1
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Akgul M, Williamson SR, Ertoy D, Argani P, Gupta S, Caliò A, Reuter V, Tickoo S, Al-Ahmadie HA, Netto GJ, Hes O, Hirsch MS, Delahunt B, Mehra R, Skala S, Osunkoya AO, Harik L, Rao P, Sangoi AR, Nourieh M, Zynger DL, Smith SC, Nazeer T, Gumuskaya B, Kulac I, Khani F, Tretiakova MS, Vakar-Lopez F, Barkan G, Molinié V, Verkarre V, Rao Q, Kis L, Panizo A, Farzaneh T, Magers MJ, Sanfrancesco J, Perrino C, Gondim D, Araneta R, So JS, Ro JY, Wasco M, Hameed O, Lopez-Beltran A, Samaratunga H, Wobker SE, Melamed J, Cheng L, Idrees MT. Diagnostic approach in TFE3-rearranged renal cell carcinoma: a multi-institutional international survey. J Clin Pathol 2021; 74:291-299. [PMID: 33514585 DOI: 10.1136/jclinpath-2020-207372] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 01/07/2021] [Indexed: 12/19/2022]
Abstract
Transcription factor E3-rearranged renal cell carcinoma (TFE3-RCC) has heterogenous morphologic and immunohistochemical (IHC) features.131 pathologists with genitourinary expertise were invited in an online survey containing 23 questions assessing their experience on TFE3-RCC diagnostic work-up.Fifty (38%) participants completed the survey. 46 of 50 participants reported multiple patterns, most commonly papillary pattern (almost always 9/46, 19.5%; frequently 29/46, 63%). Large epithelioid cells with abundant cytoplasm were the most encountered cytologic feature, with either clear (almost always 10/50, 20%; frequently 34/50, 68%) or eosinophilic (almost always 4/49, 8%; frequently 28/49, 57%) cytology. Strong (3+) or diffuse (>75% of tumour cells) nuclear TFE3 IHC expression was considered diagnostic by 13/46 (28%) and 12/47 (26%) participants, respectively. Main TFE3 IHC issues were the low specificity (16/42, 38%), unreliable staining performance (15/42, 36%) and background staining (12/42, 29%). Most preferred IHC assays other than TFE3, cathepsin K and pancytokeratin were melan A (44/50, 88%), HMB45 (43/50, 86%), carbonic anhydrase IX (41/50, 82%) and CK7 (32/50, 64%). Cut-off for positive TFE3 fluorescent in situ hybridisation (FISH) was preferably 10% (9/50, 18%), although significant variation in cut-off values was present. 23/48 (48%) participants required TFE3 FISH testing to confirm TFE3-RCC regardless of the histomorphologic and IHC assessment. 28/50 (56%) participants would request additional molecular studies other than FISH assay in selected cases, whereas 3/50 participants use additional molecular cases in all cases when TFE3-RCC is in the differential.Optimal diagnostic approach on TFE3-RCC is impacted by IHC and/or FISH assay preferences as well as their conflicting interpretation methods.
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Affiliation(s)
- Mahmut Akgul
- Pathology, Albany Medical Center, Albany, New York, USA
| | - Sean R Williamson
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Dilek Ertoy
- Department of Pathology, Koc University School of Medicine, Istanbul, Turkey
| | - Pedram Argani
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Sounak Gupta
- Department of Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Anna Caliò
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, Verona, Veneto, Italy
| | - Victor Reuter
- Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Satish Tickoo
- Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Hikmat A Al-Ahmadie
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - George J Netto
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ondrej Hes
- Faculty of Medicine in Plzen, Charles University, Plzen, Czech Republic.,Medical Teaching School, University Hospital, Charles University, Plzen, Czech Republic
| | - Michelle S Hirsch
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Brett Delahunt
- Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, Wellington South, New Zealand
| | - Rohit Mehra
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Stephanie Skala
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Adeboye O Osunkoya
- Department of Pathology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Lara Harik
- Department of Pathology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Priya Rao
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ankur R Sangoi
- Department of Pathology, El Camino Hospital, Mountain View, California, USA
| | - Maya Nourieh
- Department of Pathology, Institut Curie, Paris, France
| | - Debra L Zynger
- Department of Pathology, The Ohio State University Medical Center, Columbus, Ohio, USA
| | - Steven Cristopher Smith
- Department of Pathology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Tipu Nazeer
- Pathology, Albany Medical Center, Albany, New York, USA
| | - Berrak Gumuskaya
- Department of Pathology, Yildirim Beyazit University School of Medicine, Ankara, Turkey
| | - Ibrahim Kulac
- Department of Pathology, Koc University School of Medicine, Istanbul, Turkey
| | - Francesca Khani
- Department of Pathology, Cornell University Joan and Sanford I Weill Medical College, New York City, New York, USA
| | - Maria S Tretiakova
- Department of Pathology, University of Washington, Seattle, Washington, USA
| | - Funda Vakar-Lopez
- Department of Pathology, University of Washington, Seattle, Washington, USA
| | - Guliz Barkan
- Department of Pathology, Loyola University Health System, Maywood, Illinois, USA
| | - Vincent Molinié
- Pathology, University Hospital Center of Martinique, Fort-de-France, Martinique
| | - Virginie Verkarre
- Department of Pathology, Hôpital Européen Georges Pompidou Anatomie Pathologie, Paris, Île-de-France, France
| | - Qiu Rao
- Department of Pathology, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China
| | - Lorand Kis
- Department of Pathology, Karolinska Institute, Stockholm, Sweden
| | - Angel Panizo
- Department of Pathology, Complejo Hospitalario de Navarra Servicio de Cardiologia, Pamplona, Navarra, Spain
| | - Ted Farzaneh
- Department of Pathology, Univer Irvine Healthcare, Orange County, California, USA
| | - Martin J Magers
- IHA Pathology and Laboratory Medicine, Ann Arbor, Michigan, USA
| | - Joseph Sanfrancesco
- Department of Pathology, Charleston Area Medical Center, Charleston, South Carolina, USA
| | - Carmen Perrino
- Department of Pathology, Mount Auburn Hospital, Cambridge, Massachusetts, USA
| | - Dibson Gondim
- Department of Pathology, University of Louisville, Louisville, Kentucky, USA
| | - Ronald Araneta
- Department of Pathology, Hartford Hospital, Hartford, Connecticut, USA
| | - Jeffrey S So
- Department of Pathology, St Luke's Hospital, Manila, Philippines
| | - Jae Y Ro
- Department of Pathology, Houston Methodist Hospital, Houston, Texas, USA
| | - Matthew Wasco
- Department of Pathology, St Joseph Mercy Hospital, Ann Arbor, Michigan, USA
| | - Omar Hameed
- Forward Pathology Solutions, Vanderbilt University, Kansas City, Montana, USA
| | - Antonio Lopez-Beltran
- Department of Pathology and Surgery, Cordoba University Medical School, Cordoba, Spain
| | | | - Sara E Wobker
- Department of Pathology, University of North Carolina System, Chapel Hill, North Carolina, USA
| | - Jonathan Melamed
- Department of Pathology, New York University Langone Medical Center, New York City, New York, USA
| | - Liang Cheng
- Department of Pathology & Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Muhammad T Idrees
- Department of Pathology & Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Eich ML, Rodriguez Pena MDC, Springer S, Taheri D, Tregnago AC, Salles DC, Bezerra SM, Cunha IW, Fujita K, Ertoy D, Bivalacqua TJ, Tomasetti C, Papadopoulos N, Kinzler KW, Vogelstein B, Netto GJ. Incidence and distribution of UroSEEK gene panel in a multi-institutional cohort of bladder urothelial carcinoma. Mod Pathol 2019; 32:1544-1550. [PMID: 31028363 PMCID: PMC6872189 DOI: 10.1038/s41379-019-0276-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 03/22/2019] [Accepted: 03/23/2019] [Indexed: 11/22/2022]
Abstract
Noninvasive approaches for early detection of bladder cancer are actively being investigated. We recently developed a urine- based molecular assay for the detection and surveillance of bladder neoplasms (UroSEEK). UroSEEK is designed to detect alterations in 11 genes that include most common genetic alterations in bladder cancer. In this study, we analyzed 527 cases, including 373 noninvasive and 154 invasive urothelial carcinomas of bladder from transurethral resections or cystectomies performed at four institutions (1991-2016). Two different mutational analysis assays of a representative tumor area were performed: first, a singleplex PCR assay for evaluation of the TERT promoter region (TERTSeqS) and second, a multiplex PCR assay using primers designed to amplify regions of interest of 10 (FGFR3, PIK3CA, TP53, HRAS, KRAS, ERBB2, CDKN2A, MET, MLL, and VHL) genes (UroSeqS). Overall, 92% of all bladder tumors were positive for at least one genetic alteration in the UroSEEK panel. We found TERT promoter mutations in 77% of low-grade noninvasive papillary carcinomas, with a relatively lower incidence of 65% in high-grade noninvasive papillary carcinomas and carcinomas in situ; p = 0.017. Seventy-two percent of pT1 and 63% of muscle-invasive bladder tumors harbored TERT promoter mutations with g.1295228C>T alteration being the most common in all groups. FGFR3 and PIK3CA mutations were more frequent in low-grade noninvasive papillary carcinomas compared with high-grade noninvasive papillary carcinomas and carcinomas in situ (p < 0.0001), while the opposite was true for TP53 (p < 0.0001). Significantly higher rates of TP53 and CDKN2A mutation rates (p = 0.005 and 0.035, respectively) were encountered in muscle-invasive bladder tumors compared with those of pT1 stage. The overwhelming majority of all investigated tumors showed at least one mutation among UroSEEK assay genes, confirming the comprehensive coverage of the panel and supporting its potential utility as a noninvasive urine-based assay.
