ISSN 2415-1297 (Online)   ISSN 2415-1300 (Print)
Volume : 27 Issue : 3 Year : 2019
Med J Islamic World Acad Sci: 26 (3)
Volume: 26  Issue: 3 - 2018
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1.Programmed Death Ligand 1 in Non-Clear Cell Renal Cell Carcinoma and Correlation with Tumor Microenvironment and Prognostic Factors
Hayriye Tatlı Doğan
doi: 10.5505/ias.2018.37267  Pages 49 - 54
Non-clear cell renal cell carcinomas (non-ccRCC) are relatively uncommon tumors compared with clear cell RCC. Targeting immune checkpoints such as Programmed Death / Programmed Death Ligand 1 (PD1/PD-L1) axis has been promising. In addition intratumoral PD-L1 expression is a predictor of poor prognosis in some cancers. In this study we aimed to characterize the association between PD-L1 expression and clinico-pathological prognostic factors and to evaluate lymphocyte density displaying the PD-1, CD4, and CD8 expression in the tumor microenvironment in non-ccRCC. Immunohistochemical analysis was performed for the expression of PD-L1, PD-1, CD4 and CD8 on tissue microarray sections. PD-L1 positivity rate was found to be %24. Dense lymphocytic infiltration staining with PD-1, CD4, and CD8 was significantly high in PD-L1 positive tumors. There was no correlation between PD-L1 expression and any of the tested negative prognostic factors. Only the rate of WHO ISUP grade 3–4 tumors was considerably higher in PD-L1-positive cases than that in negative ones. Further evaluation of PD-L1 as a potential predictive biomarker in larger series and standardization of staining procedures and scoring methods are warranted. At the mean time pathologists should be aware of the importance of lymphocytic infiltration in the tumor microenvironment, which potentially may be a predictive marker for targeted therapy.

2.Evaluation of visual hallucination based on pareidolia testing in patients with Alzheimer’s Disease
Şadiye Gümüşyayla, Hesna Bektaş, Gülsüm Akdeniz, Gönül Vural, Mehmet İlker Yön
doi: 10.5505/ias.2018.69926  Pages 55 - 58
AIM: Pareidolia is a complex visual illusion that is considered as a marker of visual hallucinations. In this study, we aimed to measure pareidolic illusions with a simple experimental paradigm using the pareidolia test as an indicator of visual hallucination in the Alzheimer's Disease.
MATERIALS and METHODS: Thirty-four patients with Alzheimer's disease and 30 healthy subjects with no difference in age and sex were included in the study. The degree of cognitive impairment was determined by the Mini Mental State Examination and the MOCA test. 60 images is used as pareidolia test material including human face, some objects and artefacts. The patients' answers were divided into three groups as correct resoonse, illusory response and other response while test is scoring.
RESULTS: In this study, the correct response averages of healthy individuals were higher than the individuals in the patient group. Moreover, the mean number of illusory responses in the patients was 2.27 ± 3.42, whereas no illusory response was obtained in healthy subjects. There was no relationship between the number of illusory responses and the Mini Mental Test score, MOCA test score and duration of illness.
DISCUSSION and CONCLUSION: Pareidolia paradigm is a simple and useful test that reveals the tendency to subclinical visual hallucinations or hallucinations in patients with Alzheimer's disease.

3.Retrospective analysis of patients with chronic myeloproliferative neoplasms: a single center experience
Demet Cekdemir, Mehmet Gündüz
doi: 10.5505/ias.2018.90093  Pages 59 - 64
Aims: Chronic myeloproliferative diseases(CMPD) are clonal diseases which may cause hemostatic and thrombotic abnormalities and progress to acute leukemia and characterized by increases in the number of mature and immature cells in the peripheral blood as a result of uncontrolled proliferation of one or more than one type of myeloerythroid cells in the bone marrow.The purpose of this study is to determine demographic features, the incidence of JAK2 mutation,disease characteristics and treatment strategies in patients with the diagnosis of CMPD.
Methods: A total of 100 CMPD patients[essential thrombocytosis(ET),n=52;primary myelofibrosis (PMF), n=31 and polycythemia vera(PV),n=17] admitted to our clinic between February 2006 and February 2013 were included with the diagnosis of BCR/ABL–negative CMPD based on 2008 WHO criteria in whom JAK mutation was analyzed were included in the study. Age, gender, family history, secondary cancer, bleeding, history of thrombosis, whole blood cell counts, the presence of hepatomegaly and splenomegaly and other symptoms and signs at the time of diagnosis were evaluated. Besides, thrombotic and hemorrhagic history of the patients were assessed.The presence of JAK mutation in DNA samples was analyzed using Real-Time PCR.
Results: Distribution of age and gender of the patients, besides family history, previous incidents of bleeding, thrombosis, secondary cancer, also blood hemoglobin,LDH values, platelet and white blood cell counts, constitutional symptoms, minor neurologic symptoms, presence of hepatomegaly and splenomegaly at the time of diagnosis.In our study, the incidence of JAK2 mutation was highest among cases with PMF(70.9%), followed by cases with PV(70.6%) and ET(51.9%).
Conclusion: The incidence of JAK2 mutation has offered a different perspective in BCR/ABL- negative cases with CMPD and has taken its place as an acceptable diagnostic factor.In our study, since a limited number of cases were analyzed in our study,the relationship between this mutation and CMPD should be confirmed by the studies with higher number of cases.

