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Öğe An AGEP case due to COVID-19 or favipiravir or enoxaparin(Wiley, 2022) Daye, Munise; Oltulu, Pembe[Abstract Not Availabe]Öğe Alopecia areata, morphea and psoriasis(Termedia Publishing House Ltd, 2020) Durmaz, Koray; Ataseven, Arzu; Ozer, Ilkay; Oltulu, Pembe[Abstract Not Availabe]Öğe Alpha-Amanitin Poisoning, Nephrotoxicity and Oxidative Stress: An Experimental Mouse Model(Kowsar Publ, 2015) Ergin, Mehmet; Dundar, Zerrin Defne; Kilinc, Ibrahim; Colak, Tamer; Oltulu, Pembe; Girisgin, Abdullah SadikBackground: Alpha-amanitin (alpha-AMA) plays a major role in Amanita phalloides poisoning, showing toxic effects on multi-organs, particularly on the liver and kidneys. Studies have shown a relationship between alpha-AMA-related injuries and reactive oxygen species. Objectives: We aimed to investigate whether there is renal injury and its relationship with oxidative stress after intraperitoneal injection of alpha-AMA in mice experimental poisoning models. Materials and Methods: There were 37 male BALB/c laboratory mice treated with alpha-AMA, according to the study groups: control group (n = 7); low dose (0.2 mg/kg) (n = 10); moderate dose (0.6 mg/kg) (n = 10), and high dose (1 mg/kg) (n = 10). The sample size was detected according to the ethical committee's decision as well as similar studies in the literature. After a 48-hour follow-up period, all the subjects were sacrificed for pathological and biochemical assays. The study was held in Turkey. Results: alpha-AMA poisoning in mice results in inflammatory changes and necrosis in renal structures. There were statistically significant differences between the study groups regarding measured levels of catalase, superoxide dismutase, glutathione peroxidase, total antioxidant status (TAS), total oxidant status (TOS) and malonyl dialdehyde in renal homogenates of mice (P < 0.001, P < 0.001, P < 0.001, P < 0.001, P < 0.001, and P = 0.001, respectively). The TOS and TAS measurements helped to eliminate cumbersome analysis of diverse oxidant and antioxidant molecules. The TOS levels in renal homogenate of mice were significantly higher in all the intoxication groups compared to the control group (5.73, 7.02, 7.77, and 9.65 mmol trolox eq/g protein and P = 0.002, P = 0.001, and P = 0.001, respectively). The TAS levels in moderate and high-dose groups were significantly lower than all the other groups treated with alpha-AMA (0.130, 0.152, 0.065, and 0.087 mmol trolox eq/g protein and P = 0.031, P = 0.001, and P = 0.001, respectively). Conclusions: Our results indicated that alpha-AMA poisoning in mice led to inflammatory changes and necrosis in renal structures. Biochemical analysis showed a shift in the oxidative/anti-oxidative balance towards the oxidative status.Öğe Anemi etiyolojisi ile 56 yaşında tespit edilen Çölyak hastalığı(2015) Kutlu, Ruhuşen; Büyükyörük, Cennet; Oltulu, PembeÇölyak hastalığı genetik yatkınlığı olan bireylerde, glutene karşı sıradışı bağışıklık yanıtı olarak tanımlanır. Çocuklarda ve infantlarda görülen malabsorbsiyonun en sık görülen nedenlerindendir. Emilim bozukluğu buğday, çavdar, arpa ve yulaftaki gliyadin varlığına bağlıdır. İnce bağırsak mukozasında gliyadin peptitleri ile "Human leucocyte antigen" sınıf II moleküllerinin konjugasyonu, klinik bulgulara yol açan immünolojik reaksiyonları tetiklemektedir. Çok geniş bir klinik yelpazesi olmakla birlikte, 6-12 aylar arasında ishalin başlaması karakteristik özelliklerindendir. Demir eksikliği anemisi de çölyak hastalığının sık görülen bulgularındandır. Antig- liyadin, antiendomizyum ve doku transglütaminaz antikorları tanıda yardımcı olmakla birlikte, kesin tanı için ince bağırsak biyopsisi gereklidir. Biyopside total villus atrofisinin olması tanıda altın standarttır. Tedavi amaçlı glutensiz diyet verildiğinde bariz bir iyileşme görülür. Bu yazıda anemi etiyolojisi araştırılırken tespit edilen gluten enteropatili bir olgudan yola çıkılarak anemi ile çölyak hastalığı ilişkisi incelenmiştir.