WHY ARE FISH OF BALIKLI SPA (KANGAL-TURKEY) ATTRACTED TO HUMAN BODY?

Akpınar, Mehmet Ali and M. Sarı

Cumhuriyet University, Faculty of Science and Art, Department of Biology, Sivas, Turkey

The behavior of Kangal Spa fish Cyprinion macrostomus and Garra rufa was investigated using fed and unfed fish in an aquarium. In addition, the total lipid and fatty acid content of these fish was analyzed and compared with that of fish living under natural conditions in pools. It is concluded that fish are attracted by the human body for feeding purposes.

HOT SPRINGS AND INFECTIOUS DISEASES

Bakır, M.

Cumhuriyet University, Faculty of Medicine, Department of Clinical Microbiology and Infectious Diseases, Sivas, Turkey

All pathogenic microorganisms known to pose a significant public health threat in hot springs and other recreational water environments are transmitted via the faecal-oral route or through the respiratory system. Outbreaks of water-borne infections usually include gastroenteritis, dermatitis, meningo-encephalitis, keratitis, otitis, acute respiratory infections and Pontiac fever. Gastroenteritis normally occurs during summer months, dermatitis from February to July and amoebic meningo-encephalitis occurs from April to October. Infections associated with pools or hot springs belong to two groups: a. gastrointestinal and b. non-gastrointestinal. Gastrointestinal infections are caused by parasites, bacteria and viruses. Non-gastrointestinal ailments are caused by Pseudomonas aeruginosa (“spa” folliculitis) and atypical mycobacterium, especially Mycobacterium marinum and Mycobacterium ulcerans, which causes skin ulcers. Respiratory diseases are caused by viruses (particularly adenovirus), Legionella spp. (associated with spas or whirlpools), and mycobacteria (especially Mycobacterium kansasii and Mycobacterium avium-complex). Ear infections (otitis externa, and media) are associated with P. aeruginosa and Staphylococcus aureus. Liver diseases are generally caused by Leptospira spp., hepatitis A and hepatitis E viruses. Central nervous system infections, e.g., fatal amoebic meningo-encephalitis, is caused by Naegleria fowleri and Acanthamoeba spp. In order to prevent outbreaks of water-borne infections a surveillance system including data from outbreaks associated with drinking water and recreational water, should be used. State, territorial and local public health departments are primarily responsible for detecting and investigating water-borne disease outbreaks. Two criteria must be met for an event to be defined as water-borne disease outbreaks. First, two or more people must suffer from similar symptoms either after ingestion of drinking water or exposure to water from recreational areas or occupational settings. Second, epidemiological evidence must implicate water as the probable source of the illness. The public health department and other institutions have been using surveillance data to identify the types of water systems, their deficiencies and the etiologic agents associated with outbreaks and have evaluated current technologies for providing safe recreational and drinking water.

TREATMENT OF A LARGE HEMATOMA IN A DOG WITH THE MEDICINAL LEECH, HIRUDO MEDICINALIS

Canpolat, Ibrahim¹ and Naim Saglam²

¹Veterinary Faculty, Firat University, ²Department of Aquaculture and Fish Diseases, Fisheries Faculty, Firat University, Elazig, Turkey

Leeches have been used for centuries for the treatment of diseases such as hematomas, thromboembolic disorders, inflammations, hemorrhoids, superficial inflammations of veins and anal eczemas. In this study, a dog with a large hematoma on the right side of its body after a blunt injury was brought to the Surgical Clinic of Veterinary Faculty in the University of Firat, Elazig. Five medicinal leeches (H medicinalis), which were obtained from Cip Fisheries Research Station of Fisheries Faculty, Firat University were placed on the skin in the area of the hematoma. The leeches detached from the skin after completing a blood meal, usually after 15–25 minutes. The treatment was repeated daily for 4 days. The hematoma dissolved within a few days after the end of the treatment.

APITHERAPY AS A NEW APPROACH TO THE TREATMENT OF INFECTIOUS DISEASES

Cherbuliez, Theodore

1209, Post Road, Scarsdale, NY 10583, USA

Infectious diseases represent a major part of the pathologies affecting mankind; bacterial upper-respiratory infections cause 3.5 million deaths each year worldwide; more than 36 million people are infected with AIDS - 500,000 in Europe and 1 million in the USA. Less than 10% of infected persons can afford the cost of medication. The annual cost of treatment is between 10,000 and 15,000 US dollars. Therapy for AIDS is only partially effective and the death toll from this disease amounts to 2.3 million yearly. . In the USA each year hospital-acquired infections cost the country 10 billion US dollars; bacterial resistance to antibiotics is estimated to cost 4–5 billion US dollars. Two million people acquire infections during hospitalization, and of these between 60,000 and 80,000 are fatal. There is no solution to these problems. The aggravating factors are medical, scientific, economical, political, biological and socio-cultural. Apitherapy’s main fields of application are: bacterial infections (broncho-pulmonary, gastro-intestinal, septicemia, bone infections); viral infections (Herpes simplex 1 and 2, shingles, varicella, hepatitis, AIDS); cicatrisation and burns (healthy, non-infected wounds, necrotic wounds, pressure ulcers). The different phases of our work include: pre-clinical research on bacterial infections, clinical observation of bacterial infections, clinical observation of hospital-acquired infections, clinical observation of cicatrisation and of major burns, in vitro research on viral infections. Apitherapy’s combined approach to infections are: a. re-enforcing the immune system while at the same time acting against the infectious agent; b. acting on the immune system through certain products of the hive (particularly bee venom); c. combating the agents with Aro-honeys, which are combinations of honey and essential oils. The advantage of these substances when compared with antibiotics: their safety and efficacy the absence of iatrogenic effects and of bacterial resistance, the beneficial secondary effects as well as the very low cost for the treatment was shown in a study with 2,400 patients. We did not observe any recurrence of illnesses that typically reoccur (such as bronchial asthma) in the first year of the study. Scientifically, the innovation of our approach is based on the synergy of different active principles, e.g., honey with several essential oils. The treatment is given according to strict university protocols and our claims are supported by the results from large numbers of patients. Health providers can be taught to recognize patients with medical conditions, which are suitable for treatment using these methods as well as treatment techniques. The raw material necessary for manufacturing api-pharmacopeia come from natural resources and are readily available. The manufacturing costs of the antibacterial products are about 5% of the price of comparable synthetic antibiotics. The treatment has a success rate of 87%, is well tolerated by the patients and do not cause side-effects. There has been a remarkable absence of bacterial resistance.

APITHERAPY IN CUBA: THE APITHERAPY COMMISSION’S PROJECT

Cherbuliez, Theodore

1209, Post Road, Scarsdale, NY 10583, USA

Apimondia, the International Federation of Beekeepers’ Association, was created 105 years ago and it is represented in 53 countries by some 6 million beekeepers. The present Commission was formed in 1997 and one of its missions is the establishment of humanitarian projects. Their purpose is to increase the wellbeing of under-privileged populations, to increase the medical and financial autonomy of the country (all products of the hive can be produced in the country) and to introduce a superior and sustainable form of health care. The Commission began to work on this project in 1998 by giving a course on Apitherapy in Havana at the Finley Institute for Serum and Vaccine. Twenty people participated in this course. The following year, in a course that took place at the Galixto Garcia University, 70 health providers participated and this number reached 230 in 2000. This fall, the fifth course will be available to Cubans and foreigners. Apitherapy requires Apiculture. Apiculture for medicine is a major link in the health chain. The development of this new field will result in an increase in the demand for bee products. In addition to regular use of bee products, we have combined them with essential oils and so re-enforced the oils already present in honey and propolis. Part of the course deals with special techniques for distilling plants, which is essential in the production of first grade chemo-typed essential oils. In 2001, the Commission produced a CD-ROM on Apitherapy, summarizing the knowledge of our team, in French, English and Spanish, including 19 PowerPoint presentations. In parallel to the teaching, we developed several clinical programs for in- and outpatients in collaboration with the Ministry of Health, Ministry of Agriculture and Ministry of Planning, as well as with the army, the Finley Institute, the Calixto Garcia University and the University Hospital Frans Pais. A fundamental component of this approach was the creation of a university “green medicine” protocol for the treatment of all infectious diseases. As of spring 2003, more than 2,400 patients had been treated - most were suffering from broncho-pulmonary infections. A smaller number of patients with gastro-intestinal disorders as well as septicemia and skin conditions such as ulcers, burns and trauma were also treated. The success rate was 87%. Our plan to extend this activity to all 12 regions of Cuba is considered of national interest to the government.

PROGRESS REPORT ON MAGGOT DEBRIDEMENT THERAPY IN THE UK AND GLOBALLY

Church, J.C.T.

Abney Court, Bourne End, Bucks. SL8 5DL, UK

This presentation will be a historical and geographical overview. It will include a brief overview of the history of maggot debridement therapy (MDT) prior to Professor Sherman’s work in the USA, then the historic moment when Professor Sherman presented his work in the UK in January 1995, with all that followed in the UK, and beyond, from that time. Details of the development of MDT in Israel, Germany, and Switzerland, will be addressed in subsequent presentations. A report will be given on the recently established fly culture laboratory in Northern Tanzania, considering the particular challenges of this venture in that environment. The development of MDT is a reflection of a complex mixture of the professional, political, cultural and economic factors, in different parts of the world that have interacted to give the somewhat uneven current global situation. Some of these factors will be considered, especially in the light of our desire to make this treatment available to all people who would benefit from it, as much in ‘Western’ countries as in the Tropics.

MAGGOT INTERVENTION IN THE CHRONIC WOUND

Church, J.C.T.

Abney Court, Bourne End, Bucks, SL8 5DL, UK

This paper will be presented in the form of a schema of the physiopathology of the chronic wound, focusing on factors, which mitigate against wound healing and the host resources, which combat these factors. Of particular concern will be the nature of bacterial bio-film and the role of maggot exo-secretions in the removal of bio-film and its contained organisms.

THE TRAINING OF SNIFFER DOGS TO RECOGNISE HUMAN CANCER

Church, J.C.T.

