Hülya Aybek

Elevation of serum and urinary carbohydrate antigen 19-9 in benign hydronephrosis

Objective: The aim of this study was to find out the predictive role of serum and urinary carbohydrate antigen 19‐9 levels in benign hydronephrosis and whether these levels are helpful for differentiation of complete or partial urinary obstruction.

The effects of amifostine and dexamethasone on brain tissue lipid peroxidation during oxygen treatment of carbon monoxide-poisoned rats

The mechanisms of injury of, and methods of treating patients with, carbon monoxide (CO) poisoning are poorly understood. Besides the hypoxic degenerative effects of CO, reoxygenation injury may play an important role. Amifostine (Ami), which is most often used in radiotherapy for its tissue protective characteristics, may offer benefits. In this study, investigators evaluated the effectiveness of various treatments in a CO-poisoned rat model. A total of 36 Wistar rats were randomly assigned to 1 of 6 groups (n=6 each), including control and poisoned groups exposed to CO at 2000 ppm (v/v) for 1 h, followed by various 1-h treatments: group C (control), group CO-air (ambient air), group CO-NBO (normobaric 100% oxygen), group CO-HBO (hyperbaric oxygen with 3 atmospheres absolute [3 ATA]), group CO-NBO-Ami (normobaric oxygen with intraperitoneal [IP] injection of amifostine 250 mg/kg body weight [bw]), and group CO-70O (70% O2 and 5% CO2 with dexamethasone 10 mg/kg bw, IP). Blood gas analysis, carboxy-hemoglobin determination, brain tissue lipid peroxidation, and glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), lactate dehydrogenase (LDH), and creatine kinase (CK) activities were evaluated. Carboxyhemoglobin concentration in the air-treated group was 44±2%; it decreased to the control level with all oxygen treatments. Brain tissue GSH-Px and SOD measurements did not change. The activity of LDH in group CO-HBO and the activities of LDH and CKin group CO-70O were similar to those of group C. Lipid peroxides were high in ambient air and normobaric oxygen, but HBO, amifostine with oxygen, or 70% O2 reduced these to control levels (P < .05).

Free and Total Prostate–Specific Antigen Levels in Saliva and the Comparison with Serum Levels in Men

Objective: We investigated free and total prostate–specific antigen (PSA) levels and free/total (f/t) ratio in the fasting saliva and compared them with the serum levels in normal individuals, in patients with benign prostatic hyperplasia (BPH) and prostate cancer. Our aim was to determine free and total PSA and f/t ratio in saliva and to improve and simplify the differentiation between BPH and prostate cancer by using saliva as an alternative to serum.Methods: Serum and fasting saliva concentrations of free and total PSA were measured in 35 men with BPH, 16 men with stage D prostate cancer, and 25 healthy men. Serum and fasting saliva samples were collected at the same time and were analyzed on the same day at our laboratory with microparticle enzyme immunoassay technology.Results: For the total of 76 men, there was a significant correlation between free and total PSA levels in each sample (r = 0.97 for serum and r = 0.44 for saliva, p<0.001). Although there was a significant difference between three groups for serum–free and total PSA levels and serum f/t ratios, no significant difference was determined between groups for salivary free and total PSA levels and salivary f/t ratios. No correlations were found between patient age and salivary PSA levels.Conclusions: Fasting salivary free and total PSA levels are not effected by high serum levels of prostatic origin. Although there was a significant difference between mean serum and salivary levels of free and total PSA in each group, the f/t ratio of saliva was very close to the serum ratio of normal subjects. Determination of free and total PSA in saliva to improve and simplify the differentiation between prostate cancer and BPH is not suitable for use as alternative measurement of serum.

The use of biomarkers in the diagnosis and treatment of overactive bladder: Can we predict the patients who will be resistant to treatment?

The main objective of this study was to define urinary biomarkers that can predict the severity of overactive bladder and detect patients who would benefit most from treatment.

