Browsing by Author "Kösem, M"

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Bilateral Galactocele in a Male Infant
(Freund Publishing House Ltd, 2001) Cesur, Y; Çaksen, H; Demirtas, I; Kösem, M; Üner, A; Özer, R
A galactocele is a rare benign breast lesion usually occurring in females during or following lactation. These lesions are a rare cause of breast enlargement in infants and children. In this article we present a 10 month-old boy who was admitted with a two-month history of bilateral progressive breast enlargement, and diagnosed as having galactocele. Our purpose was to emphasize the importance of galactocele as a benign condition in the differential diagnosis of gynecomastia in childhood.
Biliary Tract Reconstruction With Autologous Rectus Sheath Graft -: an Experimental Study
(H G E Update Medical Publishing S A, 2005) Aydin, M; Bakir, B; Kösem, M; Kisli, E; Gençelep, M
Background/Aims: Common bile duct injuries which cause significant morbidity and mortality are one of the most serious complications of cholecystectomies. They can be repaired by various approaches. Methodology: We used an autologous graft obtained from the posterior sheath of the rectus muscle in biliary tract reconstruction for common bile duct defect. This experimental study was carried out on six dogs. A tissue fragment was excised from the posterior sheath of the rectus muscle together with the fascia transversalis and peritoneum. A channel from the fascial graft was formed around a T-tube. The autologous rectus sheath graft was sutured to the common bile duct as a segmental conduit graft. Afterwards, blood biochemistry values and liver histopathology were investigated. Dogs were studied by T-tube cholangiography 4 months postoperatively just prior to removing the T-tube and again 2 months later at relaparotomy. The hepatic parenchyma, intra- and extrahepatic bile ducts were detected by ultrasonography during the last 2 months, one time in fifteen days. Results: There was no anastomotic insufficiency. The fascial graft gained an appearance similar to bile duct in dogs. Postoperatively, no change in blood biochemical parameters was observed, and in the preoperative and postoperative periods no histopathological change in the liver was Conclusions: These findings indicate that the use of an autologous fascial graft to repair common bile duct injuries as a conduit graft for segmental bile duct loss may be a feasible and alternative method of treatment.
A Case of Typhoid Fever Associated With Hemophagocytic Syndrome
(Elsevier Science inc, 2003) Çaksen, H; Akbayram, S; Öner, AF; Kösem, M; Tuncer, O; Atas, B; Odabas, D
Choriocarcinoma Metastatic To Mandibular Gingiva
(B C decker inc, 2004) Kösem, M; Çankaya, H; Kaya, Z
Clear Cell Adenocarcinoma of the Urinary Bladder
(informa Healthcare, 2005) Kösem, M; Sengül, E
Clear cell adenocarcinoma of the lower urinary tract, and particularly of the bladder, is a rare neoplasm and its histogenesis remains obscure. The authors report the clinical and pathologic findings of a 55-year-old male with clear cell carcinoma of the bladder. The histogenesis of the tumor is discussed, and 35 cases reported in the literature are reviewed.
Clinical Characteristics and Genetic Screening of an Extended Family With Men2a
(Editrice Kurtis S R L, 2002) Algün, E; Abaci, N; Kösem, M; Kotan, C; Köseoglu, B; Boztepe, H; Aksoy, H
MEN-2A is characterized by medullary thyroid carcinoma (MTC) with pheochromocytoma and sometimes parathyroid adenoma. In affected members of the family, the risk of MTC is about 100%. Biochemical screening allows tumors to be detected early but even at this stage treatment is not always curative. Missense mutations in exon 10 and 11 of the RET proto-oncogene are associated with MEN2A. Early detection of this mutation by DNA analysis allows the identification of the carriers of the gene. We performed genetic screening in 88 members of an extended family with MEN2A and found 18 members positive for RET mutation (Cys634Gly). Only three of these 18 RET positive cases had a previous diagnosis of medullary cancer and/or pheochromocytoma. Up to now, 12 of the RET positive cases have undergone thyroidectomy. There was extended disease with cervical lymph node metastasis in 6 of them, bilateral medullary microcancer in 3 and c-cell hyperplasia in the remaining 3. Three of the 18 RET positive patients had also pheochromocytoma. Primary hyperparathyroidism was present in only one patient. The mean age of diagnosis of medullary cancer was between 25-50 yr and mean age of death was between 35-95 yr in affected members of the family. The family had many other affected members in other cities in Turkey and in other countries throughout the world from Australia to the Netherlands. So this family is perhaps one of the most extended families with MEN2A. (C) 2002, Editrice Kurtis.