Abney Court, Bourne End, Bucks. SL8 5DL UK

This paper will present a number of case studies of patients with pet dogs that, by their specific behaviour, have caused their owners to seek medical advice, and have appropriate treatment of a malignant lesion, with good result. The first such case study was published in The Lancet in April 1989. Following this, a number of doctors, working with dog trainers have succeeded in training dogs to recognise early cancer, for instance malignant melanoma or cancer of the lungs. The work of a group in San Francisco will be briefly described, with a dog trained to recognise cancer of the lung and breast on breathalysed samples. The early detection of cancer is essential if there is to be a reasonable hope of satisfactory treatment and possible cure. Screening programmes are well established throughout the ‘Western’ world, but despite their efficiency, numbers of patients still ‘slip through the net’ in that they either do not avail themselves of these programmes, or the programmes themselves are not sufficiently ‘watertight’ to identify all patients with early disease. There is sufficient evidence now for dedicated pilot studies to be set up, to test the hypothesis that dogs can be trained to recognise a wide range of human conditions, particularly cancer. Dogs primarily use their sense of smell for such discrimination, but dogs can respond to other signals and much further study of the interaction of dogs with their human companions is called for, particularly in the context of human medicine.

THE HYDROGEOLOGICAL CHARACTERISTICS OF BALIKLI SPA

Degirmenci, M.

Cumhuriyet University, Environmental Engineering Department, Sivas, Turkey

There are more than 1,000 thermal and mineral water springs with temperatures from 20–120 °C in Turkey. The Kangal Balikli Hot Spring in Central Anatolia is one of the most important springs. The most important characteristic of this spring is the existence of the fish Garra rufa Heckel, 1843 and Cyprinion macrostomus Heckel, 1843, which belong to the family Cyprinidae. They are 3–10 cm long and are used to cure diseases such as psoriasis. The spring contains isothermal-hypotonic and oligometalic mineral water, which has an average electrical conductivity of 530 μS/cm^-1. The temperature of the water is 35 °C, the CO₂ content 8.7 mg/l, the pH 7.3 and the O₂ quantity 4 mg/l. The total amount of dissolved material is approximately 220 mg/l. The purpose of this research was to determine the hydrogeology and water chemistry of Kangal Balikli hot spring. Recent data on selenium concentration received from two different laboratories do not agree with results of previous studies. Therefore, we are sceptical about the concentration of selenium documented by previous studies and the assumption that this mineral is the only or major factor in the psoriasis treatment.

HYPERBARIC OXYGEN AND MAGGOT DEBRIDMENT THERAPY

Dundar, K.¹,Tanyuksel M.²,Araz E.²,Gumus T.¹, and Uzun G¹.

¹Department of Undersea and Hyperbaric Medicine, Gulhane Military Medical Academy, Ankara, Turkey
²Division of Medical Parasitology, Gulhane Military Medical Academy, Ankara, Turkey

The aim of Hyperbaric Oxygen Therapy (HBO) is to enhance partial oxygen pressure and oxygen tension in tissue. This method is being effectively used in the therapy of non-healing wounds. Debridement of small areas of necrotic tissue without damaging the underlying healthy tissue is a difficult task. Therefore, maggot debridement therapy (MDT) was added to HBO. Ten patients have been included in this study. Six had diabetic foot ulcers, three had arterial insufficiency ulcers and one had a venous stasis ulcer. Eight out of ten wounds were infected with bacteria. Maggots were applied for 24 hrs after which the dressing was opened and improvement of the wound and size of the maggots were notted. In cases where maggots were sufficiently large, they were replaced by smaller maggots. MDT was continued until the necrotic tissue was removed completely. In three patients minor amputations were carried out due to arterial insufficiency. In wounds, treated with MDT fewer surgical interventions were necessary. Two to four treatments by maggots were necessary to clean the wounds completely. Granulation tissue formed more rapidly around wounds treated by MDT than those treated with conventional methods. During MDT four patients complained of increased pain. However, the pain was not severe enough to stop the therapy. We found that using MDT in combination with HBO is an effective and quick method for treating intractable wounds.

EVOLUTION OF BIOSURGERY IN GERMANY (1996-2003)

Fleischmann, Wim

Department of Traumatology and Reconstructive Surgery, Teaching Hospital of the University of Heidelberg, Bietigheim, Germany

In 1996, we started treating wounds with maggots imported from SMTL in Great Britain and we applied them according to the recommendations of Sherman. Five patients were treated in 1996, 21 in 1997, and 91 in 1998. As a result of reports in the German media maggot debridement therapy (MDT) became very popular and the demand for it in our hospital was so great that we had to restrict the number treated to about 250 a year. The Institute of Parasitology in Hohenheim (Germany) then began to produce maggots, which were distributed by Biomonde to a growing number of physicians. Then, the first company to produce medicinal maggots – Neocura was founded, and they received a license from the German authorities. Today, an estimated number of 1,000 physicians use maggots for wound healing. Biomonde claims to have had a turnover of 1.250.000 Euro in 2002, which was a 50% increase compared with the previous year. As we gained clinical experience, we now treat deep wounds that are found in bone and soft tissue infection as well as superficial wounds such as stasis and diabetic ulcers or bed sores. We try to remove the septic focus and if this is not possible, we use surgery to create ample space for the maggots. To prevent suffocation of the maggots we use textile spacers or polyvinyl-alcohol sponges. Profuse wound secretions need to be drawn off with drainage systems, which are also used for ventilation in particularly deep wounds. Since 1999, we have developed the Biobag (a moist PVA-bag containing the maggots), which dramatically changed the daily routine of maggot therapy. We estimate that it takes at least 20 min to replace “free range” maggots. This time is reduced to less than 5 min when using the Biobag. There is also less pain and improved patient hygiene: during a bath or shower the Biobag can be removed and subsequently replaced. Since 1996, nearly 900 physicians and some nurses from Germany, Austria, Switzerland, Benelux, and France have been trained in our unit on Biosurgical-Mechanical Wound treatment (BMW). We believe that the IBS is necessary to coordinate and support research and teaching, in order to get the greatest benefit from maggot therapy.

THE ORIGIN OF PROPOLIS, MEDICAL APPLICATIONS AND IMPORTANCE OF ITS CHEMICAL CHARACTERIZATION

Gençay, Ömür and Kadriye Sorkun

University of Hacettepe, Faculty of Sciences, Department of Applied Biology, Beytepe, Ankara, Turkey

Since ancient times man has been interested in both the life cycle of the honeybee and its valuable products. Recently, the composition of propolis, a bee product as important as honey, and its effect on human health was investigated and its clinical applications have increased. Propolis is a resinous substance, collected by honeybee workers from buds, leaves and damaged tree trunks. It has a pleasant aromatic odour and its colour varies from yellowish-green to dark brown depending on its source and age. This natural product has been used in many parts of the world for thousands of years in folk medicine as an antiseptic, antimycotic and anti-imflammatory remedy. Plant sources of propolis change according to the geographical zone where it is harvested and the season of the year. Determination of the plant source of propolis can be possible by palynological analysis. These analyses can provide a means for standardization of propolis. The chemical composition of propolis is very complex and contains many different organic compounds. The composition also varies according to local factors such as climate, location and year. Since the different chemical compounds in propolis may affect its activity in living organisms, determination of the chemical composition and amount of each component is important.

HIRUDOTHERAPY IN MODERN RUSSIAN MEDICINE: CLINICAL AND EXPERIMENTAL ASPECTS

Gilyova, Olga S.

Perm State Academy of Medicine, Russia, Ust-Katchka Health Resort, Russia

Hirudotherapy (HTH) as well as apitherapy, phytotherapy, mineral therapy, mumie-therapy are traditional methods of medicine officially recognized by the Ministry of Public Health in Russia. HTH is one of the most ancient treatment methods, although for many years clinical applications of HTH were based on experiment and experience only. Now, as we have entered the 21^st century, HTH is recognized by the physicians and general population of Russia as a safe and effective method for the treatment of a wide range of diseases and symptoms, i.e., there has been a renaissance of HTH in this country. This was the result of scientific research, post-diploma education in medical institutions and the exchange of knowledge between foreign and Russian biotherapists. The local decongestive effect of HTH is important for diseases which are characterized by marked edema and pain. This decongestive activity is due to loss of blood, relief of capillary net, decrease in venous congestion, reinforcement of lymph flow in lesions, positive changes in local hemodynamics, amelioration of hemoreology, increased oxygen supply and metabolic process. Later effects are connected with complex antithrombus, antiaggregate, antiischemic, analgesic and vasodilative components of Hirudo medicinalis salivary, secreted to blood and tissues during the blood drainage. The possibility that leech therapy also produces neuroflex or viscerodermal effects should be considered. In addition, the local skin reaction may also be considered as “distracted” therapy. Male Wistar rats were used as experimental model to evaluate the general and local effects of HTH. In the first experiment, it was shown that aspirative HTH had no permanent influence on blood indices such as number of leukocytes, blood viscosity and erythrocyte sedimentation, as all changes observed were transient and returned to normal at the end of the experiment. In the second part of the study, the effect of leeching on wounds of rats was examined. Histological examination showed that the size and duration of the local necrotic and inflammatory reaction decreased, the epithelialization and granulation accelerated, the formation of new blood and lymphatic vessels was enhanced and there was a well-balanced activity of mast cells in the lesion. The anti-inflammatory effect of HTH can also be attributed to stimulation of phagocytosis during the post-traumatic period of inflammation and regeneration. One of the mechanisms by which HTH effects post-traumatic regeneration is through the activation of the antioxidant (antiperoxide) activity of blood serum catalase. The effect of HTH on treatment of cardio-vascular diseases was also studied. The clinical and functional efficacy of HTH as a single therapy and in combination with balneotherapy was examined in a randomized study on 141 hypertonic patients. A positive influence of HTH on hemostasis was demonstrated. A positive effect was also observed in cases of phlebopathology (acute and chronic thrombophlebitis, varicosis complicated with phlebothrombosis and trophic ulcer) in 37 patients. The results of HTH were compared with those, which were obtained by treating the patients with pharmaceutical products. The positive effect of HTH on various degenerative and inflammatory vertebral lesions such as neuritis and neuralgia, in ophthalmology (cataract, glaucoma) was also examined. HTH was used alone or in combination with surgery for the treatment of furuncles and carbuncles in 27 maxillofacial patients. The clinical results in patients who received HTH were better than in patients, who were treated with traditional medications and/or surgery without HTH. We have investigated the efficiency of HTH in 14 cases of Lichen ruber planus, and 65% of patients reacted positively. The clinical amelioration was parallel to improvement in oxygen supply to the damaged tissues. Despite the high number of HTH prescriptions, there are very few contraindications or side effects. The frequency and characteristics of side effects and complications of HTH were analyzed and ways to reduce or eliminate them were investigated.

