Kimura Disease’s: A Case Report

Kimura is a chronic inflamatuary disease at oral mucosa which presents as large subcutaneous nodules or masses on the head or neck of adulthood males. The lesions characteristics are eosinophilia in lymphocytic infiltration, fibrosis and diffuse vascularity. Eosinophilia and elevated blood IgE can be peresent. A 62 years old female with inguinal mass and itching was presented

Increased serum procalcitonin levels in pregnant patients with asymptomatic bacteriuria

Background: Among the pregnancy urinary tract infections, asymptomatic bacteriuria (ASB) is the most common one. Untreated ASB can progress to pyelonephritis in 30-50% of the patients and can also result in prematurity in 27% of the pregnancy so it needs immediate diagnosis and treatment. In this study, we wanted to evaluate procalcitonin levels, compared to other inflammatory in pregnant women with ASB.Methods: The study was designed between the period of January 2012 and February 2013 at Sakarya University School of Medicine, Department of Gynecology and Obstetrics. The study population included 30 pregnant patients with asymptomatic bacteriuria and 39 healthy pregnant controls.Results: Mean age was 28 (SD, 5.5) of the study population; mean maternal weight was 70 (SD, 8) kilogram. There were no statically significant differences between the groups according to the routine biochemical parameters, but gestational age was significantly lower in the ASB group compared to the controls (20.4 vs 28.6, respectively; p 0.05 ng/ml and 21(70%) patients had negative procalcitonin levels (Chi-squrae, p < 0.001). The sensitivity and specificity of procalcitonin assay for ASB was calculated as 30% and 100%, respectively. The positive predictive value was 100% and the negative predictive value was 65%. The most frequent microorganisms in the urine culture were Escherichia coli (26 patients, 87%), Proteus mirabilis (3 patients, 10%) and Klebsiella (1 patient, 3%) in the ASB group. We experienced four (44%) recurrences among nine positive procalcitonin in ASB patients after completion of treatment of the first ASB diagnosis.Discussion: Procalcitonin levels were significantly higher in ASB group than the control group and serum procalcitonin levels were higher in pregnant women with recurrent ASB. This finding is an important result revealed that high procalcitonin level can predict the further urinary tract infection risk. Finally, serum procalcitonin levels were normal in healthy pregnant women while other inflammatory markers such as WBC, ESR and CRP levels were higher. © 2013 Bilir et al.; licensee BioMed Central Ltd

Clinical Study Effect of Gender on Coagulation Functions: A Study in Metastatic Colorectal Cancer Patients Treated with Bevacizumab, Irinotecan, 5-Fluorouracil, and Leucovorin

Introduction. We designed this study to evaluate how coagulation parameters are changed in metastatic colorectal cancer (mCRC) patients treated with bevacizumab, irinotecan, 5-fluorouracil, and leucovorin (FOLFIRI). Methods. A total of 48 mCRC patients who initially received bevacizumab with FOLFIRI were eligible for this study. Thirty-four patients were analyzed at baseline and on the 4th, 8th, and 12th cycles of chemotherapy. Results. There were 19 male and 15 female patients. Baseline characteristics of the groups were similar, but women had better overall survival than men (14 months versus 12 months, = 0.044). D-dimer levels decreased significantly after the 12th cycle compared with baseline in men but not in women. Men and women had increased levels of serum fibrinogen at the early cycles, but these increased fibrinogen levels continued after the 4th cycle of chemotherapy only in women. In addition, serum fibrinogen levels did not significantly change, but aPTT levels decreased in men. Discussion. The major finding of this study is that bevacizumab-FOLFIRI chemotherapy does not promote changes in the coagulation system. If chemotherapy treatment and the possible side effects of FOLFIRI-bevacizumab treatment are well managed, then alterations of the coagulation cascade will not have an impact on overall survival and mortality

Effect of Gender on Coagulation Functions: A Study in Metastatic Colorectal Cancer Patients Treated with Bevacizumab, Irinotecan, 5-Fluorouracil, and Leucovorin

Introduction. We designed this study to evaluate how coagulation parameters are changed in metastatic colorectal cancer (mCRC) patients treated with bevacizumab, irinotecan, 5-fluorouracil, and leucovorin (FOLFIRI). Methods. A total of 48 mCRC patients who initially received bevacizumab with FOLFIRI were eligible for this study. Thirty-four patients were analyzed at baseline and on the 4th, 8th, and 12th cycles of chemotherapy. Results. There were 19 male and 15 female patients. Baseline characteristics of the groups were similar, but women had better overall survival than men (14 months versus 12 months, P=0.044). D-dimer levels decreased significantly after the 12th cycle compared with baseline in men but not in women. Men and women had increased levels of serum fibrinogen at the early cycles, but these increased fibrinogen levels continued after the 4th cycle of chemotherapy only in women. In addition, serum fibrinogen levels did not significantly change, but aPTT levels decreased in men. Discussion. The major finding of this study is that bevacizumab-FOLFIRI chemotherapy does not promote changes in the coagulation system. If chemotherapy treatment and the possible side effects of FOLFIRI-bevacizumab treatment are well managed, then alterations of the coagulation cascade will not have an impact on overall survival and mortality

