Wos Açık Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10754
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Item Androgenetic Alopecia or Fibrosing Alopecia in a Pattern Distribution: When to Perform Biopsy in Unusual Cases?(2022) Ozcan, Deren; Vural, Ayse Tuncer; Ozen, Ozlem; 35656261Item Recurrence patterns and prognostic factors in lymphovascular space invasion-positive endometrioid endometrial cancer surgically confined to the uterus(2019) Sahin, Hanifi; Meydanli, Mehmet Mutlu; Sari, Mustafa Erkan; Kocaman, Eda; Cuylan, Zeliha Fırat; Yalcin, Ibrahim; Coban, Gonca; Ozen, Ozlem; Sirvan, Levent; Gungor, Tayfun; Ayhan, Ali; 30638487Objective: The purpose of this study was to determine the patterns of failure and prognostic factors for lymphovascular space invasion (LVSI)-positive endometrioid endometrial cancer (EC) patients in the setting of negative lymph nodes (LNs). Materials and methods: A multicenter, retrospective department database review was performed to identify LVSI-positive patients with disease surgically confined to the uterus at two gynecologic oncology centers in Turkey. Demographic, clinicopathological and survival data were collected. Results: We identified 185 LVSI-positive women with negative LNs during the study period. Fifty-five (29.7%) were classified as Stage IA, 94 (50.8%) as Stage IB, and 36 (19.5%) as Stage II. The median age at diagnosis was 59 years and the median duration of follow-up was 44 months. The total number of the recurrences was 12 (6.5%). We observed 5 (2.9%) loco-regional recurrences, 3 (1.5%) retroperitoneal failures, and 4 (2.0%) distant relapses. The 5-year progression-free survival (PFS) was 86.1% while the 5-year overall survival (OS) rate was 87.7%. Grade 3 histology (Hazard Ratio [HR] 2.9, 95% Confidence Interval [CI] 1.02-8.50; p = 0.04), cervical stromal invasion (HR 4.5, 95% CI 1.61-12.79; p = 0.004) and age > 60 years (HR 5.8, 95% CI 1.62-21.32; p = 0.007) were found to be independent prognostic factors for decreased OS. Adjuvant treatment did not appear as a prognostic factor for OS even in univariate analysis. Conclusion: The recurrence rate among LVSI-positive endometrioid EC patients is low in the setting of negative LNs. However, one out of three patients with a recurrence experiences distant relapses which usually portend worse outcomes. (C) 2018 Taiwan Association of Obstetrics & Gynecology. Publishing services by Elsevier B.V.Item Uterine smooth muscle tumor of uncertain malignant potential: fertility and clinical outcomes(2019) Sahin, Hanifi; Karatas, Funda; Coban, Gonca; Ozen, Ozlem; Erdem, Ozlem; Onan, Mehmet Anil; Ayhan, Ali; 0000-0002-3285-5519; 31074239Objective: In this study, we aimed to evaluate the clinicopathological features, obstetric, and oncological outcomes of patients diagnosed with a uterine smooth muscle tumors of uncertain malignant potential (STUMP). Methods: A dual-institutional, database review was carried out to screen patients with STUMP who were treated with upfront surgery between January 2006 and December 2017. Data including age at the time of diagnosis, recurrence rate, disease-free survival, overall survival, and fertility outcomes were retrospectively analyzed. Results: Fifty-seven patients with STUMPs were included in the study. The median age at the time of diagnosis was 42 (range, 16 to 75) years. The median follow-up was 57 (range, 16 to 125) months. Eight patients (14%) had recurrence during follow-up. Recurrent STUMPs were seen in seven patients and leiomyosarcoma after 14 months in one patient. Seven patients with a recurrent STUMP survived, while the remaining patient died. Recurrence rates were similar for women who underwent myomectomy and those who underwent hysterectomy. The presence of uterine localization of tumor (subserosal vs intramural-submucosal) statistically significantly affected recurrence rates (odds ratio=5.72; 95% confidence interval=1.349-24.290; p=0.018). Ten of 27 patients who underwent myomectomy for uterine myoma had fertility desire. Seven pregnancies were recorded. Conclusions: Our study results suggest that fertility-sparing approaches are feasible in patients with STUMP, although recurrence may be seen.Item Microsatellite Instability in Glioblastoma: Is It Really Relevant in Tumor Prognosis?