Hakan Turkon

The relationship between high-sensitive troponin T, neutrophil lymphocyte ratio and SYNTAX Score

Abstract Aim. Cardiac troponins are the most preferred biomarkers in the evaluation of acute coronary syndromes (ACS). The aim of our study was to examine the association between high sensitive troponin T (hs-TnT), and neutrophil to lymphocyte ratio (NLR) and the complexity of ACS assessed by SYNTAX Score. Methods and results. 287 patients who underwent coronary angiography were studied (215 male, mean age 62.0 ± 12.7 years). 133 patients were ST elevation myocardial infarction (STEMI), 154 patients were non-ST elevation (NSTE) ACS . The patients are divided to tertiles according to SYNTAX Score; SYNTAX Score ≤ 22 (n = 122) 22 < SYNTAX Score ≤ 32 (n = 120), and SYNTAX Score > 32 (n = 45). NLR was significantly correlated with SYNTAX Score in both STEMI and NSTE-ACS groups (r = 0.254, p = 0.003, r = 0.419 p < 0.001). Multiple linear regression analysis showed NLR predicted the angiographic severity of ACS assessed by SYNTAX Score in two groups (β = 0.231, p = 0.004; β = 0.232, p = 0.003). Hs-TnT was significantly correlated with SYNTAX Score in two groups (r = 0.327, p < 0.001; r = 0.430, p < 0.001). Multiple linear regression analysis showed hs-TnT was independent predictor of SYNTAX Score in STEMI and NSTE-ACS patients (β = 0.292, p < 0.001; β = 0.317, p < 0.001). Conclusion. Hs-TnT and NLR were significantly correlated with angiographic severity of ACS assessed by SYNTAX Score.

Maternal and Cord Blood Homocysteine and Folic Acid Levels in Smoking and Nonsmoking Pregnant Women

Introduction: The homocysteine level in blood is affected by gender, diet, smoking, folic acid and B-complex vitamins. It is known that higher than normal homocysteine levels in plasma may cause vascular endothelium dysfunction, resulting in the promotion of thrombus formation. In our study, we aimed to assess the effects of smoking during pregnancy on the homocysteine and folic acid levels of the mother and baby. Methods: The study included 58 pregnant women who had completed their 37th week of gestation: 30 women were nonsmokers (NONSM) and 28 were smokers (SM). The measurement of homocysteine and folic acid levels in all samples were performed with an Immulite 2000 analyzer, using the chemiluminescence method. Results: Maternal blood folic acid levels were significantly lower in SM (p = 0.041) than in NONSM. In SM, homocysteine levels in the umbilical cord blood were found to be significantly higher than those in NONSM (p = 0.006). Conclusion: High homocysteine levels in umbilical cord blood of smoking mothers, and the probable continuation of passive smoking for the babies after birth, make us think that the baby may have a predisposition towards vascular diseases at later periods in life.

The protective effect of quercetin on IMA levels and apoptosis in experimental ovarian ischemia-reperfusion injury.

OBJECTIVE To investigate the protective effect of quercetin (QE), an anti-inflammatory and anti-oxidant agent, on torsion-detorsion induced histopathological changes and blood IMA levels in experimental ovarian ischemia-reperfusion (IR) injury. STUDY DESIGN Twenty-four female Wistar rats were randomly divided into four groups in this study (n=6). Group I, (sham operation); Group II, torsion-detorsion plus saline (IR); Group III, torsion-detorsion plus solvent (dimethylsulfoxide: DMSO, IR+DMSO); Group IV, torsion-detorsion plus 15 mg/kg/bw quercetin (IR+QE) injected intraperitoneally 30 min prior to detorsion. After 3h of reperfusion, the right ovaries were removed surgically. The ovary tissue samples were fixed in 10% formalin solution for histopathological and immunohistochemical examination. Blood samples were obtained at the end of the procedures for each group of animals. RESULTS Ovarian sections in Groups II and III showed higher follicular cell degeneration, hemorrhage, vascular congestion and edema when compared with Group I. Administration of quercetin in rats significantly prevented degenerative changes in the ovary. Significantly less histopathological changes were found in Group IV compared with Groups II and III. Caspase-3 and TUNEL positive cells were detected in the ovarian surface, follicle epithelium, and stromal cells in all experimental groups, and there was a significant increase in Groups II and III compared with Group I (P<0.05). Treatment with quercetin decreased the number of caspase-3 and TUNEL positive cells. IR increased the ischemia modified albumin (IMA) levels in comparison to the sham group (1.06 ± 0.10 ABSU and 0.92 ± 0.08 ABSU, P<0.05). Quercetin administration before IR reduced the levels of IMA (0.93 ± 0.08 ABSU, P<0.05). CONCLUSION Administration of quercetin is effective in preventing tissue damage induced by IR injury in ovaries.

