Gaye Tezel - Academia.edu (original) (raw)

Papers by Gaye Tezel

Research paper thumbnail of Comparison of Clinicopathologic Parameters and Survivals Between Epstein-Barr Virus-positive and Her2-positive Gastric Cancers

Applied immunohistochemistry & molecular morphology : AIMM / official publication of the Society for Applied Immunohistochemistry, Jan 3, 2016

Gastric carcinomas are highly mortal neoplasms for which new therapeutic options are being search... more Gastric carcinomas are highly mortal neoplasms for which new therapeutic options are being searched. The molecular subtyping of gastric adenocarcinomas was proposed recently, and the relationship between etiopathogenetic types is still under investigation. Here we compared histopathologic, prognostic, and survival differences between Epstein-Barr virus (EBV)-positive and Her2-positive gastric adenocarcinomas. In a retrospective design, we searched the EBV status with Epstein Barr Virus encoded small RNA (EBER) in situ hybridization, and the Her2 status both by immunohistochemistry and by chromogenic in situ hybridization of 106 gastrectomized gastric carcinomas. Histologic and clinical prognostic parameters and survival information were determined, and retrieved from archival tissues and clinical notes. The Her2 positivity rate was 12.3% and the EBV positivity rate was 7.6%. Among EBER-positive cases, Her2 positivity was not detected. Her2 positivity was detected more in intestinal ...

Research paper thumbnail of Genetic Alterations in Differentiated Thyroid Cancers

Endocrine, Metabolic & Immune Disorders - Drug Targets, 2009

Differentiated thyroid cancers are the predominant malignancies of the thyroid. Due to advances i... more Differentiated thyroid cancers are the predominant malignancies of the thyroid. Due to advances in the understanding of the activation of the cell proliferation pathway at a molecular level, multiple genetic alterations have been linked to the development of thyroid carcinogenesis. Although the genetic alterations can be categorized into 7 categories, the BRAF mutation, RET/PTC, Pax8/PPARGamma, and dysfunctional Fas pathway have been most commonly described. Each of the gene alterations can ultimately result in cancer development, invasion and/or metastasis. This article provides a detailed review of the altered cell proliferation pathway activations found in thyroid carcinogenesis. The molecular targets that may be disrupted by therapeutic agents during the abnormal proliferation are also summarized.

Research paper thumbnail of Melanomda Moleküler Patoloji ve Karsinogenez

Turkiye Klinikleri Medical Oncology - Special Topics, 2014

Research paper thumbnail of Expression of glial cell line-derived neurotrophic factor correlates with perineural invasion of bile duct carcinoma

Research paper thumbnail of The role of apoptosis in blepharoptosis

Eye, Apr 19, 2013

Purpose The purpose of this study is to evaluate the role of apoptosis in the pathogenesis of ble... more Purpose The purpose of this study is to evaluate the role of apoptosis in the pathogenesis of blepharoptosis. Patients and methods Forty-five eyelids of 43 consecutive patients (16 female, 27 males) that underwent levator resection surgery for ptosis correction were included in the study. Twenty-six of the eyelids had congenital myogenic ptosis and 19 had aponeurotic ptosis. Levator palpebrae superioris function and height of the vertical palpebral fissure were measured in all patients. After levator resection surgery, the distal part of the levator aponeurosis was fixed and sent for evaluation. Apoptotic cells were detected using Apop Tag Plus Peroxidase In Situ Apoptosis Detection Kit. Results The mean levator palpebrae superioris function was 8.4 mm (range 5-10 mm) in congenital ptosis group and 12.1 mm (range 10-17 mm) in the aponeurotic ptosis group. The mean height of the vertical palpebral fissure in patients with congenital ptosis and aponeurotic ptosis were 6.5 mm (range 5-9 mm) and 6.1 mm (3-9 mm), respectively. The mean apoptotic index of congenital ptosis and aponeurotic ptosis were 27.3 (16-39) and 29.8 (18-41), respectively. There was no statistically significant difference between congenital and aponeurotic ptosis groups in a mean apoptotic index (Po0.05). Apoptotic index was not correlated with age, levator palpebrae superioris function, palpebral fissure height, and lid crease height in two groups. Conclusion We found no statistically significant difference between two subtypes of blepharoptosis regarding apoptosis. According to this study, apoptosis seems to have no significant role in the development of aponeurotic blepharoptosis.

Research paper thumbnail of Human papillomavirus infection in patients with laryngeal carcinoma

BMC Cancer, Oct 20, 2018

This study evaluated the ultrasound (US) features of 20 patients with MAGI and concomitant papill... more This study evaluated the ultrasound (US) features of 20 patients with MAGI and concomitant papilloma virus (HPV) infection compared to 20 patients with microbial (presence of Chlamydia trachomatis alone) MAGI and 20 patients with amicrobial (inflammatory) MAGI. Patients with HPV infection showed significantly (< 0.05) higher total prostate, seminal vesicles, and epididymal US signs (18.0 ± 2.0) compared to the other 2 groups (12.0 ± 4.0 versus 10.0 ± 3.0, resp.). In addition, patients with MAGI and HPV had a higher prevalence of complicated forms of MAGI [prostatovesiculitis (PV) and prostate-vesiculo-epididymitis (PVE)] and a higher frequency of the fibrosclerotic variant compared to the other groups (70.0 ± 10.0% versus 48.0 ± 5.0% versus 15.0 ± 10.0%). Moreover, HPV infected patients had a higher number of US criteria suggestive for MAGI in the periurethral region of the prostate compared to the other groups. In particular, the patients showed a higher ratio between periurethral and lobar US criteria distribution (5.0 versus 0.5). Finally, the seminal fluid concentration of CD45 pos leukocytes (2.0 ± 0.2 versus 1.3 ± 0.3 versus 1.0 ± 0.3 mil/mL) was significantly higher and sperm progressive motility was significantly lower in these patients compared to other groups.

Research paper thumbnail of Vascular endothelial growth factor, vascular endothelial growth factor receptor-3 and cyclooxygenase-2 expression in psoriasis

PubMed, Dec 1, 2007

Objective: To investigate expression patterns and relationship of vascular endothelial growth fac... more Objective: To investigate expression patterns and relationship of vascular endothelial growth factor (VEGF), vascular endothelial receptor-3 (VEGF-R3) (FLT-4) and cyclooxygenase-2 (COX-2) in psoriasis. Study design: Forty-three patients were included in this study. The clinical severity of psoriasis was assessed using the psoriasis area and severity index (PASI). Punch biopsy samples both from psoriatic and nonlesional skin were taken and VEGF, VEGF-R3 and COX-2 expressions determined. Results: VEGF, VEGF-R3 and COX-2 expressions were detected in 90.9%, 78.0% and 86.4% of psoriatic and 84.1%, 71.8%, and 84.1% of nonlesional skin, respectively. Epidermal VEGF, VEGF-R3 and COX-2 expressions were detected in 56.8%, 77.8% and 34.1 of psoriatic and 75%, 78.1% and 65.9% of nonlesional skin, respectively. In dermis, VEGF, VEGF-R3 and COX-2 expression was observed in 88.6%, 77.5% and 84.1% of psoriatic and 81.8%, 64.1% and 77.3% of nonlesional skin, respectively. Among the PASI subgroups no statistically significant differences were detected for VEGF, VEGF-R3 and COX-2 expression. Conclusion: Our study demonstrated that VEGF, VEGF-R3 and COX-2 expression in psoriatic and nonlesional skin is significantly high in epidermis and dermis. Although there was significant concordance between VEGF and VEGF-R3 expressions in psoriatic lesions, there seems to be no concordance between the others.

