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Öğe Aggressive natural killer cell leukemia in a patient with common variable immunodeficiency syndrome(Parthenon Publishing Group, 2006) Ayyildiz, Orhan; Altintas, Abdullah; Isikdogan, Abdurrahman; Tuzcu, Alpaslan[Abstract Not Available]Öğe Atypical skin metastases from early tubular breast carcinoma(Wiley-Blackwell, 2008) Cil, Timucin; Altintas, Abdullah; Pasa, Semir; Isikdogan, Abdurrahman[Abstract Not Available]Öğe BREAST CARCINOMA METASTASIS TO THE TAIL OF PANCREAS(Aves, 2009) Cil, Timucin; Altintas, Abdullah; Pasa, Semir; Urakci, Zuhat; Isikdogan, AbdurrahmanThe most common distant metastasis of breast cancer are detected in liver, lung, bone and brain. However, atypical organ metastasis is not uncommon. Isolated pancreas metastasis can be seen rarely as well. There have been only seven cases described in the literature. Here, we report extremely a rare case of breast cancer, which metastasizes to the pancreas tail. The patient has diagnosed as breast cancer four years ago, gradual increases in serum levels of CEA and Ca15-3 were detected (129 (0-4,3ng/ml) and 84 U/ml (0-25 U/ml) respectively) in routine follow-up. Although she had no symptoms, contrast-enhanced abdominal computerized tomography (CT) scan revealed a mass of 81mm x 79mm x 68mm, with a necrozis in the tail of the pancreas. No other metastatic sites were detected by gastric endoscopy, lung CT scan or bone scintigraphy. Percutan transabdominal biopsy from tail of pancreas was showed that metastasis of breast carcinoma. We propose that, when an increase is detected in tumor markers, such as CA15-3 or CEA, without any detectable metastasis in common metastatic organs, should be investigated other atypical metastatic areas such as pancreas.Öğe Cancer and thrombotic thrombocytopenic purpura(Ortadogu Ad Pres & Publ Co, 2008) Altintas, Abdullah; Cil, Timucin; Atay, A. Engin; Kaplan, M. Ali; Isikdogan, Abdurrahman; Ayyildiz, OrhanThrombotic thrombocytopenic purpura (TTP) is a rare and fatal disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurologic disorder, renal function deterioration and fever. TTP may be idiopathic or secondary to autoimmune diseases, drugs, cancer and infections. Clinical findings of TTP are also present in cancer patients with disseminated intravascular coagulation and sepsis. TTP must be considered in the differential diagnosis in the case of concurrent microangiopathic hemolytic anemia and thrombocytopenia with or without leukoerythroblastic blood smear in cancer patients. Here we presented two patients who were followed up in our clinic with TTP secondary to metastatic breast cancer.Öğe A case of essential mixed cryoglobulinemia and associated acquired von-Willebrand disease treated with rituximab(Springer, 2009) Pasa, Semir; Altintas, Abdullah; Cil, Timucin; Danis, Ramazan; Ayyildiz, Orhan; Muftuoglu, EkremCurrent treatment options of essential mixed cryoglobulinemia (EMC); include immunosuppressive approaches, such as corticosteroids, cyclophosphamide, plasma exchange, other cytotoxic drugs in moderate to severe manifestations. Some controlled studies have been carried out to assess the efficacy of anti-CD20 monoclonal antibody, rituximab in patients with hepatitis C (HCV) related cryoglobulinemia (CG) and in patients with autoimmune disorders. Recent trials and some case reports demonstrate a beneficial role for rituximab in HCV related mixed CG. Although, the published evidence for treatment of EMC with rituximab is restricted to case reports, which have shown positive results. Several diseases include lymphoproliferative and myeloproliferative disorders, solid tumors, immunological disorders, cardiovascular disorders and some drugs associated with acquired von Willebrand disease (avWD). CG, which is a kind of immune complex disease, may be related with development of autoantibodies to various autoantigens. In this present case report, we showed the efficacy of rituximab in a 21-year-old female patient, suffered from neuropathy and arthralgia related with EMC, and developed avWD, presented with mucosal bleeding associated with CG. von Willebrand factor activity of our patient also increased with controlling the underlying disease, EMC by rituximab. This case demonstrate that rituximab may be an effective treatment option in EMC and avWD mainly related to CG.