Is methyl methacrylate fixator reliable for the treatment of gartland type IV supracondylar fractures?

Background

In childhood supracondylar fractures of the humerus, fixation with percutaneous Kirschner wire is the standard treatment. In the case of irreducible-unstable fractures, these can be defined as fractures in which reduction is not well-achieved or in which fixation cannot be achieved with the K-wire. Intraoperative management of these types of fractures may be difficult. Treatment with a methyl methacrylate fixator consisting of K-wire and methyl methacrylate cement, as defined by the senior author of the article, may be a good option for Gartland type IV supracondylar humeral fractures where the fracture is unstable in flexion and extension due to complete periosteal tearing.

Materials and Methods

The short-term and mid-term results of 27 patients between the ages of 4-12 with Gartland type IV supracondylar fracture of the humerus treated with methyl methacrylate fixation were reviewed. The patients were scored in terms of function and cosmetic satisfaction.

Results

A total of 19 of the 27 patients treated with the methyl methacrylate fixator had full elbow motion function and rated the outcome of the treatment as excellent, which was judged by orthopedic surgeons on the basis of Flynn's criteria. Six patients had nearly full elbow motion and evaluated their recovery outcome as good. Two patients reported nearly full range of motion (ROM) and evaluated the method as moderate in terms of treatment.

Discussion

Treatment with the methyl methacrylate fixation method is an inexpensive method that allows early joint mobilization, provides strong biomechanical stability, ensures good outcomes, and should be considered in the treatment of irreducible and unstable supracondylar fractures of the humerus.

Comparison of Oxidant and Antioxidant Parameters in Patients with Sjögren’s Syndrome and Healthy Subjects

Objective Oxidative stress may have an effect on the pathogenesis of diseases, including autoimmune rheumatic diseases. We aimed to investigate the serum paraoxonase activity and other oxidant/antioxidant parameters in patients with Sjögren’s syndrome (SS) and healthy controls.

Methods 85 patients with SS and 65 healthy subjects were included in the study. Groups were age and gender-matched and had no liver disease. Serum paraoxonase (PON)-1 activity, stimulated paraoxonase (SPON), PON-1 phenotypes that represent polymorphism (Q192R; QQ, QR, RR), arylesterase (ARE), total oxidant status (TOS), total antioxidant capacity (TAC), oxidative stress index (OSI), advanced oxidative protein products (AOPP), total thioles (TTL) and ischaemia-modified albumin (IMA) were measured in all study participants.

Results Statistically significant differences were found in the QQ and QR+RR phenotype of PON-1 for TAC, TOS and TTL (p<0.001) between SS and healthy groups. The other parameters were statistically insignificant.

Conclusion Antioxidant parameters were lower in SS patients compared with healthy controls. Conversely, oxidant parameters were higher. This imbalance may play a role in SS pathogenesis.

Dynamic Thiol/Disulfide Homeostasis in Predicting Adverse Neonatal Outcomes in Fetal Growth Restriction

Aim: The main aim of this study was to investigate thiol/disulfide homeostasis associated with fetal growth restriction (FGR) and to evaluate whether alterations are predictive for adverse neonatal outcomes. Methods: 273 pregnant women (77 with FGR and 196 with normal fetal growth) were enrolled in this prospective case-control study. Results: Native thiol and total thiol were decreased in FGR compared to the control group (p < .001; p < .001). Decreased levels of maternal serum native and total thiol were significantly associated with adverse neonatal outcomes in FGR (OR: 0.983, 95% CI 0.976-0.991, p < .001; OR: 0.983, 95% CI 0.976-0.991, p < .001). Decreased maternal serum total thiol levels were the only significantly associated risk factor with adverse neonatal outcomes in FGR (OR: 0.981, 95% CI 0.963-1.000, p = .046). Conclusion: The decrease in the antioxidants of thiol/disulfide mechanism may be related to the development of both FGR and adverse neonatal outcome in FGR.

Dynamic Thiol/Disulfide Balance in Patients with Seborrheic Dermatitis: A Case-Control Study

Background:

Seborrheic dermatitis is a chronic, inflammatory skin disease, in which many endogenous and exogenous factors play a role. Recent studies have shown that oxidative stress increases in these patients. The role of the dynamic thiol/disulfide homeostasis, an important component of the oxidative stress, in the pathogenesis of seborrheic dermatitis has not yet been investigated.

Objectives:

The objective was to investigate the relationship between the dynamic thiol/disulfide balance in the plasma of seborrheic dermatitis patients and disease severity.

Methods:

In this case–control study, 70 seborrheic dermatitis patients and 61 age- and sex-matched healthy controls were included. Thiol/disulfide homeostasis was calculated from venous blood samples, and tests were performed by automated spectrophotometric method. The thiol/disulfide balance between the patient and control groups was compared. In addition, disease severity and other demographic characteristics and thiol/disulfide balance parameters were compared.

Results:

Native and total thiols were significantly higher in the patient group than that in the control group (P < 0.001). Disulfide levels were nonsignificantly lower in the patient group than controls (P = 0.821). Patients' age and age at the onset of disease were found to have a negative correlation with native and total thiol levels.

Conclusion:

Higher levels of thiols in the serum may be responsible for the increased proliferation of seborrheic dermatitis lesions. To the best of the authors' knowledge, this is the first report on the correlation between thiol/disulfide homeostasis in patients with seborrheic dermatitis.

Are serum levels of ADAMTS5, TAS and TOS at 24-28 gestational weeks associated with adverse perinatal outcomes in gestational diabetic women?

We aimed to determine the role of placental A Disintegrin and Metalloproteinase with thrombospondin motifs 5 (ADAMTS5), and maternal serum ADAMTS5, total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI) levels at 24-28th gestational weeks in GDM. This study included 57 patients, who had been diagnosed as having GDM at their 24-28th gestational week, and 29 controls. The maternal blood samples were collected at the 24-28th gestational week and ADAMTS5 was studied with the enzyme-linked immunosorbent assay (ELISA) method, whereas an automated colorimetric method was used to study TAS, TOS, and OSI. The level of ADAMTS5 in maternal serum of patients with GDM were significantly lower than the controls (p = .017); whereas TOS and OSI levels were significantly higher (p = .003 and p = .008). Multivariable logistic regression analysis revealed ADAMTS5 and TOS levels were independently associated with adverse perinatal outcomes (p = .004 and p = .018). We found that serum ADAMTS5 levels decreased and TOS level increased in GDM pregnant at 24-28th gestational weeks. In addition, we found that increased levels of serum ADAMTS5 and decreased TOS levels at 24-28th weeks were associated with adverse perinatal outcomes independent of the mode of treatment in GDM.Impact statementWhat is already known on this subject? Gestational diabetes mellitus (GDM) is one of the most common medical complications of pregnancy. The insulin resistance, which starts at the 24-28th gestational weeks, increases during gestation. GDM increases maternal complications like preeclampsia, cesarean rate, cardiovascular disease, obesity, and diabetes after pregnancy; and neonatal complications like macrosomia, hypoglycemia, hyperbilirubinemia, delivery trauma, shoulder dystocia, and adult-onset obesity, and diabetes.What the results of this study add? A significant relationship between ADAMTS5, TOS levels and adverse perinatal outcome. insulin resistance and was observed.What the implications are of these findings for clinical practice and/or further research? Based on this finding, we concluded that increased levels of oxidative stress and decreased ADAMTS5 levels are associated with GDM and predictive for adverse perinatal outcomes. The results of the present study were consistent with the previous reports and indicated that increased oxidative stress in GDM patients are related to adverse perinatal outcomes.

