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    Detection of primary clarithromycin resistance of Helicobacter pylori and association between cagA+ status and clinical outcome
    (Springer, 2013) Yula, Erkan; Nagiyev, Togrul; Kaya, Ozlem Aycan; Inci, Melek; Celik, M. Murat; Koksal, Fatih
    Helicobacter pylori was examined in 110 patients (82 (74.5) with gastritis, 18 (16.4) with duodenitis, six (5.5) with duodenal ulcer and gastroesophageal reflux, and four (3.6 %) with normal) with gastrointestinal problems living in rural area, no history of macrolide use, and detected by culture (71.8) or direct detection from gastric biopsies by PCR (82.7 %). Also, cagA gene was identified using PCR and was found positive in 68/91 (74.7 %) strains. The prevalence of clarithromycin-resistant H. pylori was investigated by two methods including PCR-RFLP (7.7 (A2142G 1.1 and A2143G 6.6 %)) and twofold agar dilution (8.9 %) to detect phenotypic and genotypic status simultaneously. Among all the H. pylori positive patients, eight (8.8 %) isolates were found to be resistant to clarithromycin by at least one of the AD and/or PCR-RFLP methods. H. pylori positive rates were significantly correlated with patients' sex, age, and endoscopic findings (p = 0.040, < 0.001 and < 0.001, respectively). There were no differences in gender or endoscopic findings related to cagA (+) and cagA (-) patients. The gene of cagA was not significantly helpful in predicting the clinical outcome of H. pylori infection alone. In conclusion, we revealed that there was a low prevalence of primer clarithromycin resistance in patients living in rural area with no history of macrolide use. The prevalence of mutant strains among the macrolide-resistant H. pylori varies even geographically between close provinces.
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    In vitro and in vivo antimicrobial effects of mastic chewing gum against Streptococcus mutans and mutans streptococci
    (Pergamon-Elsevier Science Ltd, 2006) Aksoy, Alev; Duran, Nizami; Koksal, Fatih
    Background and objective: Dental caries is associated with oral pathogens and Streptococcus mutans (S. mutans) is one of the primary cariogenic organisms. Mastic gum, from Pistacia lentiscus, has been shown to have antibacterial properties. The objective of this study was to determine antibacterial activity of mastic chewing gum against S. mutans and mutans streptococci in vitro and in vivo conditions. Setting: Cukurova University, Dental School, in 2002. Materials and methods: Antimicrobial activity of mastic gum was evaluated using standard S. mutans strain by disc diffusion method in vitro. Cytotoxicity effect of mastic gum on HEp-2 cells was evaluated by conventional haemocytometer using the trypan blue exclusion method. Clinical studies were then performed on 25 periodontally healthy volunteers. The inhibitory effect of chewing mastic gum against mutans streptococci in sativa was compared to a placebo gum. Saliva samples were taken from the subjects immediately before and after chewing the mastic gum and the placebo gum for 15 min. Additional sativa samples were collected every 30 min. The samples were inoculated onto mitis sativarius-bacitracin agar and incubated for 48 h anaerobicatty at 37 degrees C. The total number of viable bacteria was then counted. Results: Among tested solvents (chloroform, acetone petrolium ether and ethanol), it was found that the acetone was found to be more convenient than the others to dissolve the mastic gum. In the cytotoxicity assay, concentrations up to 75 mg/ml of the mastic gum were not toxic for the replication of HEp-2 cells. Thus, tower concentrations of mastic gum (20 and 50 mg/ml) were used for the experiments. In vitro experiments, the diameters of growth inhibition zones of mastic gum were in the range 9.0-27.0 mm. In the clinical trials, the mean number of bacteria in samples taken after chewing the mastic gum and placebo gum were following; at minute 15 was 112 x 10(4) +/- 268 x 10(3) and 175 x 10(4) +/- 417 x 10(3) cfu/ml, for minute 45 was 85 x 10(4) +/- 219 x 10(3) and 165 x 10(4) +/- 329 x 10(3) cfu/ml, at minute 75 was 65 x 104 100 X 103 and 160 x 104 216 x 103 cfu/ml, at minute 105 was 60 x 10(4) +/- 127 x 10(3) and 150 x 10(4) +/- 138 x 10(3) cfu/ml, and at minute 135 was 55 x 10(4) +/- 65 x 10(3) and 145 x 10(4) +/- 354 x 10(3) cfu/ml, respectively. Significantly fewer bacteria was found in saliva samples collected after chewing mastic gum compared to those after chewing paraffin (p < 0.001). Conclusions: This preliminary study showed that mastic gum had significant antibacterial activity against S. mutans and mutans streptococci and it may be a useful adjunct in the prevention of caries. (c) 2005 Elsevier Ltd. All rights reserved.
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    Short-term effect of mastic gum on salivary concentrations of cariogenic bacteria in orthodontic patients
    (E H Angle Education Research Foundation, Inc, 2007) Aksoy, Alev; Duran, Nizami; Toroglu, Serdar; Koksal, Fatih
    Objective: To determine antibacterial activity of chewing mastic gum against the salivary levels of Streptococcus mutans, the total number of viable bacteria, and lactobacilli in patients undergoing therapy with fixed orthodontic appliances. Materials and Methods: In this study, the levels of S mutans, lactobacilli, and total cultivated bacteria were measured before and after chewing mastic gum. The antibacterial effects of chewing mastic gum against these microorganisms in saliva were compared with a placebo gum. The counts for orthodontically treated patients were evaluated before chewing gum; just after chewing gum; and after 45, 75, 105, and 135 minutes. Saliva samples taken from the patients were inoculated onto trypticase-yeast-cystine-bacitracin agar for mutans streptococci and onto Rogosa agar for lactobacilli. The agar plates were incubated for 48 hours anaerobically at 37 degrees C. The total number of viable bacteria was then counted. Results: Just after chewing the mastic gum for 15 minutes, a significant decrease of total bacteria and S mutans was observed (P <.001). The reduction in lactobacilli was not significant at later first stage (P >.05). However, at the end of 135 minutes, there were significantly fewer S mutans (P <.001), total viable bacteria (P <.001), and lactobacilli (P <.001) in the oral cavity after chewing mastic gum than after chewing paraffin (P <.001). The results show that chewing mastic gum decreased the total viable bacteria, S mutans, and lactobacilli in saliva in orthodontically treated patients with fixed appliances. Conclusion: Chewing mastic gum might be useful in preventing caries lesions.