[The significance of omega-3 fatty acids in the treatment of non-alcoholic fatty liver disease]

Today, non-alcoholic fatty liver disease is the most common chronic liver disease, yet there is no clearly accepted effective therapy. What is certain is that the number of people suffering from the disease is increasing, making prevention, treatment and recognition of co-morbidities of paramount importance. Current evidence suggests that the development of non-alcoholic fatty liver disease may be due to pathological factors of different origins. The main risk factors include genetic factors, acquired environmental influences and lifestyle. Lifestyle modification, i.e., the elimination or reduction of these harmful factors, can reverse liver damage, depending on the stage of the disease. In this summary statement, we review the pathophysiology of non-alcoholic fatty liver disease, risk factors and therapeutic options, within that in particular lifestyle modification (dietary changes, increasing physical activity, weight loss). Furthermore, we also show the importance of omega-3 fatty acids such as eicosapentaenoic acid and docosahexaenoic acid in detail. With our knowledge, the personalized treatment of non-alcoholic fatty liver disease can be elaborated. Orv Hetil. 2023; 164(33): 1294-1299.

Altered element homeostasis and transmethylation ability in short-term polyphenol rich supplementation in hyperlipidemic animal model

Non-alcoholic fatty liver disease is one of the most common chronic liver diseases with unclarified pathomechanism and without evidence-proven therapy. Dietary polyphenols, targeting oxidative stress, are at the center of investigations. Our aim was to examine the effects of a polyphenol rich extract on metal element homeostasis and transmethylation ability in non-alcoholic fatty liver model. A ten-day rat model was used (control group, hyperlipidemic group with fat-rich diet, hyperlipidemic group with fat-rich diet and polyphenol supplementation, N = 8 in each group). The hyperlipidemic diet increased the concentration of the majority of the elements with significantly higher contents of B, Co, Cu, Fe, Mg, Mn, Na, Ni, P, Se, Si, and Zn in the liver. Further elevation of Al, Pb, and Sn concentrations could be observed in polyphenol supplemented animals. The polyphenol supplement unexpectedly decreased the transmethylation ability of the liver (132.00 vs. 114.15 vs. 92.25 HCHO μg g−1) further. The results emphasize the possible role of altered metal and non-metal element concentrations and decreased transmethylation ability in the pathomechanism of fatty liver disease. Dietary supplementation with natural compounds may have undesirable effect as well, there is the necessity to improve the efficacy of polyphenol formulations because of their low oral bioavailability.

A Kanpó hagyományos orvoslás, ma is támogatott terápiás lehetőség Japánban

Összefoglaló. A japánok hagyományos gyógymódja, a Kanpó a több ezer éves kínai gyógyító tapasztalaton alapul. A Kanpó filozófiája azonban csak részben hasonlít a hagyományos kínai orvosláshoz, bár megtartja annak több fontos alaptételét, de annak egyszerűsített, pozitivista és pragmatikus változata, amely igazodik a japán kultúrához. A Kanpó a japán egészségbiztosítási rendszer fontos része a korszerű nyugati gyógymódokkal együtt. A nyugati orvostudomány viszont kevésbé érdeklődik a Kanpó terápiás lehetőségei iránt, tekintettel arra, hogy a hagyományos kínai orvoslás és az Ájurvéda-gyógymódok széles körben elterjedtek a világban az utóbbi néhány évtizedben. A Kanpó készítményei elérhetők az internet különböző kereskedelmi honlapjain. Sajnálatos módon a készítmények összetétele általában pontatlanul van megadva. A gyógynövények fajait nem jelölik, így nemcsak félrevezető, hanem az összetevők hatása sem ismert. A dolgozat a leggyakrabban használt néhány hagyományos készítmény összetételét és hatását tárgyalja. Orv Hetil. 2022; 163(110): 386–392.

Summary. Kanpo, the traditional Japanese medicine, is based on thousands of years of Chinese healing experience. Kanpo’s philosophy, however, is only partially similar to traditional Chinese medicine. Although it retains several important basic tenets, it is a simplified, positivist, and pragmatic version of aligning to Japanese culture. Kanpo is an important part of the Japanese health insurance system along with modern western therapies. Western medicine, on the other hand, is less interested in Kanpo’s therapeutic options, given that traditional Chinese medicine and Ayurvedic therapies have become widespread in the world over the past few decades. Kanpo’s herbal preparations are available on various commercial internet websites. Unfortunately, the composition of the formulas is generally inaccurate. The species of herbs are not identified, so not only are they misleading, but the effects of the ingredients are not known either. The article discusses the composition and effects of some of the most commonly used conventional formulas. Orv Hetil 2022; 163(10): 386–392.

[Peritoneum, the multifunctional membrane]

Introduction: Not only atraumatic surgical technique, precise bleeding control, removal foreign materials from the abdomen, but also avoiding desiccation or mechanical damage of peritoneal surface at abdominal surgery mean today evidence based expectation. Peritoneum with its extensive surface and special histological structure represents an important factor in normal physiological processes, furthermore as “Guard of abdomen” it has an important role to localise inflammatory reactions, useful as dialysing surface and provides also possibility for hyperthermic abdominal chemotherapy in tumour treatment. Largest part of peritoneal sac covers small intestine and colon. To prevent postoperative complications it is necessary to avoid desiccation of intestinal tract at laparoscopic and at open procedures as well – consequently “rehyration” is a routine recommendation today. Desiccation of intestinal tract results postoperative adhesions, furthermore damage of serosa will increase permeability of intestine wall and can result perforation. All the surgical recommendations suggest keeping intestine moist, whereas there are only a few real studies in surgical literature to support or to deny this theory. Our study reviews the pathophysiological and surgical respects of this situation and summarizes the results of latest researches of combined functions of peritoneum.

