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Burn injury is a common cause of trauma. Non-fatal burn injuries are a leading cause of morbidity, and significant numbers of the victims are children. Scar contracture after burn injury can cause severe functional limitation, pain, and aesthetic and psychological problems and patients may present for contracture release and reconstructive surgery. The aim of this systematic review was to identify research relevant to airway management of children with burn contracture of the face and neck with special emphasis on awake airway management and airway anesthesia, and synthesize results that can aid practice. Literature search was performed on Medline, PubMed, Cochrane Library, and Google Scholar with selected keywords. The search was restricted to human subjects of ≤18 year age, there was no language or time restriction, and the final search was concluded in July 2021. The review included 41 articles involving airway management of 56 patients in 61 anesthesia episodes. Patients aged between 8 months to 18 years. Mask ventilation and direct laryngoscopy, video laryngoscopy, optical stylet, supraglottic airway, flexible scope intubation and tracheostomy, and extracorporeal membrane oxygenation were the devices and methods used for securing the airway and oxygenation while the patients were awake or after anesthesia induction. Detailed planning and patient preparation are the fundamentals of airway management of pediatric patients with burn contracture of the face and neck; awake airway management with airway anesthesia can be safely used in selected patients. This review provides information for good clinical practice and might serve to improve the care of such children.

To determine which treatment technique and modality would offer better dosimetric results and be preferable for spinal stereotactic body therapy (SBRT) depending on the three different regions of the vertebrae. Linear accelerator (LINAC)- and CyberKnife (CK)-based treatment techniques were compared in terms of their dosimetric quality, treatment efficiency, and delivery accuracy. Thirty previously treated patients were included in this study. Intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) techniques were used for LINAC-based treatment, whereas CK-based treatment plans were generated for two different collimator systems: fixed and multileaf collimator (MLC). The plans were compared based on spinal cord sparing, dose homogeneity, conformity index (CI), gradient index (GI), monitor unit (MU), and beam-on time. The percentage volumes of V2Gy, V5Gy (representing volume low of the dose spillage region), V10Gy, and V20Gy (representing the volume of the high-dose spillage region) of the healthy tissue were analyzed. The CI and GI of the VMAT plans were better than those of the IMRT plans. For spinal cord sparing, the VMAT and MLC-based CK (CK-MLC) techniques were superior. The percentage of low-dose spillage regions was the lowest for IMRT and fixed cone-based CK (CK-FIX) plans. The percentage of the high-dose spillage region was the lowest for the VMAT and CK-MLC plans. In terms of treatment efficiency, the VMAT and CK-MLC plans were superior to the IMRT and CK-FIX plans. The VMAT technique lowered the MU and beam-on time values. The plan delivery accuracy of the VMAT and CK-FIX plans was better than that of the IMRT plans. VMAT is the best option for LINAC-based spinal SBRT. For CK-based spinal SBRT, MLC-based plans are preferred. If the clinic has both treatment modalities and the patient can tolerate long treatment times, CK-MLC-based treatment should be chosen because of its superiority in sparing the spinal cord and sharp dose fall-off.

Putrescine is reported to be necessary for cold acclimation under low-temperature stress. In this study, the effect of low-temperature on some physiological and biochemical parameters has been investigated using the green algae Chlamydomonas reinhardtii. The lipid peroxidation rate, amount of Rubisco protein, activities of antioxidant enzymes and gene expression of polyamine biosynthesis (odc2, and spd1), heat shock proteins (hsp70c, hsp90a, and hsp90c), and PSII repair mechanisms (psba, rep27, and tba1) were determined to understand the low-temperature response. Exogenous putrescine application significantly increased Rubisco protein concentration and catalase enzyme activities under low-temperature stress. Moreover, real-time RT-PCR results and gene expression analysis showed that polyamine metabolism induced gene expression at low-temperatures in the first 24 h. In the same way, the gene expression of heat shock proteins (hsp70c, hsp90a, and hsp90c) decreased under low-temperature treatment for 72 h; however, application of putrescine enhanced the gene expression in the first 24 h. The results obtained indicated that molecular response in the first 24 h could be important for cold acclimation. The psba and tba1 expressions were reduced under low-temperatures depending on the exposure time. In contrast, the exogenous putrescine enhanced the expression level of the psba response to low-temperature at 24 and 72 h. The results obtained in this study indicate that putrescine could play a role in the PS II repair mechanisms under low-temperature stress., Bilecik Seyh Edebali University Research Foundation [2014-02-BIL-04-03], This study was partially supported by the Bilecik Seyh Edebali University Research Foundation (2014-02-BIL-04-03) .

