Search

BACKGROUND Cervical cancer screening algorithms are increasingly focused on Human Papillomavirus (HPV)-based screening while the accuracy of using abnormal cytological findings to detect dysplastic lesions still remains important. This retrospective study correlated the results of conventional cervical cytology, colposcopy guided biopsy, and cold knife conization (CKC) procedures performed in a tertiary center. MATERIALS AND METHODS Data from 9399 patients who underwent screening with conventional cervical cytology between 2010 and 2019 was obtained from the hospital registry. Abnormal cervical cytology and high-risk HPV DNA genotypes were recorded and their colposcopic and CKC pathology was determined. RESULTS Two hundred and ninety two patients underwent colposcopy for abnormal cervical cytology and/or high-risk HPV positivity. One hundred and twenty three patients were positive for High-risk HPV. Abnormal cervical cytology was detected in 216 patients. The most common cytological anomaly was atypical squamous cells of undetermined significance (ASCUS) found in 9399 patients (1.39%). It was determined that conventional cytology had a sensitivity of 70.8% and a specificity of 62.2% for the detection of low-grade lesions, while it had a sensitivity of 72.4% and a specificity of 86.0% for the detection of high-grade lesions. CKC was applied to 68 patients who were diagnosed with high-grade squamous intraepithelial lesions (HSIL) as a result of the colposcopy. As a result of CKC, a high-grade lesion was detected in 73.5% of these patients. CONCLUSION Conventional cervical cytology and colposcopy exhibited higher accuracy as the severity of lesions increased. Detection of HPV may prevent unnecessary surgical procedures, especially with ASCUS.

Bu araştırmanın amacı enerji emtiaları arasında getiri ve volatilite yayılımı olup olmadığını incelemektir. Farklı makroekonomik gelişmeler neticesi varlık fiyatlarında meydana gelen getiri oynaklıkları emtialar arasında yayılım göstererek birbirlerinin getirilerini de etkileyebilmektedir. Enerji emtialarının fiyatlarını etkileyen unsurların ve aralarındaki yayılımın tespiti özellikle yatırım yapmak isteyenler ve enerji piyasası ile ilgilenenler açısından incelenmeye değer bulunmaktadır. Araştırma kapsamında 01.01.2008-31.12.2020 tarihleri arasındaki Brent Petrol, Heating Oil, Natural Gas ve WTI ham petrol verileri VAR-EGARCH yöntemiyle değerlendirilmiştir. Araştırma sonucunda enerji emtialarına ait getirilerin kısa dönemli etkileşim halinde olduğu bilgi şoklarının getiri ve volatilitede çoklu ve asimetrik olarak yayıldığı görülmüştür. Doğalgaz getiri serisinin diğer emtiaların fiyatlarından etkilendiği fakat kendisinin hiçbir enerji emtiasını etkilemediği ayrıca tespit edilmiştir. Volatilite yayılımında ise ısıtma yağından doğalgaz serilerine tek taraflı diğer emtialar arasında karşılıklı yayılım olduğu sonucuna varılmıştır., This study aims to examine whether there is a return and volatility spillover among energy commodities. As a result of different macroeconomic developments, return volatility in asset prices can spillover among commodities and affect each other's returns. The determination of the factors affecting the prices of energy commodities and the spillover among them is worth examining, especially for those who invest and are interested in the energy market. Within the scope of the study, the data regarding Brent Oil, Heating Oil, Natural Gas, and WTI between 01.01.2008-31.12.2020 are evaluated by VAR-EGARCH method. The results demonstrate that the information shocks, in which the returns of energy commodities interact in the short-term, spillover multidirectionally and asymmetrically in returns and volatility. It is determined that the natural gas return series is affected by the prices of other commodities, but it does not affect any energy commodities. As for the volatility spillover, there is unidirectional spillover from heating oil to natural gas series, but there is a multidirectional spillover among other commodities.

