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Özaslan E, Günşar F, Çiftçibaşı Örmeci A, Hatemi İ, Efe C, Akyol G, Turhan N, Barbet FY, Sağol Ö, Ataizi Çelikel Ç, Güllüoğlu M, Gökçe DT, İstemihan Z, Eşkazan T, İdilman R. Diagnosis and Treatment of Autoimmune Hepatitis: Questions, Answers, and Illustrative Cases: Endorsed by Autoimmune Liver Diseases Special Interest Group, Turkish Association for the Study of Liver. Turk J Gastroenterol 2023; 34:S1-S33. [PMID: 37947207 DOI: 10.5152/tjg.2023.23242] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Autoimmune hepatitis (AIH) is a rare, immune-mediated liver disease. It has a heterogeneous nature with varied clinical presentations. The management of patients with AIH is challenging in many ways. The main difficulties are inexperience due to the rarity of the disease, diagnostic confusion in controversial areas such as variant/overlap cases, acute presentations, the presence of non-alcoholic fatty liver disease or drug-induced liver injury features, and the long and complex course of treatment. Here, we provide a clear, concise, and visualized review regarding the diagnosis and treatment of AIH, including illustrative cases.
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Affiliation(s)
- Ersan Özaslan
- Department of Gastroenterology, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Fulya Günşar
- Department of Gastroenterology, Ege University, İzmir, Turkey
| | - Aslı Çiftçibaşı Örmeci
- Department of Gastroenterology, İstanbul University Çapa Faculty of Medicine, İstanbul, Turkey
| | - İbrahim Hatemi
- Department of Gastroenterology, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Cumali Efe
- Department of Gastroenterology, Harran University, Şanlıurfa, Turkey
| | - Gülen Akyol
- Department of Pathology, Gazi University, Ankara, Turkey
| | - Nesrin Turhan
- Department of Pathology, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Turkey
| | | | - Özgül Sağol
- Department of Pathology, Dokuz Eylül University, İzmir, Turkey
| | | | - Mine Güllüoğlu
- Department of Pathology, İstanbul University Çapa Faculty of Medicine, İstanbul, Turkey
| | - Dilara Turan Gökçe
- Department of Gastroenterology, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Zülal İstemihan
- Department of Gastroenterology, İstanbul University Çapa Faculty of Medicine, İstanbul, Turkey
| | - Tuğçe Eşkazan
- Department of Gastroenterology, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Ramazan İdilman
- Department of Gastroenterology, Ankara University, Ankara, Turkey
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Sayan M, Çelik A, Şatır Türk M, Özkan D, Akarsu I, Yazıcı O, Aydos U, Yılmaz Demirci N, Akyol G, Kurul İC, Taştepe Aİ. Oxidized Regenerated Cellulose can be a Cause of False Tumor Recurrence on PET/CT in Patients with Lung Cancer Treated Surgically. Mol Imaging Radionucl Ther 2023; 32:8-12. [PMID: 36816516 PMCID: PMC9950677 DOI: 10.4274/mirt.galenos.2022.20082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 02/24/2023] Open
Abstract
Objectives Regular follow-up of patients with lung cancer treated surgically is crucial to detect local recurrence or distant metastasis of the tumor. Postoperative follow-ups are performed with thorax computed tomography (CT) and, if necessary, positron emission tomography (PET)/CT. Sometimes, inflammatory tissue reactions due to the materials used during the surgery for hemostasis may cause the appearance of tumor recurrence in imaging modalities. In this study, we presented that oxidized regenerated cellulose (ORC) used intraoperatively may cause false tumor recurrence on PET/CT. Methods The records of patients who had local tumor recurrence after lung cancer surgery was reviewed retrospectively. Inclusion criteria were the presence of local recurrence of cancer on PET/CT, specification of using ORC in the surgical notes, and histopathological diagnosis of the recurrence site of tumor was reported as a foreign body reaction. Data of patients were collected according to age, gender, surgery performed, adjuvant therapy status, resolution status and time ORC, and standard uptake value of 18F-fluorodeoxyglucose on PET/CT. Results Eleven patients (1 female, 10 males) who met the criteria were included in the study. The median age was 64. Histopathological results of all patients were reported as foreign body reactions. The median detection time of PET/CT positivity after surgery was 139 days (range: 52-208 days). False tumor recurrence was resolved in 8 patients (72.7%) in their control radiological examinations and median resolution time was 334 days (range: 222-762 days). The median maximum standard uptake value of the lesions was 6.2 (1.7-11) on the PET/CT. Conclusion ORC used intraoperatively in patients undergoing surgery for lung cancer may cause false tumor recurrence in imaging modalities in postsurgical follow-ups. When tumor recurrence is suspected in the follow-up of these patients, histopathological confirmation is necessary to prevent unnecessary operations and treatments.
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Affiliation(s)
- Muhammet Sayan
- Gazi University Faculty of Medicine, Department of Thoracic Surgery, Ankara, Turkey,* Address for Correspondence: Gazi University Faculty of Medicine, Department of Thoracic Surgery, Ankara, Turkey Phone: +90 312 202 50 32 E-mail:
| | - Ali Çelik
- Gazi University Faculty of Medicine, Department of Thoracic Surgery, Ankara, Turkey
| | - Merve Şatır Türk
- Gazi University Faculty of Medicine, Department of Thoracic Surgery, Ankara, Turkey
| | - Dilvin Özkan
- Gazi University Faculty of Medicine, Department of Thoracic Surgery, Ankara, Turkey
| | - Irmak Akarsu
- Gazi University Faculty of Medicine, Department of Thoracic Surgery, Ankara, Turkey
| | - Ozan Yazıcı
- Gazi University Faculty of Medicine, Department of Medical Oncology, Ankara, Turkey
| | - Uğuray Aydos
- Gazi University Faculty of Medicine, Department of Nuclear Medicine, Ankara, Turkey
| | | | - Gülen Akyol
- Gazi University Faculty of Medicine, Department of Pathology, Ankara, Turkey
| | - İsmail Cüneyt Kurul
- Gazi University Faculty of Medicine, Department of Thoracic Surgery, Ankara, Turkey
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Deniz K, Umetsu SE, Ferrell L, Yılmaz F, Güllüoğlu M, Sağol Ö, Doğusoy GB, Kırımlıoğlu H, Turhan N, Doran F, Kepil N, Çelikel ÇA, Nart D, Özgüven BY, Ceyran B, Karadağ N, Kır G, Erden E, Yılmaz G, Akyol G. Hepatocellular adenomas in the Turkish population: reclassification according to updated World Health Organization criteria. Histopathology 2021; 79:23-33. [PMID: 33406290 DOI: 10.1111/his.14330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 09/14/2020] [Revised: 12/31/2020] [Accepted: 01/06/2021] [Indexed: 11/30/2022]
Abstract
AIMS Hepatocellular adenoma (HCA) is an uncommon liver neoplasm, and studies of HCA subtypes have been primarily limited to France, the USA, and Japan. The aim of this study was to describe the clinicopathological features of HCA subtypes in Turkey. METHODS AND RESULTS The resection specimens of 59 cases diagnosed as 'hepatocellular adenoma' collected from 15 institutions were reviewed to confirm the diagnosis and to classify them according to the current World Health Organization 2019 classification. Immunostaining for glutamine synthetase, liver fatty acid-binding protein, C-reactive protein, β-catenin and reticulin was performed. Of the 59 cases, 48 (81%) were diagnosed as HCA. We identified 24 (50%) hepatocyte nuclear factor 1α (HNF1α)-inactivated HCAs, five (10%) inflammatory HCAs, 15 (32%) β-catenin-activated HCAs, three (6%) β-catenin-activated inflammatory HCAs, and one (2%) unclassified HCA. HCA patients were predominantly female (female/male ratio of 5:1); they had a median age of 34 years and a median tumour diameter of 60 mm. In the β-catenin-activated HCA group, nine cases (19%) showed cytoarchitectural atypia, and were also referred to as atypical hepatocellular neoplasms. In the β-catenin-activated HCA group, three cases (6%) showed focal areas supportive of transition to HCA. The original diagnosis of HCA was changed to well-differentiated hepatocellular carcinoma in nine cases and to focal nodular hyperplasia in two cases. CONCLUSION In our series, the major HCA subtype was HNF1α-inactivated HCA. We found a low incidence of inflammatory-type HCA. Our data also showed that β-catenin-activated hepatocellular neoplasms, including cases with atypical histology, constituted a relatively high proportion of the cases. These findings are in contrast to those of most other studies of HCA subtypes.
