Protective role of S-adenosylmethionine on high fat/high cholesterol diet-induced hepatic and aortic lesions and oxidative stress in guinea pigs.

S-adenosylmethionine (SAM) is the main methyl group donor and has antioxidant potential. In this study, preventive and regressive potential of SAM were investigated in high fat/high cholesterol (HFHC) diet-induced non-alcoholic fatty liver disease (NAFLD) in guinea pigs. They were injected with SAM (50 mg/kg, i.p.) for 6 weeks along with HFHC diet or 4 weeks after HFHC diet. Serum transaminase activities, total cholesterol (TC), triglyceride (TG), cytochrome p450-2E1 (CYP2E1) and hydroxyproline (Hyp) levels, prooxidative and antioxidative parameters, protein expressions of α-smooth muscle actin (α-SMA) and transforming growth factor-ß1 (TGF-ß1) together with histopathological changes were examined in the liver. SAM treatment diminished HFHC diet-induced increases in serum transaminase activities and hepatic TC, TG, CYP2E1, Hyp, α-SMA and TGF-ß1 expressions and ameliorated prooxidant-antioxidant balance. Histopathological scores for hepatic steatosis, inflammation, and fibrosis were decreased by SAM treatment. Increases in TC, diene conjugate levels, and lipid vacuoles within the tunica media of the aorta were reduced in HFHC-fed animals treated with SAM. These protective effects were also detected in the regression period of HFHC-guinea pigs due to SAM. In conclusion, SAM treatment was found to be effective in prevention and regression of HFHC-induced hepatic and aortic lesions together with decreases in oxidative stress in guinea pigs with NAFLD.

Comparison of oxidative stress markers in the saliva, gingival crevicular fluid, and serum samples of pregnant women with gestational diabetes and healthy pregnant women.

BACKGROUND AND OBJECTIVE: To compare oxidative stress (OS) markers in the saliva, gingival crevicular fluid (GCF), and serum samples of pregnant women with gestational diabetes (GDM) and healthy pregnant women and to investigate the association between periodontal health/diseases and OS and GDM. METHOD: Eighty women with GDM and 80 healthy pregnant women were included in the study. Medical and clinical anamnesis was obtained from all the pregnant women included in the study, and their plaque index (PI), gingival index (GI), bleeding on probing (BoP), probing pocket depth (PPD), and clinical attachment level (CAL) measurements were performed. GCF, saliva, and serum samples were collected for the measurements of the local and systemic total antioxidant status (TAS) and total oxidant status (TOS). RESULTS: Clinical periodontal parameters were found to be significantly higher in the GDM group compared to the control group. The serum and saliva TAS, TOS, and TAS/TOS values were significantly lower in the GDM group than in the control group. In the analysis of the GCF samples, the mean TAS and TAS/TOS values were significantly lower and the TOS value was significantly higher in the GDM group than in the control group. The multivariate reduced model indicated that gravidity, salivary TAS/TOS, and GCF TAS were significant independent variables in the development of GDM (p < .05). CONCLUSION: Our results indicated that the OS of serum, saliva, and GCF samples increased in patients with GDM compared to healthy pregnant women. The role of local OS parameters in GDM may be associated with elevated clinical periodontal parameters.

Carnosine decreased oxidation and glycation products in serum and liver of high-fat diet and low-dose streptozotocin-induced diabetic rats.

High-fat diet (HFD) and low-dose streptozotocin (STZ)-treated rats provide useful animal model for type II diabetes mellitus. Oxidative stress and advanced glycation end products (AGEs) play a role in the development of diabetic complications. Carnosine (CAR) has anti-oxidant and anti-glycating properties. We investigated the effects of CAR on oxidation and glycation products in HFD+STZ rats. Rats were fed with HFD (60% of total calories from fat) for 4 weeks, and then a single dose of STZ (40 mg/kg; i.p.) was applied. Rats with blood glucose levels above 200 mg/dl were fed with HFD until the end of the 12th week. CAR (250 mg/kg body weight; i.p.; five times a week) was administered to the rats for the last four weeks. CAR significantly decreased serum triglyceride (TG) (57.7%), cholesterol (35.6%) levels and hepatic marker enzyme activities of HFD+STZ rats. It significantly reduced serum reactive oxygen species (ROS) (23.7%), AGEs (13.4%) and advanced oxidized protein products (AOPP) (35.9%) and hepatic TG (59%), ROS (26%), malondialdehyde (MDA) (11.5%), protein carbonyl (PC) (19.2%) and AGE (20.2%) levels. Liver steatosis and hepatocyte ballooning were also significantly reduced. However, CAR treatment did not alter serum glucose and blood glycated haemoglobin and hepatic anti-oxidant enzyme activities/mRNA expressions in HFD+STZ rats. Our results indicate that CAR decreased accumulation of oxidation and glycation products, such as MDA, AGE, AOPP and PC in the serum and liver and ameliorated hepatic dysfunction in HFD+STZ rats. This effect may be related to its anti-oxidative, anti-glycating, and anti-lipogenic potential.

