Browsing by Author "Aker, Sibel"

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Anatomy of the floor of the third ventricle in relation to endoscopic ventriculostomy
(Wiley, 2009-11) Aydın, Selçuk; Yılmazlar, Selçuk; Aker, Sibel; Korfalı, Ender; Uludağ Üniversitesi/Tıp Fakültesi/Nöroşirürji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0003-3633-7919; AAH-5070-2021; 35408763200; 6603059483; 12795285000; 7004641343
Neuroanatomical structures that form the floor of the third ventricle (FTV) and neighboring tissues are important in the context of third ventriculostomy (TV) procedures. Thorough knowledge of the anatomical and histological organization of the region would be useful in understanding and preventing surgical complications. Taking the third ventricle region as a model, we aimed to simulate TV and make measurements of 23 cadaver brains, as well as perform histological examinations of the third ventricular floor on five cadaver brains. During the endoscopic TV, we examined the degree to which the structures surrounding the FTV were affected by surgical simulation. To make a clinical comparison, the distance between the center of the FTV and the basilar apex was measured on cranial magnetic resonance images (MRIs) of 15 subjects with normal ventricular systems and 15 subjects with moderately enlarged ventricles. Histological examination revealed that the ependynnal cells and arachnoid membrane formed the inner and outer surfaces of the third ventricle floor, respectively, whereas the stroma was made up of glial cells exclusively. This region was gliotic and avascular. When cadaver brains with normal and hydrocephalic ventricles were compared, there were significant differences in the distance between the center of the floor and the basilar apex (P < 0.001). On the basis of our study, the optimal site for TV fenestration and balloon inflation is just anterior to the mamillary bodies to avoid injury to neighboring structures.
Anti-inflammatory efficiency of levobupivacaine in an experimental colitis model
(Baishideng Publishing Group, 2010-05-28) Duman, Uğur; Yılmazlar, Aysun; Öztürk, Ersin; Aker, Sibel; Sarandöl, Emre; Yılmazlar, Tuncay; Uludağ Üniversitesi/Tıp Fakültesi/Genel Cerrahi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Patoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Biyokimya Anabilim Dalı.; 0000-0002-2593-7196; 0000-0002-4946-555X; ABE-1716-2020; H-5770-2018; 36971700700; 55899579900; 35070171400; 12795285000; 55943324800; 6701800362
AIM: To investigate the efficiency of levobupivacaine in treating experimentally induced colitis in rats. METHODS: Colitis was induced by trinitrobenzene sulfonic acid and ethanol in 30 rats under general anesthesia, and 10 rats were used as a sham group. Subsequent to induction of colitis, rats were divided into three groups; budesonide group received 0.1 mg/kg budesonide, levobupivacaine group received 10 mg/kg levobupivacaine and saline group received 1 mL saline solution via rectal route for 7 d. In the sham group, only routine rectal catheterization was performed without use of any material. At the end of 7 d, laparotomy and total colectomy were performed for histopathological examination in all rats and blood samples were drawn for measurement of tumor necrosis factor (TNF)-alpha and interleukin (IL)-6 following cardiac puncture. Macroscopic and microscopic evaluations of the specimens were performed by a pathologist blinded to group assignment of the rats. RESULTS: Weight loss (P = 0.016) and macroscopic examination scores (P = 0.001) were significantly higher in saline group than others. Histopathological scoring was comparable between all colitis groups (P = 0.350). There was no significant difference in TNF-alpha levels and IL-6 levels (P = 0.150). CONCLUSION: The significant improvement in macroscopic scores suggests that levobupivacaine may have topical anti-inflammatory effects in an experimental colitis model; however, this finding was not supported by microscopic findings.
