The effects of dexmedetomidine on biomarkers of oxidative stress and antioxidants in kidney.

BACKGROUND AND AIM: Cerebral ischemia not only disrupts brain functions, but also damages other organs. We aimed to determine whether two different doses of dexmedetomidine (DEX) had protective effects against the oxidative damage to kidneys. MATERIALS AND METHODS: Forty-two rats were equally divided into 7 groups. The first group was the control group. Second group members were operated to expose the cerebral artery without inducing cerebral ischemia. The third and fourth groups were DEX treatments groups. The fifth, sixth and seventh group were operated to induce cerebral ischemia. DEX was given to the groups at the 3rd, 24th and 48th hour. RESULTS: MDA levels in the kidneys were higher in the group with cerebral ischemia. Significant reductions in MDA levels were observed after treatment with DEX in the ISCH group (p < 0.05). Decreased GSH-Px activity and reduced glutathione GSH levels in the kidneys were observed with DEX treatments. After treatment, there was a significant increase in α-tocopherol and ß-carotene levels (p < 0.01). CONCLUSION: DEX administration during cerebral ischemia had a positive effect on oxidative stress and antioxidants in rat kidney (Tab. 1, Fig. 5, Ref. 31).

Correlation of the coronary severity scores and mean platelet volume in diabetes mellitus.

INTRODUCTION: It is known that mean platelet volume (MPV) increases during acute coronary syndrome. However, there are conflicting data about the importance of MPV in patients with stable coronary artery disease (CAD). This study aimed to assess relationship between MVP and the severity of coronary atherosclerosis in patients with diabetes mellitus (DM), stable CAD and normal left ventricular ejection fractions. METHODS: Thirty-three DM and 46 nonDM patients with stable CAD diagnosed by selective coronary angiography were included in the study. All angiographic variables pertinent to Gensini score (GS) and Syntax score (SS) calculation were computed by two experienced interventional cardiologists. All patients underwent echocardiographic examination. MPV and other biochemical markers were measured on admission. RESULTS: All patients were evaluated and it was found that both scoring systems are correlated with MPV (GS: r = 0.373, p < 0.001; SS: r = 0.385, p < 0.001). DM and nonDM groups were severally evaluated, it was found that the correlation between MPV and GS and SS increased in DM patients (GS: r = 0.638, p < 0.001; SS: r = 0.624, p < 0.001); however, no differences were identified in nonDM patients (GS: r = 0.124, p = 0.410; SS: r = 0.124, p = 0.411). CONCLUSION: It is thought that high MPV levels may be an effective marker in determining the severity of CAD in patients with DM. And the high MPV level may be related with CAD pathophysiology in DM patients.

Acute-phase reactants and cytokines in ischemic stroke: do they have any relationship with short-term mortality?

BACKGROUND: Many unknown risk factors play a role in the etiopathogenesis of stroke. The appearance of inflammatory cells within the damaged tissue after cerebral ischemia suggests that an inflammatory response may play a role in stroke pathogenesis. In our study, we examined whether an association exists between the acute-phase reactants and the levels of cytokines, the volume and diameter of the stroke, and short-term mortality in patients who were diagnosed as acute ischemic a stroke after admission to the Emergency Department. PATIENTS AND METHODS: A total of 50 consecutive patients who applied to the Emergency Service with acute ischemic stroke were enrolled in the study. Their stroke volume were calculated and serum samples were obtained as soon as they arrived into the Emergency Service. The patients were evaluated according to the Glasgow Coma Scale (GCS) and National Institutes of Health Stroke Scale (NIHSS). RESULTS: There was no significant correlations between stroke volume and levels of cytokine and acute-phase reactants in dead patient group or in living patient group. A correlation and statistical significance was found between stroke volume and hospital stay time in living patient group. In addition, GCS and NIHSS scores were correlated with stroke volume and was found a significant statistically. CONCLUSIONS: Scales such as GKS and NIHHS, which evaluate the functional state of patients, are the best indicators for defining prognosis in our daily practices. In addition, we found a positive correlation between levels of CRP (C reactive protein) and prognosis. However, we did not observe a statistically significant correlation between prognosis and other acute-phase reactants such as TNF-alpha, IL-6, IL-8, IL-10, fibrinogen, and leukocytes.

Effects of apolipoprotein E genotypes and other risk factors on the development of coronary artery disease in Southern Turkey.

