Accumulation of Oxidized Low-Density Lipoprotein in Psoriatic Skin and Changes of Plasma Lipid Levels in Psoriatic Patients

Background. Psoriasis is a chronic inflammatory skin disease characterized by an accelerated turnover of epidermal cells and an incomplete differentiation in epidermis with lesion. However, the exact etiology of psoriasis is unknown. Abnormalities in essential fatty acid metabolism, free radical generation, lipid peroxidation, and release of lymphokines have been proposed. Objective. Our purpose was to evaluate the plasma lipids and oxidized low-density lipoprotein accumulation in psoriatic skin lesion in order to ascertain the possible participation of oxidative stress and oxidative modification of lipids in pathogenesis of psoriasis. Methods. The study group included 84 patients with psoriasis, and 40 sex- and age-matched healthy volunteers. Blood lipid profile was determined. Psoriatic and nonlesional skin samples of psoriatic patients were evaluated for the presence of oxidized low-density lipoprotein by using an immune-fluorescent staining method. Results. The mean levels of lipids (total cholesterol, triglyceride, and LDL cholesterol) in patients with psoriasis were found to be significantly higher than those of healthy subjects. Psoriatic skins were shown positive oxidized low-density lipoprotein staining. There was no staining in nonlesional skin samples of the same individuals. Conclusion. Lipid peroxidation mediated by free radicals is believed to be one of the important causes of cell membrane destruction and cell damage. This study shows for the first time the accumulation of oxidized low-density lipoprotein in psoriatic skin lesion. We believe that accumulation of ox-LDL in psoriatic skin may have an important role in the immune-inflammatory events that result in progressive skin damage

The Effects of Ketamine, Midazolam and Ketamine/Xylazine on Acute Lung Injury Induced by alpha-Naphthylthiourea in Rats

WOS: 000342277100003PubMed: 24979504Objectives. Ketamine is a drug used in human and veterinary medicine, primarily for the induction and maintenance of general anesthesia, analgesia (particularly in emergency medicine), and treatment of bronchospasm. Midazolam is the preferred drug in intensive care units for sedation and anesthesia. Ketamine/xylazine combination is used as an anesthetic agent in veterinary medicine and experimental animals. Aside from anaesthetic properties, these agents can cause physiologic and metabolic alterations and modulate and improve the inflammatory responses. The objective of the present study was to investigate the effects of ketamine, midazolam, and veterinary and experimentally used ketamine/xylazine combination in acute lung injury induced by alpha-naphthylthiourea (ANTU). Material and Methods. ANTU was injected intraperitoneally (i.p.) in rats at the dose of 10 mg/kg. Ketamine (15, and 50 mg/kg, i.p.), midazolam (2 and 4 mg/kg, i.p.), and ketamine/xylazine (50/10 mg/kg, i.p.) administered to rats 30 min prior to ANTU. Four hours later, the lung weight/body weight (LW/BW) ratio and pleural effusion (PE) were measured. Histopathological changes were documented in each lung tissue, including intra-alveolar hemorrhage, alveolar edema and inflammation. The severity of the lung injury was scored (0-3). Results. Ketamine, midazolam and ketamine/xylazine had a significant prophylactic effect on pleural effusion formation at all doses and significantly reduced pleural effusion. Ketamine caused a significant reduction of inflammation, hemorrhage and edema scoring and midazolam (2 mg/kg) and ketamine/xylazine caused a significant reduction of inflammation and edema scoring. Conclusions. It can be concluded that ketamine and midazolam may attenuate lung injuries induced by ANTU. In addition to their anesthetic or sedative properties, the prophylactic effects of these agents on lung tissue damage will contribute to the treatment of intensive care unit diseases including acute lung injury. Similarly, the effects of these agents on lung pathophysiology should be considered in experimental applications.Bulent Ecevit University's Office of Research and Sponsored ProgramsBulent Ecevit University [2009-42-01-01]This study was supported by intramural funding from Bulent Ecevit University's Office of Research and Sponsored Programs (No. 2009-42-01-01

Protective effect of dexmedetomidine in a rat model of alpha-naphthylthioureae-induced acute lung injury

