GÝRÝÞ ve AMAÇ: Tükürük bezi tümörleri, baþ-boyun kanserlerinin yaklaþýk %3-5'ini oluþturan, farklý histolojik tiplere sahip heterojen bir kanser türüdür. Bu heterojenite ve görülme sýklýklarý nedeni ile malign tükürük bezi tümörleri hakkýnda geniþ serilerde araþtýrma makalesi bulunmamaktadýr. Bu nedenle literatüre katký saðlamak amacý ile Mukoepidermoid Karsinom (MEK) ve Adenoid Kistik Karsinom (AKK) tanýlý hastalarýmýzýn verileri çalýþmada paylaþýlmýþtýr.
YÖNTEM ve GEREÇLER: Temmuz 2007- Aralýk 2018 tarihleri arasýnda tükrük bezi MEK ve AKK tanýlarý ile takip ve tedavileri yapýlan 37 hasta çalýþmaya dahil edildi. Hastalarýn patolojik tanýlarý, tümör lokalizasyonlarý, uygulanan tedaviler, lokal nüks varlýðý, uzak metastaz varlýðý ve sað kalým süreleri retrospektif olarak deðerlendirilerek ortalama veriler incelendi.
BULGULAR: Çalýþmaya dahil edilen hastalarýn 14'ü MEK, 23'ü AKK idi. Ortalama yaþ 50,15'di. AKK'lý hastalarýn yaþ ortalamasý daha fazlaydý (52,77 - 45,84). Tüm hastalarýn 16'sý parotis, 8'i submandibuler, 13'ü ise sublingual ve minör tükürük bezleri yerleþimliydi. MEK'li %14,3, AKK'lý %13 hastada lokal nüks izlenirken, MEK'da %7,1, AKK'da %34,8 uzak metastaz saptandý. MEK'li hastalarda ortalama sað kalým süresi 71,2 ay olarak hesaplanýrken bu süre AKK'da 56,4 aydý.
TARTIÞMA ve SONUÇ: Çalýþmamýzda elde ettiðimiz veriler, genel olarak güncel literatür ile uyumlu bulunmuþtur. Nadir görülen bu hastalýk grubunda literatür verilerine katký saðlandýðý düþünülmektedir. Takip ve tedavi standardizasyonu amacý ile çok merkezli randomize klinik çalýþmalara ihtiyaç vardýr.

INTRODUCTION: Salivary gland tumors are a heterogeneous type of cancer with different histological types, accounting for approximately 3-5% of head and neck cancers. Due to this heterogeneity and its incidence, there are no research articles about malignant salivary gland tumors in large series. Therefore, in order to contribute to the literature, the data of our patients with Mucoepidermoid Carcinoma (MEC) and Adenoid Cystic Carcinoma (ACC) were shared in the study.
METHODS: Thirty-seven patients with salivary gland MEC and ACC between July 2007 and December 2018 were included in the study. Pathological diagnoses, tumor localizations, treatments, presence of local recurrence and distant metastasis and survival were evaluated retrospectively and mean data were analyzed.
RESULTS: Of the patients included in the study, 14 were MEC and 23 were ACC. The mean age was 50.15. The mean age of patients with ACC was higher (52.77 - 45.84). Tumor localization of all patients; 16 were parotid, 8 were submandibular, 13 were sublingual and minor salivary glands. Local recurrence was observed in 14.3% of MEC and 13% of ACC patients. Distant metastasis were seen in 7.1% of MEC and 34.8% of ACC patients. The mean survival time was 71.2 months in patients with MEC, and 56.4 months in ACC.
DISCUSSION AND CONCLUSION: The data we obtained in our study were generally consistent with the current literature. It is thought to contribute to the literature data in this rare group of diseases. Multicentre randomized clinical trials are needed for follow-up and treatment standardization.

GÝRÝÞ ve AMAÇ: Parçacýk tedavisinin dünyada yaygýnlýðý, geliþimi, kapasitesi ve gelecekteki durumu ile tedavi edilen hasta ve parçacýk tedavi merkez sayýlarýnýn son 10 yýllýk dönemde deðiþiminin deðerlendirilmesi amaçlanmýþtýr. Ayrýca çalýþmamýzda kanser tedavisinde en son teknoloji ve güncel yöntemler uygulanan ülkemizde þu anda bulunmayan parçacýk radyoterapi sistemlerin kurulumu, planlanmasý ve ihtiyacýn belirlenmesine katký saðlanmasý da amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþmada, dünya genelinde parçacýk radyoterapi sistemlerini kullanan merkezlerin; kurulum tarihleri, tedavi oda sayýlarý, kurulum süreci, planlama aþamasý ve tedavi edilen hasta sayýlarýna yönelik bilgilerine ulaþýldý. Bu merkezlerin 2010 – 2020 yýllarý arasýndaki verileri merkez, tedavi oda sayýsý ve tedavi edilen hasta sayýlarý ve yýl bazlý oranlarý retrospektif olarak deðerlendirilmiþtir.
BULGULAR: Dünyada parçacýk tedavi sistemine sahip 2010 yýlýnda 9 ülke varken 2020 yýlýnda bu rakam 19 ülkeye çýkmýþtýr. Ýnþaatý devam eden parçacýk radyoterapi merkezleri ile birlikte 25 ülkeye, karbon radyoterapi sisteminde 8 ülkeye çýkacaðý görülmektedir.
Tedavi merkez sayýlarý yönünden baktýðýmýzda 2010 yýlýnda toplamda 31 merkez olup bunun; 26 tanesi proton, 3 tanesi karbon ve 2 tanesi proton+karbon iken 2020 yýlýnda bu rakamlar toplamda 96 merkeze çýkmýþ olup bunun da 83 tanesi proton, 7 tanesi karbon ve 6 tanesi proton+ karbon tedavi merkezidir. Planlama aþamasýndaki merkezleri de dikkate aldýðýmýzda toplamda 161 merkeze çýkacaktýr.
Parçacýk radyoterapisi ile tedavi olan hasta sayýlarý 2010 yýlýnda 76.266 iken 2018 yýlýnda bu rakam 221.528'lere ulaþmýþtýr. Tedavi odasý baþý yýllýk tedavi edilen yeni hasta sayýlarý protonda 86-197 yeni hasta/yýl aralýðýnda olup karbon tedavisinde 28-211 yeni hasta/yýl aralýðýndadýr.

TARTIÞMA ve SONUÇ: Özellikle saðlýk sektöründeki geliþmeler sayesinde ülkemiz bölgemizin referans hastaneleri ve merkezleri konumuna gelmiþtir. Dünyadaki durum ve ülkemizin içinde bulunduðu durum düþünüldüðünde bu özelliðimizinin devam edebilmesi için ülkemizin proton tedavisi yaný sýra karbon tedavisine de geçmesi gerektiði görülmektedir

INTRODUCTION: The aim of this study is to evaluate the extent, development, capacity and future status of the particle treatment in the world and the change in the number of patients and particle treatment centers treated in the last 10 years. In addition, in our study, it is aimed to contribute to the establishment, planning and determination of the need for particle radiotherapy systems that are not currently available in our country where the latest technology and current methods in cancer treatment are applied.
METHODS: In the study, the centers using particle radiotherapy systems worldwide; information on the dates of installation, number of treatment rooms, installation process, planning stage and number of patients treated were reached. The data of these centers between 2010 and 2020 were evaluated retrospectively based on the center, number of treatment rooms and number of patients treated, rates.
RESULTS: While there were 9 countries in the world with a particle treatment system in 2010, this figure increased to 19 countries in 2020. When particle radiotherapy centers are included, the number of centers will increase to 25 countries, while carbon radiotherapy systems will increase to 8 countries. When we look at the number of treatment centers in 2010, there are 31 centers in total; 26 of them are protons, 3 of them are carbon and 2 of them are proton+ carbon. In 2020, these numbers have increased to 96 centers, of which 83 are proton, 7 are carbon and 6 are proton+ carbon treatment centers. When we consider the centers in the planning stage, it will increase to 161 centers in total. While the number of patients treated with particle radiotherapy was 76,266 in 2010, this figure reached 221,528 in 2018. The number of new patients treated annually per treatment room is in the range of 86-197 new patients/years in Proton and in the range of 28-211 new patients/years in carbon therapy.
DISCUSSION AND CONCLUSION: Thanks to the developments in the health sector, our country has become the reference hospitals and centers of our region. Considering the situation in the world and the situation our country is in, it is seen that in order for this feature to continue, our country should switch to carbon therapy in addition to proton therapy.

GÝRÝÞ ve AMAÇ: Amaç:
Diyaliz öncesi serum sodyum deðeri ile malnutrisyon, kas kitlesi, kas fonksiyonu deðerlendirme parametreleri ve interdiyalitik kilo alýmý arasýndaki iliþki deðerlendirildi.

YÖNTEM ve GEREÇLER: Gereç ve Yöntem:
Kesitsel planlanan çalýþmaya 150 hemodiyaliz hastasý dahil edildi. Deðerlendirmede: malnutrisyon inflamasyon skoru, el kavrama kuvveti, orta üst-kol çevresi, triseps cilt kalýnlýðý; orta üst-kol kas çevresi, biyoelektiriksel impedans analizi (Yað yüzdesi, yaðsýz vücut kitlesi, bazal metabolizma hýzý, vücut kitle indeksi, toplam vücut suyu) bakýldý. Aylýk bakýlan diyaliz giriþ SNa’nin altý aylýk ortalamasý alýndý. Hastalar 136.84 mEq/L olan ortalama serum sodyum deðerinin altýnda: Grup 1 ve üzerinde Grup 2’yi oluþturdu. Serum albümin, C reaktif protein ve diðer aylýk rütin laboratuvar tetkikleri hasta dosyasýndan alýndý. Ýnterdiyalitik kilo alýmý: hastanýn diyaliz öncesi kilosundan, diyaliz sonrasý kilosu çýkarýlarak hesaplandý.

BULGULAR: Bulgular:
Yaþ ve cinsiyet uyumlu iki grup arasýndaki tek anlamlý fark interdiyalitik kilo alýmýydý (p < 0.001). Analizde serum sodyum deðeri ile interdiyalitik kilo alýmý arasýnda anlamlý iliþki (p < 0.001) ve ters orantý vardý (r= -0.311, p < 0.001).

TARTIÞMA ve SONUÇ: Sonuç:
Hemodiyaliz hastalarýnda giriþ serum sodyum deðeri ile inflamasyon, malnutrisyon, ve antropometrik ölçümlerimiz arasýnda iliþki bulunamadý. Hemodiyaliz giriþ serum sodyum deðeri ve interdiyalitik kilo alýmý arasýnda negatif korelasyon vardýr ve istatistiksel anlamlýdýr.

INTRODUCTION: Objective:
We evaluated the relationship between the pre-dialytic serum sodium value and malnutrition, the parameters of evaluating the muscular function, muscular mass or interdialytic weight gain.

METHODS: Material and Method:
150 haemodialysis patients were included in the study planned to be cross-sectional. In the evaluation; malnutrition-inflammation score, handgrip strength, mid arm circumference, triceps skinfold, mid arm muscle circumference, and bioelectrical-impedance analysis (fat percent, fat free mass, basal metabolism rate, body mass index, total body water) were considered and examined. The six-month average of the pre-dialytic serum sodium value, which is considered monthly, was taken. The patients under the average value of 136.84 mEq/L pre-dialytic serum sodium value were included in the Group 1 and those above it were included in the Group 2. Serum albumin, C-reactive protein and the other monthly routine laboratory examinations were taken from the patient’s follow-up file. Interdialytic weight gain was calculated by extracting the patient’s post-dialysis weight from the patient’s pre-dialytic weight.

RESULTS: Results:
The only significant difference between the two groups concordant according to the age and sex was interdialytic weight gain (p < 0.001). In the analysis, there was a significant relationship (p < 0.001) and inverse correlation (r= -0.311, p < 0.001) between pre-dialytic serum sodium value and interdialytic weight gain.

DISCUSSION AND CONCLUSION: Conclusion:
No relationship was found between the pre-dialytic serum sodium value of the haemodialysis patients and inflammation, malnutrition and anthropometric measurements. There was a negative correlation between the pre-dialytic serum sodium value and interdialytic weight gain, and it was statistically significant.

