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Öğe Acute generalized exanthematous pustulosis associated with terbinafine: a case report(Informa Healthcare, 2013) Turan, Hakan; Acer, Ersoy; Erdem, Havva; Uslu, Esma; Aliağaoğlu, CihangirA 27-year-old male patient who has used oral terbinafine for two weeks was admitted to our outpatient clinic for non-follicular millimetric pustules on erythematous and edematous different-sized plaques on his trunk and flexural areas. He was diagnosed with acute generalized exanthematous pustulosis (AGEP) because of terbinafine use in the light of history, clinical and histopathological findings. An AGEP is a rare and severe pustular reaction usually triggered by systemic drug intake. Approximately, 2.3% of the patients having oral terbinafine have been reported to develop cutaneous adverse effects. Although terbinafine is a commonly used medicine, it must be considered that it may cause severe adverse reactions.Öğe AEG-1 expression in invasive ductal and lobular breast cancers and its relationship with prognostic parameters(Tubitak Scientific & Technical Research Council Turkey, 2013) Erdem, Havva; Oktay, Murat; Uzunlar, Ali Kemal; Yıldırım, Ümran; Ankaralı, Handan; Yaşar, MehmetAim: The astrocyte-elevated gene-1 (AEG-1, also known as metadherin) is associated with various aspects of tumour malignancy; however, little knowledge is available related to the role of AEG-1 in ductal and lobular carcinomas. The aim of this study was to investigate the relationship of AEG-1 with the prognostic parameters in invasive ductal and lobular carcinomas. Materials and methods: This study was conducted on a total of 72 paraffin-embedded breast tumour samples. They consisted of 61 ductal and 11 lobular carcinomas. Breast tumour samples were stained for AEG-1. The prognostic parameters were compared with the results of AEG-1 stains. Results: We observed that more ductal carcinoma types than lobular carcinoma types resulted in high AEG-1 staining, whereas low AEG-1 staining occurred more in lobular carcinomas than in ductal carcinomas (P = 0.05). A significant negative correlation was also found between HER-2 (r = -0.30, P = 0.019) and AEG-1 (r = -0.804, P = 0.003) in lobular carcinomas. A significant relationship was found between increasing numbers of positive lymph nodes and AEG-1 in ductal carcinoma cases (P = 0.05). Conclusion: These results are consistent with previous reports of the role of AEG-1 in tumour progression. AEG-1 could be a useful marker for the development of new treatments and resistant hormonal therapy.Öğe An aggressive Basal Cell Carcinoma with multiple focuses and distant lung metastasis: case report(2012) Erdem, Havva; Kadıoğlu, Nilüfer; Uzunlar, Ali Kemal; Yıldırım, Ümran; Oktay, Murat; Şahiner, Cem; Turan, HakanBazal hücreli karsinom (BHK) epidermisin bazal tabakasından kaynaklanan ve nonkeratinize hücrelerden oluşan en yaygın cilt tümörüdür. Dev BHK (yani çapı 5 cmden büyük) oldukça nadirdir ve tüm BHKların %0,5 ini oluşturmaktadır. BHK insidansı yüksek olmasına rağmen, bu tümörün metastaz oranı tüm vakaların %0,0028-%0,55 arasında değişmektedir. Bu vakada tümör dev boyuta ulaştı ve akciğer metastazı vardı. Burada, BHKlar genellikle yavaş seyirli olmasına rağmen gerekli vakalarda yeterli cerrahi ve kemoradyoterapinin önemini vurgulamak istedik.Öğe Akciğer Dışı Organ Tüberkülozu(2012) Erdem, Havva; Uzunlar, Ali Kemal; Yıldırım, Ümran; Yaman, Hüseyin; Aydın, Leyla; Şahiner, CemTüberküloz, vücudun herhangi bir organında görülebilir. En sık akciğer tüberkülozu görülmekle birlikte, akciğer dışı tüberküloz da önemli bir klinik sorundur. Akciğer tüberkülozu, Türkiye'de sık olmasına rağmen, akciğer dışı organ tüberkülozu çok nadir görülür. Burada, ekstrapulmoner tüberküloz tanılı üç hasta sunulmuştur. Tutulum yerleri vertebra, nazofarenks ve orta kulaktır. Vertebra, nazofarenks ve orta kulaktan alınan materyallerin histopatolojik incelemesi sonucu tüberküloz granülomu olarak rapor edildi.