Role of T-helper 17 cell related cytokines in laryngeal cancer

OBJECTIVE

To explore the role of T-helper 17 cells and their cascade in the pathogenesis of laryngeal cancer.

METHODS

Prospectively, 110 consecutive patients with a suspicious laryngeal lesion were evaluated for serum levels of T-helper 17 cell related interleukins, including interleukins 23, 17A and 22, determined by enzyme-linked immunosorbent assay. The patients were divided into 2 groups after pathological evaluation: 49 patients with malignancy and 61 with benign pathology. Associations between interleukin levels and malignancy were determined via correlation analyses.

RESULTS

Interleukin 17A and 22 levels were significantly higher in the malignancy group than the benign lesion group. Pearson correlation analysis showed that interleukins 17A and 22 acted in a cascade, but interleukin 23 did not. According to predictive values, interleukin 17A levels were 3.87 times and interleukin 22 levels were 1.09 times more likely to be associated with laryngeal cancer. The cut-off values for predicting laryngeal cancer were 3.55 pg/ml for interleukin 17A and 119.82 pg/ml for interleukin 22.

CONCLUSION

T-helper 17 cell related interleukins are potential biomarkers that may be helpful in diagnosing laryngeal cancer. Moreover, these data may support neutralisation of T-helper 17 cell related cytokine activity, which could be an attractive strategy for treating laryngeal cancer.

Comparison of the Effects of Sevoflurane and Desflurane on Thiol-Disulfide Homeostasis in Patients Undergoing Laparoscopic Cholecystectomy

Objective

This study aims to compare the effects of different inhalation anesthetics on oxidative status by measuring thiol-disulfide homeostasis in laparoscopic cholecystectomy surgeries. The effect of inhaler agents on thiol-disulfide homeostasis that shows the oxidative status in laparoscopic cholecystectomy is unknown.

Materials and Methods

In this study, 71 patients planned to undergo laparoscopic cholecystectomy under general anesthesia were included. They were divided into two groups: desflurane (group D, n: 35) and sevoflurane (group S, n: 36). Blood samples were taken before induction (T1), at 30th minute of insufflation (T2) (30th min of ischemia), and at 30th min postdeflation (T3) (30th min of reperfusion). The native thiols (-SH) and total thiols (-SH+ -SS) were determined. The amounts of disulfide (-SS), disulfide/native thiol percent ratios (-SS/-SH), disulfide/total thiol percent ratios (-SS/-SH+-SS), and native thiol/total thiol percent ratios (-SH/-SH+ -SS) were calculated.

Results

In the sevoflurane group, preoperative values and intraoperative 30th-minute SS-SH ratio were significantly reduced (p=0.017). In the desflurane group, intraoperative native thiol values and postdeflation levels significantly decreased compared to those in the preoperative values (p<0.001).

Conclusion

We think that the usage of sevoflurane was more protective in terms of the oxidative damage occurring during laparoscopic surgery.

How does thiol/disulfide homeostasis change in children with type 1 diabetes mellitus?

AIMS

An increase in reactive oxygen species leads to formation of covalent bonds between sulfur atoms, thus thiol/disulfide homeostasis shifts towards the disulfide direction and oxidative damage occurs. We aimed to determine thiol/disulfide homeostasis in children with T1DM.

METHODS

Thiol/disulfide homeostasis was evaluated in 30 patients with T1DM and 30 age, gender matched healthy controls. Thiol/disulfide homeostasis parameters were measured using a novel automated measurement method and correlation between demographic data and parameters was measured.

RESULTS

There weren't any significant differences in age or gender between the T1DM and control groups. T1DM group, findings were as follows: native thiol: 388.3 ± 76.7 µmol/L, total thiol: 426.2 ± 87 µmol/L, disulfide: 18.9 ± 7 µmol/L, control group findings were as follows: native thiol: 423.1 ± 45.2 µmol/L, total thiol: 455.7 ± 49.9 µmol/L, disulfide: 16.2 ± 5.6 µmol/L. The disulfide/native thiol and disulfide/total thiol ratios were significantly higher in the T1DM group (p = 0.005 and p = 0.004, respectively), whereas the native thiol level and the native thiol/total thiol ratio were significantly lower in the T1DM group than in the control group (p = 0.036 and p = 0.015, respectively). There wasn't significant correlation between demographic data and thiol/disulfide homeostasis parameters.

DISCUSSION

This study shows that dynamic thiol/disulfide homeostasis in children with T1DM shifts towards the disulfide direction. We think that this shift is caused by oxidative damage in β-cells. Additional research on thiol/disulfide homeostasis in children with T1DM might provide techniques for early detection of oxidative damage in β-cells.

A New Kinetic, Automated Assay to Determine the Ferroxidase Activity of Ceruloplasmin

A new kinetic and automated assay was developed to determine ceruloplasmin ferroxidase activity. Ferrous ions are turned into ferric ions via catalytic activity of the ferroxidase enzyme. Acetohydroxamic acid, a chromogen, forms a colored complex with ferric ions. This reaction was measured kinetically. Significant and strong correlations were obtained between the new acetohydroxamic method and the p-phenylenediamine oxidase (r = 0.988, p <0.001), o-dianisidine oxidase (r = 0.981, p <0.001), norfloxacine oxidase (r = 0.989, p <0.001) and nephelometric methods (r = 0.861, p <0.001). This reliable, applicable, user-friendly, and low-priced method can be performed fully automatically or with manual spectrophotometry, and can be used to measure the ferroxidase activity of ceruloplasmin.

Comparison of Serum A Disintegrin and Metalloproteinase with Thrombospondin Motifs-19 Levels in Different Fertility Situations: Could It Be a Serum Marker of Ovarian Function and Oocyte Pool?

BACKGROUND/AIMS

A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) enzymes take part in extracellular matrix (ECM) remodeling which has been shown to contribute to the ovulation and follicular functions. We aimed to compare serum levels of ADAMTS-19 in patients with different fertility situations.

