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Introduction:Multiple sclerosis (MS) is the most common, chronic, inflammatory, demyelinating disease of the central nervous system. We aimed to evaluate the levels of some neurobiochemical markers in order to evaluate their predictive role in MS.Methods:Fifty-one patients with a diagnosis of MS and 37 healthy subjects were included in the study. The patients with MS were diagnosed by a skilled neurologist based on the medical history and physical examination according to revised McDonald criteria. Neuron-specific enolase (NSE) and S100B levels were measured by electrochemiluminescence immunoassay. Glial fibrillary acidic protein (GFAP) and myelin basic protein (MBP) were measured by quantitive sandwich enzyme immunoassay technique with a commercially available ELISA kit.Results:There was a significant difference in NSE levels between the patient and the control groups. No significant difference was determined between the patient and the control groups in terms of S100B, MBP, and GFAP levels. S100B levels were positively correlated with Expanded Disability Status scale scores.Conclusion:Our findings indicated that NSE levels are significantly lower in MS patients. However, NSE levels should not be used alone at discriminating the disease. Multifactorial evaluation should be done during the diagnosis and follow-up of MS.

Objectives: To evaluate the relationship between the expression level and biologic role of YKL-40 in bipolar disorder (BD). Methods: This case-control study was conducted in the Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey in 2015. One hundred and four patients diagnosed as having bipolar disorder (DSM5 criteria), and 96 participants were included as healthy controls in this study. A human YKL-40 enzyme-linked immunosorbent assay (ELISA) kit was used to measure the serum YKL-40 levels. As independent variables, we collected data on C-reactive protein ( CRP), demographic variables, and medications. Results: The mean YLK-40 levels for the BD was 2723.5±543.8 pg/ml and control groups was 2132.5±576.3 pg/ml (t=7.42, p less than 0.001). The mean CRP levels for the BD was 0.4±0.6 mg/dl and control groups was 0.4±0.7 mg/dl (t=0.02, p =0.985). The receiver operating characteristics (ROC) analysis revealed an area under the curve (AUC) of YKL-40 in the diagnosis of BD as 0.79 (95% confidence interval [CI]: 0.72-0.85) with a sensitivity of 82.7% and specificity of 68.1% at a cutoff level of 2307.1 pg/ml. The use of antidepressants, antipsychotics, mood modifiers, and the presence of any comorbidity was not related to the YKL-40 levels ( p greater than 0.05). Conclusion: With acceptable sensitivity and specificity levels, the YKL-40 can be utilized as a marker in the diagnosis and follow-up of BD. Saudi Med J 2019; 40 (1): 26-32 doi: 10.15537/smj.2019.1.23396 How to cite this article: Sahin B, Inanli I, Caliskan AM, Uysal S. Chitinase-3-like protein 1 levels in bipolar disorder. Saudi Med J 2019; 40: 26-32.

Background Iron deficiency is common in obese children although the underlying mechanism is unclear. Several studies have investigated the relation between iron deficiency and obesity, but studies focusing on children are rare. The aim of this paper is to investigate the associations between iron parameters, pro-hepcidin and soluble transferrin receptor levels in obese children. Methods A total of 110 children aged from 6 to 16, 50 with primary obesity and 60 healthy children and adolescents, were enrolled. Complete blood count, serum iron levels, iron binding capacity, ferritin levels, soluble transferrin receptor, and pro-hepcidin levels were studied. Results Serum iron and transferrin saturation index levels were significantly low, red cell distribution width and ferritin levels were significantly high in obese children compared to control group. No association between soluble transferrin receptor, pro-hepcidin and iron parameters was detected. A positive correlation between ferritin and pro-hepcidin levels was defined. Conclusions Obese children and adolescents were at greater risk for iron deficiency. It should be considered in the diet recommendations.

Objectives: To evaluated Fetuin-A levels of patients admitted in the intensive care unit with a diagnosis of sepsis. Methods : This study was conducted at the Faculty of Medicine, Canakkale Onsekiz Mart University Hospital, Canakkal, Turkey, between February 2015 and October 2015. Forty septic patients were included in the study. Subsequent to clinical suspicion of sepsis, serum levels of C-reactive protein (CRP) and procalcitonin; and white blood cell (WBC) counts were evaluated at 3 time-points: 0 (basal), 24, and 72 hours. Results : The mean Fetuin-A levels at the 3 time-points were 58.5 ± 29.2 ng/mL, 40.9 ± 23.6 ng/mL, and 47.8 ± 25.7 ng/mL, respectively. Fetuin-A levels at 24 hours were significantly lower than the basal level ( p greater than 0.05), where as no significant difference was observed between the basal levels and those at 72 hours ( p greater than 0.05). Correlation between the temporal changes in Fetuin-A levels and the changes in other inflammatory markers (CRP, procalcitonin and WBC) was examined. Fetuin A was found to have only a negative correlation with serum procalcitonin level ( p less than 0.05). Conclusion : In this study, serum Fetuin-A levels in septic patients decreased significantly in the first 24 hours, followed by an insignificant increase at 72 hours. These findings suggest that monitoring of Fetuin-A levels may help predict the time of occurrence of sepsis and prognosis of sepsis. Saudi Med J 2018; Vol. 39 (7): 679-684 doi: 10.15537/smj.2018.7.22418 How to cite this article: Altinisik HB, Altinisik U, Uysal S, Sacar S, Simsek T, Demiraran Y.Are Fetuin-A levels beneficial for estimating timing of sepsis occurrence? Saudi Med J . 2018 Jul;39(7):679-684. doi: 10.15537/smj.2018.7.22418.

