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Öğe Long-Term Survival Outcomes of Early-Stage Grade 1 and 2 Endometrioid Type Endometrial Cancer Patients(Selçuk Üniversitesi, 2023 Nisan) Avcı, Fazıl; Eren, Önder; Bilgi, Ahmet; Başaran, Hamit; Çelik, Murat; Çağlayan, Melek; Çelik, ÇetinAim: Early-stage endometrioid-type endometrial cancer (EC) has a favorable prognosis. The recurrence is still the biggest issue. There are differences in the literature in terms of treatment modalities in the early-stage. The aim of the study is to retrospectively investigate the long-term survival outcomes of early-stage grade 1 and 2 endometrioid-type endometrial cancer patients. Methods: Out of 327 cases, 294 cases in stage 1 and 33 cases in stage 2 were evaluated. Age, stage, tumor size, histologic grade, degree of myometrial invasion, presence of lymphovascular invasion (LVSI), peritoneal cytology positive, presence of recurrence, overall survival (OS), and disease-free survival (DFS) between two groups were evaluated statistically. Results: The mean age of 327 patients was 64.0±10.0 years. Out of 327, 65.7% were ?60 years, and 90% were stage 1, 74.6% were grade 1, 1.8% had positive peritoneal cytology, 8.3% had LVSI and 86% had ?50% myometrial invasion. Recurrence was detected in 6.4% of patients. 40.7% of patients received adjuvant radiotherapy. Only the adjuvant radiotherapy found a significant association between two groups. Only presence of recurrence in terms of OS and DFS durations was a significant parameter in the regression analysis. Conclusion: Development of recurrence in the early-stage endometrioid-type EC is the main prognostic predictor for survival. The early diagnosis and treatment of recurrence have a positive impact on the prognosis.Öğe Küçük Hücre Dışı Akciğer Karsinomlarinda Biyolojik Davranışın Belirlenmesinde P53 ve Ki-67 Ekspresyonunun Değeri(Selçuk Üniversitesi, 2020 Aralık) Günler, Tuğba; Karabağlı, Pınar; Çelik, Zeliha Esin; Uğurluoğlu, CeyhanAmaç: Akciğer karsinomlarında yapılan son çalışmalar, tümörü erken evrede tespit etme, nüks ve mortalite riskini belirleme ile hedef tedavide etkili olan klinikopatolojik faktörleri saptamak için yürütülmektedir. Bu çalışmamızda rezeke edilen küçük hücre dışı akciğer karsinom(KHDAK)olgularını 2015 Dünya Sağlık Örgütü (DSÖ) sınıflamasına göre yeniden değerlendirerek, p53 ve Ki-67'nin immünohistokimyasal ekspresyonunun klinikopatolojik parametreler ile ilişkisini ve prognostik önemini belirlemeyi amaçladık. Gereç ve Yöntem: Rezeksiyon materyallerinde KHDAK tanısı alan Evre I - III arasındaki 125 olguda retrospektif olarak klinikopatolojik özellikler (cinsiyet, yaş, sigara kullanımı, tümör boyutu, plevra invazyonu, lenf nodu tutulumu, evre, sağkalım) ile p53 ve Ki-67 immunhistokimyasal ekspresyonu değerlendirildi. Bulgular: p53 ekspresyonu 125 olgunun 61’inde>%10’du. Ki-67 ekspresyonunun ortalama değeri %32,9’du. Hem p53 hem de Ki-67 ekspresyonunun tümörün histolojik tipler ile ilişkisi incelendiğinde anlamlı sonuçlar bulundu (p=0,036 ve p=0,000). Ki-67’den farklı olarak p53 ekspresyonu adenokarsinom (ADK) alt tiplerinde derece yükseldikçe anlamlı yüksek bulundu (p=0,036). Yüksek Ki-67 ekspresyonu tümör boyutu ve evre artışı ile ilişkiliydi (p=0,008 ve p=0,020). Tek değişkenli ve çok değişkenli analizlerde prognozu etkileyen faktörler yaş ve tümörün evresi idi (p=0,021 ve p=0,041). Klinikopatolojik bulgular sağkalıma tek başına etkili değildi. Wald testi p53 ve Ki-67 ekspresyonu, sigara ve cinsiyet ile genel sağkalım arasında anlamlı bir ilişki olmadığını ortaya koymuştur. Sonuç: KHDAK’larında Ki-67 ekspresyonu büyük tümör boyutu ve ileri evre ile güçlü bir ilişkiyi göstermektedir. p53 mutasyonu skuamöz hücreli karsinomlarda ve özellikle ADK solid varyantta daha sık görülmektedir. Bununla birlikte, p53 ve Ki-67 proteinlerinin prognostik öneminin daha büyük hasta gruplarında ve uzun süreli takiplerle araştırılmasının daha anlamlı sonuçlar sunabileceği ön görülmektedir.