Öğe Antioxidant effects of bisphosphonates in smoking- induced lung injury in rat model(European Respiratory Soc Journals Ltd, 2015) Korkmaz, Celalettin; Yavsan, Durdu Mehmet; Demirbas, Soner; Oltulu, Pembe; Kilinc, Ibrahim; Uyar, Mehmet; Gok, Mehmet[Abstract Not Availabe]Öğe Assessment of Ocular Surface in Patients With Ankylosing Spondylitis(Lippincott Williams & Wilkins, 2020) Oltulu, Refik; Turk, Huseyin Bugra; Oltulu, Pembe; Turk, Nazli; Satirtav, Gunhal; Gunduz, Mehmet KemalPurpose: To evaluate the clinical findings and ocular surface changes in patients with ankylosing spondylitis (AS). Methods: This prospective study involved 45 patients with AS (group 1) and 28 healthy subjects (group 2). Patients in group 1 were in the inactive period. The study subjects underwent a complete ophthalmic examination. The right eyes of the subjects in each group were tested for the study including slit-lamp examination, Schirmer I test, tear break-up time (TBUT), conjunctival impression cytology (CIC), and ocular surface disease index (OSDI). Results between the two groups were compared. Results: The mean Schirmer I test result was found as 12.2 +/- 8 mm in group 1 and 20.3 +/- 9.9 mm in group 2 (P<0.001), whereas the mean TBUT value was found as 3.8 +/- 1.9 sec in group 1 and 10.1 +/- 4.8 sec in group 2 (P<0.001). The OSDI scores were significantly higher in group 1 (36.5 +/- 19.4) than in group 2 (9.1 +/- 12.9, P<0.001). The CIC scores were significantly higher in group 1 (2.12 +/- 0.7) than in group 2 (0.57 +/- 0.6, P<0.001). Notably, none of the patients in group 1 showed grade 0 differentiation, and none of the patients in group 2 showed grade 2 or 3 differentiation. The CIC scores were significantly higher in group 1 (2.12 +/- 0.7) than in group 2 (0.57 +/- 0.6, P<0.001). Conclusion: Ocular surface changes, including squamous metaplasia in the bulbar conjunctiva, can be observed in patients with AS.Öğe Association between interleukin 6 polymorphisms (rs1800796, rs1800795, rs2069837, rs17147230, and rs1800797) and hepatocellular carcinoma susceptibility: a meta-analysis(Termedia Publishing House Ltd, 2020) Aleagha, Omid Emami; Oltulu, Pembe; Sadeghi, MasoudAim of the study: We reported the association between interleukin 6 polymorphisms (rs1800796, rs1800795, rs2069837, rs17147230, and rs1800797) and hepatocellular carcinoma (HCC) susceptibility in a meta-analysis. Material and methods: The studies were retrieved by searching the search terms in Scopus, PubMed, Web of Science, and Cochrane Library databases until June 2020. The analyses were done by RevMan 5.3 software using odds ratios (ORs) and 95% confidence intervals (Cis) and the analysis of publication bias and sensitivity analyses were performed by CMA 2.0 software. Results: Searching through the databases, 316 records were retrieved and finally 13 studies were analyzed in the present meta-analysis. For the rs1800797 polymorphism, there was an elevated risk of AA genotype (OR = 2.68, p = 0.03) in HCC patients compared to healthy controls. Also, there was an elevated risk of M (OR = 3.06, p = 0.04) and GA (OR = 2.61, p = 0.005) genotypes in HCC patients compared to liver cirrhosis patients. For rs2069837 polymorphism, there was an elevated risk of GG genotype (OR = 2.25, p = 0.01) in HCC patients compared to healthy controls. For rs17147230, T allele (OR = 1.31, p = 0.03) and TT genotype (OR = 1.83, p = 0.02) had elevated risks in HCC patients compared to healthy controls. Conclusions: The present meta-analysis confirmed that there was an elevated risk of the AA and GA genotypes of rs1800797 polymorphism and the GG genotype of rs2069837, and the T allele and TT genotype of rs17147230 in HCC.