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Introduction: The present study aimed to investigate the role of plasma presepsin in the early detection of septic shock and in determining the prognosis and mortality of patients with sepsis. Methodology: The study was conducted in the emergency department between 1 January 2017 and 1 July 2017. A total of 106 patients 18 years of age or older who were diagnosed with sepsis according to the quick sequential organ failure assessment (qSOFA) criteria were included in this prospective study. The patients’ symptoms, vital signs, additional diseases, demographic attributes, laboratory results, Mortality in Emergency Department Sepsis (MEDS) scores, imaging findings and treatments were recorded. Moreover, the patients’ blood samples were collected to measure plasma presepsin, procalcitonin and CRP levels. Results: In total, 55.7% of the patients were female. The median age of the patients was 78 (24–103) years, and their 30-day mortality rate was 67%. The presepsin level was significantly higher in the sepsis group than in the healthy control group (p < 0.001). The presepsin levels did not differ significantly between the sepsis and septic shock groups (p = 0.12). Similarly, the procalcitonin levels did not differ significantly between the sepsis and septic shock groups (p > 0.05). There was no significant difference in the presepsin, procalcitonin and CRP levels between survivor and non-survivor patients (p = 0.74). Conclusions: The plasma presepsin level was found to be ineffective in determining the incidence of septic shock and mortality in patients with sepsis in the emergency department.

Purpose: Recent studies indicate that plasma heart-type fatty acid binding-protein (H-FABP) concentration can be used as an early biochemical marker for macrovascular diseases. Patients with primary hyperparathyroidism (PHT) reportedly display an increase in cardiovascular (CV) risk factors. Our aim was to evaluate plasma H-FABP concentration in these subjects with primary hyperparathyroidism, by comparing them with healthy controls.

Purpose: Overt hypothyroidism affects mostly women with an increasing prevalence with age. Hypothyroidism is associated with accelerated atherosclerotic cardiovascular diseases possibly caused by the higher incidence of hyperlipidemia, insulin resistance, and hypertension. Heart-type fatty acid-binding protein (H-FABP) is specific for cardiomyocytes and a sensitive marker of myocardial injury. The purpose of this study was examining the effect of hypothyroidism on H-FABP levels and carotid artery intima-media thickness (CIMT). Material and Method: We measured serum H-FABP levels in 33 patients with overt hypothyroidism and age, gender, and body mass index-matched 39 control subjects. The patients were newly diagnosed with Hashimoto’s thyroiditis. All participants underwent high-resolution B-mode ultrasonography for the measurement of CIMT. Results: There was no significant difference in serum levels of H-FABP between the patient group and controls (1515.87±2143.0 pg/mL vs. 953.0±416.0 pg/mL, respectively; p=0.15). CIMT level was significantly higher in the patient group than in the control group (0.53±0.08 mm vs. 0.48±0.05 mm; p=0.02). However, the homeostasis model assessment of insulin resistance and fasting insulin levels did not differ between the two groups. Discussion: Based on the results of this study, we assume that H-FABP is not a useful marker in detecting preclinical atherosclerosis in patients with overt hypothyroidism associated with Hashimoto’s thyroiditis, however, CIMT might be a useful marker in detecting early atherosclerosis.

SummaryBachground: Sample classification and registration have been recognized as important and time-consuming processes in laboratories. There is increasing pressure on laboratories to automate processes due to intense workload and reduce manual procedures and errors. The aim of the present study was to evaluate the positive effects of an automatic tube registration and sorting system on specimen processing.Methods: An automatic tube registration and sorting system (HCTS2000 MK2, m-u-t AG, Wedel, Germany) was evaluated. Turnaround time (TAT), rate of sample rejection and unrealized tests were examined 12 months pre- and post-implementation of the automatic tube sorting and registration system.Results: The mean TAT of routine chemistry immunoassay, complete blood cell count (CBC) and coagulation samples were significantly improved (P0.05).Conclusions: By reducing delays and errors in the preanalytical processing and sorting of samples, significant improvements in specimen processing were observed after implementation of the system. These results suggest that an automatic tube registration and sorting system may also be used to improve specimen processing in a higher-volume core laboratory.

