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Öğe Akciğer kanserine bağlı hipertrofik osteoartropati: Olgu sunumu(2007) Özen, Alaattin; Alas, Ruşen Coşar; Koçak, Zafer; Argın, Gülden Bayır; Saynak, Mert; Uzal, Mustafa Cem; Üregen, BurcuMalign hastalıklar çeşitli paraneoplastik romatolojik sendromlara yol açabilir. Bu sendromlardan biri olan hipertrofik osteoartropati (HPO) çoğunlukla toraks içi malignitelere ve en sık olarak da akciğer kanserine bağlı olarak ortaya çıkar. Hipertrofik osteoartropati çomak parmak ve periostal yeni kemik oluşumu ile kendini gösterir. En önemli klinik bulgusu bilateral bacak ağrısıdır. Hastalığın patogenezi henüz aydınlanmamıştır. Kemik sintigrafisi tanı için duyarlı bir yöntemdir. Bu yazıda, ileri evre küçük hücreli dışı akciğer kanseri tanılı 49 yaşındaki bir erkek hastanın hipertrofik pulmoner oseoartropati bulguları bildirilmiş ve bu konudaki literatür bilgisi özetlenmiştir.Öğe An ambiguous phenomenon of radiation and drugs: Recall reactions(Karger, 2007) Caloglu, Murat; Yurut-Caloglu, Vuslat; Cosar-Alas, Rusen; Saynak, Mert; Karagol, Hakan; Uzal, CemThe term 'radiation recall' describes an acute inflammatory reaction in previously irradiated areas after the administration of certain inciting systemic agents. It was first described in 1959 by D'Angio that dermatitis is related to the application of actinomycin D on the skin. Though this reaction occurs frequently on the skin, it may also be seen in the oral mucosa, the larynx, esophagus, small intestine, lungs, muscle tissue, and brain. Most drugs associated with recall reactions are cytotoxics, however, several other drugs may also elicit the phenomenon. Although this phenomenon is well known, its etiology is not understood. Radiation recall reactions are generally associated with megavoltage radiotherapy. The time interval between the completion of radiotherapy and the recall reaction ranges from days to years. The recall reaction occurs on average 8 days (3 days to 2 months) after the application of the promoting agent. Although no standard treatment exists, some authors suggest discontinuation of the inciting drug and the use of corticosteroids or nonsteroidal anti-inflammatory agents.Öğe Amifostine use in radiation-induced kidney damage(Springer Heidelberg, 2008) Kaldir, Mine; Cosar-Alas, Rusen; Cermik, Tevfik Fikret; Yurut-Caloglu, Vuslat; Saynak, Mert; Altaner, Semsi; Caloglu, MuratPurpose: To assess the degree of protective effects of amifostine on kidney functions via semiquantitative static renal scintigraphy and histopathologic analysis. Material and Methods: 30 female albino rats were divided into three equal groups as control (CL), radiotherapy alone (RT), and radiotherapy + amifostine (RT+AMI). The animals in the CL and RT groups were given phosphate-buffered saline, whereas the animals in the RT+AMI group received amifostine (200 mg/kg) by intraperitoneal injection 30 min before irradiation. RT and RT+AMI groups were irradiated with a single dose of 6 Gy using a Co-60 unit at a source-skin distance of 80 cm to the whole right kidney. They were followed up for 6 months. CL, RT, and RT+AMI groups underwent static kidney scintigraphy at the beginning of the experiment and, again, on the day before sacrificing. Histopathologically, tubular atrophy and fibrosis of the kidney damage were evaluated. Results: After irradiation, the median value of right kidney function was 48% (44-49%) and 50.5% (49%-52%) in RT and RT+AMI groups, respectively (p = 0.0002). Grade 1 kidney fibrosis was observed to be 60% in the RT group, while it was only 30% in the RT+AMI group. Grade 2 kidney fibrosis was 30% and 0% in the RT and RT+AMI group, respectively. Grade 1 tubular atrophy was 70% and 50% in the RT and RT+AMI group, respectively. Grade 2 tubular atrophy effect was the same in both groups (10%). Conclusion: Static kidney scintigraphy represents an objective and reproducible method to noninvasively investigate kidney function following irradiation. Amifostine produced a significant reduction in radiation-induced loss of renal function.