27 years of experience with the Fontan procedure: characteristics and clinical outcomes of children in a tertiary referral hospital.

BACKGROUND: The Fontan operation has improved the survival of children born with congenital heart disease with single ventricle physiology. The most widely adopted variations of the Fontan procedure are the extracardiac conduit, the lateral tunnel ve the intra/extracardiac conduit with fenestration. Despite advances in the treatment and prevention of early and late complications that may develop after Fontan surgery, morbidity still remains an important problem. METHODS: 304 patients who underwent Fontan surgery in our center between 1995 and 2022 were included in our study. The complications that developed in patients who underwent primary Fontan or lateral tunnel surgery and extracardiac conduit Fontan application were compared. RESULTS: Classic Fontan surgery and lateral tunnel surgery were performed in 26 of the patients, and extracardiac Fontan surgery was performed in 278 patients. 218 of 304 cases were patients with single ventricular pathology. 86 cases were patients with two ventricular morphologies but complex cardiac pathology. Fenestration was performed in only 6 patients, other patients did not require fenestration. The mean follow-up period of our patients was 12 years (3 months-27 years). When the complications between Fontan procedures were compared in our study, it was found that the length of hospital stay and mortality were statistically significantly reduced in patients who underwent extracardiac Fontan surgery. There was no significant difference in terms of complications that can be seen after Fontan surgery and the length of stay in the intensive care unit. CONCLUSION: Fontan complex is a palliative surgery for children with complex heart disease. Palliative surgical operations aimed at the preparation of the Fontan circulation lead to the preparation of the pulmonary vascular bed and the preservation of ventricular function. The techniques applied in Fontan surgery affect the early and long-term complications and the survival of the patients. In our study, when we examined the patients who extracardiac conduit Fontan procedure for the non-cardiac route, we found that mortality and morbidity were minimal.

In Vitro Antiviral Evaluations of Coldmix®: An Essential Oil Blend against SARS-CoV-2.

Coldmix® is a commercially available Eucalyptus aetheroleum and, Abies aetheroleum blend for medicinal applications. In this present study, the in vitro antiviral potential of Coldmix®, and its major constituents 1,8-cineole and α-pinene were evaluated by using the in vitro ACE2 enzyme inhibition assay as well as the direct contact test against SARS-CoV-2. The observed ACE2 enzyme inhibitory activity of Coldmix®, 1,8-cineole, and α-pinene were 72%, 88%, and 80%, respectively; whereas in the direct contact test in the vapor phase, the destruction of the virus was 79.9% within 5 min and 93.2% in the 30th min, respectively. In a similar Coldmix® vapor phase setup using the in vitro cytotoxicity cell assay, E6 VERO healthy cells were experimentally not affected by toxicity. According to the promising initial antiviral results of Coldmix® and the individually tested constituents, detailed further in vivo evaluation using different virus classes is suggested.

Inactivation of airborne SARS-CoV-2 by thyme volatile oil vapor phase.

BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a global pandemic mainly through air transmission. Novel variants are emerging and thus innovative methods of air disinfection still warrant exploration. Essential oils with virucidal properties may be an alternative to known air disinfectants. OBJECTIVES: Analysis of virucidal potential of thyme oil vapor phase against airborne SARS-CoV-2. MATERIALS AND METHODS: Chemical composition of thyme oil was analyzed by Gas chromatography-mass spectrometry.Thyme oil was tested in solution in different dilutions against soluble SARS-CoV-2. For air disinfection analysis, different volumes of thyme oil were placed in a container with hot water and its vapor phase was tested against airborne/aerosolized SARS-CoV-2 in a 30 m3 room. The aerosolized virus was collected in a gelatine filter using a vacuum system after the test and the collected virus was quantified utilizing inoculations of serial dilutions into 96-well plates with VERO E6 cells. RESULTS: The main component of thyme oil was carvacrol. Thyme oil had virucidal action both in solution and in the air. Thyme oil at 1/1000 dilution (volume/volume, final concentration) in a solution eliminated more than 99,99% of SARS-CoV-2 in the solution in 60 min. In air disinfection tests in 30 m3 room, vapor phase of 40 ml of extracted thyme oil eliminated more than 99,99% (>4 LOG10) of airborne SARS-CoV-2, and vapor phase of 20 ml of thyme oil resulted in elimination of 90,88% (1,04 LOG10) airborne SARS-CoV-2 in 60 min. CONCLUSION: We have shown that vapor phase of thyme oil inactivates more than 99,99% of airborne SARS-CoV-2 in a room for the first time to the best of our knowledge. This finding may have implications on the use of thyme oil as a potential air disinfectant against SARS-CoV-2.

