The plasma galectin-3 level has high specificity and sensitivity for predicting postoperative atrial fibrillation after coronary artery bypass surgery

OBJECTIVE

Postoperative new-onset atrial fibrillation (POAF) commonly occurs after coronary artery bypass graft (CABG) surgery. This study aimed to determine the utility of the preoperative netrin-1 and galectin-3 levels for predicting POAF following CABG surgery, as well as that of postoperative serial measurement for assessing these markers' patterns of expression.

PATIENTS AND METHODS

This prospective cohort study included 50 patients that underwent CABG surgery. The plasma netrin-1 and galectin-3 levels were measured via enzyme-linked immunosorbent assay (ELISA) before surgery (baseline) and at 6, 12, and 24 h after surgery. The patients were divided into two groups according to the occurrence of POAF; the POAF (+) group and the POAF (-) group.

RESULTS

In total, 26 patients developed POAF, whereas 24 remained in sinus rhythm. Baseline galectin-3 levels were higher in the POAF (+) group than in the POAF (-) group (30.7 ± 10.1 pg mL-1 and 15.7 ± 3.6 pg mL-1, respectively). The post-CABG surgery galectin-3 level increased in both the POAF (+) and POAF (-) groups at 6 h (46.2 ± 26.3 pg mL-1 and 24.9 ± 5.9 pg mL-1, respectively), 12 h (45.2 ± 24.1 pg mL-1 and 26.6 ± 9.3 pg mL-1, respectively), and 24 h (54.2 ± 33.5 pg mL-1and 28.6 ± 7.7 pg mL-1, respectively). The plasma netrin-1 level did not differ between groups at baseline or at 6, 12, and 24 h post CABG surgery.

CONCLUSIONS

Whereas netrin-1 does not appear to have any utility as a marker for the development of POAF in CABG surgery patients, the plasma galectin-3 level has high specificity and sensitivity for predicting POAF following CABG surgery and could be considered a marker for predicting POAF.

Prorenin and secreted frizzled-related protein 4 levels in women with gestational diabetes mellitus

OBJECTIVE

This study was designed to investigate prorenin and secreted frizzled-related protein 4 (SFRP4) levels in pregnancies with or without gestational diabetes mellitus (GDM).

METHODS

A total of 76 pregnant women were included in the study. Thirty-five of the pregnant women were included in GDM group according to the results of oral glucose tolerance tests (OGTT) and 41 of them were included in the control group.

RESULTS

In the group with GDM, SFRP4 value was found to be significantly higher than that of the control group (5.59 ± 3.32 ng/mL vs 4.05 ± 2.15 ng/mL; p = 0.017). Women with GDM had significantly higher serum prorenin levels compared with control group [737 (427-1339) pg/mL vs. 535 (376-725) pg/mL; p = 0.009]. There was a significant positive association between prorenin and SFRP4 levels in GDM (r = 0.91; p < 0.001) and control groups (r = 0.42; p = 0.002) and whole pregnancies (r = 0.75; p = 0.002).

CONCLUSION

We have shown that prorenin and SFRP4 were significantly elevated in GDM patients when compared to healthy control group. Furthermore, we found that there was a positive correlation between prorenin and SFRP4 (Tab. 1, Fig. 2, Ref. 38).

Evaluation of fractalkine (FKN) and secreted frizzled-related protein 4 (SFRP-4) serum levels in patients with prediabetes and type 2 diabetes

OBJECTIVE

The objective of this study is to compare serum levels of FKN and SFRP-4 in patients with normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and type 2 diabetes mellitus (T2DM).

METHODS

A total of 152 patients presented to the endocrinology outpatient clinic of our hospital were included in the study. Eighty-two patients with a history of T2DM were assigned to the T2DM group. IGT (n = 34) and NGT (n = 36) groups included the patients who received oral glucose tolerance test outcomes.

RESULTS

Serum FKN levels were significantly higher in the IGT and T2DM groups compared to the NGT group (p < 0.001 and p < 0.001, respectively). Serum SFRP-4 levels were significantly higher in the T2DM group compared to the IGT and NGT groups (p = 0.001 and p = 0.004, respectively). A significant correlation was observed between FKN and fasting glucose levels. SFRP-4 was significantly correlated with fasting glucose, HbA1c, and triglyceride levels.

