Two cases of hereditary benign telangiectasia in Turkey: sporadic occurrence with punctate telangiectasias surrounded by anemic halos.

Hereditary benign telangiectasia (HBT) is a very uncommon, genetically inherited, benign skin disorder, identified by widespread cutaneous telangiectasias. Herein, we present two sporadic cases of HBT that were admitted to the dermatology clinic for multiple punctate telangiectasias surrounded by anemic halos, favoring sun-exposed areas. These cases had no mucosal or visceral involvement and exhibited no family history of the disorder. The phenotypes of HBT are clinically and genetically heterogeneous. More clinical experience and genetic analyses are needed to understand the basis for the genetic heterogeneity and to determine genotype-phenotype correlations. We aimed to emphasize the hereditary and clinical heterogeneity of HBT by presenting two cases of HBT with punctate telangiectasias surrounded by anemic halos, with a sporadic occurrence.

Effects of tamoxifen citrate on postoperative intra-abdominal adhesion in a rat model.

BACKGROUND/AIMS: The aim of this study was to evaluate the effects of oral tamoxifen citrate on postoperative intra-abdominal adhesions. MATERIALS AND METHODS: Forty five rats were randomly separated in to 3 groups. Group 1: Control group (15 rats), Group 2: tmx 1 group (15 rats) and Group 3: tmx 10 group (15 rats). The cecum was abraded with a sterile gauze until subserosal hemorrhage had developed. Full- thickness 4-0 silk sutures were also placed in the traumatized anterior cecal wall to increase the adhesive reaction. In Group 1 (control group), adhesion induction was performed and no treatment was given. In Group 2 (tmx 1 group), after adhesion induction, 1 mg/kg/day tamoxifen citrate was given by orogastric gavage. In Group 3 (tmx 10 group), adhesion induction was performed and 10 mg/kg/day tamoxifen citrate was given by orogastric gavage. Rats were sacrificed on postoperative day 30. At the time of second surgery, after the abdominal fascia had been opened blood samples were collected to evaluate serum TGFß-1 levels and following the macroscopic adhesion scoring, tissue specimens of the bowel and adhesions were subjected to histopathological investigation. RESULTS: In group 1 and group 2 we detected higher scores for the macroscopic classification (2.25 ± 1.13 vs. 1.53 ± 0.77) and histopathological scores (2.72 ± 0.64 vs. 2.53 ± 0.87) for fibrosis and serum TGFß-1 levels (42000 ± 2935 vs. 32988 ± 10804). In group 3 we have detected decreased scores for macroscopic classification (0.91 ± 0.51) and histopathological scores (1.58 ± 0.90) for fibrosis and serum TGFß-1 levels (22847 ± 4976). There were no significant differences between group 1 and group 2 according to the macroscopic classification and pathological scores for fibrosis. There were statistically significant difference between tamoxifen 10 mg/kg group and the other groups according to macroscopic classification ( P: G1-3: 0.004; G2-3: 0.046), pathological scores for fibrosis (P: G1-3: 0.004; G2-3: 0.011) and serum TGFß-1 levels (P: G1-3:<0.001). CONCLUSIONS: In conclusion tamoxifen citrate seems to be useful for preventing postoperative intra-abdominal adhesions. Its effects are in a dose and time dependent manner. Further studies must be carried out to use tamoxifen for preventing intra-abdominal postoperative adhesions in clinical practice.

[Posttraumatic primary cutaneous aspergillosis with Candida guilliermondii infection in a healthy host]. / Saglikli bir olguda posttravmatik primer kütanöz aspergillozis ve Candida guilliermondii enfeksiyonu birlikteligi.

Opportunistic fungal infections are usually seen in immunocompromised patients. While Candida is the most prevalent agent in such infections, Aspergillus is at the second order. Primary cutaneous aspergillosis is most common in immunocompromised patients but can rarely be seen in healthy hosts as well. We report a case of posttraumatic primary cutaneous aspergillosis and Candida guilliermondii coinfection in a 70-years-old healthy man. The patient had an ulcerous lesion which developed in the site of a trauma on the middle finger of the right hand. Histopathological examination of the biopsy specimens revealed septate hyphae with dichotomous branching small circular blastospores. The cultures of the biopsy specimen yielded yellow-green colored, granular mold colonies and creamy white yeast colonies. Microscopic examination of the lactophenol cotton blue stained mold colonies indicated long conidiophores with vesicles surrounded by uniseriate phialides, compatible with Aspergillus flavus. Yeast colonies were identified as Candida guilliermondii by ID32C (BioMerieux, France) and by their microscopical morphology detected in corn meal-Tween 80 agar incubated at 25°C for 72 hours. The patient was treated properly with surgical debridement and itraconazole therapy. Since the immune system is compressed as a consequence of aging, cutaneous opportunistic fungal infections should be considered in the differential diagnosis of posttraumatic necrotic ulcers and black eschar in aged patients.

[Very rare presentation of extrapulmonary tuberculosis: primary gastric tuberculosis]. / Akciger disi tüberkülozun nadir görülen bir sekli: Primer gastrik tüberküloz.

The most common site for gastrointestinal involvement in tuberculosis is the ileocecal region. Tuberculosis of stomach is quite uncommon. It is usually associated with pulmonary tuberculosis or with immunodeficiency. In this case non specific gastrointestinal complaints yielded a diagnosis of primary gastric tuberculosis, which is very rare. Absence of pulmonary focus and endoscopic findings of pangastritis are different features of this case which makes it presentable.