Effect of dietary celery (Apium graveolens) on the growth performance, immune responses, and bacterial resistance against Vibrio anguillarum of European seabass (Dicentrarchus labrax).

In this study, we evaluated to reveal the effects of aqueous methanolic extract of celery (Apium graveolens) on the growth performance, immune responses, and resistance against Vibrio anguillarum in European seabass (Dicentrarchus labrax). For this purpose, twenty fish (initial mean weight of 4.80 ± 0.06 g) were placed into twelve tanks (400 L) in triplicate and fish were fed with control (C) and three different levels (0.01, 0.05, and 0.1 g/kg) of A. graveolens (AG) extract-containing diets (AG0.01, AG0.05, and AG0.1) for 30 days. Blood and tissue (kidney, spleen, and intestine) samples were taken from the fish every 10 days during the study to determine the immune responses of the fish. Respiratory burst activity (RBA) was significantly decreased in the AG0.1 group compared to all other groups on the 10th day of the study (P < 0.05). Significance was noticed in the RBA of fish in all AG groups compared to the C group (P < 0.05) on the 30th day of the experiment Lysozyme activity (LYS) was raised on the 10th day of the study in all celery groups compared to the C group (P < 0.05). No differences in the myeloperoxidase activity (MPO) were observed among the experimental groups (P > 0.05). The final mean weight (FMW) was not affected in any experimental groups (P > 0.05). However, in the AG0.05 group, the specific growth rate (SGR) increased, and the feed conversion ratio (FCR) decreased compared to other groups (P < 0.05). IL-1ß in the kidney was highly elevated in the AG0.01 group on the 20th day of the study (P < 0.05). Similar results were observed on IL-6, IL-8, and TNF-α expression in the kidney (P < 0.05). Anti-inflammatory responses (IL-10 and TGF-ß) also increased in all experimental groups and tissues compared to the C group (P < 0.05). COX-2 was upregulated on the 20th day of the study in all tissues (P < 0.05). At the end of the feeding trial, the survival rate of the AG0.1 group in fish infected with Vibrio anguillarum infection was higher than the C group. Dietary celery extract did not affect growth performance directly but increased innate immune responses and a high survival rate. Overall, compared to the control group, the growth, immunity, and resistance of European seabass fed with a diet containing 0.05 g/kg celery aqueous methanolic extract has been improved, and this could be used as an immunostimulant feed additive.

Effects of dietary marine sulphated polysaccharides (Algimun®) on growth performance, immune responses and disease resistance of juvenile gilthead seabream (Sparus aurata) to Photobacterium damselae subsp. piscicida.

The present study evaluated the effects of a dietary mix of marine sulphated polysaccharides, named Algimun® (AL), supplementation to gilthead seabream (Sparus aurata) juveniles in terms of growth performance, immune responses, and resistance against Photobacterium damselae subsp. piscicida. A total of 240 fish (initial mean weight of 6.00 ± 0.03 g) was randomly separated into 12 tanks (400 L, 20 fish per tank) distributed in four replicates. Fish were fed three experimental diets: a basal diet (Control), and a basal diet with two inclusion rates of Algimun® as 3 g/kg (AL0.3) and 5 g/kg (AL0.5) for 30 days before bacterial infection with P. damselae subsp. piscicida. After a 30-day feeding-period, growth performance was significantly improved in AL0.3 and AL0.5 groups compared to the control group (P < 0.05). AL0.3 and AL0.5 groups showed significantly higher lysozyme activity and myeloperoxidase activity when compared to the control group (P < 0.05). The gene expression of immune mediators (IL-1ß, IL-6, IL-10, IL-18, TNF-α and COX-2) was significantly upregulated in the intestine, spleen and head kidney in AL0.3 and AL0.5 groups when compared to the control group (P < 0.05). Eight days post-challenge, the survival rate against P. damselae subsp. piscicida was numerically higher in fish within AL0.3 and AL0.5 groups compared to control (+20%). The study findings suggest that marine sulphated polysaccharides (Algimun®) could be used as an immunomodulator in gilthead seabream to support animal's health and boost resistance in case of disease outbreak.

