Performance Evaluation of Urine Osmolality Measurement on Sysmex UF-5000 and the Effect of Molecules and Particles in Urine.

BACKGROUND: Urine osmolality determines the concentration ability of the kidney. Therefore, it is used to assess the body's hydration status, electrolyte levels, and acid-base disturbances. We aimed to evaluate the analytical performance of osmolality measurement of the Sysmex UF-5000 (UF-5000), to examine the effect of different molecules and particles in the urine on the osmolality measurement. METHODS: Complete urinalysis and conductivity-based osmolality analysis with UF-5000 and osmolality analysis with Advanced® Model 3320 Micro-Osmometer (AI-3320) by freezing point reduction method were performed in the urine samples. Samples were grouped as negative, glucosuria, proteinuria, hematuria, pyuria, crystalluria, and urobilinogen. RESULTS: Total impressions were calculated as < 5% and accuracy values were < 1.66% in both analyzers. The regression equation was found to be y = -12.54 + 0.956x and the relative difference between the analyzers was 8.7% in 586 samples. When patients with Glucose > 2+ were excluded the regression equation of 507 samples was found as y = 5.10 + 0.948x and the relative difference was 4.6%. The percentages of samples with a difference greater than the allowable difference were 18.8%, 11.6%, 35.9%, 13.7%, 18.7%, and < 12.2% in all samples, all samples without glucosuria > 2+, glucosuria, glucosuria < 3+, proteinuria, and other subgroups, respectively. CONCLUSIONS: Considering the good accessibility of the automated routine complete urine analyzer, UF-5000 can be considered to determine whether urine osmolality is within reference or should be measured by methods based on colligative properties. Thus, referral of patients to a clinic that uses the colligative measurement method may be used more effectively.

Analytical Performance Evaluation of Siemens Sysmex CS-2500 and Sekisui CP-3000.

BACKGROUND: Automatic coagulation analyzers have been used in the last 50 years and have been developed considerably. Newly developed tests and methods cannot be conducted in routine laboratories without evaluating their performance. Therefore, their performance must be evaluated and approved before being used routinely. The aim of this study is to evaluate the analytical performance of Sysmex Coagulation System-2500 (CS-2500) and Sekisui CP-3000 automatic coagulation analyzer (CP-3000). METHODS: For APTT, PT, and D-dimer tests, reference range verification study, a method comparison study was performed in both analyzers in accordance with CLSI protocols, and precision and accuracy were evaluated using internal and external quality control samples. In the evaluation of precision and accuracy, CV% and bias% values were calculated. Bland-Altman, Passing-Bablok regression analysis, and correlation coefficient were used in the comparison study. RESULTS: The CV% values calculated for APTT and PT in both analyzers were found to be below the CLSI recommendation of 5%. D-dimer test results meet the quality criteria recommended by CLSI. Accuracy for both analyzers was within the acceptable limits. The reference ranges recommended by the manufacturer have been veryfied. Regression equations for APTT, PT, and D-dimer are y = -3.313 + 1.188x, y = -0.0399 + 1.048x, and y = 0.155 + 0.655x, respectively, and r values were 0.904, 0.978, and 0.974, respectively. CONCLUSIONS: CS-2500 and CP-3000 analyzers are suitable for laboratory use for routine coagulation. Since the CP-3000 device is newly used in our country, it needs to be supported by more comparison studies.

The effect of astaxanthine on ischemia-reperfusion injury in a rat model.

