Armagan Gunal

The effect of combined use of platelet-rich plasma and adipose-derived stem cells on fat graft survival.

BackgroundFree fat grafts have an unpredictable survival rate that limits their successful use. To increase the viability of fat grafts, it is important to minimize the reabsorption rate. ObjectiveOur aim was to investigate whether the combined use of platelet-rich plasma (PRP) and adipose derived stem cells (ADSCs) would contribute an improvement in lower resorption rates of fat grafts. MethodsInbred Fischer 344 rats were randomized into 4 groups (n = 10). Fat grafts were mixed with Dulbecco modified Eagle medium in group A, with PRP in group B, with ADSC in group C, and with PRP + ADSC in group D and were injected to the scalp.In vitro growth factor (vascular endothelial growth factor, transforming growth factor-&bgr;, and fibroblast growth factor) levels were compared using enzyme-linked immunoassay method. After 12 weeks weight, volume and histology of the transplants were evaluated. ResultsThe mean weight and volume of the fat grafts were highest in group D. Histopathological investigations revealed that the number of viable adipocytes and blood vessels were highest in group D. The level of growth factors was significantly higher in stem cell plus PRP group. ConclusionAdipose-derived stem cells combined with PRP can enhance the survival of transplanted fat tissue.

Fascin expresion in glial tumors and its prognostic significance in glioblastomas

Fascin is a ‐55 kDa‐actin binding protein. Actin bundles rearranged by fascin proteins are concentrated in cell membrane protrusions and these protrusions provide motility of the cell. In this study, we evaluated fascin expression in glial tumors and its relation with histologic grade. Its prognostic value in glioblastomas (GBs) was also investigated. Seventy‐six glial tumors including 44 glioblastomas with known survival time, 18 anaplastic astocytomas (AAs), six diffuse astrocytomas (DAs), and eight pilocytic astrocytomas (PAs) were examined immunohistochemically for fascin expression. Fascin was observed in the neurons of normal brain tissue and endothelium of vascular spaces in the glial tumors. Fascin expression was correlated with histologic grade in DAs. PAs expressed low levels of fascin. Half of the GBs showed high levels of fascin expression. In the GB group, overall survival was poor for cases with percentage of stained cells >50% having moderate or strong staining intensity. In GBs, overall survival was also poor for >50‐year‐old cases and cases that refused radiotherapy. Multivariate Cox regression analysis revealed that age (>50 years, P = 0.021) and higher level of fascin expression (immunohistochemical score >8, P = 0.040) were independent poor prognostic factors. In conclusion, fascin expression levels are correlated with histologic grade and fascin overexpression may play an important role in the biologic behavior of glial astrocytic tumors and in the prognosis of GBs.

Long-term results of endoscopic resection for type I gastric neuroendocrine tumors

A number of different therapies, including endoscopic resection, have been suggested for the treatment of Type 1 gastric neuroendocrine tumors (NETs). The current study aimed to determine the long‐term efficacy of endoscopic resection for Type 1 gastric NETs.

The effect of bevacizumab on wound healing modulation in an experimental trabeculectomy model.

Abstract Purpose: Glaucoma filtration surgery remains the most effective surgical procedure for lowering intraocular pressure (IOP) in uncontrolled glaucoma. Modulation of wound healing is critical to ensure long-term surgical success. This study aimed to determine if bevacizumab is an alternative agent for wound modulation in glaucoma surgery. Materials and methods: Forty-eight eyes of New Zealand rabbits were divided into four groups undergoing standard trabeculectomy surgery in the right eye. In group 1, balanced salt solution injections (0.1 ml) were performed into the bleb. Bevacizumab (0.1 ml, 1.25 mg) was injected into the bleb in group two and into the vitreous body in group three. Subconjunctival injections of 5-fluorouracil (5-FU) were performed into the non-bleb area in group four. Postoperatively; IOP, bleb size, bleb height, bleb vascularity were evaluated. Right eyes of two animals from each group were enucleated in 10th, 20th and 30th d postoperatively and evaluated histopathologically for inflammation, neovascularization and fibrosis. Results: The length, the width and the height of the bleb in the group two were greater than other groups. Mean IOP values were lower in group two. IOP measurements in the operated eyes of group two were statistically significantly lower than the other groups until the 28th d. Inflammation (p = 0.030), neovascularization (p = 0.004) and fibrosis (p < 0.000) in group two were lower in histopathological evaluation. Conclusions: Post-operative subconjunctival injection of bevacizumab is more effective than intravitreal bevacizumab or subconjunctival 5-FU injections for bleb survival. Furthermore, IOP is lower for a long period with lower level of fibrosis, which increases the success of trabeculectomy.

The relationship of the BRAF(V600E) mutation and the established prognostic factors in papillary thyroid carcinomas.

