Biomedical subjects
Publications and source records attributed to S Akay.
A quantitative determination of alpha-tocopherol in Pistacia lentiscus, Pistacia lentiscus var. chia, and Pistacia terebinthus, leaves was established by TLC-densitometry and colorimetry. The highest amount of alpha-tocopherol was found in P. lentiscus var. chia.
Kaposi's sarcoma has a higher incidence in organ transplant recipients. We report on a 41-year-old Turkish man with liver transplantation-associated Kaposi's sarcoma that involved the skin and the gut. Immediately after discontinuation of immunosuppressive medication, there was an acute rejection episode. After controlling the acute rejection with steroids, the immunosuppressive treatment was continued together with vincristine, which resulted in disease remission. After 6 months, withdrawal of vincristine lead to relapse of the disease, prompting commencement of vincristine again, which has maintained the patient in remission for more than 3 years without any significant side effects. In conclusion, long-term vincristine may be an effective, safe treatment option for Kaposi's sarcoma.
Failure of prophylaxis for hepatitis B virus (HBV) recurrence in liver transplant patients with HBV immunoglobulin (HBIG) or lamivudine or both can be associated with rapid development of liver failure. Some of these patients develop a devastating clinicopathological state characterized by jaundice and rapidly progressive liver failure or fibrosing cholestatic hepatitis. We present two liver transplant recipients who experienced HBV recurrence while they were under lamivudine and HBIG prophylaxis. One of them had finding of severe HBV infection; the other, fibrosing cholestatic hepatitis. After commencing adefovir dipivoxil both patients showed improvements in clinical status and laboratory data. At month 4 of treatment, HBV DNA values became negative and liver function tests almost normalized. In addition, in one case showed HBs ag/anti-HBs seroconversion. When failure of prophylaxis with lamivudine and HBIG occurs, adefovir dipivoxil should be considered to be a safe and effective choice for recurrent HBV infections in liver transplant patients.
Patients with severely increased blood pressure often present to the emergency department. Rapid lowering of blood pressure can precipitate or worsen end organ damage. We report two cases that developed cerebrovascular and cardiovascular adverse events associated with aggressive treatment of increased blood pressure by the use of sublingual nifedipine capsule. The first patient had developed ischaemic stroke; the second patient actually had acute left ventricular failure causing deteriorated, and required positive inotropic treatment for persistent hypotension. These cases emphasise that the pseudoemergency may rapidly progress into a real emergency when blood pressure is rapidly and aggressively reduced.
UFT (Uftoral), a blend of uracil and Tegafur, is an antitumour agent for oral administration that is presumed to maintain the concentration of 5-fluorouracil (5-FU) in tumour tissue. As a result of increased use of high-dose 5-FU-based chemotherapy for various solid tumours, complicated drug-induced colitis is more frequently observed. Dihydropyrimidine dehydrogenase (DPD) is the rate-limiting enzyme in the catabolism of 5-FU and its deficiency is responsible for the severe toxicities encountered in cancer patients receiving 5-FU. The authors present the case of a patient with locally advanced temporal bone carcinoma who developed haematochezia during a course of chemotherapy with UFT. Colonoscopy of the patient showed bleeding petechia-like lesions and superficial inflammatory exudate, whilst histology revealed non-specific inflammatory changes of the colon mucosa. As the haematochezia improved with supportive treatment, neutropenia complicated the clinical picture. This patient developed life-threatening UFT toxicity without an exon-14 DPD gene mutation.
Electroencephalographic studies were done in rheumatic fever patients in order to determine the distribution of normal and abnormal EEG patterns in different clinical forms. The duration of EEG abnormalities related to rheumatic activity was compared with the duration of increased sedimentation rate and tachycardia. Rheumatic fever cases were divided into four groups: (1) acute active rheumatic carditis, (2) acute polyarthritis without carditis, (3) nonactive old rheumatic valvular heart disease, and (4) Sydenham's chorea. EEG findings were within normal limits in acute polyarthritis and in nonactive rheumatic valvular heart disease, but there were abnormal EEG findings in 29 per cent of chorea and in 94 per cent of active carditis cases. In active carditis all EEG changes returned to normal approximately within 8 weeks, whereas the sedimentation rate and tachycardia returned to normal within a shorter period.