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Objective: Coronavirus disease-2019 (COVID-19) was declared a pandemic in March 2020. As the number of cases increased, the infection emerged as a multi-systemic disease. Respiratory, cardiac, hepatic, urinary, circulatory, gastrointestinal systems and finally skin may be the target organs of COVID-19. The aim of this study was to evaluate the cutaneous signs of COVID-19 and their effect on the patients' prognosis. Material and Methods: A total of 192 hospitalized COVID-19 cases, between May 2021 to July 2021 were included in the study. The length of stay (LoS) of the patients were recorded. Hospitalization and discharge decisions and all treatments of the patients were determined at the discretion of the treating physician according to the pandemic guidelines of the Ministry of Health. Fever, fatigue, cough, dyspnea, myalgia, anosmia, and headache were considered COVID-19 symptoms. Results: Dermatological manifestations were seen in 10 cases. LoS in the group with dermatological findings was shorter than the group without dermatological findings and the difference was statistically significant between the groups. Discharge of the patients was the endpoint of the study. Conclusion: Our multicenter study suggests that patients with cutaneous findings usually do not have classical symptoms for COVID-19 and have a shorter LoS. © 2022 OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S.. All rights reserved. 2-s2.0-85130755814

Glutathione is the important antioxidant agent that is used for body detoxification system. Because of the fact that ıt is crucial for protecting health. A feeding trial was conducted to evaluate the effect of natural additives such as live yeast culture Saccharomyces cerevisiae (SC) and microalgae Spirulina platensis (SP) on the glutathione and leukocytes counts of rabbits. Forty male New Zealand white rabbits, aged 5-6 weeks, were studied in 4 groups. Treatments were control group, SC (added 3 g/kg diet), SP (added 5% of the diet) and, SC and SP (added 3g/kg diet and added 5% of the diet) respectively. The experiment lasted for 90 days and the blood samples were obtained by ear venipuncture on the 90th day. In conclusion, according to the results of this study, although not statistically significant, supplementing rabbit with S. cerevisiae or S. platensis had increased on glutathione values. Glutathione tend to be positively correlated with the addition of SC or SP. No significant difference in white blood cell counts was evidenced, even if lymphocyte counts tended to increase and neutrophil counts to decrease in rabbits fed SC or SC+SP. The determination of biological consequences (antioxidant potential, resistance to diseases, and improvement of nutritional status) requires further investigations.

Transplantasyon; Temel Tıbbi Bilimler, Moleküler Tıp, Genetik ve İmmünolojiden klinik uygulamalardan destek alan multidisipliner bir tıp dalıdır. Temel bilimlerdeki başarılı çalışmaların kliniğe uygulanması, klinikte karşılaşılan sorunların da, oluşturulan deneysel hayvan modellerinde irdelenmesi, elde edilen bilgilerin klinik uygulamalara aktarılması; diğer deyişle tecrübelerin “Translational” özellikli olması günümüz transplantasyon çalışmalarında bir gerekliliktir. İmmün sistemin bileşenlerinin ve reaksiyonlarının iyi bilinmesi, hücreler arası ilişkilerde greftin reddi ya da kabul edilmesinin şartlarını doğru anlamak ve uygun laboratuvar yöntemleri ile klinik durumun aydınlatılması transplantasyonda stratejik önemdedir. Bu nedenle, klinik transplantasyon çalışmaları yapanlar temel bilimler bilgileri ile de donanımlı olmalıdırlar. Multidisipliner bir dal olma bilinci ile yapılan klinik transplantasyon çalışmalarında başarı yakalanmaktadır. Laboratuvardan Kliniğe Transplantasyon kitabımızda tüm yönleri ile transplantasyonun organizmaya etkileri ve bunların klinik sonuçlarını, çalışmalarımızın ışığında sunmayı ve tartışmayı hedefledik. Editör: Prof.Dr. Mesut İzzet TİTİZ Yardımcı Editör: Doç.Dr. Pınar ATA

El-ayak sendromu (EAS) bazı kemoterapötiklerin yan etkisi olarak dizestezi, keskin kenarlı plaklarla ve palmoplantar alanlarda simetrik lezyonlar şeklinde görünür. Olgumuz ileri evre metastatik karsinom için kapesitabin tedavisinin üçüncü döngüsünde avuç içi ve ayak tabanlarında hafif eritem ve deskuamasyon gelişen, 68 yaşındaki erkek hastadır. Bu olgu sunumu ile kapesitabin kemoterapisi alan hastalarda gelişebilen EAS konusuna dikkat çekmeyi ve bilinç düzeyini yükseltmeyi amaçladık. Günümüz literatüründe ağız mukozasında hemorajik bül oluşumu hakkında bilgiye rastlanmaması nedeniyle olgumuz dikkat çekicidir

Background and Design.- High density lipoprotein (HDL), lecithine: Cholesterol acyltransferase (LCAT) and cholesterol ester transfer protein (CETP) are three important factors that play role in the reverse cholesterol transport. Disturbances related to these factors have been proposed to be responsible for the development of coronary artery disease. The subjects angiographically examined (total n= 96) were divided into four groups: those who had >50% luminal stenosis in single (n=20), double (n= 20) and triple (n= 23) coronary arteries and those who had normal (n= 33) coronary arteries.Results.- LCAT and CETP activities and total cholesterol, HDL-C, HDL2-C, low density lipoprotein-cholesterol, lipoprotein (a), apolipoprotein (apo)-AI and apo B levels had been found significantly different between subjects with coronary artery disease and those with normal coronary arteries. In patients with coronary artery disease, there were significant positive correlation between HDL-C and LCAT activity and significant negative correlation between HDL-C and CETP activity. In addition, HDL-C, HDL2-C levels and LCAT activity were significantly decreased and CETP activity was significantly increased as the severity of coronary stenosis increased.Conclusion.- Decreased HDL-C levels might be in connection with decreased LCAT activity and enhanced CETP activity; and as a result it might be concluded that impaired reverse cholesterol transport may be responsible for the development of coronary artery disease.* Anahtar Kelimeler: Koroner arter hastalığı, LCAT, CETP, HDL* Key Words: Coronary artery disease, LCAT, CETP, HDL

Lipoprotein oxidation may play a pivotal role in the pathogenesis of atherosclerosis, and vitamin E and b-carotene have been proposed to prevent the development and progression of atherosclerosis. The aim of this study was to investigate the oxidative susceptibility of apolipoprotein B (apo B)-containing lipoproteins and their relation with vitamin E and total carotene levels. The susceptibility of apo B-containing lipoproteins to oxidation, plasma malondialdehyde (MDA), serum vitamin E, total carotene, lipid and lipoprotein levels were studied in 177 patients with coronary artery disease (CAD) and 75 non-CAD subjects. All subjects (n = 252) had undergone coronary catheterization. Student's unpaired t-test, chi-square test and Pearson's correlation test were used for the statistical analyses. CAD patients demonstrated significant decreases in serum vitamin E and total carotene levels and significant increases in low density lipoprotein-cholesterol (LDL-C) and MDA levels. D MDA (oxidizability of apo B-containing lipoproteins) was negatively correlated with vitamin E and inversely correlated with LDL-C, apo B and MDA levels in CAD patients. In conclusion, oxidized forms of apo B-containing lipoproteins may play an important role in the pathogenesis of atherosclerosis, and antioxidant vitamin supplementation may be useful in CAD by improving the oxidative balance.

AMAÇ: B tipi Natriütetik peptid düzeyi akut koroner sendromlu hastalarda prognozu belirlemede kullandığımız belirteçlerdendir. Bu çalışmada natriüretik peptid ailesinden N Terminal (NT) proBNP' nin ST segment yükselmeli miyokard enfarktüslü olgulardaki prognostik değerini araştırmayı amaçladık.GEREÇ ve YÖNTEM: Uludağ Üniversitesi Tıp Fakültesi Kardiyoloji Kliniği yoğun bakım ünitesinde akut ST segment yükselmeli miyokard enfarktüsü tanısı ile izlenen 57 hasta incelendi. Olgulardan 6 ve 36. saatte plazmada NT-proBNP bakılmak üzere venöz kan örnekleri alındı. Eş zamanlı EKG'leri çekildi ve kardiyak enzimleri çalışıldı. Üçüncü ayda hastalar, istenmeyen major kardiyak olaylar (ölüm, revaskülarizasyon, tekrarlayan miyokard enfarktüsü ve angina) açısından değerlendirilirken NT-proBNP değerleri ölçüldü. Her üç NT-proBNP değeri ile istenmeyen major kardiyak olaylar arasındaki ilişki araştırıldı.BULGULAR: Hastalar ST segment yükselmesine göre anterior MI geçiren (Grup A) ve inferior MI geçiren (Grup B) hastalar olarak iki gruba ayrıldı. Grup A' da sol ventrikül ejeksiyon fraksiyonunun daha düşük, duvar hareket skor indeksinin daha yüksek olduğu saptandı. Üçüncü ay sonunda en az bir istenmeyen major kardiyak olay geçirenlerle hiç geçirmeyenler arasında NT-proBNP seviyeleri açısından anlamlı istatistiksel fark elde edilemedi (p>0,05). 36. saatte saptanan ortalama NT-proBNP düzeyi 6. saat ortalama NT-proBNP düzeyi ile kıyaslandığında grup A olgularında 10,6±26,2 kat artış gösterdiği, grup B olgularında 3,6±4,7 kat artış gösterdiği saptandı ve bu değer her iki grup arasında istatiksel olarak anlamlı farklılık saptandı (p=0,016). Sol ventrikül ejeksiyon fraksiyonu ve NT-proBNP düzeyleri arasında ilişki saptanmadı. 36. saat NT-proBNP düzeylerinin 300 pg/ml'nin üzerinde olması kötü prognozun öngörücüsüydü.SONUÇ: NT-proBNPdüzeyleri istenmeyen major kardiyak olayları öngörmede önemli katkı sağlayabilir. Özellikle 36. saat NT-proBNP değerlerinin 300 pg/ml'nin üzerinde olması istenmeyen major kardiyak olayların önceden tespitinde ve önlem alınmasında yararlı olabilir, Objective: B-type natriuretic peptide levels has been used as a biological marker for prognosis in patients with acute coronary syndrome (ACS). We sought to determine the prognostic value of N-Terminal (NT) proBNP in patients with ST segment elevation myocardial infarction. Materials and Methods: 57 patients from Uludağ University Cardiology Department Intensive Care Unit with ST segment elevation myocardial infarction if they matched the inclusion criteria after the standart treatment was began to patients were enrolled. We measured the NT-proBNP in plasma specimens in the 6th and 36th hours after hospitalization. The cardiac markers were measured and taken ECG records at the same times. After follow up of third month the major advers cardiovascular events (MACE) were evaluated and NTproBNPwas measured again. The relation between MACE and each of NT-proBNP levels were analysed. Results: The patients which were included to the study were divided in two groups in terms of ST segment elevation. These groups are anterior MI (Group A) and inferior MI (Group B) patients. In Group A the left ventricle ejection fraction was found lower and wall motion score index was found higher but they were not statistically significant (p>0,05). After the third month there was no statistically difference in NT-proBNPlevels between the group which had minimally one MACE and the other group which had no MACE (p>0,05). The 36th hours mean NT-proBNP levels compared with sixth hours mean NT-proBNP levels was statistically different in two groups. In Group A, NT-proBNPlevelsincreased 10,6±26,2 timesand in Group B NT-proBNPlevels increased 3,6±4,7 times (p=0,016). There was no correlation between left ventricle ejection fraction and NTproBNP levels. Especially we found that the patients which had 36th hours NT-proBNP level sover 300 pg/ml showed worse prognosis depending on major cardiovascular advers events. Conclusion: Circulating NT-proBNP levels appear elevated in patients with ST Elevation ACS. 36th hours NT-proBNP value sover 300 pg/ml, are associated with worse prognosis depending on major cardiovascular events.

