Laboratuvardan Kliniğe Transplantasyon Pratiği

Transplantasyon; Temel Tıbbi Bilimler, Moleküler Tıp, Genetik ve İmmünolojiden klinik uygulamalardan destek alan multidisipliner bir tıp dalıdır. Temel bilimlerdeki başarılı çalışmaların kliniğe uygulanması, klinikte karşılaşılan sorunların da, oluşturulan deneysel hayvan modellerinde irdelenmesi, elde edilen bilgilerin klinik uygulamalara aktarılması; diğer deyişle tecrübelerin “Translational” özellikli olması günümüz transplantasyon çalışmalarında bir gerekliliktir. İmmün sistemin bileşenlerinin ve reaksiyonlarının iyi bilinmesi, hücreler arası ilişkilerde greftin reddi ya da kabul edilmesinin şartlarını doğru anlamak ve uygun laboratuvar yöntemleri ile klinik durumun aydınlatılması transplantasyonda stratejik önemdedir. Bu nedenle, klinik transplantasyon çalışmaları yapanlar temel bilimler bilgileri ile de donanımlı olmalıdırlar. Multidisipliner bir dal olma bilinci ile yapılan klinik transplantasyon çalışmalarında başarı yakalanmaktadır. Laboratuvardan Kliniğe Transplantasyon kitabımızda tüm yönleri ile transplantasyonun organizmaya etkileri ve bunların klinik sonuçlarını, çalışmalarımızın ışığında sunmayı ve tartışmayı hedefledik. Editör: Prof.Dr. Mesut İzzet TİTİZ Yardımcı Editör: Doç.Dr. Pınar AT

Clinical evaluation of the complications found in bitches after total bilateral mastectomy operations

The aim of the study was to investigate early and late postoperative complications and their incidence in bitches undergoing total bilateral mastectomy surgery for diagnosed mammary gland tumor growths. The study investigated a total of 40 bitches operated under general anesthesia for surgical removal of affected tissues and retained under clinical control for the postoperative duration of one year in order to trace any clinical complications

Fever of unknown origin in uremic patients: A controlled prospective study

Twenty-nine uremic patients with fever of unknown origin(FUO) admitted to our clinic between 1994 and 1998 were evaluated prospectively. A group of 50 consecutive non-uremic patients with FUO followed up during the same period was used for comparison. The causes of FUO found in the uremic and non-uremic groups, respectively were as follows: infectious diseases, 69 vs. 44% (p=0.03); collagen vascular diseases, 6.9 vs. 6%; neoplasms, 3.4 vs. 26%; miscellaneous causes, 3.4 vs. 16%; and undiagnosed, 17.2 vs. 8%. Tuberculosis was the most common cause of FUO in both groups. The spectrum of underlying conditions for FUO in our uremic patients differed from that in the non-uremic patients and the uremic patients had a very high propensity for infectious diseases, especially tuberculosis

Systemic fungal infections after renal transplantation

In a retrospective evaluation. the incidence of systemic fungal infections (SFIs) in 296 kidney graft recipients admitted to our center between 1986 and 1999 was found to be 4%. Eighteen percent of 28 recipients transplanted in India and 8% of 12 recipients transplanted in Russia developed SFI. In contrast, SFI was encountered in only 2% of recipients transplanted at our center. The median time of diagnosis of SFI was 5 months after transplantation. The lungs and central nervous system were the most frequently affected sites. The most common etiologic agent was Aspergillus fumigatus (n=7) but Candida spp. (n = 1), Rhizopus spp. (n = 1) and Cryptococcus neoformans (n = 1) were also encountered. In 2 patients, 2 different pathogens were isolated at the same time: A. fumigatus and Rhizopus spp. in I patient and Candida spp. and A. fumigatus in another. In order to determine predisposing factors for SFI, patients admitted immediately before and after those with SFI were used as controls: long-term hospitalization, long-term antibiotic use and post-transplant diabetes mellitus were found to be predisposing factors. Eight patients were treated with antifungal drugs and a good response to liposomal amphotericin B therapy was obtained in 3/5. Nine patients (75%) with SFI died. As SFIs are associated with a high mortality rate in renal transplant recipients, antifungal therapy, especially with liposomal amphotericin B, should be started whenever fungal infection is suspected, even before the results of microbiologic and/or histologic examinations are known

Incidence of gallstones in chronic renal failure patients undergoing hemodialysis: Experience of a center in Turkey

OBJECTIVES: In this case-control study, we sought to determine whether the incidence of gallbladder stones (GBS) was increased in chronic renal failure (CRF) patients on a hemodialysis (HD) program. We also evaluated factors, Such as lipid profiles and gallbladder motility, that could affect the formation of GBS. In addition, we reviewed other available studies on this subject and compared the factors that might have some influence on the development of GBS