Elimination of NTproBNP in peritoneal dialysis patients. Does peritoneal membrane type make a difference in plasma level and elimination of NTproBNP?

BACKGROUND: Brain natriuretic peptide and its derivative peptide NTproBNP are utilized to exclude cardiac diseases, and predicting risk of mortality in dialysis patients. Our aim was to evaluate both elimination of NTproBNP through dialysate and a possible relationship between plasma and/or dialysate NTproBNP level and membrane transport status of peritoneal dialysis patients. METHODS: 57 plasma (P) and dialysate (D) samples of 44 peritoneal dialysis (PD) patients were analyzed for NTproBNP. Modified peritoneal equilibration test (PET) results and other variables were obtained from the charts. RESULTS: Median (IQR) NTproBNP concentrations (pg/mL × 1,000) in P and D were 3.3 (1 - 13) and 0.5 (0.2 - 3.6), respectively. There was a linear correlation between P-NTproBNP and D-NTproBNP (r = 0.928, p = 0.0001; regression equation was y = 0.897*x -0.28). Mean P/D-NTproBNP ratio was 5.5 ± 0.5. Median P and D-NTproBNP levels by the membrane transport status were aligned as high (H) > high average (HA) > low average (LA), and the difference between H and LA was statistically significant (p < 0.001). Mean arterial pressure (MAP), residual Kt/V and dialysate/plasma ratio of crearinine (D/P Cr) were significant predictors of D-NTproBNP; whereas only MAP and residual Kt/V were significant predictors of P-NTproBNP in multiple regression analysis. Both P- and D-NTproBNP have significant and similar size of correlations with MAP, albumin, D/P Cr ratio, and Na. CONCLUSIONS: D-NTproBNP level is ~ 1/5 of P-NTproBNP, and the issue of relationship between membrane transport status and natriuretic peptide levels needs more work.

Evaluation of the Tosoh G8 Analyzer and Comparison with the Trinity Biotech Premier Hb9210 Analyzer for the Measurement of HbA1c.

BACKGROUND: The aim of our study was to assess the analytical performance of the Tosoh HLC-723G8 automated analyzer and to compare it with the Trinity Biotech Premier Hb9210 analyzer for the measurement of hemoglobin A1c (HbA1c). METHODS: A total of 101 patients with pre-diabetes or diabetes mellitus were included in the study. HbA1c, was measured by both an ion-exchange high-performance liquid chromatography (IE-HPLC) method and a boronate affinity chromatography method. Statistical analysis was performed using Deming regression. Bland-Altman plots were used to calculate mean difference (bias). RESULTS: The CV% values of IE-HPLC and boronate affinity methods for within run and between days were lower than 2.0%. High correlation was found (y = 1.0045x + 0.2111; r = 0.9941) between the two methods. The method shows no interference from carbamylated hemoglobin. CONCLUSIONS: Both systems showed acceptable performance and are suitable for clinical application in the analysis of HbA1c. However, laboratories should be aware of the limitations of their methods and the availability of more accurate and precise HbA1c, determination methods.

Serum fetuin-A levels, QT dispersion and P dispersion in dialysis patients.

BACKGROUND: This study aims to find association of fetuin-A with serum lipids, QT dispersion (QT-d), and P dispersion (P-d) in dialysis patients. METHODS: Fetuin-A serum levels were assessed in 50 dialysis patients. RESULTS: Serum fetuin-A levels were significantly associated with QT-d (r = 0.289, p = 0.044), P-d (r = 0.39, p = 0.005), total cholesterol (r = 0.526, p = 0.000), low-density lipoprotein cholesterol (LDL-C) (r = 0.456, p = 0.00), triglyceride (r = 0.360, p = 0.011) and highly sensitive C-reactive protein (hsCRP) (r = -0.347, p = 0.030). In step-wise multiple regression analysis including being on hemodialysis (HD), presence of diabetes mellitus (DM), total cholesterol, LDL-C, triglycerides, hsCRP, only total cholesterol (b = 0.419, p = 0.03), and hsCRP (b = -0.316, p = 0.03) proved to be independent predictors of serum fetuin-A levels. QT-d showed a linear correlation with total cholesterol (r = 0.309, p = 0.029), LDL-C (r = 0.304, p = 0.038), P-d (r = 0.390, p = 0.005), and fetuin-A levels (r = 0.289, p = 0.044). In multiple regression analyses, the independent predictor of QT-d was being on HD (b = -0.417, p = 0.004), whereas total cholesterol, LDL-C, presence of DM, serum fetuin-A levels, and P-d had no independent effect on corrected QT (QT-C). Being on HD and age were important determinants of P-d whereas presence of DM, total cholesterol, LDL-C, fetuin-A, and QT-d had no independent effect on P-d. CONCLUSIONS: Lower fetuin-A levels are associated with high hsCRP and low cholesterol levels in dialysis patients.