WOS: 000310450300064PubMed: 22445456Background: We assessed the effects of dexmedetomidine in a rat model of alpha-naphthylthiourea (ANTU)-induced acute lung injury. Methods: Forty Wistar Albino male rats weighing 200-240 g were divided into 5 groups (n = 8 each), including a control group. Thus, there were one ANTU group and three dexmedetomidine groups (10-, 50-, and 100- mu g/kg treatment groups), plus a control group. The control group provided the normal base values. The rats in the ANTU group were given 10 mg/kg of ANTU intraperitoneally and the three treatment groups received 10, 50, or 100 mu g/kg of dexmedetomidine intraperitoneally 30 min before ANTU application. The rat body weight (BW), pleural effusion (PE), and lung weight (LW) of each group were measured 4 h after ANTU administration. The histopathologic changes were evaluated using hematoxylin-eosin staining. Results: The mean PE, LW, LW/BW, and PE/BW measurements in the ANTU group were significantly greater than in the control groups and all dexmedetomidine treatment groups (P < 0.05). There were also significant decreases in the mean PE, LW, LW/BW and PE/BW values in the dexmedetomidine 50-mu g/kg group compared with those in the ANTU group (P < 0.01). The inflammation, hemorrhage, and edema scores in the ANTU group were significantly greater than those in the control or dexmedetomidine 50-mu g/kg group (P < 0.01). Conclusion: Dexmedetomidine treatment has demonstrated a potential benefit by preventing ANTU-induced acute lung injury in an experimental rat model. Dexmedetomidine could have a potential protective effect on acute lung injury in intensive care patients. (C) 2012 Elsevier Inc. All rights reserved.Zonguldak Karaelmas University's Office of Research and Sponsored ProgramsBulent Ecevit UniversityThe authors would like to thank Dr. E. Schilliger from Schering AG, Berlin, Germany, for his gift of a-naphthylthiourea (Interchem). We thank Hasan Tahsin Yilmaz and Bayram Cakan for their assistance in the Animal Research Laboratory. This study was supported by intramural funding from the Zonguldak Karaelmas University's Office of Research and Sponsored Programs

Protective effect of dexmedetomidine in a rat model of alpha-naphthylthioureae-induced acute lung injury

Background: We assessed the effects of dexmedetomidine in a rat model of alpha-naphthylthiourea (ANTU)-induced acute lung injury

Miliary tuberculosis Epidemiologicaland clinical analysis of large-case series from moderate to low tuberculosis endemic Country

WOS: 000394253800016PubMed ID: 28151863The aim of this study was to determine the clinical features, and outcome of the patients with miliary tuberculosis (TB). We retrospectively evaluated 263 patients (142 male, 121 female, mean age: 44 years, range: 16-89 years) with miliary TB. Criteria for the diagnosis of miliary TB were at least one of the followings in the presence of clinical presentation suggestive of miliary TB such as prolonged fever, night sweats, anorexia, weight loss: radiologic criterion and pathological criterion and/or microbiological criterion; pathological criterion and/or microbiological criterion. The miliary pattern was seen in 88% of the patients. Predisposing factors were found in 41% of the patients. Most frequent clinical features and laboratory findings were fever (100%), fatigue (91%), anorexia (85%), weight loss (66%), hepatomegaly (20%), splenomegaly (19%), choroid tubercules (8%), anemia (86%), pancytopenia (12%), and accelerated erythrocyte sedimentation rate (89%). Tuberculin skin test was positive in 29% of cases. Fifty percent of the patients met the criteria for fever of unknown origin. Acid-fast bacilli were demonstrated in 41% of patients (81/195), and cultures for Mycobacterium tuberculosis were positive in 51% (148/292) of tested specimens (predominantly sputum, CSF, and bronchial lavage). Blood cultures were positive in 20% (19/97). Granulomas in tissue samples of liver, lung, and bone marrow were present in 100% (21/21), 95% (18/19), and 82% (23/28), respectively. A total of 223 patients (85%) were given a quadruple anti-TB treatment. Forty-four (17%) patients died within 1 year after diagnosis established. Age, serum albumin, presence of military pattern, presence of mental changes, and hemoglobin concentration were found as independent predictors of mortality. Fever resolved within first 21 days in the majority (90%) of the cases. Miliary infiltrates on chest X-ray should raise the possibility of miliary TB especially in countries where TB is endemic. Although biopsy of the lungs and liver may have higher yield rate of organ involvement histopathologicaly, less invasive procedures including a bone marrow biopsy and blood cultures should be preferred owing to low complication rates

