Recep Dursun

Conjunctival impression cytology, ocular surface, and tear-film changes in patients treated with systemic isotretinoin.

Purpose: To evaluate the ocular surface changes and tear-film functions in patients treated with systemic isotretinoin. Methods: Fifty subjects treated with 0.8 mg/kg oral isotretinoin were enrolled in this prospective clinical trial. All patients underwent a full ophthalmoscopic examination before, during, and after treatment with isotretinoin. Ocular surface changes of the cell content of the surface conjunctival epithelium were evaluated by conjunctival impression cytology and tear-film functions using the Schirmer test, anesthetized Schirmer test, tear breakup time, and rose bengal staining. Subjective ocular complaints were scored with an Ocular Surface Disease Index questionnaire. Results: There were no significant differences observed in average Schirmer test scores for patients before, during, or after isotretinoin treatment. Mean anesthetized Schirmer test scores and tear breakup time decreased significantly during treatment (P < 0.001). Mean impression cytology scores, Ocular Surface Disease Index scores, and rose bengal staining scores increased significantly during treatment (P < 0.05, P < 0.001 and P < 0.001, respectively). Blepharitis was seen in 36% of patients. All abnormal findings disappeared 1 month after the cessation of treatment. Conclusions: Conjunctival epithelial cells, tear basal secretion, and tear quality are markedly affected in patients during systemic treatment with isotretinoin (0.8 mg/kg). Ocular adverse effects of isotretinoin are generally not serious and are reversible after discontinuation.

Genetic analysis of MEFV gene pyrin domain in patients with Behcet's disease.

Objectives. Behçets disease (BD) is a systemic vasculitis with recurrent oral and genital ulcers and uveitis. MEFV gene, which is the main factor in familial Mediterranean fever (FMF), is also reported to be a susceptibility gene for BD. The pyrin domain of MEFV gene is a member of death-domain superfamily and has been proposed to regulate inflammatory signaling in myeloid cells. This study was designed to determine if mutations in pyrin domain of MEFV gene are involved in BD. Methods. We analyzed the pyrin domain of MEFV gene in 54 Turkish patients with BD by PCR-analysis and direct sequencing. Results. Neither deletion or insertion mutations nor point mutations in pyrin domain were found in any patient. Conclusion. Although pyrin gene mutations have been reported in patients with BD, pyrin domain is not mutated. However, alterations in other regions of MEFV gene and interaction between pyrin domains are needed to be further investigated.

Patients with Behcet's disease carry a higher risk for microvascular involvement in active disease period

Background. Behcets disease (BD) is characterized with remissions and exacerbations. However, to date, there is no study to investigate a possible association of disease activity (active versus inactive disease period) with cardiovascular complications. Methods. Forty patients with BD were evaluated in both active and in inactive disease period. For the control group 45 healthy volunteers, age and sex matched, were registered. Subjects with at least a 15‐day lesion‐free period were regarded in inactive disease period, and subjects with any oral, skin, and/or genital lesion was regarded as in active disease period. In each subject coronary diastolic peak flow velocities (DPFV) were measured at baseline and after dipyridamole infusion (0.84 mg/kg over 6 minutes) using an Acuson Sequoia C256® echocardiography system. Coronary flow reserve (CFR) was defined as the ratio of hyperemic to baseline DPFV. Results. CFR values were significantly lower in BD patients compared to the controls (2.57±0.50 versus 2.87±0.53, P = 0.006). In active disease period, basal DPFV (24.6±7.5 versus 27.3±6.6, P = 0.019) was significantly higher than in the inactive disease period. In the active disease period hyperemic DPFV (61.7±14.9 versus 56.8±16.7, P = 0.015) values decreased significantly. Therefore, in the active disease period CFR significantly decreased from 2.57±0.50 to 2.09±0.46, P<0.001. The only independent predictor of CFR within the active disease period was the disease duration (β = −0.384, P = 0.012). Conclusion. Within the active disease period, coronary microvascular function is more prominently impaired in BD patients. Therefore, BD patients are possibly more vulnerable to cardiovascular manifestations when they are in an active disease period.