Amaç: Yaşa Bağlı Makula Dejeneresansı (YBMD) sonucu gelişen koroid neovaskülarizasyonlarının farklı tiplerinde, verteporfin kullanılarak yapılan fotodinamik tedavinin (FDT) sonuçlarını değerlendirmektir. Gereç ve Yöntem: Ege Üniversitesi Tıp Fakültesi Göz Hastalıkları Anabilim Dalı’nda YBMD'ye bağlı koroid neovaskülarizasyonlarında FDT uygulanmış 40 hastanın 42 gözü çalışma kapsamına alındı. Olguların tedavi öncesi ve sonrası görme keskinlikleri, kontrast duyarlılıkları ve floresein anjiografideki (FA) lezyon özellikleri kaydedildi. FDT uygulanmış hastaların 7. gün, 6. hafta, 12. hafta ve sonrasında ise bir sorun izlenmediği takdirde 1 yıl süre ile 3 ayda bir olan kontrolleri değerlendirildi. Hastaların 3 ay arayla çekilen FA görüntülerinde lezyonun sızdırma özelliklerine göre tedavinin başarısı değerlendirildi. Bulgular: Çalışmaya alınan 28 erkek, 12 kadın hastanın yaş ortalaması 64.50±12.00 yıldı. Lezyonların 18'i (%43) saf klasik, 4'ü (%9) minimal klasik, 15'i (%36) predominant klasik, 5'i ise okkült idi. Bu lezyonlardan 31'i (%74) subfoveal, 11'i (%26) ise juxtafoveal; 18'i (%43) iyi sınırlı, 28'i (%67) ise kötü sınırlıydı. Lezyon türleri açısından predominant klasik grupta başarı oranı daha yüksek bulundu, ancak bu fark anlamlı değildi (p=0.062). Subfoveal yerleşimli 31 gözden 30'unda başarı sağlanırken (%97), juxtafoveal yerleşimli 11 gözün 8'inde (%73) başarı sağlanmıştı (p=0.049). Tedavi öncesi lezyon çapı, görme keskinliği, kontrast duyarlılık ve uygulanan FDT sayısı açısından başarılı ve başarısız grup arasında anlamlı fark yoktu. Başarılı grupta son muayenede saptanan görme keskinliği düzeyi belirgin olarak yüksekti (p=0.015). Kontrast duyarlılıkta tedavi sonrasında istatistiksel olarak anlamlı düzelme saptandı (p=0.028). Sonuç: FDT, YBMD'ye bağlı gelişen özellikle subfoveal koroid neovaskülarizasyonlarında görme kaybı r sk n azaltmaktadır. Ancak son yıllarda yaygın kullanılan vasküler endotelyal büyüme faktörü inhibitörlerinin başarılı sonuçları nedeniyle FDT'nin YBMD tedavisinde sınırlı bir kullanımı mevcuttur., Aim: To evaluate the results of photodynamic therapy (PDT) using verteporfin in different types of choroidal neovascularization resulting from age-related macular degeneration (AMD). Materials and Methods: Forty-two eyes of 40 patients were included in the study. Visual acuity, contrast sensitivity and lesion characteristics in fluorescein angiography (FA) of the cases were recorded before and after PDT. The patients were evaluated at the 7th day, 6th week, 12th week, and afterwards, if no problem was observed, every 3 months in a year. We evaluated the success or failure rates of the treatment. Results: Mean age of the patients was 64.50±12.00 years. Eighteen of the lesions (43%) were pureclassical, 4 (9%) minimally-classical, 15 (36%) predominant-classical and 5 occult. Of these lesions, 31 (74%) were subfoveal and 11 (26%) juxtafoveal; 18 (43%) well-defined, and 28 (67%) poorly-defined. When examined in terms of lesion types, success rate was higher in predominant-classical group, but this difference was not statistically significant (p=0.062). Success was achieved in 30 of 31 eyes with subfoveal lesions (97%) and in 8 of 11 (73%) eyes with juxtafoveal lesions (p=0.049). The visual acuity level determined at the last visit in the successful group was significantly higher than that of the unsuccessful group (p=0.015). Statistically significant improvement in contrast sensitivity was achieved after treatment (p=0.028). Conclusion: PDT reliably reduces the risk of visual loss in subfoveal choroidal neovascularization due to AMD. However, the use of PDT in the treatment of AMD is limited because of the higher success of recently used vascular endothelial growth factor (VEGF) inhibitors.

