We report a patient and his family, who have branchio-oto-renal (BOR) syndrome and coexisting mitral valve prolapse. A literature review of BOR syndrome failed to identify any similar families and we report this as a new observation. During the preoperative assessment of a patient with BOR syndrome, tachycardia was noted and a cardiologic examination including echocardiography revealed mitral valve prolapse. Members of his extended family were investigated, including carrying out cardiology and otolaryngology examinations to determine whether they had signs of either BOR syndrome or cardiac problems. Mitral valve prolapse was identified in five (71.4%) of the seven BOR syndrome patients in the family. Deafness was present in all patients. Distribution of the other clinical findings of the BOR syndrome patients were as follows: branchial fistula in five (71.4%), preauricular pits in four (57.1%), ear deformity in two (28.5%), renal anomalies in three (42.8%), lacrimal duct anomaly in two (28.5%) and orbital anterior compartment anomaly in one (14.2%). We conclude that mitral valve prolapse can be associated with BOR syndrome. Further large studies are needed to clarify this association.

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We investigated the effects of smokeless tobacco on the survival of random-pattern skin flaps in rats. Twenty rats were divided into two groups (n=10 each). In the experimental group 200 mg smokeless tobacco (Maras powder) (1 mg nicotine) was inserted intraorally once a day for seven days under general anaesthesia. It was not given to the control group, but the rats were similarly anaesthetised with ketamine. On day 8, plasma cotinine concentrations were measured. The random-pattern dorsal skin flaps measuring 3 x 10 cm were then raised and resutured. Percentage survival area was assessed after a further eight days. The mean (SD) survival was 39 (7)% in the experimental, and 65 (8.9)% in the control, groups (p=0.0001). The mean (SD) plasma cotinine concentrations were 124.4 (73) ng/ml and <10 ng/ml, respectively. Smokeless tobacco use increased the incidence of flap necrosis in random-pattern skin flaps in rats.

We report on a 17-year-old man who presented with unreported combination of right sided microtia and preauricular skin tag with conductive hearing loss, unilateral renal agenesis, partial syndactyly of forth and fifth metacarpals, multiple tarsal coalitions, absent toe, and hypoplastic tibia and fibula. Radiological and clinical findings did not match with the previously described syndromes with the type of anomalies seen in the case. We propose that this represents a new syndrome.

Aim: One of the main functions of apoptosis is the elimination of cells with damaged DNA, including premalignant cells in skin. Apoptosis is regulated by the balance between antiapoptotic and proapoptotic proteins. The bcl-2 protein has been shown antiapoptotic effect. It protects cell against apoptosis induced by different death-inducing signals. Material and Methods: In this study the authors have analyzed imunohistochemically the expression of bcl-2 protein in the histopathological variants of the precancerous lesion [actinic keratosis (AK) (28 cases) and keratoacanthomas (KA) (12 cases) and seborrheic keratosis (SK) (22 cases) in skin. Results: In cases of AK, bcl-2 expression was confined to basal cell layer, as well as in two cases of thorough epidermis. SK expression of bcl-2 protein was in areas of basaloid proliferation.KA expression of bcl-2 protein was not dome-shaped keratin-filled crater areas but bcl-2 expression was confined of non crater areas. Conclusion: In conclusion, bcl-2 expression supports the observation that tumor cells are derived from basal keratinocytes in AK and SK and not support the observation that tumor cells are derived from basal keratinocytes in KA.

PURPOSE:To investigate the effects of pharmacological delay with insulin-like growth factor-1 (IGF-1) on skin flap survival. METHODS:Thirty Sprague-Dawley rats were submitted to dorsal skin flap (3x9 cm). Seven days before the surgery, the animals were subdivided into three groups of 10 rats. In group 1 (controls), no injection was done. Seven days before the elevation, saline had been injected to the marked skin flap area in group 2 (sham group), and group 3 (experimental group) underwent a pharmacological delay with subcutaneous IGF-1 injections. On the seventh postoperative day, flap area was analyzed for survival. Tissue samples were obtained for histological and biochemical evaluations. RESULTS:Survival rates were 43.55 ± 16%, 21.40 ± 8%, and 43.12 ± 14% in groups 1, 2, and 3, respectively. Differences between group 2 and other groups were statistically significant. No significant difference was detected between all three groups for tissue or plasma vascular endothelial growth factor (VEGF) levels. There was no significant histological difference between groups. CONCLUSION:Although a single injection of insulin-like growth factor-1 (IGF-1) did not significantly increase flap survival, its wound healing features are still encouraging and further meticulously planned studies, especially with repeated applications or controlled-release methods, and combinations with binding protein are required.

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Objective: The skin is the largest organ of our body and may develop different benign skin lesions in different periods of life. Benign skin lesions generally cause cosmetic discomfort and morbidity is not high. However, as part of some syndromes they may be precursors of paraneoplastic or metabolic diseases. In this study benign skin lesions frequently sent to Ordu University Faculty of Medicine Pathology Department were analyzed and discussed accompanied by the literature. Material and Methods: The study included 127 benign skin lesion cases with diagnosis at the pathology laboratory in our center in 2015 and 2016. Preparations were retrospectively reassessed and current diagnoses recorded. The age, gender and lesion localization of patients included in the study were recorded. Results: Of cases, 34 had epidermal cyst, 33 had fibroepithelial polyp, 10 had squamous papilloma, 23 had seborrheic keratosis, 18 had trichilemmal cyst and 9 had verruca vulgaris. Of all cases 55.2% were male and 44.8% were female. There were 69 cases (54%) with head and neck localization, and 58 cases (46%) with localization other than the head and neck. Head and neck localization was present for 41% of epidermal cysts, 88% of trichilemmal cysts, all squamous papilloma, 21% of fibroepithelial polyps, 65% of seborrheic keratosis and 77% of verruca vulgaris. Conclusion: There were higher male patient rates among cases included in the study. According to frequency, locations included the head-neck, trunk, genital region and extremities. Disease was identified in all age ranges. The study concluded that for diagnostic methods to be effective and accurate for benign skin lesions, it is necessary to use pathologic methods.