The role of laparoscopic sleeve gastrectomy on inflammatory parameters in morbidly obese patients.

BACKGROUND: Obesity is an excessive increase in body fat mass and triggers chronic inflammation which causes increased fat accumulation in the visceral fat tissue. The aim of this study was to analyze serum zinc (Zn), Zn-alpha 2 glycoprotein (ZAG), peroxisome proliferator-activated receptor-γ (PPAR-γ) and nuclear factor kappa-light-chain-enhancer of activated B cell (NF-κB) levels in morbidly obese patients before and after laparoscopic sleeve gastrectomy (LSG) and determine the association between alteration in body mass index (BMI), the % Excess Weight Loss (% EWL) and the biochemical parameters. METHODS: Thirty healthy individuals as a control group and 30 morbidly obese patients who had undergone LSG were enrolled in this study. Routine anthropometric and laboratory biochemical parameters in venous blood samples of groups at baseline and 1 and 12 months after LSG were recorded. RESULTS: Significant weight loss was achieved at 1 and 12 months after LSG. At baseline serum ZAG and PPAR-γ levels were lower, while NF-кB levels were higher in morbidly obese patients compared with the control group. Serum ZAG and PPAR-γ levels increased while NF-кB levels decreased 1 month and 12 months after LSG. Decreased %EWL was negatively correlated with changes in NF-кB, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), fasting plasma glucose and insulin at 12 months after LSG in morbidly obese patients. However, %EWL was positively correlated with changes in ZAG. CONCLUSIONS: Obesity was associated with down-regulated serum ZAG and PPAR-γ levels while up-regulated serum NF-кB. Our findings suggest that LSG ameliorates upregulating PPAR-γ expression, thereby inhibiting NF-κB-mediated inflammation by weight loss.

Where we are in the fight against Hepatitis B Infection; Trends in Hepatitis B virus seroprevalence in Black Sea Region of Turkey.

CONTEXT: To determine new strategies for complete coverage of hepatitis B virus (HBV) vaccination, every country needs to take into concern factors of infection transmission in its own region. AIMS: The aim of this study was to investigate the seroprevalence of hepatitis B among all age groups in northern Turkey using HBsAg and anti-HBs serological markers. MATERIALS AND METHODS: The laboratory records of a total of 101648 patients of all ages attending a tertiary level hospital in Samsun, a Black Sea coastal city, between January 2014 and May 2016 were evaluated retrospectively. RESULTS: HBsAg and anti-HBs seropositivity was found to be 4% and 38.3%, respectively. There was a significant difference between HBsAg (χ2 = 209.08; P = 0.00), anti-HBs (χ2 = 124.12; P = 0.00) seropositivity, and immunization status. Although we found a statically difference between men and women (χ2 = 32.2 P = 0.00) for HBsAg seropositivity, there was no significant difference for anti-HBs (P = 0.22). In 1998, the universal infant immunization program changed the HBV epidemiology in Turkey, and resulted in an apparent trend towards reduced disease levels. However, prevalence of HBV infection is still high in adolescent and young adults. CONCLUSIONS: Therefore, a catch-up immunization program, education, and follow-up policy for these groups, in addition to routine infant immunization, will decrease the HBV infection rate, reducing morbidity and mortality rates, and will help to reduce hepatitis B transmission in Turkey.

Indoor radon measurements in Turkey dwellings.

In this work, indoor radon radioactivity concentration levels have been measured in dwellings of Turkey within the frame of the National Radon Monitoring Programme. The (222)Rn concentrations were measured with time-integrating passive nuclear etched track detectors in 7293 dwellings in 153 residential units of 81 provinces, and the radon map of Turkey was prepared. Indoor radon concentrations were distributed in the range of 1-1400 Bq m(-3). The arithmetic mean of the radon gas concentration was found to be 81 Bq m(-3); the geometric mean was 57 Bq m(-3) with a geometric standard deviation of 2.3.

Determination of natural radioactivity by gross alpha and beta measurements in ground water samples.

In this study, the activity concentrations of the gross α and ß in ground water samples collected from the different drilled wells in Nevsehir province were measured to assess annual effective dose due to the ingestion of the water samples. Nevsehir province is one of the major cities of Cappadocia Region which is a popular tourist destination as it has many areas with unique geological, historic, and cultural features. Sampling and measurements were carried out in the autumn of 2011 and the spring of 2012. The values of the activity concentrations of the gross α and ß measured in the water samples ranged from 80 to 380 mBq L(-1) with a mean of 192 mBq L(-1) and 120-3470 mBq L(-1) with a mean of 579 mBq L(-1) respectively. All values of the gross α were lower than the limit value of 500 mBq L(-1) while two ground water samples were found to have gross ß activity concentrations of greater than 1000 mBq L(-1). Therefore two water samples were the subject of further radioisotope-specific analysis. The obtained result indicated that the elevated activity concentrations of the gross ß in these water samples are dominated by (40)K activity. Annual effective doses ranged from 0.04 to 0.20 mSv y(-1).

