Determination of SARS-CoV-2 IgG antibody levels in hematology-oncology patients after COVID-19 vaccination.

OBJECTIVE: Cancer patients are among the high-risk groups where COVID-19 infection tends to be severe and can lead to increased mortality. Therefore, they are included in the priority groups for COVID-19 vaccination. This study aimed to compare the levels of SARS-CoV-2 immunoglobulin G (IgG) antibodies following two different COVID-19 vaccinations between hematology-oncology patients and healthcare personnel and to identify factors associated with these antibody levels. PATIENTS AND METHODS: A prospective study was conducted with 91 hematology-oncology patients (cancer group) and 75 healthcare personnel (control group) from January 2020 to June 2023. The cancer and control groups comprised adults who had received a booster dose, with either a single dose of BNT162b2 or two doses of CoronaVac™ spaced one month apart, following their primary vaccination with two doses of either CoronaVac™ or BNT162b2. Four weeks after the administration of the booster dose, levels of SARS-CoV-2 IgG antibodies were assessed using an ELISA kit. Antibody levels above 50 AU/mL were accepted as signifying seropositivity. RESULTS: The median SARS-CoV-2 IgG antibody level was lower in the cancer group compared to the control group (4,509 vs. 7,268, p = 0.004), while the rate of seroconversion was similar between the groups (97.8% vs. 100%, p = 0.564). In the cancer group, no association was found between SARS-CoV-2 IgG antibody levels and age, sex, comorbidity, type of malignancy, stage and duration, or type of vaccine. CONCLUSIONS: In cancer patients, the seroconversion positivity rate was about 98%. However, antibody responses were still lower compared to the control group. No difference was detected in antibody levels among cancer patients based on the type of vaccine.

Effect of intracanal cryotherapy on the inflammatory cytokine, proteolytic enzyme levels and post-operative pain in teeth with asymptomatic apical periodontitis: A randomized clinical trial.

AIM: To investigate the changes in the biomarker levels related to inflammation and tissue destruction in the periapical exudate of mandibular pre-molar teeth with asymptomatic apical periodontitis after receiving intracanal cryotherapy, to compare cryotherapy and control groups in terms of analgesic intake, interappointment, and post-operative pain and evaluate the correlation between biomarker levels and interappointment pain. METHODOLOGY: Mandibular pre-molar teeth of 44 patients aged 18-35 years, diagnosed with asymptomatic apical periodontitis, were root canal treated in two visits (registered as NCT04798144). Baseline periapical exudate samples were obtained, and the patients were assigned to either control or intracanal cryotherapy group according to the final irrigation with distilled water either at room temperature or 2.5°C. The canals were dressed with calcium hydroxide. In the second visit, the calcium hydroxide was removed with passive ultrasonic irrigation, and the periapical exudate was sampled again. IL-1ß, IL-2, IL-6, IL-8, TNF-α, PGE2 and MMP-8 levels were determined with ELISA. Post-operative pain levels were recorded for 6 days following both visits using a visual analogue scale. Data were analysed using t-test, the Mann-Whitney U test and correlation tests. RESULTS: There was a significant correlation between the pain scores reported after first visit and IL-1ß and PGE2 levels (p < .05). IL-1ß, IL-2 and IL-6 levels showed no significant difference in the cryotherapy group (p > .05), while they significantly increased in the control group (p < .05). There was a decrease in IL-8, TNF-α, PGE2 and MMP-8 levels, however, the difference was not significant (p > .05). Pain scores were significantly lower in the cryotherapy group for the first 3 days (p < .05), except for 24th hours (p > .05). CONCLUSIONS: The positive correlation between interappointment pain and IL-1ß and PGE2 levels might indicate that these biomarker levels can be used to predict the severity of post-operative pain. Intracanal cryotherapy was effective in reducing post-operative pain in the short term in teeth with asymptomatic apical periodontitis. Cryotherapy prevented an increase in IL-1ß, IL-2 and IL-6 levels compared with the control group.

