Vagal Nerve Schwannoma Clinically Mimicking Gastrointestinal Stromal Tumor: Report of a Case

Introduction: Mesenchymal tumors of the gastrointestinal (GI) tract are mainly comprised of a spectrum of spindle cell tumors which include gastrointestinal stromal tumors (GISTs), leiomyomas or leiomyosarcomas, and schwannomas. As all of these tumors of the GI are located in the submucosal layer of the bowell wall, differential diagnosis is very difficult. Histopathological evaluation using immunohistochemical staining is required for the definitive diagnosis.Presentation of case: A 20-year-old female patient was presented with an upper abdominal pain and dyspepsia since 2 months duration.This case  is initially thought as GIST but finally diagnosed as vagal nerve schwannoma by histopathological evaluation after resection of the mass.Conclusion: Schwannomas should be considered in the differential diagnosis of other mesenchimal tumors, such as gastrointestinal stromal tumors and leiomyomas or leiomyosarcomas, indeed it can grow in any part of the peripheral nerves along the gastrointestinal tract. Histopathological evaluation including immunohistochemical staining is required for the definitive diagnosis

Model based process optimization of enhanced wastewater treatment plants

Avrupa Birliği’ne uyum sürecinde ele alınan atık sorunu kapsamında, alıcı ortamlara yapılacak deşarjlarda konvansiyonal parametrelerin yanısıra azot ve fosfor (besi maddesi) parametrelerinin de belli standart değerlerin altına indirilmesi gerekli hale gelmiştir. Bu nedenle, “Kentsel Atıksu Arıtımı Yönetmeliği, 2006” ile uyum sürecinde olan ülkemizde azot ve fosfor standartları mevzuatımıza dâhil edilmiştir. “Kentsel Atıksu Arıtımı Yönetmeliği, 2006” kapsamında mevcut tesislerin besi maddesi giderimine yönelik olarak geliştirilmesi, yeni kurulacak tesislerin ise besi maddesi giderecek şekilde en uygun arıtma teknolojisi kavramı çerçevesinde boyutlandırılması gereklidir. Besi maddesi giderimine yönelik en uygun arıtma teknolojisi biyolojik prosesler, bunlar arasında en ekonomik çözüm ise aktif çamur sistemleri olarak tanımlanmaktadır. Bu çalışma aktif çamur tesislerinin, Avrupa Birliği normlarında performansını sağlayabilecek optimum tasarım ve işletme süreçlerinin değerlendirilmesini amaçlamaktadır. Bu kapsamda, bir örnek olarak ele alınan İstanbul Su ve Kanalizasyon İdaresi (İSKİ) Paşaköy İleri Biyolojik Atıksu Arıtma Tesisi’nde mevcut durumda atıksu karakterizasyonu ve sistem performansı deneysel olarak belirlenmiş, elde edilen bilgiler kullanılarak sürekli kullanıma uygun olacak model-bazlı tasarım ile işletme simülasyon programları hazırlanmış ve işletme optimizasyonu çerçevesinde çıkış besi maddesi konsantrasyonlarının düşürülmesi amacıyla işletme senaryoları oluşturularak önerilerde bulunulmuştur. Yürütülen senaryo analizleri ile, havalandırma tanklarındaki çözünmüş oksijen seviyelerinin uygun ayarlanması, tesisin geri devir denitrifikasyonu prensibi yerine A2O veya UCT tipi sistem şeklinde işletilmesi ile sistem veriminin arttırılabileceği ve dolayısıyla çıkış besi maddesi konsantrasyonlarının azaltılabileceği belirlenmiştir. Anahtar Kelimeler: İleri biyolojik atıksu arıtma tesisi, atıksu karakterizasyonu, model-bazlı tasarım, işletme optimizasyonu.The Urban Wastewater Treatment Directive published in the Official Gazette No. 26047 of 08.01.2006 was adapted from the “The Council Directive (91/271/EEC)” concerning urban waste-water treatment was accepted in European Union Countries, which imposes enforcements about the collection and treatment of wastewater. This directive requires that also nitrogen and phosphorus (nutrients) to be removed together with the conventional parameters. In this context, it is very important to follow and apply the technological advances while the harmonization of legislations in Turkey with European Union Standards. Mathematical models are frequently used for the design and optimum operation of wastewater treatment systems. In order to use the activated sludge models for the process design and control, it is crucial to understand the behavior of complex biological reactions under steady and dynamic conditions. The initial step for the use of models should be, a model calibration according to the data obtained from the treatment plant and an analysis of the behavior of the treatment plant under dynamic influent and environmental conditions (Vanrolleghem et al., 2003). After the calibration of the prepared model according to the operational conditions of the treatment plant, the model can be used for the optimization of the plant, meeting the effluent quality standards, minimizing operational costs and for developing appropriate process control strategies. On the other hand the effect of changes in the process conditions on the model stability should be taken into consideration (Insel et al., 2007). The aim of this study was to evaluate the optimum design and operational criteria of advanced biological wastewater treatment plants by applying international monitoring and evaluation mechanisms that will increase the performance to norms required in the European Union. Accordingly, İSKİ Paşaköy Advanced Biological Wastewater Treatment Plant (ABWWTP) was chosen as a model plant and in the first stage on influent wastewater characterization, chemical oxygen demand (COD) fractionation and performance of the activated sludge system were experimentally determined. In the second stage, using the dimensions of the İSKİ Paşaköy ABWWTP units and the experimentally determined operational parameters, model calibration studies were conducted. On this context, theoretical parameters of model-based design and operational simulation programs applied for the plant were evaluated. In the last stage of the study, for operational optimization, according to the results obtained from the experimental and simulation studies conducted at İSKİ Paşaköy ABWWTP, operational scenarios were developed and suggestions were made. In the scenario analysis reduction of effluent phosphorus and total nitrogen concentration was aimed and the effect of (i) the aeration system control, (ii) recycle denitrification (iii) influent VFA concentration was analyzed and the effect of (iv) different system configurations was evaluated. The results of statistical data analysis of wastewater characterization studies conducted at İSKİ Paşaköy Advanced Biological Wastewater Treatment Plant aiming nitrogen and phosphorus removal revealed that due to low influent Chemical Oxygen Demand (COD), Total Kjeldahl Nitrogen (TKN), Total Phosphorus (TP) and Volatile Fatty Acids (VFA) concentrations, high efficiencies of biological phosphorus removal was not achievable. According to the scenario analysis performed for the treatment plant it has been concluded that it is possible to increase the removal efficiency of the system and achieve lower effluent total nitrogen and phosphorus concentrations by setting the dissolved oxygen levels to appropriate levels and operating the systems as an A2O or a UCT type system instead of a recycle denitrification system. It has been concluded that if the scenario analyses were applied it is not possible to meet the European Union Effluent Quality Standard of 1.0 mg/l for the phosphorus parameter. Experimental and model based studies have to be conducted for the installation of a fermentation process together with different system configurations that are required to meet the effluent quality standard by biological treatment. Keywords: Paşaköy wastewater treatment plant, wastewater characterization, model based optimization, process control

