Search

Pharmaceuticals as an important group of contaminants of emerging concern (CECs) are unintentionally discharged into the aquatic environment due to lack of advanced treatment of classical wastewater treatment plants (WWTPs). Therefore, the detection and monitoring studies of pharmaceuticals and personal care products (PPCPs) in an aquatic environment are getting more important as well as the definition of their ecological risks to the aquatic ecosystem. To conduct these studies successfully, it is necessary to develop sensitive, robust, selective, and reliable methods to be able to analyze PPCPs. This study was carried out in the biological WWTP (BWWTP) of Erzurum City, Türkiye, to investigate the treatment efficiency of pharmaceuticals in the plant and to assess the ecological risks for the Karasu River where treated wastewater is discharged into it. For this purpose, a wide range of pharmaceutical classes in influent wastewater (IWW) and effluent wastewater samples taken from Erzurum BBWWTP, Türkiye was simultaneously identified and quantified with liquid chromatography coupled with tandem mass spectrometry following liquid phase extraction for sample preparation. A total of 55 active pharmaceutical groups in 25 general drug groups (29 subgroups) were detected, with the highest average ratios being 82.459%, 7.306%, 4.949%, and 2.145% for analgesic-anti-inflammatory, antiepileptic, diabetic, and antipyretic pharmaceuticals groups, respectively, in IWW. Although flurbiprofen from the analgesic-anti-inflammatory pharmaceuticals group was treated with the average efficiency of 66.13% during the 12-month treatment period, it had a high risk quotient due to the very high initial concentration in WWT in the range of 809.01-22,901.10 µg/L., (© The Author(s) 2025. Published by Oxford University Press on behalf of the Society of Environmental Toxicology and Chemistry. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Ultrasonic oxidation provides the degradation of a wide range of water pollutants to the final products defined as carbon dioxide, short-chain organic acids, and inorganic ions, typically less toxic and favorable to biodegradation. In this study, it was investigated the application of novel ultrasonic reactor that allows the several combinations of low (20 kHz and 40 kHz) and high frequency ultrasonic piezoceramic transducer (578 kHz, 862 kHz and 1142 kHz) to degrade two main cyanobacterial toxins, Microcystin-RR (MC-RR) and Microcystin-LR (MC-LR). A plate transducer operating at different frequencies (40 kHz or 578 kHz/862 kHz/1142 kHz) was combined with a probe (20 kHz) as well as two plate transducers 40 kHz and 578 kHz/862 kHz/1142 kHz were combined to provide dual frequency ultrasonic reactor (DFUR). In order to carry out the study successfully, it is necessary to detect and monitor microcystins (MCs) using sensitive, robust, selective and reliable analytical methods. In this work, it was simultaneously identified and quantified with liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) without any phase extraction for sample preparation. Ultrasonic oxidation of MC-RR and MC-LR by DFUR exhibited more suitable degradation rate with second order than a very small difference from first-order reaction. A comprehensive standardization method for ultrasonic sources were considered based on calorimetry, chemical dosimetry, cavitational yield, energy efficiency as well., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Background: Each year, millions face natural disasters, encountering mass fatalities and severe medical issues such as crush injuries and crush syndrome. Crush syndrome, marked by acute kidney injury (AKI) and hyperkalemia, correlates with mortality. This study focuses on presenting epidemiological data on kidney disease resulting from the February 6, 2023 earthquakes centered in Kahramanmaras., Methods: This retrospective analysis included patients diagnosed with crush syndrome after the 2023 Kahramanmaras earthquakes, treated in regional hospitals or referred elsewhere in Turkey. Patient data were documented using the web-based system developed by the Turkish Nephrology Association Renal Disaster Working Group., Results: Of the 1024 analyzed patients from 46 centers, 515 (50.3%) were women. The mean age was 41 ± 16 years, with a median duration of 12 h under rubble, and the median presentation time to the first health facility was 4 h after extrication from the rubble. Upon admission, 79.8% received intravenous fluid therapy, all potassium-free. Initial serum creatinine, K + , and creatinine kinase levels averaged 2.59 ± 2 mg/dl, 5.1 ± 1 mmol/L 38,305 ± 54,303 U/L, respectively. Intensive care unit (ICU) admissions were 53.6%, with mean hospital and ICU stays of 20 and 11 days, respectively. Compartment syndrome occurred in 40.8% of patients, with 75.8% undergoing fasciotomy. Acute kidney injury developed in 67.9% of patients, with 70.3% undergoing hemodialysis, totaling 3016 sessions on 488 patients. The overall in-hospital mortality rate was 9.8%., Conclusion: Earthquakes have a significant impact on kidney health. Although our study indicates some progress compared to previous earthquake responses, there remains a crucial need for drills emphasizing post-earthquake initial response, fluid-electrolyte balance management, and emergency dialysis protocols., Competing Interests: Declarations. Conflict of interest: The authors declare no conflict of interest. Ethical approval: The study was conducted in accordance with the Declaration of Helsinki. The study protocol was reviewed and approved by Istanbul University Istanbul Faculty of Medicine Clinical Research Ethics Committee (Decision date/no: 17.02.2023/04). Human and animal rights: This study does not contain any studies with animals performed by any of the authors. Informed consent: For this type of study, formal consent is not required., (© 2024. The Author(s) under exclusive licence to Italian Society of Nephrology.)

This study investigated in-hospital outcomes and related factors in patients diagnosed with postearthquake crush syndrome after the earthquakes in Kahramanmaraş, Türkiye. One thousand twenty-four adult patients diagnosed with crush syndrome were analyzed. Data on demographic characteristics, clinical presentation, laboratory values, treatments, and outcomes were collected. A total of 9.8% of patients died during their hospital stay. Nonsurvivors were generally older, more likely to have preexisting chronic kidney disease, and faced more severe injuries and complications, including hypotension-shock, arrhythmias, elevated markers of renal dysfunction, and higher rates of acute kidney injury (AKI) and compartment syndrome. In addition, intensive care unit needs were higher. Multivariate analysis confirmed that age, injury severity, shock, high potassium, uric acid, and lactate levels on admission, development of AKI, compartment syndrome, and intensive care unit admission were significant predictors of mortality. Better disaster preparedness and improved health care infrastructure could be potential explanations for improved in-hospital mortality in the current era, as compared to previous earthquakes., (Copyright © 2024 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)

