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Öğe Comparison of the clinicopathological features of invasive ductal, invasive lobular, and mixed (invasive ductal + invasive lobular) carcinoma of the breast(Springer-Verlag Tokyo, 2015) Zengel B.; Yararbas U.; Duran A.; Uslu A.; Elıyatkın N.; Demırkıran M.A.; Cengiz F.; Şimşek C.; Postacı H.; Vardar E.; Durusoy R.Background: In this retrospective analysis, the clinicopathological features and pattern of metastatic spread of invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC), and mixed ductal/lobular carcinoma (MDLC), together with the type and outcome of surgical intervention, were comparatively evaluated. Methods: A total of 633 breast cancer patients with histopathological subtype IDC, ILC or MDLC were included in the study. The mean age was 52.6 ± 12.7 years. Follow-up period ranged between 0 and 33 (median 6.0) years. The groups were compared with respect to age, tumor size, nodal involvement, stage, hormonal therapy, multicentricity, multifocality, bilaterality, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2)/neu, p53, and Ki67 expression, disease-free survival (DFS) and overall survival (OS) rates, and surgical approach. Results: The distribution of patients was as follows: IDC 508 (80.3 %), ILC 78 (12.3 %), MDLC 47 (7.4 %). Among the parameters evaluated, statistically significant differences were observed in mean tumor size (IDC 2.5 ± 1.98 cm, ILC 3.0 ± 1.8 cm, MDLC 3.2 ± 2.4 cm), advanced T stage (T3 + T4) at diagnosis (IDC 14.7 %, ILC 21.4 %, MDLC 25.6 %), N stage (N0 was dominant in IDC and ILC; N3 was dominant in MDLC), tumor–node–metastasis (TNM) stage (stage II was dominant in IDC and ILC; stage III was dominant in MDLC), HER2/neu expression (IDC 23.8 %, ILC 11.8 %, MDLC 21.4 %), and frequency of bone metastasis (IDC 14.3 %, ILC 17.9 %, MDLC 25.5 %). Conclusions: MDLC-type tumors have different histopathological characteristics and are often diagnosed at advanced stage. However, their survival outcomes do not vary significantly from ILC and IDC. © 2013, The Japanese Breast Cancer Society.Öğe Infliximab in experimental alkali burns of the oesophagus in the rat(2008) Yukselen V.; Vardar E.; Yukselen O.; Oruc N.; Yenisey C.; Karaoglu A.; Ozutemiz O.Backgrounds : We aimed to investigate the efficacy of infliximab, a chimeric TNF-? antibody, in the prevention of fibrosis in an experimental alkaline burn of the oesophagus in the rat. Methods : Thirty-two Wistar albino rats divided into four experimental groups. Caustic oesophageal burn was induced by applying 37.5% NaOH to the distal oesophagus. Infliximab was given at a dose of 5 mg/kg via the intraperitoneal route. Group A (sham) animals were uninjured, group B had untreated oesophageal burns, group C had oesophageal burns treated with a single dose of infliximab on the first day, and Group D had oesophageal burns treated with infliximab on the first and 14th days. Efficacy of the treatment was assessed on the 28th-day by measuring stenosis index of the oesophagus and histopathological damage score, and biochemically by determining tissue hydroxyproline content. Results ; There was no significant difference between the Group B and the infliximab treated Groups C and D in means of tissue hydroxyproline content and histopathological damage scores. Stenosis index was not significantly different between the Group B, Group C, and Group D. Conclusion : Anti-TNF-? treatment with infliximab does not ameliorate the degree of fibrosis in alkali burns of the oesophagus in the rat. Further evaluation of inflammatory and immunological events leading to stricture in alkaline oesophageal burns may provide new perspectives for the treatment of alkaline oesophageal burns.Öğe Is there any non-invasive marker replace the needle liver biopsy predictive for liver fibrosis, in patients with chronic hepatitis?(2009) Vardar R.; Vardar E.; Demir S.; Sayhan S.E.; Bayol Ü.; Yildiz C.; Postaci H.Background/Aims: Non-invasive serum markers are being used to determine fibrosis score as an alternative to liver biopsy. The aim of the present study was to evaluate the accuracy and predictive value of the non-invasive markers in identifying the presence or absence of significant fibrosis in patients with chronic viral hepatitis. Methodology: A total of 557 patients (401 chronic hepatitis B (CHB), 156 chronic hepatitis C (CHC)) were enrolled into the study retrospectively. Liver biopsies were evaluated histopathologically according to the Knodell scoring system. Laboratory values such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), ?-glutamyltranspeptidase (GGT) and platelet count (PLT) was tested on the same day of liver biopsy. Using these laboratory values, AST/ALT ratio (AAR), age-platelet index (API) and AST/PLT ratio index (APRI), GGT/ PLT ratio index (GAPI) and AST to GGT ratio (AGR) were calculated. Results: Advanced liver fibrosis including stage 3-4 was observed in 197 (49%) of patients with CHB, 84 (54%) of patients with CHC. Mean age and GGT were higher and PLT was lower in patients with advanced liver fibrosis (stage 3-4) than those in patients with absence of significant fibrosis (stage 0-1) (p<0.001). But, there was no statistically significant relationship for mean value of AST and ALT between patients with stage 0-1 and stage 3-4. The API and GAPI were found to be significantly associated with the fibrosis score and correlation co-efficient (r) were 0.35 and 0.23, respectively (p<0.001), while the APRI, AAR and AGR values were not associated with the fibrosis score in all of the patients (p>0.05). But, APRI has showed correlation with liver fibrosis in patients with CHC contrary to patients with CHB. Conclusion: Age, GGT, PLT, API and GAPI are significantly associated with the extent of fibrosis. But these non-invasive markers can not replace liver biopsy. © H.G.E. Update Medical Publishing S.A.