Suna Turkoglu

Effect of Congenital Heart Disease on Renal Function in Childhood

Background: Nephropathy is a well-known complication of congenital heart disease (CHD), and the risk of developing renal impairment is particularly high in patients with cyanotic CHD. Most investigations of renal impairment in CHD have involved patients 20 years and older. This study investigated renal tubule function in pediatric patients with CHD, and compared findings in cyanotic and acyanotic groups. Methods: Twenty children with acyanotic CHD, 23 children with cyanotic CHD, and 13 healthy children were enrolled. Blood and early morning urine samples were collected from each subject to measure urinary concentrations of sodium, microalbumin, creatinine, β2-microglobulin, and N-acetyl-β-D-glucosaminidase (NAG). Results: The age and sex distributions in the three groups were similar. Median fractional excretion of sodium (FeNa) and urinary NAG/creatinine were significantly higher in the cyanotic group than in the control group (p = 0.022 and p = 0.002, respectively). There were no statistically significant differences among the groups with respect to urinary β2-microglobulin/creatinine, urinary microalbumin/creatinine or glomerular filtration rate. Conclusion: Tubular injury can be detected before glomerular injury occurs even within the first decade of life in patients with cyanotic CHD.

Minocycline treatment inhibits lipid peroxidation, preserves spinal cord ultrastructure, and improves functional outcome after traumatic spinal cord injury in the rat.

Study design. A prospective, randomized experimental research. Objective. To evaluate the short- and long-term neuroprotective effects of minocycline on the secondary injury process of an experimental traumatic spinal cord injury (SCI) model. Summary of Background Data. Traumatic SCI is a devastating problem of health that results in high morbidity and mortality rates. The loss of function after SCI results from both the primary mechanical insult and the subsequent, multifaceted secondary response. Methods. A total of 80 adult male Spraque-Dawley rats (breeded by the Baskent University Animal Research Center) were randomly divided into 4 groups. A T10 contusion injury was produced by using modified Allen technique in all groups except the control group. No medication was administered to the rats in the trauma group. Minocycline was administered intraperitoneally and intravenously to the treatment groups. Short-term and/or long-term neuroprotective effects of minocycline on the lipid peroxidation (malondialdehyde, glutathione), apoptosis (terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate-biotin nick end labeling), ultrastructure of spinal cord (tissue electron microscopy), and behavioral assessments (Basso-Beattie-Bresnahan) were evaluated. Results. As compared with the trauma group, tissue malondialdehyde and glutathione levels demonstrated that minocycline significantly diminishes lipid peroxidation. Electromicroscopic study showed that minocycline preserves the ultrastructure of spinal cord tissue in the early post-traumatic period. Minocycline treatment significantly reduced the number of terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate-biotin nick end labeling positive cells both 1 day and 28 days after SCI. Behavioral assessments showed significant improvement in the hind limb functions of minocycline receiving rats starting 7 days after the SCI. Any statistically significant difference was not found between intraperitoneal or intravenous routes for minocycline injection. Conclusion. Minocycline is neuroprotective and contributes to functional improvement after traumatic SCI by eliminating the destructive process of secondary injury. Having both satisfying anti-inflammatory and antiapoptotic effects in experimental models, it promises to be of therapeutic use in human SCI.

Effect of iron deficiency anemia on renal tubular function in childhood

Abstract.Little is known about renal function in children with iron deficiency anemia. The purpose of this study was to investigate renal tubular function in these children. We compared renal tubular function in 20 children with iron deficiency anemia with 20 healthy age-matched controls. Blood and urine samples were obtained for hematological and biochemical analysis. Mean fractional excretion of sodium and mean urinary N-acetyl-β-D-glucosaminidase/creatinine were significantly higher in the children with iron deficiency anemia than in controls (P<0.05). Hemoglobin levels were negatively correlated with urinary N-acetyl-β-D-glucosaminidase/creatinine (r= -0.44, P=0.015), but were not correlated with fractional excretion of sodium (r= -0.29, P=0.13). There was no correlation between urinary N-acetyl-β-D-glucosaminidase/creatinine and fractional excretion of sodium (r=0.32, P=0.09). The results suggest that children with iron deficiency anemia have impaired renal tubular function.

Can first-trimester screening program detect women at high risk for gestational diabetes mellitus?