METHODS

A total of 86 women were enrolled to this cross sectional and case-control study. Four groups were constituted with respect to women's clinical and hormonal status: group 1, women with premature ovarian failure (POF; n = 21); group 2, women with natural menopause (n = 21); group 3, women with polycystic ovary syndrome (PCOS; n = 22); and group 4, healthy fertile controls. Serum ADAMTS-19 levels and individual characteristics were compared among groups.

RESULTS

-ADAMTS-19 levels were found as 36.7 ± 10.2, 40.1 ± 12.6, 46.7 ± 16.1, and 51.0 ± 18.8 ng/mL in POF, fertile, natural menopause, and PCOS groups, respectively (p = 0.012). Especially, ADAMTS-19 levels in the PCOS group were significantly higher than the POF group, as found in dual comparisons (p = 0.010).

CONCLUSIONS

ADAMTS-19 was found to be higher in PCOS patients than in POF patients. This work provides a novel vantage point for function of ECM within the ovary. ADAMTS-19 may have a potential for being an important marker of ovarian function and oocyte pool.

The Role of Follicular Fluid Thiol/Disulphide Homeostasis in Polycystic Ovary Syndrome

BACKGROUND

Oxidative stress has been proposed as a potential trigger in the etiopathogenesis of polycystic ovary syndrome-related infertility. Thiol/disulphide homeostasis, a recently identified oxidative stress marker, is one of the antioxidant mechanism in humans with critical roles in folliculogenesis and ovulation.

AIMS

To investigate follicular fluid thiol/disulphide homeostasis in the etiopathogenesis of polycystic ovary syndrome and to determine its association with in vitro fertilization outcome. The study procedures were approved by the local ethics committee.

STUDY DESIGN

Cross-sectional study.

Methods

Follicular fluid from 22 women with polycystic ovary syndrome and 20 ovulatory controls undergoing in vitro fertilization treatment was sampled. Thiol/disulphide homeostasis was analyzed via a novel spectrophotometric method.

Results

Follicular native thiol levels, as well as the native thiol/total thiol ratio, were lower in the polycystic ovary syndrome group than in the non-polycystic ovary syndrome group (p=0.041 and p<0.0001, respectively). Disulphide levels, disulphide/native thiol, and disulphide/total thiol ratios were increased in the polycystic ovary syndrome group (p<0.0001). A positive correlation between the fertilization rate and native thiol (p=0.01, r=0.53) and total thiol (p=0.01, r=0.052) among polycystic ovary syndrome patients was found. A positive predictive effect of native thiol level on the fertilization rate in the polycystic ovary syndrome group was also found (p=0.03, β=0.45, 95% CI= 0.031-0.643).

Conclusion

Deterioration of thiol/disulphide homeostasis, especially elevated disulphide levels, could be one of the etiopathogenetic mechanisms in polycystic ovary syndrome. Increased native thiol levels are related to the fertilization rate among polycystic ovary syndrome patients and are positive predictors of the fertilization rate among polycystic ovary syndrome patients. Improvement of thiol/disulphide homeostasis could be important in the treatment of polycystic ovary syndrome to increase in vitro fertilization success.

The effects of Desflurane and Sevoflurane on Nesfatin-1 levels in laparoscopic Cholecystectomy: a randomized controlled trial

Background

Nesfatin-1 is involved in cardiovascular regulation, stress-related responses. The objective of this study is to investigate the impact of volatile anesthetics on Nesfatin-1 levels.

Method

Fourty-two patients aged 30–65 years with the American Society Anesthesiology (ASA) Class I-II who were scheduled for laparoscopic cholecystectomy were included in the study Patients were randomized into two group; desflurane administered group (Group I, n = 21) and sevoflurane administered group (Group II, n = 21). For anesthesia maintenance, the patients received 6% desflurane or 2% sevoflurane in 40% O2 and 60% air. The patient’s heart rate (HR), mean, systolic and diastolic arterial pressures (MAP, SAP, DAP), peripheral O2 saturation (SpO2) were monitored and recorded before induction, after induction, after intubation, and during extubation. Blood samples were collected before induction (T1), and after extubation when aldrete score was 10 (T2).

Results

Demographic data were similar between the groups. The preoperative levels of nesfatin were similar in the two groups (p = 0.715). In desflurane group, post-operative nesfatin levels were similar compared to preoperative levels (p = 0.073). In sevoflurane group, post-operative nesfatin levels were similar (p = 0.131). The nesfatin levels (postoperative vs preoperative) were similar between the groups (p = 0.900).

Conclusion

In conclusion, this study results suggest that nesfatin-1 levels are not affected by the use of sevoflurane or desflurane in patients undergoing laparoscopic cholecystectomy.

Trial registration

Australian New Zealand Clinical Trials Registry, ACTRN12617001023347, retrospectively registered on 17 July 2017.

The Variation of Disulfides in the Progression of Type 2 Diabetes Mellitus

AIM

The purpose of this study was to examine thiol-disulfide balance in patients with type 2 diabetes mellitus.

METHODS

This study included 32 subjects with known type 2 diabetes mellitus without complications, 30 patients with type 2 diabetes mellitus with complications, 28 newly diagnosed patients with type 2 diabetes mellitus, and 45 healthy individuals. Thiol-disulfide profile tests were quantified in all groups.

RESULTS

Compared to the control group, patients in each of the diabetic groups had significantly lower native and total thiol levels, higher disulfide levels, and higher disulfide/native thiol and disulfide/total thiol ratios (p<0.05 for all). Disulfide levels were significantly lower in the newly diagnosed group than in other diabetic groups (p<0.05). There were significant associations between glycemic parameters and thiol-disulfide tests (p<0.05).

CONCLUSIONS

A disequilibrium between thiol-disulfide pairs occurs in patients with type 2 diabetes mellitus, and a gradual increase to disulfide levels may contribute to the disease's severity. Deteriorated thiol-disulfide homeostasis may be relevant to the pathophysiology of type 2 diabetes mellitus.

Maternal venous SHARP1 levels in preeclampsia

AIM

Owing to its mysterious etiology, pathogenesis of preeclampsia (PE) remains controversial. Here we aimed to compare the levels of an angiogenesis marker, split and hairy related protein-1 (SHARP1), in PE vs. normal pregnancy.

METHODS

Thirty-one patients with early-onset PE (EOPE), 26 patients with late-onset PE (LOPE), and 33 patients as a control group were recruited for this study in a tertiary referral center in Ankara, Turkey. Maternal venous SHARP1 levels and individual characteristics of the three groups were compared.

RESULTS

Age and body mass indices were similar among the three groups. SHARP1 levels in patients with PE (27.7±13.2 ng/mL) were significantly lower than in the control group (34.7±17 ng/mL) (P=0.006). Additionally, SHARP1 levels were significantly different among patients in EOPE, LOPE, and control groups (P=0.022). Birth weights and Apgar scores in patients in EOPE group were significantly lower than the other two groups and showed a gradual increase from the EOPE group to the LOPE and the control group. Binary logistic regression method demonstrated that maternal venous SHARP1 level was a risk factor for PE.