Coexistent Thyroid Pathologies and High Rate of Papillary Cancer in Patients With Primary Hyperparathyroidism
(Acta Medical Belgica, 2004) Kösem, M; Algün, E; Kotan, Ç; Harman, M; Öztürk, M
Thyroid carcinoma and benign thyroid diseases associated with primary hyperparathyroidism (PHPT) may cause difficulties in the diagnosis, localization and therapy of PHPT. In this study, we analysed coexistent thyroid pathologies in 51 patients who underwent neck exploration with a diagnosis of PHPT between 1999-2002. Five hundred thirteen patients who underwent thyroidectomy for nodular thyroid disease without a parathyroid pathology in histopathological examination served as controls. In patients with PHPT there were 43 cases (84.3%) of coexistent thyroid pathology. Nine patients (17.6%) had coexistent papillary thyroid cancer. Nine patients (17.6%) had lymphocytic thyroiditis, two (3.9%) had benign thyroid adenoma and 24 (47%) had nodular hyperplasia. In one patient (2%), there was intrathyroidal metastasis from a parathyroid cancer. One patient had coexistent lymphocytic thyroiditis and multi-focal papillary cancer. One of the two cases with thyroid adenomas was Hurthle cell type. In the control group only 28 patients (5.5%) had thyroid malignancy (27 papillary cancer and one follicular cancer). In conclusion, the coexistent thyroid pathologies are highly prevalent in patients with PHPT and pre- and intra-operative thyroid examination should be performed to avoid overlooking important thyroid pathologies.
Contrast-Enhanced Ct and Mri Findings of Atypical Hepatic Echinococcus Alveolaris Infestation
(Springer, 2005) Etlik, Ö; Bay, A; Arslan, H; Harman, M; Kösem, M; Temizöz, O; Dogan, E
Diagnosis of liver infestation by Echinococcus alveolaris (EA) is based on serological and radiological findings. In this report, we present a 15-year-old girl with atypical hepatic EA infestation showing central punctate calcifications and contrast enhancement on the portal and late phases of CT and MRI. CT showed a hypodense mass involving more than half of the liver with prominent central calcifications. MRI revealed hypointense signal of the infiltrative mass on both T1- and T2-weighted images. Contrast enhancement is a unique finding in hepatic EA infestation that may cause difficulties with diagnosis. MRI may provide invaluable information in the diagnosis of EA infestation of the liver, either by disclosing the infiltrative pattern of infestation without significant effect to vascular structures, or by the signal characteristics.
Ectomesenchymoma
(Turkish J Pediatrics, 2004) Kösem, M; Ibiloglu, I; Bakan, V; Köseoglu, B
Ectomesenchymoma (EMCH) is a rare tumor that may arise in the brain or soft tissue. This tumor type is defined as a form including ectodermal components represented by neuroblasts or ganglion cells and differentiated mesenchymal structures of various types. The mesenchymal component is most often a rhabdomyosarcoma, but liposarcoma, malignant fibrous histiocytoma, leiomyosarcoma, chondrosarcoma, malignant schwannoma, and osseous elements have also been recorded. We report a case of an abdominal malignant ectomesenchymoma, containing three components, schwannoma, embryonal rhabdomyosarcoma, and ganglion cells, in a four-month-old infant. We also review 43 previously reported cases.
