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Colakogullari M, Karatas L, Tatar Z. Investigating associations between HLA DQA1 ~ DQB1 haplotypes, H. pylori infection, metaplasia, and anti-CagA IgA seropositivity in a Turkish gastritis cohort. Immunogenetics 2024; 76:1-13. [PMID: 37979046 DOI: 10.1007/s00251-023-01325-5] [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: 06/05/2023] [Accepted: 10/29/2023] [Indexed: 11/19/2023]
Abstract
Helicobacter pylori was reported as an important cause of gastritis, and gastric ulcers and CagA oncoprotein-producing H. pylori subgroups were blamed to increase the severity of gastritis. Disparities were reported in that the presence of serum anti-CagA IgA was not parallel with CagA-positive H. pylori cohabitation. We hypothesized that the HLA-DQA1 ~ DQB1 haplotypes in human populations include protective haplotypes that more effectively present immunogenic CagA peptides and susceptible haplotypes with an impaired capacity to present CagA peptides. We recruited patients (n = 201) admitted for gastroendoscopy procedures and performed high-resolution HLA-DQA1 and DQB1 typing. Serum anti-CagA IgA levels were analyzed by ELISA (23.0% positive), and H. pylori was classified as positive or negative in gastric mucosal tissue slides (72.6% positive). The HLA DQA1*05:05 allele (29.1%) and HLA DQB1*03:01 allele (32.8%) were found at the highest frequency among gastritis patients of Turkish descent. In HLA DQA1*05:05 ~ DQB1*03:01 double homozygous (7.3%) and heterozygous (40.7%) haplotype carriers, the presence of anti-CagA IgA decreased dramatically, the presence of H. pylori increased, and the presence of metaplasia followed a decreasing trend. The DQ protein encoded by HLA DQA1*05:05-DQ*03:01 showed a low binding affinity to the CagA peptide when binding capacity was analyzed by the NetMHCIIPan 4.0 prediction method. In conclusion, HLA DQA1 ~ DQB1 polymorphisms are crucial as host defense mechanisms against CagA H. pylori since antigen binding capacity plays a crucial role in anti-CagA IgA production.
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Comba C, Aslan E, Vatankulu B, Tatar Z, Demir AA, Demir O. An Extraordinary Location of Sentinel Lymph Nodes in a Patient with Endometrial Cancer. J Minim Invasive Gynecol 2023; 30:613-614. [PMID: 37137423 DOI: 10.1016/j.jmig.2023.04.012] [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: 01/27/2023] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVE To show dissection of sentinel lymph nodes. DESIGN A step-by-step demonstration of the technique with narration. SETTING Endometrial cancer (EC) is the most common gynecologic malignancy worldwide. Sentinel lymph node biopsy with indocyanine green (ICG) has become more widely used and has been featured in recently published guidelines for EC [1]. Minimally invasive approaches with the sentinel lymph node concept (conventional laparoscopy, laparoscopic-assisted vaginal surgeries or robotic) to EC staging have resulted in lower rates of peri- and postoperative complications than conventional staging procedures [2]. INTERVENTIONS No video article has been published in the literature about high pelvic, para-aortic sentinel lymph node dissection. An informed consent form was obtained from the patient. An institutional review board approval was not required. A 45-year-old female with gravidity 0, parity 0, and body mass index of 23.4 kg/m2 presented with complaints of abnormal uterine bleeding (spotting). Increased endometrial thickness was detected on transvaginal ultrasound (10 mm) in the postmenstrual period. Endometrioid-type endometrial adenocancer with focal squamous differentiation International Federation of Gynecology and Obstetrics grade I was detected on endometrial biopsy. The patient had hepatitis B virus positivity and no other chronic disease. A laparotomic myomectomy had been performed in 2016. Laparoscopic high pelvic, low para-aortic sentinel lymph node dissection with ICG and hysterectomy (without uterine manipulator) + bilateral salpingo-oophorectomy were performed (Supplemental Video 1). The operation time for the procedure was 110 minutes and the estimated blood loss was <20 mL. No major complications occurred during or after the surgery. The patient stayed in the hospital for 1 day. The final pathology result showed an International Federation of Gynecology and Obstetrics grade I, endometrioid-type endometrial adenocancer with focal squamous differentiation, as a 1.5 × 1 cm tumorous mass invading less than one-half of the myometrium. Neither lymphovascular invasion nor sentinel lymph node metastasis was detected. A multicenter, prospective study showed that sentinel lymph node dissection with ICG in clinical stage 1 EC is feasible and has a high degree of diagnostic accuracy in detecting EC metastases. In that study, isolated para-aortic sentinel lymph node was detected in 3 of 340 patients (<1%) [2]. Another study reported the detection rate of isolated para-aortic sentinel lymph node to be 1.1% in patients with intermediate- and high-risk EC [3]. CONCLUSION There are in some cases 2 distinct channels emanating from one side, and it is important to follow each and to acknowledge there may be more than one sentinel, one of which is lower in a typical location and one higher as in this case. This video article is the first video demonstration of bilateral isolated high pelvic, para-aortic sentinel lymph node dissection in EC.