GÝRÝÞ ve AMAÇ: Berrak hücreli kondrosarkom, yavaþ büyüme ve düþük metastaz potansiyeli ile karakterize, nadir bir kondrosarkom varyantýdýr. Bu çalýþmada berrak hücreli kondrosarkoma ait demografik veriler ve sað kalým oranlarýnýn raporlanmasý amaçlandý.
YÖNTEM ve GEREÇLER: Bu çalýþma Surveillance, Epidemiology and End Results (SEER) veritabanýnýn en son versiyonu kullanýlarak yapýldý. Berrak hücreli kondrosarkom tanýlý hastalar yaþ, cinsiyet, etnik köken, medeni durum, hastalýðýn yönü, tümörün yerleþim yeri, tümör derecesi, takip süresi ve takip sonuçlarý açýsýndan deðerlendirildi. Hastalarýn yaþlarý, 30 yaþ üstü ve 30 yaþ ve altý olarak iki gruba ayrýldý. Takip sonuçlarý yaþýyor ve ölü olarak iki grupta incelendi. Tanýmlayýcý istatistikler ortalama ± standart sapma, sýklýk ve yüzde olarak ifade edildi.
BULGULAR: Bu çalýþmaya yaþ ortalamasý 44,4±18,2std (10-84 yaþ arasý) olan 19 kadýn ve 51 erkek (%72,8) olmak üzere toplam 70 kiþi dahil edilmiþtir. En sýk tümör yerleþim yeri, alt ekstremite uzun kemikleri ve iliþkili eklemler (%68,5) olarak deðerlendirildi. Tümör diferansiasyonlarý incelendiðinde, en sýk orta derece diferansiasyon (grade II) (%46,4) görüldü. Hastalarýn ortalama takip süresi, 84,3 ay (1-238 ay arasý) idi. Bu çalýþmaya dahil edilen 70 hastanýn 11'i (%15,7) eksitus olmuþtur.
TARTIÞMA ve SONUÇ: Berrak hücreli kondrosarkom düþük dereceli kondrosarkom olarak bilinse de çalýþmamýza dahil edilen hastalarýn %78,6' sýnýn orta ya da ileri dereceli tümör olduðu bulunmuþtur. Ayrýca en sýk görüldüðü yaþ aralýðý 30-50 yaþ arasý olduðu bilinmekle beraber geniþ bir yaþ aralýðýnda görüldüðü saptandý.

INTRODUCTION: Clear cell chondrosarcoma is a rare variant of chondrosarcoma and it is characterized by slow growth and low metastasis potential. The aim of this study is to report the demographic data and survival rates of clear cell chondrosarcomas.
METHODS: This study was conducted using the latest version of the Surveillance, Epidemiology and End Results (SEER) database. Patients with clear cell condrosarcoma were evaluated for age, sex, ethnicity, marital status, disease prognosis, tumor location, tumor grade, follow-up period and follow-up results. The patients were divided into two groups as older than 30 years old and younger than 30 years old. Follow-up results were evaluated as alive and dead in two groups. Descriptive statistics were expressed as mean ± standard deviation, frequency and percentage.
RESULTS: A total of 70 patients 19 women and 51 men (72.8%) with a mean age of 44.4 ± 18.2 std (10-84 years)were included in this study. The most common tumor locations were considered as lower extremity long bones and associated joints (68.5%) When the tumor differentiation was examined, the most common was observed as medium differentiation (grade II) (46.4%). The mean follow-up period was 84.3 months (1-238 months). Of the 70 patients included in this study, 11 (15.7%) died.
DISCUSSION AND CONCLUSION: Although clear cell chondrosarcoma is known as low-grade chondrosarcoma, 78.6% of the patients included in our study were found to be have moderate or advanced tumors. We also have found that the most common age range seen in a wide age range, although known to be aged between 30-50.

GÝRÝÞ ve AMAÇ: Baþ-boyun kanserlerinin küratif definitif veya adjuvant radyoterapisi (RT) sonrasýnda en sýk karþýlaþýlan kronik toksisite kserostomidir. Bu çalýþmanýn amacý baþ-boyun kanserlerinin tedavisi için uygulanan RT sonrasýnda ortaya çýkan parotis bezindeki boyutsal ve parankimal deðiþiklikler ile klinik kserostomi derecesi arasýndaki iliþkilerin incelenmesidir.
YÖNTEM ve GEREÇLER: Baþ-boyun bölgesine 50-70 Gy küratif RT uygulanmýþ 50 hastanýn 43’ü larinks (%86), 3’ü nazofarenks (%6) ve 4’ü oral kavite (%8) kanseri tanýlýdýr. RT öncesi, RT sonrasý ve tedavi sonrasý 3. ay kontrollerinde çekilen bilgisayarlý tomografi veya manyetik rezonans görüntüleme yöntemlerinden parotis bezi boyutlarý ölçüldü ve parotis bezi parankimi, parotit açýsýndan deðerlendirildi. Takiplerde kserostomi derecelendirilmesi Radiation Therapy Oncology Group common toxicity criteria version 2.0’a göre yapýldý. Parotis bezi boyutlarý, parankimal parotit, evre, cerrahi, total RT dozu, fraksiyon dozu ve eþ zamanlý kemoterapinin (KT) kserostomi derecesi ile iliþkisi deðerlendirildi.
BULGULAR: Yirmi bir (%42) hastada grade 1, 29 (%58) hastada grade 2 kserostomi saptandý. Grade 1 ve grade 2 kserostomi gruplarý karþýlaþtýrýldýðýnda; grade 2 grubundaki hastalarýn daha ileri evre, daha az cerrahi yapýlmýþ, daha çok eþ zamanlý KT uygulanmýþ ve parotis boyutlarý daha fazla oranda küçülmüþ olduðu görüldü (p<0,01). Spearman ρ analizleri sonucunda kserostomi derecesi ile evre ve eþ zamanlý KT varlýðýnýn pozitif korelasyonu (p<0,001); fraksiyon dozu ve parotis boyutlarýyla negatif korelasyon (p<0,001) saptanýrken; radyolojik parotitis varlýðý ile anlamlý korelasyon bulunamadý (p>0.05).
TARTIÞMA ve SONUÇ: RT sonrasý parotis bezi boyutlarýnýn radyolojik olarak küçülmesi kserostomi derecesi ile korele iken radyolojik parotitis durumunun klinik kserostomi derecesini yansýtmayabileceði gösterilmiþtir.

INTRODUCTION: The most common chronic toxicity observed in head and neck cancer after curative definitive and adjuvant radiotherapy (RT) is xerostomia. The purpose of this study is to investigate the relationships between clinical xerostomia grade and the magnitude and parenchymal changes in the parotid gland ensuing after RT that is conducted for treating head and neck cancers.
METHODS: Fifty patients with larynx (43, 86%), nasopharynx (3, 6%), and oral cavity tumor (4, 8%), who were treated with 50-70 Gy curative RT in their head and neck regions, participated in the study. Patients were scanned by computerized tomography or magnetic resonance imaging before and after RT, as well as during the third-month examinations after their treatments. Parotid gland sizes were measured and parotid gland parenchyma were assessed with regards to parotitis by analyzing the images. Xerostomia grading was carried out in accordance with the common toxicity criteria version 2.0 of the Radiation Therapy Oncology Group. Relationships of xerostomia grade with parotid gland size, parenchymal parotitis, stage, operation, total RT dosage, fraction dosage, and concurrent chemotherapy were analyzed.
RESULTS: Twenty-one (42%) patients had grade 1 xerostomia and 29 (58%) patients had grade 2 xerostomia. Compared to Grade 1 xerostomia group; Grade 2 patients were more advanced stage, had less surgery but more concurrent chemotherapy, and had further reduced parotid sizes (p<0.01). Spearman ρ analyses revealed that xerostomia grade had significant positive correlations with stage and presence of concurrent chemotherapy (p<0.001); significant negative correlations with fraction dosage and parotid sizes (p<0.001). However, xerostomia grade did not significantly correlate with presence of radiological parotitis (p>0.05).
DISCUSSION AND CONCLUSION: Reduction in the parotid gland sizes after RT treatment is correlated with xerostomia grade. However, radiological parotitis condition may not indicate the grade of clinical xerostomia.

GÝRÝÞ ve AMAÇ: Bu çalýþmada, adelosesan ve genç eriþkin (AGE'li) meme kanseri olan hastalarda aspartat aminotransaminazýn alanin aminotransaminaza (De-Ritis oraný) oranýnýn prognostic bir belirteç olarak rolü araþtýrýldý.
YÖNTEM ve GEREÇLER: Bu çalýþmada, Ocak 2006 - Mayýs 2016 tarihleri arasýnda Ýzmir Katip Çelebi Üniversitesi Atatürk Eðitim ve Araþtýrma Hastanesi Týbbi Onkoloji Kliniðinde izlenen 18-39 yaþlarý arasýndaki hastalarý geriye dönük olarak deðerlendirdi. De-Ritis oranýnýn cut-off deðerlerini bulmak için ROC eðrisi analizi kullanýlmýþtýr. Hastalar kesim deðerine göre iki gruba ayrýldý.
BULGULAR: Toplamda 190 meme kanseri hastasý vardý. Taný sýrasýndaki ortanca yaþ 34 idi (min: 23, maks: 39). Takiplerinde 37 hastada (% 19.5) nüks saptandý. Histolojik olarak, hastalarýn büyük çoðunluðu 2. ve 3. derece idi. Tek deðiþkenli analizde De-Ritis oranýnýn, histolojik derecenin, ER durumunun, PR durumunun ve Luminal durumunun hastalýksýz saðkalým(HS) açýsýndan iyi prognostik faktörler olduðunu saptandý [sýrasýyla p: 0.014, p: 0.006, p: 0.032, p: 0.002, p: 0.05]. De-Ritis oraný<0,93 olan grupta HS 106,2 ay iken De-Ritis oraný≥0,93 79,2 ay olarak saptandý (p: 0,014). Hastalýksýz saðklaým açýsýndan çok deðiþkenli analizde histolojik derece, PR durumu ve De-Ritis oraný istatistiksel olarak anlamlý bulundu.
TARTIÞMA ve SONUÇ: Bu çalýþmada De-Ritis oranýnýn adelosesan ve genç eriþkin meme kanserli hastalarda prognostik bir belirteç olarak kullanýlabileceði gösterilmiþtir.

INTRODUCTION: The present study aimed to investigate the potential of ratio of aspartate aminotransaminase to alanine aminotransaminase (De-Ritis ratio) as prognostic marker in adelocesant and young adults(AYAs) patients with breast cancer.
METHODS: This study retrospectively evaluated patients aged 18-39 who were followed-up from January 2006 to May 2016 at the Medical Oncology Clinic of Izmir Katip Celebi University, Ataturk Training and Research Hospital. In order to find out De-Ritis ratio cut-off values, ROC curve analysis was used. The patients were divided into two groups according to the cutoff value.
RESULTS: We had 190 patients with breast cancer in total. The median age at diagnosis was 34 (min: 23, max: 39). 37 patients (19.5%) experienced a relapse in the follow-up period. Histologically, the great majority of patients were grade 2 and 3. The univariate analysis demonstrated that De-Ritis ratio, histological grade, ER status, PR status and Luminal status were good prognostic factors in terms of disease free survival(DFS) [p: 0.014, p: 0.006, p: 0.032, p: 0.002, p: 0.05 respectively]. The group De-Ritis ratio<0,93 had 106.2 months of DFS while the group De-ritis ratio≥0,93 had 79.2 months [p<0.014]. In multivariate analysis for DFS histological grade, PR status and De-Ritis ratio were found to be statistical significance.
DISCUSSION AND CONCLUSION: In this study, it has been shown that the De-Ritis ratio can be used as a prognostic marker in AYAs with breast cancer.

GÝRÝÞ ve AMAÇ: Bu çalýþmada nadir görülen yumuþak doku sarkomlarýndan olan malign periferik sinir kýlýfý tümörlerinin (MPSKT) klinik özelliklerini ve Nörofibromatozis tip 1 (NF1) ile prognostik iliþkisini araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Ocak 2002 ve Aralýk 2015 tarihleri arasýnda MPSKT nedeniyle opere edilen 42 (26 E, 16 K) hastanýn klinik özellikleri, tedavi yöntemleri, klinik sonuçlarý ve tedavi baþarýsýzlýklarý retrospektif olarak deðerlendirildi.16 hasta (%38) (10 erkek, 6 kadýn, ortalama yaþ 40± 14) NF1 ile iliþkili bulundu. 26 hasta (%62) (16 erkek, 10 kadýn, ortalama yaþ 38± 15) sporadik MPSKT tanýsý ile takip ve tedavi edildi. Ortalama takip süresi NF1 ile iliþkili grupta 30 ay (± 12) ve sporadik MPSKT grubunda 42 ay (± 15) idi. En sýk yerleþim yeri ekstremite (% 85) ve ortalama tümör boyutu 11,2 cm (daðýlým 2-21cm) idi. Tüm hastalara taný sonrasý geniþ rezeksiyon uygulandý.
BULGULAR: Ýki grup arasýnda tümör boyutu,tümör yerleþimi ve lenf nodu tutulumu ve uzak organ metastazý açýsýndan anlamlý fark yoktu.Tüm hastalarda makroskopik cerrahi sýnýr negatif iken,NF1 ile iliþkili grupta 5 hastada(% 31) ve sporadik grupta 9 hastada(% 34) mikroskobik cerrahi sýnýr pozitif (R1) olarak rapor edildi. 42 hastanýn 20’sinde (% 47) nüks görüldü. NF1 iliþkili grupta 13 hastada (% 81), sporadik grupta 7 hastada(% 26) nüks görüldü. Mikroskobik cerrahi sýnýr pozitif olan hastalarda mortalitenin 11,4 kat artýðý gözlenmiþtir.
TARTIÞMA ve SONUÇ: NF1 zemininde geliþen malign periferik sinir kýlýfý tümörlerinde prognoz sporadik tipe göre daha kötüdür. Ayrýca tümörün boyutu, derinliði, pozitif cerrahi sýnýr kötü prognoz göstergeleridir. Saðkalýmý etkileyen en önemli faktör NF1 varlýðý ve pozitif cerrahi sýnýrdýr.

