Habib Emre

The relationship among acute-phase responce proteins, cytokines, and hormones in various gastrointestinal cancer types patients with cachectic

Background: Acute-phase response proteins (APRPs), cytokines, and hormones have been claimed to be an independent, important factor of cancers. We suggest that in gastrointestinal system cancers, changes in APRP, cytokines, and hormones are associated.Methods: C-reactive protein (CRP), albumin, interleukin 1α (IL-1α), IL-1β, IL-6, IL-8, IL-10, tumor necrosis factor α (TNF-α), midkine, vascular endothelial growth factor-A(VEGF-A), VEGF-C, VEGF receptor 1 (VEGFR1), leptin, adiponectin, and ghrelin serum levels are studied in 148 gastrointestinal system cancer types and 40 healthy controls.Results: We found statistically significant differences and correlations between groups. We found significantly higher serum CRP, IL-1α, IL-1β, IL-6, IL-8, IL-10, TNF-α, VEGF-A, VEGF-C, VEGFR1, and leptin concentrations in patients with esophageal, gastric, pancreas, colon, and rectum cancers than controls (p < 0.001, p < 0.0001). But, we found lower levels of the serum albumin, midkine, adiponectin, and ghrelin in patients with esophageal, gastric, pancreas, colon, and rectum cancers compared to control subjects (p < 0.05, p < 0.001).Conclusions: Cachexia in gastrointestinal system cancer types is associated with changes in APRP, cytokines, and hormone concentrations. This may be reflected between the outcomes in malignancies and the biomarkers.

Serum paraoxonase activity and oxidative stress in patients with adult nephrotic syndrome

OBJECTIVE It has been shown that low paraoxonase-1 (PON1) activity is associated with a risk of an early development of atherosclerosis. In the present study, we investigated serum paraoxonase, and arylesterase activities and oxidative stress in patients with adult nephrotic syndrome (NS). In addition, we examined the relationship between these measurements and atherosclerosis. METHODS Twenty-one patients with NS and 21 healthy controls were enrolled in the study. Serum basal and salt-stimulated paraoxonase activities, arylesterase activity, lipid hydroperoxide (LOOH) and total thiol (SH) levels were measured. RESULTS Serum basal and salt-stimulated paraoxonase activities, arylesterase activity and total SH levels were significantly lower in patients with NS than in controls (p<0.05, p<0.05, p<0.01 and p<0.05, respectively), whereas LOOH levels were significantly higher (p<0.05). Serum LOOH levels were significantly correlated with total-SH levels in patients with NS (r=-0.467; p<0.01). Moreover, proteinuria levels were significantly correlated with serum LOOH levels (r=0.397; p<0.01), whereas no correlation was found among serum paraoxonase activity, arylesterase activity and total-SH levels in NS patients (p>0.05). CONCLUSIONS We concluded that oxidative stress is increased, while serum PON1 activity is decreased in patients with adult NS. In addition, these results indicate that lower PON1 activity is associated with an oxidant-antioxidant imbalance that may contribute to atherosclerosis in adult patients with NS.

Serum malondialdehyde levels, myeloperoxidase and catalase activities in patients with nephrotic syndrome

Abstract Objectives Some studies have indicated the pathophysiological importance of reactive oxygen species (ROS) in patients with nephrotic syndrome. Myeloperoxidase (MPO) is a leukocyte-derived enzyme-generating ROS that has been proposed to exert a wide array of pro-atherogenic effects throughout all stages of the atherosclerotic process. The aim of this study was to investigate the serum malondialdehyde (MDA) levels, MPO and catalase activities in patients with adult nephrotic syndrome. Patients and Methods Twenty-four patients with nephrotic syndrome and 24 healthy controls were enrolled. Serum MPO activity, catalase activity, and MDA levels were assessed. Results Serum MPO activity and MDA levels were significantly higher in patients with nephrotic syndrome than controls (both, P < 0.001), while catalase activity was significantly lower (P < 0.001). Serum catalase activity was found to be significantly correlated with MPO activity (r = −0.417, P = 0.003) and MDA levels (r = −0.532, P = 0.007). The serum MDA levels were also found to be significantly correlated with MPO activity (r = 0.419, P = 0.003). Conclusions We concluded that serum MPO activity and oxidative stress were increased and that serum catalase activity was decreased in patients with adult nephrotic syndrome. In addition, these results indicate that increased MPO activity is associated with an oxidant–antioxidant imbalance that may contribute to atherosclerosis in patients with adult nephrotic syndrome.