Molecular communication between Apelin-13, Apelin-36, Elabela, and nitric oxide in gestational diabetes mellitus.

OBJECTIVE: Gestational diabetes mellitus (GDM) is a type of diabetes that affects from 3.8% to 6.9% of pregnancies worldwide, causing significant mortality and unfavorable obstetric outcomes, such as delivery trauma and macrosomia risk. The fundamental processes of this metabolic disorder that first appeared during pregnancy are still unknown. Tissue hormones, particularly adipokines, have aided in understanding the pathophysiology of numerous disorders in recent years. This study aims to determine if Apelin-13 (APLN-13), Apelin-36 (APLN-36), Elabela (ELA), and nitric oxide (NO) molecules have all a part in the pathophysiology of GDM. PATIENTS AND METHODS: The study included 30 pregnant control women and 30 pregnant women who had been diagnosed with GDM in the second trimester and whose body mass index and age were compatible with each other. Blood samples were collected from 60 participants during the second trimester (30 control pregnant women and 30 GDM pregnant women) and postpartum (17 controls vs. 14 GDM). In these blood samples, the amounts of APLN-13, APLN-36, ELA, and NO were studied using the ELISA method. In addition, the participants' glucose, lipid profiles, and other parameters were obtained from the hospital record files. At postpartum, 29 pregnant women (13 control and 16 pregnant women with GDM) dropped out of the study without explanation. RESULTS: In the second trimester and postpartum plasma of mothers with GDM, APLN-13, APLN-36, NO, and ELA molecules were found to be significantly higher (< 0.05), compared to those of the control mothers, while APLN-13, APLN-36, NO values were significantly lower (0.05). While APLN-13, APLN-36, NO amounts in mothers with GDM were positively correlated with glucose amounts, they were negatively correlated with ELA amounts. Similarly, the triglyceride amounts in mothers with GDM were positively correlated with APLN-13, APLN-36 and NO, while they were negatively correlated with the ELA amounts. Due to gestational diabetes, APLN-13, APLN-36, NO, glucose, and triglyceride increased, and ELA decreased. CONCLUSIONS: It is predicted that the glucose increase in GDM is because Apelins reduce glucose transport to erythrocytes by inhibiting the sodium-dependent glucose transporter (SGLT) and that the increase in triglyceride and NO may be associated with high glucose levels in GDM. As a result, we believe that the above-mentioned chemicals may cause GDM Pathology by triggering one another.

Effect of occlusal splint on interleukin 6, malondialdehyde and 8-hydroxydeoxyguanosine levels in the synovial fluid of patients with temporomandibular disorders.

The actual role of splint therapy in preventing excessive loading of the temporomandibular joint (TMJ) is still debated. Lower intra-articular pressure levels have been measured in patients wearing occlusal splints, which may also reduce oxidative stress in the articular spaces. The aim of this study was to determine whether splint therapy reduces oxidative stress and inflammation in TMJ internal derangement patients by measuring interleukin 6 (IL-6), malondialdehyde (MDA), and 8-hydroxydeoxyguanosine (8-OHdG) levels in the synovial fluid (SF). Twenty-four patients with a temporomandibular disorder (TMD) were included in the study. TMJ SF samples were obtained prior to arthrocentesis. Twelve patients used a 2-mm hard acrylic, maxillary stabilization-type splint for 3 months after arthrocentesis. Twelve patients had no treatment after the SF aspiration. Second SF samples were obtained from all patients at 3 months post arthrocentesis. IL-6, MDA, and 8-OHdG levels in the samples were evaluated. All patients showed a significant symptomatic improvement after treatment (P < 0.005). No statistical correlation was found between the two groups concerning pre-treatment and 3-month SF levels of MDA, 8-OHdG, and IL-6. Although splint therapy was found to be successful in eliminating clinical symptoms of TMD, the results showed no beneficial effect on inflammation and oxidative stress markers in the synovial fluid.

