The triglyceride-glucose index as a predictive marker for coronary slow flow phenomenon.

OBJECTIVE: The triglyceride-glucose index (TyG) has been proposed as a marker of insulin resistance (IR) and has shown associations with cardiovascular diseases. This study aimed to investigate the relationship between the TyG and the coronary slow flow phenomenon (CSFP) and explore the index's potential as a predictor of this condition. PATIENTS AND METHODS: A total of 187 patients who underwent coronary angiography were included; of these, 91 patients were diagnosed with CSFP, and 96 patients with normal coronary flow served as a control group. The TyG was calculated using fasting triglyceride and glucose levels. RESULTS: The results showed that the TyG was significantly higher in the CSFP group compared with the control group (p < 0.001). Additionally, the TyG exhibited a moderate positive correlation with the thrombolysis-in-myocardial-infarction frame count in coronary arteries (p < 0.001). A multivariate logistic regression analysis revealed that the TyG, along with gender, ejection fraction, and uric acid, remained significant predictors of CSFP (p < 0.05). CONCLUSIONS: This study's findings suggest that the TyG may serve as a useful marker for identifying individuals at risk of CSFP and provide insights into the potential role of IR in its pathophysiology.

The effects of Digoxin use on long-term prognosis in patients with heart failure with reduced ejection fraction.

OBJECTIVE: This study aimed to investigate the effect of digoxin on mortality and rehospitalization in heart failure with reduced ejection fraction (HFrEF) patients. Heart failure is a clinical syndrome that requires frequent rehospitalization and has a high mortality. This study aimed to investigate the effect of digoxin on mortality and rehospitalization in patients with heart failure with reduced ejection fraction. PATIENTS AND METHODS: The study included 326 patients with HFrEF that were hospitalized for decompensation between September 2014 and January 2016. The patients were divided into two groups: digoxin users and a control group. The study's endpoints were cardiovascular death and rehospitalization after 24-month long-term follow-ups. RESULTS: Rehospitalization was lower in patients taking digoxin (25% vs. 47%, p = 0.001). The mean age of patients taking digoxin (n: 78) was 63.7 ± 12.4 years, among which 64% were males. The mean age of the control group was 65.4 ± 11.8 years, among which 74% were males. However, there was no difference in mortality between the two groups (34% vs. 45%, p = 0.10). While Kaplan-Meier curves revealed no significant differences between mortality rates in the groups (log-rank p = 0.508), a statistical difference was found between the groups in rehospitalization rates (log-rank p =  0.013). A multiple linear regression analysis revealed that smoking (HR: 1.97, CI: 1.24-3.11, p = 0.004), systolic blood pressure (HR: 0.983, CI: 0.974-0.992, p < 0.001), atrial fibrillation (HR: 2.09, CI: 1.17-3.72, p = 0.012), C-reactive protein (CRP) (HR: 1.009, CI: 1.003-1.015, p = 0.004), beta-blockers (HR: 0.891, CI: 0.799-0.972, p = 0.009), angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (HR: 0.778, CI: 0.641-0.956, p < 0.001), mineralocorticoid receptor antagonists (HR: 0.41, CI:0.26-0.65, p < 0.001), and digoxin use (HR: 0.59, CI: 0.43-0.80, p = 0.001) are independent predictors of rehospitalization in patients with HFrEF. CONCLUSIONS: Our results show that digoxin use does not affect mortality in HFrEF patients. However, rehospitalization decreased in patients taking digoxin in HFrEF.

Correlation between the serum lumican level and the severity of coronary artery disease.