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Affiliation(s)
- Kemal Deniz
- Department of Pathology, Erciyes University, Kayseri, Turkey
| | - Sarah E Umetsu
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA
| | - Linda Ferrell
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA
| | - Funda Yılmaz
- Department of Pathology, Ege University, İzmir, Turkey
| | - Mine Güllüoğlu
- Department of Pathology, İstanbul University, İstanbul, Turkey
| | - Özgül Sağol
- Department of Pathology, Dokuz Eylül University, İzmir, Turkey
| | - Gülen B Doğusoy
- Department of Pathology, Florence Nightingale University, İstanbul, Turkey
| | | | - Nesrin Turhan
- Department of Pathology, Ankara City Hospital, Ankara, Turkey
| | - Figen Doran
- Department of Pathology, Çukurova University, Adana, Turkey
| | - Nuray Kepil
- Department of Pathology, Cerrahpaşa University, İstanbul, Turkey
| | | | - Deniz Nart
- Department of Pathology, Ege University, İzmir, Turkey
| | - Banu Y Özgüven
- Department of Pathology, Şişli Hamidiye Etfal Research and Training Hospital, İstanbul, Turkey
| | - Bahar Ceyran
- Department of Pathology, Demiroğlu Bilim University, İstanbul, Turkey
| | - Neşe Karadağ
- Department of Pathology, İnönü University, Malatya, Turkey
| | - Gözde Kır
- Department of Pathology, Medeniyet University, İstanbul, Turkey
| | - Esra Erden
- Department of Pathology, Ankara University, Ankara, Turkey
| | - Güldal Yılmaz
- Department of Pathology, Gazi University, Ankara, Turkey
| | - Gülen Akyol
- Department of Pathology, Gazi University, Ankara, Turkey
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Abdullazade S, Akarca FG, Esendağlı G, Turhan N, Erden E, Savaş B, Markoç F, Tunçel D, Özgüven Yılmaz B, Saka B, Hallaç Keser S, Şengiz Erhan S, Gücin Z, Sağol Ö, Aysal Ağalar A, Çelik S, Özer H, Erbarut Seven İ, Ataizi Çelikel Ç, Ekinci Ö, Eğilmez HR, Balcı S, Akyol G. The Contribution of Additional Sampling in Cholecystectomy Materials: A Multicenter Prospective Study. Turk Patoloji Derg 2020; 36:188-194. [PMID: 32364613 PMCID: PMC10510599 DOI: 10.5146/tjpath.2020.01483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 02/26/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Cholecystectomy materials are frequently encountered in routine practice. The aim of this study was to determine the true frequency of gallbladder lesions, the diagnostic consistency, and standardization of reports after macroscopic sampling and microscopic evaluation based on previously defined criteria. MATERIAL AND METHOD 14 institutions participated in the study within the Hepato-Pancreato-Biliary Pathology Study Group. Routinely examined cholecystectomies within the last year were included in the study in these institutions. Additional sampling was performed according to the indications and criteria. The number of blocks and samples taken in the first macroscopic examination and the number of blocks and samples taken in the additional sampling were determined and the rate of diagnostic contribution of the additional examination was determined. RESULTS A total of 5,244 cholecystectomy materials from 14 institutions were included in the study. Additional sampling was found to be necessary in 576 cases (10.98%) from all institutions. In the first macroscopic sampling, the mean of the numbers of samples was approximately 4 and the number of blocks was 2. The mean of the numbers of additional samples and blocks was approximately 8 and 4, respectively. The diagnosis was changed in 144 of the 576 new sampled cases while the remaining 432 stayed unaltered. CONCLUSION In this study, it was observed that new sampling after the first microscopic examination of cholecystectomy materials contributed to the diagnosis. It was also shown that the necessity of having standard criteria for macroscopic and microscopic examination plays an important role in making the correct diagnosis.
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Affiliation(s)
- Samir Abdullazade
- Department of Pathology, İzmir Tepecik Education and Research Hospital, İzmir, Turkey
| | - Fahire Göknur Akarca
- Department of Medical Pathology, Gazi University, Faculty of Medicine, Ankara, Turkey
| | - Güldal Esendağlı
- Department of Medical Pathology, Gazi University, Faculty of Medicine, Ankara, Turkey
| | - Nesrin Turhan
- Department of Pathology, Turkey Yüksek İhtisas Education and Research Hospital, Ankara, Turkey
| | - Esra Erden
- Department of Medical Pathology, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Berna Savaş
- Department of Medical Pathology, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Fatma Markoç
- Department of Pathology, Dr. Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Ankara, Turkey
| | - Deniz Tunçel
- Şişli Etfal Education and Research Hospital, İstanbul, Turkey
| | | | - Burcu Saka
- Department of Medical Pathology, Medipol University, Faculty of Medicine, İstanbul, Turkey
| | - Sevinç Hallaç Keser
- Department of Pathology, Lütfi Kırdar Education and Research Hospital, İstanbul, Turkey
| | | | - Zühal Gücin
- Department of Medical Pathology, Bezmialem Vakıf University, Faculty of Medicine, İstanbul, Turkey
| | - Özgül Sağol
- Dokuz Eylül University, Faculty of Medicine, İzmir, Turkey
| | | | - Sevinç Çelik
- Bozok University, Faculty of Medicine, Yozgat, Turkey
| | - Hatice Özer
- Cumhuriyet University, Faculty of Medicine, Sivas, Turkey
| | | | | | - Özgür Ekinci
- Department of Medical Pathology, Gazi University, Faculty of Medicine, Ankara, Turkey
| | | | | | - Gülen Akyol
- Department of Medical Pathology, Gazi University, Faculty of Medicine, Ankara, Turkey
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Esendağlı G, Akarca FG, Balcı S, Argon A, Erhan SŞ, Turhan N, Zengin Nİ, Keser SH, Çelik B, Bulut T, Abdullazade S, Erden E, Savaş B, Bostan T, Sağol Ö, Ağalar AA, Kepil N, Karslıoğlu Y, Günal A, Markoç F, Saka B, Özgün G, Özdamar ŞO, Bahadır B, Kaymaz E, Işık E, Ayhan S, Tunçel D, Yılmaz BÖ, Çelik S, Karabacak T, Seven İE, Çelikel ÇA, Gücin Z, Ekinci Ö, Akyol G. A Retrospective Evaluation of the Epithelial Changes/Lesions and Neoplasms of the Gallbladder in Turkey and a Review of the Existing Sampling Methods: A Multicentre Study. Turk Patoloji Derg 2018; 34:41-48. [PMID: 28984336 DOI: 10.5146/tjpath.2017.01404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE As there is continuing disagreement among the observers on the differential diagnosis between the epithelial changes/lesions and neoplasms of the gallbladder, this multicentre study was planned in order to assess the rate of the epithelial gallbladder lesions in Turkey and to propose microscopy and macroscopy protocols. MATERIAL AND METHOD With the participation of 22 institutions around Turkey that were included in the Hepato-Pancreato-Biliary Study Group, 89,324 cholecystectomy specimens sampled from 2003 to 2016 were retrospectively evaluated. The numbers of adenocarcinomas, dysplasias, intracholecystic neoplasms/adenomas, intestinal metaplasias and reactive atypia were identified with the review of pathology reports and the regional and countrywide incidence rates were presented in percentages. RESULTS Epithelial changes/lesions were reported in 6% of cholecystectomy materials. Of these epithelial lesions, 7% were reported as adenocarcinoma, 0.9% as high-grade dysplasia, 4% as low-grade dysplasia, 7.8% as reactive/regenerative atypia, 1.7% as neoplastic polyp, and 15.6% as intestinal metaplasia. The remaining lesions (63%) primarily included non-neoplastic polypoids/hyperplastic lesions and antral/pyloric metaplasia. There were also differences between pathology laboratories. CONCLUSION The major causes of the difference in reporting these epithelial changes/lesions and neoplasms include the differences related to the institute's oncological surgery frequency, sampling protocols, geographical dissimilarities, and differences in the diagnoses/interpretations of the pathologists. It seems that the diagnosis may change if new sections are taken from the specimen when any epithelial abnormality is seen during microscopic examination of the cholecystectomy materials.
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Affiliation(s)
- Güldal Esendağlı
- Department of Medical Pathology, Gazi University School of Medicine, Ankara, Turkey
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Cetin M, Akyol G, Gonen ZB, Keklik M, Zararsiz G, Unal A, Tiren-Verbeet NL, Kaynar L. Additional infusions of mesenchymal stem cells improve response rate in multidrug-resistant GvHD patients. Bone Marrow Transplant 2017; 52:783-785. [PMID: 28287643 DOI: 10.1038/bmt.2017.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- M Cetin
- Erciyes University Transplantation Center, Kayseri, Turkey
| | - G Akyol
- Department of Hematology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Z B Gonen
- Genome and Stem Cell Center, Erciyes University, Kayseri, Turkey
| | - M Keklik
- Department of Hematology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - G Zararsiz
- Department of Statistics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - A Unal
- Erciyes University Transplantation Center, Kayseri, Turkey
| | | | - L Kaynar
- Erciyes University Transplantation Center, Kayseri, Turkey
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Dogan M, Sen M, Koc M, Silig Y, Akyol G, Karadayi K, Turan M. Effects of the Pringle Manoeuvre on the Healing of Left Colonic Anastomoses in Rats. Acta Chir Belg 2016. [DOI: 10.1080/00015458.2014.11680979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M. Dogan
- Department of General Surgery, Sivas, Turkey
| | - M. Sen
- Department of General Surgery, Sivas, Turkey
| | - M. Koc
- Department of General Surgery, Sivas, Turkey
| | - Y. Silig
- Department of Biochemistry, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | - G. Akyol
- Department of General Surgery, Sivas, Turkey
| | - K. Karadayi
- Department of General Surgery, Sivas, Turkey
| | - M. Turan
- Department of General Surgery, Sivas, Turkey
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Dogan M, Sen M, Koc M, Silig Y, Akyol G, Karadayi K, Turan M. Effects of the Pringle manoeuvre on the healing of left colonic anastomoses in rats. Acta Chir Belg 2014; 114:63-65. [PMID: 24720141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Whether to perform colorectal cancer and liver metastasis resections simultaneously or in separate procedures is controversial. The aim of the present study was to investigate the effect of the Pringle manoeuvre on the healing of left-sided colonic anastomoses in rats. METHODS Sixteen rats were randomly separated into two groups. In Groups 1 and 2, 1 cm of descending colon was resected and a primary anastomosis was performed. In Group 2, an intermittent pedicle clamp (the Pringle manoeuvre) was performed. On postoperative day 5, laparotomy was performed and the bursting pressures of all colon anastomoses were determined. Tissues were sampled for assay of hydroxyproline levels. Cultures of intraperitoneal swabs were also performed. RESULTS Clostridium was twice as abundant in the Pringle manoeuvre group as in the control group (p < 0.05). Anastomosis-bursting pressures and tissue hydroxyproline levels were significantly lower in the Pringle manoeuvre group than in the control group (p < 0.05). CONCLUSIONS The Pringle manoeuvre may compromise the viability of colonic anastomoses.
