Familial Mediterranean Fever and Seronegative Arthritis

Familial Mediterranean fever (FMF) is characterized by recurrent, self-limited episodes of polyserositis, with articular involvement also being a common manifestation. The pattern and joint predilection of arthritis show many similarities to those of spondyloarthritis. Moreover, case series suggest an increased prevalence of ankylosing spondylitis or spondyloarthritis among FMF patients. FMF is caused by mutations in the MEFV gene encoding pyrin, which is believed to be involved in regulation of interelukin-1β activation. Recent studies conducted in populations with a high background carrier rate of MEFV variants have reported an increased frequency of M694V among AS patients with no personal or family history of FMF. These findings are of interest, as both candidate gene and genome-wide association studies suggest that the interleukin-1 cytokine pathway may be implicated in the pathogenesis of ankylosing spondylitis. Therefore, association of M694V with ankylosing spondylitis can be recognized as a geographic region–specific risk factor affecting a common inflammatory pathway in the disease pathogenesis.     

Atypical teratoid/rhabdoid tumor in an infant conceived by in vitro fertilization

Background  

Atypical teratoid/rhabdoid tumor (ATsRT) is a rare tumor and extremely aggressive embryonal neoplasm of the central nervous system. Brain tumors in infant are suggestive of some oncogenic prenatal factors.     

Fifty-one Kaposi sarcoma patients

Introduction

Kaposi sarcoma (KS) is a mesenchymal tumor originating from lymphatic endothelial cells. Immunsupressive patients have higher risk for KS. HHV-8 has a role in immunpathogenesis of KS.

Aim

Evaluation of demographical properties with tumor characteristics and treatment modalities of KS.

Material and method

Histopathologically documented KS patients were evaluated retrospectively. Anti-HIV seroprevalence was also evaluated with patient and tumor characteristics besides treatment regimens.

Results

Fifty-one patients were included between September 1998 and February 2009. Male/female ratio was 3.25 (39/12). Median age was 68 (31–94). Lower extremity was the most common site whereas excisional biopsy was the most common diagnostic procedure. Smoking rate was 42.8%. Twenty percent had family history for cancer. Anti-HIV seropositivity rate was 1.9%. Thirty eight percent had local monotherapy, and radiotherapy was most common (26%). Multidisciplinary approach rate was 44%. Most of them had surgery and radiotherapy combination. Two-third of the patients had radiotherapy alone or with other modalities. Rates were as 12% for chemotherapy and 6% for interferon. Vincristine-bleomycin-doxorubicin combination was the most preferred regimen (60%).

Conclusion

Male patients in the sixth decade seem to have higher risk for KS. Smoking rate was almost as high. Local therapy might be sufficient in most of the patients. However, we may also consider systemic chemotherapy for selected patients, including vincristine, bleomycin and doxorubicin.     

Necrotizing fasciitis of eyelid secondary to parotitis

PURPOSE: Evaluation of a patient with necrotizing fasciitis of the eyelid spreading from parotid gland. METHODS: Interventional case report. The patient admitted with rapidly progressive swelling, redness, and pain of four eyelids, and whole face. Pathogenic microorganism was searched, laboratory tests were evaluated. Intensive medical treatment and necrotic wound debridement was performed. RESULTS: The patient had been receiving oral cephalosporin at the time she was referred to our hospital, but her infection had spread rapidly under this treatment. In addition to her eyelid necrosis, septic shock developed within 24 hours. No pathogenic microorganism was detected in cultures. The patient responded to intravenous sulbactam ampicillin, surgical debridement of necrotic wound and supportive medical care. Moderate ptosis was the only complication observed in this patient. Reconstructive surgery was not needed. CONCLUSIONS: With prompt antibiotic treatment and surgical debridement, cosmetic and functional success may be obtained in necrotizing fasciitis cases rarely seen with parotid gland origin.     

