Evaluation of serum prolidase enzyme activity and oxidative stress in patients with tinnitus / Avaliação da atividade da enzima sérica prolidase e do estresse oxidativo empacientes com zumbido

Abstract Introduction Tinnitus is defined as the perception of sound in the head or in the head in the absence of external sounds. The cause of tinnitus is still unknown. Objective We aimed to compare the serum levels of total oxidant status, total antioxidant status, serum prolidase enzyme activity and the oxidative stress index in patients with tinnitus to those of normal subjects. Methods Twenty five patients with tinnitus (mean age 34.3) and 25 healthy controls (mean age 37.2) were included in the study. Results Total oxidant status levels in the patient group were significantly higher than in the control group (p = 0.037). The mean total oxidant status value was 2.54 ± 0.95 mmoL/L in the patient group, and 2.06 ± 0.98 mmoL/L in the control group. The mean oxidative stress index level was 0.22 ± 0.10 AU in the patient group, while it was 0.17 ± 0.08 AU in the control group. Oxidative stress index was significantly higher in the patient group (0.026). There was no significant difference between the groups in terms of total antioxidant status values (p = 0.838). The mean serum prolidase enzyme activity level was 202.74 ± 33.56 U/L in the patient group and 175.46 ± 42.68 U/L in the control group. Serum prolidase enzyme activity levels in the patient group were significantly higher than in the control group (0.040). Conclusion We detected that the total oxidant status, oxidative stress index and serum prolidase enzyme activity levels were higher in patients with tinnitus when compared to the healthy controls. This finding suggests that oxidative stress index and serum prolidase enzyme activity may play a role in the etiopathogenesis of tinnitus.

Resumo Introdução O zumbido é definido como a percepção de um som na cabeça na ausência de sons externos. A causa do zumbido ainda é desconhecida. Objetivo Comparar os níveis séricos do estado oxidante total, estado antioxidante total, atividade da enzima prolidase sérica e o índice de estresse oxidativo em pacientes com zumbido e em indivíduos normais. Método Foram incluídos no estudo 25 pacientes com zumbido (média de 34,3 anos) e 25 controles saudáveis (média de 37,2 anos). Resultados Os níveis do estado oxidante total no grupo de pacientes foram significantemente maiores do que no grupo controle (p = 0,037). O valor médio do estado oxidante total foi de 2,54 ± 0,95 mmoL/L no grupo de pacientes e de 2,06 ± 0,98 mmoL/L no grupo controle. O nível médio de índice de estresse oxidativo foi de 0,22 ± 0,10 AU no grupo de pacientes, enquanto no grupo controle foi de 0,17 ± 0,08 AU. O índice de estresse oxidativo foi significantemente maior no grupo de pacientes (0,026). Não houve diferença significante entre os grupos em relação aos valores do estado antioxidante total (p = 0,838). O nível médio de atividade da enzima prolidase sérica foi de 202,74 ± 33,56 U/L no grupo de pacientes e de 175,46 ± 42,68 U/L no grupo controle. Os níveis de atividade da enzima prolidase sérica no grupo de pacientes foram significantemente maiores do que no grupo controle (0,040). Conclusão Detectamos que os níveis de estado oxidante total, índice de estresse oxidativo e atividade da enzima prolidase sérica foram maiores nos pacientes com zumbido quando comparados aos controles saudáveis. Esse achado sugere que o índice de estresse oxidativo e a atividade da enzima prolidase sérica podem desempenhar um papel na etiopatogenia do zumbido.

Evaluation of serum prolidase enzyme activity and oxidative stress in patients with tinnitus.

INTRODUCTION: Tinnitus is defined as the perception of sound in the head or in the head in the absence of external sounds. The cause of tinnitus is still unknown. OBJECTIVE: We aimed to compare the serum levels of total oxidant status, total antioxidant status, serum prolidase enzyme activity and the oxidative stress index in patients with tinnitus to those of normal subjects. METHODS: Twenty five patients with tinnitus (mean age 34.3) and 25 healthy controls (mean age 37.2) were included in the study. RESULTS: Total oxidant status levels in the patient group were significantly higher than in the control group (p=0.037). The mean total oxidant status value was 2.54±0.95mmoL/L in the patient group, and 2.06±0.98mmoL/L in the control group. The mean oxidative stress index level was 0.22±0.10AU in the patient group, while it was 0.17±0.08AU in the control group. Oxidative stress index was significantly higher in the patient group (0.026). There was no significant difference between the groups in terms of total antioxidant status values (p=0.838). The mean serum prolidase enzyme activity level was 202.74±33.56U/L in the patient group and 175.46±42.68U/L in the control group. Serum prolidase enzyme activity levels in the patient group were significantly higher than in the control group (0.040). CONCLUSION: We detected that the total oxidant status, oxidative stress index and serum prolidase enzyme activity levels were higher in patients with tinnitus when compared to the healthy controls. This finding suggests that oxidative stress index and serum prolidase enzyme activity may play a role in the etiopathogenesis of tinnitus.

Arterial distensibility in patients with ruptured and unruptured intracranial aneurysms: is it a predisposing factor for rupture risk?