Öğe Assessing the impact of radiation-induced changes in soft tissue density/thickness on the study of radiation-induced perfusion changes in the lung and heart(Amer Assoc Physicists Medicine Amer Inst Physics, 2012) Lawrence, Michael V.; Saynak, Mert; Fried, David V.; Bateman, Ted A.; Green, Rebecca L.; Hubbs, Jessica L.; Jaszczak, Ronald J.Purpose: Abnormalities in single photon emission computed tomography (SPECT) perfusion within the lung and heart are often detected following radiation for tumors in/around the thorax (e. g., lung cancer or left-sided breast cancer). The presence of SPECT perfusion defects is determined by comparing pre- and post-RT SPECT images. However, RT may increase the density of the soft tissue surrounding the lung/heart (e. g., chest wall/breast) that could possibly lead to an apparent SPECT perfusion defect due to increased attenuation of emitted photons. Further, increases in tissue effective depth will also increase SPECT photon attenuation and may lead to apparent SPECT perfusion defects. The authors herein quantitatively assess the degree of density changes and effective depth in soft tissues following radiation in a series of patients on a prospective clinical study. Methods: Patients receiving thoracic RT were enrolled on a prospective clinical study including pre- and post-RT thoracic computed tomography (CT) scans. Using image registration, changes in tissue density and effective depth within the soft tissues were quantified (as absolute change in average CT Hounsfield units, HU, or tissue thickness, cm). Changes in HU and tissue effective depth were considered as a continuous variable. The potential impact of these tissue changes on SPECT images was estimated using simulation data from a female SPECT thorax phantom with varying tissue densities. Results: Pre- and serial post-RT CT images were quantitatively studied in 23 patients (4 breast cancer, 19 lung cancer). Data were generated from soft tissue regions receiving doses of 20-50 Gy. The average increase in density of the chest was 5 HU (range 46 to -69). The average change in breast density was a decrease of -1 HU (range 13 to -13). There was no apparent dose response in neither the dichotomous nor the continuous analysis. Seventy seven soft tissue contours were created for 19 lung cancer patients. The average change in tissue effective depth was +0.2 cm (range -1.9 to 2.2 cm). The changes in HU represent a <2% average change in tissue density. Based on simulation, the small degree of density and tissue effective depth change is unlikely to yield meaningful changes in either SPECT lung or heart perfusion. Conclusions: RT doses of 20-50 Gy can cause up to a 46 HU increase in soft tissue density 6 months post-RT. Post-RT soft tissue effective depth may increase by 2.0 cm. These modest increases in soft tissue density and effective depth are unlikely to be responsible for the perfusion changes seen on post-RT SPECT lung or heart scans. Further, there was no clear dose response of the soft tissue density changes. Ultimately, the authors findings suggest that prior perfusion reports do reflect changes in the physiology of the lungs and heart. (C) 2012 American Association of Physicists in Medicine. [http://dx.doi.org/10.1118/1.4766433]Öğe Awareness of Invasive Micropapillary Breast Carcinoma is an Essential Requirement(Galenos Publ House, 2023) Nurlu, Dilek; Saynak, Mert; Ozler, Talar; Cosar, Rusen[Abstract Not Available]Öğe Böbrek hücreli karsinomda mediastinal lenf nodu metastazı: Olgu sunumu ve literatür derlemesi(2006) Alas, Coşar Ruşen; Saynak, Mert; Çaloğlu, Yürüt Vuslet; Çaloğlu, Murat; Karagöl, Hakan; İbiş, Kamuran; Uzal, Mustafa CemBöbrek hücreli karsinom böbreğin en sık görülen malign tümörüdür ve yetişkinlerdeki böbrek tümörlerinin %90-95'ini oluşturur. Tanı sırasında hastaların %30'unda uzak organ yayılımı vardır. Tanı anında uzak yayılım olması kötü prognozun güçlü bir göstergesidir. Yayılım lenf yoluyla ya da kan yoluyla olabilir. Akciğerler, kemikler, karaciğer, lenf nodları ve mediasten en sık yayılım görülen bölgelerdir. Akciğer parankim lezyonları böbrek hücreli tümörlerde sık görülmesine rağmen parankim tutulumu olmaksızın mediastinal lenf nodlarına yayılım nadirdir.Bu yazıda böbrek hücreli karsinom tanılı 71 yaşındaki erkek hasta sunuldu. Radikal nefrektomi ve ameliyat sonrası radyoterapi uygulanan hastanının toraks tomografisinde mediastinal lenfadenopati belirlendi. Olgumuz güncel literatür ışığında tartışıldı.