• Title/Summary/Keyword: Turkey

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Factors Affecting Prognosis in Metastatic Colorectal Cancer Patients

  • Eker, Baki;Ozaslan, Ersin;Karaca, Halit;Berk, Veli;Bozkurt, Oktay;Inanc, Mevlude;Duran, Ayse Ocak;Ozkan, Metin
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.7
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    • pp.3015-3021
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    • 2015
  • Background: Colorectal cancer (CRC) is a major cause of mortality in developed countries, and it is the third most frequent malignancy in Turkey. There are many biological, genetic, molecular, and tissue-derived prognostic factors for CRCs. In this study, we evaluated prognostic factors in patients who were metastatic at diagnosis or progressed to metastatic disease during follow-up. Patients and Methods: This study included 116 patients with malignancies either in the colon or rectum. Of these, 65 had metastatic disease at diagnosis, and 51 progressed to metastatic disease during the course of the disease. The parameters evaluated were age, gender, comorbidity, performance status and stage of the disease at the beginning, localization, history of surgery, chemotherapy regimen, response to first-line treatment, K-RAS status, site and number of metastases, expression of tumor predictors (CEA, CA19-9), and survival times. A multivariate analysis conducted with factors that considered statistically significant in the univariate analysis. Findings: Median age was 56 (32-82) years and the male/female ratio was 80/36. Eleven patients were at stage II, 40 at stage III, and 65 at stage IV at diagnosis. Twenty three patients had tumor in the right colon, 48 in the left colon, and 45 in the rectum. Ninety seven patients were operated, and 27 had surgical metastasectomy. Ninety three patients received targeted therapy. At the end of follow-up, 61 patients had died, and 55 survived. Metastatic period survival times were longer in the adjuvant group, but the difference did not reach the level of statistical significance (adjuvant group: median 29 months, metastatic group: median 22 months; p=0.285). In the adjuvant group before the metastatic first-line therapy, CEA and CA 19-9 levels were significiantly lower compared to the metastatic group (p<0.005). We also found that patients with elevated tumor predictor (CEA, CA 19-9) levels before the first-line therapy had significiantly poorer prognosis and shorter survival time. Survival was significiantly better with the patients who were younger than 65 years of age, had better initial performance status, a history of primary surgery and metastatectomy, and single site of metastasis. Those who benefitted from the first-line therapy were K-RAS wild type and whose tumor markers (CEA, CA 19-9) were not elevated before the first line therapy. Conclusions: Among the patients with metastatic CRC, those who benefited from first-line therapy, had history of metastasectomy, were K-RAS wild type and had low CA 19-9 levels before the first-line therapy, showed better prognosis independent of other factors.

Low-Dose Docetaxel/Cisplatin - Leucovorin and 46 Hour Infusional Fluorouracil in Metastatic Gastric Carcinoma

  • Alici, Suleyman;Buyukberber, Suleyman;Alkis, Necati;Benekli, Mustafa;Ozkan, Metin;Bilici, Ahmet;Demirci, Umut;Karaca, Halit;Arpaci, Erkan;Gumus, Mahmut;Altunbas, Mustafa;Dane, Faysal;Turk, H. Mehmet;Anatolian Society of Medical Oncology
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.423-427
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    • 2013
  • Background: Phase II and III trials of docetaxel, cisplatin and fluorouracil (DCF) have shown superior efficacy versus cisplatin and fluorouracil alone but with high rates of hematologic toxicity in metastatic gastric cancer cases. To reduce toxicity while maintaining the efficacy of DCF, we investigated low dose docetaxel (D), cispatin (C) - leucovorin and fluorouracil (De Gramont regimen). Patient and methods: Chemotherapy-naïve patients with metastatic gastric cancer (MGC) received D 60 mg/$m^2$ on day 1 and cisplatin 30 mg/$m^2$ on day 1-2 and the De Gramont regimen (Folinic acid 400 mg/m2 on day 1 and 5-FU 2400 mg/$m^2$/46h continuous infusion) every 3 weeks. The primary endpoint was response rate. Results: One hundred twenty patients with a median age of 52.5 years (range, 32-78) received a median of 6 cycles (range, 2-12 cycles). Of the 120 evaluable patients, 4 showed complete remission and 36 achieved a partial response. The overall response rate was 56.6%. Twenty eight patients (23.3%) showed stable disease and 52 (43.3%) progression. The median time to progression was 7 months (95%CI 6-7.9). The median overall survival was 15 months (95%CI 13.7-16.2). The most frequent hematological toxicity was leucopenia, which occurred at grade 3/4 intensity in 24 patients (20%). Conclusions: Low-dose DC-De Gramont regimen is active in MGC with a tolerable toxicity profile.

