The effect of age on the paraoxonase and arylesterase activity of pregnant mothers and their infants.

AIM: The study aimed to research the effect of maternal age at pregnancy on the paraoxonase (PON) and arylesterase activity levels of mothers and infants. METHOD: The study comprised 30 mothers aged more than 35 years and their infants, and 30 mothers aged under 25 years and their infants. All pregnancies had been of 38-42 weeks with normal spontaneous vaginal birth. PON and arylesterase activities were measured using paraoxon and phenylacetate substrates. RESULTS: When the PON and arylesterase enzyme activities were compared, the PON and arylesterase activity of the mothers aged more than 35 years was found to be statistically significantly lower compared to that of the mothers aged under 25 years (P = 0.006 and P = 0.03, respectively), while there was no statistically significant difference in PON and arylesterase enzyme activity between the two groups of infants (P > 0.05). CONCLUSION: While the PON and arylesterase enzyme activity of the mothers aged more than 35 years was found to be significantly lower compared to that of the mothers aged under 25 years, there was no statistical significance between the infants. This can be explained by the reduced PON and arylesterase enzyme activity during pregnancies at an older age, although this did not affect the PON and arylesterase enzyme activity of the infants.

Harderoporphyria due to homozygosity for coproporphyrinogen oxidase missense mutation H327R.

Hereditary coproporphyria (HCP) is an autosomal dominant acute hepatic porphyria due to the half-normal activity of the heme biosynthetic enzyme, coproporphyrinogen oxidase (CPOX). The enzyme catalyzes the step-wise oxidative decarboxylation of the heme precursor, coproporphyrinogen III, to protoporphyrinogen IX via a tricarboxylic intermediate, harderoporphyrinogen. In autosomal dominant HCP, the deficient enzymatic activity results primarily in the accumulation of coproporphyrin III. To date, only a few homozygous HCP patients have been described, most having Harderoporphyria, a rare variant due to specific CPOX mutations that alter enzyme residues D400-K404, most patients described to date having at least one K404E allele. Here, we describe a Turkish male infant, the product of a consanguineous union, who presented with the Harderoporphyria phenotype including neonatal hyperbilirubinemia, hemolytic anemia, hepatosplenomegaly, and skin lesions when exposed to UV light. He was homoallelic for the CPOX missense mutation, c.980A>G (p.H327R), and had massively increased urinary uroporphyrins I and III (9,250 and 2,910 µM, respectively) and coproporphyrins I and III (895 and 19,400 µM, respectively). The patient expired at 5 months of age from an apparent acute neurologic porphyric attack. Structural studies predicted that p.H327R interacts with residue W399 in the CPOX active site, thereby accounting for the Harderoporphyria phenotype.

Prolidase activity and oxidative status in patients with thalassemia major.

AIM: Prolidase is a specific imidodipeptidase involved in collagen degradation. The increase in the enzyme activity is believed to be correlated with the increased intensity of collagen degradation. The study aimed to evaluate the relationship between prolidase activity and oxidative status in patients with thalassemia major. METHODS: Comparison was made between 87 patients diagnosed with thalassemia major and 33 healthy children of similar age and gender. Mean age of the subjects was 7.5+/-4.3 years in the group of patients with thalassemia major and 8.9+/-3.1 years in the control group. Serum prolidase activity was measured spectrophotometrically. Oxidative status was determined using total oxidant status (TOS), total antioxidant capacity (TAC), and oxidative stress index (OSI) measurement. RESULTS: Prolidase activity was significantly increased in patients with thalassemia major (53.7+/-8.7 U/l) compared to the control group (49.2+/-7.2 U/l, P<0.001). TOS was significantly increased in the patient group (5.31+/-3.14 mmol H2O2 equiv./l) compared to the control group (3.49+/-2.98 mumol H2O2 equiv./l) and the OSI was also significantly increased in the patient group (3.86+/-3.28 arbitrary unit) compared to the control group (2.53+/-2.70 arbitrary unit) (P<0.0001 and P<0.001, respectively), while there were no significant differences between the patient (1.61+/-0.30 mumol Trolox equiv./l) and control (1.64+/-0.33 mumol Trolox equiv./l) groups with respect to TAC. CONCLUSION: Significant increases in prolidase activity in patients with thalassemia major may constitute a key parameter in demonstrating a disorder of the collagen metabolism.

