Effect of macro-creatine kinase and increased creatine kinase BB on the rapid diagnosis of patients with suspected acute myocardial infarction in the emergency department.

Although there are more sensitive and earlier diagnostic markers for the diagnosis of acute myocardial infarction (AMI), measurement of creatine kinase (CK) MB isoenzyme (CKMB) using the immunoinhibition method is still widely used in stat laboratories. In this study, 3,290 patients with the prediagnosis of AMI underwent physical examinations, electrocardiography, and repetitive measurements of CK, CKMB activity, and CKMB mass, and 304 of them were diagnosed as having AMI. Electrophoresis of CK and CKMB mass was performed for the samples from 415 patients whose CKMB activity values were found to be increased and were not correlated with total CK levels. According to CKMB activity, CK electrophoresis, and CKMB index (100 x CKMB activity/CK) values, macro-CK (MCK) and/or increased CKBB levels were detected in 27 cases (MCK-I in 10 cases, MCK-II in 9, increased CKBB in 5, and both MCK-II and increased CKBB in 3). CKMB activity was found to be increased for all except one patient (96.3%), and the CKMB index was >25% in 25 (92.5%) of 27 cases. CKMB mass values were within the normal range in 25 of the cases with MCK. Two patients with MCK-I were diagnosed as having AMI because of increased CKMB mass and positive electrocardiography findings. The incidence of MCK and/or high CKBB levels (0.82%) in the whole group was similar to that reported for a normal population. MCK existence and increased CKBB levels may cause misleading diagnoses if CKMB mass measurements and/or CKMB index values are not used together for patients with suspected AMI.

MEFV mutations in familial Mediterranean fever: association of M694V homozygosity with arthritis.

OBJECTIVE: Familial Mediterranean fever (FMF) is an autosomal recessive recurrent polyserositis with a higher prevalence in some ethnic groups, including Turks. Mutations in the FMF gene (MEFV) were found associated with FMF. The aim of this study was to analyze MEFV gene mutations in FMF patients to gain insight into the mutation phenotype correlation. OBJECTIVES: We analyzed the most frequent mutations (M680I, M694V, V726A, and E148Q) in a group of young male Turkish FMF patients using an amplification refractory mutation system and a commercial kit. RESULTS: M694V mutation was detected in 80% of the patients. After making a strict diagnostic discrimination between arthralgia and arthritis, arthritis was present in 71% of homozygous and 29.4% of heterozygous patients for M694V mutation. Other mutations were not found to correlate with specific symptoms or findings. CONCLUSION: The homozygosity of M694V mutation in the MEFV gene is associated with arthritis in FMF patients.

The effect of desferrioxamine on peroxynitrite-induced oxidative damage in erythrocytes.

The aim of this study was to investigate the effect of desferrioxamine on peroxynitrite-mediated damage in erythrocytes by measuring the 3-nitrotyrosine level and glutathione peroxidase and Na(+)-K(+) ATPase activities in vitro. 3-Nitrotyrosine levels were determined by HPLC; glutathione peroxidase and Na(+)-K(+) ATPase activities were measured by spectrophotometry. Peroxynitrite increased the 3-nitrotyrosine level but decreased both enzyme activities. In the presence of desferrioxamine, glutathione peroxidase activity was increased with a decrease in the 3-nitrotyrosine level. Desferrioxamine was found to possess an important antioxidant activity as assessed in an in vitro system, reducing protein nitration, restoring enzyme activities and maintaining erythrocyte membrane integrity.

Role of urinary zinc and copper on calcium oxalate stone formation.

INTRODUCTION: It is considered that many factors may play a role in urolithiasis. Experimental and clinical studies have shown that zinc has an inhibitory effect on urolithiasis. MATERIALS AND METHODS: In this study, urinary zinc and copper were measured in 27 healthy controls and 30 calcium oxalate stone formers. RESULTS: Urinary zinc excretion was significantly higher (p < 0.001) in stone formers than healthy controls (2,575 +/- 274 and 960 +/- 80 mg/day, respectively). There was no significant difference in urinary copper excretion between healthy controls and stone formers (32.3 +/- 3.5 and 33.3 +/- 3.2 microg/day, respectively). CONCLUSIONS: According to our results, the potent inhibitory effect of urinary zinc excretion on urolithiasis could be reviewed.

Do spinal cord injuries adversely affect serum lipoprotein profiles?

