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Τρίτη 19 Μαρτίου 2019

Thiol/disulfide homeostasis as a novel indicator of oxidative stress




Redox Rep. 2016 Sep;21(5):197-203. doi: 10.1179/1351000215Y.0000000027. Epub 2016 Feb 15.
Thiol/disulfide homeostasis: A prognostic biomarker for patients with advanced non-small cell lung cancer?
Dirican N1, Dirican A2, Sen O3, Aynali A4, Atalay S1, Bircan HA1, Oztürk O1, Erdogan S5, Cakir M1, Akkaya A1.
Author information
1
a Department of Chest Diseases, Medical Faculty , Suleyman Demirel University , Isparta , Turkey.
2
b Department of Medical Oncology , State Hospital , Isparta , Turkey.
3
c Department of Biochemistry , Ankara Ataturk Training and Research Hospital , Turkey.
4
d Department of Clinical Microbiology , Suleyman Demirel University , Isparta , Turkey.
5
e Department of Biochemistry , Ankara Numune Training and Research Hospital , Turkey.
Abstract
BACKGROUND:
The aim of this study was to investigate oxidative stress and thiol/disulfide status with a novel automated homeostasis assay in advanced non-small cell lung cancer (NSCLC).

METHODS:
Thirty-five patients with advanced NSCLC, who had been newly diagnosed and previously untreated, and 35 healthy subjects were chosen for the study. We measured plasma total thiol (-SH+-S-S-), native thiol (thiol) (-SH), and disulfide (-S-S-) levels in the patients with NSCLC and the healthy subjects. The thiol/disulfide (-SH/-S-S-) ratio was also calculated.

RESULTS:
Statistically significant differences between the patient group and the control group were detected for the thiol/disulfide parameters. The mean native thiol, total thiol, and disulfide levels were significantly lower in the group with advanced stage NSCLC. The cut-off value was 313 and 13.8 for native thiol and disulfide, respectively. Median overall survival (OS) was significantly shorter in patients with low native thiol and disulfide levels according to the cut-off value (respectively, P = 0.001; P = 0.006). Native thiol, total thiol, and disulfide levels were correlated with Karnofsky performance status (KPS), OS, and age. Additionally, hierarchical regression analyses showed gender, KPS, lung metastases, and plasma native thiol levels were the determinants of OS in the final model.

CONCLUSION:
These results suggest that in advanced stage NSCLC, the native thiol, total thiol, and disulfide levels decrease, while the native thiol/disulfide ratio does not change. Low levels of thiol/disulfide parameters are related to tumor aggressiveness and may predict a poor outcome for patients with NSCLC.

KEYWORDS:
Disulfide; Lung cancer; Oxidative stress; Prognosis; Thiol

PMID: 26200761 DOI: 10.1179/1351000215Y.0000000027

Clin Lab. 2017 May 1;63(5):867-870. doi: 10.7754/Clin.Lab.2017.161117.
Clinical Utility of Thiol/Disulfide Homeostasis.
Erenler AK, Yardan T.
Abstract
BACKGROUND:
Recently, the usefulness of thiol/disulfide homeostasis (TDH) in various diseases is being widely investigated. In this mini-review, our aim is to clarify the role of TDH in clinical practice in the light of current literature.

METHODS:
We performed a systematic review of the existing literature describing the clinical utility of TDH in the clinical setting. MEDLINE, EMBASE, and CINAHL were used as data sources. Two reviewers conducted independent screening and data extraction. Use of TDH in each system was investigated separately.

RESULTS:
A total of 35 studies were detected in this mini-review. Our results revealed the protective role of TDH and its utility as a diagnostic marker in many common diseases in clinical practice.

CONCLUSIONS:
Maintenance of TDH as a crucial part of antioxidant defense system is critical in diagnosis and prognosis of potentially lethal diseases.

PMID: 28627824 DOI: 10.7754/Clin.Lab.2017.161117

Is otitis media with effusion associated with oxidative stress? Evaluation of thiol/disulfide homeostasis

Publication date: March–April 2019

Source: American Journal of Otolaryngology, Volume 40, Issue 2

Author(s): Eda Şimşek, Cemile Koca Bicer, Muhammed Recai Mazlumoğlu, Soner Sertan Kara, Ozcan Erel, Ayşe Çarlıoğlu

Abstract
Background

We evaluated the relationship between otitis media with effusion and thiol/disulfide homeostasis using a novel marker of oxidative stress.

Methods

The study group consisted of 30 patients (mean age 8.33 ± 3.30 years) with bilateral otitis media with effusion admitted to our hospital. The control group consisted of 35 (mean age 7.40 ± 3.97 years) age-, sex-, and body mass index-matched healthy subjects. Thiol/disulfide homeostasis was measured using a newly developed method.

Results

Native and total thiol levels were lower in the study than the control group (native thiols 421.37 ± 72 μmol/L vs. 464.46 ± 46.42 μmol/L, p < 0.05; total thiols 468.42 ± 77.89 μmol/L vs. 501.32 ± 50.30 μmol/L, respectively). Disulfide levels and the disulfide/native thiol and disulfide/total thiol ratios were higher in the study group (disulfides 23.56 ± 4.68 μmol/L vs. 18.43 ± 4.94 μmol/L; disulfide/native thiol ratio 5.65 ± 1.05 vs. 3.97 ± 1.03%; disulfide/total thiol ratio 5.06 ± 0.83 vs. 3.66 ± 0.88%, respectively).

Conclusion

Oxidative stress may be the major cause of the increase in oxidized thiols in patients with bilateral otitis media with effusion, however, this relationship requires further investigation.


J Endocrinol Invest. 2017 Apr;40(4):431-435. doi: 10.1007/s40618-016-0585-7. Epub 2016 Nov 17.

Thiol/disulfide homeostasis in postmenopausal osteoporosis.

Korkmaz V1, Kurdoglu Z2, Alisik M3, Turgut E2, Sezgın OO4, Korkmaz H5, Ergun Y2, Erel O3.

Author information

1

Department of Obstetrics and Gynecology, Ankara Training and Research Hospital, Ankara, Turkey. korkmazvakkas@gmail.com.

2

Department of Obstetrics and Gynecology, Ankara Training and Research Hospital, Ankara, Turkey.

3

Department of Biochemistry, Yıldırım Beyazıt University, Ankara, Turkey.

4

Department of Biochemistry, Ankara Training and Research Hospital, Ankara, Turkey.

5

Department of Physiology, Hacettepe University, Ankara, Turkey.

Abstract

AIM:

To evaluate the impact of postmenopausal osteoporosis on thiol/disulfide homeostasis.


MATERIALS AND METHODS:

A total of 75 participants were divided into two groups: Group 1 (n = 40) was composed of healthy postmenopausal women, and group 2 (n = 35) was composed of women with postmenopausal osteoporosis. Clinical findings and thiol/disulfide homeostasis were compared between the two groups.


RESULTS:

The disulfide/native thiol ratio was 8.6% ± 3.6 in group 1 and 12.7% ± 8.4 in group 2 (p = 0.04). The disulfide/native thiol percent ratio was significantly higher in group 2 after adjustment for the years since menopause and age (p < 0.05). The native thiol/total thiol percent ratio was 85.6% ± 4.8 in group 1 and 73.8% ± 24.9 in group 2 (p = 0.01). The native thiol/total thiol percent ratio was significantly lower in group 2 after adjustment for the years since menopause and age (p < 0.05).


CONCLUSION:

Thiol/disulfide homeostasis shifted to the disulfide side independent of age and years since menopause in postmenopausal osteoporosis.


KEYWORDS:

Disulfide; Postmenopausal osteoporosis; Thiol


PMID: 27858341 DOI: 10.1007/s40618-016-0585-7

[Indexed for MEDLINE]

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Publication type, MeSH terms, Substances

Publication type

Comparative Study

MeSH terms

Case-Control Studies

Disulfides/blood*

Female

Homeostasis/physiology*

Humans

Middle Aged

Osteoporosis, Postmenopausal/blood*

Prognosis

Sulfhydryl Compounds/blood*

Substances

Disulfides

Sulfhydryl Compounds

Select item 28808794

2.

Neurol Sci. 2017 Nov;38(11):1969-1975. doi: 10.1007/s10072-017-3087-2. Epub 2017 Aug 14.

Thiol/disulfide homeostasis as a novel indicator of oxidative stress in children with simple febrile seizures.

Elmas B1, Erel Ö2, Ersavaş D3, Yürümez Y4.

Author information

1

Department of Pediatrics, Faculty of Medicine, Sakarya University, Sakarya, Turkey. bahrielmas@gmail.com.

2

Department of Biochemistry, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey.

3

Department of Pediatrics, Faculty of Medicine, Sakarya University, Sakarya, Turkey.

4

Department of Emergency, Faculty of Medicine, Sakarya University, Sakarya, Turkey.

Abstract

Simple febrile seizures are generally benign, but during the seizure, elevated levels of glutamate and high levels of oxygen use due to the high metabolic brain activity result in oxidative stress. However, the relationship between febrile seizures and oxidative stress remains unclear. In this study, we investigated thiol/disulfide homeostasis as a new oxidative stress parameter in patients with simple febrile seizures. This study was performed between February 2016 and May 2016 at the Pediatric Emergency Unit. The study population consisted of 40 patients with a diagnosis of simple febrile seizure and 30 control participants aged 8-59 months. Total thiol, native thiol and disulfide levels, disulfide/native thiol, disulfide/total thiol, and native thiol/total thiol ratios were used as thiol/disulfide homeostasis parameters and were quantified in patient and control groups. Furthermore, correlations with seizure duration were investigated. In the patient group, native and total thiol levels and native thiol/total thiol ratios were low, and disulfide levels, disulfide/native thiol, and disulfide/total thiol ratios were significantly higher than in the control group. Negative correlations were observed between seizure duration, total and native thiol levels, and native thiol/total thiol ratio, whereas positive correlations were observed between seizure duration and disulfide/native thiol and disulfide/total thiol ratio. The sensitivities of both disulfide/native thiol and disulfide/total thiol ratios were high for simple febrile seizures. Simple febrile seizures may cause impairment in favor of disulfide bonds in thiol/disulfide homeostasis. Overall, these changes may contribute to neuronal cell damage after simple febrile seizures.


KEYWORDS:

Oxidative stress; Simple febrile seizures; Thiol/disulfide homeostasis


PMID: 28808794 DOI: 10.1007/s10072-017-3087-2

[Indexed for MEDLINE]

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MeSH terms, Substances

MeSH terms

Area Under Curve

Case-Control Studies

Child, Preschool

Disulfides/blood*

Emergency Medical Services

Female

Homeostasis/physiology*

Humans

Infant

Male

Oxidative Stress/physiology*

ROC Curve

Seizures, Febrile/blood*

Seizures, Febrile/therapy

Sulfhydryl Compounds/blood*

Substances

Disulfides

Sulfhydryl Compounds

Select item 28085507

3.

