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It's known that many acute leukemia patients in morphologic remission would eventually relapse due to the persistence of residual leukemic cells. The aim of this study was to evaluate the use of flow cytometry (FC) to detect minimal residual disease (MRD) and the correlation between MRD and relapse-free survival. We have first evaluated the immunophenotypic outcomes of 89 acute leukemia patients during admission and rarely seen coexpressions (UC) were found in 73% of them. Then the initial levels of UC were compared with the levels during complete remission (CR) in 16 alive cases and a significant decrease was observed in 8 cases who have remained in CR for 28-40 weeks of follow-up. However, in 3 cases, coexpression levels in remission were almost the same with the initial levels and 2 of them relapsed after 19 and 30 weeks. These results confirm that FC would be useful in the assessment of MRD and a gradual increase of leukemic cells would be suggestive for subsequent relapse., Morfolojik olarak tam remisyonda kabul edilen akut lösemi olgularında kemik iliğindeki rezidüel lösemik hücrelerin relapsa yol açtığı bilinmektedir. Bu çalışmanın amacı, minimal residüel hastalık (MRD) tesbitinde akım sitometrisinin kullanımını ve MRD ile hastalıksız yaşam arasındaki korelasyonu değerlendirmektir. Biz önce 89 akut lösemi olgusunda tanıdaki immünfenotip sonuçlarını değerlendirdik ve %73'ünde nadir görülen koekspresyonlar saptadık. Daha sonra, halen hayatta olan 16 olgunun başlangıçta ve komplet remisyondaki (KR) koekspresyon düzeyleri karşılaştırıldı ve 28-40 haftalık takip süresince KR'da kalan 8 olguda anlamlı azalma gözlendi. Buna karşın, olguların 3'ünde, remisyondaki koekspresyon düzeylerinin tanıda belirlenene yakın olduğu dikkati çekti ve bunlardan 2'si 19 ve 30 hafta sonrasında nüksettiler. Bu veriler, rezidüel hastalığın relapsın habercisi olduğunu ve bunu belirlemede akım sitometrisi yönteminin kullanılabileceğini desteklemektedir.

Introduction Brucellosis is a public health problem that is prevalent in several developing countries. Methods The clinical and laboratory characteristics of 164 cases of brucellosis in Bursa, Turkey, were retrospectively evaluated. Results The ages of the 164 patients ranged from 15-85 years. All of the patients underwent the Rose Bengal test and 163 (99.4%) patients tested positive. 122 (74.4%) patients were diagnosed with acute brucellosis, 31 (18.9%) with subacute brucellosis and 11 (6.7%) with chronic brucellosis. Focal involvement was found in 101 (61.6%) patients. Although patients with focal involvement had a higher white blood cell count (p = 0.002), those without focal involvement had higher aspartate transaminase and alanine transaminase values, and lower platelet values (p = 0.005, 0.007 and 0.039, respectively). Spondylodiscitis was observed on imaging in 58 (66.7%) of the 87 patients who presented with back pain. Among the 118 patients who were examined within the first month of treatment, 79 (66.9%) responded to treatment. The relapse rate was 11.6% among all 164 patients. Conclusion Brucellosis should be considered as a differential diagnosis among patients who present with fever, and joint or back pain. Focal involvement should be investigated in the presence of leucocytosis, and subacute or chronic forms of brucellosis. To identify cases of spondylodiscitis, radiography should be performed in patients who present with back pain.

Although our knowledge about Brucella virulence factors and the host response increase rapidly, the mechanisms of immune evasion by the pathogen and causes of chronic disease are still unknown. Here, we aimed to investigate the immunological factors which belong to CD8+ T cells and their roles in the transition of brucellosis from acute to chronic infection. Using miRNA microarray, more than 2000 miRNAs were screened in CD8+ T cells of patients with acute or chronic brucellosis and healthy controls that were sorted from peripheral blood with flow cytometry and validated through qRT-PCR. Findings were evaluated using GeneSpring GX (Agilent) 13.0 software and KEGG pathway analysis. Expression of two miRNAs were determined to display a significant fold change in chronic group when compared with acute or control groups. Both miRNAs (miR-126-5p and miR-4753-3p) were decreased (p 2). These miRNAs have the potential to be the regulators of CD8+ T cell-related marker genes for chronic brucellosis infections. The differentially expressed miRNAs and their predicted target genes are involved in MAPK signaling pathway, cytokine-cytokine receptor interactions, endocytosis, regulation of actin cytoskeleton, and focal adhesion indicating their potential roles in chronic brucellosis and its progression. It is the first study of miRNA expression analysis of human CD8+ T cells to clarify the mechanism of inveteracy in brucellosis.

Background Helicobacter pylori is associated with gastrointestinal diseases such as gastritis, peptic ulcers, malignancy and lymphoma, and extra-gastrointestinal conditions. H. pylori infection is negatively associated with children's growth. Chronic inflammation of the stomach that results in the loss of appetite and, dysregulation of neuroendocrine hormones such as leptin, and ghrelin are the probable reasons of this negative association. The objective of this study is to determine the serum levels of leptin, ghrelin, and IGF-1 in H. pylori-infected children and their relations with growth. Materials and methods A hundred and sixty-one school children aged between 6 and 14 years were selected randomly from five primary schools representing a cross section of population. Demographic and sociocultural characteristics, and anthropometric measurements were recorded. Serum H. pylori IgG, insulin-like growth factor-1, leptin, and ghrelin levels were measured in all children. The children were grouped according to the nutritional status and Helicobacter pylori seropositivity. Nutritional indices were compared among groups in association with serum leptin, ghrelin, and insulin-like growth factor-1 levels. Results H. pylori IgG positivity was found in 34.2%, and 14.9% of children were malnourished. H. pylori seropositivity was significantly higher in older ages (10.32 ± 2.26 vs 9.53 ± 2.36 years, p = .036), and body weight and height Z scores were significantly lower in H. pylori-seropositive children (−0.33 ± 1.08 vs 0.04 ± 1.26, p = .044 and 0.13 ± 0.92 vs 0.23 ± 0.91, p = .018 respectively). H. pylori seropositivity was found to be an independent risk factor for shorter body height (p = .01). Serum leptin, ghrelin, and IGF-1 levels were not associated with H. pylori IgG seropositivity (0.35 vs 0.55 ng/mL, p = .3; 3267.4 ± 753.0 vs 2808.3 ± 911.4 pg/mL, p = .06; 470 ± 176 vs 521 ± 179 ng/mL, p = .32, respectively). Conclusions Children infected with H. pylori are prone to short stature. This effect seems to be independent of neuroendocrine hormones.

Brucellosis is a zoonotic disease that is still endemic in developing countries. Despite early diagnosis and treatment of patients, chronic infections are seen in 10–30% of patients. In this study, we aimed to investigate the immunological factors that play roles in the transition of brucellosis from acute infection into chronic infection. Here, more than 2000 miRNAs were screened in peripheral blood mononuclear cells (PBMCs) of patients with acute or chronic brucellosis and healthy controls by using miRNA array, and the results of the miRNA array were validated through qRT-PCR. Findings were evaluated using GeneSpring GX (Agilent) 13.0 software and KEGG pathway analysis. Four miRNAs were expressed in the chronic group but were not expressed in acute and control groups. Among these miRNAs, the expression level of miR-1238-3p was increased while miR-494, miR-6069, and miR-139-3p were decreased (p<0.05, fold change > 2). These miRNAs have the potential to be markers for chronic cases. The differentially expressed miRNAs and their predicted target genes involved in endocytosis, regulation of actin cytoskeleton, MAPK signaling pathway, and cytokine-cytokine receptor interaction and its chemokine signaling pathway indicate their potential roles in chronic brucellosis and its progression. It is the first study of miRNA expression analysis of human PBMC to clarify the mechanism of inveteracy in brucellosis.

