Comparison of oxidative stress markers in the saliva, gingival crevicular fluid, and serum samples of pregnant women with gestational diabetes and healthy pregnant women.

BACKGROUND AND OBJECTIVE: To compare oxidative stress (OS) markers in the saliva, gingival crevicular fluid (GCF), and serum samples of pregnant women with gestational diabetes (GDM) and healthy pregnant women and to investigate the association between periodontal health/diseases and OS and GDM. METHOD: Eighty women with GDM and 80 healthy pregnant women were included in the study. Medical and clinical anamnesis was obtained from all the pregnant women included in the study, and their plaque index (PI), gingival index (GI), bleeding on probing (BoP), probing pocket depth (PPD), and clinical attachment level (CAL) measurements were performed. GCF, saliva, and serum samples were collected for the measurements of the local and systemic total antioxidant status (TAS) and total oxidant status (TOS). RESULTS: Clinical periodontal parameters were found to be significantly higher in the GDM group compared to the control group. The serum and saliva TAS, TOS, and TAS/TOS values were significantly lower in the GDM group than in the control group. In the analysis of the GCF samples, the mean TAS and TAS/TOS values were significantly lower and the TOS value was significantly higher in the GDM group than in the control group. The multivariate reduced model indicated that gravidity, salivary TAS/TOS, and GCF TAS were significant independent variables in the development of GDM (p < .05). CONCLUSION: Our results indicated that the OS of serum, saliva, and GCF samples increased in patients with GDM compared to healthy pregnant women. The role of local OS parameters in GDM may be associated with elevated clinical periodontal parameters.

Evaluation of Surface Change and Roughness in Implants Lost Due to Peri-Implantitis Using Erbium Laser and Various Methods: An In Vitro Study.

The aim of our study was to obtain similar surface properties and elemental composition to virgin implants after debridement of contaminated titanium implant surfaces covered with debris. Erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser, erbium, chromium-doped:yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser, curette, and ultrasonic device were applied to contaminated implant surfaces. Scanning electron microscopy (SEM) images were taken, the elemental profile of the surfaces was evaluated with energy dispersive X-ray spectroscopy (EDX), and the surface roughness was analyzed with profilometry. Twenty-eight failed implants and two virgin implants as control were included in the study. The groups were designed accordingly; titanium curette group, ultrasonic scaler with polyetheretherketone (PEEK) tip, Er: YAG very short pulse laser group (100 µs, 120 mJ/pulse 10 Hz), Er: YAG short-pulse laser group (300 µs, 120 mJ/pulse, 10 Hz), Er: YAG long-pulse laser group (600 µs, 120 mJ/pulse, 10 Hz), Er, Cr: YSGG1 laser group (1 W 10 Hz), Er, Cr: YSGG2 laser group (1.5 W, 30 Hz). In each group, four failed implants were debrided for 120 s. When SEM images and EDX findings and profilometry results were evaluated together, Er: YAG long pulse and ultrasonic groups were found to be the most effective for debridement. Furthermore, the two interventions have shown the closest topography of the sandblasted, large grit, acid-etched implant surface (SLA) as seen on virgin implants.

Impact of Smoking on Neutrophil Enzyme Levels in Gingivitis: A Case-Control Study.

