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Öğe A case of Crohn's disease presenting with massive intestinal hemorrhage(2001) Köylüo?lu, Gökhan; Cevit, Ömer; Yildiz, EsinA 14-year-old boy who had no previous medical history and presenting with massive rectal bleeding related to Crohn's disease is reported. Despite ten units of blood transfusion within less than the first 24 hours of admission, hemodynamic state was not stabilized. The patient was underwent surgical exploration and a subtotal ileocolectomy was carried out with ileostomy and colonic mucous fistula. Three months later, his ileostomy was closed and no evidence of disease recurrence was observed during the past three years. Massive rectal bleeding from Crohn's disease is a very rare entity especially in children. This type of hemorrhage should be considered in the differential diagnosis of massive rectal bleeding.Öğe An examination of liver enzymes and histopathological changes in rats affected by diethylstilbestrol(2002) Göze, Ismihan; Göze, Fahrettin; Yildiz, EsinPurpose: In this study, we aimed to observe possible changes in enzymatic parameters, and histopathological effects on the rat liver tissues caused by diethylstilbestrol (DES). Material and Method: Diethylstilbestrol at the dose of 0.4 mg/ g/ day, (· 60 mg/ rat) had orally been given to the pregnant rats starting from the second day of the pregnancy for 19 days by oral gavage. Mother rats were killed by cervical dislocation on the last day, of pregnancy. In prepared homogenates from liver tissues alanin amino transferase (ALT), laktate dehidrogenase (LDH), alkaline fosfatase (ALP), gamma glutamik transferase (GGT), aspartat aminotransaminase (AST) enzymes were measured by Ciba Corning Express Plus autoanalyzer. GST enzyme was studied by spectrophotometric assay. Histopathological examination was performed by a routine method using light microscope. Results: Statistically significant differences were found in liver ALT (U= 36; p<0,05), LDH (U=32;p<0,05), AST (U=36; p<0,05) and ALP (U=36;p<0,05) in the experimental group compared to control rats. Other enzyme activities did not show any significant differences between the two groups (p>0,05). Histopathological examination generally revealed diffuse hydropic degeneration and reactive Kupffer cell hyperplasia. Focal necrosis and perivenous inflammatory, infiltration were occasionally seen in livers of mother rats. In the offsprings, diffuse hydropic degeneration, hyperemia and remnants of extramedullary hematopoiesis were observed. Conclusion. Morphological and biochemical interaction in rat livers after DES administration could be time and dose depent.Öğe A Case of Acute Renal Failure Caused by Hodgkin's Lymphoma: Concurrent Membranous Glomerulonephritis and Interstitial HL-CD 20 Lymphoid Infiltration(INFORMA HEALTHCARE, 2011) Kayatas, Mansur; Yildiz, Gursel; Timucin, Meryem; Candan, Ferhan; Yildiz, Esin; Sencan, MehmetAlthough acute renal failure developing due to malignancies is a frequent condition, malignant renal infiltration is rarely observed among these causes. Among all malignant diseases, the hematolymphoid malignancies are the most prone to renal infiltration. Other types involved in cases with lymphoma are glomerulopathies, including immune-complex glomerular diseases such as minimal change disease, membranous glomerulonephritis, membranoproliferative glomerulonephritis, and focal segmental glomerulosclerosis. We present herein the rare case of a 22-year-old male with both membranous glomerulonephritis and CD20 (+) lymphoid infiltration related to Hodgkin's lymphoma in the renal interstitial tissue, as detected on biopsy. The patient was treated with adriamycin, bleomycin, vinblastine, and dacarbazine protocol after pulse corticosteroid treatment, and a dramatic improvement in renal function was observed after 2 days of treatment. In this article, an exceptional renal involvement of Hodgkin's lymphoma is discussed in light of the related literature.