Objective: Ankylosing spondylitis (AS) is a chronic inflammatory disease and the increased mortality in these patients is largely caused by cardiovascular diseases. Endothelial cell-specific molecule-1 (ESM-1) is a novel marker to assess endothelial dysfunction and expressed by the vascular endothelium. In this study, the serum ESM-1 levels in patients with AS and the possible association between serum ESM-1 and carotid intima-media thickness (CIMT) as a marker of atherosclerosis was evaluated. Methods: A total of thirty-seven patients with AS and thirty healthy control subjects were included in this study. ESM-1, erythrocyte sedimentation rate(ESR),C-reactive protein (CRP) and CIMT were measured in all subjects. ESM-1 levels were measured by ELISA method. The disease activity of patients with AS were assessed using questionnaires Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Results: Serum ESM-1 levels were lower in AS patients than in healthy controls. However, there was no statistically significant difference between ESM-1 levels (304.3±185.2 vs. 373.9±206.9 ng/L, respectively; p=0.064). Patients with AS had significantly higher CIMT levels compared with controls (0.77±0.16 vs. 0.53±0.09 mm, respectively; p Conclusion: The results showed that CIMT values in AS patients were increased when compared to control group. There was no correlation among ESM-1 levels, disease activity and CIMT. In order to reveal the pathological role of the ESM-1 levels in patients with AS need more studies.

Dyslipidemia is one of the most important risk factors for coronary artery disease (CAD), and low-density lipoprotein cholesterol (LDL-C) is used to measure dyslipidemia. Non-high-density lipoprotein cholesterol (non-HDL-C) seems to be an alternative parameter to LDL-C as it is not influenced by triglyceride (TG) levels. The aim of this study is to compare non-HDL-C and LDL-C levels as risk markers in CAD patients. Materials and methods: One hundred and ten CAD patients and 42 individuals with normal coronary angiography results were included in this study. Patients were divided into 2 groups: TG < 200 mg/dL (n = 75) as group 1 and TG > 200 mg/dL (n = 35) as group 2. Total cholesterol (TC), TG, and HDL-C levels were analyzed with a Roche Modular P800 autoanalyzer. LDL-C and non-HDL-C levels were calculated. Results: There were statistically significant differences in TC, TG, HDL-C, and non-HDL-C levels when the groups were compared. Non-HDL-C levels of group 2 were statistically higher than those of group 1 and the control group. There was no significant difference in LDL-C levels between the groups. Conclusion: Non-HDL-C levels are better risk markers than LDL-C levels, especially in patients with TG > 200 mg/dL, and non-HDL-C levels should be taken into consideration when evaluating the risk of CAD.

WOS: 000349619500010 PubMed: 25672430 OBJECTIVES: Prevention of the development of paraplegia during the repair of the damage caused by descending thoracic and thoracoabdominal aneurysms remains an important issue. Therefore, we investigated the protective effect of atorvastatin on ischemia-induced spinal cord injury in a rabbit model. METHOD: Thirty-two rabbits were divided into the following four equally sized groups: group I (control), group II (ischemia-reperfusion), group III (atorvastatin treatment) and group IV (atorvastatin withdrawal). Spinal cord ischemia was induced by clamping the aorta both below the left renal artery and above the iliac bifurcation. Seventy-two hours postoperatively, the motor function of the lower limbs of each animal was evaluated according to the Tarlov score. Spinal cord and blood samples were obtained for histopathological and biochemical analyses. RESULTS: All of the rabbits in group II exhibited severe neurological deficits. Atorvastatin treatment (groups III and IV) significantly reduced the level of motor dysfunction. No significant differences were observed between the motor function scores of groups III and IV at the evaluated time points. Light microscopic examination of spinal cord tissue samples obtained at the 72nd hour of reperfusion indicated greater tissue preservation in groups III and IV than in group II. CONCLUSION: This study demonstrates the considerable neuroprotective effect of atorvastatin on the neurological, biochemical and histopathological status of rabbits with ischemia-induced spinal cord injury. Moreover, the acute withdrawal of atorvastatin therapy following the induction of spinal cord ischemia did not increase the neuronal damage in this rabbit model.

WOS: 000406892300025 Objective: The authors aimed to investigate whether there was any effect of 1800 MHz GSM-modulated radio frequency radiation (RFR) as a source of non-ionizing radiation on the ovarian reserves of female rats by hematoxylin eosin staining under a light microscope, and also to evaluate the effect on the anti-Mulllerian hormone (AMH) level of rats. Design: A prospective observational study. Materials and Methods: A total of 12 age-matched young adult female Wistar albino rats were divided into two groups. Group 1 (n=6) constituted the controls; group 2 (n=6) constituted the 1800 MHz exposed animals. RFR exposed group were kept ten cm away from the horn antenna to satisfy the near field condition. The control group was kept in the same setting without any RFR exposure. The exposure period was 20 minutes for five days/week for one month. Results: The results of this study showed that 1800 MHz RFR did not have a significant effect on the ratios of atretic follicles in rat ovary tissues when compared with the control group (p>0.05). However, the authors detected statistically significantly higher AMH levels in RFR exposed groups (p