BACKGROUND: Apolipoprotein E (apoE) plays a major role in lipoprotein metabolism and lipid transport. Associations between apoE genotypes, coronary artery disease (CAD) and other risk factors have been described by many investigators. The aim of this study was to investigate the role of apoE gene polymorphism and other risk factors in the development of CAD in subjects whose coronary arteries were evaluated by means of coronary angiography. METHODS: The study population consisted of 199 subjects (114 male and 55 female). Of the total, 107 had CAD. The apoE gene was amplified by polymerase chain reaction (PCR) and then digested by CfoI restriction enzyme. The plasma lipid levels and other risk factors were also determined in all subjects. RESULTS: The epsilon2 and epsilon4 allele frequencies and genotypes carrying epsilon4 allele were significantly higher in CAD (+) patients. Plasma lipids except triglycerides were increased in CAD (+) cases. We found that apoE genotypes, HT, DM, male gender, age and smoking were the independent predictors of CAD. There was no association between apoE alleles and lipids. CONCLUSION: We conclude that apoE polymorphism (presence of epsilon4 allele) is associated with the development of CAD in Southern Turkey. In our study, we did not observe any effect of apoE alleles on lipid levels.

Technetium-99m-tetrofosmin scintigraphy in pulmonary tuberculosis.

UNLABELLED: Technetium-99m-tetrofosmin, an agent that is widely used in myocardial imaging, has been reported to accumulate in several types of malignancies, including lung tumors. Yet, there is limited knowledge about its role in imaging infection or inflammatory lesions. The aim of this study was to investigate the role of 99mTc-tetrofosmin scintigraphy in pulmonary tuberculosis in cases with active and inactive tuberculosis in comparison with radiological and microbiological findings. METHODS: Twenty-seven patients with active pulmonary tuberculosis (APTB) and 6 patients with inactive pulmonary tuberculosis (IPTB), proven by sputum smears and cultures, were included in this study. Mean age of the group was 42.6+/-13 yr. Nine months after therapy, 99mTc-tetrofosmin scintigraphy was repeated in 6 patients with APTB to evaluate response to therapy. Ten-minute anterior and posterior chest images were acquired 20 and 60 min after the injection of 370 MBq (10 mCi) 99mTc-tetrofosmin. The images were evaluated both visually and semiquantitatively by two blinded nuclear medicine physicians. For semiquantitative evaluation, regions of interest (ROIs) were drawn over the lesion (L) and nonlesion areas (NL). The mean count values of ROIs were obtained and L/NL ratios were calculated. RESULTS: According to the visual evaluations, 99mTc-tetrofosmin uptake was Grade (+) in 4 (15%) and Grade (++) in 23 (85%) patients with APTB. Technetium-99m-tetrofosmin uptake was negative in 5 patients with IPTB. Grade (+) 99mTc-tetrofosmin uptake was observed in only one inactive case. After therapy, there was no 99mTc-tetrofosmin uptake in 3 patients, which correlated well with chest radiography and clinical findings. In the other 2 patients, 99mTc-tetrofosmin uptake was slightly decreased when compared with a previous scan that correlated with radiological and clinical findings. In 1 patient with bilateral lung disease, 99mTc-tetrofosmin uptake decreased on the right lung lesions, whereas the left lung lesions persisted with no change. The mean early and delayed L/NL ratios of APTB were 1.53+/-0.22 and 1.45+/-0.21, respectively. Although 99mTc-tetrofosmin uptake in APTB lesions was more visually marked in early images than that in delayed images, there was no statistically significant difference between these two sets of images. CONCLUSION: Technetium-99m-tetrofosmin scintigraphy showed increased uptake in APTB lesions related to disease activity. After treatment, 99mTc-tetrofosmin uptake disappeared or decreased, correlating well with radiological and clinical findings. Technetium-99m-tetrofosmin scintigraphy may have a complementary role in the assessment of APTB as well as in follow-up treatment.

Apoptosis bcl-2 and p53 expression and their relation to tumour stage in non-small cell lung carcinomas (NSCLC).