Comparison of Serum Neurofilament Light Chain and Tau Protein Levels in Cases with Autism Spectrum Disorder and Their Healthy Siblings and Healthy Controls.

Objective: : There is a growing interest among clinicians and researchers in identifying potential biomarkers associated with autism. Neurofilament light chain (NfL) and Tau protein, which are proteins associated with neurodegeneration and neuroaxonal degeneration, are particularly promising potential biomarker candidates in this field. Methods: : In this study, we compared serum NfL (sNfL) and serum Tau (sTau) levels in Autism spectrum disorder (ASD) patients, their healthy siblings (HS), and healthy controls (HC), aimed to investigate their relationship with ASD severity. Our study included 43 ASD-diagnosed participants, 43 HS participants and 42 HC participants. Clinical characteristics of the participants were assesed by Kiddie Schedule for Affective Disorders and Schizophrenia, Childhood Autism Rating Scale, Aberrant Behavior Checklist, and Strengths and Difficulties Questionnaire. Serum samples were subjected to analysis via enzyme-linked immunosorbent assay to quantitatively measure the levels of NfL and Tau protein. Results: : sNfL levels in the ASD group were significantly higher than both of the control groups. Regarding sTau levels, no significant difference was found between study and control groups. In addition, NfL and Tau levels were not significantly correlated with ASD symptom severity. Conclusion: : Our findings may indicate that the sNfl levels associated with neuroaxonal damage may constitue a potential clinical biomarker rather than being an endophenotype phenomena.

Evaluation of the effect of vascularized fibula graft harvesting on coronal plane alignment and functional outcomes of the lower limb.

Recent studies on fibular osteotomy for varus gonarthrosis and possible subsequent biomechanical changes have attracted increasing attention to the topic. Existing studies have focused mainly on proximal fibular osteotomy with short follow-up periods. The aim of this study was to investigate changes in the alignment of the coronal plane of the ankle and knee joints in patients who underwent vascularized fibula graft harvest (VFGH). The evaluation was based on functional outcomes and radiological measurements.In the comparison between the VFGH side and the contralateral side, no significant differences in the knee inclination (KI) or talar inclination (TI) angle, knee medial clear space (K-MCS) or ankle medial clear space (A-MCS) distance were noted. However, a significant difference in the hip knee (HKA) angle was observed between the operated and nonoperated sides (0.3° ± 1.8° and 1.5° ± 1.9°, respectively [p = 0.019]). Statistically significant differences in both the knee society score (KSS) and the AOFAS scores were found between the ipsilateral donor limb and the contralateral healthy limb. Although the contralateral healthy side had better clinical scores than the VFGH side, the outcomes of the VFGH side were still satisfactory or excellent.

Mid-Term Clinical and Radiological Results at a Tertiary Care Hospital in Türkiye: Is Residual Varus Really Important After Mechanically-Aligned Total Knee Arthroplasty?

