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Biomedical subjects

C Baykal

Publications and source records attributed to C Baykal.

At least 19 recordsLinked to original sources
PubMed2001

Childhood bullous pemphigoid developed after the first vaccination.

Bullous pemphigoid (BP) typically affects the elderly. There are at least 40 reported cases of BP in childhood, 10 reported cases at 1 year of age or younger. The antigen of this autoimmune disease is localized to the hemidesmosome. Neoplasia, recurrent trauma, some systemic diseases, and psoriasis were previously reported as possible triggering factors of bullous pemphigoid in some cases. In the last 5 years, 10 adult and 2 infantile BP cases with a close relation of vaccination have been reported. Anti-influenza vaccine, tetanus toxoid booster, and tetracoq vaccine were the possible causes of these cases. We report herein a 3.5-month-old BP case in whom the lesions developed 24 hours after the first tetracoq vaccine. We suggest that vaccination may be the triggering factor of BP of any age by stimulating the immune system with an unexplained mechanism.

Anti-Bacterial Agents↗
PubMed2001

Effects of hormone replacement on hemostasis in spontaneous menopause.

OBJECTIVE: To examine the effects of continuous combined estrogen-progesterone replacement therapy on coagulation and natural anticoagulant systems in spontaneous menopause. DESIGN: A randomized, double-blind, placebo-controlled study was conducted during a 6-month period to examine the effect of hormone replacement therapy (HRT) on blood coagulation parameters. One hundred-ten healthy postmenopausal women were randomized into two groups. Those in group 1 were given conjugated estrogen (0.625 mg/d, Premarin) and medroxyprogesterone acetate (5 mg/d, Farlutal), and those in group 2 were given identical tablets of placebo for 6 months. Serum levels of modified activated protein C resistance, antithrombin III, fibrinogen, factor VIIIa, factor VIII, factor IX, activated partial thromboplastin time, prothrombin time, thrombin time, and lipoprotein (a) were measured before and 6 months after the treatment and analyzed for changes in extrinsic and intrinsic coagulation parameters. RESULTS: At the end of the 6-month period, fibrinogen, lipoprotein (a), and activated protein C resistance levels were decreased significantly in the HRT group compared with the control group. Antithrombin III levels were increased, indicating antithrombin activity. Activated partial thromboplastin time, as a measure for intrinsic coagulation cascade, was prolonged in concert with decreased intrinsic coagulation factors, factor VIII, and factor IX (p < 0.05). In the extrinsic coagulation system, prothrombin time was significantly increased, although factor VIIa level was not changed (p > 0.05). CONCLUSION: Significant changes were observed in the coagulation parameters, which may further explain the cardioprotective effect of HRT.

Activated Protein C Resistance↗
PubMed2001

Comparison of enoxaparin and standard heparin in gynaecologic oncologic surgery: a randomised prospective double-blind clinical study.

OBJECTIVE: This study aimed to compare the haemorrhagic complications and efficacy of enoxaparin, a low molecular weight heparin (LMWH), and conventional standard heparin (SH) in gynaecological oncologic surgery. MATERIALS METHODS: A double blind, randomised trial was performed on 102 consecutive women undergoing gynaecologic cancer surgery with pelvic and paraaortic lymphadenectomy. The women were separated into those who were given 2,500 IU enoxaparin once daily and SH in a dose of 5,000 IU three times daily. The groups were analysed for intraoperative blood loss, drainage, transfusion requirements, perioperative haemoglobin decrease, wound haematoma, and clinical deep venous thrombosis. RESULTS: The two groups were well matched for age, weight, and other factors, which could predispose to the development of deep venous thrombosis (DVT) and haemorrhage. No patient developed clinical significant DVT, wound haematoma or intra-abdominal bleeding. There was no significant difference in bleeding complications between the two regimens. The antiFXa level in the plasma was correlated strongly with patient weight. CONCLUSIONS: A dose of 2,500 IU enoxaparin/day does not cause more bleeding complications than SH 5,000 IU three times daily when used to prevent thrombosis. However, the dose of enoxaparin must be adjusted to the patient's weight.

Adult↗
PubMed2001

Diagnostic and prognostic value of serum and peritoneal fluid lactate dehydrogenase in epithelial ovarian cancer.

OBJECTIVE: The aim of this study was to investigate the peritoneal fluid and serum lactate dehydrogenase (LDH) levels in patients with ovarian masses. MATERIALS & METHODS: Peritoneal fluid and serum lactate dehydrogenase (LDH) levels were measured in 27 patients with epithelial ovarian carcinoma and 38 with benign ovarian tumors. Serum and peritoneal fluid LDH levels were also compared with the levels of CA-125. RESULTS: Both of the marker levels in ovarian cancer patients were significantly higher than those in patients with benign ovarian tumors. Serous and undifferantiated carcinomas presented higher marker levels than endometrioid and mucinous carcinomas. High grade, advanced stage and positive cytology were associated with higher serum and peritoneal fluid LDH levels; there was an inefficient correlation between them but, when these two markers were used together with CA-125, sensitivity of CA-125 increased to 70%. CONCLUSIONS: In conclusion, serum LDH can be used to discriminate adnexal mass origin and peritoneal fluid LDH may have prognostic value because of the strict relationship with advanced stage, poor histologic type, higher grade and positive abdominal cytology. Peritoneal LDH is found to be a reliable biochemical marker related to prognosis in ovarian carcinoma patients.

