First isolation and molecular characterization of canine parvovirus-type 2b (CPV-2b) from red foxes (Vulpes vulpes) living in the wild habitat of Turkey

BACKGROUND

The canine parvovirus, with its many variants, is responsible for a pivotal and common viral infection affecting millions of dogs and other carnivore species worldwide, particularly the wild ones, which are considered as the main reservoir hosts. To that end, this study investigated the presence of canine parvovirus (CPV) in red foxes (Vulpes vulpes) living in wild habitats of several regions of Turkey.

METHODS

We randomly collected 630 archival fox stool specimens from rural areas of 22 provinces and used real-time PCR to detect CPV.

RESULTS

Two of the 630 (0.3%) stool samples were positive for CPV-DNA, named Tr-Fox/128(Aydın) and Tr-Fox/159(Manisa). We attempted to isolate the virus in a MDCK cell line, and cytopathic effects were observed four days post-inoculation. Three regions corresponding to the CPV capsid protein VP2 gene from extracted DNA of positive samples were amplified by conventional PCR, and the products were visualised, purified, and Sanger sequenced. Three overlapping DNA raw sequence fragments, were read, assembled, and aligned to obtain approximately 1.5 kb-long regions that cover most of the VP2 gene, then deposited in GenBank. After comparing the isolates with parvovirus sequences data of domestic and wild carnivores by BLAST processing, our isolates' similarity rate with each other was 99.40%, with base differences in 9 nucleotide positions. They were classified as 2b variant closely related to isolates from dogs in Turkey, Egypt, Iraq, Italy, Thailand, and China.

CONCLUSION

This study presents evidence of interspecies transmission of CPV, of which there are no reports on prevalence in wildlife carnivores of our country. Identification of CPV in red foxes threatens local and hunting dogs, which may contract the infection or disseminate it to other wild animal species or vice-versa.

A prevalence study of COVID-19 among healthcare workers in a pandemic hospital in the Samsun province of Turkey

Among populations globally, many healthcare workers have been disproportionally impacted by the COVID-19 pandemic because of their above average exposure to people infected with SARS-CoV-2. Exposure to asymptomatic or pre-symptomatic individuals is particularly challenging, if those individuals continue to work, not knowing that they are potentially infectious. This study aimed to measure the level of asymptomatic infection in a cohort of workers in a healthcare setting in Turkey during the second major wave of infection in late 2020. Blood samples were collected and tested by electrochemiluminescence immunoassay for SARS-CoV-2 IgM and IgG antibodies. Nasal and throat swabs were performed in a subset of this cohort and RT-qPCR was used to search for the presence of SARS-CoV-2 RNA. The results showed that approximately 23% of the cohort were positive for anti-SARS-CoV-2 IgM antibodies and approximately 22% were positive for anti-SARS-CoV-2 IgG antibodies despite no reported history of COVID-19 symptoms. Just less than 30% of a subset of the group were positive for the presence of SARS-CoV-2 RNA indicating the likelihood of a current or recent infection, again despite a lack of typical COVID-19 associated symptoms. This study indicates a high rate of asymptomatic infection and highlights the need for regular testing of groups such as healthcare workers when community prevalence of disease is high and there is a desire to limit entry of virus into settings where vulnerable people may be present, because symptoms cannot be relied on as indicators of infection or infectiousness.

A retrospective molecular investigation of selected pigeon viruses between 2018–2021 in Turkey

A recent first detection of pigeon aviadenovirus-1 and pigeon circovirus co-infection associated with Young Pigeon Disease Syndrome (YPDS) in a pigeon flock in Turkey, prompted a study focused on documenting the distribution of Pigeon aviadenovirus (PiAdV-1 and PiAdV-2), Pigeon circovirus (PiCV), Columbid alphaherpesvirus 1 (pigeon herpesvirus (PiHV)) and Fowl aviadenovirus (FAdV) in the country. These viruses were selected as they are associated with severe disease in pigeons across the world. A total of 192 cloacal swabs were collected from young (<1 year old) pigeons from 16 different private pigeon flocks across Turkey, between 2018 and 2021 as part of routine diagnostic sampling. PiCV genetic material was the most frequently detected 4/16 (25%), PiAdV-1 and CoHV-1 DNA were both found in one flock each, while neither PiAdV-2 and FAdV were detected in any of the studied pigeon flocks. PiCV and PiHV genetic material were both detected in the same pigeon flock’s cloacal samples as a co-infection with the identification of PiHV being a first in Turkey.

The first serological detection of West Nile virus infection among residents living in northern Turkey

BACKGROUND & OBJECTIVES

West Nile virus (WNV) is transmitted by a mosquito-borne virus whose natural reservoir is birds. Humans and horses are considered accidental hosts. Even if the vast majority of WNV infections in humans have asymptomatic or mild disease settings, serious neurological disorders with lethal outcomes can also be observed in around 1% of the cases. We aimed to serologically investigate the presence of WNV in humans living in Black sea of Turkey, and to obtain epidemiological data that will contribute to the implementation of public health policies to control and prevent potentially other life-threatening arboviral infections.

METHODS

In the current study, a total of 416 human sera were collected from native patients of Samsun and its boroughs attending Samsun Training and Research Hospital; these sera were tested for WNV with pooling method, using anti-IgM and IgG ELISA commercial kits. All pools that were found positive for both IgM and IgG were individually retested for the detection of positive WNV sera. After that, all positive samples were tested using real-time PCR to detect the presence of WNV-RNA particles.

RESULTS

Total seropositivity rates of WNV in terms of IgM and IgG were found as 0.96% and 0.72%, respectively. No presence of WNV-RNA could be detected in positive samples.

INTERPRETATION & CONCLUSION

According to the data, further studies should be conducted to better understand the epidemiological dynamics of WNV in Turkey. It is recommended that other antigenically related flaviviruses which can give cross-reaction with WNV should also be investigated.

First detection and molecular characterisation of a pigeon aviadenovirus A and pigeon circovirus co-infection associated with Young Pigeon Disease Syndrome (YPDS) in Turkish pigeons (Columba livia domestica)

Pigeon aviadenovirus A and Pigeon circovirus are both DNA viruses, infect and cause severe clinical diseases in pigeons. These viruses are associated with an immunosuppression syndrome similar to ‘Young Pigeon Disease Syndrome’ (YPDS). This study reports the identification of a natural co‐infection, with severe clinical signs (crop vomiting, watery diarrhoea, anorexia and sudden death) of Pigeon aviadenovirus A and Pigeon circovirus in a breeding pigeon flock in Central Anatolia, Turkey. Both viruses were isolated from pigeons pooled internal organs using primary chicken embryo kidney cell cultures (CEKC) and specific pathogen‐free (SPF) embryonated chicken eggs. Also, both viruses were identified by PCR amplification followed by Sanger sequencing whereas histopathological examination showed degenerated hepatocytes with basophilic intranuclear viral inclusions. As known, both viruses typically have similar transmission characteristics and common clinical manifestations; however, co‐infection may exacerbate the disease with devastating outcomes. This is the first report of its kind in Turkey for those viruses and is essential for the protection against these kinds of infections in pigeons.

