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Öğe Altın tedavisi sırasında görülen Pityriasis Rosea benzeri döküntü(2000) Kavak, Ayşe; Alper, Murat; Atila, SelimÇeşitli romatolojik ve deri hastalıklarında sistemik altın tedavisinin yararlı etkileri yanında, mukokütanöz yan etkileri de bilinmektedir. Altın tedavisi sırasında pitriyasis rosea benzeri erüpsiyonu olan bir romatoid artrit hastası sunuldu. Döküntü, tedavinin kesilmesi ile geriledi.Öğe Bacillary angiomatosis in an HIV seronegative patient(2004) Aydo?an, Ilker; Parlak, Ali Haydar; Alper, Murat; Aksoy, K. AylinBacillary angiomatosis is a rare infectious disease usually occuring in immunodeficient patients with a history of contact with cats. It is characterized by cutaneous angiomatous lesions and systemic involvement may occur. There are only a few case reports about bacillary angiomatosis in immunocompetent individuals. We report a 23-year-old immunocompetent man without history of contact with cats, whose diagnose was based on the demonstration of bacilli in histopathological sections stained with the reticulin silver dye.Öğe Bilateral multiple piloleiomyomas on the breast(Churchill Livingstone, 2004) Alper, Murat; Parlak, Ali Haydar; Kavak, Ayşe; Aksoy, Kasım A.Piloleiomyomas are benign smooth muscle tumors arising from the erector pilorum muscles in the skin. They vary in size and number, and are often spontaneously painful or sensitive to touch and cold. In this paper, we present two young female patients who have multiple breast piloleiomyoma and discuss the related findings.Öğe Blue nevus with an unusual presentation: Two patients with endocervical location(2004) Alper, Murat; Aydın, A.; Özdemir, I.; Suna, Mazlume; Çıralık, Harun; Aksoy, K. A.Objective: To report two cases of endocervically located blue nevus. Subject: Case report. Setting: University of Abant Izzet Baysal, Duzce, Turkey. Subject and Method: Blue nevus is a benign lesion, which is usually found on the skin, rarely on mucous membranes. In two patients the endocervical location of blue nevus was described. Conclusion: Blue nevus when located on the cervix may be confused with other benign or malignant lesions.Öğe Breast carcinoma with three coexistant type of metaplasia: Sarcomatoid, giant cell and squamous differantiation(2006) Belenli, K.O.; Markoć, F.; Saglam A.; Çukur, Sağlam; Alper, Murat; Murat, AlpexWe report on a women with metaplastic carcinoma of the right breast. After diagnosis she had a simple mastectomy operation. Pathological investigations were carried out on mastectomy material. Immunohistochemical analyses were performed. Bizarre, malignant giant cells and diffuse inflammatory reactions were predominantly noted. Sarcomatous metaplasia and rare squamous metaplasia were also seen. There was not any area of classic intraductal, invasive ductal, lobular or papillary carcinoma. The patient is still alive and well for more than five years. This uncommon case is described and discussed, and the related literature is reviewed.Öğe Characterization of biodegradable chitosan microspheres containing vancomycin and treatment of experimental osteomyelitis caused by methicillin-resistant staphylococcus aureus with prepared microspheres(Elsevier Science Bv, 2006) Cevher, Erdal; Orhan, Zafer; Mulazimoğlu, Lütfiye; Şensoy, Demet; Alper, Murat; Yıldız, Ayça; Özsoy, YıldızThe biodegradable chitosan microspheres containing vancomycin hydrochloride (VANCO) were prepared by spray drying method with different polymer:drug ratios ( 1: 1, 2:1, 3:1 and 4: 1). Thermal behaviour, particle size and distribution, morphological characteristics, drug content, encapsulation efficiency, in vitro release assessments of formulations have been carried out to obtain suitable formulation which shows sustained-release effect when implanted. Sterilized VANCO loaded microspheres were implanted to proximal tibia of rats with methicillin-resistant Staphylococcus aureus (MRSA) osteomyelitis. Intramuscular (IM) injection of VANCO for 21 days was applied to another group for comparison. After 3 weeks of treatment, bone samples were analysed with a microbiological assay. According to the results, encapsulation efficiency and yield of microspheres in all formulations were higher than 98% and 47%, respectively. Particle sizes of microspheres were smaller than 6 mu m. All microsphere formulations have shown sustained-release effect. In vitro drug release rate decreased due to the increase in polymer:drug ratio but no significant difference was seen between these results (p > 0.05). Based on our in vivo data, rats implanted VANCO-loaded chitosan inicrospheres and administered IM injection showed 3354 3366 and 52500 25635 colony forming, unit of MRSA in 1g bone samples (CFU/g), respectively. As a result, implanted VANCO-loaded microspheres were found to be more effective than IM route for the treatment of experimental osteomyelitis.