Protective effect of nebivolol on gentamicin-induced nephrotoxicity in rats.

OBJECTIVE: Nephrotoxicity is a major complication of gentamicin (GEN), which is widely used in the treatment of severe Gram-negative infections. As we know, treatment with nebivolol has been shown to decrease renal fibrosis and glomerular injury as well as improve endothelial dysfunction. Therefore, we evaluated the potential protective effect of nebivolol (NBV) against GEN-induced nephrotoxicity in rats. MATERIAL AND METHOD: Twenty-four rats were randomly divided into four groups: control group (Group 1); rats intraperitoneally injected with GEN (100 mg/kg/day; Group 2); rats treated with GEN plus distilled water (Group 3); and rats treated with GEN plus NBV (10 mg/kg/day; Group 4). After 15 days, the rats were sacrificed, their kidneys taken, and blood analysis performed. Tubular necrosis and interstitial fibrosis scores were determined histopathologically in a part of kidneys; nitric oxide (NO), malondialdehyde (MDA), and reduced glutathione (GSH) levels were determined in other part of kidneys. RESULTS: The GSH levels in renal tissue of only GEN-treated rats were significantly lower than those in control group, and administration of NBV to GEN-treated rats significantly increased the level of GSH. The group that was given GEN and NBV had significantly lower MDA and NO levels in kidney cortex tissue than that given GEN alone. Despite the presence of mild tubular degeneration, the rats treated with GEN+NBV showed a less severe tubular necrosis, and their glomeruli maintained a better morphology compared to GEN group. CONCLUSION: NBV exerts antioxidant, anti-inflammatory and antifibrotic effects on GEN-induced kidney damage by reducing oxidative stress in rat model (Tab. 3, Fig. 2, Ref. 68).

Lipoprotein-associated phospholipase A2 levels are associated with erectile dysfunction in patients without known coronary artery disease.

Endothelial dysfunction and microvascular damage play a crucial role in the pathogenesis of erectile dysfunction (ED). Lp-PLA2 is a calcium-independent member of the phospholipase A2 family and hydrolyses oxidised phospholipids on low-density lipoprotein (LDL) particles that plays a pivotal role in ox-LDL-induced endothelial dysfunction. The purpose of the current study was to determine the association between Lp-PLA2 levels and ED in patients without known coronary artery disease (CAD). All patients were evaluated for ED and divided into two groups: 88 patients suffering from ED for >1 year were enrolled as an experimental group and 88 patients without ED were enrolled as a control group in this study. Diagnosis of ED was based on the International Index of Erectile Function Score-5. Levels of Lp-PLA2 were measured in serum by colorimetric assay. The relationship between Lp-PLA2 levels and ED in patients was evaluated statistically. The mean age of patients with ED group was 59.4 ± 11.32 and 55.8 ± 9.67 in the control group. Plasma Lp-PLA2 levels were significantly higher in ED than in the control group (220.3 ± 66.90 and 174.8 ± 58.83 pg ml(-1) , respectively, P < 0.001). The Lp-PLA2 levels were negatively correlated with score of ED (r = -0.482, P < 0.05). In logistic regression analysis, enhanced plasma Lp-PLA2 levels result in approximately 1.2-fold increase in ED [1.22 (1.25-2.76)]. In this study, serum Lp-PLA2 levels were found to be associated with endothelial dysfunction predictive of ED. Serum Lp-PLA2 level appears to be a specific predictor of ED, and it may be used in early prediction of ED in the male population.

Relevance of serum nitric oxide levels and the efficacy of selective serotonin reuptake inhibitors treatment on premature ejaculation: decreased nitric oxide is associated with premature ejaculation.