Sample classification and registration have been recognized as important and time-consuming processes in laboratories. There is increasing pressure on laboratories to automate processes due to intense workload and reduce manual procedures and errors. The aim of the present study was to evaluate the positive effects of an automatic tube registration and sorting system on specimen processing.An automatic tube registration and sorting system (HCTS2000 MK2, m-u-t AG, Wedel, Germany) was evaluated. Turnaround time (TAT), rate of sample rejection and unrealized tests were examined 12 months pre- and post-implementation of the automatic tube sorting and registration system.The mean TAT of routine chemistry immunoassay, complete blood cell count (CBC) and coagulation samples were significantly improved (By reducing delays and errors in the preanalytical processing and sorting of samples, significant improvements in specimen processing were observed after implementation of the system. These results suggest that an automatic tube registration and sorting system may also be used to improve specimen processing in a higher-volume core laboratory.Klasifikacija i registracija uzoraka u laboratorijama prepoznate su kao važni i dugotrajni procesi. Laboratorije su pod sve većim pritiskom da automatizuju postupke zbog velikog obima posla i smanje manuelne procedure i greške. Cilj ove studije bio je da se procene pozitivni efekti jednog sistema za automatsko registrovanje i sortiranje uzoraka na njihovu obradu.Ocenjivali smo sistem za automatsko registrovanje i sortiranje uzoraka (HCTS2000 MK2, m-u-t AG, Wedel, Nemačka). Ukupno vreme za obradu uzorka (Srednje ukupno vreme obrade uzoraka za rutinske hemijske imunoeseje, kompletnu krvnu sliku i koagulaciju bilo je znacajno bolje (Zahvaljujući relim slučajevima kašnjenja i ređim greškama prilikom preanalitičke obrade i sortiranja uzoraka, uočena su značajna poboljšanja u obradi uzoraka posle implementacije ovog sistema. Naši rezultati pokazuju da se sistemi za automatsko registrovanje i sortiranje mogu koristiti radi poboljšane obrade uzoraka i u centralnim laboratorijama sa velikim obimom posla.

Objective: Erythrocyte Sedimentation Rate (ESR) can be used for the follow-up of number of diseases. In recent years, closed automated systems that measure ESR directly from a capped EDTA and citrate blood sample tube have been developed. In this study, we aimed to compare and evaluate the consistence of assay results of iSed Alcor Auto-instrument and Berkhun SDM60 Auto-instrument. Methods: K2EDTA and citrated blood samples were taken from 149 randomly selected outpatients. The ESR of blood samples in tubes containing K2EDTA was determined by iSed Alcor Auto-instrument whereas Berkhun SDM60 Auto-instrument was used to determine the ESR of blood samples in tubes containing citrate. Results: The mean ± SD ESR was 24.48 ± 23.10 mm/hr (95% CI for the mean was 20.54–28.02 mm/hr) for iSed Alcor Auto-instrument and 23.94 ± 17.24 mm/hr (95% CI for the mean was 21.15–26.73 mm/hr) for the Berkhun Auto-instrument. We found the mean difference between two methods as 0.336 mm/hr (95% CI for the mean was −2.06 to 1.39 mm/hr; P = 0.701). The obtained correlation coefficient was 0.90 (P = 0.0001). There was no evidence of systemic bias, equal to 0.3 mm/hr (limits of agreement, –20.6 to 21.2 mm/hr). Conclusion: iSed Alcor Auto-instrument and Berkhun SDM60 Auto-instrument might be used as alternative systems each other. However, it should be monitored carefully in especially high ESR (>50 mm/hr) results and the results should be checked according to the Westergren method. J Clin Exp Invest 2014; 5 (3): 371-375, Amaç: Eritrosit Sedimentasyon Hızı (ESR) birçok hastalığın takip edilmesinde kullanılabilir. Son yıllarda ESR\'yi direk olarak ağzı kapalı EDTA ve sitrat kan örneği tüplerinden ölçen kapalı otomatik sistemler geliştirilmiştir. Bu çalışmada iSed Alcor Oto-Cihazı ve Berkhun SDM60 Oto-Cihazlarının sonuçlarını karşılaştırmayı ve aralarındaki uyumu değerlendirmeyi amaçladık. Yöntemler: K2EDTA ile sitratlı kan örnekleri 149 adet rastgele seçilen günübirlik hastadan alındı. K2EDTA\'lı tüplere alınan kan örneklerinin ESR\'si iSed Alcor Auto-instrument ile tayin edilirken, sitrat içeren tüplere alınan kandan Berkhun SDM60 Auto-instrument ile tespit edildi. Bulgular: iSed Alcor Oto-cihazı için ortalama ± SD ESR 24,48 ± 23,10 mm/saat (20.54-28.02 mm/saat ortalama için %95 GA) iken bu değer Berkhun Oto-cihazı için 23,94 ± 17,24 mm/saat (21,15–26,73 mm/saat ortalama için %95 GA) idi. İki yöntem arasındaki ortalama farkı 0,336 mm/saat (−2,06 ila 1,39 mm/saat ortalama için %95 GA; P = 0,701). Elde edilen korelasyon katsayısı 0,90 (P = 0,0001) idi. Sistematik taraflılığa yönelik bir kanıt mevcut olmayıp 0,3 mm/saat değerine eşitti (uyum sınırları –20,6 ila 21,2 mm/saat). Sonuç: iSed Alcor Oto-cihazı ile Berkhun SDM60 Oto-cihazı birbirlerine karşı alternatif sistemler olarak kullanılabilir. Ancak özellikle yüksek ESR (>50 mm/hr) sonuçlarında dikkatli bir şekilde takip edilmeli ve sonuçlar ise Westergren yöntemine göre kontrol edilmelidir.