4.Effectiveness of Holmium Laser Therapy Together with 7Fr Ureterorenoscopy in Preschool Children
Mehmet Özgür Yücel, Ali Çift, Can Benlioğlu
doi: 10.5505/ias.2018.79989  Pages 65 - 69
Purpose: We aimed to evaluate the success of semirigid (7 Fr) ureterorenoscope used in our clinic in the treatment of ureteral stone in pre-school children (0-6 years)
Materials and Methods: Between January 2012 and February 2018, 36 patients who underwent endoscopic ureteral stone treatment for ureteral stone in our clinic were retrospectively evaluated. During the procedure, 7 Fr semirigid ureterorenoscope and were used holmium: YAG laser as lithotripter. The evaluation of the stone-free rates of the patients was done visually during the fragmentation and 1 month later by the urinary ultrasonography.
Results: The mean age of the patients was 37.5 months. Of the patients, 55.6% were male and 44.4% were female. Stone localization was 58.3% distal ureter, 16.7% middle ureter and 25% proximal ureter. After the first ureterorenoscopy procedure stone-free rate was 58.3%. During the first ureterorenoscopy procedure, 38.9% patients were admitted with DJ stent, which could not reach intra-operative stones. After 1 month, 2nd session ureterorenoscopy was performed. During the first ureterorenoscopy procedure, ureteral perforation developed in 2.8% of the patients. Ureterolithotomy was performed with open surgery. After the first and second ureterorenoscopy procedures, the stone-free rate was 97.2%. In the early postoperative period, slight bleeding in 2 patients and high fever (> 38.5 °C) in 4 patients was observed. Mean hospital stay was 2.3 days.
Conclusion: Endoscopic ureteral stone treatment with 7 Fr ureterorenoscopy can be safely performed in preschool age group with high success and low complication rates even in very young children.

5.Upper gastrointestinal endoscopy performed before sleeve gastrectomy in patients with morbid obesity: retrospective analysis of 460 patients
Gökhan Akkurt, Hakan Buluş, Mustafa Alimoğulları, Özgür Albuz
doi: 10.5505/ias.2018.13281  Pages 70 - 73
Objective: We aim to retrospectively evaluate results of preoperative upper gastrointestinal endoscopy(UGE) performed in our endoscopy unit on morbid obese patients who underwent Laparoscopic Sleeve Gastrectomy (LSG).
Material and Method: The study was carried out on 460 morbid obese patients who underwent UGE before LSG at the General Surgery Endoscopy Unit of Keçiören Training and Research Hospital and their age, body mass index, additional diseases and endoscopy findings were evaluated..From endoscopy findings, antral gastritis, LES laxity, pyloric dysfunction, esophagitis, hiatal hernia, pancreatitis, body mass index were evaluated with univariate analysis and comparative logistic method.
Findings: UGE was performed in 460 patients who were scheduled for LSG. Patients had antral gastritis, 46 (10%) patients had pangastritis, 30 (6.6%) patients had esophagitis, 163 (35.6) patients had LES laxity, 58 (12.7%) patients had Hiatal Hernia, 25 (5.5%) patients had pylor dysfunction and additional comorbidities were detected in 18 (3.9;%) patients.Patients with antral gastritis had statistical significance with LES laxity and age (p 0,002, p 0,003), patients with pancreatitis had statistical significance with Hiatal Hernia, pyloric dysfunction and LES laxity(p 0.007, p 0.004, p 0.002). There is also significant statistical relationship between esophagitis and hiatal hernia (p 0.001).In multivariant analysis; Hiatal Hernia increased the risk of pancreatitis by 2.5 times, while LES laxity increased risk of pangastritis by 0.42 times. Pyloric dysfunction has been shown to increase pangastritis risk by 5.6 fold.Age increased risk of antral gastritis by 1.04 fold, and LES laxity increased risk of antral gastritis by 2.07 fold.
Discussion and Conclusion:
We believe that an upper GIS endoscopy that will be performed before obesity surgery will play a very important role in surgical method selection.

6.Effect of poor oral health on respiratory functions which is one of the important factor of sportive performance
Osman Hamamcılar, Tuğba Kocahan, Bihter Akınoğlu, Adnan Hasanoğlu
doi: 10.5505/ias.2018.43402  Pages 74 - 79
Objective: To determine the effect of periodontal disease and dental decay on the respiratory system, which cause deterioration of oral health in athletes, to show the relationship and thus to support sports performance.
Method: As a result of oral examination, athletes, first group; no periodontal disease and no rot (age: 16,8 ± 4,72,10male, 15 female). The second group; <4 patients with oral disease (age: 18.2 ± 4.88, 22 males, 22 females). The third group is; ≥ 4 oral diseases (age: 20,8 ± 4,60, 19 males, 23 females). The mean prevalence value (DM), DMF-T index, and gingival assessment (GI) were performed. FEV1/FVC % ratio and FVC mean value were measured.
Results: The mean FEV1/FVC % value of the first group of 25 athletes was 84,8±2,26 and the mean value of BKI was 20,8 ± 4,56. The DMF-T index of 44 athletes in the second group was found to be 1.7. As a result of the GI assessment, 13 sportsmen were diagnosed with Acute Gingivitis dental disease. The mean body mass index of this group was 22.2 ± 3.49; As a result of the respiratory test, the mean value of FEV1/FVC % was found to be 85±2,22. The DMF-T index of 42 sportsmen in the third group was found to be 6.7. There was no significant difference between the oral health problems of the second group of athletes and FEV1/FVC % (P> 0,05). However, there was a significant relationship between FEV1/FVC % and oral health status of third group athletes (P = 0.038, P <0.05).
Conclusion: FEV1/FVC % decreases with poor oral health and this shows that respiratory values are affected when oral health is bad. This can affect the athlete's performance negatively.

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