Association of serum betatrophin with fibroblast growth factor-21 in women with polycystic ovary syndrome.

PURPOSE: Betatrophin and fibroblast growth factor-21 (FGF-21), which are recently discovered members of hepatokine/adipokine family, have been proposed to be associated with some metabolic disorders in which insulin resistance plays a major role. METHODS: We aimed to investigate serum betatrophin and FGF-21 concentrations in women with polycystic ovary syndrome (PCOS). In this cross-sectional study, we recruited 31 women with PCOS and 34 women as healthy controls. Serum betatrophin level and its relationship with serum FGF-21 level as well as metabolic parameters were examined. RESULTS: Serum betatrophin level was significantly higher in women with PCOS than the control group [1.10 (0.20-4.20) vs 0.70 (0.20-3.50) ng/ml, p = 0.004], whereas FGF-21 did not differ between the groups [74.80 (7.80-435.90) vs 119.30 (10.50-443.40) pg/ml, p = 0.13]. Serum betatrophin correlated positively with LH levels (r = 0.26, p = 0.03). After controlling BMI, there was a significant positive correlation between betatrophin and FGF-21 (r = 0.25, p = 0.04). Multivariate regression analysis revealed that FGF-21 and presence of PCOS were the significant predictors of betatrophin concentrations (R2 = 0.22, F = 2.56, p = 0.03). CONCLUSIONS: Our results indicate that betatrophin levels are increased and associated with LH and FGF-21 levels, but not with insulin resistance, in women with PCOS.

Candesartan mediates microcirculation in acute necrotizing pancreatitis.

AIM: In the present study we aimed to determine the effect of an AT-II antagonist candesartan on pancreatic microcirculation in an experimental model of acute necrotizing pancreatitis. MATERIALS AND METHODS: There were five study groups with 10 animals in each. Pancreatitis was induced by intravenous infusion of cerulein and coadministration of glycodeoxycholate into biliopancreatic canal. Candesartan is given at 6th and 18th hour to the 24th and 48th hour groups, respectively. At 24th and 48th hours; following anaesthesia laparotomy was performed and laser Doppler flowmetry was performed in the pancreatic tissue of the animals. Following scarification blood samples were obtained for amylase, myeloperoxidase, IL-6 and tumour necrosis factor alpha. Tissue samples from the pancreas were obtained for histopathological analysis, endothelial cell apoptosis (TUNEL assay) and matrix metalloproteinase-9 immunohistochemistry. RESULTS: Pancreatic microcirculation was higher in the candesartan treated groups (p < 0.05). Myeloperoxidase, IL-6 and tumour necrosis factor alpha was found to be lower in the candesartan treated groups (p < 0.05). The pancreatic edema and inflammation were found to be reduced in the candesartan treated groups (p < 0.05). Endothelial apoptosis was found to be reduced by cadesartan treatment but it did not reach statistical significance (p > 0.05). Tissue matrix metalloproteinase -9 levels were found to be reduced with candesartan treatment (p < 0.05). CONCLUSION: Treatment with candesartan in the early phases of acute necrotizing pancreatitis effective on microcirculation of pancreatic tissue (Tab. 3, Fig. 6, Ref. 28).

Comparison of the effects of pulsatile cardiopulmonary bypass, non-pulsatile cardiopulmonary bypass and off-pump coronary artery bypass grafting on the respiratory system and serum carbonyl.

BACKGROUND: We aimed to investigate the effects of off-pump coronary artery bypass grafting (CABG), pulsatile cardiopulmonary bypass (CPB), and non-pulsatile CPB techniques on oxidative stress and the respiratory system in the current study. MATERIALS AND METHODS: The patients were allocated into three different groups according to perfusion techniques, as follows: off-pump CABG group (n=10); pulsatile CPB (n=11); and non-pulsatile CPB group (n=11). Serum carbonyl level was measured and a pulmonary function test was performed preoperatively and postoperatively. RESULTS: The postoperative increase in the carbonyl level was significantly lower in the off-pump CABG group compared to the other two groups, while there was no significant difference between the pulsatile and non-pulsatile CPB groups with respect to carbonyl levels. Arterial partial pressure of oxygen, forced expiratory volume in one second, and forced vital capacity were significantly higher in the off-pump CABG group compared to other two groups in the postoperative period. CONCLUSION: We found that off-pump CABG had less negative effects on oxidative stress and the respiratory system compared to pulsatile CPB and non-pulsatile CPB techniques. Additionally, there was no significant difference between pulsatile and non-pulsatile CPB.

Comparison of the effects of pulsatile cardiopulmonary bypass, non-pulsatile cardiopulmonary bypass and off-pump coronary artery bypass grafting on the inflammatory response and S-100beta protein.