Pulmonary artery banding and venous bidirectional cava-pulmonary shunt for two-stage arterial switch procedure in late referral of patients with transposition of the great arteries and intact ventricular septum: midterm results.

OBJECTIVE: Two-stage arterial switch operation and left ventricle retraining are necessary for the patients with left ventricle dysfunction and transposition of great vessels with intact ventricular septum (TGA-IVS) who are referred late. MATERIAL AND METHODS: Forty-seven patients with the diagnosis of TGA-IVS and left ventricle dysfunction who underwent arterial switch operation in our centre between July 2013 and August 2017 were analysed retrospectively. The inclusion criteria for left ventricle retraining were patients older than 2 months of age at presentation, having an echocardiographic left ventricle mass index of less than 35 g/m², and having an echocardiographic "banana-shaped" left ventricle geometric appearance. The patients were divided into two groups: pulmonary artery banding and Blalock Taussig shunt were performed as the initial surgical procedure for later arterial switch operation in Group I (n = 19) and pulmonary artery banding and bidirectional cava-pulmonary shunt in Group 2 (n = 28). RESULTS: The average age was found to be 122.3 ± 45.6 days in Group I and 145.9 ± 37.2 days in Group II. There was no statistically significant difference (p = 0.232 versus p = 0.373) between the average left ventricle mass index of the two groups neither before the first stage nor the second stage (26.6 ± 4.8 g/m² versus 25.0 ± 4.9 g/m² and 70.5 ± 12 g/m² versus 673.8 ± 12.0 g/m², respectively). The average time interval for the left ventricle to retrain was 97.7 ± 42.9 days for Group I and 117.3 ± 40.3 days for Group II, significantly lower in Group I (p = 0.027). The time spent in ICU, length of the period during which inotropic support was required, and the duration of hospital stay were significantly higher in Group I (p<0.001, p < 0.001, and p < 0.00, respectively). CONCLUSION: Pulmonary artery banding and bidirectional cava-pulmonary shunt can be performed as a safe and effective alternative to pulmonary artery banding and arterial Blalock Taussig shunt for patients with TGA-IVS in whom arterial switch operation is needed beyond the neonatal period. This approach involves a shorter hospital stay and fewer post-operative complications.

Predictive value of platelet-to-lymphocyte ratio in severe degenerative aortic valve stenosis.

BACKGROUND: Aortic valve stenosis (AVS) is the most common cause of left ventricular outflow obstruction, and its prevalence among elderly patients causes a major public health burden. Recently, platelet-to-lymphocyte ratio (PLR) has been recognized as a novel prognostic biomarker that offers information about both aggregation and inflammation pathways. Since PLR indicates inflammation, we hypothesized that PLR may be associated with the severity of AVS due to chronic inflammation pathways that cause stiffness and calcification of the aortic valve. MATERIALS AND METHODS: We retrospectively enrolled 117 patients with severe degenerative AVS, who underwent aortic valve replacement and 117 control patients in our clinic. PLR was defined as the absolute platelet count divided by the absolute lymphocyte count. Severe AVS was defined as calcification and sclerosis of the valve with a mean pressure gradient of >40 mmHg. RESULTS: PLR was 197.03 ± 49.61 in the AVS group and 144.9 ± 40.35 in the control group, which indicated a statistically significant difference (P < 0.001). A receiver operating characteristic (ROC) curve analysis demonstrated that PLR values over 188 predicted the severity of aortic stenosis with a sensitivity of 87% and a specificity of 70% (95% confidence interval = 0.734-0.882; P < 0.001; area under ROC curve: 0.808). CONCLUSION: We suggest that the level of PLR elevation is related to the severity of degenerative AVS, and PLR should be used to monitor patients' inflammatory responses and the efficacy of treatment, which will lead us to more closely monitor this high-risk population to detect severe degenerative AVS at an early stage.