Postload hyperglycemia is associated with increased subclinical inflammation in patients with prediabetes.

Abstract Background/aims. In this present study, we aimed: (i) To clarify if prediabetes is associated with subclinical inflammation independent of underlying obesity, and (ii) to evaluate the effect of postload glucose concentration on subclinical inflammation markers in a group of patients with elevated fasting glucose. Material and methods. In a cohort of 165 patients with newly detected fasting hyperglycemia, according to 75 g oral glucose tolerance test (OGTT), subjects were classified either as newly diagnosed type 2 diabetes (diabetes group, n = 40), impaired fasting glucose (IFG) plus impaired glucose tolerance (IGT) (IFG/IGT group, n = 42) or IFG only (IFG group, n = 83). A control group (n = 47) consisted of age- and body mass index (BMI)-matched healthy subjects with a normal OGTT. Circulating concentrations of lipids, insulin, interleukin-6 (IL-6), interleukin-8 (IL-8) and high sensitive C-reactive protein (hsCRP) were measured. HOMA index was calculated. Results. Subclinical inflammation markers were elevated in patients with diabetes and IFG/IGT compared to healthy controls and also IFG patients (diabetes vs. control: p < 0.05 for hsCRP, IL-8, and IL-6; IFG/IGT vs. control: p < 0.05 for hsCRP, and IL-6; diabetes vs. IFG: p < 0.05 for hsCRP, and IL-6; IFG/IGT vs. IFG: p < 0.05 for hsCRP, and IL-6). In multiple regression analysis, postload glucose concentration was independently associated with circulating hsCRP and IL-6 concentrations when the data was controlled for age, gender, BMI and lipid concentrations (p < 0.05 for hsCRP, and IL-6). Conclusion. Our results suggest that patients with prediabetes, independent of underlying obesity, have increased concentrations of subclinical inflammation which is mostly driven by postload glucose concentrations.

Protective effect of syringic acid on kidney ischemia-reperfusion injury

Abstract The objective of the present study was to determine whether preischemic administration of syringic acid (SA) would attenuate renal ischemia-reperfusion injury (IRI). Rats were divided into three groups: Sham group; IR group; and IR + SA group. The effects of SA were examined using biochemical parameters including serum ischemia-modified albumin (IMA), total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), tissue superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (CAT) and malondialdehyde (MDA). The apoptosis status and histopathological changes were evaluated. After calculating the score for each histopathological change, the total score was obtained by summing all the scores. In the SA group, MDA, IMA, TOS, and OSI decreased significantly compared to the IR group. After SA administration, the increase in GPx activity was found to be significant. Apoptosis decreased significantly in the SA group compared with the IR group. The total score significantly decreased after administration of SA. Taken together, our findings suggest that SA preconditioning is effective in reducing tissue damage induced in kidney IRI. Renal histology also showed convincing evidence regarding the protective nature of SA.

Correlation between Bethatrophin and 25(OH)D Concentrations in a Group of Subjects With Normal and Impaired Glucose Metabolism.

