Role of ACE I/D gene polymorphisms on the effect of ramipril in inflammatory response and myocardial injury in patients undergoing coronary artery bypass grafts

Background

Angiotensin-converting enzyme (ACE) inhibitors block angiotensin II formation and release bradykinin, which is effective in the regulation of oxidoinflammatory injury. Some reports denote alterations in the effectiveness of ACE inhibitors in association with ACE insertion/deletion (I/D) gene polymorphisms. This study investigates the effects of ramipril on the oxidoinflammatory cytokines (IL-6, IL-8, TNF-alpha) and TnT (myocardial injury marker) and their alteration in association with ACE I/D gene polymorphisms.

Methods

The study group (n?=?51) patients received ramipril before coronary artery bypass grafting (CABG), while patients not receiving ramipril (n?=?51) constituted the controls. TNFα, IL-6, and IL-8 were evaluated using ELISA and TnT by electrochemiluminescence methods before the induction of anesthesia (t1), at the 20th minute following cross-clamping (t2), at the end of the operation (t3), and at the 24th hour from the commencement of anesthesia (t4). Genotyping was performed by PCR.

Results

Differences between the groups were significant at t4 for the TNFα and at t3 for IL-6 (p?p?p?>?0.05). The IL-6, IL-8, TNFα, and TnT serum levels had no correlation with the ACE I/D gene polymorphism.

Conclusion

Low cytokine and TnT levels in the study group, especially after cross-clamping, may indicate the protective effect of ramipril from oxidoinflammatory injury. This effect did not appear to be associated with the ACE I/D gene polymorphism.     

Treatment of vaginal agenesis using a modified McIndoe technique: Long-term follow-up of 23 patients and a literature review

BACKGROUND:

Congenital vaginal agenesis is a rare malformation with an incidence of one in 4000 to 5000 female newborns. The purpose of vaginal agenesis treatment is not only to create an adequate passageway for penetration but also to facilitate satisfactory sexual intercourse.

OBJECTIVE:

To present the results of a modified McIndoe technique with respect to sexual function, vaginal length and complication rates in patients with vaginal agenesis.

METHODS:

Between 2002 and 2010, 23 patients with vaginal agenesis were admitted to the Gynecology Clinic of Istanbul University School of Medicine (Istanbul, Turkey) for vaginal reconstruction. All patients underwent a modified McIndoe procedure. The long-term results with a follow-up period ranging from 18 to 118 months are presented.

RESULTS:

The postoperative mean vaginal length was 8.4 cm (range 6 cm to 11 cm) in 19 patients who used the mould regularly. Among 14 patients who used the mould regularly and had partners, only one experienced severe pain during intercourse and 13 reported that they were engaging in satisfactory sexual activity with mild or no pain, and with good mucosal sensitivity. Conversely, two of three patients who used the mould irregularly experienced severe pain during intercourse and had a mean vaginal length of 6 cm (range 4 cm to 8 cm).

CONCLUSION:

The findings suggest that a modified McIndoe technique is a simple, effective procedure for the treatment of vaginal agenesis; however, proper mould use after surgery remains the cornerstone of the treatment.     

Ventricular repolarization disturbances after high dose intravenous methylprednisolone Theraphy

Objective

There are no randomized trials evaluating the effects of pulse steroid treatment on cardiac electrophysiologic functions. The data are limited only to case series. In this study, we sought to evaluate the effects of high dose intravenous methylprednisolone therapy on indices of ventricular repolarization.

Contribution of Renal Function Impairment to Unexplained Troponin T Elevations in Congestive Heart Failure