[Plasmodium ovale malaria and molecular diagnosis: Could it be a relapse?] / Plasmodium ovale sitmasi ve moleküler tanisi: relaps olabilir mi?

Malaria caused by Plasmodium species continues to affect the half of the world population. According to the World Health Organization 2017 data, 445.000 cases of malaria and 219 million cases of new clinical malaria cases were reported during the year. African continent is the geographical region where the disease is most frequent. In recent years there has been an increase in the number of imported cases after travels to this continent. In this case report, relaps caused by Plasmodium ovale in a male Republic of Turkey citizen patient who has travelled to Uganda only and no other place a year and half ago was presented. Thin blood smear was prepared from the peripheral blood of the patient who admitted to our hospital with complaints of fever and chills. The smear was stained with Giemsa and examined with a x100 objective microscope and trophozoites belonging to Plasmodium genus were detected. Considering the size and locality of the trophozoites in the erythrocytes, it is thought that the parasite may be Plasmodium vivax. Nested PCR method was used for the species identification. Nested PCR studies were performed using Plasmodium genus and specific primers for P.vivax, Plasmodium falciparum, P.ovale and Plasmodium malariae. Nested PCR products were run on gel and P.ovale was visualized in 787 bp region. P.vivax, P.malariae, P.falciparum, P.ovale and Plasmodium knowlesi species specific primers and probe-based quantitative real-time PCR (qRt-PCR) study revealed that the patient was infected with P.ovale. The patient had no history of chronic illness but had a history of recovered malaria 7-8 years ago. The patient did not have any complaints other than these complaints. CMV IgM and IgG and Brucella aglutinisation tests were negative. It is clear that relapse cases can also be seen when P.ovale species are in hypnozoite stage in the liver. Although there are 18 reported cases of relapse in the last century, these phenomena do not provide sufficient evidence for the theory of relapse. A true relapse is thought to be mild symptoms and even subclinical disease. It is also known that it is difficult to distinguish a true recurrence in cases of relapses that can occur after a long time from primer infection. The best way to overcome this difficulty is to assume being in a malaria endemic area or not between primary infection and recurrence. We think that the applications that are carried out together with the microscope and molecular studies, especially in cases where there is relapses in which low parasitemia or travel story are insufficient, are extremely important both in terms of diagnosis and accurate identification of species and in the selection of treatment.

[Retrospective evaluation of serologic and molecular test results of toxoplasmosis suspected patients]. / Toxoplasmosis süpheli hastalara ait serolojik ve moleküler test sonuçlarinin retrospektif dlarak degerlendirilmesi.

Toxoplasma gondii is a compulsory intracellular protozoan parasite with a wide range of host in warm-blooded vertebrates and has importance in terms of health and economy. Toxoplasmosis is very common because it can infect people with a variety of ways; ingestion of contaminated water and nutrients; raw or undercooked meats containing tissue cysts, blood transfusions, organ transplantantation and transplacental transfer. The aim of this study was to evaluate serologic and molecular test results of toxoplasmosis pre-diagnosed patients. Anti-T.gondii-IgG, anti-T.gondii-IgM ELISA, anti-T.gondii-IgM IFAT and anti-T.gondii-IgG avidity serological tests and PCR tests were applied by using blood, cerebrospinal fluid, amniotic fluid, pericardial fluid and abscess samples from patients who have admitted to Erciyes University Faculty of Medicine Department of Parasitology routine serology and molecular diagnosis laboratories with a pre-diagnosis of toxoplasmosis. Among 6547 patients 3.3% (n= 220) were only IgM positive, 9.2% were both IgG and IgM positive (n= 598). Among male patients, the positivity rates were lower and only IgM seropositive patients were 0.6% (n= 45) while the frequency of both IgG and IgM positive patients was 0.8% (n= 47). The number of both IgG and IgM seropositive cases among new borns, constituting 6.4% (n= 425) of the total number of patients, was 20 (0.3%) and the number of IgM seropositive samples was 25 (0.4%). Only 290 patients positive for IgM antibodies were studied for IFAT and 22 of these patients were positive for anti-T.gondii-IFAT IgM. Anti-T.gondii IgG avidity test was performed in all IgG positive patients regardless of their IgM seropositivity; low avidity was found in 0.7% (n= 18) of IgM-negative patients' sera and equivocal avidity was detected in 6.5% (n= 179). Low avidity was detected in 2.6% of IgM positive patients. Nine of the patients evaluated as anti-T.gondii IgM negative and IgG positive were detected as positive by PCR and two of them were negative. One of these PCR-positive patient's amniotic fluid was sent after the serological test results and detected as positive. Twenty CSF samples were studied by PCR and 7 samples were positive. Also, 8 blood samples which were anti-T.gondii IgM negative and IgG positive were found to bepositive in 7 and negative in one sample with PCR results, subsequently. PCR tests with pericardial fluid and abscess materials were found to be negative. In the case of suspicious or risky situations such as false negatives or false positives resulting from cross-reaction that can occur in ELISA tests, unnecessary medication or interventional approaches can be avoided by applying molecular-based testing at laboratories with appropriate infrastructure. For this reason, we believe that the application of molecular tests in addition to serological tests in risky situations may give more reliable results.

