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Increased risk for non-Hodgkin lymphoma (NHL) is associated with infections and environmental agents. We hypothesized that these factors chronically trigger the T helper-2 (Th2) pathway and result in lymphoma. We investigated the role of the Th2 pathway by exploring the relationships between components of the Th2 pathway, interleukin (IL)-10, IL-4, immunoglobulin E (IgE), and eosinophils, and prognostic markers of NHL.Thirty-one NHL patients and 27 healthy controls were enrolled. IL-10, IL-4, IgE, and eosinophils were measured. IL-4 and IL-10 were analyzed with the enzyme amplified sensitivity immunoassay method.High IL-10 levels were correlated with several poor prognostic features, short early survival, and lymphopenia. There was a positive correlation between albumin and IL-4 levels and a negative correlation between IL-10 and albumin. There was no relationship related with eosinophils and IgE. We found remnant increased IL-4, which could be a clue for the triggering of the Th2 pathway in the background.There is a need for differently designed studies to detect the place of the Th2 pathway in NHL.Amaç: Non-Hodgkin lenfoma (NHL) riski enfeksiyonlar ve çevresel ajanlarla artmış olarak ilişkilendirilmiştir. Hipotezimize göre bu faktörlere kronik olarak maruz kalmak T helper-2 (Th2) yolağını aktifler ve lenfomaya sebep olur. Bu amaçla Th2 yolağı komponentleri olan IL-10, IL-4, IgE, ve eozinofille, NHL’nin prognostik belirteçleri arasındaki ilişkiye baktık. Gereç ve Yöntemler: Otuz bir NHL hastası ve 27 sağlıklı kontrolde IL-10, IL-4, IgE ve eozinofil değerlerine bakıldı. IL-4 ve IL-10 EASIA metodu ile ölçüldü. Bulgular: Yüksek IL-10 düzeyleri pek çok kötü prognostik özellikle, çok kısa yaşam süresi ve lenfopeni ile ilişkiliydi. Albümin açısından IL-10 ile negatif ilişki, IL-4 ile pozitif ilişki bulundu. Eozinofil ve IgE ile ilgili herhangi bir ilişki kurulamadı. Bazı hastalarda gözlenen artmış IL-4 geri planda kalmış Th2 yolağı aktivasyonunun bir ip ucu olabilir. Sonuç: Th2 yolağının NHL patogenezindeki yerini tespit etmek için farklı dizaynlarda çalışmalara ihtiyaç vardır.Amaç: Non-Hodgkin lenfoma (NHL) riski enfeksiyonlar ve çevresel ajanlarla artmış olarak ilişkilendirilmiştir. Hipotezimize göre bu faktörlere kronik olarak maruz kalmak T helper-2 (Th2) yolağını aktifler ve lenfomaya sebep olur. Bu amaçla Th2 yolağı komponentleri olan IL-10, IL-4, IgE, ve eozinofille, NHL’nin prognostik belirteçleri arasındaki ilişkiye baktık. Gereç ve Yöntemler: Otuz bir NHL hastası ve 27 sağlıklı kontrolde IL-10, IL-4, IgE ve eozinofil değerlerine bakıldı. IL-4 ve IL-10 EASIA metodu ile ölçüldü. Bulgular: Yüksek IL-10 düzeyleri pek çok kötü prognostik özellikle, çok kısa yaşam süresi ve lenfopeni ile ilişkiliydi. Albümin açısından IL-10 ile negatif ilişki, IL-4 ile pozitif ilişki bulundu. Eozinofil ve IgE ile ilgili herhangi bir ilişki kurulamadı. Bazı hastalarda gözlenen artmış IL-4 geri planda kalmış Th2 yolağı aktivasyonunun bir ip ucu olabilir. Sonuç: Th2 yolağının NHL patogenezindeki yerini tespit etmek için farklı dizaynlarda çalışmalara ihtiyaç vardır.

Objective: Diabetic autonomic neuropathy is a common, serious and even fatal complication. The aim of this study was to investigate the autonomic functions in diabetic patients with distal symmetric polyneuropathy, via clinical and electrophysiological tests. Material and Methods: This study was performed on 50 patients with diabetic distal symmetric neuropathy (patient group) and 30 healthy volunteer subjects (control group). To assess autonomic functions, sympathetic skin response (SSR) and RR interval variability (RRIV) were studied, and the corrected QT interval (QTc) and QT dispersion (QTcd) were calculated with electrocardiography (ECG) in both patient and control groups. Data obtained from the control and the patient groups were compared. The sensitivity and specificity of the autonomic tests were measured. Results: In 98% of 44 patients, foot or both foot and hand SSR could not be registered. Survey of autonomic symptoms (SAS) scores were higher in the patient group in whom SSR could not be recorded when compared to the patient group in whom SSR could be recorded. Almost all the parameters of RRIV (RR interval variation) were significantly lower in the patient group when compared to the control group (p

Demir, Ahmet/0000-0002-8820-3122 WOS: 000329365100006 PubMed: 23884881 Vessel grafting is commonly used for revascularization or pedicle lengthening. Although veins are more commonly used, they can form aneurysms when bridging an arterial gap. This can lead to thrombosis, and the risk is increased when there is a size discrepancy. This study reports the long-term results of arterial lengthening via size discrepant carotid artery and femoral vein grafts in a rat femoral artery model (1:1.5 ratio). A total of 28 rats were used in this study, divided into two groups of 14. By the 21st day, one anastomosis in each group has been found to be thrombosed. Long-term patency rates were the same for both groups (93.3%). Radiologic imaging showed that size match in the carotid artery grafts was excellent despite of slightly fusiform dilatation, but in the vein groups, pronounced aneurismal deformation and distortion in the anastomosis was seen. Histologic analysis revealed that in the arterial grafts, endothelial continuity was smooth and mural inflammation was less than that of the vein grafts. Organized or recanalized mural thrombi were seen in 38.5% in the vein grafts, whereas in arterial grafts there were none. Ondokuz Mayis UniversityOndokuz Mayis University [PYO.TIP.1901.10.008] This work is supported by the Scientific Research Project Fund of Ondokuz Mayis University under the project number PYO.TIP.1901.10.008.

Summary Background Cytomorphological assessment of erosive skin tumours offers a rapid and minimally invasive way to obtain a diagnosis. However, the studies so far conducted on this method have been relatively small. Aim To conduct a large retrospective study on cytomorphological assessment of erosive skin tumours. Methods In this study, 86 cytological smears prepared from erosive cutaneous tumours clinically suspicious for melanoma were examined to test the diagnostic accuracy and practicability of cytomorphological evaluation of such tumours, and to compare the assessments of two investigators with different experience levels. In a subgroup of tumours, cytological assessment was compared with dermoscopic evaluation. Results There was agreement in the cytological and histopathological results for 68 of 86 cases (79%) assessed by the experienced investigator and in 64 of 86 cases (74%) assessed by the inexperienced investigator. The diagnosis was confirmed cytologically in 39 and 34 of 42 melanomas, and in 28 and 27 of 35 basal cell carcinomas, respectively. The sensitivity of the cytodiagnosis was not significantly different between the two investigators. The dermoscopic evaluation showed good agreement with the cytological results for melanoma (82.4%), although use of dermoscopy was only possible for 49.9% of the lesions because of difficulties with the samples. Conclusions Cytological assessment of erosive melanoma and BCC lesions is a useful tool for gaining additional information on clinically uncertain skin tumours, and shows good agreement between different investigators.

WOS: 000405948700007 PubMed: 28759087 Background: We aimed to compare ghrelin, obestatin, homocysteine (Hcy), vitamin B-12 and folate levels in the serum and saliva of ischaemic heart disease patients. Methods: Serum and saliva were collected from 33 ischaemic heart disease (IHD) patients and 28 age- and body mass index-matched healthy individuals. Levels of acylated and desacylated ghrelin, obestatin and Hcy were determined using the ELISA method. Results: Acylated ghrelin, desacylated ghrelin and obestatin levels in the saliva were found to be higher than those in the serum of the control group, while acylated and desacylated ghrelin levels in the saliva were significantly lower than those in the serum. Obestatin levels were higher in IHD patients (p = 0.001). Saliva and serum vitamin B-12 and folate levels in IHD patients were significantly lower than in the control group (p = 0.001). Conclusions: It was determined that serum ghrelin levels increased in ischaemic heart disease patients, while serum levels of obestatin decreased.

