Volume 2, Issue 3

Probiotics are nonpathogenic microorganisms mostly of human origin which, when administered in adequate amounts, confer a health benefit on the host and enable to prevent or improve some diseases. Probiotics may be a natural temporary constituent of the resident intestinal microflora, but their concentration is not sufficient for therapeutic purposes. The microbiota, the intestinal epithelium, and the mucosal immune system constitute the gastrointestinal ecosystem. All three components are essential for complete functional and developmental maturity of the system. The viability of intestinal microflora (including probiotic strains) requires the availability of nutritional substrates (prebiotics), i.e. various types of fiber and oligosaccharides. Prebiotics are cleaved by microbial enzymes to numerous substances (short-chain fatty acids, aminoacids, polyamines, growth factors, vitamins and antioxidants) indispensable for metabolic and functional activities of the intestinal mucosa. The principal probiotics in use include lactobacilli, bifidobacteria, some nonpathogenic strains of Escherichia coli, and Saccharomyces boulardii. These microbiota display favourable effects which qualify them for therapeutic use. For this purpose, probiotics have to fulfill a series of requirements verifying their efficacy and safety. Experimental and clinical studies examine the prerequisites for the administration of probiotics in digestive diseases, allergic and atopic affections, as well as in some extraintestinal conditions. Future goals of probiotic application include genomic analysis, controlled postnatal colonisation of the digestive tract, the use of probiotics as carriers of peroral vaccines, and recombinant probiotics with in-situ production and targeted application of therapeutic molecules.

Intrauterine Parvovirus B19 infections may cause fetal anemia, non-immune hydrops fetalis or abortion. This study focuses on the pathogenic role of Parvovirus B19 in non-immune hydrops fetalis at Hacettepe University, a major reference hospital in Turkey. Twenty-two cases of non-immune hydrops fetalis were retrospectively selected out of a total of 431 hydrops fetalis specimens from the Department of Pathology archieves. Paraffine embedded tissue sections from placental and liver tissues from each case were evaluated by histopathology, immunohistochemistry, nested PCR and commercial quantitative Real-time PCR. Viral DNA was detected in placental tissues by Real-time PCR in 2 cases (2/22, 9.1%) where histopathology also revealed changes suggestive of Parvovirus B19 infection. No significant histopathologic changes were observed for the remaining sections. Nested PCR that targets the VP1 region of the viral genome and immunohistochemistry for viral capsid antigens were negative for all cases. As a result, Parvovirus B19 is identified as the etiologic agent for the development of non-immune hydrops fetalis for 9.1% of the cases in Hacettepe University, Turkey. Real-time PCR is observed to be an effective diagnostic tool for nucleic acid detection from paraffine embedded tissues. Part of this study was presented as a poster at XIIIth International Congress of Virology, San Francisco, USA (Abstract V-572).

Data in literature that use methods for studying the learning and memory processes suggest that GABA and especially GABAB receptor antagonists may be active against amnesia. The aim of our study was to examine the effects of three new GABAB-antagonists on learning and memory processes. Active and passive avoidance tests with negative reinforcement in rats were used. The rats treated with different GABAB receptor antagonists showed improving effects in both tests (active and passive avoidances)on learning as well as on memory retention. There are some differences in their activities, probably due to its chemical structures. The phosphinic analogue CGP63360A is potent to the point that the benzoic one CGP76290A and the left isomer of the benzoic analogue CGP76291A has no effect. It may be concluded that the obtained results on the GABAB receptor antagonists could contribute to their pharmacological characteristics and might be of interest for potential clinical implication.

The aim of this study was to determine underweight, overweight, and obesity prevalence in representative sample of adult (≥ 18 years old) Turkish population living in urban and rural area of Turkey. Turkish citizens aged ≥ 18 who can represent adult population and permanently resident in Turkey were taken to this study in 1999–2000. The nationally representative sample population was selected from the target population using the census which was performed by national institute of statistics at 1997. Target population was 13.570 individuals living in these houses and 8674 people who aged ≥ 18 are chosen for the study. BMI was used as widely accepted diagnostic criteria of obesity. This study demonstrated that the prevalence of underweight was 10.7% in men, 5.9% in women and 8.1% for overall. The prevalence of overweight was 17.4% in men, 20.4% in women and 19% for overall. The prevalence of obesity was 7.8% in men, 22.1% in women and 15.6% for overall. The prevalence of overweight is higher (19.6%) in urban areas but prevalence of obesity is higher (17%) in rural areas of Turkey. Age, educational level and marital status seem to have association with obesity prevalence. The data we obtained showed us that while the underweight is still an issue for men, the overweight and obesity prevalence is high and needs to take early prevention steps for Turkish population.

Cardiac valvular calcification is frequent among hemodialysis (HD) patients. The presence of valvular calcification can help identify HD patients with a higher risk for cardiovascular diseases. Our aim was to determine the prevalence of valvular calcification (VC) in our maintenance hemodialysis (HD) population and to examine some possible etiologic factors for its occurrence. We studied forty-four patients on hemodialysis (23 women and 21 men; mean age 57 ± 18 year; mean HD duration 34 ± 28 months). Valvular calcification (VC) was observed in 21 patients (48%). Of these patients, 6 patients (13%) had mitral valvular calcification, 9 patients (20%) had aortic valvular calcification, and 6 patients (13%) had calcification of both valves. The patients with VC were older than patients without VC (66±14 vs. 50±18). The patients with aortic calcification had longer HD duration than others (48±29 vs. 27±24 months). Patients with VC had higher systolic and diastolic blood pressures than patients without VC. The patients with mitral calcification had higher C-reactive protein (CRP) levels (14 ± 13 vs. 7 ± 7). No significant differences were found with respect to calcium, phosphorus, parathyroid hormone, alkaline phosphatase and mean Ca × P product. Our study confirmed that there is an increased prevalence of VC in HD patients. Age is a risk factor for cardiac VC in HD patients. Longer HD duration was associated with aortic valve calcification. In addition, elevated level of CRP is associated with mitral valve calcification in HD patients.