Several genes encoding for different cytokines may play crucial roles in host susceptibility to Brucellosis, since the cytokine production capacity varies among individuals and depends on the cytokine gene polymorphism. The association of the cytokine gene polymorphisms with the development of Brucellosis was investigated in this study. DNA samples were obtained from a Turkish population of 40 patients with Brucellosis, and 50 healthy control subjects. All genotyping (IL-6, IL10, IFN-gamma, TGF-beta and TNF-alpha) experiments were performed using sequence-specific primers PCR (PCR-SSP). When compared to the healthy controls, the frequencies of high/intermediate producing genotypes of IL-10 and high producing genotype of IL-6 were significantly more common in the patient group. These results suggest that IL-10 and IL-6 gene polymorphisms may affect susceptibility to Brucellosis and increase risk of developing the disease. In order to confirm the biological significance of our results, further studies should be performed in larger population groups. (c) 2007 Published by Elsevier Ltd.

Aim: Antifungal susceptibility testing may be an important aid in the treatment of patients with life threatening yeast infections. The aim of this study was to determine the susceptibility of Candida isolates obtained from clinical specimens to the antifungal agents amphotericin B and fluconazole, which are frequently used in our clinical practice. Materials and methods: Susceptibility to antifungal agents was investigated using the Etest (AB Biodisk, Solna, Sweden) and the reference broth macrodilution susceptibility test (CLSI M27-A2). The MICs obtained with each of the methods were read after 24 h and 48 h of incubation. Results: Overall agreement rates within +/- 1 dilution between the 2 methods were 86.7% (24 h) and 94.1% (48 h) for amphotericin B, and 85.5% (24 h) and 73.3% (48 h) for fluconazole. All C. albicans, C. pelliculosa, C. glabrata, and C. kefyr isolates were inhibited by

Both cluster of differentiation (CD)4+ and CD8+ T lymphocytes play key roles in immunity to Brucella, in part because they secrete interferon (IFN)- and activate bactericidal functions in macrophages. Therefore, use of markers of macrophage activation may have diagnostic and prognostic significance. High-mobility group-box 1 protein (HMGB1), a late-onset pro-inflammatory cytokine, is secreted by activated macrophages. Soluble hemoglobin scavenger receptor (sCD163) is a specific marker of anti-inflammatory macrophages. The aim of this study was to investigate the diagnostic value of HMGB1 and sCD163 concentrations in brucellosis and its various clinical forms. Serum HMGB1 and sCD163 concentrations in 49 brucellosis patients were compared with those in 52 healthy control subjects. Both serum HMGB1 and sCD163 concentrations were significantly higher in brucellosis patients than in healthy controls (P

Bu çalışma nonfermentatif gram negatif bakterilerde metallo-beta-laktamaz (MBL) varlığının fenotipik ve genotipik yöntemlerle araştırılarak polimeraz zincir reaksiyonu (PCR) ile en uyumlu fenotipik testin saptanması amacıyla yapıldı.Çalışmaya Haziran 2011 ? Haziran 2012 tarih¬leri arasında Uludağ Üniversitesi Tıp Fakültesi Tıbbi Mikrobiyoloji Anabilim Dalı Bakteriyoloji Laboratuvarı'na gönderilen çeşitli klinik örneklerden izole edilen; Phoenix (Becton Dickinson, Amerika Birleşik Devletleri) otomatize bakteri tanımlama ve duyarlılık test sisteminde imipenem (IMP) ve/veya meropeneme (MRP) CLSI kriterlerine göre dirençli bulunan 35 Pseudomonas ve 35 Acinetobacter suşu alındı.MBL varlığını belirlemek için modifiye Hodge test (MHT), Etest, çift disk sinerji testi (ÇDST), kombine disk testi (KDT); ayrıca blaIMP, blaVIM, blaNDM, blaSPM genlerini saptamak için PCR kullanıldı.Acinetobacter izolatlarının tümü IMP, MRP, seftazidim (CAZ) ve piperasilin-tazobaktama; Pseudomonas izolatlarının ise %85,7'si IMP, %88,5'i MRP, %54,2'si CAZ , %45,7'si piperasilin-tazobaktama dirençli bulundu. Çok ilaca dirençli Acinetobacter türleri %88,5, Pseudomonas türleri %28,5 saptandı.Acinetobacter'lerin 29'unda (%82,8) Etest, 16'sında (%45,7) MHT, 14'ünde (%40) ÇDST, 5'inde (%14,2) KDT ile; Pseudomonas'ların 6'sında (%17,1) KDT, 5'inde (%14,2) CAZ-MPA ÇDST, 4'ünde (%11,4) IMP-EDTA ÇDST, 2'sinde (%5,7) Etest, 1'inde (%2,8) MHT ile MBL pozitifliği bulundu.PCR ile Acinetobacter ve Pseudomonas suşlarının hiçbirinde blaSPM ve blaNDM pozitifliği saptanmadı. Sadece 3 P. aeruginosa izolatında (%8,5) blaIMP, 33 Acinetobacter izolatında (%94,2) ise blaVIM pozitif bulundu.PCR sonuçları ile en uyumlu fenotipik testler Pseudomonas izolatları için IMP-EDTA ÇDST (duyarlılık %100, özgüllük %96); Acinetobacter izolatları için Etest (duyarlılık %84,8; özgüllük %50) olup; bu testlerin moleküler yöntemlerle mutlaka doğrulanması gerekse de yapılamadığı durumlarda laboratuvarımızda MBL tanısında kullanılabileceği kanısına varıldı. The aim of this study was to investigate the presence of metallo-beta-lactamase (MBL) by phenotypic and genotypic methods in nonfermentative gram negative bacteria and to determine the most compatible phenotypic method with polimerase chain reaction (PCR).35 Pseudomonas spp., 35 Acinetobacter spp. strains isolated from various clinical specimens sent to Uludağ University Medicine Faculty Medical Microbiology laboratory between the dates of January 2011-January 2012 that were resistant to imipenem (IMP) and/or meropenem (MRP) by Phoenix (Becton Dickinson, United States of America) automated bacteria identification and susceptibility testing system according to CLSI criteria included in the study.Modified Hodge test (MHT), Etest, double disc synergy test (DDST), combined disc synergy test (CDST) were used to determine the presence of MBL and PCR was performed to detect blaIMP, blaVIM, blaNDM, blaSPM genes.While all Acinetobacter spp. strains were found to be resistant to IMP, MRP, ceftazidime (CAZ) and piperacillin-tazobactam, the resistance rates of Pseudomonas spp. were 85,7% for IMP, 88,5% for MRP, 54,2% for CAZ and 45,7% for piperacillin-tazobactam. 88,5% of Acinetobacter spp. and 28,5% of Pseudomonas spp. were determined to be multi-drug resistant.For Acinetobacter spp. strains, 29 isolates (82,8%) by Etest, 16 isolates (45,7%) by MHT, 14 isolates (40%) by DDST, 5 isolates (14,2%) by CDST were found as MBL positive; on the other hand for Pseudomonas strains 6 isolates (17,1%) by CDST, 5 isolates (14,2%) by CAZ-MPA DDST, 4 isolates (%11,4) by IMP-EDTA DDST, 2 isolates (5,7%) by Etest, 1 isolate (2,8%) by MHT were found as MBL positive.blaSPM and blaNDM positivity was not detected neither Acinetobacter nor Pseudomonas strains by PCR. blaIMP was found positive in only 3 (8,5%) P. aeruginosa isolates and blaVIM was found positive in 33 (94,2%) Acinetobacter isolates.The most compatible phenotypic tests with PCR results were IMP-EDTA DDST (sensitivity 100%, spesifity 96%) for Pseudomonas isolates, and Etest (sensitivity 84,8%, spesifity 50%) for Acinetobacter isolates. These tests must be confirmed by molecular methods; however at our laboratory they can be used to detect MBL in the situations that molecular methods couldn?t be performed. 88

