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Effect of early preoperative 5-fluorouracil on the integrity of colonic anastomoses in rats

World Journal of Gastroenterology 2009年第33期15卷 4156-4162页

作者： Leyla Ozel M Sefa Ozel Ahmet Burak Toros Melih Kara Kemal Sirri Ozkan Gurkan Tellioglu Osman Krand Meral Koyuturk Ibrahim Berber Haydarpasa Numune Education and Research Hospital Department of General Surgery Haydarpasa Numune Education and Research Hospital Department of Orthopedics and Traumatology istanbul Education and Research Hospital Department of Gastroenterology Acibadem Hospital Department of General Surgery istanbul bilim university Faculty of MedicineDepartment of Histology and Embryology

AIM： To determine the effect of chemotherapy on wound healing by giving early preoperative 5-fluorouracil （5-FU） to rats with colonic ***： Sixty Albino-Wistar male rats （median weight, 235 g） were used in this study. The rots were fed with standard laboratory food and given tap water ad libitum. The animals were divided into three groups： Group 1： Control group （chemotherapy was not administered）, Group 2： Intraperitoneally （IP） administered 5-FU group （chemotherapy was administered IP to animals at a dose of 20 mg/kg daily during the 5 d preceeding surgery）, Group 3： Intravenously （IV） administered 5-FU group. Chemotherapy was administered v/a the penil vein, using the same dosing scheme and duration as the second group. After a 3-d rest to minimize the side effects of chemotherapy, both groups underwent surgery. One centimeter of colon was resected 2 cm proximally from the peritoneal reflection, then sutured intermittently and subsequently end-to-end anastomosed. In each group, half the animals were given anaesthesia on the 3rd postoperative （PO） day and the other half on the 7th PO day, for in vivo analytic procedures. The abdominal incisions in the rats were dissected, all the new and old anastomotic segments were clearly seen and bursting pressures of each anastomotic segment, tissue hydroxyproline levels and DNA content were determined to assess the histologic tissue repair process. RESULTS： When the IV group was compared with the IP group, bursting pressures of the anastomotic segments on the 3rd and 7th PO days, were found to be significantly decreased, hydroxyproline levels at the anastomotic segment on the 7th PO day were significantly decreased （P 〈 0.01）. CONCLUSION： In this study, we conclude that early preoperative 5-FU, administered IV, negatively affects wound healing. However, IP administered 5-FU does not negatively affect wound healing.

关键词： 5-fluorouracil Neoadjuvant therapy Rats Wound healing

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World Journal of Clinical Cases 2022年第19期10卷 6722-6727页

作者： Aysegul Gencer Gizem Ozcibik Fatma Gulsum Karakas Ismail Sarbay Sebnem Batur Sermin Borekci Akif Turna department of Pulmonary Diseases Istanbul University-CerrahpasaCerrahpasa Medical Faculty CampusIstanbul 34098Turkey department of thoracic surgery Istanbul University-CerrahpasaCerrahpasa Medical FacultyIstanbul 34098Turkey department of Pathology Istanbul University-CerrahpasaCerrahpasa Medical FacultyIstanbul 34098Turkey

BACKGROUND Pulmonary Langerhans cell histiocytosis(PLCH)is a rare cystic lung disease usually affecting young *** is predicted that PLCH is a lung tumor precursor associated with dysfunction of the myeloid dendritic cells in the *** SUMMARY A 70-year-old male patient presented with chronic cough and *** had symptoms for 5 years and described shortness of breath on exertion for the previous 3 *** had a 60 packs/year smoking *** tomography of the thorax revealed an 11-mm nodule in the right lung lower lobe superior segment and a 7-mm nodule in the right lung lower lobe poster basal *** two nodules were resected by means of right thoracoscopic *** evaluation revealed a squamous cell carcinoma and *** Coexistent squamous cell carcinoma and PLCH suggest possible association between PLCH and lung cancer.

