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Varna, Bulgaria

Huellner M.W.,Lucerne Cantonal Hospital | Huellner M.W.,University of Zurich | Collen T.D.,Lucerne Cantonal Hospital | Gut P.,Lucerne Cantonal Hospital | And 8 more authors.
EJNMMI Research | Year: 2014

Background: The purpose of this study was to assess the relationship of CT-perfusion (CTP), 18F-FDG-PET/CT and histological parameters, and the possible added value of CTP to FDG-PET/CT in the initial staging of lung cancer. Methods: Fifty-four consecutive patients (median age 65 years, 15 females, 39 males) with suspected lung cancer were evaluated prospectively by CT-perfusion scan and 18F-FDG-PET/CT scan. Overall, 46 tumors were identified. CTP parameters blood flow (BF), blood volume (BV), and mean transit time (MTT) of the tumor tissue were calculated. Intratumoral microvessel density (MVD) was assessed quantitatively. Differences in CTP parameters concerning tumor type, location, PET positivity of lymph nodes, TNM status, and UICC stage were analyzed. Spearman correlation analyses between CTP and 18F-FDG-PET/CT parameters (SUVmax, SUVmean, PETvol, and TLG), MVD, tumor size, and tumor stage were performed. Results: The mean BF (mL/100 mL min-1), BV (mL/100 mL), and MTT (s) was 35.5, 8.4, and 14.2, respectively. The BF and BV were lower in tumors with PET-positive lymph nodes (p = 0.02). However, the CTP values were not significantly different among the N stages. The CTP values were not different, depending on tumor size and location. No significant correlation was found between CTP parameters and MVD. Conclusions: Overall, the CTP information showed only little additional information for the initial staging compared with standard FDG-PET/CT. Low perfusion in lung tumors might possibly be associated with metabolically active regional lymph nodes. Apart from that, both CTP and 18F-FDG-PET/CT parameter sets may reflect different pathophysiological mechanisms in lung cancer. © 2014 Huellner et al.


Kaya A.O.,Clinic of Medical Oncology | Kaya A.,Istanbul University
Turkiye Klinikleri Jinekoloji Obstetrik | Year: 2013

Carboplatin related hypersensitivity reactions usually occur following multiple infu sions. These infusions rarely cause acute or severe cutaneous reactions. Premedication therapy with dexamethasone and diphenhydramine are utilized to avoid possible side effects of this drug. The pa tient in our case study initially received six cycles of chemotherapy consisting of carboplatin plus paclitaxel as first line therapy between the dates of February 2010 and June 2010. However in Au gust 2011, the disease had reoccurred. The same treatment regimen was started due to the prior pla tinium sensitivity. Within the second minute of the third cycle of the chemotherapy carboplatin infusion, an erythematous cutaneous eruption appeared widely on the trunk and arms. The carbo platin infusion was immediately discontinued. Dexamethasone, diphenhydramine and ranitidine therapy was rapidly administered. In the two hour follow up examination, all the erythematous le sions disappeared. In this article, we will present the very early onset of carboplatin hipersensiti vity reaction in a female patient with relapsed ovarian cancer. Copyright © 2013 by Türkiye Klinikleri.


Guner O.S.,Clinic of General Surgery | Tumay L.V.,Clinic of General Surgery | Zorluoglu A.,Clinic of General Surgery | Orhan B.,Clinic of Medical Oncology
Turkiye Klinikleri Journal of Medical Sciences | Year: 2013

Objective: In general surgery, venous port catheters (VPC) are useful for maintaining long-term parenteral nutrition and protecting the venous system from trauma due to repeated access, such as in cancer patients. However, the most common users of this technique are cardiovascular surgeons and radiologists. The most popular route for long-term central venous catheterization is the subclavian vein, although it carries a 12% rate of peri-procedural complications. The aim of this retrospective study was to investigate the early and late complications associated with percutaneous insertion of VPCs by general surgeons and to compare the complication rates with those reported in the literature. Material and Methods: We investigated clinical and demographical data of 238 cancer patients who underwent totally implantable, indwelling, subclavian port catheterization in our General Surgery Clinic between March 2006 and December 2009. The port catheters implanted to the patients by the two experienced surgeons, using the same technique. Results: One patient developed pneumothorax (0.42%) and in 4 (1.68%) patients inadvertent subclavian artery puncture was occurred. Catheter migration developed in 3 (1.26%) cases, two caused by spontaneous catheter rupture (Pinch-off Syndrome) and the other one caused by catheter disconnection. Conclusion: In experienced hands, percutaneous implantation of an indwelling port catheter through the subclavian vein is safe with low complications and a high success rate. Good patient monitoring and a multidisciplinary approach are important for management of any likely complications. © 2013 by Türkiye Klinikleri.