Lead is a toxic element that accumulates in agricultural soils through various anthropogenic sources. It inhibits the growth and development of plants and causes mutations in DNA. Macroalgae such as Halopteris filicina contain multifunctional components that may improve plant tolerance to lead stress. In this study, seeds of tomato (Solanum lycopersicum) were subjected to six treatments comprising two levels of lead exposure (60 or 120 μM PbCl2) with or without H. filicina extract (0.5% in distilled water), a distilled water control, and a positive control (H. filicina extract) for 7 days. Physiological responses were investigated. Seedlings that had been treated with 60 and 120 μM PbCl2 without H. filicina extract showed root growth reduction of 55% and 68.6%, respectively, relative to the control, whereas for 60 and 120 μM PbCl2-treated seedlings with H. filicina extract applied, the reductions in root growth were lower, at 27.44% and 50.51%. The seedling viability index was decreased by 68.14% at 120 μM PbCl2 application without H. filicina extract, whereas a 42.48% reduction was recorded for 120 μM PbCl2-treated seedlings with H. filicina extract applied. Moreover, PbCl2 accumulation resulted in a decrease in leaf pigment content. Leaf pigment content was high in plants receiving the H. filicina extract. The rate of lipid peroxidation caused by PbCl2 was reduced with application of H. filicina extract. Genomic template stability was determined by using the inter simple sequence repeat-PCR technique, which revealed a decrease in DNA stabilisation with an increase in lead accumulation. However, this was alleviated by application of H. filicina extract. Our findings indicate that H. filicina extract both stimulates plant growth and protects from toxic effects by reducing accumulation of metals in the cell.

Background Hodgkin lymphoma (HL) is predominantly a nodal disease with extranodal presentation being uncommon. Presentation with neurological symptoms is not uncommon in adult patients with HL. Subdiaphragmatic involvements are less common especially in childhood. In the literature, there has been no case which presented with both spinal cord compression and bilateral hydronephrosis in pediatric patients with HL. Observation We report a 9-year-old boy diagnosed with HL who presented with bilateral hydronephrosis and epidural involvement. Conclusion Differential diagnosis of abdominal mass in patients presenting with spinal cord compression and/or hydronephrosis should include HL. Retrograde J ureteral stenting is the treatment of choice for malignant ureteral obstruction.

Chloroplasts compose about one-quarter of the mesophyll cell volume and contain about 60% of the cell protein. Photosynthetic carbon assimilation is the dominating metabolism in illuminated leaves. To optimize the resource expenditure in these costly organelles and to control and adjust chloroplast metabolism, an intensive transfer of information between nucleus–cytoplasm and chloroplasts occurs in both directions as anterograde and retrograde signalling. Recent research identified multiple retrograde pathways that use metabolite transfer and include reaction products of lipids and carotenoids with reactive oxygen species (ROS). Other pathways use metabolites of carbon, sulfur and nitrogen metabolism, low molecular weight antioxidants and hormone precursors to carry information between the cell compartments. This review focuses on redox- and ROS-related retrograde signalling pathways. In analogy to the microbe-associated molecular pattern, we propose the term ‘chloroplast-associated molecular pattern' which connects chloroplast performance to extrachloroplast processes such as nuclear gene transcription, posttranscriptional processing, including translation, and RNA and protein fate. This article is part of the theme issue ‘Retrograde signalling from endosymbiotic organelles'.

In this study, structural alterations in the biomolecular profile of the Cladonia convoluta exposed to lead were investigated considering the potential of lichens in biomonitoring practices. Partic...

