Gulsah Seydaoglu

Improved wound healing by low‐level laser irradiation after gingivectomy operations: a controlled clinical pilot study

AIM Low-level laser therapy (LLLT) may induce morphological, molecular and cellular processes, which are involved in wound healing. The aim of this split-mouth controlled clinical trial was to assess the effects of LLLT on healing of gingiva after gingivectomy and gingivoplasty. MATERIAL AND METHODS Twenty patients with inflammatory gingival hyperplasias on their symmetrical teeth were included in this study. After gingivectomy and gingivoplasty, a diode laser (588 nm) was randomly applied to one side of the operation area for 7 days. The surgical areas were disclosed by a solution (Mira-2-tones) to visualize the areas in which the epithelium is absent. Comparison of the surface areas on the LLLT-applied sites and controls were made with an image-analysing software. RESULTS Despite the prolonged time needed for application, patients have tolerated LLLT well. While there were no statistically significant differences between the stained surface areas of the LLLT applied and the control sites immediately after the surgery, LLLT-applied sites had significantly lower stained areas compared with the controls on the post-operative third, seventh and 15th day (p<0.001 for each). CONCLUSIONS Within the limitations of this study, the results indicated that LLLT may enhance epithelization and improve wound healing after gingivectomy and gingivoplasty operations.

EFFECTS OF PHYSICAL EXERCISE ON QUALITY OF LIFE, EXERCISE CAPACITY AND PULMONARY FUNCTION IN CHILDREN WITH ASTHMA

OBJECTIVE To investigate the effects of regular submaximal exercise on quality of life, exercise capacity and pulmonary function in asthmatic children. PATIENTS AND METHODS Sixty-two children with mild-moderate asthma (mean age 10.4 (SD 2.1) years) were randomly allocated into exercise and control groups. The exercise group underwent a moderately intensive basketball training program for 8 weeks. A home respiratory exercise program was advised to both groups. Pediatric Asthma Quality of Life Questionnaire (PAQLQ) was used for the evaluation of activity limitation, symptoms and emotional functions. Exercise capacity was evaluated through the physical work capacity (PWC 170 test) on a cycle ergometer and 6-minute walk test. Spirometric tests were also performed and medication and symptom scores were recorded. RESULTS Although PAQLQ scores improved in both groups, the improvement in the exercise group was significantly higher. The exercise group performed better in the PWC 170 and 6-minute walk tests, whereas no improvement was detected in the control group at the end of the trial. Medication scores improved in both groups, but symptom scores improved only in the exercise group. No significant changes were detected in pulmonary function in either group, except for peak expiratory flow values in the exercise group. CONCLUSION Eight weeks of regular submaximal exercise has beneficial effects on quality of life and exercise capacity in children with asthma. Submaximal basketball training is an effective alternative exercise program for asthmatic children.

Comparison of Blood Gas and Acid-Base Measurements in Arterial and Venous Blood Samples in Patients with Uremic Acidosis and Diabetic Ketoacidosis in the Emergency Room

Background/aims: The aim of this study was to examine a plausible correlation between venous and arterial blood gas values in acidotic patients with chronic uremia or diabetic ketoacidosis (DKA). Methods: A total of 152 arterial and 152 venous blood samples from uremic patients (n = 100), DKA patients (n = 21) and healthy controls (n = 31) were analyzed for measurements of blood gas and acid-base status. Results: The means of arterial and venous pH, and arterial and venous HCO^–₃ values for the uremic patients were 7.17 ± 0.14, 7.13 ± 0.14, 10.13 ± 4.26 and 11.86 ± 4.23 mmol/l, respectively. The respective mean differences between arterial and venous pH values and arterial and venous HCO^–₃ values were 0.04 ± 0.02 and –1.72 ± 0.42 mmol/l, respectively, for these patients. The means of the laboratory findings of DKA patients were arterial pH, 7.15 ± 0.15; venous pH, 7.10 ± 0.15; arterial HCO^–₃, 8.57 ± 5.71 mmol/l and venous HCO^–₃, 10.46 ± 5.73 mmol/l. The respective mean differences between arterial and venous pH and arterial and venous HCO^–₃ for this group were calculated to be 0.05 ± 0.01 and –1.88 ± 0.41 mmol/l. In the healthy controls, the means of arterial and venous pH, and arterial and venous HCO^–₃ values were 7.39 ± 0.02, 7.34 ± 0.02, 24.91 ± 0.82 and 26.57 ± 0.83 mmol/l, respectively. For the healthy controls the mean differences between the respective values in arterial and venous pH, and arterial and venous HCO^–₃ were 0.05 ± 0.01 and –1.66 ± 0.58 mmol/l. Although in healthy controls the correlation between arterial and venous pH values (r²: 0.595) and arterial and venous HCO^–₃ values (r²: 0.552) were moderate, these correlations were significantly increased in both the acidotic patient group (r²: 0.979 and 0.990) and the DKA group (r²: 0.989 and 0.995) Conclusion: A venous blood sample can be used to evaluate the acid-base status in uremic and DKA patients.