Human Umbilical Cord Mesenchymal Stromal Cell Transplantation in Myocardial Ischemia (HUC-HEART Trial). A Study Protocol of a Phase 1/2, Controlled and Randomized Trial in Combination with Coronary Artery Bypass Grafting.

Mesenchymal stem cells (MSCs), which may be obtained from the bone marrow, have been studied for more than a decade in the setting of coronary artery disease (CAD). Adipose tissue-derived MSCs have recently come into focus and are being tested in a series of clinical trials. MSC-like cells have also been derived from a variety of sources, including umbilical cord stroma, or HUC-MSCs. The HUC-HEART trail (ClinicalTrials.gov Identifier: NCT02323477) is a phase 1/2, controlled, multicenter, randomized clinical study of the intramyocardial delivery of allogeneic HUC-MSCs in patients with chronic ischemic cardiomyopathy. A total of 79 patients (ages 30-80) with left ventricle ejection fractions ranging between 25 and 45% will be randomized in a 2:1:1 pattern in order to receive an intramyocardial injection of either HUC-MSCs or autologous bone marrow-derived mononuclear cells (BM-MNCs) in combination with coronary arterial bypass grafting (CABG) surgery. The control group of patients will receive no cells and undergo CABG alone. Human HUC-MSCs will be isolated, propagated and banked in accordance with a cGMP protocol, whereas the autologous BM-MNCs will be isolated via aspiration from the iliac crest and subsequently process in a closed-circuit cell purification system shortly before cell transplantation. The cell injections will be implemented in 10 peri-infarct areas. Baseline and post-transplantation outcome measures will be primarily utilized to test both the safety and the efficacy of the administered cells for up to 12 months.

Renal failure after coronary bypass surgery and the associated risk factors.

OBJECTIVE: We aimed to evaluate the risk factors associated with acute renal failure in patients who underwent coronary artery bypass surgery. METHODS: One hundred and six patients who developed renal failure after coronary artery bypass grafting (CABG) constituted the study group (RF group), while 110 patients who did not develop renal failure served as a control group (C group). In addition, the RF group was divided into two subgroups: patients that were treated with conservative methods without the need for hemodialysis (NH group) and patients that required hemodialysis (HR group). Risk factors associated with renal failure were investigated. RESULTS: Among the 106 patients that developed renal failure (RF), 80 patients were treated with conservative methods without any need for hemodialysis (NH group); while 26 patients required hemodialysis in the postoperative period (HR group). The multivariate analysis showed that diabetes mellitus and the postoperative use of positive inotropes and adrenaline were significant risk factors associated with development of renal failure. In addition, carotid stenosis and postoperative use of adrenaline were found to be significant risk factors associated with hemodialysis-dependent renal failure (P < .05). The mortality in the RF group was determined as 13.2%, while the mortality rate in patients who did not require hemodialysis and those who required hemodialysis was 6.2% and 34%, respectively. CONCLUSIONS: Renal failure requiring hemodialysis after CABG often results in high morbidity and mortality. Factors affecting microcirculation and atherosclerosis, like diabetes mellitus, carotid artery stenosis, and postoperative vasopressor use remain the major risk factors for the development of renal failure.

Matrix-induced autologous mesenchymal stem cell implantation versus matrix-induced autologous chondrocyte implantation in the treatment of chondral defects of the knee: a 2-year randomized study.