Central nervous system metastatic epithelial ovarian cancer. Clinical parameters and prognostic factors: a multicenter study of Anatolian Society of Medical Oncology.

Central nervous system (CNS) metastasis is a rare event in the course of late stage epithelial ovarian cancer (EOC); however its incidence is increasing in parallel with prolonged survival of patients. OBJECTIVE: The authors assessed the clinical parameters and potential prognostic features in patients with CNS metastatic disease. MATERIALS AND METHODS: Clinical data of the 33 patients from the participating centers were retrospectively collected and analyzed. Median age at the time of CNS metastasis was 57 years. Median time from the diagnosis of primary EOC until CNS metastatic disease was 22 months. Nearly half (45.5%) of the patients had single CNS metastatic lesions and all patients in the study group except two received radiotherapy as palliative treatment. Median overall survival (OS) from the time of CNS metastasis was 15 months (0-66). At univariate analysis only number of brain metastatic lesions (p = 0.001) and presence of extracranial disease (p = 0.004) were strongly associated with OS whereas multimodal treatment, size of metastatic lesions, platinum sensitivity, age, grade, and disease stage at presentation were not. Development of CNS metastasis carries a poor prognosis, however patients with single metastatic lesions and only intracranial metastatic disease can have prolonged survival after appropriate palliative management of their disease.

Effects of diclofenac sodium on the hippocampus of rats with acute subdural hematoma: histological, stereological, and molecular approach.

This study was aimed at evaluating the potential effects of acute subdural hematoma (ASDH) and diclofenac sodium (DS) therapy following ASDH on the rat hippocampus. Twenty-four male Sprague Dawley rats were used and divided into four groups. 0.1 ml of non-heparinized autologous blood from the tail vein of the animals in the non-treatment group (NTG) and treatment group (TG) was injected into the subdural space. The TG received intramuscular diclofenac sodium at a 15 mg/kg dose daily from the postoperative second hour to the seventh day after the operation. The control group (CG) and sham group (SG) were used for control and sham operations, respectively. On the postoperative eighth day, all animals were sacrificed, and the hippocampi of all animals were stereologically and histologically evaluated. Also blood samples of the animals were biochemically analyzed. As a result of the study, the mean number of neurons in CA1, CA2, and CA3 regions of the hippocampus and the total number of neurons were decreased in the hippocampus samples of the NTG and especially the TG subjects. When comparing the second blood samples, there was no difference between the levels of adrenaline and serotonin among the groups. However, after the operation, noradrenalin levels in the treatment group were found to be higher than those of the sham and control groups (p < 0.05). In the NTG and TG, histopathological findings were observed such as Nissl condensation as well as completely dead and indistinguishable neurons with abnormally shaped, shrunken cytoplasm and nuclei. Also necrotic areas on the specimens of the TG were seen. In immunohistochemical sections, c-FOS positivity was decreased in the NTG and especially the TG. Otherwise, PGC-1 positive cells were increased in the NTG and especially the TG. In this study, it was shown for the first time by means of stereological techniques that using DS after ASDH caused a decrease in the number of hippocampal neurons (CA1, CA2, and CA3 regions).

A familial case of Coffin-Lowry syndrome caused by RPS6KA3 C.898C>T mutation associated with multiple abnormal brain imaging findings.

Coffin-Lowry syndrome (CLS) is a rare X linked mental retardation syndrome characterised by severe psychomotor and growth retardation, distinct facial phenotype, and progressive skeletal malformations. It is caused by mutations in the RPS6KA3 gene located at Xp22.2. In this report we describe a family with CLS consists of three affected males, and two affected females, arising from c.898C>T mutation in RPS6KA3 gene. A 6 year-old, and a 3 year-old boy both had distinct clinical features of Coffin-Lowry syndrome; severe mental and motor retardation, microcephaly, prominent forehead, hypertelorism, large mouth, large ears, large soft hands, puffy tapered fingers, and pectus carinatum. In addition, they had multiple abnormal brain MRI findings. Other siblings presented with a mild and variable phenotype.

