An effective approach for the treatment of severe punctal stenosis: Bicanalicular silicone tube intubation with pigtail probe.

PURPOSE: To evaluate the results of using a pigtail probe to open the inferior punctum followed by bicanalicular silicone tube intubation in patients with severe acquired punctal stenosis. METHODS: Forty-one eyes of 25 patients with severe inferior punctal stenosis admitted to our tertiary care center were included in the study. The degree of epiphora was determined using the Munk score and the fluorescein disappearance test. The inferior punctum was located and opened by entering the superior punctum with a pigtail probe. Then, bicanalicular silicone tube intubation was performed. The silicone tube was removed after six months. A Munk score of 0 or 1 and a fluorescein disappearance test score of 1 and 2 were considered a complete success. RESULTS: Ten (40%) patients were male, and 15 (60%) were female. The mean age was 60.4±15.5years. One year after the surgery, epiphora was absent in 18 eyes (43.9%) (Munk score grade 0) and rarely seen in 9 eyes (22%) (Munk score grade 1). At the one-year follow-up, the fluorescein disappearance test score was stage 1 (<3min) in 21 eyes (51.2%) and stage 2 (3-5min) in 13 eyes (31.7%). There was a statistically significant difference between the preoperative and one-year postoperative test results (P<0.001). CONCLUSION: In cases with severe punctal stenosis, a pigtail probe is an effective method for locating and opening the punctum, and punctal opening and prevention of restenosis were achieved by a bicanalicular stent.

Assessment of the relationship between monocyte to high-density lipoprotein ratio and subclavian artery stenosis.

OBJECTIVE: Assessment of the monocyte-to-high-density lipoprotein ratio (MHR) is a new tool for predicting inflammation, which plays a major role in atherosclerosis. Subclavian artery stenosis (SAS) is usually asymptomatic, and atherosclerosis is the most common cause of chronic obstruction of the subclavian artery in adults. The aim of this study was to determine the relationship between the MHR and SAS. PATIENTS AND METHODS: Between January 2015 and January 2020, 43 patients with SAS and 43 patients without SAS were enrolled in the study. The patients' angiographic, demographic and clinic characteristics were reviewed from their medical records. Monocytes and HDL (high-density lipoprotein) cholesterols were measured through a complete blood count. The MHR was calculated as the ratio of the absolute monocyte count to the HDL cholesterol value. The resulting MHR values were divided into the following three groups: low (7.16 ± 1.59), moderate (11.08 ± 1.53) and high (21.70 ± 5.62). A p-value of less than 0.05 was considered significant. RESULTS: MHR was found to be significantly higher in the SAS group compared to the control group with normal subclavian arteries (p<0.001). The frequency of SAS was found to increase with an increase in the MHR tertiles. Sensitivity and specificity values were 69.8% and 95.3%, respectively. The cut-off of the MHR value, taken as 13.39, was found to provide a significantly accurate prediction of the subclavian diagnosis (ROC area under the curve: 0.868, 95% CI: 0.789-0.947, p<0.001). After adjusting for other hematological parameters in the multivariate analysis, MHR (p=0.061) was found to be a predictor of the presence of SAS. CONCLUSIONS: This study showed that MHR can be a convenient marker for predicting SAS because of the correlation between MHR and SAS.

Does combined usage of FFP2 and Surgical mask against SARS-CoV-2 affect SpO2 values and pulse rates of dental health-care workers?