Objective: Ischemic stroke is defined as acute neurological disorder according to cerebral vascular damage and reduced blood flow to a particular region of the brain. Ischemic stroke is a major cause of morbidity and mortality and placed 3rd among the causes of death. About 80% of all strokes depend on ischemic cause. Atherosclerotic plaque rupture or addition of a thrombus on plaque is the most common cause of ischemic stroke. Atherosclerosis is associated with the level of blood lipids from the first stages of the formation process. In our study, we aimed to investigate non-HDL, total cholesterol / HDL-cholesterol and LDL-cholesterol levels in patients with acute ischemic stroke. Methods: This study was performed in 52 patients who were admitted at Ankara Numune Hospital for Education and Investigation, Division of Neurology between December 2009- May 2010 with a diagnosis of acute ischemic stroke in the first 24 hours and 48 healthy individuals matched for age and gender, who was admitted at the hospital during the same period. Total cholesterol, triglycerides and HDL cholesterol levels were measured by DXC 800 autoanalyzer (Beckmann-Coulter, USA). LDL cholesterol, total cholesterol / HDL-cholesterol and non-HDL cholesterol levels were calculated according to the formulas. Results: Patient group had significantly lower HDL-C levels than the control group (p=0.009), whereas the triglyceride and total cholesterol / HDL-C levels were significantly higher (p=0.013, p=0.018). Total cholesterol, LDL cholesterol and non-HDL cholesterol levels did not differ significantly between groups. There were significant correlations between non-HDL-cholesterol levels and triglycerides, total cholesterol, LDL cholesterol (respectively r=0.468, r=0.964, r=0.851) (respectively p

Background International Council for Standardization in Haematology suggested Westergren method as the reference method to analyze erythrocyte sedimentation rate (ESR). However, in recent years closed automated systems that measure ESR directly from a capped EDTA blood sample tube have been developed. We evaluated the analytic performance of one of these new methods, the Ves-Matic Cube 200. Methods K2EDTA and citrated blood samples were taken from 101 randomly selected outpatients in Ankara Numune Education and Research Hospital. The ESR results using Ves-Matic Cube 200 and Westergren as reference method from 101 patients were compared and interference studies were performed. Results We found the mean difference between the two methods as 0.19 ± 15.85 mm/hr (−3.317 to 2.940 mm/hr, 95% confidence interval). Regression analysis yielded the equation “y = −2.59 + 1.15x” between the two methods (r = 0.82). Conclusions Ves-Matic Cube 200 should be monitored carefully for good quality control. Temperature correction should be applied to study control material as recommended by the manufacturer. Ves-Matic Cube 200 device should be monitored carefully, performance studies should be performed, and the results should be checked in order to eliminate the random errors during the routine studies.

Amac: Immunfiksasyon elektroforezi (IFE), monoklonal gammapatilerin (MG) tani, takip ve tedavi surecinin yon­lendirilmesinde kullanilan bir yontemdir. Monoklonal gam­mapatiler; malignite potansiyeli olan ya da malign hasta­liklardan multipl myelom (MM), Waldenstrom makroglo­bulinemisi (WM), soliter plazmositom, onemi bilinmeyen monoklonal gamapati (MGUS), plazma hucreli losemi ve amiloidozu (AL) kapsamaktadir. Calismamizda, Ankara Numune Egitim ve Arastirma Hastanesi Merkez Labora­tuvarinda Ocak 2011 -Temmuz 2011 tarihleri arasinda ca­lisilmis olan IFE verilerinin retrospektif olarak incelenerek sunulmasi amaclanmistir. Yontemler: IFE laboratuvarimizda Interlab G26 cihazin­da calisilmaktadir. Calismamizda Ocak-Temmuz 2011 tarihleri arasinda calisilan tum IFE sonuclari incelenmis­tir. Sonuclar MG sikligi, MG turu ve hastalarin aldigi tani acisindan degerlendirilmistir. Bulgular: Ocak-Temmuz 2011 tarihleri arasinda toplam 688 hastaya IFE yapilmis, 126 (%18,3)\'sinda MG tespit edilmistir. MG tespit edilen hastalarin 72 (%57,1) \'si er­kek, 54 (%42,9)\'u kadindi. Izotip dagilimlari IgG kappa %41,3, IgG lambda %35,6, IgA kappa %11,5, IgA lambda %5,8, IgM kappa %3,8, IgM lambda %1,9 seklindeydi. Hastalarin tanilari; MM (%65,9), WM (%0.07) ve MGUS (%33) olarak belirlendi. Sonuc: MG tespit edilen hastalarda en sik gorulen pa­tern IgG kappa idi. Hastalarin en cok aldigi tani ise MM idi. Laboratuarimiza IFE istemi ile basvuran hastalarda MG saptanma orani ise %18 olarak bulundu. Bu oranin dusuklugu, hastalarin once serum protein elektroforezi (SPE) ile degerlendirilip MG varligi ya da suphesinde IFE istemi yapilmasinin onemini ortaya koymaktadir.