Öğe Rektal Adenokarsinomlarda Aldehid Dehidrogenaz 1 (ALDH1) ve Gamma Synuclein Ekspresyonunun Prognostik Değeri(Selçuk Üniversitesi, 2020 Aralık) Harmankaya, İsmail; Karabağlı, Pınar; Yavaş, Güler; Çelik, Zeliha Esin; Ata, ÖzlemAmaç: Kolorektal kanserler arasında her evrede sağkalımın en olumsuz olduğu tümörler rektum kanserleridir. Bununla birlikte cerrahi tekniğin optimizasyonu ve neo-adjuvan tedavi yaklaşımı, son yıllarda rektum kanserlerinde 5 yıllık sağ kalım sürelerinin kolon kanserinden daha iyi olmasına neden olmuştur. Erken evre rektum tümörlü hastaların tedavisinde küratif tedavinin köşe taşı cerrahidir. Ancak transmural invazyon ve/veya pozitif perirektal lenf nodu olan hastalarda, hastalığın lokal kontrolü ve kürü açısından olumlu sonuçlar elde edebilmek için cerrahi tedaviye radyoterapi ve kemoterapinin eklenmesi gerekir. Kanser kök hücre belirteci olan ALDH1 ekspresyonunun kemoterapiye rezistansta, tümör progresyonunda ve metastazında anlamlı olduğu yapılan çalışmalarda gösterilmiştir. Ayrıca metastatik ve ileri evre meme over, karaciğer, prostat ve kolon kanserlerinde normal dokudan farklı olarak anormal gamma synuclein ekspresyonu varlığı da gösterilmiştir. Gamma synuclein ekspresyonu meme kanser hücrelerinin proliferasyonu, invazyonu ve metastazıyla ilişkili bulunmuştur. Gereç ve Yöntem: Çalışmamızda rektum rezeksiyon materyallerinden rektal adenokarsinom tanısı alan 55 olguya ait tümöral ve normal mukoza örnekleri incelendi. Prognostik parametreler ile ALDH 1 ve Gamma synuclein antikorlarının ekspresyonları arasındaki ilişki araştırıldı. Bu şekilde çalışmamızda rektum kanserinde gamma- synuclein ve ALDH1 ekspresyonu ile tümör agresivitesi ve prognozu üzerine etkilerini belirlemeyi amaçladık. Bulgular: İmmunohistokimyasal olarak Gamma synucleinin rektum kanseri ve normal mukozasında boyanmadığı görüldü. ALDH 1 ile farklı boyanma paternleri saptanarak bulgular literatür eşliğinde yorumlandı. Sonuç: Çalışmamızda rektum kanseri ve normal mukozal dokuda derece, evre, lenf nodu metastazı, Lenfovasküler invazyon ve Perinöral invazyon ile ALDH1 ekspresyonu arasında istatiksel olarak anlamlı olmayan, boyanma kuvveti açısından ters orantılı bir ilişki saptandı. Gamma synucleinin ise rektum kanserlerinde eksprese olmadığı görülmüştür.Öğe Endometrium Kanserli Hastalarda Preoperatif Tam Kan Sayımının Prognostik Parametreler ve Sağkalımla İlişkisi(Selçuk Üniversitesi, 2018 Mart) Çelik, Zeliha Esin; Yavaş, Güler; Yılmaz, Burcu Sanal; İlhan, Tolgay Tuyan; Yavaş, Çağdaş; Ata, Özlem; Çelik, ÇetinAmaç: Çalışmamızda endometriyum adenokarsinomu tanılı hastalarda preoperatif tam kan sayımı parametrelerinin çeşitli klinikopatolojik prognostik parametrelerle ve sağkalım ile ilişkisi olup olmadığını değerlendirmeyi amaçladık. Gereç ve Yöntem: Ocak 2011-Aralık 2014 tarihleri arasında fakültemizde opere edilen ve endometrial adenokarsinom tanısı alan 144 hasta çalışmaya dahil edilmiştir. Hemogram parametrelerinden absolü beyaz küre sayısı (BK), absolü platelet sayısı (Plt) hematokrit (Hct), hemoglobin (Hb) değerleri yanı sıra absolü nötrofil sayısının absolü lenfosit sayısına bölümü olan NLR, absolü platelet sayısının absolü lenfosit sayısına bölümü olan PLR ve absolü monosit sayısının absolü lenfosit sayısına bölümü olan MLR oranlarının; tümör çapı, tümör derecesi, FIGO evresi, serviks invazyonu, pozitif lenf nodu sayısı, lenf nodunda ekstrakapsüler yayılım, lenfovasküler invazyon (LVİ), myometrial invazyon derinliği gibi prognostik parametreler ve hastalıksız ve genel sağkalım süreleri ile olan ilişkisi istatistiksel metodlarla araştırılmıştır. Bulgular: Derece 3 tümöre sahip hastalarda BK sayısının derece 1 tümörlü hastalara göre anlamlı derecede düşük olduğu görüldü (p=0.04). LVİ olan olgularda PLR (p=0.018) ve MLR (p=0.028) LVİ olmayan hastalara göre daha düşük idi. Düşük evre olgularda (evre I-II) PLR, yüksek evreli olgulara göre (evre II-III) daha düşük tespit edildi (p=0.03). Tedavi öncesi bakılan tam kan parametreleri ile tümör çapı, serviks invazyonu, pozitif lenf nodu sayısı, lenf nodunda ekstrakapsüler yayılım, myometrial invazyon derinliği, hastalıksız sağkalım ve genel sağkalım arasında anlamlı bir ilişki saptanmadı (p>0.05). Sonuç: Endometriyum kanserinde tedavi öncesi tam kan sayımı parametrelerinin bir arada kullanılması, hastalığın prognozu ile ilgili fikir verebilir. Çalışmamızın sonuçlarının daha uzun takip süresine ve daha geniş olgu sayısına sahip çalışmalarla desteklenmesi gereklidir.