2000; 31(1): 1-56.
CONTENTS
ABSTRACTS
Comparison of three conservation method
for stock fungus cultures
Yucel A, Kantarcioglu AS
Cerrahpasa J Med 2000; 31 (1): 7-15.
BACKGROUND AND DESIGN: The storage and maintenance of
stock-culture collection of fungi serves to research and educational fonctions of
specialized mycology laboratories. Several methods have been proposed for maintaining
culture collections of fungi. In this study a general collection of stock cultures consisting
of several hyaline, dematiaceous molds, dermatophytes and dimorphic primary pathogens
and yeasts and yeast-like fungi has been stored at room temperatures and in a refrigerator
and in a deep freezer for three years by frequent subculturing.
RESULTS: 170 of 216 strains maintained at
+4oC, 18 of 212 strains maintained at
+20oC and 105 of 154 strains kept in
-20oC survived the entire three year period.
Both of the two methods maintain the original characters of the strains and require
approximately equal time, equipment, material and space. The room temperatures
storage method has been eliminated due to the risk of mit contamination.
CONCLUSION: Keeping stock cultures at
+4oC appears to be the most convenient method
for our laboratory conditions and also the composition of our actual collection.
(Return)
Evaluation of the distribution of deaths occurred at
Cerrahpaşa Medical School in the year 1998
Vehid S, Köksal S, Aran SN, Kaypmaz A, Sipahioğlu F, Özbal AN.
Cerrahpasa J Med 2000; 31 (1): 16-22.
BACKGROUND AND DESIGN: Several health information of
people are being collected and recorded by health institutions during their lives.
Among these informations called vital statistics, death statistics give information
about the quality and distribution of health services in a country. They also make
the comparison of them with that of other countries possible. In order to evaluate
this information obtained from death statistics, records must be sufficient and
reliable. Although the death registrations are standardized, data are not reliable
in our country. The aim of this study was to find out the wrong death reports by
examining the death distribution occurred at Cerrahpaşa Medical School in 1998.
It was also aimed to emphasize important points for having more reliable death
registrations. So death certificates of 1313 death events, which occurred in our
hospital in 1998 and the data from these records, which were obtained from our
information center, were examined. Several distributions of these deaths are shown
in the results section of this study.
RESULTS: Most of the deaths were occurred at 70 years of
age or above (24.44%). The majority of the deaths (31.15%) occurred in the Intensive
Care Units. The most frequent cause of death was reported as cardiopulmonary arrest
(31.98%), cancer (18.91%), cardiac arrest (13.63%), pulmonary arrest (6.93%). After
examining the records obtained from the information center, the actual causes of death
showed to be due to cancer in 28.08% of the cases, cardiac arrest in 16.76 % of the
cases, pulmonary arrest in 26.37% of the cases, which altogether had been reported
as cardiopulmonary arrest.
CONCLUSION: 52.55% of the deaths were reported wrongly.
Cancers were the most frequent cause of death at Cerrahpaşa Medical School in 1998.
For having more accurate vital statistics, rules for death registration should be lectured
as a course in curriculum and postgraduate education. We must start to use ICD 10,
which having 900 headings on reporting and restricting of deaths.
(Return)
The effect of Ureaplasma urealyticum and Chlamydia trachomatis infections
to the semen parameters
Irez T, Alici B, Ozkara H, Akkus E, Yencilek F, Ocal P, Ozalp AU,
Hattat H
Cerrahpasa J Med 2000; 31 (1): 23-27.
BACKGROUND AND DESIGN: Aim of this study is to
determine the effect of urogenital Ureaplasma urealyticum and Chlamydia
trachomatis infections to the semen parameters. 47 randomly chosen infertile
and 22 fertile men were enrolled in this study. Semen were analysed according
to WHO 1992 and morphology according to Kruger's strict criteria. Each semen
specimen was tested for sperm autoantibobies, semen culture were done and
specimens were tested for chlamydia trachomatis and ureaplasma urealyticum.
