Evaluation of the seroprevalence and the demographic and clinical findings of fascioliasis patients in the Dicle River Basin in Turkey: a nine-year experience at a university hospital.

OBJECTIVE: Fasciola hepatica and Fasciola gigantica are liver trematodes that cause fascioliasis in humans and animals. In Turkey, the medical importance of fascioliasis has been increasing in humans, and it continues to cause great economic loss in the field of animal husbandry. Therefore, it is important to diagnose fascioliasis quickly and reliably. The aim of this study is to show that the ELISA test is a reliable and specific method for diagnosing fascioliasis both in the early stage and in the acute stage. PATIENTS AND METHODS: In this study, 640 individuals aged 7-75 years who showed one or more symptoms of fascioliasis, such as abdominal pain, fever, weight loss, weakness, fatigue, headache, sweating, nausea, vomiting, allergic urticaria, liver mass, hypereosinophilia, or liver enzyme elevation, were recruited from the Dicle University Research and Application Hospital in southeastern Turkey. Serum and fecal samples were taken from them to investigate if the Fasciola hepatica IgG antibody was present in the serum and if eggs were present in the feces. To detect the IgG antibodies, an enzyme-linked immunosorbent assay (ELISA) kit was used. The stool samples were analyzed for three consecutive days in mini Parasep fecal parasite concentrator tubes using the native-lugol and sedimentation methods. Abdominal ultrasonography and computed tomography were performed in all the patients. RESULTS: Among the subjects of this study, 90 (14%) were positive for fascioliasis, of whom 85 (94.4%) were adults and 5 (5.5%), children; 73 (81.1%) were women and 17 (18.8%), men; 57 (63.3%) lived in the rural areas and 33 (36.6%), in the city center; 90 (14%) were positive for Fasciola hepatica IgG antibodies; (20%) had helminth eggs in their stools; and 85 (94.4%) had a history of eating watercress. CONCLUSIONS: According to the epidemiological classification for fascioliasis by Mas-Coma, the Dicle Basin, which is the setting of this study, is indeed a hyperendemic region. Thus, ELISA is a reliable and specific method of diagnosing fascioliasis, both in the early phase and in the acute phase, when the eggs are no longer seen in the stool.

Microbial chondroitin sulfate in experimental knee osteoarthritis model investigation of chondroprotective effect.

OBJECTIVE: Chondroitin sulfate (CS) is a glycosaminoglycan with proven anti-inflammatory, anti-apoptotic, anti-oxidant properties. CS increases type II collagen and proteoglycan synthesis in human joint chondrocytes. CS can reduce the production of pro-inflammatory mediators and proteases to improve the anabolic/catabolic balance of the extracellular cartilage matrix (ECM). Due to these characteristics, it is a natural compound that is considered to be Symptomatic Slow-Acting Drugs for Osteoarthritis (SYSADOA). Microbial chondroitin sulfate (MCS) was produced from two different bacterial sources using biotechnological methods by our team. In this study, we aimed to apply microbially produced CS and bovine-derived commercial CS forms to rabbit knees with osteoarthritis experimentally and to evaluate the results. MATERIALS AND METHODS: In this study, a cruciate ligament cutting model was applied to 40 New Zealand rabbits to induce experimental osteoarthritis. Four weeks after the surgical procedure, rabbits were divided into 4 groups as control, animal-derived MCS, E coli-derived MCS and PaJC-derived MCS group. The standard rabbit diet was fed to the control group, and the other groups were additionally fed 17 mg/kg/day CS/MCS for 12 weeks. The rabbits were sacrificed at the 12th week after surgery and the preparations obtained were evaluated histopathologically. RESULTS: As a result, it was observed that regeneration tissue was statistically significant in histopathological cartilage tissue compared to the control group of CS developed from different sources given to rabbits with osteoarthritis. It was determined that among the CS groups produced from different sources, the group with the highest chondroprotective effect was MCS originating from E.coli. CONCLUSIONS: This vegan product (MCS), which we obtained as a result of our study, was produced by our team from a microbial source. According to our analysis, it has the potential to be an effective alternative therapy agent in the treatment of osteoarthritis.

