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Purpose: To assess the safety and efficacy of a gemcitabine plus docetaxel regimen as a second line therapy for patients with advanced soft tissue sarcoma (STS) resistant to doxorubicin and ifosfamide-based therapy. Patients and Methods: Medical records of 64 patients with advanced STS who received gemcitabine plus docetaxel regimen as a second line treatment between May 2006 and June 2011 were examined. All patients had been previously treated with doxorubicin plus ifosfamide-based regimen at first line setting. Patients received gemcitabine 900 mg/m(2) on days one and eight intravenously over 90 minutes, followed by docetaxel 75 mg/m(2) on day eight intravenously over one hour. Cycles were repeated every 3 weeks. Results: The male-to-female ratio was 37/27 and the median age was 44 years (range; 19-67 years). Objective responses were observed in 13 (20.3 %) patients (2 CR, 11 PR) and stable disease in 21 (32.8 %). Total clinical benefit (CR+PR+SD) was observed in 34 (53.1 %). Median overall survival (OS) was 18 months (95% confidence interval (CI):12.1-23.9) and Median time to progression (TTP) was 4.8 months (95% CI: 3.6-6). A total of 243 cycles of chemotherapy were administered. The median number of cycle was 3 (range; 1-11). The most common grade 3-4 hematologic toxicity was neutropenia (35.9 %). The most common nonhematologic toxicities consisted of nausea/vomiting (37.5 %), mucositis (32.8 %), peripheral neuropathy (29.7%), and fatigue (26 %). There was no toxicity-related death. Conclusion: The combination of gemcitabine plus docetaxel is an active and tolerable regimen as a second line therapy for patients with advanced soft tissue sarcoma who have failed doxorubicin and ifosfamide-based therapy.

Objectives: The present study was designed to investigate the efficacy of irinotecan monotherapy as a second-line treatment for small cell lung cancers (SCLCs). Methods: Irinotecan monotherapy was administered to 46 SCLC patients who were previously undergone cisplatin based chemotherapy protocols. Response to treatment, time to progression (TTP), overall survival rates and adverse events associated with irinotecan monotherapy (300mg/m2; total 153 cycles; mean 3.78 +/- 1.98) were determined, retrospectively. Results: Limited stage disease was diagnosed in 19.6% of patients (n=9) while 80.4% (n=37) were diagnosed with extensive stage cancer preceeding the irinotecan monotherapy. None of the patients had complete response to irinotecan. Partial response and stable disease were achieved among 17.5% of patients. Mean time to tumor progression (TTP) was determined to be 11.3 +/- 5.94 weeks while overall survival was 13.3 +/- 6.83 months. Considering adverse events, grade 3 and 4 toxicity was encountered in 8.9% and 4.5% of patients, respectively. Irinotecan monotherapy in brain metastasized tumors was found to be associated with significantly higher survival times compared with tumors lacking brain metastasis (15.0 +/- 5.95 vs 10.7 +/- 4.82 months; p

Radiotherapy and concomitant/adjuvant therapy with temozolomide are a common treatment regimen for children and adults with high-grade glioma. Although temozolomide is generally safe, it can rarely cause life-threatening complications. Here we report a case of a 31-year-old female patient who underwent surgical resection followed by radiotherapy plus concomitant temozolomide. She developed pancytopenia after adjuvant treatment with temozolomide. A bone marrow aspiration and biopsy showed hypocellularity with very few erythroid and myeloid cells, consistent with aplastic anemia. In the English literature, aplastic anemia due to temozolomide is extremely rare.

BACKGROUND: Brucellosis, constituting a major health problem in many parts of the world--particularly in the Mediterranean and the Middle East--is a multisystem disease with a broad spectrum of clinical manifestations. Hematological abnormalities ranging from a fulminant state of disseminated intravascular coagulopathy to subtle hemostatic alterations have been reported in brucella infection. Immunemediated thrombocytopenia is also a clinically important mechanism that can be encountered during brucellosis. CASE: A young lady with fever was referred to a university hospital because of thrombocytopenia. The provisional diagnosis was idiopathic thrombocytopenic purpura, as the bone marrow examination showed an increased number of megakaryocytes and the absence of fever after hospitalization. The patient responded well to corticosteroid treatment. However, she was finally diagnosed with brucellosis with positive bone marrow and blood cultures for B. abortus and agglutination test of 1:320. The patient was discharged from the hospital 10 days later in good health on rifampicin and doxycycline therapy. The follow-up of the patient revealed normal hematological findings together with a progressive reduction in the titer of the agglutination test for brucella. CONCLUSION: Brucella infection may cause severe thrombocytopenia, mimicking a primary hematological disease that is reversible after appropriate antimicrobial therapy. In cases of brucellosis-induced immune thrombocytopenic purpura, a short-term standard dose of corticosteroid treatment might be an alternative and additional treatment as an urgent approach for thrombocytopenia while initiating antibrucellosis treatment.

