Radioprotective effects of melatonin and thymoquinone on liver, parotid gland, brain, and testis of rats exposed to total body irradiation.

BACKGROUND: This study aimed to investigate thymoquinone (TQ), and melatonin's radioprotective effects on liver, parotid gland, brain, and testis of rats which were exposed to total body irradiation (IR). METHODS: Thirty adult Wistar rats were randomly divided into four groups that are Group 1 (control group): total body IR only, Group 2: IR-Melatonin (10 mg/kg), Group 3: IR-TQ (10 mg/kg), and Group 4 (sham group): nothing. Total body IR dose was 6 Gy. Tissue samples were taken 90 min after IR. The measurements of malondialdehyde (MDA), glutathione peroxidase (GSH-Px), and superoxide dismutase (SOD) were performed in all groups. RESULTS: In IR group, GSH-Px and SOD activities significantly decreased whereas MDA levels significantly increased when compared with the sham in all tissues. We recorded a significant decrease in MDA levels in IR-TQ group in liver and parotid gland of rats. Moreover, SOD did not change in IR-TQ group compared with IR only group. DISCUSSION: Melatonin, a powerful antioxidant, plays role in preventing oxidative stress. We revealed that premedication with TQ significantly inhibited the increase in MDA induced by IR in liver and parotid gland and protected the activities of SOD, an antioxidant enzyme, in all other tissues. It has been revealed that TQ has a potential effect preventing IR-induced damage as much as melatonin.

The Evaluation of Dietary Antioxidant Capacity, Dietary Inflammatory Index and Serum Biomarkers in Breast Cancer: A Prospective Study.

Dietary antioxidant capacity (dTAC) and dietary inflammatory index (DII) are commonly used to assess nutrition. This prospective study examined dTAC, DII, and serum biomarkers in women with breast cancer (BC). Patients were followed-up before surgery (T1), before chemotherapy (T2), at 6th (T3) and 12th months of chemotherapy (T4). Serum tumor necrosis factor alpha, interleukin 1ß, interleukin 6, protein carbonyl, malondialdehyde, total antioxidant capacity (TAC), and total oxidant status levels were analyzed. Dietary antioxidant intake, dTAC, and DII were determined using a three-day dietary record. dTAC was calculated using vitamin C equivalent (VCE), oxygen radical absorption capacity (ORAC), trolox equivalent antioxidant capacity (TEAC), total radical-trapping antioxidant parameter (TRAP), and ferrous ion reducing antioxidant potential (FRAP). This study included 32 women with BC and 32 controls (CG). ORAC, TEAC, TRAP, and FRAP were significantly lower in BC than in CG. During follow-up, only ORAC increased significantly at T2 compared to T1. A weak positive correlation was found between dTAC (VCE) and serum TAC levels at T2 (rho = 0.371, p = 0.036). The relationship between diet and serum biomarkers was not significant. Multicenter prospective studies on different age groups are needed to understand the association between diet and serum biomarkers levels in patients with BC.

Are dietary and serum advanced glycation end-products related to inflammation and oxidation biomarkers in breast cancer patients: a follow-up study.

PURPOSE: This study is aimed at evaluating the relationship between dietary and serum advanced glycation end-products (AGEs) with serum inflammatory and oxidative stress biomarkers in breast cancer (BC). METHODS: A sample of BC patients was followed for 12 months (March 2020-January 2022). Three-day food consumption record and serum samples were taken before surgery (T1), before chemotherapy (T2), at the 6th month of chemotherapy (T3), and at the 12th month of chemotherapy (T4). Dietary AGE intake was represented by carboxymethyl lysine (dCML). Serum levels of CML, inflammation, and oxidation biomarkers were determined with biochemical blood tests. The results were compared according to human epidermal growth factor receptor-2 (HER2) status. RESULTS: Thirty-two women with BC and 32 age and body mass index-matched healthy women participated. No significant correlation was found between dCML and serum CML, inflammatory or oxidative stress biomarkers at T1, T2, and T4. A weak positive correlation was demonstrated between dCML and serum malondialdehyde levels (rho=0.355, p=0.046) at T3. The serum CML, inflammation, and oxidation biomarker levels of the HER2- group were significantly higher than those of the HER2+ group at T1. CONCLUSION: This study suggests that there is limited correlation between dCML and serum inflammation and oxidative stress biomarkers in BC patients. Inflammation and oxidative biomarker levels appear to decline with treatment although dietary and serum AGE levels show not a corresponding significant decline. The HER2- subtype appears to be associated with higher dietary and serum AGEs and higher inflammatory and oxidative stress biomarkers.

