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Öğe A Rare Cause of Dysphagia: Hypopharyngeal Schwannoma(Springer India, 2025) Aslan, Mehmet; Sozubatmaz, Esma Hande; Akatli, Ayse NurSchwannomas, also known as neuroma/neurolemma, are benign tumors of the nerve sheath. Schwannomas are very rare in the hypopharyngeal area in the literature. In this article, we present a rare case of hypopharyngeal schwannoma, which was found in a 62-year-old female patient, which did not show any symptoms other than dysphagia and foreign body sensation in the throat.Öğe Ancient schwannoma in phthisis bulbi: Case ReporT(2019) Ozcan, Mehmet; Akatli, Ayse Nur; Turkmen Samdanci, Emine; Demirel, SonerAbstract: Schwannoma is benign nerve sheath tumor of Schwann cells. A 41-year-old female patient presented with pain and a complaint of inability to see. A mass revealed in left eye. Mass was histopathologically evaluated as schwannoma. This lesion in a rare location is presented with the literatureÖğe Are Ki-67 and Procalcitonin Expression Levels Useful in Predicting the Biological Behavior of Hepatocellular Carcinoma After Liver Transplantation?(Mdpi, 2025) Karabulut, Ertugrul; Akbulut, Sami; Samdanci, Emine Turkmen; Akatli, Ayse Nur; Elsarawy, Ahmed; Kucukakcali, Zeynep; Ogut, ZekiBackground: Examinations of procalcitonin (PCT) and Ki-67 expression levels in hepatocellular carcinoma (HCC) patients who have undergone liver transplantation (LT) through immunohistochemical analyses of tumor tissue may reveal the biological characteristics of the tumor, thus informing the selection of HCC patients for LT. Methods: Hepatectomy specimens from 86 HCC patients who underwent LT were obtained and analyzed immunohistochemically for the expression of PCT and Ki-67. The percentage and intensity of PCT staining, as well as the percentage of Ki-67 expression, were assessed for each patient. The impacts of PCT and Ki-67 expression on disease-free survival, overall survival, and the recurrence rate were studied, as well as their correlations with other clinicopathological features. Results: The recurrent HCC group showed a higher Ki-67 level (p < 0.001), larger maximum dominant tumor diameter (p < 0.001), and higher rate of vascular invasion (p = 0.001). The pre-transplant AFP (p = 0.001), maximum dominant tumor diameter (p < 0.001), number of tumor nodules (p < 0.001), rate of vascular invasion (p = 0.001), and Ki-67 level (p = 0.044) were higher in patients beyond the Milan criteria. Similarly, the pre-transplant AFP (p < 0.001); maximum dominant tumor diameter (p < 0.001); number of tumor nodules (p < 0.001); rates of portal vein tumor thrombus (p = 0.002), poor differentiation (p = 0.021), and vascular invasion (p < 0.001); and Ki-67 level (p = 0.010) were higher in patients beyond the expanded Malatya criteria. The maximum dominant tumor diameter (p = 0.006); Ki-67 level (p = 0.003); rates of vascular invasion (p < 0.001), cases beyond the Milan criteria (p = 0.042) and the expanded Malatya criteria (p = 0.027), and portal vein tumor thrombus (p = 0.020); and presence of recurrence (p < 0.001) were higher in HCC patients with mortality. The Kaplan-Meier estimates indicated that Ki-67 levels exceeding 5% significantly affected DFS and OS. Although the Kaplan-Meier estimates indicated that a PCT staining percentage of >= 25% did not have a statistically significant effect on DFS or OS, the outcomes may be considered clinically significant. Conclusions: This study demonstrated that the Ki-67 proliferation index can be used as a predictive biomarker of the biological behavior of HCC. Furthermore, we claim that PCT expression over a particular threshold might impact recurrence and survival, and we believe that further multicenter prospective studies focused on standardized PCT antibody staining are crucial in order to determine its potential as a biomarker for HCC.