Gastric Histopathological Findings and Ghrelin Expression in morbid Obesity Morbid Obezitede Gastrik Histopatolojik Bulgular ve Ghrelin Ekspresyonu

Abstract Objective: Th e role of Ghrelin, also known as the appetite hormone, is not fully explained in the development of morbid obesity. Plasma Ghrelin level is low in obese and high in slim subjects. Ghrelin-expressing cells were investigated histopathologically in the stomach of morbid obese patients in this study. Tissue Ghrelin expression was also compared with various parameters such as the distribution of endocrine cells, age, gender, body mass index, preoperative plasma Ghrelin level and presence of accompanying diseases. Material and Method: Th e study included 33 morbidly obese patients, and 8 non-obese control patients. Plasma Ghrelin levels were measured preoperatively. Sleeve gastrectomy resection materials of 33 cases were evaluated with histopathological and immunohistochemical (Ghrelin and Chromogranin-A) techniques. Th e results were statistically evaluated by nonparametric tests. Results: Histopathological findings observed in sleeve gastrectomy resection materials were interstitial lymphocytic infiltration (63.6%), hyperplasia of lymphoid follicles in the lamina propria (60.7%) and microvesiculation / dilatation of parietal cells (57.6%). Th e number of Ghrelin immunopositive cells in the gastric mucosa in females was significantly higher compared to males (p=0,007). Additionally, the number of Ghrelin immunopositive cells was significantly higher at the fundus-proximal corpus compared to the distal corpus of the stomach (p=0.0001). No significant correlation was found between Ghrelin-chromogranin immunopositive endocrine cell distribution and preoperative plasma Ghrelin levels and endocrine cell hyperplasia. Conclusion: Our study confirms that Ghrelin producing cells are most dense in the proximal stomach. Increased number of Ghrelin expressing cells in the gastric mucosa in females compared to males suggests that gender may also be a factor in determining the method for treatment of morbid obesity. ÖZ Amaç: İştah hormonu olarak da bilinen Ghrelin hormonunun morbid obezite gelişimindeki rolu tam olarak acıklanamamıştır. Plazma Ghrelin duzeyi obezlerde duşuk, zayıflarda yuksektir. Bu calışmada; morbid obezitede midede gorulen histopatolojik değişiklikler, Ghrelin eksprese eden hucreler araştırılmış, doku Ghrelin ekspresyonu; doku endokrin hucre dağılımı, yaş, cinsiyet, vucut kitle indeksi, preoperatif serum Ghrelin duzeyi ve eşlik eden hastalık varlığı gibi parametrelerle karşılaştırılmıştır. Gereç ve Yöntem: Calışmaya morbid obezite nedeniyle laparoskopik ”sleeve” gastrektomi uygulanan 33 olgu ve obez olmayan 8 kontrol hastasının mide rezeksiyon materyalleri dahil edildi. Olguların preoperatif plazma Ghrelin duzeyleri olculdu. Sleeve gastrektomi materyalleri prospektif olarak histopatolojik ve immunohistokimyasal yontemlerle (Ghrelin ve Kromogranin-A) değerlendirildi. Bulgular istatistiksel olarak nonparametrik testlerle karşılaştırıldı. Bulgular: Sleeve gastrektomi materyallerindeki histopatolojik bulgular; interstisyel lenfosit infiltrasyonu (%63,6), lamina propriyada lenfoid folikul hiperplazisi (%60,7) ve pariyetal hucrelerde mikrovezikulasyon/ dilatasyon (%57,6) olarak saptandı. Kadınlarda gastrik mukozadaki Ghrelin immunopozitif hucre sayısı erkeklere kıyasla anlamlı duzeyde yuksekti (p=0,007). Ayrıca Ghrelin immunopozitif hucre sayısının, midenin fundus-proksimal korpus kısmında distal korpusa gore anlamlı olarak yuksek olduğu gozlendi (p=0,0001). Ghrelin ekspresyonu ile kromogranin-A immunopozitif endokrin hucre dağılımı, araştırılan diğer parametreler veya preoperatif plazma Ghrelin duzeyi ile endokrin hucre hiperplazisi arasında anlamlı ilişki saptanmadı. Sonuç: Calışmamız, Ghrelin ureten hucrelerin midenin proksimalinde daha yoğun olduğunu doğrulamaktadır. Kadınlarda gastrik mukozadaki Ghrelin eksprese eden hucre sayısının erkeklerden yuksek olması ise morbid obezite tedavisi icin secilecek yontemde cinsiyet faktorunun de etkili olabileceğini duşundurmektedir.

