Hypothalamo-pituitary function of male patients with chronic active hepatitis was evaluated. The effects of interferon alpha therapy on hypothalamo-pituitary-gonadal axis were also investigated.
...Twenty patients with chronic B and C hepatitis, and 10 healthy subjects were studied. Before and after treatment with IFN alpha, basal levels of FSH, and LH were obtained and all groups were evaluated with LH-RH stimulation test.
Baseline hormone levels and FSH and LH responses to LH-RH stimulation test were similar in patients and controls. It was notable that the LH response was considerably greater than that of FSH and pretreatment FSH results in patients with HCV infection appeared earlier than those of patients with HBV infection. Following IFN alpha treatment, the results of LH-RH stimulation test were similar to those of controls but there were a delayed LH and FSH response to LH-RH stimulation test.
Hypothalamic and/or gonadal hypogonadism is correlated with the degree of liver damage in cirrhosis. In patients with chronic hepatitis, which is characterized by lesser degree of liver damage than cirrhosis, HPG axis is not affected. IFN alpha, still in use for treatment of hepatitis, did not have any effect on HPG axis although it has many side effects.
A prospective in vitro study was conducted to investigate the potential for various perfluorocarbon liquids to support the growth of microbes, which may be introduced into these liquids as ...contaminants during intraocular surgery. Perfluorodecaline, perfluoro-noctane, and perfluorophenanthrene were tested for the growth of Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans by using tryptone soy broth, pancreatic digest of casein, and Sabouraud broth as culture media for up to 10 days. No microbial growth was observed in any of these perfluorocarbon liquids. Perfluorocarbon liquids do not promote microbial growth. Thus, they do not increase the risk of endophthalmitis in vitreoretinal surgery.
This study was performed to investigate the use of chromogenic tube and methyl blue-Sabouraud agar for the presumptive identification of Candida albicans. 124 clinical isolates, including 111 ...C.albicans and 13 Candida spp strains, which had been identified by morphology on cornmeal tween 80 agar and Vitek automated identification system, were included. Three different identification procedures, a) germ tube test, b) chromogenic tube test by using CHROMagar Candida and c) methyl blue-Sabouraud agar test, were performed to the strains. 88 of 111 (79.3%) C.albicans strains were detected to be positive by germ tube test. 87 (78.4%), 97 (87.4%) and 102 (91.9%) of these isolates were identified as C.albicans by chromogenic tube test after 2, 8 and 24 hours of incubation, respectively. 88 (79.3%), 92 (82.9%) and 88 (79.3%) of the isolates were correctly identified as C.albicans by methyl blue-Sabouraud agar test after 2, 8 and 24 hours of incubation, respectively. The sensitivity and specificity values were found to be 79.3 and 69.2 for the germ tube test. These values ranged between 78.4-91.9% and 69.2-76.9% for chromogenic tube test and 79.3-82.9% and 76.9-84.6% for methyl blue-Sabouraud agar depending on the incubation period. It can be concluded that the use of chromogenic tube and methyl blue-Sabouraud agar are rapid, simple and objective methods for the identification of C.albicans strains.
Abstract Background context Intraradicular lumbar disc herniation is rare, having been reported to date in only three postoperative patients. The diagnosis is typically made intraoperatively. Purpose ...To report a fourth case of intraradicular disc herniation, to emphasize its radiological characteristics and operative findings. Study design Case report. Patient sample A 41-year-old female. Methods Retrospective case review. Results The patient underwent a second operation and intraradicular disc fragment was removed. She was completely well at her 9-month check up. Conclusions The diagnosis, mechanism, and surgical treatment of intraradicular lumbar disc herniation are reviewed. The round shape of the sequestrated fragment, as seen on magnetic resonance imaging, may help to establish the correct diagnosis.