Metronidazole does not show direct antioxidant activity in in vitro global systems

Metronidazole has been widely used topically and systemically for more than 50 years but data on its antioxidant properties are still incomplete, unclear and contradictory. Its antioxidant properties are primarily hypothesized based on in vivo results, therefore, studies have been performed to determine whether metronidazole has antioxidant activity in vitro. We used so-called global spectrophotometric and luminometric methods. Fe³⁺/Fe²⁺-reducing ability, hydrogen donor activity, hydroxyl radical scavenging property and lipid peroxidation inhibitory activity were investigated. Under the condition used, metronidazole has negligible iron-reducing ability and hydrogen donor activity. The hydroxyl radical scavenging capacity cannot be demonstrated. It acts as a pro-oxidant in the H₂O₂/^.OH-microperoxidase-luminol system, but it can inhibit the induced lipid peroxidation. According to our results, metronidazole has not shown antioxidant activity in vitro but can affect redox homeostasis by a ROS-independent mechanism due to its non-direct antioxidant properties.

Impact of milk thistle (Silybum marianum) on the mycotoxin caused redox-homeostasis imbalance of ducks liver

The Fusarium mycotoxins deoxynivalenol (DON) and zearalenone (ZEA) frequently contaminate grain crops, especially maize, the basis of poultry's feed. Mycotoxins enter the food chain and induce pathological changes in edible tissues. Milk thistle (Silybum marianum) has been used for the treatment of liver disease in humans because of its antioxidant and hepatoprotective effects, but its utility in veterinary use is poorly examined. To investigate possible protective properties against mycotoxin caused oxidative stress in poultry, pressed form of milk thistle seed (0.5%) was tested in white, female, Hungarian ducks over a feeding period of 47 days. Ducks were separated into 3 groups. The first group was fed with normal diet. The second group was fed with normal diet contaminated with DON (4.9 mg/kg) and ZEA (0.66 mg/kg). The third group received mycotoxin contaminated feed with milk thistle supplementation. Histological examination, markers of the redox status and metal element concentration measurements were carried out. The results showed alterations in the histological examination and in the redox homeostasis markers as a short-term effect by strengthening the antioxidant system. Acute exposure of mycotoxins caused an oxidative stress, which induced an effective antioxidant defensive response of the organism indicated by the free sulfhydryl group content (from 0.72 ± 0.06 to 0.77 ± 0.11) and the reducing power (0.49 ± 0.06 to 0.52 ± 0.08) elevation. The short-term free radical injury may be compensated by the liver resulting in decreased lipid peroxidation markers (malondialdehyde concentration: from 16.86 ± 0.49 to 0.94 ± 0.15, conjugated diene concentration: from 0.21 ± 0.07 to 0.17 ± 0.03). Silymarin further strengthtened the antioxidant defense by the elevation of sulfhydryl groups concentration and reducing power property resulted in decreased total scavenger capacity. However the concentration of lipid peroxidation markers were further elevated by the used antioxidant treatment (MDA: 5.2 ± 0.35, DC: 0.26 ± 0.08). In conclusion, the mycotoxin-contamination activated effectively the antioxidant system. The milk thistle supplementation has cytoprotective effects according to the histological findings, activated the antioxidant system, however the elevation of lipid peroxidation products need further explanation.

Factors affecting liver disease progression, with emphasis on the role of free radical reactions

Chronic liver disorders are the main leading cause of morbidity and mortality data. Viral infection, toxic injury, metabolic, autoimmun, storage disorders, in the case of ongoing presence of the etiological factors, could result in fibrotic remodelling in the liver. The process is complex, not fully understood in details; cells, cytokines, chemokines release, altered secretion of hepatokines, lipotoxicity, innate immun system, gut microbiom, metal ions and free radical reactions all have a role in it. Chronic liver disorders are often symptomless, diagnosed in the stage of fibrotic tissue accumulation, liver failure or hepatocellular carcinoma formation, when the prognosis is poor, treatment options are narrow. Noninvasive, properly sensitive and specific biomarkers are the targets of studies, with them the necessity of liver biopsies can be decreased, through the follow-up of processes, progression and treatment efficacy. Authors review the processes taking part in the progression of the most frequent chronic liver disorders, emphasizing the parameters of pro/antioxidant balance, and the necessity of a combined reliable biomarker. Orv Hetil. 2020; 161(35): 1441-1448.

Fat rich diet-induced steatosis and changes in the gut–liver axis

INTRODUCTION

Fatty liver can develop as a result of diseases, surgical procedures, medicaments, malnutrition or excessive alcohol consumption, however, fat and poor fiber feeding can be attributed as the primary cause. Non-alcoholic fatty liver can be found in 20-30% of the population. Generally, alimentary-induced fatty liver in early state is described as uncomplicated liver injury.