[Dientamoeba fragilis infection in patients with gastrointestinal system complaints]. / Gastrointestinal sikayeti olan hastalarda dientamoeba fragilis enfeksiyonu.

In this study, we aimed to investigate the incidence of Dientamoeba fragilis with different diagnostic methods in patients with gastrointestinal symptoms and determine the sensitivity and specificity of existing diagnostic methods. Fecal samples collected from 101 patients with gastrointestinal complaints (especially upper abdominal pain, abdominal and pelvic pain, nausea and vomiting, gastroenteritis and colitis, unexplained fever and diarrhea) and 20 control cases from various clinics were included in the study. Samples were first examined with native-Lugol (N-L) method and cultured in Robinson medium. All 121 stool and culture samples were stained with iron hematoxylin stain (IHS) and trichrome stain (TS) methods and examined by PCR and QPCR for D.fragilis. Among 121 stool samples 13 (10.7%), 2 (1.7%), 7 (5.7%) 13 (10.7%), and 7 (5.8%), 4 (3.3%), 2 (1.7%), 3 (2.5%) of cultured samples were determined positive with IHS, TS, PCR, QPCR respectively. Fifteen of the 121 stool samples were determined as diarrheal. All diarrheal stool samples were negative with IHS and TS. One of the diarrheal stools and 6 (4.9%) of the non-diarrheal stools were positive by PCR. All of the diarrheal stools were negative. Thirteen of the non-diarrheal stool samples (10.7%) were positive by QPCR. When the QPCR method was considered as gold standard, sensitivity and specificity values were determined as 46% and 93% in IHS, 0% and 99% in TS, 54% and 100% by PCR and sensitivity and specificity values were 67% and 96% in IHS, 33% and 98% in TS, 67% and 100% by PCR among cultured stool samples. As a result, it was determined that there was a statistically significant difference between the samples of the patients and the control groups and the sensitivity and specificity of the conventional and molecular methods (IHS, TS, PCR and QPCR) determined in this study supported the results of other compared studies. It has been determined that staining methods used for the diagnosis of D.fragilis gave false positivite or negativite results. In addition, the QPCR method is more advantageous in terms of time saving for the diagnosis and initiation of the treatment and in cases where QPCR is not available, IHS and conventional PCR methods should be used together. In our opinion, this study will contribute to the results of epidemiological and scientific studies on D.fragilis in Turkey.

[Molecular characterization of Echinococcus granulosus isolates obtained from different hosts]. / Farkli konaklardan elde edilen Echinococcus granulosus izolatlarinin moleküler karakterizasyonu.