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Gümüşay O, Ozenirler S, Atak A, Sönmez C, Ozkan S, Tuncel AF, Yılmaz G, Akyol G. Diagnostic potential of serum direct markers and non-invasive fibrosis models in patients with chronic hepatitis B. Hepatol Res 2013; 43:228-37. [PMID: 22734888 DOI: 10.1111/j.1872-034x.2012.01057.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
AIM Liver biopsy is recommended in the majority of patients with chronic viral hepatitis for fibrosis evaluation. Because of the disadvantages of liver biopsy, many studies related to non-invasive biomarkers and scores have been performed. In this study, we aimed to assess the diagnostic value of serum direct markers and non-invasive fibrosis models to predict liver fibrosis in the treatment-naive chronic hepatitis B (CHB) patients and to compare their diagnostic performance. METHODS This study included 58 patients with a diagnosis of CHB virus infection and 30 healthy controls. Hyaluronic acid, tissue inhibitor of matrix metalloproteinase 1 and amino-terminal propeptide of type III procollagen were measured by enzyme-linked immunosorbent assay; and the Original European Liver Fibrosis panel, the Enhanced Liver Fibrosis (ELF) panel, PP score, aspartate aminotransferase to platelet ratio index (APRI) and FIB-4 indexes were calculated using the formulas taken from previous publications. Fibrosis stage was determined using Ishak's scoring system. RESULTS The fibrosis stages identified upon liver biopsy was F0 in 12 patients (20.7%), F1-2 in 36 (62.1%) and F3-5 in 10 (17.2%). The diagnostic value of all the non-invasive indices was low to detect mild fibrosis. We demonstrated that the diagnostic accuracy of HA is the best for predicting fibrosis of F3 or more (area under the receiver-operator curve, 0.902). In our study, the results from a combination of tests showed that ELF and APRI had the highest diagnostic value sensitivity of 90%, specificity of 100%, positive predictive value of 100% and negative predictive value of 96.4% for detection of fibrosis of F3 or more. CONCLUSION In CHB patients, combination of ELF and APRI has a better diagnostic value in predicting fibrosis of F3 or more.
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Affiliation(s)
- Ozge Gümüşay
- Departments of Internal Medicine Gastroenterology Immunology Public Health Biochemistry Pathology, Gazi University Faculty of Medicine, Ankara, Turkey
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Keklik M, Kaynar L, Pala C, Sivgin S, Aribas S, Akyol G, Unluhizarci K, Cetin M, Eser B, Unal A. P-56 THERAPEUTIC APHERESIS DUE TO SEVERE HYPERTHYROIDISM. Transfus Apher Sci 2012. [DOI: 10.1016/s1473-0502(12)70092-7] [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: 10/27/2022]
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Keklik M, Sivgin S, Kalin B, Akyol G, Pala C, Solmaz M, Kaynar L, Eser B, Cetin M, Unal A. P-43 THE CONTROL OF ACUTE LYMPHOBLASTIC LEUKAEMIA CAUSED HYPERLEUKOCYTOSIS WITH LEUKOPHERESIS ON AN ADULT ATAXIA-TELANGIECTASIA PATIENT. Transfus Apher Sci 2012. [DOI: 10.1016/s1473-0502(12)70079-4] [Citation(s) in RCA: 1] [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: 11/15/2022]
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Ergün M, Cindoruk M, Akyürek N, Akyol G, Ünal S. A case of primary gastric Burkitt-like lymphoma with chemotherapy-induced perforation. Turk J Gastroenterol 2012; 23:299-300. [PMID: 22798124 DOI: 10.4318/tjg.2012.0373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Erpolat P, Gocun PU, Akmansu M, Ozgun G, Akyol G. 8720 POSTER Positive Osteopontin Expression in High Grade Gliomas Predicts Poor Prognosis. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72271-7] [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: 11/24/2022]
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Ozenırler S, Erkan G, Gülbahar O, Bostankolu O, Ozbaş Demırel O, Bılgıhan A, Akyol G. Serum levels of advanced oxidation protein products, malonyldialdehyde, and total radical trapping antioxidant parameter in patients with chronic hepatitis C. Turk J Gastroenterol 2011; 22:47-53. [PMID: 21480111 DOI: 10.4318/tjg.2011.0156] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND/AIMS Oxidative stress increases in chronic hepatitis C, and antioxidant defense mechanisms are impaired. The aims of this study were to compare chronic hepatitis C patients and healthy subjects according to oxidative stress and antioxidant system markers, and to determine the relationship between oxidative stress and hepatosteatosis. METHODS This is an observational study in a tertiary center. Twenty-nine biopsy-proven chronic hepatitis C patients, with no prior anti-viral treatment and persistently elevated serum transaminase levels for 6 months, were included. The control group included 46 healthy subjects. Advanced oxidation protein products and malonyldialdehyde levels were measured. Total radical-trapping antioxidant parameter was calculated. RESULTS Baseline characteristics were similar in the patient and control groups. In chronic hepatitis C patients, serum levels of advanced oxidation protein products were significantly higher than in the control group (235.0±142.8 vs 116.7±79.5, p<0.001). Serum levels of malonyldialdehyde were also significantly higher than in the control group (9.3±2.1 vs 6.5±1.1, p<0.001). However, there was no significant difference in total radical-trapping antioxidant parameter. The total radical-trapping antioxidant parameter/advanced oxidation protein products index was significantly lower in chronic hepatitis C patients than in healthy controls (p<0.05). There was no significant correlation between advanced oxidation protein products and malonyldialdehyde and hepatosteatosis. CONCLUSIONS We conclude that oxidative stress occurs in chronic hepatitis C, and antioxidant defense mechanisms are inadequate. Serum levels of advanced oxidation protein products and malonyldialdehyde are higher in chronic hepatitis C patients when compared to healthy individuals, and may be useful markers in chronic hepatitis C.
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Affiliation(s)
- Seren Ozenırler
- Departments of, Gastroenterology, Gazi University School of Medicine, Ankara.
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15
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Erpolat P, Uyar Gocun P, Akmansu M, Karakus E, Akyol G. Aurora-B and Survivin Expression in Head and Neck Cancer: Correlation with Clinicopathologic Features and Patient Survival. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1043] [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: 11/15/2022]
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16
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Ozturk B, Coskun U, Yaman E, Cakir A, Akdemir UO, Yildiz R, Akyol G, Demirci U, Buyukberber S, Tezel E, Benekli M. Adult hepatic epitheloid haemangioendothelioma presenting with Kasabach-Merrit syndrome: a case report. J Clin Pathol 2010; 62:1053-5. [PMID: 19861572 DOI: 10.1136/jcp.2009.070706] [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] [Indexed: 11/04/2022]
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17
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Arslan M, Ozkose Z, Akyol G, Barit G. The age- and gender-dependent effects of desflurane and sevoflurane on rat liver. ACTA ACUST UNITED AC 2009; 62:35-43. [PMID: 19181502 DOI: 10.1016/j.etp.2008.12.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2008] [Revised: 12/10/2008] [Accepted: 12/30/2008] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This study aimed to investigate the age- and gender-dependent effects of desflurane and sevoflurane on the liver. MATERIAL AND METHOD Upon the approval of ethics committee, 84 rats were divided into four groups as 21 young male, 21 young female, 21 old male, and 21 old female rats. Then, each group was further divided into three groups as desflurane, sevoflurane, and control groups. Maintaining the minimum alveolar concentration of 1, desflurane at 6vol% and sevoflurane at 2vol% in 6Lmin(-1) 100% O2 were administered for 2h in a transparent plastic container of 40cmx40cmx70cm. Each liver preparation was evaluated for hydropic degeneration, nuclear polymorphism, portal neutrophile infiltration, portal lymphocyte infiltration, and focal necrosis, and each preparation was assigned injury points of 0-3; thus, the number of histopathologically injured cases, total injury scores of each preparation, and the mean injury scores of each group were determined. RESULTS Desflurane and sevoflurane did not significantly increase hepatic injury in the young male rats, while both agents caused significantly more hepatic injury in the young female rats. In the old rats, both desflurane and sevoflurane inflicted more hepatic injury on both genders. In addition, desflurane caused more hepatic injury in the old female rats than in the young female or the old male rats. CONCLUSION Hepatic injury associated with desflurane and sevoflurane was mild to moderate, suggesting that both agents can be safely used in routine anaesthesia procedures.
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Affiliation(s)
- M Arslan
- Department of Anaesthesiology and Reanimation, Gazi University School of Medicine, Ankara, Turkey.
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18
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Erdem O, Erdem M, Erdem A, Memis L, Akyol G. Expression of vascular endothelial growth factor and assessment of microvascular density with CD 34 and endoglin in proliferative endometrium, endometrial hyperplasia, and endometrial carcinoma. Int J Gynecol Cancer 2007; 17:1327-32. [PMID: 17442020 DOI: 10.1111/j.1525-1438.2007.00942.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [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: 11/28/2022] Open
Abstract
The aim of this study was to compare vascular endothelial growth factor (VEGF), CD 34, and endoglin expressions as markers of angiogenesis in proliferative endometrium (PE), endometrial hyperplasia (EH), and endometrial carcinoma (EC) and to find the possible impact of angiogenesis on malign transformation. Formalin-fixed, paraffin-embedded tissues from 12 patients with PE, 23 patients with simple EH and complex EH with atypia, and 31 patients with EC were included. A semiquantitative scoring system was used to assess the intensity and degree of staining of VEGF. Microvessel density (MVD) was assessed with endoglin and anti-CD 34 in most vascular areas. VEGF expression was significantly higher in EC and EH than PE, but there was no difference between EC and EH. According to CD 34 staining, there were no differences in MVD between groups. However, mean MVD counts assessed by endoglin were significantly higher in EC than PE and EH. Although VEGF expression in EC was significantly higher, it did not correlate with other measures of angiogenesis. MVD using endoglin seemed to reflect neoplastic angiogenesis better than CD 34
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Affiliation(s)
- O Erdem
- Department of Pathology, Gazi University, Ankara, Turkey.