关键词： Pulmonary Langerhans cell histiocytosis Lung cancer Squamous cell carcinoma BRAF Mitogen-activated protein kinase Case report

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Neoadjuvant hyperfractionated accelerated radiotherapy plus concomitant 5-fluorouracil infusion in locally advanced rectal cancer: A phase Ⅱ study

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World Journal of Gastrointestinal Oncology 2018年第1期10卷 40-47页

作者： Zeynep Gural Sezer Saglam Serap Yucel Esra Kaytan-Saglam Oktar Asoglu Cetin Ordu Hediye Acun Rasul Sharifov Semen Onder Ahmet Kizir Ethem N Oral department of Radiation Oncology Acibadem University Medical Faculty department of Medical Oncology Istanbul Bilim University department of Radiation Oncology Istanbul Medical FacultyIstanbul University department of General surgery Academia of Clinical Science of Bogazici department of Medical Biophysics Harran University Medical Faculty department of Radiology Bezm-i AlemUniversity department of Pathology Istanbul Medical FacultyIstanbul University

AIM To evaluate the efficacy and tolerability of neoadjuvant hyperfractionated accelerated radiotherapy(HART)and concurrent chemotherapy in patients with locally advanced infraperitoneal rectal cancer. METHODS A total of 30 patients with histopathologically confirmed T2-3/N0+ infraperitoneal adenocarcinoma of rectum cancer patients received preoperative 42 Gy/1.5 Gy/18 days/bid radiotherapy and continuous infusion of 5-fluorouracil(325 mg/m^2). All patients were operated 4-8 wk after neoadjuvant concomitant therapy. RESULTS In the early phase of treatment, 6 patients had grade Ⅲ-Ⅳ gastrointestinal toxicity, 2 patients had grade Ⅲ-Ⅳ hematologic toxicity, and 1 patient had grade Ⅴ toxicity due to postoperative sepsis during chemotherapy. Only 1 patient had radiotherapy-related late side effects, i.e., grade Ⅳ tenesmus. Complete pathological response was achieved in 6 patients(21%), while near-complete pathological response was obtained in 9(31%). After a median follow-up period of 60 mo, the local tumor control rate was 96.6%. In 13 patients, distant metastasis occurred. Disease-free survival rates at 2 and 5 years were 63.3% and 53%, and corresponding overall survival rates were 70% and 53.1%, *** Although it has excellent local control and complete pathological response rates, neoadjuvant HART concurrent chemotherapy appears to not be a feasible treatment regimen in locally advanced rectal cancer, having high perioperative complication and intolerable side effects. Effects of reduced 5-fluorouracil dose or omission of chemotherapy with the aim of reducing toxicity may be examined in further studies.

关键词： Hyperfractionated accelerated radiotherapy Rectal cancer Neoadjuvant chemoradiotherapy

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Stenting for the Management of Posttracheostomy Tracheomalacia: Case Report

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Open Journal of Respiratory Diseases 2013年第1期3卷 1-3页

作者： Demirhan Ozkan Hurkal Tugce Sener Sibel Ece Ferah department of Anesthesiology and Reanimation Medical School Istanbul Bilim University Istanbul Turkey department of Chest Diseases Medical School Istanbul Bilim University Istanbul Turkey department of thoracic surgery Medical School Istanbul Bilim University Istanbul Turkey

In patients who undergo prolonged endotracheal intubation, tracheostomy is performed to prevent the tracheal and laryngeal trauma which may be caused by the intubation tube. In this report, a patient who was intubated after a cerebrovascular embolism and required a tracheostomy for 6 months due to decannulation problems is presented. The patient subsequently developed a tracheomalacia. A stent was inserted and seen to provide functional support. Upon removal of the stent, the tracheomalacia improved. Although surgical therapy is claimed to provide higher success rate, stenting may also be a viable option for the management of tracheomalacia and improve the quality of life in patients with good general condition.

