EFFECT OF B. SUBTILIS ІМV B-7724 LECTIN ON THE ACTIVITY OF EFFECTORS OF CELLULAR ANTITUMOR IMMUNITY OF MICE WITH LEWIS LUNG CARCINOMA

AIM

To evaluate the effect of B. subtilis IMV B-7724 lectin on the functional activity of macrophages (Mph), natural killer (NK) cells and cytotoxic lymphocytes (CTL) of mice bearing Lewis lung carcinoma (LLC).

MATERIALS AND METHODS

The studies were performed on C57Bl/6J mice; LLC was used as an experimental transplantable tumor. The lectin from B. subtilis IMV B-7724 was administered to LLC-bearing mice subcutaneously at a dose of 1 mg/kg of body weight for 10 days. The immunological testing was performed on days 14, 21, and 28 after tumor grafting. The cytotoxic activity of Mph, NK, and CTL was estimated in MTT-assay; the content of the stable metabolites of nitric oxide (NO) was measured by a standard Griess reaction; the arginase activity (Arg) was determined based on the measurement of urea.

RESULTS

The administration of the B. subtilis IMV B-7724 lectin to LLC-bearing mice exerted its antitumor and antimetastatic effects partially via a significant (p < 0.05) increase of Mph and NK activities after the completion of the treatment. In the group of animals injected with lectin, the NO/Arg ratio increased significantly, indicating the prevalence of Mph with proinflammatory and antitumor properties. The cytotoxic activity of Mph exceeded the indices of untreated mice and intact control by 1.8 times and 5.3 times respectively; of NK - by 2.8 and 1.3 times respectively. The effect of treatment on the CTL activity was less pronounced.

CONCLUSION

Antitumor and antimetastatic activity of the lectin from B. subtilis IMV B-7724 ensured the preservation of the cytotoxic activity of the main effectors of antitumor immunity (Mph, NK, and CTL) throughout LLC growth.

Investigation of level density parameter dependence for some 233U, 235U, 237U, 239U, 249Cf, 251Cf, 237Pu and 247Cm nuclei in neutron fission cross sections with the incident energy up to 20 MeV

Level density models have increasing importance to gain more in-depth into the nature of nuclear reactions. Many novel and advanced medical application use radioisotopes, which are produced with nuclear reactions. In this study, the effect of the level density parameters of the nucleus on the cross sections of neutron-fission reactions for 233U, 235U, 237U, 239U, 249Cf, 251Cf, 237Pu and 247Cm nuclei were investigated for up to 20 MeV neutrons. TALYS 1.8 software was used to calculate the cross-sections of neutron-fission reactions for different level density parameters. The calculations were compared with the EXFOR nuclear data library and the level density parameters, and the closest fit were searched. As outputs of the study, the effect of selection of level density parameter on cross section calculations was observed. The theoretically obtained data were compared with the experimental data taken from the literature. The results are presented graphically for better interpretation.

A comparison of full arthroscopic and arthroscopic-assisted mini-open repair methods in rotator cuff tears 1-3 cm in size

Introduction

Retrospective evaluation of rotator cuff repair with arthroscopic or arthroscopic-assisted mini-open methods for a diagnosis of non-retracted rotator cuff tear.

Materials and methods

A total of 45 patients underwent rotator cuff repair; Group 1 (n = 24) with arthroscopic-assisted mini-open method and Group 2 (n = 21) with full arthroscopic method.

Results

Within both Group 1 and Group 2, a statistically significant results is p = 0.001. The patients of Group 2 were seen to return to daily life earlier than those of Group 1 (p = 0.001).

Conclusions

Patients where full arthroscopic repair was applied, there was evidence of an earlier return to daily life.

Level of evidence

IV, retrospective comparative study.

