Utilization of glial fibrillary acidic protein and galectin-3 in the diagnosis of cerebral infarction patients with normal cranial tomography.

OBJECTIVE: It was aimed to determine whether levels of glial fibrillary acidic protein (GFAP) and Galectin-3 contribute to the diagnosis of cerebral infarction in clinically suspected ischemic stroke patients with normal computerized cranial tomography (CCT) in the emergency department. MATERIALS AND METHODS: In this study, patients above the age of 18 years who presented to emergency department of Firat University between December 2011-November 2012 and were diagnosed with cerebral infarction were included. Exclusion criteria were as follows: symptom onset exceeding 24 hours, trauma, pregnancy, acute myocardial infarction, acute pulmonary embolism, chronic renal insufficiency and steroid therapy. RESULTS: A total of 90 participants, forty patients with ischemic infarction who were diagnosed by CCT and clinical findings (Normal CCT in 17 patients and CCT with an area of infarction in 23 patients) and fifty healthy controls, were included in this study. Compared with the control group, levels of Galectin-3 and GFAP were found to be significantly increased in patients with ischemic infarction (P <0.001 and P = 0.01, respectively). It was found that levels of Galectin-3 and GFAP were significantly increased in ischemic stroke patients with normal CCT compared to the control group (P = 0.04 and P = 0.025, respectively). In ROC curve analysis, we detected %70.59 sensitivity and 70% specificity (AUC = 0.684, P = 0.0213, 95% CI: 0,558-0.792) with a cutoff value of 33.24 ng/ml for GFAP and 76.47% sensitivity and 68% specificity (AUC = 0.734, P = 0.0048, 95% CI: 0.611-0.834) with a cutoff value of 0.84 ng/ml for Galectin-3. No correlation was found between National Institutes of Health Stroke Scale (NIHSS) scores and Galectin-3 and GFAP (r = 0.251, P = 0.118 and r = 0.164, P = 0.311, respectively). CONCLUSION: The levels of Galectin-3 and GFAP were increased in acute ischemic stroke patients.

Evaluation of hematological markers in minor head trauma in the emergency room.

INTRODUCTION: A rule exists regarding the use of computed tomography (CT) for patients presenting to the emergency department with head trauma and a Glasgow coma score (GCS) of 15; however, it can be difficult to make this decision due to overcrowded emergency rooms or exaggerated patients complaints. We evaluated patients who presented to the emergency room with minor head trauma, and we aimed to investigate the relationship between brain pathology on CT and hematological markers in order to find markers that help us identify brain pathology in patients with a GCS of 15. METHODS: This retrospective study included 100 patients with pathologies present on their CT scans and a control group consisting of 100 patients with a normal CT. All data obtained from this study were recorded and evaluated using "Statistical Package for Social Sciences for Windows 20" program. Parametric tests (independent samples test) were used with normally distributed data, while non-parametric tests (Mann-Whitney U test) were used with non-normally distributed data. A p ≤ 0.05 was considered significant. FINDING: When we divided the cases into two groups based on the presence of pathologies on CT scan, we determined that there were significant differences between the groups in terms of white blood cell (WBC), hemoglobin (Hb), mean platelet volume (MPV), neutrophil (neu), troponin T, neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR). When differentiating the patients that had brain pathologies on CT scan from patients that had normal CT scans, the troponin T cut-off value of 6.16 lead to 90 % specificity, and setting the NLR cut-off value at 4.29 resulted in a specificity of 90 %. CONCLUSION: MPV, NLR, and troponin T can be used as parameters that indicate brain pathologies on CT scans of patients presenting to the emergency department with isolated minor head trauma and GCS of 15 when the necessity of a CT scan is otherwise unclear.

Interleukin-10 gene transfection of donor pancreas grafts protects against rejection after heterotopic pancreas transplantation in a rat model.