Adult↗
PubMed2000

Pustular psoriasis with a striking linear pattern.

Pustular psoriasis has different clinicomorphologic forms such as generalized, localized (mainly palmoplantar or acral), and annular. There are also few cases with a linear distribution pattern. We report a case of pustular psoriasis with a striking linear distribution probably related to Blaschko's lines. We suggest that linear pattern should also be considered among the morphologic variants of pustular psoriasis.

Acitretin↗
PubMed2000

HLA in alopecia areata.

BACKGROUND: The aim of this study was to investigate the human leukocyte antigen (HLA) characteristics of Turkish alopecia areata patients, and the correlation of the HLA profile with age of onset, severity and duration of the disease, presence of ophiasis, and family history. METHODS: A total of 88 patients with alopecia areata, alopecia totalis, or alopecia universalis were compared with 100 healthy controls. HLA typing was performed by the Terasaki microlymphocytotoxicity method. RESULTS: The frequency of HLA-A1, HLA-B62(15), HLA-DQ1, and HLA-DQ3 was significantly higher in patients than in controls. HLA-DR16 was significantly less common in patients than in the control group, and we concluded that this allele might have a protective role for alopecia areata. Juvenile onset and severe involvement were related with HLA-Cw7 and HLA-DR1, respectively. The HLA profile was independent of the existence of long-standing disease, presence of ophiasis, and a positive family history. CONCLUSIONS: In HLA-alopecia areata association, ethnic differences may play a role.

Adolescent↗
PubMed2000

Cutaneous fixed drug eruption to paclitaxel; a case report.

The aim of this report was to investigate an adverse effect of paclitaxel. Cutaneous fixed drug eruption against paclitaxel--which is rarely seen--is explained. A 70-year-old caucasian woman experienced three operations for ovarian carcinoma and finally a paclitaxel-based chemotherapy regimen was initiated as adjuvant chemotherapy. Following the administration of the first dose of paclitaxel, the patient had a cutaneous reaction that was clinically consistent with "fixed drug eruption". Lesions regressed with a topical steroid dressing. Histopathological examination of the lesion confirmed clinical diagnosis. It is interesting that such a reaction could occur despite the use of premedication with systemic corticosteroid antihistaminic prophylaxis yet heal rapidly with topical corticosteroid therapy. Thus we recommend careful observation for cutaneous side-effects in patients who receive paclitaxel or other taxanes, even with premedication prophylaxis.

Adenocarcinoma↗
PubMed2000

The combined occurrence of macular amyloidosis and prurigo nodularis.

The association of prurigo nodularis (PN) and macular amyloidosis (MA) has not been reported before. Although pruritus related frictional trauma is a well-known cause of PN, its role in the development of MA has always been questioned. We herein report two cases with chronic liver disease and iron deficiency who concomitantly developed MA and PN lesions. Pruritus was the preceding factor and both lesions were confined to scratched areas. The association of two otherwise uncommon dermatoses in pruritic patients and their characteristic distribution might indicate an important role for pruritus-induced scratching in the pathogenesis of MA, too.

Amyloid↗
PubMed1999

Association of a syndrome resembling Wegener's granulomatosis with low surface expression of HLA class-I molecules.

BACKGROUND: Granulomatous syndromes, such as Wegener's granulomatosis, are defined according to complex criteria, but the underlying cause is rarely identified. We present evidence for a new aetiology for chronic granulomatous lesions associated with a recessive genetic defect, which is linked to the human leucocyte antigen (HLA) locus. METHODS: Five adults with necrotising granulomatous lesions in the upper respiratory tract and skin, associated with recurrent bacterial respiratory infections and skin vasculitis, were identified. A diagnosis of Wegener's granulomatosis was considered in all of them, but abandoned because of an incompatible disease course and resistance to immunosuppressive treatments. Peripheral-blood samples were taken and analysed by immunohistochemistry and fluorescent-activated-cell-sorter analysis. Since all five patients were homozygous for the HLA locus, we looked for genetic defects located within the HLA-locus with PCR and restriction fragment length polymorphism. FINDINGS: A severe decrease in cell-surface expression of HLA class-I molecule was seen in all patients. Defective expression of the transporter associated with antigen presentation (TAP) genes was responsible for the HLA class-I down-regulation, and in two patients we identified a mutation in the TAP2 gene responsible for the defective expression of the TAP complex. We showed the presence of autoreactive natural killer (NK) cells and gammadelta T lymphocytes in the peripheral blood cells of two patients. Correction of the genetic defect in vitro restored normal expression of HLA class-I molecules and prevented self-reactivity in the patients' cells. Histology of granulomatous lesions showed the presence of a large proportion of activated NK cells. INTERPRETATION: Our findings define the cause and pathogenesis of a new syndrome that affects patients with a defective surface expression of HLA class-I molecules. The syndrome resembles Wegener's granulomatosis both clinically and histologically. Patients have chronic necrotising granulomatous lesions in the upper respiratory tract and skin, recurrent infections of the respiratory tract, and skin vasculitis. A predominant NK population within the granulomatous lesions suggests that the pathophysiology of the skin lesions may relate to the inability of HLA class-I molecules to turn off NK cell responses. Accurate genetic analysis of a defined syndrome can provide a better understanding of the cause and pathogenesis of a disease.