HIRUDOTHERAPY IN TREATMENT OF PERIODONTAL DISEASES: CLINICAL AND FUNCTIONAL INDICES

Gilyova Olga S.¹ and Natalia V. Gibadullina²

¹Perm State Academy of Medicine, Russia, ²Perm State Pharmaceutical Academy, Russia

Periodontic disease is present in 98% of the world population. High rates of periodontitis and resultant changes in the structure and functioning of the maxillodental system, create a problem of social and medical importance. The involvement of local and general mechanisms in pathogenesis of inflammatory/dystrophic processes of the peridontium indicates the need for hirudotherapy (HTH) in the complex treatment of gingivitis and parodontitis. The possibility of using HTH in stomatology has not been fully investigated. Meanwhile, the decongestive, antiinflammatory, antiaggregation, thrombolitic and fibrinolitic effects of HTH I indicate that this method could also be used for treating diseases in the oral cavity which are typified by edema and pain and where changes such as in hemostasis, microcirculation and metabolic processes occur. The mechanism of the anti-inflammatory, antiedemic, immunostimulative and regenerative activities of HTH were studied in posttraumatic inflammation and regeneration of the oral mucosa. Using an experimental inflammation model it could be demonstrated that HTH has an antiexudative effect, stimulates non-specific resistance (e.g.,phagocytosis, lysozyme activity, quantity of circulating immune complexes) and enhances the antioxidant defense as seen in the peroxide oxidation of lipids. The morphological examination during posttraumatic period after HTH shows a decrease in necrotic and perifocal inflammation, early epitheliazation and granulation, which leads to total reconstruction of the damaged layer of the mucous membrane in oral cavity. We present the complex clinical and functional basis for the use of HTH in patients with chronic generalized peridontitis (CGP). 33 patients (19 male, 14 female; ages 19 to 60 years) with CGP were evaluated clinically. 18 patients had a mild form of CGP, 12 patients a medium degree of CGP and 3 patients were suffering from severe CGP. The traditional (orthopedic and surgical) treatment consisted of liquidation of traumatic factors in oral cavity, abolition of inflammation and stabilization of dystrophic process in peridontium. The aim of our study was to use HTH in patients with CGP. The medicinal leech Hirudo medicinalis cultivated under artificial conditions in “Rospharmacy” was used. In the patient with a mild CGP 3-5 leeches were applied, the patient with a medium degree of CGP received 4-6 leeches and the patients suffering from severe CPG was treated with 5-7 leeches. The leeches were applied daily. Russian pharmacies produce drugs on the base of Hirudo medicinalis. The preparation “Piyavit” (reg. № 94/302/6) has thrombolytic, analgetic, antiinflammatory and antisclerous effects. “Piyavit” has now been added to a biosoluble gel for the treatment of inflammatory parodontitis (IP). The gel was prepared according to the original methods of the Department of Technology of Medical Preparations at Perm State Pharmaceutical Academy. After the treatment with HTH, the biosoluble gel was placed on the gum region (3–--5 applications daily). The clinical changes were evaluated according to the hygienic conditions of the oral cavity and the index of bleeding. The index of hemostasis was evaluated using a coagulogram. The spontaneous aggregation of thrombocytes (SAT) and the quantity of thrombocytes in blood was used to evaluate thrombocytic hemostasis. The autocoagulation test of Bercarda was used to evaluate the coagulative hemostasis. The prothrombin time index was recorded according to Qwick. The gravimetric method of Rutberg was used to quantify the fibrinogen in plasma. The antithrombine-III (AT-III) in blood was measured according to the method of Abilgaard and Hageman and the fibrinolysis was studied according to Ogston, modified by Arhipov and Eremin. The hemodynamics of the periodontium was examined by photoplethysmography according to Prohonchukov (1980). Peripheral vascular tension, dicrotic index and time of hemopoiesis were the most informative parameters. The cupping of an inflammatory process in the paradontium was confirmed by the positive dynamic of periodontal indices, which showed significant differences compared to the initial data. The index of hygiene according to Fedorov and Volodkina decreased from 2.39±0.16 to 0, the Silness-Loe from 2.49±0.17 to 0 and the CPITN index from 2.18±0.20 to 0.8±0.03. By the end of the treatment the PMA index diminished from 37.31±7.98% to 3.23±1.15% and the index of bleeding from 1.85±0.13 to 0.90±0.02 points. After treatment with HTH a positive effect in the majority of fibrinogen FPG indexes was observed in patients with CGP. The photoplethysmogram was characterized by a gently slopping curve, increasing amplitude and appearance of a dicrotic wave on top. The blood flow in the peridontium increased by an average of 24–27% while the vasospasm decreased by an average of 12–13%. The elasticity of the vascular wall of the parodontium increased by an average of 10–12.5%. The L value in most patients (64–70%) reached the values of healthy patients. Before treatment the activation of thrombocytic hemostasis by SAT index was 32.02±3.11%. After treatment the CGP index decreased significantly to 16.42±0.18% (p<0.001). The thrombine time index increased from 14.20±0.56 sec to 16.80±0.72 sec (p<0.01). The level of fibrinogen before treatment was 3.86±0.26 g/l and after treatment 2.74±0.18 g/l (p<0.001). The index of AT-III increased from 86.56±2.30% to 97.30±3.0% (p<0.01). The time of dependent fibrinolysis decreased from 9.06±.66±0.68 min. (p<0.01). Thus, these clinical and functional examinations show that there is a need for HTH in patients with CGP of different degrees both for the improvement of the clinical condition of the periodontium and for improvement of the functional parameters.

C, G AND RESTRICTION ENDONUCLEASE BANDING OF THE CHROMOSOMES IN CYPRINION MACROSTOMUS HECKEL, 1843 AND GARRA RUFA HECKEL, 1843 LIVING IN THE KANGAL SPA

Gül, S., N. Akpınar and B. Kaloğlu

Cumhuriyet University, Faculty of Science and Art, Department of Biology, Sivas, Turkey

Karyotype analysis was performed in Cyprinion macrostomus Heckel, 1843 and Garra rufa Heckel, 1843, which are members of the family Cyprinidae, by investigating the number and structure of their chromosomes. The fish used in this study were caught with a net from the Kangal Spa and taken to the laboratory. Fish were injected i. p. with a 0.6 % solution of colchicine (at a dose of 0.01 ml/g body weight) for 190 minutes. As a result of metaphase investigation, it was determined that Cyprinion macrostomus had 2n=48 chromosomes and Garra rufa had 2n=50 chromosomes. We were unable to identify any sex-related chromosomes in these two fish. Cyprinion macrostomus and Garra rufa chromosomes were treated with five restriction endonucleases, stained with Giemsa and examined for banding patterns. The enzymes Alu I revealed banding patterns similar to the C-bands produced by treatment with barium hydroxide. The enzymes Hae III, Hinf I, Nhe I, Mbo I revealed banding patterns similar to the G-bands. The restriction endonucleases markedly reduced the extent of Giemsa staining.

OBSERVATIONS ON THE USE OF HIRUDOTHERAPY BASED ON OUR CLINICAL EXPERIENCE

E. Guneren¹, and M. Hokelek²

Ondokuz Mayis University Medical School, ¹Department of Plastic and Reconstructive Surgery, ²Department of Medical Microbiology, Samsun, Turkey

Although leech therapy has been known since ancient times, its use in plastic surgery based on scientific research was first reported in the literature in the early 1980’s. Today, leeches are widely used in the treatment of venous congestion, in cases of reconstructive surgery, microvascular replantations, free flaps and traumatology. Venous compromise could occur within hours after surgery or trauma and it is necessary to quickly evaluate if surgical intervention is necessary or whether an alternative treatment, i.e., leech therapy would be sufficient. Leeching drains venous congestion by removing blood directly from tissue. Blood from the bite site can ooze for a while after detachment. Oozing is caused by the release of chemical agents in leech saliva into the tissue. Some of these have been identified, e.g., hirudin, egglin, collegenase, hyaluronidase, local anesthetics and vasodilatory agents. Hirudin is the most potent natural anticoagulant. It causes bleeding, which generally lasts for at least 2 hours but can be prolonged for as long as 48 hours by frequently changing the moistened gauze on the wound. Prophylactic use of broad-spectrum antibiotics is strongly recommended in leech therapy to prevent bacterial complications. One or more leeches are applied 2 to 6 times/day on the flap depending on the flap size and severity of the compromised tissue. At least 3-4 days are needed until the beginning of autonomous capillary venous drainage from flap to host. Leech therapy is painless and well tolerated by the patient, it is easy to use and a not expensive. Scars due to the bite site are either small or invisible.

HIRUDOTHERAPY AND THE BACTERIAL FLORA OF HIRUDO MEDICINALIS: IS IT POSSIBLE TO STERILIZE THE LEECH?

