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BACKGROUND: In this study, we aimed to evaluate the salivary ß-galactosidase and Halimeter values (HMV), organoleptic scores (OLS) and Winkel tongue coating index (WTCI) in periodontal health and periodontitis (P), and also their changes after phase I periodontal therapy and tongue cleaning. METHODS: The participants were separated as follows: 25 P with halitosis (Group 1), 25 P without halitosis (Group 2) and 25 healthy controls (Group 3). Periodontal recordings, HMV, OLS and WTCI scores were recorded, and whole saliva ß-galactosidase levels were measured colorimetrically in the samples at baseline and 1 month after the therapy. RESULTS: The baseline values of HMV, OLS, WTCI and salivary ß-galactosidase levels were significantly higher in Group 1 than in Group 2 (P < 0.05). There was a statistically significant decrease in periodontal recordings, HMV, OLS, WTCI and salivary ß-galactosidase levels in all P patients by the therapy (P < 0.05). However, major reductions in halitosis measurements and saliva enzyme levels were observed in Group 1 after the treatment. CONCLUSION: Our results showed that salivary ß-galactosidase was associated with halitosis parameters and phase I periodontal therapy played an important role to reduce this enzyme level and halitosis parameters in P.

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PURPOSE: Metabolic syndrome (MetS) is considered as a proinflammatory and prothrombotic state with atherogenic risk factors including dyslipidemia, obesity and glucose intolerance. Oxidative stress is a unifying basis of several disorders including diabetes mellitus (DM) and MetS. We therefore designed this cross-sectional study to investigate the potential interaction among iron metabolism, inflammation and endothelial plexus in MetS and DM patients. METHODS: A total of 62 patients [median age 54 (23-76) years; male/female 16/46] and 18 healthy controls [median age 38 (30-64) years; male/female 6/12] were included in the study. Patient population was classified as MetS (n = 30) and DM (n = 32). RESULTS: Leukocyte count (p = 0.002) and osteopontin (OPN) levels (p = 0.008) were significantly higher, while C-reactive protein (CRP) (p = 0.056) and IL-6 (p = 0.059) represented a relative increase in the patient group. Leptin, endothelin 1 (ET1), hepcidin, nitric oxide synthase (NOS), erythrocyte sedimentation rate (ESR), iron, transferrin saturation (TS) and ferritin levels were not significantly different between the patient and control groups. Endothelin 1 was found to be higher in the DM group compared to MetS group (p = 0.15, p = 0.049). Leukocyte count, leptin, hepcidin, OPN, NOS, IL-6, ESR, CRP, iron, TS and ferritin levels were not different between DM and MetS groups. A positive correlation was demonstrated between leptin and OPN (p = 0.001, r = 0.360), ferritin and hepcidin (p < 0.01, r = 0.633), IL-6 and CRP (p = 0.023, r = 0.319), leptin and NOS (p = 0.005, r = 0.309) and OPN and NOS (p < 0.001, r = 0.803). There was a negative correlation between hepcidin and NOS (p = 0.009, r = -0.289). When the study cohort was divided into two particular groups based on median ferritin and hepcidin levels, hepcidin (p = 0.002), ALT (p = 0.001) and LDL (p = 0.049) levels were higher in the high-ferritin group. Nitric oxide synthase levels (p = 0.033) were lower, whereas ferritin levels (p = 0.004) were higher in the high-hepcidin group. CONCLUSION: Mechanisms involved in the vicious circle of MetS including inflammation, endothelial vasculature and iron metabolism remain to be elucidated. The role of iron metabolism in this complex interaction should be confirmed with further studies.