Curr Eye Res. 2017 Jun;42(6):876-879. doi: 10.1080/02713683.2016.1256412. Epub 2017 Jan 13.

Thiol Disulfide Homeostasis in Pseudoexfoliation Syndrome.

Tetikoğlu M1, Aktas S1, Sağdik HM1, Özcura F1, Uçar F2, Koçak H3, Neşelioğlu S4, Erel Ö4.

Author information

1

a Department of Ophthalmology , Dumlupinar University School of Medicine , Kutahya , Turkey.

2

b Department of Biochemistry , Dışkapı Yıldırım Beyazit Training and Research Hospital , Ankara , Turkey.

3

c Department of Biochemistry , Dumlupinar University School of Medicine , Kutahya , Turkey.

4

d Department of Biochemistry , Yıldırım Beyazit University , Ankara , Turkey.

Abstract

PURPOSE:

To determine the serum thiol disulfide homeostasis in patients with pseudoexfoliation (PEX) syndrome.


METHOD:

Thirty-five patients with PEX syndrome and forty healthy subjects were included in this observational case-control study. Serum native thiol, total thiol, disulfide, and native thiol/disulfide ratio were determined using a novel and automated assay.


RESULTS:

The mean serum total thiol and native thiol levels were significantly lower in patients with PEX syndrome compared to healthy controls (p = 0.001). The mean serum disulfide level was significantly higher in patients with PEX syndrome compared to healthy controls (p = 0.023). The serum native thiol/disulfide ratio was lower in patients with PEX syndrome compared to healthy subjects (16 ± 10.1 vs 22.3 ± 11.5, respectively, p = 0.014).


CONCLUSION:

Our findings provide evidence that the dynamic native thiol/disulfide ratio is lower in PEX syndrome, which shows a reduction in the natural cell reductive capacity reservoir.


KEYWORDS:

Disulfide; oxidative stress; pseudoexfoliation syndrome; thiol


PMID: 28085507 DOI: 10.1080/02713683.2016.1256412

[Indexed for MEDLINE]

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Publication type, MeSH terms, Substances

Publication type

Observational Study

MeSH terms

Aged

Biomarkers/blood

Case-Control Studies

Disulfides/blood*

Exfoliation Syndrome/blood*

Female

Homeostasis*

Humans

Male

Middle Aged

Oxidative Stress*

Sulfhydryl Compounds/blood*

Substances

Biomarkers

Disulfides

Sulfhydryl Compounds

Select item 28627824

4.

Clin Lab. 2017 May 1;63(5):867-870. doi: 10.7754/Clin.Lab.2017.161117.

Clinical Utility of Thiol/Disulfide Homeostasis.

Erenler AK, Yardan T.

Abstract

BACKGROUND:

Recently, the usefulness of thiol/disulfide homeostasis (TDH) in various diseases is being widely investigated. In this mini-review, our aim is to clarify the role of TDH in clinical practice in the light of current literature.


METHODS:

We performed a systematic review of the existing literature describing the clinical utility of TDH in the clinical setting. MEDLINE, EMBASE, and CINAHL were used as data sources. Two reviewers conducted independent screening and data extraction. Use of TDH in each system was investigated separately.


RESULTS:

A total of 35 studies were detected in this mini-review. Our results revealed the protective role of TDH and its utility as a diagnostic marker in many common diseases in clinical practice.


CONCLUSIONS:

Maintenance of TDH as a crucial part of antioxidant defense system is critical in diagnosis and prognosis of potentially lethal diseases.


PMID: 28627824 DOI: 10.7754/Clin.Lab.2017.161117

[Indexed for MEDLINE]

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Publication types, MeSH terms, Substances

Publication types

Review

Systematic Review

MeSH terms

Diagnosis

Disulfides*

Homeostasis*

Humans

Prognosis

Sulfhydryl Compounds*

Substances

Disulfides

Sulfhydryl Compounds

Select item 27002242

5.

Curr Eye Res. 2016 Nov;41(11):1489-1491. Epub 2016 Mar 22.

Thiol/Disulfide Homeostasis in Patients with Central Serous Chorioretinopathy.

Turkoglu EB1, Dikci S2, Çelik E3, Erel Ö4, Neselioglu S5, Alışık M4, Koca C4.

Author information

Abstract

PURPOSE:

To evaluate dynamic thiol/disulfide homeostasis in patients with chronic central serous chorioretinopathy (cCSC).


METHODS:

This prospective study included 34 cCSC cases and 37 healthy individuals who were age- and sex-matched. A new colorimetric method for measuring thiol/disulfide homeostasis was used. Native thiol, total thiol/disulfide levels, disulfide/native thiol, disulfide/total thiol, and native thiol/total thiol ratios were measured.


RESULTS:

The age and gender distributions were similar in both main groups. The mean duration of disease was 47.29 ± 24 months. Native and total thiol levels were significantly lower among the cCSC group relative to the control group (p < 0.001). There was not a statistically significant difference between the cCSC and the control group in terms of disulfide levels (p = 0.492). While disulfide/native thiol and disulfide/total thiol ratios were elevated, the native thiol/total thiol ratio was decreased in the cCSC group (p = 0.017, 0.021, 0.036, respectively). Ratios obtained using plasma native thiol, total thiol, and disulfide levels differed significantly between the both groups.


CONCLUSION:

Disulfide/thiol ratio was significantly greater in cCSC patients relative to healthy control subjects. Our results suggest that the oxidative process is involved in the pathogenesis of the cCSC.


KEYWORDS:

Antioxidant; automated quantitation; mercaptan; oxidative stress; retina


PMID: 27002242 DOI: 10.3109/02713683.2015.1127390

[Indexed for MEDLINE]

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MeSH terms, Substances

MeSH terms

Adult

Biomarkers/blood

Central Serous Chorioretinopathy/blood*

Central Serous Chorioretinopathy/diagnosis

Chronic Disease

Disulfides/blood*

Female

Follow-Up Studies

Homeostasis

Humans

Male

Oxidative Stress*

Prospective Studies

Sulfhydryl Compounds/blood*

Time Factors

Substances

Biomarkers

Disulfides

Sulfhydryl Compounds

Select item 27915219

6.

Compr Psychiatry. 2017 Feb;73:53-60. doi: 10.1016/j.comppsych.2016.11.003. Epub 2016 Nov 13.

Dynamic thiol/disulfide homeostasis in children with attention deficit hyperactivity disorder and its relation with disease subtypes.

Avcil S1, Uysal P2, Avcil M3, Alışık M4, Biçer C4.

Author information

Abstract

BACKGROUND:

The aim of this study was to evaluate a novel oxidative stress marker (thiol/disulfide homeostasis) in attention deficit hyperactivity disorder (ADHD) children for the first time in literature.


METHODS:

Ninety children with ADHD diagnosed according to DSM-V and as control group, 65 healthy children were included to the study. Native thiol, total thiol, disulfide, disulfide/native thiol, disulfide/total thiol were compared between the groups.


RESULTS:

Total and native thiol levels were significantly higher whereas the disulfide/native thiol ratios were significantly lower in children with ADHD. ADHD combined type appeared to have higher disulfide, disulfide/native thiol and disulfide/total thiol ratios compared to other subtypes. Disulfide levels of the males with ADHD were significantly higher than those of the females with ADHD.


CONCLUSION:

This study suggests that thiol/disulfide homeostasis is abnormal in children with ADHD. It may be used as a novel OS marker in ADHD children because it is easy, practical, fully automated and relatively inexpensive.


Copyright © 2016 Elsevier Inc. All rights reserved.


PMID: 27915219 DOI: 10.1016/j.comppsych.2016.11.003

[Indexed for MEDLINE]

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MeSH terms, Substances

MeSH terms

Adolescent

Attention Deficit Disorder with Hyperactivity/blood*

Attention Deficit Disorder with Hyperactivity/diagnosis

Biomarkers/blood

Case-Control Studies

Child

Disulfides/blood*

Female

Homeostasis

Humans

Male

Sex Characteristics

Sulfhydryl Compounds/blood*

Substances

Biomarkers

Disulfides

Sulfhydryl Compounds

Select item 27198712

7.

Redox Rep. 2017 Nov;22(6):246-251. doi: 10.1080/13510002.2016.1180100. Epub 2016 May 19.

Assessment of serum thiol/disulfide homeostasis in multiple myeloma patients by a new method.

Guney T1, Kanat İF2, Alkan A3, Alisik M4, Akinci S5, Silay K6, Neselioglu S7, Dilek I8, Erel O7.

Author information

Abstract

OBJECTIVES:

The etiology of multiple myeloma (MM) is not exactly known. This study investigated the role of thiol/disulfide homeostasis in the etiopathogenesis of MM.


METHODS:

Some 50 patients with MM (aged 39-84 years) and 50 sex-matched healthy volunteer controls (aged 50-91 years) participated in this study. Venous blood samples were collected, and levels of native thiols, total thiols, and disulfide were measured.


RESULTS:

Native and total thiol levels in the control group were determined to be higher than in the study and patient groups (P<0.001). Disulfide levels were found to be higher in the control group than in the study group and higher in newly diagnosed patients than in outpatients who were undergoing treatment (P=0.002). The ratios of thiol levels were found to be similar in both the study and control groups (P>0.05).


DISCUSSION:

The results of the study show that although there was a decrease in the levels of disulfide, native thiol, and total thiol, the balance of thiol/disulfide was maintained. This is the first study to research the homeostasis of dynamic thiol/disulfide from the perspective of the new method that was used. We hope that this study will encourage and facilitate further studies in this area.


KEYWORDS:

Disulfide; Multiple myeloma; Oxidative stress; Thiol


PMID: 27198712 DOI: 10.1080/13510002.2016.1180100

[Indexed for MEDLINE]

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MeSH terms, Substances

MeSH terms

Aged

Aged, 80 and over

Case-Control Studies

Disulfides/metabolism*

Female

Homeostasis/genetics

Homeostasis/physiology

Humans

Male

Middle Aged

Multiple Myeloma/metabolism*

Oxidative Stress/physiology

Sulfhydryl Compounds/metabolism*

Substances

Disulfides

Sulfhydryl Compounds

Select item 28264620

8.

J Matern Fetal Neonatal Med. 2018 Mar;31(6):783-790. doi: 10.1080/14767058.2017.1297413. Epub 2017 Mar 6.

The maternal thiol/disulfide homeostasis does not change in pregnancies complicated by preterm prelabor rupture of membranes.

Cetin O1, Karaman E1, Boza B1, Cim N1, Erel O2, Alisik M2, Kolusarı A1, Yildizhan R1, Sahin HG1.

Author information

Abstract

PURPOSE:

To evaluate the maternal thiol/disulfide homeostasis in pregnant women complicated by preterm prelabor rupture of membranes (PPROM) and to compare the results with healthy pregnancies.