Comparison of the therapeutic efficacy of linezolid and vancomycin and correlation of serum and tissue malondialdehyde and myeloperoxidase in an experimental mediastinitis model.

BACKGROUND We aimed to investigate the therapeutic efficacy of linezolid in an experimental mediastinitis model and to compare it with vancomycin, which is commonly used. The objective of this study was also to evaluate the role of the immune system in mediastinitis. MATERIALS AND METHODS Fifty adult Wistar rats were randomly divided into five groups: an uncontaminated and contaminated untreated control groups; a group that received sefazolin prophylaxis; and two groups treated with vancomycin or linezolid. Median sternotomy without access to pleural spaces was performed on all rats. All groups, except the uncontaminated one, were inoculated with 0.5 mL 10(8) colony-forming units/mL methicillin-resistant Staphylococcus aureus in the mediastinal and sternal layers. Postoperatively, vancomycin and linezolid groups were given antibiotic treatment for 7 d, starting 24 h after the end of the procedure. After 7-d treatment tissue samples from the upper ends of the sternotomy line and mediastinum were obtained and evaluated microbiologically. Additionally, serum, heart, lung, liver, kidney, and mediastinal tissues samples were obtained to determine malondialdehyde (MDA) and myeloperoxidase (MPO). RESULTS The study showed that either vancomycin or linezolid successfully reduced bacterial counts in mediastinum and sternotomy line. MDA and MPO levels were found to be decreased in the treated groups. There was a positive correlation between serum and tissues MDA and MPO in all of the groups. CONCLUSIONS Our study showed that linezolid appears to be a promising option for treating mediastinitis due to methicillin-resistant S. aureus. Additionally, it was demonstrated that a wide inflammatory process occurred after mediastinitis.

Preventive Effects of Vitamin E Against Oxidative Damage in Aged Diabetic Rat Bladders

OBJECTIVES To examine the effects of aging and/or diabetes mellitus on oxidative stress and the protective effect of vitamin E in the bladder. It was proposed that the balance between oxidant and antioxidant species is important regarding the aging process and prevention of diabetic complications. METHODS Young and aged rats were randomly allotted into six experimental groups: aged control, aged diabetic, aged diabetic and vitamin E-treated, young control, young diabetic, young diabetic and vitamin E-treated. Diabetes was induced by streptozotocin. Vitamin E was administered to the treated groups. Malondialdehyde and reduced glutathione levels were measured in all rat bladders, and histological changes were examined by electron microscopy. RESULTS We found increased malondialdehyde and decreased glutathione levels in the young and aged diabetic groups compared with the nondiabetic control groups. Elevated malondialdehyde and reduced glutathione levels were observed in the aged compared with the young control groups. There were no significant differences in the malondialdehyde and glutathione levels between young and aged diabetic vitamin E-treated groups compared with the related control groups. Degeneration was greatest in the aged diabetic group. The protective effects of vitamin E were seen in young and aged diabetic groups, especially in the young diabetic group. CONCLUSIONS Our results suggest that vitamin E supplementation prevents free radical damage in bladders of young and aged diabetic rats.

Increased urinary 6-hydroxymelatoninsulfate levels in attention deficit hyperactivity disorder diagnosed children and adolescent.

