Dental approaches in children with congenital heart disease treated under general anesthesia for oral rehabilitation.

BACKGROUND: Children with congenital heart disease (CHD) are at high risk of contracting oral diseases. The aim of this study is to investigate dental procedures to prevent the risk of infective endocarditis in children with CHD. MATERIAL AND METHODS: 146 patients aged 2-14 years, in need of prophylaxis before cardiovascular surgery and who had filled out anamnesis records, were considered. Dental caries in all the children with CHD was reported as the number of decayed, missing and filled teeth (DMFT). RESULTS: There was a significant strong positive relationship between the pre-oral rehabilitation DMF-T/dmf-t scores and the number of caries patients (r=0.95, p=0.01). There was no significant correlation between the pre-oral rehabilitation DMF-T/dmf-t scores and both tooth loss (r=0.14, p=0.09) and the number of restorations (r=0.11, p=0.17). In addition, there was no significant correlation between the post-oral rehabilitation DMF-T/dmf-t scores and the prevalence of dental caries. A positive and moderately strong correlation was found between the post-oral rehabilitation DMF-T/dmf-t scores and the number of missing teeth (r=0.56, p=0.01), while there was a positive and strong relationship between the post-treatment DMF-T/dmf-t scores and the number of fillings (r=0.62, p=0.01). CONCLUSIONS: Extraction should be considered when providing oral rehabilitation, rather than endodontic and deep restorative treatments.

Percutaneous Closure of Left Atrial Appendage significantly affects Lipidome Metabolism.

Patients with non-valvular atrial fibrillation (AF) and a high risk for oral anticoagulation can be treated by percutaneous implantation of left atrial appendage occlusion devices (LAAC) to reduce the risk of cardio-embolic stroke. This study evaluates whether LAAC may influence lipid metabolism, which has never been investigated before. Patients with successful LAAC were included consecutively. Venous peripheral blood samples of patients were collected immediately before (T0, baseline) and 6 months after (T1, mid-term) LAAC. A targeted metabolomics approach based on electrospray ionization liquid chromatography-mass spectrometry (ESI-LC-MS/MS) and MS/MS measurements was performed. A total of 34 lipids revealed a significant change from baseline to mid-term follow-up after successful LAAC. Subgroup analysis revealed confounding influence by gender, age, diabetes mellitus type II, body mass index, left ventricular ejection fraction, creatinine and NT-proBNP. After multivariable adjustment within logistic regression models, these 34 lipids were still significantly altered after LAAC. Successful percutaneous LAAC may affect lipid metabolism and thereby may potentially affect pro-atherogenic and cardio-toxic effects.

Correction to: Occlusion of left atrial appendage affects metabolomic profile: focus on glycolysis, tricarboxylic acid and urea metabolism.

The article Occlusion of left atrial appendage aff ects metabolomic profile:focus on glycolysis, tricarboxylic acid and urea metabolism, written by K. Sattler, M. Behnes, C. Barth, A. Wenke, B. Sartorius, I. El-Battrawy, K. Mashayekhi, J. Kuschyk, U. Hoffmann, T. Papavasiliu, C. Fastner, S. Baumann, S. Lang, X. Zhou, G. Yücel, M. BorggrefeI, Akin, was originally published Online First without open access.

Effects of epidermal growth factor on reduction of the formation of thrombus and vessel wall healing in an experimental rat model.

OBJECTIVES: The aim of the current study was to investigate the synergistic effects of epidermal growth factor (EGF) and Enoxaparin in thrombus resolution. METHOD: Forty rats were divided into five groups (n = 8/group). Thrombosis was induced in all groups except the Sham group. Group 1: Sham; Group 2: Phosphate buffered saline; Group 3: Enoxaparin; Group 4: EGF; Group 5: EGF+Enoxaparin. The treatments were applied 2 hours preoperatively, then postoperatively at 48 hours. Rats were sacrificed 7 days after the 2nd injection. Tissue samples were examined with hematoxylin-eosin, trichrome, vascular endothelial growth factors (VEGF), von Villebrand factor (VWF), CD34 and CD68 for histopathological and immunohistochemical analyses. RESULTS: Neovascularisation, recanalization and macrophage accumulation were statistically significantly higher in the EGF+Enoxaparin group than the other groups (p < 0.05), and the volume of thrombus was determined to be significantly lower. Recanalization was found to be higher in the Enoxaparin group than in the other groups. As for the thrombus resolution, statistically significant regress in the EGF+Enoxaparin group (p < 0.05) compared to the other groups was found. Immunohistochemical antibodies were statistically higher in the EGF+Enoxaparin group than in the other groups (p < 0.05). CONCLUSION: The results of this study demonstrate that concomitant use of EGF and Enoxparin has a synergistic effect and contributes significantly to thrombus resolution (Fig. 10, Ref. 35).