AIM

The aim of our research was to study the effect of fat rich nutrition on the gut-liver axis by routine laboratory, analytical and histological methods in rats.

METHODS

We also examined the redox parameters of the liver and of the bowel. Fatty acid composition and element content of liver were measured.

RESULTS

Significant changes were found in parameters of redox homeostasis as well as alterations in liver enzymes and metabolites. The changes could be detected in the liver, blood and bowel parts. The development of fatty liver is associated with the decrease of transmethylation capacity. Fatty acid composition and metal ion homeostasis were also altered in liver. Histological examinations showed that hepatocytes were swollen in the central part of the liver lobules, showed droplets and pycnotic nuclei, which were characterized by fatty degeneration. Small and large bowel enterocytes were damaged, sometimes pushed from the surface, and sometimes inflammatory reactions in the mucous membrane were observed.

CONCLUSION

Our results suggest that alimentary fatty liver in early state is not considered simply as a reversible alteration because it alters the entire body's redox homeostasis and establishes heart and serious metabolic diseases as well as hasten the development of gastrointestinal tumors. Orv Hetil. 2020; 161(35): 1456-1465.

The potential role of organic and conventional yoghurt consumption in the treatment of non-alcoholic fatty liver disease

INTRODUCTION

Health is an important motivation for the consumption of both organic and functional foods. Organic food contains fewer pesticide residues and statistically more selected health-related compounds such as polyphenols in plant products and polyunsaturated fatty acids in milk and meat products. Recent studies suggest that the gut-liver axis plays an important role in the pathogenesis of non-alcoholic fatty liver disease, so probiotics could be a therapeutic tool. Comparing the health effects of yoghurt from organic origin with so-called conventional yoghurt is difficult, because there is no biomarker that would signal the difference with good specificity and sensitivity.

AIM

The aim of this study was to investigate numerous biomarkers to evaluate the difference between yoghurt from conventional and organic origin and their health effects in NAFLD.

PATIENTS AND METHOD

We performed a prospective, cohort study consisting of 37 (age = 51.73 ± 11.82, male = 21, female = 16) patients with NAFLD at the 2nd Department of Internal Medicine of the Semmelweis University, Budapest. Diagnosis of NAFLD was based on ultrasonography and the exclusion of other etiololgy. The patients were examined also with shear wave elastography to evaluate the hepatic fibrosis stage. We divided the patients randomly into two groups. The patients consumed individually daily 300 grams of yoghurt from organic (n = 21) or conventional (n = 16) origin for 8 weeks. We collected 37 routine laboratory data, measured 4 cytokines, 3 markers of the redox-homeostasis and 14 body composition values before, after, and 12 weeks after the yoghurt consumption.

RESULTS

We found a mild elevation of vitamin D and a minimal reduction of LDL after the yoghurt consumption, but in the other 35 routine laboratory data there was no statistical difference. Adiponectin and leptin levels were elevated after the yoghurt consumption in the "conventional group". In contrast, we found significant decrease of adiponectin levels in the "organic group" after the treatment. Only the adiponectin tendency was different in the two groups. The induced free radical content was also statistically lower after the yoghurt consumption. In the body composition measurements, there were no significant differences.

CONCLUSION

These data suggest that adiponectin could be a possible biomarker to evaluate the effectiveness of probiotic treatment in non-alcoholic fatty liver disease. Our work can serve as a basis for future studies investigating relationships between organic yoghurt consumption and health outcomes. Orv Hetil. 2020; 161(35): 1466-1474.

Changes in endogenous metal element concentrations in various aetiologies of chronic liver disease

Our body contains physiologically many metal ions used for its metabolic processes and function. Metal ion changes can start pathological processes, however, the pathological processes may also lead to changes in metal ion concentration. In this study, the authors summarize the physiologically present metal ions' change in liver diseases with various aetiologies, the consequences are discussed as well as the connections with the progression. Further, the authors point out the element concentration changes as diagnostic or prognostic values for the liver diseases as well. Orv Hetil. 2020; 161(22): 917-923.

[The interpretation and integration of traditional Chinese phytotherapy into Western-type medicine with the possession of knowledge of the human genome]

The terminology of traditional Chinese medicine (TCM) is hardly interpretable in the context of human genome, therefore the human genome program attracted attention towards the Western practice of medicine in China. In the last two decades, several important steps could be observed in China in relation to the approach of traditional Chinese and Western medicine. The Chinese government supports the realization of information databases for research in order to clarify the molecular biology level to detect associations between gene expression signal transduction pathways and protein-protein interactions, and the effects of bioactive components of Chinese drugs and their effectiveness. The values of TCM are becoming more and more important for Western medicine as well, because molecular biological therapies did not redeem themselves, e.g., in tumor therapy. Orv Hetil. 2018; 159(18): 696-702.