Can Urinary KIM-1 and NGAL Predict Management Endoscopic Surgery in Acute Unilateral Obstructive Stone Disease? Results from a Prospective Cohort Study.

INTRODUCTION: Kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) are the leading novel biomarkers used efficiently in acute kidney injury (AKI). The levels of these biomarkers increase especially in the early period of nephrotoxic and ischemic renal damage. In this study, we aimed to investigate the clinical importance of NGAL and KIM-1 biomarkers used in the effective evaluation of kidney functions in patients with acute unilateral obstructive stone disease (AUOSD) in the management of endoscopic surgery. MATERIALS AND METHODS: We prospectively included patients who underwent endoscopic surgery due to AUOSD between January 2018 and December 2019. Urine KIM-1 and NGAL values of the patients were measured preoperative period, postoperative 4th h, and postoperative 7th day. The patients were evaluated according to the location and size of the stone, the degree of renal hydronephrosis, the duration of the operation, complications, and JJ stent placement. RESULTS: The study enrolled 50 patients. Urinary KIM-1/Cr and urinary NGAL/Cr ratios were higher in postoperative 4th h than in others (p < 0.001). Also, we found that urinary KIM-1/Cr and urinary NGAL/Cr ratios with Grade 2 and higher hydronephrosis were statistically higher than Grade 0-1 hydronephrosis (p < 0.001 and p: 0.042, respectively). Additionally, a preoperative urinary KIM-1 value of 1.24 ng/mL had a sensitivity of 78% and a specificity of 63% to predict the presence of hydronephrosis. When urine KIM-1 and NGAL results were compared with surgery time, stone size and location, serum creatinine (sCr) value, and Post-Ureteroscopic Lesion Scale grade, the difference was not statistically significant. Postoperative 7th day NGAL/Cr and KIM-1/Cr ratios were statistically higher in those with JJ stents placed (p: 0.03 and p: 0.004, respectively). CONCLUSION: KIM-1 and NGAL can be used in our assessment of renal function in patients with AUOSD, even if sCr is normal. Also, these biomarkers can predict the presence of hydronephrosis. It can be helpful in determining the time of surgical treatment, as well as providing information in the follow-up of patients with JJ stents after treatment.

Evaluation of the radioprotective effects of thymoquinone on dynamic thiol-disulphide homeostasis during total-body irradiation in rats.

Ionizing radiation-induced free radicals cause functional and structural harmful effects. Thiol, an important antioxidant, plays a major role in the eradication of reactive oxygen molecules. Thiol/disulphide homeostasis is a marker of oxidative stress. The objective of this study was to assess the potential radioprotective effects of thymoquinone (TQ) on the dynamic thiol/disulphide homeostasis of rats receiving total-body irradiation (IR). Twenty-two rats were divided into three groups to test the radioprotective effectiveness of TQ. The sham control group did not receive TQ or IR. The IR group received only total-body IR. The TQ + IR group received IR plus TQ. Following IR, blood samples were taken. The thiol/disulphide homeostasis parameters were analysed by a newly established method. In the IR group, native thiol and the native thiol/total thiol ratio were significantly decreased (P = 0.003 and P = 0.003, respectively), whereas the disulphide/native thiol and disulphide/total thiol ratios were significantly increased when compared with those of the sham control group (P = 0.003 and P = 0.003, respectively). In the TQ + IR group, the mean disulphide, native thiol and total thiol levels and the disulphide/native thiol, disulphide/total thiol and native thiol/total thiol ratios were not found to be significantly different when compared with those of the sham control group (P > 0.05 for all). Thiol/disulphide homeostasis was found to be disturbed after IR exposure. The results showed that TQ had antioxidant effects and reduced the IR-induced oxidative stress, which was demonstrated through the dynamic thiol/disulphide homeostasis. Thus, the use of TQ before radiation treatment helped protect the rats from oxidant side effects.