Echinococcus granulosus is a parasite that can be seen throughout the world. So far, five species of genus Echinococcus have been identified as parasite in people: E.granulosus, E.multilocularis, E.vogeli, E.oligarthrus, E.shiquicus. Larval (metacestod) form of parasite settles in internal organs of hoofed animals (cattle, goats, pigs, horses, sheep, etc.) and human; the adult form is found in small intestine of final host, canine. Disease caused by parasite called as "Cystic echinococcosis" (CE) is an important health problem and causes economic losses in many countries including our country that livestock is common. Infective eggs cause infections in intermediate hosts by taking oral way and rarely inhalation. Received egg opens in the stomach and intestines of intermediate host and oncosphere is released. Oncosphere quickly reaches the lamina propria of the villus epithelium by its histolytic enzymes and hooks. It usually transported from here to the liver and lungs, less frequently, muscle, brain, spleen, kidney and to other organs through the veins. By molecular studies, five species have been validated taxonomically and 10 different variants or strains of E.granulosus have been identified. Host and developmental differences between strains may negatively affect control studies and fight against the parasite. This study aimed to determinate E.granulosus strains obtained from cyst material of different intermediate hosts from different regions of Turkey by molecular methods. In the study, 25 human, 8 cattle, 6 sheep and 2 goat cysts material has been collected. Total genomic DNA was isolated from protoscoleces in cyst fluid and analyzed by PCR with COX-1 (L) and COX-1 (S) genes specific primers. DNA sequence analysis for each PCR product has been made. DNA sequence analysis results evaluated phylogenetically by MEGA analyze and BLAST software. As a result of this study, all isolates were identified as E.granulosus sensu stricto (G1) by DNA sequence analysis. CE is a major public health problem for our country so we believe that obtained data from this study is an important source for parasite control, effective diagnosis, treatment techniques, eradication, vaccination and drug development. Similar studies will be beneficial to cover all other regions of Turkey and to develop effective and successful control programs.

[Investigation of the presence of Encephalitozoon intestinalis and Enterocytozoon bieneusi in bone marrow transplant patients by IFA-MAbs method]. / Kemik iligi transplant hastalarinda Encephalitozoon intestinalis ve Enterocytozoon bieneusi varliginin IFA-MAbs yöntemiyle arastirilmasi.

Microsporidian pathogens are obligatory intracellular eukaryotic parasites which can be found worldwide. They have been represented in 144 genera and more than 1200 species that may cause infections in both vertebrate and invertebrate hosts. Enterocytozoon bieneusi and Encephalitozoon intestinalis are the most common species among 14 species of microsporidia identified as human pathogens and they cause infections in the gastrointestinal tract. These species may also cause chronic diarrhea particularly in immunocompromised patients, as well as disseminated infections with severe clinical conditions which can be life-threatening. Since the spores of microsporidia are quite small-sized structures, they frequently may be overlooked in routine stool examinations. Therefore, molecular methods and transmission electron microscopy, if possible, are used as the gold standard methods in laboratory diagnosis. In laboratories in which those methods could not be applied, immunofluorescence assay using monoclonal antibodies (IFA-MAbs) may be advantageous compared to conventional methods. The aim of this study was to investigate the presence of E.intestinalis and E.bieneusi in bone marrow transplant (BMT) patients by using IFA-MAbs method. A total of 200 BMT patients (134 male, 66 female; mean age: 43.2±15.01 years), of them 147 with diarrhea and 80 healthy subjects (43 male, 37 female; mean age: 31.9±11.76 years) as control group were included in the study. All of the stool samples were examined by a commercial IFA-MAbs (Bordier Affinity Products, Switzerland) method as well as conventional (native-lugol and modified acid-fast staining) methods. Of the patients 25.5% (51/200) were positive for E.intestinalis, 4% (8/200) for E.bieneusi and 9.5% (19/200) for both of them, giving a total positivity rate of 39% (78/200). Those rates were 5% (4/80), 2.5% (2/80), 3.8% (3/80) and 11.3% (9/80), respectively for control group. The difference between the patient and control groups in terms of positivity was found statistically significant (39% vs 11.3%, p<0.05). Among 78 positive BMT patients, 67 (85.9%) were suffering from diarrhea. The correlation between the presence of diarrhea and the presence of microsporidia was statistically significant (p<0.05). It was concluded that, BMT patients particularly those with gastrointestinal complaints, have to be evaluated for microsporidian pathogens regularly to improve quality of life and to decrease the problems during the treatment period.

Treatment of recurrent vulvar Paget disease with imiquimod cream: a case report and review of the literature.

