Erkan Sogut

The relationship between inflammation and slow coronary flow: increased red cell distribution width and serum uric acid levels

OBJECTIVES The underlying mechanism of slow coronary flow (SCF) has yet to be elucidated. Increased red cell distribution width (RDW) and uric acid level may be indicative of an underlying inflammatory state. We aimed to investigate RDW and serum uric acid levels in patients with normal coronary arteries and SCF without stenosis. STUDY DESIGN The study included 46 consecutive patients (25 males, 21 females; mean age 54 ± 11 years) with angiographically normal coronary arteries but having SCF in all three coronary arteries. The control group consisted of 40 patients (18 males, 22 females; mean age 54 ± 9 years) with angiographically normal coronary arteries without SCF. In both groups, RDW and serum uric acid levels were measured and compared. RESULTS In the SCF group, TIMI frame counts measured in the left anterior descending coronary artery, left circumflex coronary artery, and right coronary artery were significantly higher compared to the control group (p<0.05). Patients with SCF exhibited significantly higher RDW (13.4 ± 1.6% vs. 12.6 ± 1.2%, p=0.01) and serum uric acid levels (5.3 ± 1.6 mg/dl vs. 4.7 ± 1.3 mg/dl, p=0.01) compared to controls. In logistic regression analysis, uric acid [Exp(B)=1.612, 95% CI 0.206-5.35, p=0.021] and RDW [Exp(B)=1.496, 95% CI 0.403-4.72, p=0.030] were found as independent predictors of SCF. CONCLUSION Our findings show that patients with SCF have significantly increased RDW and serum uric acid levels. This may help throw more light on the pathophysiological basis of SCF.

The effect of Sertraline, Paroxetine, Fluoxetine and Escitalopram on testicular tissue and oxidative stress parameters in rats

INTRODUCTION The aim of this study was to evaluate the effect of selective serotonin reuptake inhibitors (SSRIs) on testicular tissue and serum malondialdehyde (MDA) levels in rats. MATERIALS AND METHODS A total of 40 male Wistar albino rats, 5.5-6 months old, were equally divided at random into five groups: group 1 was the control group, group 2 received sertraline 10mg/kg (p.o), group 3 was administered fluoxetine 10mg/kg (p.o), group 4 received escitalopram 10mg/kg (p.o), and group 5 (n = 8) was administered paroxetine 20mg/kg. Each dose was administered orally for two months. Johnsens criteria were used to categorize spermatogenesis. Johnsens method assigns a score of 1 to 10 to each tubule cross-section examined. In this system, a Johnsen score of 9 and 10 indicates normal histology. Serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone levels were evaluated. Serum MDA levels were also measured. RESULTS The mean Johnsen scores were 9.36 ± 0.33, 9.29 ± 0.32, 8.86 ± 0.48, 9.10 ± 0.56, and 8.33 ± 0.90 in control group, sertraline group, fluoxetine group, escitalopram group, and paroxetine group, respectively. The Johnsen score was significantly lower for paroxetine group compared with the control group (p < 0.05). The mean FSH level increased only in the sertraline group. With the exception of the fluoxetine group, the testosterone levels were lower in all groups compared with the control group. The total testosterone level was significantly lower in the sertraline group compared with the control group [40.87 (22.37-46.8) vs. 15.87 (13.53-19.88), p < 0.01]. There were no significant differences between the groups with respect to the MDA and LH levels (p = 0.090 and p = 0.092). CONCLUSION These data suggest that SSRIs have a negative effect on testicular tissues. This negative impact is markedly greater in the paroxetine group. To determine the exact mechanism of action of these drugs on testicular tissue, well-designed randomized controlled clinical studies are needed on a larger population.

Mildly Decreased Glomerular Filtration Rate Is Associated With Poor Coronary Collateral Circulation in Patients With Coronary Artery Disease

The aim of this study was to evaluate the association between mildly decreased glomerular filtration rate (GFR) and coronary collateral circulation (CCC).

Investigating the Effect of Aromatherapy in Patients with Renal Colic

AIM The aim of the present study was to investigate the usefulness of rose essential oil as a supplementary and adjunctive therapy for the relief of renal colic, specifically because rose essential oil is soothing and can act as a muscle relaxant. MATERIALS Eighty patients who were diagnosed with renal colic in the emergency room were included in the study, with ages ranging from 19 to 64 years. Half of the patients (n=40) were treated with conventional therapy (diclofenac sodium, 75 mg intramuscularly) plus placebo (physiological serum, 0.9% NaCl), while the other half (n=40) were given aromatherapy (rose essential oil) in addition to conventional therapy. In each patient, the severity of pain was evaluated using the Visual Analog Scale (VAS) (0 [no pain] to 10 [very severe pain]). FINDINGS The VAS values prior to the start of therapy, and 10 and 30 minutes after therapy were 8.18 ± 1.36, 5.60 ± 2.02, and 3.75 ± 2.08 for the conventional therapy plus placebo group, while for the conventional therapy plus aromatherapy group, the VAS values were 8.63 ± 1.03, 4.25 ± 1.72, and 1.08 ± 1.07, respectively. There was no statistically significant difference between the starting VAS values of the two groups, but the VAS values 10 or 30 minutes after the initiation of therapy were statistically lower in the group that received conventional therapy plus aromatherapy. CONCLUSION This study demonstrated that rose essential oil therapy in addition to conventional therapy effectively reduces renal colic pain.