Öğe Bronchiectasis: Retrospective Analysis of Clinical and Pathological Findings in a Tertiary-Care Hospital(Wiley-Hindawi, 2022) Akatli, Ayse Nur; Ulutas, Hakki; Samdanci, Emine Turkmen; Celik, Muhammet RehaBackground. Bronchiectasis is still a challenging chronic lung disease in developing countries. Patients with bronchiectasis can also have pulmonary hypertension. There are sparse data on the prevalence of pulmonary hypertension in patients with bronchiectasis. Materials and methods. Archived H&E-stained slides of 141 patients histopathologically diagnosed with bronchiectasis were reevaluated. Cases were categorized into 4 subgroups based on histology: tubular, varicose, follicular, and cystic. In addition, concomitant histopathological changes were also reevaluated. For patients with available CT sections, main, right, and left pulmonary artery (PA) diameters and PA/aorta ratio were measured with regard to pulmonary hypertension. Results. Of the cases, 70% (n = 89) were female and 30% (n = 52) were male, with a mean age of 36.58 in females and 33.84 in males. Histopathologically, 43% (n = 68) of the cases showed follicular, 37% (n = 59) showed varicose, 35% (n = 56) showed tubular, and 28% (n = 45) showed cystic bronchiectasis morphology. All cases showed chronic inflammation, fibrosis, muscle destruction, and cartilage destruction. Aspergillus were present in 11% of the cases showing cystic morphology. Approximately 17% of the cases (n = 24) were found to have neuroendocrine cell proliferations. In cases with medial hypertrophy, a statistically significant increase in the left pulmonary artery diameter was radiologically determined. Conclusions. Medial hypertrophy was found to be significant with regard to indicating a radiological increase in left pulmonary artery diameter. Vascular changes observed in bronchiectasis cases and the presence of neuroendocrine cell proliferations should be specified in pathology reports, and aspergilloma should be carefully investigated in cases with predominant cystic morphology.Öğe Clinicopathological Features of Two Extremely Rare Hepatocellular Carcinoma Variants: a Brief Review of Fibrolamellar and Scirrhous Hepatocellular Carcinoma(Springer, 2020) Samdanci, Emine Turkmen; Akatli, Ayse Nur; Soylu, Nese KaradagPurpose We aimed to distinguish between fibrolamellar hepatocellular carcinoma and scirrhous hepatocellular carcinoma histopathologically. Methods and results In this review, fibrolamellar hepatocellular carcinoma and scirrhous hepatocellular carcinoma two specific and rare variants of hepatocellular carcinoma, which are difficult to diagnose histopathologically are discussed. Conclusion The clinical, radiological, gross, histopathological, immunohistochemical, and molecular features of these two tumors, which are defined by the World Health Organization (WHO), are mentioned.Öğe Comparison of liver resection and living donor liver transplantation in patients with hepatocellular carcinoma within Milan criteria and well-preserved liver function(Kare Publ, 2023) Karakas, Serdar; Yilmaz, Sezai; Ince, Volkan; Akbulut, Sami; Dalda, Yasin; Akatli, Ayse Nur; Kahraman, Aysegul SagirBackground and Aim: Liver resection (LR) and liver transplantation (LT) are curative treatments for hepatocellular carcinoma (HCC). The main pur-pose of this study was to compare the survival of LR and LDLT in patients with HCC within the Milan criteria. Materials and Methods: The results of the LR (n=67) and LDLT (n=391) groups were compared for overall survival (OS) and disease-free survival (DFS). Twenty-six of the HCCs in the LRs met the Milan and Child A cri-teria. Also, 200 of the HCC patients in the LDLTs met the Milan criteria, of which 70 also met the Child A criteria. Results: Early mortality was higher in the LDLT group (13.9% vs 1.47%; p=0.003). The 5-year OS was higher in the LDLTs than the LRs, but not statistically significant (84.6% vs 74.2%; p=0.287). However, 5-year DFS was better in the LDLT group (96.8% vs 64.3%; p<0.001). When the LRs (n=26) and the LDLTs (n=70) that met both Milan and Child A criteria were compared, 5-year OS was similar (81.4% vs 74.2%; p=0.512), but DFS was better in the LDLTs (98.6% vs 64.3%; p<0.001). Conclusion: LR can be justified as the first-line treatment for HCC patients who meet Milan and Child A criteria in terms of and OS.