The African-American race was examined as a risk factor for cardiotoxicity from doxorubicin-based therapy for cancer.Retrospective survey of the Howard University Hospital cancer registry during 1997-2001 identified 100 evaluable patients out of 120 African Americans who underwent doxorubicin-based combination chemotherapy (65% women, 35% men, median age 46 years, range 32-84 years). The fraction of patients who developed post-treatment cardiotoxicity, defined as congestive heart failure or a left-ventricular ejection fraction less than 45%, was compared with that from a retrospective study of 399 patients of unknown age and racial distribution. Cases were stratified by cumulative dose of doxorubicin. Statistical significance of the difference in incidence of cardiotoxicity was tested by chi-square analysis.Patients received multiple doses of doxorubicin (range 264 to 580 mg/m2 with median of 374) with the final echocardiographic assessment at a median of 1.3 years. Howard oncologists frequently used a 48-hour infusion rather than the conventional rapid bolus to reduce the cardiotoxicity of doxorubicin. The fraction with cardiotoxicity in our study versus Lefrak's review at four ranges of doxorubicin was 25% versus 18% at 551-600 mg/m2, 10% versus 4% at 501-550 mg/m2, 4% versus 1% at 451-500 mg/m2, and 0% versus1% at450 mg/m2. Seventy-two percent of the patients having depressed ejection fraction and/or heart failure were women. African Americans had a higher rate of cardiotoxicity after doxorubicin (7/100 cases) than that of Lefrak's (10/399) study population and were statistically significant at p0.027 with an odds ratio of 2.93.We have shown for the first time that African Americans at our institution appear to suffer cardiotoxicity from doxorubicin three times more frequently than the previously noted study population. To better clarify this observation, a larger study in a multiracial setting is needed.

Transfusion related acute lung injury has been known to appear following transfusion of plasma including blood components. In this report, we present a patient with acute lung injury after whole blood transfusion who was successfully treated with high dose intravenous methylprednisolone (HDIVMP).

Smoking is a majör risk factor for many cardiovascular and neoplastic diseases. The properties of smoker population must be find out for use in preparing of strategies and plans to pull down the smoker ratio. For this reason in 1995, as a part of our AYDINHİP study (Aydın Hipertansiyon Araştırması) we tried to find out the properties of smokers in our university region. İn Turkey a law issued on 26 December 1997, which was prohibiting smoking in the place crovvded more than five people. Our results are giving us the last data about the smoking and its relation with hypertension here before that law mentioned above. In this study 1600 people more than 17 years old from different social and geographic areas were visited. After fiiling a questionnaire list their blood pressure obtained. According to the results 42% of the people were smoker (16,8% for women and 62,2% for men). Mean systolic blood pressures of non-smokers and smokers were 133,55 mmHg and 125,23 mmHg respectively. This numbers for diastolic blood pressure were 79,60 mmHg and 76,62 mmHg respectively. The prevalence of systolic hypertension in non-smoker and smoker population was 27,4% and 14,3% respectively. These numbers for diastolic hypertension were 19,4% and 13,7%. In conclusion in the Aydın City area, the smoker prevalence is high. The blood pressure is significantly lovver in smoker population than the nonsmoker population., Sigara içimi bir çok kardiyovasküler ve malign hastalığın etiyopatogenezine katılmaktadır. Bu nedenle sigara içimini azaltmaya yönelik önlemler tasarlanırken sigara içen kitlenin özellikleri belirlenmelidir. 1995 yılında yapılan AYDINHİP (Aydın Hipertansiyon) çalışması ile yörenin sigara içimiyle ilgili özelliklerinin araştırılması amaçlanmıştır. Ülkemizde 26 Aralık1997'de "Resmi Dairelerde ve Beş Kişiden Fazla Yolcu Bulunan Taşıtlarda Sigara içilmesini Yasaklayan" yasa yürürlüğe girmiştir. Bu çalışmada sigara içimi ve bunun hipertansiyonla ilişkisi konusunda, toplumun bu yasa öncesindeki özelliklerinin son durumunu belirlenmektedir. Çalışmada değişik kesimlerden 17 yaş üstü 1600 kişi ziyaret edilerek bir anket formu dolduruldu ve JNC V (Vh Report of Joint National Committee on Hypertension) önerilerine uygun olarak kan basınçları ölçüldü. Sonuçlara göre halkın %42'si (kadınların %16,8 ve erkeklerin %62,2'si) sigara içmektedir. Sigara içmeyenlerin ortalama sistolik kan basıncı (SKB) 133,55 mmHg, içenlerin ortalama SKB 125,23 mmHg ve sigara içmeyenlerin ortalama diyastolik kan basıncı (DKB) 79,60 mmHg, içenlerin ortalama DKB 76,62 mmHg saptanmıştır. Sigara içenlerin %14,3'ü içmeyenlerin %27,4'ü yüksek sistolik kan basıncına sahiptir. Yüksek diyastolik kan basıncı için bu oranlar sırasıyla %13,7 ve %19,4. Sonuç olarak Aydın yöresinde sigara içme sıklığı önemli düzeydedir ve sigara içenlerde yüksek kan basıncı, içmeyenlere kıyasla daha az bulunmaktadır.