It has been shown that BRAFV600E mutation in papillary thyroid carcinomas (PTC) is associated both with pathogenesis and poor prognosis. In this study, we aimed to investigate the relationship of the BRAFV600E mutation and the established prognostic factors in a cohort of Turkish patients with PTC. Forty-six cases of papillary thyroid carcinoma have been evaluated for the presence of BRAFV600E mutation. BRAFV600E has been examined by restriction fragment length polymorphism. BRAFV600E mutation status has been compared with well-known histopathological and clinical prognostic parameters such as invasion of thyroid capsule, extrathyroidal extension, and the presence of lymph node and/or distant metastasis. We have found that BRAFV600E mutation was present in the majority of our cases (40/46). Considering the stage of the disease, five of the negative cases were in stage 1 while the remaining one was in stage 2. Only one BRAFV600E negative case has shown extrathyroidal extension and lymph node metastasis. All four patients with distant metastasis had BRAFV600E mutation. Statistical analyses revealed that there are no significant relationship between the BRAFV600E mutation and the established prognostic factors. We found a relatively higher BRAFV600E mutation rate in classical type PTC than in other similar studies. We think that the limited number of our cases may either weaken or mask some potentially important relationship between BRAFV600E mutation and the established prognostic factors.

Protective efficiacy of taurine against pulmonary edema progression: experimental study.

Re-expansion pulmonary edema (RPE) is an acute, rare and potentially lethal complication [1,2]. Its beginning is sudden and dramatic. The mechanism is not yet fully understood [1]. Some authors suggest that it may occur after rapid re-inflation of a collapsed lung [1]. It was reported by other authors that it may relate to surfactant depletion or may result from hypoxic capillary damage, leading to increased capillary permeability [1,3]. In RPE, unilateral lung injury is initiated by cytotoxic oxygen metabolites and temporally associated with an influx of polymorphonuclear neutrophils [1]. These toxic oxygen products are the results of re-oxygenation of a collapsed lung. Treatment of re-expansion pulmonary edema is basically preventive [4].

Rate of allergic fungal etiology of chronic rhinosinusitis in Turkish population

The aim of this study is to investigate intranasal fungal incidence in Turkish patients with chronic rhinosinusitis (CRS). One hundred patients with CRS and 40 healthy subjects as a control group were included in the prospective study. Nasal lavage samples were investigated for the presence of fungus, using new culture techniques and histopathologic examination. Epidermal and intradermal hypersensitivity tests were used to find out fungal atopy. Levels of serum eosinophils, total IgE and presence of fungus-specific IgE were investigated in the blood samples. Quantitative parameters were analyzed using Pearson χ2 test. Allergic fungal sinusitis (AFS) was diagnosed in 13(13%) patients. There was no fungal growth in the control group. Eosinophilic mucin was detected in 94% of patients. Clinical and laboratory parameters of CRS were not significantly different in patient groups with or without intranasal fungi. As a result, fungal incidence was not as high as expected in Turkish patients with CRS. Furthermore, no significant correlation could be found between presence of intranasal fungus and type-1 hypersensitivity in patients with CRS.

The efficacy of mesenchymal stem cell transplantation in caustic esophagus injury: an experimental study.

Introduction. Ingestion of corrosive substances may lead to stricture formation in esophagus as a late complication. Full thickness injury seems to exterminate tissue stem cells of esophagus. Mesenchymal stem cells (MSCs) can differentiate into specific cell lineages and have the capacity of homing in sites of injury. Aim and Methods. We aimed to investigate the efficacy of MSC transplantation, on prevention of esophageal damage and stricture formation after caustic esophagus injury in rats. 54 rats were allocated into four groups; 4 rats were sacrificed for MSC production. Group 1, untreated controls (n: 10). Group 2, membrane labeled MSCs-treated rats (n: 20). Group 3, biodistribution of fluorodeoxyglucose labeled MSCs via positron emission tomography (PET) imaging (n: 10). Group 4, sham operated (n: 10). Standard caustic esophageal burns were created and MSCs were transplanted 24 hours after. All rats were sacrificed at the 21st days. Results. PET scan images revealed the homing behavior of MSCs to the injury site. The histopathology damage score was not significantly different from controls. However, we demonstrated Dil labeled epithelial and muscle cells which were originating from transplanted MSCs. Conclusion. MSC transplantation after caustic esophageal injury may be a helpful treatment modality; however, probably repeated infusions are needed.

Initial experience of 3 tesla apparent diffusion coefficient values in differentiating benign and malignant thyroid nodules

To evaluate the role of diffusion‐weighted magnetic resonance imaging (DWMRI) in differentiating benign and malignant thyroid nodules using a 3 Tesla (T) MRI scanner.

Efficacy of a Modified Sequential Therapy Including Bismuth Subcitrate as First-Line Therapy to Eradicate Helicobacter pylori in a Turkish Population

Eradication rates of Helicobacter pylori with standard triple therapy are not satisfactory. Sequential therapy is an alternative method to overcome this problem.