Detecting Gram-positive anaerobic cocci directly from the clinical samples by multiplex polymerase chain reaction in odontogenic infections.

PURPOSE: Gram-positive anaerobic cocci (GPAC) can be isolated as pathogens from odontogenic infections. Culturing GPAC is time consuming and labor intensive. The objectives of the present study were to examine the utility of polymerase chain reaction (PCR) in directly detecting the presence of GPAC in clinical samples obtained from patients with odontogenic infections and to compare the distribution of GPAC in infected and healthy tissue. MATERIALS AND METHODS: In the present case-control study, the infected tissue from patients and oral mucosal swabs from healthy control subjects were subjected to anaerobic culture and direct PCR analysis for the presence of GPAC. The McNemar, chi-square, and Fisher exact tests and kappa analysis were used for the statistical analyses. P < .05 was regarded as significant. RESULTS: The patient group included 13 men and 14 women, including 9 patients diagnosed with granulation of tooth extraction, 6 with impacted tooth follicles, 4 with peri-implantitis, 3 with abscesses, 2 with epithelial cysts, 2 with infected cysts, and 1 with an oroantral fistula. The control group included 14 men and 12 women. All the patient and control samples contained at least 1 GPAC. The groups did not differ by method of determining GPAC presence, but more microorganisms were detected when clinical samples were directly used for PCR analysis than when cultured bacteria were used (P = .001). CONCLUSIONS: The presence of GPAC in infected tissue cannot be directly related to the development of odontogenic infections. PCR performed directly on clinical material is a sensitive and specific method that can detect GPAC and save time.

Umbilical cord blood endocan levels according to the delivery mode.

PURPOSE OF INVESTIGATION: The authors aimed to evaluate the endocan levels in the umbilical cord blood regarding the delivery mode. MATERIALS AND METHODS: One hundred six women aged between 20 to 35 years, undergoing delivery at term were studied. Three groups were formed; 37 neonates born by spontaneous vaginal delivery (group 1), 34 neonates born by an elective cesarean section with the general anesthesia (group 2), and 35 neonates, born by an elective cesarean section with spinal anesthesia (group 3). In delivery, umbilical cord blood samples were collected and endocan levels were measured. RESULTS: The endocan levels of cord blood (mean ± standard deviation, ng/ml) were found to be lower in group 2 (1.21 ± 0.46) compared to group 1 (1.52 ± 0.52) (p = 0.011). Cord blood endocan levels were not different in group 1 than those of group 3 (p = 0.49). CONCLUSION: It may be concluded that cord blood endocan levels are affected by the delivery mode.

The effect of dexketoprofen on ischemia reperfusion injury.

OBJECTIVE: The purpose of this study was to demonstrate the effects of dexketoprofen on experimental ischemia/reperfusion injury induced in rat testicles. METHODS: Twenty-four male Wistar albino-type rats were randomly separated into three groups. To develop testicular torsion, the right testicle was rotated 720° clockwise. After five hours of rotation, reperfusion was applied for 24 hours. The control group rats (Group C) had no procedures or treatments; basal numbers were used. Intraperitoneal 25 mg/kg dexketoprofen (1 cc) (Group D) or the same volume of serum physiologic (Group SP) were given to the Group D and Group SP rats 40 minutes before and 12 hours after detorsion. Twenty-four hours after detorsion, histopathological evaluation was performed by bilateral orchiectomy. Malondialdehyde (MDA) levels were detected in testicular tissue and in serum. RESULTS: Histopathologic changes in the spermatic cells of torsioned testicles in Group D were significantly less than those of Group SP (p < 0.05). MDA levels in both testicles in Group D were similar to those of the control group. Although they were lower than Group SP, the difference was not statistically significant. Serum MDA levels were lower in Group D compared to the other groups (p < 0.05). CONCLUSION: We detected that dexketoprofen decreases I/R injury in both the torsion-formed testicle and the contralateral testicle. Thus, in patients who have urgent surgery for testicular detorsion, dexketoprofen can be preferred as an analgesic to reduce I/R injury. Further study is warranted to demonstrate this effect of dexketoprofen (Tab. 3, Fig. 1, Ref. 30).