Ambulatory blood pressure monitoring and renal functions in children with a solitary kidney.

The aim of this study is to investigate the blood pressure (BP) profile, microalbuminuria, renal functions, and relations with remaining normal kidney size in children with unilateral functioning solitary kidney (UFSK). Sixty-six children with UFSK were equally divided into three groups: unilateral renal agenesis (URA), unilateral atrophic kidney (UAK), and unilateral nephrectomy (UNP). Twenty-two age-, weight-, and height-matched healthy children were considered as a control group. The serum creatinine level and first-morning urine microalbumin and creatinine concentrations were determined by the standard methods. Also, the BP profile was determined by ambulatory blood pressure monitoring (ABPM). We found that the serum creatinine level was higher and creatinine clearance was lower in each patient groups compared to those of the control group (p < 0.05). Compared with the controls, each group of patients had mean office, 24-h, daytime, and night-time systolic and diastolic BP values similar to those of the controls (p > 0.05). An inverse correlation was found between the renal size standard deviation scores (SDS) of normal kidneys and 24-h systolic and diastolic BP load SDS in all of the patients (p < 0.05; r = −0.372, r = −0.295, respectively). The observed relationship between renal size SDS and 24-h mean arterial pressure (MAP), systolic and diastolic BP load SDS suggests that children with UFSK should be evaluated by using ABPM for the risk of hypertension.

Oxidant-antioxidant balance in patients with COPD.

The goal of this study was to evaluate the role of oxidant–antioxidant balance in the pathogenesis of COPD. We included 30 healthy nonsmokers [24 male, 6 female; mean age (yr) ± SD: 62.4 ± 9.3], 30 healthy smokers [27 male, 3 female; mean age (yr) ± SD: 58.7 ± 6.0], 71 patients with stable COPD [68 male, 3 female; mean age (yr) ± SD: 63.5 ± 7.9], and 31 patients with COPD exacerbation [30 male, 1 female; mean age (yr) ± SD: 64.2 ± 7.3]. In all study groups the peripheral venous blood samples were taken for plasma malonyldialdehyde (MDA), a parameter of lipid peroxidation caused by the oxidants, and erythrocyte superoxide dismutase (SOD), an antioxidant enzyme. The mean plasma MDA level was higher in healthy smokers and in patients with COPD than in healthy nonsmokers (p < 0.05), and erythrocyte SOD enzyme activity in patients with COPD exacerbation (1048.2 ± 226.5 Ug/Hb) was significantly higher than in healthy nonsmokers (947.9 ± 198.0 Ug/Hb) (p < 0.05). Although mean erythrocyte SOD enzyme activity in healthy smokers and patients with stable COPD was higher than in healthy nonsmokers, the difference was not statistically significant. We found that healthy smokers and stable and exacerbated COPD patients had an impairment in oxidant–antioxidant balance. We suggested that new therapeutic interventions, which may repair the impaired oxidant-antioxidant balance in COPD, are needed to prevent the development of COPD.