Meme kanserinde tpoizomeraz 2 alfa ve her2 / neu saptanmasında immünohistokimyasal ve floresan in situ hibridizasyon yöntemlerinin karşılaştırılması

Bu tezin, veri tabanı üzerinden yayınlanma izni bulunmamaktadır. Yayınlanma izni olmayan tezlerin basılı kopyalarına Üniversite kütüphaneniz aracılığıyla (TÜBESS üzerinden) erişebilirsiniz.[Abstarct Not Available

Importance of P53, Ki-67 expression in the differential diagnosis of benign/malignant phyllodes tumors of the breast

Background: Conventionally growth pattern, stromal overgrowth, stromal cellularity and stromal mitotic activity are the main parameters in the grading of phyllodes tumors (PTs). Recent studies revealed that both p53 and Ki-67 expressions are correlated with grade of PTs of the breast. Expression of hormone receptors and overexpression/amplification of HER2 has been studied in PTs to discover the roles of these markers as new treatment modalities. Materials and Method: We studied 26 PT cases. Seventeen benign and nine malignant PTs were re-evaluated as regards stromal cellularity mitotic activity, p53/Ki-67 expression rates and the relation between these parameters. Estrogen receptor and progesterone receptor (ER, PR) positivity were determined by counting nuclear staining in five high-power fields. Also, the presence of any HER2 staining and staining patterns were documanted. Results: Stromal cellularity, mitotic rate, p53 and Ki-67 expression rates were all correlated with benign and malignant histologic subgroups (P = 0.000-0.001). Ki-67 and p53 expressions were statistically significantly correlated with histologic subgroups, stromal cellularity and mitotic rate (P < 0.005). ER and PR expressions in the epithelial component were not statistically significant between the two groups. HER2 showed different staining patterns in the epithelial component, and there was no staining in the stromal component. Conclusion: Ki-67 and p53 expression rates were statistically significantly correlated with grade of mammary PTs; therefore, they can be used in the determination of tumor grade, especially for the differential diagnosis of benign and malignant tumors. Malignant and benign tumors did not differ significantly in terms of hormone receptor and HER2 expression. HER2 expression showed different patterns in the epithelial component of the PTs

Exenatide improves ovarian and endometrial injury and preserves ovarian reserve in streptozocin induced diabetic rats

