Saim Yologlu

Effects of valproate and carbamazepine on serum levels of homocysteine, vitamin B12, and folic acid

Homocysteine (HMC) is a sulfur containing amino acid, which plays a role in methionine metabolism. Folic acid (FA) and vitamin B12 (B12) are essential for remethylization of HMC to methionine. HMC level increases in the deficiency of these vitamins. Hyperhomocysteinemia causes vascular endothelial damage, which causes atherosclerosis. The aim of this study is to investigate the effect of valproate (VA) and carbamazepine (CBZ) on the serum levels of HMC, B12, and FA.Thirty-six children receiving CBZ and 30 children receiving VA for epilepsy for the last 1-year period and 29 healthy children as control were the population of this study. After 6 h of fasting serum HMC, B12, and FA levels were measured and results were compared statistically. Mean values of HMC, FA, and B12 levels in control group were 9.2+/-2.7 micromol/l, 9.0+/-2.0 ng/ml, and 342+/-162 pg/ml, in VA group 14.0+/-6.8 micromol/l, 7.3+/-2.9 ng/ml, and 368+/-159 pg/ml, in CBZ group 16.0+/-13.1 micromol/l, 7.5+/-3.3 ng/ml, and 285+/-158 pg/ml, respectively. Serum HMC levels were higher in VA and CBZ groups than control group (P<0.01 and P<0.05, respectively). Serum FA levels were lower in VA and CBZ groups compared to control group (P<0.05). Serum levels of B12 were not different between VA and control groups (P>0.05). In CBZ group serum B12 levels were lower than control group (P<0.05).FA may be added to the treatment protocol (if the patients take only CBZ, then B12 should also be added) for patients taking these antiepileptic drugs to decrease the degenerative effect of VA and CBZ on vascular endothelium.

Central nervous system protection by resveratrol in streptozotocin-induced diabetic rats

The objective of the present study was to investigate the possible neuroprotective effect of resveratrol against streptozotocin-induced hyperglycaemia in the rat brain and medulla spinalis. Thirty adult male Wistar rats were divided into three groups as follows: control group, streptozotocin-induced diabetic-untreated group, and streptozotocin-induced diabetic resveratrol-treated group. Diabetes was induced by a single injection of streptozotocin (STZ) (60 mg/kg body weight). Three days after streptozotocin injection, resveratrol (10 mg/kg) was injected intraperiteonally daily over 6 weeks to the rats in the treatment group. Six weeks later, seven rats from each group were killed and the brain stem and cervical spinal cord were removed. The hippocampus, cortex, cerebellum, brain stem and spinal cord were dissected for biochemical studies (lipid peroxidation measuring malondialdehyde [MDA], xanthine oxidase [XO], nitric oxide [NO] and glutathione). MDA, XO and NO levels in hippocampus, cortex, cerebellum, brain stem and spinal cord in the streptozotocin-induced diabetic-untreated group increased significantly. Treatment with resveratrol significantly reduced MDA, XO and NO production and increased glutathione levels when compared to the streptozotocin-induced diabetic-untreated group. This study demonstrates that resveratrol is a potent neuroprotective agent against diabetic oxidative damage.

Evaluation of anterior segment parameters in keratoconic eyes measured with the Pentacam system

PURPOSE: To evaluate the alteration in anterior chamber parameters with the progression of keratoconus using a rotating Scheimpflug camera. SETTING: Inonu University, Turgut Ozal Medical Center, Ophthalmology Department, Malatya, Turkey. METHODS: Two hundred sixteen eyes of 123 patients diagnosed with keratoconus and 224 eyes of 112 normal subjects were evaluated with a Pentacam Scheimpflug camera (Oculus Inc.). Keratoconic eyes were divided into 3 groups according to mean keratometer (K) readings: mild (K = less than 47.0 diopters [D]), moderate (K = 47.0 to 52.0 D), and severe (K = 52.0 D or higher). The following parameters were obtained: thinnest corneal thickness (TCT), anterior chamber depth (ACD), corneal volume (CV), anterior chamber angle (ACA), and anterior chamber volume (ACV). RESULTS: One hundred twenty‐nine eyes had mild keratoconus, 59 had moderate keratoconus, and 35 had severe keratoconus. There were no statistically significant differences between the keratoconus group and control group in age, sex, or eye distribution (P>.05). With the progression of the disease, TCT and ACD were statistically different between all groups (P<.05). There were statistically significant differences in ACA and CV measurements between the mild keratoconus and severe keratoconus groups (P<.05). Also, CV readings were significantly different between the control group and all keratoconus groups (P<.05), although there was no significant difference in ACA measurements (P>.05). Despite a progressive increase in the ACV with disease progression, the differences between groups were not statistically significant (P>.05) except between the severe keratoconus group and the control group (P<.05). CONCLUSION: Anterior segment parameters of the eye showed significant alterations with the progression of keratoconus.

