Acute and chronic impact of smoking on salivary and serum total antioxidant capacity.

OBJECTIVE: To investigate increased oxidative stress in saliva of smokers along with their serum. METHODS: The case-control study was conducted from September to December 2008 in the Department of Biochemistry of the Medical School, Kirikkale University, Kirikkale, Turkey. A blood sample and saliva samples before and after smoking were collected from the smokers, while blood and saliva samples were taken from the controls. All samples were taken concurrently. The samples were measured for total antioxidant capacity, total oxidant stress, oxidative stress index, malondialdehyde, nitric oxide and total sulfhydryl groups. Levels of superoxide dismutase and glutathione peroxidase were also measured on saliva samples. SPSS 13 was used for statistical analysis. RESULTS: Of the 54 subjects in the study, 27(50%) were smokers with a mean age of 28.4 ± 5.42 years, and 27 (50%) were controls with a mean age of 29.7 ± 8.03 years. Total oxidant stress, oxidative stress index, malondialdehyde and nitric oxide levels were found higher in the serum samples of smokers (p < 0.05), and the levels of total sulfhydryl groups in smokers were lower compared with the controls (p < 0.05). Among the smokers, salivary malondialdehyde levels were higher before and after smoking (p < 0.05), glutathione peroxidase levels were lower than the controls, and salivary nitric oxide levels after smoking were higher than both those of the control group and the levels before smoking (p < 0.05). CONCLUSION: Both acute and chronic increased oxidative conditions may be a significant sign of the destructive effects of smoking. The investigation of disorders in smokers concerning oxidative stress will be beneficial in terms of novel approaches and treatment modalities.

Prevention of retrosternal pericardial adhesions after cardiac surgery with mitomycin C.

BACKGROUND: Retrosternal pericardial adhesions may cause significant injuries to the heart and great vessels in cases that require reoperation. Fibroblast proliferation is one of the mechanisms for adhesion formation. Inhibition of fibroblast proliferation is important in reduction of retrosternal adhesions. Mitomycin C (MMC) is able to reduce fibroblast proliferation. We aimed to determine the effect of MMC on prevention of retrosternal pericardial adhesions after primary cardiac operations. METHODS: Thirty Sprague-Dawley female rats were used in the study. The rats were divided into two groups. First group was control (n=10) and second group was MMC study group (n=20). Xiphoid cartilage resection and retrosternal abrasion via subxiphoidal incision was performed. In the study group, MMC (1mg/kg) was topically applied to the retrosternal space. After 15 days, rats were taken into reoperation and adhesion was graded. Tissue and blood samples were taken before termination procedure. Standard staining procedures and fibroblast growth factor receptor 3 antibody staining, were applied immunohistochemically to tissue samples. RESULTS: The average adhesion scores of the control (n=10) and study (n=20) (MMC; 1mg/kg) groups were 2.50 ± 1.27 and 0.70 ± 0.86, respectively. The adhesion score of the study group was lower than the control group (p<0.05). Immunohistochemical samples revealed that tissue fibroblast intensity was significantly higher in the control group than the study group (p<0.05). There was no statistical significance between two groups in case of hydroxyproline levels (p>0.05). CONCLUSION: MMC was found to be effective in the prevention of retrosternal pericardial adhesions without any delay in normal tissue regeneration.

Effect of phototherapy on gastrointestinal smooth muscle activity and oxidative stress.

AIM: To evaluate the effect of phototherapy on gastrointestinal smooth muscle activity and oxidative stress. METHODS: Wistar albino rats (n = 18, in the first 7 days of life) weighing 7 ± 2 g with both sexes were included in the study. The animals were randomized into three groups. In control group (CG), median laparotomy was performed to obtain 1 cm of jejunum, terminal ileum and colonic segments. In the phototherapy group (PTG), led phototherapy with a wave density of 40 µw/cm(2)/nm were used (Bilitron 3006, Fanem, Brasil). The efficacy surface of phototherapy was 30-40 cm and the exposure distance was 30 cm. The duration of phototherapy was 24 h. Sham group (SG) received white light with the same wave density and exposure distance. The oxidative stress markers and contraction responses were investigated from intestinal segments obtained from experiments. RESULTS: The jejunum segments showed significantly lowered contraction response to carbachol in SG when compared to CG and PTG (p < 0.05). Decreased contractile response to KCl was detected in both SG and PTG in terminal ileum segments. MDA levels showed no difference between groups (p > 0.05). Total sulfhydryl (T-SH) levels were found significantly increased in PTG when compared to CG and SG (p < 0.05). When NO levels were evaluated, NO levels were found decreased in PTG and SG with respect to CG (p < 0.05). CONCLUSION: PT may cause various alterations in oxidant/antioxidant system in intestinal segments. Unlike to clinical findings, decreased contractile responses were detected in rat gastrointestinal smooth muscles after PT.