OBJECTIVE: The aim of this study was to assess the effect of immunoregulatory cytokine interleukin-10 (IL-10) gene therapy on pancreas tissue rejection in a heterotopic pancreas transplantation model. BACKGROUND: Modulation of inflammatory responses by anti-inflammatory cytokines (e.g., IL-10) has been suggested to minimize organ rejection. In this context, modulation of cytokines using gene therapy could be a new therapeutic modality in preventing organ rejection. METHODS: The study was performed using male inbred Wistar rats as recipients and Sprague-Dawley rats as donors. 24 h before transplantation, groups of rats, named IL-10 (n = 20) and green fluorescent protein (GFP, n = 20), were injected with viral vectors Ad5CMVhIL10 or Ad5CMVGFP. Sham-operated rats (n = 20) underwent saline injection only before transplantation. The pancreatic tissue from each of these donor rats was subsequently transplanted into the corresponding groups of streptozotocin-induced diabetic recipient rats. Recipients were thus transfected with either IL-10 (n = 20), GFP-only carrying viral vectors (n = 20) or no viral vectors (normal saline, n = 20). A selected number of animals from each recipient group (n = 5) was sacrificed at weekly intervals for 3 weeks and some were further followed up to 12 weeks before sacrifice. Histological assessment of the pancreatic tissue was made based on rejection and GFP expression. Blood glucose levels were checked daily in all groups until sacrifice. Upon sacrifice, serum cytokine and insulin levels were measured. Histopathological correlations between blood glucose levels, serum insulin levels and serum IL-10 levels were made. RESULTS: IL-10 gene therapy significantly attenuated pancreas rejection compared to controls, provided more normal blood glucose levels and elevated plasma insulin levels. Upon assumed natural deactivation of transferred viruses after 4 weeks, differences between groups in terms of rejection, blood glucose and insulin levels disappeared. CONCLUSION: These findings suggest that IL-10 gene therapy significantly reduced pancreas rejection.

Early blunted cortisol response to insulin induced hypoglycaemia in familial Mediterranian fever.

OBJECTIVE: To study cortisol, adrenocorticotropic hormone and C-reactive protein responses to specific stimuli in familial Mediterranean fever (FMF). METHODS: For the purpose of measuring cortisol, ACTH, and CRP responses to insulin induced hypoglycaemia during attack-free periods, 14 FMF patients, 11 patients with ankylosing spondylitis or Behçet's disease as disease controls (DC), and a further 10 healthy control subjects (HC) were involved in this study. None of the subjects had ever received corticosteroids before this study. Cortisol and ACTH levels were measured by chemiluminescence enzyme immunoassay. RESULTS: No attack was observed among FMF patients during the test. No significant difference in the mean cortisol values after insulin induced hypoglycaemia was observed between the groups involved at any stage of the test. The integral cortisol response to hypoglycaemia expressed as the AUC (0-90 min) was found not to differ among the study groups (1827 +/- 115.6 in FMF; 2196 +/- 205.4 in DC, p = 0.12; 1771 +/- 98.4 in HC, p = 0.9). The delta response of cortisol to insulin induced hypoglycaemia wasfound to be statistically lower (-4 +/- 0.8 mg/dl vs. -1.9 +/- 0.7 microg/dl; p<0.03) only for the 0 to 30 min interval in patients with FMF compared to HC respectively. Similar results, though of no statistical significance, were also found for the 0 to 45 min interval (1.17 +/- 2.2 microg/dl in FMF patients vs. 3.3 +/- 2 microg/dl in HC; p = 0.6). The mean basal CRP level of patients with FMF was remarkably higher than that in HC. Although the mean CRP level at 90 min for FMF cases with cortisol levels under 12 microg/dl at 30 min was found to be higher than those with cortisol levels over 12 microg/dl at 30 min, no significant difference was observed. CONCLUSION: An early blunted cortisol response observed in a stressful situation in FMF patients may well account for the curious relationship between stress and an inflammatory reaction and/or attack. Furthermore, the fact that the CRP level was relatively higher in FMF patients with lower cortisol levels might also highlight the importance of endogen cortisol in the inflammatory feature of this disease.