Öğe Clinical and histologic evaluations of experimental Acanthamoeba keratitis(SPRINGER, 2007) Polat, Zubeyde Akin; Ozcelik, Semra; Vural, Ayse; Yildiz, Esin; Cetin, AliAmoebic keratitis, a sight-threatening, progressive corneal disease, is commonly caused by ubiquitous, pathogenic, free-living Acanthamoeba spp., which are widely distributed in the environment. We investigated clinical findings and histology of Acanthamoeba keratitis in a rat cornea model. Experimental Acanthamoeba keratitis was induced in Wistar rats by intrastromal inoculation of Acanthamoeba castellanii trophozoites. The clinic features of Acanthamoeba keratitis by day 70 are observed. All rats inoculated with Acanthamoeba developed keratitis. Histologically, the eyes displayed blood vessels, edema, and amoebae in stroma. A mixed cellular response, including neutrophils, mononuclear cells, and spindle-shaped cells, was seen. In conclusion, progressive, suppurative Acanthamoeba keratitis can be induced in the rat cornea model. This rat cornea model assists researchers who study the pathogenesis of Acanthamoeba keratitis and devise treatment for this difficult condition.Öğe Effect of angiotensin-converting enzyme inhibition and angiotensin II type 1 receptor blockade on apoptotic changes in contralateral testis following unilateral testicular torsion(SPRINGER, 2008) Gokce, Gokhan; Karboga, Hasan; Yildiz, Esin; Ayan, Semih; Gultekin, YenerIn this experimental study, our aim was to determine whether angiotensin-converting enzyme (ACE) inhibition and angiotensin II type 1 (AT1) receptor blockade affect the apoptotic changes in contralateral testis following unilateral testicular torsion (UTT). Study groups consisted of 30 adult male Wistar rats. The rats were randomly separated into five groups. Group 1 was maintained as control without manipulation. Group 2 underwent the sham operation. Torsion was created by rotating the left testis 720 clockwise for 4 h and maintained by fixing the testis to the scrotum in the other groups. Group 3 underwent torsion and detorsion, with saline administration after detorsion. In group 4, the same surgical procedure was done as in the detorsion group, but AT1 receptor blocker (losartan 30 mg/kg) was injected intraperitoneally for 60 min before detorsion. In group 5, the same surgical procedure was done as in the detorsion group, but ACE inhibitor (lisinopril 50 mg/kg) was injected intraperitoneally for 60 min before detorsion. Bilateral testes were removed from each rat 24 h after surgery. Apoptosis was assessed in paraffin-embedded sections stained for TUNEL method. Reticulum staining was performed to evaluate the extracellular changes semiquantitatively. Testicular biopsy score counts were performed on these sections according to Johnsen. The mean apoptotic scores of group 1, group 2 and group 3 were significantly higher than that of the other groups. There was no difference between the apoptotic scores of groups 1, 2, 4 and 5. Reticulum stain was increased in group 3 as compared to other groups. The mean Johnsen biopsy score of group 3 was significantly lower than that of the other groups. ACE inhibition and AT1 receptor blockade reduced the tubular damage and apoptosis in the contralateral testes after UTT. The beneficial effect of these drugs may arise from inhibition of ischemic process resulting from increased sympathetic activity and elimination of insults subsequent to dysregulation of RAS. These results suggest that ACE inhibitors and AT1 receptor blockers may be of potential value in patients with UTT.Öğe Epigenetic alterations and oncogenes mutations in urinary bladder carcinomas(SPRINGER, 2009) Ozdemir, Oztuerk; Yildiz, Esin; Ayan, Semih; Gul, Eylem; Gokce, Goekhan; Yildiz, Fazilet; Koksal, Binnur; Goze, Fahrettin; Gultekin, E. Yener…Öğe Evaluation of 61 Secondary Amyloidosis Patients: A Single-Center Experience from Turkey(DERMAN MEDICAL PUBL, 2016) Huzmeli, Can; Candan, Ferhan; Bagci, Gokhan; Alaygut, Demet; Bagci, Binnur; Yildiz, Esin; Kockara, Ayse Seker; Kayatas, MansurAim: To evaluate demographic,clinical and laboratory characteristics. causes, MEFV gene mutations, and mortality rates of patients with secondary amyloidosis. Material and Method: 61 patients who had been diagnosed with secondary amyloidosis by renal and rectal biopsy between 2007 and 2013 in the nephrology clinic of Cumhuriyet University. Faculty of Medicine, were included in the study. Demographic characteristics, causes of secondary amyloidosis, MEFV gene mutations, end-stage renal failure (ESRF), renal transplantation, and mortality rates were examined retrospectively. Results: In etiological terms, Familial Mediterranean Fever (FMF) occurrence was 62.2% (38), bronchiectasis and emphysema 9.8% (6), tuberculosis 4.9% (3), coexistence of FMF and ankylosing spondylitis 3.2% (2), coexistence of FMF and rheumatoid arthritis 1.60,6 (1), coexistence of FMF and systemic lupus erythematosus (SLE) 1.6% (1), osteomyelitis 1.6% (1). septic arthritis 1.6% (1), Crohn's disease 1.6% (1), colon cancer 1.6% (1), coexistence of bronchiect-axis and tuberculosis 1.6% (1), rheumatoid arthritis 1.6% (1), and idiopathic cases 6.5% (4). Proteinuria was determined at nephrotic level among 68% (32) of 47 patients who had secondary amyloidosis. MEFV gene mutation of 45 patients with secondary amyloidosis was assessed. Most patients had M694V gene mutation. Surprisingly, we detected heterozygous 61480 mutation in 3 cases. 