The Effect of Ginkgo Extract Egb761 in Cisplatin-Induced Peripheral Neuropathy in Mice
(Academic Press inc Elsevier Science, 2004) Öztürk, G; Anlar, Ö; Erdogan, E; Kösem, M; Özbek, H; Türker, A
Neuroprotective effect of Ginkgo biloba extract EGb761 in cisplatin (cis-diamminedi-chloroplatinum, or CDDP)-induced peripheral neuropathy was investigated. Swiss albino mice were treated with CDDP, 2 mg/kg ip twice a week for nine times. One group of the animals also received EGb761 in the drinking water at an estimated dosage of 100 mg/kg per day. Two other groups received vehicle (control) or EGb761 only. Development of neuropathy was evaluated with changes in sensory nerve conduction velocity (NCV). Following the treatments, dorsal root ganglia (DRGs) were microscopically examined and some were cultured for 3 days. EGb761 proved effective in preventing the reduction in NCV (P < 0.0001) caused by CDDP. CDDP caused a decrease in the number of migrating cells (P < 0.01) and in the length of outgrowing axons (P < 0.01) while EGb761 treatment prevented the latter. CDDP led to smaller nuclear and somatic sizes in neurons (P < 0.01), while with EGb761 co-administration, both were close to control values. Animals having EGb761 only had similar results with controls. In conclusion, EGb761 was found to be effective in preventing some functional and morphological deteriorations in CDDP-induced peripheral neuropathy. (C) 2004 Elsevier Inc. All rights reserved.
Effect of Leukemia Inhibitory Factor in Experimental Cisplatin Neuropathy in Mice
(Academic Press Ltd- Elsevier Science Ltd, 2005) Öztürk, G; Erdogan, E; Anlar, Ö; Kösem, M; Taspinar, M
In this study, the effect of leukemia inhibitory factor (LIF) on cisplatin (CDDP)-induced neuropathy was evaluated. Mice were treated with CDDP, 2 mg/kg i.p. twice a week nine times. During the last week some of the mice were also injected with LIF, 2 mug/kg s.c. every other day for a total of four injections. Development of neuropathy was evaluated with changes in tail flick latency and sensory nerve conduction velocity (NCV). At the end of the treatment period dorsal root ganglia (DRG) were microscopically examined. Some of the DRGs were explanted into extracellular matrix, covered with culture medium and incubated for 3 days. During and at the end of the incubation, cellular migration and axonal outgrowth from the DRGs were quantified. LIF proved effective in reversing the increase in tail flick latency (p < 0.05) and improving the reduction in NCV induced by CDDP. CDDP led to smaller nuclear and somatic size in neurons, while with LIF, the latter was restored to control values (p<0.01). No apoptotic nucleus was observed among DRG neurons while very few and moderate numbers detected among satellite and Schwann cells, respectively. With LIF, none of the cells had apoptosis. CDDP caused a decrease in the number of migrating cells and in the length of outgrowing axons while LIF treatment restored both capacities (p < 0.05) In conclusion, in CDDP-induced neuropathy, LIF was found to be effective in correcting some functional and morphological deteriorations related with major involvement of Schwann cells. (C) 2004 Elsevier Ltd. All rights reserved.
The Effects of Prednisolone and Serum Malondialdehyde Levels in Puppies With Experimentally Induced Meconium Aspiration Syndrome
(Sage Publications Ltd, 2003) Kirimi, E; Tuncer, O; Kösem, M; Ceylan, E; Tas, A; Tasal, I; Caksen, H
The aim of this study was to investigate the effect of different doses of prednisolone in puppies experimentally induced with meconium aspiration syndrome (MAS). Meconium was collected from human babies in the first day of life and was released into the trachea of 11 newborn puppies to induce MAS. Puppies were treated with 2 mg/kg prednisolone (standard dose), 30 mg/kg prednisolone (megadose) or 0.9% saline, all administered intravenously. The study ended 20 h after meconium aspiration and the lungs were then scored for histopathology. Animals not treated with prednisolone deteriorated after 8 h while respiration rate, oxygenation, pH and partial pressure of carbon dioxide values were better in the prednisolone-treated groups. Histopathology scores were better in the treatment groups compared with the control group, with megadose giving the best result. At the end of the study, serum malondialdehyde levels were significantly higher in the megadose prednisolone group compared with the other two groups. In conclusion, we determined that prednisolone reduced physiological and histological changes in puppies with MAS and that a 30 mg/kg dose was more effective than 2 mg/kg.