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Affiliation(s)
- Cihan Comba
- Department of Gynecologic Oncology (Dr. Comba).
| | - Erkan Aslan
- Department of Obstetrics and Gynecology (Dr. Aslan)
| | | | - Zeynep Tatar
- Department of Pathology (Dr. Tatar), Patomer Pathology Laboratory, Istanbul, Turkey
| | - Ali Aslan Demir
- Department of Diagnostic Radiology (Dr. A. Demir), VM Medical Park Florya Hospital, Istanbul Aydin University, Istanbul, Turkey
| | - Omer Demir
- Department of Obstetrics and Gynecology (Dr. O. Demir), Karadeniz Technical University, Trabzon, Turkey
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Ozmerdiven G, Guler Y, Sahin E, Tatar Z, Erbin A, Dirican E, Haliloglu AH. Effect of testicular morphology on embryo development to the blastocyst stage after round spermatid injection. Am J Clin Exp Urol 2021; 9:469-478. [PMID: 34993266 PMCID: PMC8727789] [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] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 08/25/2021] [Indexed: 06/14/2023]
Abstract
If spermatozoa cannot be found after testiculer sperm extraction (TESE) in patients followed up due to nonobstructive azospermia (NOA) and the patients do not want donor spermatozoa, performance of round spermatid injection (ROSI) with the current technology seems to be the last resort. This retrospective study was conducted to evaluate the effect of testicular morphology on the development of embryos to the blastocyst stage obtained from ROSI. Between September 2019 and March 2020, after TESE and biopsy 29 patients who had only spermatid were taken to study. Tubular appearance, basal membrane appearance, Johnson score, peritubular fibrosis, interstitial fibrosis, and Leydig cell proliferation were pathologically examined. Following egg collection, ROSI was applied to the oocytes using the piezoelectric method. The embryos were monitored until the blastocyst stage. The mean age of the 29 patients was 36.3±5.01 years. Also, 7 patients had not previously undergone TESE, 20 had previously undergone once, and 2 had previously undergone twice. It was observed that having a history of TESE and a high Johnson score increased the likelihood of the embryo remaining in the blastocyst stage (P=0.021 and 0.014, respectively). However, other parameters do not affect the likelihood of blastocyst formation (P>0.05). Low TESE history and high Johnson score were associated with embryo development to the blastocyst stage. If spermatozoa are not found in patients with nonobstructive azoospermia, ROSI performed during initial TESE increases the likelihood of blastocyst formation.