Cost and Effectiveness Comparison of Immediate Colposcopy Versus Human Papillomavirus DNA Testing in Management of Atypical Squamous Cells of Undetermined Significance in Turkish Women

  • Kececioglu, Mehmet;Seckin, Berna;Baser, Eralp;Togrul, Cihan;Kececioglu, Tugban Seckin;Cicek, Mahmut Nedim;Gungor, Tayfun
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.511-514
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    • 2013
  • Background: A small but significant proportion of cases with atypical squamous cells of undetermined significance (ASCUS) may harbour CIN 2-3, or even invasive carcinoma. Although immediate colposcopy, HPV-DNA testing or expectant management are three recommended options in ASCUS triage, a consensus does not currently exist on which one of these approaches is the most efficient. In this study, we aimed to compare the performance and cost of immediate colposcopy and colposcopy based on the human papillomavirus (HPV) testing for detecting histologically confirmed high-grade cervical intraepithelial neoplasia (CIN) in women with ASCUS. Materials and Methods: Records of 594 women with an index Papanicolaou smear showing ASCUS were retrospectively analyzed. Women in the immediate colposcopy arm were referred directly to colposcopy (immediate colposcopy group, n=255) and those in the HPV triage arm were proceeded to colposcopy if the high-risk HPV (hrHPV) test was positive (HPV triage group, n=339). High grade CIN (CIN2+) detection rate and treatment costs were compared between the groups. Results: The detected rate of CIN2+ was higher in the HPV triage group compared to immediate colposcopy group (8% vs. 1.6%, p=0.011). In the HPV triage group, the total cost, cost per patient, and the cost for detecting one case of high grade CIN were higher than the immediate colposcopy group (p<0.001). Conclusions: In women with ASCUS cytology, HPV DNA testing followed by colposcopy is more costly than immediate colposcopy, but this approach is associated with a higher rate of CIN2+ detection. This findings suggest that HPV DNA testing combined with cervical cytology could reduce the referral rate to colposcopy.

Assessment of Cervical Cancer Risk in Women between 15 and 49 Years of Age: Case of Izmir

  • Sogukpınar, Neriman;Saydam, Birsen Karaca;Can, Hafize Ozturk;Hadımli, Aytul;Bozkurt, Ozlem Demirel;Yucel, Ummahan;Kocak, Yeliz Cakir;Akmese, Zehra Baykal;Demir, Dogan;Ceber, Esin;Ozenturk, Gulsun
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.2119-2125
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    • 2013
  • Background: The aim of the study was to determine risk factors for cervical cancer for women in Izmir. Methods: This cross-sectional, descriptive field covered a population of 4319 women of reproductive age (15-49) (household registration in the Mukhtar's office-2007). A total of 1,637 women were included in the sample given a four-part questionnaire through face-to-face interview by visiting the women in their homes in order to determine socio-demographic factors, obstetric history, genital hygiene and the use of family planning methods. In addition, during the data collection process, the women were given group training in order to raise awareness of cervical cancer. The number and percentage distributions of the data were calculated. Results: While the average age of the women was $31.9{\pm}9.77$ (Min: 15.00-Max: 49.00), education level of 43.4% of them was elementary school only. It was determined that 70.3% of the women experienced at least one pregnancy, 71.0% had vaginal delivery and 75.9% used a contraceptive method. In the study it was determined that among the cervical cancer related risks vaginal delivery, vaginal lavage and having three or more pregnancies had the highest rates, while having sexual intercourse before 16 years of age and having more than one sexual partner constituted lower rates. The rate of the women who stated not having a smear in the last three years was 82.4%. Conclusions: Considering the case in terms of having Pap smear test, women's awareness on the risk factors and early diagnosis of cervical cancer was found to be low. Due to this reason, awareness of women has to be raised through education.

Prognostic Significance of Circulating Tumor Cells and Serum CA15-3 Levels in Metastatic Breast Cancer, Single Center Experience, Preliminary Results

