Handan Bilen

Left ventricular mechanics in Behcet’s disease: A speckle tracking echocardiographic study

Although cardiac involvement is rarely seen in Behcets disease (BD), it is essential to detect subclinical left ventricular (LV) dysfunction for prognostic purposes. Herein we aimed to show the role of two dimensional (2D) speckle tracking echocardiography (STE) in determination of subclinical LV dysfunction in patients with BD. 30 patients diagnosed as BD due to International Study Group Behcets diagnostic criteria and 25 control subjects underwent Doppler echocardiography including pulsed tissue Doppler of the mitral annulus and speckle-tracking echocardiography. LV peak longitudinal strain and strain rate (SR) was calculated in four-chamber (4C), apical long-axis (LAX), and two-chamber (2C) views, and values of the three views were averaged LV global longitudinal strain (LV-GLS) and SR. LV torsion was determined as the net difference in the mean rotation between the apical and basal levels. There was not any significant difference in age and gender between groups. Patients with BD had significantly lower LV longitudinal strain and Sr measurements than the control group. Although LV basal rotation (LVR) basal values were similar in both groups, LVR-apical and LV torsion (LVTR) values were significantly higher in patient group. LVR-apical and LV-GLS were found to have a good positive corelation (r:0.44, p<0.001) (r: -0.56, r: -0.65,respectively. p<0.001). There was a weak positive correlation between LVTR and LV-GLS (r: 0.29, p<0.05). We demonstrated that combined assessment of LV-GLS, LV-GLSR, LVTR and LVR-apical values detected by STE can be useful in determination of subclinical left ventricular dysfunction in BD.

Effects of immunosuppressive drugs on oral mucosa in patients with Behçet's disease: cytomorphological and cytopathological assessment.

BACKGROUND/AIM The aim of this study was to investigate cytomorphological and cytopathological changes in oral exfoliated smears collected from immunosuppressed patients with Behçets disease (BD) using stereological methods. MATERIALS AND METHODS For cytomorphometric analysis, mucosal cell smears were obtained from the buccal mucosa and the floor of the mouths of BD patients treated with immunosuppressive drugs and from healthy volunteers. All mucosal smears from the patients and the healthy volunteers were stained using the Papanicolaou method and examined cytopathologically under light microscopy and cytomorphologically via the stereological nucleator method. RESULTS The cytomorphological analysis revealed 3 types of mucosal cells, with numbers of particularly pink cells lower in the aphthous areas of the patients with BD compared to the healthy controls (P < 0.05). The nuclear volumes (NVs) and cytoplasmic volume (CVs) were significantly higher in the BD patients (P < 0.05), but the NV/CV ratio was higher only in the drug-use patient groups (P > 0.05). There was lower apoptotic activity in the nondrug-use patients with BD and in the immunosuppressive-taking BD patients. CONCLUSION The findings suggest that quantifiably morphological and morphometric changes in oral mucosa can be detected by stereological techniques. Changes in these parameters may indicate malignant transformation in the oral mucosa.

Cytokine, C-Reactive Protein, and Heat Shock Protein mRNA Expression Levels in Patients with Active Behçet’s Uveitis

Background To investigate the gene expression levels of interleukin 10 (IL10), IL18, interferon gamma (IFNG), IFN-gamma receptor (IFNGR), C-reactive protein (CRP), and heat shock protein 70 (HSP70) in patients with active Behçet’s uveitis. Material/Methods Forty patients with Behçet’s disease diagnosed according to the International Study Group criteria and 30 healthy individuals were included in the study. IL10, IL18, IFNG, IFNGR, CRP, and HSP70 gene expression levels were compared. Results Expression levels of IL18, IFNG, IFNGR, and CRP were significantly higher in patients with active Behçet’s uveitis than in control subjects (P<0.01 for all), whereas no significant differences were found in IL10 and HSP70 gene expression levels (P>0.01 for both). Conclusions IL18, IFNG, IFNGR, and CRP gene expression is significantly increased in active Behçet’s uveitis. There was no significant difference between active Behçet’s uveitis patients and controls in terms of IL10 and HSP70 gene expression levels. We conclude that drugs prescribed to Behçet’s patients with active uveitis downregulate gene expression.

Coexistence of nevus flammeus and nevus depigmentosus: Is it a new subtype of phakomatosis pigmentovascularis?