Hokelek, Murat¹ and Ethem Guneren²

Ondokuz Mayis University Medical School, ¹Department of Medical Microbiology and ²Department of Plastic and Reconstructive Surgery, Samsun, Turkey

Leeches are widely used to treat venous congestion. The leeches are in contact with the wound site and there is danger of contamination with the leech’s bacterial flora. Hirudo medicinalis has endosymbiotic bacteria in the gut, which help them to digest blood. Contamination of the wound can occur by the introduction of gut flora during initial secretion into the wound and regurgitation at the end of feeding. The most common bacteria are Aeromonas sp., which can cause infectious complications. The incidence of infectious complications of leech therapy are almost 20% in clinical cases and even greater in animal studies. Suppression of leech enteric bacterial flora by administration of antibiotics to the patient may be an effective strategy to prevent an invasive infection as well as bacterial contamination of devitalized tissue that could be the source of further infection. Sterilization of leeches might be an alternative to treating the patient with antibiotics. The aim of the study was to determine the bacterial flora of H. medicinalis in our region and their sensitivity to antibiotics. We decided to sterilize or at least to reduce the amount of bacteria in Hirudo medicinalis. The most common bacteria were Aeromonas hydrophila, Ochrobacter anthropi, non-fermenting Gram-negative rods, Acinetobacter lwoffi and Aeromonas sobria. All isolates were susceptible to ciprofloxacin, cefotaxime, ceftazidime, gentamicin, and trimethoprim/sulfamethoxazole. Leeches were treated with several antibiotics and the number of bacteria were reduced but we were not able to completely sterilize the leeches. Statistically significant reduction of bacterial load was obtained after treatment with ciprofloxacin and chloramphenicol. Treatment of leeches with antibiotics before application to the patient might be beneficial in the prevention of invasive bacterial infections.

ANTIBACTERIAL SUBSTANCES EXCRETED BY THE MAGGOT OF THE GREEN BOTTLE FLY, LUCILIA SERICATA

Huberman, Lea,¹ Kosta Y. Mumcuoglu,² Natan Gollop,¹ and Rachel Galun²

¹Department of Food Science, The Volcani Center, ARO, Bet Degan, Israel and
²Department of Parasitology, Hebrew University-Hadassah Medical School, Jerusalem, Israel

Maggots of the green-bottle fly, Lucilia sericata are able to destroy most of the bacteria, which are ingested with the food. The aim of this study was to purify and characterize the antimicrobial substance, which is partially also excreted with the feces. The maggots were crushed in acidic water and the extract clarified by centrifugation. The supernatant filtered using an ultra filtration membrane and the filtrate of the 1 Kd MWCO was further purified by dual HPLC C-18 reverse phase columns. The fractions harboring the antibacterial agent were identified by the zone inhibition assay with Micrococcus luteus as indicator bacteria. The antimicrobial agent has been tested using mass spectrometer. No substances above 175 Dalton were observed, however, a major band at 121 Dalton was seen. Proteases did not abolish the antimicrobial activity of the partially purified agent, which has a wide antimicrobial spectrum including Gram positive bacteria such as Listeria, Staphylococcus epidermidis, Staphylococcus aureus, Micrococcus luteus, Lactobacillus, Bacillus cereus and Bacillus subtilis and Gram negative bacteria such as Escherichia coli, Pseudomonas aeroginosa, Salmonella sp. and Serratia marcescencs. It also has some anti-fungal activity. All bacterial strains that were isolated from chronic wounds in humans, including methicilin-susceptible Staphylococcus aureus (MSSA) and methicilin-resistant Staphylococcus aureus (MRSA) were sensitive to this agent. The primary target of this antimicrobial agent is the bacterial cell membrane as it facilitates the leakage of potassium ions from the bacterial cell and has a dramatic effect on the membrane potential.

VETERINARY APPLICATION OF MAGGOT THERAPY: FULBRIGHT PROJECT AT CAIRO UNIVERSITY FACULTY OF VETERINARY MEDICINE

Iversen, Eve¹, Mohamed Saleh² and Mohamed Ibrahim²

¹1953 22nd St San Pablo, California, USA and ²Department, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt

During 2000–2001 with the support of the United States Fulbright Commission clinical trials of maggot therapy on donkeys produced promising results. Five donkeys with chronically infected surface wounds were treated using a clean technique to raise maggots rather than the sterile technique that is the standard in human medicine. This paper presents a detailed description of the husbandry procedures as well as the clinical results. More extensive trials are needed to test the range of species that can benefit from maggot therapy and refine the methods that can be used.

MAGGOT THERAPY IN ORTHOPAEDICS: A DISTRICT HOSPITAL EXPERIENCE

Jarvis, Andrew

High Salvington, Worthing, West Sussex, UK

During the last 5 years, 80 patients have been treated with maggot debridement therapy (MDT) in our orthopaedic department and it has become a ‘routine’ option in wound management. From late 2001, ‘Biobag’ sachets were used in 15 patients and these both simplified the treatment and improved patient acceptance. The general profile of patients and conditions treated has varied little over the last few years; the majority of patients (88%) had lesions of the lower limb; around 20% had diabetes, and the commonest lesion treated was some form of lower limb ulceration or wound breakdown. In addition, some atypical lesions were encountered. These included infected gout, animal scratches and bites and sting of a sea-urchin. These unusual lesions responded very well to the treatment. MDT also proved especially useful in awkward orthopedic problems such as infected amputation stumps (five cases), and pin track infections (four cases). Chronic ulcers remained the most taxing condition to treat. MDT was most effective against Gram-positive organisms and anaerobes although results with MRSA varied. The MDT method is safe and not more expensive than antibiotics and should be used where necessary.

HYDROGEOLOGICAL AND HYDROBIOLOGICAL INVESTIGATION OF KALKIM THERMAL SPRINGS (ÇETINKAYA, SIVAS)

Kaçaroğlu, F.,¹ B. Unver², S. Kılınç,² M.A. Akpınar,² M.Aydın,³ Y. Özcan3 and S. Ekici⁴

¹Cumhuriyet University, Faculty of Engineering, Department of Geological Engineering, Sivas, Turkey; ²Cumhuriyet University, Faculty of Science and Art, Department of Biology, Sivas, Turkey; ³DSI XIX. Bölge Müdürlüğü, Sivas, Turkey and ⁴MTA Genel Müdürlüğü, Orta Anadolu I. Bölge Müdürlüğü, Sivas, Turkey

Kalkım Thermal Springs are situated in the Kalkım Creek to the east of the Kalkım Village, 6 km from Cetinkaya (Sivas). The springs are situated at two points along the fault in Kalkım Creek alluvium. The objective of this study was to determine hydrogeological, hydrobiological, physical, chemical properties and capacity of the Kalkım Thermal Springs and to propose new ideas for development and usage. Geological and hydrogeological observations, mapping, flow rate measurements, water, fish, planktonic, benthic algae and zooplankton sampling were carried out. The chemical composition of the water was determined. The fish fauna of Kalkım Thermal Springs was also identified. In the study area, metamorphic, ophiolitic, sedimentary and volcanic rocks ranging in age between Upper Devonian and Quaternary are found. Kıratgedigi recrystallized limestone form the reservoir for the springs, and Yamadag volcanoes are the heat source. The flow rate of the Kalkım Thermal Spring water is 35 L/sec. The temperature, electrical conductivity and pH of the spring water range between 28.0–28.6oC, 450–484mS/cm and 7.22–7.78, respectively. The total dissolved solids are about 360 mg/L and the water belongs to the “poor mineralized thermal water” class. The major ions in the waters are Ca, Mg and HCO₃ while heavy metals are not present in high concentrations. In the study area, 5 species of fish belonging to Cyprinidae family were identified. Of these Cyprinion macrostomus and Garra rufa constitute the natural fish fauna of the springs. The other three species (Leuciscus cephalus, Capoeta trutta, Chalcalburnus mossulensis) belong to the Kalkım stream population. The population density of the two former species is low in comparison to that of the fish in the Kangal Thermal Springs, due to the small size of the ponds and the small volume of water flowing from the springs. The Cyprinion macrostomus and Garra rufa in Kalkım Thermal Springs are healthier and stronger than the same species in Kangal Thermal Springs. In the ponds of the Kalkım Thermal Springs 3, 14 and 7 species of algae belonging to the divisions of Chlorophyta, Bacillariophyta and Cyanophyta respectively were identified. It was observed that these springs do not have much zooplankton. There are no facilities for removing water from the Kalkım Thermal Springs. Patients, who suffer from dermatological disorders such as psoriasis and wish to use the thermal water have to sleep in tents in the vicinity of the springs. In order to create a thermal spring resort in the area it would be necessary to increase the volume of spring water. Excavations near the springs in order to increase amount of thermal water emerging from the springs can be carried out while preserving the two natural ponds.

ANTIMICROBIAL EFFECTS OF HONEY AND PROPOLIS COLLECTED FROM DIFFERENT REGIONS OF TURKEY

Kılıc, A.¹, M. Baysallar¹, B. Salih², K. Sorkun³, S.T. Yıldıran¹, and M. Tanyuksel¹

¹Department of Microbiology and Clinical Microbiology, Division of Medical Parasitology, Gulhane Military Medical Academy, Ankara, Turkey
²Hacettepe University, Faculty of Science, Department of Chemistry, Ankara, Turkey
³Hacettepe University, Faculty of Science, Department of Biology, Ankara, Turkey

Propolis (bee glue) is a natural resinous product of honeybees. A pronounced effect of propolis on viral, bacterial and fungal infections was documented previously. The aim of this study was to determine the anti-bacterial and anti-fungal efficiency of seven propolis and six honey samples having different characteristics. The minimal inhibitory concentration of seven propolis and six honey samples was identified using four standard strains of bacteria, Escherichia coli (ATCC 25922), Staphylococcus aureus (ATCC 25923), Acinetobacter woffii (ATCC 19002) and Pseudomonas aeruginosa (ATCC 27853)) and one standard strain of fungi, Candida albicans (ATCC 36802). Tests were performed in triplicate for each strain by the macrodilution broth method as described by NCCLS. Serial two-fold dilutions of both propolis and honey were prepared in macrodilution tubes with concentrations ranging from 1/2-1/512. The minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) were used for the evaluation of propolis and honey samples. It was observed that all propolis and honey samples were effective against standard strains at different concentrations. It was concluded that propolis and honey may act as an effective wound antiseptic against a broad-spectrum of bacteria. Their high activity against S. aureus is especially important, because MRSA in wounds is always a matter of concern and MRSA-infected wounds are an increasingly important problem in hospitals.

ALGEAL COMPOSITION OF BALIKLI SPA

Kilinc, S.

