EFFECT OF PARATHYROIDECTOMY ON OXIDATIVE STRESS IN PATIENTS WITH PRIMARY HYPERPARATHYROIDISM.

Introduction: Primary hyperparathyroidism is diagnosed earlier and more frequently with the introduction of routine serum calcium measurements. In literature, it is shown that mortality and morbidity decrease after parathyroidectomy. In our study, we aimed to determine the effect of parathyroidectomy on oxidative stress. Materials and Methods: The results of 41 patients who underwent parathyroidectomy for primary hyperparathyroidism between March 2018 and end of December 2018 were evaluated prospectively. Total antioxidant capacity (TAC), superoxide dismutase (SOD), thiobarbituric acid reactive substances (TBARS), 8-hydroxy-2'-deoxyguanosine (8-OHdG), malondialdehyde (MDA), parathyroid hormone, calcium and albumin were measured before and after parathyroidectomy. Results: The mean age of the patients in the study was 45 ± 13.1 years (age range: 18-76 years). The female/male ratio was 32/9. Postoperative values of 8OHdG, MDA and SOD 1 were significantly lower than preoperative values (p <0.05). There was no significant difference between preoperative and postoperative TAC and TBARS values. Conclusion: Oxidative stress decreased in patients with primary hyperparathyroidism after parathyroidectomy. Randomized prospective studies are needed to show the relationship between biochemical and clinical parameters in order to see the clinical reflection of the study.

EARLIER PREDICTION OF HYPOCALCEMIA BY POSTOPERATIVE SECOND HOUR PARATHYROID HORMONE LEVEL AFTER TOTAL THYROIDECTOMY.

CONTEXT: Thyroidectomy is becoming an ambulatory surgical procedure. By predicting hypocalcemia,duration of hospital stay might decline. We tried to determine whether measuring parathormone two hours after total thyroidectomy predicts hypocalcemia. OBJECTIVE: We aimed to design a protocol for early prediction of hypocalcemia by defining PTH measurement time and cut-off value of our center. DESIGN: One hundred and six patients undergoing total thyroidectomy between November 2017 and October 2018 were prospectively studied. METHODS: Pregnant women, patients with renal failure, parathyroid disease, previous neck operation and thyroid malignancy requiring neck dissection were excluded from the study. Parathormone (PTH) and calcium measurement was done preoperatively and in the postoperative second hour. RESULTS: Group 1 consisted of 75 normocalcemic patients while group 2 had 31 hypocalcemic patients. Mean age was 45±13.1 (age range: 18-76). Female/male ratio was 82/24. While with a 8.36 pg/mL postoperative second hour PTH, hypocalcemia can be predicted with a 51.5% sensitivity and 90.7% specificity while with a PTH decline of 40.8% hypocalcemia can be diagnosed with a 83.9% sensitivity and 52% specificity. CONCLUSION: Postoperative second hour PTH and PTH percentage decline can predict postoperative hypocalcemia in total thyroidectomies. Preoperative Dual-energy X-ray absorptiometry (DXA) was not found useful in hypocalcemia prediction.

Relationship of hemoxygenase-1 and prolidase enzyme activity with oxidative stress in papillary thyroid cancer.

AIM: Recent studies associate thyroid cancer with oxidative stress. We aim to clarify the relation between papillary thyroid cancer, oxidative stress, hemoxygenase-1, prolidase enzymes and investigate the availability of these enzymes as markers for diagnosis, success of treatment, and follow-up. METHODS: Thirty-one patients with papillary thyroid carcinoma and 25 healthy control subjects were included in this study. Hemoxygenase-1, prolidase (oxidant stress indicator), malondialdehyde, protein carbonyl, and superoxide dismutase (an indicator of antioxidant defense system) were measured pre-operatively and 30 days after thyroidectomy. RESULTS: There was a significant decrease in serum levels of malondialdehyde and superoxide dismutase (p <0.001 for both) after thyroidectomy in papillary thyroid carcinoma group. In addition, there was a significant difference in the postoperative serum levels of prolidase, malondialdehyde, protein carbonyl, and superoxide dismutase between papillary thyroid carcinoma and control groups (p =0.024, p <0.001, p =0.002, and p =0.016, respectively) beside significant difference of malondialdehyde, protein carbonyl, hemoxygenase-1, and superoxide dismutase pre-operative serum levels (p <0.001, p =0.003, p =0.006, and p =0.025, respectively). CONCLUSION: When the unquestionable role of oxidative stress in the pathogenesis of cancer is considered, in the future it is expected to associate parametric changes in the serum of patients caused by oxidative stress to papillary thyroid cancer. Hippokratia 2016, 20(1): 55-59.

Use of infliximab in treatment of acute pancreatitis.