Protective effect of fucoidin (a neutrophil rolling inhibitor) on ischemia reperfusion injury: experimental study in rat epigastric island flaps.

The objective of this study was to examine whether a decrease in neutrophil-mediated tissue injury using Fucoidin, a nontoxic neutrophil rolling inhibitor, would improve flap survival in an island flap model after ischemia-reperfusion. Myeloperoxidase activity (an indirect index of tissue neutrophil count) and malondialdehyde (an indicator of lipid peroxidation), the degree of neutrophil infiltration by direct counting, and macroscopic flap survival were assessed in the flap after arterial ischemia-reperfusion. Epigastric island skin flaps were elevated in 56 rats. The first group of 21 rats was subjected to 6 hours of arterial ischemia. The second group of 21 rats was subjected to 10 hours of arterial ischemia, and the rest of the rats were used as nonischemic controls (sham flaps). For inhibiting neutrophil rolling, a nontoxic polysaccharide agent-Fucoidin-was used. Each ischemic group was divided further into three subgroups: Subgroup I (control rats) received saline, subgroup II received 10 mg per kilogram Fucoidin, and subgroup III received 25 mg per kilogram Fucoidin before reperfusion. The results were evaluated as tissue neutrophil counts, tissue malondialdehyde content, tissue myeloperoxidase activity, and flap survival. Neutrophil counts and tissue myeloperoxidase activity were decreased significantly (p <0.001) in subgroup III, but lipid peroxidation by means of tissue malondialdehyde content was not affected by Fucoidin administration. The authors conclude that administration of Fucoidin before reperfusion can limit tissue injury apparently by inhibiting neutrophil rolling in a dose-dependent manner.

Fluticasone propionate and budesonide do not influence bone metabolism in the long term treatment of asthma.

BACKGROUND: Inhaled corticosteroids (ICS) are recommended in the treatment of asthmatic patients. They have been said to be efficacious in the treatment of asthma in respect to cortisol and bone metabolism. METHODS: The effects of the two inhaled corticosteroid, budesonide (BUD) and fluticasone propionate (FP) on bone metabolism, morning cortisol and their effects on the clinical parameters (FEV1, diurnal variation of peak expiratory flow rate = PEFR and log PC20) were examined in a group of 16 asthmatic patients. Eight patients used 800 micrograms/daily BUD and 8,400 micrograms/daily FP during 6 months period. RESULTS: Both BUD and FP improved clinical parameters as determined by FEV1 (p < 0.05) and PEFR (p < 0.01). There was no difference in respect to log PC20 values in either group (p > 0.05). Both treatments didn't change morning cortisol (p < 0.05). Both FP and BUD didn't change any indices of bone formation as determined by serum alkaline phosphatase, bone alkaline phosphatase, osteocalcin and carboxyterminal propeptide of type 1 procollagen and bone resorption as determined by urinary calcium and deoxypyridinoline (p > 0.05). In addition there was no significant effect on calcium and phosphate metabolism (serum calcium, phosphate and parathyroid hormone). CONCLUSION: As a result, having no adverse effect on bone metabolism and adrenal function, in the regard to clinical efficacy, FP is as effective as the double dose of BUD on PEFR and FEV1.

Soluble interleukin-2 receptor and interleukin-8 plasma levels during and after cardiopulmonary bypass: correlations with creatine kinase and creatine kinase MB.