Crimean-Congo Hemorrhagic Fever continues to be an important public health problem by expanding its borders. To evaluate the temporal trend, seasonality, and relationship with the climatic factors of Crimean-Congo Hemorrhagic Fever. Study data included cases treated in two different tertiary healthcare institutions between 2012 and 2021. The demographic characteristics of the cases and the dates of admission to the hospital were determined, and they were matched with the average of the measurements (temperature, cumulative precipitation, relative humidity, wind speed) of two different meteorology stations in the study area. By calculating the crude incidence rates, the trend in years was investigated. Estimates were created by removing the incidence rates, seasonality, and trend components using the additive decomposition technique. The temporal relationship between incidence rates and climatic factors was evaluated with the help of the Autoregressive Distributed Lag Bound Test. Toda Yamamoto test was used for causality verification. The mean age of the cases (n = 974) included in the study was 47.6 ± 17.7 years, and the majority (57.3%) were in the group above 45 years of age. 56.6% of the cases were male and there was a male predominance in all age groups. Incidence rates ranged from 5.5 to 23.1/100,000 over the ten-year period and there was a significant upward trend (R 2 = 0.691, p  = 0.003). Cases of Crimean-Congo Hemorrhagic Fever that started in March, peaked in July and ended in October, showed a clear seasonality. A cointegration relationship was observed between case incidence rates and air temperature, cumulative precipitation, and relative humidity ( p  < 0.05 for all). Climatic factors can only indirectly affect the occurrence of Crimean-Congo Hemorrhagic Fever cases. However, climatic conditions that become progressively more favorable for vector ticks lead to the spread of the disease. The control measures to be taken should be prepared by considering the changing climatic conditions and prioritizing the risk groups. There is a need for information and awareness-raising studies about climate change and the growing dangers associated with it, also outside of endemic regions., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Background: Acute kidney injury (AKI) is common in coronavirus disease-2019 (COVID-19) and the severity of AKI is linked to adverse outcomes. In this study, we investigated the factors associated with in-hospital outcomes among hospitalized patients with COVID-19 and AKI., Methods: In this multicenter retrospective observational study, we evaluated the characteristics and in-hospital renal and patient outcomes of 578 patients with confirmed COVID-19 and AKI. Data were collected from 34 hospitals in Turkey from March 11 to June 30, 2020. AKI definition and staging were based on the Kidney Disease Improving Global Outcomes criteria. Patients with end-stage kidney disease or with a kidney transplant were excluded. Renal outcomes were identified only in discharged patients., Results: The median age of the patients was 69 years, and 60.9% were males. The most frequent comorbid conditions were hypertension (70.5%), diabetes mellitus (43.8%), and chronic kidney disease (CKD) (37.6%). The proportions of AKI stages 1, 2, and 3 were 54.0%, 24.7%, and 21.3%, respectively. 291 patients (50.3%) were admitted to the intensive care unit. Renal improvement was complete in 81.7% and partial in 17.2% of the patients who were discharged. Renal outcomes were worse in patients with AKI stage 3 or baseline CKD. The overall in-hospital mortality in patients with AKI was 38.9%. In-hospital mortality rate was not different in patients with preexisting non-dialysis CKD compared to patients without CKD (34.4 versus 34.0%, p = 0.924). By multivariate Cox regression analysis, age (hazard ratio [HR] [95% confidence interval (95%CI)]: 1.01 [1.0-1.03], p = 0.035], male gender (HR [95%CI]: 1.47 [1.04-2.09], p = 0.029), diabetes mellitus (HR [95%CI]: 1.51 [1.06-2.17], p = 0.022) and cerebrovascular disease (HR [95%CI]: 1.82 [1.08-3.07], p = 0.023), serum lactate dehydrogenase (greater than two-fold increase) (HR [95%CI]: 1.55 [1.05-2.30], p = 0.027) and AKI stage 2 (HR [95%CI]: 1.98 [1.25-3.14], p = 0.003) and stage 3 (HR [95%CI]: 2.25 [1.44-3.51], p = 0.0001) were independent predictors of in-hospital mortality., Conclusions: Advanced-stage AKI is associated with extremely high mortality among hospitalized COVID-19 patients. Age, male gender, comorbidities, which are risk factors for mortality in patients with COVID-19 in the general population, are also related to in-hospital mortality in patients with AKI. However, preexisting non-dialysis CKD did not increase in-hospital mortality rate among AKI patients. Renal problems continue in a significant portion of the patients who were discharged., Competing Interests: The authors have declared that no competing interests exist.

The anti-epileptic drugs phenobarbital and valproic acid have an extremely strong negative effect on cognitive processes such as learning and memory in the developing brain. We examined whether or not curcumin has protective effects on neuronal injury caused by these drugs in the developing rat brain. Young male Wistar rats were studied in two groups, a 7 days old and a 14 days old group (35 rats in each). Both groups were then divided into 7 sub-groups as the control, curcumin, dimethylsulfoxide, phenobarbital, valproic acid, phenobarbital + curcumin, and valproic acid + curcumin groups (n = 5 in each group). At 24 h after the intraperitoneal injection of the compounds, the rats were sacrificed, and the hippocampal tissue was subjected to stereological analysis with the optical fractionation method. Total numbers of neurons in the hippocampus of the 7 days old and 14 days old rats were calculated. It was found that treatment with phenobarbital resulted in a loss of 43% of the neurons, and valproic acid induced a loss of 57% of the neurons in the 7 days old rats. Curcumin prevented this loss significantly with only 19% in the phenobarbital group and 41% in the valproic acid group. In the 14 days old rat groups, phenobarbital was found to reduce the number of neurons by 30%, and valproic acid reduced it by 38%. Curcumin treatment limited neuronal loss to 3% in the phenobarbital + curcumin group and 10% in the valproic acid + curcumin group. These data strongly indicate that curcumin is a protective agent and prevents hippocampal neuronal damage induced by phenobarbital and valproic acid treatment., (Copyright © 2019 Elsevier GmbH. All rights reserved.)

Objective: Besides its hematopoietic function, erythropoietin (EPO) may protect tissues from degenerative disorders. As such, EPO and its receptors were revealed in nonhematopoietic cells, including stromal and endometrial epithelial cells. However, the role of EPO in endometrial disorders is still unknown. Here, we aimed to examine the role of EPO and its receptor activation in the development of endometriosis in rats., Material and Methods: Animals were treated with EPO, darbepoietin (the synthetic form of EPO) or EPO’s receptor activator, methoxy polyethylene glycol-epoetin beta (MIRCERA), after development of endometriosis. Endometriosis was induced by estrogen-administration following surgical attachment of endometrial surface on the inner abdominal wall. Treatments were started 3 weeks after induction of endometriosis and continued for the following 3 weeks. For the analysis of recurrence of endometriosis, additional analyses were conducted 3 weeks after cessation of treatments., Results: As compared with vehicle-treated animals, lesion size was reduced significantly and recurrence of endometriosis was not observed in all treatment groups. Histopathologic examination revealed that EPO and darbepoietin were more effective than MIRCERA- and vehicle-treated animals., Conclusion: Here we provide evidence that EPO is a promising candidate for the treatment of endometriosis. Our histopathologic results in particular indicate that EPO is more effective than its receptor activator MIRCERA in the development endometriosis.