Objective: To evaluate the prevalence of asymptomatic cholelithiasis in type-II diabetes. Method: Abdominal ultrasonography was performed on 138 patients with type-II diabetes (100 women and 38 men) over 35 years old 270 people (190 women and 80 men) over 35 years old were examined as the control group. Results: 17 of the patients (12.3 %) and 28 controls (10.3 %) had cholelithiasis. These rates weren’t statisti-cally different (p>0.05). 13 % of female patients and 10.5 % of men patients were found that they had cholelithiasis. These rates were 11 % and 8.75 % in the control group . There was no statistically significant difference between these groups either (p > 0.05). Conclusion: The prevalance of asymptomatic cholelithiasis in type-II diabetes was not different than that of healthy persons.

Hemolytic anemia associated with pregnancy is a rare and usually Coombs’ test (direct antiglobulin test=DAT) is negative. In this paper we presented a woman who had DAT negative hemolytic anemia during the second pregnancy. In patient hemolysis was controlled with steroid therapy.

ÖZET Meme kanseri, üzerinde en çok çalışma yapılan ve tedavisinde gelişmeler kaydedilen bir kanser olup dünyada kadınlarda en sık görülen tümörlerden birisini oluşturmaktadır. Hastalığın erken tanısı ve uygun tedavisi kür şansını artırmaktadır. Meme kanserinde prognozu belirlemede pek çok faktör kullanılmaktadır. Bu çalışmada son yıllarda meme kanserinde iyi prognostik faktör olduğu ileri sürülen PSA ile, bir tümör süpresör gen olan WTl'in meme kanserli dokularda immünhistokimyasal yöntemle boyanma özelliklerini klinikopatolojik parametrelerle karşılaştırması amaçlandı. Meme kanseri tanısı almış 66 hastaya ait dokulardan yapılan kesitlerde WT1 monoklonal antikoru ve PSA poliklonal antikoru strept avidin-biotin yöntemi kullanılarak boyandı. Sonuçta tümör dokusunda WT1 boyanması ile menapozal durum arasında sınırda ilişki saptarken, çevre normal dokularda tümör grade'i, klinik evre ve lenf nodu tutulumu arasında anlamlı korelasyon saptandı. Erken evre tümörlerde ve lenf nodu tutulumu olmayan olgularda daha kuvvetli boyanma saptandı. PSA ile elde edilen sonuçlar ise, tümör dokusunda PSA varlığı ile iyi diferansiye tümörler arasında pozitif korelasyon saptandı. Çevre dokuda PSA pozitifliği ise premenapozal gurupta daha belirgin idi. Anahtar kelimeler: Meme kanseri, WT1, PSA, immünhistokimya, prognoz ABSTRACT Although the breast cancer is one of the most studying cancer and some improvements achieved about its therapy, it is still the most common cancer in the world and leading cause of cancer deaths in women. The cure rate might be increased by early diagnosis and appropriate therapy. One of the priorities of breast cancer research is to define new biochemical markers that could be utilized to enhance the prognostic ability of available markers, and to facilitate treatment strategies on the basis of likelihood of response. The aim of this study was to compare clinical and pathologic parameters of breast cancer patients, and WTl(a member of tumor suppressor gene family) and PSA (which thought to be good prognostic factor in breast cancer) immunohistochemical staining pattern and to investigate prognostic significance of this markers on 66 formallin fixed, paraffin embedded breast cancer tissue sections. For this purpose, WT1 monoclonal antibody (mAb) and PSA polyclonal antibody (pAb) were used and strept avidin-biotin staining was performed. A correlation between WT1 mAb staining in tumor tissue and menapousal status was find out. In addition, WT1 mAb staining in normal tissues beside of the tumor correlated with grade, clinical stage and axillary lymph node status. Stage I tumors were more positive than the others with WT1. PSA pAb staining was correlated with differantiated tumors and normal tissue staining was more prominent in premenapousal subset. Key words: Breast cancer, WT1, PSA, immunhistochemistry, prognosis 53