BACKGROUND: We aimed to investigate the effects of off-pump coronary artery bypass grafting, pulsatile cardiopulmonary bypass, and non-pulsatile cardiopulmonary bypass techniques on the inflammatory response and the central nervous system in the current study. METHODS: A total of 32 patients who were scheduled for elective coronary artery bypass graft surgery were included in the study. The patients were allocated into three different groups according to the perfusion techniques used during the cardiopulmonary bypass procedure as follows: off-pump coronary artery bypass grafting group (n=10); pulsatile cardiopulmonary bypass group (n=11); and non-pulsatile cardiopulmonary bypass group (n=11). Serum interleukin-6, interleukin-8, tumor necrosis factor-alpha and S-100beta levels were measured preoperatively, and at 0, 6, and 24 hours postoperatively. RESULTS: The postoperative increase in the levels of interleukin-6 and interleukin-8 was significantly lower in the off-pump group compared to the other two groups (p<0.05), while there was no significant difference in tumor necrosis factor-alpha levels between the groups. Postoperative S-100ß levels, an indicator of cerebral injury, was significantly lower in the off-pump CABG group compared to the other two groups (p<0.05). CONCLUSION: We found that off-pump coronary artery bypass grafting had less negative effects on inflammatory response and central nervous system compared to pulsatile cardiopulmonary bypass and non-pulsatile cardiopulmonary bypass techniques.

Effect of stent placement, balloon or cutting balloon dilatation on stricture formation after caustic esophageal burn in rats.

INTRODUCTION: This study aimed to evaluate the effects of stent placement prior to stricture development following caustic esophageal burn (CEB) in an animal model. The outcomes after stent placement were also compared with those after balloon dilatation and cutting balloon dilatation performed after stricture development. Groups were compared with regard to stricture development and weight loss. MATERIALS AND METHODS: 40 rats were divided into 5 groups. CEB was created as described by Gehanno et al. In Group A (control) no CEB was performed and the esophagus was only rinsed with saline. Group B rats underwent CEB with no subsequent treatment. Group C rats underwent CEB followed by balloon dilatation in the 3 (rd) and 4 (th) week. Group D rats underwent CEB followed by cutting balloon dilatation in the 3 (rd) week. Group E rats underwent CEB with subsequent placement of a silicon stent in the same session. The animals were sacrificed in the 6 (th) week, and the stenosis index (SI), collagen deposition, and hydroxyproline (HP) levels were determined in the esophageal segments and statistically compared. RESULTS: Although weight loss occurred in Group C and Group B rats (238.87±15.95 g vs. 233.83±19.01 g), weight loss in Group C rats was less marked compared to Group B. Similarly, the SI in Group C was lower compared to that of Group B and the difference was statistically significant. Although there was no difference in weight between the rats in Group C and Group B before the procedure (p=0.318), there was statistically significant difference thereafter (p=0.002). The SI of Group D was also lower compared with that of Group B, and the difference was statistically significant. Weight gain in Group E rats was similar to that noted in Group A rats and was higher compared to Group B; this difference was statistically significant. The SI for Group E was lower compared to that of Group B. CONCLUSION: Stenting performed at the time of corrosive injury and cutting balloon dilatation performed after stricture formation had a positive effect with regard to SI and weight gain in an animal model.

Serum granulocyte colony-stimulating factor levels in gliomas.

PURPOSE: Apart from its known effects on granulopoiesis, granulocyte-colony stimulating factor (G-CSF) is also involved in growth and progression of malignant cells. In this study we report the serum G-CSF levels and their relationship with survival in patients with glial cell tumors. METHODS: Serum G-CSF levels of 17 patients (10 male, 7 female, median age 55 years, range 19-75), with histologically proven glial cell tumors and of 17 sex- and age-matched healthy controls were assayed by enzyme-linked immunosorbent assay (ELISA). RESULTS: All patients were treated with radiotherapy and concomitant temozolomide, followed by temozolomide alone. Eight patients were treated with carboplatin plus cyclophosphamide combination as second-line chemotherapy. The median follow-up was 21 months (4-42). The median OS was 36 months (95% CI, 15.7-56.4). Serum G-CSF levels in glioma patients and healthy controls were 44.14 ± 18.89 pg/ ml and 28.84±15.65 pg/ml, respectively (p=0.027). There was no significant correlation between survival time and serum G-CSF levels (r=0.384; p=0.217). CONCLUSION: Serum G-CSF levels were high in glioma patients compared with healthy controls and they may be involved in tumor progression, but the G-CSF role in prognosis was not clarified. Further studies with larger numbers of patients must be conducted to elucidate the role of G-CSF in glial cell tumors.

Clinical and immunological analysis of 23 adult patients with common variable immunodeficiency.