Öğe Alterations in placental pendrin expression in pre-eclampsia(Informa Healthcare, 2014) Karataş, Ahmet; Erdem, Havva; Albayrak, Mustafa; Oktay, Murat; Özlü, Tülay; Çakmak, Bülent; Dönmez, Melahat EmineIntroduction: Pendrin is an integral membrane protein and plays a key role in extracellular fluid volume and blood pressure control. We aimed to investigate the relationship between pendrin immunostaining intensity in normal and pre-eclamptic placental tissue. Methods: Fifty-six placental tissues, of which 26 were in pre-eclamptic, and 30 were in control group were evaluated by immunohistochemical staining. Positive immunostaining was evaluated using a semiquantitative score: 0, negative; +, mild; ++, moderate; and +++, intense. Results: There was more positive immunstaining in the pre-eclamptic placenta compared to the controls (p<0.001). A significant positive correlation was observed between immunostaining level and diastolic blood pressure (r = 0.533, p = 0.005) in the pre-eclamptic group. However, no significant correlation was observed between any condition and immunostaining level in the control group. Conclusions: Placentas in the pre-eclamptic group were significantly more immunostained with pendrin than were those in the control group. In addition, a positive correlation between immunostaining intensity with pendrin and both systolic and diastolic blood pressure were observed. Pendrin may play a role in the mechanism of severe hypertension in women with pre-eclampsia.Öğe Anormal uterin kanamalı hastalarda endometrium kanseri ve benign endometrial patoloji tanısı alanların hematolojik parametrelerinin karşılaştırılması(2014) Yavuzcan, Ali; Çağlar, Mete; Erdem, Havva; Oktay, Murat; Üstün, Yusuf; Dilbaz, Serdar; Kumru, SelahattinAmaç: Çalışmamızın amacı 40 yaş ve üstünde anormal uterin kanama (AUK) şikayeti bulunan hastalarda evre 1 ve evre 2 endometrium kanseri tanısı alanlar ile benign endometrial patoloji tanısı alanların ortalama trombosit hacmi (MPV), nötrofil/lenfosit oranı (NLR) ve trombosit/lenfosit oranı (PLR) değerlerini karşılaştırmaktır. Yöntem: Çalışmamıza Temmuz 2012-Temmuz 2013 tarihleri arasında Düzce Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı’na AUK ön tanısıyla histeroskopi, dilatasyon küretaj yada endometrial biopsi ile endometrial örnekleme yapılan hastalar dahil edilmiştir. Hastalara ait bilgiler retrospektif olarak hasta dosyaları incelenerek elde edilmiştir. Bulgular: Hastaların ortalama yaşı 52.8111.47 yıl olarak bulunmuştur. Hastaların %37.1’si menopozdadır. Yapılan endometrial örneklemelerin sonucunda hastalardan 10 tanesinde (%14.2) endometrioid tip endometrial adenokarsinom, 1 tanesinde (%1.4) seröz papiller karsinom ve 1 tanesinde (%1.4) endometrial stromal sarkom tanısı konulmuştur. Hastaların 58 (%83) tanesinde non invaziv benign endometrial değişiklikler tespit edilmiştir. Endometrium kanseri saptanan ve saptanmayan hastalar arasında MPV,NLR ve PLR değerleri açısından istatistiksel olarak anlamlı farklılık tespit edilmemiştir (p0.148; p0.775 ve p0.942 sırasıyla). Sonuç: MPV, NLR ve PLR değerlerinin ileri evre endometrial malignitelerde yükseldiği ve prognostik bir faktör olarak kullanılabileceği bazı çalışmalarda gösterilmiştir. Ancak bu parametrelerin erken evre endometrium kanseri ve benign endometrial patoloji tespit edilen hastalar arasında gösterdiği değişimlerin net olarak ortaya konabilmesi için geniş kapsamlı yeni çalışmalara gerek duyulmaktadır.