Nurinnisa Ozturk

S-100β and neuron-specific enolase levels in carbon monoxide―related brain injury

INTRODUCTION Carbon monoxide (CO) toxicity may cause persistent injuries in tissues sensitive to hypoxia. Neuropsychiatric sequelae may be observed in about 67% of cases after severe CO exposure. AIM The aims of this study were to demonstrate the usefulness of S-100beta and neuron-specific enolase (NSE) in CO intoxications, show the degree of neurological response, and determine the indications for hyperbaric oxygen treatment (HBOT) as biochemical markers. RESULTS The S-100beta and NSE levels of the sera of 30 patients were studied upon admittance and at the third and sixth hours. S-100beta levels were found to be high in all 3 analyses. There was no significant change in NSE levels. When the S-100beta levels were compared with Glasgow Coma Scale levels, a strong negative correlation was found for all hours (r = -0.7, -0.8; P = .00). The correlation between S-100beta and carboxyhemoglobin levels at the initial hour was found to be statistically significant (r = 0.4; P = .01). The S-100beta levels in patients receiving HBOT showed a considerable decrease compared with those in patients not receiving the treatment. The same decrease was valid for NSE, although it was insignificant. CONCLUSION S-100beta may be useful in evaluating intoxications as an early biochemical marker in CO intoxications, as well as in the differential diagnosis due to other causes, and in determining HBOT indications.

Fetuin-A Gene Polymorphism in Patients With Calcium Oxalate Stone Disease

OBJECTIVES To evaluate the association of fetuin-A polymorphisms with calcium oxalate nephrolithiasis. Fetuin-A is a circulating calcium-regulatory glycoprotein that inhibits extraosseous calcification. METHODS Fetuin-A c.742C > T and c.766C > G polymorphisms were investigated in 103 patients with calcium oxalate nephrolithiasis and 73 age- and gender-matched healthy volunteers, using polymerase chain reaction-restriction fragment length polymorphism techniques. Additionally, we compared serum fetuin-A levels in the 2 groups. RESULTS A statistically significant difference was observed between the control and patient groups (chi(2) test, P = .003) for the genotype of fetuin-A c.766C > G polymorphism. The odds ratio (95% confidence interval) for the CG genotype in those at risk of stone disease was 4.2 (1.73-10.28). The frequency distribution for fetuin-A c.742C > T polymorphism was not statistically different in stone patients and controls (P = .77). Serum mean fetuin-A concentration was significantly lower in the patients (710.38 +/- 156.42 microg/mL) than in the controls (810.89 +/- 173.43 microg/mL, P = .0001). In the patient group (but not in the control group), subjects carrying fetuin-A genotype 1 had significantly higher serum fetuin-A concentrations than the group carrying fetuin-A genotype 2-1 (P = .001). CONCLUSIONS These results reveal that the patients with fetuin-A c.766C > G gene polymorphism may be at higher risk for renal calcium oxalate stone formation.

Comparison of Cobas 6500 and Iris IQ200 fully-automated urine analyzers to manual urine microscopy.

Introduction Urine screening is achieved by either automated or manual microscopic analysis. The aim of the study was to compare Cobas 6500 and Iris IQ200 urine analyzers, and manual urine microscopic analysis. Materials and methods A total of 540 urine samples sent to the laboratory for chemical and sediment analysis were analyzed on Cobas 6500 and Iris IQ200 within 1 hour from sampling. One hundred and fifty three samples were found to have pathological sediment results and were subjected to manual microscopic analysis performed by laboratory staff blinded to the study. Spearman’s and Gamma statistics were used for correlation analyses, and the McNemar test for the comparison of the two automated analyzers. Results The comparison of Cobas u701 to the manual method yielded the following regression equations: y = - 0.12 (95% CI: - 1.09 to 0.67) + 0.78 (95% CI: 0.65 to 0.95) x for WBC and y = 0.06 (95% CI: - 0.09 to 0.25) + 0.66 (95% CI: 0.57 to 0.73) x for RBC. The comparison of IQ200 Elite to manual method the following equations: y = 0.03 (95% CI: - 1.00 to 1.00) + 0.88 (95% CI: 0.66 to 1.00) x for WBC and y = - 0.22 (95% CI: - 0.80 to 0.20) + 0.40 (95% CI: 0.32 to 0.50) x for RBC. IQ200 Elite compared to Cobas u701 yielded the following equations: y = - 0.95 (95% CI: - 2.13 to 0.11) + 1.25 (95% CI: 1.08 to 1.44) x for WBC and y = - 1.20 (95% CI: - 1.80 to -0.30) + 0. 80 (95% CI: 0.55 to 1.00) x for RBC. Conclusions The two analyzers showed similar performances and good compatibility to manual microscopy. However, they are still inadequate in the determination of WBC, RBC, and EC in highly-pathological samples. Thus, confirmation by manual microscopic analysis may be useful.

