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Biomedical subjects

Ozlem Yilmaz

Publications and source records attributed to Ozlem Yilmaz.

At least 19 recordsLinked to original sources

Systematic tuning of parameters in support vector clustering.

Clustering algorithms divide a set of observations into groups so that members of the same group share common features. In most of the algorithms, tunable parameters are set arbitrarily or by trial and error, resulting in less than optimal clustering. This paper presents a global optimization strategy for the systematic and optimal selection of parameter values associated with a clustering method. In the process, a performance criterion for the optimization model is proposed and benchmarked against popular performance criteria from the literature (namely, the Silhouette coefficient, Dunn's index, and Davies-Bouldin index). The tuning strategy is illustrated using the support vector clustering (SVC) algorithm and simulated annealing. In order to reduce the computational burden, the paper also proposes an alternative to the adjacency matrix method (used for the assignment of cluster labels), namely the contour plotting approach. Datasets tested include the iris and the thyroid datasets from the UCI repository, as well as lymphoma and breast cancer data. The optimal tuning parameters are determined efficiently, while the contour plotting approach leads to significant reductions in computational effort (CPU time) especially for large datasets. The performance criteria comparisons indicate mixed results. Specifically, the Silhouette coefficient and the Davies-Bouldin index perform better, while the Dunn's index is worse on average than the proposed performance index.

Algorithms↗

Detection of H. pylori infection by ELISA and Western blot techniques and evaluation of anti CagA seropositivity in adult Turkish dyspeptic patients.

AIM: To detect H pylori infection and to evaluate the anti CagA seropositivity in adult Turkish dyspeptic patients. METHODS: We evaluated anti-H pylori IgA, IgG and anti-CagA antibodies using commercial enzyme-linked immunoassay (ELISA) and Western blot in dyspeptic Turkish patients. H pylori status was determined by histology and rapid urease testing. RESULTS: Fifty-six patients were entered. Forty-eight (85.7%) out of the 56 patients were positive for H pylori. H pylori IgG seropositivity was 82.1%, IgA seropositivity 48.2%. CagA ELISA showed that IgG was positive in 50% and IgA in 30.4% of those with H pylori infections. Western blot showed that IgG seropositivity was 80.4% and IgA seropositivity 33.9%. Western blot detected IgG antibodies with reactivity to CagA in 50%, VacA in 62.5%, UreB in 87.5%, UreA in 80.4%, and OMP in 57.1%. None of the tests had a sensitivity and specificity above 80%. CONCLUSION: None of these commercial tests seems clinically useful for H pylori detection in adult dyspeptic patients, while Western blot can give seropositivity and determine anti-CagA, VacA virulence factor status of Turkish dyspeptic patients in the Izmir region.

Adult↗

Comparison of invasive methods and two different stool antigen tests for diagnosis of H pylori infection in patients with gastric bleeding.

AIM: To compare two different H pylori stool antigen tests as noninvasive diagnostic methods. METHODS: The study population consisted of 22 upper gastrointestinal system bleeding patients. Urea breath test (UBT), rapid urease test (RUT) and histopathological examination were applied to all patients. Stool specimens from these patients were examined by rapid STRIP!HpSA and one step simple H pylori antigen cassette test for the detection of H pylori antigens. RESULTS: For these 22 patients, 15 (68.2%) were diagnosed as positive and seven (31.8%) were diagnosed negative for H pylori infection by the gold standard methods. Whereas 10 (45.5%) were positive and 12 (54.5%) were diagnosed negative by the rapid STRIP!HpSA test. The sensitivity, specificity, positive and negative predictive values were 60%, 86%, 90% and 50%, respectively. When compared to the gold standard methods, these differences were not significant. However, six patients (27.3%) were positive, and 16 (72.7%) were negative by the simple H pylori stool antigen cassette test. The sensitivity, specificity, positive and negative predictive values were 33%, 86%, 83% and 38%, respectively. Compared to the gold standard methods, the simple H pylori stool antigen cassette test results were significantly different (P = 0.012). CONCLUSION: Rapid STRIP!HpSA test could be used as a routine diagnostic tool in the microbiology laboratory for assessing clinical significance and eradication control of H pylori in upper gastrointestinal system bleeding patients.

Adult↗

Neuroprotective agents: is effective on toxicity in glial cells?