OBJECTIVES: Previous reports indicate that dyslipidemia is very common in persons with spinal cord injury. This study aimed to examine the relationship between spinal cord injury and serum lipoprotein profiles. METHODS: We assessed 28 healthy control subjects matched for age and sex and 60 persons (46 men and 14 women; mean age, 28.1 years) with spinal cord injury having a mean duration of injury of 3.6 +/- 0.8 years (range, 1-13 years). RESULTS: Serum low-density lipoprotein cholesterol level was higher (109 +/- 37, 91 +/- 23.7 mg/dL, respectively) (p = 0.04) and serum high-density lipoprotein cholesterol level was lower (33 +/- 7.1, 44 +/- 7.4 mg/dL, respectively) (p < 0.001) in the patients with spinal cord injury than in the control. Apolipoprotein A-I level was significantly low (94 +/- 10.3, 103 +/- 11.5 mg/dl) (p = 0.003) and apolipoprotein B level was significantly high (93 +/- 15.6, 81 +/- 13.7mg/dL) (p = 0.004) in the group of spinal cord injury. No significant difference was observed the other parameters of these two groups. CONCLUSION: Our results have shown that serum lipoprotein level should not be ignored for the follow-up of the patients with spinal cord injury.

Monitoring of serum ionized magnesium in neurosurgical intensive care unit: preliminary results.

BACKGROUND: Our purpose was to determine the values for serum ionized magnesium (Mg) concentrations in traumatic brain injury and its effect on the prognostic scores of patients. METHODS: We prospectively measured serum ionized magnesium concentrations in 30 patients that were classified into three groups (severe, moderate, mild) by Glasgow Coma Scale Score. Serum ionized magnesium concentrations were measured during posttraumatic 5 days. Thirty patients with head trauma were followed in a neurosurgical intensive care unit with monitoring serum ionized magnesium concentrations. All patients were treated conservatively. RESULTS: We found significant difference of serum ionized magnesium concentrations when we compared all groups with each other (p<0.001). CONCLUSIONS: Based on this clinical preliminary study, traumatic brain injury is associated with graded deficit in serum ionized magnesium concentrations. Thus, measurement of serum ionized magnesium concentrations can be used as a clinical marker in traumatic brain injury.

Is high concentration of serum lipids a risk factor for Achilles tendon rupture?

BACKGROUND: The incidence of the Achilles tendon ruptures (ATR) seems to be increasing due to changes in life style and intensified sports activities in recent years. Intrinsic and extrinsic factors have been implicated as predisposing risk factors to rupture. The purpose of this study was to investigate whether the high serum lipid concentrations could be an intrinsic factor in patient with complete ruptures of Achilles tendon. METHODS: The data were collected from the records of 47 patients with complete rupture of Achilles and the control group consisted of 26 subjects. RESULTS: Total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) concentrations of the patients with ATR were higher (p<0.001), and their high-density lipoprotein cholesterol (HDL-C) was lower than the control group (p<0.05). Moreover, the concentrations of triglyceride (TG) and very low-density lipoprotein cholesterol (VLDL-C) were significantly higher than controls (p<0.05). CONCLUSIONS: The causes of ATR are multifactorial and still unclear. However, high serum lipid concentrations might be considered, as a predisposing factor in patients with complete rupture of Achilles tendon and further investigations with larger groups would be better.

The effect of isoprenoid side chain length of ubiquinone on life span.

The isoprenoid side chain length of ubiquinone (Q) can have an effect on the life span of mammals. The short living mouse and rat have Q(9), while primates have Q(10) as the major form. Ubiquinones (Qs) having longer hydrophobic tail are likely more imbedded in the mitochondrial inner membrane than the ones having shorter tails. In case of short tail length, ubisemiquinone (Q(*-)) produced during electron transport can be more exposed to the aqueous phase on both sides of the membrane, generate more superoxide radical and damage the neighbouring macromolecules. Considering the inefficient subcellular distribution of exogenous Q, production of transgenic animals synthesizing Qs having longer than 10 isoprenoid units (Q(>10)) can increase their life span.

Peripheral blood telomerase activity in non-Hodgkin lymphoma.

Telomerase, a ribonucleoprotein, stabilizing chromosomes by adding telomeric repeats to their ends, is highly expressed in most neoplastic cells and has a critical role in cellular immortalization. In this study, telomerase activity was measured in the peripheral blood mononuclear cells of patients with non-Hodgkin lymphoma (NHL). A total of 18 patients with B-cell NHL and 12 healthy volunteers were included in the study. Of the patients 7 (38.9%) were found to have telomerase activity, but no activity was detected in control subjects. No correlation was found between the telomerase activity and the grade of the disease. When the patients were divided into two subgroups as follicular and non-follicular NHL, telomerase activity was detected in 5 of 10 follicular NHL (50%) and 2 of 8 non-follicular NHL (25%) samples, but these results were not found statistically significant. In conclusion, there is detectable telomerase activity in peripheral blood of some patients with NHL, possibly suggesting the existence of neoplastic cells in the circulation or activation of lymphocytes.