INTRODUCTION: Extra-mammary Paget disease is one of the rare neoplastic conditions of the skin. The most common site of involvement is the vulva and presents itself with erythematous plaques. Surgery is the most important treatment option. In the recent years, there are publications of the topical use of imiquimod cream in extra-mammary cutaneous Paget disease. We report the case of a woman with recurrent vulvar Paget disease, who underwent successful treatment with imiquimod cream. We also review the reports of other patients with vulvar Paget disease who were treated with topical imiquimod cream. CASE REPORT: A 65-year-old woman presented to the Oncology Outpatient Clinic with an itchy lesion in her vulva for 2 years. In the gynecologic examination, a hyperkeratotic erythematous lesion was found starting from the right labium to involve clitoris, with a size of 4 × 3 cm. Pathology result was reported as Paget disease. She was operated and wide vulvar excision was performed with a safety margin of 2 cm. Then recurrence two times occurred. Because she refused surgery, imiquimod cream 5% was applied for treatment. CONCLUSION: Imiquimod cream is an effective and safe therapeutic agent for both primary and recurring vulvar Paget disease.

Complete lymph node dissection: is it essential for the treatment of borderline epithelial ovarian tumors?

OBJECTIVE: The present study aims to compare the clinical and reproductive outcomes of women who have undergone lymph node dissection with those who have not and to discuss the indications for retroperitoneal evaluation in the treatment of borderline ovarian tumors. METHODS: The present study investigated 123 women who were finally diagnosed with borderline epithelial ovarian tumors at the study center between January 1999 and January 2009. A total of 68 patients (55.3%) were found to have a complete surgical staging procedure. RESULTS: The patients who underwent complete lymph node dissection were significantly younger than those who did not have lymphadenectomy. Thus, the ratio of postmenopausal women was significantly higher among those in whom retroperitoneal evaluation was performed. As expected, the intraoperative blood loss was significantly more and the hospital stay was significantly longer in patients who underwent complete lymph node dissection. Also, the non-serous borderline ovarian tumors were significantly more frequent in the latter patient group. However, overall and disease-free survival spans were found to be statistically similar for both study groups as well as the recurrence rate. CONCLUSIONS: Retroperitoneal evaluation can be spared in every woman with borderline ovarian tumor unless she is to undergo complete surgical staging procedure because of high recurrence risk, advanced stage disease or personal choice.

Genetic diversity of Leishmania tropica: Unexpectedly complex distribution pattern.

In this study, we characterized a collection of clinical samples obtained from Syrian and Turkish patients with cutaneous leishmaniasis using internal transcribed spacer 1 (ITS1) sequences. All obtained sequences belonged to Leishmania tropica. Combining them with those available from GenBank allowed us performing a broad-scale analysis of genetic diversity for this species. We demonstrated that L. tropica has a complex phylogeographic pattern with some haplotypes being widespread across endemic countries and others restricted to particular regions. We hypothesize that at least some of them may be associated with alternative vectors or animal reservoirs.

Anti-Toxoplasma gondii antibodies in patients with chronic heart failure.

Chronic heart failure (CHF) involves interactions between the cardiovascular, neuroendocrine and immune systems. This study investigated the seropositivity rate for anti-Toxoplasma IgG and IgM antibodies by ELISA in patients with CHF. Ninety-seven patients with CHF and 50 healthy volunteers were selected for this investigation. The seropositivity rate for anti-Toxoplasma IgG antibodies among CHF patients (68%) was significantly higher than in healthy volunteers (36%). Thus, parasitological screening of this group of patients should be periodically performed to prevent the possible dissemination of toxoplasmosis.

Cystic echinococcosis in Central Anatolia, Turkey.