A különleges és egyedi polifenol-összetételű meggy egészségi hatásai

Abstract:

Health effects of fruit consumption are confirmed by many studies. Such effects are attributed to the polyphenolic compounds accumulating in fruit skin and mesocarp tissues. They contribute to the regulation on transcriptional, post-transcriptional and epigenetic levels. Since people consume much less fruits than the recommended quantities, a new approach includes the promotion of super fruits that are extremely rich sources of specific health compounds. A comparative analysis of Hungarian stone fruit cultivars detected a huge variability in fruit in vitro antioxidant capacity and total polyphenolic content. Two outstanding sour cherry cultivars (‘Pipacs 1’ and ‘Fanal’) were identified to accumulate elevated levels of polyphenolic compounds in their fruits. Sour cherries with different polyphenolic compositions were tested against alimentary induced hyperlipidemia using male Wistar rat model. Consumption of cherry fruit had different consequences for different cultivars: consumption of ‘Pipacs 1’ and ‘Fanal’ fruits resulted in 30% lower total cholesterol levels in the sera of hyperlipidemic animals after only 10 days of treatment. However, the consumption of ‘Újfehértói fürtös’ fruit has not induced significant alterations in the same parameter. Other lipid parameters also reflected the short-term beneficial effects of ‘Pipacs 1’ and ‘Fanal’ fruits. We suggest that not only some tropical and berry fruits might be considered as super fruits but certain genotypes of stone fruits as well. These have indeed marked physiological effects. Since ‘Pipacs 1’ and ‘Fanal’ are rich sources of colourless polyphenolics (e.g., phenolic acids and isoflavonoids) and anthocyanins, respectively, the protective effects associated with their consumption can be attributed to different polyphenolic compounds. Orv Hetil. 2018; 159(18): 720–725.

[Phytoestrogens in the treatment of menopause]

In previous centuries many women did not even live until their menopause years due to poor economic conditions, deficiencies of medicine, epidemics and wars. Nowadays in the developed countries, people live until they are 75-80 years old, and with the expansion of average age, the number of people affected by menopause and the years spent in that state increase. Nowadays women spend one third of their lives in the menopausal stage. The only effective way to treat unpleasant symptoms for centuries was with the use of herbs, and the knowledge about them spread through oral tradition. In the 20th century, this therapeutic form was pushed into the background by the development of synthetic drug production and the introduction of hormone replacement therapy. Thanks to the influence of media in the 20th century, women began to have the social need for preserving their beauty and youth for as long as they could. Hormone replacement therapy enjoyed great popularity because women were temporarily relieved of their life quality-impairing menopausal symptoms, but years later it turned out that hormone replacement therapy could pose serious risks. A distinct advantage of herbal therapy is the more advantageous side-effect-profile opposite the used synthetics in hormone replacement therapy. Women are therefore happy to turn to valuable and well-tried natural therapies, which have been used for thousands of years. There is growing interest in herbal remedies. Studying the effects of phytoestrogens has now become an active area for research. However, the results of studies in animals and humans are controversial, some sources suggest that phytoestrogens are effective and safe, other authors claim that they are ineffective in menopause or they have particularly dangerous properties, and cannot be recommended to everyone. It is important to address this issue for the sake of health, mental health and safety of women, and so it is necessary to assess the benefits and the risks before applying them. Orv Hetil. 2017; 158(32): 1243-1251.

A bél–máj tengely vizsgálata colitis ulcerosában. Retrospektív tanulmány

Abstract:

Introduction: Examination of the gut–liver axis came into the spotlight worldwide. Liver enzyme elevations are commonly seen in patients with inflammatory bowel disease (IBD), which is a diagnostic challenge in everyday clinical practice. Liver and biliary diseases are common extra-intestinal manifestations in Crohn’s disease and ulcerative colitis. The assessment of routine liver function tests could be an inaccurate reflection of liver damage, so its prevalence could be underestimated. There would be a need for non-invasive biomarkers and/or scoring systems, which would help the diagnosis of liver damage associated with intestinal diseases. Aim: In our work we considered to highlight the importance of the gut–liver axis significance. We used data of patients suffering from ulcerative colitis, as a model for bowel diseases to understand the underlying factors of the pathogenesis of hepatobiliary manifestations. Method: In our retrospective study, we investigated the data of 100 ulcerative colitis patients (male = 46, female = 54) (mean age: 42.5 ± 12.7) and compared to healthy controls (n = 42) (male = 17, female = 25) (mean age: 40.2 ± 13.5). Liver function tests (ALT, AST, GGT, ALP, bilirubin, albumin, thrombocyte), bile acid levels were determinated, and various free radical markers (global, enzymatic) were used to assess the redox homeostasis of patients. Hydrogen donor activity, reducing power, superoxide dismutase and glutathione peroxidase activity, total antioxidant status and induced chemiluminescence were measured, considering that the patients received 5-aminosalicilate and/or azathioprin and elemental diet treatment. Results: Liver function parameters were increased in ulcerative colitis patients, and total antioxidant status, as well. Reducing power significantly decreased, but there was no significant difference compared to the control group of glutathione peroxidase and H-donor activity, we observed only tendentious decrease. The antioxidant protection of more than 54% of patients had a significantly lower rate, according to all the parameters. With chemiluminescence measurement we measured better free radical scavenging capacity, both in plasma and in erythrocytes as a result of the therapy, however, it showed an increase of superoxide dismutase activity, which warns of inflammatory processes. The cause of the decrease in bile acid levels found in the group of ulcerative colitis patients, can be the accelerated peristaltic. Conclusions: In the daily routine, liver enzyme values do not give an accurate picture of liver damage associated with ulcerative colitis. With the help of various specific parameters determined by us, we can estimate the background processes of the gut–liver axis alterations. The decrease in bile acid levels can be a predictive factor in ulcerative colitis. Our work highlights the need of non-invasive screening for liver diseases in inflammatory bowel disease. Orv Hetil. 2017; 158(26): 1014–1021.