A case with three primary tumors of the ovary, endometrium and gallbladder
(IMR Press, 2008) Ozan, Hakan; Özerkan, Kemal; Aker, Sibel; Bülbül, Mehmet; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0001-5695-2586; A-6588-2019; AAH-9791-2021; 7003908072; 6603345841; 12795285000; 7004692452
A case with three synchronous tumors is presented. A 52-year-old patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy, bilateral pelvic kind paraaortic lymph node dissection. and partial omentectomy for endometrial carcinoma accompanied by an adnexal mass. She further underwent cholecystectomy for a perioperative incidental suspicious nodule on the serosal surface of the gallbladder. Histopathology revealed a uterine endometrioid adenocarcinoma, a mucinous adenocarcinoma of the gallbladder, and kin ovarian endometrioid carcinoma with a clear cell component. The progress of the patient until the time of death is discussed.
Comparison of lateral and superior walls of the pituitary fossa with clinical emphasis on pituitary adenoma extension: Cadaveric-anatomic study
(Springer, 2008-01) Kürşat, Erim; Yılmazlar, Selçuk; Aker, Sibel; Aksoy, Kaya; Oygucu, Hakan; Uludağ Üniversitesi/Tıp Fakültesi/Nöroşirürji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Anatomi Anabilim Dalı.; 0000-0003-3633-7919; AAH-5070-2021; 7199344935; 6603059483; 12795285000; 6701720577; 23012506600
Pituitary adenomas extend to the suprasellar region via diaphragmal passage and extend to the cavernous sinus via the medial wall (MW). Better understanding of the dynamics of suprasellar and parasellar extension of sellar region pathologies requires microanatomical comparison of diaphragma sellae (DS) and the MW of the cavernous sinus. This study provides the first detailed quantitative assessment between DS and MW of the cavernous sinus. Microanatomical details and histopathological examinations of the DS and MWs of the cavernous sinus were studied in sphenoid block samples obtained from adult cadavers, and the thicknesses of the DS and the MW of the cavernous sinus were measured. Mean thickness of the DS was 216.73±51.26 μm in the center and 367.33±133.66 μm in the periphery. Mean thickness of the lower third of the MW was 161.53±53.86 μm and that of the upper third was 278.46±162.79 μm. Difference between the thicknesses of the upper and lower thirds was significant (P<0.001). When the central thickness of the DS and lower third of the MW were compared, a significant difference was found (P<0.01). Our measurements suggest that when the DS is thick and the stalk opening is complete, the thickness of the lower third of the medial wall could be the major determinant of parasellar extension.
Cystadenoma originating from the gallbladder
(Wiley, 2010-04) Duşak, Abdürrahim; Topal, Naile Bolca; Gökalp, Gökhan; Aker, Sibel; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Patoloji Anabilim Dalı.; AAI-2336-2021; 8312505100; 12795285000
Biliary cystadenomas are very uncommon benign tumors. They are very rare occurrences in the gallbladder, and there are only a few case reports in the literature.(1-3) Cystadenomas are more frequently seen among middle-aged women. The clinical presentation varies and depends on the size and location of the cyst. They are unilocular or multilocular cystic tumors that contain septations. Although biliary cystadenomas are of a benign nature, they may recur after excision, nd there is a risk of development of cystadenosarcomas.(4-6) Hepatobiliary cystadenomas are most commonly seen in the liver (83%) followed by the extrahepatic biliary system (13%) and gallbladder (0.02%).(7) In this report, we present the sonographic results of a rare case of cystadenoma originating in the gallbladder.