Sentinel serosurveillance of backyard hens proved West Nile virus circulation in the western provinces of Turkey

West Nile virus (WNV) is a mosquito-borne virus of a re-emergence importance with a wide range of vertebrate hosts. Granted, it causes asymptomatic infection, but fatal cases and neurologic disorders were also recorded, especially in humans, horses and some exposed birds. The virus is globally spread and birds are considered an amplifying and reservoir host of WNV, helping to spread the disease due to their close contact with main hosts. In this study, we aimed to detect the presence of antibodies against WNV in backyard hens that were reared in the western Anatolian part of Turkey. A total of 480 chicken sera were randomly collected from six provinces in the west of Turkey (Mugla, Izmir, Aydin, Afyonkarahisar, Kutahya and Manisa) with 80 samples from each province (40 in spring and 40 in fall seasons). They were tested by using a competitive ELISA method to identify the specific avian antibodies of IgG that produced against the WNV envelope proteins (pr-E). Twelve of 480 (2.5%) sera were found seropositive, three of these positive sera were detected from the Izmir province (3.75%) collected in the spring session and the other nine positive sera were detected from the Mugla province (11.25%) collected in the fall session. Both of these provinces are located seaside and have suitable climate conditions for vectors of infection. The results indicated that WNV infection is in circulation in these provinces, and that may put the other susceptible vertebrates under risk of infection.

A serosurvey for bovine respirovirus 3 in Turkish domestic ruminants: The first comparison study of A and C genotypes

Bovine parainfluenza virus‐3 (BPIV‐3), also known as bovine respirovirus 3, causes serious respiratory infection in ungulates, often involving other pathogens, such as viruses, bacteria and mycoplasmas. In this study, we evaluated antibody titers against virus genotypes A (BPIV‐3a) and C (BPIV‐3c). We conducted a serological survey and comparison analysis of archived serum samples from small and large ruminants reared in four Turkish provinces. A total of 1,307 samples, consisting of sheep (n = 444), cattle (n = 402), water buffalo (n = 261) and goat (n = 200) sera, were randomly selected from stock samples collected between 2015 and 2019 and screened by standard virus neutralisation assay. We found that 49.9% (653/1307) of all samples were positive for neutralising antibody titers. Goats had the highest titer, with total seropositivity of 63% (126/200), followed in descending order by cattle, sheep and water buffalo at 56.2% (226/402), 32.2% (143/444) and 26% (68/261) total seropositivity, respectively. BPIV‐3c had the highest neutralising antibody rate at 34.3% (448/1307), whereas BPIV‐3a had a 24.3% (317/1307) seropositivity rate. Neutralising antibody titers for positive samples ranged between 1/4 and 1/512 per the SN₅₀ test. Seropositivity rates ranged from a low of 8.9% to a high of 18.3%. Our study was the first to compare antibody seroprevalence for two BPIV‐3 genotypes in small and large domestic ruminants, which were shown to be more commonly exposed to BPIV‐3c than BPIV‐3a. This finding could have significant implications as current vaccines mainly use the BPIV‐3a genotype. Further research can determine if current vaccines protect against different BPIV‐3 virus genotypes.

Marek's disease virus in vaccinated poultry flocks in Turkey: its first isolation with molecular characterization

Marek's disease (MD) is an important disease of avian species and a potential threat to the poultry industry worldwide. In this study, 16 dead commercial chickens from flocks with suspected MD were necropsied immediately after death. Pathological findings were compatible with MD, and gallid alphaherpesvirus 2 was identified in PCR of spleen samples. Virus isolation was performed in primary cell culture, and partial sequencing of the meq gene of the isolate revealed >99% nucleotide sequence identity to virulent and very virulent plus strains from a number of European countries, placing it in the same subclade of clade III as two virulent Italian strains and a very virulent plus Polish strain as well as virulent strains of geese and ducks. The data reported here indicate that a virulent strain of Marek's disease virus is circulating in Turkey and has not been stopped by the current national vaccination programme.

Serological study on the presence of some alpha-herpesviruses in goats of northern Anatolia, Turkey

The aim of this study was to investigate the presence of caprine herpes virus-1 (CpHV-1) and bovine herpes virus-1 (BoHV-1) in 269 goat sera collected from small-scale family farms located in six provinces within the Black Sea region of northern Turkey. The overall seropositivity for alpha-herpesvirus in the native goats was found as 19.33% using BoHV-1 glycoprotein B (gB)-blocking enzyme-linked immunosorbent assay (ELISA). Additionally, the seroprevalence of BoHV-1 was determined in 5.20% of the goats using virus neutralization test. To distinguish between CpHV-1 and BoHV-1, the combinations of gB/gE-blocking ELISA tests were performed. Of tested samples, 15.24% were CpHV-1 seropositive; whereas, 4.09% were BoHV-1 seropositive. The results indicated that CpHV-1 is in circulation among local goats of northern Turkey. Considering the close relationship between BoHV-1 and CpHV-1, the transmission of BoHV-1 via goats may also be one of the predisposing factors involving in the spread of virus among the surrounding cattle.

Circulation of Indigenous Bovine Respiratory Syncytial Virus Strains in Turkish Cattle: The First Isolation and Molecular Characterization

Bovine respiratory disease (BRD) is a huge economic burden on the livestock industries of countries worldwide. Bovine respiratory syncytial virus (BRSV) is one of the most important pathogens that contributes to BRD. In this study, we report the identification and first isolation, with molecular characterization, of a new BRSV strain from lung specimens of three beef cows in Turkey that died from respiratory distress. After the screening of lung tissues for BRD-associated viruses using a multiscreen antigen-ELISA, a BRSV antigen was detected. This was then confirmed by real-time RT-PCR specific for BRSV. Following confirmation, virus isolation was conducted in MDBK cell cultures and clear CPE, including syncytia compatible with BRSV, were detected. RT-nested PCR, using F gene-specific primers, was performed on the cultured isolates, and the products were sequenced and deposited to Genbank with accession numbers MT179304, MT024766, and MT0244767. Phylogenetic analysis of these sequences indicated that the cattle were infected with BRSV from subgroup III and were closely related to previously identified American and Turkish strains, but contained some amino acid and nucleotide differences. This research paves the way for further studies on the molecular characteristics of natural BRSV isolates, including full genome analysis and disease pathogenesis, and also contributes to the development of robust national strategies against this virus.

Development of a multiplex RT-PCR assay for the routine detection of seven RNA viruses in Apis mellifera

Colony losses in apiaries are frequently one of the most important problems in beekeeping. Colony loss is multifactorial with many reported disorders, Colony Collapse Disorder (CCD), is an increasingly recognised phenomenon which is thought to be caused by many pathogens, including viruses. The aim of this study was to develop a multiplex RT-PCR (mRT-PCR) test to obtain faster results in routine diagnostic laboratories for seven crucial bee viruses. Specific primers for seven RNA viruses, including Israeli acute bee paralysis virus (IAPV), deformed wing virus (DWV), sacbrood virus (SBV), acute bee paralysis virus (ABPV), black queen cell virus (BQCV), kashmir bee virus (KBV) and chronic paralysis virus (CBPV), were used for testing procedure. The mRT-PCR assay can amplify seven plasmid DNA fragments from the pooled viral genomes and it was shown to be sensitive because virus copy numbers were detected to be 10⁴ copies/μl when log₁₀ serial dilutions were performed for the optimized mRT- PCR method. It is concluded that, mRT-PCR test can be used in routine analysis because this assay can perform specific, sensitive and reliable results also achieves economic gains and time due to detecting seven viral agents simultaneously.