Protective effect of thymoquinone against testicular torsion induced oxidative injury

We aimed to determine the protective effects of thymoquinone (TQ), against ischaemia–reperfusion (I/R) injury in the testis tissue of rats. Twenty‐seven male Wistar albino rats were randomly divided into three equal groups as follows: Group I, sham group; Group II, torsion group; and Group III, torsion + thymoquinone group. The ischaemia period was 2 h, and orchiectomy was performed after 30 min of detorsion. Testis tissue sections were analysed with the terminal transferase mediated dUTP‐nick end labelling (TUNEL) assay to determine in situ apoptotic DNA fragmentation. Additionally, Caspase 3 and Bax proteins were analysed immunohistochemically. The superoxide dismutase (SOD), glutathione peroxidase (GSH‐Px) and malondialdehyde (MDA) activity levels in the testis tissue were also measured. The superoxide dismutase activity and malondialdehyde levels in the torsion group were significantly higher than those of the sham group (P < 0.05). Thymoquinone administration significantly reduced these levels. Torsion significantly increased active‐Caspase 3 and Bax expression, which was decreased by thymoquinone. The apoptotic index of the torsion group was significantly higher than that of the control group. However, thymoquinone significantly reduced the apoptotic index (P < 0.05). Our results indicate that thymoquinone plays a protective role in oxidative stress induced ischaemia–reperfusion in the testis tissue of rats.

Association of MMP2-1306C/T and TIMP2G-418C polymorphisms in retinal vein occlusion.

Matrix metalloproteinases (MMPs) are large groups of zinc-dependent proteases that play an important role in many diseases and pathological processes such as cancer, angiogenesis, atherosclerosis, and vascular disease. Also, it was found that the expression of MMPs was high during the initial period of thrombosis in a rat model of traumatic deep vein thrombosis. Moreover, the presence of metalloproteinase activity and endogenous inhibitor activity in vitrectomy samples are associated with neovascularization of several retinal diseases such as exudative age related maculopathy, proliferative diabetic retinopathy, and central retinal vein occlusion. In this study, we aimed to investigate the possible association of the matrix metalloproteinase 2-1306C/T (rs 243865) and tissue inhibitors of matrix metalloproteinase 2 G-418C (rs 8179090) polymorphisms with the risk of retinal vein occlusion (RVO). Genomic DNA was extracted from peripheral leukocytes from ethylenediaminetetraacetic acid anticoagulated blood. Genotyping of the MMP2-1306C/T and TIMP2G-418C polymorphisms were performed using real-time polymerase chain reaction. The MMP2-1306 T allele carriers (CT + TT) had a significantly increased risk of RVO compared with the CC homozygotes (p < 0.001, odds ratio = 4.78; 95% CI = 2.85-8.09). After adjusting for hypertension, diabetes, hypertriglyceridemia, and hypercholesterolemia, MMP2-1306 T allele carriers (CT + TT) also had a significantly increased risk of RVO (B = 1.453; p < 0.001; odds ratio = 4.275; 95% CI:2.529-7.224). MMP2-1306C/T, but not TIMP2G-418C, gene variants are a risk factor for the development of retinal vein occlusion.

Age-related changes of aquaporin expression patterns in the postnatal rat retina

Previous studies revealed that the rat retina contains numerous membrane-located water channels, the aquaporins (AQPs). Protein expression patterns of AQP1-4, 6 and 9 were examined by immunohistochemistry. In the present study, we investigated the immunolocalization of AQP1-4, 6 and 9 during postnatal development in the rat retina and examined the effect of age on the tissue distribution of these channels. AQP1, 3, 4, 6 and 9 showed gradually increased expression in rat retinas from postnatal week 1 to week 12, and decreased in the 40-week-old rat retinas. AQP2 expression was barely seen in the first week in rat retinas and displayed a significant increase from week 1 to week 4, however no significant alteration of AQP2 was observed after 4weeks of development. AQP1 and 4 immunoreactivities were present in the inner limiting membrane (ILM), the ganglion cell layer (GCL), inner nuclear layer (INL) and retinal pigment epithelium (RPE) in the 4-, 12- and 40-week-old rat retinas. The RPE, OLM and ILM showed a remarkable expression of AQP1-4, 6 and 9 in the 4, 12 and 40-week-old rat retinas. The reduced expression of AQPs in aged rat retinas may indicate the involvement of AQPs in the pathogenesis of age-related retinal diseases.