BACKGROUND: Common variable immunodeficiency (CVID) is characterized by hypogammaglobulinemia, defective antibody production, and recurrent upper and lower airway tract infections. OBJECTIVES: To reveal the clinical heterogeneity of this condition, analyze the high frequency of respiratory and gastrointestinal complications despite satisfactory trough immunoglobulin (Ig) G levels, and determine the main difficulties in management and treatment. METHODS: We performed a retrospective analysis of 23 patients (13 male and 10 female) diagnosed with CVID between 2001 and 2008. RESULTS: The median diagnostic delay for females and males was 15 years (range, 1-32 years) and 8 years (range, 1-31 years), respectively. Restrictive, obstructive, and combined pulmonary function defects were determined in 23%, 27%, and 14% of patients, respectively. The most frequent findings on the thoracic computed tomography scan were bronchiectasis, mediastinal lymphadenopathy, fibrosis, ground-glass patterns, mosaic oligemia, peribronchial cuffing, and parenchymal nodules. Giardiasis and duodenal lymphoid hyperplasia were detected in 52% and 42% of the patients, respectively, and Helicobacter pylori in 42%. Vitamin A levels were normal, although beta-carotene and/or vitamin E levels were decreased in patients presenting malabsorption-related symptoms. Malignancy was documented in 3 patients and decreased bone mineral density in 9 patients (3 had osteoporosis and 3 had osteomalacia). CONCLUSION: CVID is a multisystemic disease that should be managed by a multidisciplinary team. Intravenous immunoglobulin therapy and antibiotics do not seem to have a suppressive effect on granulomatous or inflammatory manifestations. More comprehensive studies based not only on peripheral blood but also on immunohistological analysis are necessary to shed light on the pathogenesis of these life-threatening complications.

Effects of radiation on protein oxidation and lipid peroxidation in the brain tissue.

Radiation produces reactive oxygen species that modify macromolecules such as protein and lipid by oxidation and act in many pathological processes, causing serious damage to the brain. This study sought to evaluate the effects of radiation and the protective effect of N-acetylcysteine (NAC) on the brain tissue of guinea pigs based on the levels of lipid peroxidation and protein oxidation. Thirty-two guinea pigs were divided into groups of eight animals each: control group (group I); radiation group (group II); NAC group (group III), and NAC administered before radiation exposure group; (group IV). Guinea pigs in groups II and IV were exposed to Co(60) radiotherapy using the Source-Axis-Distance = 80 technique. The levels of protein carbonyl content and malondialdehyde (MDA), which is a marker for lipid peroxidation, were investigated by the Evans-Levine and Uchiyama-Mihara methods, respectively. The protein carbonyl and MDA levels of group II were significantly greater than those of group I (P < .01). The protein carbonyl and MDA levels of group IV were lower than those of group II. The difference between the MDA levels of group IV and group II was significant (P < .01); however, the difference in protein carbonyl levels between the two groups was not significant. The results indicated that radiation increased protein oxidation and lipid peroxidation in the brain, and NAC administration before radiation exposure may aid in the treatment by decreasing protein and lipid oxidation.

Effects of different suture materials on wound healing and infection in subcutaneous closure techniques.

BACKGROUND: In this study we aimed to investigate the effects of different suture materials on wound healing and infection in subcutaneous closure techniques. MATERIALS AND METHODS: Twenty-nine rats were randomly allocated to 5 groups. All subjects received 2-cm vertical dermal and subdermal incisions on their backs under sterile and proper surgical conditions. The subdermal cuts were then closed with vicryl (polyglycolic acid), biosyn (monofilament glycomer), prolene (polypropylene) and tissue adhesive (2-octylcyanoacrylate). After 10 days, all sutured areas were examined for seroma, haematoma formation and cosmetic outcome. The incisional lines were excised with 1-cm-wide skin strips and tissue hydroxyproline levels were determined. The specimens obtained were evaluated for the presence of giant cells, mononuclear cells, fibrosis and neutrophils. RESULTS: No differences in tissue hydroxyproline levels were found between any of the suture materials used. Fibrotic process and inflammatory cell infiltration were more prominent in the biosyn and prolene groups than in other groups. Foreign body giant cells were observed in the biosyn group. CONCLUSION: Vicryl and tissue adhesive should be preferred in subcutaneous closure techniques.

Locally advanced breast carcinoma treated with neoadjuvant chemotherapy: are the changes in serum levels of YKL-40, MMP-2 and MMP-9 correlated with tumor response?

