Comparison of Glucose Values of Blood Samples Taken in Three Different Ways.

The purpose of the study was to determine differences and correlations between the blood glucose values of venous blood and the first and second drops of capillary blood samples taken in three different ways. Blood samples were (a) venous blood, (b) the first and second drops of capillary blood from the middle finger of the right hand (only washed with soap and water), and (c) the first and second drops of capillary blood from the middle finger of the left hand (washed with soap and water and cleaned with alcohol). It was concluded that the fasting capillary blood glucose values could be used in place of venous blood glucose values, that only washing the hands with neutral soap and water for 30 s could be sufficient for capillary blood glucose measurement, and that the first or second blood drop from a clean hand could be used for capillary blood glucose measurement.

Effect of oncological treatment on serum adipocytokine levels in patients with stage II-III breast cancer.

Adipose tissue-derived hormones (adipocytokines), such as adiponectin, leptin, resistin and visfatin, and the pancreatic hormone insulin, have been suggested to play a role in carcinogenesis. we therefore hypothesized that the oncological treatment of breast cancer may alter the serum levels of these adipocytokines and insulin. In this study, we aimed to compare the serum levels of adipocytokines and insulin between the pre- and post-treatment period in patients with breast cancer. In this prospective study, 20 consecutive patients with stage II and III breast cancer underwent breast-conserving surgery or total mastectomy and/or axillary dissection. The patients received adjuvant chemotherapy and radiotherapy, if necessary. Blood samples were obtained during the preoperative period and postoperatively after completion of the adjuvant therapy. There was no statistically significant difference between the pre- and post-treatment levels of visfatin, adiponectin and leptin. However, the serum insulin and resistin levels and insulin resistance were found to be statistically significantly increased following treatment (P<0.05). Post-treatment resistin levels were positively correlated with insulin resistance (r=0.45, P<0.05). Therefore, oncological treatment of stage II and III breast cancer did not affect visfatin, adiponectin and leptin levels, but statistically significantly increased resistin levels and insulin resistance. In addition, the post-treatment resistin levels were positively correlated with insulin resistance, suggesting that resistin may be involved in the development of insulin resistance in breast cancer patients following treatment.

A multicenter nationwide reference intervals study for common biochemical analytes in Turkey using Abbott analyzers.

BACKGROUND: A nationwide multicenter study was organized to establish reference intervals (RIs) in the Turkish population for 25 commonly tested biochemical analytes and to explore sources of variation in reference values, including regionality. METHODS: Blood samples were collected nationwide in 28 laboratories from the seven regions (≥400 samples/region, 3066 in all). The sera were collectively analyzed in Uludag University in Bursa using Abbott reagents and analyzer. Reference materials were used for standardization of test results. After secondary exclusion using the latent abnormal values exclusion method, RIs were derived by a parametric method employing the modified Box-Cox formula and compared with the RIs by the non-parametric method. Three-level nested ANOVA was used to evaluate variations among sexes, ages and regions. Associations between test results and age, body mass index (BMI) and region were determined by multiple regression analysis (MRA). RESULTS: By ANOVA, differences of reference values among seven regions were significant in none of the 25 analytes. Significant sex-related and age-related differences were observed for 10 and seven analytes, respectively. MRA revealed BMI-related changes in results for uric acid, glucose, triglycerides, high-density lipoprotein (HDL)-cholesterol, alanine aminotransferase, and γ-glutamyltransferase. Their RIs were thus derived by applying stricter criteria excluding individuals with BMI >28 kg/m2. Ranges of RIs by non-parametric method were wider than those by parametric method especially for those analytes affected by BMI. CONCLUSIONS: With the lack of regional differences and the well-standardized status of test results, the RIs derived from this nationwide study can be used for the entire Turkish population.

Possible relations between oxidative damage and apoptosis in benign prostate hyperplasia and prostate cancer patients.