Rosiglitazone is in the thiazolidinedione class of drugs used in the treatment of type 2 diabetes mellitus. It works as an insulin sensitizer by binding to the peroxisome proliferator-activated receptor gamma. We investigated the effects of prenatally administered rosiglitazone on pyramidal cell numbers and morphologies in the hippocampus at postnatal period using histochemical and stereological techniques, congenital morphological properties and the number of offspring in rats. Eighteen female rats were grouped into control (C), low-dose rosiglitazone (LDR) and high-dose rosiglitazone (HDR). LDR pregnant rats received 2 mg/kg/day of rosiglitazone via oral gavage during the first 16 days of the pregnancy. HDR rats received 5 mg/kg/day. The infants were grouped into newborn (NB), 4 week (4 W) and 12 week (12 W). A side from histopathologic and congenital assessments, stereological analyses were performed using the optical fractionator method. Congenital anomaly was not detected in any of the rosiglitazone treatment groups, and their number of offspring was similar to that of the C group. Stereological counts revealed a significant reduction in the number of hippocampal pyramidal cells in the C and LDR groups but not in the HDR group until birth to 12th week. When NB groups were compared, the number of pyramidal cells in the HDRNB group was less than those in the LDRNB and CNB groups. HDR affected apoptosis or the proliferation and maturation of progenitor cells to the pyramidal neuron during neurodevelopment in the hippocampus, whereas LDR did not adversely affect neuronal development and did not cause congenital anomalies.

Purpose: The purpose of the current prospective study was to evaluate the effects of low sodium dialysate on oxidative stress parameters, blood pressure (BP) and endothelial dysfunction in maintenance hemodialysis (HD) patients., Methods: After baseline measurements were taken, the dialysate sodium concentration was reduced from 140 to 137 mEq/L. Oxidative stress parameters and flow-mediated dilatation (FMD %) were measured before and after 6 months of HD with low sodium dialysate. Interdialytic weight gain (IDWG) and pre- and post-dialysis BP were monitored during the study., Results: A total of 52 patients were enrolled and 41 patients completed the study. There was a significant reduction in systolic blood pressure at the end of the study [130.00 (90.00-190.00) vs. 120.00 (90.00-150.00), p < 0.001]. Similarly, there were significant improvements in IDWG [2670.00 (1670.00-4300.00) vs. 1986.00 (1099.00-3998.00), p < 0.001] and FMD % [7.26 (4.55-8.56) vs. 9.56 (6.55-12.05), p < 0.001]. Serum MDA levels (p < 0.001) were significantly decreased; serum SOD (p < 0.001) and GPx (p < 0.001) activities were significantly increased after low sodium HD compared to standard sodium HD., Conclusion: Our data seem to suggest a potential role of 137 mEq/L sodium dialysate for improving hemodynamic status, endothelial function and reducing oxidative stress than 140 mEq/L sodium dialysate in maintenance HD patients.

Background: This study aimed at investigating the possible protective effect of erythropoietin beta on experimental diabetic nephropathy (DN) model in rats., Methods: Sprague Dawley rats (n = 32) were allocated into 4 equal groups of 8 each, the control (Group C), diabetes (Group D), erythropoietin beta (Group E), and erythropoietin beta treated DN (Group E + D) groups. Streptozocin (65 mg/kg) was used to induce diabetes in 10-week old rats. Erythropoietin beta was given intraperitoneally at a dose of 500 IU/kg/3 days of a week for 12 weeks. Renal function parameters, intrarenal levels and activities of oxidative stress biomarkers, serum inflammatory parameters and kidney histology were determined., Results: Group E + D had lower mean albumin-to-creatinine ratio (p < 0.001) as well as higher creatinine clearance (p = 0.035) than the diabetic rats (Group D). Intrarenal malondialdehyde levels were significantly lower (p = 0.004); glutathione (GSH) levels (p = 0.003), GSH peroxidase (p = 0.004) and superoxide dismutase (p < 0.005) activities of renal tissue were significantly higher in Group E + D than in Group D. The mean serum levels of interleukin-4 (p < 0.005), interleukin 1 beta (p = 0.012), interferon gamma (p = 0.018) and tumor necrosis factor alpha (p < 0.005) were significantly lower; serum levels of monocyte chemoattractant protein 1 (p = 0.018) was significantly higher in Group E + D when compared to Group D. The mean scores of tubulointerstitial inflammation (p = 0.004), tubular injury (p = 0.013) and interstitial fibrosis (p = 0.003) were also lower in Group E + D when compared to Group D., Conclusion: Our data seem to suggest a potential role of erythropoietin beta for reducing the progression of DN in an experimental rat model. This protective effect is, in part, attributable to the suppression of the inflammatory response and oxidative damage., (© 2016 S. Karger AG, Basel.)

Aim: We carried out the present study to determine the prevalence, associated comorbidities and impact on mortality of chronic kidney disease (CKD) in nursing home residents., Methods: This was an 8-year prospective single-center, longitudinal cohort study consisting of 612 patients living in a nursing home from 2005-2013. The glomerular filtration rate (GFR) was estimated from a prediction equation, the Chronic Kidney Disease Epidemiology Collaboration equation, based on the serum creatinine concentration, age, race, sex and body size. The demographic and clinical characteristics of the residents were collected., Results: CKD, defined as abnormalities of kidney structure or function, present for >3 months, with implications for health, was present in 197 (39.9%) residents. Specifically, 109 (21.5%) residents had an estimated GFR of 45-59 mL/min, and 64 (12.6%) had an estimated GFR of 30-44 mL/min. Multivariate logistic regression identified older age (OR 0.97, 95% CI 0.95-0.99), female sex (OR 2.99, 95% CI 1.99-4.49) and hypertension (OR 1.55, 95%, CI 1.00-2.40) as the only independent predictors of CKD. After a follow up of 8 years, 208 (41.1%) of the 506 residents died. Of these residents, 104 (52.8%) had CKD and 104 (33.4%) did not have CKD. The Kaplan-Meier survival curves showed that residents with CKD had a significantly higher mortality than those without CKD., Conclusion: CKD is prevalent in nursing home residents. A decline in renal function is associated with cardiovascular disease and mortality. Early recognition of CKD might improve drug dosage, renal management and outcomes in this particular group of patients., (© 2014 Japan Geriatrics Society.)