Comparison of hematological and biochemical parameters in sheep naturally and persistently infected with a border disease virus.

In this study, we investigated the changes occurring in the activities of determining the biochemical and hematological parameters in persistently infected sheep with border disease virus (BDV) and control sheep. While cholesterol, aspartate aminotransferase, lactate dehydrogenase, high-density lipoprotein, and glucose parameters were found to be statistically different between control and BDV positive groups (p<0.01), total protein, alkaline phosphotase, creatine kinase, amylase, glucose, and high-density lipoprotein were found to be statistically different between control and persistently infected group (p<0.01). Interestingly, all groups were shown only mean corpuscular volume parameter was different (p<0.01). It was found that cholesterol, aspartate aminotransferase, amylase, high-density lipoprotein, and low-density lipoprotein parameters were different between PI and infected sheep (p<0.01). It was speculated that BDV might effect also the expression of low-density lipoprotein receptor and determination of the changes in BD and its clinical importance might contribute to the veterinarians and scientists studying in this area.

The value of CRP, IL-6, leptin, cortisol, and peritoneal caspase-3 monitoring in the operative strategy of secondary peritonitis.

BACKGROUND: We aimed to investigate the impact of C-reactive protein (CRP), interleukin (IL)-6, leptin, cortisol, and caspase-3 on the decision of terminating planned abdominal repair in secondary peritonitis. METHODS: Fifteen patients with peritonitis were enrolled into the study. Serum CRP, IL-6, leptin, cortisol, and peritoneal caspase-3 activities were measured. RESULTS: APACHE II scores at 48 hours (h) and age were significantly higher in non-survivors. A significant decrease was observed in caspase-3 activities of patients in whom ≤4 laparotomies were performed when compared with those who underwent >4 laparotomies. For patients who underwent ≤4 laparotomies, there was a significant difference in caspase-3 levels between 0 and 72 h. There was no significant difference in caspase-3 levels in non-survivors; caspase-3 levels were significantly lower in the survivors at 48 and 72 h. Changes in CRP, IL-6, leptin, and cortisol levels were not statistically significant. CONCLUSION: CRP, IL-6, leptin, cortisol, and caspase-3 are not valuable in discriminating the number of planned operations, even though there is a significant decrease in caspase-3 "within" survivors. The discriminative value of caspase-3 for closure should be evaluated in studies in which caspase-3 is monitored for a longer duration in a large number of patients.

The effect of hypothermia on splanchnic flows and lung in a two-hit hemorrhagic shock model.

BACKGROUND: To evaluate the effect of hypothermia on bacterial translocation, splanchnic vascular flow, lung tissue weight, and levels of malondialdehyde (MDA) and nitric oxide (NO) in a two-hit model of hemorrhagic shock. METHODS: Thirty rats were randomly allocated into three groups of 10 rats each. In the control group (group C), rats were treated without hemorrhage, and normothermia (37 degrees C) was maintained. In the mild hypothermia group (group MH), rats were subjected to volume-controlled hemorrhage (2 mL/100g) and a rectal temperature of 34 degrees C was maintained. In the normothermic group (group NT), rats were treated as in group MH, except for hypothermia. Seventy-two hours after hemorrhagic shock (first insult), Pseudomonas aeuruginosa was administered intratracheally as a second insult. Finally, mesenteric vascular flow patterns were recorded. Bacterial translocation was studied from tissue samples of spleen, liver, and mesenteric lymph nodes. Blood samples were obtained to evaluate the possible presence of bacteria in the bloodstream. Lung tissue weight ratio, MDA, and NO levels in lung tissue were assessed. RESULTS: Renal, mesenteric, and portal venous flow rates were found to be lower in groups MH and NT in comparison with group C. Blood flow profiles were lower in group NT than in group MH (P<0.05). Bacterial translocation was not observed in group C, and it was detected more often in group NT than in group MH. Lung weight ratio was found to be higher in group NT compared with groups MH and C. Although it did not reach the level of statistical significance, MDA level in the control group was lower than that in the NT group (P=0.085). CONCLUSION: Hypothermia corrected mesenteric blood flow and decreased the occurrence of bacterial translocation in the two-hit model of hemorrhagic shock and tracheal inoculaton of P. aeruginosa.