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OBJECTIVES: To evaluate the beneficial effects of spirulina on the treatment of experimental colitis. BACKGROUND: Spirulina, a planktonic blue green algae from oascillateriaceae family, has anti-inflammatory, antioxidant, antitumor, anti-viral, and antimicrobial effects, rendering it a natural drug of prophylactic and therapeutic properties. The effects of spirulina on colitis are not known. METHODS: Wistar rats weighing 200-300 g were used. Experimental colitis was created during anesthesia using the trinitrobenzene sulfonic (TNBS) acid. The rats were randomly divided into the 3 groups. In the group 1 (sham; n = 8), saline was administered via oral gavage 7 days after 1 ml of rectal saline was administered. In the group 2 (experimental colitis + spirulina; n = 8), 2 g/kg spirulina was administered via oral gavage 7 days after the rectal 1 ml TNBS was administered. In group 3 (experimental colitis; n = 8), enema was administered via oral gavage 7 days after the rectal 1 ml TNBS was administered. Eight days after the instigation of TNBS colitis, the rats were sacrificed and blood and tissue samples were taken. Histopathologic and immunohistochemical evaluations were conducted, and malondialdehyde (MDA), advanced oxidation protein products (AOPP), catalase (CAT), total antioxidant status (TAS), and glutathione (GSH) levels were determined. RESULTS: Inflammation on mucosa and submucosa, hemorrhage, necrosis, cellular infiltration and crypt abscess formation, immunoreactivity and tissue MDA levels were decreased in the experimental colitis + spirulina group when compared to the experimental colitis group (p < 0.05). CONCLUSION: The results of the present study indicate the beneficial effects of spirulina on TNBS-induced inflammatory bowel disease (Tab. 6, Fig. 10, Ref. 40).

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BACKGROUND: Major surgery is associated with a stress response. The aim of this study was to compare the effects of isoflurane or propofol, both supplemented with remifentanil, on the glucose, cortisol and insulin-based stress responses prospectively. METHODS: Forty patients undergoing craniotomy randomly received either 1% isoflurane (Group I, N.=20) or propofol 6 mg kg h(-1) (Group P, N.=20) during remifentanil-based (0.125 µg kg min(-1)) anesthesia. Blood glucose was recorded preoperatively, after induction, intubation and pin placement, before and after skin incision, craniotomy, dura incision, 15th, 30th, 60th, 90th, 120th, 150th, 180th min post-dura incision, following dura and skin closure, extubation and at the 1st and 24th postoperative hours. Insulin and cortisol were measured preoperatively, after intubation, dura incision, at the 60th min, extubation and at the 1st and 24th hour postoperatively. The glucose/insulin ratio and glycemic stress index were calculated after all the measurements were obtained. RESULTS: Patient characteristics were comparable in both groups. Blood glucose significantly decreased after induction in comparison to the baseline value in both groups. Blood glucose was significantly higher in Group I than Group P before skin incision, after craniotomy and dura incision and at all measurement time points after the 60th minute following dura incision. There was a significant alteration with time in insulin values in both groups and the insulin values at the 60th min were significantly lower in Group I than in Group P. There was not any difference in the inter-group analysis of cortisol; however, there was a significant change over time in the insulin values in both groups. There was no difference in the intra-group glucose/insulin ratio, however, there was a significant difference between groups at the 60th min and at extubation. The Glycemic Stress Index was comparable between groups (Group I vs. Group P: 2.48±1.15 vs. 2.15±0.86, P=0.465). CONCLUSION: Isoflurane and propofol, both combined with remifentanil, provided clinically comparable cortisol and insulin responses to surgery in craniotomy operations, whereas propofol attenuated the increase in plasma blood glucose.

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INTRODUCTION: Pretransplantation iron overload (IO) is considered as a predictor of adverse outcome in hematopoietic stem cell transplantation (HSCT). Peroxidative tissue injury caused by IO leads to progressive organ dysfunction. METHODS: This is a retro-prospective study which explores the possible relationship between IO, oxidative stress and transplant outcome. Serum samples of 149 consecutive HSCT candidates were subjected to analysis of iron parameters, including nontransferrin bound iron (NTBI) and pro-oxidant/antioxidant status. RESULTS: Serum ferritin was found to be positively correlated with NTBI and negatively correlated with glutathione peroxidase (GPx) and superoxide dismutase (SOD). An inverse correlation of NTBI with SOD, total antioxidant potential (TAP) and malonyldialdehide (MDA) was also demonstrated. An adverse impact of serum ferritin level on early posttransplant complications including pulmonary toxicity, fungal infections and sinusoidal obstruction syndrome (SOS) was shown. A significant impact of NTBI on +30 day (P = 0.027) and +100 day survival (P = 0.028) was shown in auto-transplanted patients. MDA levels had a significant impact on +30 day and +100 day survival in autologous (P = 0.047; P = 0.026) and allogeneic (P = 0.053; P = 0.059) groups. GPx (P = 0.016) and MDA (P = 0.021) were identified as independent prognostic parameters for overall survival in allo-transplanted patients. CONCLUSION: Pretransplantation IO might be a major contributor to adverse outcome in HSCT recipients through an impaired pro-oxidative/antioxidative homeostasis. The reversible nature of IO and oxidative stress suggests that early preventive strategies might have a potential to improve transplant outcome.

