Mehmet Vural

Increased prolidase activity and oxidative stress in PCOS.

Matrix metalloproteinases (MMPs) have been considered to have a role in various pathological processes, including inflammatory response, cardiovascular disease and recently also in ovarian dysfunction. Since prolidase could be accepted as a matrix metalloproteinase, on the biochemical level, we aimed to evaluate serum prolidase activity and oxidative–antioxidative status in patients with polycystic ovary syndrome (PCOS) and healthy individuals.

Oxidative Stress Increased in Healthcare Workers Working 24-Hour On-Call Shifts

Introduction:Long work hours, night shifts, stressful situations and insufficient social support increase levels of anxiety and depression and decrease motivation to perform among healthcare professionals. In this study, we evaluated oxidative stress levels in medical residents working 24-hour on-call shifts, and in nurses, relative to non-healthcare hospital staff in sedentary positions. We also measured serum prolidase activity, a measure of collagen turnover, as an objective proxy for level of physical activity. Methods:Fifty-five male and 15 female medical residents on 24-hour, in-house, on-call duty, and 45 nurses and 30 (15 male/15 female) non-healthcare staff working 8-hour shifts were recruited. All were healthy nonsmokers. Parameters of oxidative stress and serum prolidase activity were measured twice for each subject, upon arising at 8 am after an overnight fast; and then again near the end of the work shift, or after 16 hours of consecutive work (at 12 pm) for residents. Results:After hours of continuous work, serum total oxidative status and the oxidative stress index increased significantly, whereas total antioxidant status decreased (all P < 0.0001) in healthcare staff (nurses, male and female residents). All these variables remained virtually unchanged in non-healthcare staff. Similarly, serum prolidase activity increased in healthcare staff (P < 0.0001), but failed to increase statistically in non-healthcare staff. Conclusions:Healthcare workers suffer increased oxidative stress after prolonged work hours, especially while still on duty. Possible mechanisms for this include increased workload and, perhaps, psychological stress as well. However, long-term studies are needed to clarify the effects of sustained exposure to oxidative stress.

DNA damage and oxidative stress in patients with mild preeclampsia and offspring

OBJECTIVE Oxidative stress has been shown to play an important role in the pathogenesis of pre-eclampsia, and DNA damage frequently occurs in cells exposed to such stress. The aim of the present study was to investigate DNA damage and oxidative stress in mildly pre-eclamptic women and their offspring. STUDY DESIGN We studied 25 mildly pre-eclamptic mothers, 20 healthy controls, and their infants. Mononuclear leukocyte DNA damage, total antioxidant status (TAS), and total oxidant status (TOS) were determined and the oxidative stress index (OSI) was calculated. RESULTS DNA damage, and TOS and OSI levels were significantly increased, and TAS levels significantly decreased, in maternal and cord blood samples of the mildly pre-eclamptic group. A positive correlation between the extent of DNA damage and diastolic blood pressure was evident in pre-eclamptic mothers and there was a negative correlation between the extent of DNA damage and TOS. CONCLUSION Both oxidative stress and DNA damage are elevated in mildly pre-eclamptic patients and their offspring. Increased oxidative stress may be important in inducing DNA damage in pre-eclamptic patients.

Internal iliac artery ligation for severe postpartum hemorrhage and severe hemorrhage after postpartum hysterectomy

Aim:  The aim of this study was to evaluate the effect of internal iliac artery (IIA) ligation performed for severe postpartum hemorrhage (PPH).