1. Glial cells are the most abundant cell population in the central nervous system. The aim of this study was to examine the effects of melatonin, 7-nitroindazole, and riluzole on glutamate toxicity in primary glial cell culture. 2. Glutamate toxicity was induced by addition of 100 microM glutamate to the cultures, and then 100 microM melatonin, 500 microM 7-nitroindazole, and 10 (M riluzole were administered in different groups. Lactate Dehydrogenase activity and nitrite levels were determined at the 1st, 6th, and 24th h. 3. Melatonin, 7-nitroindazole, and riluzole decrease Lactate Dehydrogenase activity at the 1st, 6th, and 24th h (at all hours, p<0.05). Nitrite levels were decreased by melatonin and riluzole at the 1st, 6th, and 24th h. 4. In this study, we observed that melatonin, 7-nitroindazole, and riluzole are effective as protective agents on glutamate toxicity in mixed glial cells.

Animals↗

A retrospective study of central nervous system shunt infections diagnosed in a university hospital during a 4-year period.

BACKGROUND: Ventriculoperitoneal (VP) shunts are used for intracranial pressure management and temporary cerebrospinal fluid (CSF) drainage. Infection of the central nervous system (CNS) is a major cause of morbidity and mortality in patients with CSF shunts. The aim of the present study was to evaluate the clinical features, pathogens, and outcomes of 22 patients with CSF shunt infections collected over 4 years. METHODS: The patients with shunt insertions were evaluated using; age, sex, etiology of hydrocephalus, shunt infection numbers, biochemical and microbiological parameters, prognosis, clinical infection features and clinical outcome. RESULTS: The most common causes of the etiology of hydrocephalus in shunt infected patients were congenital hydrocephalus-myelomeningocele (32%) and meningitis (23%). The commonest causative microorganism identified was Staphylococcus (S.) aureus, followed by Acinetobacter spp., and S. epidermidis. CONCLUSION: In a case of a shunt infection the timely usage of appropriate antibiotics, according to the antimicrobial susceptibility testing, and the removal of the shunt apparatus is essential for successful treatment.

Acinetobacter Infections↗

Intercellular spreading of Porphyromonas gingivalis infection in primary gingival epithelial cells.

Porphyromonas gingivalis, an important periodontal pathogen, is an effective colonizer of oral tissues. The organism successfully invades, multiplies in, and survives for extended periods in primary gingival epithelial cells (GECs). It is unknown whether P. gingivalis resides in the cytoplasm of infected cells throughout the infection or can spread to adjacent cells over time. We developed a technique based on flow cytofluorometry and fluorescence microscopy to study propagation of the organism at different stages of infection of GECs. Results showed that P. gingivalis spreads cell to cell and that the amount of spreading increases gradually over time. There was a very low level of propagation of bacteria to uninfected cells early in the infection (3 h postinfection), but there were 20-fold and 45-fold increases in the propagation rate after 24 h and 48 h, respectively, of infection. Immunofluorescence microscopy of infected cells suggested that intercellular translocation of P. gingivalis may be mediated through actin-based membrane protrusions, bypassing the need for release of bacteria into extracellular medium. Consistent with these observations, cytochalasin D treatment of infected cells resulted in significant inhibition of bacterial spreading. This study shows for the first time that P. gingivalis disseminates from cell to cell without passing through the extracellular space. This mechanism of spreading may allow P. gingivalis to colonize oral tissues without exposure to the humoral immune response.

Actins↗

Hand disability and related variables in patients with rheumatoid arthritis.

OBJECTIVE: To carry out a cross-sectional study of patients with rheumatoid arthritis (RA) for hand disability, articular damage and to define their relation with demographic, laboratory and clinical parameters. METHODS: The study included 105 RA patients with a mean age of 49.4 years. Demographic parameters of the patients were recorded. Clinical parameters including disease duration, duration of morning stiffness, pain assessed by visual analog scale, Ritchie Articular Index, grip strength, lateral, tip and three-fingered pinch, and laboratory parameters comprising C-reactive protein, erythrocyte sedimentation rate and rheumatoid factor were evaluated in all patients. The Rheumatoid Arthritis Articular Damage (RAAD) score was used to assess the irreversible articular damage and deformities of the hand. Hand disability was assessed by the special hand disability index of Standford Health Assessment Questionnaire (HAQ). RESULTS: Hand disabilities of various levels were detected in 81% of the patients. Disease duration, grip strength, pinch measurements, clinical and laboratory activity parameters were strongly correlated with hand disability (p<0.01). Hand disability was more related to disease activity parameters than articular damage (p<0.01 and p<0.05, respectively). Grip strength and pinch measurements were the most related parameters with hand disability. The disability scores were significantly higher in female patients (p<0.01). The RAAD score was correlated with disease duration and grip strength (p<0.01). The clinical and laboratory parameters and seropositivity were not correlated with articular damage assessed by RAAD score (p>0.05). CONCLUSION: Our data suggest that grip strength and pinch measurements seem to be the most related variables with hand disability and articular damage. Therefore, grip strength and pinch measurement should be included in the evaluation and follow-up of the patients with RA in hand rehabilitation units.

