Diagnostic Value of Ischemia-Modified Albumin as a Biomarker in Patients with Peripheral Vertigo at Emergency Department of State Hospital in Ankara: A Cross-Sectional Study

BACKGROUND

In previous studies, it was shown that ischemia-modified albumin (IMA) is an early marker of ischemia and different pathologies. However, IMA level change is unknown in patients with peripheral vertigo. It is also known that serum albumin levels can change in some patients with peripheral vertigo and that changes in serum albumin levels affect IMA levels.

AIM

In this study, we aimed to assess IMA, albumin-adjusted IMA, and albumin levels in patients with peripheral vertigo by comparing a control group.

MATERIALS AND METHODS

This prospective, case-control study included 46 patients aged 18-70 years who presented to emergency department with vertigo. Forty-nine healthy volunteers without known disease were included as controls. Serum albumin and IMA levels were measured, and albumin-adjusted IMA levels were calculated. Data were analyzed by statistical methods.

RESULTS

Mean age was 54.0 ± 15.7 in the patient group, whereas 43.8 ± 9.9 years in the control group. Albumin level was found to be significantly lower in patients with peripheral vertigo when compared to controls (P < 0.001). IMA level was found to be higher in the patient group compared to the controls, but it was not statistically significant (P = 0.06). However, albumin-adjusted IMA, which shows the real IMA level, was found to be higher than the control group (P = 0.02).

CONCLUSION

It was observed that IMA level was slightly higher in patients with peripheral vertigo, although not significantly, compared to the control group. However, the albumin-adjusted IMA level, which indicates the real IMA level, was observed to be higher in this group than in the control group. It was determined that the sensitivity of this test was 34%, and the specificity was 87%. Patients with peripheral vertigo had lower albumin levels compared to controls.

Vaspin, neutrophil gelatinase-associated lipocalin and apolipoprotein levels in patients with psoriatic arthritis

OBJECTIVES

To examine the relationship between disease activity and vaspin, neutrophil gelatinase-associated lipocalin (NGAL) and apolipoprotein levels in patients with psoriatic arthritis (PsA).

BACKGROUND

Psoriatic arthritis (PsA) is a chronic inflammatory arthritis, which is related with psoriasis. Adipokines are the mediators which play a role in metabolic homeostasis and inflammatory conditions.

METHODS

The levels of vaspin, NGAL, apolipoproteins and their correlations with disease activity were compared in 50 psoriatic arthritis patients and 36 healthy controls.

RESULTS

The levels of vaspin, NGAL and apolipoprotein B/A1 ratio were significantly higher in the patient group (p 0.05).

CONCLUSION

This is the first study to have compared vaspin and NGAL levels in patients with PsA. Vaspin and NGAL can be used as a biomarker in PsA. Vaspin, NGAL and dyslipoproteinemia are not correlated with disease activity (Tab. 3, Ref. 63).

IRISIN AND CHEMERIN LEVELS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Context

Changes in the secretion of signaling molecules that originates from adipose tissue and inflammation draw attention in the pathogenesis of type 2 DM. Chemerin, one of the signaling molecules of adipose origin, and irisin, defined as the Renaissance of the metabolism, are among these molecules.

Objectives

This cross-sectional study was planned in order to compare the values of serum irisin and chemerin levels in patients newly diagnosed with T2DM and in healthy subjects.

Subjects and Methods

The study included 41 patients newly diagnosed with T2DM and 49 healthy individuals. The chemistry parameters were analyzed with a biochemistry autoanalyzer, and hormonal parameters were analyzed with an immunoassay analyzer. Plasma irisin and chemerin levels were measured using the enzyme-linked immunosorbent assay method.

Results

There was a significant difference between the groups in terms of glucose, HbA1C, Insulin, HOMA-IR and lipid panel results. Irisin levels in the group of patients newly diagnosed with T2DM were lower than in the control group. Chemerin levels in the group of patients newly diagnosed with T2DM were higher than in the control group.

Conclusion

Consequently, diabetes-dependent changes in chemerin and irisin concentrations suggest that these two hormones have a role in the pathophysiology of DM. Further studies are required to understand the complex structure of the signaling pathways of chemerin and irisin molecules as well as the physiological importance of these molecules as metabolism regulators especially in humans.

Matrix metalloproteinase-9 in broncho-alveolar lavage fluid of patients with non-small cell lung cancer

AIM

To evaluate concentration of MMP-9 in blood plasma and broncho-alveolar lavage fluid (BALF) from patients with non-small cell lung cancer (NSCLC).