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Affiliation(s)
- Marie-Lisa Eich
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, United States
| | | | - Simeon Springer
- Howard Hughes Medical Institute, Ludwig Cancer for Cancer Genetics and Therapeutics, Baltimore, United States,Sidney Kimmel Comprehensive Cancer Center, Baltimore, United States
| | - Diana Taheri
- Department of Pathology, Johns Hopkins University, United States,Department of Pathology, Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | | - Stephania Martins Bezerra
- Department of Pathology, AC Camargo Cancer Center, Sao Paulo, Brazil,Department of Pathology, Rede D’OR-São Luiz, Sao Paulo, Brazil
| | - Isabela W. Cunha
- Department of Pathology, AC Camargo Cancer Center, Sao Paulo, Brazil
| | | | - Dilek Ertoy
- Department of Pathology, Hacettepe University, Ankara, Turkey
| | | | - Cristian Tomasetti
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States,Division of Biostatistics and Bioinformatics, Department of Oncology, Sidney Kimmel Cancer Center
| | - Nickolas Papadopoulos
- Howard Hughes Medical Institute, Ludwig Cancer for Cancer Genetics and Therapeutics, Baltimore, United States,Sidney Kimmel Comprehensive Cancer Center, Baltimore, United States
| | - Ken W. Kinzler
- Howard Hughes Medical Institute, Ludwig Cancer for Cancer Genetics and Therapeutics, Baltimore, United States,Sidney Kimmel Comprehensive Cancer Center, Baltimore, United States
| | - Bert Vogelstein
- Howard Hughes Medical Institute, Ludwig Cancer for Cancer Genetics and Therapeutics, Baltimore, United States,Sidney Kimmel Comprehensive Cancer Center, Baltimore, United States
| | - George J. Netto
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, United States
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3
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Palsgrove DN, Taheri D, Springer SU, Cowan M, Guner G, Mendoza Rodriguez MA, Rodriguez Pena MDC, Wang Y, Kinde I, Ricardo BFP, Cunha I, Fujita K, Ertoy D, Kinzler KW, Bivalacqua TJ, Papadopoulos N, Vogelstein B, Netto GJ. Targeted sequencing of plasmacytoid urothelial carcinoma reveals frequent TERT promoter mutations. Hum Pathol 2018; 85:1-9. [PMID: 30447301 DOI: 10.1016/j.humpath.2018.10.033] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/25/2018] [Accepted: 10/31/2018] [Indexed: 02/07/2023]
Abstract
Activating mutations in the promoter of the telomerase reverse transcriptase (TERT) gene are the most common genetic alterations in urothelial carcinoma (UC) of the bladder and upper urinary tract. Although the cadherin 1 (CDH1) gene is commonly mutated in the clinically aggressive plasmacytoid variant of urothelial carcinoma (PUC), little is known about their TERT promoter mutation status. A retrospective search of our archives for PUC and UC with plasmacytoid and/or signet ring cell features (2007-2014) was performed. Ten specimens from 10 patients had archived material available for DNA analysis and were included in the study. Intratumoral areas of nonplasmacytoid histology were also evaluated when present. Samples were analyzed for TERT promoter mutations with Safe-SeqS, a sequencing error-reduction technology, and sequenced using a targeted panel of the 10 most commonly mutated genes in bladder cancer on the Illumina MiSeq platform. TERT promoter mutations were detected in specimens with pure and focal plasmacytoid features (6/10). Similar to conventional UC, the predominant mutation identified was g.1295228C>T. In heterogeneous tumors with focal variant histology, concordant mutations were found in plasmacytoid and corresponding conventional, glandular, or sarcomatoid areas. Co-occurring mutations in tumor protein p53 (TP53, 2 cases) and kirsten rat sarcoma (KRAS) viral proto-oncogene (1 case) were also detected. TERT promoter mutations are frequently present in PUC, which provides further evidence that TERT promoter mutations are common events in bladder cancer, regardless of histologic subtype, and supports their inclusion in any liquid biopsy assay for bladder cancer.
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Affiliation(s)
- Doreen N Palsgrove
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Diana Taheri
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21287, USA; Department of Pathology, Isfahan University of Medical Sciences, Isfahan Kidney Diseases Research Center, Isfahan 81746 73461, Iran
| | - Simeon U Springer
- Department of Oncology, Johns Hopkins University, Baltimore, MD 21287, USA; The Ludwig Center for Cancer Genetics and Therapeutics and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21287, USA
| | - Morgan Cowan
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Gunes Guner
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21287, USA
| | | | - Maria Del Carmen Rodriguez Pena
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21287, USA; Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35249, USA
| | - Yuxuan Wang
- The Ludwig Center for Cancer Genetics and Therapeutics and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21287, USA
| | - Isaac Kinde
- The Ludwig Center for Cancer Genetics and Therapeutics and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21287, USA
| | | | - Isabela Cunha
- Department of Pathology, Rede D'OR São Luiz, São Paulo 03313-000, Brazil
| | | | - Dilek Ertoy
- Department of Pathology, Koç University, İstanbul 34450, Turkey
| | - Kenneth W Kinzler
- Department of Oncology, Johns Hopkins University, Baltimore, MD 21287, USA; The Ludwig Center for Cancer Genetics and Therapeutics and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21287, USA
| | | | - Nickolas Papadopoulos
- Department of Oncology, Johns Hopkins University, Baltimore, MD 21287, USA; The Ludwig Center for Cancer Genetics and Therapeutics and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21287, USA
| | - Bert Vogelstein
- Department of Oncology, Johns Hopkins University, Baltimore, MD 21287, USA; The Ludwig Center for Cancer Genetics and Therapeutics and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21287, USA
| | - George J Netto
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21287, USA; Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35249, USA.