12 cases died; of these, 9 had ESRF. Five cases with ESRF underwent renal transplantation. Discussion: We found FMF as the most common cause for secondary AA amyloidosis in this study. Further studies should be done with larger or multicenter cohorts.Öğe Gleason Score Correlation Between Prostate Need e Biopsy and Radical Prostatectomy Materials(Federation Turkish Pathology Soc, 2019) Yeldir, Nese; Yildiz, Esin; Dundar, GokceObjective: Prostate cancer is the second most common cancer in men. Digital rectal examination, transrectal ultrasonography and serum prostate specific antigen represents a diagnostic triad for the detection of prostatic carcinoma. About 50 years ago, Dr. Donald Gleason created a grading system for prostate cancer based on its histologic patterns. Currently, this system maintains its validity with various changes. New updates were made in 2005 and 2014 by the International Society of Urological Pathology. The goal of biopsies is to determine the Gleason score and prognosis in prostatectomy material. The aim of this study was to determine the concordance of the Gleason score, tumor volwne and tumor laterality between prostate needle biopsy and prostatectomy materials. Material and Method: The study was performed with 112 patients who had biopsy and prostatectomy materials. The Gleason grades of the tumors have been evaluated with the new grading system. Tumor volumes were calculated by the number of positive blocks while tumor laterality was evaluated as unilateral or bilateral. Statistical analysis was performed on the obtained data. Results: Gleason score, tumor volume and tumor laterality discordance between needle biopsy and prostatectomy materials was found to be statistically significant. However, the concordance increased as the Gleason score and tumor volume increased. Conclusion: Digital examination, serum prostate specific antigen value and needle biopsy together are very sensitive for a prostate adenocarcinoma diagnosis. The Gleason score, localization and volume of the tumors are important for patient follow-up, treatment and prognosis.Öğe Impact of pathology review of stage and margin status of radical prostatectomy specimens (EORTC trial 22911)(Galenos Yayincilik, 2006) Yildiz, EsinPathological staging and surgical margin status of radical prostatectomy specimens are the most important prognosticators for recurrence. A central review of pathological stage and surgical margin status was performed on a series of 552 radical prostatectomy specimens of patients, participating in EORTC trial 22911. Inclusion criteria of the trial were pathological stage pT3 and/or positive surgical margin at first pathology. Data of the second review were compared with those of first pathologists and related to clinical follow-up. Although a high concordance between second pathology and first pathologists existed for seminal vesicle invasion, agreement was much less for extraprostatic extension and for surgical margin status. Second pathology of surgical margin status was a stronger predictor of biochemical progression-free survival in univariate analysis [hazard ratio than first pathology. The second pathology demonstrated a significant difference between those with and without extraprostatic extension, while first pathology failed to do so. The observations suggest that review of pathological stage and surgical margin of radical prostatectomy strongly improves their prognostic impact in multiinstitutional studies or trials.