Effect of antioxidants on the clinical outcome of patients with nasal polyposis.

AIM: To investigate the therapeutic effects of antioxidants on the clinical and biochemical outcome of patients with nasal polyposis. METHODS: Thirty-four patients with nasal polyposis were divided into two groups receiving either intranasal steroid or intranasal steroid plus per-oral vitamins A, C and E and selenium. Paranasal sinus computed tomography, endoscopy, and polyp tissue and serum sampling were conducted pre- and post-therapy. Serum levels of malondialdehyde, superoxide dismutase, nitrite and myeloperoxidase and tissue levels of malondialdehyde and superoxide dismutase were measured. Group results were compared using the Mann-Whitney U test and Wilcoxon signed-rank test. RESULTS: Both groups had significantly lower tissue parameters, computed tomography scores and serum malondialdehyde levels, comparing pre- versus post-treatment results. Post-treatment, the steroid plus antioxidant group had significantly lower tissue malondialdehyde levels and a greater fall in tissue and serum malondialdehyde, compared with the steroid group. CONCLUSION: Serum and tissue levels of malondialdehyde (an oxidative marker) were significantly decreased by adding antioxidants to standard therapy. This is the first report of the positive effects of adding antioxidants to steroid therapy for nasal polyposis.

CA 72-4 levels in patients with type 2 diabetes mellitus.

OBJECTIVE: CA 72-4 is one of the blood group carbohydrate antigens which can be used as a tumour marker in ovarian, pancreatic and gastrointestinal carcinomas. It can also be elevated in various benign conditions including pancreatitis. Diabetes mellitus is a chronic disorder related with the pancreas. In this study, we investigated CA 72-4 levels in patients with type 2 diabetes and its relation to the metabolic status. METHODS: Sixty-nine patients with type 2 diabetes mellitus (female/male = 40/29) and 60 healthy subjects (female/male = 35/25) participated in this study. The levels of serum CA 72-4 were measured and faecal occult blood tests (following 3 days of white diet were obtained for three consecutive days) were performed in all patients. Patients had a pathological finding for any of these two parameters were further investigated with upper gastrointestinal endoscopy, colonoscopy and computerised tomography. RESULTS: The mean levels of CA 72-4 was 1.89 +/- 2.61 U/ml in the study group and 1.4 +/- 0.98 U/ml in the control group (p > 0.05). There was no association between CA 72-4 levels and age and sex of the patients, duration of diabetes, body mass index, biochemical indicators of metabolic control (the levels of HbA(1c), fasting and postprandial glucose, serum lipids), the presence of microvascular complications (retinopathy, nephropathy, neuropathy) or treatment modalities. CONCLUSIONS: Elevated levels of CA 72-4 in diabetic patients are not related to diabetes and it should be interpreted as evaluated in a non-diabetic patient.

Thyroid fine needle aspiration biopsy: is topical local anaesthesia beneficial?

OBJECTIVE: Thyroid fine needle aspiration biopsy (TFNAB) is the gold standard in the differential diagnosis of the thyroid nodules. In general, no analgesia is needed before this procedure. However, it is usually believed that the patients may be more comfortable if the procedure is performed under local anaesthetics. In this study, we examined the impact of the use of dermal anaesthetic on the patient's level of discomfort during palpation-guided TFNAB. METHODS: Fifty female patients with nodular goitre were enrolled in this study. Patients were randomised into two groups: a placebo cream was applied to group 1 patients (25 females; mean age 47.45 +/- 11.61 years), and local anaesthesia (EMLA 5% cream) was applied to group 2 patients (25 females; mean age 50.89 +/- 12.01 years) approximately 1 h before TFNAB. All patients were asked to mark the pain they felt during the TFNAB on Visual Analogue Scale. RESULTS: The pain scores during TFNAB were 27.73 +/- 20.01 mm and 24.79 +/- 21.98 mm in the placebo group and in the EMLA group respectively. There was no significant difference between the groups (p = 0.496). CONCLUSIONS: Topical anaesthesia before palpation-guided TFNAB provides no benefit.

Penile blood cyclic guanosin monophosphate level is associated with penile Doppler ultrasound findings.