METHODS

Blood plasma from 40 NSCLC patients and 40 healthy donors was collected and concentrations of blood plasma and BALF MMP-9 were measured using ELISA. Correlation between MMP-9 level and gender, histological type of tumor and stage of disease was analyzed.

RESULTS

Levels of blood plasma MMP-9 were significantly higher in NSCLC patients (p < 0.0001) then in control group, and were especially high in patients with stage IV of disease (stage I vs stage IV - p < 0.005, stage II vs stage IV - p < 0.01, stage III vs stage IV - p < 0.01). Also, stage IV of NSCLC was characterized by the highest level of BALF MMP-9 (stage I vs stage IV - p < 0.002, stage II vs stage IV p < 0.002, and stage III vs stage IV p < 0.007). Correlation between blood plasma and BALF MMP-9 levels and gender or histological type of tumor was insignificant.

CONCLUSION

Our data revealed significant correlation between tumor stage and BALF and plasma MMP-9 levels in NSCLC patients.

Relationship between Anterior Inferior Cerebellar Artery and Facial-Vestibulocochlear Nerve Complex: An Anatomical and Magnetic Resonance Images Correlation Study

For the successful microneurosurgical treatment of CP angle located pathologies, an understanding of the relationship and variations between neural and vascular structures and a certain diagnosis are the most valuable factors for surgeons. CP angle lesions have now become a visible area by advances in magnetic resonance imaging (MRI) technology. An evaluation of this area and the decision for a neurosurgical decompression procedure are easier than before. Twenty unfixed adult human cadaver specimens, that have no sign of central nervous system pathology, were obtained and dissected bilaterally at routine autopsy. The facial-vestibulocochlear (VII - VIIIth) nerve complex and the anterior inferior cerebellar artery (AICA) were identified in all specimens. Thirteen of the 40 (32.5 %) AICA were situated ventrally and fourteen (35 %) were located dorsally to the VII - VIIIth nerve complex. Thirteen (32.5 %) passed between the VIIth and the VIIIth nerve fibers. Five of the 40 (12.5 %) AICA had a loop near the nerve complex and then passed the nerves ventrally or dorsally. In an MRI study 74 adult persons (148 sides) were investigated by using three-dimensional Fourier transformation constructive interference in the steady state technique (3D FT-CISS) on a 1.5 Tesla MRI system (Siemens Magnetom, Erlangen, Germany). The results were as follows; 48 AICA (32.4 % of all 148 AICA) were situated ventrally to the VII-VIIIth nerve complex, 45 AICA (30.4 %) were situated dorsally to the VII-VIIIth nerve complex, and the AICA passed between the VIIth and VIIIth nerves in 51 samples (34.5 %). In four of the 148 CP angles (2.7 %), the AICA was not identified. There was an AICA loop coursing to the internal acoustic meatus in 15 patients (10.1 %). In this study, we examined the relations between VIIth and VIIIth nerve complex and the AICA in cadaver and MRI materials for an understanding of the value and reliability of the radiological data. This study also shows the anatomical variation between these structures.

The value of 5-hydroxy indole acetic acid measurement in spot urine in diagnosis of acute appendicitis

OBJECTIVE

To assess the role of 5-Hydroxy Indole Acetic Acid (5-HIAA) levels in spot urine in diagnosis of acute appendicitis.

DESIGN

A prospective, controlled study.

SETTING

Ankara Numune Teaching and Research Hospital, Ankara, Turkey.

SUBJECT

Twenty six patients with histologically proven acute appendicitis following appendectomy were included in the study. Control group with consisted of patients prepared for hernia repair in the same duration. In the preoperative period, urine samples were collected from every patient for measurement of 5-HIAA.

RESULTS

The study group comprised 26 patients; 15 of those had high urine 5-HIAA levels, whereas 11 patients had values within normal range. None of ten control patients displayed positive test result. The test had 58% sensitivity and 48% specificity. In histopathological examination only two of ten patients with gangrenous appendicitis showed positive test result, whereas 13 of 16 patients with no histopathological gangrenous changes had high values.

CONCLUSION

Urine 5-HIAA measurement has low sensitivity and specificity. The value of the test is even clearly lower in gangrenous appendicitis. This may be misleading in management of patients in late phase of appendicitis and in cases with perforation which is mainly responsible for morbidity.

