Browsing by Author "Ayhan S."

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    Histopathological and immunohistochemical clues in the differential diagnosis of benign and malignant focal lymphocytic aggregates in paraffin sections of the bone marrow biopsies
    (1998) Isisag A.; Hekimgil M.; Soydan S.; Ayhan S.; Turkdogan P.
    One of the problems in evaluating bone marrow trephine biopsies is to determine whether a focal lymphocytic aggregate is benign or not. To assess the value of anti-bcl-2 monoclonal antibody on the differential diagnosis, bone marrow biopsies with focal lymphocytic aggregates were evaluated by conventional histopathological criteria and an immunohistochemical study using anti-bcl-2 monoclonal antibody was performed. Of the 27 bone marrow trephine biopsies from patients with lymphoproliferative disorders malignant aggregates were found in 14. The remaining 13 contained benign aggregates according to the conventional criteria and in none of these cases malignancy was confirmed. Conventional criteria were tested by comparing the histopatological characteristics of benign and malignant aggregates. The trephine biopsies of all 27 cases were immunostained with anti-bcl-2 antibody. A moderate to intense nuclear staining in the mononuclear calls of the aggregates was observed in 12 of 14 malignant cases. None of the cases diagnosed as benign stained with the anti-bcl-2 monoclonal antibody. It is concluded that positive immunostaining with this antibody strongly suggests that a focal lymphocytic aggregate is malignant.
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    Primary genital non-Hodgkin lymphoma
    (Blackwell Publishing, 1998) Sungurtekin Ü.; Lacin S.; Ayhan S.
    Although genital lymphoma either being an initial manifestation of occult nodal disease or secondary involvement is not uncommon, extranodal lymphoma originating primarily from the genitalia is quite rare. Here, we report a new case of primary genital lymphoma involving the uterus and ovaries, but not the Fallopian tubes. We also wish to emphasize that misdiagnosis of genital lymphoma, either clinically or histologically can occur.
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    Recidivans cutaneous leishmaniasis unresponsive to liposomal amphotericin B (AmBisone®)
    (2000) Gündüz K.; Afsar S.; Ayhan S.; Kandiloglu A.R.; Türel A.; Filiz E.E.; Ok U.Z.
    A 60-year-old woman with thick crusted erythematous plaques on her glabella, apex nasi and left infraorbital region was diagnosed as recidivans cutaneous leishmaniasis. The lesions were resistant to antimonial drugs. Although some response was observed on the infraorbital region, lesions on the glabella and nose continued to infiltrate despite therapy with liposomal amphotericin B.
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    Organized hematoma of the maxillary sinus mimicking tumor
    (2001) Unlu H.H.; Mutlu C.; Ayhan S.; Tarhan S.
    The authors present two cases of organized hematoma of the maxillary sinus. Both patients showed no bleeding abnormalities. Clinical symptoms, signs and radiologic appearance of the mass mimicked tumor during the initial diagnosis of the disease. To our knowledge, this is the first article describing organized hematoma in the maxillary sinus mimicking tumor without bleeding history and disorders. A provisional diagnosis of organized hematoma should be considered when a patient with history of epistaxis develops a slow-growing mass of the cheek and/or nasal obstruction. © 2001 Elsevier Science Ireland Ltd. All rights reserved.
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    A case of systemic sclerosis and diverticulosis coli complicated by intestinal haemorrhage [4]
    (2002) Pirildar T.; Saruç M.; Aydede H.; Ayhan S.
    [No abstract available]
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    Osteochondroma of the posterior nasal septum managed by endoscopic transnasal transseptal approach
    (2002) Unlu H.H.; Unlu Z.; Ayhan S.; Egrilmez M.
    A case of osteochondroma of the posterior nasal septum is presented. A 57-year-old female patient presented with a history of bilateral nasal obstruction for 20 years. To the best of our knowledge, this is the second reported case of an osteochondroma of the nasal septum. It was treated by endoscopic transnasal transseptal surgery.