Occlusion of left atrial appendage affects metabolomic profile: focus on glycolysis, tricarboxylic acid and urea metabolism.

BACKGROUND: Left atrial appendage (LAA) closure (LAAC) by implantation of an occlusion device is an established cardiac intervention to reduce risk of stroke while avoiding intake of oral anticoagulation medication during atrial fibrillation. Cardiac interventions can alter local or systemic gene and protein expression. Effects of LAAC on systemic metabolism have not been studied yet. OBJECTIVES: We aimed to study the effects of interventional LAAC on systemic metabolism. METHODS: Products of glycolysis, tricarboxylic acid and urea metabolism were analyzed by ESI-LC-MS/MS and MS/MS using the AbsoluteIDQ™ p180 Kit in plasma of 44 patients undergoing successful interventional LAAC at baseline (T0) and after 6 months (T1). RESULTS: During follow up, plasma concentrations of several parameters of glycolysis and tricarboxylic acid cycle (TCA) and urea metabolism increased (alanine, hexose, proline, sarcosine), while others decreased (aspartate, glycine, SDMA, serine). Multivariate linear regression analysis showed that time after interventional LAAC was an independent predictor for metabolite changes, including the decrease of SDMA (beta -0.19, p < 0.01) and the increase of sarcosine (beta 0.16, p < 0.01). CONCLUSIONS: Successful interventional LAAC affects different pathways of the metabolome, which are probably related to cardiac remodeling. The underlying mechanisms as well as the long term effects have to be studied in the future.

Effect of Lonicera japonica extract on Mycoplasma gallisepticum in naturally infected broiler flocks.

1. In this study, the effect of chlorogenic acid extract from Lonicera japonica Thunb. on Mycoplasma gallisepticum infections and the performance of broiler flocks was investigated. 2. A total of 360 Ross-308 broiler chicks taken from M. gallisepticum seropositive flocks were divided equally into three groups designated as control (nothing administered), antibiotic (Tylosin tartrate given for the first 3 d and d 20-22) and test group (chlorogenic acid extract given twice a day on d 16 and 22). 3. Broiler performance analysis, serological tests (slide agglutination), molecular identification (polymerase chain reaction) and histopathological examination were performed to detect M. gallisepticum. 4. The results show that chlorogenic acid not only increases live body weight but is also an alternative treatment option in M. gallisepticum-infected broiler flocks.

Abnormal Neural Activation to Faces in the Parents of Children with Autism.

Parents of children with an autism spectrum disorder (ASD) show subtle deficits in aspects of social behavior and face processing, which resemble those seen in ASD, referred to as the "Broad Autism Phenotype " (BAP). While abnormal activation in ASD has been reported in several brain structures linked to social cognition, little is known regarding patterns in the BAP. We compared autism parents with control parents with no family history of ASD using 2 well-validated face-processing tasks. Results indicated increased activation in the autism parents to faces in the amygdala (AMY) and the fusiform gyrus (FG), 2 core face-processing regions. Exploratory analyses revealed hyper-activation of lateral occipital cortex (LOC) bilaterally in autism parents with aloof personality ("BAP+"). Findings suggest that abnormalities of the AMY and FG are related to underlying genetic liability for ASD, whereas abnormalities in the LOC and right FG are more specific to behavioral features of the BAP. Results extend our knowledge of neural circuitry underlying abnormal face processing beyond those previously reported in ASD to individuals with shared genetic liability for autism and a subset of genetically related individuals with the BAP.