The Correlation of Increased CRP Levels with NFKB1 and TLR2 Polymorphisms in the Case of Morbid Obesity

Morbid obesity (MO) is associated with an increase in circulating levels of systemic acute phase proteins such as C-reactive protein (CRP). Toll-like receptor is possible candidate for inflammatory responses which is mainly mediated by NFKB1. The aim of this study was to investigate the relationship between NFKB1 and Toll-like receptor (TLR) 2 polymorphisms and the risk of MO in a Turkish population in the context of CRP serum levels which may contribute to susceptibility to the disease. We analysed the distribution of NFKB1-94 ins/del ATTG rs28362491 and TLR2 Arg753Gln rs5743708 polymorphisms using PCR-RFLP method and CRP serum levels using ELISA method in 213 MO and 200 healthy controls. The frequency of the ins/ins genotype and ins allele of rs28362491 was significantly higher in the patients compared to control group (P: 0.0309; P: 0.0421, respectively). Additionally, the frequency of GG genotype and G allele of rs5743708 was found to be statistically higher in the patient group (P: 0.0421; P < 0.0001, respectively). In addition, serum CRP levels (>20 mg/l) in MO patients with ins/ins genotype were significantly higher than in patients with del/ins genotype (P: 0.0309). Serum CRP levels were also higher in MO patients with GG genotype and G allele (P: 0.0001). According to combined analysis, the wild type of rs28362491 and rs5743708 polymorphisms (ins/ins/GG genotype) was also significantly higher in the patient group versus the control group when compared with the combined ins/ins/GA and del/ins/GA genotype (P < 0.0001). Therefore, our findings suggest that rs28362491 and rs5743708 polymorphisms were significantly associated with MO disease through acting by modulating serum CRP levels.

A novel AVP gene mutation in a Turkish family with neurohypophyseal diabetes insipidus

PURPOSE

Familial neurohypophyseal diabetes insipidus (FNDI) is a rare, autosomal dominant, inherited disorder which is characterized by severe polydipsia and polyuria generally presenting in early childhood. In the present study, we aimed to analyze the AVP gene in a Turkish family with FNDI.

METHODS

Four patients with neurohypophyseal diabetes insipidus and ten healthy members of the family were studied. Diabetes insipidus was diagnosed by the water deprivation test in affected family members. Mutation analysis was performed by sequencing the whole coding region of AVP-NPII gene using DNA isolated from peripheral blood samples.

RESULTS

Urine osmolality was low (<300 mOsm/kg) during water deprivation test, and an increase more than 50 % in urine osmolality and recovery of the symptoms were observed by the administration of desmopressin in all patients. Plasma copeptin levels were lower than expected according to plasma osmolality. Pituitary MRI revealed partial empty sella with a bright spot in index patient and a normal neurohypophysis in the other affected subjects. Genetic screening revealed a novel, heterozygous mutation designated as c.-3A>C in all patients.

CONCLUSION

c.-3A>C mutation in 5'UTR of AVP gene in this family might lead to the truncation of signal peptide, aggregation of AVP in the cytoplasm instead of targeting in the endoplasmic reticulum, thereby could disrupt AVP secretion without causing neuronal cytotoxicity, which might explain the presence of bright spot. The predicted effect of this mutation should be investigated by further in vitro molecular studies.

Comparison of different femoral fixation implants and fit techniques for tunnel widening and clinical outcome in ACL reconstruction using hamstring autograft

PURPOSE

The purpose of the current study is to investigate in different femoral fixation devices whether tight (undersize drilled) fit technique decreases the tunnel widening and improves the clinical outcome compared to conventional technique in ACL reconstruction using hamstring tendon autograft.

METHODS

93 patients, who underwent Arthroscopic ACL reconstruction whether cortical-cancellous suspension (CP) or cortical suspension (BF) used as fixation device for the hamstring tendon autograft, were included in the study. The cases also grouped as undersize drilled (tight fit) and normal drilled (normal fit) according to their autograft size. There was no difference in demographic data of these four subgroups (CP-TF, CP-NF, BF-TF, and BF-NF) preoperatively.