CONCLUSIONS

Maternal venous SHARP1 levels in PE are lower than a normal pregnancy. Its clinical applicability and role as a candidate for making sense of the distinctive pathogenesis of the EOPE and LOPE remain to be elucidated.

Dynamic thiol/disulfide homeostasis in patients with age-related macular degeneration

Purpose:

We evaluated dynamic thiol/disulfide homeostasis (TDH), malondialdehyde (MDA) levels, and catalase (CAT) activity in patients with age-related macular degeneration (AMD). All analyzes were conducted on plasma samples.

Methods:

Thirty-two patients with AMD and 38 age-matched healthy controls were included. Native thiol, total thiol, and disulfide levels and TDH status were determined using a novel, automated assay. MDA levels and CAT activity were determined. Percentages were compared using the chi-squared test. The Student's t-test and Mann-Whitney U-test were used to compare quantitative variables.

Results:

Native thiol levels were significantly lower (p=0.004) in patients with AMD (272.02 ± 52.41 µmol/l) than in healthy individuals (307.82 ± 47.18 µmol/l), whereas disulfide levels were significantly higher (p<0.001) in patients with AMD than in controls (21.64 ± 5.59 vs. 14.48 ± 5.37 µmol/L). Dynamic TDH was also significantly lower (p<0.001) in patients with AMD than in controls (13.41 ± 4.3 vs. 25.41 ± 14.52 µmol/l). No significant differences were evident in total thiol or MDA levels. Mean CAT activity was significantly higher (p=0.043) in patients with AMD compared with controls (0.035 vs. 0.018 k/ml).

Conclusions:

The antioxidant/oxidant balance demonstrated by dynamic TDH is shifted to the oxidative side in patients with AMD.

Serum and Aqueous Humor Levels of Fetuin-A in Pseudoexfoliation Syndrome

PURPOSE

To evaluate serum and aqueous humor levels of fetuin-A in patients with pseudoexfoliation syndrome (PEXS) in comparison with those of age- and sex-matched healthy subjects.

MATERIALS AND METHODS

This prospective study included 25 patients with PEXS and 25 control subjects who were undergoing cataract surgery without any systemic or ocular disease. Aqueous humor and serum fetuin-A levels were measured with enzyme-linked immunosorbent assay method.

RESULTS

The mean age of the PEXS group (14 males, 11 females, n = 25) was 57.7 ± 6.9 years, and the control group (13 males, 12 females, n = 25) was 58.1 ± 5.7 years. There was no difference between the groups in terms of age (p = 0.77) and sex (p = 0.83). The mean serum fetuin-A level of the PEXS group did not differ from that of the control group (p = 0.53). The mean aqueous humor level of the PEXS group was significantly higher than that of the control group (p = 0.032). There were no significant correlations between aqueous humor and serum fetuin-A levels among patients with PEXS and control group (p > 0.05).

CONCLUSIONS

Increased levels of fetuin-A in aqueous humor of patients with PEXS may show the local effect of fetuin-A on the anterior segment. With considering the wide range of possible biological functions of fetuin-A in the pathogenesis of PEXS, further studies are needed to clarify the clinical relevance of these findings.

Follicular ADAMTS-1 and aggrecan levels in polycystic ovary syndrome

PURPOSE

Polycystic ovary syndrome (PCOS) is the most common cause of ovulatory dysfunction and female infertility. The etiopathogenetic mechanisms of PCOS have been studied for many years, although exact causes remain unclear. It has been demonstrated that proteoglycan degradation by a disintegrin-like metalloproteinase with thrombospondin type motifs-1 (ADAMTS-1) is essential for ovulation and fertilization. The objective of our study is to analyze the levels of ADAMTS-1 and aggrecan in the follicular fluid (FF) of PCOS patients compared with normal ovulatory women and to determine whether these markers could be a predictor of in vitro fertilization (IVF) success in PCOS patients.

METHODS

Women with PCOS (n = 21) and normal ovulatory controls (n = 22) undergoing IVF treatment were recruited. ADAMTS-1 and aggrecan levels were analyzed with enzyme-linked immunosorbent assay (ELISA) and compared between PCOS and normal ovulatory controls. The predictor effect of ADAMTS-1 and aggrecan on fertilization rate and implantation was evaluated.

RESULTS

FF ADAMTS-1 and aggrecan levels increased in women with PCOS compared to controls. Elevated ADAMTS-1 levels but not aggrecan were related to increased implantation in PCOS.

CONCLUSION

Our study demonstrated that altered levels of ADAMTS-1 and aggrecan may have a partial role in the etiopathogenesis of PCOS, and ADAMTS-1 could be a predictive marker for implantation success in PCOS patients.

Role of Versican and ADAMTS-1 in Polycystic Ovary Syndrome

OBJECTIVE

ADAMTS-1 is a matrix metalloproteinase which cleaves versican in the cumulus oocyte complex under the effect of luteinizing hormone surge in the periovulatory period. Altered levels may have a role in the pathogenesis of polycystic ovary syndrome (PCOS). We aimed to determine the serum versican and ADAMTS-1 (a disintegrin and metalloproteinase with thrombospondin motif-1) levels in PCOS patients and compare the results with healthy controls.

METHODS

Thirty-eight patients with PCOS and forty healthy controls aged between 15 and 22 years were included in the study. They were sampled according to their basal hormone, serum versican, and ADAMTS-1 levels. Serum versican and ADAMTS-1 levels were measured by enzyme-linked immunosorbent assay. A multivariate logistic regression model was used to identify the independent risk factors of PCOS.

RESULTS

Serum versican levels were significantly decreased in the PCOS group when compared with the controls. The best versican cut-off value for PCOS was calculated to be 33.65 with 76.74% sensitivity and 52.94% specificity. Serum versican levels, homeostasis model assessment of insulin resistance index, a Ferriman-Gallwey score higher than 8, and oligomenorrhea were the strongest predictors of PCOS. Serum versican levels were significantly decreased in PCOS patients. Besides, serum ADAMTS-1 and versican levels were significantly and positively correlated with each other.

CONCLUSION

Serum versican levels were significantly decreased in patients with PCOS. This suggests a possible role of versican in ovulatory dysfunction and in the pathogenesis of PCOS.

Impact of Gestational Diabetes Mellitus and Maternal Obesity on Cord Blood Dynamic Thiol/Disulfide Homeostasis

AIM

Our aim in this study was to investigate the effect of maternal obesity and gestational diabetes mellitus (GDM) on cord blood dynamic thiol/disulfide homeostasis.

METHODS

A prospective case-control study was carried out in 125 pregnant women (27 GDM, 30 obese, 68 controls). Cord blood samples were collected from all participants and native thiol-disulfide exchanges were examined with automated method enabling the measurement of both sides of thiol-disulfide balance.