Epstein-Barr virus (EBV), öncelikle enfeksiyöz mononükleoz ve ayrıca çeşitli lenfomalar ve posttransplant lenfoproliferatif hastalığın (PTLD) etiyolojisinden sorumlu, latent enfeksiyon oluşturan bir herpes virustur. EBV enfeksiyonlarının laboratuvar tanısı; atipik lenfositlerin, heterofil antikorların, virusun kapsid antijeni (VCA), nükleer antijeni (EBNA) ve erken antijeni (EA)'ne karşı oluşan özgül antikorların ve viral DNA'nın saptanmasına dayanır. Ülkemizde yetişkin popülasyondaki seropozitiflik oranının çok yüksek (%80-95) olması nedeniyle, transplant alıcıları veya onkoloji hastaları gibi özellikle immünsüpresif hasta gruplarında EBV reaktivasyonunun belirlenmesinde rutin serolojik testler yetersiz kalabilir. Bu gibi durumlarda VCA IgG avidite testi ve moleküler yöntemlerden yararlanılmaktadır. Bu çalışmada, renal transplant ve çocuk onkoloji hastalarında EBV enfeksiyonlarının tanı ve takibinde serolojik yöntemlerin yanı sıra gerçek zamanlı polimeraz zincir reaksiyonu (Rt-PCR) ile viral DNA düzeylerinin belirlenmesi amaçlanmıştır. Çalışmaya, 62 erişkin renal transplant alıcısı, 37 çocuk onkoloji hastası ile EBV seropozitif immün kompetan sağlıklı 50 birey (28'i çocuk, 22'si erişkin) dahil edilmiştir. Transplant alıcılarından transplantasyon öncesi bir kez, transplantasyon sonrası üç kez (birinci hafta, birinci ay ve üçüncü ay) olmak üzere toplam dört kez; çocuk onkoloji hastalarından tedavi öncesi bir kez, immünsüpresif tedaviye başlandıktan sonra üç kez (birinci ay, üçüncü ay ve altıncı ay) olmak üzere toplam dört kez; kontrol grubundan ise bir kez kan örneği alınmıştır. Serum örneklerinde EBV serolojik profilleri Paul-Bunnel ve immünoblot testleri ile; VCA IgG avidite testi ELISA ile ve EBV-DNA düzeyi Rt-PCR yöntemiyle araştırılmıştır. Renal transplant grubundaki hastaların 3 (%4.8)'ünde EBV-DNA pozitif bulunmuştur. Bu hastalarda CD4/CD8 oranları transplantasyon öncesi değerlerine göre transplantasyon sonrası birinci hafta ve üçüncü ayda anlamlı olarak düşük bulunmakla birlikte PTLD ve organ reddi gelişmemiştir. Çocuk onkoloji grubundaki hastaların 3 (%8.1)'ünde EBV-DNA pozitif bulunmuş; bu durum Hodgkin lenfoma tanısıyla takip edilen iki çocukta hastalık, diğerinde ise reaktivasyon ile ilişkilendirilmiştir. Kontrol grubundaki olguların ise 10 (%20)'unda EBV-DNA pozitifliği tespit edilmiştir. İmmünoblot sonuçları akut enfeksiyon serolojisi ile uyumlu olan erişkin kontrol olgularında EBV-DNA pozitifliği, Paul-Bunnel pozitifliği ve düşük avidite sonuçları arasındaki uyum istatistiksel olarak anlamlıdır. Çocuk kontrol grubunda ise bu serolojik profil ile sadece düşük avidite arasındaki uyum anlamlı kabul edilmiştir. Sonuç olarak bu çalışmada erişkin renal transplant hastalarında transplantasyonu takip eden üç aylık dönemde EBV ile ilişkili PTLD ve akut rejeksiyon riskinin bulunmadığı; EBV ile ilişkili malignitesi bulunan çocuklarda tedavi öncesi Rt-PCR ile EBV-DNA araştırılmasının tanı, takip ve prognozu değerlendirmede yararlı olabileceği; immünsüpresif hastalarda EBV reaktivasyonunu saptamak için serolojik sonuçların avidite ve PCR testleri ile desteklenmesi gerektiği düşünülmüştür. Epstein-Barr virus (EBV), a herpesvirus leading to latent infections, is principally responsible for infectious mononucleosis, and also plays role in the etiology of various lymphomas and post-transplantation lymphoproliferative disease (PTLD). Laboratory diagnosis of EBV infections depends on the detection of atypical lymphocytes, heterophile antibodies, specific antibodies against viral capsid (VCA), nuclear (EBNA) and early (EA) antigens, and of the viral DNA. Since the seropositivity rate in adult population is very high (80-95%) in our country, routine serologic tests may be insufficient to characterize EBV reactivation in immunosuppressive subjects, such as transplant recipients or oncology patients. In those cases VCA IgG avidity test and molecular methods are more useful. This study was conducted to determine the role of viral DNA levels detected by real-time polymerase chain reaction (Rt-PCR) and serological tests for the diagnosis and follow up of EBV infections in renal transplant recipients and pediatric oncology patients. A total of 62 adult renal transplant recipients, 37 children with oncological diseases, and 50 EBV-seropositive immunocompetent healthy subjects (28 children, 22 adults) as controls, were included in the study. Four blood samples, once before transplantation and three times thereafter (at first week, first and third months) were collected from transplant recipients; in pediatric oncology patients blood samples were collected four times, once before immunosuppressive treatment and three times thereafter (at first, third and sixth months), while the control group had a single blood sample collected. Serological profiles for EBV were searched by Paul-Bunnel and immunoblotting tests; VCA IgG avidity by ELISA and viral load by Rt-PCR. EBV-DNA was found positive in 3 (4.8%) of the renal transplant patients. While in these patients the CD4/CD8 ratio was significantly lowered in the first week and third month post-transplant, no PTLD or organ rejection developed. EBV-DNA was positive in 3 (8.1%) of the pediatric oncology patients. This positivity was attributed to Hodgkin's disease in two of these cases and to reactivation in the third case. EBV-DNA positivity was present in 10 (20%) of the control subjects. In the adult controls whose immunoblot results were compatible with the serologic pattern of an acute infection, the correlation among positive EBV-DNA, positive Paul-Bunnel and low IgG avidity results was statistically significant. As for children in the control group, this serologic profile was significantly correlated with low IgG avidity only. The data obtained from this study indicated that no risk of EBV-related PTLD or acute rejection was found in the first three months in the adult renal transplant patients. In children with EBV-related malignancy the search for EBV-DNA by RtPCR before therapy may be useful in the diagnosis, follow-up and prognostic evaluation. Serologic results should be supported by IgG avidity and PCR in order to ascertain the presence of EBV reactivation in immunosuppressive patients.

