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Öğe BÖBREK TÜMÖRÜ VAKALARININ RETROSPEKTİF OLARAK DEĞERLENDİRİLMESİ(2019) Devrim, TubaAmaç: Böbreğin epitelyal karsinomu olan renal hücre kanseri,yetişkin tümörlerin yaklaşık %2-4’ünü oluşturmaktadır. Renalhücre kanseri vakalarının yaklaşık %80’i berrak hücreli renalhücreli karsinom (RHK) olarak tanımlanmaktadır. Bu çalışmaile böbrek tümörleri sınıflamasındaki bilgilerin revize edilerekböbrek tümör arşivimizin gruplandırılması ve elde edilmişverilerle literatüre katkı sağlanması amaçlanmıştır.Gereç ve Yöntemler: Patoloji laboratuvarımızda, 2010-2019yılları arasında tanı alan 52 böbrek tümörü vakası histopatolojiktanı, tümör çapı ve nükleer dereceleri açısından retrospektifolarak tekrar gözden geçirildi.Bulgular: Vakaların 34’ü (%65) erkek, 18’i (%34) kadındı. Yaşaralığı, 33-85 arasında değişmekte olup, ortalama yaş 58 olaraktespit edildi. Elli iki böbrek tümörünün 34’ü (%65) berrakhücreli renal hücre karsinomu, 5’i (%10) kromofob renal hücrekarsinomu, 5’i (%10) papiller renal hücre karsinomu, 2’si (%3)onkositom ve 6’sı (%12) ise sınıflandırılamayan renal hücrekarsinomu idi. Tümörlerin 15’i (%34.1) nükleer derece (ND) 1,13’ü (%29.5) ND 2, 12’si (%27.3) ND 3 ve 4’ü (%9) ise ND 4olarak tespit edildi. En büyük tümör çapına sahip histolojik alttip 10.5 cm ile berrak hücreli renal hücre karsinom iken, enküçük çapa (1 cm) sahip histolojik tipin papiller renal hücrekarsinom olduğu tespit edildi.Sonuç: Renal hücre karsinomunda tümör tipi,sarkomatoid/rabdoid farklılaşması, tümör nekrozu vederecelendirmesi, potansiyel prognostik parametreler olarakkabul edilmektedir. Papiller renal hücre karsinomu alt tiplerinin(Tip 1 ve 2) belirlenmesi ek prognostik bilgi sağlamakta olup,berrak hücreli tubulopapiller renal hücre karsinomu daha iyi birprognoz ile ilişkilendirilmiştir. Sarkomatoid veya rabdoidfarklılaşması gösteren tümörler minimum bir tümör oranınabakılmaksızın belirtilmelidir. Makroskopik ve mikroskobikincelemeye dayalı değerlendirme ile tümör nekrozununprognostik önemi olduğu bildirilmektedir. Nükleol belirginliği,berrak hücreli ve papiller RHK’lerin 1 ila 3’lük derecelerinitanımlamaktadır. Aşırı nükleer pleomorfizm veya sarkomatoidve/veya rabdoid farklılaşma ise 4. derecedeki tümörlerigöstermektedir. Ayrıca pT evreleme kategorisinin ise prognostikönemlerini koruduğu bildirilmektedir.Öğe COEXISTENCE OF CD44 AND KI-67 AS THE PROGNOSTIC MARKERS IN RENAL CELL CARCINOMA(2020) Devrim, Tuba; Balcı, MahiObjective: An important feature of renal cell carcinoma (RCC) is its changeable prognosis. In recent years, several potential biomarkers have been investigated and confirmatory studies of these promising biomarkers are necessary to improve the clinical practice. In the present study, it was aimed to investigate the prognostic significance of CD44 expression by comparing it with Ki-67 and p53 in clear cell RCC. Material and Methods: Formalin- fixed, paraffin-embedded tissue sections of clear cell RCC from 34 patients, who had undergone radical or partial nephrectomy, were included in this study. Correlations between CD44, Ki-67 and p53 immunohistochemical expressions and clinicopathological parameters were determined. Results: CD44-high expression group (HEG) was significantly associated (p=0.035) and correlated (p=0.016, r=0.41) with a high nuclear grade. Similarly, the Ki-67-HEG was significantly associated (p=0.01) and correlated (p=0.01, r=0.436) with a high nuclear grade. We also found significant association (p<0.01) and correlation (p<0.01, r=0.621) between expressions of these markers. However, no antigen-antibody interaction was detected by p53 staining in clear cell RCC tissue sections. Conclusion: We concluded that increased expressions of CD44 and Ki-67 in tumour tissues predict an aggressive course of RCC patients.