[Evaluation of free radical quantity in the anterior chamber following femtosecond laser-assisted capsulotomy]

INTRODUCTION

Femtosecond laser is a revolutionary, innovative treatment method used in cataract surgery.

AIM

To evaluate free radical quantity in the anterior chamber of the eye, during femtosecond laser assisted capsulotomy, in a porcine eye model.

METHOD

Seventy fresh porcine eyes were collected within 2 hours post mortem, were transported at 4 ºC and treated within 7 hours. Thirty-five eyes were used as control and 35 as femtosecond laser assisted capsulotomy group. A simple luminol-dependent chemiluminescence method was used to measure the total scavenger capacity in the aqueous humour, as an indicator of free radical production. The emitted photons were expressed in relative light unit %.

RESULTS

The relative light unit % was lower in the control group (median 1%, interquartile range [0.4-3%]) than in the femtosecond laser assisted capsulotomy group (median 4.4%, interquartile range [1.5%-21%]) (p = 0.01).

CONCLUSIONS

Femtosecond laser assisted capsulotomy decreases the antioxidant defense of the anterior chamber, which refers to a significant free radical production during femtosecond laser assisted capsulotomy. Orv. Hetil., 2016, 157(47), 1880-1883.

[Ayurveda for the treatment of obesity]

Obesity is an increasing problem all over the world as the lifestyle changes and fast food chains gain popularity. In India, 31% of men and 29% of women are overweight, which is a growing trend over the last 11 years. Obesity increases the risk of many diseases such as cardiovascular diseases, reflux disease, gastrointestinal tumors, and sleep apnea. Obesity without complications can also cause serious complications during surgery. In Ayurveda the formation of diseases depends on the balance of the three doshas - vata, pitta, kapha. The rate of three doshas varies depending on the body constitution of the indvidual. Studies of an Indian research group have shown that Ayurvedic body type classification may be associated with genes of inflammation and oxidative stress factors, the rate of DNA methylation and development of cardiovascular diseases. Orv. Hetil., 2016, 157(34), 1349-1352.

Metabolic Alterations of Toxic and Nonessential Elements by the Treatment of Sempervivum tectorum Extract in a Hyperlipidemic Rat Model

A hyperlipidemic rat model was used to examine the therapeutic effect of Sempervivum tectorum plant extract on the metabolic alterations of Al, As, B, Ba, Cd, Hg, Ni, Pb, and Ti in the liver and bile. Hyperlipidemia was produced by lipogenic diet and alcohol and verified by morphological investigation of the liver with the aid of light and an electron microscope. Element concentration in the liver and bile were determined by inductively coupled plasma optical emission spectrometry (ICP-OES). The concentration values in the liver higher than the detection limit (Al, Ba, Ni, Ti) were unambiguous. Significant differences were found for the four groups at p < 0 .05 level (ANOVA). A significant difference was observed between Al and B concentration in the bile fluids of the 4 groups ( p < 0 .05). The excretion of Al and Ti into the bile fluid increased significantly ( p < 0 .05). Following the administration of S. tectorum extract to rats with hyperlipidemia, the excretion of Al, B and Ba increased, whereas the excretion of Ti decreased significantly ( p < 0 .05). The favorable action of the extract (protecting the liver in hyperlipidemic rats) was verified by morphological studies, and its detoxicating property was shown by the elimination of Al, Ba, Ni, and Ti from the liver.

[Various pathways leading to the progression of chronic liver diseases]

As the result of various effects (viruses, metabolic diseases, nutritional factors, toxic agents, autoimmune processes) abnormal liver function, liver steatosis and connective tissue remodeling may develop. Progression of this process is complex including various pathways and a number of factors. The authors summarize the factors involved in the progression of chronic liver disease. They describe the role of cells and the produced inflammatory mediators and cytokines, as well as the relationship between the disease and the intestinal flora. They emphasize the role of oxidative stress, mitochondrial dysfunction and cell death in disease progression. Insulin resistance and micro-elements (iron, copper) in relation to liver damage are also discussed, and genetic and epigenetic aspects underlying disease progression are summarized. Discovery of novel treatment options, assessment of the effectiveness of treatment, as well as the success and proper timing of liver transplantation may depend on a better understanding of the process of disease progression.

Changes of erythrocyte element status of colectomysed cancerous patients: Retrospective study

Nowadays it has been established that metals and metal-induced oxidative stress act on signal transduction pathways, and are in association with cancer growth and spreading as well as in neurodegenerative disorders. In cases of several neurodegenerative diseases metals, especially Al, can be considered as a risk factor. Frequency of chemotherapy-related cognitive impairment or "chemobrain" is mentioned to be significant in literature, although very little is known about the chemotherapy-caused chemobrain and its connection with metal homeostasis alteration. Dysregulation of metal homeostasis can be assumed as one of the key factors in the progression of neurodegeneration. Therefore we were interested in studying metal element status of 27 adult patients in 3 years after their colectomy, 22 outpatients and 10 healthy volunteers in both genders. Tumour markers, laboratory parameters and metal element concentrations were determined. We found significant difference among the Al concentrations in operated patients compared with controls. Redox active Fe and Cu levels were also elevated slightly in this patient group. P and S concentrations changed in different ways, and Ca levels were slightly lower, than in healthy controls. Because of all above mentioned, examination of metal homeostasis in cancerous patients is necessary to moderate the risk of chemobrain and other redox-related disorders.