AMAÇ: B tipi Natriütetik peptid düzeyi akut koroner sendromlu hastalarda prognozu belirlemede kullandığımız belirteçlerdendir. Bu çalışmada natriüretik peptid ailesinden N Terminal (NT) proBNP' nin ST segment yükselmeli miyokard enfarktüslü olgulardaki prognostik değerini araştırmayı amaçladık. GEREÇ ve YÖNTEM: Uludağ Üniversitesi Tıp Fakültesi Kardiyoloji Kliniği yoğun bakım ünitesinde akut ST segment yükselmeli miyokard enfarktüsü tanısı ile izlenen 57 hasta incelendi. Olgulardan 6 ve 36. saatte plazmada NT-proBNP bakılmak üzere venöz kan örnekleri alındı. Eş zamanlı EKG'leri çekildi ve kardiyak enzimleri çalışıldı. Üçüncü ayda hastalar, istenmeyen major kardiyak olaylar (ölüm, revaskülarizasyon, tekrarlayan miyokard enfarktüsü ve angina) açısından değerlendirilirken NT-proBNP değerleri ölçüldü. Her üç NT-proBNP değeri ile istenmeyen major kardiyak olaylar arasındaki ilişki araştırıldı. BULGULAR: Hastalar ST segment yükselmesine göre anterior MI geçiren (Grup A) ve inferior MI geçiren (Grup B) hastalar olarak iki gruba ayrıldı. Grup A' da sol ventrikül ejeksiyon fraksiyonunun daha düşük, duvar hareket skor indeksinin daha yüksek olduğu saptandı. Üçüncü ay sonunda en az bir istenmeyen major kardiyak olay geçirenlerle hiç geçirmeyenler arasında NT-proBNP seviyeleri açısından anlamlı istatistiksel fark elde edilemedi (p>0,05). 36. saatte saptanan ortalama NT-proBNP düzeyi 6. saat ortalama NT-proBNP düzeyi ile kıyaslandığında grup A olgularında 10,6±26,2 kat artış gösterdiği, grup B olgularında 3,6±4,7 kat artış gösterdiği saptandı ve bu değer her iki grup arasında istatiksel olarak anlamlı farklılık saptandı (p=0,016). Sol ventrikül ejeksiyon fraksiyonu ve NT-proBNP düzeyleri arasında ilişki saptanmadı. 36. saat NT-proBNP düzeylerinin 300 pg/ml'nin üzerinde olması kötü prognozun öngörücüsüydü. SONUÇ: NT-proBNPdüzeyleri istenmeyen major kardiyak olayları öngörmede önemli katkı sağlayabilir. Özellikle 36. saat NT-proBNP değerlerinin 300 pg/ml'nin üzerinde olması istenmeyen major kardiyak olayların önceden tespitinde ve önlem alınmasında yararlı olabilir. OBJECTIVE: B-type natriuretic peptide levels has been used as a biological marker for prognosis in patients with acute coronary syndrome (ACS). We sought to determine the prognostic value of N-Terminal (NT) proBNP in patients with ST segment elevation myocardial infarction. MATERIALS and METHODS: 57 patients from Uludağ University Cardiology Department Intensive Care Unit with ST segment elevation myocardial infarction if they matched the inclusion criteria after the standart treatment was began to patients were enrolled. We measured the NT-proBNP in plasma specimens in the 6th and 36th hours after hospitalization. The cardiac markers were measured and taken ECG records at the same times. After follow up of third month the major advers cardiovascular events (MACE) were evaluated and NTproBNPwas measured again. The relation between MACE and each of NT-proBNP levels were analysed. RESULTS: The patients which were included to the study were divided in two groups in terms of ST segment elevation. These groups are anterior MI (Group A) and inferior MI (Group B) patients. In Group A the left ventricle ejection fraction was found lower and wall motion score index was found higher but they were not statistically significant (p>0,05). After the third month there was no statistically difference in NT-proBNPlevels between the group which had minimally one MACE and the other group which had no MACE (p>0,05). The 36th hours mean NT-proBNP levels compared with sixth hours mean NT-proBNP levels was statistically different in two groups. In Group A, NT-proBNPlevelsincreased 10,6±26,2 timesand in Group B NT-proBNPlevels increased 3,6±4,7 times (p=0,016). There was no correlation between left ventricle ejection fraction and NTproBNP levels. Especially we found that the patients which had 36th hours NT-proBNP level sover 300 pg/ml showed worse prognosis depending on major cardiovascular advers events. CONCLUSION: Circulating NT-proBNP levels appear elevated in patients with ST Elevation ACS. 36th hours NT-proBNP value sover 300 pg/ml, are associated with worse prognosis depending on major cardiovascular events.

Figurate erythemas are a group of dermatoses mostly developing in response to an underlying condition. They are characterized by erythematous papules growing centrifugally to form annular or polycyclic figures. Here, we describe a 16-year-old girl with EGR-like lesions confined to the dorsum of hands, present since she was eight years of age.

D-dimer is the smallest degradation product of cross-linked fibrin. It reflects a global activation of blood coagulation and fibrinolysis and, therefore, an indirect marker of thrombotic activity. D-dimer can be regarded as a most valuable laboratory tool to diagnose and manage a vast array of thrombosis-related clinical conditions, including; diagnosis of venous thromboembolism (VTE), identification of individuals at increased risk of first thrombotic event (both arterial and venous), identification of individuals at increased risk of recurrent VTE, pregnancy monitoring, and diagnosis/monitoring of disseminated intravascular coagulation. The clinical utility of D-dimer measurement has been established in some scenarios, most notably for the exclusion of VTE. Deep venous thrombosis (DVT) and pulmonary embolism (PE) repre-sent two expressions of a similar clinical pathological process traditionally referred to as venous thromboembolism. Timely and accurate diagnosis of both is essential as delayed or missed diagnoses can result in death or longer term complications. Therefore, patients with sus-pected DVT or PE should be managed with a diagnostic strategy that includes clinical pretest probability assessment, D-dimer test, and imaging., D-dimer çapraz bağlı fibrinin en küçük yıkım ürünüdür. Koagulasyon ve fibrinolizin global bir aktivasyonunu yansıtır ve bu nedenle trombo-tik aktivitenin indirekt bir belirtecidir. D-dimer; venöz tromboembolizm (VTE) tanısı, ilk trombotik olay (arteryal ve venöz) ve tekrarlayan VTE riski artmış bireylerin tesbiti, gebelik ve yaygın damar içi pıhtılaşma (DIC) takibi gibi bir dizi trombozla ilişkili klinik tablonun tanı ve takibinde en değerli laboratuvar testi olarak kabul edilebilir. D-dimer ölçümünün klinik yararı üzerine kurulmuş senaryoların en önemlisi, VTE dışlanmasıdır. Derin ven trombozu (DVT) ve pulmoner embolizm (PE) geleneksel olarak VTE şeklinde ifade edilen benzer klinik tablolardır. Gecikmiş veya yanlış tanılar, ölüm veya uzun dönem komplikasyonlarla sonuçlanabileceği için zamanında ve doğru tanı önemli-dir. Bu nedenle, DVT veya PE şüphesi olan hastalar klinik olasılık ön testleri, D-dimer testi ve görüntülemeyi içeren bir tanısal strateji ile değerlendirilmelidir.

Amyopathic dermatomyositis (AD) can be a part of paraneoplastic syndrome of an underlying malignancy. Paget’s disease is a rare form of breast cancer. We present a very rare case of Paget’s disease associated with AD. Paget’s disease has been diagnosed in a patient with AD who is under surveillance of dermatology department. The patient has undergone central lumpectomy with removal of the nipple-areola complex and sentinel lymph node biopsy. Surgical margins after lumpectomy and sentinel node biopsy were negative. The whole breast irradiation was performed after surgery. The patient receives medical treatment for AD of which lesions regressed in 1 year during the follow-up period. This is a very rare case of Paget’s disease diagnosed in a patient with AD. Female patients with dermatomyositis have been absolutely recommended to undergo screening for breast and gynaecological malignancies. AD may be an early finding of primary or recurrent malignancy of the breast.

In chronic heart failure, several hormonal systems are activated with diagnostic and prognostic implications. Chronic heart failure is a complex syndrome characterized by neuroendocrine activation: catecholamines, natriüretic peptides and components of renin-angiotensin system all chronic heart failure. Serum Chromogranin-A (CgA), that is an acid protein of 49 kDa, presents in the secretuar granules of neuroendocrine cells and increases in chronic heart failure. Increased CgA levels are related to the clinical severity of the chronic heart failure and predictive factor for mortality., Kronik kalp yetmezliğinin (KKY) tanı ve prognozundan çeşitli hormonal sistemlerin aktivasyonu sorumludur. KKY katekolaminlerin, natriüretik peptidlerin ve renin-anjiotensin sistem kompanentlerinin artışının olduğu nöroendokrin aktivasyonla karakterize kompleks bir sendromdur. Nöroendokrin hücrelerin sekretuar granüllerinde 49 kDa ağırlığında asit bir protein olarak bulunan kromogranin A'nın (CgA), KKY'de serum düzeyleri artmaktadır. Cg A artmış düzeyleri kalp yetmezliğinin klinik şiddetiyle ilişkili olup, mortalite için de prediktif faktördür.