Research paper thumbnail of Expressions of vascular endothelial growth factor and CD34 in oral aphthous lesions of Behçet's disease

PubMed, Dec 1, 2006

Objective: Behçet's disease (BD) is an immunoin-flammatory vasculitis with an unknown etiopathoge... more Objective: Behçet's disease (BD) is an immunoin-flammatory vasculitis with an unknown etiopathogenesis. Vascular endothelial growth factor (VEGF) is a cytokine-stimulating angiogenesis. It has been suggested to play a role in inflammation and pathogenesis of vasculitic processes. Study design: VEGF and CD34 expressions were assessed in samples taken from oral aphthous lesions. The patients were evaluated for disease activity, duration of lesions, serum C-reactive protein (CRP) levels and erythrocyte sedimentation rate (ESR). Results: Twenty-six patients were included. Fourteen (53.9%) had increased CRP levels and 12 (46.1%) had increased ESR levels. Positive VEGF and CD34 staining were detected in 46.2% and 69.2% of biopsy samples, respectively. There was good positive correlation between them. The frequency of positive VEGF and CD34 staining was statistically higher in lesions with a duration of more than 6 days. No correlation was found between positive VEGF staining and serum CRP level, ESR and disease activity. Conclusion: Increased VEGF expression in correlation with CD34 positivity in oral aphthous lesions may show the role of VEGF in pathogenesis of these vasculitic lesions. We have concluded that VEGF may play a role during the course of oral aphthous lesions in BD.

Research paper thumbnail of Expression of Vascular Endothelial Growth Factor-A, Matrix Metalloproteinase-9, and Extravascular Matrix Patterns and Their Correlations with Clinicopathologic Parameters in Posterior Uveal Melanomas

Japanese Journal of Ophthalmology, Sep 1, 2007

Purpose: To assess extravascular matrix patterns (EMP) and expression of vascular endothelial gro... more Purpose: To assess extravascular matrix patterns (EMP) and expression of vascular endothelial growth factor-A (VEGF-A) and matrix metalloproteinase-9 (MMP-9) in posterior uveal melanomas and their correlations with histopathologic parameters and metastasis. Methods: This study was conducted on 100 consecutive eyes enucleated for posterior uveal melanomas. All tumors were examined by immunohistochemical techniques for VEGF-A and MMP-9 expression, and the presence of EMPs was assessed on routine paraffi n sections stained with reticulin. Cell type, tumor localization, degree of pigmentation, necrosis, mitotic index, lymphocytic infi ltration, and scleral and optic nerve invasion were analyzed by using light microscopy. No eyes had received prior treatment such as radiotherapy or transpupillary thermotherapy. Results: Identifi ed histopathologically, cell types were spindle cells in 60% of the cases, mixed cells in 14%, and epithelioid cells in 26% of tumors. Positive reaction for VEGF-A and MMP-9 was present in 84% and 72% of the tumors, respectively. Microvascular loops and/or networks were seen in 34% of the tumors, with the remaining 16% of the tumors displaying an arc pattern, 21% displaying a parallel pattern, and 29% displaying the normal pattern. The relationships between VEGF-A and MMP-9 expression and necrosis, the degree of lymphocyte infi ltration, mitotic rate, and the formation of loop and network patterns were found to be statistically signifi cant (P < 0.05). Metastatic disease developed in 14 patients during follow up. Conclusions: The incidence of metastatic melanoma increased with the increasing expression of VEGF-A and MMP-9. Our data suggest that increasing VEGF-A and MMP-9 expression and the EMP can be used as independent prognostic factors in the management of posterior uveal melanoma following enucleation.

Research paper thumbnail of Normal parathyroid hormone levels in a diabetic patient with parathyroid adenoma

Endocrine, Dec 31, 2008

The incidence of diabetes mellitus in patients with primary hyperparathyroidism and, conversely, ... more The incidence of diabetes mellitus in patients with primary hyperparathyroidism and, conversely, primary hyperparathyroidism in diabetic patients are approximately threefold higher than the respective expected prevalence in the general populace. The diagnosis is straightforward when the patient presents hypercalcemia and inappropriately elevated serum parathyroid hormone (PTH) levels. We report a case of parathyroid adenoma in a diabetic patient with persistent hypercalcemia and normal PTH levels. A 50-year-old female patient who was referred to our outpatient clinic presented with persistent hypercalcemia (serum Ca levels between 10.5 and 11 mg/dl) with a normal serum intact PTH level of 46.1 pg/ml. Her blood pressure was 120/80 mmHg, and she was being treated with antihypertensive therapy. Her HbA1c was 7.2%, and her triglycerides were in the normal range. A bone densitometry exam revealed osteopenia of radius -1.39, femoral neck -1.39, and the total hip -1.04. A neck ultrasound revealed a mass of 13 mm next to the inferior and posterior of the right thyroid lobe. A dual phase Tc-99m-sestamibi scan revealed an area of increased uptake in the same region, which is indicative of a parathyroid adenoma. The parathyroid adenoma was removed, which resulted in the achievement of normocalcemia. Diabetic patients should be evaluated for hyperparathyroidism as associated hypertension can complicate the course of the disease. These patients should be evaluated for primary hyperparathyroidism when they exhibit persistent hypercalcemia and when clinical suspicion is aroused even if the serum PTH levels are within the normal range.

Research paper thumbnail of Orbital Heterotopic Glial Tissue Presenting as Exotropia

Orbit, 2008

A 5-month-old female infant was noted to have difficulty in fixating with the left eye with accom... more A 5-month-old female infant was noted to have difficulty in fixating with the left eye with accompanying progressive exo-deviation and axial proptosis. She also had optic disc hypoplasia with the double ring sign. Computed tomography showed left superomedial orbital mass without any orbital bony defect. Incisional biopsy through a medial orbitotomy allowed significant reduction in tumor burden except for the most apical portion. The affected eye resumed normal alignment and full motility. Histopathologically, the tumor was composed of glial tissue intermixed with muscle fibers. Immunohistochemically, desmin and glial fibrillary acidic protein were strongly expressed. Minimal proptosis of the left eye heralded the recurrence of the tumor 4 years later, also confirmed by magnetic resonance imaging studies. This patient embodies the rare occurrence of isolated heterotopic glial tissue in the orbit with skeletal muscle as one of its components and optic disc hypoplasia as the associated ocular anomaly. Late recurrence may occur following incomplete tumor removal.