(2019) Tepeoglu, Merih; Borcek, Pelin; Ozen, Ozlem; Altinors, Nur; 31529454AIM: To evaluate the frequency and prognostic significance of microsatellite instability (MSI) in patients with glioblastoma (GBM immunohistochemical analysis of mismatch repair (MMR) proteins was performed. MATERIAL and METHODS: A total of 71 patients with GBM who underwent surgery between 2011 and 2019, were included in the study. MMR protein expression was examined using immunohistochemistical analysis of tumor tissue samples; the association between the MMR status and clinicopathological findings was evaluated. RESULTS: Immunohistochemical analysis revealed expressions of MLH1, MSH2, MSH6, and PMS2 proteins in 67 (94.4%), 65 (91.5%), 67 (94.4%), and 64 (90.1%) patients, respectively. Among the 71 patients, 64 (90.1%) expressing all MMR proteins were considered microsatellite stable (MSS), and 7 (9.9%) patients showing loss of at least one of the MMR proteins were considered to show MSI. Tumor recurrence was noted in 25 (39.1%) patients in the MSS GBM group, and 4 (57.1%) patients in the MSI GBM group (p=0.433). The overall median survival was 30.65 +/- 5.1 and 10.71 +/- 5.2 months in the MSS GBM and MSI GBM groups, respectively (p=0.059). CONCLUSION: The results of this study showed no significant relationships between MMR protein expression and recurrence rates or overall survival in patients with GBM.Item Good Outcomes of Patients with Stage IB Endometrial Cancer with Surgery Alone(2014) Rahatli, Samed; Dizdar, Omer; Kucukoztas, Nadire; Oguz, Arzu; Yalcin, Selim; Ozen, Ozlem; Reyhan, Nihan Haberal; Tarhan, Cagla; Yildiz, Ferah; Dursun, Polat; Altundag, Ozden; Ayhan, AliBackground: Most patients with endometrial cancer have stage I disease. Adjuvant therapy in stage IB (formerly IC) endometrial cancer is controversial, treatment options including observation or brachytherapy/radiotherapy in grade 1-3 patients with or without chemotherapy. The purpose of this study was to assess the outcomes of our patients with stage IB endometrioid endometrial cancer. Materials and Methods: Sixty two patients with stage IB endometrial cancer and endometrioid histology were retrospectively evaluated. All patients were initially treated surgically by the same surgeon with comprehensive staging, i.e. total abdominal hysterectomy, bilateral salphingooopherectomy, bilateral pelvic and paraaortic lymph node dissection and omentectomy. Adjuvant radiotherapy was discussed with patients and utilized by those who accepted. Adjuvant chemotherapy was not given to any of the patients. Results: Median age was 62 (range, 42-95). Ninety percent of the patients had grade 1-2 disease. Thirteen patients (21%) received intra vaginal brachytherapy (IVBT) and one received whole pelvic radiotherapy (WPRT). Median follow-up time was 46 months (range, 9-77 months). Three patients experienced recurrence (4.8%), two of them died on follow-up and one was still alive at last visit. Two patients with recurrence had FIGO grade 2 tumors and one had a grade 3 tumor. Two patients (3.2%) died without evidence of recurrent disease. Relapse free survival at 5 years was 94.4% and overall survival was 93.1%. Conclusions: Patients with stage IB disease in our study demonstrated relatively low recurrence rates with this stage of endometrial cancer.Item Diagnostic value of histopathologic examination in alopecias(2014) Ozcan, Deren; Ozen, Ozlem; Seckin, DenizAlopecias are evaluated in two groups, namely noncicatricial type and cicatricial type. Cicatricial alopecias are generally irreversible due to the permenant damage to the hair follicles and as follicular epithelium is replaced by connective tissue in the late stages. In noncicatricial alopecia, the follicular epithelia is intact and hair regrowth is likely. The accurate diagnosis of alopecia subtypes which have different etiologies and occasionally result in permanent hair loss is of paramount importance to initiate the appropriate treatment in the early stages. Most of the subtypes of alopecia can be diagnosed with a detailed history and clinical evaluation. However, most of the disorders leading to alopecia present with nonspecific and overlapping clinical findings which