Evaluation of the relationship of erythrocyte membrane Na+/K+-ATPase enzyme activity and tumor response to chemoradiotherapy in patients diagnosed with locally advanced nonsmall cell lung cancer and glioblastoma multiforme.

CONTEXT: Radiotherapy is the commonly used therapeutic modality for inoperable cancer types. We investigated chemoradiotherapy (CRT) effects on the Na +/K +-ATPase enzyme. AIMS: The aim of the present study was to determine the usefulness of Na +/K +-ATPase enzyme as a prognostic factor and as a potential target for increasing the CRT response of nonsmall cell lung cancer (NSCLC) and glioblastoma multiforme (GBM). SETTINGS AND DESIGN: We prospectively evaluated 30 patients (all were treated with CRT) and 20 healthy controls. SUBJECTS AND METHODS: Blood samples were taken before and after the completion of CRT from the patients and once from the control group. Erythrocyte membranes were isolated and Na +/K +-ATPase enzyme activities were measured. STATISTICAL ANALYSIS USED: The statistical significance was calculated using the one-way analysis of variance test and the Tukey's test. RESULTS: Na +/K +-ATPase activity levels were increased in the patient groups before completion of CRT CRT, when compared to the control group. A significant decrease in Na +/K +-ATPase activity was noted in the patient groups after the completion of CRT when compared to before CRT, but the activity remained higher than in the control group. No relationship was noted between survival and Na +/K +-ATPase activity in NSCLC and GBM patients. CONCLUSION: Levels of Na +/K +-ATPase activity were initially high in patients with NSCLC and GBM, and decreased after the completion of CRT. This supports a linkage between the altered activity of Na +/K +-ATPase and the treatment effects of CRT. The observed change in Na +/K +-ATPase activity in cancer patients receiving CRT suggests that targeting this enzyme could represent a novel mean of combatting NSCLC and GBM.

Prognostic value of interferon-gamma, interleukin-6, and tumor necrosis factor-alpha in the radiation response of patients diagnosed with locally advanced non-small-cell lung cancer and glioblastoma multiforme

Background/aim: This study aimed to investigate the effect of chemoradiotherapy (CRT) on interferon-gamma (IFN-γ), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α), which are critical markers of the clinical radiation response of patients with locally advanced non-small-cell lung cancer (NSCLC) and glioblastoma multiforme (GBM). Materials and methods: Thirty patients who were treated with CRT and 20 healthy controls were prospectively evaluated. Circulating levels of cytokines were measured by enzyme-linked immunosorbent assay procedure. Post-CRT and pre-CRT levels were compared. Results: Post-CRT, TNF-α and IFN-γ levels were significantly lower than pre-CRT levels in the NSCLC and GBM groups, respectively. The statistical analysis did not show any significant difference between the post- and pre-CRT IL-6 levels. However, the pre-CRT IL-6 levels in the GBM group and post-CRT IL-6 levels in the NSCLC group were significantly higher than those of the control group. Conclusion: CRT affected TNF-α levels in NSCLC and IFN-γ levels in GBM, with the levels of both decreasing significantly. The IL-6 levels of the post-CRT NSCLC group were higher than those of the post-CRT GBM group. Irradiation-induced IL-6 may be responsible for tumor regrowth. Therefore, treatment with IL-6 inhibitors could be a potential therapeutic strategy for sensitizing NSCLC to irradiation in the clinic.

Urinary kidney injury molecule-1 levels in renal stone patients.