Objectives: The study demonstrates a gel problem sourced from the internal heat of centrifuges without temperature control. It was planned to investigate the internal temperatures of temperature controlled centrifuges and the centrifuges without temperature control and the effect of centrifuge temperature on enzymes and thyroid panel. Design and Methods: Internal heat of the centrifuges were monitored in the most busy working hours. Blood samples were obtained from 42 patients to two separate biochemistry tubes. One sample of the same patient was centrifuged with a temperature-controlled centrifuge (Group 1) and the other was centrifuged with a centrifuge without temperature control (Group 2). AST, ALT, GGT, LDH, total protein, albumin, TSH, fT3 and fT4 levels were determined in the same run of the analyzer. Results: ALT and TSH values in Group 2 were significantly lower, fT4 values were significantly higher than Group 1. Conclusions: Laboratories should be aware of a possible internal heat production in centrifuges without temperature control and gel tubes should be centrifuged in temperature controlled centrifuges especially in centrifuge units with high working load.

Chemerin is expressed mainly in the adipose tissue. It is an agonist of chemokine-like receptor-1, which is expressed by the immune system cells. Chemerin stimulates the chemotaxis of the immune system cells, and this indicates the function of chemerin and chemokine-like receptor-1 in the immune response. The tumor microenvironment is very important for determining cancer cell growth and spreading. Therefore, we aimed to investigate the association between colorectal cancer, inflammation, and adipokines including chemerin, adiponectin, and vaspin. The study group consisted of patients with colon cancer, whereas the control subjects consisted of patients with benign conditions, diagnosed with colonoscopy. The two groups were compared in terms of the C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen, adiponectin, chemerin, and vaspin. A total of 41 (28 men, 13 women) patients with confirmed colon cancer, and 27 (15 men, 12 women) controls without, confirmed by colonoscopy, were enrolled. The median chemerin levels were found significantly higher in the study group than the controls (390 vs. 340 ng/mL, p = 0.032), whereas the mean vaspin and adiponectin levels were not significantly different. The median values for the CRP, fibrinogen, and ESR were significantly higher in the patients with colon cancer, when compared to the control group (6.08 vs. 1.4 mg/L, p

Pseudothrombocytopenia (PTCP) is a laboratory event of platelet clustering related to drugs used for anticoagulation. This condition is engendered by autoantibodies against platelets in usually EDTA-anticoagulated blood. Pseudothrombocytopenia has no clinical significance but when evaluated as true thrombocytopenia, this misconception may lead to unnecessary diagnostic procedures. Heparin-induced thrombocytopenia with thrombosis (HITT) is a complication of heparin treatment caused by heparin platelet factor 4 (HPF-4) antibodies, leading to platelet activation and hypercoagulability. In our study, 48 patients with PTCP and 36 healthy volunteers were included. Heparin platelet factor 4 antibody positivity was detected in 12 patients from PTCP group; nobody from control group had. Citrated serum samples and peripheral blood smears showed normal platelet count. Of the 4 patients using heparin derivative, 1 (2.1%) had antibody positivity but without any bleeding symptoms. In conclusion, HPF-4 antibody positivity might be a risk factor for PTCP. Clinicians should be aware of this kind of condition.

WOS: 000290313300006, PubMed: 21389698, Background and Objectives: Cardiovascular disease is prevalent in chronic kidney disease (CKD). Uric acid is increased in subjects with CKD and has been linked with cardiovascular mortality in this population. However, no study has evaluated the relationship of uric acid with angiographically proven coronary artery disease (CAD) in this population. We therefore investigated the link between serum uric acid (SUA) levels and (i) extent of CAD assessed by the Gensini score and (ii) inflammatory parameters, including C-reactive protein (CRP) and pentraxin-3, in patients with mild-to-moderate CKD. Material and Methods: In an unselected population of 130 patients with estimated glomerular filtration rate (eGFR) between 90 and 30 ml/min/1.73 m(2), we measured SUA, serum pentraxin-3, CRP, urinary protein-to-creatinine ratio, lipid parameters and the severity of CAD as assessed by coronary angiography and quantified by the Gensini lesion severity score. Results: The mean serum values for SUA, pentraxin-3 and CRP in the entire study population were 5.5 +/- 1.5 mg/dl, 6.4 +/- 3.4 ng/ml and 3.5 +/- 2.6 mg/dl, respectively. The Gensini scores significantly correlated in univariate analysis with gender (R = -0.379, p = 0.02), uric acid (R = 0.42, p = 0.001), pentraxin-3 (R = 0.54, p = 0.001), CRP (R = 0.29, p = 0.006) levels, eGFR (R = -0.33, p = 0.02), proteinuria (R = 0.21, p = 0.01), and presence of hypertension (R = 0.37, p = 0.001), but not with smoking status, diabetes mellitus, and lipid parameters. After adjustments for traditional cardiovascular risk factors, only uric acid (R = 0.21, p = 0.02) and pentraxin-3 (R = 0.28, p = 0.01) remained significant predictors of the Gensini score. Conclusions: SUA and pentraxin-3 levels are independent determinants of severity of CAD in patients with mild-to-moderate CKD. We recommend a clinical trial to determine whether lowering uric acid could prevent progression of CAD in patients with CKD. Copyright (C) 2011 S. Karger AG, Basel, NIHUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [HL-68607], R.J.J. is supported by NIH grant HL-68607.