Adult↗

Differential protein expression by Porphyromonas gingivalis in response to secreted epithelial cell components.

The human oral pathogen Porphyromonas gingivalis colonizes the gingival crevice and invades gingival epithelial cells. Multidimensional capillary high-performance liquid chromatography coupled with tandem mass spectrometry and two-dimensional gel electrophoresis were used to analyze the proteome of P. gingivalis as it adapts to a set of experimental conditions designed to reflect important features of an epithelial cell environment. 1014 proteins (46% of the total theoretical proteome) were identified in four independent analyses; 479 of these proteins showed evidence of differential expression after exposure of P. gingivalis to either conditioned epithelial cell growth medium or control conditions: i.e., they were only detected under one set of conditions. Moreover, 276 genes annotated as hypothetical were found to encode expressed proteins. Among the proteins up-regulated in the presence of epithelial cell components were a homolog of the internalin proteins of Listeria monocytogenes and subunits of the ATP-dependent Clp protease complex. Insertional inactivation of clpP, encoding the Clp proteolytic subunit, resulted in approximately a 50% reduction in invasion of P. gingivalis. These results suggest that adaptation to an epithelial cell environment induces a major shift in the expressed proteome of the organism. Furthermore, ClpP, that is up-regulated in this environment, is required for optimal invasive activity of P. gingivalis.

Bacterial Adhesion↗

Detection of Helicobacter pylori DNA by a simple stool PCR method in adult dyspeptic patients.

INTRODUCTION: Helicobacter pylori is the major agent causing peptic ulcer, gastric cancer and mucosa-associated lymphoid tissue (MALT) gastric lymphoma. A simple stool polymerase chain reaction (PCR) method was performed and compared with the gold standards for the diagnosis of H. pylori infection. MATERIAL AND METHODS: A total of 54 adult patients (mean age, 46.41 +/- 13.12 years) with dyspeptic symptoms from Gastroenterology at Dokuz Eylül University Hospital between May and November 2003 were included. Two antrum and corpus biopsies were taken from each patient. Infection by H. pylori was defined as positivity and negativity of the gold standards. DNA extraction of stool specimens was done using QIAamp DNA Stool Mini Kit (QIAGEN) and PCR conditions included amplification and reamplification steps using the H. pylori ureA gene specific primers (HPU1, HPU2) and were visualized on 1% agarose gel stained with ethidium bromide. RESULTS: Forty-six of 54 patients (85.2%) were diagnosed positive and eight (14.8%) were negative for H. pylori infection by the gold standard methods. Thirty-two patients were positive (59.3%) and 22 of them (40.7%) were detected negative by stool PCR method. The stool PCR method and gold standard methods showed a statistical difference for the detection of H. pylori infection (p < .0001). Sensitivity, specificity, likelihood ratio, and positive and negative predictive values were 65.22%, 75%, 2.61%, 93.75%, and 27.7%, respectively. DISCUSSION: The PCR on the stool specimens resulted as being a very specific test. We suggest that a simple stool PCR method that we developed can be used to detect H. pylori, virulence genes, and in drug resistance studies either first line diagnostic methods in the laboratory or in the clinical management of dyspeptic patients.

Adult↗

[Antibiotic resistance in Helicobacter pylori and molecular methods for the detection of resistance].

Helicobacter pylori which is the major agent causing peptic ulcer, gastric cancer and gastric lymphoma, is identified as a class I carcinogen. Invasive and non-invasive tests have been used in the diagnosis of H. pylori infection. Clarithromycin resistance in H. pylori strains is increasing nowadays, thus leading to failures in eradication therapy. Fluorescence in situ hybridization (FISH) method which can simultaneously detect the presence of H. pylori and clarithromycin resistance is a non-culture dependent molecular technique. In this review article the prevalence and clinical outcome of antibiotic resistance in H. pylori, molecular mechanisms of the resistance and molecular methods to detect the resistance, with priority of FISH technique have been discussed.

Anti-Bacterial Agents↗

[The importance of antinuclear (ABA) and anti-double stranded dna (anti-dsDNA) antibodies in the diagnosis of connective tissue diseases.].