Öğe Argyrophilic nucleolar organizing region associated protein synthesis for cytologic discrimination of follicular thyroid lesions(Informa Healthcare, 2015) Oktay, Murat; Eröz, Recep; Oktay, N.A.; Erdem, Havva; Başar, Feyza; Akyol, L.; Bahadır, AnzelFine needle aspiration biopsy (FNAB) of the thyroid gland is an important tool for preoperative diagnosis; however, its benefit is limited for follicular lesions. Nucleolar organizer regions (NORs) are ribosomal gene regions that stain with silver (Ag) when they are active. These regions can be used to differentiate neoplastic and non-neoplastic lesions. We used a new AgNOR technique to investigate FNAB of cases diagnosed as follicular adenoma and carcinoma. Fourteen cases of follicular thyroid carcinoma (FTC) and 28 cases of thyroid follicular adenomas (FA) were stained using the silver NOR-associated protein (AgNOR) technique. One hundred nuclei per sample were examined, AgNORs were counted, and the total AgNOR area/nuclear area (TNORa/Na) ratio of each cell was calculated. We found that cases with FTC had significantly higher TNORa/Na than cases of FA. Also, cases with FTC had significantly higher AgNOR counts than cases with FA. AgNOR counting may help discriminate FTC and FA by routine cytopathology before surgery.Öğe Baş Ve Boyun Tüberkülozları(2012) Yaman, Hüseyin; Alkan, Nihal; Erdem, Havva; Aydın, Leyla Yılmaz; Yıldırım, Ümran; Güçlü, EnderAmaç: Bu çalışmada baş boyun bölgesinde tüberküloz tanısı alan hastaların klinik ve tedavileri araştırıldı. Gereç ve Yöntem: Servikal tüberküloz lenfadenit ve baş boyunun diğer bölgelerinde tüberküloz tanısı alan 16 hastanın dosyaları retrospektif olarak incelendi. Hastaların yaş, cinsiyet, klinik, histopatolojik tanı ve tedavi protokolleri incelendi. Hastalara nodal eksizyon veya total eksizyon yapılmış olup tanıları histopatolojik inceleme sonucunda konulmuştur. Tüberküloz tanısı alan hastalar antitüberküloz tedavi protokolüne alınmıştır. Bulgular: Çalışmamız yaş aralığı 18 ile 72 yaş arasında değişen 16 hastayı [15 bayan (%93.75), 1 erkek (%6.25); ortalama yaş 43.614.7] içermektedir. Hastaların 13ünde (%81.25) tüberküloz lenfadenit, 1inde (%6.25) alt dudak tüberküloz, 1inde (%6.25) nazofarengeal tüberküloz, 1inde (%6.25) larengeal tüberküloz tespit edilmiştir. Antitüberküloz tedavi alan hastalarda tedavi sonucunda kitlelerin kaybolduğu gözlenmiştir. Sonuç: Baş boyun bölgesindeki kitlelerinin ayırıcı tanısında tüberküloz unutulmamalıdır. Baş boyunda genellikle tüberküloz lenfadenit şeklinde görülmekle birlikte nadirde olsa dudak, nazofarenks, larenks gibi bölgelerde de görülebilmektedir.Öğe Bilaterally recurrent spontaneous pneumothorax due to lymphangioleiomyomatosis(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2013) Karapolat, Sami; Erbaş, Mesut; Dumlu, Talha; Erdem, Havva; Karapolat, Banu; Erekul, SelimPulmonary lymphangioleiomyomatosis is an extremely rare interstitial lung disease. The clinical presentation is generally recurrent spontaneous pneumothorax and progressive dyspnea. No definitive treatment option is available and it leads to respiratory failure due to multicystic destruction of the lung parenchyma in the following years. A 39-year-old female patient was admitted to our clinic with the complaints of sudden onset dyspnea and diffuse chest pain. Auscultation revealed decreased respiratory sounds in both lungs. Chest X-ray showed bilateral pneumothorax and bilaterally tube thoracostomy was performed. Thoracic tomography demonstrated a few thin-wall cystic structures in both lungs with a higher number on the right side. We performed bullectomy, apical wedge resection, apical parietal pleurectomy and mechanic pleural abrasion on residual pleural spaces through right posterolateral thoracotomy. One month later, we performed bullectomy, bulla ligation, apical wedge resection, apical parietal pleurectomy and