OBJECTIVE: Several studies have previously shown that some small leucine-rich proteoglycans (SLRPs) are associated with atherosclerotic plaque. We aim to investigate the relationship between circulating lumican levels and the severity of coronary artery disease (CAD). PATIENTS AND METHODS: This study included 255 consecutive patients who underwent coronary angiography for stable angina pectoris. All demographic and clinical data were collected prospectively. The severity of CAD was assessed based on the Gensini score and a value >40 was defined as advanced CAD. RESULTS: Eighty-eight patients were in the advanced CAD group; these are older and the frequency of diabetes mellitus, cerebrovascular accidents, reduced ejection fraction (EF), left atrium diameter was higher. Serum lumican levels were found as higher in advanced CAD group (0.4 ng/ml vs. 0.6 ng/ml, respectively, p<0.001). When the Gensini score increased, a statistically significant increase was observed in lumican levels with a good correlation (r=0.556 and p<0.001). In multivariate analysis, diabetes mellitus, EF and lumican were predictive for advanced CAD. Lumican level predicts CAD seriousness with a sensitivity rate of 64%, specificity rate of 65%. CONCLUSIONS: In this study, we reveal a relationship between serum lumican levels and CAD severity. More research is warranted to determine the mechanism and prognostic values of lumican in the atherosclerosis.

Imaging in paediatric blast injuries: musculoskeletal injuries in the Syrian Civil War.

AIM: To examine the radiological images of children with musculoskeletal injuries and accompanying organ injuries caused by explosions to determine the differences and frequency of injury types and to emphasise the importance of radiology in war injuries. MATERIALS AND METHODS: Seventy-four children with injuries caused by bomb explosions were included in the study. The paediatric trauma scores evaluated in the emergency department on the first admission were recorded. All radiographs and computed tomography (CT) images were evaluated for musculoskeletal injuries and accompanying organ injuries. RESULTS: The highest incidence of fracture in the primary blast injury (PBI) group was skull fracture in 15 (62.5%) patients (p=0.01) and fractures in the other groups were most common in the lower extremities. Amputation was observed in nine (31%) patients in the PBI group (p=0.003); however, there were no patients with amputations in the secondary blast injury (SBI) group (p=0.002). The frequency of pneumothorax (79.3%) and pulmonary contusion (59.4%) was high in the PBI group (p<0.001 and p=0.004, respectively). Skull fractures were observed in 15 (88.2%) of 17 patients with brain injury (p<0.001), and skull fractures were the most common fracture site accompanying pulmonary trauma. The average paediatric trauma score of individuals exposed to shrapnel was found to be high (p<0.001). CONCLUSION: Because paediatric musculoskeletal injuries vary with the type of blast injury and severe trauma can occur in children due to blast effects, radiologists who triage mass injuries should understand the effects of blast injury patterns and the spectrum of injury.

An investigation on systematic history and distribution areas of tarek (Alburnus tarichi (Güldenstädt, 1814)) / Uma investigação sobre a história sistemática e as áreas de distribuição de tarek (Alburnus tarichi (Güldenstädt, 1814))

Abstract This study aimed to determine the distribution area of tarek (Alburnus tarichi (Güldenstädt, 1814)) and to define how it must be called according to the scientific name by evaluating its previous studies made by various systematisers and their reports on its distribution, and by comparing literature knowledge. The taxonomic characteristics of the collected samples were evaluated and several measurements and counts were taken on the samples; analfin origin 0-4 scales behind dorsal fin-base; 72-91 lateral line scales; 21-29 gill rakers; 7½-10 branched dorsal-fin rays and 10-12½ branched anal-fin rays. Body and caudal peduncle was moderately compressed. Body was covered by overlapping scales. Tarek has five different populations in the Basin. They are Van, Erçek, Nazik and Aygır Lakes and Koçköprü Dam Lake populations. The main living area of the tarek population is Lake Van; however, between May and June, mature individuals of tarek enter to tributaries of Van Lake. Some of them are Karasu, Bendimahi, Deliçay, Zilan, Karmuç, Sapur, Yanıkçay, Gevaş, Engil, Kurubaş and Akköprü Streams. At the end of study, it was concluded that tarek should be called as Alburnus tarichi (Güldenstädt, 1814) and it is an endemic fish species distributed only in Van Lake Basin.

