Comparison of 2D vena contracta area with 3D planimetric mitral valve area in rheumatoid mitral valve disease.

Rheumatoid valve disease is a general health problem of developing countries, and it mainly affects after the age of 40. Assessment of the correct mitral valve area (MVA) is important for the treatment of rheumatoid valve disease. However, there are contradictions between the three-dimensional (3D) and two-dimensional (2D) methods. A measurement with 3D echocardiography is a more accurate method to measure the MVA. However, in centers without 3D echocardiography, there are some difficulties in the accurate measurement of the MVA. The aim of this study was to assess the value of 2D transesophageal echocardiography (TEE) mitral valve vena contracta area (VCA) in predicting the severity of rheumatoid mitral stenosis (RMS) by comparing 3D planimetry. A total of 24 patients (10 females and 14 males) who were diagnosed with mild/moderate/severe RMS with using pressure half time, mean transmitral gradient, and planimetry methods were included in this study. 3D images were acquired using the 3D zoom and full volume. 2D TEE VCA was measured at an angle of 140° and 60°, which was perpendicular to the former, with color Doppler and the VCA was measured with an ellipsoid area using mathematical formula. There was statistically significant relationship between the measurements of 2D VCA and 3D zoom mode MVA planimetry and MVA full measurements (MVA full volume) (p < 0.01). Calculation of the valvular area after measuring the mitral valve VCA with 2D TEE is a reliable method that is usable in centers without 3D echocardiography.

Correction to: Comparison of 2D vena contracta area with 3D planimetric mitral valve area in rheumatoid mitral valve disease.

In the original publication of the article one co-author, A. Zencirci, was listed by mistake. Dr. A. Zencirci has not contributed to this article and therefore, the author list has been updated. The author name A. Zencirci has been removed. All authors have agreed to the updated author list.

Perfil esteroideo urinario tras la realización de una sesión de ejercicio concéntrico y otra concéntrico/excéntrico con similar carga de trabajo total / Urinary steroid profile after the completion of concentric and concentric/eccentric trials with the same total workload

High intensity strength training causes changes in steroid hormone concentrations.This could be altered by the muscular contraction type: eccentric or concentric.The aim of this study was to compare the effect of the completion of a short concentric(CON) and concentric/eccentric (CON/ECC) trial on the urinary steroidprofile, both with the same total work. 18 males performed the trials on an isokineticdynamometer (BIODEX III) exercising quadriceps muscles, right and left, on differentdays. Trial 1(CON): 4x10 Concentric knee extension + relax knee flexion,speed 60º/second; rest 90 seconds between each series and 4 minutes between each legexercise. Trial 2(CON/ECC): 4x5 concentric knee extension + Eccentric knee flexionunder similar conditions. Urine samples were taken before the exercise and onehour after finishing it. Androsterone, Etiocholanolone, DHEA, Androstenedione,Testosterone, Epitestosterone, Dehydrotestosterone, Estrone, B-Estradiol, Tetrahydrocortisone,Tetrahydrocortisol, Cortisone and Cortisol (free, glucoconjugated andsulfoconjugated) urinary values were determined using gas chromatography/massspectrometry techniques. No significant differences were noted in Total Work andAverage Peak Torque, although Maximum Peak Torque in the CON/ECC trial washigher than in the CON trial. These results demonstrate no changes in the steroidprofile before and after trials, or when comparing CON to CON/ECC trials. Thedata suggest that eccentric contractions do not cause hormonal changes different tothe ones produced by concentric contractions, when they are performed in strengthshort trials with the same total workload(AU)

El entrenamiento de fuerza de alta intensidad provoca variaciones en la concentración de esteroides. El tipo de contracción muscular, excéntrica o concéntrica, podría ser un factor que la alterase. El objetivo de este estudio fue comparar el efecto de la realización de una sesión corta de ejercicio concéntrico (CON) y otra concéntrica/excéntrica (CON/EXC), con la misma carga de trabajo total, sobre el perfil esteroideo urinario. 18 hombres realizaron dos sesiones de ejercicio de corta duración utilizando una máquina isocinética (BIODEX III) en días diferentes y trabajando los músculos cuádriceps de ambas piernas. La sesión de ejercicio 1 (CON) fue un 4 x 10 rep de extensión concéntrica de rodilla más relajación en el movimiento de flexión, a una velocidad de 60º/segundo y con una recuperación de 90 seg. entre cada serie y 4 minutos entre cada una de las piernas. La sesión de ejercicio 2 (CON/EXC) fue un 4x 5 rep. de extensión concéntrica de rodilla más flexión excéntrica de rodilla, con las mismas condiciones de velocidad y recuperación. Muestras de orina fueron se tomaron antes del ejercicio y una hora después de finalizarlo. Los niveles urinarios (fracción libre, glucoconjugada y sulfoconjugada) de Androsterona, Etiocolanolona, DHEA, Androstenodiona, Testosterona, Epitestosterona, Dehidrotestosterona, Estrona, β-estradiol, Tetrahidrocortisona, Tetrahidrocortisol, Cortisona y Cortisol, se determinaron usando técnicas de cromatografía de gases espectrometría de masas. No se encontraron diferencias significativas en los valores de Trabajo Total y de Pico Torque Medio, aunque los valores de Pico Torque Máximo fueron más alto en el CON/EXC ejercicio que en el CON(AU)

Tampoco se observó ningún cambio en el perfil esteroideo urinario entre antes y después de las sesiones de ejercicio, o comparando las sesiones CON/EXC con la CON. Por tanto, los datos sugieren que las contracciones excéntricas no producen alteraciones hormonales diferentes a las producidas por las contracciones concéntricas, cuando se trata de sesiones de ejercicio de fuerza de corta duración con similar carga de trabajo total(AU)

Vitamin B(6) therapy does not improve hematocrit in hemodialysis patients supplemented with iron and erythropoietin.