Research paper thumbnail of Neuronal Nuclear Antigen (NeuN): A New Tool in the Diagnosis of Central Neurocytoma

Pathology Research and Practice, 2003

The use of neuronal nuclear antigen (NeuN) as a reliable neuronal marker in the differential diag... more The use of neuronal nuclear antigen (NeuN) as a reliable neuronal marker in the differential diagnosis of clear cell neoplasms of the central nervous system was determined in a biopsy series of 23 cases. Immunohistochemical analyses were carried out by antisera against neuronal nuclear antigen, synaptophysin, neuron-specific enolase, microtubule-associated protein 2, and glial fibrillary acidic protein. All eight central neurocytomas were characteristically immunolabeled by NeuN. NeuN immunoreactivity was uniformly strong and basically located in the nuclei of neurocytes. Despite this uniform staining pattern of central neurocytomas, 12 cases of oligodendrogliomas and three cases of ependymoma were negative for NeuN. As the diagnostic criteria for central neurocytoma include immunohistochemical and/or ultrastructural evidence for neuronal differentiation, NeuN as a sensitive and specific neuronal marker in formalin-fixed, paraffin-embedded tissues may greatly facilitate the differential diagnosis of central neurocytomas.

Research paper thumbnail of Detection of human papilloma virus in normal and tumoral oropharyngeal tissue using HPV DNA in situ hybridization and p16 expression and its clinicopathologic importance

Ent updates, Apr 1, 2018

Özet: Normal ve tümöral orofaringeal dokuda in situ hibridizasyon ve p16 ekspresyonu ile human pa... more Özet: Normal ve tümöral orofaringeal dokuda in situ hibridizasyon ve p16 ekspresyonu ile human papilloma virüsü varl›¤›n›n de¤erlendirilmesi ve klinikopatolojik önemi Amaç: Human papilloma virüs (HPV) pozitif orofaringeal hücreli kanser olgular›nda son y›llarda görülen art›fl, bu virüsün tespitinin klinik önemini art›rmaktad›r. Bu çal›flmada amac›m›z orofaringeal kanser hastalar›m›z›n HPV pozitiflik oranlar›n› bulmak, farkl› HPV tespit yöntemleri olan p16 immünohistokimya (IHC) ve in situ hibridizasyonunun (ISH) etkinli¤ini karfl›laflt›rarak boyanma paternlerini göstermektir. Yöntem: Retrospektif dosya taramas› ile bulunan 23 hasta ve 10 kontrol çal›flmaya dahil edilerek hastalar›n patoloji arflivinden bulunan parafin bloklar›nda p16 IHC ve HPV ISH çal›fl›ld›. Bulgular: Yirmi üç olgunun 7'si p16 pozitif idi. Bunlar›n alt›s› yüksek p16 ekspresyonu gösterirken biri düflük p16 ekspresyonu göstermekteydi. 23 olgunun alt›s› ISH pozitif idi. Yüksek p16 ekspresyonu gösteren tüm olgular HPV ISH pozitif iken düflük ekspresyon gösteren bir olgu HPV ISH negatif idi. Tüm p16 pozitif olgular diffüz p16 ekspresyonu göstermekteydi, dolay›s›yla tümör heterojenitesi göstermemekteydi. Sonuç: Yüksek p16 ekspresyonu (>%70) HPV pozitifli¤inin güvenilir bir göstergesidir ve p16 IHC ile kombine etmek spesifitesini art›rmak-tad›r. Olgular tümör heterojenitesi göstermemekte, dolay›s›yla al›nan az miktarda biyopsi parças›nda bile p16 ekspresyonunun gözlenmesi bize tüm tümöral dokuda p16 ekspresyonu oldu¤unu göstermektedir.

Research paper thumbnail of Brief Report of Special Case A glioma with an arteriovenous malformation: an association or a different entity?

A 58-year-old male was admitted with headache to our neurosurgery clinic. His neurological examin... more A 58-year-old male was admitted with headache to our neurosurgery clinic. His neurological examination revealed slight left hemiparesis. The radiological evaluation with contrast administred magnetic resonance imaging (MRI) scan demonstrated a right temporo-parietal ring enhancing mass lesion surrounded by edema which was resembling a typical glioma (Fig. 1). The patient was operated on via a temporoparietal craniotomy and an arteriovenous malformation surrounded by abnormal glial tissue was observed during the exposure. A nidus supplied by several branches arising from the middle cerebral artery (MCA) was obvious. The venous drainage of the malformation was to the superficial venous system. The observed arterial feeders and the draining vein were coagulated and the nidus was macroscopically totally excised. The frozen examination from surrounding glial tissue revealed a high grade glioma. The tumor was also macroscopically totally excised. Postoperatively, the cerebral angiogram demonstrated a right temporal arteriovenous malformation with a centrally excised nidus. The remaning major feeders involved the angular gyrus and the posterior temporal arteries. The venous drainage was to the straight and sigmoid sinuses (Fig. 2). The final histopathological examination of the specimen revealed an arteriovenous malformation surrounded by a high grade glioma (Fig. 3). The patient refused a second operation for total removal of the AVM. Postoperatively, he is doing well with improvement of his left hemiparesis.

Research paper thumbnail of Occurrence of Dysplasia and Human Papilloma Virus Typing in Penile Condylomas

Urology, 2013

To determine the incidence of dysplasia as a preneoplastic change and high-risk human papilloma v... more To determine the incidence of dysplasia as a preneoplastic change and high-risk human papilloma virus (HPV) infection in penile condylomas, which are common HPV-related lesions and considered a risk factor for penile cancer. Histologic analysis was done of 58 consecutive penile condylomas with tissue diagnosis. An immunohistochemical panel that included stains for p53, Ki-67, and p16INK4a was also used. HPV typing was successfully performed in 43 lesions. Genotyping was accomplished through polymerase chain reaction and flow-through hybridization with an HPV GenoArray Diagnostic Test kit. Dysplasia was observed in 13 of the 58 condylomas (22%). High-risk HPV DNA was detected in 5 of 10 dysplastic lesions (50%) for which tissue blocks were available for study. High-risk HPV was not detected in the nondysplastic lesions (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.001). Ki-67≥20% above the basal layer of epithelium and p53-positive immunostaining occurred more frequently in dysplastic lesions than in nondysplastic lesions; however, the difference was not statistically significance. Staining for p16INK4a was not helpful. Anogenital condylomas in men are usually treated using destructive methods or with medication. We suggest that at least a part of the lesion must be removed and sent for histopathologic examination. If the histologic result shows significant dysplastic alteration, the lesion should be further investigated to determine the subtype of infective virus, because 50% of such lesions are associated with high-risk HPV. When oncogenic pathogens are found, careful patient follow-up for recurrences and counseling for the patient and his sexual partner(s) may be warranted.