OBJECTIVE: To study kidney injury molecule-1 (KIM-1) biomarker levels, indicating renal tubular damage, in patients with kidney stones and in those who underwent minimally invasive method stone treatment. PATIENTS AND METHODS: Sixty patients with renal stones between 10 and 20 mm were included into the present study. Patients who were divided into three cohorts underwent micropercutaneous nephrolithotomy (microperc), retrograde intrarenal stone surgery (RIRS), and percutaneous nephrolithotomy (PNL). Urine samples were obtained from all participants before, 4 h and 14 days after the procedure. In all the samples obtained, urinary KIM-1 and creatinine (Cr) levels were measured and KIM-1/Cr ratios (ng/mg creatinine) were calculated. RESULTS: Preoperative urine KIM-1/Cr ratio was higher than postoperative 14th day. The bigger the renal stone size, the higher was the ratio (correlation coefficient 0.353, p = 0.006). According to preferred treatment procedure, there was a statistically significant decrease in preoperative and postoperative 4th hour and 14th day urine KIM-1/Cr rates in the RIRS and PNL, yet none in the microperc group (p = 0.010, p = 0.001, p = 0.212, respectively). CONCLUSION: In renal stone patients, the elevated urine KIM-1/Cr ratio levels increase further according to stone size. KIM-1/Cr ratio is a promising marker might be helpful in monitoring the damage created by stone disease.

Parathyroid autotransplantation in rats having hypoparathyroidism.

Re-implantation techniques of extracted parathyroid tissue were developed in order to prevent temporary hypocalcemia. During thyroid surgery; inadvertently removed or devascularized parathyroid gland is usually implanted in the sternocleidomastoid muscle. In this experimental study using rats with hypoparathyroidism, our aim was to investigate whether the excised parathyroid tissue could be seeded in the liver and in the peritoneum, instead of the SCM muscle. In our study, four different groups, each consisting of 10 Wistar albino rats were used (Control group, sternocleidomastoid muscle group, liver group, peritoneum group). Parathyroidectomy was performed and the parathyroid tissue was seeded into the sternocloid mastoid muscle, liver and peritoneum. After 14 days, the rats were sacrificed and levels of calcium, magnesium, phosphorus, alkaline phosphatase and parathyroid hormone were measured in rats' blood samples. The autotransplanted parathyroid tissue was then excised and examined. In all groups, parathyroid tissues were analyzed histopathologically according to calcification, necrosis, tissue loss, foreign body reaction, inflammation and fibrosis. Regarding Ca, Mg, PO4, ALP; There were no difference between the groups. When we compared control group with the other groups; a difference was observed in the levels of PTH (P<0.05). In pathological examination; regarding tissue loss; there was a difference between liver and peritoneum groups (P<0.05). In our study, we expected better result in plantings inside liver and peritone compared to SKM. However, there were no difference between the groups.

A multicenter nationwide reference intervals study for common biochemical analytes in Turkey using Abbott analyzers.

BACKGROUND: A nationwide multicenter study was organized to establish reference intervals (RIs) in the Turkish population for 25 commonly tested biochemical analytes and to explore sources of variation in reference values, including regionality. METHODS: Blood samples were collected nationwide in 28 laboratories from the seven regions (≥400 samples/region, 3066 in all). The sera were collectively analyzed in Uludag University in Bursa using Abbott reagents and analyzer. Reference materials were used for standardization of test results. After secondary exclusion using the latent abnormal values exclusion method, RIs were derived by a parametric method employing the modified Box-Cox formula and compared with the RIs by the non-parametric method. Three-level nested ANOVA was used to evaluate variations among sexes, ages and regions. Associations between test results and age, body mass index (BMI) and region were determined by multiple regression analysis (MRA). RESULTS: By ANOVA, differences of reference values among seven regions were significant in none of the 25 analytes. Significant sex-related and age-related differences were observed for 10 and seven analytes, respectively. MRA revealed BMI-related changes in results for uric acid, glucose, triglycerides, high-density lipoprotein (HDL)-cholesterol, alanine aminotransferase, and γ-glutamyltransferase. Their RIs were thus derived by applying stricter criteria excluding individuals with BMI >28 kg/m2. Ranges of RIs by non-parametric method were wider than those by parametric method especially for those analytes affected by BMI. CONCLUSIONS: With the lack of regional differences and the well-standardized status of test results, the RIs derived from this nationwide study can be used for the entire Turkish population.

