Glokom Hastalarında Sıklıkla Görülen Streptokok Endoftalmilerine, Kirpik ve Konjonktiva Florası - Özgün Araştırma

Amaç: Glokom hastalarının kirpik ve konjonktiva floralarını normal bireylerle karşılaştırmak. Gereç ve Yöntem: Her bir grupta 33 göz olmak üzere 83 hastanın 132 gözü çalışmaya dahil edildi. Grup 1; trabekülektomi uygulanmış ve ameliyat sonrası anti-glokomatöz damlalara (AGD) ihtiyaç duyulmayan, Grup 2; trabekülektomi sonrası AGD kullanmaya devam eden, Grup 3; trabekülektomi uygulanmamış fakat AGD kullanan gözlerden, Grup 4 ise sağlıklı gözleri içeren kontrol grubundan oluşturuldu. Bütün AGD’lar koruyucu olarak benzalkonyum klorid (BAK) içermekteydi. Sonuçlar: Alınan kirpik kültürlerinde; AGD kullanan gruplar ve kontrol grubu arasında izole edilen koagülaz negatif stafilokokların sayısı bakımından anlamlı bir fark saptandı (p=0,03). Alınan konjonktiva kültürlerinde ise; grup 1, 2 ve 3’de Streptococcus türleri ve Haemophilus türleri izolasyon oranlarının yüzdeleri kontrol grubuna göre daha yüksek bulundu fakat istatistiksel olarak anlamlı değildi, sırasıyla (p=0,87 ve p=0,29). Tartışma: Trabekülektomi ile birlikte uzun süreli AGD kullanımı veya tek başına uzun süreli AGD kullanımı konjonktiva ve kirpik floralarında bulunan koagülaz negatif stafilokokların sayısını azaltırken, Streptococcus türü ve Hemophilus türü bakterilerin sayısını da arttırmaktadır. Geç başlangıçlı bleble ilişkili endoftalmilerde Streptococcus türleri en yaygın bakteriler olduğundan, kötü prognozlu endoftalmilerin azaltılmasında, kirpik ve konjonktivadan belli aralıklarla kültür alınarak bu bakterilerin eradike edilmesinin faydalı olabileceğini düşünmekteyiz. (TOD Dergisi 2010; 40: 4-7) Anahtar Kelimeler: Benzalkonyum klorid, endoftalmi, glokom, streptokok, trabekülektomi Summary Purpose: To compare the eyelid and conjunctival flora of glaucoma patients with normal subjects. Material and Method: One hundred and thirty-two eyes of 83 patients were assigned to 4 groups, consisting of 33 eyes each. Group 1 consisted of eyes which underwent trabeculectomy without need for postoperative antiglaucoma drops (AGD), group 2 consisted of eyes which needed to use AGD following the trabeculectomy, group 3 consisted of eyes which did not undergo trabeculectomy but used AGD, and group 4, the control group, consisted of healthy eyes. All AGD contained benzalkonium chloride (BAC) as a preservative. Results: A statistically significant difference was found between the group using AGD and the control group, regarding the number of coagulase-negative staphylococci isolated from eyelid specimens (p=0.03). Although the isolation rates of Streptococcus spp. and Haemophilus spp. were higher in groups 1, 2 and 3 than in the control group for the conjunctival specimens, the difference was not statistically significant (p=0.87, p=0.29, respectively). Discussion: Trabeculectomy together with long-term use of AGD, or long-term use of AGD with BAC itself, seemed to decrease the number of coagulase-negative Staphylococci and to increase the number of Streptococcus spp. and Haemophilus spp. in the eyelid and conjunctival flora of the control group. As Streptococcus spp. predominate in cases of delayed-onset bleb-associated endophthalmitis, by taking eyelid and conjunctiva specimens for culture at certain intervals, their eradication might be achieved and therefore, the potentially devastating endophthalmitis might be prevented. (TOD Journal 2010; 40: 4-7) Key Words: Benzalkonium chloride, endophthalmitis, glaucoma, Streptococcus, trabeculectom

Uzun Süreli Antiglokomatöz Damla Kullanımının Konjonktiva ve Kirpik Florası Üzerine Etkisi