Objective: Vitamin D that has pleiotropic hormone characteristics is a fat soluble vitamin. In general, vitamin D is known to be associated with rickets, but the studies show that vitamin D also acts on tissues and cells other than bone itself. In this study, we aimed to investigate if vitamin D has any effects on hemogram parameters or not. Methods: This retrospective study was done with the data obtained from 243 female and 59, totally 302 patients. Vitamin D level and hemogram parameters [(red blood cell (RBC), hemoglobin (Hb), white blood cell (WBC), platelet (PLT), mean platelet volume (MPV), and red cell distribution width (RDW)] of patients were obtained. Patients were divided into 4 groups according to their levels of vitamin D: Group 1: < 10 ng/mL; Group 2: 10-19 ng/mL; Group 3: 20-29 ng/mL, and Group 4: 30-60 ng/mL. Results: There were no significant differences in RBC, Hb, WBC, PLT, MPV, and RDW between the groups (p>0.05). Also, there was no correlation between the hemogram parameters and vitamin D. Conclusion: According to the literature, there are a lot of studies that show the relationship between vitamin D and WBC, RBC, and PLT. However, contrary to the previous studies, we were unable to find any significant relationship between vitamin D and hemogram parameters. These results serve the idea that the effects of vitamin D on the hematopoietic system should be further investigated experimentally and clinically., Amaç: D vitamini pleitropik hormon özellikleri olan yağda çözünen bir vitamindir. Genel anlamda rikets ile beraber anılır ancak yapılan araştırmalar D vitamininin kemik dışı dokularda da etkin olduğunu göstermektedir. Biz de bu çalışmada serum D vitamini düzeyinin hemogram parametrelerine etkisi olup olmadığını araştırmayı amaçladık. Yöntemler: Bu retrospektif çalışma, 243 kadın 59 erkek toplam 302 hastanın verileri değerlendirilerek gerçekleştirildi. Hastaların D vitamini düzeyi ve hemogram [eritrosit sayısı (RBC), hemoglobin (Hb), beyaz küre sayısı (WBC), trombosit sayısı (PLT), ortalama trombosit volümü (MPV) ve eritrosit dağılım genişliği (RDW)] parametreleri elde edildi. Hastalar D vitamini düzeylerine göre 4 gruba ayrıldı: Grup 1: < 10 ng/mL; Grup 2: 10-19 ng/mL; Grup 3: 20-29 ng/mL ve Grup 4: 30-60 ng/mL. Bulgular: Gruplar arası RBC, Hb, WBC, PLT, MPV ve RDW değerleri arasında anlamlı bir farklılık saptanmadı (p>0.05). Ayrıca, D vitamini ile hemogram parametreleri arasında herhangi bir korelasyon tespit edilmedi. Sonuçlar: Literatüre bakıldığında D vitamini ile WBC, RBC ve PLT arasında ilişki olduğunu gösteren çok sayıda yayın bulunmaktadır. Ancak, bizim çalışmamızda literatürün aksine D vitamini ile hemogram parametreleri arasında herhangi bir ilişki tespit edilemedi. Bu sonuçlar D vitamininin hematopoietik sistem üzerindeki etkilerinin deneysel ve klinik olarak daha iyi araştırılması gerektiği fikrini vermektedir.

Background Early life-threatening cardiotoxicity and cardiac death have been reported after hematopoietic stem cell transplantation (HSCT). The purpose of the current study was to evaluate cardiac toxicity of conventional chemotherapy followed by HSCT with cardiac markers: heart-type fatty acid binding protein (H-FABP), glycogen phosphorylase BB (GPBB), high sensitive C reactive protein (hsCRP) cardiac troponin I, (cTnI), creatine kinase MB (CK-MB mass) and myoglobin. Methods A total of 20 children who underwent HSCT for malignant and non-malignant diseases were included in this study. Blood samples were collected from all patients in 0th, 7th and 21st day for evaluating these cardiac biomarkers. The patients’ echocardiography was assessment before and after one-month of HSCT. Results Serum 21st H-FABP level was significantly higher when compared with the 0th day H-FABP level (P < 0.05) . 7th day hsCRP level was significantly higher than 0th and 21st day levels (P < 0.05). Interestingly, 7th day GPBB level was significantly lower than 0th and 21st day levels (P < 0.05). Myoglobin, CK-MB mass and cTnI biomarkers remained within the reference range in all patients. Conclusions This study showed that H-FABP and hsCRP both seem to be promising markers for evaluation of cardiotoxicity in HSCT process and probably superior to GPBB, cTnI, CK-MB mass and myoglobin.

