Analysis of superoxide dismutase activity levels in gingiva and gingival crevicular fluid in patients with chronic periodontitis and periodontally healthy controls

OBJECTIVES: Superoxide dismutase (SOD) is an antioxidant enzyme that acts against superoxide, an oxygen radical, released in inflammatory pathways and causes connective tissue breakdown. In this study, SOD activities in gingiva and gingival crevicular fluid (GCF) from patients with chronic periodontitis (CP) and periodontally healthy controls were compared. MATERIAL AND METHODS: Twenty-six CP patients and 18 controls were studied. In patients, teeth with moderate-to-severe periodontal breakdown and > or =5 mm pockets that required full-thickness flap surgery in the right or left maxillary quadrant, and in controls, teeth scheduled for extraction for orthodontic reasons were studied. After the clinical measurements (probing depth, clinical attachment level, gingival index, gingival bleeding index, plaque index), GCF samples were collected. Tissue samples were harvested from the same teeth, during flap operation in patients and immediately after tooth extraction in controls. SOD activities were spectrophotometrically assayed.The results were statistically analysed. RESULTS: Gingival SOD activity was significantly higher in the CP group than in controls (p<0.05). No significant difference was found in GCF SOD activity between the groups (p>0.05). Correlations between gingival and GCF SOD activities were not statistically significant in CP and control groups (p>0.05). CONCLUSION: In CP, SOD activity seems to increase in gingiva, probably as a result of a higher need for SOD activity and protection in gingiva in CP than in periodontal health, while not significantly changing in GCF, suggesting a weak SOD activity in GCF in periodontal disease state. The weak correlation between gingival and GCF SOD activities suggests distinct actions of these SODs.     

David's procedure for pulmonary artery aneurysm

Pulmonary artery aneurysm (PAA) is a rare entity with fatal complications. Its silent course contributes to large aneurysms with compression symptoms. We present a 39-year-old female idiopathic pulmonary arterial hypertension patient with a giant PAA causing severe pulmonary regurgitation (PR) and symptomatic left main coronary artery compression (LMCA). Since she had a failed LMCA stenting attempt, she underwent surgery. A valve-sparing David-like pulmonary trunk reconstruction and coronary artery bypass were performed. This case illustrates that David-like reconstruction procedure can be applied to the PAA with severe PR.     

Pinealectomy Does Not Affect the Healing of Experimental Colonic Anastomoses

Gastrointestinal system anastomoses, especially colonic anastomoses, have significant morbidity and mortality despite recent technical improvements. Besides regulating the circadian rhythm, the pineal gland and its main neurohormone product melatonin have widespread actions in the organism. The purpose of this study was to investigate the effects of pinealectomy on the healing of colonic anastomoses. One hundred male albino Wistar rats were used in this study. The rats were separated into three groups: control, pinealectomy, and sham groups. In the control group, only colonic resection and anastomoses were performed. Following pinealectomy, colonic anastomosis was performed 2 weeks later on one half and 2 months later on the other half of the pinealectomy group. Only craniotomy was performed on the sham group, and the rats were separated and evaluated like the pinealectomy group. Colonic anastomoses were evaluated on postanastomotic day 3 and 7 by measuring the bursting pressure and the hydroxyproline levels in the anastomotic segments. There was no difference in the bursting pressure measurements between the groups on both postoperative day 3 and 7. Although hydroxyproline levels were different between groups on both postanastomotic days 3 and 7, it has been observed that neither normal nor anastomotic hydroxyproline levels influenced the anastomotic bursting pressure measurements. The percent deviation from the normal values was compared in the anastomotic segments, and no differences were found regarding the bursting pressure and hydroxyproline levels. It was concluded that pinealectomy has no effect on the healing of colonic anastomoses.     

PC-1基因K121Q多态性与2型糖尿病合并视网膜病变的相关性研究

目的探讨浆细胞膜糖蛋白(PC-1)基因K121Q多态性与2型糖尿病合并视网膜病变的相关性。方法应用聚合酶链反应-限制性酶切片段长度多态性分析(PCR-RFLP)技术,对2型糖尿病合并视网膜病变(DR组,n=48)、2型糖尿病未合并视网膜病变(NDR组,n=56)进行PC-1基因K121Q多态性分型及研究,并与正常组(对照组组,n=56)对照分析。结果 DR组和NDR组KQ基因型频率、K等位基因频率均显著高于对照组组,差异有统计学意义(P<0.05);DR组和NDR组比较,KK型与KQ型基因型构成频率和等位基因频率差异无统计学意义(P>0.05)。结论 PC-1基因K121Q多态性与2型糖尿病相关,但其可能不是糖尿病视网膜病变发生的主要原因。     

A prospective study of hepatocellular carcinoma incidence in thalassemia

Hepatocellular carcinoma (HCC) is a complication of cirrhosis. Due to blood transfusions, patients with beta-thalassemia (thal) are often infected with either hepatitis C virus (HCV) or hepatitis B virus (HBV). In the past, many patients did not survive long enough to develop HCC. The recent improvements in prognosis have helped in the diagnosis of HCC that has developed. The aim of this study was to evaluate HCC incidence in beta-thal. We performed liver ultrasound (US) on all adults without a previous diagnosis of HCC. Risk factors (iron overload, HCV infection, HBV infection, cirrhosis) were evaluated. One hundred and eight thalassemia patients have been evaluated; of whom three were excluded (two patients as they were under the age of 18 years and one patient because he had a previous history of HCC). Seventy-two patients [31 had thalassemia major (TM), 41 had thalassemia intermedia (TI)] with risk factors (iron overload in 72, HCV infection in 46, HBV infection in two, cirrhosis in 10) and 33 (four with TM and 29 with TI) without risk factors underwent liver US. Overall, two patients were found to have a newly developed HCC. Of these two patients, one was treated with surgery and the other with percutaneous radiofrequency. Further follow-up did not show any evidence of recurrence after 23 and 15 months, respectively. Ultrasound screening can allow early detection and treatment of HCC in thalassemia patients.     

