Unsal Han

T.C. Sağlık Bakanlığı Ankara Eğitim ve Araştırma Hastanesi, Engüri, Ankara, Turkey

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Publications (12)15.81 Total impact

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    ABSTRACT: The purpose of this study was to investigate the expression level of KAI-1 in gastric carcinomas and compare with the clinicopathological characteristics. KAI-1 expressions were detected with immunohistochemical methods in 257 patients with gastric carcinomas. KAI-1 was highly expressed in normal gastric epithelium, whereas only 86 of 257 (33.5%) patients with gastric carcinomas were KAI-1 positive. The expression levels, however, decreased with the loss of tumor differentiation, increase in tumor invasion depth, increase in the number of metastatic lymph nodes and perinodal invasions, and progression in the tumor stage. Distant metastatic and stage 4 tumors were all KAI-1 negative. All of these results were statistically significant (P<0.05). There were no correlations between KAI-1 expression and the other parameters such as age, sex, tumor location, tumor size, WHO, Lauren's and Bormann's classifications, neural and angiovascular invasion of the tumor and intestinal metaplasia in adjacent gastric mucosa (P>0.05). Loss of KAI-1 may be considered a significant prognostic parameter in predicting the progression of the gastric carcinomas when evaluated along with the clinical and pathological parameters.
    European journal of gastroenterology & hepatology 06/2009; 21(12):1369-72. · 1.66 Impact Factor
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    ABSTRACT: To compare clinical and histopathologic outcomes of tissue glue and vicryl suture to attach limbal conjunctival autografts in pterygium surgery. Twenty-four eyes of 24 patients were included in this study. All eyes had primary pterygia and were treated with limbal conjunctival autograft transplantation after pterygium resection. Tissue glue (Tisseel) was used to attach the limbal conjunctival autograft in 12 eyes and vicryl sutures in 12 eyes. Patients were followed for 6 months. Histopathologic examination was performed in both groups on postoperative days 1, 15, and 45. Main outcome measures were patient comfort, graft success, complications, histopathologic evaluation, and recurrence of pterygium. Patient comfort was significantly higher in the tissue glue group than the vicryl suture group (P < 0.05). All grafts were intact in both groups during the follow-up period. No recurrence was observed during the 6-month follow-up in both groups. Foreign-body granulation tissue was not seen in any histopathologic studies in eyes with tissue glue, whereas it was observed in eyes with vicryl sutures from day 15 to day 45. The tissue glue was seen under the conjunctiva on the first postoperative day and was not seen on days 15 and 45. Our results showed that limbal conjunctival autografting is an effective surgical technique for the treatment of pterygium, and tissue glue was efficacious in securing the limbal conjunctival autograft in pterygium surgery. The use of tissue glue decreases patient symptoms during the postoperative period after pterygium surgery. Compared with sutures, tissue glue had no adverse effects on ocular tissue.
    Cornea 06/2008; 27(5):552-8. · 1.75 Impact Factor
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    ABSTRACT: The prognosis of esophageal squamous cell carcinoma is primarily determined by staging. Although radiological methods have revealed lymph node metastasis preoperatively, these radiological findings cannot be correlated with pathological staging. The aim of this study was to compare the expressions of p53, vascular endothelial growth factor C (VEGF C) and p21 with lymph node metastasis in preoperative endoscopic biopsy and postoperative resection material. Tissue samples were taken from 40 patients who had undergone endoscopic biopsies and radical esophagectomies. The expressions of p53, VEGF C and p21 proteins in these sections were immunohistochemically examined. The expression of each antibody was characterized as a negative or positive reaction according to the pattern and intensity of semiquantitative immunostaining. The staining pattern of antibodies was divided into three groups: < 10% cancer cells were accepted to be (-), 10-50% were (+), heterogenous and > 50% were (+ +), homogenous. For each antibody, statistical correlation with conventional prognostic parameters such as localization, microscopic grade, stage, pathological lymph node metastasis and survival, were investigated. p53 expression was observed in 65.5% (19/29) of lymph node positive cases, whereas p53 was in 50% (20/40) of cases. VEGF C was in 65% (26/40) and p21 was in 15% (6/40) of cases. p53 has the specificity of 90.9% and sensitivity rate of 65.5% in detecting lymph node metastasis and positive predictive value was 95%. Expression of p53 was significantly correlated with stage and lymph node metastasis (P = 0.02 and P = 0.03, respectively). Prediction of lymph node metastasis by p53 was correlated independently and in coexpression with VEGF C (P < 0.01). There was no relation detected between p21 and other parameters. In esophageal squamous cell carcinoma (SCC), p53 and VEGF C expressions were correlated with pathologically positive lymph nodes. When preoperative staging has been insufficient in esophageal carcinoma cases, immunohistochemical analysis of p53 and VEGF C staining in tissues could be an aid to clinicians regarding lymph node metastasis.