Amaç: Uzun süreli antiglokomatöz damla (AGD) kullanımının ve bu damlalar ın içerdiği benzalkonyum klorürün (BAK) konjonktiva ve kirpik floras ı üzerine etkisini araştırmak. Gereç ve Yöntem: Ortalama 24±17 (6-72) ay süreyle AGD kullanan 24 hastan ın 40 gözü ve kontrol grubu olarak glokom hikayesi bulunmayan 34 hastan ın 40 gözü çalışmaya dahil edildi. Kullan ılan toplam 8 çeşit AGD, koruyucu olarak ortalama %0.05±0.015 (%0.02-%0.075) oran ında BAK içermekte idi. Konjonktiva ve kirpiklerden dakron çubukla al ınan kültürler kanlı agar ve çukulatamsı agara ekilerek, %5-7 CO 2’li ortamda, 37ºC’da 2 gün enkübe edildi. Çal ışma vaka-kontrol araştırması olarak planlandı. Bakterilerin identifikasyonu sonras ı gruplar; üreyen bakteriler ve bakterilerin antibiyotiklere duyarl ılıkları bakımından incelendi. Bulgular: Konjonktiva kültürlerinde; kontrol ve ilaç kullanan grupta en s ık olarak Difteroid çomak, sırasıyla %23(9/40) ve %25(10/40) oran ında izole edildi. Kirpiklerden alınan kültürlerde ise; kontrol ve ilaç kullanan grupta en s ık koagulaz negatif stafilokoklar s ırasıyla, %93 (37/40) ve %83 (33/40) oran ında izole edildi. İlaç kullanan gruptaki bakteriler kontrol grubundan izole edilen bakterilere oranla antibiyotiklere daha dirençli idi (p>0.05). İzole edilen bakterilere kar şı en etkili antibiyotikler vankomisin, amikasin ve netilmisin idi. Konjonktiva ve kirpik kültürlerinde üreyen bakteriler aras ında istatistiksel olarak anlaml ı fark bulunamadı (p>0.05). Sonuç: Genel olarak ilaç kullanan gruptaki bakteriler kontrol grubuna göre antibiyotiklere daha dirençli idi. AGD kullan ımı ile ayn ı zamanda bir dezenfektan olan BAK’a uzun süre maruz kal ım sonucu konjonktiva ve kirpiklerde daha dirençli su şların kolonize olabileceği düşüncesindeyi

Is Single Measurement Enough to Get a Reliable Result with Optical Coherence Tomography?

Pur po se: To evaluate the repeatability and reliability of retinal nerve fiber layer (RNFL) thickness measurements using optical coherence tomography (OCT). Ma te ri al and Met hod: Two hundred sixty-six eyes of 135 subjects (glaucoma, glaucoma suspects and healthy) were included in this study. Three sequential inferior, superior, nasal and temporal RNFL thickness measurements were performed using Spectral OCT [Opko/OTI, Inc., Miami, FL] by one operator at one session without pupillary dilatation. The differences between these three measurements of each quadrant in each eye were compared in microns and percentages. Repeated measures analysis of variance was performed for statistical analysis. Reliability is measured by intraclass correlation coefficient (ICC) for each quadrant. Re sults: ICCs of all quadrants ranged between 0.77 and 0.92, with the measurements of nasal quadrant being the least reproducible and the inferior being the most reproducible of all quadrants. RNFL measurement errors over 20% were seen in 9.63% of nasal quadrant, 5.3% of temporal quadrant, 0.6% of superior quadrant and only 0.3% of inferior quadrant measurements. Dis cus si on: In order to get more repeatable and reliable results with OCT, sequential measurements more than one should be considered. We believe that special attention is required in the analysis of data of nasal and temporal quadrants. (Turk J Ophthalmol 2012; 42: 11-5

The effect of long-term use of antiglaucomatous drops on conjunctival and eyelid flora