BACKGROUND/AIM: Pyridoxine deficiency may be the cause of failure to respond appropriately to iron and erythropoietin (EPO) administration in hemodialysis patients. METHOD: We studied 36 patients on chronic hemodialysis amply supplemented with iron and EPO, who failed to raise hematocrit levels >33%. Patients were divided into three equal groups and evaluated for 6 months as follows: Group A -- no additional therapy; group B -- supplemented with oral pyridoxine 50 mg/day, and group C received 100 mg/day pyridoxine orally. RESULTS: In all our patients, erythrocyte pyridoxine levels were initially within reference range for a healthy population and did not vary significantly during the study period. Likewise, ferritin levels and iron saturation values remained normal and constant. Hemoglobin and/or hematocrit levels remained practically unchanged in all three groups. CONCLUSIONS: The results indicate that in hemodialysis patients with normal pyridoxine status who, despite appropriate supplementation of iron and EPO, fail to reach optimal hematocrit levels, additional pyridoxine treatment does not produce any hematocrit elevation.

[The evaluation of the severity of mitral regurgitation using color Doppler echocardiographic methods]. / Renkli Doppler ekokardiyografi yöntemleri ile mitral yetersizligi ciddiyetinin degerlendirilmesi.

OBJECTIVE: This study was planned to assess the vena contracta (VC), flow convergence area (PISA) and jet area (JA) methods in evaluating the severity of mitral regurgitation (MR) and to test the accuracy of a proposed algorithm using these methods. METHODS: Eighty-seven patients with chronic MR were enrolled in the study. VC of < 0.3 cm, maximal MR flow rate calculated by PISA (Qmax) of < 72 cm3/sn and JA of < 4 cm2 were classified as mild MR. VC of > 0.5 cm, Qmax of > 240 cm3/sn and JA of > 8 cm2 were classified as severe MR. Whereas the values between these ranges were called to be moderate MR. The algorithm was planned as follows: In the first step, VC width was measured. If a patient has VC = 0.3-0.5 cm, it was used Qmax in the eccentric jets and JA in the central jets in the second step. The severity of MR were considered as severe, moderate and mild for > 50%, 21-49% and 20% of the regurgitant fraction calculated by the reference method (the quantitative Doppler method depending on aortic and mitral stroke volumes), respectively. RESULTS: The sensitivity of VC was low in differentiating between moderate and severe MR (63%). In eccentric jets, the regurgitant volume calculated by PISA was higher than that of reference method (70 +/- 49 vs. 59 +/- 29 cm3) and the JA was found to be less than that of central jets despite similar regurgitant fraction (6.8 +/- 3.2 vs. 8.5 +/- 3.3 cm2). The algorithm agreed well with the reference method and it was better than those of each tree methods (Cappa coefficients 0.89 vs. 0.65, 0.63 and 0.45 for VC, Qmax and JA; respectively). The accuracies of the algorithm in discriminating between mild and moderate MR or severe and non-severe MR were high (98% and 95%, respectively). CONCLUSIONS: The severity of MR can be determined accurately and simply by using VC, PISA and JA methods together.

IL-8 producing cells in patients with Behçet's disease.

OBJECTIVE: IL-8 is thought to be the principal chemokine responsible for neutrophil activation and tissue infiltration in patients with Behçet's disease (BD). In various studies serum levels of IL-8 were reported to be increased. METHODS: IL-8 mRNA was purified from both peripheral whole blood samples and separated lymphocytes, granulocytes and monocytes of patients with BD and compared to that from healthy (HC) and disease controls. IL-8 sequences were revealed by PCR amplification using appropriate sequence-specific primers. mRNA levels were determined semi-quantitatively using an image analyser in comparison with beta-actin. RESULTS: Although the differences did not reach statistical significance, BD patients tended to have higher IL-8 mRNA levels compared to HC in whole blood samples (2.0 +/- 1.4 vs 1.5 +/- 1.2) as well as in their lymphocytes (2.7 +/- 1.6 vs 1.5 +/- 0.9). No differences were observed between BD and HC in monocyte or granulocyte IL-8 mRNA levels. CONCLUSION: Our results suggest that the cellular source of IL-8 is diverse in BD with a possible major contribution by lymphocytes.

Double G0/G1 peak in the DNA histogram of aberrant marker positive acute leukemia patients is associated with a poor clinical outcome.

In order to investigate the relationship between aberrant marker expression and DNA ploidy, 61 adult patients with acute leukemia (39 AML and 22 ALL) were studied. Aberrant marker expression was observed in 20 patients (16/39 of AML and 4/22 of ALL patients). In flow cytometric DNA analysis aneuploidy was observed in 18 patients (9/39 of AML and 9/22 of ALL patients). The incidence of aneuploidy in patients with aberrant marker expression was 35% whereas this was 26.8% in patients without aberrant marker expression. Furthermore, 7 patients with aberrant marker expression showed an aneuploid, double G0/G1 peaks appearance whereas the remaining 11 patients with aberrant marker expression had euploid DNA content. Double G0/G1 appearance was not observed in patients without aberrant marker expression. Further analyses revealed that this did not correlate with apoptosis. All 7 patients, who had both aberrant marker expression and double G0/G1 peak had a poor clinical outcome with a short survival and all died within three months whereas three-months survival was 67% for AML, 69% for ALL patients and 81% for patients with aberrant marker expression respectively (p<0.01). Our data indicate that the evaluation of the DNA ploidy in patients with aberrant marker expression may be of prognostic importance.