BACKGROUND: The determination of the impact of risk factors such as smoking in periodontal disease development is of importance to better characterize the disease. However, its impact on host response remains unclear. This study aimed to evaluate the effects of tobacco smoking on GCF levels of neutrophil enzymes (myeloperoxidase (MPO), beta-glucuronidase (BGD), neutrophil elastase (NE) and periodontal parameters in healthy young adults with dental plaque biofilm-induced gingivitis. METHODS: The study population consisted of 60 systemically healthy young adults (39 smokers (Sm) and 21 non-smokers (n-Sm)) diagnosed with plaque-induced gingivitis. The periodontal examination consisted of a plaque index (PI); gingival index (GI); probing depth (PD); bleeding on probing (BoP), and clinical attachment level (CAL). GCF MPO, BGD, and NE levels were determined by means of an enzyme-linked immunosorbent assay (ELISA). RESULTS: PI, GI, and BoP were significantly increased in the Sm group (p < 0.05). PD and CAL showed no significant difference between Sm and n-Sm groups (p > 0.05). In GCF, MPO, BGD, and NE levels were significantly increased in Sm group (p < 0.05). NE levels showed a significant correlation with GI and BoP (p < 0.05 for both). Moreover, a positive correlation between BGD and NE levels (p < 0.05) was measured. CONCLUSIONS: It may be concluded that, even in young patients, tobacco consumption affects the host's immune response related to gingival inflammation. It is, therefore, mandatory to inform young patients about the risk related to tobacco consumption for their gingival health.

Periodontitis Prevalence, Severity, and Risk Factors: A Comparison of the AAP/CDC Case Definition and the EFP/AAP Classification.

BACKGROUND: This cross-sectional study evaluated the utility of the 2018 European Federation of Periodontology/American Academy of Periodontology (EFP/AAP) classifications of epidemiological studies in terms of periodontitis severity, prevalence and associated risk factors and the 2012 American Academy of Periodontology/Centers for Disease Control and Prevention (AAP/CDC) case definitions. METHODS: We included 488 participants aged 35-74 years. Measurements were recorded at six sites per tooth by two qualified examiners. The evaluated parameters included pocket depth (PD), clinical attachment loss (CAL) and bleeding on probing (BOP). Periodontitis prevalence and severity were reported using the 2018 EFP/AAP classification and the AAP/CDC case definitions. The data were stratified by recognized risk factors (age, diabetes and smoking status). RESULTS: The 2018 EFP/AAP classification indicated that all patients suffered from periodontitis. When CAL served as the main criterion, the frequency of patients with severe (Stages III-IV) periodontitis was 54%. When the AAP/CDC case definitions were applied, the prevalence of periodontitis was 61.9% and that of severe periodontitis 16.8%. Age was the most significant risk factor, regardless of the chosen case definition. CONCLUSION: It is essential to employ a globalized standard case definition when monitoring periodontitis and associated risk factors.

Neuroactivity of the naturally occurring aporphine alkaloid, roemerine.

Roemerine is a naturally occurring aporphine alkaloid. In this study, we screened a conformer library of Food and Drug Administration (FDA)-approved drugs to identify similar drugs that can assist in identifying the biological targets of roemerine. To assess the neuroactivity in vitro, we measured the levels of cell metabolites, Brain-Derived Neurotrophic Factor (BDNF) and serotonin (5-HT) in SH-SY5Y cell line. By means of structure-based virtual screening, we identified five drugs that are similar to roemerine; mirtazapine, atomoxetine, epinastine, diphenhydramine and orphenadrine. GC-MS metabolomics study revealed that roemerine has a high impact on alanine-aspartate-glutamate pathway in cell lysate and cultured medium. Additionally, roemerine increased intercellular 5-HT level and intracellular BDNF protein expression at 10 µM. In conclusion, roemerine - a major alkaloid in antidepressant-like effect possessing plants (P. lacerum and P. syriacum) - has a neuronal activity through increasing BDNF protein expression and affecting serotonergic and glutamatergic systems in SH-SY5Y cell line.

Neuroactivity of naturally occurring proaporphine alkaloid, pronuciferine.