Öğe A COMPARISON OF SATB2 EXPRESSION RESULTS WITH CK20 AND CDX2 IN METASTATIC COLORECTAL CARCINOMA CASES(Carbone Editore, 2019) Bozdag, Zehra; Akatli, Ayse NurIntroduction: SATB2 (The special AT-rich sequence-binding protein 2) is the new DNA binding protein and nuclear transcrip-tion factor. In normal epithelial tissues, the SATB2 protein is specifically expressed in the nuclei of the lower gastrointestinal (GI) tract epithelial cells. The elective expression of SATB2 in the lower GI tract implies that it can be used as a diagnostic marker for metastatic colorectal carcinoma (CRC). Materials and methods: Immunohistochemical (IHC) analysis was performed by applying SATB2, CK20 and CDX2 in 96 meta-static CRC cases (51 liver, 22 lung, 19 ovarian, 3 skin and 1 uterine myometrial tissue) with various origins. The aim is to evaluate the diagnostic value of SATB2 alone, and the double and triple combinations of SATB2 with CK20 and CDX2. Results: Out of 96 metastatic colon carcinoma cases, 94 (97.9%) had positive SATB2 expressions. It was found that 93.7% (90/96) of the cases had expression with CK 20 and CDX2. The sensitivity of SATB2 alone was 97.92%, and the sensitivity of CK20 and CDX2 alone was the same, i.e. 93.75%. This rate was also higher in the double combination of SATB2 with CDX2 and CK20 in comparison to the double combination of CK20 and CDX2. The sensitivity of SATB2 and CK20 combination was 98.8%, which was higher than that of CK20 and CDX2 combination. Conclusions: Our results support the requirement of including SATB2 in the IHC panel for metastatic CRC cases.Öğe Conjunctival impression cytology and tear-film changes in cases with vitamin D deficiency(Springer, 2020) Dikci, Seyhan; Akatli, Ayse Nur; Yildirim, TulayPurpose To evaluate conjunctival surface cells and tear-film functions in cases with vitamin D deficiency. Methods Thirty-six patients with serum vitamin D deficiency and 27 control subjects with normal serum vitamin D levels were included in this prospective study. The tear break-up time (TBUT), Schirmer II test, and conjunctival impression cytology tests were performed to all participants. Results The mean serum vitamin D levels were 10.5 +/- 5.0 mu l in the study group and 33.9 +/- 11.7 mu l in the control group (p < 0.001). The median TBUT scores were 11 s and 17 s and the median Schirmer II values were 7.5 mm and 12 mm in the study and the control groups, respectively (p = 0.003, p = 0.049). According to the Nelson staging system, 69.4% of the patients in the study group had grade 2 or 3 impression cytology, whereas 18.5% of the participants in the control group had grade 2 or 3 impression cytology (p < 0.001). Conclusion Our study results showed that vitamin D deficiency may lead to dry eye causing conjunctival squamous metaplasia and loss of goblet cells on the ocular surface.Öğe Contribution of aspiration to the diagnosis of lung cancer in endobronchial ultrasound-guided fine-needle biopsy(Assoc Medica Brasileira, 2021) Guven, Arzu Nakis; Yalcinsoy, Murat; Akatli, Ayse Nur; Arslan, Ahmet KadirOBJECTIVE: Endobronchial ultrasound-guided transbronchial needle aspiration has been successfully applied in both diagnosis and staging of mediastinal and hilar lymphadenopathies and masses, especially in malignant cases. However, the optimal procedure of Endobronchial ultrasound-guided transbronchial needle aspiration to further increase diagnostic yield and minimize processing complexity remains controversial. This study aims to compare aspiration biopsy (Endobronchial ultrasound-guided transbronchial needle aspiration) and non-aspiration biopsy (Endobronchial ultrasound-guided transbronchial needle capillary sampling) in terms of sample adequacy, diagnosis, and quality in malignant cases. METHODS: Between March 2018 and June 2020, Endobronchial ultrasound- guided was performed sequentially on patients with mediastinal and/or hilar lymph nodes that were considered malignant. Each lymphadenopathy was sampled with and without aspiration. A single-blinded pathologist evaluated the samples. RESULTS: A total of 84 lymph nodes evaluations of 51 patients were included. Most samples were taken from the right lower paratracheal lymph nodes ( n=27, 32.2%) and subcarinal LN (n=21, 25%). The mean size of the lymph nodes was 21.21 +/- 8.257 (8-40) mm. The agreement between the two procedures in terms of sample adequacy and diagnostic yield was 69.1% (95%CI 58-78.7, p=0.076). In addition, according to the goodness-of-fit statistics, the kappa values were 0.255 (p=0.015) and 0.302 (p=0.004) for sample adequacy and diagnostic yield, respectively. There was no difference between the two procedures in relation to complications. CONCLUSION: Although the agreement between the two procedures is weak, Endobronchial ultrasound-guided transbronchial needle capillary sampling can be performed with less personnel, without reducing diagnostic yield and tissue adequacy. These findings can assist clinicians in determining the optimal procedure for Endobronchial ultrasound-guided.