[Show abstract][Hide abstract] ABSTRACT: ZET: Feokromasitoma adrenal medulladaki kromaffin hücreler ya da sempatik sinir sistemindeki diğer paraganglionik hücrelerden köken alan, tanı konulmadığı takdirde ciddi morbidite ve mortaliteleye neden olabilen; nadir nöroendokrin tümörlerdendir. Başlıca klinik belirti hipertansiyondur. %10 oranında malign özellik gösterir. Tanıda idrarda vanilmandelik asit ve metanefrinlerin tayini en duyarlı testtir. Tümörün lokalizasyonunun belirlenme-sinde bilgisayarlı tomografi, magnetik rezonans görüntüleme ve işaretli metaiyodobenzilguanidin-MIBG sintigrafisi kullanılabilir. Tedavi seçeneği de α-blokörlerle tehlikeli hemodinamik dalgalanmayı engelledikten sonra primer tümörün ve mümkün ise metastazların komplet cerrahi rezeksiyondur. Laparoskopik adrenalektomi birçok adrenal hastalıkta standart tedavi yöntemi olarak açık cerrahinin yerini almaya başlamıştır. Anahtar Kelimeler: Feokromasitoma, adrenalektomi, lapa-roskopik adrenalektomi ABSTRACT: Pheochromocytoma, is rare neuroendocrine tumor arising from chromaffin cellş in the adrenal medulla or in other paraganglionic cells of the sympathetic nervous system, is associated with high degree of morbidity and mortality if not recognized. Principal clinic presentation is hypertension. 10% of tumors are malign. Diagnosis should be confirmed with the measurement of vanilylmandelic acid and total metanephrine in urine. Computerized tomography, magnetic resonance imaging and labelled metoiodobenzylguanidine MIBG scanning could be used for tumor localization. After pretreatment with an α-blocker to prevent dangerous hemodynamic fluctuation; complete surgical resection should be recommended for primary tumor and metastasis if it is possible. Laparoscopic adrenalectomy as standard treatment procedure for many adrenal diseases, has taken the place of open surgery.
[Show abstract][Hide abstract] ABSTRACT: In this study, we looked for a relationship between the extent of angiogenesis and mast cell density (MCD) in human leiomyomas and endometrial carcinomas (EC), and investigated the clinicopathological relevance of mast cells (MCs) in EC. Specimens of 15 control, 20 leiomyoma, and 23 EC patients were investigated immunohistochemically using anti-CD31 and anti-tryptase antibodies. In EC, both stromal and myometrial expressions of CD31 were significantly higher than in the controls (p<0.01 and p=0.013; respectively). Stromal tryptase expression was not significantly lower than that of leiomyoma. In addition, in the leiomyoma group, CD31 and tryptase expressions were not much different compared to the controls. Moreover, a correlation was detected between cancer histological grade and both stromal and myometrial expressions of CD31 (p=0.017 and p=0.005; respectively). The findings show that high grade EC has a higher degree of vascularization than EC of lower grade, but MCD does not increase in parallel with the histological grade. This study has demonstrated that MCD does not correlate with angiogenesis and progression of grade in EC. Moreover, MCD in EC was found to be lower than in benign lesions of the uterus. In conclusion, MCs may not account for the angiogenic process which facilitates tumor growth.
Pathology - Research and Practice 08/2011; 207(10):618-22. · 1.21 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Gallbladder is one of the most commonly encountered specimen in a pathology laboratory. A diverse spectrum of diseases affect the biliary system, often presenting with similar clinical signs and symptoms. We aimed to define the profile of gallbladder diseases in our region, and to determine potential correlations between histopathologic features we observed.
We reviewed all cholecystectomies processed in Department of Pathology of Afyon Kocatepe University Hospital between January 2000 and March 2008. Gross and histopathologic features of the specimens were reevaluated.
Among 1500 patients; 69.9% were women and 30.1% were men. We found out fourteen primary gallbladder carcinomas (0.93%) with adenocarcinomas being the most frequent type (78.57%). The rate of cholelithiasis was found as 89.9%. The most common type of gallstones was mixed cholesterol type gallstones with 67.5% followed by black pigment and brown pigment types as 23.83% and 5.89%, respectively. The association of metaplasia with dysplasia and also gallstones were statistically significant (p < 0.001, p < 0.005). The rate of the gallbladder polyps was 2.6% with the cholesterol polyps being the most common type (56.4%).
