Primary splenic hydatidosis.
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Biomedical subjects
Publications and source records attributed to Kaya Yorganci.
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OBJECTIVE: Antibiotically coated or impregnated catheters are effective in eliminating gram-positive bacteria from their surfaces. However, their activity against gram-negative bacteria is not well known. The aim of this study was to evaluate and compare the adherence, persistence and colonization of Klebsiella pneumoniae on catheter surfaces and also to assess bacteriostatic and bactericidal levels. DESIGN: Randomized, controlled, laboratory study. SETTING: University surgical microbiology laboratory. SUBJECTIVE: Silver sulfadiazine-chlorhexidine impregnated (SSC), minocycline and rifampin bonded (M+R), silver, platinum and carbon incorporated (SP+C) and non-antiseptic central venous catheter segments. INTERVENTIONS: Catheter segments were immersed in 1 ml of phosphate buffered saline (0.01 mol/l) with 0.25% dextrose (PBSD) and incubated at 37 degrees C. The PBSD was replaced daily. Effluents were frozen at -70 degrees C for subsequent determination of bacteriostatic and bactericidal activity. On days 1,3,7,14 and 21 after initial immersion, 1 ml standardized inoculum of Klebsiella pneumoniae was added to 90 tubes for a period of 30 min. The inoculum was then replaced with PBSD. One third of the samples were immediately sonicated and plated for the determination of bacterial adherence. The remaining segments were incubated for 4 and 24 h, followed by the same procedure to determine bacterial persistence and colonization with time. All plates were read after 24 h of incubation. MEASUREMENTS AND RESULTS: There was a significant reduction in initial bacterial adherence for SP+C catheters on all days ( p<0.05). SSC catheters prevented initial bacterial adherence for the first 7 days only ( p<0.05). SSC and SP+C catheters prevented bacterial persistence and further colonization on all days. However M+R catheters prevented bacterial colonization for 3 days only. Effluent studies indicated that the impregnated agents in catheter SSC were bactericidal compared to catheter M+R, which were bacteriostatic to K. pneumoniae. No antibacterial activity was detected in the effluents from catheter SP+C. CONCLUSIONS: SSC and SP+C catheters are effective in eliminating K. pneumoniae from their surfaces for at least 21 days. M+R catheters are less effective in eliminating bacterial adherence and colonization may be due to their bacteriostatic property.
BACKGROUND: Although surgery is the recommended treatment for liver hydatid disease, percutaneous treatment has been introduced as an alternative to surgery. No previous studies have been reported for patients who have not been suitable for percutaneous treatment and undergone surgery. The aim if this study was therefore to evaluate the patients who have liver hydatid disease and not suitable for percutaneous treatment and to determine the effectiveness of different types of surgical interventions in these patients. PATIENTS AND METHODS: Ninety-five patients who underwent operations for liver hydatid disease were retrospectively reviewed. All patients were radiologically evaluated before surgery for possible percutaneous treatment. Besides other related factors, conventional and radical surgical approaches were compared in terms of complication and recurrence rate. RESULTS: Overall complication and recurrence rates were 40% and 25%, respectively. Conventional surgical approaches and common bile duct exploration were significantly associated with an increased complication and recurrence rate. CONCLUSIONS: Selection of simple liver hydatid cysts for percutaneous treatment had led us to operate more difficult and complicated cases. It seems that routine use of endoscopic retrograde cholangiography in the preoperative period and more efforts to perform radical procedures are two major determinants in the successful treatment of theses complicated cases.
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The aim of this study was to investigate the relationship between the obstructive jaundice-induced cellular immune suppression and endotoxin challenge with respect to the levels of tumor necrosis factor (TNF), interleukin-10 (IL-10), and interleukin-2 (IL-2). Rats underwent either bile duct ligation or sham operation. At 21 days, all rats were challenged either with lipopolysaccharide (LPS) or saline. In the sham-operated group LPS injection significantly increased TNF levels at 90 min. The common bile duct ligated group showed a significant increase in TNF levels compared with all other groups, including the sham-operated, LPS-injected group, at 90 min. At 180 min following LPS challenge, TNF levels decreased, and there was no difference between any of the LPS-challenged groups at 180 min and any of the saline groups at either 90 or 180 min. In the sham-operated group, LPS injection significantly increased IL-10 levels at both 90 and 180 min. In the bile duct ligated group, LPS injection significantly increased IL-10 levels compared with saline injection at both 90 and 180 min. On the other hand, bile duct ligated animals had significantly less increase in IL-10 levels following LPS challenge at 90 min but not at 180 min. In common bile duct ligated rats, LPS challenge induced a significantly greater increase in IL-2 levels compared with all other groups. In conclusion, in the presence of obstructive jaundice, endotoxemia primes a more vigorous inflammatory response despite cellular immune depression.