Öğe Cytological and cytomorphometric characteristics of buccal mucosa cells from smokeless tobacco users(Wiley, 2017) Dagli, Adile Ferda; Sahin, Nurhan; Bozdag, Zehra; Ucer, Ozlem; Akatli, Ayse Nur; Artas, Gokhan; Sahin, IbrahimBackgroundUse of smokeless tobacco (ST) is increasing in many communities. We investigated whether ST alters the cytological and cytomorphometric features of buccal mucosa cells. MethodsTwenty male participants who had used Nicotiana rustica Linn.-containing ST (Maras powder) for at least 10 years, and 20 healthy male controls who did not use ST, were included in this study. After rinsing the mouth with water, samples were taken using a toothbrush from the buccal mucosa of subjects in both groups. Samples were gently spread over a glass slide. After applying a cytofixative spray, the Papanicolaou method was used to stain the slides. The presence of dysplasia, dyskeratosis, parakeratosis, hyperkeratosis, hypergranulosis, karyorrhexis, and pyknosis was evaluated by light microscopy, as were the increment amount of candida, cocco-bacillus, and Leptotrichia buccalis. Cytomorphometric analysis was performed and at least 20 cells with well-defined borders were evaluated from each slide, and the cellular diameter (CD), nuclear diameter (ND), and nucleus/cytoplasm (N/C) ratio of the cells were analyzed using a 60x objective. ResultsOther than the presence of dysplasia and candida, all measured cytological parameters were significantly higher in the ST users than in the non-ST users. Furthermore, CD was lower while nuclear/cytoplasmic ratio was higher in the ST users than in those non-ST users. ConclusionCytological changes associated with the use of ST, include dyskeratosis, parakeratosis, hyperkeratosis, hypergranulosis, karyorrhexis, pyknosis together with increase in the bacterial population of cocco-bacillus and L. buccalis. There were no significant differences in patients with dysplasia in spite of reduction of CD, increased nuclear size and N/C ratio.Öğe Cytoprotective effects of molsidomine against methotrexate-induced hepatotoxicity: an experimental rat study(Dove Medical Press Ltd, 2019) Samdanci, Emine Turkmen; Huz, Mustafa; Ozhan, Onural; Tanbek, Kevser; Pamukcu, Esra; Akatli, Ayse Nur; Parlakpinar, HakanIntroduction and aim: Methotrexate (Mtx) is an antineoplastic and immunosuppressive drug that may cause hepatotoxicity, whereas molsidomine (Mol) is a vasodilating and antioxidant agent. This study aimed to investigate the potential protective effects of Mol in Mtx-induced liver toxicity in rats. Materials and methods: Forty Wistar albino rats were equally divided into five groups: control, Mol, Mtx, Mol Mtx, and Mtx Mol. Following treatment, the animals were sacrificed, and liver tissue samples were histopathologically evaluated using Roening grading and Bcl-2 antibody staining. Tissue oxidants, antioxidants, and serum transaminases were measured and statistically compared across all groups. Results: No hepatic fibrosis or steatosis was observed in any of the groups. In the Mtx group, grade 2 liver injury and score 2 Bcl-2 antibody staining were observed; however, in the Mol-Mtx group, these were lower (grade 1, score 1). There were no statistically significant differences in serum transaminase levels among groups. Malondialdehyde levels were higher in all rats that received Mtx, but no differences in myeloperoxidase levels were observed among the groups. Levels of tissue antioxidants, including superoxide dismutase, glutathione (GSH) peroxidase (GSH-Px), and reduced GSH, were significantly higher in the Mol-treated and Mol pre-treated groups. Catalan (CAT) levels were elevated in all Mol-treated groups, but only in that group were CAT levels statistically significantly higher than in the control group. Conclusion: Our results suggest that some oxidant levels could increase following Mtx administration in the liver, possibly contributing to liver damage, whereas Mol could mitigate the histopathological and biochemical effects of hepatotoxicity. However, molecular studies are required to understand the exact mechanisms of these alterations.