Öğe The proinflammatory cytokine-mediated protective effects of pentoxifylline, iloprost, and cilostazol on a mitigating lung injury induced by lower limb ischemia and reperfusion in rats(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2014) Hidiroglu, Mete; Uguz, Emrah; Ozerdem, Gokhan; Yildiz, Esin; Berkan, OcalBackground: This study aims to elucidate whether pentoxifylline, iloprost and cilostazol mitigates acute lung injury induced by lower limb ischemia-reperfusion (I/R) and their protective effects cover cytokines. Methods: Forty rats were randomized into five groups: control (group 1), ischemia-reperfusion (group 2), pentoxifylline (group 3), iloprost (group 4), iloprost and cilostazol (group 5). All drugs were administered before ischemia. Samples were obtained for tumor necrosis factor alpha (TNF-alpha), interleukin 6 (IL-6), and total sialic acid (TSA) assays. Findings of lung injury were examined. Results: Interleukin-6 and TNF levels were increased at 90 minutes and sustained elevated even after 240 minutes. In groups 3 and 4, IL-6 and TNF levels were significantly lower at 90, 180 and 240 minutes compared to group 2. At 180 minutes, TSA levels in groups 2, 3, 4 and 5 were significantly different from baseline and 90 minute levels. At this time point, TSA levels of group 2 and 3 were significantly higher compared to group 4 and 5. Conclusion: In this acute lung injury model induced by I/R of the lower limbs, pretreatment with pentoxifylline, iloprost and cilostazol significantly attenuated proinflammatory activities and parenchymal lung damage.Öğe The reduction in inflammation and impairment in wound healing by using strontium chloride hexahydrate(TAYLOR & FRANCIS LTD, 2018) Hayta, Sibel Berksoy; Durmus, Kasim; Altuntas, Emine Elif; Yildiz, Esin; Hisarciklio, Mehmet; Akyol, MelihBackground: Numerous growth factors, cytokine, mitogen and chemotactic factors are involved in wound healing. Even though inflammation is important for the stimulation of proliferative phase, excessive inflammation also causes impairment in wound healing. Strontium salts suppress keratinocyte-induced TNF-alpha and interleukin-1 and interleukin-6 in in vitro cultures. This study was conducted to determine the effects of administration of topical strontium chloride hexahydrate on wound healing through TNF-alpha and TGF-beta in surgical wound healing model of in-vivo rat skin.Material and methods: Twenty-four rats were used in the study. After approximately 2cm cutaneous-subcutaneous incision was horizontally carried out on the mid-neckline of the rats, the incision was again closed using 2.0 vicryl. The rats were assigned into three groups including eight rats in each group. Placebo emollient ointment and also the ointments, which were containing 5% and 10% strontium chloride hexahydrate and were prepared at the same base with placebo ointment, were administered to the groups by a blind executor twice a day for a week. At the end of seventh day, the rats were sacrificed and cutaneous and subcutaneous tissue of their wound site was resected for histopathological examination. Scoring of histopathological wound healing and scoring of tissue TNF-alpha and TGF-beta level with immunohistochemical staining were performed.Results: The groups, to which both 5% and 10% strontium chloride hexahydrate was administered, had lower immunohistochemical TNF-alpha levels and histopathological wound scores compared to controls, which was statistically significant (p<0.05).Conclusion: Strontium chloride hexahydrate can lead to impairment in wound healing by suppressing inflammation through TNF-alpha.Öğe Relation of microvessel density with microvascular invasion, metastasis and prognosis in renal cell carcinoma(BLACKWELL PUBLISHING, 2008) Yildiz, Esin; Ayan, Semih; Goze, Fahrettin; Gokce, Gokhan; Gultekin, Emin Y.To clarify the significance of microvessel density (MVD) in a retrospective investigation the relationship between the pattern of MVD (reflecting angiogenesis), and tumour stage, grade, size, and occurrence of microvessel invasion (MVI), metastasis, and cancer-specific survival (CSS) in patients who had surgery for renal cell carcinoma (RCC). Vessels were labelled in sections of formalin-fixed, paraffin-embedded tissues from 54 RCCs by CD34 immunohistochemistry. The mean MVD, expressed as the number of vessels per 10 high-power fields (HPF, x400) were measured for each case. In addition, all pathological slides were reviewed for the presence and absence of MVI. The prognostic value of MVD and MVI was then evaluated, and correlated with the usual prognostic variables, tumour metastasis and CSS. In a univariate analysis of CSS, the MDV tended to be lower as stage increased from pT1 to pT3, and as grade increased from G1 to G4, although it was statistically significant only for stage (P < 0.001 and 0.050, respectively). The mean MVD was higher in 42 nonmetastatic than in 12 metastatic tumours, and in 33 tumours associated with MVI than in 21 