The aim of the present study was to determine the relevance of serum nitric oxide levels and the efficacy of selective serotonin reuptake inhibitors (SSRI) treatment on premature ejaculation. Sixty married men (aged 20-50) with lifelong premature ejaculation and forty healthy men (aged 24-48) as control group were included in this study. The patients were evaluated by intravaginal ejaculation latency time (IELT) for premature ejaculation (PE). IELT<1 min is accepted PE. Patients with diabetes mellitus, chronic disorders or erectile dysfunction and heavy smokers were excluded. All patients were evaluated with history, physical examination, International Index of Erectile Dysfunction-5 (IIEF-5) score and IELT by stopwatch method. Nitric oxide levels were measured by Griess reaction, and all samples were frozen at -80 °C. Patients were randomly categorised 4 group to receive fluoxetine 20 mg day(-1) (Group 1), paroxetine 20 mg day(-1) (Group 2), sertraline 50 mg day(-1) (Group 3) and healthy control (Group 4) for 4 weeks. Baseline and post-treatment findings were compared between the four groups. At the end of 4 weeks, in fluoxetine, paroxetine, sertraline groups mean IELT values showed a statistically significant improvement from the baseline values (P < 0.001, P < 0.001, P = 0.03; respectively). Baseline and 1st month follow-up mean IIEF scores were 24.5 and 23.05, 24.70 and 23.60 (P < 0.05) in group 1 and group 3 respectively; also 23.09 and 23.32 (P > 0.05) in group 2. Baseline serum NO levels were 31.8, 30.44, 30.8 and 42.84 in fluoxetine, paroxetine, sertraline and healthy control groups respectively. NO levels were statistically lower in patients with PE. After treatment of fluoxetine, paroxetine and sertraline, NO levels were increased baseline (35.8, 36.4, 38.08) (P < 0.05). Our findings indicated that PE is associated with decreased serum NO levels. After the SSRI treatment increased, NO may retard ejaculation presumably by central peripheral mechanism. Further studies are needed to confirm this suggestion and the role of NO in pathophysiology and treatment for premature ejaculation.

EFFECTS OF STANDARD AND/OR GLUTAMINE DIPEPTIDE AND/OR OMEGA-3 FATTY ASCID-SUPPLEMENTED PARENTERAL NUTRITION ON NEUTROPHIL FUNCTIONS, INTERLEUKIN-8 LEVEL AND LENGTH OF STAY--A DOUBLE BLIND,CONTROLLED, RANDOMISED STUDY.

BACKGROUND AND AIMS: Protein calorie malnutrition for cancer patients is related with altered cellular and humoral immunity. Standard TPN and glutamine and lipid emulsion with omega 3 fatty acids were given to colorectal cancer patients and the effects of these to neutrophil functions and IL-8 levels are compared. METHODS: Consecutive 36 patients with colorectal cancer diagnosed with endoscopic biopsy and with malnutrition determined by subjective global assessment were enrolled to study. The patients are randomly divided into four groups. Standard TPN to control group, TPN with glutamine solution to S-D group, TPN with omega 3 fatty acid solution to S-O group and TPN with omega 3 fatty acids solution and glutamine to S-D-O group were given for seven days after the operation. At the preoperative, postoperative first day and 7th day, neutrophil phagocytosis index, neutrophil adhesivity index and IL-8 levels were determined. RESULTS: In all groups compared to control group neutrophil phagocytosis index were increased significantly (p<0.05). The most increasing was in group 3. There wasn't significant difference between groups about postoperative first day neutrophil adhesiveness index (p>0.05). At the 7th day the neutrophil adhesivity index for study groups were increased compared with control group, but there was no significant differences between groups. There was no significant difference between groups for IL-8 levels. CONCLUSIONS: As a result of the study, altered cellular immunity in colorectal cancer patients with malnutrition can be corrected with omega 3 fatty acid emulsions and glutamine added to TPN so the ratio of morbidity and mortality can be decreased.

Nitric oxide and malondialdehyde levels in plasma and tissue of psoriasis patients.