Cancer has been described as the twentieth century plague, and is a very common health problem. It has been reported that ROS and ROS products play a key role in cancer and that oxidative damage is effective in apoptosis initiation. In this study we aimed to evaluate the relationship between MDA (malondialdehyde), DNA damage (8-hydroxyguanine, 8-OH-dG), and caspase-3 in BHP and prostate cancer patients. Twenty male patients with prostate cancer and 20 male patients with benign prostate hyperplasia were included into this study. The MDA (nanomole), DNA damage (nanograms per millilitre), and caspase-3 (nanograms per millilitre) levels were measured in prostate cancer and benign prostate hyperplasia using Elisa kits (Millipore Corporation, Billerica, MA, USA). In the prostate cancer group, serum MDA (30.96 ± 9.25) and DNA damage (4.42 ± 0.36) levels were significantly raised (p < 0.05) when compared to the benign prostate hyperplasia group (24.05 ± 8.06, 3.99 ± 0.54). However, in the prostate cancer group, serum caspase-3 (2.36 ± 0.82) levels were statistically significantly lowered (p < 0.05) compared with the benign prostate hyperplasia group (3.15 ± 1.04). We observed that altered prooxidant, DNA damage levels may lead to an increase in oxidative damage and may consequently play an important role in prostate carcinogenesis. These findings indicate that, although the triggering of these changes is unknown, changes in the levels of MDA, DNA damage, and caspase-3 in the blood are related to prostatic carcinoma development. In addition, it would be appropriate to conduct new studies with a large number of patients at different stages.

Myocardial performance after successful intervention for native aortic coarctation.

Coarctation of the aorta is associated with increased risk for hypertension in adulthood, despite successful repair. The intrinsic mechanisms underscoring hypertension and left ventricular performance in these patients, however, remains to be determined. Our objective was to evaluate left ventricular performance by means of echocardiographic and biochemical parameters at midterm follow-up in normotensive children who have had undergone successful surgical or catheter interventional treatment of coarctation with a residual gradient of less than 20 mmHg at rest. We studied prospectively 14 patients with native aortic coarctation who underwent surgery or balloon angioplasty, the cohort made up of equal numbers of boys and girls, and having a mean age of 8.5 plus or minus 4 years. We also studied 30 age-matched healthy subjects, measuring mitral inflow pulsed wave signals, isovolumic relaxation and contraction times, myocardial performance index parameters, and levels of B-type natriuretic peptide and endothelin-1 in both groups. We found no differences in systolic blood pressure at rest between the patients and their controls. The ventricular septal diastolic dimensions, left ventricular posterior wall dimensions, mitral valve E wave, deceleration time, isovolumic relaxation time, isovolumic contraction time and myocardial performance index were all significantly increased in the patients. Levels of plasma B-type natriuretic peptide and endothelin-1 were also significantly higher in the patients when compared to the control group. We conclude that aortic coarctation is a chronic disease characterized by persistency of myocardial and vascular alterations. The elevated levels of plasma b-type natriuretic peptide and endothelin-1 may be indicative of late onset hypertension after successful treatment of native coarctation in early childhood.

Leptin levels in thyroid cancer.

BACKGROUND: Leptin has physiological roles in multiple systems, and has possible effects on several carcinogenesis steps. The aim of this study was to investigate the leptin levels in thyroid papillary carcinoma (TPC) patients. METHODS: Forty-three female TPC patients and 30 healthy female control subjects were recruited for the study. TPC was diagnosed by fine needle aspiration biopsy. TPC patients had a bilateral total thyroidectomy operation and their leptin levels were measured before and 20 days after the operation. RESULTS: Serum leptin levels of TPC patients were higher than in control group subjects (21.15 +/- 14.12 ng/mL vs. 9.89 +/- 0.21 ng/mL, p < 0.05). The leptin levels decreased after total thyroidectomy (13.92 +/- 10.55 ng/mL) compared to prethyroidectomy levels (22.94 +/- 14.67 ng/mL) in 34 patients who came to the follow-up visit (p < 0.05). However, the decreased post-thyroidectomy levels of leptin were still statistically significantly higher than the control group levels. Multivariate regression analysis showed that the leptin levels in TPC patients were not related to age, menopausal status or pathologic occult status but were directly related to the cancer group. CONCLUSION: Leptin levels were elevated in thyroid cancer, decreased after total thyroidectomy, and might be associated with thyroid papillary carcinogenesis.

