JPMA. The Journal of the Pakistan Medical Association, 2018
To investigate some of the new inflammatory and oxidative stress markers in acute appendicitis. T... more To investigate some of the new inflammatory and oxidative stress markers in acute appendicitis. This clinical pilot study was conducted at the emergency department of Bezmialem Vakif University, Istanbul, Turkey, between January and July 2015, and comprised patients with definitive diagnosis of acute appendicitis and as many healthy controls. Venous blood was collected to assess white blood cell count, C-reactive protein, raftlin, presepsin, total thiol, native thiol and disulphide levels. Alvarado scores of patients were determined at the time of admission. Surgical excisions were sent for pathological examination. The results of histopathology of appendectomy specimens were categorised as non-perforated or perforated appendicitis. There were130 subjects with 65(50%) patients and 65(50%) controls. Serum raftlin, presepsin, white blood count, C-reactive protein and disulphide levels were higher, and the total and native thiol levels were significantly lower in patients compared to c...
266 Background: The prognostic value of multifocal, multicentric breast cancer is still not well ... more 266 Background: The prognostic value of multifocal, multicentric breast cancer is still not well known. Although some studies have suggested that it is associated with a worst prognosis some have not suggest. We evaluated the effect of treatment modalities on overall survival and disease-free survival in breast cancer. Methods: One hundred and sixty two women with multifocal multicentric breast cancer diagnosed at our oncology center between January 2004 and December 2010 were retrospectively evaluated. Multifocality was defined as the presence of 2 or more foci of the tumor clearly separated in the same breast. Multicentricity was defined as the presence of 2 or more foci at different quadrants. Patients received neoadjuvant chemotherapy were excluded. Results: Median age of 162 women was 48 y ± 13,63 y. Eighty two of 162 patients were treated with breast-conserving surgery and 80 were treated with mastectomy. Radiotherapy was added to adjuvant therapy to patients with 4 or more positive axillary nodes and/or treated with breast conserving surgery. Three (1.8%) patients were excluded because of bilateral cancer and 1 (0.6%) was excluded because of Tx tumor. Eleven of 162 (6.7%) patients were not seen after surgery so data about adjuvant treatment was not known. Fifty of 147 patients were stage III, 68 were stage II and 30 were stage I. 27 (17.2%) patients received anthracycline based chemotherapy, 30 (20.3%) patients received hormonotherapy and 91 (56.1%) patients received taxane based chemotherapy. Trastuzumab added to the treatment at all patients, if HER2 neu-positive. Median follow up was 41 ± 4.1 (72-9 months) months. 30 systemic diseases at 24 patients were seen on follow up. 18 patients were in taxane group, 4 patients were in anthracycline group, 2 patients were in hormonotheraphy group. Nine patients were died in taxane group, 1 died in anthracycline group and 1 died in hormonotherapy group. Conclusions: Our retrospective analysis showed worst prognosis at taxane group but; patients with positive lymph nodes and perinodal invasion gets taxane based treatments. This retrospective analysis showed that systemic recurrence and survival in multifocal breast cancer are similar with unifocal disease.