Purpose The prevalence of obesity has significantly increased among children and adolescents worldwide and is becoming an important health care problem in parallel with the increased prevalence of obesity pediatric non-alcoholic fatty liver disease. Betatrophin is a newly define hormone that is commonly secreted by liver and plays role in glucose tolerance. This study aimed to investigate the relationship between serum betatrophin levels and non-alcoholic fatty liver disease in obese children. Methods The study included 40 obese children with a body mass index (BMI) above 95th centile, and 35 non-obese subjects with a BMI 3-85th centile, whose age and gender were similar to those of the patient group. For the evaluation of metabolic parameters fasting serum glucose, insulin, alanine aminotransferase, aspartate aminotransferase, lipid profile and serum betatrophin levels were measured. Total cholesterol: high-density lipoprotein cholesterol and low-density lipoprotein cholesterol: high-density lipoprotein cholesterol ratios were calculated as “atherogenic indices.” Results Serum betatrophin levels of the obese subjects were similar to that of non-obese subjects (p=0.90). Betatrophin levels were not correlated with the metabolic parameters. Conclusion In the present study, levels of betatrophin are not different between obese and insulin resistant children and non-obese subjects, and they are not correlated with atherogenic indices. To elucidate the exact role of betatrophin in obesity, further studies are required to identify the betatrophin receptor and/or other possible cofactors.

Chronic obstructive pulmonary disease (COPD) is an inflammatory disease of the lung associated with progressive airflow limitation. The aim of this study is to assess the influence of tiotropium treatment on airway inflammation and symptoms in stable COPD patients. Materials and methods: Inflammatory markers were measured in the expired breath condensate fluid (EBC) before starting tiotropium treatment and at the end of the first month. Results: Twenty-two patients (81% men) with a mean age of 65.4 ± 10.1 years completed the study. The mean nitrotyrosine and 8-isoprostane levels for oxidative stress markers in EBC before and after treatment were 4.5 ± 2.3, 3.5 ± 1.9 pg/mL (P = 0.06) and 7.3 ± 10.8, 8.1 ± 11.7 pg/mL (P = 0.28), respectively. The mean interleukin-6 and tumor necrosis factor-alpha levels for inflammation markers in EBC before and after treatment were 1.03 ± 1.1, 0.77 ± 0.8 pg/mL (P = 0.41) and 27.8 ± 2.6, 29.2 ± 5.7 pg/mL (P = 0.36) respectively. The mean symptom scores decreased significantly with tiotropium and a mean increase of 124.6 ± 0.86 mL was observed in a lung function test (FEV1). Conclusion: Although a 4-week treatment with tiotropium did not modify any of the inflammatory or oxidative stress markers in EBC fluid, tiotropium treatment helps to control symptoms in COPD.

research Aim: Inflammation plays an important role in acute ischemic stroke. In this study we aimed to investigate the relationship between acute ischemic stroke and serum amyloid A, fetuin-A, and pentraxin-3 which are inflammation markers. Materials and methods: We enrolled 52 patients with acute ischemic stroke and 30 sex-matched control subjects in the study. The patients were followed for 3 months. We evaluated the common risk factors, laboratory variables, and neurological examination of stroke patients according to prognosis scales. Results: The median serum amyloid A, fetuin-A, and pentraxin-3 levels in the stroke patients were higher than in control subjects (respectively, P = 0.000, P = 0.002, and P = 0.037). National Institutes of Health Stroke Scale scores, glucose, C-reactive protein, fibrinogen, and white blood cell count showed differences within the group in terms of the serum amyloid A tertiles statistically. Conclusion: Pentraxin-3, fetuin-A, and serum amyloid A all arise together as novel prognostic factors in a group of patients with ischemic stroke. Relationships between higher levels of inflammation markers, especially serum amyloid A, and the severity of acute ischemic stroke were shown. Aim: Inflammation plays an important role in acute ischemic stroke. In this study we aimed to investigate the relationship between acute ischemic stroke and serum amyloid A, fetuin-A, and pentraxin-3 which are inflammation markers. Materials and methods: We enrolled 52 patients with acute ischemic stroke and 30 sex-matched control subjects in the study. The patients were followed for 3 months. We evaluated the common risk factors, laboratory variables, and neurological examination of stroke patients according to prognosis scales. Results: The median serum amyloid A, fetuin-A, and pentraxin-3 levels in the stroke patients were higher than in control subjects (respectively, P = 0.000, P = 0.002, and P = 0.037). National Institutes of Health Stroke Scale scores, glucose, C-reactive protein, fibrinogen, and white blood cell count showed differences within the group in terms of the serum amyloid A tertiles statistically. Conclusion: Pentraxin-3, fetuin-A, and serum amyloid A all arise together as novel prognostic factors in a group of patients with ischemic stroke. Relationships between higher levels of inflammation markers, especially serum amyloid A, and the severity of acute ischemic stroke were shown.

Behçet's disease is a relapsing vasculitis characterized by endothelial dysfunction. This study was conducted to determine the levels of nitric oxide (NO) and 2 related parameters, asymmetric dimethylarginine (ADMA) and homocysteine levels, in relation to the pathogenesis of Behçet's disease. Materials and methods: A total of 49 Behçet's patients, comprising 26 patients with the active disease and 23 patients with the inactive disease, and a healthy control group of 24 individuals participated in this study. International Study Group Diagnostic Criteria were followed in the diagnosis of Behçet's disease; patients who had at least 2 signs were considered as having the active disease. Results: Serum NO and plasma homocysteine levels were found to be significantly higher in patients with active Behçet's disease compared to patients with inactive Behçet's disease and healthy controls. In active and inactive Behçet's patients, serum ADMA levels were significantly higher than those of healthy controls. No statistically significant difference was found between patients with inactive Behçet's and healthy controls with respect to serum homocysteine levels. Conclusion: The increased serum levels of ADMA presumably cause endothelial dysfunction because of a deficiency in NO production, which also appears to be involved in the vasculitis of Behçet's disease.

