Intestinal Perforations in Behçet’s Disease

Behçet’s disease accompanied by intestinal involvement is called intestinal Behçet’s disease. The intestinal ulcers of Behçet’s disease are usually multiple and scattered and tend to perforate easily, so that many patients require emergency operation. The aim of this study is to determine the extent of surgical resection necessary to prevent reperforation and to point out the findings of concurrent oral and genital ulcers and multiple intestinal perforations in all patients of our series. During a 25-year study period, information of 125 Behçet’s disease cases was gathered. Among the 82 patients who were diagnosed with intestinal Behçet’s disease, 22 cases had intestinal perforations needing emergency laparotomy. We investigated and analyzed these cases according to the patients’ demographic characteristics, clinical presentations, laboratory data, and surgical outcome. There were 14 men and 8 women ranging from 22 to 65 years of age. Nine cases were diagnosed preoperatively, and the diagnoses were confirmed in all 22 cases during the surgical intervention. Surgical resection was performed in every patient, with right hemicolectomy and ileocecal resection in 11 cases, partial ileum resection in 8 cases with two reperforations, and ileocecal resection in 3 cases with one reperforation

TURKIYE KLINIKLERI TIP BILIMLERI DERGISI

Objective: Experimental studies showed that fibrin glue (FG) which was used in orchidopexy and testicular torsion caused less tissue damage in the ipsilateral testis when compared with the transparenchymal suture materials. However, whether the usage of the FG in testis fixation causes any histological changes in the contralateral testis is not known. The aim of this study was to compare the effects of FG and other suture materials on the contralateral testis where no surgical procedure is performed. Material and Methods: Fifty prepubertal rats were randomly divided into 5 groups and the tunica vaginalis of all the right testes were longitudinally incised. In group 1, the incision line was closed with FG, whereas silk, catgut and polypropylene were used respectively in the groups 2, 3 and 4. Group 5 was the control group and no surgical procedure was performed on the left testes. The rats were sacrificed 3 weeks later and the diameters of the right and left testes were measured. Testes were evaluated by means of inflammation, seminiferous tubular diameter (STD), spermatogenetic activity and epididymal inflammation. Result: In group 2, 3 and 4, spermatogenetic activity, STD and the testis diameter of the ipsilateral testes decreased, whereas testicular and epidydimal inflammation increased. When the contralateral testis was evaluated, STD of the FG group decreased and FG had no extra benefit on testicular histology when compared to other suture materials. Conclusion: Surgical procedures performed on the ipsilateral testis cause only a decrease in the contralateral STD, which is observed by light microscope, but this decrease seems to have no effect on the spermatogenetic activity. Besides, the usage of FG instead of other materials in testis fixation has no extra benefit. However, it must be kept in mind that these results might vary when ultrastructural and immunological evaluations are performed

Reaktionstechnische Untersuchungen zur extrazellulären Produktion humaner Calcitonin-Precursor mit Staphylococcus camosus

This study presents the development of a fedbatch process for the production of secreted heterologous proteins using the Gram-positive bacterium Staphylococcus carnosus up to a semi-technical scale

Immunohistology of Skin Pathergy Reaction in Behçet's Disease

The immunophenotypic characteristics of the skin pathergy reaction (SPR) at 48 h in Behçet's disease (BD) were investigated in 12 patients with BD and in five controls. The findings in 11 positive and one negative SPR lesions of patients with BD were evaluated in comparison with those of normal adjacent skin and with the negative pathergy biopsies from the controls. Positive SPR biopsies showed variable epidermal thickening and cell vacuolization, as well as subcorneal pustule formation. In the SPR dermis, a variable dense focal mononuclear cell (MNC) infiltrate was seen around vessels and skin appendages, extending into the deep dermis. The MNC infiltrate was predominantly composed of T lymphocytes and monocytes/macrophages. The majority of the T lymphocytes were CD4+, and almost all expressed CD45RO. Approximately half of the infiltrating cells strongly expressed HLA-DR. Neutrophils constituted less than 5% of the infiltrating cells, but were present as clusters of elastase-positive cells at the needle-prick sites. Vessels within the lesion showed marked congestion and endothelial swelling. The endothelial cells expressed ICAM-1 strongly, and E-selectin moderately. VCAM-1 was not expressed on endothelial cells. The basal and mid-epidermal layers of keratinocytes expressed HLA-DR and ICAM-1 strongly, particularly so in areas close to the dermal MNC infiltrates. In negative pathergy biopsies, there were increased numbers of neutrophils and a few small clusters of macrophages and T lymphocytes only at the needle-prick site, and the endothelial cells of vessels close to these areas expressed E-selectin weakly. The immunohistological findings of the SPR appear to indicate an augmented antigen-independent non-specific induction phase of the inflammatory response. Absence of VCAM-1 expression by endothelial cells suggests that direct epidermal injury is the cause of the cutaneous inflammation

IMMUNOHISTOLOGY OF SKIN PATHERGY REACTION IN BEHCETS-DISEASE

The immunophenotypic characteristics of the skin pathergy reaction (SPR) at 48 h in BehCet's disease (BD) were investigated in 12 patients with BD and in five controls. The findings in 11 positive and one negative SPR lesions of patients with ED were evaluated in comparison with those of normal adjacent skin and with the negative pathergy biopsies from the controls. Positive SPR biopsies showed variable epidermal thickening and cell vacuolization, as well as subcorneal pustule formation, In the SPR dermis, a variable dense focal mononuclear cell (MNC) infiltrate was seen around vessels and skin appendages, extending into the deep dermis. The MNC infiltrate was predominantly composed of T lymphocytes and monocytes/macrophages. The majority of the T lymphocytes were CD4(+), and almost all expressed CD45RO, Approximately half of the infiltrating cells strongly expressed HLA-DR, Neutrophils constituted less than 5% of the infiltrating cells, but were present as clusters of elastase-positive cells at the needle-prick sites. Vessels within the lesion showed marked congestion and endothelial swelling, The endothelial cells expressed ICAM-1 strongly, and E-selectin moderately, VCAM-1 was not expressed on endothelial cells. The basal and mid-epidermal layers of keratinocytes expressed HLA-DR and ICAM-1 strongly, particularly so in areas close to the dermal MNC infiltrates, In negative pathergy biopsies, there were increased numbers of neutrophils and a few small clusters of macrophages and T lymphocytes only at the needle-prick site, and the endothelial cells of vessels close to these areas expressed E-selectin weakly, The immunohistological findings of the SPR appear to indicate an augmented antigen-independent non-specific induction phase of the inflammatory response. Absence of VCAM-1 expression by endothelial cells suggests that direct epidermal injury is the cause of the cutaneous inflammation