Although the pathophysiology of systemic sclerosis (SSc) is not fully clarified, there are considerable data implicating abnormalities of microvascular changes, fibroblast activation and immune system abnormalities. Immune system activation may play a part as a stimulus in both fibrotic and vascular damage.1 To investigate the immune system abnormalities in the pathogenesis of SSc we evaluated lymphocyte phenotypes in patients with SSc and healthy controls by flow cytometry (Epics Profile II) for total T (CD3), T helper (CD4), T supressor (CD8), B lymphocyte cell surface marker (CD19), activation marker (CD25) and natural killer (NK) cell surface marker NKH-1 (CD56).
We studied 29 patients (27 women, two men) 16 limited, 12 diffuse and one overlap who fulfilled preliminary criteria for classification of SSc.2 Anti-nuclear antibody was positive in 25 (86.2%) and anti-Scl70 antibodies was positive in seven (24.1 %) patients. The age range of the patients was 20–63 years (mean (SEM) 40 (5)) and the mean (SEM) disease duration was 5.6 (5.5) years. …
In recent years, it has been demonstrated that losartan lowers macroproteinuria in diabetic or non‐diabetic renal transplant recipients (RTx) similar to angiotensin converting enzyme (ACE) inhibitors. Microalbuminuria (MAU) may reflect subclinical hyperfiltration damage of the glomerulus. It could be a marker of kidney dysfunction in renal transplantation. The aim of the study was to assess the efficacy of losartan in hypertensive RTx with MAU. This study was conducted in 17 (M/F: 4/13) stable RTx. No change was made in the medical treatment of the patients. All cases received 50 mg/day losartan therapy for 12 wk. Renal functions and MAU were determined 12 and 6 wk and just before the treatment as well as sixth and twelfth week of the treatment in all patients. Losartan satisfactorily lowered systemic blood pressure. A significant reduction in MAU was observed from 103 ± 53 μg/min at the beginning to 59 ± 25 μg/min in the sixth week and 47 ± 24 μg/min in the twelfth week (p=0.0007 and 0.0005, respectively). From the sixth week of the treatment, the therapy significantly decreased hemoglobin, hematocrit and erythrocyte levels but did not change mean leukocyte and platelet counts, urea, creatinine levels and creatinine clearances. No serious side‐effect was observed during the study. In conclusion, we found that losartan decreased MAU in hypertensive RTx. For that reason, it might be considered as the first choise antihypertensive agent for the renoprotection in selected patients.
Summary 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 .
To investigate pituitary and growth hormone status in patients with fibromyalgia (FM) and their response to balneotherapy. This is a nonrandomized controlled trial performed with the outpatients and hospital staff. 20 FM patients diagnosed according to American College of Rheumatology (ACR) criteria and 20 healthy controls who volunteered to participate in the study were selected from 64 outpatients and 24 hospital staff. All of the participants completed the study except 1 FM patient. Both groups had balneotherapy by the supervision of a physiotherapist for totally 3 weeks (15 sessions). Analysis of adrenocorticotropic hormone (ACTH), growth hormone (GH), cortisol and insuline like growth factor-1 (IGF-1) were done before and after the balneotherapy sessions at the first and the last days of the study in both of the groups. Pain is evaluated by the number of tender points (NTP) by a pressure algometer. Both of the groups showed non-significant hormonal changes after balneotherapy session at the 1st day of the study, except IGF-1 increase in favor of FM patients. When the groups were compared by percent of changes, difference was found between the groups for change in GH, cortisol and IGF-1 levels. GH baseline values and IGF-1 were negatively correlated with the decrease in NTP in the FM patients. GH insensitivity and improper IGF-1 levels are observed in FM patients and it is found that decrease in tender points was in negative correlation with IGF-1 increase as a therapeutic response to balneotherapy.
Over the last ten years (1976-1986), 3,041 hemodialyses have been performed with 6,082 femoral vein catheterization in 336 patients with chronic renal failure. In the 3,041 hemodialyses, severe hematoma (0.29%), superficial hematoma (5.55%), and retroperitoneal hematoma (0.06%) have been observed. In 29 patients whose hemodialyses have been performed successively with femoral vein catheterization over a period of three to twelve months, subcutaneous fibrosis was observed in 24 and femoral vein regional narrowing was seen in 2.
