA-B12 as the phenotype of patients with slipped capital femoral epiphysis.

Cyclosporine nephrotoxicity in the ischemic kidney and the protective effect of pentoxifylline--a study in the rat.

In order to prevent cyclosporine nephrotoxicity in the ischemic kidney, pentoxifylline was used in a rat model. Seventy-two rats were divided into six groups according to treatment after right nephrectomy: Group I was the control, group II was treated with 25 mg/kg cyclosporine, group III underwent renal ischemia for 45 min, group IV was given 25 mg/kg cyclosporine and subjected to renal ischemia, and group V was subjected to renal ischemia and given 45 mg/kg pentoxifylline (repeated at 12, 36, and 48 hr), group VI underwent renal ischemia and was then given both cyclosporine and pentoxifylline. BUN, creatinine, and potassium levels were significantly elevated 24 hr after cyclosporine (group II), ischemia (group III), and cyclosporine and ischemia (group IV). Sodium levels remained unaffected. BUN levels normalized in all but groups III and IV after 48 hr. Creatinine levels normalized in all but group IV after 48 hr. Creatinine clearance fell in all groups and remained low even after 48 hr. Pentoxifylline prevented dramatic rises in BUN and creatinine and levels nearly normalized after 48 hr. It also histologically prevented extensive tissue damage seen after ischemia. In conclusion, pentoxifylline has a protective effect upon the kidney when subjected to cyclosporine in the presence of ischemia.

von Willebrand factor antigen compared with other factors in vasculitic syndromes.

In order to analyse their role as a specific marker of vascular damage and their value in monitoring disease activity the plasma concentrations of von Willebrand factor antigen (vWFAg) and the ristocetin cofactor (RiCoF) activities were determined in 43 children with vasculitis and 20 controls. These patients were sub-divided into three groups according to diagnosis: Henoch-Schönlein purpura (n = 18), polyarteritis nodosa (n = 16), and systemic lupus erythematosus (n = 9). High concentrations of vWFAg and activities of RiCoF were found in all the patient groups. vWFAg and RiCoF returned to normal as the patients became symptom free and remained above normal in those with continuing symptoms. The amount of vWFAg did not correlate with the acute phase reactants. vWFAg acted as a specific marker of vascular damage and was useful for the monitoring of disease activity both in small vessel vasculitis and systemic necrotising arteritis.