BACKGROUND: The pathogenesis of psoriasis has not been known exactly yet. Recently, it has been suggested that increased reactive oxygen species (ROS) such as nitric oxide (NO) and malondialdehyde (MDA) may play a part in the pathogenesis of various skin diseases, including psoriasis. OBJECTIVES: In this study, we aimed to investigate the role of ROS in the pathogenesis of psoriasis. METHODS: A convenience sample of 23 patients with psoriasis and 23 healthy subjects consented to participate in the study. Plasma NO and MDA levels were measured in all participants. Psoriasis area and severity index (PASI) and tissue levels of MDA on lesional and non-lesional skin regions of psoriasis patients were measured. In addition, the correlation between age, gender with plasma NO, plasma MDA and tissue MDA was assessed. RESULTS: Plasma levels of NO and MDA in psoriasis patients (135.8 µmol/L, 4.33 µmol/L, respectively) were statistically significantly higher than those in controls (33.6 µmol/L, 2.03 µmol/L, respectively). Tissue levels of MDA in lesional tissues (49.18 nmol/gr) were significantly higher than those in non-lesional tissues (28.41 nmol/gr). A significant correlation was not found between the PASI and levels of NO and MDA. In addition, a significant negative correlation was found between the plasma NO levels and age. CONCLUSION: NO and MDA levels are elevated in psoriasis patients, which may indicate that oxidative stress plays an important role in the aetiopathogenesis of psoriasis.

Potential role of p38-mitogene-activated protein kinase and nuclear factor-kappa B expression in testicular dysfunction associated with varicocele: an experimental study.

The aim of this study was to investigate p38-mitogene-activated protein kinase (p38-MAPK), nuclear factor-kappa B (p65-NF-kB) and inducible nitric oxide synthase (iNOS) expression in an experimental model of varicocele in the rat testis. Male Wistar albino rats (n = 18) were divided into three equal groups: control group, sham operated group and left varicocele-induced group. Malondialdehyde (MDA), nitric oxide (NO) and reduced glutathione (GSH) levels were biochemically assessed, and the p38-MAPK and NF-kB activity, and iNOS expression were immunohistochemically studied in the right and left testicles of rats from each group. The GSH levels were significantly decreased, whereas the level of MDA and NO was significantly increased in the testicular tissues of rats in varicocele group compared with those of the control and sham groups. There was a marked staining for iNOS, p38-MAPK and p65-NF-kB expression in rats of varicocele group compared with the sham group. There was no positive staining in rats of control group. There were significant differences in biochemical, histological and immunohistochemical studies, but no significant differences were noted between other groups. p38-MAPK and p65-NF-kB activation, and iNOS expression have a significant role in varicocele-induced testicular dysfunction.

Plasma adrenomedullin levels in children with asthma: any relation with atopic dermatitis?

BACKGROUND: Asthma is a chronic, inflammatory disease of the airway, and adrenomedullin (ADM) may have some effects against bronchoconstriction. However, the role(s) of ADM in asthmatic children have not been evaluated yet. The aims of this study were to determine if there are any changes in plasma ADM levels during acute asthma attack, and to search for any association between allergen sensitivity and ADM level in asthmatic children. METHODS: Twenty-seven children with acute asthma attack, ranging in age from 5 to 15 years were investigated and compared with 20 controls. Plasma ADM levels (ng/mL) were measured by ELISA method. RESULTS: No significant difference was found in ADM levels between the controls and patients in either the acute attack or remission period. Plasma ADM levels were significantly higher in the acute attack (p=0.043) compared to the remission period in patients who were considered as having a "severe attack" according to GINA (Global Initiative for Asthma) classification. There were statistically significant correlations between the patients' AlaTOP and Food Panel 7 levels and plasma ADM levels in the acute attack period (p=0.010, p=0.001, respectively). The ADM levels in patients with a history of atopic dermatitis were significantly higher in the acute attack period compared to those without a history of atopic dermatitis (p=0.007). CONCLUSION: We speculate that ADM may have a role in children with atopic dermatitis, and may also have a role in the immuno-inflammatory process of asthma.

Protective effect of hydrogen sulfide on experimental testicular ischemia reperfusion in rats.