OBJECTIVE: Human cystic echinococcosis (CE) caused by infection with a larval stage of Echinococcus granulosus is a serious public health problem in Turkey. Echinococcosis is a zoonotic disease; dogs and livestock are important hosts in transmission. The aim of this study is to evaluate the rate of CE in Kayseri Rural Area, Central Anatolia, Turkey. METHODS: At the present study, we planned to evaluate the rate of CE in Kayseri rural area in Central Anatolia between 2000 and 2002. We investigated 2,242 subjects using enzyme-linked immunosorbent assay (ELISA) and indirect fluorescence antibody (IFA), and we examined the seropositivity by using Western blotting (WB). RESULTS: The seropositivity rate was 2.7% by ELISA and IFA. We retested seropositive serum samples and 200 seronegative sera by WB. Seropositive serum samples were studied using abdominal ultrasound and chest x-ray to confirmed the presence of hydatid cyst and we found 10 (0.5%) different localized cysts. CONCLUSION: The results of our study indicate that Kayseri rural area has a high endemicity of human CE.

The high prevalence of Encephalitozoon intestinalis in patients receiving chemotherapy and children with growth retardation and the validity of real-time PCR in its diagnosis.

BACKGROUND/AIM: The aim of this study was to investigate the presence of Encephalitozoon intestinalis in different patient groups consisting of immunocompromised and immunocompetent individuals. MATERIALS AND METHODS: The stool samples of 100 patients consisting of 25 patients receiving chemotherapy and with acute gastrointestinal complaints, 25 with bone marrow transplant and acute gastrointestinal complaints, 25 with urticaria, and 25 with growth retardation were included in the study. As control groups, 25 subjects without any chronic disease but with acute gastrointestinal complaints and 25 healthy volunteers, making a total of 50 subjects, were included in the study. E. intestinalis was investigated by IFA-MAbs and molecular methods. RESULTS: Forty percent of patients receiving chemotherapy and with acute gastrointestinal complaints, 24% of patients with bone marrow transplant and acute gastrointestinal complaints, 20% of patients with urticaria, 40% of children with growth retardation, and 28% of patients without any chronic disease but with acute gastrointestinal complaints were determined as positive. CONCLUSION: To the best of our knowledge, this is the first report to assess the relationship between E. intestinalis and growth retardation. We think that the reliability of the use of molecular methods, especially real-time PCR, should be improved for the diagnosis of E. intestinalis.

Nosocomial Oral Myiasis by Sarcophaga sp. in Turkey.

We present a case of oral myiasis in a 15-year-old boy with tuberculosis meningitis. The diagnosis was based on the visual presence of wriggling larvae about 1 cm in size and on the microscopic features of the maggots, especially those relating to stigmatic structures. The larvae were identified as third-stage larvae of Sarcophaga sp.

Treatment of pediculosis capitis infested children with 1% permethrin shampoo in Turkey.

Pediculosis capitis (head lice) is an infestation that affects many children. Although, there are a number of different treatment modalities, at the present study, we investigated the efficacy of permethrin in the treatment of pediculosis capitis in children. This study was carried out in 3 village primary schools in the Kayseri region involving 185 of 712 school children infested with Pediculus humanus capitis during a survey conducted in March 2001. It was found that 173 (97.29%) of the 178 students who applied the prescribed medications were cured, indicating that interestingly 1% permethrin shampoo (Kwellada) is an effective and safe treatment choice for pediculosis capitis.

[The Investigation of Prevalence of Enterobius vermicularis (L.1758) in Primary School Age Children and Its Relation to Various Symptoms]. / Ilkögretim Çagi Çocuklarinda Enterobius vermicularis (L.1758) Yayginligi ve Çesitli Semptomlar ile Iliskisinin Arastirilmasi.

OBJECTIVE: In this study, we aimed to determine the prevalence of Enterobius vermicularis (E. vermicularis) using anal tape technique in four different primary schools in the town of Kayseri. METHODS: For this purpose, cellophane-tape samples were collected from a total of 438 students. Of all the students, 229 (52.2%) are female and 209 (47.7%) are male. In this study, the relationship between E. vermicularis and the parameters such as school, gender, residential structure, bathroom, water source, parents' monthly income, the number of rooms and members in the house and some symptoms such as anal itching, nasal itching, allergies, irritability, headaches and dizziness, night fears, dental grinding at night, abdominal pain, diarrhea, loss of appetite and weight loss were investigated. RESULTS: E. vermicularis was determined in 44 of the 438 students (which is 10.4%). There were statistically significant relation betweenE. vermicularis and parameters such as residential structure, the number of rooms in the house, dental grinding at night, abdominal pain, parents' level of education. There was also statistically significant relation between E. vermicularis and socio-echonomical situation of primary schools. CONCLUSION: We believe that carrying out periodic screening in schools in which especially low-income and parasite-infected children should be treated, informed about prevention and control methods.

