Hepatitis C virus infection among patients admitted to a rheumatology ward in northern Cyprus

Aim of the work

To detect the frequency of hepatitis C virus (HCV) infection among patients admitted to a rheumatology ward in northern Cyprus.

Psychological health of caregivers and association with functional status of stroke patients

Objective: Stroke does not only affect the physical state of patients but also the emotional state of their relatives, most effectively their caregivers. The study aims to examine the mood of caregivers experienced with care for patients with stroke who are highly dependent on the assistance and also to establish the relationship between the emotional state of caregivers and the severity of disability of the patients.

Methods: This study contained a total of 76 patients with sufficient cognitive functions and severe physical disabilities with hemiplegia caused by a cerebrovascular accident and their caregivers and 94 controls. The functional state of patients was assessed by the Barthel Index (BI). Furthermore, emotional state of the caregivers was assessed by the Hospital Anxiety and Depression Scale (HADS) and their life quality was assessed by the SF36 Health Survey.

Results: The mean anxiety (9.73 ± 4.88) and depression rates (9.81 ± 5.05) in the caregivers were significantly higher than those in controls (p<0.001, respectively). Significant impairments were observed in both their mental and physical health. Regression analysis also showed a significant negative correlation between the BI scores and the HADS scores.

Conclusion: Caregivers had an impaired emotional state and the level of their anxiety was associated with the severity of functional disability of the patients. Therefore, the support provided to the caregiver might be influential on the functional recovery of the patients.     

Breast MR segmentation and lesion detection with cellular neural networks and 3D template matching

A novel fully automated system is introduced to facilitate lesion detection in dynamic contrast-enhanced, magnetic resonance mammography (DCE-MRM). The system extracts breast regions from pre-contrast images using a cellular neural network, generates normalized maximum intensity-time ratio (nMITR) maps and performs 3D template matching with three layers of 12x12 cells to detect lesions. A breast is considered to be properly segmented when relative overlap >0.85 and misclassification rate <0.10. Sensitivity, false-positive rate per slice and per lesion are used to assess detection performance. The system was tested with a dataset of 2064 breast MR images (344slicesx6 acquisitions over time) from 19 women containing 39 marked lesions. Ninety-seven percent of the breasts were segmented properly and all the lesions were detected correctly (detection sensitivity=100%), however, there were some false-positive detections (31%/lesion, 10%/slice).     

Hydroheptin: a water-soluble polyene macrolide. I. Taxonomy, fermentation and isolation

A soil isolate of Streptomyces, which has been deposited in the culture collection of the Waksman Institute of Microbiology, Rutgers University as IMRU 3962, produces a new heptaene macrolide antifungal antibiotic, hydroheptin. The producing microorganism, which co-produces the antibiotic, chartreusin, has been identified as a strain of Streptomyces chartreusis. Fermentation and bioassay procedures were developed for the production and analysis of hydroheptin and chartreusin. Isolation and purification procedures based on solvent extraction and precipitation of an organic acid yielded a relatively pure product of hydroheptin.     

V-Y and rectangular flap combination for syndactyly repair

Objective: For syndactyly repair, several delicate, well-planned flap combination techniques have been reported. This study presents technique details with functional and aesthetic results of a dorsal rectangular and volar V-Y advancement flap combination for web reconstruction and S incisions for finger separation in patients with syndactyly.

Method: Ten patients with 16 syndactyly webs were treated. Patients were examined in terms of function and aesthetic. Evaluation criteria included the Vancouver Scar Scale, range of motion, degree of web creeping, parent’s satisfaction rates, and finger abduction. During the initial period, vascular compromise of fingers, haematoma, infection, seroma, flap necrosis, or graft failures were not noted in any patients. No patients required revision surgery. During the later period, parent satisfaction scores were excellent or good, finger function was complete, and the Vancouver Scar Scale showed that two webs had hyperpigmented areas and two had supple pliability.

Conclusion: This simple syndactyly release technique can provide a low rate of web creep, good scar quality, and optimal functional results.     

Factors Affecting Use of Resources for Asthma Patients

Objective: This study aims at exploring the variance in resources used for management and treatment of asthma disease and analyzing the impact of patient and physician characteristics on total test expenditures and the number of drugs prescribed as resource utilization variables. Study setting: The study was undertaken in Hacettepe University Chest Diseases Polyclinic and Allergy Unit. 387 asthma patients visiting the unit between August 2000 and March 2001, were included in the study. Results: The regression analysis showed that patient characteristics did not have a statistically meaningful impact on total test expenditures (p > 0.05). The laboratory test expenditures for patients who referred to academicians (professors and associate professors) were higher compared to patients who referred to their counterparts (p < 0.05). Similarly, the laboratory test expenditures for patients referred to two physicians in the allergy unit were higher and statistically meaningful (p < 0.05) than patients who referred to 8 physicians in the chest diseases polyclinic. When factors affecting the number of drugs prescribed is analyzed it was found that duration of treatment, severity of disease, quality of life, frequency of referral to a physician in the last 6 months were meaningful (p < 0.05). Conclusions: The variances in total test expenditures for different academic careers and specialties indicate the need to standardize the treatment process for asthma and to reconsider medical education.     

Collagen-production inhibitors evaluated as antitumor agents

Proline analogues such as cis-4-hydroxy-L-proline (CHP) and L-azetidine-2-carboxylic acid (A2C) were tested for their antitumor activity in tissue culture and in vivo. In culture, CHP specifically inhibited those tumor cells that synthesized basement-membrane collagen. CHP appeared to selectively inhibit collagen biosynthesis with only a slight effect on protein synthesis. Culturing cells on type IV collagen matrix did not alter the antiproliferative effect of CHP. The inhibition of 450.1 mouse mammary tumor cells was fully reversible when cultures were incubated for 6 or 12 hours with 25 micrograms CHP/ml but was irreversible after 24 hours of exposure. Of the proline analogues tested against 450.1 tumor cells, A2C and CHP were the most potent inhibitors of cell growth. These two compounds were therefore tested in vivo using 3 transplantable tumors, all of which synthesized basement-membrane collagen. CHP and A2C were given twice daily to mice for 7 to 10 days at doses ranging from 50 mg/kg (body wt) to 600 mg/kg (body wt) per injection. Both CHP and A2C were completely inactive against the 450.1 mammary tumor and the EHS sarcoma. Both compounds also caused considerable liver toxicity. Against CD8F1 mammary tumors, treatment with maximum tolerated doses of CHP and A2C resulted in a slight but insignificant inhibition of tumor growth. While our studies confirmed previous findings that CHP specifically inhibited those tumor cells that synthesized basement-membrane collagen, CHP and A2C did not appear to be efficacious antitumor agents.