The role of fecal calprotectin and lactoferrin in the diagnosis of necrotizing enterocolitis.

BACKGROUND: Early detection of necrotizing enterocolitis can improve the prognosis, however, there is not a reliable laboratory test to detect either newborns at risk for necrotizing enterocolitis development or those at early stages of the disease. Since fecal lactoferrin and fecal calprotectin are inflammatory markers of gastrointestinal diseases, it was hypothesized that both these biomarkers could be successfully used in the diagnosis of necrotizing enterocolitis. METHODS: In a prospective study, fecal lactoferrin and fecal calprotectin concentrations of 14 newborns with necrotizing enterocolitis and consecutively admitted 40 healthy preterm, and 23 healthy full-term newborns were measured with enzyme-linked immunosorbent assay technique. RESULTS: Mean fecal lactoferrin and fecal calprotectin were not different between preterm and full-term newborns (p = .235 and p = .845, respectively), or those who were diagnosed with necrotizing enterocolitis or not (p = .545 and p = .968, respectively). Prevalence of necrotizing enterocolitis was 1.51% (14 of 2734). Stage of the disease did not have a statistical effect on mean levels (p = .694 and p = .267, respectively). Mean fecal lactoferrin and fecal calprotectin levels were not different in the case of breastfeeding (p = .623 and p = .792, respectively). CONCLUSION: Neither fecal lactoferrin nor fecal calprotectin has a role in the identification of necrotizing enterocolitis, especially in early stages of the disease. Further studies on wider necrotizing enterocolitis series are needed for a more definite conclusion.

Celiac disease in children with urolithiasis.

There are a few studies suggesting a relationship between celiac disease (CD) and kidney disease, but no study has investigated CD in patients with urolithiasis. In this study, we aimed to determine the prevalence of CD in infants and children with urolithiasis. One hundred and eighty-seven infants and children (4 months-17 years) with urolithiasis, and 278 age- and sex-matched healthy children were included. CD was screened using tissue transglutaminase (tTG) immunoglobulin (Ig)A. Seropositive cases, whose parents gave consent, underwent upper gastrointestinal system endoscopy for duodenal biopsy. Seven (3.7%) among those with urolithiasis and one (0.3%) among controls were positive for tTG IgA (p=0.008). Six of the urolithiasis group and one from the control group underwent upper gastrointestinal endoscopy. Intestinal biopsy revealed Marsh-Oberhuber type 1 intestinal lesions in two children. The other five had normal histology. Biopsy-proven CD was detected in two (1%) children with urolithiasis. The prevalence of biopsy-proven CD among all cases was 0.4%. When children were evaluated with respect to age factor, it was found that seropositivity in children younger and older than two years was not different (4% vs. 3.6%; p=0.880). In this first study investigating CD prevalence in children with urolithiasis, we found a higher seropositivity for CD in children with urolithiasis compared to controls, but in terms of biopsy-proven CD, no difference was found.

Prevalence of celiac disease in parents of preterm or low birthweight newborns.