This study was designed to compare first-trimester maternal serum biochemical markers of aneuploidy and fetal nuchal translucency in pregnancies complicated by gestational diabetes mellitus and those of a control group. The study included 60 gestational diabetic and 60 control women who attended the first-trimester combined screening program for Down syndrome between 11 and 14 gestational weeks with complete follow-up data and delivered in our institution. Maternal serum free β-human chorionic gonadotropin, pregnancy-associated plasma protein-A and fetal nuchal translucency were investigated. The combined risks, double test risks and age risks were calculated by PRISCA software version 4.0. Comparison of the results between the two groups yielded no significant differences in serum levels of free β-human chorionic gonadotropin and fetal nuchal translucency. However, women who developed gestational diabetes mellitus had significantly lower pregnancy-associated plasma protein-A. And also, the combined risks and double test risks calculated by PRISCA software were statistically higher in gestational diabetic women than normal pregnant women. These results suggest that differences can be seen between diabetic and healthy pregnant women in first-trimester maternal serum biochemical markers of aneuploidy.

Protective Role of Simvastatin on Lung Damage Caused by Burn and Cotton Smoke Inhalation in Rats

BACKGROUND Smoke inhalation injury is a major comorbid factor in patients with thermal injury and occurs in about 30% of patients with major burns. In addition, inhalation injury reportedly accounts for 20%-84% of the mortality in burned individuals and is associated with higher mortality rates for every age and burn size category. The aim of the present study was to investigate the effects of simvastatin on lung damage with burn and cotton smoke inhalation. METHODS Wistar rats were randomly assigned to three groups: saline treated control group, via an orogastric route (group 1, n = 6), burn (30%) and cotton smoke inhalated group (group 2, n = 6), and simvastatin treated (25 mg/kg/d, via an orogastric route) burn (30%) and cotton smoke inhalated group (group 3, n = 6). Rats were sacrificed at 48 h of the treatments and the trachea and lungs were removed completely. Tissue samples were taken for histopathologic, immunohistopathologic, and biochemical analyses. Univariate analysis of variance coupled with Duncans post-hoc test was performed for statistical evaluation. RESULTS Lung parenchymal and tracheoepithelial damage was confirmed in group 2 by histopathologic examination. Lung malonedialdehyde (MDA) levels were significantly decreased (P < 0.001), while glutathione (GSH) concentration did not alter in group 2 compared with group 1. Also, immunopathologic data revealed that epithelial iNOS level was elevated, while no modulation was detected in the level of myeloperoxidase (MPO). Simvastatin administration resulted in decreasing the lung parenchymal and tracheoepithelial damage. Tissue MDA levels were decreased significantly (P < 0.001), whereas GSH concentrations were elevated in group 3 compared with group 1 and group 2 (P < 0.001). Simvastatin treatment caused a decrease in epithelial iNOS levels, while MPO levels were not modulated. In addition, simvastatin significantly reduced pulmonary apoptosis in lung injury. CONCLUSIONS Our results have indicated that simvastatin administration seems to play beneficial role in lung injury of rats promoted by combined burn and smoke inhalation. Thus, simvastatin may represent a potential approach to prevent smoke inhalation-associated lung dysfunction. However, the significant decrease in basal oxidant production may cause impairment in cellular signalling processes.

Protective Effect of Resveratrol, A Red Wine Constituent Polyphenol, on Rats Subjected to Portal Vein Thrombosis

This experimental study investigated the prophylactic effects of the antioxidant and antiaggregant compound resveratrol (R) on portal vein thrombosis (PVT) in rats. Thirty rats weighing 200- 250 g were distributed in 3 groups: Group A (n = 10) and underwent PVT+R, Group B (n = 10) PVT alone, and Group C (n = 10) were subjected to a sham operation. Group A rats received R (60 mg/d per naso-gastric tube) for 10 days before PVT. Concerning antioxidant status, statistically significant increases in both tissue and plasma levels of reduced glutathione (GSH) and decrease in malondialdehyde (MDA) levels were observed in the PVT+R group compared with the PVT group (P < .001 for all). Comparison of these parameters with those of the sham group revealed significantly higher tissue and plasma levels of GSH and low MDA levels among the sham-operated group when compared with to the PVT+R or PVT groups (P < .001 for all). Concerning the antiaggregant status, significant increases of c-AMP levels were detected in rats treated with R before experiencing PVT (P < .001). Cyclic AMP levels in the sham group were significantly higher than those of either the PVT or PVT+R groups (P < .001). One may advise patients undergoing liver transplantation and carrying certain cardiovascular disease risk factors to ingest foods containing R to minimize PVT.