Amaç: Uzun süreli antiglokomatöz damla (AGD) kullanımının ve bu damlaların içerdiği benzalkonyum klorürün (BAK) konjonktiva ve kirpik florası üzerine etkisini araştırmak. Gereç ve Yöntem: Ortalama 24±17 (6-72) ay süreyle AGD kullanan 24 hastanın 40 gözü ve kontrol grubu olarak glo- kom hikayesi bulunmayan 34 hastanın 40 gözü çalışma- ya dahil edildi. Kullanılan toplam 8 çeşit AGD, koruyucu olarak ortalama %0.05±0.015 (%0.02-%0.075) oranında BAK içermekte idi. Konjonktiva ve kirpiklerden dakron çu- bukla alınan kültürler kanlı agar ve çukulatamsı agara eki- lerek, %5-7 CO2’li ortamda, 37ºC’da 2 gün enkübe edildi. Çalışma vaka-kontrol araştırması olarak planlandı. Bak- terilerin identifikasyonu sonrası gruplar; üreyen bakteriler ve bakterilerin antibiyotiklere duyarlılıkları bakımından in- celendi. Bulgular: Konjonktiva kültürlerinde; kontrol ve ilaç kullanan grupta en sık olarak Difteroid çomak, sırasıyla %23(9/40) ve %25(10/40) oranında izole edildi. Kirpiklerden alınan kültürlerde ise; kontrol ve ilaç kullanan grupta en sık ko- agulaz negatif stafilokoklar sırasıyla, %93 (37/40) ve %83 (33/40) oranında izole edildi. İlaç kullanan gruptaki bak- teriler kontrol grubundan izole edilen bakterilere oranla antibiyotiklere daha dirençli idi (p>0.05). İzole edilen bakterilere karşı en etkili antibiyotikler vankomisin, amika- sin ve netilmisin idi. Konjonktiva ve kirpik kültürlerinde üreyen bakteriler arasın- da istatistiksel olarak anlamlı fark bulunamadı (p>0.05). Sonuç: Genel olarak ilaç kullanan gruptaki bakteriler kontrol grubuna göre antibiyotiklere daha dirençli idi. AGD kul- lanımı ile aynı zamanda bir dezenfektan olan BAK’a uzun süre maruz kalım sonucu konjonktiva ve kirpiklerde daha dirençli suşların kolonize olabileceği düşüncesindeyiz.Purpose: To investigate the effect of long-term use of anti- glaucomatous drops (AGD), and benzalkonium chloride (BAK) on eyelid and conjunctival flora. Materials and Methods: Forty eyes of 24 subjects who used AGD with a mean usage time of 24±17 (6-72) months, and 40 eyes of 34 subjects who had no glaucoma history as a control group were recruited. In this study, 8 diffe- rent AGD were used, and all drops contained benzalko- nium chloride (BAK) 0.05% (range, 0.02% to 0.075) as a preservative. Cultures of conjunctiva and eyelid samples were obtained by dacron swab, inoculated onto blood and chocolate agar, and incubated at 37 °C in an atmosphe- re of 5-7% CO2 for 2 days. This study was planned as a case-control study. All bacterial isolates was identified, and isolated bacteria in both groups and their sensitivities to antibiotics were compared. Results: Diphtheroid rods were the most frequent isolated bacteria from the conjunctivas in the control group and in the group that used AGD, 23% (9/40) and 25% (10/40), respectively. Coagulase negative Staphylococcus was the most frequently isolated bacteria from the eyelids in the control group and in the group that used AGD, 93% (37/40) and 83% (33/40), respectively. The bacteria isola- ted from the group that had used AGD were more resistant to antibiotics than the bacteria isolated from the control group (p>0.05). Isolated bacteria were most susceptible to vancomycin, netilmicin and amikacin. There was no sta- tistically significant difference between the groups in the proportion of conjunctival and eyelids’ cultures that yielded positive (p>0.05). Conclusions: Isolated bacteria in the group that used AGD were more resistant to antibiotics in comparison with the control group. We conclude that long-term use of AGD containing BAK, which is also a disinfectant agent, may ca- use colonisation with more resistant bacteria on conjuncti- vas and eyelids

Aphid (Hemiptera: Aphidoidea) species of the Urla district of İzmir region

As a result of the study organized to determine aphid fauna of the Urla district of İzmir region, 38 species were identified. Of these species, Chaitophorus saliciniger (Knowlton, 1927) and Aphis serpylli Koch, 1954 are new records for Turkey aphid fauna. With these new records, the total number of aphid species in Turkey comes up to 450. Findings of the presented study and other recent studies showed that with the detailed study Turkey aphid fauna will be substantially increased.As a result of the study organized to determine aphid fauna of the Urla district of İzmir region, 38 species were identified. Of these species, Chaitophorus saliciniger (Knowlton, 1927) and Aphis serpylli Koch, 1954 are new records for Turkey aphid fauna. With these new records, the total number of aphid species in Turkey comes up to 450. Findings of the presented study and other recent studies showed that with the detailed study Turkey aphid fauna will be substantially increased

Kill rates of preserved and preservative-free topical 8-methoxy fluoroquinolones against various strains of Staphylococcus