BACKGROUND: We aimed to compare biochemical and histopathological findings of astaxanthin's potential effects on oxidative stress in ischemia/reperfusion damage (I/R). METHODS: Thirty-two rats were randomly divided into four groups: control group; I/R group; I/R + treatment group; drug group. Astaxanthin was orally administered to groups C and D for 14 days. In groups B and C, the femoral artery was clamped for 2 h to form ischemia. The clamp was opened, and reperfusion was performed for 1 h. In all groups, 4 ml of blood sample through intracardiac puncture and gastrocnemius muscle tissue samples were collected. Serum and tissue samples were analyzed by measuring malondialdehyde (MDA), superoxide dismutase (SOD), total antioxidant capacity (TAC), and total oxidative level (TOL). Necrosis, inflammation, and caspase-3 in muscle tissue collected for histopathological examination were evaluated. RESULTS: Tissue MDA, SOD and TOL values significantly differed between groups. Serum MDA, SOD, TOL and TAC values significantly differed between groups. On necrosis examination, there was a significant difference between groups B and C. Although signs of inflammation significantly differed between groups, there was no significant difference between groups A and C and groups A and D. Although there was a significant difference in caspase-3 results between groups, there was no significant difference between groups A and C. CONCLUSIONS: The use of astaxanthin before and after surgery showed preventive or therapeutic effects against I/R damage.

Evaluation of subclinical atherosclerosis in Turkish patients with acne vulgaris receiving systemic isotretinoin.

Studies conducted on isotretinoin have shown that it may indirectly lead to atherosclerosis. The objective of this study was to determine the effect of systemic isotretinoin on subclinical atherosclerosis. The present study included 63 patients with acne vulgaris who had used isotretinoin for 6 months. Glucose, insulin, and homeostatic model assessment of insulin resistance levels; body mass index; waist circumference; blood pressure; lipid profile; and lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1), high-sensitivity C-reactive protein, and oxidized low-density lipoprotein (Ox-LDL) levels were compared in the patients at the initiation and discontinuation of the treatment. At the discontinuation of the treatment, LOX-1 and Ox-LDL levels showed a significant increase (P < .001 and P = .040, respectively). Differences in waist circumference were positively correlated with an increase in LOX-1 levels (r = .274; P = .030). Isotretinoin causes an increase in the levels of subclinical atherosclerosis markers. Although the present study sample size was small, we believe that caution should be exercised considering the risk of atherosclerosis during isotretinoin use in men with high waist circumference and cardiovascular risk factors; further studies are warranted in this regard.

Analytical Evaluation of Vitamin D Measurements in Routine Laboratories.

BACKGROUND: Its increasing clinical importance has turned 25-hydroxy-Vitamin D (25(OH)D) into an indispensable test in clinical laboratories. In this study, we aimed to analyze the analytical performances of two widely used immunoassays, namely new restandardized Abbott product Architect 25-OH Vitamin D test and the Beckman Coulter product Access 25(OH) Vitamin D Total Test by making comparisons with the reference method liquid chromatography tandem mass spectrometry (LC-MS/MS). METHODS: The new restandardized Architect I2000SR System (Abbott Laboratories, IL, USA; ref 5P02) and Access2 (Beckman Coulter, Brea, CA, USA; ref B24838) immunoassay were compared with LC-MS/MS (Shimadzu LCMS-8030, Kyoto, Japan) method 25(OH)D test for precision and reproducibility in 90 serum samples. In comparison with reference method, Deming Regression analysis and Bland Altman graphs were used. RESULTS: Within run coefficient of variation (CV%) for Architect was found to be lower than 3.1%. Within run coefficient of variation (CV%) for Access2 was lower than 7.04%. When compared with LC-MS/MS, R value of Architect 25-OH Vitamin D kit was 0.911 (intercept 1.62, slope 1.06), mean bias was -0.04% and for Access 25(OH) Vitamin D Total kit, R value was 0.841 (intercept 9.43, slope 0.92) and mean bias of 6.9%. CONCLUSIONS: When renewed 5P02 Abbott Architect 25(OH)D and Beckman Coulter Access2 25(OH)D Total tests were compared with LC-MS/MS method in our study, they were found to have appropriate analytical values.

Zinc deficiency and its predictive capacity for anemia: Unique model in school children.