Effectiveness of laser-assisted subepithelial keratectomy without mitomycin-C for the treatment of high myopia

PURPOSE: To evaluate the effectiveness and therapeutic range of laser-assisted subepithelial keratectomy (LASEK) without mitomycin-C (MMC) to treat high myopia. SETTING: Isik Eye Clinic, Ankara, Turkey. METHODS: This study comprised 31 highly myopic eyes (19 patients) that had LASEK. Before primary LASEK treatment and 1, 3, 6, 12, and 24 months after, all patients had a complete ophthalmic examination including visual acuity, refractive outcomes, and biomicroscopy. RESULTS: The mean spherical equivalent (SE) was -9.01 diopters (D) +/- 2.66 (SD) preoperatively and -1.00 +/- 1.15 D at the end of follow-up. At 24 months, the mean SE was within +/-1.00 D of the intended correction in 23 eyes (74.19%). The median uncorrected visual acuity (UCVA) increased from 20/606 preoperatively to 20/28.6 at 24 months and the median best corrected visual acuity, from 20/25 to 20/22, respectively. Total higher-order and spherical aberrations increased significantly at the end of follow-up. All 14 eyes that had ablations greater than -8.62 D developed varying degrees of haze. Significant myopic regression (>1.00 D) leading to UCVA loss occurred in all eyes with a preoperative SE of -12.00 D or greater. CONCLUSIONS: The results of LASEK without MMC were excellent in eyes with up to -8.6 D of SE. All eyes with a preoperative SE between -8.6 and -12.0 D developed haze but had acceptable refractive and visual outcomes. Haze and myopic regression limited the success of LASEK in eyes with a preoperative SE of -12.0 D and greater.     

Gray scale histogram analysis of solid breast lesions with ultrasonography: can lesion echogenicity ratio be used to differentiate the malignancy?

PurposeThe aim of this study was to investigate the diagnostic performance of lesion echogenicity ratios (LER) calculated by image histogram analysis for distinction of malignant and benign breast lesions.Material and methodsA total of 55 patients (mean age, 44 years) with 59 lesions were included. Ultrasound images were analyzed retrospectively.ResultsMean LER values in benign and malignant lesions were 1.63±0.41 and 3.1±0.87, respectively. The difference between LER values of benign and malignant breast lesions was statistically significant (P<.001).ConclusionLER can be used as an adjunct ultrasound parameter to differentiate between benign and malignant breast lesions.     

The comparison of the thickness of the cementum layer in Type 2 diabetic and non-diabetic patients

It has been suggested diabetes plays an important role in tooth loss. Studies examining the periodontal structures and the alveolar bone architecture in diabetics have revealed some alterations. However, mechanisms responsible for these alterations have not been elucidated completely. Established relationships between the cementum layer, which is resistant to resorption, and diabetes are few in number. The aim of this study was to compare the thickness of the cementum layer in Type 2 diabetic and non-diabetic subjects in order to improve the understanding of dental mobility in Type 2 diabetes and its effect on tooth loss. A total of 46 male patients with a mean age of 61.72 +/- 5.45 yr. were included in this study (Type 2 diabetics, n=23; non-diabetics, n=23); undecayed. Single rooted premolar teeth extracted from 46 male patients were used to assess the alterations in the cementum layer in Type 2 diabetics. Histological preparations from extracted teeth were examined under light microscopy. In each tooth, the thickness of the cementum layer was measured by an oculometer in 4 different sites on the specimen with the largest pulp space including the pulp chamber and root canals. Statistical analyses were performed with student's t test. The average thickness of the cementum layer in the decalcified teeth extracted from non-diabetic patients was compared to the average thickness of the cementum layer in Type 2 diabetic patients. A significant difference was observed in every site of measurement between Type 2 diabetic and non-diabetic patients with regard to the thickness of the cementum layer (p < 0.05). The cementum layer was thicker at the apical part of the root and at the midpoint of the apical half, and thinner at the central part of the root and at the midpoint of the coronal half in Type 2 diabetic patients.