RESULTS

The patients, who had been followed for at least 2 years were included in the study. They were looked for their clinical outcome (Lysholm and IKDC scoring), tunnel widening (on AP and lateral radiographs), and also anterior translation. The BF-TF subgroup showed significantly the best clinical results compared to other three subgroups. There was no difference between BF-TF, CP-TF, and CP-NF in terms of tunnel widening.

CONCLUSION

Button fixation of femoral side in ACL reconstruction surgery has good clinical outcome and lower complication rate. Undersize drilling might be preferred in button fixation in order to reduce TW and improve stability and clinical satisfaction.

LEVEL OF EVIDENCE

Therapeutic case series, Level IV.

Anti-inflammatory effects of curcumin in a murine model of chronic asthma

BACKGROUND

Curcumin, a dietary pigment responsible for the yellow colour of curry, has been used for the treatment of inflammatory diseases and exhibits a variety of pharmacological effects.

METHODS

Forty-two BALB/c mice were divided into six groups: I, II, III, IV, V, and control group. All groups except the controls were sensitised and challenged with ovalbumin. Group I received nebulised saline in challenge period. Mice in groups II, III, IV, and V were administered curcumin at a dose of 10 mg/kg, curcumin 20 mg/kg, dexamethasone 1 mg/kg, and dimethyl sulfoxide 1 mg/kg, respectively, intraperitoneally once a day for the final 5 days of the challenge period. Animals were sacrificed 24 h after the last drug administration and the airway samples were evaluated histologically by light microscopy.

RESULTS

All histological parameters in Group III improved similar to Group IV when compared to Group I. In Group II, only thickness of epithelium was significantly lower compared with regard to Group I. All variables except epithelium thicknesses were found to be significantly better in Group III compared to Group II.

CONCLUSIONS

In our study, we demonstrated that curcumin administration alleviates the pathological changes of chronic asthma. Curcumin might be a promising therapy for asthma in the future.

Beneficial effects of erythropoietin on airway histology in a murine model of chronic asthma

BACKGROUND

Erythropoietin (EPO) is originally defined as a haematopoietic growth factor, but also has anti-inflammatory effects through cytokine modulation. This anti-inflammatory and cytokine modulating effect has not been investigated for the treatment of asthma. We aimed to determine the beneficial effects of erythropoietin on lung histology of murine model of chronic asthma.

METHODS

Thirty-five BALB/c mice were divided into five groups: I; II; III; IV; and control group. All groups except control group were sensitised and challenged with ovalbumin. Mice with experimentally induced asthma in Group I received saline; Group II EPO 500IU/kg; Group III EPO 1000IU/kg; and Group IV dexamethasone 1mg/kg intraperitoneally once a day in the last five days of the challenge period. Animals were sacrificed 24h after the last administration of study drugs. Histological findings of airways were evaluated by light and electron microscopic examination.

RESULTS

All histological parameters of asthma in the group treated with a high dose of EPO (Group III) were significantly ameliorated when compared with the group treated with saline (Group I). In comparison to the group treated with low dose of EPO (Group II) and the group treated with saline (Group I), basement membrane thicknesses and number of mast cells were significantly lower in the group treated with low dose of EPO (Group II). All histological parameters were similar between the group treated with high dose of EPO (Group III) and the group treated with dexamethasone (Group IV) except higher number of mast cells in the group treated with high dose of EPO (Group III). Additionally, the results of all histological parameters in the group treated with high dose of EPO (Group III) were significantly better when compared with the group treated with low dose of EPO (Group II).

CONCLUSIONS

We found that EPO ameliorated histological changes of chronic murine model of asthma. Further studies are needed to evaluate the efficacy of EPO in the treatment of asthma.

Histopathologic changes in two mouse models of asthma

BACKGROUND

No studies to date have compared mouse models of asthma by evaluating airway histopathology.

OBJECTIVE

To compare 2 such models by studying chronic histopathologic changes of the airways using light and electron microscopy.