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    The association of dehydroepiandrosterone, obesity, waist-hip ratio and insulin resistance with fatty liver in postmenopausal women - A hyperinsulinemic euglycemic insulin clamp study
    (2003) Saruç M.; Yüceyar H.; Ayhan S.; Türkel N.; Tuzcuoglu I.; Can M.
    Background/Aims: The relationship between insulin resistance and the occurrence of fatty acid has been documented. Recently DHEA (dehydroepiandrosterone) was shown to have a protective effect against development of fatty liver in rats. We aimed to investigate the association of nonalcoholic fatty liver and serum levels of DHEA, obesity, fat distribution and insulin resistance and to evaluate the effect of DHEA on fatty liver, obesity and insulin resistance. Methodology: Thirteen postmenopausal women with nonalcoholic fatty liver and 14 postmenopausal women with normal liver histology were included into the study. Body mass index, waist-hip ratio, serum DHEA, DHEAS, triglyceride, cholesterol levels and insulin resistance were determined. Fatty liver was determined by ultrasound and established by liver biopsy and histology. Hyperinsulinemic euglycemic clamp studies were performed. Results: The subjects in both groups were age matched (p>0.05). Body mass index showed obesity in patients with fatty liver but not in control group (p=0.01). Central obesity was present in women with fatty liver (p=0.039). As expected, insulin resistance was significantly present in patients with fatty liver (p=0.001). DHEA and DHEAS levels of women with fatty liver were greater than those of control group (p1=0.001 and p2=0.0001, respectively). DHEA and DHEAS were positively correlated with both body mass index and waist-hip ratio. However, glucose disposal rate was inversely and significantly correlated with DHEA and DHEAS levels. Conclusions: These data do not support the hypothesis that DHEA or DHEAS protect postmenopausal women against fatty liver, diabetes and obesity. Indeed, DHEA and DHEAS may be the cause of fatty liver, obesity (especially abdominal obesity) and diabetes in estrogen-deficient women.
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    Functional dyspepsia: Relationship between clinical subgroups and Helicobacter pylori status and Western Turkey
    (Associacao Brasileira de Divulgacao Cientifica, 2003) Saruc M.; Ozden N.; Turkel N.; Ayhan S.; Demir M.A.; Tuzcuoglu I.; Akarca U.S.; Yuceyar H.
    The etiology of functional dyspepsia is not known. The objective of the present study was to determine the characteristics of functional dyspepsia in Western Turkey. We divided 900 patients with functional dyspepsia into three subgroups according to symptoms: ulcer-like (UL), 321 (35.6%), motility disorder-like (ML), 281 (31.2%), and the combination (C) of these symptoms, 298 (33.1%). All patients were submitted to endoscopic evaluation, with two biopsies taken from the cardia and corpus, and four from the antrum of the stomach. All biopsy samples were studied for Helicobacter pylori (Hp) density, chronic inflammation, activity, intestinal metaplasia, atrophy, and the presence of lymphoid aggregates by histological examination. One antral biopsy was used for the rapid urease test. Tissue cagA status was determined by PCR from an antral biopsy specimen by a random sampling method. We also determined the serum levels of tumor necrosis factor-a (TNF-α) and gastrin by the same method. Data were analyzed statistically by the Kolmogorov-Smirnov test and by analysis of variance. Hp and cagA positivity was significantly higher in the UL subgroup than in the others. The patients in the ML subgroup had the lowest Hp and cagA positivity and Hp density. The ML subgroup also showed the lowest level of Hp-induced inflammation among all subgroups. The serum levels of TNF-α and gastrin did not reveal any difference between groups. Our findings show a poor association of Hp with the ML subgroup of functional dyspepsia, but a stronger association with the UL and C subgroups.
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    Long-term outcomes of thymosin-α1 and interferon α-2b combination therapy in patients with hepatitis B e antigen (HBeAg) negative chronic hepatitis B
    (John Wiley and Sons Inc., 2003) Saruc M.; Ozden N.; Turkel N.; Ayhan S.; Hock L.M.; Tuzcuoglu I.; Yuceyar H.
