Browsing by Author "Temiz, P"
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Item Amlodipine-induced generalized fixed drug eruption clinically mimicking mycosis fungoidesCetinarslan, T; Ermertcan, AT; Temiz, PItem Giant eccrine porocarcinoma in an unusual locationErmertcan, AT; Evrenos, MK; Öztürk, F; Temiz, PItem Dermoscopic clues of palmoplantar hyperkeratotic eczema and palmoplantar psoriasis: A prospective, comparative study of 90 patientsÇetinarslan, T; Türel Ermertcan, A; Temiz, PDiagnosis can be difficult in isolated palmar and plantar lesions in patients with psoriasis and eczema. The purpose of our study is to compare the dermoscopic findings in patients with palmoplantar psoriasis and palmoplantar hyperkeratotic eczema. This prospective, comparative study included 90 patients histopathologically diagnosed with eczema or psoriasis (35 psoriasis and 55 eczema). The age range was 18-75 years. The most common vessel type was dot vessel in psoriasis. Red globular ring vessels were seen in five patients with psoriasis, but not in any with eczema (P = 0.007). The most common vascular distribution pattern was regular in psoriasis (40%). Patchy vascular pattern was significant in eczema. The most common background color was light red in psoriasis (48.6%) (P < 0.001). Brownish-orange globules were observed in 25.7% of patients with eczema and 5.7% in patients with psoriasis (P = 0.02). There is only one study in the published work about dermoscopy of palmoplantar psoriasis and eczema. In our study, yellow crusts, patchy scale distribution, patchy vascular pattern, yellow scale color, dull red background color and brownish-orange globules were significant in patients with palmoplantar eczema. On the other hand, patients with psoriasis had light red background color, regular vascular distribution pattern and white scale color. We observed globule structures with a pale center and dark peripheral rim only in patients with eczema, which was not identified in previous studies. This globule structure may be a new finding in eczema.Item Dermoscopy of scalp cutaneous metastasis of sarcomatoid renal cell carcinomaÇetinarslan, T; Ermertcan, AT; Temiz, P; Evrenos, MK; Müezzinoglu, TItem Langerhans cell histiocytosis: A rare cause of pathological rib fractureYolcu, A; Tulay, CM; Temiz, P; Aydogdu, ILangerhans cell histiocytosis, formerly known as histiocytosis X, represents clonal proliferations of the antigen-presenting dendritic cells, which are normally found in many organs. It is a rare disease which tends to affect children and adolescents. In particular, adult-onset type is very rare. Herein, we present a female adult diagnosed with Langerhans cell histiocytosis of the rib without any systemic involvement which was successfully treated with surgery.Item Case report: Coexistence of takotsubo syndrome and severe mononeuritis multiplex in rheumatoid vasculitisAcar, EA; Uslu, S; Gemici, YI; Cetin, N; Temiz, P; Gündüz, OSItem Clinicopathological characteristics and mutation profile of BRAF and NRAS mutation in cutaneous melanomas in the Western Turkish populationEvrenos, MK; Temiz, P; Çam, FS; Yaman, M; Yoleri, L; Ermertcan, ATBackground/aim: Malignant melanoma is the most common cause of death due to skin cancers. The most common mutations in RAF-RAS pathway from tumor oncogenes are BRAF and NRAS. In this study, we analyzed the frequency of BRAF and NRAS gene mutations and investigated their association with clinicopathological features of melanomas in the Turkish population. Materials and methods: 65 primary cutaneous melanoma were included in the study. The mutations were evaluated with real-time PCR-based PCR-array through allele-specific amplification, and the results were correlated with various clinicopathological characteristics. Results: 52.3% of the patients were female and 47.7% were male. The mean age of the patients with a mutation was lower than those without mutation. 16 patients had BRAF mutation. 