Periodontal health in children exposed to passive smoking.

AIM: To determine (1) the cotinine levels of saliva, urine and gingival crevicular fluid (GCF) of children in families with and without smoking members and (2) a possible association between the periodontal health of the children and exposure to passive smoking. MATERIAL AND METHODS: The study population comprised of 109 children in the age range 6-12 years. Children were classified as exposed to passive tobacco smoking (PTS-exposed, n=51) and as unexposed controls (PTS-unexposed, n=58). Plaque index, gingival index, bleeding on probing, probing depth and clinical attachment level (CAL) were recorded. GCF, saliva and urine samples were also collected. The levels of cotinine in these fluids were determined by enzyme-linked immunosorbent assay. RESULTS: The mean salivary cotinine concentration was significantly increased in PTS-exposed children compared with PTS-unexposed children (p<0.05). Further, in a dose-dependent way, the mean salivary concentration was significantly higher in children whose father or mother was a smoker (p<0.05) as compared, respectively, with children whose fathers and mothers were non-smokers. The mean CAL was significantly less in PTS-exposed children compared with non-PTS-exposed children (0.09 mm; p<0.05) and also in children whose father was a smoker (p<0.05), but not in children whose mother was a smoker as compared with non-smoker fathers and mothers, respectively. The GCF cotinine levels were below the detection limits with the assay method that was used. CONCLUSIONS: We have observed that children who are exposed to passive smoking have elevated cotinine levels in their saliva concomitant with a lowered CAL.

Cotinine levels in serum and bronchoalveolar lavage fluid.

Cotinine is a major metabolite of nicotine. This study was planned to investigate the relationship between bronchoalveolar lavage (BAL) fluid cotinine levels and serum cotinine levels in smokers and nonsmokers with various pulmonary diseases and to investigate whether these levels are affected by passive smoking. Serum and BAL fluid cotinine levels were measured in 27 patients. BAL cotinine levels were measured using a sensitive ELISA kit produced to measure cotinine in saliva. Plates were read by microuant (BioTek, USA) micro plate reader. All patient serum cotinine levels were detectable except for one nonsmoker patient. However, BAL fluid cotinine levels were measurable in only 6 patients (two of them were nonsmokers). A significant positive correlation was seen between serum and BAL fluid cotinine levels (r = 0.726; p = 0.000). Serum cotinine levels were significantly higher in present smokers than non-smokers (21.0 +/- 16.01; 5.35 +/- 7.65; p = 0.004). However, there were no significant differences in BAL fluid cotinine levels between smokers and nonsmokers. Passive smoking can increase nicotine metabolites in serum and other body fluids, including BAL fluid. Since BAL fluid and serum cotinine levels were well correlated, there is no need to use invasive procedures, such as bronchoscopy and expensive, time consuming BAL fluid analyses. Serum cotinine levels can give a rough idea of smoking status. BAL fluid cotinine meaurements should be done for only scientific reasons.

Prevention of the harmful effects of free oxygen radicals by using N-acetylcysteine in testicular torsion.