INTRODUCTION: In this study, we aimed to research the clinical features of malignant peripheral nerve sheath tumors (MPNST) which are rare soft tissue sarcomas and their prognostic relationship with Neurofibromatosis type 1 (NF1).
METHODS: The clinical features, treatment modalities, clinical outcomes and treatment failures of 42 (26 males, 16 females) patients operated for MPNST between January 2002 and December 2015 were evaluated retrospectively. 16 patients (38%) (10 males, 6 females, mean age 40 ± 14) were associated with NF1. 26 patients (62%) (16 males, 10 females, mean age 38 ± 15) were treated and followed up with sporadic MPNST diagnosis. The mean follow-up period was 30 months (± 12) in the NF1-associated group and 42 months (± 15) in the sporadic MPNST group. The most common site was extremity (85%) and mean tumor size was 11.2 cm (range between 2 and 21 cms). All patients underwent wide resection after diagnosis.
RESULTS: There was no significant difference between the two groups in terms of tumor size, tumor location, lymph node involvement and distant metastasis. In all patients, macroscopic surgery margin was negative, while 5 patients (31%) in the NF1-associated group and 9 patients (34%) in the sporadic group the margin was reported as positive (R1). Recurrence was seen in 20 of 42 patients (47%). Recurrence was seen in 13 patients (81%) in the NF1-associated group and 7 patients (26%) in the sporadic group. Mortality rate increased by 11.4 times in patients with positive microscopic surgical margin.
DISCUSSION AND CONCLUSION: The prognosis of malignant peripheral nerve sheath tumors developing on NF1 background is worse than sporadic type. In addition, tumor size, tumor depth and positive surgical margin are indicators of poor prognosis. The most important factor affecting survival is the presence of NF1 and the positive surgical margin.

GÝRÝÞ ve AMAÇ: Prostat Kanseri (PCa) kesin tanýsýnda altýn standart yöntem prostat iðne (PB) biyopsisidir. PB sonrasý üriner sistem enfeksiyonlarý gibi hayatý tehdit eden önemli komplikasyonlar meydana gelebilir. Bu çalýþmada siprofloksasin, gentamisin ve siprofloksasin+gentamisin kombinasyonlarýnýn PB proflaksisindeki etkinliklerinin karþýlaþtýrýlmasý amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Bu retrospektif çalýþmada, prostat kanseri þüphesi nedeniyle transrektal ultrasonografi kýlavuzluðunda standart 10-12 kor prostat biyopsisi uygulanan hastalarýn verileri analiz edilmiþtir. Hastalar uygulanan proflaksi yöntemine göre 3 gruba ayrýlmýþtýr; 1) iþlemden önce tek doz im. gentamisin 80 mg uygulananlar, 2) iþlemden 24 saat önce baþlanarak günde 2 kez toplam 3 gün (oral) siprofloksasin 500 mg uygulananlar, 3) her ikisinin kombinasyonu uygulanalar. Gruplarýn ateþli üriner sistem enfeksiyon (AÜSE) oranlarýnýn yaný sýra yaþ, serum prostat spesifik antijen (PSA) düzeyleri gibi bazý demografik ve klinik verileri kaydedilerek karþýlaþtýrýlmýþtýr.
BULGULAR: Çalýþmaya toplam 180 hasta dahil edildi (grup 1= 67, grup 2= 51, grup 3= 62). Tüm hastalarýn yaþ ortalamasý 64.41 (+/-7.08) yýldý. Hastalarda biyopsi sonrasý AÜSE görülme oraný %4.4 idi. Gruplarýn ortalama yaþ, ortanca prostat hacimleri, ortanca PSA düzeyleri ve kanser saptanma oranlarý istatistiksel olarak benzerdi. En fazla AÜSE Grup-2’de tespit edilirken (%11.7), Grup-1 ve Grup-3 ise AÜSE oranlarý açýsýndan benzerdi (sýrasýyla %1.4, %1.6). En sýk izole edilen etken Escherichia coli idi.
TARTIÞMA ve SONUÇ: Çalýþmamýzýn sonuçlarýna göre, biyopsi öncesi tek doz im. gentamisin uygulanarak yapýlan proflaksi, tek baþýna oral siprofloksasin ile yapýlan antibiyotik proflaksisine göre daha etkin görünmektedir. Tek doz gentamisin ile kombinasyon proflaksisi etkinlikleri benzer bulunmakla birlikte, uygulama kolaylýðý ve akýlcý antibiyotik kullanýmý açýsýndan iþlem öncesi tek doz gentamisin ile proflaksi önermekteyiz.

INTRODUCTION: The gold standard method for the definitive diagnosis of Prostate Cancer (PCa) is prostate needle biopsy (PB). Significant life-threatening complications such as urinary tract infections may occur after PB. The aim of this study was to compare the efficacy of ciprofloxacin, gentamicin and ciprofloxacin+gentamicin in PB prophylaxis.
METHODS: In this retrospective study, the data of patients who underwent standard 10-12 core prostate biopsy under the guidance of transrectal ultrasonography because of the suspicion of prostate cancer were analyzed. Patients were divided into 3 groups according to the applied prophylaxis method; 1) Single dose im. gentamicin 160 mg administered before biopsy. 2) Ciprofloxacin 500 mg administered twice a day for a total of 3 days (oral) starting 24 hours before biopsy. 3) The combination of both drugs applied. Febrile urinary tract infection (FUTI) rates of the groups, as well as some demographic and clinical data such as age, serum prostate specific antigen (PSA) levels, were recorded and compared.
RESULTS: A total of 180 patients were included in the study (group 1= 67, group 2=51, group 3= 62 patients). The mean age of all patients was 64.41 (+/-7.08) years. The incidence of FUTI after biopsy was 4.4%. The mean age, median prostate volumes, median PSA levels and cancer detection rates of the groups were statistically similar. While the most number of FUTIs were detected in Group-2 (11.7%), Group-1 and Group-3 were similar in terms of FUTI rates (1.4%, 1.6%, respectively). The most commonly isolated agent was Escherichia Coli.
DISCUSSION AND CONCLUSION: According to the results of our study, a single dose im. prophylaxis with gentamicin appears to be a more effective prophylaxis method than antibiotic prophylaxis with oral ciprofloxacin alone. Although the effectiveness of single-dose gentamicin and combination prophylaxis are similar, because of the ease of administration and the choice of rational antibiotics, we recommend single-dose gentamicin.

GÝRÝÞ ve AMAÇ: Primer hiperparatiroidizm (PHPT) ayaktan hastalarda hiperkalseminin en sýk sebebidir.Tedavi edilmediðinde progresif olarak ilerler, nefrokalsinosis ve kemik mineral kaybý geliþir ve son dönem böbrek yetmezliði, kemik kýrýklarý gibi ciddi komplikasyonlar ortaya çýkabilir. Hiperkalsemiye eþlik eden yüksek veya normal parathormonu varlýðýnda PHPT ayýrýcý tanýsýnda ailesel hipokalsiürik hiperkalsemi düþünmek gerekir. Ýki antitenin ayýrýcý tanýsýnda 24 saatlik idrarda kalsiyum atýlýmý ve fraksiyone idrar kalsiyum ekskresyonu kullanýlmaktadýr. Bu çalýþmanýn amacý fraksiyone idrar atýlýmý formülünde serum total kalsiyum düzeyini albumine göre düzeltmenin klinik anlamý olup olmadýðýný araþtýrmaktýr.
YÖNTEM ve GEREÇLER: Primer hiperparatiroidizmi olan toplam yirmi hastanýn fraksiyone idrar atýlýmý “idrarkalsiyumu x plazma kreatinin/ serum kalsiyumu x idrar kreatinin” formülü ile hesaplandý.Hesaplama yaparken serum kalsiyumu albumine göre düzeltilmiþ ve düzeltilmemiþ olarak iki ayrý ölçüm yapýldý ve ölçümler birbiriyle karþýlaþtýrýldý.
BULGULAR: Albumine göre düzeltilmiþ kalsiyum kullanýldýðýnda ortalama fraksiyone atýlýmý 0.0008(%0.8) ±0.00013, düzeltilmemiþ kalsiyum kullanýldýðýnda hesaplanan deðer ise 0.016 (%1.6) ±0.057 idi. Ýki sonuç arasýndaki fark istatistiksel olarak anlamlý idi (p=0.01). Klinik olarak PHPT ve ailesel hipokalsiürik hiperkalsemi ayýrýcý tanýsý için kesim noktasý %1 alýndýðýnda hiçbir hastada taný deðiþmezken, %2 alýndýðýnda iki PHPT’li hastanýn tanýsý ailesel hipokalsiürik hiperkalsemi olarak deðiþti
TARTIÞMA ve SONUÇ: Fraksiyone idrar atýlýmý PHPT ve ailesel hipokalsiürik hiperkalsemi ayýrýcý tanýsýnda önemlidir. Serum kalsiyum ölçümü serum albumin düzeyinden etkilenmekte ve yanlýþ yüksek veya düþük ölçülmektedir. Fraksiyone idrar atýlýmý hesaplanýrken albumine göre düzeltilmiþ kalsiyumu kullanmak, sonuçlarý gri zonda olan bazý hastalarýn klinik tanýsýný deðiþtirebilir.

INTRODUCTION: Primary hyperparathyroidism (PHPT) is the most common cause of hypercalcemia in outpatients. When left untreated, it has detrimental effects on bones and kidneys that result in fractures, nephrocalcinosis and end stage renal failure. In case of hypercalcemia if the parathyroid hormone is high or normal, there are two clinical entities to be differentiated; PHPT and familial hypocalciuric hypercalcemia (FHH). In the differential diagnosis we usually use 24 hours collection of urinary calcium and fractionated urinary calcium (FECa). In this study we aimed to determine the clinical utility of using corrected calcium for albumin in calculation of fractionated calcium excretion in differentiating PHPT and FHH.
METHODS: We conducted the study with twenty operated patients with PHPT and all had single parathyroid adenoma in the histopathology report. We retrospectively evaluated the laboratory parameters and recalculated the fractionated calcium excretion according to the corrected serum calcium for albumin. The formula for FECa is as follows; urinary calcium x plasma creatinine/ plasma calcium x urinary creatinine. Two calculations of FE Ca with and without correcting serum Ca according to serum albumin were compared with each other.
RESULTS: Mean FE Ca was 0.016 ±0.057. Recalculated FE Ca excretion was 0.0008±0.0013. The difference between two calculations of FECa was statistically different. If we accept the cutoff of FECa as 0.01 for the differentiation of PHPT from FHH, recalculation of FECa didn’t change the diagnosis in any patient. But when we accept the cut off as 0.02, two patients would have falsely been diagnosed as FHH with the new calculated FECa
DISCUSSION AND CONCLUSION: FECa is important for differential diagnosis of PHPT and FHH. Serum total calcium measurement is affected by serum albumin levels. Using corrected calcium level while calculating FECa can change the diagnosis of some patients whose FECa is in the gray zone.

GÝRÝÞ ve AMAÇ: Primer anorektal malign melanom (ARMM) nadir tümördür. Anorektal karsinomlarýn %1’ini melanomlar oluþturur. Prognozu kötüdür, 5 yýllýk saðkalým oraný %10’dur. Biz çalýþmamýzda nadir görülen tümör olmasý nedeni ile ARMM tanýlý hastalarý deðerlendirdik.
YÖNTEM ve GEREÇLER: ARMM tanýsý ile Ekim 1998- Þubat 2019 tarihleri arasýnda takip edilen 21 hastanýn dosya bilgileri retrospektif olarak incelendi. Hastalarýn demografik, klinik, radyolojik ve saðkalým özellikleri kayýt edildi. Sað kalým analizleri için Kaplan-Meier sað kalým analizi kullanýldý.
BULGULAR: Hastalarýn yaþ ortalamasý 59,5±13,3 (28-76); 8 (% 38,1)’ i erkek, 13 (% 61,9)’ü kadýn cinsiyetteydi. Tümör lokalizasyonuna göre 8 (% 38,1)’i anal bölge, 11 (% 52,4)’i rektal bölge ve 2 (% 9,5)’ si anorektal bölge yerleþimliydi. Saðkalým analizine göre genel saðkalým (GSK) 16 ay ( %95 Güvenlik Aralýðý (GA); 13,2-18,7) idi. Tanýda metastaz olup olmamasýna göre ortanca GSK erken evrede 18 ay (% 95 GA;15,6- 20,3), metastatik hastalýkta 11 ay (% 95 GA;4,5-17,4) olarak saptandý (p: 0,003).
TARTIÞMA ve SONUÇ: ARMM þu an için herhangi bir tedavi kýlavuzuna sahip deðildir, terapötik yöntemin seçimi dikkatle düþünülmelidir. Erken teþhis ve özelleþtirilmiþ, multidisipliner bir tedavi planý muhtemelen ARMM'nin tedavi sonucunu iyileþtirir.