with no MVI (P < 0.001). The mean MVD was also lower and significantly different for 28 large than 26 small tumours (P = 0.005). The survival rate of patients with tumours that were small, low-stage, of higher MVD, with no MVI and metastasis was significantly higher than that of patients with large, high-stage, low MVD, with MVI and metastatic tumours (all P < 0.001). MVI was significantly more common with a decreasing trend in MVD and the presence of metastasis (Spearman rank correlation r(s) = -0.68, P = 0.01, and r(s) = 0.39, P = 0.01, respectively). Independent prognostic factors in a multivariate analysis were: in all patients with RCC, tumour stage (P = 0.013) and metastasis (P = 0.028); in those with low MVD, MVI (P = 0.004) and metastases (P = 0.016); in those with no MVI, stage (P = 0.020); in those with MVI, MVD (P = 0.001); in those with no metastases, stage (P = 0.045); and in those with metastases, MVD (P < 0.001). No independent predictor was identified in patients with high MVD. In patients with no metastases there was a significantly shorter median CSS time in RCCs with low MVD and with MVI (P = 0.004 for both). Similarly, patients who had grade 3-4 tumours, vs those with lower MVD and with MVI, had a significantly shorter median CSS (P = 0.020 for MVD, and 0.01 for MVI). This study suggested that MVD in RCC was inversely associated with MVI, tumour metastasis, patient survival and tumour diameter and stage, from the usual prognostic variables, but MVD was not an independent prognostic factor in multivariate analysis for all patients with RCC. Low MVD and the presence of MVI appears to be a marker for identifying patients with an adverse prognosis.Öğe The role of apoptosis and protective effect of carnitine in contralateral testicular injury in experimental unilateral testicular torsion(TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2009) Cankorkmaz, Levent; Koyluoglu, Gokhan; Ozer, Hatice; Yildiz, Esin; Sumer, Zeynep; Ozdemir, OzturkBACKGROUND We examined the role of programmed cell death (PCD) in the etiology of contralateral testis injury as well as the protective effect of carnitine. METHODS Thirty-six Wistar Albino rats were used in the study. Rats were divided into six groups as control, sham, torsion-detorsion with 6- and 24-hour intervals, and torsion-detorsion-carnitine administration with 6- and 24-hour intervals. The left testes of all rats were torsioned 720 degrees. Intraperitoneal carnitine was administered to groups as 100 mg/kg one hour before detorsion. Orchiectomy was applied to the contralateral testis a week after detorsion. Testes were examined with respect to diameters of seminiferous tubules (DST), ratios of malonyl dialdehyde and Johnsen biopsy scores (JBS), and PCD ratios. Results were evaluated by ANOVA test. RESULTS Programmed cell death ratios were significantly higher in the torsion-detorsion with 6- and 24-hour intervals groups compared to the sham group. Those increases were more prominent in the torsion-detorsion with 24-hour interval group. DST and JBS of the control group were significantly higher than in the experimental groups (p<0.05). The protective effect of carnitine was significant in the 24-hour torsion group, while no significant difference were detected in the 6-hour torsion-detorsion-carnitine group. CONCLUSION Increased injury and PCD in the contralateral testis was observed with prolonged exposure time in this model. It was possible to decrease the injury with carnitine.Öğe Unusual manifestations of acute Q fever: autoimmune hemolytic anemia and tubulointerstitial nephritis(BIOMED CENTRAL LTD, 2012) Korkmaz, Serdal; Elaldi, Nazif; Kayatas, Mansur; Sencan, Mehmet; Yildiz, EsinQ fever is a worldwide zoonotic infection that caused by Coxiella burnetii, a strict intracellular bacterium. It may be manifested by some of the autoimmune events and is classified into acute and chronic forms. The most frequent clinical manifestation of acute form is a self-limited febrile illness which is associated with severe headache, muscle ache, arthralgia and cough. Meningoencephalitis, thyroiditis, pericarditis, myocarditis, mesenteric lymphadenopathy, hemolytic anemia, and nephritis are rare manifestations. Here we present a case of acute Q fever together with Coombs' positive autoimmune hemolytic anemia (AIHA) and tubulointerstitial nephritis treated with chlarithromycin, steroids and hemodialysis. Clinicians should be aware of such rare manifestations of the disease.