Non steroidal antiinflammatory drugs may be harmful to normal kidneys: experimental surgery model*.

BACKGROUND AND AIM: The exact effect of analgesics on normal kidneys is not known yet. We aimed to evaluate the impression of non steroidal antiinflammatory drugs (NSAID) used post-operatively on kidneys, in rat (tracheotomy) model. METHODS: Twenty-five non-uremic male wistar albino rats were included. For 18 rats, tracheotomy was performed and divided into two groups. First group, NSAID (diclofenac 10 mg/kg/day intramuscular (im)) (NSAID, n=8); second group isotonic (im)(Control, n=10) were administered for a week. For third group (Histological control,n=7) in order to evaluate normal histology neither surgery nor medication were applied. At the end (7th day), 24 hours urine collected then, blood samples were taken by intracardiac punction and were sacrified. One of the kidneys fixed for histological evaluation, the other was preserved for the measurements of tissue enzyme levels. Lipid peroxidation products and antioxidant enzyme levels were measured both from plasma and renal tissues. Histologically inflammation, regeneration, degeneration assessed semiquatitativelly and immunohistochemical dyes were applied. RESULTS: Hemoglobin thiobarbituric acid reactive substance level indicating the increase of lipid peroxidation in NSAID group was higher than control group (673±204 vs.373±27nmol/gHb respectively, p>0.05). Superoxide dismutase (one of the antioxidant enzymes responsible for reduction of reactive oxygen substances) and serum nitrate levels were lower in NSAID groups (700±68 vs.1371±164U/gHb and 26±4.4 vs.50.8±6.8 µmol/mL respectively, p<0.05).Although tissue levels were parallel to plasma levels but the difference wasn't significant. In histological assessment degeneration was present only in NSAID group (1.3±0.6 vs.0.0±0, p<0.05). Inflammation were lower than the control group (0.8±0.4 vs.1.2±0.2, p>0.05). Cyclooxygenase-2 expression was disappeared in NSAID group. CONCLUSIONS: NSAIDs mostly used post-operatively for analgesia, may cause unfavorable effects on kidneys by oxidative stress.

Natural and anthropogenic radionuclides in the granitic region of Kapidag peninsula, Western Anatolia, Turkey.

Naturally occurring radionuclides of terrestrial origin (also called primordial radionuclides) are present in various degrees in all media in the environment. This study represents the reports on the natural and anthropogenic radionuclides in the Kapidag granitic region. For this purpose, activities of radionuclides in soil, beach sands and rocks of the region have been investigated to assess the radiological hazard of the natural radioactivity. The radium equivalent activities, the absorbed dose rates and the external hazard indexes have been calculated, and also in situ gamma dose rates have been measured in the region. The mean activities of (238)U, (232)Th and (40)K with the ranges were determined as 31.1±15.7 (12.1-71.9), 42.5±15.9 (19.7-94.9), 590.3±192.2 (184.7-892.5), in the soil, as 16.5±9.5 (4.9-40.8), 67.1±106.9 (18.5-433.0), 569.2±212.6 (162.0-821.1) in the sand and as 25.4±12.8 (4.8-50.7), 37.8±21.5 (4.5-96.7), and 592.4±285.5 (62.4-1121.6) Bq kg(-1) in the rocks, respectively. It was also observed that the average activities of (137)Cs were ranged 0-27.8 Bq kg(-1) in the soil and 0.6-3.8 Bq kg(-1) in the beach sands. The mean Ra(eq) activities of the rocks, sands and soil were found to be 125.1±59.5, 156.3±157.2 and 137.3±48.8 Bq kg(-1), respectively, lower than the recommended maximum value of 370 Bq kg(-1) with some exceptions. The maximum contributors to the total absorbed gamma dose rates in air were determined as (238)U (45%) for the beach sands, (238)U (40%) for the soil and (40)K (41%) for rocks. The average outdoor gamma dose rates for the soil due to terrestrial and cosmic radiations were found to be 64.6±22.7 and 47.1±9.6 nGy h(-1), respectively, with the total of 111.7±29.5 nGy h(-1) outdoor gamma exposure rate and the annual average effective outdoor gamma dose was calculated as 137±36.2 µSv for the region. The results of the study were discussed with similar studies in close regions and the worldwide averages.

Methylated APC and GSTP1 genes in serum DNA correlate with the presence of circulating blood tumor cells and are associated with a more aggressive and advanced breast cancer disease.