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4
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Springer SU, Chen CH, Rodriguez Pena MDC, Li L, Douville C, Wang Y, Cohen JD, Taheri D, Silliman N, Schaefer J, Ptak J, Dobbyn L, Papoli M, Kinde I, Afsari B, Tregnago AC, Bezerra SM, VandenBussche C, Fujita K, Ertoy D, Cunha IW, Yu L, Bivalacqua TJ, Grollman AP, Diaz LA, Karchin R, Danilova L, Huang CY, Shun CT, Turesky RJ, Yun BH, Rosenquist TA, Pu YS, Hruban RH, Tomasetti C, Papadopoulos N, Kinzler KW, Vogelstein B, Dickman KG, Netto GJ. Correction: Non-invasive detection of urothelial cancer through the analysis of driver gene mutations and aneuploidy. eLife 2018; 7:43237. [PMID: 30418154 PMCID: PMC6231759 DOI: 10.7554/elife.43237] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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5
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Sahin H, Gok Oguz E, Akoglu H, Atilgan G, Ulusal Okyay G, Karaveli Gursoy G, Kip Teymur T, Ertoy D, Canbakan B, Ayli MD. Successful Treatment of Posttransplant Recurrent Complement C3 Glomerulopathy with Eculizumab. Iran J Kidney Dis 2018; 12:315-318. [PMID: 30367025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 03/22/2018] [Accepted: 04/12/2018] [Indexed: 06/08/2023]
Abstract
Two-thirds of complement C3 glomerulopathy (C3G) recur after transplantation and commonly cause graft loss. There is not a standard treatment protocol for these cases. We present a kidney transplant patient with recurrent C3G who was successfully treated with eculizumab. Nephrotic proteinuria and hematuria occurred and creatinine levels increased after transplantation. A graft biopsy revealed recurrent C3G. The patient was administered 250 mg pulse methylprednisolone for 3 days and had 9 sessions of plasmapheresis. Since elevated creatinine levels and proteinuria persisted, eculizumab was instituted. A complete remission was observed after 9-month maintenance eculizumab treatment. Eculizumab may be a potentially effective option in kidney transplant patients with recurrent C3G unresponsive to other treatment modalities.
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Affiliation(s)
| | - Ebru Gok Oguz
- Department of Nephrology, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey.
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Springer SU, Chen CH, Rodriguez Pena MDC, Li L, Douville C, Wang Y, Cohen JD, Taheri D, Silliman N, Schaefer J, Ptak J, Dobbyn L, Papoli M, Kinde I, Afsari B, Tregnago AC, Bezerra SM, VandenBussche C, Fujita K, Ertoy D, Cunha IW, Yu L, Bivalacqua TJ, Grollman AP, Diaz LA, Karchin R, Danilova L, Huang CY, Shun CT, Turesky RJ, Yun BH, Rosenquist TA, Pu YS, Hruban RH, Tomasetti C, Papadopoulos N, Kinzler KW, Vogelstein B, Dickman KG, Netto GJ. Non-invasive detection of urothelial cancer through the analysis of driver gene mutations and aneuploidy. eLife 2018; 7:32143. [PMID: 29557778 PMCID: PMC5860864 DOI: 10.7554/elife.32143] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 02/19/2018] [Indexed: 12/15/2022] Open
Abstract
Current non-invasive approaches for detection of urothelial cancers are suboptimal. We developed a test to detect urothelial neoplasms using DNA recovered from cells shed into urine. UroSEEK incorporates massive parallel sequencing assays for mutations in 11 genes and copy number changes on 39 chromosome arms. In 570 patients at risk for bladder cancer (BC), UroSEEK was positive in 83% of those who developed BC. Combined with cytology, UroSEEK detected 95% of patients who developed BC. Of 56 patients with upper tract urothelial cancer, 75% tested positive by UroSEEK, including 79% of those with non-invasive tumors. UroSEEK detected genetic abnormalities in 68% of urines obtained from BC patients under surveillance who demonstrated clinical evidence of recurrence. The advantages of UroSEEK over cytology were evident in low-grade BCs; UroSEEK detected 67% of cases whereas cytology detected none. These results establish the foundation for a new non-invasive approach for detection of urothelial cancer.
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Affiliation(s)
- Simeon U Springer
- Howard Hughes Medical Institute, Ludwig Center for Cancer Genetics and Therapeutics, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Baltimore, United States
| | - Chung-Hsin Chen
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
| | - Maria Del Carmen Rodriguez Pena
- Department of Pathology, Johns Hopkins University, Baltimore, United States.,Department of Pathology, University of Alabama at Birmingham, Birmingham, United States
| | - Lu Li
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Christopher Douville
- Department of Biomedical Engineering, Institute for Computational Medicine, Johns Hopkins University, Baltimore, United States
| | - Yuxuan Wang
- Howard Hughes Medical Institute, Ludwig Center for Cancer Genetics and Therapeutics, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Baltimore, United States
| | - Joshua David Cohen
- Howard Hughes Medical Institute, Ludwig Center for Cancer Genetics and Therapeutics, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Baltimore, United States
| | - Diana Taheri
- Department of Pathology, Johns Hopkins University, Baltimore, United States.,Department of Pathology, Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Natalie Silliman
- Howard Hughes Medical Institute, Ludwig Center for Cancer Genetics and Therapeutics, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Baltimore, United States
| | - Joy Schaefer
- Howard Hughes Medical Institute, Ludwig Center for Cancer Genetics and Therapeutics, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Baltimore, United States
| | - Janine Ptak
- Howard Hughes Medical Institute, Ludwig Center for Cancer Genetics and Therapeutics, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Baltimore, United States
| | - Lisa Dobbyn
- Howard Hughes Medical Institute, Ludwig Center for Cancer Genetics and Therapeutics, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Baltimore, United States
| | - Maria Papoli
- Howard Hughes Medical Institute, Ludwig Center for Cancer Genetics and Therapeutics, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Baltimore, United States
| | - Isaac Kinde
- Howard Hughes Medical Institute, Ludwig Center for Cancer Genetics and Therapeutics, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Baltimore, United States
| | - Bahman Afsari
- Department of Oncology, Johns Hopkins University, Baltimore, United States.,Division of Biostatistics and Bioinformatics, Department of Oncology, Sidney Kimmel Cancer Center, Johns Hopkins School of Medicine, Baltimore, United States
| | - Aline C Tregnago
- Department of Pathology, Johns Hopkins University, Baltimore, United States
| | | | | | | | - Dilek Ertoy
- Department of Pathology, Hacettepe University, Ankara, Turkey
| | - Isabela W Cunha
- Department of Pathology, AC Camargo Cancer Center, Sao Paulo, Brazil
| | - Lijia Yu
- Department of Pathology, University of Alabama at Birmingham, Birmingham, United States
| | | | - Arthur P Grollman
- Department of Pharmacological Sciences, Stony Brook University, Stony Brook, United States.,Department of Medicine, Stony Brook University, Stony Brook, United States
| | - Luis A Diaz
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, United States
| | - Rachel Karchin
- Department of Biomedical Engineering, Institute for Computational Medicine, Johns Hopkins University, Baltimore, United States.,Department of Oncology, Johns Hopkins University, Baltimore, United States
| | - Ludmila Danilova
- Division of Biostatistics and Bioinformatics, Department of Oncology, Sidney Kimmel Cancer Center, Johns Hopkins School of Medicine, Baltimore, United States.,Department of Pathology, Hacettepe University, Ankara, Turkey
| | - Chao-Yuan Huang
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Tung Shun
- Department of Forensic Medicine and Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Robert J Turesky
- Masonic Cancer Center, University of Minnesota, Minneapolis, United States.,Department of Medicinal Chemistry, University of Minnesota, Minneapolis, United States
| | - Byeong Hwa Yun
- Masonic Cancer Center, University of Minnesota, Minneapolis, United States.,Department of Medicinal Chemistry, University of Minnesota, Minneapolis, United States
| | - Thomas A Rosenquist
- Department of Pharmacological Sciences, Stony Brook University, Stony Brook, United States
| | - Yeong-Shiau Pu
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ralph H Hruban
- Department of Pathology, Johns Hopkins University, Baltimore, United States
| | - Cristian Tomasetti
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States.,Division of Biostatistics and Bioinformatics, Department of Oncology, Sidney Kimmel Cancer Center, Johns Hopkins School of Medicine, Baltimore, United States
| | - Nickolas Papadopoulos
- Howard Hughes Medical Institute, Ludwig Center for Cancer Genetics and Therapeutics, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Baltimore, United States
| | - Ken W Kinzler
- Howard Hughes Medical Institute, Ludwig Center for Cancer Genetics and Therapeutics, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Baltimore, United States
| | - Bert Vogelstein
- Howard Hughes Medical Institute, Ludwig Center for Cancer Genetics and Therapeutics, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Baltimore, United States
| | - Kathleen G Dickman
- Department of Pharmacological Sciences, Stony Brook University, Stony Brook, United States.,Department of Medicine, Stony Brook University, Stony Brook, United States
| | - George J Netto
- Department of Pathology, Johns Hopkins University, Baltimore, United States.,Department of Pathology, University of Alabama at Birmingham, Birmingham, United States
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7
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Rodriguez Pena MDC, Tregnago AC, Eich ML, Springer S, Wang Y, Taheri D, Ertoy D, Fujita K, Bezerra SM, Cunha IW, Raspollini MR, Yu L, Bivalacqua TJ, Papadopoulos N, Kinzler KW, Vogelstein B, Netto GJ. Spectrum of genetic mutations in de novo PUNLMP of the urinary bladder. Virchows Arch 2017; 471:761-767. [PMID: 28597078 DOI: 10.1007/s00428-017-2164-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 05/19/2017] [Accepted: 05/26/2017] [Indexed: 12/26/2022]
Abstract
Our group and others have previously demonstrated the presence of TERT promoter mutations (TERT-mut) in 60-80% of urothelial carcinomas and some of their histologic variants. Five other genes have been frequently implicated in bladder cancer: FGRF3, TP53, PIK3CA, HRAS, and CDKN2A. In the current study, we sought to determine the prevalence of mutations in TERT and these five other genes in de novo papillary urothelial neoplasms of low malignant potential (PUNLMP) of the urinary bladder. A retrospective search of our archives for PUNLMP was performed and 30 de novo cases were identified and included in the study. We found mutations in TERT (TERT-mut) and FGFR3 (FGFR3-mut) to be the most common alterations in the cohort (63 and 60%, respectively). The majority of the TERT-mut-positive tumors (84%) had a g.1295228C > T alteration with the remaining tumors demonstrating g.1295250C > T. Approximately one fourth of tumors had TP53 mutations. These findings support the potential utility of a uniform genetic mutation panel to detect bladder cancers of various subtypes.