Epidemiological Aspects of Endemic Upper Gastrointestinal Cancers in Eastern Turkey
(H G E Update Medical Publishing S A, 2005) Türkdogan, MK; Akman, N; Tuncer, I; Uygan, I; Kösem, M; Özel, S; Memik, F
Background/Aims: The aim of our study was to present the epidemiological aspects of endemic upper gastrointestinal (esophageal and gastric) cancers in the Van region of Eastern Turkey. Methodology: The patients were diagnosed by esophagogastroscopy, biopsy and histopathological analysis. The control group consisted of 73 healthy subjects. Epidemiological characteristics (age, sex, dietary habits, educational status, life style) were evaluated by questionnaires. Helicobacter pylori infection was diagnosed in nontumoral gastric mucosal biopsy specimens by Giemsa staining. Results: 298 esophageal Ca and 384 gastric Ca patients were diagnosed in seven years (1994-2001). Most of the patients (90%) were of rural origin. Endoscopic prevalence rate of upper gastrointestinal (UGI) Ca was the highest (1 Ca per 7 esophagogastroscopy) in the Van region compared to other parts of Turkey. Esophageal Ca were 1.5 times more common in females whereas gastric Ca were 1.6 times more common in males. Ninety per cent of esophageal cancers were epidermoid and the remaining 10% were adenocarcinomas. Ninety-seven per cent of gastric Ca were adenocarcinomas. Helicobacter pylori infection was not significantly increased in gastric Ca patients compared to controls. Conclusions: Low educational and socioeconomic status, consumption of smoked, salted, hot, fatty foods, overdrinking hot tea and well water, cigarette smoking, poor intake of fresh fruits and vegetables and poor hygienic conditions were probable culprit factors.
Malignant Pheochromocytoma With Peritonitis Carcinomatosa
(Lippincott Williams & Wilkins, 2005) Algün, E; Kösem, M; Alici, S; Harman, M; Güler, O; Kotan, E
Pheochromocytomas and functioning paragangliomas are rare tumors arising from the primitive neural crest. Approximately 10% of adrenal pheochromocytomas are malignant. Malignant pheochromocytomas usually recur in the retroperitoneum or appear as metastatic deposits in bone, lung, or liver. Here, we report a 51-year-old woman with malignant pheochromocytoma with a peritoneal metastasis, which is a very unusual metastatic site. She was referred to the hospital with headache, abdominal pain, and ileus. A right adrenal mass was surgically removed in May 1997. Pathologic examination revealed pheochromocytoma and capsular with adjacent muscle invasion. During the next 3 years, the patient remained well. The disease recurred in 2001, with hypertensive episodes and peritonitis carcinomatosa. Further investigation revealed no other metastatic sites. Peritoneal metastasis is very rare in malignant pheochromocytoma and generally is attributed to direct peritoneal seeding during surgery.