Comparison of three conservative treatment protocols in carpal tunnel syndrome

The aim of this study was to investigate and compare the therapeutic effect of three different combinations in the conservative treatment of carpal tunnel syndrome (CTS) by means of clinical and electrophysiological studies. The combinations included tendon‐ and nerve‐gliding exercises in combination with splinting, ultrasound treatment in combination with splinting and the combination of ultrasound, splinting, tendon‐ and nerve‐gliding exercises. A total 28 female patients (56 wrists) with clinical and electrophysiologic evidence of bilateral CTS were studied. In all patient groups, the treatment combinations were significantly effective immediately and 8 weeks after the treatment. The results of the long‐term patient satisfaction questionnaire revealed that symptomatic improvement is more prominent in the group treated with splinting, exercise and ultrasound therapy combination. Our results suggest that a combination of splinting, exercise and ultrasound therapy is a preferable and an efficacious conservative type of treatment in CTS.

Platelet counts in adults with iron deficiency anemia

In adults with iron deficiency anemia (IDA), abnormal platelet counts were seen in several studies. However we retrospectively examined the clinical records of a larger number of adults with IDA to assess abnormal platelet counts. From November 2006 to April 2008, 615 consecutive adults (73 men and 542 women; age range, 16–88 years) with IDA were included in this study. The mean initial hemoglobin was 9.0 ± 1.8 g/dL (range 2.7–12.8 g/dL), and the mean initial platelet count was 304 × 103/µL ± 92.3 (range, 105–700 × 103/µL). The initial platelet counts were normal in 520 (84.6%) adults with IDA. Thrombocytosis (>400 × 103/µL) and thrombocytopenia (<150 × 103/µL) were detected in 82 (13.3%) and 13 (2.1%) adults with IDA, respectively. In conclusion, thrombocytosis was seen at lower rates in our study. Furthermore, this study shows that mild thrombocytopenia is not so rare in adults with IDA.

Effects of resveratrol and methylprednisolone on biochemical, neurobehavioral and histopathological recovery after experimental spinal cord injury

AbstractAim:To investigate the neuroprotective effect of resveratrol in an experimental spinal cord injury (SCI) model in rats.Methods:Male Wistar albino rats weighing 200–250 g were randomized into six groups. Weight-drop trauma was performed for SCI. Group 1 underwent laminectomy alone. Group 2 underwent laminectomy followed by SCI. Groups 3, 4, 5, and 6 underwent laminectomy followed by SCI and received resveratrol (100 mg/kg), methylprednisolone (MP) (30 mg/kg), resveratrol (100 mg/kg) plus MP (30 mg/kg), and ethanol (2%), respectively. The rats were divided into two subgroups for biochemical analysis (killed at 24 h after surgery) and for neurobehavioral and histopathological evaluation (killed at 6 weeks after surgery). Posttraumatic neurological recovery after surgery was recorded weekly.Results:Groups 3 and 5 revealed significantly lower malondialdehyde, nitric oxide, xanthine oxidase, and higher glutathione levels than group 4 (P<0.05). Neurological recovery rates were significantly better in groups 3 and 5 than group 4 (P<0.05). When spinal trauma size ratios were compared, there was no significant difference between treatment groups.Conclusion:Resveratrol treatment revealed better biochemical recovery in the acute stage of trauma than MP treatment. Although resveratrol and combined treatment revealed better neurobehavioral recovery than MP treatment; resveratrol, MP, and combined treatment modalities improved histopathological recovery at the same level in the final stage of the experiment. Future studies involving different doses of resveratrol and different doses combinations with MP could promise better results as each drug has a different anti-oxidative mechanism of action.

Effect of combined treatment with melatonin and methylprednisolone on neurological recovery after experimental spinal cord injury

Spinal cord injury (SCI) results in the loss of function below the lesion. Secondary injury following the primary impact includes a number of biochemical and cellular alterations leading to tissue necrosis and cell death. Methylprednisolone (MP), by reducing edema and protecting the cell membrane against peroxidation, is the only pharmacological agent with a proven clinically beneficial effect on SCI. Melatonin, known as a free radical scavenger, has been shown to have an effect on lipid peroxidation following experimental SCI. The purpose of this study was to examine the effect of MP and melatonin on neurological, ultrastructural, and electrophysiological recovery. Female albino rats weighing 200–250 g were randomized into five groups of 18 rats each and six rats for the control group. Weight-drop trauma was performed for each group and a 30-mg/kg single dose of MP for rats in group 1, a 10-mg/kg single dose of melatonin for rats in group 2, and MP and melatonin in the same doses for rats in group 3 were administered immediately after trauma. The rats in group 4 were the vehicle group (treated with ethanol) and group 5 was the trauma group. The motor and somatosensory evoked potentials were recorded at the 4th hour, the 24th hour, and on the 10th day of the study for six rats in each group. Posttraumatic neurological recovery was recorded for 10 days using “motor function score” and inclined plane test. After electrophysiological study the rats were terminated for an analysis of lipid peroxidation level of the injured site of the spinal cord. Electron microscopic studies were performed to determine the effects of melatonin, MP, and the combined treatment with MP and melatonin on axons, neurons, myelin, nucleus, and intracytoplasmic edema. The groups treated with MP, melatonin, and a combination of both had significantly enhanced electrophysiological, biochemical, and neurological recovery and also showed better ultrastructural findings than the trauma and vehicle groups. Although combined treatment was significantly more effective on lipid peroxidation than melatonin or MP treatments alone, at the 10th day, neurobehavioral, electrophysiological, and ultrastructural recovery were at the same level. In conclusion, MP, melatonin, and MP and melatonin combined treatment modalities improved functional recovery at the same level. Future studies involving different doses of melatonin and different dose combinations with MP could promise better results since each drug has a different antioxidative mechanism of action.