Pronuciferine is a naturally occurring proaporphine alkaloid that belongs to isoquinoline alkaloids. The aim of this study is to investigate the neuroactivity of pronuciferine. We assessed the neuroprotective effect of pronuciferine against hydrogen peroxide (H2 O2 )-induced apoptosis in human neuronal SH-SY5Y cells. In addition, we measured the effect of pronuciferine on cell metabolites and brain-derived neurotrophic factor (BDNF) level in SH-SY5Y cells. In vitro result shows that pronuciferine at 10 µM significantly (P < .001) increased the proliferation of SH-SY5Y by 45%, and upon H2 O2 addition, pronuciferine significantly (P < .001) suppressed neuronal death caused by H2 O2 . Gas Chromatography-Mass Spectrometry (GC-MS) metabolomics study revealed that pronuciferine has a high impact on glycine-serine-threonine pathway by changing the intracellular level of serine dimethylglycine, sarcosine, and threonine. Also, pronuciferine increased the intercellular level of aspartic acid, glutamine, and tryptophan. Additionally, pronuciferine significantly (P < .05) increased the intracellular BDNF protein expression at 10 µM. Therefore, pronuciferine is a neuroactive molecule that might act as a neuroprotective agent to prevent apoptosis in neurodegenerative diseases.

From nutrition to medicine: Assessing hemorrhoid healing activity of Solanum melongena L. via in vivo experimental models and its major chemicals.

ETHNOPHARMACOLOGICAL RELEVANCE: Solanum melongena L. (eggplant) is used for treatment of rheumatism, beriberi, itching, toothache, bleeding, asthma, bronchitis, cholera, neuralgia and hemorrhoids in traditional medicine (Turkish, Chinese, and Indian). Hemorrhoids from these diseases, are common illness in all over the world, which are treated with various approaches including ethnobotanicals. AIM OF THE STUDY: This study aimed to evaluate the anti-hemorrhoidal activity of eggplant, an edible plant, which is commonly utilized around the world. MATERIALS & METHODS: In vivo anti-hemorrhoidal activity of the methanolic extract prepared from eggplant was evaluated by experimental hemorrhoid model, subsequently histological and biochemical analysis. Hemorrhoid, which was induced by applying croton oil to the anal area of the rats. Furthermore, the extract was screened for anti-inflammatory activity which is based on the inhibition of acetic acid-induced increase in capillary permeability. The healing potential was comparatively assessed with a reference Pilex® tablet and cream. Phytochemical analysis performed by HPLC. The amount of the major phenolic compound (chlorogenic acid) in extract was found by using HPLC method. RESULTS: Histological and biochemical analysis demonstrated that eggplant extract is highly effective against hemorrhoid in comparison to the controls and the commercial preparation. In addition, the methanolic extract demonstrated significant inhibitory effect on acetic acid-induced increase in capillary permeability. The phytochemical studies identified major compound as chlorogenic acid (2.86%) by liquid chromatography. CONCLUSION: The eggplant calyxes, not edible, are easy to reach, by products/vast from the food sources. This is the first scientific evidence revealing that the eggplant extract has significant anti-hemorrhoidal and anti-inflammatory activity.

Metabolomics and proteomics profiles of some medicinal plants and correlation with BDNF activity.

BACKGROUND: Identification of the low abundance of phytochemicals in plant extracts is very difficult. Pharmacological activity observed in such plants is not due to a single compound. In most cases, plant extracts show activity based on synergistic or antagonistic effects. Therefore, the idea of a holistic approach is more rational. PURPOSE: This study was planned to compare the metabolomics and proteomics profiles of Valeriana officinalis L. (Valerianaceae), Melissa officinalis L. (Lamiaceae), Hypericum perforatum L. (Hypericaceae) and Passiflora incarnata L. (Passifloraceae) used in sedative anxiolytic and sleep disorders. Integrated omics analyses were used to provide a better understanding of the effect of plant extracts on the brain-derived neurotrophic factor (BDNF) expression levels on the SH-SY5Y cell line by a holistic approach. METHODS: Metabolomic profiling of the plants was performed using the GC-MS and LC-qTOF-MS systems, and the proteomics analysis using the LC-qTOF-MS system after trypsin digestion. The Human BDNF Quantikine ELISA kit was utilized to test BDNF expression activity on the SH-SY5Y cell line. RESULTS: The investigated plant extracts showed a significant increase in BDNF expression (p < 0.05). M. officinalis was found as the most active extract. According to the correlation analyses between BDNF activity and metabolomics or proteomics level, 94 metabolites had a positive correlation while 23 metabolites had a highly negative correlation; those for proteins are 24 and 6, respectively. CONCLUSION: The multivariate data analysis revealed a similar metabolomics profile of H. perforatum and P. incarnata, which also had a similar activity profile. Remarkably, all the primary metabolites belonging to the Krebs Cycle (citric acid, fumaric acid, succinic acid, pyruvic acid, malic acid and citramalic acid, an analog of malic acid) were positively correlated with BDNF activity. Secondary metabolites with a high BDNF expression belonged to flavonoids, xanthone, coumarines, tannin, naphtalenes, terpenoids and carotenoid skeleton. Two proteins from the cytochrome P450 family (P450 71B11 and P450 94B3) were positively correlated with BDNF activity. Employing omics technologies in the plant research area will offer a better understanding of the role of plant extracts and may lead to the discovery of new compounds with specific activity.