RESULTS

Disulfide amounts, disulfide/native thiol and disulfide/total thiol ratios were increased (p < 0.001), while native thiol/total thiol was decreased in the cord blood of babies born to an obese or diabetic mother (p < 0.001). Moreover, increased disulfide amounts, disulfide/native thiol, disulfide/totalthiol ratios and decreased native/total thiol were found to be significantly associated with adverse outcomes in GDM.

CONCLUSION

The current study suggests that the offsprings born to obese or diabetic mothers are exposed to increased oxidative stress.

The effects of adding ischemic preconditioning during desflurane inhalation anesthesia or propofol total intravenous anesthesia on pneumoperitoneum-induced oxidative stress

BACKGROUND

The aim of the study was to explore the differences in oxidative stress during anesthesia with desflurane/N₂O or propofol/remifentanil in patients undergoing laparoscopic cholecystectomy and additionally to evaluate the differential effects of desflurane and propofol on ischemic preconditioning (IP).

MATERIALS AND METHODS

One hundred patients were randomly allocated to four groups. For anesthesia maintenance, the inhalation group (Group I) and the inhalation plus IP group (Group IIP) received desflurane at an end-tidal concentration of 4-6 vol% in oxygen/N₂O, and the TIVA group (Group T) and TIVA plus IP group (Group TIP) received infusions of propofol and remifentanil. In Groups IIP and TIP, IP was carried out by 10 min of pneumoperitoneum followed by 10 min of deflation. Preoperative and postoperative plasma total antioxidant status (TAS), total oxidant status (TOS), paraoxonase, stimulated paraoxonase, arylesterase, ceruloplasmin, and myeloperoxidase levels were analyzed; oxidative stress index (OSI) was calculated.

RESULTS

When oxidative stress parameters were compared between groups, myeloperoxidase values in Group I were statistically significantly lower compared to Group TIP (p = .004 with Bonferroni's correction). There were no differences between preoperative and postoperative TAS, paraoxonase, stimulated paraoxonase, arylesterase, or ceruloplasmin levels (p > .05). In intragroup evaluations, postoperative paraoxonase and stimulated paraoxonase levels were found to be lower than preoperative values in Group TIP (p = .021 and .012, respectively).

CONCLUSION

In laparoscopic cholecystectomy lasting less than 60 min, there were no differences in the measured oxidative stress parameters between maintenance of anesthesia by desflurane/N₂O and propofol/remifentanil/N₂O. The addition of 10 min IP administration during both anesthesia techniques did not result in additional changes in the analyzed oxidative stress.

The effects of transport by car on coagulation tests

Background:

This research investigated the effects of the transport of blood samples between centers/laboratories by car on coagulation tests.

Methods:

Five tubes of blood samples were taken from 20 healthy volunteers. The samples consisted of a baseline (control) group, centrifuged and noncentrifuged transported samples; centrifuged and noncentrifuged untransported samples. The groups of centrifuged and noncentrifuged samples were transported by car for 2 h. The centrifuged and noncentrifuged untransported samples were incubated in the laboratory until the transported samples arrived. Prothrombin time (PT) and activated partial thromboplastin time (APTT) tests were conducted for all samples.

Results:

Significant differences between the baseline group and the centrifuged and noncentrifuged transported samples and the noncentrifuged untransported samples were found for APTT levels (p<0.05, for all). In addition, significant mean percentage differences in PT values were found between the baseline group and the noncentrifuged transported samples (p<0.001) and the noncentrifuged untransported samples (p=0.005). The mean level of PT in the noncentrifuged transported samples was outside the upper limit of the clinical decision level.

Conclusions:

Noncentrifuged transported samples showed clinically significant differences in PT test results that may have stemmed from mechanical agitation during transportation. Therefore, we recommend not transporting noncentrifuged specimens for PT testing by car.

3Ds: decorin, discordance, and diamniotic dichorionic twins

aullimary Investigation: The cause of discordance in dichorionic diamniotic (DD) twins is still unknown. The authors aimed to compare decorin (DCN) and oxidative/antioxidative state levels between the placentas of discordant and concordant twins.

MATERIALS AND METHODS

Prospective study of 43 spontaneous DD twin pregnancies included and placentas samples taken from each twin and prepared for homogenization. Total oxidant/antioxidant status levels in placental tissue were determined by automated colorimetric method. Decorin levels were detected by using ELISA method; 23 of these were discordant and 20 of them were concordant.

RESULTS

DCN levels in the placentas of the low birth-weight twins were significantly lower than the levels of the placentas of appropriate gestational age twins (p = 0.006). There were no statistically significant differences in total antioxidant status (TAS), total oxidant status (TOS), or arylesterase (ARES) levels in discordant (p = 0.631, p = 0.370, and p = 0.079, respectively) and in the placental DCN, TAS, TOS, or ARES levels of the concordant twins (p = 0.407, p = 0.035, p = 0.194, and p = 0.979, respectively). When the authors compared the twins of similar birth weight, the DCN, TAS, and TOS levels were significantly lower in the discordant twins (p < 0.001, p < 0.001, and p = 0.002, respectively).

CONCLUSIONS

Decreased levels of DCN in discordant twin fetuses compared to the same birth weight-concordant twins shows that it contributes to disease pathogenesis.

Impaired Thiol-Disulfide Balance in Acute Brucellosis

The objective of this study was to examine a novel profile: thiol-disulfide homeostasis in acute brucellosis. The study included 90 patients with acute brucellosis, and 27 healthy controls. Thiol-disulfide profile tests were analyzed by a recently developed method, and ceruloplasmin levels were determined. Native thiol levels were 256.72 ± 48.20 μmol/L in the acute brucellosis group and 461.13 ± 45.37 μmol/L in the healthy group, and total thiol levels were 298.58 ± 51.78 μmol/L in the acute brucellosis group and 504.83 ± 51.05 μmol/L in the healthy group (p < 0.001, for both). The disulfide/native thiol ratios and disulfide/total thiol ratios were significantly higher, and native thiol/total thiol ratios were significantly lower in patients with acute brucellosis than in the healthy controls (p < 0.001, for all ratios). There were either positive or negative relationships between ceruloplasmin levels and thiol-disulfide parameters. The thiol-disulfide homeostasis was impaired in acute brucellosis. The strong associations between thiol-disulfide parameters and a positive acute-phase reactant reflected the disruption of the balance between the antioxidant and oxidant systems. Since thiol groups act as anti-inflammatory mediators, the alteration in the thiol-disulfide homeostasis may be involved in brucellosis.

Disulfide stress in carbon monoxide poisoning

OBJECTIVES

Carbon monoxide (CO) remains the most common cause of lethal poisoning around the world. The purpose of this study was to investigate the homeostasis between thiol-disulfide couples and to evaluate oxidative status comprehensively in acute CO poisoning, using new parameters along with other well-known oxidant-antioxidant molecules.