Öğe COMPREHENDING COVID-19: IMMUNOPATHOGENIC MECHANISMS OF CYTOKINE ACTION(2021) Akanbong, Elisha; Devrim, Alparslan Kadir; Şenol, Ali; Devrim, TubaCytokine release syndrome (CRS) or cytokine storm is as a result of the excess production of pro-inflammatory cytokines which is due to the disproportionate response of the immune system which can be instigated by SARS-CoV-2. COVID-19 which is caused by SARSCoV- 2 has a correlation with cytokines. SARSCoV- 2 instigates the production of IL-1 by ubiquitous macrophages and mast cells. IL-1 tends to influence the production of IL-6 and TNF-?. The progression of COVID-19 severity influences the level of certain cytokines such as IL-6. IL-6 is the cytokine chiefly responsible for the occurrence of CRS. CRS is the cause of COVID-19-related complications and the main cause of COVID-19-related deaths. Despite the data reported in the literature so far, the relationship between SARS-CoV-2 and cytokines has not been fully elucidated. The aim of the present review is to examine the relationship in question. Targeting cytokines during COVID-19 treatment has the potential to increase patient survival and reduce COVID-19-related deaths. It is concluded that focusing on the mechanisms of cytokine release and the effects of released cytokines, especially examining the effects on T lymphocytes and IFN-? production in COVID-19 disease, may help reduce the lethal effects of the disease.Öğe The concomitant use of USP28 and p53 to predict the progression of urothelial carcinoma of the bladder(ELSEVIER GMBH, 2020) Devrim, Tuba; Atac, Fatih; Devrim, Alparslan Kadir; Balci, MahiThe Ubiquitin Specific Peptidase 28 (USP28) is a deubiquitinase involved in the DNA damage pathway. Recently, USP28 protein is reported to play roles in the mechanism of p53 action and could be a possible prognostic marker for bladder cancer (BCa). This study aims to explore the relation of USP28 with tumor growth and invasion, and also to investigate the interplay between USP28 and p53 in BCa. Expression levels of USP28 and p53 in human BCa (invasive and non-invasive, n = 43) and control tissues (n = 8) were evaluated by immunohistochemistry and quantitative real-time polymerase chain reaction (qPCR) profiling. The relationship between protein and gene expression levels, clinicopathologic features and prognosis were evaluated. Significant positive correlations were found between BCa tumor progression and the USP28 expression, and also between the USP28 and p53 scores (p all < 0.05). Immunohistochemistry staining percentages were strongly correlated between USP28 and p53, and also positive correlations between tumor progression and p53 expressions were determined (p all < 0.001). Interestingly, USP28 and p53 were highly expressed and correlated in BCa. Consequently, the immunohistochemistry and qPCR results reported in our study suggested the idea that USP28 in coordination with p53 could serve as a marker in BCa progression.Öğe Could erythropoietin reduce the ovarian damage of cisplatin in female rats?(Taylor & Francis Ltd, 2018) Sayan, Cemile Dayangan; Tulmac, Ozlem Banu; Karaca, Gokhan; Ozkan, Zehra Sema; Yalcin, Selim; Devrim, Tuba; Badem, Nermin DindarThe aim of this study is to investigate whether erythropoietin (EPO) can reduce the ovarian damage of cisplatin or not. Thirty, female, Wistar-Albino rats were used in the study. Control group (N=10): Intraperitoneal saline infusion, Cisplatin group (N=10): Intraperitoneal 7mg/kg cisplatin, Cisplatin+EPO group (N=10): Intraperitoneal 7mg/kg cisplatin and subcutaneous 200IU/kg/day EPO. Serum AMH concentrations were