AIM: Testicular torsion is an urgent urological condition. Ischemia-reperfusion (I/R) processes that occur after detorsion as a treatment for torsion are caused by testicular injury. The purpose of our study is investigating the protecting effect of hydrogen sulfide (H2S) on the testicular ischemia reperfusion injury. MATERIALS AND METHODS: Thirty-eight Wistar-Albino rats were divided randomly into 6 different groups: Control (6); sham (6); IR-E (6)-2 h of torsion and 4 h of reperfusion; IR-E + H2S (6)-in addition to the IR-E group, 75 µmol/kg of sodium hydrogen sulfide (NaHS) was administered intraperitoneally 30 min before reperfusion; IR-L (7)-2 h of torsion and 24 h of reperfusion; IR-L + H2S (7)-in addition to the IR-L group, 75 µmol/kg NaHS was administered intraperitoneally 30 min before reperfusion. Biochemically, nitric oxide (NO), malondialdehyde (MDA), superoxide dismutase (SOD), reductive glutathione (GSH), and tumor TNF-α levels were measured in the testis. Serum TNF-α levels were also measured. Hematoxylin and eosin (H & E) was used for histopathological staining and microscopic findings were examined. The Johnsen score was performed to assess spermatogenesis activity in the testis. Apoptosis protease activating factor-1 (Apaf-1) and inducible nitric oxide synthase (iNOS) activity were evaluated immunohistochemically as well. Statistical analyses were made by the Chi-squared test and one-way analysis of variance. RESULTS: MDA and NO levels were significantly increased in the IR-L group compared with sham and which decreased by the addition of H2S treatment to the IR-L group (p < 0.05) in biochemical evaluation. GSH vs SOD levels were decreased in the IR-L group compared with sham and which increased by the addition of H2S treatment to the IR-L group, but this correlations were not statistically significant (p > 0.05). Tissue and serum TNF-α levels were significantly increased in the IR-E group compared with sham and which decreased by the addition of H2S treatment to the IR-E group. Johnsen score was the lowest in IR-L group (p < 0.05). Apaf-1 and iNOS activity were significantly increased in the IR-L group compared with sham and which decreased by the addition of H2S treatment to the IR-L group (p < 0.05) in immunohistochemical evaluation. CONCLUSIONS: First, the authors would like to say that H2S treatment is protective and it is against ischemia reperfusion injury in testicular torsion. The anti-inflammatory, antioxidant, and antiapoptotic properties of H2S caused protective effect as shown in this study.

Effects of L-NAME and timolol on aqueous IL-1beta, IL-6, IL-8, TNF-alpha and NO levels after Nd:YAG laser iridotomy in rabbits.

PURPOSE: Pro-inflammatory cytokines are produced by tissues and play a vital role in the host inflammatory response and uveitis. Nitric oxide (NO) can be produced in large amounts as a response to experimentally-induced uveitis or cytokines. In this study, we measured the levels of pro-inflammatory cytokines such as interleukin (IL)-1beta, IL-6, IL-8, tumor necrosis factor (TNF)-alpha and free-radical in aqueous humor after Nd:YAG laser iridotomy in rabbits, and investigated whether timolol maleate an anti-glaucoma drug, or a NO synthase inhibitor, NG-nitro-L-arginine methyl esther (L-NAME) had an inhibitory effect on these molecules, since L-NAME is a known anti-inflammatory agent in rabbits. METHODS: Bilateral experimental Nd:YAG laser iridotomy (power 7.5 mJ, mode single burst, aiming beam 4) was performed on 18 rabbits under general plus topical anesthesia. Aqueous humor samples were taken by clear corneal paracentesis preoperatively, and 1 and 24 h postoperatively. Six rabbits (12 eyes) were given bilateral topical timolol maleate 0.5% (Timoptic) drop b.i.d. (group 1), six rabbits (12 eyes) received bilateral 0.1 ml subconjuntival injections of L-NAME (150 mg/kg) (group 2), and six rabbits (12 eyes) were treated with topical balanced salt solution (BSS) b.i.d. (control). RESULTS. Preoperative cytokine and NO levels were comparable in the three groups, with no significant differences. In addition, there was no significant difference in baseline cytokine levels between the right and left eyes. In all groups, pre- and postoperative mean IL-1beta levels were below the detection limit of the assay (<5.0 pg/ml). In the control group, postoperative mean IL-6, IL-8 and NO levels were significantly higher after Nd:YAG laser iridotomy than before (for each, p < 0.01). Timolol and L-NAME both inhibited the rise in IL-8 and TNF-alpha levels. Timolol also inhibited the rise in IL-6 but not NO. L-NAME had an inhibitory effect against NO, but not IL-6. CONCLUSIONS: L-NAME has an inhibitory effect on IL-8, TNF-alpha and NO, but not on IL-6. Timolol had inhibitory effects on IL-6, IL-8 and TNF-alpha, but not on NO. These preliminary experimental results might help in assssing the effect of Nd:YAG laser iridotomy in aqueous humor, and to understand the inhibitory effects of timolol and L-NAME against these molecules.

