Browsing by Author "Temiz P."
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Item TDP-43 accumulation in inclusion body myopathy muscle suggests a common pathogenic mechanism with frontotemporal dementia(2008) Weihl C.C.; Temiz P.; Miller S.E.; Watts G.; Smith C.; Forman M.; Hanson P.I.; Kimonis V.; Pestronk A.TAR DNA binding protein-43 (TDP-43) is found in ubiquitinated inclusions (UBIs) in some frontotemporal dementias (FTD-U). One form of FTD-LJ, due to mutations in the valosin containing protein (VCP) gene, occurs with an inclusion body myopathy (IBMPFD). Since IBMPFD brain has TDP-43 in UBIs, we looked for TDP-43 inclusions in IBMPFD muscle. In normal muscle, TDP-43 is present in nuclei. In IBMPFD muscle, TDP-43 is additionally present as large inclusions within UBIs in muscle cytoplasm. TDP-43 inclusions were also found in 78% of sporadic inclusion body myositis (sIBM) muscles. In IBMPFD and sIBM muscle, TDP-43 migrated with an additional band on immunoblot similar to that reported in FTD-U brains. This study adds sIBM and hereditary inclusion body myopathies to the growing list of TDP-43 positive inclusion diseases.Item Acute generalized exanthematous pustulosis (AGEP) due to exposure to sulfuric acid and bromic acid vapor: A case report(2008) Bilaç D.B.; Ermertcan A.T.; Öztürkcan S.; Şahin M.T.; Temiz P.Acute generalized exanthematous pustulosis (AGEP, toxic pustuloderma, pustular drug eruption) is a not uncommon cutaneous reaction pattern that is usually related to drug administration. The eruption is of sudden onset and appears 7-10 days after the medication is started. A 22-year-old male patient who was a student at a chemical faculty attended our outpatient clinic with a complaint of pustular eruption on his face. According to his history, the eruption started with pruritus and erythema on his chin 3 days ago and spread to his face and chest. He explained that he had performed an experiment with sulfuric acid and bromic acid and was exposed to their vapor. His dermatological examination revealed erythema and pustules on his cheeks, on his chin, above his upper lip, and on his eyebrows. He also had a few pustules on his chest. There were no ocular, mucous membrane, or pulmonary symptoms. Histopathological examination of the skin biopsy specimen revealed superficial orthokeratosis, focal subcorneal pustule formation, and perivascular chronic inflammatory cell infiltration in superficial dermis. After administration of systemic antihistamines and wet dressing topically, we observed rapid healing of the lesions. Because there was no systemic drug intake in his history, we were concerned that exposure to sulfuric acid and bromic acid vapor caused AGEP in this patient. We present this rare case to show that the vapor of chemical materials may cause AGEP or other drug eruptions. Copyright © Informa Healthcare.Item Effect of cepea extract-heparin and allantoin mixture on epidural fibrosis in a rat hemilaminectomy model; [Cepea ekstresi-allantoin ve heparinin rat hemilaminektomi modelinde oluşturulan epidural fibrozisi önlemedeki etkinliǧi](Turkish Neurosurgical Society, 2009) Temiz C.; Temiz P.; Sayin M.; Ucar K.Aim: Epidural fibrosis following a laminectomy procedure is a serious problem that results in failed back surgery syndrome. Aserious 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 Inflammatory myopathies with mitochondrial pathology and protein aggregates(2009) Temiz P.; Weihl C.C.; Pestronk A.Objectives: To compare the clinical course and muscle biopsy features of polymyositis with mitochondrial pathology (PM-Mito) to inclusion body myositis (IBM) and steroid-responsive inflammatory myopathies (polymyositis). Methods: We compared clinical, laboratory and myopathologic features in a retrospective study of patients with PM-Mito (23), IBM (26) and polymyositis (12). Results: Selective weakness in the quadriceps or finger flexors was common in PM-Mito (62%) and IBM (87%). Weakness progressed more slowly in PM-Mito than in IBM. PM-Mito patients