METHODS

Twenty-one male BALB/c mice were divided into 3 groups: a nebulization group sensitized via an intraperitoneal injection of 10 microg ovalbumin on days 0 and 14 and exposed to 2.5% aerosolized ovalbumin 3 days a week over the subsequent 8 weeks; an intranasal group sensitized via 2 intraperitoneal injections of 100 microg ovalbumin on days 0 and 14 and administered an intranasal dose of 500 microg ovalbumin on days 14, 27, 28, 29, 47, 61, 73, 74, and 75; and a control group that received nothing. Airway histopathologies were evaluated.

RESULTS

Basement membrane, epithelium, and subepithelial smooth muscle layer thicknesses and mast and goblet cell numbers were significantly higher in the nebulization group than in the control group. With the exception of mast cell numbers, these parameters were also significantly higher in the intranasal group than in the control group. On comparing the intranasal and the nebulization group, goblet cell numbers were significantly higher in the former and mast cells in the latter.

CONCLUSION

Both models replicated all the structural parameters of asthma except for mast cell numbers in the intranasal group (no significant difference with respect to the control group). Our findings do not provide sufficient evidence that one protocol is superior to the other. Larger studies are needed to compare different asthma protocols.

Multiorgan involvement in a pediatric patient with hydatid disease

Human Echinococcus infection still remains an important health problem in endemic regions. Herein, we report a 5-year-old boy with hydatid disease who has spleen, lung, kidney and liver involvement simultaneously. To our knowledge, there is no pediatric case with hydatid disease in the literature reporting simultaneous involvement of spleen, kidney, liver and lungs as in our case.

[The frequency of intestinal parasites and head lice among students of the Akşemsettin Primary School for Deaf Students]

Parasitic infections especially affect those children in critical phases of growing and development. They can lead to malnutrition, malabsorption, mental and social adaptation problems, and critical illnesses that hinder productivity. This is an important health problem in Turkey, and intestinal parasites are quite frequently found in boarding school and care centers for children. The aim of this study was to discover and treat the parasitological agents found in the students of the Primary School for Deaf Students. A total of 117 fecal specimens and material from the perianal region (using the cellophane tape method) were collected from deaf students and examined during 2003-2004 school season. Also the students were scanned for adult head lice and their eggs. As a result, 53 (45.3%) children with intestinal parasites and 6 (5.1%) with head lice were detected in the study. The patients were treated and informed about means of protection. The same children were examined again after six months: Only 24 (20.5%) children had intestinal parasites and 2 (1.7%), head lice. Thus, the decrease in parasitic infections was found to be significant (qui-square test in dependent samples P < 0.05). Therefore it was concluded that the schools should be scanned for intestinal parasites and head lice, and both treatment and training in the subject should be given the necessary importance.

Impaired endothelium-dependent flow-mediated dilation in Behçet's disease: more prominent endothelial dysfunction in patients with vascular involvement

Brachial artery endothelial dysfunction was shown previously in a small group of Behçet's disease (BD) patients. This study aimed to compare the endothelial function in BD patients with and without vascular involvement. The study group consisted of 25 BD patients with vascular involvement, 25 BD patients without any vascular disease and 46 healthy controls. Brachial artery flow-mediated (endothelium-dependent) dilation (FMD), nitroglycerine-induced dilation and carotid artery intima-media thickness were measured. FMD was impaired in patients with BD (10.41 +/- 3.85%) compared to healthy controls (14.41 +/- 3.39%, p < 0.001). FMD was significantly lower in BD patients with vascular involvement (8.80 +/- 3.63%) than those without any vascular disease (12.02 +/- 3.43%, p = 0.003). This study reveals that endothelial dysfunction documented by brachial artery FMD is a feature of BD, and it is more prominent in patients with vascular involvement.