BACKGROUND: Tumor-related methylated DNA and circulating tumor cells (CTC) in the peripheral blood might be of prognostic importance in breast cancer. Thus, the aim of our study was to examine free methylated DNA and CTC in the blood from breast cancer patients and to correlate it with clinicopathological features known to influence prognosis. MATERIALS AND METHODS: We prospectively obtained serum samples from 85 patients with breast cancer and 22 healthy volunteers. Sera were analysed by methylation specific PCR (MethyLight PCR) for five genes: adenomatous polyposis coli (APC), ras association domain family protein 1A (RASSF1A), estrogen receptor 1 (ESR1), CDKN2A (p16) and glutathione s-transferase pi 1 (GSTP1). Beta actin (ACTB) served as control. In parallel matched peripheral blood of 63 patients was used to assay for circulating tumor cells in the peripheral blood by a modified immunomagnetic AdnaTest BreastCancerSelect with PCR detection for EPCAM, MUC1, MGB1 and SPDEF. RESULTS: A hypermethylation in the APC gene in 29% (25/85), in RASSF1A in 26% (22/85), in GSTP1 in 18% (14/76) and in ESR1 in 38% (32/85) of all breast cancer patients was detected. No hypermethylation of CDKN2A was found (0/25). Blood samples of patients were defined CTC positive by detecting the EPCAM 13% (8/63), MUC1 16% (10/63), MGB 9% (5/55), SPDEF 12% (7/58) and in 27% detecting one or more genes (15/55). A significant difference was seen in methylated APC DNA between cancer patients and healthy volunteers. Moreover, methylated APC, RASSF1 and CTC were significantly different in metastatic versus non-metastatic disease. In addition, the presence of methylated APC, RASSF1A and CTC correlated significantly with AJCC-staging (p = 0.001, p = 0.031 and 0.002, respectively). High incidences of methylations were found for the genes RASSF1 and ESR1 in healthy individuals (both 23% 5/22). Methylated GSTP1 was predominantly found in the serum of patients with large primaries (p = 0.023) and was highly significantly correlated with positive Her2/neu status (p = 0.003). Elevated serum CA15.3 was strongly correlated with methylated APC and CTC detection (both p = 0.000). Methylated ESR1 failed to exhibit significant correlations with any of the above mentioned parameters. The presence of CTC in peripheral blood was significantly associated with methylated APC (p = 0.012) and methylated GSTP1 (p = 0.001). CONCLUSION: The detection of methylated APC and GSTP1 DNA in serum correlated with the presence of CTC in the blood of breast cancer patients. Both methylated DNA and CTC correlated with a more aggressive tumor biology and advanced disease.

Environmental radioactivity assessment for Bayburt, Turkey.

This study assesses the results of environmental radioactivity measurements for Bayburt Province in the Eastern Black Sea area of Turkey. Using gamma-ray spectrometry, activity concentrations of the natural radionuclides (226)Ra, (232)Th and (40)K and a fission product (137)Cs were investigated in soil samples. The activity concentrations of (226)Ra, (232)Th and (40)K in various building materials such as sand, cement and marble and in drinking waters were determined. The activity concentrations vary from 16 to 54 Bq kg(-1) for (226)Ra, from 10 to 21 Bq kg(-1) for (232)Th and from 113 to 542 Bq kg(-1) for (40)K in building materials. The mean specific activity concentrations of (226)Ra, (232)Th and (40)K in drinking waters were 93, 30 and 504 mBq l(-1), respectively. The concentrations of gross alpha and beta radioactivity in drinking water samples collected from four different sampling stations have been determined. The results show that the gross alpha and beta activities are lower than the screening levels given by the World Health Organization (WHO), which are a maximum contaminant level of 0.5 Bq l(-1) and 1.0 Bq l(-1) gross alpha and beta radioactivity, respectively, in drinking water. Indoor radon measurements were made in 44 dwellings in Bayburt by using Cr-39 detectors. Radon concentrations in dwellings in Bayburt varied from 17 to 125 Bq m(-3) and the average value was 56 Bq m(-3). The results obtained in this study indicate that the region has a background radiation level that is within the typical natural range and shows no significant departures from other parts of the country.

Radionuclide concentrations in soil and lifetime cancer risk due to gamma radioactivity in Kirklareli, Turkey.

The objective of this study is to evaluate and map soil radionuclides' activity concentrations and environmental outdoor gamma dose rates (terrestrial and cosmic) in Kirklareli, Turkey. The excess lifetime cancer risks are also calculated. Outdoor gamma dose rates were determined in 230 sampling stations and soil samples were taken from 177 locations. The coordinates of the readings were determined by the Global Positioning System (GPS). The outdoor gamma dose rates were determined by Eberline smart portable device (ESP-2) and measurements were taken in air for two minutes at 1m from the ground. The average outdoor gamma dose rate was 118+/-34nGyh(-1). Annual effective gamma dose of Kirklareli was 144microSv and the excess lifetime cancer risk of 5.0x10(-4). Soil samples were analyzed by gamma spectroscopy. The average 226Ra, 238U, 232Th, 137Cs, and 40K activities were 37+/-18Bqkg(-1), 28+/-13Bqkg(-1), 40+/-18Bqkg(-1), 8+/-5Bqkg(-1) and 667+/-281Bqkg(-1), respectively. The average soil radionuclides' concentrations of Kirklareli were within the worldwide range although some extreme values had been determined. Annual effective gamma doses and the excess lifetime risks of cancer were higher than the world's average.