Effect of Resveratrol on Oxidative Stress Enzymes in Rats Subjected to 70% Partial Hepatectomy

This experimental study investigated the antioxidant status of rats after resveratrol (R) treatment following 70% partial hepatectomy. Thirty Wistar albino rats (200 to 250 g) were divided among: groups A and B (n = 10 each) underwent laparotomy and 70% partial hepatectomy (PH). Whereas rats in group A received resveratrol 60 mg/d per nasogastric tube for 7 days before and 3 days after PH (PH + R), those in group B underwent PH only. Rats in group C (n = 10) were subjected to a sham operation. Significant increases in tissue levels of reduced glutathione (GSH) and decreased malondialdehyde (MDA) levels were observed in the PH group receiving R compared with those of the PH group (P < .001 for all). Comparison of these parameters with those of the sham group revealed significantly higher tissue levels of GSH and lower MDA levels among sham-operated compared with PH + R and PH groups (P < .001 for all). Concerning the NO levels, a trend to a slightly decrease was observed in the PH + R group (P < .06). Interleukin-6 levels showed significant decreases in both PH + R and PH groups (P < .001 and P < .05, respectively). The tissue GSH levels were slightly decreased in PH + R (P < .05), and decreased in the PH group compared with the controls (P = .002). We have suggested that patients undergoing living donor liver transplantation would likely benefit from prophylactic treatment with foods having resveratrol.

Effect of Topical Platelet-Rich Plasma on Burn Healing After Partial-Thickness Burn Injury.

Background To investigate the effects of platelet-rich plasma on tissue maturation and burn healing in an experimental partial-thickness burn injury model. Material/Methods Thirty Wistar albino rats were divided into 3 groups of 10 rats each. Group 1 (platelet-rich plasma group) was exposed to burn injury and topical platelet-rich plasma was applied. Group 2 (control group) was exposed to burn injury only. Group 3 (blood donor group) was used as blood donors for platelet-rich plasma. The rats were killed on the seventh day after burn injury. Tissue hydroxyproline levels were measured and histopathologic changes were examined. Results Hydroxyproline levels were significantly higher in the platelet-rich plasma group than in the control group (P=.03). Histopathologically, there was significantly less inflammatory cell infiltration (P=.005) and there were no statistically significant differences between groups in fibroblast development, collagen production, vessel proliferations, or epithelization. Conclusions Platelet-rich plasma seems to partially improve burn healing in this experimental burn injury model. As an initial conclusion, it appears that platelet-rich plasma can be used in humans, although further studies should be performed with this type of treatment.

Wound healing at adaptation zones of skin flaps harvested from acute burned skin

BACKGROUND Early reconstruction of burn defects culminates in more successful results. The wound healing process of the burned skin affects not only the curative phase of the burned area but also result of any reconstructive procedure including the regional flaps. Thus, in this study, we have evaluated the wound healing process at the distal incisions of random-pattern skin flaps prepared from burned dorsal skin of rats. MATERIALS AND METHODS Thermal burn damage was performed with dimensions of 3cm×3cm on Wistar albino rats. In group 1 (n=12), no burn was produced and 3cm×3cm caudally based, random-pattern skin flaps were elevated. In group 2 (n=12), a 5cm×5cm area of partial-thickness thermal damage was produced and after three days a 3cm×3cm random-pattern skin flap was elevated as in group 1 inside the burned skin site. In group 3 (n=12), 3cm×3cm area of partial-thickness thermal damage was produced and after three days 3cm×3cm random-pattern skin flap was elevated. In group 4 (n=12), 3cm×3cm area of partial-thickness thermal damage was produced and after three days a 3cm×3cm random-pattern skin flap was elevated at the distal margin of the burned area. The flaps were adapted to the donor sites in all groups. The histopathological evaluation was done and hydroxyproline levels were measured. RESULTS There were no significant differences between groups regarding presence of epithelialization, myofibroblast numbers, and collagen texture (p>0.05). Neovascularization level was significantly higher in group 2 than the other groups (p<0.05). There were no statistically significant difference among the hydroxyproline levels in all four groups (p>0.05). CONCLUSION The preference of the incision site in a burn zone while designing a flap during the acute burn period was proposed to possess no difference in terms of wound healing in an animal model.