Bu çalışma Epstein-Barr Virus (EBV) enfeksiyonlarının tanı ve takibinde EBV-DNA'nın önemini belirlemek amacıyla yapılmıştır.Çalışmamızda 62 erişkin renal transplant ve 37 çocuk onkoloji hastasından tedavi öncesinde bir, tedavi sonrasında üç olmak üzere toplam dört kez; immünsüprese olmayan çocuk ve erişkinlerden oluşan 50 kontrol hastasından bir kez alınan serum örneklerinde Paul-Bunnel ve immünblot ile EBV serolojisi belirlendi. ELISA ile Viral Kapsid Antijen (VCA)-IgG avidite ve Real Time Polymerase Chain Reaction (RT-PCR) ile EBV-DNA testleri çalışıldı.Renal transplant grubundaki hastaların üçünde (%4,8) EBV-DNA pozitif bulundu. Bu hastalarda CD4/CD8 oranları transplantasyon öncesi değerlerine göre transplantasyon sonrası birinci hafta ve üçüncü ayda anlamlı olarak düşük bulunmakla birlikte EBV enfeksiyonu ile ilişkili organ reddi gelişmedi.Çocuk onkoloji grubundaki hastaların üçünde (%8,1) EBV-DNA pozitif saptandı. EBV-DNA pozitifliği Hodgkin lenfoma tanısıyla takip edilen iki çocukta hastalık, diğerinde ise reaktivasyon ile ilişkilendirildi.Kontrol grubunda yer alan hastaların 10'unda (%20) EBV-DNA pozitif bulundu. İmmünblot sonuçları akut enfeksiyon serolojisi ile uyumlu olan erişkin kontrol hastalarında EBV-DNA pozitifliği, Paul-Bunnel pozitifliği ve düşük avidite sonuçları arasındaki uyum istatistiksel olarak anlamlı idi. Çocuk kontrol grubunda ise bu serolojik profil ile sadece düşük avidite arasındaki uyum anlamlı bulundu.Çalışmamız renal transplant hastalarında EBV reaktivasyonunun saptanması; çocuk onkoloji hastalarında EBV ilişkili kanserlerin tanısı ve prognozunun değerlendirilmesi; immünkompetan erişkin ve çocuk hastalarda akut enfeksiyonun tanı ve takibinde Paul-Bunnel ve spesifik antikor testleri ile birlikte doğrulama amacıyla VCA-IgG avidite ve EBV-DNA testlerinin yararını ortaya koymuştur.Anahtar kelimeler: EBV, Paul-Bunnel, İmmünblot, VCA-IgG avidite, RT-PCR The aim of this study was to evaluate the importance of Epstein-Barr Virus (EBV) DNA in the diagnosis and monitoring of EBV infections.EBV serology was determined from the serum of 62 renal transplant and 37 pediatric oncology patients and 50 non-immunocompromised adult and pediatric controls by using Paul-Bunnel and Immunoblotting tests. Serum specimens were collected four times (once before treatment and three times after treatment) from the renal transplant and pediatric oncology patients, whereas once from the control group. ELISA and Real Time Polymerase Chain Reaction (RT-PCR) tests were used for the evaluation of Viral Capsid Antigen (VCA)-IgG avidity and EBV-DNA respectively.EBV-DNA was found positive in three (4.8%) of renal transplant patients. In these patients, CD4/CD8 ratios were found significantly lower one week and three months after transplantation comparing with pre-transplantation period but there was no organ rejection associated with EBV infections.EBV-DNA was found positive in three (8.1%) of pediatric oncology patients. The positivity of EBV-DNA was considered associated with Hodgkin?s lymphoma disease in two patients and reactivation in the other patient.EBV-DNA was found positive in 10 (20%) of the control group. At acute infections, immunoblot serology were found significantly compatible with Paul-Bunnel, EBV-DNA positivity and low avidity in adult controls but only low avidity were significantly found compatible in pediatric controls.In this study, the usefulness of EBV-DNA was shown; in determining the reactivation in renal transplant patients; in evaluation of the diagnosis and prognosis of EBV associated cancers in pediatric oncology patients and the diagnosis and monitoring of acute infections associated with Paul-Bunnel, immunblotting and VCA-IgG avidity at the adult and pediatric immunocompetant control patients.Key words: EBV, Paul-Bunnel, Immunblot, VCA-IgG avidity, RT-PCR 87

Background: Because of high morbidity of the brucellosis in humans and the potential use of the microorganism as an agent of biologic warfare, protection of effective vaccines and specific diagnostic reagents become necessary to eradicate brucellosis. Objective: In this study we aimed to investigate the cytokine responses and changes in peripheral blood lymphocyte subgroups of acute brucellosis patients in response to L7/L12 and glyceraldehyde 3-phosphate dehydrogenase (GAPDH) recombinant proteins derived from Brucella abortus. Methods: levels of IFN-gamma, IL-4 and IL-10 secreted from PBMCs of 25 acute brucellosis patients and 15 healthy controls, stimulated with Phytohemagglutinin (PHA), L7/L12 or GAPDH were measured by ELISA. Furthermore alterations in lymphocyte subgroups in response to these Brucella antigens were determined by flow cytometry. Results: Extracellular IFN-gamma levels were found to be elevated after stimulation with L7/L12 in patients with acute brucellosis, whereas no significant changes were found in IL-4 and IL-10 levels. Similar data was also obtained with GAPDH, but the stimulation of IFN-gamma production was not observed in all patients and was not as strong as that observed for L7/L12. Moreover, when the distribution of lymphocytes subgroups (CD3(+), CD3(+)CD4(+), CD3(+)CD8(+), CD4(+)CD25(+), CD3(+)CD69(+) and CD3(+)CD152(+)) was evaluated, it was found that the stimulation with L7/L12 and GAPDH only led to an increase in the percentage of CD3(+)CD69(+) lymphocytes. Conclusion: These data indicate that Brucella abortus L7/L12 or GAPDH induce a Th1 type immune response in acute brucellosis patients. Additionally, these recombinant proteins, especially L7/L12, may be used in new vaccine preparations and diagnostic tests.