Research paper thumbnail of Prevalence of Epidermal Growth Factor Receptor Mutations in Patients with Non-Small Cell Lung Cancer in Turkish Population

Balkan Medical Journal, Dec 1, 2017

Lung cancer is one of the most common causes of cancer deaths in men and women (1). It is the mos... more Lung cancer is one of the most common causes of cancer deaths in men and women (1). It is the most common cancer in men and the fifth most common cancer in women in Turkey (2). Most lung cancer patients receive their diagnosis when their cancer is already advanced or metastatic, and the 1-year survival rate is unfortunately less than 15% if the cancer is not treated (3). Epidermal growth factor receptor (EGFR) is a receptor tyrosine kinase (TK) of the ErbB family. Mutations in the TK domain of EGFR lead to autophosphorylation and therefore a continuous activation in the TK region. Consequentially, abnormal expression of EGFR results in tumour cell proliferation, angiogenesis, invasion, metastasis and inhibition of apoptosis (4,5). Aims: Epidermal growth factor receptor mutation analysis in non-small cell lung cancer is important for selecting patients who will receive treatment with tyrosine kinase inhibitors. In this study, we aimed to investigate the prevalence of epidermal growth factor receptor mutations and mutation patterns in the Turkish population. Methods: We retrospectively reviewed molecular pathology reports of 959 cases with lung cancer analysed for epidermal growth factor receptor mutations. We analysed all four epidermal growth factor receptor exon mutations using a real-time polymerase chain reaction platform. Results: In this study, the epidermal growth factor receptor mutation rate in the Turkish population was 16.7% (160 of 959). The epidermal growth factor receptor mutation frequency was significantly higher in women (37.1%, n=96) than in men (9.1%, n=64) (p<0.001). In addition, the epidermal growth factor receptor mutation rate was higher in the adenocarcinoma histologic type (p<0.001). Patients with mutations were older than those without mutations (p=0.003). The most frequent mutations were exon 19 deletions (48.8%, 78/160) and exon 21 L858R point mutations (38.1.1%, 61/160). We also detected compound mutation patterns in three cases (1.9%). Conclusion: The prevalence of epidermal growth factor receptor mutations in the Turkish population was slightly higher than that in the Caucasian population and lower than that in the East Asian population. The results of this study may provide guidance in personalized therapy of non-small cell lung cancer in the Turkish population.

Research paper thumbnail of Effect of Sildenafil Citrate on Penile Weight and Physiology of Cavernous Smooth Muscle in a Post–radical Prostatectomy Model of Erectile Dysfunction in Rats

Urology, Mar 1, 2011

OBJECTIVES To evaluate the gross morphometric changes and in vitro responses of the corpus cavern... more OBJECTIVES To evaluate the gross morphometric changes and in vitro responses of the corpus cavernosus of rats treated with sildenafil citrate after cavernous neurotomy. METHODS The animals were divided into 3 groups. Group 1 consisted of sham-operated rats (n ϭ 16); group 2 consisted of rats that underwent bilateral cavernous neurotomy (BCN) (n ϭ 16); and group 3 consisted of rats that underwent unilateral cavernous neurotomy (UCN) (n ϭ 16). Each group of rats was further classified into 2 subgroups according to whether or not they received sildenafil treatment. The rats were killed on postoperative day 14, and penectomy was performed. Apoptosis was assessed by terminal deoxynucleotidyl transferasemediated deoxyuridine triphosphate nick end labeling (TUNEL), and organ-bath studies were evaluated by Phenylephrine (Phe), acetylcholine (Ach), sodium nitroprusside (SNP), and electrical field stimulation (EFS) responses. RESULTS Penile weight in the BCN group was significantly lower than that of sham-treated group. UCN allowed much more preservation of penile weight compared with that in the sham-treated group. Sildenafil citrate treatment had positive effects on penile weight of both BCN (P ϭ .003) and UCN (P ϭ .004) groups. BCN increased smooth muscle apoptosis when compared with the sham or UCN group. Sildenafil citrate had a positive effect on the apoptotic index. In the BCN group, responses to Phe, Ach, SNP, and EFS decreased significantly, and sildenafil treatment corrected the responses to Phe, Ach, and SNP. CONCLUSIONS Our experimental study results support that early and daily sildenafil citrate treatment has a protective affect on the adrenergic and cholinergic systems, which play a role in erectile function. UROLOGY 77: 761.e1-761.e7, 2011.

Research paper thumbnail of Occurrence of Dysplasia and Human Papilloma Virus Typing in Penile Condylomas

Urology, 2013

To determine the incidence of dysplasia as a preneoplastic change and high-risk human papilloma v... more To determine the incidence of dysplasia as a preneoplastic change and high-risk human papilloma virus (HPV) infection in penile condylomas, which are common HPV-related lesions and considered a risk factor for penile cancer. Histologic analysis was done of 58 consecutive penile condylomas with tissue diagnosis. An immunohistochemical panel that included stains for p53, Ki-67, and p16INK4a was also used. HPV typing was successfully performed in 43 lesions. Genotyping was accomplished through polymerase chain reaction and flow-through hybridization with an HPV GenoArray Diagnostic Test kit. Dysplasia was observed in 13 of the 58 condylomas (22%). High-risk HPV DNA was detected in 5 of 10 dysplastic lesions (50%) for which tissue blocks were available for study. High-risk HPV was not detected in the nondysplastic lesions (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.001). Ki-67≥20% above the basal layer of epithelium and p53-positive immunostaining occurred more frequently in dysplastic lesions than in nondysplastic lesions; however, the difference was not statistically significance. Staining for p16INK4a was not helpful. Anogenital condylomas in men are usually treated using destructive methods or with medication. We suggest that at least a part of the lesion must be removed and sent for histopathologic examination. If the histologic result shows significant dysplastic alteration, the lesion should be further investigated to determine the subtype of infective virus, because 50% of such lesions are associated with high-risk HPV. When oncogenic pathogens are found, careful patient follow-up for recurrences and counseling for the patient and his sexual partner(s) may be warranted.

Research paper thumbnail of Effect of Sildenafil Citrate on Penile Weight and Physiology of Cavernous Smooth Muscle in a Post–radical Prostatectomy Model of Erectile Dysfunction in Rats

Urology, 2011

OBJECTIVES To evaluate the gross morphometric changes and in vitro responses of the corpus cavern... more OBJECTIVES To evaluate the gross morphometric changes and in vitro responses of the corpus cavernosus of rats treated with sildenafil citrate after cavernous neurotomy. METHODS The animals were divided into 3 groups. Group 1 consisted of sham-operated rats (n ϭ 16); group 2 consisted of rats that underwent bilateral cavernous neurotomy (BCN) (n ϭ 16); and group 3 consisted of rats that underwent unilateral cavernous neurotomy (UCN) (n ϭ 16). Each group of rats was further classified into 2 subgroups according to whether or not they received sildenafil treatment. The rats were killed on postoperative day 14, and penectomy was performed. Apoptosis was assessed by terminal deoxynucleotidyl transferasemediated deoxyuridine triphosphate nick end labeling (TUNEL), and organ-bath studies were evaluated by Phenylephrine (Phe), acetylcholine (Ach), sodium nitroprusside (SNP), and electrical field stimulation (EFS) responses. RESULTS Penile weight in the BCN group was significantly lower than that of sham-treated group. UCN allowed much more preservation of penile weight compared with that in the sham-treated group. Sildenafil citrate treatment had positive effects on penile weight of both BCN (P ϭ .003) and UCN (P ϭ .004) groups. BCN increased smooth muscle apoptosis when compared with the sham or UCN group. Sildenafil citrate had a positive effect on the apoptotic index. In the BCN group, responses to Phe, Ach, SNP, and EFS decreased significantly, and sildenafil treatment corrected the responses to Phe, Ach, and SNP. CONCLUSIONS Our experimental study results support that early and daily sildenafil citrate treatment has a protective affect on the adrenergic and cholinergic systems, which play a role in erectile function. UROLOGY 77: 761.e1-761.e7, 2011.