alter over the course of the disease. In those instances, scalp biopsy and histopathologic evaluation is necessary to make or confirm the diagnosis. Transverse and vertical sections used for the interpretation of scalp biopsy specimens offer different advantages. Therefore, idealy, obtaining two 4 mm punch biopsy samples and combining both methods is suggested to enhance the diagnostic yield in patients with alopecia. In this review, the value of scalp biopsy in the diagnosis of subtypes of alopecia, the significance of evaluation of transverse and vertical sections in the histopathologic examination and the major histopathologic findings of the disorders involved in the etiology are described.Item A Rat Model of Acute Respiratory Distress Silymarin's Antiinflamatory and Antioxidant Effect(2016) Adiguzel, Senay Canikli; Pirat, Arash; Turkoglu, Suna; Bayraktar, Nilufer; Ozen, Ozlem; Kaya, MugeObjective: In this study, it was aimed to evaluate the anti-inflammatory and antioxidative effects of Silymarin in rats in whom artificial acute pulmonary damage was provided with caecal ligation-perforation method. Material and Method: Forty-six rats were randomized to sham (n=14), control (n=16), silymarin (n=16) groups. Each group had early and late subgroups. Silimarin was administered in the silimarin group and saline was administerd in control and sham groups. Artificial acute pulmonary damage associated with sepsis was provided with caecal ligation-perforation method in control and silimarin groups. Rats in the early subgroup Were terminated at the end of the 12th hour and threats in the late group were followed-up. Serum and bronchoalveolar lavage fluid (BAL) tumor necrosis factor (TNF)-alpha, interleukin (IL)-1beta, and IL-6; lung tissue malondialdehyde (MDA) and glutathione (GSH) levels; lung histopathologic examination; and lung wet-to-dry (w/d) weight ratio measurements were used to compare and evaluate the severity of lung injury between the groups. Results: Mortality rates for silymarin and control groups were 62.5% and 12.5%, respectively (log-rank p=0.0506). Compared with the silymarin group, the control group exhibited significantly more severe lung injury, as indicated by higher mean values for serum and BAL TNF-alpha, IL-1beta and IL-6 (p<0.05 for all measurements), total lung histopathologic injury score (p=0.001), w/d (p=0.019) and lung-tissue MDA (p=0.011) levels. Lung tissue GSH levels were significantly higher in silymarin group than control group (p=0.001). Conclusion: Silymarin reduces the severity of sepsis induced-acute lung injury and may also improve survival in a cecal ligation and perforation rat model. These beneficial effects of this agent are probably due to its inhibitory effects on inflammatory process and oxidative injury.Item Effect of Topical Platelet-Rich Plasma on Burn Healing After Partial-Thickness Burn Injury(2016) Ozcelik, Umit; Ekici, Yahya; Bircan, Huseyin Yuce; Aydogan, Cem; Turkoglu, Suna; Ozen, Ozlem; Moray, Gokhan; Haberal, Mehmet; 27262706Background: To investigate the effects of platelet-rich plasma on tissue maturation and burn healing in an experimental partial-thickness burn injury model. Material/Methods: Thirty Wistar albino rats were divided into 3 groups of 10 rats each. Group 1 (platelet-rich plasma group) was exposed to burn injury and topical platelet-rich plasma was applied. Group 2 (control group) was exposed to burn injury only. Group 3 (blood donor group) was used as blood donors for platelet-rich plasma. The rats were killed on the seventh day after burn injury. Tissue hydroxyproline levels were measured and histopathologic changes were examined. Results: Hydroxyproline levels were significantly higher in the platelet-rich plasma group than in the control group (P=.03). Histopathologically, there was significantly less inflammatory cell infiltration (P=.005) and there were no statistically significant differences between groups in fibroblast development, collagen production, vessel proliferations, or epithelization. Conclusions: Platelet-rich plasma seems to partially improve burn healing in this experimental burn injury model. As an initial conclusion, it appears that platelet-rich plasma can be used in humans, although further studies