BACKGROUND: Cell-based strategies that combine in vitro- expanded autologous chondrocytes with matrix scaffolds are currently preferred for full-thickness cartilage lesions of the knee ≥2 cm(2). Although this approach is reasonable, continuing advances in the field of cartilage repair will further expand the options available to improve outcomes. HYPOTHESIS/PURPOSE: In the present clinical study, we compared the outcomes of matrix-induced autologous mesenchymal stem cell implantation (m-AMI) with matrix-induced autologous chondrocyte implantation (m-ACI) for the treatment of isolated chondral defects of the knee. STUDY DESIGN: Prospective, single-site, randomized, single-blind pilot study. METHODS: Fourteen patients with isolated full-thickness chondral lesions of the knee >2 cm(2) were randomized into two treatment groups: m-AMI and m-ACI. Outcomes were assessed pre-operatively and 3, 6, 12 and 24 months post-operatively. RESULTS: Clinical evaluations revealed that improvement from pre-operation to 24 months post-operation occurred in both groups (p < 0.05). At all follow-up intervals, m-AMI demonstrated significantly better functional outcomes (motion deficit and straight leg raise strength) than did m-ACI (p < 0.05). At all follow-up intervals, m-AMI demonstrated significantly better subjective sub-scale scores for pain, symptoms, activities of daily living and sport and recreation of the knee injury and osteoarthritis outcome score (KOOS) than did m-ACI (p < 0.05). Additionally, m-AMI demonstrated significantly better (p < 0.05) scores than m-ACI for the quality of life sub-scale of the KOOS and visual analog scale (VAS) severity at the 6-month follow-up. The Tegner activity score and VAS frequency were not significantly different between the two groups. Graft failure was not observed on magnetic resonance imaging at the 24-month follow-up. m-AMI and m-ACI demonstrated very good-to-excellent and good-to-very good infill, respectively, with no adverse effects from the implant, regardless of the treatment. CONCLUSION: For the treatment of isolated full-thickness chondral lesion of the knee, m-AMI can be used effectively and may potentially accelerate recovery. A larger patient cohort and follow-up supported by histological analyses are necessary to determine long-term outcomes.

Induction of potent protection against acute and latent herpes simplex virus infection in mice vaccinated with dendritic cells.

BACKGROUND AIMS: Dendritic cells (DCs) are the most potent antigen presenting cells of the immune system and have been under intense study with regard to their use in immunotherapy against cancer and infectious disease agents. In the present study, DCs were employed to assess their value in protection against live virus challenge in an experimental model using lethal and latent herpes simplex virus (HSV) infection in Balb/c mice. METHODS: DCs obtained ex vivo in the presence of granulocyte-macrophage colony-stimulating factor and interleukin-4 were loaded with HSV-1 proteins (DC/HSV-1 vaccine). Groups of mice were vaccinated twice, 7 days apart, via subcutaneous, intraperitoneal or intramuscular routes with DC/HSV-1 and with mock (DC without virus protein) and positive (alum adjuvanted HSV-1 proteins [HSV-1/ALH]) control vaccines. After measuring anti-HSV-1 antibody levels in blood samples, mice were given live HSV-1 intraperitoneally or via ear pinna to assess the protection level of the vaccines with respect to lethal or latent infection challenge. RESULTS: Intramuscular, but not subcutaneous or intraperitoneal, administration of DC/HSV-1 vaccine provided complete protection against lethal challenge and establishment of latent infection as assessed by death and virus recovery from the trigeminal ganglia. It was also shown that the immunity was not associated with antibody production because DC/HSV-1 vaccine, as opposed to HSV-1/ALH vaccine, produced very little, if any, HSV-1-specific antibody. CONCLUSIONS: Overall, our results may have some impact on the design of vaccines against genital HSV as well as chronic viral infections such as hepatitis B virus, hepatitis C virus and human immunodeficiency virus.

Cytotoxicity of a new hemostatic agent on human pulp fibroblasts in vitro.

OBJECTIVE: The objective of this study was to evaluate the cytotoxicity of the plant extract ankaferd blood stopper (ABS) in vitro. STUDY DESIGN: ABS was eluted with fresh Dulbecco's Modified Eagle's Medium (DMEM) without serum for 72 h, at 37 °C. The cells treated with various dilutions of ABS were seeded into 96-well microplate at 104/well in triplicates. Cells without treatment served as a control group. The number of viable cells after 48 h incubation was determined by a modified 3-(4, 5-dimethyl-thiazol-2-yl)-2, 5-diphenyl-tetrazolium bromide (MTT) assay. The relative viability of pulp cells was expressed as color intensity of the number in the experimental wells relative to that of the control group. Absorbances were read at 570 nm on a microplate reader with a background subtraction at 620 nm. RESULT: The results showed that ABS was cytotoxic to human pulp fibroblasts by MTT assay. CONCLUSIONS: The influence of cytotoxicity to human pulp fibroblasts depended on concentration of ABS. The more dilutions exhibited less cytotoxic characteristics compared to the more concentrated forms.