Background and Aim: Combined use of surgical mask with filtering facepiece (FFP) 2 masks has been popular among the health-care workers. However, the effect of this preference on the vital values of individuals stays as a challenge among the professionals. The present study aimed to assess the effect of FFP2 mask versus combined use of it with surgical mask on the SpO2 values and pulse rates of individuals. Patients and Methods: This study was conducted on 20 health-care workers. The pulse rates and SpO2 values were evaluated by pulse oximeter placed in the index fingers of the participants. The participants were divided into two groups: those using the FFP2 mask and those using FFP2-surgical mask combination. Individuals wearing FFP2 mask were examined for a period of 60 min and the same examination was repeated for another period of 60 min in those using combination of FFP2 with surgical mask. The values were measured at the beginning and at 15, 30, 45, and 60 min intervals, respectively. The examinations were conducted in the rest position to obtain standardization. Results: The observed data showed no statistical difference at all periods in either SpO2 values or pulse rates between FFP2 and FFP2-surgical mask combined groups. The SpO2 values reduced from the initial time to 15 min in the FFP2-surgical mask group. Also, in the FFP2-SM group, statistically significant increase in values was observed between 15 and 45 min and 15 and 60 min. Another increase in SpO2 value was found in the observations made between made 30 and 45 min in the same group (P < 0.05). The pulse rates of the individuals showed no statistical difference in both the groups and at all experimental periods (P > 0.05). Conclusion: According to the present study, wearing only the FFP2 mask or FFP2-surgical mask combination seems not to cause any effect on the SpO2 values and pulse rates of the participants.

Boron-incorporated biocomposite coatings on 316L and NiTi alloys: Enhanced structural, antibacterial activity, and cell viability performances.

Boron doped (5 %, 10%, and 15 wt.%) Hydroxyapatite (B-HA) biocomposites were syntesized and coated on 316L SS and NiTi (Ni-45Ti) metallic substrates by using the electrophoretic deposition process (EPD). The morphological and structural characterization of the coatings was executed using scanning electron microscopy (SEM) and X-ray diffraction devices (XRD). Antibacterial tests were conducted using Escherichia coli (E. coli, JM103) and Staphylococcus aureus (S. aureus, ATCC29293) microorganisms. The mitochondrial activity assay (MTT)-[3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] was used to examine cell viability and cytotoxicity in Saos-2 osteoblast cells. HA and boron peaks, as well as B-TCP and metallic components, were detected in XRD examinations. Porous morphologies were generated on the surface with boron doped B-HA coatings, as revealed by SEM views. Antibacterial activity studies revealed that both metallic coating groups, notably with boron doping, demonstrated antibacterial activity against gram-negative E. coli and gram-positive S. aureus. The antibacterial activity of the 316L group was shown to be better than that of the NiTi group in comparisonal testing. The syntesized boron-doped biocomposite coatings did not have any detrimental effects on living cells, according to cell viability studies. The cell viability rate was found to be greater in NiTi coatings than in 316 SS coatings, and the impact was amplified by the addition of boron.

The association between coronaphobia and attitude towards COVID-19 Vaccine: A sample in the east of Turkey.

PURPOSE: This study was conducted to examine the association between coronaphobia and attitude towards COVID-19 vaccine in the society. METHODS: This cross-sectional descriptive study was conducted with snowball sampling method between December 30, 2020 and January 10, 2021. The survey form was sent online to individuals who were 18 years of age and older. 1252 individuals who responded to the surveys were included in the study. The data were collected by using "Descriptive Information Form", "Attitudes towards the Covid-19 vaccine scale" and "Coronavirus 19 Phobia Scale (CP19-S)". Descriptive statistics and Pearson Correlation analysis were used in the evaluation of data. RESULTS: In the study, it was found that the participants had a mean ATV-COVID-19 scale positive attitude sub-dimension score of 2.81±1.04, while they had a mean negative attitude sub-dimension score of 2.95±0.78 and a mean total score of 2.89±0.78. It was found that the participants had a mean C19P-S psychological sub-dimension score of 21.03±5.36, a mean psychosomatic sub-dimension score of 10.30±4.11, a mean social sub-dimension score of 15.04±4.71, a mean economic sub-dimension score of 8.89±3.46 and a mean total scale score of 55.28±15.00. It was found in the study that there was a positive association between the participants' C19P-S and social sub-dimension and ATV-COVID-19 and positive attitude sub-dimension, while there was a negative association between ATV-COVID-19 and negative attitude sub-dimension (p<0.05). CONCLUSIONS: It was found that the participants had a moderate level of coronavirus phobia and positive attitudes towards the vaccine. It was found that positive attitudes towards COVID-19 vaccine increased as the coronavirus phobia increased.