Öğe The Association of Cataract and Lens Epithelial Cell Apoptosis in Patients with Pseudoexfoliation Syndrome(Taylor & Francis Inc, 2018) Oltulu, Pembe; Oltulu, RefikPurpose: The aim of this study was to measure the density of apoptotic lens epithelial cells (LECs) and to determine its association with cataract formation in eyes with pseudoexfoliation syndrome (PEX). Materials and Methods: Twenty-one eyes of 21 patients diagnosed with PEX without glaucoma (Group 1) and 22 eyes of 22 subjects without PEX (Group 2) were enrolled in this study. During cataract surgery, anterior capsule samples were obtained by the 5.5mm continuous curvilinear capsulorhexis method. Apoptosis was determined with a TUNEL kit (Boster, Wuhan, China) according to the manufacturer's protocol. Four fields in each pathology preparation were chosen randomly under a microscope, and 100 cells were counted in each field to calculate the apoptosis rates. Results: Forty-three eyes of 43 subjects were enrolled in this study. There were no significant differences in age or sex between the two studied groups (p > 0.05). Under a microscope, the LECs were stained light blue and their nuclei were oval shaped. Positive stained cells were found occasionally in Group 2, while a significant amount of black-brown positively stained LECs with condensed nuclei was found in Group 1. The apoptosis rates were 35.2 +/- 2.1% and 14.1 +/- 1% in Groups 1 and 2, respectively. The proportion of positively stained LECs was higher in Group 1 (p < 0.001). Conclusion: Our study suggests that apoptosis in LECs is the pathophysiological mechanism for the higher rate of cataracts in PEX patients, in addition to the ocular ischemia hypothesis.Öğe Associations of IL-4, IL-4R, IL-17A, and IL-17F Polymorphisms with Colorectal Cancer Risk: A Meta-Analysis, Meta-Regression, and Trial Sequential Analysis(Mary Ann Liebert, Inc, 2022) Javadirad, Etrat; Sadeghi, Masoud; Oltulu, Pembe; Sadafi, SepehrBoth interleukin (IL)-4 and IL-17 polymorphisms may be involved in the pathogenesis and progression of colorectal cancer (CRC). Herein, we designed a meta-analysis to assess the associations between IL-4, IL-4R, IL-17A, and IL-17F polymorphisms and CRC risk. Scopus, Web of Science, Cochrane Library, and PubMed databases were searched to retrieve articles published until October 21, 2021. We used crude odds ratio (OR) and 95% confidence interval assessing the association of the polymorphisms and CRC risk in 5 genetic models. Trial sequential analysis for the primary analyses was used to control random errors. Twenty-three studies (8: IL-4 rs2243250, 4: IL-4R rs1801275, 5: IL-17A rs2275913, and 6: IL-17F rs763780) were involved in the meta-analysis. The pooled OR (P-value) for the association between IL-4 rs2243250 polymorphism and the CRC risk was 1.11 (0.08), 1.27 (0.12), 1.07 (0.37), 1.09 (0.17), and 1.22 (0.12), for IL-4R rs1801275 polymorphism was 0.71 (0.18), 1.05 (0.76), 0.86 (0.37), 0.87 (0.41), and 0.69 (0.39), for IL-17A rs2275913 polymorphism was 1.83 (0.0003), 1.73 (0.06), 1.47 (<0.001), 1.61 (0.001), and 1.42 (0.15), and for IL-17F rs763780 polymorphism was 1.07 (0.48), 5.33 (0.02), 1.08 (0.49), 1.08 (0.47), and 8.42 (0.002) in allelic, homozygous, heterozygous, recessive, and dominant models, respectively. The G allele and GA genotype of IL-17A rs2275913 polymorphism and the CC genotype of IL-17F rs763780 polymorphism had an elevated risk in CRC cases. The ethnicity and genotyping method, sample size, control, and publication year were effective factors on the pooled results.Öğe Bing-Neel syndrome: A case reports(Sage Publications Ltd, 2021) Demircioglu, Sinan; Oltulu, Pembe; Emlik, Ganime D.; Tekinalp, Atakan; Ceneli, OzcanIntroduction Bing-Neel syndrome (BNS) is a rare complication of of Waldenstrom macroglobulinemia (WM) identified by involvement of central nervous system (CNS) lymphoplasmacytic cells. Case report We present a patient who was diagnosed with Bing-Neel syndrome four years after the diagnosis of Waldenstrom macroglobulinemia. Management & outcome The patient was admitted with neurological symptoms. There were lesions associated with WM involvement on brain imaging. The diagnosis was made by brain biopsy. High dose methotrexate treatment was given. Discussion CNS infiltrating agents such as fludarabine, methotrexate and cytarabine are often used in BNS treatment. Ibrutinib, which is a new bruton tyrosine kinase inhibitor, has recently started to be used in BNS treatment, as it has been shown to be effective and penetrate the CNS.