Browsing by Author "Irmak, H"

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Central Nervous System Brucellosis
(W B Saunders Co Ltd, 1998) Akdeniz, H; Irmak, H; Anlar, Ö; Demiröz, AP
Although neurological symptoms in brucellosis are frequent,, central nervous system (CNS) involvement is uncommon. Five patients with neurobrucellosis are presented. Three patients presented with meningoencephalitis, one with polyradiculoneuritis and one with myelitis and an eighth nerve palsy. All patients had lymphocytic pleocytosis, low glucose and elevated levels of protein in the cerebrospinal fluid (CSF). Gamma-globulin and IgG values in the CSF were also increased. Results of agglutination tests for Brucella in serum and CSF were positive for all patients, although titres were less in the CSF. Brucella melitensis was cultured from two patients. Treatment included concurrent administration of three of the following drugs: doxycycline, rifampicin, streptomycin, co-trimoxazole, ceftriaxone or ciprofloxacin. The three patients with meningoencephalitis fully recovered; the other two patients were left with minor disability.
Chronic Hepatitis Delta Virus Infection in Eastern Turkey
(Elsevier Science Bv, 2003) Turkdogan, MK; Bozkurt, H; Tuncer, I; Uygan, I; Irmak, H; Buzgan, T; Akdeniz, H
Cutaneous Manifestations of Anthrax in Eastern Anatolia
(Okayama Univ Med School, 2003) Irmak, H; Buzgan, T; Karahocagil, MK; Sakarya, N; Akdeniz, H; Çaksen, H; Demiröz, P
Anthrax is essentially a disease of grazing herbivorous animals. The most common form of the disease is cutaneous anthrax, which accounts for 95% of all cases. We report here 39 cutaneous anthrax cases in humans that were seen in Eastern Anatolia over a six-year period. The clinical presentation was malignant edema in 16 of the cases (41%) and malignant pustule in 23 (59%). A secondary bacterial infection was present in 13 patients (33.3%) in the vicinity of the lesions. The agent was observed using Gram-stained smears in 25 patients (64%), and Bacillus anthracis was isolated from 15 patients (38.5%). All of the patients were treated with penicillin G or penicillin procaine, except one patient who had a penicillin allergy. One patient with cervical edema (2.5%) died as a result of laryngeal edema and sepsis syndrome. In conclusion, we found that the appearance of the skin lesion of cutaneous anthrax may vary, and this fact, combined with the rarity of this disease, which contributes to a general lack of experience among medical personnel, may make diagnosis difficult in nonagricultural settings.
Effect of Estrogen on Fibrinogen Clotting Time in Rabbits
(Scientific Technical Research Council Turkey, 1998) Ercan, M; Yegin, E; Akdeniz, H; Irmak, H; Bayiroglu, F; Tuncer, I
The aim of this study was to examine the effect of estrogen on fibrinogen clotting time in rabbit model experimentally, The study was performed on 14 white New Zealand race female prepubertary rabbits at two months old weighing meanly 1.4+/-0.3 kg. Blood samples was taken from ear veins of the rabbits and first fibrinogen clotting time levels were measured to obtain control values. Next day, female sex hormone preparate estradiol valerinate at a dose of 0.3 mg/kg were injected to the rabbits IM. In their examinations made on 10(th) day of injection, they were evaluated as in oestrus and under the maximal effects of estrogen, acid their blood samples were taken again to measure their fibrinogen clotting time levels. Fibrinogen clotting time levels were determined from blood samples taken before and after female sex hormone administration. Samples taken from ear veins of the rabbits were used for measurement of fibrinogen clotting time. In the study, fibrinogen clotting time values were found meanly 18.13+/-1.00 sec. from blood samples taken before estrogen injection versus 18.87+/-0.61 sec. from blood samples after 10 days of estrogen injection, in statistical assessment performed, there were not statistically significant differences (t=0.94, p>0.05) between fibrinogen clotting time values before and after estrogen administration. Our data revealed that estrogen administration caused a silghtly but insignificantly increase in fibrinogen clotting time values in the rabbits.
The Effect of Levamisole Combined With the Classical Treatment in Chronic Brucellosis
(Tohoku Univ Medical Press, 2003) Irmak, H; Buzgan, T; Karahocagil, MK; Evirgen, Ö; Akdeniz, H; Demiröz, AP
Levamisole is an immunopotenciator drug which is used as an antihelmintic drug as well as very effective remedy on cellular immunity compared with humoral immunity. A total 71 patients (37 men, 34 women) who referred to our department between March 1997 and December 2001, with a history of the disease for about I year, were diagnosed as having chronic brucellosis through those tests brucella serum agglutination test (SAT), SAT with Coombs and SAT with 2-mercaptoethanol. The patients were randomly divided into levamisole group (36 patients) and control group (35 patients). All patients were given rifampicin 600 mg/day + doxycycline 200 mg/day for 6 weeks as a standard classical combined therapy for brucellosis. In the levamisole group, oral levamisole 80 mg every other day for 6 weeks was added to the treatment. There was a statistically significant difference between two groups, in complaints of arthralgia, fatigue and sweats before and 6 months after treatment, as well as in erythrocyte sedimentation rate and C-reactive protein elevations and lymphomonocytosis finding. While it was provided both clinical and serological improvement in all patients in the levamisole group; 11 patients in the control group did not improve both clinically and in view of specific and nonspecific laboratory findings and a recurrence occurred in one case, in this group. In conclusion, levamisole added to classical antibiotic therapy in treatment of chronic brucellosis was found quite efficient in all patients in providing adequate clinical and laboratory response in comparison to classical antibiotic therapy alone. -chronic brucellosis; levamisole; treatment (C) 2003 Tohoku University Medical Press.