The Effect of Pre-emptive Dexketoprofen Administration on Postoperative Pain Management in Patients with Ultrasound Guided Interscalene Block in Arthroscopic Shoulder Surgery.

Background: Postoperative pain is an important problem for patients undergoing shoulder surgery. Our study investigated analgesic efficacy, duration of analgesia, postoperative analgesic use and patient satisfaction with the use of preemptive intravenous dexketoprofen for interscalene block in addition to general anesthesia in arthroscopic shoulder surgery. Methods: 60 patients, scheduled for arthroscopic shoulder surgery were randomized (30 patients each) into either: - control group (Group1) or dexketoprofen group (Group 2). Patients were followed for 48 hours to compare both groups for; post-operative pain scores, effectiveness of postoperative analgesia, duration of analgesia, and analgesia consumption. Duration of postoperative sensory block of the shoulder joint was defined as time to onset of pain at the incision site. Duration of postoperative motor block of the shoulder joint was defined as time to onset of first shoulder movement. Results: While no significant difference was determined for motor block time, sensory block time was significantly longer in the dexketoprofen group (p < 0.05).VAS scores were significantly lower at all times in the dexketoprofen group (p < 0.05).Total PCA fentanyl consumption was 274.16 ± 314.89 (µg) in the dexketoprofen group, and 490.00 ± 408.98 (µg) in the control group, the difference was statistically significant (p < 0.05). No significant difference was observed between the groups' demographic and hemodynamic data. Conclusion: Pre-emptive IV dexketoprofen may be a good option for arthroscopic shoulder surgery and provides effective analgesia.

Dynamic thiol/disulphide homeostasis in patients with hypertrophic cardiomyopathy.

BACKGROUND: In addition to the genetic complexity of hypertrophic cardiomyopathy (HCM), there must be other disease-modifying factors that contribute to its highly variable clinical and phenotypic expression. The authors aimed to investigate serum thiol/disulphide homeostasis as a proxy for oxidative stress using a novel automated assay in patients with HCM. METHODS: This cross-sectional study was conducted on 119 patients with HCM and 52 without HCM. The methods used to measure dynamic thiol/disulphide homeostasis as calorimetric and duplex quantities were developed in 2014. RESULTS: Median serum native thiol levels were significantly lower in patients with HCM than in those without (312.5 µmol/L [285-370 µmol/L] vs 421 µmol/L [349-469.5 µmol/L]; p < 0.001). Serum total thiol levels and disulphide levels were considerably lower than those in the control group ([844.68 ± 195.99 µmol/L vs 1158.92 ± 243.97 µmol/L; p < 0.001], [259.13 ± 65.66 µmol/L vs 375.02 ± 79.99 µmol/L; p < 0.001], respectively). Serum disulphide/native thiol ratios and disulphide/total thiol ratios were significantly lower in HCM patients than in controls (0.80 ± 0.09 vs 0.92 ± 0.05; p < 0.001 and 0.31 [0.30-0.32] vs 0.32 [0.32-0.33]; p < 0.001). Finally, reduced thiol ratios were higher and oxidized thiol ratios were significantly lower in patients with HCM than in controls. CONCLUSIONS: Despite the fact that antioxidant capacity was impaired, the extracellular environment remained in a reducing state by keeping serum disulphide/native thiol ratios low. Therefore, the authors speculate that HCM may behave similarly to tumours with respect to serum thiol-disulphide levels.

Efficacy of diclofenac & thiocolchioside gel phonophoresis comparison with ultrasound therapy on acute low back pain; a prospective, double-blind, randomized clinical study.