    Diseases of the Esophagus 02/2007; 20(5):379-85. · 1.64 Impact Factor
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    ABSTRACT: The aim of this study was to compare the vascular density of Vascular endothelial growth factor (VEGF) expression with microvascular density determined by CD34 and CD31 with conventional prognostic parameters. The study involved 50 renal cell carcinoma (RCC) cases. VEGF, CD34, and CD31 were stained by immunohistochemistry, and then preparations were evaluated by two pathologists under light microscopy. The whole tumor area was scrutinized in all the sections. In the evaluation of VEGF, due to the lack of homogenous staining within the tumor, two parameters, distribution and intensity of expression, were evaluated semiquantitively. In the evaluation of microvascular density with CD34 and CD31 staining, three hot areas with the highest density were determined. In x200 magnification of these areas, on a single plane, the quantity of vascular structures with lumens was determined. Intensity of VEGF Expression was higher in papillary type carcinoma of kidney parenchyma (P = 0.014) and it was significantly correlated with tumor stage (P = 0.013), survival time (P = 0.01), and tumor size (P = 0.035). Distribution of VEGF expression was also higher in papillary RCC (P = 0.055) and it was significantly correlated with tumor stage (P = 0.043) and tumor size (P = 0.039). Vascular density determined with CD34 staining was higher in conventional RCC (P < 0.05); in addition, it was significantly correlated with distribution and intensity of VEGF expression (P < 0.05) and tumor stage (P < 0.05). Vascular density determined with CD31 staining was not significantly correlated with tumor type, tumor stage, nuclear grade, and survival time. Intensity and distribution of VEGF were higher in papillary RCC. Both parameters were significantly correlated with tumor size, stage, and vascular density determined with CD34 staining. Intensity of VEGF was also significantly correlated with capsule invasion. Vascular density determined with CD34 staining, however, was higher in conventional RCC, and it was correlated with tumor size and stage.
    International Urology and Nephrology 01/2007; 39(3):691-8. · 1.33 Impact Factor
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    ABSTRACT: To compare the diagnostic value of testicular fine needle aspiration (FNA) cytology with that of open biopsy in primary infertility and nonobstructive azospermia or severe oligozoospermia, to evaluate the reliability of percentage cell counts and cell indices. Thirty patients (21 azospermic and 9 severe oligozoospermic) who had samples for testicular FNA obtained from both testis (mean age = 28.7) and open biopsy were included in the prospective study. Primary infertility, history, complete physical examination, hormonal assay and testicular ultrasound data were evaluated. One case was excluded because of an unsatisfactory result in aspiration cytology. The percentage population of Sertoli cells and spermatogenetic cells, in addition to spermatic index, sertoli cell index and sperm-Sertoli cell indexes, was calculated. The statistical analysis was determined using the paired t test. Progressively increasing values of the Sertoli cell index and progressively decreasing values of the sperm--Sertoli cell index were seen in maturation arrest, hypospermatogenesis and Sertoli cell-only syndrome. The difference between mean counts and indices in normal spermatogenesis and other histologic categories was statistically significant (p < 0.05). Percentage cell counts and cell indices in testicular FNA significantly correlate with histological categories. In primary male infertility, testicular FNA can be performed instead of open biopsy.