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INTRODUCTION: Resveratrol (RSV) is a natural polyphenolic compound found in grape skins and the red wine which improves histological reorganization of the regenerating tissue in dermal wound healing. Since anastomotic healing possesses paramount importance to prevent complications in colorectal surgery, the present study is aimed to evaluate the effect of RSV on the healing of experimental left colonic anastomoses. METHODS: Thirty-two male Wistar albino rats were randomized into two groups and subjected to colonic anastomosis. The study group was treated with RSV and the control group received tap water instead. The rats were sacrificed 3 and 7 days postoperatively. Wound complications, intra-abdominal abscesses, and anastomotic leaks and stenosis were recorded. Four types of assessment were performed: bursting pressure, hydroxyproline (OHP) content, histopathology, and biochemical analysis. RESULTS: Compared to the control group, the RSV-treated rats displayed a higher bursting pressure (p < .001) and anastomotic OHP content (p < .05)]. RSV treatment leads to significant increase in PON activity at both time points and decrease in malondialdehyde levels on postoperative day 3 (p < .001). Histopathological analysis revealed that RSV administration leads to a better anastomotic healing in terms of mucosal ischemia, neovascularization, reepithelialization, fibroblast, and lymphocyte infiltration. CONCLUSION: The study results suggest that exogenous RSV administration exerts a positive effect on experimental colonic wound healing in the rat. Although the precise cellular mechanisms by which RSV enhances anastomotic wound healing is not clear, stimulation of neovascularization, generation of collagen synthesis, inhibition of over inflammation, and restriction of oxidative injury seems to be of paramount importance.

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BACKGROUND: Simvastatin is a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor commonly known as a cholesterol-lowering drug with additional pleiotropic effects. Also, it is demonstrated that it prevents postoperative peritoneal adhesions in rat. This study was designed to assess its effects on the healing process of colonic anastomosis. METHODS: Thirty-two male Wistar albino rats were randomized into two groups and subjected to colonic anastomosis. The study group was treated with simvastatin and the control group received only tap water instead. The rats were killed 3 and 7 days postoperatively. Wound complications, intra-abdominal abscesses, and anastomotic leaks and stenosis were recorded. Four types of assessment were performed: bursting pressure, hydroxyproline content, histopathology, and biochemical analysis. RESULTS: Compared to the control group, simvastatin-treated rats displayed a higher bursting pressure (p < 0.001) and anastomotic hydroxyproline content (p < 0.05). Simvastatin treatment leads to a significant decrease in malondealdehyde levels (p < 0.05) and increase in paraoxonase activity (p < 0.001) at both time points. Histopathological analysis revealed that simvastatin administration leads to a better anastomotic healing in terms of reepithelialization, decreased granuloma formation, reduced ischemic necrosis, and inflammatory infiltration to muscle layer. CONCLUSION: Clinically relevant doses of simvastatin do not have a negative impact on colonic anastomosis but improve intestinal wound healing in rats.