Changes in serum CA-125 levels after laparotomy?

There is no adequate data in the medical literature defining serum CA-125 levels after laparotomy. Therefore we designed this prospective study to evaluate the effects of laparotomy for hysterectomy on serum CA-125 levels. Ninety-four women (mean age 44.6 +/- 6.9 years) were included in the study between January, 2001 and April, 2003. Hysterectomies were performed in patients with chronic pelvic pain, dysfunctional uterine bleeding and myoma uteri. Mean serum CA-125 levels of the patients before and after laparotomy were 16.29 +/- 8.11 U/ml and 16.37 +/- 8.05 U/ml, respectively. The change in serum CA-125 levels prior to the operation was statistically insignificant when compared with the levels obtained at 24 hours after laparotomy (p > 0.05). We found that laparotomy for hysterectomy did not change the levels of CA-125 at the 24th hour after the operation, indicating either serum CA-125 levels are not correlated, at least within 24 hours, with peritoneal irritation or peritoneal irritation was minimal or absent in our operations.

Is there a change in serum CA-125 levels after laparoscopy?

There is no adequate data in the medical literature defining serum CA-125 levels after laparoscopy. Therefore we designed this prospective study to evaluate the effects of laparoscopy on serum CA-125 levels. Eighty-two women (mean age 34.2 +/- 12.30 years) were included in the study between January, 2001 and April, 2003. Laparoscopies were performed in patients with chronic pelvic pain, dysmenorrhea, infertility, ovarian cysts and for tubal ligation. Mean serum CA-125 levels of the patients before and after the laparoscopic procedures were 13.96 +/- 4.86 U/ml and 14.02 +/- 4.96 U/ml, respectively. The change in serum CA-125 levels prior to laparoscopy was statistically insignificant when compared with the levels obtained at 24 hours after laparoscopic procedure (p > 0.05). We found that diagnostic laparoscopy or laparoscopic surgical procedures did not change the levels of CA-125 at the 24th hour after laparoscopy indicating either serum CA-125 levels are not correlated, at least within 24 hours, with peritoneal irritation or peritoneal irritation is minimal or absent in our operations.

The levels of cytokines and nitric oxide in rabbit vitreous humor after retinal laser photocoagulation.

OBJECTIVE: To determine the levels of nitric oxide (NO) and cytokines such as interleukin 1-beta (IL-1beta), interleukin 6 (IL-6), interleukin 8 (IL-8), and tumor necrosis factor-alpha (TNF-alpha) on vitreous humor following retinal laser photocoagulation. MATERIALS AND METHODS: The rabbits were divided into 3 groups of 4 animals (8 eyes) each. Twelve pigmented rabbit eyes underwent modified grid pattern photocoagulation with a power of 240 mW (group I); 300 mW (group II); and 360 mW (group III). The eyes received 200 burns using a spot size of 200 micro, and duration of 0.2 s. Vitreous humor samples were collected from each eye preoperatively and at 24 and 72 hours after the laser. RESULTS: When compared to preoperative levels, IL-6 levels were increased in all groups; IL-1beta levels were increased significantly only in group III. IL-8 levels were high in groups II and III only at 72 hours (P <0.05). TNFalpha levels were elevated significantly in group II and III only at 24 hours (P <0.05). NO levels were significantly higher than preoperative values in all groups at all times. CONCLUSION: Our results support that especially IL-6, IL-8, and NO levels increase significantly following laser photocoagulation. This preliminary study suggests that IL-6, IL-8, and NO might be dominant contributing factors in the occurrence of the inflammation postoperatively.