[Pandemic influenza A/H1N1/2009 virus RNA isolation rate in specimens of patients diagnosed as flu in a University Hospital in Eastern Black Sea Region, Turkey]. / Hastanemizde klinik olarak grip tanisi alan hasta örneklerinde pandemik influenza A/H1N1/2009 virus RNA izolasyon orani

Swine origin influenza virus (S-OIV) has been of global concern towards the end of 2009 with its high morbidity rate and pandemic aspect. In this study, the presence of pandemic influenza A/H1N1/2009 virus RNA was investigated in patients clinically diagnosed as influenza infection in the university hospital in Trabzon province (located at Eastern Black Sea Region, Turkey). Oropharyngeal and nasal swab samples were collected from 211 patients (mean age: 18.5 years) who were admitted to our hospital between 16 November 2009 and 10 January 2010. Pandemic influenza A/H1N1/2009 virus RNA in the samples was investigated by real-time polymerase chain reaction. Viral RNA was detected in 41 of the patients (19.4%). The mean age of the cases was 11.7 years old. The highest positivity rate (44%) was seen in samples collected between 23-29 December 2009, while no positive samples were detected after 29 December 2009.

[Comparison of COBAS AmpliPrep/COBAS TaqMan 48 and VERSANT HCV-RNA 3.0 systems for the determination of hepatitis C virus load]. / Hepatit C virus yükünün belirlenmesinde COBAS AmpliPrep/COBAS TaqMan 48 ve VERSANT HCV-RNA 3.0 sistemlerinin karsilastirilmasi.

The aim of this study was to investigate the concordance between COBAS Taqman 48 (Roche Molecular Systems, Pleasanton, CA, USA) and VERSANT HCV RNA 3.0 (Bayer Diagnostics, Terrytown, NY) test systems for the detection of hepatitis C virus (HCV) load. Plasma samples taken from 42 patients with chronic HCV infection between 15 May-15 June 2006, were included to the study, and HCV-RNA levels have been searched with the use of the two above mentioned systems. Thirteen of the samples (30.9%) yielded negative and 26 (61.9%) samples yielded positive results by both of the systems. Two samples that were found negative by COBAS system, displayed 3.38 and 3.41 log10 IU/ml HCV-RNA by VERSANT system, respectively, while one sample that was found negative by VERSANT system, displayed 2.52 log10 IU/ml HCV-RNA by COBAS system. The correlation and linearity of the tests were found high according to Pearson correlation analysis [(r = 0.904, p < 0.0005), (R2 = 0.817)]. The viral load values detected by COBAS AmpliPrep/COBAS Taqman 48, were higher than the values obtained by VERSANT HCV-RNA 3.0, with a mean of 0.33 log10 IU/ml. In conclusion, both of the systems yielded similar results, however, since HCV viral load values may differ in different systems, the follow-up of viral load should be done by the same system for a particular patient.

Asymptomatic Chlamydia trachomatis infection and predictive criteria among low-risk women in a primary care setting.

The aim of this study was to estimate the prevalence and predictors of Chlamydia trachomatis infection among young adult low-risk women attending either of two inner-city family planning clinics in Trabzon, the most densely populated city in Turkey's Black Sea region. The study group comprised 150 sexually active women attending either of two family planning clinics. Two endocervical swabs were collected from each woman and tested for the presence of C. trachomatis by tissue culture and a commercially available enzyme immunoassay (ELISA). Multivariable logistic regression analysis was used to identify the associations of clinical factors for predicting C. trachomatis infection. C. trachomatis was detected in 19 of the samples (12.7%) by cell culture and in 15 (9.9%) by ELISA. None of the demographic characteristics could be associated with the state of infection, but the women preferring the withdrawal method for contraception accounted for a significantly higher percentage of the C. trachomatis-positive cases than women who used other contraceptive methods. The most frequent signs of cervical infection were vaginal discharge (RR = 4.86, 95% CI 1.60 and 14.79, P = 0.005) and cervical erosion (RR = 3.26, 95% CI 0.97 and 10.90, P = 0.056).

[Biotypes and antibiotic resistance patterns of Gardnerella vaginalis strains isolated from healthy women and women with bacterial vaginosis]. / Saglikli ve bakteriyel vajinozlu kadinlardan izole edilen Gardnerella vaginalis suslarinin biyotiplendirilmesi ve antibiyotik direnç durumlarinin belirlenmesi.