The aim of this study was to assess the effect of N-acetylcysteine (NAC) treatment, as an adjunct therapy in myocardial infarction on oxidative stress, infarct size and dispersion of QT. Patients with acute myocardial infarction received either 15 mgc of NAC infused intravenously over 24 hours (n=15) or no NAC (n=15), combined along with streptokinase. In order to assess the oxidative stres, plasma malondialdehyde (MDA) level was measured at admission and after 4 and 24 hours. For all patients, QT dispersion (QTd) and Bazett rate corrected QTc dispersion (QTcd) were measured from a high quality 12 lead ECG recorded at 50 mm/s on admission, at 4 and 24 hours. Coronary angiography were performed to assess reperfusion. At admission, plasma MDA levels were not different between the groups. In the NAC treated patients percent plasma MDA changes according to the baseline decreased whereas in the NAC non-treated patients percent MDA changes increased at 4 and 24 hours (p=0.001 and p=0.0001, respectively). Significant decreases in the percent QTd (p=0,04) and QTcd (p=0.03) period changes were observed in patients treated with NAC compaired to patients treated without NAC at 24 hours. N-acetylcysteine treatment reduces lipid peroxidation during ischemia and reperfusion and decreases QT dispersion., Çalışmanın amacı, miyokard infarktüsünde ek tedavi olarak, N-asetil sisteinin (NAS) oksidatif stres, infarkt büyüklüğü ve QT dispersiyonu üzerine olan etkisinin değerlendirilmesidir. Akut miyokard infarktüsü (Mİ) geçiren hastalar, streptokinaz ile birlikte 24 saat süreyle intravenöz infüzyon şeklinde 15 gram N-asetil sistein alanlar (n=15) ve almayanlar (n=15) şeklinde iki gruba ayrıldı. Oksidatif stresin değerlendirilmesi için kabulde, 4 saatte ve 24. saatte plazma malondialdehid (MDA) düzeyleri ölçüldü. Tüm hastaların başlangıçta, 4. ve 24. saatte 50 mm/sn ile 12 derivasyonlu elektrokardiyografileri çekilerek QT dispersiyonları ve “Bazett” formülü ile hıza göre düzeltilmiş QT dispersiyonları hesaplandı. Reperfüzyonun değerlendirilmesi için koroner anjiyografi yapıldı. Kabulde her iki grup arasında plazma MDA düzeyleri arasında farklılık yoktu. N-asetil sistein ile tedavi edilen hastalarda, plazma MDA düzeyleri azalırken, NAS ile tedavi edilmeyen hastalarda, plazma MDA düzeyleri 4. saat ve 24. saatte artış gösterdi (sırasıyla p=0.001 ve p=0.0001). 24. saatte NAS alan hastalarda, NAS almayan hastalara göre, QT dispersiyonu (p=0,04) ve hıza göre düzeltilmiş QT dispersiyonunun yüzde değişiminde (p=0.03) anlamlı olarak azalma izlendi. NAS tedavisi, iskemi reperfüzyon sırasında lipid peroksidasyonunu ve sonucunda QT dispersiyonunu anlamlı olarak azaltabilmektedir.

Çalışmamızda Ekim 1992-Ocak 1994 tarihleri arasında polikliniğimize başvuran, 18-32 yaşlan arasında (ortalama 21.2), akne lezyonlar 5 yıldan daha uzun süredir devam eden veya menstruasyon başlangıcından en az 5 yıl sonra başlayan 80 kadında polikistik over insidansı araştınldı. Bu hastalarda FSH, LH, DHEA-S, TT, PRL hormonlarının serum seviyelerine bakıldı. Aknesiz 18-35 yaşlan arasında (ortalama 20.3) 20 kadın kontrol grubu olarak alındı. Akne vulgarisli kadınlarda pelvik ultrasonografik incelemede 80 hastanın % 40'ında (32 hasta) polikistik over saptandı. Kontrol grubunda yapılan incelemede ise, 20 sağlıklı kadının % 10'unda (2 kadın) polikistik over tespit edildi. Hasta grubu ile kontrol grubunun polikistik over yüzdeleri arasındaki fark, istatistiksel olarak yüksek derecede anlamlı bulundu (p

Başlıca yağ dokusu tarafından sentezlenen ve salgılanan leptin, hipotalamus'daki spesifik reseptörlerine etki ederek enerji alımı ve enerji harcanması arasındaki dengeyi düzenleyerek bir tür antiobezite faktörü olarak fonksiyon görür. Üreme, hematopoez, gastrointestinal fonksiyonların düzenlenmesi, anjiyogenez, sempatik sinir sistemi aktivasyonunun düzenlenmesi, kemik yoğunluğunun belirlenmesi, termogenez ve beyin gelişimi gibi birçok fonksiyonunun da olduğu saptanan leptinin, sentez ve salgılanmasında birçok faktör rol oynar. Bu derlemede, literatür bilgisi ışığında leptinin genel özellikleri ve fonksiyonları tartışılacaktır., Leptin, which is primarily synthesized and secreted by adipose tissue, functions as a type of anti-obesity factor by regulating the balance between energy uptake and consumption via the receptors in the hypothalamus. Numerous factors play a role in the synthesis and secretion of leptin. It has been reported that leptin has a number of functions in reproduction, hematopoiesis, regulation of gastrointestinal functions, angiogenesis, regulation of sympathic nerve system activation, determination of bone density, thermogenesis, and brain development. In this review, the general characteristics and functions of leptin will be discussed in the light of literature.

Scleromyxedema (SM) is a rare chronic progressive and highly intractable cutaneous disease with unknown etiology, affecting both genders equally between 30 and 50 years. The disease is characterized with mucin deposits in the skin and/or other organs. In fact it is a clinicopathological subset of lichen myxedematosus (LM) according to a new classification. Sclerodermiform plaques and lichenoid papules are characteristic cutaneous lesions. An elevation of IgG λ (lambda) chain exists in most cases and extracutaneous involvement occurring with variable systemic findings is also detected. Generalized form is quite difficult to treat and may even be fatal. Herein, we present a male patient with typical features of generalized papular and sclerodermoid LM variety and with benign outcome by isotretinoin.

Glutathione is the important antioxidant agent that is used for body detoxification system. Because of the fact that ıt is crucial for protecting health. A feeding trial was conducted to evaluate the effect of natural additives such as live yeast culture Saccharomyces cerevisiae (SC) and microalgae Spirulina platensis (SP) on the glutathione and leukocytes counts of rabbits. Forty male New Zealand white rabbits, aged 5-6 weeks, were studied in 4 groups. Treatments were control group, SC (added 3 g/kg diet), SP (added 5% of the diet) and, SC and SP (added 3 g/kg diet and added 5% of the diet) respectively. The experiment lasted for 90 days and the blood samples were obtained by ear venipuncture on the 90th day. In conclusion, according to the results of this study, although not statistically significant, supplementing rabbit with S. cerevisiae or S. platensis had increased on glutathione values. Glutathione tend to be positively correlated with the addition of SC or SP. No significant difference in white blood cell counts was evidenced, even if lymphocyte counts tended to increase and neutrophil counts to decrease in rabbits fed SC or SC+SP. The determination of biological consequences (antioxidant potential, resistance to diseases, and improvement of nutritional status) requires further investigations.

Bu çalışmanın amacı serum sistatin C, nötrofil jelatinaz ilişkili lipokalin (NGAL) ve beyin natriüretik peptid (BNP) düzeyleri ile koroner arter hastalığının (KAH) şiddeti arasındaki ilişkiyi incelemektir.Çalışmaya kronik böbrek hastalığı olmayan ve koroner anjiografi yapılan 170 hasta alındı. Koroner anjiogramları normal olan olgular (n=77) kontrol olarak değerlendirilirken, KAH olanlar da (n=93) tutulan koroner damar sayısına göre 3 gruba ayrıldılar; bir damar (n=33), iki damar (n=30) ve üç damar (n=30). Ayrıca olgular serum sistatin C, NGAL ve BNP çeyreklerine göre de sınıflandırıldı. Biyokimyasal ve hematolojik parametreler rutin laboratuvar yöntemleri ile belirlendi. Oksidan ve antioksidan parametreler ise spektrofotometrik olarak incelendi. Sistatin C ve high sensitivity CRP ( hs-C Reactive protein) immunotürbidimetrik, NGAL mikro-ELISA ve BNP de kemilüminesan mikropartikül immünolojik yöntemle öçüldü. Sistatin C, NGAL, BNP ve hs-CRP düzeyleri 2 ve 3 damar hastalarında kontrol ve/veya 1 damar hastalarına göre anlamlı olarak daha yüksekti. Daralmış ortalama koroner arter yüzdesi de sistatin C, NGAL ve BNP'nin yüksek konsantrasyon çeyreklerinde anlamlı olarak daha yüksekti. Oksidan ve antioksidan parametreler ise 3 damar hastalarında kontrol grubuna göre anlamlı olarak daha yüksekti. Sistatin C yaş, kreatinin, üre, BNP, NGAL ve hs-CRP ile pozitif ve anlamlı bir korelasyon gösterirken, ejeksiyon fraksiyonu, Alanin transaminaz ve paraoksonaz ile de anlamlı negatif korelasyonlar bulundu. BNP ise yaş, üre, sistatin C, hs-CRP ve protein karbonil düzeyleri ile pozitif ve anlamlı bir korelasyon gösterdi.Sonuç olarak, Sistatin C, NGAL ve BNP koroner aterosklerozun derecesi ile ilişkilidir ve KAH'nın varlığını ve şiddetini tahminde yararlı belirteçler olabilirler. Anahtar Kelimeler: Koroner Arter Hastalığı, Sistatin C, NGAL, BNP. SUMMARYThe aim of this study was to determine the association between the serum cystatin C (Cys C), neutrophil gelatinase-associated lipocalin (NGAL) and brain natriuretic peptide (BNP) levels and the severity of coronary artery disease (CAD). The population included 170 patients without chronic kidney disease, undergoing clinically-indicated coronary angiography. While the subjects with normal coronary angiograms (n=77) were evaluated as controls, the patients with CAD (n=93) were divided into three categories according to the number of diseased coronaries; one-vessel (n=33), two-vessels (n=30) and three-vessels (n=30). Moreover, subjects were categorized into quartiles of serum Cys C, NGAL and BNP. Biochemical and hematologic parameters were determined by routine laboratory methods. Oxidant and antioxidant parameters were studied spectrophotometrically. Cys C and high sensitivity CRP (hs-CRP) were determined by immunoturbi¬dimetric method. NGAL was determined by micro-ELISA method and BNP was also determined by chemiluminescent microparticle immunoassay method. Cys C, NGAL, BNP and hs-CRP levels were significantly higher in two and three-vessels patients than those in control and/or one-vessel patients. The average percent of stenotic coronary arteries was significantly higher in the quartiles of higher concentration of Cys C, NGAL and BNP. Oxidant and antioxidant parameters were significantly higher in three-vessels patients than those in controls. Cys C was positively and significantly correlated with age, creatinine, urea, BNP, NGAL and hs-CRP, whereas significantly negative correlations were observed with ejection fraction, alanin transaminaz and paraoxonase. BNP was positively and significantly correlated with age, urea, cys C, hs-CRP and protein carbonyl levels. In conclusion; Cys-C, NGAL and BNP are associated with coronary atherosclerosis extent and could be useful markers in predicting the presence and severity of CAD.Key Words: Coronary Artery Disease, Cystatin C, NGAL, BNP. 89