The diagnostic value of immunohistochemistry in the typing of renal tumors with eosinophylic cytoplasma.

AIM: In this study, we aimed to review the diagnostic approach to eosinophilic cell renal neoplasms by light microscopy and immunohistochemical techniques. METHOD: In this study 23 of these tumors were eosinophilic variant classic RCC, 15 eosinophilic variant papillary RCC, 13 eosinophilic variant chromophobe RCC and 13 oncocytoma cases. These tumors were immunohistochemically treated with CK7, CD117, EpCAM, Vimentin, RCCm (Renal cell carcinoma marker) and GST-α. RESULTS: In our study, contrary to the general literature on Vimentin, 65.2 % negativity was found in our patients with eosinophilic variant classic RCC. However, when compared with other tumor types in our study, vimentin expression was highest in eosinophilic variant classical RCC with 34.8 %. Statistically; RCCm, GST-α, EpCAM, CD117, CK7 were found to be significantly associated with tumor types, while no significant relationship was found between Vimentin and tumor types. RCCm positivity and CK7 and CD117 negativity were in favour of eosinophilic variant classical RCC, EpCAM, CK7 and CD117 positivity and Vimentin, GST-α and RCCm negativity supported eosinophilic variant chromophobe RCC, CK7 and RCCm positivity and CD117 and GST-α negativity were found in favour of eosinophilic variant papillary RCC. CD117 positivity and Vimentin, CK7 and GST-α negativity were found to support oncocytoma. CONCLUSIONS: The panel with RCCm, GST-α, EpCAM, CD117, CK7 will contribute to the differentiation of eosinophilic cytoplasm renal tumors that cannot be determined by morphological findings and to reach the correct diagnosis (Tab. 3, Fig. 4, Ref. 54). Text in PDF www.elis.sk Keywords: RCC, oncocytoma, immunohistochemistry.

Effect of melatonin on torsion and reperfusion induced pathogenesis of rat uterus.

We investigated the use of melatonin to improve fertility and reduce uterine damage caused by torsion of the uterus in pregnant rats. We used 35 pregnant rats at gestational age 18 days. The animals were randomized into five groups. Group 1 was anesthetized only. Group 2 was subjected to experimental uterine torsion of 360° and the torsion was corrected after 6 h. Group 3 was subjected to uterine torsion of 360°, the torsion was corrected after 6 h and melatonin was administered at the time of correction. Group 4 rats were subjected to 360º uterine torsion and melatonin was administered 6 h later at the time of correction. Group 5 was administered melatonin followed by uterine torsion of 360 degrees followed by correction of torsion 6 h later. Samples were obtained from the uterine horns on the day 1 postpartum. We used Bax, Bcl-2 and caspase 3 staining to measure apoptosis in the uterine tissues. The mRNA levels of Rho-associated, coiled-coil containing protein kinases 1 (ROCK1), homeobox D10 (Hox4 HoxD10), TLR4, NFκB1, caveolin 1 (Cav1) heat shock protein 90 alpha (cytosolic), class B member 1 (Hsp90ab1) and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) were determined using quantitative real-time polymerase chain reaction analysis (qRT-PCR). Bax, Bcl-2 and caspase 3 were detected using immunohistochemistry. No difference was observed among groups with respect to abortion, neonatal mortality or congenital abnormalities. Compared to the control group, the mRNA levels of Rock1, Hox4, TLR4, NFκB1, Cav1 and Hsp90 genes were decreased significantly in the study groups; the decrease was greater in groups 3 and 4, which were treated with melatonin. The greatest amount of Bax staining was found in group 1 and the least amount of Bcl-2 staining was found in groups 4 and 5; the greatest amount of caspase 3 staining was found in group 2. Our findings indicate that melatonin reduced uterine torsion related tissue damage and that its application during torsion was more effective than application following removal of torsion.

Investigation of short- and long-term effects of ovarian hyperstimulation syndrome on ovarian reserve: an experimental study.