As Gardnerella vaginalis is accepted as a member of normal vaginal flora, it is one of the dominant species which has been related to bacterial vaginosis (BV). The aim of this study was to determine the isolation rate, biotypes and antibiotic resistance patterns of G.vaginalis from the vaginal swab samples of 408 women who were admitted to the outpatient clinics of Family Planning Center. Hippurate hydrolysis, lipase and beta-galactosidase tests were performed for biotyping the isolates, and agar dilution (for metronidazole) and disk diffusion (for clindamycin) tests were used for the detection of antibiotic resistance patterns. As a result, by Nugent's BV scoring protocol, 122 (29.9%), 20 (29.4%), 137 (33.6%), and 18 (4.4%) of the women were diagnosed as BV, intermediate form, normal vaginal flora (NVF) and mycotic vaginosis, respectively. The overall isolation rate of G.vaginalis was found as 23% (94/408). Of them, 56.4% (53/94) and 8.5% (8/94) were isolated from samples of BV cases and subjects with NVF, respectively, and the difference was statistically significant (p<0.05). The biotyping results showed that the most frequently detected types were biotype 1 (44%), 5 (20%) and 4 (18%). There was no statistically significant difference between the biotype distribution of BV patients and the subjects who have NVF (p=0.687). The results of antibiotic susceptibility tests indicated that 70% and 53% of the isolates were resistant to metronidazole and clindamycin, respectively. It was of interest that MIC values for metronidazole was > or =128 microg/ml in 57% of resistant strains. The data of this study has emphasized that the metronidazole resistance is very high in our population, and the large scale studies are needed to clarify the relationship between BV and G.vaginalis biotypes, which can be found in the normal vaginal flora.

The role of hepatocyte growth factor in the differentiation of dendritic cells from peripheral blood monocytes.

OBJECTIVE: To find out the effects of hepatocyte growth factor (HGF) in the development of dendritic cells (DC) from the peripheral monocytes. METHODS: The study was carried out in Black Sea Technical University Hospital, Trabzon, Turkey between 2003-2004. Seven different cytokine combinations were employed to assess phenotypical and functional differences of DCs from the peripheral monocytes in serum free culture media. Peripheral monocytes were incubated in media with cytokines for 5 days. The tumor necrosis factor-alpha (TNF-alpha) was added to the cell culture on day 5 and incubated for another 2 days. Surface and co-stimulating molecules on the cells were assessed by flowcytometry. The functional capacity of the DCs was evaluated on day 7 by purified protein derivative loading and subsequent lymphoproliferation test using methyl tetrazolium staining. RESULTS: On the 5th day of incubation DC development was observed in all cytokine groups, but cells were superior in cultures maintained in the presence of interleukin-4 combinations with granulocyte-macrophage colony stimulating factor (GM-CSF) or with GM-CSF+HGF. Moreover, the expression of surface and co-stimulating molecules increased significantly after incubation with TNF-alpha. The effect of PPD loaded-DCs on proliferation of lymphocytes was more striking in HGF containing groups. CONCLUSION: It was concluded that HGF supplemented cultures exert some additive effects in relation to function of monocyte-derived DCs. But HGF alone does not seem to augment monocyte-derived DC proliferation and maturation significantly.

The relation of lymphoma and hepatitis B virus/hepatitis C virus infections in the region of East Black Sea, Turkey.

AIM AND BACKGROUND: Hepatitis B virus (HBV) and hepatitis C virus (HCV) are not only hepatotropic, but also lymphotropic viruses. Infections with these viruses induce chronic antigenicity and may stimulate clonal expansion of malignant B-cell neoplasms. Moreover, these viruses can proliferate in lymphatic structures and bone marrow. However, the relationship between lymphomas and HBV/HCV infections is not clear. In our region of the East Black Sea, Turkey (the city of Trabzon), we intended to demonstrate a relation of lymphoma and HBV/HCV infections with a case-controlled study. METHODS: A total of 109 patients diagnosed with lymphoma between 2002-2005 in the Black Sea Technical University Hospital was investigated. Seventy-one patients had a high-grade and 38 patients a low-grade lymphoma. Hepatitis B surface antigen (HBsAg) and anti-HCV antibodies (anti-HCV Ab) were screened. The control group consisted of patients (n = 551) from other departments with diagnoses other than lymphoma. RESULTS: HBsAg was 3.7% and anti-HCV Ab positivity was 2.8% in lymphoma patients, compared with control of 5.3%, 5.1%, respectively. There was no statistically significant difference between two groups (P = 0.7, OR = 0.69, 95% CI, 0.20-2.10; P = 0.4, OR = 0.53, 95% CI, 0.13-1.86, respectively). CONCLUSION: Our findings suggest that the incidence of HBV and HCV infections in lymphoma patients is no different than that of nonlymphoma patients. Therefore, no direct correlation can be deduced between lymphoma and HBV-HCV infections in our East Black Sea region of Turkey.