PURPOSE: To investigate the effect of Phonophoresis (PP) with the combination of nonsteroidal anti-inflammatory drugs (NSAID's) and myorelaxant versus routine Ultrasound (US) treatment with non-therapeutic gel on the patients with acute low back pain (ABP). METHODS: Sixty patients with ABP were randomly assigned into 2 groups. In Group 1 (n = 30) US was applied using diclofenac + Thiocolchicoside gel for 10 min and for a total of 10 sessions. In Group 2 (n = 30) the same US protocol was applied with the same setting and timing with Group 1 using US gel that does not contain any pharmaceutical ingredient. Evaluation parameters were Visual numeric scale (VNS), Oswestry Disability Index (ODI), and Shober test. RESULTS: Comparison of the results obtained from the two groups before treatment and at second (W2) and sixth weeks (W6) posttreatment showed significant improvement in all parameters in both groups (p < 0.05). Comparison of the groups showed significantly superior improvement in Group 1 for ODI while there was no difference in other parameters at W2. At W6, there was significantly superior improvement in all parameters (p < 0.05) except for Shober test in Group1. CONCLUSION: Our results showed that PP treatment is superior than conventional US therapy at short term in ABP patients.

TP53 polymorphisms in smokers' and nonsmokers' pericoronal follicles of asymptomatic impacted third molars.

BACKGROUND AND PURPOSE: The investigators designed and implemented a prospective cohort study composed of smoking and nonsmoking patients with asymptomatic fully impacted mandibular third molars. The objective of the paper was to evaluate 21 single-nucleotide polymorphisms (SNP) on the TP53 gene in smokers' (S) and nonsmokers' (NS) pericoronal follicles of asymptomatic impacted third molars. MATERIALS AND METHODS: Matrix-assisted desorption/ionization time of the flight mass spectrometry was used for SNP analysis of 21 regions in the TP53 gene. Descriptive statistics and Chi-square tests were computed with a P value of 0.05. RESULTS: : Ten of the 21 SNPs related to oral pathologies according to NCBI dbSNP, were detected; in these, the genotypic frequencies showed no differences between the S and NS groups (P > 0.05). The results showed a high ratio of SNPs without correlation between smoking and TP53 gene status. CONCLUSION: Further studies should examine the entire TP53 gene to elucidate how smoking affects it in larger study populations.

The effectiveness of the low-power laser and kinesiotaping in the treatment of carpal tunnel syndrome, a pilot study.

In mild and moderate cases of carpal tunnel syndrome (CTS), the conservative approach is suggested. The purpose of this study is to assess and compare the effect of low-power laser versus the combination of low-power laser and kinesiotaping on pain, muscle strength, functionality, and electrophysiologic parameters in the patients with CTS. The study was planned as single-blind, prospective, randomized control. 64 hands diagnosed with CTS were included in the study. The patients were randomly divided into three groups by closed envelope method. Low-power laser therapy was applied to Group 1 (21 hands), kinesiotaping and low-power laser therapy in group 2 (22 hands), sham laser therapy in Group 3 (21 hands). All patients were assessed by visual numeric pain scale (VNS), hand grip strength (HGS), finger pinch strength (FPS), the Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ), before treatment, after treatment (3rd week), and after (12th week) 3 months the treatment with the same physician. Motor and sensory nerve conduction studies were performed with electroneuromyography (ENMG) before the treatment (0th week) and at the end of the 12th week. Comparison of the group 1 with the group 3 showed significantly better improvement in the former in VNS, BCTSQ at 3rd week and 12th week compared to 0th week, and in FPS and HGS at 3rd week. Comparison of the group 2 with the group 3 showed significantly better improvement in the former VNS, BCTSQ, FPS and HGS at 3rd and 12th week compared to 0th week. When Group 1 and Group 2 were compared there was no statistically significant difference in any parameters in the 3rd week, but there was a statistically significant difference in favor of group 2 in FPS and HGS parameters at the 12th week. We have found that the kinesiotaping method applied with low-power laser treatment does not provide any additional benefit to the low-power laser treatment in the short term, however, in the long term, the increase in the HGS and FPS has occurred. In conclusion, low-power laser and kinesiotaping method in the treatment of CTS may be an effective and reliable treatment option in clinical parameters.

Antimicrobial activity of chitosan and a chitosan oligomer against bacterial pathogens of warmwater fish.