[Removal of weremit from the abdomen. Interpretation and efficacy of an ancient Egyptian prescription by the newest scientific results]

Significant percentage of today's knowledge of ancient Egyptian medicine has been acquired from papyri left behind from various periods of Egyptian history. The longest and the most comprehensive is the Ebers papyrus, kept at the University Museum of Leipzig, which was written more than one thousand years before Hippocrates (c. 460-377 BC). One of the riddles among the prescriptions of the Ebers papyrus Eb20 has been used in order to remove the so called "wemyt" weremit from the abdomen with the help of a drink, which consists of "jnnk", Conyza dioscoridis in milk or sweet beer. The authors assume that the disease could be an infection of Schistosoma haematobium and/or Schistosoma mansoni. Nowadays the tea of Conyza dioscoridis is widely used as an important part of traditional medicine against rheumatism, intestinal distention and cramps, as well as an antiperspirant, and with external use for wound healing. The authors' intent is to interpret the efficacy of the above-mentioned ancient prescription with the help of modern medical and pharmaceutical knowledge.

Antihyperlipidemic Effects of Sour Cherries Characterized by Different In Vitro Antioxidant Power and Polyphenolic Composition

The aims of the present study were to clarify in vivo effects of three sour cherry cultivars characterized by different polyphenolic composition in hyperlipidemic animals in a short term experiment. The three different sour cherry cultivars were chosen based on their total in vitro antioxidant capacity, total polyphenolic, monomeric anthocyanin and flavonoid content. Male Wistar rats were divided randomly into eight groups: rats kept on normal diet (control) and normal diet supplied with sour cherry powder of one of the three cultivars; others were kept on fat-rich diet and fat-rich diet supplied with sour cherry powder prepared from one of the three cultivars. The treatment lasted 10 days. Lyophilized sour cherry administered in the diet decreased both total cholesterol and LDL cholesterol levels, and increased the HDL cholesterol concentration in sera of hyperlipidemic animals. Significant differences were found in the efficacy of different sour cherry cultivars in case of hyperlipidemia. Sour cherries characterized by higher polyphenol content seem to have a more pronounced effect on serum cholesterol levels. Our results suggest that besides anthocyanins, colourless polyphenols also have lipid lowering effect.

[Natural bioactive agents in liver therapy]

Medical science alongside with other sciences, aiming to preserve health and combat diseases, has evolved significantly since the late 1930s. It has reached incredible results and opened up unpredicted perspectives for future generations to come. From the 1980s significant results also emerged from researching natural plant active ingredients for the prevention of damage from free radicals which were discovered in different symptoms. One of the important areas of research is the recognition of significant bioactive molecules from the aspects of food consumption, alongside the detection of their effect in the context of their structure. It is also important that by possessing these data it is possible to develop correct food consumption habits, especially for people who are suffering from diseases. Through the decades we came a long way from folk medicine observations to molecular, biological justification of effect mechanisms.

Cisplatin administration influences on toxic and non-essential element metabolism in rats

Nowadays several papers deal with the effectiveness and side effects of metal complexes, especially cisplatin, in cancer therapy. The excretion of essential metal elements from the body is a serious problem in the treatment, but there are no data concerning the distribution and metabolism of toxic and nonessential elements. Therefore our aim was to study the concentration of some of these elements after treatment with cisplatin. Male Wistar rats (n=20, 175-190 g) were randomly divided into 2 groups (n=10/group). The control group received 1% (w/v) methyl cellulose at 10 mL/kg body weight, p.o. by gastric gavage twice daily for 14 days, while cisplatin was injected i.p. in a single dose of 6.5 mg/kg body weight. Inductively coupled plasma optical emission spectrometry (ICP-OES) was used for measuring Al, B, Ba, Cr, Li, Ni, Pb, Pt, Sb, Si, Sn, Sr and V content in plasma, liver and kidney. Liver total scavenger capacity, diene conjugate content and malondialdehyde concentration were also determined. Cisplatin elevated the free radical reactions in the liver, although redox balance did not change significantly. According to the study it seems that the metabolism of Al, Ba, Cr, Ni, Pb, Sr were changed by the effect of cisplatin, and the most notable alterations were found for Al and Pb. Therefore, besides the toxic effect of and free radical induction by Pt, the side effects of increased levels of other toxic and non-essential elements have to be taken into consideration.

Effect of haemodynamic changes on epithelium-related intestinal injury in off-pump coronary surgery

OBJECTIVES

Intestinal injury is thought to play a central role in the occurrence of multiorgan dysfunction after on-pump coronary surgery. Clinical benefits of off-pump revascularisation remain, however, controversial.

MATERIAL AND METHODS

Hepatic enzymes and plasmatic IL-6, IL-8 and intestinal-type fatty acid binding protein (I-FABP) were determined in 20 patients (age 65-75) undergoing either on-pump (n = 10) or off-pump (n = 10) coronary surgery. Haemodynamic and biochemical parameters, catecholamine and volume therapy were monitored.