CONCLUSION

To our knowledge, increased FKN levels in patients with IGT were demonstrated for the first time in this study. The results of our study support the opinion that FKN and SFRP-4 may contribute to the pathogenesis of T2DM (Tab. 1, Fig. 3, Ref. 23).

The effect of vitamin D on MCF-7 breast cancer cell metabolism

The role of vitamin D in calcium absorption and bone health is known. The studies revealed that vitamin D modulates breast cancer cell growth and it is also associated with a reduced breast cancer risk. The primary objective of this study was to highlight the metabolic effect of Vitamin D on MCF-7 breast cancer cell line. For that purpose, we checked the apoptosis, energy, amino-acid and acylcarnitine levels in cancer cells, that the study propose, that 1α, 25(OH)2D3 could inhibit cell growth in a dose and time dependent manner. IC50 dose was calculated as 145 nM for vitamin D. We observed the apoptosis level in vitamin D groups, which were 18, 28 and 38.5 % at 24, 48 and 72 hours, respectively. During metabolic screening analysis, it was observed that glutamine, methionine and glutamic acid levels were treated more by Vitamin D groups in cell line and also, that acylcarnitine level was increased in 24 and 48 hour groups when compared to the control, but decreased in 72 hours. Further studies are needed to analyze the role of amino acids and acylcarnitines for early apoptosis and cancer metabolism (Tab. 2, Fig. 4, Ref. 24).

Endothelial nitric oxide synthase intron 4a/b polymorphism in coronary artery disease in Thrace region of Turkey

Coronary artery disease (CAD) is one of the frequent cardiovascular mortality causes in the world. Common risk factors explain only about half the risk of CAD. The healthy familial predisposition to CAD, combined with advances in genetic analysis, has led to a number of studies in recent years making an effort to identify the genetic factors that influence the risk. The approach taken by most studies was to examine the association of naturally occurring genetic polymorphisms in candidate genes with risk of or severity of CAD. Endothelial nitric oxide synthase (eNOS) is important for vascular and tissue protection and is found in endothelial cells that encompass the entire vasculature, including the vessels in the heart. Nitric oxide (NO) is produced in a catabolic reaction in the endothelial cells, neurons, glia and macrophages by nitric oxide synthase (NOS) isoenzymes. eNOS is a subgroup of this family of enzymes that catalyses the production of nitric oxide (NO) from L-arginine and oxygen, which leads to vascular relaxation by activating the guanylate cyclase. This finally induces smooth muscle relaxation. The aim of this study was to investigate the allelic frequency and the genotypic distribution of the variable number of tandem repeat 27 (27 VNTR) gene polymorphism in intron 4 of the eNOS (eNOS 4a/b) gene in Thrace region, to compare CAD patients with appropriate healthy controls and to correlate the genetic findings with CAD subtypes. The study group included 281 (153 subjects with CAD and 128 controls) patients. The eNOS polymorphism was identified with a polymerase chain reaction. Genotypes were defined as aa, ab and bb according to the presence of a and b alleles. In this case–control study, we found that there was sensible correlation between eNOS gene intron 4a/b VNTR polymorphism and the risk of CAD in Thrace region of Turkey. However, there was no major difference for the genotype distribution and the allelic frequency among the CAD subtypes. Further studies on the interaction of such genes are needed to clarify the association between eNOS 4a/b polymorphism and CAD patients.

First Report of Bacterial Blight of Pomegranate Caused by Xanthomonas axonopodis pv. punicae in Turkey