Öğe Cholesterol granuloma of the maxillary sinus(Ethiopian Med Assn, 2004) Alper, Murat; Belenli, Olcay Kandemir; Aksoy, Kamuran Aylin; Suna, Mazlume; Çukur, SelmaCholesterol granuloma is usually associated with middle ear disease and is very rare in the paranasal sinuses. We report a case of cholesterol granuloma originating in the maxillary sinus of a 36-year-old female. Endoscopic sinus surgery was performed on the left maxillary sinus, and the cholesterol granuloma was successfully removed by the middle meatal antrostomy.Öğe Chronic actinic dermatitis: Associated depigmentation and its relationship with "compositae" dermatitis(2003) Kavak, Ayşe; Alper, MuratA variety of etiologies such as photoallergic, phototoxic, immunologic and metabolic factors have been postulated in chronic actinic dermatitis. Presented case had a chronic eczematous plagues consistent with chronic actinic dermatid. In addition, he had an uncommon lesion presented as vitiligo like depigmentation. Sesquiterpene lactone mix was positive in the standard patch test. Thus, we discussed the relationship between chronic actinic dermatitis and "compositae" dermatitis according to the result of this test. Finally, the effectiveness of azathioprine treatment was summarized.Öğe The effect of cyclosporine, diclophenac sodium and diltiazem on mesenteric artery ischemia and reperfusion(Medimond S R L, 2000) Arıkan, Yüksel; Şenel, M. Ferda; Günal, Ömer; Pehlivan, Mevlüt; Alper, MuratWe searched the sequential serum levels of cytokines and seromuscular enzymez such as TNF, IL-1, IL-2, IL-6, TGF, serotonin, creatinine kinase, alkaline phosphatase, and lactate dehydrogenase obtained from the portal blood after 45-minute mesenteric artery ischemia in Wistar-Albino rats. We also examined the effect of cyclosporine, diclophenac sodium, and diltiazem administered before the ischemia. Serum levels of TNF, IL2, IL6, serotonin, and LDH showed significant rise 30 minutes after mesenteric artery ischemia. Serotonin and IL2 showed nearly 2 fold increase where as IL6, TNF, and LDH showed more than 4 fold increase after the ischemia. Ninety minutes following reperfusion IL2 and IL6 levels were still significantly higher than the initial levels. CsA pretreated rats did not show significant cytokine elevation during the ischemia and reperfusion period, In rats pretreated with diclophenac sodium TNF and LDH showed only 2 fold elevation during ischemia. Diltiazem did not significantly effect these parameters. Pretreatment with CsA and diclophenac sodium significantly reduced the rise in cytokine and enzyme levels such as IL2, IL6, serotonin, LDH TNF in I-at mesenteric artery ischemia model and lead to rapid reduction in these levels after reperfusion.Öğe The effect of intraperitoneal paclitaxel administration on colonic anastomosis(H G E Update Medical Publ Ltd., 2000) Arıkan, A. Yüksel; Günal, Ömer; Pehlivan, Mevlüt; Alper, MuratBackground/Aims: The effect of intraperitoneal administration of chemotherapeutic agents on colonic anastomosis are still under investigation. In this study the effects of intraperitoneally administered paclitaxel on rat colonic anastomosis was investigated. Methodology: After colonic anastomosis, 3mL of isotonic saline was administered intraperitoneally to rats in control group (Group 1, n = 20). The study group (Group 2, n = 20), paclitaxel 3 mg/kg diluted with isotonic saline was administered intraperitoneally after colonic anastomosis. Rats were sacrificed on 14th day and mean body weight, mean anastomosis bursting pressure and the histopathology of the anastomosis site of the two groups were compared. Results: Mean body weight was approximately the same with the preoperative values at 14th day in both groups. Anastomosis bursting pressure in paclitaxel group (127 +/- 3mm Hg) was found to be similar to control group (133 +/- 5mm Hg) (P > 0.05). Mucosal layer formation in the anastomosis line was complete on the 14th day in both groups. Conclusions: As a result intraperitoneal paclitaxel administration was found to be safe as it did not reduce the anastomotic strength and not delay wound healing.