mechanic pleural abrasion on residual pleural spaces through left posterolateral thoracotomy due to the left recurrent pneumothorax. The patient was diagnosed with lymphangioleiomyomatosis based on the histopathological examination. No recurrent pneumothorax was observed at the end of the two-year follow-up period. Lymphangioleiomyomatosis should be kept in mind in premenopausal women who have bilaterally recurrent spontaneous pneumothorax. Early surgical treatment should be planned in these patients due to multiple pneumothorax recurrences with conservative procedures.Öğe A case of subungual exostosis(Medknow Publications, 2012) Turan, Hakan; Uslu, Mustafa; Erdem, Havva…Öğe Case report: Large adrenal ganglioneuroma(Elsevier Ltd, 2014) Kaçağan, Coşkun; Başaran, Enise; Erdem, Havva; Tekin, Ali; Kayıkçı, Ali; Çam, KamilIntroduction Ganglioneuromas are localized tumors derived from neural crest tissues. Characteristically, they originate in the posterior mediastinum. Pure adrenal gangliomas are extremely rare. PRESENTATION OF CASE A left adrenal mass with the size of 68 mm × 50 mm × 86 mm on magnetic resonance imaging was documented in a 53-year-old female patient. Endocrine tests revealed a non-functioning adrenal mass. The actual size of the mass was macroscopically measured to be 16 cm × 8.5 cm × 6 cm after the surgery. Histopathological examination indicated ganglioneuroma. DISCUSSION Most adrenal ganglioneuromas can incorrectly be diagnosed as other adrenal tumors, since they are rare neurogenic benign tumors with no specific imaging properties. They have a slow growth pattern and usually asymptomatic. Our case represents a huge adrenal ganglioneuroma in a female patient with nondiagnostic flank pain. Radiological imaging showed a large adrenal mass with no differentiation from other adrenal tumors. Endocrine evaluation should be performed for such adrenal masses. Since our case had a relatively large size, open surgery was preferred. Pathology revealed the definitive diagnosis. CONCLUSION This case suggests that ganglioneuromas can wrongly be diagnosed as other adrenal tumors. It is significant that a proper differential diagnosis should be performed by using hormonal and imaging techniques. Nevertheless, pathological examination is usually required for definitive diagnosis. © 2014 The Authors.Öğe Cildin İyi Huylu Nadir Görülen Tümöral Lezyonu: Pilomatriksoma(Düzce Üniversitesi, 2012) Aydoğdu, Didem; Erdem, Havva; Tihan, DenizPilomatriksoma, cildin kıl matriksinden köken alan iyi huylu ve nadir görülen tümörallezyonudur. “Malherbe’nin kalsifiye epitelyoması” olarak da bilinir. Sıklıkla baş-boyunbölgesinde cilt altında mobil, düzgün sınırlı ağrısız kitle şeklinde ortaya çıkar. Bununla berabervücudun kıl folikülü içeren her hangi bir cilt bölgesinden kaynaklanabilir. Çoğunlukla, ameliyatöncesi net bir tanı konulması mümkün olmaz. Nitekim bu yazıda, sol kolda lipomatöz bir kitleile polikliniğe başvuran 12 yaşındaki bir çocuğa uygulanan eksizyonel biyopsi sonrasıhistopatolojik incelemelerde pilomatriksoma tanısı alan olgu sunulmaktadırÖğe Collision tumor of menningioma and non Hodgin malignant lymphoma of cerebellum(Springer, 2012) Erdem, Havva; Uzunlar, Ali Kemal; Yıldırım, Ümran; Sav, Aydın; Döşoğlu, Murat…Öğe Comparing the Effects of Antiadhesıve Materials after Abdominal Surgery(2020) Doğan, Sami; Çetin, Mehmet Fuat; Günal, Ömer; Erdem, HavvaObjective: We aimed to evaluate and compare the effects of anti-adhesion materials,Seprafilm, Suprofilm, olive oil, and olive oil containing Vitamin E by measuring tensionforces.Methods: 60 male Wistar-Albino rats were divided into six groups. The front side of thececum and right abdominal parietal peritoneal wall were abrased. The rats wereeuthanized on the 14th postoperative