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    Glial cell line-derived neurotrophic factor and synaptophysin expression in pelviureteral junction obstruction
    (Elsevier Science Inc, 2006) Demirbilek, S; Edali, MN; Gürünlüoglu, K; Türkmen, E; Tas, E; Karaman, A; Akin, M
    Objectives. To examine the expression of neuronal markers in congenital pelviureteral junction (PUJ) obstruction as a causative factor. The findings from some investigations have suggested that defective neuronal innervation may play an important role in the pathogenesis of PUJ obstruction. Methods. Using specific antibodies, we studied the neuronal markers of specimens from 12 cases of PUJ obstruction and 10 normal PUJs by immunohistochemistry using glial cell line-derived neurotrophic factor (GDNF), synaptophysin, S-100, and neurofilament. Results. In the PUJ obstruction specimens, staining with hematoxylin-eosin and Masson's trichrome revealed muscular hypertrophy and an increase in collagen tissue and fibrosis in the lamina propria and tunica muscularis. The most striking finding on immunohistochemistry was the marked nuclear staining of cells with synaptophysin in all layers of the PUJ obstruction specimens that was totally absent in the normal PUJ specimens. In addition, significantly less intense staining for GDNF was found in the PUJ obstruction specimens compared with the normal PUJ specimens. The underexpression of GDNF in PUJ obstruction specimens was localized in the muscular layer especially. Immunohistochemical staining for S-100 and neurofilament showed no differences in the expression level of these neuronal markers in normal and PUJ obstruction specimens. Conclusions. Because GDNF is a survival factor for central and peripheral neurons, defective expression of GDNF could play an important role in the defective neuronal innervation of PUJ obstruction. Intense nuclear expression of synaptophysin in all layers of obstructed PUJ specimens suggested that obstructed PUJs have a serious structural abnormality.
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    Obstructive congenital gingival granular cell tumour
    (Elsevier Ireland Ltd, 2004) Bilen, BT; Alaybeyoglu, N; Arslan, A; Türkmen, E; Asian, S; Çelik, M
    Congenital gingival granular cell tumours; (CGCT) are rare and always benign intraoral tumours originating from the alveolar ridge. They are also known as congenital epulis, congenital myobtastoma or Neumann's tumour. They are typically seen as a mass protruding out of a newborn child's mouth. In general., CGCT occurs as a solitary tumour. The main differential diagnosis is epignathus (oral teratoma). This report describes a newborn with a mass originating from tower alveolar ridge obtruding into the oral cavity. Clinical features, histiogenesis and necessity for early surgical treatment due to risk of airway obstruction and difficulty in feeding were discussed. (C) 2004 Elsevier Ireland Ltd. All rights reserved.
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    Spindle cell lipoma in an intramuscular lipoma
    (Blackwell Publishing Asia, 2004) Usta, U; Türkmen, E; Mizrak, B; Yildiz, D; Güzel, Z
    Intramuscular lipoma (IML) is a relatively common variant of lipomas. The most important sites for IML are the large muscles of the extremities. Spindle cell lipoma (SCL) is a rare and distinct variant of lipoma. Most SCL arise in the neck, shoulders or back. It has also been described in unusual sites, such as the oral cavity, larynx, bronchus, breast, orbit and extremities. However, localization of a SCL in an IML has not been described yet. Thus, we present the first SCL located in an IML, which was localized underneath the fascia and embedded within the left sartorius muscle of a 55-year-old man. Microscopically, the SCL component of the tumor was sharply circumscribed by a fibrous capsule and clearly seperated from the IML in which it was localized. The collagen-forming spindle cells of the SCL showed neither atypia nor pleomorphism. These cells stained positive for CD34, while the mature fat tissue component of the SCL was positive for S-100 protein and negative for CD34. Spindle cells were negative for S-100 protein. Vimentin stained both components of the SCL, as well as the striated muscle fibers and mature fat tissue of the IML. In conclusion, careful morphological observation along with immunohistochemistry for CD34 and S-100 protein are essential to differentiate this rare tumor from lesions that enter the differential diagnosis.