Öğe Diagnostic Value of Conjunctival Impression Cytology and Nelson Grading in Evaluating Dry Eye Disease in Ankylosing Spondylitis(Mdpi, 2025) Yildirim, Tulay; Dikci, Seyhan; Akatli, Ayse NurBackground and Objectives: Ankylosing spondylitis (AS) is a chronic inflammatory disorder frequently associated with acute anterior uveitis; however, it may also predispose individuals to dry eye disease. We aimed to evaluate dry eye in AS participants employing both conventional tests and conjunctival impression cytology (Nelson grading) to compare their sensitivity in detecting ocular surface changes. Materials and Methods: This prospective case-control study enrolled 24 patients with AS and 27 age- and sex-matched healthy controls. Dry eye was evaluated using the Schirmer I test (measuring tear production), fluorescein tear break-up time (BUT, assessing tear film stability), the Ocular Surface Disease Index (OSDI) questionnaire (evaluating symptoms), and conjunctival impression cytology (analyzing ocular surface changes). Intergroup differences were assessed using non-parametric statistical methods, and their correlations with clinical variables were examined. Results: Nelson conjunctival cytology scores were significantly higher in AS patients than control subjects (1.63 +/- 0.92 vs. 0.74 +/- 0.86; p = 0.001), indicating greater conjunctival goblet cell loss and squamous metaplasia. In contrast, Schirmer, BUT, and OSDI observations did not differ significantly between AS and control subjects (all p > 0.05). Within AS, the Nelson cytology grade did not correlate accompanied by tear test observations or disease activity indices, and symptom scores did not align accompanied by Schirmer or BUT values. Conclusions: AS patients demonstrated evidence of subclinical dry eye changes detectable by impression cytology even when standard tests were normal. Conjunctival cytology was more sensitive than Schirmer, BUT, or symptom assessment in identifying ocular surface involvement in AS. Integrating such ocular surface evaluation into AS management could allow earlier diagnosis of dry eye and prompt intervention to improve patient quality of life.Öğe Effects of Noopept on Oxidative Stress Related Parameters in the Streptozotocin-Induced Diabetes Model(Wiley, 2022) Gurbuz, Perihan; Duzova, Halil; Kayhan, Basak; Cig, Bilal; Naziroglu, Mustafa; Akatli, Ayse Nur[Abstract Not Available]Öğe Emergency Laparoscopic Gastrectomy for Intraperitoneal Ruptured Gastric Gastrointestinal Stromal Tumor(Springer, 2019) Saglam, Kutay; Sumer, Fatih; Gokler, Cihan; Akatli, Ayse Nur; Kayaalp, Cuneyt[Abstract Not Available]Öğe An experimental rat model of electric shock injury with isolated electric shock and water conduction: the histopathological changes on the skin and internal organs and the effect on biochemical parameters(Springer, 2023) Dundar, Ahmet Sedat; Oruc, Mucahit; Celbis, Osman; Samdanci, Emine Turkmen; Akatli, Ayse Nur; Okumus, Hasan; Taskapan, CagatayIt is difficult to determine the cause of death in electric shock injuries when no trace can be determined on the skin, and this is accepted as a reason for negative autopsy. We aimed to determine useful parameters in the definition of the cause of deaths associated with electric shock and particularly those formed with water conduction. This study used a total of 42 rats, applied with fatal electric shock formed of isolated electric shock at 220 V and with water conduction. The serum NT-ProBNP and H-FABP levels were examined together with histopathological changes in the brain, cerebellum, brainstem, heart, liver and skin and the Bax, caspase-3 and HSP-60 antibody status in these tissues. A statistically significant difference was determined between the groups in respect of the serum H-FABP values and the immunohistochemical staining of the samples taken from the organs. In conclusion, this study is the first in literature with an experimental model of electric shock with water conduction. Using immunohistochemical and biochemical markers in deaths associated with isolated electric shock and electric shock with water conduction, the results of this study can contribute to the clarification of one of the reasons for negative autopsy in forensic medicine.