Interleukin-2 gene polymorphism in Turkish patients with Behçet's disease and its association with ocular involvement.

Behçet's disease (BD) is a chronic immune-mediated systemic disease, characterized by oral and genital lesions and ocular inflammation. Several cytokine genes may play crucial roles in host susceptibility to BD, because the cytokine production capacity varies among individuals and depends on the cytokine gene polymorphisms. The association of the interleukin (IL)-2 gene polymorphisms with the susceptibility to BD was investigated in this study. DNA samples were obtained from a Turkish population of 97 patients with BD and 76 healthy control subjects. Polymorphisms of IL-2 gene at position -330 and +166 were determined using the polymerase chain reaction with sequence-specific primers. In the patients with BD, there was a significantly increased frequency of IL-2 -330 GT genotype. Interestingly, we demonstrated that the frequencies of IL-2 -330 GT and IL-2 + 166 GG genotypes were increased in BD patients with ocular involvement, whilst IL-2 -330 TT genotype was significantly decreased. Also, analysis of allele frequency demonstrated that the presence of G allele at position +166 of IL-2 seems to be a risk factor for ocular involvement. These results reveal that IL-2 -330 GT genotype may be a susceptibility factor for BD, whereas IL-2 -330 TT genotype seems to display a protective association with BD. Additionally, IL-2 gene polymorphisms might be associated with ocular involvement in BD.

Cytokine gene polymorphisms in Behçet's disease and their association with clinical and laboratory findings.

The association of the cytokine gene polymorphisms with the development of Behçet's Disease (BD) was investigated in this study. DNA samples were obtained from a Turkish population of 97 unrelated patients with BD, and 127 unrelated healthy control subjects.All genotyping (IL-6, IL10, IFN-gamma, TGF-Beta1 and TNF-alpha) experiments were performed using sequence-specific primers PCR. The frequency of TGF-Beta1 codon 25 GG genotype was found significantly lower in BD patients compared to healthy control subjects. The IL-10 -1082 GA genotype was more frequent whereas the AA genotype was less common in the BD group compared to the control group. The association between clinial findings and cytokine gene polymorphisms was further investigated in the patients with BD. The frequency of IFN-gamma AA genotype was lower in the patients with genital ulcer. Additionally, it was found that the frequency of IL-6 -174 GG genotype was lower in the patients with Pathergy positivity. These results suggest that TGF-Beta1 and IL-10 gene polymorphisms may affect host susceptibility to BD. Also, to confirm the biological significance of our results, further studies should be performed on other population groups and in large number of cases.

[Not Available].

AIM: We aimed to report our postoperative results in elderly patients that had off-pump coronary bypass grafting. METHOD: Data of 173 patients with isolated coronary bypass 70 years of age or older were retrospectively evaluated. One month follow-up data were evaluated in all patients. After getting verbal informed consent a total of 91 patients were included in the quality of life assessment via EuroQoL form. The data of patients with age of 70-74 and 75 or older were compared. RESULTS: The mean ages of patients at age of 70-74 and ≥75 were 71.69±0.16 and 76.81±0.23 years; respectively. Eleven cases had in-hospital mortality (%6 of 173 patients). The mean follow-up period for the group that were reached for EuroQoL assessment was 46,3 ± 20,8 months. The percent of cases among the whole study group that had participated in the quality of life questionnaire were in good condition in terms of mobility, self-care, usual activities, pain/discomfort, anxiety/depression were %75, %87, %81, %92 and %89; respectively. DISCUSSION: Off-pump coronary bypass operation may be safely used in elderly patients with high quality of life and low morbidity and mortality.

Assessment of the efficacy of bio-absorbable oxidized regenerated cellulose for prevention of post-operative pericardial adhesion in the rabbit model.

Pericardial adhesions complicate re-operative cardiac surgery and several attempts have been made to reduce adhesion formation. The efficacy of bio-absorbable oxidized regenerated cellulose in preventing post-operative pericardial adhesions was evaluated in the present study. Forty New Zealand white rabbits were divided into four groups of 10. In all rabbits an area of pericardium (2 x 2 cm) was excised. The wound was left open in groups 1 and 2 but replaced with bio-absorbable oxidized regenerated cellulose in groups 3 and 4. Rabbits in groups 1 and 3 were killed 3 weeks after surgery and those in groups 2 and 4 were killed at 6 weeks. Groups 1 and 2 showed more severe pericardial adhesions, more fibrous reaction and increased visibility of coronary vessels than groups 3 and 4, although there was no difference in inflammation. Light microscopy showed a mesothelium-like cell layer in groups 3 and 4. It is concluded that bio-absorbable oxidized regenerated cellulose may be suitable in patients receiving staged cardiac surgery and in those with a high probability of re-operation.