The roles of valerenic acid on BDNF expression in the SH-SY5Y cell.

The roots of Valeriana officinalis L. (Valerianaceae) are used for treating sleep disorders and/or mild nerve tension. The effect of valerenic acid on brain-derived neurotrophic factor (BDNF) has not yet been studied, although it is known that gamma-amino butyric acid A (GABAA) receptor is regulated by BDNF, which modulates the depressive-like behavior and neurogenesis. The purpose of this study is to determine the effect of V. officinalis root extract (VO), its main constituents valerenic acid (VA) and acetoxy valerenic acid (AVA) as well as valerenic acid-free (VAF), acetoxy valerenic acid-free (AVAF) extracts and increasing amounts of valerenic acid containing extracts on the BDNF expression in SH-SY5Y cell lines. The effect of methanolic extracts of VO, VA, AVA, VAF, AVAF, and the extracts whose amount of VA were increased gradually, were tested using a Human BDNF ELISA kit with 17ß-estradiol as a positive control. The VO and VA extracts caused a significant (p < 0.001) increase in the BDNF expression in SH-SY5Y cells compared to control. This effect completely disappeared when cells were treated with VAF extract. AVA alone did not show any significant change in the BDNF levels. The extracts with increasing amount of VA led to a concentration- dependent effect on the cells. In conclusion, our findings suggest that the antidepressant-like effect of the VO extract is also related to BDNF expression, and that this is mainly due to the presence of VA in the extract. Removing VA from VO extract leads to a loss of activity. Moreover, the concentration of VA plays a role for BDNF expressions in SH-SY5Y cells, which demonstrates the importance of quality control on the commercially available products.

An LC-ESI-MS/MS method for the simultaneous determination of pronuciferine and roemerine in some Papaver species.

Papaver species, well known for their alkaloids, have been used for the treatment of several diseases, such as inflammation, diarrhea, depression, and sleep disorders in certain parts of Anatolia. In this study, four Papaver species (P. lacerum, P. syriacum, P. glaucum and P. rhoeas) were collected from different localities of Turkey. Methanolic extracts were prepared from the aerial parts of the plants. A rapid analytical method was developed for the simultaneously quantitative analysis of two alkaloids, pronuciferine and roemerine, using liquid chromatography tandem mass spectrometry. Multiple reaction monitoring in the positive ionization mode was used for detection. Pronuciferine and roemerine were analyzed on a C18 column (2.1 × 50 mm, 3 µm) with the mobile phase run in the gradient mode with 0.1% formic acid in water (A) and 0.1% formic acid in acetonitrile at a flow rate of 0.3 mL/min. The transitions 312.1→283.1 m/z and 280.0→249.0 m/z were used to monitor pronuciferine and roemerine, respectively. The assay was linear in the concentration range of 0.01 µg/mL to 1 µg/mL (r = 0.996 for roemerine, r = 0.998 for pronuciferine). The validation studies revealed that the method was linear, sensitive, accurate, precise, selective, repeatable, robust, and rugged. Finally, the developed method was applied to quantify pronuciferine and roemerine in the selected species. The amounts of pronuciferine and roemerine were respectively found as 8.5 to 48 µg/g and 4.4 to 43,000 µg/g.