Aim: Inducing beta cell replication is a potential therapeutic approach for the treatment of diabetes mellitus. Recently betatrophin was suggested as a novel stimulator of beta cell proliferation in mice but its role in humans remains to be established. We aimed to investigate betatrophin concentration and its association with metabolic parameters in a group of individuals with normal glucose tolerance, pre-diabetes and diabetes mellitus who had not been previously treated. Methods: A total of 72 subjects were recruited for this cross sectional study: 23 subjects with normal glucose tolerance (NGT), 22 subjects with prediabetes, and 27 subjects with diabetes mellitus (DM). Circulating betatrophin concentration, 75 g oral glucose tolerance test, fasting insulin, glycosylated hemoglobin, 25hydroxy vitamin D and HOMA IR were measured. Results: The difference in betatrophin values did not reach statistical significance between the 3 groups [NGT:206 (176-297)pg/mL, Prediabetes:232 (181-254)pg/mL, DM:245 (205-526)pg/mL, p=0.078]. Betatrophin was negatively significantly correlated with BMI and positively significantly correlated with 25(OH)vitD (p=0.043 and p=0.001 respectively). Multivariate linear regression showed that 25(OH) vitD (β=0.440 p=0.001) and fasting glucose (β=0.003 p=0.038) were variables associated with betatrophin concentration (R2=0.251). Conclusions: In a group of subjects ranging from those with normal glucose tolerance to newly diagnosed diabetes, we found that 25(OH)D and fasting glucose were factors associated with serum betatrophin concentration.

Effect of Topically Applied Azithromycin on Corneal Epithelial and Endothelial Apoptosis in a Rat Model of Corneal Alkali Burn.

Purpose: To investigate the antiapoptotic effect of topically administered azithromycin (AZM) on corneal epithelial and endothelial cells in a rat model of corneal alkali burn. Methods: Twenty-four Wistar albino rats were divided into 4 equal groups as pseudovehicle (group 1), control (group 2), alkali burned (group 3), and treatment (group 4) groups. Alkali injury was induced only in the right corneas of rats belonging to groups 3 and 4 using 1N NaOH. The rats in group 3 and the rats in group 4 were respectively treated either with an artificial tear gel or with 1.5% AZM eye drops for 5 days. At the fifth day of the experiment, the apoptosis in the corneal epithelium and endothelium of all rats was assessed using a terminal dUTP nick-end labeling (TUNEL) assay. In addition, tumor necrosis factor-alpha (TNF-&agr;) density in the corneal epithelium was measured in all rats. Results: The mean numbers of TUNEL+ cells in the corneal epithelium and endothelium of rats in group 3 were 117.1 ± 23.8 and 34.6.± 11.3, respectively, whereas in group 4, they were 75.8 ± 15.7 and 14.7 ± 3.5, respectively. Also the mean TNF-&agr; densities in the corneal epithelium in group 3 and group 4 were 2.65 ± 1.3 and 1.65 ± 1.1, respectively. There was a significant decrease in the mean number of TUNEL+ cells in the corneal epithelium and endothelium and in the mean TNF-&agr; density in the corneal epithelium of rats in group 4, when compared with group 3. Conclusions: Topically applied AZM can decrease TNF-&agr;–induced apoptosis in corneal alkali burn.

Does Omegaven have beneficial effects on a rat model of ovarian ischemia/reperfusion?

OBJECTIVE The beneficial effects of omega-3 fatty acids on an intestinal ischemia/reperfusion (I/R) model was shown previously. Therefore, we aimed to examine the potential beneficial effects of parenteral omega-3 fatty acids, a safe and inexpensive product, on a rat model of ovarian I/R. STUDY DESIGN A group of 39 rats was divided into six groups. Group 1 (Sham Group; n=6) underwent two laparotomies with a 3-h interval and their ovaries were removed 3h later. Group 2 (torsion-detorsion Group; n=7) had their ovaries torsioned clockwise and fixed at 720°; 3h later a detorsion operation was done and after another 3h, their ovaries were removed. Group 3 (n=7) and Group 4 (n=7) received the same treatment as Group 2; however, half an hour prior to detorsion, these rats received Omegaven at 1mL/kg and 5mL/kg, respectively. Group 5 (n=6) and Group 6 (n=6) received the same treatment as Group 1; however, half an hour prior to the second laparotomy, these rats received Omegaven at 1mL/kg and 5mL/kg, respectively. One ovary from each rat was evaluated histologically by hematoxylin and eosin (H&E) staining and the other ovary was homogenized and evaluated for total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI). RESULTS While we failed to show any significant relationship among groups in oxidative parameters, there was a significant worsening in the torsion-detorsion group in histological evaluation. High Omegaven doses, but not low doses, improved tissue injury scores of torsioned and detorsioned ovaries to the levels observed in the control group. CONCLUSION Omegaven improves the detrimental effects of ovarian I/R when used in sufficient doses. Its effects and dose adjustment on women with ovarian torsion must be investigated by further studies.

