Fakülteler / Faculties
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Item Fine-Needle Aspiration Biopsy Findings of the Thyroid Gland in Renal Transplant Patients(2023) Akcay, Eda Yilmaz; Tepeoglu, Merih; Atilgan, Alev Ok; Yagci, Sergen; Ozdemir, Binnaz Handan; Haberal, Mehmet; 37885286Objectives: For patients with end-stage renal disease, thyroid diseases are common due to altered hormone excretion and transport, and for renal transplant recipients this is due to immunosuppressive drugs. We investigated the prevalence of thyroid disorders, including thyroid cancer, by fine-needle aspiration biopsy in kidney transplant candidates and recipients and estimated the outcomes. Materials and Methods: For 305 thyroid fine-needle aspiration biopsies performed from January 2000 to December 2020 in patients with end-stage renal disease, we recorded patient demographics, thyroid ultrasonography, and biopsy findings. Results: Of biopsy results from 305 patients, 272 (89.2%) were benign, 24 (7.9%) showed atypia of undetermined significance/follicular lesion of undetermined significance, 2 (0.7%) had suspicion for malignancy, and 7 (2.3%) were malignant. Thyroid surgery was performed for 13 patients with benign results, 6 with atypia of undetermined significance/follicular lesion of unde-termined significance, 2 with suspicion for malignancy, and 7 with malignancy. In 13 patients with benign cytology, the histopathology finding was also benign in lobectomy specimens. In 6 patients with atypia of undetermined significance/follicular lesion of undetermined significance, the final diagnosis was papillary thyroid carcinoma in 3 patients, adeno-matous hyperplasia in 2 patients, and Hurthle cell adenoma in 1 patient. For all 9 patients for whom fine-needle aspiration biopsy was suspicious for malignancy or malignant, histopathologic examination showed papillary thyroid carcinoma in total thyroidectomy materials. Among 12 papillary thyroid carcinoma patients, 4 underwent renal transplant after thyroidectomy, and survival for these 4 patients was 116.25 +/- 29.30 months after transplant without tumor recurrence or distant metastases. Conclusions: Thyroid diseases are more frequent in patients with end-stage renal disease or renal transplant versus the normal population and also affect morbidity and mortality at higher rates in these patients. Fine-needle aspiration biopsy is a useful diagnostic modality in evaluation and treatment of thyroid nodules in both kidney transplant candidates and recipients.Item T-Cell Acute Lymphoblastic Leukemia After Liver Transplant(2014) Ozkan, Eylem Akar; Ozdemir, B. Handan; Akcay, Eda Yilmaz; Atilgan, Alev Ok; Haberal, Mehmet; https://orcid.org/0000-0002-7528-3557; https://orcid.org/0000-0001-6831-9585; https://orcid.org/0000-0001-8595-8880; https://orcid.org/0000-0002-3462-7632; 24635812; X-8540-2019; AAK-1960-2021; AAK-3333-2021; AAJ-8097-2021T-cell posttransplant lymphoproliferative disorders after solid-organ transplant are rare and may be clinically aggressive. A 3-year-old boy had liver transplant from his grandfather because of hepatoblastoma. The immunosuppressive regimen was based on tacrolimus and prednisolone. At 22 months after transplant (age, 5 years)., the patient presented to the hospital because of severe cough. Computed tomography scan of the chest showed a large left mediastinal mass (9 x 7.2 x 7 cm) and left pleural effusion. A Tru-Cut biopsy of the mediastinal mass showed diffuse infiltration with blast cells, and the diagnosis of 1-cell acute lymphoblastic leukemia was made. Immunohistochemical examination of blasts showed strong and diffuse terminal deoxynucleotidyl transferase and CD3 antibody expression; Ki-67 proliferation index was > 95%, and tumor cells were negative for Epstein-Barr virus. Tacrolimus was stopped, sirolimus was started, and chemotherapy was given, but he died 2 months after diagnosis because of chemotherapy-induced sepsis. Monomorphic 1-cell posttransplant lymphoproliferative disorder with features of acute lymphoblastic leukemia and lymphoblastic lymphoma is rare after liver transplant.Item A Case of Cerebral Tuberculosis After Liver Transplant and Literature Review(2014) Tunca, M. Zeyneb; Akcay, Eda Yilmaz; Moray, Gokhan; Ozen, Ozlem; Ozdemir, B. Handan; https://orcid.org/0000-0001-6831-9585; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-9082-1317; https://orcid.org/0000-0002-7528-3557; 24635807; AAK-1960-2021; AAE-1041-2021; AAK-4468-2021; X-8540-2019The risk of active tuberculosis is high in solid-organ recipients. We evaluated the clinical presentation of tuberculosis. Pulmonary locations were the most frequent, and extrapulmonary locations were rarely seen. Among