    Analytical and quantitative cytology and histology / the International Academy of Cytology [and] American Society of Cytology 12/2006; 28(6):331-6. · 0.60 Impact Factor
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    ABSTRACT: The simultaneous occurrence of meningioma and breast cancer with or without brain metastasis is an unusual but well-known event. However, contiguous occurrence of meningioma and brain cancer metastasis is a less rare evidence and we are aware of only one previously published case in the literature. A 72-year-old woman presented with headache, nausea and vomiting, and diminished mentation and memory. Seven years ago, she had had simple mastectomy at another hospital. Histopathologic examination had been reported as breast carcinoma. The patient had not gone to the controls and was unaware of the diagnosis. Cranial MRI examination of the patient showed two extraaxial masses. Histopathologic examination of the lesion at the frontal convexity, which was reported as en plaque meningioma radiologically, revealed meningioma but the other tumor at the sylvian fossa resembling the other meningioma was reported as breast carcinoma metastasis at histopathologic examination. Although meningiomas have well-known radiological features, the other pathologies like breast metastasis may simulate them. A possible hormonal relationship between breast cancer and meningioma has not been clarified. We are not sure that this has played a role in dissociation of both tumor cells in our case.
    Surgical Neurology 10/2006; 66(3):324-7; discussion 327. · 1.67 Impact Factor
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    ABSTRACT: The objective was to determine whether the interleukin-6 (IL-6) level in umbilical cord blood can be used for the prediction of histologic chorioamnionitis, funisitis, fetal membrane cultures and neonatal infection. A case-control study was conducted on 30 controls (control group) and on 40 women with term premature rupture of the membranes (PROM group). The interleukin-6 concentration of cord blood was measured. Fetal membranes and newborn blood were cultured. Placentas were examined for histologic chorioamnionitis and funisitis. Receiver operator curve analysis was used to obtain a cut-off value of interleukin-6 concentration for predicting histological and clinical infection. The mean interleukin-6 level in cord blood was significantly higher in the PROM group (p=0.01). Histological chorioamnionitis and positive placental cultures were significantly higher in the PROM group (p=0.006 and 0.02, respectively). The PROM group had seven (17.5%) cases of funisitis and positive newborn blood cultures while neither was observed in the control group. A cord blood interleukin-6 level >29 pg/ml was found to have 84% sensitivity and 72.5% specificity for predicting positive placental cultures and 74.1% sensitivity and 76.7% specificity for identifying cases of histologic chorioamnionitis. For predicting funisitis and positive newborn cord blood cultures a cord blood interleukin-6 level >39 pg/ml has 100% sensitivity and 81% specificity. Cord blood interleukin-6 level can be a tool for the evaluation of the extent of maternal-fetal infection and guides proper planning of the treatment.
    European Journal of Obstetrics & Gynecology and Reproductive Biology 01/2006; 128(1-2):34-9. · 1.84 Impact Factor
  • The Breast Journal 01/2006; 12(4):391-2. · 1.83 Impact Factor
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    ABSTRACT: Surgical specimens belonging to 16 patients who underwent partial laryngectomy for T1 glottic cancer were subjected to detailed histopathologic examination; 11 of the patients were staged as T1a while 5 were staged as T1b. It was detected that in 11 patients the tumor was confined to the mucosal or submucosal connective layer, and in 5 (31.2%) cases, the tumor invaded the thyroarytenoid (TA) muscle. In cases involving the one-third anterior part of the vocal cords and the anterior commissure, a 50% (4/8) TA muscle invasion was detected. Our finding TA muscle invasion at the rate of 31.2% in our 16 case series clinically staged as T1 revealed that deep invasion did not always impair the vocal cord mobility. Observing TA muscle invasion at the rate of 50% in cases involving the one-third anterior part of the vocal cord and the anterior commissure suggested that TA muscle invasion in the anterior part did not significantly impair mobility.