Simple Anterior Orbitotomy

OBJECTIVE

Simple anterior orbitotomy is one of the popular surgical procedures through the orbital cavity. In this approach no bony orbitotomy is required so very satisfactory cosmetic results should be achieved. The authors of this paper report on three patients with space-occupying lesions in orbital cavity which were operated by anterior orbitotomy techniques without craniotomies.

METHODS

Three patients with space-occupying lesions in the orbital cavity underwent a microsurgical procedure with simple anterior orbitotomy.

RESULTS

No bony orbitotomy was used in this technique and the cosmetic results were very satisfactory. Although the surgical area is very narrow, no neurological deficit has appeared after this procedure using microsurgical operative procedures.

CONCLUSION

Although the orbital cavity is very narrow, multiple neurological important structures occur in this area. Traction of the ocular bulb and optic nerve can be harmful for the patient. Therefore, many the surgeons prefer the transfrontal intracranial approach with superior orbital craniotomy for wide exposure. One of these three cases is a typical example for the simple anterior orbitotomy which is a useful operative approach for patients with solid space-occupying lesions in the superior part of the orbital cavity. Another patient with a hydatid cyst in orbital cavity was operated successfully via a simple anterior orbitotomy. The third patients was 6 years old and shows that the procedure can be used easily in children as well.

Safety of colonic anastomosis following portal triad occlusion in rats

Traumatic colon injuries frequently coexist with liver injury. Stopping the bleeding from hepatic pool may require complete portal triad occlusion. The possible effects of portal venous occlusion on healing of colonic anastomosis were examined using a rat model. A colo-colonic anastomosis following resection of a 1 cm segment of the transverse colon was done with just a simple manipulation on the liver and portal triad in the group A. In the group B the portal triad was clamped for 15 minutes. Then, the clamp was released for a thirty minutes reperfusion time. Subsequently, the same technique in the control group for colonic resection and anastomosis was applied. Ischemia/reperfusion resulted in histologically proven alterations in the large bowel in the group B. However, colonic tissue superoxide dismutase values showed no significant differences between the groups. On day 7, no differences were recorded in bursting pressures of the anastomoses and the hydroxyprolene levels of the anastomotic tissues of the two groups. These findings suggest that colonic anastomosis after portal triad occlusion is safe in the absence of peritonitis.

Effect of pinealectomy on immune parameters in rats with Staphylococcus aureus infection

It is generally accepted that the pineal gland is a neuroendocrine organ. Several recent experiments have shown that the pineal gland has functional and anatomical connections, particularly with the immune system, and therefore the gland is now recognized as an important immunoneuroendocrine organ in both man and animals. The present study investigates the effect of pinealectomy on some immune parameters, including hematological alterations, and the response of the brain tissue against infection caused by Staphylococcus aureus. Experiments were performed on two different age groups of rats (neonatal and young). The results showed a significant reduction of the plasma zinc level in the third week following pinealectomy, impairment of the hematological parameters including lymphocyte, erythrocyte, and leucocyte, and the deficiency of the brain response to the infective agent, particularly in pinealectomized neonatal rats. In view of these data and as described previously, the pineal gland has a main regulatory function in immune physiology, but our study indicates that only neonatal immune functions are significantly affected by pinealectomy.

The effect of pinealectomy on immune parameters in different age groups in rats: results of the weekly alteration of the zinc level and the effect of melatonin administration on wound healing

It is generally accepted that the pineal gland is a neuroendocrine organ. Several recent experiments have shown that the pineal gland has functional and anatomic connections with many organs and systems, particularly with the immune system, and, therefore, the gland is now recognised as an important immunoneuroendocrine organ both in man and animals. The present study investigates the effect of pinealectomy on some immune parameters including zinc pool alterations and wound healing process in different age group in rats and also investigates the effect of melatonin administration on wound healing in different age groups. Experiments were performed on two different age groups of rats (neonatal and young). We have experimentally shown the induction of immune depression by pinealectomy and the restorative competence of melatonin administration in the present study. The results also showed that the plasma zinc level was significantly reduced in the third week after the pinealectomy particularly in pinealectomised neonatal rats and the wound healing process affected only in pinealectomised neonatal rats but restored to normal by melatonin administration. In view of these data, as described previously, the pineal gland has a main regulatory function in immune physiology, but our study indicates that only neonatal immune functions are significantly affected by pinealectomy.