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Affiliation(s)
- Gokhun Ozmerdiven
- Department of Urology, Istanbul Aydin University, Medical FacultyIstanbul, Turkey
| | - Yavuz Guler
- Department of Urology, Private Safa HospitalIstanbul, Turkey
| | - Eren Sahin
- IVF Center, Istanbul Aydin University Medical FacultyIstanbul, Turkey
| | - Zeynep Tatar
- Patomer Pathology-Cytology Research CenterIstanbul, Turkey
| | - Akif Erbin
- Department of Urology, Haseki Training and Research HospitalIstanbul, Turkey
| | - Ebubekir Dirican
- Health Services Vocational School, Bayburt UniversityBayburt, Turkey
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Akyüz O, Tatar Z. Is it safe to use a thermocautery device for circumcision? Examination of the histopathological changes emerging after thermocautery-assisted circumcisions. Andrologia 2021; 53:e13968. [PMID: 33421180 DOI: 10.1111/and.13968] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/08/2020] [Accepted: 12/26/2020] [Indexed: 11/28/2022] Open
Abstract
Multiple number of techniques and devices have been described concerning circumcision method so far. One of them is thermocautery device, and it has been widely used. Although there is controversy that the penis may be damaged due to the heat generated during the use of the device, not enough histopathological studies have been conducted. We aimed to determine the histopathological changes in human foreskin caused by heat after circumcision with thermocautery and to demonstrate the safety of the use of a thermocautery-assisted circumcision. Forty-one patients were divided into two groups according to the thermal energy used during cutting with thermocautery as follows: high temperature (Group 1, n = 22) and low temperature (Group 2, n = 19). The effect of the heat intensity and depth of the coagulation necrosis produced with thermocautery-assisted circumcisions performed at low and high temperatures were evaluated. The difference between the groups was not statistically significant. Tissue damage is extremely limited in thermocautery-assisted circumcisions, even when it is used at high temperatures. The thermocautery device can be used for effective and safe circumcisions.
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Affiliation(s)
- Osman Akyüz
- Medicine Hospital Department of Urology, Atlas University, Istanbul, Turkey
| | - Zeynep Tatar
- Patomer Pathological Cytological Research Center, Istanbul, Turkey
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Abstract
Epidermoid cyst of the bladder is a very rarely encountered benign lesion. Up to our knowledge, we present the second case of epidermoid cyst of the urinary bladder in literature. We report a case of epidermoid cyst developed in a 59-year-old patient followed up with bladder tumor.
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Affiliation(s)
- Osman Akyüz
- Medicine Hospital Department of Urology, Biruni University, Istanbul, Turkey
| | - Zeynep Tatar
- Department of Pathology, Patomer Pathological Cytological Research Center, Istanbul, Turkey
| | - Soner Çoban
- Department of Urology, Bursa Yuksek Ihtisas Education and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Mehmet Demir
- Department of Urology, Birinci Hospital Department of Urology, Istanbul, Turkey
| | - Kamil Çam
- Professor of Urology, Medical Faculty Department of Urology, Marmara University, Istanbul, Turkey
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Güler Y, Erbin A, Üçpınar B, Vural Ö, Tatar Z. Congenital prepubic sinus presenting with purulent discharge after circumcision: a case report. J Med Case Rep 2019; 13:46. [PMID: 30813946 PMCID: PMC6393969 DOI: 10.1186/s13256-019-2019-6] [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] [Received: 12/19/2018] [Accepted: 02/18/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Congenital prepubic sinus is a rare anomaly found in the midline of the lower abdomen. Congenital prepubic sinus is usually asymptomatic in neonates, and a diagnosis is often achieved later in life after spontaneous extrusion of purulent material from the pre-existing hole in the pubic region. We present a case of congenital prepubic sinus presenting with purulent discharge after circumcision. A 4-year-old Caucasian boy presented to our urology out-patient clinic with purulent discharge from the distal part of the dorsum of his penis. He had a history of circumcision performed at a different center, 6 months ago. His parents stated that although various antibiotics were used, the purulent discharge continued for 6 months and the child had no complaints before circumcision. His condition was reported as superficial dorsal venous thrombosis, known as penile Mondor disease, in magnetic resonance imaging that was performed in the previous hospital. A physical examination revealed a small pinhole lesion at the distal part of his penis and a rigid cylindrical tube extending to the proximal side of his penis. We performed fistulography by injecting contrast material through a small angiocatheter and confirmed the diagnosis of prepubic sinus. Surgical exploration was performed and a long sinus, apparently ending as a fibrous tract at the anterior surface of his pubic symphysis, was found and resected. CONCLUSIONS Before congenital prepubic sinus surgery, it is critically important to rule out penile Mondor disease and the possibility of a circumcision complication (especially infective complications) mimicking congenital prepubic sinus.