Cuscuta arvensis Beyr "Dodder": In Vivo Hepatoprotective Effects Against Acetaminophen-Induced Hepatotoxicity in Rats.

Cuscuta arvensis Beyr. is a parasitic plant, and commonly known as "dodder" in Europe, in the United States, and "tu si zi shu" in China. It is one of the preferred spices used in sweet and savory dishes. Also, it is used as a folk medicine for the treatment particularly of liver problems, knee pains, and physiological hepatitis, which occur notably in newborns and their mothers in the southeastern part of Turkey. The purpose of this study was to investigate the hepatoprotective effects and antioxidant activities of aqueous and methanolic extracts of C. arvensis Beyr. on acetaminophen (APAP)-induced acute hepatotoxicity in rats. The results were supported by subsequent histopathological studies. The hepatoprotective activity of both the aqueous and methanolic extracts at an oral dose of 125 and 250 mg/kg was investigated by observing the reduction levels or the activity of alkaline phosphatase, alkaline transaminase, aspartate aminotransferase, blood urine nitrogen, and total bilirubin content. In vivo antioxidant activity was determined by analyzing the serum superoxide dismutase, malondialdehyde, glutathione, and catalase levels. Chromatographic methods were used to isolate biologically active compounds from the extract, and spectroscopic methods were used for structure elucidation. Both the methanolic and aqueous extracts exerted noticable hepatoprotective and antioxidant effects supporting the folkloric usage of dodder. One of the bioactive compounds was kaempferol-3-O-rhamnoside, isolated and identified from the methanolic extract.

Oxidative stress and DNA damage due to one-lung ventilation.

AIM: One-lung ventilation (OLV) is an anesthesia technique used to provide visualization in thoracoscopic lung surgeries and increase surgical site visibility during operation. In OLV, atelectasis occurs and blood from the lung participates in circulation without receiving oxygen. We designed a prospective study on patients we implemented surgery in order to research whether OLV leads to oxidative stress and DNA damage or not. METHODS: It was taken 5cc blood samples 4 times from these patients in the postoperative preparatory stage (T1), on the 60th minute after the start of OLV (T2), on the 60th minute after the termination of OLV (T3) and 24 hours after surgery (T4). Total antioxidant capacity (TAC), total oxidant status (TOS), oxidative stress index (OSI) values were examined with regards to DNA damages in the blood samples taken. RESULTS: DNA damage was statistically increased with OLV compared to baseline level (p<0.05) and statistically decreased in 24 hour (p<0.05). TAC level was statistically decreased with OLV compared to baseline level and statistically increased in 24 hour (p<0.05 ). TOS level was statistically increased with OLV compared to baseline level (p<0.05) and statistically decreased in 24 hour (p<0.05 ). OSI level was statistically increased with OLV compared to baseline level (p<0.05) and statistically decreased in 24 hour (p<0.05 ). CONCLUSION: To the best of our knowledge this is the first study showing DNA damage in thoracic surgery which was operated with OLV. This DNA damage found to be decreased in first postoperative day and might be related to changes in oxidative status of this patient group. KEY WORDS: Oxidative stress, lung ventilation, DNA damage.

Deteriorations of pulmonary function, elevated carbon monoxide levels and increased oxidative stress amongst water-pipe smokers.