Gallbladder diseases often present with similar clinical signs and symptoms and a surgical pathologist should be alert especially of precancerous lesions. With our results, we also conclude that elderly women with longstanding gallstone disease should undergo elective surgery even when no symptoms are present.
[Show abstract][Hide abstract] ABSTRACT: β-Catenin is a critical component of the Wnt signaling pathway that regulates cell proliferation and differentiation. Wnt signaling leads to the stabilization of cytosolic β-catenin and to translocation to the nucleus, where it binds with T-cell factor and promotes the transcription and changes in target gene expression, including vascular endothelial growth factor and cyclin D1. The aim of this study was to assess the expression of cyclin D1 and vascular endothelial growth factor and to correlate them with β-catenin expression and some clinicopathologic parameters.
In this study, we analyzed paraffin-embedded specimens from 42 patients with pT3 rectosigmoid cancer for β-catenin, vascular endothelial growth factor and cyclin D1 expression using immunohistochemistry.
Thirty-six (85.7%) and 24 (57.1%) tumors expressed vascular endothelial growth factor and cyclin D1, respectively. Nuclear expression of β-catenin was detected in only 26.1% of tumors. It was revealed that cytoplasmic β-catenin expression was significantly related to vascular endothelial growth factor expression (p=0.011). No association was found between nuclear or cytoplasmic β-catenin and cyclin D1 expression. No significant association was seen between β-catenin, vascular endothelial growth factor or cyclin D1 expression and some investigated clinicopathologic features.
Our results may contribute to knowledge regarding the functional interaction between β-catenin and vascular endothelial growth factor. We suggest that the overexpression of cyclin D1 in rectosigmoid cancers may be more complicated than purely upregulation by β-catenin. Further larger studies on Wnt/β-catenin and target gene activity and protein expression are necessary to better understand and define their roles in the pathogenesis of colorectal carcinoma.
The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology 12/2010; 21(4):365-71. · 0.48 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Oncocytic lipoadenoma of the salivary gland is a rarely encountered tumor. A 56-year-old man presented with a two-year history of a slow-growing mass of the left parotid gland. Computed tomography scan with contrast showed a 7x6.5x6 cm well-circumscribed solid parotid mass of the left superficial and deep lobe. Fine-needle aspiration yielded oncocytic cells exclusively, suggesting Warthin tumor or an oncocytoma. Left total parotidectomy was performed. A diagnosis of oncocytic lipoadenoma was made. At six-month follow-up no evidence of recurrence has been noted. Oncocytic lipoadenoma should be considered in the differential diagnosis of oncocytic proliferations and oncocytic tumors in the parotid gland.
Kulak burun bogaz ihtisas dergisi: KBB = Journal of ear, nose, and throat 01/2010; 20(3):146-9.
[Show abstract][Hide abstract] ABSTRACT: Chondroid syringoma is a benign skin adnexal tumor. The reported incidence of chondroid syringoma among primary skin tumors is low and has been reported at 0.01-0.098%.
A 57-year-old woman presented with a 10-year history of a slowly growing lump on her philtrum. Fine needle aspiration cytology was performed. The smears showed cohesive groups of round cells embedded in a chondromyxoid ground substance. A diagnosis of benign appendageal tumor of the skin was made. Surgical excision of tumor was done. Histopathologic examination was consistent with chondroid syringoma.
Chondroid syringoma should be included in the differential diagnosis of a slowly growing nodule on the head or neck. The diagnosis can be confirmed by means of fine needle aspiration cytology. The treatment of choice is local excision.
[Show abstract][Hide abstract] ABSTRACT: Prostaglandins are critical mediators of inflammation and affect both humoral and cell-mediated immune responses. Recent findings show that T and B cells express COX-2 upon activation. The purpose of this study is to investigate the potential occurrence of COX-1 and COX-2 immunoreactivity in cases of chronic tonsillitis and to determine the sites of their expression. In addition, their expression in adult patients is compared with that in child patients.
Immunohistochemical techniques were used to evaluate the expression of the enzymes COX-1 and COX-2, in chronic tonsillitis tissue specimens from adults (n = 15) and children (n = 15).
There was no staining in surface epithelium or reticulated crypt epithelium. COX-1 and COX-2 expressions were observed mainly in the intraepithelial lymphoid cells in reticulated crypt epithelium and subepithelial cells. Also, COX-1 and COX-2 stained cells were found in the germinal center. There was no difference of the expressions of COX-1 and COX-2 among adults and children. The only significant difference noted between the adults and children was that, the adults had rich subepithelial plasma cells.