measured by enzyme-linked immunosorbent assay kit of AMH. Follicular counts were evaluated according to mean diameter of the follicles. Ovarian damage; including follicular cell degeneration, vascular congestion, hemorrhage, and inflammation was scored histologically using a graduated scale. Posttreatment AMH levels of cisplatin group were significantly lower than control and cisplatin+EPO groups. In cisplatin group, there was a significant decrement in posttreatment AMH level compared to pretreatment AMH level. The total damage score of cisplatin group was significantly higher than scores of control and cisplatin+EPO groups. The mean primordial follicle counts of control and cisplatin+EPO groups were significantly higher than that of cisplatin group (p=.007 and p=.003). The results of this study revealed that EPO administration to cisplatin chemotherapy could ameliorate the ovarian damage. Erythropoietin administration to chemotherapeutic agents might suggest to protect ovarian failure and infertility.Öğe Effect of ondansetron for preventing of ovarian hyperstimulation syndrome: in an experimental rat model(Taylor & Francis Ltd, 2022) Bakirci, Suekrue; Sagsoez, Nevin; Devrim, Tuba; Sahin, Yasar; Bulanik, Murat; Goezueyukari, HilalObjective: Ovarian hyperstimulation syndrome is an iatrogenic condition that occurs in the treatment of infertility. There is no specific treatment available for OHSS. Cabergoline is a dopamine receptor 2 agonist and VEGF-VEGF2 receptor antagonist . Recently, cabergoline has been widely used to prevent the development of OHSS and reduce its severity Serotonin is known as a neurotransmitter and thought to have a role in the mechanism of angiogenesis and in signaling in endothelial cells. Serotonin is said to have similar effects to VEGF . Ondansetron is Selective Serotonin (5-HT3) Receptor Antagonist . It works by blocking the action of serotonin, a natural substance that may cause nausea and vomiting. In the clinical practice today, there is no choice other than cabergoline, to prevent occurrence and reduce severity of OHSS, and sometimes its effects are limited. Methods: In our study, we compared the effect of cabergoline and ondansetron. 32 immature rats were used and the OHSS model was created. Parameters such as hematocrit value , ovarian size, the number of follicles in the ovary, endometrial capillary congestion and thickness values were evaluated and compared. Results: As a result, in our study, it was seen that ondansetron was effective on OHSS in many parameters. It is thought to be as effective as cabergoline. When we look at the literature, this is the first study in which ondansetron was evaluated for this purpose. It would be good to show this effect of ondansetron with other studies.Öğe The Effects of Periostin in a Rat Model of Isoproterenol: Mediated Cardiotoxicity(Humana Press Inc, 2018) Sozmen, Mahmut; Devrim, Alparslan K.; Kabak, Yonca B.; Devrim, Tuba; Sudagidan, MertPeriostin is an extracellular matrix protein from fasciclin family, and it plays an important role in the cell adhesion, migration, and growth of the organism. Periostin prevents apoptosis while stimulating cardiomyocytes. The present study was designed to investigate cardioprotective effects of the recombinant murine periostin peptide administration in a rat model of isoproterenol (ISO)-induced myocardial injury. The experiment was performed on 84 adult male Sprague Dawley rats in 4 groups (n = 21): control group (1), periostin-treated group (2), ISO-treated group (3), and ISO + periostin-treated group (4). The groups were further divided into three subgroups based on the duration of the experiment in which rats were killed on days 1, 7, and 28 (n = 