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.Öğe Çocuklarda primer böbrek tümörlerinin klinik özellikleri, tedavi yaklaşımları ve tedavi sonuçları(Selçuk Üniversitesi, 2021) Kara, Buket; Sarıkaya, Mehmet; Ertan, Kübra; Uğraş, Nevzat Serdar; Çiftci, İlhan; Yavaş, Güler; Köksal, YavuzAmaç: Bu çalışmanın amacı, çocuklarda primer malign böbrek tümörlerinin klinik özellikleri, tedavi yaklaşımları ve tedavi sonuçlarının değerlendirilmesidir. Gereç ve Yöntem: 2006 ile 2020 yılları arasında primer malign böbrek tümör tanısı alan ve izlenen çocuk hastaların onkoloji dosyaları geriye yönelik incelendi. Hastaların demografik ve klinik özellikleri ile tedavi yaklaşımları ve izlemleri not edildi. Bulgular: Bu yıllar arasında izlenen 950 malign hastalıklı çocuğun 49’unda(%5,2) primer malign böbrek tümörü vardı. Hastaların yaşı üç gün ile 13 yıl arasında değişiyordu (ortanca, 3 yıl). Erkek kız oranı 25/24’dü. En sık görülen semptom ve bulgu karında kitle idi. İki hastada bilateral hastalık vardı (%4,1). Patolojik tanılar, Wilms tümörü (n = 44, % 89,8), mezoblastik nefroma (n=2, % 4,1), böbreğin clear hücreli sarkomu (n=2, % 4,1) ve böbreğin primer sinovyal sarkomuydu (n=1, %2). Wilms tümörlü hastalardan sadece ikinde diffüz anaplazi vardı. Hastalarımızın risk grupları düşük (n = 4, % 8.3), orta (n = 35, % 72.9) ve yüksek riskli (n = 9, % 18.8) idi. Hastaların takip süreleri iki ay ile 15 yıl (ortanca, 5 yıl) arasında değişiyordu. Primer böbrek tümörlerinde genel ve olaysız sağ kalım oranları sırasıyla % 72,7 ve% 59,7 idi. Wilms tümörlü hastaların genel ve olaysız sağ kalım oranları %79 ve %63’dü. Sonuç: Primer malign böbrek tümörlerinde özellikle de Wilms tümöründe multidisipliner yaklaşımlarla başarı oranları yükselmiştir. Bundan sonra hem tedavi başarısının daha da artırılması hem de tedavi ilişkili yan etkilerin azaltılması üzerinde durulmalıdır.Öğe The effects of local and intraperitoneal zinc treatments on maxillofacial fracture healing in rabbits(Churchill Livingstone, 2020) Azgın, İsa; Arbağ, Hamdi; Eryılmaz, Mehmet Akif; Çelik, Zeliha EsinThis study aimed to determine whether administration of topical and intraperitoneal zinc formaxillofacial fractures has any impact on the bone healing process.Material and method:Thirty-two New Zealand rabbits were randomly assigned to four groups of eighteach. Thefirst group was the control group; fracture lines werefixed using titanium microplates and nomedication was administered. The second group receivedfixations using zinc-coated titanium micro-plates. A single dose of 3 mg/kg zinc was administered intraperitoneally to the third group followingfixations with titanium microplates. A single dose of 3 mg/kg zinc was administered intraperitoneally tothe fourth group followingfixations with zinc-coated titanium microplates. Zinc coating on to the ti-tanium microplates was achieved using the physical vapor deposition technique. A fracture line wascreated in the nasal bones of all subjects andfixed withfive-holeflat microplates and three 5-mm microscrews. All work groups were sacrificed at the end of the sixth week.Results:Histological examination showed that the number of osteoblasts were significantly higher inzinc-coated group (Group 2) than zinc uncoated, control group (Group 1), (415.6±46.7 vs 366.3±11.8)(p<0.001). It was observed that intraperitoneal zinc treatment alone (Group 3) did not significantlyincrease in the osteoblast count compared to zinc un-coated group (Group 1), (390.6±83.2 vs366.3±11.8), (p¼0.341). The immunoreactivity scores for IGF-1 were significantly higher in the zinc-coated group compared to control group (Group 2 vs 1), (9.3±2.8 vs 3.7±1.9) (p<0.05). It wasobserved that intraperitoneal zinc treatment did not cause a significant difference in the aspect of IGF-1for zinc-coated groups (Group 2 vs 4) (9.3±2.8 vs 9.6±2.2) (p¼0.791). The difference in the immu-noreactivity