[Cryptosporidium parvum Gastroenteritis in a Patient with Renal Transplantation]. / Renal Transplantli Bir Hastada Cryptosporidium parvum Gastroenteriti.

In this study, a case who starting abundant watery diarrhea on the 14th day of renal transplantation is presented. Stool sample was analyzed for Cryptosporidium spp. by carbol fuchsin staining method, copro-ELISA and nested polimeraze chain reaction (PCR). From sample found positive by Carbol-fuchsin staining method and Copro-ELISA, DNA sequence analysis was performed, gel-purified from amplicon obtained by nested PCR. As a result of DNA sequence analysis was determined to be Cryptosporidium parvum. Although C. parvum is a rare causative agent of gastroenteritis it can be cause serious clinical diarrhea solid organ transplantation patient. As a result, also C.parvum must be considered as a causative agent of diarrhea occurring after organ transplantation.

Investigation of anti-Toxoplasma gondii antibodies in patients with neoplasia.

This study aimed to determine the prevalence of anti-Toxoplasma gondii antibodies in patients with neoplasia. One hundred and eight patients with neoplasia and 108 healthy controls were studied for the presence of anti-T. gondii antibodies using a micro ELISA and peroxidase-labelled anti-human IgG (rabbit) and IgM (goat). Anti-T. gondii IgG antibodies were detected in 68 (63.0 %) patients and in 21 (19.4 %) of the controls, which was a statistically significant difference. In addition, anti- T. gondii IgM antibodies were detected in seven (6.5 %) patients and in one (0.9 %) control. A high percentage of positivity for Toxoplasma antibodies in patients with neoplasia was detected. Therefore, parasitological surveys of this patient group should be periodically performed.

Human cyclosporiosis in Turkey.

Six patients infected with Cyclospora cayetanensis who sought medical care at three different hospitals in Turkey are herein presented. Four patients were male and the others were female and their ages ranged from 7 to 62 years. The first patient was HIV-positive and presented with watery diarrhea with a frequency of up to 18 times a day for more than ten months and diagnosed as cyclosporiosis in Kayseri, 1996. The second patient was also HIV positive and diagnosed as cyclosporiosis in Kayseri, 2000. The third patient was an acute myeloblastic leukemia (AML) patient and diagnosed in Istanbul, 2000. The fourth patient was idiopathic hepatic cirrhosis complaining of diarrhea and weakness and diagnosed in Kayseri, 2001. The fifth and sixth patients were immunocompetent patients complaining of diarrhea and diagnosed in Izmir and Kayseri, 2002. Diarrhea occurring from one to ten times a day continued for 7 to 70 d in the last 5 patients. Treatment with a trimethoprim/sulfamethoxazole compound was done for all patients. Both symptomatic and parasitologic improvements were quickly observed. In summary, C. cayetanensis infection is rare in Turkey and most patients infected with this pathogen tend to be immunosuppressive individuals at present.

Dysentery caused by Balantidium coli in a patient with non-Hodgkin's lymphoma from Turkey.

Balantidium coli is the only parasitic ciliate of man. It is a flattened oval organism covered with cilia, and a gullet at the anterior end. It is infrequently pathogenic for man, although epidemic buds in tropical zones have been described. The infection fundamentally affects the colon and causes variable clinic pictures, from asymptomatic to serious dysenteric forms. We present a case of parasitologically diagnosed as causes of diarrhea in a patient with non-Hodgkin's lymphoma from Turkey. In order to find out the causative etiologic agent of diarrhea, stool samples were examined by native, lugol and flotation methods and we detected moving trophozoites, which were approximately 60 microm long and 35 microm wide. These bodies were diagnosed as Balantidium coli. This case underlines that Balantidium coli should also be considered as a possible pathogen in immunocompromised patients with diarrhea.