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    Gastric heterotopia in the gallbladder: Mimicking the tumor imagine in radiology
    (Sivas Cumhuriyet University, 2021) Yeldir, Neşe; Bozbıyık, Nisa; Özer, Hatice; Topçu, Ömer
    Heterotopia is mass of tissue normal to the site in abnormal location. Heterotopic gastric mucosa has been described in almost every part of the gastrointestinal tract including the tongue, oesophagus, epiglottis, small bowel, appendix vermiformis, rectum and gallbladder. The diagnosis of heterotopic gastric mucosa in gallbladder can be difficult clinically . Heterotopic gastric mucosa in gallbladder can be symptomatic or detected incidentally. It is relevant to distinguish heterotopic gastric mucosa from benign polyps, gallbladder carcinoma or metastasis. We present a case of a 51 year old female patient who represented suspicious lesion on computed tomography (CT). After cholecystectomy, in the microscopical examination gastric mucosa consisting of fundic glands and pyloric glands and typical features of chronic cholecystitis are seen.
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    Histological and scanning electron microscopy investigation of the effects of titanium surface modifications on osseointegration in rabbits
    (AVES, 2024) Aydın, Burak; Öztemür, Zekeriya; Yeldir, Neşe; Kılınç, Seyran; Aktı, Sefa; Bilgin, İsmail
    Objective: This study aimed to compare the novel Estaş Medical Anodization (EMA) surface treatment technique with the techniques commonly used in the literature and to examine their effects on osteointegration in the rabbit tibia. Methods: A total of 24 rabbits used in this study were divided into 3 groups, with 8 rabbits in each group. Using both tibias of all rabbits in the study, screws belonging to the control group were placed in the left tibia, and the right tibia belonging to the experimental group were placed. In the first 8 rabbits, a single experimental group in the right tibia were used; in the second 8 rabbits, 2 different experimental groups in the right tibia were used; and in the last 8 rabbits, 2 different experimental groups in the right tibia were used. Thus, 5 different experimental groups with 8 screws in each group and a separate control group were formed for each of them. EMA-treated surfaces were named 200-800 nm iris oxidation and 800-1200 nm gray oxidation according to the TiO2 layer thickness. Group 1 was implanted with mini-screws prepared with chemical etching + EMA iris oxidation, while group 2 was implanted with sandblasted, large-grit and acid-etched (SLA) mini screws treated with EMA gray oxidation. Group 3 was implanted with mini-screws treated with EMA gray oxidation, group 4 was implanted with mini-screws treated with chemical etching + micro-arc oxidation, and group 5 was implanted with mini-screws treated with chemical etching + EMA gray oxidation. The control group was implanted with mini-screws prepared with pure titanium. At the end of 6 weeks, osseointegration percentages were calculated and compared using histological and scanning electron microscope (SEM) analyses. Results: The histological results confirmed the increase in osseointegration percentages in all experimental groups compared to those that received pure titanium implants (P values control group vs group 1 = .005, control group vs group 2, 3, 4, 5 = .001). The comparison between the groups revealed that the chemical etching + EMA gray oxidation modification technique (group 5) significantly increased osseointegration compared to the SLA + EMA gray oxidation technique (group 5 vs group 2 P = .016) and the chemical etching + EMA iris oxidation technique (group 5 vs group 1 Pp = .001). The EMA gray oxidation technique (group 3) significantly increased osseointegration compared to the chemical etching + EMA iris oxidation technique (group 1) (group 3 vs group 1 P = .043). The results of the SEM analysis showed that osseointegration was significantly increased in all experimental groups compared to that in the pure titanium (control) group (P values control group vs group 1, 2, 3 = .001, control group vs Group 4,5 = .006). The mean osseointegration percentage in the experimental groups was the highest in group 5, followed by group 4, group 3 and group 1 equally, and group 2. However, the differences among the experimental were not significant (group 1, group 2, group 3, group 4 vs group 5 P = .408). Conclusion: The EMA titanium surface modification techniques we developed significantly increased osseointegration compared to the pure titanium surface. The EMA gray oxidation technique seems to result in higher osseointegration rates than the EMA iris oxidation technique, and similar rates can be found with the SLA and chemical etching techniques. © 2024, AVES. All rights reserved.