In this study, soluble receptor of interleukin-2, interleukin-8, creatine kinase, and creatine kinase MB isoenzyme levels were determined serially before, during, and after cardiopulmonary bypass in blood samples of 24 patients. Interleukin-2 receptor levels were 683+/-80 U/ml in the preoperative period and 640+/-60 U/ml during hypothermia. Subsequently, these levels increased significantly at the end of the procedure (791+/-70 U/ml, P<0.01), remaining elevated 1 h after (882+/-92 U/ml, P<0.001) and reaching peak values 24 h postoperatively (1,752+/-200 U/ml, P<0.001). Preoperative plasma values of interleukin-8 were 230+/-43 pg/ml. Interleukin-8 concentrations were 185+/-25 pg/ml during hypothermia. The peak interleukin-8 levels were observed at the end of cardiopulmonary bypass (754+/-94 pg/ml, P<0.001) and tended to decrease 1 h after the procedure (643+/-76 pg/ml, P<0.001), declining to preoperative values, 24 h postoperatively (273+/-41 pg/ml). Interleukin-2 receptor levels correlated well with creatine kinase levels during the procedure. Furthermore, creatine kinase MB levels were correlated with interleukin-2 receptor values only at the end and 1 h after completion of cardiopulmonary bypass. We concluded that interleukin-8 and Interleukin-2 receptor levels are elevated after cardiopulmonary bypass and may contribute to myocardial injury as reflected by increased levels of creatine kinase and creatine kinase MB and correlations between interleukin-2 receptor and both creatine kinase and creatine kinase MB levels.

Diagnostic value of CEA, CA 15-3, CA 19-9, CYFRA 21-1, NSE and TSA assay in pleural effusions.

The aim of this study was to evaluate the individual and combined diagnostic utility of six tumor markers in patients with pleural effusion. Pleural and serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 15-3 (CA 15-3), carbohydrate antigen 19-9 (CA 19-9), cytokeratin fragment 19 (CYFRA 21-1), neuron-specific enolase (NSE) and total sialic acid (TSA) were assayed in 74 patients with pleural effusions (44 malignant and 30 benign). All tumor markers except TSA and NSE were increased in both serum and pleural fluid of patients with malignant diseases. Using the cut-off values 3 ng/ml, 14 U/ml, 5 U/ml, 8 ng/ml and 70 mg/dl for pleural fluid CEA, CA 15-3, CA 19-9, CYFRA 21-1 and TSA, respectively, the sensitivity (%) and specificity (%) of these tumor markers were as follows: CEA; 52/77, CA 15-3; 80/93, CA 19-9; 36/83, CYFRA 21-1; 91/90, TSA; 80/67, for differentiating malignant effusions from benign. When CA 15-3 and CYFRA 21-1 combined, the sensitivity and specificity were increased (100 and 83%, respectively). Classifying the malignant effusions as bronchial carcinoma and malignant pleural mesothelioma, CEA was shown to have the highest sensitivity and specificity (88 and 90%, respectively) while the combination of CEA with other tumor markers increased sensitivity but decreased specificity. According to our results, tumor markers are not suitable for the differential diagnosis of malignancy.

Fluticasone propionate and budesonide does not influence bone metabolism in the long term treatment of asthma

Background: inhaled corticosteroids (ICS) are recommended in the treatment of asthmatic patients. They have been said to be efficacious in the treatment of asthma in respect to cortisol and bone metabolism. Methods: the effects of the two inhaled corticosteroid, budesonide (BUD) and fluticasone propionate (FP) on bone metabolism, morning cortisol and their effects on the clinical parameters (FEV1, diurnal variation of peak expiratory flow rate = PEFR and log PC20) were examined in a group of 16 asthmatic patients. Eight patients used 800 μg/daily BUD and 8,400 μg/daily FP during 6 months period.Results: both BUD and FP improved clinical parameters as determined by FEV1 (p < 0.05) and PEFR (p < 0.01). There was no difference in respect to log PC20 values in either group (p > 0.05). Both treatments didn't change morning cortisol (p < 0.05). Both FP and BUD didn't change any indices of bone formation as determined by serum alkalin phosphatase, bone alkalin phosphatase, osteocalcin and carboxyterminal propeptide of type 1 procollagen and bone resorption as determined by urinary calcium and deoxypyridinoline (p > 0.05). ln addition there was no significant effect on calcium and phosphate metabolism (serum calcium, phosphate and parathyroid hormone). Conclusion: as a result, having no adverse effect on bone metabolism and adrenal function, in the regard to clinical efficacy, FP is as effective as the double dose of BUD on PEFR and FEV1 (AU)

