CYTOMEGALOVIRUS INFECTION AFTER HEMATOPOIETIC STEM CELL TRANSPLANTATION: THE CHANGE IN CLINICAL PICTURE, DIAGNOSIS, AND TREATMENT MODALITY

Cytomegalovirus (CMV) infection takes an important place as a major cause of morbidity and mortality after hematopoietic stem cell transplantation. There have been significant advances in understanding the pathogenesis of CMV, early detection of virus by modern laboratory technics, and conformable antiviral treatment. In this work, determination of high risk stem cell recipients for CMV infection and prophylactic (from the onset of engraftment until 100 days after transplantation) or preemptive (prevention of CMV disease after detection of CMV infection) treatment are reviewed in the context of important literature on this subject

Multiple Primary Malignancies - A Retrospective Analysis at a Single Center in Turkey

Background: A literature review on 1,104,269 cancer patients concluded that the prevalence of multiple primary malignancies (MPM) is between 0.73% and 11.7%. MPMs seem to have higher incidence than that influenced by hazard only. The purpose of this study was to investigate clinically useful information for effective screening for synchronous and metachronous second primary cancers and to identify a potential surveillance protocol. Materials and Methods: Using statistical and epidemiological indicators we evaluated the patients with MPMs (double locations) admitted to Dr. Abdurrahman Yurtarslan Ankara Oncology Education and Research Hospital between 1981 and 2010. Results: Out of the 130 cases, 24 (18.4%) were synchronous while 106 cases (81.6%) were metachronous tumours. Mean interval time from first to second primary cancers was 4.65 years (0-27 years). The most frequent malignant associations were breast-breast, breast-endometrium and breast-ovary. Both primary and secondary tumors tended to be in an advanced stage explained by the low compliance of the patients to follow-up. Conclusions: The possibility that MPMs exist must always be considered during pretreatment evaluation. Screening procedures are especially useful for the early detection of associated tumors, whereas careful monitoring of patients treated for primary cancer and a good communication between patients and medical care teams should ensure early detection of secondary tumors, and subsequent appropriate management

The Comparative Advantages in Vegetable Export of Turkey

Karşılaştırmalı üstünlüklerin ölçümü amacıyla Liesner (1958) tarafından ortaya atılan, Balassa (1965) tarafından işlevsel hale getirilen "Açıklanmış Karşılaştırmalı Üstünlük (RCA) katsayıları", ülkenin belli bir sektör ihracatının toplam ihracatına oranının, aynı sektörün dünyadaki ihracatının dünya toplam ihracatına oranı şeklinde hesaplanmaktadır. Balassa Endeksi şeklinde de ifade edilebilen RCA katsayıları; ülkenin bir sektördeki yurtiçi uzmanlaşmasını, dünyanın uzmanlaşmasıyla karşılaştırır. Katsayının 1'den büyük olması; söz konusu sektörde ülkenin açıklanmış karşılaştırmalı üstünlüğe sahip olduğunu ve uzmanlaştığını, 1'den küçük olması ise, açıklanmış karşılaştırmalı dezavantaja sahip olduğunu ve uzmanlaşmadığını gösterir. Çalışmada, 1993-2012 yılları arasında Türkiye'nin dünya piyasalarında sebze ihracatındaki karşılaştırmalı üstünlüklerinin belirlenmesi amacıyla SITC Rev. 3, 4. seviye için karşılaştırmalı üstünlük katsayıları hesaplanmıştır. Buna göre Türkiye, sebze ve alt grupları ihracatında global piyasalarda önemli bir karşılaştırmalı üstünlüğe sahiptir. Bununla birlikte, sebze alt gruplarının büyük çoğunluğunun ihracatında karşılaştırmalı üstünlük olmasına rağmen, son yıllardaki üstünlükler nispi anlamda azalmaktadırThe index of revealed comparative advantages (RCA) was first introduced by Liesner (1958) and operationalized by Balassa (1965) in order to measure comparative advantages. The RCA index of a country for a product is often measured by the product’s share in the country’s exports in relation to its share in world trade. The index of RCA, also called Balassa Index, is used to measure relative importance of a product in a country’s export composition relative to that product’s relative importance in world trade. If the index exceeds 1 the country is said to have a comparative advantage in the sector in question, since it is more important for the country’s exports than for the exports of the reference countries and vice versa. In this study, between the years 1993-2012, the indices of revealed comparative advantages indices of Turkey are calculated on SITC Revision 3, 4 digit codes in order to determine comparative advantages in vegetable export in World markets. Accordingly, Turkey has a significant comparative advantage in the export of vegetable and its sub-groups in global markets. However, although comparative advantage in the export of the majority of vegetable sub-groups, the advantages have relatively been decreasing in recent year

Primary squamous cell carcinoma of the breast: A case report in a review of current literature