Tuberculosis (TB) pleurisy is accepted to be the best model for evaluating the local protective cellular immune response to Mycobacterium tuberculosis (MTB) since it can be spontaneously self-cured. Therefore, we aimed to evaluate the involvement of cytokines and the soluble apoptosis-modulating factors sFas and sFasL in local protective cellular immunity to MTB. Pleural fluid samples were collected from 35 patients with TB pleurisy, 39 patients with malignant pleurisy, and 14 patients with non-TB nonmalignant (n-TB n-M) pleurisy and were evaluated for the levels of several cytokines, soluble Fas (sFas), and sFas ligand (sFasL) by using ELISA. The levels of IFN-gamma, IL-12p40, IL-18, IL-8, and sFasL in TB pleurisy were significantly higher in comparison to those in the malignant pleurisy and n-TB n-M pleurisy groups. In addition, pleural sFasL levels were increased and positively correlated with IFN-gamma and IL-18 levels in TB patients. In conclusion, this study demonstrates that Th1-type-specific cellular immunity is responsible for protective immunity in TB and suggests that Fas-mediated apoptosis may be at least a part of protective immunity to tuberculosis and could be regulated by type 1 T-cell response. IFN-gamma and sFasL levels can be used as diagnostic markers for differing TB pleurisy from other pleurisies.

Leblebicioglu, Hakan/0000-0002-6033-8543 WOS: 000255834000008 PubMed: 17983789 Objective: The aim of this study was to identify the potential factors associated with infection sources and modes of transmission during a recent outbreak (October 2004) of tularemia in Suluova, Turkey. Methods: Following the diagnosis of five patients with tularemia in October 2004, active surveillance was initiated to identify further cases. This was a matched case-control study with analysis based on the first 43 cases of tularemia (probable or suspected) and 43 matched controls. A probable case was defined as a patient, resident in Suluova, who had signs and symptoms (regional Lymphadenopathy and fever) compatible with tularemia and a positive serology or PCR for Francisella tularensis during the period October 21 to November 31, 2004. A suspected case was defined as a patient with compatible signs and symptoms who did not meet the laboratory criteria for a probable case, who also had no laboratory evidence of infection by other microorganisms, and who was resident in Suluova between the same dates. The microagglutination test was used for serological diagnosis. A standardized questionnaire was used to collect information on general demographics, exposure to all known sources of tularemia infection, potential risk factors related to water and animals (i.e., fishing, farming, hunting, and other activities), and the environmental conditions of the house. PCR was used to screen for evidence of the tularemia agents in clinical samples from patients and water samples. Results: The overall attack rate was 2.3 per 1000 population (86/38 000). Twenty-eight suspected cases and 15 probable cases of tularemia were included in the study. The most common presenting symptom was lymphadenopathy present in 95.3%, followed by fever (83.7%) and sore throat (79.1%). Twenty-eight out of 43 were reported to have painful lymph nodes. F tularensis was detected by PCR in samples obtained from the ulcerated lesions of two patients. In the multivariate logistic regression model, keeping a domestic animal in the garden was associated with an increased risk of contracting the disease (OR = 10.87; 95% CI: 1.26-93.65; p = 0.03). F tularensis was detected by PCR in the water sample obtained from the rivulet that passes through Suluova. Conclusions: The results of this study show that case-control studies may be useful for analyzing epidemics and for identifying the source of infection. In order to prevent water-related zoonotic infections, water and sewerage systems should be improved. (C) 2007 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Various types of cancer are more frequent in men than women, and bladder cancer is one of the most common of these. Intravesical instillation of Bacillus Calmette-Guerin (BCG) after transurethral resection is the most effective treatment for superficial bladder cancers. The main aim of this study was to investigate for possible links between cytokine gene polymorphisms and different outcomes after BCG immunotherapy. Sixty patients who had been diagnosed with transitional cell cancer were investigated. All genotyping experiments were performed using polymerase chain reaction sequence-specific primers and a commercially available kit. The genes investigated were those that code for interleukin (IL)-1 alpha, IL-1 beta, IL-1R, IL-1RA, IL-4RA, IL-2, IL-4, IL-6, IL-10, IL-12, interferon-7 (IFN-7), transforming growth factor-beta (TGF-beta), and tumor necrosis factor-alpha (TNF-alpha). Analyses of the data identified TGF-beta codon 25 GG (92.85% vs. 64.44%, p = 0.04, OR = 7.17), IL-4-1098 GG (16.6% vs. 0.0%, p = 0.05, OR = 18.33), 1L-10-1082 GG (28.5% vs. 6.8%, p = 0.05, OR = 5.47), and IL-10-1082 GCC/GCC (28.57% vs. 4.5%, p = 0.025, OR = 8.4) polymorphisms as risk factors for progression of bladder cancer. (c) 2006 Elsevier Ltd. All rights reserved.

Several genes encoding for different cytokines may play crucial roles in host susceptibility to tuberculosis (TB), since the cytokine production capacity varies among individuals and depends on the cytokine gene polymorphism. The association of the cytokine gene polymorphisms with the development of TB was investigated in this study. DNA samples were obtained from a Turkish population of 81 patients with the different clinical forms of TB, and 50 healthy control subjects. All genotyping (IL-6, IL-10, IFN-gamma, TGF-beta and TNF-alpha) experiments were performed using sequence-specific primers PCR (PCR-SSP). Analysis of allete frequencies showed that IL-10 - 1082 G allele frequency was significantly more common in TB patients than healthy controls (37.7% vs 23.0%, p: 0.0 14). No statistically significant differences were observed betwe\en the different clinical forms of the disease. These results suggest that the polymorphisms in IL-10 gene may affect susceptibility to TB and increase risk of developing the disease. To confirm the biological significance of our results, further studies should be performed on other population groups. (c) 2006 Elsevier Ltd. All rights reserved.

Çalışma Blood (Journal of the American Society of Hematology) Vol 94, No 10, Supplement 1, 1999’da abstract olarak yayınlanmıştır. Morfolojik olarak tam remisyonda kabul edilen akut lösemi olgularında kemik iliğindeki rezidüel lösemik hücrelerin relapsa yol açtığı bilinmektedir. Bu çalışmanın amacı, minimal residüel hastalık (MRD) tesbitinde akım sitometrisinin kullanımını ve MRD ile hastalıksız yaşam arasındaki korelasyonu değerlendirmektir. Biz önce 89 akut lösemi olgusunda tanıdaki immünfenotip sonuçlarını değerlendirdik ve %73’ünde nadir görülen koekspresyonlar saptadık. Daha sonra, halen hayatta olan 16 olgunun başlangıçta ve komplet remisyondaki (KR) koekspresyon düzeyleri karşılaştırıldı ve 28-40 haftalık takip süresince KR’da kalan 8 olguda anlamlı azalma gözlendi. Buna karşın, olguların 3’ünde, remisyondaki koekspresyon düzeylerinin tanıda belirlenene yakın olduğu dikkati çekti ve bunlardan 2’si 19 ve 30 hafta sonrasında nüksettiler. Bu veriler, rezidüel hastalığın relapsın habercisi olduğunu ve bunu belirlemede akım sitometrisi yönteminin kullanılabileceğini desteklemektedir. It’s known that many acute leukemia patients in morphologic remission would eventually relapse due to the persistence of residual leukemic cells. The aim of this study was to evaluate the use of flow cytometry (FC) to detect minimal residual disease (MRD) and the correlation between MRD and relapse-free survival. We have first evaluated the immunophenotypic outcomes of 89 acute leukemia patients during admission and rarely seen coexpressions (UC) were found in 73% of them. Then the initial levels of UC were compared with the levels during complete remission (CR) in 16 alive cases and a significant decrease was observed in 8 cases who have remained in CR for 28-40 weeks of follow-up. However, in 3 cases, coexpression levels in remission were almost the same with the initial levels and 2 of them relapsed after 19 and 30 weeks. These results confirm that FC would be useful in the assessment of MRD and a gradual increase of leukemic cells would be suggestive for subsequent relapse.