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19
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Yakaryilmaz F, Guliter S, Savas B, Erdem O, Ersoy R, Erden E, Akyol G, Bozkaya H, Ozenirler S. Effects of vitamin E treatment on peroxisome proliferator-activated receptor-? expression and insulin resistance in patients with non-alcoholic steatohepatitis: results of a pilot study. Intern Med J 2007; 37:229-35. [PMID: 17388862 DOI: 10.1111/j.1445-5994.2006.01295.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [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: 11/29/2022]
Abstract
BACKGROUND Insulin resistance (IR) is commonly associated with non-alcoholic steatohepatitis (NASH). Peroxisome proliferator-activated receptor-alpha (PPAR-alpha) may also play a role in the pathogenesis of NASH. A pivotal role in NASH pathogenesis depends on the hypothesis of increased oxidative stress. The aim of our study was to evaluate the effects of supplemental oral vitamin E, a potent antioxidant, on liver functions, PPAR-alpha expression and IR in patients with NASH. METHODS Nine patients with biopsy-proven NASH were given oral vitamin E 800 mg daily for 24 weeks. Liver functions, lipid parameters, IR index with homeostatic metabolic assessment and liver histology and PPAR-alpha staining index in biopsy specimens were detected before and after the treatment. RESULTS Seven patients (78%) had IR initially. After 6 months of therapy in nine patients, fasting insulin improved (P = 0.01), but serum cholesterol, triglyceride, fasting blood glucose levels and body mass index remained unchanged. Aspartate aminotransferase and alanine aminotransferase levels decreased (P = 0.01 and P = 0.01, respectively). IR index with homeostatic metabolic assessment resistance improved (P = 0.01), but PPAR-alpha staining index did not change (P = 0.37). Although the histological grade of steatosis decreased (P = 0.01), necroinflammation and fibrosis remained unchanged. In seven patients with IR, however, necroinflammation and PPAR-alpha staining index were improved (P = 0.04 and P = 0.02). CONCLUSION Vitamin E treatment, in addition to its previously shown beneficial effect by suppressing oxidative stress, may also achieve improvement by reducing IR and PPAR-alpha expression in NASH.
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Affiliation(s)
- F Yakaryilmaz
- Department of Internal Medicine, Division of Gastroenterology, University of Kirikkale, School of Medicine, Kirikkale, Turkey.
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20
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Dalgiç B, Sari S, Gündüz M, Ezgü F, Tümer L, Hasanoğlu A, Akyol G. Cholesteryl ester storage disease in a young child presenting as isolated hepatomegaly treated with simvastatin. Turk J Pediatr 2006; 48:148-51. [PMID: 16848116] [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: 05/10/2023]
Abstract
Cholesteryl ester storage disease (CESD) is an autosomal recessive disorder resulting from lysosomal acid lipase deficiency and is usually characterized by hepatomegaly and hyperlipidemia. This paper reports a two-year-old boy who had hepatosplenomegaly, hyperlipidemia and hypertransaminasemia determined incidentally. The liver biopsy sample was orange-yellow in appearance. Microscopically, microvesicular steatosis and birefringent crystals were seen in liver biopsy. The diagnosis of CESD was confirmed by the reduced human acid lipase activity in peripheral leukocytes. Simvastatin therapy was given and tolerated without side effects. Our patient is the youngest reported case in the literature treated with 3-hydroxy 3-methyl glutaryl (HMG) CoA reductase inhibitor.
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Affiliation(s)
- Buket Dalgiç
- Department of Pediatrics, Gazi University Faculty of Medicine, Ankara, Turkey
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21
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Idilman R, Kuzu I, Erden E, Arat M, Soydan E, Soykan I, Akyol G, Karayalcin S, Akan H, Beksac M. Evaluation of the effect of transplant-related factors and tissue injury on donor-derived hepatocyte and gastrointestinal epithelial cell repopulation following hematopoietic cell transplantation. Bone Marrow Transplant 2005; 37:199-206. [PMID: 16299546 DOI: 10.1038/sj.bmt.1705214] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [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: 11/08/2022]
Abstract
The aim of this study was to detect donor-derived hepatocytes and gastrointestinal epithelial cells in recipients of sex-mismatched allogeneic hematopoietic cell transplants, and to assess the effect of tissue injury on the extent of the repopulation. A total of 29 paraffin-embedded biopsy samples were reviewed. Double labeling by immunohistochemistry and fluorescence in situ hybridization was performed. Eighty-nine percent of sex-mismatched samples with histologic evidence of injury demonstrated the presence of donor-derived hepatocytes and gastrointestinal epithelial cells (mean 2.4%). None of the hepatocytes and gastrointestinal epithelial cells in samples obtained from female recipients with female donors showed a Y chromosome signal. The proportion of donor-derived hepatocyte and gastrointestinal epithelial cells in samples with severe graft-versus-host disease was greater than that of samples with mild/moderate graft-versus-host disease (P = 0.09). No relationship between the source of stem cells and the population rate was detected (P > 0.05). We conclude that some recipient hepatocytes and gastrointestinal tract epithelial cells are replaced by donor-derived cells during tissue injury. The severity of tissue injury seems to influence on the extent of this repopulation.
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Affiliation(s)
- R Idilman
- Department of Gastroenterology, Ankara University School of Medicine, Ibn'i Sina Hospital, Sihhiye, Ankara, Turkey.
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Simsek Z, Ekinci O, Cindoruk M, Karakan T, Degertekin B, Akyol G, Unal S. Fibrinogen storage disease without hypofibrinogenemia associated with estrogen therapy. BMC Gastroenterol 2005; 5:36. [PMID: 16287505 PMCID: PMC1299324 DOI: 10.1186/1471-230x-5-36] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2005] [Accepted: 11/15/2005] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cytoplasmic inclusion bodies within hepatocytes may have different etiologies, including the Endoplasmic Reticulum Storage Diseases (ERSDs). ERSD is a pathological condition characterized by abnormal accumulation of proteins destined for secretion in the endoplasmic reticulum of hepatocytes; it may be congenital (primary) or acquired (secondary). Fibrinogen storage disease is a form of ERSD. CASE PRESENTATION We present a case of fibrinogen storage disease secondary to estrogen replacement therapy. Its causal relationship to the drug is shown by histological, immunohistochemical and ultrastructural studies of paired liver biopsies obtained during and after the drug therapy. CONCLUSION The liver biopsies of patients with idiopathic liver enzyme abnormalities should be carefully evaluated for cytoplasmic inclusion bodies and, although rare, fibrinogen deposits.
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Affiliation(s)
- Z Simsek
- Gazi University Faculty of Medicine, Gastroenterology Department, Ankara, Turkey
| | - O Ekinci
- Gazi University Faculty of Medicine, Pathology Department, Ankara, Turkey
| | - M Cindoruk
- Gazi University Faculty of Medicine, Gastroenterology Department, Ankara, Turkey
| | - T Karakan
- Gazi University Faculty of Medicine, Gastroenterology Department, Ankara, Turkey
| | - B Degertekin
- Gazi University Faculty of Medicine, Gastroenterology Department, Ankara, Turkey
| | - G Akyol
- Gazi University Faculty of Medicine, Pathology Department, Ankara, Turkey
| | - S Unal
- Gazi University Faculty of Medicine, Gastroenterology Department, Ankara, Turkey
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Uzüm N, Akyol G, Asal K, Köybaşioğlu A. Ameloblastic carcinoma containing melanocyte and melanin pigment in the mandible: a case report and review of the literature. J Oral Pathol Med 2005; 34:618-20. [PMID: 16202083 DOI: 10.1111/j.1600-0714.2005.00306.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [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
A case of ameloblastic carcinoma containing melanocyte and melanin in a 66-year-old male with swelling and an ulcerating firm mass in the left submandibular region is presented. The diagnosis was confirmed by biopsy. The current histopathological diagnosis and management are discussed.
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Affiliation(s)
- N Uzüm
- Gazi Universitesi Tip Fakültesi, Patoloji Anabilim Dali, Ankara, Turkey.
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24
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Doğanci T, Akyol G, Bulaç S. Progressive familial intrahepatic cholestasis with normal GGT level appearing with lichenification and enlargement of hands and feet. Turk J Pediatr 2005; 47:385-9. [PMID: 16363353] [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: 05/05/2023]
Abstract
Progressive familial intrahepatic cholestasis is a serious disease of the liver, known as Byler disease, characterized by hepatocellular cholestasis. Severe pruritus and high serum bile acid concentrations are the most important diagnostic criteria of this autosomal recessive inherited disease. Here, we present a five-year-old boy with lichenification and enlargement of hands and feet as a sign of progressive familial intrahepatic cholestasis due to severe pruritus.
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Affiliation(s)
- Tümay Doğanci
- Department of Pediatric Gastroenterology, Social Security Children's Hospital, Ankara, Turkey
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Dalgiç B, Dursun I, Akyol G. A case of visceral leishmaniasis misdiagnosed as autoimmune hepatitis. Turk J Gastroenterol 2005; 16:52-3. [PMID: 16252191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
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26
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Unal OF, Ghoreishi SM, Ataş A, Akyürek N, Akyol G, Gürsel B. Prevention of gentamicin induced ototoxicity by trimetazidine in animal model. Int J Pediatr Otorhinolaryngol 2005; 69:193-9. [PMID: 15656952 DOI: 10.1016/j.ijporl.2004.08.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [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: 05/22/2004] [Revised: 08/15/2004] [Accepted: 08/30/2004] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To show the efficacy of intra-peritoneally administered trimetazidine to prevent gentamicin ototoxicity, which is still an important cause of profound deafness among children in different parts of the world. METHODS Two groups of Swiss albino mice received daily intra-muscular injections of gentamicin for 30 days. One of the groups received trimetazidine intra peritoneally in addition to the gentamicin. Auditory thresholds of the animals were measured by evoked brain stem response at the beginning and the end of the study. Results were compared to the results of the control group, which received intra peritoneal saline injections. RESULTS Both groups receiving gentamicin injections had significant auditory threshold shifts, but in the group receiving additional trimetazidine, the threshold shift was not statistically significant when compared to control group. Threshold shift in gentamicin group significantly differed from that of the control group (p=0.0001) and gentamicin+trimetazidine group (p=0.0001), on the other hand there was no statistically significant difference between control group and trimetazidine+gentamicin group (p=0.102). CONCLUSION Gentamicin ototoxicity can be prevented by intra peritoneal trimetazidine injections in animal model. This treatment modality may be a mode of protection from gentamicin ototoxicity in children.