BACKGROUND: A risk factor assessment that reliably predicts whether patients are predisposed to intracranial aneurysm (IA) rupture has yet to be formulated. As such, the clinical management of unruptured IA remains unclear. Our aim was to determine whether impaired arterial distensibility and hypertrophic remodeling might be indicators of risk for IA rupture. MATERIAL/METHODS: The study population (n=49) was selected from consecutive admissions for either unruptured IA (n=23) or ruptured IA (n=26) from January to December 2010. Hemodynamic measures were taken from every patient, including systolic and diastolic blood pressure using a sphygmomanometer. Unruptured IA and ruptured IA characteristics, including aneurysmal shape, size, angle, aspect ratio, and bottleneck factor, were measured and calculated from transverse brain CT angiography images. With ultrasound, the right common carotid artery intima-media thickness was measured, as well as the lumen diameter during systole and diastole. Arterial wall strain, distensibility, stiffness index, and elastic modulus were calculated and compared between patients with unruptured IAs and ruptured IAs. A p-value less than 0.05 was considered statistically significant. RESULTS: General demographic data did not differ between patients with unruptured IAs and ruptured IAs. Greater mean intima-media thickness (p=0.013), mean stiffness index (p=0.044), and mean elastic modulus (p=0.026) were observed for patients with ruptured IAs. Moreover, mean strain (p=0.013) and mean distensibility (p=0.024) were decreased in patients with ruptured IAs. CONCLUSIONS: Patients with ruptured IAs demonstrated decreased arterial distensibility and increased intima-media thickness at the level of the carotid arteries. By measuring these parameters via ultrasound, it may be possible to predict whether patients with existing IAs might rupture and hemorrhage into the subarachnoid space.

Reasons, procedures, and outcomes in ventriculoatrial shunts: A single-center experience.

BACKGROUND: Ventricular shunts are used to drain cerebrospinal fluid into extra-cranial spaces. Ventriculoatrial (VA) shunts are provided to transfer cerebrospinal fluid from the cerebral ventricle into the right atrium of the heart. A single center experience of indications, procedure, and clinical outcomes in VA shunt was presented in current study. METHODS: VA shunts were applied in 10 patients who had repeated previous shunt dysfunction or infection. The reasons, clinical findings, replacement methods, and postoperative clinical follow-ups and outcomes were recorded retrospectively. RESULTS: There were seven female (70%) and three (30%) male patients; their ages ranged from 5 to 13 years (mean ± SD; 8.5 ± 2.6 years). Shunt re-placement reasons were as follows: Shunt occlusion in five patients, intraperitoneal infection in four patients and a distal catheter was kinked and knotted in one patient. Postoperative early complications were seen in one patient as early catheter thrombosis and catheter revision were applied. Late complications were seen in two patients as follows: Catheter infection and infective endocarditis occurred in one patient and pulmonary thrombus occurred in one other patient. There was not any catheter-related mortality observed at the one year follow-up period. CONCLUSION: VA shunts may be an option for cerebrospinal fluid drainage at necessary conditions. However, sterilization and general training on asepsy and antisepsy are the most important determinants affecting the clinical outcome due to the cardio systemic relationship.

Predictors of surgical approaches for the repair of anterior cranial base encephaloceles.

Surgical approaches to the anterior cranial base have changed considerably with the introduction of endonasal endoscopic surgery. This study aims to define the factors which help in selecting the optimal surgical approach for the treatment of anterior cranial base encephaloceles. Patients who received treatment for anterior cranial base encephaloceles at our department between 1996 and 2011 were included in the study. Patients' charts were reviewed retrospectively to collect the necessary data. Treatment periods were classified as before 2000, between 2000 and 2005, and after 2005. The relationship between the treatment period, localization of encephalocele, symptoms related with the lesion, size of skull base defect, and selected treatment modality were investigated. Twenty-five patients, aged between 1 and 61 years with anterior encephaloceles were included in the study. Patients with small asymptomatic frontonasal and trans-ethmoidal encephaloceles (n = 5) were followed without surgery. An external approach with or without subfrontal craniotomy was mainly preferred for resection of sincipital encephaloceles (n = 10), especially with facial deformity. A subfrontal craniotomy approach was used for resection of basal encephaloceles in two cases before 2000. Two cases with sincipital encephaloceles and six cases with basal encephaloceles underwent pure endonasal endoscopic surgery after 2000. Cranial base defects of every size could be repaired using the endoscopic approach. Hydrocephalus and meningitis were the two complications seen after craniotomy in a follow-up period of 13-26 (mean 14.5) months. An external approach with or without craniotomy is needed for encephaloceles with external mass and facial deformity. Otherwise, sincipital and basal encephaloceles can be repaired successfully using the endonasal endoscopic approach.

Malign transformation in the low grade astrocytomas and related factors.

AIM: Retrospective investigation of prognostic factors in low-grade astrocytomas. MATERIAL AND METHODS: In the study, prognostic factors were prospectively identified and assumed to be effective on prognosis, which were reviewed in 67 cases diagnosed as low-grade astrocytoma with craniotomy between May 1998 to December 2005 at Erciyes University Neurosurgery Department. Assessment of demographic, neurologic, radiological, surgical and clinical features of cases and adjuvant therapies and their relationship with prognosis were evaluated. Post-operative cumulative survival of the cases was estimated by using the Kaplan-Meier method. The Log Rank test was used to compare the survival curve of the sub-groups. Multivariate analysis of survival was analyzed by using the Cox regression method. RESULTS: It was seen that malign transformation occurred in 9 patients of subtotal resection group. The difference was statistically significant (p < 0.01). malign transformation was detected in one female (3.2%) and 8 male patients (22.2%). Difference in favor of men was statistically significant (p < 0.05). Malignant transformation was detected in 7 of the patients given post-operative radiotherapy, only 2 patients displayed malign transformation in the group which received no radiotherapy. Comparison of groups revealed a significant difference (p=0.01). CONCLUSION: Detection of higher malign transformation rate in cases underwent radiotherapy than those did not and the statistical significance in this meaning mandates to revise treatment plan regarding radiotherapy.