Murat Bolayirli

Involvement of neutrophils in ischemia-reperfusion injury of inguinal island skin flaps in rats

&NA; Increased production of oxygen free radicals and infiltration of neutrophils into tissue subjected to ischemia‐reperfusion have emphasized that neutrophils play a direct role in the development of injury. The present study was designed to elucidate the effect of FK506, a new immunosuppressive drug, on 11 hours of complete ischemia and reperfusion of the inguinal island skin flaps in rats. Group 1 (n = 10) control animals underwent ischemia and reperfusion and no treatment. Group 2 (n = 10) animals received FK506 0.3 mg/kg/day, and group 3 (n = 9) animals received 0.5 mg/kg/day intramuscularly for 3 days before the ischemia. The effect of the drug was evaluated by measuring flap survival and tissue malondialdehyde content and myeloperoxidase activity and also by histopathologic examination of the skin specimens taken at the 1st and 24th hour after reperfusion. The survival of flaps controlled for 7 days was found to be significantly improved in group 2 (65.0 ± 10.93 percent) and group 3 (93 ± 6.25 percent) when compared with the control group (14 ± 10.12 percent) (p < 0.04 and p < 0.0001). The tissue contents of malondialdehyde and activities of myeloperoxidase were significantly lower in groups 2 and 3 than in the control group. Three days of pretreatment with FK506 significantly reduced neutrophil infiltration in groups treated with either of the doses. These results showed that neutrophils play an important role in island flap survival associated with ischemia‐reperfusion injury. Increased neutrophil infiltration was found related with increased levels of malondialdehyde and myeloperoxidase. Flap necrosis and the increase in malondialdehyde, myeloperoxidase, and neutrophil infiltration were improved by FK506 pretreatment, a neutrophil modulating agent. (Plast. Reconstr. Surg. 102: 153, 1998.)

Involvement of Neutrophils in Ischemic Injury. I. Biochemical and Histopathological Investigation of the Effect of FK506 on Dorsal Skin Flaps in Rats

The purpose of this study was to investigate the role of neutrophils in ischemic tissue injury and the possible inhibition by pretreatment with FK506, a neutrophilic modulating agent. A dorsal caudally based skin flap (3x9 cm) was used as an ischemic injury model in experimental groups. Prior to flap elevation, FK506 at doses of 0.3 mg per kilogram (group 2), 0.5 mg per kilogram (group 3), and 1.0 mg per kilogram (group 4) was given for 3 days intramuscularly. The relationship among neutrophil accumulation (histopathologically), myeloperoxidase (MPO) activity, malondialdehyde (MDA) content (biochemically) of the flap tissue, and flap survival were studied. Skin flaps showed reduced necrosis in the FK506-treated groups (p < 0.08, p < 0.0001, and p < 0.0001 respectively). The increase in accumulation of neutrophils, and MDA and MPO levels (which were induced by ischemia) observed 1 and 24 hours after flap elevation was diminished by FK506 pretreatment. The increased neutrophilic infiltration, and raised tissue MDA content and MPO activity revealed involvement of both free radical production and neutrophils in ischemia. This injury was decreased by FK506, probably by inhibition of neutrophilic chemotaxis, infiltration, and releasing factors.

Total antioxidant status and markers of oxidative stress in subjects with normal or impaired glucose regulation (IFG, IGT) in diabetic patients

Abstract Background. We investigated the ischemia-modified albumin (IMA), advanced oxidation protein products (AOPPs), prooxidants–antioxidants balance (PAB), and ferric reducing antioxidant power (FRAP) concentrations in patients with impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and diabetes mellitus (DM) and compared the results to those of normoglycemic individuals at baseline and 2 hours after glucose loading. Methods. An oral glucose tolerance test was performed on age-matched subjects (n = 110) with a body mass index (BMI) < 27 kg/m2. Subjects were categorized as normoglycemic (n = 35), IFG (n = 25), IGT (n = 30) and DM (n = 20) according to the WHO criteria. The IMA, AOPP, PAB, FRAP concentrations were determined by colorimetric methods. Results. At baseline, the AOPP concentrations were significantly higher in subjects with IFG and DM compared to normoglycemic subjects (p < 0.01 for all cases). The IFG, IGT and DM patients had a significantly higher IMA at baseline when compared with the normoglycemic individuals (p < 0.001 for all cases). The IMA in IFG subjects was significantly elevated (p < 0.05), while in DM patients, the IMA was significantly decreased (p < 0.001) after glucose loading with respect to baseline concentrations. Following glucose loading, the PAB was significantly decreased from baseline concentrations in normoglycemic individuals (p < 0.001) and in the IFG (p < 0.001) and IGT (p < 0.001) patients. Conclusion. In subjects with impaired glucose metabolism, the hyperglycemia is associated with increased IMA, AOPP and PAB concentrations. Increased IMA in subjects with IFG and decreased FRAP concentrations in subjects with IGT after glucose loading suggests that an increase in glucose concentrations can lead to tissue damage by increasing oxidative stress.