Öğe Capecitabine-related intracranial hypotension syndrome mimicking dural metastasis in a breast cancer patient: Case report and review of the literature(Medknow Publications, 2010) Cosar-Alas, Rusen; Alas, Aykan; Ozen, Alaattin; Denizli, Bengu; Saynak, Mert; Uzunoglu, Sernaz; Aydogdu, NurettinSpontaneous intracranial hypotension (SICH) is an entity, which is secondary to iatrogenic manipulation and breaching of dura. Postural headache in patients should be suspected, cranial magnetic resonance imaging (MRI) is essential for precise diagnosis. Hallmark of MRI is regular shape of pachymeningeal gadolinium enhancement and subdural effusion. It may mimic central nervous system (CNS) metastasis. Prevention of such cases from receiving cranial radiotherapy by misinterpretation of the gadolinium enhancement as CNS metastasis is an important issue. Capecitabine is an antineoplastic agent, of which metabolites can cross blood-brain barrier in CNS via epithelial tissue. It may cause decrease in CSF production. SICH might be the clinical reflection of this decrease in CSF production. Review of the English literature revealed limited data because of the very little experience with oncologic patients suffering from intracranial hypotension. We report a case of spontaneous intracranial hypotension during capecitabine treatment. Patient was completely well following drug discontinuation and supportive treatment.Öğe Comparison of Protective Effects of L-Carnitine and Amifostine on Radiation-induced Toxicity to Growing Bone: Histopathology and Scintigraphy Findings(Asian Pacific Organization Cancer Prevention, 2010) Yurut-Caloglu, Vuslat; Durmus-Altun, Gulay; Caloglu, Murat; Usta, Ufuk; Saynak, Mert; Uzal, Cem; Cosar-Alas, RusenPurpose: The aim of the present study was to evaluate the radioprotective efficacy of L-carnitine (LC) in growing bones in comparison to amifostine. Materials and Methods: Sixty two-week-old Wistar albino rats were randomly assigned to six equal groups: Group 1, control (CONT); Group 2, irradiation alone (RT); Group 3, amifostine plus irradiation (AMI+RT); Group 4, L-carnitine plus irradiation (LC+RT); Group 5, amifostine alone (AMI); Group 6, L-carnitine alone (LC). The rats in the AMI+RT, LC+RT and RT groups were irradiated individually with a single dose of 20 Gy to the left femur. LC (300mg/kg) and amifostine (200mg/kg) were applied 30 min before irradiation. The animals were scanned for bone area, mineral content and bone mineral density (BMD) by DEXA and the 99mTc methylene diphosphonate uptake ratio (MUR) was calculated by bone scintigraphy. Histopathological analysis of bone and cartilage was also carried out after euthanasia. Results: Pretreatment with LC or amifostine reduced the radiation-induced damage in growing bone (p=0.007 and p=0.04 respectively) and in the epiphysial cartilage (p=0.002 and p=0.015 respectively). The protective effect of LC was similar to that of amifostine on both growing bone and on the epiphysial cartilage. The mean left-femur BMD values were significantly higher in the LC+RT (p=0.02) and AMI+RT (p=0.01) groups than in the RT group. but did not differ with the two protective agents. Pretreatment with AMI (p=0.002) and LC (p=0.01) improved the MUR. Conclusions: L-carnitine is equally as effective as amifostine at protecting growing bone against single dose irradiation damage.