AYGUN, CANAN/0000-0002-7955-5943 WOS: 000393323800007 PubMed: 28123334 Aim: The adequacy of 50 mcg folic acid supplementation given to low-birth-weight babies was investigated. The folate levels of the mothers and infants, and breastmilk, and the optimum dose for folic acid supplementation were also investigated. Material and Methods: After obtaining blood from 141 low-birth-weight infants on the 1st day of life for serum and red cell folate levels, the infants were randomly allocated into three groups according to the folic acid supplement dose. Forty-six infants were given 25 mu g/d folic acid, 39 were given 50 mu g/d folic acid, and 44 were given 75 mu g/d folic acid. Folic acid could not be given to 12 infants. Follow-up blood samples were obtained at the end of folic acid supplementation. Maternal samples for red cell and serum folate levels and breast milk folate levels were obtained within the first 48 hours and the samples for measuring breastmilk folate level were obtained on the 3rd day postnatally. The feeding modes of the infants, maternal folic acid intake, and details of neonate intensive care unit course were recorded. Results: The mean birth weight and gestational age of the infants were found as 1788.2 +/- 478.4 g and 33.5 +/- 2.9 weeks, respectively. The mean serum and red cell folate levels on admission were found as 21.2 +/- 12.2 ng/mL and 922.7 +/- 460.7 ng/mL, respectively. The mean maternal serum and red cell folate levels and the mean breast milk folate levels were found as 12.3 +/- 7.5 ng/mL, 845.5 +/- 301.4 ng/mL, and 30.6 +/- 33.0 ng/m, respectively. The breast milk folate levels of mothers who were supplemented with folic acid during pregnancy were significantly higher compared with mothers who were not supplemented with folic acid (p

AYGUN, CANAN/0000-0002-7955-5943 WOS: 000406760000013 PubMed: 27806665 Objectives: To describe the effect of extremely advanced maternal age (EAMA) on maternal/neonatal outcomes.Methods: This was a case-control study in which 127 women 40 years at the time of delivery out of 2853 singleton hospital deliveries in Ondokuz Mayis University between 1 January 2008 and 31 August 2010 constituted the study group. One hundred and twenty-seven else were chosen randomly out of 2412, 21-35 years old women, via a computer system as controls. Demographic features of 254 mothers and infants as well as maternal and neonatal complications were recorded.Results: Mean maternal age was 41.51.9 (40-49) years in EAMA group and 28.9 +/- 4.2 (21-35) years in controls. Primigravidity was 19.6% in the EAMA group, whereas 37.8% in controls (p=0.003). No difference was found between groups according to route of delivery, stillbirth, preterm birth, congenital abnormalities, gender of babies, NICU admission and respiratory problems (for all p>0.05). A 5th min Apgar score

WOS: 000306451200008 PubMed: 22748212 Study Objective: To determine the optimal remifentanil dose required to provide acceptable intubating conditions following induction of anesthesia with propofol without using neuromuscular blockade. Design: Dose-response study. Setting: Operating room of a university hospital. Patients: 50 ASA physical status 1 men, aged between 20 and 40 years, who were scheduled for general anesthesia. Interventions: Intubating conditions were evaluated according to the scoring system described by Viby-Mogensen et al. Successful intubation was defined as excellent or good. Measurements: For induction of anesthesia, an intravenous (IV) bolus dose of propofol 2.0 mg/kg was given over 30 seconds followed by the administration of predetermined IV remifentanil over 30 seconds; intubation was performed 90 seconds after completion of the remifentanil administration. The dose of remifentanil used for each patient was determined by the response of the previously tested patients, using the modified Dixon's up-and-down method (using 0.2 mu g/kg as a step size). The first patient was tested with remifentanil 1.0 mu g/kg. If intubation failed, the remifentanil dose was increased by 0.2 mu g/kg; if intubation was successful, the dose was decreased by 0.2 mu g/kg. Mean arterial pressure (MAP), heart rate (HR), and peripheral oxygen saturation were recorded during the study period. Main Results: According to probit analysis, the effective dose of remifentanil in 50% (ED50) and 95% (ED95) of patients were 1.40 mu g/kg and 2.40 mu g/kg, respectively. Preintubation and postinduction HR and MAP values were lower than preinduction values (P < 0.001). Conclusion: The optimal bolus dose of remifentanil for acceptable intubating conditions was 2.40 mu g/kg (95% confidence interval, 1.90-9.0 mu g/kg) in 95% of patients during induction of anesthesia with propofol 2.0 mg/kg without neuromuscular blocking agents. (C) 2012 Elsevier Inc. All rights reserved. Ondokuz Mayis University Scientific Research Project Commission, Kurupelit-Samsun, TurkeyOndokuz Mayis University Supported by the Ondokuz Mayis University Scientific Research Project Commission, Kurupelit-Samsun, Turkey.

WOS: 000295041200011 PubMed: 21774660 Background. Melasma is a pigmentary disorder often recalcitrant to treatment. Few studies have objectively evaluated the efficacy of treatment colorimetrically. Aim. To evaluate the safety and efficacy of a depigmentation cream, including mainly glycolic acid and Rumex occidentalis. Method. Twenty-seven patients applied the cream twice daily for the first 3 months and twice weekly for the following 3 months. L*, C* and h* values of the target lesions and the perilesional area were analyzed at baseline, 12 and 24 weeks colorimetrically. The physician and patient evaluated the clinical response rate. These results were compared statistically between the lesional and perilesional area. Results. There was a significant difference between 0-12, 0-24 (L*, C* and h* values) and 12-24 weeks (L* value) (p < 0.001). For C* and h* values, the difference was not significant between 12 and 24 weeks (p = 0.464 and 0.151, respectively). Statistical significance was detected only between 3 and 6 months for C* value (p < 0.05) for the lesional and the perilesional areas. Clinical response rate was significant (p < 0.05). Conclusion. Our depigmentation cream is a moderate effective agent, well tolerated and can be considered as an alternative treatment of melasma. Twice-daily application may enhance the efficacy of treatment instead of twice-weekly application in the maintenance period.

Ozaslan, Cihangir/0000-0002-2611-4837 WOS: 000291164000005 PubMed: 21323572 Cytokine genes are important for researching cancer predisposition to cancers that elicit anti-tumor immune response. In this study, we investigated the association between breast cancer and tumor necrosis factor alpha (TNF-alpha) -308 (G>A), TNF-beta +252 (A>G), and interferon gamma (IFN-gamma) +874 (T>A) gene polymorphisms in a Turkish population. This study involved 204 female breast cancer patients and 204 healthy female controls. Genomic DNA was extracted from EDTA-preserved peripheral venous blood of patients and controls by a salting-out method and analyzed by polymerase chain reaction, allele-specific oligonucleotide polymerase chain reaction, and restriction fragment length polymorphism. TNF-alpha -308 genotype was found to have no effect on breast cancer susceptibility. However, there were statistically significant differences between the genotype frequencies of patients and controls for TNF-beta polymorphism (p = 0.016) and the allele and genotype frequencies for the IFN-gamma polymorphism (p = 0.0312 and p = 0.001, respectively). In the composite genotype analysis, the TNF-alpha/beta GAAG composite genotype (p = 0.0424), the TNF-alpha/IFN-gamma GGTT and GATT composite genotypes (p = 0.0296 and p = 0.0129, respectively), the TNF-beta/IFN-gamma AGTT composite genotype (p = 0.0003), and the TNF alpha/beta/IFN-gamma GGAGTT and GAAGTT composite genotypes (p = 0.0437 and p = 0.0038, respectively) were estimated to have a protective effect against breast cancer. However, the TNF-alpha/IFN-gamma GGTA composite genotype is a risk factor for breast cancer (p = 0.0156). In conclusion, TNF-beta +252GG genotype was found more frequent in Turkish breast cancer patients than controls and IFN-gamma TA+AA genotypes were estimated to increase breast cancer risk significantly in Turkish population. Ondokuz Mayis UniversityOndokuz Mayis University [T-403] This study was supported by the Ondokuz Mayis University (Project No. T-403) and is a report of a Ph.D. thesis.

To analyze the effect of possible risk factors, including breastfeeding, on the development of childhood-onset psoriasis, a multicenter case-control study with prospective collection of data was performed. Using a standard questionnaire, personal and specific variables including family history of psoriasis, maternal and environmental tobacco smoke exposure, body mass index (BMI), exclusive and partial breastfeeding for at least 3 and 12 months, cow's milk intake before 1 year, birth delivery method, and stressful life events were collected during 2009 from 537 patients with psoriasis and 511 controls younger than 18. Overall, patients more frequently reported exposure to environmental tobacco smoke at home and stressful life events in the year preceding the diagnosis than controls. The odds ratios (OR) for smoking and stressful life events were 2.90 (95% confidence interval [CI]=2.27-3.78) and 2.94 (95% CI=2.28-3.79), respectively. In addition, children with psoriasis were more likely to have a higher BMI (>26) than controls (OR=2.52; 95% CI=1.42-4.49). High BMI, environmental tobacco smoke exposure at home, and stressful life events may influence the development of pediatric psoriasis.