    Hepatitis B e antibody (HbeAb) and hepatitis B virus (HBV) DNA positive chronic hepatitis is a clinical entity, distinct from classical hepatitis B e antigen (HbeAg) positive chronic hepatitis B. Our aim was to evaluate the long-term therapeutic efficacy of the combination of interferon α-2b and thymosin-α1 compared with lamivudine plus interferon α-2b and interferon α-2b alone. Fifty-two patients with HbeAg-negative chronic hepatitis B were assigned to three different groups in a nonrandomized manner. Group 1 (n = 27) received thymosin-α1 [1.6 mg subcutaneously (sc), twice a week] and interferon α-2b (10 MIU sc, three times per week) for 26 weeks, subsequently followed by interferon α-2b monotherapy at the same dosage for an additional 26 weeks. Group 2 (n = 10) received interferon α-2b (10 MIU sc, three times per week) for 52 weeks. Group 3 (n = 15) received interferon α-2b (10 MIU sc, three times per week) and lamivudine [100 mg orally (po), q.d.] for 52 weeks, followed by continuous lamivudine (100 mg po, q.d.) therapy. By the end of 78 weeks, a sustained response (SR-6 mo) was seen in 74% (20/27) of the patients within Group 1. On the contrary, Groups 2 and 3 had sustained response rates of 40 (4/10) and 53.3% (8/15), respectively (p = 0.13). At the end of 12 months post-treatment in Group 1, a virological and biochemical response rate was seen in 70.3% of patients (19/27); in contrast, Groups 2 and 3 had response rates of 20 (2/10) and 26.6% (4/15), respectively (p = 0036). At the end of the 18-month post-treatment follow-up period, 71.4% (19/27) of patients in Group 1, 10% of patients in Group 2 (1/10), and 20% of patients in Group 3(3/15) preserved their sustained response (p = 0.0003). Interferon α-2b and thymosin-α1 combination therapy results in significant virological and biochemical response rates compared with standard therapeutic regimens and is well tolerated. © 2003 Wiley-Liss, Inc. and the American Pharmacists Association.
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    Features of chronic inflammation at the gastric cardia and the relationship with Helicobacter pylori infection and oesophagitis
    (2003) Ayhan S.; Demir M.A.; Kandiloglu A.R.; Saruc M.; Kucukmetin N.
    Background: The etiopathogenesis of chronic inflammation at the gastric cardia is still debated. It is suggested that carditis may be a finding of gastro-oesophageal reflux disease (GORD) or it may occur as a result of the gastritis caused by Helicobacterpylori (H. pylori) infection. Aim: To examine morphological features of carditis, as well as the associations of carditis with Helicobacter pylori gastritis and oesophagitis as a marker of gastro-oesophageal reflux disease. Patients and methods: Endoscopic biopsy specimens obtained systematically from oesophagus, cardia, corpus and antrum of 135 dyspeptic patients were retrospectively evaluated. In biopsies, we have searched for any correlations between clinical, endoscopic, and histological features. Results: Carditis was detected in 123 (91.1%) of the cases. The mean age of the carditis group was 47.9 years and the male-to-female ratio was 1.08:1. The relation of carditis with age and sex was not significant (p = 0.19 and p = 0.24, respectively). All cases of the carditis group had concomitant chronic gastritis. In these cases, chronic inflammation, degree of neutrophil-mediated activity and H. pylori colonisation were significantly correlated in cardia, corpus and antrum (p < 0.001). Intestinal metaplasia was observed in 14 cases (11.3%) and, was associated with H. pylori colonisation (p < 0.001). Microscopic oesophagitis detected in 37.7% cases also showed correlation with reflux symptoms and endoscopic oesophagitis but not carditis. When all cases with carditis were evaluated for H. pylori infection and oesophagitis, which are presumed risk factors for carditis, H. pylori infection appeared to be an independent risk factor for carditis (p = 0.012), while oesophagitis did not. Conclusions: This study suggests that carditis is commonly found in patients presenting with dyspepsia and the histological features of carditis were similar to those seen in H. pylori gastritis in antrum and corpus. In addition, our data have also shown that carditis was significantly associated with H. pylori infection but not with symptoms or signs of GORD.