DESIGN AND METHODS

This case study consisted of 43 subjects who were diagnosed with carbon monoxide poisoning and 35 healthy individuals who were used as controls. Thiol-disulfide paired tests were examined in both groups using the method developed recently.

RESULTS

Patients with CO poisoning had significantly higher levels of serum disulfide than the control patients (20.7±5.03 versus 16.43±3.97, p=0.001). Native thiol and total thiol levels were lower in the CO patient group than in the control group (p<0.001, for each variable). The disulfide/native thiol ratios and disulfide/total thiol ratios were significantly higher, while native thiol/total thiol ratios were significantly lower, in patients with acute CO poisoning than in the healthy controls (p<0.001, for all ratios). The disulfide/native ratios were negatively correlated with both total antioxidant response and paraoxonase and arylesterase values and were positively correlated with total oxidant status and ceruloplasmin values (p<0.05, for all correlations).

CONCLUSIONS

Excessive disulfide levels and their related ratios were found in CO poisoning patients. In particular, the disulfide/native thiol ratio was identified as an indicator for overall oxidative status. Among CO poisoning patients, the thiol-disulfide balance was found to be impaired. Therefore, the disruption of thiol-disulfide homeostasis might be involved in CO toxicity.

Thiol/disulphide homeostasis in Bell's palsy as a novel pathogenetic marker

OBJECTIVES

The aim of this study was to investigate the relationship between Bell's palsy and a novel oxidative stress parameter, thiol/disulphide homeostasis.

DESIGN

A prospective study evaluating oxidative stress in Bell's palsy.

SETTING

This research took place in the department of Otorhinolaryngology, Ataturk Training and Research Hospital.

PARTICIPANTS

Totally, 77 patients with Bell's palsy and 38 healthy controls were included in this study.

MAIN OUTCOME MEASURES

The blood levels of total and native thiol and disulphide activity were assessed, and their levels were compared in the patients and controls.

RESULTS

There were statistically significant differences between the patients and controls regarding thiol/disulphide parameters. The mean native thiol and total thiol were significantly lower and disulphide levels were higher in the Bell's palsy than controls. On binary logistic regression analysis, the created model showed 45.3% variation. The cut-off value was 18.95 for disulphides.

CONCLUSION

Native and total thiol levels were low in the Bell's palsy. This metabolic disturbance may have a role in the pathogenesis of Bell's palsy.

A retrospective controlled study of thiol disulfide homeostasis as a novel marker in Crimean Congo hemorrhagic fever

OBJECTIVES

Crimean Congo hemorrhagic fever (CCHF) is the second most common hemorrhagic fever worldwide. This study aimed to evaluate the oxidant-antioxidant balance of patients with CCHF by detecting dynamic thiol disulfide homeostasis (TDH), which is a novel oxidative stress marker, and other molecules, including paraoxonase (PON), arylesterase (ARES), ceruloplasmin (CLP), myeloperoxidase (MPO), and catalase.

METHODS

This retrospective, cross-sectional, controlled study, which involved patients with CCHF and healthy volunteers, measured dynamic TDH using a novel automated method developed by Erel.

RESULTS

We recruited 69 adult patients with CCHF (31 females, 38 males, median age 46 years). The case fatality rate was 1.49% (1/69). Increased disulfide/native thiol and disulfide/total thiol ratios, decreased total antioxidant status (TAS), and increased total oxidant status (TOS) were found in patients with CCHF. TAS, PON, and ARES values were found to be positively correlated with both native and total thiol levels, whereas TOS and CLP were negatively correlated with both, at a significant level. MPO activity was similar in both groups.

DISCUSSION

This is the first study in the literature to evaluate dynamic TDH in CCHF. TDH shifts to the oxidative side in patients with CCHF, leading to an increase in TOS.

The Association between N-terminal Pro-Brain Natriuretic Peptide Levels in the Umbilical Vein and Amniotic Fluid Volume Abnormalities

Purpose The amniotic fluid volume (AFV) is known as a predictor for the wellness of a fetus. We aimed to investigate whether N-terminal pro-brain natriuretic peptide (NTproBNP) levels reflect AFV abnormalities in otherwise normal fetuses. Methods We recruited 24 women with isolated oligohydramnios, 23 women with isolated polyhydramnios, and 36 women with normal AFV at a tertiary referral center. NT-proBNP levels in umbilical venous samples and the individual characteristics of the three groups were compared. One-way ANOVA and Kruskal-Wallis analysis of variance were used for multi-group comparisons of continuous variables. When a significant difference was detected, the Scheffe test was performed as a post-hoc analysis. Proportions were compared using the Chi-square (χ2) test. Results Maternal age, body mass indices, weight gained in pregnancy and NT-proBNP levels were similar among the three groups. Apgar scores at 1 and 5 minutes significantly correlated with NT-proBNP levels in all newborns (Spearman's r = 0.23; p = 0.03 and Spearman's r = 0.24; p = 0.02, respectively). The umbilical venous NT-proBNP levels did not differ between newborns who needed mechanical ventilation and those who didn't (p = 0.595). Conclusions NT-proBNP is a biomolecule that may provide insights into the pathogenesis of fetal circulatory problems and subsequent renal failure. Further investigations are warranted.

Increased levels of serum clusterin is associated with intrauterine growth restriction and adverse pregnancy outcomes in preeclampsia

AIM

Our aim was to investigate serum clusterin levels in preeclampsia and to determine whether any changes in clusterin levels are useful in distinguishing the presence of concomitant intrauterine growth restriction (IUGR) and in predicting adverse pregnancy outcomes.

METHODS

A prospective case-control study was carried out which included 86 pregnant women (47 patients with preeclampsia and 39 healthy controls). Maternal serum samples obtained from all participants and clusterin levels were determined by enzyme-linked immunosorbent assay (ELISA).

RESULTS

Compared with controls, women with preeclampsia had significantly higher clusterin levels (mean 83.8±23.6 vs. 119.2±40.5, P<0.01). Further analysis revealed the highest clusterin levels were in patients with preeclampsia and IUGR (P<0.001). According to the receiver operating characteristic (ROC) analysis performed for the predictive value of clusterin levels for adverse maternal outcomes, the area under the curve (AUC) was 0.738 (95% CI: 0.616-0.859). The best clusterin cut-off value in predicting adverse maternal outcomes was 102.6 pg/mL with 75% sensitivity and 66% specifity. Multivariable logistic regression analysis revealed serum clusterin levels of >102.6 pg/mL was independently associated with preeclampsia (OR: 6.18, 95% CI: 2.41-15.9) and maternal adverse outcomes (OR: 5.13, 95% CI: 2.01-13.1) and also clusterin levels higher than 117.4 pg/mL were associated with adverse neonatal outcomes (OR: 5.02, 95% CI: 1.04-24.3).