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Affiliation(s)
| | - Aline C Tregnago
- Department of Pathology, Johns Hopkins University, Baltimore, MD, 21287, USA
| | - Marie-Lisa Eich
- Department of Pathology, Johns Hopkins University, Baltimore, MD, 21287, USA
| | - Simeon Springer
- The Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, 21231, USA
| | - Yuxuan Wang
- The Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, 21231, USA
| | - Diana Taheri
- Department of Pathology, Johns Hopkins University, Baltimore, MD, 21287, USA
| | - Dilek Ertoy
- Department of Pathology, Hacettepe University, Ankara, Turkey
| | | | | | - Isabela W Cunha
- Department of Pathology, AC Camargo Cancer Center, Sao Paulo, Brazil
| | | | - Lijia Yu
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, 35249, USA
| | | | - Nickolas Papadopoulos
- The Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, 21231, USA
| | - Kenneth W Kinzler
- The Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, 21231, USA
| | - Bert Vogelstein
- The Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, 21231, USA
| | - George J Netto
- Department of Pathology, Johns Hopkins University, Baltimore, MD, 21287, USA.
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, 35249, USA.
- Department of Pathology, The University of Alabama at Birmingham, WP Building, Suite P230, 619 19th Street South, Birmingham, AL, 35249-7331, USA.
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8
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Nguyen D, Taheri D, Springer S, Cowan M, Guner G, Mendoza Rodriguez MA, Wang Y, Kinde I, VandenBussche CJ, Olson MT, Ricardo BFP, Cunha I, Fujita K, Ertoy D, Kinzler KW, Bivalacqua TJ, Papadopoulos N, Vogelstein B, Netto GJ. High prevalence of TERT promoter mutations in micropapillary urothelial carcinoma. Virchows Arch 2016; 469:427-34. [PMID: 27520411 DOI: 10.1007/s00428-016-2001-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 07/16/2016] [Accepted: 08/02/2016] [Indexed: 12/22/2022]
Abstract
Somatic activating mutations in the promoter of the telomerase reverse transcriptase (TERT) gene are the most common genetic alterations in urothelial carcinoma (UC) of the bladder and upper urinary tract. Little is known, however, about TERT-mutation status in the relatively uncommon but clinically aggressive micropapillary (MPC) variant. We evaluated the presence of TERT promoter mutations in MPC of the bladder and upper urinary tract. A retrospective search of our archives for MPC and UC with micropapillary features (2005-2014) was performed. All slides were reviewed to confirm the histologic diagnosis. Thirty-three specimens from 31 patients had FFPE blocks available for DNA analysis and were included in the study. Intratumoral areas of non-micropapillary histology were also evaluated when present. Samples were analyzed with Safe-SeqS, a sequencing error reduction technology, and sequenced using the Illumina MiSeq platform. TERT promoter mutations were detected in all specimens with pure MPC (18 of 18) and UC with focal micropapillary features (15 of 15). Similar to conventional UC, the predominant mutations identified occurred at positions -124 (C228T) (85 %) and -146 (C250T) (12 %) bp upstream of the TERT ATG start site. In heterogeneous tumors with focal variant histology, intratumoral concordant mutations were found in variant (MPC and non-MPC) and corresponding conventional UC. We found TERT promoter mutations, commonly found in conventional UC, to be frequently present in MPC. Our finding of concordant intratumoral mutational alterations in cases with focal variant histology lends support to the common oncogenesis origin of UC and its variant histology.
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Affiliation(s)
- Doreen Nguyen
- Department of Pathology, Johns Hopkins University, Baltimore, MD, 21287, USA
| | - Diana Taheri
- Department of Pathology, Johns Hopkins University, Baltimore, MD, 21287, USA.,Department of Pathology, Isfahan University of Medical Sciences, Isfahan Kidney Diseases Research Center, Isfahan, Iran
| | - Simeon Springer
- Department of Oncology, Johns Hopkins University, Baltimore, MD, 21287, USA.,The Ludwig Center for Cancer Genetics and Therapeutics and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, 21231, USA
| | - Morgan Cowan
- Department of Pathology, Johns Hopkins University, Baltimore, MD, 21287, USA
| | - Gunes Guner
- Department of Pathology, Johns Hopkins University, Baltimore, MD, 21287, USA
| | | | - Yuxuan Wang
- The Ludwig Center for Cancer Genetics and Therapeutics and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, 21231, USA
| | - Isaac Kinde
- The Ludwig Center for Cancer Genetics and Therapeutics and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, 21231, USA
| | | | - Matthew T Olson
- Department of Pathology, Johns Hopkins University, Baltimore, MD, 21287, USA
| | | | | | | | - Dilek Ertoy
- Department of Pathology, Hacettepe University, Ankara, Turkey
| | - Kenneth W Kinzler
- Department of Oncology, Johns Hopkins University, Baltimore, MD, 21287, USA.,The Ludwig Center for Cancer Genetics and Therapeutics and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, 21231, USA
| | | | - Nickolas Papadopoulos
- Department of Oncology, Johns Hopkins University, Baltimore, MD, 21287, USA.,The Ludwig Center for Cancer Genetics and Therapeutics and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, 21231, USA
| | - Bert Vogelstein
- Department of Oncology, Johns Hopkins University, Baltimore, MD, 21287, USA.,The Ludwig Center for Cancer Genetics and Therapeutics and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, 21231, USA
| | - George J Netto
- Department of Pathology, Johns Hopkins University, Baltimore, MD, 21287, USA. .,Department of Urology, Johns Hopkins University, Baltimore, MD, 21287, USA. .,Department of Pathology, The Johns Hopkins Hospital, 401 North Broadway Street, Weinberg 2242, Baltimore, MD, 21231, USA.