Little quantitative data exist on the extent of apoptosis (genetically mediated cell deletion) and no data are available on its relation to p53 and bcl-2 expression and on its value as a prognostic factor in NSCLCs. We examined 38 NSCLCs (26 squamous, 8 adeno, 2 adenosquamous and 2 large cell carcinomas) for the frequency of apoptotic bodies by morphometric methods using haematoxylin eosin stained sections and for the bcl-2 and mutant p53 gene product expression using immunohistochemical techniques. We also evaluated the relation of apoptosis, bcl-2 and p53 expression to tumour stage and to each other. Eleven cases were in stage I, 5 were in stage II, 13 were in stage III and 9 were in stage IV. The mean apoptotic count was 9.52 (r: 2-26); 36.8% of cases were positive for bcl-2 and 76.3% of cases were positive for p53 expression. Statistical analysis did not show any correlation between tumour stage and any of the three tested parameters. There was no statistically significant relation between apoptosis and either p53 or bcl-2 expression. There are conflicting reports on the complex relationship between bcl-2, p53 and apoptosis. bcl-2 is suggested to have a prognostic value, independent from stage in SCLCs. Though we did not find any relation between stage and bcl-2 or apoptosis, it remains to be tested whether they have any independent prognostic value in larger series with survival data.

CD44 expression in metastatic and non-metastatic non-small cell lung cancers.

CD44 is an integral membrane glycoprotein that functions as a receptor for the extracellular matrix glycan, hyaluronan. It exists as standard (CD44s) and variant (CD44v) isoforms which have been shown to be associated with metastasis in a range of tumors. Both CD44s and CD44v are found in normal respiratory epithelium and in non small cell lung cancers (NSCLCs). However, there isn't much information regarding their role in the metastatic process of NSCLCs. We examined the expression of CD44s in 30 NSCLCs using immunohistochemical techniques. Ten were non-metastatic (N0, M0), 5 were metastases to lymph nodes (N1, M0) and 15 were excised brain metastases. We found CD44s positivity in all non-metastatic tumors with varying degrees of expression, whereas 10 out of 15 metastatic tumors in brain and 3 out of 5 lymph node metastases were negative for CD44s. There was a statistically significant inverse relation between the CD44s expression and metastatic potential (P < 0.05). Our results support the hypothesis that diminished or lack of CD44s is the functional equivalent of CD44v which may be an accompaniment of enhanced metastatic potential. The value of CD44 in predicting metastatic behavior of NSCLCs remains to be established in a larger series.

High resolution computed tomographic findings in pulmonary tuberculosis.

BACKGROUND: Although chest radiographs usually provide adequate information for the diagnosis of active pulmonary tuberculosis, minimal exudative tuberculosis can be overlooked on standard chest radiographs. The aim of the present study was to assess the findings of active pulmonary tuberculosis on high resolution computed tomographic (HRCT) scans, and to evaluate their possible use in determining disease activity. METHODS: Thirty two patients with newly diagnosed active pulmonary tuberculosis and 34 patients with inactive pulmonary tuberculosis were examined. The diagnosis of active pulmonary tuberculosis was based on positive acid fast bacilli in sputum and bronchial washing smears or cultures and/or changes on serial radiographs obtained during treatment. RESULTS: With HRCT scanning centrilobular lesions (n = 29), "tree-in-bud" appearance (n = 23), and macronodules 5-8 mm in diameter (n = 22) were most commonly seen in cases of active pulmonary tuberculosis. HRCT scans showed fibrotic lesions (n = 34), distortion of bronchovascular structures (n = 32), emphysema (n = 28), and bronchiectasis (n = 24) in patients with inactive tuberculosis. CONCLUSIONS: Centrilobular densities in and around the small airways and "tree-in-bud" appearances were the most characteristic CT features of disease activity. HRCT scanning clearly differentiated old fibrotic lesions from new active lesions and demonstrated early bronchogenic spread. These findings may be of value in decisions on treatment.

The effects of theophylline on serum alprazolam levels.

Theophylline and benzodiazepines are frequently combined in clinical practice. Because of a number of case reports about antagonism of benzodiazepine-induced sedation by theophylline, we investigated serum alprazolam levels in a convenient sample of pulmonary medicine inpatients receiving theophylline and no theophylline. One mg of alprazolam was given daily for seven days to 6 patients receiving theophylline and 7 patients not receiving theophylline treatment. On days 2 through 7, trough serum alprazolam levels were measured. On day 7, blood samples were collected before (0 hour), and at 3, 6, 9 and 12 hours after alprazolam administration. In patients receiving theophylline, serum trough alprazolam levels were significantly lower during each day of the study. In patients receiving no theophylline, serum alprazolam levels were in the therapeutic range, except for two patients who had high alprazolam levels. In this small study, serum alprazolam levels were found to be consistently below the therapeutic range in patients receiving chronic theophylline treatment. Previously reported antagonism of anxiolytic effects of benzodiazepines by theophylline is probably due to the lower serum benzodiazepine levels in these patients.