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Browsing by Author "Kandiloglu, AR"

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Endometrial fluid in postmenopausal women
Inceboz, U; Uyar, Y; Baytur, Y; Kandiloglu, AR
Hormone receptor expressions and proliferation markers in postmenopausal endometrial polyps
Inceboz, US; Nese, N; Uyar, Y; Ozcakir, HT; Kurtul, O; Baytur, YB; Kandiloglu, AR; Caglar, H; Fraser, IS
Background/Aims: Endometrial polyps are quite common in the general population, they have a significant role in postmenopausal bleeding, and the pathogenesis is unclear. The aim of this study was to investigate proliferation markers and expression of estrogen and progesterone receptors in endometrial polyps in postmenopausal women. Methods: Endometrial polyps were removed by hysteroscopy from 36 women who presented with postmenopausal bleeding. None were using hormonal therapy. The control group consisted of 16 inactive-atrophic postmenopausal endometrial specimens removed at hysterectomy. Immunohistochemistry was used to demonstrate expression of estrogen and progesterone receptors and the cell growth and apoptosis markers, Ki67, bcl-2, c-erbB-2. Results: In both the glandular epithelium and stroma of endometrial polyps, estrogen and progesterone receptors, Ki67 and bcl-2 showed significantly more positive staining than the inactive endometrium from the control group. There was no difference in expression of c-erbB-2 between the two groups. Conclusions: Estrogen may have a role in the development of postmenopausal endometrial polyps, either by direct stimulation of localized proliferation or by stimulation of proliferation via other pathways, such as activation of Ki67 or through inhibition of apoptosis via bcl-2. c-erbB-2 is unlikely to play any role in development of these lesions. Copyright (C) 2006 S. Karger AG, Basel.
Combination thymosin-α1 and interferon-α2b in the treatment of anti-HBe-positive chronic hepatitis B in Turkey
Saruc, M; Yuceyar, H; Kucukmetin, N; Demir, MA; Kandiloglu, AR
Background/Aims: The most prevalent type of chronic hepatitis B in Turkey is anti-HBe-positive. No consistently effective therapy is yet available for the treatment of these patients. The aim of this study was to assess the efficacy and safety of interferon-alpha and thymosin-alpha(1) combination in the treatment of naive anti-HBe-positive and HBV DNA-positive chronic hepatitis B patients. Methodology: Twenty-one patients were enrolled in the study. All patients had documented anti-HBe-positive, HBV DNA-positive chronic active hepatitis B without evidence of cirrhosis. Patients received a 26-week combination course of 1.6mg thymosin-alpha(1) subcutaneously twice a week and 10 MIU interferon-alpha subcutaneously three times a week, followed by interferon-alpha monotherapy at the same dose for another 26 weeks. After treatment patients were observed for a further 26 weeks. Endpoints were a normalization of alanine aminotransferase and negativity of HBV DNA at weeks 52 and 78, as well as an improvement in liver histology at week 78. Results: Eighteen (87.7%) of the 21 patients responded by losing serum HBV DNA and normalizing alanine aminotransferase values at the end of the 52-week treatment period. Sixteen (76.2%) of these patients became sustained responders, with normal alanine aminotransferase and negative HBV DNA at the end of 78 weeks. Two patients were non-responders, two relapsed and one had a breakthrough during therapy. Significant improvements in the Knodell histological activity index were observed in the responders. No adverse events other than those seen previously with interferon monotherapy were reported. Conclusions: Combination interferon-Q2b and thymosin-alpha(1) treatment may provide a safe and effective therapeutic approach for the difficult-to-treat antiHBe-positive chronic hepatitis B patients. Further controlled studies are needed to assess the full role of this treatment strategy.