Öğe Fascioliasis: A Rare Parasitic Infection-Mimicking Tumor in the Liver: Report of Two Cases(De Gruyter Poland Sp Zoo, 2019) Samdanci, Emine; Sahin, Nurhan; Dagli, Adile Ferda; Akatli, Ayse Nur; Aydin, Nasuhi EnginFascioliasis is a rarely encountered parasitic infection in Turkey that mainly affects the liver and bile ducts. Other defined localizations of the parasite are the lungs, gastrointestinal system, and subcutaneous fatty tissue. Two cases of female patients who presented to the hospital with abdominal pain and whose physical examination and laboratory findings were normal except peripheral eosinophilia, were detected to have liver masses with necrotic areas. Segmental hepatectomies were performed in both cases with the preliminary diagnosis of liver tumors. Upon microscopic examinations of the resection materials, necrotic granulomatous inflammation with eosinophilic reaction at the periphery and the parasite (Fasciola hepatica) were seen. Both cases were reported to be fascioliasis according to these findings. Two cases of fascioliasis mimicking malignancy in the liver are presented here together with literature findings.Öğe Histopathological gastric mucosal changes in patients using proton pump inhibitors(2020) Alan, Saadet; Akatli, Ayse NurAbstract: As a result of the widespread use of proton pump inhibitors (PPI), parietal cell hyperplasia/ hypertrophy (PCH/H) and a significant increase in fundic gland polyp (FGP) is observed in gastric mucosa in recent years. The aim of this study is to evaluate clinical and histopathological results of patients diagnosed with PCH/H and FGP. Clinical data and archieved slides of 60 patients who were diagnosed with PCH/H or FGP at our institution between 2012-2019 were reviewed. Of the patients included in the study , 40 were women and 20 were men. Thirty-three cases, diagnosed with PCH/H and 27 cases diagnosed with FGP were investigated. H. Pylori gastritis was seen in 6 cases. In one case with a FGP, micronodular-linear neuroendocrine cell hyperplasia was observed. The FGPs, developing in the later stages of PPI use, are identified by endoscopic and pathological findings. Enterocromafine cell-like hyperplastic changes can become apparent in patients using PPI. H. Pylori gastritis was found to be less common in patients diagnosed with FGP and PCH/H than in the general population.Öğe Incidental Hepatocellular Carcinoma after Liver Transplantation: Clinicopathologic Features and Prognosis(Mdpi, 2023) Ozdemir, Fatih; Ince, Volkan; Usta, Sertac; Carr, Brian I. I.; Bag, Harika G. G.; Akatli, Ayse Nur; Kahraman, Aysegul SagirBackground: The prognostic impact and clinicopathologic features of incidental hepatocellular carcinoma (iHCC) detected in explanted livers of patients undergoing liver transplantation (LT) has been a controversial issue in previous studies when compared with patients who are diagnosed with hepatocellular carcinoma (pdHCC) before LT. We aimed to review and compare these patient groups in a high-volume LT center. Methods: The present study involves a retrospective analysis of 406 HCC patients who received LT between January 2002 and April 2022. Among these patients, demographic data, histopathologic features and prognosis for iHCC and pdHCC were evaluated. Results: In our series, 406 patients' final diagnosis was HCC after they had received LT, nevertheless 54 patients in this HCC group were diagnosed incidentally after the pathological evaluation of the explanted livers. The etiology of the underlying liver disease between pdHCC (n = 352) and iHCC (n = 54) groups had some differences in our study population. Most of the patients in the pdHCC group had moderately differentiated tumors (45.7%). On the other hand, most of the patients in the iHCC group had well differentiated tumors (79.6%). There were 158 (44%) patients who met the Milan criteria in the pdHCC group while there were 48 (92%) patients in the iHCC group (p < 0.001). IHCC patients had statistically better 1, 3, 5 and 10 years disease-free and overall survival rates when compared with pdHCC patients. There was only 1 (1.8%) patient who had tumor recurrence in the iHCC group while 76 (21%) patients had tumor recurrence in the pdHCC group (p = 0.001). There is no disease free and overall survival difference when iHCC patients are compared with pdHCC patients who met the Milan criteria. Conclusion: It is the first study to show that iHCC patients may differ from pdHCC patients in terms of etiological features. IHCC tumors show better histopathologic features than pdHCC with low recurrence rate and iHCC patients have better survival rates than pdHCC patients.