Amaç: Endometriyal örnekleme, jinekoloji pratiğinin en sık başvurulan invazif işlemlerinin başında gelmektedir. Anormal uterin kanamanın jinekoloji polikliniklerinde çok sık karşılaşılan bir semptom olması endometriyal örneklemenin sıklığını açıklamaktadır. Bu çalışmanın amacı endometriyal örnekleme yaptığımız hastaların histopatolojik sonuçlarının literatür eşliğinde değerlendirilmesidir. Gereç ve Yöntem: Ocak 2014/Aralık 2018 tarihleri arasında Kadın Hastalıkları ve Doğum polikliniğinde yapılan endometriyal örneklemeleri kapsayan, retrospektif nitelikte bir çalışmadır. Tıbbi nedenli tahliyeler, isteğe bağlı yapılan gebelik terminasyonları ve mol gebelikler çalışma dışında tutulmuştur. Patoloji sonuçları ise atrofik endometrium, endometrit, proliferatif endometrium, sekretuar endometrium, desidualizasyon, düzensiz proliferasyon gösteren endometrium, endometrial polip, endometrial hiperplazi, endometrium adenokarsinomu olarak gruplanmıştır. Ayrıca hastalar yaşlarına göre de gruplanmıştır: 55 yaş; Grup 3. Bulgular: İki bin yirmi üç hastanın dahil edildiği çalışmada, hastaların yaş ortalaması 47.1 ± 10.0’dı. Düzensiz proliferatif endometrium, proliferatif endometrium, sekretuar endometrium, desidualizasyon, yetersiz materyal ve atipisiz hiperplazi sonuçları yaş gruplarına göre anlamlı farklılık göstermekteydi (p

WOS: 000402475400003, PubMed ID: 28433069, In this study, female rats induced with chemical cystitis were administered the hormone human choriogonadotropin (HCG), and it was aimed to reveal the usefulness of HCG in the treatment of interstitial cystitis/bladder pain syndrome. The materials for this study were 32 Wistar albino female rats. The study groups were formed as follows: the cystitis group (Group 1), the cystitis + HCG protection group (Group 2), the cystitis + HCG treatment group (Group 3), and the control group (Group 4), with eight rats in each group. In this study, blood and urine samples were taken from the rats, they were euthanized, and their bladders were removed for glutathione, malondialdehyde, tumor necrosis factor alpha, and interferon gamma measurements. It was observed that tissue damage in Group 2 was lower than that in the other two groups. Glutathione levels in Groups 2 and 4 were significantly higher than in Groups 1 and 3 (p = 0.01). Malondialdehyde levels of Groups 2 and 4 were significantly lower than the values in Groups 1 and 3 (p < 0.001). When the cystitis groups were compared in terms of their interferon gamma and tumor necrosis factor alpha levels, the lowest interferon gamma and tumor necrosis factor alpha levels were detected in Group 3. It was found that HCG has positive effects on experimental cystitis in rats. This study revealed that HCG should be researched as a therapeutic agent and formed a step for studies to be carried out on this subject. Copyright (C) 2017, Kaohsiung Medical University. Published by Elsevier Taiwan LLC., Bozok University Scientific Research Project Department [2014TF/A136], This study was financially supported by Bozok University Scientific Research Project Department (2014TF/A136).

Konfluent ve retiküler papillomatozis, ilk kez 1927 yılında Gougerot ve Carteaud tarafından tanımlanmıştır. Nadir görülen bu hastalık daha çok adolesanları etkileyen, birleşmeye eğilimli retiküler paternde hiperkeratotik papül ve plaklarla karakterizedir. Patofizyolojisi halen net olarak bilinmemektedir, tedaviye dirençlidir ve rekürrensler sık görülmektedir. Pitriyazis versikolor, akantozis nigrikans, Darier hastalığı, kutanöz amiloidoz, prurigo pigmentosa, epidermal nevüs, Dowling-Degos hastalığı, iktiyozis, seboreik dermatit, ekzema ve parapsoriazis gibi hastalıklar ayırıcı tanıda akla gelmelidir. Konfluent ve retiküler papillomatozis tedavisi oldukça güçtür. Topikal ve sistemik retinoidler, topikal kalsipotriol, topikal 5 fluorourasil, topikal antifungaller, mupirosin, topikal takrolimus, oral amoksisilin, eritromisin, azitromisin, minosiklin, fototerapi ve dermabrazyon tedavi seçenekleri arasındadır. Burada 14 yaşında ve 25 yaşında konfluent ve retiküler papillomatozis tanısı konulan iki kadın olgu sunulmaktadır.