The aim of this study was mainly to develop a microbial biosensor for the simultaneous determination of lactic acid and pyruvic acid. In developing biosensor, lyophilised Lactobacillus delbruecki sp. bacterial cells were immobilised with polypyrrole on a platin electrode surface using electropolymerization method. Lactate concentration was determined based on the differences in amperometric responses at cathodic peak (+0.2V) of potassium ferricyanide, whereas pyruvate concentration was determined using the differences at anodic peak (+0.1V). The response of biosensor showed linearity between 0.1 and 1.0mM for both of two substrates. Optimisation studies were carried out for amount of microorganism, pyrrole concentration, pH and temperature. In the characterisation studies, substrate specificity, interference effect of some substances on the biosensor response, and storage stability were established., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Background: Oxidative stress is accepted as a non-classical cardiovascular risk factor in patients on maintenance hemodialysis (HD). The aim of this study was to evaluate the impact of cinacalcet on oxidative stress biomarkers, oxidative DNA damage (8-hydroxy-2'-deoxyguanosine/deoxyguanosine), endothelial function (FMD %) and carotid artery intima-media thickness (CIMT) in HD patients., Methods: Forty-two chronic HD patients with secondary hyperparathyroidism undergoing 60 mg/day cinacalcet treatment with a follow-up of 6 months and 38 age- and sex-matched healthy individuals were included in this prospective study. Plasma malondialdehyde (MDA) levels and 8-hydroxy-2'-deoxyguanosine/deoxyguanosine ratio (8-OHdG/dG) were determined as oxidative stress markers. Superoxide dismutase (SOD), paraoxonase (PON), catalase (CAT), carbonic anhydrase (CAN) and glutathione peroxidase (GPx) activities were measured as antioxidants. FMD % and CIMT were assessed by ultrasonography., Results: MDA levels were decreased; SOD, PON, CAT, CAN and GPx activities were increased after 6 months of cinacalcet treatment in HD patients. Although CIMT remained stabile, there was a significant improvement in FMD % as well as a notable reduction trend in 8-OHdG/dG ratio after 6 months of treatment., Conclusion: Our data have demonstrated that cinacalcet improves oxidative stress, genomic damage, endothelial function and increases antioxidant protection in HD patients after 6 months of treatment.

Purpose: The current study aimed to investigate short- and long-term postoperative ocular refractive effects of medial rectus recession on the involved eye and to describe the detectable effects in detail by the results of vector analysis., Methods: Data of patients in whom medial rectus recession was performed between 2010 and 2012 were retrospectively evaluated. The study included 52 eyes of 32 patients. Patients with a history of previous ocular surgery, congenital or progressive corneal disease, familial or acquired posterior segment disease, glaucoma, a history of ocular trauma, or any neurological or systemic disease were excluded. Best-corrected and uncorrected visual acuities and refraction examination findings of the patients were recorded before the surgery and at the postoperative first month and first year. A vector analysis program was used to analyze surgically induced astigmatism., Results: Significant myopic shift and astigmatic change were determined in the spherical equivalent refraction in the early postoperative period (first month); however, these changes disappeared in the long term (at the postoperative first year). A positive correlation was not observed between the amount of surgical recession and the results of ophthalmic examination at the postoperative first month and first year., Conclusions: Only postoperative first month spherical equivalent showed a positive correlation with the amount of surgical recession; however, this correlation disappeared at the postoperative first year., (Copyright 2014, SLACK Incorporated.)

Saccharomyces cerevisiae, known as baker's yeast, is also used as a probiotic agent to treat gastroenteritis by modulating the endogenous flora and immune system. However, since there have been increasing reports of fungemia due to S.cerevisiae and its subspecies S.boulardii, it is recommended that probiotics should be cautiously used in immunosuppressed patients, people with underlying diseases and low-birth weight babies. To emphasize this phenomenon, in this report, a case of S.cerevisiae fungemia developed in a patient given probiotic treatment for antibiotic-associated diarrhea, was presented. An 88-year-old female patient was admitted to our hospital with left hip pain, hypotension, and confusion. Her medical history included hypertension, chronic renal failure, left knee replacement surgery, and recurrent urinary tract infections due to neurogenic bladder. She was transferred to the intensive care unit with the diagnosis of urosepsis. After obtaining blood and urine samples for culture, empirical meropenem (2 x 500 mg) and linezolid (1 x 600 mg) treatment were administered. A central venous catheter (CVC) was inserted and after one day of inotropic support, her hemodynamic parameters were stabilized. The urine culture obtained on admission yielded extended-spectrum beta-lactamase-producing Klebsiella pneumoniae and Escherichia coli. Urine culture was repeated after three days and no bacteria were isolated. On the 4th day of admission she developed diarrhea. Toxin A/B tests for Clostridium difficile were negative. To relieve diarrhea, S.boulardii (Reflor 250 mg capsules, Sanofi Aventis, Turkey) was administered twice a day, without opening capsules. Two days later, her C-reactive protein (CRP) level increased from 23.2 mg/L to 100 mg/L without fever. Her blood culture taken from the CVC yielded S.cerevisiae. Linezolid and meropenem therapies were stopped on the 13th and 14th days, respectively, while prophylactic fluconazole therapy was replaced with caspofungin 1 x 50 mg on the fifth day. After seven days of therapy CRP and serum creatinine levels decreased to 9.1 mg/L and 1.2 mg/dl, respectively; and she was discharged from the hospital with improvement. The probiotic capsules were used unopen, thus, it was proposed that S.cerevisiae fungemia originated from translocation from the intestinal mucosa. Since it was not possible to investigate the molecular genetics of the strain isolated from the blood culture and the strain present in the probiotic, a definite conclusion about the origin of the strain could not be reached. It was thought that old age and underlying disease of the patient were the related predisposing factors for S.cerevisiae fungemia. This case emphasized that clinicians should be cautious in case of probiotic application even though in encapsulated form, even in immunocompetent patients with a history of long-term hospital stay and use of broad-spectrum antimicrobials since there may be a risk of S.cerevisiae fungemia development.