Pomegranate (Punica granatum L.) is an increasingly important fruit crop that is widely cultivated in Turkey. Typical bacterial blight symptoms were observed since spring of 2011 in pomegranate orchards located in Antalya Province. Symptoms were characterized by dark brown, angular to irregularly shaped spots on leaves and fruit; cankers on stems, branches, and trunks; and split trunks. The pathogen was isolated from leaf spots on naturally infected plants showing typical symptoms onto yeast dextrose chalk agar. Bright yellow bacterial colonies were consistently isolated. Bacterial strains were characterized as gram negative, oxidase negative, catalase positive, tobacco hypersensitivity positive, and able to produce acid from L-arabinose, D-galactose, D-glucose, and D-mannitol but not from D-xylose. Pathogenicity of the representative bacterial strain Serik-4 was performed on 2-year-old pomegranate plants cv. Hicaz. Leaves were sprayed until runoff with bacterial cell suspensions containing 10⁷ CFU/ml. Inoculated plants were covered with transparent plastic bags to maintain moisture for 48 h. Negative control plants were inoculated with sterile distilled water. Plants were then incubated in a greenhouse at 30°C for 14 days. Symptoms on leaves included dark brown, angular to irregularly shaped water soaked lesions along the veins of the inoculated plants 10 days after inoculation. No lesions developed on the control plants. The symptoms on inoculated plants were similar to those on naturally infected plants. Yellow bacterial colonies were re-isolated from the inoculated plants and identified as the same as the original strain by conventional tests and FAME analysis, thus fulfilling Koch's postulates. Fatty acid methyl ester profiling of the representative strain Serik-4 using GC-MIDI (Microbial Identification Inc, Newark, DE) identified the genus of the bacterium as Xanthomonas. The identity of Serik-4 was further confirmed by amplifying the 16S rRNA gene with the universal primers 27F and 1492R (3) and sequence analysis (GenBank Accession No. KM007073). The 16S rRNA gene sequences of Serik-4 was 99% identical to the corresponding gene sequences of the Xanthomonas axonopodis pv. punicae strain present in the NCBI database (JQ067629.1). High incidence of bacterial blight caused by X. axonopodis pv. punicae on pomegranate has been previously reported in India (2), Pakistan (1), and South Africa (4). To our knowledge, this is the first report of bacterial blight on pomegranate caused by X. axonopodis pv. punicae in Turkey. References: (1) M. A. Akhtar and M. H. R. Bhatti. Pakistan J. Agric. Res. 13:95, 1992. (2) R. Chand and R. Kishun. Indian Phytopathol. 44:370, 1991. (3) D. J. Lane. Page 115 in: Nucleic Acid Techniques in Bacterial Systematics, 1991. (4) Y. Petersen et al. Australas. Plant Pathol. 39:544, 2010.

Levels of arginine and its products in dialysis patients

OBJECTIVES

Chronic renal failure is among significant public health problems all over the world. Despite advances in diagnosis and treatment approaches, cardiovascular morbidity and mortality is still high in chronic renal failure patients on dialysis. The aim this study is to investigate the importance of arginine, asymmetric dimethylarginine (ADMA) and nitric oxide (NO) levels in the pathophysiology of cardiovascular morbidity and mortality in patients with dialysis treatment program.

PATIENTS AND METHODS

53 patients with chronic renal failure receiving hemodialysis treatment and 34 healthy persons were participated to the study. Arginine and ADMA levels were measured by high-performance liquid chromatography (HPLC) fluorescence detector. NO levels were assessed by a colorimetric method. Albumin, urea, creatinine levels was performed using the spectrophotometric method.

RESULTS

Arginine levels were similar in dialysis patients when compared to the control group. Similarly NO levels did not show any difference between patient group and the control group. ADMA levels were found to be significantly high in dialysis patients compared to the control group (p < 0.005). Arginine/ADMA ratio was lower in the patient group compared to the control group (p < 0.001). Dialysis patients who have diagnosed coronary artery disease had low levels of albumin and creatinine. Arginine levels, ADMA levels and NO levels did not show any difference in the patients with coronary artery disease or not (p > 0.05). Arginine levels were significantly higher in men compared to women. Pearson correlation analysis showed that there was a correlation between NO and arginine levels. Arginine and Arginine/ADMA showed a positive correlation while ADMA and arginine/ADMA levels showed a negative correlation.

CONCLUSIONS

As a result, our data showed that ADMA clearance was impaired in hemodialysis patients. Increase in ADMA levels may play a role in atherosclerosis dependent morbidity and mortality.

Treatment of pilonidal sinus by phenol application and factors affecting the recurrence

BACKGROUND

Phenol injection, a less invasive method, has become more popular for the treatment of sinus pilonidalis. Recurrence rates after the use of phenol have been reported to be less than those after other surgical methods.

METHODS

In this study, we applied 80% phenol to 143 patients with sinus pilonidalis. Patients were reevaluated at 1, 3, 6, 12 and 24 months after the phenolization procedure to search for any recurrences. Age, sex, skin color, occupation, hair distribution, complaints, macroscopic characteristics of the lesion, pouch volume, microbiological yield, complications of phenol injection, healing time, and recurrences were determined.

RESULTS

The mean follow-up period was 24 months and the recurrence rate was 8.3% (12 of 143 patients). Volume of the sinus tract and number of sinus orifices were determined to be the factors significantly affecting recurrences (p<0.05).