The women in infertile couples were investigated by hormon profiles,
histerosalphingographies and basal body temperatures.
RESULTS: C. trachomatis and/ or U. urealyticum were
positive in 57.5% of infertile patients while these were positive in 27% of fertile
patients. There was no significant difference in sperm count and morphology while
the decrease of sperm motility was significant. (p=0.0076 and 0.0114 respectively).
The antisperm antibody count was positive in 36.4% of patients with positive
Chlamydia and Ureaplasma infection and it was positive in 14% of patients
with negative Chlamydia and Ureaplasma infection.
CONCLUSION: C. trachomatis and U. urealyticum are two
microorganisms which may have a role in infertility.(Return)
Peroperative isoflorane requirements:
Effect of interpleural morphine given before or after induction of anaesthesia
Erolcay H, Yuceyar L, Ipek N, Aykac B
Cerrahpasa J Med 2000; 31 (1): 28-31.
BACKGROUND: Morphine injected interpleurally produces
antinociceptive effects, which are mediated by opioid receptors located on intercostal
nerves. This study investigates the effect of interpleural morphine on intraoperative
isoflorane requirements.
DESIGN: Twenty patients scheduled to thoracotomy were randomly
allocated to two goups to receive interpleural morphine before or after the induction of
anaesthesia. Systolic, diastolic and mean arterial pressures, hearth rate,
SpO2, ETCO2,
and end-tidal isoflorane concentrations were recorded at 5 min. intervals. In the 1st group
0.3 mg/kg morphine was injected interpleurally using a 'Touhy' needle 30 minutes before
the anaesthetic induction. In the 2nd group after the anaesthetic induction operating lung
was collapsed by applying one lung ventilation to the dependent lung using double-lumen
endotracheal tube and the same dose of morphine was injected with a standard injector.
Surgical incision was allowed 30 minutes after the injection. Anaesthetic depth was evaluated
with PRST score (blood pressure, pulse rate, sweating, tear formation). Isoflorane concentration
was titrated depending upon the same score and also increased or decreased in order to
keep mean blood pressure within 10% of baseline values. Anaesthesia was induced with
thiopental and atracurium and maintained with isoflorane O2/Air.
Atracurium was used to maintain surgical relaxation. Following thoracotomy dependent lung
was ventilated with IPPV (intermittent positive pressure ventilation) and operated lung was
with HFJV (high frequency jet ventilation). In both groups statistical evaluations were
performed in the following periods: The period before incision: 1, retraction of ribs: 2, period
of IPPV+HPJV: 3, period of IPPV: 4. Comparison of mean end-tidal isoflorane concentrations
of two groups was performed using Student's t-test and p<0.05 was considered significant.
RESULTS: There was no significant difference between the two
groups (p>0.05).
CONCLUSION: Administration of interpleural morphine before
or after the induction of anaesthesia did not alter intraoperative isoflorane requirements.
These observations suggest that morphine is effective on suppressing the stress response
in both methods. It is concluded that giving morphine after induction of anaesthesia may
be preferred as it is applied under general anaesthesia and so less traumatic to the
patients. (Return)
Proconvulsant effect of compound 48/80
and its interaction with morphine
Yillar DO, Akcasu A, Silan C
Cerrahpasa J Med 2000; 31 (1): 32-37.
BACKGROUND AND DESIGN: Some compound 48/80 administered mice
respond to voiced and tactile stimulation by a convulsion-like contraction and this effect is
decreased by morphine. After these two observations; it was thought that compound 48/
80 passes somehow to the central nervous system. For this reason, we aimed to determine
the effect of these two substances on maximal electroshock seizure (MES). (1) In the first part
of study, convulsive current 50 (CC50) was determined as 46 mA. In all electroshocks this level
was used during whole study. (2) 5 mg/kg compound 48/80 was administered subcutanously
(s.c.) to mice and electroshock was given in different time intervals (15, 30, 60, 120, 240 min).