Öğe Current Status of Postoperative Radiation for Non-Small-Cell Lung Cancer(W B Saunders Co-Elsevier Inc, 2010) Saynak, Mert; Higginson, Daniel S.; Morris, David E.; Marks, Lawrence B.Radiation therapy can increase local control and potentially improve survival in patients who have had resection for lung cancer. However, radiation therapy also has the potential to cause serious toxicity and should not be indiscriminately delivered. The PORT meta-analysis clearly illustrated the potential toxic effects of postoperative radiotherapy (PORT). Modern three-dimensional radiation treatment planning facilitates the design of treatment fields that more conformally treat the site(s) at risk, and this appears, based on limited data, to improve the therapeutic ratio of PORT. Moreover, systemic and local therapies are likely synergistic, and thus improvements in systemic staging and treatment may increase the ability of local therapies to improve overall survival. Therefore, a reassessment of the utility of postoperative radiation therapy using limited fields and modern techniques is warranted. Semin Radiat Oncol 20:192-200 (C) 2010 Elsevier Inc. All rights reserved.Öğe CYCLIN D1 A870G POLYMORPHISM AND PROGNOSIS OF NON-SMALL CELL LUNG CANCER(Lippincott Williams & Wilkins, 2011) Kocak, Zafer; Ozen, Alaattin; Cakina, Suat; Saynak, Mert; Gulyasar, Tevfik; Sipahi, Tammam[Abstract Not Available]Öğe Dural sinus vein thrombosis in a patient with colon cancer treated with FOLFIRI/bevacizumab(Wolters Kluwer Medknow Publications, 2009) Ozen, Alaattin; Cicin, Irfan; Sezer, Atakan; Uzunoglu, Sernaz; Saynak, Mert; Genchellac, Hakan; Karagol, HakanThe adverse effects of regimes in cancer treatment have forced us to change to new targeted therapy options. Understanding these side effects, which can lead to discontinuation of the new therapy strategies, will allow the clinical management of these side effects and result in continuing therapies with effective medications. Bevacizumab, which is an IgG1 antibody against vascular endothelial growth factor, has side effects such as proteinuria, hypertension, venous and arterial thromboembolic events, and hemorrhage. This is the first reported case of dural sinus vein thrombosis, during the treatment with bevacizumab.Öğe Eccrine porocarcinoma: a case report and literature review(Kare Publ, 2007) Saynak, Mert; Kocak, Zafer; Altaner, Semsi; Ozen, Alaattin; Cosar Alas, Rusen; Yurut Caloglu, Vuslat; Uregen, BurcuEccrine porocarcinoma is a rare malignant sweat gland tumor. The lower extremity represents the most common tumor site for this entity. Surgical excision seems to be the best treatment choice. The surgical margins should be free of tumor, otherwise a local recurrence is most likely. Regional lymph node dissection should be performed if there is evidence of lymphadenopathy. Here, we present clinical and pathological findings of a 69 years old woman diagnosed with eccrine porocarcinoma arising from the skin of the trunk.Öğe Öğe The effect of low molecular weight heparin on survival in patients with cancer(Kare Publ, 2006) Saynak, Mert; Yurut-Caloglu, Vuslat; Bayir, Gulden; Caloglu, Murat; Uzal, CemThe association between cancer and venous thromboembolism (VTE) is well established. Of all new venous tromboembolism, approximately 20% are associated with active malignancy. In these cases, the pathogenic mechanisms of thrombosis involve a complex interaction between tumour cells, the haemostatic system, and charateristics of the patient. Anticoagulants are the mainstay therapy for the prevention and treatment of acute VTE. The natural history of VTE is more agressive and anticoagulant treatment failure is more frequent in cancer patients than in patients without cancer. Recently, the results of new prospective randomized clinical trials to evaluate the effect of low-molecular-weight heparin on cancer survival have become available. The results suggest a benefit from treatment, particularly in patients with nonadvanced disease. However, these results are not conclusive and require further research.