There are some studies in attention deficit hyperactivity disorder (ADHD) which note altered circadian rhythms, suggesting abnormalities in melatonin physiology. In order to better characterize the possible melatonin alteration in ADHD, in this study we aimed to detect daytime, nighttime and 24 h levels of 6-hydroxymelatoninsulfate (6-OH MS) in the patients diagnosed with ADHD. Twenty-seven patients between 6 and 16 years-old, who had been diagnosed initially with ADHD, but without other physical and psychiatric disease history and who had not taken psychotropic pharmacotherapy for six months, plus 28 healthy volunteer controls, were included in the study. Urine samples were collected during the whole 24 h cycle, daytime and nighttime separately to assess the time-dependent excretion of the 6-OH MS, which is the main urine metabolite of melatonin. The Enzyme-Linked Immunosorbent Assay (ELISA) method was used for measuring the urine 6-OH MS level. Daytime (15.4 (8.9-24.8) ng/ml vs 6.9 (2.5-15.9) ng/ml, p=0.002), nighttime (102.9 (65.3-197.7) ng/ml vs 61.5 (37.2-114.4) ng/ml, p=0.012) and 24 h (54.1 (34.6-83.9) ng/ml vs 27.3 (14.3-48.9) ng/ml, p=0.000) 6-OH MS levels median (25p-75p) were found to be significantly higher in the ADHD group. After adjustment for age and sex, there was a statistically significant difference between the ADHD group (59.8 ± 4.9) and control group (33.8 ± 4.8) in 24-h 6-OH MS levels (F(1, 51)=13.673, p=.001, partial η2=.211). There was no relationship between 6-OH MS levels and Conners Parent Rating Scale short form subscale scores for the ADHD group. These findings indicate that melatonin production is increased in ADHD cases. Further research is needed to determine and thereby understand the mechanisms underlying the higher melatonin production, to assess the impact of altered melatonin on the pathophysiology of ADHD.

Evaluation of Oxidative Status in Patients Treated with Electroconvulsive Therapy

Objective Electroconvulsive therapy (ECT) is used in the treatment of many psychiatric diseases and this therapy may be effective on antioxidant defence system. In this study, we aimed to evaluate the effects of ECT on oxidative stress. Methods Fourteen major depression, 11 schizophrenia and 8 bipolar affective disorder patients diagnosed and received ECT treatment, and 37 healthy volunteers enrolled in the study. ECT was applied to all patients. Before ECT, after the first and last ECTs, serum samples were obtained. Serum total antioxidant status (TAS), total oxidant status (TOS), and calculated oxidative stress index (OSI) were measured in patients before and after ECTs. Results TOS values before ECT were higher in major depression (p=0.005) and schizophrenia (p=0.001) groups compared to the control group. TAS values were lower in major depression (p=0.0001), schizophrenia (p=0.004), bipolar affective disorder (p=0.004) groups compared to the controls. Also OSI values were higher in major depression (p=0.0001), schizophrenia (p=0.001), bipolar affective disorder (p=0.009) groups compared to healthy group. After the last ECT, TOS values were significantly lower compared to TOS values before ECT in major depression (p=0.004) and schizophrenia patients (p=0.004). TAS values after the first ECT were higher compared to values before ECT in major depression patients (p=0.004). After last ECT, OSI values were significantly lower compared to before ECT in schizophrenia patients (p=0.006). Conclusion As a result, it can be said that ECT did not increase oxidative stress. However, further studies with more patients are needed.

The effect of hypothermia on adnexal torsion/detorsion injury in a rat ovary model.

PURPOSE Much attention has been given to hypothermia as it is effective in inhibiting inflammatory responses and also ischemia/reperfusion injury. Therefore, the aim of this study was to evaluate the effect of hypothermia on torsion/detorsion injury in rats. METHODS Twenty-eight rats were randomly divided into four groups of sham-operated (SG), adnexal torsion/detorsion group (TG), adnexal torsion/detorsion+hypothermia group (THG) and hypothermia group (HG). In the SG group, right ovaries were excised after 3-h fixation to abdominal wall. In the TG, right adnexal underwent 720° torsion in a counterclockwise direction for 3h and then excised after 3-h detorsion period. In the THG, after 3-h torsion period, ovaries were immediately subjected to hypothermia (4°C) for 30-min and they were excised after 3-h detorsioned period. In the HG, the right ovaries were subjected to hypothermia for 30-min and excised after 3-h fixation period. One half of each ovary was immediately stored for antioxidant enzyme activity and tissue lipid peroxidation. The remainder was fixed for histopathological examination. RESULTS Adnexal torsion and detorsion significantly increased the tissue level of Malondialdehyde, Superoxide dismutase and Reduced glutathione. On the other hand, hypothermia significantly reduced these oxidative stress parameters. The histopathological changes were less in the THG group; these changes were not statistically different from the other groups. CONCLUSION The results of this study suggested that hypothermia inhibited the production of oxidative stress in the ovaries subjected to torsion/detorsion injury.