Possible role of antioxidants and nitric oxide inhibitors against carbon monoxide poisoning: Having a clear conscience because of their potential benefits.

Carbon monoxide poisoning is one of the important emergency situations manifested by primarily acute and chronic anoxic central nervous system (CNS) injuries and other organ damages. Current descriptions and therapeutic approaches have been focused on the anoxic pathophysiology. However, this point of view incompletely explains some of the outcomes and needs to be investigated extensively. Considering this, we propose that reactive oxygen species (ROS) including especially nitric oxide (NO) are likely to be a key concept to understand the emergency related to CO poisoning and to discover new therapeutic modalities in CO toxicity. If we consider the hypothesis that ROS is involved greatly in acute and chronic toxic effects of CO on CNS and some other vital organs such as heart, it follows that the antioxidant and anti-NO therapies might give the clinicians more opportunities to prevent deep CNS injury. In support of this, we review the subject in essence and summarize clinical and experimental studies that support a key role of ROS in the explanation of pathophysiology of CO toxicity as well as new treatment modalities after CO poisoning.

Increased ischemia-modified albumin and malondialdehyde levels in videothoracoscopic surgery.

BACKGROUND: Videothoracoscopic surgery leads to general organ hypoperfusion by reducing mean arterial pressure, systemic vascular resistance, and end-diastolic volume index. Oxidative stress occurs as a result of hypoperfusion. Evaluation of the short-term effects of videothoracoscopic sympathectomy on serum ischemia-modified albumin (IMA), malondialdehyde (MDA), and nitric oxide (NO) levels in patients with primary hyperhidrosis was aimed. METHODS: Twenty-six patients who underwent videothoracoscopic surgery were contributed in this study. Venous blood samples were obtained from these patients 1 h before and after the surgery. IMA, MDA, and NO levels were measured in serum samples by colorimetric methods. Albumin concentrations were also measured for each sample, and albumin-adjusted IMA levels were calculated. RESULTS: Postoperative IMA, albumin-adjusted IMA, and MDA values were significantly higher compared to the preoperative values (P = 0.003, 0.027, 0.018, respectively). However, postoperative NO levels were lower than the preoperative values (P = 0.002). There was no significant difference between pre- and postoperative albumin concentrations, and there was no significant correlation between the parameters tested. CONCLUSIONS: We can conclude that elevation in MDA and IMA levels after videothoracoscopic surgery was caused by increased oxidative stress due to minimal ischemia-reperfusion injury after the infusion of CO2 during the surgical process. Videothoracoscopic sympathectomy operation causes a decrease in NO production, and this should be taken in consideration when evaluating nitrosative stress in videothoracoscopic surgery.

Evaluation of Platelet Indices in Lung Cancer Patients.

BACKGROUND: In this study, we aimed to determine platelet indices such as platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), Plateletcrit (PCT) platelet count (PLT) in lung cancer cases, and evaluate any relationships between these parameters and stage or histologic types. MATERIALS AND METHODS: This retrospective study covered 44 lung cancer patients and 47 healthy subjects. Platelet indices including PLT, PCT, MPV, PDW were estimated and compared with normal subjects. The results were evaluated statistically. RESULTS: The PDW value was significantly higher in the cancer group compared to the control group; however, the values for PCT and MPV were lower. CONCLUSIONS: We suggest potential use of platelet indices in diagnosis of lung cancer.

The Investigation of ADAMTS16 in Insulin-Induced Human Chondrosarcoma Cells.

OBJECTIVES: A disintegrin-like metalloproteinase with thrombospondin motifs (ADAMTS) is a group of proteins that have enzymatic activity secreted by cells to the outside extracellular matrix. Insulin induces proteoglycan biosynthesis in chondrosarcoma chondrocytes. The purpose of the present in vitro study is to assess the time course effects of insulin on ADAMTS16 expression in OUMS-27 (human chondrosarcoma) cell line to examine whether insulin regulates ADAMTS16 expression as well as proteoglycan biosynthesis with multifaceted properties or not. METHODS: Chondrosarcoma cells were cultured in Dulbecco's modified Eagle's medium having either 10 µg/mL insulin or not. While the experiment was going on, the medium containing insulin had been changed every other day. Cells were harvested at 1st, 3rd, 7th, and 11th days; subsequently, RNA and proteins were isolated in every experimental group according to their time interval. RNA expression of ADAMTS was estimated by quantitative real-time polymerase chain reaction (qRT-PCR) by using primers. Immunoreactive protein levels were encountered by the western blot protein detection technique by using proper anti-ADAMTS16 antibodies. RESULTS: ADAMTS16 mRNA expression level of chondrosarcoma cells was found to be insignificantly decreased in chondrosarcoma cells induced by insulin detected by the qRT-PCR instrument. On the other hand, there was a gradual decrease in immune-reactant ADAMTS16 protein amount by the time course in insulin-treated cell groups when compared with control cells. CONCLUSION: It has been suggested that insulin might possibly regulate ADAMTS16 levels/activities in OUMS-27 chondrosarcoma cells taking a role in extracellular matrix turnover.

