Study of leukocytic hydrolytic enzymes in patients with acute stage of coronary heart disease

BACKGROUND: Coronary heart disease (CHD) is a major killer worldwide. Atherosclerosis, which is the basis of CHD, is believed to be an inflammatory disorder. Though various aspects of atherosclerosis are extensively studied, leukocytic hydrolytic enzymes are not studied very well with respect to CHD. AIM: This study was planned to assess changes associated with leukocytic hydrolases in CHD patients. SETTING AND DESIGN: A tertiary care hospital; case-control study. MATERIALS AND METHODS: 106 patients with acute myocardial infarction, 60 patients with unstable angina and 45 healthy controls were included in the study. Acid phosphatase, lysozyme, adenosine deaminase (ADA) and cathepsin-G levels were estimated from leukocytes. Reduced glutathione (GSH) and malondialdehyde (MDA) levels were measured. STATISTICAL ANALYSIS: Statistical comparison of data was done using student′s t-test (unpaired). Correlation difference was calculated by using Pearson correlation coefficient. RESULTS: Significantly higher levels of acid phosphatase, lysozyme, ADA with lower levels of cathepsin G in leukocytes were observed in CHD group. We also found significantly higher levels of serum MDA with lower concentrations of blood GSH in CHD group. In diabetic CHD group, significantly higher levels of leukocytic acid phosphatase, lysozyme, ADA and serum MDA with lower levels of cathepsin G and blood GSH were observed. CONCLUSIONS: Our study indicates that leukocyte hydrolytic enzymes, mainly acid phosphatase, lysozyme and ADA were more active in CHD patients and may contribute to inflammation related with CHD. Its also indicates that leukocyte cathepsin-G may have antiinflammatory role

Biochemical changes in erythrocyte membrane in uncontrolled type 2 diabetes mellitus

250-253The levels of lipid peroxidation and alterations in lipid composition and ATPase activities were determined in erythrocyte plasma membrane of uncontrolled type 2 diabetes mellitus (DM) patients. The study groups consisted of 30 patients (16 males, 14 females) attending the Out Patients’ Department of Lokmanya Tilak Municipal General Hospital, Mumbai, and 23 age- and sex-matched control subjects (15 males, 8 females). Glycated haemoglobin (an index of long-term glycaemic control), erythrocyte membrane cholesterol, phospholipid and cholesterol to phospholipid molar ratio, lipid peroxidation products in the form of thiobarbituric acid-reactive substances (TBARS), and Na⁺-K⁺-ATPase activity were found to be significantly increased, and Mg²⁺-ATPase activity significantly decreased, in the diabetic subjects, as compared to controls. The study suggests that biochemical changes in the erythrocyte membrane may be involved in the pathophysiology of type 2 DM

Perioperative blood lactate levels, pyruvate levels, and lactate-pyruvate ratio in children undergoing cardiopulmonary bypass for congenital heart disease.

Background: Cardiopulmonary bypass (CPB) affects almost every body system by hypoperfusion either subclinically or clinically and produces a systemic inflammatory response owing to contact of blood with mechanical surfaces. There has been no documentation regarding pyruvate in predicting postoperative mortality and morbidity. Aim: This study was carried out to evaluate lactate levels, pyruvate levels, and lactate-pyruvate ratio in pediatric patients undergoing CPB (for correction of congenital cardiac anomaly) and their correlation to perioperative outcomes. Method: 50 consecutive patients (less than 14 years of age) of various congenital heart diseases undergoing CPB were studied. Patients were classified into three categories according to their surgical complexity. Arterial blood samples were collected at different stages of CPB to estimate blood lactate and pyruvate levels by using documented spectrophotometric method. Results: The observed mean baseline lactate levels were 2.24± 0.79 mmol/l (normal range of 0.9-1.7 mmol/l). The mean circulating lactate levels, at 15 and 45 min after institution of CPB, increased to 4.49 ± 1.2 and 5.24± 1.02 mmol/l, respectively. A progressive decline in the mean lactate levels was noted during rewarming (at 35°C) and immediately off-bypass which continued steadily even 24 and 48 h postoperatively. The mean baseline lactate-pyruvate ratio was 24.73, which increased at 15 and 45 min after institution of CPB, rewarming (at 35°C), and immediately off-bypass. As far as the duration of CPB is concerned, we found that lactate levels were elevated significantly (P < 0.05) and the lactate-pyruvate ratio was significantly high (P < 0.001) during rewarming, off-bypass, and 24- and 48-h post-CPB in patients requiring CPB for more than 1 h. The average duration of postoperative mechanical ventilation, inotropic support, and lactate-pyruvate ratio were significantly higher (P < 0.001) in category III of patients in comparisons with categories I and II. Conclusion: In patients undergoing CPB for congenital heart operation, elevations in lactate-pyruvate ratio can predict the postoperative outcome significantly better in comparison with lactate levels

Perioperative blood lactate levels, pyruvate levels, and lactate-pyruvate ratio in children undergoing cardiopulmonary bypass for congenital heart disease

Background: Cardiopulmonary bypass (CPB) affects almost every body system by hypoperfusion either subclinically or clinically and produces a systemic inflammatory response owing to contact of blood with mechanical surfaces. There has been no documentation regarding pyruvate in predicting postoperative mortality and morbidity. Aim: This study was carried out to evaluate lactate levels, pyruvate levels, and lactate-pyruvate ratio in pediatric patients undergoing CPB (for correction of congenital cardiac anomaly) and their correlation to perioperative outcomes. Method: 50 consecutive patients (less than 14 years of age) of various congenital heart diseases undergoing CPB were studied. Patients were classified into three categories according to their surgical complexity. Arterial blood samples were collected at different stages of CPB to estimate blood lactate and pyruvate levels by using documented spectrophotometric method. Results: The observed mean baseline lactate levels were 2.24± 0.79 mmol/l (normal range of 0.9-1.7 mmol/l). The mean circulating lactate levels, at 15 and 45 min after institution of CPB, increased to 4.49 ± 1.2 and 5.24± 1.02 mmol/l, respectively. A progressive decline in the mean lactate levels was noted during rewarming (at 35°C) and immediately off-bypass which continued steadily even 24 and 48 h postoperatively. The mean baseline lactate-pyruvate ratio was 24.73, which increased at 15 and 45 min after institution of CPB, rewarming (at 35°C), and immediately off-bypass. As far as the duration of CPB is concerned, we found that lactate levels were elevated significantly (P < 0.05) and the lactate-pyruvate ratio was significantly high (P < 0.001) during rewarming, off-bypass, and 24- and 48-h post-CPB in patients requiring CPB for more than 1 h. The average duration of postoperative mechanical ventilation, inotropic support, and lactate-pyruvate ratio were significantly higher (P < 0.001) in category III of patients in comparisons with categories I and II. Conclusion: In patients undergoing CPB for congenital heart operation, elevations in lactate-pyruvate ratio can predict the postoperative outcome significantly better in comparison with lactate levels

Mucinous carcinoma of the male breast with axillary lymph node metastasis: Report of a case based on fine needle aspiration cytology

Pure mucinous carcinoma of the male breast is an uncommon malignant breast neoplasm and extremely rare is its metastasis in axillary lymph nodes. Most of these cases have been diagnosed after surgical resection with only a few cases diagnosed on fine needle aspiration cytology (FNAC). Although FNAC is well established in the evaluation of breast masses in females there are few reports in males. We are presenting a case of pure mucinous carcinoma of the male breast with metastasis in axillary lymph nodes in a 75-year-old male diagnosed by FNAC and confirmed on histopathology