Radiological aspect of fungus ball within a mucocele of the sphenoid sinus.

Paranasal sinus fungus ball is within the non-invasive forms and is characterized by the presence of aggregated hyphae that do not invade the sinus mucosa. Mucoceles are benign, expansile, cyst-like lesions of the paranasal sinuses. The mucoid secretions of mucoceles are usually sterile. However, secondary infections, mostly bacterial, may lead to the development of pyocoeles. Although an association between a fungus ball and a mucocele is rare in the paranasal sinuses, this disease entity should be considered in the differential diagnosis of expansile, cystic sinus lesions. In this article, clinical and radiological findings of a 61-year-old male patient with isolated sphenoid sinus fungus ball within a mucocele presented with headache and periorbital pain were discussed with recent literature.

Protection of rat pancreatic islet function and viability by coculture with rat bone marrow-derived mesenchymal stem cells.

The maintenance of viable and functional islets is critical in successful pancreatic islet transplantation from cadaveric sources. During the isolation procedure, islets are exposed to a number of insults including ischemia, oxidative stress and cytokine injury that cause a reduction in the recovered viable islet mass. A novel approach was designed in which streptozotocin (STZ)-damaged rat pancreatic islets (rPIs) were indirectly cocultured with rat bone marrow-derived mesenchymal stem cells (rBM-MSCs) to maintain survival of the cultured rPIs. The results indicated that islets cocultured with rBM-MSCs secreted an increased level of insulin after 14 days, whereas non-cocultured islets gradually deteriorated and cell death occurred. The cocultivation of rBM-MSCs with islets and STZ-damaged islets showed the expression of IL6 and transforming growth factor-ß1 in the culture medium, besides the expression of the antiapoptotic genes (Mapkapk2, Tnip1 and Bcl3), implying the cytoprotective, anti-inflammatory and antiapoptotic effects of rBM-SCs through paracrine actions.

Listeria monocytogenes meningitis in two immunocompetent children.

Listeria monocytogenes is an uncommon cause of bacterial meningitis beyond the neonatal period. Patients with immunosuppression or neoplastic disease are at increased risk of developing serious invasive disease, particularly meningitis. L. monocytogenes meningitis in two previously healthy, immunocompetent children aged 7 years and 18 months is described. One of them was successfully treated with ampicillin and amikacin. In the other there was resistance to ampicillin, and meropenem, vancomycin and amikacin were given. One patient developed unilateral abducens paralysis and inappropriate antidiuretic hormone secretion. L. monocytogenes should be suspected in children with bacterial meningitis who fail to respond to empirical antibiotic therapy.

[Comparison of different primers used for the genotyping of Candida albicans clinical isolates by randomly amplified polymorphic DNA method]. / Candida albicans klinik izolatlarinin "randomly amplified polymorphic DNA" yöntemiyle genotiplendirmesinde kullanilan farkli primerlerin karsilastirilmasi.