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Affiliation(s)
- Yavuz Güler
- Department of Urology, Safa Hospital, Istanbul, TR, Turkey.
| | - Akif Erbin
- Department of Urology, Haseki Traning and Research Hospital, Istanbul, TR, Turkey
| | - Burak Üçpınar
- Department of Urology, Haseki Traning and Research Hospital, Istanbul, TR, Turkey
| | - Ömer Vural
- Department of Pediatric Surgery, Safa Hospital, Istanbul, TR, Turkey
| | - Zeynep Tatar
- Department of Pathology, Patomer Pathological Cytological Research Center, Istanbul, TR, Turkey
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Tatar Z. The effect of positive lifestyle on reversal of metabolic syndrome in patients with schizophrenia followed for two years. PBS 2019. [DOI: 10.5455/pbs.20181106082036] [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: 11/03/2022]
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Guler Y, Tatar Z, Ucpinar B, Erbin A. An epidermal cyst of the penis after distal hypospadias surgery: a case report. J Med Case Rep 2018; 12:378. [PMID: 30580759 PMCID: PMC6304758 DOI: 10.1186/s13256-018-1930-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 11/19/2018] [Indexed: 11/18/2022] Open
Abstract
Background Epidermoid cyst is a benign tumor that can occur anywhere in the body but is rarely seen in the penis. Congenital and previous penile surgeries have been reported to be involved in the etiology of the disease, which is usually asymptomatic. Here we describe a case of a patient with a penile epidermoid cyst, which occurred in the circumcision line on the left side of his penis, and urethral dehiscence following hypospadias surgery. Case summary A 3-year-old white boy who underwent primary distal hypospadias surgery 1.5 years ago presented with a slowly growing mass in the left ventrolateral portion of the penile circumcision line and urethral dehiscence. The histology of the excised mass revealed an epidermal inclusion cyst. Since then, he has remained healthy. Conclusions Epidermal inclusion cyst as a complication of hypospadias surgery is a very rare situation. The diagnosis is made histologically and surgical excision is sufficient for treatment.
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Affiliation(s)
- Yavuz Guler
- Department of Urology, Safa Hospital, Istanbul, Turkey.
| | - Zeynep Tatar
- Department of Pathology, Patomer Pathological Cytological Research Center, Istanbul, Turkey
| | - Burak Ucpinar
- Department of Urology, Haseki Traning and Research Hospital, Istanbul, Turkey
| | - Akif Erbin
- Department of Urology, Haseki Traning and Research Hospital, Istanbul, Turkey
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Kozan R, Tatar Z. An unusual localization; esophageal melanocytosis. Turk J Surg 2018; 37:76-79. [PMID: 34585099 DOI: 10.5152/turkjsurg.2017.3807] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 05/11/2017] [Indexed: 11/22/2022]
Abstract
Esophageal melanocytosis is a rare clinical and pathological condition characterized by non-atypical melanocytic proliferation and increased melanin in the esophageal mucosa, which is normally histologically non-melanocytic. Intensive melanin accumulation and hyperpigmentation are necessary for endoscopic recognition. Due to the fact that it is a rare gastrointestinal system pathology, experience and knowledge about its diagnosis, treatment and course are also limited. Although it is argued that chronic stimulating factors have an influence, there is no clear information about its etiology and pathogenesis. Malignant melanomas and melanocytic nevus in particular come to the fore in the differential diagnosis. Opinions and findings indicating that melanocytosis may be a precursor for malignant melanoma make the recognition and follow-up of this clinical and pathological entity more important. In this article, a patient with esophageal melanocytosis diagnosed by endoscopic evaluation is presented, with the aim of increasing the awareness of clinicians, especially endoscopists and pathologists, on this subject.