INTRODUCTION: Testicular torsion is a urological emergency both in childhood and in adult life. Many studies on experimental testicular torsion have demonstrated biochemical and pathological ischemia-reperfusion injury and the efficacy of some drugs have been investigated to prevent this damage. N-acetylcysteine (NAC) promotes glutathione synthesis and acts as a glutathione precursor because of the fact that it increases the glutathione-reductase activity by transporting sulfhydryl groups. AIM: In this experimental study, the authors aimed to investigate the effectiveness of NAC in preventing ischemia-reperfusion injury following testicular torsion and detorsion. STUDY DESIGN: For this experimental study, 36 albino Wistar-male rats were used. The rats were randomly divided into 4 groups: sham (n = 8), ischemia-reperfusion (n = 8), ischemia-NAC -reperfusion (n = 10), and ischemia-NAC-reperfusion-NAC (n = 10) groups. Two hours of torsion and 4 h of detorsion were created in the left testis. After 4 h of detorsion, the rats were sacrificed. Each tissue was divided into two sections for biochemical and pathological examinations. RESULTS: There was a statistically significant difference between the study groups in terms of the total-sulfhydryl level, nitric oxide level, and the malondialdehyde values. Histopathological examination revealed that NAC was effective in preventing reperfusion injury in the testis but ineffective in preventing the reduction in the spermatid count. DISCUSSION: The results of this experimental study support that NAC can histopathologically maintain the structure of seminiferous tubules against ischemis reperfusion injury and prevent damage to the germinative cells. However, it was unable to prevent the reduction in spermatid count. There was no significant difference in the prevention of ischemia-reperfusion injury between NAC administration during the first hour of ischemia and NAC administration during reperfusion. Although NAC can prevent tissue damage from ischemia reperfusion injury, it is not effective against the reduction in the spermatid count. CONCLUSION: N-acetylcysteine may be biochemically effective in preventing ischemia-reperfusion injury after testicular torsion and detorsion. NAC is a readily available and easy to use agent that can be used during testicular ischemia.

Effect of carnitine on cutaneous wound healing in immunosuppressed rats.

BACKGROUND: The wound is ischemic in nature. Chronic steroid administration impairs wound healing by changing enzymes in the glycolytic pathway. Carnitine supplementation may help to restore the energy deficiency caused by chronic steroid administration in the wound. The aim of this study was to evaluate the effect of carnitine on impaired wound healing. METHODS: The study was conducted in three groups. Surgical intervention was a 4 cm long midline skin incision at the back. In Group A, eight rats received methylprednisolone for 7 d prior to surgical intervention, and it was continued until the end of the experiment. In Group B, 12 rats received methylprednisolone for 7 d prior to surgical intervention. After surgery, methylprednisolone injection was continued and carnitine was supplemented until the end of the experiment. In Group C, eight rats received no medication. The wound of half of the animals in each group was harvested on the seventh day after surgical intervention and the remaining on the 14th d. Tensile strength and hydroxyproline content were measured in all groups. RESULTS: There was no significant difference in parameters in any of the groups on day seven. On day 14, all parameters were statistically different between methylprednisolone and control groups (P < 0.05). Values for tensile strength were higher in the methylprednisolone/carnitine group compared with methylprednisolone group (P < 0.05). Carnitine administration had also increased hydroxyproline levels in the methylprednisolone/carnitine group compared with the control group (P < 0.05). CONCLUSIONS: Carnitine is shown to increase tensile strength of the wound when supplemented to immunosuppressed rats in which wound healing is impaired by methylprednisolone.

In vitro antibacterial activity of some systemic and topical antihistaminic preparations.

PURPOSE: In vitro antibacterial activity of topical and systemic antihistaminic preparations containing different active substrates against the standard strains of two bacteria was evaluated. METHODS: Four topical and 3 systemic preparations containing pheniramine maleate, chlorophenoxamine hydrochloride, and diphenhydramine hydrochloride were studied. The antibacterial activities of these preparations against strains of S. aureus (American Type Culture Collection, ATCC 29213) and S. epidermidis (ATCC 25212) were tested using the disc diffusion method. In addition, the Minimal Innhibitory Concentration (MIC) and Minimal Bactericidal Concentration (MBC) of parenteral preparations for these two bacteria were determined. RESULTS: Pheniramine maleate-topical and pheniramine maleate-systemic had no activity against bacteria, but the others showed various rates of activity. Chlorophenoxamine hydrochloride-topical and chlorophenoxamine hydrochloride-systemic were the most effective (P < 0.05). Despite the same active substrate content, diphenhydramine hydrochloride-topical-1 and diphenhydramine hydrochloride-topical-2 yielded different results when they were compared with each other or with the other preparations. Diphenhydramine hydrochloride-topical-2 had a relatively higher rate of activity than diphenhydramine hydrochloride-topical-1. Inhibition zone diameters were 16.9+/-1.5 mm 12.3+/-0.5 mm for S .aureus, 17.4+/-1.0 mm 0 mm for S .epidermidis respectively (P < 0.05). MIC values of parenteral preparations were equal to or above 125 ?g/ml. CONCLUSION: MIC values of parenteral preparations were higher than their blood levels in clinical use. Thus, effects of parenteral preparations may not have been reflected in routine clinical practice. However, topical forms have antibacterial activity due to additive substrates and the use of high concentration levels at the site of application. Therefore, in selection of topical forms for appropriate cases, these effects should also be taken into consideration. The antibacterial activity of topical antihistaminic preparations may be useful in certain dermatological pathology.