12 patients had NRAS mutation. NRAS mutation was statistically more common in men (P = 0.036). The number of mitoses increased with the increase of the tumor thickness (P = 0.003). There was more mitosis in the presence of ulceration (P = 0.05). A total of 41.7% of NRAS mutations had adjuvant chemotherapy. Conclusion: We found lower mutation rate when compared to regional studies. NRAS mutation was common in men. This is the first study from our region evaluating the prognostic value of clinical stage and necessity of adjuvant treatment with the presence of BRAF and NRAS mutations.Item Investigation of effect of vitamin D receptor, calcium-sensing receptor and β-catenin on cutaneous squamous cell carcinomaTugrul, B; Soylev, S; Temiz, P; Gençoglan, GBackground: Cutaneous squamous cell carcinoma (cSCC) is a malignant and invasive tumor which is originated from epidermis with a high incidence among non-melanoma skin cancers. The aim of this study was to determine whether vitamin D receptor (VDR), calcium-sensing receptor (CaSR) and beta catenin (beta-catenin) proteins have an effect on cSCC. Materials and methods: VDR, CaSR and beta-catenin proteins in tissue samples of cSCC and control group were analyzed by immunohistochemistry (IHC) and Western blotting (WB) method. IHC findings were statistically evaluated. Results: IHC staining density of VDR and beta-catenin were higher in cSCC tissue samples than control. The difference between IHC staining density of VDR and beta-catenin in the patient and the control groups were statistically significant (p = 0.021, p = 0.021, respectively), but not for CaSR (p = 0.237). While the VDR and beta-catenin staining rates obtained by the IHC method could be supported by WB results, the WB bands for CaSR could not be shown. Conclusion: The findings suggest that VDR and beta-catenin may have an effect on the disease. Further research is required to better understand the role of VDR and beta-catenin together on cSCC.Item Effect of Cepea Extract-Heparin and Allantoin Mixture on Epidural Fibrosis in a Rat Hemilaminectomy ModelTemiz, C; Temiz, P; Sayin, M; Ucar, KAIM: Epidural fibrosis following a laminectomy procedure is a serious problem that results in failed back surgery syndrome. A serious number of manuscripts have explained its possible mechanism and results but no effective preventive surgical technique or treatment is currently present. MATERIAL and METHODS: We used a rat hemilaminectomy model at lumbar fourth level. In the treatment group (n:10), the hemilaminectomy sites were filled with cepea extract-allantoin and heparin mixture as sterile cream form. In the second group, the same surgical procedure was performed and the site was filled with physiological saline. All animals were terminated after 6 weeks and laminectomy sites removed en-bloc. Epidural fibrosis was evaluated and compared using semi-quantitative histopathological scoring scales. RESULTS: In the physiological saline group, the fibrosis score was 10.3 points and 90% of the subjects had acute inflammatory reaction, 80% chronic inflammatory reaction and 100% showed bone destruction and reparation process. In the cepea extract group, these values were fibrosis score 4.2 points, 0% acute inflammatory reaction, 33.3% chronic inflammatory reaction and 10% bone destruction and reparation process, respectively. CONCLUSION: This study showed that aloe cepea extract-allantoin and heparin mixture diminished epidural scarring formation effectively with decreased scores of acute and chronic inflammation, compared to the physiological saline solution group.Item Primary cutaneous CD30-positive anaplastic large cell lymphoma in a 16-year-old girlKocabas, E; Ermertcan, AT; Akinci, S; Temiz, P; Gündüz, KItem Leptin expression in proliferative, secretory and hyperplastic endometrial tissuesÖzler, A; Kusçu, NK; Temiz, P; Kandiloglu, AR; Koyuncu, FMObjective: 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.Item Urticarial Vasculitis Successfully Treated With OmalizumabErmertcan, AT; Aktas, A; Öztürk, F; Temiz, PItem Primary Squamous Cell Carcinoma of the Breast: a Case Report and Immunohistochemical Features for Differential DiagnosisTemiz, P; Kandiloglu, AR; Simsek, G; Coskun, T; Göktan, CWe 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.Item Histologic Changes At The Intervertebral Disc Tissue After Laser NucleotomyÖsün, A; Samancioglu, A; Temiz, P; Temiz, C; Sayin, MMinimally invasive surgical techniques have become widely used for lumbar disc disease. Each of these techniques have a different physical effect in terms of retracting the prolapsed disc tissue and decompressing the adjacent nerve root by reducing the intradiscal pressure. Various types of laser generators with different wave lengths and electrode systems have been used for percutaneous laser disc decompression (PLDD). There are numerous studies regarding the clinical effectiveness of PLDD but histologic parameters which can prove the effectivity are few. Three patients with L4-5 disc prolapsus had undergone open microdiscectomy three months after PLDD because