Öğe Ekrin porokarsinom: Olgu sunumu ve literatür derlemesi(2007) Saynak, Mert; Koçak, Zafer; Altaner, Şemsi; Özen, Alaattin; Alas, Coşar Ruşen; Çaloğlu, Yürüt Vuslat; Üregen, BurcuEkrin porokarsinom, ekrin ter bezlerinden kaynaklanan nadir bir tümördür. Alt ekstremiteler en sık görüldüğü bölgedir. Cerrahi eksizyon en iyi tedavi seçeneği gibi görünmektedir. Cerrahi sınırların temiz olması lokal nüksleri önlemek açısından önemlidir. Lenf nodu tutulumu varsa bölgesel lenf nodu diseksiyonu yapılmalıdır. Biz, gövde cildinden kaynaklanan ekrin porokarsinom tanılı 69 yaşında bir kadın olgunun klinik ve patolojik özelliklerini sunuyoruz.Öğe Erken evre küçük hücreli-dışı akciğer kanserinin stereotaktik ablatif tedavisinde tek ve çoklu ark tedavi planlarının dozimetrik olarak karşılaştırılması(Sosyal Bilimler Enstitüsü, 2021) Ceylan, Seda; Saynak, MertTıbbi sebeplerle inoperabl, erken evre (T1-2 N0) KHDAK’inin güncel tedavisi stereotaktik ablatif radyoterapidir (SABR). SABR, toraks, batın, pelvis, spinal ve paraspinal bölge yerleşimli primer ve oligometastik lezyonların tedavisinde yüksek tümör kontrol oranları sağlayan etkili bir radyoterapi (RT) tekniğidir. SABR’yi konvansiyonel RT tekniklerinden ayıran en önemli özellik yüksek fraksiyon dozlarının (>5Gy), az sayıda fraksiyon ile (1-12) küçük bir tümör hacmine odaklanarak (genellikle <5 cm) verilmesidir. SABR’de normal doku toksisitesini en aza indirebilmek için, hedefin hemen dışında keskin doz düşüşünün gerçekleşmesi gerekmektedir. Bu çalışmanın amacı, erken evre küçük hücreli dışı akciğer kanseri (KHDAK) tanılı hastalarda dört farklı SABR tekniğinin (coplanar tek ışın tek-ark, tek ışın iki-ark, iki ışın ikiark ve non-coplanar iki ışın iki-ark) doz/hacim parametrelerini karşılaştırmaktır. Bu amaçla erken evre KHDAK’i tanısı ile tedavi edilmiş 20 hastanın BT-sim görüntüleri retrospektif olarak kullanıldı. Her hasta için yeniden hedef hacim ve risk altındaki organ (RAO) konturlamaları yapıldı ve dört ayrı teknik için Monoco Planlama Sistemi (TPS) kullanılarak tedavi planları (60Gy/8fr) oluşturuldu. Hedef hacmin %98-99’unun 60Gy tam dozu alması için her dört uygulamada da benzer şekilde normalizasyon yapıldı. Seri yapıdaki RAO’ların doz hacim kriterlerine uymak için tüm planlar optimize edildi. Doz-hacim histogramlarından (DVH) faydalanılarak, her planda Dmaks, D95, Dmin değerleri bulunarak gruplar arasında istatistiksel olarak karşılaştırıldı. Ayrıca kalp için Dmaks ve Dort, proksimal bronşiyal ağaç, ösofagus, medulla spinalis, göğüs duvarı ve büyük damarlar için Dmaks, toplam akciğer için V5, V10, V20, Dort, aynı taraf akciğer için Dort, karşı taraf akciğer için ise Dort ve V5 değerleri 60 karşılaştırıldı. Aynı zamanda, monitor unit değerleri ve tedavi süreleri kaydedildi; heterojenite indeksi, konformite indeksi ve gradient indeks değerleri hesaplanarak, bu değerlerin gruplar arasındaki karşılaştırmaları yapıldı. Hedef hacim için değerlendirilen, Dmaks, D95 ve Dmin dozları planlar arasında karşılaştırılabilir bulunmuştur. Yalnızca, PTV’nin Dmaks dozu, tek ışın tek ark grubunda tek ışın iki ark grubuna göre istatiksel olarak anlamlı düzeyde büyüktür (p=0,033). Santral yerleşimli risk altındaki organlar için bakılmış olan, proksimal bronşiyal ağaç, ösofagus ve medulla spinalis maksimum doz değerleri non-coplanar iki ışın iki ark uygulamasında coplanar uygulamalara göre anlamlı düzeyde düşüktür. Toplam akciğerin V5 ve V10 değerleri ve karşı taraf akciğerin V5 değerleri, non-coplanar iki ışın iki ark uygulamasında diğer uygulamalara göre istatiksel anlamlılık düzeyinde düşük bulunmuştur. Toplam akciğer V20, Dort; aynı taraf akciğer Dort ve karşı akciğer Dort değerleri açısından, planlar arasında anlamlı fark bulunmamıştır. Sonuç olarak, Monaco TPS kullanılarak oluşturulan tek ışın tek ark SABR planları iki ark uygulamalara kıyasla daha düşük monitör unit değerleri ve tedavi sürelerine sahiptir. Aslında, tüm planlamalarda genel olarak uygun hedef ve RAO doz-hacim değerleri elde edilmiştir. Non-coplanar SABR planları, daha düşük gradient indeks, RAO maksimum doz ve doz-hacim değerleri elde etmek gerektiğinde kullanılabilir. Özellikle seri dizilimli RAO’lara yakın yerleşimli lezyonların SABR uygulamalarında, non-coplanar teknik bu yapıların maksimum dozlarını düşürmede fayda sağlayabilir. Ancak tek ark SABR planları, erken evre KHDAK'li hastaların tedavisinde genellikle uygun konformite ve gradient indeks değerleri ve hedef hacim ve RAO dozları sağlayabilmekte ve nispeten kısa tedavi süresi ve düşük set-up hatası riski ile uygulanabilmektedir.