Background/aims: The aim of the present study was to investigate the effect of combination of aliskiren with paricalcitol on experimental diabetic nephropathy (DN) model in rats., Methods: Forty male Sprague Dawley rats were divided into 5 groups of 8 rats each, namely the control (Group C), diabetes (Group D), aliskiren (Group A), paricalcitol (Group P), and aliskiren plus paricalcitol (Group A+P) groups. Aliskiren was given by oral-gavage at a dose of 50 mg/kg/day once daily for 12 weeks. Paricalcitol was given by intraperitoneally at a dose of 0,4 µg/kg/three day of week for 12 weeks. Renal function parameters, oxidative stress biomarkers, mRNA expression of renin-angiotensin system parameters and kidney histology were determined., Results: Group A+P had lower mean albümin-to-creatinine ratio (ACR) (p=0.004) as well as higher creatinine clearance (CCr) (p<0.005) than the diabetic rats (Group D). Combination therapy significantly increased CCr (Group A+P vs. Group A, p<0.005; Group A+P vs. Group P, p=0.022) and reduced ACR (Group A+P vs. Group A, p=0.018; Group A+P vs. Group P, p<0.005) when compared to monotherapy. Serum malondialdehyde levels were significantly lower (p=0.004); glutathion levels (p=0.003), glutathion peroxidase (p=0.004) and superoxide dismutase (p<0.005) activities were significantly higher in group A+P than in group D. The mean scores of mRNA expression of renin (p<0.005), angiotensin II (p=0.012) and angiotensin type 1 receptor (p=0.018) in group A+P were significantly lower. Although combination therapy showed no additional effect on oxidative system, renin-angiotensin system and renal histology, aliskiren plus paricalcitol significantly decreased interstitial fibrosis volume when compared to monotherapy (Group A+P vs. Group A, p<0.005; Group A+P vs. Group P, p=0.002)., Conclusion: Our data seem to suggest a potential role of aliskiren plus paricalcitol acting synergystically for reducing the progression of diabetic nephropathy in an experimental rat model.

Objective: We aimed to evaluate possible risk factors assocıated wıth acute kidney injury (AKI) after hip fracture surgery in the elderly individuals., Design: Level II diagnostic study, evidence obtained from prospective cohort study from 1 center with level 2, and 3 patients., Patients: A total of 165 patients (>65 years) with femoral neck fracture were enrolled in this prospective study between 2007 and 2010. Two patients were dropped for inadequate laboratory follow-up data. Patients with kidney failure or renal replacement therapy (RRT) history or AKI at admission were excluded., Intervention: Nephrology consultation was obtained from all patients at admission. All patients had undergone bipolar cemented hip arthroplasty that was performed by the same surgical team in all patients within 24 hours of fracture and admission under the same protocol., Main Outcome Measurements: Serum creatinine (SCr), urine output, and complete blood counts were evaluated at baseline and daily basis thereafter. The AKI was defined based on Acute Kidney Injury Network classification. Hospital charges were converted from Turkish Liras to US dollars and rounded., Results: Among 163 patients, AKI occurred in 25 (15.3%) patients, all within the first 48 postoperative hours. Three (1.8%) patients required RRT. Baseline SCr levels were restored within 4.84 ± 1.34 days on average (3-8 days). No patient required RRT after discharge. The mean hospital stay was 3 days (2-6 days) longer and the hospital charge was 2500 US$ higher for the patients with AKI. After multivariable adjustment, only lower estimated glomerular filtration rate levels (odds ratio 0.945, 95%confidence interval 0.92-0.96) emerged as an independent predictor for AKI., Conclusion: The AKI represents a frequent complication after hip fracture surgery associated with longer hospital stay and higher treatment costs with increased morbidity. Our results show baseline renal function is an independent predictor of AKI.

Ultrasonic treatment of recalcitrant contaminants has been of utmost interest recently due to the advantages of the cavitation phenomenon, which enhances the efficiency of Advanced Oxidation Processes (AOPs). The current review summarizes the use of ultrasound with biochemical, electrochemical, ozonation, photolysis, photocatalysis and Fenton processes for the degradation of mostly textile dyes and dyebath. There is a few studies about ultrasonic degradation of textile effluents or wastewater due to highly variable contents. It was found that the most common use of ultrasonic irradiation for dye degradation is the combined with the heterogeneous catalysts/adsorbents. The reaction mechanism of the ultrasonic irradiation in heterogeneous media was well investigated and understood. However, there is still lack of information about the reaction mechanism of ultrasonic irradiation in the homogeneous solutions, especially containing ferrous ions. Fenton reaction is already fast itself and gives effective degradation during the oxidation. Therefore, addition of ultrasonic irradiation to Fenton oxidation was less effective compared to other auxiliary processes. It should also be noted that ultrasonic irradiation had a negative effect on dye degradation during combined with electro-oxidation process., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

OBJECTIVE: Cardiac and kidney diseases are common, and the impact of acute kidney injury (AKI) on patient outcome is well known. We aimed to investigate the incidence of acute cardiorenal syndrome (CRS) and the risk factors and outcomes associated with the disease. METHODS: We conducted a retrospective cohort study comprising 289 patients with acute coronary syndrome (ACS) and acute decompensated heart failure (ADHF), examining the incidence of AKI defined according to the Acute Kidney Injury Network (AKIN) classification, the factors contributing to AKI, and the impact of AKI on in-hospital mortality and hospital re-admission. RESULTS: Of 71 patients with AKI, 36 (50.7%) had ACS and 35 (49%) had ADHF. Overall in-hospital mortality was 5.5% (n = 16). Multivariate logistic regression identified the following independent predictors of AKI in male patients with ACS: previous myocardial infarction at age >65 years (OR 5.967, 95% CI 1.16-30.47, p = 0.03), chronic kidney disease (OR 3.72, 95% CI 1.31-16.61, p = 0.01), and decreased hemoglobin levels (OR 0.684, 95% CI 0.53-0.88, p = 0.03). No variable was identified as an independent risk factor in ADHF patients. Kaplan-Meier survival curves indicated that patients with ACS plus AKI had significantly higher in-hospital mortality (log rank = 0.007). CONCLUSION: Acute CRS (type 1 CRS) is more frequent in patients with ADHF and can be considered multifactorial. Although CRS is less frequent in ACS patients, it is associated with longer hospital stay and with higher in-hospital mortality. The heart-kidney interaction should be managed collaboratively between cardiologists and nephrologists to increase our knowledge and enhance clinical approaches.

Objectives: The aim of the study was to assess the effect of paricalcitol on the experimental contrast-induced nephropathy (CIN) model. We hypothesised that paricalcitol may prevent CIN., Methods: 32 Wistar albino rats were divided into four groups (n=8 each): control group, paricalcitol group, CIN group and paricalcitol plus CIN group. Paricalcitol (0.4 µg kg(-1) day(-1)) was given intraperitoneally for 5 consecutive days prior to induction of CIN. CIN was induced at day 4 by intravenous injection of indometacin (10 mg kg(-1)), Nω-nitro-L-arginine methyl ester (L-NAME, 10 mg kg(-1)) and meglumine amidotrizoate (6 ml kg(-1)). Renal function parameters, oxidative stress biomarkers, histopathological findings and vascular endothelial growth factor (VEGF) immunoexpression were evaluated., Results: The paricalcitol plus CIN group had lower mean serum creatinine levels (p=0.034) as well as higher creatinine clearance (p=0.042) than the CIN group. Serum malondialdehyde and kidney thiobarbituric acid-reacting substances levels were significantly lower in the paricalcitol plus CIN group than in the CIN group (p=0.024 and p=0.042, respectively). The mean scores of tubular necrosis (p=0.024), proteinaceous casts (p=0.038), medullary congestion (p=0.035) and VEGF immunoexpression (p=0.018) in the paricalcitol plus CIN group were also significantly lower., Conclusion: This study demonstrates the protective effect of paricalcitol in the prevention of CIN in an experimental model.