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    Ki-67 Proliferation Index Positivity Limit (Cut-off) Value in Meningiomas
    (Bolu Abant İzzet Baysal Üniversitesi, 2023) Yeldir, Neşe; Doğan, Ezgi; Özer, Hatice; Söylemez, Burçak; Çelikgün, Serkan; Eğilmez, Reyhan
    Objective: Meningiomas are usually slow-growing grade 1 tumors according to World Health Organization (WHO) classification. Histological and molecular criterias were defined for the determination of meningiomas of high grade and more aggressive. The proliferation activity is also considered among histopathological criterias. A commonly used parameter for determining proliferation activity is the Ki-67 index. This study was formed retrospectively to identife the positivity limit (cut-off) value of the Ki-67 proliferation index in cases diagnosed with meningioma. Materials and Methods: The Ki-67 indices of a total 190 patients diagnosed with meningioma was compared with the histological degrees of the tumors. The ROC analysis method was used in the statistical analysis for Ki-67 values. Results: The mean Ki-67 proliferation index was found to be 6.3% for grade 1, 11.2% for grade 2 and 26% for grade 3 in the cases diagnosed with meningioma in our center. The Ki-67 proliferation index, which can be used in addition to histopathological findings in the distinction of grade 1 and grade 2 meningiomas in our laboratory, was determined as a positivity limit value of 6.5 (p>0.05). Conclusion: The Ki-67 proliferation index in meningioma is an important parameter that can be used to determine the histological grade of atypical meningioma in particular. Although the index seems to be easy to use, it is a value that can create difficulties in borderline cases and also in interobserver and intraobserver evaluations. Therefore, each pathology laboratory should determine the Ki-67 value that they can accept as a limit for meningioma grading.
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    Pathological Prognostic Features and Analysis of Renal Cell Carcinoma
    (Sivas Cumhuriyet University, 2022) Öztürk, Sena; Çelikgün, Serkan; Yeldir, Neşe
    Renal cell carcinomas is 2-3% of all adult cancers. Kidney cancer is currently the seventh most common cancer in men and the tenth most common in women 1. There were 19,3 million new cancer diagnoses and 10 million cancer deaths worldwide in 2020 2. Survival in renal cell carcinomas has a strong correlation with the stage of diagnosis. 5-year survival in stage 1 tumors is 93%, 72,5% in cases with local lymph node metastases and 12% in metastatic carcinomas cases 3. There is an inverse correlation between age / tumor size and survival. Metastatic lymph node, tumor necrosis and adipose tissue invasion are associated with poor prognosis 4. The study is including 179 renal cell carcinoma cases. The clinical and pathological datas of these cases were retrospectively analyzed from the Cumhuriyet University Hospital patient system. The distribution sex of cases are 111 males (62%) and 68 females (38%). The mean age of the 179 cases was 58,5±11,9 years (range of 21-90). The mean tumor diameter is 5,7±3,4 (range of 1-19 cm). The nuclear grades of cases are 53,1% with low grade and 46,8% with high grade. Radical nephrectomies were evaluated for vascular invasion, ureter invasion, capsule/adipose tissue invasion, lymph node metastasis and adrenal gland metastasis. There is a statistically significant relationship between nuclear grade and vein invasion, microvascular invasion, capsule/adipose tissue invasion (p
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    Patient With A Diagnosis Of Ochronosis After Lumbar Dyscectomy: Case Report
    (Sivas Cumhuriyet University, 2020) Yeldir, Neşe; Küçükyıldız, Halil Can; Başpınar, Nisa; Özüm, Ünal; Eğilmez, Reyhan
    Ochronosis is the black discoloration of connective tissues seen with alkaptonuria, a metabolic disorder. Alkaptonuria is a rare autosomal recessive metabolic disorder caused by the lack of homogentisic acid oxidase enzyme. Alkaptonuria causes degenerative changes in cartilage, intervertebral disc and other tissues. The patients operated due to lumbar disc herniation in alkatonuria are very few. In this article a case of ochronosis in which the patient was determined after lumbar discectomy is presented.
