Sadi Turkay

NITRIC OXIDE AFFECTS SERUM FERRITIN LEVELS IN CHILDREN WITH IRON DEFICIENCY

In iron deficiency, serum levels of ferritin decrease. The lack of iron has been thought to be the main factor in this decrease, but another potential factor is nitric oxide, which has been shown to affect ferritin metabolism in vitro. The aim of this study was therefore to evaluate in children with iron deficiency the relation of serum ferritin, nitric oxide degradation products (nitrate and nitrite), and endothelin-1, a protein closely related to nitric oxide function. A total of 80 children were included in the study (39 with iron deficiency, 41 controls). Serum levels of ferritin, nitrate, nitrite, and endothelin-1 were measured in all participants. In children with iron deficiency, nitrate and nitrite levels were significantly higher (p <. 009 and. 01, respectively). Also, serum ferritin was negatively correlated with serum levels of nitrate and nitrite (p =. 034, r = −.254 for nitrate and p =. 01, r = −.593 for nitrite). No statistical relationship was found between serum ferritin and endothelin-1.

Woolly hair, palmoplantar keratoderma and arrhythmogenic dilated cardiomyopathy in a 7-year-old Turkish girl: Carvajal syndrome.

Abstract Carvajal syndrome (OMIM 605676) is a familial syndrome consisting of woolly hair, palmoplantar keratoderma and heart disease. It leads to dilated cardiomyopathy that affects predominantly the left ventricle. It is caused by a recessive mutation in desmoplakin, an intracellular protein that links desmosomal adhesion molecules to intermediate filaments of the cytoskeleton. Very few patients with this syndrome have been reported, and all have been from Equador or India. We report a 7-year-old Turkish girl with Carvajal syndrome.

Assessment of cardiac function in iron-deficient children without anemia.

Iron deficiency anemia may lead to impairment of many vital functions, including those in the cardiovascular system. However, the effects of iron depletion on cardiac function in the absence of anemia are not well known. In this study the authors examined the effects of iron deficiency without overt anemia on cardiac function in 59 children. Complete blood count, serum iron, serum iron-binding capacity, and serum ferritin levels were measured in all children. The children were divided into two groups according to serum ferritin levels: an iron-depleted group (n = 28) and a non-iron-depleted control group (n = 31). Echocardiographic examinations were performed using M mode and Doppler echocardiographic methods in all children to assess cardiac function. No statistically significant difference was found between the two groups in terms of echocardiographic indices. Although the number of subjects in this study was small, the authors conclude that iron deficiency in the absence of overt anemia does not lead to important changes in cardiac function.

Supernumerary nipple: Should we be alert?

Supernumerary nipples (SN) are common minor congenital anomalies. SN pose no medical threat, however they can be associated with other medical conditions especially kidney and urinary tract malformations.We present here a female infant with SN with interesting associated malformations. In our patient, umbilical hernia, umbilical granuloma, spina bifida occulta and bilateral ovarian cyst accompanied the accessory nipple, instead of the expected renal or urinary system anomalies. Case Report

Effects of Zileuton on the Development of Autoimmune Myocarditis in an Experimental Rat Model

BACKGROUND Myocarditis is associated with high morbidity and mortality in childhood, but the pathogenesis of this disease is still unclear. Current knowledge indicates that complex immunopathogenic mechanisms are involved. It is understood that leukotrienes play an important role in the inflammation associated with asthma, and recent reports indicate that leukotrienes participate in immune processes and in autoimmunity. OBJECTIVE The aim of this study was to assess the role of leukotriene synthesis in the development of myocardial inflammation and necrosis during myocarditis. METHODS The effect of zileuton, a leukotriene synthesis inhibitor, was assessed in an experimental model of autoimmune myocarditis in rats. Healthy adult (10-week-old) male Wistar albino rats were randomly divided into 3 groups. Groups A and B received injections of 1.0 mg porcine cardiac myosin to induce autoimmune myocarditis and group C (the control group) received phosphate-buffered saline. Group B also received zileuton by oral gavage at 100 mg/kg · d(-1). Myocardial inflammation was assessed biochemically via serum concentrations of creatine kinase MB subunit (CK-MB) and troponin T. Cardiac tissue was assessed macroscopically (0 = no inflammation; 1 = a small discolored focus; 2 = diffuse discolored areas covering less than half of the cardiac surface; 3 = diffuse discolored areas covering more than half of the cardiac surface) and microscopically (0 = no inflammation; 1 = ⪯5% infiltration; 2 = 5% to <10% infiltration; 3 = 10% to < 20% infiltration; 4 = >20% infiltration). RESULTS Twenty-four rats were divided equally into 3 groups. All rats survived the duration of the study. After 21 days, all rats were euthanized. No significant differences were found between groups A and B in terms of serum concentrations of CK-MB or troponin T. The microscopic pathology score was significantly lower in group B (myosin + zileuton) than in group A (myosin only) (0.12 [0.35] vs 1.25 [1.03]; P = 0.023). The microscopic pathology score was significantly higher in group A than in group C (1.25 [1.03] vs 0; P < 0.01), but the difference between groups B and C was not statistically significant. The macroscopic pathology score was significantly higher in group A than in group B (1.37 [0.91] vs 0.37 [0.51]; P = 0.029). The macroscopic pathology score was significantly higher in group A than in group C (1.37 [0.91] vs 0; P < 0.01). There was no significant difference in macroscopic scores between groups B and C (0.37 [0.51] vs 0). CONCLUSIONS In this study of the effects of zileuton in an experimental rat model of autoimmune myocarditis, no significant differences were found in the serum concentrations of the biochemical markers in the 2 groups administered myosin. However, lower macroscopic and microscopic inflammation scores in the zileuton-treated group (group B) compared with the group administered only myosin (group A) suggest that zileuton, a leukotriene-synthesis inhibitor, may suppress the development of experimental autoimmune myocarditis in rats.