7). Growth factors (VEGF, ANGPT, FGF-2, TGF beta), mitosis and apoptosis (Bcl-2, Bax, PCNA, Ki-67, phospho-histone H3), cell cycle activators and inhibitors (cyclin D1, D2, A2, Cdc2), the origin of regenerating cells (cKit and CD45) mRNA were detected using quantitative real-time polymerase chain reaction (PCR) and PCR array. Immunohistochemistry staining was used to directly detect protein level and distribution in the heart tissues. Administration of periostin following ISO-induced cardiotoxicity revealed that periostin alleviated deleterious effects of ISO through several pathways: (1) periostin induced mitotic activity of endothelial/fibroblastic cells, (2) periostin drives cardiomyocytes into S and M phases, thus promoting proliferation of cardiomyocytes, (3) periostin contributed to collagen degradation, tissue remodeling, and reduced cardiac fibrosis during the healing process following myocardial damage while preserving tissue matrix, (4) periostin stimulated angiogenesis by upregulating THBS1, TGFB2, and HGF genes, (5) periostin regulated cell growth and proliferation while maintaining cell shape and cellular muscle contractions (ACTB) and functioned as chemoattractant factor (CCL2) at the beginning of myocardial damage.Öğe Healing of Ischemic Colon Anastomosis in Rats Could Be Provided by Administering Dexpanthenol or Coenzyme Q10(Mdpi, 2018) Pehlivanli, Faruk; Aydin, Oktay; Karaca, Gokhan; Aydin, Gulcin; Devrim, Tuba; Bulut, Huri; Daphan, Cagatay ErdenBackground: In this study, the effectiveness of dexpanthenol and coenzyme Q10 (CoQ10) on the healing of ischemic colon anastomosis was investigated. Methods: Forty eight maleWistar Albino rats were divided into four equal groups (Sham-S, Sham-I, DXP, Q10). Following full layer colon resection, single layer colon anastomosis, without creating ischemia, was performed on the Sham-S group. The same experimental model was performed on remaining groups after ischemia was created. Intraperitoneal dexpanthenol and CoQ10 was administered to the DXP and Q10 groups once a day for three days. Ten days later, all colon anastomoses were investigated histopathologically and biochemically, as well as their burst pressure values, in all sacrificed rats. Results: The highest burst pressure value was observed in the Sham-S group, decreasing from high to low in the DXP, Q10, and Sham-I groups, respectively (p = 0.008). Furthermore, tissue hydroxyproline (p = 0.001) level values were significantly different among the groups. Additionally, histopathological analysis revealed a significant difference among groups regarding reepithelization (p = 0.027) and polymorphonuclear leukocyte density (p = 0.022). Conclusions: This preliminary study has shown that ischemia-reperfusion injury may impair the healing of colon anastomosis and it has been concluded that dexpanthenol and CoQ10 may have positive effects on the healing of ischemic colon anastomosis in rat, although re-epithelization may be adversely affected using CoQ10.Öğe Intralesional Avirulent Bacillus Calmette-Guerin Injection as a Promising Method for the Treatment of Tuberculosis Verrucosa Cutis(Karger, 2022) Gunduz, Ozgur; Kocak, Gulsah; Kacmaz, Birgul; Devrim, Tuba; Simsek, HulyaCutaneous involvement is a relatively uncommon manifestation of tuberculosis (TB), particularly outside the endemic regions. Cutaneous TB manifests itself in various clinical forms, depending on the host's immune status and mode of transmission. Nonetheless, the same treatment regimen is recommended for every subtype. Tuberculosis verrucosa cutis (TBVC) is a specific subgroup in which the affected persons are usually healthy adults who are vaccinated or exposed to mycobacteria during their occupational activities. These patients have the ability to launch a strong cellular immune reaction against mycobacteria. In this article, we present an elderly patient with a 4-year history of TBVC who was treated with intralesional injection of avirulent Bacillus Calmette-Guerin (BCG) and report our clinical observation on the inflammatory and healing process of the patient's lesion following the intralesional BCG injection.