OBJECTIVES: A water pipe (hookah) is a tobacco smoking tool which is thought to be more harmless than a cigarette, and there are no adequate studies about its hazards to health. Water-pipe smoking is threatening health of the youth in the world today. The objective of this study has been to investigate the carbon monoxide (CO) levels in breath, examine the changes in pulmonary function tests (PFT) and to assess the change of the oxidative stress parameters in blood after smoking a water pipe. MATERIAL AND METHODS: This study is a cross-sectional analytical study that has included 50 volunteers who smoke a water pipe and the control group of 50 volunteers who smoke neither a cigarette nor a water pipe. Carbon monoxide levels were measured in the breath and pulmonary function tests (PFTs) were performed before and after smoking a water pipe. Blood samples were taken from either the volunteer control group or water-pipe smokers group after smoking a water pipe for the purpose of evaluation of the parameters of oxidative stress. RESULTS: Carbon monoxide values were measured to be 8.08±7.4 ppm and 28.08±16.5 ppm before and after smoking a water pipe, respectively. This increment was found statistically significant. There were also significant reductions in PFTs after smoking a water pipe. Total oxidative status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI) were found prominently higher after smoking a water pipe for the group of water-pipe smokers than for the control group. CONCLUSIONS: This study has shown that water-pipe smoking leads to deterioration in pulmonary function and increases oxidative stress. To the best of our knowledge this study is the only one that has shown the effect of water-pipe smoking on oxidative stress. More studies must be planned to show the side effects of water-pipe habit and protective policies should be planned especially for young people in Europe. Int J Occup Med Environ Health 2017;30(5):731-742.

Role of Low-Level Laser Therapy as an Adjunct to Initial Periodontal Treatment in Type 2 Diabetic Patients: A Split-Mouth, Randomized, Controlled Clinical Trial.

OBJECTIVE: In this split-mouth clinical trial, we evaluated the clinical benefits of low-level laser therapy (LLLT) as an adjunct to nonsurgical periodontal treatment in patients with type 2 diabetes mellitus (DM). BACKGROUND DATA: The impaired wound healing seen in diabetic patients may affect the results of periodontal treatment and may require an additional approach. MATERIALS AND METHODS: In total, 22 chronic periodontitis patients with type 2 DM were included. Applying a split-mouth design, two quadrants were treated with only scaling and root planing (SRP) as the control and those in the other two were treated with SRP + LLLT as the test sites in each patient. An 808 nm GaAlAs diode laser was performed in the test sites at the energy density of 4.46 J/cm2 on days 1, 2, and 7 after SRP. Plaque index (PI), probing depth (PD), bleeding on probing (BOP), and clinical attachment level were measured at baseline and again at 1 and 3 months after treatment. Deep periodontal pockets (PD ≥4 mm) were evaluated separately. RESULTS: Test sites showed significant improvement in PI and BOP in deep pockets at the 1-month follow-up period (p < 0.001 and <0.001, respectively), whereas no difference was found between the control and the test sites in other periodontal parameters. CONCLUSIONS: LLLT during periodontal treatment offered minimal short-term additional benefit in deep pocket healing in patients with type 2 DM.

Does Obstructive Sleep Apnea Increase the Risk for Periodontal Disease? A Case-Control Study.

BACKGROUND: A possible association between periodontitis and obstructive sleep apnea (OSA) has been suggested. The aim of this study is to compare periodontitis prevalence between controls and patients with OSA by assessing clinical periodontal parameters and gingival crevicular fluid (GCF) levels of interleukin (IL)-1ß, tumor necrosis factor (TNF)-α, and high-sensitive C-reactive protein (hs-CRP); serum hs-CRP was also sampled. METHODS: A case-control study was performed that included 163 individuals: 83 individuals (18 females and 65 males) with OSA and 80 non-OSA individuals (23 females and 57 males) as controls. The test group was classified according to OSA severity. Clinical periodontal measurements were recorded, and GCF samples were collected. GCF hs-CRP, IL-lß, and TNF-α levels were analyzed using an enzyme-linked immunosorbent assay method. Serum hs-CRP was measured by latex-enhanced immunoturbidimetric assay. RESULTS: Prevalence of periodontitis in the OSA group (96.4%) was significantly higher than in the control group (75% [P <0.001]). Severe periodontitis prevalence was higher in the OSA group than control group. All periodontal clinical parameters and GCF IL-lß concentrations were significantly higher in patients with OSA than in controls (P = 0.001). No significant differences were found between the mild OSA and moderate-to-severe OSA groups. Additionally, there was no significant difference in GCF TNF-α and hs-CRP levels between the groups (P >0.05). Serum hs-CRP levels were significantly higher in patients with OSA. A significant correlation was found between GCF IL-1ß and all clinical parameters. CONCLUSIONS: Results demonstrated higher prevalence of periodontitis and higher levels of GCF IL-1ß and serum hs-CRP in patients with OSA. However, there is still a need for randomized clinical trials testing oral care interventions.