Decreased plasma levels of soluble receptor for advanced glycation endproducts (sRAGE) in patients with nonalcoholic fatty liver disease
(Pergamon-Elsevier Science, 2009-06) Atuğ, Özlen; Yılmaz, Yusuf; Ulukaya, Engin; Gül, Özen Öz; Arabul, Mahmut; Gül, Cuma Bülent; Oral, Arzu Yılmaztepe; Aker, Sibel; Dolar, Mahmut Enver; Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Dahiliye Anabilim Dalı.; 0000-0003-2467-9356; 0000-0003-0463-6818; 0000-0003-4518-5283; A-7063-2018; AAI-1005-2021; AAG-9177-2021; A-5841-2017; K-5792-2018; 22936014300; 6602927353; 26040787100; 15925230900; 23988796000; 23091316500; 12795285000; 6602075084
Objectives: Levels of soluble receptor for advanced glycation endproducts (sRAGE) have been linked to several components of the metabolic syndrome. We tested the hypothesis that plasma levels of sRAGE may be associated with non-alcoholic fatty liver disease. Design and methods: We enrolled subjects with definite nonalcoholic steatohepatitis (NASH, n=40), borderline NASH (n=8), simple fatty liver (n=9) and healthy controls (n=14). Plasma levels of sRAGE were measured by ELISA. Results: Concentrations of sRAGE were significantly lower in patients with definite NASH (1080 +/- 392 pg/mL, P<0.01) and borderline NASH (1050 +/- 278 pg/mL, P<0.05) compared to controls (1480 +/- 387 pg/mL). Levels of sRAGE were significantly and inversely correlated with ALT (r=-0.30, P<0.05) and AST (r=-0.23, P<0.05). Conclusion: Plasma levels of sRAGE are significantly reduced in definite and borderline NASH.
Do liver IL-12 levels predict sustained response to ifn-α therapy in children with chronic hepatitis B?
(Mary Ann Liebert, 2010-06) Özkan, Tanju B.; Budak, Ferah; Erdemir, Gülin; Özgür, Taner; Aker, Sibel; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/ Tıbbi Mikrobiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/ Tıbbi Patoloji Anabilim Dalı.; 0000-0001-5740-9729; AAG-8381-2021; F-4657-2014; 7004474005; 6701913697; 36015044400; 36087775800; 12795285000
The aim of this study is to investigate the immunoregulatory role of interleukin-12 and interferon-gamma in children with chronic hepatitis B who are treated with interferon-alpha therapy. The patients were divided into 2 groups: Group I included 16 children with naive chronic replicative hepatitis B infection, and Group II included 6 children who are inactive hepatitis B virus (HBV) carriers. Group I received interferon-alpha subcutaneously (10 mU/m(2)/dose), 3 times a week during 4 months. Initial serum alanine aminotransferase (ALT) levels, hepatitis B serologic markers, serum interleukin-12 and interferon-gamma levels were measured. In Group I, laboratory tests were re-evaluated in the second and fourth months. Liver biopsy was performed in all patients and samples were used for tissue interleukin-12 level evaluation and histopathological examination. Hepatic activity index (HAI) and serum interferon-gamma were significantly higher in Group I (P < 0.05). Initial tissue interleukin-12 levels in Group I were low but a significant increase was observed at the fourth month (P < 0.05). While responder patients in Group I had marked elevation of tissue interleukin-12 levels, nonresponders did not reveal considerable changes at the fourth month evaluation. A negative correlation was found between serum HBV-DNA copies and interferon-gamma levels prior to therapy (P < 0.01, r: -0.66). The analysis of cytokine levels with serum transaminases demonstrated a positive correlation between the tissue interleukin-12 levels at the fourth month and serum ALT levels at the beginning and second month of the therapy (r: 0.77, P < 0.05 and r: 0.92, P < 0.05, respectively). This is the first study emphasizing the relationship between tissue cytokine levels and therapy success. Understanding the course of chronic hepatits B in the pediatric population will help us to clarify some debates on the treatment.