Results of a multinational study suggest the need for rapid diagnosis and early antiviral treatment at the onset of herpetic meningoencephalitis

Data in the literature regarding the factors that predict unfavorable outcomes in adult herpetic meningoencephalitis (HME) cases are scarce. We conducted a multicenter study in order to provide insights into the predictors of HME outcomes, with special emphasis on the use and timing of antiviral treatment. Samples from 501 patients with molecular confirmation from cerebrospinal fluid were included from 35 referral centers in 10 countries. Four hundred thirty-eight patients were found to be eligible for the analysis. Overall, 232 (52.9%) patients experienced unfavorable outcomes, 44 died, and 188 survived, with sequelae. Age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02 to 1.05), Glasgow Coma Scale score (OR, 0.84; 95% CI, 0.77 to 0.93), and symptomatic periods of 2 to 7 days (OR, 1.80; 95% CI, 1.16 to 2.79) and >7 days (OR, 3.75; 95% CI, 1.72 to 8.15) until the commencement of treatment predicted unfavorable outcomes. The outcome in HME patients is related to a combination of therapeutic and host factors. This study suggests that rapid diagnosis and early administration of antiviral treatment in HME patients are keys to a favorable outcome

Miliary tuberculosis Epidemiologicaland clinical analysis of large-case series from moderate to low tuberculosis endemic Country

The aim of this study was to determine the clinical features, and outcome of the patients with miliary tuberculosis (TB). We retrospectively evaluated 263 patients (142 male, 121 female, mean age: 44 years, range: 16-89 years) with miliary TB. Criteria for the diagnosis of miliary TB were at least one of the followings in the presence of clinical presentation suggestive of miliary TB such as prolonged fever, night sweats, anorexia, weight loss: radiologic criterion and pathological criterion and/or microbiological criterion; pathological criterion and/or microbiological criterion. The miliary pattern was seen in 88\% of the patients. Predisposing factors were found in 41\% of the patients. Most frequent clinical features and laboratory findings were fever (100\%), fatigue (91\%), anorexia (85\%), weight loss (66\%), hepatomegaly (20\%), splenomegaly (19\%), choroid tubercules (8\%), anemia (86\%), pancytopenia (12\%), and accelerated erythrocyte sedimentation rate (89\%). Tuberculin skin test was positive in 29\% of cases. Fifty percent of the patients met the criteria for fever of unknown origin. Acid-fast bacilli were demonstrated in 41\% of patients (81/195), and cultures for Mycobacterium tuberculosis were positive in 51\% (148/292) of tested specimens (predominantly sputum, CSF, and bronchial lavage). Blood cultures were positive in 20\% (19/97). Granulomas in tissue samples of liver, lung, and bone marrow were present in 100\% (21/21), 95\% (18/19), and 82\% (23/28), respectively. A total of 223 patients (85\%) were given a quadruple anti-TB treatment. Forty-four (17\%) patients died within 1 year after diagnosis established. Age, serum albumin, presence of military pattern, presence of mental changes, and hemoglobin concentration were found as independent predictors of mortality. Fever resolved within first 21 days in the majority (90\%) of the cases. Miliary infiltrates on chest X-ray should raise the possibility of miliary TB especially in countries where TB is endemic. Although biopsy of the lungs and liver may have higher yield rate of organ involvement histopathologicaly, less invasive procedures including a bone marrow biopsy and blood cultures should be preferred owing to low complication rates

Antituberculosis drug resistance patterns in adults with tuberculous meningitis: results of haydarpasa-iv study

Background: Tuberculous meningitis (TBM) caused by Mycobacterium tuberculosis resistant to antituberculosis drugs is an increasingly common clinical problem. This study aimed to evaluate drug resistance profiles of TBM isolates in adult patients in nine European countries involving 32 centers to provide insight into the empiric treatment of TBM

Cranial imaging findings in neurobrucellosis: results of Istanbul-3 study

Objective Neuroimaging abnormalities in central nervous system (CNS) brucellosis are not well documented. The purpose of this study was to evaluate the prevalence of imaging abnormalities in neurobrucellosis and to identify factors associated with leptomeningeal and basal enhancement, which frequently results in unfavorable outcomes