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The role of Nigella sativa L. (Ranunculaceae) (NS) and Urtica dioica L. was investigated (UD) in the prevention of carbon tetrachloride (CCl4) induced liver fibrosis and cirrhosis. Fifty Sprague-Dawley rats were allocated into fi ve groups (I, IIA and B, IIIA and B) and CCl4 was injected biweekly to all groups. Group I (control, CCl4 only), group IIA and B (NS fixed oil and volatile oil), group IIIA and B (UD fixed oil and UD decoction extract) rats were killed at the end of week 12 and histopathological and immunohistochemical examinations of liver tissues were performed. In the control group, coagulation necrosis and hydropic degeneration were marked in the periacinar regions (zone 3) associated with fibrosis in the periacinar regions and in the portal tracts. In groups IIA-B and IIIA-B (NS and UD), none of the serious histopathological findings were detected except for sparse coagulation necrosis in the periacinar regions. ASMA-positive perisinusoidal cells with myo fibroblastic transformation and lysosomal enzyme activity suggesting fibrogenesis were also significantly more common in the control group than in the NS and UD groups. UD and NS seem to be significantly effective in the prevention of carbon tetrachloride induced hepatotoxicity in rats.

Background: In eastern Turkey, upper gastrointestinal (oesophageal and gastric) cancers are endemic and dietary factors play an essential role in carcinogenesis. Design: Laboratory analysis of benzo(a)pyrene (BP) and 1,2-benzanthracene (BA) levels in a range of cooked foods in use in the Van region. Materials and Methods: BP and BA levels (ppb) in bread and cooked meat samples were determined by high performance liquid chromatography. An analysis of variance and the multitest were used. Results: The mean BP level was highest in bread baked in a bakery using fuel oil (3.32 ppb), followed by bread baked in an oven burning dried dung, fatty pizza cooked using a wood fire and meat roasted on a liquid petroleum gas (LPG) fire (2.51, 2.37 and 2.32 ppb, respectively; p>0.05). The mean BP level in bread baked in a bakery using fuel oil was significantly higher than that in meat roasted in an oven burning dried dung, bread baked in an oven using wood fire and meat cooked using a wood fire (2.03, 1.54 and 1.39 p...

MEN-2A is characterized by medullary thyroid carcinoma (MTC) with pheochromocytoma and sometimes parathyroid adenoma. In affected members of the family, the risk of MTC is about 100%. Biochemical screening allows tumors to be detected early but even at this stage treatment is not always curative. Missense mutations in exon 10 and 11 of the RET proto-oncogene are associated with MEN2A. Early detection of this mutation by DNA analysis allows the identification of the carriers of the gene. We performed genetic screening in 88 members of an extended family with MEN2A and found 18 members positive for RET mutation (Cys634Gly). Only three of these 18 RET positive cases had a previous diagnosis of medullary cancer and/or pheochromocytoma. Up to now, 12 of the RET positive cases have undergone thyroidectomy. There was extended disease with cervical lymph node metastasis in 6 of them, bilateral medullary microcancer in 3 and c-cell hyperplasia in the remaining 3. Three of the 18 RET positive patients had also pheochromocytoma. Primary hyperparathyroidism was present in only one patient. The mean age of diagnosis of medullary cancer was between 25-50 yr and mean age of death was between 35-95 yr in affected members of the family. The family had many other affected members in other cities in Turkey and in other countries throughout the world from Australia to the Netherlands. So this family is perhaps one of the most extended families with MEN2A. (C) 2002, Editrice Kurtis.

