Low-Density Lipoprotein Oxidizability and the Alteration of Its Fatty Acid Content in Renal Transplant Recipients Treated With Cyclosporine/Tacrolimus

Renal transplantation is widely used to treat patients with end-stage renal disease. Atherosclerosis is an important posttransplantation risk factor for renal transplant recipients. Subsequent to transplantation low-density lipoprotein (LDL) particles become susceptible to oxidative modification, which results in atherosclerosis. Therefore, the aim of our study was to investigate differences in the susceptibility of LDL particles to oxidation by analyzing LDL fatty acid levels among renal transplant recipients. The changes in lag phases and fatty acid levels of LDL were observed over 4 months among renal transplant recipients treated with Cyclosporine (CsA; n = 7) or Tacrolimus (FK-506; n = 9). We also analyzed cholesterol and triglyceride levels of patients and healthy controls. The lag phase at the 60th day after transplantation was significantly shorter than the results either before transplantation or among control subjects. In conclusion, a similar decrease in lag phase was observed in both above groups, but the FK-506-treated group showed a better lipid profile than the CsA-treated group.     

Detection of t(14;18) in turkish follicular lymphomas using the polymerase chain reaction

A t(14;18) translocation is closely associated with the follicular lymphoma but is also seen in diffuse B cell lymphomas with a previous history of a follicular lymphoma as well as de novo diffuse lymphomas. Estimation of the frequency of t(14;18) in follicular lymphoma vary widely from 33 to 89%. Furthermore, no extensive data have been published on the frequency of t(14;18) in Turkish cases of follicular lymphoma. Representative tissue blocks from 67 patients with follicular lymphoma, 12 cases of diffuse large B cell lymphomas and 11 cases of reactive hyperplasias were examined for the presence of this translocation using PCR. DNA probes capable of detecting rearrangement at both the major and minor break point regions were employed. We could detect t(14;18) in 46 out of 67 cases (68.7%) of follicular and 25% of diffuse large B cell lymphomas. In follicular lymphomas 64.2% of these break points were at mbr and 4.5% were at the mcr region. Review of the literature showed that comparable results have been obtained previously using molecular techniques. Our data showed that despite the relative infrequency of follicular lymphomas in the Turkish population these lymphomas share a common molecular pathogenesis with involvement of bcl-2 gene and background incidence of such rearrangement is similar in all populations, regardless the incidence of folicular lymphoma.     

In vitro bacterial adherence to teicoplanin and calcium sulfate-soaked bone cement

The aim of this study was to assess in vitro the improvement in release kinetics for teicoplanin and the inhibition of bacterial adhesion on calcium sulfate-soaked PMMA discs. Calcium sulfate has been used in vivo and shown to be biocompatible, and prevention of bacterial adhesion may be expected with calcium sulfate-soaked polymethylmethacrylate (PMMA). Discs were made by adding teicoplanin and calcium sulfate in powder form to PMMA powder. The antibiotic concentration eluted from PMMA discs was assayed by agar diffusion assay. Nonadherent bacteria were removed by washing and adherent bacteria were detached by sonication. The suspension including nonadherent bacteria was seeded on sheep blood agar plate and incubated for 24 h at 37 degrees C for the growth of microorganisms. The teicoplanin released from discs containing calcium sulfate was higher than that released from discs which had not been soaked with calcium sulfate. The count of bacteria adhering to the calcium sulfate-soaked discs was lower than that from the discs without calcium sulfate. In conclusion, the addition of calcium sulfate to teicoplanin-loaded PMMA bone cement may provide local antibiotic concentrations higher than MIC values due to increased antibiotic release. Furthermore, calcium sulfate was found to be effective in reducing bacterial adherence to treated discs.     

Primary granulocytic sarcoma of the urinary bladder: case report and review of the literature

We report a case of granulocytic sarcoma of the urinary bladder, with no evidence of hematologic involvement. The patient was initially misdiagnosed and was treated with chemotherapy for transitional carcinoma grade 3. Despite this treatment, the clinical features of the patient progressed, and a repeated biopsy yielded the correct diagnosis. Three cases of granulocytic sarcoma of the urinary bladder have been reported in published studies, with only one of these primary. To our knowledge, ours is the second case of granulocytic sarcoma of the urinary bladder presenting with urologic symptoms but without hematologic findings.     