Öğe Lichen Planus Pigmentosus-Inversus: A Report of Two Cases(2019) Demirkan, Serkan; Gündüz, Özgür; Devrim, TubaLichen planus pigmentosus (LPP)-inversus has been identified in a few East European cases primarily intertriginous areas such as axilla and groin which is not contacting with sunlight, and involvement in other skin areas was rarely detected. Because the lesions are similar to LPP in clinical and histological appearance, this condition, which is characterized by hyperpigmented, brown macules or plaques, is called LPP-inversus. Until today, actinic LP, linear LP, zosteriform, and LP pigmentosus clinical subtypes of lichen planus have been described. LPP-inversus is a rare form of LP and so far, there have been few case reports. LPP-inversus has been reported mostly in Caucasians and Asians, and axilla was the most involved body region. In a small proportion (approximately 10%) of the cases, classical LP or LPP lesions may be located outside the flexural areas. So far, about 50 cases have been reported; also we presented two new cases that we diagnosed.Öğe MEME KANSERİ BİYOPSİ ve REZEKSİYON MATERYALLERİNDE HORMON RESEPTÖRLERİ (ER/PgR) ve HER2 DEĞERLERİNİN KARŞILAŞTIRILMASI(2020) Devrim, Tuba; Balcı, MahiAmaçMeme kanseri tanısı almış olgularda, tanısal biyopsive rezeksiyon materyalleri arasında histopatolojiközelliklerin tanısal uyumunun değerlendirilmesi vehistolojik derece, tümör moleküler alt tipleri, östrojenreseptörü (ER), progesteron reseptörü (PgR) veHER2 düzeylerinin karşılaştırılarak sonuçların literatüreşliğinde irdelenmesi amaçlanmıştır.Gereç ve YöntemKırıkkale Üniversitesi Tıp Fakültesi Tıbbi Patoloji AnabilimDalı’nda Ocak 2013 ve Haziran 2019 tarihleriarasında malign tanı almış, meme tanısal biyopsi verezeksiyon materyalleri bulunan hastalara ait patolojiraporları incelendi. Her iki materyali de bölümümüzdebulunan 14 olgunun, hemotoksilen-eozin ve immünhistokimyasalER, PgR ve HER2 preparatları arşivdençıkarılarak tekrar değerlendirildi. Sonuçlar arasındakiuyum düzeyi istatistiksel olarak analiz edildi.BulgularMeme karsinomu tanısı alan olguların tanısal biyopsive rezeksiyon materyalleri arasındaki tümör histolojikderece uyumu % 78,5 olarak saptandı. Her iki materyalarasında biyobelirteç skor uyumluluğu ER için% 100, PgR için %92,8 ve HER2 için % 78,5 olarakbelirlendi. Moleküler alt tiplendirmedeki uyum ise %88,9 olarak saptandı.SonuçÇalışmamız kapsamındaki meme karsinomu vakalarınaait tanısal biyopsi ve rezeksiyon materyalleri arasında;tümör derecesi, ER/PgR ekspresyonu, HER2skorları ve moleküler alt tiplerin belirlenmesi bakımındanyüksek oranda uyum saptandı. Uyumsuzlukbelirlenen vakalarda ise, rezeksiyon materyallerinin,tümörün daha yüksek dereceli alanlarını içermesi ve/veya doku takip prosesinden kaynaklanabileceği düşünüldü.Söz konusu yüksek uyum oranı, tümörünhistopatolojik özelliklerinin belirlenmesi ve tedaviyipredikte eden biyobelirteç çalışılması için tanı amaçlıbiyopsi örneklerinin güvenle kullanılabileceğini göstermektedir.