Effect of deferoxamine on Na+K+ATPase activity after cerebral ischemia in rabbits.

OBJECTIVE: To study the effects of deferoxamine on tissue sodium-potassium adenosine triphosphatase (Na+-K+ ATPase) activity on cerebral ischemia in rabbits. METHODS: We cared for the animals in the Pharmacology Department of the Medical School of Selcuk University in 2004. We used 30, New Zealand, 7-day-old male rabbits in the experiment. We anesthetized all the animals with xylazine hydrochloric acid and ketamine. We divided the rabbits equally into 3 groups. In group 1 (n=10) (sham group), we observed baseline levels, and did not apply ischemia. In group 2 (n=10) (untreated group) we produced cerebral ischemia by clamping the bilateral common carotid arteries for 60 minutes, and in group 3 (n=10), we administered deferoxamine (DFO) 50 mg/kg intravenously immediately after opening the clamps. RESULTS: The Na+-K+ATPase activity increased after DFO treatment (p=0.045). CONCLUSION: We conclude that Na+-K+ATPase activity in cortical brain tissue was higher in DFO-treated rabbits compared with untreated animals after ischemia.

Increased bone resorption in the proximal femur in patients with hemiplegia.

OBJECTIVES: To investigate the relationship between the proximal femoral bone mineral density and bone resorption markers, determinants of calcium metabolism and vitamin D levels in elderly stroke patients. DESIGN: A total of 80 patients and 20 controls were enrolled in the study. Bone mineral density measurements were obtained at the proximal femur. In all subjects, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, intact parathyroid hormone, osteocalcin, deoxypyridinoline, and ionized calcium concentrations were measured. Barthel Index and Motricity Index Leg Score were recorded all patients. RESULTS: The serum concentrations of deoxypyridinoline, intact parathyroid hormone, and the mean serum ionized calcium levels were significantly higher in patients with stroke than that of the control subjects. The mean serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D concentrations in patients were significantly lower than those of the control group (P < 0.05). The bone mineral density of proximal femurs of paretic limbs was decreased significantly compared with those of the control group (P < 0.05). There were significant correlations between the Z score of the hemiplegic side and the patients' Barthel Index, Motricity Index Leg Score, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, calcium, and deoxypyridinoline. CONCLUSIONS: This study provides clear evidence that decreased mobility, vitamin D status, and bone turnover variables in patients after stroke are important factors in the greater bone loss in the paretic leg.

Effect of gamma-hydroxybutyric acid on lipid peroxidation and tissue lactate level in experimental head trauma.

BACKGROUND: This study was designed to determine the effects of gamma-hydroxybutyric acid (GHB) on tissue lactate and malondialdehyde (MDA) levels in rabbit brain after experimental head trauma. METHODS: Thirty New Zealand rabbits were divided equally into three groups: group S was the sham-operated group, group C, and group GHB received head trauma, where group C was the untreated and group GHB was the treated group. Head trauma was delivered by performing a craniectomy over the right hemisphere and dropping a weight of 10 g from a height of 80 cm. GHB was administered 400 mg/kg intravenously for 10 minutes after the head trauma to group GHB. The nontraumatized side was named "1" and the traumatized side was named "2." One hour after trauma, brain cortices were resected from both sides and the concentrations of lactate and MDA were determined. RESULTS: There were significant differences between lactate and MDA levels of group S and all other groups (C1, C2, GHB1, and GHB2) except between lactate levels of group S and group GHB1, the nontraumatized and traumatized sides of groups C and group GHB, group C2 versus group GHB2, and group C1 versus group GHB1 (p < 0.05). Rectal temperature after the administration of GHB in group GHB was found lower than in groups S and C (p < 0.05). CONCLUSION: These results demonstrate that head trauma leads to an increase in brain tissue lactate and MDA levels, and GHB effectively suppresses the increase of lactate and MDA.