关键词： Tracheostomy Tracheomalacia Stent

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Neoadjuvant intermediate-course versus long-course chemoradiotherapy in T3-4/N0+rectal cancer:istanbul R-02 phase II randomized study

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Oncology Research 2023年第5期31卷 689-696页

作者： SUKRAN SENYUREK SEZER SAGLAM ESRA KAYTAN SAGLAM HAKAN YANAR KAAN GOK DIDEM TASTEKIN CANAN KOKSAL AKBAS NERGIZ DAGOGLU SAKIN GULBIZ DAGOGLU KARTAL EMRE BALIK METIN KESKIN YASEMIN SANLI MINE GULLUOGLU ZULEYHA AKGUN department of Radiation Oncology Koc University School of MedicineIstanbul34450Türkiye department of Medical Oncology Demiroglu Bilim University Faculty of MedicineIstanbul34394Türkiye department of Radiation Oncology Istanbul University Oncology InstituteIstanbul34093Türkiye department of General surgery Istanbul University Istanbul Faculty of MedicineIstanbul34093Türkiye department of Medical Oncology Istanbul University Oncology InstituteIstanbul34093Türkiye department of Medical Physics Istanbul University Oncology InstituteIstanbul34093Türkiye department of Radiology Istanbul University Istanbul Faculty of MedicineIstanbul34093Türkiye department of General surgery Koc University School of MedicineIstanbul34450Türkiye department of Nuclear Medicine Istanbul University Istanbul Faculty of MedicineIstanbul34093Türkiye department of Pathology Istanbul University Istanbul Faculty of MedicineIstanbul34093Türkiye department of Radiation Oncology Memorial Sisli HospitalIstanbul34384Türkiye

Radiation therapy(RT)is typically applied using one of two standard approaches for preoperative treatment of resectable locally advanced rectal cancer(LARC):short-course RT(SC-RT)alone or long-course RT(LC-RT)with concurrent fluorouracil(5-FU)*** Phase II single-arm KROG 11-02 study using intermediate-course(IC)(33 Gy(Gray)/10 fr(fraction)with concurrent capecitabine)preoperative chemoradiotherapy(CRT)demonstrated a pathologically complete response rate and a sphincter-sparing rate that were close to those of *** current trial aim to compare the pathological/oncological outcomes,toxicity,and quality of life results of LC-CRT and IC-CRT in cases of *** prescribed dose was 33 Gy/10 fr for the IC-CRT group and 50.4 Gy/28 fr for the LC-CRT *** chronomodulated capecitabine(Brunch regimen)1650 mg/m2/daily chemotherapy treatment was applied in both *** European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Colorectal Cancer Module(EORTC QLQ-CR29)was administered at baseline and at three and six months after CRT.A total of 60 patients with LARC randomized to receive IC-CRT(n=30)or LC-CRT(n=30)were included in this phase II randomized *** significant difference was noted between groups in terms of pathological outcomes,including pathological response rates(ypT0N0-complete response:23.3%vs.16.7%,respectively,and ypT0-2N0-downstaging:50%for each;p=0.809)and Dworak score-based pathological tumor regression grade(Grade 4-complete response:23.3 vs.16.7%,p=0.839).The 5-year overall survival(73.3 vs.86.7%,p=0.173)rate was also *** acute radiation dermatitis(p<0.001)and any hematological toxicity(p=0.004)rates were significantly higher in the LC-CRT group,while no significant difference was noted between treatment groups in terms of baseline,third month,and sixth month EORTC QLQ-CR29 scores.

关键词： Chemoradiotherapy Rectal cancer Neoadjuvant therapy

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Prognostic Values of PET/CT Findings and Tumor/Patient Characteristics with Non-Small Cell Lung Cancer

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Open Journal of Respiratory Diseases 2012年第4期2卷 101-106页

作者： Ozkan Demirhan Zinnet Berrin Balta Gunay Aydin Tosun Serdar Erturan Kerim Sonmezoglu istanbul bilim university department of thoracic surgery Istanbul Turkey istanbul university Cerrahpasa Medical School Department of Chest Diseases Istanbul Turkey istanbul university Cerrahpasa Medical School Department of Nuclear Medicine Istanbul Turkey