Öğe Effects of extra corporeal shock wave lithotripsy on portal vein cytokine levels, and liver(Medimond S R L, 2000) Arıkan, Yüksel; Şenel, M. Ferda; Günal, Ömer; Pehlivan, Mevlüt; Alper, MuratWe aimed to determine the effect of shock waves on the liver tissue, as well as on the portal vein IL-6 and TNF alpha levels.. The rats in the control group (n:10) did not receive any shock waves, while other rats (n:10) received 1000 shock waves. Twenty four hours after administration of shock waves all rats were sacrified and livers were taken out for histopathological evaluation. In addition portal vein IL-6 and TNF alpha serum levels were assayed. The mean IL-6 and TNF alpha levels of rats receiving shock waves ESWL were 276+/-10,7 pg / mi and 230+/-12,8 pg/ml respectively, These were significantly higher than that of the control group (p<0,05). The mean liver damage scores in this group (3,3+/-0,3) was also significantly higher than the control group (0,3+/-0,1; p<0.01), Histopathological examination of the livers revealed mild venous congestion, kupper cell hyperplesia, and erythrocyte extravasation in the sinusoids. As the safety range of shock wave administration to liver seems to be narrow we suggest low dose treatment for intrahepatic bile stones. In addition, early cytokine levels might be good indicators of the tissue damage, and guide us to determine the safety margin of shock wave administration.Öğe The effects of extracorporeal shock waves on the rat achilles tendon: is there a critical dose for tissue injury?(Springer, 2004) Orhan, Zafer; Çam, Kamil; Alper, Murat; Özturan, KutayIntroduction: Extracorporeal shock waves (ESW) have been extensively studied in the field of orthopedics. Experimental and focused, well-designed clinical studies have suggested the clinical utilisation of ESW in several pathologies including delayed bone union, tennis elbow, and plantar fasciitis. However, the unwanted detrimental effects of ESW on various tissues have been questioned by some authors. In this experimental study, the effects of ESW were investigated at different intensity applications on the Achilles tendons of rat. Materials and methods: A total of 32 adult Wistar albino rats was divided into four groups. The first three groups received 1000 impulses of 0.15 MJ/mm(2) 1500 impulses of 0.15 mJ/mm(2), and 2000 impulses of 0.20 mJ/mm(2), respectively. The last group was kept as the control group. Subsequently, Achilles tendons were harvested for histological studies from all rats at the 3rd week after a single application of ESW. Results: There were no histological abnormalities observed in the Achilles tendons of the first two groups compared with the control group. No alteration in the histological configuration was observed, and consequently the pathologist who had been blinded could not differentiate these rats from the control group by light microscopy. However, in the high intensity group (2000 impulses of 0.20 mJ/mm(2)), grade II and III disorganisation of collagen fibers was noticed in 7 out of 8 rats, which was not detected in any of the rats from the first two groups (p<0.05). Consequently, the pathologist could distinguish the majority of the rats (7 out of 8) of this group from the remaining ones. Meanwhile, grade I lymphocyte infiltration was observed in some sections of the rats receiving the highest ESW dose. Conclusion: This study confirms that ESW application at high intensity is associated with detrimental tissue effects. Additionally, it was suggested that the extent of tissue injury caused by ESW is dose-related.