Resumo Este estudo teve como objetivo determinar a área de distribuição de tarek (Alburnus tarichi) (Güldenstädt, 1814) e definir como deve ser chamado de acordo com o nome científico, avaliando estudos anteriores feitos por vários sistematizadores e seus relatórios sobre sua distribuição, e comparando o conhecimento da literatura. As características taxonômicas das amostras coletadas foram avaliadas e várias medições e contagens foram realizadas nas amostras, como origem analfin 0-4 escalas atrás da base da barbatana dorsal; 72-91 escalas de linha lateral; 21-29 rakers branquiais; 7½-10 raios da nadadeira dorsal ramificada, e 10-12½ raios da nadadeira anal ramificados. Pedúnculo caudal e corporal foram moderadamente comprimidos. O corpo estava coberto por escamas sobrepostas. Tarek tem cinco populações diferentes na bacia estudada. São as populações dos lagos Van, Erçek, Nazik e Aygır, e Koçköprü barragem. A principal área de presença da população tarek é o Lago Van; no entanto, entre maio e junho, indivíduos maduros de tarek entram nos afluentes do lago Van. Alguns deles são os fluxos Karasu, Bendimahi, Deliçay, Zilan, Karmuç, Sapur, Yanıkçay, Gevaş, Engil, Kurubaş e Akköprü. No final do estudo, concluiu-se que tarek deveria ser chamado Alburnus tarichi (Güldenstädt, 1814) e que é uma espécie de peixe endêmica distribuída apenas na Bacia do Lago Van.

Prognostic significance of Tp-e interval and Tp-e/QTc ratio in patients with COVID-19.

OBJECTIVE: Ventricular arrhythmias were the most frequent manifestations in patients with COVID-19. Both the natural course of the disease and the treatment drugs used have effects on ventricular repolarization. The objective of this study was to evaluate the effects of repolarization parameters obtained from surface electrocardiography (ECG) on prognosis. PATIENTS AND METHODS: Participants were 205 consecutive patients hospitalized with COVID-19 diagnosis. The 12-lead surface ECG was obtained from each patient on admission. The ECG results were evaluated against the patients' clinical characteristics and outcomes by experienced cardiology specialists. RESULTS: The mean age was higher in the non-survivor group compared to the survivor group (57.4 ± 15.7 vs. 65.6 ± 16.6; p = 0.001). The demographical characteristics were similar between the survivor and non-survivor groups. Multivariate analyses demonstrated that age (OR: 1.041; p = 0.009), D-dimer (OR: 1.002; p = 0.031), high-sensitivity troponin I (hs-TnI) (OR: 1.010; p = 0.041), pneumonia on computed tomography (CT) (OR: 4.985; p < 0.001), the peak-to-end interval of the T wave (Tp-e) (OR: 3.421; p < 0.001), and Tp-e/QTc ratio (OR: 1.978; p = 0.013) were statistically significant independent predictors in terms of determining mortality. CONCLUSIONS: Prolonged Tp-e interval and increased Tp-e/QTc ratio on admission are decent predictors and linked with mortality. ECG is a practical study to evaluate prognosis and potential arrhythmias, as well as initiating suitable treatment.

Effect of coexistence of Chlamydia pneumoniae and increased epicardial fat thickness on coronary artery disease.

OBJECTIVE: Epicardial fat thickness (EFT) and chlamydia infection are independent cardiovascular risk factors in coronary artery disease (CAD). We aimed to evaluate the effect of coexistence of EFT and chlamydia infection on the presence and severity of CAD in patients with stable angina pectoris (SAP). PATIENTS AND METHODS: The study included 208 patients with SAP, divided into a CAD group (n=112) and a control group (n=96). The presence of Chlamydia pneumoniae-IgG (CP-IgG), EFT, and left ventricular ejection fraction (LVEF) were compared between groups. RESULTS: CP-IgG, LVEF, and EFT were found to be independent predictors of CAD (CP-IgG, OR=1.559, p=0.021; LVEF, OR=0.798, p<0.001; EFT, OR=3.175, p=0.026). Moreover, a statistically significant interaction was detected between CP-IgG and EFT for predicting the presence of CAD (p<0.001). A good positive correlation was found between EFT and Gensini score (r=0.684, p<0.001). CONCLUSIONS: We found that there was an interaction between CP-Ig and EFT for CAD development. This finding suggests that the interaction of CP-IgG and EFT plays a prominent role in the inflammatory process.

An investigation on systematic history and distribution areas of tarek (Alburnus tarichi (Güldenstädt, 1814)).