Idiopathic spontaneous coronary artery dissection: a case report.

Spontaneous coronary artery dissection frequently causes death, and most cases are diagnosed at autopsy. In most cases the affected persons are young pregnant females or women in the early postpartum period. We report a case of a female aged 36. She complained of acute chest pain and had ventricular fibrillation. She recovered after successful defibrillation. The coronary angiogram revealed dissection in the proximal left anterior descending artery. ST segment elevation was demonstrated on the electrocardiogram and the patient continued to have chest pains and underwent a coronary bypass operation. The etiology of spontaneous coronary artery dissection is still obscure and is mostly seen in young females. Early surgical intervention and stenting may save lives.

Sutureless vascular anastomoses by N-butyl-2 cyanoacrylate adhesive: an experimental animal study.

BACKGROUND: The purpose of this animal study was to find out whether sutureless anastomoses using N-butyl-2-cyanoacrylate were effective in the suppression of neointimal hyperplasia or not. MATERIAL AND METHODS: Ten male adult mongrel dogs were used in this animal study. The animals were randomly divided into a control group (n = 5) and a study group (n = 5). The study group underwent sutureless anastomoses using N-buthyl-2-cyanoacrylate adhesive. Infrarenal aortoaortic graft was interposed using polytetrafluoroethylene. RESULTS: In the study group, the mean intimal thickness at the proximal anastomosis was 27.4 +/- 1.94 microm and 27.4 +/- 1.51 microm at the distal anastomosis. In the control group, the mean intimal thickness was 138.4 +/- 5.02 mum at the proximal anastomosis and 67.6 +/- 6.42 microm at the distal anastomosis. Intimal thickness at the proximal and distal anastomoses in the control group was significantly (p < 0.001) greater than in the study group. Also, perianastomotic inflammation was more obvious in the control group compared to the study group (p < 0.01). CONCLUSION: Sutureless anastomoses using with N-butyl-2-cyanoacrylate adhesive might be a good alternative to conventional suture technique.

Long-term outcomes of basilic vein transposition fistula for hemodialysis.

BACKGROUND: There has been a dramatic increase in both the availability of hemodialysis and long-term survival of patients with chronic renal failure. Patients who require long-term hemodialysis need long-term vascular access. The transposed autologous basilic vein to brachial artery arteriovenous fistula provides vascular access in the absence of adequate superficial vein. PATIENTS AND METHODS: We follow an aggressive "all-autogenous" policy with regard to dialysis access and recommend prosthetic graft when autogenous options are exhausted. A retrospective analysis was performed of consecutive patients who underwent basilic vein transposition for hemodialysis access between January 2000 and March 2004. Mean follow-up was 21 months (range, 4 to 32 months). RESULTS: A retrospective review of 42 patients undergoing basilic vein transposition was performed. 18 of the patients were men and 24 patients were women. The mean age was 34.6 +/- 12.9 (mean +/- SD) years. Most of the patients were already receiving hemodialysis (92%), with a mean of 2.2 (range, 1 to 4) previous access attempts. Maturation rate was 85.7%. Primary patency rates were 71.4%, 54.7% and secondary (overall) patency rates were 88.0%, 64.2% at the end of the first and second years, respectively. Complications developed in 23 (54.7%) cases, and included arm edema, thrombosis, hematoma, infection, steal syndrome, poor flow and aneurysm formation. CONCLUSION: Transposed brachial-basilic fistula have a good long-term patency rate and should be considered early, before prosthetic grafting, in the absence of a suitable superficial vein.

Arterial lesions in Behçet's disease.

BACKGROUND: Arterial involvement is a rare but serious condition in the course of Behçet's disease. We aimed to assess the results of therapeutic approaches in our patients with arterial lesions caused by Behçet's disease. PATIENTS AND METHODS: The records of 534 patients with Behçet's disease between 1987 and 2002 were retrospectively evaluated for the presence of arterial lesions. All patients were followed up regularly at 3 to 6 months intervals. RESULTS: Arterial lesions were diagnosed in 21 (3.9%) patients. Eight of these patients had pulmonary artery aneurysms (PAA), and the other 13 patients had non-pulmonary arterial lesions. Urgent surgical intervention was performed in three patients with PAA leading to death in all three. In addition, three other patients died due to massive haemoptysis at home despite to immunosuppressive therapy. Only two out of eight patients with PAA are still alive who were treated with cyclophophamide and corticosteroids. Thirteen operations were performed in 7 out of 13 patients having non-pulmonary arterial lesions. Although ten of the operations were primary operations, three reoperations had to be performed. A stent-graft was applied for the management of an iliac artery aneurysm in one patient. Only one patient died 8 years after the first non-pulmonary arterial involvement following a type IV thoracoabdominal aortic aneurysm repair. Five patients with arterial occlusive lesions were successfully treated by corticosteroids. CONCLUSIONS: Pulmonary artery aneurysms in Behçet's disease patients have a poor prognosis despite any form of therapy. High dose corticosteroids alone can be successfully used for isolated non-pulmonary arterial occlusive lesions, unless disabling symptoms occur. Surgery or stent-graft insertion is indicated for non-pulmonary arterial aneurysms because these aneurysms entail high risk of complications.