CONCLUSIONS

Injection of 80% phenol is an ideal approach for the conservative treatment of sinus pilonidalis. This study confirms that this is an effective and costless method with low recurrence rates.

Endoscopic anatomy of sphenoid sinus for pituitary surgery

Endoscopic endonasal transsphenoidal approach to the sellar region yields an alternative to classical microsurgical approaches. Endoscopes provide images that differ from microscopic view. This study aimed to highlight surgical landmarks and their anatomical relationships for pituitary surgery through endoscopic perspective. Ten sides of five adult cadaveric heads with red-colored latex injected arteries were evaluated. Endoscopic dissections were performed and measurements were done in the sphenoid sinuses before and after the removal of bony structures in all the aspects. Endoscopic vision of the sellar region enabled a wide panoramic perspective and detailed inspection. The measurements, in general, indicated the variations in the bony structures and soft tissues. The width of the pituitary, which is the distance between the medial margins of the carotid prominences, was measured as 21 +/- 2.5 mm and the distance between the medial margin of the carotid prominences at the lower margin of the pituitary was 18 +/- 3.1 mm. After the bony structures were removed, further measurements were done. The width of the pituitary, which is the distance between the medial margins of the anterior curvature of the ICA, was measured as 23.2 +/- 3 mm, while the distance between the posterior curvature of the ICA was 19.7 +/- 4.9 mm. Endoscopic view provided superior detailed visualization of the close relationships between pituitary gland, internal carotid arteries, and optic nerves. This facilitated exact evaluation for variations, which could result in more effective and safe surgery. However, these variations again emphasize the necessity of preoperative radiological evaluation in each case.

Late dissemination of ependymoma: case report

Spinal cord dissemination over 10 years after surgical removal of the fourth ventricle ependymoma without local recurrence is extremely rare. A 49-year-old male underwent a macroscopically gross total removal of the fourth ventricle ependymoma and postoperative radiotherapy to the posterior fossa. Twelve years after the initial operation, the patient complained from uncontrolled fever attacks, low back pain and numbness of the legs. Spinal Magnetic Resonance Imaging revealed intradural extramedullary mass lesions located at the thoracic 2-3 and lumbar 5 vertebrae levels. Cerebrospinal fluid examination showed no tumour cells. He underwent total excision of these spinal lesions. Although the majority of the recurrences take place within a few years after surgery, we experienced a case with multiple spinal disseminations 12 years after the resection of the fourth ventricle ependymoma and administration of the radiation therapy to the posterior fossa. Up to our knowledge, this case represents the second unusual late recurrence reported in the literature. We conclude that low grade ependymomas should be followed neurologically and radiologically for more than 10 years after the initial treatment.

Multilocated mature teratoma: a case report and review of the literature

Mature teratomas are rare inclusion tumors, which have benign behaviors. Different locations of the tumor were reported in the literature. However, multiple tumor locations are extremely rare. An eight year old patient presented with an intraventricularly mature teratoma. During the six year follow up-period, two separately located masses were observed in the chest area and in the right iliac region, and both tumors were histologically diagnosed as mature teratomas. In this study, this unique case of mature teratoma presented with multiple locations in three separate body compartments. Furthermore, intraventricular dissemination with sellar and parasellar extension was observed in the third ventricle.

Apolipoprotein B gene polymorphisms in people in the East Mediterranean area of Turkey

Point mutations in the receptor binding domain of low density lipoprotein may increase cholesterol levels in blood. Three mutations of Apo B-100 protein result in defective binding [Arg 3500 —-> [corrected] Gln, Arg 3500 —-> [corrected] Trp and Arg 3531 —-> [corrected] Cys]. We estimated the frequency of Apo B point mutations [codon 3500] C9774T [Arg 3500 —-> [corrected] Trp] and G9775A [Arg 3500 —-> [corrected] Gln] in 179 atherosclerotic, 145 hyperlipidaemic individuals and 272 healthy individuals in the east Mediterranean region of Turkey. Lipid and lipoprotein levels were measured with routine biochemical analyser and Apo B mutation was detected using real-time PCR. Neither mutation was found. In this region, Apo B-100 protein mutations are rare and causes of hyperlipidaemia and atherosclerosis may therefore be unrelated to them

Apolipoprotein B gene polymorphisms in people in the east Mediterranean area of Turkey