Background. Patients with severe congestive heart failure (CHF) often have unexplained elevations in serum concentrations of troponin T (TnT), and it is proposed that this is due to cardiac TnT release because of underlying cardiac disease. We investigated whether impaired renal function is an additional underlying phenomenon contributing to increased TnT levels in patients with CHF. Methods. Sixty-two patients with nonischemic CHF, New York Heart Association (NYHA) class III–IV, with normal coronary angiogram and normal serum creatinine were included in the study. Baseline glomerular filtration rate (GFR) was calculated using the Cockcroft Gault equation. Results. Although mean creatinine level was normal (0.92 ± 0.17 mg/dL), mean GFR was low (56 ± 16 mL/min) in the cohort. Elevated (≥0.02 >g/L) TnT was measured in 33 patients (53%). Compared with patients with normal (<0.02 >g/L) TnT levels, patients with elevated TnT had significantly higher NYHA class (p = 0.02), longer duration of disease (p = 0.02), lower GFR (p = 0.0001), and lower LVEF (p = 0.0001). There were significant associations between TnT levels and duration of disease (r = 0.29, p = 0.01), creatinine (r = 0.30, p = 0.01), GFR (r = ?0.55, p < 0.0001), and LVEF (r = ?0.39, p = 0.001). Independence of these associations was evaluated in multiple linear regression analysis, and serum TnT was independently and negatively associated only with GFR (p = 0.005). Conclusions. Renal function (GFR) correlated significantly and more strongly than cardiac function (LVEF) with the serum TnT levels in patients with CHF. This supports our hypothesis that impaired renal function causes the accumulation of troponin and is very likely the cause of unexplained elevations of serum TnT in patients severe CHF.     

Lumbar disk herniation with contralateral symptoms

The aim of the study is to determine if leg pain can be caused by contralateral lumbar disk herniation and if intervention from only the herniation side would suffice in these patients. Five patients who had lumbar disk herniations with predominantly contralateral symptoms were operated from the side of disk herniation without exploring or decompressing the symptomatic side. Patients were evaluated pre- and postoperatively. To our knowledge, this is the first reported series of such patients who were operated only from the herniation side. The possible mechanisms of how contralateral symptoms predominate in these patients are also discussed. In all patients, the shape of disk herniations on imaging studies were quite similar: a broad-based posterior central-paracentral herniated disk with the apex deviated away from the side of the symptoms. The symptoms and signs resolved in the immediate postoperative period. Our data clears that sciatica can be caused by contralateral lumbar disk herniation. When operation is considered, intervention only from the herniation side is sufficient. It is probable that traction rather than direct compression is responsible from the emergence of contralateral symptoms.     

Morphometric evaluation of cranial base and sella turcica in patients with bilateral agenesis of maxillary lateral incisors

Odontology - The aim of this paper is to evaluate the dimensions and morphology of cranial base and sella turcica in patients with bilateral agenesis of maxillary lateral incisors (BMLI). This...     

Molecular mechanism of vasorelaxant and antiatherogenic effects of the statins in the human saphenous vein graft

In this study we aimed to investigate the vasorelaxant and antiatherogenic effects of the statins (fluvastatin and pravastatin) in the human saphenous vein grafts at the molecular level by using histopathologic, pharmacological and immunochemical techniques. The saphenous vein grafts evaluated histopathologically displayed a loss in their endothelium up to a ratio of 30% and set forth indications of functional deterioration. The pharmacological evaluations proved that the relaxation responses induced by fluvastatin and pravastatin were significantly inhibited by nitric oxide synthase inhibitor, N(G)-nitro-l-arginine, and cyclooxygenase inhibitor, indomethacin, while these responses were significantly increased by angiotensin converting enzyme inhibitors, captopril and enalapril, and rho kinase inhibitor, Y27632. The results of immunochemical studies are in accordance with the results of the pharmacological studies that the related statins increased the levels of nitric oxide, phospholipase A(2) and they decreased the levels of angiotensin II and active rho kinase. On the other hand mevalonolactone, a substrate of lipid metabolism, failed to change the effects of fluvastatin and pravastatin in the related tissue. The experimental results indicate that activation of nitric oxide synthase and phospholipase A(2)-cyclooxygenase pathway and inhibition of angiotensin converting enzyme and rho kinase may have a role on the effects of fluvastatin and pravastatin in the human saphenous vein grafts. It seems that the vasorelaxant and antiatherogenic effects of the related statins are independent of their lipid lowering mechanism.     

Antioxidant and antimicrobial activities of essential oils obtained from oregano (Origanum vulgare ssp. hirtum) by using different extraction methods

In this study, antioxidant and antimicrobial activities of essential oils obtained from oregano (Origanum vulgare ssp. hirtum) were determined by using solvent-free microwave extraction (SFME), supercritical fluid extraction, and conventional hydrodistillation (CH) methods. The inhibitory effects on the 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) radical of essential oils obtained from oregano by using SFME and CH were similar. However, essential oil extracted by CH showed greater (2.69?μmol/μL of oil) Trolox equivalent antioxidant capacity (TEAC) than oregano oils obtained by SFME (P?相似文献