This study aimed to determine the distribution area of tarek (Alburnus tarichi (Güldenstädt, 1814)) and to define how it must be called according to the scientific name by evaluating its previous studies made by various systematisers and their reports on its distribution, and by comparing literature knowledge. The taxonomic characteristics of the collected samples were evaluated and several measurements and counts were taken on the samples; analfin origin 0-4 scales behind dorsal fin-base; 72-91 lateral line scales; 21-29 gill rakers; 7½-10 branched dorsal-fin rays and 10-12½ branched anal-fin rays. Body and caudal peduncle was moderately compressed. Body was covered by overlapping scales. Tarek has five different populations in the Basin. They are Van, Erçek, Nazik and Aygir Lakes and Koçköprü Dam Lake populations. The main living area of the tarek population is Lake Van; however, between May and June, mature individuals of tarek enter to tributaries of Van Lake. Some of them are Karasu, Bendimahi, Deliçay, Zilan, Karmuç, Sapur, Yanikçay, Gevas, Engil, Kurubas and Akköprü Streams. At the end of study, it was concluded that tarek should be called as Alburnus tarichi (Güldenstädt, 1814) and it is an endemic fish species distributed only in Van Lake Basin.

Type I cardiorenal syndrome in patients with acutely decompensated heart failure: the importance of new renal biomarkers.

OBJECTIVE: Type 1 cardiorenal syndrome (CRS) is an acute renal failure in patients with acute decompensated heart failure with an incidence of 24% to 45%. The aim of our study was to investigate the significance of new renal biomarkers to predict type 1 CRS. PATIENTS AND METHODS: The study included 111 patients with acute decompensated heart failure diagnosed at the Istanbul Medical Faculty Emergency Department between 2014 and 2016, and 24 healthy volunteers. All urine samples were stored at -80°C after centrifugation. Samples were run according to the instructions of TIMP-2, ILGF-7, KIM-1, and IGFBP-7 ELISA kits. Diuretic treatments were then administered with intravenous administration of at least 80 mg furosemide per day. Follow-up biochemical and spot urine specimens were taken after 72 hours. For statistical analysis, SPSS version 21.0 statistical software was used. Significance was evaluated at p<0.05. RESULTS: The baseline creatinine level was measured as 1.33 ± 0.39 mg/dL in the heart failure group. It was seen that 67% (75) of the patients had increased creatinine levels and developed type 1 CRS. ILGF-7, TIMP-2, and (ILGF-7 * TIMP-2) values were significantly higher in patients with cardiorenal syndrome when we separated the two groups as patients with and without cardiorenal syndrome (0.40 (0.25-0.71), p1: 0.049/2.40 (1.42-3.70), p2: 0.003/1.15 (0.29-2.43), p3: 0.001). CONCLUSIONS: Renal tubular markers reveal promising developments in the pathophysiology of cardiorenal syndrome in light of recently obtained data. Renal tubular biomarkers may have the potential to be a predictor of heart failure and cardiorenal syndrome.

Reliability of the Modified Ashworth Scale and Modified Tardieu Scale in patients with spinal cord injuries.

STUDY DESIGN: Psychometrics study. OBJECTIVES: To assess the reliability of the Modified Ashworth Scale (MAS) and Modified Tardieu Scale (MTS) in patients with spinal cord injuries (SCIs). SETTING: Inpatient rehabilitation clinics at two state hospitals. METHODS: The study included 65 participants aged between 18 and 88 years with SCI with spasticity. All participants were at least 6 months after injury and had an American Spinal Injury Association Impairment Scale grade of A-D. The MAS and MTS scores were collected from the right hip adductor and hip extensor muscles, right knee extensor and knee flexor muscles and right plantar flexor muscles. Each participant was assessed twice by two experienced physiatrists 1 week apart. The raters were blinded to each other's scores. RESULTS: Inter-rater and test-retest agreement for the MAS scores (κ=0.531-0.774) was moderate to substantial. Inter-rater and test-retest agreement for the MTS X scores (κ=0.692-0.917) was substantial to almost perfect. Inter-rater reliability and test-retest reliability of the MTS R2-R1 was excellent (intra-class correlation coefficient (ICC) 0.874-0.973, confidence interval (CI): 0.79-0.98) for all muscles tested. Inter-rater reliability of the MTS R2 for the hip adductor and knee extensor muscles was poor (ICC 0.248, CI: -0.00 to 0.47 and ICC 0.094, CI: -0.16 to 0.34, respectively). The test-retest reliability of the MTS R2 was also poor for the knee extensor muscles (ICC 0.318, CI: -0.06 to 0.53). CONCLUSION: MAS has adequate reliability for determining lower-extremity spasticity in patients with SCI. The demonstration of excellent inter-rater reliability and test-retest reliability of the MTS R2-R1 suggests its utility as a complementary tool for informing treatment decisions in patients with SCI.