Drain-site metastasis observed following surgery and radiotherapy of an endometrial carcinoma figo stage ic patient: Case report
(Galenos Yayıncılık, 2008-03-01) Ozan, Hakan; Özdil, Murat; Özyürek, Eser Tefik; Özerkan, Kemal; Kıran, Beray; Aker, Sibel; OZAN, HAKAN; Özdil, Murat; Özyürek, Eser Tefik; ÖZERKAN, KEMAL; Kıran, Beray; Aker, Sibel; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; DKZ-4159-2022; AAH-9791-2021; JLF-4109-2023; INC-9610-2023; FDT-3930-2022; EJH-8721-2022
Endometrial carcinoma is the most prevalent malignancy of the genital tract. With early diagnosis and treatment, its prognosis is more favorable than other gynecological malignancies. The objective of this case study is to present a very rare condition of a drain site metastasis following the treatment of a low stage endometrial carcinoma.A 63 year old woman was operated for endometrial carcinoma (histological subtype: Endometrioid) FIGO Stage IC (Grade I) and treated with the brachytherapy protocol, postoperatively. During the routine postoperative follow-up exams every three months, she presented with a mass in the right lower abdominal quadrant located at the drain site in the 15th postoperative month. Biopsy sampling of this mass revealed metastatic endometrioid adenocarcinoma. Radiotherapy followed by chemotherapy and eventually surgery was planned forthe resection of the regressed mass.Similar metastatic lesions in gynecological cancers are mostly restricted to high stage ovarian and peritoneal malignancy conditions, and are usually located at trochar port sites and paracentesis puncture points. Nevertheless, this case shows that other early stage malignancies may as well metastasize in a similar fashion and should not be overlooked in the follow-up examinations.
Foramen of Monro meningioma with atypical appearance: CT and conventional MR findings
(Wiley-Blackwell Publishing, Inc, 2007-10-08) Hakyemez, Bahattin; Erdoǧan, Cüneyt; Oruç, Esra; Aker, Sibel; Aksoy, Kaya; Parlak, Müfit; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Nöroşirürji Anabilim Dalı.; 0000-0002-3425-0740; AAI-2318-2021; 6602527239; 8293835700; 22136162300; 12795285000; 6701720577; 7003589220
Intraventricular meningiomas have often been reported; however, literature reveals very few cases localized within foramen of Monro. Herein we report a 57-year-old woman admitted with obstructive hydrocephalus-related symptoms. Strikingly, the lesion was completely calcified in CT and had no marked solid component on MRI. The lesion was completely removed by surgical resection with a transfrontal intraventricular approach. The resected mass was histopathologically diagnosed as meningioma. The patient's symptoms resolved immediately after the operation.
Hibernoma of the spermatic cord in a child: Case report
(Ortadogu Yayınevi, 2012-08) Kiriştioğlu, İrfan; Adıgüzel, Ünal; Aker, Sibel; Doğruyol, Hasan; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Cerrahisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 21645753900; 36503502000; 12795285000; 56624750400
Hibernomas are rare benign neoplasms derived from the remnants of fetal brown adipose tissue, seen mainly in adults. Most of them are located in areas that normally include brown-fat remnants. Although these tumors are considered benign and malignant transformation has not been reported, they tend to grow into large sizes. If a hibernoma is detected during inguinoscrotal approaches, it should be excised totally because of the risk of growth. To date, recurrence has not been described following complete excision, which is therefore recommended as the treatment of choice. We would like to present an 11-month-old child with hibernoma of the spermatic cord which was surgically treated. One child presenting such a lesion has previously been reported in the literature.
Lumbar spinal extradural angiolipomas - Two case reports
(Japan Neurosurgical Society, 2006-03) Doğan, Şeref; Arslan, Erhan; Şahin, Soner; Aksoy, Kaya; Aker, Sibel; Uludağ Üniversitesi/Tıp Fakültesi/Beyin Cerrahisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; AAI-6531-2021; 7102693077; 7004957314; 8272141000; 6701720577; 12795285000
Spinal extradural angiolipomas are benign tumors mostly localized in the thoracic region. A 50-year-old woman and a 36-year-old man presented with rare lumbar spinal angiolipoma manifesting as low back pain but without neurological signs. Magnetic resonance imaging showed lumbar extradural tumors at the L4-5 and L1-2 levels, respectively. Each patient underwent complete surgical resection of the epidural tumors. Histological examination revealed characteristics of angiolipomas in both tumors. The symptoms of both patients improved postoperatively and no recurrence of the tumors was found 1 year after surgery.