Background There is a need for a laboratory marker that correlates with the clinical activity of Behcet’s disease (BD). Objective We aimed to investigate whether serum galectin-3 (Gal-3) levels were affected during the course of the disease with regard to disease activity. Methods A total of 131 subjects were involved in the study as follows: Group 1: BD active (n = 39); Group 2: BD inactive (n = 31); Group 3: Disease controls with leucocytoclastic vasculitis confirmed with a skin biopsy (n = 22); and Group 4: Healthy control subjects (n = 39). The BD patients were followed regularly and samples were taken in their active and inactive periods of the disease over a 2-year period. Results Serum Gal-3 levels were significantly higher in active BD patients (mean 2.38) than inactive BD patients (mean 0.63; P

Aim: In this experimental study, the side effects of praziquantel and dymethylsulfoxide on the hepatobiliary system has been investigated comparing with alcohol , hypertonic and normal saline. Material and Methods: This study contains five groups of ten rats each. In all groups, transduodenal choledochal cannulation was done and either dymethylsulfoxide, praziquantel in dymethylsulfoxide solution ,0.9 % NaCI, 20 % NaCI or 98 % alcohol were injected. Before surgery, blood samples were taken for measuring AST, ALT, ALP, GGT levels, and repeated every months for three months period. At the end of study, all rats were sacrificed; hepatobiliary excision was done. Results: Biochemical content and blood samples have not statistically significant difference at the beginning of the study. After protoscolocidals injection into common bile duct, ALT, AST and ALP levels were siginificantly found higher at hypertonic saline group than control’s (p

Summary Background. Laser-assisted hair removal has become a popular treatment for eradication of body hair. Many studies have been published concerning the safety and efficacy of several laser systems. Adverse events are hyperpigmentation, hypopigmentation, erythema, oedema, scarring, pain and blistering. Changes in sweating have not previously been reported. Aim. To investigate the effects on axillary sweating of hair removal by a 1064-nm neodymium:yttrium–aluminium–garnet (Nd:YAG) laser. Methods. The sweating function of both axillae was evaluated objectively by the iodine starch test for planimetry measurement and subjectively using a visual analogue scale (VAS) before the treatment, and 1 month and 1 year after the last session. Results. The difference in hyperhidrotic activity before and after treatment was significant (P

WOS: 000259550000011 PubMed: 18672230 Objective: To investigate the association between passive smoking, as deter-mined by salivary cotinine level, and caries, salivary PH, buffering capacity, flow rate and microbiological counts in young children. Design: Ninety passive smokers (PS) with a mean age of 5.02 years and 90 healthy age-matched controls were included in this study. Family income, smoking habits of household members, parental education levels, child's tooth-brushing habit and child's daily dietary sugar exposure were recorded by questionnaire. Three categories were formed with respect to the number of cigarettes smoked. A dmft score was calculated according to the criteria recommended by the World Health Organization. The children were also investigated for stimulated salivary cotinine level, pH, flow rate, buffering capacity and salivary Streptococcus mutans and lactobacilli colonisation. Results: There were no significant differences in tooth-brushing habit, sugar exposure, family income and parental education levels between the two groups (P > 0.05). The mean cotinine level of the PS subjects was 1.58 +/- 4.3 ng/ml. The dmft scores, and salivary S. mutans and lactobacilli colonisation in PS children were significantly higher than in the control subjects (P < 0.05). Statistically significant decreases in salivary pH, flow rate and buffering capacity were found in the PS subjects (P < 0.05). Conclusion: PS children are at increased risk of caries compared with control subjects. (c) 2008 Elsevier Ltd. All rights reserved.

GULER, Ahmet/0000-0003-0167-2346 WOS: 000255541700027 PubMed: 26050005 The aims of the study were to discriminate comb and strained honeys produced by the standard beekeeping method (control), shaking method (pure blossom honey), and feeding intensively (100 kg/colony) with sucrose (adulterated honey) syrup by using sensory analysis and to develop a method to be used in identification of unknown or suspicion honey samples. In the study, twenty trained panelists assessed honey samples in relation to their properties including taste, odor, color, aroma, viscosity, dissolution in mouth, inflammation in throat, attractiveness, flavor and general impression during four months. There were no differences in odor, viscosity, and dissolution in mouth between comb and strained honey samples which produced by different methods (P > 0.05). Discrimination of strained honey by sensory analysis was more reliable when compared to comb honey. The ratio of correctly classified sample was 78.3%) for comb and 86.7% for strained honey. The more honey was pure the more discrimination of honey sample by sensory analysis was reliable. In verification test five unknown honey samples were classified 100% in their real groups by using canonical discriminant function Coefficients of each properties evaluated and the projections of the sample points on the plane of the canonical function-1 and function-2. (C) 2008 Elsevier Ltd. All rights reserved.

ozkaya, ozan/0000-0002-0198-1221; BEK, KENAN/0000-0002-1005-2379 WOS: 000258726000009 PubMed: 18663330 Background/Aims: The aim of this study was to evaluate the characteristics of pruritus in pediatric patients undergoing peritoneal dialysis. Patients and Methods: Twenty-seven patients (16 females, 11 males), aged between 5 and 18 years, were evaluated for the presence, intensity, onset, activation time, duration, characteristics, localization and increasing factors for pruritus. The intensity of pruritus was scored using a visual analog scale. Patients were grouped according to the existence of pruritus and other clinical and laboratory parameters (dialysis duration, dialysis adequacy, hemoglobin, blood urea nitrogen, creatinine, Ca, P, albumin, bicarbonate, parathyroid hormone (PTH), C-reactive protein (CRP)) were compared between the 2 groups. Results: The mean age of patients was 11.85 +/- 4.4 years. There were 21 patients (77.7%) without pruritus and 6 patients with pruritus (22.2%). Serum P, PTH, CRP levels and Ca x P product were significantly higher in patients with pruritus compared to patients without pruritus (p = 0.027, p = 0.03, p < 0.026, p = 0.031, respectively). In a stepwise logistic regression model, P (p = 0.01), Ca x P product (p = 0.09), PTH (p = 0.03) and CRP (p = 0.02) were independently associated with pruritus. Conclusion: Our study indicates that pruritus remains a common but not troublesome symptom in children on peritoneal dialysis. Higher serum P, Ca x P product, PTH and CRP concentrations appear to be important factors associated with uremic pruritus in this group. Copyright (c) 2008 S. Karger AG, Basel.

WOS: 000258081700003 PubMed: 17966116 A chronic intake of high dose alcohol may cause oxidative stress and inflammation in the stomach. It is hypothesized that cysteine-methionine and vitamin C may neutralize harmful compounds while potentiating the antioxidant capacity of the cell or tissue. The experimental animals were fed regular diets and were maintained for 90 days in the control group, the alcoholic group, which was given 2.5 g of 50% ethanol kg(-1) body wt. administered intragastrically every other day, or the alcoholic with antioxidant supplement group, to whom 2.5 g of 50% ethanol kg(-1) body wt. + a solution that contained 200 mg vitamin C, 100 mg cysteine and 100 mg methionine was administered intragastrically every other day. After the treatments, the stomach was taken for pathological and biochemical analysis. The stomach of the alcoholic group rats had higher scores of pathological findings compared with the control group, whereas the scores of the antioxidant-supplemented group were lower than the alcoholic group. In addition, the oxidized protein and lipid content in the stomachs of the alcoholic group were significantly higher than the control, but antioxidant supplementation lowered the amount of oxidation in the antioxidant supplemented group. The amount of stomach glutathione in the alcoholic group was higher than that of the control and antioxidant-supplemented groups. Interestingly, the level of total thiol in the stomach tissue of rats with antioxidant supplement was statistically higher than that of the control and alcoholic groups. In conclusion, the scores of the pathological findings in the stomach of rats with the antioxidant supplement were lower than the chronic alcohol-treated rats, albeit the amount of total thiol was increased in this group. Moreover, chronic alcohol treatment led to an increase in the level of lipid and protein oxidation in the stomach tissue of rats. A simultaneous intake of ascorbate/L-cys/L-met along with ethanol attenuated the amount of oxidation which suggested that cysteine-methionine and vitamin C could play a protective role in the stomach against oxidative damage resulting from chronic alcohol ingestion. Copyright (C) 2007 John Wiley & Sons, Ltd.

