The Cutoff Level for Urine Protein in Urine Immunofixation Electrophoresis.

BACKGROUND: Immunofixation electrophoresis (IFE) maintains its importance in diagnosing monoclonal gammopathies. In particular, urine IFE detects free light chains (FLC) in urine samples even at low concentrations and offers higher sensitivity compared to serum electrophoresis and serum IFE. The aim of the present study was to determine the place and significance of quantitative urinary protein measurement before IFE in interpreting the results of subsequent IFE and to determine the most appropriate protein concentrations for the appearance of bands. METHODS: The records of a total of 600 patients, who underwent screening for Bence Jones proteinuria using IFE on 24-hour urine, were retrospectively reviewed. Urine IFE was performed using Helena SAS-I and SAS-I devices. The total protein concentration in the urine was quantitatively determined by the Pyrogallol red method, and the urine albumin level was determined using the immunoturbidimetric method. These analyses were measured on an Olympus/Beckmann AU5800. RESULTS: The evaluation of IFE results revealed that 311 patients had normal results, 108 patients had monoclonal bands, five patients had biclonal bands, 28 had polyclonal bands, and 148 patients had various degrees of proteinuria. ROC curves were created in order to determine the most appropriate urinary protein and albumin levels to observe bands in IFE. Accordingly, urine baseline protein level (mg/dL) showed the highest AUC value (cutoff value: 19.4 mg/dL, sensitivity: 92%, specificity: 98.2%, AUC: 0.972). CONCLUSIONS: The present study showed that quantitative protein measurement before IFE eliminated the disadvantages associated with the IFE method and its interpretation.

Multiple myeloma: relationship to antioxidant esterases.

OBJECTIVE: To investigate the status of the oxidant/antioxidant balance in patients with multiple myeloma compared to healthy controls. MATERIALS AND METHODS: This study was conducted on 40 multiple myeloma patients and 40 healthy controls of matched age and sex. Serum total thiol, oxidative stress index (OSI), total oxidant status (TOS), and total antioxidant status (TAS) were measured using colourimetric methods; paraoxonase-1 and arylesterase enzyme activities were also quantified. RESULTS: Serum paraoxonase-1 and arylesterase activities and total thiol levels were significantly lower (p = 0.0001, p = 0.036 and p < 0.0001, respectively), whereas TOS and OSI levels were significantly higher (p < 0.0001 for both parameters) in multiple myeloma patients compared to controls. However, no significant differences in TAS were identified when the two groups were compared. CONCLUSIONS: Our findings indicate an impaired oxidative/antioxidative balance in multiple myeloma. We recommend further studies with larger groups to investigate the possible relationship between oxidative stress and the aetiopathogenesis of multiple myeloma.

Diminished arylesterase enzyme activity and total thiol levels in bladder cancer patients.

BACKGROUND: It is difficult to think of a disease in the etiology of which free radicals would not be involved. The human body has a number of endogenous free-radical scavenging systems to avoid harm that can lead to any disease including cancer. This study aims to measure the total anti-oxidative status (TAS), in particular the activities of HDL-associated anti-oxidative enzymes paraoxonase (PON1), arylesterase (ARE), and total thiol levels (Ttl) in bladder cancer (BC) patients for the first time in literature. METHODS: Forty two male patients (mean age, 66.6 +/- 12.7 years) with BC who had presented at the Urology Outpatient Clinic were prospectively included in the study. Forty age- and gender-matched healthy control subjects (mean age 65 +/- 7.4 years) were also enrolled for comparison. Analysis of PON1, ARE activities, measurement of TAS, and Ttl of serum were carried out using colorimetric measurement methods. Statistical analyses were performed using the MedCalc statistical software program. RESULTS: ARE enzyme activity and Ttl levels were significantly lower in patients with BC compared to controls (p = 0.03; p = 0.02, respectively), whereas PON1 enzyme activity and TAS did not show significant differences. Ttl levels were lower in patients with a high grade cancer compared to those with a low grade cancer (p = 0.03). CONCLUSIONS: Anti-oxidant measurements might be essential in routine clinical use, not only as cancer disease markers but also as major actors in the management of anti-oxidant remedies in the very near future. Our findings showed that determination of ARE enzyme activity and Ttl levels were more precise than PON1 enzyme activity or TAS measurements, particularly in BC patients. When composing a marker panel, it should be kept in mind that determination of anti-oxidant levels based merely on TAS or PON1 activity may be deceptive and must include ARE enzyme activity and/or Ttl measurements. However, long-term clinical studies are needed to clarify the pathophysiological role of serum anti-oxidative levels and HDL-associated PON1 activity in BC patients.