BACKGROUND: Zinc deficiency is thought to be common in children, but its predictive capacity for anemia is unclear. Thus, this study identified zinc deficiency in school children, and investigated the association between zinc status and hemoglobin, together with other estimates of anemia. METHODS: For this case-control study, 349 of 483 children between 6.5 and 14.8 years old were included from primary schools in Bolu, Turkey. We measured weight, length, body mass index, and complete blood count with serum zinc, ferritin, vitamin B12 and folate. We investigated the differences between the groups and the effects of independent predictors such as age, gender, ferritin, zinc, vitamin B12 and folate on hemoglobin, on hierarchical multiple regression analysis. RESULTS: Thirty-eight (10.9%) of 349 children had low serum zinc concentration, and 21 (6.0%) were anemic. There were 12 anemic children in the zinc-deficient group and nine in the zinc-sufficient control group (31.5% vs 2.9%) with similar ferritin levels. On regression analysis, zinc had the strongest association with hemoglobin. On receiver operating characteristic analysis, the cut-off for serum zinc for prediction of anemia was 71.5 µg/dL. CONCLUSIONS: The strongest association of zinc with hemoglobin suggests that low zinc contributed the most to the observed anemia in children.

Can pregnancy-associated plasma protein-A be a marker for the assessment of atherosclerosis risk in patients with chronic plaque psoriasis?

INTRODUCTION: Psoriasis is an immune-mediated chronic inflammatory dermatosis. Several studies have shown that patients with psoriasis have a much greater risk of cardiovascular diseases than the normal population. The chronic inflammation observed in psoriasis is thought to have a role in the development of atherosclerosis and vascular endothelial injury. AIM: To examine serum pregnancy-associated plasma protein-A (PAPP-A) levels, which has been regarded as a marker of early stage atherosclerosis in patients with psoriasis that do not have concurrent conventional cardiovascular risk markers. MATERIAL AND METHODS: Forty-one patients diagnosed with a chronic plaque type of psoriasis and 42 equally matched healthy volunteers were included in this study. The PAPP-A levels were compared between patient and control groups and the association between PAPP-A levels and disease duration and severity were evaluated in the patient group. RESULTS: Statistically, serum PAPP-A levels were significantly higher in the psoriasis group than in the control group (p = 0.015). Serum PAPP-A levels were found to be positively correlated with severity (p = 0.036, r = 0.329) and duration (p = 0.014, r = 0.269) of the disease. CONCLUSIONS: As a marker of early stage atherosclerosis, PAPP-A levels were elevated in the psoriasis group and were correlated with disease duration and severity. This elevation reveals the presence of atherosclerosis in patients with psoriasis. Further studies are needed to confirm the use of PAPP-A as an available and inexpensive screening test and cardiovascular risk assessment for all centers.

The use of reference change values in clinical laboratories.

BACKGROUND: The use of Reference Change Values (RCV) has been advocated as very useful for monitoring individuals. Most of these are performed for monitoring individuals in acute situations and for following up the improvement or deterioration of chronic diseases. In our study, we aimed at evaluating the RCV calculation for 24 clinical chemistry analytes widely used in clinical laboratories and the utilization of this data. METHODS: Twenty-four serum samples were analyzed with Abbott kits (Abbott Laboratories, Abbott Park, IL, USA), manufactured for use with the Architect c8000 (Abbott Laboratories, Abbott Park, IL, USA) auto-analyzer. We calculated RCV using the following formula: RCV = Z x 2 1/2x (CVA2 + CVw2)1/2. Four reference change values (RCV) were calculated for each analyte using four statistical probabilities (0.95, and 0.99, unidirectional and bidirectional). Moreover, by providing an interval after identifying upper and lower limits with the Reference Change Factor (RCF), serially measured tests were calculated by using two formulas: exp (Z x 2 1/2 x (CV(A)2 + CVw2)½/100) for RCF(UP) and (1/RCF(UP)) for RCF(DOWN). RESULTS: RCVs of these analytes were calculated as 14.63% for glucose, 29.88% for urea, 17.75% for ALP, 53.39% for CK, 46.98% for CK-MB, 21.00% amylase, 8.00% for total protein, 8.70% for albumin, 51.08% for total bilirubin, 86.34% for direct bilirubin, 6.40% for calcium, 15.03% for creatinine, 21.47% for urate, 14.19% for total cholesterol, 46.62% for triglyceride, 20.51% for HDL-cholesterol, 29.59% for AST, 46.31% for ALT, 31.54% for GGT, 20.92% for LDH, 19.75% for inorganic phosphate, 3.05% for sodium, 11.75% for potassium, 4.44% for chloride (RCV, p < 0.05, unidirectionally). CONCLUSIONS: We suggest using RCV as well as using population-based reference intervals in clinical laboratories. RCV could be available as a tool for making clinical decision, especially when monitoring individuals.