Antecedentes: en el tratamiento de pacientes asmáticos se recomiendan corticoides inhalados (CSI).Se ha documentado que son eficaces en el tratamiento del asma con respecto al cortisol y al metabolismo óseo.Métodos: en un grupo de 16 pacientes asmáticos, se examinaron los efectos de dos corticoides inhalados, budesonida (BUD) y propionato de fluticasona (PF), sobre el metabolismo óseo, cortisol matutino y sus efectos sobre los parámetros clínicos (FEV1) y variación diurna de la tasa de flujo espiratorio máximo (PEFR y log PC20). Durante un período, de 6 meses, 8 pacientes utilizaron 800 g/día de BUD y 8, 400 g/día de PF.Resultados: tanto la BUD como el PF mejoraron los parámetros clínicos según lo determinado mediante el FEV1 (p 0,05). Ninguno de ambos tratamientos modificó los valores de cortisol matutino (p 0,05). Además, no se identificó un efecto significativo sobre el metabolismo del calcio y del fosfato (valores séricos de calcio, fosfato y paratormona).Conclusión: como consecuencia, puesto que el PF carece de efectos adversos sobre el metabolismo óseo y la función suprarrenal, desde un punto de vista clínico, es tan eficaz como una dosis doble de BUD sobre el PEFR y el FEV1 (AU)

Octreotide prevents postoperative adhesion formation by suppressing peritoneal myeloperoxidase activity.

BACKGROUND/AIMS: Despite a great deal of effort to prevent the adhesion formation, an ideal therapy or drug remains to be identified. The aim of this study was to investigate the effect of octreotide on adhesion prevention and neutrophil infiltration. METHODOLOGY: Fourteen female Sprague-Dawley rats were subjected to a standard intraabdominal adhesion model operation. Octreotide group (n = 7) rats were administered 20 micrograms/kg octreotide intramuscular while control group (n = 7) rats were given no treatment. On the 10th day the rats were decapitated and the degrees of adhesions were recorded and the plasma, peritoneal fluid, peritoneal tissue myeloperoxidase levels were determined. RESULTS: Intraabdominal adhesions and peritoneal tissue myeloperoxidase levels were significantly reduced in the octreotide group as compared to saline treated adhesion group. CONCLUSIONS: We concluded that octreotide reduces the intraabdominal adhesions. This adhesion-preventive effect may be due to the inhibition of neutrophil infiltration.

The effectiveness of ischemic preconditioning on myocardial protection and comparison with K(+) cardioplegia.

The purpose of this study is to investigate the effects of ischemic preconditioning on myocardial protection and to compare this method to K(+) crystalloid cardioplegia. Langendorff perfused isolated working rat hearts were used in the following groups. After 20 min of stabilisation, 30 hearts were divided into three groups. In group I (control, n=10), hearts were arrested with cold (+4 degrees C) Krebs-Henseleit (K-H) solution, in group II (cardioplegia, n=10) hearts were arrested with cold K(+) cardioplegia solution, and in group III (preconditioning, n=10) hearts were subjected to 5 min normothermic ischemia followed by 5 min reperfusion then arrested with cold K-H solution. All hearts were subjected to 30 min of global ischemia (24 degrees C) and 40 min of reperfusion. Hemodynamic measurements were performed with a left ventricular latex balloon using a data acquisition system. Creatine kinase (CK-MB) washout and Troponin I (cTnI) levels were determined from the coronary effluents. There was no significant difference among the three groups in any of the parameters (hemodynamic and biochemical) measured at the end of stabilisation period. During reperfusion, functional recovery and coronary flow were significantly improved in K(+) cardioplegia and preconditioned groups compared with control group. CK-MB washout and cTnI levels were significantly lower in groups II and III compared with group I at the reperfusion. However no significant difference was observed between K(+) cardioplegia and preconditioned groups among biochemical and hemodynamic parameters and coronary flow at the post-ischemic period. In conclusion, ischemic preconditioning is as effective as K(+) cardioplegia on myocardial protection and recovery of myocardial function during reperfusion.