AIM: Celiac disease (CD) may present with atypical symptoms, including poor pregnancy outcomes, such as preterm and low birthweight (LBW) deliveries, thus we aimed to investigate the frequency of CD in mothers and fathers of preterm or LBW newborns. MATERIALS AND METHODS: In this study, 316 parents of 164 preterm or LBW newborns and 246 parents of 123 healthy newborns were included. CD was screened using tissue transglutaminase immunoglobulin A. Endoscopic duodenal biopsy was provided in the seropositive cases. RESULTS: Positive tissue transglutaminase immunoglobulin A was found in six (1.1%; 1/94) individuals (three mothers and three fathers); five were from the study group (1.6%; 1/63) and one was from the control group (0.4%; 1/246). CD prevalence in mothers, fathers and parents of preterm newborns was 1/57 (1.8%), 1/57 (1.8%) and 1/29 (3.5%), respectively. In the LBW group, seropositivity in fathers was 1/50 (2%) with no seropositive mothers. Biopsy-proven CD was found in 1/159 mothers (0.6%) and 1/79 fathers (1.3%). Mean birthweights of the newborns of seropositive mothers and fathers were 214 g (P < 0.05) and 320 g lower than those of seronegative ones, respectively. However, in logistic regression analysis it was found that seropositivity of mothers or fathers did not affect gestational age or birthweight of the newborns. CONCLUSION: Because the prevalence of CD in parents of preterm or LBW newborns is not statistically higher than the healthy population, routine CD screening in that group cannot be recommended at the time being. For more definite conclusions further studies are needed.

The prevalence of nutritional anemia in pregnancy in an east Anatolian province, Turkey.

BACKGROUND: Anemia is considered a severe public health problem by World Health Organization when anemia prevalence is equal to or greater than 40% in the population. The purpose of this study was to determine the anemia prevalence with the associated factors in pregnant women and to determine the serum iron, folate and B12 vitamin status in anaemic pregnants in Malatya province. METHODS: This is a cross-sectional survey. A multi-sage stratified probability-proportional-to-size cluster sampling methodology was used. A total of 823 pregnant women from sixty clusters were studied. Women were administered a questionnaire related with the subject and blood samples were drawn. Total blood count was performed within four hours and serum iron, folate and B12 vitamin were studied after storing sera at -20 C for six months. RESULTS: Anemia prevalence was 27.1% (Hb < 11.0 gr/dl). Having four or more living children (OR = 2.2), being at the third trimester (OR = 2.3) and having a low family income (OR = 1.6) were determined as the independent predictors of anemia in pregnancy. Anemia was also associated with soil eating (PICA) in the univariate analysis (p < 0.05). Of anaemic women, 50.0% had a transferrin saturation less than 10% indicating iron deficiency, 34.5% were deficient in B12 vitamin and 71.7% were deficient in folate. Most of the anemias were normocytic-normochromic (56.5%) indicating mixed anemia. CONCLUSIONS: In Malatya, for pregnant women anemia was a moderate public health problem. Coexisting of iron, folate and B vitamin deficiencies was observed among anaemics. To continue anemia control strategies with reasonable care and diligence was recommended.

Evaluation of Ear, Nose, and Throat Involvement in Pemphigus Vulgaris in Comparison with Pemphigus Severity Scoring Systems: A Cross-sectional Study.

Pemphigus vulgaris (PV) frequently affects the mucous membranes of the ear, nose, and throat (ENT). Since ENT examination is not a routinely performed procedure, the exact involvement of PV remains unrecognized. The available severity scoring systems (Pemphigus Disease Area Index (PDAI) and Autoimmune Bullous Skin Disorder Intensity Score (ABSIS)) for PV do not include a full ENT examination. This study was designed to evaluate the real extent of PV in ENT areas and to find out the specific scores which indicate the need for ENT examination. The patients were evaluated for ENT manifestations by endoscopic examination whether or not they exhibited symptoms. PDAI, ABSIS, and ENT scores were calculated, and the results were compared for correlation and significance. The mucosal involvement was more severe when scored by ENT examination than when assessed by PDAI or ABSIS. The ENT score was significantly associated with symptoms and endoscopic findings, especially when PDAI ≥15 and/or ABSIS ≥17. ENT endoscopic examination could result in more accurate grading in PV. In particular, performing such an examination should be considered in patients, especially when PDAI ≥15 and/or ABSIS ≥17, regardless of ENT symptoms.

Methylprednisolone prevents bacterial translocation in thioacetamide-induced liver failure in rats.