The chondroitin sulfate proteoglycans (CSPGs) aggrecan, versican, and brevican are large aggregating extracellular matrix molecules that inhibit axonal growth of the mature central nervous system (CNS). ADAMTS proteoglycanases, including ADAMTS4 and ADAMTS5, degrade CSPGs, representing potential targets for ameliorating axonal growth-inhibition by CSPG accumulation after CNS injury. We investigated the proteolysis of CSPGs in mice homozygous forAdamts4orAdamts5null alleles after spinal cord injury (SCI). ADAMTS-derived 50–60 kDa aggrecan and 50 kDa brevican fragments were observed inAdamts4−/−,Adamts5−/−, andwtmice but not in the sham-operated group. By contrastAdamts4−/−andAdamts5−/−mice were both protected from versican proteolysis with an ADAMTS-generated 70 kDa versican fragment predominately observed in WT mice. ADAMTS1, ADAMTS9, and ADAMTS15 were detected by Western blot inAdamts4−/−mice’ spinal cords after SCI. Immunohistochemistry showed astrocyte accumulation at the injury site. These data indicate that aggrecan and brevican proteolysis is compensated inAdamts4−/−orAdamts5−/−mice by ADAMTS proteoglycanase family members but a threshold of versican proteolysis is sensitive to the loss of a single ADAMTS proteoglycanase during SCI. We show robust ADAMTS activity after SCI and exemplify the requirement for collective proteolysis for effective CSPG clearance during SCI.

Background: The aim of this study was to establish the protective effect of caffeic acid phenethyl ester (CAPE) against the ifosfamide (IFOS)-induced central neurotoxicity in rats and to determine the changes in oxidant–antioxidant status of brain tissue. Method: A total of 35 Wistar rats (aged 7-12 days) were used in the experiments. The study comprised of five groups. Control untreated rats ( n = 7) belonged to group 1; group 2 was given intraperitoneal (IP) injection of CAPE alone (10 µmol/kg; n = 7); group 3 was treated with single IP injection of IFOS (500 mg/kg; n = 7); group 4 was treated for 2 days with IP administration of CAPE (10 µmol/kg) beginning from one day before single IP injection of IFOS ( n = 7); and group 5 was treated with saline and 10% ethanol. At the 24th hour of IFOS treatment, brain tissues were removed for analysis. Results: The brain catalase activity was lower in IFOS group than the other groups ( p Conclusion: This study revealed that pretreatment with CAPE might protect brain tissue against IFOS-induced central neurotoxicity. CAPE could be an effective course of therapy to enhance therapeutic efficacy and to lessen IFOS toxicity in clinical chemotherapy.

Objectives Available data on biological variation of HbA 1c revealed marked heterogeneity. We therefore investigated and estimated the components of biological variation for HbA 1c in a group of healthy individuals by applying a recommended and strictly designed study protocol using two different assay methods. Design and methods Each month, samples were derived on the same day, for three months. Four EDTA whole blood samples were collected from each individual (20 women, 9 men; 20–45 years of age) and stored at − 80 °C until analysis. HbA 1c values were measured by both high performance liquid chromatography (HPLC) (Shimadzu, Prominence, Japan) and boronate affinity chromatography methods (Trinity Biotech, Premier Hb9210, Ireland). All samples were assayed in duplicate in a single batch for each assay method. Estimations were calculated according to the formulas described by Fraser and Harris. Results The within subject (CV I )–between subject (CV G ) biological variations were 1.17% and 5.58%, respectively for HPLC. The calculated CV I and CV G were 2.15% and 4.03%, respectively for boronate affinity chromatography. Reference change value (RCV) for HPLC and boronate affinity chromatography was 5.4% and 10.4% respectively and individuality index of HbA 1c was 0.35 and 0.93 respectively. Conclusions This study for the first time described the components of biological variation for HbA 1c in healthy individuals by two different assay methods. Obtained findings showed that the difference between CV A values of the methods might considerably affect RCV. These data regarding biological variation of HbA 1c could be useful for a better evaluation of HbA 1c test results in clinical interpretation.

The aim of this study was to evaluate the potential use of serum transforming growth factor-β1 (TGF-β1), tissue inhibitor of metalloproteinase-1 (TIMP-1), fetuin-A, and fibroblast growth factor 21 (FGF21) in the detection of liver fibrosis in patients with chronic hepatitis B (CHB). The value of the noninvasive fibrosis models - that is, the aspartate aminotransferase to platelet ratio index (APRI), the fibrosis index based on the four factors (FIB-4) score, and Forn's index - was also examined.CHB patients who underwent liver biopsy for the evaluation of fibrosis were included in the study. A total of 73 patients were divided into two groups according to their METAVIR scores (F0-1, no/minimal fibrosis; F2-4, significant fibrosis). Serum levels of TGF-β1, TIMP-1, fetuin-A, and FGF21 were measured besides APRI, FIB-4, and Forn's scores. The area under the receiver operating characteristic curve was measured for each parameter, followed by calculation of sensitivity, specificity, and positive and negative predictive values.APRI, FIB-4, and Forn's index scores were significantly higher in patients with significant fibrosis (P0.05). There was no difference between no/minimal fibrosis and significant fibrosis groups in terms of serum levels of TGFβ-1, TIMP-1, fetuin-A, and FGF21 (P0.05). The areas under the receiver operating characteristic curve for TGF-β1, TIMP-1, fetuin-A, FGF21, APRI, FIB-4, and Forn's index were 0.445, 0.483, 0.436, 0.585, 0.662, 0.687, and 0.680, respectively.Our results suggest that serum TGF-β1, TIMP-1, fetuin-A, and FGF21 are not useful for the assessment of the extent of liver fibrosis in CHB in this patient group. However, APRI, FIB-4, and Forn's index have a better diagnostic value in patients with significant fibrosis than in those with no/minimal fibrosis.