An investigation on systematic history and distribution areas of tarek (Alburnus tarichi (Güldenstädt, 1814))

Abstract This study aimed to determine the distribution area of tarek (Alburnus tarichi (Güldenstädt, 1814)) and to define how it must be called according to the scientific name by evaluating its previous studies made by various systematisers and their reports on its distribution, and by comparing literature knowledge. The taxonomic characteristics of the collected samples were evaluated and several measurements and counts were taken on the samples; analfin origin 0-4 scales behind dorsal fin-base; 72-91 lateral line scales; 21-29 gill rakers; 7½-10 branched dorsal-fin rays and 10-12½ branched anal-fin rays. Body and caudal peduncle was moderately compressed. Body was covered by overlapping scales. Tarek has five different populations in the Basin. They are Van, Erçek, Nazik and Aygr Lakes and Koçköprü Dam Lake populations. The main living area of the tarek population is Lake Van; however, between May and June, mature individuals of tarek enter to tributaries of Van Lake. Some of them are Karasu, Bendimahi, Deliçay, Zilan, Karmuç, Sapur, Yankçay, Geva, Engil, Kuruba and Akköprü Streams. At the end of study, it was concluded that tarek should be called as Alburnus tarichi (Güldenstädt, 1814) and it is an endemic fish species distributed only in Van Lake Basin.

Resumo Este estudo teve como objetivo determinar a área de distribuição de tarek (Alburnus tarichi) (Güldenstädt, 1814) e definir como deve ser chamado de acordo com o nome científico, avaliando estudos anteriores feitos por vários sistematizadores e seus relatórios sobre sua distribuição, e comparando o conhecimento da literatura. As características taxonômicas das amostras coletadas foram avaliadas e várias medições e contagens foram realizadas nas amostras, como origem analfin 0-4 escalas atrás da base da barbatana dorsal; 72-91 escalas de linha lateral; 21-29 rakers branquiais; 7½-10 raios da nadadeira dorsal ramificada, e 10-12½ raios da nadadeira anal ramificados. Pedúnculo caudal e corporal foram moderadamente comprimidos. O corpo estava coberto por escamas sobrepostas. Tarek tem cinco populações diferentes na bacia estudada. São as populações dos lagos Van, Erçek, Nazik e Aygr, e Koçköprü barragem. A principal área de presença da população tarek é o Lago Van; no entanto, entre maio e junho, indivíduos maduros de tarek entram nos afluentes do lago Van. Alguns deles são os fluxos Karasu, Bendimahi, Deliçay, Zilan, Karmuç, Sapur, Yankçay, Geva, Engil, Kuruba e Akköprü. No final do estudo, concluiu-se que tarek deveria ser chamado Alburnus tarichi (Güldenstädt, 1814) e que é uma espécie de peixe endêmica distribuída apenas na Bacia do Lago Van.

Diagnostic value of preoperative serum carcinoembryonic antigen and carbohydrate antigen 19-9 in colorectal cancer.