Activated B and T cells express COX-1 and COX-2 in paraffin-embedded tissue sections of chronic tonsillitis. Further studies need to be performed to elucidate expression of COX enzymes and their immunologic role in tonsil diseases. They will play an important role in the treatment of chronic tonsillitis. Additional studies are warranted to study the effects of NSAIDs and selective COX-2 inhibitors in chronic tonsillitis.
Indian Journal of Pathology and Microbiology 01/2010; 53(3):451-4. · 0.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To investigate the association between high-risk human papillomavirus (HPV) types and soluble interleukin-2 receptor (sIL-2R) levels in female sex workers with a negative cervical smear result, and to determine the effectiveness of using sIL-2R levels to screen for high-risk strains of HPV.
A negative cervical smear result and a blood sample were obtained from 68 women: 43 female sex workers and 25 women acting as controls. HPV DNA genotyping was performed and sIL-2R levels were assessed.
Female sex workers had significantly higher sIL-2R levels than women in the control group (318.37+/-239.7 vs 114.4+/-56.5 U/mL, respectively P<0.001). In addition, female sex workers with high-risk strains of HPV had significantly higher sIL-2R levels than those who did not have high-risk strains of HPV (736.7+/-251.5 vs 250.5+/-156.1 U/mL, respectively; P=0.001).
High sIL-2R levels may be useful in screening for high-risk strains of HPV in female sex workers who have a negative cervical smear result.
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 05/2009; 106(3):210-2. · 1.41 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Pneumoperitoneum (Pp) induces an ischemia and reperfusion (I/R) injury as a result of released oxidative stress markers. Ischemic preconditioning (IP) is one of the used methods to reduce the harmful effects of Pp, which is a mechanism for reducing organ I/R injury by a brief period of organ ischemia. The aim of this study was to investigate the ideal time for IP in the laparoscopic model.
Thirty-two rats were assigned into four groups: group 1 (control, n = 8) was subjected to a sham operation. Group 2 (5-minutes IP, n = 8) was subjected to 5 minutes of Pp with 15 mm Hg of pressure followed immediately by 5 minutes of deflation, and after that, 60 minutes of Pp with 15 mm Hg, followed by 60 minutes of deflation. Group 3 (10-minutes IP, n = 8) was subjected to 10 minutes of Pp and 10 minutes of deflation. Group 4 (Pp only, n = 8) was subjected to 60 minutes of Pp with 15 mm Hg of pressure, followed by 60 minutes of deflation. At the end of the experiment, plasma malondialdehyde (MDA) values, the oxidative stress marker, and plasma-reduced glutathione (GSH) levels, the marker showing antioxidant activity, were determined.
Highest plasma MDA values were in group 4 (Pp only), followed by groups 2 and 3 and group 1 (P = 0.181). In addition, IP groups had almost the same values for MDA. Plasma GSH levels in the control group were significantly higher than those in the IP groups and the Pp-only group (P < 0.001). Similarly, as in MDA levels, no difference was found between plasma GSH levels of the IP 5-minutes and IP 10-minutes groups.
Five minutes of the IP model may be as reliable as 10 minutes of the IP model. In that case, 5 minutes of IP can be more suitable in reducing I/R injury in laparoscopy.
[Show abstract][Hide abstract] ABSTRACT: This study investigates the expression of cyclooxgenase (COX)-2 and matrix metalloproteinase (MMP)-2 in patients with adenomyosis or endometrial polyps and their possible relation to microvascular density in these lesions. The subjects were 25 patients with adenomyosis, 30 patients with endometrial polyps, and 20 female controls. The expression of COX-2, MMP-2, and CD34 was studied immunohistochemically. Microvesseldensity (MVD) was calculated by the counting of CD34-positive vascular endothelial cells. The quantity and intensity of COX-2 expression in endometrium did not vary during the menstrual cycle in the control group and in patients with endometrial polyps. In patients with adenomyosis, it was higher in the secretory phase. MMP-2 expression in stromal cells in adenomyotic foci and endometrial polyps were higher than in normal endometrium. In the proliferative phase, MVD in adenomyosis foci was higher than in normal endometrium and endometrial polyps. In the secretory phase, MVD in adenomyotic foci and endometrial polyps was higher than in normal endometrium. Overexpression of stromal MMP-2 may play a role in the development of adenomyosis and endometrial polyps. Aberrant COX-2 expression in eutopic endometrium during the luteal phase may be associated with the pathogenesis of adenomyosis; however, expression of COX-2 does not seem to play a role in the development of endometrial polyps. MVD was high in both lesions, but there was no significant correlation between MVD and the expression of MMP-2 or COX-2. Mechanisms other than COX-2 and MMP-2 may contribute to the promotion of angiogenesis in these lesions.