Candida albicans causes severe infections with high mortality rates especially in immunocompromised patients. The aim of this study was to evaluate the efficiency of randomly amplified polymorphic DNA (RAPD) method and compare the discriminatory powers (DP) of different primers used for genotyping Candida albicans isolates. A total of 109 C. albicans strains recovered from throat, sputum, blood, feces, urine, vagina and wound cultures of 65 hospitalized paediatric patients with haematologic malignancy were evaluated by RAPD method using 10 different primers (OPE-03, OPE-04, OPE-12, OPE-18, OPE-19, OPE-20, OPF-10, OPF-12, P1 and P2) between June 1999-April 2003. Strains were separated into groups by analyzing band patterns derived from each primer and the DP was calculated. Reproducibility of the method was determined by evaluating randomly chosen 20 isolates with the same and different PCR devices under the same PCR conditions. C. albicans isolates generated 1-16 bands and were grouped in 41-80 genotypes depending on the primers used. DP of the RAPD method was calculated as > or = 0.90 for each primer (range between 0.90-0.99), which were accepted as reliable values. However, the strains clustered in the same group when studied with a primer could be dispersed into different groups by another primer. The reproducibility of the method was poor and the comparison of band patterns was difficult especially in isolates which generated many bands. In conclusion, for obtaining reliable results by RAPD method, using more than one primer and comparative analysis of these primers are appropriate. RAPD is an adequate method for studying small outbreaks in which a few number of isolates are evaluated, but it is laborious and unreliable for many number of isolates recovered in a long time period because of its poor reproducibility and difficulties in evaluating the strains generating many bands.

Frequencies of serum antibodies to Helicobacter pylori CagA and VacA in a Turkish population with various gastroduodenal diseases.

Infection with Helicobacter pylori (H. pylori) strains secreting cytotoxin-associated gene A (CagA) and vacuolating cytotoxin A (VacA) proteins is associated with more severe gastroduodenal pathologies. However, this association varies among geographical regions and ethnic groups. We investigated the frequencies of antibodies to CagA and VacA proteins in 131 H. pylori-infected dyspeptic patients [40 duodenal ulcer (DU), 19 gastric ulcer (GU), 28 gastric cancer (GC), and 44 non-ulcer dyspepsia (NUD)] across 30 H. pylori-infected and endoscopically normal asymptomatic subjects (AS). Anti-CagA and anti-VacA antibodies were detected by Western blotting. The positivity rates of anti-CagA and anti-VacA antibodies were higher in patients with DU (92.5 and 75%), GU (89.5 and 84.2%) and GC (96.4 and 85.7%) than patients with NUD (70.5 and 50%) and AS (50 and 23.3%) (p < 0.05). CagA+ VacA+ phenotype was more frequent in patients with DU, GU and GC than patients with NUD and AS (75, 84.2, 85.7 vs. 47.7 and 20%, respectively) (p < 0.01). Our results showed that there is a significantly positive association between the presence of anti-CagA and anti-VacA antibodies and DU, GU and GC in our region.

An investigation of the factors that affect surgical hand disinfection with polyvidone iodine.

This study investigated the factors influencing the effectiveness of 7.5% polyvidone iodine as a surgical antiseptic. The study involved 100 operating staff (75 doctors and 25 nurses) from hospital surgical teams. Fingertips of both hands of the subjects were pressed on to agar culture before and after washing and after completion of surgery. Handwashing lasting for more than 3 min led to a significant decrease in the number of colonies compared with handwashing lasting for less than 3 min. Moreover, the number of colonies was significantly higher when surgery lasted for longer than 95 min. However, the handwashing style (with or without brushing) was not found to have a significant effect on the outcome of the disinfection procedure in terms of bacterial colonization. Subjects who had colonization of their hands after surgery were found to have significantly higher colony counts before handwashing compared with those who did not have any colonization on their hands after surgery. The results of this study revealed that in order to attain effective disinfection with polyvidone iodine, the duration of handwashing should be at least 3 min. The risk of recolonization increases when the duration of surgery exceeds 95 min.

Bilateral complete avulsion of ocular globes in a Le Fort III maxillofacial fracture: a case report and review of the literature.