extrapulmonary sites, intracranial tuberculosis is rare, with a few case reports reported in the literature. We report a case of 27-year-old man, who received deceased-donor liver transplant due to hepatitis B virus-related chronic liver failure. One month after the liver transplant, neurologic symptoms developed, then he had attacks of tonicclonic convulsions. Cerebral stereotactic needle biopsy of left temporal lobe was performed. Histopathologically gliosis, rare lymphocyte infiltration, and epithelioid histiocytes were seen. Histochemical staining by Ziehl Neelsen stain noted acid-fast resistant bacillus. The case was diagnosed as granulomatous inflammation which led to tuberculosis. In addition to antituberculosis therapy, he was given antiviral therapy for prophylaxis. During therapy, reactivation of hepatitis B virus was noted, and the recurrent diseases of hepatitis B virus-related viral hepatitis was diagnosed on serial biopsies. Ten months after transplant, he died from liver failure. Tuberculosis is a serious opportunistic infection in transplant recipients. The incidence of transplant recipients worldwide ranges from 0.35% to 15%. In nonrenal transplant, rejection within 6 months before the onset of tuberculosis and type of primary immunosuppressive regimen were predictors of tuberculosis infection occurring 12 months after transplant. The diagnosis and effective management of tuberculosis after transplant warnings recognition of the epidemiologic and clinical characteristics of tuberculosis in transplant recipients.Item Bone Marrow Involvement by Lymphoproliferative Disorders After Solid-Organ Transplant(2015) Ozkan, Eylem Akar; Ozdemir, B. Handan; Akcay, Eda Yilmaz; Terzi, Aysen; Karakus, Sema; Haberal, Mehmet; 0000-0002-7528-3557; 0000-0002-1225-1320; 0000-0001-6831-9585; 0000-0002-3462-7632; 0000-0001-7615-4581; 25894151; X-8540-2019; F-7546-2013; AAK-1960-2021; AAJ-8097-2021; W-9092-2019Objectives: Posttransplant lymphoproliferative disorders are classified as monomorphic, polymorphic, early lesions, or Hodgkin lymphoma. Bone marrow staging examination is recommended in posttransplant lymphoproliferative disorder patients. However, information about bone marrow involvement in these disorders is scarce. We evaluated 19 transplant patients with posttransplant lymphoproliferative disorder to investigate incidence of bone marrow involvement, associated morphologic changes, and prognosis. Materials and Methods: We retrospectively assessed bone marrow findings of 19 transplant patients with posttransplant lymphoproliferative disorder who underwent bone marrow staging at Baskent University from 1985 to 2013. Clinical and pathologic data were reviewed from the medical records. Follow-up information was obtained from medical records or communication with patients or families. Data collected including age, sex, Epstein-Barr virus status, immunosuppressive therapy, elapsed time from transplant to diagnosis of posttransplant lymphoproliferative disorder, B symptoms, number of extranodal sites, involvement of different organs, Ann Arbor clinical staging, hematologic parameters, and serum lactate dehydrogenase levels. Results: There were 5 of 19 patients (26.3%) who had bone marrow involvement with posttransplant lymphoproliferative disorder, including 2 patients diagnosed with posttransplant lymphoproliferative disorder by lymph node biopsy and 1 patient each diagnosed by native liver biopsy, nasopharyngeal biopsy, or allograft liver biopsy. In 4 patients, there was monomorphic posttransplant lymphoproliferative disorder subtype and 1 patient had early lesion posttransplant lymphoproliferative disorder subtype. In 10 of 19 patients (52.6%), Epstein-Barr virus was detected with in situ hybridization, including 3 patients with bone marrow involvement who were diagnosed with Burkitt lymphoma (n = 1), diffuse large B-cell lymphoma (n = 1), or early lesion (n = 1). Conclusions: Patients with posttransplant lymphoproliferative disorder have high incidence of bone marrow involvement and high mortality rates. Therefore, bone marrow examination may be important in the diagnosis and staging evaluation of posttransplant lymphoproliferative disorder.Item The Beneficial Impact of D3 Vitamin on the Decline of Rejection, Epithelial-Mesenchymal Transition (EMT), And Interstitial Fibrosis Among Pediatric Renal Transplant Patients(2022) Akcay, Eda Yilmaz; Ozdemir, B. Handan; Baskin, Esra; Ozdemir, F. Nurhan; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0001-6831-9585; AAJ-8097-2021; AAK-1960-2021Item The Age of the Recipient and the Ratio of CD4/CD8 in Renal Allografts Influences the Prognosis and the Presenting Time of the Polyoma