PURPOSE: To investigate the short and long-term effects of ovarian hyperstimulation syndrome (OHSS) on serum levels of vascular endothelial growth factor (VEGF) and endothelin-1 and ovarian follicular reserve (OFR). MATERIALS AND METHODS: An experimental case-control study was conducted on a university animal laboratory with 20 immature (22-day-old) virgin female Wistar Albino rats. Firstly, rats were divided into two groups. Group 1 (n = 10): control and Group 2 (n = 10): experimental OHSS induced rats. Secondly, Group 2 was randomly divided into two groups on the day of OHSS development (27th day) as follows: Group 3 (n = 5): 27-day-old OHSS induced rats and Group 4 (n = 5): 27-day-old OHSS induced rats supervised for seven days. Group 1 was divided into two groups to constitute age-matched controls as follows: Group 5 (n = 5): 27-day-old rats, Group 6 (n = 5): 35-day-old rats. The comparisons of Group 3 vs Group 5 and Group 4 vs Group 6 were performed. Main outcome measures were OFR, serum levels of VEGF, and endothelin-1. RESULTS: While the OFR and primordial follicle number (PFN) of Group 3 were significantly lower than those of Group 5 (p < 0.05); VEGF and endothelin-1 levels and atretic follicle number (AFN) were significantly higher in Group 3 compared to Group 5 (p < 0.05). In Group 4, PFN was significantly lower (p < 0.05) and AFN was significantly (p < 0.05) higher than Group 6. However, there were no statistically significant difference between Group 4 and Group 6 regarding the parameters of OFR, serum levels of VEGF, and endothelin-1. CONCLUSION: This experimental OHSS model revealed increased serum VEGF and endothelin-1 levels and decreased OFR during short-term of OHSS. OHSS showed detrimental effect on PFN of rats during long-term.

Quercetin prevents docetaxel-induced testicular damage in rats.

The protective effect of quercetin on docetaxel - an anticancer agent - induced testicular damage in rats was investigated. Thirty-two rats were randomly divided into four groups: group 1 - control, carrier solutions were given; group 2 - quarcetin 20 mg kg(-1)  day(-1) was given orally; group 3 - docetaxel 5 mg kg(-1) was given intraperitoneally as single dose; group 4 - docetaxel and quarcetin were given together. The histopathological changes; the specific biochemical markers, including antioxidants; and the sperm characteristics were evaluated. Docetaxel caused a significant increase in TBARS level and a significant decrease in SOD, GPX, CAT and GSH levels in the testicular tissues compared with the control group, whereas quercetin led to a significant decrease in lipid peroxidation, which was caused by docetaxel, via reducing TBARS level and increasing the levels of SOD, CAT, GPX and GSH. In addition, after docetaxel administration, sperm motility, sperm concentration, testicular and epididymis weights were significantly decreased and abnormal sperm rate and histopathological changes were increased. However, these effects of docetaxel on sperm parameters, histological changes and the tissue weights were eliminated by quercetin treatment. Our results show that the administration of docetaxel induced the testicular damage (oxidative stress, testes tissue damage and sperm parameters), and quercetin prevented docetaxel-induced testicular damage in rats.

Determination of serological profiles and avidity of specific antibodies in the sera of patients with potential Epstein-Barr virus (EBV) infection.

BACKGROUND: Epstein-Barr Virus, frequently referred to as EBV, is a member of the herpesvirus family and one of the most common human viruses. The virus occurs worldwide, and most people become infected with EBV sometime during their lives. OBJECTIVES: The purpose of this study was to investigate the serological profiles of specific antibodies among the sera of suspected EBV infection patients along with VCA-IgG avidity. METHODS: A total of 522 patient's sera were sent to The Clinical Microbiology Laboratory for EBV specific antibody detection and were studied by IFA method during a two year period. The serum samples were tested for EBV specific VCA IgG, VCA IgM, EA, EBNA antibodies and VCA IgG aviditity. RESULTS: Among 33 patients those who had low avidity for VCA IgG, 27 (81.8 %) of them had a serologic profile as follows; positive VCA IgG, negative VCA IgM, negative EA and negative EBNA. CONCLUSION: While this profile is considered as a primary infection, the frequency of the coexistence of VCA IgG low avidity with this profile is interpreted that avidity may lead to detect primary infection (Tab. 2, Ref. 25)

Melatonin use in unilateral total salpingectomy in rats.