Specific Substitutions in Region V2 of gp120 env confer SHIV Neutralisation Resistance

A tier 2 SHIV-MK38 strain was obtained after two in vivo passages of tier 1 SHIV-MK1. SHIV-MK38#818, cloned from the MK38 strain, was neutralisation-resistant, like the parental MK38 strain, to SHIV-infected monkey plasma (MP), HIV-1-infected human pooled plasma (HPP), and KD247 monoclonal antibody (mAb) (anti-V3 gp120 env). We investigated the mechanisms underlying the resistance of #818, specifically the amino acid substitutions that confer resistance to MK1. We introduced amino acid substitutions in the MK1 envelope by in vitro mutagenesis and then compared the neutralisation resistance to MP, HPP, and KD247 mAb with #818 in a neutralisation assay using TZM-bl cells. We selected 11 substitutions in the V1, V2, C2, V4, C4, and V5 regions based on the alignment of env of MK1 and #818. The neutralisation resistance of the mutant MK1s with 7 of 11 substitutions in the V1, C2, C4, and V5 regions did not change significantly. These substitutions did not alter any negative charges or N-glycans. The substitutions N169D and K187E, which added negative charges, and S190N in the V2 region of gp120 and A389T in V4, which created sites for N-glycan, conferred high neutralisation resistance. The combinations N169D+K187E, N169D+S190N, and N169D+A389T resulted in MK1 neutralisation resistance close to that of #818. The combinations without 169D were neutralisation-sensitive. Therefore, N169D is the most important substitution for neutralisation resistance. This study demonstrated that although the V3 region sequences of #818 and MK1 are the same, V3 binding antibodies cannot neutralise #818 pseudovirus. Instead, mutations in the V2 and V4 regions inhibit the neutralisation of anti-V3 antibodies. We hypothesised that 169D and 190N altered the MK1 Env conformation so that the V3 region is buried. Therefore, the V2 region may block KD247 from binding to the tip of the V3 region.

An investigation of the seroprevalence of CrimeanCongo Hemorrhagic Fever and Lumpy Skin Disease in domesticated water buffaloes in northern Turkey

This study was conducted in Samsun Province of Turkey to investigate the serological status of domesticated water buffaloes for both Crimean-Congo Hemorrhagic Fever (CCHF) and Lumpy Skin Disease (LSD). Serum was collected from a total of 272 water buffaloes from different age groups and both genders; of the total, 48.1% had been vaccinated against LSD with heterologous sheep-goat pox vaccine. The serum samples were individually assessed by using a commercial ID screen enzyme-linked immune-sorbent assay (ELISA) to detect neutralizing antibodies against both CCHF virus and LSD virus. All 272 buffaloes were negative for antibodies against the CCHF virus. All the unvaccinated buffaloes (141) were seronegative for LSD virus but of the 131 vaccinated buffaloes, 10 (7.6%) were seropositive for the LSD virus. In addition, 8.6% of vaccinated animals age >1 year old were seropositive for LSD, whereas the seropositivity was 5.1% for the animals age <= 1 year old. There was no significant difference for seropositivity between male and female animals in the >1 year old or <= 1 year old age groups. When seroprevalances for LSD in the tested water buffaloes are evaluated by gender, there was a significant difference between females (8.6%) and males (0%) in the <1 year old water buffaloes (X²=20.24; P<0.001). Separately, the results of this study indicate that Bafra district water buffaloes are not infected by CCHFV and LSDV and some of the buffaloes that vaccinated with LSDV did not develop sufficient antibodies to protect them after they were vaccinated for the LSD virus. Furthermore, the authors of this study conclude that both the commercially produced vaccine that is currently administered and the vaccination strategy have to be urgently evaluated by the veterinary authorities in Turkey. This is essential in order to combat the spread of LSD virus infection with an effective vaccine and a comprehensive management strategy across Turkey.

Epidemiological findings on Hepatitis C infection in a tertiary level hospital in mid-northern Anatolia in Turkey: A four-year analysis

The hepatitis C virus (HCV) is a blood-borne pathogen that causes acute or chronic infection of the liver, sometimes leading to serious liver damage and fatality. The objective of this study was to evaluate HCV prevalence in patients attending the Regional Training and Research Hospital for Medical Examination and Surgery in Samsun Province of Turkey between 2014 and 2017. Blood specimens taken from 152 596 patients were screened for HCV infection by using the anti-HCV assay. Seropositive samples were subjected to polymerase chain reaction (PCR) testing in order to determine whether the HCV infection was active. Genotyping was then performed. Overall, HCV seropositivity and active HCV infection were 2.76% and 2.05%, respectively. Foreign nationals accounted for 5.61% of the seropositive samples and 1.37% of active HCV infective samples. We further report that 2017 was the year with the highest seroprevalence which was 3.64%. HCV genotype 1 was the most common genotype detected in residents of Samsun Province at 89.86%, followed by Genotype 3 at 4.54%. This study provides important information on the levels of HCV infection in the Samsun region of Turkey. The data indicate that there was a rising trend of HCV infection between 2014 and 2017.

Cross-sectional imaging and laparoscopic findings of diaphragmatic mesothelial cysts

AIM

To present cross-sectional imaging, surgical findings, and follow-up results of diaphragmatic mesothelial cysts.

MATERIALS AND METHODS

Radiological findings for location, size, shape, and internal structure of cysts were reviewed retrospectively. For patients that underwent surgery, surgical reports and laparoscopy images were reviewed. In conservatively managed patients, changes in size and imaging findings of the cyst were assessed during follow-up visits.

RESULTS

A total of 13 paediatric cases with an imaging and/or pathological diagnosis of diaphragmatic mesothelial cyst were identified. In all cases, the cystic lesions were located between the diaphragm and the posterolateral aspect of the right lobe of the liver. Eleven lesions (84.6%) had a bi-lobulate shape. Eight of these cases underwent laparoscopic cyst aspiration/unroofing. The postoperative course was uneventful and there were no cases of recurrence. The remaining five cases were managed conservatively with follow-up available in four cases. In three cases (75%), there was reduction in the size of the cysts with a mean volume reduction of 55%.

CONCLUSION

Diaphragmatic mesothelial cysts are congenital cystic lesions that are usually detected incidentally. A common pitfall is incorrect interpretation of the lesion as a hepatic cyst. Conservative management with imaging follow-up can be adopted in asymptomatic cases with typical imaging findings.

The first serological report for genotype C bovine parainfluenza 3 virus in ruminant species of mid-northen Turkey: Traces from the past

Bovine parainfluenza 3 virus (BPI3V)is one of the most important respiratory pathogens and a leading cause of serious respiratory illnesses in cattle, both independent of and in connection with other pathogens involved in the bovine respiratory disease complex (BRDC). In this study, we aimed to identify the historical circulation of genotype C bovine BPI3V (BPI3Vc) in Turkey using the archival serum samples of domestic ruminants that had been collected from six provinces of northern Anatolia in Turkey between 2009-2010. A total of 896 sera from cattle (n=442), sheep (n=330), and goats (n=124) were randomly selected and screened with a virus neutralization test in order to detect antibodies for BPI3Vc. The overall seropositivity rate was 21.09%, with seropositivity rates for cattle, sheep, and goats of 21.04%, 20.00%, and 24.19%, respectively. Neutralizing antibody titers for selected samples ranged between 1/4 to 1/512. This study represents the first serological study conducted using the first BPI3V isolate of Turkey.

Differentiation of hepatocellular carcinoma from non-hepatocellular malignant tumours of liver by chemical-shift MRI at 3 T

AIM

To evaluate the diagnostic performance of chemical shift magnetic resonance imaging (MRI) in distinguishing hepatocellular carcinomas (HCCs) from non-hepatocellular malignant tumours (non-HCCs) of the liver.

