Evaluation of eNOS gene polymorphisms in relation to BMD in postmenopausal women

Objective

The aim of the present study was to evaluate the relations between T⁻⁷⁸⁶C and Glu298Asp polymorphisms of the endothelial nitric oxide synthase (eNOS) gene and BMD in postmenopausal Turkish women.

Methods

The T⁻⁷⁸⁶C and Glu298Asp polymorphisms were genotyped by PCR-RFLP method in 311 postmenopausal osteoporotic women (OP) and in 305 age-matched postmenopausal females (CG) with normal BMD.

Results

None of the SNPs of the eNOS gene was significantly associated with BMD at the lumbar spine, femoral neck, Ward's triangle and femoral trochanter in the combined group. Mean BMD values were therefore found to be similar across the genotypes in postmenopausal Turkish women. However, there was a significant association between the T⁻⁷⁸⁶C polymorphism and BMD values at the lumbar spine in the normal control group (P = 0.005), and at the femoral trochanter in the osteoporotic patients (P = 0.046). The mean value of the lumbar spine BMD in the normal controls was significantly higher in women with the TC genotype of the T⁻⁷⁸⁶C polymorphism than in women with the TT genotype (P = 0.0012). Women with the CC genotype of the T⁻⁷⁸⁶C polymorphism in the osteoporotic patients had significantly higher BMD value at the femoral trochanter than those with the TC (P = 0.018) and TT genotypes (P = 0.024). Frequencies of the TC heterozygotes for T⁻⁷⁸⁶C polymorphism were significantly higher among osteoporotic subjects than normal controls. Also, the CC and TT genotype frequencies of control group were significantly higher than those of the osteoporotic group at the femoral neck.

Conclusions

We conclude that, although the biological role of the nitric oxide synthases is well established, our study does not suggest that eNOS gene polymorphisms, T⁻⁷⁸⁶C and Glu298Asp, are major contributors to adult bone mineral density in the postmenopausal Turkish women.     

Prevalence and clinical significance of elevated antinuclear antibody test in children and adult patients with idiopathic thrombocytopenic purpura

Background To determine the clinical significance of the antinuclear antibody (ANA) test in children and adult patients with idiopathic thrombocytopenic purpura (ITP). Method We conducted a retrospective analysis of 365 children and 108 adult patients with ITP. Patients found to have positive ANA were regularly followed-up by an experienced hematologist until December 2006 for development of symptoms indicative of autoimmune disorder. Mean follow-up 3.6 years (range: 2.1–7 years) for all patients. At the time of diagnosis of ITP, patients with connective tissue diseases (CTD) were excluded. Out of 365 childhood ITP; 301 (82.4%) patients were acute, 64 (17.6%) patients were chronic ITP. ANA titer ≥1:80 were positive in 33 (9.04%) of 365 patients with childhood ITP; 21 patients (6.9%) were in acute, and 12 patients (18.7%) were in chronic group. Out of 108 adult patients with ITP; 31 (28.7%) patients were acute and 77 (71.3%) patients were chronic ITP cases. ANA titer ≥1:80 were positive in 36 (33.3%) of 108 patients with adult ITP; 12 patients (38.8%) were in acute, and 24 patients (31.2%) were in chronic group. At the end of follow-up period Sjogren’s syndrome (SS) was diagnosed in only one adult chronic ITP cases. None of the other ANA positive patients developed SLE or other CTD. Conclusions Our data demonstrated that ANA positivity is often found in adult and children patients with ITP, and indicate that the detection of ANA positivity is not enough to identify those patients with ITP who are at risk of developing SLE or other CTD. There is a statistically significant difference in terms of ANA positivity between childhood acute and chronic ITP patients. We think that ANA positivity may be an indicator in terms of chronicity for childhood ITP. However, large-scale studies should be considered to determine the significance of ANA positivity and their utility in differentiating acute from chronic ITP.     

Relationship of mast cell density with lymphangiogenesis and prognostic parameters in breast carcinoma

In many cancers, mast cell density (MCD) in the tumor microenvironment is associated with tumor progression and, to a greater extent, angiogenesis. Our study was designed to investigate the correlation between MCD, tumor lymphangiogenesis, and several well-established prognostic parameters in breast cancer. One hundred and four cases of invasive breast carcinoma diagnosed in our clinic between 2007 and 2011 were included. Mast cells and lymphatic vessels were stained with toluidine blue and D2-40, respectively, and their densities were calculated in various areas of tumors and lymph nodes. The variables of MCD and lymphatic vessel density (LVD) were compared using prognostic parameters as well as with each other. As tumor size and volume increased, MCD increased comparably in metastatic lymph nodes; intratumoral and peritumoral LVD also increased. Lymphovascular invasion, lymphatic invasion, perineural invasion, and estrogen receptor positivity were positively related to intratumoral MCD. The relationship between peritumoral MCD and nontumoral breast tissue MCD was statistically significant. Stage was correlated with MCD in metastatic lymph nodes. Metastatic lymph node MCD and intratumoral MCD were also significantly related. Stage, lymphatic invasion, perineural invasion, lymphovascular invasion, and metastatic lymph node MCD were all correlated with intratumoral and/or peritumoral LVD. As nuclear grade increased, intratumoral LVD became higher. In breast carcinoma, MCD, depending on its location, was related to several prognostic parameters. Notably, mast cells may have at least some effect on lymphangiogenesis, which appears to be a predictor of tumor progression.     