MATERIALS AND METHODS:

This cohort study consisted of thirty-nine pregnancies complicated by PPROM and 44 gestational age-matched healthy pregnancies in the third trimester of gestation. Maternal serum samples were obtained at the day of diagnosis, and thiol/disulfide profiles were measured by using an automated assay method. The patients were followed till delivery, and perinatal outcomes were noted.


RESULTS:

The maternal native thiol (319.9 ± 30.5 μmol/L versus 305.1 ± 49.2 μmol/L, p: .100), total thiol (379.2 ± 38.8 μmol/L versus 363.6 ± 56.4 μmol/L, p: .142) and disulfide (29.7 ± 11.7 μmol/L versus 29.3 ± 10.1 μmol/L, p: .864) levels were similar between the groups. Maternal disulfide/native thiol, disulfide/total thiol and native thiol/total thiol ratios were similar between the groups (p: .610, p: .565 and .562, respectively). The maternal serum thiol/disulfide profiles were not significantly correlated with maternal serum C-reactive protein, white blood cell count values and ongoing pregnancy outcomes (p > .05).


CONCLUSIONS:

The current study demonstrated that there was not any disturbance in maternal thiol/disulfide homeostasis in pregnancies complicated by PPROM at the time of initial diagnosis. Follow-up studies with larger sample size are needed to confirm our results.


KEYWORDS:

Preterm prelabor rupture of membranes; maternal serum; pregnancy; thiol/disulfide homeostasis


PMID: 28264620 DOI: 10.1080/14767058.2017.1297413

[Indexed for MEDLINE]

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MeSH terms, Substances

MeSH terms

Adult

Biomarkers/blood

C-Reactive Protein/analysis

Case-Control Studies

Cohort Studies

Disulfides/blood*

Female

Fetal Membranes, Premature Rupture/blood*

Fetal Membranes, Premature Rupture/etiology

Homeostasis*

Humans

Pregnancy

Pregnancy Trimester, Third

ROC Curve

Sensitivity and Specificity

Sulfhydryl Compounds/blood*

Substances

Biomarkers

Disulfides

Sulfhydryl Compounds

C-Reactive Protein

Select item 28397526

9.

Cutan Ocul Toxicol. 2017 Dec;36(4):393-396. doi: 10.1080/15569527.2017.1311339. Epub 2017 Apr 25.

Dynamic thiol/disulfide homeostasis and effects of smoking on homeostasis parameters in patients with psoriasis.

Emre S1, Demirseren DD1, Alisik M2, Aktas A1, Neselioglu S2, Erel O2.

Author information

Abstract

PURPOSE:

Recently, increased reactive oxygen species (ROS), reduced antioxidant capacity, and oxidative stress have been suggested in the pathogenesis of psoriasis. The aim of this study to evaluate the thiol/disulfide homeostasis in patients with psoriasis.


MATERIALS AND METHODS:

Ninety patients with psoriasis who did not receive any systemic treatment in the last six  months were included in the study. Seventy-six age and gender-matched healthy volunteers served as control group. Thiol/disulfide homeostasis was measured in venous blood samples obtained from patient and control groups.


RESULTS:

Native thiol and total thiol levels were significantly higher in patients than in control group. When thiol/disulfide hemostasis parameters and clinical and demographic characteristics were compared, a negative correlation was detected between native thiol and total thiol with age. The levels of total thiols had also negative correlation with PASI and duration of the disease. When we divided the patients into smokers and non-smokers, native thiol and total thiol levels were significantly higher in smokers than in controls, whereas native thiol and total thiol levels were comparable in non-smoker patients and controls.


CONCLUSIONS:

Thiol/disulfide balance shifted towards thiol in psoriasis patients and this may be responsible for increased keratinocyte proliferation in the pathogenesis of psoriasis.


KEYWORDS:

Psoriasis; smoking; thiol/disulfide homeostasis


PMID: 28397526 DOI: 10.1080/15569527.2017.1311339

[Indexed for MEDLINE]

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MeSH terms, Substances

MeSH terms

Adolescent

Adult

Aged

Disulfides/blood*

Female

Homeostasis

Humans

Male

Middle Aged

Psoriasis/blood*

Smoking/blood*

Sulfhydryl Compounds/blood*

Young Adult

Substances

Disulfides

Sulfhydryl Compounds

Select item 26230037

10.

Arch Environ Occup Health. 2016 Sep 2;71(5):268-272. Epub 2015 Jul 31.

Thiol/disulfide homeostasis in asphalt workers.

Yilmaz ÖH1, Bal C2, Neşelioglu S3, Büyükşekerci M4, Gündüzöz M5, Eren F3, Tutkun L6, Yilmaz FM7.

Author information

Abstract

The aim of this study was to investigate thiol/disulfide homeostasis in asphalt workers who are exposed to polycyclic aromatic hydrocarbons occupationally. The study was carried out in 34 nonsmoker asphalt workers. Additionally, 35 healthy nonsmoker volunteers were recruited as control group. Thiol and disulfide concentrations were determined using the novel automated measurement method. Levels of urinary 1-OH-pyrene were analyzed by liquid chromatography. Disulfide/thiol ratio was significantly higher in exposed group (p = .034). Also, a positive correlation was detected between disulfide/thiol ratio and 1-OH-pyrene values (r = .249, p = .036). Thiol/disulfide homeostasis was found to be disturbed in asphalt workers. The novel test used in this study may be useful for evaluating the oxidative status in polycyclic aromatic hydrocarbon (PAH) exposure.


KEYWORDS:

Asphalt workers; oxidative stress; polycyclic aromatic hydrocarbons; thiol/disulfide ratio


PMID: 26230037 DOI: 10.1080/19338244.2015.1076760

[Indexed for MEDLINE]

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MeSH terms, Substances

MeSH terms

Adult

Air Pollutants, Occupational/blood*

Biomarkers/urine

Chromatography, High Pressure Liquid

Construction Industry*

Disulfides/blood*

Homeostasis

Humans

Hydrocarbons

Male

Middle Aged

Occupational Exposure*

Oxidative Stress

Pyrenes/urine

Spectrophotometry

Sulfhydryl Compounds/blood*

Turkey

Substances

Air Pollutants, Occupational

Biomarkers

Disulfides

Hydrocarbons

Pyrenes

Sulfhydryl Compounds

asphalt

1-hydroxypyrene

Select item 28136082

11.

Arch Environ Occup Health. 2018 Mar 4;73(2):90-95. doi: 10.1080/19338244.2017.1287047. Epub 2017 Feb 26.

Alteration of thiol-disulfide homeostasis in workers occupationally exposed to arsenic.

Büyükşekerci M1, Bal C2, Serkant U3, Gündüzöz M4, Alışık M2, Tutkun E5, Yılmaz ÖH6.

Author information

Abstract

This study evaluates the redox state in occupationally arsenic-exposed workers (n = 71) by assessing the dynamic serum thiol-disulfide homeostasis. We determined the serum thiol-disulfide homeostasis parameters of exposed workers and controls (n = 43) using a novel automated colorimetric assay. Median urinary As and 8-isoprostane levels of exposed group were significantly higher than control group (16.40 μg/L vs 2μg/L, p < .001 and 2.28 ng/ml vs 0.54 ng/ml, p < .001, respectively). Disulfide level, disulfide/native thiol ratio, and disulfide/total thiol ratio were significantly higher in exposed group. The mean ceruloplasmine and myeloperoxidase activities of As-exposed group were significantly higher than control group (117.15 U/L vs 87.02 U/L, p = .035 and 148.53 U/L vs 97.75 U/L, p = .000, respectively). The median catalase activity did not differ in the two groups. Our findings revealed that As disrupts the thiol-disulfide homeostasis in favor of disulfide.


KEYWORDS:

Arsenic exposure; isoprostane; oxidative stress; thiol-disulfide homeostasis


PMID: 28136082 DOI: 10.1080/19338244.2017.1287047

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12.

Int Heart J. 2017 Feb 7;58(1):69-72. doi: 10.1536/ihj.16-124. Epub 2017 Jan 17.

The Role of Thiol/Disulphide Homeostasis in Anthracycline Associated Cardiac Toxicity.

Topuz M1, Şen O, Kaplan M, Akkus O, Erel O, Gur M.

Author information

Abstract

The aim of the present study was to evaluate whether the baseline thiol/disulfide state can predict the occurrence of anthracycline induced cardiac toxicity. A total of 186 cancer patients receiving anthracycline (doxorubicin)-based chemotherapy were enrolled. All patients underwent 2-dimensional (2D) speckle tracking echocardiography (STE) to determine their left ventricular ejection fraction (LVEF) and blood samples for measuring thiol forms were obtained before treatment and 4 weeks after completion of the chemotherapy. The mean dose of doxorubicin exposure was 255 ± 39.2 mg/m2. Baseline native thiol was found to be lower whereas baseline disulfide and the disulfide/total thiol ratio were found to be higher in patients who had a decrease in LVEF after anthracycline therapy. Also, the amount of decrease in LVEF was well correlated with the delta value of the thiol forms. Logistic regression analysis revealed that changes in BNP and global longitudinal strain (GLS), baseline level of native thiol, disulfide, and the disulfide/total thiol ratio were strong predictors for a decrease in LVEF.The thiol/disulfide pathway may be a factor for predicting chemotherapy-induced cardiac toxicity as one of the oxidative stress mechanisms.


PMID: 28100875 DOI: 10.1536/ihj.16-124

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MeSH terms, Substances

MeSH terms

Aged

Antibiotics, Antineoplastic/adverse effects*

Disulfides/metabolism*

Doxorubicin/adverse effects*

Female

Heart Diseases/chemically induced*

Heart Diseases/metabolism

Homeostasis

Humans

Male

Middle Aged

Oxidative Stress

Prospective Studies

Sulfhydryl Compounds/metabolism*

Substances

Antibiotics, Antineoplastic

Disulfides

Sulfhydryl Compounds

Doxorubicin

Select item 27045442

13.

Endocr Res. 2016 Nov;41(4):343-349. Epub 2016 Apr 4.

Dynamic thiol/disulfide homeostasis in patients with autoimmune subclinical hypothyroidism.

Ates I1, Altay M1, Yilmaz FM2,3, Topcuoglu C2, Neselioglu S3, Erel O3, Yilmaz N1.

Author information

Abstract

OBJECTIVE:

The aim of this study was to investigate dynamic thiol/disulfide homeostasis in autoimmune subclinical hypothyroidism.


METHODS:

Forty-eight patients with a new diagnosis of subclinical hypothyroidism due to Hashimoto thyroiditis who were not yet under medical therapy, and 48 healthy control subjects were enrolled. Thiol/disulfide homeostasis [native thiol-disulfide exchanges] was measured in both groups using the automated method developed by Erel and Neselioglu. An absolute difference of 0.5 between the total thiol and native thiol concentrations revealed the disulfide bond amount.


