Multi-centric basal and squamous cell skin malignancies of the craniofacial region

The etiology of skin malignancies is evaluated as multi-factorial. The human phenotype, syndromes, precursor lesions, and immunologic differences play as risk factors as well as environment. Twenty-seven patients with multi-centric skin malignancies investigated as if having predisposing syndromes. The etiological factors and the classification of skin malignancies are assessed. We last discussed about the management options. The mean age was 47 (9-91). Men to women ratio was 16:11. Four out of 27 patients having multi-centric skin malignancies were realized as syndromic. The localization of these tumors was entirely at the head and neck region. Ninety-eight areas were distinguished as having skin malignancies in 27 patients. Sixty-one incisional biopsies for type analysis and 37 excisional biopsies were handled. Of the 98 malignancies, 24 were squamous cell cancer, 67 were basal cell cancer, and seven were basosquamous cell cancer pathologically. Wound closures were carried out as primarily in 39 excisions; using skin grafts in 21 excisions, local flaps in 28 excisions, and distant flap procedures in 10 regions. The follow-up period was between six and 25 months. No complications or recurrences were seen. Eight patients applied with new lesions on new regions, six patients had excision, and two were treated with radiotherapy.     

Amlodipine-induced delirium in a patient with ischemic stroke

Amlodipine is a dihydropyridine calcium antagonist drug with distinctive pharmacokinetic characteristics that seem to be attributable to a high degree of ionization. Delirium is a neuropsychiatric syndrome recognized as a marker for increased health care costs, morbidity, mortality, and institutionalization that often complicates acute physical illness in elderly people. This case is the first report concerning amlodipine use as a cause of delirium.     

Agmatine as retinal protection from ischemia-reperfusion injury in guinea pigs

Purpose  To determine the neuroprotective effect of agmatine (Agm) on the retinas of guinea pigs subjected to a transient ischemia-reperfusion insult. Methods  Twenty-eight guinea pigs were randomly divided into four groups. Forty-five minutes before ischemic insult, the guinea pigs were intraperitoneally administered either Agm (50 mg/kg) (Agm 1) or saline (control 1 group) once, or twice separated by a 12-h interval (Agm 2; control 2). Transient ocular ischemia was achieved under general anesthesia by cannulating an anterior chamber maintainer connected to an infusion line of a semiflexible bottle. The saline reservoir pressure was increased by using a blood pressure tolls cuff to achieve an intraocular pressure (IOP) of 150 mmHg. This IOP was maintained for 90 min. Reperfusion was achieved by pulling off the anterior chamber maintainer. The animals in the Agm 1 and control 1 groups were killed at the end of the 4-h reperfusion period. The eyes were enucleated for histopathological (retinal thickness) and biochemical (thiobarbituric acid reactive substance, TBARS, and nitric oxide, NO) investigation. The animals in the Agm 2 and control 2 groups were killed at the end of a 24-h reperfusion period. Results  The mean retinal thickness of the animals in the Agm 1 (25.94 ± 1.23 μm) and Agm 2 (24.49 ± 0.88 μm) groups was lower than that of those in the control 1 (37.60 ± 2.27 μm) and control 2 (36. 64 ± 1.32 μm) groups (P < 0.05). The mean TBARS level of the animals in the Agm 1 (8.37 ± 0.94 nmol/ml) and Agm 2 (8.01 ± 0.97 nmol/ml) groups was lower than that of those in the control 1 (12.09 ± 1.27 nmol/ml) and control 2 (12.09 ± 1.27 and 11.72 ± 1.63 nmol/ml) groups (P < 0.05). The mean NO level of the animals in the Agm 1 (100.77 ± 6.20 nmol/ml) and Agm 2 (94.63 ± 5.24 nmol/ml) was lower than that of those in the control 1 (131.77 ± 4.61 nmol/ml) and control 2 (122.43 ± 4.35 nmol/ml) groups (P < 0.05). There were positive correlations between the TBARS and NO levels and retinal thickness in the Agm and control groups. Conclusion  Agmatine exerts a significant neuroprotective effect on guinea pig retinas after transient ischemia-reperfusion insult.