Decreased paraoxonase 1, arylesterase enzyme activity, and enhanced oxidative stress in patients with mitral and aortic valve insufficiency.

BACKGROUND: Oxidative stress is reportedly associated with several cardiovascular diseases. The antioxidant ability of high density lipoprotein (HDL) is, at least in part, attributable to the pleiotropic serum paraoxonase (PON1). The aim of the study was to investigate the body oxidant/antioxidant balance in patients with mitral regurgitation (MR) and aortic regurgitation (AR) to get new points of view for the underlying oxidative mechanisms. METHODS: Oxidative stress index (OSI), total oxidant status (TOS), and total antioxidant status (TAS) were examined in addition to the PON1 and arylesterase (ARE) enzyme activities in fifty-six patients and thirty-seven healthy control subjects. RESULTS: Serum PON1 and ARE enzyme activities were statistically significantly reduced in heart valve disease (HVD) patients (p = 0.0005 and p < 0.0001, respectively), whereas TOS and OSI levels were found to be significantly higher (p = 0.0021 and p < 0.0001, respectively). CONCLUSIONS: Serum PON1 activity is reduced in patients with HVD, caused by elevated oxidative stress and disturbances of heart valve metabolism. The findings from this novel detailed approach, implicate an inflammatory/oxidative stress process in the pathogenesis of the valve's presentation associated with the HVD. The strength of the significance in differences encourage us to propose that the role of oxidative stress in HVD pathogenesis is very prominent, and oxidative stress markers are potential ancillary tests to evaluate the state of the disease.

An evaluation of the change in serum SCUBE-1 levels with CPAP treatment in patients with severe obstructive sleep apnea.

OBJECTIVE: Signal peptide CUB-EGF domain-containing protein 1 (SCUBE-1) is a cell surface protein, wherein inflammation causes an increase in serum. The aim of this study was to compare serum SCUBE-1 levels in OSA patients and to investigate the serum SCUBE-1 change with CPAP treatment. METHODS: Blood samples were obtained from 61 severe OSA patients and from 25 control subjects evaluated as simple snorers. The 61 patients with severe OSA were treated with CPAP therapy and were recalled for follow up after 1 year. Evaluation was made after 1 year of CPAP therapy. RESULTS: Serum SCUBE-1 values were significantly higher in patients with severe OSA. The SCUBE-1 values significantly decreased after treatment with CPAP. CONCLUSION: Serum SCUBE-1 values in OSA patients showed a significant reduction in SCUBE-1 levels following 1 year of CPAP treatment.

Synthesis and photophysical characterizations of thermal-stable naphthalene benzimidazoles.

Microwave-assisted synthesis, photophysical and electrochemical properties of thermal-stable naphthalene benzimidazoles and naphthalimides are studied in this paper. Microwave-assisted synthesis of naphthalene benzimidazoles provide higher yields than the conventional thermal synthesis. Comparative photophysical properties of naphthalene benzimidazoles and naphthalimides are revealed that conjugation of electron-donating group onto naphthalimide moiety increases fluorescence quantum yields. Fluorophore-solvent interactions are also investigated using Lippert-Mataga equation for naphthalimides and naphthalene benzimidazoles. Thermal stabilities of naphthalene benzimidazoles are better than naphthalimides due to increased aromaticity. The experimental E(LUMO) levels of naphthalene benzimidazoles are found to be between 3.15 and 3.28 eV. Therefore, naphthalene benzimidazole derivatives consisting of anchoring groups are promising materials in organic dye sensitized solar cells.

A Machine Learning Approach for Metal Oxide Based Polymer Composites as Charge Selective Layers in Perovskite Solar Cells.