A relationship of sex hormone levels and erectile dysfunction: which tests should be done routinely?

PURPOSE: In this study, the relationship between sex hormone levels and erectile dysfunction (ED), as well as the necessity of routinely measuring sex hormone levels were evaluated. MATERIALS AND METHODS: This study included one hundred patients admitted to a urology clinic for sexual dysfunction. To determine the hormone levels, following the history (included IIEF-5 score) and physical examination, triple blood samples were collected at intervals of 15 minutes between 08:00 and 10:00 am. Total and free testosterone, prolactin, follicle stimulating hormone and luteinizing hormone levels were studied. RESULTS: Mean age was 43 (23-80) years. IIEF-5 score was less than 21 [9.8-4.3 (3-19)] in all study groups. There was a statistically significant correlation between tT and FSH, as well as between LH and FSH in Pearson (r =-0.513, p < 0.001, respectively) and also in Spearman tests (r=-0.224, p=0.042 and r=-0.459, p < 0.001, respectively). However, there was no correlation between age and serum hormone levels (p > 0.05). Of the 100 patients, 18 (18%) had low tT, 77 (77%) had normal and 5 (5%) had high tT levels. No statistically significant correlation was found between decreased libido and tT levels (p > 0.05). Twelve (66.6%) of the 18 patients with low tT had normal libido. CONCLUSION: Analyzing the medical history in detail and performing a thorough physical examination can reduce the need for excessive studies and consultations, and enables patients to save time and costs.

Advanced oxidation protein products, ferrous oxidation in xylenol orange, and malondialdehyde levels in thyroid cancer.

AIMS AND BACKGROUND: The oxidation of protein plays an essential role in the pathogenesis of an important number of degenerative and cancer diseases, which is now widely recognized. The aim is to examine advanced oxidation protein products (AOPPs), lipid peroxidation products malondialdehyde (MDA), and ferrous oxidation in xylenol orange (FOX) in blood samples of papillary thyroid cancer patients compared with healthy controls to determine the oxidation status and the change after thyroidectomy. METHODS: Thirty-five female thyroid cancer patients who underwent total thyroidectomy and 39 female control subjects were included into this study. Prethyroidectomy and postthyroidectomy, AOPP, FOX, and MDA levels were studied. RESULTS: Prethyroidectomy AOPP, FOX, and MDA levels were significantly higher compared to control (P < .05). In postthyroidectomy AOPP, FOX, and MDA levels were significantly decreased compared with prethyroidectomy levels (P < .05). However, postthyroidectomy levels on the 20th day were still significantly higher, compared to control subjects (P < .05). CONCLUSION: In conclusion, all of AOPP, FOX, and MDA levels that are markers of protein oxidation and lipid hyperoxidation may induce thyroid cancer development and begin to decrease after thyroidectomy.

Increased serum leptin concentrations in patients with chronic stable angina pectoris and ST-elevated myocardial infarction.