ATP-Binding Cassette Transporters↗
PubMed1999

Annular elastolytic giant cell granuloma: sparing of a burn scar and successful treatment with chloroquine.

Annular elastolytic giant cell granuloma is a rare granulomatous skin disease characterized by phagocytosis of elastic fibres by multinucleated giant cells. Lesions are either solitary or grouped in a few annular patches with elevated borders and central atrophy. Sun-exposed areas are more commonly involved than covered skin. The pathogenesis of the disease is still controversial. We report a 72-year-old fair-skinned woman with unusual clinical findings. An irregularly shaped erythematous plaque covered the entire face, and hundreds of lichenoid papules were present on both sun-exposed and covered areas which gradually evolved into annular lesions of about 0.5-1 cm in diameter. Sparing of an old burn scar and a nearly complete lack of elastic fibres in the scar site were noted, illustrating the presumed importance of dermal elastic tissue in the pathogenesis. The course of the disease is chronic. Several treatments have been tried, with variable success. In our patient, improvement was achieved with chloroquine over a period of 16 weeks.

Aged↗
PubMed1999

Nevoid hyperkeratosis of the nipple and areola: treatment with topical retinoic acid.

Nevoid hyperkeratosis of the nipple and areola is a rare dermatosis with unknown etiology, (Perez-Izquierdo JM, Vilata JJ, Sanchez JL, et al. Retinoic acid treatment of nipple hyperkeratosis. Arch Dermatol 1990;126:687-688). Only 40 cases have been reported until 1997 (Alpsoy E, Yilmaz E, Aykol A. Hyperkeratosis of the nipple: report of two cases. J Dermatol 1997;24:43-45). The disease has a benign course and may only be a cosmetic problem. Different modalities have been used in the treatment of NHNA. In our case treatment with topical retinoic acid induced an acceptable response.

Administration, Cutaneous↗
PubMed1998

Dyskeratosis congenita associated with Hodgkin's disease.

Dyskeratosis congenita is a rare, hereditary, multisystem disorder characterized by mucocutaneous changes, pancytopenia and increased incidence of malignancy. Different types of neoplasia have been reported in association with dyskeratosis congenita. We present a second case associated with Hodgkin's disease. Delayed appearance of dermatological signs and association with chronic hepatitis B are other unusual features of this case.

Adult↗
PubMed1997

[Local DMSO treatment of macular and papular amyloidosis].

Macular amyloidosis (MA) and lichen amyloidosus (LA) are the two major variants of the primary cutaneous amyloidoses which present with severe and therapy resistant itching. Various therapeutic modalities such as antihistamines, intralesional injection or topical application of corticosteroids, etretinate, UVB irradiation and dermoabrasion have been employed with variable success. Recently, in a few case reports authors have observed encouraging beneficial clinical effects by using topical dimethyl sulphoxide (DMSO). In our study 10 patients with either MA or LA or biphasic amyloidosis were treated with a 50% solution of DMSO in water. 9 of them showed marked clinical improvement at the end of 6-20 weeks of treatment. Degranulation and depletion of the mast cells by DMSO is the most probable explanation for the rapid improvement of itching beginning within the first week of therapy. Remarkable flattening of the lichenoid papules which was obtained within 11 weeks of treatment is interpreted as a result of the improvement of itching and the related scratch effect. Histological examination after treatment revealed no disappearance of amyloid deposits in the papillary dermis. In the follow-up period relapses of itching and papules were observed. Therefore further studies are needed to find out the optimal procedure of therapy.

Administration, Topical↗
PubMed1997

[Oral DMSO therapy in 3 patients with lipoidproteinosis. Results of long-term therapy].

Lipoid proteinosis is a rare autosomal recessive disorder with a chronic, benign course. There is no generally accepted systemic therapy apart from the experimental oral use of dimethyl sulphoxide (DMSO) and etretinate in two single cases. We treated two sisters and an unrelated man with lipoid proteinosis with longterm oral DMSO (60 mg/kg/d). At the end of an average treatment time of 3 years, DMSO was withdrawn because it produced no beneficial effects with regard to their skin, mucosal lesions or hoarseness. Additionally, one patient showed progression of her disease with worsening hoarseness and onset of dyspnea, requiring surgical removal of vocal cord infiltrates. Three patients with lipoid proteinosis failed to show any beneficial response to long term treatment with DMSO.

Administration, Oral↗