Research paper thumbnail of Dermoid Cyst of the Lacrimal Gland

Research paper thumbnail of Comparison of Clinicopathologic Parameters and Survivals Between Epstein-Barr Virus-positive and Her2-positive Gastric Cancers

Applied immunohistochemistry & molecular morphology : AIMM / official publication of the Society for Applied Immunohistochemistry, Jan 3, 2016

Gastric carcinomas are highly mortal neoplasms for which new therapeutic options are being search... more Gastric carcinomas are highly mortal neoplasms for which new therapeutic options are being searched. The molecular subtyping of gastric adenocarcinomas was proposed recently, and the relationship between etiopathogenetic types is still under investigation. Here we compared histopathologic, prognostic, and survival differences between Epstein-Barr virus (EBV)-positive and Her2-positive gastric adenocarcinomas. In a retrospective design, we searched the EBV status with Epstein Barr Virus encoded small RNA (EBER) in situ hybridization, and the Her2 status both by immunohistochemistry and by chromogenic in situ hybridization of 106 gastrectomized gastric carcinomas. Histologic and clinical prognostic parameters and survival information were determined, and retrieved from archival tissues and clinical notes. The Her2 positivity rate was 12.3% and the EBV positivity rate was 7.6%. Among EBER-positive cases, Her2 positivity was not detected. Her2 positivity was detected more in intestinal ...

Research paper thumbnail of Genetic Alterations in Differentiated Thyroid Cancers

Endocrine, Metabolic & Immune Disorders - Drug Targets, 2009

Differentiated thyroid cancers are the predominant malignancies of the thyroid. Due to advances i... more Differentiated thyroid cancers are the predominant malignancies of the thyroid. Due to advances in the understanding of the activation of the cell proliferation pathway at a molecular level, multiple genetic alterations have been linked to the development of thyroid carcinogenesis. Although the genetic alterations can be categorized into 7 categories, the BRAF mutation, RET/PTC, Pax8/PPARGamma, and dysfunctional Fas pathway have been most commonly described. Each of the gene alterations can ultimately result in cancer development, invasion and/or metastasis. This article provides a detailed review of the altered cell proliferation pathway activations found in thyroid carcinogenesis. The molecular targets that may be disrupted by therapeutic agents during the abnormal proliferation are also summarized.

Research paper thumbnail of Melanomda Moleküler Patoloji ve Karsinogenez

Turkiye Klinikleri Medical Oncology - Special Topics, 2014

Research paper thumbnail of Expression of glial cell line-derived neurotrophic factor correlates with perineural invasion of bile duct carcinoma

Research paper thumbnail of The role of apoptosis in blepharoptosis

Eye, Apr 19, 2013

Purpose The purpose of this study is to evaluate the role of apoptosis in the pathogenesis of ble... more Purpose The purpose of this study is to evaluate the role of apoptosis in the pathogenesis of blepharoptosis. Patients and methods Forty-five eyelids of 43 consecutive patients (16 female, 27 males) that underwent levator resection surgery for ptosis correction were included in the study. Twenty-six of the eyelids had congenital myogenic ptosis and 19 had aponeurotic ptosis. Levator palpebrae superioris function and height of the vertical palpebral fissure were measured in all patients. After levator resection surgery, the distal part of the levator aponeurosis was fixed and sent for evaluation. Apoptotic cells were detected using Apop Tag Plus Peroxidase In Situ Apoptosis Detection Kit. Results The mean levator palpebrae superioris function was 8.4 mm (range 5-10 mm) in congenital ptosis group and 12.1 mm (range 10-17 mm) in the aponeurotic ptosis group. The mean height of the vertical palpebral fissure in patients with congenital ptosis and aponeurotic ptosis were 6.5 mm (range 5-9 mm) and 6.1 mm (3-9 mm), respectively. The mean apoptotic index of congenital ptosis and aponeurotic ptosis were 27.3 (16-39) and 29.8 (18-41), respectively. There was no statistically significant difference between congenital and aponeurotic ptosis groups in a mean apoptotic index (Po0.05). Apoptotic index was not correlated with age, levator palpebrae superioris function, palpebral fissure height, and lid crease height in two groups. Conclusion We found no statistically significant difference between two subtypes of blepharoptosis regarding apoptosis. According to this study, apoptosis seems to have no significant role in the development of aponeurotic blepharoptosis.

Research paper thumbnail of Human papillomavirus infection in patients with laryngeal carcinoma

BMC Cancer, Oct 20, 2018

This study evaluated the ultrasound (US) features of 20 patients with MAGI and concomitant papill... more This study evaluated the ultrasound (US) features of 20 patients with MAGI and concomitant papilloma virus (HPV) infection compared to 20 patients with microbial (presence of Chlamydia trachomatis alone) MAGI and 20 patients with amicrobial (inflammatory) MAGI. Patients with HPV infection showed significantly (< 0.05) higher total prostate, seminal vesicles, and epididymal US signs (18.0 ± 2.0) compared to the other 2 groups (12.0 ± 4.0 versus 10.0 ± 3.0, resp.). In addition, patients with MAGI and HPV had a higher prevalence of complicated forms of MAGI [prostatovesiculitis (PV) and prostate-vesiculo-epididymitis (PVE)] and a higher frequency of the fibrosclerotic variant compared to the other groups (70.0 ± 10.0% versus 48.0 ± 5.0% versus 15.0 ± 10.0%). Moreover, HPV infected patients had a higher number of US criteria suggestive for MAGI in the periurethral region of the prostate compared to the other groups. In particular, the patients showed a higher ratio between periurethral and lobar US criteria distribution (5.0 versus 0.5). Finally, the seminal fluid concentration of CD45 pos leukocytes (2.0 ± 0.2 versus 1.3 ± 0.3 versus 1.0 ± 0.3 mil/mL) was significantly higher and sperm progressive motility was significantly lower in these patients compared to other groups.

Research paper thumbnail of Vascular endothelial growth factor, vascular endothelial growth factor receptor-3 and cyclooxygenase-2 expression in psoriasis

PubMed, Dec 1, 2007

Objective: To investigate expression patterns and relationship of vascular endothelial growth fac... more Objective: To investigate expression patterns and relationship of vascular endothelial growth factor (VEGF), vascular endothelial receptor-3 (VEGF-R3) (FLT-4) and cyclooxygenase-2 (COX-2) in psoriasis. Study design: Forty-three patients were included in this study. The clinical severity of psoriasis was assessed using the psoriasis area and severity index (PASI). Punch biopsy samples both from psoriatic and nonlesional skin were taken and VEGF, VEGF-R3 and COX-2 expressions determined. Results: VEGF, VEGF-R3 and COX-2 expressions were detected in 90.9%, 78.0% and 86.4% of psoriatic and 84.1%, 71.8%, and 84.1% of nonlesional skin, respectively. Epidermal VEGF, VEGF-R3 and COX-2 expressions were detected in 56.8%, 77.8% and 34.1 of psoriatic and 75%, 78.1% and 65.9% of nonlesional skin, respectively. In dermis, VEGF, VEGF-R3 and COX-2 expression was observed in 88.6%, 77.5% and 84.1% of psoriatic and 81.8%, 64.1% and 77.3% of nonlesional skin, respectively. Among the PASI subgroups no statistically significant differences were detected for VEGF, VEGF-R3 and COX-2 expression. Conclusion: Our study demonstrated that VEGF, VEGF-R3 and COX-2 expression in psoriatic and nonlesional skin is significantly high in epidermis and dermis. Although there was significant concordance between VEGF and VEGF-R3 expressions in psoriatic lesions, there seems to be no concordance between the others.

