The effects of nitrous oxide on vascular endothelial growth factor (VEGF) and its soluble receptor 1 (VEGFR1) in patient undergoing urological surgery.

OBJECTIVE: Anesthesia and surgical intervention, leads to the development of systemic inflammatory response. The severity of the inflammatory response depends on the pharmacological effects of anesthetic agents and duration of anesthesia. OBJECTIVE of the study was to investigate the effect of nitrous oxide on VEGF and VEGFR1 levels in patients undergoing surgery. METHODS: Forty-four patients undergoing elective urological surgery were included in the study. Anesthesia maintenance was provided with 1-2 MAC sevoflurane, O2 50%, N2O 50% in 4L/m transporter gase for group 1 (n=22) and 1-2 MAC sevoflurane, O2 50%, air 50% in 4L/m transporter gase for group 2 (n=22) Venous blood samples for the measurement of VEGF and VEGFR1 were taken before the induction of anaesthesia, 60 minutes of anesthesia induction, at the end of anaesthesia and 24 hours after operation. In statistical analysis Bonferroni test and analysis of variance at the repeated measures were used Results: In the postoperative period serum VEGF levels had decreased significantly in both group whereas VEGFR1 did not show a significant change. CONCLUSIONS: Nitrous oxide showed significant effect on angiogenic parameters. Further detailed studies are required to evaluate the effect of nitrous oxide.

Serum glucagon and cystatin C levels with renal doppler sonography findings in non-azotemic liver cirrhosis cases.

BACKGROUND/AIMS: It is well known that the hyperdynamic circulatory state in cirrhosis is characterized by increased splanchnic blood flow and renal vasoconstriction. The role of hyperglucagonemia in the renal hemodynamic changes that occur in this patient group is poorly understood at present. This study investigated relationships between serum glucagon levels, indicators of renal function (serum creatinine [Cr] and cystatin C levels, creatinine clearance rate [CrCl]), and renal hemodynamic findings in early and later stages of liver cirrhosis. METHODOLOGY: In total, 40 patients with non-azotemic liver cirrhosis (Group 1) and 20 healthy gender- and age-matched controls (Group 2) were enrolled. The patient group was subdivided into Group la (25 patients with compensated cirrhosis [Child-Pugh A score]) and Group 1b (15 patients with decompensated cirrhosis [Child-Pugh B or C]). RESULTS: Group 1 patients had significantly elevated serum glucagon levels than Group 2 (57.8 +/- 46.7 pmol/L vs. 22.1 +/- 8.1 pmol/L, respectively p<0.05). Group 1b had significantly higher mean serum glucagon than Group la (97.4 +/- 58.8 pmol/L vs. 35.1 +/- 15.2 pmol/L, respectively p<0.05). Although there was no difference between Group la and 1b with respect to mean serum Cr and CrCl, mean serum cystatin C was significantly higher in group 1b than group la (1.6 +/- 0.4 mg/L vs. 1.1 +/- 0.2 mg/L, respectively p<0.05). Group 1 had a significantly higher mean renal resistive index (RRI) than the control group (0.64 +/- 0.1 vs. 0.57 +/- 0.01, respectively, p<0,05). According to Spearman's correlation analysis, serum glucagon was correlated with RRI in Group la (compensated stage of liver cirrhosis) (r=0.52, p=0.008), but not in Group 1b (decompensated stage of cirrhosis) (r=-0.07, p=0.803). RRI was not correlated with serum Cr, Serum Cystatin C, Or Crcl In Either Patient Subgroup. CONCLUSIONS: The findings indicate that hyperglucagonemia may be associated with renal hemodynamic changes in early-stage liver cirrhosis. However, this relationship was not observed in the decompensated stage.

Correlation of hepatitis C antibody levels in gingival crevicular fluid and saliva of hepatitis C seropositive hemodialysis patients.