A reference interval study for common biochemical analytes in Eastern Turkey: a comparison of a reference population with laboratory data mining

Introduction The aim of this study was to define the reference intervals (RIs) in a Turkish population living in Northeast Turkey (Erzurum) for 34 analytes using direct and indirect methods. In the present study, the regional RIs obtained were compared with other RI studies, primarily the nationwide study performed in Turkey. Materials and methods For the direct method, 435 blood samples were collected from a healthy group of females (N = 218) and males (N = 217) aged between 18 and 65 years. The sera were analysed in Ataturk University hospital laboratory using Roche reagents and analysers for 34 analytes. The data from 1,366,948 records were used to calculate the indirect RIs using a modified Bhattacharya method. Results Significant gender-related differences were observed for 17 analytes. There were also some apparent differences between RIs derived from indirect and direct methods particularly in some analytes (e.g. gamma-glutamyltransferase, creatine kinase, LDL-cholesterol and iron). The RIs derived with the direct method for some, but not all, of the analytes were generally comparable with the RIs reported in the nationwide study and other previous studies in Turkey.There were large differences between RIs derived by the direct method and the expected values shown in the kit insert (e.g. aspartate aminotransferase, total-cholesterol, HDL-cholesterol, and vitamin B12). Conclusions These data provide region-specific RIs for 34 analytes determined by the direct and indirect methods. The observed differences in RIs between previous studies could be related to nutritional status and environmental factors.

Serum Zinc, Copper, Magnesium and Selenium Levels in Children with Helicobacter Pylori Infection.

OBJECTIVE Helicobacter pylori infection can cause disease from mild to severe that may be accompanied by micronutrient deficiencies. We aimed to investigate serum zinc, copper, magnesium and selenium levels in Helicobacter pylori positive children. MATERIALS AND METHODS Thirty-four children, with chronic abdominal pain and diag-nosed to be Helicobacter pylori-positive and 20 healthy children with the same demo-graphic characteristics were included in the study. Serum zinc, copper and magnesium levels were measured in the flame unit of atomic absorption spectrophotometer, selenium levels were measured in the graphite unit of the same atomic absorption spectrophotometer. RESULTS Serum zinc levels were significantly higher and serum magnesium levels were significantly lower (p<0.05) in Helicobacter pylori positive children than those of the control group. Although copper levels were lower in patient group than in control group, this difference was not statistically significant (p>0.05). There was no significant difference between serum selenium levels of two groups. CONCLUSION We concluded that in Helicobacter pylori-positive children, many trace elements and mineral metabolism may change.

Evaluation of Circulating Nitric Oxide Levels in Patients with Complex Regional Pain Syndrome Type

Objectives: Proinflammatory mediators play an important role in the pathophysiology and development of complex regional pain syndrome type 1. Elevated cytokine production is suggested to increase nitric oxide production by activating the inducible nitric oxide synthase pathway. In this study, we aimed to determine the circulating nitric oxide concentrations in complex regional pain syndrome type 1 patients, and to compare them with those of healthy controls. Methods: Serum circulating nitric oxide concentrations were measured in twenty-five patients (15 female and 10 male) with complex regional pain syndrome type 1 who fulfillied the criteria of the modified International Association for the Study of Pain (IASP) and compared those of twentyfive (15 female and 10 male) age, gender matched healthy subjects. Nitric oxide concentration is estimated indirectly based on Greiss method by measuring the combined oxidation products of nitric oxide (total nitrites and nitrates). Results: There was no significant difference in the demographic data among two groups (p>0.05). The mean serum nitric oxide concentration (39.50±13.26 μmol) was significantly higher in the complex regional pain syndrome type 1 patients group compared to those of controls (27.15±11.90 μmol) (p<0.001). Conclusions: We suggest that nitric oxide levels play an important role on inflammatory reactions in CPRS 1 patients.

Hepatocellular damage following burn injury demonstrated by a more sensitive marker: alpha-glutathione S-transferase.

Following burn injury, some complex reactions are initiated that are mainly managed by the liver and that can cause injury at the liver. Alpha glutathione S-transferase (&agr;-GST) is a sensitive marker that is very sensitive in the monitoring of hepatocellular damage. We tried, in this study, to demonstrate liver injury in burn patients using &agr;-GST. Forty-four patients with burn injury treated at the Burn Treatment and Care unit of the Atatürk University Medical School between July 2006 and July 2007 were included in the study. Patient data were collected. Three blood samples were taken from the patients (at admittance [first sample], 120 hours after admittance [second sample], and on the fourteenth day [third sample]) for the analysis of &agr;-GST, alanine amino transferase, aspartate amino transferase activities, and albumin and c-reactive protein levels. There was a statistically significant difference between &agr;-GST activities of the study group at admission (P < .001), on the fifth day (P < .001), and the 14th day (P < .001) and those of the control group. There was a decrease in &agr;-GST activities during the hospitalization period. Alanine amino transferase and aspartate amino transferase activities in all three samples of the study group were not different from each other and from the values obtained from the control group. The albumin levels of the study group were significantly different from those of the control group. The c-reactive protein levels of the study group were different from those of the control group at admission, on the fifth day, and fourteenth day (P < .001, P < .001, and P < .01). Our findings suggest that burn injury causes liver injury, and &agr;-GST can be used to demonstrate this.