BACKGROUND/AIMS: Steroids have been shown to prevent intestinal oxidative stress. We investigated the effects of methylprednisolone on intestinal oxidative damage and bacterial translocation in thioacetamide-induced liver failure in rats. MATERIALS AND METHODS: Group 1 (n=8) was the control group. In group 2 (n=8), the thioacetamide group, rats received 300 mg/kg intraperitoneal thioacetamide daily for 2 days. In group 3 (n=8), the thioacetamide+methylprednisolone group, treatment with methylprednisolone (30 mg/kg intraperitoneal) was commenced 48 h before the first dose of thioacetamide. In group 4 (n=8), the methylprednisolone group, the rats received only methylprednisolone (30 mg/kg intraperitoneal). RESULTS: Serious hepatic and intestinal oxidative damage and high bacterial translocation frequencies were observed in the thioacetamide group compared with those of the controls. Bacterial translocation frequency in the thioacetamide+methylprednisolone group was significantly lower than that in the thioacetamide group (p<0.05). Intestinal thiobarbituric acid-reactive substances and myeloperoxidase levels and tissue damage scores for the intestines in the thioacetamide+methylprednisolone group were lower than those in the thioacetamide group (p<0.01, p<0.01, and p<0.0001, respectively). CONCLUSION: Our findings suggest that methylprednisolone reduces bacterial translocation by preventing intestinal oxidative damage in this model of acute liver failure in rats.

The effect of moxonidine on endothelial dysfunction in metabolic syndrome.

BACKGROUND: Endothelial dysfunction has been reported in patients with type 2 diabetes mellitus and even in healthy obese individuals with a normal metabolic profile. Sympathetic activity commonly is increased in obese hypertensive patients, and moxonidine is effective in lowering BP and improving insulin sensitivity. OBJECTIVE: To evaluate the effect of moxonidine on endothelial dysfunction in patients with metabolic syndrome. METHODS: Twenty-six patients with mild hypertension were treated with moxonidine and a hypocaloric diet for 3 months, while a second normotensive group (n = 26) were followed-up with calorie restriction alone. Anthropometric (body mass index, waist and hip circumferences, and waist-to-hip ratio) and metabolic features (fasting plasma glucose and insulin, aminotransferases, gamma-glutamyl transpeptidase, triglycerides, and cholesterol levels) and flow-mediated dilatation (FMD) were evaluated. Insulin resistance was calculated by using the homeostasis model assessment formula. Insulin sensitivity was calculated according to the quantitative insulin-sensitivity check index (QUICKI). RESULTS: SBP and DBP (both p < 0.001) and waist circumference (p = 0.02) were higher, and QUICKI (p = 0.043) and FMD (p = 0.01) were lower in the hypertensive group at baseline. After 3 months, nearly all the study parameters improved in both treatment groups. The decrease in BP, increase in FMD, and improvements in metabolic and anthropometric parameters were significantly greater in the moxonidine-treated group than in those treated with diet alone. CONCLUSION: Moxonidine is proposed as a valuable option for treating mild-to-moderate hypertension in obese and insulin-resistant patients with metabolic syndrome as it appears to improve endothelial dysfunction in these patients.

The effects of G-CSF and naproxen sodium on the serum TGF-beta1 level and fracture healing in rat tibias.

Local and systemic release of transforming growth factor beta 1 (TGF-beta1) is known to increase during the process of fracture healing and this cytokine stimulates bone healing. The majority of the non steroidal anti inflammatory drugs (NSAIDs) inhibit fracture healing. Granulocyte colony stimulating factor (G-CSF) is a hematopoietic growth factor that stimulates bone marrow. In this study, the effects of the NSAID naproxen sodium, G-CSF, and both of them in combination on the TGF-beta1 serum level in rats with tibia fractures were measured and fracture healing was evaluated by histopathologic and radiologic examination. The TGF-beta1 serum levels obtained on day one (24 h after fracture but before administration of naproxen or G-CSF) were found to be similar in all of the five groups (p > 0.05). At the end of the first week, TGF-beta1 levels were significantly lower in naproxen-treated rats than those of the other groups excluding control (p = 0.002). Similar changes in TGF-beta1 levels were found at the end of the second and fourth weeks. TGF-beta1 levels were significantly higher in G-CSF-treated rats at the end of the first, second and fourth weeks (p < 0.05). Fracture healing scores measured with histopathological and radiological methods were higher in G-CSF-treated rats than in naproxen-treated ones. When both naproxen and G-CSF were given, the scores resumed to normal. The results point to the negative effect of naproxen sodium on fracture healing is due to its decreasing effect on the level of TGF-beta1, which may be a new possible mechanism. Moreover, this negative effect can be inhibited by the use of G-CSF.

Association between cytokines in induced sputum and severity of chronic obstructive pulmonary disease.