To evaluate cytogenetic damage of radiotherapy (RT) and chemoradiotherapy (CRT) in long-term head and neck cancer survivors.This study included 20 patients treated with RT (10 patients) or CRT (10 patients) for head and neck cancer. Nine healthy volunteers were included as control subjects. Cytochalasin B-blocked micronucleus (CBMN) assay was used to evaluate cytogenetic damage. To evaluate micronucleus (MN) by CBMN, the venous blood samples were drawn median 68 months (range 60-239 months) after the completion of treatment (RT or CRT) for head and neck cancer.Nuclear division index (NDI) and number of MN in mononuclear and binuclear lymphocytes were significantly higher in patients with head and neck cancer than in control subjects [1.19 (1.08-1.47) vs. 1.07 (1.04-1.14), p 0.001; 11.0 (2.0-22.0) vs. 1.0 (0-3.0), p 0.001 and 15.0 (5.0-45.0) vs. 9.0 (2.0-15.0), p = 0.020, respectively]. NDI and number of MN in mononuclear lymphocytes were significantly lower in control subjects compared patients received CRT and those received only RT, but there was no significant difference between patients received CRT and those received only RT. Number of MN in binuclear lymphocytes was significantly lower in control subjects compared to patients received CRT, but there was no significant difference between control subjects and those received only RT. Also there was no significant difference between patients received CRT and those received only RT in terms of number of MN in binuclear lymphocytes.MN frequency of mononuclear and binuclear lymphocytes in medical follow-up of patients with head and neck cancer after RT could be important in evaluating cytogenetic damage of RT. However, further investigations are needed to provide quantitative correlations between MN yields and the clinical features in post-radiotherapy period.

Objective This study investigated the relationship between weight loss, depression and anxiety, and appetite hormones, leptin and ghrelin levels in patients with head and neck cancer (HNC), as well as the effect of radiotherapy and antidepressant treatment on weight and these hormones. Methods Forty male patients with HNC and twenty physically and mentally healthy male controls were recruited for the study. Psychiatric status was evaluated with clinical interview and psychometric tests. All patients received radiotherapy and antidepressant treatment with mirtazapine that was given to patients with psychiatric disorders. Serum leptin and ghrelin levels were measured pre- and post-treatment in the patients and once in the controls. Results There was no significant difference between the serum leptin and ghrelin levels of patients and controls. The leptin levels of the patients were decreased by radiotherapy. Eleven patients were diagnosed with major depressive disorder and adjustment disorder and were classed as depressive patients. Depressive patients were affected more by radiotherapy with respect to weight loss. The basal leptin levels of depressive patients were also lower than non-depressive patients and controls. Conclusion It seems that depression aggravated weight loss and, in addition, decreased leptin levels in cancer patients. Detection and treatment of psychiatric disorders may improve prognosis by preventing weight loss as well as by providing psychiatric treatment in cancer patients.

Fazilet Özlem Çekiç (Aksaray, Yazar) Sefa Ekinci (Aksaray, Yazar), Among nanoparticles, silver nanoparticles (AgNPs) are intensively used in many materials owing to their antibacterial effects. In the present study different concentrations of AgNPs in Hoagland solution were applied to tomato seedlings. Total chlorophyll content, relative water content (RWC), antioxidant enzyme activities, and malondialdehyde content (MDA) as well as the genomic template stability (GTS) were analyzed. The intersimple sequence repeat polymerase chain reaction assay (ISSR-PCR) was used to determine the genotoxic effects of AgNPs on DNA. RWC did not change under AgNPs treatments; however, total chlorophyll content was significantly reduced by AgNPs applications. ISSR profiles demonstrated a consistent increase in polymorphic bands by the increase in the concentration of AgNPs. GTS value was also reduced depending on the concentration of AgNPs. SOD and APX activities were increased under low AgNPs treatments; however, these activities were decreased under high concentrations of AgNPs treatments. Tomato plants could be sensitive to AgNPs within the increase in MDA content in all of the AgNPs treatments. AgNPs nanotoxicity could be quite dose-dependent. AgNPs could also have negative effects on tomato plants by enhancing DNA damage and lipid peroxidation.