Histological and clinical predictive value of determination of tissue CagA status by PCR in Helicobacter pylori infected patients;: Results of the large population based study in western Turkey
Saruç, M; Demir, MA; Küçükmetin, N; Kandiloglu, AR; Akarca, US; Yüceyar, H
Background/Aims: Early experimental and epidemiological studies have suggested that the presence of cagA gene was a virulence factor for Helicobacter pylori. We aimed to investigate the clinical significance of tissue CagA status in Helicobacter pylori infected patients and to assess its association with histological changes in gastric mucosa. Methodology: Three hundred and forty-five patients with Helicobacter pylori infection established by both urease test and histological examination were included in the study. The symptoms of the patients were recorded according to the Glasgow dyspepsia scale. Biopsies (cardia, corpus, angulus and antrum) were evaluated histologically according to the Sidney system. The cagA status was determined by polymerase chain reaction method from an antral biopsy. Polymerase chain reaction studies were performed by Wizard genomic DNA purification system (promega). We also determined the serum levels of tumor necrosis factor-alpha, and gastrin. They were all prescribed lansoprazole (30mg b.i.d.), clarithromycin (500mg b.i.d.), and amoxycillin (1g b.i.d.) for a week. At the 8th week a second endoscopy was performed and further biopsy specimens were obtained from the same sites. Mann-Whitney U and chi(2) tests were used for statistical analyses. Results: Two hundred and thirty-five patients (68.1%) were infected with cagA-positive strains of Helicobacter pylori and the other 110 patients (31.8%) were infected with cagA-negative strains. We compared the parameters and measurements studied in this trial between the patients infected with cagA-positive and negative Helicobacter pylori strains. Helicobacter pylori density was greater in the cagA-positive group by 1.9 0.9 than in the cagA-negative group by 1.2 +/- 0.7 (P=0.01). Helicobacterpylori activity and chronic inflammation also were significantly higher in the cagA-positive group with the values of 1.4 +/- 0.8 and 2.1 +/- 1.1 than in the cagA-negative group with 0.7 +/- 0.2 and 1.3 +/- 0.5, respectively (P=0.001, P=0.002). The presence of atrophy and lymphoid aggregate was not different between the two groups (P>0.05). However intestinal metaplasia was shown to be significantly frequent in patients infected with cagA-positive Helicobacter pylori strains (0.001). Serum tumor necrosis factor-a and gastrin levels which were accepted as the markers of inflammation in Helicobacter pylori infection were increased in the cagA-positive group compared with the cagA-negative group. Serum tumor necrosis factor-alpha level was 11.3 +/- 7.0pg/mL in the cagA-positive group and 4.9+/-2.7pg/mL in the cagA-negative group (P=0.001). Gastrin level also showed a significant difference between two groups by 66.8+/-31.1pg/mL and 37.2+/-19.2pg/mL, respectively, in the cagA-positive and negative groups (P=0.001). The virulent strains seem to cause peptic ulcer more frequently. Peptic ulcer was determined in 17% of patients in the cagA-positive group but this ratio was 9% in the cagA-negative group (P=0.608). Although, all these differences of the degree of inflammation, clinical spectrum and biochemical parameters were seen, interestingly there was no significant difference in the severity of the symptoms of the patients in both groups according to Glasgow dyspepsia severity score (P=0.20). Conclusions: Our results confirm that cagA-positive strains of Helicobacter pylori cause greater histological changes. However this virulence is not associated with more severe symptoms. The histological changes can be predictable by determining the tissue cagA status.
Malignant proliferating trichilemmal tumor arising in multiple trichilemmal cysts
Yoleri, L; Baser, NT; Kandiloglu, AR
Col IV and Fn distribution in prostatic adenocarcinoma and correlation of 67LR, MMP-9 and TIMP-1 expression with Gleason score
Isisag, A; Nese, N; Ermete, M; Lekili, M; Ayhan, S; Kandiloglu, AR
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, andfibronectin (Fn), an adhesion protein in extracellular matrix. Others are matrix metalloproteinase-9 (MMP9), a type IV collagenase, tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), which has a high affinity for A4MP-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.