with more rapidly progressive weakness had more cytochrome oxidase negative muscle fibers. There was no history of benefit from corticosteroid treatment in any PM-Mito or IBM patients. B-cell foci were absent in IBM and PM-Mito. LC3, an autophagy marker, and αB-crystallin were common in aggregates in PM-Mito and IBM, but not polymyositis. SMI-31 and TDP-43 positive aggregates were common in IBM but not in PM-Mito or polymyositis. β-amyloid showed no differences in aggregates among the three groups. Conclusions: PM-Mito and IBM may be part of the same disease spectrum. PM-Mito has more slowly progressive weakness than IBM and rarely has TDP-43 or SMI-31 staining aggregates in muscle fibers. The most frequent proteins in aggregates in both PM-Mito and IBM are LC3, an autophagy marker, and αB-crystallin. Alterations in autophagic degradation pathways may be a common pathogenic mechanism in PM-Mito and IBM. In pathologically typical polymyositis, staining for mitochondrial enzyme activity, aggregates and B-cells helps to distinguish PM-Mito from inflammatory myopathy syndromes that are more likely to respond to corticosteroid treatment. © 2008 Elsevier B.V. All rights reserved.Item Calcinosis cutis on the face(Medknow Publications and Media Pvt. Ltd, 2009) Kayhan T.; Temiz P.; Ermertcan A.[No abstract available]Item Calciphylaxis with recalcitrant ulcers in the presence of moderate renal insufficiency(2009) Bilac C.; Ozturk F.; Ermertcan A.T.; Bilac D.B.; Sahin M.T.; Temiz P.; Gumuser F.G.; Ozturkcan S.A 69-year-old woman with painful crural ulcers of 3 months duration presented at the authors outpatient clinic. Dermatological examination revealed a necrotic ulceration with eschar formation localized on the anterior left crural region and the lateral malleolus of the right ankle. According to the clinical and histopathological findings, she was diagnosed with calciphylaxis. She had moderate renal insufficiency and secondary hyperparathyroidism due to hypertension. The ulcers improved significantly after 3 months of topical wound therapy. This case of calciphylaxis with recalcitrant ulcers in the presence of moderate renal insufficiency is presented to stress the importance of early diagnosis and management in this life-threatening disorder.Item Effect of sodium phenytoin concentration on neural tube development in the early stages of chicken embryo development(2009) Temiz C.; Temiz P.; Demirel A.; Sayin M.; Umur A.S.; Özer F.D.Animal and human research has shown that anticonvulsants are teratogens and pose a risk of causing fetal malformations. In various studies, the teratogenic effects of sodium phenytoin (PTH) in several systems have been investigated. Toe and finger, renal, and even facial malformations have been described in the literature. However, there is debate about whether the true risk of teratogenesis is lower or higher than previously reported for PTH. There is also little published information on the effect of this agent on neural tube closure in an embryological model. In this study, 0.1 mL of three different concentrations of PTH solution (mg/mL: 1, 3, 5) or vehicle was applied under the embryonic disc of specific pathogen-free Leghorn chicken embryos after 24 hours' incubation. Incubation was continued until 72 hours of maturation. At 72 hours, all embryos were evaluated macroscopically and microscopically. There were serious neural tube closure defects in the embryos administered large amounts (0.5 mg) of PTH, but doses of 0.1 mg (subtherapeutic concentration for humans) and 0.3 mg (therapeutic concentration for humans) produced no statistically significant defects (p = 0.05). The difference between the defects in the high concentration group and the other three groups was statistically significant. In our study PTH administered in a strict concentration regimen produced a lower level of neural tube closure-related defects than previously reported. © 2008 Elsevier Ltd. All rights reserved.Item Case report of a late onset bowenoid papulosis progressing to squamous cell carcinoma: Letter to the editor(Turkiye Klinikleri, 2009) Aydin N.; Türel Ermertcan A.; Öztürkcan S.; Bilaç C.; Yoleri L.; Temiz P.