Suzan Zorludemir

Purpose: The study aims to investigate the effect of bone marrow-derived mesenchymal stem cells (BM-MSCs) administered subacute period to neuropathic mice on allodynia and nerve-muscle tissue functions during 24 weeks. Materials and Methods: Peripheral neuropathy was induced by partial sciatic nerve ligation. Experiments were conducted in Control, Sham, Neuropathic, BM-MSC, and Neuropathic+BM-MSC groups. Allodynia was measured by cold plate test at the 2nd, 6th, and 24th weeks. Electrophysiological and histopathological examinations were performed on isolated nerve-muscle tissues at the end of the 24th week. Results: Allodynia threshold increased in the Neuropathic+BM-MSC group (7.76±0.33 sec) from the 6th week and continued to increase along 24 weeks compared to the Neuropathic group (4.36±0.21 sec). Action potential (137.9±7.85 mV) and depolarization (0.74±0.01 msec) values of the Neuropathic+BM-MSC group exhibited partial improvement compared to the Neuropathic group (121.5±3.03 mV and 0.81±0.02 msec, respectively) at the 24th week. Muscle tissue's resting membrane potential values increased in the Neuropathic+BM-MSC group compared to the Neuropathic group (-73.4±0.2 and -87.7±0.2 mV, respectively). Histopathological examination of nerve tissue revealed loss of myelinated axons and significant fibrosis in the endoneurium in the Neuropathic group while Schwann cell proliferation and preservation of myelinated axons were observed in the Neuropathic+BM-MSC group. Muscle fiber atrophy, compensatory hypertrophic fibers, and increased central nuclei were seen in the Neuropathic group, while small atrophic muscle fiber groups were identified in the Neuropathic+BM-MSC group. Conclusion: BM-MSC application in the subacute period is found to reduce allodynia and provide functional recovery in nerve-muscle tissue in experimental peripheral neuropathy.

Breast cancer is the most common malignancy in women. In the treatment of these patients, pathological complete response is defined as the absence of invasive cancer in breast or lymph node tissue after the completion of neoadjuvant chemotherapy. In this study, we aimed to investigate the relationship of enhancer of zeste homolog 2 and mucin 1 expressions with pathological complete response in patients with breast cancer receiving neoadjuvant chemotherapy. A total of 151 patients were included in the study. Enhancer of zeste homolog 2 and mucin 1 expressions were evaluated in the biopsy materials pre-neoadjuvant chemotherapy and post-neoadjuvant chemotherapy surgical material, and their relationship with pathological complete response was investigated. The pathological complete response rates were significantly higher among the hormone receptor-negative patients, those with a high Ki-67 score, and patients with HER2-positive. Higher pathological complete response rates were obtained from patients with enhancer of zeste homolog 2 expression positivity pre-neoadjuvant chemotherapy. In addition, after neoadjuvant chemotherapy, enhancer of zeste homolog 2 expression was found to be completely negative in materials with pathological complete response; that is, in breast tissues considered to be tumor-free. While there was no significant relationship between mucin 1 expression and pathological complete response pre-neoadjuvant chemotherapy, mucin 1 expression was determined to significantly differ between the tissues with and without pathological complete response among the surgical materials examined. In our study investigating the relationship between enhancer of zeste homolog 2 and mucin 1 expression and pathological complete response in patients who received neoadjuvant chemotherapy, we found that enhancer of zeste homolog 2 expression could be used as a predictive marker for pathological complete response. However, mucin 1 expression was not associated with pathological complete response.

Background: Silent pituitary adenomas are clinically found to be non-functional (i.e., without clinically evident pituitary hormone production). Introduction: The aim of this study was to investigate subjects with silent pituitary adenomas for possible variations in their clinical status. Methods: A total of 102 patients who had undergone surgery for pituitary adenoma and had been diagnosed with silent pituitary adenoma was included in the study. The patients’ preoperative and postoperative hormonal parameters and magnetic resonance imaging (MRI) features were collected, and pathological specimens were re-evaluated. Results: Immunohistochemistry results of the 102 patients were as follows: hormone-negative adenomas (n=35) 35.5%; FSH+LH-positivity (n=32) 31.3%; ACTH-positivity (n=11) 10.7%; α-subunit-positivity (n= 9) 8.8%; prolactin-positivity (n=8) 7.8%; GH-positivity (n=6) 5.4%; and plurihormonal adenoma (n=1). The mean sizes of SGA, SGHA, and SCA were 28.0±12.7, 30.0±16.0, and 27.7±8.9mm (p>0.05), respectively. With the exception of silent gonadotroph adenomas (SGAs), female gender dominance was shown in patients with silent growth hormone adenoma (SGHA) and silent corticotroph adenoma (SCA). Although no clinical relevance was observed in relation to hormonal excess, preoperative GH (4.21±4.6,vs 0.27±0.36 p=0.00) was slightly more elevated in SGHA than in GH-negative adenomas. Additionally, preoperative basal ACTH values (47.3±28.7 vs 23.9±14.4, p=0.003) were also higher in SCA compared to the other types. Our findings revealed SCAs to be more aggressive behaviour than SGHAs and SGAs due to invasiveness in radiological imaging, their elevated re-operation and postoperative ACTH values. Conclusion: Silent pituitary adenomas represent a challenging diagnostic tumour group. Careful initial evaluation of patients with pituitary adenomas should consider any mild signs and symptoms of functionality, particularly in cases of GH- and ACTH-secreting adenomas.