Background: Endotoxins can cause serious organ damage and death by triggering the secretion of pro-inflammatory cytokines such as TNF-alpha, IL-6 and IL-1beta in bacterial infections., Objectives: The goal of this study was to evaluate the effects of a high dose (3000 U/kg) of erythropoietin-beta (EPO) on inflammatory cytokine levels, renal function and histological changes during the early period of Lipopolysaccharide (LPS)-induced endotoxemia using a rat model., Material and Methods: Male Sprague Dawley (350-400 g) rats were randomized into 3 groups: Control group (n = 7); LPS group (received 20 mcg/kg LPS through intraperitoneal (i.p.) injection (n = 7); LPS+EPO group (received 3000 U/kg, ip 30 minutes before LPS administration (n = 7). Four hours after the administration of LPS, kidney tissue and serum samples were collected. Kidney function parameters, TNF-alpha, IL-6, IL-1beta, C reactive protein (CRP) and complete blood counts (CBC) were measured. The severity of renal tubular injury and caspase-9 immunoreactive cells was expressed as a percentage., Results: Serum levels of urea, creatinine, TNF-alpha, IL-6 and IL-1beta were significantly increased in the LPS group (p < 0.0001 - p = 0.04) and were lower in LPS+EPO group (p < 0.0001, p = 0.01, p = 0.02, p = 01 and p < 0.0001, respectively). Pretreatment with EPO significantly increased platelet counts (p = 0.00) and decreased white blood cell counts (p = 0.02). The renal tubular injury percentage was significantly higher in the LPS group than in the control and LPS+EPO groups (p = 0.002, p = 0.003, and p = 0.005, respectively) and caspase-9 expression was lower in the LPS+EPO and control groups than in the LPS group., Conclusions: EPO might have renoprotective effects against the inflammatory process and cell apoptosis during endotoxemia.

Introduction: Human paraoxonase 1 (PON1) is an enzyme related with high-density lipoprotein cholesterol. The link between genetic polymorphisms of PON1 and hyperlipidemia and increased lipid oxidation may explain these complications in the course of glomerular diseases. In this study, we aimed to investigate PON1 192 and PON1 55 polymorphisms in patients with primary glomerulonephritis and healthy individuals., Materials and Methods: Eighty-six patients with biopsy-proven primary glomerulonephritis and 50 healthy controls were included in the study. Clinical characteristics, lipid profile, paraoxonase activity, and PON1 genotypes (PON1 192 and PON1 55) of all of the participants were studied., Results: Histopathological diagnoses of the patients were membranoproliferative glomerulonephritis (53.5%), focal segmental glomerulosclerosis (33.7%), and membranous nephropathy (12.8%). The patients had lower PON1 activity levels than the healthy controls. No differences were observed in PON1 192 genotypes between the two groups. However, the controls were more likely to carry PON1 55 LM genotype (odds ratio, 4.10; 95% confidence interval, 1.96 to 8.61; P < .001) and M allele (odds ratio, 3.0; 95% confidence interval, 1.45 to 6.19; P = .003) compared to the patients with primary glomerulonephritis. There was a marked elevation in the frequency of PON1 55 LL genotype in the patients compared to the controls (odds ratio, 0.33; 95% confidence interval, 0.16 to 0.68; P = .003)., Conclusions: This preliminary study shows that the LL genotype might be a risk factor for the development of primary glomerulonephritis and the M allele might be a protective factor against its progression.

We report JC virus (JCV)-associated nephropathy in a renal allograft recipient and summarize the clinical and laboratory data of the 8 previous cases. A 28-year-old male renal allograft recipient received a preemptive transplant from his father. Six months later, a kidney biopsy was performed because of deterioration of allograft function. Biopsy revealed tubulointerstitial mononuclear infiltrates with normal glomeruli; on hematoxylin and eosin staining, basophilic nuclear inclusions were seen in the nucleus of tubular cells. Urinary cytology failed to demonstrate decoy cells, but polymerase chain reaction of a urinary sample was positive for JCV 3.15 × 10(10) copies/mL. Additionally, polyomavirus (SV40) immunohistochemical staining was performed and was positive in the enlarged nuclei of tubular epithelial cells in the kidney biopsy sample. After the diagnosis of polyomavirus-associated nephropathy (PVAN) was confirmed by kidney biopsy, immunosuppressive agents were reduced. Intravenous immunoglobulin was administered 5 times at a dose of 500 mg/kg every other 3 weeks. Two months after diagnosis, the serum creatinine became stable and urinary viral load of JCV was decreased. Because viruria was still present, tacrolimus was converted to sirolimus. Four months after immunosuppressive agent conversion from tacrolimus to sirolimus, the viruria had disappeared. Review of the literature and our case demonstrates that male gender, previous acute rejection episode, low incidence of JCV viremia, PVAN pattern B histology, and reducing immunosuppression are the diagnostic touchstones for PVAN due to JCV., (© 2010 John Wiley & Sons A/S.)

The study describes degradation of two azo dyes at low and high frequency ultrasound (US) to compare their reactivity and to assess the impacts of frequency, OH, chemical structure and soluble/nonsoluble additives. Low frequency US alone was found totally ineffective for bleaching the dyes even after 2-h irradiation, while high frequency provided significant color decay in 30-min contact. The result was attributed to larger number of oscillations at high frequency that allowed a larger fraction of OH ejection to the bulk liquid. The difference in the rates of dye degradation was due to different substituents around the azo bonds that dictated the reactivities of the dyes with OH and other species. The performance of low frequency US was remarkably improved and exceeded that of high frequency in the presence of CCl(4), nano-sized TiO(2) and zero-valent copper. The effect was attributed to the advantage of low frequency for long bubble-life time, high collapse temperatures, turbulent flow conditions and high sonoluminescence intensity. The efficacies of the additives in terms of the reduction in dye concentration per unit mass of additive were: TiO(2)>CCl(4)>Cu, regardless of the dye structure and the operation frequency. Much better performance of TiO(2) than Cu was attributed to its larger surface area with a slight positive charge on it and to the effect of stable sonoluminescence that may have induced photocatalytic properties on semiconductor surface., (Copyright (c) 2010 Elsevier B.V. All rights reserved.)