Applicability of a different estimation equation of glomerular filtration rate in Turkey

Abstract We aimed to investigate the performance of various creatinine based glomerular filtration rate estimation equations that were widely used in clinical practice in Turkey and calculate a correction coefficient to obtain a better estimate using the isotope dilution mass spectrometry (IDMS)-traceable Modification of the Diet in Renal Disease (MDRD) formula. This cross-sectional study included adult (>18 years) outpatients and in patients with chronic kidney disease as well as healthy volunteers. Iohexol clearance was measured and the precisions and bias of the various estimation equations were calculated. A correction coefficient for the IDMS-traceable MDRD was also calculated. A total of 229 (113 male/116 female; mean age 53.9 ± 14.4 years) subjects were examined. A median iohexol clearance of 39.21 mL/min/1.73 m2 (range: 6.01–168.47 mL/min/1.73 m2) was found. Bias and random error for the IDMS-traceable MDRD equation were 11.33 ± 8.97 mL/min/1.73 m2 and 14.21 mL/min/1.73 m2, respectively. MDRD formula seems to provide the best estimates. To obtain the best agreement with iohexol clearance, a correction factor of 0.804 must be introduced to IDMS-traceable MDRD equation for our study population.

Is There Any Effect of Tumor Burden on Hemostatic Parameters in Cancer Patients? A Case—Control Study of Hemostatic Abnormalities and Anticardiolipin Antibodies in Solid Tumors

Hemostatic complications are one of the leading causes of mortality in cancer patients. In the present study, we assessed the hemostatic parameters and anticardiolipin antibodies in patients with solid tumors (n = 104) and healthy controls (n = 25) and also find out whether the abnormalities in these hemostatic parameters vary related to tumor burden. Prothrombin time, activated partial thromboplastine time, D-dimer, and fibrinogen as hemostatic parameters were determined by photo-optometric clot detection system, and serum anticardiolipin levels were measured by enzyme-linked immunosorbent assay. The plasma levels of fibrinogen, D-dimer, and serum anticardiolipin IgM levels in cancer patients were significantly higher compared with those in controls (P < .001, P = .001, and P = .01, respectively). Only fibrinogen levels were significantly higher in metastatic group than nonmetastatic group (P < .001 ). Hemostatic abnormalities that are detected in asymptomatic cancer patients may not give any clue about tumor burden or stage of the cancer patients.

Effects of electroconvulsive therapy on plasma levels of neuroactive steroids in inpatients with major depression.

Abstract Objectıve. Neuroactive steroids (NAS) are neuroactive molecules that have been shown to be associated with various psychiatric disorders. There are some inconclusive findings about the alteration in neuroactive steroid levels after the treatment of depression and ECT is still one of the most effective treatment choices for treatment resistant depression. Thus, we aimed to investigate the alterations of several NAS in plasma after ECT in inpatients with treatment resistant depression. Methods. In this study we enrolled 19 consecutive patients, 12 female and 7 male inpatients with major depression, who were not responding to medication, for whom ECT was Indicated, and were not taking any antidepressant treatment for at least a week prior to enrolment. We measured plasma progesterone, testosterone, pregnenolone, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate, and estradiol levels before and after ECT. Results. The mean age of the participants was 38.3 ± 9.4 years. The mean plasma neuroactive steroid levels were insignificant between baseline and post ECT in patients with treatment resistant depression. Conclusıons. ECT does not seem to influence plasma neuroactive steroid levels in patients with treatment resistant depression. Additionally, plasma dehydroepiandrosterone and pregnenolone levels might be associated with improvement in depressive symptoms after ECT.