The relationship between carotid intima media thickness and oxidative stress in asthmatic children.

BACKGROUND: Asthma and atherosclerosis are both chronic inflammatory diseases. The progression of the inflammation in asthmatic patients is known to be similar to the increased development of atherosclerosis. OBJECTIVE: The aim of this study was to research the relationship between the difference in carotid intima media thickness (CIMT) and oxidative stress together with difference in CIMT in asthmatic children and control group. METHODS: A total of 84 subjects between 6-15 years of age who had been attending the Pediatric Allergy Unit of the Medical Faculty were included in this study. Asthmatic patients and a control group were evaluated by ultrasonography for measurements of CIMT and oxidative status. RESULTS: In the asthmatic patient group, the CIMT was 0.48 +/- 0.06 mm (right side) and 0.44 +/- 0.05 mm (left side). In the control group it was 0.42 +/- 0.05 mm (right side) and 0.42 +/- 0.04 mm (left side). This difference is statistically significant (p < 0.0001, p = 0.019 respectively). In the asthmatic group a positive correlation was determined between the total oxidant status (TOS) value and the right and left CIMT (p = 0.007, r = 0.44 and p = 0.001, r = 0.50 respectively). CONCLUSIONS: A significant correlation was determined between an increase in oxidative stress and CIMT in asthmatic children. This indicates that atherosclerosis, which is known as an adult disease, may start in childhood. These findings show that it might be beneficial for children who are being followed-up from a diagnosis of asthma to also be evaluated in respect of the development of atherosclerosis.

DNA damage in children with asthma bronchiale and its association with oxidative and antioxidative measurements.

Increased production of reactive oxygen species leading to an imbalance between the oxidative forces and the antioxidant defense systems favoring an oxidative injury has been implicated in the pathogenesis of asthma. The aim of the study was to investigate the peripheral DNA damage, and its association with oxidative and antioxidative measurements in children with asthma bronchiale. The study population contained 42 children with asthma bronchiale and 32 healthy controls. DNA damage was assessed by alkaline comet assay in peripheral lymphocytes. Plasma levels of total antioxidant status (TAS), total peroxide concentration (LOOHs), and total oxidant status (TOS) were determined. In asthma bronchiale patients, DNA damage was significantly higher than in controls (17.9 +/- 11.8 AU vs. 1.2 +/- 2.0 AU, p < 0.001). Plasma TOS and LOOHs were higher in patients than in healthy controls (13.4 +/- 7.0 vs. 9.0 +/- 3.5, p = 0.002; 9.9 +/- 3.4 vs. 4.4 +/- 1.5, p < 0.001, respectively). Plasma TAS level in patients was higher than in healthy controls (5.5 +/- 2.5 vs. 1.0 +/- 0.6, p < 0.001). DNA damage was correlated with TOS (r = 0,616, p < 0.001). The findings indicated that lymphocyte DNA damage level increases in children with asthma bronchiale. Elevated DNA damage may be related to increased oxidative stress. However, the mechanism of this association, and whether it is direct or indirect, remains to be explored.

Paraoxonase and arylesterase activity with oxidative status in children with thalassemia major.

PURPOSE: The aim of this study was to study paraoxonase and arylesterase activities along with oxidative status parameters, and to find out whether there is any increased susceptibility to atherogenesis, which might be reflected with increased oxidative stress and decreased serum paraoxonase/arylesterase activity in beta-thalassemia major (BTM) patients. PATIENTS AND METHODS: Eighty-seven patients with BTM and 33 healthy individuals were enrolled in the study. RESULTS: Paraoxonase and arylesterase activities were significantly lower in BTM patients than controls (for all P<0.0001), whereas total oxidant status, total peroxide concentration levels, and oxidative stress index were significantly higher (P<0.0001, <0.0001, and <0.001, respectively). Correlations were found between serum iron and ferritin and levels of total oxidant status in BTM patients. Significant correlation was found with serum total peroxide concentration levels and paraoxonase and arylesterase activities in patients with BTM. CONCLUSIONS: It was seen that oxidative stress increases, while serum paraoxonase activity is decreased in BTM patients. Decrease in paraoxonase activity seems to be associated with both the degree of oxidative stress and anemia. BTM patients may be more prone to development of atherogenesis because of low serum paraoxonase/arylesterase activity.