Evaluation of the protective effects of hesperetin against cisplatin-induced ototoxicity in a rat animal model.

OBJECTIVES We aimed to investigate the effects of hesperetin as a flavanon both histopathologically and immunohistochemically on cochlear apoptosis in a rat model of cisplatin-induced ototoxicity (CIO). The evaluation of the effects of hesperetin on cisplatin-induced hearing loss was performed using distortion product otoacoustic emission (DPOAE). METHODS Twenty-eight wistar albino rats were used in the current study. The rats were randomly divided into four groups with seven rats in each group. Group C was exposed to a single dose of cisplatin (12mg/kg) by intraperitoneal injection. Group CH received intraperitoneally cisplatin (12mg/kg) and hesperetin (20mg/kg). Group H was exposed to hesperetin (20mg/kg) intraperitoneally. The sham group (group S) received normal saline (6cc) intraperitoneally. The measurements of DPOAE and signal-noise ratios (SNR) were performed before the treatment and again on the first and 6 days after administration of the drugs. Rats were sacrificed and cochleae were dissected 10 days after drug administration. The cochlear tissue was assessed in all groups by histopathologic, immunohistochemical and TUNEL assay. In addition, serum oxidative stress markers and antioxidant parameters were analyzed. RESULTS There was a significant difference between the basal value and the sixth day at frequencies 8.4, 9.6 and 9.96 for group C. We also found a significant difference between the first and sixth day at frequencies 7.2, 8.4, 9.6 and 9.96. On the 6th day, there were significant differences between C and S groups at all frequencies except 2.4. We showed a significant difference between C and H groups at frequencies 4.8, 6.0, 8.4, 9.6 and 9.96. There was also a significant difference between C and CH groups at frequencies 2.4, and 3.6. We found lower levels of oxidants and higher levels of antioxidants in CH group as compared to C group. C group had a significantly greater number of TUNEL-positive cells than did S, H and CH groups. The number of TUNEL-positive cells in CH group was higher than in S and H groups. There was a significant difference between the positive PCNA cells of CH group compared to S and H groups in spiral ganglion and stria vascularis. In addition, there were no positive PCNA cells in C group. CONCLUSIONS Hesperetin may prevent ototoxicity by increased antioxidant enzymes and reduced oxidant parameters and protected against apoptosis resulting from a proliferation of cochlear cells in CIO.

Relationship between Abdominal Aortic Intima Media Thickness and Central Obesity in Children

Background: Childhood obesity is one of the important risk factors for early atherosclerosis. We aimed to evaluate the effect of obesity on abdominal aortic intima media thickness (aaIMT) in children. Methods: We consecutively recruited 60 obese and 28 healthy children from the outpatient clinic of pediatrics. In all patients, BMI, waist circumference (WC) and hip circumference (HC) were measured, and fasting serum lipid profile, plasma glucose and plasma insulin were studied. Homeostasis model assessment-estimated insulin resistance (HOMA-IR) was calculated for the obese group. All children underwent ultrasonography to evaluate hepatosteatosis and to measure aaIMT. Results: There was a significant difference between the groups in terms of aaIMT, insulin, glucose, HOMA-IR, total cholesterol, low-density lipoprotein, triglyceride and hepatosteatosis. aaIMT was 1.12 ± 0.25 and 0.61 ± 0.18 mm in the obese and nonobese groups, respectively (p < 0.001). In the obese group, there was a positive correlation between aaIMT and WC, WC/height ratio, BMI, HC and hepatosteatosis (p < 0.05 for all), with the highest significance for WC. Conclusions: This study showed that aaIMT was significantly higher in obese children than in nonobese children, and that WC was a strong predictor for aaIMT. Early detection of an increased aaIMT in obese children may guide the follow-up of these patients in terms of developing atherosclerosis and its complications.