Cytokines are known to be increased in induced sputum in chronic obstructive pulmonary disease (COPD). In this study, the relationship between the levels of interleukin-6 (IL-6), interleukin-8 (IL-8), and tumour necrosis factor-alpha (TNF-alpha) in induced sputum of patients with exacerbation of COPD, and the severity of the disease, pulmonary function tests (PFT), arterial blood gases (ABG) were studied. Twenty-four patients with exacerbation of COPD were included in the study. The patients were grouped according to their PFT into two as: Group 1 (FEV1 below 50% of the predicted value, severe-very severe COPD, n=12) and, Group 2 (FEV1 above 50% of the predicted value, mild-moderate COPD, n=12). The levels of IL-6, IL-8 and TNF-alpha in induced sputum of the subjects were measured. The mean levels of IL-6, IL-8 and TNF-alpha in induced sputum were found to be higher in Group 1 (severe-very severe COPD) than in Group 2 (mild-moderate COPD). The differences in IL-6 and IL-8 levels between groups were statistically significant (P<0.05). A significant correlation was observed between the IL-6 value and FEV(1) (r=-0.435, P=0.034), FEV1/FVC (r=-0.446, P=0.029), PaO2 (r=-0.711, P=0.000), SaO2 (r=-0.444, P=0.030) and disease duration (r=0.427, P=0.037), respectively. Also, the level of IL-8 in induced sputum was inversely correlated with FEV1 (r=-0.562, P=0.004), PaO2 (r=-0.540, P=0.006) and SaO2 (r=-0.435, P=0.034). However, all three cytokines were positively correlated with the smoking load (r=0.653, P=0.001; r=0.439, P=0.032; r=0.649, P=0.001). We conclude, therefore, that in exacerbated COPD cases with greater degrees of obstruction of the airways have higher levels of cytokines in induced sputum. This can be interpreted to mean that these cytokines are related to the clinical parameters like the ABG and PFT and seem to be the determinant of the severity of the disease.

Relationship between meconium staining, umbilical cord plasma motilin level and infantile colic.

OBJECTIVE: To assess the effects of meconium-stained amniotic fluid and umbilical cord plasma motilin levels on the development of infantile colic. STUDY DESIGN: One hundred forty pregnant women referred to our department for labor care were enrolled in the study. All subjects were laboring women with singleton, vertex-presenting fetuses, with a gestational age of > or = 36 weeks. After each infant with meconium-stained amniotic fluid was born, the following 2 infants without meconium were selected as controls. Umbilical cord plasma motilin levels were measured in 47 infants with meconium-stained amniotic fluid and 93 infants with no meconium. At the end of the third month of the infants' lives, the development of infantile colic was evaluated. Umbilical cord serum specimens were collected from 45 infants with colic and 95 infants without colic. Statistics included Student's t, chi2 and Mann-Whitney U tests, as appropriate. Multivariate analysis was performed. RESULTS: There was no correlation between the presence of meconium-stained amniotic fluid and the development of infantile colic. No association was found between umbilical cord plasma motilin levels and the development of infantile colic. Neonatal intensive care unit admission was found to be a significant risk factor for the development of infantile colic. CONCLUSION: Meconium-stained amniotic fluid and umbilical cord plasma motilin levels do not affect the development of infantile colic.

Prevalence of goiter and urinary iodine status of 7-11-year-old children in Malatya province, Turkey.

Goiter prevalence and urinary iodine excretion levels were assessed in 568 schoolchildren (317 boys and 251 girls), aged 7-11 years, living in the Malatya province, a well-known endemic goiter area in Turkey. Five hundred sixty-eight children aged 7-11 years consented to thyroid gland palpation and provided a urine sample on the day of examination in April 2004. Median urinary iodine concentration for the total group was 66 microg/L. There was an association between presence of goiter or not and urinary iodine levels (67 microg/L versus 62 microg/L, p=0.000). The median urinary iodine concentration was lower in rural areas than in urban areas (54.6 microg/L versus 59.7 microg/L, respectively) and schoolchildren living in rural areas had significantly lower urinary iodine levels (p=0.000). In conclusion, the present study reports mild iodine deficiency in the Malatya province, despite a mandatory iodization program in Turkey which has been in force since 1998.

The effects of Gingko biloba extract on acetic acid-induced colitis in rats.

