Prognostic factors for lymph node negative stage I and IIA non-small cell lung cancer: Multicenter experiences

Surgery is the only curative treatment for operable non-small lung cancer (NSCLC) and the importance of adjuvant chemotherapy for stage IB patients is unclear. Herein, we evaluated prognostic factors for survival and factors related with adjuvant treatment decisions for stage I and IIA NSCLC patients without lymph node metastasis. Materials and Methods: We retrospectively analyzed 302 patients who had undergone curative surgery for prognostic factors regarding survival and clinicopathological factors related to adjuvant chemotherapy. Results: Nearly 90% of the patients underwent lobectomy or pneumonectomy with mediastinal lymph node resection. For the others, wedge resection were performed. The patients were diagnosed as stage IA in 35%, IB in 49% and IIA in 17%. Histopathological type (p=0.02), tumor diameter (p=0.01) and stage (p<0.001) were found to be related to adjuvant chemotherapy decisions, while operation type, lypmhovascular invasion (LVI), grade and the presence of recurrence were important factors in predicting overall survival (OS), and operation type, tumor size greater than 4 cm, T stage, LVI, and visceral pleural invasion were related with disease free survival (DFS). Multivariate analysis showed operation type (p<0.001, hazard ratio (HR):1.91) and the presence of recurrence (p<0.001, HR:0.007) were independent prognostic factors for OS, as well visceral pleural invasion (p=0.01, HR:0.57) and LVI (p=0.004, HR:0.57) for DFS. Conclusions: Although adjuvant chemotherapy is standard for early stage lymph node positive NSCLC, it has less clear importance in stage I and IIA patients without lymph node metastasis

Demir eksikliği anemisinde HbA1c değerleri

Bu çalışma, Kasım 1993 - Aralık 1994 tarihleri arasında Selçuk Üniversitesi Tıp Fakültesi İç Hastalıkları Anabilim Dalı polikliniğine baş vuran ve klinikte yatarak takip edilen, 80 demir eksikliği anemili hasta ile 17 sağlıklı kişi üzerinde yapıldı. Çalışmanın amacı; demir eksikliği anemisinde HbAic durumuyla ve demir tedavisiyle olan değişimleri görmek, laboratuar parametreleri ve HbAic' de önemli bir değişiklik olup olmadığını tesbit etmekti. Bu amaçla demir eksikliği anemili hastalardan oluşan hasta grubuyla sağlıklı kişilerden oluşan kontrol grubu oluşturuldu. Demir eksikliği anemisi tanısı konmuş 73 hastaya 6 hafta süreyle 200 mg elementer demire eşdeğerde demir sülfat preparatı ağızdan verilirken, 7 hastaya parenteral olarak verildi. Hasta grubunda tedavinin başlangıcı ve tedavi sonrasında olmak üzere iki kez total kan sayımı, serum demir değerleri ve HbAic çalışmaları yapıldı. Kontrol grubunda ise bu değerler bir kez çalışıldı. Tedavi ile birlikte MCHC hariç, eritrosit indekslerinde ve serum demir değerlerinde istatistiki olarak anlamlı değişme bulundu(p0.05). Sonuç: Demir eksikliği anemisinde HbAıc seviyelerinde az miktarda yükselme olmakta ve tedaviyle birlikte belirgin düşme ortaya çıkmaktadır. HbAıc' deki bu değişiklik, hastaların teşhisinde, tedaviye cevap durumunu değerlendirmede ve takibinde diğer parametrelerle birlikte kullanılabilir. Diyabetle birlikte demir eksikliği bulunduğunda HbAıc seviyeleri diyabetin takibi açısından yanıltıcı sonuçlara sebep olabilir.This study was performed on 80 patients with iron deficiency anemia who applied to the department of internal medicine at the Selçuk University Medical School. The control group were 17 healty persons. The aim of this study was to invastigate if treatment with iron would cause any changes in some laboratory parameters and HbAic. The patient group was given ferrous sulphate equivalent to 200 mg elementary iron for 6 weeks. Only 7 patient were given the same amount of iron parenteraly. Complete blood count, serum iron values and HbAic were assayed at the onset and at the end of study for patient group. For the control group these assays were done only once. With treatment, except for MCHC, erythrocyte indexes and serum iron values were changed significantly(p0.05). Results: HbAic levels increase slightly in iron deficiency anemia and these levels tend to decrease after treatment of iron deficiency. This change in HbAic levels may be used in diagnosis and follow up of other paramethers. When diabetes mellitus and iron deficiency anemia is seen together, HbAic levels may cause mistakes in the follow up of diabetes mellitus