BK virus nephropathy developing after renal transplantation and its treatment with ciprofloxacin: a case report.

BK virus nephropathy (BKVN) is among the most important problems in renal transplant recipients. This report presented an assessment of treatment with a fluoroquinolone antibiotic, ciprofloxacin, for 6 months in a 21-year-old male patient who developed BKVN after transplantation. Ciprofloxacin treatment reduced the viral load and improved the clinical findings.

Increased serum nitric oxide and malondialdehyde levels in patients with acute intestinal amebiasis.

OBJECTIVE: To determine the level of oxygen-nitrogen stress parameters in the pathogenesis of amebiasis. METHODS: Twenty-four acute intestinal amebiasis patients and 20 healthy controls were enrolled in the present study. Serum malondialdehyde and nitric oxide levels were determined spectrophotometrically. RESULTS: Serum malondialdehyde and nitric oxide levels were significantly higher in acute intestinal amebiasis patients than healthy controls (P<0.001). CONCLUSIONS: These results suggest that oxidative and nitrosative stress may play a major role in tissue damage in acute intestinal amebiasis patients. Also these parameters can be used to supplement the conventional microscopic method for reliable diagnosis of intestinal amebiasis.

Monitoring of hepatitis B virus surface antigen escape mutations and concomitantly nucleos(t)ide analog resistance mutations in Turkish patients with chronic hepatitis B.

BACKGROUND: The hepatitis B virus (HBV) polymerase gene completely overlaps with the envelope gene. In the present study we aimed to monitor the prevalence and pattern of the typical mutations for hepatitis B surface antigen (HBsAg) escape, and concomitantly nucleos(t)ide analog (NUC) resistance mutations, in Turkish patients undergoing different antiviral therapies and in treatment-naïve patients with chronic hepatitis B (CHB). METHODS: The investigation was undertaken between March 2007 and August 2009 and involved a total of 142 patients under NUC therapy (88 males; mean age 42 years (range 13-68); hepatitis B e antigen (HBeAg) negativity in 94 patients; HBV DNA median log 4.3 log(10) IU/ml (range 2.0->6.0); alanine aminotransferase (ALT) median level 76.1 IU/ml (range 12-1082)) and 185 treatment-naïve CHB patients (120 males; mean age 39 years (range 1-76 years); HBeAg negativity in 132 patients; HBV DNA median log 3.5 log(10) IU/ml (range 2.0-6.0); ALT median level 60.7 IU/l (range 8-874)). RESULTS: The overall prevalence of typical HBsAg escape mutations found in the CHB patients was 8.3% (27/327). In the NUC therapy group the prevalence was 8.5% (12/142), with the following patterns: sY100C+sI110V, sL109I, sP120T, sP127T, sG130R+sG145X, sS132A+sY134N, sY134N+sG145R, sC137G, sD144E, sG145R. In the treatment-naïve group the prevalence was 8.1% (15/185), with the following patterns: sL109I, sI110V, sS117INST, sP120T, sP127T, sM133I, sC137L+sG145R, sS143L. However, NUC resistance mutations were found in 7.7% (11/142) of the patients on NUC therapy and 3.8% (7/185) of the treatment-naïve group patients. Interestingly, the treatment-naïve patients had preexisting drug resistance mutations related to lamivudine (rtL180M+rtM204I), adefovir (rtA181V, rtQ215S, rtI233V), entecavir (intermediate susceptibility with rtL180M+rtM204IHBV variant), telbivudine (rtL180M+rtM204I), and tenofovir (rtA194T). CONCLUSIONS: The findings of this study show preexisting typical HBsAg escape and NUC resistance mutations are possible. The genetic arrangement of the HBV genome with polymerase and surface genes overlapping has substantial public health and diagnostic implications and relevance.