AIM: The antibacterial activities of chitosan (CS) and its derivative chitosan oligosaccharide lactate (COL) were evaluated against Aeromonas hydrophila, Edwardsiella ictaluri and Flavobacterium columnare, three highly pathogenic bacteria of warmwater finfish. METHODS AND RESULTS: The magnitude and mode of antimicrobial action on Gram-negative bacterial pathogens was investigated with an emphasis on examining the inhibition of bacterial growth and the weakening of barrier functions. Both CS and COL exhibited antibacterial activity against all three bacteria tested and their activity was dose-dependent. CS and COL completely inhibited growth of A. hydrophila at 0·8% and E. ictaluri and F. columnare at 0·4% or higher concentrations. COL was more effective in killing or inhibiting the growth of all bacteria tested. CS and COL molecules have the ability to interact with bacterial surfaces via adsorption. This was confirmed by initial decreases in the conductivity of CS or COL treated bacterial cell solutions. A marked re-increase in conductivity from 18 to 48 h was documented, which was due to the leakage of cellular ions into the solution through damaged bacterial cell membranes. CONCLUSION: Both CS and COL exhibited antibacterial activity against all three bacterial species through a sequential process beginning with adsorption to bacterial surfaces culminating in the leakage of intracellular constituents and cell death. SIGNIFICANCE AND IMPACT OF THE STUDY: These findings indicate that CS-based strategies are promising candidates for exploration as alternatives to antibiotics for mitigating disease outbreaks in cultured fish.

Multidisciplinary assessment of congenital insensitivity to pain syndrome.

BACKGROUND: Congenital insensitivity to pain and anhidrosis (CIPA) is a rare clinical condition characterized by the absence of normal subjective and objective responses to noxious stimuli in patients with intact central and peripheral nervous systems. CASE PRESENTATIONS: Two patients with CIPA are reported. The first patient was a 13-year-old girl who presented to our hospital with multiple joint destructions secondary to osteomyelitis. The second patient was a 10-year-old boy who presented with multiple hand lesions and right leg osteomyelitis. Our patients were treated with multiple debridements and intravenous antibiotics according to our hospital protocol. CONCLUSION: Early recognition of the disease is important. The treatment for this condition is focused more on the prevention of bone injuries and joint infection, as opposed to a cure. There are no standard techniques or guidelines available to treat this rare disease. Overall, effective CIPA treatment is built around family education and patient training.

The effect of colloid preload versus prophylactic ephedrine administration on QTc intervals during cesarean delivery: A randomized controlled study.

AIM: We aimed to investigate the effect of colloid infusion immediately before the spinal anesthesia, and the prophylactic intravenous (IV) infusion of ephedrine after injection of intrathecal bupivacaine on hemodynamic parameters, QT, The QT interval corrected for heart rate (QTc), and dispersion of QTc (QTcDisp) intervals in women undergoing the elective cesarean section. MATERIALS AND METHODS: Sixty women scheduled for elective cesarean delivery with spinal anesthesia were allocated randomly to receive either IV fluid preloading with 0.5 L of 6% w/v hydroxyethyl starch solution immediately before the spinal anesthesia (colloid group, n = 30) or prophylactic IV infusion of 15 mg ephedrine (diluted with 10 ml saline, n = 30) over 1-min period after the injection of intrathecal bupivacaine (ephedrine group). Electrocardiography (ECG) tracings were recorded before anesthesia procedure at baseline (T0), 5 min (T1), 10 min (T2), 30 min (T3), 60 min (T4), and 120 min (T5) after the spinal anesthesia. Systolic blood pressure, diastolic blood pressure, mean arterial pressure (MAP), heart rate (HR), and peripheral oxygen saturation (SpO2) values were also recorded at the same time intervals. RESULTS: There were no significant differences between groups with respect to MAP, HR, SpO2, QT, and QTc intervals at any time points (P > 0.05). When compared with the colloid group, the QTcDisp interval at T1was significantly longer in the ephedrine group (P < 0.05). CONCLUSION: Both methods have similar effects on the ECG and hemodynamic parameters during cesarean section. So, both methods may be used in patients undergoing elective cesarean delivery under spinal anesthesia.