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BACKGROUND: Hepatic ischemia/reperfusion (IR) injuries associated with hepatic resections are unresolved problems in the clinical practice. The aim of this study is to elucidate the effect of ischemic preconditioning (IPC) on the energy charge (EC) and related mechanisms at the late phase of hepatic IR injury. METHODS: 30 Wistar rats were randomly divided into sham, IR and IPC groups. The model of partial hepatic IR was used. The rats were subjected to 60 min hepatic ischemia, pretreated by IPC (10/15 min) or not. After 24 h of reperfusion, serum alanine aminotransferase (ALT), nitrite/nitrate (NOx), malondialdehyde (MDA), hepatic tissue arginase activity, adenosine triphosphate (ATP), adenosine diphosphate (ADP), adenosine monophosphate (AMP) and EC of the liver were measured. RESULTS: Liver injury reduced by IPC is measured by liver tissue arginase activity and serum ALT. Tissue NOx levels in rats pretreated with IPC were significantly higher than levels in the IR group (p < 0.001). Tissue levels of MDA in the liver of the IPC group were found to be significantly lower than the levels in the IR group (p < 0.001). ATP and EC levels 24 h after hepatic ischemia in rats pretreated with IPC were higher than the levels in the IR (p < 0.05). All groups had similar ADP and AMP levels in the liver tissues. The IPC procedure significantly reduced the hepatic necrosis (p < 0.001). CONCLUSION: The results of this study demonstrated that pretreatment with IPC improved tissue ATP, EC, and hepatic necrosis at late stages of ischemia reperfusion injury of the liver. Increased nitric oxide, reduced MDA and arginase activity seemed to play a regulatory role in this delayed protective effect of IPC.

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INTRODUCTION: The aim of this study was to investigate the effects of dimethyl sulfoxide on liver damage caused by ischemia-reperfusion after portal vein clamping. MATERIAL AND METHODS: Forty New Zealand rabbits were divided into three groups with the portal veins of all the rabbits except the sham group clamped for 30 minutes: group I, sham procedure; group II, control group; and group III, 500 mg/kg DMSO. The drug was administered IM in the left inguinal region 30 minutes before the operation. Blood samples (5 mL) were taken from the animals at 15, 30, and 45 minutes. At the end of the experiment 1 g of liver tissue samples were obtained. Malondialdhyde (MDA), nitric oxide (NO), AST, ALT, and LDH plasma levels were measured in the blood samples. Liver tissue samples stained with hematoxylin eosin were examined under light microscopy for histopathological changes. FINDING: The liver enzymes in both clamping groups increased significantly compared with the sham group (P < .01). Enzyme levels of the DMSO group decreased significantly compared to the control clamping group (P < .05). Similar to the enzyme changes, MDA and NO levels increased in the portal vein clamping versus the sham group and decreased in the drug-administered group versus the control clamped group (P < .03). The severity of histopathological changes was less in the DMSO group than in the clamped controls. CONCLUSION: DMSO decreased the severity of liver damage after portal vein clamping.

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In this experimental study, the neuroprotective effect of the xanthine oxidase inhibitor allopurinol on focal cerebral ischaemia created by permanent middle cerebral artery occlusion (MCAO) was investigated. Using high performance liquid chromatography (HPLC), we measured hypoxanthine, xanthine, and uric acid (UA) levels in rabbit brains following focal cerebral ischaemia. Rabbits were randomly and blindly assigned into four groups of eight animals each. The control groups received 2% carboxymethylcellulose solution, while 10% allopurinol 150 mg/kg was given to the treatment group 1 h before ischaemia. Each group was subdivided into two groups which were sacrificed 4 h or 24 h after ischaemia, respectively. UA and xanthine values of the rabbits in the control groups were quite high at both times and highest after 24 h, particularly in the centre of the ischaemia. A significant decrease in UA and xanthine values was observed in rabbits that were given allopurinol (P<0.05). According to our results, it was concluded that allopurinol pretreatment protects neural tissue in the early period after arterial occlusion and prevents cerebral injury in the late period, especially in the perifocal area, possibly by preventing the formation of free radicals with xanthine oxidase inhibition.

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Nitric oxide is a gas and free radical, which modulates pulmonary and vascular tone. Pulmonary vascular endothelial cell produce the nitric oxide. To define the relation between nitric oxide and hemodynamic parameters in children with pulmonary hypertension, we measured the nitric oxide concentrations of the right atrium, right ventricle, pulmonary artery, left ventricle and aorta in 40 patients during cardiac catheterizations. Patients were divided into two groups according to their pulmonary arterial pressure. In group I, the mean pulmonary arterial pressure was higher than 25 mmHg and in group II, lower than 25 mmHg. Pulmonary nitric oxide level in group I was significantly lower than group II (P < 0.05). The right ventricle and mean pulmonary arterial pressures, pulmonary vascular resistance and pulmonary flow/systemic flow of the patients in group I were significantly higher than those of group II (P < 0.05). In conclusion, we found low nitric oxide levels in patients with pulmonary hypertension and congenital heart defects.