Öğe A Case of neuroleptic malignant syndrome accompanied to an atypical antipsychotic agent: Risperidone(Elsevier Science Bv, 2008) Pasa, Semir; Sayhan, Mustafa Burak; Boyraz, Taylan; Urakci, Zuhat; Altintas, Abdullah[Abstract Not Available]Öğe A Case of Polycythemia Vera Accompanied with Neurofibromatosis Type 1(Akad Doktorlar Yayinevi, 2010) Pasa, Semir; Altintas, Abdullah; Bayan, Kadim; Tuzun, Yekta; Cil, Timucin; Ayyildiz, OrhanClassical myelofibrosis syndromes (MPS) most frequently occur in adults, but MPS unique to childhood also exist. Such syndromes include juvenile chronic myelomonocytic leukemia (JMML), the MPS of monosomy 7 in childhood, familial chronic myeloid leukemia (CML), the transient MPS of infants with trisomy 21, and childhood forms of myelofibrosis. Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disorder with pigmentary abnormalities and are predisposed to benign and malignant neoplasms, mostly in children. MPSs were disproportionately common among children with NF1. Herein we reported a case of polycythemia vera (PV) accompanied to NF1 in an adult patient. The co-existance of NF1 and childhood MPS is a well known condition. The same relation was not demonstrated in adulthood NF1 patients according to our screening of the literature. Most of the reported cases were define a relation with JMML and monosomy 7 syndrome. Probably this is the first case of PV, a type of classic adult MPS accompanied to NF1.Öğe Central nervous system blastic crisis in chronic myeloid leukemia on imatinib mesylate therapy: a case report(Springer, 2007) Altintas, Abdullah; Cil, Timucin; Kilinc, Ilhan; Kaplan, Muhammet Ali; Ayyildiz, OrhanChronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by a reciprocal translocation between chromosomes 9 and 22. Imatinib mesylate is a potent and selective inhibitory of the BCR/ABL tyrosine kinase. Imatinib is a first choice of treatment of chronic phase CML. It has also shown activity in patients with CML in accelerated or blastic phases. However, the penetration of the drug and its active metabolites into the central nervous system (CNS) is poor. Therefore, the CNS is sanctuary site for malignant cells in patients treated with imatinib. Herein, we report a patient with CML in accelerated phase that developed central nervous system disease while on imatinib mesylate therapy.Öğe Clinical characteristics of gastrointestinal stromal tumors in southeast region of Turkey(Oxford Univ Press, 2006) Cil, Timucin; Altintas, Abdullah; Kaplan, Mehmet A.; Ayyildiz, Orhan; Sayar, Suleyman; Akgun, Yilmaz; Isikdogan, Abdurrahman[Abstract Not Available]Öğe Clinical outcome of patients with hairy cell leukemia(Oxford Univ Press, 2006) Altintas, Abdullah; Cil, Timucin; Ayyildiz, Orhan; Atay, Ahmet E.; Kaplan, Mehmet A.; Isikdogan, Abdurrahman; Muftuoglu, Ekrem[Abstract Not Available]Öğe A comprehensive analysis of 12 thrombophilic mutations and related parameters in patients with inflammatory bowel disease(Springer, 2006) Yilmaz, Serif; Bayan, Kadim; Tuezuen, Yekta; Batun, Sabri; Altintas, AbdullahBackground Possible association of inflammatory bowel disease (IBD) with the most common inherited prothrombotic conditions has been the focus of many investigations. Advance in modern molecular biology is expanding the thrombophilia evaluation steadily. We tried to put forward a comprehensive thrombophilic profile in IBD and to see the probable role of this profile in pathogenesis. Methods A total of 60 adults (33 patients and 27 healthy controls) were included. We used the CVD-StripAssay which is based on the reverse-hybridization principle to identify a total of 12 thrombophilic gene mutations: Factor V R506Q, Factor V H1299R, prothrombin G20210A, Factor XIII V34L, beta-Fibrinogen-455 G-A, PAI-1 4G/5G, platelet GPIIIa L33P, MTHFR C677T, MTHFR A1298C, ACE I/D, Apo B R3500Q and Apo E2/E3/E4, respectively. Besides, we evaluated many related blood parameters such as protein C, protein S, AT-III, IL-6, TNF-alpha, Apo-A1, Apo-B100, homocysteine (tHcy) etc. using commercially available assays. Results The frequencies of genetic polymorphisms were found to be statistically insignificant among patients and controls, except for three: Beta-Fibrinogen-455G-A, MTHFR A1298C and ACE-I/D. Two patients with a history of deep venous thrombosis had more than one polymorphism. Patients with MTHFR C677T and MTHFR A1298C gene mutations had a similar mean tHcy levels with controls. Patients with Apolipoprotein B R3500Q and Apolipoprotein E4 gene mutations had similar mean LDL-cholesterol levels. Mean total cholesterol and triglyceride levels were similar in patients and controls of Apo E2, E3, E4 alleles. Conclusion Predominantly, the presence of genetic mutations that predispose to hypercoagulable states does not appear to be in correlation with IBD. There was a statistical difference between the proportions of the mutated allele frequencies of Beta-Fibrinogen-455G-A, MTHFR A1298C and ACE-I/D in IBD.