[Blunt injury of the aortic arch: report of two cases]. / Künt arkus aorta yaralanmasi iki olgu sunumu.

Blunt injury of the aortic arch and its great vessels is rare. Although most of the cases die at the event side, those who can reach the hospital present with a clinic of pseudoaneurysm or arterial occlusion. The mainstay of diagnosis is to have a high suspicion index. As the physical examination findings are subtle, radiodiagnostic tools are helpful. Aortography is the most important investigation technique in suitable cases in order to plan surgery. Extracorporeal circulation and deep hypothermia may successfully be used with known side effects. In this study, we report our recent experience with two cases of blunt injury of the arcus aorta.

The assessment of internal mammary artery grafts by colour Doppler in coronary artery surgery.

BACKGROUND: Various studies in progress on the flow and diameter parameters based assessment and suitability of internal mammary artery by preoperative colour Doppler examination in coronary artery surgery. Postoperative visualisation of these grafts is also in evolution. Due to its noninvasive approach, colour Doppler sonography is taking its place in the follow-up of coronary artery bypass procedure. The aim of this study was to show the effectiveness and feasibility of colour Doppler in the routine postoperative follow-up evaluation. METHODS: In GATA Haydarpasa Education Hospital, coronary artery bypass grafting was performed by anastomosing left internal mammary artery to left anterior descending artery and saphenous veins to remaining lesions of the coronary arteries in 36 male patients between the ages of 42 to 66 (mean 54.8) in 1995. Left internal mammary artery and unused right internal mammary artery were imaged by colour Doppler six to eight weeks after the operations in all cases. Coronary angiography was also performed in two cases 4 months postoperatively. RESULTS: Colour Doppler sonography findings showed that the diameter of left internal mammary artery was larger (p=0.03) and mean flow value was greater than intact right internal mammary artery (p=0.02). CONCLUSIONS: These results shows that colour Doppler sonography should be applied as a noninvasive method, in the follow-up of internal mammary artery grafts after coronary artery revascularisation.

Venous lesions in Behçet's disease.

OBJECTIVES: Review of venous lesions in Behçet's disease (BD). DESIGN: Retrospective study. SETTING: University Hospital, Turkey. MATERIALS AND METHODS: One hundred and twenty nine patients with BD diagnosed and treated in our hospital during the last 10 years were reviewed. Fifty-two patients with 54 vascular lesions of Behçet's disease were identified. MAIN RESULTS: The incidence of isolated venous lesions in BD was 26%. Venous lesions developed after the initial diagnosis of BD in all patients within 10 years. Thirty-four (63%) of the 54 vascular lesions were venous and 15 (28%) were arterial. In 5 (9%) patients, both arterial and venous lesions were present. Deep vein thrombosis was the most frequent lesion (76%), followed by superficial thrombophlebitis (10%), superior vena cava thrombosis (10%) and inferior vena cava thrombosis (2%) and varicose veins (2%). CONCLUSIONS: Venous lesions are not rare and affect the prognosis of BD. For this reason, venous lesions of BD should always be sought at follow-up of patients with BD.

Synthesis of nucleoside 3'-(S-alkyl phosphorothioates) and their use as substrates for nucleases.

The synthesis of cytidine, uridine, guanosine, and adenosine 3'-(S-methyl phosphorothioates) by treatment of the 2',5'-di-O-(4-methoxytetrahydropyran-4-yl)ribonucleosides with 2-(methylthio 4H-1,3,2-benzodioxaphosphorin 2-oxide is described. These nucleotide analogues are stable compounds both in the solid state and the neutral aqueous solution. All four of these compounds are degraded by RNase T2 to the parent nucleotides and methanethiol. In addition, cytidine and uridine 3'-(S-methyl phosphorothioates) are substrates for bovine pancreatic ribonuclease and guanosine 3'-(S-methyl phosphorothioate) is a substrate for RNase T1 and RNase U1. When used in conjunction with a chromophore-producing reagent, nucleoside 3'-(S-methyl phosphorothioates) provide a means for direct kinetic measurement of ribonuclease activity over a wide pH range (pH 2-9). The reactivities of these substrates with ribonucleases are compared to the reactivities of other synthetic substrates as well as a number of natural substrates. The utility of ribonucleoside 3'-(S-methyl phosphorothioates) as substrates for the assay of ribonucleases is discussed.