Ifosfamide (IFOS) which is a cytotoxic alkylating agent may cause central nervous system toxicity. Alpha-lipoic acid (ALA) has a strong antioxidant effects. We hypothesized that ALA could attenuate on ifosfamide-induced central neurotoxicity in rats. Rats were divided into Control, IFOS, ALA and IFOS+ALA groups. The toxic effects of IFOS were analyzed by oxidative parameters and caspase 3 immunohistochemical examinations of brain tissue. The catalase activity of IFOS group significantly reduced in comparison with control groups (p0.05). The malondialdehyde (MDA) level and protein carbonyl (PC) content in brain tissue were significantly higher in IFOS group than in the other groups (p0.05). ALA treatments significantly prevented the increase in MDA level (p0.001) and PC content (p0.05) in brain tissue. IFOS group showed profound activation of caspase 3. The control, ALA and IFOS+ALA groups did not show caspase 3 activation. It was concluded that ALA treatments may have beneficial effects protecting neurons from central neurotoxicity caused by IFOS.

Cancer prevention and treatment strategies have attracted increasing interest. Caffeic acid phenethyl ester (CAPE), an active component of propolis extract, specifically inhibits NF-κB at μM concentrations and shows ability to stop 5-lipoxygenase-catalyzed oxygenation of linoleic acid and arachidonic acid. Previous studies have demonstrated that CAPE exhibits antioxidant, antiinflammatory, antiproliferative, cytostatic, antiviral, antibacterial, antifungal, and, most improtantly, antineoplastic properties. The primary goal of the present review is to summarize and critically evaluate the current knowledge regarding the anticancer effect of CAPE in different cancer types.

Background Liver biopsy is an invasive procedure that is currently still necessary for predicting underlying hepatic injury related to chronic viral hepatitis B (CVHB). To date, none of the studied non-invasive methods have been able to replace liver biopsy. An apoptotic serum marker, M30, which has been reported to indicate ongoing liver fibrosis, has been popular in recent years. Objectives We aimed to investigate the possible role of M30 in predicting CVHB-associated hepatic injury and its severity. Methods Forty-eight patients undergoing liver biopsy for evaluation of the severity of CVHB-related liver injury and 40 healthy controls were included in this cross-sectional study. M30 levels were determined for all CVHB patients and controls, and other laboratory parameters and demographic features were obtained from our hospital’s database. Results The mean ages of patients and controls were 39.7 and 45.7 years, respectively, and 35% of the controls and 52% of the patients were male. In contrast to lower platelet counts, transaminase and M30 levels were both higher in the patient group than in the controls. Among the investigated parameters, only transaminase increased as the fibrosis stage changed from mild to moderate; however, none of the laboratory parameters, including M30, differed as the histological activity index (HAI) score increased. Conclusions M30 levels were higher in CVHB patients compared to healthy controls. However, M30 levels were similar in the mild and moderate stages of fibrosis, so they did not indicate the severity of underlying fibrotic or inflammatory processes in CVHB patients.

Background Hyperemesis gravidarum, which affects 0.3–2.3% of pregnancies, is defined as excessive vomiting during pregnancy and usually starts in week 4 or 5 of gestation. Symptoms include weight loss, dehydration, ketonaemia, ketonuria, fasting acidosis, alkalosis due to hydrochloric acid loss and hypokalaemia and its exact cause is unknown. The present study was undertaken to investigate the relationship between prealbumin, ghrelin, nesfatin-1 and obestatin concentrations in pregnancies associated with hyperemesis gravidarum. Methods A total of 40 pregnant females with hyperemesis gravidarum and 38 pregnant females without hyperemesis gravidarum as controls were included in this study. Serum concentrations of prealbumin, ghrelin, obestatin and nesfatin-1 were measured. Results There were no significant differences in age, gestational week, gravidity and parity between the two groups. Body mass index was significantly lower in cases than in controls. Serum ghrelin and prealbumin concentrations were significantly lower in cases than in controls ( P Conclusions Decreased serum concentrations of ghrelin and prealbumin in patients with hyperemesis gravidarum are independent of body mass index. Based on our results, we believe that ghrelin may be considered to play a role in the aetiopathogenesis of hyperemesis gravidarum and that hyperemesis gravidarum may result in disruption of the relationship between nesfatin-1 and ghrelin. In addition, we believe that the measurement of serum prealbumin may be used for assessing nutritional status in pregnancy.