WOS: 000358467100006PubMed ID: 25366063We aimed to evaluate: (1) endometrial and ovarian tissue injury caused by the glucose toxicity in diabetic rat model and (2) the effect of GLP-1 analog (exenatide) on endometrial and ovarian diabetes induced injury with emphasizing the underlying mechanism. The study group composed of 24 female rats assigned randomly into 3 groups. Group 1 was the control group (n = 8) and received no treatment. Diabetes was induced by intraperitoneal injection of streptozocin for 16 rats which are further assigned randomly into 2 groups: 1 ml/kg intraperitoneal saline was given to Group-2 (diabetic non-treated control group, 8 rats) and 10 mu g/kg/day of intraperitoneal exenatide was given to Group 3 (exenatide treated group, 8 rats) for four weeks. After four weeks, blood samples were collected and hysterectomy with bilateral oophorectomy was performed for histopathological examination. Diabetes caused endometrial and ovarian tissue injury in rats (p < 0.0001). Serum transforming growth factor beta (TGF-beta), malonylaldehyde (MDA), pentraxin-3 (PTX-3) levels were higher in diabetic rats (p < 0.0001), whereas antimullerian hormone (AMH) was lower (p < 0.001). Serum levels of these markers reflected that Diabetes induced injury in the reproductive tract occured via oxidative stress, fibrosis and severe inflammation. Diabetes diminished ovarian reserve. Exenatide treatment improved the histological degeneration and fibrosis in the endometrium and ovary with concomitant decrease in inflammatory and oxidative stress markers (p < 0.05). Exenatide also improved ovarian reserve (p < 0.05). Glucose toxicity occured severely in ovary and endometrium in DM. After exenatide treatment; ovarian and endometrial injury and fibrosis seems to decrease significantly. The effects of exenatide in rat models give hope to prevent the women with DM from premature ovarian failure and endometrial dysfunction

Prostate cancer volume estimations based on transrectal ultrasonography-guided biopsy in order to predict clinically significant prostate cancer

ABSTRACTIntroduction:Tumor diameter is a reliable parameter to estimate tumor volume in solid organ cancers; its use in prostate cancer is controversial since it exhibits a more irregular pattern of growth. This study aimed to examine the association between the tumor volume estimations based on transrectal ultrasound (TRUS) guided biopsy results and the tumor volume measured on the pathological specimen.Materials and Methods:A total of 237 patients who underwent radical retropubic prostatectomy (RRP) were included in this retrospective study. The differences and correlations between cancer volume estimations based on TRUS guided biopsy findings and cancer volume estimations based on post-prostatectomy pathology specimens were examined. In addition, diagnostic value of TRUS guided biopsy-based volume estimations in order to predict clinically significant cancer (>0.5 cc) were calculated.Results:The mean cancer volume estimated using TRUS biopsy results was lower (5.5±6.5 cc) than the mean cancer volume calculated using prostatectomy specimens (6.4±7.6 cc) (pConclusions:TRUS guided biopsy-derived estimations seem to have a limited value to predict pathologically established tumor volume. Further studies are warranted to identify additional methods that may more accurately predict actual pathological characteristics and prognosis of prostate cancer.</sec

Ovarian failure in diabetic rat model: Nuclear factor-kappaB, oxidative stress, and pentraxin-3

WOS: 000348753800012PubMed ID: 25510691Objective: The aim of the present study was to investigate the effects of diabetes mellitus (DM) on ovarian reserve and injury by considering laboratory and histopathological parameters in rat models. Materials and methods: An experimental DM model was created in 16 rats. Eight rats with normal blood glucose levels were included in the control group. Diabetic rats were divided randomly into two groups: nontreated and resveratrol-treated groups. Histopathological examination and nuclear factor (NF)-kappa B immunoexpression level determination were performed. Plasma malondialdehyde, glutathione, pentraxin-3, and anti-Mullerian hormone levels were measured. Relations between the variables were compared by Student t test, analysis of variance, and Mann-Whitney U and X-2 tests. Results: We found statistically significantly lower glutathione and anti-Mullerian hormone levels, and higher malondialdehyde and pentraxin-3 levels in nontreated diabetic group when compared with the control and resveratrol-treated diabetic groups. Stromal degeneration, follicle degeneration. stromal fibrosis scores, and NF-kappa B immunoexpression levels were significantly higher in nontreated diabetic rats. Primordial and primary follicle counts were significantly lower in the nontreated diabetic group when compared with the control and resveratrol-treated groups. There was no statistically significant difference in secondary and tertiary follicles between these groups. Conclusion: These findings provide strong evidence that the ovarian follicle pool in nontreated diabetic rats is affected in the early stages of the follicle development process. We precluded negative effects of DM on ovaries by inhibiting the NF-kappa B pathway with resveratrol. We thought that the NF-kappa B pathway plays a role in the pathophysiology of ovarian failure in diabetic rats. Further studies should evaluate this precise mechanism that leads to a decline in the anti-Mullerian hormone levels. In addition, the relationship between this abnormality and reproductive function in diabetic patients should be analyzed further. Copyright (C) 2014, Taiwan Association of Obstetrics & Gynecology. Published by Elsevier Taiwan LLC. All rights reserved