Background and Design: It has been known that isotretinoin may cause rabdomyolysis besides its many side affects. The purpose of our study was to evaluate the effect of isotretinoin therapy with a cumulative dose of 120 mg/kg on serum creatine phosphokinase levels and muscle physiology in patients with acne vulgaris.MATERIAL-METHOD: A total of 66 patients with severe acne vulgaris were enrolled in the study and treated with isotretinoin twice daily at the dose of 0.6-0.8 mg/kg/day and for approximately 6.1±0.54 (3-7) months. Thirty-seven female (71.2%) and 15 male (28.8%) patients completed the study. The change in serum creatine kinase levels was measured before and monthly during the treatment course. Electromyography was performed in patients with a high serum CPK level and myalgia for the exclusion myopathy. All patients were evaluated with their laboratory findings and they were questioned for exercise habits and intramuscular injections.RESULTS: The mean age and body weight was 24.6±6.1 years and 62.3±11.9 kg respectively. We have detected 7 patients having elevated (13.5%) serum CPK levels. Three of them had associating myalgia and muscle tenderness. The evaluation of these patients with EMG revealed no myopathy sign. (CPK values =1000, 880,726 respectively) Only one patient with an elevated serum CPK was performing exercise. There was no history of intramuscular injection history in any of these patients. CONCLUSION: The use of standard isotretinoin therapy appears to have a relation with marked hyperCKemia with or without muscle-related complaints. Isotretinoin could have a potentializing effect on other myotoxicity inducers (drugs, infection, fever, muscular exertion). Although this phenomenon in isotretinoin-treated patients with acne appears to be validated as benign in nature, the clinicians must keep this side affect in mind and should monitorize serum CPK levels since there are some patients who had severe or persistent signs.

Background Psoriasis is a multifactorial disease in which genetic and inflammatory factors play important roles. Leptin is classified as a cytokine and plays an important role in the regulation of the T-helper response. A common polymorphism in the promoter of the human leptin gene (G-2548A) may have a role in the pathogenesis of psoriasis. Aim To investigate the association between psoriasis and leptin gene polymorphism (G-2548A). Methods The study involved 109 patients with psoriasis and 125 healthy controls. Analyses of G-2548A polymorphism of the leptin gene were made by the polymerase chain reaction-restriction fragment length polymorphism technique. The genotypes (GG, GA, and AA of leptin gene G-2548A) and alleles (G and A) were scored and the frequencies were estimated. The frequencies of alleles and genotypes in patients and controls were compared. The relationship between leptin gene polymorphism and the clinical features of the patients was analyzed. Results Both genotype [odds ratio (OR), 0.921; 95% confidence interval (CI), 0.501–1.694; P = 0.792] and allele (OR, 0.864; 95% CI, 0.600–1.242; P = 0.429) frequencies were not significantly different between patient and control groups. In addition, there was no significant association between genotype and allele frequencies and the clinical characteristics of psoriasis. Conclusion In this case–control study, no evidence of association between the G-2548A variant of the leptin gene and psoriasis was found.

WOS: 000247783800015 PubMed: 17211678 The pathogenesis of Behcet's disease (BD) is not fully understood and immunological abnormalities and genetic factors have been investigated. Because serum concentrations of mainly T helper 1 (Th1) type cells have been reported to be increased in BD, we aimed to investigate whether certain cytokine polymorphisms might represent a risk factor for developing BD. We genotyped 80 patients with BD and 105 healthy controls for interleukin (IL)-1 alpha (T/C -889), IL-1 beta (C/T -511, T/C +3962), IL-1R (C/T pst11970), IL-1RA (T/C mspa111100), IL-2 (T/G -330), IL-12 (C/A -1188), interferon (IFN)-gamma (A/T UTR 5644), and TNF-alpha (G/A -238) polymorphisms. Analyses of cytokine polymorphisms were performed with PCR-SSP. The genotype and allele frequencies of the patients and controls were compared and the association between the polymorphisms of the cytokines with the clinical findings was investigated. Genotype distribution showed significant differences between the patients and the controls for the IL-1 alpha -889, IL-1 beta -511, IL-1 beta +3962, IL-1R, IL-12, IFN- gamma, and TNF-alpha cytokines. We didn't observe significant difference in genotypic frequencies of IL-1RA and IL-2 in our study. Comparison of the IL-1 alpha -889, IL 1 beta -511, and IL 1 beta +3962 genotype frequencies showed significant increase in CC genotype between the patients and the controls. The individuals with IL-1R TT polymorphism had a higher risk for BD compared to patients with CT/CC polymorphism. Comparison of IL-12, IFN- gamma, and TNF-alpha, genotype frequencies showed significant increase in CA, AA, and AA genotypes between the patients and controls, respectively. The frequencies of genotypes according to the clinical features of the patients with BD did not show a significant difference (p > 0.05). Our study suggests that development of BD might be determined by various cytokine gene polymorphisms. However, further studies on larger numbers of cases are needed before definite conclusions can be drawn.

PubMed: 17233569 Background: Surveillance of surgical site infection (SSI) is one of the most effective methods for decreasing the incidence. We determined the risk factors for SSI and the effect of a one-year surveillance program on the rate at a tertiary-care center. Methods: The annual SSI rate before the study period was determined in a preliminary study. Risk factors related to SSI, the bacteria cultured from infected sites, and the effect of surveillance were then analyzed prospectively. Risk factors were determined by logistic regression analysis, and 95% confidence intervals were calculated. Results: The incidence of SSI decreased from 12.8% before the study to 8.8% at the end of the surveillance period. There were 90 SSIs (8.8%) in 1,017 procedures during the study period, most of which (77; 69%) were detected during the hospital stay. The distribution of superficial incisional, deep incisional, and organ/space SSI was 61.1%, 33.4%, and 5.5%, respectively. Prolonged preoperative hospital stay (>8 days), abdominal incision, early preoperative hair removal, inappropriate antimicrobial prophylaxis, whole blood transfusion, famotidine treatment, repair with mesh, age >75 years, wound contamination, high American Society of Anesthesiologists score, malnutrition, diabetes mellitus, emergency surgery, obesity, and coexistent infection proved to be independent risk factors for SSI, whereas the skin closure technique, patient sex, presence of malignancy, smoking history, and duration of operation were not. Staphylococcus aureus and Escherichia coli were the bacteria isolated most frequently. Six infected patients (5.4%) died, four because of SSI. Development of SSI increased hospital expenses by around US$600 per patient. Conclusion: Surveillance even for one year decreases the incidence of SSI. © Mary Ann Liebert, Inc.

Background Behcet's disease is a chronic, multisystem, inflammatory disease characterized by the predominance of T-helper 1 cytokines. The disease is also characterized by infiltration of lymphocytes and neutrophils into the affected tissues. Because cytokines are involved in the regulation of lymphocyte and phagocyte functions, they may play an important role in the pathogenesis of Behcet's disease. Leptin, a member of the gp 130 family of cytokines, induces a strong T-helper 1 response and is regarded as a proinflammatory inducer. Recent studies have shown that serum leptin concentration was increased in patients with Behcet's disease and correlated with disease activity. Objectives We aimed to investigate the role of G2548A polymorphism of leptin gene in patients with Behcet's disease and compare the results with healthy controls. Patients and methods A total of 93 subjects with Behcet's disease and 125 healthy controls were included in this study. Analyses of G-2548A polymorphism of the LEP gene were performed using the PCR-restriction fragment length polymorphism technique. The genotypes (GG, GA, and AA of leptin G2548A) and alleles (G and A of leptin 2548) were scored and the frequency was estimated. The frequencies of the alleles and genotypes in patients and controls were compared. We analysed the correlation between leptin gene polymorphism and the clinical features of BD. Results Both genotype and allele frequencies were not significantly different between controls and Behcet's disease patients [OR = 0.67, 95% CI (0.35–1.29), P = 0.197 and OR = 0.77, 95% CI (0.52–1.15), P = 0.184]. We did not find any significant relationship between leptin gene polymorphism and the clinical features of BD (P > 0.05). Conclusion In the present case-control study, we found no evidence of an association between the G-2548A variant of the leptin gene and BD among Turks. Further studies are needed to investigate serum leptin level to explain the mechanisms behind the lack of association between leptin G2548A gene polymorphism and BD.

The choice of specialization branch is one of the most important decisions for the medical students during the medical education all over the world. It is known that short rotation period causes insufficient information about the subspecialty branches of medicine during the rotation period of medical education. The objective of the present study was to examine the tendency of students toward plastic, reconstructive and aesthetic surgery (PRAS), which has one of the short rotation periods during medical education in Turkey. In this study, 90 male and 63 female fourth year medical students were included. According to our findings, 133 students agreed that PRAS will be one of the splendid occupations of the future. However, only 10 students' (6.5%) primarily chose PRAS as a specialization branch. The high complication risks which were believed to be following the reconstructive surgery was the deterrent factor to prefer PRAS as a specialization branch (P=0.036), and also the long educational period and the requirement of experience for PRAS specialization (94.1%) have influence on the choice of students making career in PRAS. The socio-demographic features of the students did not have any statistically significant effect on their responses to questions (P>0.05). © Springer-Verlag 2005.