Öğe Complete treatment with partial cystectomy in giant xanthogranulomatous cystitis case imitating bladder tumor(Medknow Publications & Media Pvt Ltd, 2017) Balasar, Mehmet; Sonmez, Mehmet Giray; Oltulu, Pembe; Kandemir, Abdlkadir; Kilic, Mehmet; Gurbuz, RecaiXanthogranulomatous cystitis (XC) is a very rare chronic benign inflammatory disease of the bladder. It may cause local invasion although it is not a malign lesion and may occur together with malign lesions. It has a clinical importance as the distinction from malign lesions is difficult clinically and pathologically. Sharing a 37-year-old female case with giant XC imitating bladder tumor referring to the hospital with hematuria and stomach ache, together with current literature, we wanted to present that the disease can be treated with bladder-preserving approaches instead of radical approaches even though the mass is big in these cases. Application of basic excision and partial resection for small masses and radical cystectomy for large masses was reported in literature. We think that our case may provide a contribution to literature in treatment approach since we provided surgical cure with partial resection in a big mass with dimensions of 9 cm x 8 cm which is different from the present literature. Even though XC is a rare disease, it should be considered in prediagnosis for especially big dimensioned masses, and treatment should be planned according to the pathology result after together with cystoscopy in suitable patients.Öğe Conjunctival Impression Cytology and Dry Eye in Patients With Ulcerative Colitis: A Pilot Study(Lippincott Williams & Wilkins, 2018) Oltulu, Pembe; Oltulu, Refik; Asil, Mehmet; Satirtav, Gunhal; Mirza, EnverPurpose: The aim of this study was to compare signs of dry eye between ulcerative colitis (UC) patients and healthy subjects. Methods: Fifteen patients with UC (group 1) and 15 healthy subjects (group 2) were enrolled in this study. Tear volume measurement, Schirmer-I test with no anesthetic, tear break-up time, and conjunctival impression cytology (CIC) were evaluated in both groups. Results: Patients with UC showed lower tear volumes when compared with healthy subjects (P<0.05). There was a statistically significant difference in distribution of CIC grades between groups 1 and 2 (P<0.05). Tear break-up time and Schirmer-I measurements were significantly lower in group 1 compared with group 2 (P<0.05). Conclusions: The results of this study indicate that UC is associated with demonstrable disturbances in tear function and conjunctival cytology.Öğe Conjunctival impression cytology and tear film parameters in patients with multiple sclerosis(Springer, 2022) Belviranli, Selman; Oltulu, Pembe; Uca, Ali Ulvi; Gundogan, Ali Osman; Mirza, Enver; Altas, Mustafa; Turk, NazliPurpose To evaluate conjunctival impression cytology (CIC) findings and tear film parameters in patients with multiple sclerosis (MS) compared with controls. Methods Thirty-three patients with MS (MS group) and 33 age- and sex-matched healthy subjects (control group) were included in this cross-sectional comparative study. CIC grades, tear break-up time (TBUT), Schirmer 1 test results, and Ocular Surface Disease Index (OSDI) scores were compared between the two groups, and correlations between CIC grade, TBUT, Schirmer 1 test result, OSDI score, Expanded Disability Status Scale score, and disease duration were analyzed. Results Mean CIC grade was higher in the MS group than in the control group (1.48 +/- 0.71 and 0.39 +/- 0.56, respectively; p < 0.001). In the MS group, CIC of the 14 participants (42.4%) was grade 2-3. In the control group, CIC of the only one participant (3.3%) was grade 2, and none of them was grade 3. TBUT (8.12 +/- 3.16, 13.06 +/- 4.23 s in MS and control groups, respectively; p < 0.001) and Schirmer 1 test results (8.45 +/- 5.75, 17.36 +/- 10.89 mm in MS and control groups, respectively; p < 0.001) were lower, and OSDI score (36.36 +/- 19.19, 13.70 +/- 15.36 in MS and control groups, respectively; p < 0.001) was higher in the MS group compared to the control group. Conclusion In patients with MS, objective findings of dry eye, subjective symptoms related to dry eye, and CIC abnormalities, including high grades of conjunctival squamous metaplasia and goblet cell loss, are more common. Patients with MS should be monitored for ocular surface alterations and dry eye disease.