PURPOSE: The purpose of this paper is to demonstrate a case of bilateral complete avulsion of the globes following maxillofacial trauma. METHODS: A 23-year-old man with bilateral complete globe avulsion following a maxillofacial trauma. Both globes were luxated out of the orbit and suspended on the skin of the upper lid below the brows. No direct or indirect light reflexes or any eye movements could be noted. Computerized tomography showed complete lacerations of both optic nerves at a level just anterior to the optic canal. There were also multiple fractures corresponding to Le Fort III fracture with Le Fort II components. The brain parenchyma was normal with an exception of brain edema. As the globes were unsuitable for repositioning, both were enucleated. The maxillofacial fractures were immobilized with plates and screws. Although the patient gained consciousness with normal vital signs in the early postoperative period, he died on the ninth day due to Pseudomonas aeruginosa infection, despite invasive antibiotic treatment. DISCUSSION: The optic nerve and the globes are very resistant to mild and moderate trauma. The avulsion of the nerve at the canalicular or more posterior level may demonstrate central nervous system complications resulting in life-threatening conditions. The most critical issue in complete globe avulsions with a transected optic nerve is to rescue the vision. In total transected optic nerves the final eyes could only have had cosmetic benefits. In spite of promising experimental research on optic nerve regeneration, there are unknowns, such as the methods to eliminate the risk of anterior segment ischemia and phthisis bulbi. CONCLUSIONS: Globe avulsions with a complete optic nerve cut remain a challenging problem. More research is required to better understand the pathophysiology of optic nerve repair.

A late onset carotido-jugular fistula following shotgun injury.

The incidence of arteriovenous fistulae (AVF) is quite rare in the head and neck region comprising less than 4% of all the traumatic AVF encountered elsewhere in the body. A 42-year-old man presented with a palpable thrill in the cervical region and headache. He had a shotgun injury 10 years ago and had no problem until the previous three months. Diagnosis of a high output traumatic AVF between right common carotid artery and internal jugular vein was made arteriographically. Presence of a neighbouring traumatic aneurysm on the common carotid artery and 9 mm diameter of the fistula tractus suggested open surgery. At the operation ligation of the tractus and aneurysmorraphy was performed and the patient was discharged in the third postoperative day. He has still no problem. This case documented that a shotgun injury even 10 years later may result with an AVF.

Effect of CO(2) insufflation on bacteremia and bacterial translocation in an animal model of peritonitis.

BACKGROUND: The widespread adoption of the laparoscopic approach has created some concern over the potential for increased risk of bacteremia and sepsis due to increased intraabdominal pressure in patients with intraabdominal infection and peritonitis. This study examines the effect of the CO(2) pneumoperitoneum on bacteremia and bacterial translocation. METHODS: New Zealand white rabbits were assigned into three groups of 10 animals. In group 1, 100 ml of sterile saline was infused into the peritoneal cavity under 10 mmHg CO(2) insufflation for 1 h. Group 2 received 100 ml of saline containing 10(9) CFU/ml (colony-forming units) E. coli strain 0163 and 10 mmHg CO(2) insufflation for 1 h. Group 3 received an identical bacterial inoculum, followed by a 10-cm midline laparotomy. Blood samples were taken for culture by cardiac puncture at various intervals during the experiment. At 6 h after being subjected to the experimental procedures, the rabbits were killed and their organs were cultured quantitatively for translocating bacteria. RESULTS: In group 1, neither blood nor organ cultures were positive, whereas in group 2 all blood cultures became positive in 1 h, and intraperitoneally infused bacteria translocated to the lung and kidney in all rabbits. In group 3, blood cultures became positive in 1 h, all but two of the rabbits had translocated bacteria in their lungs, and kidney samples from two of the rabbits were culture-positive. CONCLUSIONS: Our results indicate that both CO(2) pneumoperitoneum and laparotomy increase the incidence of bacterial translocation from the peritoneal cavity into the bloodstream. Thus, the risk of translocation to extraperitoneal organs such as lung and kidney is increased significantly by laparoscopy. Therefore, laparoscopic surgery should be avoided or used cautiously in the setting of acute peritonitis.