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)