Background and study aims: Due to their high morbidity and mortality, anastomotic leakage and dis... more Background and study aims: Due to their high morbidity and mortality, anastomotic leakage and disruption are still serious problems in colonic surgery. Bowel clamps applied during anastomosis in order to prevent abdominal contamination with colonic contents, may cause microcirculation and perfusion problems and subsequent ischemia-reperfusion injury. Papaverine, a myorelaxant and vasodilatator, and pentoxiphylline, a hemorrheologic agent are used for microcirculation disorders and vascular endothelial growth factor (VEGF) is a stimulator of angiogenesis. With this experimental study, we aimed to measure trace element [copper (Cu) and zinc (Zn)] levels in ischemia-reperfusion injury due to clamps after left colonic anastomosis in rats and show the effects of papaverine and pentoxiphylline on VEGF that stimulates angiogenesis in anastomotic healing. Materials and methods: 50 female Wistar albino rats were randomized in 5 groups (n: 10). Laparotomy in group 1, left colonic transsection and anastomosis in group 2, and clamp application 1 cm proximal and distal to the anastomosis (for about 20 minutes long) during left colonic transsection and anastomosis in groups 3, 4 and 5 were performed. Additionally, after the operations, pentoxiphylline (Group 4) and papaverin (Group 5) were injected intraperitoneally. On the 10th postoperative day, plasma trace element and plasma VEGF levels were measured. Results: In this study, VEGF levels in group 1 were significantly low and this was explained as being exposed to hypoxic damage less than the other groups. In group 3, VEGF levels were significantly higher showing that the hypoxic stimulus continued without any treatment and in Group 4, significantly lower than Group 3 related to the inhibition of pentoxiphylline. Lower VEGF levels in Group 1 were thought to be related to lower VEGF induction due to less hypoxic effect. Zinc, an important trace element of the antioxidant system showed significantly higher levels in Group 4 with pentoxiphylline treatment, and this was thought to be related to the antioxidant characteristics of pentoxiphylline. Conclusions: During surgical procedures, care should be taken not to cause ischemia to the intestinal tissues, and trace elements that are important in ischemia reperfusion injury should be replaced appropriately. Although the antioxidant effect of pentoxiphylline in ischemia reperfusion injury may be benefical in treatment, its inhibition of VEGF is a disadvantage in wound healing.
Metal ions are required as active components of several proteins, including pancreatic enzymes, a... more Metal ions are required as active components of several proteins, including pancreatic enzymes, and they can play important roles in the etiopathogenesis of acute pancreatitis. In the present study, we measured the concentrations of zinc (Zn) and copper (Cu) in both serum and pancreatic tissue, as markers of trace element status in an experimental acute pancreatitis model. Twenty-four male Wistar rats were divided into two groups: the experimental group (N=24) and the control group (N=10). Acute pancreatitis was induced by injection of 48% ethyl alcohol into the common biliary duct. The animals were sacrificed 24 h later to detect the concentrations of Zn and Cu. There was no significant difference in tissue Zn and Cu concentrations between control and experimental groups (p<0.05). However, in the acute pancreatitis group, serum Zn and Culevels were very significantly lower (p<0.001 and p<0.0001, respectively). In conclusuion, these findings suggested that altered mineral metabolism in serum and pancreatic tissue may have contributed to the pathophysiology of acute pancreatitis.
BACKGROUND Basic and clinical studies about parathyroid allotransplantation have to be utilized w... more BACKGROUND Basic and clinical studies about parathyroid allotransplantation have to be utilized with more definitive criteria for longer graft survival. Several reports demonstrated different isolation and cultivation methods for parathyroid cells to minimize their immunogenicity. In this study, we aim to compare and evaluate the clinical characteristics and the status of HLA class II expression changes in parathyroid tissue. METHODS A total of 22 parathyroid hyperplasia tissue donors was included in this study. Clinical characteristics were evaluated and compared with the HLA-DR, -DP, -DQ mRNA, and protein expression levels which were determined by qRT-PCR and Western blot. RESULTS We have compared the clinical characteristics (age, dialysis duration, frequency, recurrency of hyperparathyroidism and, calcimimetic usage) and HLA class II expression. HLA class II mRNA and protein levels showed varied expression patterns between tissues. Only, the HLA-DP has high mRNA expression levels without affecting the protein level when compared with the ages of the tissue donors. In addition, the HLA-DR, HLA-DP, and HLA-DQα1 protein expression levels showed a permanent and varied expression rate between tissues. CONCLUSION Expression of HLA class II molecules in parathyroid cells appears to constitute a decisive factor. Despite the lack of clinical outcomes, present data proposes new insight with a detailed understanding of parathyroid immunogenicity. In the future, randomized controlled clinical trials are needed for the accurate assessment of the effect of the varied HLA class II expression profiles in parathyroid tissue.