Öğe Factors affecting local control, distant recurrence and survival in patients with locally advanced bladder cancer treated by definitive radiotherapy or chemoradiotherapy(Kare Publ, 2006) Caloglu, Murat; Yurut-Caloglu, Vuslat; Saynak, Mert; Cosar-Alas, Rusen; Karagol, Hakan; Kaplan, Mustafa; Ibis, KamuranOBJECTIVES Treatment results of 34 patients with bladder cancer admitted to Department of Radiation Oncology, Medicine Faculty of Trakya University between October 1997 and June 2005 were retrospectively analyzed. Prognostic factors associated with survival were determined. METHODS Their median age was 69 years (range 44-93). Thirty patients (88%) were male and 4 patients (12%) were female. Histopathological diagnosis was transitional cell carcinoma in 20 (59%) patients. Chemotherapy was administered concomitantly with radiotherapy to the 11 (32.35%) of the patients. The median radiotherapy dose was 62.5 (35-68) Gy. The median follow-up was 22 months (5-76 months). Median survival and median disease-free survival were 14.2 months (3.8-57.5) and 10 months (0-55), respectively. RESULTS Three years loco-regional control, metastasis free survival, disease free survival and overall survival rates were 76.59 , 72.2%, 55% and 41.1%, respectively. Epidermoid carcinoma histopathology (p=0.002), not performing concomitant chemotherapy (p=0.003), applying carboplatin instead of cisplatin with radiotherapy (p=0.004) and not conducting complete TURB (p=0.008) were significant poor prognostic factors on loco-regional control. Undifferentiated cell type (p=0.012) and not performing concomitant chemotherapy (p=0.046) were significant adverse factors on distant metastases. Factors that affect overall survival were tumor in stage T-4 (p=0.05), hemoglobin value below 10 g/dl (p=0.032) and not performing concomitant chemo-radiotherapy (p=0.017) and complete TURB (p=0.049). CONCLUSION Complications of radiotherapy were acceptable. For the treatment of muscle invasive locally advanced bladder cancer, RT combined with cisplatin is an acceptable treatment option. Moreover, complete TURB before RT is important both for local control and for survival.Öğe Factors Associated With the Development of Brain Metastases Analysis of 975 Patients With Early Stage Nonsmall Cell Lung Cancer(Wiley, 2010) Hubbs, Jessica L.; Boyd, Jessamy A.; Hollis, Donna; Chino, Junzo P.; Saynak, Mert; Kelsey, Chris R.BACKGROUND The risk of developing brain metastases after definitive treatment of locally advanced nonsmall cell lung cancer (NSCLC) is approximately 30%-50%. The risk for patients with early stage disease is less defined. The authors sought to investigate this further and to study potential risk factors. METHODS The records of all patients who underwent surgery for T1-T2 N0-N1 NSCLC at Duke University between the years 1995 and 2005 were reviewed. The cumulative incidence of brain metastases and distant metastases was estimated by using the Kaplan-Meier method. A multivariate analysis assessed factors associated with the development of brain metastases. RESULTS Of 975 consecutive patients, 85% were stage I, and 15% were stage II. Adjuvant chemotherapy was given to 7%. The 5-year actuarial risk of developing brain metastases and distant metastases was 10% (95% confidence interval [CI], 8-13) and 34% (95% CI, 30-39), respectively. Of patients developing brain metastases, the brain was the sole site of failure in 43%. On multivariate analysis, younger age (hazard ratio [HR], 1.03 per year), larger tumor size (HR, 1.26 per cm), lymphovascular space invasion (HR, 1.87), and hilar lymph node involvement (HR, 1.18) were associated with an increased risk of developing brain metastases. CONCLUSIONS