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D Demirel

Publications and source records attributed to D Demirel.

10 recordsLinked to original sources

Prognostic significance of nuclear morphometry in renal cell carcinoma.

OBJECTIVE: To assess nuclear morphometry as a predictor of prognosis in patients with renal cell carcinoma (RCC). PATIENTS AND METHODS: The study included 65 consecutive patients with RCC who underwent radical nephrectomy and were followed up for a median (range) of 80 (27-138) months. Nuclear morphometry was assessed using a computer-assisted image analysis system on histological sections and characterized by five nuclear variables (area, perimeter, major and minor diameter, and form factor). From the patients' records and pathology specimens, the clinicopathological prognostic variables (histological type, Fuhrman grade and pathological stage) were recorded. The proliferative activity was assessed using immunohistochemical staining with Ki-67 antibody. RESULTS: Higher values of mean nuclear area, perimeter, and major and minor diameter were significantly related to higher nuclear grade, proliferative activity and advanced tumour stage. They were significant predictors of disease progression and survival, together with grade, stage, sarcomatoid histology and proliferative activity. Of all significant prognostic factors predicting progression-free survival, only stage was independent (T4 vs T1, hazard ratio 6.55, 95% CI 1.63-26.13, P=0.008). CONCLUSION: Although the significance of these preliminary results must not be overstated, nuclear morphometry might provide significant prognostic information in predicting survival and tumours at high risk of progression in RCC.

Adult↗

Prognostic significance of nuclear morphometry in superficial bladder cancer.

OBJECTIVE: To evaluate the significance of nuclear morphometry in predicting the clinical course in superficial (pTa and pT1) bladder cancer. STUDY DESIGN: The study included 73 patients with superficial transitional cell carcinoma of the bladder who were followed for a median of 21 months (range, 1-90). Nuclear morphometry was performed by a computer-assisted image analyzer system on hematoxylineosin-stained histologic sections and characterized by five nuclear variables: area, perimeter, major and minor diameter, and form factor. Patient charts and microscopic slides were reviewed to record tumor stage, grade and size. Tumor proliferative activity was assessed by immunohistochemical staining with Ki-67 antibody. RESULTS: None of the morphometric variables showed a significant relation to tumor progression and recurrence. Higher values of mean nuclear area, perimeter, and major and minor diameter were significantly related to higher grade and proliferative activity. Mean nuclear area and minor diameter were associated with advanced stage. Of established prognostic factors, only histologic grade was significant in predicting progression. CONCLUSION: The results suggest that nuclear morphometry may be valuable in determining proliferative activity and may be well correlated with histologic grade in superficial bladder cancer. However, like many other potential prognostic factors, it seems to be unreliable in predicting clinical behavior.

Adult↗

A histologic and histomorphometric evaluation of pulpal reactions following rapid palatal expansion.

The aim of this study was to investigate the effects of the heavy forces exerted by the rapid palatal expansion (RPE) appliance on the pulpal tissue of anchor premolar teeth and to evaluate these effects by histologic and histomorphometric methods. Materials consisted of 34 sound upper premolars, extractions of which were required as part of orthodontic treatment. Twenty-three teeth were extracted after RPE; the remaining 11 teeth, which had not undergone any orthodontic force, were taken as controls. After extraction, the teeth were prepared for histologic examination under light microscopy. Histomorphometric measurements were performed by using image analysis. The data gained were statistically evaluated by nonparametric tests. The null hypothesis was that there was no difference between pulpal tissues of control and test teeth with respect to different durations of RPE. Our results reveal that the null hypothesis was rejected. Of the parameters evaluated, vessel area and minimum and maximum vessel diameters showed significant differences among the groups. Especially the difference between the control and 3-month groups had marked statistical significance. In conclusion, forces applied by RPE appliances caused an adaptive vascular tissue response, as well as fibrotic changes, in the "affected" upper premolars.

Adolescent↗

Ovarian tumors of low malignant potential. Correlation of DNA index and S-phase fraction with histopathologic grade and clinical outcome.

BACKGROUND: DNA ploidy and/or S-phase fraction have been used as biologic predictors of aggressive behavior in a variety of solid tumors, including ovarian carcinomas. Recently, attention has focused on borderline lesions to determine if flow cytometry plays a role in separating potentially aggressive tumors from those which will pursue a more innocuous course. METHODS: Paraffin-embedded tissue from 42 tumors with low malignant potential (LMP) were analyzed by flow cytometry (FC) to determine the DNA index (DI) and S-phase fraction (SPF). These result were then correlated with conventional pathologic parameters (size, nuclear grade, architecture, and mitotic index) and with clinical parameters (stage and age). Statistical analysis was carried out using the Fisher's Exact and Kruskal-Wallis tests. RESULTS: Thirty-five cases (83.3%) were diploid, while 7 cases (16.7%) showed aneuploid stemlines, with a mean DI of 1.2 (range: 1.1-1.4). The mean SPF was 3.5% for the diploid tumors and 4.5% for the aneuploid tumors. Serous tumors comprised 74% of our cases; the remainder were either mucinous or endometrioid tumors. Complex solid architectural patterns were found in 29 tumors whereas high nuclear grade was seen in 24. A mitotic rate (MR) of 0-3/10 high power fields was seen in 29 tumors (69%), with only 5 having 10 or more mitotic figures. Aneuploidy statistically correlated with higher stage (P < 0.009). Marginal correlation was seen with a larger tumor size (P = 0.06). SPF showed a direct linear correlation with MR (P < 0.001). Also, smaller SPF's were seen in the serous tumors versus the mucinous and endometroid group (P < 0.05). Two patients with diploid and one patient with aneuploid stemlines had recurrent disease during the follow-up period. CONCLUSIONS: DI and SPF correlated with some of the histologic parameters we evaluated. DI and SPF, however, could not predict which tumor(s) would behave in a more aggressive fashion.