Prevalence of rheumatoid arthritis in Antalya, Turkey.

The aim of this study was to evaluate the prevalence of rheumatoid arthritis (RA) in Antalya, Turkey. A cross-sectional study was performed face-to-face using a structured interview. Subjects were asked whether they had arthritis at present or previously. Subjects suspected of having RA were invited to the hospital for physical examination and laboratory investigations. Diagnosis of RA was confirmed if the patient fulfilled 1987 American College of Rheumatology (ACR) criteria for RA. A total of 3173 subjects were interviewed. The diagnosis of RA was established in 12 subjects. The prevalence of RA was determined as 0.38% [95% confidence interval (CI): 0.16-0.59]. The mean age was 49.92+/-11.56 years in subjects with RA and greater than that of other subjects (p<0.001). Of 12 subjects with RA, 9 had previously been diagnosed with the disease. Rheumatoid factor was detected in the sera of eight subjects. RA is less frequent in Turkey than in Northern Europe. Different genetic and environmental factors may have a role in this result.

Pentoxifylline contributes to the hepatic cytoprotective process in rats undergoing hepatic ischemia and reperfusion injury.

AIM: Considerable efforts have been made to find and/or eliminate the underyling causes of hepatic ischemia-reperfusion injury, but many points are still unclear. Pentoxifylline-related cytoprotection is one of these unclear points. Our study tests the effects of pentoxifylline on the hepatic cytoprotective process in an experimental model. MATERIALS AND METHODS: The animals were divided into two groups: (1) placebo-pretreated rats and (2) pentoxifylline-pretreated rats. After pretreatment, all rats underwent the hepatic ischemia-reperfusion procedure which was performed by clamping the hepatoduodenal ligament. To evaluate the liver injury, serum levels of alanine transaminase (ALT) and aspartate transaminase (AST), and liver tissue levels of prostaglandin E(2) (PGE(2)) were measured before ischemia, immediately after ischemia and immediately after reperfusion. RESULTS: Before ischemia and immediately after ischemia, there were no significant differences between ALT and AST levels of groups 1 and 2 (p >0.05). However, at the end of reperfusion, ALT and AST levels of group 2 were significantly decreased when compared with group 1 (p < 0.05 and p < 0.01, respectively). Additionally, tissue levels of PGE(2) that were obtained before ischemia, immediately after ischemia and immediately after reperfusion in group 2 were significantly higher than those of group 1 (p < 0.001). CONCLUSION: Pentoxifylline reduces reperfusion injury of the liver through significantly decreased transaminase levels, and contributes to hepatic cytoprotection by increasing tissue levels of PGE(2) significantly. These effects reflect the role of tissue PGE(2) in pentoxifylline-related hepatoprotection against ischemia-reperfusion injury of the liver.

Maternal serum screening for Down's syndrome, open neural tube defects and trisomy 18.

Maternal serum screening identifies women at an increased risk of a pregnancy with Down's syndrome or trisomy 18 or an open neural tube defect. The triple test, consisting of maternal serum alpha-fetoprotein, unconjugated estriol and human chorionic gonadotropin was carried out by a chemiluminescence immunoassay method in our laboratory. The study consisted of 373 pregnant women. The gestational range for the study group was 14-22 weeks. The mean maternal age for the study group was 28.53 +/- 5.46 years (range 17.4 to 43.5 years); 9.1% of the women were considered at high risk for Down's syndrome based on the test results. In our study the detection rate for Down's syndrome by prenatal karyotyping was 66.6%. Maternal serum screening allows reduction of the number of women requiring amniocentesis without a significant decrease in the detection rate.

Effect of sulfur dioxide inhalation on erythrocyte antioxidant status and lipid peroxidation in experimental diabetes.