RESULTS:

The native thiol level (p = 0.014) and native thiol/total thiol ratio (p = 0.001) were lower in patients with subclinical hypothyroidism than in the control group. Meanwhile, the disulfide level (p = 0.004), disulfide/native thiol ratio (p = 0.001), and disulfide/total thiol (p = 0.001) ratio were higher in patients with subclinical hypothyroidism than in the control group. The antithyroid peroxidase and anti-thyroglobulin levels were positively correlated with the disulfide/native thiol ratio (r = 0.339, p = 0.019; r = 0.243, p = 0.023, respectively) and the disulfide/total thiol ratio (r = 0.133, p = 0.019; r = 0.238, p = 0.026, respectively) and negatively correlated with the native thiol/total thiol ratio (r = -0.292, p = 0.004; r = -0.233, p = 0.022, respectively).


CONCLUSION:

We found that thiol/disulfide homeostasis shifted to disulfide formation in patients with subclinical hypothyroidism and that thyroid autoantibodies were positively correlated with thiol oxidation. It is not clear whether abnormal thiol/disulfide homeostasis is a cause or a consequence in Hashimoto thyroiditis. Further studies are required.


KEYWORDS:

Hashimoto thyroiditis; oxidative stress; thiol oxidation; thiol/disulfide homeostasis


PMID: 27045442 DOI: 10.3109/07435800.2016.1156124

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MeSH terms, Substances

MeSH terms

Adult

Disulfides/blood*

Female

Hashimoto Disease/blood*

Homeostasis/physiology*

Humans

Male

Middle Aged

Oxidative Stress/physiology*

Sulfhydryl Compounds/blood*

Substances

Disulfides

Sulfhydryl Compounds

Select item 28804016

14.

Clin Neurol Neurosurg. 2017 Oct;161:17-21. doi: 10.1016/j.clineuro.2017.08.002. Epub 2017 Aug 5.

Dynamic thiol-disulphide homeostasis in low-grade gliomas: Preliminary results in serum.

Inal BB1, Emre HO2, Baran O3, Ahmedov M4, Ozdemir AF4, Kemerdere R4, Ates S5, Tanriverdi T4.

Author information

Abstract

OBJECTIVE:

Maintaining of precise balance between oxidation and anti-oxidation is important in both physiological and pathological states. Knowledge about this balance may give an idea about the process of the disease. The aim of this study was to investigate dynamic thiol-disulfide homeostasis in patients with low-grade gliomas.


PATIENTS AND METHODS:

Serial serum samples were collected in 13 patients operated on low-grade gliomas before and after surgery. Control serum samples were obtained from venous cord blood from 13 healthy women during cesarean section. Total thiol, native thiol, and disulfide bond formation were measured and compared with the controls.


RESULTS:

Total thiols, native thiols, and disulfide bond formation were significantly elevated in patients before the surgery compared to the controls (p<0.05). Even after the surgery, these three parameters were still high in patients, and the differences were significant (p<0.05). Although no significant difference was found between patients and controls regarding the ratios of disulfide/total thiol, disulfide/native thiol, and native thiol/total thiol (p>0.05), the balance seemed to shift to oxidative side.


CONCLUSIONS:

Thiol-disulfide homeostasis was disrupted in patients with low-grade gliomas, and oxidation may play a role in the process of this disease. Supplementation with antioxidants before and after surgery may be taken into consideration.


Copyright © 2017 Elsevier B.V. All rights reserved.


KEYWORDS:

Disulfide bond; Gliomas; Native thiol; Oxidation; Total thiol


PMID: 28804016 DOI: 10.1016/j.clineuro.2017.08.002

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MeSH terms, Substances

MeSH terms

Adult

Central Nervous System Neoplasms/blood*

Central Nervous System Neoplasms/surgery

Disulfides/blood*

Female

Glioma/blood*

Glioma/surgery

Homeostasis/physiology*

Humans

Male

Middle Aged

Neoplasm Grading

Oxidative Stress/physiology

Sulfhydryl Compounds/blood*

Substances

Disulfides

Sulfhydryl Compounds

Select item 27535382

15.

Metab Brain Dis. 2017 Feb;32(1):179-184. doi: 10.1007/s11011-016-9898-7. Epub 2016 Aug 18.

Evaluation of dynamic thiol/disulphide homeostasis as a novel indicator of oxidative stress in maple syrup urine disease patients under treatment.

Zubarioglu T1, Kiykim E2, Cansever MS3, Neselioglu S4, Aktuglu-Zeybek C2, Erel O4.

Author information

Abstract

Maple syrup urine disease (MSUD) is a metabolic disorder that is caused by deficiency of branched-chain α-keto acid dehydrogenase complex. Although accumulation of toxic metabolites is associated with neurotoxicity, mechanisms underlying brain damage remain unclear. Aim of this study is to evaluate thiol/disulphide homeostasis as a novel indicator of oxidative stress in MSUD patients under treatment. Twenty patients with MSUD and 20 healthy individuals were included in study. All patients were under regular follow-up and had a good metabolic control. Serum native thiol (-SH), total thiol (-SH + -S-S-), disulphide (-S-S) levels were measured in all subjects. Disulphide/native thiol, disulphide/total thiol and native thiol/total thiol ratios were calculated from these values. Simultaneous blood sampling for plasma quantitative amino acid analysis was performed in both groups. Any significant difference was not observed in -SH, -SH + -S-S-, -S-S levels between two groups. In addition no increase of disulphide/native thiol and disulphide/total thiol ratios was detected in patient group. This study is the first study that evaluates dynamic thiol/disulphide homeostasis as an indicator of oxidative stress in MSUD patients. Among previous studies that were made to determine oxidative stress in treated MSUD patients, this study had the largest sample size also. In recent studies, it was claimed that oxidative stress could be responsible from neurotoxicity even in treated patients. Here, dynamic thiol/disulfide homeostasis status showed that providing good metabolic control in MSUD patients prevent oxidative stress. Under regular follow-up and good compliance with diet, additional antioxidant therapies would possibly not be necessary.


KEYWORDS:

MSUD; Neurotoxicity; Oxidative stress; Thiol/disulphide homeostasis


PMID: 27535382 DOI: 10.1007/s11011-016-9898-7

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MeSH terms, Substances

MeSH terms

Adolescent

Child

Child, Preschool

Diet, Protein-Restricted

Disulfides/blood*

Female

Homeostasis/physiology*

Humans

Infant

Male

Maple Syrup Urine Disease/diet therapy

Maple Syrup Urine Disease/metabolism*

Oxidative Stress/physiology*

Sulfhydryl Compounds/blood*

Substances

Disulfides

Sulfhydryl Compounds

Select item 29236866

16.

An Acad Bras Cienc. 2018 Jan-Mar;90(1):99-108. doi: 10.1590/0001-3765201720160348. Epub 2017 Dec 7.

Thiol/disulfide status regulates the activity of thiol-containing kinases related to energy homeostasis in rat kidney.

Rech VC1,2, Mezzomo NJ2, Athaydes GA1, Feksa LR1,3, Figueiredo VC1, Kessler A1,4, Franceschi ID1, Wannmacher CMD1.

Author information

Abstract

Considering that thiol-containing enzymes like kinases are critical for several metabolic pathways and energy homeostasis, we investigated the effects of cystine dimethyl ester and/or cysteamine administration on kinases crucial for energy metabolism in the kidney of Wistar rats. Animals were injected twice a day with 1.6 µmol/g body weight cystine dimethyl ester and/or 0.26 µmol/g body weight cysteamine from the 16th to the 20th postpartum day and euthanized after 12 hours. Pyruvate kinase, adenylate kinase, creatine kinase activities and thiol/disulfide ratio were determined. Cystine dimethyl ester administration reduced thiol/disulfide ratio and inhibited the kinases activities. Cysteamine administration increased the thiol/disulfide ratio and co-administration with cystine dimethyl ester prevented the inhibition of the enzymes. Regression between the thiol/disulfide ratio, and the kinases activities were significant. These results suggest that redox status may regulate energy metabolism in the rat kidney. If thiol-containing enzymes inhibition and oxidative stress occur in patients with cystinosis, it is possible that lysosomal cystine depletion may not be the only beneficial effect of cysteamine administration, but also its antioxidant and thiol-protector effect.


PMID: 29236866 DOI: 10.1590/0001-3765201720160348

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Publication type, MeSH terms, Substances

Publication type

Evaluation Studies

MeSH terms

Adenylate Kinase/analysis

Adenylate Kinase/drug effects

Animals

Creatine Kinase/analysis

Creatine Kinase/drug effects

Cysteamine/pharmacology*

Cystine/analogs & derivatives*

Cystine/pharmacology

Cystine Depleting Agents/pharmacology

Disulfides*

Homeostasis/drug effects*

Kidney/drug effects*

Kidney/enzymology

Pyruvate Kinase/analysis

Pyruvate Kinase/drug effects

Random Allocation

Rats, Wistar

Reference Values

Reproducibility of Results

Sulfhydryl Compounds*

Substances

Cystine Depleting Agents

Disulfides

Sulfhydryl Compounds

Cystine

Cysteamine

Pyruvate Kinase

Creatine Kinase

Adenylate Kinase

cystine dimethyl ester

Select item 27451003

17.

Atherosclerosis. 2016 Oct;253:209-213. doi: 10.1016/j.atherosclerosis.2016.07.904. Epub 2016 Jul 16.

Plasma thiols and thiol-disulfide homeostasis in patients with isolated coronary artery ectasia.

Kızıltunç E1, Gök M2, Kundi H2, Çetin M2, Topçuoğlu C2, Gülkan B2, Çiçekçioğlu H2, Örnek E2.

Author information

Abstract

BACKGROUND AND AIMS:

Thiol/disulfide homeostasis has an important role in the antioxidant defense system. Oxidative stress may contribute to the pathogenesis of coronary artery ectasia. The aim of this study was to evaluate plasma thiol levels and thiol/disulfide homeostasis in patients with isolated coronary artery ectasia.


METHODS:

Forty-one patients with isolated coronary artery ectasia and 72 patients with normal coronary arteries were included in the study. Markis classification and number of ectatic coronary arteries were recorded. Plasma total thiol levels, native thiol levels and disulfide levels were measured. Thiol/disulfide homeostasis was appraised by calculating thiol/disulfide ratio.


RESULTS:

Plasma native thiol levels were significantly lower (336.9 (252.9-374.1) vs. 353.1 (327.0-380.0), p = 0.041) and disulfide levels were significantly higher (18.9 ± 6.3 vs. 16.6 ± 3.4, p = 0.014) in patients with coronary artery ectasia than control patients. Both native thiol/disulfide and total thiol/disulfide ratio was significantly lower in the coronary artery ectasia group (p < 0.001). Multivariate logistic regression analysis revealed that native thiol levels, disulfide levels and native thiol/disulfide ratio were independently associated with the presence of coronary artery ectasia. Thiol/disulfide ratio was not different according to number of ectatic coronary arteries and there was no association between thiol/disulfide ratio and Markis classification.