Connective tissue diseases (CTD) are characterized by the presence of autoantibodies against several tissues. These autoantibodies occur against cell membrane, cell receptors, plasma proteins, and cytoplasmic and nuclear components. In laboratories, anti-nuclear antibodies (ANA) and anti-double stranded DNA (anti-dsDNA) antibodies are widely used in diagnosis of CTD. The aim of this study was to investigate the presence and accompaniment of ANA and anti-dsDNA antibodies in diagnosis of several CTD and also to study the prevalence of ANA and anti-dsDNA in a group of 88 patients with various types of CTD. ANA were detected by immunofluorescence (IFA) using HEp-2 cells (Zeus Scientific, Inc. USA) and anti-dsDNA antibodies using Crithidia luciliae (BioSystems, Spain) as substrates in immunofluorescence. ANA Western Blot (WB) Immunoassay (ImmuBlot, International Immuno-Diagnostics, USA) was also used along with the tests referred to previously. ANA was found in the sera of 84 (96.5%) patients while anti-dsDNA was detected in 7 (7.95%). Moreover different fluorescence patterns were also evaluated with ANA IFA in accordance with anti-dsDNA results. Mixed patterns in three and a homogeneous pattern in four anti-dsDNA positive patients' sera were determined on HEp-2 cell line by IFA. Seven sera which were ANA and anti-dsDNA positive with IFA were also found to be positive with WB and their ANA patterns with the specific ANA WB bands were also evaluated. It was observed that IFA results were in concordance with WB results. Our data indicated that the above findings should be controlled and evaluated with a more advanced method such as western blotting technique in order to confirm the presence of specific antibodies along with clinical outcome of the patients. As a result we think that ANA WB method is an appropriate technique in diagnosis of CTD as anti-dsDNA and ANA bands can be evaluated together with this method.

English Abstract↗

[The importance and validity of anti-Toxoplasma gondii IgG, IgM, IgA antibodies and IgG avidity tests in the diagnosis of Toxoplasmosis infection during pregnancy.].

Detection of specific IgG, IgM and IgA antibodies by enzyme immunoassay (EIA) tests are not always sufficient in the diagnosis of early and late Toxoplasma gondii infection during pregnancy. For this reason, the specific IgG avidity test should be used to detect primary toxoplasmosis infection. In this study, an investigation was made of the serological status of pregnant women who were suspected of having primary or late toxoplasmosis as well as the importance and relationship of specific anti-Toxoplasma gondii IgG, IgM and IgA antibodies and specific IgG avidity in their sera. TORCH panels were also used for these patients. A total of 52 pregnant women who were admitted in the Dokuz Eylül University Gynecology and Obstetrics Clinic were included in this study. The sera were sent to the serology and immunology laboratory for investigation of the anti-Toxoplasma gondii IgG, IgM and IgA antibodies by the EIA (Cobas Core, Roche, Germany and ETI-TOXOK-A, DiaSorin, Germany) technique. The anti- Toxoplasma gondii IgG avidity test was performed on IgG as well as IgM and/or IgA in positive sera with the EIA (Toxoplasma IgG Avidity EIA Well- RADIM, Italia) technique. The anti-Toxoplasma gondii IgG avidity test was not performed on sera from 21 pregnant women negative for anti-Toxoplasma gondii IgG, IgM and IgA antibodies. Borderline and high IgM levels showed a good correlation with the IgG avidity results. The ratio for the IgM and IgA positivity was 32.3% and both the IgM positivity and IgA negativity were 29%. In conclusion, anti- Toxoplasma gondii IgG avidity and anti-Toxoplasma gondii IgM antibody tests should be used together. However, positivity or high avidity of IgA was limited in the diagnosis of active toxoplasmosis infection of pregnant women.

English Abstract↗

The prevalence of joint hypermobility among high school students.

OBJECTIVE: The aim of this study was to determine the prevalence of joint hypermobility among high school students and to define the characteristics of patients with joint hypermobility. METHODS: The students underwent complete history and physical examination. In order to designate marfanoid habitus, body weight, height, and span/height and upper/lower segment ratios were recorded. The degree of joint hypermobility was scored by the Beighton scoring system. The following features were also examined: arthralgia, myalgia, low back pain, sciatica, spinal deformities, temporomandibular joint pain and crepitus, effusion, swan neck deformity, arachnodactyly, joint dislocation, joint sprain, Raynaud's phenomenon, stria, varicose veins, abdominal and inguinal hernia, heart disease history, myopia, dropping eyelids, and antimongoloid slant. RESULTS: Eight hundred sixty-one students (433 females and 428 males) with a mean age of 15.4+/-1.1 years (range 13-19) were examined. Joint hypermobility was observed in 101 (11.7%) of the students. According to the Beighton scoring system, the majority of these (61.4%) were observed to score 4. Our results show that phenotype has no relation with joint mobility. Of the total number of students, there were 31 male (7.2%) and 70 female (16.2%) hypermobile subjects. The difference between sexes was highly significant (P=0.00005). Joint sprain was detected in 14 of hypermobile students (13.9%) and 50 of nonhypermobile students (6.6%). Its presence was the only significant parameter between hypermobile and nonhypermobile students (P=0.0094). CONCLUSIONS: Joint hypermobility was found in 11.7% of the students in our study, and the results are in harmony with the previous studies on Western populations. Although hypermobility does not seem to be very problematic in young people, as in our focus group, we believe that it is important for physicians to recognize this problem to ensure correct diagnosis and treatment, since it may lead to mimic rheumatic diseases in the future.