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Affiliation(s)
- Omer Faruk Unal
- Department of Otolaryngology Head and Neck Surgery, Medical Faculty, Ankara, Hacettepe University, Turkey.
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Oğretmenoğlu O, Akyol G. The repair of cerebrospinal fluid rhinorrhea: comparison of histopathologic findings with cadaveric human temporal fascia, dura mater, and autologous fascia in a rabbit model. Kulak Burun Bogaz Ihtis Derg 2004; 13:1-8. [PMID: 16027484] [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] [Indexed: 05/03/2023]
Abstract
OBJECTIVES To evaluate the repair of cerebrospinal fluid rhinorrhea through the transnasal approach, we investigated histopathologic findings of grafting with human temporalis fascia and dura mater in a rabbit model. DESIGN AND METHODS Thirty-two rabbits were assigned to three groups according to the graft material to be used: human dura mater, human temporalis fascia, and autologous muscle fascia (control group). The repair of the surgically induced bony opening was performed via the transnasal approach. To evaluate healing process histopathologically, decapitation was performed at the end of 1, 2, 3, and 4 weeks in the control group; 1, 2, 3, 4, 32 and 40 weeks in the dura mater group; 4, 32 and 40 weeks in the temporalis fascia group. RESULTS Macroscopically, adhesions to the cerebral cortex were not observed with any of the grafts. Histopathologically, complete healing occurred in four weeks in the control group. Healing took longer in both cadaveric graft groups, in which formation of giant cells was the most prominent feature at the end of four weeks, suggesting a late rejection. Nevertheless, these cells disappeared and complete resolution was observed at the end of 32 and 40 weeks. Despite prolonged healing, no adverse clinical effects were observed. CONCLUSION This experimental model showed that human temporalis fascia can be used instead of dura mater in the repair of cerebrospinal fluid rhinorrhea.
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Affiliation(s)
- Oğuz Oğretmenoğlu
- Department of Otolaryngology, Medicine Faculty of Hacettepe University, Ankara, Turkey.
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Işik Gönül I, Asal K, Ceylan A, Akyol G. Hamartoma of the larynx: an unusual cause of upper airway obstruction. Eur Arch Otorhinolaryngol 2003; 261:435-8. [PMID: 14624305 DOI: 10.1007/s00405-003-0712-x] [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] [Received: 03/13/2003] [Accepted: 10/03/2003] [Indexed: 10/26/2022]
Abstract
Hamartomas are rare lesions in the larynx. Both clinical and histopathological findings may be misleading to both the physician and the pathologist in terms of diagnosis. A 51-year-old female with the complaints of nonproductive cough and severe dyspnea lasting for a year was found to have a subglottic, submucosal mass almost totally obstructing the laryngeal lumen. Excisional biopsy was performed under suspensory direct laryngoscopy. Histopathological examination showed numerous, large, distended blood vessels, some of which had prominent thickened walls and mature adipose tissue beneath the surface epithelium. The final diagnosis was hamartoma, but we discussed its validity and other possible identifications in accordance with the literature.
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Affiliation(s)
- Ipek Işik Gönül
- Department of Pathology, Gazi University School of Medicine, Ankara, Turkey.
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Akyürek N, Akyol G, Dursun A, Yamaç D, Günel N. Expression of MUC1 and MUC2 mucins in gastric carcinomas: their relationship with clinicopathologic parameters and prognosis. Pathol Res Pract 2003; 198:665-74. [PMID: 12498221 DOI: 10.1078/0344-0338-00318] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [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] [Indexed: 12/11/2022]
Abstract
The aim of this study was to investigate the relationship between MUC1 and MUC2 mucin expressions and clinicopathologic variables in gastric carcinomas with regard to survival times. MUC1 and MUC2 expressions were revealed immunohistochemically in 143 gastric carcinomas. Of these 143 patients, follow-up data were available for 45 (median survival time of 30 months, ranging from 2 to 80 months). MUC1 was detected in 82 (58%), and MUC2 in 60 (42%) out of 143 cases. Papillary adenocarcinomas showed significantly higher MUC1 and MUC2 immunoreactivity than did signet-ring cell and mucinous tumors (p = 0.045 and p = 0.01, respectively). MUC1 was highly positive in intestinal-type carcinomas (p = 0.006), whereas intestinal and diffuse carcinomas did not differ in MUC2 expression. There was a positive correlation between tumor differentiation and MUC1 expression. However, no correlation was found between MUC1 and MUC2 expressions and angiolymphatic invasion. According to the TNM classification, stage 1A tumors have significantly lower rates of MUC1 reactivity compared to higher stages (p = 0.04). The patients with gastric carcinomas expressing MUC1 showed significantly poorer survival than those without MUC1 expression (p = 0.04). The present study suggests that MUC1 expression be a useful prognostic factor for predicting the outcome of gastric carcinoma patients, whereas the role of MUC2 expression is still unclear.
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Affiliation(s)
- Nalan Akyürek
- Pathology Department, Gazi University Medical School, Ankara, Turkey.
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Bilgihan A, Bilgihan K, Yis O, Sezer C, Akyol G, Hasanreisoglu B. Effects of topical vitamin E on corneal superoxide dismutase, glutathione peroxidase activities and polymorphonuclear leucocyte infiltration after photorefractive keratectomy. Acta Ophthalmol Scand 2003; 81:177-80. [PMID: 12752058 DOI: 10.1034/j.1600-0420.2003.00042.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE Photorefractive keratectomy (PRK) induces free radical formation and polymorphonuclear (PMN) cell infiltration in the cornea. Vitamin E is a free radical scavenger and protects the cells from reactive oxygen species. We investigated the effects of topical vitamin E on corneal PMN cell infiltration and corneal antioxidant enzyme activities after PRK. METHODS We studied four groups, each consisting of seven eyes. Group 1 were control eyes. In group 2 the corneal epithelium was removed by a blunt spatula (epithelial scrape). In group 3, corneal photoablation (59 micro m, 5 dioptres) was performed after epithelial removal (traditional PRK). In group 4 we tested the effects of topical Vitamin E after traditional PRK. Corneal tissues were removed and studied with enzymatic analysis (measurement of corneal superoxide dismutase and glutathione peroxidase activities) and histologically. RESULTS Stromal PMN leucocyte counts were significantly higher after mechanical epithelial removal and traditional PRK (p < 0.05). Corneal superoxide dismutase and glutathione peroxidase activities decreased significantly after mechanical epithelial removal and traditional PRK (p < 0.05). In group 4, treated with vitamin E, corneal superoxide dismutase activity did not differ significantly from that in the medically non-treated groups, nor did corneal PMN cell infiltration after traditional PRK. The reduction of corneal glutathione peroxidase activity after PRK was reduced significantly after topical vitamin E treatment. CONCLUSIONS Topical vitamin E treatment may be useful for reducing the harmful effects of reactive oxygen radical after epithelial scraping and PRK in that it increases corneal glutathione peroxidase activity.
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Affiliation(s)
- Ayse Bilgihan
- Department of Biochemistry, Gazi University Medical School, Ankara, Turkey.
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Abstract
Tumor angiogenesis is believed to be related to prognostic factors involved in tumor development and metastasis. Using immunohistochemical methods, we evaluated tumor angiogenesis in 42 early invasive breast cancer patients (T1-2, NO-1-2, M0). Four patients received tamoxifen, 25 patients received CAF or CA, and 15 patients received CMF as adjuvant therapy. The median follow-up was 47 (range 24-119) months. Ten patients (43.5%) in the node-positive group and 2 patients (10.5%) in the node-negative group relapsed (p = 0.019). The mean microvessel count (MVC) was 60.3 3.05 per 200x field (range: 16-95). MVCs of postmenopausal and premenopausal patients were 50.13 +/- 5.74 and 68.64 +/- 4.11, respectively, in the axillary lymph node (ALN)-negative patient group (p = 0.04). Staining was moderate to strong in 13 (68%) ALN-negative and in 17 (74%) ALN-positive patients (p > 0.05), and was also moderate to strong in 82% of premenopausal patients and in 50% of postmenopausal patients (p = 0.037). There was no significant relationship between angiogenesis and p53, nor was angiogenesis significantly associated with the patient ER status and tumor size. No significant correlations were found between OS/DFS and Factor VIII staining or p53 (log rank test, p > 0.05). Of all ALN-negative patients with increased angiogenesis, one patient of the CMF group relapsed, but no recurrence occurred in patients undergoing anthracycline-based chemotherapy (p > 0.05). On the other hand, of all ALN-positive patients with increased angiogenesis, 5/14 patients treated with anthracylcine and 2/2 CMF-treated patients relapsed (p = 0.175). Despite the statistical insignificance, anthracycline-based adjuvant chemotherapy appears to be more effective than CMF as regards relapse prevention particularly in early ALN-positive breast cancer patients with increased angiogenesis. Additional studies are necessary to demonstrate the clinical importance of angiogenesis.
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Affiliation(s)
- Nazan Gunel
- Gazi University Medical School, Department of Medical Oncology, Turkey.