Impact of adiponectin on left ventricular mass index in non-complicated obese subjects.

To evaluate the relationship between the adiponectin levels and left ventricular mass index (LVMI) in uncomplicated obese subjects. Fifty-nine subjects were assigned to the obese (BMI> or =30 kg/m(2)) and 58 to the lean (BMI<30 kg/m (2) ) group. Plasma glucose, insulin, serum total cholesterol and high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, triglycerides and adiponectin were measured. Insulin resistance was determined by the Homeostasis Assessment Model (HOMA-IR). The left ventricular functions of all subjects were determined by 2D and pulse wave Doppler echocardiography. LVMI was calculated as left ventricular mass (LVM) normalized for height in m (2.7) . The obese group displayed significantly higher LVMI and late mitral inflow velocity. Thirty-three obese subjects met the criteria for left ventricular hypertrophy (LVH) and had lower serum adiponectin levels compared with obese subjects without LVH and lean subjects (p<0.05). Adiponectin was negatively correlated with LVMI (R: -0.277, p: 0.002). Furthermore, during the partial correlation analysis where HOMA-IR was controlled, the negative correlation between adiponectin and LVMI progressed (r: -0.283, p: 0.002). The linear regression analysis showed an independent relationship between LVMI and adiponectin. (beta: -0.214, p: 0.01) Obesity is associated with LVH. This study showed direct influence of adiponectin on LVMI.

Evaluation of serum resistin levels in patients with ocular and non-ocular Behçet's disease.

BACKGROUND: Resistin, a recently identified adipocytokine, has been found to play an important role in inflammation and the processes of inflammation-related diseases. Serum resistin levels in patients with Behçet's disease (BD) have not yet been investigated. We aimed to evaluate the relation between resistin and interleukin-6 (IL-6) in Behçet patients with or without ocular involvement and in normal controls. METHODS: Twenty-two patients with BD and 19 healthy control subjects were included in this study. While 14 patients had posterior segment involvement of the eye, the other 8 did not have ocular disease. Serum resistin and interleukin-6 (IL-6), levels were measured in all samples. Data from all groups were tested for statistical significance. RESULTS: The mean resistin and IL-6 concentrations were significantly higher in patients with BD than the control subjects (p = 0.011 and p = 0.0001, respectively). There was a significant difference in resistin and IL-6 levels between the patients with non-ocular BD and controls (p = 0.013 and p = 0.0001, respectively), as well as resistin and IL-6 levels between the ocular BD group and the control group (p = 0.05 and p = 0.0001, respectively). However, there was no significant difference between patients with ocular versus non-ocular BD. INTERPRETATION: Resistin levels were found to be raised in Behçet patients with or without ocular involvement compared with the control subjects.

Evaluation of adrenomedullin and endothelin-1: are they factors in the adaptation of maternal vascular system in normotensive pregnancy.