Research paper thumbnail of Expressions of vascular endothelial growth factor and CD34 in oral aphthous lesions of Behçet's disease

PubMed, Dec 1, 2006

Objective: Behçet's disease (BD) is an immunoin-flammatory vasculitis with an unknown etiopathoge... more Objective: Behçet's disease (BD) is an immunoin-flammatory vasculitis with an unknown etiopathogenesis. Vascular endothelial growth factor (VEGF) is a cytokine-stimulating angiogenesis. It has been suggested to play a role in inflammation and pathogenesis of vasculitic processes. Study design: VEGF and CD34 expressions were assessed in samples taken from oral aphthous lesions. The patients were evaluated for disease activity, duration of lesions, serum C-reactive protein (CRP) levels and erythrocyte sedimentation rate (ESR). Results: Twenty-six patients were included. Fourteen (53.9%) had increased CRP levels and 12 (46.1%) had increased ESR levels. Positive VEGF and CD34 staining were detected in 46.2% and 69.2% of biopsy samples, respectively. There was good positive correlation between them. The frequency of positive VEGF and CD34 staining was statistically higher in lesions with a duration of more than 6 days. No correlation was found between positive VEGF staining and serum CRP level, ESR and disease activity. Conclusion: Increased VEGF expression in correlation with CD34 positivity in oral aphthous lesions may show the role of VEGF in pathogenesis of these vasculitic lesions. We have concluded that VEGF may play a role during the course of oral aphthous lesions in BD.

Research paper thumbnail of Expression of Vascular Endothelial Growth Factor-A, Matrix Metalloproteinase-9, and Extravascular Matrix Patterns and Their Correlations with Clinicopathologic Parameters in Posterior Uveal Melanomas

Japanese Journal of Ophthalmology, Sep 1, 2007

Purpose: To assess extravascular matrix patterns (EMP) and expression of vascular endothelial gro... more Purpose: To assess extravascular matrix patterns (EMP) and expression of vascular endothelial growth factor-A (VEGF-A) and matrix metalloproteinase-9 (MMP-9) in posterior uveal melanomas and their correlations with histopathologic parameters and metastasis. Methods: This study was conducted on 100 consecutive eyes enucleated for posterior uveal melanomas. All tumors were examined by immunohistochemical techniques for VEGF-A and MMP-9 expression, and the presence of EMPs was assessed on routine paraffi n sections stained with reticulin. Cell type, tumor localization, degree of pigmentation, necrosis, mitotic index, lymphocytic infi ltration, and scleral and optic nerve invasion were analyzed by using light microscopy. No eyes had received prior treatment such as radiotherapy or transpupillary thermotherapy. Results: Identifi ed histopathologically, cell types were spindle cells in 60% of the cases, mixed cells in 14%, and epithelioid cells in 26% of tumors. Positive reaction for VEGF-A and MMP-9 was present in 84% and 72% of the tumors, respectively. Microvascular loops and/or networks were seen in 34% of the tumors, with the remaining 16% of the tumors displaying an arc pattern, 21% displaying a parallel pattern, and 29% displaying the normal pattern. The relationships between VEGF-A and MMP-9 expression and necrosis, the degree of lymphocyte infi ltration, mitotic rate, and the formation of loop and network patterns were found to be statistically signifi cant (P < 0.05). Metastatic disease developed in 14 patients during follow up. Conclusions: The incidence of metastatic melanoma increased with the increasing expression of VEGF-A and MMP-9. Our data suggest that increasing VEGF-A and MMP-9 expression and the EMP can be used as independent prognostic factors in the management of posterior uveal melanoma following enucleation.

Research paper thumbnail of Normal parathyroid hormone levels in a diabetic patient with parathyroid adenoma

Endocrine, Dec 31, 2008

The incidence of diabetes mellitus in patients with primary hyperparathyroidism and, conversely, ... more The incidence of diabetes mellitus in patients with primary hyperparathyroidism and, conversely, primary hyperparathyroidism in diabetic patients are approximately threefold higher than the respective expected prevalence in the general populace. The diagnosis is straightforward when the patient presents hypercalcemia and inappropriately elevated serum parathyroid hormone (PTH) levels. We report a case of parathyroid adenoma in a diabetic patient with persistent hypercalcemia and normal PTH levels. A 50-year-old female patient who was referred to our outpatient clinic presented with persistent hypercalcemia (serum Ca levels between 10.5 and 11 mg/dl) with a normal serum intact PTH level of 46.1 pg/ml. Her blood pressure was 120/80 mmHg, and she was being treated with antihypertensive therapy. Her HbA1c was 7.2%, and her triglycerides were in the normal range. A bone densitometry exam revealed osteopenia of radius -1.39, femoral neck -1.39, and the total hip -1.04. A neck ultrasound revealed a mass of 13 mm next to the inferior and posterior of the right thyroid lobe. A dual phase Tc-99m-sestamibi scan revealed an area of increased uptake in the same region, which is indicative of a parathyroid adenoma. The parathyroid adenoma was removed, which resulted in the achievement of normocalcemia. Diabetic patients should be evaluated for hyperparathyroidism as associated hypertension can complicate the course of the disease. These patients should be evaluated for primary hyperparathyroidism when they exhibit persistent hypercalcemia and when clinical suspicion is aroused even if the serum PTH levels are within the normal range.

Research paper thumbnail of Orbital Heterotopic Glial Tissue Presenting as Exotropia

Orbit, 2008

A 5-month-old female infant was noted to have difficulty in fixating with the left eye with accom... more A 5-month-old female infant was noted to have difficulty in fixating with the left eye with accompanying progressive exo-deviation and axial proptosis. She also had optic disc hypoplasia with the double ring sign. Computed tomography showed left superomedial orbital mass without any orbital bony defect. Incisional biopsy through a medial orbitotomy allowed significant reduction in tumor burden except for the most apical portion. The affected eye resumed normal alignment and full motility. Histopathologically, the tumor was composed of glial tissue intermixed with muscle fibers. Immunohistochemically, desmin and glial fibrillary acidic protein were strongly expressed. Minimal proptosis of the left eye heralded the recurrence of the tumor 4 years later, also confirmed by magnetic resonance imaging studies. This patient embodies the rare occurrence of isolated heterotopic glial tissue in the orbit with skeletal muscle as one of its components and optic disc hypoplasia as the associated ocular anomaly. Late recurrence may occur following incomplete tumor removal.

