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Öğe Acinar Cell Cystadenoma (Acinar Cystic Transformation) of the Pancreas: the Radiologic-Pathologic Features(KOREAN RADIOLOGICAL SOC, 2011) Gümüş, Mehmet; Uğraş, Serdar; Algın, Oktay; Gündoğdu, HaldunAcinar cystic transformation of the pancreas is also known as acinar cell cystadenoma (ACC), and this is an extremely rare benign lesion that was first described in April 2002. We report here on a case of a previously asymptomatic patient with pancreatic ACC and this was diagnosed by computed tomography (CT) and magnetic resonance imaging (MRI). To the best of our knowledge, there is no previous report concerning the CT or MRI features of ACC in the medical Literature. We present here the CT, MRI and pathological findings of pancreatic ACC.Öğe Burkitt Lenfomalı Bir Çocukta İzole Skrotal Deri Relapsı(2015) Köse, Doğan; Kıvrak, Ali Sami; Uğraş, Serdar; Köksal, YavuzEn hızlı büyüyen insan tümörü olan Burkitt lenfoma (BL), agresif bir B hücre neoplazisidir. Genellikle ekstranodal bir hastalık şeklinde ortaya çıkar. Ekstranodal alanlara metastazı da sıktır ancak cilt tutulumu nadirdir. On bir yaşında erkek hasta, karın ağrısı ve yutma güçlüğü şikayeti ile başvurdu. Batın sol alt kadranda tespit edilen kitleye uygulanan trucut biyopsi ile BL tanısı konuldu ve BFM-95 B hücreli Non-Hodgkin lenfomu (NHL) tedavi protokolü uygulandı. Hasta tedavi bitiminden 1,5 ay sonra sağ skrotal şişlik şikayeti ile tekrar başvurdu. Fizik muayenesinde, sağ skrotal ödem ve kızarıklık vardı. Skrotum cildinden yapılan biyopsi ile hastaya relaps BL tanısı konuldu ve LMB-Grup C tedavi protokolü uygulandı. Tedavi bitiminden 20 ay sonra hasta batında şişlik ve ağrı şikâyeti ile tekrar geldi. Muayenesinde; batında sol üst-orta kadranda bir kitle saptandı. Yapılan biyopsinin sonucu yine BL olarak rapor edildi ve hastaya COPM (vinkristin, prednizolon, siklofosfamid, metotreksat) tedavi protokolü ile birlikte rituksimab başlandı. Ancak santral sinir sistemi relapsı gelişti ve hasta kaybedildi. Bu olgu daha önce literatürde izole skrotal cilt relapsı bildirilmediği için sunulmuşturÖğe Coexistent Familial Nonmultiple Endocrine Neoplasia Medullary Thyroid Carcinoma and Papillary Thyroid Carcinoma Associated With RET Polymorphism(Lippincott Williams & Wilkins, 2010) Gül, Kamile; Özdemir, Didem; Uğraş, Serdar; İnançlı, Serap S.; Ersoy, Reyhan; Çakır, BekirFamilial nonmultiple endocrine neoplasia medullary thyroid cancer accounts for 10% to 15% of hereditary medullary thyroid carcinoma and is characterized by lack of accompanying endocrine or nonendocrine diseases. Simultaneous occurrence of medullary and papillary thyroid carcinoma in the same patient is rare and known as collision tumor. Here, the authors present familial nonmultiple endocrine neoplasia medullary thyroid cancer in 4 sisters, all having RET proto-oncogene polymorphism in exon 15 at codon 904 and 2 having additional polymorphism in exon 13 at codon 769. The index case had concomitant medullary and papillary thyroid carcinomas, which are suggested to be completely different tumors in terms of incidence, cell origin, histopathologic features and prognosis. Histopathologically, she also had Hashimoto thyroiditis in the remaining thyroid tissue and medullary thyroid carcinoma metastasis in 3 cervical lymph nodes. This case is the first in the literature to report coexistent familial nonmultiple endocrine neoplasia medullary thyroid cancer and papillary thyroid carcinoma related with a RET polymorphism (S904S in exon 15).Öğe Comparison of 21 and 27 gauge needles for determining sample adequacy in the aspiration biopsy of thyroid nodules(AVES, 2012) Gümüş, Mehmet; Çay, Nurdan; Algın, Oktay; İpek, Ali; Ersoy, Reyhan Ünlü; Belenli, Olcay; Uğraş, SerdarPURPOSE To compare 21 and 27 gauge (G) needles used for fine-needle aspiration (FNA) of thyroid nodules to obtain better specimens for adequacy and cytological diagnosis. MATERIALS AND METHODS One hundred patients with thyroid nodules (100 nodules) were included in this study. Each nodule was aspirated with both 27 G and 21 G needles. The obtained aspirates were classified as adequate and inadequate by two separate cytopathologists. The results were analyzed by appropriate statistical methods. RESULTS There was no statistically significant difference between 21 G and 22 G needles in terms of adequacy, according to each pathologist (P > 0.05). After pathological evaluation with consensus, the adequacy prevalence was the same (84%) for both needle types in all