Topical effects of nebivolol on wounds in diabetic rats

OBJECTIVE Recently, it has reported that nebivolol might be useful in the treatment of diabetes mellitus foot ulcers. The aim of this study was to examine treatment of the wounds in streptozotocin-induced diabetic rats with topical nebivolol. METHODS Two 15 × 15 mm-sized wounds were created in 56 streptozotocin-induced rats. A total of 56 diabetic wounds were studied in eight groups (n=7). No treatment was administered to the first and second groups. The third and fourth groups consisted of diabetic rats that were administered 1:1 mixture of lanolin and vaseline for 7 and 14 days, respectively. Five percent nebivolol plus 1:1 mixture of lanolin and vaseline was administered to rats in the fifth and sixth groups for 7 and 14 days, respectively, and 10% nebivolol plus 1:1 mixture of lanolin and vaseline was administered to rats in the seventh and eighth groups for 7 and 14 days, respectively. On days 7 and 14, wound healing was observed, and the percent of wound healing was determined by measuring its size and histopathologic examination. The ratio was calculated by the formula, healing ratio (%)=100 ×(1-wound area/initial wound area). Statistical analysis was performed by ANOVA with Tukeys HSD test and Mann-Whitney U test, using SPSS 15.0 software. RESULTS On days 7 and 14, rates of wound healing in the fifth, sixth, seventh, and eighth groups were 57.42%, 89.16%, 60.80%, and 91.80%, respectively. Multiple comparison showed that rates of wound healing were significantly higher in rats administered 5% and 10% nebivolol than those in rats administered a mixture of lanolin and vaseline and in the untreated group (P<0.05). CONCLUSION Topical nebivolol therapy may be useful for wound healing in diabetic rats. Further studies are needed to support these data.

Dialysis therapy for lactic acidosis caused by metformin intoxication: presentation of two cases

Metformin is an oral antidiabetic, which is frequently used in the treatment of type II diabetes mellitus. Serious side effects may be seen during the administration of high doses of metformin. Two cases of lactic acidosis due to ingestion of high dose metformin for suicidal purposes have been presented here; in both cases, clinical improvement was seen with bicarbonate hemodialysis.

Exfoliative Cytology of Oral Mucosa in Kidney Transplant Patients: A Cytomorphometric Study

OBJECTIVES The aim of this study was to investigate quantitative cytologic changes in oral mucosal smears collected from kidney transplant patients by modern stereologic methods. METHODS Smears were obtained from the clinically healthy buccal mucosa and floor of mouth of transplant patients (n = 21) and healthy volunteers (n = 27). Smears from each individual stained by the Papanicolaou method were analyzed using a stereologic method. Nuclear (NV) and cytoplasmic (CV) volumes were evaluated with Stereo Investigator software. RESULTS CV values were 123,012.71 ± 15,840.96 fL in the floor of the mouth and 133,667.10 ± 26,653.39 fL in the buccal mucosa of the kidney transplant patients. CV values were 133,746.93 ± 14,210.67 fL in the floor of the mouth and 167,797.78 ± 21,007.70 fL in the buccal mucosa of the control group. NV values were 945.68 ± 65.85 fL in the floor of the mouth and 845.15 ± 81.56 fL in the buccal mucosa of the kidney transplant patients and 485.17 ± 18.03 fL in the floor of the mouth and 410.25 ± 52.84 μm(3) in the buccal mucosa of the control group. Significantly higher NV (P = .000) and NV/CV (P = .000) and lower CS (P = .000) values were found in the patient group compared with the control group. CONCLUSION The findings suggest that there were alterations in oral epithelial cells, detectable by microscopy and cytomorphometry in kidney transplant patients.

Serum leptin levels in gastric cancer patients and the relationship with insulin resistance