A nationwide multicentre study in Turkey for establishing reference intervals of haematological parameters with novel use of a panel of whole blood

Introduction A nationwide multicentre study was conducted to establish well-defined reference intervals (RIs) of haematological parameters for the Turkish population in consideration of sources of variation in reference values (RVs). Materials and methods K2-EDTA whole blood samples (total of 3363) were collected from 12 laboratories. Sera were also collected for measurements of iron, UIBC, TIBC, and ferritin for use in the latent abnormal values exclusion (LAVE) method. The blood samples were analysed within 2 hours in each laboratory using Cell Dyn and Ruby (Abbott), LH780 (Beckman Coulter), or XT-2000i (Sysmex). A panel of freshly prepared blood from 40 healthy volunteers was measured in common to assess any analyser-dependent bias in the measurements. The SD ratio (SDR) based on ANOVA was used to judge the need for partitioning RVs. RIs were computed by the parametric method with/without applying the LAVE method. Results Analyser-dependent bias was found for basophils (Bas), MCHC, RDW and MPV from the panel test results and thus those RIs were derived for each manufacturer. RIs were determined from all volunteers’ results for WBC, neutrophils, lymphocytes, monocytes, eosinophils, MCV, MCH and platelets. Gender-specific RIs were required for RBC, haemoglobin, haematocrit, iron, UIBC and ferritin. Region-specific RIs were required for RBC, haemoglobin, haematocrit, UIBC, and TIBC. Conclusions With the novel use of a freshly prepared blood panel, manufacturer-specific RIs’ were derived for Bas, Bas%, MCHC, RDW and MPV. Regional differences in RIs were observed among the 7 regions of Turkey, which may be attributed to nutritional or environmental factors, including altitude.

Endocan Measurement for Active Behçet Disease

Objectives This study aims to investigate the relationships between serum endocan, vascular endothelial growth factor (VEGF), and tumor necrosis factor-alpha (TNF-α) levels in active Behçet disease. Patients and methods Forty patients with active Behçet disease (24 males, 16 females; mean age 37.6±8.7 years; range 20 to 50 years) and 40 healthy controls (22 males, 18 females; mean age 38.8±7.9 years; range 21 to 52 years) were included in this study. Both patient and control groups underwent a complete systemic and ophthalmic examination by the same specialist. Endocan, VEGF, and TNF-α levels were measured with an enzyme-linked immunosorbent assay kit in all subjects. Results Serum endocan levels were 775.2±479.3 ng/mL and 275.8±145.8 ng/mL in the patient and control groups, respectively. VEGF levels were 1768.2±900.5 pg/mL and 980.2±135.3 pg/mL in the patient and control groups, respectively. TNF-α levels were 22.4±74.3 pg/mL-1 and 11.4±16.9 pg/mL-1 in the patient and control groups, respectively. There was a statistically significant difference between groups in terms of serum endocan, VEGF, and TNF-α levels. There was a significant positive correlation between serum endocan and VEGF levels in the patient group (r=0.630; p<0.001). Also, there was a significant positive correlation between serum endocan and TNF-α levels in the patient group (r=0.713; p<0.001). Conclusion Serum endocan level may be a new marker in evaluation of both the prognosis and activity of Behçet disease.

The Frequency of Some Thrombophilic Mutations in Eastern Turkey.

OBJECTIVE Factor V / Factor II / Methylenetetrahydrofolate reductase, gene polymorphisms are closely associated with thrombophilia. Regional frequencies of these mutations may show a characteristic state. The aim of our study was to evaluate the frequency of commonly seen Factor V / Factor II / Methylenetetrahydrofolate reductase gene polymorphisms in Eastern Turkey. MATERIALS AND METHODS In 433 patients sent to the laboratory with the suspicion of thrombophilia, using whole blood samples, an automated Nucleic Acid Test was used for mutation determinations in Verigene System. The kit module was designed to detect the Factor V G1691A / Factor II G20210A / Methylenetetrahydrofolate reductase gene C677T single nucleotide polymorphisms. RESULTS In 433 patients, 8.7% for Factor V G1691A polymorphisms were heterozygous genotype, 3.9% for Factor II G20210A polymorphisms were heterozygous genotype, and 43.9% for methylenetetrahydrofolate reductase 677C>T polymorphisms were heterozygous genotype and 3.0% homozygous mutation genotype. CONCLUSION Detection of these commonly seen Factor V / Factor II / Methylenetetrahydrofolate reductase single nucleotide polymorphisms can help to identify patients in high risk group and to evaluate the interaction of genetic and acquired risk factors. Our findings suggest that commonly seen thrombophilic allele mutation frequency in our region is the same as the data reported in the literature.