Insulin resistance is a well-documented risk factor for the development of endometrial cancer. Adiponectin and vaspin are insulin-sensitizing proteins that are secreted from adipose tissue. A clear association between serum levels of adipokines and endometrial cancer has yet to be established. The study group consisted of postmenopausal women with confirmed endometrial cancer, whereas patients with benign endometrial conditions constituted the control group. The two groups were compared in terms of insulin resistance and serum levels of adiponectin and vaspin. A total of 60 patients with confirmed endometrial cancer and 70 controls with benign endometrial conditions (polyps and atrophy) were enrolled. Median homeostasis model assessment of insulin resistance value was significantly higher in the study group compared with the control group (2.93 vs 1.27, PPPPP=0.001) and 13.23 (2.94–59.64; P=0.001). Our results show that lower levels of circulating adiponectin and vaspin levels are associated with an increased risk of developing endometrial cancer.

OBJECTIVE: We aimed this study to evaluate the relationship between some biochemical parameters and glycemic control in diabetic patients categorized by HbA1c levels.METHODS: This study includes 24 good glycaemic control HbA1c6,5 patients with diabetes mellitus and 29 healthy subjects. Plazma levels of HbA1c measured by HPLC. Serum fasting and post-prandial glucose, creatinin, triglyceride, total cholesterol, HDL cholesterol concentrations analyzed by photometric methods. Urine protein and microalbumin levels studied by turbidimetric method. Serum TSH, sT3, sT4, vitamin B12 and folic acid concentrations measured by electrochemiluminescent assay.RESULTS: Serum triglyceride levels of poorly glycemic control group were higher than healthy subjects p=0,003 . Urine microalbumin/creatinine ratio was increased in patients with poorly glycemic control when compared good glycaemic control group p=0,05 . There was no significant differences between groups and other biochemical parameters. CONCLUSION: The triglyceride and microalbumin levels were associated with glycemic control in diabetic patients. These data suggested that glycemic control may affect development of nephropathy and coronary artery disease in patients with diabetes mellitus., AMAÇ: Bu çalışmanın amacı diyabetes mellitus hastalarını HbA1c düzeylerine göre iyi ve kötü kontrollü diyabet olarak sınıflandırarak glisemik kontrol ile bazı biyokimyasal parametrelerin ilişkisini araştırmaktır.YÖNTEMLER: Çalışmaya 24 iyi kontrollü diyabet HbA1c6,5 hastası ve diyabeti olmayan 29 sağlıklı birey katıldı. HbA1c seviyeleri HPLC yöntemiyle, açlık ve tokluk kan glukozu, kreatinin, trigliserid, total kolesterol ve HDL kolesterol seviyeleri fotometrik, idrar protein ve mikroalbumin düzeyleri türbidimetrik, TSH, sT3, sT4, B12 vitamini ve folik asit seviyeleri elektrokemilüminesans yöntemle ölçüldü.BULGULAR: Kötü kontrollü diyabet hastalarının trigliserid düzeyleri kontrol gurubuna göre anlamlı derecede yüksek bulundu p=0,003 . İdrar mikroalbumin/kreatinin düzeyleri, kötü kontrollü diyabet hastalarında iyi kontrollü diyabet hastalarına göre anlamlı şekilde yüksek bulundu p=0,05 . Diğer parametreler açısından, gruplar arasında anlamlı bir farklılık tespit edilemedi. SONUÇ: Diyabetik hastalarda glisemik kontrol, trigliserid ve mikroalbumin düzeyi ile ilişkili bulunmuştur. Bu veriler, diyabetli hastalarda glisemik kontrolün nefropati ve koroner kalp hastalığı gelişimini etkileyebileceğini düşündürmektedir.

The widespread usage of blood count autoanalyzers has led to a major improvement in cellular hematology because of quick and accurate results found in most instances. However, spurious test results also can be observed like pseudothrombocytopenia (PTCP). In our study, we aimed to evaluate the clinical and laboratory factors associated with PTCP. Forty-six patients with PTCP and 69 healthy volunteers were enrolled in the study. Sex distribution was similar between the groups. Hospitalization, infection, the use of low-molecular-weight heparin and pregnancy increased the incidence of PTCP. Atherosclerosis and some drugs such as warfarin and calcium channel blockers were associated with PTCP, but the coincidence was not statistically significant. Antinuclear antibody positivity was higher in PTCP group (18.8% vs 7.2%; P=0.033) but anticardiolipin positivity rates were similar when compared to controls. Pseudothrombocytopenia was frequently misdiagnosed, which led to inappropiate treatments. Therefore, this situation should be kept in mind.

The aim of this study was to evaluate mean platelet volume (MPV), thrombopoietin (TPO), and platelet levels in patients with ischemic stroke and compare this with healthy controls.We prospectively studied 50 patients with ischemic stroke and compared them with 37 control participants who have evaluated in internal medicine polyclinic and had no history of cerebrovascular events. All patients were within 24 hours after stroke; MPV and TPO were measured on admission.Both TPO and MPV values were significantly higher in patients with stroke (P = .00; P = .001).Increased TPO levels may increase both platelet count and platelet size, resulting in more hemostatic tendency, which may contribute to the progression of ischemic stroke.

