Systemic lupus erythematosus and thrombotic thrombocytopenic purpura: a case report.

BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) is a multisystem disorder characterised by platelet aggregation causing microvascular occlusion. Early diagnosis and utilization of plasmapheresis can provide an improvement in prognosis. CASE REPORT: A 17 year old male with classical findings of TTP was later diagnosed as systemic lupus erythematosus (SLE). Plasmapheresis resulted in the significant amelioration of the course. CONCLUSION: The coexistence of TTP and SLE may facilitate a better understanding of in the pathophysiology of TTP. These association may provide the role of autoimmunity in TTP. SLE should be considered in the differential diagnosis of patients with TTP because of therapeutic implications.     

A cross-sectional study of workers in the chemical industry with occupational exposure to hexamethylenetetramine

Objectives: To assess the health effects of hexamethylenetetramine (HMT) on the airways and the skin of workers in the chemical industry. Methods: A cross-sectional study was performed with 17 employees of a HMT-producing chemical plant and 16 control subjects from the plant. In addition, we examined 4 out of 5 subjects who had left the production for medical reasons during the last 10 years. Anamnestic data, total and specific IgE to four environmental allergens, lung function and bronchial responsiveness to methacholine were assessed by standard procedures. Skin prick tests (SPT) and patch tests were performed with known sensitizing substances and HMT 100 mg/ml and 2% pet and aq. Results: A high number of exposed subjects and controls reported symptoms during the previous year (64.7% vs 68.8%), most of them were not related to work. Work-related symptoms and objective parameters did not show differences between groups. No sensitizations to HMT as assessed by SPT or patch tests were found. Among those who had left the HMT production for medical reasons, 2 former baggers showed sensitizations to HMT by patch tests. These reported eczema during exposure but lost symptoms after removal from exposure. Geometric mean HMT concentrations as assessed by personal sampling were 0.3 [95% confidence intervals (CI) 0.1; 0.9] mg/m³ in shiftleaders and 0.6 (95% CI 0.3; 1.1) mg/m³ in baggers. Conclusion: High exposures to HMT may cause allergic contact dermatitis. There was no evidence of an increased risk for occupational asthma at mean airborne HMT concentrations below 1 mg/m³. Received: 4 February 1999 / Accepted: 10 July 1999     

Retrospective multicenter evaluation of patients diagnosed with mucosal melanoma: a study of Anatolian Society of Medical Oncology

Tumor Biology - Mucosal melanoma (MM) is a rare type of cancer that differs significantly from cutaneous melanoma. In this study, we aimed to evaluate clinical and demographical characteristics,...     

Studies on di- and triterpenoids from Salvia staminea with cytotoxic activity

A new ursane-type triterpenoid, 3 beta,11 alpha,21 alpha-trihydroxyurs-12-ene, named salvistamineol (1), has been isolated from the methanol extract of Salvia staminea. In addition to 1, the methanol extract yielded four known compounds and the acetone extract yielded twelve known compounds consisting of two sesquiterpenes, six diterpenoids, a triterpenoid, two steroids and one flavone. DNA damaging properties of the extracts and some isolated diterpenes were investigated against three yeasts and only taxodione gave a positive response and also showed the highest cytotoxic activity against a panel of cell lines among the investigated compounds in this study.     

Relationship between Humphrey 30-2 SITA Standard Test, Matrix 30-2 threshold test, and Heidelberg retina tomograph in ocular hypertensive and glaucoma patients

PURPOSE: To evaluate the relationship between global indices of Humphrey standard automated perimetry (SAP, 30-2 SITA standard test), Humphrey Matrix frequency doubling technology (FDT, 30-2 threshold test), and Heidelberg Retina Tomograph (HRT II) parameters and measure the level of agreement among these 3 tests in classifying eyes as normal or abnormal. METHODS: The study included 1 eye of 29 ocular hypertensive and 56 glaucoma patients with a mean age of 60.9+/-10.5 years. All subjects had reliable visual fields and HRT measurements performed within a 2-week period. The eyes were classified as normal/abnormal according to visual field criteria and Moorfields regression analysis (MRA). Correlations between visual field indices (mean deviation and pattern standard deviation) and HRT parameters were analyzed using Spearman correlation coefficient (r) and the agreement between the tests in classifying eyes was defined with kappa value. RESULTS: FDT Matrix mean deviation and pattern standard deviation parameters were found to be highly correlated with those of SAP (r=0.66 and 0.69, respectively). Visual field indices showed statistically significant correlations with cup area, rim area, cup/disc (C/D) area, linear C/D, cup shape, mean retinal nerve fiber layer thickness and retinal nerve fiber layer area parameters (P<0.05). Fifty-eight patients (68.2%) had abnormal results at least with 1 of the tests and 21 subjects (24.7%) had abnormal results with all 3 tests. The kappa values were 0.6 for SAP and Matrix (P<0.001), 0.33 for SAP and MRA (P=0.002), and 0.31 for Matrix and MRA (P=0.004). CONCLUSIONS: FDT Matrix results are highly comparable with SAP in the assessment of glaucoma. Visual field global indices show statistically significant, but low-moderate correlations with most of the HRT parameters. The agreement among MRA and visual fields for abnormality is fair. Either HRT or visual fields may show the first evidence of glaucomatous damage; therefore, the combination of optic nerve head parameters and visual field results could improve glaucoma diagnosis and follow-up.     

An unusual and difficult diagnosis of intestinal obstruction: The abdominal cocoon. Case report and review of the literature

Abdominal cocoon is a rare cause of intestinal obstruction. The abdominal cocoon is probably a developmental abnormality, largely asymptomatic, and is found incidentally at laparotomy or autopsy. Pre-operative diagnosis cannot be often made correctly. This rare entity of intestinal obstruction has been described in the whole literature as a thick fibrotic sac covering the small bowel partially or completely. The etiology of abdominal cocoon is unknown and most often it is found in adolescent girls from tropical or subtropical countries. Complete recovery is generally expected after the removal of the membrane surgically. This paper reports a male patient who has had intestinal obstruction symptoms and has per-operatively been diagnosed as abdominal cocoon.     

A case of pemphigus vulgaris possibly triggered by quinolones

Pemphigus vulgaris is an autoimmune blistering disorder in which both genetic and environmental factors, mainly drugs, are thought to play a part in its aetiopathogenesis. Although some drugs that contain thiol groups, such as D-penicillamine and captopril, and non-thiol drugs, such as cephalosporin, have been reported to trigger or induce pemphigus, there are no previous reports regarding the influence of quinolones in triggering this disease. Here we present a case of pemphigus possibly triggered by quinolones.