CONCLUSIONS

The current study suggests that increased levels of clusterin is associated with IUGR and probably predictive for adverse pregnancy outcomes in preeclampsia.

The association of thiol/disulphide homeostasis and lipid accumulation index with cardiovascular risk factors in overweight adolescents with polycystic ovary syndrome

OBJECTIVE

To assess thiol/disulphide homeostasis and lipid accumulation product index, and to determine whether they are associated with increased cardiovascular disease (CVD) risk or not in overweight adolescents with polycystic ovary syndrome (PCOS).

DESIGN

Case-control study.

SETTING

Education and Research Hospital.

PATIENTS

Group 1: 43 overweight+PCOS, Group 2: 45 normal weight+PCOS, Group 3: 27 overweight adolescents and Group 4: 96 age-matched, normal weight healthy controls.

INTERVENTIONS

Serum lipid profiles, hormonal parameters and thiol/disulphide homeostasis were measured. Lipid accumulation index (LAP index) and homeostasis model assessment (HOMA-IR) were calculated.

MAIN OUTCOME MEASURES

The relation between thiol/disulphide homeostasis and LAP index, and increased CVD risk were evaluated in overweight adolescents with PCOS.

RESULTS

Native and total thiol levels were significantly lower in overweight+PCOS adolescents when compared with both normal weight PCOS and control adolescents (P = 0·002). LAP index values were significantly higher in Group 1 when compared separately with the rest of the three groups (P < 0·001). Multivariable logistic regression analysis revealed serum total thiol levels of lower than 405·45 μmol/l were independently associated with increased risk of CVD in overweight PCOS adolescents (OR: 1·019, 95% CI: 1·001-1·036). In addition, a LAP index greater than 21·54 was also associated with increased CVD risk in overweight PCOS adolescents (OR: 1·270, 95% CI: 1·174-1·374).

CONCLUSION

In conclusion, we suggest that increased LAP index and decreased total thiol levels may contribute to the increased CVD risk in overweight adolescents with PCOS.

Thiol/disulfide homeostasis in predicting adverse perinatal outcomes at 24-28 weeks of pregnancy in gestational diabetes

OBJECTIVE

The main aim of this study was to investigate thiol/disulfide homeostasis at 24-28 weeks of pregnancy and to evaluate whether it is predictive for adverse perinatal outcomes or not in gestational diabetes mellitus (GDM).

METHODS

A total of 110 pregnant women at 24-28 weeks of pregnancy (74 GDM patients and 36 age- and BMI-matched healthy pregnant women) were enrolled in this prospective case-control study. Thiol/disulfide homeostasis was evaluated with a novel spectrophotometric method to determine if there is an association with adverse perinatal outcomes in GDM, by using logistic regression analysis.

RESULTS

GDM patients, with decreased native thiol levels at 24-28 weeks (OR: 4.890, 95% CI: 1.355-5.764, p = 0.015) and with higher pre-pregnancy BMI (OR: 1.280, 95% CI: 1.072-1.528, p = 0.006), were found to be at increased risk of adverse perinatal outcomes in GDM. There were no statistically significant differences in thiol/disulfide homeostasis between diet- and insulin-treated GDM subgroups. Additionally, 1-h and 2-h glucose levels on 100 g OGTT were found to be predictive for the insulin need in achieving good glycemic control in GDM (OR: 1.022, 95% CI: 1.005-1.038, p = 0.010 and OR: 1.019, 95% CI: 1.004-1.035, p = 0.015).

CONCLUSIONS

GDM patients, with decreased native thiol levels at 24-28 weeks of pregnancy and with higher pre-pregnancy BMI, have an increased risk of possible adverse perinatal outcomes. Also, increased 1-h and 2-h glucose levels on 100 g OGTT can predict the need for insulin treatment for GDM.

Increased levels of serum granzyme-B is associated with insulin resistance and increased cardiovascular risk in adolescent polycystic ovary syndrome patients

OBJECTIVES

Our aim was to determine serum perforin and granzyme-B levels in adolescent PCOS patients, and to investigate whether they are associated with some of the insulin sensitivity, obesity and cardiovascular (CV) risk markers and metabolic syndrome.

STUDY DESIGN

A case-control study was carried out including a total of 172 adolescents (83 PCOS patients and 89 age-matched healthy controls). Participants were recruited consecutively. Homeostasis model assessment (HOMA-IR), lipid parameters, and anthropometric measurements were determined. Serum perforin and granzyme B levels were measured by commercially available ELISA kits. HOMA-IR>3.16 was considered to indicate the presence of insulin resistance. Logistic regression analysis was applied for the predictive value of granzyme-B for increased CV risk in PCOS patients.

RESULTS

As body mass index (BMI) of the PCOS patients was significantly higher than the controls (median 24.6kg/m(2) and 21.4kg/m(2), respectively, p<0.001) all parameters were evaluated after adjustment for BMI. Adolescents with PCOS had significantly higher levels of fasting glucose, insulin, HOMA-IR and granzyme-B when compared with controls. According to the results of logistic regression analysis, granzyme-B levels were found to be significantly associated with increased HOMA-IR (OR=6.120, 95% CI: 2.352-15.926, p<0.001) in adolescent PCOS patients. Additionally, elevated levels of serum granzyme-B were predictive for increased CV risk in PCOS patients (OR=0.237, 95% CI: 0.091-0.616, p=0.003).

CONCLUSIONS

Increased levels of serum granzyme-B are independently associated with insulin resistance and also with increased CV risk in adolescent polycystic ovary syndrome patients.

ADAMTS4 and Oxidative/Antioxidative Status in Preterm Premature Rupture of Membranes

AIM

To determine the function of a disintegrin and metalloproteinase with thrombospondin motifs-4 (ADAMTS4), total oxidant status (TOS), total antioxidant status (TAS), and aryl esterase (ARES) in preterm premature rupture of membranes (PPROM) and to investigate the association with premature rupture of membranes (PROMs).

MATERIAL AND METHODS

58 pregnant women were included in this prospective study which comprised 29 PPROM patients as the study group and 29 patients, having healthy amniotic membranes, as the control group. ADAMTS4, TAS, TOS, and ARES levels were studied in the amniotic membrane homogenates of the patients.

RESULTS

ADAMTS4, TAS TOS, and ARES levels of amniotic membrane lysates were significantly different between PPROM and control groups (p < 0.001, p < 0.001, p = 0.008 and p = 0.002, respectively). Increased amniotic membrane ADAMTS4 (OR: 1.051 95% CI 1.006-1.098, p = 0.024) and TOS (OR: 12.777 95% CI 1.595-102.323, p = 0.016) were found to be significantly associated with the increased risk of PPROM.