Tuberculosis in Turkish patients with systemic lupus erythematosus: increased frequency of extrapulmonary localization

The objective was to investigate the frequency and characteristics of tuberculosis (TB) in patients with systemic lupus erythematosus (SLE). We reviewed the charts of 556 patients with SLE who were followed up between 1978 and 2001 in our lupus clinic. Patients who developed TB after the diagnosis of SLE were identified (SLE/TB+). Ninety-six consecutive patients with SLE who did not develop TB during the follow-up were evaluated as a control group (SLE/TB-). Clinical, laboratory and management characteristics of these two groups of patients were recorded according to a predefined protocol, and compared. Of the 556 patients evaluated, 20 patients (3.6%) with TB were identified. Nine of the 20 patients (45%) had extrapulmonary TB (vertebral involvement in three patients, meningeal in two, and joint and soft tissue in four). Arthritis and renal involvement were significantly high in the SLE/TB+ group (P = 0.045, P = 0.009, respectively). The mean daily dose of prednisolone before the diagnosis of TB and the cumulative dose of prednisolone were significantly higher in the SLE/TB+ group compared to the SLE/TB- group (27 +/- 22 g versus 16 +/- 16 g, 24 +/- 45 mg versus 11 +/- 8.5 mg, respectively). In conclusion, we found an increased frequency of TB infection and a high prevalence of extrapulmonary TB in a large cohort of SLE patients. The mean daily dose of prednisolone before the diagnosis of TB and the cumulative dose of prednisolone, which possibly related to disease severity, were important determinants for the increased risk of TB in these patients with SLE.

Evaluation of montelukast in 8 to 14 year old children with mild persistent asthma and compared with inhaled corticosteroids

OBJECTIVES

To determine the clinical effectiveness, tolerability and reliability of montelukast and to compare this drug with inhaled corticosteroids.

METHODS

We performed a randomized, 14-week, 2-period, prospective parallel group study. After a 2-week run-in period, patients received treatment for 12 weeks. Sixty-three clinically stable outpatients aged 8 to 14 years with a history of mild persistent asthma for at least 1 year and a forced expiratory volume in one second (FEV1) greater than 80 % of the predicted value were evaluated.

RESULTS

Montelukast produced improvement in airway obstruction, daily symptom scores, total daily as-needed beta-agonist use, nocturnal awakenings, percentage of days and percentage of patients with asthma exacerbations, and urinary leukotriene E4 levels. These beneficial effects were similar to those produced by inhaled corticosteroids. There were no significant adverse effects requiring treatment discontinuation.

CONCLUSIONS

Montelukast may be a well-tolerated and effective therapeutic option in 8 to 14-year-old patients with mild persistent asthma.

Retrospective evaluation of epidermal skin prick tests in patients living in Aegean region

Sensitization to aeroallergens of Aegean region is not well decumented. In this study we evaluated the epidermal skin prick test results of the patients who applied to allergy outpatient department retrospectively. Epidermal skin prick test of the 5055 patients were evaluated. Of these patients 2638 (52 %) were female, 2417 (48 %) male, 1213 (24 %) adult and 3842 (76 %) pediatric patient, 1163 (23 %) patients were allergic rhinitis, 2477 (49 %) were bronchial asthma, 505 (10 %) were allergic rhinitis with bronchial asthma, 556 (11 %) were chronic urticaria, 253 (5 %) were wheezy infant and 101 (2 %) patients were atopic dermatitis, 2932 (58 %) had atopy history in their first and second degree relatives. Patients were aged between 3.5 months and 79 years (mean 14.1 3.2 years and median 11 years). In epidermal skin prick tests sensitization to house dust mites (D. farinae, D. pteroniyssinus), pollens (grass, cereals and trees), moulds, animal danders, foods (especially in early childhood) and cockroach were evaluated. Our data indicate that allergens that may be the cause of the high prevalence of allergic diseases in Izmir are probably produced by pollens and mites.