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Affiliation(s)
- Ramazan Kozan
- Clinic of General Surgery, Eren Hospital, İstanbul, Turkey
| | - Zeynep Tatar
- Division of Pathology, Patomer Pathology Center, İstanbul, Turkey
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Fan A, Pereira B, Tournadre A, Tatar Z, Malochet-Guinamand S, Soubrier M, Dubost JJ. THU0543 Evaluation of The fibromyalgia Rapid Screening Tool (First) Questionnaire To Screen fibromyalgia Associated with Inflammatory Rheumatic Disease. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1990] [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: 11/04/2022]
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Dubost JJ, Pereira B, Tournadre A, Tatar Z, Couderc M, Soubrier M. AB0352 The Changing Face of Septic Arthritis Complicating Rheumatoid Arthritis in The Era of Biotherapies. Retrospective Single-Center Study over 35 Years. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1983] [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: 11/03/2022]
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Soubrier M, Pereira B, Tournadre A, Malochet-Guinamand S, Couderc M, Mathieu S, Tatar Z, Abdi D, Frayssac T, Fan A, Dubost JJ. FRI0186 Retention of First-Line anti-TNF Treatments and in Cases of Failure Retention Rates of anti-TNF Drug or A Non-TNF-Targeted Biologic in A Monocentric Cohort of 200 Rheumatoid Arthritis Patients. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3866] [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: 11/03/2022]
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Fan A, Tournadre A, Pereira B, Tatar Z, Couderc M, Malochet-Guinamand S, Sylvain M, Soubrier M, Dubost JJ. AB1008 Prevalence of fibromyalgia in Inflammatory Rheumatic Disease. Single-Center Cross-Sectional Study in 691 Patients. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1988] [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: 11/04/2022]
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Çiftci F, Abdurrahman I, Tatar Z. Stump Appendicitis: A Clinical Enigma. Chirurgia (Bucur) 2015; 110:562-564. [PMID: 26713833] [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] [Accepted: 12/01/2015] [Indexed: 06/05/2023]
Abstract
Appendectomy is one of the most frequently performed operations. Stump appendicitis, as a postoperative complication of appendectomy, is inflammation of the remnant residue when an incomplete excision occurs. We present a patient with stump appendicitis who had been operated on, laparoscopically, for acute appendicitis 6 months before. The patient was diagnosed with acute appendicitis, underwent surgery, and was discharged on postoperative day 3 without complications. Stump appendicitis is a rare cause of acute abdominal disease but should be considered in the differential diagnosis. Ultrasonography is helpful in the diagnosis.
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Çiftci F, Abdurrahman İ, Tatar Z. The effect of corticosteroid treatment on bilateral idiopathic granulomatous mastitis. Turk J Surg 2015; 33:113-115. [PMID: 28740962 DOI: 10.5152/ucd.2015.2950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 12/15/2014] [Indexed: 11/22/2022]
Abstract
Idiopathic granulomatous mastitis (IGM) is the commonly encountered form of granulomatous mastitis that may result into repetitive infections and/or abscess formation. Mastitis may develop secondary to a systemic disorder such as tuberculosis, diabetes mellitus, or rheumatoid arthritis, or it may develop as an idiopathic disorder. Idiopathic granulomatous mastitis is the most frequent form of all granulomatous diseases affecting the breast. This disorder frequently presents as painful and fast-growing mass in the breast. Biopsy is required to confirm diagnosis. Surgical excision and immunosuppressive treatment with corticosteroids are employed for therapeutic management. Here we present 3 female cases of bilateral IGM who were followed up and treated successfully with 1 mg/kg/day prednisolone.