Acute effect of exercise on plasma leptin level and insulin resistance in obese women with stable caloric intake

Obese individuals are frequently hyperleptinemic and insulin resistant. Chronic exercise is associated with improvements in plasma leptin level and insulin sensitivity; however, little is known about the acute effect of exercise on these parameters. The aim of this study was to evaluate the acute effect of aerobic exercise on plasma leptin and insulin sensitivity in obese women with stable caloric intake. Patients and Methods: Twenty-three obese women (age 41.2 +/- 10.3 years, body mass index 40.7 +/- 6.7 kg/m2) were included to the study. All subjects were admitted to an exercise program (45-minute walking sessions at 60-80% of maximum heart rate) every day except weekends for four weeks (total 20 exercise sessions). Insulin resistance was evaluated by HOMA model. Plasma glucose, insulin and leptin levels were determined at baseline and at the end of the first, seventh, and twentieth exercise session. RESULTS: Baseline and at the end of the first, seventh, and twentieth exercise session plasma leptin levels were 59.1 +/- 20.1, 58.5 +/- 21.0, 53.4 +/- 21.9, and 51.2 +/- 20.5 ng/ml and HOMA-r were 2.75 +/- 1.47, 1.77 +/- 0.71, 1.73 +/- 0.89, 1.62 +/- 0. 70, respectively. Compared to baseline, at the end of the seventh (p = 0.021) and twentieth exercise session (p = 0.003), plasma leptin levels were significantly low. Plasma leptin level did not change significantly at the end of the first exercise session (p > 0.05). At the end of the first exercise session (p = 0.005), end of the seventh (p = 0.003) and twentieth exercise session (p = 0.007) HOMA-r was lower than baseline. There was no correlation between weight loss during exercise period and the change of leptin, and HOMA-r. Fasting plasma glucose, insulin and leptin levels were determined at baseline and at the end of the first, seventh, and twentieth exercise session. CONCLUSION: Our study suggests that acute exercise decreases insulin resistance at the first exercise session with no effect on leptin levels. Significant leptin decrement was evident at the first week and lasted during the entire four weeks exercise session.     

Fever during post-acute rehabilitation in patients with brain injury.

OBJECTIVE: To investigate the incidence of fever during the post-acute rehabilitation phase in patients with brain injury. DESIGN: Prospective study. SUBJECTS: Seventy-four patients with brain injury. METHODS: Patients were evaluated for the presence of fever during the rehabilitation phase. Demographics, time since injury, acute hospital and rehabilitation stay, brain injury and clinical characteristics were recorded for all subjects. RESULTS: Of the study group, 36 patients (36/74; 48.6%) had at least 1 event qualified as fever. The most common cause of fever was urinary tract infection. There were only 2 patients considered as having central fever. Fever was significantly more frequent in patients with a greater number of neurological impairments, more severe neurological impairments and a lower level of independence. The rehabilitation stay was prolonged in patients with fever. The average length of rehabilitation stay was 62.5 days and 49.8 days in patients with or without fever, respectively. CONCLUSION: Infection is the most common cause of fever after brain injury and the incidence of central fever is low.     

Evaluation of fracture resistance of inlay-retained fixed partial dentures fabricated with different monolithic zirconia materials

Statement of problem

Data are lacking on the fracture resistance of monolithic zirconia inlay-retained fixed partial dentures as a conservative treatment for a single missing tooth.

Demonstration of the histopathological and immunohistochemical effects of a novel hemostatic agent,ankaferd blood stopper,on vascular tissue in a rat aortic bleeding model

Background

Ankaferd Blood Stopper^® (ABS) is a folkloric medicinal plant extract used as a hemostatic agent in traditional Turkish medicine. This experimental study investigated the histopathological and immunohistochemical effects of ABS on vascular tissue in a rat model of aortic bleeding.

Methods

Four groups of 11 Wistar albino rats were used. The abdominal aortas of the rats were wounded; an ABS-soaked tampon was applied to rats in Groups 1 and 3, and a plain gauze tampon was applied to rats in Groups 2 and 4 until the bleeding stopped. The bleeding time was recorded. Immediately following sacrificing, the arteriotomy sites from Groups 1 and 2 were removed. The abdominal incisions in Groups 3 and 4 were closed following hemostasis. On Day 7 of the study, Group 3 and 4 rats were sacrificed and the abdominal aorta arteriotomy sites were removed for histopathological and immunohistochemical evaluation.

Results

The mean bleeding time in 15 animals in Groups 2 and 4 was 4.9 ± 0.6 s, and in 22 animals in Groups 1 and 3 was 3.1 ± 0.6 s. Distal aortic occlusion was not observed on either Day 1 or 7 in any group. Significantly more widespread and dense endothelial nitric oxide synthase (eNOS) staining was observed in Group 1 animals than Group 2. On Days 1 and 7 after application of ABS, histopathological changes, consisting of necrosis, inflammation, and endothelial cell loss, in the rat abdominal aortas did not differ between Groups 1 and 2. The basophilic discoloration in the ABS group on the operation day was a result of a foreign body reaction and hemosiderin-loaded histiocyte accumulation, which occurred on Day 7.

Conclusions

In this study, hemostasis was successfully achieved with ABS in rat abdominal aortas. No histopathological change was found in the rat abdominal aortas between the ABS and control groups on Days 1 and 7. Further studies on the long-term effects of foreign body reactions and hemosiderin-loaded histiocyte accumulation are required.

     

Statins may decrease skeletal-related events in breast cancer patients with bone metastases

Metastasis to the skeleton frequently occurs in breast carcinoma patients resulting in different skeletal-related events including pain, hypercalcemia, pathological fracture, and spinal cord or nerve root compression. Bisphosphonates are class of agents most frequently used to reduce skeletal-related events in patients with bone metastases by inhibiting osteoclast activity through inhibition of mevolanate pathway which is also important in cholesterol synthesis. Statins are cholesterol lowering agents and inhibit the same pathway. Therefore statins may also reduce skeletal-related events in breast cancer patients with bone metastases by inhibiting osteoclastic activity.