Objective Sensitivity about appearance is one of the sine qua non of adolescence and adolescents’ self-esteem effecting their socialization processes. We explored if verruca vulgaris, a common visible infectious skin disease, affects social anxiety levels and self-esteem in adolescents compared to controls. Also, the difference in sociodemographic properties between two groups and the effect of clinical properties (the distribution and number of warts) on these parameters were investigated in the patient group. Materials and methods The study group consisted 98 adolescents (49 controls and 49 patients) without other medical/psychiatric diseases. The Sociodemographic form (SDF), the Çapa Social Phobia Scale for Children and Adolescents (ÇCASPS) and the Rosenberg Self-Esteem Scale (RSES) were completed by both groups. Results There was no difference in social anxiety levels and self-esteem between the two groups. Also, the control and patient groups were found matched. However, lower self-esteem was the only factor that increased the risk for social phobia in the patient group. Conclusion Verruca vulgaris distributed in hands and face in adolescents were not found to be related with higher social anxiety and lower self-esteem. However, clinicians should monitor psychiatric symptoms and especially lower self-esteem should be taken into account.

Background: The aim of the present study was to determine the predictive/prognostic value of the secreted protein, acidic and rich in cysteine (SPARC) in cases of unresectable, locally advanced, non-small cell lung cancer. Materials and Methods: The study included 84 patients with Stage IIIA-B non-small cell lung cancer, undergoing simultaneous chemoradiotherapy including radiotherapy at a dose of 66 Gy and weekly docataxel (20 mg/m(2)) and cisplatin (20mg/m(2)). SPARC expression was studied in biopsy material by immunohistochemical methods and correlations with treatment responses or survival were evaluated. Results: Median overall survival was 16 +/- 2.73 (11.55-20.46) months for low expression vs 7 +/- 1.79 months (7.92-16.08) months for high expression (p=0.039), while median local control was 13 +/- 2.31 (8.48-17.5) months for low expression vs 6 +/- 0.85 (4.34-7.66) months for high expression (p=0.045) and median progression-free survival was 10 +/- 2.31 (5.48-14.5) months for low expression vs 6 +/- 1.10 (3.85-8.15) months for high expression (p=0.022). In both univariate and multivariate analyses, high SPARC expression was associated with significantly shorter overall survival (p=0.003, p=0.007, respectively), local control (p=0.008, p=0.036) and progression-free survival (p=0.004, p=0.029) when compared to low SPARC expression. No significant difference was detected between high and low SPARC expression groups regarding age, sex, T stage, N stage, histopathology and stage-related patient characteristics. Conclusions: High SPARC expression was identified as a poor prognostic factor in cases with locally advanced NSCLC treated with concurrent chemoradiotherapy.

WOS: 000343832900034, PubMed: 25169505, Introduction: Breast cancer in young women is a relatively rare disease; however it tends to be more aggressive and is the leading cause of cancer death in this population. The aim of this study is to investigate the clinical and biological features of breast cancer arising in young Turkish breast cancer patients. Materials and Methods: Patients with breast cancer aged 35 or less (

Objective: Our aim was to investigate the effect of tamoxifen on cervical smear of patients with breast cancer at our clinic. Methods: The data of patients with breast cancer who had received tamoxifen were analyzed between 2006 and 2014, retrospectively. Pap smear results, age, gravidity, parity, smoking status, age of first birth, and detailed gynecologic and obstetric history of patients were noted. Patients who had not received at least one-year tamoxifen therapy and patients without cervicovaginal smear controls or those who left or had received interrupted tamoxifen treatment were excluded. The pap smear results of the tamoxifen and control groups were analyzed. Results: A total of 246 patients (123 in the tamoxifen group and 123 in the control group) were included in this study. None of the patients had cervical squamous intraepithelial lesions and atypical glandular lesions. Atypical squamous cells were significantly higher in the tamoxifen group than in the control group (p=0.03). Conclusion: The use of tamoxifen may be associated with benign squamous atypia in cervical smears. Therefore, pelvic examination and pap smear test are recommended for breast cancer patients annually.