OBJECTIVE: To investigate the effects of melatonin use in unilateral total salpingectomy on ovarian histology in rats. SETTING: Firat University, Medical School, Obstetrics and Gynecology Department, Elazig. MATERIAL AND METHOD: Thirty adult, female rats of Wistar albino species with regular cycles were randomly allocated to three groups in the estrus phase. G1 (n: 10): The group where the abdomen was opened and closed, and left oophorectomy was performed six months later. G2 (n: 10): The group where left total salpingectomy was performed and followed by left oophorectomy six months later. G3 (n: 10): The group where the abdomen was opened, left total salpingectomy was performed 15 min after 10 mg/kg/IP melatonin administration, and left oophorectomy was performed six months later. Samples of the left ovary were fixed in formaldehyde. The preparations were stained with hematoxylineosin, and primordial, primary, secondary and tertiary follicles were counted. All the numbers were added up to determine the ovarian follicle reserve. Atretic follicles were counted. Corpus luteum and corpus albicans were counted. Number of total corpuses was calculated. Regression of the presence of angiogenesis within the corpus luteum was examined. Presence of fibrosis on the ovarian stroma was examined. An ordinal scale was formed for the presence of regression of angiogenesis within the corpus luteum and presence of fibrosis (none: 0p, present: 1p, markedly present: 2p). Follicle cysts in the ovary were counted. Kruskal Wallis variance analysis was used in the statistical analysis of data; p < 0.05 was considered significant. RESULTS: Primordial follicle count, ovarian follicle reserve and regression of angiogenesis in the corpus luteum were found to be significantly lower (p < 0.05, Mann-Whitney U test), and atretic follicle count, microscopic follicle cyst and fibrosis development were found to be significantly higher in G2, when compared to G1 and G3 (p < 0.05, Mann-Whitney U test). None of the rats in G1 and G3 had ovarian cysts, whereas five rats in G2 were identified as having macroscopic follicle cysts. Other data were found to be similar in G1, G2, and G3 (Kruskal Wallis variance analysis). CONCLUSION: Left total salpingectomy reduces primordial follicles, ovarian follicle reserve and regression of angiogenesis in the corpus luteum, while increasing atretic follicles, microscopic ovarian cysts and fibrosis development. It leads to the development of macroscopic follicle cysts in the ovary at a high rate (50%) in the sixth month. Melatonin use eliminates these harmful effects. Melatonin can be used to avoid the unfavorable effect of total salpingectomy on the ovary.

Examination of the effect of melatonin use in Pomeroy method of tubal ligation on ovarian histology in rats.

OBJECTIVE: To examine the effects of melatonin use in the unilateral Pomeroy method of tubal ligation on ovarian histology in rats. SETTING: Firat University Medical School, Obstetrics and Gynecology Department, Elazig. MATERIAL AND METHOD: Thirty adult, female rats of Wistar albino species with regular cycles were randomly allocated to three groups in the estrus phase: G1 (n: 10): The abdomen was opened and closed. G2 (n: 10): The group where the abdomen was opened, and the Pomeroy method of tubal ligation was performed. G3 (n: 10): The group where the abdomen was opened, and Pomeroy method of tubal ligation was performed 15 min after 10 mg/kg/ip melatonin administration. Abdomens of all rats were opened six months later and left oophorectomy was performed. Samples of the left ovary were fixed in formaldehyde. The preparations were stained with hematoxylin eosin, and primordial, primary, secondary and tertiary follicles were counted. All the numbers were added up to determine the ovarian follicle reserve. An atretic follicle count was made. The corpus luteum and corpus albicans were counted, and the number of total corpuses were calculated. Regression of angiogenesis within the corpus luteum was examined. Presence of fibrosis on ovarian stroma was examined. An ordinal scale was formed for the regression of angiogenesis within the corpus luteum and presence of fibrosis (none: 0p, present: 1p, markedly present: 2). Follicle cysts in the ovary were counted. Kruskal Wallis variance analysis was used in the statistical analysis of data; p < 0.05 were considered significant. RESULTS: The comparison between G1 and G3 showed that all values were similar (p > 0.05, Kruskal Wallis variance analysis). When G2 was compared with G1 and G3, regression of angiogenesis in the corpus luteum was found to be significantly lower (p < 0.05, Mann Whitney U test), while atretic follicle count and fibrosis were significantly higher in G2 (p < 0.05, Mann Whitney U test). CONCLUSION: The Pomeroy method of tubal ligation reduces regression of angiogenesis in the corpus luteum, and increases atretic follicles and fibrosis development. Melatonin use restores these harmful effects. Melatonin can be used to refrain from this negative effect of the Pomeroy method of tubal ligation on the ovary.