Research paper thumbnail of Neuronal Nuclear Antigen (NeuN): A New Tool in the Diagnosis of Central Neurocytoma

Pathology Research and Practice, 2003

The use of neuronal nuclear antigen (NeuN) as a reliable neuronal marker in the differential diag... more The use of neuronal nuclear antigen (NeuN) as a reliable neuronal marker in the differential diagnosis of clear cell neoplasms of the central nervous system was determined in a biopsy series of 23 cases. Immunohistochemical analyses were carried out by antisera against neuronal nuclear antigen, synaptophysin, neuron-specific enolase, microtubule-associated protein 2, and glial fibrillary acidic protein. All eight central neurocytomas were characteristically immunolabeled by NeuN. NeuN immunoreactivity was uniformly strong and basically located in the nuclei of neurocytes. Despite this uniform staining pattern of central neurocytomas, 12 cases of oligodendrogliomas and three cases of ependymoma were negative for NeuN. As the diagnostic criteria for central neurocytoma include immunohistochemical and/or ultrastructural evidence for neuronal differentiation, NeuN as a sensitive and specific neuronal marker in formalin-fixed, paraffin-embedded tissues may greatly facilitate the differential diagnosis of central neurocytomas.

Research paper thumbnail of Detection of human papilloma virus in normal and tumoral oropharyngeal tissue using HPV DNA in situ hybridization and p16 expression and its clinicopathologic importance

Ent updates, Apr 1, 2018

Özet: Normal ve tümöral orofaringeal dokuda in situ hibridizasyon ve p16 ekspresyonu ile human pa... more Özet: Normal ve tümöral orofaringeal dokuda in situ hibridizasyon ve p16 ekspresyonu ile human papilloma virüsü varl›¤›n›n de¤erlendirilmesi ve klinikopatolojik önemi Amaç: Human papilloma virüs (HPV) pozitif orofaringeal hücreli kanser olgular›nda son y›llarda görülen art›fl, bu virüsün tespitinin klinik önemini art›rmaktad›r. Bu çal›flmada amac›m›z orofaringeal kanser hastalar›m›z›n HPV pozitiflik oranlar›n› bulmak, farkl› HPV tespit yöntemleri olan p16 immünohistokimya (IHC) ve in situ hibridizasyonunun (ISH) etkinli¤ini karfl›laflt›rarak boyanma paternlerini göstermektir. Yöntem: Retrospektif dosya taramas› ile bulunan 23 hasta ve 10 kontrol çal›flmaya dahil edilerek hastalar›n patoloji arflivinden bulunan parafin bloklar›nda p16 IHC ve HPV ISH çal›fl›ld›. Bulgular: Yirmi üç olgunun 7'si p16 pozitif idi. Bunlar›n alt›s› yüksek p16 ekspresyonu gösterirken biri düflük p16 ekspresyonu göstermekteydi. 23 olgunun alt›s› ISH pozitif idi. Yüksek p16 ekspresyonu gösteren tüm olgular HPV ISH pozitif iken düflük ekspresyon gösteren bir olgu HPV ISH negatif idi. Tüm p16 pozitif olgular diffüz p16 ekspresyonu göstermekteydi, dolay›s›yla tümör heterojenitesi göstermemekteydi. Sonuç: Yüksek p16 ekspresyonu (>%70) HPV pozitifli¤inin güvenilir bir göstergesidir ve p16 IHC ile kombine etmek spesifitesini art›rmak-tad›r. Olgular tümör heterojenitesi göstermemekte, dolay›s›yla al›nan az miktarda biyopsi parças›nda bile p16 ekspresyonunun gözlenmesi bize tüm tümöral dokuda p16 ekspresyonu oldu¤unu göstermektedir.

Research paper thumbnail of Brief Report of Special Case A glioma with an arteriovenous malformation: an association or a different entity?

A 58-year-old male was admitted with headache to our neurosurgery clinic. His neurological examin... more A 58-year-old male was admitted with headache to our neurosurgery clinic. His neurological examination revealed slight left hemiparesis. The radiological evaluation with contrast administred magnetic resonance imaging (MRI) scan demonstrated a right temporo-parietal ring enhancing mass lesion surrounded by edema which was resembling a typical glioma (Fig. 1). The patient was operated on via a temporoparietal craniotomy and an arteriovenous malformation surrounded by abnormal glial tissue was observed during the exposure. A nidus supplied by several branches arising from the middle cerebral artery (MCA) was obvious. The venous drainage of the malformation was to the superficial venous system. The observed arterial feeders and the draining vein were coagulated and the nidus was macroscopically totally excised. The frozen examination from surrounding glial tissue revealed a high grade glioma. The tumor was also macroscopically totally excised. Postoperatively, the cerebral angiogram demonstrated a right temporal arteriovenous malformation with a centrally excised nidus. The remaning major feeders involved the angular gyrus and the posterior temporal arteries. The venous drainage was to the straight and sigmoid sinuses (Fig. 2). The final histopathological examination of the specimen revealed an arteriovenous malformation surrounded by a high grade glioma (Fig. 3). The patient refused a second operation for total removal of the AVM. Postoperatively, he is doing well with improvement of his left hemiparesis.

Research paper thumbnail of Occurrence of Dysplasia and Human Papilloma Virus Typing in Penile Condylomas

Urology, 2013

To determine the incidence of dysplasia as a preneoplastic change and high-risk human papilloma v... more To determine the incidence of dysplasia as a preneoplastic change and high-risk human papilloma virus (HPV) infection in penile condylomas, which are common HPV-related lesions and considered a risk factor for penile cancer. Histologic analysis was done of 58 consecutive penile condylomas with tissue diagnosis. An immunohistochemical panel that included stains for p53, Ki-67, and p16INK4a was also used. HPV typing was successfully performed in 43 lesions. Genotyping was accomplished through polymerase chain reaction and flow-through hybridization with an HPV GenoArray Diagnostic Test kit. Dysplasia was observed in 13 of the 58 condylomas (22%). High-risk HPV DNA was detected in 5 of 10 dysplastic lesions (50%) for which tissue blocks were available for study. High-risk HPV was not detected in the nondysplastic lesions (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.001). Ki-67≥20% above the basal layer of epithelium and p53-positive immunostaining occurred more frequently in dysplastic lesions than in nondysplastic lesions; however, the difference was not statistically significance. Staining for p16INK4a was not helpful. Anogenital condylomas in men are usually treated using destructive methods or with medication. We suggest that at least a part of the lesion must be removed and sent for histopathologic examination. If the histologic result shows significant dysplastic alteration, the lesion should be further investigated to determine the subtype of infective virus, because 50% of such lesions are associated with high-risk HPV. When oncogenic pathogens are found, careful patient follow-up for recurrences and counseling for the patient and his sexual partner(s) may be warranted.