Öğe Meme Kanseri Olgularının Retrospektif Değerlendirilmesi(2020) Devrim, Tuba; Akkaya, Merva Aydemir; Atasoy, Pınar; Balcı, Mahi; Altunkaya, Canan; Zengin, MehmetAmaç:Bu çalışma ile meme kanseri tanısı almış kadınlarda klini-kopatolojik parametrelerin retrospektif olarak değerlendirilmesi ve moleküler alt tiplerin araştırılması amaçlandı.Materyal ve Metot:Çalışmamız kapsamında Kırıkkale Üniversitesi Tıp Fakültesi Tıbbi Patoloji Anabilim Dalı arşivi taranarak Ocak 2007- Haziran 2019 tarihleri arasında meme kanseri tanısı verilmiş 191 hasta incelendi.Bulgular:İncelenen histopatolojik tümör tipleri, meme tümörlerinin Dünya Sağlık Örgütü 2012 sınıflamasına göre, en yüksek oranda (%89) özel tip olmayan (NST, duktal) meme kanseri olgularına ait olduğu belirlendi. Tümör çapı bakımından en büyük grubu (%48,7) 2–5 cm arası olan olguların oluşturduğu anlaşıldı. Modifiye Scarff-Bloom-Richardson ile değerlendirilen meme kanseri derece 2 (%55,5) tümörler, çalışmamızdaki en büyük grubu oluşturdu. Yaş grubu arttıkça tümör derecesinin arttığı istatistiksel olarak anlamlı düzeyde (p<0,001) belirlendi. Tümörlerde, hormon reseptörleri (ER ve PgR) ile yüksek oranda boyanma saptandı. Hastaların %61,2’sin-de lenf nodu invazyonu belirlendi. Bölgesel lenf nodu evresi (pN) 0 olan hastalar %38,8 ile en büyük grubu oluşturdu. Moleküler alt tip bakımından ise en çok (%48,2) luminal A (LA) tipi izlendi. Bunu luminal B (LB) (%37,4), HER2 overeksprese (HO) (%10,8) ve triple negatif (TN) (%4,6) oranları takip etti. LB’nin, LA’ya göre histolojik tümör derecesi bakımından daha ileri olduğu (p<0,001) anlaşıldı. Tümör derecesi HO ve TN’de LA’ya göre daha ileri (p<0,005) dü-zeyde saptandı. Tümör çapı bakımından ise HO, LA’ya göre yüksek düzeyde tespit (p<0,05) edildi. TN’de HO’ya göre daha büyük bir yaş düzeyi (p<0,05) saptandı.Sonuç:Heterojen bir tümör olan meme kanserinde, tümör derece-si en önemli prognostik faktörlerden biridir. Çalışma verilerimiz bir arada değerlendirildiğinde, meme kanseri moleküler alt tiplerinin belirlenmesinin rutin histopatolojik analiz için önemli yararlar sağla-yacağı kanısına varılmışÖğe MEME KANSERİNDE MOLEKÜLER ALT TİPLERİN KLİNİKOPATOLOJİK ÖZELLİKLERLE İLİŞKİSİ(2020) Bozkurt, Kemal Kürşat; Ciriş, İbrahim Metin; Durak, Özlem; Kapucuoğlu, Nilgün; Devrim, TubaAmaçMeme kanserinde, moleküler alt tiplerin, klinikopatolojiközellikler (tanı yaşı, histolojik tip, histolojik derece,pT ve pN evreleri) ile ilişkilerinin tespit edilmesiamaçlanmıştır.Gereç ve YöntemÇalışma grubu 194 kadın meme kanseri içermekteydi.Süleyman Demirel Üniversitesi Tıp Fakültesi TıbbiPatoloji Anabilim Dalı arşivi taranarak 2010-2015 yıllarıarasında meme kanseri tanısı verilmiş olgulara aitbiyopsi ve radikal meme rezeksiyonu materyallerininpreparatları tekrar incelendi. Olguların immünhistokimyasalER, PgR, HER2 ve Ki67 boyalı preparatlarıtekrar değerlendirilerek moleküler alt tiplendirme yapıldı.BulgularTümör moleküler alt tipleri; %47,4 olguda Luminal A[ER ve/veya PgR(+)/HER2(-)/Ki67 ? %14], %25,8 olgudaLuminal B [ER ve/veya PgR(+)/HER2(+) veya(-) /Ki67 > %14], %13,4 olguda HER2 overeksprese[ER(-)/PgR(-)/HER2(+)] ve %13,4 olguda ise üçlünegatif [ER(-)/PgR(-)/HER2(-)] idi. Tümör derecesive aksiller lenf nodu metastazı; Luminal B, HER2overeksprese ve üçlü negatif tümörlerde Luminal Atümörlere göre daha yüksek izlendi. Luminal tip tümörlerlekarşılaştırıldığında, HER2 overeksprese veüçlü negatif tümörlerde lenfovasküler invazyon oranıanlamlı olarak daha fazla idi.SonuçHeterojen bir tümör grubu olan meme kanserlerindeevre ve diğer iyi bilinen klinikopatolojik özelliklerin yanındamoleküler alt tiplendirmenin de hasta yönetimiiçin faydalı bilgiler verebileceği sonucuna varılmıştır.