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    Gastric infection by Strongyloides stercoralis: A case report
    (Aves, 2009) Yaldiz, Mehmet; Hakverdi, Sibel; Aslan, Ahmet; Temiz, Muhittin; Culha, Guelnaz
    Strongyloides stercoralis is an intestinal nematode with a complex life cycle that involves colonizing and reproducing in the upper small intestinal mucosa. In a healthy host, the parasite usually does not cause any symptoms. We report a gastric infection case of S. stercoralis. A 72-year-old Turkish man was admitted to the Department of General Surgery with complaints of epigastric pain, nausea and vomiting for five days. Upper gastrointestinal endoscopy evidenced a diffuse infiltrate in the stomach, causing decreased distensibility. Microscopically, superficial chronic inflammation with hyperplastic reactive changes and damaged surface was observed. Histopathological examination of the gastric mucosa showed numerous cross-sections of adult worms, eggs and rhabditiform larvae of S. stercoralis developing in the gastric crypts.
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    The Investigation of the Association Between the Frequency of Trichomonas Vaginalis and Using Intrauterine Contraceptive Device
    (Aves Yayincilik, Ibrahim Kara, 2009) Duran, Nizami; Culha, Guelnaz; Hakverdi, Ali Ulvi; Gungoren, Arif
    Objectives: We investigated the association between the frequency of Trichomonas vaginalis and using intrauterine contraceptive device (IUD). Patients and Methods: A total of 1058 vaginal swab samples were collected. The study population included 402 symptomatic and 656 asymptomatic women, between 18-45 years of age. Specimens were taken with a speculum and sterile cotton swabs from the posterior fornix of the vagina. Wet mount preparations were examined first, and then inoculated into Trypticase-yeast extract-maltose medium. Results: T vaginalis was determined in 35 (3.31%) samples out of 1058 specimens using both diagnostic methods (direct examination and/or culture). While a total of 402 women were symptomatic, 656 women were asymptomatic. Among 190 IUD users, the frequency of T vaginalis was determined as 6.84%, and among 868 non-users, this ratio was determined as 2.53%. Moreover, while among 100 symptomatic women with IUD, 11 women were positive for T vaginalis (11%), of the 302 symptomatic women without IUD, 17 were positive (5.63%) for T vaginalis. Significant correlation was determined between the use of IUD and the presence of T vaginalis (p<0.05). Conclusion: These results showed that IUD use may increase the growth of T vaginalis in the vaginal mucosa. To reduce the incidence of this pathogen in IUD users, they should be followed up closely.
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    Leishmaniasis in Turkey: first clinical isolation of Leishmania major from 18 autochthonous cases of cutaneous leishmaniasis in four geographical regions
    (Wiley, 2016) Ozbilgin, Ahmet; Culha, Guelnaz; Uzun, Soner; Harman, Mehmet; Topal, Suhan Gunasti; Okudan, Fulya; Zeyrek, Fadile
    ObjectiveTo report isolation of Leishmaniamajor strains obtained from 18 Turkish autochthonous cutaneous leishmaniasis (CL) patients infected with L.major between 2011 and 2014. MethodsInitial diagnosis relied on microscopy and culture in enriched medium, prepared by adding specific amounts of liver extract, protein and lipid sources to NNN medium. Promastigotes were then transferred to RPMI medium including 10% of foetal calf serum for mass culture. Species-specific real-time PCR targeting ITS1 region of Leishmania spp. was performed using both lesion aspiration samples and cultured promastigotes. Two of 18 isolates were identified by isoenzyme analysis in the Leishmaniasis Reference Center in Montpellier, France. Each isolate was inoculated into the footpads of six mice to observe the pathogenicity of L.major. Developing lesions were observed, and the thickening of footpads was measured weekly. ResultsMelting curve analyses of 18 isolates showed a peak concordant with L.major, and two of them were confirmed by isoenzyme analyses as L.major zymodeme MON103. In the mouse model, acute lesions seen on day 21 were accepted as an indication of heavy infection. Severe impairments were observed on all mouse footpads over 3weeks, which even progressed to extremity amputation. ConclusionCutaneous leishmaniasis-causing L.major was recently identified in Adana province in southern Turkey, with PCR. Our study shows that such CL cases are not limited to Adana but currently present from western to Southeastern Anatolia, and along the Mediterranean coast. The role of small mammals, the main reservoirs of L.major in Anatolia, needs to be elucidated, as do the underlying factors that cause severe clinical manifestations in L.major infections in Turkey, contrary to the infections in neighbouring countries. ObjectifRapporter sur l'isolement de souches de Leishmania major obtenues a partir de 18 cas de leishmaniose cutanee (LC) de patients turcs autochtones infectes par L. major entre 2011 et 2014. MethodesLe diagnostic initial a porte sur la microscopie et la culture sur un milieu enrichi, prepare en ajoutant des quantites specifiques d'extrait de foie, de proteines et de sources de lipides au milieu NNN. Les promastigotes ont ensuite ete transferes dans le milieu RPMI contenant 10% de serum fOEtal de veau pour la culture de masse. La PCR en