Background Vanadyl sulfate (VS) and taurine are two promising agents in the treatment of diabetes related to their antihyperglycemic, antihyperlipidemic, and hyperinsulinemic effects. Data about the effects of VS on the oxidant–antioxidant system is limited and controversial. However, taurine is a well-documented antioxidant agent and our aim was to investigate the effects of VS, taurine and VS and taurine combination on the oxidative–antioxidative systems in streptozotocin–nicotinamide (STZ-NA) diabetic rats. Methods Nicotinamide (230 mg/kg, i.p.) and streptozotocin (65 mg/kg, i.p.) were administered. VS (0.75 mg/mL) and taurine (1%) were added to drinking water for 5 weeks. Rats were divided as control (C), diabetes (D), diabetes + VS (D + VS), diabetes + taurine (D + T), diabetes + VS and taurine (D + VST). Plasma and tissue malondialdehyde (MDA) levels were measured by high-performance liquid chromatography and spectrophotometry, respectively. Paraoxonase and arylesterase activities were measured by spectrophotometric methods and superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities were determined using commercial kits. Results VS, taurine and VS and taurine combination treatments reduced the enhanced blood glucose, serum total cholesterol and triglyceride, tissue MDA and plasma MDA (except in the D + VS group) levels and increased the reduced serum insulin level, serum paraoxonase and arylesterase activities, GSH-Px activity and SOD activity (except in the D + VS group). Conclusions The findings of the present study suggest that VS and taurine exert beneficial effects on the blood glucose and lipid levels in STZ-NA diabetic rats. However, VS might exert prooxidative or antioxidative effects in various components of the body and taurine and VS combination might be an alternative for sole VS administration.

Objectives We aimed to evaluate the association of lipid peroxidation, protein oxidation and antioxidant system, and to assess an association with the severity of the disease, in patients with and without coronary artery disease (CAD) documented by coronary angiography. Design and methods The population included 208 patients, undergoing clinically indicated coronary angiography. While the subjects with normal coronary angiograms ( n = 54) were evaluated as controls, the patients with CAD ( n = 154) were divided into three categories according to the number of diseased coronaries; one-vessel ( n = 50), two-vessels ( n = 51) and three-vessels ( n = 53). Lipid parameters were determined by routine laboratory methods. Plasma malondialdehyde and vitamin E concentrations were determined with the high-performance liquid chromatography. Other oxidant and antioxidant parameters were studied spectrophotometrically. Results While plasma malondialdehyde levels, the susceptibilities of erythrocyte and apolipoprotein B containing lipoproteins to in vitro induced oxidative stress, serum protein carbonyls, low density lipoprotein-cholesterol, triglyceride, apolipoprotein B and lipoprotein (a) levels had significantly increased, high-density lipoprotein–cholesterol and apolipoprotein AI levels, erythrocyte glutathione peroxidase, glutathione reductase, glucose 6 phosphate dehydrogenase, serum catalase, paraoxonase and arylesterase activities, plasma vitamin E and C and carotenoid levels had significantly decreased. The odds ratios for one-, two-, and three-vessel disease increased across especially higher tertiles of concentrations for oxidation parameters and lower tertiles of concentrations for antioxidant parameters. Conclusions According to the results, we suggest that increased lipid and protein oxidation products and decreased antioxidant enzymes and vitamins contribute to increased oxidative stress which in turn is related to the severity of the disease.

Although there is a general consensus concerning the lower risk for cardiovascular disease in moderate drinkers, the mechanisms responsible for the cardioprotective effect of red wine remain unknown. It has been proposed that increased serum paraoxonase activity may be a mechanism of action underlying reduced cardiovascular disease risk in moderate drinkers, since paraoxonase inhibits lipoprotein oxidation. The aim of this study was to investigate the effects of red wine consumption on serum paraoxonase/arylesterase activities and on lipoprotein oxidizability in healthy-men. Fourteen healthy-men were included in the study. The subjects consumed 0.375 g alcohol / kg body weight for 3 weeks. Paraoxonase and arylesterase activities were studied spectrophotometrically. Oxidizability of apolipoprotein B-containing lipoproteins were determined, after separating them with precipitation method, by incubating with copper-sulfate. Paraoxonase activity did not change, however arylesterase activity significantly decreased after red wine consumption (P < 0.01). There was a reduced susceptibility of apolipoprotein B-containing lipoproteins to copper-sulfate induced oxidation after red wine consumption (P < 0.01). Our results support that red wine protects lipoproteins against oxidation, however there was not any significant change in serum paraoxonase activity after red wine consumption.

Objective: Apoptosis is the early and predominant form of cell death in infarcted myocardia. The aim of the study was to investigate the effects of trimetazidine (TMZ) and N-acetylcysteine (NAC), used alone or in combination, on oxidative stress, infarct size, and ischemia-reperfusion (IR)-induced cardiomyocyte apoptosis in a rat model of myocardial IR. Methods and results: Myocardial IR was established by ligating an area under the left main coronary artery for 30 min followed by 3 h of reperfusion. Saline (1 ml/kg), NAC (50, 150 mg/kg), or TMZ (3, 5 mg/kg) was intravenously injected during the middle of the ischemic period. At the end of the reperfusion, blood samples were collected from the animals to measure serum M30 and M65 levels, which are markers of cell death, the S100b level, which is a marker of inflammation, and the malondialdehyde (MDA) level, which is a marker of oxidative stress. The infarct size was evaluated as the ratio of the infarct area to the risk area. Apoptotic activation was assessed by caspase-3 immunostaining and a TUNEL assay. TMZ and NAC, either alone or in combination, significantly reduced serum MDA levels, infarct area and apoptotic activity compared to those observed in saline group. Interestingly, the infarct area was more smaller in TMZ (3 and 5 mg/kg) injected groups (9.72 +/- 1.3% and 9.96 +/- 2.3%) than those observed in NAC (50 and 150 mg/kg) (16.1 +/- 2.5% and 19.1 +/- 2.14%) or TMZ (5 mg/kg)- NAC (150 mg/kg) combination groups (16.9 +/- 1.6%). However, the apoptotic activity was reduced more significantly in the combination of TMZ (5 mg/kg)-NAC (50 mg/kg) compared to TMZ-only group. Neither TMZ or NAC treatments nor the combination of the drugs significantly affected serum M30, M65 and S100B levels. Conclusion: Intravenous NAC and TMZ administration decreased oxidative stress, infarct area and apoptotic activity in a rat model of IR. Although the combination treatment was more effective in reducing the apoptotic activity than either treatment groups alone, TMZ treatment was more successful in reducing the infarct area than NAC or combination treatments. Present results suggest that, in addition to mechanical attempts to secure myocardial reperfusion, the use of TMZ and NAC may help to reduce IR injury.

Background: It has been suggested that off-pump coronaryartery bypass grafting (CABG) surgery reduces myocardialischemia-reperfusion injury, postoperative systemicinflammatory response, and oxidative stress. The aim of thisstudy was to measure serum malondialdehyde (MDA), highsensitivityC-reactive protein (hs-CRP), M30, and M65 levelsand to investigate the relationship between M30 levels andoxidative stress and inflammation in patients undergoing onandoff-pump CABG surgery.Methods: Fifty patients were randomly assigned to onpumpor off-pump CABG surgery (25 patients off-pump and25 on-pump CABG surgery), and blood samples were collectedprior to surgery, and 30 minutes, 60 minutes, 6 hours,and 24 hours after CABG surgery.Results: Compared to the on-pump group, serum MDAlevels at 30 minutes, 60 minutes, 6 hours, and 24 hours afterthe CABG surgery were significantly lower in the off-pumpgroup (P = .001, P = .001, P = .001, and P = .001, respectively).Serum M30 levels were found to be elevated in both groups,returning to baseline at 24 hours. When compared to baseline,the hs-CRP level reached its peak at 24 hours at 13.28 ±5.32 mg/dL in the on-pump group, and 15.44 ± 4.02 mg/dLin the off-pump group.Conclusion: CABG surgery is associated with an increasein inflammatory markers and serum M30 levels, indicatingepithelial/endothelial apoptosis in the early period.

Objectives: To assess the relationship between lipoprotein (a) [Lp (a)] and lipoprotein oxidation in patients with coronary artery disease (CAD). Design and methods: Oxidation of apolipoprotein (apo)B-containing lipoproteins, vitamin E, carotenoids, lipid-lipoprotein levels were determined in 171 CAD and 70 non-CAD subjects. Results: In CAD patients with Lp (a) concentrations greater than or equal to 30 mg/dL; total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), malondialdehyde (MDA), and apo B levels were significantly higher and lag-time and age were significantly lower than those of CAD patients with Lp (a) concentrations < 30 mg/dL. In non-CAD subjects with Lp (a) concentrations a 30 mg/dL; TC, LDL-C, and vitamin E levels were significantly higher and lag-time was significantly lower than those of non-CAD subjects with Lp (a) concentrations < 30 mg/dL. In CAD patients, Lp (a) correlated negatively with lag-time and positively with MDA levels. Lp (a) correlated negatively with lag-time and vitamin E levels in non-CAD subjects. Conclusions: We have shown that plasma apo B-containing lipoproteins of both CAD and non-CAD subjects with Lp (a) levels 30 mg/dL are more susceptible to in vitro oxidative modification than those of subjects with Lp (a) levels < 30 mg/dL. The relationship between Lp (a) and enhanced susceptibility of apo B-containing lipoproteins to oxidation, appears to support routine investigation of Lp (a).

D-dimer çapraz bağlı fibrinin en küçük yıkım ürünüdür. Koagulasyon ve fibrinolizin global bir aktivasyonunu yansıtır ve bu nedenle trombo tik aktivitenin indirekt bir belirtecidir. D-dimer; venöz tromboembolizm (VTE) tanısı, ilk trombotik olay (arteryal ve venöz) ve tekrarlayan VTE riski artmış bireylerin tesbiti, gebelik ve yaygın damar içi pıhtılaşma (DIC) takibi gibi bir dizi trombozla ilişkili klinik tablonun tanı ve takibinde en değerli laboratuvar testi olarak kabul edilebilir. D-dimer ölçümünün klinik yararı üzerine kurulmuş senaryoların en önemlisi, VTE dışlanmasıdır. Derin ven trombozu (DVT) ve pulmoner embolizm (PE) geleneksel olarak VTE şeklinde ifade edilen benzer klinik tablolardır. Gecikmiş veya yanlış tanılar, ölüm veya uzun dönem komplikasyonlarla sonuçlanabileceği için zamanında ve doğru tanı önemli dir. Bu nedenle, DVT veya PE şüphesi olan hastalar klinik olasılık ön testleri, D-dimer testi ve görüntülemeyi içeren bir tanısal strateji ile değerlendirilmelidir. D-dimer is the smallest degradation product of cross-linked fibrin. It reflects a global activation of blood coagulation and fibrinolysis and, therefore, an indirect marker of thrombotic activity. D-dimer can be regarded as a most valuable laboratory tool to diagnose and manage a vast array of thrombosis-related clinical conditions, including; diagnosis of venous thromboembolism (VTE), identification of individuals at increased risk of first thrombotic event (both arterial and venous), identification of individuals at increased risk of recurrent VTE, pregnancy monitoring, and diagnosis/monitoring of disseminated intravascular coagulation. The clinical utility of D-dimer measurement has been established in some scenarios, most notably for the exclusion of VTE. Deep venous thrombosis (DVT) and pulmonary embolism (PE) repre sent two expressions of a similar clinical pathological process traditionally referred to as venous thromboembolism. Timely and accurate diagnosis of both is essential as delayed or missed diagnoses can result in death or longer term complications. Therefore, patients with sus pected DVT or PE should be managed with a diagnostic strategy that includes clinical pretest probability assessment, D-dimer test, and imaging.

