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].