Browsing by Author "Ugraş, Nesrin"
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Publication Do morphologic characteristics play a role in nodal metastatic progression of well-differentiated pancreatic neuroendocrine tumors?(Sage Publications Ltd, 2020-07-24) Hasdemir, Seçil; HASDEMİR, SEÇİL; Ugraş, Nesrin; UĞRAŞ, NESRİN; Yerci, Omer; YERCİ, ÖMER; Tasar, Pınar; TAŞAR, PINAR; Dundar, Halit Ziya; DÜNDAR, HALİT ZİYA; Macunluoğlu, Aslı Ceren; Bursa Uludağ Üniversitesi/Tıp Fakültesi/ Genel Cerrahi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/ Bioistatistik Anabilim Dalı.; 0000-0003-1769-7484; 0000-0002-6802-5998; AAH-2716-2021Background: Pancreatic neuroendocrine neoplasms (NENs) are tumors with histopathologic and prognostic heterogeneity that pose difficulties in establishing standards for diagnosis, classification, and treatment. Among NENs, well-differentiated neuroendocrine tumors (NETs) have been classified as grade 1, 2, and 3 in the most recently released World Health Organization classification. Although well-differentiated NETs are associated with relatively better prognosis, they have a potential for malignant behavior such as extrapancreatic spread, metastasis, or recurrence. The present study aimed to evaluate clinical and histomorphologic findings of patients with well-differentiated pancreatic NETs and to identify histopathologic findings effective in predicting nodal metastatic progression. Methods: The study group consisted of 54 patients diagnosed with well-differentiated NET. All preparations and blocks of the patients were examined for the following histopathologic parameters: tumor diameter, microscopic tumor growth pattern (solid, trabecular, acinar, and mixed), cellular features (clear, eosinophilic, oncocytic, peliotic, and pseudopapillary), stromal changes (calcification, lymphocytic infiltration, and stromal hyalinization), presence of necrosis, perineural invasion, lymphovascular invasion, mitotic activity, and Ki67 proliferative index. Results: Lymph node metastasis was present in 7 patients. Lymph node metastasis was significantly associated with tumor diameter of >2 cm (p= 0.012), Ki67 proliferative index of >20% (p= 0.022), grade 3 tumors (p= 0.002), presence of dense stromal hyalinization (p= 0.034), and mild lymphocytic infiltration (p= 0.041). Conclusion: The present study revealed that the new findings such as presence of dense stromal hyalinization and absence of remarkable lymphocytic infiltration could be predictive morphologic findings for the development of lymph node metastasis.Publication Effects of systemic and local interferon beta- 1a on epidural fibrosis(Korean Soc Spine Surgery, 2016-06-01) Taskapılıoğlu, Mevlüt Özgür; TAŞKAPILIOĞLU, MEVLÜT ÖZGÜR; Doğan, Seref; DOĞAN, ŞEREF; Işık, Semra; Ocakoğlu, Gökhan; OCAKOĞLU, GÖKHAN; Özgün, Gonca; Ugraş, Nesrin; UĞRAŞ, NESRİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroşurji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0001-5472-9065; 0000-0002-6929-7135; 0000-0002-1114-6051; AAH-5180-2021; AAW-5254-2020; ABB-8161-2020; HLG-6346-2023; AAH-2716-2021; K-6580-2015; AAI-6531-2021; KGL-6139-2024Study Design: Level 1 randomized controlled study.Purpose: To investigate the effects of systemic and local interferon-beta-1a (IFN-beta-1a) on prevention of epidural fibrosis using histopathological parameters.Overview of Literature: Epidural fibrosis involves fibroblastic invasion of nerve roots into the epidural space. Formation of dense fibrous tissue causes lumbar and radicular pain. Many surgical techniques and several materials have been proposed in the literature, but no study has assessed the effect of IFN-beta-1a on prevention of epidural fibrosis.Methods: Forty-eight adult female Sprague-Dawley rats were divided into six groups of eight: sham group, control group, systemic 44 mu g IFN-beta-1a group and 22 mu g IFN-beta-1a group (after laminectomy and discectomy, 0.28 mL and 0.14 mL IFN-beta-1a applied subcutaneously three times for a week, respectively), local 