Sahin, Bunyamin/0000-0001-8538-8443; Kaplan, Suleyman/0000-0003-1477-5002; WOS: 000187616100015 PubMed: 14652153 Objective: The exact volume of the vertebral body is necessary for the evaluation, treatment and surgical application of related vertebral body. Thereby, the volume changes of the vertebral body are monitored, such as infectious diseases of vertebra and traumatic or non-traumatic fractures and deformities of the spine. Several studies have been conducted for the assessment of the vertebral body size based on the evaluation of the different criteria of the spine using different techniques. However, we have not found any detailed study in the literature describing the combination of the Cavalieri principle and vertebral body volume estimation. Materials and methods: In the present study we describe a rapid, simple, accurate and practical technique for estimating the volume of vertebral body. Two specimens were taken from the cadavers including ten lumbar vertebras and were scanned in axial, sagittal and coronal section planes by a computed tomography (CT) machine. The consecutive sections in 5 and 3 mm thicknesses were used to estimate the total volume of the vertebral bodies by means of the Cavalieri principle. Furthermore, to evaluate inter-observer differences the volume estimations were carried out by three performers. Results: There were no significant differences between the performers' estimates and real volumes of the vertebral bodies (P > 0.05) and also between the performers' volume estimates (P > 0.05). The section thickness and the section plains did not affect the accuracy of the estimates (P > 0.05). A high correlation was seen between the estimates of performers and the real volumes of the vertebral bodies (r = 0.881). Conclusion: We concluded that the combination of CT scanning with the Cavalieri principle is a direct and accurate technique that can be safely applied to estimate the volume of the vertebral body with the mean of 5 min and 11 s workload per vertebra. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved.

WOS: 000361199100001 PubMed: 26413501 Time-weighted graphs are used to detect small shifts in statistical process control. The aim of this study is to evaluate the inclination of the acetabular component with CUmulative SUM (CUSUM) chart, Moving Average (MA) chart, and Exponentially Weighted Moving Average (EWMA) chart. The data were obtained directly from thirty patients who had undergone total hip replacement surgery at Ondokuz Mayis University, Faculty of Medicine. The inclination of the acetabular component of these people, after total hip replacement, was evaluated. CUSUM chart, Moving Average chart, and Exponentially Weighted Moving Average were used to evaluate the quality control process of acetabular component inclination. MINITAB Statistical Software 15.0 was used to generate these control charts. The assessment done with time-weighted charts revealed that the acetabular inclination angles were settled within control limits and the process was under control. It was determined that the change within the control limits had a random pattern. As a result of this study it has been obtained that time-weighted quality control charts which are used mostly in the field of industry can also be used in the field of medicine. It has provided us with a faster visual decision.

Aim: Carpal tunnel (CTS) is the most common trap neuropathy but, still fully understood the cause of this and effective factors. In this study was aimed to the evaluation demographic features of the cases with CTS admitted to our electroneuromyography (ENMG) laboratory. Material and Methods: In the study, 119 patients with CTS to evaluate our ENMG laboratory were received. All patients age, sex, dominant and affected hand, duration of education, marital status, height, weight, additional diseases, occupational, hand and wrist repetitive motion made, use of computer and smoking status was assessed. Patients’ body mass index (BMI) was calculated. Results: 102 cases (85.7%) females, mean age was 46.32 years ± 12: 18. While in 115 (96.6%) cases using the right hand is dominant, in 85 cases (76.6%) with bilateral involvement were at hand. While the rate of patient who between five to eight year duration of education had was 47.1%, 84% patients were married. Also, BMI were determined as 29.33± 3.01. According to the state in 22 patients with additional diseases, diabetes mellitus in 22, hypothyroidism in 4, also 1 patient had arthritis. The majority of our patients (70.6%) housewives formed. The 67.2% rate of repetetive activities as making crafts, the computer usage at a rate of 11.8% had history. The rate of smoking was 19.3%. Conclusions: As a result, CTS, especially in middle-aged housewives and obese is a common syndrome. Despite many reasons to be reported in the etiology of idiopathic 85%. At a rate of 25.4% of women in our society is considered paid work, especially in terms of determining the etiology of the more detailed studies are needed to ousewives.

Narrow-band ultraviolet therapy has been used successfully for the treatment of inflammatory skin disorders and generalized pruritus. We have prospectively evaluated seven consecutive patients with resistant psychogenic excoriation (PE) treated with narrow-band ultraviolet B (NB-UVB). Approximately 70% of all patients showed improvement in their condition. NB-UVB therapy was well tolerated, with no serious side effects. We may conclude that, when treating a patient with PE, NB-UVB in combination with other approaches may provide extra benefit in resistant cases.

The increase in the prevalence of epidemic strains of methicillin resistant Staphylococcus aureus (MRSA) in hospitals and community requires special attention of infection control. The aim of this study was to determine the pathogenic phenotype (i.e. infectivity and resistotype) and genotypic characteristics (i.e. PFGE-pulsotyping, SLST-spa typing, MLST-sequence typing, eBURST-clonal complex detection algorithm) of clinical MRSA isolates in the Central Blacksea region of Turkey, in order to understand their short- and long-term epidemiological and evolutionary dynamics, and to investigate any probable presence of a significant clustering. This prospective study included consecutive but non-repetitive 48 MRSA isolates (of them 18 were colonized strains and 30 were causes of nosocomial infection) and seven methicillin-susceptible S.aureus (MSSA, all were isolated from nosocomial infection), collected between December 2006-February 2007 period from hospitalized patients. Identification of the isolates were performed by Vitek-2 automated system (BioMérieux, USA), and in vitro antimicrobial susceptibility testing by broth microdilution method and Vitek-2 automated system. The MRSA isolates found susceptible to erythromycin (n= 10) were further investigated for the presence of ermA gene by the PCR method. All the strains were typed by spa-typing and PFGE-pulsotyping methods. Among the isolates with different spa-types, representatives were selected (3 MRSA, 7 MSSA) and typed with MLST typing method. Among the isolates with different spa-types, representatives with different antimicrobial susceptibility patterns were selected (n= 8), and SCCmec types were determined by the multiplex PCR method. Antimicrobial resistance patterns of the isolates were digitized to get standardized antimicrobial resistance phenotypes. Clustering of MRSA isolates in pattern groups on the basis of discriminatory characteristics, namely infectivity, phenotype and genotype were statistically analyzed with specific inclusion and exclusion criteria. As a result, three different antimicrobial resistance phenotypes were found in MSSA isolates, whereas 13 were identified in MRSA isolates. In MSSA isolates, seven different PFGE-pulsotypes were detected, as compared to 14 pulsotypes in MRSA isolates. Among MRSA isolates, 10 sporadic strains with single PFGE-pulsotypes were detected. All MRSA isolates, with two exceptions (t459, t632), were of t030 spa-type; in the MLST analysis of the representatives of different spa-types (n= 3), a single type of MLST-clonal complex (CC8) and single MLST-sequence type (ST239) were identified. Each of the seven MSSA isolates yielded different spa-types, MLST-clonal complex types and MLST-sequence types (t777-ST5-CC5; t660-ST25-CC5; t153-ST34-CC30; t015-ST45-CC45; t267-ST97-CC97; t377-ST360-CC8; t084-ST15-C15). In the statistical analysis of 38 non-sporadic MRSA isolates, the isolates in Group-13 (n= 16; infectious, resistotype 14, pulsotype 4; antimicrobial resistance score= 24) displayed significant infectivity-phenotype-genotype clustering (p0.001). In 27 of the MRSA isolates, decreased susceptibility to teicoplanin (MIC= 4 µg/mL) was detected. Although, global MRSA isolates belonging to MLST-CC8, MLST-ST239, t030 spa-type were usually expected to be resistant to erythromycin, 10 such strains were erythromycin susceptible. However, ermA gene was found in six of these 10 strains, leading to a conclusion that the ermA gene of these isolates might be dysfunctional due to a point mutation or deletion. Selected representatives of MRSA isolates with different antimicrobial susceptibility patterns (n= 8) were detected to be SCCmec type III. In conclusion, S.aureus isolates in the patient population of our hospital representing the Central Blacksea region showed statistically significant clustering in infectivity, antimicrobial resistance phenotype and clonal genotype (p0.001). The dominant MRSA clone was ST239 which was one of the five major pandemic MRSA clones. Nosocomial MSSA isolates displayed long-term clonal diversity. This study produced regional evolutionary-epidemiological data that may support further regional, national and international long-term surveillance studies of S.aureus strains.