Öğe Cutaneous Vasculitis after Radiotherapy(Aves, 2019) Temiz, Selami Aykut; Ozer, Ilkay; Kanyilmaz, Gul; Ataseven, Arzu; Oltulu, PembeCutaneous vasculitis is a large heterogeneous group of diseases, where blood vessels are targeted by immunological and inflammatory reactions, which are the primary causes of this condition. Infections, medications, systemic collagenosis, chronic diseases, and malignancies are the secondary factors that cause cutaneous vasculitis. Hemangiomas are the most common primary benign tumors of the spinal cordand are rarely symptomatic. The most commonly manifestedsymptom is pain, but in rare cases, cutaneous vasculitis may lead to paraparesis and paralysis. Radiotherapy (RT) is a safe and effective treatment for symptomatic spinal cord hemangiomas. A 44-year-old male patient was admitted to our dermatology polyclinic with a complaint of a bilateral rash on both legs that had lasted for 1 week. The medical history of the patient included no disease other than a sacral hemangioma with symptomatic pain, for which the patient had been treated with 4500 cGy curative radiotherapy 1 month previously. In our case, it was thought that cutaneous vasculitis was caused by the radiotherapy without any other triggering factor. A skin biopsy was taken to arrive at a definite diagnosis, and in the histopathological examination, abundant amounts of extra-red blood cells and lymphocytes were observed, along with endothelial profiling in superficial vessels; all of which are findings consistent with vasculitis. The patient was diagnosed with cutaneous vasculitis, both clinically and histopathologically. To the best of our knowledge, radiotherapy as a cause of vasculitis has been the subject of very few studies in the literature to date. In this regard, the present report describes a case of cutaneous vasculitis as a possible immune-related side effect of RT.Öğe Demodex positive discoid lupus erythematosus: Is it a separate entity or an overlap syndrome?(Wiley, 2020) Dursun, Recep; Durmaz, Koray; Oltulu, Pembe; Ataseven, ArzuDiscoid lupus erythematosus (DLE) is a chronic inflammatory erythematous skin disease that can be triggered by several factors. Rosacea is another skin disease that causes facial redness and tenderness. Demodex mites have been reported in rosacea and DLE patients commonly in the literature. These two diseases can be seen concomitant, mimic each other clinically and share common possible etiologic factors. To assess demodex mite infestation in both clinical and histopathological findings in DLE patients. We retrospectively evaluated the files of 42 patients with DLE who had been diagnosed DLE based on clinical and histopathological findings between August 2018 and August 2019. Demodex positivity was detected 50% of patients (n = 21). Neutrophile percentages in the dermal and perivascular area were higher in the demodex positive patients (4.43%) than in the Demodex negative patients (2.19%). The intensity of demodex mites correlated positively with dermal neutrophile percentages. ANA was negative in 29 patients (69%) and positive in 13 patients (31%). Anti-dsDNA was negative in serology and follicular plugging was positive in histopathology in all 42 patients (100%). This was a retrospective study. DLE and rosacea share common features in etiopathogenesis and clinical presentation. Inflammation and exacerbations caused by the demodex mites may increase the clinical severity of DLE. Although the position of demodex mites in DLE etiopathogenesis is not known exactly, the presence of high demodex in DLE patients has been determined. Standard skin surface biopsy can be a routine procedure for the evaluation of DLE patients in daily clinical practice.