(3) Mice's mast cells were depleted and electroshock was administered to both groups
(control and 5 mg/kg 48/80 given group) at the 60th minute. (4) In this part of the study the
MES response of control and morphine administered group (100 mg/kg) was determined at
the 30th and 60th minutes. (5) In the last
section, electroshock was given to morphine and compound 48/80 administered mice groups.
RESULTS: (1) Convulsive current (CC50) was 46 mA. (2) Compound
48/80 decreased the maximal electroshock seizure threshold at the 60th minute
significantly (p<0.0001). (3) It also decreased MES threshold in mast cell depleted
mices. (4) When morphine and compound 48/80 were administered, anticonvulsant effect
of morphine was increased. (5) Death mice is changed in every step of our study by an
unknown mechanism.
CONCLUSION: Compound 48/80 decreased maximal electroshock
seizure threshold by an unknown mechanism. Combination of morphine and compound
48/80 increased the anticonvulsant effect of morphine. This effect probably raised from
the ability of compound 48/80 to increase the permeability of blood-brain barrier.
(Return)
Malignant glomus
jugulare paraganglioma presenting with massive bony destruction: Case report
Tuzgen S, Tanriover N, Canbaz B, Ozyurt E, Kuday C.
Cerrahpasa J Med 2000; 31 (1): 38-41.
BACKGROUND: Glomus jugulare paragangliomas are uncommon,
hypervascular neoplasms that arise from the temporal paraganglia and typically display
a benign histology. Bone changes, including bony destruction, within or around the tumor
is extremely rare. These tumors rarely display clinical or histological malignant characteristics
with a commonly cited figure of only 5% in the literature.
OBSERVATION: We present a review of the literature of glomus
jugulare paragangliomas and report a case with massive bony destruction in the temporal
and occipital bones, secondary to a hypervascular glomus jugulare tumor. Embolization of the
feeding arteries was carried out prior to total resection and finally a histological diagnosis of
malignant glomus jugulare paraganglioma was made.
(Return)
Creutzfeldt-Jakob disease
Oz B, Ersoy G, Demirkesen C
Cerrahpasa J Med 2000; 31 (1): 42-48.
BACKGROUND: Creutzfeldt-Jakob disease (CJD) is a very rare
untreatable progressive neurodegenerative disorder. Its incidence is one in 1 million
per year in European countries, which is rarer in Turkey. It is associated with the
presence of a protein in the brain, incompletely defined transmissible agent, called
as prion.
OBSERVATION: An autopsy case of 64 years old man was
presented. Grossly there was a severe cortical atrophy in the brain especially in the
frontal and temporal lobes. Histopathological sections showed spongiform changes
and neuronal loss in the gray matter. Immunohistochemical examination revealed
synaptic and plaque like prion protein (PrP) accumulation in the cortex and severe
reactive astrogliosis which was positive for GFAP.(Return)
A proposal for scoring of the
evaluation of randomized clinical trials
Cagatay P, Senocak M, Baykal IE
Cerrahpasa J Med 2000; 31 (1): 49-55.
BACKGROUND: Randomized controlled trials are generally
regarded as the most scientific method in decision making for diagnosis and treatment.
Therefore they must be far away from methodological and statistical mistakes, but it
is know that there are inadequate points in these studies. A system of scoring
parameters has been established to put forward the scientific quality of randomized
controlled trials. It has been planned so that these parameters show the scientific
reliability of the studies, evaluation of academic papers, inclusion for meta-analyses.
Three criterions have been developed for scoring orders. This three criterion are:
1) 12 headlines for methodological and statistical main items (maximum 60 points);
2) 6 headlines for scientific research (maximum 24 points); 3) 6 headlines for secondary
parameters in supervision and control (maximum 12 points). Our mean objective was to
establish a scoring system to show the quality of the scientific literature according to
their contents especially in randomized controlled trials. As a result, our scoring system
will demonstrate all the specification of a scientific literature which has to contain also
the future inclinations and the supplementing informations in itself so that an evaluation
method will help determine the scientific level, acceptance of a paper, education of
methodology for scientists working in this field and pursuit of developments.
(Return)
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