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Gomceli I.,Antalya Education and Research Hospital | Demiriz B.,Ankara Numune Education and Research Hospital | Tez M.,Ankara Numune Education and Research Hospital
World Journal of Gastroenterology | Year: 2012

Gastric cancer is the second most common cancer worldwide and the second most common cause of cancer-related deaths. Despite complete resection of gastric cancer and lymph node dissection, as well as improvements in chemotherapy and radiotherapy, there are still 700 000 gastric cancer-related deaths per year worldwide and more than 80% of patients with advanced gastric cancer die of the disease or recurrent disease within 1 year after diagnosis. None of the treatment modalities we have been applying today can influence the overall survival rates: at present, the overall 5-year relative survival rate for gastric cancer is about 28%. Cellular metaplasia due to chronic inflammation, injury and repair are the most documented processes for neoplasia. It appears that chronic inflammation stimulates tumor development and plays a critical role in initiating, sustaining and advancing tumor growth. It is also evident that not all inflammation is tumorigenic. Additional mutations can be acquired, and this leads to the cancer cell gaining a further growth advantage and acquiring a more malignant phenotype. Intestinalization of gastric units, which is called 'intestinal metaplasia'; phenotypic antralization of fundic units, which is called 'spasmolytic polypeptide-expressing metaplasia'; and the development directly from the stem/progenitor cell zone are three pathways that have been described for gastric carcinogenesis. Also, an important factor for the development of gastrointestinal cancers is peritumoral stroma. However, the initiating cellular event in gastric metaplasia is still controversial. Understanding gastric carcinogenesis and its precursor lesions has been under intense investigation, and our paper attempts to highlight recent progress in this field of cancer research. © 2012 Baishideng. All rights reserved. Source


Ozdemir O.,Zekai Tahir Burak Womens Health Education and Research Hospital | Erol M.K.,Antalya Education and Research Hospital
Cutaneous and Ocular Toxicology | Year: 2014

Context: Central serous chorioretinopathy (CSC). Objective: To evaluate the effect of intravitreal ranibizumab injection and the correlation between foveal morphologic changes and visual outcomes in patients with resolved CSC. Materials and methods: We measured outer nuclear layer (ONL) thickness, outer layer (OL) thickness and evaluated the integrity of the photoreceptor inner-outer segment (IS/OS) junction, the status of the external limiting membrane (ELM) at the central fovea using spectral-domain optical coherence tomography (OCT) in 35 eyes of 35 patients with resolved CSC. The eyes were divided into two groups: The initial medical treatment administered to Group1 (n=17) then received intravitreal ranibizumab injections, Group 2 (n=18) received medical treatment. Group 3 was composed of normal eyes (n=20, as a control). We also investigated a correlation between the ONL thickness and best corrected visual acuity (BCVA). Results: The mean age was 45.7± 7.2 (ranged from 27 to 55 years). The mean follow-up period was 14.2 months (minimum 6, maximum 24 months). The mean ONL and OL thickness in Group 1 were significantly thinner than Group 3 (p< 0.005). The ONL thickness was correlated with the BCVA (r=0.681, p=0.001). Thirty-tree patients had improvement in BCVA after treatment. Discontinuity of the IS/OS junction was found in 15 eyes (88.2%) in Group 1, in 5 eyes (27.7%) in Group 2 and in no eyes in Group 3. Discussion: We demonstrated that prolonged serous detachment results in photoreceptor cell loss (apoptosis) and thinning of the ONL. Thinning of the ONL correlates with poorer vision, which has been found by other investigators. Furthermore, vascular endothelial growth factor (VEGF) may be neuroprotective to the photoreceptors which might explain the additional thinning in the patients treated with ranibizumab. This raises the possibility that treatment with VEGF inhibitors may be unfavourable to patients with CSC, even though it speeds recovery and vision does improve. Conclusion: Intravitreal ranibizumab injection leads to thinning of the ONL and the OL in patients with resolved CSC. The ONL thickness reduction and discontinuity of the IS/OS junction results in poor visual prognosis in resolved CSC eyes. © 2014 Informa Healthcare USA, Inc. Source


Kaya V.,Suleyman Demirel University of Turkey | Yildirim M.,Ministry of Health Batman Regional Government Hospital | Demirpence O.,Ministry of Health Batman Regional Government Hospital | Yildiz M.,Antalya Education and Research Hospital | Yalcin A.Y.,Suleyman Demirel University of Turkey
Asian Pacific Journal of Cancer Prevention | Year: 2013