Research paper thumbnail of Prevalence of Epidermal Growth Factor Receptor Mutations in Patients with Non-Small Cell Lung Cancer in Turkish Population

Balkan Medical Journal, Dec 1, 2017

Lung cancer is one of the most common causes of cancer deaths in men and women (1). It is the mos... more Lung cancer is one of the most common causes of cancer deaths in men and women (1). It is the most common cancer in men and the fifth most common cancer in women in Turkey (2). Most lung cancer patients receive their diagnosis when their cancer is already advanced or metastatic, and the 1-year survival rate is unfortunately less than 15% if the cancer is not treated (3). Epidermal growth factor receptor (EGFR) is a receptor tyrosine kinase (TK) of the ErbB family. Mutations in the TK domain of EGFR lead to autophosphorylation and therefore a continuous activation in the TK region. Consequentially, abnormal expression of EGFR results in tumour cell proliferation, angiogenesis, invasion, metastasis and inhibition of apoptosis (4,5). Aims: Epidermal growth factor receptor mutation analysis in non-small cell lung cancer is important for selecting patients who will receive treatment with tyrosine kinase inhibitors. In this study, we aimed to investigate the prevalence of epidermal growth factor receptor mutations and mutation patterns in the Turkish population. Methods: We retrospectively reviewed molecular pathology reports of 959 cases with lung cancer analysed for epidermal growth factor receptor mutations. We analysed all four epidermal growth factor receptor exon mutations using a real-time polymerase chain reaction platform. Results: In this study, the epidermal growth factor receptor mutation rate in the Turkish population was 16.7% (160 of 959). The epidermal growth factor receptor mutation frequency was significantly higher in women (37.1%, n=96) than in men (9.1%, n=64) (p<0.001). In addition, the epidermal growth factor receptor mutation rate was higher in the adenocarcinoma histologic type (p<0.001). Patients with mutations were older than those without mutations (p=0.003). The most frequent mutations were exon 19 deletions (48.8%, 78/160) and exon 21 L858R point mutations (38.1.1%, 61/160). We also detected compound mutation patterns in three cases (1.9%). Conclusion: The prevalence of epidermal growth factor receptor mutations in the Turkish population was slightly higher than that in the Caucasian population and lower than that in the East Asian population. The results of this study may provide guidance in personalized therapy of non-small cell lung cancer in the Turkish population.

Research paper thumbnail of Effect of Sildenafil Citrate on Penile Weight and Physiology of Cavernous Smooth Muscle in a Post–radical Prostatectomy Model of Erectile Dysfunction in Rats

Urology, Mar 1, 2011

OBJECTIVES To evaluate the gross morphometric changes and in vitro responses of the corpus cavern... more OBJECTIVES To evaluate the gross morphometric changes and in vitro responses of the corpus cavernosus of rats treated with sildenafil citrate after cavernous neurotomy. METHODS The animals were divided into 3 groups. Group 1 consisted of sham-operated rats (n ϭ 16); group 2 consisted of rats that underwent bilateral cavernous neurotomy (BCN) (n ϭ 16); and group 3 consisted of rats that underwent unilateral cavernous neurotomy (UCN) (n ϭ 16). Each group of rats was further classified into 2 subgroups according to whether or not they received sildenafil treatment. The rats were killed on postoperative day 14, and penectomy was performed. Apoptosis was assessed by terminal deoxynucleotidyl transferasemediated deoxyuridine triphosphate nick end labeling (TUNEL), and organ-bath studies were evaluated by Phenylephrine (Phe), acetylcholine (Ach), sodium nitroprusside (SNP), and electrical field stimulation (EFS) responses. RESULTS Penile weight in the BCN group was significantly lower than that of sham-treated group. UCN allowed much more preservation of penile weight compared with that in the sham-treated group. Sildenafil citrate treatment had positive effects on penile weight of both BCN (P ϭ .003) and UCN (P ϭ .004) groups. BCN increased smooth muscle apoptosis when compared with the sham or UCN group. Sildenafil citrate had a positive effect on the apoptotic index. In the BCN group, responses to Phe, Ach, SNP, and EFS decreased significantly, and sildenafil treatment corrected the responses to Phe, Ach, and SNP. CONCLUSIONS Our experimental study results support that early and daily sildenafil citrate treatment has a protective affect on the adrenergic and cholinergic systems, which play a role in erectile function. UROLOGY 77: 761.e1-761.e7, 2011.

Research paper thumbnail of Occurrence of Dysplasia and Human Papilloma Virus Typing in Penile Condylomas

Urology, 2013

To determine the incidence of dysplasia as a preneoplastic change and high-risk human papilloma v... more To determine the incidence of dysplasia as a preneoplastic change and high-risk human papilloma virus (HPV) infection in penile condylomas, which are common HPV-related lesions and considered a risk factor for penile cancer. Histologic analysis was done of 58 consecutive penile condylomas with tissue diagnosis. An immunohistochemical panel that included stains for p53, Ki-67, and p16INK4a was also used. HPV typing was successfully performed in 43 lesions. Genotyping was accomplished through polymerase chain reaction and flow-through hybridization with an HPV GenoArray Diagnostic Test kit. Dysplasia was observed in 13 of the 58 condylomas (22%). High-risk HPV DNA was detected in 5 of 10 dysplastic lesions (50%) for which tissue blocks were available for study. High-risk HPV was not detected in the nondysplastic lesions (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.001). Ki-67≥20% above the basal layer of epithelium and p53-positive immunostaining occurred more frequently in dysplastic lesions than in nondysplastic lesions; however, the difference was not statistically significance. Staining for p16INK4a was not helpful. Anogenital condylomas in men are usually treated using destructive methods or with medication. We suggest that at least a part of the lesion must be removed and sent for histopathologic examination. If the histologic result shows significant dysplastic alteration, the lesion should be further investigated to determine the subtype of infective virus, because 50% of such lesions are associated with high-risk HPV. When oncogenic pathogens are found, careful patient follow-up for recurrences and counseling for the patient and his sexual partner(s) may be warranted.

Research paper thumbnail of Effect of Sildenafil Citrate on Penile Weight and Physiology of Cavernous Smooth Muscle in a Post–radical Prostatectomy Model of Erectile Dysfunction in Rats

Urology, 2011

OBJECTIVES To evaluate the gross morphometric changes and in vitro responses of the corpus cavern... more OBJECTIVES To evaluate the gross morphometric changes and in vitro responses of the corpus cavernosus of rats treated with sildenafil citrate after cavernous neurotomy. METHODS The animals were divided into 3 groups. Group 1 consisted of sham-operated rats (n ϭ 16); group 2 consisted of rats that underwent bilateral cavernous neurotomy (BCN) (n ϭ 16); and group 3 consisted of rats that underwent unilateral cavernous neurotomy (UCN) (n ϭ 16). Each group of rats was further classified into 2 subgroups according to whether or not they received sildenafil treatment. The rats were killed on postoperative day 14, and penectomy was performed. Apoptosis was assessed by terminal deoxynucleotidyl transferasemediated deoxyuridine triphosphate nick end labeling (TUNEL), and organ-bath studies were evaluated by Phenylephrine (Phe), acetylcholine (Ach), sodium nitroprusside (SNP), and electrical field stimulation (EFS) responses. RESULTS Penile weight in the BCN group was significantly lower than that of sham-treated group. UCN allowed much more preservation of penile weight compared with that in the sham-treated group. Sildenafil citrate treatment had positive effects on penile weight of both BCN (P ϭ .003) and UCN (P ϭ .004) groups. BCN increased smooth muscle apoptosis when compared with the sham or UCN group. Sildenafil citrate had a positive effect on the apoptotic index. In the BCN group, responses to Phe, Ach, SNP, and EFS decreased significantly, and sildenafil treatment corrected the responses to Phe, Ach, and SNP. CONCLUSIONS Our experimental study results support that early and daily sildenafil citrate treatment has a protective affect on the adrenergic and cholinergic systems, which play a role in erectile function. UROLOGY 77: 761.e1-761.e7, 2011.

Research paper thumbnail of Dermoid Cyst of the Lacrimal Gland