score among whole groups for TGF-bwas not statistically significant (Group 1 vs 2, 3.2±1.7vs 4.4±2.3, p¼0.256; Group 1 vs 3, 3.2±1.7 vs 3.8±2.8, p¼0.524; Group 1 vs 4, 3.2±1.7 vs 2.8±1.3,p¼0.717; Group 2 vs 3, 4.4±2.3, vs 3.8±2.8, p¼0.610; Group 2 vs 4, 4.4±2.3, vs 2.8±1.3, p¼0.124;Group 3 vs 4, 3.8±2.8, vs 2.8±1.3, p¼0.311).Conclusion:The local use of titanium microplates coated with zinc by PVD technique was found effectivefor fracture healing. Zinc coating of titanium microplates used in fracture treatment can acceleratefracture healing. It may be concluded that clinical studies should be performed now in order to explore ifcomparable results can be achieved in humans.Öğe Prognostic significance of solid growth in endometrioid endometrial adenocarcinoma(SPRINGER JAPAN KK, 2020) Akar, Serra.; Çelik, Zeliha Esin.; Fındık, Sıddıka.; İlhan, Tolgay Tuyan.; Ercan, Fedi.; Çelik, Çetin.Background Endometrioid endometrial cancer is the most common histological subtype of endometrial adenocarcinoma. In the FIGO grading scheme, both architectural and nuclear grade are taken into consideration. However, the specific impact of solid growth alone on endometrioid endometrial adenocarcinoma outcome is not well documented. We sought to assess the degree of impact of solid growth on lymphovascular space invasion (LVSI), myometrial invasion, tumor size, FIGO stage, lymph node metastasis (LNM), relapse-free survival (RFS) and disease-specific survival (DSS). Methods Paraffin blocks of 269 patients treated for endometrioid endometrial cancer were retrospectively analyzed with morphometry for solid growth percentages. Results A statistically significant cut-off value of 1% solid growth was found for predicting LNM and advanced stage (III or IV), myometrial invasion and LVSI (p < 0.001) and a cut-off value of 8% was found for predicting adverse survival outcome (p < 0.001). The mean DSS was significantly higher in patients with < 6% solid growth compared to patients with 6-50%, 51-75% and > 75% solid growth (p < 0.001). Although, the mean RFS and DSS were lowest in patients with 51-75% solid growth, this did not reach statistical significance in comparison to 6-50% and > 75% (p > 0.05). Conclusion Although > 75% solid growth was most significantly associated with many of the adverse prognostic factors, this subset did not provide prognostic superiority in predicting adverse survival when compared to subsets within 6-75% solid growth. In conclusion, although no statistically significant difference in survival was found among subdivisions of architectural grades 2 and 3, solid growth, especially >= 8%, appeared to be an independent prognostic factor for survival in patients with early-stage endometrioid endometrial cancer.Öğe Expression of Ring Box-1 protein and its relationship with Fuhrman grade and other clinical-pathological parameters in renal cell cancer(ELSEVIER SCIENCE INC, 2020) Altıntaş, Emre; Kaynar, Mehmet; Çelik, Zehra Esin; Çelik, Murat; Kılıç, Özcan; Akand, Murat; Göktaş, SerdarObjective: To determine the relationship between RING-box protein 1 (RBX-1) expression and renal cell carcinoma (RCC) with prognostic factors. Methods: A total of 88 patients who underwent radical/partial nephrectomy between January 2009 and January 2016 have been included in our study. The age, gender, tumor location, tumor size, and tumor-node-metastasis stage of each patient was evaluated. From the best sections in hematoxylin-eosin stained pathology preparations, tumor histological subtype, Fuhrman nuclear grade, lymphovascular invasion, renal artery/vein invasion, capsule invasion, perirenal fatty tissue invasion, and tumor grade were evaluated. Participants were divided into 2 groups according to Fuhrman grade. Fuhrman grades 1 to 2 comprised Group 1, and Fuhrman grades 3 to 4 comprised Group 2. An immunoreactivity scoring system was used to evaluate RBX-1 expression. Results: Upon examining all histological subtypes together, it was observed that RBX-1 expression was statistically higher in Group 2 compared to Group 1 (P < 0.008). Upon examining clear RCC cases, it was observed again that Group 2 had a higher RBX-1 expression than Group 1 (P < 0.009). RBX-1 expression was not associated with clinical-pathological parameters including tumor grade, lymphovascular invasion, capsule invasion, or perirenal invasion. Conclusion: RBX-1 expression is closely associated with a highly important prognostic factor in RCC-Fuhrman grade-and it shows promise as a prognostic marker. Further studies are required to reveal the importance of RBX-1 in RCC prognosis and treatment. (C) 2019 Elsevier Inc. All rights reserved.