Öğe Dry eye disease and ocular surface characteristics in patients with keratoconus(Wolters Kluwer Medknow Publications, 2022) Mirza, Enver; Oltulu, Refik; Oltulu, Pembe; Mirza, Gunsu D.; Okka, MehmetPURPOSE: The purpose of this study is to investigate the ocular surface alterations in patients with mild or severe keratoconus (KC). METHODS: A total of 80 participants were included in the study. The corneal topography was performed on each participant using Pentacam and the grouping was done accordingly. The patients with Kmax >= 52.0 D (severe KC) were considered Group 1 (n = 28), the patients with Kmax >= 47.2 and <52.0 D (mild KC) were considered Group 2 (n = 30). Healthy control participants with Kmax <47.2 D were considered Group 3 (n = 22). Tear breakup time (TBUT), Schirmer-I test, ocular surface disease index (OSDI) questionnaire, and conjunctival impression cytology (CIC) were evaluated among the groups. RESULTS: The mean values of TBUT and Schirmer-I test were significantly lower (P = 0.012, P = 0.012) and the mean scores of OSDI and CIC were significantly higher (P = 0.006, P < 0.001) in Group 1 and Group 2 than in Group 3. The mean values of TBUT and Schirmer-I test were lower and the mean scores of OSDI and CIC were higher in Group 1 than in Group 2 but the differences were insignificant (P > 0.05 for all). CONCLUSION: These results indicated that the tests associated with dry eye disease are correlated with KC. Tear film alterations and goblet cell loss are higher in severe KC.Öğe Dynamic thiol-disulfide homeostasis is disturbed in hepatitis B virus-related chronic hepatitis and liver cirrhosis(2018) Dertli, Ramazan; Keskin, Muharrem; Bıyık, Murat; Ataseven, Hüseyin; Polat, Hakkı; Demir, Ali; Oltulu, Pembe; Asıl, MehmetBackground/aim: Thiol-disulfide homeostasis is an important antioxidant defense mechanism. This study was conducted to investigatedynamic thiol-disulfide homeostasis in patients with hepatitis B virus-related chronic hepatitis and liver cirrhosis.Materials and methods: Seventy-one treatment-naive patients with chronic hepatitis B (CHB), 50 patients with hepatitis B virusassociated liver cirrhosis, and 45 healthy controls were included in the study. Serum total and native thiol concentrations and serumdisulfide concentrations were measured using an automated method.Results: Mean serum total thiol concentrations in the control, CHB, and cirrhosis groups were 481.64 37.87 µmol/L, 438.50 71.35µmol/L, and 358.07 80.47 µmol/L, respectively (P 0.001), and mean serum native thiol concentrations in the control, CHB, andcirrhosis groups were 452.92 36.43 µmol/L, 400.16 65.92 µmol/L, and 328.15 74.91 µmol/L, respectively (P 0.001). Mean serumdisulfide concentrations in the control, CHB, and cirrhosis groups were 14.38 3.38 µmol/L, 19.19 6.16 µmol/L, and 14.98 5.53µmol/L, respectively (P 0.001). There was a progressive decrease in both mean serum native and total thiol concentrations parallel tothe liver fibrosis stage.Conclusion: : Thiol-disulfide homeostasis is disturbed in patients with hepatitis B virus-related chronic hepatitis and liver cirrhosis.Öğe #EBUSTwitter Novel Use of Social Media for Conception, Coordination, and Completion of an International, Multicenter Pathology Study(Coll Amer Pathologists, 2020) Lepe, Marcos; Oltulu, Pembe; Canepa, Mariana; Wu, Roseann I.; Deeken, Amy; Alex, Deepu; Dinares, CarmeContext.-Social media sites are increasingly used for education, networking, and rapid dissemination of medical information, but their utility for facilitating research has remained largely untapped. Objective.-To describe in detail our experience using a social media platform (Twitter) for the successful initiation, coordination, and completion of an international, multi-institution pathology research study. Design.