Öztekin Oto

Determination of glutathione, glutathione reductase, glutathione peroxidase and glutathione S-transferase levels in human lung cancer tissues

This study was performed to elucidate the lung glutathione-related defense potential in tumoral tissues. Reduced (GSH) and oxidized (GSSG) glutathione, glutathione reductase (GR), selenium-dependent (SeGPx) and total glutathione peroxidase (tGPx), and glutathione S-transferase (GST) activities in 38 tumoral lung tissues and 17 normal lung tissues were determined to obtain a comprehensive profile of the lung glutathione and glutathione-related enzymes in cancer. The enzyme levels in tumoral tissues (n = 38) were found to be significantly higher (P < 0.05) than those in normal tissues (n = 17). Reduced glutathione levels, and not oxidized glutathione levels, were found to be higher in normal tissues than those in tumoral tissues. We found no statistically significant difference between the adenocarcinoma and squamous cell carcinoma groups for any of the parameters studied.

The effects of amrinone and glucagon on verapamil-induced myocardial depression in a rat isolated heart model

1. We measured the ability of glucagon and amrinone, used alone and in combination, to improve the myocardial function in a rat isolated heart model of calcium channel blocker (CCB) cardiotoxicity. 2. Verapamil 10(-4) mol consistently decreased heart rate and cardiac contractile force in our Langendorff rat isolated heart preparations. Glucagon increased the heart rate in a dose-dependent fashion. Amrinone increased the heart rate only at the 1 x 10(-1) mol concentration, and had no significant effect on cardiac contractility. 3. A positive linear correlation was found between the glucagon concentration and the percent recovery of baseline contractile force. 4. Although complete reversal of verapamil-induced myocardial depression occurred at glucagon concentrations of > 3 x 10(-6) mol, amrinone produced only 23.8 +/- 3.6% recovery from baseline at its highest concentration (4 x 10(-3) mol). 5. When glucagon and amrinone were administered together, there was no additional increase over glucagon alone in the increase in contractile force. 6. Glucagon, and not amrinone, is an appropriate agent, capable of reversing verapamil-induced myocardial toxicity in this rat isolated heart model. In vivo studies should be performed to assess whether this may be a reliable therapy in clinical cases.

Brucella pancarditis with dissecting aortic root abscess, left ventricular pseudoaneurysm and ventricular septal defect.

A rare case of Brucella pancarditis is reported in a 38-year-old male farmer who presented with heart failure. Brucella pancarditis was diagnosed with positive serology, and echocardiographic examination showed pericardial effusion, vegetation and mycotic aneurysms on the aortic root. The development of a fistula between the aorta and right ventricle, aortic dissection, a subaortic ventricular septal defect, and left ventricular pseudoaneurysm were observed. This case illustrates that life-threatening cardiac complications may develop, even under aggressive antibiotic therapy. It is recommended that echocardiographic follow-up and close collaboration between colleagues working in infectious disease, cardiology and cardiovascular surgery are crucial in the treatment of Brucella pancarditis.

Ocular Bleeding Related to Warfarin Anticoagulation in Patients with Mechanical Heart Valve and Atrial Fibrillation

We investigated the incidence of ocular bleeding in patients taking anticoagulant therapy (warfarin) and its association with other related factors. We examined 210 patients taking warfarin and 210 gender-and age-matched controls for ocular bleeding. Patients and controls were examined by external ocular examination and fundoscopic examination. The incidence of ocular bleeding was 11.4% in patients and 3.8% in controls. It was five times higher in patients with hypertension than in other patients. The incidence of ocular bleeding was higher in older than in younger patients. No association was found between ocular bleeding and factors such as gender, international normalized ratio, duration of warfarin therapy, concomitant aspirin use and diabetes mellitus. Thus, warfarin therapy increases the frequency of ocular bleeding. The higher incidence of ocular bleeding in the patients with hypertension and advanced age should be kept in mind and this subgroup of patients taking warfarin should be monitored closely.