Introduction Serum leptin levels have been examined in various cancers, with conflicting results. However, there is limited information regarding serum leptin levels and insulin resistance in gastric cancer patients. Therefore, we aimed to investigate serum leptin levels, performance status, insulin levels and insulin resistance in patients with gastric cancer. In addition, we examined the relationship between these measurements and leptin levels. Material and methods Thirty-nine patients with gastric cancer and 30 control subjects were enrolled in the study. Serum leptin, total protein, albumin, growth hormone, insulin and glucose levels were measured. The homeostasis model assessment (HOMA) was used to assess insulin resistance. Results Serum levels of insulin, glucose and growth hormone and insulin resistance were significantly lower in gastric cancer patients than controls (p < 0.05 for all). In the Pearson correlation analysis, insulin resistance was found to be significantly correlated with serum leptin levels in gastric cancer patients (r = 0.320, p = 0.047). We observed a significant negative correlation between performance status and insulin resistance in patients with cachexia (r = –0.512, p = 0.030), while no association was found in non-cachectic patients. Conclusions We concluded that serum leptin levels are significantly lower in gastric cancer patients. In addition, gastric cancer patients have decreases in insulin levels, insulin resistance and growth hormone levels. This study found a positive association between serum leptin levels and insulin resistance. Moreover, there is a negative association between serum leptin levels and growth hormone levels. Thus, low insulin and growth hormone levels may suppress the production of leptin in gastric cancer patients.

Fenofibrate-induced rhabdomyolysis in a patient with chronic renal failure due to nephrotic syndrome: A rare case report

OBJECTIVES Fenofibrate is a fibric acid derivative that is used alone or combination with statins in the treatment of hyperlipidemia. These drugs have potential risks, including rhabdomyolysis and acute renal failure. Despite reports of rhabdomyolysis with the use of fenofibrate alone or with statin-fibrate combinations, there have been no cases of rhabdomyolysis described when fenofibrate was used alone to treat patients with chronic renal failure owing to nephrotic syndrome. DESIGN AND METHODS We report on a 26-year-old male who presented with fenofibrate-induced rhabdomyolysis with chronic renal failure due to nephrotic syndrome. RESULTS After the discontinuation of fenofibrate, the patient was treated with intravenous fluid replacement and urine alkalization. Subsequently, his clinical and biochemical findings improved. CONCLUSIONS Before starting fenofibrate therapy, the causes of secondary hyperlipidemia, especially nephrotic syndrome, should be investigated. In the presence of chronic renal failure and hypoalbuminemia, the fenofibrate dose should be adjusted. Physicians should be aware of the potential toxicities of fenofibrate, and patients should be informed about its potential side effects.

The association between serum Dickkopf-1 levels and esophageal squamous cell carcinoma.

Serum Dickkopf-1(DKK-1) is elevated in many malignancies and is an important indicator of malignant potential. However, its significance in esophageal squamous cell cancer (ESCC) has not yet been clarified. We hypothesized a role for DKK-1 in patients with ESCC. The study consisted of 90 ESCC patients and 85 healthy controls. After diagnosis, the level of DKK-1 was measured in the serum samples by enzyme-linked immunosorbent assay and the levels of DKK-1 were much higher in the ESCC patients than in the healthy control group (p < 0.0001). For serum DKK-1, the sensitivity and specificity of the assay were 70 and 80%, respectively. The preoperative serum DKK-1 level was elevated in the ESCC patients. Although serum DKK-1 is not a specific biomarker for ESCC, it might be a useful marker for the diagnosis and treatment of ESCC.

Comparison of the oxidant-antioxidant parameters and sialic acid levels in renal transplant patients and peritoneal dialysis patients.

OBJECTIVE Several studies have shown that in end-stage renal failure, increased oxidative stress and reduced antioxidant system functions may play an important role in inflammation, atherosclerosis, and many other complications. Paraoxonase (PON) and arylesterase (ARE) are antioxidant and malondialdehyde (MDA) an oxidant agent. Increased sialic acid (SyA) levels in uremic patients is an acute-phase response showing tissue and organ damage. The aim of this study was to compare PON, ARE, MDA, and SyA among continuous ambulatory peritoneal dialysis (CAPD) and renal transplant patients. METHODS Twenty-six CAPD patients including 7 women and 19 men of overall mean age 40.5 ± 10.66 years were included in this study. There were 28 preemptive transplant patients, namely 6 women and 22 men of overall mean age 36.5 ± 10.97 years. CAPD was the initial sole replacement therapy. Serum PON, ATE, MDA, and SyA levels were measured at 13-15 months of treatment. RESULTS Higher PON (P = .015) and ARE (P = .002) and lower MDA (P = .002) and SyA (P = .000) values were determined among transplanted compared with CAPD patients. CONCLUSIONS In the transplant group, antioxidant parameters were higher and oxidant parameters lower with less activation of SyA than in the CAPD group. We observed that renal transplantation had a constructive effect on the oxidant-antioxidant system and consequent tissue destruction, which were impaired in uremic subjects. This study showed that renal transplantation is a more appropriate replacement treatment than CAPD.