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Trauma-induced lipid peroxidation (LP) is one of the most important factors that produces tissue damage in head trauma. In the present study, the protective effects of free radical suppression with methylprednisolone (MP), tirilazad mesylate (TM) and vitamin E on the development of cerebral LP and oedema resulting from head trauma have been investigated. Rats were divided randomly into four groups. Bolus injections of physiological saline, MP (initial 30 mg/kg for 1 h, continuing administration of 5.4 mg/kg per hour until 24 h), TM (10 mg/kg), or vitamin E (30 mg/kg) were given 1 h after the head trauma. The animals were killed 24 h after the weight-drop injury for removal of the brain, and the malondialdehyde (MDA) level and water content of the brain were determined. Rats treated with TM had MDA levels which decreased significantly in comparison with the control group (P<0.03), and none of the drugs had an effect on LP and water content of the brain (P>0.05) that was statistically different. These findings demonstrated the beneficial effect of TM in this model of experimental brain injury.

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Type 2 diabetes mellitus is a chronic disease which causes neurologic, cardiac, vascular, ocular and renal complications. The present study documented the prevalence of diabetes and associated risk factors in 1774 adults who were older than 30 years. An oral glucose tolerance test (OGTT) was conducted according to the World Health Organization (WHO) criteria. Of the 1452 subjects, 58 (4%) had diagnosed diabetes, 41 (2.9%) undiagnosed diabetes and 130 (9%) had impaired glucose tolerance. The total glucose intolerance was 15. 9%. The prevalences of type 2 diabetes mellitus (9.7%-4.1%) were significantly different in low occupational and high occupational activity groups, respectively (P<0.0001). The prevalence of type 2 diabetes mellitus was 17.9% among the hypertensive group (P<0.0001). The prevalence of type 2 diabetes mellitus was higher in smokers (P<0.05). Patients with diagnosed diabetes, undiagnosed diabetes and IGT were older, more obese and have higher blood glucose values, triglyceride values, systolic and diastolic blood pressures than healthy subjects (P<0.001). We conclude that type 2 diabetes mellitus and IGT prevalences are quite high in the urban area of Kayseri, central Anatolia and multivariate analysis indicated that low occupational activity, low leisure activity, family history for diabetes, hypertension and obesity were significant independent risk factors for diabetes mellitus.

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The cerebrospinal fluid (CSF) levels of substance P (SP), serotonin (5-HT) and lipid peroxidation (LPx) products were measured in patients with traumatic head injury and then compared to the levels obtained from control subjects. CSF samples were collected from 45 patients (31 male, 14 female, aged 19.2 +/- 17.79) within 24 h of the head trauma and the control CSF samples were obtained from 25 healthy subjects (23 male, 2 female, aged 51.44 +/- 17.6 years) having minor surgical operations under spinal anaesthesia. CSF SP and 5-HT levels in patients with head trauma were significantly lower than the levels in controls (P < 0.005, P < 0.001, respectively). On the other hand, the CSF Lpx products were significantly increased in patients with head trauma (P < 0.001). No significant correlation was found between the CSF changes and the admission Glasgow Coma Scale scores of the patients. This study constitutes the second part of our work on endogenous neuropeptides in patients with traumatic head injury and it emphasizes the role of SP, 5-HT and lipid peroxidation as additional endogenous factors in traumatic head injuries.

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OBJECTIVE: To investigate the oxidative state of glutathione and glutathione peroxidase (GSH-Px), glutathione reductase (GSSG-R), and glucose-6-phosphate dehydrogenase (G-6-PD) levels in patients with chronic renal failure (CRF) and controls. RESULTS: Erythrocyte GSH levels of patients were decreased, but GSSG was not significantly different from that of controls. Also, plasma GSH levels were not different, although GSSG was increased. GSSG/GSH ratios in erythrocyte and plasma were significantly higher in CRF patients. Erythrocyte GSSG-R activity was high, but G-6-PD and GPX were low. CONCLUSIONS: The findings suggest that: 1. Low GSH is related to decreased G-6-PD activities. 2. The reduction of peroxides with GPX are decreased by low GSH and low GPX activity. 3. GSSG may react with hemoglobin and causes protein aggregation in erythrocytes. These alterations cause hemolysis and could play a role in the pathogenesis of anemia in hemodialyzed patients.

