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Background: Maximum standardized uptake value (SUVmax) is the primary quantitave parameter given in 18F-FDG PET/CT reports. Calculations derived from three dimensional metabolic volumetric images have been proposed to be more successful than SUVmax alone in prognostification with a lower interobserver variability in many cancers. We aimed to determine the prognostic value of metabolic parameters derived from 18F-FDG PET/CT studies in small cell lung cancer (SCLC) patient population with a long follow-up time., Methods: In this study, 38 consecutive SCLC patients (34M, 4F, age:65.76 ±8.18 years) who were referred to 18F-FDG PET/CT for staging between October 2006-January 2011 were included. SUVmax, SUVmean, SUVpeak, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were calculated. Overall survival (OS) was calculated from the date of the initial PET/CT to death from any cause. Survival tables were obtained and Kaplan Meier curves were reconstructed. Mantel-Cox regression analysis was performed in order to investigate if any of these parameters have an effect on survival along with other clinical risk factors., Results: Median SUVmax, SUVmean, SUVpeak, MTV, TLG and LDH values were calculated as 13.9 g/dL, 6.4 g/dL,10.69 g/dL, 147 cm 3 , 1898.52 and 375U/L respectively. Median follow-up was 761.23±873.21 days (25.37 months, range:110-3338 days). Since basal 18F-FDG PET/CT scans, all patients were lost in the follow-up except for two patients. MTV was a significant prognostic factor in SCLC patients. Estimated mean survival times were 261.0±45.6 (95% CI: 171.6-350.3) days in patients with MTV value above the calculated median 147, and 577.0±124.0 (95% CI: 333.7-820.2) days in patients with MTV<147. The difference was statistically significant with a P=0.037., Conclusions: Baseline whole body MTV reflecting total tumor load is a prognostic index in SCLC. SUV is insufficient to predict prognosis.

Chronic diseases served as a silent global epidemic before the pandemic, and individuals living with chronic disease now form one of the groups most affected by COVID-19. This study aims to determine the problems that employees with chronic disease face during the COVID-19 pandemic. As part of the study, data were collected from 952 individuals who live with chronic disease in Turkey. Of these, 76.6% of respondents worked for the public sector, a large majority of whom (67.7%) have worked full time during the COVID-19 pandemic. It was found that the COVID-19 fear level of employees living with chronic disease was higher than moderate (21.061 ± 7.607). When the variables affecting the COVID-19 fear level are listed in order of relative significance, eating problems, residing in the Mediterranean region, having asthma, and working as a female employee made the greatest impact, respectively. Necessary conditions of work should be provided to those living with chronic disease who could adapt themselves to working flexibly or working from home, so that they would not feel isolated from business life. This group should be provided with essential protective equipment, their working conditions must be reviewed and vaccination priority could be given to them.

Background: In the post-acute COVID-19 syndrome, many patients suffer from palpitations, effort-associated fatigue, and even sudden death. The mechanism of heart involvement in this syndrome is uncertain. The main purpose of the study was to identify possible cardiac involvement causes in patients with post-acute COVID-19 by using biomarkers such as NT-proBNP and nitric oxide (NO) and cardiac imaging modalities., Methods: In this cross-sectional study, a total of 105 participants were included according to the existence of symptoms, and 40 of these participants were asymptomatic patients. The ages of the participants ranged from 20 to 50 years. All patients were healthy before COVID-19. The symptoms were defined as palpitations and/or fatigue association with exercise in post-acute COVID-19 term. The comparison of the two groups was made by using biochemical parameters (NT-proBNP, Troponin I, NO) and imaging techniques (echocardiography, cardiovascular magnetic resonance (CMR) and cardiac positron emission tomography (PET))., Results: The symptomatic patients had higher NT-proBNP levels compared with asymptomatic patients (132.30±35.15; 76.86±16.79, respectively; p < 0.001). Interestingly, the symptomatic patients had lower NO levels than asymptomatic patients (9.20±3.08; 16.15±6.02, respectively; p < 0.001). Echocardiography and CMR were normal. However, we found regional increased 18F-FDG uptake on cardiac PET to be compatible with myocardial fatigue., Conclusion: We found elevated NT-proNBP levels, low serum NO levels, and increased 18F-FDG uptake on cardiac PET in post-acute COVID syndrome. Cardiac PET could replace or be added to CMR for detecting subtle subacute/chronic myocarditis. The follow-up of patients with post-acute COVID-19 could target the possibility of risk of heart failure., Competing Interests: The authors report no other potential conflicts of interest for this work and no financial or other relationships that might lead to a conflict of interest. There are no relationships with industry., (© 2021 Sarıçam et al.)