Primary squamous cell carcinoma of the breast is a rare malignancy considered a subtype of metaplastic breast carcinomas. Here we presented a case of 56-year-old female patient with a history of modified radical mastectomy, chemotherapy and radiotherapy for invasive ductal carcinoma of the right breast in 2005. After eleven years primary squamous cell carcinoma of the breast has been detected in the left breast. Any other localization were screened for squamous cell carcinoma but there was no localization beyond the breast. The case was discussed and complied in a review of current literature

Mature Cystic Teratoma of the Fallopian Tube in a Postmenopausal Woman: A Case Report and Review of the Literature

Background. Mature cystic teratomas of the fallopian tube are extremely rare and only 54 cases have been reported in the literature. In this paper, we report a mature cystic teratoma of the fallopian tube in a postmenopausal woman and we report the review of literature of tubal cystic teratomas. Case. A 62-year-old, gravida 4 postmenopausal woman presented with pain in the right lower abdominal region for a long time. An 88 × 72 × 95 mm heterogeneous mass which contained calcifications and lipoid components was detected in the right adnexal region by transvaginal ultrasonogram (TV-USG). Serum tumour markers, namely, CA125, CA15-3, and CA19-9, were within normal range. A laparotomy revealed a 9 × 10 cm cystic mass within the fimbrial region in the right fallopian tube, and right salpingoopherectomy was performed consequently. Microscopic examination revealed squamous epithelium with sebaceous glands and hair follicles, and pseudostratified ciliated respiratory epithelium with cartilage and mucous glands. Because the frozen section resulted in a benign dermoid cyst, no further operative procedure was performed. The postoperative follow-up was uneventful and the patient was discharged on the second postoperative day. Conclusion. In cases of undetermined pelvic or abdominal masses, a teratoma of the fallopian tube should be considered

Prognostic factors and clinical outcome of patients with Ewing's sarcoma family of tumors in adults: multicentric study of the Anatolian Society of Medical Oncology

The aim of this study was to evaluate prognostic factors, survival rate and the efficacy of the treatment modalities used in patients with Ewing sarcoma family of tumors (ESFT). Data of patients with ESFTs followed up at different cancer centers in Turkey between 2001 and 2010 were retrospectively analyzed. The median age of 114 patients was 26 years (range 14-66). The median follow-up was 20 months (range 1-118 months). Tumor size was between 1.5 and 14 cm (median 8 cm). Eighty-six percent of patients had localized disease at presentation, and 14 % had metastatic disease. Local therapy was surgery alone in 31 % of patients, surgery combined with radiotherapy in 41 % and radiotherapy alone in 18 %. Approximately 70 % of patients were treated with vincristine, doxorubicin, cyclophosphamide and actinomycin-D, alternating with ifosfamide and etoposide every 3 weeks. In patients with localized disease at presentation, the 5-year disease-free survival and overall survival were 60 and 65 %, respectively. At univariate analysis, patients with tumor size >= 8 cm, high serum lactate dehydrogenase, metastasis at presentation, poor histological response to chemotherapy and positive surgical margin had significantly worse event-free survival. The significant predictors of worse overall survival at univariate analysis were tumor size <= 8 cm, high lactate dehydrogenase, metastasis at presentation, poor histological response to chemotherapy, radiotherapy only as local treatment and positive surgical margin. ESFTs are aggressive tumors with a high incidence of local recurrence and distant metastasis. Multimodality treatment consisting of adequate surgical resection, aggressive chemotherapy (VAC alternating with IE) and radiotherapy is recommended for patients with ESFTs

Spectrum of Vulvar Lesions in an Obstetrics and Gynecology Outpatient Clinic

Wide range lesions may occur in the vulvar region. The aim of the present study is to have an insight into the diverse morphologic spectrum of vulvar lesions. Total of 263 patients with primary vulvar complaints seen in Ankara Numune Training and Research Hospital Gynecology and Obstetrics Outpatient Clinic were recruited into study. The present retrospective study was carried out by compiling the data from archival records from January 2010 to May 2014. The vulvar biopsies specimens were studied for histomorphological features. The lesions were categorized as non-neoplastic, neoplastic and inconclusive; neoplastic ones were further divided into benign, malignant and premalignant.The age of the women ranged from 11 to 85 years (mean 46.27±14.32) with the maximum number of patients between 41 to 50 years of age. Most common clinical presentation was itching (126 cases; 47.9%). The commonest site of vulvar lesions was labia majora (145 cases, 55.1%). Non neoplastic lesions were more common (n = 172; 65.4%) than the neoplastic lesions (n =91; 34.6%). There were 81 (30.8%) benign lesions while 10 cases (3,8%) were malignant or premalignant ones. Amongst the non-neoplastic lesions, the most common histopathologic diagnosis was of lichen sclerosus et atrophicus (46 cases; 17,5%). Early recognition of vulvar lesions and a prompt biopsy diagnosis for all lesions with suspicious changes is of great significance. [Med-Science 2015; 4(1.000): 1876-84