In this large series of patients treated surgically for early stage NSCLC, the 5-year actuarial risk of developing brain metastases was 10%. A better understanding of predictive factors and biological susceptibility is needed to identify the subset of patients with early stage NSCLC who are at particularly high risk. Cancer 2010;116:5038-46. (C) 2010 American Cancer SocietyÖğe HISTOPATHOLOGICAL AND SCINTIGRAPHIC COMPARISONS OF THE PROTECTIVE EFFECTS OF l-CARNITINE AND AMIFOSTINE AGAINST RADIATION-INDUCED LATE RENAL TOXICITY IN RATS(Wiley-Blackwell Publishing, Inc, 2009) Caloglu, Murat; Yurut-Caloglu, Vuslat; Durmus-Altun, Gulay; Oz-Puyan, Fulya; Ustun, Funda; Cosar-Alas, Rusen; Saynak, MertThe aim of the present study was to compare the protective effects of l-carnitine and amifostine against radiation-induced late nephrotoxicity using technetium-99m diethylenetriaminepentaacetic acid scintigraphy and histopathological examination. Seventy-one Albino rats were randomly divided into six groups as follows: (i) AMI + RAD (n = 15), 200 mg/kg, i.p., amifostine 30 min prior to irradiation (a single dose of 9 Gy); (ii) LC + RAD (n = 15), 300 mg/kg, i.p., l-carnitine 30 min prior to irradiation; (iii) LC (n = 10), 300 mg/kg, i.p., l-carnitine 30 min prior to sham irradiation; (iv) AMI (n = 10), 200 mg/kg, i.p., amifostine 30 min prior to sham irradiation; RAD (n = 11), 1 mL/kg, i.p., normal saline 30 min prior to irradiation; and (vi) control (n = 10), 1 mL/kg, i.p., normal saline 30 min prior to sham irradiation. Scintigraphy was performed before treatment and again 6 months after treatment. Kidneys were examined by light microscopy and a histopathological scoring system was used to assess the degree of renal damage. The main histopathological findings were proximal tubular damage and interstitial fibrosis. Glomerular injury was similar in all groups. Tubular degeneration and atrophy were less common in the AMI + RAD group than in the RAD group (P = 0.011 and P = 0.015, respectively), as well as in the LC + RAD group compared with the RAD group (P = 0.028 and P = 0.036, respectively). Interstitial fibrosis in the AMI + RAD and LC + RAD groups was significantly less than that in the RAD group (P = 0.015 and P = 0.015, respectively). The highest total renal injury score (9) was seen in the RAD group. On scintigraphy, there were significant differences in post-treatment time to peak count (T(max)) and time from peak count to half count (T(1/2)) values (P = 0.01 and 0.02, respectively) between groups in the right kidney. In the control and RAD groups, the T(1/2) of the right kidney was 8 +/- 2 and 21 +/- 2 min, respectively. The T(max) values for the AMI + RAD and LC + RAD groups (2.8 +/- 0.2 and 3.2 +/- 0.2 min, respectively) were similar to those in the control group (2.5 +/- 0.3 min). Based on the results of the present study, l-carnitine and amifostine have comparable and significant protective effects against radiation-induced late nephrotoxicity.Öğe Hypertrophic osteoarthropathy associated with lung cancer: a case report(Kare Publ, 2007) Ozen, Alaattin; Saynak, Mert; Kocak, Zafer; Bayir-Angin, Gulden; Uregen, Burcu; Cosar-Alas, Rusen; Cicin, IrfanMalignant neoplasms are sometimes associated with a variety of paraneoplastic rheumatic syndromes. Hypertrophic osteoarthropathy is one of these syndromes and the vast majority of cases are associated with intra thoracic neoplasms mainly broncogenic cancer. Hypertrophic osteoarthropathy (HOA) is characterized by clubbed fingers and periosteal new bone formation. Etiologically, it can be divided into primary and secondary HOA. The major clinical manifestation was severe bilateral leg pain. The pathogenesis of the disease remains unclear. Bone scintigraphy is a sensitive method to detect HOA. In this case, a 49-year-old man who had hypertrophic pulmonary osteoarthropathy associated with advanced stage non-small cell lung carcinoma is presented and a review of the literature is performed.
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