CONCLUSIONS:

Plasma thiol/disulfide homeostasis is altered in patients with coronary artery ectasia.


Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.


KEYWORDS:

Coronary artery ectasia; Oxidative stress; Thiol


Comment in

Thiol/disulfide homeostasis: A new insight into coronary artery ectasia. [Atherosclerosis. 2016]

PMID: 27451003 DOI: 10.1016/j.atherosclerosis.2016.07.904

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MeSH terms, Substances

MeSH terms

Aged

Coronary Vessels/pathology*

Cross-Sectional Studies

Dilatation, Pathologic/blood*

Dilatation, Pathologic/pathology*

Disulfides/blood*

Female

Homeostasis

Humans

Hypertension

Male

Middle Aged

Multivariate Analysis

Oxidative Stress

Sulfhydryl Compounds/blood*

Substances

Disulfides

Sulfhydryl Compounds

Select item 27546170

18.

J Matern Fetal Neonatal Med. 2017 Aug;30(15):1803-1808. doi: 10.1080/14767058.2016.1226795. Epub 2016 Sep 5.

Maternal serum thiol/disulfide homeostasis in pregnancies complicated by neural tube defects: report of a preliminary study.

Karaman E1, Çetin O1, Boza B1, Alışık M2, Erel Ö2, Çim N1, Yıldızhan R1, Şahin HG1.

Author information

1

a Department of Obstetric and Gynecology , Medical Faculty, Yuzuncu Yil University , Van , Turkey and.

2

b Department of Biochemistry , Medical Faculty, Yıldırım Beyazit University, Ankara , Turkey.

Abstract

OBJECTIVE:

To determine and evaluate the maternal serum thiol/disulfide homeostasis in pregnancies complicated by neural tube defects (NTD) via a novel method.


METHODS:

Seventy-three pregnant women with NTD (study group) and seventy-one healthy control pregnant women (control group) were included in the study. A new and fully automated method was used to measure plasma native thiol, total thiol and disulfide levels, based on the reduction of dynamic disulfide bonds to functional thiol groups by sodium borohydrate.


RESULTS:

The study and control groups were gestational age-matched. There were no statistical differences in demographic variables regarding age, gravidity, parity and body mass index. The serum native thiol levels (-SH) were 360.5 ± 50.3 and 353.3 ± 31.0 μmol/l in study and control groups, respectively, which was not statistically different (p = 0.308). The native thiol/total thiol, disulfide/native thiol and disulfide/total thiol ratios were not statistically significantly different (p > 0.05).


CONCLUSION:

Our preliminary results show that maternal serum thiol/disulfide homeostatis does not change in pregnancies complicated by NTD. Larger further studies are required to evaluate the relation of oxidative stress and development of NTD.


KEYWORDS:

Neural tube defects; oxidative stress; pregnancy; thiol/disulfide


PMID: 27546170 DOI: 10.1080/14767058.2016.1226795

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MeSH terms, Substances

MeSH terms

Adult

Disulfides/blood

Female

Gestational Age

Homeostasis*

Humans

Neural Tube Defects/blood*

Oxidative Stress

Pregnancy

Sulfhydryl Compounds/blood*

Substances

Disulfides

Sulfhydryl Compounds

Select item 28108906

19.

Int Ophthalmol. 2018 Feb;38(1):175-181. doi: 10.1007/s10792-017-0444-3. Epub 2017 Jan 21.

A novel marker in acute central serous chorioretinopathy: thiol/disulfide homeostasis.

Altinkaynak H1, Kurkcuoglu PZ2, Caglayan M3, Yorgun MA3, Yuksel N3, Kosekahya P4, Koca C5, Toklu Y6.

Author information

1

Department of Ophthalmology, Ankara Atatürk Education and Research Hospital, Ankara, Turkey. altinkaynak167@yahoo.com.

2

Department of Ophthalmology, World Eye Hospital, Ankara, Turkey.

3

Department of Ophthalmology, Ankara Atatürk Education and Research Hospital, Ankara, Turkey.

4

Ulucanlar Eye Education and Research Hospital, Ankara, Turkey.

5

Department of Biochemistry, Yıldırım Beyazıt University, Ankara Atatürk Education and Research Hospital, Ankara, Turkey.

6

Department of Ophthalmology, Yıldırım Beyazıt University, Ankara Atatürk Education and Research Hospital, Ankara, Turkey.

Abstract

PURPOSE:

The aim of this study was to compare dynamic thiol/disulfide homeostatic status in acute central serous chorioretinopathy (CSCR) patients by using a novel and automated assay determining dynamic thiol/disulfide homeostasis.


METHODS:

Fifty-one patients with acute CSCR (study group) and 65 healthy individuals (control group) were enrolled in this study. Diagnosis of acute CSCR was made clinically and using spectral-domain RTVue OCT (optical coherence tomography) (Optovue, Fremont, CA). Fluorescein angiography confirmed the diagnosis of acute CSCR in all subjects. Total thiol, native thiol, disulfide amount, and native thiol/disulfide ratio (TDR) were calculated in the blood samples.


RESULTS:

Mean total thiol, native thiol, and native TDR values were lower in patients with acute CSCR (364.2 ± 14.1, 326.4 ± 13.2, 17.14 ± 1.9, respectively) than in healthy eyes (441.2 ± 16.3, 398.5 ± 16.4, 22.70 ± 2.15, respectively; mean total thiol, p = 0.017; native thiol, p = 0.011; native TDR, p = 0.031).


CONCLUSIONS:

Total thiol, native thiol, and native TDR were significantly lower statistically in patients with acute CSCR when compared with healthy controls.


KEYWORDS:

Central serous chorioretinopathy; Native thiol; Thiol/disulfide ratio; Total thiol


PMID: 28108906 DOI: 10.1007/s10792-017-0444-3

[Indexed for MEDLINE]

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Publication type, MeSH terms, Substances

Publication type

Comparative Study

MeSH terms

Acute Disease

Adult

Biomarkers/blood

Central Serous Chorioretinopathy/diagnosis

Central Serous Chorioretinopathy/metabolism*

Central Serous Chorioretinopathy/physiopathology

Cross-Sectional Studies

Disulfides/blood*

Female

Fluorescein Angiography

Follow-Up Studies

Fundus Oculi

Homeostasis

Humans

Male

Microscopy, Acoustic

Middle Aged

Retrospective Studies

Severity of Illness Index

Sulfhydryl Compounds/blood*

Tomography, Optical Coherence

Visual Acuity*

Substances

Biomarkers

Disulfides

Sulfhydryl Compounds

Select item 28954023

20.

Arq Bras Oftalmol. 2017 Jul-Aug;80(4):234-237. doi: 10.5935/0004-2749.20170057.

Dynamic thiol/disulfide homeostasis in patients with age-related macular degeneration.

Aktaş S1, Sağdık HM1, Tetikoğlu M1, Aktaş H2, Özcura F1, Uçar F3, Alışık M4, Ergin M4.

Author information

1

Department of Ophthalmology, Dumlupinar University School of Medicine, Kutahya, Turkey.

2

Clinic of Ophthalmology, DPU Evliya Celebi Training and Research Hospital, Kutahya, Turkey.

3

Department of Clinical Biochemistry, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.

4

Department of Clinical Biochemistry, Ataturk Training and Research Hospital, Ankara, Turkey.

Abstract

PURPOSE::

We evaluated dynamic thiol/disulfide homeostasis (TDH), malondialdehyde (MDA) levels, and catalase (CAT) activity in patients with age-related macular degeneration (AMD). All analyzes were conducted on plasma samples.


METHODS::

Thirty-two patients with AMD and 38 age-matched healthy controls were included. Native thiol, total thiol, and disulfide levels and TDH status were determined using a novel, automated assay. MDA levels and CAT activity were determined. Percentages were compared using the chi-squared test. The Student's t-test and Mann-Whitney U-test were used to compare quantitative variables.


RESULTS::

Native thiol levels were significantly lower (p=0.004) in patients with AMD (272.02 ± 52.41 µmol/l) than in healthy individuals (307.82 ± 47.18 µmol/l), whereas disulfide levels were significantly higher (p<0.001) in patients with AMD than in controls (21.64 ± 5.59 vs. 14.48 ± 5.37 µmol/L). Dynamic TDH was also significantly lower (p<0.001) in patients with AMD than in controls (13.41 ± 4.3 vs. 25.41 ± 14.52 µmol/l). No significant differences were evident in total thiol or MDA levels. Mean CAT activity was significantly higher (p=0.043) in patients with AMD compared with controls (0.035 vs. 0.018 k/ml).


CONCLUSIONS::

The antioxidant/oxidant balance demonstrated by dynamic TDH is shifted to the oxidative side in patients with AMD.


PMID: 28954023 DOI: 10.5935/0004-2749.20170057

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Oxidative stress-induced hearing loss

Sensorineural hearing loss and volatile organic compound metabolites in urine

Publication date: Available online 4 March 2019

Source: American Journal of Otolaryngology

Author(s): Charles Pudrith, William N. Dudley

Abstract
Purpose

Oxidative stress in the auditory system contributes to acquired sensorineural hearing loss. Systemic oxidative stress, which may predict auditory oxidative stress, can be assessed by measuring volatile organic compound metabolite concentrations in urine. The purpose of this retrospective study was to determine if hearing decreased in those with higher concentrations of urinary volatile organic compound metabolites.

Materials and methods

Audiometric, demographic, and metabolite concentration data were downloaded from the 2011–2012 cycle of the U.S. National Health and Nutritional Examination Survey. Participants were first grouped by reported noise exposure. For each metabolite, an analysis of covariance was used to look for differences in age-adjusted hearing loss among urinary volatile organic compound metabolite concentration groups. Participants were grouped into quartiles based on concentration for each metabolite separately because many individuals were at the lower limit of concentration detection for several metabolites, leading to a non-normal distribution.

Results

Age-adjusted high-frequency pure-tone thresholds were significantly (FDR < 0.05) increased by about 3 to 4 dB in high concentration quartile groups for five metabolites. All five metabolites were glutathione-dependent mercapturic acids. The parent compounds of these metabolites included acrylonitrile, 1,3 butadiene, styrene, acrylamide, and N,N-dimethylformamide. Significant associations were only found in those with no reported noise exposure.

Conclusions

Urinary metabolites may help to explain susceptibility to oxidative stress-induced hearing loss.