To observe thrombopoietin (TPO) levels in patients with non-alcoholic fatty liver disease (NAFLD).The study was performed between November 2010 and March 2011 at the Department of Internal Medicine, Faculty of Medicine, Fatih University, Ankara, Turkey. A total of 60 consecutive patients with ultrasound proven NAFLD (study group), and 28 healthy volunteers (control study) were included in the study. The patient group was divided into 3 subgroups according to the ultrasonographic images as follows: minimal, intermediate, and marked hepatosteatosis. The TPO levels of the patient subgroups were compared with the healthy controls. All the data were collected prospectively, and recorded in FUHIS data collecting system, which is produced by our data-knowledge team. Quantitative measurements of thrombopoietin level were carried out by using the Human Thrombopoietin Quantikine ELISA Kit (RD Systems, Minneapolis, Minnesota, USA).Thrombopoietin levels were significantly increased in the patient subgroups compared with the controls. The TPO levels were also higher in the patient subgroup of grade 1-nonalcoholic fatty liver disease (grade 1- NAFLD) compared with the control group.The TPO increased in patients with NAFLD possibly as an acute phase reactant to decreased inflammation. In clinical practice, physicians should be alerted to increased TPO levels in patients.

Aim The aim of this study is to investigate the effect of formoterol (β2 adrenergic receptor agonist) on peritoneal VEGF levels in rats with endometriosis. Materials and methods Experimental endometriosis was constituted with implantation of endometrial tissue. The implants were examined by second laparatomy and rats were divided randomly into four groups. One cc saline was applied ip to the control (C) group ( n = 8) daily, 22.5 μg/kg/day ip formoterol was applied to the second (F) group ( n = 10) daily, 22.5 μg/kg/day ip formoterol and 10 mg/kg/day ip propranolol were applied to the third (FP) group ( n = 10) daily, 45 μg/kg/day ip formoterol was applied to the fourth (FF) group ( n = 9). Before treatment and after 30 days treatment period, peritoneal VEGF levels, the volumes and histopathological properties of the implants were evaluated. Results There were significant differences in between the peritoneal VEGF levels before and after treatment in group 2(F) and group 4(FF) ( p (a): 0.01, 0.01 respectively). But there were no significant changes in between the volumes of implants before and after treatment among the groups ( p > 0.05). There were no significant differences among the groups in histopathological parameters ( p > 0.05). Conclusion Formoterol treatment was seen to have no effect on the volumes and histopathological structure of endometriotic implants in our study. On the other hand, based on the group 2(F) and 4’s (FF) VEGF levels after the treatment, low dose or high dose formoterol may be effective with long term therapy. Formoterol may reduce the development of endometriosis.

Necrotizing enterocolitis (NEC) is the most common neonatal gastrointestinal emergency, predominantly affecting low-birth weight, premature infants. Early clinical signs of NEC are nonspecific and the laboratory findings are not fully reliable. Its severe morbidities and rapid progression require the application of new biomarkers for early diagnosis and intervention. The complement activation product, C5a (anaphylatoxin) has been reported to be a contributing factor leading to mesenteric ischemia/reperfusion injury which is a predisposing factor in the pathogenesis of NEC. Therefore, our aim was to evaluate the efficacy of serial C5a measurements in the diagnosis and follow-up of NEC. Preterm infants, whose gestational age and weight matched each other, were grouped as controls (n = 23) and NEC (n = 22). Serum levels of C5a, serum amyloid-A (SAA), C-reactive protein (CRP), and interleukin-6 (IL-6) levels were measured on the third day of life for the control group and on the day of diagnosis (1st day), 3rd and 7th days of the NEC group. C5a, SSA, CRP, and IL-6 levels were significantly higher in the NEC patients compared to the control group (P < 0.05) in the follow-up. Additionally, serum levels of C5a were found to be more accurate than the other parameters for the prediction of death and requirement for surgery at the time of diagnosis (P < 0.05). In conclusion, C5a may be useful as a new marker for both diagnosis and follow-up of infants with NEC in combination with clinical and radiographical findings.

Purpose The purpose of this study was to evaluate the preventive effect of CDP-choline treatment on hyperoxic lung injury, inflammation and apoptosis in a neonatal rat model of bronchopulmonary dysplasia BPD. Methods A total of 30 newborn pups were arranged in control, hyperoxia, and hyperoxia+CDP-choline groups. Immediately after birth, pups in the control group were kept in room air containing 21% O2 and received daily saline injections, while those in hyperoxia and hyperoxia+CDP-choline groups were exposed to 95% O2 and received daily injections of saline and CDP-choline (300 mg/kg), respectively, throughout postnatal day 10 (P10). Histopathological scoring, radial alveolar count, lamellar body protein expression, fibrosis, proinflammatory cytokine levels, oxidant/antioxidant enzyme activities, malondialdehyde content and apoptosis were evaluated on lung samples obtained at P10. Results Hyperoxia induced severe lung damage as evidenced by cell infiltration, edema and fibrosis which were reduced significantly by CDP-choline treatment. Radial alveolar count and lamellar body protein expression were significantly recovered, while number of TUNEL-positive cells and active Caspase-3 expression were decreased by CDP-choline administration. Tissue proinflammatory cytokine (IL-1b, IL-6 and TNF-α) levels as well as tissue MDA content and MPO activities were reduced, whereas GSH-Px and SOD activities were preserved in hyperoxia+CDP-choline group. Conclusions Our data show for the first time that parenteral CDP-choline administration prevents hyperoxic lung injury in a neonatal rat model of BPD. It may therefore be suggested that CDP-choline can be used as an effective therapeutic agent for prevention of BPD in case it exhibits similar effects in humans.