DETERMINATION OF DEFENSIN HNP-1 IN HUMAN SALIVA OF PATIENTS WITH ORAL MUCOSAL DISEASES

Saliva is a biological fluid that is easily obtainable and that can give useful information both in systemic and oral diseases. In this study, a chromatographic method was applied to determine the amount of defensin HNP-1 in human saliva of patients with oral mucosal diseases before and after treatments and compared with controls. Defensin human neutrophil peptide-1 (HNP-1) was identified and confirmed. The concentration of HNP-1 in saliva was determined by comparing the area of eluted HNP-1 with that of HNP-1 standard. Linear calibration range of defensin HNP-1 was 0.10 to 0.90 μg/10 μL with R2 values of 0.996. The concentrations of HNP-1 in the saliva of patients with oral lichen planus, Behçets disease, and recurrent apthous stomatitis were 33.6 ± 10.6, 15.5 ± 7.6, and 36.3 ± 9.5 μg mL−1 (mean ± S.D.), respectively. The salivary defensin-1 concentration was significantly higher in patients with oral mucosal diseases than in healthy volunteers; furthermore, in patients with oral mucosal diseases, the concentration was significantly higher before treatment than after treatment.

Impression cytology and ocular surface characteristics in patients with seborrhoeic dermatitis

Purpose:  To evaluate the clinical findings, tear film functions and ocular surface changes in patients with seborrhoeic dermatitis.

Psychiatric disorders in patients with Behçet's disease

Objective. In this study, we aimed to investigate current prevalence and related clinical factors of psychiatric disorders in Behçet patients. Methods. Seventy-three outpatients who applied to a Behçet clinic and whose diagnosis was Behçets disease according to criteria of the International Study Group for Behçets disease were recruited in this study. Psychiatric diagnoses were assessed with The Structured Clinical Interview for DSM-IV/Clinical Version (SCID-I/CV). Results. Thirty patients (41.1%) reported at least one current psychiatric disorder. Major depression (17.8%) was the most frequent psychiatric disorder. Specific phobia (16.4%), generalized anxiety disorder (15.1%) and social phobia (9.6%) were other frequent disorders. Prevalence rates of any psychiatric and anxiety disorder were significantly higher in females than males. There was no significant relationship between psychiatric morbidity and clinical characteristics of Behçets disease. Conclusion. Our study suggests that Behçet patients have high prevalence of psychiatric disorders. Therefore, psychiatric evaluation should be performed in all patients with Behçets disease.

NAT2 Gene Polymorphisms in Turkish Patients with Psoriasis Vulgaris.

Psoriasis is a common, chronic, and autoimmune skin disease. Factors that play a role in etiopathogenesis of psoriasis include internal factors such as genetic susceptibility and immunological factors and external factors such as stress, infection, trauma, drug, and environmental compounds. N-acetyltransferase 2 (NAT2) is a xenobiotic enzyme that is involved in the metabolism of drugs, environmental toxins, and carcinogens. In this study, we aimed to demonstrate whether the variations in the NAT2 gene lead to a predisposition to psoriasis by affecting the enzymes ability to metabolize drugs and environmental components or not. Three polymorphisms (rs1799929, rs1799930, and rs1799931) in NAT2 gene were genotyped and compared by real-time PCR method in 260 psoriasis vulgaris patients and 200 healthy controls. There was no difference in the genotype distributions and allele frequencies of polymorphisms between psoriasis vulgaris patients and controls. When the effects of polymorphisms on the clinical features of the disease, such as onset age and severity, are assessed, it has been found that rs1799930 and rs1799929 are, respectively, associated with early onset age and severity of the disease. In conclusion, rs1799929, rs1799930, and rs1799931 polymorphisms of the NAT-2 gene do not appear to be a risk factor for the development of psoriasis. Conversely, they may have an effect on either more severe or early onset cases of the disease.