Öğe Lipoma of the Large Intestine: A Clinicopathological Review of Six Cases(2010) Erkan N.; Çalişkan C.; Vardar E.; Yilmaz C.; Korkut M.Objectives: Symptoms of colonic lipomas generally have a silent clinical course. We presented the clinical features, treatment methods, and follow-up results of six cases with large bowel lipoma. Patients and Methods: A retrospective review of patients with a diagnosis of large bowel lipoma between January 2000 and December 2006 was conducted. Data related to presentation, diagnosis, surgical treatment and pathology were analyzed. Results: Six patients (4 men, 2 women; mean age 63 years; range 43 to 82 years) were operated on due to lipoma of large intestine. Abdominal pain was the most common presenting complaint. One of the patients was treated urgently due to colo-colonic intussusception and the others were operated in elective conditions. The endoscopic biopsies were inconclusive. The preoperative diagnosis was colonic lipoma in two patients and four patients were treated due to suspected tumor of the colon. The locations of the lesions were ascending and transverse colon in two patients, cecum and sigmoid colon in the others. Right hemicolectomy was performed in three patients, left hemicolectomy, sigmoid and segmenter colon resections were performed in the others. Histopathologic examinations of the resected materials showed submucosal lipoma of the large intestine. Postoperative period was uneventful in all of the patients. Conclusion: In large symptomatic colonic lipomas that can cause obstruction or hemorrhage, surgical treatment is needed to prevent complications and to exclude the possibility of malignancy. © Medical Journal of Trakya University. Published by Ekin Medical Publishing. All rights reserved.Öğe Primary gastric invasive micropapillary carcinoma: A case report [Primer mide ınvaziv mikropapiller karsinomu: Olgu sunumu](Federation of Turkish Pathology Societies, 2015) Vardar E.; Günay Yardim B.; Vardar R.; Ölmez M.Invasive micropapillary carcinoma is a recently identified neoplasm. A 77-year-old-female was admitted to the hospital due to progressive loss of weight and nausea. Endoscopic biopsy of the antral/prepyloric located mass was diagnosed as moderately differentiated adenocarcinoma. Subtotal gastrectomy and regional lymph node resection were performed. The tumor was composed of moderately differentiated cells arranged in micropapillary structures with only a few poorly formed glandular foci in lamina propria. Immunohistochemically, neoplastic cells of micropapillary and focal conventional adenocarcinoma areas were diffusely positive for pancytokeratin, cytokeratin 7 and epithelial membrane antigen. In micropapillary areas, membranous and peripheral cytoplasmic positivity with epithelial membrane antigen in outside of the cell clusters called “inside-out polarity” pattern that is characteristic for invasive micropapillary carcinoma were seen. Invasive micropapillary carcinoma is very rare in the stomach in the English literature. © 2015, Federation of Turkish Pathology Societies. All rights reserved.Öğe Study on prophylactic efficacies of daptomycin and vancomycin in a rat model of MRSA infection secondary to spinal implantation [Spinal enstrümantasyon sonrasi{dotless} MRSA enfeksiyonu oluşturulmuş rat modeli üzerinde vankomisin ve daptomisin'in profilaktik etkileri](2013) Özer Ö.; Özer F.D.; Akçay E.; Atci I.B.; Kocaman U.; Ozinel M.A.; Vardar E.; Ozdemir N.The present study aims to investigate the prophylactic effects of daptomycin and vancomycin in an experimental spinal infection induced by spinal implantation. The study involved inoculation of a bacterial suspension prepared with the MRSA ATCC 43300 strain to the implant bed and to the peripheral tissue immediately the implantation of titanium spinal implants to the bone in adult Winstar rats. The animals were divided into three groups; seven rats in the first group received no antibiotics, while the seven rats in group two and eight rats in group three received daptomycin and vancomycin, respectively. Microbiological and histological assessments were carried out on rats with induced infections. In the swab cultures of deep surgical areas, vancomycin demonstrated inhibition of infection of the surgical site in half of animals (50%) whereas daptomycin exhibited the same effect in more animals (71.4%), which was statistically significant compared to the control group (p<0.05). In the implant and bone culture, a statistically significant superiority was not observed in prophylactically treated with either antibiotic and nontreated control group (p>0.05). As a result; comparing control group, preventive effects of daptomycin and vancomycin in infection induced model of spinal implantation with high bacteria inoculums were not found statistically significant whereas daptomycin showed statistically significant inhibition on deep surgical area infection.