Leptin expression in proliferative, secretory and hyperplastic endometrial tissues
Özler, A; Kusçu, NK; Temiz, P; Kandiloglu, AR; Koyuncu, FM
Objective: The goal of this study was to detect endometrial leptin expression in proliferative and secretory phases and then to compare the results with that of hyperplastic endometrium. Material and Methods: Seventeen proliferative, 23 secretory phase and 18 hyperplastic endometrial tissues diagnosed in our hospital between 2002 and 2007 were included in the study. These samples were stained with leptin antibody using an immunohistochemical method. Endometrial glandular and surface epithelium and stroma were evaluated for staining distribution and intensity. Conclusion: Staining intensity seen in early proliferative phase samples (2.33 +/- 0.51) increased significantly throughout the middle (2.40 +/- 0.54) and late phases (2.83 +/- 0.40) (p<0.05). Early secretory phase samples had the least staining intensity (1.42 +/- 0.53), while it increased significantly in later periods (2.38 +/- 0.51) (p<0.05). There was no difference in staining intensity among proliferative, secretory and hyperplastic tissues (p>0.05). Conclusion: Although endometrial leptin expression was observed in a differential manner throughout the whole menstrual period, no difference was seen in endometrial hyperplasia. We consider that leptin does not play a role in hyperplastic transformation of the endometrium.
Primary Squamous Cell Carcinoma of the Breast: a Case Report and Immunohistochemical Features for Differential Diagnosis
Temiz, P; Kandiloglu, AR; Simsek, G; Coskun, T; Göktan, C
We present a 68-year-old postmenopausal woman with a rapidly growing right breast mass. It was diagnosed as invasive ductal carcinoma on tru-cut biopsy owing to infiltrative pattern and c-erbB-2 (HER2/neu) and progesterone receptor positivities. Partial response was obtained after four cure chemotherapy (adriamycin and cyclophosphamide). Then, she underwent a modified radical mastectomy with axillary lymph node dissection (level III). Grossly, a white-tan, solid, ill-defined tumor with 5 cm diameter located in the upper inner and outer quadrant of the breast was detected. Central portion of the tumor showed necrotic and hemorrhagic changes. Microscopic examination revealed poorly differentiated squamous cell carcinoma (SCC) having intraductal epithelial hyperplasia with squamous cell metaplasia and multiple small tumor foci at the periphery. The tumor had patchy necrotic, hemorrhagic and fibrotic areas representing regressive changes due to chemotherapy effect. Immunohistochemically, the tumor stained diffusely with CK7, CK8, CK19, HMW-CK and E-cadherin, whereas focally with CEA. Estrogenand progesterone receptors and c-erbB-2 were negative in the tumor. Five out of 20 lymph nodes dissected from the specimen were metastatic. Clinically, other organs were ruled out as the originating site of the tumor. She had taken oral chemotherapy (capecitabine) after surgery and has been living healthy for one year.
Serum her-2/neu and survivin levels and their relationship to histological parameters in early-stage breast cancer
Goksel, G; Taneli, F; Uslu, R; Ulman, C; Dinc, G; Coskun, T; Kandiloglu, AR
This study was conducted to investigate the serum levels of her-2/neu and survivin in patients with early-stage breast cancer and their relationship with known histological parameters. Forty-one patients with early-stage breast cancer were investigated. Serum samples were collected from patients on their first admission before adjuvant chemotherapy, and from healthy controls. Serum her-2/neu and survivin levels were determined using an enzyme-linked immunosorbent assay. There was no difference in the levels of serum her-2/neu and survivin between the breast cancer patients and the control group. Serum her-2/neu concentration showed moderate correlations with disease stage and the Ki-67 level, and the serum survivin level showed a moderate correlation with progesterone receptor concentration. Serum levels of her-2/neu and survivin were not significantly related to age and histological parameters in patients with early-stage breast cancer. However, much research continues on the prognostic value of serum her-2/neu and survivin levels, and important new knowledge may ultimately emerge.
Effects of extracorporeal shockwave lithotripsy at different stages of pregnancy in the rabbit
Gumus, B; Lekili, M; Kandiloglu, AR; Isisag, A; Temeltas, G; Nazli, O; Buyuksu, C
Although SWL is now the most common treatment modality for urinary tract stone disease, it is not regarded as a safe method for pregnant patients because of its potential harmful effects on fetus, Using a rabbit model, Re investigated whether SWL might cause fetal injury when administered at various developmental stages. Two groups of pregnant rabbits were given 1000 shockwaves either early or late in the gestational period, Time-matched controls did not receive shockwaves, After spontaneous labor, all newborn rabbits were counted, weighted, and measured, and specimens were taken from organs and examined histopathologically. The numbers, weights, and diameters of the newborns in each group were similar, There was no notable histopathologic finding in the heart and brain specimens of any of the newborns, whereas noticeable congestion and multiple focal intraparanchymal microhemorrhages were found in lungs, livers, and kidneys of the animals that had been exposed to shockwaves early in gestation, In conclusion, this study shows that SWL is not a safe treatment in early pregnancy.