-Following a tweet describing a hitherto-unreported biopsy-related histologic finding in a mediastinal lymph node following endobronchial ultrasound-guided transbronchial needle aspiration, a tweet was posted to invite pathologists to participate in a validation study. Twitter's direct messaging feature was used to create a group to facilitate communication among participating pathologists. Contributing pathologists reviewed consecutive cases of mediastinal lymph node resection following endobronchial ultrasound-guided transbronchial needle aspiration and examined them specifically for biopsy site changes. Data spreadsheets containing deidentified data and digital photomicrographs of suspected biopsy site changes were submitted via an online file hosting service for central review by 5 pathologists from different institutions. Results.-A total of 24 pathologists from 14 institutions in 5 countries participated in the study within 143 days of study conception, and a total of 297 cases were collected and analyzed. The time interval between study conception and acceptance of the manuscript for publication was 346 days. Conclusions.-To our knowledge, this is the first time that a social media platform has been used to generate a research idea based on a tweet, recruit coinvestigators publicly, communicate with collaborating pathologists, and successfully complete a pathology study.Öğe The effect of a gap concept on peripheral nerve recovery in modified epineurial neurorrhaphy: An experimental study in rats(Wiley, 2022) Ismayilzade, Majid; Ince, Bilsev; Zuhour, Moath; Oltulu, Pembe; Aygul, RecepBackground: Several factors such as surgical approach that only consider topographic anatomy; inadequate fascicular alignment, extraepineurial sprouting in the repair zone; contact of axons with the suture area are the disadvantages of epineurial neurorrhaphy. Accordingly, axonal mismatch, neuroma, and unfavorable nerve recovery become inevitable. Neurotropism is the theory clarifying appropriate matching of the nerve fibers independently without needing surgical approach. The studies comparing the primary nerve repair with the nerve defects bridged in different ways demonstrated better outcomes of nerve recovery in the groups with a nerve gap. In this study, we aimed to demonstrate the effects of the gap concept in primary nerve repair bridged by own epineurium. We hypothesized that this technique will provide better results in terms of peripheral nerve recovery and will significantly eliminate the occurrence of a neuroma, which is quite possible in epineurial neurorrhaphy. Materials and Methods: A total of 35 Wistar female rats weighing 200 similar to 250 g were randomly divided into five groups each with seven rats. Sham controls constituted Group 1, while the rats with epineural neurorrhaphy were included in Group 2. The remaining three groups were the study groups. In Group 3, after the sciatic nerve transection, epineurium of the distal segment was sleeved and preserved. A 2-mm axonal segment was removed from the epineurium free distal ending and no any procedure was applied to the proximal ending of the transected sciatic nerve. Epineuriums of the both sides were approximated and repaired. In Group 4, a 2-mm axonal segment was removed from the proximal ending of the sciatic nerve after preservation of epineurium and no any procedure was applied to the distal part of sciatic nerve. Epineuriums of the both sides were approximated and repaired. In addition, in Group 5, after epineuriums were sleeved in the both distal and proximal stumps, a 1-mm nerve segment was removed from both endings and epineuriums were Correspondence repaired in the middle bridging a 2-mm axonal gap again. After a 3 months follow-up period Sciatic Functional Index (SFI) was measured by walking track analysis; the area under the evoked compound muscle action potential (CMAP) and latency periods were calculated via electromyographic (EMG) analysis; and histopathological evaluation were