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9
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Cowan ML, Springer S, Nguyen D, Taheri D, Guner G, Mendoza Rodriguez MA, Wang Y, Kinde I, Del Carmen Rodriguez Pena M, VandenBussche CJ, Olson MT, Cunha I, Fujita K, Ertoy D, Kinzler K, Bivalacqua T, Papadopoulos N, Vogelstein B, Netto GJ. Detection of TERT promoter mutations in primary adenocarcinoma of the urinary bladder. Hum Pathol 2016; 53:8-13. [PMID: 26980028 DOI: 10.1016/j.humpath.2016.02.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 02/09/2016] [Accepted: 02/12/2016] [Indexed: 12/13/2022]
Abstract
TERT promoter mutations (TERT-mut) have been detected in 60% to 80% of urothelial carcinomas. A molecular urine-based screening assay for the detection of TERT-mut is currently being pursued by our group and others. A small but significant number of bladder carcinomas are adenocarcinoma. The current study assesses the incidence of TERT-mut in primary adenocarcinomas of urinary bladder. A retrospective search of our institutional pathology records identified 23 cystectomy specimens with a diagnosis of adenocarcinoma (2000-2014). All slides were reviewed by a senior urologic pathologist to confirm tumor type and select a representative formalin-fixed, paraffin-embedded block for mutational analysis. Adequate material for DNA testing was available in 14 cases (7 enteric type and 7 not otherwise specified). TERT-mut sequencing analysis was performed using previously described SafeSeq technique. Overall, 28.5% of primary adenocarcinoma harbored TERT-mut. Interestingly, 57% of nonenteric adenocarcinomas were mutation positive, whereas none of the enteric-type tumors harbored mutations. Similar to urothelial carcinoma, we found a relatively higher rate of TERT-mut among nonenteric-type adenocarcinomas further supporting the potential utility of TERT-mut urine-based screening assay for bladder cancer.
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Affiliation(s)
- Morgan L Cowan
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21287
| | - Simeon Springer
- Department of Oncology, Johns Hopkins University, Baltimore, MD 21287; Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21231
| | - Doreen Nguyen
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21287
| | - Diana Taheri
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21287
| | - Gunes Guner
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21287
| | | | - Yuxuan Wang
- Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21231
| | - Isaac Kinde
- Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21231
| | | | | | - Mathew T Olson
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21287
| | - Isabela Cunha
- AC Camargo Cancer Centre, Sao Paulo, Brazil, 01509-010
| | | | - Dilek Ertoy
- Department of Pathology, Hacettepe University, Ankara, Turkey 06100
| | - Kenneth Kinzler
- Department of Oncology, Johns Hopkins University, Baltimore, MD 21287; Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21231
| | | | - Nickolas Papadopoulos
- Department of Oncology, Johns Hopkins University, Baltimore, MD 21287; Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21231
| | - Bert Vogelstein
- Department of Oncology, Johns Hopkins University, Baltimore, MD 21287; Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21231
| | - George J Netto
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21287; Department of Urology, Johns Hopkins University, Baltimore, MD 21287.
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10
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Yazici S, Inci K, Bilen CY, Gudeloglu A, Akdogan B, Ertoy D, Kaynaroglu V, Demircin M, Ozen H. Renal cell carcinoma with inferior vena cava thrombus: The Hacettepe experience. Urol Oncol 2010; 28:603-9. [DOI: 10.1016/j.urolonc.2008.11.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2008] [Revised: 11/20/2008] [Accepted: 11/21/2008] [Indexed: 12/30/2022]
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11
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Eker A, Saka E, Dalmau J, Kurne A, Bilen C, Ozen H, Ertoy D, Oguz KK, Elibol B. Testicular teratoma and anti-N-methyl-D-aspartate receptor-associated encephalitis. J Neurol Neurosurg Psychiatry 2008; 79:1082-3. [PMID: 18708569 DOI: 10.1136/jnnp.2008.147611] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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12
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Barun S, Ertoy D, Dileköz E, Müftüoglu S, Erten Y, Sucak G, Bali M, Tekeli N, Sarioglu Y, Ercan ZS. Effects of Amifostine on Glycerol-Pretreated Rabbit Kidneys. Basic Clin Pharmacol Toxicol 2005; 97:168-73. [PMID: 16128911 DOI: 10.1111/j.1742-7843.2005.pto_97389.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Glycerol-induced acute renal failure is an experimental model for myoglobinuric nephropathy. Amifostine is a cytoprotective agent which scavenges the free radicals. Since there is enhanced production of reactive oxygen metabolites in glycerol-induced acute renal failure, we wanted to examine whether amifostine has a protective role against vascular reactivity and histological changes in kidneys isolated from glycerol-pretreated rabbits. Perfusion pressure was recorded from kidneys obtained from rabbits injected with glycerol 3 hr before the experiments and from glycerol-pretreated and non-pretreated rabbits injected with amifostine 30 min. before the experiments. Acetylcholine-induced (10(-8)-10(-5) M) vasodilatation was tested following the construction of submaximal vasoconstriction by phenylephrine. Histological investigation was performed using light microscope. Acetylcholine-induced vasodilatation was found to be significantly decreased in glycerol, glycerol+amifostine and amifostine groups compared to controls at all concentrations. Reduction in acetylcholine-induced vasodilation was more prominent in amifostine group compared to amifostine+glycerol group. There was histological renal damage in all experimental groups and this damage was more pronounced in glycerol+amifostine group. In conclusion, contrary to expectation, amifostine per se led to histological damage and potentiated the histological damage caused by glycerol and produced a decrease in acetylcholine-induced vasodilatation. The mechanisms by which amifostine exerts its effects are not known.
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Affiliation(s)
- Süreyya Barun
- Department of Pharmacology, Medical School, Gazi University, 06510 Beşevler, Ankara, Turkey.
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13
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Dizdar O, Kahraman S, Gençtoy G, Ertoy D, Arici M, Altun B, Yasavul U, Turgan C. Membranoproliferative glomerulonephritis associated with type 1 diabetes mellitus and Hashimoto's thyroiditis. Nephrol Dial Transplant 2004; 19:988-9. [PMID: 15031362 DOI: 10.1093/ndt/gfh059] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Omer Dizdar
- Hacettepe Hastanesi, Nefroloji Bölümü, 06100-Sihhiye, Ankara, Turkey
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14
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Abstract
OBJECTIVES To evaluate the efficiency of pentoxifylline (PTX), a methyl xanthine derivative, in preventing renal scar formation after the induction of pyelonephritis in an experimental rat model with delayed antimicrobial therapy. METHODS An inoculum of 1 x 10(9) colony-forming units/0.1 mL of the K-12 strain of Escherichia coli, which has both type 1 and P pili, was injected directly into both renal parenchyma of Wistar rats (n = 40). Group 1 (control) received isotonic saline instead of bacterial solution (n = 10). Four equal groups were then formed: group 2 was not treated and group 3 was treated only with ciprofloxacin for 5 days, starting 3 days after bacterial inoculation; in group 4, 50 mg/kg of PTX, and in group 5, PTX (50 mg/kg) and ciprofloxacin (15 mg/kg) together were administered intraperitoneally for 5 days, starting 3 days after bacterial inoculation. Six weeks after bacterial inoculation, all the rats were killed, and both kidneys were examined histopathologically for renal scarring. RESULTS Delayed treatment with antibiotics had no effect on scarring compared with the untreated controls. However, the addition of PTX to the delayed antibiotic therapy significantly inhibited renal scarring compared with the untreated or antibiotic-only groups (P <0.05). CONCLUSIONS These results suggest that PTX is effective in preventing renal scar formation in pyelonephritis when the initiation of antimicrobial treatment is delayed in this rat model of pyelonephritis.
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Affiliation(s)
- Aydin Yagmurlu
- Department of Pediatric Surgery, University of Ankara School of Medicine, Ankara, Turkey
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15
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Koçer U, Aksoy HM, Tiftikcioðlu YÖ, Ertoy D, Karaaslan O. Giant eccrine acrospiroma: A case report and review of the literature. Can J Plast Surg 2003; 11:43-6. [PMID: 24115850 DOI: 10.1177/229255030301100105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Acrospiromas are histologically distinct cutaneous tumours of sweat duct origin and usually measure 1 to 2 cm in size. OBJECTIVE We describe a patient with a large benign eccrine acrospiroma. METHODS Case report and literature review. RESULTS A 50-year-old woman underwent excision of a 5.5×5.0 cm cystic mass located on the left gluteal region, and the resulting defect was closed by a local flap. A diagnosis of benign eccrine acrospiroma was made after histopathological examination. On histological examination, the lesion was characterized by multilobular dermal masses composed of a biphasic cell population. There was no recurrence five months after the operation. CONCLUSION Although eccrine acrospiromas are usually benign, they can, on rare occasions, undergo malignant transformation. In addition, the clinical appearance of this lesion is not specific and differential diagnosis from other lesions, both benign and malignant, can only be done after the complete removal of the lesion.