RESULTS

Central venous pressure (CVP) was significantly higher in the off-pump group during and 12h after operation (9.5 ± 1.35 vs. 6.21 ± 0.63 mmH2O, p = 0.012). Higher GGT and GLDH levels occurred in the off-pump group and correlated with the elevated I-FABP levels at 24h (935.8 ± 83.7 vs. 370.4 ± 67.7 pg/mL, p<0.001). CVP correlated with I-FABP peak values (Pearson's coefficient 0.852). IL-6 and IL-8 were released to a lower extent in the off-pump group compared to on pump (p<0.05) at 24h (139.3 ± 27.7 vs. 279.4 ± 56.2 and 15.3 ± 7.4 vs. 38.5 ± 13.8 pg/mL) and at 72 h post-operatively (4.5 ± 2.1 vs. 30.1 ± 12.1 and 7.8 ± 1.2 vs. 17.1 ± 5.2 pg/mL).

CONCLUSIONS

While inflammatory activation is reduced with CPB avoidance, elevated CVP during off-pump surgery is followed by temporary postoperative enterocyte damage that may threaten the normal function of the gastrointestinal system and lead - in certain groups of high risk patients--to irrecoverable injury.

Protective effect of CV247 against cisplatin nephrotoxicity in rats

CV247 (CV), an aqueous mixture of copper (Cu) and manganese (Mn) gluconates, vitamin C and sodium salicylate increased the antitumour effects of cisplatin (CDPP; cis-diamminedichloroplatinum) in vitro. We hypothesized that the antioxidant and cyclooxygenase-2 (COX-2; prostaglandin-endoperoxide synthase 2) inhibitory components of CV can protect the kidneys from CDPP nephrotoxicity in rats. CDPP (6.5 mg/kg, intraperitoneally) slightly elevated serum creatinine (Crea) and blood urea nitrogen (BUN) 12 days after treatment. Kidney histology demonstrated extensive tubular epithelial damage and COX-2 immunoreactivity increased 14 days after treatment. A large amount of platinum (Pt) accumulated in the kidney of CDPP-treated rats. Furthermore, CDPP decreased renal iron (Fe), molybdenum (Mo), zinc (Zn), Cu and Mn concentrations and increased plasma Fe and Cu concentrations. CDPP elevated plasma free radical concentration. Treatment with CV alone for 14 days (twice 3 ml/kg/day orally) did not influence these parameters. Chronic CV administration after CDPP reduced renal histological damage and slightly decreased COX-2 immunoreactivity, while failed to prevent the increase in Crea and BUN levels. Blood free radical concentration was reduced, that is, CV improved redox homeostasis. CV restored plasma Fe and renal Fe, Mo and Zn, while decreased Pt and elevated Cu and Mn concentrations in the kidney. Besides the known synergistic antitumour effects with CDPP, CV partially protected the kidneys from CDPP nephrotoxicity probably through its antioxidant effect.

[Effect of "Pintes" white wine on metabolic parameters in patients with metabolic syndrome]

Moderate alcohol consumption has been associated with decreased cardiovascular mortality in the general population. Relatively few studies have been conducted to evaluate the effect of white wine on insulin sensitivity.

AIMS

The authors studied the impact of moderate Pintes white wine consumption on insulin sensitivity and other metabolic parameters.

METHODS

The prospective study involved 18 patients with metabolic syndrome. The patients consumed Pintes white wine for 4 weeks, and parameters were measured before and after consumption.

RESULTS

The HOMA-IR decreased significantly after white wine consumption (2.28±2.04 vs 1.08±0.6; p = 0.002). There were no changes in serum cholesterol, LDL-cholesterol, triglyceride and fasting plasma glucose levels.

CONCLUSION

White wine consumption improved insulin sensitivity in patients with metabolic syndrome.

Accumulation of antioxidants in apricot fruit through ripening: characterization of a genotype with enhanced functional properties

Two apricot genotypes, 'Gonci magyarkajszi' and 'Preventa' were assayed at three ripening stages for flesh color indices (L*, a*, b*, C* and Hº), contents of total phenolics and vitamin C, and both water- and lipid-soluble antioxidant capacities (ferric reducing antioxidant power; 2,2'-diphenyl-1-picrylhydrazyl scavenging activity; total radical scavenging activity; and Photochem lipid-soluble antioxidant capacity) to compare their dynamics in the accumulation of antioxidant compounds and capacities through ripening. The increase in a*, b* and C* and decrease in Hº during ripening represented a color shift from green to yellow and orange due to carotenoid accumulation. Parallel to carotenoid accumulation, contents of total phenolics and vitamin C and antioxidant capacity increased significantly (p < 0.05) from unripe to fully ripe fruits. More phenolics and vitamin C accumulated in fully ripe fruits of 'Preventa' than 'Gönci magyarkajszi'. The accumulation patterns of these compounds were different: while the vitamin C contents in unripe fruit of 'Preventa' and 'Gönci magyarkajszi' were identical (approx. 6 mg/100 g fresh weight), unripe 'Preventa' contained even more phenolics (approx. 12 mmolGA/l) than fully ripe 'Gönci magyarkajszi' (8 mmolGA/l). Our results confirm that fully ripe 'Preventa' fruits are characterized by outstanding functional properties due to the increased accumulation of vitamin C and phenolics throughout the ripening process.