Amniotic Fluid Prolidase Activity and Oxidative Status in Neural Tube Defects

Objective: To evaluate oxidative stress markers and prolidase activity in the amniotic fluid of fetuses with a neural tube defect (NTD) compared to the amniotic fluid of normal fetuses. Methods: Amniotic fluid samples from 36 pregnancies of fetuses with NTD were compared with the amniotic fluid from 36 pregnancies of genetically normal fetuses for analysis of oxidative status and prolidase activity. The control group consisted of fetuses from pregnancies that were diagnosed as high-risk according to a 1st or 2nd trimester aneuploidy screening, but which were later confirmed to have normal results. An automated method was used to measure oxidative status. Prolidase enzyme activity was determined using a photometric method. Results: Prolidase activity, total oxidant status and oxidative stress index of amniotic fluid from fetuses with NTD were significantly higher compared to controls (p < 0.001, p = 0.003 and p = 0.002, respectively), whereas total antioxidant capacity was significantly lower (p < 0.001). Conclusion: Levels of prolidase activity and oxidative stress are increased in the amniotic fluid of fetuses with NTD. These indicators may serve as diagnostic markers in this disease.

Total oxidative stress and antioxidant status in patients with carpal tunnel syndrome

Abstract Objectives Studies in the carpal tunnel syndrome (CTS) are supported ischemia-induced changes rather than inflammation of the flexor tenosynovium. In this study, total antioxidant status (TAS), total oxidative stress (TOS) and oxidative stress index (OSI) in patients with CTS has been investigated. Methods Forty-three patients (38 female and 5 male, 81 hands in total) diagnosed as CTS after the physical examination and electrophysiological findings included in study. The mean age of patients was 43.30 ± 10.49 years. Results Bilateral CTS in 38 (88%) patients and unilateral CTS in five patients were detected. Dominant hand was involved in all patients. The mean symptoms duration was 30.9 months (range, 5–67 months). TAS in patients with CTS was significantly lower compared with control (1.01 ± 0.14 versus 1.11 ± 0.20 mmol Trolox equiv./l), (P = 0.008). TOS and OSI in patients with CTS were significant higher compared with control (15.60 ± 7.03 versus 11.86 ± 2.18 µmol H2O2 equiv./l and 1.57 ± 0.72 versus 1.09 ± 0.28), (respectively P = 0.002 and <0.001). Conclusion This study shows that there is a change in the oxidative stress and antioxidant defences in patients with CTS. Increased TOS and OSI and decreased TAS might be stimulate fibrosis through disturbed signaling pattern in the tenosynovium and median nerve. These processes might play a role in occurrence and progression of CTS.

May mean platelet volume levels be a predictor in the diagnosis of pelvic inflammatory disease

SummaryBackgroundOur aim in this study was to investigate whether mean platelet volume (MPV) value could be used as an early marker to predict pelvic inflammatory disease (PID).MethodsOverall, 44 patients with PID and 44 healthy women were included in the study. The control group consisted of 44 women who applied to the clinic for a routine gynaecological check-up, without chronic disease or a history of medication use. Owing to the fact that it would affect thrombocyte function, women who have the following conditions were excluded from the study: women who were taking anticoagulant therapy, oral contraceptives, nonsteroid anti-inflammatory medications and who had chronic diseases. The leukocyte count, platelet count, neutrophil ratio and MPV values were collected from PID and the control group. C reactive protein values of patients with PID were also noted.ResultsMPV values in patients with PID were lower than those in the control group. This reduction in MPV is statistically significant when the PID patient group is compared with the control group (p < 0.001). A negative correlation was discovered between platelet count and MPV values (p = 0.019, r = − 0.425). Receiver-operating curve analysis pointed out that MPV has greater area under curve value than neutrophil rate, leukocyte and platelet count (0.73, 0.64, 0.72 and 0.49 respectively).ConclusionSince the MPV value was significantly decreased in patients with PID, it may serve as an additional and even more valuable marker than leukocyte count in the diagnosis of PID.ZusammenfassungGrundlagenZiel dieser Studie war es zu untersuchen, ob das mittlere Thrombozytenvolumen (MPV) als früher Marker einer Erkennung von Entzündungen im Beckenbereich verwendet werden kann.Methodik44 Patienten mit Entzündungen im Becken und 44 gesunde Frauen wurden in die Studie aufgenommen. Die Kontrollgruppe waren Frauen, die die Ambulanz der Klinik zur gynäkologischen Routineuntersuchung aufgesucht hatten. Um andere Einflüsse auf die Thrombozytenfunktion zu vermeiden, wurden Frauen, die unter oraler Antikoagulationstherapie standen, die orale Kontrazeptiva und/oder nicht-steroidale antiinflammatorische Medikamente nahmen oder die eine chronische Erkrankung hatten, nicht in die Studie aufgenommen. Die Leukozytenzahl, die Thrombozytenzahl, der Neutrophilen Quotient und die MPV Werte wurden bei beiden Gruppen erhoben. Bei der Patientengruppe wurden zusätzlich die CRP Werte gemessen.ErgebnisseDie MPV Werte bei den Patientinnen waren niedriger als in der Kontrollgruppe (p < 0,001). Es bestand eine negative Korrelation zwischen der Thrombozytenzahl und den MPV Werten (p = 0,019, r = − 0,425). ROC Analysen ergaben, dass die MPV eine größere Fläche unter der Kurve hatte als die Neutrophilen Rate, oder die Leukozyten- beziehungsweise die Thrombozytenzahl (0,73, 0,64, 0,72 und 0,49 respektive).SchlussfolgerungDa das MPV bei Patientinnen mit Entzündungen im Beckenbereich signifikant erniedrigt war, kann dieser Parameter als ein zusätzlicher und im Vergleich zur Leukozytenzahl sogar wertvollerer Marker bei der Diagnose von Entzündungen im Beckenbereich dienen.