Lipoprotein profile in long term theophylline administration in children with asthma

Atherosclerosis in childhood has a slowly progressive course and its clinical features usually become prominent in middle ages. Hypercholesterolemia is one of the major risk factors for the development of atherosclerosis. A clear correlation exists between hypercholesterolemia in childhood and atherosclerotic lesions extending into adulthood.In this study, we evaluated the effect of slow release theophylline (SRT) treatment on plasma lipid profile and assessed the risk for atherosclerotic coronary heart disease in children with bronchial asthma. Group 1 consisted of 15 children with a mean age of 10.8 3.19 years who received SRT for bronchial asthma for a mean period of 9.13 2.17 months. Group 2 was composed of 15 children with a mean age of 11.40 3.78 years and followed up for bronchial asthma, who received no SRT treatment. Group 3 comprised 15 children with a mean age of 9.00 3.76 years and no history of asthma or wheezing. In all patients lipid profiles were assessed by measuring levels of plasma triglyceride, total cholesterol, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) apolipoprotein A (Apo-A) and apolipoprotein B (Apo-B). In group 1, the mean total cholesterol level was 175.53 24.36 mg/dl, LDL-C level was 91.00 24.07 mg/dl and Apo-B level was 87.27 12.74 mg/dl after SRT treatment. In group 1, group 2 (control group with asthma) and group 3 (the non-asthmatic control group), the mean plasma lipid level after SRT treatment was significantly higher than that before SRT treatment. In conclusion, long-term SRT treatment in children with bronchial asthma may alter lipid profile and may increase the risk for developing atherosclerotic coronary heart disease.

The comparison of the efficacy of fluticasone propionate with cetirizine in perennial allergic rhinitis

BACKGROUND

Allergic rhinitis is an IgE mediated hypersensitivity reaction of the nasal mucosa characterised by nasal discharge, obstruction, and pruritus.

PATIENTS AND METHODS

In this study, 43 patients with perenneal allergic rhinitis were enrolled in order to compare the efficacy of Fluticasone Propionate (FP), a corticosteroid nasal spray, with Cetirizine, a systemic oral antihistaminic preparation, which is supposed to have nonsteroidal antiinflammatory activity. Cetirizine (10 mg daily as a single dose) was administered to 22 patient for 45 days. On the other hand, FP (400 micrograms/day) was administered into each nostril twice a day in the remaining 21 patients for 45 days. Skin test was obtained from each patient before therapy. Total eosinophil count, eosinophil count in nasal smear, electrorhinomanometric investigation, PGE2 and ratio of LTC4 to LTD4 both in the serum and in the nasal secretions were determined before and after therapy. In addition, percentage of eosinophils, and mast cells count in the biopsy specimens taken from anterior edge of middle choncha were evaluated before and after therapy, and than the results were graded for each patients.

RESULTS

When we compared the eosinophil count in nasal smear, eosinophil percentage and total eosinophil parameters between two groups, it was shown that FP was more effective than Cetirizine. On the other hand, when we compared the ratio of LTC4 to LTD4 in serum and nasal smear, level of PGE2 and mast cell and nasal airway resistance measured by ERM, there were non statistical difference between two groups.

CONCLUSION

These results suggest that FP and Cetirizine may be used alternatively in case of an adverse reaction to any of them.

Results of the gastroesophageal reflux assessment in wheezy children

Gastroesophageal reflux (GER) is implicated in the pathogenesis of respiratory symptoms in childhood. It should be taken into account especially in the differential diagnosis of children presenting with wheezing. Although, oesophageal pH monitorization has been reported to be the best technique in the evaluation of GER, radionuclide studies have also been shown to be very sensitive recently. In this study, 82 children presenting with recurrent wheezing (n = 74) and/or vomiting (n = 28) (mean age 17.4 months; range 3-48 months) were evaluated. GER scintigraphy was performed to determine the frequency of GER. GER was determined in 18 of the 82 cases (21.9%). The GER was found in 21.1% of children with recurrent wheezing and in 16.6% of children suffering from recurrent vomiting. GER scintigraphy should be kept in mind in the evaluation of children with the complaint of recurrent wheezing since it is a noninvasive and easily applicable method.