The objective of this study was to compare the results of transthoracic biopsies performed through the use of FDG PET/CT imaging with the results of transthoracic needle biopsy performed without using the FDG PET/CT imaging.The medical files of a total of 58 patients with pulmonary and mediastinal masses. A total of 20 patients, who were suspected of malignancy with the SUVmax value of over 2.5 in FDG PET/CT, underwent a biopsy process. Twelve patients with no suspicion of malignancy in accordance with CT images and with the SUVmax value below 2.5 underwent no biopsy procedure, and hence, they were excluded from the study. On the other hand, 26 patients directly went through a biopsy process with the suspicion of malignancy according to CT imaging, regardless of performing any FDG PET/CT imaging.According to the biopsy results, the number of the patients diagnosed with cancer was 20 (43.5%), while the number of non-cancerous patients was 26 (56.5%). When these findings were considered, it was determined that the sensitivity of the whole TTNB (transthoracic needle biopsy) was 80.8%, and the specificity was found as 100%. The positive predictive value of the whole TTNB was 100%, while its negative predictive value was found to be 80%. The sensitivity in TTNB performed together with FDG PET/CT was 90.9%, whereas the specificity was 100%. The positive predictive value of TTNB with FDG PET/CT was 100%, while its negative predictive value was found to be 81.8%. The sensitivity in TTNB performed without the use of FDG PET/CT was 73.3%, whereas the specificity was determined as 100%.Performing FDG PET/CT imaging process prior to a transthoracic biopsy as well as preferring FDG PET/CT for the spot on which the biopsy will be performed during the transthoracic biopsy procedure increases the rate of receiving accurate diagnosis.

Pityriasis rosea is a common, self-limited and inflammatory skin disease. The etiology is not clearly known. Viral agents, autoimmunity, psychogenic factors and drugs have all been suggested as risk factors. Isotretinoin is usually used in the treatment of resistant, nodulocytic acne. We present a case of pityriasis rosea-like eruption induced by isotretinoin. To our knowledge, this is the second clinical case of pityriasis rosea-like eruption induced by isotretinoin.

Mal de Meleda, also known as keratoderma palmoplantaris transgrediens, is a rare type of autosomal recessive palmoplantar keratoderma. A 19-year-old male presented with a congenital yellowish discoloration and thickening of both palms and soles of the feet. His family history revealed that there was no consanguinity between the mother and the father and that the patient had three healthy brothers. The second- and third-degree relatives, five females and one male, also exhibited similar skin findings. From the isolated DNA samples, the extrinsic regions of the SLURP1 gene were screened using the sequence analysis and the Sanger sequencing was performed with the 3130 Sequence Analyzer. Results of this analysis show that a p.Arg 96 Pro (R96P) (c.287 CGA>CCA) homozygous missense point mutation was detected on the SLURP 1 (a secreted toxin-like mammalian lymphocyte antigen 6/urokinase-type plasminogen activator receptor-related protein 1) gene of the patients, while heterozygous p.Arg 96 Pro (R96P) (c.287 CGA>CCA) mutation was detected in the mother, father, and brothers. Our search of the Human Genome Mutation Database and previous literature revealed no reports of this mutation in mal de Meleda. We report this case due to the identification of a novel gene mutation in a patient with mal de Meleda, a palmoplantar keratoderma.