of the unsatisfactory results. The disc tissues were evaluated histologically. Fibrous fibrillary degeneration, integrity deformation of the fibres and chondrocyte proliferation were seen at the site of the microdiscectomy tissue. Previously laser irradiated disc materials had more severe fibrillary degeneration and the chondroid component degeneration was significant. In addition, degenerative calcification and massive necrosis of the chondrocytes were seen. Changes in fibronectin, tissue inhibitors of metalloproteinases (TIMP) and matrix metalloproteinases (MMPs) of the disc tissue were examined with immunohistochemical dyes. As a result, we found that PLDD causes a decrease in the water content of the disc tissue, hyaline degeneration, fibrillary destruction and chondrocyte depletion. Immunostaining showed that the extracellular matrix was effected, the metalloproteinase activity and protein compound of the extracellular matrix had changed. The findings were discussed in light of the literature.Item The effect of human recombinant epidermal growth factor on neovascularization and pedicle division time in a rat interpolation flap modelParspanci, A; Keçeci, Y; Temiz, PBackground/aim: In practice, waiting 2-3 weeks for interpolation flaps pedicle division result in certain morbidities and discomfort for patient. The division time of flap pedicle depends on neovascularization from the recipient bed and includes wound healing stages. We aimed to investigate the effect of recombinant human epidermal growth factor (rhEGF) on the flap viability during early pedicle division. Materials and methods: Thirty-six rats were allocated to two main groups as control and study. A cranial based flap measuring 5 x 5 cm was elevated from the back, including all layers of the skin. While the cranial half of the defect was primarily closed, the flap was inset into the distal half. In the study group, a single dose of 20 mu g EGF was injected into the recipient site and wound edges before the flap inset. The control group received no treatment. Each main group was divided into three subgroups based on pedicle division time of 8, 11 and 14 days. After pedicle division, each flap was monitored and photographed for 7 days, and histopathological samples were collected. Viable and necrotic areas were compared, and flaps were examined histopathologically. Results: The necrosis area in the study group on the 11th day was significantly lower than that in the control group. The fibroblastic activity, granulation tissue and neovascularization on the 8th day, the granulation tissue level on the 11th day, and the neovascularization level on the 14th day were significantly higher in the study groups. Conclusion: Following the application of EGF, the necrosis area decreased within the study group. Histopathological assessments revealed a statistically significant increase in parameters related to granulation tissue and fibroblastic activity, notably neovascularization, across all subgroups within the study. It was concluded that the use of EGF positively affected the neovascularization, and flaps could be divided earlier.Item Birt Hogg Dube syndrome: Rare family lung diseaseSimsek, SM; Savas, R; Temiz, P; Çelik, PBirt Hogg Dube syndrome is a rare disease characterized by autosomal dominant inherited multiple cysts in the lungs, renal tumors and skin fibrofolliculomas. It was first described in 1977 by Birt et al. In this case report, a patient who was diagnosed with symptoms and his first degree relative is presented. Diseases that should be considered in differential diagnosis are discussed. The diagnosis of this disease is usually made after recurrent pneumothorax. Since it is a genetic disease, the importance of follow-up and screening needs of patients and their relatives is emphasized.Item Black colored intervertebral disc; ochronosis: A case reportÖsün, A; Korkmaz, M; Temiz, P; Samancioglu, A; Atay, BAlkaptonuria is a rare inborn error of metabolism caused by mutations in the gene responsible for the production of homogentisate 1,2-dioxygenase, an enzyme that plays an important role in the normal degradation of the aromatic amino acids tyrosine and phenylalanine. Defective production of this enzyme results in the accumulation of homogentisic acid, a tyrosine degradation product, in the bloodstream. Accumulation of homogentisic acid and its metabolites in tissues cause ochronosis. The word ochronosis refers to the dark bluish black discoloration of connective tissues including the