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Öğe An outbreak of tularemia in western Black Sea Region of Turkey(Yonsei Univ College Medicine, 2004) Gurcan, S; Tatman-Otkun, M; Otkun, M; Arikan, OK; Ozer, BThe aim of this study was to investigate the source and the size of a tularemia outbreak in a village located in a non-endemic area. Five patients from the same village were admitted to hospital with the same complaints all within one week of September 2001. Tularemia was suspected and a diagnosis was made after physical and anamnesis examinations. The village was visited the same week that the patients were admitted to the hospital, in the January and April 2002. The villagers were examined and screened serologically by microagglutination method and the water sources were investigated bacteriologically. A total of 14 people were found to be infected from the outbreak and the oropharyngeal form was the only clinical presentation. Antibody titers ranged between 1 : 80 and 1 : 640. The patients responded well to the aminoglycoside plus tetracycline therapy. Examination of the pipewater and three springs revealed that all the water sources were contaminated by coliforrns, however, Francisella tularensis could not be isolated in glucose-cystine. medium. Antibody levels stayed stable or decreased seven months after. Tularemia had not been reported in this area before, so the first patients were misdiagnosed. In conclusion tularemia should be considered in differential diagnosis of patients with fever, sore throat and cervical lymphadenopaties.Öğe Prevalence of Helicobacter pylori in patients with nasal polyps: A preliminary report(Wiley, 2004) Koc, C; Arikan, OK; Atasoy, P; Aksoy, AObjectives: The aim of the study is to determine the presence of H. pylori in nasal polyps by both immunohistochemical staining with H. pylori antibody of biopsy specimens and enzyme-linked immunoadsorbent assay (ELISA) of sera. Study Design: A prospective, controlled, clinical trial. Methods: We enrolled 30 patients with nasal polyps and 20 controls with middle concha bullosa undergoing endoscopic sinus surgery (ESS). Blood samples of both the study and control groups were evaluated for anti-H. pylori specific immunoglobulin (Ig)G antibodies by ELISA. In addition, biopsy specimens of the removed polyps and the mucosal part of middle conchas were examined by the immunohistochemical analysis with H. pylori antibody. Results: In the blood samples, specific IgG antibodies to H. pylori were found in 26 (86.7%) of 30 polyp patients and 17 (85%) of 20 controls. In 6 (20%) of the 30 patients, H. pylori was identified in the nasal polyp tissue, but it was not detected in the mucosal part of the middle concha specimens. No significant statistical difference was observed for H. pylori antibodies by ELISA among the patients with nasal polyps and the control group (Fisher's exact test, P = .59). However, there was a statistical difference between the polyp biopsy specimens and the control biopsy specimens by immunohistochemical staining (Fisher's exact test, P = .037). Conclusions: This study indicates that H. pylori was found in increased prevalence in the nasal polyps. However, further controlled epidemiologic studies would be necessary to confirm our results and clarify the potential underlying pathogenetic mechanisms.Öğe Recurrent laryngeal nerve paralysis resulting from a metastatic lymphadenopathy caused by a right-sided lung cancer(Elsevier Science Bv, 2004) Kara, M; Dikmen, E; Arikan, OK; Kara, SA…