METASTATIC MALIGNANT MELANOMA OF THE BREAST: A CASE REPORT
Nalbant, OA; Vural, S; Keles, MC; Nalbant, E; Kandiloglu, AR
Metastasis of a malignant melanoma or any other type of tumour to the breast is rarely seen. A 70-year-old female patient came to the breast clinic due to a mass in her right breast. The case did not have any known history of malignincy. After the initial incisional biopsy, a right modified radical mastectomy and axillary lymph node dissection were performed. On the cut surface, a yellow to pink, solid and well-circumscribed tumoural lesion with a maximum diameter of 8 cm was observed. Given its histopathological and immunohistochemical attributes, the case was diagnosed as metastatic malign melanoma involving breast and ipsilateral axillary lymph nodes. This case was determined to be worthy of presentation due to the fact that the histological diagnosis of metastatic tumours can be more difficult than of primary breast cancers and that metastasis of malignant melanoma to breast is rarely seen.
Comparison of the Desmoplastic Reaction and Invading Ability in Invasive Ductal Carcinoma of the Breast and Prostatic Adenocarcinoma Based on the Expression of Heat Shock Protein 47 and Fascin
Nese, N; Kandiloglu, AR; Simsek, G; Lekili, M; Ozdamar, A; Catalkaya, A; Coskun, T
OBJECTIVE: To investigate the diversity within invasive ductal carcinoma (IDC) and prostatic adenocarcinoma (PCa) by evaluating immunohistochemical expression of heat shock protein 47 (HSP47) and fascin, the molecules that are related to desmoplasia and invasion, and analyze its correlation with clinicopathologic parameters. STUDY DESIGN: HSP47 and fascin immunoreactivity (IR) was evaluated in 49 mastectomies diagnosed as IDC and 57 radical prostatectomies diagnosed as PCa. IR was evaluated as: 0: <5%, 1+: 5-25%, 2+: 25-50%, 3+: >50%. RESULTS: HSP47 and fascin were localized to cytoplasm, and HSP47 and fascin IR were higher in IDC and PCa than benign groups (p<0.05). HSP47 IR in neoplastic cells was 42.1% and 28,6%, in stroma was 81.6% and 15.8% in IDC and PCa, respectively; fascin IR in neoplastic cells was 65.3% in IDC and 15.8% in PCa. Fascin expression correlated with estrogen receptor and progesterone receptor negativity, tumor size and stage in IDC and surgical margin status in PCa. HSP47 expression correlated bilaterality in PCa. HSP47 positively correlated with survival in IDC. CONCLUSION: HSP47 and fascin expression may play role in the pathogenesis of IDC and PCa because their expression is significantly higher in IDC and PCa than their normal counterpart. Although there is no relationship with recurrence or metastatic status, fascin overexpression correlated with tumor size, which may prompt its use as a prognostic factor in IDC. (Anal Quant Cytol Histol 2010;32:90-101)
Human Papilloma Virus Frequency and Genotype Distribution in a Turkish Population
Akcali, S; Goker, A; Ecemis, T; Kandiloglu, AR; Sanlidag, T
Objectives: To determine human papillomavirus (HPV) frequency, genotypes and the relation between cervical smear results, risk factors and types in women living in Manisa, Turkey. Materials and Methods: A total of 410 women were included in the study. Cervical specimens were obtained for linear array HPV genotyping and pathological testing. Conventional Pap test and Bethesda system were used for evaluation of cytology specimens. Results: A total of 410 women with a mean age of 34.9 years were tested. A positive result of any HPV was found in 35 patients (8.5%). Among them, 26 different serotypes of HPV were identified and the most frequent type was HPV 16 (28.5%) followed by type 45 and 53 (11.4%). Patients were infected by 65.7% high risk, 11.4% probable high risk and 22.9% low risk HPV types. Multiple HPV positive results were found in 13 patients (37.1%). Patients with single partner, history of abnormal smear or condyloma had positive HPV results and this was statistically significant (p<0.05). Correlation analysis showed a statistically weak relation between positive HPV and abnormal smear results (r=0.120). Conclusions: Determining HPV types of genital HPV infections is important for epidemiological studies. We have found the rate of positive HPV as 8.5% which implies the need for extended screening programs in order to diagnose oncogenic HPV at an early stage.