Background: In our study, the LDH, albumin, hemoglobin, neutrophile, thrombocyte, lymphocyte counts and prognostic significance of neutrophile-lymphocyte and thrombocyte-lymphocyte ratios in NSCLC derived from these counts obtained during regular examinations of patients were examined. Materials and Methods: Histopathologically diagnosed non-small-cell-lung cancer patients between 2008 and 2010 were included in the study. Before the treatment, full blood count including routine lymphocyte count, blood biochemistry examinations including liver (AST, ALT, total protein, Albumin), LDH and kidney (BUN, Cre) function tests were performed. Results: A total of 156 patients, 76 of whom (48.7%) were female and 80 of whom (51.3%) were male were included. Mean hemoglobin level was determined as 12. Overall survival was found to be significantly dependent on whether patients were anemic or not (p: 0.005). Mean LDH level was determined as 233.4. There was nosurvival difference between patients with and without high LDH (p: 0.532). In patients where NLR showed systemic inflammatory response, overall survival was 10.8 months whereas this duration was 19.6 months in patients where the systemic inflammatory response was negative (p: 0.012). In patients where TLR showed systemic inflammatory response, overall survival was 13.6 months whereas this duration was 21.9 months in patients where the systemic inflammatory response was negative (p: 0.04). Conclusions: Molecular methods have been changing rapidly in today's world and they manage the treatment besides defining the prognosis of patients. However, easily accessible and cheap laboratory parameters should be considered in the prognosis of patients besides these new methods. Source


Sari F.,Antalya Education and Research Hospital | Taskapan H.,Akdeniz University
International Urology and Nephrology | Year: 2012

Objective: Chronic renal failure is accompanied by various abnormalities of innate and acquired, cellular and humoral immunity. We aimed to investigate whether positive Candida skin test results, CD4+ and CD8+, before the first dose of vaccination could be a predictor for antibody response to hepatitis B vaccination and the relation of these parameters with hepatitis B antibody levels 1 month after the last dose of vaccination. Materials and methods: The present study was carried out in 57 dialysis patients. All patients received recombinant hepatitis B vaccine (40 μg) given intramuscularly in the deltoid muscle in a fourdose schedule at 0, 1, 2, and 6 months. Candida skin test and lymphocyte subsets (CD4? and CD8+) were determined before the first dose of vaccination and 1 month after the fourth inoculation of hepatitis B vaccine. Results: Ten patients (17.5%) were non-responders (HBsAb<10 IU/L), while 47 patients (82.5%) were responders (HBsAb ≥ 10 IU/L). However, 29 patients (50.9%) were weak responders (HBsAb:10-100 IU/L), 18 patients (31.6%) good responders (HBsAb>100 IU/L), which was determined 1 month after the fourth dose of vaccination. Thirty-nine patients (68.4%) and 44 patients (77.2%) were anergic to Candida skin test before the first dose and 1 month after fourth inoculation of hepatitis B vaccine, respectively. There was no relationship between Candida skin test and response to hepatitis B vaccination. Mean age was lower, and CD4+/CD8+ ratio measured both before and after vaccination was higher in good responders compared with that of weak responders and that of nonresponders. Females were better responders than males. Conclusion: High skin test anergy rate and low seroconversion rate after hepatitis B vaccination are important problems in patients on dialysis. Females, younger patients, and patients with higher CD4+/CD8+ ratio have better HBsAb antibody response to hepatitis B vaccination. © Springer Science+Business Media, B.V. 2012. Source


Ege T.,Gulhane Military Medical Academy | Kose O.,Antalya Education and Research Hospital | Koca K.,Gulhane Military Medical Academy | Demiralp B.,Gulhane Military Medical Academy | Basbozkurt M.,Gulhane Military Medical Academy
Skeletal Radiology | Year: 2013

Objective: The purpose of this study was to compare the measurements made using a smartphone accelerometer and computerized measurements as a reference in a series of 32 hallux valgus patients. Materials and methods: Two observers used an iPhone to measure the hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (of anteroposterior foot radiographs in 32 patients with symptomatic hallux valgus on a computer screen. Digital angular measurements on the computer were set as the reference standard for analysis and comparison. The difference between computerized measurements and all iPhone measurements, and the difference between the first and second iPhone measurements for each observer were calculated. Inter- and intraobserver reliability of the smartphone measurement method was also tested. Results: The variability of all measurements was similar for the iPhone and the computer-assisted techniques. The concordance between iPhone and computer-assisted angular measurements was excellent for the HVA, IMA, and DMAA. The maximum mean difference between the two techniques was 1.25 ± 1.02 for HVA, 0.92 ± 0.92 for IMA, and 1.10 ± 0.82 for DMAA. The interobserver reliability was excellent for HVA, IMA, and DMAA. The maximum mean difference between observers was 1.31 ± 0.89 for HVA, 0.90 ± 0.92 for IMA, and 0.78 ± 0.87 for DMAA. The intraobserver reliability was excellent for HVA, IMA, and DMAA. Conclusions: We conclude that the Hallux Angles software for the iPhone can be used for measurement of hallux valgus angles in clinical practice and even for research purposes. It is an accurate and reproducible method. © 2012 ISS. Source

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