day. Adhesions between intestines, omentum, otherabdominal organs, cecum, incisionsites, and abdominal anterior wall peritoneum were allevaluated. Adhesion strength was measured with dynamometer. Histopathologicalevaluations of the adhesion area was performed.Results: Stage-I (0.43Newton) in Group-I, stage-IV (1.0540N) in Group-II, stage-II(0.6370N) in Group-III, stage-II in Group-IV (0, 5230N), stage-III (0.7620N) in Group-V,stage-IV (1.3560N) in Group-VI, were detected. A significant difference was foundbetween these findings. P = 0.001, (p <0.05). Histopathological examination: It was foundthat GroupV-VI reduced inflammation, increased collagen production, fibroblastic activityand vascular proliferation.Conclusions: More objective evaluation can be made by measuring the tension force ofthe adhesions. Suprafilm can also be effectively used as an antiadhesive, such asSeprafilm. Olive oil and vitamin E require more studies to be used as antiadhesives.Öğe Correlation of astrocyte elevated gene-1, basic-fibroblast growth factor, beta-catenin, Ki-67, tumor necrosis factor-alfa with prognostic parameters in ductal carcinomas and ductal intraepithelial neoplasms(Medknow Publications & Media Pvt Ltd, 2015) Erdem, Havva; Gündoğdu, Betül; Ankaralı, Handan; Yaşar, Mehmet; Şener, Ebru; Oktay, Murat; Şahiner, CemBackground: Breast cancer is the second most frequent cancer in the world. Although it is widely accepted that the etiology of breast cancer includes both genetic and environmental factors, the molecular mechanism of its development and progression remains poorly understood, and thus far, no specific signature of breast cancer gene expression has been reported to allow for patient-tailored therapy strategies. Hence, it is of great clinical value to further understand the molecular mechanisms underlying the progression of breast cancer and to identify effective early markers for the diagnosis and prognosis of the disease as well as novel therapeutic targets. Materials and Methods: This study was conducted on a total of 90 paraffin-embedded breast tumor samples. Immunohistochemical stains for astrocyte elevated gene-1 (AEG-1), basic-fibroblast growth factor (b-FGF), beta-catenin, Ki-67, tumor necrosis factor- (TNF-) were performed on tissue microarray using standard procedures. Each patient age, grade, estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) status, size, lymphovascular invasion, metastasis of lymph node (LNM), nipple and ductal hyperplasia areas were assessed. Results: We observed significant relationship between the age and LNM or FGF (P = 0.018, 0.035, respectively). The relationship between histological and nuclear grade, LNM, ER, PR, HER-2 and prognostic parameters was evaluated in cases of ductal carcinomas (DC). There was a significant positive correlation between TNF-, size, LNM (P % 0.0001, 0.002, 0.005). We found that significant relationship between AEG-1 and TNF-. There was a significant positive correlation between FGF and Ki-67 and negative correlation AEG-1. Although, FGF, TNF-, AEG-1 staining in DC were observed higher than ductal intraepithelial neoplasms, this observation could not statistically (P >= 0.05). Conclusions: The present work aims to investigate the relationship between the expression of AEG-1, b-FGF, beta-catenin, Ki-67, TNF- other prognostic parameters in DC and ductal intraepithelial neoplasm. We found a relationship between these factors.