Nasopharyngeal Rhabdomyosarcoma in a Patient With Hypohidrotic Ectodermal Dysplasia Syndrome
(Elsevier Sci Ltd, 2002) Çankaya, H; Kösem, M; Kiris, M; Üner, A; Metin, A
Hypohidrotic ectodermal dysplasia (Christ-Siemens-Touraine syndrome) is characterized by partial or complete absence of sweat glands, hypotrichosis, hypodontia, prominent frontal ridges and chin, saddle nose, sunken cheeks, thick, everted lips, large ears and sparse hair. While association of other ectodermal dysplasia syndromes with tumors such a non-Hodgkin's lymphoma, hamartoma, keratoakanthoma, Merkel-cell cancer, squamous-cell carcinoma, syringofibroadenomatosis has been reported, association of hypohidrotic ectodermal dysplasia and a tumor has not been reported. In a five-year-old male patient admitted with nasal obstruction and nasal mass complaints, we have reported firstly an association of hypohidrotic ectodermal dysplasia and nasopharyngeal. rhabdomyosarcoma. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
Primary Ewing's Sarcoma of the Paranasal Sinus With Intracranial Extension
(British inst Radiology, 2003) Harman, M; Kiroglu, F; Kösem, M; Ünal, Ö
Extraskeletal Ewing's sarcoma is often described as a tumour involving the soft tissues of the lower extremities and the paravertebral region. Involvement of the paranasal sinus is a very rare entity. We present a case of primary Ewing's sarcoma of the paranasal sinus extending into the middle cranial fossa in a 40-year-old female. CT and MRI findings of this unusual case are discussed. To our knowledge, this case is the first to be reported with CT and MRI documentation.
Primary Varicella Infection Associated With Stevens-Johnson Syndrome in a Turkish Child
(Japanese dermatolgical Assoc, 2005) Bay, A; Akdeniz, N; Çalka, Ö; Kösem, M; Öner, AF; Dogan, M
Stevens-Johnson syndrome (SJS) is defined as a severe erythema-multiforme-like eruption of the skin and lesions of the oral, genital and anal mucosa and hemorrhagic crusting on the lips; it is associated with fever, headache, and arthralgia. The disease is a part of a continuum of immunologically mediated mucocutaneous diseases at various grades of severity. SJS is often induced by drugs, but the pathophysiologic mechanism is completely unknown. Patients and their first degree-relatives may have genetic defects in their metabolic pathways that lead to the accumulation of toxic metabolites. However, viral infections are known triggers of this skin disorder. Varicella zoster virus has been only very rarely reported as an etiological agent in SJS, despite its high incidence as a pathogen in childhood. In this study, we report a case of primary varicella infection associated with SJS because of its rare presentation. To the best of our knowledge, our case is the youngest child in the literature.
Report of Eight Infants With Acute Infantile Hemorrhagic Edema and Review of the Literature
(Japanese dermatolgical Assoc, 2002) Çaksen, H; Odabas, D; Kösem, M; Arslan, S; Öner, AF; Atas, B; Ceylan, N
Acute infantile hemorrhagic edema (AIHE) is a cutaneous leukocytoclastic vasculitis, clinically characterized by the symptom triad of fever, large purpuric skin lesions, and edema. The clinical picture has a violent onset, a short benign course, and spontaneous complete recovery. In this article, we present eight patients who were admitted with rashes on the skin and edema on the eyelids and extremities, and were diagnosed with AIHE according to their clinical and histopathological features (immunohistological study was also performed in three of them). Our purpose was to emphasize that, aside from Henoch-Schonlein purpura, meningococcemia, septicemia, and purpura fulminans, AIHE benign disorder should also he considered in the differential diagnosis to determine the clinical course and treatment protocol in patients with purpuric rashes.
Short Rib-Polydactyly Syndrome Type I Associated With a Single Umbilical Artery
(Medecine Et Hygiene, 2004) Tuncer, O; Çaksen, H; Kirimi, E; Kösem, M; Oral, H; Atas, B; Odabas, D
Simultaneous Occurrence of Papillary Intrafollicular and Microcarcinomas With Bilateral Medullary Microcarcinoma of the Thyroid in a Patient With Multiple Endocrine Neoplasia Type 2a
(Springer-verlag, 2002) Kösem, M; Kotan, Ç; Algün, E; Topal, C
We report the case of a simultaneous occurrence of papillary intrafollicular and microcarcinomas with bilateral medullary microcarcinoma of the thyroid in a patient with multiple endocrine neoplasia type 2A. The concurrent presence of two thyroid carcinomas is rare. The simultaneous occurrence of two different tumors in the same thyroid each being multifocal and smaller than 1 cm in diameter has not been previously reported in the literature. Furthermore, we define the first case of intrafollicular papillary thyroid carcinoma (carcinoma in situ).