University of Ulster, School of Biological and Environmental Sciences, Coleraine, U.K.

We report on the plankton population of the hot springs of Balikli Spa in Turkey, which are centers for psoriasis treatment. Algal samples were collected from all pools. Phytoplankton and zooplankton samples were collected using 55µm mesh size plankton nets and fixed with Lugol’s iodine and zooplankton fixative respectively. The samples were transported to the laboratory for further examination. Algal samples taken from the concrete walls and from the bottom of 6 pools were identical. Phytoplankton samples mainly consisted of fragments of algae either detached from the bottom or sides of the pools. Forty-three taxa belonging to Cyanophyta, Chlorophyta, Euglenophyta, Cryptophyta and Bacillariophyta were identified in the pools. Zooplankton consisted mainly of ciliates and nematodes. The composition and abundance of phytoplankton found to be poor and limited due to existing physico-chemical factors.

EFFICACY OF APITOXIN (APITOX, PURE HONEYBEE VENOM)

Kim, Christopher M-.

International Pain Institute, USA

Apitherapy (bee venom therapy) has been used since ancient times. Ancient writers as diverse as Hesiod (800 BC), Aristophanes (450-388 BC), Varro (166-27 BC) and Columella (1st century AD) all wrote about cultivation of bees. Hippocrates (460-377 BC), the father of medicine, used apitherapy and called it Arcanum - a very mysterious remedy. Galan (131-201 AD), the father of experimental physiology, referred to apitherapy in his 500 treatises on medicine. Charlemagne (742-814 AD) is said to have treated himself with bee stings. The Koran (XVI: 71) refers to bee venom in the following terms: "There proceeded from their bellies a liquor wherein is a medicine for men." About 100 years ago the physician Phillip Terc of Austria advocated the deliberate use of bee stings in his work: "Report about a peculiar connection between the beestings and rheumatism". Today's proponents of apitherapy cite the benefits of bee venom for alleviating chronic pain and for treating many ailments including various rheumatic diseases involving inflammation and degeneration of connective tissue (e.g., several types of arthritis), neurological disease (migraine, peripheral neuritis, chronic low back pain), autoimmune disease (multiple sclerosis, lupus) and dermatological conditions (eczema, psoriasis, herpes virus infections). In conventional medicine interest in bees has been sporadic, focusing mainly on two areas. These areas are: (i) the danger of hypersensitivity reactions, including anaphylactic shock, from the sting of insects of the genus Apis; (ii) the use of bee venom in immunotherapy for allergic reactions to such stings, especially to prevent life-threatening anaphylactic reactions. Apitherapy is being widely used today, especially in China, Korea, Russia, Eastern Europe and South America, but its use in the U.S. is still controversial. However in spite of this controversy, apitherapy continues to be studied both in animals and in man. Apitoxin has just been approved as a new biological drug in Korea. The development of this new drug has taken 12.5 years. This is the first ever approved bee venom drug through scientific clinical studies in the world (Korean FDA).This lecture will discuss the effectiveness of Apitoxin for chronic inflammatory diseases and some diseases of the auto-immune system.

BACTERIOLOGICAL ANALYSIS OF DRONE BROOD

Kuzyaev, R.Z.¹, R.G. Khismatoullin², Y.E..Lyapunov¹ and E.A. Elovikova¹

¹Laboratory of Ecological Monitoring of Bees “Federal”, Perm, Russia and ²Tentorium, Perm, Russia

The drone brood of honey bees is a valuable source of bioactive substances traditionally used for the improvement of health in the Far East. In contrast to honey, bee brood and royal jelly do not contain sterilizing factors. Development and industrial production of new food products based on bee brood demand elaboration of effective quality performance criterions of hygienic standards, including microbiological indices. An analysis of the hygienic standards and code compliance of 40 bee brood samples bought from beekeepers in the Western Urals was carried out The number of mesophilic aerobic and elective anaerobic microorganisms, the number of mycelial fungi and yeast was determined. The number of coliforms in 0.1 g of sample, of Staphylococcus aureus and Escherichia coli in 1.0 g of sample and of pathogenic Salmonella in 10 gram of sample was evaluated. The data were processed statistically. The species of isolated specimens were identified according to “Bergey’s Manual of Determinative Bacteriology”. Only 21% of the native brood samples analyzed met the standards of hygiene required for active substances in bee products (T≤10000, M≤200, Y≤200; absence of the listed bacteria as indicated). Seventy-one percent of the samples were discarded due to the presence of aerobic bacteria, 18% because of mycelial fungi and 59% because of yeasts. In 18% of the samples there were coliform bacteria and in 24% Staphylococcus sp. were present. Escherichia coli was found in 24% of the samples, and was present in all samples, which contained coliforms. Pathogenic bacteria were not detected. All samples, which met the requirements of the sanitary code regarding the levels of aerobic bacteria and yeasts, were of high quality, also according to the other indices. In general, the analysis of all material, which was classified according to the logarithm of the number of yeasts, was very close to normal levels with an average value of 2.52 and a standard deviation of 0.66. This index correlated with the logarithm of the number of mycelial fungi (k=0.81) and detection of Escherichia coli in 1 g (k=0.62). While examining the 10 gram of pollen load for pathogenic Salmonella, the bacteria Citrobacter, Enterobacter and Klebsiella were found.

RESEARCH ON MAGGOTS OF LUCILIA SERICATA (MEIGEN, 1826) AND THEIR CLINICAL IMPORTANCE

Lapanje, A.¹, D. Jaklič¹, K. Zupančič¹, D. Smrke², Z. Arnež², and N. Gunde-Cimerman¹

¹University of Ljubljana, Biotechnical Faculty, Department of Biology, Ljubljana and ²University Medical Centre Ljubljana, Ljubljana, Slovenia

Maggots of the green bottle fly (Lucilia sericata) are well accepted in the treatment of necrotic wounds. Several effects of maggots on healing and tissue repair have been discovered: antibacterial activity, damaged cell and necrotic tissue removal, stimulation of granulation and tissue repair. There are two main problems in the clinical applications of maggots: (i) storage of maggots for direct/indirect applications and (ii) problems connected with the use of living biological material (escape of maggots from wounds, their application, sterilisation of eggs and preservation of the maggot’s sterility). It would be a great advantage if only the excretions of the maggots could be used. The antibacterial activity of maggot’s excretion is the most important agent in wound healing, therefore we focused our research on two directions: (i) long term storage of larvae and (ii) antibacterial activity of the excreta. Protocols for storage of Drosophila melanogaster and Lucilia cuprina are not suitable for L. sericata. Until now the best viability results were obtained with storage of L. sericata maggots embedded in 5% alginate with 0.5 M saccharose at 8°C. The protocol for storage in liquid nitrogen is being prepared. Although it is known that maggot’s excreta have antibacterial activity for Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli, its effect on bacteria in culture varies according to the growth stage of bacteria, concentration of the excreta and whether sterile or non-sterile maggots are used. It was shown recently that the antibacterial activity of the excreta is effective only in liquid cultures, i.e., not on bacteria growing on solid media.Storage of embryos in liquid nitrogen could solve many problems connected with transport and planning of the therapy. Clinical use of maggots could be simplified in certain cases by applications of L. sericata maggot’s excretions instead of using whole larvae.

THE INFLUENCE OF HIRUDOTHERAPY ON HAEMOSTATIC AND IMMUNOLOGIC INDICES IN WOMEN SUFFERING FROM ENDOMETRIOSIS

Lomaeva B. Irina

Department of Obstetrics and Gynecology, Pediatric Faculty, Perm State Academy of Medicine, Russia.

Among inflammatory disorders in women of reproductive age, endometriosis takes the second place and occurs at a frequency of 7-50%. Endometriosis is a painful syndrome, accompanied by prolonged and heavy menstruation, which causes anemia and dyspareunia and leads to work absenteeism, psychological and emotional complications and a decrease in the quality of life. The objective of this study was to determine the effectiveness of hirudotherapy in the treatment of internal retrocervical and rectovaginal endometriosis in areas where the treatment with conservative surgery is not suitable or has failed. Seventy-one women of reproductive age who had been suffering from endometriosis for 3–35 years were included in the study. The symptoms of endometriosis were pain (59 patients), hyperpolymenorrhea (43 patients), primary sterility (22 patients) and secondary sterility (16 patients). Previously, these patients had been treated with conventional methods including hormones and surgical interventions such as laparoscopy and supravaginal amputation of the uterus. The control group included 16 healthy women of reproductive age. Specimens (15-30) of Hirudo medicinalis were placed on intravaginal, pubic, perianal and coccygeal zones of the patient during each session. The effectiveness of the treatment was evaluated according to ultrasonic examination of the area, levels of T and B lymphocytes in the peripheral blood and resistance to theophylline. Some hemostatic indexes were also studied, e.g., vascular-thrombocytic hemostasis was determined by measuring the amount of thrombocytes and adenosine diphosphoric acid as well as by the induction and spontaneous aggregation of thrombocytes and Willerbrand’s factor. The coagulative hemostasis was determined according to activated partial thromboplastic time, thrombin time, prothrombin index, coaline time of plasma coagulation and time of blood coagulation. The fibrinolytic system was evaluated according to plasmatic lyses induced by streptokinases. After the first session of hirudotherapy, absence of algomenorrhea within 3–4 menstrual cycles, normal sleep and reduction in the size of uterus was observed in 23 patients. In 27 patients retrocervical foci of endometriosis at 5±2 mm and in 50 patients a decrease in the duration of menstruation were noticed. Five out of 22 patients with primary sterility became pregnant after 3 months of hirudotherapy and subsequently gave birth. The level of thrombocytes reached normal values after the second course of hirudotherapy. The anticoagulation potential, local anti-edematic and analgesic effect of the treatment with Hirudo medicinalis was also documented. Proteolytic enzymes of the salivary glands of Hirudo medicinalis dissolved the vascular wall that caused the hemorrhage, and inhibitors of coagulation and the thrombocytic unit of hemostasis slowed down the process of blood coagulation. The positive influence of hirudotherapy on hemostatic indices is one of the mechanisms responsible for the relief from endometriosis symptoms. Reports related to intravaginal hemorrhage during hirudotherapy are exaggerated.