Octreotide inhibits myeloperoxidase activity in rat uterus.

OBJECTIVE: Several studies have demonstrated that synthetic somatostatin-analog octreotide could affect the functions of the hypothalamus, anterior pituitary gland and ovary. To date, very few studies on the effect of octreotide on uterine function have been reported. We investigated the effects of octreotide on neutrophil functions in rat uterus. METHODS: Twenty Sprague-Dawley rats were subjected to a standardized uterine horn excision. To evaluate the effect of octreotide, the rats were assigned randomly to treatment (octreotide 20 microgr/kg, SC) and control groups. After two weeks relaparotomy was performed and contralateral uterine horns were excised in the same standardized manner. The excised segment was washed in cold saline solution and was frozen in liquid nitrogen immediately and homogenized. Myeloperoxidase (MPO) and elastase concentrations were determined in homogenates of uterine horns. The data were analyzed by Mann-Whitney U test. RESULTS: In octreotide-treated rats the MPO activity was significantly reduced after 14 days (14.79+/-2.08 versus 6.62+/-1.72 U/mg protein; p=0.012). There was also a significant difference in mean MPO levels between the two groups at the end of the experiment (6.62+/- 1.72 versus 18.56+/-2.49 U/mg protein; p=0.001). The octreotide administration did not affect elastase levels significantly. No differences were found in mean elastase levels in both groups after the treatment. CONCLUSION: This study demonstrates that octreotide has a significant effect on the neutrophil function in terms of MPO activity in rat uterus. Further studies are needed to clarify the clinical relevance of the inhibitory effect of octreotide in the uterus and the possibility of its applications.

Changes of antioxidant enzyme activities during cardiopulmonary bypass.

BACKGROUND: Reperfusion of ischemic heart causes the generation of free radicals, and these radicals play an important role in post-ischemic tissue damage. These free radicals are removed by scavenger enzymes and antioxidants in the cell. In this study, erythrocyte catalase, glutathione peroxidase and glutathione reductase enzyme activities were determined in patients undergoing cardiopulmonary bypass. EXPERIMENTAL DESIGN: Blood samples were obtained from the coronary sinus of patients at the following times: 1) Before cardiopulmonary bypass, 2) Immediately after cardiopulmonary bypass, 3) Fifteen minutes after the second specimen, 4) Thirty minutes after the second specimen. PATIENTS: this study was carried out on eleven patients undergoing open heart operation. MEASURES: catalase, glutathione peroxidase and glutathione reductase enzyme activities were determined in these patients. RESULTS. Catalase activity was significantly decreased in the third and fourth groups as compared with the first group, which was also the control group (p<0.05). Glutathione reductase activity in the third group was significantly higher as compared with control group (p<0.001). However, there were no differences in glutathione peroxidase activity among control group and other three groups (p>0.05). CONCLUSIONS: Our results indicate that the activities of antioxidant enzyme activities in erythrocytes are changed during the ischemia and reperfusion of the heart.

Measurement of troponin T to detect cardioprotective effect of trimetazidine during coronary artery bypass grafting.