Epicardial adipose tissue, hepatic steatosis and obesity

Objective: Hepatic steatosis is a common companion of obesity. Moreover, the measurement of epicardial adipose tissue (EAT) has been reported to be related with both obesity and insulin resistance. Therefore, we aimed to evaluate the relationship between hepatic steatosis, EAT and insulin resistance in obese patients. Methods: Sixty-three obese subjects were enrolled in the study. Patients were divided into 3 groups according to body mass index (BMI) as follows: 20 patients with 30≤BMI<35 kg/m2 (Group 1, mean age 39.3±12.9 yr), 25 patients with 35≤BMI<40 kg/m2 (Group 2, mean age 41.7±9.3 yr), and 18 patients with BMI≥40 kg/m2 (Group 3, mean age 36.8±13.9 yr). EAT and grade of hepatic steatosis were assessed sonographically. Anthropometrical measurements were assessed with the foot-to-foot bioelectrical impedance analysis. Insulin resistance was assessed according to basal insulin, quantitative insulin sensitivity check index (QUICKI) and homeostasis model assessment (HOMA) equations. Results: Although EAT was similarly higher in both groups 2 and 3, these groups were found to be similar in terms of the grade of hepatic steatosis. Both EAT and the grade of hepatic steatosis were correlated with whole body fat mass, abdominal adiposity, insulin resistance, and triglyceridemia but waist circumference was the only factor affecting EAT thickness. Highly sensitive C-reactive protein (hsCRP) was the only metabolic parameter that was significantly higher in Group 3 than in Group 1 (p=0.02). Conclusion: Hepatic steatosis should be assessed as a valuable predictor that reflects the increments of whole body fat mass as well as abdominal adiposity. However, in an attempt to demonstrate marginal differences between patients with similar obesity levels, epicardial adipose tissue appears to be a more sensitive marker compared to hepatic steatosis.

The Role of Ghrelin in Weight Gain and Growth in Epileptic Children Using Valproate

Ghrelin is a major hormone, regulating the energy balance of the body. Weight gain is a significant side effect of valproic acid, which has not been clearly identified pathogenetically. The aim of this study was to investigate the effect of valproic acid on ghrelin and its potential effects on weight gain and growth. Each patient and control group consisted of 35 children aged 3 to 15 years. Fasting serum glucose, insulin, C-peptide, leptin, ghrelin, insulin-like growth factor-1, and insulin-like growth factor binding protein-3 levels were measured in patients treated with valproic acid before and at month 6 of treatment. A significant increase in body weight, body mass index, height, and height standard deviation scores was observed in all patients after 6 months of treatment. Significant increases in growth velocity and weight gain were observed in the patient group compared with controls at 6 months of therapy. A significant increase in serum ghrelin levels (P < .01) was detected at the same time in the study group. A negative correlation of ghrelin with insulin-like growth factor-1 and insulin-like growth factor binding protein-3 was detected. Serum ghrelin levels were significantly increased (P < .05), and insulin-like growth factor-1 and insulin-like growth factor binding protein-3 levels were significantly decreased ( P < .01 and P < .05, respectively) in the prepubertal group at 6 months of treatment, but no significant change was observed in the pubertal group. Consequently, ghrelin levels significantly increase in the prepubertal children treated with valproic acid. The weight gain in using valproic acid may be associated with the increase in ghrelin level in the early treatment period.

Genotoxicity Testing of Four Textile Dyes in Two Crosses of Drosophila Using Wing Somatic Mutation and Recombination Test

In this study, four textile dyes, namely Astrazon Yellow, Red, Blue, and Black, were tested for their genotoxic effects in the wing cells of Drosophila melanogaster. Two crosses were used, the standard cross (ST) and the improved high-bioactivation cross (HB), the latter being characterized by increased sensitivity to the genotoxic effects of promutagens and procarcinogens. Three-day-old larvae were exposed to different concentrations of dyes. Commonly known mutagens were applied as positive controls. All concentrations of textile dyes, ethyl methanesulfonate (EMS), and urethane caused a decrease in survival proportional to concentration used. EMS and urethane caused an increase in the number of all types of spots in both standard and high-bioactivation crosses. Compared to ST crosses, the number of induced spots in the HB cross treated with urethane was considerably high. Treatment of the standard and the high-bioactivation crosses with textile dyes gave positive results, apparent from increase in the frequency of the small single spots. Yellow and red dyes also increased the number of large single spots in both crosses, whereas the twin spots were positive only at the highest dose of yellow dye. All these results indicate that D. melanogaster wing spot test can be recommended as a suitable in vivo test for the determination of genotoxicity of textile dyes.