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Dinçer S, Ozenirler S, Oz E, Akyol G, Ozoğul C. The protective effect of taurine pretreatment on carbon tetrachloride-induced hepatic damage--a light and electron microscopic study. Amino Acids 2002; 22:417-26. [PMID: 12107767 DOI: 10.1007/s007260200025] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [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: 10/27/2022]
Abstract
The results regarding taurine pretreatment on CCl(4)-induced hepatic injury are controversial. To assess the therapeutic efficacy of taurine on rat liver injury, hepatic malondialdehyde, glutathione, and hydroxyproline levels together with morphologic alterations in the liver following CCl(4) administration were investigated. The rats were divided into three groups. Taurine-treated animals received 15 ml/kg/day of a 5% taurine solution by a gastric tube for 5 days before administering CCl(4) (2 ml/kg, intraperitoneally, in a single dose). CCl(4)-treated rats received the same amount of saline solution. Control animals received no treatment. The increase of hepatic malondialdehyde formation in the CCl(4)-treated group was partially prevented by taurine pretreatment, but taurine had no significant effect on the glutathione and hydroxyproline content in the CCl(4)-treated rats. Taurine pretreatment induced a marked beneficial effect regarding the prevention of hepatocellular necrosis and atrophy as demonstrated morphologically. In conclusion, these results suggest that taurine pretreatment might not significantly change the biochemical parameters, but prevents the morphologic damage caused by CCl(4) in the early stages.
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Affiliation(s)
- S Dinçer
- Department of Physiology, Faculty of Medicine, Gazi University, Ankara, Turkey.
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Abstract
We present a case of multiple myeloma who died of liver failure 7.5 months after initial diagnosis. Postmortem liver biopsy revealed diffuse CD3-expressing plasma cell infiltration and eosinophilic amorphous material deposition which was considered as light chain deposits. T cell receptor-gamma rearrangement was not detected in liver biopsy sections using the polymerase chain reaction despite CD3 positivity. To our knowledge, this is the first report of CD3-expressing plasma cell infiltration in tissue sections. The discordance between the phenotype and the genotype suggests a partial activation of genes encoding the T cell antigens by the transforming event. We also concluded that CD3 positivity was associated with short survival, which is consistent with previous data.
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Affiliation(s)
- Münci Yağcí
- Department of Haematology, Gazi Medical School, Gazi University, TR-06610 Ankara, Turkey.
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Gurelik G, Bilgihan K, Sezer C, Akyol G, Hasanreisoglu B. Effect of mechanical vs dilute ethanol epithelial removal on keratocyte apoptosis and polymorphonuclear leukocyte migration. Eye (Lond) 2002; 16:136-9. [PMID: 11988812 DOI: 10.1038/sj.eye.6700074] [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] [Received: 12/14/2000] [Accepted: 08/14/2001] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To investigate keratocyte apoptosis and polymorphonuclear (PMN) cell infiltration to the corneal stroma after mechanical epithelial scraping and chemical de-epithelialization with 18% ethanol solution. METHODS Twelve New Zealand Albino rabbits (24 eyes) were randomly divided into three groups. Group A was the control group with no epithelial removal. Group B underwent a 7.5-mm mechanical epithelial removal with a blunt spatula. Group C underwent 7.5-mm chemical de-epithelialization with 18% ethanol-balanced salt solution. Corneas were stained with terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick-end labeling (TUNEL) assay after 24 h. Only nuclear staining in keratocytes was counted. Polymorphonuclear (PMN) leukocyte densities were also assessed by light microscopy. RESULTS Mechanical de-epithelialization (group B) and chemical de-epithelialization with 18% ethanol (group C) showed no difference in keratocyte apoptosis compared with the control group. There was also no difference between groups B and C. Group B showed no difference in PMN leukocyte counts compared with the control group. But the number of PMN leukocytes observed in group C was significantly higher than those encountered in the corneas of the control group (P < 0.05) and group B (P < 0.05). CONCLUSIONS Dilute alcohol induces more PMN cell infiltration when compared with mechanical de-epithelialization although there is no difference in the apoptosis rates.
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Affiliation(s)
- G Gurelik
- Dept of Opthalmology, Gazi University, Medical Faculty, Ankara, Turkey
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Bilgihan K, Bilgihan A, Adiguzel U, Sezer C, Yis O, Akyol G, Hasanreisoglu B. Keratocyte apoptosis and corneal antioxidant enzyme activities after refractive corneal surgery. Eye (Lond) 2002; 16:63-8. [PMID: 11913891 DOI: 10.1038/sj.eye.6700065] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [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: 11/09/2022] Open
Abstract
PURPOSE Refractive corneal surgery induces keratocyte apoptosis and generates reactive oxygen radicals (ROS) in the cornea. The purpose of the present study is to evaluate the correlation between keratocyte apoptosis and corneal antioxidant enzyme activities after different refractive surgical procedures in rabbits. METHODS Rabbits were divided into six groups. All groups were compared with the control group (Group 1), after epithelial scraping (Group 2), epithelial scrape and photorefractive keratectomy (PRK) (traditional PRK: Group 3), transepithelial PRK (Group 4), creation of a corneal flap with microkeratome (Group 5) and laser-assisted in situ keratomileusis (LASIK, Group 6). Terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick-end labelling assay (to detect DNA fragmentation in situ) and light microscopy were used to detect apoptosis in rabbit eyes. Glutathione peroxidase (Gpx) and superoxide dismutase (SOD) activities of the corneal tissues were measured with spectrophotometric methods. RESULTS Corneal Gpx and SOD activities decreased significantly in all groups when compared with the control group (P<0.05) and groups 2, 3 and 6 showed a significantly higher amount of keratocyte apoptosis (P<0.05). Not only a negative correlation was observed between corneal SOD activity and keratocyte apoptosis (cc: -0.3648) but Gpx activity also showed negative correlation with keratocyte apoptosis (cc: -0.3587). CONCLUSION The present study illustrates the negative correlation between keratocyte apoptosis and corneal antioxidant enzyme activities. This finding suggests that ROS may be partly responsible for keratocyte apoptosis after refractive surgery.
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Affiliation(s)
- K Bilgihan
- Department of Ophthalmology, Gazi University Medical School, Ankara, Turkey.
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Abstract
In vitro studies of B-cells immortalized by Epstein-Barr Virus (EBV) have shown that B-cell leukemia/lymphoma-2 (bcl-2) protein expression is upregulated by the EBV-latency-associated antigen, latent membrane protein 1 (LMP1). The same phenomenon has also been observed in epithelial cells in vitro. However, such correlation between these 2 markers has not been shown in nasopharyngeal carcinoma (NPC), in which EBV infection is a well-known etiologic factor. This retrospective study examined 35 cases of undifferentiated NPC to answer the question of whether LMP1 and/or bcl-2 presence can be used as biomarkers at treatment response, as well as to see the relationship between bcl-2 and LMP in NPC. Of the 35 patients, 26 (74.3%) were bcl-2, and 10 (28.6%) were LMP1-positive. Although a significant correlation was observed between bcl-2 and LMP1 staining (P =.003), it appeared that bcl-2 expression could be independent of LMP1. Statistical analysis showed that cervical lymph node metastasis (P =.04) and cranial nerve involvement (P =.03) are the only variables that significantly affect patient survival. At this time, bcl-2 and LMP1 presence are not significant indicators of outcome; however, although they are not directly related to survival, expression of both bcl-2 and LMP1 was strongly correlated with cervical lymph node metastasis, which is a potent predictor of patient survival.
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Affiliation(s)
- S Sarac
- Hacettepe University Medical School, Department of Otolaryngology, Ankara, Turkey
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Akyürek N, Sayin T, Dinçer I, Berkalp B, Akyol G, Ozenci M, Oral D. Association between the severity of heart failure and the susceptibility of myocytes to apoptosis in patients with idiopathic dilated cardiomyopathy. Int J Cardiol 2001; 80:29-36. [PMID: 11532544 DOI: 10.1016/s0167-5273(01)00451-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Bcl-2 proto-oncogene, an inhibitor of apoptosis and Bax proto-oncogene, an inducer of apoptosis play critical roles in the molecular circuit controlling apoptosis in cardiac muscle. The ratio of Bax to Bcl-2 proto-oncogene determines survival or death after an apoptotic stimulus. We speculated that susceptibility of myocytes to apoptosis determined as the Bax/Bcl-2 ratio might vary with the severity of heart failure. METHODS AND RESULTS We studied immunohistochemically 108 endomyocardial biopsy specimens from 30 patients with idiopathic dilated cardiomyopathy (mild heart failure, n=14; moderate or severe heart failure, n=16) with the use of Bcl-2 and Bax monoclonal antibodies. The expression of each protein was determined semiquantitatively as the fraction of myocytes labeled with specific monoclonal antibodies using a digital morphometric analysis system. Patients with mild heart failure showed significantly increased Bax/Bcl-2 ratio than the patients with advanced heart failure (1.59+/-1.26 vs. 0.34+/-0.43, P=0.002). The expression of Bcl-2 was found to be independent of the severity of heart failure whereas the expression of Bax was significantly higher in patients with mild heart failure compared to the patients with moderate or severe heart failure (52.1+/-29.3 vs. 21.6+/-22.4%, P=0.005). Additionally, Bax/Bac-2 ratio was inversely correlated with the mitral E-interventricular septum distance, left ventricular end-systolic and end-diastolic diameter. CONCLUSION The susceptibility of myocytes to apoptosis is significantly increased in the early phase of heart failure but it decreases with worsening of the disease due to depressed expression of Bax onco-protein. Increased myocyte susceptibility to apoptosis may have a role in the transition from mild heart failure to severe in patients with idiopathic dilated cardiomyopathy.