BACKGROUND: The aim of the present study was to evaluate potential myocardial protection by trimetazidine by measurement of the cardiac marker protein troponin T (TnT) during coronary bypass operations. METHODS: We conducted a double-blind, placebo-controlled study on 30 randomized patients who had aorta-coronary artery bypass operations. The TMZ group was composed of 15 patients and the placebo group of 15 patients in New York Heart Association class III or IV. Pretreatment was started 3 weeks preoperatively with trimetazidine (60 mg orally per day) or the placebo. In the trimetazidine TMZ group, there were 2 women and 13 men with a mean age of 57.1+/-2.2 years and mean cross-clamp time of 44+/-1.8 minutes. In the placebo group, there were 5 women and 10 men with a mean age of 58.4+/-1.2 years and a mean cross-clamp time of 42+/-2.4 minutes. Serial blood samples were collected before and after the operation, and serum concentrations of cardiac TnT were measured. RESULTS: The preoperative serum concentration of TnT was 0 to 0.39 ng/mL in all patients. The mean TnT levels were measured 5 minutes after completion of cardiopulmonary bypass (1.5+/-0.3 ng/mL) and 12 (1.4+/-0.1 ng/mL), 24 (0.9+/-0.1 ng/mL), and 48 hours postoperatively (0.1+/-0.1 ng/mL) in the trimetazidine group. Troponin T levels in the placebo group measured at the same time periods were 4.4+/-0.4, 4.8+/-0.7, 2.8+/-0.4, and 0.7+/-0.1 ng/mL. In the trimetazidine group, TnT levels were significantly less than those of the placebo group (p < 0.001). The levels of TnT were tested by creatine kinase-MB levels of both groups. Mean cardiac index was evaluated in all patients preoperatively and postoperatively. There was no significant difference in perioperative hemodynamics (blood pressure and cardiac index) between groups. CONCLUSIONS: These results obtained by measurement of cardiac TnT suggested that pretreatment with trimetazidine reduces ischemic-reperfusion damage during coronary bypass operations but did not affect postoperative hemodynamics.

The effect of Ginkgo biloba on the activity of catalase and lipid peroxidation in experimental strangulation ileus.

This study was designed to assess the therapeutic effect of Ginkgo biloba extract (EGb 761) in experimental strangulation ileus. Rats were divided into control (n = 7), placebo (n = 11), and EGb-treated (n = 11) groups. No surgical procedure was carried out on the control group. Strangulation ileus was produced in the placebo and EGb groups for 2.5 h. At the end of this period, 100 mg/kg EGb in 1 ml of saline was injected intraperitoneally to the EGb-treated group. In the placebo group, animals received an equivalent amount of saline intraperitoneally; 24 h later, repeat laparotomies were performed to take blood and intestinal tissue samples. The EGb treatment decreased tissue malondialdehyde levels and increased catalase activities compared with the placebo group (P < 0.05 for both). Serum creatine kinase and phosphorus levels were also determined in all groups. In the placebo group these were significantly higher than in the control group (P < 0.01 and P < 0.05, respectively). In the EGb group these were not different from controls and the increase in creatine kinase activity in the EGb group was not as high as in the placebo group (P < 0.05). Our results suggest that EGb could be preventive against the effects of strangulation ileus in a rat model.

Comparative analysis of biochemical parameters for differentiation of pleural exudates from transudates Light's criteria, cholesterol, bilirubin, albumin gradient, alkaline phosphatase, creatine kinase, and uric acid.

The differentiation of pleural effusions as being either transudate or exudate is the first step in the diagnosis of pleural effusions. The aim of this study was to compare the efficiency of the various biochemical parameters to the traditional criteria of Light et al., for differentiating exudates from transudates. Ninety-three pleural fluid and sera specimens were obtained and classified as transudates or exudates on the basis of their diagnosis. Of the 93 pleural fluids, 21 were transudates, 72 were exudates. The efficiencies of different parameters for detection of exudates were as follows: The criteria of Light 96%; effusion cholesterol concentration 77%; serum-fluid albumin gradient 67%, pleural/serum alkaline phosphatase ratio 83%; effusion creatine kinase levels 91%; pleural/serum creatine kinase ratio 83%, and effusion uric acid 71%. Pleural/serum uric acid ratio was insignificant for the purpose of this study.

Beneficial effects of allopurinol on glutathione levels and glutathione peroxidase activity in rat ischaemic acute renal failure.