INTRODUCTION:  Traditionally, in total knee arthroplasty (TKA), it is aimed to keep the mechanical axis of the lower extremity neutral (mechanical alignment: 3° varus-valgus in the coronal plane) to improve long-term outcomes. This study aimed to assess the mid-term radiological and clinical results of patients with postoperative residual varus (more than 3° of varus) after mechanically-aligned TKA. METHODS: A total of 616 individuals who had undergone TKA for primary knee osteoarthritis between 2008 and 2013 in our tertiary care hospital were retrospectively examined. All TKAs were performed with the mechanical alignment strategy. For radiological evaluation, hip-knee-ankle (HKA) angle, knee alignment angle (KAA), mechanical medial proximal tibial angle (mMPTA), knee inclination (KI), joint line orientation angle relative to ground (JLOA-G), posterior tibial slope (PS), joint line convergence angle (JLCA) were measured. Besides, patients' latest radiographs were screened for any clue of aseptic loosening or mechanical failure. Knee Society Score (KSS) (knee and functional subgroups), and Lysholm, Oxford, and Tegner scores were used for clinical evaluation. In addition, knee flexion and extension limitations were assessed. RESULTS: After applying the exclusion criteria, a minimum of five-year follow-up result of 110 patients was demonstrated. There were 101 females (92%) and nine males (8%). The mean follow-up time was 65.8 ± 6.3 months (range: 60.8-75.8 years). The mean age was 65.9 ± 7.7 years (range: 39 to 89 years). The preoperative mean mechanical axis angle of the lower extremity was 17.3° ± 7.8° (range: 13.4-43.9°), whereas it was 8.3° ± 3.6° (range: 3.2-19.8°) postoperatively. The preoperative mean flexion angle was 90.7° ± 23.8° (range: 40-130°), and the extension limitation was -2.5° ± 7.4° (range: -40-0°), whereas, postoperatively, they were 102.8° ± 15.4° (range from 40° to 150°) and -3.7° ± 7.5° (range from -40° to 0°), respectively. The latest follow-up's mean KSS knee subgroup was 67 ± 18.4 (range: 12-93), the mean KSS functional subgroup was 74 ± 23.6 (range: 20-100), the mean Lysholm score was 81.7 ± 15.7 (range:25-100), the mean Tegner score was 3.65 ± 0.99 (range: 1-5), the mean Oxford score was 37.4 ± 6.5 (range: 9-48). There was no patient with aseptic loosening or mechanical failure. CONCLUSIONS: In the mid-term follow-up of patients with residual varus after mechanically-aligned TKA, satisfactory clinical and radiological results were obtained without aseptic loosening or implant failure.

Comparison of Contemporary Surgical Indications for Revision Total Knee Arthroplasty between 2005-2011 and 2012-2017 in a Referral Center.

Background: Different causative factors for revision total knee arthroplasty (TKA) surgeries are elucidated in the arthroplasty registry data of different countries and the patient records at tertiary care centers. We aimed to determine the changes in the causes for revision TKAs before and after 2011 (The year that the Musculoskeletal Infection Society proposed a new definition for periprosthetic joint infection) and the changes in the demographics of patients who underwent revision TKAs during the same time intervals. Methods: Patients who underwent revision TKAs between 2004 and 2017 were evaluated. A total of 291 patients operated before (period 1, n = 139) and after (period 2, n = 152) 2011 were included, while 53 patients with inconclusive diagnoses were excluded. The demographic data of patients and the causes for revision TKAs were collected and compared between the two periods. Results: Infection was the most common cause of revision TKAs during periods 1 (58%) and 2 (48%). Aseptic loosening (46%) and infection (37%) were the 2 most common causes for late revisions during period 2. Aseptic loosening almost doubled during period 2 compared with that in period 1. Age, sex, and body mass index distribution in patients were similar across both the periods. Conclusion: Although the incidence of aseptic loosening has significantly increased since 2011, infection is still the most common cause for revision knee arthroplasty surgery.

Comparison of clinical and radiological results of fixation methods with retrograde intramedullary Kirschner wire and plate-screw in extra-articular metacarpal fractures.

OBJECTIVES: In this study, we aimed to compare clinical and radiographic outcomes of retrograde intramedullary Kirschner-wire (K-wire) fixation with those of plate-screw (PS) fixation. PATIENTS AND METHODS: A total of 98 metacarpal shaft fractures in 75 patients (65 males, 10 females; mean age: 31.2±10.9 years; range, 16 to 65 years) were included between January 2011 and December 2017. The total joint active range of motion (AROM) and grip strength of the healthy and broken hands were evaluated. The Visual Analog Scale (VAS) and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores were recorded. We compared surgery duration, number of fluoroscopy images, and cost-effectiveness for each technique. RESULTS: The overall mean follow-up was 21.9 (range, 12 to 56) months. At the last follow-up, total joint AROM (p=0.072), VAS score (p=0.298), QuickDASH score (p=0.132), and hand grip strength (p=0.947) were similar between the groups. Radiological union occurred in the PS and K-wire groups in a mean of 5.84 (range, 3 to 8) and 4.46 (range, 3 to 20) weeks, respectively (p=0.173). A significant difference was found in surgery duration (p=0.021) and number of fluoroscopy images (p<0.05) between the PS and K-wire groups. Two wound complications were observed in the PS group and one with K-wires. CONCLUSION: Retrograde intramedullary K-wire fixation has certain advantages such as being less invasive and more accessible with shorter operation time, compared to PS fixation. Similar radiological and clinical scores can be obtained in patients undergoing retrograde intramedullary K-wire fixation or PS fixation.