INTRODUCTION: The aim of our study was to analyse the role of adrenomedullin (AM) and endothelin-1 (ET-1) in the adaptation of the maternal vascular system in normotensive pregnancy. METHODS: Twenty-eight pregnant women, who were normotensive throughout the duration of their pregnancy, were recruited into the study. Plasma levels of AM and ET-1 at each trimester were measured and the AM/ET-1 ratio was calculated. RESULTS: Our experiment showed a significant decrease in plasma concentrations of AM in the first trimester for the study group (n=28) compared with the non-pregnant control group (n=16). There was also a significant decrease in plasma concentrations of ET-1 in all three trimesters (P<0.05) and a significant increase in the AM/ET-1 ratio in all three trimesters (P<0.05) for the study group compared with the control group. CONCLUSION: An alteration in vascular equilibrium between AM and ET-1, favouring AM, may be a reason why the physiological adaptation of the maternal vascular system to pregnancy occurs during normotensive pregnancy.

[The effect of suturing technique and nasal packing on oxidative stress in septoplasty operations]. / Septoplasti ameliyatlarinda dikis teknigi ve nazal tampon uygulamasinin oksidatif stres üzerine etkisi.

OBJECTIVES: We investigated the effect of nasal packing or suturing of the nasal septum after septoplasty on oxidative stress. PATIENTS AND METHODS: The study included 37 patients who underwent septoplasty for isolated septal deviation. At the end of the operation, intranasal packing was used in 18 patients (5 women, 13 men; mean age 30+/-10 years; range 18 to 47 years), and nasal septal suturing was used in 19 patients (5 women, 14 men; mean age 31+/-12 years; range 18 to 54 years). Nasal packs were removed after 48 hours. Plasma levels of malondialdehyde (MDH), total sulphydryl content (SH), and nitric oxide (NO) were measured at four sequential times to evaluate oxidative stress. RESULTS: There were no significant changes in plasma levels of MDH, SH, and NO in both treatment groups (p>0.05). Levels of MDH and NO did not differ significantly at four sequential times between the two treatment groups, whereas postoperative SH levels were always significantly higher following septal suturing (p<0.05). CONCLUSION: High levels of SH observed in the suturing group favor this technique over nasal packing application in terms of antioxidant systems and oxidative stress.

Prevalence of coeliac disease in patients with autoimmune thyroiditis in a Turkish population.

AIM: To investigate the prevalence of coeliac disease in a series of Turkish patients with autoimmune thyroiditis. METHODS: Sera from 136 consecutive patients with newly diagnosed autoimmune thyroiditis and 119 healthy blood donors were tested for IgA tissue transglutaminase antibody with enzyme-linked immunosorbent assay. Endoscopic mucosal biopsy from the second part of duodenum was performed in patients with positive antibody test. RESULTS: Eight patients (5.9%) and one control subject (0.8%) were positive for IgA tissue transglutaminase antibody (OR: 7.38, 95% CI: 0.91-59.85, P = 0.04). Six patients and one control agreed to take biopsies. Histopathological examination revealed changes classified as Marsh IIIa in one, Marsh II in one, Marsh I in two, and Marsh 0 in two patients with autoimmune throiditis, and Marsh I in one blood donor. CONCLUSION: Turkish patients with autoimmune thyroiditis have an increased risk of coeliac disease and serological screening may be useful for early detection of coeliac disease in these patients. Our findings need to be confirmed in a larger series of patients.

Serum leptin levels in patients with ocular and nonocular Behçet's disease.

AIMS: To investigate serum leptin levels in Behçet's patients with or without ocular involvement compared with healthy subjects and the relationship between serum leptin and uveitis activity in patients with ocular involvement. METHODS: Fifty-seven patients with Behçet's disease and 20 healthy control subjects were included in this study. While 27 patients had ocular involvement (18 had acute uveitis, 9 had inactive ocular involvement), 30 did not have ocular disease. C-reactive protein, alpha 1-antitrypsin, and serum leptin levels were measured in all samples. RESULTS: There was a significant difference between the patients with Behçet's disease and control group for both logarithm of leptin (P = .000) and logarithm of CRP (P = .031). Logarithm of leptin in non-ocular Behçet's patients was significantly higher compared to its level in ocular Behçet's disease and controls (P = .009). There was a significant difference between the patients with active ocular disease and control group (P = .03). CONCLUSIONS: Leptin might have a possible role in the pathogenesis of Behçet's disease.

The decrease in erythrocyte sedimentation rate related to general anesthesia.