[No abstract available]Item Sorafenib-induced erythema multiforme in metastatic renal cell carcinoma(2009) Bilaç C.; Müezzinoǧlu T.; Ermertcan A.T.; Kayhan T.C.; Temeltaş G.; Özütrkcan S.; Temiz P.Sorafenib is a new therapeutic agent being used in metastatic renal cell carcinoma, hepatocellular carcinoma, and malignant melanoma. The most frequently seen cutaneous side effects due to sorafenib are erythema, exfoliative dermatitis, acne vulgaris, and flushing. Folliculitis, eczema, and erythema multiforme are other, rare side effects of sorafenib. A 59-year-old man underwent left radical nephrectomy due to renal cell carcinoma 8 months ago, and after the operation he received immunochemotherapy and then sorafenib. On the third day of sorafenib therapy his lesions occurred. His dermatologic examination revealed multiple erythematous papules on his neck, arms, and legs and bullae and iris lesions on his palms and soles. He was diagnosed as having erythema multiforme. In the literature we found only 1 other erythema multiforme case due to sorafenib. We present this interesting case to show and discuss cutaneous side effects of sorafenib, especially erythema multiforme as a very rare cutaneous side effect. © 2009 Informa UK Ltd.Item Verrucous hemangioma(2009) Yasar A.; Ermertcan A.; Bilac C.; Bilac D.; Temiz P.; Ozturkcan S.[No abstract available]Item The imbalance of enzymatic antioxidants in cholesteatoma(2009) Eskiizmir G.; Yuceturk A.V.; Onur E.; Var A.; Temiz P.Conclusion. Depletion of enzymatic antioxidants was observed in cholesteatoma. However, a relationship between activity of enzymatic antioxidants and the extent of bone erosion was not found. Objectives. To measure the level of major enzymatic antioxidants in cholesteatoma, and to investigate the relationship between the level of enzymatic antioxidants and the extent of bone erosion. Patients and methods. The cholesteatoma and skin samples were obtained during otologic surgeries. All cases were grouped according to the number of bone erosion sites. Samples were examined biochemically and the levels of enzymatic antioxidants were measured. The results were analyzed statistically. Results. Thirteen patients were included in the study. The mean level of superoxide dismutase in cholesteatoma and skin was 45.87 U/mg and 71.04 U/mg, respectively. When the catalase level was evaluated, the mean level was 5.04 U/g in cholesteatoma and 11.62 U/g in skin. The mean level of glutathione peroxidase in cholesteatoma and skin was 12.13 IU/g and 236.74 IU/g, respectively. All the results of cholesteatoma and skin samples were compared through non-parametric tests and statistically significant differences were found. However, a statistically significant difference between the levels of enzymatic antioxidants and the extent of bone erosion was not observed.Item Lamellar Ichtyosis: Case Report; [Lameller İtiyoz: Olgu Sunumu](2009) Gündüz K.; Kayhan T.Ç.; Gençoǧlan G.; Inanir I.; Temiz P.Introduction: Ichtyosiform dermatoses are a group of hereditary disorders characterized by excessive scaling on the skin. Lamellar ichtyosis is an autosomal recessive disorder. The clinical findings are seen at birth and become widespread and prominent in time; gray-brown scales are seen all over the body. Emollients and keratolytics containing salicylic acid or glycolic acid are used topically. Symptoms are improved significantly by acitretin usage. Case Report: Here we present a 5-year-old girl with lamellar ichtyosis. She was born in a collodion membrane. Besides the skin scales, ectropion and deformities of the nails and ears were observed. Significant clinical improvement was seen with acitretin (10 mg/day) therapy. Conclusion: Lamellar ichtyosis is a severe form of ichtyosiform dermatoses and topical agents may be insufficient. Systemic acitretin treatment improves the symptoms significantly but long