Vitamin D: An Overlooked Parameter in Studies of Depression Using Optic Coherence Tomography.

Introduction: The relationship between depression and inflammation and the resulting vascular/neuronal damage have been demonstrated in recent studies. In this study we aimed to investigate inflammation and the possible degeneration that can be caused by depression and accompanying vitamin D deficiency using a non-invasive imaging method of optical coherence tomography (OCT). Methods: Twenty-four healthy controls and 42 drug free major depressive patients matched for age, sex and eye measurements were compared in terms of vitamin D, C Reactive Protein (CRP) and OCT parameters. The Hamilton Depression Rating Scale (HAM-D), The Clinical Global Impressions Scale (CGI) and Global Assessment of Functioning Scale (GAF) were used to assess disease severity. Results: CRP level and choroidal thickness in the major depression group were significantly higher than the healthy controls. Vitamin D level and the ganglion cell layer (GCL) volume was significantly lower in the major depression group compared to healthy controls. Positive correlation was found between HAM-D and CRP in major depressive patients; a negative correlation was found between current attack duration and GCL volume. CGI was positively correlated with CRP and HAM-D. GAS was negatively correlated with CRP and HAM-D. Conclusion: It has been shown that major depression might be an inflammatory disorder with possible degenerative processes observed with OCT and CRP measurements. But longitudinal follow up studies are needed to demonstrate a cause and effect relationship.

A Chemically Induced Experimental Colitis Model with a Simple Combination of Acetic Acid and Trinitrobenzene Sulphonic Acid.

BACKGROUND: It was aimed to induce a new experimental colitis model by using acetic acid and trinitrobenzene sulphonic acid together and to investigate the severity of inflammation biochemically and histopathologically in comparison with other models. METHODS: Fifty-six Wistar albino male rats were randomly divided into 4 groups as control, acetic acid, trinitrobenzene sulphonic acid, and combined groups, and the animals were sacrificed following the induction of colitis on the third day and on the seventh day. The serum amyloid A and myeloperoxidase were tested in plasma samples, and the tumor necrosis factor-alpha, interleukin 33, and ST2 were assayed in colon tissue samples with enzyme-linked immunosorbent assay in addition to histopathological examination. RESULTS: There were statistically significant differences between the combined and the control groups both on the third day and on the seventh day in all parameters. There was no difference between the acetic acid group on the seventh day and the control groups in biochemical parameters. CONCLUSIONS: The acetic acid model forms acute colitis. The combined model is found to be more successful in forming inflammation when compared to other models.

The effects of exercise on food intake and hunger: relationship with acylated ghrelin and leptin.

