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Gunhan O.,Gulhane Military Medical Academy | Avci A.,Ataturk Research and Education Hospital | Dereci O.,Ankara University | Akgun S.,Ankara University | Celasun B.,Goren Pathology Laboratory
American Journal of Dermatopathology | Year: 2012

Certain abnormal products of human tissues are resistant to degradation. The fibrillary ultrastructure of some of these are seen integrated with normal tissue components. The accumulations seen in colloid milium, lichen, and macular amyloidosis are of this type. Apoptosis of keratinocytes and filamentous degeneration of some proteins can be important in the pathogenesis. A similar pathogenetic mechanism is possible in ligneous mucosal disease, which is a rare disorder of plasminogen deficiency characterized by amyloid-like amorphous accumulations. Gingival and conjunctival mucosal pseudomembraneous masses are typical and concomitant involvement of other sites are not unusual. The accumulated substance is thought to be an abnormal fibrin degradation product. In this study, we have examined 6 representative samples from 5 gingival and 1 conjunctival lesions displaying characteristic features. Immunohistochemically, fibrinogen was detected as an early change. TUNEL staining revealed numerous apoptotic keratinocytes in this phase as well. These cells also expressed nuclear factor kappa beta. Apoptotic cells showed loss of epithelial cadherin immunostaining. In the later phase, the subepithelial accumulations failed to stain with antifibrinogen, wide spectrum, and high molecular keratins, type 4 collagen and nuclear factor kappa beta. Our findings suggest that the accumulations in ligneous mucosal disorder result from an abnormal healing process and they probably form as a combination of organised fibrinogen, epithelial fragments, and connective tissue matrix. Copyright © 2012 by Lippincott Williams & Wilkins. Source

Murat S.N.,Etlik Ihtisas Research and Education Hospital | Duran M.,Kayseri Research and Education Hospital | Kalay N.,Erciyes University | Gunebakmaz O.,Kastamonu City Hospital | And 10 more authors.
Angiology | Year: 2013

Platelets play a central role in the pathophysiology of coronary artery disease (CAD). Increased mean platelet volume (MPV) is an indicator of platelet function and associated with poor clinical outcome in patients with acute coronary syndrome (ACS). We evaluated the relationship between MPV and severity of CAD in patients with ACS. A total of 395 patients with ACS were included. Severity of CAD was assessed with the Gensini and Syntax scores. High levels of MPV were associated with the Gensini and Syntax scores, number of diseased vessels (>50%), number of critical lesions (>50% and >70%), and noncritical lesions. After multivariate analysis, high levels of MPV were independent predictors of multivessel CAD together with age. In patients with ACS, high MPV levels were associated with severity of CAD. It is possible that MPV can be a helpful marker in patients with CAD for the severity of coronary atherosclerosis. © The Author(s) 2013. Source

Zor M.H.,Gazi University | Acipayam M.,Mustafa Kemal University | Bayram H.,Ataturk Research and Education Hospital | Oktar L.,Gazi University | And 2 more authors.
Surgery Today | Year: 2014

Purpose: Although various techniques have been described, the ideal reconstructive procedure for treating massive sternal fragmentation and necrosis is still a matter of debate. Sometimes, reconstruction is so challenging that repetitive operations are required, particularly when complicated by mediastinitis and sternal osteomyelitis. Methods: Five patients (three males, two females, median age 66) with severe osteomyelitis and sternal destruction after receiving myocardial revascularization underwent partial or radical sternal resection, omental flap transposition, titanium mesh implantation and rectus abdominis muscle flap transposition. The final procedure involved single-stage closure. Results: One patient died 9 days after the final procedure due to pneumonia and septicemia. The other patients received antibiotics for at least 6 weeks postoperatively. The mean hospital stay was 36 days. Optimal wound healing was observed, with acceptable cosmetic disorders. Conclusions: Although lateral sternal support is the first-line surgical treatment for sternal dehiscence, performing primary closure of complicated defects is often impossible. Aggressive treatment modalities are required in such cases for anterior chest wall defects. This technique provides the ability to perform rigid and stable sternal closure in complicated cases. © 2013 Springer. Source

Kaptanoglu A.F.,Near East University | Uncu M.,Near East University | Ozyurt S.,Ataturk Research and Education Hospital | Hincal E.,Near East University
Journal of Dermatological Treatment | Year: 2013

Patients with severe acne may need elective/urgent surgical interventions during treatment with isotretinoin and it is critical for the surgeon to consider the possible effects of this medication on coagulation systems. The aim of this study is to determine the changes in prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (aPTT) during isotretinoin treatment. PT, aPTT, and INR values of 51 severe acne patients were evaluated during routine pre-treatment biochemical analysis. Only patients with normal values were included in the study. The results of before and after 1 month treatment were compared statistically. There were no statistically significant change in mean alanine aminotranferease (ALT), aspartate aminotransferase (AST), PT, and INR values after treatment. A significant increase in aPTT was detected. The INR values, which are more trusted and safe, showed no difference. Isotretinoin seems to have no effect on these coagulation parameters. © 2013 Informa Healthcare USA on behalf of Informa UK Ltd. Source

Guler G.,Hacettepe University | Guler G.,Ataturk Research and Education Hospital | Himmetoglu C.,Hacettepe University | Jimenez R.E.,Ohio State University | And 14 more authors.
Breast Cancer Research and Treatment | Year: 2011

Landmark studies of the status of DNA damage checkpoints and associated repair functions in preneoplastic and neoplastic cells has focused attention on importance of these pathways in cancer development, and inhibitors of repair pathways are in clinical trials for treatment of triple negative breast cancer. Cancer heterogeneity suggests that specific cancer subtypes will have distinct mechanisms of DNA damage survival, dependent on biological context. In this study, status of DNA damage response (DDR)-associated proteins was examined in breast cancer subtypes in association with clinical features; 479 breast cancers were examined for expression of DDR proteins γH2AX, BRCA1, pChk2, and p53, DNA damage-sensitive tumor suppressors Fhit and Wwox, and Wwox-interacting proteins Ap2α, Ap2γ, ErbB4, and correlations among proteins, tumor subtypes, and clinical features were assessed. In a multivariable model, triple negative cancers showed significantly reduced Fhit and Wwox, increased p53 and Ap2γ protein expression, and were significantly more likely than other subtype tumors to exhibit aberrant expression of two or more DDR-associated proteins. Disease-free survival was associated with subtype, Fhit and membrane ErbB4 expression level and aberrant expression of multiple DDR-associated proteins. These results suggest that definition of specific DNA repair and checkpoint defects in subgroups of triple negative cancer might identify new treatment targets. Expression of Wwox and its interactor, ErbB4, was highly significantly reduced in metastatic tissues vs. matched primary tissues, suggesting that Wwox signal pathway loss contributes to lymph node metastasis, perhaps by allowing survival of tumor cells that have detached from basement membranes, as proposed for the role of Wwox in ovarian cancer spread. © 2010 Springer Science+Business Media, LLC. Source

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