We are grateful to the participating families. This study was partially supported by NIH R01DC009645 and the John T. and Winifred M. Hayward Foundation to M. T., Background: 3MC1 syndrome is a rare autosomal recessive disorder characterized by intellectual disability, short stature and distinct craniofacial, umbilical, and sacral anomalies. Five mutations in MASP1, encoding lectin complement pathway enzymes MASP-1 and MASP-3, have thus far been reported to cause 3MC1 syndrome. Only one previously reported mutation affects both MASP-1 and MASP-3, while the other mutations affect only MASP-3. Methods: We evaluated six unrelated individuals with 3MC1 syndrome and performed Sanger sequencing for all coding exons of MASP1. We also measured complement lectin and alternative pathway activities in an affected individual's serum. Results: We found two novel splice site mutations, c.1012-2A > G in one and c.891 + 1G > T in two probands, and three novel missense mutations, c.1451G > A (p.G484E), c.1657G > A (p.D553N), and c.1987G > T (p.D663Y). Missense mutations affect only MASP-3, while splice site mutations affect both MASP-1 and MASP-3. In a proband who is homozygous for c.891 + 1G > T, we detected a total lack of lectin complement pathway activity and a 2.5-fold lower alternative pathway activity. The phenotype observed in patients whose both MASP-1 and MASP-3 are affected and in those whose only MASP-3 is affected does not appear to be different. We observed structural brain abnormalities, neonatal tooth, a vascular anomaly and a solid lesion in liver as novel phenotypic features of 3MC1 syndrome. Conclusion: Novel mutations and additional phenotypic features expand the genotypic and phenotypic spectrum of 3MC1 syndrome. Although patients with MASP-1 dysfunction in addition to disrupted MASP-3 have an altered complement system, their disease phenotype is not different from those having only MASP-3 dysfunction., NIH [R01DC009645]; John T. and Winifred M. Hayward Foundation

Amac: Bu calismada Bozok Universitesi Tip Fakultesi’nde degerlendirilen servikal smear sonuclarinin istatistiksel analizini ve verilerin literatur ile korelasyonunu yapmak amaclanmistir. Gerec ve Yontemler: Bozok Universitesi Tip Fakultesi Tibbi Patoloji Anabilim Dali’nda Eylul 2012- Eylul 2013 tarihleri arasinda degerlendirilen 2279 olguya ait servikal smear sonuclari Bethesda 2001’e gore retrospektif olarak incelenmistir. Bulgular: 2272 olgunun smear testi intraepitelyal lezyon veya malignite (ILM) negatif, 7’si ILM pozitif seklinde raporlanmistir. ILM pozitif olgulardan 4’u onemi belirsiz atipik skuamoz hucreler (ASC-US), biri dusuk grade’li skuamoz intraepitelyal lezyon (LSIL), biri yuksek grade’li skuamoz intraepitelyal lezyon (HSIL), biri atipik glanduler hucreler (AGC) olarak raporlanmistir. ASC-US tanisi alan olgulardan biri servikal biyopside LSIL, digeri kronik servisit tanisi almistir. Smear testi AGC olarak raporlanan olgunun serviks biyopsisinde HSIL saptanmistir. Sonuc: Smear testinin guvenilirligini gosteren bazi kalite kontrol parametreleri kullanilmaktadir. Servikal biyopsi verifikasyonu en guvenilir parametredir. Ayrica ASC-US tanisi oraninin %5’den az, ASC-US/SIL oraninin 2-3 arasinda tutulmasi onerilmektedir. Bizim serimizde ASC-US orani %0.01, ASC-US/SIL orani ise 2 olup literatur ile uyumludur.

The interaction between multiple myeloma (MM) cells and the bone marrow stroma constitutes the basis of myeloma pathogenesis and has led the way for the corresponding therapeutic strategies. The aim of this study is to evaluate tumor-associated macrophages (TAMs) which is an important element of bone marrow stroma and its prognostic relevance in newly diagnosed MM patients. We also wanted to determine the association between TAMs and microvessel density (MVD). Sixty-eight patients, who were diagnosed with MM at the Department of Hematology, Gazi University Hospital, between January 2000 and January 2011, were reviewed retrospectively. Tumor-associated macrophages were evaluated by staining with anti-CD68 and anti-CD163 monoclonal antibodies, and MVD was evaluated by factor VIII staining. Median age was 60 (range, 40-84) years with 36 males and 32 females. The number of both CD 68+ and CD 163+ cells had a negative impact on OS at 6 years (p = 0.013 vs. 0.036; p = 0.015 vs. 0.039) in univariate and multivariate analysis in which age, sex, ISS, the induction treatment, and response to induction treatment are included as variables. High-grade MVD was found to be associated with increased CD163+ cell count. In conclusion, TAMs seems to be a promising prognostic histopathological marker in newly diagnosed MM patients.