This study investigated the effects of a long bout of aerobic exercise on hunger and energy intake and circulating levels of leptin and acylated ghrelin. Ten healthy male subjects undertook two, 4 h trials in a randomized crossover design. In the exercise trial subjects ran for 105 min at 50% of maximal oxygen uptake and the last 15 min at 70% of maximal oxygen uptake followed by a 120 min rest period. In the control trial, subjects rested for 4 h. Subjects consumed a buffet test meal at 180 min during each trial. Hunger ratings, acylated ghrelin, leptin, glucose and insulin concentrations were measured at 0, 1, 2, 3 and 4 h. No differences were found at baseline values for hunger, acylated ghrelin, leptin, insulin and glucose for both trials (p > 0.05). The estimated energy expenditure of the exercise trial was 1550 ± 136 kcal. Exercise did not change subsequent absolute energy intake, but produced a significant decrease (p < 0.05) in relative energy intake. A two-way ANOVA revealed a significant (p < 0. 05) interaction effect for hunger and acylated ghrelin. In conclusion, this exercise regimen had a positive effect on reducing appetite which is related to reduced acylated ghrelin responses over time. This finding lends support for a role of exercise in weight management. Key pointsPhysical exercise is a strategy used to counteract obesity, since it lowers the energetic balance by increasing energy expenditure. However, because any energy expended in exercise elevates the intensity of hunger and drives food consumption, it is pertinent to ask how effective exercise could be in helping people to lose weight or to prevent weight gain.The effects of exercise on hunger sensations and food intake are fairly controversial and depend on the intensity and duration of exercise.120 min prolonged treadmill exercise with mix intensity, temporarily decreased hunger sensations, acylated ghrelin and relative energy intake.Variations in exercise intensity should theoretically be a useful means of weight loss.

Oxidative stress and lipid peroxidation products: effect of pinealectomy or exogenous melatonin injections on biomarkers of tissue damage during acute pancreatitis.

BACKGROUND: Melatonin (N-acetyl-5-methoxytripta-mine) is a free radical scavenger and a strong antioxidant, secreted by the pineal gland. In this study, we evaluated the effects of decreasing and increasing serum melatonin levels on malonyldialdehyde (MDA), superoxide dismutase (SOD), and reduced glutathione (GSH) levels in pancreatic tissue from rats with experimental acute pancreatitis. METHODS: Experimental acute pancreatitis was induced in three groups of Wistar albino rats (10 animals per group) by pancreatic ductal ligation. The first group had only acute pancreatitis and served as the control. Surgical pinealectomy was added to acute pancreatitis in the second group, removing the source of endogenous melatonin (low melatonin levels group). The third group was given 0.1 ml daily intraperitoneal injections of 20 mg/ml melatonin solution for one week (high melatonin levels group). The effects of melatonin levels were evaluated by comparison of the levels of MDA, SOD, and GS in pancreatic tissue. RESULT: We found that intraperitoneal melatonin injections decreased the levels of MDA and increased the levels of SOD and GSH in pancreatic tissue. CONCLUSION: Exogenous melatonin has a preventive effect on lipid peroxidation and oxidative damage in acute pancreatitis.

Thymoquinone Inhibits Neurogenic Inflammation Underlying Migraine Through Modulation of Calcitonin Gene-Related Peptide Release and Stabilization of Meningeal Mast Cells in Glyceryltrinitrate-Induced Migraine Model in Rats.

Two main contributors of sterile neurogenic inflammation underlying migraine pain, calcitonin gene-related peptide (CGRP), and meningeal mast cells (MMCs) play a key role in the activation of the inflammatory cascade resulting in the sensitization of trigeminal nociceptors. It is well established that phytochemical agent thymoquinone exhibits multiple anti-inflammatory effects in different in vitro and in vivo models of neuroinflammation. But its effects on the CGRP release and meningeal mast cells are unknown. In the present study, we investigated the effects of thymoquinone on the CGRP release in migraine-related strategic structures which are crucial targets for anti-migraine drugs, and on the MMCs in glyceryl trinitrate (GTN)-induced in vivo migraine model as well as in the ex vivo meningeal preparations in rats. Anti-inflammatory thymoquinone ameliorated GTN-stimulated CGRP levels in plasma, and migraine-related structures including trigeminal ganglion and brainstem; moreover, thymoquinone inhibited degranulation of MMCs and prevented the increase in the number of MMCs in GTN-induced in vivo migraine model. However, in the ex vivo meningeal preparations, thymoquinone did not inhibit the GTN-induced CGRP release from trigeminal meningeal afferents. Our findings suggest that thymoquinone mediates modulation of CGRP release in trigeminal ganglion neurons and brainstem, and stabilization of MMCs. Thus, thymoquinone may be a promising candidate to prevent the meningeal neurogenic inflammation and consequently migraine.