A survey in the year 2007 among medical students of Ankara University Medical School to assess the smoking rates showed that 25.1 % of them were smoking. Moreover, the smoking rate was 35 % at sixth grade students and 60 % of the smokers specified that they started smoking at medical school. This report provides a successful approach to decrease smoking among medical students by measures against starting smoking. An "Antismoking Group" composed of voluntary academic staff, nurses, students, psychologists, and a social worker of the medical school was established to engage in lowering the smoking rate and eliminating it eventually among our students. Several methods including regular monthly meetings, annual "Smoking or Health" symposiums, and lectures to first, second, and third grade students to increase their awareness related to harms of smoking and their role in the fight against smoking were carried out. Our surveys in the years 2009 (641 students) and 2012 (975 students) showed that total smoking rates dropped to 15.0 and 11.0 %, respectively (p < 0.0002). Moreover, the smoking rate for the sixth grade students dropped from 35.0 % in 2007 to 21.8 and 8.8 % in the years 2009 and 2012, respectively (p < 0.0002). In 2012, the smoking rates of first year and sixth year students were 7.8 and 9.0 %, respectively. These close rates of smoking at the first and last years of medical school training and the significant drop in smoking rates in 5 years confirm that our group pursued a realistic and successful strategy against smoking.

Opipramol 2-HCl (OP) is used for therapy of general somatoform and anxiety disorders. Conventional tablets in the market contain 50 mg OP to be used once or up to three times a day in effective treatment of depression in mild. In case of serious depressive disorders, OP may be administired up to 300 mg a day. Decrease in frequency of high dose administration via sustained drug release would reduce incidence of symptoms of intoxication in long-term use of OP. With this aim, OP matrix tablets containing 100 mg were prepared by direct compression method to be used once a day to provide patient compliance and constant blood level, consequently to decrease side effects. Two concentrations of polymers (10% and 20%): hydroxypropylcellulose (HPC) and hydroxypropyl methylcellulose (HPMC), sodium alginate (NaAlg), xanthan gum (XG) and Carbopol(®)941 (C941) were used in preparation of matrix tablets. Drug release study were performed in distilled water, pH1.2 HCl buffer and pH7.4 phosphate buffer solutions according to the Method II in USP 29. Two commercial tablets containing 50 mg OP available in Turkish market were used for comparison. Kinetic models of release patterns from tablets were evaluated. Drug release was displayed slower to faster pattern in order of formulations containing C941, HPMC and HPC. Drug release was significantly faster in tablets of 10% polymers than those of 20%. NaAlg and XG were insufficient to sustain drug release. The most sustaining drug release effect at the lowest polymer concentration was obtained with C941. Drug release from matrix tablets containing 10% C941 was determined as 58.2%, 52.4 and 57.0% in related dissolution mediums above after 8 hours, respectively. However, HPMC and HPC sustained drug release at 20% concentration. As a result, Carbopol® 941, HPMC and HPC can be suggested as suitable to prepare matrix tablets of OP.

Calcium ascorbate (CAAS), which is a hydrophilic and stable derivative of ascorbic acid (vitamin C) (AA), is commonly used in foods as an antioxidative agent. There are very limited reports on its dermatological use in the literature. In this paper, it is reported that CAAS could be used in place of ascorbic acid, which has chemical stability problems in topicals due to degradation by oxidation. The aim of this study was to investigate the skin-hydrating effect of CAAS compared to those of ascorbic acid and tocopherol (vitamin E) (T), which is a potential skin moisturizer and commonly used in dermocosmetics. Vitamins are incorporated into two kinds of base creams (o/w and w/o emulsion creams), alone and in combinations. Formulations were applied to the inner forearms of volunteers, and skin conductance was measured by using a corneometer. Data obtained were statistically evaluated. It was found that the skin-hydrating effect of CAAS was higher than that of AA and lower than that of T. However, its effect was very close to that of T.