Ability and utility of diffusion-weighted MRI with different b values in the evaluation of benign and malignant renal lesions.

AIM: To evaluate the ability and the utility of diffusion-weighted (DW) magnetic resonance imaging (MRI) with high and low b values to visualize benign and malignant renal lesions, and to determine which b value (b=100, 600, or 1000s/mm(2)) was most useful in differentiating benign from malignant renal lesions. MATERIALS AND METHODS: Fifty-eight patients with 67 renal lesions and 50 normal contralateral kidneys (as control) were enrolled in the study. DW imaging was performed with b values of 100, 600, and 1000s/mm(2). Results of the histopathological evaluation were compared with the DW MRI results. Apparent diffusion coefficient (ADC) values, and the sensitivity and specificity for differentiating malignant renal lesions from benign renal lesions were calculated for each b value. RESULTS: The mean ADC values of normal renal parenchyma with b=100, 600, and 1000s/mm(2) values were (3.14±0.54)×10(-3), (2.52±0.30)×10(-3), and (2.16±0.43)×10(-3)mm(2)/s, respectively. The mean ADC values of benign renal lesions (n=35) with b=100, 600, and 1000s/mm(2) values were (2.88±0.88)×10(-3), (2.58±0.91)×10(-3), and (2.10±0.93)×10(-3)mm(2)/s, respectively. The mean ADC values of malignant renal lesions (n=32) with b=100, 600, and 1000 values were (2.74±0.58)×10(-3), (2.09±0.63)×10(-3), and (1.66±0.51)×10(-3)mm(2)/s, respectively. Using DW imaging malignant renal lesions could be differentiated from benign renal lesions, and also angiomyolipomas and oncocytomas could be differentiated from renal cell carcinoma. CONCLUSIONS: DW MRI with quantitative ADC measurements can be useful in the differentiation of benign and malignant renal lesions. High b values (b=600 and 1000s/mm(2)) had the best specificity and sensitivity.

Use of antibiotic - impregnated DuraGen® to reduce the risk of infection in dura repair: an in vitro study.

AIM: To investigate the efficacy of antibiotic-impregnated DuraGen® in preventing infection when used for repair of dural defects. MATERIAL AND METHODS: 2 groups of 7 samples were formed. In the first group, normal DuraGen® samples without antibiotic impregnation and in the second group, DuraGen® samples with antibiotic impregnation (30 mg vancomycin) were used. Staphylococcus aureus (ATCC 25923), and Staphylococcus epidermidis (ATCC 12228) were selected for this study. Antimicrobial efficacy was evaluated by counting the number of colonies on and by measuring the diameter of the inhibition zone around the samples. RESULTS: There was no zone diameter around the normal DuraGen® for the 2 types of bacteria. There was significant bacterial growth (10 (5)) according to the colony count. For antibiotic-impregnated DuraGen®, there was a zone with a mean diameter of 32 mm in the agar with S. aureus and a zone with a mean diameter of 35 mm in the agar with S. epidermidis. Antibiotic-impregnated DuraGen® was quite effective against both microorganisms and there was no bacterial growth according to the bacterial colony count. CONCLUSIONS: In our in vitro study, antibiotic-impregnated DuraGen® material significantly inhibited microorganism growth. Our results show that antibiotic-impregnated DuraGen® has the potential to prevent infection.