JPMA. The Journal of the Pakistan Medical Association, 2018
To investigate some of the new inflammatory and oxidative stress markers in acute appendicitis. T... more To investigate some of the new inflammatory and oxidative stress markers in acute appendicitis. This clinical pilot study was conducted at the emergency department of Bezmialem Vakif University, Istanbul, Turkey, between January and July 2015, and comprised patients with definitive diagnosis of acute appendicitis and as many healthy controls. Venous blood was collected to assess white blood cell count, C-reactive protein, raftlin, presepsin, total thiol, native thiol and disulphide levels. Alvarado scores of patients were determined at the time of admission. Surgical excisions were sent for pathological examination. The results of histopathology of appendectomy specimens were categorised as non-perforated or perforated appendicitis. There were130 subjects with 65(50%) patients and 65(50%) controls. Serum raftlin, presepsin, white blood count, C-reactive protein and disulphide levels were higher, and the total and native thiol levels were significantly lower in patients compared to c...
266 Background: The prognostic value of multifocal, multicentric breast cancer is still not well ... more 266 Background: The prognostic value of multifocal, multicentric breast cancer is still not well known. Although some studies have suggested that it is associated with a worst prognosis some have not suggest. We evaluated the effect of treatment modalities on overall survival and disease-free survival in breast cancer. Methods: One hundred and sixty two women with multifocal multicentric breast cancer diagnosed at our oncology center between January 2004 and December 2010 were retrospectively evaluated. Multifocality was defined as the presence of 2 or more foci of the tumor clearly separated in the same breast. Multicentricity was defined as the presence of 2 or more foci at different quadrants. Patients received neoadjuvant chemotherapy were excluded. Results: Median age of 162 women was 48 y ± 13,63 y. Eighty two of 162 patients were treated with breast-conserving surgery and 80 were treated with mastectomy. Radiotherapy was added to adjuvant therapy to patients with 4 or more positive axillary nodes and/or treated with breast conserving surgery. Three (1.8%) patients were excluded because of bilateral cancer and 1 (0.6%) was excluded because of Tx tumor. Eleven of 162 (6.7%) patients were not seen after surgery so data about adjuvant treatment was not known. Fifty of 147 patients were stage III, 68 were stage II and 30 were stage I. 27 (17.2%) patients received anthracycline based chemotherapy, 30 (20.3%) patients received hormonotherapy and 91 (56.1%) patients received taxane based chemotherapy. Trastuzumab added to the treatment at all patients, if HER2 neu-positive. Median follow up was 41 ± 4.1 (72-9 months) months. 30 systemic diseases at 24 patients were seen on follow up. 18 patients were in taxane group, 4 patients were in anthracycline group, 2 patients were in hormonotheraphy group. Nine patients were died in taxane group, 1 died in anthracycline group and 1 died in hormonotherapy group. Conclusions: Our retrospective analysis showed worst prognosis at taxane group but; patients with positive lymph nodes and perinodal invasion gets taxane based treatments. This retrospective analysis showed that systemic recurrence and survival in multifocal breast cancer are similar with unifocal disease.