  • Tarhan, Mustafa Oktay;Gonel, Ataman;Kucukzeybek, Yuksel;Erten, Cigdem;Cuhadar, Serap;Yigit, Seyran Ceri;Atay, Aysenur;Somali, Isil;Dirican, Ahmet;Demir, Lutfiye;Koseoglu, Mehmet
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1725-1729
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    • 2013
  • Background: Breast cancer is the second leading cancer causing death in women. Circulating tumor cells are among the prognostic factors while tumor markers are of diagnostic value and can be used for follow-up. The aim of this study was to investigate the correlation between the prognostic significance of the serum CA15-3 levels, number of circulating tumor cells and histopathological tumor factors. Materials and Methods: Thirty patients recently diagnosed with breast cancer were included in the study. Number of circulating tumor cells and serum CA15-3 level were assessed when metastasis was detected and diagnostic value was assessed. Presence of associations with estrogen and progesterone receptors, c-erbB2, Ki-67 proliferation index and histological grade were also evaluated. Results: Median overall survival of the patients with serum CA15-3 levels of >108 ng/dl was 19 months whereas for those with a low serum level it was 62 months. Median overall survival for CTC ${\geq}5$ vs CTC<5 patients was 19 months and 40 months respectively. The difference between the two groups was statistically significant. Conclusions: Prognostic significance of the CTC count and CA15-3 levels in metastatic breast cancer patients was demonstrated.

Evaluation of shear bond strength between dual cure resin cement and zirconia ceramic after thermocycling treatment

  • Lee, Jung-Jin;Kang, Cheol-Kyun;Oh, Ju-Won;Seo, Jae-Min;Park, Ju-Mi
    • The Journal of Advanced Prosthodontics
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    • v.7 no.1
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    • pp.1-7
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    • 2015
  • PURPOSE. This study was performed to evaluate shear bond strength (SBS) between three dual-cured resin cements and silica coated zirconia, before and after thermocycling treatment. MATERIALS AND METHODS. Sixty specimens were cut in $15{\times}2.75mm$ discs using zirconia. After air blasting of $50{\mu}m$ alumina, samples were prepared by tribochemical silica coating with $Rocatec^{TM}$ plus. The specimens were divided into three groups according to the dual-cure resin cement used: (1) Calibra silane+$Calibra^{(R)}$, (2) Monobond S+$Multilink^{(R)}$ N and (3) ESPN sil+$RelyX^{TM}$ Unicem Clicker. After the resin cement was bonded to the zirconia using a Teflon mold, photopolymerization was carried out. Only 10 specimens in each group were thermocycled 6,000 times. Depending on thermocycling treatment, each group was divided into two subgroups (n=10) and SBS was measured by applying force at the speed of 1 mm/min using a universal testing machine. To find out the differences in SBS according to the types of cements and thermocycling using the SPSS, two-way ANOVA was conducted and post-hoc analysis was performed by Turkey's test. RESULTS. In non-thermal aged groups, SBS of Multilink group (M1) was higher than that of Calibra (C1) and Unicem (U1) group (P<.05). Moreover, even after thermocycling treatment, SBS of Multilink group (M2) was higher than the other groups (C2 and U2). All three cements showed lower SBS after the thermocycling than before the treatments. But Multilink and Unicem had a significant difference (P<.05). CONCLUSION. In this experiment, Multilink showed the highest SBS before and after thermocycling. Also, bond strengths of all three cements decreased after thermocycling.

Flexibility of resin splint systems for traumatized teeth (외상성 치아모형에서의 레진 스플린트 시스템의 유연성 비교연구)

  • Park, Jin-Hong;Shin, Joo-Hee;Ryu, Jae-Jun;Lee, Jeong-Yol;Shin, Sang Wan
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.4
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    • pp.389-393
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    • 2017
  • Purpose: The aim of this study is to evaluate the flexural strength of flexible resins and the flexibility of different resin splint (RS) systems in comparison with resin wire splint (RWS) system. Materials and methods: Three different resin materials (G-aenial flo, GA, GC; Superbond, SB, Sun medical; G-fix, GF, GC) were tested flexural strength test in accordance with ISO-4049:2000. For the flexibility test of splint systems, a artificial model with resin teeth was used to evaluate three types of resin splint systems (GA, SB, and GF) and one resin wire splint system. The left central incisor was simulated 'injured teeth' with third degree mobility. Three consecutively repeated measurements of periotest value were taken in horizontal direction, before and after splinting to access tooth mobility. The splinting effect was calculated through the periotest value. Differences were evaluated through One-way Anova and Tukey HDS post-hoc tests for pair-wise comparison (${\alpha}=.05$). Results: Although GA group showed significant higher flexural strength than SB and GF groups, all of three different resin splint systems produced a significantly higher and rigid splinting effect compared with 016" resin-wire splint system (P < .05). Conclusion: Within the limits of an in vitro study, it can be stated that resin splint systems are too rigid and may not be acceptable to treat tooth avulsion.