BACKGROUND: Since the first introduction of tumour markers, their usefulness for diagnosis has been a challenging question. The aim of the present prospective study was to investigate, in colorectal cancer patients, the relationship between preoperative tumour marker concentrations and various clinical variables. METHODS: The study prospectively enrolled 131 consecutive patients with a confirmed diagnosis of colorectal carcinoma and 131 age- and sex-matched control subjects with no malignancy. The relationships of the tumour markers carcinoembryonic antigen (cea) and carbohydrate antigen (ca) 19-9 with disease stage, tumour differentiation (grade), mucus production, liver function tests, T stage, N stage, M stage were investigated. RESULTS: Serum concentrations of cea were significantly higher in the patient group than in the control group (p = 0.001); they were also significantly higher in stage iii (p = 0.018) and iv disease (p = 0.001) than in stage i. Serum concentrations of cea were significantly elevated in the presence of spread to lymph nodes (p = 0.005) in the patient group. Levels of both tumour markers were significantly elevated in the presence of distant metastasis in the patient group (p = 0.005 for cea; p = 0.004 for ca 19-9). CONCLUSIONS: Preoperative levels of cea and ca 19-9 might provide an estimate of lymph node invasion and distant metastasis in colorectal cancer patients.

Cisplatin-based chemotherapy in elderly patients with advanced stage (IIIB and IV) non-small cell lung cancer patients.

Lung cancer continues to be the leading cause of cancer-related mortality and approximately 70% of patients present with locally advanced or metastatic disease at the time of diagnosis. More than 50% of lung cancer cases are diagnosed in patients over the age of 65 years. The doublet chemotherapies consisting of platinum plus one of the third-generation agents become currently the standard regimen, the first line chemotherapy The most of the available data regarding the optimal treatment of lung cancer comes from clinical trials in which the vast majority of patients are significantly younger than 65 years of age. We aimed to investigate whether there is any difference in tolerability and efficacy in between adult(<65 years old) and elderly(≥65 years old) patients who received cisplatin based chemoteherapy or chemoradiotherapy for stage IIIB and IV non-small cell lun cancer. We retrospectively evaluated the total 134 patients with advanced stage (stage IIIB or IV) NSCLC, in Ondokuzmayis University, Faculty of Medicine, Department of Pulmonary Medicine between 2001 and 2004. The response rates were 30.3% in adults and 28.8% in elderly patients. The median survival was 13.6±1.4 months and 11.8±2.0 months for adults and elderly patients, respectively. The one-year, two year and five year survival rates were 37%, 9% , 4% for adult patients and 29%, 7%, 4% for elderly patients, respectively. There was no statistical difference between the groups. Percentages of grade 3-4 anemia (0% vs 6.6%) and grade 3-4 neutropenia (0% vs 4.4%) were higher in elderly patients than adult patients. Other toxic effects were similar among both of groups. In conclussion; standart cisplatin containing chemotherapy regimens (cisplatin plus gemcitabine or vinorelbine) can be used in elderly patients with advanced non-small cell lung cancer.

Use of granulocyte colony-stimulating factor for neutropenia after orthotopic liver transplantation: report of two cases.

Early postoperative infections are one of the major causes of morbidity and mortality following orthotopic liver transplantation. The severity of these infections may be increased in patients with neutropenia. There are no guidelines on the use of granulocyte colony-stimulating factor (G-CSF) for the treatment of neutropenia in posttransplant liver recipients. However, it has been recommended by several authors. We have herein presented two patients who were treated effectively with G-CSF. Both patients developed severe neutropenia (<500/mm(3)) on the third postoperative day, and received intravenous G-CSF administration for 3 days. The neutrophil counts gradually increased and additional infusions were not needed. The immunosuppressive and prophylactic treatments were not altered. G-CSF administration was used effectively for 3 days in our two patients. No evidence of infectious or acute rejection episode was encountered during or following G-CSF treatment.

Acute pulmonary edema secondary to long-term use of oral ritodrine in a woman with a triplet pregnancy.

A 28-year-old primigravida who had taken oral ritodrine for 5 months to stop premature uterine contractions and was admitted in labor in the 33rd week of pregnancy developed acute pulmonary edema after cesarean section. Although parenteral ritodrine is the beta-adrenergic agent used most extensively to treat premature labor, only 1 case of pulmonary edema associated with long-term use of oral ritodrine had been reported so far. The present report presents for the first time computed tomographic findings of acute pulmonary edema secondary to tocolytic therapy.

Neutrophil chemotaxis and random migration in preterm and term infants with sepsis.