Background and study aims: Due to their high morbidity and mortality, anastomotic leakage and dis... more Background and study aims: Due to their high morbidity and mortality, anastomotic leakage and disruption are still serious problems in colonic surgery. Bowel clamps applied during anastomosis in order to prevent abdominal contamination with colonic contents, may cause microcirculation and perfusion problems and subsequent ischemia-reperfusion injury. Papaverine, a myorelaxant and vasodilatator, and pentoxiphylline, a hemorrheologic agent are used for microcirculation disorders and vascular endothelial growth factor (VEGF) is a stimulator of angiogenesis. With this experimental study, we aimed to measure trace element [copper (Cu) and zinc (Zn)] levels in ischemia-reperfusion injury due to clamps after left colonic anastomosis in rats and show the effects of papaverine and pentoxiphylline on VEGF that stimulates angiogenesis in anastomotic healing. Materials and methods: 50 female Wistar albino rats were randomized in 5 groups (n: 10). Laparotomy in group 1, left colonic transsection and anastomosis in group 2, and clamp application 1 cm proximal and distal to the anastomosis (for about 20 minutes long) during left colonic transsection and anastomosis in groups 3, 4 and 5 were performed. Additionally, after the operations, pentoxiphylline (Group 4) and papaverin (Group 5) were injected intraperitoneally. On the 10th postoperative day, plasma trace element and plasma VEGF levels were measured. Results: In this study, VEGF levels in group 1 were significantly low and this was explained as being exposed to hypoxic damage less than the other groups. In group 3, VEGF levels were significantly higher showing that the hypoxic stimulus continued without any treatment and in Group 4, significantly lower than Group 3 related to the inhibition of pentoxiphylline. Lower VEGF levels in Group 1 were thought to be related to lower VEGF induction due to less hypoxic effect. Zinc, an important trace element of the antioxidant system showed significantly higher levels in Group 4 with pentoxiphylline treatment, and this was thought to be related to the antioxidant characteristics of pentoxiphylline. Conclusions: During surgical procedures, care should be taken not to cause ischemia to the intestinal tissues, and trace elements that are important in ischemia reperfusion injury should be replaced appropriately. Although the antioxidant effect of pentoxiphylline in ischemia reperfusion injury may be benefical in treatment, its inhibition of VEGF is a disadvantage in wound healing.
Metal ions are required as active components of several proteins, including pancreatic enzymes, a... more Metal ions are required as active components of several proteins, including pancreatic enzymes, and they can play important roles in the etiopathogenesis of acute pancreatitis. In the present study, we measured the concentrations of zinc (Zn) and copper (Cu) in both serum and pancreatic tissue, as markers of trace element status in an experimental acute pancreatitis model. Twenty-four male Wistar rats were divided into two groups: the experimental group (N=24) and the control group (N=10). Acute pancreatitis was induced by injection of 48% ethyl alcohol into the common biliary duct. The animals were sacrificed 24 h later to detect the concentrations of Zn and Cu. There was no significant difference in tissue Zn and Cu concentrations between control and experimental groups (p<0.05). However, in the acute pancreatitis group, serum Zn and Culevels were very significantly lower (p<0.001 and p<0.0001, respectively). In conclusuion, these findings suggested that altered mineral metabolism in serum and pancreatic tissue may have contributed to the pathophysiology of acute pancreatitis.
BACKGROUND Basic and clinical studies about parathyroid allotransplantation have to be utilized w... more BACKGROUND Basic and clinical studies about parathyroid allotransplantation have to be utilized with more definitive criteria for longer graft survival. Several reports demonstrated different isolation and cultivation methods for parathyroid cells to minimize their immunogenicity. In this study, we aim to compare and evaluate the clinical characteristics and the status of HLA class II expression changes in parathyroid tissue. METHODS A total of 22 parathyroid hyperplasia tissue donors was included in this study. Clinical characteristics were evaluated and compared with the HLA-DR, -DP, -DQ mRNA, and protein expression levels which were determined by qRT-PCR and Western blot. RESULTS We have compared the clinical characteristics (age, dialysis duration, frequency, recurrency of hyperparathyroidism and, calcimimetic usage) and HLA class II expression. HLA class II mRNA and protein levels showed varied expression patterns between tissues. Only, the HLA-DP has high mRNA expression levels without affecting the protein level when compared with the ages of the tissue donors. In addition, the HLA-DR, HLA-DP, and HLA-DQα1 protein expression levels showed a permanent and varied expression rate between tissues. CONCLUSION Expression of HLA class II molecules in parathyroid cells appears to constitute a decisive factor. Despite the lack of clinical outcomes, present data proposes new insight with a detailed understanding of parathyroid immunogenicity. In the future, randomized controlled clinical trials are needed for the accurate assessment of the effect of the varied HLA class II expression profiles in parathyroid tissue.
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Papers by Yeliz Emine Ersoy