Öğe Lifesaving re-transplantation with liver paired exchange donor(Kare Publ, 2025) Celik, Neslihan; Karakas, Serdar; Akatli, Ayse Nur; Yilmaz, SezaiLiver re-transplantations (re-LTx) have been documented as high-risk operations considering technical and immunological challenges. However, improvements over the last two decades have increased success rates, bringing them closer to those of primary liver transplantations (LTx). At present, deceased organ shortage is a critical issue, and even potential live donors may not be suitable regarding vascular and biliary challenges, volume discrepancies, and ABO incompatibility for both primary and re-LTx. The hospital records of a patient who underwent two liver transplantations in our institution were evaluated retrospectively. A twelve-year-old girl with Progressive Familial Intrahepatic Cholestasis Type 3 underwent live-donor LTx with a graft from her mother. The patient required emergency re-LTx due to primary non-function of the graft, and there were no suitable deceased or live donors during that critical period. The patient was introduced to the liver paired exchange system and underwent a lifesaving re-LTx from an altruistic paired exchange donor. As a developing strategy, liver paired exchange transplantation is a reasonable solution to achieve the most suitable liver graft when it is most needed, especially in populations with very low deceased organ donation rates. There is a need for large studies to analyze the role and success of liver paired exchange transplantation in pediatric patients in urgent and elective situations.Öğe Long-term effects of orchiopexy and orchiectomy on the testes of rats with testicular torsion(Elsevier Sci Ltd, 2022) Tasci, Aytac; Uguralp, Sema; Akatli, Ayse Nur; Arslan, Ahmet Kadir; Karabulut, Aysun BayIntroduction Ischemia/reperfusion injury occurs after testicular torsion, levels of free oxygen radicals and inflammatory cytokines are increased in both the torsional and contralateral testis, leading to testicular injury. Objective The present study investigated whether orchiopexy or orchiectomy after testicular torsion was superior in terms of fertility potential in the long term. Study design Following 720 degrees, 4 h left testicular torsion, orchiectomy or orchiopexy was performed on 84 rats, which were then sacrificed and evaluated for testicular function at day 1, at 3 months and 6 months (n = 14 per group). An additional 14 rats were in the control group. Results Follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone levels were significantly lower in the orchiopexy group than the orchiectomy and control groups after 3 months. However, there were no significant differences in hormone parameters among the three groups after 6 months. The hormone levels, Johnsen score, seminiferous tubule diameter, and inducible nitric oxide synthase (iNOS) expression at 3 and 6 months were not significantly different between the orchiectomy group and controls. Histopathological analyses at 3 and 6 months indicated significant decreases in Johnsen score and seminiferous tubule diameter in the ipsilateral testis in the orchiopexy group. At 3 months, the level of iNOS expression in the contralateral testis was significantly lower in the orchiopexy group than in other groups. At 6 months, however, it was not significantly different between the orchiopexy and control groups. There were no significant differences in iNOS expression at 3 or 6 months in the orchiectomy group compared to controls. Discussion The ipsilateral testis in the orchiopexy group began to atrophy at 3 months, and the degree of atrophy became more evident at 6 months. The level of iNOS expression was low in the bilateral testis at 3 months in the orchiopexy group, and sperm in the contralateral testis were not yet functionally healthy. The level of iNOS expression in the ipsilateral testis decreased further at 6 months in the orchiopexy group, while that in the contralateral testis returned to the normal level. Conclusion Testicular functions were restored faster after orchiectomy compared to orchiopexy following testicular torsion. However, follow-up of the rats for 6 months demonstrated that orchiopexy or orchiectomy procedures conducted on the testicular torsion had no effect on future fertility potential after 4 h of torsion.