Öğe Beta-Hydroxy-Beta-Methyl-Butyrate, L-glutamine, and L-arginine supplementation improves Radiation-Induce acute intestinal toxicity(Taylor and Francis Ltd, 2019) Yavaş, Çağdaş; Yavaş, Güler; Çelik, Esin; Büyükyörük, Ahmet; Büyükyörük, Cennet; Yüce, Deniz; Ata, ÖzlemWe aimed to evaluate effects of ?-hydroxy-?-methylbutyrate, L-glutamine, and L-arginine (HMB/GLN/ARG) on radiation-induced acute intestinal toxicity. Forty rats were divided into four groups: group (G) 1 was defined as control group, and G2 was radiation therapy (RT) control group. G3 and G4 were HMB/GLN/ARG control and RT plus HMB/GLN/ARG groups, respectively. HMB/GLN/ARG started from day of RT and continued until the animals were sacrificed 10 days after RT. The extent of surface epithelium smoothing, villous atrophy, lamina propria inflammation, cryptitis, crypt distortion, regenerative atypia, vascular dilatation and congestion, and fibrosis were quantified on histological sections of intestinal mucosa. Statistical analyses were performed using the analysis of variance (ANOVA) test. There were significant differences between study groups regarding extent of surface epithelium smoothing, villous atrophy, lamina propria inflammation, cryptitis and crypt distortion, regenerative atypia, vascular dilatation and congestion, and fibrosis (p values were 0.019 for fibrosis, <.001 for the others). Pair-wise comparisons revealed significant differences regarding surface epithelium smoothing, villous atrophy, lamina propria inflammation, cryptitis, vascular dilatation, and congestion between G2 and G4 (p values were <.001,.033, <.001,.007, and <.001, respectively). Fibrosis score was significantly different only between G1 and G2 (p =.015). Immunohistochemical TGF-? score of G2 was significantly higher than G1 and G3 (p values were.006 and.017, respectively). There was no difference between TGF-? staining scores of G2 and G4. Concomitant use of HMB/GLN/ARG appears to ameliorate radiation-induced acute intestinal toxicity; however, this finding should be clarified with further studies. © 2018, © 2018 Taylor & Francis Group, LLC.Öğe Two-stage surgery for extra pelvic intravenous leiomyomatosis: Report of a case(TAYLOR & FRANCIS INC, 2019) Bayramoglu, Denizhan.; Orhan, Atilla.; Gul, Ayhan.; Sahin, Gozde.; Celik, Zeliha Esin.; Koplay, Mustafa.; Celik, Cetin.Intravenous leiomyomatosis (IVL) is a variant of leiomyoma characterised by intravascular proliferation and originates from the uterine mesoderm. The main pathogenesis of IVL has not been exactly assessed, yet (Xu et al. 2013; Li et al. 2014). There are two main theories; the first one is: a tumour arises from the walls of venous structures and the second one is: a primary tumour (e.g. myoma) directly spreads into adjacent small venouses (Moniaga and Randall 2012). The early studies have reported an incidence of 0.25–0.41% of IVL in patients with uterine fibroid tumours (Ma et al. 2016; Low et al. 2017). Here, we presented a case suspected of IVL during the operation; although it was reported as uterine sarcoma and vena cava inferior thrombus on radiological imaging methods, pre-operation.