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Affiliation(s)
- Fatih Çiftci
- Department of General Surgery, İstanbul Gelişim University Safa Hospital, İstanbul, Turkey
| | | | - Zeynep Tatar
- Department of Pathology Patomer, İstanbul, Turkey
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Lopez J, Tatar Z, Mathieu S, Tournadre A, Couderc M, Soubrier M, Dubost J. THU0250 Changes in the Efficiency of Infectious Spondylodiscitis Bacteriological Testing in the Last Twenty Years. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5463] [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: 11/04/2022]
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Tatar Z, Pereira B, Mathieu S, Malochet-Guinamand S, Guellec D, Nocturne G, Gossec L, Loeuille D, Soubrier M. FRI0243 Bone Mineral Density in Ankylosing Spondylitis: Meta-Analysis of Retrospective Observational Data from 3420 Subjects. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3615] [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: 11/03/2022]
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Tournadre A, Pereira B, Frayssac T, Tatar Z, Malochet-Guinamand S, Verny MA, Mathieu S, Couderc M, Dubost J, Soubrier M. SAT0098 Changes in Metabolic Profile During Treatment with Tocilizumab in Patients with Rheumatoid Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2499] [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: 11/03/2022]
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Abstract
Gastrointestinal stromal tumors (GISTs) are rare tumor of the gastrointestinal tract. GISTs occur in the entire gastrointestinal tract and may also arise from the retroperitoneum, omentum and mesenteries. They are originated from gastrointestinal pacemaker cells (Cajal's interstitial cells) and range from benign tumors to sarcomas at all sites of occurrence. Diagnosis of GIST could be deceptive because of their similarity in appearance to gynecological neoplasms. We would like to present a case of a woman with GIST in the small intestine giving a imprint of an adnexal mass was diagnosed correctly during surgery. The diagnosis and treatment of GIST has been reformed over the past years. It is crucial to separate GISTs from possible misdiagnosis because their prognosis and treatment could be unlike clearly. The purpose of this case is to evaluate this rarely seen clinical entity, and thus, make some contribution to the literature.
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Affiliation(s)
- Nilay Karaca
- Bezmi Alem Vakif University, Medical Faculty, Department of Obstetrics and Gynecology, Istanbul, Turkey.
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Abstract
Eosinophilic esophagitis (EE) is attributable to environmental factors, allergens and several immunological causes. The most typical symptoms include dysphagia and sensation of food impingement in the retrosternal area. Although its clinical features resemble those of gastroesophageal reflux, proton pump inhibitors are not effective for its treatment. The diagnosis of EE is dependent on the pathological detection of eosinophilic infiltration in esophageal mucosa. In this study, we evaluated a patient who applied to our clinic with complaints of long-term difficulty in swallowing, sensation of food sticking while eating and weight loss; the patient was diagnosed with EE, following biochemical, radiological, endoscopic and pathological assessments and was treated with steroids. The results show that EE should be considered in the differential diagnosis of patients with dysphagia and food impingement in the retrosternal area, and the diagnosis should be confirmed through multiple esophageal biopsies.
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Affiliation(s)
| | | | | | | | - Yesim Erbil
- General Surgery Department, Istanbul University Medical School, İstanbul, Turkey
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21
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Vayssade M, Tatar Z, Soubrier M. Rhumatisme palindromique. Rev Med Interne 2013; 34:47-52. [DOI: 10.1016/j.revmed.2012.07.016] [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] [Received: 12/10/2011] [Revised: 05/06/2012] [Accepted: 07/30/2012] [Indexed: 01/06/2023]
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Dane C, Rustemoglu Y, Kiray M, Ozkuvanci U, Tatar Z, Dane B. Vaginal leiomyoma in pregnancy presenting as a prolapsed vaginal mass. Hong Kong Med J 2012; 18:533-535. [PMID: 23223657] [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: 06/01/2023] Open
Abstract
Vaginal leiomyomas are rare benign solid tumours of the vagina. They can cause mechanical dystocia, which is a common problem in obstetrics leading to serious maternal and perinatal complications. Here we describe a patient with a vaginal leiomyoma diagnosed during the mid-trimester that could have caused dystocia. This 22-year-old woman presented with a vaginal mass and leaking vaginal fluid during pregnancy. On examination, a prolapsed, pedunculated mass, measuring 5 × 3 × 4 cm was detected in the anterior vaginal wall. Via a midline incision, the mass was easily enucleated and removed. Transvaginal surgical enucleation of the vaginal leiomyoma is usually curative and recommended as the initial treatment of choice to prevent for dystocia. Such treatment is indicated when the tumour is a potential obstacle to normal labour.