Effects of magnesium sulfate on Na+,K+ -ATPase and intracranial pressure level after cerebral ischemia.

In the present study, the effects of magnesium sulfate on Na+,K+ -ATPase levels and intracranial pressure (ICP) after cerebral ischemia in rabbits were studied. Thirty New Zealand rabbits were divided into three groups. Group 1 was the control group. In group 2 (untreated group) cerebral ischemia was produced by clamping bilateral common carotid arteries for 60 min but in group 3 magnesium sulfate was administered 100 mg/kg i.v. 10 min after opening the clamps. In group 1, ICP recordings were obtained 5, 60 and 120 min after craniectomy. In groups 2 and 3, ICP recordings were obtained 5 min after craniectomy but before clamping, 60 min after clamping and 60 min after opening the clamps. After taking ICP recordings, brain cortices were resected and Na+,K+ -ATPase activity was determined by subtracting the enzyme activity in the presence of ouabain from the total activity in the absence of ouabain method. There was a significant difference between Na+,K+ -ATPase levels of group 1 and group 2 (P < 0.05). There was no significant difference in Na+,K+ -ATPase levels between group 1 and 3 (P > 0.05), also preischemic ICP values were same in all groups (P > 0.05). Preischemic and postischemic ICP values were significantly different between groups 1 and 2 (P < 0.05), also postischemic (120 min) ICP values were significantly different between group 2 and group 3 (P < 0.05). ICP values correlate well with Na+,K+ -ATPase level. These results demonstrate that cerebral ischemia leads to a decrease of ATPase level in the brain and magnesium sulfate suppresses the decrease of Na+,K+ -ATPase, also magnesium sulfate treatment improves the ICP changes.

Enteral glutamine supplementation and dexamethasone attenuate the local intestinal damage in rats with experimental necrotizing enterocolitis.

The pathogenesis of necrotizing enterocolitis (NEC) presumptively is due to an inappropriate intestinal epithelial immunologic response of immature gut to luminal stimuli. Glutamine is essential for intestinal crypt cell proliferation and enhances the cellular response to growth factors. We aimed to test the hypothesis that the supplementation of enteral feedings with glutamine may stimulate an immature intestine and decrease the intestinal inflammatory change in NEC. Immediately after birth, the neonatal rats were weighed and randomized into one of four treatment groups. Group 1 consisted of rats whom were breast-fed. Group 2 (NEC group) consisted of neonates whom were fed with a special rodent formula. Rats in groups 3 and 4 were fed in a similar fashion to those in group 2, and glutamine 0.3 mg/kg per day and dexamethasone 0.5 mg/kg per day were added to their formula, respectively. The neonatal rats were weighed and killed on day 4: the last 4 cm of terminal ileum was harvested for morphological studies and detection of nitrite and nitrate levels in tissue. The animals in the NEC group showed various degrees of inflammatory changes similar to clinical NEC. The inflammatory changes of the intestine appeared to be attenuated in both glutamine- and steroid-treated animals compared to those in the NEC group. Only steroid treatment decreased the tissue levels of these nitrogen oxides that were increased in rats in the NEC group. We herein provide evidence that maturational agents such as glutamine and dexametasone can attenuate the local intestinal inflammatory damage in experimental NEC. These findings support the hypothesis that the gut immaturity in premature infants represents a risk factor for NEC.

Cardiac troponin-I in the serum of infants of diabetic mothers.