MATERIALS AND METHODS

Patients with a diagnosis of malignant liver tumours examined at 3 T MRI were included in this retrospective study. Forty-seven HCCs and 75 non-HCCs that were studied with chemical-shift MRI between January 2012 and October 2016 were retrieved from the radiology database. Two blinded observers measured the signal intensities of the tumours, adjacent normal-looking liver parenchyma, and spleen on chemical-shift MRI. The fat quantification for HCCs, non-HCCs, and adjacent normal-looking liver parenchyma were calculated by using the spleen as a reference standard. The subtraction scores were calculated by subtracting fat percentages in liver parenchyma from those in tumours. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the fat percentage subtraction scores in distinguishing HCCs from non-HCCs were calculated.

RESULTS

According to the optimal cut-off value acquired from both readers, a subtraction score >-0.26 was considered to be a HCC. Fat signal percentage subtraction scores were ≥-0.26 in 45 of 47 HCCs and were <-0.26 in 69 of 75 non-HCCs. The sensitivity, specificity, PPV, and NPV of fat signal percentage subtraction score to differentiate HCCs from non-HCCs were found to be 95.7%, 89.3%, 84.9%, and 97.1%, respectively.

CONCLUSION

Intracytoplasmic lipid in HCCs demonstrated by quantitative chemical-shift MRI may be a potentially powerful imaging biomarker to distinguish HCCs from the other malignant liver tumours.

A Study on the Identification of Five Arboviruses from Hematophagous Mosquitoes and Midges Captured in Some Parts of Northern Turkey

Background: Whether zoonotic or not, arboviral infections are continuing to be a major threat to human health as well as the livestock industry all around the world. This project presented the results of the identification study on five arboviruses, including West Nile virus (WNV), Bovine ephemeral fever virus, Akabane virus, Bluetongue virus, and Epizootic hemorrhagic disease virus, in mosquitos and midges from eight provinces of the Black Sea Region. Methods: During 2011 and 2012, 3193 mosquitoes were captured around natural streams, rivers, lakes, and ponds using dry-baited miniature light-traps. Identification studies were concluded by employing molecular methods. Results: According to the morphological identification, blood-sucking mosquitoes and biting-midges belonged to Aedes (44.69%), Anopheles (28.34%), Culex (22.14%) and Culicoides (4.83%) species. Overall, 146 pools were made up of captured mosquitos and midges. None of the five viruses were directly identified by mosquitoes. Conclusion: Mosquitoes and midges have got a crucial role in the transmission of arboviruses. The risk of occurrence for the investigated arboviruses will continue depending upon many factors including the presence of these viruses in Turkey and its neighboring countries, uncontrolled livestock movements, global warming and climate changes.

A Study on the Identification of Five Arboviruses from Hematophagous Mosquitoes and Midges Captured in Some Parts of Northern Turkey

BACKGROUND

Whether zoonotic or not, arboviral infections are continuing to be a major threat to human health as well as the livestock industry all around the world. This project presented the results of the identification study on five arboviruses, including West Nile virus (WNV), Bovine ephemeral fever virus, Akabane virus, Bluetongue virus, and Epizootic hemorrhagic disease virus, in mosquitos and midges from eight provinces of the Black Sea Region.

METHODS

During 2011 and 2012, 3193 mosquitoes were captured around natural streams, rivers, lakes, and ponds using dry-baited miniature light-traps. Identification studies were concluded by employing molecular methods.

RESULTS

According to the morphological identification, blood-sucking mosquitoes and biting-midges belonged to Aedes (44.69%), Anopheles (28.34%), Culex (22.14%) and Culicoides (4.83%) species. Overall, 146 pools were made up of captured mosquitos and midges. None of the five viruses were directly identified by mosquitoes.

CONCLUSION

Mosquitoes and midges have got a crucial role in the transmission of arboviruses. The risk of occurrence for the investigated arboviruses will continue depending upon many factors including the presence of these viruses in Turkey and its neighboring countries, uncontrolled livestock movements, global warming and climate changes.

Characterisation of the First Bovine Parainfluenza Virus 3 Isolate Detected in Cattle in Turkey

A respiratory disease outbreak on a cattle farm in northern Turkey produced respiratory tract symptoms and severe pneumonia symptoms in 20 calves. Eight calves died, and a lung specimen from one carcass was analysed for bacteria and for viruses of the Bovine respiratory diseases complex. Bacteriological analysis was negative, but antigen detection ELISA and RT-PCR results indicated the presence of Bovine parainfluenza virus (BPIV). Virus isolation succeeded on Madin-Darby Bovine Kidney cells, and subsequent whole genome sequencing and phylogenetic analysis identified BPIV-3c. This is the first report of BPIV-3c isolation from cattle in Turkey, indicating the need for more virological and epidemiological studies.

Where we are in the fight against Hepatitis B Infection; Trends in Hepatitis B virus seroprevalence in Black Sea Region of Turkey

CONTEXT

To determine new strategies for complete coverage of hepatitis B virus (HBV) vaccination, every country needs to take into concern factors of infection transmission in its own region.

AIMS

The aim of this study was to investigate the seroprevalence of hepatitis B among all age groups in northern Turkey using HBsAg and anti-HBs serological markers.

MATERIALS AND METHODS

The laboratory records of a total of 101648 patients of all ages attending a tertiary level hospital in Samsun, a Black Sea coastal city, between January 2014 and May 2016 were evaluated retrospectively.

RESULTS

HBsAg and anti-HBs seropositivity was found to be 4% and 38.3%, respectively. There was a significant difference between HBsAg (χ2 = 209.08; P = 0.00), anti-HBs (χ2 = 124.12; P = 0.00) seropositivity, and immunization status. Although we found a statically difference between men and women (χ2 = 32.2 P = 0.00) for HBsAg seropositivity, there was no significant difference for anti-HBs (P = 0.22). In 1998, the universal infant immunization program changed the HBV epidemiology in Turkey, and resulted in an apparent trend towards reduced disease levels. However, prevalence of HBV infection is still high in adolescent and young adults.

CONCLUSIONS

Therefore, a catch-up immunization program, education, and follow-up policy for these groups, in addition to routine infant immunization, will decrease the HBV infection rate, reducing morbidity and mortality rates, and will help to reduce hepatitis B transmission in Turkey.

Molecular identification and phylogenetic analysis of non-cytopathic bovine viral diarrhea virus isolate obtained from a local respiratory outbreak in Northern Turkey

In February 2016, a local respiratory disease outbreak with two fatalities was reported in Samsun, Turkey. A non-cytopathic bovine viral diarrhea virus (ncp-BVDV) was identified from the organ and leucocyte samples of dead juvenile heifers using RT-PCR with specific primers for the NS2/3 gene coding region. The NS2/3 gene of BVDV was sequenced and compared with other published sequences of BVDV. The sequences of our isolate which was named as Samsun TR, had 81–83% nucleotite (nt) identity for BVDV-1. Phylogenetic analysis revealed that Samsun-TR was closely related to LC089875 (Japan), AF526381 (China) and also shared 83% nucleotide(nt) identity with them. The NS2/3 gene sequence of Samsun-TR was deposited in the GenBank database with the accession number of KX428495.

Does porphyrin suppres the apoptotic and necrotic effects of bovine herpes virus type-1(BoHV-1) and herpes simplex virus type-1(HSV-1)?