The effect of sulfur dioxide (SO(2) ) on red cell antioxidant status and lipid peroxidation was examined in this research. Forty healthy male albino rats, aged three months, were divided into four equal groups: Control (C), SO(2) +C (CSO(2) ), diabetic (D) and SO(2) +D (DSO(2) ). Experimental diabetes mellitus was induced by i.v injection of alloxan with a dose of 50 mg/kg body weight. Ten ppm SO(2) was administered to the animals of SO(2) exposed groups in an exposure chamber for one hr/day x 7 days/wk x 6wks while other groups were exposed to filtered air in the same condition. SO(2) exposure, while markedly decreasing Cu, Zn-Superoxide dismutase (Cu, Zn-SOD) activity, significantly increased glutathione peroxidase (GSH-Px), catalase (CAT), glutathione (GSH) and glutathione-s-transferase (GST) activities and TBARS values in CSO(2) and DSO(2) groups compared with their respective control groups. From these results, it could be concluded that adaptative changes occurred in antioxidant systems that may counteract the free radical effect of SO(2) in the experimental groups.

The effect of recombinant human granulocyte/macrophage-colony-stimulating factor (rHu GM-CSF) and rHu G-CSF administration on neutrophil chemiluminescence assay in patients following cyclic chemotherapy.

Secondary infections related to neutropenia and functional defects of phagocytes are common consequences in patients treated for cancer. The hematopoietic colony-stimulating factors (CSF) have been introduced into clinical practice as additional supportive measures that can reduce the incidence of infectious complications in patients with cancer and neutropenia. The aim of this study was to determine the role of granuolcyte/macrophage(GM)-CSF and granulocyte(G)-CSF in enhancing in vivo human neutrophil function. A luminol-dependent chemiluminescence assay was developed to evaluate whether the repair in neutropenia accompanies the ability of neutrophils to function. A dose of 5 microg G-CSF kg(-1) day(-1) [recombinant human (rHu) G-CSF; filgrastim] or 250 microg GM-CSF m(-2) day(-1) (rHu GM-CSF; molgramostim) was administered subcutaneously once daily to 12 metastatic cancer patients being treated with different cytotoxic regimens. All injections of CSF were given after the initiation of neutropenia and continued until the occurrence of an absolute neutrophil recovery. rHu GM-CSF and rHu G-CSF, administered once daily at the 250 microg m(-2) day(-1) and 5 microg kg(-1) day(-1) level, were effective in increasing the absolute neutrophil count and neutrophil function, as measured by an automated chemiluminescence system.

Increased resistance to oxidative stress in normal and glucose-6-phosphate dehydrogenase-deficient hemolysates in the presence of enzyme substrates.

Erythrocytes and hemolysates from 10 normal and 10 glucose-6-phosphate dehydrogenase-deficient individuals were incubated with cumene hydroperoxide, and free radical-induced lipid peroxidation was monitored by chemiluminescence. Chemiluminescence intensities in erythrocytes of normal and deficient subjects were similar in the presence or absence of glucose-6-phosphate dehydrogenase substrates. Hemolysates of normal and deficient subjects also showed similar chemiluminescence in the absence of substrates. However, with the addition of substrates to the incubation medium, deficient hemolysates reached maximum chemiluminescence intensity within a shorter period, and maximum values were higher than in normal hemolysates. We believe this offers a new means of detection of glucose-6-phosphate dehydrogenase-deficient patients.

Prevalence of erythrocyte pyruvate kinase deficiency and normal values of enzyme in a Turkish population.

A pyruvate kinase deficiency prevalence study and determination of the normal levels of the enzyme were performed in Antalya city, Turkey. Heparinized blood samples obtained from a representative population of the Antalya province (617 women and 573 men) were tested for pyruvate kinase deficiency by qualitative and quantitative tests between April 1992 and March 1994. The mean pyruvate kinase activity was found to be 19.8 +/- 4.0 IU/g Hb whereas the enzyme activity of deficient cases varied between 7.5 and 12.2 IU/g Hb. Taking into account that pyruvate kinase deficiency is the second most common cause of nonspherocytic congenital hemolytic anemia, detection of deficient cases by genetic screening tests appears to be an informative clinical indicator of hemolytic anemia.

A chemiluminescence assay detecting the antioxidative effects of glutathione and uric acid on erythrocytes and hemolysates exposed to t-butyl hydroperoxide.