Objective: To examine the relationship between aspirin resistance and oxidative stress in patients with coronary artery disease. Material and Method: A total of 100 patients (35 females, 65 males) with coronary arteiy disease were enrolled in the study. Platelet function was evaluated by a Multiple Platelet Function Analyzer according to impedance aggregomeby method. Agregation Unite (AU) with a >706 AU*min despite regular aspirin therapy, was defined as Aspirin resistance. and aspirin semiresponders were defined as a 300-706 AU*min. Aspirin-sensitive patients were defined as a

Objective: To investigate the usefulness and diagnostic performance of glycogen phosphorylase BB (GPBB) to aid early diagnosis of acute coronary syndrome and to compare with cardiac-specific troponin I (cTnI), creatine kinase isoenzyme MB and myoglobin. Material and Method: Non-traumatized 72 patients arriving at the emergency department within 3 hours after the onset of chest pain suggestive of acute coronary syndrome were included. The patients were classified as having acute myocardial infarction (AMI) or unstable angina pectoris (UAP). Blood samples were obtained on arrival (0 hours), 6 hours, and 24 hours. To determine the diagnostic performances of GPBB and other cardiac markers for ACS, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios and receiver operating characteristic (ROC) curves with areas under curves were calculated. Results: Seventy two non-traumatic chest pain patients and 45 controls were enrolled. GPBB was the most sensitive biochemical cardiac marker of all tested in AMI and UAP patients on admission, whereas its specificity was low In both AMI and UAP patients, the area under the GPBB ROC curve, was significantly greater than the areas under all other ROC curves on admission. Conclusion: GPBB is a promising enzyme for the early laboratory detection of ischemic myocardial damage. Because the diagnostic specificity of GPBB for myocardial damage is low, a positive GPBB result should subsequently be confirmed by cTnI measurement. However; further studies on specificity and development of a fast, automated assay are necessary before GPBB can be recommended as a routine diagnostic tool.

Objective: The aim of this study was to investigate the effect of thrombolytic therapy on oxidant and antioxidant parameters and glycogen phosphorylase isoenzyme BB (GPBB) concentrations in patients with acute myocardial infarction (AMI). Material and Method: This was a prospective study at an urban academic hospital. We enrolled non-traumatized patients arriving at the emergency department within 3 hours after the onset of chest pain suggestive of AMI. The diagnosis of AMI was established according to clinical features, electrocardiographic findings and increased biochemistry cardiac marker levels. The study was carried out on a total of 75 patients with AMI (50 patients received thrombolytic therapy and 25 patients did not receive thrombolytic therapy), and 45 controls. Blood samples were collected before, and, 2 and 24 hours after tissue-type plasminogen activator therapy Serum malondialdehyde (MDA) and vitamin E were analyzed by high-performance liquid chromatography. Serum total sialic acid and other oxidant and antioxidant parameters were studied spectrophotometrically. Determination of GPBB concentration is based on immunoenzymometric assay. Results: Successful reperfusion was followed by increased serum MDA, protein carbonyls, total sialic acid and GPBB concentrations and by decreased antioxidant vitamins and enzymes. Conclusion: These findings indicate the significance free radical generation processes in reperfusion injury in AMI patients, and suggest the potential involvement of antioxidants in the management of AMI treated by thrombolysis. Also, these parameters especially GPBB can be used for the noninvasive assessment of the effectiveness of thrombolytic therapy.

Objective: Pregnancy is characterized with hyperlipidemia and mild oxidative stress. Paraoxonase1 is an antioxidant enzyme which is also suggested to be involved in lipoprotein metabolism. Our aim was to investigate serum paraoxonase and arylesterase activities and their relation with the lipid profile and oxidative-antioxidative system parameters throughout normal pregnancy. Material and Method: Seventeen healthy pregnant women and 17 age-matched non-pregnant controls were included in the study. Serum paraoxonase and arylesterase activities were determined spectrophotometrically. Plasma malondialdehyde (MDA) level was measured by high-performance liquid chromatography. Serum total antioxidant capacity (TAOC), red blood cell superoxide dismutase and whole blood glutathione peroxidase activities were measured by commercial hits. Lipid profile was studied by routine biochemical methods. Results: There were not any significant differences in either serum paraoxonase or arylesterase activities between the three trimester values and between each trimester level and non-pregnant group. Plasma MDA levels obtained in each trimester were significantly higher than those of the non-pregnant control group, however there were not any significant differences among the three trimesters. TAOC value of the pregnant groups increased significantly throughout pregnancy. However, TAOC levels were significantly lower in each trimester compared with the non-pregnant group. Triglyceride and total cholesterol levels increased throughout pregnancy. Triglyceride and total cholesterol levels obtained at each trimester were significantly higher than those of the nonpregnant group. Conclusion: The results of the present study demonstrated hyperlipidemia and oxidative stress in normal pregnancy, however failed to show any effects of paraoxonase 1 on lipoprotein metabolism or oxidative-antioxidative system parameters in pregnancy.

Aspirin (asetilsalisilik asit), aterotrombotik kardiyovasküler olayların önlenmesinde kullanılan güçlü bir antiagregandır. Ancak aspirinin antiagregan etkinliği tüm hastalarda aynı düzeyde görülmemekte ve bazı hastalar aspirinden yararlanamamaktadır. Bu hastalar klinik olarak aspirin direnci olan hastalar veya aspirine yanıtsız hastalar olarak adlandırılmaktadır. Aspirin direncinin oluşum mekanizmaları henüz tam olarak aydınlatılamamış olup bu konuda çok sayıda araştırma yürütülmektedir. Oksidatif stres özellikle son yıllarda ileri sürülen olası mekanizmalardan bazılarıdır.Bu tezin amacı; koroner arter hastalarında aspirin kullanımının oksidan ve antioksidan parametrelerde yol açtığı değişiklikleri araştırmak ve aspirin direnci ile oksidatif stres arasındaki ilişkiyi incelemektir.Çalışmaya, koroner arter hastalığı olan total 100 hasta (35 kadın, 65 erkek; ortalama yaş 67±10) ile 45 gönüllü kontrol (16 kadın, 29 erkek; ortalama yaş 63±9) alındı. Trombosit fonksiyonu trombosit fonksiyon analizörü (Multiplate Analyzer) ile değerlendirildi. Düzenli aspirin kullanımına rağmen agregasyon biriminin (AU*dak) 300 - 706 arasında bulunması aspirine orta derecede duyarlılık, > 706 bulunması ise aspirin direnci olarak kabul edildi. Hastaların % 7' si (n=7) aspirine dirençli, % 15' i ise (n=15) aspirine orta derecede duyarlı bulundu.Serum malondialdehid (MDA) ve vitamin E konsantrasyonları yüksek performanslı sıvı kromatografisi (HPLC) ile belirlenirken, diğer oksidan ve antioksidan parametreler spektrofotometrik olarak ölçüldü.Aspirin direnci olan hastalarda serum MDA, protein karbonilleri ve total sialik asit konsantrasyonları anlamlı olarak artarken, serum antioksidan etkili vitaminler (vitamin E ve total karoten) ve enzimler (paraoksonaz, arilesteraz ve katalaz) ise anlamlı olarak azaldı. Aspirin direnci ile oksidan parametreler arasında güçlü pozitif korelasyonlar, antioksidan vitamin ve enzimlerle ise zayıf negatif korelasyonlar bulundu.Sonuç olarak; koroner arter hastalarında aspirin direnci oksidan ve antioksidan parametrelerle ilişkilidir. Ancak, kardiyovasküler olaylar için bir risk faktörü olduğu bilinen oksidatif stres ile aspirin direnci arasındaki ilişkiyi daha iyi açıklamak için hala daha ileri çalışmaların yapılmasına gereksinim vardır.Anahtar kelimeler: Aspirin direnci, koroner arter hastalığı, oksidatif stres, antioksidanlar. Aspirin (acetylsalicylic acid) is a powerful antiplatelet agent used in prevention of atherothrombotic vascular events. However, antiplatelet effect of aspirin is not uniform and some patients could not benefit from aspirin. These patients are clinically called as aspirin resistant or aspirin non-responders. Mechanisms of aspirin resistance have not been elucidated yet and a number of research carried out in this issue. Oxidative stress, especially in recent years are some of the suggested possible mechanisms of aspirin resistance.The aim of this thesis was to investigate the changes caused by aspirin in oxidant and antioxidant parameters and to examine the relationship between the aspirin resistance and oxidative stress in patients with coronary artery disease.A total of 100 patients (35 females, 65 males; mean age 67±10 years) with coronary artery disease and 45 voluntary controls (16 females, 29 males; mean age 63±9 years) were enrolled in the study. Platelet function was evaluated by a Multiple Platelet Function Analyzer (Multiplate Analyzer). Moderate sensitivity to aspirin was defined as a 300 - 706 AU*min (agregation unite), and aspirin resistance was defined as a > 706 AU*min despite regular aspirin therapy. 7 % of patients were aspirin resistant and 15 % of patients were moderately sensitive to aspirin by Multiplate Analyzer.While serum malondialdehyde (MDA) and vitamin E concentrations were determined by the high-performance liquid chromatography (HPLC), other oxidant and antioxidant parameters were measured spectrophotometrically.While serum MDA, protein carbonyls and total sialic acid concentrations were significantly increased, serum antioxidant vitamins (vitamin E and total carotene) and enzymes (paraoxonase, arylesterase and catalase) were significantly decreased in patients with aspirin resistance. We found strong positive correlations between aspirin resistance and oxidant parameters and weak negative correlations between aspirin resistance and antioxidant vitamins and enzymes.In conclusion; aspirin resistance is related to oxidant and antioxidant parameters in patients with coronary artery disease. However, there is still need for further studies to better elucidate the relationship between aspirin resistance and oxidative stress, which is now known to be a risk factor for cardiovascular events.Key words: Aspirin resistance, coronary artery disease, oxidative stress, antioxidants. 89

Background: Hemodialysis patients are exposed to oxidative stress, which can lead to several complications. We therefore sought to evaluate the effect of using vitamin E-coated dialysis membranes for a period of 3 months on serum paraoxonase activity and oxidative stress markers. Methods: Twenty patients and 25 healthy controls were included in this study. Hemodialysis patients were evaluated before and after 3 months of treatment with vitamin E-coated dialysis membranes. Plasma malondialdehyde (MDA) levels, as well as the oxidizability of red blood cells (RBCs) and apolipoprotein B-containing lipoproteins (expressed as RBC-MDA and Delta MDA, respectively) were determined in order to investigate the patients' oxidative status. Plasma vitamin E and vitamin C levels, serum total carotenoid levels and paraoxonase activity were measured to investigate the patients' antioxidative defenses. Results: After 3 months of treatment with vitamin E-coated membranes, vitamin E levels were significantly increased and the oxidizability of RBCs was significantly reduced in the hemodialysis patients. However, there were not any differences from baseline in serum paraoxonase activity, plasma MDA levels or the oxidizability of apolipoprotein B-containing lipoproteins in these patients. Conclusions: Despite promising improvements in vitamin E levels and the oxidizability of RBCs, the results of this study do not support a satisfactory antioxidative effect of vitamin E-coated dialysis membranes. Further studies are needed to identify antioxidative treatments for hemodialysis patients.