MULTI-MODAL THERAPY OF AN EXTENSIVE SKIN LESION ON THE DORSAL ASPECT OF THE FOOT AND ANKLE: A CASE REPORT

Marquardt, C., F. Tarantini, H. Matzke, M. Konig and K. Junghanns

Abteilung fur Allgemein- und Viszeralchirurgie des Klinikum Ludwigsburg, Germany

A 53 year old male suffered a skin injury on the dorsal side of his foot from paddles while scuba diving in Turkey. A necrotizing soft tissue infection with sepsis developed rapidly at the site of the wound. After antibiotic treatment and debridement of the lesion in the ICU the patient recovered, but a 10x20 cm lesion remained on the skin and underlying soft tissue of the foot and lower leg. Flap-transplantation was attempted but was rejected. The lesion was treated with sterile blowfly maggots (biosurgery) and debridements under local anesthesia for 3 weeks in the outpatient clinic. The patient was readmitted to hospital and after 4 days of vacuum sealing of the wound, mesh graft transplantation was carried out. This was covered by a vacuum sealing dressing for 5 more days. Two weeks later there were still some areas of the lesion which had not healed. Autologous keratinocytes were transplanted on these areas and the wound closed completely. One year later, our patient is satisfied with the result of his treatment. His ankle joint is mobile, he has returned to work and is able to continue his sporting activities.

MAGGOT THERAPY: THE ISRAELI EXPERIENCE

Mumcuoglu Kosta Y.

Department of Parasitology, Hebrew University-Hadassah Medical School, Jerusalem, Israel

In Israel, the use of maggots for treatment of chronic wounds started in1996. Sterile maggots of the green bottle fly, Lucilia sericata, are being used for this purpose. Up to 800 maggots (24 – 36 hours old) are placed over necrotic and infected chronic wounds and left for 24 hrs. The maggots produce an abundance of proteolytic enzymes, antibacterial substances and granulation tissue growth enhancing substances. Their minute size (2-10mm) and mobility enables them to penetrate all necrotic areas of the wound, where their secretory products induce degradation and clearance of the necrotic debris. To date, over 200 patients (32-95 years old) were treated. Most of the wounds were leg ulcers, mainly diabetic foot ulcers and the remaining were pressure sores. Within a relatively short period of treatment (median 4 days) the maggots achieves a significant debridement of the ulcer bed, thus enabling further treatments towards complete healing of the wound, e.g., skin grafting. The treatment achieved complete debridement in 79.5% of the wounds, significant debridement in 16.9% of the wounds, partial debridement in only 2.4% and failed in only 1.2%. The only side effects were pain in 20-25% of the patients, controlled in most of them with analgesics, and psychological problems of a mild nature. The maggot therapy has been proven to be an invaluable tool in the treatment of hard to heal chronic wounds. It is an easy to use, relatively cheap and effective treatment method. In order to investigate the fate of bacteria in the alimentary tract, sterile maggots were incubated with a GFP-producing E. coli and the digestive tract was subsequently removed. The presence of bacteria in the different parts of the intestinal tract was studied using a Zeiss 410 laser scanning confocal microscope. A computer program was used to analyze the intensity of the fluorescence. The crop and the midgut were the most heavily infected areas of the intestine. A decrease in the amount of bacteria toward the end of the midgut was observed. The number of bacteria decreased even more significantly in the anterior part of the hindgut and practically no bacteria were seen in the posterior end, near the anus.

BEE KEEPING: A PILLAR FOR AGRICULTURAL DEVELOPMENT

Okofu, C.N., O. Essien and J. Afolabi

Federal Ministry of Health, Nigeria

Bee keeping is the management of honeybees for a higher yield and better quality of its by-products. Apart from the by-products, bees also serve as the most important agents of crop pollination. They increase crop yield by about 40%. Apitherapy is the use of bee by-products for medicinal purposes. Honeybees are also kept for their economic benefit and for pleasure (as a hobby). The by-products of bees are: propolis, bee venom, bee wax, bee pollen, honey, royal jelly and bee larvae (bee brood). By opening a bee hive the first thing to be removed is a sticky black substance, which is gathered by the bee from the buds, leaves and bark of many shrubs, trees and grasses. However, the most common sources are buds and leaves of trees. Propolis is used by the bees for: 1. Coating cracks and holes in the hive (temperature regulator); 2. Controlling entrances (pest control); 3. Preservation of dead bees or pest insects. Humans use propolis as an antibiotic, antiviral, anti-fungal and anti- inflammatory remedy. It is also used for treating illnesses such as asthma, high blood pressure, sinus and bronchial ailments. The bee venom is a rich source of pharmaceutically active components. It is rich in enzymes, peptides and biogenic amines (there are at least 18 active components in the venom). It is used as a cream, ointment, in capsule form and for injection. It is used for the treatment of cancer, chronic pains, multiple sclerosis and cardiovascular disorders. One of the simplest ways to take bee venom without being stung is by using capped combed honey. The bee wax is a complex mixture of organic compounds secreted by four pairs of glands in the underside of a young bee workers' abdomen; secreted as droplets, which harden into scales, they are used to built the honey comb. Bee wax is used in the manufacturing of cosmetics and crayons, paints, pharmaceutical product, ointments for treating infections, leatherwork, shoe polish, textiles (batik), wigs, chewing gum and sewing materials. Pollen is collected by the worker bees, which built a pollen sac on their hind legs. Bee pollen contains approximately 25% pollen, at least 18 amino acids, more than a dozen vitamins, 28 minerals, 11 enzymes or co- enzymes, 14 beneficial fatty acid and 11 carbohydrates. It is rich in hormones and poor in calories. It is used for the treatment of stomach ulcers, cancer, allergies and asthma. Nectar is a secretion product of specific glands that are located in a flower at the base of the stamen. Bees are very selective while collecting nectar and they are able to identify nectar that is rich in sugar. During the process of collection, bees add enzymes (particularly invertase) to the nectar, which breaks down the sucrose to glucose and fructose. On returning to the hive, the bee regurgitates the nectar and passes it on to other bees, which in turn add more invertase and the amino acid proline and deposit this into an empty cell in the honeycomb. The next step is the evaporation of water, which is enhanced by the high temperature of the hive and the fanning activity of the bee. When the water content reaches 18%, the honey is then capped. This prevents the honey from absorbing moisture from the atmosphere, which would otherwise cause fermentation. Finally, the bee injects a small amount of its venom through the seal, which also protects it from decomposition.

TREATMENT OF PSORIASIS USING KANGAL HOT SPRING FISH

Özçelik, S.

Department of Dermatology, Cumhuriyet University, School of Medicine, Sivas, Turkey

Psoriasis is a disease of unknown etiology with an incidence of 1-3% in the general population. Several drugs have been tried for the treatment of psoriasis but none of them cures the disease completely or prevents recurrences. It is known that many factors contribute to the beneficial effect of the Kangal Spa. Two different types of fish live in the pools in the hot springs. Both of them are members of the family Cyprinidae. In the spa, patients are exposed to fish, which clean the squams. The spa provides other therapeutic factors e.g., selenium, ultraviolet radiation, the reverse Koebner phenomenon and the Jacuzzi-like action of the pools. Climatotherapy in the Kangal hot spring is another alternative treatment for psoriasis.

APITHERAPY IN TURKEY

Ozkok, A. and K. Sorkun

Hacettepe University, Science Faculty, Department of Biology, Beytepe Campus, Ankara, Turkey

The use of honey bee products (honey, pollen, royal jelly, propolis, beeswax and bee venom) for medical treatment is called apitherapy. Apitherapy is a relatively new word for Turkish beekeepers. The healing properties of honey and beeswax were recognized in ancient times. Today, other bee products such as pollen, propolis, royal jelly and bee venom are becoming of increasing interest to both the Turkish population and beekeepers. The location of Turkey is advantage for beekeepers because it is one of the most important centers for world trade and communication. The climate and the rich variety of plants make Turkey one of the leading countries for the cultivation of bees. There are about 10,000 plant species, 4,000 of them are endemic and 450 of them are rich in pollen and nectar. Beekeepers are beginning to be aware of the importance of bee products for health, and the economical potential of their development.

BIOBAG VERSUS FREE RANGE MAGGOTS: WE NEED BOTH!

Russ, M. and W. Fleischmann

Department of Traumatology and Reconstructive Surgery, Teaching Hospital of the University of Heidelberg, Bietigheim, Germany

In 1999, after three years of successful maggot treatments we developed the Biobag for more efficient and easier application of the larvae on the wound surface. This has become the standard method for maggot debridement therapy in our unit. The Biobag is a closed, air and fluid permeable PVA-bag in which the maggots are sealed. The Biobag provides an easy, safe and fast method of applying live maggots to lesions and the results are as good as those using the free range method. We now apply maggot therapy more than 1,000 times a year and we use the Biobag for at least 95% of the cases. Nevertheless, in small cavities, irregular wounds and sinus formations we need free crawling maggots to obtain optimal results.

TREATMENT OF EAR HEMATOMAS IN DOGS WITH THE MEDICINAL LEECH, HIRUDO MEDICINALIS

Saglam, Naim¹ and Ibrahim Canpolat²

¹Department of Aquaculture and Fish Diseases, Fisheries Faculty, Firat University, ²Veterinary Faculty, Firat University, Elazig, Turkey

The main application areas of hirudotherapy are blunt injuries (traumas) with or without hematoma, superficial inflammation of the veins, hemorrhoids, perianal thromboses and anal eczema. In this study, a hematoma was induced experimentally on the ears of five healthy adult dogs by causing trauma to the arteries and veins of the ears. The following day, three medicinal leeches (H. medicinalis) were attached to the area of the hematoma. Leeches were left until they were fully satiated and the treatment was continued daily for three days. In most of the cases, the leeches attach to the area of hematoma quickly and detach themselves when they complete the blood meal, usually after 10–15 minutes. The hematoma of the ear resolved soon after the treatment.