BACKGROUND/AIMS: Gingko biloba is an antioxidant substance which has antagonistic activity on platelet-activating factor. We aimed to investigate the antioxidant effect and the histopathologic changes caused by Gingko biloba on acetic acid-induced colitis. METHODS: Totally 22 rats were divided into three groups. Group 1 (n=7) served as the control group. Group 2 (n=7) and Group 3 (n=8) were given 2 ml/day of 4% acetic acid by intracolonic instillation for three days. Gingko biloba (100 mg/kg) was then given only to Group 3 intraperitoneally for three days. Oxidative stress was assessed by determinate tissue and serum malondialdehyde (MDA) levels, and colonic damage was assessed by histologic examination. RESULTS: Depth of necrosis, extent of necrosis, degree of inflammation, extent of inflammation, fibrosis and total histologic scores in Group 2 were significantly higher than in the control group (p<0.05). The same parameters were lower in Group 3 versus Group 2, but the difference was not significant. Tissue and serum MDA levels in Group 2 were significantly higher than Group 1 (p<0.01 and 0.05, respectively). Again, the same parameters in Group 3 were lower than in Group 2, but the difference was not significant statistically. CONCLUSIONS: Gingko biloba did not significantly affect histopathological and oxidative stress parameters in experimental colitis.

Evaluation of the analytical performance of Unicel DXI 800 for the Total 25 (OH) Vitamin D measurements.

OBJECTIVES: We assessed the analytical performance of newly developed Access 25(OH) Vitamin D Total assay with Beckman Coulter Unicel DXI 800 and evaluated the agreement between a reference method liquid chromatography/tandem mass spectrometry (LC-MS/MS) and a chemiluminescence method (LIAISON, DiaSorin). DESIGN AND METHODS: 160 serum samples were included. Deming Regression analysis and Bland-Altman plots were used. The concordance correlation coefficient (CCC) was used to assess the degree of agreement between assays and the reference method. RESULTS: The CV% values of Unicel DXI 800 for within-run, between-run and between-day were lower than 6%. When compared to LC-MS/MS, the Access 25(OH) Vitamin D Total assay demonstrated an R value of 0.9444 (intercept -0.089, slope 0.951), with an average bias of -2.9%, and the LIAISON 25(OH) Vitamin D Total assay an R value of 0.9405 (intercept -0605, slope 0.924), with an average bias of -13.6%. In comparison with the LIAISON 25(OH) Vitamin D Total assay, the Access 25(OH) Vitamin D Total assay demonstrated an R value of 0.9498 (intercept 0.528, slope 1.029), with an average bias of 1.2%. The agreement with the LC-MS/MS method, based on values of the CCC, was moderate for the Unicel DXI 800 and LIAISON method (0.95, 0.94 respectively). CONCLUSIONS: The new, automated Access 25(OH) Vitamin D Total assay showed an acceptable correlation with LC-MS/MS and LIAISON. Both methods moderately achieved to classify the patients according to their vitamin D status. However, we need further standardization of vitamin D assays to enhance the accuracy and comparability.

Homocysteine, lipid profile, nitric oxide, vitamin B12, and folate values in patients with premature coronary artery disease and their children.

The plasma concentrations of homocysteine and lipoprotein A are independent risk factors for atherosclerotic vascular disease. Nitric oxide (NO) and folate values are also important in atherogenesis. The authors aimed to evaluate these parameters in patients having coronary artery bypass surgery (CABS) before 50 years of age and in their children. In 31 patients having CABS, 47 children of these patients, and 28 normal control subjects, homocysteine, NO, vitamin B12, folate, lipoprotein A, triglyceride, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, apolipoprotein A1, and apolipoprotein B values were determined. Homocysteine values of the patients with premature coronary heart diseases and their children were significantly higher than those of controls (p < 0.031 and p < 0.006, respectively). Also, NO levels were significantly higher in both groups than in controls (p < 0.001 and p < 0.031, respectively). B12 values were significantly higher in both groups (p < 0.05 and p < 0.033, respectively). Lipoprotein A levels were higher in both groups but not significantly so.

Diagnosis and treatment of malignant lymphomas of parotid gland.