Hastanelerde ve toplum içinde, metisiline dirençli Staphylococcus aureus (MRSA) epidemik kökenlerinin prevalansındaki artış, enfeksiyon kontrol önlemleri açısından büyük önem taşımaktadır. Bu çalışmanın amacı, Türkiye’nin Orta Karadeniz bölgesindeki klinik MRSA izolatlarının, kısa ve uzun dönemli epidemiyolojik özelliklerinin anlaşılabilmesi için, patojenik fenotip (enfeksiyözite, resiztotip) ve genotip (PFGE pulsotipi, SLST spa tipi, MLST dizi tipi, eBURST klonal kompleks tipi) özelliklerinin belirlenmesi ve olası bir kümelenme varlığının araştırılmasıdır. Çalışmaya, prospektif olarak, Aralık 2006-Şubat 2007 tarihleri arasında hastanede yatan hastalardan izole edilen, ardışık ve tekrarlardan arındırılmış, 48 MRSA izolatı (18’i kolonizasyon, 30’u hastane enfeksiyonu etkeni) ile tümü hastane enfeksiyonu etkeni olarak tanımlanan yedi metisiline duyarlı S.aureus (MSSA) izolatı alınmıştır. İzolatların tanımlaması Vitek-2 otomatize sistemi (BioMérieux, ABD) ile, in vitro antimikrobiyal duyarlılıkları testleri ise sıvı mikrodilüsyon yöntemi ve Vitek-2 otomatize sistemiyle yapılmıştır. Eritromisine duyarlı bulunan MRSA izolatlarında (n 10), PCR yöntemi ile ermA geni araştırılmıştır. Tüm izolatlar, spa tiplendirme ve PFGE pulsotiplendirme yöntemleriyle tiplendirilmiştir. Farklı spa tiplerini temsilen seçilen üç MRSA izolatı ile tüm (n 7) MSSA izolatlarına MLST yöntemiyle tiplendirme yapılmıştır. Farklı spa tiplerine ait izolatlar içinde, antibiyotik a duyarlılık paternleri birbirinden farklı olan MRSA izolatları arasından seçilen temsilcilerin (n 8) SCCmec tipleri, multipleks PCR yöntemiyle belirlenmiştir. İzolatların, antimikrobiyal direnç paternleri sayısallaştı- rılarak, standardize antimikrobiyal direnç fenotipleri belirlenmiştir. MRSA izolatlarının, ayırt edici özel- liklerinden olan enfeksiyözite, fenotipik ve genotipik özellikleri temelinde oluşan patern gruplarındaki kümelenmeleri, belirli içerme ve dışlama ölçütleri ile istatistiksel analize alınmış ve anlamlılık bakımından incelenmiştir. Çalışmamızda, MSSA izolatlarında üç, MRSA izolatlarında 13 farklı antimikrobiyal direnç fenotipi belirlenmiş ve MRSA izolatlarında 14, MSSA izolatlarında yedi farklı PFGE pulsotipi saptanmıştır. MRSA izolatlarının 10’u, PFGE-pulsotipi ile sporadik tekil kökenler olarak saptanmıştır. MRSA izolatlarının, ikisi (t459, t632) hariç, diğerlerinin t030 spa tipinde olduğu belirlenmiş; farklı spa tipi temsilcilerinin (n 3) analizi sonucunda, tek MLST klonal kompleks tipi (CC8) ve tek MLST dizi tipi (ST239) bulunmuştur. Yedi MSSA izolatının ise her birisinin spa tipi, MLST dizi tipi ve MLST klonal kompleks tipinin farklı olduğu izlenmiştir (t777-ST5-CC5; t660-ST25-CC5; t153-ST34-CC30; t015-ST45-CC45; t267-ST97-CC97; t377- ST360-CC8; t084-ST15-C15). Sporadik olmayan 38 MRSA izolatının istatistiksel analizinde, Grup-13’te yer alan izolatların (n 16; enfeksiyöz, rezistotip 14, pulsotip 4; antimikrobiyal direnç skoru 24), anlamlı düzeyde enfeksiyözite-fenotip-genotip kümelenmesi sergilediği saptanmıştır (p 0.001). MRSA izolat- larının 27‘sinde azalmış teikoplanin duyarlılığı (MİK 4 ?g/mL) saptanmıştır. Global olarak, MLST-CC8, MLST-ST239, t030 spa tipi MRSA izolatlarının, genellikle eritromisine dirençli olması beklenmesine karşın, duyarlı olan 10 izolatın altısında ermA geninin bulunduğu gösterilmiş; bu genlerin nokta mutasyonu veya delesyon nedeniyle işlevsiz olabileceği düşünülmüştür. Antimikrobiyal duyarlılık paternleri birbirinden farklı olan MRSA izolatları arasından seçilen sekiz temsilci suşun SCCmec tipleri, tip III olarak saptanmıştır. Sonuç olarak, Orta Karadeniz bölgesi hasta popülasyonunu temsil eden hastanemizde saptanan S.aureus izolatlarının, enfeksiyözite, antimikrobiyal direnç fenotipi ve klonal genotip bakımından, istatistiksel ola- rak anlamlı kümelenme sergilediği ortaya konmuştur (p 0.001). Baskın olan MRSA klonunun, beş büyük pandemik MRSA klonundan biri olan, epidemik ST239 klonu olduğu ve nozokomiyal MSSA izolatlarının uzun dönemli klonal çeşitlilik sergilediği belirlenmiştir. Bu çalışmanın sonuçları, hastane enfeksiyonlarına yol açan çeşitli S.aureus kökenlerinin, bölgesel, ulusal ve uluslararası uzun dönemli sürveyans çalışmaları için veri sağlamaktadır. The increase in the prevalence of epidemic strains of methicillin resistant Staphylococcus aureus (MRSA) in hospitals and community requires special attention of infection control. The aim of this study was to determine the pathogenic phenotype (i.e. infectivity and resistotype) and genotypic character- istics (i.e. PFGE-pulsotyping, SLST-spa typing, MLST-sequence typing, eBURST-clonal complex detection algorithm) of clinical MRSA isolates in the Central Blacksea region of Turkey, in order to understand their short- and long-term epidemiological and evolutionary dynamics, and to investigate any probable presence of a significant clustering. This prospective study included consecutive but non-repetitive 48 MRSA isolates (of them 18 were colonized strains and 30 were causes of nosocomial infection) and seven methicillin-susceptible S.aureus (MSSA, all were isolated from nosocomial infection), collected between December 2006-February 2007 period from hospitalized patients. Identification of the isolates were per- formed by Vitek-2 automated system (BioMérieux, USA), and in vitro antimicrobial susceptibility testing by broth microdilution method and Vitek-2 automated system. The MRSA isolates found susceptible to erythromycin (n 10) were further investigated for the presence of ermA gene by the PCR method. All the strains were typed by spa-typing and PFGE-pulsotyping methods. Among the isolates with differ- ent spa-types, representatives were selected (3 MRSA, 7 MSSA) and typed with MLST typing method. Among the isolates with different spa-types, representatives with different antimicrobial susceptibility patterns were selected (n 8), and SCCmec types were determined by the multiplex PCR method. Antimicrobial resistance patterns of the isolates were digitized to get standardized antimicrobial resist- ance phenotypes. Clustering of MRSA isolates in pattern groups on the basis of discriminatory character- istics, namely infectivity, phenotype and genotype were statistically analyzed with specific inclusion and exclusion criteria. As a result, three different antimicrobial resistance phenotypes were found in MSSA isolates, whereas 13 were identified in MRSA isolates. In MSSA isolates, seven different PFGE-pulsotypes were detected, as compared to 14 pulsotypes in MRSA isolates. Among MRSA isolates, 10 sporadic strains with single PFGE-pulsotypes were detected. All MRSA isolates, with two exceptions (t459, t632), were of t030 spa-type; in the MLST analysis of the representatives of different spa-types (n 3), a single type of MLST-clonal complex (CC8) and single MLST-sequence type (ST239) were identified. Each of the seven MSSA isolates yielded different spa-types, MLST-clonal complex types and MLST-sequence types (t777-ST5-CC5; t660-ST25-CC5; t153-ST34-CC30; t015-ST45-CC45; t267-ST97-CC97; t377- ST360-CC8; t084-ST15-C15). In the statistical analysis of 38 non-sporadic MRSA isolates, the isolates in Group-13 (n 16; infectious, resistotype 14, pulsotype 4; antimicrobial resistance score 24) displayed significant infectivity-phenotype-genotype clustering (p< 0.001). In 27 of the MRSA isolates, decreased susceptibility to teicoplanin (MIC 4 μg/mL) was detected. Although, global MRSA isolates belonging to MLST-CC8, MLST-ST239, t030 spa-type were usually expected to be resistant to erythromycin, 10 such strains were erythromycin susceptible. However, ermA gene was found in six of these 10 strains, leading to a conclusion that the ermA gene of these isolates might be dysfunctional due to a point mutation or deletion. Selected representatives of MRSA isolates with different antimicrobial susceptibility patterns (n 8) were detected to be SCCmec type III. In conclusion, S.aureus isolates in the patient population of our hospital representing the Central Blacksea region showed statistically significant clustering in infectivity, antimicrobial resistance phenotype and clonal genotype (p< 0.001). The dominant MRSA clone was ST239 which was one of the five major pandemic MRSA clones. Nosocomial MSSA isolates displayed long-term clonal diversity. This study produced regional evolutionary-epidemiological data that may support further regional, national and international long-term surveillance studies of S.aureus strains.