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Affiliation(s)
- Uður Koçer
- Plastic and Reconstructive Surgery Department, Ankara Training and Research Hospital, Ankara, Turkey
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16
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Vargel I, Erdem A, Ertoy D, Pinar A, Erk Y, Altundag MK, Gullu I. Effects of growth factors on doxorubicin-induced skin necrosis: documentation of histomorphological alterations and early treatment by GM-CSF and G-CSF. Ann Plast Surg 2002; 49:646-53. [PMID: 12461449 DOI: 10.1097/00000637-200212000-00015] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Extravasation of vesicant antineoplastic agents such as doxorubicin into the skin or subcutaneous tissues may result in loss of the full thickness of the skin or underlying structures. Several treatment methods have been advocated but none has demonstrated any superiority to the others. The authors designed a controlled animal study in 88 rats to test three methods of early treatment of extravasation of the vesicant antineoplastic agent doxorubicin. The first step of the study included 48 Sprague-Dawley rats. All animals received intradermal injections of 1 mg doxorubicin superficially to the panniculus carnosus in the dorsum. The rats were then divided into four groups of 12 rats each, as follows: group 1, no treatment; group 2, immediate intradermal injection of 0.1 ml saline to the same site; group 3, immediate intradermal injection of 10 microg granulocyte macrophage-colony stimulating factor (GM-CSF) in 0.1 ml saline to the same site; group 4, immediate intradermal injection of 10 microg granulocyte-colony stimulating factor (G-CSF) in 0.1 ml saline to the same site. During the next 6 weeks the rats were observed for the development of necrosis. Ulcers developed and reached maximum size two weeks after the injections. The largest ulcers according to area were observed in group 1 and the mean value was 21.25 mm (p < 0.05). Although wound areas were significantly smaller in the saline group than in the control group and the mean value was 7.58 mm (p < 0.05), the smallest lesions were observed in groups 3 and 4, and the mean values were 1.08 mm and 0.83 mm respectively (p < 0.05). There was statistically no difference with regard to mean ulcer area between groups 3 and 4. During the second step of the experiment, the remaining 40 Sprague-Dawley rats were used. Groups containing 10 rats each were designed similarly after all animals received intradermal injections of 1 mg doxorubicin into the back. On the 10th day after the injection, the entire area of the ulcer together with the underlying panniculus carnosus was excised for pathological examination and for determination of glucose 6-phosphate dehydrogenase (G6PD) activity. On microscopic examination, the extravasated ulcer consisted of a large area of ischemic necrosis. There was marked damage to small blood vessels in the form of fibrinoid necrosis and vasculitis. Injured vessel counts were higher in the control group (group 1; p < 0.05). No difference was observed in G6PD activity between the groups. The authors conclude that both saline and tissue growth factors (GM-CSF and G-CSF) are useful for the early treatment of doxorubicin extravasation; however, GM-CSF and G-CSF are more beneficial.
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Affiliation(s)
- Ibrahim Vargel
- Department of Plastic and Reconstructive Surgery, Hacettepe University School of Medicine, Samanpazari 06100 Ankara, Turkey
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17
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Aydemir A, Abbasoglu O, Topaloglu S, Ertoy D, Ayhan A, Kilinç K, Karabulut E, Sayek I. Protective effect of roscovitine on renal ischemia–reperfusion injury. Transplant Proc 2002; 34:2027-8. [PMID: 12270300 DOI: 10.1016/s0041-1345(02)02838-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- A Aydemir
- Hacettepe University School of Medicine, Ankara, Turkey
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18
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Koçer U, Aksoy HM, TiftikçioğLu YÖ, Ertoy D, Karaaslan Ö. Giant dentigerous cyst occupying the right hemimandible. Canadian Journal of Plastic Surgery 2002. [DOI: 10.1177/229255030201000405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dentigerous cysts are the second most common odontogenic cysts of the mandible. They may vary in size from 2 cm to more than 10 cm. In the present report, a dentigerous cyst with massive involvement of the right half of the mandible in a young patient is presented. For cosmetic reasons and long term risks these cysts must be treated. Surgical removal is the preferred modality and a submandibular route should be chosen in large lesions. Bony cavities may be decreased in volume by using osteoperiosteal flaps, but there is no need for primary bone grafting, even for large defects.
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Affiliation(s)
- Uğur Koçer
- Plastic and Reconstructive Surgery Clinic, Ankara Training and Research Hospital
| | - H Mete Aksoy
- Plastic and Reconstructive Surgery Clinic, Ankara Training and Research Hospital
| | - YiğIt Ö TiftikçioğLu
- Plastic and Reconstructive Surgery Clinic, Ankara Training and Research Hospital
| | - Dilek Ertoy
- Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Önder Karaaslan
- Plastic and Reconstructive Surgery Clinic, Ankara Training and Research Hospital
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19
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Derici U, Kan E, Ertoy D, Arinsoy T, Dursun A, Bicik Z, Sindel S. Rheumatoid arthritis and membranoproliferative glomerulonephritis: an unusual case. Nephrology (Carlton) 2002. [DOI: 10.1046/j.1440-1797.2002.00097.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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20
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Koçer U, Aksoy H, Tiftikcioğlu Y, Bingül F, Ertoy D, Bükülmez G. Coexistence of aplasia cutis congenita of the scalp with symbrachydactyly of bilateral feet: an unreported form of Adams-Oliver syndrome. Eur J Plast Surg 2001. [DOI: 10.1007/s00238-001-0307-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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21
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Ozen S, Ertoy D, Heidet L, Cohen-Solal L, Ozen H, Besbas N, Bakkaoglu A, Antignac C. Benign familial hematuria associated with a novel COL4A4 mutation. Pediatr Nephrol 2001; 16:874-7. [PMID: 11685592 DOI: 10.1007/s004670100673] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2001] [Accepted: 06/06/2001] [Indexed: 10/27/2022]
Abstract
We describe a father and three offspring with hematuria. The father and one girl also complained of flank pain. Renal function tests and ophthalmological examinations were normal in all. The father had very mild neural deafness. The renal biopsy samples of two affected siblings showed changes compatible with thin basement membrane disease. Genetic analysis revealed a novel missense mutation in exon 32 of COL4A4 to be responsible for the phenotype in this family. We suggest that thin basement membrane disease may have overlapping clinical features with other causes of hematuria; genetic analysis may help in the differential diagnosis and help us further understand the disease processes.
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Affiliation(s)
- S Ozen
- Department of Pediatric Nephrology and Rheumatology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.
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22
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Zorlu F, Yildiz F, Ertoy D, Atahan IL, Erden E. Dermatofibrosarcoma protuberans metastasizing to cavernous sinuses and lungs: a case report. Jpn J Clin Oncol 2001; 31:557-61. [PMID: 11773265 DOI: 10.1093/jjco/hye117] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Dermatofibrosarcoma protuberans (DFSP) is a locally aggressive tumor with a low potential for distant metastases. We report a 22-year-old female patient with a typical cutaneous DFSP who developed five local recurrences followed by left cavernous sinus metastasis at the eighth year and right cavernous sinus and lung metastases at the ninth year. In each local recurrence the tumor showed histological signs of progression as being more cellular, having higher mitotic index and being aggressively invasive through the underlying soft tissues. The histopathological evaluation of the metastatic tumor resected from the left cavernous sinus revealed dedifferentiation from low-grade DFSP to higher grade fibrosarcomatous morphology. Immunohistochemical studies of the primary tumor and also the recurrent and metastatic tumors showed diffuse CD34 positivity in all specimens and p53 positivity was detected in the metastatic tumor resected from left cavernous sinus.