A transient form of hypertrophic cardiomyopathy has been previously described in infants of diabetic mothers. When it occurs, it is generally benign. The purpose of our study was to establish the extent of injury to the cardiomyocytes in symptomatic and asymptomatic patients with and without hypertrophic cardiomyopathy. Thus, we compared 35 consecutive patients to 20 healthy controls, establishing the significance, if any, of differences in cardiac troponin-I and creatine kinase, including its MB-fraction, and seeking to establish the value of these parameters in the diagnosis of cardiac injury. We also determined to levels of glucose and insulin in the serum, and took note of electrocardiographic and echocardiographic investigations. Values were determined at the 1st and 7th days after admission in the patients, while parameters were measured in the control group only on the first day. We found that the levels of cardiac troponin-I in the serum, known to be a marker for cardiac injury, were significantly elevated in symptomatic patients with life-threatening respiratory or haemodynamic distress. We speculate that transient ventricular hypertrophy is neither the cause nor the consequence of damage to the cardiomyocytes. It would be interesting, nonetheless, to determine the relationship, if any, between cardiomyocytic damage and clinical outcome.

[Evaluation of "admission index of insulin resistance (AIRI)" as an early stage risk predictor in nondiabetic acute coronary syndromes]. / Diyabetik olmayan akut koroner sendromlarda erken dönem yeni bir risk onbelirleyicisi olarak "gelis insülin rezistans indeksi (GIRI)'nin" degerlendirilmesi.

OBJECTIVE: Insulin resistance is a risk predictor for many cardiovascular diseases, but its effect on etiology and prognosis of diseases has not been clearly identified. In this study, we aimed to investigate whether admission index of insulin resistance (AIRI), recently and practically presented for determination of insulin resistance, could be a new risk predictor of early prognosis in nondiabetic acute coronary syndromes. METHODS: One hundred and sixty nondiabetic patients admitted to the intensive coronary care unit and underwent coronary angiography with the diagnosis of acute myocardial infarction (AMI) (Group I; 72 patients; mean age - 58+/-12 years) or unstable angina pectoris (UAP) (Group II; 88 patients; mean age 58+/-10 years) were included in the study. In all patients blood glucose and insulin levels were measured on admission and AIRI was calculated by the formula of "admission glucose level X insulin level / normal blood glucose level (5 mmol/L) X normal insulin level (5 mU/L)" for each patient. After determining the left ventricular ejection fraction (LVEF) and wall motion score index (LVWMSI) echocardiographically and calculating the Gensini score index from coronary angiography, the patients were followed up for major cardiac events (heart failure, atrial fibrillation, reinfarction, life-threatening ventricular arrhythmias, atrio-ventricular block, need for revascularisation and mortality) for 30 days. RESULTS: AIRI was found higher in Group I (7.2+/-5.3 versus 5.2+/-4.4, p< 0.01) than in Group II. AIRI was positively correlated with Gensini score and LVWMSI (r=0.41, p<0.01 and r=0.48, p<0.001, respectively) and negatively correlated with LVEF (r=-0.37, p=0.001) in Group I. In addition, it was seen that positive correlation of AIRI with Gensini score (r=0.23, p=0.01) and LVWMSI (r=0.43, p=0.0001) in Group I persisted on multivariate regression analysis. Again, AIRI was significantly correlated with heart failure (r=0.42, p<0.0001), atrial fibrillation (r=0.35, p=0.002) and reinfarction (r=0.23, p=0.04) in Group I. Along with this, in multivariate regression analysis, it was correlated with heart failure (r=0.21, p<0.007), atrial fibrillation (r=0.18, p=0.01) and reinfarction (r=0.18, p=0.01). On the other hand, there was no significant correlation between AIRI and these parameters in Group II. CONCLUSION: AIRI can be used in early stage as a risk predictor to determine high-risk subgroups of nondiabetic patients presenting with AMI. Also AIRI, a parameter, which is practically calculated and easily used, is an independent risk factor detecting the extent of coronary artery disease and left ventricular dysfunction in patients with AMI.

Correlation between tissue lactate levels and electroencephalogram in evaluating the severity of experimental head trauma.