Background: An easy, reproducible and simple marker is needed to estimate phase of endometrial pathologic lesions such as hyperplasia and endometrial cancer and distinguish from pathologically normal results. We here aimed to clarify associations among neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), endometrial hyperplasia and cancer in patients with abnormal uterine bleeding. Materials and Methods: Patients (n=161) who were admitted with abnormal uterine bleeding and the presence of endometrial cells on cervical cytology or thick endometrium were investigated. The study constituted of three groups according to pathologic diagnosis. Group 1 included endometrial precancerous lesions like hyperplasia (n=63), group 2 included endometrial cancerous lesions (n=38) and group 3 was a pathologically normal group (n=60). Blood samples were obtained just before the curettage procedure and the NLR was defined as the absolute neutrophil count divided by the absolute lymphocyte count; similarly, PLR was defined as the absolute platelet count divided by the absolute lymphocyte count. Results: The white blood cell count was significantly higher in patients with cancer than in those with hyperplasia (p=0.005). The platelet count and neutrophil to lymphocyte ratio were significantly higher in patients with cancer than in control patients, but there was significantly no difference between patients with hyperplasia and other groups (p=0.001 and p=0.025 respectively). PLR was significantly lower in control subjects than in other groups (p

Aim: To evaluate precancerous lesions such as hyperplasia and endometrial polyps in obese postmenopausal women. Materials and Methods: Women who were referred with abnormal uterine bleeding in postmenopausal period or the presence of endometrial cells on cervical cytology in our department were investigated. Anthropometric measurements such as height, weight, body mass index, waist/hip ratio and endometrial thickness were compared between a precancerous lesion (hyperplasia and endometrial polyp) group and a pathologically normal group. Results: We detected statistically significant thickening of endometrium in patients with precancerous lesions. Moreover patients with precancerous lesions had higher body mass index than the pathologically normal group. Conclusions: We found elevated precancerous lesion rates in overweight and obese women in the postmenopausal period, of interest given that the prevalence of obesity is increasing in most parts of the world. Although screening for endometrial cancer is not recommended for the general population, in high-risk populations like obese postmenopausal women, it may be very important.

Background The status of the axillary lymph nodes is an important factor in the prognosis and treatment of breast cancer. Extracapsular extension (ECE) is the spread of lymphatic tumor cells beyond the capsule of an axillary lymph node. Recent studies have demonstrated that ECE is a strongly unfavorable prognostic factor. Objective In the present study, we investigated whether the rate of metastasis among examined lymph nodes can be used to predict ECE in patients with axillary node-positive breast cancer. Methods The subjects were 95 women with axillary node-positive breast cancer. The numbers of lymph nodes removed (examined) and lymph nodes involved were recorded. The cut-off values, area under the curve, sensitivity, and specificity were calculated with the receiver operating characteristic curve technique for ability of the rate of metastasis to examined lymph nodes to predict ECE. Results The rate of metastasis to examined lymph nodes was significantly greater in patients with ECE than in patients without ECE [0.57 (0.03-1.00) vs. 0.22 (0.04-1.00), respectively, p: 0.001]. Similarly, the presence of vascular infiltration was significantly higher in patients with ECE than in those without ECE [30 (73.2%) vs. 25 (47.2%) respectively, p: 0.010]. On the other hand, other variables did not differ between the groups (p>0.05). When the cut-off value was ≥0.23, the sensitivity and specificity of the rate of metastasis to examined lymph nodes were 80.49% and 55.56%, respectively. The area under the curve was 0.697 (95% confidence interval: 0.594-0.787, p: 0.004). Conclusion Our results suggest that rate of metastasis among examined lymph nodes is a predictor of ECE in patients with axillary node-positive breast cancer.