Öğe Cranial Involvement in a Follicular Lymphoma Patient with Systemic Complete Remission After Yttrium-90-Ibritumomab-Tiuxetan Treatment: Scientific Letter(Ortadogu Ad Pres & Publ Co, 2008) Cil, Timucin; Altintas, Abdullah; Pasa, Semir; Kilinc, Ilhan; Isikdogan, AbdurrahmanNon-Hodgkin's lymphoma is a heterogeneous group of lymphoproliferative disorders with varying patterns of behavior and treatment responses. Advances in understanding of tumor biology have made it possible to exploit novel treatment strategies such as monoclonal antibodies and their conjugation with radioimmunotherapy was recommended in patients with first relapse of low-grade lymphomas such as follicular lymphoma after rituximab containing chemotherapy. Treatment with radioimmunotherapy such as yttrium-90-ibritumomab-tiuxetan utilizes a monoclonal anti-CD20 antibody to deliver beta-emitting yttium-90 to the malignant B-cells. Clinical trials have demonstrated its efficacy, which is largely independent of the intrinsic activity of the anti-CD20 antibody. Relapses of nodal lymphomas usually occur in extra lymphoid areas. Central nervous system (CNS) involvement develops in less than 1% of patients with lymphomas. Herein, we are presenting a rare case of CNS involvement of follicular lymphoma in a patient who has achieved systemic complete remission after yttrium-90-ibritumomab treatment.Öğe Cytosine-arabinoside induced bradycardia in patient with non-Hodgkin lymphoma: A case report(Taylor & Francis Ltd, 2007) Cil, Timucin; Kaplan, M. Ali; Altintas, Abdullah; Pasa, Semir; Isikdogan, Abdurrahman[Abstract Not Available]Öğe Distribution of ABO and Rh Blood Groups in Diyarbakir(Akad Doktorlar Yayinevi, 2008) Temiz, Hakan; Altintas, Abdullah; Gul, KadriThe detection of ABO and Rh system is important in transfusion medicine. In this study, we aimed to detect the profile of ABO and Rh blood groups in Diyarbakir region and provide new data on this subject. Among 206.673 individuals who applied to blood centers in Diyarbakir; 75.547 were (36.55%) A Rh(+), 61.385 were (29.70%) O Rh(+), 34.417 were (16.65%) B Rh(+), 12.944 were (6.26%) AB Rh(+), 8.806 were (4.26%) A Rh(-), 8.183 were (3.95%) O Rh(-), 3.897 were (1.88%) B Rh(-), 1.494 were (0.72%) AB Rh(-) blood group and Rh positivity was found in 184.293 cases (89.17%), as Rh(-) negativity was found in 22.380 cases (10.82%). There was little differences between the results of other regions of Turkey but blood group distribution in our region was similar with the results of all over the Turkey.Öğe Disturbances of hematologic malignancies between 1995-2005: A single center experience from southeastern region of Turkey(Elsevier, 2006) Altintas, Abdullah; Kaplan, Mehmet Ali; Cil, Timucin; Atay, Ahmet Engin; Isikdogan, Abdurrahman; Ayyildiz, Orhan; Muftuoglu, Ekrem[Abstract Not Available]Öğe Ectopic lingual thyroid as a rare cause of primary hypothyroidism - A case report(Lippincott Williams & Wilkins, 2008) Pasa, Semir; Beyaz, Coskun; Arikan, Senay; Altintas, Abdullah; Gokalp, Deniz; Cil, Timucin; Tuzcu, AlparslanEctopic lingual thyroid gland is all uncommon abnormality of migration of the thyroid gland. Although it is uncommon, it is often found in the region of the foramen cecum as a lingual thyroid at the base of the tongue in patients whose gland fails to descend. The true incidence of lingual thyroid is unknown. Treatment depends on the presence of symptoms. In this case report, we described a 17-year-old mail who presented with growth retardation due to severe hypothyroidism associated with a lingual thyroid gland. He did not complain of pressure symptoms. We recommended regular follow-up visits to monitor this state of thyroid function and the size and shape of the gland. We wanted to note that ectopic thyroid tissue should be taken into consideration in the differential diagnosis of all lingual and pharyngeal masses, and in the differential diagnosis of hypothyroidism.