The aim of this study was to look into a molecule in penile blood sample that shows correlation with the tumescence grade and/or penile Doppler ultrasound findings. Patients admitted to urology outpatient clinic with the complaint of erectile dysfunction between November 2006 and April 2007 were evaluated. Patients with the history of phosphodiesterase inhibitor usage or genital trauma, genital abnormalities, Peyronie's disease, endocrinopathies, cardiovascular diseases and major psychiatric or neurological disorders were excluded. Those patients were later evaluated with a penile Doppler ultrasound, 10-20 min after intracavernosal injection of 60 mg of papaverine hydrochloride. Tumescence grade, peak-systolic velocity (PSV), end-diastolic velocity (EDV) and resistive index (RI) were recorded. Blood samples were drawn from penis and the levels of calcium, myeloperoxidase, malondialdehyde, nitrite, nitrate, vasoactive intestinal peptide and cyclic guanosin monophosphate (cGMP) and the activity of superoxide dismutase were measured. A total of 46 patients with erectile dysfunction were included. The median age of the patients was 49.3+/-10.2 (range 24-67). We could not find any significant correlation between penile Doppler ultrasound parameters and any of penile blood measurements except cGMP that demonstrated a significant negative correlation with PSV (rho=-0.533, P=0.001) and RI (rho=-0.468, P=0.005). However, a positive correlation between cGMP and EDV was detected (rho=0.322, P=0.059). Mean cGMP levels were 3.347+/-0.694 pmol ml(-1) (2.295-4.685), 3.193+/-0.669 pmol ml(-1) (2.165-4.094) and 2.742+/-0.690 pmol ml(-1) (1.290-4.011) in grades 2, 3 and 4 tumescence groups, respectively, and the difference among mean cGMP levels of these groups were statistically significant (P=0.027). As a conclusion, penile blood cGMP level showed a significant negative correlation with mean PSV, RI values and tumescence grade, whereas there was a positive but insignificant correlation between cGMP and mean EDV value.

The effect of taurine on polymorphonuclear leukocyte functions in endotoxemia.

The aim of the present study was to measure MPO activity in PMN leukocytes after endotoxin administration, and to compare the levels of NO2- competing with taurine for reaction with HOCl. Furthermore we aimed to determine TauCl levels, a product of MPO-H2O2-Halide system, and to evaluate anti-inflammatory properties of PMN in endotoxemia. In addition, our second objective was to investigate the effect of taurine, an antioxidant amino acid, on anti-bactericidal and anti-inflammatory functions of PMN after administration of endotoxin together with taurine. All experiments were performed with four groups (control, taurine, endotoxemia, and taurine plus endotoxin) of ten guinea pigs. After endotoxin administration (4 mg/kg), MPO activities increased and taurine levels decreased. Therefore levels of TauCl, NO2*- increased. We observed the effects of taurine as conflicting. When taurine was administrated alone (300 mg/kg), all of these parameters decreased.Consequently, we suggested that taurine is influential in infected subjects but not on healthy ones as an antioxidative amino acid. In addition, we believe that in vivo effects of taurine may differ from those in vitro depending on its dosage.

Protective effect of taurine on respiratory burst activity of polymorphonuclear leukocytes in endotoxemia.

The aim of this study was to evaluate the effect of endotoxin on PMN leukocyte respiratory burst activity by measuring G6PD, NADPH oxidase and XO activities in guinea pig. In addition, the possible protective role of taurine against endotoxin-mediated PMN leukocyte function was examined. All experiments were performed with four groups (control, taurine, endotoxemia, taurine plus endotoxin) of ten guinea pigs. After the endotoxin was administrated (4 mg/kg) both G6PD and NADPH oxidase activities were significantly reduced compared with the control group. NADPH oxidase activity returned to the control value and G6PD activity also increased but it did not reach the control value. However when taurine was administrated (300 mg/kg) the activity of NADPH oxidase reached the control value; furthermore, G6PD activity also increased but it could not reach to the control value. When taurine was administrated alone, no effect on these enzymes was observed. Following the endotoxin administration, the activity of XO considerably increased. When taurine was administrated together with endotoxine and alone, this activity decreased compared to control value in both conditions. These results indicate that the O2*- formation in PMN leukocytes after the endotoxin administration is ensured by the catalysis of XO due to the inhibited NADPH oxidase activity. It was observed that taurine has considerable anti-inflammatory and antioxidant effects. However, conflicting results were obtained when taurine was administrated alone or together with an oxidant agent.