Curcumin prevents oxidative renal damage induced by acetaminophen in rats.

Acetaminophen (APAP) can cause life-threatening renal damages and there is no specific treatment for APAP-induced renal damage. The aim of this study was to investigate the protective effects of curcumin (CMN) on APAP-induced nephrotoxicity. Nephrotoxicity was induced in male Wistar Albino rats by the administration of a single dose of 1000 mg/kg APAP intraperitoneally (i.p.). Some of these rats also received i.p. CMN (200mg/kg) at 30 min after the administration of APAP. Twenty-four hours after the administration of APAP, all the rats were sacrificed with a high dose of ketamine. Urea and creatinine levels were measured in the blood, and the levels of malondialdehyde (MDA) and glutathione (GSH), and antioxidant enzyme activity were determined in the renal tissue. Histopathological changes were studied. APAP administration caused elevated levels of renal MDA, and marked depletion of GSH levels and antioxidant enzyme activity, and deteriorated the renal functions as assessed by the increased plasma urea and creatinine levels as compared to control rats. CMN markedly reduced the elevated MDA levels, significantly increased the antioxidant enzyme activity and normalized the altered renal morphology in rats treated with APAP. CMN might be a potential candidate agent against APAP-induced nephrotoxicity, but further studies are required to identify this issue before clinical application becomes possible.

Effect of ascorbic acid on surgical stress response in gynecologic surgery.

Surgical stress may cause neural, endocrine, metabolic and humoral responses depending on the severity of the procedure. In this study, we aimed to study the effect of the preoperatively given ascorbic acid (AA), which is an antioxidant, and its role in the biosynthesis of neuropituitary hormones on the surgical stress response. Twenty-two American Society of Anaesthesiologists I and II patients ageing between 18 and 40, who have no endocrine and metabolic disease, and undergoing abdominal operation for non-malignant diseases were allocated to the study. These non-premedicated patients were divided into two groups in random: Group I, etomidate group; and Group II, AA plus etomidate group. AA was given to patients in Group II 20min before etomidate injection. After monitoring the patient, anaesthetic induction was applied by giving 0.3 mg/kg of etomidate, 2 microg/kg of fentanyl and 0.1 mg/kg of vecuronium. Anaesthesia was continued with 1-0.7% isoflurane and N2O/O2 (67 and 37%, respectively). Tramadol was given for the management of post-operative analgesia. Blood samples were obtained from all patients before the operation and at second, sixth, twelfth and twenty-forth hours after the beginning of operation for cortisol, adrenocorticotropic hormone (ACTH), osteocalcin, insulin and blood glucose level analyses. There was no statistically significant difference in cortisol, osteocalcin, insulin and glucose levels in both groups, when compared to the control levels. Whereas, patients in Group II had higher levels of cortisol than the control group at sixth hour, which were in normal limits, and there was no decrease in osteocalcin concentration. ACTH level was increased at the second and sixth hours, which was statistically significant, but at twelfth and twenty-forth hours, they were close to control group levels. As a result, we conclude that AA given before anaesthesia achieved by etomidate is not sufficient for the prevention of surgical stress response and that AA induction before anaesthesia should be preferred, particularly for the prevention of decrease in osteocalcin levels.

Oxidant and antioxidant levels in preterm newborns with idiopathic hyperbilirubinaemia.