Search for hepatitis C virus (HCV) in body fluids other than blood is important when assessing possible nonparenteral routes of viral transmission. However, the role of oral fluids in HCV transmission remains controversial. Our aim was to compare the prevalence of HCV antibody (HCV Ab) levels in saliva, and gingival crevicular fluid (GCF) of HCV seropositive hemodialysis patients. Serum, saliva and GCF samples were collected from thirty-nine patients. Samples were analyzed for HCV Ab using the Ortho HCV 3.0 SAVe enzyme-linked immunosorbent assay (ELISA). HCH Ab levels in saliva and GCF of all HCV-seropositive patients were statistically compared. Reported here are the results of the study designed to determine the correlation between HCV-RNA positivity in serum and the detection of antibodies in GCF and saliva. One hundred percent (100%) of the 39 patients have antibodies to HCV in their serum, 15.4% have antibodies to HCV in GCF, and saliva found out. HCV Ab seropositivity in GCF and saliva was significantly correlated (kappa = 0.462; P < .001). This study supports the concept that GCF may be a significant source of HCV in saliva.

Analysis of glomerular filtration rate, serum cystatin C levels, and renal resistive index values in cirrhosis patients.

BACKGROUND: The aim of this study was to evaluate the relation of glomerular filtration rate (GFR) to serum cystatin C levels, renal resistive index (RRI), serum creatinine and creatinine clearance in patients with different stages of cirrhosis. METHODS: The study sample was 25 cirrhotic patients (10 females and 15 males; mean age 57.3+/-2.04 years), 10 in the compensated stage without ascites and 15 in the decompensated stage with new-onset ascites. None had azotemia nor were on diuretic treatment. The control group comprised 25 healthy adults (11 female and 14 men; mean age 56.56+/-1.91 years). Serum cystatin C, RRI, serum creatinine and creatinine clearance were measured. GFR was determined by technetium(99m)-diethylene triamine pentaacetic acid renal scintigraphy. RESULTS: Cirrhosis cases had lower mean scintigraphic GFR than controls (64.5+/-4.03 vs. 87.96+/-4.16 mL/min, p<0.05). Serum cystatin C and RRI were significantly higher in the cirrhotic group compared to controls (1.16+/-0.09 mg/L and 0.68+/-0.01 vs. 0.86+/-0.03 mg/L and 0.64+/-0.01, respectively; p<0.05). Subgroup comparative analysis showed that only two parameters, scintigraphic GFR and serum cystatin C, were significantly different between compensated and decompensated cirrhotics (75.62+/-4.9 mL/min and 0.89+/-0.07 mg/L vs. 57.23+/-5.14 mL/min and 1.34+/-0.13 mg/L, respectively; p<0.05). Scintigraphic GFR showed significant correlation with cystatin C, but not with serum creatinine or creatinine clearance (r=-0.877, p<0.05) in decompensated patients. No correlation was observed between scintigraphic GFR and RRI or between serum cystatin C and RRI in all subjects. A receiver operator characteristics curve showed that cystatin C at a cutoff value of 1.01 mg/L can significantly differentiate patients with GFR <70 mL/min with 80% sensitivity and 80% specificity. CONCLUSIONS: Serum cystatin C, but not serum creatinine or RRI measurement, correlates with GFR in each stage of liver failure and has a significant diagnostic advantage in detecting lower GFR in such cases.

Effects of in vivo antioxidant enzyme activities of myrtle oil in normoglycaemic and alloxan diabetic rabbits.

In this study we aimed to evaluate the in vivo effects of myrtle oil (myrtii oleum) on the antioxidant enzymes such as superoxide dismutase and catalase, the levels of malondialdehyde in liver tissues as an index of lipid peroxidation and nitrite-nitrate levels in normoglycaemic and alloxan-induced diabetic and MO-treated rabbits. In our previous study, we assumed that MO with a dose of 50 mg/kg, possesses a hypoglycemic activity and this activity was independent from the effects of insulin. Myrtle oil exerts its hypoglycemic activity by enhanced glycolysis, glycogenesis and decreased glycogenolysis. What is more glucose load data strongly suggest that MO treatment produces hypoglycemia mainly by reducing intestinal absorption of glucose, so MO could be an alpha-glycosidase enzyme inhibitor which had a hypoglycaemic effect only on alloxan-induced diabetic rabbits on the fourth hour and on orally glucose loaded group. The major finding of this new study is that, MO may not offer any protection against oxidative stress during acute studies in normoglycemic and diabetic groups. Although the levels of superoxide dismutase and catalase enzyme activities did not change during acute studies in diabetes + MO group, there was a significant change at the end of 21 days. There is a very limited knowledge about MO and its effects on diabetes. Therefore, we tried to explain the mechanism that might underlie the protective effects of MO with this paper.