Hematological Manifestations in Brucellosis Cases in Turkey
(Okayama Univ Med School, 1998) Akdeniz, H; Irmak, H; Seckinli, T; Buzgan, T; Demiroz, AP
The hematological findings of 233 patients with brucellosis are presented and the possible pathologies discussed. Anemia was present in 128 patients (55%), leukopenia in 49 (21%) and thrombocytopenia in 59 (26%). Bone marrow aspirates of 18 patients (8%) with pancytopenia were examined. The bone marrow was hypercellular in 15 and normocellular in 3 patients. Granulomatous lesions were detected in 12 cases (67%), and slight to moderate cytophagocytosis of erythrocytes, granulocytes and platelets existed in all patients. Blood cell counts reverted to normal within 2-3 weeks of initiating chemotherapy with recovery from the disease.
Mr Findings in Pericardial Hydatid Cyst
(Tohoku Univ Medical Press, 2003) Sakarya, ME; Irmak, H; Etlik, Ö; Evirgen, Ö; Temizöz, O; Sakarya, N
Pericardial hydatid cyst is rare. We present a 32-year-old man with a pericardial. hydatid cyst. Chest x-ray film showed a spherical mass located left mediastinum. A pericardial cyst with low signal intensity was noted on T1 weighted magnetic resonance (MR) images. The cyst had high signal intensity, but signal intensity of folded parasitic membranes in the cyst were seen lower intensity on T2 weighted MR images. Based on these MR findings, pericardial hydatid cyst was diagnosed. The patient underwent surgical removal of the cyst. Histologic study of the cyst confirmed hydatid cyst diagnosis. (C) 2003 Tohoku University Medical Press.
Popliteal Artery Pseudoaneurysm
(John Wiley & Sons inc, 2004) Harman, M; Irmak, H; Arslan, H; Arslan, Ü; Kayan, M
Brucellosis is still a public health problem, particularly in developing countries. After the primary infection subsides, a chronic stage characterized by nonspecific manifestations can develop, during which it may not be possible to isolate Brucella organisms and agglutination test titers may or may not be high. We present the case of a 49-year-old man who had only nonspecific symptoms and a 2-month history of a pulsatile painful swelling in his right popliteal region. He had no history of trauma or surgery in that region, but he did ingest unpasteurized milk products. The patient's agglutination test titers were high, and Brucella melitensis was isolated from a bone marrow culture. Color Doppler sonography, T2-weighted MRI, and digital subtraction angiography were performed. Treatment with ultrasound-guided compression of the pseudoaneurysm failed because of high blood flow in its neck. Aneurysmectomy was undertaken, and the excised material was consistent with that from a mycotic pseudoaneurysm. Although both MRI and angiography provided useful information, the color Doppler sonography findings were characteristic of a pseudoaneurysm in the popliteal artery, and only that modality could detect the flow dynamics within the pseudoaneurysm. (C) 2003 Wiley Periodicals, Inc.
Salmonella Myocarditis in a Patient With Wolf-Parkinson Syndrome That Was Confused With an Inferior Myocardial Infarction
(Univ Chicago Press, 1997) Akdeniz, H; Tuncer, I; Irmak, H; Demiroz, AP
Use of the Brucella Igm and Igg Flow Assays in the Serodiagnosis of Human Brucellosis in an Area Endemic for Brucellosis
(Amer Soc Trop Med & Hygiene, 2004) Irmak, H; Buzgan, T; Evirgen, Ö; Akdeniz, H; Demiroz, AP; Abdoel, TH; Smits, HL
The clinical utility of two complementary tests for brucellosis, the Brucella IgM and IgG flow assays, was evaluated in a hospital in eastern Turkey. The results show that the flow assays are convenient diagnostic tests for use in endemic areas. A positive result in the flow assays was obtained in 91% and 97% of the admission sera from adult and pediatric patients with brucellosis, respectively, and the sensitivity at admission was 100% for culture-confirmed brucellosis. The assay system performed equally well in diagnosing patients at different stages of illness including patients with acute, subacute, or chronic disease and with relapse. The results of the flow assays correlated well with those of a serum agglutination test at a cut-off greater than or equal to1:160. The agreement was 92%. Application of the flow assays on serum samples collected during a village survey for brucellosis after an outbreak demonstrated their diagnostic potential as field tests.