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Hypercalcemia has been known to be associated with tuberculosis. In some studies it has been reported to occur commonly. It seems that the studies in which tuberculosis was complicated by hypercalcemia were retrospective and therefore the other causes of hypercalcemia could not be excluded. We have a great deal of experience concerning tuberculosis and have not seen a patient with hypercalcemia due to tuberculosis itself. Therefore we aimed to investigate whether tuberculosis really cause hypercalcemia in a prospective study. We evaluated 104 patients with tuberculosis aged between 14-85 (mean +/- SD 38.5 +/- 15) years, 73 males and 31 females, and 50 age-matched healthy subjects aged between 19-70 (mean +/- SD 39 +/- 13) years, 33 males and 17 females. No significant differences between the patients and healthy subjects were detected in terms of 250HD3, calcium and phosphate levels. Albumin levels were significantly higher in the control group than in the tuberculous group (p < 0.02). No significant difference was found between the calcium levels measured before the therapy (2.4 +/- 0.1 nmol/L) and after the therapy (2.4 +/- 0.2). We think that patients with tuberculosis are not at risk for hypercalcemia either before or during treatment and the development of hypercalcemia as a result of tuberculosis is rather doubtful and needs to be clarified.

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The changes in the cerebrospinal fluid (CSF) beta-endorphin (beta-end) levels within 24 h following the trauma were examined in 45 patients with head injuries. CSF samples obtained from 25 healthy subjects who had minor surgical operations under spinal anaesthesia were included as the controls. Patients with head injuries were evaluated according to their Glasgow Coma Scale (GCS) scores on admission to the neurosurgery clinic and four subgroups were formed as follows: Group I: minor head trauma (GCS: 13-15) without skull fracture; Group II: mild head injury (GCS: 13-15) with skull fracture; Group III: moderate head injury (GCS: 8-12) and Group IV: severe head injury (GCS: < 8). All patients with head injury had significantly higher CSF beta-end levels than the controls (P < 0.001). The levels in patients with mild head injury (Group II) were significantly higher than those with severe head trauma (Group IV) (P < 0.001). There was not any correlation between the CSF beta-end changes and the GCS scores of the patients. Endogenous opioid peptides are suggested to have a role in central nervous system (CNS) injuries. However, the CSF levels of beta-end in patients with varying degrees of head trauma have not yet been clearly documented in the literature. In the present study, significant changes in CSF beta-end levels are detected in patients with a wide range of head trauma (from minor head trauma to severe injury); however, the increased CSF beta-end levels were not correlated to the early prognosis of the patients.

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Serum osteocalcin levels are a marker of bone formation. In this study, bone and mineral metabolism in type I diabetes mellitus (DM) were investigated, and the changes related to diabetic microvascular complications were examined. Serum calcium (Ca), inorganic phosphate (P), osteocalcin (OC) and parathyroid hormone (PTH) levels were measured in 42 type I diabetic subjects. Diabetics were subdivided into those with or without complications. Age and sex-matched control subjects were used for comparisons with the diabetic groups. Serum P and PTH levels were not different from those of controls. Serum Ca levels were significantly increased (p < 0.001) although the values were within the normal range. OC levels were significantly lower in the complicated (retinopathy and/or protenuria) diabetic group (p < 0.005). In Type I diabetes mellitus, the serum OC level is influenced by the presence of microvascular complications.

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Ischaemia-induced lipid peroxidation is one of the most important factors producing tissue damage in spinal cord injury. In our study, the protective effects of Ginkgo biloba, thyroid releasing hormone (TRH) and methylprednisolone (MP) on compression injury of the rat spinal cord were investigated. For this study 45 rats in four groups, including control, MP, TRH and Gingko biloba, were used to determine the formation of malondialdehyde (MDA). All the animals were made paraplegic by the application clip method of Rivlin and Tator. Rats were divided randomly and blindly to one of four treatment groups (ten animals in each). MP and Ginkgo biloba treatments significantly decreased MDA levels (F = 54.138, P < 0.01). These results suggest that MP and Ginkgo biloba may have a protective effect against ischaemic spinal cord injury by the antioxidant effect.

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