Öğe Non-Sebaceous Lymphadenoma: A Rare Salivary Gland Tumor(2020) Balcı, Mahi; Akkaya, Merva Aydemir; Devrim, TubaLymphadenomas comprise a very rare group of salivary gland tumors, the two types of which are defined as sebaceousand non-sebaceous lymphadenomas. In the case presented here, a patient presented with swelling in the right parotid gland, and themass seen by ultrasonography was suggestive of pleomorphic adenoma. According to fine needle aspiration biopsy, the presence oflymphoid and epithelial cells first suggested a diagnosis of Warthin tumor. However, the presence of cystic degenerated ductalstructures and the solid, benign nature of the epithelial islands intertwined with mature lymphoid cells in the biopsied specimenshowed no sebaceous differentiation, and thus, the case was reported as “non-sebaceous lymphadenoma.” We aimed to present therelevant literature and our case of non-sebaceous lymphadenoma, whose clinicopathological features and etiopathogenesis are notclearly understood, since it is considered to be underreported due to its sonographic and histomorphological similarities topleomorphic adenoma and Warthin tumor.Öğe Photodermatitis Following the Use of Pirfenidone in a Patient with Idiopathic Pulmonary Fibrosis: an Ultraviolet Recall Reaction(2020) Baççıoğlu, Ayse; Kalpaklıoğlu, Ayşe Füsun; Devrim, TubaUltraviolet recall is a photodermatitis reaction that can occur in prior ultraviolet burned skin during the administration of systemic medication. No such reaction has been reported with pirfenidone. We report here on a 75-year-male patient who developed acute erosive erythema on his face, forearms and hands under pirfenidone treatment for idiopathic pulmonary fibrosis after 4 months. The initial diagnosis was drug eruption, since it developed after the initiation of pirfenidone, in accordance with hypereosinophilia and solar dermatitis on a skin biopsy, all of which improved with discontinuation. However, the patient tolerated the rechallange test with pirfenidone. The presence of necrotic keratinocytes in a skin biopsy and exaggerated dermatitis was unlikely for photo dermatitis, but supported an ultraviolet recall reaction. Pirfenidone was resumed in a tapered dose, and the patient was successfully followed up for 5 months for a relapse of skin reaction, as well as IPF disease activity. This case is important in indicating that the drug can be tolerated with dose adjustment in the presence of an ultraviolet recall reaction in contrast to discontinuation need in drug allergy.Öğe Prostat Adenokarsinomunda İğne Biyopsisi Ve Radikal Prostatektomi Örneklerinden Elde Edilen Gleason Skor Sonuçlarının Değerlendirilmesi(2019) Devrim, Tuba; Balcı, MahiAmaç: Bu çalışmada, prostat adenokarsinomunda iğne biyopsi (İB) ve radikal prostatektomi (RP) materyalleri, histopatolojik olarak karşılaştırılarak, prognozda önem arz eden Gleason skor ve grade grup sınıflamalarının uyumunun değerlendirilmesi amaçlandı. Gereç ve Yöntem: Kırıkkale Üniversitesi Tıp Fakültesi Tıbbi Patoloji Anabilim Dalı’nda, 2013-2018 yılları arasında 42 adet, prostat adenokarsinomu tanısı almış olan hastaya ait RP ve İB materyalleri histopatolojik olarak değerlendirildi. Bulgular: Çalışma kapsamındaki 42 olgunun ortalama yaşı 61,1 (48-79) ve serum PSA düzeyleri 4 ng/ml (0,03-26,320 ng/ml) idi. Otuz olguda İB ve RP Gleason skorlarında birebir, 12 olguda ise 1 grade skoru farkla uyum tespit edildi. Benzer şekilde RP materyalinde de 6 (%14,2) hastada grade grup skorunda İB’ye göre azalma (düşük skor verme, down-grade), 8 (%19) hastada ise artma (yüksek skor verme, up-grade) belirlenirken 28 (%66,6) hastada ise birebir uyum saptandı. RP ve İB örneklerinde Gleason (p<0,001, kappa= 0,524) ve grade grup (p<0,001, kappa= 0,490) skorları karşılaştırıldığında istatistiksel olarak anlamlı tutarlılıklar tespit edildi. Sonuç: Literatürde İB ve RP materyallerine verilen Gleason skorlarındaki tam uyumluluk oranları %28,2-68 arasında bildirilmiştir. Bu çalışmada ise incelenen İB ve RP örnekleri arasındaki literatüre kıyasla yüksek düzeyde (%71,4) uyum belirlendi. İB ve RP örnekleri arasında Gleason skor uyumsuzluğunun başlıca nedenleri olarak; tümörün multifokal dağılımı, gözlemciler arası uyumsuzluk ve Gleason skor aralığının darlığı olarak düşünüldü.