Diagnosing thyroid nodules : Strain elastography, shear wave elastography, and conventional ultrasound

Comparison of strain elastography, shear wave elastography, and conventional ultrasound in diagnosing thyroid nodules
Li-Jen Liao, Huan-Wen Chen, Wan-Lun Hsu, Yung-Sheng Chen

Journal of Medical Ultrasound 2019 27(1):26-32

Objective: The purpose of this study is to compare the diagnostic performances of strain elastography (SE), shear wave elastography (SWE), and traditional ultrasound (US) features in diagnosing thyroid nodules. Subjects and Methods: This study included 185 adult patients with thyroid nodules who underwent conventional gray-scale US, SE, and SWE. SE was scored using a four-pattern elastographic scoring (ES) system. SWE values were presented as mean SWE values and standard derivation using Young&#39;s modules. The optimal cutoff values of the mean SWE values for predicting malignancy were determined using receiver operating characteristic (ROC) curve analysis. We used logistic regression models to test elastography as a novel significant predictor for the diagnosis of malignant nodules. The diagnostic performance of elastography parameters was compared with a traditional trained model. Results: Malignant thyroid nodules were stiffer for SE (ES patterns 1 and 2/3 and 4) and mean SWE values (4/17; 51.0 &#177; 24.4 kPa) than for benign nodules (114/50; 33.1 &#177; 25.2 kPa) (P &#60; 0.01). In ROC curve analyses, a mean SWE value of 32 kPa was the optimal cutoff point, with diagnostic performance measures of 81&#37; sensitivity, 65&#37; specificity, a 23&#37; positive predictive value (PPV), and 96&#37; negative predictive value (NPV). In multivariate logistic regression, the mean SWE value (&#8805;32 kPa) was an independent predictor for malignancy (odds ratio: 16.8; 95&#37; confidence interval [CI]: 3.6&#8211;78.3). However, after the addition of SE and SWE to traditional US features, the C-statistic was not significantly increased compared to the traditional model (0.88, 95&#37; CI: 0.81&#8211;0.94 vs. 0.91, 0.85&#8211;0.97, P &#61; 0.4). Conclusion: In this study, we confirmed SWE as an independent predictor for malignant thyroid nodules. However, in comparing the new extended elastography model to our previous prediction model, the new extended model showed no significant difference in the diagnostic performance.

The damaging effect of rheumatoid arthritis (RA) on cartilage, bone, ligaments, and tendons.The Disease Activity Score (DAS)-28 with the musculoskeletal ultrasonography (US) examination

A longitudinal study of the 28 joints of disease activity score by ultrasonographical examination in rheumatoid arthritis patients
Rabab Hussin Ali, Osama Sayed Daifallah, Hanan Sayed M. Abozaid, Esam Mohmad Abu Alfadl, Sahar Abdel-Rahman Elsayed

Journal of Medical Ultrasound 2019 27(1):33-39

Background: The damaging effect of rheumatoid arthritis (RA) on cartilage, bone, ligaments, and tendons has raised the importance of the disease activity and severity assessment to enable therapeutic decisions and to evaluate disease outcome. Aim: The aim is to compare the clinical examination of the Disease Activity Score (DAS)-28 with the musculoskeletal ultrasonography (US) examination in RA patients. Moreover, finding if we can use ultrasonographical results as a tool for predicting subsequent radiological damage. Patients and Methods: It is a longitudinal study included 60 adult RA patients. Patients were under assessment at baseline, 6 months, and 12 months from the recruitment time. Twenty-eight joints of DAS were assessed for tenderness and swelling. US gray scale (GS) and US power Doppler (PD) score also was done at each visit. Results: DAS-28, with its parameters, is positively and highly significantly correlated to synovitis severity both by US GS and US-PD score along the study follow-up visits. There was highly significant difference between the number of 28 swollen and tender joints by clinical examination with both US GS and US-PD. Linear regression analysis to predict the number of swollen and tender joints after 12 months showed significance between US PD with swollen and tender joints&#39; numbers. The correlation was positive and significant between Larsen score at 12 months with GS US and PD US assessment, but linear regression analysis was only significant for Larsen score with only GS US. Conclusion: GS US and PD is a sensitive and reliable noninvasive method complementary to standard clinical assessment and could be a tool for predicting subsequent joints&#39; damage.

Otolaryngology

Transdermal lidocaine as treatment for chronic subjective tinnitus: A pilot study

Publication date: Available online 18 March 2019

Source: American Journal of Otolaryngology

Author(s): Daniel C. O'Brien, Aaron D. Robinson, Nancy Wang, Rodney Diaz

Abstract
Objective

To assess the efficacy of transdermal lidocaine as a treatment for chronic subjective tinnitus as measured by the Tinnitus Functional Index (TFI).

Study design

Pilot, prospective efficacy trial.

Setting

Tertiary care hospital.

Patients

Men and women, over the age of 18 with chronic subjective tinnitus for >6 months.

Intervention

Daily application of commercially available transdermal lidocaine patch.

Outcome measure

Change in the TFI.

Results

The average pre-treatment TFI score was 56.2. After 1 month the average TFI decreased to 41 (p < 0.05). The scores dropped to 34 and 35 after 2 and 3 months of treatment respectively. Despite improvement in symptoms of tinnitus, most patients did not continue the study after the first month, dropping out due to the size, discomfort, and appearance of the lidocaine patch, failure to follow-up and lack of perceived benefit from treatment.

Conclusions

In this preliminary study, 5% transdermal lidocaine appears to be a potential treatment for chronic subjective tinnitus. The majority of subjects who completed 1 month of treatment had clinically significantly improved tinnitus. These findings are confounded however by the small sample size and significant drop out rate.



Mild hypothermia is associated with improved outcomes in patients undergoing microvascular head and neck reconstruction

Publication date: Available online 16 March 2019

Source: American Journal of Otolaryngology

Author(s): Benjamin M. Laitman, Yue Ma, Bryan Hill, Marita Teng, Eric Genden, Samuel DeMaria, Brett A. Miles

Abstract
Objective

Microvascular free tissue transfer has become the standard for reconstruction for large defects. With long operative times and an increased surface area exposed, transient hypothermia is common, but it is unclear how this impacts surgical outcomes. This study evaluated the impact of core body temperature on free tissue flap outcomes in patients undergoing microvascular reconstruction.

Study design

Retrospective data analysis.

Setting

Mount Sinai Hospital; NYC, NY; 2007–2016.

Subjects and methods

Demographic information, mean/minimum/maximum body temperatures, and the presence of flap complications (venous thrombosis, arterial insufficiency, flap death, wound infection/dehiscence, fistula, chyle leak, hematoma/seroma) of 519 free tissue transfer patients were documented. Binomial logistic regression was used to examine associations between the presence of flap complications and mean temperature. Statistical analysis used SPSS, with p-values ≤0.05 deemed statistically significant.

Results

393 soft-tissue and 125 osteocutaneous flaps were included. 19.8% (n = 103) patients had the presence of ≥1 flap complication, while 80.2% (n = 416) did not. Average temperature for all patients was 36.12 ± 0.84 °C, with minimum at 34.43 ± 0.97 °C and maximum at 37.24 ± 1.23 °C. After controlling for several factors including: tumor stage, radiation, diabetes, BMI, age, sex, and flap type, there was a significant association between flap complications and mean intraoperative temperature (Exp(B) = 1.559, p = 0.004).

Conclusion

Higher intraoperative temperatures were associated with worse outcomes. A mild relative hypothermia may improve flap outcomes in this population. This represents the largest study to date evaluating the impact of intraoperative temperature on free tissue transfer outcomes.



Non-recurrent laryngeal nerve in thyroid surgery: Frequency, anatomical variations according to a new classification and surgery consideration

Publication date: Available online 12 March 2019

Source: American Journal of Otolaryngology

Author(s): Quang Van Le, Quoc Ngo Duy, Quy Xuan Ngo

Abstract
Background

Iatrogenic injury to the recurrent laryngeal nerve (RLN) is one of the most concerning problems of thyroid surgery. The non-recurrent laryngeal nerve (NRLN) is a rare variation of the RLN.

Objectives

We aimed to identify the proportion of NRLN (during thyroidectomy), introduce a new details classification and recommend some surgical considerations.

Materials and methods

From May 2017 to September 2018, our hospital carried out 2462 thyroid operations. We reported the NRLN rate and distinguished NRLN into three types: (a) Type 1: descending – NRLN runs downward to the cricothyroid joint; (b) Type 2: vertical – NRLN runs vertically to the cricothyroid joint; (c) Type 3: ascending – NRLN runs upward to the cricothyroid joint.

Results

Overall, right-side NRLN had an incidence rate of 0.74% (16 out of 2158 total right thyroid surgeries). However, we did not detect any patient with left-sided NRLN. 12.5% of our patients had type 1, 25% had type 2 and 62.5% had type 3. All 16 patients with NRLN were treated without any complications or injury and some considerations for surgeons were mentioned on how to avoid injury of the NRLN.

Conclusion

Despite NRLN occurrence being rare, the injury probability during surgery can reach up to 12.9% if correct procedures were not carried out. Here, we introduce a new details classification and information with which they can make appropriate surgical considerations to avoid nerve injury in thyroid surgery.



Angiolymphoid hyperplasia with eosinophilia of the external ear

Publication date: Available online 12 March 2019

Source: American Journal of Otolaryngology

Author(s): Brian C. Deutsch, Zachary G. Schwam, Vivian Z. Kaul, George B. Wanna

Abstract

Herein we present the rare case of angiolymphoid hyperplasia with eosinophilia of the external ear treated by surgical resection and full-thickness skin graft. Current diagnosis and management options are reviewed.



Thyroid cancer in patients undergoing surgery for hyperthyroidism

Publication date: Available online 11 March 2019

Source: American Journal of Otolaryngology

Author(s): Yogesh More, Aly Bernard Khalil, Huda Mustafa, Manjiri Gupte, Musa al abbadi, Doua Elamin, Luay Aziz, Shaikh Irfan Basha



Seed and soil? - Pharyngeal Merkel cell carcinoma after radiotherapy for laryngeal squamous cell carcinoma

Publication date: Available online 9 March 2019

Source: American Journal of Otolaryngology

Author(s): Monica K. Rossi, D. Anand Rajan Kanagasabapathy, Henry T. Hoffman

Abstract

Merkel cell carcinoma (MCC) is a neuroendocrine cutaneous malignancy that may present as metastatic disease without a known primary site but, most commonly originates in the sun-exposed skin of the head, neck, and extremities. We present a 66-year-old male treated with chemo-radiation for T3N2cM0 laryngeal squamous cell carcinoma (SCCa) six years before he was diagnosed with MCC isolated to the radiated laryngopharynx. Mucosal MCC is rare and radiation-induced MCC has been hypothesized to occur in previously radiated tissue but, never before to the laryngopharynx. Implications regarding cancer biology and management is focused with discussion on relevant advances in pathologic assessment and immunotherapy.