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Bilgihan K, Adiguzel U, Sezer C, Akyol G, Hasanreisoglu B. Effects of topical vitamin E on keratocyte apoptosis after traditional photorefractive keratectomy. Ophthalmologica 2001; 215:192-6. [PMID: 11340390 DOI: 10.1159/000050857] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [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: 11/19/2022]
Abstract
PURPOSE To evaluate the keratocyte apoptosis and effects of topical vitamin E on keratocyte apoptosis after photorefractive surgery. METHODS Rabbits were divided into 7 groups, and all groups were compared with controls after epithelial scraping, epithelial scrape and photorefractive keratectomy (PRK) (traditional PRK), transepithelial PRK, production of a corneal flap with microkeratome and laser-assisted in situ keratomileusis (LASIK). The effects of topical Vitamin E treatment were investigated in the traditional PRK group. The terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick-end labelling assay (to detect DNA fragmentation in situ) and light microscopy have been used to detect apoptosis in rabbit cornea. RESULTS Transepithelial PRK induced minimal keratocyte apoptosis, less than in all other refractive surgical procedures. The greatest amount of keratocyte apoptosis was observed after traditional PRK (p = 0.001), therefore we tested the effects of topical vitamin E in this group. The number of apoptotic keratocytes significantly reduced after vitamin E therapy (p < 0.005). CONCLUSION Keratocytes undergo apoptosis after refractive surgery in response to mechanical epithelial removal, preparing of corneal flap and excimer laser stromal photoablation. The topical application of vitamin E immediately after surgery can prevent keratocyte apoptosis, and this result suggests that free radicals may be partly responsible for keratocyte apoptosis after excimer laser keratectomy.
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Affiliation(s)
- K Bilgihan
- Department of Ophthalmology, Gazi University Medical School, Ankara, Turkey.
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Akyol MU, Sarac S, Akyol G, Atac A, Poyraz A, Belgin E, Turan E. Investigation of the ototoxic effects of interferon alpha2A on the mouse cochlea. Otolaryngol Head Neck Surg 2001; 124:107-10. [PMID: 11228464 DOI: 10.1067/mhn.2001.112312] [Citation(s) in RCA: 16] [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] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This prospective randomized study investigates the possible toxic effects of interferon (IFN) alpha2A on the mouse cochlea. Thirty-six albino Swiss mice that were randomly assigned to 3 groups underwent baseline auditory brain stem response testing bilaterally to objectively assess baseline hearing levels. The first group received a single dose of 50,000 units, and the second group received 100,000 units of IFN-alpha2A intraperitoneally, whereas the third group was given no medication. Repeat auditory brain stem response testing revealed a significant rise in mean baseline peak equivalent sound pressure level thresholds in the groups that received IFN (P < 0.001). Histologically, the cochleae of mice that received IFN had a decreased number of fibroblasts in the spiral limbus, as well as prominent cytoplasmic vacuolation of these cells, compared with control animals. Loss of hair cells was not observed. It is possible that reversible biochemical and metabolic changes in the cochlea, rather than morphologic abnormalities, manifest IFN ototoxicity.
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Affiliation(s)
- M U Akyol
- Department of Otolaryngology-Head and Neck Surgery, Hacettepe University Medical Faculty, Ankara, Turkey
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Abstract
Several studies have been demonstrated the value of c-ErbB-2 and Bcl-2 in predicting the biological behaviour of tumors. The aim of this study was to investigate Bcl-2 and c-ErbB-2 expression in colorectal carcinomas and the correlation between their presence and other clinicopathologic parameters. Eighty-six colorectal carcinomas and 17 adenomas were stained with Bcl-2 and c-ErbB-2 immunohistochemically. Staining patterns were assessed semi-quantitatively and correlated with tumor size, Duke s classification, tumor differentiation, mucinous characteristic and anatomic locations. We detected Bcl-2 expression in 10 of 17 adenomas (58.8 %) and 31 of 86 carcinomas (36.04 %). Positive staining in normal mucosa was observed only in the compartment of cryptic cells. However neither the difference in the rates of Bcl-2 positivity in adenoma and carcinoma groups, nor the correlation with other mentioned clinicopathological parameters, were found statistically significant. Bcl-2 expression was found to be significantly high in mucinous carcinomas. Expression of c-ErbB-2 was observed in 12 of 86 (13.95 %) carcinomas. It was not detected in adenomas and normal mucosa. Although the incidence of c-ErbB-2 in nonmucinous carcinoma was higher than that of mucinous carcinoma, this was not significant. In addition we were unable to show any significant relation between c-ErbB-2 expression and other clinicopathologic features. Our result suggest that c-ErbB-2 protein expression in colorectal carcinomas, is not very frequent event. There is no correlation between c-ErbB-2 expression and malignant potential of colorectal carcinomas. Higher expressions of Bcl-2 in adenomas than carcinomas suggest us a possible role of Bcl-2 in early carcinogenesis of colon. However since we were unable to find any significant correlation between Bcl-2 expression and other parameters the impact of this gene on biological behavior is still unclear for us.
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Affiliation(s)
- A Dursun
- Gazi University Medical School Be evler, Department of Pathology, Ankara, Turkey.
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Ustün C, Ozcan M, Gürman G, Cakir M, Erekul S, Akyol G, Arat M, Celebi H, Idlman R, Ilhan O, Demirer T, Beksac M, Koc H. Differences in liver pathology and clinical outcome between two patients with hepatitis B virus and graft versus host disease. Pathol Oncol Res 1999; 5:229-32. [PMID: 10491023 DOI: 10.1053/paor.1999.0229] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Our two patients undergoing allogeneic bone marrow transplantation (AlloBMT) had both Hepatitis B virus (HBV) and graft-versus-host disease (GVHD). In the first patient, liver enzymes elevated three months after AlloBMT, and GVHD was diagnosed. Two weeks after the diagnosis of GVHD, HBsAg appeared in his serum. At that time, liver biopsy was not able to discriminate two disorders, but his sequential liver biopsies disclosed GVHD. Despite the patient was treated with cyclosporin A (CsA), he died for chronic GVHD. In contrast to the first patient, the second patient had HBsAg prior to GVHD. His liver enzymes deterioration was detected in the first month after AlloBMT, and reached the highest level in the third month while withdrawing CsA. In the fifth month he developed scleradermatous skin changes, and skin biopsy revealed chronic GVHD, whereas concurrent liver biopsy revealed chronic active hepatitis. This observation showed that immunosuppressive conditions such as GVHD or its prophylaxis may affect the appearance of liver pathology caused by HBV, which depends on the time of GVHD development, and the duration and depth of GVHD prophylaxis.
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Affiliation(s)
- C Ustün
- Ankara University, School of Medicine, Department of Hematology Ibni Sina Hospital, Ankara, 06100, Turkey.
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Ustün C, Idilman R, Gürman G, Ozcan M, Akyol G, Akan H, Ilhan O, Beksaç M, Uysal A, Konuk N, Karayalçin S, Poyraz A, Van Thiel D, Koç H. Hematopoietic stem cell transplantation from non-replicative hepatitis B virus carriers is safe. J Hepatol 1999; 31:202-9. [PMID: 10453930 DOI: 10.1016/s0168-8278(99)80214-1] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND/AIMS Hepatitis B virus can cause serious problems in individuals undergoing organ transplantation. The aim of this study was to evaluate the hepatic events among HBs-Ag positive recipients and HBs-Ag negative recipients who received products from hepatitis B virus carriers. METHODS A total of 151 patients received an allogeneic hematopoietic stem cell transplantation at the Department of Hematology-Oncology, University of Ankara, between June 1989 and June 1998. Among these, eight HBs-Ag positive and four HBs-Ag negative recipients received a product from a hepatitis B virus positive donor. The median follow-up period for these 12 patients was 13.2 months. RESULTS Three of the eight HBs-Ag positive recipients died (one from hepatic failure); of the remainder, two are HBs-Ag negative, two HBs-Ag positive with normal liver injury tests and one HBs-Ag positive with elevated ALT levels. Of the four HBs-Ag negative recipients who received stem cells from a hepatitis B positive donor, two died; none of the patients in this group became HBs-Ag positive after transplantation. CONCLUSION Hepatitis B virus infection is a common problem in patients being considered for allogeneic hematopoetic stem cell transplantation, especially in areas where hepatitis B virus infection is endemic. We believe that the presence of HBs-Ag positivity is not an absolute contraindication for allogeneic hematopoetic stem cell transplantation unless the hepatitis B virus is in a replication phase.
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Affiliation(s)
- C Ustün
- University of Ankara, Medical School, Department of Hematology-Oncology, Turkey
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Dursun A, Poyraz A, Celik B, Akyol G. Expression of c-erbB-2 oncoprotein in gastric carcinoma: correlation with histopathologic characteristics and analysis of Ki-67. Pathol Oncol Res 1999; 5:104-6. [PMID: 10393360 DOI: 10.1053/paor.1999.0171] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [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: 12/15/2022]
Abstract
Amplification and overexpression of the c-erbB-2 gene has been demonstrated in several tumors and thought to be important determinants of biologic behaviors of carcinomas. In this study, correlation between c-erbB-2 expression und histopathologic parameters, including proliferative activity of gastric carcinomas was evaluated. Paraffin-embedded tissue sections from 62 patients who underwent curative resection of gastric carcinoma were analyzed immunohistochemically for the expression of c-erbB-2 and Ki-67. Strong membrane staining for c-erbB-2 was detected in 11 of 62 gastric carcinomas (17,7%) and no positive reaction was evident in noncancerous tissue. The incidence of c-erbB-2 positivity in intestinal type carcinomas (24,3%) was higher than that of diffuse type carcinomas (4,76%). Positive staining for c-erbB-2 was present in one of the 9 (11,1%) early gastric carcinomas and 10 of 53 (18, 8%) advanced gastric carcinomas. However, no statistically significant relationships were found between c-erbB-2 expression and histopathologic type, depth on invasion, the tumor size or lymph node metastases. Among the metastatic lymph nodes, 3 were positively stained with c-erbB-2 whereas the primary tumors of two cases had been found to be negative. Additionally, no correlation was found between c-erbB-2 reactivity and proliferative activity of carcinoma cells. The results suggest that expression of c-erbB-2 protein may occur selectively in intestinal type of gastric carcinomas. However, c-erbB-2 expression is not a reliable marker of malignant potential in gastric carcinomas.