In this study, antiviral effect of porphyrin was investigated. Cooper strain of Bovine Herpes Virus type 1(BoHV-1) and Kos strain of Herpes Simplex Virus type-1 (HSV-1) were used to determine the potential of porphyrins to inhibit infection in vitro (with morphological and cytopathological criteria). Apoptotic and necrotic changes were determined by using DAPI and propidium staining. The non-cytotoxic dose of porphyrin (NCD-p) was initially calculated as 312.50µg/mL on MDBK and Vero cells. The apoptotic cell (APC) count was found 10% with BoHV-1 while it was 5.3% with BoHV-1 treated with porphyrin on MDBK cells between 6th to 24th hours post infection (hpi). Necrotic cell (NEC) count was 51% with BoHV-1 and 37.8% BoHV-1 treated with porphyrin on MDBK cells at 24th hpi. On the other hand, the APC count was found 23% with HSV-1, while 22% with the HSV-1 treated with porphyrin on Vero cells between 6th to 24th hpi. NEC count was 49% with HSV-1 and 34% HSV-1 treated with porphyrin on MDBK cells at 24th hpi. The results show that BoHV-1 was inhibited by porphyrin resulting in decreased apoptotic and necrotic changes in MDBK cells. On the contrary, porphyrine was not effective in the inhibition of HSV-1 in terms of apoptosis but it caused necrotic changes in Vero cells.

Contribution of thin-slice (1 mm) axial proton density MR images for identification and classification of meniscal tears: correlative study with arthroscopy

OBJECTIVE

To evaluate the diagnostic efficacy of thin-slice (1 mm) axial proton density-weighted (PDW) MRI of the knee for meniscal tear detection and classification.

METHODS

We prospectively assessed pre-operative MR images of 58 patients (41 males, 17 females; age range 18-62 years) with arthroscopically confirmed meniscal tear. First, we evaluated the performance of the sagittal and thin-slice axial MR images for the diagnosis of meniscal tears. Second, we compared the correlation of tear types presumed from sagittal and axial MRI with arthroscopy and tear classification from axial MRI. Tears were classified on the sagittal plane and the axial plane separately. The diagnostic performance and tear classification were compared statistically with arthroscopy results, which is accepted as the standard of reference.

RESULTS

8 of 58 patients were removed from the study group because they had complex or degenerative tears. A total of 62 tears were detected with arthroscopy in 50 patients. On the sagittal images, sensitivity and specificity values were 90.62% and 70.37%, respectively, for medial meniscus tears and 72.73% and 77.14%, respectively, for lateral meniscus tears. The corresponding values for axial images were 97.30% and 84.00%, respectively, for medial meniscus tears and 95.65% and 80.50%, respectively, for lateral meniscus tears. There was no significant difference in tear classification between the arthroscopy results and the thin-slice axial PDW MRI results (p>0.05).

CONCLUSION

thin-slice axial PDW MRI increases the sensitivity and specificity of meniscal tear detection and especially classification, which is important for surgical procedure decisions.

Maedi-visna virus infection in Karayaka and Amasya Herik breed sheep from provinces in northern Turkey

Maedi-visna is an important virus infection of sheep having prolonged incubation period (slow disease) and reflecting two distinct forms clinically and pathologically. In this study, the presence of MVV was investigated serologically in 58 Amasya Herik sheep breed and 525 Karayaka sheep breed. Seropositivity rates in Amasya Herik sheep breed and Karayaka sheep breed were detected as 69.0% and 18.5%, respectively. MVV antibodies were found in 137 of 583 serum samples (23.5%). Positivity rates for the provinces varied and were as follows: Samsun 19.4%, Sinop 15.4%, Ordu 25.8%, Trabzon 26.7%, Rize 36.7%, Amasya 69.0% and Tokat 35.0%, however no antibody response was detected in all of the sheep in Giresun province.

Hydration and sweating responses to hot-weather football competition

During a football match played in warm (34.3 ± 0.6 °C), humid (64 ± 2% rh) conditions, 22 male players had their pre-match hydration status, body mass change, sweat loss and drinking behavior assessed. Pre-match urine specific gravity (1.012 ± 0.006) suggested that all but three players commenced the match euhydrated. Players lost 3.1 ± 0.6 L of sweat and 45 ± 9 mmol of sodium during the 90-min match and replaced 55 ± 19% of their sweat losses and hence by the end of the game were 2.2 ± 0.9% lighter. The water volume consumed during the game was highly variable (1653 ± 487 mL; 741-2387 mL) but there was a stronger relationship between the estimated pre-game hydration status and water volume consumed, than between sweat rate and water volume consumed. In a second match, with the same players 2 weeks later in 34.4 ± 0.6 °C, 65 ± 3% rh, 11 players had a sports drink available to them before and during the match in addition to water. Total drink volume consumed during the match was the same, but approximately half the volume was consumed as sports drink. The results indicate that substantial sweat water and electrolyte losses can occur during match play in hot conditions and a substantial water and sodium deficit can occur in many players even when water or sports drink is freely available.

Effect of boron supplementation on plasma element distribution in ovariectomized rats subjected to acute swimming exercise

BACKGROUND

This study aims to examine how boron supplementation affects distribution of elements in the plasma of rats whose ovaries were removed and who were subjected to swimming exercise.

METHODS

The study included 80 Sprague-Dawley type female rats, which were equally allocated to 8 groups. Group 1: General control, Group 2: Exercise control; Group 3: Ovariectomized control, Group 4: Ovariectomized exercise, Group 5: IP (intraperitoneal) boron-supplemented control, Group 6: IP boron-supplemented exercise, Group 7: Ovariectomized, IP boron-supplemented exercise, group 8: Ovariectomized, IP boron-supplemented. Following the exercise, blood samples were collected from all animals by decapitation, and analyzed in terms of plasma copper, iron, phosphorus, magnesium, calcium, and zinc using an atomic absorption spectrophotometer.

RESULTS

Groups 1 and 5 had the lowest copper (p < 0.01) and the highest zinc and calcium (p < 0.01) levels, in comparison to other groups. Phosphorus levels in groups 3, 5 and 8 were significantly lower than those in other groups (p < 0.01). Magnesium levels in groups 3, 5 and 8 were higher, relative to the levels in other groups (p < 0.01).

CONCLUSION

Results of the study indicate that acute swimming exercise in ovariectomized rats supplemented with boron leads to significant modifications in the distribution of some trace elements in the plasma. It can be emphasized as a separate result of this study that changes in copper, zinc and calcium levels were independent of boron supplementation (Tab. 2, Ref. 14).

Herpes simplex type I infection and atopy association in Turkish children with asthma and allergic rhinitis

This study investigated the association between HSV-1 infection and atopy by comparing seropositivity to HSV-1 in atopic children with asthma and allergic rhinitis and in non-atopic children. Totally 249 children randomly selected from the university outpatient pediatric clinics were prospectively enrolled in the study between September 1 and November 30, 2007. Serum samples were examined using the virus neutralization test (VNT) for HSV-1 Immunoglobulin G(IgG) seropositivity. Skin prick tests (SPTs) were performed to determine atopic status. The results showed that HSV-1 IgG seropositivity was significantly higher in atopic children (56.8%) with asthma and allergic rhinitis than in the age-matched non-atopic children group (30.4%) (p<0.001). Although the occurrence of atopy was higher in seropositive girls (57%) than in seropositive boys (47%), the difference was not significant (p=0.329). These results support a possible relationship between the atopic status of children with asthma and allergic rhinitis and HSV-1 infection.