Severe osteoporosis and high level TSH in a child before the diagnosis of acute lymphoblastic leukemia.

Osteoporosis in children is rare and mostly secondary to such conditions as prolonged immobilization, malabsorption syndromes, corticosteroid excess, osteogenesis imperfecta, celiac disease, Turner syndrome, and malignancy. Idiopathic juvenile osteoporosis (IJO) is a very rare condition of primary bone demineralization that presents in childhood. IJO, a disease of unknown etiology, manifests typically by pain, bone deformities, and fractures. Diagnosis of IJO was made by excluding other common causes of osteoporosis in this age. Bisphosphonates, calcitriol, fluoride, and calcitonin have been administered therapeutically, but the results were equivocal. Usually the disease remits by itself. Patient that has serious osteoporosis and high thyroid stimulating hormone level was diagnosed as IJO by eliminating secondary reasons. We report this case, whose symptoms were disappeared after parenteral pamidronat treatment, and he was reexamined owing to anemia and trombositopenia, and diagnosed as B-cell acute lymphoblastic leukemia, just to emphasis the importance of close follow-ups of IJO patients.

Oxidative status and paraoxonase activity in children with asthma.

OBJECTIVE: To compare paraoxonase activity and changes in oxidative status in asthmatic children and healthy children by determining serum paraoxonase activity and total oxidative status, total antioxidant capacity and lipid hydroperoxidation. METHODS: Forty two asthmatic children were compared with 32 healthy children of similar age and sex. To evaluate the paraoxonase and oxidative status, total antioxidant capacity and lipid hydroperoxidation were examined. Serum paraoxonase activity was evaluated by measuring the rate of paraoxon hydrolosis. Oxidative status was evaluated by the method developed by Erel. Lipid hydroperoxide was measured by an iodometric method. RESULTS: In comparison with the healthy control group, the paraoxonase activity of the asthmatic children was found to be low (163.7 +/- 73.0 (U/L) and 349.2 +/- 153.9 (U/L), P = 0.002) and total oxidant status (9.0 +/- 3.5 micromol H2O2 Eq/L and 13.4 +/- 7.0 micromol H2O2 Eq/L, P =0.002), total antioxidant capacity (5.5 +/- 2.5 micromol Trolox Eq/L and 1.0 +/- 0.6 micromol Trolox Eq/L, P < 0.001), and lipid hydroperoxidation values (9.9 +/- 3.4 micromol H2O2 Eq/L and 4.4 +/- 1.5 micromol H2O2 Eq/L, P < 0.001) were found to be high. The high density lipoprotein (HDL) concentration of the asthmatic children was lower than that in the control group (40.1 +/- 9.2 mg/dl and 54.5 +/- 15.9 mg/dl, P < 0.001) CONCLUSION: In asthmatic children, when total oxidant status, total antioxidant capacity and lipid hydroperoxidation levels increase, paraoxonase activity decreased.

Serum prolidase activity and oxidative status in patients with bronchial asthma.

Asthma is a disease where there is an accumulation of collagen in the reticular basal membrane of the airway leading to chronic inflammation. The enzyme prolidase plays an important role in the breakdown of collagen and the breakdown of intracellular protein especially in the final stage when peptides and dipeptides contain a high level of proline. To evaluate the relationship between prolidase activity and oxidative status in asthma patients. Comparison was made between 42 patients diagnosed with bronchial asthma and 32 healthy children of similar age and gender. Serum prolidase activity was measured spectrophotometrically. Oxidative status was determined using total antioxidant capacity (TAC) and total oxidant status (TOS) measurement. The prolidase activity of the asthma patient group was statistically significant compared with the control group (P< or =0.001). TAC and TOS levels in the asthma patient group were higher than the control group (P< or =0.001, P< or =0.002, respectively). No correlation was found between the prolidase and oxidative levels of the two groups. A positive correlation was determined between the prolidase activity and TAC in the asthma patient group (P< or =0.001, r=0.501). The prolidase enzyme activity, which plays a role in the collagen turnover, was low in the asthma patients; therefore, their collagen metabolism had undergone a change and this indicates that there may be an effect on the accumulation of collagen in the reticular basal membrane. Moreover, the high level of TOS indicates that these patients were exposed to severe oxidative stress with an increased TAC response.