44 mu g IFN-beta-1a group (laminectomy and discectomy, followed by 0.28 mL IFN-beta-1a on the surgical area), and local 22 mu g IFN-beta-1a group (laminectomy and discectomy, followed by 0.14 mL IFN-beta-1a on the surgical area). All rats were sacrificed after 4 weeks and groups were evaluated histopathologically.Results: Compared with sham and control groups, significantly less epidural fibrosis, dural adhesion, and fibroblast cell density were observed in the local and systemic 44 mu g IFN-beta-1a groups. No other differences were evident between the local and systemic groups.Conclusions: IFN-beta-1a is effective in preventing epidural fibrosis with systemic and local application.Publication Histopathological changes of neoadjuvant chemoradiation and relation with the pre-treatment tumor stage in rectal carcinoma(Gazi Univ, Fac Med, 2017-01-01) Özgün, Gonca; ÖZ ATALAY, FATMA; Ugraş, Nesrin; UĞRAŞ, NESRİN; Yerci, Ömer; YERCİ, ÖMER; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0002-7188-6115; AAH-2716-2021Objective: Neoadjuvant chemoradiotherapy has considered one of the standard treatment modalities for locally advanced rectal cancers. Chemoradiotherapy has a variety of different effects and responses on tumor, tumor bed and peritumoral tissues. The purpose of the present study was to evaluate the stromal responses in tumor bed between the different treatment modalities and different clinical T stages.Methods: Fifty-seven consecutive patients with median age of 62.4 years were treated for rectal adenocarcinoma between January 2005 and July 2012 in Uludag University Medical Faculty. Twenty-three of the patients were treated with neoadjuvant chemoradiation therapy and following surgery, 34 patients treated with surgery only.Results: When we compared the stromal responses in the tumor bed between the two different treatment modalities, the amount of fibrosis and intensity of inflammatory cell infiltration were found considerably marked. The existence of calcification, hemosiderin-laden macrophages and mucin lakes were found also significant marked. There was no difference found in between the patients with different clinical stages which were received neoadjuvant CRT.Conclusion: The stromal response in the tumor bed increases with the neoadjuvant chemoradiotherapy but the excess of the response doesn't have any relation with the clinical T stage.Publication Insulinoma case admitted with reactive hypoglycemia symptoms(Bentham Science Publ, 2020-01-01) Koca, Nizameddin; Ugraş, Nesrin; Cander, Soner; CANDER, SONER; Gül, Ozen Oz; ÖZ GÜL, ÖZEN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; AAI-1005-2021Aim: To present an insulinoma case with post-prandial hypoglycemic symptoms associated with glucose inducible endogenous hyperinsulinemia.Case: A 52-year-old female patient was evaluated for hypoglycemic symptoms especially those occuring within 3 hours after consuming sugary foods. These symptoms were persistent for a year and a half. She was diagnosed with reactive (post-prandial) syndrome and followed a recommended diet and was given acarbose but there was no improvement. The results suggested post-prandial endogenous hyperinsulinemia related hypoglycemia. Multiphasic computerized tomography revealed an 11x15x12 mm size mass lesion, anteriorly in the head and uncinate process of the pancreas and then the patients were treated surgically with pancreatic enucleation and cured.Conclusion: Distinguishing post-prandial syndrome by careful history and clinical evaluation in patients with postprandial symptoms is of great importance in terms of cost-effectivity. However, it should not be forgotten that although organic pathologies are mostly presented with fasting hypoglycemia, they may also cause post-prandial symptoms. Severity and progression of the symptoms that point to neuroglycopenia is important, and in this condition the most convenient clinical approach to the patient should be performed with careful and appropriate assessment steps.