Epigenetic mechanisms might play an important role in development of BPD. The aim of this study was to evaluate the protective effect of valproic acid (VPA), an histon deacetylase inhibitor, in hyperoxic lung injury in neonatal rat model. Methods A total of 30 rat pups (0 days old) were divided equally into 3 groups: control, hyperoxia and hyperoxia+VPA groups. In hyperoxia groups, pups were maintained in 95% O2 for 10 days while control group was maintained in room air. VPA was administered intraperitoneally once daily for the first 10 days of life. On day 10, histopathological score, radial alveolar count, lamellar protein count, histone deacetylase activity (HDAC), proinflammatory cytokine concentrations were determined with ELISA, whereas acetylated H4 protein and caspase-3 expression were evaluated with Western-Blot analysis. Also apoptosis was evaluated with TUNEL method. Results The histopathological score, radial alveolar count, lamellar protein count of the pups in VA group were significantly higher. VPA also preserved alveolarization significantly and fibrosis was significantly decreased in rat pups exposed to VPA treatment. HDAC activity significantly reduced with VPA treatment. The proinflammatory markers, caspase-3 expression and number of TUNEL positive cells were also significantly decreased with VPA treatment. Acetylated H4 protein expression was significantly higher in the hyperoxia+VPA group. Conclusion All these data suggest that VPA might provide possible protective effect against hyperoxic lung injury as an histone deacetylase inhibitor. VPA exhibit these effects by preserving alveolarization, decreasing fibrosis and inflammation via decreasing HDAC activity, increasing acetylated H4 protein expression and reducing inflammation.

Background The aim of this study was to evaluate the possible cytoprotective effect of CDP-choline treatment on intestinal cell death and apoptosis in a neonatal rat model of NEC. Methods A total of 30 newborn pups were divided equally into 3 groups as follows: Control, NEC, and NEC+CDP-choline groups. NEC was induced by enteral formula feeding, exposure to hypoxia-hyperoxia and cold stress. CDP-choline was administered intraperitoneally at a dose of 300 mg/kg/day for 3 days starting from the first day of life. Macroscopical, histopathological, ibflammatory markers, caspase-3 expression and apoptosis were evaluated on the gut samples. Activities of xanthine oxidase, superoxide dismutase, glutathione peroxidase, malondialdehyde and myeloperoxidase were determined. Results Median clinical sickness score, macroscopic gut assessment score and intestinal injury score were significantly improved in pups in NEC+CDP-choline group. In contrast, median apoptosis score was significantly higher in NEC group compared with NEC+CDP-choline group. Proinflammatory cytokine concentrations (IL-1β, IL-6 and TNF-α) and caspase-3 expression in the intestinal tissue of the NEC+CDP-choline group were significantly lower. Moreover, tissue GSH-Px and SOD activities were preserved, whereas tissue MDA content, MPO and XO activities were significantly lower in NEC+CDP-choline group. Conclusion This is the first study to report beneficial effects of CDP-choline treatment on intestinal injury in a neonatal rat model of NEC. Intraperitoneal CDP-choline administration significantly reduced clinical sickness score, ameliorated macroscopic and histopathological intestinal injury, reduced the inflammation and decreased apoptosis. These data suggest that, CDP-choline may be used as an effective therapeutic agent for prevention of NEC.

OBJECTIVE: The polycystic ovary syndrome PCOS is a disorder of reproductive-aged women. The objective of this prospective randomised study was to observe antimullarian hormone AMH levels in patients with PCOS after metformin therapy.METHODS: A total of eighty- four 84 consequtive patients diagnosed according to the criteria proposed in Rotterdam and twenty 28 healthy volunteers were included in the study. Half of patients 42 were treated with 1. 7 gr/ day metformin for six months. The other patients n=42 were observed without therapy for six months and all laboratory tests were compared with control group after 6-month-period.RESULTS: AMH levels were similar in two patient groups before treatment. After metformin therapy, AMH was measured significantly higher in PCOS- untreated group and PCOS+ metformin group before treatment p, AMAÇ: Polikistik over sendromu, üretken çağdaki kadınlarda sık görülen bir klinik durumdur. Hiperinsülinemi ve insülin direnci, hastalığın patofizyolojisinde önemli bir antite olarak karşımıza çıkar. Çalışmamızın amacı; antimüllerian hormon AMH düzeylerinin metformin tedavisi sonrası değişimini incelemekti.YÖNTEMLER: Rotterdam kriterlerine göre Polikistik over tanısı alan 84 hasta ve 28 sağlıklı gönüllü çalışmaya alındı. Hastaların yarısı n=42 1,7 gr/gün metformin tedavisi alırken diğer 42 hasta tedavisiz izlendi. 6 aylık perioddan sonra hastaların laboratuar testleri karşılaştırıldı.BULGULAR: AMH düzeyleri tedavi öncesi benzerdi. Metformin tedavisi sonrası tedavi alan PCOS hastaları ve kontrol grubu AMH düzeyleri 6 aylık period sonrasında benzer düzeylerde bulundu. Tedavi edilmeyenlere göre 1.7 gr/gün metformin alan hastalarda AMH düzeyleri belirgin düşük olarak izlendi p