[Effects of magnesium supplementation on calcium and magnesium levels, and redox homeostasis in normolipidemic and food-induced hyperlipidemic rats]

Magnesium supplementation is quite popular because of intention of health and healthy lifestyle. However, there is no information on the metabolic effects of magnesium supplementation in healthy people and in different diseases.

AIMS

Authors examined the effects of magnesium-malate on calcium, magnesium levels, and antioxidant parameters in normolipidemic and hyperlipidemic rats.

METHODS

Male Wistar rats (n = 40; 150-200 g) were divided into 4 groups (control, control-treated, hyperlipidemic, hyperlipidemic-treated). Rats in the control and control-treated groups were fed with normal diet, while hyperlipidemic and hyperlipidemic-treated groups were fed with fat rich diet (2% cholesterol, 20% sunflower oil, 0.5% cholic acid). After the 9-day-long diet the following parameters were measured: routine laboratory parameters with automatic analysator, metal content using ICP-OES, and redox-parameters using spectrophotometric and luminometric methods.

RESULTS

Magnesium-malate failed to produce significant changes in the measured parameters in control animals in most cases. Magnesium-malate decreased significantly serum glucose concentration, alkaline phosphatase and amylase activities in the hyperlipidemic group. Significantly low induced chemiluminescent activity was measured in the plasma and erythrocytes of hyperlipidemic group. The magnesium supplementation did not increase significantly magnesium concentration in different organs although the calcium/magnesium concentration ratio was decreased.

CONCLUSIONS

In control animals there was no significant change in the measured parameters in most cases after dietary supplementation with a large amount of magnesium for a short period of time, but magnesium supplementation affected the metal homeostasis, routine laboratory parameters and redox system in hyperlipidemic animals. Although several changes were favorable, it should be emphasized that magnesium supplementation must be applied watchfully particularly in metabolic diseases.

The effect of ischemic preconditioning on redox status during liver resections--randomized controlled trial

BACKGROUND AND OBJECTIVES

Portal clamping during liver resection decreases intraoperative blood loss, but causes ischemic-reperfusion (I-R) injury. Intermittent portal clamping (IPC) and ischemic preconditioning (IP) decreased I-R injury in animal models. Most of the human studies about IP excluded cirrhotic patients, whose liver is more vulnerable to I-R injury. The effect of IP and IPC during extended liver resection was investigated in this randomized controlled trial, with special respect to cirrhotic patients.

METHODS

One hundred sixty patients (100 normal liver, 60 cirrhotic) undergoing major liver resection were randomized to receive IPC (15  min ischemia, 5  min reperfusion), or IP (10  min ischemia, 10  min reperfusion). Serum oxygen-derived free radicals (ODFR) and antioxidant concentrations (preoperative, after reperfusion and 7th postoperative day), such as "conventional" liver tests (preoperative, 1st, 3rd, and 7th postoperative day) were measured.

RESULTS

IP resulted in significantly lower peak ODFR, AST, ALT, and bilirubin levels after liver resection than IPC (P < 0.05). The level of serum antioxidants after reperfusion was significantly higher in IP than in IPC groups (P < 0.05). In cirrhotic patients without IP none of these values normalized until the 7th postoperative day.

CONCLUSIONS

Ischemic preconditioning--especially in patients with liver cirrhosis--is a suitable method to decrease the I-R injury of the liver.

[Hyperlipoproteinemia in pregnancy]

Physiological changes in lipoprotein levels occur in normal pregnancy. Women with hyperlipoproteinemia are advised to discontinue statins, fibrates already when they consider pregnancy up to and including breast-feeding the newborn, because of the fear for teratogenic effects. Hypertriglyceridemia in pregnancy can rarely lead to acute pancreatitis. Management of acute pancreatitis in pregnant women is similar to that used in non-pregnant patients. Further large cohort studies are needed to estimate the consequence of supraphysiologic hyperlipoproteinemia or extreme hyperlipoproteinemia in pregnancy on the risk for cardiovascular disease later in life.

[Investigation of postconditioning in intestinal ischemia-reperfusion experimental models]

INTRODUCTION

The ischemic-reperfusion injury of the intestine, which occurs as a consequence of circulatory redistribution or occlusion of the superior mesenteric artery, is associated with high mortality rates. Postconditioning may reduce ischemic-reperfusion damage in such cases. Effects of this new surgical method were investigated in rats.

METHODS

Male Wistar rats underwent 60 minutes of superior mesenteric artery occlusion in four groups: sham-operated, control and two postconditioned groups with different algorithms. Postconditioning was performed immediately at the beginning of reperfusion, by repetitive cycles of reperfusion and reocclusion. 3 cycles of 1 minute and 6 cycles of 10 seconds were applied according to groups. Intestinal microcirculation was followed by laser Doppler flowmetry. Blood and tissue samples were taken after 60 minutes of reperfusion. Histological analayses of the small intestine, measurement of serum necroenzyme levels and IL-6, mesenterial venous blood gas analyses were preformed and antioxidant state of the mucosa was investigated.

RESULTS

The microcirculation during the reperfusion showed significant improvement in both postconditioned groups. Histological damage, necroenzyme and IL-6 levels were significantly reduced, while antioxidant state was improved in the postconditioned groups.

CONCLUSION

Postconditioning was capable of increasing the guts chance to survive ischemic-reperfusion injury caused by superior mesenteric artery occlusion.