Future opportunities in preventing ototoxicity: Caffeic acid phenethyl ester may be a candidate (Review).

Caffeic acid phenethyl ester (CAPE) is an important active component of propolis, which is derived from honeybee hives. It has received increasing attention in a variety of medical and pharmaceutical research, due to its anti­oxidant, antiproliferative, anti­inflammatory, antiviral and antifungal activity, in addition to its antineoplastic properties. Besides the use of CAPE as an antioxidant and anti­inflammatory agent in a number of in vivo studies of ear disease, its beneficial effects have been reported in the treatment of cancer, arthritis, allergies, heart disease, diabetes, kidney disease, liver disease and neurological disease. CAPE influences a number of biochemical pathways, as well as several targets involved in ear diseases, in particular, in ototoxicity. The protective effects of CAPE in ototoxicity, which may be induced by a number factors, including lipopolysaccharides, hydrogen peroxide and streptomycin, are evaluated and discussed in the present review.

Serum leptin, atherogenic lipids and glucose levels in patients with skin tags.

AIM: To investigate the relationship between serum leptin, atherogenic lipid and glucose levels in patients with skin tags and healthy controls. MATERIALS AND METHODS: A total of 58 patients, with at least three skin tags, aged 24 to 85 years, and 31 healthy controls aged 30 to 70 years, were examined in the present study. The subjects in all the groups were selected with statistically similar Body Mass Index (BMI). Fasting concentrations of plasma glucose, serum lipids including triglyceride, total cholesterol, and high-density lipoprotein cholesterol (HDL) and low-density lipoprotein cholesterol (LDL), HbA1c, and leptin were measured by enzyme-linked immunosorbent assay (ELISA). In addition, serum LDL level was calculated using Friedewald's formula. RESULTS: There was no significant difference in age, sex, BMI, HbA1c, triglyceride, HDL and leptin levels between the groups. Skin tags group showed significantly higher levels of total cholesterol and LDL, when compared with the healthy controls groups (P < 0.01). In addition, regression analysis showed that leptin level was positively correlated to serum triglyceride level (r = 0.265, P = 0.044). CONCLUSION: Total cholesterol and LDL serum levels should be controlled in patients with skin tags. On the other hand, glucose, leptin and HbA1c serum levels may not be as important as is being considered in recent times.

Migraine, Helicobacter pylori, and oxidative stress.

BACKGROUND: The aim of this study was to ascertain whether oxidative stress is a causative factor of migraine attacks for Helicobacter pylori-infected migraineurs. MATERIALS AND METHODS: A total of 35 consecutive migraine patients without aura who came to gastroenterology polyclinic with various complaints and diagnosed H. pylori infection were included in the study group and compared with a group of 29 patients (control group) without migraine and H. infection. H. pylori infection was diagnosed by histopathological biopsies, which were taken by endoscopy (Olympus-GIFXQ240 endoscope). Both the diagnosis and the classification of migraine were made according to the International Headache Society criteria. Blood samples for nitric oxide were taken from patients with migraine during headache-free period as well as the control group. The interaction of nitric oxide was measured by the determination of both nitrite and nitrate concentrations in the sample. RESULTS: The study group included 31 women and 4 men (mean age 49 +/- 8 years) and the control group included 25 women and 4 men (mean age 52.6 +/- 11 years). The mean frequency of migraine attacks was 2.94 +/- 1.58 days/month and the mean duration of attacks was 21.2 +/- 3 hours. It was found that the study group has lower nitrate levels than the control group. CONCLUSIONS: Our results do not support the role of oxidative stress in patients suffering from H. pylori infection and migraine.

Serum atrial natriuretic peptide levels in infants with transient tachypnea of the newborn.