Akut koroner sendrom (AKS), anstabil angina pektoris (USAP) ve akut miyokard infarktüsünü (AMI) içeren koroner arter hastalıkları tablosudur. AKS tanısı için troponinler (cTnT ve cTnI), kreatin kinaz MB (CKMB) ve miyoglobin günümüzde tercih edilen biyokimyasal belirteçler olarak kabul edilmektedir. Son zamanlarda önerilen yeni belirteçler arasında glikojen fosforilaz BB izoenzimi (GPBB), AKS'un erken tanısı için en ümit verici olanıdır. Biyokimyasal belirteçler trombolitik tedavinin başarısını izlemede de önemli bir role sahiptir. Reperfüzyon, serbest oksijen radikallerinin aracılık ettiği geçici veya kalıcı miyokardiyal hasar (reperfüzyon hasarı) ile sonuçlanabilir. Serbest oksijen radikalleri membran lipid ve proteinlerinin peroksidasyonuna neden olur. Bu çalışmanın amacı, AKS'lu hastalarda miyokardiyal iskeminin tanısında GPBB'nin tanısal etkinliğini araştırmak ve trombolitik tedavinin oksidan ve antioksidan parametreler üzerindeki etkisini göstermektir.Çalışmamıza, AKS'u düşündüren göğüs ağrısı şikayeti ile acil servise başvuran 72 non?travmatize hasta alındı. Hastaların 45'ine AMI tanısı konulurken, 27 hastaya da USAP tanısı konuldu. AMI tanısı konulan hastaların 20'sine trombolitik tedavi uygulandı.cTnI, CKMB ve miyoglobin ölçümleri otoanalizörde yapıldı. Plazmada GPBB konsantrasyonunun tayini ELISA kiti kullanılarak yapıldı. Serum malondialdehid (MDA) ve vitamin E konsantrasyonları yüksek performanslı sıvı kromotografisi ile belirlenirken, diğer oksidan ve antioksidan göstergeler ile lipid parametreleri ise spektrofotometrik yöntemler ile ölçüldü.AKS'lu hastalarda GPBB, miyoglobin, CKMB ve cTnI'nın tanısal etkinliğini karşılaştırdığımızda, acil servise ilk gelişte özellikle GPBB diğer kardiyak belirteçlere göre en yüksek duyarlılık, negatif tahmin değeri ve ROC eğri altı alanı ile en düşük negatif olabilirlik oranı gösterdi. Fakat özgüllüğü daha düşüktü.Trombolitik tedavi alan AMI'lü hastalarda serum MDA, protein karbonilleri, total sialik asit ve GPBB konsantrasyonları anlamlı olarak artarken, antioksidan vitamin ve enzimler ise anlamlı olarak azaldı.Sonuç olarak, GPBB, AKS'un erken laboratuar tanısı için ümit verici bir enzimdir. Ayrıca, trombolitik tedavinin etkinliğinin non-invaziv olarak değerlendirilmesi için de kullanılabilir. Ancak GPBB rutin bir tanı aracı olarak önerilmeden önce özgüllüğü ve hızlı, otomatize ölçüm yöntemlerinin geliştirilmesi üzerine daha ileri araştırmalar gereklidir.Hem antioksidan parametrelerde azalma hem de oksidan parametrelerde artma trombolitik tedavi alan AMI'lü hastalarda reperfüzyon hasarının gelişiminde serbest radikal üreten sistemlerin önemini göstermektedir. Bu nedenle, bu hastalar iskemi-reperfüzyon hasarının önlenmesi için antioksidan vitaminlerin uygulanmasından yarar sağlayabilir.Anahtar kelimeler: Akut koroner sendrom, glikojen fosforilaz izoenzim BB, trombolitik tedavi, reperfüzyon hasarı, oksidan ve antioksidan parametreler. SUMMARYInvestigation of the Role of Glycogen Phosphorylase Isoenzyme BB in Early Diagnosis of Acute Coronary Syndrome and the Effect of Thrombolytic Treatment on Oxidant and Antioxidant ParametersAcute coronary syndrome (ACS) encompasses a spectrum of coronary artery diseases, including unstable angina pectoris (USAP) and acute myocardial infarction (AMI). For the diagnosis of ACS, troponins (cTnT and cTnI), creatine kinase MB (CKMB) and myoglobin are currently regarded as the preferrred biochemical markers. Among the recently proposed new markers, glycogen phosphorylase isoenzyme BB (GPBB) is the most promising marker for the early diagnosis of ACS and could probably act as a marker of ischemia. Biochemical markers will also have an important role in monitoring the success of thrombolytic therapy. Reperfusion may result in transient or permanent myocardial injury (reperfusion injury), assumed to be free oxygen radical mediated. Free oxygen radicals cause peroxidation of the membrane lipids and proteins. The aim of this study was to investigate the diagnostic performance of GPBB in identifying myocardial ischemia in patients with ACS and to show the effect of the thrombolytic therapy on the oxidant and antioxidant parameters.We included 72 non-traumatized patients arriving at the emergency department with chest pain suggestive of ACS. Forty five patients had an AMI and 27 patients had USAP. Twenty of the patients who had AMI diagnosis has undergone thrombolytic therapy.The measurements of cTnI, CKMB and myoglobin were done by using an automatic analyzer. Determination of GPBB concentrations in plasma was performed by using a commercially available ELISA kit. While serum malondialdehyde (MDA) and vitamin E concentrations were determined by the high-performance liquid chromotography, other oxidant and antioxidant markers and the levels of lipid parameters were measured by using spectrophotometric methods.When we compared the diagnostic performances of GPBB, myoglobin, CKMB and cTnI in patients with ACS, on emergency admission, especially GPBB showed the highest sensitivity, negative predictive value and receiver-operating characteristic (ROC) area under curve and the lowest negative likelihood ratio compared to other cardiac biomarkers, but it showed lower specificity.While serum MDA, protein carbonyls, total sialic acid and GPBB concentrations were significantly increased, serum antioxidant vitamins and enzymes were significantly decreased in AMI patients receiving thrombolytic therapy.In conclusion, GPBB is a promising enzyme for the early laboratory detection of ACS. Also, it may be useful for assessing the effectiveness of thrombolytic therapy non?invasively. However, further studies on specificity and development of a fast, automated assay are necessary before GPBB can be recommended as a routine diagnostic tool.Both reduction in antioxidant parameters and elevation in oxidant parameters indicate the significance of free radical generating processes in reperfusion injury in AMI patients receiving thrombolytic therapy. Therefore, these patients may benefit from administration of antioxidant vitamins for prevention of ischemia-reperfusion injury.Key words: Acute coronary syndrome, glycogen phosphorylase isoenzyme BB, thrombolytic treatment, reperfusion injury, oxidant and antioxidant parameters. 113

Objective -Acute coronary syndromes (ACS) encompass a continuum of cardiac ischaemic events, ranging from unstable angina pectoris (UA) to ST-segment elevation myocardial infarction (STEMI). Oxidative stress may play an important role in the pathogenesis of acute coronary diseases. In the present study, we examined the associations between lipid and protein susceptibility to oxidation and total sialic acid (SA) and antioxidant status and the severity of ACS as determined by having UA, non-STEMI or STEMI. Methods and results - The study sample consisted of 102 patients with ACS and 45 controls. Malondialclehyde (MDA) as a marker of lipid peroxiclation and protein carbonyls as a marker of protein oxidation were measured to show the susceptibility to oxidation. Antioxidant status was determined by measuring the carotenoids, vitamin C and vitamin E levels and paraoxonase and arylesterase activities. In addition to conventional lipid and lipoprotein analysis, MDA and vitamin E were quantitated by high-performance liquid chromatography. Total SA and other oxidant and antioxidant parameters were studied spectrophotometrically. As expected, patients had significantly higher total cholesterol, triacylglycerol, low-density lipoprotein cholesterol, lipoprotein (a), apolipoprotein (apo) B values and lower high-density lipoprotein cholesterol and apoAl values than controls. Our results demonstrated significant increases both in total SA levels and in indicators of oxidative stress in patients with ACS compared with the controls. However, antioxidant parameters were decreased in patients with ACS. When the patients were divided into groups with UA, non-STEMI and STEMI, respectively, total SA and oxidant parameters were significantly increased and antioxidant parameters were significantly decreased in going from UA to STEMI. Conclusions - Our study shows gradually increased lipid and protein oxidation and total SA and gradually decreased antioxidant status when the conditions advance from UA to STEMI. These results indicate that these markers may be useful both in understanding plaque destabilization and in determination of risk stratification of patients. Also, measurement of these markers may provide a non-invasive window to study atherosclerotic lesions.

Background: Hemodialysis (1413) patients are exposed to oxidative stress which contributes to cardiovascular disease (CVD). The purpose of this study was to investigate the oxidative and antioxidative status in HD patients with (CVD+, n = 38) and without (CVD-, n = 67) prevalent CVD. Patients and methods: A total of 105 HD patients and 21 healthy controls were assessed for lipid peroxidation indices (plasma malondialdehyde (MDA)), oxidizability of apolipoprotein B-containing lipoproteins (apo B-AMDA) and red blood cells (RBC-MDA) together with various components of the antioxidant system in plasma (paraoxonase/arylesterase activities, total carotenoids, vitamins C and E) and RBC (superoxide dismutase and glutathione peroxidase activities). Results: Plasma MDA and RBC-MDA were significantly higher, vitamin C and total carotenoid levels were significantly lower in both CVD+ and CVD- HD groups than in the control group. Plasma MDA levels were significantly higher and serum paraoxonase activity, uric acid and albumin levels were significantly lower in patients with CVD+ HD patients compared to those of the CVD- patients. Conclusion: This study suggests that the elevated level of plasma MDA and the lower activity of paraoxonase could contribute to the increased incidence of cardiovascular disease in hemodialysis patients.