A library of metal oxide-conjugated polymer composites was prepared, encompassing WO3 -polyaniline (PANI), WO3 -poly(N-methylaniline) (PMANI), WO3 -poly(2-fluoroaniline) (PFANI), WO3 -polythiophene (PTh), WO3 -polyfuran (PFu) and WO3 -poly(3,4-ethylenedioxythiophene) (PEDOT) which were used as hole selective layers for perovskite solar cells (PSCs) fabrication. We adopted machine learning approaches to predict and compare PSCs performances with the developed WO3 and its composites. For the evaluation of PSCs performance, a decision tree model that returns 0.9656 R2 score is ideal for the WO3 -PEDOT composite, while a random forest model was found to be suitable for WO3 -PMANI, WO3 -PFANI, and WO3 -PFu with R2 scores of 0.9976, 0.9968, and 0.9772 respectively. In the case of WO3 , WO3 -PANI, and WO3 -PTh, a K-Nearest Neighbors model was found suitable with R2 scores of 0.9975, 0.9916, and 0.9969 respectively. Machine learning can be a pioneering prediction model for the PSCs performance and its validation.

Serum total homocystein, folate and vitamin B12 levels and their correlation with antipsychotic drug doses in adult male patients with chronic schizophrenia.

BACKGROUND: Elevated blood levels of homocysteine (hCY) have been associated with schizophrenic male patients. However, controversy remains regarding the association between lowered plasma folate and vitamin B12, hyperhomocysteinemia, and schizophrenia. Sixty-six (66) male patients with chronic schizophrenia were investigated to test the hypotheses that alterations in Hcy, folate, and vitamin B12 levels might be related to the antipsychotic drug doses used in treatment. METHODS: Serum total homocysteine, folic acid, and vitamin B12 levels were determined by chemiluminescence methods in both patients and control subjects. The patients were grouped according to the antipsychotic drug doses used in their treatment. RESULTS: Patients had higher homocysteine levels but they did not differ from controls in terms of folate and vitamin B12 levels. On the other hand, only folate levels were negatively correlated in the patient group treated with higher therapeutic doses of chlorpromazine equivalents (> 400 mg/day) compared to the patient group with lower doses (< 400 mg/day). CONCLUSIONS: Our findings show that higher typical antipsychotic drugs may play a role as modifiying factor for folate metabolism in chronic schizoprenic male patients.

Comparison of Machine Learning Models on Performance of Single- and Dual-Type Electrochromic Devices.

This study shows that the model fitting based on machine learning (ML) from experimental data can successfully predict the electrochromic characteristics of single- and dual-type flexible electrochromic devices (ECDs) by using tungsten trioxide (WO3) and WO3/vanadium pentoxide (V2O5), respectively. Seven different regression methods were used for experimental observations, which belong to single and dual ECDs where 80% percent was used as training data and the remaining was taken as testing data. Among the seven different regression methods, K-nearest neighbor (KNN) achieves the best results with higher coefficient of determination (R 2) score and lower root-mean-squared error (RMSE) for the bleaching state of ECDs. Furthermore, higher R 2 score and lower RMSE for the coloration state of ECDs were achieved with Gaussian process regressor. The robustness result of the ML modeling demonstrates the reliability of prediction outcomes. These results can be proposed as promising models for different energy-saving flexible electronic systems.

Circulating SCUBE1 levels in women with polycystic ovary syndrome.

OBJECTIVE: Polycystic ovary syndrome (PCOS) is thought to represent an early manifestation of metabolic syndrome, which is associated with cardiovascular disease. Signal peptide-CUB (complement C1r/C1s, Uegf, and Bmp1)-epidermal growth factor domain-containing protein 1 (SCUBE1) is a platelet activation marker that plays important roles in vascular biology and has been closely linked to cardiovascular events. In the present study, we investigated SCUBE1 levels in lean glucose-tolerant women with PCOS and assessed the possible association between SCUBE1 levels and hormonal and metabolic features of women with PCOS. MATERIALS AND METHODS: The study population consisted of 90 lean [body mass index (BMI) <25 kg/m2] women who were diagnosed as having PCOS using the Rotterdam criteria and 100 age- and BMI-matched healthy controls with no clinical or biochemical feature of hyperandrogenism. Glucose tolerance was evaluated in all subjects before recruitment using the 2 h 75 g oral glucose tolerance test, and only those exhibiting normal glucose tolerance were enrolled. Hormonal and metabolic parameters, and serum SCUBE1 levels were evaluated. RESULTS: Circulating SCUBE1 levels were significantly higher in women with PCOS than in controls (5.9±3.9 vs. 4.2±1.4 ng/mL, p=0.022). No association between SCUBE1 level and clinical or biochemical parameters was found in the control or PCOS group. CONCLUSION: SCUBE1 levels are elevated in women with PCOS compared with those in healthy controls; thus, this protein may be an early biomarker of cardiovascular disease later in life.