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Affiliation(s)
- A Dursun
- Gazi University Medical School Besevler, Department of Pathology Turgut Reis Caddesi 16/8, Mebusevleri Tandogan, Ankara, 06580, Turkey
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Ozenirler S, Dinçer S, Akyol G, Ozoğul C, Oz E. The protective effect of Ginkgo biloba extract on CCl4-induced hepatic damage. Acta Physiol Hung 1999; 85:277-85. [PMID: 10101542] [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] [Indexed: 02/11/2023]
Abstract
The aim of this study was to evaluate the protective effect of Ginkgo biloba extract on CCl4-induced hepatic damage in rats. Hepatic malondialdehyde, glutathione and hydroxyproline levels and histopathologic alterations in liver specimens were assessed. 200 mg/kg/day Ginkgo biloba extract were given orally to the animals for 10 days, then a single dose of 2 ml/kg b.w. carbon tetrachloride was, administered intraperitoneally. Ginkgo biloba extract treatment reduced hepatic malondialdehyde levels significantly (p < 0.05), but did not alter glutathione (p > 0.05) and hydroxyproline levels (p > 0.05). The light and electron microscopic findings showed that Ginkgo biloba extract limited the CCl4-induced hepatocyte necrosis and atrophy. These results suggest that this extract may protect the hepatocytes from carbon tetrachloride-induced liver injury.
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Affiliation(s)
- S Ozenirler
- Department of Gastroenterology, Gazi University Faculty of Medicine, Beşevler, Ankara, Turkey
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Akyol G, Dursun A, Poyraz A, Uluoglu O, Ataoglu O, Edalý N, Memis L. P53 and proliferating cell nuclear antigen (PCNA) expression in non-tumoral liver diseases. Pathol Int 1999; 49:214-21. [PMID: 10338076 DOI: 10.1046/j.1440-1827.1999.00849.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [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: 11/20/2022]
Abstract
The tumor suppressor gene p53 is known to be involved in the negative regulation of cell growth. Proliferating cell nuclear antigen (PCNA), which is a nuclear protein and a component of the DNA replication process, is also involved in growth regulation. Both have been studied as progression markers in various tumors including hepatocellular carcinoma. In the present study, the aberrant p53 protein and PCNA expressions in non-tumoral liver diseases were investigated. Using monoclonal antibodies anti-p53 (D07-DAKO) and anti-PCNA (PC10-DAKO), 149 samples were stained, including 10 normal and 10 tumoral control liver tissues. p53 Overexpression was detected in 52 specimens (35%) whereas PCNA positivity was found in 96 (64%). There were 21 different pathological entities but most of the positive samples could be grouped into four types of diseases; namely, non-specific reactive hepatitis, steatohepatitis, chronic hepatitis and cirrhosis. Statistical analyses performed on these groups revealed that p53 positivity was found to be significantly higher in steatohepatitis (P < 0.05), while PCNA positivity did not show any statistical significance. The number of samples showing both p53 and PCNA positivity was 42 but their coexistence was not found to be significant. Certain cytological alterations like nuclear pleomorphism, steatosis and cholestasis, in addition to necroinflammatory activity, were evaluated for their possible impact on p53 and/or PCNA positivity. Necroinflammatory activity in steatohepatitis and steatosis in chronic hepatitis was found to be significant for p53 positivity (P < 0.05). In contrast, nuclear pleomorphism in non-specific reactive hepatitis was found to be significant for PCNA positivity (P < 0.05).
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Affiliation(s)
- G Akyol
- Department of Pathology, Gazi University Medical School, Besevler, Ankara, Turkey.
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Akyol MU, Dursun A, Akyol G, Edaliota N. Proliferating cell nuclear antigen immunoreactivity and the presence of P53 mutation in basaloid squamous cell carcinoma of the larynx. Oncology 1998; 55:382-3. [PMID: 9732213 DOI: 10.1159/000011882] [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: 11/19/2022]
Abstract
Basaloid squamous cell carcinoma (BSCC) is an aggressive variant of squamous cell carcinoma (SCC) that was first described in 1986. In the English literature, only 28 cases of this histopathological entity have been reported in the larynx. Proliferative features of this infrequent tumor were investigated by proliferating cell nuclear antigen immunoreactivity, and the presence of P53 mutation was also investigated in a series of 4 cases. BSCC was found to share similar features with regular SCC in terms of its proliferation rate and P53 mutation positivity, as well as biological behavior and clinical outcome.
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Affiliation(s)
- M U Akyol
- Otorhinolaryngology Department, Hacettepe University Medical School, Ankara, Turkey
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47
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Ozoğul C, Karaöz E, Erdoğan D, Akyol G. Immunohistochemical localization of the epidermal growth factor receptor in normal mouse tissues. Acta Physiol Hung 1998; 85:113-20. [PMID: 9706305] [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] [Indexed: 02/08/2023]
Abstract
The levels of epidermal growth factor (EGF) receptors were investigated in normal mouse tissues. Two patterns of reactivity were recognized: strong membraneous of diffuse cytoplasmic staining. The basal epithelial cells of the skin and the collecting tubule cells of the kidney showed membraneous reactivity whereas the bronchial epithelial cells, parietal cells of the stomach and tubular cells of the kidney showed cytoplasmic reactivity predominantly with the antibody. The distribution of the epidermal growth factor receptors in different cell types and cellular compartments may implicate varying activation states of the growth factor and its interaction with a milieu available ligand.
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Affiliation(s)
- C Ozoğul
- Gazi University Faculty of Medicine Department of Histology Embryology, Ankara, Türkiye
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48
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Ustün C, Koç H, Karayalcin S, Akyol G, Gürman G, Ilhan O, Akan H, Ozcan M, Arslan O, Konuk N, Uysal A, Beksaç M. Hepatitis B virus infection in allogeneic bone marrow transplantation. Bone Marrow Transplant 1997; 20:289-96. [PMID: 9285543 DOI: 10.1038/sj.bmt.1700885] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.6] [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: 02/05/2023]
Abstract
Fourty-four patients who underwent allogeneic bone marrow transplantation (alloBMT) were studied for hepatitis B virus (HBV)-related complications. The mean follow-up period was 15.3 months. Positivity for HBV surface antigen (HBsAg) was observed in 10 patients (22.7%) throughout the study. Four of the 10 patients were HBsAg carriers before alloBMT, while the remaining six became HBsAg(+) after alloBMT. During the follow-up period (from 6 months to 45 months), an elevation in serum ALT activity was observed in the four carriers when immunosuppression was reduced or withdrawn. All of the four HBsAg carriers developed hepatitis, but none of them died of liver failure due to HBV. Only one death due to GVHD and diabetic ketoacidosis was observed in this group. Two of the four carriers received marrow from anti-HBs positive donors and one of them cleared HBsAg from his serum via adoptive immunity 8 months after transplantation. The remaining six patients acquired HBV after alloBMT, but we were unable to demonstrate the source of HBV. Five of them had a moderate increase in serum ALT activity while the other patient had a normal ALT. Two patients seroconverted to anti-HBs spontaneously. Two patients died during the follow-up, one due to intracranial hemorrhage and the other due to GVHD and accompanying pulmonary infection. The rest of the study group (34 patients) remained HBsAg(-) throughout the study. Two of them had an HBsAg(+) donor, but neither developed HBV infection in their follow-up period. The acquisition rate of HBV infection was relatively low in recipients who were positive for anti-HBs compared to those who were negative for anti-HBs (8 vs 19%). Anti-HBs positivity remained for a longer period in recipients who received marrow from anti-HBs positive donors compared to those recipients who had anti-HBs negative donors (median 12 vs 3 months). We think that HBV is a frequent cause of liver dysfunction in alloBMT patients where HBV infection is endemic. Whether the disease is in the form of reactivation of HBsAg-positive recipients, or is acquired from unknown sources in recipients who never had contact with the virus, the course of the disease is not fatal. Silent serologic changes can be demonstrated if viral serologic markers are sought serially. Among them, the disappearance of serum anti-HBs may be important as it increases the risk of HBV contamination in recipients.
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Affiliation(s)
- C Ustün
- Department of Haematology/Oncology, Ankara University, Ibn-i Sina Hospital, Turkey
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Sinik Z, Alkibay T, Ataoğlu O, Akyol G, Tokuçoğlu H, Bozkirli I. Correlation of nuclear p53 over-expression with clinical and histopathological features of transitional cell bladder cancer. Int Urol Nephrol 1997; 29:25-31. [PMID: 9203034 DOI: 10.1007/bf02551413] [Citation(s) in RCA: 7] [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: 02/04/2023]
Abstract
Forty-four pathologic specimens of 39 bladder cancer patients were analyzed immunohistochemically with D07 monoclonal antibody to detect over-expression of mutant p53 gene. The findings were interpreted by correlating with patient age, sex, cigarette smoking, number and macroscopic appearance of tumour, histological tumour grade, muscular invasion, vascular invasion, necrosis and urothelial atypia or dysplasia. Mutant p53 gene was over-expressed in 8 (18.2%) specimens. Statistically significant correlation with grade, vascular invasion, necrosis and patient sex was found with p53 over-expression. Available follow-up data were insufficient to draw a conclusion about the prognostic role of p53 over-expression. Prospective studies with larger number of patients are needed to define the exact place of nuclear p53 over-expression in transitional cell bladder cancer.
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Affiliation(s)
- Z Sinik
- Department of Urology, Gazi University, School of Medicine, Ankara, Turkey
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