Türkderm-Deri Hastalıkları ve Frengi Arşivi Dergisi, Galenos Yayınevi tarafından basılmıştır. Turkderm-Archives of the Turkish Dermatology and Venerology, published by Galenos Publishing. Phakomatosis pigmentovascularis is a rare genodermatosis characterized by combination of vascular malformations and pigmented nevi. There are numerous subtypes of phakomatosis pigmentovascularis and various classifications have been proposed in the literature. Nevus depigmentosus and dermatomal nevus flammeus were detected in a 7-month-old baby girl with birthmark on the face and body. Only one case was found to be present with similar clinical features in the literature. We have reported this case because we assume that it may be defined as a new type of phakomatosis pigmentovascularis. (Turkderm 2015; 49: 167-8)

A retrospective study of 102 patients with pemphigus

Türkderm-Deri Hastalıkları ve Frengi Arşivi Dergisi, Galenos Yayınevi tarafından basılmıştır. Turkderm-Archives of the Turkish Dermatology and Venerology, published by Galenos Publishing. Background and Design: Pemphigus is a severe and life-threatening chronic autoimmune mucocutaneous blistering disease. The aim of this study was to evaluate and analyze the course, prognostic factors and epidemiological, clinical and therapeutic features of pemphigus in patients followed between 2004 and 2013. Materials and Methods: We performed a 10-year retrospective study of patients diagnosed with pemphigus in Erzurum. The parameters that were evaluated include age, sex, diagnostic methods, duration of hospitalizations, distribution of lesions, duration of treatment and therapeutic doses. Results: The results showed that the estimated annual incidence rate was 1.31 cases per 100.000 person-years. The male to female ratio was 1: 0.81. The mean age at onset of the disease was 48 years (range: 7-95 years). Thirty-six patients had only skin lesions and sixty-six cases had both skin and oral mucosal lesions. The majority of the patients (58.8%) with pemphigus were treated with middle or high-dose corticosteroids (40-160 mg/day). Conclusions: Pemphigus vulgaris is the most common clinical subtype in Erzurum and the mean age of the disease onset in the present study was found to be a decade earlier than in other parts of the world. The patients with both oral mucosa and skin involvement required higher corticosteroid doses and longer hospitalization time when compared to the patients with oral mucosa involvement alone. (Turkderm 2015; 49: 125-8)

Bullous pemphigoid in Erzurum: A 10 year retrospective study

Atatürk Üniversitesi Tıp Fakültesi, Deri ve Zührevi Hastalıkları, ***Tıbbi Patoloji Anabilim Dalı, Erzurum, Türkiye *Afşin Devlet Hastanesi, Deri ve Zührevi Hastalıkları Kliniği, Kahramanmaraş, Türkiye **Medeniyet Üniversitesi Tıp Fakültesi, Göztepe Eğitim ve Araştırma Hastanesi, Deri ve Zührevi Hastalıkları Kliniği, İstanbul, Türkiye ****Kayseri Eğitim ve Araştırma Hastanesi, Deri ve Zührevi Hastalıkları Kliniği, Kayseri, Türkiye Okan Kızılyel, Ömer Faruk Elmas, Handan Bilen, Mahmut Sami Metin*, Necmettin Akdeniz**, Betül Gündoğdu***, Mustafa Atasoy****

Pyogenic granuloma-like Kaposi sar-coma: Report of two cases

SUMMARY Kaposi sarcoma is a vascular tumor associated with Human Herpes Virus-8 infections. Lesions predominantly present at mucocutaneous sites but may involve all organs. There are many kinds of Kaposi sarcoma variants. Pyogenic granuloma like Kaposi sarcoma is a new variant which protrudes from skin and resembles a pyogenic granuloma. We decided to report two cases of Kaposi sarcoma because there are only few case reports about pyogenic granuloma like Kaposi sarcoma in literature, which is usually misdiagnosed as pyogenic granuloma. Keywords: Human Herpes Virus-8, kaposi sarcoma, pyogenic granuloma OZET Kaposi sarkomu Human Herpes Virusu-8 enfeksiyonu ile iliskili vaskuler bir tumordur. Lezyonlar genellikle mukokutanoz bolgelere yerlesir. Ancak tum organlarda gorulebilir. Kaposi sarkomunun bircok varyanti vardir. Piyojenik granulom benzeri Kaposi sarkomu deriden kabarik olan ve piyojenik granuloma benzeyen yeni bir varyanttir. Literaturde, piyojenik granulom benzeri Kaposi sarkomu ile ilgili sadece birkac olgu sunuldugu ve genellikle piyojenik granulom yanlis tanisi aldigi icin Kaposi sarkomlu iki olguyu sunmaya karar verdik. Anahtar sozcukler: Human Herpes Virusu-8, kaposi sarkomu, piyojenik granulom