Relationship between thioredoxin and thioredoxin-binding protein in patients with gestational diabetes mellitus.

OBJECTIVE: This study examined the clinical and biological significance of thioredoxin (Trx) and thioredoxin-binding protein (TrxBP), which are redox-active proteins that control multiple biological functions, in gestational diabetes. METHODS: We measured serum concentrations of Trx, TrxBP, insulin and other blood parameters, as well as insulin resistance and glucose tolerance in pregnant women with or without gestational dieabetes mellitus (GDM) (34/34) at the early second trimester. RESULTS: Contrary to diabetes patients, serum TrxBP levels were lower in women with GDM than healthy pregnant controls. The serum insulin concentrations were higher in GDM, but the difference was not statistically significant. Furthermore, the intracellular redox potential ratio (Trx/TrxBP) of GDM patients was higher than that of the control group. CONCLUSION: During pregnancy, the mother is potentially subjected to glucotoxicity as well as oxidative stress (OS) to help the foetus absorb more nutrients. Our results suggest that the Trx/TrxBP system may mediate a compensating mechanism. Reduced TrxBP levels and consequent enhanced Trx activity may alleviate OS and protect the foetus from hypoglycaemia. We hypothesise that the decrease in TrxBP levels is not a consequence of GDM, but rather is an instance of the active functional role of TrxBP in maternal development, unifying redox regulation and glucose metabolism.

Heterozygote Hemoglobin G-Coushatta as the Cause of a Falsely Decreased Hemoglobin A1C in an Ion-exchange HPLC Method.

Glycated hemoglobin (HbA1c) is used for the assessment of glycemic control in patients with diabetes. The presence of genetic variants of hemoglobin can profoundly affect the accuracy of HbA1c measurement. Here, we report two cases of Hemoglobin G-Coushatta (HBB:c.68A>C) variant that interferes in the measurement of HbA1c by a cation-exchange HPLC (CE-HPLC) method. HbA1c was measured by a CE-HPLC method in a Tosoh HLC-723 G7 instrument. The HbA1c levels were 2.9% and 4%. These results alerted us to a possible presence of hemoglobinopathy. In the hemoglobin variant analysis, HbA2 levels were detected as 78.3% and 40.7% by HPLC using the short program for the Biorad Variant II. HbA1c levels were measured by an immunoturbidimetric assay in a Siemens Dimension instrument. HbA1c levels were reported as 5.5% and 5.3%. DNA mutation analysis was performed to detect the abnormal hemoglobin variant. Presence of Hemoglobin G-Coushatta variant was detected in the patients. The Hb G-Coushatta variants have an impact on the determination of glycated hemoglobin levels using CEHPLC resulting in a false low value. Therefore, it is necessary to use another measurement method.

Phenotype distribution of the paraoxonase gene in patients with cardiac disease.

INTRODUCTION: Paraoxonase (PON1) is an enigmatic enzyme with multiple enzymatic properties including arylesterase and lactonase activities besides its ability to hydrolyze the toxic metabolite of parathion, paraoxon. The aim of this study was to determine the phenotype distribution of PON1 in patients with cardiac disease who were classified in coronary artery bypass grafting (CABG), heart valve disease (HVD), heart failure (HF) and ST elevation myocardial infarction (STEMI) groups and healthy subjects as a control group. MATERIAL AND METHODS: A total of 300 people (100 cardiac surgery (70 CABG and 30 HVD), 70 HF, 30 STEMI patients and 100 healthy controls) were admitted to this study. Individual variations in PON1 were determined using the dual substrate (paraoxon and phenylacetate) method. RESULTS: The following phenotype distributions were found in the cardiac disease and control groups: cardiac disease group (n = 200): 48.5% (QQ), 42.5% (QR), 9% (RR) and control group (n = 100): 58% (QQ), 39% (QR), 3% (RR). RR (high activity) phenotypic distribution was more common in the cardiac disease group than in controls (p = 0.04). In particular, the frequency of the RR phenotype was two- to three-fold higher in the STEMI and HF patients compared to the controls as well as CABG and HVD groups. CONCLUSIONS: We found a higher percentage of RR phenotype in STEMI and HF patients compared to a large control group as well as compared to two other groups of cardiac disease patients.