OBJECTIVE: The mechanisms responsible for lung liquid clearance during the neonatal period result in switching of the lung epithelium from net secretion to net absorption following birth and driven by active Na(+) absorption. Transient tachypnea of the newborn (TTN) is known as the most common consequence of inadequate neonatal lung liquid clearance. It has been reported that alveolar type II cells behaved as a target for atrial natriuretic peptide (ANP) which inhibits the amiloride-sensitive Na-channel activity. The objective of this study is to investigate serum ANP concentrations in infants with TTN. METHODS: Fourteen newborn infants who were diagnosed with TTN (gestational age; 35.6 +/- 2.0 weeks) and twenty healthy neonates (gestational age; 36.3 +/- 2.2 weeks) were included in the study. Serum pro ANP concentrations were measured by ELISA using Biomedica GmbH (AUSTRIA) proANP kit on the 4th and 72nd hours of life. RESULTS: The mean serum pro ANP concentration was 2996 fmol/ml at 4 and 2694 fmol/ml at 72 hours of age for the infants with TTN and mean serum pro ANP concentrations of healthy infants found 3301 fmol/ml (p = 0.34) and 3204 fmol/ml (p = 0.04), respectively. CONCLUSION: It is concluded that serum ANP concentrations decreased in infants with TTN.

Comparison of hydroxyethyl starch and ringer lactate as a prime solution regarding S-100beta protein levels and informative cognitive tests in cerebral injury.

BACKGROUND: Cognitive dysfunction (as an indicator of cerebral dysfunction after open heart surgery) was observed in as many as 70% of patients who underwent cardiopulmonary bypass. S-100beta protein is a sensitive indicator of cerebral injury. We aimed to compare the effects of hydroxyethyl starch and Ringer lactate prime solutions in the protection of cerebral tissue in cardiopulmonary bypass using serum S-100beta protein levels and informative cognitive tests. METHODS: Patients were randomized into two groups. Open heart surgery was performed by using hydroxyethyl starch solution in group 1 (n = 15) and Ringer lactate solution in group 2 (n = 15). Preoperative, perioperative, and postoperative S-100beta protein levels and informative cognitive test scores, clinical and operational characteristics of the patients were compared. RESULTS: A significant difference was found only between preoperative and postoperative results of verbal accuracy (human) test in group 1, whereas differences between preoperative and postoperative scores of continuous skill, verbal accuracy (human), verbal accuracy (animal), verbal accuracy (human-animal), go-no-go paradigm, calculation, and abstract thinking tests were significant in group 2 (p < or = 0.05). The S-100beta protein levels were not significantly different between the groups (group p = 0.97). CONCLUSIONS: Because hydroxyethyl starch prime solution used in extracorporeal circulation had significant positive effects with informative-cognitive tests when compared to Ringer lactate solution, it seems to be a better prime solution to prevent cerebral dysfunction in these patients.

Pyrimidine 5'nucleotidase I and II activities in acute leukaemias.

BACKGROUND AND OBJECTIVE: Pyrimidine 5'nucleotidase I and II activities of peripheral mononuclear cells were studied to evaluate their role in diagnosis, assessment of therapy and follow up of remission in acute leukaemias. DESIGN AND METHODS: Blood samples were obtained from 40 untreated patients with acute lymphoblastic and myeloid leukaemia and 40 healthy controls, before the therapy and after remission. The correlation between the activity of the enzymes and the efficacy of therapy were established. The enzyme activities were measured by High-Performance Liquid Chromatography (HPLC), using the method described by Amici. For statistical analysis, Mann-Whitney U, Kruskal-Wallis and Wilcoxon methods were used. RESULTS: Before the therapy, Pyrimidine 5'nucleotidase I levels in the leukaemic group were found to be significantly elevated when compared to the control group (p<0.001). Also Pyrimidine 5'nucleotidase II levels were significantly elevated before the therapy and during remission (p<0.02 and p<0.001 respectively). The isoenzyme activities were compared in patients who were in remission, who did not respond to therapy and in patients who died during the therapy, but no significant difference was found. INTERPRETATION AND CONCLUSIONS: We concluded that, Pyrimidine 5'nucleotidase I and II activities can be used as markers for diagnosis and follow up of remission in patients with acute leukaemia. But, they can not have predictive value for prognosis.

Serum homocysteine level in Behçet's disease.

Recent studies of the prevalence of hyperhomocysteinemia in Behçet's disease have shown contradicting results. The aim of the present study was to investigate the serum homocysteine level in patients diagnosed as having Behçet's disease. Venous blood was taken from 27 patients with Behçet's disease and 21 healthy controls. Serum homocysteine levels were measured using fluorescence polarization immunoassay. In addition, serum vitamin B12 and folic acid levels were measured by chemiluminescent enzyme immunoassay. The mean levels of vitamin B12, folic acid, and homocysteine were not significantly different in patients with Behçet's disease when compared with the healthy controls (p = 0.17, p = 0.13, and p = 0.05, respectively). The results of this study confirmed that homocysteine levels were not elevated in Behçet's disease when compared with the control group. Further studies in a subset of Behçet patients with a history of thrombosis are needed to determine the prevalence of hyperhomocysteinemia in the thrombotic form of the disease.