Öğe The impact of imiquimod on radiation-induced lung injury: Results of an experimental study(BAYRAKOL MEDICAL PUBLISHER, 2019) Calik, Mustafa.; Yavaş, Güler.; Çelik, Zeliha Esin.; Yavaş, Çağdaş.; Calik, Saniye Goknil.; Sargon, Mustafa Fevzi.; Esme, Hidir.Aim: Radiation-induced lung injury (RILI) is a major dose-limiting factor during thoracic irradiation. Imiquimod (Imq) is a heterocyclic amine that has been shown to be effective in diseases related to inflammation and fibrosis. In this study, we aimed to evaluate the impact of Imiquimod on RILI. Material and Method: The study included 60 adult female Wistar-Albino rats (250-300 g). Rats were divided into 6 groups: Group (G) 1: control, G2: radiotherapy (RT) only, G3 and G4: 5 and 10 mg/kg Imq; G5 and G6 RT: plus 5 and 10 mg/kg Imq groups respectively. A single dose of 15 Gray (Gy) RT was given to the lungs. Imq was applied intraperitoneal. Results: The inflammation, fibrosis, and transforming growth factor (TGF)-beta scores of the study groups were significantly different at 6th and 16th week of RT (p < 0.001 for all). At the 6th week of RT, inflammation, fibrosis, and TGF-beta scores did not differ in both RT and non-RT groups. By the 16th week of RT inflammation, fibrosis, and TGF-beta scores were significantly different between G2 and G5, and G2 and G6. Electron microscopy findings supported the results of the light microscopy. Discussion: Although Imq did not improve pneumonitis phase, Imq attenuated radiation-induced lung fibrosis. These findings should be clarified with further preclinical and clinical studies.Öğe The impact of spironolactone on the lung injury induced by concomitant trastuzumab and thoracic radiotherapy(IJRR-IRANIAN JOURNAL RADIATION RES, 2019) Yavaş, Güler; Yavaş, Çağdaş; Çelik, Esin; Şen, E.; Ata, O.; Afşar, Rengin ElsürerBackground: To evaluate impact of spironolactone (S) on pulmonary toxicity of concomitant use of thoracic radiotherapy (RT) and trastuzumab (T). Materials and Methods: Eighty rats were divided into eight groups: group (G) 1 was control group; G2, G3 and G4 were RT, S and T groups; G5, G6, G7 and G8 were RT+T, T+S, RT+S and RT+T+S groups respectively. Rats were sacrificed at 6 hour, 21 and 100 day after RT and lung samples were retrieved. Results: By 100th days of RT inflammation score, lung fibrosis score and TGF- expression were significantly different within study groups (p values were 0.002, 0.001 and 0.043 respectively). Inflammation score of G8 was significantly lower than inflammation scores of G2 and G5 (p values: G2-G8=0.004, and G5-G8=0.022). Inflammation score of G2 was significantly higher than G7 (p=0.028). There were significant differences regarding to fibrosis scores between G2-G8 (p=0.015), G2-G7 (p=0.017) and G5-G8 (p=0.011). TGF-beta expression was higher in both G2 and G5 when compared to G8 (p = 0.038). Conclusion: Our results suggested that S is an effective treatment option for improving radiation-induced pulmonary fibrosis. These findings should be clarified with further preclinical and clinical studies.Öğe The effects of intra-articular injection of ibuprofen on knee joint cartilage and synovium in rats(TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2019) Kutahya, Emine Cepni; Oc, Bahar; Ugurluoglu, Ceyhan; Duman, Ipek; Arun, OguzhanObjective: The aim of this animal study was to investigate the short and long-term local histomorphologic effects and the utility of intra-articular application of ibuprofen. Methods: Forty-six Wistar Albino rats were used in the study. The rats were randomized into 5 groups of 8 and a sham group of 6. The 40 rats in the study groups were anaesthetised with 60 mg/kg of ketamine, then 0.25 ml ibuprofen (25 mg) was injected to the right knee joint of each rat (ibuprofen group) and 0.25 ml 0.9% saline to the left knee joint as the control group. To the 6 rats in the sham group, only puncture was applied to both knee joints. The rats in each of the 5 study groups were sacrificed on days 1, 2, 7, 14 and 21 respectively. The histomorphologic changes were graded on a 6-point scale regarding inflammation of the synovia, cartilage tissue, and subchondral bone. Inflammation scores were compared using the Mann Whitney U-test and comparisons of the sacrifice day and drug used were evaluated with the Kruskal Wallis test. The p values below 0.05 were considered as significant. Results: Statistically significant difference was found between the ibuprofen injected knees (10/40) and the saline injected (0/40) and sham knees (0/12) in