Iodine status of Turkish pregnant women and their offspring: A national cross-sectional survey.

BACKGROUND: This national cross-sectional survey aimed to assess the iodine status in pregnant women and their offspring, and also to demonstrate regional differences by measuring urinary iodine concentration (UIC). For each woman and her newborn a questionnaire was prepared with basic facts as age, parity number or birth weight and additional information regarding thyroid diseases, use of iodized salt in the household, extra iodine supplementation during pregnancy, education level and wage income. METHODS: The target population represented 1444 pregnant women who gave birth between January 1 st, 2018 and 2019, and their offspring. Iodine deficiency for pregnant women and their offspring were defined as urine iodine level <150 µg/L and <100 µg/L, respectively. Results are given as median (25th-75th percentile). RESULTS: The median UIC in the group of pregnant woman was 94 (52-153) µg/L. Within the sample of 1444 pregnant women, UIC indicative of mild iodine deficiency (100-149 µg/L) was present in 21 % (n = 306), moderate deficiency (50-99 µg/L) in 30 % (n = 430), and severe deficiency (<50 µg/L) in 23 % (n = 337). This study showed a prevalence of 74 % of iodine deficiency in Turkish pregnant woman. The median UIC in the group of offspring was 96 (41-191) µg/L. Within the new-borns, UIC indicative of mild iodine deficiency (50-99 µg/L) was present in 22 % (n = 323), moderate deficiency (20-49 µg/L) in 15 % (n = 222), and severe deficiency (<20 µg/L) in 13 % (n = 192). This survey showed a prevalence of 51 % of iodine deficiency in Turkish new-borns. Pregnant women with lower socioeconomic and education level, lower access to household iodized salt, lower rates of exposure to povidone-iodine containing skin disinfectant, higher parity and higher iodine deficiency had higher rates of iodine deficiency in their offspring. Regional differences were observed both in mothers and their offspring concerning their iodine status. CONCLUSIONS: Our findings suggest that iodine deficiency is still an important public health problem in Turkey. More drastic measures should be taken to decrease these important iodine deficiencies, both in pregnant women and in their offspring.

The protective effects of sesamol in a neonatal rat model of necrotizing enterocolitis.

Background and aim: Necrotizing enterocolitis (NEC) is a severe gastrointestinal inflammatory disease associated with high rates of morbidity and mortality. Its pathophysiology includes hypoxic-ischemic injury that may be related to oxygen-derived free radical formation. Sesamol is considered to be an antioxidant and free radical scavenger with anti-inflammatory effects. The aim of this study is to investigate the effects of sesamol in a neonatal rat model of NEC.Materials and methods: The study included 1-day-old Wistar albino rat pups (n = 34) that were randomly divided into four groups: Group 1 (NEC), group 2 (NEC + intraperitoneal sesamol), group 3 (NEC + oral sesamol), and a control group. NEC was induced by exposure to hypoxia/reoxygenation, following cold stress and hyperosmolar enteral formula feeding. Sesamol 100 mg kg-1 dose-1 was administered intraperitoneally to group 2 and orally to group 3 for 3 days. On day 4 all rats were sacrificed. Histological injuries, the Bcl-2, caspase-3, malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione-peroxidase (GSH-Px) activities were measured in intestinal samples.Results: The grade of intestinal damage, and Bcl-2 and caspase-3 levels in group 1 were significantly higher than in groups 2 and 3 and the control group, and intestinal damage was significantly more severe in group 1 than in groups 2 and 3. The MDA activity was significantly lower in groups 2 and 3 than in group 1 (112, 89, and 144 nmol mL-1, respectively). Groups 2 and 3 had significantly higher SOD and GSH-Px activities than group 1 (SOD: 1.75, 1.74, and 0.89 U mg-1; GSH-Px: 114, 121, and 110 nmol of NADPH min-1 mg-1, respectively).Conclusions: The present findings highlight that sesamol has beneficial effects on intestinal injury in a rat model of NEC through its antioxidant and anti-inflammatory properties.