Background: Inflammation is a critical component of tumor progression. Many cancers arise from sites of infection, chronic irritation, and inflammation. It is now becoming clear that the tumour microenvironment, which is largely orchestrated by inflammatory cells, is an essential participant in the neoplastic process, promoting proliferation, survival and migration. Platelets can release some growth factors such as platelet-derived growth factor, platelet factor 4, and thrombospondin. Such factors have been shown to promote hematogenous tumour spread, tumor cell adhesion and invasion, and angiogenesis and to play an important role in tumor progression. In this study, we aimed to investigate effects of the pretreatment neutrophil to lymphocyte ratio (NLR) and the platelet to lymphocyte ratio (PLR) on survival and response to chemoradiotherapy in patients with non-small-cell lung cancer (NSCLC). Materials and Methods: Ninety-four patients with non-metastatic NSCLC were included and separated into two groups according to median valuse of NLR and PLR (low

Introduction: Lung cancer, the leading cause of cancer deaths, is divided into 2 main classes based on its biology, therapy and prognosis: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Many cases are at an advanced stage at diagnosis, which is a major obstacle to improving outcomes. It is important to define the high risk group patients for early diagnosis and chance of cure. Blood group antigens are chemical components on erythrocyte membranes but they are also expressed on a variety of epithelial cells. Links between ABO blood groups with benign or malignant diseases, such as gastric and pancreas cancers, have been observed for a long time. In this study, we aimed to investigate any possible relationship between lung cancer histological subtypes and ABO-Rh blood groups. Materials and Methods: The files of 307 pathologically confirmed lung cancer patients were reviewed retrospectively. Cases with a serologically determined blood group and Rh factor were included and those with a history of another primary cancer were excluded, leaving a total of 221. The distribution of blood groups of the lung cancer patients were compared with the distribution of blood groups of healthy donors admitted to the Turkish Red Crescent Blood Service in our city in the year 2012. Results: There was no significant difference between patients with lung cancer of either type and the control group in terms of distribution of ABO blood groups and Rh factor (p: 0.073). There was also no relationship with non small cell cancer histological subtypes. Conclusions: In this study, we found no relationship between the ABO-Rhesus blood groups and NSCLC and SCLC groups. To our knowledge this is the first analysis of ABO blood groups in SCLC patients.

Aim of the study: Gastrointestinal stro­ mal tumors (GISTs) are the most fre­ quent mesenchymal tumors of the gastrointestinal system. We aimed to determine whether nuclear transcrip­ tion factor κB (NF­κB), CD9 and vascu­ lar endothelial growth factor (VEGF) have prognostic value in patients with GIST. Material and methods: Thirty­five pa­ tients with GIST, who were diagnosed in the Pathology Department of Erciyes University, were included in the study. Cases were classified based on the 2002 NIH consensus. CD9, VEGF, and NF­κB immunohistochemistry were ap­ plied to GIST cases positive for CD117 and CD34, which are used to evaluate GISTs immunohistochemically. Results: Although there are no statis­ tically significant differences between NF­κB (p = 0.329), CD9 (p = 0.269), and VEGF (p = 0.372) and risk groups, 79.22% of cases that stained positive for NF­κB, 81% of cases that stained po­ sitive for CD9, and 80% of cases that stained positive of VEGF were in the high risk group. Conclusions: It was found that NF­κB, CD9, and VEGF, which are important in predicting behaviors of other ma­ lign tumors, were expressed at high rates in high risk group GISTs. This can be used to determine prognosis with tumor diameter, mitosis rate under 50 BBS, Ki­67 proliferation index and other parameters.

Background The aim of this study is to search the prognostic value of SPARC expression in rectum cancer cases receiving postoperative radiotherapy. Methods Forty three rectal cancer patients are recruited to this retrospective study. All patients received postoperative radiotherapy which the median dose was 5040 cGy and concomitant chemotherapy. Samples taken from their paraffin blocks were examined with immunohistochemical procedures. Results When the association between SPARC expression and the clinicopathological feature was examined, there was a significant association between age and expression levels. Overall survival of patients with low expression was found to be 67 months whereas the overall survival of the patients with high expression was 32 months and the difference was statistically significant. Time to local recurrence of patients with low expression was found to be 74 months whereas time to local recurrence of the patients with high expression was 31 months. Progression free survival of the patients with low expression and high expression were 67 months and 32 months, respectively. In multivariate Cox regression analyses, high expression of SPARC was found to be associated with a statistically significant shorter overall survival and progression free survival. Conclusions High expression of SPARC is related to worse prognosis in rectal cancer patients.