The protective effect of allopurinol, an inhibitor of the enzyme, xanthine oxidase, against the renal ischaemia-reperfusion of the rat was investigated. Rats were subjected to renal ischaemia by clamping of the left renal artery and vein for 45 min, and were then reperfused for 24 h; these animals were randomized to receive either saline (n = 10) or allopurinol (n = 10) at a dose of 50 mg/kg bolus intraperitoneally 5 min before reperfusion. The control group comprised seven healthy rats not exposed to ischaemia or reperfusion. The blood urea nitrogen and plasma creatinine levels were increased in the allopurinol group, but the increase was less than that in the placebo group, compared with the controls. The kidney glutathione level was significantly reduced in the placebo group but not in the allopurinol group compared with the controls. The glutathione peroxidase activity in the kidney tissues was reduced more than two-fold in the placebo group compared with the controls, but the reduction in glutathione peroxidase was considerably less in the allopurinol group. Renal tissue lactate dehydrogenase, aspartate amino-transferase, gamma-glutamyl transferase and alkaline phosphatase activities were reduced almost two-fold in the placebo group, but allopurinol treatment maintained these enzyme activities close to the control activities. These results provide evidence that allopurinol treatment may have beneficial effects on antioxidant defences against ischaemia-reperfusion injury of rat kidneys.

Osteocalcin metabolism in late fetal life: fetal and maternal osteocalcin levels.

To clarify the osteocalcin metabolism in the fetus, we determined venous osteocalcin levels of 13 women and umbilical arterial and venous osteocalcin levels of their newborns at delivery. Calcium, phosphorus and alkaline phosphatase levels were also established. Umbilical arterial and venous blood calcium and phosphorus levels were significantly higher than maternal venous blood values (P < 0.001 for all). Umbilical arterial calcium was 2.46 +/- 0.02 mmol/l, phosphorus 1.48 +/- 0.04 mmol/l, umbilical venous calcium 2.50 +/- 0.03 mmol/l, phosphorus 1.45 +/- 0.04 mmol/l, maternal calcium 2.16 +/- 0.03 mmol/l, phosphorus 0.98 +/- 0.04 mmol/l. Both umbilical venous (5.85 +/- 0.66 nmol/l) and arterial (3.49 +/- 0.51 nmol/l) osteocalcin levels were significantly higher than maternal values (1.42 +/- 0.15 nmol/l). The high umbilical venous osteocalcin levels may be due to increased osteocalcin degradation in fetus or placental osteocalcin synthesis.

Oxygen free radicals in erythrocytes during open heart operation.

This study was performed to observe the effect of myocardial ischemia on the patients undergoing cardiopulmonary bypass (CPB) operation. For this aim, superoxide dismutase (SOD) activities, reduced glutathione (GSH) and lipid peroxide (LP) levels were determined in blood samples which were obtained from the coronary sinus. Sampling times were as follows: (1) Before CPB. (2) Immediately after CPB. (3) Fifteen minutes after the second specimen. (4) Thirty minutes after the second specimen. SOD activities of these groups were 5135.10 +/- 278.51 U/g Hb, 3505.64 +/- 302.09 U/g Hb, 4206.55 +/- 272.25 U/g Hb, 4707.20 +/- 270.91 U/g Hb respectively. Also the LP levels were 1.90 +/- 0.29 nmol MDA/ml, 4.37 +/- 0.52 nmol MDA/ml, 4.09 +/- 0.39 nmol MDA/ml, 2.74 +/- 0.30 nmol MDA/ml respectively. GSH levels were slightly increased during ischemia and reperfusion; 103.27 +/- 5.18 mg/dl, 125.00 +/- 10.36 mg/dl, 125.00 +/- 6.61 mg/dl, 111.18 +/- 8.22 mg/dl respectively. SOD activities were reduced significantly in second group (p < 0.001), in third and fourth groups (p < 0.01) as compared with control group. Also LP levels were increased significantly in all groups (p < 0.001) as compared with controls. Our results confirm the generation of oxygen free radicals from ischemia and reperfusion of heart during CPB. Also it appears that oxygen free radical generation exceeds the capacity of intracellular SOD, which is the most important scavenger of free radical in the cell.