INTRODUCTION: Primary anorectal malignant melanoma (ARMM) is a rare tumor. Melanomas form 1% of anorectal carcinomas. The prognosis is poor, the 5-year survival rate is 10%. In our study, we evaluated patients with ARMM because of the rare tumor.
METHODS: The patient information of 21 patients with ARMM between October 1998 and February 2019 were retrospectively reviewed. Demographic, clinical, radiological and survival characteristics of the patients were recorded. Kaplan-Meier survival analysis was used for survival analysis.
RESULTS: The mean age of the patients was 59,5 ± 13,3 years (28-76); 8 (38,1%) were male and 13 (61,9%) were female gender. According to tumor localization, 8 (38,1%) anal region, 11 (52,4%) rectal region and 2 (9,5%) were located in the anorectal region. Overall survival (OS) was 16 months (95% Confidence Interval (CI); 13,2-18,7) according to survival analysis. According to the diagnosis of metastasis, the median OS in the early stage was 18 months (95% CI;15,6-20,3); 11 months (95% CI;4,5 ± 17,4) in metastatic disease (p: 0,003).
DISCUSSION AND CONCLUSION: The ARMM does not currently have any treatment guidelines, the choice of the therapeutic method should be carefully considered. Early diagnosis and a personalized, multidisciplinary treatment plan will probably improve the outcome of ARMM treatment.

GÝRÝÞ ve AMAÇ: Mide kanseri tüm dünyada her yýl yaklaþýk yarým milyon hastanýn ölümüne neden olmaktadýr. Dinamik abdominal BT preoperatif taný ve mide kanserlerinin evrelemesinde yaygýn olarak kullanýlmaktadýr. Burada en önemli nokta preoperatif evrelemenin doðru yapýlarak, hastalarýn neoadjuvan kemoterapi gibi uygun tedavi seçeneklerine kavuþabilmesidir. Dinamik abdominal BT'nin preoperatif rolünü daha da netleþtirmek için; preoperatif BT bulgularýný postoperatif ve histopatolojik bulgular eþliðinde karþýlaþtýrdýk.
YÖNTEM ve GEREÇLER: Mide kanseri nedeniyle 2016 - 2019 yýllarý arasýnda operasyon geçiren hastalarýn kayýtlarý geriye dönük olarak incelendi. Tüm preoperatif BT bulgularý cerrahi bulgularla istatistiksel olarak karþýlaþtýrýldý ve preoperatif BT görüntüleri ameliyat sonrasý baþka bir radyolog tarafýndan deðerlendirildi.
BULGULAR: Üç yýl boyunca kliniðimizde toplam 103 hastaya mide kanseri tanýsý konuldu ve opere edildi. Ýncelenen hastalarýn 76 'sý (% 73.7) erkek ve 25' i (% 24.2) kadýndý ve ortalama yaþ 67' idi.Tüm hastalara preoperatif dinamik abdominal BT inceleme yapýldý. Preoperatif BT bulgularý evreleme ve taný için ayrýca hastanýn 16' sýnda (% 15.84) yetersizdi. Bu 16 hastanýn ek görüntüleme teknikleri (PET CT, MR, EUS) ve endoskopi nedeniyle tedavi seçenekleriyle, mortalite ve morbidite oranlarý deðiþmedi.
TARTIÞMA ve SONUÇ: Dinamik abdominal BT' nin mide tümörlerinde preoperatif taný ve evrelemesinde önemli bir rolü vardýr, ancak bazý vakalar yanlýþ deðerlendirilebildiði veya gözden kaçabildiði görülmektedir. Bu yüzden mide tümörü düþünülen hastalarda preoperatif evreleme yapýlýrken BT yanýnda primer olarak endoskopi ve sonrasýnda MRI, PET, EUS gibi ek görüntüleme yöntemleriyle deðerlendirilmesi önemli olarak görülmektedir.

INTRODUCTION: Gastric cancer accounts for nearly half a million deaths each year all over the world. Dynamic abdominal CT is used for preoperative diagnosis and staging of gastric cancers. Preoperative staging must be done correctly, so the patient can get the proper treatment options such as neoadjuvan chemotherapy. To further clarify of preoperative role of dynamic abdominal CT; we compared preoperative CT findings with postoperative, and histopathological findings.
METHODS: Patients’ records, who underwent gastric operation for gastric cancer, between 2016 to 2019 were analyzed retrospectively. All preoperative CT findings were compared with surgical and histopathological findings statistically, and also preoperative CT images were evaluated by another radiologist postoperatively.
RESULTS: For 3 year period total 103 patients were diagnosed and operated for gastric cancer in our clinic. The population was comprised of 76 (73.7%) male and 25(24.2%) female patients who were averagely 67 years old. All of the patþents have preoperative dynamic abdominal CT. Preoperative CT findings for staging and also diagnosis were insufficient for 16 (15.84 %) patients of 101. The treatment options, mortality and morbidity rates for 16 patients did not change, because additional imaging technics (PET CT, MRI, EUS) and endoscopy were performed to these patients preoperatively.
DISCUSSION AND CONCLUSION: Dynamic abdominal CT has a major role for preoperative diagnosis and staging of gastric tumors, but some cases could be misevaluated, so that preoperative evaluation of gastric tumors should be done with dynamic CT and if necessary MRI, PET CT, EUS or endoscopy.

GÝRÝÞ ve AMAÇ: Amaç: Tiroid cerrahisinin en kritik ve istenmeyen, yaþam kalitesini önemli ölçüde azaltabilen komplikasyonu rekürren laringeal sinir felcidir. Ýntraoperatif nöromonitorizasyonu (IONM), rekürren laringeal sinir hasarýný önlemek için yeni bir teknik olarak tanýtýlmýþ olmasýna raðmen, IONM'nin yararlarý hala tartýþmalýdýr. Bu çalýþmanýn amacý, tiroid cerrahisinin postoperatif komplikasyon oranlarýný intraoperatif nöral izlemeli kulanýlan veya kullanýlmayan vakalarda literatür eþliðinde tartýþmaktýr.
YÖNTEM ve GEREÇLER: Hastalar iki gruba ayrýldý; IONM kullanýlan grup (Grup 1, n: 72) ve IONM grubu olmayan geleneksel direkt görsel teknik kullanýlan grup (Grup 2, n: 276). Yaþ, cinsiyet, preoperatif taný, ultrasonografik bulgular, ameliyat türü, ameliyat süresi, postoperatif kalsiyum, parathormon düzeyleri ve erken postoperatif komplikasyonlar kaydedildi.
BULGULAR: Ýki grup arasýnda yaþ, cinsiyet, ameliyat tipi, hastanede kalýþ süresi, postoperatif kalsiyum, parathormon düzeyleri ve preoperatif taný açýsýndan anlamlý fark yoktu. Postoperatif kanama ve ses kýsýklýðý sýrasýyla 6 (% 2.2) hastada ve 3 (% 1.1) hastada grup 2'de belirlendi. Bununla birlikte postoperatif kanama ve ses kýsýklýðý 1.grupta 1 hastada belirlendi. Hipokalsemi, grup 1'de 9 (% 12.5), grup 2'de 48 (% 17.4) hastada (p= 0.24) belirlendi.
TARTIÞMA ve SONUÇ: IONM'nin postoperatif komplikasyon oranlarý üzerine anlamlý bir etkisi saptamadýk

INTRODUCTION: The most critical and undesirable complication of thyroid surgery is recurrent laryngeal nerve palsy which can be significantly deteriorate the quality of life. Although intraoperative neu-romonitoring (IONM) has been introduced as a new technique to prevent recurrent laryngeal nerve damage, the benefits of IONM are still controversial. The aim of this study was to dis-cuss the postoperative complication rates of thyroid surgery with and without intraoperative neural monitoring in the context of the literature.
METHODS: The patients were divided into two groups; IONM used group (Group 1, n: 72) and conven-tional direct visual technique without IONM group (Group 2, n: 276). Age, sex, preoperative diagnosis, ultrasonographic findings, type of surgery, duration of surgery, postoperative calci-um, parathormone levels, and early postoperative complications were recorded.
RESULTS: There was no significant difference between two groups regarding age, gender, operation type, total hospitalization period, postoperative calcium, parathormone levels, and preopera-tive diagnoses. Postoperative bleeding and hoarseness were determined in 6 (2.2%) patients and 3 (1.1%) patients in group 2 respectively. However postoperative bleeding and hoarseness were determined in 1 patient in group 1. Hypocalcemia was determined in 9 (12.5%) patients in group 1 and in 48 (17.4%) patients in group 2 (p= 0.24).
DISCUSSION AND CONCLUSION: We did not determine a significant effect of IONM on postoperative complication rates.

GÝRÝÞ ve AMAÇ: Kliniðimizde primer radyoterapi -kemoradyoterapi uygulanan kasa invaze mesane kanserli hastalarýn akut toksisite ve saðkalým sonuçlarýný deðerlendirmek hedeflenmiþtir.
YÖNTEM ve GEREÇLER: Ankara Atatürk Eðitim ve Araþtýrma Hastanesi Radyasyon Onkolojisi Kliniðinde 2009-2017 yýllarý arasýnda primer küratif tedavi hedeflenerek RT-KRT verilen lokal ileri mesane kanseri 39 hastasýnýn tedavi sonuçlarý ve akut toksisite bilgileri deðerlendirilmiþtir.
BULGULAR: Medyan 23 aylýk takipte genel saðkalým % 32, hastalýksýz saðkalým %28 olarak hesaplanmýþtýr. Hastalarda grad 3 toksisite 3 hastada izlenmiþ, bunlardan 1 i genitoüriner toksisite 2 si ise gastrointestinal toksiste þeklinde görülmüþtür. Tüm hastalar planlanan tedavi þemasýný tamamlamýþtýr.
TARTIÞMA ve SONUÇ: Çeþitli nedenlerle cerrahi tedavi uygulanmayan bu dezavantajlý grupta KRT sonuçlarý cerrahi ile elde edilen sonuçlara ulaþamamaktadýr; bununla birlikte bu hasta grubunda optimal tedavi þemasý için randomize kontrollü çalýþmalara ihtiyaç duyulmaktadýr.

INTRODUCTION: The aim of this study was to evaluate the acute toxicity and survival outcomes of patients with bladder carcinoma who underwent primary radiotherapy - chemoradiotherapy.
METHODS: The treatment results and acute toxicity of 39 patients with local advanced bladder cancer treated with RT-CRT were evaluated in the Radiation Oncology Clinic of Ankara Atatürk Training and Research Hospital between 2009-2017.
RESULTS: Overall survival was 32% and disease-free survival was 28% at median 23-month follow-up. Grade 3 toxicity was observed in 3 patients, one of them was genitourinary toxicity and 2 was gastrointestinal toxicity. All patients completed the planned treatment scheme.
DISCUSSION AND CONCLUSION: In this disadvantaged group, which did not undergo surgical treatment for various reasons, CRT results could not reach the results obtained by surgery; however, randomized controlled trials are needed for the optimal treatment scheme in this patient group.

GÝRÝÞ ve AMAÇ: Benign periferik sinir kýlýfý tümörleri (BPSKT), sik görülen ve tedavisi zorlu tumorlerdir. BPSKT'lerin cerrahi tedavisinde ana hedef nörolojik fonksiyonlarýn korunarak tümörün eksizyonudur. Bu çalýþmanýn amacý BPSKT hastalarinin demografik özelliklerini, klinik prezentasyonlarýný, tumorun cerrahi ve patolojik bulgularýný ve morbidite açýsýndan sonuçlarýný araþtýrmaktýr.
YÖNTEM ve GEREÇLER: 2006 ve 2016 yýllarý arasýnda üçüncü basamak hastanemizde cerrahi olarak tedavi edilen ekstremite yerleþimli BPSKT'li 100 hastanýn klinik ve radyolojik bulgularýnýn retrospektif bir analizi yapýldý.
BULGULAR: Bu seride 55 schwannom, 38 nörofibrom, 5 pleksiform nörofibrom ve 2 pleksiform schwannom olmak uzere 52’si erkek 48’i kadýn toplam 100 hastanýn deðerlendirilmesi yapýldý. En sik klinik prezentasyon aðrýlý kitleydi. Malignite þüphesi olan 20 hastaya ameliyat öncesi biyopsi yapýldý. Bu 20 hastanýn poatoperatif takiplerinde 6'sýnda motor defisit, 7'sinde sürekli aðrý saptandi. %5 (5/100) hastada nüks görüldü. BPSKT 'lerin %23'ü (23/100) NF tip-1 ile iliþkiliydi. Ortalama takip süresi 77 aydý.
TARTIÞMA ve SONUÇ: BPSKT’ler tümörün tamamen eksizyonu ile mükemmel klinik sonuçlara sahiptir. BPSKT’leri her yaþta görülebilirler ve genellikle ele gelen kitle þikayetiyle baþvururlar. Çoðu BPSKT’lerini schwannomalar oluþturmaktadýr. Ortopedistler bir biyopsi ve / veya cerrahi iþlemden kaynaklanan olasý sinir hasarýný göz önünde bulundurmalýdýr. Malignite þüphesi ile olasý sinir hasarý arasýndaki denge göz önüne alýndýðýnda, biyopsi dikkatle planlanmalýdýr.