Analytical performance evaluation of Sysmex CS-2500 and Stago STA Compact.

: The Sysmex Coagulation System-2500 (CS-2500) is a fully automated coagulation analyzer that uses the optical reaction method. In this study, we aimed to evaluate performance characteristics of the CS-2500 in two coagulation tests [prothrombin time (PT) and activated partial thromboplastin time (aPTT)] at our hospital laboratory. PT and aPTT measurements were performed using the CS-2500 and STA-Compact Diagnostica Stago coagulometers (STA-Compact). Then, precision, accuracy, reference range verification, and method comparison statistics were performed. In the precision study, which was performed with normal and pathologic controls for the PT-international normalized ratio (INR) and aPTT tests, all coefficient of variation% were found less than 3.5%. In the comparison study, the Passing-Bablok regression analysis demonstrated the good agreement between each analyzer for PT-INR (y = -0.081 + 1.07x and r = 0.962) and for aPTT (y = 5.498 + 0.86x and r = 0.944). Both analyzers exhibited less than 9.9% bias in the accuracy study. The reference range verification analyses revealed that the manufacturer ranges were acceptable. The verification studies of the CS-2500 coagulation system were acceptable; however, in the comparison studies, there were small differences between STA-Compact. Overall, we propose that these differences could be eliminated in future standardization studies performed to use the same reference ranges for all systems.

Montelukast protects axial pattern rat skin flaps against ischemia/reperfusion injury.

BACKGROUND: Recent studies have shown that neutrophils play an important role in the pathogenesis of reperfusion injury. Using an inferior epigastric artery skin flap as a flap ischemia/reperfusion (I/R) injury model, we investigated whether the administration of montelukast sodium, a selective reversible cysteinyl leukotriene 1 (CysLT1) receptor antagonist, decreases neutrophil infiltration and promotes flap survival. METHODS: Eighteen rats were used and randomly divided into three groups (n=6 for each group). Group I was the sham group and did not undergo ischemic insult; rather, normal saline (1 mL) was administrated intraperitonealy (i.p.) 30 min before surgery and continued for 6 d. Group II (control) and Group III (montelukast) underwent 12 h of ischemic insult. For Group II, normal saline (1 mL) was injected i.p. 30 min before the surgery and immediately before reperfusion, and this continued for 6 d. In Group III, 1 mL of montelukast (10mg/kg) was injected i.p. and continued for 6 d. Malondialdehyde (MDA) and glutathione (GSH) levels and myeloperoxidase (MPO) enzyme activities were investigated. Histological evaluation was made to investigate the tissue neutrophil count. Survival areas were assessed at 7 d postoperatively. RESULTS: Group III (montelukast- treated) showed a significantly higher survival rate than Group II (control) (P=0.029) but a lower survival rate than Group I (sham). Histological and biochemical assays corroborated this data. CONCLUSION: This study suggests that montelukast CysLT1 receptor antagonist montelukast reversed I/R-induced oxidant responses and improved flap survival by inhibiting neutrophil infiltration and balancing oxidant and antioxidant status.

The effect of an intraperitoneal injection of melatonin on serum amylase levels in acute pancreatitis.

