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    Cholecystitis related to Brucella melitensis: A rare presentation
    (2008) Gunal E.K.; Topkaya A.E.; Arisoy A.; Aydiner O.; Gökçen G.; Aksungar F.B.; Karabulut M.; Tulbek M.Y.; Aytug O.N.
    Although human brucellosis is a multisystemic disease, cholecystitis due to Brucella species is a rare manifestation. Here we present a 64-year-old woman with Brucella cholecystitis who was admitted to the hospital with fever and arthralgias for the last 10 days. Her complete blood count and blood chemistry were unremarkable other than C-reactive protein: 3.08 mg/dL (<0.5 mg/dL), aspartate transaminase: 70 U/L (<65 U/L), alanine transaminase: 71 U/L (<37 U/L), ?-glutamyl transferase: 748 U/L (<85 U/L), and alkaline phosphatase: 285 U/L (<136 U/L). On the second day of hospitalization, she complained of diffuse abdominal pain, and physical examination revealed Murphy sign. Abdominal ultrasonography was consistent with acute cholecystitis. She was given ciprofloxacin because she refused cholecystectomy. On the 10th day of admission, she still had fevers, and Brucella melitensis was recovered from blood culture specimens. Brucella agglutination tests were also found to be positive. She was symptom free after the fifth day of introduction of streptomycin, doxycycline, and rifampicin. © 2008 Lippincott Williams & Wilkins, Inc.
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    Is there any relationship between streptococcal infection and multiple sclerosis?
    (2007) Topkaya A.E.; Sahin S.; Aksungar F.B.; Boru U.T.; Yildiz Z.; Sur H.
    Background: Multiple sclerosis (MS) is an immune-mediated inflammatory demyelinating disease of uncertain etiology. Although the mechanisms of inducting autoimmunity by some of the infectious agents have been investigated, there is not yet enough research on streptococcal infections. Material/Methods: To understand the effect of past group A streptococcal infection on MS, antistreptolysin O (ASO) and antideoxyribonuclease B (ADNase B) were measured in 21 patients with relapsing-remitting MS and 21 healthy blood donors by nephelometric assay. Results: ADNase B levels in the patients with MS were found to be significantly higher than in the controls (p<0.001); however, ASO levels were similar in both groups. Conclusions: These findings indicate that a relationship between multiple sclerosis and streptococcal infections may exist, but to acquire a better understanding of the role of group A streptococci in the pathogenesis of multiple sclerosis, more studies with animal models are necessary. © Med Sci Monit, 2007.
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    Nitric oxide, endothelin-1, and superoxide production in arterial bypass grafts
    (2006) Aksungar F.B.; Moini H.; Unal M.; Yilmaz O.; Sonmez B.; Bilsel S.
    In this study, basal and thrombin-stimulated release of nitric oxide and endothelin-1 in the internal mammary artery and the radial artery were measured, together with superoxide radicals generated after anoxia and reoxygenation. Arterial segments were obtained from patients undergoing coronary bypass operations. Quantification of nitric oxide was performed by measuring the stable oxidation products of nitric oxide. Endothelin levels were measured by an enzyme immunoassay kit, and the superoxides were measured by lucigenin-enhanced chemiluminescence. Basal and stimulated release of nitric oxide from the internal mammary artery is significantly higher than that in the radial artery. On the other hand, basal release of endothelin-1 is less in the internal mammary artery than in the radial artery, but similar after stimulation. In our study, the quantity of superoxide radicals produced by the internal mammary artery was greater than that produced by the radial artery. Our results show that there are differences between these 2 arteries in regard to production of nitric oxide, endothelin-1, and superoxide radicals. These differences may have a role in the process of atherogenesis and may contribute to long-term patency of arterial bypass grafts. These results may also explain the mechanism of radial artery graft spasm in coronary artery surgery and may constitute a basis for future pharmacological and clinical improvements for successful surgical application. © 2006 by the Texas Heart® Institute.