INTRODUCTION: Benign peripheral nerve sheath tumors (BPNST) are common tumors, with challenging management. The main target of surgical management of BPNSTs is excision of the tumor with preservation of neurological functions. The aim of the present study was to investigate the demographic features, clinical presentations, surgical and pathological findings, and outcomes of BPNSTs in respect of morbidity.
METHODS: A retrospective analysis of clinical and radiological findings of 100 patients with BPNSTs involving the extremities who were surgically treated at our tertiary hospital center, between 2006 and 2016.
RESULTS: In this series, evaluation was made of 100 patients comprising 52 males and 48 females with 55 schwannomas, 38 neurofibromas, 5 plexiform neurofibromas, and 2 plexiform schwannomas. The most presenting feature was painful mass. A pre-operative biopsy was performed in 20 patients with suspicion of malignancy. Of these 20 patients, 6 had post-operative motor deficits and 7 had continuous pain in the follow-up period. Recurrence was seen in 5% (5/100) patients. There were 23% patients (23/100) with BPNSTs were associated with NF type-1. The overall average follow-up was 77 months.
DISCUSSION AND CONCLUSION: BPNSTs have great clinical outcome with total excision of the tumor. BPNSTs are tumors that can be seen at any age, and generally they are presented with a palpable mass. Most of the BPNSTs are schwannomas. Orthopedic surgeons should in mind the possible nerve damage caused by a biopsy and/or surgery. Considering the balance between malignancy suspicion and possible nerve damage, biopsy should be planned carefully.

GÝRÝÞ ve AMAÇ: Akciðer kanseri hem erkek hem de kadýnlarda kansere baðlý ölüm nedenleri arasýnda ilk sýrada yer almaktadýr. Metastatik KHDAK (küçük hücreli dýþý akciðer kanseri) hastalarýnda günümüzde EGFR, ALK ve ROS1 mutasyonu yoksa standart tedavi platin bazlý bir kombinasyon rejimidir. Platinin yanýna kombine edilen ajanýn seçimi genellikle ilacýn toksisite profili ve hastanýn toleransý göz önüne alýnarak belirlenmektedir. Bu çalýþmada metastatik KHDAK tanýsý almýþ olgularda farklý histolojik alt tiplere göre uygulanan birinci seri sistemik kemoterapi ile elde edilen yanýt oranlarýný, progresyonsuz saðkalým ve genel saðkalým sürelerini belirlemeyi amaçladýk.
YÖNTEM ve GEREÇLER: Çalýþmaya Cerrahpaþa Týp Fakültesi Medikal Onkoloji BD’na 2005-2010 yýllarý arasýnda baþvuran, evre IV KHDAK tanýlý 300 hasta alýnmýþtýr. Hastalarýn dosyalarý retrospektif olarak taranarak hastalarýn demografik özellikleri, sigara içme durumu, tümör tipi, birinci seride uygulanan kemoterapi tipi, tedavi yanýt oranlarý, progresyona kadar geçen zaman ve genel saðkalým süreleri belirlendi.
BULGULAR: Birinci seri kemoterapi sonrasý progresyona kadar geçen süre ortalama 5 hafta (GA: 4.5-5.5 ) olarak saptandý.
Tüm histopatolojik tipler açýsýndan progresyona kadar geçen süreler deðerlendirildiðinde birinci seride kullanýlan 5 temel ilaç grubu arasýnda sadece sisplatin-dosetaksel kombinasyonu ile sisplatin-gemsitabin kombinasyonu arasýndaki fark istatistiksel olarak anlamlý bulundu (p=0.03).
Skuamöz hücreli karsinomlarda birinci seride kullanýlan 5 ana ilaç grubu arasýnda progresyona kadar geçen süre açýsýndan istatistiksel olarak anlamlý bir fark saptanmadý.
Adenokarsinom alt tipi için birinci seride kullanýlan 5 ana ilaç grubu arasýnda progresyona kadar geçen süre açýsýndan bakýldýðýnda sadece sisplatin-dosetaksel ve sisplatin- gemsitabin kombinasyonu arasýnda sisplatin – dosetaksel lehine istatistiksel olarak anlamlý bir üstünlük saptandý.
TARTIÞMA ve SONUÇ: Günümüzde Evre 4 KHDAK tedavisinde moleküler testleri deðerlendirmekteyiz. Eðer EGFR, ALK ve ROS 1 mutasyonu yoksa sistemik sitotoksik kemoterapi rejimlerini kullanmaktayýz. Bu rejimler de platin bazlý rejimler olmaktadýr. Platin yanýna ilk basamakta verilecek ajanlarýn progresyona kadar geçen süre göz önüne alýndýðýnda skuamöz hücreli kanserde rejimler arasýnda bir fark saptanmamýþtýr. Adenokarsinomda ise sisplatin – dosetaksel kombinasyonu daha etkin saptanmýþtýr.

INTRODUCTION: Lung cancer is the leading cause of cancer-related death in both men and women. If there is no EGFR, ALK and ROS1 mutation in patients with metastatic NSCLC (non-small cell lung cancer), the standard treatment is a platinum-based combination regimen. The choice of agent combined with platinum is generally determined by considering the toxicity profile of the drug and the tolerance of the patient. In this study, we aimed to determine the response rates, progression-free survival and overall survival in patients with metastatic NSCLC with first-line systemic chemotherapy according to different histological subtypes.
METHODS: The files of totally 300 patients 62 of whom were female and followed with the diagnosis of Stage IV Non-Small Cell Lung Cancer in the Clinic of Medical Oncology of Cerrahpaþa Medical Faculty were investigated retrospectively between 2005 and 2010. Types of first line chemotherapy, the number of cures, treatment response rates, time to progression and overall survival times were determined.
RESULTS: Median time to progression after first line chemotherapy for all the cases was detected as 5 weeks. In the cases with squamous cell cancer, no significant superiority was detected in terms of time to progression with different regimens. In the cases with adenocarcinoma, Cisplatin-Docetaxel combination was found to provide a significant superiority to the Cisplatin-Gemcitabine combination in terms of time to progression.
DISCUSSION AND CONCLUSION: We are currently evaluating molecular tests for the treatment of stage 4 NSCLC. If there is no EGFR, ALK and ROS 1 mutation, we use systemic cytotoxic chemotherapy regimens. These regimens are platinum-based. There was no difference between the regimens in squamous cell carcinoma when the time to progression of the agents to be given to platinum first step was taken into consideration. Cisplatin - docetaxel combination was found to be more effective in adenocarcinoma.

GÝRÝÞ ve AMAÇ: Yeni ajanlar döneminde tedavi edilen multipl myelom (MM) hastalarýnda, bu ajanlara hiç maruz kalmamýþ hastalarla karþýlaþtýrýldýðýnda nüksten itibaren genel saðkalýmda (OS) iyileþme gözlenmiþtir. Bununla birlikte, yeni ajanlar kullanýlsa dahi bazý hastalarda zamanla direnç geliþir ve tekrarlayan nüksler yaþanmaya devam eder. Allojenik kök hücre nakli (AKHN), yüksek riskli sitogenetik özellik taþýyan ve otolog kök hücre nakli (OKHN) sonrasý erken dönemde nüks olan fit hastalar için potansiyel küratif seçenek oluþturur.
YÖNTEM ve GEREÇLER: Aralýk 2009-Aralýk 2017 yýllarý arasýnda indüksiyon tedavisinde en az bir yeni ajan alan, OKHN sonrasý nüks eden ve AKHN yapýlan 9 hastanýn verileri geriye dönük olarak analiz edildi.
BULGULAR: Tüm hastalarda AKHN sýrasýnda medyan yaþ 42 (aralýk 25-56 yaþ), AKHN sonrasý medyan takip süresi 31.5 ay idi. Tüm hastalarda nakil sonrasý OS 27 ay ve progresyonsuz saðkalým (PFS) 15 ay bulundu. Fludarabin-busulfan verilen hastalarda medyan PFS 18 ay, OS 69 ay; siklofosfamid-total vücut ýþýnlamasý (TBI) verilen hastalarda medyan PFS 4 ay, OS 6 ay saptandý. Transplant iliþkili mortalite (TRM) %11 olarak saptandý.
TARTIÞMA ve SONUÇ: Yüksek risk özellikleri taþýyan MM hastalarýnda kemoterapiye refrakter ya da OKHN sonrasý relaps durumlarda AKHN tedavi seçeneði olarak düþünülebilir. Yeni taný veya standart riskli relaps refrakter MM hastalarýnda standart yaklaþým olarak düþünülmemelidir.

INTRODUCTION: In the era of new agents, overall survival (OS) of multiple myeloma (MM) patients have improved compared to patients who had never received these agents. However, some patients develop resistance to new agents and relapse over time. Allogeneic stem cell transplantation (allo-SCT) is a potential curative option for fit patients with high-risk cytogenetic features and in patients who relapse early after autologous stem cell transplantation (ASCT).
METHODS: The data of 9 MM patients who received at least one novel agent during induction treatment and underwent allo-SCT after relapse following ASCT between December 2009 and December 2017 were analyzed retrospectively.
RESULTS: The median age at the time of allo-SCT was 42 years (range 25-56 years) in all patients, and the median follow-up period was 31.5 months. Median OS after allo-SCT was 27 months and median progression free survival (PFS) was 15 months in all patients. Median PFS was 18 months and OS was 69 months in patients who received fludarabine-busulfan and median PFS was 4 months, OS was 6 months in patients who received cyclophosphamide-total body irradiation (TBI). Transplant-related mortality (TRM) was 11%.
DISCUSSION AND CONCLUSION: Allo-SCT may be considered as a treatment option after relapse following ASCT in MM patients with high risk characteristics. Allo-SCT should not be considered in initial treatment or in relapse refractory MM patients with standard risk.

GÝRÝÞ ve AMAÇ: Medikal turist tanýmý çeþitli týbbi tedavi türlerini almak için uluslararasý sýnýrlar arasýnda seyahat etmeyi seçen demektir. Hizmetin kalitesi ve kullanýlabilirliði, týp turizmi davranýþýnýn yaný sýra ekonomik ve kültürel faktörleri de etkiler. Birçok ülke, medikal turizm tarafýndan saðlanan fýrsatlardan yararlanmanýn yollarýný araþtýrmaya baþladý. Ülkemizde saðlýk turizmi hastalarý genellikle özel hastanelerde tedavi edilmektedir. Saðlýk turizmi hastalarýnýn devlet hastanelerinde kabulü, ülke ekonomisine katkýda bulunacaktýr. Bu çalýþmanýn amacý, hastanemiz hematoloji kliniðinin kemik iliði naklinde saðlýk turizmi potansiyeline dikkat çekmek.
YÖNTEM ve GEREÇLER: Ankara Onkoloji Hastanesi'nde 2009-2019 yýllarý arasýnda saðlýk turizmi ve iki taraflý anlaþma kapsamýnda yapýlan kemik iliði nakillerinin sayýsal analizi yapýldý.
BULGULAR: Geçtiðimiz on yýlda merkezimizde 33 hastada otolog transplantasyon, 37 hastada allojeneik kemik iliði transplantasyonu yapýldý.
TARTIÞMA ve SONUÇ: Tecrübeli kemik iliði nakil merkezlerinde saðlýk turizmi, yakýndaki coðrafyadaki ülkelerden hastalarý çekerek ülke ekonomisine katkýda bulunabilir.

INTRODUCTION: Medical tourists select to travel across international borders to receive various kinds of medical treatment. The quality and availability of the service also affects the behavior of medical tourism, as well as economic and cultural factors. Many countries started to investigate the ways to benefit from the opportunities provided by the medical tourism. In our country, health tourism patients are generally treated in private hospitals. The acceptance of health tourism patients in public hospitals will contribute to the national economy. The aim of this study is to draw attention to the health tourism potential of bone marrow transplantation of our hematology clinic.
METHODS: Quantitative analysis of bone marrow transplants performed in Ankara Oncology Hospital between 2009-2019 under the scope of health tourism and bilateral agreement was performed.
RESULTS: In the last decade, 33 patients underwent autologous transplantation and 37 patients underwent allogenic bone marrow transplantation in our clinic.
DISCUSSION AND CONCLUSION: Health tourism in experienced bone marrow transplant centers can contribute to the country's economy by attracting patients from countries in the nearby geography.

GÝRÝÞ ve AMAÇ: Meme kanseri dünyada en sýk görülen ikinci kanser türüdür. Meme kanserinin en sýk görülen tipi invaziv duktal karsinomdur. Memenin nöroendokrin differansiasyon gösteren tümörleri ise daha nadir görülür ve 2003’ten itibaren Dünya Saðlýk Örgütü nöroendokrin diferansiyasyon gösteren meme kanserlerini sýnýflamaya sokmuþtur. Farklý serilerde farklý oranlar bildirilmiþtir. Bu yazýmýzda kliniðimizde son 4 yýl içerisinde nöroendokrin meme kanseri tanýsý alan 21 hastamýzý sunduk.

YÖNTEM ve GEREÇLER: Bu çalýþmada Dr. Abdurrahman Yurtaslan Ankara Onkoloji Eðitim ve Araþtýrma Hastanesi’nde 2015-2019 yýllarý arasýndaki 4 yýllýk sürede nöroendokrin differansiasyon gösteren meme kanseri tanýsý alýp, opere edilen 21 hasta deðerlendirildi.
BULGULAR: Kliniðimizde 2016-2019 yýllarý arasýnda 1015 hastaya meme kanseri tanýsý kondu ve bunlarýn 21’i nöroendokrin meme kanseri tanýsý aldý(%2.07).
TARTIÞMA ve SONUÇ: Nöroendokrin meme tümörleri, sýklýðý konusunda bir konsensus oluþmamýþ olsa da 2003’ten itibaren Dünya Saðlýk Örgütü sýnýflamasýna girmiþ bir meme kanseri türüdür. Onkolojideki son geliþmeler ve hedefe yönelik tedavi planlarý, tümör hücrelerinin moleküler biyolojilerinin çok önemli olduðunu göstermiþtir.