Relation of elastic properties of pulmonary artery with left ventricular abnormalities and aortic stiffness in patients with moderate to severe obstructive sleep apnea: A cross-sectional echocardiographic study.

OBJECTIVE: In this study, the associations between pulmonary artery stiffness (PAS) and aortic stiffness, left ventricular diastolic parameters, and left ventricular mass (LVM) index in moderate to severe obstructive sleep apnea syndrome (OSAS) patients without coexisting disorders were investigated. METHODS: A total of 66 non-diabetic, non-hypertensive, and non-smoking volunteers were enrolled. Participants were categorized by apnea-hypopnea index (AHI; event/hour). The control group was defined as no OSAS: AHI<5 (n=35), and OSAS group had moderate to severe OSAS: AHI>15 (n=31).Echocardiographic and biochemical tests, including measurement of C-reactive protein (CRP), were performed. PAS (kHz/s) was calculated by dividing the maximal frequency shift of the pulmonary flow by the acceleration time. RESULTS: PAS (kHz/s), obtained by echocardiography, was statistically significantly higher in the OSAS group than the control group (28±5 vs 18±4, p<0.001), and was positively correlated with AHI, CRP, aortic stiffness index, E/E', and LVM index (p=0.034, p=0.039, p<0.001, p=0.040, and p<0.001, respectively), and negatively correlated with aortic strain (AS), aortic distensibility (AD), E/A, E'/A', and E' (p<0.001). Regression analyses indicated that CRP and PAS are independent predictors of aortic stiffness (p<0.05). E/A and LVM index were independent predictors of PAS (p=0.002 and p=0.001, respectively). CONCLUSION: Increased PAS is associated with aortic stiffness, left ventricular diastolic function, and increased LVM index. PAS may be a more effective indicator of aortic stiffness in OSAS patients than CRP.

Evaluation of Pulmonary Artery Stiffness in Patients with Obstructive Sleep Apnea Syndrome.

OBJECTIVE: To investigate whether obstructive sleep apnea syndrome (OSAS) has any effect on pulmonary artery stiffness (PAS) derived from echocardiographic calculation. METHODS: Fifty-two patients with newly diagnosed OSAS and forty-two subjects without OSAS matched by age and sex were enrolled in the study. OSAS was categorized according to apnea hypopnea index (AHI, event/h) as follows: normal (AHI<5), mild OSAS (AHI 5-15), moderate and severe OSAS (AHI>15). All participants were evaluated by echocardiography to determine PAS and right ventricle functions. PAS was calculated throughout pulmonary artery flow by the formula; PAS (kHz/sec) = maximal frequency shift/acceleration time. RESULTS: Demographic and clinical parameters were similar in both groups. PAS significantly increased in OSAS compared with the control group (26.9 ± 6.1 vs. 18.0 ± 3.5, P < 0.001). Additionally, PAS in severe and moderate OSAS was considerably high compared with that in mild OSAS and control group (P < 0.001). Right ventricular myocardial performance index (MPI) and mean pulmonary artery pressures (mPAP) were considerably higher in OSAS group than control group (P < 0.001). Tricuspid E/A, right ventricle tissue Doppler E'/A', and right ventricular ejection time (RVET) decreased in OSAS group compared with control group (P < 0.001). There was a significantly positive correlation between PAS and AHI, mPAP, and MPI (P < 0.001), and a significantly negative correlation between PAS and tricuspid E/A, E'/A', and RVET (P < 0.001). Linear regression analyses showed that PAS was an independent factor for mPAP (ß = 0.595, P = 0.034). CONCLUSION: Elastic properties of pulmonary artery deteriorate with severity of OSAS and may be responsible for right ventricular dysfunctions in OSAS.