performed to compare the parameters of edema, fibrosis, inflammation, vascularization, axonal degeneration, axonal density, myelination, disorganization, and neuroma occurrence. Vascular structures and nerve fibers were counted at x200 magnification: +1, +2, and +3 indicated the presence of 0-15, 16-30, and >30 structures, respectively. For uncountable parameters (edema, disorganization, myelination, fibrosis, and inflammation): +1 indicated mild, +2 indicated moderate, and +3 indicated severe. Results: The differences between the groups with axonal gap repair and epineural neurorrhaphy were not significant regarding to SFI. The areas under CMAP were as follows: 27.9 +/- 5.9 (Delta = 12.1%) in Group 1; 16.5 +/- 5.5 (Delta = 6.3%) in Group 2; 14.1 +/- 6.2 (Delta = 4.8%) in group 3; 13.8 +/- 2.3 (Delta = 9.2%) in Group 4, and 22.5 +/- 18.3 (Delta = 2.2%) in Group 5. Group 5 (1 mm gap in the distal +1 mm gap in the proximal segments) had a significantly better result in terms of the area under CMAP with the value of 22.5 +/- 18.3 m/Mv (p = .031). Axonal density was 0.9 +/- 0.6 (Delta = 2.2%) in Group 2, 2.4 +/- 0.3 (Delta = 5.1%) in Group 3, 2.8 +/- 0.1 (Delta = 7.7%) in Group 4, and 2.8 +/- 0.2 (Delta = 4.8%) in Group 5. Myelination was 1.1 +/- 0.5 (Delta= 3.4%) in group 2, 2.2 +/- 0.2 (Delta = 6.7%) in group 3, 2.4 +/- 0.4 (Delta = 6.0%) in Group 4, and 2.7 +/- 0.3 (Delta = 4.6%) in Group 5. Disorganization was 2.3 +/- 0.4 (Delta = 4.1%) in Group 2, 1.2 +/- 0.2 (Delta = 7.7%) in Group 3, 1.3 +/- 0.2 (Delta = 6.5%) in Group 4, and 1 +/- 0.3 (Delta = 5.9%) in Group 5. And, neuroma occurrence was found 2.2 +/- 0.6 (Delta = 2.8%) in Group 2 and 0.3 +/- 0.2 (Delta= 0.1%) in Group 4 while neuroma was not encountered in Group 3 and Group 5. Comparison between the epineurial neurorrhaphy group and the groups with axonal defect revealed the statistically significant results in the factors of axonal density (p =.001), myelination (p = .028), disorganization (p = .016) and neuroma (p = .001). Conclusions: Creating axonal gap bridged by own epineurium showed favorable results comparing with epineurial neurorrhaphy. Resection of a 1 mm axonal segment from the proximal and distal stumps following the epineurial sleeve procedure and performing the epineurium- only repair can facilitate the nerve regeneration. The feasibility of the described technique has been demonstrated in a small rat model and must be further validated in larger animals before clinical testing.Öğe Effect of cineole, alpha-pinene, and camphor on survivability of skin flaps(Tubitak Scientific & Technological Research Council Turkey, 2018) Ince, Bilsev; Dadaci, Mehmet; Kilinc, Ibrahim; Oltulu, Pembe; Yarar, Serhat; Uyar, MehmetBackground/aim: The aim of this study was to determine the specific component of Rosmarinus officinalis (RO) responsible for increased flap survival and how RO displays its efficacy. Materials and methods: Rectangular random-pattern flaps were elevated from the back of each rat. Group I was the control group. In group II 0.1 mL of cineole, in group III 0.1 mL of alpha-pinene, in group IV 0.1 mL of camphor, in group V 0.1 mL each of alpha-pinene and cineole, in group VI 0.1 mL each of alpha-pinene and camphor, in group VII 0.1 mL each of cineole and camphor, and in group VIII, 0.1 mL each of alpha-pinene, cineole, and camphor was orally administered once a day before surgery. The luminal area of the largest blood vessel in the proximal flap was measured. Interleukin-1, tumor necrosis factor alpha, thiobarbituric acid reactive substances, and vascular endothelial growth factor values were measured. Results: The mean percentage of the viable surface area was significantly greater in groups VIII, III, and V. The mean percentage of vessel diameter was significantly greater in groups V, VIII, and VII. Conclusion: We suggest that alpha-pinene and cineole were the components of RO that were responsible for increased flap survival. The most effective of feature of RO was the antiinflammatory effects.