Congenital dyserythropoietic anemia type I with ringed sideroblasts

A 25-year-old male with anemia, jaundice and liver dysfunction was admitted to our institution. Anisopoikilocytosis with tear-drop forms, polychromasia, basophilic stippling in peripheral blood smear, erythroid hyperplasia with megaloblastoid changes, binucleated cells and intranuclear bridging in bone marrow aspirate and spongy, unevenly condensed nuclear chromatin in electron microscopy studies indicated that he had congenital dyserythropoietic anemia (CDA) type I. As a rare finding in CDA, ringed sideroblasts were noted. It is proposed that this patient is an example for the designation 'variant congenital dyserythropoietic anemia with ringed sideroblasts'.     

Classic kaposi sarcoma with pulmonary involvement mimicking endobronchial tuberculosis in a child

Kaposi' sarcoma (KS) is a low‐grade vascular neoplasm and classic KS, a subtype of KS, is extremely rare in children. Childhood pulmonary involvement in classic KS has not been reported in the literature. We describe an HIV‐seronegative pediatric case with a fulminant course of classic KS with pulmonary involvement mimicking endobronchial tuberculosis. Pediatr Pulmonol. 2013; 48:310–312. © 2012 Wiley Periodicals, Inc.     

Preoperative diclofenac sodium and tramadol for pain relief after bimaxillary osteotomy.

PURPOSE: The aim of this study was to compare the postoperative analgesic affects of preoperative use of a synthetic opioid tramadol and a nonsteroidal anti-inflammatory drug diclofenac sodium for postoperative pain, with placebo, in patients undergoing bimaxillary osteotomy. PATIENTS AND METHODS: Thirty-six orthognathic surgery patients who underwent both Le Fort I osteotomy in the maxilla and bilateral sagittal split ramus osteotomy in the mandible as bimaxillary osteotomy were randomly allocated into 3 groups via sealed envelope technique. Group T (n = 12), group D (n = 12), and group P (n = 12) received preoperative 50 mg tramadol intramuscularly, 75 mg diclofenac sodium intramuscularly, and saline, respectively. Postoperative pain intensity (visual analog scale, verbal pain score), postoperative opioid consumption with intravenous patient-controlled analgesia, hemodynamic variables, and postoperative complications were compared among the 3 groups. RESULTS: The median number of patient-controlled analgesia demands (n) in group P (34, 28-39) was higher than other groups (group D 14, 11-13; group T 19, 12-25; P = .001). Total tramadol consumption was higher in group P (330 mg, 290-390) compared with group D (260 mg, 190-340; P = .046) and group T (270 mg, 200-330; P = .034). The 3 groups were comparable for the area under the hemodynamic variables time curves. The area under the visual analog scale and verbal pain score curves were lower in group D and group T compared with group P, however, there was no significant difference between group T and group D. CONCLUSIONS: Preoperative diclofenac or tramadol, compared with placebo, effectively decreases postoperative opioid consumption via intravenous patient-controlled analgesia.     

Klebsiella pneumoniae peritonitis shortly after kidney transplantation

We report a case of spontaneous bacterial peritonitis caused by Klebsiella pneumoniae in a 34-year-old male recipient shortly after kidney transplantation. On posttransplant day 10, the patient started complaining of severe abdominal pain and nausea. Body temperature was 38.4°C. The abdomen was diffusely tender with rigidity and rebound. Laboratory data showed a normal erythrocyte sedimentation rate and serum creatinine level but a slightly elevated C-reactive protein concentration and leukocytosis of 36,200 cells/mm³ with 88% neutrophils. Explorative laparotomy revealed diffuse purulent peritonitis without an intraabdominal source of infection, such as intestinal perforation. The peritoneal fluid revealed greater than 1000/mm³ white blood cells and many gram-negative bacilli. Fluid cultures yielded growth of Klebsiella pneumoniae. The patient responded to antibiotic therapy; he was discharged in good condition. This case report draws attention to the impaired host defense that may predispose to spontaneous bacterial peritonitis in renal transplant recipients and alerts the clinician to the possibility of this rare disease.