The use of mycophenolate mofetil in experimental encapsulating peritoneal sclerosis.

INTRODUCTION: Encapsulated peritoneal sclerosis (EPS) is a rare complication of long-term peritoneal dialysis usually associated with the inadequacy and early termination of dialysis modality. Adequate treatment of peritoneal fibrosis has not been achieved by medical intervention so far. Mycophenolate mofetil (MMF), which inhibits inosine monophosphate dehydrogenase reversibly and highly selectively, is the most widely used drug for maintenance immunosupression in renal transplantation. Recent studies have shown that MMF has also antifibrotic effects. In this study, we evaluated the effects of MMF on EPS model in rats based on antifibrotic effects. MATERIALS AND METHODS: Twenty-four Wistar albino rat have been randomly divided into four groups. Group I (control group) received isotonic saline intraperitoneally (i.p) 2 ml/day for (0-3rd weeks). Group II (chlorhexidine (CG) group) received CG 2 ml/day i.p. for (0-3rd weeks). Group III (chlorhexidine + MMF group) received CG (2 ml/day) i.p. for (0-3rd weeks) plus MMF 30 mg/kg/day peroral (4th-6th weeks). Group IV (resting group) received CG 2 ml/day) i.p. (0-3rd weeks) plus peritoneal resting without any treatment (4th-6th weeks) At the end of the sixth weeks, all of the rats were killed. All of the groups were analyzed in terms of peritoneal thickness, degree of inflammation, vasculopathy, neovascularization and fibrosis. Also, the parietal peritoneal tissue samples were evaluated for matrix metalloproteinase 2 (MMP-2) by using the immunohistochemical analysis. RESULTS: When the CG group was compared with the MMF group, the medication resulted in a statistically significant reduction in peritoneal thickness, inflammation and fibrosis score (53.23 ± 16.24 vs. 17.22 ± 3.62, 1 ± 1.225 vs. 1 ± 0, 1.6 ± 0.548 vs. 0.2 ± 0.447, respectively, all p < 0.05). In the resting group, no beneficial effects on morphological abnormality of the peritoneum were observed as compared with MMF group. However, according to immunohistochemical analysis of the expression of MMP-2 on peritoneal samples, the highest expression of MMP-2 was observed in the MMF group. CONCLUSION: MMF was effective for the treatment of encapsulating peritoneal fibrosis in our rat model. Most recently, MMF may be first choice for EPS due to antifibrotic effect.

Plasma and salivary total antioxidant capacity in healthy controls compared with aggressive and chronic periodontitis patients.

OBJECTIVES: To evaluate the plasma and salivary total antioxidant capacity (TAOC) in patients with generalized chronic periodontitis (CP), generalized aggressive periodontitis (AgP), and periodontally healthy controls. METHODS: This cross-sectional study includes of 88 individuals seeking dental treatment at the Faculty of Dentistry, Istanbul University, Istanbul, Turkey between January 2011 and March 2012. Fifteen AgP patients were compared with 21 healthy controls (C1), while 36 CP patients were compared with 16 healthy controls (C2). Clinical periodontal measurements were recorded, and plasma and saliva samples were collected. The TAOC of the plasma and saliva samples were determined using a commercially available colorimetric kit. RESULTS: The plasma TAOC of both AgP and CP patients was significantly lower for C1 and C2. The salivary TAOC of CP patients was significantly lower for C2, but there was no significant difference between AgP patients and C1. CONCLUSION: Our results demonstrate that severe periodontitis may be associated with a lower plasma antioxidant capacity. The reduced antioxidant capacity in patients with severe periodontitis, especially with aggressive forms may be an important contributing factor to severe tissue destruction.