Öğe The effects of nonsteroidal anti-inflammatory drugs on platelet function and severity of upper gastrointestinal haemorrhage(Springer, 2009) Pasa, Semir; Bayan, Kadim; Kucukoner, Mehmet; Tuzun, Yekta; Altintas, Abdullah; Cil, Timucin; Danis, RamazanNonsteroidal anti-inflammatory drugs (NSAIDs) cause gastrointestinal (GI) damage primarily due to the inhibition of prostaglandin synthesis in gastric mucosa, which is an important factor in mucosa protection. Platelets are a cardinal feature of vascular repair. A variety of angiogenic stimulators are stored in platelets and are released during clotting at the wound. When there is a defect in any of these functions and/or platelet number, haemostasis is usually impaired and there may be an associated increased risk and severity of bleeding. While the mechanism of mucosal injury and bleeding are well documented with the use of NSAIDs, very little is known about the platelet function abnormalities and their effects on severity of upper GI bleedings. We performed a prospective analysis of 49 patients who had a history of NSAIDs use to investigate the association between the platelet function impairment associated with NSAIDs and severity of upper GI haemorrhages. Thirty-six of 49 patients (73.5%) had deteriorated platelet function. Mean severity score of patients with deteriorated platelet functions was 3.39, and that of patients with normal platelet functions was 2.46. Mean severity score was statistically significantly higher in patients with deteriorated platelet functions. In conclusion, impaired platelet functions associated with NSAIDs may cause more severe upper GI bleeding. Clinicians should be alert for GI complications especially in older patients and in those with a history of ulcer bleeding.Öğe The efficacy of rituximab in patients with splenectomized refractory chronic idiopathic thrombocythopenic purpura(Springer, 2009) Pasa, Semir; Altintas, Abdullah; Cil, Timucin; Danis, Ramazan; Ayyildiz, OrhanThe most difficult problem a physician encounters is the management of patients with idiopathic thrombocytopenic purpura (ITP), who has persistent severe thrombocytopenia after failure of initial treatment with glucocorticoids and splenectomy. Most of the patients refractory to corticosteroids and splenectomy will become refractory to other available agents, such as intravenous immunoglobulin (IVIg), danazol or chemotherapy. In this study, we investigated the effect of rituximab on 17 splenectomized refractory chronic ITP patients. Here, we showed that the anti-CD20 antibody, rituximab, induces a clinically significant response in severe chronic ITP patients, who are unresponsive to other therapeutic options. After sixth month, 10 out of 14 responders were still maintaining their durable and significant platelet responses (platelet counts > 50 x 10(9)/l), without requirement to any other ITP medication. Therefore, we suggest that, rituximab is an effective treatment option in splenectomized refractory or relapsed ITP patients. Rituximab was well tolerated without severe side effects.Öğe Eosinophilia and related hematological disorders(Ortadogu Ad Pres & Publ Co, 2007) Altintas, Abdullah; Oezmen, Sehmus; Ayyildiz, OrhanEosinophilia is defined by an eosinophile count of >600/mm(3); it may be primary or secondary due to the underlying cause. End-organ damage may develop in familial form as well as primary or secondary eosinophilia and it may also develop regardless of a specific cause in severe or mild eosinophilia;. Recently, the pathogenesis of clonal hypereosinophilia is well recognized and different variants are defined.Öğe The evaluation of effects of demographic features, biochemical parameters, and cytokines on clinical outcomes in patients with acute renal failure(Taylor & Francis Ltd, 2007) Kadiroglu, Ali Kemal; Sit, Dede; Atay, A. Engin; Kayabasi, Hasan; Altintas, Abdullah; Yilmaz, M. EminAim. To evaluate the effects of cytokines, biochemical parameters and demographic features on clinical outcomes of acute renal failure (ARF). Patients and Methods. 59 patients with acute renal failure (28 men, 31 women) were enrolled to the study. Cytokines, biochemical parameters, and complete blood count were measured. Patients were divided into two groups: as survivors (group 1, n = 46) and nonsurvivors (group 2, n = 13). Results. Mean age of patients were 52.3 +/- 17.9 years. 46 patients survived (77.9%) and 13 patients died (22. 1 %). There was a statistically significant relationship between IL-2R, IL-6, and TNF-oc levels and mortality rates (p = 0.004, p = 0.016, p = 0.020, respectively) and between TC levels and mortality rates (p = 0.041). In multivariable logistic regression analysis, the effects of proinflammatory cytokines (IL- I beta, IL-2R, IL-6, TNF alpha, CRP, and ESR) on the clinical outcomes in ARF was observed to be statistically significant (r = 0.341, p = 0.005). Conclusion. We realized that in totally demographic features (male gender, advanced age, poor nutritional status), biochemical parameters (TC, albumin, and hemoglobin) and cytokine levels (IL-2R, IL-6, TNF-oc), CRP and ESR may be predictive factors for mortality in patients with ARF.
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