IgG subclasses in wheezing infants

The wheezing infant is a common but difficult patient to approach diagnostically. The prevalence of IgG subclass antibody deficiency in wheezing infants is still controversial. We studied serum concentration of IgG subclasses in 38 wheezing infants (aged 6-24 months who had not received systemic steroids before investigation) and in 30 healthy age matched control (aged 6-24 months). The prevalence of one or more IgG subclass deficiency was 31.6% in wheezing infants and 26.7% in controls. There was no significant difference in prevalence of IgG subclass deficiency between patients and controls (p > 0.05). The mean concentration of IgG subclasses in patients were compared with controls. There was no significant difference in mean serum concentration of IgG1, G2 and G3 subclasses. But there was a trend towards higher concentrations of IgG4 in wheezing infants and this difference for IgG4 was significant (p < 0.01). However, IgG subclass deficiency was found in 25% and 36.4% of wheezing infants who had experienced from two to four and five or more wheezing episodes in two years, respectively (p > 0.05). These findings suggest that wheezing in infancy is not associated with IgG subclass deficiency and in wheezing infants low IgG subclass levels do not increase the frequency of wheezing.

Risk factors in wheezing infants

BACKGROUND

Some lifestyle factors may be important for the occurrence of wheezing and there are considerable differences around the world.

METHODS

Risk factors of wheezing were examined in 38 children (aged 6-24 months). Results were compared with healthy age-matched controls.

RESULTS

Family history of atopy, asthma and eczematoid dermatitis, and parental and pregnancy smoking were all reported as being substantially more common in wheezing infants than in controls (P < 0.05 for each parameter). Living conditions showed that the incidence of wheezing in infants was more common in households with wooden floor coverings compared with controls, which used plastic floor coverings (P < 0.05). They also showed that 55.3% of wheezing infants and only 20% of controls were living in moist dwelling environments (P < 0.05). With regard to bedding, the incidence of wheezing in infants was higher in households using synthetic materials compared with controls (P < 0.05). A history of in utero and environmental tobacco smoke exposure was associated with increased risk of recurrent wheezing. Odds ratio and logistic regression analysis were done with presence of wheezing as the dependent variable and all risk factors of interest as independent variables. Family history of atopy, high household humidity levels, parental smoking and wooden floors used in the home were significant risk factors for wheezing. Skin test positivity and gastroesophageal reflux were determined in wheezing infants as 18.4 and 13.2%, respectively.

CONCLUSION

Recurrent wheezing in infancy may be associated with many environmental and genetic factors. It is possible that allergen avoidance merely delays rather than prevents the development of allergic disorders.

Immunoglobulin G subclasses in wheezing infants

BACKGROUND

The wheezing infant is a common but difficult patient to approach diagnostically. The prevalence of immunoglobulin (Ig) G subclass deficiency in wheezing infants is still controversial.

METHODS

We studied the serum concentration of IgG subclasses in 38 wheezing infants (aged 6-24 months) who had not received systemic steroids before investigation and in 30 healthy age matched controls (aged 6-24 months).

RESULTS

The prevalence of one or more IgG subclass deficiencies was 31.6% in wheezing infants and 26.7% in controls. There was no significant difference in prevalence of IgG subclass deficiency between patients and controls (P > 0.05). The mean concentration of IgG subclasses in patients were compared with controls. There was no significant difference in mean serum concentration of IgG1, G2 and G3 subclasses. However, there was a trend towards higher concentrations of IgG4 in wheezing infants and this difference for IgG4 was significant (P < 0.01). Immunoglobulin G subclass deficiency was found in 25 and 36.4% of wheezing infants who had experienced from two to four and five or more wheezing episodes in 2 years, respectively (P > 0.05).