Abdominal Compartment Syndrome: Current Problems and New Strategies

BackgroundAbdominal compartment syndrome (ACS) is a diffucult entity with two main problems during its course: (1) survival of the patient during the early period and (2) closure of the open wounds during the late period. In this study we evaluated the decision to decompress according to the level of intraabdominal pressure (IAP) and analysis of any recurrent or persistent increase in IAP.MethodsA prospective study was undertaken on 119 patients with increased IAP. The IAP was measured daily by obtaining the bladder pressure. Patients were monitored via a central venous line; and vital signs, arterial blood gases, the Acute Physiology, Age, and Chronic Health Evaluation II (APACHE II) score, and abbreviated mental tests were recorded. The suggestions of Meldrum et al. were taken as a guideline during the treatment. The sensitivity and specifity of IAP and APACHE II scores for different cutoff values were calculated using the receiver operating characteristic curve.ResultsHospital mortality was 33.6%, which increased with co-morbidities (p = 0.03). A cutoff value for IAP of 23 mmHg was considered an optimal point predicting mortality. The IAP within the first 3 days for patients who died was higher than the cutoff value. For patients with IAP of 15 to 25 mmHg, nonsurgical therapy increased the rate of mortality (odds ratio 5.2, 95% confidence interval 1.0–27.7; p = 0.03).ConclusionsIn patients with ACS emergency, it is recommended that decompressive laparotomy to be performed even if the IAP falls below 25 mmHg. For patients with IAP levels higher than 25 mmHg, the IAP should be meticolusly brought below the cutoff level during the postoperative period.

Prognostic significance of EBV-LMP1 and VEGF-A expressions in non-Hodgkin's lymphomas ,

BACKGROUND AND AIM EBV is an important virus in the pathogenesis of NHL. VEGF-A is the essential factor in tumor angiogenesis. There is evidence of cross talk between angiogenesis and viral carcinogenesis. The viral latent protein LMP1, may play a role by inducing expression of angiogenic factors In this study EBV-LMP1 and VEGF-A expressions have been studied in cases with NHL and prognostic significance of these has been evaluated. PATIENTS AND METHODS One hundred seventy-seven cases (60 had low grade lymphoma (LGL), 117 had aggressive lymphoma (AL)) with NHL have been included in this analysis. Immunohistochemistry has been used for the detection of EBV and VEGF-A. RESULTS EBV was found in 25 cases (14%); 5 of 60 cases with LGL while 20 of 117 cases with AL had EBV positivity; (OR: 2.3, 95% CI: 0.8-6.3, p=0.113). VEGF-A expression was found in 108 cases (61%); 30 of 60 cases with LGL and 78 of 117 cases with AL showed VEGF-A expression. There was an association between VEGF-A and aggressive histology (OR: 2.0, 95% CI: 1.1-3.8, p=0.031). EBV positivity was associated with VEGF-A expression in diffuse large B cell lymphoma (DLBCL) (0.045). Mean Survival rates were shorter in EBV (+) and/or VEGF-A (+) cases. COMMENT Highly significant association between VEGF-A and EBV expression and survival rate, suggests an association between angiogenesis and viral lymphomagenesis. Targeting both the angiogenesis and EBV may be important in the therapy of cases with NHL expressing EBV and/or VEGF-A.

Methylenetetrahydrofolate reductase gene C677T mutation and plasma homocysteine level in Behçet's disease

ObjectiveThe aim of this study was to assess whether homozygosity for the 5, 10-methylenetetrahydrofolate reductase (MTHFR) C677T mutation and plasma homocysteine concentration are related to deep vein thrombosis in Behçets disease (BD) patients.MethodsForty BD patients (23 males, 17 females; mean age 40.2±8.4 years) and 60 healthy controls (HC) (34 males, 26 females; mean age 41.6±6.9 years) were included in the study. Fourteen of the BD patients had a history of deep venous thrombosis (DVT), as confirmed by Doppler ultrasound.ResultsThe rates of homozygosity for the MTHFR C677T mutation in the BD and HC groups were 7.5% and 10%, respectively. The distribution of MTHFR genotypes was similar in the two groups (p>0.05), and analysis showed that homozygosity for the mutation was not a risk factor for DVT. The mean plasma homocysteine levels were 13.4±4.2 µmol/l for the overall BD patients and 12.6±3.8 µmol/l for HC (p>0.05). However, the mean plasma homocysteine level in the BD patients with DVT history (15.9±4.6 µmol/l) was significantly higher than the level in the BD patients with no DVT history (12.1±3.3 µmol/l) (p=0.013) and the level in the HC group (12.6±3.8 µmol/l) (p=0.025).ConclusionThe study results suggest that elevated plasma homocysteine level may play a role in the pathogenesis of venous thrombosis in BD.