Oxidative stress and prolidase activity in women with uterine fibroids

The aim of this study was to investigate oxidative stress markers and prolidase activity in serum and tissue samples of women with uterine fibroids, with further analysis on position and size. Lipid hydroperoxide, ceruloplasmin, catalase, arylesterase, free sulfhydryl group activity and prolidase activity levels were measured in fibroid tissue, myometrial tissue and serum of the same patients (n = 51), at the same time. Results show that ceruloplasmin, catalase, arylesterase, free sulfhydryl group and prolidase activities were higher in fibroid tissue than those in myometrial tissue (p = 0.003, 0.009, 0.004, 0.02, 0.008, respectively). Serum levels of catalase and prolidase were lower, and arylesterase and free sulfhydryl groups were higher in the fibroid group than those in the control group (p < 0.001 for all). Fibroid volume in submucosal subgroup of the fibroid group yield significant correlation with ceruloplasmin, catalase, arylesterase and prolidase activities (r = 0.84, p = 0.02; r = 0.93, p < 0.001; r = 0.63, p = 0.049 and r = 0.87, p = 0.01, respectively). Despite the lack of statistical significance, the highest levels of prolidase activity were found in fibroid samples, especially in submucosal ones. It is concluded that this study demonstrated increased antioxidative repair system in the fibroid tissue compared to the myometrium and serum of the same patients. Additionally, higher pathophysiological potential of the submucosal fibroids over intramural and subserosal fibroids were shown with the levels of oxidative stress markers and prolidase activity levels.

Evaluation of the Future Atherosclerotic Heart Disease with Oxidative Stress and Carotid Artery Intima Media Thickness in Gestational Diabetes Mellitus

Background and objective. In this study our aim was to evaluate paraoxonase (PON1) activity and free sulfhydryl groups (–SH) as antioxidative parameters and lipid hydroperoxide (LOOH) as oxidative parameter in the serum of women with gestational diabetes mellitus (GDM) and determine their relation with the degree of subclinical atherosclerosis. Material and methods. Serum samples from 39 pregnant women complicated with GDM and 40 healthy pregnant women were collected for the analysis of oxidative markers. Common carotid artery intima media thickness (CIMT) was measured for both groups to assess future atherosclerotic heart disease risk. PON1 activity and –SH were measured spectrophotometrically. LOOH levels were measured by ferrous oxidation with a xylenol orange assay. Results. CIMT and LOOH levels were significantly higher (p = 0.01, p < 0.001, respectively) in GDM group compared to controls, whereas PON1 and –SH levels were significantly lower (p < 0.001 for both). CIMT values were significantly correlated with body mass index (BMI), 50 g oral glucose tolerance test (OGTT), and mean arterial blood pressure (MABP) (p = 0.003, p = 0.02, and p = 0.03, respectively). However, there was no correlation between CIMT and oxidative markers. Conclusions. Increased levels of LOOH and decreased levels of PON1 and –SH showed disturbance of antioxidative mechanisms in GDM. These changes were associated with increased BMI and MABP which may be relevant to GDM pathophysiology. Furthermore, increased CIMT values in GDM compared to healthy controls designate increased risk of future atherosclerotic heart disease.