The roles of extracellular matrix proteins, apoptosis and c-kit positive cells in the pathogenesis of ureteropelvic junction obstruction.

AIM: To investigate histopathological changes in ureteropelvic junction obstruction (UPJO) from an etiological perspective. PATIENTS AND METHODS: Medical records of patients with UPJO were reviewed and pathological specimens collected. Nephrectomy materials from forensic autopsies were taken as controls. Specimens were assessed with light microscopy. Fibronectin, type 4 collagen, laminin, Bax and Bcl-2 expression for apoptosis, together with interstitial cells of Cajal determination with c-kit were determined immunohistochemically. Staining scores were evaluated semiquantitatively. Results were evaluated using Mann-Whitney U-test. RESULTS: Control group comprised 14 children (median age, 3.5 years; 6 months-17 years). Study group comprised 22 children with UPJO (median age, 9 months; 1 month-10 years). Light microscopy revealed non-specific inflammation, epithelial proliferation and atrophy with fibrosis in the smooth muscle of the UPJ in all patients. Fibronectin, type 4 collagen and laminin were found to be significantly increased in UPJO at the intrafascicular space of smooth muscle and the matrix of stroma. Bcl-2 expression was increased in UPJO. c-Kit was unable to stain interstitial cells of Cajal, but staining for mast cells was significant. CONCLUSIONS: High expression of fibronectin, laminin and type 4 collagen may indicate a relation to the pathogenesis of UPJO. Defective kidney morphogenesis, during branching and tubulogenesis of ureteric bud, may be responsible for this congenital pathology.

Use of GnRH antagonists in ovarian remnant syndrome experimentally induced in rats.

PURPOSE: The objective of this study was to demonstrate the efficacy of cetrorelix, a GnRH antagonist, in rats with experimentally induced ovarian remnant syndrome. METHODS: 25 Wistar female rats at seven to eight weeks of age and weighing 200-250 g were used. The rats were randomly divided into five groups: the first group was used as a control group; the second and third groups underwent a sham operation; and the fourth and fifth groups underwent bilateral hemiovariectomy. At the first proestrus detected by vaginal cytology from postoperative day 2, the animals in groups 1, 2 and 5 received placebo and the animals in groups 3 and 4 received cetrorelix subcutaneously. In the study, the Kruskal-Wallis analysis of variance was used for comparison of the results of vaginal irrigation, histopathblogical examination, and of blood FSH and LH values, and the Mann Whitney U-test was used for determination of the differences between the groups. RESULTS: It was determined that according to vaginal cytology results, estrus-like cytological changes disappeared in a shorter time and according to histopathology results, the number of follicles were fewer in the ovarian remnant syndrome-induced and cetrorelix-injected group 4 (p < 0.05), but there was no difference between the groups for FSH and LH concentrations. CONCLUSIONS: Ovarian remnant syndrome is a complication of bilateral ovariohysterectomy. In cases with this syndrome, certain treatment is possible with re-operation. However, it may not always be possible to perform an operation, or even if operated, it is difficult to determine the place of the residual ovarian tissue. In this study, it was determined that the use of cetrorelix as a GnRH antagonist in rats with ovarian remnant syndrome reduced the duration of estrogenic affect.

Scrotal ultrasonography: should it be used in routine evaluation of infertile men?

Several studies have suggested that male infertility and testicular cancer may have common aetiological factors. Scrotal ultrasonography (US) has an important role in the diagnosis of testicular tumours when not palpable by physical examination. In this study, we present two infertile men referred to our clinic. Patients were evaluated by a detailed physical examination, semen analyses and hormonal assessment. Both patients underwent scrotal US examination. Semen analysis of the patients revealed oligoasthenospermia in both patients. Scrotal US revealed hypoechoic masses in the left and right testes of both patients, which were nonpalpable by physical examination. Scrotal exploration and subsequent orchidectomy were performed. Histopathological examination revealed mixed germ cell tumour and Sertoli-Leydig cell tumour in case 1 and case 2 respectively. With these cases, we discussed the role of scrotal US in the routine diagnostic evaluation of infertile men.

