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Apart from demonstrating the interaction behavior of malondialdehyde (MDA) with Na+/K+-ATPase using in silico, the current study aims to investigate the effect of rheumatoid arthritis-related oxidative stress on Na+/K+-ATPase activity that is present in the erythrocyte cell membrane, which is rich in proteins vulnerable to damage from MDA and other free radicals. The target population of this study consists of 28 rheumatoid arthritis patients and 20 healthy volunteers whose MDA levels and Na+/K+-ATPase activity were determined. It was shown that MDA levels of rheumatoid arthritis patients increased (p < 0.001) and their Na+/K+-ATPase activity noticeably decreased when compared to those of healthy individuals. Also, according to this in silico modeling, MDA decreased Na+/K+-ATPase activity in line with the correlation analyses. Consequently, while elevated levels of MDA in the rheumatoid arthritis group were suggestive of oxidative stress, a decreased Na+/K+-ATPase-activity led us to speculate that the cellular membrane had sustained injury. Therefore, our results could be useful in explaining how MDA affects Na+/K+-ATPase activity in the interior of a specific molecular pathway.

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Rheumatoid Arthritis (RA) is the most prevalent cause of the systematic inflammatory arthritis that destroys the joints. While the pathogenesis of RA remains to be clarified, the imbalance in the oxidant and anti-oxidant defense system plays a crucial role. This study aims to evaluate oxidant and anti-oxidant levels of RA patients and their impacts on the activity of the disease via in silico studies. 28 patients who had not previously received any treatment for RA and 20 healthy controls were included. Their oxidative stress markers, antioxidant markers, and inflammatory factors were investigated via in silico studies. Compared to the Control Group, serum CRP levels, MDA levels, and XO activities were higher in RA Group. Cu/ZnSOD and GPx activities decreased while CAT activities remained unchanged. Besides, there was a positive correlation between MDA-serum CRP levels but a negative correlation between MDA levels-Cu/ZnSOD activities. Furthermore, we observed a negative correlation between CRP levels and Cu/ZnSOD activities. Based on these results, it was concluded that oxidative stress had increased, the defense system had weakened, and ROS production had increased. Finally, our study results with SOD and CAT activity were confirmed by molecular docking studies.

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Wegener's granulomatosis (WG) is a rare necrotizing granulomatous vasculitis of unknown etiology commonly involving vessels, the upper and lower respiratory system and the kidneys. There are various symptoms and signs of WG due to a wide spectrum of involvement sites. The initial presentation of the disease as intraoral lesions is rare. In this paper, a case of WG that presented with a necrotic lesion confined to the right tonsil before other symptoms and signs occurred is described. The diagnosis was established based on the clinical presentation and the histopathological findings of the characteristic inflammatory pattern.

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OBJECTIVE: Lupus nephritis (LN) is a type of organ involvement of systemic lupus erythematosus (SLE) that leads to disease-related morbidity and mortality. Lack of good treatments for LN continues to be problematic. Many different treatment protocols are applied in treatment centers. Not every treatment protocol is successful. Moreover, patients who reached remission may present with exacerbations. In this study, we aimed to evaluate the treatment results of our patients and investigate their remission rates as well as factors that affect remissions. MATERIALS AND METHODS: We retrospectively investigated the results of 41 patients who were diagnosed with lupus nephritis after kidney biopsy in the Nephrology and Immunology-Rheumatology departments of Atatürk University Medical Faculty Training Hospital between January 2000 and December 2008. Demographic information, clinical history and laboratory results were collected from each patient's records. The relationships among clinical, laboratory, demographic parameters and remissions were investigated. The patients were grouped in terms of urine protein levels; patients with urine protein < 330 mg/day were regarded as in remission and patients with urine protein ≥ 330 mg/day were were regarded as uncontrolled. RESULTS: At the end of a 12-month period of therapy, 24 (58.5 %) of the patients were in remission. There were no statistically significant relationships among age, sex, anti-ds-DNA, C3, C4, activity indexes, chronicity indexes, serum level of creatinine, urine protein levels and remission (p>0.05). We compared class 3 LN patients at the 6th and 12th months according to treatment protocols. Azathioprin or mycophenolate mophetil were significantly better at placing urine protein levels in remission as compared to cyclophosphamide (p<0.05). CONCLUSION: According to our study, no relationship was found between basal clinical and laboratory parameters and patient remission. Response rates of our LN patients were similar to those in the literature. However, complete remission is still a problem in LN. The results of the protocols used in the treatment of LN show similarities. Although there are some data suggesting that MMF used in recent years is effective, it should be supported by prospective multicenter studies. It is important to note that it is difficult to achieve complete remission in LN patients.