    Otolaryngology Head and Neck Surgery 05/2005; 132(4):581-3. · 1.73 Impact Factor
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    ABSTRACT: Due to its rarity, chordoma may be difficult to differentiate from other neoplasms with a similiar myxoid background. We describe a case of chordoma involving the oropharynx inferiorly that was diagnosed by transoral fine needle aspiration (FNA) cytology (FNAC) and confirmed by histologic studies. This appears to be 1 of the few reported applications of FNA in the diagnosis of chordoma of the oropharynx in the English-language literature. A 50-year-old male presented with nocturnal dyspnea and rare hemoptysis for 6 months. A hypodense mass was located in the left posterior side of the oropharynx. FNAC of the mass showed classic physaliferous cells with a bubbly appearance and myxoid fibrillary background. The aspirate was reported as "myxoid tumor suggestive of chordoma," as confirmed by histopathologic investigation of the excisional biopsy. The cytologic features of chordoma are quite characteristic, especially on May-Grünwald-Giemsa (MGG)-stained slides. The cytoplasmic vacuoles of the physaliferous cells and the mucoid matrix of the tumor become conspicuous on MGG staining. When Papanicolaou staining is used as the only staining procedure, the cytoplasmic vacuoles of the physaliferous cells and mucoid matrix of chordomas may be overlooked. The differential diagnosis of myxoid tumors is of utmost importance for therapy and prognosis.
    Acta cytologica 01/2005; 49(2):173-6. · 0.69 Impact Factor
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    ABSTRACT: Fibroblast growth factor-2 (FGF-2) is a multifunctional protein which plays a role in smooth muscle cell growth, wound healing, tissue repair and angiogenesis. FGF-2 is also released by mechanically wounded cells. Herein, the importance of FGF-2 release from periannular tissue in the mechanism of pannus formation in obstructed mechanical prostheses was investigated. Between January 1993 and December 2002, 35 patients with an obstructed bileaflet prosthetic mitral valve were classified according to the nature of obstruction as either thrombus or pannus. Data were related to patient age and gender, prosthesis model and size, intraoperative and pathology findings, and interval between implant and thrombosis. FGF-2 release was monitored immunohistochemically in all cases. Thrombus formation was found in 19 patients, and pannus formation in 16. Patients were reoperated on after 3.10 +/- 0.7 years in the thrombus group, and after 6.3 +/- 0.46 years in the pannus group (p = 0.04). A foreign body reaction was found 78.9% of thrombus patients and 81.2% of pannus patients (p = 0.602), chronic inflammation in 31.5% and 50%, respectively (p = 0.317), and FGF-2 release in 78.9% and 87.5%, respectively (p = 0.582). As FGF-2 release was similar in both patient groups, the duration of FGF-2 release from injured periannnular tissue was considered to form part of the chronic healing process, and was not attributed to mitral valve obstruction by pannus formation.
    The Journal of heart valve disease 08/2004; 13(4):676-80. · 1.07 Impact Factor
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    ABSTRACT: The value of polytetrafluoroethylene (PTFE) surgical membrane as a pericardium substitute in patients who undergo reoperation for rheumatic valve disease is reported in this observational study. PTFE was used for pericardial closure in 56 rheumatic valve patients. During reoperation of seven cases, adhesions were classified as none, minimal, moderate to severe and scored in the sections of heart. Data found at reoperations were collected prospectively in all patients. Seven of 56 patients reoperated mean period of 67.1+/-23.4 (SD) months later. No infection, complication and operative or late death attributable to the membrane were observed. There were two right ventricular, three minimal right atrial and one innominate vein lacerations during resternotomy and all of them were controlled. During histological examination, a microscopically significant foreign body reaction was found. PTFE membrane produced an undesirable fibrous membrane that obscured the epicardial anatomy and hardened the dissection in patients with rheumatic heart disease.
    Cardiovascular Surgery 11/2002; 10(5):489-93.