Serum anti-Müllerian hormone levels in euthyroid adolescent girls with Hashimoto's thyroiditis: relationship to antioxidant status.

OBJECTIVE: Free radical-mediated oxidative stress has been implicated in the etiopathogenesis of Hashimoto's thyroiditis (HT), which is the most common thyroid disorder in adolescents. HT requires lifelong thyroid surveillance, particularly in women of childbearing age to avoid adverse effects on reproductive function. The aims of this study were to investigate serum concentrations of anti-Müllerian hormone (AMH), a marker of ovarian reserve, in euthyroid adolescent girls with newly diagnosed HT and explore the relationships between AMH levels and biomarkers of antioxidant status. STUDY DESIGN: We recruited 57 non-obese (body mass index [BMI] Z-score<2) adolescent girls with newly diagnosed HT and 50 age- and BMI-matched healthy controls for this case-control study. All participants were euthyroid. Hormonal and metabolic parameters, serum levels of AMH, and antioxidant status [paraoxonase (PON) and arylesterase (ARE) activities] were assessed. RESULTS: Serum AMH levels were significantly higher and serum PON and ARE activities were significantly lower in adolescents with HT than in the controls (p<0.001 for all). No significant associations were detected between the AMH level and any of the clinical or biochemical parameters in the control group. Serum AMH levels were negatively correlated with PON (r=-0.435, p=0.001) and ARE (r=-0.422, p=0.001) activities in adolescents with HT. CONCLUSION: The AMH level was significantly higher while the PON and ARE activities were significantly lower in euthyroid adolescent girls with newly diagnosed HT.

The relationship between serum ferritin levels and serum lipids and HDL function with respect to age and gender.

Elevated serum ferritin (SFer) levels have been associated with chronic diseases such as coronary heart disease and diabetes mellitus type 2. The aim of this study was to examine the relationship between SFer levels and serum lipid parameters, and how this relation changes in terms of age and gender. Additionally, we investigated a possible relationship between SFer levels and high-density lipoprotein (HDL) function. SFer levels and lipid panel (total cholesterol (TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C) and HDL-C) of 4205 people (3139 women, 1066 men) were examined retrospectively. Study population was classified according to age and gender. Separately, 100 subjects (52 women, 48 men) were randomly recruited to investigate the relation between SFer levels, and HDL dependent paraoxonase-1 (PON1) and arylesterase (ARE) activities. In all age groups, women's SFer levels were found to be significantly lower and HDL-C levels significantly higher compared to men. In the 50-70 ages range, TC and LDL-C levels of women were found to be significantly higher than those of men (P < 0.01). SFer levels tended to increase with age in women. Correlation analyses revealed a negative correlation between levels of SFer and HDL-C, while positive correlations existed between levels of SFer, and TC, TG and LDL-C. There was no significant correlation between SFer levels and PON1 or ARE activities. The finding that increased SFer levels are accompanied by increased serum TC, TG and LDL-C levels may help us to explain the increased risk of metabolic disorders and cardiovascular disease in postmenopausal women.

Higher serum lipids and oxidative stress in patients with normal tension glaucoma, but not pseudoexfoliative glaucoma.