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Affiliation(s)
- F Zorlu
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey
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Karamürsel S, Kayikçioğlu A, Ertoy D, Karamürsel B, Dayican A, Celebioğlu S, Keçik A. Long-term effects of extraluminal dilatation with a rigid circle on arteriovenous anastomotic line in venous grafts transposed into arterial defects. Ann Plast Surg 2001; 47:279-84. [PMID: 11562032 DOI: 10.1097/00000637-200109000-00010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Postanastomotic narrowing resulting from subintimal hyperplasia is a well-known phenomenon. In the current study the authors compared a metallic circle and conventional suture technique in anastomoses performed in two ends of external jugular vein grafts interposed in carotid arteries of rabbits. They recorded the patency rates, fluid flow rates, and histological effects of the circle on the anastomotic line and compared them with conventional suture anastomoses. In 16 rabbits (experimental group) a standard suture was used in both ends of the jugular vein graft transposed to the carotid arteries on one side. On the other side, circle anastomoses were performed on both ends of the vein graft. In an additional 8 rabbits (control group), the anterior jugular veins and carotid arteries were dissected on both sides and left. During postoperative week 12, in 8 rabbits of the experimental group, the flow rates of carotid arteries were measured in vitro, and intraluminal silicone casts were prepared. In the remaining 8 experimental rabbits, carotid angiographies were performed and anastomotic segments were harvested for histological examination. Flow rates were also measured in the control group, and artery and vein segments were harvested. The patency rates of the vein grafts with metallic circle anastomoses were 100%, whereas conventional suture patency was 75% at week 12. Flow rates were significantly higher in the metallic circle-anastomosed vein grafts (74 ml per minute vs. 123 ml per minute, mean values; p < 0.05). Histological examination revealed reduced intimal thickness in the metallic circle anastomoses compared with conventional suture anastomoses. Dilatation of the arteriovenous end-to-end anastomotic line by a rigid circle prevents anastomotic narrowing in the long term.
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Affiliation(s)
- S Karamürsel
- Department of Plastic and Reconstructive Surgery, Ankara, SSK Hospital, Turkey
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24
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Ozatlı D, Balaban Y, Haznedaroǧlu IC, Karakuş S, Ertoy D, Sayınalp N, Oto A, Ozcebe O, Dündar S. Mature ovarian teratoma as a possible cause of fever and clinical exacerbation in Behçet's disease: a case report. Mod Rheumatol 2001; 11:172-5. [PMID: 24383699 DOI: 10.3109/s101650170034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract Behçet's disease (BD) is a chronic relapsing systemic vasculitis of unknown etiology. BD is very rarely associated with neoplastic diseases. We report the case of a 39-year-old woman who had been treated for BD for 3 years. She presented with relapsing oral and genital lesions and persistent high-grade fever which had lasted for 1 month. The possible cause of the exacerbation of BD and fever in this patient was a mature ovarian teratoma. To our knowledge this is the first report of a patient with BD associated with a ovarian teratoma.
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Affiliation(s)
- D Ozatlı
- Department of Haematology, Hacettepe University Medical School , İlk Yerleşim Mahallesi, Güzelevler Blokları B-13/3, Batıkent 06370, Ankara , Turkey
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25
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Hakki SS, Celenligil-Nazliel H, Karaduman A, Usubütün A, Ertoy D, Ayhan A, Ruacan S. Epidermolysis bullosa acquisita: clinical manifestations, microscopic findings, and surgical periodontal therapy. A case report. J Periodontol 2001; 72:550-8. [PMID: 11338310 DOI: 10.1902/jop.2001.72.4.550] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Epidermolysis bullosa acquisita (EBA) is an uncommon, acquired, chronic subepidermal bullous disease. This report describes a case of EBA with gingival involvement. A 43-year-old woman with EBA was referred to our clinic for periodontal therapy because of gingival tenderness and bleeding. She has been on cyclosporin A therapy for the last 2 years. METHODS Clinical findings were analyzed. Anterior gingivectomy operations were performed in 2 stages. The samples obtained during the surgery were examined using histopathologic, immunohistologic, and electronmicroscopic methods. Long-term effects of the surgical periodontal treatment on gingiva were evaluated both clinically and microscopically. RESULTS The dentition displayed minimal enamel hypoplasia. Decayed, missing, and filled surfaces score was found to be elevated. Periodontal examination showed generalized diffuse gingival inflammation and gingival enlargement localized mainly to the anterior region. Nikolsky's sign was positive. However, wound healing was uneventful after the operations. Microscopic findings were similar to those obtained from the skin. Twenty-one months after the operations, Nikolsky's sign was negative and no remarkable gingival inflammation was noted. Microscopic examination revealed that the blisters were fewer in number and smaller in size. CONCLUSIONS These results indicate that gingival tissues may also be involved in EBA. Uneventful wound healing after periodontal surgery in this case suggests that periodontal surgery can be performed in patients with EBA. Moreover, both our clinical and histopathologic findings imply that gingivectomy proves useful in maintaining gingival integrity in these patients. Our data may also suggest that the patients with EBA are highly likely to develop dental caries.
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Affiliation(s)
- S S Hakki
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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26
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Abstract
The aim of this study was to underline the frequently seen problems in diagnosing the lesions seen in the hyperplasia-carcinoma sequence by evaluating the variances between the observers. Four pathologists re-evaluated 137 endometrial biopsies and grouped them into diagnostic categories. The results were analyzed by Kappa statistics. Full agreement was reached in 89 cases (64.96%), with Kappa values ranging between 0.63-0.74. Three observers rendered the same diagnosis in 34 (24.81%) cases, and only one pathologist disagreed. Two or more observers held different views in 16 cases (10.95%). The problem areas were as follows: criteria distinguishing simple hyperplasia from other benign lesions, discrimination between atypical hyperplasia and carcinoma, and decision-making regarding the presence of atypia. There was a tendency towards overdiagnosis of hyperplasia in our department. Since the progression to carcinoma is a sequential event, borderline cases will exist if categories based on simple and clear cut off points are not defined.
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Affiliation(s)
- A Usubütün
- Hacettepe University, School of Medicine, Department of Pathology, Ankara, Turkey.
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27
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Semerci CN, Bebitoglu I, Kaçar A, Yurttagül S, Erçakmak S, Ertoy D, Ozaltin F, Balci S. An unusual fetus with complete absence of thoracic, lumbar and sacral vertebrae, bilateral renal agenesis, VSD, meningomyelocele, imperforate anus, and teratoma. Clin Dysmorphol 2001; 10:57-60. [PMID: 11152150 DOI: 10.1097/00019605-200101000-00012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We present a 30 week old male fetus who had a very interesting malformation complex which can not be explained by teratogenic or hereditary diseases. The aim of this paper is to discuss this complicated entity and compare it with other reported cases.
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Affiliation(s)
- C N Semerci
- Zübeyde Hanim Maternity Hospital Department of a Genetics, Turkey
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28
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Cole J, Ertoy D, Lin H, Sutliff RL, Ezan E, Guyene TT, Capecchi M, Corvol P, Bernstein KE. Lack of angiotensin II-facilitated erythropoiesis causes anemia in angiotensin-converting enzyme-deficient mice. J Clin Invest 2000; 106:1391-8. [PMID: 11104792 PMCID: PMC381466 DOI: 10.1172/jci10557] [Citation(s) in RCA: 128] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
While nephrologists often observe reduced hematocrit associated with inhibitors of angiotensin-converting enzyme (ACE), the basis for this effect is not well understood. We now report that two strains of ACE knockout mice have a normocytic anemia associated with elevated plasma erythropoietin levels. (51)Cr labeling of red cells showed that the knockout mice have a normal total blood volume but a reduced red cell mass. ACE knockout mice, which lack tissue ACE, are anemic despite having normal renal function. These mice have increased plasma levels of the peptide acetyl-SDKP, a possible stem cell suppressor. However, they also show low plasma levels of angiotensin II. Infusion of angiotensin II for 2 weeks increased hematocrit to near normal levels. These data suggest that angiotensin II facilitates erythropoiesis, a conclusion with implications for the management of chronically ill patients on inhibitors of the renin-angiotensin system.
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Affiliation(s)
- J Cole
- Department of Pathology, Emory University, Atlanta, Georgia, USA. Institute National de la Santé et de la Recherche Medicale Unit 36, College de France, Paris, France
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29
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Abstract
The evaluation of ACE knockout mice has illustrated the tremendous physiologic importance of the RAAS. We have discussed how interruption of this system influences blood pressure, renal function, renal development, serum and urine electrolyte composition, haematocrit and male reproductive capacity. This body of data underlines the modelling of the RAAS as a type of biological machine that is positioned to respond to environmental insult and to maintain a homeostasis of blood pressure, blood volume and electrolyte composition. These data also emphasise Harry Goldblatt's seminal observation that the kidney and the RAAS are intimately linked in the regulation of normal blood pressure.