Leptin is an adipocytokine that is produced mainly by adipose tissue; it is also identified in atherosclerotic lesions in human coronary atherosclerosis. However, the relation of serum leptin concentrations to ischemic heart disease (IHD) is still obscure. The aims of the present study were to investigate serum leptin concentrations in patients with ST-elevated myocardial infarction (STEMI) and with chronic stable angina pectoris (CSAP) and to evaluate the possible correlations of leptin to other atherosclerotic risk factors; including serum high sensitive C-reactive protein (Hs-CRP), serum homocysteine, and fibrinogen concentrations. For this purpose, 35 patients with CSAP, 40 with acute STEMI, and 30 control subjects with normal findings from coronary angiography were taken into the study prospectively. Serum leptin concentrations were significantly higher in patients with CSAP and STEMI compared to the control group (7.74 +/-1.34 vs 6.37 +/-1.85 ng/mL, p=0.021 and 8.22 +/-3.13 vs 6.37 +/-1.85 ng/mL, p=0.023, respectively). In addition, serum homocysteine concentrations were significantly increased in patients with CSAP (15.23 +/-5.96 vs 11.40 +/-2.11 micromol/L, p=0.025) and patients with STEMI (15.90 +/-5.02 vs 11.40 +/-2.11 micromol/L, p=0.012) compared to the control group. Serum fibrinogen concentrations were significantly increased only in the CSAP group as compared to controls (4.15 +/-1.39 vs 3.45 +/-1.19 g/L, p=0.025). No significant correlation was found between leptin levels and selected risk factors. In conclusion, serum leptin concentrations were significantly higher in both the CSAP and STEMI groups. However, owing to the lack of correlation between the leptin levels and selected classical coronary risk factors, it may be considered that leptin can be evaluated as one of the independent risk factors for IHD. Further randomized and controlled studies will be required to determine the pathophysiological meaning of the increased leptin levels and the central role between adipocyte function and atherosclerosis.

The long-term effect of mesh bioprosthesis in inguinal hernia repair on testicular nitric oxide metabolism and apoptosis in rat testis.

Polypropylene mesh is the most widely used material in inguinal hernia repair. Although polypropylene mesh is known as an inert material, it is experimentally proven that mesh generates a chronic inflammatory tissue reaction. The aim of the present study was to investigate the long-term effects of polypropylene mesh material used in inguinal hernia operations on testicular function, testicular nitric oxide (NO) metabolism and germ cell-specific apoptosis in rats. The study comprised 40 male rats that were randomly allocated into two groups. In group 1, the left spermatic cord was elevated and a 0.5 x 1 cm polypropylene mesh was placed behind the left inguinal spermatic cord and group 2 consisted of the sham-operated controls. Blood samples were taken at 6 months preoperatively and postoperatively after to assess luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels for hormonal evaluation. Testicular NO was evaluated by the Griess method, apoptosis by a TUNEL method and inducible nitric oxide synthase (iNOS) and endothelial NOS (eNOS) expressions by immunohistochemical staining. Mild (+) eNOS expression was observed in all specimens. Mild (+) iNOS expression was only detected in ipsilateral testis of the mesh-implanted study group. Apoptotic cells were not detected in any samples. We are of the opinion that long-term polypropylene mesh implantation has no effect on testicular hormonal function and only a limited effect on nitric oxide levels and this effect is not sufficient to cause apoptosis in testis that could lead to infertility. It seems that mesh implantation is a reliable method in inguinal hernia repair; however, further work is required by more sensitive methods to fully elucidate the potential testicular damage.

Serum nitric oxide metabolite levels and the effect of antipsychotic therapy in schizophrenia.

BACKGROUND: Recently it was proposed that nitric oxide metabolites (NO) may have a role in the pathophysiology of schizophrenia and major depressive disorders. The present study was performed to assess changes in serum nitric oxide metabolite levels in schizophrenic patients compared with healthy controls. Our secondary aim was to further evaluate the impact of psychopharmacologic treatment on circulating NO levels not assessed previously. METHODS: Serum NO levels of patients with schizophrenia (n=20) before and after 6 weeks of treatment were compared with those of healthy controls (n=20). Severity of schizophrenia and response to treatment were assessed with positive and negative symptoms of schizophrenia. NO levels were estimated by Griess method in serum samples. RESULTS: In patients with schizophrenia, pre-treatment serum NO levels were higher than those of control subjects (39.15 +/- 18.24 vs. 25.40 +/- 5.83 micromol/L, p=0.036) and also of post-treatment values (34.41 +/- 16.35 vs. 25.40 +/- 5.83 micromol/L, p=0.049), respectively. However, no significant difference was found between serum NO levels in pre- and post-treatment values. CONCLUSIONS: Our findings of increased serum NO levels in schizophrenic patients confirmed the role of NO in the pathophysiology of schizophrenia. However, we found that antipsychotic drugs do not reveal significant effects on serum levels of NO in schizophrenia in a 6-week treatment regimen. Further studies with longer therapy periods may suggest some new clues for novel treatment strategies employing antioxidants and NOS inhibitors in schizophrenia.