INTRODUCTION: Breast cancer is the second most common cancer type in the world. The most frequent type of breast cancer is invasive ductal carcinoma. However neuroendocrine tumors of the breast are uncommon and World Health Organization(WHO) defined and classified neuroendocrine differantiated breast tumors as a different type in 2003. There are different frequency rates in literature. In this study we reported 21 patients who had been diagnosed with neuroendocrin breast cancer in our clinic between 2016 and 2019.
METHODS: In this study we reported 21 patients who had been diagnosed and operated with neuroendocrine differantiated breast cancer between 2015 and 2019 in Dr Abdurrahman Yurtaslan Training and Research Hospital.
RESULTS: 1015 patients had been diagnosed with breast cancer between 2016 and 2019 in our clinic and 21 of them%2.07) were neuroendocrine differantiated breast cancer.
DISCUSSION AND CONCLUSION: However there is not a consensus about its frequency neuroendocrine breast tumors are defined and classified by who in 2003 as a different type of breast tumor. The recent progress in technology and targeted therapies shows us the importance of defining the molecular biology of the tumor cells.

GÝRÝÞ ve AMAÇ: Müsinöz adenokarsinom kolorektal adenokanserlerin alt tipidir. Diðer müsinöz olmayan adenokanserlerden (MOA) genetik, klinik ve patolojik farklýlýklarý olmasýna raðmen müsinöz adenokanserlerin( MA) prognostik önemi halen tartýþmalýdýr. Bu çalýþmanýn amacý kolorektal müsinöz adenokarsinomun klinikopatolojik özelliklerini ve prognostik önemini deðerlendirmektir.
YÖNTEM ve GEREÇLER: Ocak 2012 ile Aralýk 2018 tarihleri arasýnda kliniðimizde kolon adenokanseri nedeniyle opere edilen 413 hastanýn verileri incelendi. Analizlerde yaþ, cinsiyet, lokasyon, tümör büyüklüðü, invazyon derinliði, lenf nodu metastazý, uzak metastaz varlýðý, operasyon yöntemi ve aciliyeti, perinöral ve lenfovasküler invazyon varlýðý, müsinöz histoloji varlýðý prognostik faktör olarak incelendi.
BULGULAR: Müsinöz grupta hastalýk daha çok kolonda lokalize, 5 cm’den daha büyük olma eðiliminde ve invazyon derinliði daha fazla idi. Tüm grubun 3 yýllýk genel saðkalýmý %74, 5 yýllýk saðkalýmý %63 olarak saptandý. Müsinöz grupta saðkalým oranlarýnýn daha düþük olduðu (3 yýllýk genel saðkalým; MA % 58, MOA % 75 p=0.01; 5 yýllýk genel saðkalým; MA % 58, MOA % 64 p=0.01) gözlendi. Tek deðiþkenli analizlerde tümör büyüklüðü ve cinsiyet dýþýnda diðer tüm deðiþkenler anlamlý olarak fark yaratmakta idi. Çok deðiþkenli analizlerde yaþýn 65 ve üzerinde olmasý, uzak metastaz varlýðý, perinöral invazyon varlýðý, acil opere edilmiþ olmasý ve müsinöz histoloji varlýðýnýn prognostik özellik olduðu saptandý. (MA 33.9±3.4, MOA 58.1±1.7ay p: 0.006).
TARTIÞMA ve SONUÇ: MA’un biyolojik davranýþý müsinöz olmayan adenokarsinomlara göre daha kötüdür. Kolorektal kanserlerde tedavi baþarýsýný artýrmak için kanserlerin alt tiplerine, histolojik özelliklerine ve genetik özelliklerine dayalý bireyselleþtirilmiþ tedavilerin ve takiplerin geliþtirilmesi gerekmektedir.

INTRODUCTION: Mucinous adenocarcinoma is a subtype of colorectal adenocarcinomas. Although it differs from non-mucinous adenocarcinomas (nMA) genetically, clinically and pathologically, the prognostic significance of mucinous adenocarcinomas (MA) is controversial. The aim of this study is to evaluate the clinicopathological features and prognostical significance of colorectal mucinous adenocarcinoma.
METHODS: The datas of 413 patients that has been operated in our clinic between January 2012 and December 2018 due to adenocarcinoma of colon were scanned. In the analyses, age, sex, location, tumour size, invasion depth, lymph node metastasis, existence of distant metastasis, operation method and degree of urgency, perineural and lymphovascular invasion, mucinous histology were investigated as prognostic factors.
RESULTS: In the mucinous group, the disease was more localized in the colon, tending to be greater than 5 cm, and the depth of invasion was greater. All patients had a 3-year overall survival rate of 74% and a 5-year overall survival rate of 63%. Survival rates were lower in the mucinous group (3-year overall survival; MA 58%, nMA 75% p = 0.01; 5-year overall survival; MA 58%, nMA 64% p = 0.01). In univariate analyzes, all variables except tumor size and gender were significantly different. In multivariable analyses, it is observed that being over 65 years, distant metastasis, perineural invasion, the urgency of the operation and mucinous histology presence were related to poor prognosis. (MA 33.9±3.4, nMA 58.1±1.7 months p: 0.006)
DISCUSSION AND CONCLUSION: Biological behaviour of MA is worse than nonmucinous adenocarcinomas. It is mandatory to develop individual therapies according to subtypes, histological and genetical features of cancers in order to increase the therapeutic success in colorectal cancers.

GÝRÝÞ ve AMAÇ: Bu çalýþmada farklý grade’deki astrositomalarda COX-2 ve Ki-67 ekspresyonu incelendi. Bu iki belirteçin grade’ler arasýndaki ekspresyon farklýlýðý ve birbiri ile olan iliþkisi deðerlendirildi
YÖNTEM ve GEREÇLER: Çalýþmaya retrospektif olarak 20 grade II, 20 grade III, 20 grade IV astrositoma tanýsý almýþ toplam 60 operasyon materyali dahil edildi. Ýmmünhistokimyasal yöntemle Ki-67 ve COX-2 çalýþýldý. Verilerin analizi SPSS for Windows 11.5 paket programýnda yapýldý. Shapiro Wilk testi, Mann Whitney U testi, Kruskal Wallis testi, çoklu karþýlaþtýrma testi kullanýldý.
BULGULAR: Grade II’ye göre grade III ve IV astrositomalý olgularda COX-2 boyanma yaygýnlýðý daha yüksek olarak bulundu (p<0.001 ve p<0.001). Grade III ile grade IV astrositomalý olgular arasýnda COX-2 boyanma yaygýnlýðý açýsýndan anlamlý farklýlýk yoktu (p=0.087). Grade II’ye ve grade III’e göre grade IV’te COX-2 ile kuvvetli boyanan olgu sayýsý fazla idi (p<0.001 ve p=0.030). Grade II ile grade III astrositomalý olgular arasýnda COX-2 boyanma yoðunluðu açýsýndan anlamlý farklýlýk yoktu (p=0.198). Grade II’ye göre grade III ve grade IV tümörlerde ayrýca grade III’e göre grade IV tümörlerdeki Ki-67 indeksi daha yüksek olarak bulundu (p=0.007, p<0.001, p<0.001). COX-2 boyanmasý olmayan gruba ve zayýf boyanan gruba göre kuvvetli boyanan grubun Ki-67 indeksi daha yüksek olarak bulundu (p=0.004 ve p=0.004). Boyanmayan ve zayýf boyanan grup arasýnda Ki-67 indeksi benzerdi (p=0.096).
TARTIÞMA ve SONUÇ: COX-2 ekspresyonunun astrositomalarýn progresyonunda rol oynayabileceði, daha agresif tümörleri yansýtabileceði, astrositomalarýn tedavisinde COX-2 inhibitörlerinin mevcut tedavi protokollerine ek terapötik role sahip olabileceði, farklý grade’e sahip tümörleri birbirinden ayýrt etmede Ki-67’nin kullanýlabileceði düþünüldü.

INTRODUCTION: In the present study, COX-2 and Ki-67 expression were investigated in astrocytomas of different grade. Difference between the expressþon levels of these two markers and their relationship with each other were evaluated.
METHODS: A total of 60 surgical materials diagnosed as 20 grade II, 20 grade III, 20 grade IV astrocytoma retrospectively were included in the study. Ki-67 and COX-2 were studied by immunohistochemical method. Data analysis was performed using SPSS for Windows, version 11.5. Shapiro Wilk test, Mann Whitney U test, Kruskal Wallis test, and multiple comparison test were used.
RESULTS: The prevalence of COX-2 staining was higher in patients with grade III and IV astrocytoma than grade II (p <0.001 and p <0.001). There was no significant difference between grade III and IV astrocytomas in terms of COX-2 staining prevalence (p = 0.087). The number of cases stained with COX-2 in grade IV was higher than those of grade II and grade III (p <0.001 and p = 0.030). There was no significant difference between Grade II and Grade III astrocytomas in terms of COX-2 staining intensity (p = 0.198).Ki-67 index was higher in grade III and grade IV tumors compared to grade II and in grade IV tumors compared to grade III (p = 0.007, p <0.001, p <0.001). The Ki-67 index of the strongly stained group was higher than the group without COX-2 staining and weak staining group (p = 0.004 and p = 0.004). Ki-67 index was similar between unstained and poorly stained groups (p = 0.096).
DISCUSSION AND CONCLUSION: We conclude that COX-2 expression may play a role in the progression of astrocytomas, may be associated with more aggressive gliomas, and COX-2 inhibitors may have a therapeutic role in addition to the existing treatment protocols of astrocytomas, and Ki-67 immunostaining might be effective in differentiating tumors of different grades.

GÝRÝÞ ve AMAÇ: Pankreas kanseri, tüm diðer kanser türleri arasýnda en yüksek mortalite oranýna sahip olan türdür. Pankreas kanserinin 2030 yýlýna kadar akciðer kanserinden sonra en sýk ölüme sebebiyet veren kanser türü olacaðý ön görülmektedir. BRCA1, BRCA2, CDKN2A, ATM, PALB2 ve Lynch sendromu genleri pankreas kanserine yatkýnlýk oluþturmaktadýr. Bu genlerde ki patojenik veya þüpheli varyantlarýn bilinmesi önemlidir. Bizde çalýþmamýzda ailesel yatkýnlýk olduðu düþünülen Türk pankreas kanseri hastalarýnda ki varyantlarý araþtýrmayý hedefledik.
YÖNTEM ve GEREÇLER: Pankreas kanseri nedeni ile baþvuran ve soygeçmiþinde çok sayýda kanser öyküsü bulunan 16 hastanýn sonuçlarý retrospektif olarak incelendi. Hastalara ait DNA örnekleri yeni nesil DNA dizi analizi yöntemi ile dizilendi.
BULGULAR: Çalýþma sonucunda 7 hastada hastalýk sebebi olduðunu düþündüren herhangi bir deðiþim saptanmadý. Beþ hastada klinik önemi bilinmeyen (VUS) deðiþim, 3 hastada patojenik ve bir hastada ise muhtemel patojenik deðiþim tespit edildi.
TARTIÞMA ve SONUÇ: Çalýþma sonrasýnda daha önce pankreas kanseri ile iliþkili olduðu bilinen genlerde patojenik deðiþimler saptadýk. Özellikle BRCA2, ATM ve MEN1 geninde bulunan deðiþimlerin hastalýkla güçlü bir iliþkisi olduðunu düþünmekteyiz. Türk pankreas kanseri hastalarýnda daha önce böyle bir çalýþma yapýlmamýþ olmasýnýn yanýnda yeni tespit ettiðimiz varyantlarýn literatüre katkýsý olacaðýný düþünüyoruz.

INTRODUCTION: Pancreatic cancer has the highest mortality among the all cancers. It is predicted that pancreatic cancer will be the most common cancer that causes death after lung cancer until 2030. BRCA1, BRCA2, CDKN2A, ATM, PALB2 and Lynch syndrome genes predispose to pancreatic cancer. It is important to know the pathogenic or VUS variants in these genes. In our study, we aimed to investigate variants in Turkish pancreatic cancer patients who are thought to have familial predisposition.
METHODS: The results of 16 patients who referred to for pancreatic cancer and had a family history of cancer history were analyzed retrospectively. DNA samples of the patients were sequenced by the next generation DNA sequence analysis method.
RESULTS: As a result of the study, no change was detected in 7 patients suggesting the cause of the disease. Five patients had unknown clinical significance (VUS) variant, three patients had pathogenic variant and one patient had likely pathogenic variant.
DISCUSSION AND CONCLUSION: In this study, we detected pathogenic variants in genes previously known to be associated with pancreatic cancer. We think that especially the variants in BRCA2, ATM and MEN1 gene have a strong relation with the pancreatic cancer. We think that in Turkish pancreatic cancer patients, such a study has not been done before and the new variants we have identified will contribute to the literature.