Antioxidant enzyme levels in cases with gastrointesinal cancer

UNLABELLED The aim is to evaluate the antioxidant enzyme levels in tumoral tissues and accompanying normal tissues in gastrointestinal cancer; and compare the colorectal cancer (CRC) with gastric cancer (GC). METHOD Antioxidant enzymes including glutathione reductase (GR), glutathione peroxidase (GPX), superoxide dismutase (SOD), malondialdehyde (MDA) and glucose 6 phosphate dehyrogenase (G6PD) which are important for anti-oxidant functions were evaluated in fresh tumor tissues and adjacent normal tissues obtained from a total of 58 patients. RESULTS All the enzyme levels were higher in tumoral tissues compared to normal tissue from non-cancerous disease. There was not a significant difference for enzyme levels between CRC and GC groups except GPx. GPx activity tended to be higher in cases without serosal involvement (SI), and this activity was higher in cases without lymph node (LN) involvement in normal tissue (p=0.012). MDA activity was higher in cases without serosal involvement compared to with SI groups in tumor tissue (p=0.050). G6PD activity in normal tissue was higher in cases with serosal involvement and LN involvement (p=0.064, 0.046, respectively). GR activity was higher in signet ring cell cancer (SRC) than adeno cancer. In GC, G6PD activity in tumor was tended to be higher in undifferentiated cancer (p=0.071). CONCLUSION The antioxidant enzymes activities such as GPX, SOD, G6PD, MDA and GR were found to be related with malignant phenotype in gastrointestinal cancers. We need further studies to understand the biologic and clinical importance of these enzymes in GI cancers.

Pronostic significance of angiogenic/lymphangiogenic, anti-apoptotic, inflammatory and viral factors in 88 cases with diffuse large B cell lymphoma and review of the literature

BACKGROUND Diffuse large B cell lymphoma (DLBCL) is the most common subtype of Non-Hodgkins lymphomas (NHL). The outcome of these patients shows a wide variation. We evaluated the effect of six biologic parameters including Cyclooxygenase-2 (Cox-2), Survivin, Epstein Barr Virus (EBV), Vascular Endothelial Growth Factor-A (VEGF-A), Vascular Endothelial Growth Factor-C (VEGF-C), Thrombospondin-1 (TSP-1) and clinical parameters. PATIENTS AND METHODS A follow up study was conducted and 88 cases with DLBCL were included in the study. The data of 72 patients were eligible for the survival analyses. Immunohistochemistry was used to detect these parameters. RESULTS The ratio of positive cases for Cox-2, VEGF-A, Survivin, VEGF-C, EBV, TSP-1 were 71.6%, 64.8%, 60.2%, 36.4%, 21.6%, 14.8%, respectively. Survivin (+) cases showed higher LDH levels and VEGF-A (+) cases showed higher beta 2 microglobulin (B2M) levels compared with (-) cases. Mean survival rates were found to be significantly shorter in cases expressing VEGF-A, VEGF-C, EBV and Survivin than cases not expressing these. EBV expression (HR: 3.78; 95%CI: 1.47-9.74; p=0.006), VEGF-C expression (HR: 3.22; 95%CI: 1.07-9.68; p=0.037) and extranodal involvement (HR: 3.02; 95%CI: 1.01-8.97; p=0.047) were found to be independent risk factors for prognosis according to the Cox regression analysis. COMMENT Lymphangiogenesis (VEGF-C) and EBV related viral lymphomagenesis have been found to be related with prognosis in DLBCL patients.