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    Col IV and Fn Distribution in Prostatic Adenocarcinoma and Correlation of 67LR, MMP-9 and TIMP-1 Expression with Gleason Score
    (2003) Işisaǧ A.; Neşe N.; Ermete M.; Lekili M.; Ayhan S.; Kandiloǧlu A.R.
    OBJECTIVE: To assess the immunoreactivity of 5 proteins related to basement membrane (BM) and extracellular matrix in order to investigate whether any of them correlates with differentiation of prostatic adenocarcinoma (PAc). Two of these markers are collagen type IV (Col IV), the collagenous component of basement membrane, and fibronectin (Fn), an adhesion protein in extracellular matrix. Others are matrix metalloproteinase-9 (MMP-9), a type IV collagenase, tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), which has a high affinity for MMP-9, and 67-kd laminin receptor (67LR), which belongs to the non-integrin laminin binding receptor family. STUDY DESIGN: Forty-three PAc cases with Gleason scores ranging between 5 and 10 and 10 benign prostatic hyperplasia (BPH) cases, the control group, were included in the study. Formalin-fixed and paraffin-embedded tissue slides from each case were immunostained with the avidin-biotin-peroxidase method. Immunoreactivity was determined by means of a scoring system similar to the Gleason scoring system. RESULTS: Overexpression of Col IV, Fn, 67LR and MMP-9 was detected in PAc as compared with BPH, whereas no difference was determined in TIMP-1 expression. Among these, only 67LR correlated statistically with Gleason score. CONCLUSION: Expression of 67LR in tumor cells was significantly increased in parallel to tumor grade. This may be useful in microscopic evaluation of PAc.
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    Repeated subcutaneous administration of dermatophagoides allergen does not cause immune or non-immune glomerular injury in wistar-albino rats
    (2004) Akil I.; Yuksel H.; Ayhan S.; Nese N.; Giray G.
    We aimed to investigate the risk of immune or non-immune mediated glomerular injury associated with immunotherapy with dermatophaogoides allergen. Three groups of 7 male rats aged 10 weeks were gathered. Group 1 received 1250 units of dermatophaogoides allergen injection 3 times with an interval of 2-weeks via subcutaneous route, group 2 received 2500 units of dermatophaogoides allergen injection, and the control group received isotonic saline solution equal in volume to the antigen. Kidneys were evaluated by both light and immunofluorescence microscopy. Urine was analyzed with urinalysis strips and light microscopy. Some cases demonstrated mesangial proliferation as well as an increase in mesangial matrix and tubulointerstitial inflammation. However, these changes did not differ statistically significantly between the groups (P>0.05 for mesangial proliferation, increase in mesangial matrix and tubulointerstitial inflammation). Neither hematuria nor proteinuria was detected in control or treatment groups at the beginning or at the end of the study. This study demonstrated that repeated inoculation of dermatophagoides allergen, as required for subcutaneous allergen specific immunotherapy, did not result in any non-immune or immune complex induced glomerular injury. Thus, despite the fact that dermatophagoides allergen are exogenous macromolecules, subcutaneous allergen specific immunotherapy using these purified allergens may not have any risk for glomerular injury.
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    A case of a small cell lung carcinoma presenting with jaundice due to pancreatic metastasis.
    (2005) Sakar A.; Kara E.; Aydede H.; Ayhan S.; Celik P.; Yorgancioglu A.
    Though the high incidence of pancreatic metastasis of lung cancer has been reported in autopsy series, symptomatic cases with jaundice due to that is very rare. Dominant histological type with pancreatic metastases is small cell carcinoma and prognosis is poor. Hereby, we report a case initially presenting with gastroenterologic symptoms as jaundice, nausea, vomiting, weight loss and abdominal pain and then diagnosed as primary small cell carcinoma of the lung with metastasis to pancreas. He underwent a palliative surgery due to obstructive jaundice. This presented case is a rare one with its priority of gastroenterologic symptoms rather than pulmonary complaints.