GÝRÝÞ ve AMAÇ: Kromozomal boyutta 50 bazdan daha büyük alaný kaplayan deðiþikliklere kopya sayýsý deðiþikliði (copy number variation – CNV) adý verilmektedir. Beþinci kromozom, üzerinde yerleþik genlerin fonksiyonu itibariyle farklý fenotiplerin geliþimine açýk ve diðer kromozomal lokasyonlara nazaran patojenik deðiþikliklerin daha sýk görüldüðü bir alandýr. Makalemizde, bu antiteyi desteklemek amacýyla mikrodizin analizlerinde tespit edilen, beþinci kromozomda yerleþik patojenik CNV’lerin sebep olduðu bir Sotos sendromu, bir CCT5 geni iliþkili nöropati ve üç 5q14 mikrodelesyonu bildirilmiþtir.
YÖNTEM ve GEREÇLER: Mikrodizin çalýþmalarý, Affimetrix® Cytoscan Optima çipleri ile yapýlýp, hasta verileri Chromosome Analysis Suite (ChAS) 3.1 Thermo Fisher Scientific® programý yardýmýyla analiz edildi.
BULGULAR: Vaka 1, vaka 2 ve vaka 3’de, delesyonlu alanlarýn kapsamý deðiþken olmakla birlikte, 5q14.3 mikrodelesyonu tespit edilmiþtir. Vaka 4, NSD1 gen delesyonu ile Sotos sendromu tanýsý almýþtýr (arr[GHCR38]5q35.2q35.3(176144147_177716919)x1). Vaka 5’in temel bulgusu kas güçsüzlüðü ve bununla iliþkili olarak EMG’de nöropati ile uyumlu denervasyon bulgularý olup, mikrodizin analizinde CCT5 geninin delesyonu klinikle iliþkilendirilmiþtir (arr[GRCh38]5p15.2(10236581_10253807)x1) (Tablo 1).
TARTIÞMA ve SONUÇ: Mikrodizin analizinin bu algoritmadaki yeri ve limitasyonlarý; sunulan vakalardaki literatürdeki yeni bulgularla beraber tartýþýlmýþtýr. Özellikle beþinci kromozomda yerleþik genlerde görülen CNV’lerin OMIM fenotipleri ile yoðun iliþkisi bu bölgeye ait hastalýklarýn tanýsýnda mikrodizin analizinin önceliðini ön plana çýkarmýþtýr.

INTRODUCTION: Chromosomal rearrangements that cover more than 50 bases are called copy number variation (CNV). The fifth chromosome is a position, open to the development of different phenotypes in terms of the function of the genes located on it, and pathogenic changes are more common than other chromosomal locations. To support this entity, we reported a Sotos syndrome, a CCT5 gene-related neuropathy, and three 5q14 microdeletions, detected by microarray analysis, caused by pathogenic CNVs located on the fifth chromosome.
METHODS: Microarray analysis were performed with Affimetrix® Cytoscan Optima chips and patient data were analyzed with the help of Chromosome Analysis Suite (ChAS) 3.1 Thermo Fisher Scientific® program.
RESULTS: Although the scope of deletion areas in case 1, case 2 and case 3 is variable, 5q14.3 microdeletion was detected. Case 4 was diagnosed with Sotos syndrome by deletion involving the NSD1 gene (arr [GHCR38] 5q35.2q35.3 (176144147_177716919) x1). The main finding of Case 5 is muscle weakness and denervation findings in EMG compatible with neuropathy, and in the microarray analysis, deletion of the CCT5 gene has been clinically associated (arr [GRCh38] 5p15.2 (10236581_10253807) x1) (Table 1).
DISCUSSION AND CONCLUSION: The importance and limitations of microarray analysis in this algorithm have been discussed along with new findings in the literature in the presented cases. CNVs, especially in the genes located in the fifth chromosome, have a strong relationship with OMIM phenotypes, highlighting the priority of microarray analysis in the diagnosis of diseases belonging to this region.

Giriþ: Kolorektal kanser (KRK) insidans ve kansere baðlý mortalitede tüm dünyada 3. sýrada yer almaktadýr. Biz bu olgu ile literatürde nadir olan, endometriyum metastazlý rektum kanseri vakasýný sunmayý amaçladýk.
Olgu sunumu: 62 yaþýnda kadýn hasta 2014 yýlý Ekim ayýnda rektal kanama þikâyeti ile dýþ merkeze baþvurduðunda yapýlan kolonoskopisinde lümeni tama yakýn dolduran ülserovejetan kitle tespit edilmiþ ve biyopsi alýnmýþtý. Biyopsi patolojisi adenokarsinom ile uyumlu olarak raporlanmýþ ve hastaya rektum kanseri tanýsý ile low anterior rezeksiyon ameliyatý yapýlmýþtý. Hastanýn adjuvan tedavisi tamamlanmasýnýn ardýndan takibinin devamý için devir alýnmýþtý. 3 ay aralýklarla takibi yapýlan hastanýn kontrol tomografilerinde akciðer nodüllerinde RECIST kriterlerine göre %20’nin üzerinde boyut artýþý görülmesinden dolayý pozitron emisyon tomografisi (PET/CT) çekildi. PET/CT de akciðerdeki noduler lezyonlarda ve uterus korpusu içerisinde hipermetabolik odaklar tespit edildi. Hastaya akciðer nodüllerinden ve endometriyumdan biyopsi yapýldý. Hastanýn yapýlan akciðer tru-cut biyopsisi ve endometriyum küretaj biyopsisi metastatik adenokarsinom ( gastrointestinal sistem-kolon ile uyumlu) olarak raporlandý.
Tartýþma: KRK'lý hastalarýn yaklaþýk % 20'sinde taný anýnda uzak metastaz mevcuttur. Genel olarak, KRK’lar bölgesel lenf nodlarýna, karaciðere, akciðere ve daha az sýklýkla kemik, beyin ve periton boþluðuna metastaz yapar. Çoðunlukla düz kas dokusundan oluþan uterus, nadiren ekstragenital kanserlerin metastatik bölgesi olarak tanýmlanmaktadýr. KRK’larýn ise endometriyum metastazý geliþen vakalarý literatürde sýnýrlý sayýda mevcuttur. Biz bu vakayý hem nadir görülmesi hem de metastatik tümörler ile uterusun primer tümörlerinin ayýrýcý tanýsýnýn önemli olmasý nedeni ile vurguladýk.

Background: Colorectal cancer (CRC) is ranked third in the world in incidence and cancer-related mortality. In this case report, we aimed to present a case of rectum cancer with endometrial metastasis which is rare in the literatüre.
Case report: On October, 2014; a 62-year-old woman was admitted to outer clinic with a complaint of rectal bleeding. In the colonoscopy, an ulcerovegetan mass was detected and biopsied. Biopsy pathology was reported as adenocarcinoma and the patient underwent a low anterior resection due to diagnosis of rectal cancer. The adjuvant therapy of the patient was completed and the patient was transferred to our clinic for follow-up. After adjuvant therapy, PET/CT examination was performed due to the fact that the sizes of nodules showed 20% increase according to RECIST criteria by thoracic tomography performed three months intervals. In PET / CT, hipermetabolic foci were detected in nodular lesions in the lung and within the uterine corpus. The patient's lung tru-cut biopsy and biopsy of the endometrial cavity was reported adenocarcinoma.
Conclusion: Approximately 20% of patients with CRC have distant metastasis at the time of diagnosis. In general, CRCs metastasize to regional lymph nodes, liver, lung, and less frequently to the bone, brain, and peritoneal cavity. The uterus, which is mostly composed of smooth muscle tissue, is rarely described as the metastatic region of extragenital cancers. Endometrium metastases of CRCs are cases in a limited number in the literature. We emphasize this case because of its rarity and beacuse of importance of differatial diagnosis of primary and metastatic tumors of the uterus.

Bir Nargile Ýçimi Ýle Geliþen Nadir Görülen Karbon Monoksit Zehirlenmesi: Vaka Sunumu

Özellikle kýþ aylarýnda ülkemizde karbonmonoksit (CO) ile zehirlenme en ölümcül olan çok önemli bir morbidite nedenidir. Taburcu olanlarýnda yaklaþýk %50-75’inde nörolojik veya psikiyatrik sekeller býrakmaktadýr. Ülkemiz þartlarýnda CO ile zehirlenmesi olan her hastanýn hiperbarik oksijen tedavisi yapýlan bir merkeze sevki mümkün olmamaktadýr. CO zehirlenmesi olan hastalar %100 oksijen veya hiperbarik oksijen ile tedavi edilebilir. Bu vakamýzda da olduðu gibi destek tedavinin iyi yapýlmasý hayat kurtarýcýdýr.
Nargile son dönemlerde gençler tarafýndan yaygýn olarak kullanýlmaktadýr. Nargile içicilerinde CO intoksikasyonu nadir izlenir. Bu sunumda, 19 yaþýnda olan ve nargile içimi sonrasýnda CO intoksikasyonu sonucu bayýlma ve hipotansiyon ile 112 acil servis tarafýndan acil servise getirilen erkek hasta sunulmuþtur. Acil servise baygýn halde112 acil servis tarafýndan getirilen hastanýn Karboksihemoglobin seviyesi %43 olarak ölçülmüþtür. Acil servise baþvuran bayýlma, bilinç bulanýklýðý, yorgunluk, halsizlik gibi nonspesifik þikayetler ile gelen özellikle genç hastalarda nargile kullanýmý ve duman maruziyeti derinlemesine sorgulanmalý ve CO intoksikasyonu konusunda uyanýk olunmalýdýr.

Rare side effect of Hookah Smoking; Carbon Monoxide Poisoning: Case Report
Carbon monoxide poisoning is a very important cause of morbidity, especially in winter at our country. Approximately 50-75% of those discharged leave neurological or psychiatric sequelae. In our country, it is not possible to refer every patient with carbon monoxide poisoning to a center where hyperbaric oxygen treatment is performed. Patients with carbon monoxide poisoning can be treated with 100% oxygen or hyperbaric oxygen. As in this case, good supportive treatment is life-saving.
Hookah is widely smoked among young people in recent years. Carbon monoxide (CO) intoxication is rare in hookah smokers. In this report, we present a 19-year-old male patient who was brought to the emergency department by 112 emergency with fainting and hypotension following CO intoxication after smoking a hookah. patient's carboxyhemoglobin level was detected 43% at admission. The use of hookah and smoke exposure should be questioned in depth ýn terms of carbon monoxide (CO) intoxication, especially in young patients presenting with nonspecific complaints such as fainting, blurred consciousness, fatigue, weakness, and vigilance.

Peritoneal karsinomatozisi olan seçilmiþ hasta grubunda sitoreduktif cerrahi ve hipertermik intraperitoneal kemoterapi oldukça etkili bir tedavi metodudur. Bu strateji pseudomiksoma peritonei, peritoneal mezotelyoma gibi hastalýklarda uzun dönem sonuçlarý oldukça iyidir. Overin epitelyal tümörlerine, koleraktal kanserlerin peritoneal metastazlarýnda da faydalý olduðunu gösteren çalýþmalar mevcuttur. Bir çok iyi sonucunun yanýnda sitoreduktif cerrahi ve hipertermik intraperitoneal kemoterapinin mortalitesi ve morbiditesi oldukça yüksektir. Bu makalemizde sitoreduktif cerrahi ve hipertermik kemoterapi sonrasý geliþen oldukça nadir görülen cilt nekrozu komplikasyonunu sunduk.

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is a very effective treatment combination in selected patients with peritoneal carcinomatosis. This protocol has good long-term results in diseases such as pseudomyxoma peritonei and peritoneal mesothelioma. There are also studies that show the benefits of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in ovarian epithelial tumors and peritoneal metastasis of colorectal cancers. However mortality and morbidity rates of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy are high. In this report, we presented a very rare case, skin necrosis that occured after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

Pigmente villonodüler sinovit (PVNS) nadir görülen, sinoviyal eklemleri/membraný tutan iyi davranýþlý bir hastalýktýr. En sýk diz ekleminde görülür ve standart tedavisi cerrahidir. Diffüz PVNS' de tek baþýna cerrahi ile yüksek lokal yineleme oranlarý vardýr. Literatürde bildirilen küçük olgu serilerine göre cerrahiye radyoterapi (RT)'nin eklenmesi ile lokal kontrol artmaktadýr. Biz de bu yazýda cerrahi sonrasý RT uyguladýðýmýz iki diffüz PVNS olgusunu ve ilgili literatürü sunmaktayýz. Diz aðrýsý ve þiþlik þikayeti ile hastanemize baþvuran iki kadýn olguda yapýlan manyetik rezonans görüntüleme (MRG)’de diz eklemlerinde solid kitle görüntüsü izlendi. Radyolojik olarak PVNS düþünülen olgular total sinovektomiye gitti. Ýki diffüz PVNS olgusuna da þüpheli cerrahý sýnýr nedeni ile postoperatif 32 ve 36 Gy RT uygulandý. Otuz bir ve 32 aylýk takipte her iki olguda da lokal yineleme görülmedi. Akut yan etki gözlenmezken, bir olguda RT'nin geç komplikasyonu olarak artiküler effüzyon ve peripatellar aðrý gözlendi. Sonuç olarak RT, diffüz PVNS 'de lokal yinelemeyi önleyen ve daha ileri olgularda ekstremite koruyucu yaklaþýmlara olanak saðlayan etkili ve güvenilir tedavi seçeneði olabilir.