should be performed with this type of treatment.Item Lichen planopilaris: Demographic, clinical and histopathological characteristics and treatment outcomes of 25 cases(2015) Ozcan, Deren; Seckin, Deniz; Gulec, A.Tulin; Ozen, Ozlem; 0000-0002-7450-6886; 0000-0002-9082-1317; AAQ-6649-2021; AAK-4468-2021Background and Design: Lichen planopilaris (LPP) is a type of cicatricial alopecia characterized by autoreactive lymphocytic destruction of the hair follicle. We aimed to evaluate the demographic, clinical and histopathological features, and treatment outcomes of patients with LPP. Materials and Methods: Medical reports of 25 patients, who have been diagnosed with LPP according to the clinical and histopathological findings between January 2006 and June 2012, were retrospectively reviewed. The transverse and vertical sections of scalp biopsy specimens were re-evaluated by a pathologist, and the findings were noted. Results: Of the 25 patients, 18 were female and 7 were male, the mean age was 49.8 +/- 12.4 years. Eighteen patients had been diagnosed with classic LPP and 7 patients with frontal fibrosing alopecia (FFA). The alopecia has begun in postmenopausal period in 5 patients with FFA. Alopecia was associated with pruritus, pain and/or burning in 19 patients. Extra-scalp involvement was observed in 11 patients. The most common clinical findings were follicular hyperkeratosis (92%), perifollicular erythema (48%), perifollicular lichenoid papules, and positive hair-pull test (44%). Dermatoscopic examination was performed in 14 patients, and most commonly, absence of follicular openings (100%), perifollicular scales (92.9%) and perifollicular erythema (50%) were noted. The most common diagnostic histopathological findings were follicular vacuolar and lichenoid degeneration (88%) and vacuolar and lichenoid interface changes (56%). Twenty-three patients who were started on treatment received topical, intramuscular and intralesional corticosteroids, topical minoxidil, oral tetracycline, cyclosporine A, and hydroxychloroquine either alone or in combination. Progression of alopecia was prevented and the symptoms and/or signs were reduced in 12 (75%) of 16 patients whose follow-up data were available. Conclusion: LPP can be diagnosed accurately through a detailed clinical examination, dermatoscopy and histopathological examination. The symptoms and/or signs can be reduced and progression of the disease can be prevented with treatment.Item SEROUS VERSUS HIGH-GRADE ENDOMETRIOID ENDOMETRIAL CARCINOMA: IMMUNOHISTOCHEMISTRY OF RFP IS NOT USEFUL FOR DIFFERENTIATION(2016) Ussakli, Cigdem; Usubutun, Alp; Dicner, Nazmiye; Dolgun, Anil; Bulbul, Dilek; Isikdogan, Zuhal; Haberal, Nihan; Ozen, Ozlem; Tezel, Gaye Guler; 0000-0001-9852-9911; 28155970; AAK-4587-2021We evaluated the immunohistochemical expression of ret finger protein (RFP) along with conventional immunohistochemical markers in endometrioid and serous carcinomas of the endometrium. A total of 124 endometrial carcinoma cases (24 grade 1 endometrioid, 60 grade 3 endometrioid, 40 serous) were retrieved from pathology archives. Tissue microarrays were constructed. The expression of RFP, WT1, ER., PR, p53 and p16 was examined immunohistochemically. Sensitivity, specificity, area under the receiver operating characteristic (ROC) curve, kappa statistic for interobserver reproducibility, Kruskal-Wallis test, Mann-Whitney U test and Fisher's exact tests were performed for statistical analyses. The mean RFP score was 1.54 in grade 1 endometrioid, 4.31 in grade 3 endometrioid, and 6.31 in serous carcinomas (p < 0.001). Overall, RFP scores were higher both in serous and grade 3 endometrioid carcinoma (p > 0.05), and significantly lower in grade 1 endometrioid carcinoma (p < 0.05). p16 and p53 staining patterns were able to differentiate between high-grade endometrioid and serous carcinoma (p < 0.001). ER, PR and WT-1 did not reach statistical significance for subtyping. The kappa values of the general agreement between the observers were 0.737 and 0.727 for endometrioid and serous carcinomas respectively (p < 0.001). Diffuse p53 and p16 staining provides the most sensitive and specific immunomarkers for differentiating high-grade endometrioid and serous carcinomas.