International journal of gynecological pathology: official journal of the International Society of Gynecological Pathologists 02/2009; 28(2):148-56. · 2.07 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study investigates angiogenesis and the expression of thrombospondin 1 in invasive ductal carcinoma of the breast and their possible relation to platelet counts and platelet activity. The study included 20 cases of invasive ductal carcinoma. Platelet activity was evaluated by determining thromboxane B2 and cyclic guanosine monophosphate (cGMP) levels by enzyme immunoassay (EIA).Thrombospondin (TSP) 1 and CD34 expression was studied immunohistochemically. Mean platelet count of the patient group was significantly greater than the mean platelet count of the control group (P < 0.05). The platelet counts were positively correlated with tumour size (r=0.609; P < 0.01). Platelet counts were higher in the patients who had grade 3 microvessel density (P < 0.05). The mean basal platelet cGMP level in the patient group was significantly lower than it was in the control group (P < 0.05). Focal TSP immunoreactivity was detectable in 5 (20%) cases in the tumour cells, and in 9 (45%) cases in the stroma. We did not find any correlation between TSP-1 staining and angiogenesis, platelet counts, platelet activity, and the histological prognostic parameters. Our study confirms the essential role of platelets in tumour growth and angiogenesis. Decreased levels of cGMP in the patient group may cause platelet hyperreactivity. Although thrombospondin 1 may be upregulated in malignant breast tissue, this is not sufficient for tumour growth and dissemination according to our results.
Upsala journal of medical sciences 01/2009; 114(2):108-15. · 0.73 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To evaluate localizations of cyclooxygenase (COX)-1 and COX-2 following traumatic brain injury (TBI) and the effects of 2 therapeutic agents on COX inhibition.
Forty rabbits were used in this study for developing a TBI model and divided into 4 groups (n=10) at Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey in June 2004. Differential cellular COX-1 and COX-2 protein expression profiles were analyzed following TBI, and the effects of 2 therapeutic agents, indomethacin and nimodipine, on COX inhibition were evaluated immunohistochemically.
This study revealed that COX-1 and COX-2 protein expression were significantly increased in vascular endothelial, smooth muscle cells, and CD68+ microglia/macrophages following TBI. Indomethacin inhibited the COX expression in glial cells more than nimodipine, however, both did not affect endothelial COX-1 and COX-2 expression.
The restricted accumulation of COX-1 at the perilesional area points to an acute inflammatory response and the role of COX-1 in TBI. This study revealed that COX-1 expression should be a pharmacological target following TBI, and COX-2 should also be evaluated in this aspect, and indomethacin is more effective than nimodipine for blocking COX-1.
[Show abstract][Hide abstract] ABSTRACT: PTEN seems to play an important role in cell cycle, growth, migration, and death. Integrins are cell surface receptors that play a role in the regulation of cell proliferation, differentiation, implantation, and embryogenesis. PTEN inhibits beta1 integrin signaling. The objective of this study is to investigate the expression of PTEN and beta1 integrin in placental tissues of early spontaneous abortion and first and third trimesters of normal pregnancy.
A total of 43 placental tissue samples were evaluated using immunohistochemistry for PTEN and beta1 integrin. Group 1 included placental tissues of volunteer termination of normal pregnancy during the first trimester (5-10 wk gestation). Group 2 included placental tissues of normal vaginal delivery at the third trimester of pregnancy (36-40 wk gestation). Group 3 included placental tissues of pregnancy termination because of spontaneous abortion during the first trimester (5-10 wk gestation).
PTEN expression of villous trophoblast was decreasing as the pregnancy advanced. PTEN staining of decidual cells was significantly stronger in tissue samples from early spontaneous abortion than in tissue samples from early and late normal pregnancy (p=0.003, p=0.001, respectively). There was no significant difference between beta1 integrin expression of villous trophoblast and decidual cells in three groups.
Our findings suggest that altered patterns of PTEN expression may be associated with abortion, but it seems that beta1 integrin does not contribute to this process as a signaling protein. Further evaluation is needed to highlight this subject.
Upsala journal of medical sciences 02/2008; 113(2):235-42. · 0.73 Impact Factor