Point mutations in the receptor binding domain of low density lipoprotein may increase cholesterol levels in blood. Three mutations of Apo B-100 protein result in defective binding (Arg 3500 ----> [corrected] Gln, Arg 3500 ----> [corrected] Trp and Arg 3531 ----> [corrected] Cys). We estimated the frequency of Apo B point mutations (codon 3500) C9774T (Arg 3500 ----> [corrected] Trp) and G9775A (Arg 3500 ----> [corrected] Gln) in 179 atherosclerotic, 145 hyperlipidaemic individuals and 272 healthy individuals in the east Mediterranean region of Turkey. Lipid and lipoprotein levels were measured with routine biochemical analyser and Apo B mutation was detected using real-time PCR. Neither mutation was found. In this region, Apo B-100 protein mutations are rare and causes of hyperlipidaemia and atherosclerosis may therefore be unrelated to them.

Infection-related atlantoaxial subluxation in two adults: Grisel syndrome or not?

Grisel's syndrome involves the subluxation of the atlanto-axial joint from inflammatory ligamantous laxity following an infectious process in the head or neck. It is a rare disease usually affecting children, but infrequent adult cases do occur. Today, due to the widened use of antibiotics and availability of MR imaging, some cases presenting with neck pain, resulting from the infectious inflammation of C1 and C2 but without pronounced subluxation, can be a challenging problem for most neurosurgeons. Several theories have been proposed to explain the pathogenesis of inflammatory subluxation. The primary treatment of Grisel's syndrome is medical. The underlying infectious organism must be isolated and appropriate antibiotics must be prescribed. The subluxation is reduced in holter or skeletal traction. This paper reports two cases of infection-related atlanto-axial subluxation in two adults. The literature on this subject is briefly reviewed.

Effects of trimetazidine on tissue damage in kidney after hindlimb ischemia-reperfusion

The objective of this study was to investigate the effects of trimetazidine (TMZ) on tissue damage in kidney after hindlimb ischemia-reperfusion (I/R), by assessing blood biochemical assay and histopathological analysis. Adult male Wistar rats were divided into two groups. TMZ 10 mg kg(-1)day(-1) was administrated twice a day for 10 days to the treatment group (group T, n=10). Sham group was given only 5% gum arabic (group S, n=10). On 11th day of treatment, 8h I/R period was performed on right hindlimb of the rats. At the end of reperfusion period, a 5 ml blood withdrawn from ascending aorta for biochemical assays and their right kidneys were harvested for histopathological examination. Superoxide dismutase, Na(+)-K(+) ATPase, and reduced glutathione levels were significantly increased in group T (P<0.001). On the other hand, myeloperoxidase and malondialdehyde levels were significantly less in group T than group S (P<0.001). Kidneys from the sham-operated group displayed intense leukocytic infiltration in histopathological examination. These overall results strongly suggested that TMZ contributes renal protection from hindlimb I/R injury by decreasing systemic oxidative stress.

The spontaneous umbilical perforation of the distal end of ventriculoperitoneal shunt

We present a case of umbilical perforation of the distal end of ventriculoperitoneal shunt as a rare complication of ventriculoperitoneal shunts including an umbilical abscess and an infection related with ventriculoperitoneal shunt. The ventriculoperitoneal catheter was removed, the umbilical abscess was drained and appropriate medication was employed for infection with successful outcome. Possible factors that might predispose to these complications of ventriculoperitoneal shunting are suggested.

Chiari Type I malformation presenting as glossopharyngeal neuralgia: case report

OBJECTIVE AND IMPORTANCE

Chiari Type I malformation is an important pathological state in which the brainstem is compressed by the cerebellar tonsil. We present a case of glossopharyngeal neuralgia caused by Chiari Type I malformation.

CLINICAL PRESENTATION

A 50-year-old male patient was admitted with glossopharyngeal neuralgia. Magnetic resonance imaging studies revealed caudal displacement of the left cerebellar tonsil.

INTERVENTION

Small occipital craniectomy and C1 laminectomy were performed. The left cerebellar tonsil was resected.

CONCLUSION

This glossopharyngeal neuralgia was caused by compression of the lower cranial nerves and brainstem by the displaced left cerebellar tonsil. Decompression and pain relief were obtained with resection of the cerebellar tonsil. The patient was pain-free 30 weeks after the operation.