A case series of 46 appendectomies during pregnancy

ZusammenfassungZIEL DER ARBEIT: Von den Patienten mit Appendizitis sind nur wenige schwanger. Bei Schwangeren ist die Diagnose und das Management einer akuten Appendizitis oft schwierig. Wir haben versucht, an Hand unserer Serie von schwangeren Patientinnen mit akuter Appendizitis diese Schwierigkeiten zu durchleuchten. STUDIEN DESIGN: Die vorliegende Studie umfasst 46 schwangere Patientinnen, die von 2006 – 2009 nach Diagnosestellung einer akuten Appendizitis in unserer Klinik operiert wurden. Folgende Daten wurden retrospektiv aus den Krankengeschichten erhoben: Alter, Zeit bis zur Diagnose, Leukozytenzahl, Schwangerschaftsalter, Schwangerschaftsanamnese, Morbidität, Mortalität und Ergebnisse der Pathologie. ERGEBNISSE: Das mittlere Alter der Patieninnen lag bei 26 Jahren, das Schwangerschaftsalter bei 21 und die Zahl früherer Schwangerschaften im Mittel bei 2,6. Die Dauer vom Auftreten der ersten Symptome bis zur Aufnahme ins Spital lag bei ungefähr 40 Stunden (6–120 Stunden). Die mittlere Dauer von der Aufnahme bis zur Operation lag im Mittel bei 5.89 (range 1–32) Stunden. Die Perforationsrate lag bei unseren Fällen bei 21%, die Rate negativer Appendektomien bei 13%. Die Perforationsrate war signifikant mit einem fortgeschrittenen Schwangerschaftsalter (p ≤ 0.001) und einer verzögerten Spitalsaufnahme korreliert (p = 0.027). SCHLUSSFOLGERUNGEN: Die Diagnose einer Appendizitis ist während der Schwangerschaft schwierig – die Perforationsrate ist hoch. Wir empfehlen daher die Durchführung einer Appendektomie unmittelbar im Anschluss an den Kaiserschnitt.SummaryOBJECTIVE: Among appendicitis patients pregnant ones occupy only a small proportion. Still there are difficulties in the diagnosis and management of the acute appendicitis in pregnant population. We tried to find answers to these difficulties with our acute appendicitis cases in pregnant patients. STUDY DESIGN: This study involved 46 pregnant patients who received an operation following diagnosis of acute appendicitis in our clinic from 2006 to 2009. Data were collected retrospectively from medical records. Age, time delay to diagnosis, leukocyte count (WBC), gestational age, gestational history, morbidity-mortality and pathology results were evaluated. RESULTS: The mean age of patients, gestational age and number of prior pregnancies were 26, 21 and 2.6, respectively. The amount of time spent in the hospital, from presentation of first symptom to admission, was approximately 40 hours (range 6–120). The mean time from admission to operation was 5.89 (range 1–32) hours. The perforation rate among our cases was 21%. The negative appendectomy rate was 13%. The perforation rate was associated with advanced gestational age and delayed admission to the hospital (p ≤ 0.001 and p = 0.027, respectively). CONCLUSION: The diagnosis of appendicitis in pregnancy is difficult, and the perforation rate is high. Particularly in term pregnancies, we recommend performing appendectomy immediately after cesarean section.