The aim of this study was to evaluate neutrophil chemotaxis and random migration in healthy newborn infants and septic neonates with similar gestational and postnatal age. Possible relationships between chemotactic activity, random migration, causative microorganisms, and clinical course of septic infants were also investigated. The neutrophil chemotaxis and random migration was evaluated in 24 healthy newborn babies and 34 septic neonates and 20 healthy adults by modified Boyden technique. The mean neutrophil chemotaxis of healthy preterm-term infants and adults were similar (66.6 +/- 18.9, 64.4 +/- 19.9, and 74.7 +/- 17 microm, respectively). The mean neutrophil random migration of healthy term infants was not different than that of adults. But the mean neutrophil random migration of healthy preterm infants was lower than that of adults (36.9 +/- 13.7 and 43.5 +/- 1 1.8 microm, respectively) (p = 0.03). The mean neutrophil chemotaxis and random migration septic term infants were not different from the value of healthy term infants (p > 0.05). Although the mean random migration of septic and preterm infants were similar (p > 0.05), the mean neutrophil chemotaxis of septic preterm infants was lower than the value of healthy preterm infants (p = 0.04). Not only mean neutrophil chemotaxis of septic preterm and term infants were significantly lower than that of adults (p = 0.002 and p = 0.006, respectively), but also neutrophil random migration of septic preterm and term infants were significantly lower than that of adults (p = 0.001 and p = 0.005, respectively). There was no relationship between the nature of causative microorganism and neutrophil random migration or chemotactic activity. Polymorphonuclear leukocytes chemotaxis was significantly lower in preterm with sepsis compared with healthy preterm-term infants and adults. These findings may indicate deterioration in neutrophil functions in premature babies under stress but more detailed studies with larger groups are needed.

Erythrocyte pyruvate kinase activity in term and preterm infants.

The activity of erythrocyte pyruvate kinase (PK), one of the most important enzymes in the anaerobic glycolytic pathway, was measured in a total of 57 healthy (22 term and 35 preterm) infants. The mean PK activity was 8.98 +/- 3.43 IU/gHb in term and 16.56 +/- 7.26 IU/gHb in preterm infants. The mean PK activity was significantly higher in preterm babies than term infants (16.56 +/- 7.26 IU/gHb and 8.98 +/- 3.43 IU/gHb, respectively) (P < .001). A significant negative correlation was found between gestational age, birth weight, and PK activity (r = 0.40, P < .05; r = -0.37, P < .05). No correlation was found between postnatal age and PK activity in both preterm and term infants. The increased PK activity in preterm babies was thought to be due to increased glycolytic activity and energy production in these infants.

Serum tumor necrosis factor-alpha in neonatal sepsis.

Tumor necrosis factor-alpha (TNF-alpha) is thought to be an important mediator in the pathogenesis of neonatal septicemia. To assess the role of TNF-alpha in neonatal sepsis, serum levels of TNF-alpha were measured in a group of neonates with septicemia and compared with the levels of gestational-postnatal, age-matched healthy controls. The relationships between severity of infection, the nature of causative microorganisms, and TNF-alpha levels were also investigated in this prospective study. A total of 49 infants (25 full-term, 24 preterm) with proven sepsis and 40 healthy infants (20 full-term, 20 preterm) were included. Serum TNF-alpha levels were measured using the TNF-alpha immunoradiometric assay. The median level of TNF-alpha was found to be significantly higher in infants suffering from sepsis (154 pg/mL) particularly in those with septic shock (242.5 pg/mL) as compared to healthy controls (61.5 pg/mL) (p < 0.001). No correlation was found between TNF-alpha and postnatal ages, gestational ages or birth weights of the infants. TNF-alpha levels were not different in surviving and terminal neonates. Although serum, TNF-alpha levels were found to be slightly higher in gram-negative septicemia, the difference was not significant. These findings suggest that TNF-alpha plays an important role in the pathophysiology of neonatal septicemia, but its importance as a prognostic factor is not yet clear.

A case of spondylocostal dysostosis with a fra (5) (q32).

Spondylocostal dysostosis is a rare hereditary syndrome with various costal and vertebral deformities. No chromosomal abnormalities in connection with this syndrome were previously reported in literature. We report a case with spondylocostal dysostosis and chromosomal abnormality [fra (5) (q32)].