respect of hematoma positivity (p = 0.002). Significantly higher inflammation scores were found in ibuprofen injected knees on the 1st, 2nd, 7th and 14th days compared to controls and sham (p < 0.05). Inflammation scores were similar in ibuprofen injected knees with and without hematoma (p > 0.05). Inflammation of the ibuprofen injected group was most severe on day one and the severity of inflammation reduced gradually throughout the 3 weeks. Conclusion: Our results show that intra-articular injection of ibuprofen can cause intra-articular hematoma. It also leads to transient inflammation of the synovia that is more severe in the early period, which gradually recovers. (C) 2019 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V.Öğe Small cell lung carcinoma metastasis to atypical meningioma: ımportance of perfusion magnetic resonance ımaging graphics in differential diagnosis(ELSEVIER SCIENCE INC, 2019) Danisman, Mehmet Cagri; Koplay, Mustafa; Paksoy, Yahya; Keleşoğlu, Kazım Serhan; Karabağlı, Pınar; Köktekir, EnderWe described the imaging findings of small cell lung carcinoma metastasis to atypical meningioma and the importance of magnetic resonance imaging perfusion graphics at the differential diagnosis. To be able to determine subtypes of meningiomas and differentiate whether they are malignant or benign may provide a preoperative idea to determine prognosis and surgical procedure.Öğe Serpentine supravenous hyperpigmentation related to carboplatin and vinorelbine chemotherapy: A case report(WILEY, 2019) Akyürek, Fatma Tunçez; Sarı, Nihal; Uğurluoğlu, Ceyhan; Kurtipek, Gülcan SaylamSerpentine supravenous hyperpigmentation (SSH) is a unique type of chemotherapy-associated drug eruption, characterized by hyperpigmentation along the superficial venous network. Histopathology reveals an increase in melanin production without destruction of basal cells of the epidermis or dermal inflammatory infiltrate. Herein, we describe a patient who developed SSH after repeated intravenous infusions with carboplatin and vinorelbine; two medications that have been uncommonly reported in association with SSH previously.Öğe Paratesticular solitary fibrous pseudotumor and a brief literature review(GALENOS YAYINCILIK, 2019) Batur, Ali Furkan.; Kaynar, Mehmet.; Çelik, Zeliha Esin.; Göktaş, Serdar.A 19-year-old male patient was admitted to our clinic with a left-sided scrotal painless mass. Ultrasonography of the scrotum revealed a paratesticular mass arising from the left testicular sac. Surgical excision of the mass was performed. lntraoperative frozen section evaluation revealed a benign fibrous tumor. Microscopically, the specimen was composed of eosinophilic cytoplasmic tumor cells with spindle nucleus on a fibrous connective tissue ground. It is important to diagnose correctly this rare condition preoperatively or intraoperatively to avoid unnecessary orchiectomies. We present this case report to increase awareness and knowledge with the support of a brief literature review.Öğe Nicotinamide N-Methyltransferase expression in high-grade serous carcinoma and its association with survival(SPRINGER INDIA, 2019) Akar, Serra.; Harmankaya, İsmail.; Uğraş, Serdar.; Çelik, Çetin.Introduction Ovarian cancer is the most lethal gynecological malignancy. Mechanisms involved in the progression of primary high-grade serous carcinoma (HGSC) into metastatic carcinoma are not understood. Nicotinamide N-methyltransferase (NNMT) is overexpressed in cancer, and its overexpression leads to epigenetic changes through hypomethylation of histones. It plays a role in epithelial-mesenchymal transition and sustenance of cancer stem cells. NNMT expression in primary and metastases of ovarian carcinoma and its relationship with survival have not been studied before. Materials and Methods We compared the expression of NNMT between primary and matched synchronous metastatic carcinoma of patients, diagnosed with HGSC. Benign ovarian and omental tissues were used as controls. The relationships between NNMT expression and relapse-free and disease-specific survival were analyzed. Results NNMT expression in metastases was significantly higher than matched primary carcinoma. NNMT was overexpressed in the stroma of primary and metastatic tumors. Increased NNMT expression was associated with decreased relapse-free and disease-specific survival. Conclusion This study detected a higher expression of NNMT in metastases of HGSC compared to matched primary and associated increased metastatic NNMT expression with decreased survival. Upregulation of NNMT in tumor stroma suggests it plays a role in desmoplasia. Targeting of NNMT and desmoplasia may play a critical role in the treatment of HGSC.