Quantitative evaluation of oxidative stress status on peripheral blood in beta-thalassaemic patients by means of electron paramagnetic resonance spectroscopy

High oxidative stress status (OSS) is known to be one of the most important factors determining cell injury and consequent organ damage in thalassaemic patients with secondary iron overload. Using an innovative hydroxylamine 'radical probe' capable of efficiently trapping majority of oxygen-radicals including superoxide we measured, by electron paramagnetic resonance (EPR) spectroscopy, OSS in peripheral blood of 38 thalassaemic patients compared with sex-/age-matched healthy controls. Thalassaemic patients showed sixfold higher EPR values of OSS than controls. Significantly higher EPR values of OSS were observed in those with a severe phenotype (thalassaemia major, transfusion-dependent) with respect to mild phenotype (sickle-cell/beta-thalassaemia, not transfusion-dependent) or thalassaemia intermedia. In patients with thalassaemia major, EPR values of OSS were positively correlated with serum ferritin and with alanine aminotransferase levels. In patients with sickle cell/beta-thalassaemia, there was no correlation between EPR value of OSS and all parameters considered. The type of chelating therapy (desferrioxamine or deferiprone) did not have an effect on EPR value of OSS. In conclusion, EPR 'radical probe' seems to be a valid innovative method to determine total OSS in patients affected by thalassaemia and might be used for evaluating new strategies of chelation, new chelators, or the efficacy of antioxidant formula.     

Can only histological evaluation determine the allocation of ECD kidneys?

Introduction

There is a recent debate on the "transplantability" of ECD (Expanded Criteria Donors) kidneys and the selection criteria used to allocate them to single or double transplantation. Remuzzi et al. have defined a protocol incorporating pre-transplant donor biopsy to guide the use of older donor organs. They allocated organs as single or double transplants on the basis of histological findings. We aim to show the pros and cons of the only histological evaluation in the allocation of ECD kidneys, to compare the different experiences in United States and Europe and thus to discuss whether this tool should be used alone or included in a comprehensive clinical and histopathological evaluation.

Discussion

In the United States many Authors stated that the biopsy actually increases the percentage of kidney discarded and they raised questions about the importance of the biopsy in evaluating ECD kidneys for transplantation. On the other hand, the experiences of the majority of european transplant centers showed that allocating kidneys as single or dual transplant based on biopsy findings may achieve good graft and patient outcomes.Moreover, the experience of some centers as ours showed that kidneys allocated as DKT (Dual Kidney Transplant) on the basis of Remuzzi’s score could have been suitable for single transplantation suggesting the need of an adjustment of the Remuzzi Score System. Many Authors, who are in favor of histological evaluation, actually believe that a comprehensive clinical and histopathological assessment before transplantation remains necessary.

Summary

We lack precise national- or international-based selection criteria to guide clinicians. An adjustment of the Remuzzi Score System could be taken into consideration such as narrowing the indication for DKT from those ECD kidneys with higher scores and including the histological evaluation in a multifactor score.

     

Serum heavy metal and antioxidant element levels of children with recurrent wheezing

Study ObjectivesThe aim of the study is to investigate the levels of toxic heavy metals related with environmental pollution and trace elements involved in antioxidant system in children suffering from recurrent wheezing.Study DesignOne hundred children with recurrent wheezing (at least three recurrences) between the ages from 1 to 6 years took part in the study, and also 116 age- and sex- matched healthy children were involved in the study as a control group. Venous blood samples were collected and serum mercury, lead, aluminium, zinc, selenium, and copper levels were studied using ICP-MS.ResultsSerum lead (0.76 ± 0.15 vs. 0.27 ± 0.01, p:0.001) and mercury levels (1.31 ± 0.15 vs 0.71 ± 0.05, p < 0.001) were higher in wheezy group than those acquired from the control group. Serum zinc (69.4 ± 1.65 vs. 78.9 ± 2.78, p:0.005) and selenium (115.6 ± 1.87 vs. 125.4 ± 2.94, p:0.008) levels were lower in wheezy group than those acquired from the control group. Serum zinc levels were found to be correlated with number of ARTIs (r_p:?0.332, p:0.001) and the number of wheezy attacks (r_p:?0.776, p < 0.001) during the previous year in the wheezy group.ConclusionElevated levels of serum lead and mercury and low levels of zinc and selenium may suggest some disturbances in the antioxidant system in children with recurrent wheezing. This means that children with recurrent wheezing are much more susceptible to environmental pollutants and respiratory tract infections than healthy children and this heavy metal-antioxidant relationship may play a role as a contributing factor in the pathogenesis of recurrent wheezing in children.     

Views of regulatory authorities on standards to assure quality in online nursing education

BackgroundWith the rapid growth in online education programs in nursing, quality of education through this modality is becoming of greater importance.PurposeThis paper aims to explore current recommendations and standards for quality in online nursing education offered by nursing regulatory, accrediting, and licensing organizations.MethodIndividual interviews were conducted with the leaders from four accrediting, licensing and certifying organizations in nursing about their perspectives on quality standards for online education.FindingsThe following themes emerged from the qualitative interviews: Theme 1- Standards are not specific to online education; Theme 2-This is not up to us - Professional organizations can offer recommendations but not responsible for regulations; and Theme 3- Each institution has responsibility to provide support and evaluate the quality of online education.DiscussionSchools of nursing should continue to incorporate current standards for quality in online education as the methods of delivery continue to evolve in this highly technologically-oriented world.