The major aim of this study was to investigate the association of the cytokine gene polymorphisms with the development of renal cell carcinoma (RCC). The study included 29 patients with RCC and 50 healthy controls. All genotyping (TNF-alpha, TGF-beta, IL-10, IL-6, IFN-gamma) experiments were performed using sequence-specific primers PCR (PCR-SSP). It was found that TNF-alpha -308 G/G and TGF-beta codon 10-25 T/T-G/C genotypes were significantly higher in frequency in the patients with RCC group compared with the healthy control group. Additionally, the frequency of TNF-alpha -308 G allele was significantly higher in the patients when compared to controls. On the other hand, the frequencies of TNF-alpha -308 G/A, IL-6 C/C and TGF-beta 1 codon 10-25 C/C-G/G genotypes were significantly lower in the cancer group compared with the healthy control group. However, after correction for multiple comparisons (Bonferroni), these results did not remain significant. Nevertheless, these findings suggest that the TNF-alpha -308 G/G and TGF-beta codon 10-25 T/T-G/C genotypes may be potential risk factors for RCC, whereas TNF-alpha -308 G/A, IL-6 C/ C and TGF-beta 1 codon 10-25 C/C-G/G genotypes may be possible protective factors. The number of the cases has to be increased to investigate the independency of these polymorphisms involved in the oncogenesis of RCC.

ÖZET Mesane kanseri erkekler arasında en sık görülen kanserlerden biridir. Nedeni tam olarak bilinmemekle birlikte hastalık ile aromatik kimyasal maddelere maruz kalma, sigara ve bilhariazis gibi kronik enfeksiyonlar arasındaki ilişki belirgindir. Mesane kanserinde trans üretral rezeksiyon (TUR) sonrasında intravezikal Bacille Calmette Guerin (BCG) uygulanması en etkili tedavi şeklidir. BCG ile üriner sistem epitel hücreleri arasındaki ilişki, tümör hücresi ile efektör hücre arasındaki ilişkiyi artıran sitokmlerin endüksiyonu gibi çeşitli immünolojik değişikliklere neden olur. İmmün ve enflamatuvar cevabın efektör fazını endükleyen sitokinlerin sentezi, başka faktörlerin yanı sıra sitokin genlerinin polimorfizmleri ile de ilişkilidir. Mesane kanseri gelişimi ile T helper 1 (Thl), Th2 veya regülatuvar tip sitokin gen polimorfizmi arasındaki ilişkinin araştırılması amacıyla yapılan bu çalışmaya, transisyonel hücreli kanser tanısı almış 60 hasta ile kontrol grubunu oluşturmak üzere 60 donör alındı. Etilendiamino tetraasetat (EDTA)'lı kan örneklerinden izole edilen genomik DNA'lann, sekans spesifik primerler kullanılarak polimeraz zincir reaksiyonu (PCR-SSP) ile sitokin genotiplendirmeleri yapıldı. Hasta ve kontrol grubunun sitokin genotiplendirmeleri karşılaştırıldığında, interferon gama (IFN-y) UTR 5644 AA, interlökin-4 (IL-4) -590 TT, IL-6 -174 G, IL- 6-565 G, -565 GG polimorfizmlerinin hastalığın oluşmasında risk faktörü olduğu; tedaviye iyi yanıt veren hasta grubu ile nüks grubu karşılaştırıldığında transforming growth faktör-beta (TGF-p) kodon 10 T, kodon 25 G ve kodon 25 GG, IL-4 -1098 GG, IL-10 -1082 GG ve IL-10 -1082 GCC polimorfizmlerinin nüks için risk faktörü olduğu saptandı. Anahtar Sözcükler: Sitokin, mesane kanseri, BCG, polimorfizm. SUMMARY Determination of Cytokine Gene Polymorphisms in Patients with Bladder Cancer Who Received Bacille Calmette Guerin (BCG) Immunotherapy Bladder cancer is one of the commonest cancer in males. Although the cause of bladder cancer is unknown, the disease has been strongly associated with exposure to certain aromatic chemicals, smoking and chronic infections such as bilhariasis. Application of intravesikal Bacille Calmette Guerin (BCG) installation, applied after the trans urethral resection (TUR), is the most effective treatment of bladder cancer. The interaction of BCG with urinary epithelial cells is through to result in several immunologically important changes including induction of cytokines which promote effector cell-tumor cell interaction. Cytokines participate in the induction and effector phases of the immune and inflammatory response and levels of their production are associated with polymorphisms in cytokine genes. In the present study which investigated association of bladder cancer development with gene polymorphisms in T helperl (Thl), Th2 or regulatory type cytokines, sixty patients who diagnosed transitional cell cancer and 60 donors as controls were included. Cytokine genotyping of genomic DNA, isolated from ethylenediamine tetraacetate (EDTA) blood samples was done by PCR using sequence specific primers (PCR-SSP). When the results of the patients were compared to those of healthy controls, it is found that interferon-gamma (EFN-y) UTR 5644 AA, interleukın-4 (TL-4) -590 TT, IL-6 -174 G, IL-6-565 G, -565 GG polymorphisms are risk factors for bladder cancer. When the results of the patients were compared to those of nuks group it is found that transforming growth factor-beta (TGF-P) codon 10 T, codon 25 G and codon 25 GG, IL-4 -1098 GG, IL-10 -1082 GG and IL-10 -1082 GCC polymorphisms are risk factors for nuks in bladder cancer. Key Words: Cytokine, bladder cancer, BCG, polymorphism. TT 354