Osteoprotegerin has been shown to be increased in cardiovascular disorders and type 2 diabetes mellitus. Prediabetes represents a high risk condition for diabetes and diabetic complications. Therefore, we aimed to find the relationship between prediabetes and osteoprotegerin with nuclear factor-B ligand, carotid intima media thickness, and metabolic markers. A total of 54 participants with prediabetes including impaired fasting glucose (n = 21), impaired glucose tolerance (n = 8), impaired fasting glucose and impaired glucose tolerance (n = 25), and 60 healthy individuals as a control were admitted to the study. Metabolic and anthropometric parameters, insulin resistance variables, osteoprotegerin, and nuclear factor-B ligand markers, carotid intima media thickness were examined at baseline for all participants. To evaluate the effect of therapy we determined the same parameters after the end of the study. Measurements of waist circumference, body mass index, body fat percentage and levels of fasting blood glucose, fasting insulin, homeostatic model assessment of insulin resistance, triglyceride levels and hsCRP and carotid intima media thickness were significantly higher in patients with prediabetes (p 0.05). We also found higher osteoprotegerin and lower nuclear factor-B ligand levels in patients than in controls however, the value was non-significant (p 0.05). Patients with prediabetes were under lifestyle interventions with (group 1, n = 33) or without metformin (group 2, n = 21) therapy. Baseline anthropometric and metabolic characteristics were not found statistically different in group 1 and group 2. Mean follow up period of the patients were 7.9 ± 2.2 month (min-max: 6-12 months). After the follow up period we evaluated the same parameters and found significant differences between waist circumference, body mass index, body fat percentage, fasting insulin, homeostatic model assessment of insulin resistance, and osteoprotegerin levels (p 0.05). However, carotid intima media thickness, and nuclear factor-B ligand levels significantly different only in the group treated with metformin (p 0.05). We also compared the variables after the treatment period with the control group and found significantly lower levels in terms of fasting insulin, homeostatic model assessment of insulin resistance, waist circumference, body mass index, body fat percentage, carotid intima media thickness, osteoprotegerin, and nuclear factor-B ligand values (p 0.05). Correlation analysis revealed a negative relationship between nuclear factor-B ligand and body mass index, and body fat percentage in group 1 (p = 0.05, r = -0.646, p = 0.01, r = -0.585). Therapy of prediabetes was associated with a significant decrease in osteoprotegerin and certain metabolic variables together with an increase in nuclear factor-B ligand levels particularly in patients with under metformin therapy.

Vitreous humour (VH) is a quite stable and well-protected biological fluid from post-mortem degradation and contamination, making it a usable specimen in forensic pathology. We aimed to analyse the biochemical markers in VH stored for one month at -20 degrees C and to compare them with those of serum samples of the same deceased people. To the best of our knowledge this is the first time this has been reported in the literature. Serum levels of sodium, potassium and calcium, phosphorous and VH levels of calcium, creatinine, and urea were not statistically different between fresh and stored samples. There was no significant difference in VH urea and creatinine levels whereas serum levels were significantly decreased by the 15th and 30th days. In conclusion, urea and creatinine levels in VH showed adequate stability after one month of storage at -20 degrees C, whereas large variations were seen in the stability of inorganic components such as Na, K, Mg, Cl, and P. Our results indicate the validity of using post-mortem VH samples for urea and creatinine but not for VH stored at -20 degrees C for a limited time frame. The differences in sample handling before being stored at -20 degrees C may introduce bias on some components of VH.

Objectives: Obstructive sleep apnea syndrome (OSAS)which is characterized by recurrent pharyngeal narrowingand breathing disturbances, can affect central neuralsystem (CNS). S100B, which exerts neurotrophic andgliotrophic features, is a calcium binding protein. The aimof this study was to evaluate serum levels of S100B inpatients with OSAS.Materials and methods: Clinical and laboratory assessmentwere performed in 26 patients (5 women and 21men) with OSAS and 28 (8 women and 20 men) age-,body mass index (BMI)- and sex- matched healthy subjectsserved as controls . The patients included in thestudy had whole-night polysomnography (PSG) performedin the sleep laboratory. Measurements of S100Bwere done using the commercially available ELISA kit.Results: Patients and controls were well matched withregard to demographic characteristics. Serum S100Bconcentrations were 149.4±84.5 ng/L and 139.2±70.7ng/L for patients with OSAS and control subject, respectively.There was no statistically significant difference inserum S100B concentrations between OSAS and controlgroups (p>0.05).Conclusions: Serum S100B protein level in serum didnot significantly higher in patients with OSAS comparedto the healthy subjects. However, further investigationsare required, particularly in the area of biochemical markersof mild cerebral damage in patients with OSAS. J ClinExp Invest 2012; 3 (3): 345-349Key words: Obstructive sleep apnea syndrome, serumS100B, brain, polysomnography

Protection of the patients against the side effects of chemotherapy and radiotherapy regimens has attracted increasing interest of clinicians and practitioners. Caffeic acid phenethyl ester (CAPE), which is extracted from the propolis of honeybee hives as an active component, specifically inhibits nuclear factor κB at micromolar concentrations and show ability to stop 5-lipoxygenase-catalysed oxygenation of linoleic acid and arachidonic acid. CAPE has antiinflammatory, antiproliferative, antioxidant, cytostatic, antiviral, antibacterial, antifungal and antineoplastic properties. The purpose of this review is to summarize in vivo and in vitro usage of CAPE to prevent the chemotherapy-induced and radiotherapy-induced damages and side effects in experimental animals and to develop a new approach for the potential usage of CAPE in clinical trial as a protective agent during chemotherapy and radiotherapy regimens.