Interferon (IFN)-gamma plays a pivotal role in protective immunity against Mycobacterium tuberculosis. Elevations of IFN-gamma have been found in the affected lung and bloodstream of patients with pulmonary tuberculosis. In the present study, we aimed to investigate the role of serum IFN-gamma level in the differential diagnosis of active and inactive pulmonary tuberculosis. Fourty seven patients with newly diagnosed active pulmonary tuberculosis, 21 patients with inactive pulmonary tuberculosis, and 20 healthy volunteers were enrolled in the study. Serum samples were collected from each subject and stored at - 70 degrees C until the analysis of IFN-gamma. The mean value of IFN-gamma levels were 9.3 +/- 4.6 pg/mL in patients with newly diagnosed pulmonary tuberculosis, 9.8 +/- 3.8 pg/mL in patients with inactive tuberculosis, and 10.2 +/- 3.4 pg/mL in healthy controls. The comparison of IFN-gamma levels of the three groups was not found statistically significant (p= 0.4). Serum IFN-gamma level was not found to be valuable in the differential diagnosis of active and inactive pulmonary tuberculosis.

Malignant melanoma involving the respiratory tract is nearly always metastatic. True primary tumors are very rare, and only approximately 28 cases have been reported in the literature. Extensive clinical and histopathological examinations are needed to ascertain that the lung is the primary site. We present the case of a 67-year-old man with an apparent primary malignant melanoma of the lung in the right lower lobe. We also review the literature.

Solid lipid ketoprofen micropellets (SLKM) at different drug/beeswax ratios [(1:1) and (1:2)] were prepared by emulsion congealing technique and then compressed into tablets. Ketoprofen in solid state was incorporated into the melted beeswax at 90 degrees C and the mixture was emulsified in the hot aqueous Tween 80 solution by stirring at a constant rate. The SLKM were obtained by cooling the coarse emulsion down to room temperature and filtering. Drug entrapment efficiency and particle size analysis by laser diffractometry (LD) were determined, and existence of a drug-lipid interaction was investigated by differential scanning calorimetry (DSC) on the SLKM, before being compressed into the tablets by direct compression method. Finally, in vitro release studies were performed and the release kinetics of the waxy tablets were calculated. A commercial ketoprofen retard tablet (reference: Profenid Retard 200 mg) was also examined to compare the release properties. While the data obtained from DSC were indicating absence of drug-lipid interaction in the SLKM, it was determined that 28.62% (+/-2.08), 38.60% (+/-1.91) and 47.00% (+/-1.82) of ketoprofen was released from the tablets containing (1:2) and (1:1) SLKM and Profenid Retard 200 mg in pH 7.4 phosphate buffer solution after 8 h, respectively.

p53 protein, which accumulates intracellularly in over half of all human tumors, has been reported to be variably present in the sera of patients with various malignancies. In this study, it was aimed to detect p53 protein in the sera of lung cancer patients, and to verify its value as a marker of p53 alterations in lung cancer. A pantropic quantitative ELISA technique was used to detect serum p53 protein of 94 newly diagnosed patients with lung cancer. Serum samples were collected on admission before any treatment. There was no detectable serum p53 protein in the control group including 34 healthy volunteers. Serum p53 protein was present in only 3 (3.2%) of 94 patients. In nonsmall cell lung cancer (NSCLC) group, serum p53 protein had been detected in 2 (2.8%) of 72 patients, and it was detectable in 1 (4.5%) of 22 patients in SCLC group. Serum levels of p53 protein ranged from 1 U/mL to 31.25 U/mL in positive samples. Patients who had p53 protein in their serum samples, were at late stage and had poor prognosis. In conclusion; prognostic value of detectable serum p53 protein levels could not be define, because of the small number of p53 positive patients. The use of quantitative serum p53 protein analysis with ELISA is of very limited value as a marker in evaluating p53 changes in lung cancer patients, despite the fact that is an easy technique to perform.