Background: One problem associated with end to end anastomoses after preoperative radiotherapy is leakage. The strength of the anastomoses is very important. Fractionation schedules are widely under investigation to achieve higher doses with less toxicity and high curative potential. The aim of this study was to compare preoperative conventional and hyperfractionated radiotherapy effects on anastomoses., Materials and Methods: Sixty Wistar albino rats were divided into 3 groups: control, conventional radiotherapy (2 Gy/fraction, total 44 Gy), and hyperfractionated radiotherapy (1.2 Gy/fraction, total 52.8 Gy). 5 weeks after completion of the treatment, the rats underwent end to end anastomoses to the rectum. Following the surgery, the bursting pressure of the anastomoses and the hydroxyproline levels were measured on days 3 and 7., Results: The bursting pressure was lower in both radiotherapy groups on the 3rd day. On day 7, the results of the conventional radiotherapy arm matched those of the control group, but the results of the hyperfractionated group did not (p = 0.001). On day 3, hydroxyproline levels were significantly lower in both radiotherapy groups than in the control group (p = 0.001). On the 7th day, the statistical difference disappeared within the radiotherapy groups. However, the hydroxyproline levels of the 2 radiotherapy arms were still lower than those of the control group (p = 0.001)., Conclusion: Hyperfractionation strongly inhibits collagen synthesis and is associated with protracted healing., (Copyright 2009 S. Karger AG, Basel.)

Purpose: To determine the social phobia rate, social anxiety level, severity of depressive symptoms, and disease-related disability in adult strabismus patients., Methods: Forty-nine strabismus patients and 46 control subjects from 15 to 65 years of age were evaluated. A psychiatric interview focusing on social phobia and the Liebowitz Social Anxiety Scale (LSAS) were administered to each participant. All participants completed the Hospital Anxiety and Depression Scale (HADS), a psychiatric symptom checklist (Symptom Checklist 90-Revised; SCL-90R), and the Sheehan Disability Scale., Results: Social phobia was diagnosed in 26 of the 49 strabismus patients and in 8 of the 46 control subjects (p < 0.001). Strabismus patients demonstrated significantly greater scores in all of the subscores and the total scores of LSAS. They were more disabled in social life, family life, and at work. They also showed greater interpersonal sensitivity scores compared with the control group. Compared with strabismus patients without social phobia, the strabismus patients with social phobia demonstrated significantly greater depression scores in HADS and also scored in all dimensions of LSAS. Their social life and family life scores in disability scale and all scores in SCL-90-R except somatization were better than strabismus patients without social phobia., Conclusions: In adult strabismus patients, social phobia is a frequent psychiatric comorbidity. Adult patients with strabismus need to be carefully evaluated for social phobia for an appropriate referral and treatment.

Background: Patients with resistant or relapsing primary glomerulonephritis (PGN) after conventional immunosuppressive treatment have a worse renal outcome, and treatment of these patients remains problematic. In this study we aimed to determine the effect of tacrolimus in these patients., Methods: We prospectively studied 15 patients with PGN (3 membranous nephropathy, 6 membranoproliferative GN, 4 focal segmental glomerulosclerosis [FSGS], 1 IgA nephropathy and 1 IgM nephropathy) who were either resistant (n=7) or relapsing (n=8) after or during conventional immunosuppressive therapy. Tacrolimus was started at a dosage of 0.05 mg/kg per day. Prednisolone was either maintained or added to the tacrolimus regimen., Results: The mean duration of tacrolimus treatment was 28.9 +/- 2.4 months. Proteinuria decreased from 6.3 +/- 5.0 g/day to 0.5 +/- 0.6 g/day at the end of follow-up (p=0.001). Complete or partial remission was achieved by 60% and 40% of patients, respectively. Relapse occurred in only 2 patients with FSGS under tacrolimus treatment. There was no significant change in serum creatinine at the end of follow-up (from 1.4 +/- 1.0 mg/dL to 1.2 +/- 0.6 mg/dL, p=0.3). Serum albumin increased from 3.2 +/- 0.5 g/dL to 4.3 +/- 0.3 g/dL (p=0.0001). There were 6 relapses among 10 patients after the withdrawal of tacrolimus., Conclusions: These data suggest that the combined therapy of tacrolimus and low-dose prednisolone may have a promising role to obtain long-term remission in resistant or relapsing PGN.

Objective: To investigate the effect of glucose-insulin-potassium (GIK) infusion on erythrocyte antioxidant enzyme activity levels during therapy and post-therapy in patients with dilated cardiomyopathy (DCM)., Methods: Forty-one patients with DCM were enrolled in the present study. GIK solution (50 U of insulin in 500 mL of 30% glucose, plus 60 mmol/L KCl), in addition to the standard treatment, was administered by 24 h infusion in 28 patients (GIK group). In the remaining 13 patients (control group), 0.9% NaCl solution was administered. Venous blood samples from all patients were collected at baseline, during therapy (2 h, 8 h, 12 h and 24 h after baseline) and after therapy (48 h after baseline). The activity levels of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSHP) were measured., Results: In the GIK group, SOD values showed a significant increase at 24 h and 48 h compared with baseline and 2 h values (P<0.05). An increasing trend in CAT activity was observed during and after GIK infusion compared with baseline (0 h) values. However, these differences were not statistically significant (P>0.05). With regard to GSHP activity, no significant change was found in the GIK group during follow-up (P>0.05). In the control group, SOD, CAT and GSHP activity levels measured during and after therapy were found to be similar to those measured at baseline (P>0.05)., Conclusion: Administration of GIK solution, in addition to standard therapy, in patients with DCM may improve the metabolic scope of the disease by reducing myocardial oxidative stress.

Objectives: In this study, we sought to examine the effect of glucose-insulin-potassium (GIK) treatment on oxidative stress in patients with acute coronary syndromes (ACSs) undergoing percutaneous coronary interventions (PCIs)., Methods: Patients with ACSs who had been electively treated with a stent implantation into the culprit vessel were included in this study. Patients were divided into two groups and were randomly administered either the GIK treatment (GIK group; n=28) or isotonic NaCl (control group; n=19) infusion during PCI. Blood samples from the coronary artery ostium (CO) were collected through the femoral artery and from the coronary sinus (CS) through the femoral vein, before and immediately after PCI. Superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) activities were measured., Results: A total of 47 patients were included in the study. SOD, CAT, and GSH-Px activities, whether in the CO or the CS, were similar in both the GIK and control groups before the intervention (P>0.05). In the control group, SOD (in both the CO and the CS), CAT (in the CS), and GSH-Px (in the CS) activities were higher compared with baseline values (P<0.05). Such increases were, however, not seen in the GIK group (P>0.05). Although the CS-CO activity differences (venous-arterial) of SOD, CAT, and GSH-Px, which are parameters of myocardial reactive antioxidant enzyme production, were increased in the control group, there was no increase in the GIK group., Conclusions: In patients with ACSs, reactive local enzyme activity increases for the scavenging to myocardial-free radicals during PCI. Administration of a solution of GIK as a metabolic support agent might prevent oxidative stress in the myocardial level, in these patients.