Serum testosterone, growth hormone, and insulin-like growth factor-1 levels, mental reaction time, and maximal aerobic exercise in sedentary and long-term physically trained elderly males.

The aim of the study was to investigate the effect of regular exercise on maximum oxygen uptake capacity (VO2max), reaction time (RT), testosterone (T), growth hormone (GH), insulin-like growth factor-I (IGF-I) in athletes compared to sedentary controls. VO2max, RT, T, GH, and IGF-I levels were 31.2 +/- 6.2 ml/min/kg, 106.7 +/- 23.2 s, 8.3 +/- 1.3 ng/mL, 1.6 +/- 0.7 ng/mL, 106.5 +/- 27.0 ng/mL in master athlete group and 18.8 +/- 5.1 ml/min/kg, 148.3 +/- 39.3 s, 5.4 +/- 1.7 ng/mL, 0.8 +/- 0.3 ng/mL, 90.2 +/- 23.8 ng/mL in sedentary control group, respectively. The differences between regularly exercising males and the control group of sedentary males were found to be statistically significant. The results showed that long-term exercise decreased RT and increased VO2max, T, and GH in elderly males; elevated serum T and GH levels may be advantageous for brain functions.

The diagnostic value of the phosphate levels in serum and 24-hour urine samples in patients with recurrent renal stone disease.

OBJECTIVE: The aim of this study is to investigate the value of phosphate levels in serum and urine in patients with recurrent renal stone disease. MATERIALS AND METHODS: The patients (n:60) were divided into two groups as first-time stone disease (group 1) and recurrent renal stone disease (group 2). The demographical datas and their historical information were recorded and physical examination was done. The sera and urine for 24 hr were obtained from patients to measure electrolyte levels especially phosphorus. In addition, based on presenting serum phosphate levels, patients were divided into the hypophosphatemia group, less than 2.5 mg/dl; normophosphatemia group, between 2.5-5.2 mg/dl; and hyperphosphatemia group greater than 5.2 mg/dl. RESULTS: The mean age of study group was 45 (21-70) years. Thirty-six patients (60%) were in group 1 and 24 patients (40%) were in group 2. No statistically correlation was found between stone recurrence and phosphate levels both in serum and urine. There was only a statistical association of K levels in 24-hour urine samples between group 1 and 2. CONCLUSION: There was no significant association between stone recurrence and initial phosphate levels in the serum or in urine. We do not propose to determine phosphate levels routinely in management of patients with stone disease.

Serum lipids and apolipoproteins in patients with psoriasis.

Psoriasis is characterized by defects in the normal cycle of epidermal development that lead to epidermal hyperproliferation, altered maturation of skin cells, vascular changes and inflammation. Also, psoriasis has been associated with an abnormal plasma lipid metabolism. Changes in plasma lipid and lipoprotein composition in patients with psoriasis may be the reason for the increased risk of atherosclerosis in these patients. We determined serum concentrations of lipids, lipoproteins and apolipoprotein Al and B (apo A1 and apo B) in 72 patients with psoriasis and 30 age matched controls. Serum lipoprotein (a) (Lp(a)), apo A1 and apo B were measured by immunoprecipitation assays, and the lipids and other biochemical parameters by enzymatic methods. Serum Lp(a) and triglyceride (TG) were significantly higher in patients with psoriasis than in healthy control subjects (p<0.01 for both). Apo B was also found to be higher in the patient group, but the difference was not significant. The levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and apo A1 did not differ significantly from those of the controls. These observations imply that serum Lp(a) and TG concentrations may play a role as risk factors for atherosclerotic disease in patients with psoriasis.