Adult↗

Malignant tumors arising in endometriosis: clinical-pathological study and flow cytometry analysis.

BACKGROUND: Malignant transformation to endometriosis is a well documented phenomenon that occurs most commonly in the ovaries with cancer arising in extra-ovarian endometriosis being a rare event. METHODS: A retrospective clinical-pathological evaluation of eleven cases with malignant tumors arising in endometriosis was performed to evaluate the prognostic impact of various factors. Nuclear DNA content (ploidy) was assessed through flow cytometric study. RESULTS: Ovarian origin was identified in eight cases and three were associated with extra-ovarian endometriosis. Histologic type was endometrioid carcinoma in ten patients. The eleventh case had high grade endometrial stromal sarcoma. All tumors were diploid with no relation to stage, grade, or clinical outcome. The S-phase fraction (SPF) was analyzed in nine patients and no correlation could be demonstrated with any histologic parameters or clinical outcome. CONCLUSIONS: The DNA content seems to have no association with the classical prognostic parameters in these cases.

Adult↗

Primary closure of gunshot wounds caused by high-velocity rifles.

Sixty gunshot injuries in 48 patients were treated in Mobile Surgical Hospital (30-bed capacity) of the Mountain and Commando Brigade in Hakkari, Türkiye, between May 1990 and May 1991. The David Sisk method was used for the classification of the injuries. Eleven type 1 injuries were treated conservatively, 39 type 2 and 10 type 3 injuries were treated by extensive debridement with suction drainage and primary closure. No infection was seen in type 1 injuries. The infection rate was 2.56% in type 2 and 20% in type 3 injuries. The following results were obtained: type 1 injuries must be treated by conservative measures; type 2 injuries must be treated by primary closure following extensive debridement and suction drainage; type 3 injuries can be treated by extensive debridement with suction drainage and primary closure.

Debridement↗

Endometrial squamous cell carcinoma.

Endometrial squamous cell carcinoma is an extremely rare female genital malignancy. Only 26 cases which fulfil the Fluhmann criteria have been reported in the literature. In this report, 2 cases of endometrial squamous cell carcinoma are presented, with a review of related current knowledge.

Carcinoma, Squamous Cell↗

Technetium-99m-MIBI and thallium-201 uptake in pulmonary actinomycosis.

A patient with pulmonary actinomycosis who unexpectedly showed focal uptake of technetium-99m-hexakis-2-methoxy isobutyl isonitrile and thallium-201 is presented. The appearance of the lesion on the chest radiograph and x-ray CT scan resembled a mediastinal tumor. The diagnosis of pulmonary actinomycosis was achieved by histopathologic examination of the surgically removed mass.

Actinomycosis↗

Cytologic diagnosis of complicated pulmonary unilocular cystic hydatidosis. A study of 131 cases.

OBJECTIVE: To determine the value of cytochemical stains and microscopic techniques for the detection of true hydatid elements (primary cytologic criteria) and to evaluate the efficacy of granulomatous elements (secondary cytologic criteria) for the diagnosis of complicated pulmonary unilocular cystic hydatidosis (CPUCH). STUDY DESIGN: Sputum, bronchial washing and bronchial brushing specimens obtained from 131 patients with a presumptive diagnosis of CPUCH were reviewed. RESULTS: CPUCH was histopathologically proven in 111 of 131 patients. Scolices were found in 11 patients in Papanicolaou-EA65 (PAP-EA65)-stained slides. Special stains and dark field microscopy (DFM) did not make any additional contribution to specifying the nature of the scolexlike objects. Hooklets were found in 26 patients in PAP-EA65-stained slides. Masson's trichrome stain and DFM revealed hooklets in 37 and 50 cases, respectively. Laminated membrane fragments were found in 14 patients in PAP-EA65-stained slides. Gomori's methenamine silver stain and DFM demonstrated laminated membrane fragments in 25 and 33 cases, respectively. Secondary cytologic criteria, such as multinucleated giant cells, degenerated squamous cells, dyskaryotic squamous cells, excessive amounts of eosinophils, plasma cells, lymphocytes, histiocytes, necrotic debris, fibrinoid material and erythrocytes, were considered to be suggestive of hydatid disease when there are more than three such factors in patients with a presumptive diagnosis of CPUCH. CONCLUSION: Though DFM examination is superior to cytochemical stains used in this study, both cytochemical stains and DFM are useful in increasing the sensitivity of cytologic detection of true hydatid elements, especially hooklets and laminated membrane fragments. They should be used as auxiliary techniques. Secondary cytologic criteria are suggestive of the diagnosis of CPUCH, and special care should be taken when there are more than three such factors in cytologic specimens.

Adolescent↗

Cementifying fibroma diagnosed by fine needle aspiration cytology. A case report.

A case of cementifying fibroma in the right lateral mandible was diagnosed by fine needle aspiration (FNA) cytology. The aspirate was a cellular specimen composed of clusters of oval and spindle-shaped fibroblasts with no atypical features. These cells were admixed with spherical, calcified structures. A diagnosis of "consistent with benign fibroosseous lesion, suggestive of cementoossifying fibroma" was made, and subsequent histologic examination confirmed this cytologic diagnosis. The clinical, cytologic and histologic findings in the case are presented, and the value of FNA cytology in the diagnosis of jaw lesions is discussed.

Adult↗