A Multicentre Study of Abdominal Aorta Diameters in a Turkish Population

The aim of this study was to determine the normal values for aortic diameters and the prevalence of aortic dilatation in a mixed Turkish population. Between March 1998 and May 2000, patients who were undergoing abdominal ultrasonography examination for pathologies not involving the aorta, in three different cities, were enrolled into the study prospectively. The anterior posterior aortic diameters were measured at the subdiaphragmatic and aortic bifurcation levels using ultrasonography. A total of 596 patients were included (302 females, 294 males). The mean age was 48 ± 16 years (range, 6–88 years). The mean aortic diameter in the whole group was 19.0 ± 3.9 mm (10–45 mm) at the subdiaphragmatic level and 15.7 ± 3.6 mm (9–65 mm) at the aortic bifurcation level. The mean subdiaphragmatic aortic diameter was 18 ± 3 mm in females and 19 ± 4 mm in males. The mean aortic diameters at the bifurcation level was 15 ± 3 mm in females and 16 ± 4 mm in males. An aortic bifurcation diameter < 30 mm was encountered in 0.67% of the population. This ratio increased to 1.8% in patients over 55 years of age, regardless of sex. A subdiaphragmatic aorta diameter above 30 mm was observed in 1.2% of the population. In patients over the age of 55 years, this ratio increased to 2.7% (3.6% in males and 1.9% in females). In this national study, the subdiaphragmatic aortic diameters were similar to mean values reported in the world literature. The mean aortic bifurcation diameters were generally lower when compared with the literature, which may be due to difficulties in standardization of the measurements. Aneurysmal dilatation rates in this study also conform to those reported in studies conducted in other countries. Considering the significant number of patients with aneurysmal dilatation of the aorta in the elderly population, we believe it would be prudent to evaluate the aorta in all patients undergoing abdominal ultrasonographic examination.

Paediatric endobronchial leiomyoma mimicking asthma

A 16-year-old male patient was admitted with complaints of cough, fever, dyspnoea, wheezing and haemoptysis for 2 months. Wheezing was bilateral but predominantly in the right lung fields. Inspiration and expiration were prolonged. In the emergency room, the initial diagnosis was bronchial asthma. His wheezing and dyspnoea did not respond to iv. theophylline, corticosteroids or inhaled salbutamol. Chest X-ray showed hyperinflation of the right lung, especially after full expiration. Mantoux test, acid-fast bacilli and sputum cultures were negative. Magnetic resonance revealed a soft tissue mass in the proximal part of the right main bronchus, and hyperinflation of the right lung (Plate 1). Fiberoptic bronchoscopy showed total occlusion in the proximal part of the right main bronchus. Bronchial leiomyoma was diagnosed in the biopsy specimen. In order to evaluate the extension of mass and distal bronchial distribution, selective bronchography via fiberoptic bronchoscopy was performed. Dionosil aqua was pooled proximal to the mass and the distal bronchial system could not be visualized. Bronchiectasis could visualize by lotrolan (Plates 2 and 3). Lung destruction, bronchiolitis obliterans and bronchiectasis were observed secondary to the endobronchial leiomyoma and right pneumonectomy was performed.

Dissection of the ascending aorta due to metastatic carcinoma

The association of aortic dissection with a malignancy is a rare finding and previous reports are usually those of primary aortic sarcomas. In this report we present a case with typical ascending aorta dissection associated with metastatic carcinoma originating from the lungs. The metastatic infiltration of the vasovasorum of the aorta by carcinoma cells may have caused aortic dissection by decreasing medial strength and integrity. This is a mechanism of aortic dissection that we have not encountered in previous reports.

Stroke and Myxoma

Cardiac myxoma was detected by transthoracic echocardiography in 8 patients (aged 11 to 64 years) who were admitted between 1991 and 1999 with stroke or transient ischemic attacks, representing 80% of the total myxoma cases treated in this period. All patients underwent surgery and the myxomas were successfully removed. There were no recurrences during a mean follow-up of 3.1 years. In the presence of unexplained transient ischemic attack, cerebral infarction, or syncope, this relatively rare cardiac lesion should be suspected and investigated by transthoracic echocardiography.

Pleural flap for treating perigraft leak after a modified blalock-taussig shunt

Plasa oozing through the graft after a modified Blalock-Taussig shunt is a troublesome complication. We encountered a massive leak following a modified Blalock-Taussig shunt in a 2 1/2 year-old-girl which required reexploration. The leak was treated by wrapping the polytetrafluoroethylene shunt with the parietal pleura flap harvested from the adjacent chest wall. The patient had an uneventful recovery. Covering of the polytetrafluoroethylene shunt with parietal pleura appears to stop plasma leak through the graft following a modified Blalock-Taussig shunt.

The inversely proportional relation between nitric oxide and lipid peroxidation in atherosclerotic plaque formation in human.

It is known that in the presence of oxygen radicals, anti-atherogenic nitric oxide is converted into pro-atherogenic products, which increase lipid peroxidation. In this study, plaque-free atherosclerotic tissues (n=26), atherosclerotic plaques (n=26) and fetal tissues (n=2; as control) were evaluated. High nitrite, but low malondialdehyde, levels in non-atherosclerotic tissues may show the protective role of nitric oxide from atherosclerosis. In plaque-developed tissues nitrite levels were three times, and lipid peroxidation levels were 10 times, higher than non-plaque developed tissues. In the atherosclerotic plaque forming process, the role of nitric oxide can be discovered according to the lipid peroxidation of tissues. In conclusion, the results of this study show an inversely proportional relation between pro- and anti-atherogenic effects of nitric oxide in the pathogenesis of atherosclerotic vascular diseases.