Çalışmanın amacı, miyokard infarktüsünde ek tedavi olarak, N-asetil sisteinin (NAS) oksidatif stres, infarkt büyüklüğü ve QT dispersiyonu üzerine olan etkisinin değerlendirilmesidir. Akut miyokard infarktüsü (Mİ) geçiren hastalar, streptokinaz ile birlikte 24 saat süreyle intravenöz infüzyon şeklinde 15 gram N-asetil sistein alanlar (n=15) ve almayanlar (n=15) şeklinde iki gruba ayrıldı. Oksidatif stresin değerlendirilmesi için kabulde, 4 saatte ve 24. saatte plazma malondialdehid (MDA) düzeyleri ölçüldü. Tüm hastaların başlangıçta, 4. ve 24. saatte 50 mm/sn ile 12 derivasyonlu elektrokardiyografileri çekilerek QT dispersiyonları ve “Bazett” formülü ile hıza göre düzeltilmiş QT dispersiyonları hesaplandı. Reperfüzyonun değerlendirilmesi için koroner anjiyografi yapıldı. Kabulde her iki grup arasında plazma MDA düzeyleri arasında farklılık yoktu. N-asetil sistein ile tedavi edilen hastalarda, plazma MDA düzeyleri azalırken, NAS ile tedavi edilmeyen hastalarda, plazma MDA düzeyleri 4. saat ve 24. saatte artış gösterdi (sırasıyla p=0.001 ve p=0.0001). 24. saatte NAS alan hastalarda, NAS almayan hastalara göre, QT dispersiyonu (p=0,04) ve hıza göre düzeltilmiş QT dispersiyonunun yüzde değişiminde (p=0.03) anlamlı olarak azalma izlendi. NAS tedavisi, iskemi reperfüzyon sırasında lipid peroksidasyonunu ve sonucunda QT dispersiyonunu anlamlı olarak azaltabilmektedir The aim of this study was to assess the effect of N-acetylcysteine (NAC) treatment, as an adjunct therapy in myocardial infarction on oxidative stress, infarct size and dispersion of QT. Patients with acute myocardial infarction received either 15 mgc of NAC infused intravenously over 24 hours (n=15) or no NAC (n=15), combined along with streptokinase. In order to assess the oxidative stres, plasma malondialdehyde (MDA) level was measured at admission and after 4 and 24 hours. For all patients, QT dispersion (QTd) and Bazett rate corrected QTc dispersion (QTcd) were measured from a high quality 12 lead ECG recorded at 50 mm/s on admission, at 4 and 24 hours. Coronary angiography were performed to assess reperfusion. At admission, plasma MDA levels were not different between the groups. In the NAC treated patients percent plasma MDA changes according to the baseline decreased whereas in the NAC non-treated patients percent MDA changes increased at 4 and 24 hours (p=0.001 and p=0.0001, respectively). Significant decreases in the percent QTd (p=0,04) and QTcd (p=0.03) period changes were observed in patients treated with NAC compaired to patients treated without NAC at 24 hours. N-acetylcysteine treatment reduces lipid peroxidation during ischemia and reperfusion and decreases QT dispersion.

The aim of this study was to investigate the possible relationship between serum total sialic acid (TSA) concentration, recently shown to be a cardiovascular risk factor, and lipid and protein oxidation and antioxidant status and the severity of coronary artery disease (CAD) according to the obstructive vessel number in patients. The study was carried out on a total of 200 patients (142 men and 58 women) who were hospitalized for elective coronary angiographic evaluation with complaint of typical angina pectoris. According to the results of angiography, 150 patients had angiographically proven CAD (CAD group) and 50 patients had a history suggestive of angina pectoris but normal coronary angiograms (control group). The CAD group was further divided into single-, double- and triple-vessel disease groups according to the number of vessels involved. Lipid parameters were determined by routine laboratory methods. Plasma malondialdehyde (MDA) and vitamin E concentrations were determined by high-performance liquid chromatography. TSA and other oxidant and antioxidant parameters were studied spectrophotometrically. Our results demonstrated significant increases both in TSA levels and in indicators of oxidative stress in the patients with CAD compared with the controls. However, antioxidant parameters were decreased in the patients with CAD. We found strong positive correlations between TSA and plasma MDA, Delta-MDA which represents the degree of oxidative modification of apolipoprotein B-containing lipoproteins, serum protein carbonyls and apolipoprotein B and weak correlations between TSA and low density lipoprotein cholesterol, triacylglycerol, paraoxonase, glutathione peroxidase (GPx), vitamin C and vitamin E. In conclusion, TSA is related to markers of lipid and protein oxidation, paraoxonase and GPx activities, vitamin C and E levels and the severity of CAD.

Background: Black tea is known to have protective effects against plasma lipid and lipoprotein oxidation, but its influence on lipid peroxidation in tissue has been less studied. The effect of oral black tea consumption on protein oxidation has also not been demonstrated. The present study investigated the antioxidant effects of oral black tea consumption. Material/Methods: Male Sprague-Dawley rats were fed a regular murine chow diet. The controls were supplied With water ad libitum, while the black tea group received aqueous black tea extract as the sole source of liquids. At the end of the ten-week experimental period, intestinal brush border, liver and kidney reduced-glutathione concentrations were evaluated as an index of cellular antioxidant defence. Plasma and tissue malondialdehyde concentrations and plasma protein carbonyl content were measured to evaluate lipid peroxidation and protein oxidation, respectively. Results: The plasma malondialclehyde and protein carbonyl contents of rats consuming the black tea were significantly less than in controls. Similarly, liver and kidney malondialdehyde concentrations were significantly lower in the experimental group, while jejunoileal mucosa were not affected. Ten weeks of black tea administration caused significantly higher reduced-glutathione levels in the kidneys of black tea-administered rats, and a significant negative correlation was observed between kidney malondialdehyde and glutathione concentrations. Conclusions: These findings provide evidence that long term black tea supplementation is capable of protecting both plasma proteins and plasma lipids from oxidative injury, and demonstrate that chronic black tea administration protects both liver and kidney tissues - but not the jejunoileal mucosa against oxidation.

Vanadyl sulfate (VS) may reduce oxidative stress related to its hypoglycemic and hypolipidemic effects in diabetes mellitus; besides, as a catalytic element, it may induce lipid peroxidation. Studies investigating effects of VS on the oxidative-antioxidative systems in diabetes yielded conflicting results, and this study was designed to investigate the effects of VS on the oxidative-antioxidative systems in streptozotocin-induced (65 mg/kg) diabetic rats. Vanadyl sulfate was administered in drinking water 0.75 mg/mL during 5 weeks after the induction of diabetes. Thirty-two male Wistar rats were randomly divided into four groups: control (C), control + vanadyl sulfate (C + VS), diabetes (D), and diabetes + vanadyl sulfate (D + VS). Vanadyl sulfate reduced the enhanced glucose, lipid, and tissue malondialdehyde levels and increased the reduced serum paraoxonase and arylesterase activity in the D + VS group. Plasma malondialdehyde level was significantly increased in the C + VS group, compared with the control group. Erythrocyte glutathione peroxidase activity was significantly higher in the C + VS and D + VS groups, compared with the C and the D groups, respectively.The results of the present study suggest that (i) VS has antioxidative potential in streptozotocin-treated rats, and it might be used as a supportive therapeutic agent in uncontrolled diabetes; (ii) VS treatment might play a role in the improvement of serum paraoxonase activity and, thus, inhibit the progression of atherosclerosis; (iii) the prooxidant potential of the VS should be taken into account.

Recent evidence suggests that postischemic myocardial dysfunction (“stunning”) may be mediated by oxygen free radicals. Various studies have reported the beneficial effects of antioxidants in ischemia–reperfusion injury. The aim of this study was to assess the effect of N-acetylcysteine (NAC) treatment on oxidative stress, infarct size, and left ventricular (LV) function, as adjunct therapy in myocardial infarction (MI). Patients with acute MI received either 15 g NAC infused over 24 h (n = 15) or no NAC (n = 15), combined with streptokinase. Peripheral venous blood was serially sampled to measure creatine kinase (CK)-MB levels. Plasma malondialdehyde (MDA) level was measured at admission and after 4 and 24 h. Echocardiography was performed within 3 days of MI and after 3 months. At admission, plasma MDA levels were not different between the groups. In the NAC-treated patients plasma MDA levels decreased, whereas in the nontreated NAC patients MDA levels increased at 4 and 24 h (P < 0.01 and P < 0.001, respectively). Left ventricular ejection fraction was higher (P < 0.05) and LV end-systolic and end-diastolic diameters were lower (P < 0.001 and P < 0.001) in patients receiving NAC on day 3. Left ventricular wall motion score index was significantly lower in patients treated with NAC on day 3 (P < 0.05). Left ventricular diastolic parameters were not different whether patients were treated with NAC or not. No difference in reduction of infarct size was detected between the groups according to CK-MB levels. It was thus demonstrated that administration of NAC in combination with streptokinase significantly diminished oxidative stress and improved LV function in patients with acute MI. These encouraging results would justify the performance of a larger controlled study.

Objective: This study was performed to evaluate the effects of 0.9% saline (SAL), 0.9% saline + sodium bicarbonate + mannitol (SAL/BIC/MAN), and hypertonic saline-dextran (HSD) on hemodynamic variables, tissue blood flow, and oxidant injuries in experimental traumatic rhabdomyolysis (TR) in rats subjected allogeneic muscle extract infusion. Design: Prospective, randomized, experimental. Setting: Physiology experiment laboratory. Subjects: Male Sprague-Dawley rats, weighing 250–300 g. Interventions: All groups (n = 8 each) underwent femoral artery and vein catheterization. The animals in the TR, SAL, SAL/BIC/MAN, and HSD groups received an infusion of 2 mL of autologous muscle extract for 60 mins. After autologous muscle extract infusion, the SAL and HSD groups received 30 mL/kg 0.9% saline for 30 mins or 4 mL/kg HSD for 5 mins, respectively. The SAL/BIC/MAN group received 30 mL/kg 0.9% saline for 30 mins plus a bolus of 1 g/kg mannitol and a bolus of 2 mEq/kg sodium bicarbonate diluted in 1 mL of saline. At 2 hrs of autologous muscle extract infusion, erythrocyte flows in liver and kidney were measured by using a laser Doppler flowmeter. Then, blood samples and kidney and liver biopsies were taken to measure levels of glutathione and malondialdehyde. Measurements and Main Results: TR caused decreases in mean arterial pressure, tissue blood flow, and tissue glutathione and an increase in malondialdehyde. Rats in the HSD group had significant metabolic acidosis. SAL resuscitation did not correct tissue blood flow and prevent oxidant injury. HSD increased tissue blood flow, mean arterial pressure, and liver and kidney glutathione and decreased serum, liver, and kidney malondialdehyde. SAL/BIC/MAN resuscitation corrected all oxidant damage variables but did not increase tissue blood flow. SAL/BIC/MAN preserved serum malondialdehyde and liver glutathione better than the HSD did. Conclusions: HSD prevented oxidant injury and restored tissue blood flow but increased metabolic acidosis that followed autologous muscle extract infusion. SAL/BIC/MAN seems to be more effective than HSD in decreasing oxidant injury. Further research on the effects of the solute overload and metabolic acidosis due to HSD resuscitation on renal function in experimental rhabdomyolysis is warranted.