HELLP syndrome is still a serious, life-threatening complication of pregnancy: admission of 34 women to an eastern Turkish intensive care unit.

OBJECTIVE: The transfer of the obstetric patient to the intensive care unit is considered as an indicator of maternal morbidity. The most important two indications for admittance of the obstetric patient to the intensive care unit are postpartum hemorrhage and hypertensive disorders. The purpose of this study was to determine maternal morbidity and mortality rates in patients diagnosed with hemolysis, elevated liver enzyme levels, and low platelet count (HELLP) syndrome who required intensive care. MATERIALS AND METHODS: The charts of 34 patients who were diagnosed with HELLP syndrome and treated in intensive care unit between the years 2005 - 2013 were evaluated retrospectively. RESULTS: During the study period, a total of 151 patients were diagnosed with HELLP syndrome and 34 patients were admitted to the intensive care unit. Mean age of the patients was 28.97 ± 7.26 years and there was no significant difference be- tween survivors and non-survivors (p = 0.442). There were no significant differences between survivors and non-survivors in terms of gestational age, parity, and multiparity rates (p > 0.05). There was 31.2% mortal cases and 77.8% of living cases had received regular antenatal follow-up and the difference was statistically significant (p = 0.006). 30 patients (88.2%) required invasive mechanical ven- tilation. The average Glasgow Coma Score (GCS) of patients was 6.47 ± 4.34. There were significant differences between patients who lived and who died in terms of Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA) score, and duration of invasive mechanical ventilation (p < 0.05). Twenty-two patients (64.7%) required transfusion of blood and blood products. Maternal mortality occurred in 16 patients (47%). The causes of death were: intracerebral hemorrhage in six cases, acute respiratory distress syndrome (ARDS) in three cases, disseminated intravascular coagulation (DIC) in three\cases, sepsis/multi- ple organ dysfunction syndrome (MODS) in two cases, hepatic rupture in one case, and massive pulmonary embolism in one case. Con- clusion: HELLP syndrome is still one of the most serious and life-threatening complications of pregnancy. Mortality rate can be reduced by regular antenatal follow-up and transfer of pregnant women who carry risk to the intensive care unit without delay.

Jugular Venous Catheterization: A Case of Knotting.

A 79-year-old woman, diagnosed for cancer of the ovary, had a central catheter that was placed with difficulty through the right internal jugular vein intraoperatively. After oophorectomy, it was realized that the catheter was knotted. Thus, the central venous catheter was removed successfully using a traction technique in the operating room. Central venous catheter use may result in various complications, although it has been used as an invasive method for hemodynamic monitoring and fluid and drug infusion. Here, we present catheter knotting in a case with solutions for this complication, under literature review.

Anesthetic Management in Children with Congenital Lobar Emphysema.

BACKGROUND: The cause of congenital lobar emphysema (CLE) is unknown and characterized by hyperinflation of one or more lobes of the lung. The purpose of this retrospective study was to present the anesthetic management of children with congenital lobar emphysema (CLE) receiving treatment in our center. METHODS: Ten children underwent CLE-related surgical treatment in our center between March 1995 and August 2014. All cases were diagnosed on the basis of postero-anterior chest radiography and computerized tomography. Age, sex, preoperative clinical findings, location of lesions, surgical and anesthetic procedures, results of anesthesia and duration of hospitalization were evaluated. RESULTS: Six patients were male (60%) and four female (40%). Their ages ranged from 40 days to 6 years. Dyspnea was present in all cases and severe in four of them. Four patients had emphysema in the left upper lobe, three in the right middle lobe, one in the right upper lobe and one in the left lower lobe. All patients were extubated in the operating room and none experienced post-operative respiratory distress. Post-operative analgesia was provided via the previously placed intrapleural catheter. All the patients were extubated in the operation room. There was no post-operative mortality or morbidity. CONCLUSIONS: Anesthetic management of patients with CLE is challenging. In these patients the surgical team and -anesthetists should collaborate closely and the time between anesthesia induction and thoracotomy should be as short as possible.