Background: Studies investigating serum vaspin and adiponectin levels in patients with prolactinoma are inconclusive. The aim of this study was to evaluate serum vaspin and adiponectin levels in patients with prolactinoma and healthy controls. Methods: A total of 42 prolactinoma patients (Group 1, 21 patients; Group 2, 21 patients) and 30 healthy controls were enrolled in the study. Group 1 consisted of newly diagnosed patients who were never treated or had not received a dopamine agonist (DA) within 6 months prior to screening. Group 2 consisted of prolactinoma patients who were on DA treatment for at least 6 months at the time of screening. The control group (group 3) consisted of healthy controls. Results. Patients with prolactinoma had higher homeostasis model assessment of insulin resistance and lower quantitative insulin sensitivity check index values in comparison to healthy controls (p0.05) and 5.041 (1.191-21.339; p

Introduction : Isotretinoin has been successfully used for the treatment of acne vulgaris. Aim : To investigate the effects of isotretinoin on body mass index (BMI), to determine whether isotretinoin causes any changes in serum adiponectin, leptin, and ghrelin levels in acne vulgaris patients, and to correlate variables. Material and methods: Thirty-two patients were included in this study. Oral isotretinoin was begun at a dose of 0.5–0.6 mg/kg and raised to 0.6–0.75 mg/kg. Pretreatment and posttreatment third-month BMI and adiponectin, leptin, and ghrelin serum levels were measured. Results : The pre- and posttreatment BMI values were not significantly different. In addition, serum adiponectin and leptin levels were significantly increased following isotretinoin therapy while serum ghrelin levels were not different. Conclusions : Isotretinoin may exert its anti-inflammatory activity by increasing leptin and adiponectin levels.

Modulation of psoriasis severity by estradiol during pregnancy, menstruation and menopause has been investigated previously. The correlation between sex hormones and Psoriasis Area Severity Index (PASI) has not been studied in male psoriasis patients. We investigated serum sex hormones in male psoriasis patients compared with healthy controls and correlated these findings with PASI. Estradiol, testosterone, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels were measured in 47 male patients with psoriasis and 20 healthy controls. Patients with psoriasis showed higher body mass index and higher serum levels of FSH and LH relative to healthy controls, although this difference was not statistically significant. However, serum levels of testosterone and estradiol were significantly different between patients with psoriasis and healthy controls. Testosterone was significantly increased in control patients and estradiol was significantly increased among psoriatic patients. A significant inverse correlation was found between estradiol and PASI. Although the role of sex hormones in the pathogenesis of psoriasis has not been demonstrated, this is the first report of an inverse correlation between estradiol and PASI in male patients.

Objective The etiology and pathogenesis of hyperemesis gravidarum (HG) is still undetermined and has been suggested to involve oxidative stress. We aimed to evaluate the status of oxidative stress in HG by measuring the levels of total oxidant status (TOS), total antioxidant status (TAS), and by calculating the oxidative stress index (OSI). Methods In a case–control trial, fasting morning blood samples of patients with HG (n = 41) and healthy pregnant women (n = 39) were collected for analysis of serum TOS and TAS values as well as for calculation of OSI according to the formula: OSI = TOS / TAS × 100. Results Serum TOS and TAS levels were similar in both groups. However, serum TAS levels were lower among HG patients compared to controls, which resulted in an increase in OSI (P = 0.025). Discussion The present study supports the role of systemic oxidative stress, reflected by an imbalance between the TOS and TAS, in patients with HG. Our findings distinguish the mechanism underlying oxidative stress to result from reduction of antioxidants rather than an increase in oxidants.

Aim: The purpose of this study was to search for the effects of adenotonsillectomy (A&T) on height, weight, and body mass index (BMI), as well as changes in ghrelin, leptin, and insulin-like growth factor 1 (IGF-1) levels in children with adenotonsillar hypertrophy (ATH)-related sleep-disordered breathing (SDB). Methods: A study cohort of 39 children clinically diagnosed with ATH-related SDB was included in this study. Twenty-three healthy children were included as controls. Height and weight standard deviation scores (SDS) and ghrelin, leptin, and IGF-1 levels of the controls were determined once; in the study group, they were determined preoperatively and in the third month postoperatively. Results: Preoperative IGF-1 (ng/mL) and ghrelin (pg/mL) levels were significantly higher in the patients than in the controls (322.51±113.10 vs. 256.96±176.73, p Conclusion: Plasma IGF-1 levels are lower in malnourished children, and plasma ghrelin levels are decreased after acute oral food intake and are increased in cachexia and fasting. Therefore, increased serum IGF-1 levels, height and weight SDS values, and decreased ghrelin levels detected postoperatively are useful parameters that help to monitor the development of children with adequate oral intakes.