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Behcet's disease (BD) is a chronic, progressive disorder that affects many systems of the body including the eye. The aim of this study was to examine the effects of nitric oxide synthase activity (NOS), nitric oxide (NO*), and homocysteine (Hcy) levels in patients with active BD. Included in this study were 18 male BD patients and 16 male healthy volunteers as controls. Erythrocyte NOS activity, (NO*) erythrocyte sedimentation rate, serum C-reactive protein, and plasma Hcy values in the patients with BD were significantly higher than those of the control group. Our results show that these parameters play a major role in the inflammatory reactions observed in BD.

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Behçet's disease (BD) is a chronic, progressive disorder that affects many systems of the body including the eye. The aim of this study was to assess whether the increase in oxidative stress in the affected tissues is reflected by lipid peroxidation and to check for alterations in antioxidants and antioxidant enzyme activities in patients with BD. Erythrocyte antioxidant potential (AOP), glutathione (GSH) and GSH-dependent enzymes (glutathione peroxidase (GSH-Px), glutathione reductase (GRD) and glutathione-S-transferase (GST), catalase (CAT), Cu-Zn superoxide dismutase (Cu-Zn SOD) activities, malondialdehyde (MDA) and some trace elements (zinc, Zn; copper, Cu; manganese, Mn) levels in men with BD. Erythrocyte CAT, GSH-Px activities, MDA, GSH, AOP and serum Zn values were significantly lower in patients with BD than in the control group. However, erythrocyte Cu-Zn SOD, GRD activities, erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP) and Cu values were significantly higher in patients with BD than in the control group, but GST activity and serum Mn values were unchanged. In conclusion, our results confirm the presence of oxidative stress in patients with BD and suggest that the severity of BD may arise from impaired antioxidant mechanisms. Therapy with antioxidants may lead to the increase in the antioxidant defense system and thus improvement in clinical symptoms.

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OBJECTIVE: This study aims to assess left ventricular diastolic functions with tissue Doppler imaging (TDI), which is a new technique, and to compare it with conventional Doppler echocardiography techniques in patients with active rheumatoid arthritis (RA). METHODS: Fifty-two patients with active RA and 47 healthy persons were included in this study. All patients and the control group were evaluated by M-mod, two-dimensional, conventional Doppler echocardiography and TDI. RESULTS: Left ventricular early diastolic (E)/late diastolic (A) flow velocity (E/A ratio) was found to be lower in patients with RA than in the control group (p<0.001). Mitral annular early diastolic (E(m))/late diastolic (A(m)) velocity(E(m)/A(m) ratio) was found to decrease in RA patients compared with the control group (p<0.001). E/E(m) ratio was higher in patients with RA than in the control group (p<0.001). CONCLUSION: Left ventricular diastolic functions were impaired in patients with RA. We have concluded that TDI alone, or together with conventional Doppler echocardiography, is useful for the evaluation of diastolic functions in RA patients.

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OBJECTIVE: The aim of this study was to evaluate left ventricular diastolic function in patients with active rheumatoid arthritis (RA), analyzing conventional Doppler and tissue Doppler echocardiographic imaging (TDI) which is a new echocardiographic application, with special regard to disease duration. METHODS: Fifty-two patients with active RA and 47 healthy persons were included in this study. Duration of disease ranged from 3 to 324 months (mean 76+/-85 months). All patients and the control group were evaluated by M-mod, two-dimensional, conventional Doppler echocardiography and TDI. RESULTS: Among conventional Doppler transvalvular mitral flow parameters, late diastolic flow velocity (A) and deceleration time (DT) values were higher in patients with RA than that in the control group (p<0.001). E (early diastolic flow velocity)/A ratio was found to be lower in patients with RA than that in the control group (p<0.001). Mitral annular early diastolic velocity (E (m)), among TDI parameters, was found to be lower in patients with RA than that in the control group (p<0.001). E (m)/A (m) (mitral annular late diastolic velocity) ratio was found to be lower in RA patients compared with that in the control group (p<0.001). The relation was found between A (r=0.43, p=0.001), DT (r=0.30, p=0.03), E/A ratio (r=0.40, p=0.004), E (m) (r=0.32, p=0.02), E (m)/A (m) ratio (r=0.30, p=0.03), and E/E (m) (r=0.32, p=0.02), with disease duration in patients with RA. CONCLUSION: At present, it is concluded that active RA patients, in the absence of clinical evidence of heart disease, show diastolic dysfunction characterized by impaired E/A ratio, E (m)/A (m) ratio, and DT. The relation between diastolic dysfunction and disease duration suggests a subclinical myocardial involvement.