term side effects limit its usage. © The Journal of Current Pediatrics, published by Galenos Publishing. All rights reserved.Item Acute generalized exanthematous pustulosis due to amoxicilline-clavulanate; [Amoksisilin-klavulanata baǧli akut yaygin ekzantematöz püstüloz](Kare Publishing, 2010) Söǧüt A.; Yilmaz Ö.; Yildirim Ş.; Özen S.; Temiz P.; Yüksel H.Acute generalized exanthematous pustulosis is an uncommon clinical condition characterized by an acute onset of pustular eruptions. A case of acute generalized exanthematous pustulosis after the use of amoxicilline-clavulanate is presented. The patient presented with pustular and pruritic eruptions after use of drug. The diagnosis was confirmed with pathological data. This condition leading to various clinical manifestations should be thought in the differential diagnosis of pustular dermatosis.Item 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.Item Primary squamous cell carcinoma of the breast: A case report and immunohistochemical features for differential diagnosis; [Memenin primer skuamöz hücreli karsinomu: Olgu sunumu ve Ayırıcı tanı açı;sından İmmunohistokimyasal özellikleri](Ekin Tibbi Yayincilik, 2010) Temiz P.; Kandiloǧlu A.R.; Şimşek G.; Coşkun 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. © Medical Journal of Trakya University.Item Glomus tumor of the stomach: Case report(2010) Ak Nalbant O.; Temiz P.; Vural S.; Celalettin Keleş M.Glomus tumors are benign, solitary neoplasms originating from modified smooth muscle cells of the glomus body. These tumors are rare in the gastrointestinal system. We present a glomus tumor that arose in the antrum of a 43-year-old female. During laparoscopic cholecystectomy for cholelithiasis, an antral submucosal tumor was found incidentally and total excision with wedge resection was performed. Histopathological and immunohistochemical features of this tumor were similar to those of a glomus tumor in any localization. In this report, we discuss the differential diagnosis of gastric glomus tumor.Item Immunohistochemical analysis of Ki-67, p53 and Bcl-2 expression related to histological features in gastroesophageal reflux disease(2010) Ayhan S.; Ak Nalbant O.; Isisag A.; Türkel Küçükmetin N.; Temiz P.Background/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/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.Item Item What is your diagnosis?; [Taniniz nedir?](2010) Öztürk F.; Bayata S.; Temiz P.; Ermertcan A.T.[No abstract available]Item A case report of postpubertal eruptive syringoma triggered with antiepileptic drugs(2010) Öztürk F.; Ermertcan A.T.; Bilaç C.; Temiz P.Eruptive syringoma is a rare variant of syringoma, which typically occurs in large numbers as multiple yellow-brown colored papules. It usually presents before or during puberty. The pathogenesis of eruptive syringoma is unclear. It could represent a hyperplastic response of the eccrine ducts to an inflammatory reaction caused by an unknown trigger. The association between drugs and eruptive syringoma has not been reported in the literature until now. A 34-year-old woman with multiple asymptomatic papular eruptions of nine years' duration visited the authors' outpatient clinic. She had been using antiepileptic drugs for epilepsy for 10 years. Dermatological examination revealed multiple skin-colored to brownish papules, 1-3 mm in diameter, on the trunk and neck. Skin biopsy was performed from a lesion on the neck. According to clinical and histopathological findings, the patient was diagnosed as having eruptive syringoma. This case is very interesting, because the patient had been using antiepileptic drugs for a long time and the onset of her lesions was in postpubertal period. The authors' hypothesize that her lesions occured due to antiepileptics which may be a trigger of syringomatous proliferation. The authors conclude that drugs, especially antiepileptics, should be kept in mind in reference to the etiology of eruptive syringomas. Copyright © 2010 Journal of Drugs in Dermatology.