A 52 year-old male patient with idiopathic hepatic cirrhosis complaining of diarrhea and weakness was accepted to the gastroenterology clinic. In order to find out the causative etiologic agent of ...diarrhea, stool samples were examined by different methods and stained using modified Kinyoun's acid-fast stain. Following examination, approximately 9 microns diameter, acid-fast variable wrinkled spheres were seen and diagnosed as Cyclospora cayetanensis. Confirmation of the diagnosis was established by fluorescent microscope (380 to 420 nm excitation filter), which showed bright green to intense blue autofluorescent oocysts. It has been shown that, Cyclospora cayetanensis is a coccidian parasite mainly found in immunocompromised patients and that it may be the agent of prolonged diarrhea. Only three cyclosporiosis cases have been previously reported in our country; all three cases were AIDS patients. We report here a further case of Cyclospora cayetanensis infection in a patient with hepatic cirrhosis and we consider that this is the first case, which was reported in hepatic cirrhosis.
This study investigated the possible role of Ureaplasma urealyticum, which is predominantly located in the urogenital tract, in the formation of infectious stones. A standardized Ureaplasma ...urealyticum broth culture isolated from a human urogenital specimen was inoculated into the renal medulla of five male rats (Rattus norvegicus L., Wistar C, weighing 170 +/- 10 g) and the same amount of culture media was used for five identical control rats. Five days after the inoculation, the rats were killed and fresh preparations from the bladders and the inoculated kidneys of both groups were prepared. At the same time biochemical and histopathological analysis of the contents of the bladders and the inoculated kidneys of both groups was performed. Crystal formation within the bladders of the inoculated rats was demonstrated and biochemical analysis of the crystals showed calcium, magnesium and phosphate, which indicated the existence of infection-induced crystals. These findings were absent in the control rats. The role of Ureaplasma in the production of urinary tract infectious stones was thus demonstrated in vivo.
A multicenter antimicrobial surveillance program was established in Turkey in 1995 to monitor the predominant Gram-negative pathogens from intensive care units (ICUs) and antimicrobial resistance ...patterns of these isolates. Sixteen hospitals participated in the study and a total of 1479 isolates from 1100 patients were collected. The isolates were tested for their susceptibility against 13 antibiotics by E-test method. Minimum inhibitory concentrations (MICs) for each isolate were determined for imipenem, ceftazidime, cef-tazidime-clavulanate, cefoperazone-sulbactam, ceftriaxone, cefepime, cefurox-ime, piperacillin-tazobactam, ticarcillin-clavulanate, gentamicin, amikacin and ciprofloxacin. The most common isolates were Pseudomonas spp. (28.2%), Escherichia coli (19.2%) and Klebsiella spp. (19.1%). We found very high resistance rates to all major antibiotics that are used to treat serious infections. Although imipenem is the most active agent, it had an overall susceptibility rate of 68%. Half of the tested Klebsiella spp. strains were found to produce ESBL. This is a very high rate when compared with the literature. Cross-resistance among species was also investigated. 52% of ciprofloxacin-resistant strains were also resistant to imipenem, 80% to ceftazidime, 97% to ceftriaxone, 86% to amikacin and 19% of imipenem-resistant strains were susceptible to ceftazidime and 18% to amikacin. When susceptibilities of the years 1995 and 1999 were compared, the most interesting finding was the decrease in resistance to 3
rd
generation cephalosporins. In conclusion, this national clinical isolate database shows that resistance rates are high, the change over years is not predictable and continuous surveillance is necessary to monitor antimicrobial resistance and to guide antibacterial therapy.
Bu çalışmada, amfoterisin B ile flukonazol ve ketokonazol kombinasyonlarının, Candida albicans ATCC 90028 ile kan ve beyin omurilik sıvısı (BOS) kültürlerinden soyutlanan 10 C.albicans suşuna ...etkinliği "dama tahtası mikrodilüsyon sinerji testi" ile araştırılmıştır. Sonuçlar gözle ve mikroplak okuyucusunda 492nm dalga boyunda okunarak değerlendirilmiştir. Ayrıca amfoterisin B ile flukonazol kombinasyonunun etkinliği E-testi uygulanarak da incelenmiştir. Araştırmamızda amfoterisin B ile flukonazol kombinasyonu her iki yöntemle de antagonistik etkili ve/veya etkisiz bulunmuştur. Amfoterisin B ile ketokonazol kombinasyonu ise suşların tümüne yüksek amfoterisin B konsantrasyonlarında antagonistik etkili ve/veya etkisiz, düşük amfoterisin B kombinasyonlarında ise suşların 7'sine aditif ve/veya sinerjik etki göstermiştir. Sonuçlarımız doğrultusunda, amfoterisin B ile flukonazol ve ketokonazol kombinasyonlarının antifungal tedavide çok etkili olmadığı ancak tedaviye yanıt vermeyen dirençli olgularda amfoterisin B ile ketokonazol kombinasyonunun in-vivo araştırmalardan sonra denenebileceğini düşünmekteyiz.