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    Prognosis in IDH-Mutant and IDH-wild type glioblastoma
    (Sivas Cumhuriyet University, 2021) Kılıç, Eren; Yeldir, Neşe; Özüm, Ünal; Yücel, Birsen; Yılmaz, Mukaddes; Özer, Hatice; Eğilmez, Reyhan
    Glioblastoma (GBM) is the most common brain tumor in adults with a poor prognosis and predominantly astrocytic differentiation. GBM is classified according to the isocitrate dehydrogenase (IDH) mutation according to the World Health Organization (WHO) Brain Tumors 2016 classification. IDH-1 gene mutations are evaluated immunohistochemically (IHC) and molecular methods in current pathology laboratory practice.The aim of this study was to determine the overall survival in GBM cases according to IDH-1 mutation status and Ki-67 proliferation index.Total of 53 patients diagnosed as GBM between 2007-2020 in Sivas Cumhuriyet University Faculty of Medicine, Department of Pathology were evaluated. Disease-free median survival of 7 (13%) GBM patients with IDH mutation was 2 months (2-year survival 14%), disease-free median survival 9 months (2-year survival 24 %) in GBM IDH-wild type cases. In cases with a higher Ki-67 proliferation index, the median disease-free survival were shorter.In conclusion statistically significant results could not be obtained between disease-free survival in GBM IDH-mutant type and GBM IDH-wild type. However, the mean Ki-67 proliferation index of GBM IDH-wild type cases was found to be much higher than GBM IDH-mutant cases. High Ki-67 proliferation index was found to be associated with a significantly shorter survival.
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    Prostat iğne biyopsi ve radikal prostatektomi materyallerinde gleason skor korelasyonu
    (Cumhuriyet Üniversitesi, 2017) Yeldir, Neşe; Yıldız, Esin
    Prostat kanseri dünya genelinde erkeklerde en sık görülen ikinci kanserdir. Hastaların çoğu 60 yaş üzerindedir. Erken tanıda digital rektal muayene, serum PSA düzeyi, transrektal USG kombinasyonu önemlidir. TRUS eşliğinde alınan biyopsi ile adenokarsinom tanısı konan hastaya klinik özellikleri de uygunsa radikal prostatektomi (RP) planlanır. Prostat kanserlerinin büyük kısmı periferik zondan gelişen asiner adenokarsinomdur. Dr. Donald Gleason, yaklaşık 50 yıl önce prostat kanseri için farklı histolojik kalıplara dayalı bir derecelendirme sistemi oluşturdu. Bu sistem çeşitli değişikliklerle geçerliliğini halen korumaktadır. Prostat adenokarsinomunda prognozla yakın ilişkisi ve tedaviyi belirlemede önemli rolü bulunan bu sistemde Uluslararası Ürolojik Patoloji Topluluğu (ISUP) tarafından 2005 yılında ve en son olarak da 2014 yılında yeni güncellemeler yapılmıştır. İğne biyopsilerinde hedef radikal prostatektomi materyallerindeki Gleason grade skoru ve prognozu en yakın olasılıkla belirleyebilmektir. Bu çalışma iğne biyopsi ve RP materyalleri arasındaki Gleason skor, tümör volümü ve tümör lateralitesi yönünden uyumu saptamak amacıyla yapılmıştır. Çalışmaya iğne biyopsi ve RP materyali bulunan 112 hasta dahil edildi. Tümör alanlarının Gleason gradeleri, son güncellemeler dikkate alınarak tekrar değerlendirildi. Tümör hacmi iğne biyopsilerinde uzunluğa, RP materyallerinde pozitif blok sayısına göre belirlendi. Tümör lateralitesi ise, biyopsi ve RP materyallerinde, unilateral ya da bilateral olarak değerlendirildi. Elde edilen veriler istatistiksel olarak karşılaştırıldı. Hastaların yaş ortalaması 64,84 olup, iğne biyopsi ve RP materyallerinin tümünde asiner tip prostat adenokarsinomu bulunmaktaydı. Gleason grade skoru, tümör volümü ve tümör lateralitesi yönünden iğne biyopsi ve RP materyalleri arasındaki uyumsuzluk istatistiksel olarak anlamlı bulundu. Ancak Gleason grade skoru ve tümör volümü arttıkça uyumda artış olduğu görüldü.
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    Sudden onset of a Sister Mary Joseph’s nodule : A case report
    (Türk Jinekolojik Onkoloji Derneği, 2023) Ünal, Gamze Sönmez; Yeldir, Neşe; Yıldız, Çağlar; Küçükyıldız, İrem
    Sister Mary Joseph’s nodule is an umbilical metastasis rarely seen in cancer patients