sclera, cornea, auricular cartilage, heart valves, articular cartilage, tendons, and ligaments. In this article, we present a 38-year-old male patient with alkaptonuria associated degenerative L4-5 disc hernia, in which the patient was diagnosed after lumbar discectomy.Item Soft tissue osteoma: A case reportTemiz, P; Bastürk, O; Ayhan, S; Yilmaz Ovali, G; Okçu, GSoft tissue osteomas are very rare and should be differentiate from other osseous lesions of soft tissue. We present two patients and discuss their clinical, radiologic and histopathological features with literatures. The first patient was 17-year-old boy, amateur football player. The other was a 43-year-old man had a firm, painless mass at his right knee. Their medical history had both trauma to their knees. Radiologically, heterogenous nodular calcification areas were observed near the proximal metaphysis of their tibias. Hardly lobulated lesions without bone attachment at the ligaments were excised. These lesions were gray-white coloured, well-circumscribed, firm masses. Microscopically, welldefined, lobulated lesions were involved mature lamellar bone trabeculae and enchondral ossification areas at peripherial portion. Both of our patients are survived healty for four years.Item Combined Therapy for Distant Metastasis of Sacral ChordomaÖzkal, B; Yaldiz, C; Temiz, P; Temiz, CChordomas are known as rare primary malign tumours that have formed from primitive notochord remains. Sacral chordomas grow slowly but locally and aggressively. Chordomas are locally invasive and have low tendency to metastasis and have a poor prognosis in long-term follow-up. Metastasis may be seen in a rate of 5-40% of the chordomas. Metastasis of chordomas is common in liver, lung, lymph nodes, peritoneum, and brain. The treatment approaches, including surgery, have been discussed in the literature before. Susceptibility to radiotherapy and chemotherapy is controversial in these tumours. The success of surgical treatment affects survival directly. In this report, we will report a sacral chordoma case in which an intraperitoneal distant metastasis occurred and discuss the surgical approach.Item Immunohistochemical analysis of Ki-67, p53 and Bcl-2 expression related to histological features in gastroesophageal reflux diseaseAyhan, S; Nalbant, OA; Isisag, A; Küçükmentin, NT; Temiz, PBackground/aims: The endoscopic and histologic findings of gastroesophageal reflux disease are usually indistinct. The current study was designed to define accurately the histology in gastroesophageal reflux disease and to develop a hypothesis that reflux produces immunohistochemical changes. Methods: The study was based on the examination of endoscopic esophageal biopsy specimens obtained from 20 patients with evidence of reflux with 24-hour pH-meter monitoring and from 20 control subjects without clinical or endoscopic reflux. The pathogenesis of reflux esophagitis was discussed by comparing the histopathologic changes with determined Ki-67, p53 and Bcl-2 immunoreactivity. Results: In this study, the presence of esophagitis was determined endoscopically in only 55% of the patients with gastroesophageal reflux disease, while microscopic esophagitis was detected in 60% of them. No correlation was found between presence of endoscopic esophagitis and microscopic esophagitis in the patients with gastroesophageal reflux disease. There was a significant difference between control cases and the patients according to histological parameters, which included basal activity (p=0.006), height of papillae (p=0.006), intraepithelial neutrophils (p=0.000), intraepithelial eosinophils (p=0.006), congestion (p=0.001), and dilated intercellular spaces (p=0.006). Immunohistochemically, there was a significant difference in the expression of p53 and Ki-67 between the three study groups (patients with I without microscopic esophagitis, controls) (p<0.05). However, there was no difference in Bcl-2 between the patients with reflux and control cases. Conclusions: In this study, we considered that microscopic esophagitis does not always accompany reflux, and the lack of reliable diagnostic histologic criteria is still a serious problem for pathologists. Immunohistochemically, an increase in cell proliferative activity and p53 protein accumulation to repair oxidative DNA damage related to reflux were observed. However, the close Bcl-2 immunoreactivity in all groups that was indicated by a weak positivity suggests that the inhibition of apoptosis may not be involved in reflux esophagitis.