Öğe Ekstrakorporeal şok dalgası tedavisinin sıçanlarda kırık iyileşmesi üzerine etkileri(2001) Orhan, Zafer; Alper, Murat; Şenel, Ferda; Yılmaz, Necati; Sayar, ÜmitAmaç: Tibia diafizlerinde kırık oluşturulduktan sonra Kirschner teliyle intramedüller tespit yapılan sıçanlarda, düşük enerjili şok dalgasının kırık iyileşmesi üzerine etkileri radyolojik, histolojik ve sintigrafik olarak incelendi. Çalışma planı: Ortalama ağırlıklar 200 gr (180-220 gr) olan üç aylık (2.5-4 ay) Wistar-albino tipi sıçanlardan dört ve alt haftalık gruplar oluşturuldu. Tüm sıçanlarda parmakla bastırarak skopi kontrolunda sağ tibia diafizlerinde transvers kırık oluşturuldu ve kırıklar intramedüller olarak K-teliyle tespit edildi. Birinci (çalışma) ve ikinci (kontrol) gruplarda 14'er adet, üçüncü (çalışma) ve dördüncü (kontrol) gruplarda beşer sıçan yer aldı. Kırık sonrası deney gruplarındaki sı çanlara 0, 5, 9, 14 ve 19. günlerde 14 kV gücünde 200'er şok dalgası uygulandı. Sıçanlarda dördüncü ve altıncı haftalarda radyolojik inceleme yapıldı. Birinci ve ikinci grup dördüncü haftada öldürülerek histolojik olarak incelendi. Üçüncü ve dördüncü gruplar altıncı haftada osteoblastik aktivite açısından sintigrafik olarak incelendi ve sonrasında histolojik tetkik için anesteziyle öldürüldü. Sonuçlar: Radyolojik skorlar dört ve altıncı haftalarda deney grubunda anlamlı derecede daha yüksekti (sırasıyla p=0.002 ve p=0.011); histolojik olarak ESWT grubunda daha yüksek oranda kemiksel kaynama saptandı. (sırasıyla p=0.027 ve p=0.001). Sintigrafi çalışmasında statik çalışmada 10 dakikalık sayımda kontrol grubuna göre daha yüksek değerler elde edildi (p=0.039). Çıkarımlar: Çalışmamızda elde edilen radyolojik, histolojik ve sintigrafik veriler ESWT uygulamasının kırık iyileşmesini hızlandırdığını gösterdi.Öğe Ekstrakorporeal şok dalgası tedavisinin tendon dokusuna etkileri: Sıçanlarda deneysel çalışma(2000) Orhan, Zafer; Alper, Murat; Demirkaya, Mehmet; Özturan, KutayAmaç: Son yıllarda gündeme gelen ekstrakorporeal şok dalgası tedavisi, kaynama gecikmesi, omzun kalsifiye tendiniti, tenisçi dirseği ve plantar fasyitis tedavisinin de aralarında olduğu bir çok hastalıkta kullanılmaktadır. Bu tedavinin tendon ve komşu dokulara muhtemel zararlı etkilerini ortaya koymak amacıyla sıçanlarda deneysel bir araştırma gerçekleştirdik. Çalışma planı: Otuz iki adet Wistar albino cinsi sıçan sekizerlik dört gruba ayrıldı. İlk üç deney grubuna sırasıyla 14 kV’ lik 1000, 14 kV’lik 1500 ve 18 kV’lik 2000 şok dalgası uygulandı. Dördüncü grup kontrol grubunu oluşturdu. Bu enerji şiddeti ve şok dalgası uygulamasının sıçanların aşil tendonlarına etkisi araştırıldı. Sonuçlar: 14 kV 1000 şok ve 14 kV 1500 şok gruplarında belirgin bir histopatolojik değişiklik görülmedi. 18 kV 2000 şok uygulanan grupta ise liflerde hafif derecede dizilim bozukluğu ve seyrek lenfositler görüldü. Çıkarımlar: Histopatolojik değişikliklerin 18 kV 2000 şok dalgasından itibaren gözlenmesi nedeniyle, yüksek enerjili şok dalgası uygulamalarında olası doku değişikliklerini göz önüne almak gerekir.Öğe Epidural extension of a lumbar vertebral haemangioma(Elsevier Sci Ltd, 2006) İş, Merih; Gezen, Ferruh; Alper, Murat; Yıldız, Hakan Kartal; Akyüz, FevzullahVertebral haemangiomas are relatively common, but those extending into the epidural space are rare. A 59-year-old man with severe lower back and right leg pain that did not resolve with conservative treatment was seen in an outpatient clinic. Magnetic resonance imaging of the lumbar spine identified an L3 vertebral corpus lesion with epidural extension. The diagnosis was unclear, so the patient underwent surgery. The pathologic diagnosis was capillary haemangioma, so angiography-guided embolization was performed postoperatively. Vertebral haemangioma must be considered when there is evidence of a vertebral corpus lesion with epidural extension on magnetic resonance imaging.Öğe Epiglottic tuberculosis in a patient treated with steroids for addison's disease(Tohoku Univ Medical Press, 2003) Egeli, Erol; Oğhan, Fatih; Alper, Murat; Harputluoğlu, Uğur; Bulut, İsmetIsolated epiglottic tuberculosis (TBC) is uncommon and has rarely been described. We report the case of a 40-year-old man with tuberculous involvement of the epiglottis and primary adrenal insufficiency. Endoscopic examination showed a severely swollen epiglottis with granulomatous and partially necrotic mucosa. The patient has been treated with glucocorticoids for four years due to primary adrenocortical. insufficiency. We therefore assume that tuferculous involvement of epiglottis is due to the reactivation of pulmonary TBC. We also discuss differential diagnosis and management of epiglottic TBC and Addison's disease.