Investigation of Metallo Beta Lactamases and Oxacilinases in Carbapenem Resistant Acinetobacter baumannii Strains Isolated from Inpatients.

BACKGROUND: Resistance to beta-lactam antibiotics is widespread among Acinetobacter strains. Plasmid-mediated metallo beta lactamases (MBL) are responsible for carbapenem resistance, as are oxacillinases (OXA). In recent years, MBL producing carbapenem-resistant strains have been reported in the world and in Turkey in increasing rates. In our country, besides the OXA 51-like enzyme which is inherent in A. baumannii strains, OXA 58-like and OXA 23-like carbapenemases producing strains have also been widely detected. In addition, Verona Imipenemase (VIM) and (IMP)-type MBL have been reported in some centers. AIMS: The aim of our study was to investigate the presence of carbapenemases in Acinetobacter strains isolated from hospitalized patients in Edirne. STUDY DESIGN: Cross-sectional study. METHODS: A total of 52 imipenem-resistant A. baumannii strains isolated between January and March 2013 were investigated. The presence of MBL was described phenotypically by the combined disk diffusion test (CDDT), double disk synergy test (DDST), MBL E-test (only performed in 28 strains) and modified Hodge test. blaIMP, blaVIM, blaGIM, blaSIM, blaSPM genes and blaOXA-23, blaOXA-51, blaOXA-40, blaOXA-58 genes were investigated by multiplex polymerase chain reaction (PCR). The blaNDM-1 gene was determined by PCR. RESULTS: By modified Hodge test, 50 strains (96%) were found to be MBL positive. Positivity of MBL was 21% by both CDDT (0.1 M EDTA) and DDST. Twenty-four of 28 strains (85.7%) were positive by MBL E-test. OXA 23-like and OXA 51-like carbapenemases were detected in all strains, but OXA 58-like and OXA 40-like carbapenemases-producing A. baumannii were not detected. Also, MBL genes were not detected by genotypic methods. CONCLUSION: Only OXA 23-like carbapenemase was responsible for carbapenem resistance in carbapenem-resistant Acinetobacter strains in Edirne. The MBL-producing Acinetobacter strain is not yet a problem in our hospital. MBL resistance was found by phenotyping tests, which must be confirmed by genotypic methods; multiplex PCR tests can be easily used for screening MBL.

Trehalose enhances osmotic tolerance and suppresses lysophosphatidylcholine-induced acrosome reaction in ram spermatozoon.

This study was aimed to investigate the influence of trehalose on osmotic tolerance and the ability of ram spermatozoon to undergo acrosome reaction induced by lysophosphatidylcholine (LPC). In experiment 1, the diluted ejaculates were exposed to anisosmotic fructose solutions (70, 500, 750 and 1000 mOsm l(-1) ) with or without 50 mm trehalose. The presence of trehalose in hyperosmotic conditions enhanced (P < 0.05) the percentage of live, live-intact and intact spermatozoa. Similarly, trehalose enhanced (P < 0.05) the live and live-intact spermatozoa during hypo-osmotic conditions. In experiment 2, the centrifuged ejaculates were diluted with TCG only or TCG containing either 50 or 100 mm trehalose. The acrosome reaction was induced by LPC. The percentage of acrosome-reacted spermatozoon was less (P < 0.05) in trehalose-supplemented groups compared to control. In experiment 3, the ejaculates were cryopreserved in an extender containing 0 mm (control), 50 mm or 100 mm trehalose. Supplementation of extender with trehalose, either 50 mm or 100 mm, enhanced the cryosurvival rate (P < 0.05) compared to the control. In conclusion, the presence of trehalose in anisosmotic conditions enhances the osmotic tolerance, cryosurvival rate of ram spermatozoon and suppresses their ability to undergo LPC and cryo-induced acrosome reaction.