Öğe Rare Plasmacytoid Urothelial Carcinoma of the Bladder: Two Case Reports(Urol & Nephrol Res Ctr-Unrc, 2019) Devrim, Tuba; Atac, Fatih; Altunkaya, Canan; Ozbek, Aye; Ozdemir, Gulhan; Eryol, MervePlasmacytoid urothelial carcinoma is a rare and aggressive form of urothelial carcinoma characterized with delayed presentation and poor prognosis. Very few cases of this carcinoma have been reported in the literature. Here, we report and discuss two cases of bladder plasmacytoid urothelial carcinoma of a 57-year-old male presented with renal colic, and a 33-year-old female presented with macroscopic hematuria. Pathologic examinations of the transurethral biopsies revealed urothelial carcinoma with plasmacytoid appearance. Subsequently, immunohistochemical evaluation showed positive expression of epithelial markers and CD138. Additionally, losing of the membranous expression of E-cadherin verified the diagnosis of plasmacytoid urothelial carcinoma.Öğe Rectal pyogenic granulomas: an uncommon cause of gastrointestinal bleeding(Aves, 2018) Devrim, Tuba; Utku, Ozlem Gul; Oguz, Dilek…Öğe Skin necrosis: An uncommon side effect of warfarin therapy(2019) Devrim, Tuba; Demirkan, SerkanWarfarin is commonly used in the treatment and prevention of thromboembolic events. However, it is known to undesirably cause hypercoagulable conditions, including warfarin-induced skin necrosis (WISN). This report describes a 70-year-old man presented with an extensive WISN while an inpatient for treatment of a left deep femoral vein thrombosis. He had a background of colon adenocarcinoma and multiple metastatic foci in the liver.Öğe The effect of krill oil on Wnt/ß-catenin signaling pathway in acetaminophen-induced acute liver injury in mice(De Gruyter Open Ltd, 2023) Şahin, Yaşar; Devrim, Alparslan Kadir; Alçiğir, Mehmet Eray; Şenol, Ali; Ekici, Hüsamettin; Devrim, Tuba; Sudağidan, MertObjectives: This study investigated the effect of krill oil (KO) on liver damage caused by acetaminophen (APAP). Methods: In the present study, the control and APAP groups were given distilled water by gavage for 14 days. In addition, the KO and APAP+KO groups were given 500 mg/kg krill oil by gavage for 14 days. At the end of 14 days, 0.9 % sodium chloride solution (saline solution) administration was applied intraperitoneally to the control and KO groups. Meanwhile, 220 mg/kg acetaminophen was administered to the APAP and APAP+KO groups. While some biochemical parameters in plasma were examined, some oxidative stress parameters in plasma and liver tissue were evaluated. Apoptotic and inflammatory responses of some primer sequences determined by quantitative Real-Time PCR (qPCR) in liver tissue. After histopathological examination of liver tissue, immunohistochemical analysis was performed with Wnt inhibitory factor-1 (Wif-1), beta-catenin (ß-Catenin), and 8-hydroxy-2'-deoxyguanosine (8-OHdG). Results: The Wif-1 positivity in hepatocytes increased significantly in the APAP group (5.29 ± 0.71) compared to the control (1.14 ±0.51), and KO (2.14 ± 0.55) groups (p<0.001). The 8-OHdG positivity in hepatocytes increased significantly in the APAP group (19.57 ± 0.58) compared to the control (0.43 ± 0.20), KO (3.57 ± 0.48), and APAP+KO (4.00 ± 2.53) groups (p<0.001).Conclusions: As a result, krill oil could be used as a nutritional supplement to protect the liver against acetaminophen-induced liver injury. © 2023 De Gruyter. 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