Memenin psödoanjiomatöz stromal hiperplazisi: olgu sunumu
(Uludağ Üniversitesi, 2004-11-12) Aker, Sibel; İnal, Gülşah; Erdoğan, Ayşe; Taşdelen, İsmet; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Genel Cerrahi Anabilim Dalı.
Psödoanjiomatöz stromal hiperplazi (PASH) meme stromasının, benign proliferatif bir lezyonudur. Çoğunlukla premenapozal kadınlarda, ağrısız ve palpe edilebilen bir meme kitlesi şeklinde görülür. PASH’ın etyolojisi bilinmemektedir. Ancak hormonal faktörlerin hastalığın gelişiminde rol aldığı düşünülmektedir. Bu yazıda, bir PASH olgusu klinik özellikleri ve histolojik bulguları ile birlikte sunulmuştur.
Primary central nervous system lymphoma in a renal transplant recipient with Bardet-Biedl syndrome
(Elsevier Science, 2005) Ersoy, Alparslan; Kahveci̇oğlu, Serdar; Bekar, Ahmet; Aker, Sibel; Akdaǧ, İbrahim; Dilek, Kamil; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Nöroşirurji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0002-0710-0923; AAH-5054-2021; 35612977100; 55956719500; 6603677218; 12795285000; 8342488100; 6603823242
Bardet-Biedl syndrome (BBS) is a rare autosomal recessive disorder. End-stage renal failure has been reported as the most frequent cause of death in this disorder. There are few reports of kidney transplantation in these patients. Renal transplant patients are known to be at increased risk for the development of malignancies. Although a few patients with BBS have been described to develop malignant disease, there was no previous association with lymphoma. We report a 20-year-old patient in whom primary central nervous system lymphoma was diagnosed 20 months after renal transplantation.
A rare reason for pulmonary hypertension: Primary sarcoma of the pulmonary artery
(Forum Multimedia Publishing, 2010-02) Kaderli, Aysel Aydın; Baran, İbrahim; Sağ, Saim; Biçer, Murat; Aker, Sibel; Uludağ Üniversitesi/Tıp Fakültesi/Kardiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Kalp ve Damar Cerrahisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Patoloji Anabilim Dalı.; 0000-0001-8404-8252; AAW-9185-2020; ABC-2231-2020; 7801322152; 35572557400; 12140008100; 6507770944; 12795285000
Primary sarcoma of the pulmonary artery (PSPA) is an extremely rare tumor of the cardiovascular system. The prognosis is very poor. The clinical symptoms and imaging findings imitate those of pulmonary emboli, causing delays in diagnosis. In this case report, we describe a 73-year-old man with PSPA who initially was admitted with exertional shortness of breath. Transthoracic echocardiographic evaluation revealed 2 masses in the pulmonary artery causing pulmonary hypertension. The patient underwent operation, but he could not be weaned off cardiopulmonary bypass at the end of the operation and died. Pathologic examination of the masses revealed pulmonary sarcoma. Although this patient was admitted to our clinic only 2 weeks after the initial symptoms, he already had distal metastases.