Reference values for neonatal thyroid volumes in a moderately iodine-deficient area

BACKGROUND

The reference ranges of thyroid volumes in neonates vary according to the iodine status of a specific region. In different studies, it ranged between 0.47 and 1.62 ml. It has been previously shown that Bursa city was a moderately iodine-deficient area. We therefore aimed at determining normal reference ranges of neonatal thyroid volumes in our moderately iodine-deficient area.

METHODS

In this cross-sectional study, thyroid volumes of 100 healthy fullterm neonates (51 boys and 49 girls; mean gestational age 38.9+/-1.1 weeks; and mean birth-weight 3370+/-446 g) were measured during the first week of life using thyroid ultrasonography. These data were compared with the gestational age, birth weight, gender, and TSH values of neonates as well as with maternal factors such as gestational diabetes, preeclampsia, smoking, medication use, and heart disease.

RESULTS

All blood samples for TSH were taken during the first 5 days (mean 1.09+/-0.9 days). The mean TSH levels in all male and female neonates were 3.77+/-3.71, 4.57+/-3.61, and 2.93+/-3.66 mIU/l, respectively. This difference was statistically significant (p=0.006). Mean thyroid volumes for all male and female neonates were calculated as 0.82+/-0.18 (range 0.51-2.04), 0.84+/-0.21 (range 0.51-2.04), and 0.80+/-0.14 ml (range 0.58-1.30), respectively. There were no statistically significant differences in thyroid volumes with respect to gestational age, birth weight, gender, TSH values of neonates and maternal factors.

CONCLUSION

Normal thyroid volumes in neonates vary between different regions. Local reference values should be used in thyroid volume assessment. Our results are in concordance with the literature and can be used as reference values for our region.

Distribution of HSV-1 IgG antibodies by two methods comparing in Turkish atopic children

Herpes Simplex Virus Type 1 (HSV-1) is a ubiquitous pathogen. Other than known diseases, HSV-1 may have an important role in the pathogenesis of atopy by causing immortality of th2 cells. From June 1st to July 31st 2006, seventy five blood samples were collected from atopic children referred to the allergy clinic of the hospital. The bloods samples were used to detect HSV-1 IgG antibodies by Enzyme-Linked Immunosorbent Assay and Virus Neutralization Test. HSV-1 IgG antibody seroprevalence in atopic children was found high, 62.6% by Enzyme-Linked Immunosorbent Assay and 57.3% by Virus Neutralization Test. Thus Virus Neutralization Test sensitivity was 92.15% and specificity was 100% regarding to the Enzyme-Linked Immunosorbent Assay technic. Although Enzyme-Linked Immunosorbent Assay was more sensitive than Virus Neutralization Test, there was no significant difference between two technics (p > 0.05) in detecting HSV-1 IgG antibodies in serum.

Occurrence of ovine herpesvirus type-2 infection in sheep and cattle in Samsun Province, Turkey

July 2004, a cow with clinical signs of ovine herpesvirus type-2 infection which is known as sheep associated malignant catarrhal fever (SA-MCF) was reported in Samsun Province in Turkey. Blood samples were collected from the suspected cow, 10 sheep housed with it, and from 150 healthy sheep and 29 healthy cattle randomly selected from different places in Samsun Province. Nested polymerase chain reaction (n-PCR) was used to detect ovine herpesvirus type-2 (OvHV-2) DNA in the suspected cow and competitive- ELISA (c-ELISA) kits were used to detect antibodies against OvHV-2. The suspected cow was found to be n-PCR positive and c-ELISA negative. The serological results were as follows: All 10 (100%) of sheep housed with the suspected cow and 18 of 29 (62%) of the randomly selected cattle were found seropositive. All 150 randomly selected healthy sheep were seronegative. The overall percentage of seropositivity was 14.7% (28/190). OvHV-2 DNA was detected in the peripheral blood leucocyte (PBL) samples of the cow and of the 10 sheep housed with the suspected cow.

Selective apoptotic behaviour of bovine herpesvirus 1 in an epithelial-like microenvironment

Apoptosis seems to play an important role in the pathogenic profile of bovine herpesvirus 1 (BHV-1) infection. Nitric oxide (NO) is also important as a signal molecule. In this study, apoptosis was selectively induced in HEp-2 cells in the early stage [1-3 h postinfection (PI)] of BHV-1 multiplication, and this apoptotic process was realised through the caspase-8, and partially through the caspase-3, pathway. BHV-1 infection inhibited staurosporine- (SS-) induced apoptosis only if the SS was added at 6 h PI. The results of this study showed that the 'NO-apoptosis' relation was realised through the caspase-8 pathway ('outer membrane receptor' pathway) at a later stage of infection in apoptosis induced by BHV-1 + SS. Our previous report (Yazici et al., 2004) and this study together showed that BHV-1 might induce and inhibit cell-type-specific pathways of apoptosis.

Effects of non toxic doses of acyclovir on nitric oxide and cellular death responses in herpesvirus types 1 and 2 infected hep-2 cells

Herpes simplex virus type-1 (HSV-1) and type-2 (HSV-2) are among the most "successful" pathogens and code for a variety of proteins to direct the apoptosis/necrosis responses of the cells they infect. Nitric oxide (NO) is an important intracellular signaling molecule in pathological processes. Acyclovir (ACV) is a chain terminator that targets the viral DNA polymerase as an antiviral agent. In this study, NO signals, and apoptosis/necrosis responses of HEp-2 cells were compared when infected by HSV-1 and -2 for 24 hours against non toxic doses (starting from 48.8, 24.4, 12.2, 6.1, 3 to 1.5 microg/mL) of ACV. In 48.8, 24.4 and 12.2 microg/mL of ACV, HSV-1 had an "upregulating effect" whereas HSV-2 had a "downregulating effect" on NO production, and in 6.1, 3 and 1.5 microg/mL of ACV HSV-1 had a "down-regulating effect" whereas HSV-2 had an "upregulating effect" on NO responses (HSV-1 had a "downregulating effect" on NO production whereas HSV-2 had an "upregulating effect" on NO production without any ACV). In 48.8, 24.4 and 12.2 microg/mL of ACV, HSV-1 had an "anti-apoptotic effect" whereas HSV-2 had a stimulation on "apoptotic effect", and in 6.1, 3 and 1.5 microg/mL of ACV HSV-1 had an "apoptotic effect" and HSV-2 turned to "its natural viral apoptotic effect level" (HSV-1 had an "natural viral apoptotic effect" whereas HSV-2 had a "natural viral apoptotic effect" on apoptosis response without any ACV). In 48.8, and 24.4 microg/mL of ACV, HSV-1 had significant "necrotic effect" on necrotic cellular death, "necrosis" increased in 12.2, 6.1, 3 and 1.5 microg/mL of ACV (HSV-1 had a negligible "necrotic effect" on HEp-2 cells alone), and HSV-2 had a "natural viral necrotic effect" alone; and also in all non toxic ACV concentrations. These results showed that HSV-1 and -2 had different "strategies" on apoptosis/necrosis and NO with and without non toxic ACV. These differences deserve further studies in order to explain the interactions between apoptotic/anti apoptotic, necrotic genes and NO, and ACV in HSV-1 and HSV-2 infections respectively.