study populations (P> 0.05). According to the ultrasound characteristics of nodules, the prevalence of inadequate samples in patients with hypoechoic or heterogeneous nodules was significantly higher compared with the prevalence of inadequate samples in patients with isoechoic or hyperechoic nodules for both types of needles (P < 0.05). However, according to the size of the needles, there was no significant difference between hypoechoic and heterogeneous nodules or between isoechoic and hyperechoic nodules with regard to the ability to yield adequate samples (P> 0.05). CONCLUSION The results of our study showed that FNA with 27 G needles can aspirate adequate material for cytopathological diagnosis. The probability of inadequate sample aspiration of hypoechoic and heterogeneous nodules is higher than that for other nodule types.Öğe Effects on Wound Healing of Different Incision Instruments: Experimental Study(2012) Şahin, Mustafa; Baysal, B.; Yılmaz, Hüseyin; Alptekin, Hüsnü; Uğraş, Serdar; Mehmetoğlu, İdrisObjective. Wound healing effects of scalpel, electrocautery, peak plasmablade, which are used for skin incisions and intestinal incisions, were searched. Material and method. 36 wistar albino rats 10-week were used as experimental animals. 3 groups were created. There were 12 wistar albino rats in each groups. Laparotomy by scalpel and transection to ascending colon were applied in the group I. The segment, which was transected, was anastomosised at once. The same processes were applied by electrocautery in the group II. The same processes were applied by peak plasmablade in the group III. Experimental animals were sacrified at the 7th post-operative day. 1 ml blood was taken by cardiac puncture for MDA measurement and then relaparotomy was applied. Approximately 4 cm intestinal segment, which included anastomosis line, was resected. Then anastomotic bursting pressures were measured. 4x4 cm2 abdominal wall was removed to measure rupture breaking pressure of incision. Tissue samples were got for incision line's and anastomosis line's histopathological examinations. Results. In the group II, anastomotic bursting pressure and rupture breaking pressure of abdominal wall were found less than the groups I and III. The difference between the groups was statistically reasonable (p<0.05). MDA values of each groups weren't statistically different. At anastomosis and incision line, any reasonable difference was found in terms of 7 criterions, which were evaluated histopathologically. Conclusion. We think that scalpel and peak plasmablade can be used for incisions safely. Peak plasmablade supplies hemostasis. So peak plasmablade shortens operation duration.Öğe The Importance of Expression of Keratin 17 (KRT17) and SPINK1 in Neoplastic (Invasive and Noninvasive) Lesions of the Bladder(Selçuk Üniversitesi, 2022) Uğraş, Serdar; Harmankaya, İsmailObjective: Diagnosis and grading of bladder cancers have a significant impact on treatment and prognosis. However, there are currently no very sensitive and specific immunohistochemical panels that can be used in the differential diagnosis of neoplastic lesions of the bladder and histomorphological findings are still the gold standard. We aimed to define the potential diagnostic importance of SPINK1, KRT17 and Laminin immunostaining in distinguishing neoplastic bladder lesions. Material and Methods: KRT17, SPINK1 and Laminin expressions were assayed in 141 tissue samples of non-neoplastic bladder mucosa (NBM) and neoplastic bladder lesions by immunohistochemistry. Results: KRT17 and SPINK1 are often expressed in tumoral tissues (86.2% and 68.7%, respectively). A statistically significant difference in KRT17 immunostaining was detected between the NBM and all seven neoplastic groups (p=0.03 to p?0.001). SPINK1 expression was significantly lower in NBM in comparison to neoplasms. Staining 2.5% or more of cells in tumor tissue with KRT17 distinguishes neoplastic lesions from nonneoplastic lesions with a sensitivity of 86.3% and a specificity of 100%. However, staining 12.5% or more of the cells in the tumor tissue with SPINK1 distinguishes neoplastic lesions from nonneoplastic lesions with a sensitivity of 62.6% and a specificity of 60%. Although both KRT17 and SPINK1 were stained in 60% of neoplasms, neither KRT17 nor SPINK1 staining was seen in 5.3% of neoplastic patients. Conclusion: Immunohistochemical panel consisting of KRT17, SPINK1 and Laminin can be used together with morphological findings for accurate diagnosis of bladder neoplasia.