Evaluation of a new rapid lateral flow chromatography test for the diagnosis of Helicobacter pylori.

OBJECTIVE: The rapid, simple and non-invasive diagnosis of Helicobacter pylori (H. pylori) infection is important in implementing chemotherapy in appropriate manner, and in assessing persistent H. pylori infection after eradication therapy. The ImmunoCard STAT! HpSA kit (Meridian Bioscience, Europe) is a lateral flow chromatography test which utilizes a monoclonal anti-H. pylori antibody. In this study, we investigated the usefulness of the ImmunoCard STAT! HpSA test before and after eradication therapy on patients referred to undergo upper gastrointestinal endoscopy. METHODS: Sixty-five consecutive patients who were referred to undergo upper gastrointestinal endoscopy at the Department of Gastroenterology, Karadeniz Technical University Medical School, Turkey between February and August 2005 were included in this study. The ImmunoCard STAT! HpSA was compared with 4 invasive tests (histology, gram staining, rapid urease test, and culture). The reference method was defined as positive when 2 of the 4 invasive tests were positive. A negative H. pylori status was considered when all 4 tests present concordant negative results. RESULTS: Overall, the ImmunoCard STAT! HpSA test had 77.8% sensitivity, 79.3% specificity, 82.4% positive predictive value (PPV) and 74.2% negative predictive value (NPV) in all patients. With regard to pre-treatment values, the sensitivity was 70.6%, specificity 70.6%, PPV 100% and NPV 100% while on post-treatment group the sensitivity was 84.2%, specificity 64.7%, PPV 72.7% and NPV 78.6%. CONCLUSION: Our results indicate that the ImmunoCard STAT! HpSA test is a rapid, simple, and helpful procedure not only to determine H. pylori infection but also to assess the success of eradication therapy.

Antimicrobial activity of some endemic plants growing in the Eastern Black Sea Region, Turkey.

The Eastern Black Sea Region has an extensive flora because of ample rainfall lasting all year. In this study, antimicrobial effects of 74 crude extracts of 22 endemic plants were investigated. Among the 30 active crude extracts, water-insoluble crude extracts from Betula medwediewii, Heracleum platytaenium, Primula longipes, Anthemis cretica ssp. argaea and Centaurea helenioides were the prominent ones with their MIC values.

Significance of cagA status and vacA subtypes of Helicobacter pylori in determining gastric histopathology: virulence markers of H. pylori and histopathology.

BACKGROUND: It has been suggested that Helicobacter pylori strains containing the cytotoxin-associated gene A (cagA), and s1m1 genotype of vacuolating cytotoxin gene A (vacA) may have been associated with peptic ulcer disease. The aim of the present study was to analyze such an association of cagA presence and vacA subtypes of H. pylori with histopathological findings in patients with gastritis. METHODS: Sixty-five independent H. pylori strains isolated from Turkish patients with gastritis were analyzed. The antral biopsy specimens were processed for culture and histopathology. Histopathological features were recorded and graded according to updated Sydney system. The vacA subtypes and cagA gene were tested by polymerase chain reaction. RESULTS: Mild degree of antral density was associated with mild degree of gastric neutrophil infiltration (P = 0.010). Positive cagA status correlated significantly with the presence of atrophy (P = 0.035) and neutrophil infiltration (P < 0.001), but not with H. pylori density (P = 0.754) nor the degree of mononuclear cell infiltration (P = 0.945). The vacA subtypes were independent of gastric histopathology. The odds ratios for atrophy and neutrophil infiltration of cagA+ versus cagA- strains were 3.62 (95% confidence interval [CI]: 1.04-12.66) and 53.18 (95%CI: 11.08-255.23), respectively. CONCLUSION: The presence of the cagA gene is strongly associated with atrophic and active gastritis. Distinct vacA subtypes of H. pylori appear to have no association with histopathological findings of gastritis.