CONTEXT: Several experimental studies have been carried out to explain the physiopathological mechanisms and to introduce endocrinological, enzymatic, biochemical and histopathological changes in organisms during acute pancreatitis. OBJECTIVE: To evaluate the effect of an intraperitoneal injection of melatonin on serum amylase levels. DESIGN: Experimental acute pancreatitis was experimentally caused through pancreatic duct ligation in 20 Winstar Albino rats. The rats were then divided into two groups: control and melatonin groups. INTERVENTION: The serum amylase level was measured on the 7th day after acute pancreatitis had developed. In the melatonin group, an intraperitoneal injection of melatonin (20 mg/kg/day) was performed starting from the 2(nd) day after pancreatic duct ligation. MAIN OUTCOME MEASURE: The levels of serum amylase were measured with an auto analyzer. RESULTS: It was found that the mean (+/-SD) level of serum amylase in the control group was 947+/-182 IU/mL while it was 358+/-177 IU/mL in the experimental group (P<0.001). CONCLUSIONS: The 20 mg/kg/day intraperitoneal injection of melatonin which was carried out for one week attenuated the serum amylase levels to a statistically significant degree. The researchers believe that intraperitoneal injections of melatonin decrease the severity of acute pancreatitis.

The effect of ethanol intake on tendon healing: a histological and biomechanical study in a rat model.

INTRODUCTION: Ethanol has a suppressive effect on inflammation and the immune system, but the effect of ethanol on tendon healing in vivo has not been studied. The purpose of this study was to investigate the histological and biomechanical effects of ethanol intake on tendon healing in a rat tendon injury model. MATERIALS AND METHODS: Forty-seven rats were randomly assigned to either ethanol or control groups. Progressively increasing concentrations of ethanol combined with glucose were administered to these rats in their drinking water. After 1 week, the Achilles tendon of each rat was injured proximal to its insertion on the calcaneus. All rats were euthanized at 4 weeks. The tendons were evaluated both histologically and biomechanically. The histologic examination of these tendons was done using a semi-quantitative 4-point scale to rate cell morphology, the degree of ground substance staining, collagen organization, and vascular changes. Load to failure (N) strength was obtained with biomechanical testing. RESULTS: Tendon failure loads were lower in the ethanol group (31.6 +/- 8.8 N) than in the control group (39.7 +/- 8.2 N) (P = 0.04). Histologic tenocyte scores were higher in the ethanol group (1.90 +/- 0.73) than the control group (0.9 +/- 0.73) (P = 0.01). CONCLUSION: Ethanol ingestion resulted in abnormal tenocyte morphology, disorganized collagen bundles with a tendency toward increased tenocyte number, and neovascularization 3 weeks after the tendon injury indicating delayed and abnormal healing. The healing tendons in the alcohol treated group failed at statistically lower loads than the control group.

Ghrelin does not change in hyperemesis gravidarum.

OBJECTIVES: Ghrelin levels can play an important role in maintaining the energy balance of pregnant women. Therefore, we investigated the relationship between HG and Ghrelin. MATERIAL AND METHODS: 50 female patients admitted to the VAN Yüzüncü Yil University, Gynecology and Obstetrics Department were evaluated. The patients were divided into two groups: Group 1 included 25 pregnant women with HG, Group 2 included 25 healthy pregnant women. RESULTS: The two groups showed similarities in terms of age, gravidity, B-HCG and gestational age. There was no statistically significant difference between the two groups in terms of the Ghrelin levels (p = 0.867). CONCLUSIONS: This study shows that there is no difference between Ghrelin levels and HG during pregnancy. Increased Ghrelin in previous studies was attributed to low oral intake. Another study reported lower Ghrelin levels are not the result of, but are rather the cause of, reduced oral intake during. The balancing of these two conditions does not lead to a change in the level of Ghrelin.

Effects of nebivolol on skin flap survival: A randomized experimental study in rats.