Soluble forms of extracellular cytokeratin 18 may differentiate simple steatosis from nonalcoholic steatohepatitis
(Baishideng Publishing Group Inc, 2007-02-14) Yılmaz, Yusuf; Dolar, Enver; Ulukaya, Engin; Akgöz, Semra; Keskin, Murat; Kıyıcı, Murat; Aker, Sibel; Yılmaztepe, Arzu; Gürel, Selim; Gülten, Macit; Nak, Selim Giray; Yılmaz, Yusuf; DOLAR, MAHMUT ENVER; Ulukaya, Engin; GÜREL, SELİM; NAK, SELİM GİRAY; Akgöz, Semra; Keskin, Murat; KIYICI, MURAT; Aker, Sibel; YILMAZTEPE ORAL, ARZU; GÜLTEN, MACİT; Uludağ Üniversitesi/Tıp Fakültesi/Dahiliye Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/İstatistik Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0003-4518-5283; 0000-0003-4875-5472; 0000-0003-4526-4352; 0000-0002-3208-6211; 0000-0002-8962-9758; K-6651-2012; AAG-9177-2021; K-5792-2018; EKV-4953-2022; JZY-7001-2024; AAI-4213-2021; EJH-8721-2022; A-5841-2017; HLH-8209-2023; EYR-7166-2022; FQM-3662-2022
AIM: To investigate whether serum levels of two soluble forms of extracellular cytokeratin 18 (M30-antigen and M65-antigen) may differentiate nonalcoholic steatohepatitis (NASH) from simple steatosis in patients with nonalcoholic fatty liver disease (NAFLD).METHODS: A total of 83 patients with suspected NAFLD and 49 healthy volunteers were investigated. Patients with suspected NAFLD were classified according to their liver histology into four groups: definitive NASH (n = 45), borderline NASH (n = 24), simple fatty liver (n = 9), and normal tissue (n = 5). Serum levels of caspase-3 generated cytokeratin-18 fragments (M30-antigen) and total cytokeratin-18 (M65-antigen) were determined by ELISA.RESULTS: Levels of M30-antigen and M65-antigen were significantly higher in patients with definitive NASH compared to the other groups. An abnormal value (> 121.60 IU/L) of M30-antigen yielded a 60.0% sensitivity and a 97.4% specificity for the diagnosis of NASH. Sensitivity and specificity of an abnormal M65-antigen level (> 243.82 IU/L) for the diagnosis of NASH were 68.9% and 81.6%, respectively. Among patients with NAFLD, M30-antigen and M65-antigen levels distinguished between advanced fibrosis and early-stage fibrosis with a sensitivity of 64.7% and 70.6%, and a specificity of 77.3% and 71.2%, respectively.CONCLUSION: Serum levels of M30-antigen and M65-antigen may be of clinical usefulness to identify patients with NASH. Further studies are mandatory to better assess the role of these apoptonecrotic biomarkers in NAFLD pathophysiology. (C) 2007 The WJG Press. All rights reserved.
Successful treatment of thymoma-associated erythroid hypoplasia and thrombocytopenia with paclitaxel
(Elsevier, 2005-02) Kanat, Özkan; Evrensel, Türkkan; Kurt, Ender; Arslan, Murat; Demiray, Mutlu; Aker, Sibel; Manavoğlu, Osman; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Onkoloji ve Patoloji Anabilim Dalı.; 0000-0002-9732-5340; 0000-0003-2501-3097; AAJ-1027-2021; M-8060-2019; 6602187347; 6603942124; 7004319959; 57197925370; 6603631569; 57207515238; 6602587152
Surgical limits in transnasal approach to opticocarotid region and planum sphenoidale: An anatomic cadaveric study
(Elsevier Science, 2010-04) Özcan, Tekin; Yılmazlar, Selçuk; Aker, Sibel; Korfali, Ender; Uludağ Üniversitesi/Tıp Fakültesi/Beyin ve Sinir Cerrahisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Patoloji Anabilim Dalı.; 0000-0003-3633-7919; AAH-5070-2021; 25636374000; 6603059483; 12795285000; 7004641343