Objective We investigated the effect of autonomic nervous system activity on exaggerated systolic blood pressure (SBP) response to exercise in healthy subjects using heart rate variability (HRV) analysis. Method and results We studied 53 healthy volunteer subjects with exercise treadmill test according to the Bruce protocol. Time domain and frequency domain of HRV were measured for each 5-minute segment before (rest) and after exercise (recovery) and during the total exercise period. The mean change in SBP (delta SBP) was 39 +/- 18 mm Hg. The delta SBP above the value of mean (> or = 40 mm Hg) was defined as an exaggerated delta SBP. According to the delta SBP, subjects were classified into two groups. Group I consisted of 32 patients who showed a normal delta SBP, group II consisted of 21 patients who showed exaggerated delta SBP. There were no significant differences in baseline clinical characteristics and exercise duration between the two groups. There were no significant differences in the mean RR intervals, SDNN (standard deviation of all RR intervals), RMSSD (the square root of the mean of the sum of the squares of differences between adjacent RR intervals), and HF (high-frequency power, 0.15 to 0.40 Hz) at rest between the two groups. However, LF (low-frequency power, 0.04 to 0.15 Hz) and LF/HF ratio at rest were significantly higher at rest in group II than in group I. There were no significant differences in the mean RR intervals and HF at exercise between the groups. However, SDNN and RMSSD were significantly lower, LF and the LF/HF ratio were significantly higher at exercise in group II than in group I. No differences in these parameters were observed at recovery between the two groups. Conclusions The sympathetic activity was higher at rest and during the total exercise period, parasympathetic activity was lower during the total exercise period in healthy subjects with exaggerated SBP response to exercise than in those with normal SBP response.

To date there has been no association of ascites, hearing loss and pancytopenia in brucellosis in the literature. A 25-year-old female patient was hospitalized with fever, hearing loss, ascites and pancytopenia. Cultures from bone marrow and ascites yielded growth of Brucella melitensis and Brucella standard tube agglutination was found to be positive at a titer of 1/1280. The patient completely recovered by the sixth week following combined antibacterial treatment of ciprofloxacin, rifampin and doxychline.

Hepatitis delta virus infection is an important cause of liver morbidity and mortality worldwide. In Eastern Turkey, hepatitis B virus infection is the major cause of chronic liver diseases. We aimed to research the role of hepatitis delta virus infection in chronic liver diseases related to hepatitis B virus infection in the Van region of Eastern Turkey.Serological markers of hepatitis B virus and hepatitis delta virus infection [HBsAg, HbeAg, Anti-HBe and Anti- hepatitis delta virus total (IgM+IgG)] were determined by ELISA test in patients with chronic hepatitis and cirrhosis. Serum hepatitis B virus DNA was determined by polymerase chain reaction (PCR) method in chronic hepatitis B patients.Hepatitis delta virus infection was detected in 5% (7/138) of asymptomatic hepatitis B virus carriers, in 16% (24/148) of chronic hepatitis B patients and in 45% (34/75) of cirrhotic hepatitis B virus patients. hepatitis delta virus infection showed a three-fold increase in chronic hepatitis (p0.01) and nine-fold increase in cirrhosis (p0.001) compared to hepatitis delta virus carriers. Also, it was three times more frequent in cirrhosis (p0.001) compared to chronic hepatitis. Chronic hepatitis delta virus infection was equally distributed between sexes in patients with chronic hepatitis B virus infection, whereas chronic hepatitis B virus infection alone was three times more frequent in males (p0.001). Mean ages of hepatitis delta virus carriers, chronic hepatitis D and hepatitis delta virus cirrhosis patients were 30.7+/-8 (14-65), 36+/-13 (19-70) and 44 +/-16 (25-55), respectively.The higher prevalence of hepatitis delta virus infection in more severe form of hepatitis B virus infection suggests that hepatitis delta virus infection increases the severity of chronic hepatitis B virus infection in the Van region. hepatitis delta virus infection remains a second major cause of chronic liver diseases in Eastern Turkey in spite of its decreasing prevalence in Western countries and in Western Turkey.

The aim of our study was to present the epidemiological aspects of endemic upper gastrointestinal (esophageal and gastric) cancers in the Van region of Eastern Turkey.The patients were diagnosed by esophagogastroscopy, biopsy and histopathological analysis. The control group consisted of 73 healthy subjects. Epidemiological characteristics (age, sex, dietary habits, educational status, life style) were evaluated by questionnaires. Helicobacter pylori infection was diagnosed in nontumoral gastric mucosal biopsy specimens by Giemsa staining.298 esophageal Ca and 384 gastric Ca patients were diagnosed in seven years (1994-2001). Most of the patients (90%) were of rural origin. Endoscopic prevalence rate of upper gastrointestinal (UGI) Ca was the highest (1 Ca per 7 esophagogastroscopy) in the Van region compared to other parts of Turkey. Esophageal Ca were 1.5 times more common in females whereas gastric Ca were 1.6 times more common in males. Ninety per cent of esophageal cancers were epidermoid and the remaining 10% were adenocarcinomas. Ninety-seven per cent of gastric Ca were adenocarcinomas. Helicobacter pylori infection was not significantly increased in gastric Ca patients compared to controls.Low educational and socioeconomic status, consumption of smoked, salted, hot, fatty foods, overdrinking hot tea and well water, cigarette smoking, poor intake of fresh fruits and vegetables and poor hygienic conditions were probable culprit factors.