Öğe An experimental study on the application of extracorporeal shock waves in the treatment of tendon injuries: Preliminary report(Springer Japan, 2001) Orhan, Zafer; Alper, Murat; Akman, Yavuz; Yavuz, Özlem; Yalçıner, AltanThe use of low-energy extracorporeal shock wave therapy (ESWT) has recently been introduced in pseudoarthrosis, fracture, and wound healing for both clinical and experimental purposes. In this study, we created an experimental rat model to investigate the histopathological and biochemical effects of ESWT in the healing of tendon injury that may accompany fractures. Twenty-eight rats were used for the histopathological investigation. The right achilles tendon of the rat was cut and then sutured, using Modified Kessler stitches method. Five hundred shock waves, set at 14kV, were applied to the achilles tendon under fluoroscopic guidance. Fourteen rats that underwent a sham operation served as the control group. Biochemical studies were done on 20 rats, divided into four groups of 5 rats in each. The first and second groups received 500 shock waves, at 14kV, after the cutting and repairing of the Achilles tendon. To measure hydroxyproline levels, the rats in the first and second groups were killed on postoperative days 3 and 9, respectively. The third and fourth groups served as controls. Hydroxyproline levels were found to be high in the study groups. The histopathological findings and the increased hydroxyproline levels revealed that ESWT may facilitate tendon healing after trauma.Öğe Extensive cutaneous metastasis of transitional cell carcinoma of the bladder(Blackwell Publishing Asia, 2003) Akman, Yavuz; Çam, Kamil; Kavak, Ayşe; Alper, MuratCutaneous metastasis of bladder carcinoma is extremely rare. Iatrogenic implantations have been the main cause in the majority of cases of transitional cell carcinoma with cutaneous metastasis. Otherwise, primary cutaneous metastasis is accepted as the late manifestation of systemic spread. The present paper describes a case of relatively early and extensive skin metastasis of transitional cell carcinoma in a 78-year-old man. The patient had a histopathological diagnosis of poorly differentiated (grade III) muscle invasive transitional cell carcinoma with a staging of T2NOMO 6 months prior to presenting. He presented to our outpatient clinic with a 3-month history of skin lesions as multiple, rubbery subcutaneous nodules. Radiological reinvestigation revealed no other metastatic site (including bone and lung), except for a metastatic nodule in the liver. The present paper reports an interesting and rare case of extensive skin metastasis of transitional cell carcinoma as the primary complaint.Öğe A fatal case of reye syndrome after varicella and ingestion of aspirin(Japanese Dermatolgical Assoc, 2001) Çaksen, Hüseyin; Güler, Ekrem; Alper, Murat; Üstünbaş, Hasan BasriReye syndrome (RS) is a mitochondrial hepatopathy, characterized by acute encephalopathy and fatty degeneration of the liver. The incidence ranges between 0.35 and 3.5 in 100,000 (1–3). The reasons for the mitochondrial dsyfunction are unknown. No toxic factor has yet been conclusively identified, but studies have suggest etiologic links among RS, use of aspirin, and viral infections (1). Here, we report a case of RS after varicella and ingestion of aspirin to emphasize the importance of avoiding the use of aspirin in varicella.Öğe Gastric pseudolipomatosis, usual or unusual? Re-evaluation of 909 endoscopic gastric biopsies(Baishideng Publishing Group Inc, 2003) Alper, Murat; Akcan, Yusuf; Belenli, Olcay K.; Çukur, Selma; Aksoy, Kamuran A.; Suna, MazlumeMicrovesicular pneumatosis intestinalis, also called "pseudolipomatosis" for resembling fatty infiltration, is characterized by the presence of small gas voids in the gastrointestinal wall, especially in mucosa. These voids are not lined with epithelia. There are few reported cases about colon, duodenum and skin. Because there is only one case report about pseudolipomatosis in the stomach, we re-evaluated 909 endoscopic biopsies taken from gastric corpus to check the presence of pseudolipomatosis. We determined pseudolipomatosis foci in 3 percent (n=27) of biopsies. In two cases there were pseudolipomatosis foci in endoscopic biopsies having otherwise normal histologic findings, while there were pseudolipomatosis foci in endoscopic biopsies of 25 patients with gastritis. H pylori was found in 85 % of biopsies having pseudolipomatosis foci. In this study, we presented some histopathologic characteristics of pseudolipomatosis seen in gastric mucosa.