The aim of this study was to use two of Vitamin C derivatives, lipophilic ascorbyl palmitate and hydrophilic calcium ascorbate to determine their skin-hydrating effects for the first time. For this purpose, anhydrous cream, gel and w/o emulsion were prepared and applied to the volunteers' inner forearms. A commercial topical preparation containing a known moisturizer, Vitamin E, was also chosen and used for comparison. Moisture contents of the skin were measured by using corneometer.

Metastatic non-small cell lung cancer (NSCLC) has a poor prognosis. Adrenal metastasis (AM), in NSCLC, are present in 5-10% of patients at initial presentation. Several case reports have shown that operation of isolated AM results in longer survival time. We describe a 55 year-old man with diagnosis of NSCLC with operable lung tumor and solitary AM treated with combination of neoadjuvant chemotherapy followed by primary site and metastasis surgery. He was diagnosed on March 2002 and is still alive.

We studied ADA and gamma interferon (gamma-IFN) levels in pleural fluid of 45 cases presenting with pleural effusion to the Ankara University School of Medicine Chest Diseases Hospital between September 2001 and September 2002. Fifteen patients had TB pleurisy, 20 patients had malignant pleurisy and 10 patients had transudative pleural effusion. The cut-off value for pleural fluid gamma-IFN levels were 12 pg/mL. According to this, all patients with transudative effusions, 19 of 10 patients with malignant effusions and 2 of 15 patients with tuberculous (TB) effusions had pleural fluid gamma-IFN levels under the cut-off value. In exudative effusions, sensitivity and specificity of gamma-IFN were 87% and 95% respectively. The sensitivity of pleural fluid ADA levels was 86% and specificity of pleural fluid ADA levels was 100%. Pleural fluid ADA levels in TB effusions were significantly higher than the non-TB effusions. Also there were no statistically significant differences between pleural fluid ADA and g-IFN levels according to sensitivity and specificity. As a result, we have shown that gamma-IFN is a valuable test in diagnosis of TB pleurisy. We think that when it is used routinely, it will be a good alternative to the conventional invasive diagnostic tests.

The aim of this study was the comparison of three different formulations (gel, o/w emulsion, oleagenous cream) and two penetration enhancers (oleic acid and menthol) as vehicle systems for celecoxib in respect of release and penetration through excised human skin in vitro. The influence of the vehicle on the release rate was studied in vitro using a cellulose acetate membrane. The release rate could be increased by up to 6.5 and 2.5 times with gel and o/w emulsion compared to oleagenous cream respectively. Further in vitro penetration measurements using human skin on Franz diffusion cells were performed with and without oleic acid and menthol as enhancers. It was shown that the penetration rate is strongly dependent upon the enhancer type and concentration but not on the vehicle itself and could be increased by 48% when 5% oleic acid was used in oleagenous cream. In all formulations tested, celecoxib was released and penetrated into human skin more quickly and to a greater extent from the gel formulations. There is no topical formulation available of celecoxib and its penetration properties through human skin have not been investigated. Since celecoxib creates some gastrointestinal disturbances, topical formulations of celecoxib preferably in gel form including 5% oleic acid could be suggested as an alternative.

There exists a rarely observed association between pulmonary histiocytosis X and bronchopulmonary cancer. However, the frequency of bronchopulmonary cancer in these patients is higher than in the general population. A 28-year-old patient who currently smokes ten packs of cigarettes a year came to our department of pneumology with complains of cough and hemoptysis. An x-ray of the thorax revealed bilateral cysts and a shadow in the upper part of the right pulmonary field. In addition, a chest tomography showed multiple cysts dispersed throughout the two pulmonary fields and an irregular mass with a diameter of four centimetres in the upper right lobe. Bronchopulmonary adenocarcinoma was diagnosed during a cytologic exam of the bronchial washing. We decided to perform a thoracotomy on the patient, since there was no far metastasis. An upper lobectomy and wedge resection of the upper segment of the lower right lobe, which had been invaded by the tumour, were performed. Histology confirmed the diagnosis of adenocarcinoma. A pulmonary biopsy was carried out on the tumour-free site and showed the presence of histiocytosis X. There is a hypothesis that a neoplasm developed on the pulmonary fibrosis could be an epiphenomenon of bronchopulmonary cancer in patients who smoke and have pulmonary histiocytosis X. It is interesting to note that histiocytosis X and bronchopulmonary cancer were diagnosed at the same time, since the bronchopulmonary cancer may have occurred within a few years following the diagnosis of histiocytosis X, even if she was a smoker. Hemoptysis, which is found in 5% of patients with histiocytosis X, may suggest cancer. This young patient, a smoker, who complained of hemoptysis, is a particularly rare case of the association between pulmonary histiocytosis X and bronchopulmonary cancer whose pathogenesis is not clear cut. It is thus important to note that smoking can have major consequences, even in young people.