Öğe Nicotinamide N-methyltransferase expression and its association with phospho-Akt, p53 expression, and survival in high-grade endometrial cancer(TUBITAK SCIENTIFIC & TECHNICAL RESEARCH COUNCIL TURKEY, 2019) Akar, Serra; Harmankaya, Ismail; Ugras, Serdar; Celik, CetinBackground/aim: Nicotinamide N-methyltransferase (NNMT) is an enzyme that is overexpressed in malignancies. NNMT expression has not been previously studied in endometrial cancer (EC). Increased phospho-Akt (pAkt) levels in response to NNMT overexpression have been reported in in vitro studies of different cancer types. We assayed NNMT expression in primary and metastatic high-grade EC and investigated the relationship of NNMT with p53, pAkt, and survival. Materials and methods: NNMT, pAkt, and p53 expressions were assayed in 100 tissue samples of benign endometria, primary EC, and metastatic EC by immunohistochemistry. Results: The NNMT immunoreactivity score was significantly higher in primary high-grade EC than benign endometrial tissue (P = 0.001). NNMT expression in metastatic tissue was significantly higher than in primary cancer (P < 0.001). Metastatic stromal NNMT expression was significantly higher than that of the adjacent tumor and stroma adjacent to the primary tumor. p53 expression in the primary tumor showed a significant positive correlation with omental NNMT and pAkt expression. NNMT expression was also correlated with pAkt expression in metastatic tissue. NNMT overexpression in metastatic tissue was associated with decreased survival (P = 0.039). Conclusion: This study suggests that NNMT may promote cancer progression and that NNMT overexpression is associated with aberrant p53 expression, pAkt, and poor survival. NNMT's role in cancer progression could make it a target of EC therapy.Öğe Nicotinamide N-Methyltransferase expression in cervical adenocarcinoma and its clinical significance(SPRINGER INDIA, 2019) Akar, Serra.; Harmankaya, İsmail.; Uğraş, Serdar.; Çintesun, Ersin.; Çelik, Çetin.IntroductionNicotinamide N-methyltransferase (NNMT) is a metabolic enzyme increasingly implicated in tumor progression and resistance to treatment. It is overexpressed in human cancers including glioblastoma, gastric, pancreatic, lung and colorectal cancers. The role of NNMT in cervical adenocarcinoma has not been studied thus far. We aimed to evaluate expression of NNMT in cervical adenocarcinoma and investigate its prognostic significance.MethodsNNMT expression was assayed in 18 cases of cervical adenocarcinoma and 19 cases of benign cervical tissue. NNMT immunoreactivity was scored by multiplying staining intensity with percentage of immunoreactive cells.ResultsThe expression of NNMT was significantly higher in cervical adenocarcinoma than in benign tissue (p=0.024). NNMT expression was significantly higher in patients with locally advanced than early cervical cancer (p=0.031). NNMT expression was higher in patients with tumor size greater than 4cm and in those with poorly differentiated tumors compared to patients with tumors of 4cm or less and well-moderate differentiation, respectively (p=0.044, p=0.014).ConclusionAlthough on a preliminary level, this is the first study to detect an overexpression of NNMT in cervical adenocarcinoma and an increased expression associated with advanced stage, increased tumor size and poor differentiation. NNMT has been shown to carry prognostic and therapeutic importance in a variety of cancers, and it can be a potential treatment target in cervical adenocarcinomas.