CONCLUSION

Our findings suggest that wheezing in infancy is not associated with IgG subclass deficiency, and in wheezing infants low IgG subclasses levels do not increase the frequency of wheezing. However, there is a relationship between recurrent wheezing and serum IgG4 subclass concentration.

The effects of L-carnitine on respiratory function tests in children undergoing chronic hemodialysis

Respiratory functions are affected during hemodialysis. Ultrafiltration rate, acid-base balance and the strength of respiratory muscles have been suggested as important factors in adults undergoing chronic hemodialysis. L-carnitine is crucial for energy producing utilization fatty acid and, possible amino acids. Carnitine treatment has been associated with hypertrophy of type I muscle fibers. Carnitine supplementation in nondialysis patients increases exercise tolerance. Eventually, administration of L-carnitine to adult hemodialysis patients improves exercise capacity, energy metabolism and muscle mass. The study was performed to investigate the chronic effects of L-carnitine treatment on respiratory functions in children receiving chronic hemodialysis therapy. Predialytic and postdialytic respiratory function tests were performed in ten children with end-stage renal disease before and after a three-month L-carnitine treatment period. The mean age was 12 +/- 4 years. L-carnitine was administered at a dose of 20 mg/kg intravenously at the end of each hemodialysis session. Mean predialytic serum carnitine value before and after the carnitine treatment period were 21.8 +/- 3 and 132.0 +/- 48.5 mmol/L, respectively, and the increase was significant (p < 0.05). Respiratory function tests performed just before the carnitine treatment period implied bronchospasm that was clinically vague and could only be detected by a significant decrease in FEV1/FVC, PEF and FEF25-75 values (p < 0.05). Nevertheless, at the end of the three-month carnitine therapy period these respiratory function parameters did not show any significant variation. Hence, it is implied that carnitine therapy might have prevented the subclinic bronchospasm that developed in children during hemodialysis.

Biacromical and biiliac length and chest circumference measurements of male Turkish adolescents according to biological maturation

Adolescence is a period which is characterized by rapid physical growth and development of secondary sex characteristics. Male adolescence begins at 11-12 years of age and lasts approximately 5 years. During this interval, there is a growth spurt period which is observed any time between 11 and 16 years of age, lasting 2-3 years. Some authors claim that a male may have nearly 20-25% of his adult height and 50% of his adult weight during adolescence. When evaluating the maturational aspects of adolescence, it is essential to consider bone age (BA) as well as chronological age (CA). Bone age is the mean CA at which the skeletal maturation is normally attained. It is influenced by genetic, endocrinological and nutritional factors. An adolescent may not demonstrate the expected maturational steps if his BA is retarded. This report examines the relationship between CA, biological maturation and some anthropometrical measurements.

Height and weight measurements of male Turkish adolescents according to biological maturation

Eight hundred and seventy-nine Turkish male adolescents aged between 11 and 19 years were investigated with respect to their physical development. Bone ages were considered as well as chronological ages in determining biacromial (BAC), biiliac lengths (BIC) and chest circumference (CC). Different bone and chronological ages were obtained at the same chronological age (CA) and bone age (BA) columns. The importance of bone ages in evaluating an adolescent's physical development was shown to be as important as the chronological ages. In this study, the mean BAC, BIC and CC values between the same CA but different BA groups showed statistically significant differences (P < 0.001). When the measurements of two consecutive age groups who had the same CA and BA and who were found to be statistically significant (P < 0.05) were compared, the maximum increments in BAC and BIC values which were between 13 and 14 years of age (2 and 1.4 cm, respectively) were similar to the maximum increment in height and weight of Turkish male adolescents found between 13 and 14 years of BA. The maximum increment in CC values which were between 14 and 15 years and 15 and 16 years (4.1 cm each) was 1 year after the maximum increment in height and weight for BA of Turkish male adolescents (13-14 years) and was similar to maximum weight increment for CA which was between 15 and 16 years.