Serum levels of YKL-40, MMP-2 and MMP-9 in 27 patients with locally advanced breast carcinoma received neoadjuvant chemotherapy were measured. All patients underwent neoadjuvant chemotherapy named as FAC protocol (5-Fluorouracil, Doxorubicin and Cyclophosphamide) with 21 days interval. There was 26,7% decrease in mean serum YKL-40 levels (from 146,4 microg/ml to 107,3 microg/ml) in clinically responsive group. This level was almost unchanged in non-responsive group (P>0, 05). There was 42, 1% decrease in mean serum YKL-40 levels (from 173,1 microg/ml to 98, 8 microg/ml) in pathologically responsive group. This decrease was more dramatic in patients with complete pathological response (70, 2%). However, this level was slightly increased in non-responsive group. Changes in serum levels of MMP-2 and MMP-9 were not found to be associated with tumor response. Serum measurement of YKL-40 can be a helpful tool to predict pathological tumor response in breast cancer patients with neoadjuvant chemotherapy but not MMP-2 and MMP-9.

Assessment of protein oxidation in women using raloxifene.

OBJECTIVES: To assess the oxidative effects of raloxifene use in postmenopausal women by investigating protein carbonyl levels in the plasma. METHODS: Nineteen osteoporotic postmenopausal women treated with raloxifene for 12 months were included in the study. Another seventeen postmenopausal women matched for age and postmenopausal years, without any medication were chosen as a control group. Protein carbonyl levels were determined as oxidative stress markers by the use of Levine's method in the plasma of these women. RESULTS: Serum protein carbonyl levels of postmenopausal women treated with raloxifene (1.27 +/- 0.32 nmol/mg protein) were significantly lower than the control group (2.18 +/- 0.27 nmol/mg protein) (p < 0.05). CONCLUSIONS: Oxidative stress has been found responsible for several diseases including cancer. Protein carbonyl levels, which are the products of protein oxidation, are one of the indicators of oxidative stress. Therefore, the decline in protein carbonyl levels in this study revealed the decreasing oxidative stress. According to our results, it might be interpreted that raloxifene does not cause oxidative stress, and it may even have protective effects in long-term use.

Low B12 levels in chronic idiopathic urticaria.

Recent studies suggest that autoimmune mechanisms may be involved in the etiology of chronic idiopathic urticaria (CIU). There is a higher prevalence of B12 deficiency in autoimmune diseases and possibly in gastric Helicobacter pylori (H. pylori) infection. The frequency of B12 deficiency in CIU is unknown. Our objective in this study was to determine the prevalence of B12 deficiency in patients with CIU and also its relationship to gastric H. pylori infection and serologic markers of autoimmunity in these groups. Thirty-three patients with CIU and 27 healthy controls were included in the study. Serum vitamin B12 levels, H. pylori infection and serological markers of autoimmunity (anti-thyroglobulin, thyroid microsomal, gastric parietal cell and antinuclear autoantibodies) were investigated. H. pylori infection was determined according to serology and gastric biopsy in 19 patients, serology and urea breath test in 4 patients and serology alone in the remaining 10 patients. Serum B12 levels were below the normal reference range in 11/33 (33.3%) patients with CIU. The mean serum B12 levels among patients with CIU and the controls were 281+/-127.5 pg/ml and 465.1+/-140.3 pg/ml (p=0.0001), respectively. Anti-thyroid antibodies were positive in 6 of 11 patients (54.5%) with low B12 levels, but only in 4 of 27 (14.8%) healthy controls (p=0.019). Anti-GPC antibodies were positive in 4 of 11 (36.4%) patients with CIU and low B12 levels, but only in 2 of 27 (7.4%) healthy controls (p=0.047). In CIU patients, there was no difference in the frequency of IgG H. pylori antibodies between those with low B12 levels and normal B12 levels. Among the 19 patients who had been performed gastric endoscopy, 15 patients (78.9%) had chronic antral gastritis, 2 patients (10.5%) had atrophic gastritis and there were normal findings in 2 patients (10.5%). In conclusion, serum B12 levels were found to be below the normal reference range in 33% of the patients with CIU. An association between low B12 levels and H. pylori could not be shown. The higher frequency of antithyroid and anti-GPC antibodies in patients with low B12 levels suggest that low B12 levels in CIU may be autoimmune in nature.

Allopurinol hypersensitivity syndrome as a cause of hepatic centrilobular hemorrhagic necrosis.

Extensive and severe hepatic centrilobular hemorrhagic necrosis is a common finding in hepatic vein obstruction and Budd-Chiari syndrome. Some drugs, including allopurinol, can also cause this histopathologic appearance but to our knowledge in this setting the lesions are not so massive. Here we report a case of a 41-year-old female who developed fever, pruritic skin rash, jaundice, eosinophilia, abnormal liver function tests, and acute renal failure 3 weeks after the beginning of allopurinol treatment, complicated with severe hepatocyte necrosis around most terminal hepatic venules suggesting Budd-Chiari syndrome.