Pure tone audiometry screening and ear examinations were conducted among 138 males working as machine and equipment operators occupationally exposed to intermittent noise of 85 to 105 dBA. Hearing loss up to 30 dB (preserved socially adequate hearing) was found in 25 workers. The hearing impairment was confirmed by distortion products of otoacoustic emissions measurements. A sharp increase in the frequency of cases can be found among the workers with service length over 10 years. While the frequency of the cases among workers with service length below 10 years is 5.45%, it is 26.5% among the subjects with service length over 10 years, with a gradual increase as a result of the increase in exposure duration. A positive correlation (p < 0.05) was found between the frequency of hearing impairment among the workers and the years of exposure to excessive noise levels. Some measures for preventing occupational noise-induced hearing loss were suggested.

Laboratory aids are extensively used in the diagnosis of diseases, in preventive medicine, and as management tools. Reference values of clinically healthy people serve as a guide to the clinician in evaluating biochemical parameters. Determination of 21 biochemical parameters of healthy persons using standard methods of analysis. Cluster analysis and principal components analysis were applied on the above 21 biochemical parameters data. The application of a typical classification approach as cluster analysis proved that four major groups of similarity between all 21 clinical parameters are formed, which correspond to the authors assumption of the existence of several summarizing pattern of clinical parameters such as “enzyme,” “major component excretion”, “general health state,” and “blood specific” pattern. These patterns appear also in the subsets obtained by separation of the general dataset into “male”, “female”, “young”, and “adult” healthy groups. The results obtained from principal components analysis have additionally proved the validity of a similar assumption. The intelligent data analysis on the clinical parameter dataset has shown that when a complex system is considered as a multivariate one, the information about the system substantially increases. All these results support an idea that probably a general health indicator could be constructed taking into account the existing classification groups in the list of clinical parameters.

Surgical intervention for extracranial carotid artery stenosis remains a major potential therapeutic modality for the prevention of stroke. Nevertheless, every kind of surgical technique for carotid entarterectomy (CEA) has its specific complications, compromising the final surgical result. The authors report about a 70-year old man, suffering from recurrent transient ischemic attacks by suspected internal carotid artery (ICA) re-stenosis, 11 and 13 years after CEA with patch angioplasty. In relation to neurological symptomatic and angiographic appearance of ICA re-stenosis an open surgery of the left ICA was preferred. Intraoperatively the old patch material was such vulnerable that it was not possible to maintain the continuity of ECA and ICA or CCA and ICA. Consequently reconstruction and replacement of ICA and ECA with 6 mm Gore-Tex grafts was performed. Follow-up three years after surgery showed no symptoms of insufficient brain metabolism as well as a good flow within the grafts. Patch angioplasty by CEA seems to be favourable to reduce the risk of early ICA re-stenosis but for all that there are other accompanying problems, which can compromise utility of patch technique. For this the authors prefer a patient adapted surgical treatment, based not only on so far not significant data but moreover on personal experience.

We have previously reported a case of a 36-year-old woman who was diagnosed with primary hyperparathyroidism following initial skeletal abnormalities in the hand phalanges and calcaneus revealed by quantitative ultrasound (QUS). Successful parathyroid adenoma surgery resulted in progressive increase of bone mineral density and QUS parameters within 6 months, 1 year and 2 years of follow-up. Now, 5 years after the last measurement and at the onset of her menopause, the study was repeated. It has shown further increase in some ultrasonic and densitometric parameters but decrease in others. This discrepancy could be associated with the early influence of perimenopause on trabecular bone. Based on the current report one can conclude that peripheral QUS used on the hand phalanges and calcaneus is a useful tool for the diagnosis and monitoring of skeletal alterations due to parathyroid dysfunction. Moreover, it can detect early changes associated with perimenopause.

Recurrent hypersomnia (RH) is a rare disorder characterized by episodes of hypersomnia, variously accompanied by behavioural and cognitive disturbances, compulsive eating behaviour and hypersexuality. Electrophysiologic evaluation of the sleep during symptomatic and asymptomatic periods of RH distinguishes RH from other primary sleep or mental disorders. Unique polysomnographic findings during the hypersomniac attack lasting 96 hours in a 16-year-old boy affected with primary RH are presented in this paper.

We present a case of atresia hymenalis in a 12.5 year old female who was admitted to gynecological emergency with a history of severe lower abdominal pains over the course of a few months. Provided are clinical pictures of the “Pseudoacute abdomen”. Upon clinical examination, we found blue, shiny, bulging and imperforated hymen. An abdominal mass was palpated in the vicinity of the navel. Transabdominal ultrasound demonstrated mass filled with thick liquid. “Mercedes hymenal incision” was performed in general anaesthesia. About 1.2 litre of dark, thick blood was removed. Postoperative course was uneventful. The two years of follow-up were characterized with regular psychomotoric development for the age with regular menstrual cycles.

Three weeks after the administration of intravenous methylprednisolone therapy, a 42-year-old female patient suffering from relapsing-remitting multiple sclerosis (RR-MS) presented with a profound elevation of liver transaminases (GOT 485 U/l, GPT 1082 U/l, glutamyl transpeptidase 170 U/l). Liver biopsy revealed a profound, still active hepatitis with portal lymphocytic infiltration and fibrosis. Most likely, existing acute hepatitis was of autoimmune origin and emerged from an immune rebound phenomenon after immunosuppressive therapy.