A Rat Model of Acute Respiratory Distress Silymarin’s Antiinflamatory and Antioxidant Effect

E-pos ta: drsenaycanikli@yahoo.com Tel.: +90 533 543 54 22 ÖZ Amaç: Çalışmamızda çekal ligasyon ve perforasyon yöntemi kullanılarak akut akciğer hasarı gelişimini sağladığımız sıçanlarda Silimarin’in anti-inflamatuvar ve antioksidan özelliklerini değerlendirmeyi amaçladık. Gereç ve Yöntem: Toplam 46 sıçanın kullanıldığı çalışmamızda sham (n=14), kontrol (n=16) ve silimarin (n=16) grupları ve her bir grubun erken ve geç alt grupları vardı. Silimarin grubundaki sıçanlara silimarin, kontrol ve sham grubuna ise salin verildi. Kontrol ve silimarin grubundaki sıçanlarda çekal ligasyon ve perforasyon yöntemi ile sepsise bağlı akciğer hasarı gelişimi sağlandı. Erken gruptaki sıçanlar 12. saatte sonlandırılırken geç gruptakiler takibe alındı. Sıçanların serum ve bronkoalveolar lavaj sıvısı (BAL) tümör nekroz faktör alfa (TNF-α), interlökin (İL)-1, İL-6 seviyeleri, akciğer dokusunda malondialdehit (MDA) ve glutatyon sülfidril (GSH) seviyeleri, akciğer dokusunun histopatolojik incelemesi ve yaş/kuru ağırlık oranına bakıldı. Bulgular: Çalışmanın sonucunda 72. saatte silimarin grubunda sağkalım oranı %62,5, kontrol grubunda %12,5 bulundu (p=0,0506). Silimarin grubunda kontrol grubuna göre yaş/ kuru ağırlık oranı (p=0,019), serum ve BAL, TNF-α, İL-1, İL-6 seviyeleri (her biri için p<0,05) ve histopatolojik skorlama anlamlı olarak daha düşük bulundu (p=0,001). Doku MDA seviyesinin kontrol grubundan daha düşük (p=0,011) ve GSH seviyesinin daha yüksek (p=0,001) olduğu tespit edildi. Sonuç: Silimarin sepsise bağlı akut akciğer hasarı gelişimini önlemede yararlı olmuştur. Bu etkinin anti-inflamatuvar ve antioksidan özellikleri sayesinde olduğunu düşünmekteyiz. Anahtar Kelimeler: Silimarin, akut akciğer hasarı, antioksidan, anti-inflamatuvar SUMMARY Objective: In this study, it was aimed to evaluate the anti-inflammatory and antioxidative effects of Silymarin in rats in whom artificial acute pulmonary damage was provided with caecal ligation-perforation method. Material and Method: Forty-six rats were randomized to sham (n=14), control (n=16), silymarin (n=16) groups. Each group had early and late subgroups. Silimarin was administered in the silimarin group and saline was administerd in control and sham groups. Artificial acute pulmonary damage associated with sepsis was provided with caecal ligationperforation method in control and silimarin groups. Rats in the early subgroup Were terminated at the end of the 12th hour and threats in the late group were followed-up. Serum and bronchoalveolar lavage fluid (BAL) tumor necrosis factor (TNF)-alpha, interleukin (IL)-1beta, and IL-6; lung tissue malondialdehyde (MDA) and glutathione (GSH) levels; lung histopathologic examination; and lung wet-to-dry (w/d) weight ratio measurements were used to compare and evaluate the severity of lung injury between the groups. Results: Mortality rates for silymarin and control groups were 62.5% and 12.5%, respectively (log-rank p=0.0506). Compared with the silymarin group, the control group exhibited significantly more severe lung injury, as indicated by higher mean values for serum and BAL TNF-alpha, IL-1beta and IL-6 (p<0.05 for all measurements), total lung histopathologic injury score (p=0.001), w/d (p=0.019) and lung-tissue MDA (p=0.011) levels. Lung tissue GSH levels were significantly higher in silymarin group than control group (p=0.001). Conclusion: Silymarin reduces the severity of sepsis induced-acute lung injury and may also improve survival in a cecal ligation and perforation rat model. These beneficial effects of this agent are probably due to its inhibitory effects on inflammatory process and oxidative injury.