A systematic review of the nasal septal turbinate: An overlooked surgical target

Publication date: Available online 4 March 2019

Source: American Journal of Otolaryngology

Author(s): William J. Moss, Farhoud Faraji, Aria Jafari, Adam S. DeConde

Abstract
Objective

The nasal septal turbinate (NST) is a conspicuous structure located in the anterior nasal cavity that impacts the internal nasal valve. Its structure and function is often thought to be poorly characterized, and it is rarely addressed surgically. The authors perform a systematic review in an attempt to synthesize what has been learned of this structure and to evaluate its potential as a treatment target.

Methods

A query of the Medline, Embase, Web of Science and Cochrane databases was undertaken in search of studies evaluating the NST. This qualitative systematic review was performed in accordance with PRISMA guidelines. Study quality and risk of bias were assessed with established criteria.

Results

Of the initial 1069 hits from the four databases, 16 articles were ultimately included in the review, which varied in quality and risk of bias. The included articles consisted predominantly of radiographic and histopathologic studies. Four studies evaluated NST treatment outcomes. The NST represents a fusiform-shaped region of erectile tissue, similar in structure and function to that of the turbinates. Preliminary treatment outcomes suggest the NST represents an important surgical target in nasal airway surgery.

Conclusion

When evaluating nasal obstruction patients, surgeons should assess the NST and consider addressing it surgically.



The role of doxycycline in the management of chronic rhinosinusitis with nasal polyps

Publication date: Available online 4 March 2019

Source: American Journal of Otolaryngology

Author(s): Arjun K. Parasher, Sarah M. Kidwai, Neeraja Konuthula, Erden Goljo, Stephanie Pan, Alok T. Saini, Anthony Del Signore, Alfred Marc Iloreta, Satish Govindaraj, Benjamin D. Malkin

Abstract
Introduction

Many theories on the pathophysiology of chronic rhinosinusitis with nasal polyposis (CRSwNP) exist. The most effective management of CRSwNP has not been elucidated. Doxycycline, which has anti-inflammatory and anti-bacterial properties, has shown durable effects; however, its efficacy in combination with standard therapy has not been examined. We hypothesized that its addition to the standard anti-inflammatory regimen would improve patient outcomes.

Methods

We performed a double-blind, placebo-controlled trial at a tertiary level institution. Patients with moderate or severe CRSwNP were randomized into two groups, each receiving a 20-day course of oral corticosteroids and doxycycline or placebo. The 22-item Sinonasal Outcome Test (SNOT-22), nasal polyp scores, and visual analog scale (VAS) scores were recorded at the initial, 3-, 8- and 12-week visits.

Results

49 patients were enrolled, 24 in the experimental and 25 in the placebo group with 3 moderate disease patients in each group. There were 12 dropouts in the treatment group and 14 in the placebo group. The most common reasons for dropout were severe CRS and asthma exacerbations. There was no significant difference in SNOT-22 scores, nasal polyp scores, and VAS scores between the two arms.

Conclusions

Non-surgical management of patients with CRSwNP remains challenging. Our conclusions are limited given the high dropout rate and thus, limited sample size with inadequate power. This study is important, however, because a high dropout rate of mostly severe disease patients may illustrate that this patient population may not be optimally managed with medical therapy alone.



Sensorineural hearing loss and volatile organic compound metabolites in urine

Publication date: Available online 4 March 2019

Source: American Journal of Otolaryngology

Author(s): Charles Pudrith, William N. Dudley

Abstract
Purpose

Oxidative stress in the auditory system contributes to acquired sensorineural hearing loss. Systemic oxidative stress, which may predict auditory oxidative stress, can be assessed by measuring volatile organic compound metabolite concentrations in urine. The purpose of this retrospective study was to determine if hearing decreased in those with higher concentrations of urinary volatile organic compound metabolites.

Materials and methods

Audiometric, demographic, and metabolite concentration data were downloaded from the 2011–2012 cycle of the U.S. National Health and Nutritional Examination Survey. Participants were first grouped by reported noise exposure. For each metabolite, an analysis of covariance was used to look for differences in age-adjusted hearing loss among urinary volatile organic compound metabolite concentration groups. Participants were grouped into quartiles based on concentration for each metabolite separately because many individuals were at the lower limit of concentration detection for several metabolites, leading to a non-normal distribution.

Results

Age-adjusted high-frequency pure-tone thresholds were significantly (FDR < 0.05) increased by about 3 to 4 dB in high concentration quartile groups for five metabolites. All five metabolites were glutathione-dependent mercapturic acids. The parent compounds of these metabolites included acrylonitrile, 1,3 butadiene, styrene, acrylamide, and N,N-dimethylformamide. Significant associations were only found in those with no reported noise exposure.

Conclusions

Urinary metabolites may help to explain susceptibility to oxidative stress-induced hearing loss.



Is otitis media with effusion associated with oxidative stress? Evaluation of thiol/disulfide homeostasis

Publication date: March–April 2019

Source: American Journal of Otolaryngology, Volume 40, Issue 2

Author(s): Eda Şimşek, Cemile Koca Bicer, Muhammed Recai Mazlumoğlu, Soner Sertan Kara, Ozcan Erel, Ayşe Çarlıoğlu

Abstract
Background

We evaluated the relationship between otitis media with effusion and thiol/disulfide homeostasis using a novel marker of oxidative stress.

Methods

The study group consisted of 30 patients (mean age 8.33 ± 3.30 years) with bilateral otitis media with effusion admitted to our hospital. The control group consisted of 35 (mean age 7.40 ± 3.97 years) age-, sex-, and body mass index-matched healthy subjects. Thiol/disulfide homeostasis was measured using a newly developed method.

Results

Native and total thiol levels were lower in the study than the control group (native thiols 421.37 ± 72 μmol/L vs. 464.46 ± 46.42 μmol/L, p < 0.05; total thiols 468.42 ± 77.89 μmol/L vs. 501.32 ± 50.30 μmol/L, respectively). Disulfide levels and the disulfide/native thiol and disulfide/total thiol ratios were higher in the study group (disulfides 23.56 ± 4.68 μmol/L vs. 18.43 ± 4.94 μmol/L; disulfide/native thiol ratio 5.65 ± 1.05 vs. 3.97 ± 1.03%; disulfide/total thiol ratio 5.06 ± 0.83 vs. 3.66 ± 0.88%, respectively).

Conclusion

Oxidative stress may be the major cause of the increase in oxidized thiols in patients with bilateral otitis media with effusion, however, this relationship requires further investigation.



Early detection of superior mesenteric artery dissection by ultrasound

: Two case reports
Chun-Yen Huang, Jen-Tang Sun, Wan-Ching Lien

Journal of Medical Ultrasound 2019 27(1):47-49

Superior mesenteric artery (SMA) dissection is a rare disease. Most of the cases are diagnosed through contrast-enhanced computed tomography. The use of emergent bedside ultrasound has been described to diagnose aortic dissection. However, evidence is limited regarding the use of bedside ultrasound for diagnosing SMA dissection, which is a known risk factor for aortic dissection. We present two case reports: one case of isolated SMA dissection and one case of SMA dissection complicated with aortic dissection. Both cases were initially diagnosed through bedside ultrasound and confirmed through contrast-enhanced computed tomography.

Haematoma OR ...?

Soft-tissue sarcoma masquerading as a haematoma
Mark Charnock

Journal of Medical Ultrasound 2019 27(1):50-53

Sarcomas commonly occur in the buttock and thigh, although the clinical presentation varies with no specific symptoms other than a painless lump. This case study reports on a soft-tissue sarcoma that was initially thought to be a haematoma on ultrasound, despite being rescanned 6 weeks later. The patient presented back to their general practitioner 8 months later with the subsequent ultrasound showing an irregular and hypervascular soft-tissue mass. Further imaging and ultrasound-guided biopsy led to a surgical excision of a myxofibrosarcoma. This case demonstrates the difficulty of differentiating between a haematoma and sarcoma, especially in patients presenting with a history of trauma.

Cervical lymphadenopathy

IgG4-related disease presenting as cervical lymphadenopathy
Po-Hsuan Wu, Yu-Chen Chang, Li-Jen Liao

Journal of Medical Ultrasound 2019 27(1):43-46

Cervical lymph node enlargement as the first and sole manifestation of IgG4-related disease (IgG4-RD) is rare and is often difficult to distinguish from lymphoma. Here, we report a case of a 63-year-old man initially presenting with bilateral posterior neck masses. Ultrasonography revealed multiple matted, ovoid, homogenous, hypoechoic, and enlarged lymph nodes below the right parotid gland. In addition, there was heterogeneous echotexture with small and indistinct hypoechoic nodules over bilateral parotid and submandibular glands which suggested sclerosing sialadenitis. Pathology of the tissues obtained by core needle biopsy revealed reactive hyperplasia, but a diagnosis of lymphoma could not be excluded. Subsequently, excisional biopsy and serological tests were done. The diagnosis of IgG4-RD was confirmed due to marked elevation of serum IgG4 levels and pathological evidence of IgG&#43; and IgG4&#43; plasma cell infiltration in the lymph node specimen. The patient&#39;s neck masses subsided gradually after 1 week of oral steroid therapy. The differential diagnosis of IgG4-RD should always be considered when sclerosing sialadenitis is presented with cervical lymphadenopathy.

Medical Ultrasound

Application of ultrasound liver elastography to the diagnosis and monitoring of liver disease
Jing-Houng Wang

Journal of Medical Ultrasound 2019 27(1):1-2



Reliability of ultrasound for the detection of rheumatoid arthritis
Rabia Hassan, Sobia Hussain, Raham Bacha, Syed Amir Gillani, Sajid Shaheen Malik

Journal of Medical Ultrasound 2019 27(1):3-12

The aim of this review article was to investigate the pooled sensitivity and specificity of musculoskeletal ultrasound (MSUS) for the detection of synovitis and early bone erosion in the small joint in rheumatoid arthritis (RA). In addition, investigate the pooled sensitivity and specificity of Power Doppler ultrasonography (PDUS) for the detection of synovial hypervascularity in small joints in RA. A systematic literature search of PubMed, Wiley online library, Google Scholar, Research gate, E-book, BioMed Central, the Journal of Rheumatology and Springer Link were investigated from 2001 to 2017. Original researches related to the article written in English including RA, synovitis, bone erosion, grayscale, and PDUS were included in this study. The sample size, study design, sensitivity, and specificity were analyzed. The review summarizes the value of MSUS for the detection of RA as it is the first choice of modality. Results show the acceptable reliability of US for the diagnosis of early bone erosions, synovitis, and synovial hypervascularity. 