PURPOSE: To assess the kill rates of preserved and preservative-free 8-methoxy fluoroquinolones and benzalkonium chloride (BAC) against isolates of Staphylococcus aureus and coagulase-negative Staphylococcus (CNS) species. SETTING: Bascom Palmer Eye Institute, Miami, Florida, USA. METHODS: Ocular and standard isolates of S aureus and CNS were inoculated with saline, 0.005% BAC, gatifloxacin 0.3% containing 0.005% BAC (Zymar), or BAC-free moxifloxacin 0.5% (Vigamox) at 37 degrees C. Bacterial viability was assessed after 15 minutes, 30 minutes, and 60 minutes. RESULTS: Thirteen isolates of S aureus and 5 isolates of CNS were used. The mean initial load of bacterial inoculum was 5.45 log colony-forming units (CFU)/mL +/- 0.37 (SD). Saline did not affect the density of staphylococci; BAC significantly decreased the staphylococci count to a mean of 3.80 +/- 0.32 log CFU/mL at 60 minutes (P<.05). Gatifloxacin 0.3% reduced the number of staphylococci significantly more than moxifloxacin 0.5% at 15 minutes (mean 0.47 +/- 1.12 log CFU/mL versus 4.55 +/- 0.60 log CFU/mL), 30 minutes (mean 0.07 +/- 0.31 log CFU/mL versus 3.82 +/- 1.07 log CFU/mL), and 60 minutes (mean 0.00 +/- 0.00 log CFU/mL versus 2.75 +/- 1.29 log CFU/mL) (P<.005). Gatifloxacin 0.3% completely eradicated most S aureus (10/13) and CNS (3/5) isolates at 15 minutes; moxifloxacin 0.5% did not achieve complete kill in any S aureus isolate (13/13) or in most CNS isolates (4/5) at 60 minutes. CONCLUSION: The commercial formulation of gatifloxacin 0.3% containing BAC 0.005% completely eradicated staphylococcal isolates more rapidly than the BAC-free formulation of moxifloxacin 0.5% or BAC 0.005% alone.Baudouin C, 2008, ACTA OPHTHALMOL, V86, P716, DOI 10.1111/j.1755-3768.2008.01250.xMoshirfar M, 2007, OPHTHALMOLOGY, V114, P686, DOI 10.1016/j.ophtha.2006.08.038Blondeau JM, 2007, J CHEMOTHERAPY, V19, P146Kowalski RP, 2006, AM J OPHTHALMOL, V142, P730, DOI 10.1016/j.ajo.2006.06.006Schlech BA, 2005, SURV OPHTHALMOL, V50, pS64, DOI 10.1016/j.survophthal.2005.05.005Herretes S, 2005, AM J OPHTHALMOL, V140, P737Durrie DS, 2005, J OCUL PHARMACOL TH, V21, P236Romanowski EG, 2005, AM J OPHTHALMOL, V139, P867, DOI 10.1016/j.ajo.2005.01.021Wallin T, 2005, J CATARACT REFR SURG, V31, P735, DOI 10.1016/j.jcrs.2004.10.057Donnenfeld E, 2005, CURR MED RES OPIN, V21, P643, DOI 10.1185/030079904X5959KOWALSKI RP, 2005, EXPERT REV ANTI-INFE, V3, P131Kowalski RP, 2003, AM J OPHTHALMOL, V136, P500, DOI 10.1016/S002-9394(03)00294-0Callegan MC, 2003, ADV THER, V20, P246Tungsiripat T, 2003, AM J OPHTHALMOL, V136, P76, DOI 10.1016/S0002-9394(02)02280-8Pushker N, 2002, J REFRACT SURG, V18, P280Lu T, 2001, ANTIMICROB AGENTS CH, V45, P2703, DOI 10.1128/AAC.45.10.2703-2709.2001Noecker R, 2001, ADV THER, V18, P205Fukuda H, 2001, ANTIMICROB AGENTS CH, V45, P1649Huczko E, 2000, INT J ANTIMICROB AG, V16, P401Dantas PEC, 2000, CORNEA, V19, P353Blondeau JM, 2000, INT J ANTIMICROB AG, V14, P45Han DP, 1996, AM J OPHTHALMOL, V122, P1SPEAKER MG, 1991, OPHTHALMOLOGY, V98, P639SCHEIN OD, 1989, CORNEA, V8, P281ORMEROD LD, 1987, OPHTHALMOLOGY, V94, P1322

Enhancer of zeste homolog 2 (EZH2) gene inhibition via 3-Deazaneplanocin A (DZNep) in human liver cells and it is relation with fibrosis

Objectives: Hepatic fibrosis is a complex and dynamic process, such as "wound healing". The effect of 3-deazaneplanocin A (DZNep) via enhancer of zeste homolog 2 (EZH2) inhibition on transforming growth factor, matrix metalloproteinases 2-9 (MMP2, MMP9) and matrix metalloproteinases inhibitor 3 (TIMP3), alpha-smooth muscle actin (alpha-SMA), collagen 3A1(COL1A1), and collagen 3A1 (COL3A1) genes/proteins in human hepatic stellate cell line were examined. Inhibition effect of EZH2 on colony formation and migration were investigated