The efficacy of conservative treatment for late term ovarian torsion.

BACKGROUND/PURPOSE: Recent reports have focused on detorsion after ovarian torsion in the literature. The aim of the study was to investigate late term changes in both ovaries after delayed detorsion following ovarian torsion in rats. MATERIALS: Female, prepubertal, Wistar albino rats were divided into four groups (n = 6/group). The left ovaries were used for the study and the right ovaries were kept as the control. The groups were constituted as follows: Group 1: left ovarian fixation, bilateral oophorectomy 48 hours later; Group 2: left ovarian torsion and fixation, bilateral oophorectomy 48 hours later; Group 3: detorsion 48 hours after torsion and bilateral oophorectomy after another 48 hours; Group 4: detorsion 48 hours after torsion and bilateral oophorectomy after 21 days. The total injury score (TIS) was compiled histologically in a double-blind fashion. Congestion, edema, bleeding and polymorphonuclear lymphocyte infiltration were assessed for TIS. RESULTS: The TIS was found to be 8 points in Group 1; 38 in Group 2; 28 in Group 3 and 12 in Group 4, respectively. The TIS was based on results from the left ovaries in Group 1, whereas 31 points were attributable to the left ovaries and 7 to the right ovaries in Group 2. In Groups 3 and 4, TIS points were the same in both study and control ovaries. The difference between the left ovaries of Groups 1 and 2 and the left ovaries of Groups 2 and 4 was statistically significant (p < 0.05). CONCLUSION: Viable ovarian tissue can be detected even after 48 hours of torsion, which is a relatively long period of ischemia. Tissue injury decreases significantly after detorsion during late recovery. In view of previous case reports in the literature and the present findings, detorsion is recommended in children with ovarian torsion regardless of the ischemic period and/or macroscopic appearance.

Does a fibrin-collagen patch support early anastomotic healing in the colon? An experimental study.

BACKGROUND: The aim of this study was to evaluate the effect of absorbable fibrin-collagen patch (FCP) during early colonic anastomotic healing in rats. METHODS: Prepubertal Wistar albino rats were randomly divided into 6 groups of 6 rats each. Colon was transected and then anastomosed with sutures (Group A), sutures+FCP (TachoComb; Nycomed, Austria) (Group AT) or only FCP (Group T). Rats were sacrificed either 3 or 7 days after the anastomosis. Anastomoses were evaluated for perianastomotic adhesion formation, bursting pressures and histological features. RESULTS: Perianastomotic adhesion formation was significant in Groups AT and T. Bursting pressures were in higher group AT than in Group A on postoperative day 3 and lower on day 7 (p < 0.05). Histological examinations revealed an increase in inflammatory cells in Group T on day 3 and decreased wound healing in Group AT when compared to Group A on day 7 (p < 0.05). CONCLUSIONS: In the early period of anastomotic healing, FCP supports anastomotic integrity. However, it also causes an inflammatory reaction which may increase the time necessary for healing process. Thus, the use of this biomaterial should be preferred in only selective clinical cases with a careful follow-up.

Effects of membrane adhesion barriers on wound healing reaction after glaucoma filtration surgery: a comparative study with Interceed and Seprafilm.