OBJECTIVES: Newborns, particularly preterm infants, have limited antioxidant protective capacity. The organism's defence system against reactive oxygen species including vitamins A, E and C, trace element selenium (Se) and enzymes, such as catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) are essential components of the antioxidant system against the oxidative injury to the cellular membranes of erythrocytes. In this study, our aim was to compare the oxidant nitric oxide (total plasma nitrite level as an indicator of nitric oxide (NO)), antioxidant vitamins and selenium and erythrocyte antioxidant enzymes in premature babies with hyperbilirubinaemia with healthy preterms. METHODS: Twenty preterm infants with newborn jaundice were included in the study group, while 15 preterm infants without jaundice were enrolled in the control group. We evaluated the mean plasma levels of, respectively, the total nitrite as an indicator of NO, bilirubin, vitamins A, E, C and selenium, and the activity of erythrocyte antioxidant enzymes such as CAT, SOD and GSH-Px of preterm infants with idiopathic hyperbilirubinaemia and compared to those of the control group. RESULTS: The mean plasma total nitrite and total serum bilirubin levels and blood reticulocyte counts of the study group were found to be significantly higher than those of the control group (P < 0.001, P < 0.001 and P < 0.05, respectively). Furthermore, the activity of erythrocyte antioxidant enzymes (all P < 0.001) and the mean plasma levels of the antioxidant vitamins A, E, and C (P < 0.05, P < 0.05 and P < 0.001, respectively) and selenium (P < 0.001) of the study group were all found to be significantly lower than those of the control group. CONCLUSION: We hypothesize that low antioxidants in pretem babies may predispose them to increased oxidative stress, and cause hyperbilirubinaemia.

Quantification of nitric oxide and cytokines in rabbit aqueous humor after neodymium:YAG laser capsulotomy.

PURPOSE: The purpose of this study was to evaluate the presence of nitric oxide (NO) and cytokines such as interleukin 1 beta, interleukin 2 receptor (IL-2R), interleukin 6 and tumor necrosis factor alpha on aqueous humor after neodymium:YAG (Nd:YAG) laser posterior capsulotomy. METHODS: Fifteen rabbits (30 eyes) with dense posterior capsule opacities underwent Nd:YAG capsulotomy 4 months after phacoemulsification cataract surgery. After general and topical anesthesia, Nd:YAG capsulotomy was performed using an equal number of shots and power setting on all eyes. Aqueous humor specimens were collected from each eye preoperatively and at 12, 24 and 48 h after the surgery to determine NO and cytokine levels. RESULTS: The levels of NO and cytokines except IL-2R were significantly high as compared to preoperative levels in all eyes at 12 and 24 h postoperatively (p < 0.05). Although the levels of NO and cytokines were higher than preoperative levels at 48 h, the differences were not statistically significant (p > 0.05). CONCLUSION: These findings suggest that NO and cytokines appear to be potential inflammatory mediators in the occurrence of early inflammation following Nd:YAG posterior capsulotomy.

Adrenomedullin and nitrite levels in children with minimal change nephrotic syndrome.

Nitric oxide (NO) serves many functions within the kidney, and recent evidence suggests that NO contributes to glomerular injury. Adrenomedullin (AM) is a novel hypotensive peptide originally isolated from human pheochromocytoma. Recent studies showed that plasma AM concentrations correlated with the extent of proteinuria. We have examined the possible role of these two agents by studying plasma and urinary total nitrite (NO-2 + NO-3) and AM levels in children with minimal change nephrotic syndrome (MCNS). In comparison with healthy controls, children with MCNS had increased urinary nitrite excretion (micromol/mg urinary creatinine), irrespective of whether the disease was in relapse or remission (3.2+/-0.2 in relapse, n=13; 1.9+/-0.3 in remission, n=12; 1.0+/-0.2 in controls, n=10, P<0.05). Plasma nitrite levels (micromol/l) were high in relapse compared with controls (53.2+/-8.7 vs. 32+/-4.0, P<0.05). Plasma AM levels (pmol/ml) were decreased in relapse (27.6+/-1.4 in relapse, 43.3+/-1.2 in remission, 41.5+/-1.6 in controls, P<0.05). Urinary AM levels (pmol/mg urinary creatinine) were significantly higher in relapse than in remission and in controls (156+/-43 in relapse, 56+/-18 in remission, 36+/-16 in controls, P<0.05). Our data indicate that NO may play a role in mediating the clinical manifestations of MCNS in children. However, changes in AM levels may be the result of heavy proteinuria.