OBJECTIVES: This study aims to report surgical outcomes of primary parotid lymphomas and to discuss the histopathological subtypes, incidence rates, and clinical course. PATIENTS AND METHODS: Between January 2002 and December 2014, eight patients (2 males, 6 females; man age 46.6 years; range 25 to 60 years) who were diagnosed with primary parotid lymphoma and underwent parotidectomy were retrospectively analyzed. Demographic characteristics of the patients, histopathological subtypes, disease stage, and survival rates were recorded. RESULTS: The ratio of the patients diagnosed with lymphoma was 2.82% among all patients, while 18.1% of the malignancies were lymphomas. Fine needle aspiration biopsy was non-diagnostic. CD20-positive low-grade B-cell lymphoma was the most common histopathological subtype in 37.5% of the patients. CONCLUSION: Based on our study results, the fine needle aspiration biopsy is not helpful in the diagnosis of the lymphomas of the parotid gland. Although rarely seen, lymphomas of the parotid gland should be considered in the differential diagnosis.

Erdosteine prevents bleomycin-induced pulmonary fibrosis in rats.

Oxidative stress plays an important role in the pathogenesis of idiopathic pulmonary fibrosis. Therefore, erdosteine, an antioxidant, is expected to have an inhibitor potential against the disease. Rats were given one dose of bleomycin in pulmonary fibrosis groups and saline in controls. The first dose of oral erdosteine (10 mg/kg/day) was given 2 days before the bleomycin injection to achieve the plateau level in blood and continued until killing. At day 14, fibrotic changes were evaluated, using Aschoft's criteria and lung hydroxyproline content. Bleomycin produced a fivefold increase in fibrosis score that was decreased by 87% by erdosteine (P>0.001) and almost twofold increases in hydroxyproline content which were completely prevented by erdosteine. Myeloperoxidase activities and MDA levels, which were significantly higher in the bleomycin group, were then significantly attenuated by erdosteine. These results revealed that oral erdosteine may prevent the development of acute pulmonary inflammation caused by bleomycin injection via the repression of neutrophil accumulation and lipid peroxidation, resulting in the inhibition of subsequent lung fibrosis.

Inhibitory effect of caffeic acid phenethyl ester on bleomycine-induced lung fibrosis in rats.

BACKGROUND: Pulmonary fibrosis (PF) induced by anticancerogenic bleomycin (BLM) is one of the more common side effects encountered during cancer treatment. It has been suggested in the last decades that the main responsible agent in PF is reactive oxygen species which were generated also in normal physiological conditions in the human body. In this experimental study, we investigated the preventive or attenuating effects of caffeic acid phenethyl ester (CAPE) that has been demonstrated to have anti-inflammatory, cytocytatic, anticancerogenic, antiprolipherative and antioxidant effects on BLM-induced PF. METHODS: Thirty-six Sprague-Dawley rats were divided randomly into four groups as sham operation, BLM, BLM + vitamin E (vit E), and BLM + CAPE groups. BLM (7.5 mg/kg, single dose) was applied intratracheally, and CAPE and vit E intraperitoneally in the appropriate groups. At the end of the fibrosis processes, lung tissues were removed and the levels of tissues hydroxyproline (OH-proline), malondialdehyde (MDA) and NO as well as the activities of superoxide dismutase (SOD), catalase (CAT) and myeloperoxidase (MPO) were determined. Also, the weights of the rats were recorded at 7th and 14th days of the experiments. RESULTS: BLM application to the rats resulted in a significant increase in the OH-proline level as compared to the controls. Administration of CAPE and vit E led to the remarkable reduction of total lung OH-proline levels compared to the rats treated with BLM alone (p < 0.0001). There were a decreases in antioxidant enzyme (SOD and CAT) activities while an increase in MPO activity in BLM group was found vs. the control group (p < 0.0001). CAPE had a regulator effect on these parameters: the increase in CAT and SOD activities and the decrease in MPO activity were seen after CAPE application. NO, MDA and OH-proline levels were increased in BLM group vs. the control group. CAPE was more effective in decreasing the tissue levels of NO, MDA and OH-proline than vit E. MPO activity, as a good marker of neutrophil sequestration to the tissues, in the BLM group was decreased by CAPE approximately to the control group. CONCLUSION: We suggest that CAPE is more effective on the prevention of BLM-induced fibrosis via antioxidant and free radical scavenger properties than vit E at the doses used in the present study. CAPE has some attenuating effects on BLM-induced PF affecting both oxidant and antioxidant systems as well as neutrophils sequestration.