temps reel specifique de l'espece et ciblant la region ITS1 de Leishmania spp. a ete realisee en utilisant a la fois les echantillons d'aspiration de la lesion et de promastigotes cultives. Deux des 18 isolats ont ete identifies par analyse des isoenzymes dans le Centre de reference de la leishmaniose a Montpellier, en France. Chaque isolat a ete inocule dans les coussinets plantaires de six souris pour observer la pathogenicite de L. major. Les lesions en developpement ont ete observees et l'epaississement des coussinets plantaires ont ete mesures chaque semaine. ResultatsLes analyses de courbe de fusion des 18 isolats ont montre un pic concordant avec L. major et deux d'entre eux ont ete confirmes par des analyses d'isoenzyme comme L. major de zymodeme MON103. Dans le modele murin, des lesions aigues observees au jour 21 ont ete acceptees comme une indication de forte infection. Des deficiences severes ont ete observees sur tous les coussinets plantaires des souris pendant plus de trois semaines, qui ont meme progresse jusqu'a l'amputation de l'extremite. ConclusionL. major causant la LC a ete recemment identifie dans la province d'Adana dans le sud de la Turquie par la PCR. Notre etude montre que de tels cas de LC ne sont pas limites a Adana, mais sont actuellement presents dans l'ouest et dans le sud-est de l'Anatolie, et le long de la cote mediterraneenne. Le role des petits mammiferes, principaux reservoirs de L. major en Anatolie, devrait etre elucide, de meme que les facteurs sous-jacents qui causent les manifestations cliniques severes dans les infections a L. major en Turquie, contrairement aux infections dans les pays voisins. ObjetivoReportar el aislamiento de cepas de L. major obtenidas de 18 pacientes turcos con leishmaniosis cutanea (LC) autoctona, infectados con Leishmania major entre 2011 y 2014. MetodosEl diagnostico inicial se realizo mediante microscopia y cultivo en medio enriquecido, preparado mediante la adicion de cantidades especificas de extracto de higado, proteina y fuentes de lipido al medio NNN. Los promastigotes fueron transferidos al medio RPMI con un 10% de suero fetal para su cultivo masivo. Se realizo PCR en tiempo real, especie-especifica, que detecta la region ITS1 de Leishmania spp., utilizando tanto muestras aspiradas de las lesiones como promastigotes de cultivo. Dos de los 18 aislados se identificaron mediante analisis isoenzimatico en el Centro de Referencia de la Leishmaniosis en Montpellier, Francia. Cada aislado fue inoculado en las almohadillas de las patas de seis ratones para observar la patogenicidad de L. major. Se observo el desarrollo de las lesiones y se midio semanalmente el engrosamiento de las almohadillas. ResultadosEl analisis de la curva de fusion de los 18 aislados mostro un pico de concordancia con Leishmania major, y dos de ellos fueron confirmados mediante un analisis isoenzimatico como L. major zymodeme MON103. En el modelo de raton, las lesiones agudas observadas en el dia 21 se aceptaron como indicativas de una infeccion masiva. Se observaron danos graves en todas las almohadillas de los ratones a lo largo de tres semanas, que progresaron hasta la amputacion de las extremidades. ConclusionRecientemente se ha identificado, mediante PCR, LC causada por L. major en la provincia de Adana al sur de Turquia. Nuestro estudio muestra que estos casos de LC no estan limitados a Adana y que actualmente existen desde el oeste al sudeste de Anatolia y a lo largo de la costa Mediterranea. Es necesario aclarar el papel que en Anatolia juegan los pequenos mamiferos, principales reservorios de L. major, al igual que el de los factores que hay detras de las manifestaciones clinicas severas en infecciones por L. major en Turquia, al contrario del de las infecciones presentes en paises vecinos.
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    Serum levels of zinc, copper, iron, cobalt, magnesium, and selenium elements in children diagnosed with Giardia intestinalis and Enterobiosis Vermicularis in Hatay, Turkey
    (Humana Press Inc, 2007) Culha, Guelnaz; Sanguen, Mustafa Kemal
    The intestinal parasites are noted to be an important health problem in Turkey as similarly reported in the globe. The aim of this study was to investigate the changes in total content of essential elements, namely, zinc, iron, copper, cobalt, magnesium, and selenium, in children infected with intestinal parasites aged between 6 and 12 years inhabiting in Hatay Province, Turkey. These essential elements were measured in the children/patient who was positive for intestinal parasites, Giardia intestinalis and Enterobius vermicularis. Scores were obtained from the positive study group (SG), and their age matched the healthy children control group (CG). Serological levels of zinc, iron, copper, cobalt, magnesium, and selenium were analyzed by Varian(R) Liberty Series II inductively coupled plasma atomic emission spectrometer (ICP-AES). The mean magnesium concentrations were found to be statistically different at 95% confidence interval level between study groups. As a result of this study, selenium was found to be uncorrelated with all other elements examined; whereas, copper was observed to have statistically significant correlations with cobalt, magnesium, and zinc. In addition, cobalt-magnesium, cobalt-zinc, and magnesium-zinc metal pairs were found to have statistically significant correlations based on study findings.