BACKGROUND: Skin flaps are among the basic treatment options in the reconstruction of soft tissue defects. To improve skin flap survival, a variety of methods, including pharmacologic agents, have been investigated. The effectiveness of anticoagulants, antioxidants, anti-inflammatory drugs, and vasodilatory drugs in improving flap survival has been studied. Nebivolol is a new-generation selective ß1-adrenoreceptor blocking agent that has vasodilatory, antithrombotic, antioxidative, and anti- inflammatory effects. OBJECTIVE: The aim of this experimental study was to investigate the effects of nebivolol (50 mg/kg/d) on random pattern skin flap survival in rats. METHODS: Male Wistar rats weighing 290 to 310 g were randomly divided into 2 groups-the nebivolol group and the control group. Random patterned, caudally-based, ~3 × 10-cm skin flaps were elevated on the back of each rat. In the nebivolol group, nebivolol 50 mg/kg/d (1 mL, of a racemic solution of nebivolol) was administered orally 2 days before surgery to reach steady-state drug blood concentrations and was continued for 6 days. In the control group, 1 mL/d of sterile saline solution was orally administered 2 days before surgery and was continued for 6 days. To observe the effects of nebivolol, cutaneous blood flow was examined using a laser Doppler flow-meter before and after surgery on days 1, 3, 5, and 7, and flap tissue, malondialdehyde (MDA) and glutathione (GSH) concentrations, and superoxide dismutase (SOD) activity were measured 7 days postsurgery. Flap viability was evaluated 7 days after surgery by measuring necrotic flap area and total flap area. RESULTS: All 20 rats (nebivolol group, n = 10; control group, n = 10) survived throughout the study period. Mean (SD) MDA concentration was significantly lower in the nebivolol group than in the control group (69.25 [5.82] vs 77.67 [6.87] nmol/g tissue; P = 0.009). GSH concentration was significantly higher in the nebivolol group than in the control group (2.14 [0.15] vs 1.88 [0.22] nmol/mg tissue; P = 0.004). SOD activity was significantly greater in the nebivolol group than in the control group (49.28 [5.49] vs 42.09 [4.95] U/g tissue; P = 0.007). The percentage of the flap that was necrotic was significantly lower in the nebivolol group than in the control group (40.27 [4.08] vs 48.87 [6.35]; P = 0.007). CONCLUSIONS: This small, experimental, in vivo animal study found that nebivolol was associated with reduced necrotic random pattern skin flap area. Further studies are needed to clarify these findings.

The effects of montelukast on random pattern skin flap survival: An experimental study in rats.

BACKGROUND: A variety of methods to improve skin flap survival, including the use of pharmacologic agents, have been intensively investigated. Decreasing neutrophil-mediated inflammation and tissue injury has been reported to be effective in improving flap survival. Montelukast is a selective reversible cysteinyl leukotriene receptor-1 antagonist that has been found to have protective effects against renal ischemia reperfusion injury and burn-induced oxidative injury of the skin in rats. However, its effects on skin flap survival have not been previously reported. OBJECTIVE: The aim of this study was to investigate the effects of montelukast on neutrophil-mediated random pattern skin flap survival. METHODS: Male Sprague-Dawley rats weighing 230 to 250 g were randomly divided into 2 groups-the montelukast-treated group and the control group. Caudally based rectangular random pattern skin flaps 3 × 9 cm were elevated on the backs of the rats. The flaps were sutured into their original places. In the montelukast group, 1 mL of solution containing 10 mg/kg montelukast was administered intraperitoneally (IP) 30 minutes before surgery and then daily for 6 days. In the control group, 1 mL of saline was administered IP 30 minutes before surgery and then daily for 6 days. To observe the effects of montelukast, myeloperoxidase (MPO) activity, an index of tissue neutrophil infiltration, was measured from extracted skin tissue 12 hours after flap elevation. Flap viability was evaluated 7 days after surgery by measuring necrotic flap area and total flap area. RESULTS: Sixteen rats (mean [SD] weight, 240.6 [6.6] g) were equally divided between the 2 groups. All rats survived throughout the study period. Mean (SD) MPO activity in flap tissue was significantly lower in the montelukast group than in the control group (14.57 [2.33] vs 21.28 [4.86] U/g protein; P = 0.005). The percentage of necrotic flap area was significantly lower in the montelukast group than in the control group (17.17 [7.95] vs 37.51 [10.72]; P = 0.001). CONCLUSION: This small, experimental, in vivo animal study found that montelukast was associated with both lower MPO activity and a lower percentage of necrotic random pattern skin flap area. Future studies are needed to clarify these findings.