Schwannoma Localized Retroperitoneally in a 14-Year-Old Boy
Cayirli, H; Tanriverdi, HI; Ozguven, AA; Gunsar, C; Ersoy, B; Kandiloglu, AR
Schwannomas usually occur in adults being between the second and fifth decades, and such neoplasms are extremely rare in a pediatric population. In addition, they are not normally found in the retroperitoneal region. Here, we present a pediatric case of a retroperitoneal schwannoma in an adrenal location where the tumor was not able to be preoperatively differentiated from other benign ormalign adrenal gland tumors. In our opinion, this tumor can be included in the differential diagnosis of a nonfunctioning retroperitoneal adrenal mass in children.
Recidivans cutaneous leishmaniasis unresponsive to liposomal amphotericin B (AmBisome®)
Gündüz, K; Afsar, S; Ayhan, S; Kandiloglu, AR; Türel, A; Filiz, EE; Ok, ÜZ
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.
Rectus Abdominis Muscle Endometriosis
Goker, A; Sarsmaz, K; Pekindil, G; Kandiloglu, AR; Kuscu, NK
Endometriosis is characterized by an abnormal existence of functional endometrial tissue outside the uterine cavity, typically occuring within the pelvis of women in reproductive age. We report two cases with endometriosis of the abdominal wall; the first one in the rectus abdominis muscle and the second one in the surgical scar of previous caesarean incision along with the rectus abdominis muscle. Pre-operative evaluation included magnetic resonance imaging. The masses were dissected free from the surrounding tissue and excised with clear margins. Diagnosis of the excised lesions were verified by histopathology.
A case of endometrial stromal sarcoma with curvilinear calcification
Pekindil, G; Tuncyurek, O; Orguc, S; Inceboz, U; Kandiloglu, AR; Caglar, H
Background. Although many histopathological, clinical, and imaging findings of ESS have been described, intense calcifications have not been reported previously. Case. A 54-year-old female was admitted with vaginal bleeding and abdominal pain. Gynecologic examination revealed a huge, firm pelvic mass extending up to the epigastrium. Transabdominal ultrasonography and computed tomography demonstrated a well-demarcated uterine mass containing heterogeneous solid and cystic areas and a centric curvilinear calcification. Histopathological diagnosis was established as undifferentiated high-grade endometrial stromal sarcoma. Conclusion. Endometrial stromal sarcomas should be considered in the differential diagnosis of uterine masses containing curvilinear calcifications. (c) 2005 Elsevier Inc. All rights reserved.
Acrodermatitis continua of Hallopeau
Sahin, MT; Öztürkcan, S; Türel, A; Kandiloglu, AR
Features of chronic inflammation at the gastric cardia and the relationship with Helicobacter pylori infection and oesophagitis
Ayhan, S; Demir, MA; Kandiloglu, AR; 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 Helicobacter pylori (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.
Nonsyndromic Giant Basal Cell Carcinoma With Follicular Differentiation and Multifocal Localized Basal Cell Carcinoma
Usluer, A; Yoleri, L; Kandiloglu, AR; Bali, ZU; Demirer, O; Inanir, I
Basal cell carcinoma is the most common malignant tumor of the skin. The most important feature is its very slow growth rate. It takes many years to reach gigantic dimensions. Various syndromes have been defined in which basal cell carcinoma exists in multiple localizations in a single patient. A case of basal cell carcinoma with multiple localizations and gigantic dimensions which is not classified as a syndrome is described in this case report.

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