Adolescent↗

Activation of the phosphatidylinositol 3-kinase/Akt pathway contributes to survival of primary epithelial cells infected with the periodontal pathogen Porphyromonas gingivalis.

Porphyromonas gingivalis, an important periodontal pathogen, infects primary gingival epithelial cells (GECs). Despite the large number of bacteria that replicate inside the GECs, the host cell remains viable. We demonstrate that P. gingivalis triggers rapid and reversible surface phosphatidylserine exposure through a mechanism requiring caspase activation. However, after 1 day of infection, the bacteria no longer induce phosphatidylserine externalization and instead protect infected cells against apoptosis. Infection exerts its effect at the level of mitochondria, as P. gingivalis also blocks depolarization of the mitochondrial transmembrane potential and cytochrome c release. Interestingly, protein kinase B/Akt is phosphorylated during infection, which can be blocked with the phosphatidylinositol 3-kinase (PI3K) inhibitor LY294002. Suppression of the PI3K/Akt pathway following staurosporine treatment results in mitochondrial-membrane depolarization, cytochrome c release, DNA fragmentation, and increased apoptosis of infected GECs. Thus, P. gingivalis stimulates early surface exposure of phosphatidylserine, which could downmodulate the inflammatory response, while also promoting host cell survival through the PI3K/Akt pathway.

Apoptosis↗

Identification of Porphyromonas gingivalis genes specifically expressed in human gingival epithelial cells by using differential display reverse transcription-PCR.

Porphyromonas gingivalis, one of the causative agents of adult periodontitis, can invade and survive within host epithelial cells. The molecular mechanisms by which P. gingivalis induces uptake and adapts to an intracellular environment are not fully understood. In this study, we have investigated the genetic responses of P. gingivalis internalized within human gingival epithelial cells (GECs) in order to identify factors involved in invasion and survival. We compared the differential display of arbitrarily PCR-amplified gene transcripts in P. gingivalis recovered from GECs with the display of transcripts in P. gingivalis control cultures. Over 20 potential differentially expressed transcripts were identified. Among these, pepO, encoding an endopeptidase, and genes encoding an ATP-binding cassette (ABC) transporter and a cation-transporting ATPase were upregulated in GECs. To investigate the functionality of these gene products, mutants were generated by insertional inactivation. Compared to the parental strain, mutants of each gene showed a significant reduction in their invasion capabilities. In addition, GEC cytoskeletal responses to the mutants were distinct from those induced by the parent. In contrast, adhesion of the mutant strains to GECs was not affected by lack of expression of the gene products. These results suggest that PepO, a cation-transporting ATPase, and an ABC transporter are required for the intracellular lifestyle of P. gingivalis.

Bacterial Adhesion↗

Multifocal tuberculosis presenting with osteoarticular and breast involvement.

BACKGROUND: Polyarticular involvement, wrist and ankle arthritis are uncommon presentation of skeletal tuberculosis. Tuberculosis of the breast is also extremely rare. CASE PRESENTATION: Wrist, ankle and breast involvement were detected in the same patient. Mycobacterium tuberculosis was isolated from both synovial and breast biopsy specimen cultures. CONCLUSIONS: In general, tuberculosis arthritis is a frequently missed diagnosis, especially in different clinical patterns. A high level of suspicion is required particularly in high-risk populations and endemic areas.

Journal Article↗

[Osteoarticular tuberculosis].

Tuberculosis (Tbc) remains as a major public health problem in the world. Extrapulmonary Tbc is gaining importance and it accounts for approximately 15% of all new cases. Osteoarticular Tbc is an infrequent form of the disease, accounting for 1-5% of all cases. Joints are uncommon site of infection; therefore, peripheral Tbc is considered rare. Tbc arthritis are usually monoarticular but oligoarticular involvement are also reported. We presented here four cases with osteoarticular Tbc and reviewed the literature.

Adolescent↗