Phthiriasis palpebrarum in an infant.

The authors describe a case of phthiriasis palpebrarum embedded in the right upper eyelid of a 9-month-old male infant. The patient was successfully treated with mechanical removal of all lice and nits from the eyelashes. In children, phthiriasis palpebrarum should be considered in the differential diagnosis of blepharoconjunctivitis that is resistant to treatment.

Tick infestation of the eyelid: a case report in a child.

A three-year-old girl presented with a small brown lesion on the right upper eyelid margin. Close examination revealed an insect body attached to the eyelid margin. Microscopic examination of the specimen identified the species of the organism as Ixodes ricinus. The tick was completely removed with blunt forceps. She was treated with lid toilet, irrigation, and application of topical 0.3% ciprofloxacin four times daily to the affected eye. The lesion healed without scarring after one week. No systemic symptoms were observed. Mechanical removal with blunt forceps may be a quick, easy, safe and effective treatment for ticks located on the eyelids.

Decreased thymus size in full-term newborn infants of smoking mothers.

BACKGROUND: Prenatal exposure to tobacco can have significant effects on infants. The objective was to investigate whether maternal smoking affects the size of the thymus. MATERIAL/METHODS: A group of 50 pregnant women who smoked throughout pregnancy and a control group of 92 non-smoking pregnant women were studied. The full-term newborn babies' length, weight, and head circumference were measured. The size of the thymus was assessed by sonography during the first six hours of life in both the study group and the control group newborns. RESULTS: The results of the anthropometric measurements in respect of length (50.36+/-2.27, 50.15+/-1.40 cm, p=0.51), weight (3.43+/-5.13, 3.57+/-4.38 kg, p=0.07), head circumference (34.47+/-1.22, 34.57+/-0.93 cm, p=0.62), and head circumference/weight ratio ((9.94+/-1.40, 9.79+/-1.16 cm/kg, p=0.50) were not significantly different between the patient and control groups, respectively. The thymic index (Ti) and thymic index/weight ratio (Ti/w) of the newborns of the smoking group were lower than in the controls (8.70+/-5.80 vs. 13.26+/-5.46, p<0.001 and 2.47+/-1.55 vs. 3.69+/-1.43, p<0.001, respectively). Moreover, the birth weight, head circumference/weight ratio, Ti, and Ti/w of the newborns of those smoking more than 10 cigarettes per day were significantly lower than those smoking less than 10 (3.08+/-0.55 vs. 3.58+/-0.45, p<0.001; 10.65+/-1.84 vs. 9.67+/-1.11, p=0.03; 5.95+/-4 vs. 10.25+/-6.12, p=0.01; and 1.82+/-1.08 vs. 2.84+/-1.66, p=0.02, respectively). CONCLUSIONS: These results show that smoking while pregnant has a significant effect on the general involution of the newborn and size of the thymus, which plays an important role in the immune system.

Can haptoglobin be an indicator for the early diagnosis of neonatal jaundice?

Neonatal jaundice is the result of an imbalance between bilirubin production and elimination. Bilirubin conjugation in newborns is significantly impaired in the first few days; even a small increase in the rate of production can contribute to the development of hyperbilirubinemia. Hemolysis has a significant role in bilirubin increase in newborns. Intrauterine is tolerated by the maternal metabolism in life. When hemolysis takes place, a decrease is accepted in the haptoglobin and hemopoexin blood levels binding hemoglobin in the environment. Therefore, it may be considered that haptoglobin and hemopoexin from the early period umbilical cord (UC) blood in newborns may be an indicator in determining jaundice likely to develop in later stages. Babies were called to the control polyclinic in the third and fifth days. Eighty-four babies with normal term birth were included in the study. Gestational age of the mothers was 39.5+/-1.5 weeks in average. A significant negative correlation was found between the haptoglobin level from the UC taken during delivery and the bilirubin value in the fifth day (r=-0.345; P=0.001). The haptoglobin value from the blood of the UC can be used as a guiding indicator to demonstrate the future occurrence of jaundice in newborns. This way, the babies with high jaundice risk may be detected earlier and closer follow-up of these babies can be obtained. As a result, the haptoglobin level of the blood from the UC during delivery allows us to make an early prediction on whether neonatal jaundice will occur.