Spatial panel analysis for PM2.5 concentrations in Korea (공간패널모형을 이용한 국내 초미세먼지 농도에 대한 분석)

  • Lee, Jong Hyun;Kim, Young Min;Kim, Yongku
    • Journal of the Korean Data and Information Science Society
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    • v.28 no.3
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    • pp.473-481
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    • 2017
  • It is well known that the air quality of 92% of the world is known to exceed the standard of WTO and the death caused by air pollution is almost 6 million per year. The $PM_{2.5}$ concentration in Korea is the second most serious among the OECD countries following Turkey. Since the $PM_{2.5}$ has a direct effect on the respiratory system, it has been actively studied in domestic and foreign countries. But current research on the $PM_{2.5}$ is limited in weather factor or air pollutants. In this paper, we consider the influence of spatial neighbor with weather factor or air pollutants using spatial panel model. We applied the proposed method to 25 borough of Seoul in Korea. The result shows a significant effect of spatial neighbor on the $PM_{2.5}$ concentration fields.

Evaluation on the Quality of Research Field with Traditional Herbal Prescriptions for Dementia Therapy (치매 치료용 한약 처방의 연구성과에 대한 정성평가)

  • Heo, Eun-Jung;Kang, Jong-Seok;Kang, Hyung-Won;Jeon, Won-Kyung
    • Journal of Oriental Neuropsychiatry
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    • v.23 no.1
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    • pp.93-114
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    • 2012
  • Objective : This study aimed to review the performance of traditional herbal prescriptions for treating dementia and present a strategy for research on dementia therapy utilizing herbal medicine. Methods : A definition was made to clarify the technology regarding the development of herbal prescriptions for treating dementia. The queries were compounded based on the initial keywords provided by experts in the field, then applied to the Web of Science database search engines from January 1986 to September 2011 to search related scientific articles. Before performing the analysis, papers were extracted from the initial search reviewed by experts and 80 articles were selected. Then, the selected papers were analyzed in terms of publish year, country, and type of herbal prescriptions. Furthermore, the research performance evaluation for treating dementia by herbal prescriptions was also created in terms of country and organization based on forward citation analysis. In addition to, for the evaluation regarding research quality, we classified and reviewed papers into two types: clinical studies and experimental studies. Results : According to the quantitative information analysis of 80 articles, the number of papers has increased by 21.9% per the yearly mean from 1995, and Japan had the largest portion within this research field. There were 34 kinds of traditional herbal prescriptions, among them Ukgansan had the highest number of studies followed by Jodeungsan, Dangkisoosan and so on. In addition, quality index as calculated by cites per paper is higher than average in Switzerland, Turkey and Japan. In the view of the evaluation on quality there were 12 clinical studies, 8 RCT reported that herbal prescriptions had efficacy at cognition, behavioral & psychological symptoms (BPSD) and activity of daily life (ADL) in various type of dementia. In experimental studies most of the studies were performed using animal models. The studies using Ukgansan were aimed at improving BPSD. The papers studied with Jodeungsan and Dangkisoosan targeted vascular dementia. Conclusions : In this study, research to develop traditional herbal prescriptions for treating dementia has the potential to improve symptoms since herbal medicines work as both multi-function and multi-target in dementia with multiple pathological or neurotoxic pathways. Therefore, the results of the research should be used in order to establish strategies to develop technology for treating dementia with traditional herbal prescriptions in the future.

Aspects of Popcorn Disease Occurrence on Mulberry Fruits in Korea (국내 오디균핵병의 발생 양상)

  • Hong, Sung-Kee;Kim, Wan-Gyu;Sung, Gyoo-Byung;Nam, Sung-Hee;Kim, Jong-Sun
    • Research in Plant Disease
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    • v.13 no.3
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    • pp.131-136
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    • 2007
  • Occurrence of popcorn disease on mulberry fruits was surveyed in several locations in Korea from 2005 to 2007. The diseased fruits turned grayish white and changed to hard and black sclerotia during overwintering after falling onto the ground. Apothecia produced from overwintered sclerotia in the fields of mulberry trees were observed in early May. Two types of apothecia were produced from the sclerotia, which were cup-shaped or club-shaped. The fungus with cup-shaped apothecia was identified as Ciboria shiraiana, and that with club-shaped apothecia as Scleromitrula shiraiana. C. shiraiana occurred at the ratio of about 6 vs. 4 in the fields. Occurrence of the disease differed remarkably depending on years, locations, and varieties of mulberry trees investigated. Field survey of the disease incidence showed that Baekhahyeongsang, Dahojosaeng, Hasusang, a native variety and Sawonppong 22 were resistant to the disease, Cheongilppong, Daeseongppong, Guksang 20 and Turkey-D were moderately susceptible, and Cateneo, Moreji and Sanggwa were highly susceptible. Disease incidence in the fields mulched with nonwoven fabrics or plastic films was much lower than that in the non-mulched fields. Disease incidence in the fields mulched with rice straws was similar to that in the non-mulched fields.