Adenosine deaminase, nitric oxide, superoxide dismutase, and xanthine oxidase in patients with major depression: impact of antidepressant treatment

BACKGROUND: There has been much evidence in recent years that free oxygen radicals and nitric oxide (NO) may play an important role in the pathophysiology of neuropsychiatric disorders. In this study, we aimed to investigate whether NO, xanthine oxidase (XO), superoxide dismutase (SOD), and adenosine deaminase (ADA) levels are associated with major depression (MD) and to evaluate the impact of antidepressant treatments on NO, SOD, ADA and XO levels in MD. METHODS: Thirty-six patients who were diagnosed as MD according to DSM-IV criteria and 20 healthy controls were included. The serum levels of NO, XO, SOD, and ADA were measured by spectrophotometric methods both in patients and controls. Patients were treated with antidepressant drugs for 8 weeks. All patients were assessed by Hamilton Depression Rating Scale (HDRS) both before and after antidepressant treatment. RESULTS: ADA and XO levels of the patients were significantly higher than the controls. SOD level of the patients was significantly lower than the controls. Although NO levels of the patients were higher than the controls, the difference was not statistically significant. There was no correlation between HDRS and the parameters studied (SOD, ADA, XO, and NO) of the patients. After 8 weeks of antidepressant treatment, ADA and SOD activities were increased, whereas NO and, XO levels decreased significantly. CONCLUSIONS: ADA, XO, and SOD activity may have a pathophysiological role in MD and may predict prognosis of MD. Activity of these enzymes may be used to monitor effects of the antidepressant treatment.     

Vascular endothelial growth factor production by rat granulated metrial gland cells and their morphological features in normal and pathological conditions

Granulated metrial gland (GMG) cells are pregnancy-specific cells that may have many functions in successful placentation and pregnancy. In the present study, changes in the rat GMG cell structure, distribution and vascular endothelial growth factor (VEGF) expression during early pregnancy were evaluated by light microscopy. Implantation sites taken from females with spontaneous abortion were also investigated. On Day 7 of pregnancy, GMG cells were distributed through the implantation and interimplantation sites. They formed metrial glands in the mesometrial triangle on Day 9, and were observed in the decidua basalis on Day 14 of pregnancy. Avidin-biotin complex immunohistochemistry revealed that GMG cells showed moderate staining for VEGF at the beginning of pregnancy and intense staining on Days 9 and 10 of pregnancy. They were localised mostly near the newly formed blood vessels. The implantation sites from spontaneously aborting females showed numerous leucocytes in the lumen of mesometrial blood vessels. In spontaneously aborting females, GMG cells showed a distinct morphology, increased in number and volume, their granules were denser and degranulation was observed. These results suggest that rat GMG cells might be a guide for placental angiogenesis and they might share a role with leucocytes in pathological conditions.     

ERCP in the diagnosis and management of complications after surgery for hepatic echinococcosis

BACKGROUND: Surgery for liver hydatidosis can result in serious morbidity and mortality. The role and efficacy of ERCP in the management of these complications was reviewed. METHODS: Retrospective analysis of 79 patients with liver hydatidosis who underwent ERCP for postoperative complications. RESULTS: All patients with biliary fistulas (n = 50) were managed by endoscopic sphincterotomy, although 9 (18%) also required a biliary endoprosthesis. Surgical reintervention was avoided in 46 (92%) patients with subsequent surgery required in only in 4 (8%). The mean time to fistula closure was 13.3 days. Patients with daughter cysts in the bile ducts (n = 7) were also treated by endoscopic sphincterotomy and evacuation of obstructing cyst material. Seven patients with elevated liver enzymes or biliopancreatic symptoms but normal ERCP findings also underwent endoscopic sphincterotomy with normalization of biochemical tests. CONCLUSIONS: ERCP is valuable for detecting and treating postoperative biliary complications after surgery for hepatic echinococcal disease. In the majority of patients, endoscopic sphincterotomy allows healing of postoperative external biliary fistulas, and should be performed as early as possible. In some cases, a biliary prosthesis may be required. Endoscopic sphincterotomy also enables clearing of the bile ducts of hydatid remnants.     

Evaluation of the clinical presentations in neurobrucellosis.

BACKGROUND: Brucellosis is a multisystem disease that may present with a broad spectrum of clinical manifestations and complications. Neurobrucellosis is one of the complications. METHODS: In this study, we describe our experience in the diagnosis, treatment, and the final outcomes of 20 patients with neurobrucellosis out of 305 patients with brucellosis, within a five-year period between January 1999 and June 2004. RESULTS: The rate of neurobrucellosis was 6.6%. Twelve males and eight females with a mean age of 37.4 years were investigated. Fever, headache, confusion, and gait disorders were the main complaints. The duration of their complaints varied between one week and six months. On physical examination, 13 patients had fever, six had neck stiffness and confusion, three had motor deficit on either their upper or lower extremities, and four of them had diplopia. The Rose-Bengal test and standard tube agglutination tests were positive in all of the patients. Brucella melitensis was isolated from the blood of six of the 20 (30%) patients. Cerebrospinal fluid (CSF) was analyzed in 18 patients. Pleocytosis with a mean value of 244x10(6)cells/L, and high protein levels were detected in all. A low glucose level in the CSF was detected in ten patients. Patients were treated medically and a complete resolution was achieved in all. CONCLUSION: Patients with a Brucella infection occasionally manifest central nervous system involvement. Clinicians, especially serving in endemic areas or serving patients coming from endemic areas should consider the likelihood of neurobrucellosis in the patients with unexplained neurological and psychiatric symptoms, and should perform the necessary tests on blood and CSF.