In this study, the efficacy of combination of amphotericin B with fluconazole or ketokonazole was investigated against Candida albicans ATCC 90028 reference strain and 10 clinical strains isolated from blood and cerebrospinal fluid cultures with checkerboard microdilution synergy method. The results were evaluated visually and by measuring the optical density at 492 nm wavelength at a microplate reader. The effect of amphotericin B and fluconazole combinations were also investigated by E-test, and the effect of this combination was found to be antagonistic and/or indifferent with both methods. . Amphotericin B and ketoconazole combination showed antagonistic and/or indifferent effect against all strains at high amphotericin B concentrations while the same combination showed additive/synergistic effect against 7 of the strains at low amphotericin B concentrations. According to our results, we can conclude that the combinations of amphotericin with fluconazole or ketoconazole are not very effective therapies, however, amphotericin B and ketoconazole combination can be tried for the treatment of resistant cases after the conduction of further in-vivo studies.
Amaç: Kandida albicans özellikle bağışıklık sistemi sağlam olan bireylerde nadir görülen bir özofajit nedenidir. Bu çalışma kandida özofajitinin prevalansını, semptomlarını ve kandida özofajiti ile ...altta yatan hastalıklar arasındaki ilişkiyi göstermek amacı ile yapıldı. Metod: 11.772 adet özofagiyal endoskopi raporu incelendi. Tanı endoskopik görünüm ve / veya biyopsi ile konuldu. Bulgular: Tüm endoskopilerin %0.17'sini oluşturan toplam 21 hastada (14 erkek, 7 kadın ; ortalama yaş: 51.9±13 yıl) kandida özofajiti tespit edildi. Sekiz hastada (%38.1) bilinen kolaylaştırıcı bir neden yoktu. Beş hastada (%23.8) malignite tespit edildi. Üç hasta (%14.3) kortikosteroid kullanıyordu. iki hasta (%9.5) diabetes mellitus nedeni ile takipte idi. Geriye kalan üç hasta (%14.3) ise sırasıyla akciğer tüberkülozu, siroz ve alkol bağımlısı idi. Yedi hastada (%33.4) özofagusa ait semptom vardı. Sonuç: Bu bulgular bize kandida özofajitinin özellikle bağışıklık yetmezliği olan hastalarda özofagusa ait semptom olma dan da görülebileceğini düşündürdü. Ayrıca, söz konusu sorunun görünürde bağışıklık yetmezliği olmayan bireylerde de ortaya çıkabileceği kanısına varıldı.
Background/Aims: Candida albicans is a rare cause of esophagitis, especially in immunocompetent individuals. This study was designed to determine the prevalence and symptoms of esophagitis and the relationship between candida esophagitis and underlying diseases. Methods: 11.772 esophageal endoscopy reports were evaluated. Diagnosis was based upon endoscopic and/or biopsy findings. Results: Candida esophagitis was determined in 21 (14 male and seven female, mean age: 51.9 ± 13 years), comprising 0.17% of all upper GI endoscopies. Eight patients (38.1%) had no known predisposing factors while malignancy was determined in five (23.8%). Three patients (14.3%) were on corticosteroid treatment, two had diabetes mellitus (9.5%) and three patients (14.3%) were being treated for tuberculosis, cirrhosis and alcohol abuse. Esophageal symptoms were reported in seven patients (33.4%). Conclusions: These findings suggest that esophageal candidiasis should be considered in immune compromised patients in particular, whether esophageal symptoms are present or not, and that it may also occur in apparently immune competent individuals.