Nicoli E.-R.,University of Medicine and Pharmacy of Craiova | Dumitrescu T.,University of Medicine and Pharmacy of Craiova | Uscatu C.-D.,University of Medicine and Pharmacy of Craiova | Popescu F.-D.,Carol Davila University of Medicine and Pharmacy | And 12 more authors.
Romanian Journal of Morphology and Embryology | Year: 2014

Autophagy has emerged not only as an essential repair mechanism to degrade damaged organelles and proteins but also as a major player in protection of tumor cells from multiple stresses. It was shown that autophagy gene polymorphisms are correlated with development of chronic inflammatory lesions, which represent a risk factor for colorectal tumors. In this study, we aimed to determine if ATG16L1 +898A>G (Thr300Ala) polymorphism is associated with an increased risk of developing colorectal cancer (CRC) and to establish correlations between ATG16L1 genotypes and the major clinical and morphological parameters. We observed that subjects carrying GG genotype were at a higher risk for CRC (OR 1.99, 95% CI: 1.02-3.91, p=0.039) when compared with the more frequent AA genotype, furthermore this was even more consistent in male subjects (OR 2.72, 95% CI: 1.11-6.63, p=0.019) but not in female subjects (OR 1.29, 95% CI: 0.43-3.86, p=0.652). In addition, we noticed a correlation between ATG16L1 GG genotype and tumor stage in moderately and poorly differentiated CRC cases. GG genotype carrying patients were at a higher risk for CRC (OR 5.19, 95% CI: 1.50-17.87, p=0.002) when compared with the more frequent AA genotype. Such correlation suggests a possible role of autophagy gene polymorphisms in the development of human colorectal cancer.


Dogu G.G.,Pamukkale University | Kargi A.,Clinic of Medical Oncology | Turgut S.,Pamukkale University | Ayada C.,Pamukkale University | And 6 more authors.
Gene | Year: 2012

We assessed whether single nucleotide polymorphisms (SNPs) in MDR1 gene C3435T predicted the outcome of platinum-based chemotherapies and survival in our non small cell lung cancer (NSCLC) patients. A total of 79 non-small cell lung cancer patients were enrolled to study. We determined the MDR1 C3435T single nucleotide gene polymorphisms. Median age was 60. years: 91.7% male, 8.9% female. We found that CC, CT, TT genotype and T, C allele frequencies in lung cancer patients as 24.1%, 62%, 13.9% and 44.3%, 55.7%, respectively. Patients with CT genotype had a higher response rate (11.4%) than the other genotypes. However, this difference is not statistically significant (. p=. 0.743). Cox regression analysis for overall survival showed that ECOG PS status 0 (HR PS 1 vs. 0, 5.68 . p=. 0.002; HR of PS 2 vs. 0 is 21.579, . p=. 0.001; HR of PS 3 vs. 0 is 35.35, . p=. 0.001), stage ≤. II (HR of stage III vs. I. +. II is 17.77; . p=. 0.016, HR of stage IV vs. I. +. II is 26.97, . p=. 0.006), and albumin level ≥. 3. g/dl (HR of albumin <. 3. g/dl vs. ≥. 3. g/dl is 2.46, . p=. 0.044) were the most important prognostic factors (also, time to progression was related to these factors). There was no significant association between the genotypes and clinicopathologic parameters; however, good performance status, early stage and ≥. 3. g/dl albumin level were found to be the most important prognostic factors for overall survival and progression-free survival. © 2012 Elsevier B.V.

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