Öğe Correlation of E-cadherin, VEGF, COX-2 expression to prognostic parameters in papillary thyroid carcinoma(Academic Press Inc Elsevier Science, 2011) Erdem, Havva; Gündoğdu, Cemal; Şipal, SareThyroid cancer represents approximately 1% of all human malignancies, papillary thyroid carcinoma (PTC) is the most common malignant tumor of the thyroid gland, accounting for 70-80% of all thyroid cancers. In the US, the incidence of thyroid cancer is 4 per 100,000 individuals. It is two to four times as frequent in women as in men. The development of PTC is influenced by many factors including genetic alterations, growth factors, and physical agents such as radiation. In order to recognize the prognosis for PTC. a lot of clinic and pathological parameters such as: age, tumor size, extra-thyroid tumor spread, lymph node, distant metastases, gender, tumor stage are used. As most of these parameters are subjective, more objective and useful prognostic factors are needed for determining biologic behavior, providing an initial assessment. In this study, we aimed to compare the expressions of COX-2, E-cadherin, VEGF to classical prognostic factors, and to investigate the correlation with prognosis. Operation records from 79 FTC cases were examined retrospectively. In the study, we aimed to investigate the whole tissue by means of stereology method, which is an impartial one, and we indicated the expression COX-2, VEGF, E-cadherin immunohistochemically in 79 resection diagnosed with PTC. We determined correlations between the expressions of COX-2 and VEGF, E-cadherin, and age, gender, and stage. (C) 2011 Elsevier Inc. All rights reserved.Öğe Correlation of ischemia-modified albumin levels and histopathologic findings in experimental ovarian torsion(Kare Publ, 2016) Yıldırım, Ahmet; Yıldırım, Şule; Topaloğlu, Naci; Tekin, Mustafa; Küçük, Adem; Erdem, Havva; Çakır, Dilek ÜlkerObjectives: Ischemia modified albumin (IMA) levels significantly increased and may be used as a diagnostic marker in ovarian torsion. The aim of this study is to investigate whether there was any correlation between IMA levels and histopathologic changes in experimental ovarian torsion. Material and methods: Fourteen Sprague-Dawley rats, each weighing 220-250 g were divided randomly into 2 groups; in Group 1, the control group (n = 7), only laparotomy was performed and in Group 2, the experimental group (n = 7), ovarian torsion was performed. Ischemia was performed for 3 h; following the ischemia period, the torsion was relieved by detwisting the adnexa and then the ovarian I/R protocol was applied for 3 h. Blood samples were taken from all of the rats to measure the IMA levels and the ovaries were surgically removed for histologic examination. A blinded pathologist examined and scored the samples. Results: The median (minimum-maximum) IMA values were 921.00 (870.00-966.00) ABSUs in the ovarian torsion group and 853.00 (782.00-869.00) ABSUs in the control group. The difference was statistically significant. In the correlation analysis, a significant and strong correlationwas found between IMA levels and histopathologic changes (Spearman's rho = vertical bar 0.987, p < 0.001). Conclusion: Positive correlation was found between the IMA levels and the histopathologic severity of the disease. This finding is important for both diagnosis of the disease and patient follow-up. As a new marker in ovarian torsion, IMA may also indicate the severity of the ovarian histopathology. Copyright (C) 2016 The Emergency Medicine Association of Turkey. Production and hosting by Elsevier B.V. on behalf of the Owner.