The Turkish foreign policy 1950-1960

II. Dünya Savaşı'nı Demokrasi Cephesi'nin kazanması dünya siyasi tarihi açısından olduğu kadar Türk siyasi tarihi açısından da bir dönüm noktası olmuş, Türkiye'de çok partili siyasi sisteme geçişi hızlandırmıştır. Bu sayede Türk siyasi hayatında önemli bir yeri olan Demokrat Parti kurulmuş ve 27 yıllık tek parti rejiminden sonra 14 Mayıs 1950'de iktidara gelmiştir.Demokrat Parti'nin iktidara gelmesi bazı kesimlerce ? Demokrasi'nin Zaferi ? olarak nitelendirilirken bazı kesimler tarafından ?Karşı Devrim? olarak nitelendirilmiştir. Bu yorumlar Demokrat Parti'nin iç politikadaki tutumlarına göre yapılmıştır.Bu çalışmanın konusu olan Demokrat Parti'nin dış politikası ise bu dönemde izlenen iç siyaset kadar farklı değerlendirmelere konu olmuştur. Sonuçları günümüze kadar uzanan dış politik olayların temeli bu dönemde atılmıştır. Türkiye ilk defa bu dönemde toprakları dışında bir ülkeye -Kore'ye- asker göndermiş, NATO'ya bu dönemde alınmıştır. Kıbrıs Sorunu bu yıllarda ortaya çıkmış, ABD'yle çok boyutlu işbirliğine bu dönemde girilmiştir.Çalışmada, on yıllık Demokrat Parti iktidarı dönemindeki dış politik olaylar ve DP'nin dış politikada karar alma süreçlerini etkileyen faktörler, döneme ilişkin kaynaklar incelenerek detaylarıyla ortaya konulmuştur. Çalışma; giriş, dört ana bölüm, sonuç ve kaynakça kısımlarından oluşmaktadır.The victory of the Democracy Front in Second World War is a milestone not only the world?s political history and Turkey?s political history, which is accelerate Turkey?s the transition to political system with many party. With this Democrat Party who had an important ground in Turk political existence was built up and was to come into power in 14 May 1950 after 27?years one party management.When Demokrat Party accession to power, some region qualify this ?The Victory of the Democracy? but some region qualify this ?counterrevolution?. This comments were made with the consistent of Demokrat Parti?s attitudes of domestic policy.The matter of this study is Demokrat Party?s Foreign policy is already a matter subject commentate different assessment like domestic policy. The Foreign political events who?s results recumbents to our day were laid the foundation in this term. Turkey sent his army to country with is out of his territory -Korea- for the first time in this term. The problem of the Kıbrıs was appear?s in this years and entered to a multidimensional collaboration with USA in this period.In this study Demokrat Party?s on years power of Foreign political events and the factor?s witch affects decision process in Foreign policy, the resources of this terms researched at great length. This study is comprise of introduction, four principal part, result and bibliograph

RHEUMATOID ARTHRITIS AND PULMONARY CARCINOID TUMOR

A 40-year old woman was admitted with a history of elbow, wrist, knee pain and prolonged morning stiffness. Rheumatoid arthritis (RA) diagnosed before five years, had been treated with non-steroidal anti-inflammatory agents and low dose corticosteroid. On hospital admission, routine chest x-ray showed a 4x4 cm solitary mass in the right pulmonary. A diagnostic thoracotomy was performed. The histological examination showed a typical carcinoid tumor. This is the third carcinoid tumor case reported to be associated with RA

Association of Pb, Cd, and Se Concentrations and Oxidative Damage-Related Markers in Different Grades of Prostate Carcinoma

Prostate cancer is known to be affected by the heavy metal levels and oxidative damage of the body, yet there are very few studies which look into the way it occurs. The aim of this study was to determine whether blood and tissue lead (Pb), cadmium (Cd), and selenium (Se) levels are associated with oxidative damage in the context of prostate cancer progression and development. Seventy-nine patients comprising 25 patients with benign prostatic hypertrophy (BPH), 23 patients with malignant prostatic carcinoma (malign Ca), 16 patients with low-grade prostatic intraepithelial neoplasia (LGPIN), and 15 patients with high-grade prostatic intraepithelial neoplasia (HGPIN) diagnosed on the basis of their clinical profile, transrectal ultrasonography, and histopathology were included in this study. Cd and Pb levels in whole blood were found to be increased in patients with HGPIN compared with the BPH group; also, the levels of Cd in whole blood and tissue were found to be increasing in patients with malign Ca, unlike BPH patients. Moreover, the levels of malondialdehyde (MDA) in plasma and tissue were significantly increased in malign Ca, LGPIN, and HGPIN than those in BPH. However, the levels of tissue Pb were found to be decreasing in BPH, unlike the malign Ca and HGPIN patients, and the levels of tissue protein carbonyls in malign Ca were significantly lower than those in HGPIN. The levels of tissue reduced glutathione (GSH) in malign Ca were significantly lower than those in BPH. Additionally, the levels of Se in serum and tissue in LGPIN were significantly lower than those in BPH. The serum Se levels in HGPIN were also significantly lower than those in BPH and malign Ca groups. Furthermore, the concentrations of serum Se in LGPIN were significantly lower than those in malign Ca. From the Pearson correlation analysis, there were significant positive correlations between tissue Cd and MDA levels in malign Ca, LGPIN, and HGPIN and between the tissue Pb and tissue MDA and protein carbonyl levels in malign Ca. Blood Pb and tissue Pb were also significantly positively correlated with plasma MDA and protein carbonyl levels in malign Ca. In addition, blood Pb was significantly positively correlated with tissue MDA and protein carbonyl levels in malign Ca, and a significant positive correlation was also found between blood Cd and plasma protein carbonyls and tissue MDA in LGPIN. We observed that altered prooxidant-antioxidant balance and heavy metal levels may lead to an increase in oxidative damage and may consequently play an important role in prostate carcinogenesis. These findings indicate that changes in the levels of Pb, Cd, Se, MDA, protein carbonyls, and GSH in the blood and/or tissue are related to the prostatic carcinoma development and progression, although triggering one of the mentioned changes is unknown; therefore, further study is required to determine the exact steps of the process and clarify the roles of different substances in order to obtain a more detailed explanation of the phenomenon.Istanbul UniversityIstanbul University [BYP-2621/30062008]This work was supported by The Research Fund of Istanbul University (Project BYP-2621/30062008)