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    Endoscopic submucosal resection of a rectal carcinoid tumor by cap aspiration - Snare resection method
    (2006) Çelebi Kobak A.; Zeybel M.; Ayhan S.; Kara E.; Ellidokuz E.
    We report a 55-year-old man with a white plaque-like lesion 4 mm in diameter located in the rectum on colonoscopic examination. Biopsy specimens showed carcinoid tumor. Endoscopic submucosal resection (ESMR) of the lesion was successfully performed by using cap aspiration-snare resection method.
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    Hemangioma of the rib
    (2006) Yilmaz Ovali G.; Göktan C.; Tarhan S.; Örgüç Ş.; Ayhan S.; Saribülbül O.; Zeybek R.
    [No abstract available]
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    The role of heme in hemolysis-induced acute pancreatitis
    (2007) Saruç M.; Yuceyar H.; Turkel N.; Ozutemiz O.; Tuzcuoglu I.; Ayhan S.; Yuce G.; Coker I.; Huseyinov A.
    Background: The aim was to reveal the mechanism of hemolysis-induced acute pancreatitis and to evaluate the role of heme and heme oxygenase activity in inducing pancreatic inflammation in an experimental hemolysis model. Material/Methods: Hemolytic anemia was induced in rats by intraperitoneal injection of 60 mg/kg acetylphenylhydrazine (APH). To evaluate the toxic effect of free heme after hemolysis, heme oxygenase inhibitor (HOI) was used to inhibit the enzyme which decreases the free heme concentration after hemolysis. One hundred and fifty rats were divided into two treatment and three control groups. Rats in the hemolysis group were given APH intraperitoneally. Rats in the HOI+hemolysis group were given Cr(III)mesoporphyrin IX chloride as HOI and then APH intraperitoneally. Serum amylase and lipase levels as well as pancreatic tissue cytokine content were determined and histological examination performed. Results: No hemolysis or pancreatitis was seen in the control groups. Massive hemolysis was seen in 22 of the 30 rats of the hemolysis group and 20 of the 30 rats of the HOI+hemolysis group. The total pancreatitis rates were 60% and 76.6% in the hemolysis and HOI+hemolysis groups, respectively (p<0.05). Pancreatic cytokine levels were significantly higher in the HOI+hemolysis and hemolysis groups than in all control groups. The highest ICAM-1 and MCP-1 levels were in the HOI+hemolysis group. Histological signs of acute pancreatitis were also more severe in this group. Conclusions: Acute massive hemolysis can induce acute pancreatitis. Excess of free vascular heme seems to be an inducer of inflammation by modulating ICAM-1 and MCP-1. © Med Sci Monit, 2007.
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    Gastric polypoid intramucosal carcinoma and an adjacently located leiomyoma at the cardia
    (2008) Çelebi Kobak A.; Zeybel M.; Ayhan S.; Aydin A.; Kaya Y.; Ellidokuz E.
    We report a 65-year-old patient with a gastric polyp of 2.5 cm in diameter located at the cardia on upper gastrointestinal (GI) endoscopy. Pathological examination of the excised polyp showed intramucosal carcinoma. Endoscopic ultrasonography (EUS) reported the lesion as early gastric carcinoma with probable submucosal involvement. On serial sections of the gastrectomy material, the lesion was an intramucosal carcinoma and surprisingly there was a leiomyoma located adjacently.
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    Coexistence of symptomatic iron-deficiency anemia and duodenal nodular lymphoid hyperplasia due to giardiasis: Case report
    (2009) Kasirga E.; Gülen H.; Şimşek A.; Ayhan S.; Yilmaz Ö.; Ellidokuz E.