Neopterin levels in nonreplicative HBV carriers.

The aim of this study was to determine the existence of immune activation by measuring neopterin in HBV (Hepatitis B virus) carriers with viral load (HBV DNA) less than 5 pg/ml. Forty-three subjects and 56 healthy controls were included in the study. Neopterin levels of were compared. ALT and ALP levels in one patient and AST levels in two patients were found minimally higher than upper limit, and GGT levels were within the reference range in all patients. Neopterin levels in the patient group and in the controls were 159.97+/-13.39 and 84.10+/-11.45 nmol/l, respectively (P<0.0001). The difference between the two groups was statistically significant (P<0.0001). In conclusion, the increased neopterin levels of HBV carriers might be the indicators of the effect of cellular immunity. This increase might also implicate a background inflammation based on mainly cellular immunity that exists within the liver.

Oxidative phosphorylation enzyme complexes in caloric restriction.

Free radicals, generated especially by electron leakage from mitochondrial electron transport chain (ETC), are accepted as one of the possible causes of aging. Long-term caloric restriction (CR) is known to increase the species specific average and maximum life spans. Thus it provides a means for investigating mechanisms of aging. There is evidence suggesting a decrease in the free radical production with CR. In this study, Blue-Native PAGE (BN-PAGE) technique was used to investigate the effect of CR on the oxidative phosphorylation enzyme complexes. Of the total 30 female Swiss Albino balb/c mice, 15 were used as control and the other 15 as CR group. Alternate day feeding regimen was used in the CR group for 66 weeks beginning at the end of 3rd month. In the control group, 5 (33.3%) mice died, 3 (20%) of them of breast cancer, 2 (13.3%) of unknown causes and no death cases were observed in the CR group during the study. BN-PAGE was performed on the extracts from brain mitochondrial fractions. Complexes II and V were excluded from the study due to some analytical limitations. No difference was found in the levels of complexes I and III between the groups. In the CR group, complex IV level was found increased and the ratio of complex III-IV decreased compared with the control group. Since there is a slight increase (108%) in the level of complex IV in the CR group, our results could suggest possible partial compensation of electron leakage in the upstream complexes in ETC, and the decrease of free radical production with CR.

Diagnostic approach to prostate cancer using total prostate specific antigen-based parameters together.

This prospective study investigated the value of serum total prostate specific antigen (tPSA)-based parameters in the diagnosis of prostate cancer (PCa). Serum tPSA, free to tPSA ratio (f/tPSA), PSA density (PSAD), and PSA transition zone (PSAT) were evaluated in 110 patients with histologically confirmed benign prostate hyperplasia (BPH) and 98 patients with PCa. Once the serum tPSA was elevated (greater than 4 ng/ml) or digital rectal examination (DRE) was suspicious, transrectal ultrasound-guided biopsies were recommended. The tPSA, f/tPSA, PSAD, and PSAT levels were significantly different between the BPH and PCa groups. In patients with a tPSA level of 4.1-9.9 ng/ml or an abnormal DRE finding, only PSAT was found to have discriminating power. The cut-off values were 0.15 for f/tPSA, 0.30 for PSAT, and 0.15 for PSAD. The diagnostic sensitivity of a positive result for one of these parameters in the whole group was 84%, but 75% in patients with a tPSA of 4.1-9.9 ng/ml or an abnormal DRE finding. The diagnostic specificity of positive results for 3 parameters was 92% in the whole group and 93% in patients with a tPSA of 4.1-9.9 ng/ml or an abnormal DRE finding. All parameters were influenced by the histological grades. Histological grades showed a negative correlation (r = -0.56) with f/t PSA and a positive correlation (r = 0.44) with PSAT. No diagnostic marker investigated heretofore was able to rule out or detect early PCa in patients with a PSA level of 4.1-9.9 ng/ml. Using the PSA-based parameters together can be helpful in management of these patients. If all of the PSA-based parameters are negative, biopsy might be postponed; patients who have three positive PSA-based parameters should be biopsied. In case of one or two of the parameters, the patient's age and race should be considered in clinical decision-making.