We have evaluated 57 patients retrospectively who underwent arthroscopic and mini open surgery in our clinic between 24.12.2009-31.12.2011. Twenty of 34 patients with impingement syndrome were treated by arthroscopic surgery and 14 of 34 patients were treated by arthroscopic and mini open surgery. Seven of 23 patients with rotator cuff lesions were treated by arthroscopic surgery and 16 of 23 patients were treated by arthroscopic and mini-open surgery. Temperature over 37 oC was considered as sub febrile temperature. The difference between the highest temperature observed in the postoperative period and the temperature in the preoperative period was calculated and termed as delta temperature. The delta temperature in the arthroscopically treated group was found 1.2± 0.7oC and was 0.8±0.50C in the other group (p

BAYDIN, AHMET/0000-0003-4987-0878 WOS: 000305781100008 PubMed: 22642594 Acute coronary syndromes (ACS) like unstable angina (UA) and acute myocardial infarction (AMI) can lead to the morbidity and mortality. The diagnosis and management of patients with ACS in the earliest times after symptom onset are considerably important in the emergency service. Study aimed to investigate the serum levels of heat shock protein 70 (Hsp 70), high sensitivity C-reactive protein (hsCRP), total creatine kinase (CK) activity, creatine kinase MB (CK-MB), cardiac troponin I (cTnI), leukocyte count (WBCs) and markers of oxidative stress in the first hours of ACS and to view their diagnostic values. 70 patients with ACS after admission and 20 sex-matched healthy controls were included in this study. Serum Hsp 70, hsCRP, CK, CK-MB, cTnI, protein carbonyls, malondialdehyde as well as whole blood WBCs were measured. The level of hsCRP was statistically higher in patients with AMI and UA than that of control group (p

Pseudomonas aeruginosa is an important opportunistic pathogen associated with various community-acquired or nosocomial infections. Multi-drug resistant P.aeruginosa strains increasingly cause epidemics and spread in various hospital wards and geographic regions. Carbapenems are among the most effective antimicrobials in the treatment of multi-drug resistant P.aeruginosa infections, and meropenem is the most successful among alternatives in initial therapy. Particularly in severe infections, inappropriate or inadequate initial antimicrobial therapy is independently associated with adverse clinical and economic outcomes. Availability of accurate and rapid susceptibility testing is a priority. Most of the automated microbiology systems can provide rapid results within 8 to 12 hours. In comparison to standard methods, problems in the antimicrobial susceptibility testing of particular microorganisms and antimicrobial agents have been reported for automated microbiology systems. Failures have been reported previously especially in the susceptibility testing of P.aeruginosa versus carbapenem. Most of these studies are designed according to the Food and Drug Administration (FDA, USA) performance analysis scheme (Class II Special Controls Guidance Document: Antimicrobial Susceptibility Test Systems) in a simplified form. However, there are many lacking issues in the design of most of these studies. Among these, insufficient sample size, use of inappropriate reference method, lack of reproducibility testing, and inadequate distribution of study isolates in interpretative categories are of notice. There are only few studies in the literature that evaluate the performance of automated systems in antimicrobial susceptibility testing of carbapenems in clinical P.aeruginosa isolates with a sufficient sample size (n ? 100). However, most of these studies still have one or more major deficiencies in the study design. Furthermore, none of these studies evaluate the performance of VITEK 2 system without a major deficiency in study design. Therefore, we aimed to evaluate the performance of VITEK 2 system (bioMérieux, France) in antimicrobial susceptibility testing of carbapenems in clinical P.aeruginosa isolates in a well-designed study. The study was conducted on nonrepetitive P.aeruginosa isolates (n= 142) of clinical origin. Isolates were selected from the isolate collections of Culture Collection Unit of the Medical Laboratories at Ondokuz Mayis University Hospital. The study collection was characterized with conventional tests and the VITEK 2 automated microbiology system. Broth microdilution method standardized by Clinical and Laboratory Standards Institute was used as the reference method. P.aeruginosa ATCC 27853 was used as the quality control strain in all experimental steps. Twofold dilutions of meropenem (AstraZeneca, USA) concentrations between 64 mg/L and 0.125 mg/L were tested. In compliance with FDA recommendations, minimum inhibitory concentrations of study isolates were shown to be on-scale and distributed within the range of five sequential dilutions in both methods. In reproducibility testing, 15 organisms were tested with VITEK 2 system in triplicate. Results of the reproducibility tests were evaluated in comparison to the test mode (the most frequent test result for the isolate) as a reference. Overall reproducibility was 100%. Essential and categorical agreements of the VITEK 2 system in comparison to the reference method were 83.8% and 96.5%, respectively. Very major and minor discrepancy rates were 1.4% and 2.8%, respectively. There was no major discrepancy. While the results of the essential agreement was not acceptable, categorical agreement was acceptable according to the FDA performance criteria. There was very good agreement between methods as shown by the kappa value (?= 0.938). In conclusion, VITEK 2 system exhibited acceptable performance in the meropenem susceptibility testing of clinical P.aeruginosa isolates. As pre-market approval may not guarantee proper validation, performance of the automated microbiology systems in antimicrobial susceptibility testing should at least be verified and the literature that reports performance evaluation results should be read critically before implementation for routine use in laboratory.

WOS: 000292569300003 PubMed: 21689029 Background : Laser therapy is the treatment of choice for cherry angiomas since it is more effective and has better cosmetic results. There is no comparative study about the treatment efficacies with KTP and Nd:YAG lasers for cherry angiomas. Objective : To compare the efficacy and side effects of 532-nm KTP and 1064-nm Nd:YAG lasers for the treatment of cherry angiomas. Methods : Two comparable lesions of the same patient were chosen. One of them was treated with the KTP laser while the other was treated with the Nd:YAG laser. Sessions were repeated every 4 weeks until complete clearance was achieved. Side effects were evaluated using a severity scale (0 to 4). Results : The number of sessions was significantly higher with the KTP than with the Nd:YAG laser (p = 0.002). Erythema, edema, pain and scar formation were higher in the Nd:YAG laser group (erythema: p = 0.001; edema: p = 0.001; pain: p = 0.001; scar: p = 0.001). The hyperpigmentation rate was statistically higher with the KTP laser (p = 0.01). Conclusion : Both KTP and Nd:YAG lasers were found to be effective methods. The Nd:YAG laser offered fewer treatment sessions, but a higher risk of scar formation. The KTP laser seems more advantageous, but in dark-skinned patients the Nd:YAG laser may be preferable.

To analyze the effect of possible risk factors, including breastfeeding, on the development of childhood-onset psoriasis, a multicenter case-control study with prospective collection of data was performed. Using a standard questionnaire, personal and specific variables including family history of psoriasis, maternal and environmental tobacco smoke exposure, body mass index (BMI), exclusive and partial breastfeeding for at least 3 and 12 months, cow's milk intake before 1 year, birth delivery method, and stressful life events were collected during 2009 from 537 patients with psoriasis and 511 controls younger than 18. Overall, patients more frequently reported exposure to environmental tobacco smoke at home and stressful life events in the year preceding the diagnosis than controls. The odds ratios (OR) for smoking and stressful life events were 2.90 (95% confidence interval [CI]=2.27-3.78) and 2.94 (95% CI=2.28-3.79), respectively. In addition, children with psoriasis were more likely to have a higher BMI (26) than controls (OR=2.52; 95% CI=1.42-4.49). High BMI, environmental tobacco smoke exposure at home, and stressful life events may influence the development of pediatric psoriasis.