Tr en Amaç: Bu çalışmanın amacı 54 meme kanseri ve 37 iyi huylu meme lezyonu olan hastada PRAME (Preferentially Expressed Antigen of Melanoma) ekspresyonunu tespit etmektir. Gereç ve Yöntem: Reverse transkripsiyon polimeraz zincir reaksiyonu (RT-PCR) ile 54 meme kanseri, 20 benign meme lezyonu ve 10 normal meme dokusu örneğindeki PRAM Eekspresyonu çalışıldı. İmmunohistokimyasal (IHC) yöntem ile PRAME ekspresyonu, 54 meme kanserili hastanın hem tümör hem de normal meme dokusundan ve 37 benign meme lezyonunda çalışıldı. PRAME için RT-PCR ve IHC sonuçları bu çalışmada karşılaştırıldı. Bulgular: Meme kanserinin %50'sinde, benign meme lezyonlarının ise %25'inde PRAME ekspresyonu olduğu saptandı. İnvaziv meme kanseri olan dokularda IHC yöntemi kullanılarak bakılan PRAME ekspresyonunda; (+), (++) ve (+++) boyanma oranları sırasıyla %29,6, %31,5 ve %3,7 oranında bulundu. Hem IHC hem de RT-PCR ile saptanan PRAME ekspresyonu prognostik parametrelerle karşılaştırıldı. Meme kanserinde PRAME ekspresyonunun yüksek grade ve negatif hormon reseptörü ile ilişkili olduğu tespit edildi. RT-PCR ile IHC ile bakılan PRAME sonuçları arasında anlamlı ilişki bulundu. Sonuç: Hem taze dokularda RT-PCR yöntemi, hem de parafin bloklarda IHC yöntemi, meme kanserinde PRAME ekspresyonunu ve PRAME’in prediktif önemini belirlemede kullanılabilir. Purpose: The aim of this study is to detect the PRAME (Preferentially Expressed Antigen of Melanoma) in 54 patients with breast cancer and 37 patients with benign breast lesions. Materials and Methods: PRAME expressions in 54 breast cancer, 20 benign breast lesions and 10 normal breast tissue samples were studied with RT-PCR. Expression of PRAME was studied with IHC in 37 benign breast lesions, in 54 breast cancer patients from both tumor and normal breast tissue. RT-PCR and IHC results for PRAME were compared in this study. Results: PRAME was found to be expressed in 50 % of the breast cancer and 25 % of the benign breast lesions. Using IHC method, (+), (++) and (+++) staining for PRAME expression were found in 29,6%, 31,5% and 3,7% of the cases, respectively in invasive component of the breast cancer. PRAME expression detected by both IHC and RT-PCR was compared with prognostic parameters. PRAME expression in breast cancer was found to be associated with high tumor grade and negative hormone receptor. We found an important association between PRAME RT-PCR and of PRAME IHC. Conclusion: Both RT-PCR in fresh tissues and IHC method in paraffin embedded tissues can be used to identify PRAME expression and the predictive role of PRAME expression.

Purpose: The aim of the study was to review our clinical 7 years experiences with silent corticotroph adenoma (SCA) and Cushing disease (CD) with regard to clinical, radiological features, immunohistochemical and surgical outcomes and compare the results between two groups. Material and Methods: We retrospectively reviewed a series of patients (n=17; SCA 10, CD 7) with corticotroph adenomas and collected biochemical, neuroradiological and pathological data of those during follow-up time. Results: Mean pre-operative ACTH values of the patients with CD and SCA were 60.429.5, 45.5 +/- 34.6 pg/mL, respectively. Mean preoperative cortisol of the patient with CD (21.2 +/- 4.4 vs 11.5 +/- 4.0 mcg/dL) was increased than the patients with SCA measurements'. Patients with SCA had larger pituitary mass (20.4 +/- 4.5 vs 8.8 +/- 4.0 mm) than the patients with CD. And cavernous sinus invasion also was determined in all patients with SCA. Sparsely granulation staining was more common in all patients with SCA (7/10) or CD (4/7). Conclusion: SCAs are totally different from functional CD adenomas related with clinical characteristics and postoperative outcomes. SCA can be thought of as a diverse group of pituitary adenomas.

Purpose: The aim of this study was to evaluate patients formerly diagnosed as neurofibroma and schwannoma in terms of hybrid peripheral nerve sheath tumors (PNSTs) via histopathological and immunohistochemical analysis. Materials and Methods: In this retrospective study, 115 patients formerly diagnosed as either neurofibroma or schwannoma were re-evaluated histopathologically. Among these patients, 32 cases which showed mixed morphology, suspicious for hybrid PNST were included in the study. Immunohistochemically, S100, CD34, EMA and ki67 were performed to these 32 cases, suspicious for hybrid PNST.Results: Based on histopathology, 32 of 115 (27.8%) cases were suspicious for hybrid PNST. By the addition of immunohistochemical staining results; 22 of 32 cases were definitely diagnosed as hybrid PNST; of which 18 (81.8%) as schwannoma-neurofibroma and, 4 (18.2%) cases as schwannoma-perineurioma. Conclusion: Hybrid PNSTs are usually benign and have distinct histopathologic and immunohistochemistry findings. In the literature, rare case reports have described local recurrence and malignant transformation in hybrid PNSTs. Therefore, further studies are needed to demonstrate the pathogenetic and prognostic significance of these tumors. Because of the risk of recurrence and malignancy potential, these tumors should be kept in mind in diagnosis of peripheral nerve sheath tumors.