Bu çalışma, 1997 tarihinde Bursa[Türkiye]’da düzenlenen XXXI. Türk Anesteziyoloji ve Reanimasyon Kongresi‘nde bildiri olarak sunulmuştur. Çalışmamızda minör cerrahi uygulanan 30 olguda, bir inhalasyon anesteziği olan isofluran ile bir intravenöz anesiezik olan propofolün bazı lenfasit subgrupları ve hematolojik parametreler üzerine olan etkilerini araştırmayı amaçladık. 18-60 yaş arasında ASA (Amerikan Anesteziyoloji Derneği) I grubu hastalar rastgele iki gruba ayrıldılar. İndüksiyon ajanı olarak birinci grup olgulara % 2.5'lik tiyopental 4 mg/kg iv ve ikinci grup olgulara % 1 'lik propofol 2.5 mg/kg iv verildi. Anestezi idamesi I. grupta % 50 N2O/O2 ve % 0.75'lik isofluran gaz karışımı ile, II. grupta % 50 N2O/O2 gaz karışımına ek olarak 6 ,ug/kg/st hızda propofol infüzyonu ile sağlandı. Her iki grupta da kas gevşetici ajan olarak vekuronyum bromür ve analjezik ajan olarak fentanil kullanıldı. İndüksiyondan önce ve operasyonun 90.dakikasında periferik venöz kandan alınan örneklerde lökosit, trombosit, hemoglobin değerleri; periferik kan yaymalarında lenfosit, nötrofil, monosit, eozinofil değerleri; lenfasit subgrupları (CD3, CD4, CD8, CD16, CD20, CD25, HLA DR) değerleri incelendi. lndüksiyondan önce ve operasyonun 90. dakikasında elde edilen değerler karşılaştırıldığında; I. grupta CD4 düzeyinde anlamlı bir artma, ll. grupta ise CD8 düzeyinde anlamlı bir azalma kaydedilirken, diğer parametrelerde bir farklılık saptanmadı. Sonuç olarak kullanılan her iki ajanın da immün sistemi baskılamadığı kanısına varıldı. In this study the effects of isoflurane and propofol on hematologic parameters and same lymphocyte subgrubs were compared in 30 patients undergoing minor surgery. ASA (American Society of Anesthesiologists) I patients aged between 18-60 years were randomly divided into two groups. The anesthesia was induced by 2.5 % thiopentone 4 mg/kg iv in the first group and by 1 % propofol 2.5 mg/kg iv in the second group. Anesthesia was maintained by 0.75 % isoflurane 50 % N2O/O1 gas mixture in the first group and by 50 % N2O/O2 gas mixture and propofol infusion at the rate of 6 ,ug/kg/hr in the second group. In both groups vecuronium were used as muscle relaxant agent and fentanyl were used as analgesic agent. Before the induction and at the 90 minutes of the operation peripheric venous blood were taken from the patients to investigate the leucocyte, platelet and hemoglobin levels; lymphocyte, neutrocyte, monocyte, eosinophil levels by the peripheric blood count and lymphocyte subgrubs (CD3, CD4, CD8, CD16, CD20, CD25 and HLA DR). When we compare the values of preinduction with the values of the 90 minutes of operation, there was an increase in CD4 level in the first group and a decrease in CD8 level in the second group and no change in the other parameters. We conclude that both agents do not suppress the immunologic response.

ÖZET Urogenital Chlamydia trachomatis enfeksiyonları dünyanın birçok ülkesinde artış göstermekte olan ve cinsel ilişki ile bulaşan hastalıkların başında gelmektedir. Etkenin kadın ve erkeklerde, enfekte anneden bebeğe bulaşarak yeni doğanlarda, çeşitli klinik tablolara ve bazen sekellerle sonuçlanan enfeksiyonlara neden olması; önemli bir sağlık sorunu yarattığını göstermektedir. C trachomatis enfeksiyonlarının tanısında kullanılan yöntemlerin başında hücre kültürü(HK) gelmektedir. Ancak bu yöntemin güç ve pahalı olması nedeniyle, son yıllarda direkt fluoresan antikor(Direct Fluorescein Antibody=DFA) testi ve enzim immün assay(Enzyme Immuno Assay=EIA) gibi antijen arama testlerinin kullanımı yaygınlaşmıştır. Bu çalışmada, klamidyaların laboratuvar tanısında kullanılan yöntemleri karşılaştırarak, en uygun yöntemi belirlemek amacıyla; urogenital örneklerde C trachomatis varlığını HK, DFA, EIA ile araştırdık. Ayrıca erkek hastalardan üretral sürüntü alınmasının hastaya verdiği sıkıntı nedeniyle son yıllarda gündeme gelen; sabah ilk idrarda antijen aranmasının pratik sonuçlarını irdelemek için etkeni; üretralsürüntü ile birlikte idrar örneklerinde de saptamaya çalıştık. C trachomatis enfeksiyonları için risk gruplarında bulunan semptomatik 50 kadın olguda servikal; 30 erkek olguda ise üretral sürüntü ve idrar örnekleri alınarak HK, DFA, EIA testleri çalışıldı. Bu testlerin duyarlılık, özgüllük, pozitif prediktif değer (Positive Predictive Value=PPV)) ve negatif prediktif değer (Negative Predictive Value=NPV) hesaplandı. Kadın olgularda, HK ile karşılaştırıldığında; duyarlılık, özgüllük, PPV ve NPV sırası ile DFA testi için %83,3,%100,%100 ve %97,8; EIA için ise %16,7,%100,%100 ve %89,8 bulundu. Erkek olgularda, HK ile karşılaştırıldığında; duyarlılık, özgüllük, PPV, NPV sırası ile DFA testi için üretral sürüntü örneklerinde %75, %96,2,%75 ve %96,2; idrar örneklerinde ise %50,%96,4,%50 ve %96,4 bulundu. EIA için bu değerler üretral sürüntü örneklerinde %25, %100,%100 ve %89,7; idrarda ise %0,%100,%0 ve %93,3 saptandı. Çalışmada kadın ve erkek hastalardan alınan urogenital örneklerde C trachomatis araştırılması amacıyla uygulanan HK.DFA testi ve EIA arasında; Mc Nemor %2 testi ile istatistiksel fark saptanmamıştır(p>0,05). Zahmetli, zaman alıcı ve maliyetinin yüksek olması nedeniyle HK, urogenital klamidya enfeksiyonlarının tanısında rutin olarak kullanılan bir yöntem değildir. Çalışmanın sonuçları, tanıda HK yerine; duyarlılık ve özgüllükleri daha düşük antijen arama testlerinin kullanılabileceğini göstermiştir.EIA duyarlılığının idrar başta olmak üzere alınan tüm örneklerde düşük bulunması, çalışmada yeterli olgu sayısına ulaşılamamasından kaynaklanabilir. Bu nedenle özellikle ElA'in gerçek duyarlılığının saptanabilmesi için daha fazla olgu ile bu araştırmanın devam ettirilmesi gerektiğini düşünüyoruz. Anahtar sözcüklere trachomatis, Hücre Kültürü, Direkt Fluoresan Antikor, Enzim İmmün Assay SUMMARY Comparison of the Different Diagnostic Test Using by the Urogenital Infection of Chlamydia Trachomatis Urogenital Chlamydia trachomatis infection, which is one of the most common cause of sexually transmitted diseases, increases wordwide. Since the infection can occur both men and women; may be transmitted to neonates from infected mother; and may cause various clinical pictures and sometimes sequels, it is considered to be an important health problem. Cell culture(CC) is the most commonly used method to diagnose C trachomatis infections. However, because of the cost and difficuties of this method, in recent years antigen screening assays, such as direct fluorescein antibody(DFA) and enzyme immune assay(EIA), have become to be more frequently used. In this study, in order to find the most relevant and feasible method to diagnose chlamydia infections in our laboratory, the presence of C trachomatis was investigated in urogenital samples by CC, DFA and EIA and compared the results. In addition, spesific antigen was also examined in the urine samples of male patients,because the collection of urethral samples by using swabs may cause several inconvinience for the patients. A total of 80 symptomatic cases(50 female, 30 male), who had been in risk groups for chlamydia infections, were included in this study. C trachomatis was investigated in cervical samples taken from females, or in urethral swab and urine samples obtained from males by using CC, DFA and EIA. The sensitivity, specificity, positive and negative predictive values (PPV.NPV) of DFA and EIA were calculated in comparison to CC method, which is accepted to be a gold standard test for the chlamydia infections. In females; sensitivity, specificity, PPV and NPV of DFA were found to be 83,3%, 100%, 100% and 97,8%, respectively; whilst these values were as follows for EIA: 16,7%, 100%, 100% and 89,8% respectively. In the urethral samples of male cases; sensitivity, specificity PPV and NPV of DFA were 75%, 96,2%, 75%, 96,2%, respectively;whilst these values were as follows in urine samples of the same cases:50%,96,4%, 50% and 96,4%, respectively. These values for EIA were 25%, 100%, 100% and 89,7% in urethral samples; and 0%, 100%, 0% and 93,3% in urine samples, respectively. In the study, by using McNemor %2 test, no statistically significant difference(p>0,05) was detected between CC, DFA and EIA methods used for seeking C trachomatis in urogenital samples taken from male and female cases. CC method is not routinely used to diagnoseurogenital chlamydia infections, because it is costly, time-consuming and difficult to perform. The result of this study demonstrate that antigen screening tests can be used instead of CC for diagnosing chlamydia infections, although their sensitivity and specificity are lower. The fact that the sensitivity of EIA in all samples(especially in urine) is found to be less may be due to insufficient numbers of cases observed in the study. Therefore, we think that this investigation including more cases should be taken further to detect actual sensitivity of EIA. Keywords: C trachomatis, Cell Culture, Direct Fluorescein Antibody, Enzyme Immune Assay T.C. YÜKSJCKÖ?RETtM MiUUW 95