BACKGROUND: Early life‐threatening cardiotoxicity and cardiac death have been reported after hematopoietic stem cell transplantation (HSCT). The purpose of the current study was to evaluate cardiac toxicity of conventional chemotherapy followed by HSCT with cardiac markers: heart‐type fatty acid binding protein (H‐FABP), glycogen phosphorylase BB (GPBB), high sensitive C reactive protein (hsCRP) cardiac troponin I, (cTnI), creatine kinase MB (CK‐MB mass) and myoglobin. METHODS: A total of 20 children who underwent HSCT for malignant and non‐malignant diseases were included in this study. Blood samples were collected from all patients in 0th, 7th and 21st day for evaluating these cardiac biomarkers. The patients’ echocardiography was assessment before and after one‐month of HSCT. RESULTS: Serum 21st H‐FABP level was significantly higher when compared with the 0th day H‐FABP level (P < 0.05) . 7th day hsCRP level was significantly higher than 0th and 21st day levels (P < 0.05). Interestingly, 7th day GPBB level was significantly lower than 0th and 21st day levels (P < 0.05). Myoglobin, CK‐MB mass and cTnI biomarkers remained within the reference range in all patients. CONCLUSIONS: This study showed that H‐FABP and hsCRP both seem to be promising markers for evaluation of cardiotoxicity in HSCT process and probably superior to GPBB, cTnI, CK‐MB mass and myoglobin.

Traumatic brain injury (TBI) is one of the most common causes of death among trauma patients. Earlier prediction of possible poor neurological outcomes, even upon admission to the emergency department, may help to guide treatment. The aim of this prospective study was to assess the predictive value of plasma copeptin levels for early morbidity and mortality in patients with isolated TBI. This prospective study comprised 53 patients who were admitted to the emergency department with isolated TBI. Forty-two of these patients (group I) survived at least 1 month after the TBI; the other 11 (group II) did not. Plasma levels of copeptin were measured in these TBI patients at admission and 6 h after trauma, and were compared with those of healthy volunteers (group III). At admission, the copeptin levels of the TBI patients (groups I and II combined) were not statistically significantly different from those of the control group (III). The copeptin levels 6 h after trauma were also not statistically significantly different from those at admission. Δ-Copeptin levels (the difference between the copeptin level at the 6th hour after trauma and that at admission) were higher in the patients who died within a month of the TBI. Further, Δ-copeptin levels were higher in patients who showed no improvement in the modified Rankin score when compared with patients with an improved modified Rankin score. The best cutoff point for Δ-copeptin was 0.51 ng/ml for predicting mortality and 0.23 ng/ml for predicting improvement in the modified Rankin score. Plasma Δ-copeptin levels may help physicians predict the prognoses of patients suffering from traumatic brain injury.

A positive family history is an important risk factor for inguinal hernia development, suggesting a genetic trait for hernia disease. However, gene mutations responsible for abdominal wall hernia formation in humans have not yet been studied. We aimed to evaluate whether the functional Sp1 binding site polymorphism within intron 1 of the collagen type I, alpha 1 (COL1A1) gene was associated specifically with inguinal hernia disease. 85 participants with surgically diagnosed inguinal hernia disease, and 82 physically active controls without any history of connective tissue disease and hernia were recruited for this case–control genetic association study. Polymerase chain reaction and restriction fragment length polymorphism and agarose gel electrophoresis techniques were used to detect these polymorphisms. Significantly, more patients gave a positive family history for an inguinal hernia compared to healthy controls (OR 3.646, 95 % CI 1.375–9.670, P = 0.006). COL1A1 Sp1 SNP (rs 1800012) was identified. Results demostrated statistically significant deviation from HWE for cases (P = 0.007), but not for the controls (P = 0.276). Our results revealed an increased frequency of COL1A1 Sp1 Ss genotype in inguinal hernia patients (OR 3.593, 95 % CI 1.867–6.915, P = 0.000). This results suggest that polymorphism of the COL1A1 Sp1 binding site is associated with an increased risk for developing inguinal hernias. So, rs 1800012 locus is a potential candidate region for susceptibility in molecular mechanism of inguinal hernia pathophysiology.

Since they are available in open markets and pharmacies, pesticides have been widely used all over the country. (Un)intentional poisoning with these compounds is one of the most common causes of chemical poisoning, especially in rural agricultural areas. Pesticide poisonings reported by various countries showed that it is a worldwide health problem with 250 000-370 000 associated deaths each year. In this study, medico-legal deaths between the years 2001 and 2011 in Ankara and nearby cities in Turkey were investigated retrospectively. The autopsies were partly carried out by Ankara Branch of Council of Forensic Medicine. Data were collected from reports of the Morgue Department whose toxicological analyses were performed in the Chemistry Department. The data revealed that 70 cases out of 10 720 autopsied ones had been attributed to fatal pesticide poisoning. The age range was 1-80 years (mean ± SD, 41.33 ± 17.42 years). Most of the cases (60%) were reported from Ankara. Insecticides were the most common (94%) cause of fatal pesticide poisonings, most of them (63%) being organophosphate insecticides. The percentages of pesticide-induced deaths are quite high in our society and should therefore not be underestimated. Accordingly, intensive efforts to reduce occupational and intentional pesticide poisonings are urgently needed in Ankara and nearby cities. Language: en