Batch adsorption studies were carried out for the sorption of C.I. Reactive Black 5, a reactive dye, onto high lime fly ash, obtained from Soma Thermal Power Plant (Turkey), to be low cost adsorbent. The effect of various experimental parameters such as contact time, adsorbent dose and initial dye concentration were investigated. Determination of the adsorption equilibrium concentrations was determined by UV-vis spectrophotometry analytical method. Equilibrium data were fitted to the Freundlich and Langmuir isotherm equations and the equilibrium data were found to be well represented by the Freundlich isotherm equation. The adsorption kinetics of C.I. Reactive Black 5 onto high lime fly ash were also studied to characterize of the surface complexation reaction. A pseudo-second-order mechanism has been developed to predict the rate constant of the adsorption, the equilibrium capacity and initial adsorption rate with the effect of initial concentration. A single-stage batch adsorber design of the adsorption of C.I. Reactive Black 5 onto high lime fly ash has been studied based on the Freundlich isotherm equation.

In this work, adsorption of Cu(II) ions on sawdust (SD) and activated sawdust (ASD) has been studied by using batch adsorption techniques. The equilibrium adsorption level was determined to be a function of the pH, initial Cu(II) concentration, and adsorbent dosage. The equilibrium nature of Cu(II) adsorption has been described by the Freundlich and Langmuir isotherms. The experimental adsorption data were fitted to the Langmuir adsorption model both sawdust and activated sawdust. The equilibrium capacity of sawdust and activated sawdust were 5.432 and 13.495 mg copper per g adsorbent, respectively at room temperature and natural pH. The maximum adsorption capacity was obtained at the maximum zeta potential value that -74.5 mV (pH 5) for activated sawdust and at -48.4 mV (pH 4) for sawdust. It was observed that activated sawdust was a suitable adsorbent than sawdust for removal of Cu(II) from aqueous solutions.

Excessive release of reactive oxygen species (ROS) in wounded tissue due to inflammation and ischaemia is a deleterious and destructive phenomenon for the healing process. Hence, scavenging of ROS is one of the essential steps in normal wound repair. In this study, we presented a profile of free radical scavenging enzyme (FRSE) activity of periodontal mucoperiosteal wounds in order to investigate ROS activity during periodontal wound healing. Mucoperiosteal periodontal flaps were elevated in the mandibular buccal region of seven dogs between the first premolar and first molar teeth, creating acute incisional wounds in the inner side of the flaps and they were replaced 30 min after elevation. Gingival samples taken from certain biopsy regions at baseline (before flap elevation), day 3, 12, 21 and 30 were processed for detection of active amounts of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX). All enzyme activities had increased by more than 100% of their baseline levels by day 3. SOD activity decreased gradually from days 3 to 30 and reached a level lower than the baseline value. The increase in CAT activity continued until day 21, and decreased to a level higher than the baseline value by day 30. GPX also decreased from day 3, and reached a level less than its baseline value by day 30. Our results suggest that FRSEs may contribute to the detoxification of ROS during periodontal mucoperiosteal healing. This relationship may be utilized to facilitate soft tissue and/or flap management in periodontal or intra-oral treatments.

We utilized a newborn rat model of hypoxia/reoxygenation (H/R) that resembles human necrotizing enterocolitis (NEC) to investigate the effects of omeprazole and/or gentamicin on the formation of free oxygen radicals (FOR) and bowel histopathology. For H/R, 1-day-old rats were placed into a chamber of 100% CO2 for 5 min, then they were reoxygenized for the next 5 min. The rats (n = 70) were divided into seven groups: group 1 (control), group 2 (H/R), group 3 (omeprazole), group 4 (H/R + omeprazole), group 5 (gentamicin), group 6 (H/R + gentamicin), group 7 (H/R + omeprazole + gentamicin). Gentamicin and/or omeprazole were given orally for 3 days, then all animals were killed; bowel specimens were harvested. Histopathologic injury scores (HIS) and malonyldialdehyde (MDA) and XO/(XO+XDH) rates (XO; xanthine oxidase, XDH; xanthine dehydrogenase) were measured, which reflect the FOR levels. In group 2, the HIS was significantly higher than groups 4 and 6. The mean MDA values in groups 1-7 were as follows: 54.16, 104.2, 56.85, 63.43, 62.31, 76.85, 79.13, respectively. The mean XO/(XO + XDH) levels were 0.306, 0.461, 0.286, 0.335, 0.323, 0.410, 0.375 from groups 1 -7, respectively. Group 2 rats had significantly more MDA and XO/(XO + XDH) rates versus other groups (P < 001). Histopathologic injury and biochemical results were significantly more severe in group 2 than in groups 4 and 6 (P < 001). There was no difference between groups 1 and 4 according to XO/(XO + XDH) rates. In newborn rats, H/R produces FOR, which cause serious intestinal damage. Omeprazole and/or gentamicin reduce biochemical and histopathologic bowel damage. This effect was more obvious in omeprazole treated rats. We think omeprazole may open new insights into the treatment of H/R related bowel injuries like NEC.

It is consented that reactive oxygen species (ROS) are deleterious to wound healing process due to the harmful effects on cells and tissues. Absorbable synthetic biomaterials are considered to be degraded via ROS. Free-radical-scavenging enzymes (FRSE) are a cytoprotective enzymal group that has an essential role in the reduction, de-activation and removal of ROS as well as regulating wound healing process. In the present study, synthetic and absorbable polylactide (PLA) barrier membranes were evaluated by means of ROS activity levels during degradation in the healing periodontal flaps measuring the activity of FRSE superoxide dismutase (SOD) and catalase (CAT). Gingival biopsies taken from 10 patients allowing both guided tissue regeneration (test) and conventional flap surgery (control) before and 1 month after the operations were processed and the supernatants were studied by Mc Cord and Fridovich, Flohe and Otting, and Luck methods to measure total SOD and CAT levels respectively. A significantly increased enzyme activity of SOD and CAT was observed in both groups (p<0.05). SOD activity change was 62.92% in the test and 3.97% in the control group, and, CAT activity change was 48.04% in the test and 11.58% in the control group. Our results suggest that ROS, particularly superoxide anions, may contribute to the degradation phase of PLA membranes and this may affect the wound healing of periodontium at least for one-month period.