Virus-Associated Nephropathy (PVAN)(2022) Ozdemir, B. Handan; Akcay, Eda Yilmaz; Ozdemir, F. Nurhan; Baskin, Esra; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0001-6831-9585; AAJ-8097-2021; AAK-1960-2021Item The Relation Between The Inflamatory Cytokine Expression with Acute Rejection Episodes and Hepatitis Recurrence in Liver Allograft Recipients(2016) Ozgun, Gonca; Ozdemir, Binnaz Handan; Akcay, Eda Yilmaz; Borcek, Pelin; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0002-7528-3557; https://orcid.org/0000-0001-6831-9585; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; X-8540-2019; AAK-1960-2021; AAE-1041-2021; AAJ-8097-2021Item Sequential Biopsy Findings of Polyomavirus Associated Nephropathy(2016) Ozdemir, Handan; Ozdemir, Nurhan; Terzi, Aysen; Ayva, Sebnem; Akcay, Eda Yilmaz; Arslan, Hande; Ozdemir, Gokce; Haberal, Mehmet; https://orcid.org/0000-0002-7528-3557; https://orcid.org/0000-0002-5682-0943; https://orcid.org/0000-0002-1225-1320; https://orcid.org/0000-0002-2280-8778; https://orcid.org/0000-0001-6831-9585; https://orcid.org/0000-0002-5708-7915; https://orcid.org/0000-0003-2545-0078; https://orcid.org/0000-0002-3462-7632; X-8540-2019; AAK-1697-2021; F-7546-2013; AAK-1967-2021; AAK-1960-2021; ABG-7034-2021; AAL-4282-2020; AAJ-8097-2021Item The Effect of Probiyotics on The Healing of Colon Anastomosis After Ischemia and Reperfusion Injury in The Rat(2016) Ozcay, Necdet; Haberal, Mehmet; Akcay, Eda Yilmaz; Altun, Elif Buse; Deveci, Yurdagul; Ermin, Ece; Gulay, Seray; Haberal, Cem; https://orcid.org/0000-0002-3462-7632; https://orcid.org/0000-0001-6831-9585; AAJ-8097-2021; AAK-1960-2021Item Role of Tumor-Associated Macrophages in The Heximl and TGF Beta/SMAD Pathway, and Their Influence on Progression of Prostatic Adenocarcinoma(2016) Atilgan, Alev Ok; Ozdemir, B. Handan; Akcay, Eda Yilmaz; Demirkan, Ozlem Ataol; Tekindal, M. Agah; Ozkardes, Hakan; https://orcid.org/0000-0001-8595-8880; https://orcid.org/0000-0002-7528-3557; https://orcid.org/0000-0001-6831-9585; https://orcid.org/0000-0002-4060-7048; https://orcid.org/0000-0002-7277-449X; AAK-3333-2021; X-8540-2019; AAK-1960-2021; U-9270-2018; AAH-1052-2020Background: Hexamethylene bisacetamide-inducible protein 1 (Heximl) regulates transforming growth factor-beta (TGF beta) activity and turnover of SMAD proteins in a cyclin-dependent kinase 9-dependent way. It does so specifically through inhibiting function of this enzyme and by inhibiting the transcriptional activity of positive transcription elongation factor b (P-TEFb). Tumor-associated macrophages (TAMs) play a role in the progression of prostate adenocarcinomas. We investigated the clinicopathological significance of Heximl, TGF beta, SMAD2, and SMAD7 expression in prostate adenocarcinoma cells, and assessed associations between TAMs density and these proteins. Methods: The cases of 100 patients diagnosed with prostate acinar adenocarcinoma who had undergone radical prostatectomy were retrospectively examined. Each was reviewed for Gleason score, cancer stage, and specific histopathological features. Original slides were re-examined, and new slides were prepared and immunostained with Heximl, TGF beta, SMAD2, SMAD7 and CD68. Results: Heximi expression was positively correlated with Gleason score, cancer stage, lymphovascular invasion, perineural invasion, extracapsular extension, and positive surgical margin. TAMs density was positively correlated with Gleason score, cancer stage, perineural invasion, extracapsular extension, and positive surgical margin. TAMs density was positively correlated with Heximl expression and TGF beta expression. More advanced cancer stage, lymphovascular invasion, perineural invasion, and extracapsular extension were correlated with strong Heximl expression, strong SMAD2 expression, and mild SMAD7 expression, respectively. Strong Heximl expression, strong TGF beta expression, and mild SMAD7 expression were associated with higher Gleason score. Strong Heximl expression was correlated with strong TGF beta expression and mild SMAD7 expression. Strong Heximi expression, strong SMAD2 expression, and mild expression of SMAD7 were associated with disease progression. Strong SMAD2 expression was associated with shorter disease-free survival. Conclusion: The results suggest that greater TAMs density, strong Heximl expression, strong SMAD2 expression, and mild SMAD7 expression play important roles in the progression of prostate adenocarcinoma. Further investigation of these proteins will help facilitate the definitive prognosis of prostate adenocarcinomas. Ultimately, these proteins may be therapeutic targets for patients with prostate cancer. (C) 2015 Elsevier GmbH. All rights reserved.