PURPOSE: To evaluate and compare the effectiveness of two adhesion barriers, Interceed and Seprafilm, on wound heal ing reaction after glaucoma filtration surgery. MATERIALS AND METHODS: Full-thickness filtration surgery was carried out on three groups, each containing four rabbits. Interceed and Seprafilm prepared in 3 x 4 mm dimensions was put on and around scleral opening in Groups 1 and 2, respectively. All groups received tobramycin and dexamethasone drops tid for 14 days. Intraocular pressure (IOP), anterior chamber depth, and bleb appearance were checked on the first, third, seventh, and 14th days. The rabbits were killed on the 14th day and the trabeculectomy area with overlying conjunctiva was excised. The samples were fixed wi th 10% formalin, buried in paraffin, and stained with hematoxylin and eosin. The surgical site and surrounding subconjunctival area were evaluated histopathologically for cell counts (fibroblast, lymphocyte, eosinophil, and macrophage), presence of edema and foreign body reaction, and potency of the fistula tract. RESULTS: Mean IOP at the first and third day examinations was significantly different between groups, but there was no statistically significant difference among the groups with respect to IOP, anterior chamber depth, or bleb appearance at the seventh and 14th days. The groups were similar with respect to number of fibroblasts, eosinophils, and neutrophils. Number of macrophages was significantly increased in Groups 1 and 2 and number of vessels was significantly decreased in Group 1. CONCLUSIONS: Neither of these two adhesion-preventing substances seems to suppress wound healing reaction after glaucoma filtration surgery. However, a diminished wound healing reaction was expected wi th a decreased number of vessels, such as in Group 1. Increased number of macrophages in both groups may result in a decreased level of some inflammatory mediators.

The value of alpha-SMA in the evaluation of hepatic fibrosis severity in hepatitis B infection and cirrhosis development: a histopathological and immunohistochemical study.

AIMS: To investigate the value of alpha-smooth muscle actin (alpha-SMA), an indicator of stellate cell activation, in predicting fibrosis in chronic hepatitis B (CHB) patients. METHODS AND RESULTS: The liver biopsy specimens of 30 patients with a clinical diagnosis of CHB were obtained before treatment and scored by Knodell's histological activity index. The specimens were then immunohistochemically stained with alpha-SMA and semiquantitatively evaluated. Fibrosis and the immunoreactivity of alpha-SMA in the periportal, perisinusoidal and pericentral areas were compared. Fibrosis and necroinflammatory activity in CHB patients were significantly correlated (P =0.022). Furthermore, the degree of alpha-SMA expression and the scores of fibrosis (in periportal, perisinusoidal and pericentral areas) were highly correlated (P =0.000, 0.001, 0.000, respectively). CONCLUSIONS: In liver biopsy samples, alpha-SMA may prove to be a valuable marker in the evaluation of stellate cell activation and fibrosis progression and an early indicator of the development of fibrosis.

Immunohistochemical, histological and ultrastructural evaluation of the effects of leptin on testes in mice.

This study was undertaken to examine the effects of leptin on testes in mice. For this purpose, 12 male mice were divided into two groups. Animals in Group I were designated as control. Mice in Group II were injected daily with leptin for 5 days. All animals were decapitated at the end of the experiment. The testes were removed and weighed out. Testicular tissue specimens were processed for light and electron microscopic examination and semi-quantitative evaluation of immunohistochemical testosterone staining. Intensity of immunostaining was determined on a scale between 0 (no staining) and 5 (heavy staining). For morphometric comparison, diameters of seminiferous tubules from each group were measured. In the leptin injected group, testicular weights and diameters of seminiferous tubules were significantly increased in comparison to control values. In light microscopic examination, an increase in secretory granules in the cytoplasm of Leydig cells was observed after leptin treatment. In the same group, distinct changes indicative of increased cell activation were seen in the ultrastructure of Leydig cells. Amount of mitochondria, lysosomes and cytoplasmic secretory granules were increased. Furthermore, an increase in extensiveness of rough endoplasmic reticulum was noted in this group. Immunohistochemical testosterone staining of the cytoplasm of Leydig cells was heavy (5+) in the leptin treated mice compared to mild score (2+) in the control mice. Additionally, heavy immunostaining of testosterone was also observed in the interstitial space after injection of leptin. The present findings indicate that testicular functions and synthesis of testosterone increase after administration of leptin.

Tinea capitis in Diyarbakir, Turkey.

The incidence and types of tinea capitis in 234 children aged 1-12 referred to our laboratory with a preliminary diagnosis of tinea capitis infection in the past 5 years were investigated. Tinea capitis was determined in 149 (63.7%) of these patients, of which agents grew in culture in 124 (83.2%). The most frequently isolated agents, in order of frequency, are as follows: Trichophyton violaceum (43.6%), Microsporum canis (37.9%), T. mentagrophytes (8.1%) and T. verrucosum (4.8%).