HIRUDOTHERAPY IN A COMBINATION TREATMENT IN PATIENTS WITH HYPERTENSION AT UST-KATCHKA RESORT

Sidorov V.¹, O. S. Gilyova², G. Korobeynikova¹, E. Gilyova², and D. Sidorov¹

¹Ust-Katchka Health Resort, Russia, ²Perm State Academy of Medicine, Russia

Hypertension is very common in Russia and constitutes 30-40% of all diseases among the adult population. Pharmacotherapy has been used for basic treatment of hypertension, while balneotherapy was recommended for some patients with mild forms of this condition. Traditional methods for the treatment of hypertension are not always effective. Hirudotherapy (HTH) is one of the methods of biotherapy that has been successfully used in our practice since 1996. At Ust-Katchka health resort, hypertension is treated by HTH alone or in combination with bromide-iodine bath (hydrotherapy). The study included 141 patients (59 males and 82 females, aged 40–63 years) with 1^st and 2^nd degree of arterial pressure (AP) increase and 1^st and 2^nd forms of cardio-vascular risks. Patients were divided into treated (100 patients) and control (41 patients) group. The first subgroup of the treated group received a combination treatment (bromide-iodine bath and HTH); the second subgroup was given a HTH course using 10–14 leeches. The control group received only a bromide-iodine bath. The dynamic of the main clinical symptoms and functional indices, i.e., of the cardio-vascular system (pulse, systolic arterial pressure (SAP), diastolic arterial pressure (DAP), ECG, hemostasis (thrombocyte numbers, spontaneous aggregation of thrombocytes, autocoagulative test, prothrombin time, fibrinogen level, thrombin time of plasma coagulation, antithrobin III level, Factor Xa) was studied in both groups. After the course of treatment, the arterial pressure of patients decreased in both groups. The optimal results of SAP and DAP reduction were obtained in the 1^st subgroup. According to ECG, an improvement of myocardium metabolism was observed in 57.2% of the patients in treated group and in 39.6% of patients in the control group. A sedative effect of HTH was observed in 90% in patients of the 1^st subgroup and in 78% of the patients of the 2^nd subgroup. A positive influence of HTH to the vascular-thrombocyte branch of hemostasis has been observed. The spontaneous aggregation of thrombocytes decreased by 63.6% and 48.8%, respectively in patients of the 1^st and 2^nd subgroup and by 27.3% in the control group. After the course of HTH, the coagulative hemostasis improved according to the authentic thrombin time growth (p<0.01) in the treated group. A fibrinolytic effect (time shortening of Factor Xa) was marked in 28.9% of patients of the 1^st subgroup and in 25.4% of patients in the 2^nd subgroup. The present study shows that there is a possibility to optimize the treatment of hypertension at an early stage by HTH. The multi-purpose use and simplicity of HTH, its medical and economic efficiency, the few contraindications and relatively low number of side effects are stressed.

PROPOLIS: CHEMICAL, ANTIBACTERIAL AND PHARMACOLOGICAL PROPERTIES

Silici, Sibel.¹ and Selcuk Mistik²

¹ Department of Animal Health, Safiye Cikrikcioglu Vocational College, Erciyes University, Erciyes, Turkey and ² Department of Family Medicine, Medical Faculty, Erciyes University, Erciyes, Turkey

Propolis is a sticky substance collected from various plant sources by the honeybee, Apis mellifera L. Propolis is used by the bee for a number of different purposes in the beehive, including as a remedy for microbial infections. The composition of propolis varies according to the plant source. In general, it contains 50% resin and herbal balsam, 30% bee wax, 10% essential and aromatic fats, 5% pollen and 5% organic substances. The medical properties of propolis have been recognized since ancient times. The ethanol extract of propolis, which has been exhibits antibacterial, antifungal, anti-protozoan, anti-inflammatory, anticarcinogenic, antioxidant, anesthetic and immuno-stimulatory properties. Propolis is being used in folk medicine, apitherapy, cosmetics and the pharmaceutical industry. In addition, in the USA, Japan and Europe it has been recommended for use as a dietary supplement, and for treatment of inflammation, heart diseases, diabetes and cancer.

EPIPELIC AND EPILITIC DIATOM COMPOSITION OF BALIKLI SPA

Sıvacı, E.R.¹ and K. Pabuçcu²

¹Cumhuriyet University, Faculty of Science and Art, Department of Biology, Sivas, Turkey and
²Gaziosmanpaşa University, Faculty of Science and Art, Department of Biology, Tokat, Turkey

The variation in the composition and concentration of epipelic, epiphytic and epilitic flora of diatoms from Balıklı Spa was investigated during April and May 2003. In addition, physical and chemical parameters were measured. The species of the genera Cymbella, Amphora and Gomphonema constituted the main groups of the benthic flora of Balıklı Spa. The species belonging to genus Navicula, Nitzschia, Epithemia, Gyrosigma, Pinnularia and Stauroneis were less numerous. Cymbella cymbiformis, Amphora commutata, Gomphonema olivaceum and Mastogloia braunii were the dominant species of the Balikli Spa. Most diatom species, with the exception of Epithemia argus, Eunotia praerupta, Caloneis permagra and Surirella minuta, were frequently found in large amounts. Cladocera and Copepoda species constituted the main zooplanktonic groups.

BEE PRODUCTS, PROPERTIES, APPLICATIONS AND APITHERAPY

Sorkun, Kadriye

University of Hacettepe, Faculty of Science, Department of Applied Biology, Beytepe, Ankara, Turkey

Honey and wax are the best-known bee products all over the world. Honey was the first bee product used by man. Nowadays pollen, propolis, royal jelly and bee venom are recognized as important and marketable bee products. Honey is a natural sweet substance, which is produced by honeybees from the nectar of flowers or the extra floral nectar of some plant species. The viscosity, density, hygroscopic nature, color and crystallization of honey are very important factors. Honey is the best-known bee product in Turkey. In addition to its sweet flavor and pleasant taste, it is commonly used for medical purposes by people in rural areas. Honey is also used to help digestion, as well as for ailments of the respiratory system, wounds and eye disorders. It is believed that honey is able to stabilize kidney function, reduce fever and prevent insomnia. Wax is used for the industrial production of brood comb. Pollen grains are small, male reproductive agents (gametophytes) formed in the anthers of the higher flowering plants. Each pollen grain carries a variety of nutrients. The chemical composition of pollen grains differs according to the plant origin. Pollen grains are used for athletic performance, digestion, rejuvenation, general vitality, skin vitality, appetite, hemoglobin content, sexual function, colds, acne, anemia, high blood pressure and ulcers. Propolis is a mixture of bee wax and resins collected by honey bees from plants, particularly from flowers and leaf buds. These resins are used by worker bees to line the inside of nest cavities and brood combs. Propolis is used in cosmetics and for treatment of medical conditions such as cardiovascular and respiratory disorders, anemia, skin and liver conditions and for dental care. Royal jelly is secreted by the hypopharyngeal glands of young worker bees. It is used for anorexia, general health improvement, skin conditions including wrinkles, increasing libido and sexual performance, influenza, high blood pressure, low blood pressure, anemia, arteriosclerosis, cholesterol levels and other chronic and incurable disorders. All stinging insects are members of the order Hymenoptera, which include ants, wasps and bees. Honeybee venom is produced by two glands associated with the sting of worker bees. The venom contains enzymes (phospholipase A₂, hyaluronidase, acid phosphomonoesterase, lysophospholipase, glycosidase), proteins and peptides (melittin, pamine), active amines, amino acids, sugars, phospholipids and volatile compounds. Bee venom is used for multiple sclerosis, migraine, arthritis and chronic pains.

TREATMENT WITH LEECHES AND BEES

Stoyeva G.N.

“HIRUDO” Center, B. Morskaya St., 54, Nikolayev, Ukraine

The “HIRUDO” Center has been working since 1992. Approximately, 3,000 patients are treated in our clinic annually. The following case reports demonstrates how hirudotherapy is used in our institution. Patient C., 8 years old, had a furuncle in the area of the right knee-joint. One leech per day was applied to the furuncle and the wound recovered after 2 sessions. Patient P., 54 years old, had suffered from bilateral hydroadenitis for 3 years. During this time he underwent three operations. The examination revealed large keloidal scars with multiple openings from which about 30 ml of purulent pus was removed. The treatment lasted for 3 months and 4-7 leeches were applied per session. Altogether 130 leeches were used until the wound canals and openings were closed. A second round of treatments was prescribed after three months in order to resolve the remaining scars. Patients B., 33 years old, had arteriovenous stasis in the penis and a continuous erection during 2 days. In 1990, the patient had a compression fracture of the 10^th thoracic vertebra and damage to the spinal cord, paraplegia and impairment of pelvic organs. For two years, the patient had been injecting papaverine into the base of the penis for coitus. The continuous erection appeared after an overdose of this substance. The patient was hospitalized in the vascular surgery department and an arteriovenous bypass was recommended. However, the patient preferred to be treated with HTH. Leeches were applied at the base of the penis and also in the area of the 10^th thoracic vertebra. After the first session, the tension on the penis weakened. After the third session the erection disappeared. In an additional patient, a significant improvement of hemorrhoids after treatment with leeches was also observed and the recovery started between the 3^rd and 5^th session. Positive results were also obtained in the treatment of the spinal cord, varicose veins, thrombophlebitis and vegetovascular dystonia. Two patients who were sterile recovered after treatment with leeches. Apitherapy (1 to 10 bees per session) was successfully used for the treatment of spinal cord diseases, bronchial asthma, rheumatoid polyarthritis, decrease in sexual potency and vascular dystonia. Patient G., 68 years old with Parkinson’s disease was treated with 4 bees, which were placed in the area of the spinal cord twice a week for 5 months. After the first two months of the treatment, the patient was able to stop taking Nacom and Darcopan. During the winter months apitherapy is not possible and it was necessary for patient to take Nacom and Darcopan but at lower doses than before. Patient Z., 30 years old had warts on both hands, which disappeared after two applications of bees. In clinical practice we used combination treatments with drugs, massage, acupuncture, salve dressings, compresses, therapeutic exercises and phytotherapy together with apitherapy and hirudotherapy.