Background/Aim: Although numerous prognostic factors have been described for non-small cell lung cancer (NSCLC), there is still a requirement for better and non-invasive markers. FDG-PET is a non invasive diagnostic tool that is being used increasingly in the diagnosis of lung cancer. This study evaluates the prognostic values of PET/CT defined SUV measurements and other patient/tumor characteristics in newly diagnosed stage IIIB and IV NSCLC. Method: This ret- rospective study included 111 patients admitted between 2005 and 2006 with stage IIIB and IV NSCLC, whose diag- noses were verified with biopsy and staging performed with PET/CT. The prognostic values of standart uptake values (SUV) of the primary lesion on PET/CT, and other patient/tumor characteristics were analyzed using survival analysis. Results: SUV was found to be unrelated with survival. Only the presence of distant metastasis, type of metastasis (bone, brain, or the contralateral lung) and the type of radiotherapy used (curative or palliative) were found to be related to survival. SUV values in epidermoid carcinoma were found to be significantly higher compared to adenocarcinoma (16.15 ± 7.18 and 12.32 ± 5.52, respectively, p = 0.021).Conclusion: Our findings do not support that SUV of the pri- mary lesion in inoperable NSCLC has a prognostic value with respect to survival. This condition may be explained by the inclusion of significantly advanced NSCLC patients who are known to have a low survival and a high mortality, and also the relatively small sampling size.

关键词： Non-Small Cell Lung Cancer Survival Prognosis Positron Emission Tomography (PET) FDG-PET

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Impact of admission blood glucose levels on prognosis of elderly patients with ST elevation myocardial infarction treated by primary percutaneous coronary intervention

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Journal of Geriatric Cardiology 2013年第4期10卷 310-316页

作者： Ahmet Ekmekci Mahmut Uluganyan Fatif Tufan Huseyin Uyarel Gurkan Karaca Seref Kul Barl(s) Gungor department of Cardiology Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital Tibbiye Caddesi 34000 Istanbul Turkey department of Cardiology Kadirli State Hospital Toki Caddesi 8075 Osmaniye Turkey department of Geriatric Istanbul University Medical Hospital Vatan Cadddessi 34000 Istanbul Turkey department of Cardiology Bezmialem Vakif University Medical Hospital Vatan Caddesi 34000 Istanbul Turkey

OBJECTIVE:Admission hyperglycemia in acute myocardial infarction (MI) is related with increased in-hospital and long term mortality and major cardiac adverse events。 We aimed to investigate how admission hyperglycemia affects the short and long term outcomes in elderly patients >65 years) after primary percutaneous coronary intervention for ST elevation myocardial infarction。 METHODS:We retrospectively analyzed 677 consecutive elderly patients (mean age 72.2 ±5.4)。 Patients were divided into two groups according to admission blood glucose levels。 Group : low glucose group (LLG), glucose 168 mg/dL。 RESULTS:In-hospital, long term mortality and in-hospital major adverse cardiac events were higher in the high admission blood glucose group (P 1, post-thrombolysis in MI <3 and admission blood glucose levels were independent predictors of in-hospital adverse cardiac events (P <0.001)。 CONCLUSIONS:Admission hyperglycemia in elderly patients presented with ST elevation myocardial infarction is an independent predictor of in-hospital major adverse cardiac events and is associated with in-hospital and long term mortality。

关键词： Admission hyperglycemia Elderly patients In-hospital mortality Long-term mortality Major adverse cardiac events

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Open reduction of a total talar dislocation: A case report and review of the literature

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World Journal of Clinical Cases 2019年第14期7卷 1850-1856页

作者： Furkan Yapici Mehmet Coskun Muhammet Coskun Arslan Erman Ulu Yunus Emre Akman department of Orthopedics and Traumatology Metin Sabancl Baltalimanl Bone and Joint Diseases Education and Research HospitalIstanbul 34470Turkey department of Orthopedics and Traumatology Demiroglu Bilim University Faculty of MedicineIstanbul 34387Turkey

BACKGROUND Total talar dislocation (TTD) is very uncommon for many orthopedic surgeons and emergency/trauma specialists. Scarce cases of TTD have been reported, mainly in the form of open fracture-dislocation injury. CASE SUMMARY We report a very rare injury of closed TTD with a follow-up period of 36 mo. Initial closed reduction was not successful because of a fractured highly unstable medial malleolus displaced into the ankle mortise, blocking the relocation of the talus. The patient was able to walk pain-free after the 3rd month of surgery. At the 36-mo follow-up, there were 10 degrees of flexion loss and 10 degrees of extension loss in the tibiotalar joint. Furthermore, 5 degrees of subtalar joint inversion-eversion loss was present. CONCLUSION Open reduction should be performed for closed TTDs unless closed reduction is successful.