The aim of this study was to investigate whether general anesthetic agents change erythrocyte sedimentation rate (ESR) affecting erythrocytes' shape and membrane structure in routine clinical dose manner. Forty patients (23 female and 17 male) undergoing elective surgery were included to the study. Blood samples were obtained just before induction of the anesthesia and 10 minutes after endotracheal intubation. The ESR was measured using Test-1 ESR analyzer. ESR values of the second blood samples were significantly lower than the first values (p<0.001). At the beginning, the ESR was 18.1+/-11.5 mm/h, and then it decreased to 13.1+/-9.3 at 10th minutes. Our results indicated that anesthetic agents affected the ESR. No increase was observed in the second ESR values which were equal to, or less than the first values. General anesthesia may lead to this decrease changing electrolyte balance of erythrocyte, affecting ligands of agglomerins in membrane directly and indirectly, or changing discoid shape of erythrocyte.

Effects of different anesthetic techniques on serum leptin, C-reactive protein, and cortisol concentrations in anorectal surgery.

AIM: To compare the effects of intratracheal general anesthesia (ITGA) and regional (saddle block) anesthesia on leptin, C-reactive protein (CRP), and cortisol blood concentrations during anorectal surgery. METHODS: Fifty-eight patients suffering from hemorrhoidal disease, pilonidal sinus, anal fissure, or anal fistula were included the study. Patients were randomly assigned into one of the two groups (n=29). Patients in one group received ITGA. After thiopental and fentanyl induction, vecuronium was used as a muscle relaxant. Anesthesia was maintained with sevoflurane. In the other group we applied saddle block, injecting hyperbaric bupivacaine into the subarachnoid space, through the L3-L4 intervertebral space, in the sitting position. Blood samples were collected for leptin, CRP, and cortisol analysis before the induction of anesthesia at 3 and 24 hours postoperatively. RESULTS: Preoperative leptin, CRP, and cortisol concentrations were comparable between the groups. There was no significant difference in postoperative levels of leptin and CRP in both groups. Although not significant, leptin and CRP concentrations were lower in the saddle block group at three hours postoperatively (mean-/+SD, 6.95-/+8.59 and 6.02-/+12.25, respectively) than in the ITGA group (mean-/+SD, 9.04-/+9.89 and 8.40-/+15.75, respectively). During early postoperative period, cortisol increased slightly in the ITGA group and remained at similar level in the saddle block group, but later decreased in both groups. Cortisol levels in the saddle block group were significantly lower than in the ITGA group at 3 hours postoperatively (343.7-/+329.6 vs 611.4-/+569.8; P=0.034). CONCLUSION: Saddle block, a regional anesthetic technique, may attenuate stress response in patients undergoing anorectal surgery, by blocking afferent neural input during early postoperative period.

The Effect of Simvastatin on Pulmonary Damage in Experimental Peritonitis in Rats.

Statins are widely used in the treatment of hyperlipidemia, as they inhibit cholesterol synthesis. They also have anti-inflammatory, antioxidant, immunomodulatory, and positive endothelial-functional effects. It is hypothesized that simvastatin ameliorates pulmonary damage secondary to peritonitis in rats. Forty Wistar albino rats were divided into four groups. In sham group, laparotomy was the standard procedure. In simvastatin group, simvastatin was given perorally before laparotomy. In sepsis group, peritoneal sepsis was constituted by cecal ligation and puncture technique. In sepsis + simvastatin group, the procedures of simvastatin and sepsis groups were applied together. After sacrification at the 72nd hour, tissue samples from lungs were harvested for histopathological examination, wet and dry weight measurements, and tissue culture, tissue malondialdehyde, and nitric oxide tests. Blood samples were taken for C-reactive protein and whole blood count. While the malondialdehyde levels were found to be significantly higher in sepsis group, nitric oxide levels were found to be significantly lower in simvastatin + sepsis group. Alveolar hemorrhage was highest in simvastatin + sepsis group. There was no difference for C-reactive protein, leukocyte levels, and histopathological examination between any groups. The ratios of wet and dry lung weights were higher in simvastatin-given groups. Simvastatin has no positive effect in terms of lung dysfunction on experimental sepsis model. For a better understanding of the effects of simvastatin on lung injury in peritoneal sepsis, experimental models of longer duration that enable to search the effects of simvastatin beyond 3 days will be more useful.