This study entailed a cross-examination of oxidant/antioxidant balance, high-density lipoprotein (HDL)-linked paraoxonase 1 (PON1) phenotypes, and levels of serum routine lipids among patients with normal tension glaucoma (NTG) or pseudoexfoliative glaucoma (PEXG) compared with healthy control groups. We aimed to investigate the links between oxidative stress (OS), HDL-related antioxidant enzyme activities and dyslipidemia in distinct subtypes of glaucoma. The study included 32 patients with NTG, 31 patients with PEXG, and 40 control subjects. Levels of PON1 and arylesterase enzymatic activity, total oxidant status (TOS), and total antioxidant status were measured by spectrophotometry and OS indexes (OSI) were calculated. The phenotype distribution of PON1 was determined using the dual substrate method. Blood serum levels of HDL, low-density lipoprotein, total cholesterol (TC), and triglyceride (TG) were measured. The TOS and OSI values in the NTG group were significantly higher compared with the other groups (both p < 0.01). The phenotype distribution found in the glaucoma and control groups were NTG: QQ, 59.4%; QR, 37.5%; RR, 3.1%; PEXG: QQ, 45.1%; QR, 48.4%; RR, 6.5%; and in the control group: QQ, 42.5%; QR, 50.0%; RR, 7.5%. Serum TC levels were significantly higher than the control in both NTG and PEXG groups, whereas TG was significantly higher in NTG only (p < 0.01 and p < 0.02, respectively). Hyperlipidemia, OS and variations in phenotype distribution of PON1 may play a role in the pathogenesis of different types of glaucoma.

The Three Sisters of Fate in Multiple Sclerosis: Klotho (Clotho), Fibroblast Growth Factor-23 (Lachesis), and Vitamin D (Atropos).

BACKGROUND: The klotho (Klt)-fibroblast growth factor-23 (FGF-23)-vitamin D axis is the main component of calcium (Ca) and phosphorus (P) metabolisms; on the contrary, it is also secreted from the choroid plexus (CP). PURPOSE: This study is aimed at evaluating serum soluble Klt (sKlt), FGF-23, and 25-(OH)-vitamin D levels in multiple sclerosis (MS) patients. METHODS: Thirty-two relapsing-remitting MS patients (11 males and 21 females; mean age 38.3 years) and 31 age-sex matched healthy controls (12 males and 19 females; median age 38.5 years) were included in this study. All patients were diagnosed with MS according to the criteria of McDonald. RESULTS: Serum sKlt, FGF-23, and P levels were significantly higher in MS patients compared to the control group (p < 0.01, p < 0.01, and p = 0.02, respectively). Serum 25-(OH)-vitamin D and Ca levels were significantly lower in MS patients (p < 0.01 and p = 0.04, respectively). CONCLUSION: Klt, which is secreted from CP, could be a response to the inflammatory condition in MS. Elevated FGF-23 levels suppress 1α-hydroxylase and upregulates 24α-hydroxylase, which results in a decrease in 1,25-(OH)2D3 levels. Thus, the neuroprotective and immunomodulatory effects of vitamin D might not be seen in MS patients.

No association between vitamin D levels and inflammation markers in patients with acute coronary syndrome.

PURPOSE: A modern concept regards acute coronary syndrome (ACS) as an auto-inflammatory disorder. The purpose of the present study is to assess the plasma levels of inflammation related to biomarkers and cytokines in ACS patients and to correlate the values with 25-hydroxy vitamin D3 (calcidiol). There are no previously published reports concerning serum concentrations of inflammatory markers in patients with hypovitaminosis D in ACS. PATIENTS AND METHODS: Eighty-eight consecutive patients with ACS [n=47 ST elevation myocardial infarction (STEMI), n=41 unstable angina pectoris (USAP)] were enrolled within 12h after symptoms. The blood samples were collected on admission in order to evaluate calcidiol, serum amyloid A (SAA), interleukin (IL)-6, interleukin (IL)-10, tumor necrosis factor-alpha (TNFα) and high sensitivity C-reactive protein (hsCRP). RESULTS: Calcidiol, TNFα and SAA levels were significantly lower (p=0.01, p<0.01 and p<0.01 respectively), whereas hsCRP levels were significantly higher (p<0.01) in STEMI group as compared to USAP group. In the STEMI group, there were negative correlations between SAA and hsCRP (r=-0.347; p=0.01) and SAA and IL-6 (r=-0.356; p=0.01). There was a positive correlation between IL-6 and hsCRP (r=0.529; p<0.01). In the USAP group, it was found that there were a strong negative correlation between SAA and hsCRP (r=-0.75; p<0.01) and a positive correlation between IL-6 and TNF-α (r=0.54; p<0.01). CONCLUSION: This study demonstrates that calcidiol levels are not associated with the inflammation markers in patients with acute phase ACS.