关键词： Total talar dislocation Pan-talar dislocation Talus Case report

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Diaphragmatic Plication: Retrospective Study with 54 Patients

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Open Journal of thoracic surgery 2013年第3期3卷 87-92页

作者： Sezai Celik Serhan Tanju Isa Dongel Onur Gurer Alper Toker Cardiothoracic surgery department Medicana HospitalsIstanbulTurkey thoracic surgery department Istanbul Medical FacultyIstanbul UniversityIstanbulTurkey.

Objective: This study seeks to evaluate the results of surgery performed according to the etiological causes of diaphragmatic eventration or paralysis. Method: Files of 54 patients (35 males, 19 females;mean age: 39.1 ± 3.01 years) who had undergone diaphragm plication between January 2005 and June 2011 in two clinics located in istanbul were studied in terms of pulmonary spirometry, applied surgical procedure, duration of hospitalization, morbidity, and mortality. Results: In diaphragm plications, observed etiologies were isolated diaphragmatic eventration without phrenic nerve injury (Group 1) in 20 (37%) patients due to blunt thoracic trauma;Group 2 (thymoma in 19 (35.2%) patients;lung cancer in 7 (12.9%) patients;mediastinal tumor in 3 (5.6%) patients) and congenital heart surgery (Group 3) in 5 (9.3%) patients. The mean time to plication was 7.4 months in Group 1. The mean duration of hospitalization was 4 days in Group 1, 6.2 days in Group 2, 11.8 days in Group 3. Mean forced vital capacity, forced expiratory volume at 1 second improved by 17%, 20.3%, respectively (p In Group 1, mean dyspnea-related hospital admission before plication was 2.4 times. At the end of 6 months after plication mean dyspnea-related hospital admission was 0 time. All of them returned to daily activities or their job within 6 months in Group 1. Postoperative mortality was observed in 2 (3.7%) patients in Group 3 while the overall complication rates were 24%. The morbidity rates were 8%, 27.5%, 60%, respectively;and the mortality rates were 0%, 0%, 40%, respectively. Conclusion: As a result, it could be suggested that early and timely performed plications for diaphragmatic eventration improves functional status and assesses a shorter lenght of stay. On the other hand,simultaneously performed plications in intraoperative phrenic nerve resections can be performed with acceptable morbidity and no mortality. In diaphragmatic paralysis due to congenital heart surgery, morbidity and mortality

关键词： Diaphragm Plication Paralysis Eventration Phrenic Nerve Resection

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Advanced interatrial block as a key marker for atrial fibrillation recurrence： Bayes＇ syndrome

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Journal of Geriatric Cardiology 2017年第3期14卷 169-173页

作者： Adrian Baranchuk Andres Enriquez Pavel Antiperovitch Bryce Alexander Goksel Cinier department of Medicine Kingston General Hospital Queen's University Kingston Ontario Canada Section of Cardiac Electrophysiology Hospital of the University of Pennsylvania Philadelphia Pennsylvania USA Dr. Siyami Ersek thoracic and Cardiovascular surgery Center Istanbul Turkey

It was not until 1979 that Bayes de Ltma described atrial conduction blocks and classified them as interatrial and intra- *** blocks refer to conduction disorders lo- cated between the atria, while intraalxial blocks occur within the same atrium. This work motivated several authors, in- cluding Bayes himself, to further investigate atrial conduc- tion and interatrial block （IAB）.

关键词： Atrial fibrillation Bayes syndrome Bachmann's bundle Interatrial block

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