Study of programmed cell death in bovine herpesvirus 1 infected MDBK cells and the possible role of nitric oxide in this process

Bovine herpesvirus 1 (BHV-1) is the aetiological agent of many disease types and may predispose infected animals, possibly through immunosuppression, to secondary bacterial infections. Immunosuppression may directly be associated with the induction of programmed cell death (PCD) in some virus-infected cells. Nitric oxide (NO) has an important mediating role against fungal, bacterial, protozoal, viral pathogens and tumours. BHV-1 induced apoptosis between 0.5-3 h postinfection (PI) in MDBK cells; however, between 3 and 6 h PI the PCD response was found to be decreased. It was interesting to see that BHV-I inhibited staurosporin-induced PCD after 1 h. These results showed similarities with those obtained from herpes simplex type I infections in human epithelial cells. PCD response decreased 1 h following caspase-3 inhibitor applications, whereas NO response increased 3 h following infection in the presence of caspase-8 and -9 inhibitory peptides. In conclusion, BHV-1 inhibited the staurosporin-induced apoptotic response and also the NO response. We propose that this inhibition is caspase-3 dependent.

Treatment of nasolacrimal duct obstruction in adults with polyurethane stent

PURPOSE

To evaluate the efficacy of polyurethane nasolacrimal duct stents in the treatment of epiphora resulting from primary acquired nasolacrimal duct obstruction in adults.

MATERIALS AND METHODS

In 25 patients (21 women and four men with mean age of 44 years, range 20 to 74 years) with nasolacrimal duct obstruction, 28 hollow polyurethane stents designed by Song and associates were placed under fluoroscopic guidance. The obstruction was complete in 20 lacrimal drainage systems and partial in eight. The lacrimal sac size was normal or large on dacryocystogram in all lacrimal drainage systems. A Ritleng probe was introduced through the upper punctum and advanced past the obstruction. A guide wire with a flexible tip was then introduced through the probe, over which the stent was advanced in retrograde fashion and placed into the lacrimal sac and nasolacrimal duct. Clinical success was defined by the demonstration of a completely patent lacrimal drainage pathway through saline irrigation and no or minimal complaint of epiphora.

RESULTS

Stent placement was technically successful in 26 of 28 lacrimal drainage systems (93%). The mean time of fluoroscopy screening was 3.2 minutes (range, 1.4 to 5.8 minutes). The overall success rate was 82% (23 of 28 lacrimal drainage systems). Two stents were completely occluded. In one lacrimal drainage system with minimal epiphora, the stented drainage pathway was partially occluded. The patients were followed up from 4 to 22 months (mean, 7.2 months).

CONCLUSIONS

Retrograde placement of a hollow polyurethane nasolacrimal duct stent is a technique that is simple and well tolerated by patients. This method achieves a high success rate and may be suggested as a nonsurgical procedure for adults with primary nasolacrimal duct obstruction and proper lacrimal sac size. The Ritleng probe facilitates the procedure.

Frequency of the common canaliculus: a radiological study

BACKGROUND

It is frequently stated in the literature that there is a common canaliculus (CC) in the lacrimal drainage system in about 90% of individuals; in the remaining 10%, the upper and lower canaliculi enter the lacrimal sac separately. To our knowledge, there is no quantitative study supporting this assumption.

OBJECTIVE

To investigate the frequency of the CC and other anatomical types connecting the upper and lower canaliculi to the lacrimal sac.

MATERIALS AND METHODS

We presumed that there might be 3 different types of anatomical connection between the lacrimal sac and the canaliculi. Digital subtraction macrodacryocystograms obtained from 281 patients with obstructive epiphora were reviewed, and those of 247 patients were included in the study. These patients were grouped according to the anatomical types.

RESULTS

Dacryocystographies were performed on 153 patients unilaterally and 94 bilaterally. We observed a CC in 321 (94.1%) of 341 lacrimal drainage systems. In 13 lacrimal drainage systems (3.8%), the CC was absent, but the upper and lower canaliculi joined at the wall of the lacrimal sac. In only 7 lacrimal drainage systems (2.0%) did the upper and lower canaliculi enter the sac separately. In 2 patients with bilateral dacryocystograms, a CC was seen on one side but not on the other side.

CONCLUSIONS

The frequency of separate drainage of the upper and lower canaliculi into the lacrimal sac is only 2.0%. The CC might not be present bilaterally in all individuals.

An unusual case: bilateral orbital varices

PURPOSE

To present a rare case of bilateral orbital varices.

METHODS

An 18-year-old man showing bilateral orbital masses on magnetic resonance (MR) imaging was examined with color Doppler ultrasonography (US), computed tomography (CT) and digital subtraction venography.

RESULTS

The presenting symptoms of the patient were pain and fullness in both orbits induced by bending forward. Ocular examination was normal with the exception of a two millimeter proptosis of both eyes during Valsalva maneuver. MR imaging demonstrated bilateral retrobulbar masses, but was not diagnostic. The comparison of CT images obtained before and after Valsalva maneuver revealed the diagnosis of orbital varices. Color Doppler US and orbital venography demonstrated a large venous connection between the lesions and systemic circulation.

CONCLUSION

Clinical presentation of orbital varices is unusual. Different radiological methods may be necessary for the confirmation of the diagnosis and demonstration of the anatomic and the dynamic features of the lesions.

Treatment of obstructive epiphora in adults by balloon dacryocystoplasty

AIMS

To determine the efficacy of dacryocystoplasty with balloon dilatation in the treatment of complete and partial obstruction of the lacrimal drainage system.

METHODS

The procedure was performed on 26 patients with epiphora due to complete (n=16) or partial (n=10) obstruction of the lacrimal drainage system. A flexible tipped guide wire was introduced through the superior canaliculus into the inferior meatus and manipulated out of the nasal cavity. A 3 mm balloon was then introduced in a retrograde direction over the guide wire and dilated at the obstruction site.

RESULTS

The procedure was technically successful in all patients with partial obstruction, but unsuccessful in four of 16 cases with complete obstruction. Reobstruction occurred in eight of 12 patients with complete obstruction, and in five of 10 patients with partial obstruction. The overall success rate was 25% for complete and 50% for partial obstructions. The mean follow up was 14 months (8-37 months).

CONCLUSION

Although the balloon dacryocystoplasty is a simple and minimally invasive technique, the outcome from our study indicates that it is not advisable for treatment of complete obstruction of the lacrimal drainage system. Balloon dilatation may prove suitable for the treatment of patients with partial obstruction below the level of the lacrimal sac, especially in those who are poor candidates for surgery, or who do not wish to undertake dacryocystorhinostomy. Even in the partial obstruction group the success rate was only 50%, so that further modification to the technique and controlled studies are likely to be required before it could be recommended for general use.

Fatty acid composition of 19 species of fish from the Black Sea and the Marmara Sea

Evidence suggests that differences in fatty acid composition among various fish species may be due to differences in diet or to environmental factors such as temperature, salinity, and depth at which the fish are caught. The beneficial effects of a diet containing fish on cardiovascular or other diseases have been associated with their high content of eicosapentaenoic (20:5n-3) and docosahexaenoic (22:6n-3) acids. In this study we analyzed the fatty acid composition of the flesh of 18 different species of marine fish and of cultured rainbow trout. The fish were obtained from the Black and the Marmara Seas, both of which have unique biological and ecological systems as well as eutrophication and pollution. The contents of 20:5n-3 and 22:6n-3 in the marine fish ranged from 4.2 to 13.3 wt% of total fatty acids, and from 6.6 to 40.8 wt%, respectively. The most important differences from other studies on oceanic fish were the tendencies toward higher percentages of 16:0 and 22:6n-3. The n-3 series of polyunsaturated fatty acids were present as 32.4+/-1.9% of the total fatty acids. The present study suggests that mature and immature Pomatomus saltator as well as Engraulis encrasicolus, Mullus surmuletus, Sardina pilchardus, Mugil cephalus, and Sarda sarda may be preferred for the Turkish diet as a result of their high 20:5n-3 and 22:6n-3 contents. The cultured rainbow trout Oncorhynchus mykiss is not as good a source of n-3 fatty acids as are the marine fish.