Ketoprofen is a non-steroidal anti-inflammatory drug which is not soluble in water and creates gastrointestinal problems. In order to improve the solubility of the drug in water and enhance its dissolution rate, physical mixture (PM) and inclusion (IC) of ketoprofen with skimmed milk (SM) were prepared and investigated. Enhancement of solubility of ketoprofen was obtained by preparing its IC with SM which can be used because of its amino acid and surface active agents content and can also be used for treatment of gastric disturbance. Lyophilization technique was used to prepare the IC. Results obtained showed that the solubility of IC of ketoprofen with SM was almost four times greater than the solubility of the plain drug. Data from the dissolution rate determination have also indicated that IC of ketoprofen with SM significantly improved the dissolution rate of the drug compared with PM and the plain form. Differential scanning calorimetry (DSC), X-ray powder diffraction and scanning electron microscopic (SEM) analysis revealed the formation of IC of ketoprofen with SM.

Objectives: The respiratory effects of exposure to welding fumes have been investigated in numerous studies; but results of these studies have not been consistent. The aim of the present study was to investigate the respiratory effects of welding exposure in a large group of manual are welders exposed primarily to mild steel welding processes in confined spaces without respiratory protection., Methods: Respiratory symptoms and spirometry were studied in 110 welders and 55 controls. The welders and controls were of similar average age and height; smoking habits of the groups were similar. Chest x ray films were taken to exclude people with radiological abnormalities that may influence pulmonary function tests. Welders were grouped according to smoking habits and duration of employment (< 20 years or > 20 years)., Results: No gross radiological abnormalities were found. Respiratory symptoms and chronic bronchitis were more prevalent in welders (P < 0.05). Welders who were smokers showed a higher frequency of chronic bronchitis than controls who smoked (P < 0.05). No significant difference in the occurrence of chronic bronchitis was found between welders who smoked and welders who were non-smokers or exsmokers. Compared with the controls, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), and maximum midexpiratory flow (MMEF) were significantly lower in welders (mean values of FVC for welders and controls were 86.06 (25.74) and 96.40 (13.03); and values for FEV1 were 87.54 (13.70) and 95.36 (12.40) respectively; P < 0.01). There was no significant difference in pulmonary function tests between welders who were non-smokers and controls who were non-smokers; whereas FVC, FEV1, PEF, and MMEF were significantly lower in welders who smoked than controls who smoked (P < 0.01). There were no significant differences in pulmonary function tests and occurrence of chronic bronchitis between welders with more or less than 20 years at work., Conclusion: Welders working in conditions of inadequate ventilation, have increased risk of chronic bronchitis and impairment of pulmonary function.

We measured DNA and protein contents of nuclei in resected tumors from 17 cases (six female and 11 male) of pulmonary primary adenocarcinoma. The relationship between the contents of nuclear DNA and protein on tumoral behavior was evaluated. We found that the content of nuclear DNA and protein was significantly higher in advanced stages than in early stages in patients with adenocarcinoma (P < 0.05). We also found the nuclear protein, DNA contents and the ratio of nuclear protein to DNA significantly higher in patients under the average age of 61 than in the patients over 61 (P < 0.05). Tumor size was found to be greater in Stage III and IV cases than Stage I cases (P < 0.05). In conclusion, it has been postulated that evaluation of malignant disease and its behavior might be simplified by measuring nuclear DNA and the protein contents of tumors, contributing to disease control.

A 68-year-old man who had had cough and sputum for ten months was referred to our hospital because sputum cytologic findings were suggestive of lung cancer. Fiberoptic bronchoscopy and biopsy revealed mucosal neuroma of the bronchi. There were no signs suggesting pheochromocytoma or medullary thyroid carcinoma. To our knowledge, this is the first case of solitary mucosal neuroma of the bronchi to be reported.