Endometrium carcinoma (EC) is the fourth common cancer among women worldwide and the incidence is increasing. It is important to define the EC earlier for survival of the patients. Women who had endometrial hyperplasia (EH) and EC in postmenopausal and premenopausal period were included to participate in this study. MN assay has been performed to participants for detection of the genetic damages and DNA instability. MN ratio was significantly higher in EC group compared to other two groups (EH and control groups) (p 0.05). MN frequency and NDI were significantly correlated with the age in endometrial hyperplasia without atypia, endometrial cancer and control groups (r 0.546, p

EROGLU C., ORHAN O., KARACA H., UNAL D., DIKILITAS M., OZKAN M. & KAPLAN B. (2013) European Journal of Cancer Care22, 133–140 The effect of being overweight on survival in patients with gastric cancer undergoing adjuvant chemoradiotherapy The aim of this study was to examine the effect of being overweight on survival in patients with gastric cancer undergoing adjuvant chemoradiotherapy and chemotherapy. In this study 152 patients were evaluated. Radiotherapy dose was 45 Gy given in 5 weeks. 5-FU 425 mg/m2 and folinic acid 20 mg/m2 were administered weekly during the radiotherapy and four cycles with 4-week intervals as consolidation chemotherapy after radiotherapy. Patients were assigned into two groups according to their body mass index: overweight (body mass index ≥25 kg/m2) and normal weight (body mass index

Metaplastic breast carcinoma accounts for less than 1% of breast malignancies. Huvos et al. first introduced the term metaplastic carcinoma in 1974. It is usually seen together with poorly differentiated ductal carcinoma of the breast. Within its mesenchymal components, undifferentiated connective tissue cells, fibroblasts, osteoblasts and chondroblasts can be found. Metaplastic breast carcinoma is an aggressive disease with a poor prognosis. In this report, a case of a 45-year-old female patient who underwent segmental mastectomy with a diagnosis of metaplastic carcinoma of the breast is presented.

The tetraspanin transmembrane protein CD9 plays an important role in inhibiting cell motility in numerous neoplastic cell lines, including lung, gastric, pancreatic, and bladder carcinomas. The prognostic importance of CD9 in the survival of gastric carcinoma patients has not been examined to date, and in the present study, we attempted to define its prognostic value. The study included 49 (35 men and 14 women) patients with locally advanced (stages II-IV) gastric cancer. The median age was 55 years (range, 22-73 years). Surgery was the initial treatment for all patients, followed by adjuvant chemoradiotherapy. Tissue sections were evaluated immunohistochemically with a monoclonal anti-CD9 antibody. Of the 49 patients with gastric adenocarcinoma, 11 (22.4%) were CD9-positive, and 38 (77.6%) were CD9-negative. A significant prognostic value in disease-free survival and overall survival was observed in T classification and CD9 positivity. In conclusion, CD9 expression in gastric cancer appears to be associated with poor prognosis.

OBJECTIVE

To evaluate the effects on the long-term survival of psychiatric disorders, inflammation, malnutrition, and radiotherapy (RT)-related toxicity in patients with locally advanced head and neck cancer.Included were 47 patients who received RT for non-metastatic locally advanced head and neck cancer. The diagnosis of psychiatric disorder was made by the Diagnostic and Statistical Manual of Mental disorders (4th edn) (DSM-IV) criteria. Malnutrition was defined as weight loss5% of baseline during RT. Interleukin 1β (IL-1β), IL-6, and tumor necrosis factor-alpha (TNF-α) were analyzed by enzyme-linked immunosorbent assay (ELISA). RT-related acute toxicity was evaluated once a week using the National Cancer Institute Common Toxicity Criteria (NCI-CTC) version 2.0.The mean patient age was 57.3±11.4 years (range 33-80); 42 (89.4%) patients were male. Mean disease-free (DFS) and overall survival (OS) were 53 and 55 months, respectively. Mean DFS was significantly lower in patients with psychiatric disorder compared with those without (35 vs 59 months, p=0.013) and the same applied for mean OS (41 vs 61 months, p=0.008). There was no significant difference between patients with and without malnutrition in terms of OS. Similarly, no significant difference was seen between patients with and without RT-related toxicities in terms of OS. Age, psychiatric disorder, T status, and stage differed significantly between these groups (p0.10) in univariate analysis. The multivariate Cox regression analysis identified that the OS was significantly associated only with psychiatric disorder (odds ratio/OR: 3.22, 95% confidence interval/CI: 1.29-8.41, p=0.013).Psychiatric disorders had unfavorable effects on OS in patients with locally advanced head and neck cancer. Inflammation, malnutrition and RT-related toxicity had no significant impact on OS.