Comparison of refractive error and central corneal thickness in neonates of diabetic and healthy mothers.

PURPOSE: To determine the refractive error and central corneal thickness of neonates born to diabetic mothers and to compare these parameters with those of healthy neonates born to healthy mothers. METHODS: This prospective, cross-sectional study was conducted on 16 consecutive full-term neonates born to diabetic mothers and 17 full-term healthy neonates. The neonates underwent ophthalmic examination within the first week of life. Refractive measurements were assessed by retinoscopy. Central corneal thickness was recorded by using ultrasound pachymeter. RESULTS: The mean spherical equivalent for both eyes in the diabetic group was +2.9 ± 2.6 and significantly greater than that of the nondiabetic group (+1.3 ± 2.1 D) (p = 0.008). The mean sphere value was +2.6 ± 2.4 D in the diabetic group and +1.0 ± 2.0 D in the nondiabetic group, significantly higher in the diabetic group (p = 0.008). In both groups, mean astigmatism was less than 1.00 D, it was lower in the diabetic group, and there was no statistically significant difference between groups (p = 0.95). There were 2 patients in each group with anisometropia. The mean central corneal thickness in the nondiabetic group was 542.9 ± 21.9 µm whereas it was 592.0 ± 40.2 µm in the diabetic group, which was significantly thicker (p = 0.05). CONCLUSIONS: Our study revealed that neonates of diabetic mothers seem to be more hypermetropic compared to full-term healthy neonates; however, we did not observe any significant astigmatism in either group. Neonates of diabetic mothers had thicker corneas.

An Evaluation of Oxidative Status in Serum and Breast Milk of Mothers Giving Birth Prematurely and at Full-Term.

BACKGROUND: Burning fat and carbohydrates to provide energy in biological systems causes the formation of free oxygen species. OBJECTIVES: This study aimed to evaluate the oxidative status of serum and breast milk of mothers giving birth prematurely and at full-term. MATERIALS AND METHODS: The study comprised 50 mothers who gave birth at full-term at more than 38 weeks and 43 mothers who gave birth pre-term at below 32 weeks. On the postnatal 5th day, samples of the mother's milk and serum were taken and stored at -80°C until the study day. On the study day, the total oxidant and total antioxidant levels were measured using the Erel method and the oxidative stress index (OSI) was calculated. RESULTS: While the total oxidant level and total antioxidant level values of the milk of the premature birth mothers were found to be significantly high compared to those of the full-term birth mothers (P = 0.001), no statistically significant difference was found in the oxidative stress index values (P > 0.05). No statistically significant difference was found in the total oxidant level and oxidative stress index values of the serum of the premature birth mothers compared to those of the full-term birth mothers, while the total antioxidant level was found to be significantly low (P = 0.04). CONCLUSIONS: The oxidants and antioxidants in the milk of mothers giving birth prematurely were found to be significantly higher than those of full-term birth mothers. This can be evaluated as the milk of the premature birth mothers providing increased antioxidant defense to protect the infant.

Diffusion-weighted imaging of patients with neonatal bilirubin encephalopathy.

PURPOSE: The aim of the study is to evaluate neonatal bilirubin encephalopathy in the acute period by the DWI. MATERIALS AND METHODS: Thirty newborn babies with hyperbilirubinemia at the gestational age of 38-40 weeks, diagnosed with acute neonatal bilirubin encephalopathy as a result of clinical findings were included in the study, and a further 24 newborn babies, whose ages, weights and gestational ages were equalized, were regarded as a control group. DWI was performed on both patient and control groups. RESULTS: When DWI apparent diffusion coefficients (ADC) of both neonatal bilirubin encephalopathy patients and the control group were compared, ACD values of neonatal bilirubin encephalopathy patients were found to be statistically significantly highly compared to that of the control group (p < 0.001). There was a significant correlation between bilirubin values and DWI findings (r = 0.41, p < 0.05). CONCLUSION: The ADC measurement could be a promising parameter in detecting neonatal bilirubin encephalopathy.

Paraoxonase activity in athletic adolescents.

