1998;29(3):115-160.
CONTENTS


ABSTRACTS

The effect of low carbohydrate/high fat diet on respiratory function in patients with chronic obstructive pulmonary disease (COPD)

Aydin Tosun G, Umut S, Yildirim N, Hacibekiroglu A, Sahin G, Yucel R

Cerrahpasa J Med 1998;29: 119-122.

BACKGROUND: The aim of the study was to evaluate the effect of low carbohydrate high fat diet in stable hypercapnic COPD patients. DESIGN: On the 1st and 15th days respiratory function tests were performed and 14 stable COPD patients entered the study. Activity of accessory respiratory muscles were detected by electromyograms of sternocleidomastoid and external oblique muscles. Patients who received inhaled steroid, inhaled and oral beta 2 agonist and oral teophylline during the study began a diet with low carbohydrate and high fat and supported by 500 ml/day liquid diet which contained 16.7% protein, 55.2% fat, 28.1% carbohydrate, vitamins and minerals (Pulmocare). RESULTS: After 10 days of diet FVC increased (p < 0.05) and PaCO2 decreased (p < 0.05). The activation time of both muscles decreased significantly (p < 0.05). CONCLUSION: These data indicate that low carbohydrate high fat diet improves respiratory muscle function and decreases CO2 retention. (Return)


Digital substraction macrodacryocystography for epiphora cases

Basar E, Demir M, Akman C, Islak C, Mirzatas C

Cerrahpasa J Med 1998;29: 123-126.

BACKGROUND: A series of patients with epiphora was evaluated by a new method of dacryocystography. The technique is digital subtraction macrodacryocystography (DSM) which is involved intubation and injection of radiopaque contrast material into each lacrimal system under the control of direct sequential digitally subtracted imaging. DESIGN: 36 eyes of 18 patients were investigated DSM. In all of the patients main complaint was epiphora unilaterally and bilaterally. DSM examination was done under the topical anesthesia and DSM method was applied with the digital radiography unit using the low iodine content, water soluble contrast material. RESULTS: 24 eyes with epiphora out of 36 examinations were evaluated. 12 eyes out of 24 epiphora cases (50%) were classified as total obstruction of lacrimal passage, 25% of them (3 cases) showed the obstruction at the common canaliculus and 75% of them (9 cases) showed to obstruction at the distal of the lacrimal sac. 7 eyes of 24 epiphora cases (30%) showed lacrimal passage stenosis and remaining 5 eyes of 24 epiphora cases (20%) showed no stenosis or obstruction but they continued to complain of the epiphora. CONCLUSION: Reliable and accurate demonstrations of lacrimal duct obstructions were produced by the DSM method. Bone and air free radiographs of lacrimal drainage system can be obtained and they can help the ophthalmic surgeon to decide the lacrimal operation type. (Return)


The relationship between endogenous glutathione depletion and energy metabolism in stress-induced gastric mucosal injury

Zengin Ulakoglu E, Gumustas MK, Belce A, Altug T, Kokoglu E

Cerrahpasa J Med 1998;29: 127-131.

BACKGROUND: Reactive oxygen species may play an important role in gastric ulceration induced by several kinds of stress. Detoxification of these radical species involves conversion of reduced glutathione to oxidized glutathione. Endogenous glutathione have been reported as a possible mediator in gastric mucosal protection. Stress-induced ischemia may adversely affect gastric energy metabolism, an important factor in mucosal self-defense against injury. The objective of this study was to examine the relationship between endogenous glutathione and ATP levels in stress-induced gastric mucosal ulceration. DESIGN: On 20 male Wistar type albino rats, who were subjected to stress by the immobilization, ATP levels were determined by the modified Bucher tecnique, reduced glutathione levels by the method of Fairbanks and glutathione peroxidase activities by the spectrophotometric assay of Paglia and Valentine. RESULTS: Significant decreases were found in ATP, reduced glutathione levels and glutathione peroxidase activities in stress group rats. CONCLUSION: Regeneration and de novo synthesis of reduced glutathione might be reduced as a consequence of decreased of availability of ATP and some cofactors induced by the ischemic episode. (Return)


Effect of TUR-P and transvesical prostatectomy operations on sexual functions

Ozkara H, Alici B, Akkus E, Ataus S, Hattat H

Cerrahpasa J Med 1998;29: 132-136.

BACKGROUND AND DESIGN: Erectile function of 105 men who underwent prostatectomy (transurethral or transvesical) for benign prostatic enlargement was assessed before and after operation in a prospective study. RESULTS: Six months aftre the operation only 80 of them were available for evaluation. Preoperatively, 22 could not maintain their erections to achieve coitus. Six months after operation a decrease in erection had been experienced by 18 of remaining 58 patients, while 1 with erectile dysfunction before surgery declared an improvement. CONCLUSIONS: Prostatectomy operations had negative effect on erectile function of men, and there is no siginificant difference between both procedures. (Return)


In vitro fertilization results of the Istanbul University In Vitro Fertilization Research and Practice Center at 1996

Ocal P, Cepni I, Idil M, Irez T, Senol H, Yaldir F, Elibol F, Aksu F

Cerrahpasa J Med 1998;29: 137-140.

