1.INTRODUCTION
It is known that oxidative stress increases as a result of the
activation of neutrophils and macrophages and overproduction of reactive
oxygen species (ROS) in inflammatory events [1-3]. Damage due to ROS
is prevented by enzymatic or nonenzymatic antioxidant mechanisms
including super-oxide dismutase, catalase and glutathione S-trans enzyme
systems, and important biological thiols such as glutathione, cysteine,
homocysteine, N-acetyl-cysteine and gamma glutamine.
Thiol is an organic compound and contains a -SH group that plays a
critical role in the prevention of oxidative stress in cells.
SH-containing amino acid groups in proteins are primary targets of ROS.
In the same medium with ROS, the -SH groups are oxidized and form
reversible disulfide bonds. The loss of thiol groups is the main
molecular mechanism that results in structural and functional changes in
proteins. Antioxidants and in particular thiol groups that try to
prevent the destructive effects of free radicals cannot maintain plasma
and tissue levels during these interactions [4]. However, the
resulting disulfide bonds can be reduced to the thiol groups by the
cellular reduction effects of some antioxidants and thus the
thiol/disulfide homeostasis is preserved [5]. The state of the
dynamic thiol-disulfide balance plays a critical role in antioxidant
protection, detoxification, signal transduction, apoptosis, the
regulation of enzymatic activity, transcription factors and cellular
signaling mechanisms [6]. In addition, distortions in the dynamic
thiol-disulfide balance has been shown to play a role in the
pathogenesis of many diseases such as diabetes, cardiovascular diseases,
cancer, rheumatoid arthritis, chronic kidney disease, AIDS, Parkinson’s
disease, Alzheimer’s disease, Friedrich’s ataxia, multiple sclerosis,
amyotropic lateral sclerosis and liver diseases [7]. Therefore,
determination of the dynamic thiol/disulfide balance may provide
valuable information regarding various normal or abnormal biochemical
processes [7]. A number of studies have shown the predictive value
of thiol/disulfide hemostasis in organ ischemia. However, measurement of
plasma/serum thiol-disulfide balance by colorimetric method has been
made possible by the method developed by a Turkish scientist for the
first time in the world [7].
Ischemia-modified albumin (IMA) is a FDA-approved test among the newly
investigated cardiac markers [8]. The principle of the test is based
on measuring the cobalt binding capacity of albumin, leading to chemical
changes in the albumin during oxidation. This new albumin molecule is
also called ischemia-modified albumin. The formation of this new albumin
molecule, which has lost its ability to cobalt, is one of the earliest
markers of ischemia [9]. However, recent studies suggest that IMA,
which stands out as a marker of cardiac ischemia, may increase in
different pathologies [10-12].
Trauma is one of the causes of admission to the emergency department and
is the most common cause of death in childhood [13]. Both our
country and the United States, trauma locates in the second place after
the infectious diseases in the applications to the emergency services
[14]. Trauma management should be fast and dynamic because it has a
high mortality and morbidity. In all traumas, ABC algorithm should be
started from the first encounter. The most common cause of trauma is
traffic accidents. This is followed by fall from height. In children,
blunt abdominal trauma is the most common trauma of the spleen and
liver. Penetrating traumas in children constitute 10% of all traumas.
However, mortality is higher in these patients. Gunshot wounds and sharp
stab wounds are the most common causes. In the penetrating injuries in
children, the most damaged abdominal organs are liver (28.8%), bowel
(26%), abdominal large vessels (24.9%), diaphragm (22%), kidneys
(11.3%), spleen (9.6%) and esophagus (9.6%), respectively [15].