The aims of this study were to investigate the presence of short segment Barrett's esophagus in people found to have tongue-like columnar mucosal protrusions in the distal esophagus and to determine the relationship between short segment Barrert's esophagus and Helicobacter pylori, gastritis and intestinal metaplasia observed in other parts of the stomach.The study included 50 patients (32 male, 18 female). Two biopsy specimens were taken from the antrum, at least 2 cm away from the pylorus, from the incisura angularis, corpus and cardia and four biopsy specimens were taken from tongue-like columnar protrusions (3 cm long) above the gastroesophageal junction. Tissue samples were stained with hematoxyline-eosine, HID-Alcian blue pH 2.5 and modified Giemsa.Of the 50 subjects who were found to have tongue-like columnar protrusions above the gastroesophageal junction, short segment Barrett's esophagus was detected in nine (18%). Whereas all short segment Barretti's esophagus cases were associated with chronic gastritis, Helicobacter pylori was found to be positive in five (55.5%) of them and there was intestinal metaplasia in other parts of the stomach (antrum in two patients, incisura angularis in three, antrum and cardia in one) in six (66.6%) cases. In 41 patients without short segment Barrett's esophagus 33 (80%) had chronic gastritis, 27 (66%) had Helicobacter pylori infection and eight had intestinal metaplasia in different locations (there in antrum, four in incisura angularis, one in the antrum and cardia) of the stomach.An association between short segment Barrett's esophagus and intestinal metaplasia was found in different parts of the stomach. The link between intestinal metaplasia in the stomach and these metaplastic changes in the tubular esophagus requires evalation in larger and more comprehensive studies.

The aim of this study was investigate nitrate and nitrite levels in some traditional foods and drinking water in Van, an endemic upper gastrointestinal (esophageal and gastric) cancer region of Eastern Turkey.Cheese with added herbs, drinking water, bread baked by wood fire and bread baked by burning animal manure specimens collected in the Van region were analyzed by Stahr's modification method. Nitrite was reduced to nitrate by the following three reagents: hydrazine sulphate ((NH2) 2SO4), CuSO4 and NaOH. Nitrate was then determined by coupling reagent containing sulphanlyamide, phosphoric acid and N-1-naphtyl ethylendiamine dihydrochloride.Nitrate and nitrite levels of all traditional foods and nitrite levels of drinking water were very significantly elevated compared to standard values (p0.001- 0.01).These findings suggest that the influence of a traditional diet rich in nitrate and nitrite is significant in the development of endemic upper gastrointestinal (esophageal and gastric) cancers in the Van region of Turkey.

The environmental exposure to heavy metals is a well-known risk factor for cancer. We investigated levels of seven different heavy metals, (Co, Cd, Pb, Zn, Mn, Ni and Cu) in soil, fruit and vegetable samples of Van region in Eastern Turkey where upper gastrointestinal (GI) cancers are endemic. Heavy metal contents of the samples were determined by flame atomic absorption spectrometer. Four heavy metals (Cd, Pb, Cu and Co) were present in 2- to 50-fold higher concentrations whereas zinc levels were present in 40-fold lower concentrations in soil. The fruit and vegetable samples were found to contain 3.5- to 340-fold higher amounts of the six heavy metals (Co, Cd, Pb, Mn, Ni and Cu) tested. The volcanic soil, fruit and vegetable samples contain potentially carcinogenic heavy metals in such a high levels that these elements could be related to the high prevalence of upper GI cancer rates in Van region. (C) 2002 Elsevier Science B.V. All rights reserved.

We present an unusual case of involvement of the liver by both Echinococcus granulosus and alveolaris infection with typical radiological appearence. E. granulosus was located in the left lobe and the E. alveolaris was in the right lobe. To our knowledge, there is no report regarding the coincidence of both hydatid diseases in the liver of the same patient so far in the literature.