Profiles of the fatty acids in the plasma membrane of human brain tumors

Several studies demonstrated that certain fatty acids have specific effects on tumor cells. n-3 series fatty acids (alpha-linolenic acid, eicosapentaenoic acid and docosahexaenoic acid) may suppress the carcinogenesis, whereas n-6 series fatty acids (arachidonic acid, linoleic acid) may exert tumor promoting effects. In this study, 19 patients with various brain tumors and 12 control brain tissues were studied. n-3, n-6, n-9 unsaturated fatty acids and certain saturated fatty acids levels were measured in the plasma membrane of tumor or control brain tissues by capillary gas chromatography. We found that the level of docosahexaenoic acid from n-3 series fatty acids was significantly lower in gliomas and meningiomas than controls (p = 0.000). Total n-3 fatty acids level was also significantly lower in tumors than controls (p = 0.000). The levels of linoleic acid, arachidonic acid and dihomogamma linolenic acid from n-6 series were significantly higher in gliomas and meningiomas compared with controls (p = 0.000). Total n-6 fatty acids level was also significantly higher in tumors than controls (p = 0.000). Furthermore, in total n-9 fatty acids, total unsaturated fatty acids and total saturated fatty acids levels, there were no significant differences in gliomas and meningiomas compared with controls (p = 0.6840, p = 0.4388 and p = 0.4343, respectively). This findings suggest that n-6 fatty acids can act as a tumor-promoting agent in human brain tumors.

Prostaglandin E2 levels in human brain tumor tissues and arachidonic acid levels in the plasma membrane of human brain tumors

Arachidonic acid is stored in the cell membrane and released when the cell is activated by appropriate stimuli. It is the substrate for prostaglandins. Both experimental and human tumors often synthesize high levels of prostaglandins, most notably prostaglandin E2 (PGE2). Some experiments suggest that these compounds increase tumor growth through their actions on host immunocytes. In this study, 22 patients with various brain tumors and 12 control brain tissues were studied. PGE2 levels in tissue samples were measured by ELISA. Arachidonic acid levels in the plasma membrane of tissue samples were analyzed by capillary gas chromatography. The levels of PGE2 were significantly higher in gliomas (n = 10) and meningiomas (n = 7) compared with control tissues (P = 0.000 and P = 0.000, respectively). Also, PGE2 levels in meningiomas were significantly higher than in gliomas (P = 0.000). Arachidonic acid levels in the plasma membrane of gliomas (n = 9) and meningiomas (n = 6) were significantly higher than in the control tissues (P = 0.000 and P = 0.000, respectively). These results suggest that the increased production of PGE2 may suppress the immune system and play an important role in tumor growth.

Polyarteritis nodosa presenting with hemobilia and intestinal hemorrhage

Polyarteritis nodosa is a multisystem disease primarily involving the small and medium-sized vessels. Prognosis depends on the presence and severity of visceral involvement. Thrombosis and aneurysm formation commonly occur in kidney and gastrointestinal tract. Although hepatic involvement is also common, hepatic aneurysmal rupture with intrahepatic or perihepatic hematoma formation is infrequent. Hemobilia secondary to aneurysmal rupture is a very rare condition. We present a case of polyarteritis nodosa accompanied by hemobilia and intestinal hemorrhage secondary to hepatic and mesenteric aneurysmal rupture.

Early postburn fatty acid profile in burn patients

To understand the alterations in lipid metabolism following burn injury, 29 patients with burns, 18 survivors for the first 15 days and 11 non-survivors until death, were studied for total fatty acid (FA) profiles. No specific dietary fat was given. The plasma total FA profile was determined by capillary gas chromatography. The main observations of this survey were that: arachidonic acid decreased by 55.7 per cent (P < 0.0002), and linoleic acid decreased by 31.6 per cent (P < 0.004), more immunosuppressive mediators were probably produced. The elevated levels of both palmitic (12.1 per cent increase, P < 0.02) and oleic acids (63.0 per cent increase, P < 0.0001) in the plasma of burned patients suggested increased lipolysis from depot triglycerides. Eicosatrienoic acid showed decreased levels (49.5 per cent decrease, P < 0.005) at 3-4 days. Docosahexaenoic acid reached its lowest level at postburn days 7-9 (32.1 per cent decrease, P < 0.04). The significant changes of FA profile in patients could be related to the increased activity of fat metabolism. The results of this study have revealed the basic FA changes and requirements. Overfeeding and unnecessary intake of the source of immunosuppressive mediators would be avoided.

Changes in tissue fatty acid composition in murine malignancy and following anticancer therapy

We studied the mouse NC tumour, a subcutaneously transplanted adenocarcinoma originally of mammary origin. Measurements per g tissue were made of 17 fatty acids (FAs), the combined amounts of n-3, n-6, saturated, unsaturated, and total FAs, and of various FA ratios in the tumour, mammary tissue, spleen, liver and plasma. Compared with mammary tissue from normal mice, tumours of vehicle-treated controls had less of seven of the FAs and more of two FAs. Mice bearing the NC tumour often had changed (usually decreased) amounts of FAs in the 'normal' spleen, liver and plasma, but not in mammary tissue. Treatment with methotrexate (MTX) was studied alone and with indomethacin which can potentiate MTX cytotoxicity. Indomethacin 1.25 mg kg-1 (INDO) increased the amounts of 3/17 tumours FAs and the unsaturated FAs, but reduced 9/17 FAs, the saturated and the unsaturated FAs in 'normal' mammary tissue, and usually had no effect on the FAs of other tissues. MTX 2 or 4 mg kg-1 (MTX 2 or 4 mg) +/- INDO in general partly restored (increased) the amounts of tumour FAs, and reduced the saturated/unsaturated FA ratio. In the 'normal' spleen and plasma also, but not in the liver, MTX 2 mg generally somewhat restored the FA composition. However, as in the liver, the spleen 20:4 and 22:6 (which form prostaglandins and lipid peroxides) did not increase in the presence of INDO. With MTX 4 mg, some of the plasma and liver FAs decreased, in contrast to the tumour. There was generally no evidence of MTX potentiation by INDO. These results are discussed in relation to carcinogenesis, cachexia, and the response to treatment.

Methotrexate alters the fatty acid composition of NC adenocarcinoma cells in culture

The effects of methotrexate and indomethacin alone and in combination have been examined on the fatty acid (FA) composition of total cellular lipids in cultured NC adenocarcinoma cells. These studies show that methotrexate can alter the lipid content of cancer cells. Methotrexate 16 ng/ml incubated with NC cells for 2 days increased the content of various FAs. When used alone, indomethacin 1 microgram/ml or methotrexate 8 ng/ml had no significant effect, but in combination caused FA increases, usually to about the same extent as with the higher concentration of methotrexate alone. No FA changes were seen up to 3 h with these drug concentrations or with methotrexate up to 10 micrograms/ml alone or with INDO 1 microgram/ml. These effects may explain previous findings that indomethacin potentiates methotrexate, an interaction which may be important in cancer therapy.