Although the pathophysiology of systemic sclerosis (SSc) is not fully clarified, there are considerable data implicating abnormalities of microvascular changes, fibroblast activation and immune system abnormalities. Immune system activation may play a part as a stimulus in both fibrotic and vascular damage.1 To investigate the immune system abnormalities in the pathogenesis of SSc we evaluated lymphocyte phenotypes in patients with SSc and healthy controls by flow cytometry (Epics Profile II) for total T (CD3), T helper (CD4), T supressor (CD8), B lymphocyte cell surface marker (CD19), activation marker (CD25) and natural killer (NK) cell surface marker NKH-1 (CD56). We studied 29 patients (27 women, two men) 16 limited, 12 diffuse and one overlap who fulfilled preliminary criteria for classification of SSc.2 Anti-nuclear antibody was positive in 25 (86.2%) and anti-Scl70 antibodies was positive in seven (24.1 %) patients. The age range of the patients was 20–63 years (mean (SEM) 40 (5)) and the mean (SEM) disease duration was 5.6 (5.5) years. …

Bu çalışmada, genitoüriner sistem şikayeti olan 114 kadın, 56 erkek hasta ile genitoüriner sistem şikayeti olmayan 20 kadın 20 erkekten alınan servikal ve üretral sürüntü materyalinde enzim immuno assay (EIA) yöntemi ile C trachomatis antijeni araştırıldı. Hasta grubundan 24 kadında (% 21.05}, 4 erkekle (% 7.14), kontrol grubundan 1 kadında (% 2.5) C trachomatis antijeni pozitif bulundu. C trachomatis 'in bölgemizdeki dağılımı hakkında bilgi edinmek amacıyla yaptığımız bu çalışmamız sonuçları, diğer kaynaklardaki bilgilerle karşılaştırılarak tartışıldı. In this study, Chlamydia trachomatis antigen has been detected by the EIA method in the clinical material taken by cervical and urethral swabs from 114 women, 56 men with genitourinary system complaints and 20 women, 20 men with no complaints. It was found to be positive in 24 (21.05 % ) women and 4(7. 14 %) men from the patients group, and 1 (2.5 %) women from the control group. The results of the study, that was carried out in order to find the distribution of C trachomatis in our region, were discussed and compared with related literature.

Relapsla seyreden bir akut viral hepatit A olgusu sunuldu. Relaps ilk ataktan yaklaşık 1 ay sonra ortaya çıktı. Bu olgunun hastalığının başlangıcının 15. ayı sonunda yapılan rutin biyokimyasal testleri normal bulundu. In this article a relapsing acute viral hepatitis A (AVHA) case has been presented. Relaps occured about 1 month after the first attack. In this case, biochemical tests found in normal ranges at the end of 15 months after begining the disease.

Bu çalışmada, 198 kadına ait ( 139 yakınması olan, 59 kontrol) serviks sürüntüsü ve 50 erkekten alınan (40 yakınması olan, 10 kontrol) üretral akıntı, endoüretral sürüntü, meni, idrar gibi örnekler rutin bakteriyolojik yöntemlerle ve genital mycoplasma izolasyonu açısından incelenmiştir. Kadın hasta grubundan % 65.4 (kontrol grubundan % 49.1) ve erkek hasta grubundan % 45 (kontrol grubundan % 10) oranında genital mycoplasma izole edilmiştir. In this study, cervical swabs of 198 women ( 139 with urogenital complaints and 59 controls) and specimens like urethral discharge, endourethral swab, ejaculate and urine from 50 men (40 with urogenital complaints and 10 controls) were examined with routine bacteriological methods and for the isolation of genital mycoplasma.

Bu çalışmada 79 Akut Viral Hepatit (AVH) hastası değerlendirildi. Olguların 43'ünde (% 54.4) Akut Viral Hepatit A, (A VHA) 35'inde (% 44.3) Akut Viral Hepatit B (AVHB) ve1l'inde (% 1.3) nonA nonB (NANB) Hepatiti saptandı . AVHA çocukluk çağında, AVHB genç erişkinlerde ağırlıklı olarak bulundu. En önemli risk gruplarının AVHA 'da öğrenciler, A VHB'de sağlık personeli olduğu görüldü. Akut Viral NANB Hepatit (AVHC) li 1 olgu ise posttransfüzyonel hepatit olarak değerlendirildi. In this study, 79 Acute Viral Hepatitis cases were evaluated. 43 (54.4 %) of them were diagnosed as Acute Viral Hepatitis A (AVHA ), 35 (44.3 %) as Acute Viral Hepatitis B (AVHB) and 1 (1.3 %) as nonA nonB (NANB) Hepatitis. It was found that AVHA was dominant in childhood and AVHB in young adults. It was also seen that the most important risk groups were students in AVHA and hospital staff in AVHB. The only one case with NANB was evaluated as posttransfusional.

Senelerce bir zoonoz olarak bilinen C. jejuni nin, insanlarda da hastalık yapabileceği anlaşılmış bulunmaktadır. Ülkemizde de C. jejuni nin etken olduğu enterit vakalarının bulunduğunu göstermek amacıyla, çalışmamızda direkt bakteriyolojik yöntemleri kullandık . Mikroorganizmayı, gaita örneklerinden Butzler besiyerinde izole ettikten sonra, hareket ve morfolojik özellikleri ile biyokimyasal özelliklerini dikkate alarak adlandırdık. Enterit uak'alarında C. jejuni nin de Salmonella ue Shigella larla birlikte rutin olarak araştırılması gerektiğini düşünüyoruz. It has been understood that, C. jejuni which was known only as a zoonose for years, also causes disease in humans. We used the direct methods of bacteriology in order to prove that cases of C. jejuni Enteritis are present in our country. After isolating the microorganisms in Butzler medium from stool samples, we identified them by their typical motility, morphological and biochemical properties. We think that in the cases of enteritis with Salmonella and Shigella, C. jejuni should also be investigated routinely.