Clarithromycin monotherapy-induced delirium.
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Aged, 80 and over↗
Biomedical subjects
A Sayin
Publications and source records attributed to A Sayin.
SPRR4, a novel cornified envelope precursor: UV-dependent epidermal expression and selective incorporation into fragile envelopes.
The cornified cell envelope (CE), a structure formed in the outermost layers of stratified squamous epithelia, provides a physical barrier against environmental insults. It is composed of several structural proteins, which are irreversibly crosslinked by calcium-activated transglutaminases. The small proline rich proteins (SPRRs) are one set of CE precursors. SPRR4, a novel member of this gene family, displayed very low or undetectable expression levels in normal human skin or other stratified squamous epithelia, but was clearly induced by UV light both in vivo and in vitro. High epidermal expression of SPRR4 was monitored only after chronic UV exposure and was concomitant with a thickening of the stratum corneum, which is believed to provide protection against subsequent damage. The calcium-dependent translocation of an SPRR4-GFP fusion protein to the cell periphery in living keratinocytes and its integration into both rigid and fragile cornified envelopes proved that SPRR4 is a novel CE precursor. Interestingly, after UV irradiation, SPRR4 was selectively incorporated into fragile CEs. Our results show for the first time that UV-induced cornification is accompanied by qualitative changes in CE precursor assembly. SPRR4 is part of an adaptive tissue response to environmental stress, which is likely to compensate for UV induced impairment of the epidermal barrier function.
3T3 Cells↗
Management of aneurysms in Behçet's syndrome: an analysis of 24 patients.
BACKGROUND: The surgical therapy of Behçet aneurysms is often unsuccessful, resulting in graft occlusions, anastomoses, and/or new aneurysms. METHODS: Twenty-nine aneurysms were documented in 24 Behçet's patients during a period of 19 years. All patients were male, ranging in age from 20 to 53 years (mean, 35 +/- 7.3 years). The mean duration of disease was 9 +/- 5 years. There were nine abdominal aorta, four iliac, three common femoral, five superficial femoral, four popliteal, one subclavian, one carotid, and one posterior tibial artery aneurysm. In addition, in one patient an aneurysm developed from the arterialized venous conduit that had been inserted for a common femoral artery aneurysm elsewhere. Five patients were already under immunosuppressive therapy for ocular problems at the time of diagnosis. Fifteen patients received immunosuppressive therapy after operation. We performed one abdominal aneurysmorrhaphy, two iliac artery PTFE graft interpositions, two aortobiliac bypasses (PTFE), six aortic tube graft (three PTFE, three Dacron) interpositions, one avrtofemoral bypass (PTFE), two iliofemoral bypasses (PTFE), two superficial femoral artery graft (PTFE) interpositions, and three popliteal graft interpositions (one PTFE, two vein graft). Also as an initial procedure one carotid, one subclavian, four superficial femoral, one popliteal, and one posterior tibial artery were ligated. RESULTS: Nineteen patients were followed up for a mean duration of 47.3 +/- 27 months (range, 1 to 108 months). The patient with a subclavian aneurysm died of massive bleeding on postoperative day 15. Four patients were lost to follow-up. In the abdominal aortic aneurysm group one patient died of gastrointestinal bleeding 4 years after the operation. Another patient from the same group died 5 years after operation without any vascular disease. In the common femoral artery group the patient with an occluded iliofemoral graft died of an exsanguinating pulmonary artery aneurysm in the first year after operation. Overall, there were five anastomotic aneurysms. In addition, after the initial operation two iliofemoral, one aortofemoral, and one popliteal interposition graft were occluded without disabling ischemia. CONCLUSIONS: Aneurysms limited to the extremities could be ligated without disabling ischemia. Abdominal aortic aneurysms could be treated with tube graft insertion, giving satisfactory results. Patients could tolerate graft occlusion without major ischemia.
Adult↗
Peripheral aneurysms in Behçet's disease.
In this report, 14 patients with Behçet's disease with a total of 16 aneurysms are presented. The most common site of aneurysm formation was the femoral artery. Patients with Behçet's disease and aneurysm formation carry the highest morbidity and mortality rates among all those with the disease. The results of reconstructive surgery in the treatment of aneurysms are discouraging, with many anastomotic aneurysms and grafts occluding. In this study, it was possible to ligate major arteries such as the common iliac, superficial femoral and popliteal without limb loss. It is suggested that ligature either at initial surgery or reoperation should be performed to avoid complications of reconstructive surgery. Adjuvant immunotherapy is required to control relapses responsible for new aneurysm formation.
Adult↗
Surgical treatment of Buerger's disease: experience with 216 patients.
Buerger's disease (thromboangiitis obliterans) is a rare peripheral vascular disease that usually affects young male smokers. It is characterized by multiple occlusions distal to the knee and elbow. Although rarely encountered in this condition, major arterial occlusions can be corrected by arterial revascularization. The hospital records of 216 patients (214 men and 2 women) with Buerger's disease were reviewed retrospectively, 142 (66%) between 1 and 120 (mean(s.d.) 72.8(24)) months after diagnosis. Of these patients 21 had had an arterial revascularization; 183 lumbar and 20 thoracic sympathectomies had been performed. In 30 of the patients a total of 29 minor and four major amputations had been performed. In appropriate cases arterial reconstruction provides better healing of ischaemic lesions. Although vasomotor tone is usually normalized in 2 weeks to 6 months after sympathectomy, the temporary increase in blood flow is often sufficient to heal ischaemic lesions during this period.
Adult↗