Regular physical activity may play a protective role against cardiovascular disease in adults, and paraoxonase activity may serve to mediate this effect. This study compared paraoxonase activity and that of other antioxidative agents in adolescent athletes compared with inactive youth. Paraoxonase level was 177.32 +/- 100.10 (U/L) in children with regular physical activity and 98.11 +/- 40.92 (U/L) in the control group (P < 0.0001). The levels of total antioxidative capacity, total oxidative status, oxidative stress index, and lipid hydroperoxide were significantly higher in the athlete group compared with controls (P < 0.0001). Paraoxonase activity was found to be greater in adolescent athletes, suggesting that regular exercise might provide a cardio-protective effect by this means.

The oxidative state of children with cyanotic and acyanotic congenital heart disease.

OBJECTIVE: The type of congenital heart disease, early diagnosis, and treatment modality all play an important role in the morbidity and mortality of these diseases. This study examined the relationship between congenital heart disease and oxidative stress in children with cyanotic and acyanotic congenital heart disease. METHODS: In this case-controlled cross-sectional study, the study groups consisted of 29 patients with cyanotic heart disease, 30 patients with acyanotic heart disease, and a control group of 32 healthy individuals. For all groups, the total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index (OSI) were calculated. Of the cyanotic group, 12 were diagnosed with tetralogy of Fallot, 7 with transposition of the great arteries, 4 with tricuspid atresia, 4 with double outlet right ventricle and 2 with truncus arteriosus. In the acyanotic group 19 patients had ventricular septal defect (VSD), 5 atrial septal defect (ASD) and 6 patent ductus arteriosus (PDA). Statistical analyses were performed using Chi-square, Mann-Whitney U and Kruskal-Wallis tests. RESULTS: The plasma TAS, TOS, and OSI were significantly higher in the cyanotic group than in the acyanotic group (p<0.0001, p<0.01, and p<0.01, respectively) and controls (p<0.0001, p<0.0001, and p<0.0001, respectively). A comparison between the acyanotic and control groups showed no statistical differences. CONCLUSION: The level of oxidative stress in patients with cyanotic congenital heart disease was significantly higher than in the acyanotic and control groups, which were similar.

Serum copper and zinc levels in mothers and cord blood of their newborn infants with neural tube defects: a case-control study.

OBJECTIVES: To measure the cord blood and maternal serum levels of folic acid, vitamin B12, zinc, copper, selenium and lead in infants born with neural tube defect (NTD), and to examine a possible relationship between the nutriture of these micronutrients and occurrence of neural tube defect. DESIGN: Case-control study. METHODS: Maternal serum and cord blood samples were obtained at delivery from 70 healthy mothers and 74 mothers who had a newborn with NTD. RESULTS: The mean (+/- SD) maternal serum zinc level in the NTD group was significantly lower than that of the control group (835.6 microg/L (+/- 333.8 /L vs. 1035.7 microg/L (+/- 299.8 g/ L, P=0.004, respectively). The mean maternal and cord serum copper levels in the NTD group were significantly higher when compared to the control group (2831.1 microg/L (+/- 1017 g/L vs. 2402 microg/L (+/- 744.2 microg/L; P=0.03; and 789.8 microg/L vs 517.2 microg/L, P < 0.001, respectively). There was a negative correlation between the cord levels of folic acid and copper in the NTD group with the respective maternal serum levels (r=-0.289; P=0.018). CONCLUSIONS: High maternal serum levels of copper and lower level of zinc during pregnancy associated with NTD in newborn.

Comparative study between the Ves-matic and microerythrocyte sedimentation rate method.

In this study, Ves-matic erythrocyte sedimentation rate and micro-erythrocyte sedimentation rate methods were compared on 96 subjects mean age 4.9+/-4.3 years. Ves-matic erythrocyte sedimentation rate an automated method, and micro-erythrocyte sedimentation rate method required minimal bloods are various approaches on the erythrocyte sedimentation rate. An important relationship between that the Ves-matic and micro-erythrocyte sedimentation rate was revealed. Although there was significantly correlation between these two methods, they are different to use interchangeably. Our study implies that "Micro-Automated Erythrocyte Sedimentation Rate Systems" could be developed which require a few amounts of blood and study automatically.