CONCLUSION

ADAMTS4, TOS, and ARES levels were higher and TAS level was lower in PPROM patients than the normal healthy control group which had healthy amniotic membranes at term. As a result, ADAMTS4 may have a role in the pathogenesis by causing increased oxidative and inflammatory environment in PPROM.

Role of ADAMTS5 in Unexplained Fetal Growth Restriction (FGR)

AIM

We aim to determine the role of serum and placental A disintegrin and metalloproteinase with thrombospondin motif 5 (ADAMTS5) in fetal growth restriction (FGR).

MATERIAL AND METHODS

43 pregnancies suffering FGR and 45 healthy ones were homogenized for their body mass indices, ages, and gestational weeks. Expression of ADAMTS5 in placental samples was determined by immunohistochemical methods and concurrent maternal serum ADAMTS5 levels were determined with enzyme-linked immunosorbent assay.

RESULTS

Expression of ADAMTS5 was higher in FGR group than the healthy control in placenta. Both the cytoplasmic staining pattern of the syncytiotrophoblasts and staining of the decidual plate were shown in the FGR group; but not in the control group. A negative correlation between serum ADAMTS5 levels and birth weight in FGR group was observed.

CONCLUSION

Increased ADAMTS5 levels were observed in placental insufficiency cases. This study demonstrates that ADAMTS5 may be a sensitive indicator of placental insufficiency which has variable factors in etiology. Additional work is needed to delineate the mechanism of its involvement.

Effects of everolimus on a rat model of cerulein-induced experimental acute pancreatitis

OBJECTIVE

To analyze the biochemical and histopathological effects of everolimus in an experimental rat model of cerulein-induced acute pancreatitis. The aim of the present study was to determine the effects of everolimus on blood biochemical parameters and tissue histopathology in an experimental rat model of cerulein-induced acute pancreatitis.

MATERIAL AND METHODS

In 30 Wistar albino rats (male; 240-260 g), acute pancreatitis was induced by an intraperitoneal injection of cerulein (50 μg/kg) administered twice in 2 h. They were equally divided into the following three groups: 0.9% isotonic solution (Group 1; control), everolimus once (Group 2), and everolimus twice (Group 3) by oral gavage after cerulein injection. Thirty hours after the induction of pancreatitis, blood samples were collected by direct intracardiac puncture, rats were sacrificed, and pancreatic tissue samples were obtained.

RESULTS

Biochemical analyses of the blood samples showed statistically significant difference in red blood cell count as well as hemoglobin, hematocrit, urea, and alanine transaminase levels among the study groups (p<0.05 in all). Everolimus proved to significantly increase red blood cell count in a dose-independent manner. Hemoglobin and hematocrit levels significantly increased only after treatment with one dose of everolimus. Urea level was significantly different between the Groups 2 and 3; however, no change was observed in both groups when compared with the control. Alanine transaminase level significantly decreased only after treatment with two doses of everolimus. Histopathological analyses revealed that everolimus significantly decreased inflammation and perivascular infiltrate in a dose-dependent manner (35% in Group 2, 75% in Group 3; p=0.048).

CONCLUSION

Treatment with two doses of everolimus improved some biochemical and histopathological parameters of experimental rat models of cerulein-induced acute pancreatitis and implied the specific inhibition of inflammatory response pathways.

Dynamic thiol-disulfide homeostasis in hyperemesis gravidarum

OBJECTIVE

To determine serum thiol-disulfide homeostasis in hyperemesis gravidarum.

STUDY DESIGN

Twenty-six pregnant women with hyperemesis gravidarum and 37 healthy pregnant women were included in the study. Native thiol, disulfide and total thiol concentrations were measured with a novel automated method.

RESULTS

Serum disulfide levels were 15.68±4.41 μmol l(-1) in the hyperemesis gravidarum group and 13.49±2.81 μmol l(-1) in the healthy group (P=0.031). Native thiol levels were 213.86±26.29 μmol l(-1) in the hyperemesis gravidarum group and 232.18±19.21 μmol l(-1) in healthy group (P=0.004), and total thiol levels were 245.23±28.58 μmol l(-1) in the hyperemesis gravidarum group and 259.17±19.94 μmol l(-1) in the healthy group (P=0.038).

CONCLUSION

Native and total thiol were deficient in the hyperemesis gravidarum group and this deficiency was correlated with the severity of the disease. The thiol-disulfide balance has shifted to the oxidative side. This metabolic disturbance may have a role in the pathogenesis of hyperemesis gravidarum.

Placental ADAMTS-12 Levels in the Pathogenesis of Preeclampsia and Intrahepatic Cholestasis of Pregnancy

Our aim was to determine whether placental A Disintegrin-like Metalloproteinase with ThromboSpondin motif 12 (ADAMTS-12), arylesterase (ARES) levels, total oxidant status (TOS), and total antioxidant status (TAS) differ in preeclampsia, intrahepatic cholestasis of pregnancy (ICP), and uncomplicated pregnancies or not. A prospective case-control study was carried out including 84 pregnant women (26 with ICP, 28 preeclamptic patients, and 30 healthy controls). Levels of ADAMTS-12, TAS, TOS, and ARES were studied in the supernatants of placental tissue homogenates. Placental ADAMTS-12 levels were distributed as 240.9 pg/mg in ICP, 289.7 pg/mg in preeclampsia, and 310.8 pg/mg in control groups. Levels of ADAMTS-12 (odds ratio = 6.509, 95% confidence interval:1.070-39.592, P = .042) in the placenta of the ICP were significantly lower than those in preeclampsia and control groups (P = .004), but no statistical significant difference was determined between preeclampsia and control groups. Decreased levels of placental ADAMTS-12 were found to be associated with ICP, suggesting a possible role of inflammation in the pathogenesis.

Prediction of gestational diabetes mellitus by first trimester serum secreted frizzle-related protein-5 levels

OBJECTIVE

The main aim of this study was to investigate the first trimester maternal serum secreted frizzle-related protein-5 (Sfrp-5) levels and to evaluate the predictive value on the subsequently developed gestational diabetes mellitus (GDM).

METHODS

A total of 40 pregnant women who subsequently developed GDM and 44 age- and pre-pregnancy BMI-matched healthy pregnant women were enrolled in this prospective case-control study. First trimester serum Sfrp-5 levels were evaluated to determine if there is an association with the onset of GDM, by using logistic regression analysis.

RESULTS

Decreased first trimester serum Sfrp-5 levels (OR = 14.332, 95%CI: 4.166-49.301, p < 0.001) were found to be significantly associated with the increased risk of GDM. There were no statistically significant differences in serum Sfrp-5 levels between the diet- and insulin-treated GDM groups and also serum Sfrp-5 levels were not found to be predictive for adverse perinatal outcomes (p > 0.05).

CONCLUSIONS

Decreased first trimester serum Sfrp-5 levels are significantly associated with the increased risk of GDM.