The aim of this study was to compare the antioxidative effects of glutathione (GSH) and uric acid (UA) on erythrocytes and hemolysates exposed to t-butyl hydroperoxide, by using a chemiluminescence (CL) technique. CL formation was induced by t-butyl hydroperoxide in an experimental system consisting of erythrocytes and hemolysates in Tris-HCl buffer (pH 7.4). GSH or UA was added as an antioxidant. In erythrocytes, 10 microM and 50 microM concentrations of either GSH or UA reduced the maximum chemiluminescence values (MCVs) significantly when compared to those of controls. In erythrocytes, MCVs observed in the 50 microM GSH group were significantly lower than those of the 50 microM UA group. In hemolysates, while 10 microM concentration of GSH or UA did not alter MCVs, 50 microM concentration of either GSH or UA reduced MCVs. The reduction of MCVs observed in the 50 microM GSH group was greater than that of the 50 microM UA group. When the effects of equimolar concentrations of GSH or UA on erythrocytes and hemolysates were compared, the MCVs of hemolysates were lower than those of erythrocytes. These results can be attributed to the fact that antioxidant agents react much more easily in the hemolysate medium.

The role of antioxidants in the prevention of t-butyl hydroperoxide-induced chemiluminescence.

An experimental system which assesses the antioxidant potential of ascorbic acid, glutathione, uric acid, and taurine was developed. The system comprised hemoglobin, luminol, t-butyl hydroperoxide, and different concentrations of antioxidants in TRIS-HCl buffer (pH 7.4). Control assays were performed by excluding antioxidants. Chemiluminescence was detected using a liquid scintillation counter in single photon mode. All antioxidants, when applied in the appropriate concentrations, decreased the maximum chemiluminescence values. The minimum concentrations which decreased the chemiluminescence values were defined for each of the antioxidants.

The effects of detergents on t-butyl hydroperoxide-induced chemiluminescence.

We examined the effects of Triton X-100, digitonin, sodium dodecyl sulfate, taurocholic acid, and cetylpyridinium chloride on hemoglobin-catalyzed and t-butyl hydroperoxide-induced chemiluminescence. The experimental system contained hemoglobin, luminol, t-butyl hydroperoxide, and different concentrations of detergents (5-100 mg/dl) in TRIS-HCl buffer. Control assays were performed by excluding detergents. Chemiluminescence was detected using a liquid scintillation counter in single photon mode. All concentrations chosen for each detergent reduced the maximum chemiluminescence value and retarded the time that maximum chemiluminescence occurred. The most prominent reduction in maximum chemiluminescence was observed with 50 and 100 mg/dl digitonin. The smallest reduction was observed with 5 mg/dl sodium dodecyl sulfate, without retardation of the time that maximum chemiluminescence occurred. Our aim was to use detergents in membrane-containing experimental systems and hence to identify the detergent with the least effect on chemiluminescence. Our results suggest that sodium dodecyl sulfate is the most suitable detergent for chemiluminescence studies in membrane systems.

Continuous monitoring of hydroperoxide-induced peroxidation in human erythrocytes by low-level chemiluminescence.

We studied the effect of cumene hydroperoxide, t-butyl hydroperoxide, and hydrogen peroxide on intact healthy human erythrocytes (15 g hemoglobin/dl) using chemiluminescence to monitor peroxidation. We measured the chemiluminescence spectrum, the process of hemolysis, the pH shift, and absorbance spectrum during the incubation with chemicals producing oxidative stress. Maximum chemiluminescence was reached with cumene hydroperoxide at about 50 min, but with t-butyl hydroperoxide at 100 min. The effect of organic hydroperoxide was concentration dependent, whereas the effect of hydrogen peroxide was independent of concentration. Peroxides induced hemolysis after 30 min. The pH shift to alkaline was observed in the first 20-min period. Incubation with organic hydroperoxides induced a decrease in absorption at 580, 545, and 345 nm. Hydrogen peroxide induced a decrease in the same period of time but this returned to the normal range by 120 min. There was no change in absorption at 420 nm with any of the peroxidative agents. Our results suggest that low-level chemiluminescence is a useful model for studying hydroperoxide-induced peroxidation in human erythrocytes.