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Behçet's disease is a systemic vasculitis of unknown aetiology. Endothelial cell injury plays an important role in the pathogenesis and immunopathology of Behçet's disease. E-selectin is expressed by activated endothelial cells. Because the selectin adhesion molecules are shed from activated cells, soluble forms of these proteins can be used as activation markers of endothelium (E-selectin). The pathogenesis of Behçet's disease (BD) is closely related to endothelial cells, leucocyte functions and immunity. The aim of this study was to investigate circulating E-selectin adhesion molecules, which are known to play a significant part in the immune response especially by regulating interaction of the leucocytes with endothelium in BD. Plasma E-selectin concentrations were evaluated in 23 patients with BD and 20 healthy control subjects. The disease activity was evaluated by clinical manifestations (oral aphthous ulcer, genital ulceration, positive pathergy test, skin lesions, eye involvement, thrombophlebitis and arthritis) and by laboratory investigations [erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)]. The patients were newly or previously diagnosed cases not taking any drug for BD. Levels of E-selectin were measured with commercially available sandwich enzyme- linked immunosorbent assay (ELISA) kits using human sE-selectin (cat. no: BMS 205). Plasma E-selectin concentrations of patients and controls were compared with the Mann-Whitney U test. Statistical significance was assigned to p values lower than 0.05. Serum levels (mean±SD) of soluble E-selectin (sE-selectin) were significantly higher in 23 patients with BD than in 20 healthy controls (53.2 ± 18.2 ng/ml vs 33.8 ± 7.5 ng/ml, p < 0.0001). A statistically significant positive correlation was observed between sE-selectin levels and CRP and ESR in patients with BD (r = 0. 78, p < 0.001 and r = 0.56, p < 0.01, respectively). Increases in the E-selectin in BD may be a direct consequence of the leucocyte and endothelium activations observed during the disease process. The noninvasive investigations can be used as biochemical markers for inflammation. This may provide additional information regarding disease activity along with the traditional indices such as ESR and CRP.

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Systemic lupus erythematosus (SLE) is a chronic progressive autoimmune disorder with a wide spectrum of clinical and immunological abnormalities. In this study, we aimed to investigate the levels of serum zinc (Zn), copper (Cu), magnesium (Mg), manganese (Mn), iron (Fe), ceruloplasmin (Cp), transferrin (Trf), and albumin (Alb) in SLE and whether it is related to the severity of the clinical condition of this chronic disease. Cp and Cu levels were higher, while Trf, Alb, Zn, Mg, Mn, and Fe levels were lower in serum of patients with SLE (n = 27) compared with healthy controls (n = 20). The mechanisms by which these alterations occur in certain inflammatory conditions need to be elucidated. It is also obscure whether these alterations are a cause or a consequence of the inflammation. As a conclusion, alterations in the levels of the parameters in SLE may not be a reason for, but in fact a consequence of the disease itself.

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Behcet's disease is a systemic vasculitis of unknown aetiology. Endothelial cell injury plays an important role in the pathogenesis and immunopathology of Behcet's disease. E-selectin is expressed by activated endothelial cells. Because the selectin adhesion molecules are shed from activated cells, soluble forms of these proteins can be used as activation markers of endothelium (E-selectin). The pathogenesis of Behcet's disease (BD) is closely related to endothelial cells, leucocyte functions and immunity. The aim of this study was to investigate circulating E-selectin adhesion molecules, which are known to play a significant part in the immune response especially by regulating interaction of the leucocytes with endothelium in BD. Plasma E-selectin concentrations were evaluated in 23 patients with BD and 20 healthy control subjects. The disease activity was evaluated by clinical manifestations (oral aphthous ulcer, genital ulceration, positive pathergy test, skin lesions, eye involvement, thrombophlebitis and arthritis) and by laboratory investigations [erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)]. The patients were newly or previously diagnosed cases not taking any drug for BD. Levels of E-selectin were measured with commercially available sandwich enzyme-linked immunosorbent assay (ELISA) kits using human sE-selectin (cat. no: BMS 205). Plasma E-selectin concentrations of patients and controls were compared with the Mann-Whitney U test. Statistical significance was assigned to p values lower than 0.05. Serum levels (mean+/-SD) of soluble E-selectin (sE-selectin) were significantly higher in 23 patients with BD than in 20 healthy controls (53.2+/-18.2 ng/ml vs 33.8+/-7.5 ng/ml, p<0.0001). A statistically significant positive correlation was observed between sE-selectin levels and CRP and ESR in patients with BD (r=0.78, p<0.001 and r=0.56, p<0.01, respectively). Increases in the E-selectin in BD may be a direct consequence of the leucocyte and endothelium activations observed during the disease process. The noninvasive investigations can be used as biochemical markers for inflammation. This may provide additional information regarding disease activity along with the traditional indices such as ESR and CRP.