OBJECTIVE: The objective of this study was to develop an electroencephalographic grading scale for evaluating the severity of head trauma and assessing the correlation of this scale with brain tissue lactate concentrations. DESIGN: Animal experiment. SETTING: Animal research laboratory in a university hospital. SUBJECTS: Thirty New Zealand rabbits were divided into three groups. INTERVENTIONS: Rabbits were anesthetized, and bilateral frontoparietal craniectomy was performed. An electroencephalogram was recorded over the dura from both sides. After electroencephalographic recording, unilateral trauma was produced by using the weight drop method with a calculated force of 400 g.cm and 800 g.cm in group 2 (n = 10) and group 3 (n = 10), whereas in group 1 (n = 10) only craniectomy was performed. Electroencephalographic recording was repeated 60 mins after trauma or craniectomy, and cortical tissue samples were resected from both sides to evaluate tissue lactate concentrations in all three groups. MEASUREMENTS AND MAIN RESULTS: Electroencephalographic recordings from both sides of the brain were evaluated together by using a 6-point scale (1 = best to 6 = worst) that was based on the presence or absence of electroencephalographic activity and the decrease in amplitude or frequency band of the electroencephalogram. Lactate was measured in resected tissue by using spectrophotometric enzymatic methods. One-way analysis of variance for repeated measures, Bonferroni-adjusted paired Student's -test, Kruskal Wallis analysis of variance, Bonferroni-adjusted Mann-Whitney-U, and Spearman's correlation tests were used as appropriate for statistical analysis. We considered p<.05 to be significant. The difference in lactate concentrations was significant between the three groups ( p<.05). Electroencephalographic grades were significantly different between the pretraumatic and posttraumatic recordings ( p<.05) and between the three groups after craniectomy or trauma ( p<.001). There was a positive high correlation between lactate concentrations and electroencephalographic grades. CONCLUSIONS: Tissue lactate concentrations and electroencephalograhic grades change with the severity of the trauma, and there is a strong positive correlation between tissue lactate concentrations and electroencephalographic grades.

Comparative effect of oral pulse and intravenous calcitriol treatment in hemodialysis patients: the effect on serum IL-1 and IL-6 levels and bone mineral density.

INTRODUCTION: Increased serum levels of bone-resorptive cytokines such as interleukin-1 beta (IL-1 beta) and interleukin-6 (IL-6) have been implicated for changes in bone remodeling in hemodialysis patients. In this prospective randomized study, we aimed to compare the effect of oral and intravenous (IV) pulse calcitriol on serum levels of IL-1 beta and IL-6. PATIENTS AND METHODS: Twenty-eight hemodialysis patients were included and consecutively randomized to receive either oral (n = 14, M/F = 7/7, mean age 42 +/- 15 years) or IV pulse (n = 14, M/F = 6/8, mean age 38 +/- 14 years) calcitriol treatment. No difference was found between groups for age, sex distribution, primary renal disease, mean time on hemodialysis and baseline biochemical parameters including serum levels of IL-1 beta and IL-6. RESULTS: The percent fall of intact parathyroid hormone (iPTH) was significantly less with oral compared to IV calcitriol between 0 and the 3rd month (32 +/- 21 vs. 56 +/- 28%, p = 0.03). However, the percent fall in iPTH at the 6th month of the therapy was not different in the oral group compared to the IV group (57 +/- 22 vs. 73 +/- 24%, p = 0.12). The increase in bone mineral densities was higher in the IV group than the oral group. Oral and IV calcitriol caused a significant fall in IL-1 beta (p = 0.02 and p = 0.03, respectively) and IL-6 levels (p = 0.02 and p < 0.001, respectively) at the 6th month of treatment. The percent fall in serum IL-6 levels at the 6th month was significantly greater in the IV compared to the oral group (61 +/- 18 vs. 36 +/- 33%, p = 0.04), while the percent changes in serum IL-1 beta levels were similar. CONCLUSION: IV calcitriol therapy has a greater suppression of PTH at the 3rd month of the therapy. Despite no difference in serum PTH levels at the 6th month, IV therapy has a greater increase in bone mineral densities and a greater decrease in serum IL-6 levels. These findings suggest IV calcitriol treatment has a superior effect on bone remodeling by influencing the levels of bone-resorptive cytokines as compared to the oral therapy group, beyond its suppressive effect on iPTH.