    Iron-deficiency anemia due to iron malabsorption and duodenal nodular lymphoid hyperplasia (NLH) has been described in children with Giardia intestinalis infection. Also, symptomatic iron-deficiency anemia is rarely encountered in male adolescents. A 14-year-old boy underwent esophagogastroduodenoscopy for investigation of symptomatic iron-deficiency anemia (hemoglobin 5.8 g/dL, mean corpuscular volume 65.3 fL, serum ferritin < 1.5 ng/mL). He had a sufficient diet for iron and recurrent bouts of diarrhea without melena. At upper endoscopy, duodenal mucosa was diffusely nodular. Histopathologic evaluation of biopsy samples from the duodenum revealed infection with Giardia intestinalis. His anemia improved with metronidazole and iron treatment. Copyright © Informa Healthcare USA, Inc.
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    Could procalcitonin be a determining factor in the diagnosis of intestinal ischemia?; [Prokalsitonin intestinal iskemide belirleyici bir faktör olabilir mi?]
    (2009) Yilmaz Ö.; Genç A.; Taneli F.; Ayhan S.; Ünden Özcan C.; Taneli C.
    Aim: Procalcitonin is one of the precursors which forms calcitonin and today, it is being used as an indicator in the infections and inflammations of adult and children. Intestinal ischemia plays an important role in the etiology of numerous diseases from infancy to adulthood. Diseases associated with intestinal ischemia include necrotizing enterocolitis and midgut volvulus. Bacterial translocation resulted in the impairment of mucosal integrity secondary to the intestinal ischemia. The objective of this study is to assess whether serum procalcitonin could be used as an early indicator of intestinal ischemia. Material and Methods: In our study, 35 rats were used. The subjects were randomly separated into 5 groups, each consisting of 7 rats. Mesenteric ischemia was applied for 120 minutes in Group 1, 60 minutes in group 2 and 30 minutes in Group 3. The subjects in Group 4 were designated as the sham control group. In Groups 1, 2 and 3 the abdomen was closed and reperfusion was applied for 4 hours. In Groups 4, the abdomen was closed upon the completion of the operation and 4 hours passed. Group 5 was classified as the control group. At the end, blood was taken for procalcitonin measurement and a segment of 3 cm was taken from the terminal ileum for pathological evaluation. Results: There was a statistically significant difference between the procalcitonin serum levels of the five groups evaluated by Kruskal-Wallis variance analysis (p=0,01). However, in comparison of the groups by Mann-Whitney U test, this difference seemed to occur only between the control groups and the groups which intestinal ischemia was developed (p<0,05). No difference was observed in groups which intestinal ischemia was developed. There was no correlation between procalcitonin serum levels of groups and the severity of the histological findings. Conclusion: It was observed that procalcitonin serum levels increased in the intestinal ischemia in the early period. As relationship between procalcitonin serum levels and degree of ischemia has not been identified in experimental intestinal ischemia, it could be considered that procalcitonin serum levels may be used as a negative screening test.
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    Gastric metastasis of merkel cell carcinoma: Case report; [Midede merkel hücreli karsinom metastazı: Olgu sunumu]
    (Ekin Tibbi Yayincilik, 2010) Temiz P.; Ayhan S.; Adigüzel L.; Kara E.; Okçu G.
    Merkel cell carcinoma (MCC) of skin is a rare tumor with aggressive behavior. Local recurrences, regional lymph node and distant metastases of MCC are frequent but to date metastasis to upper gastrointestinal tract was reported only a few. We present a 75-yearold man who had primary MCC at his left thigh. The tumor was excised and the patient was directed to local radiotherapy. He had developed abdominal and thoracal subcutaneous metastatic nodules within 5 and 8 months after surgical excision, respectively. In the tenth month, a second operation had to be performed because of a perforated duodenal ulcer and incidentally a submucosal yellow-white nodule measuring 2 cm in diameter was found in the wall of gastric cardia and excised. This lesion was histologically identical to the primary tumor, hence, gastric metastasis of MCC. The patient rejected further therapy and died 17 months after the initial diagnosis. Differential diagnosis of MCC and distinction of gastrointestinal MCC metastasis from primary neuroendocrine tumors may be difficult. Clinical information and histopathological features along with the results of immunohistochemical stainings are very important in this distinction. © Medical Journal of Trakya University. Published by Ekin Medical Publishing. All rights reserved.