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Affiliation(s)
- Cem Dane
- Department of Gynecology and Obstetrics, Haseki Training and Research Hospital, Istanbul, Turkey.
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Tatar Z, Soubrier M, Verrelle P, Lapeyre M. Estimation scanographique du risque fracturaire des métastases des os longs lors de la simulation virtuelle. Cancer Radiother 2012. [DOI: 10.1016/j.canrad.2012.07.076] [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: 11/16/2022]
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Dane C, Tatar Z, Dane B, Erqinbas M, Cetin A. A single horn endometrial carcinoma of a uterus bicornis unicollis. J Gynecol Oncol 2009; 20:195-7. [PMID: 19809556 DOI: 10.3802/jgo.2009.20.3.195] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [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: 08/03/2009] [Revised: 09/01/2009] [Accepted: 09/05/2009] [Indexed: 11/30/2022] Open
Abstract
In this report, we describe a case of endometrial carcinoma arising in one horn of a bicornuate uterus. The diagnosis of this rare combination can be missed unless an unrecognized postmenopausal bleeding alerts the gynecologist to make a careful search for both endometrial cavities that may be curetted. Physicians should remember the possible existence of a separate uterine cavity when endometrial cancer is clinically suspected but histology fails to confirm the diagnosis.
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Affiliation(s)
- Cem Dane
- Department of Gynecology and Obstetrics, Haseki Training and Research Hospital, Istanbul, Turkey
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Dane C, Tatar Z, Dane B, Cetin A. Clinicopathologic analysis: relationship between endometrial carcinoma and uninvolved endometrium. EUR J GYNAECOL ONCOL 2009; 30:71-74. [PMID: 19317261] [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: 05/27/2023]
Abstract
OBJECTIVE The aim of this study was to compare the histopathologic features and surgical stage of endometrial carcinoma with tumor-free endometrial tissues. METHODS Data from the files of 80 patients with endometrial carcinoma who were managed at Haseki Training & Research Hospital between January 2001 and July 2007 were evaluated. We assessed tumor-free endometrium, stage, histologic type and grade, depth of myometrial invasion, peritoneal cytology, adnexal-cervical involvement, lymphovascular space invasion (LVSI), and lymph node metastases. RESULTS Twenty-nine patients (43%) with endometrial carcinoma had concomitant endometrial hyperplasia. Seven patients (10%) had one or more areas of metaplasia in the endometrium adjacent to the carcinoma. Endometrial carcinoma with atrophic background was significantly associated with aggressive histopathologic type (p < 0.04) and LVSI (p < 0.02). CONCLUSION The histological characteristics of non-tumoral endometrium were found to be critical in determining the type of aggressive tumor and LVSI in atrophy-associated carcinomas.
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Affiliation(s)
- C Dane
- Department of Gynecology & Obstetrics, Haseki Training & Research Hospital, Istanbul, Turkey.
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Abstract
Fibroepithelial stromal polyps of the vulvovaginal region display a wide range of morphologic appearances. This morphologic spectrum allows the correct diagnosis to be made in some cases but when histology reveals unusual features, the lesion may be misinterpreted as malignant. We present a case of a 35-year-old woman with psoriasis who developed a 15-cm polypoid lesion localized in the left labium. The labial lesion was resected and no recurrence was detected 12 months after the initial treatment. Histologically, the lesion exhibited the characteristics of a fibroepithelial stromal polyp with focal myxoid areas and underlying vulval psoriasis disease. The clinical, microscopic, and immunohistochemical findings of this case suggest a fibroepithelial polyp of the vulva. This vulval lesion represents a unique example of giant fibroepithelial stromal polyp developed in association with psoriasis.
