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    The evaluation of Kaposi sarcoma patients diagnosed at a single center
    (Ortadogu Ad Pres & Publ Co, 2007) Pamuk, Guelsuem Emel; Doenmez, Salim; Yesil, Yusuf; Tekguenduez, Emre; Turgut, Burhan; Demir, Muzaffer
    Objective: To determine the general clinical features, treatment modalities and response to treatment in 5 Kaposi sarcoma (KS) patients diagnosed at our center. Material and Methods: Five patients diagnosed with KS at Trakya University Medical Faculty, Department of Internal Medicine, Division of Hematology between October 2001-October 2006 were retrospectively evaluated. Results: KS developed secondary to immunosuppression in four of five patients, one had classical type KS. Four patients were males, and one was female. The diagnoses in patients who used immunosuppressive therapy were aplastic anemia, Hodgkin lymphoma, MDS-RAEB II, and chronic inflammatory demyelinating polyneuropathy (CIDP). We discontinued immunosuppressive therapy and administered vincristine in the aplastic anemia patient. KS lesions disappeared spontaneously although chemotherapy continued in the Hodgkin lymphoma case. KS lesions were present on initial presentation in the patient with MDS-RAEB H; there was prominent progression after chemotherapy and regression was achieved after paclitaxel. KS lesions disappeared spontaneously in the CIDP patient after discontinuation of corticosteroids. In the patient with classical type KS, KS lesions regressed after adriamycin and one persistent big lesion was surgically excised. Conclusion: There was partial or complete improvement of KS lesions after discontinuation of immunosuppressive drugs in some of our patients and with systemic chemotherapeutics in the others. As the diagnosis of this disease requires suspicion in especially early stages, hematologists should consider KS in the differential diagnosis of skin lesions in their immunosuppressive patients and a skin biopsy should be obtained.
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    Phrenic neuropathy in diabetic and prediabetic patients without neuromuscular complaint
    (Springer-Verlag Italia Srl, 2013) Yesil, Yusuf; Ugur-Altun, Betul; Turgut, Nilda; Ozturk, Zeynel Abidin; Kuyumcu, Mehmet Emin; Yesil, Nesibe Karahan; Caner, Sedat
    Neuropathy, one of the major reasons of morbidity in diabetes mellitus (DM), is associated with prediabetic conditions as well as DM. The present study aims to compare phrenic and peripheral nerves in prediabetic, diabetic patients and healthy controls. A total of 37 diabetic, 40 prediabetic patients and 18 healthy controls were enrolled in the study. All subjects underwent conventional sensory and motor nerve conduction studies. Bilateral phrenic and peripheric nerve conduction studies were performed. In both right and left phrenic nerves, the amplitudes were lower in prediabetic and diabetic patients than control subjects, respectively (p: 0.005 and p: 0.001). Both of the phrenic nerve conductions were altered similarly. The results of our study demonstrate that phrenic nerves are affected like peripheric nerves in prediabetic and diabetic patients. We suggest reminding phrenic neuropathy in newly onset respiratory failure in diabetic and prediabetic patients.
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    The results of purified protein derivative test in ankylosing spondylitis patients: clinical features, HRCT results and relationship with TNF-blocker usage
    (Springer Heidelberg, 2008) Pamuk, Omer Nuri; Yesil, Yusuf; Donmez, Salim; Unlu, Ercument; Koker, Ibrahim Hakki; Cakir, Necati
    In this study, we evaluated the clinical features, treatment modalities, including TNF-blockers, purified protein derivative (PPD) test, chest X-ray and HRCT results in our AS patients. We evaluated the clinical features, disease activity and PPD results in 88 AS patients (72 males, 16 females, mean age: 38.3 +/- 10) diagnosed at our center. 119 RA, 28 SLE and 27 gouty arthritis patients followed up at the same time period were taken as the control group. The mean disease duration in AS patients was 12.6 +/- 8.3 years. The frequency of PPD positivity in AS patients (77.3%) was similar to that in gouty arthritis (70.4%) patients; and significantly higher than the frequency in SLE (21.4%) and RA (35.3%) patients (P values < 0.001). There was a chest X-ray abnormality in 20 AS patients (22.7%). When subjects (11 patients, 12.5%) with apical fibrosis, aspergillosis, previous or active TB on chest X-ray and/or HRCT were compared to others; it was observed that they were older (P < 0.001), had longer disease duration (P = 0.006); and less chest expansion (P = 0.01). Fifty patients were administered TNF-blockers. The PPD test was positive in 38 of patients (76%) using TNF-blockers. All of these patients were given isoniazid prophylaxis. After a median follow up of 18 months, TB did not develop. In Turkey which is a country with a relatively high incidence of TB, in spite of a higher frequency of PPD positivity in AS patients compared to RA and SLE patients, TNF-blockers did not result in any TB with suitable prophylaxis.