7ŶİĞůĞŶĞŶ ƚƺŵ ŐƌƵƉ ŝĕŝŶĚĞ ŬĂĚŦŶ ŚĂƐƚĂ ƐĂLJŦƐŦ ϲϮ ;й ϴϮ͕ϳͿ ǀĞ ĞƌŬĞŬ ŚĂƐƚĂ ƐĂLJŦƐŦ ϭϯ ;йϭϳ͕ϯͿ ŽůĂƌĂŬ ďƵůƵŶŵƵƔͲ ƚƵƌ͘ ,ĂƐƚĂůĂƌŦŶ ƚĂŶŦ LJĂƔůĂƌŦ ϭϲͲϳϵ LJĂƔ ĂƌĂƐŦŶĚĂ ĚĂŒŦůŦŵ ŐƂƐƚĞƌŵĞŬƚĞĚŝƌ͘ KƌƚĂůĂŵĂ ƚĂŶŦ LJĂƔŦ ϰϲ͕ϱцϭϯ͕ϵ ŽůƵƉ ŬĂͲ ĚŦŶ ŚĂƐƚĂůĂƌĚĂ ϰϱ͕Ϯцϭϯ͕Ϯ͖ ĞƌŬĞŬ ŚĂƐƚĂůĂƌĚĂ ϰϵ͕ϱцϱ͕ϭ ŽůĂƌĂŬ ƚĞƐƉŝƚ ĞĚŝůŵŝƔƟƌ͘ ŝĨĞƌĂŶƐŝLJĞ ƟƌŽŝĚ ŬĂŶƐĞƌŝ ƚĂŶŦƐŦ ĂůĂŶ ŚĂƐƚĂůĂƌ ƚƺŵƂƌ ƟƉůĞƌŝŶĞ ŐƂƌĞ ŐƌƵƉůĂŶĚŦƌŦůĚŦŒŦŶĚĂ ƚĂŶŦ LJĂƔŦ ĂĕŦƐŦŶĚĂŶ ŝƐƚĂƟƐƟŬƐĞů ŽůĂƌĂŬ ĂŶůĂŵůŦ ĨĂƌŬ ďƵůƵͲ ŶĂŵĂŵŦƔƨƌ ;ƉсϬ͕ϲϵϮͿ͘ ,ĂƐƚĂůĂƌŦŶ LJĂƔ ŐƌƵƉůĂƌŦŶĂ ǀĞ İŝŶͲ ƐŝLJĞƚůĞƌŝŶĞ ŐƂƌĞ ĚĂŒŦůŦŵŦ dĂďůŽ ϭ͛ĚĞ ŐƂƌƺůŵĞŬƚĞĚŝƌ͘, Amaç: Bu çalışmanın amacı, Yozgat bölgesindeki diferansiye tiroid karsinomlu (DTK) hastaların demografik ve klinik özelliklerini tespit etmektir. Gereç ve Yöntemler: 2011-2014 yılları arasında Bozok Üniversitesi Araştırma ve Uygulama Hastanesi’nde DTK tanısıyla takip edilen 62’si kadın, 13’ü erkek toplam 75 hasta retrospektif olarak değerlendirildi. Hastaların histopatolojik ve klinik özellikleri yaş, cinsiyet, tümör tipi ve metastaz açısından birbirleri ile karşılaştırıldı. Bulgular: Hastaların yaş ortalaması 46.3±13.9 olup 16-79 yaş arasında dağılım göstermekteydi. Diferansiye tiroid karsinomunda kadın/erkek oranı 4,8/1 olarak bulundu. Ortalama tanı yaşı kadın hastalarda 45,2±14,2 iken erkek hastalarda 49.5±5.1 idi. Tümör tipleri içinde % 78,7 ile en yaygın papiller karsinom, ikinci sıklıkta % 13,3 ile papiller karsinom foliküler varyant, üçüncü sıklıkta % 5,3 ile folliküler karsinom tespit edilmiştir. Bununla birlikte uzak metastaz oranı folliküler karsinomda daha fazlaydı. Sonuç: Tüm DTK’lu hastalar içinde en yaygın görüleni papiller karsinomdu. Kadın hasta sayısı erkek hasta sayısından tüm kanser tiplerinde daha yüksekti. Papiller veya folliküler tiroid karsinomu ile tanı yaşı arasında istatistiksel olarak anlamlı farklılık yoktu. Uzak metastaz oranı folliküler karsinomda papiller karsinoma göre daha yüksek bulundu.