OBJECTIVE: The aim of this study was to investigating the effects of infliximab in severe necrotizing pancreatitis. METHODS: Forty male Wistar rats were randomly divided into five groups evenly. Necrotizing pancreatitis was induced in group I and II by retrograde injection of 3% taurocholate into common pancreaticobiliary duct. In group III and IV saline was introduced instead of taurocholate to mimic pressure effect. Infliximab (8mg/kg) was infused through tail vein in group I and III and saline was infused in group II and IV just before laparotomy. Group V underwent sham laparotomy. Serum amylase activity, serum and tissue sialic acid, carbonyl content, malondialdehyde, total antioxidant activity (TAA) and pancreatic histopathology were assessed. RESULTS: In group I serum sialic acid, malondialdehyde, carbonyl content and amylase activity were significantly lower than in group II (p<0.01). There were no significant differences for serum TAA between group I and II (p>0.05). Tissue sialic acid and malondialdehyde in group I were significantly lower than in group II (p<0.01). But tissue TAA in group I was significantly higher than in group II (p<0.01). Carbonyl content of group I was not significantly different from group II (p>0.05). Histopathologically, pancreatic sections of group II demonstrated extensive acinar and fat necrosis, hemorrhage, and inflammation. In group I Infliximab improved histopathological changes (p0.05). CONCLUSION: Administration of infliximab resulted in a significant improvement in biochemical and histopathological alterations in acute necrotizing pancreatitis(Tab. 3, Ref. 43).

Serum levels of fetuin A and 8-hydroxydeoxyguanosine in morbidly obese subjects.

Insulin resistance is one of the feature of obesity. Fetuin A is inhibitor of insulin receptor which belongs the family of receptor tyrosine kinase. It has been observed that fetuin-null mice are resistant to diet-induced obesity and they exhibit increased insulin sensitivity. Increased production of reactive oxygen species is suggested to be associated with insulin resistance. Attacks of reactive oxygen species to DNA results in base oxidation. Among the oxidized bases, 8-hydroxydeoxyguanosine is predominant lesion with pro-mutagenic potential. In the present study; measurement of serum levels of fetuin A and 8-hydroxydeoxyguanosine in obese subjects (n=46) and healthy controls (n=22), and examination of the relations between these parameters and insulin resistance have been purposed. Blood samples were taken form morbidly obese subjects after a 12 h fasting. Serum levels of fetuin A and 8-hydroxydeoxyguanosine were measured by ELISA. Statistical analysis was performed by Mann Whitney U test and correlations were examined by Spearman correlation coefficient. Serum levels of total cholesterol, HDL, LDL, VLDL, triglycerides, free T3, free T4, fasting glucose, c-peptide and %HbA1c in the obese group were found to be different from those in the control group. Serum level of fetuin A was found to be higher, 8-hydroxydeoxyguanosine level was found to be lower in the morbid obese group than those in the control group. Fetuin A was found to be positively correlated with HOMA-IR (r:0,40, P<0.05) and negatively correlated with 8-hydroxydeoxyguanosine (r:-0,52, P<0.01). No significant association was determined between body mass index and measured parameters. In conclusion, serum level of fetuin A is high in morbidly obese subjects and is negatively associated with 8-hydroxydeoxyguanosine level in peripheral circulation. Fetuin A may be a promising link between insulin resistance and obesity as well its comorbidities.

Scolicidal activity of taurolidine for the treatment of hydatid disease.

OBJECTIVES: In this experimental study, we have evaluated in vivo and in vitro activities of taurolidine (TRD) against protoscolices of Echinococcus granulosus. BACKGROUND: Scolicidal agent application is mandatory for the interventional treatment of hydatid cysts. Serious adverse effects of current scolicidal agents forced the scientist to search for less toxic chemicals. METHODS: One milliliter of protoscolices suspension was administered into twelve Petri's dishes, six of them containing 5 ml of isotonic saline, and six of them containing 5 ml (5 mg/ml) TRD. Forty, male Balb/c mice were divided into five equal groups. Group 1: protoscolices inoculated group; Group 2: protoscolices inoculated and thereafter immediately administered with a single dose intravenous (IV) 0.5 ml TRD (400 mg/kg); Group 3: protoscolices inoculated and thereafter immediately administered with a single dose intraperitoneal (IP) 0.5 ml TRD (400 mg/kg); Group 4: three months after inoculating the protoscolices, one day before the sacrifice single dose IV 0.5 ml TRD (400 mg/kg) administered; Group 5: three months after inoculating the protoscolices, one day before the sacrifice single dose IP 0.5 ml TRD (400 mg/kg) administered. RESULTS: All the protoscolices were dead in TRD-added Petri's Dishes in 90 minutes. In group 2 and group 3, no mouse had an intraabdominal hydatid cyst. CONCLUSION: The results of this study are encouraging us to suggest TRD as an alternative scolicidal agent. Further clinical studies are needed to define the effectiveness and the mode of application of TRD for the treatment of hydatid disease (Tab. 1, Fig. 4, Ref. 30).

131I labeling of tamoxifen and biodistribution studies in rats.

Tamoxifen [TAM ([Z]-2-[4-(1,2-diphenyl-1-di-butenyl)-phenoxy]-N,N-dimethylethanamine)] has been used as an antiestrogen drug for treatment and prevention of human breast cancer. Tamoxifen was labeled with 131I using iodogen as an oxidizing agent. Mass spectroscopy of the cold standard showed that the labeling occurs in ortho position to the phenyl ether position of TAM as expected. Quality control, radiochemical yield and stability were established using the radioelectrophoresis method. The radiolabeled compound maintained its stability throughout working period of 24 h. Scintigraphic imaging was performed and tissue distribution was determined in Albino Wistar rats. According to biodistribution and imaging experiments the radiolabeled compound presented estrogen receptor (ER) specificity and it was uptaken by endometrium as well as breast tissue.