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Ertoy D, Ayhan A, Saraç E, Karaağaoğlu E, Yasui W, Tahara E, Ayhan A. Clinicopathological implication of cripto expression in early stage invasive cervical carcinomas. Eur J Cancer 2000; 36:1002-7. [PMID: 10885604 DOI: 10.1016/s0959-8049(00)00033-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
This study evaluates the expression of cripto (CR-1) protein in matched sets of non-neoplastic cervical epithelium, primary cervical carcinoma and metastatic tumours in the lymph nodes to investigate its role in uterine cervical cancer development and progression. Ninety-four primary cervical carcinomas in an early clinical stage and having the same surgical treatment modality were analysed. Immunoreactivity in the primary tumour was compared with that of non-neoplastic cervical epithelium and metastatic lymph nodes. The conventional clinicopathological prognostic variables for cervical carcinomas such as grade, tumour size, depth of invasion, parametrial and endometrial extension, lymphovascular space involvement and lymph node metastasis status were also compared with CR-1 expression of the primary tumour. Strong CR-1 immunopositivity was significantly correlated with tumour size and lymphovascular space involvement (P < 0.05). Furthermore, a significant relationship was found between CR-1 immunoreactivity and endometrial extension as well as parametrial involvement (P < 0.05). Interestingly, the CR-1 expression level was increased in metastatic lymph nodes compared with their primary tumours. These results suggest that CR-1 may contribute to disease progression in cervical carcinomas.
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Affiliation(s)
- D Ertoy
- Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey
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31
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Akpek EK, Ertoy D, Kalayci D, Hasiripi H. Postoperative topical mitomycin C in conjunctival squamous cell neoplasia. Cornea 1999; 18:59-62. [PMID: 9894938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
PURPOSE To report the efficacy of topical mitomycin C in preventing local recurrences after incomplete surgical excision of conjunctival squamous cell neoplasia. METHODS Four patients presented with unilateral conjunctival tumors. Excisional biopsy results revealed conjunctival intraepithelial neoplasia with an intact basement membrane. Neoplastic cells were present in at least one of the surgical borders of the excised conjunctiva in all four cases. Patients were treated with topical mitomycin C 0.02% three times daily for 2 weeks to prevent recurrences. RESULTS All four patients were free of clinically detectable tumors after a mean follow-up period of 20 months (range, 16-23 months). Side effects included mild discomfort, redness, photophobia, and punctate epithelial keratopathy that subsided on discontinuation of the medication. CONCLUSION Postoperative topical mitomycin C application may be a useful adjunct to prevent recurrences in patients with incompletely excised conjunctival squamous cell neoplasia.
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Affiliation(s)
- E K Akpek
- Cornea and External Disease Service, The Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland 21287-9238, USA
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32
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Abstract
BACKGROUND Phospholipase C (PLC) is an important factor in signal transduction because this enzyme is activated by several hormones and growth factors. Eight PLC isoforms have been described raising the possibility that different cells express a single isoform or activate specific isoforms in different cells. Therefore, the goal of this study was to determine which PLC isoforms are expressed in specific regions of rat kidney. METHODS Western blot analysis was performed in microdissected nephron segments of rat kidney, while immunohistochemical analysis was performed on whole rat kidney slices using PLC isoform-specific antibodies. RESULTS All three families of PLC isoforms (beta, gamma, and delta) were present throughout the cortical and medullary regions of the kidney. Only the PLC-beta1 isoform was observed in the brush border of the proximal tubule, but all isoforms were present in glomeruli and in the cytoplasm of tubular epithelial cells. In addition, only the PLC-gamma1 isoform was expressed in the internal elastic lamina of the renal artery, while vasa recta expressed PLC-beta1 most intensely. Medullary thick ascending limbs showed an intense level of expression of all three isoforms. CONCLUSION Multiple PLC isoforms are present in glomeruli, renal tubules, and renal vasculature in vivo, but with some segment-specific differences. These findings suggest that the response of a specific cell is not determined by expression of only one PLC isoform, with the exception of the brush border of the proximal tubule and the renal arteries. Instead, the presence of multiple PLC isoforms in specific regions of the kidney suggests that hormonal regulation in vivo involves mechanisms beyond cell-specific isoforms of PLC.
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Affiliation(s)
- J P Lea
- Renal Division, Department of Medicine, Department of Pathology, and The Center for Cell and Molecular Signaling, Emory University School of Medicine, Atlanta, Georgia, USA
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Abstract
The 17 patients with fibrosarcoma occurring after radiotherapy for breast carcinoma reported in the literature are the disastrous results of a treatment modality. All the reports concerning the sarcomas share the same feature-aggressive nature with a latent period of 4 years or more. A patient report of fibrosarcoma occurring 2 years after radiotherapy for breast carcinoma with the shortest latent period in the literature is presented and the literature is reviewed. The tumor was localized within an irradiated area and there was a clear histological distinction between the previous and current tumors. The tumor was found to encase the axillary artery and the brachial plexus. For a curative resection, a forequarter amputation was performed and the defect was closed by means of a posterior arm flap. Despite the aggressiveness of the tumors the patient had no distant metastases 1 year after the diagnosis of fibrosarcoma.
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Affiliation(s)
- H Borman
- Department of Plastic and Reconstructive Surgery, Baskent University, Ankara, Turkey
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Saraç E, Ayhan A, Ertoy D, Tuncer ZS, Yasui W, Tahara E, Ayhan A. nm23 expression in carcinoma of the uterine cervix. EUR J GYNAECOL ONCOL 1998; 19:312-5. [PMID: 9641240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
To evaluate the significance of nm23 protein expression in cervical carcinoma, 83 patients with stage IB disease, treated primarily with surgery were studied immunohistochemically. Of the cases 57 were squamous carcinoma, 9 were adenocarcinoma, 14 were adenosquamous carcinoma and 3 were small-cell carcinoma. nm23 expression was positive in 63% of the cases. Although positive expression was more common in squamous and adenosquamous type tumors, negative expression was dominant in adenocarcinoma (P<0.05). When nm23 expression was compared with the clinicopathologic risk factors, there was no correlation of expression with the grade, deep invasion of the stroma, parametrial involvement and lymph node metastasis. But expression was inversely correlated with the number of metastatic lymph nodes (P<0.05). Although 3 or more lymph node metastases is a very poor prognostic sign, nm23 expression was not correlated either with recurrence or survival. Expression was negative in 77% of metastatic lymph nodes and in all of the recurrences. The predominance of negative expression in metastatic lymph nodes (P<0.05) and recurrences seems to be related to the aggressive behavior of the negative clone in the heterogeneous primary tumor.
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Affiliation(s)
- E Saraç
- Department of Obstetrics and Gynecology, Hiroshima University School of Medicine
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35
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Atahan IL, Ayhan A, Ozyar E, Ertoy D, Gürkaynak M. A case of mucoepidermoid carcinoma of the parotid gland developing in a child after the treatment of acute lymphoblastic leukemia. Pediatr Hematol Oncol 1995; 12:403-5. [PMID: 7577394 DOI: 10.3109/08880019509029592] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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36
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Ozdemir A, Gedikoğlu G, Moray G, Ertoy D, Ozen H. Thyroid metastasis of renal cell carcinoma. A case report. Acta Chir Belg 1995; 95:133-5. [PMID: 7610744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
In this article thyroid metastasis in a patient who was operated 11 years ago for renal cell carcinoma is reported with the review of the literature. That case was also the first and the only thyroid gland metastasis in 4.124 thyroidectomies during a 17-year period at our department. Because the thyroid gland may be the only and a rare metastatic site, differentiation of the metastatic lesion from the primary thyroid neoplasm could be difficult.
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Affiliation(s)
- A Ozdemir
- Department of General Surgery, Hacettepe University, Faculty of Medicine, Ankara, Turkey
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