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Acute generalized exanthematous pustulosis (AGEP) is an uncommon disease manifested as an erythematous pustular eruption. It is usually caused by systemic medication. We describe a patient with acute generalized pustular eruption induced by iohexol. A 52-year-old woman developed fever and a generalized pustular eruption on the neck, trunk and extremities three days after taking iohexol. The culture from pustules was sterile. Other systemic and laboratory examinations were normal. A skin biopsy from a lesion on the trunk showed the features of a drug-induced pustular eruption as a subcorneal blister including neutrophils and eosinophils, mild spongiosis, and a sparse infiltrate at neutrophils and eosinophils in the papillary dermis. The patient had no history of psoriasis. The lesions resolved with systemic corticosteroid therapy within one week and did not relapse. According to our investigation, iohexol-induced AGEP has not been previously reported. We present an interesting case.

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The levels of malondialdehyde and ceruloplasmin, and superoxide dismutase activity were higher, while transferrin concentration and the activities of glutathione peroxidase and catalase were lower in serum of patients with systemic lupus erythematosus (n=24) compared with healthy controls (n=20). Disease activity index correlated positively with serum malondialdehyde level (r=0.47, p<0.05), erythrocyte sedimentation rate (r=0.41, p<0.05) and C-reactive protein concentration (r=0.41, p<0.05), while it correlated negatively with serum superoxide dismutase (r=0.42, p<0.05) and glutathione peroxidase (r=-0.44, p<0.05) activities in patients. No such correlations were found in healthy control subjects. It remains to be seen whether correlations found between disease activity score and serum malondialdehyde level, and also activities of serum superoxide dismutase and glutathione peroxidase enzymes observed in the present study may be used to predict prognosis in patients with systemic lupus erythematosus.

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We evaluated serum total adenosine deaminase, its isoenzymes adenosine deaminase-1 and adenosine deaminase-2, and cytidine deaminase activities in 24 patients with active systemic lupus erythematosus, and in 26 healthy control subjects, and found the means +/- SD values to be 21.38 +/- 5.96 IU/l, 3.74 +/- 2.12 IU/l, 17.72 +/- 5.02 IU/l and 17.89 +/- 4.62 IU/l, respectively in the patients, and 14.97+/- 4.71 IU/l, 4.01 +/- 1.35 IU/l, 10.91 +/- 3.91 IU/l and 7.39 +/- 3.97 IU/l, respectively in the control subjects. When compared to the healthy controls, serum total adenosine deaminase, adenosine deaminase-2 and cytidine deaminase levels were significantly higher (p<0.001) in systemic lupus erythematosus patients, but the decrease of adenosine deaminase-1 level was not statistically significant (p>0.05). The increased adenosine deaminase-2 may be of macrophage origin. It closely correlated with clinical signs of active systemic lupus erythematosus. The membranes of polymorphonuclear neutrophils may be damaged, and cytidine deaminase may be released into serum. In conclusion, serum total adenosine deaminase, adenosine deaminase-2 and cytidine deaminase activities may serve as useful indicators for evaluating disease activity in patients with active systemic lupus erythematosus.

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Intercellular adhesion molecule-1 (ICAM-1) is a membrane-bound molecule primarily involved in cell-cell adhesive interactions of the immune system. It is a cytokine-induced glycoprotein involved in the recruitment of cells into tissues undergoing inflammatory responses. The levels of soluble ICAM-1 were measured in sera of patients with systemic lupus erythematosus (SLE) using sandwich enzyme-linked immunoassay. Serum levels (mean +/- SD) of soluble ICAM-1 (sICAM-1) were significantly higher in 24 patients with SLE than in 20 controls (372+/-42 ng/dL vs 231+/-29 ng/dL, P < 0.001). A statistically significant positive correlation was observed between sICAM-1 levels and SLE disease activity index (SLEDAI) score in SLE patients, and no correlation was found between sICAM-1 and CRP, SLEDAI and CRP, or SLEDAI and ESR in patient groups (P>0.05). These findings suggest that sICAM-1 measurement may serve as an additional serologic marker of disease activity in patients with SLE.

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The aim of this study is to demonstrate the spectrum of radiologic findings of hyperimmunoglobulin E (hyper- IgE) syndrome that is relatively rare in adults. We describe the imaging findings of this rare disease in five patients. The study group consisted of 4 men and 1 woman. The final diagnosis was made according to laboratory findings in all cases. We detected lung involvement in 3 cases, paranasal sinus involvement in 4 cases and vascular involvement in 1 case. Soft tissues were involved in 5 cases. Bone involvement was demonstrated in 3 patients. The most frequent radiologic finding was widespread infectious involvement of soft tissues, bones and neighboring structures such as bursae and tendons and respiratory system.