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    Association between GSTP1 gene polymorphism and serum alpha-GST concentrations undergoing sevoflurane anaesthesia
    (Lippincott Williams & Wilkins, 2008) Kaymak, C.; Karahalil, B.; Ozcan, N. N.; Oztuna, D.
    Background and objectives: The measurement of alpha-glutathione-S-transferase enzyme Is one of the most sensitive indicators of hepatocellular function. Variation in the glutathione-S-transferase PI gene clusters has been intensively investigated and polymorphism has been described. The aim of the study was to assess whether an association exists between glutathione-S-transferase P1 gene polymorphism and serum alpha-glutathione-S-transferase concentrations for the first postoperative day in patients who underwent anaesthesia with sevoflurane. Methods: In all, 54 unrelated patients were enrolled in this study. Anaesthesia was induced with thiopental and fentanyl. Vecuronium was used for neuromuscular relaxation before endotracheal intubation. Anaesthesia was maintained with sevoflurane in a gas mixture containing 50% nitrous oxide in oxygen. Peripheral venous blood samples to determine serum alpha-glutathione-S-transferase concentrations were collected before induction (T-1), at the end of anaesthesia (T-2) and at 24-h postoperatively (T-3). Enzyme-linked immunosorbent assay (ELISA) immunoassay was used to measure alpha-glutathione-S-transferase levels. Genomic DNA was isolated from serum samples using a genomic DNA purification kit. In order to detect the variants of glutathione-S-transferase P1, polymerase chain reaction - restriction fragment length polymorphism analysis was employed. Results: Early postoperative serum alpha-glutathione-S-transferase levels for all patients were significantly increased when compared with preanaesthetic and 24-h postoperatively (P < 0.05). Serum alpha-glutathione-S-transferase concentrations, in individuals with glutathione-S-transferase P1 Ile105Val genotypes (heterozygote gene), remained elevated at 24 h (P < 0.05), whereas levels in individuals with glutathione-S-transferase P1 Ile105Ile (wild gene) decreased (P > 0.05). Conclusions: Although alpha-glutathione-S-transferase levels were elevated in all patients after sevoflurane anaesthesia, levels remained high at 24 h in patients with glutathione-S-transferase P1 Ile105Val genotypes compared to controls.
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    Epidural volume expansion: is there a ceiling effect?
    (Edizioni Minerva Medica, 2010) Doğancı, Nur; Apan, Alparslan; Tekin, Öznur; Kaymak, C.
    Aim. The optimal volume of epidural saline administration on spinal anesthesia is not clear. The aim of this study was therefore to evaluate the block characteristics of 5, 10, 15, and 20 mL epidural saline after spinal anesthesia. Methods. This prospective, randomized double-blind study was conducted in the operation room setting of a university hospital. Seventy-five healthy adult patients electively undergoing limb surgery under regional anesthesia were investigated. Spinal anesthesia was performed, and plain bupivacaine (10 mg) was administered within one minute using combined spinal and epidural anesthesia. Epidural catheters were introduced, and patients were allocated to one of five groups to receive 0, 5, 10, 15 or 20 mL saline through the catheter (N=15 in each group). The patient was assessed every minute for motor and sensory block levels until a maximum level was reached. In addition, the patient was assessed thereafter in five-minute intervals using Bromage's scale for motor block and pinprick/cold sensation for sensory block. Results. The maximum level of spinal analgesia was significantly lower in the control group compared to the saline treatment groups, but there was no significant difference between the epidural saline groups. The periods for motor block resolution were the same. The duration of analgesia was significantly longer in patients receiving 15 mL, saline compared to other groups. The time to regression to the L1 level was significantly longer with 15- and 20-mL treatment groups compared to the 5- and 10-mL groups. Conclusion. The present results indicate that a ceiling effect was observed on the duration of spinal analgesia using plain bupivacaine with epidural saline loading (maximum- 15 mL). (Minerva Anestesiol 2010,76:334-9)
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    Oxidative DNA damage and total antioxidant status in rats during experimental gram-negative sepsis
    (Sage Publications Ltd, 2008) Kaymak, C.; Kadioglu, E.; Ozcagli, E.; Osmanoglu, G.; Izdes, S.; Agalar, C.; Sardas, S.
    Sepsis and septic shock remains as leading cause of death in adult intensive care units. It is widely accepted that gram-negative bacteria and their endotoxins cause sepsis and septic shock, predominantly. Enhanced generation of reactive oxygen species may be responsible for tissue injury in septic shock and endotoxemia. The aim of this study was to assess oxidative DNA damage and the total antioxidant status (TAS) in peripheral lymphocytes of rats during different intraperitoneal gram-negative sepsis stages. Adult male Sprague-Dawley rats were divided randomly into four groups. Control group was intraperitoneally inoculated with 2 ml, of pyrogene-free saline (Group I, n = 6), and the other rats received an intraperitoneal inoculum with 2 ml, of saline containing 2 x 10(8) CFU of Escherichia coli. The animals were killed at time zero (Group 1, n = 6), at 6th (Group 11, n = 7), 12th (Group M, n = 7), and 24th (Group IV, n = 7) hour after the E. coli inoculation. Oxidative DNA damage in peripheral lymphocytes of rats was evaluated by modified comet assay (single-cell gel electrophoresis). Formamido-pyrimidine DNA glycosylase (Fpg) and Endonuclease III (Endo III) were used to detect oxidized purines and pyrimidines, respectively. Total antioxidant quantification was carried out using ABTS+ (2,2'-Azino-di-[3 ethyl-benzthiazoline sulphonate]) radical formation kinetics (Randox kit) in serum samples. Significant elevations of basal levels of strand breaks (SB) in Group IV were observed as compared with Group I, II, and III. There was a significant increase in Fpg sites in Group III as compared with Group I and II. However, there was no significant difference in terms of Endo III sites in any of the groups. Although the TAS was decreased with the stages of sepsis, this moderate decrease was significant in only Group IV as compared with Group I. There was no statistically significant correlation between DNA damage and TAS for any of the groups.