BEE POLLEN: PROPERTIES AND APPLICATIONS IN TURKEY

Suer, Banu and Kadriye Sorkun

Hacettepe University, Science Faculty, Department of Biology, Beytepe Campus, Ankara, Turkey

Producers have recently started to grasp the importance of pollen, propolis and bee venom besides honey production. New marketing possibilities have emerged. Since pollen can be obtained easily and commonly in comparison to other bee products, it is nowadays suggested to producers as an additional source of income. Its production is useful for the economy of the country and for beekeeping as well. Pollen is more useful than other honey products. It can be obtained more easily than other products in Turkey. The biggest problem is processing and storage. Producers developed some solutions but they are not satisfactory. Some projects on pollen morphology and chemical composition have been launched. According to the first findings, species such as Cistus salvifolius Cistus laurifolius, Trifolium spp. Helianthus annuus, Knautia spp., Raphanus raphanistrum and Convolvulus arvensis have been identified and constitute a large proportion of pollen grains. We can predict that 70-80% come from Cistaceae family, i.e., Cistus salvifolius, Cistus creticus, Cistus laurifolius and Helianthemum nummularium. This prediction needs however to be verified by further studies.

MAGGOT THERAPY IN TURKEY

Tanyukse^l, M.¹, E. Araz¹, K. Dundar², F. Saylam¹, B. Alten³, A. Taylan-Ozkan⁴ and K.Y. Mumcuoglu⁵

¹Division of Medical Parasitology, ²Department of Undersea and Hyperbaric Medicine, GMMA, Ankara, Turkey, ³Ecology Section, Department of Biology, Faculty of Science, Hacettepe University, Ankara, Turkey, ⁴Parasitology Laboratory, Communicable Disease Research Center, Refik Saydam National Institute of Health, Ankara, Turkey, ⁵Department of Parasitology, Hebrew University-Hadassah Medical School, Jerusalem, Israel

The use of maggot therapy (MT) was initiated at the Gulhane Military Medical Academy (GMMA) in August 2002 after approval of the Ethics Committee Review Board. The aim of this present study was to examine how effectively a combination of MT (using the larvae of the green-bottle fly, Lucilia sericata) and hyperbaric oxygen (HBO) would debride and heal necrotic and/or suppurative wounds. In our hospital, HBO therapy has been widely used for the treatment of wounds as well as for other ailments. Lucilia sericata was colonized in the insectarium of the Ecology Section, Department of Biology, Faculty of Science, Hacettepe University, Ankara. Eggs were isolated after oviposition and surface sterilized. After hatching, maggots were used for wound treatment in the Division of Medical Parasitology, GMMA, Ankara. We observed significant improvement of chronic wounds treated with MT and HBO. The most remarkable effects were debridement, removal of bacteria and improved granulation. One of the disadvantages of this technique is that the idea of maggot treatment is not esthetic for patients or medical staff. In addition, increased pain was observed in patients with venous stasis ulcers. Although MT is a rapid and effective method, conventional surgical debridement will remain the method of choice for wound management.

CASES OF FACULTATIVE AND OBLIGATORY MYIASIS IN TURKEY

Taylan-Ozkan, Aysegul¹, Cahit Babur¹, Selcuk Kilic1 and Sukran Dincer²

¹Parasitology Laboratory, Communicable Diseases Research Center, Refik Saydam National Institute of Health, Ankara, Turkey and ²Department of Parasitology, Veterinary Faculty, Ankara University, Ankara, Turkey

Myiasis, the infestation of man and animals with fly larvae, is common throughout the world. In humans, myiasis is relatively frequent in rural areas where people live in close contact with domestic animals. This condition was first described in 1840 by Hope. One of the most comprehensive definitions of myiasis is “the infestation of live human and vertebrate animals with dipterous larva, which at least for a certain period feed on the host’s dead or living tissue, liquid body substances or ingested food”. Myiasis-causing larvae belong to 11 families of the insect order Diptera. They can cause facultative, semi-obligatory and obligatory myiasis in different organs of the body and some larvae are known to cause pseudomyiasis. Some myiasis-causing flies are found in a specific continent and others are cosmopolitan. In Turkey, such flies are more common in warm and dry areas and are mainly active during spring and summer months. We were able to locate 64 reported cases of human and animal myiasis in this country, including myiasis of the brain, skin, digestive tract, nose, eyes, ear, mouth, pancreas and urino-genital tract was reported. Species such as Hypoderma bovis, Hypoderma lineatum, Gasterophilus hypoderma, Dermatobia hominis, Rhagoletis cerasi, Tubifera tenax, Sarcophaga haemorrhoidalis, Fannia canicularis, Wohlfahrtia magnifica, Oestrus ovis, Calliphora sp, Protophormia terrae-novae, Psychoda albipennis, Lucilia sericata, Anthomya canicularis and Rhinooestrus purpureus have been found to be involved in cases of myiasis in this country. In folk medicine, this condition is known as “kumacik” and there are a number of different treatment methods. Therefore, we assume that many cases are not treated by physicians and that myiasis cases are much more common in our country than officially reported.

IN- AND OUT-PATIENT MAGGOT THERAPY: ORGANIZATION AND RESULTS

Thoner, B., D. Moch and W. Fleischmann

Department of Traumatology and Reconstructive Surgery, Teaching Hospital of the University of Heidelberg, Bietigheim, Germany

Wound treatment with maggots requires careful organization because of difficult logistics. Due to the maggots’ limited lifespan, patients visit our outpatient unit twice a week on Tuesday and Friday. This is an optimal cycle for the application of the larvae, because we can leave them 3-4 days on the wound. The change of dressings takes place in the wards and in the OPD. We order a fixed number of larvae for our large number of patients and we inform the supplier if we need significantly larger number to reduce the risk of running out of larvae. Our specialized wound care team performs the coordination of therapy and the preparation of Biobags and is also responsible for the training of the staff on the wards. We performed 1,020 maggot applications in 2002 and spent only 6.89 ˆ a day for the maggots. This low cost situation is achieved by precise organization of maggot debridement therapy.

THE BIOLOGICAL AND ECOLOGICAL FEATURES OF CYPRINION MACROSTOMUS HECKEL, 1843 AND GARRA RUFA HECKEL, 1843 IN THE BALIKLI SPA

Unver, B.

Cumhuriyet University, Faculty of Science and Art, Department of Biology, Sivas, Turkey

The Kangal Balikli Hot Spring (Balikli Spa), which is known as a psoriasis treatment center, is one of the most important springs in the region. Two species of fish, which are known as "doctor fish" are adapted to the spa temperature of 35°C and the altitude of 1,425 m above sea level. Cyprinion macrostomus and Garra rufa originated in India and Middle Asia and reached Turkey, which is the far western distribution area of these species. These species live in both thermal water of Balikli Spa and the cool water of the Topardic stream, which runs alongside the pools. The main scope of this research was to determine the biological and ecological features of C. macrostomus and G. rufa in Balikli Spa. G. rufa was found to be more confined to the bottom of the pools whereas C. macrostomus was found in the water column. Gut analysis revealed that both species feed on algae, insect parts, fish scales and debris. In most cases, the gut of fish caught in the pools was either empty or had very little content. However, parts of ostracods, nematodes and rotifers, which were mostly digested, were found in the gut of fish. Some of the fish in the pools showed symptoms of illness such as protruding eyes, loose scales, skin ulceration, pale gills and a bloated appearance.

MEDICINAL USES OF A BLOOD-SUCKING LEECH, HIRUDO NIPPONIA IN CHINA

Yang, T.¹, J.Q. Peng² and H.Z. Zhang³

¹Institute of Hydrobiology, the Chinese Academy of Sciences, Wuhan
²Second Affiliated Hospital, Hubei Medical College, Wuhan and
³The Chinese Medicine Research Institute of Hubei, Wuhan, China

Leeches have been used in modern and traditional Chinese medicine for a very long time. The authority on traditional Chinese medicine, Zhang Zhong Jing (168-188) found that leeches could dissolve blood stasis and mentioned it in his famous book of medicine “Golden Chamber of Jade Palaces Channels”. This was the first written record of the action of leech anticoagulants. However, until recently, Chinese pharmacists did not know the different activities of blood-sucking and non-blood-sucking leeches. They normally use a non-blood-sucking leech, Whitmania pigra, which lives in large lakes, to prepare different traditional Chinese drugs. In China there are many blood-sucking leeches belonging to the families Hirudinidae and Haemadipsidae, which are used for the treatment of atherosclerosis and thrombosis. In 1987, in the Second Affiliated Hospital of Hubei Medical College we first used a blood-sucking leech, Hirudo nipponia, which lives in paddy fields of the Yangtze river basin to save the reattached fingers of five injured workers. Hungry leeches removed the excess blood from occluded tissues, prevented necrosis and provided the necessary time (about 1 week) for capillaries to grow across the sutures. H. nipponia also injects histamine and anticoagulants into the skin to prevent blood from clotting. During 1988-1997, we extracted large quantities of salivary gland secretions from H. nipponia using arginine and salt and attempted to isolate and purify the hirudin. The hirudin content in salivary extracts was 4 AT-U/ml, the hirudin production rate was 15% and the ratio activity after purification was 6708 AT-U/ml protein. We also attempted to isolate and purify hyaluronidase (Hase) from the salivary extracts of of this leech, while the enzyme activities during the whole process were measured by DNS colorimetry. The Hase productive rate was 17.8% and the ratio activity 3529u/mg. A drug named the Mai Xue Kang Capsule was prepared from the whole body of H. nipponia by the Chinese Medicine Research Institute of Hubei through a series of pharmacologic, clinical and toxicological examinations and its production began in a pharmaceutical factory. Clinical observations showed that the total curative effect for cerebral strokes was 86% and no toxic side-effects were observed with liver and kidney. The drug is also effective for treating cerebral hematogenous embolism, cerebral hematoma, cerebral strokes, atherosclerosis, coronary heart disease and hyperlipemia. H. nipponia is being cultured in our laboratories.