α-Lipoic Acid Ameliorates The Changes in Prooxidant-Antioxidant Balance in Liver and Brain Tissues of Propylthiouracil-Induced Hypothyroid Rats.

OBJECTIVE: There are controversial data about the prooxidant-antioxidant balance in hypothyroidism. We aimed to investigate the effect of α-lipoic acid (ALA) on oxidative stress parameters in the liver and brain of propylthiouracil (PTU)-induced hypothyroid rats. MATERIALS AND METHODS: In this experimental study, PTU (500 mg/L) was given to rats in drinking water for 10 weeks. ALA (0.2% in diet) alone and together with thyroxine (T4, 20 µg/kg body weight, s.c) were given to hypothyroid rats in the last 5 weeks of the experimental period. The levels of reactive oxygen species, malondialdehyde, protein carbonyl, ferric reducing antioxidant power (FRAP) and glutathione (GSH) levels, superoxide dismutase, and GSH peroxidase activities were determined in the liver and brain of rats. Histopathological examinations were also performed. RESULTS: Prooxidant parameters were increased in the brain but not liver in hypothyroid rats. ALA treatment alone lowered enhanced brain oxidative stress in hypothyroid rats. Also, ALA was found to ameliorate the changes as a result of oxidative stress arising from T4 replacement therapy. CONCLUSION: Our results indicate that ALA alone and together with T4 may be useful in reducing oxidative stress in thyroid dysfunctions.

Effect of Carnosine on Renal Function, Oxidation and Glycation Products in the Kidneys of High-Fat Diet/Streptozotocin-Induced Diabetic Rats.

High fat diet (HFD) and low dose of streptozotocin (STZ)-treated rats provide an animal model for type 2 Diabetes Mellitus (T2DM). Oxidative stress plays a role in the development of diabetic complications. Carnosine (CAR) has antioxidant and antiglycating properties. We investigated effects of CAR on renal function, oxidation and glycation products in HFD+STZ-rats. Rats were fed with HFD (60% of total calories from fat) for 4 weeks and then a single dose STZ (40 mg/kg; i.p.) was applied. Rats with blood glucose levels above 200 mg/dL were fed with HFD until the end of the 12th week. CAR (250 mg/kg body weight; i.p.; 5 times a week) was administered to rats for the last 4 weeks. Glycated hemoglobin (HbA1c), glucose, lipids, and andrenal function tests in serum as well as reactive oxygen species, malondialdehyde, protein carbonyl, advanced oxidation protein products, advanced glycation end products (AGEs), antioxidant power, and antioxidant enzyme activities and their mRNA expressions in kidneys were determined. CAR treatment did not alter glucose and HbA1c, but it decreased serum lipids, creatinine, and urea levels in HFD+STZ rats. Oxidation products of lipids and proteins and AGEs levels decreased, but antioxidant enzyme activities and their mRNA expressions remained unchanged due to CAR treatment. Our results indicate that CAR treatment alleviated renal function and decreased accumulation of oxidation and glycation products in kidneys in HFD+STZ-rats.

Can Ultrasound Imaging Predict the Success of an Experimental Steatofibrosis Model?

Our goal was to evaluate the role of ultrasound (US) imaging in an experimental 2-hit steatofibrosis rat model. Nineteen female Sprague-Dawley rats were divided into 2 groups: control group (n = 6) and high-fat diet carbontetrachloride (HFD-CCl4) group (n = 13) that was fed with HFD for 14 weeks. Ultrasound was performed to evaluate liver steatosis. The HFD-CCl4 group rats were divided further into 2 subgroups: HFD rats with liver steatosis [US (+) group; n = 6] and without steatosis [US (-) group; n = 7]. All rats in the subgroups were administered with CCl4. In both US (+) and US (-) subgroups, steatosis score, fibrosis score, triglyceride, and hydroxyproline contents were markedly higher compared with the control group. When compared with the US (-) group, triglyceride and hydroxyproline contents were significantly higher in the US (+) group, whereas steatosis and fibrosis scores were not different. Ultrasound imaging may be useful to assess the success of a 2-hit experimental steatofibrosis model.