BACKGROUND: The significance of medial and lateral opticocarotid recesses and the planum sphenoidale region in skull base pathologies for the transsphenoidal-transplanum approach were evaluated. METHODS: The sphenoid bone block samples were extracted from adult cadavers. Dissections and measurements in the opticocarotid and planum sphenoidale regions were performed in 29 samples using a surgical microscope. For histologic evaluation, oblique sections through the bilateral opticocarotid regions were obtained and examined in eight samples. RESULTS: Optic, carotid prominences, and medial and lateral opticocarotid recesses can be identified as lateral markers intraoperatively to the extent of the exposure. The lateral opticocarotid recess was observed to be prominent in all samples. In all samples, the groove formed by optic and carotid prominences between the medial and lateral opticocarotid recesses was seen. This groove was designated the inter-recess sulcus. In the transsphenoidal-transplanum approach, the area needed for a reliable bone resection was measured as a mean of 237.32 +/- 30.96 mm(2). The mean angle between optic nerves was 115.41 +/- 18.39 degrees. The mean anteroposterior length of the planum sphenoidale was 14.84 +/- 1.52 mm. In histologic sections, collagenous ligaments between the anterior part of cavernous sinus and the adventitia layer of internal carotid artery were more frequent and regular than the inferior part of optic nerve. CONCLUSIONS: The lateral opticocarotid recess is a reliable and persistent indicator for extended transsphenoidal surgery. To approach the opticocarotid region near the internal carotid artery and optic nerve, a careful dissection is needed to minimize surgical injuries to the optic nerve and carotid artery. Other factors determining a reliable bone resection are the anteroposterior length of the planum sphenoidale and the distance and width of the angle between optic nerves. Attention should be given to individual anatomic variations of the region when planning and performing transsphenoidal-transplanum surgery.
Tiroid papiller karsinomunda tiroglobülin, CEA, CerbB-2, p53 salınımı, prognostik önemleri ve diğer prognostik faktörlerle ilişkiler
(Uludağ Üniversitesi, 2003) Aker, Sibel; Yerci, Ömer; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.
Endokrin neoplazmlar arasında tiroidin malign epitelyal neoplazmları ve bunlar içinde de tiroid papiller karsinomları sık görülür. Klasik papiller karsinomda yaşam süresi uzun, nüks azdır. Bazı tiroid papiller karsinomlu olgularda ise nispeten daha erken nüks görülür. Agresif davranış gösteren bu olgularda kısa bir zaman periyodunda ölüm meydana gelebilir. Tiroid papiller karsinomlu hastalarda yetersiz ya da gereksiz agresif tedavilerin önlenmesi, agresif davranış gösterebilecek olguların belirlenmesi ve seçici bir yaklaşım şansı tanımak için prognostik faktörlerin belirlenmesi gerekmektedir. Bu amaçla yaptığımız çalışmamızda 39 tiroid papiller karsinom olgusuna immünohistokimyasal olarak tiroglobülin, CEA, CerbB-2 ve p53 markırları uygulandı. Bu markırların pozitiflik oranları belirlendi. Markırların birbiriyle ve her bir markırın yaş, cinsiyet, tümör büyüklüğü ve lenf nodülü metastaz varlığı gibi prognostik faktörlerle olan korelasyonu ayrı ayrı değerlendirildi. Çalışmamızda tiroglobülin ve CEA ile boyanma prognoz hakkında bize yeterli bilgi vermezken; CerbB-2 ve p53 markırlarının salınımı; yaş, cinsiyet, tümör büyüklüğü ve lenf nodülü metastazı varlığı ile istatistiksel olarak karşılaştırıldığında anlamlı değer bulunamadı. Fakat bu markırların pozitifliği ile lenf nodülü metastazı varlığı arasındaki korelasyonu istatistiksel olarak anlamlı olan kritik değere yakın olması ve CerbB-2'nin tümör çapı büyük olgularda pozitif boyanması dikkati çekti. Bu nedenlerle daha geniş serilerde immünohistokimyasal markırlar ile boyanmaların prognoz açısından bize bilgiler vereceği kanaatine vardık. Sonuç olarak; son yıllarda yaygınlaşan immünohistokimyasal panel uygulamalarının tiroid papiller karsinomlu olgularda kullanılmasının, bu olguların doğru tanısının konmasına, hastaların uygun şekilde tedavi görmesine ve takibine katkıda bulunacağı kanaatindeyiz.