Relatively few studies have focused on T4N2 (stage IIIB) locally advanced non-small cell lung cancer (NSCLC). In this study, we tried to identify prognostic factors for patients with clinical stage T4N2 NSCLC.We retrospectively identified 223 patients, of which 168 met the inclusion criteria. Patients treated with curative intent using concurrent chemoradiotherapy (CRT) with or without adjuvant chemotherapy, or concurrent CRT after induction chemotherapy, were included in this study. Relevant patient, treatment, and disease factors were evaluated for their prognostic significance in both univariate and multivariate analyses using the Cox proportional hazards model.The median progression-free survival (PFS) was 13 months (95% confidence interval [CI], 10.6-15.4). The median overall survival (OS) was 20 months (95% CI, 16.8-23.1), and 71, 40.3 and 28.2% of the patients survived for 1, 2 and 3 years after diagnosis, respectively. Multivariate analysis showed Eastern Cooperative Oncology Group (ECOG) performance status (PS) was independent predictor of PFS (hazard ratio [HR], 0.24; 95% CI, 0.13-0.43; p=0.001), and OS [HR, 0.48; 95% CI, 0.26-0.87; p=0.015). Absence of multifocal T4 tumors was also associated with a significantly longer OS (HR, 046; 95% CI, 0.31-0.7; p=0.001). There was no statistically significant difference in OS and PFS between treatment modalities.PFS and OS were significantly shorter in patients with poor ECOG PS. OS was also significantly shorter in patients with multifocal T4 tumors. There were no differences between the two therapeutic approaches with respect to outcome.

Stewart-Treves syndrome is an angiosarcoma that occurs because of chronic lymphedema, which in most cases is a complication after mastectomy with axillary node dissection and postoperative radiation. Prognosis for this rare tumor is poor. The best therapy is early and radical excision. Chronic lymphedema seems to be an important pathogenic factor. We report a 59-year-old patient with chronic lymphedema and lymphangiosarcoma of the left upper limb who had a left modified radical mastectomy with axillary node dissection and postoperative radiation nine years ago. Additionally, the patient underwent a right modified radical mastectomy with axillary node dissection and postoperative radiation one year ago. In this report, we present a case of Stewart-Treves syndrome after the patient was operated for bilateral breast carcinoma, a review of literature, and principles of treatment.

To evaluate whether the ratio between the number of metastatic lymph nodes and the number of total removed lymph nodes (MLR) is related survival in patients with locally advanced (stage 3) gastric cancer treated chemo-radiotherapy.We included 179 patients with locally advanced lymph node-positive gastric cancer treated chemo-radiotherapy within this study. The cut-off values, area under curve (AUC), sensitivity, and specificity were calculated using the receiver operating characteristic (ROC) curve technique for MLR.The sensitivity and specificity of MLR for mortality were 71.54% and 51.79%, respectively, when the cutoff level was accepted as the ratio ≥ 0.3. The AUC for the predictive value of MLR with regard to mortality was 0.609 (95% confidence interval [CI]: 0.533-0.681, p: 0.0135). Overall survival rates were significantly lower in patients with high MLR than in those with low MLR (15 months vs. 35 months, p: 0.002, respectively). In multivariate analysis, overall survival rates were significantly associated with MLR status (low or high).The simple and easily obtainable MLR is an independent predictor for mortality in patients with locally advanced gastric cancer even if chemo-radiotherapy, which is known to increase local control, was given.