Öğe Cyclooxygenase-2 and Survivin in Superficial Urothelial Carcinoma of the Bladder and Correlation with Intratumoural Microvessel Density(Sage Publications Ltd, 2010) Yıldırım, Ümran; Erdem, Havva; Kayıkçı, A.; Şahin, A.F.; Uzunlar, Ali Kemal; Albayrak, A.This study was designed to investigate the protein levels of cyclooxyogenase-2 (COX-2) and survivin in superficial urothelial carcinoma (UC) and their correlation with microvessel density (MVD). High-grade UC was positive for both COX-2 and survivin protein, and the proportion of tumours positive for both proteins increased with increasing tumour grade. The presence of COX-2 protein was significantly correlated with the presence of survivin protein. Both COX-2 and survivin positivity were significantly correlated with MVD in all patients regardless of tumour grade, but there was no correlation between MVD and COX-2 and survivin positivity by individual tumour grade. Although there was no significant difference in the proportion of COX-2-positive tumours when patients were stratified by tumour stage, a significantly higher proportion of patients with pT1 stage tumours were survivin-positive compared with patients with pTa stage tumours. COX-2 and survivin positivity were significantly correlated in all patients regardless of tumour grade or stage. COX-2 and survivin were significantly correlated in patients with pTa, but there was no correlation in pT1 tumours. These findings demonstrate that together, COX-2, survivin and MVD may play an important role in UC.Öğe Dermal absorption and toxicity of alpha amanitin in mice(Informa Healthcare, 2014) Kaya, Ertuğrul; Sürmen, Mustafa Gani; Yaykaşlı, Kürşat Oğuz; Karahan, Selim; Oktay, Murat; Turan, Hakan; Erdem, HavvaThe fungus Amanita phalloides is known to contain two main groups of toxins: amanitins and phallotoxins. The amanitins group effectively blocks the RNA polymerase II enzyme found in eukaryotic cells. As alpha amanitin has a lethal effect on the majority of eukaryotic cells, it can be valuable as an antiparasitic or antifungal drug. It can be used externally against ectoparasites. It is critical that percutaneous applications of the alpha amanitin toxin are not harmful to the recipient. In this study, the absorption and the toxicity of percutaneous and intraperitoneal (ip) applications of 1 mg/kg alpha amanitin to mice were compared. Potential skin, liver and kidney toxicities were investigated through pathological examination. HPLC analysis was used to determine the amount of the toxin. No toxicity or toxin were found in the skin, liver, or kidneys of the mice in the control group. Interestingly, the percutaneous application group also showed no toxicity, and the toxin was not present in this group. After 24 h, Councilman-like bodies and pyknotic cells were observed in the mice in which alpha amanitin was applied intraperitoneally, demonstrating the presence of toxicity. Peak levels of alpha amanitin (mu g/mL) in the liver, kidney, and blood in the ip application group were measured at 3.3 (6 h), 0.2 (6 h) and 1.2 (1 h), respectively. The results demonstrated that the toxin was not absorbed through the skin of the mice and that the percutaneous application of alpha amanitin did not have any toxic effects. Thus, alpha amanitin may be administered percutaneously for therapeutic purposes.Öğe Destroyed lung secondary to multiple myeloma in a previously treated tuberculosis patient(TIP ARASTIRMALARI DERNEGI, 2014) Kutlucan, Ali; Aydın, Leyla Yılmaz; Gönen, İbak; Erdem, Havva; Özşahin, Mustafa; Aydın, Yusuf; Büyükkaya, RamazanThis case is presented with a pulmonary parenchymal destruction due to acquired multiple myeloma who has a history of pulmonary tuberculosis. A 55 year old male patient attempted to emergency department with complaints of shortness of breath. The final diagnose with the existing clinical and laboratory outputs were right pulmonary parenchymal destruction and pleural involvements secondary to multiple myeloma. Our prediagnose was confirmed by the overt plasma cell increase and Russell bodies in cytopathologic examination of the pleural fluid. Even though multiple myeloma leads to destruction in the pulmonary parenchyma rarely, patients should be scrutinized enough to elicit true diagnose.