WOS: 000309254000007 PubMed: 21898066 The aim of this clinical trial was to evaluate the effectiveness of therapeutic MD on pain, functional capacity, muscle strength, quality of life, and depression in patients with subacromial impingement syndrome (SIS). A total of 40 inpatient subjects with definite SIS were included in this study. These patients were sequentially randomized into 2 groups. Group 1 (n = 20) received therapeutic MD. Group 2 (n = 20) was served as control group and received sham MD. Superficial heat and exercise program were given to both groups. Both of the programs were performed 5 times weekly for 3 weeks. Patients were assessed before treatment (BT), after treatment (AT), and at a 1-month follow-up (F). Outcome measures included visual analogue scale, goniometry, Shoulder Pain and Disability Index, Shoulder Disability Questionnaire, shoulder isokinetic muscle testing, handgrip strength, Short Form 36, and Beck Depression Index. The patients with SIS in each group had significant improvements in pain, shoulder ROM, disability, shoulder muscles and grip strength, quality of life, and depression AT and F when compared with their initial status (P < 0.05). There was no statistically significant difference between the groups according to all the parameters regarding the change scores between AT-BT test and F-BT test (P > 0.05). A 2,450-MHz MD regimen showed no beneficial effects in patients with SIS, so the superficial heat and exercise program, as it is efficient, may be preferable for the treatment of SIS, alone.

Here, we report a laboratory-developed colorimetric-plate method for rapid disk diffusion susceptibility testing of Escherichia coli . One hundred isolates were evaluated. Categorical agreement between the colorimetric plate and the standard disk diffusion method was 99%. Mean time to results was 7.07 h (95% confidence interval, 5.96 to 8.19).

Aim Laparoscopic cholecystectomy (LC) has been most preferable method for benign gallbladder disease. Advanced age may be increased morbidity and mortality. The aim of this study was to compare the results of LC in patients according to different ages (age ? 30, 31 - 64 years, and age ? 65). Material and Methods A retrospective analysis was performed including overall 511 patients who underwent LC for benign disease of gallbladder at Ondokuzmayis University Medical Faculty and Mustafa Kemal University, Medical Faculty between November 2001 and November 2009. The patients are divided into three groups according to ages: Group A (age ? 30 years, n = 47), Group B (age = 31 - 64 years, n = 368), Group C (age ? 65, n = 96). Results Symptomatic cholelithiasis was the most common indication for LC in all the groups (p > 0.05). Co-morbid diseases were significantly higher in the Group C (? 65 years) than in the Group A and B (? 30 years, 31 - 64 years) (p=0.001). Co-incidental biliary pathologies, and history of abdominal operation were similar in all the groups. However biliary duct and cystic artery anomalies were significantly more common in the Group A than in the Group B and C (p=0.001). Conversion to OC was required in 26 (5.08%) patients in this study. The major reason for the (21 cases, 80.76%) was difficult dissection of the Calot's triangle. There was no difference in morbidity among the groups (p>0.05). Conclusions As a conclusion, it's thought that biliary anomalies in young patients and co-morbid diseases disorders in elderly patients are more common. These factors do not affect the results of patient that preoperatively well evaluated. However surgeon should be aware of this condition and be careful for intraoperative and postoperative complication.

WOS: 000290762700007 PubMed: 20666669 Background: The Nd:YAG laser has been considered the gold standard of treatment for leg veins, but pain and side effects have fueled physicians to use treatment alternatives. Objective: To compare the clinical efficacy of the long-pulsed 1064-nm Nd:YAG laser with KTP laser irradiation in the treatment of leg telangiectasia. Methods: A series of 16 patients with size-matched superficial telangiectases of the lower extremities were randomly assigned to receive three consecutive monthly treatments with the long-pulsed 1064-nm Nd:YAG on one leg and 532-nm KTP laser irradiation on the other. Results: For the 16 patients who completed the study, 64 leg vein sites were treated. Average clinical improvement scores were 1.94 and 1.25 for the KTP laser-treated leg and 3.38 and 3.50 for the Nd:YAG laser-treated leg with thin (

Narrow-band ultraviolet therapy has been used successfully for the treatment of inflammatory skin disorders and generalized pruritus. We have prospectively evaluated seven consecutive patients with resistant psychogenic excoriation (PE) treated with narrow-band ultraviolet B (NB-UVB). Approximately 70% of all patients showed improvement in their condition. NB-UVB therapy was well tolerated, with no serious side effects. We may conclude that, when treating a patient with PE, NB-UVB in combination with other approaches may provide extra benefit in resistant cases.

GULER, Ahmet/0000-0003-0167-2346 WOS: 000281073100005 The honey bee races Apis mellifera carnica Pollman and A. m. caucasica Gorbachev are both found in Turkey, A. m. carnica primarily in Thrace (European Turkey) and A. m. caucasica primarily in north-eastern Anatolia (Asia Minor). Standard measures of forewing vein angles were investigated for their utility in discriminating between these two races and in identifying bees of unknown origin. A total of 76 honey bee samples was used, 61 of which were taken from north-eastern Anatolia (NEA), 8 from Thrace region (TR) and 7 from a private beekeeper who imported queens of A. in. carnica (IQC) from abroad. In each sample, 11 forewing vein angles used in standard honey bee morphometrics (A(4), B-4, D-7, E-9, G(18), J(10), J(16), K-19, L-13, N-23 and O-26) were measured. Multivariate linear discriminant analysis step-wise methods showed that A(4), K-19 and G(18) were sufficient to discriminate between the samples. While A(4) vein angle was found to be a key geometric character for the A. m. caucasica (NEA) race, B-4 was found to be key for the A. m. carnica (IQC) race. Standard norm values of A(4), and B-4 are 33 degrees and 104 degrees for A. in. caucasica (NEA) race and 32 degrees and 105 degrees for A. m. carnica race (IQC). It is possible to discriminate unknown worker bee samples of these subspecies by using these standard norm values. The range of real and observed agreement for estimation of unknown samples was 0.93-0.77 for A. in. carnica and 0.89-0.65 for A. m. caucasica honey bee subspecies. Although in discriminant analysis Thrace and Carniolan (IQC) honey bee samples were overlapping in low percentage, according to forewing geometric veinal angles they were found to be similar.

WOS: 000265881000005 PubMed: 18690546 Genetic differences in the metabolism of xenobiotics have recently been suggested as modifiers of individual susceptibility to bladder cancer (BC). The objective of this study was to investigate the relationship between bladder tumor and variants of cytochrome p450 1A2 (CYP1A2) 734 C -> A, cytochrome p450 2D6 (CYP2D6) 1934 G -> A, glutathione S-transferase M1, (GSTM1 null), glutathione S-transferase T1 (GSTT1 null), and glutathione S-transferase P1 (GSTP1) I105 V. We investigated the distribution of these polymorphisms in 135 BC patients and in 128 age and sex-matched cancer-free controls. The polymorphisms were analyzed using polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) assay and the multiplex PCR method. Genotype and allele frequencies and their associations with BC risk, demographic factors, smoking status, and tumor stage were investigated. The prevalence of GSTT1 null genotype in cases was 23%, compared with 7% in the control group (OR = 3.94, 95% CI = 1.70-9.38, P = 0.001). There was no association between the studied polymorphisms of CYP1A2, CYP2D6, GSTM1, and GSTP1 genes and BC. There was an association between smoking status and BC. These data seem to indicate that GSTT1 gene polymorphism may be associated with BC in the Turkish population studied. Further studies will be needed to clarify the role of such variation in determining susceptibility to BC. Ondokuz Mayis University Research FundOndokuz Mayis University [402] This study was completely supported by Ondokuz Mayis University Research Fund ( Project No. 402). We also thank Dr Cem Irkilata for providing some of the samples used in this study.

WOS: 000265736100010 PubMed: 19249013 Objective: To evaluate the relationship between passive smoking as determined by salivary cotinine levels and salivary electrolytes, protein, secretory IgA, sialic acid and amylase in children. Design: Saliva was collected from 90 passive smoker (PS) subjects (the study group) and 90 healthy age-matched children (the control group). The study group was divided into three subgroups according the number of cigarettes smoked. Socio-economic status, dental and dietary habits were recorded by questionnaire. Stimulated salivary calcium (Ca), phosphate (P), sodium (Na), potassium (P), total protein, amylase activity, sialic acid level, secretory IgA concentration and cotinine level were analysed. All data were analysed using SPSS, version 13.0. Results: Socio-economic status, dental and dietary habits were similar between the two groups. The salivary electrolytes concentrations did not reveal significant difference between the two groups (p > 0.05). The mean cotinine levels of PS children were 1.58 +/- 4.3 ng/mL. The salivary concentrations of protein were similar between the two groups (p > 0.05). The salivary secretory IgA concentration was significantly lower in the PS group than controls. The sialic acid level and amylase activity in PS group were found significantly higher compared with the controls (p < 0.05). No difference was observed for all these parameters with sex (p > 0.05). When saliva samples were analysed for output, the sialic acid level and amylase activity increased significantly in PS subjects (p < 0.05). Further, the output of secretory IgA concentration was found significantly lower compared with the controls (p < 0.05). Conclusion: In conclusion, we show that passive smoking was associated with a decrease in secretory IgA concentration, whereas with increase in amylase activity and sialic acid level of stimulated whole saliva in young children. (C) 2009 Elsevier Ltd. All rights reserved.