Pigmented villonodular synovitis (PVNS) is a rare, well-behaved disease involving the synovial membrane and joints. Diffuse PVNS has high recurrence rate with surgery alone. We aimed to present the results and side effects of radiotherapy (RT) in two cases with PVNS in the light of literature. Two female patients were admitted to our hospital with pain and swelling on their right knees. Magnetic resonance imaging (MRI) showed a solid mass in the knee joints. Patients who were thought to have PVNS radiologically, underwent total synovectomy. Patients with diffuse PVNS received postoperative 32 and 36 Gy RT on account of uncertain surgical margin status. No acute side effects related to radiotherapy were observed in the both cases. In one case, one year after radiotherapy, the articular effusion and peripatellar pain evolved as a late complication. There were no local recurrence at 31 and 32 months follow-up. As a result, radiotherapy is a safe and effective treatment option for preventing recurrence of diffuse PVNS and provides protection of extremities in very advanced cases. However, more studies with long-term follow-up are needed.

GÝRÝÞ ve AMAÇ: Amaç: Osteosarkom genelde çocukluk ve genç eriþkin yaþlarda görülmekte ve çok agresif seyretmektedir. Tedavide ekstremite koruyucu cerrahi ve kemoterapi yöntemleri ile büyük baþarýlar saðlanmýþtýr, ancak mikroskobik düzeyde kalabilen rezidü tümörler rekürrens olasýlýðýný arttýrmaktadýr. Bu çalýþmada kadmiyumun sement ile birlikte in vitro uygulanabilirliðini deðerlendirilmesi ve cerrahi sonrasý lokal uygulanarak rezidü tümör ve rekürrens olasýlýðýný önlemedeki etkinliði için ön bulgularýn deðerlendirilmesi amaçlanmýþtýr.

YÖNTEM ve GEREÇLER: Gereç ve Yöntem: MG-63 ve K7M2 osteosarkom hücre hatlarý dört gruba ayrýlarak ilk gruba kadmiyumun dondurulmuþ kemik çimentosuna emdirilmiþ hali; ikinci gruba ise kadmiyumun toz haldeki çimentoya eklendikten sonra karýþtýrýlarak hazýrlanmýþ þekli artan sayýlarda hücre hatlarýna uygulanmýþtýr. Sadece kadmiyum çözeltisinin uygulandýðý ve kadmiyum eklenmeden standart þekilde hazýrlanan kemik çimentosunun uygulandýðý hücre hatlarýndaki canlýlýk yüzdeleri ile WST-1 yöntemi kullanýlarak karþýlaþtýrýlmýþtýr.

BULGULAR: Bulgular: Kadmiyum eklenip karýþtýrýlarak hazýrlanan çimentonun uygulandýðý grupta; donmuþ çimentoya emdirilerek uygulandýðý gruptan daha yüksek sitotoksik etki tespit edildi. Tek baþýna kadmiyum uygulandýðýnda ise 5 ve 10 kat seyreltmeler çalýþmadaki en yüksek anti-proliferatif etkiyi gösterdi (%25 ve %42 canlýlýk). Sementin kadmiyumsuz uygulandýðý grupta ise %80’lere ulaþan en yüksek oranda canlýlýk gözlendi.
TARTIÞMA ve SONUÇ: Sonuç: Bu çalýþma ile kadmiyumun dondurulmuþ çimento içerisine emdirilerek ya da çimento hazýrlýðý sýrasýnda kemik çimentosuna eklenmesi ile uygulanabileceði ve her iki þekilde de Osteosarkom hücreleri üzerine sitotoksik etkiye sahip olduðu gösterilmiþtir.

INTRODUCTION: Objective: Osteosarcoma is usually seen in childhood and young adults and presents itself very aggressive. Great treatment success with limb-sparing surgery and chemotherapy are provided, but the residue tumor cells that remains at the microscopic level are increasing the likelihood of tumor recurrence. The aim of this study was to evaluate the in vitro applicability of cadmium with cement and to evaluate the preliminary findings for its effectiveness in preventing the possibility of residual tumor and recurrence by local application after surgery.

METHODS: Materials and Methods: The MG-63 and K7M2 osteosarcoma cell lines were divided into four groups. The first group included application of bone cement which absorbed cadmium after preparation. The second group of bone cements were prepared with adding cadmium into powdered bone cement was applied to the cell lines in increasing numbers. The percentages of viability in cell lines were evaluated using WST-1 method and compared with bone cement prepared in the standard manner without adding cadmium and application of cadmium solution into cell lines.
RESULTS: Results: In the second group where the cement was prepared by adding cadmium before bone cement mixing; higher cytotoxic effect was detected than the first group which consisted of bone cement which absorbed cadmium after cement preparation. When cadmium solution without bone cement was applied, 5 and 10-fold dilutions showed the highest anti-proliferative effect in the study (25% and 42% viability). In the group where bone cement without any cadmium was applied, the highest rate of viability was observed reaching up to %80.
DISCUSSION AND CONCLUSION: Conclusion: This study has shown that bone cement either prepared with cadmium or absorbed cadmium after preparation; may be administered as an adjuvant therapy and both have cytotoxic effects upon osteosarcoma

GÝRÝÞ ve AMAÇ: Osteosarkom, mezenkimal dokulardan türetilmiþ, yüksek maligniteli yaygýn bir tümördür. Osteosarkom genellikle ergenlerde görülür ve büyüme hýzlýdýr, metastaz ve mortalite oranlarý yüksektir ve prognozu zayýftýr. Kemoterapötik tedavilere cevap verilmemesi, yeni terapötik yöntemlerin araþtýrýlmasýnýn önemini gösterir. N-(4-klorofenil)-1H-indol-2-karboksamid, etkili antioksidan özellikler gösteren, ayný zamanda tirozin kinaz hedefleri üzerinde etkisi olan ümit verici bir terapötik ajandir. Bu baðlamda çalýþmamýzda, N- (4-Klorofenil) -1 H-Ýndol-2-Karboksamid'in Saos-2 osteosarkom hücre hattýnýn proliferasyon, apoptoz ve hücre iskeleti üzerindeki etkilerini araþtýrdýk. N- (4-klorofenil) -1 H-indol-2-karboksamidin sitotoksik etkilerini, osteosarkom hücrelerine dayanarak zamana baðlý olarak imatinib mesilatýn farmakolojik dozlarýný doðrulayarak deðerlendirdik.
YÖNTEM ve GEREÇLER: Bu çalýþmada, N- (4-klorofenil) -1 H-indol-2-karboksamid ve Imatinib mesilat dozlarýnýn osteosarkom Saos-2 hücrelerinin hücre canlýlýðý üzerindeki etkileri MTT tahlili kullanýlarak gerçekleþtirildi. Ezrin ekspresyon seviyeleri immünofloresan boyama ile incelendi.
BULGULAR: Antiproliferatif aktivitenin sonuçlarý, N- (4-klorofenil) -1 H-indol-2-karboksamidin, Saos-2 hücrelerinin hücre proliferasyonunu doza ve zamana baðlý bir þekilde inhibe ettiðini gösterdi. Daha düþük dozlarda N-(4-klorofenil)-1H-indol-2-karboksamidin bile, imatinib mesilat farmakolojik dozlarýyla karþýlaþtýrýldýðýnda osteosarkom hücre dizileri üzerinde etkili olduðunu bulduk.
TARTIÞMA ve SONUÇ: Bu çalýþmada ilk kez yeni sentezlenen indol türevi molekülü N-(4-klorofenil)-1H-indol-2-karboksamidin in vitro osteosarkom hücre hattýnda direnç açýsýndan deðerlendirildi. Tüm bu sonuçlar, N-(4-Klorofenil)-1H-Ýndol-2-Karboksamidin osteosarkom büyümesini ve metastazý inhibe etmek için potansiyel bir terapötik ajan olarak geliþtirilebileceðini gösterdi.

INTRODUCTION: Osteosarcoma is a common tumor of high malignancy, usually derived from mesenchymal tissues. The lack of response to chemotherapeutic treatments indicates the importance of investigating new therapeutic methods. Indole, which is known to inhibit proliferation on cancer cells, is new synthesized as a derivative of this molecule of N- (4-chlorophenyl) -lH-indole-2-carboxamide, has an effect on osteosarcoma cell line. We evaluated the cytotoxic effects of N- (4-chlorophenyl) -1H-indole-2-carboxamide by verification of pharmacological doses of imatinib mesylate based on time on osteosarcoma cells.
METHODS: : In the present study, the effects of N-(4-chlorophenyl)-1H-indole-2-carboxamide and Imatinib mesylate doses on cell viability of osteosarcoma Saos-2 cells were conducted using MTT assay. Ezrin expression levels was examined by immunofluorescence staining.
RESULTS: The results of the antiproliferative activity showed that N- (4-chlorophenyl) -1 H-indole-2-carboxamide inhibited cell proliferation of Saos-2 cells in a dose- and time-dependent manner. We found that even lower doses of N- (4-chlorophenyl) -1H-indole-2-carboxamide was effective on osteosarcoma cell lines when we compared with imatinib mesylate pharmacological doses.
DISCUSSION AND CONCLUSION: In this study, for the first time the newly synthesized indole derivative molecule, N- (4-chlorophenyl) -1 H-indole-2-carboxamide was evaluated for resistance in vitro Saos-2 cell line. All these results showed that N- (4-Chlorophenyl) -1 H-Indole-2-Carboxamide can be developed as a potential therapeutic agent for inhibiting osteosarcoma growth and metastasis

GÝRÝÞ ve AMAÇ: Yara iyileþmesi tüm cerrahi iþlemlerin önemli bir bileþenidir. Bu çalýþmada, deneysel bir yara iyileþme modelinde intraperitoneal simvastatin uygulanmasýnýn kollajen birikimi, inflamasyon seviyesi ve yara gerilimi üzerindeki etkilerini araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Çalýþma üç gruba ayrýlmýþ toplam 36 rat üzerinde gerçekleþtirildi. Karýn duvarý orta hat kesisinin primer onarýmý yara iyileþme modeli olarak belirlendi. Grup 1’e yüksek doz (5 mg/kg/gün) simvastatin, grup 2’ye düþük doz (1 mg/kg/gün) simvastatin, grup 3’e ise plasebo solüsyon preoperatif 14 gün boyunca intraperitoneal olarak uygulandý. Ratlar yara gerilme kuvveti, kollajen birikimi ve inflamasyon skorlarý açýsýndan karþýlaþtýrýldý.
BULGULAR: Yüksek doz simvastatin grubundaki ortalama yara gerilme kuvveti, diðer ratlarýnkinden düþük bulunmasýna raðmen; gruplar arasýnda anlamlý bir fark saptanmadý (p=0,058). Tip I ve tip III kollajen seviyesi açýsýndan gruplar arasýnda istatistiksel olarak anlamlý farklýlýk olduðu görüldü (sýrasýyla; p = 0,011 ve p = 0,002). Çoklu karþýlaþtýrma için yapýlan post-hoc testleri sonucunda tip I kollajen seviyesi yüksek doz simvastatin grubunda kontrol grubuna göre anlamlý oranda yüksek bulunurken (2,18 ± 0,75’e karþý 1,25 ± 0,45; p = 0,006); tip III kollajen seviyesi hem yüksek doz hem de düþük doz simvastatin grubunda kontrol grubuna göre istatistiksel olarak anlamlý þekilde daha yüksek bulundu (sýrasýyla; 2,27 ± 0,78’e karþý 1,16 ± 0,38, p = 0,002 ve 1,90 ± 0,70’e karþý 1,16 ± 0,38, p = 0,015). Ancak inflamasyon skorlarý gruplar arasýnda anlamlý farklýlýk göstermedi (p= 0,186).
TARTIÞMA ve SONUÇ: Her ne kadar yüksek doz simvastatin, tip I ve tip III kollajen seviyelerini anlamlý derecede arttýrmýþ olsa da; üç grup arasýnda yara gerilme kuvveti ve inflamasyon skoru açýsýndan anlamlý farklýlýk olmadýðý görüldü.

INTRODUCTION: Wound healing is an important component of all surgical operations. In this study, we aimed to investigate the effects of intraperitoneal administration of simvastatin on collagen deposition, inflammation level, and wound tension in an experimental wound healing model.
METHODS: The study was carried out on 36 rats, divided into three groups. The primary repair of abdominal wall midline incision was determined as a wound-healing model. High-dose simvastatin (5 mg/kg/day) was administered intraperitoneally for 14 days preoperatively in group 1, low-dose of simvastatin (1 mg/kg/day) was administered in group 2 rats, and the placebo solution was given to group 3. Rats were compared in terms of tensile strength, level of collagen, and inflammation scores.
RESULTS: Although tensile strength of rats in group 1 was lower than those in other groups, this difference was not significant (p = 0.058). Type I and type III collagen level were significantly different between groups (p = 0.011 and p = 0.002; respectively). The post-hoc test revealed that group 1 rats had significantly higher type I collagen level than those of group 3 rats (2.18 ± 0.75 vs. 1.25 ± 0.45; p = 0.006). The type III collagen in group 1 and group 2 were also significantly higher than that in group 3 (2.27 ± 0.78 vs. 1.16 ± 0.38, p = 0.002; 1.90 ± 0.70 vs. 1.16 ± 0.38; p = 0.015). However, inflammation scores were not different between the groups (p = 0.186).
DISCUSSION AND CONCLUSION: Although high-dose simvastatin significantly increased type I and type III collagen levels; tensile strength and inflammation score among the three groups of rats were not significantly different.