Thyroid hormones are associated with the oxidative and antioxidative status of the organism. Since data on the oxidative status of hypothyroidism are limited and controversial, we investigated the oxidant and antioxidant status and serum paraoxonase/arylesterase activities in propylthiouracil-induced hypothyroidism and examined the effect of vitamin E supplementation on this experimental model. Forty male Sprague Dawley rats were randomly divided into four groups (group 1, control; group 2, control + vitamin E; group 3, propylthiouracil; group 4, propylthiouracil + vitamin E). Plasma, red blood cell, liver, heart and skeletal muscle malondialdehyde levels were increased in the propylthiouracil-treated group compared with the control rats and were decreased in propylthiouracil + vitamin E group compared with the propylthiouracil-treated group. Vitamin E supplementation also significantly increased liver and kidney reduced glutathione levels in propylthiouracil treated animals. Serum paraoxonase and arylesterase activities were decreased in propylthiouracil treated group and vitamin E supplementation caused significant increase in serum paraoxonase activity compared with the propylthiouracil-treated rats. These findings suggest that hypothyroidism is accompanied with increased oxidative stress and vitamin E supplementation exerts beneficial effects on this situation.

Objective: Obesity is a well-known risk factor of atherosclerosis. Recent studies showed that obesity is associated with enhanced lipid peroxidation. The aim of this study is to investigate the effect of weight reduction with orlistat treatment on lipid peroxidation levels. We assessed lipid peroxidation by measuring the concentration of plasma malondialdehyde (MDA). Design: A randomized, controlled, open-label 6-month study. Subjects: In total, 36 obese (body mass index (BMI) 430 kg/m(2)) and 11 healthy age-matched control subjects were enrolled in the study. Measurements: Fasting glucose, triglyceride, total cholesterol, HDL cholesterol and LDL cholesterol and MDA levels were measured in both groups. Obese subjects received orlistat, 120 mg three times daily together with hypocaloric diet. After 6 months of treatment laboratory tests were repeated. Results: MDA levels were significantly higher in obese patients than the control group (P

The purpose of this study was to investigate the oxidative status in experimental hypothyroidism and the antioxidant effect of taurine supplementation. Forty male Sprague Dawley rats were randomly divided into four groups (group 1, control; group 2, control + taurine; group 3, propylthiouracil (PTU); group 4, PTU + taurine). Hypothyroidism was induced by giving 0.05% PTU in drinking water for 8 weeks. Taurine was supplemented in drinking water at a concentration of 1 % for 5 weeks. Plasma (p < 0.05), red blood cell (p < 0.01), liver (p < 0.001) and kidney tissue (p > 0.05) malondialdehyde levels were increased in the PTU group compared with those of the control rats and were decreased in the PTU + taurine group compared with the PTU alone group. No significant changes were observed in glutathione levels of kidney and liver in the PTU group, but taurine supplementation significantly increased the glutathione levels of these tissues. Paraoxonase and arylesterase activities were decreased in the PTU group while taurine supplementation caused no significant changes in paraoxonase and arylesterase activities. These findings suggest that taurine supplementation may play a protective role against the increased oxidative stress resulting from hypothyroidism.

Başlıca yağ dokusu tarafından sentezlenen ve salgılanan leptin, hipotalamus’daki spesifik reseptörlerine etki ederek enerji alımı ve enerji harcanması arasındaki dengeyi düzenleyerek bir tür antiobezite faktörü olarak fonksiyon görür. Üreme, hematopoez, gastrointestinal fonksiyonların düzenlenmesi, anjiyogenez, sempatik sinir sistemi aktivasyonunun düzenlenmesi, kemik yoğunluğunun belirlenmesi, termogenez ve beyin gelişimi gibi birçok fonksiyonunun da olduğu saptanan leptinin, sentez ve salgılanmasında birçok faktör rol oynar. Bu derlemede, literatür bilgisi ışığında leptinin genel özellikleri ve fonksiyonları tartışılacaktır. Leptin, which is primarily synthesized and secreted by adipose tissue, functions as a type of anti-obesity factor by regulating the balance between energy uptake and consumption via the receptors in the hypothalamus. Numerous factors play a role in the synthesis and secretion of leptin. It has been reported that leptin has a number of functions in reproduction, hematopoiesis, regulation of gastrointestinal functions, angiogenesis, regulation of sympathic nerve system activation, determination of bone density, thermogenesis, and brain development. In this review, the general characteristics and functions of leptin will be discussed in the light of literature.

To monitor the ischemic and/or reperfusion injury after porta hepatis occlusion (Pringle maneuver) in livers subjected to hypotension, serum alanine amino transferase (ALT), liver malondialdehyde, (MIDA), and liver glutathione (GSH) levels were measured. MDA is a by-product of oxidant-induced lipid peroxidation, and GSH is an endogenous antioxidant. The effects of lactated Ringer's (LR) and hypertonic saline (7.5%)/Dextran (6%; HSD) resuscitation on liver injury, if any, was investigated. Rats in sham (S, n = 8) and five other groups (n = 8) underwent femoral artery and vein catheterization and laparotomy. The hemorrhage and ischemia (HI) group was bled 30% of their blood volume and had their porta hepatis occluded for 30 min. The HI, LR, and HSD groups underwent both hemorrhage and occlusion. Thirty minutes after hemorrhage, the LR and HSD groups received either LR (equivalent to three times the shed blood) or HSD (10 mL/kg) resuscitation over 30 min. Both LR and HSD resuscitation lowered the increased ALT and liver tissue MDA seen in the HI group. ALT was decreased from 348 +/- 93 IU/L in the HI group to 200 +/- 98 IU/L in the LR and 139 +/- 74 IU/L in the HSD groups. Liver tissue MDA was 353 +/- 22 nmol/g/tissue in the HI group and LR decreased it to 261 +/- 17 nmol/g/tissue, whereas HSD decreased it to 273 +/- 20 nmol/g/tissue. The decrease in ALT and the increase in liver GSH were more pronounced with HSD resuscitation (P < 0.05). HSD seems to be more effective than LR in decreasing the liver tissue damage produced by total hepatic inflow occlusion under hypovolemic conditions.

BACKGROUND Oxidized lipoproteins may play an important role in the pathogenesis of atherosclerosis, and it has been shown that antioxidants have a protective effect against the progression of atherosclerosis. HYPOTHESIS The aim of this study was to investigate the oxidative susceptibility of apolipoprotein B-containing lipoproteins and antioxidant status in patients with acute coronary syndromes and chronic stable angina pectoris. METHODS The study population included 70 patients with acute coronary syndromes (14 with recent acute myocardial infarction and 56 with unstable angina pectoris), 105 patients with stable angina pectoris, and 75 control subjects. In addition to conventional lipid and lipoprotein analysis, the susceptibility of apolipoprotein B-containing lipoproteins to in vitro oxidation (lag phase) and plasma vitamin E and total carotene levels was measured. RESULTS The lag phase was significantly shorter in patients with acute coronary syndromes (45 +/- 12 min) than in patients with stable angina pectoris (51 +/- 10 min) and in control subjects (58 +/- 9 min) (p < 0.0001). Both plasma vitamin E and total carotene levels were lowest in patients with acute coronary syndromes (1.11 +/- 0.32 mg/dl and 119 +/- 32 micrograms/dl, respectively), followed by patients with stable angina pectoris (1.25 +/- 0.37 mg/dl and 132 +/- 37 micrograms/dl) and then controls (1.52 +/- 0.31 mg/dl and 167 +/- 41 micrograms/dl). CONCLUSIONS These data suggest that there is an intense oxidative process and a lower antioxidant status in acute coronary syndromes. This may lead to plaque instability due to the activation of the inflammatory response in coronary atherosclerotic lesions.

Bu çalışmada, serum total kalsiyum ölçümünde kullanılan titrimetrik ve kolorimetrik yöntemlerin kıyaslanması amaçlandı. Titrimetrik yöntem olarak kompleksometri yöntemi, kolorimetri yöntem olarak ta methylthymol Blue (MTB) yöntemi hem manuel olarak, hem de otoanalizörde çalışıldı. Ölçümler aynı serum havuzundan ayrılan örneklerde yapıldı. Çalışmaları sonucunda deney içi değişkenlik katsayısı (%CV) kompleksometri yönetim için %1. 78, manuel çalışılan MTB yöntemi için %1.65 ve otoanalizörde çalışılan MTB yönetim için de %1.16 olarak saptandı. Deneyler arası %CV değerleri ise kompleksometri yöntemi için %3. 07, manuel çalışılan .'MTB yöntemi için %2.58 ve otoanalizörde çalışılan MTB yöntemi için de %1 66 bulundu. "Recovery" değerleri ise kompleksometri yöntemi için %96, manuel MTB yöntemi için %98, otoanalizörde çalışılan MTB yöntemi için ise %101 olarak bulundu. Sonuç olarak, manuel çalışılan kolorimetrik MTB yönteminin linearite sınırı ve "recovery" değerlerinin daha yüksek, % CV değerlerinin ise otoanalizör değerlerine daha yakın olması nedeniyle, titrimetrik kompleksometri yöntemine göre daha güvenilir olduğu kanısına varıldı. In this study we have aimed at comparing the titrimetric and colorinıetric methods which are used to measure total calcium in serum. Complexometry as a titrimetric method and "Methylthymol Blue" (MFB) as a colorimetric method have been studied. The method of MTB has been used both manually and in an autoanalyzer. The measurements have been carried out in the samples obtained from the same serum pool. As a result of our studies, intra-assay Coefficient of Variation (% CV) for complexometry, MTB (manual) and for MTB (in an autoanalyzer) has been found to be 1. 78%, 1.65% and 1.16% respectively, but interassay% CV has been found to be 3. 07 %, 2. 58 % and 1. 66 % respectively. Analytical recovery for complexometry and MTB (manual) and for MTB (in an autoanalyzer) methods has been found to be 96 %, 98% and 101% respectively. Finally, it is seen that the colorimetric MTB (manual) method has wider ranges of linearity and higher analytical recovery than the titrimetric complexometric method and also its CV% is closer to the autoanalyzer. So we can say that it is much more reliable and sensitive than the titrimetric complexometric method.