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Affiliation(s)
- Cem Dane
- Department of Gynecology and Obstetrics Clinic, Haseki Training and Research Hospital, Istanbul, Turkey.
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Abstract
Spinal hydatid disease is rarely encountered in nonendemic regions. It is a progressive disease that is associated with risks of serious morbidity. The authors report a case of an isolated primary hydatid cyst of the spine in a 34-year-old woman who presented with back pain, which had lasted for 3 months, as well as lower-extremity pain and fatigue, which had persisted for 2 months. A neurological examination yielded findings indicative of upper motor neuron involvement with complete sensory loss below the level of T-11. Magnetic resonance imaging of the spine showed multiple extradural cystic lesions with an abscess formation at T-11 and involvement of the paraspinal muscles. The patient underwent spinal decompression in which stabilization and total excision of the multiple epidural and psoas abscesses and paraspinal multiloculated cysts were performed. The diagnosis of hydatid disease associated with another infection was confirmed by histopathological evaluation. Albendazole was administered during the postoperative period. Previous reports of secondary infections accompanying this disease in extraspinal locations have been published. However, to the best of the authors' knowledge, there have been no publications about a secondary infection associated with hydatidosis in the spinal cord. One should bear in mind that spinal hydatidosis may be accompanied by other infections in endemic regions. Antihelminthic treatment should be administered for a long period following early decompressive surgery and adequate stabilization.
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Affiliation(s)
- Kadir Kotil
- Departments of Neurosurgery, Haseki Educational and Research Hospital, Istanbul, Turkey.
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Kotil K, Tunckale T, Tatar Z, Koldas M, Kural A, Bilge T. Serum creatine phosphokinase activity and histological changes in the multifidus muscle: a prospective randomized controlled comparative study of discectomy with or without retraction. J Neurosurg Spine 2007; 6:121-5. [PMID: 17330578 DOI: 10.3171/spi.2007.6.2.121] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT The aim of this study was to determine the extent of muscle injury caused by continuous or intermittent muscle retraction during macro- and microdiscectomy in lumbar disc surgery. Pain scores, serum creatine phosphokinase (CPK) levels, and histological findings obtained in muscle specimens were compared. METHODS Sixty patients who underwent surgery for a one-level disc herniation during a 1-year period (January 2004-January 2005) and who had similar demographic characteristics were randomly assigned to one of four groups, each consisting of 15 patients: Group A, microdiscectomy in which the retractor was never released; Group B, microdiscectomy in which the retractor was released every 15 minutes; Group C, macrodiscectomy in which the retractor was never released; and Group D, macrodiscectomy in which the retractor was released every 15 minutes. Muscle biopsy samples were acquired in each group, and biochemical studies were conducted to determine serum CPK levels. The duration of muscle retraction was 15 minutes followed by 3 minutes of relaxation in Groups B and D. In all groups, muscle degeneration and elevation in serum CPK levels were observed immediately after surgery. The overall results, however, were different. The decline of serum CPK levels started 1 week after surgery. The smallest degree of muscle injury (reflected by the lowest serum CPK level) was observed in Group B. When the pre- and postoperative CPK values were compared in all groups, the patients in Groups B and D reported the least amount of back pain (p < 0.001). No significant differences in serum CPK levels were observed between Groups A and C or between Groups B and D. The extent of back pain was evaluated using a visual analog scale, and the consumption of analgesics was also assessed. The groups exhibited significantly different responses: the lowest analgesic consumption and the lowest pain scores were demonstrated in Groups B and D. CONCLUSIONS In this prospective randomized clinical trial, the authors determined that muscle injury during lumbar disc surgery was closely related to muscle retraction and relaxation times whereas the size of the paravertebral skin incision had no effect on postoperative back pain and disability. There was no significant difference among the groups in terms of back pain during the long-term follow-up period (18-19 months).
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Affiliation(s)
- Kadir Kotil
- Haseki Education and Research Hospital, Department of Neurosurgery, Istanbul, Turkey.
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