The protective effect of single dose tadalafil in contrast-induced nephropathy: an experimental study.

Objective: Contrast-induced nephropathy (CIN) is one of the most common causes of acute renal failure in hospitalized patients. The direct toxic effect of contrast media; ischemic damage caused by reactive oxygen species; increased perivascular hydrostatic pressure; high viscosity and changes in the activity of vasoactive substances play important roles in the pathogenesis. Tadalafil inhibits the phosphodiesterase enzyme which destroys nitric oxide. Nitric oxide causes renal vasodilatation, increases renal medullar blood flow and mediates the removal of free oxygen radicals. Drugs that increase levels of nitric oxide are expected to reduce the development of contrast nephropathy due to contrast media. We aimed to test the hypothesis that tadalafil reduces the development of contrast nephropathy due to contrast toxicity. Methods: A total of 24 female Wistar albino rats, three groups of eight, were included in the study. After 48 hours of dehydration, contrast media (meglumine diatrozoate, 6 mL/kg) was administered to the first group, and contrast media with tadalafil (10 mg/kg) was administered to the second group. The third group served as the control group. Blood and tissue samples were taken 48 hours after this procedure. Results: Serum cystatin C, serum creatinine and blood urea nitrogen (BUN) values were significantly lower in the contrast with tadalafil group compared to the group given only contrast. Serum and tissue malondialdehyde (MDA) levels were significantly lower in the contrast with tadalafil group than in the contrast only group. Conclusion: These results demonstrate the protective effect of tadalafil in the prevention of CIN in rats.

The apoptotic effect of a high dose of toluene on liver tissue during the acute phase: an experimental study

The aim of this study is to investigate the acute toxic effects of high-dose toluene and its mechanisms on the liver tissue of toluene-treated rats. In this study, 16 adult male Wistar albino rats (200–220 g) were divided into two equal groups. Group I was used as a control group, while group II was exposed to high dose of toluene, 5200 mg/kg (6 ml/kg per gavage). After the 3-hour experimental period, blood samples and liver tissues were taken from the euthanized animals. Serum aspartate and alanine aminotransferase levels were assayed. Liver tissues were fixed in 10% neutral formalin, then embedded in paraffin and sectioned (5 μm thickness). Sections were stained with hematoxylin and eosin for histopathological examination. A terminal transferase dUTP nick end labeling assay was also done for the determination of apoptosis in liver tissues. For the determination of Bax and caspase-3 immunoreactivity, the sections were stained using avidin–biotin–peroxidase immunohistochemical method. The level of plasma transaminase was found to be increased in toluene administered rats. Additionally, slight degeneration of hepatocyte and mononuclear cell infiltration was observed in the liver tissue sections and a high (+++) immunoreactivity for Bax and caspase-3 protein was observed in the toluene group. This study showed that the high dose of toluene triggers apoptosis in the liver of rats via the mitochondrial pathway in acute period.

Ischemia-modified albumin and total antioxidant status in patients with slow coronary flow: a pilot observational study.

OBJECTIVE Slow coronary flow (SCF) is defined as late opacification in the epicardial coronary arteries without significant stenosis. The underlying mechanism of SCF is similar to coronary atherosclerosis. Free radical damage may be responsible for the pathology. In this study, we aimed to investigate ischemia-modified albumin (IMA) levels and differences with regard to total antioxidant status (TAS) between patients with normal coronary arteries and patients with SCF without significant stenosis. METHODS Thirty patients who were diagnosed with SCF using coronary angiography were included in this cross-sectional observational study (13 male; mean age, 56±10 years). The control group consisted of 30 patients who had normal coronary arteries as shown by coronary angiography (13 male; mean age, 53±11 years). In this study, we assessed serum IMA levels, albumin-adjusted IMA and TAS. The Student t-test was used to compare serum IMA levels and TAS between the two groups. Pearsons correlation test was used to explore the relationship between TAS and serum IMA levels. RESULTS Serum IMA levels and albumin-adjusted IMA were similar in both groups (p=0.432, p=0.349). The mean value of TAS was significantly lower in the SCF group compared to control group (p=0.011). The TAS was negatively correlated with the levels of IMA and albumin-adjusted IMA in the SCF group (r=-0.457, p=0.011; r=-0.509, p=0.004). CONCLUSION This study shows that serum IMA levels and albumin-adjusted IMA were similar between the groups, however the mean value of TAS was significantly lower in the SCF group compared to control group and negatively correlated with IMA. These results are important in terms of understanding the pathophysiological basis of SCF.