Relation of color doppler twinkling artifact and scale or pulse repetition frequency
Raham Bacha, Syed Amir Gilani, Iqra Manzoor

Journal of Medical Ultrasound 2019 27(1):13-18

Objective: The aim of this study is to determine the effect of scale/pulse repetition frequency (PRF) on the appearance of color Doppler twinkling artifact. Materials and Methods: We commenced this cross-sectional study for 20 months from November 2014 to July 2016. During routine ultrasound examination, we observed multiple case of twinkling artifact produced by renal stones, calcifications in the thyroid nodules, bony fragments and intestinal gases, etc., We observed twinkling artifact with low- and high-PRF settings in 500 different structures. A total of 500 other structures were included wherein there was no Doppler twinkling artifact produced by them, with usual optimum PRF settings. These structures were also evaluated with low- and high-PRF to determine the effect of PRF on twinkling artifact effectively. All the patients were examined according to the AIUM guideline for appropriate examination protocol. Data were collected from the observation of twinkling artifact with low- and high-PRF/scale and evaluated with the help of IBM SPSS 24 package, the results were summarized as follow. Results: Change in scale/PRF could not affect the twinkling artifact. The twinkling artifact observed with low-PRF was the same as seen with high-PRF. There was a significant agreement between low- and high-PRF in the production of color twinkling artifact. The kappa value of agreement was estimated as 0.96, whereas the Pearson&#39;s correlation was significant with the value of 0.001. Same twinkling artifact was created with low- and high-PRF, with no significant variation. Conclusion: Twinkling artifact is independent of PRF/Scale.


Correlational study of nonalcoholic fatty liver disease diagnosed by ultrasonography with lipid profile and body mass index in adult nepalese population
Umesh P Khanal, Bigyan Paudel, Ghanshyam Gurung, Yong-Sin Hu, Chiung-Wen Kuo

Journal of Medical Ultrasound 2019 27(1):19-25

Objective: The purpose of this study was to categorize patients into different grades of nonalcoholic fatty liver disease (NAFLD) by ultrasonography and to compare the findings with their serum lipid profile. Materials and Methods: Descriptive, cross-sectional study design was used. One hundred and nine patients without a history of alcohol consumption of age more than 16 years attending general health checkup were selected at Tribhuvan University Teaching Hospital, Maharajganj, Kathmandu, as per the exclusion and inclusion criteria. Ultrasound scanning of the patients was done and their liver size, as well as grading of fatty liver, was done. Data were collected in predesigned pro forma and were analyzed using Statistical Package for the Social Sciences (SPSS) 16.0, IBM (SPSS Inc., Chicago, IL). Results: In this study, the mean age of fatty liver in males was found to be 44.3 years and in females was found to be 51.9 years. 22.9&#37; of patients with NAFLD had increased liver size. Significant association with increasing grades of fatty liver was found with increasing levels of cholesterol (P &#61; 0.028), low-density lipoprotein (LDL) (P &#61; 0.017), liver size (P &#61; 0.001), and body mass index (BMI) (P &#61; 0.045) in patients diagnosed with NAFLD. No significant association with increasing grades of fatty liver was found with increasing levels of triglyceride (P &#61; 0.32) and high-density lipoprotein (P &#61; 0.25). Conclusion: Ultrasound is a safe and first-line modality for the evaluation of fatty liver and its grading. Increasing grades of fatty liver had significant association with increasing levels of cholesterol LDL, increasing liver size, and BMI of patients.


Comparison of strain elastography, shear wave elastography, and conventional ultrasound in diagnosing thyroid nodules
Li-Jen Liao, Huan-Wen Chen, Wan-Lun Hsu, Yung-Sheng Chen

Journal of Medical Ultrasound 2019 27(1):26-32

Objective: The purpose of this study is to compare the diagnostic performances of strain elastography (SE), shear wave elastography (SWE), and traditional ultrasound (US) features in diagnosing thyroid nodules. Subjects and Methods: This study included 185 adult patients with thyroid nodules who underwent conventional gray-scale US, SE, and SWE. SE was scored using a four-pattern elastographic scoring (ES) system. SWE values were presented as mean SWE values and standard derivation using Young&#39;s modules. The optimal cutoff values of the mean SWE values for predicting malignancy were determined using receiver operating characteristic (ROC) curve analysis. We used logistic regression models to test elastography as a novel significant predictor for the diagnosis of malignant nodules. The diagnostic performance of elastography parameters was compared with a traditional trained model. Results: Malignant thyroid nodules were stiffer for SE (ES patterns 1 and 2/3 and 4) and mean SWE values (4/17; 51.0 &#177; 24.4 kPa) than for benign nodules (114/50; 33.1 &#177; 25.2 kPa) (P &#60; 0.01). In ROC curve analyses, a mean SWE value of 32 kPa was the optimal cutoff point, with diagnostic performance measures of 81&#37; sensitivity, 65&#37; specificity, a 23&#37; positive predictive value (PPV), and 96&#37; negative predictive value (NPV). In multivariate logistic regression, the mean SWE value (&#8805;32 kPa) was an independent predictor for malignancy (odds ratio: 16.8; 95&#37; confidence interval [CI]: 3.6&#8211;78.3). However, after the addition of SE and SWE to traditional US features, the C-statistic was not significantly increased compared to the traditional model (0.88, 95&#37; CI: 0.81&#8211;0.94 vs. 0.91, 0.85&#8211;0.97, P &#61; 0.4). Conclusion: In this study, we confirmed SWE as an independent predictor for malignant thyroid nodules. However, in comparing the new extended elastography model to our previous prediction model, the new extended model showed no significant difference in the diagnostic performance.


A longitudinal study of the 28 joints of disease activity score by ultrasonographical examination in rheumatoid arthritis patients
Rabab Hussin Ali, Osama Sayed Daifallah, Hanan Sayed M. Abozaid, Esam Mohmad Abu Alfadl, Sahar Abdel-Rahman Elsayed

Journal of Medical Ultrasound 2019 27(1):33-39

Background: The damaging effect of rheumatoid arthritis (RA) on cartilage, bone, ligaments, and tendons has raised the importance of the disease activity and severity assessment to enable therapeutic decisions and to evaluate disease outcome. Aim: The aim is to compare the clinical examination of the Disease Activity Score (DAS)-28 with the musculoskeletal ultrasonography (US) examination in RA patients. Moreover, finding if we can use ultrasonographical results as a tool for predicting subsequent radiological damage. Patients and Methods: It is a longitudinal study included 60 adult RA patients. Patients were under assessment at baseline, 6 months, and 12 months from the recruitment time. Twenty-eight joints of DAS were assessed for tenderness and swelling. US gray scale (GS) and US power Doppler (PD) score also was done at each visit. Results: DAS-28, with its parameters, is positively and highly significantly correlated to synovitis severity both by US GS and US-PD score along the study follow-up visits. There was highly significant difference between the number of 28 swollen and tender joints by clinical examination with both US GS and US-PD. Linear regression analysis to predict the number of swollen and tender joints after 12 months showed significance between US PD with swollen and tender joints&#39; numbers. The correlation was positive and significant between Larsen score at 12 months with GS US and PD US assessment, but linear regression analysis was only significant for Larsen score with only GS US. Conclusion: GS US and PD is a sensitive and reliable noninvasive method complementary to standard clinical assessment and could be a tool for predicting subsequent joints&#39; damage.


Consistency of the sonographic image (double contour sign) in patients with gout after ambulation
Angel Checa

Journal of Medical Ultrasound 2019 27(1):40-42

The aim of this study was to know whether or not any crystal shedding occurs after ambulation in patients with gout and how it affects the consistency of the sonographic image of crystal deposition on hyaline cartilage. A total of 18 consecutive patients (29 knees), 11 with early gout (17 knees) and seven with chondrocalcinosis (12 knees), were prospectively scanned by ultrasound. Examination at rest and after ambulation was performed in each patient. Crystal aggregates were measured in a transverse view. Crystal shedding after ambulation was noted in two patients (two knees) with gout. However, crystal deposits on the surface of the articular cartilage in gout kept invariable size. In patients with chondrocalcinosis, crystal shedding by ambulation was absent. The conclusion of this study is that the size of crystal deposits on the hyaline cartilage in gout and chondrocalcinosis assessed by ultrasound is not modifiable by ambulation.


IgG4-related disease presenting as cervical lymphadenopathy
Po-Hsuan Wu, Yu-Chen Chang, Li-Jen Liao

Journal of Medical Ultrasound 2019 27(1):43-46

Cervical lymph node enlargement as the first and sole manifestation of IgG4-related disease (IgG4-RD) is rare and is often difficult to distinguish from lymphoma. Here, we report a case of a 63-year-old man initially presenting with bilateral posterior neck masses. Ultrasonography revealed multiple matted, ovoid, homogenous, hypoechoic, and enlarged lymph nodes below the right parotid gland. In addition, there was heterogeneous echotexture with small and indistinct hypoechoic nodules over bilateral parotid and submandibular glands which suggested sclerosing sialadenitis. Pathology of the tissues obtained by core needle biopsy revealed reactive hyperplasia, but a diagnosis of lymphoma could not be excluded. Subsequently, excisional biopsy and serological tests were done. The diagnosis of IgG4-RD was confirmed due to marked elevation of serum IgG4 levels and pathological evidence of IgG&#43; and IgG4&#43; plasma cell infiltration in the lymph node specimen. The patient&#39;s neck masses subsided gradually after 1 week of oral steroid therapy. The differential diagnosis of IgG4-RD should always be considered when sclerosing sialadenitis is presented with cervical lymphadenopathy.


Early detection of superior mesenteric artery dissection by ultrasound: Two case reports
Chun-Yen Huang, Jen-Tang Sun, Wan-Ching Lien

Journal of Medical Ultrasound 2019 27(1):47-49

Superior mesenteric artery (SMA) dissection is a rare disease. Most of the cases are diagnosed through contrast-enhanced computed tomography. The use of emergent bedside ultrasound has been described to diagnose aortic dissection. However, evidence is limited regarding the use of bedside ultrasound for diagnosing SMA dissection, which is a known risk factor for aortic dissection. We present two case reports: one case of isolated SMA dissection and one case of SMA dissection complicated with aortic dissection. Both cases were initially diagnosed through bedside ultrasound and confirmed through contrast-enhanced computed tomography.


Soft-tissue sarcoma masquerading as a haematoma
Mark Charnock

Journal of Medical Ultrasound 2019 27(1):50-53

Sarcomas commonly occur in the buttock and thigh, although the clinical presentation varies with no specific symptoms other than a painless lump. This case study reports on a soft-tissue sarcoma that was initially thought to be a haematoma on ultrasound, despite being rescanned 6 weeks later. The patient presented back to their general practitioner 8 months later with the subsequent ultrasound showing an irregular and hypervascular soft-tissue mass. Further imaging and ultrasound-guided biopsy led to a surgical excision of a myxofibrosarcoma. This case demonstrates the difficulty of differentiating between a haematoma and sarcoma, especially in patients presenting with a history of trauma.