BACKGROUND: The aim of this study is to present the results of in vitro fertilization and embryo transfer (IVF-ET) cycles carried out at Istanbul University IVF-ET Research and Practice Center in 1996 and to determine the factors affecting success by analyzing the characteristics of our infertile population. DESIGN: 326 IVF cycles were applied to 285 infertile couples during 1996. Relation of women age, infertility duration, cause of infertility, ovulation protocol, number of human menopausal gonadotropin ampules and number of available oocytes with fertilization rate (FR) and pregnancy rate (PR) was evaluated. A semen parameters, the effect of fresh sperm density and motility and total motile sperm after preparation on fertilization and pregnancy was evaluated. RESULTS: In 326 IVF cycles, transfer rate was 45% and pregnancy rate with respect to transfer was 17%. There was a significant relation between advanced women age and pregnancy (p < 0.002) and between available oocyte and pregnancy (p < 0.0012). When sperm density was less than 20 million/ml, fertilization and 2.2% pregnancy, when sperm density was more than 20 million/ml 50% fertilization and 9% pregnancy occurred (p < 0.01). When motility was less than 50% fertilization rate was 45% and pregnancy rate was 7%, when motility was more than 50% fertilization rate was 58% and pregnancy rate was 25% (p < 0.005). When available total sperm amount after preparation was less than 5 million/ml 24% fertilization and 6% pregnancy; 5 to 10 million/ml 27% fertilization and 4% pregnancy; more than 10 million/ml 64% fertilization and 10% pregnancy occurred. In 93% of our cases there was male factor. CONCLUSION: Success rates in IVF varies according to women age, oocyte number and degree of male factor. (Return)


Asymptomatic "healthy" HBsAg carrier state in Turkey

Ozdemir S, Kural Sezer E, Sonsuz A, Basaranoglu M, Senturk H, Ozbay G, Akin P

Cerrahpasa J Med 1998;29: 141-144.

BACKGROUND AND DESIGN: This study examines the serologic, biochemical and histopathological features of 233 cases of asymptomatic HBsAg carriers. Asymptomatic HBsAg carriers state has been defined as; persistent HBsAg positivity for six months and normal serum transaminase values at least in two examinations. RESULTS: Of the orderly observed (average: 4.2 years) 192 cases, 17 had elevated ALT levels below two times normal and in one of them the increase has persisted. The majority of the cases (94%) HBeAg (-) and anti-HBe (+). HBV-DNA was positive in 13 cases. Anti-HDV has been determined in only two of the 168 cases investigated. Anti-HCV was negative in all of the 118 cases investigated. In two cases HBsAg became negative without occurrence of anti-HBs. Liver biopsy has been performed in 37 cases and in two of them moderate chronic hepatitis has been determined. In the follow up period none of the cases developed liver cirrhosis or hepatocellular carcinoma. CONCLUSION: As a result we have concluded that in this country asymptomatic HBsAg carrier state has a benign course and there is no need for routine liver biopsy. But we believe that cases with HBV-DNA positivity should have more close follow up course. (Return)


A case of bone and soft tissue infection caused by Scedosporium inflatum (An anamorph of Pseudoallascheria boydii)

Yucel A, Tugrul M, Kantarcioglu S, Aygit C, Ogutlu A

Cerrahpasa J Med 1998;29: 145-147.

BACKGROUND: Scedosporium inflatum is an anamorph of Pseudoallerscheria boydii, a common saprobe found in soil. P. boydii is involved in causing a variety of infections elsewhere in the body including paranasal sinuses, eyes, joints, subcutaneous tissue, lung and brains and soft tissue infections. Human acquires the infection by traumatic implantation of the organism into the skin and tissues. It is also the main cause of mycetoma and agent of phaeohypomycosis. OBSERVATION: Here it is presented a case of bone and soft tissue infection caused by S. inflatum, an anamorph of P. boydii. (Return)


A case of Behçet's syndrome with bilaterally pleural and pericardial effusion

Soy M, Ozbek S, Canataroglu A, Erken E

Cerrahpasa J Med 1998;29: 148-150.

BACKGROUND AND OBSERVATION: Behçet's syndrome is a primary vasculitis. In addition to mucocutaneous, ophthalmic and musculoskeletal symptoms, rarely pleural and pericardial fyuid is reported in Behçet's patients due to thrombosis of superior vena cava. Herein we report a patient with Behçet's syndrome, who had superior vena cava syndrome that caused pericardial and pleural effision, for resistance to medical therapy, unilateral pleurodesis with bleomycin solution then was performed. (Return)


Demonstrating of parchment objects as a potenital contamination source of Trichophyton verrucosum

Yucel A, Kantarcioglu S

Cerrahpasa J Med 1998;29: 151-155.

BACKGROUND AND OBSERVATION: The dermatophytes are a group of fungi comprising three genera, Microsporum, Trichophyton and Epidermophyton which cause the disease tinea or ringworm in its various forms. Apart from M. gypseum, which exists normally in the soil, the natural habitat of the dermatophytes is the skin of warm-blooded animals. In ancient times calve, sheep, goat.. skins have been used for the manufacture of parchment as a writing material. Trichophyton verrucosum was isolated from a parchment manuscript dated on XIVth century as the mycological deterioration agent of the material and the object was fumigated successively in a thymol chamber. Trichophyton species cause dermatophytoses infecting the keratinized tissues such as hair, nails, skin etc. of human and lower animals. Trichophyton verrucosum is a zoophilic pathogen usually contracted from cattle and it was observed the ability of surviving of this fungus for many years on dead materials in nature. Although it was reported certain animal skins as the source of acquisition of dermatophytosis, the transmission possibility from a museum object to human has been demonstrated as the first time in research. This conclusion should be epidemiologically important as being demonstrated a possible contamination source of Trichophyton verrucosum. (Return)