Inhibition of TLR4/TRIF/IRF3 Signaling Pathway by Curcumin in Breast Cancer Cells

Purpose: Toll-like receptor 4 (TLR4) is over-expressed in breast tumors and thus contributing to the tumor progression and metastasis. Natural products have drawn attention in cancer immunotherapy due to their various biological activities. Curcumin is well investigated in different types of cancer. However, the mechanisms underlying its anti-inflammatory actions have not been extensively elucidated. For this purpose, we explored the inhibitory effects of curcumin on lipopolysaccharide (LPS)-induced TLR4 dependent TRIF signaling pathway in two subtypes of breast cancer cell lines (MCF-7 and MDA-MB-231) in this study. Methods: In this context, the cytotoxicity of curcumin and LPS alone and the combination of curcumin with LPS on these cells was evaluated by WST-1 assay. The expression level of TLR4 and the release of type I interferon (IFN) levels were determined after treatment with curcumin and/or LPS by RT-PCR and ELISA analysis, respectively. Furthermore, the subcellular localization of TLR4 and interferon regulatory factor 3 (IRF3) were detected by immunofluorescence analysis. Results: Curcumin treatment suppressed breast cancer cells viabilities and the activation of TLR4-mediated TRIF signaling pathway by the downregulation of TLR4 and IRF3 expression levels and the inhibition of type I IFN (IFN-alpha/beta) levels induced by LPS. However, curcumin was more efficient in MDA-MB-231 cells than MCF-7 cells owing to its greater inhibitory efficacy in the LPS-enhanced TLR4 signaling pathway. Furthermore, IFN-alpha/beta levels induced by TLR4 and IRF3 were decreased in these cells following curcumin treatment. Conclusions: Consequently, these results demonstrated that the activation of LPS stimulated TLR4/TRIF/IRF3 signaling pathway was mediated by curcumin in breast cancer cells, in vitro. However, more studies are necessary to examine the curcumin's anti-inflammatory activities on TLR4/MyD88/NF-kappa B as well as other signaling pathways downstream of TLRs in breast cancer

IL-6 mediated JAK/STAT3 signaling pathway in cancer patients with cachexia

CONCLUSION: STAT3 may be considered as a therapeutic target for cachectic patients with gastric, lung and breast cancer. Furthermore, IL-6 mediates STAT3 activation in cachectic gastric and breast cancer patients (Tab. 5, Fig. 2, Ref. 62)

An individual patient-data meta-analysis of metronomic oral vinorelbine in metastatic non-small cell lung cancer

MOV is an active and well-tolerated chemotherapy in metastatic NSCLC and is a manageable therapy in frail patients

Relationship between the thyroid dysfunction and seasonal variation

YÖK Tez No: 247189Amaç: Klinik gözlemleriz doğrultusunda tiroid fonksiyon bozuklukları ile mevsimler arasındaki ilişkiyi araştırdık.Yöntem: Düzce Üniversitesi Tıp Fakültesi İç Hastalıkları kliniğinde, 2006 Şubat -2007 Ocak döneminde polikliniğimize ilk defa başvuran ve daha önce hastalıkları bilinmeyen 2133 hasta dosyası retrospektif olarak incelendi. Tüm hastalar başvuru zamanlarına göre ayrılarak tiroid disfonksiyonu olanların tanı zamanları tespit edildi.Bulgular: Tüm tiroid difonksiyonları değerlendirildiğinde eylül-şubat arası 6 aylık soğuk mevsim periyodunda tüm tiroid fonksiyon bozuklukları yaklaşık %50 (151/96, P =0.04) daha fazladır. Hipotiroid hastalarda sıcak mevsim (Mart-Ağustos) döneminde 34, soğuk mevsim (Eylül-Şubat) döneminde 65 hasta (P =0.022), hipertiroid hastalarda ise (Mart-Ağustos) döneminde 62, soğuk mevsim (Eylül-Şubat) döneminde 86 hasta olup (P >0.1) istatiksel olarak anlam yoktu.Sonuç: Endemik guatr ve uzun yıllar iyot replasmanı yapılan yerlerde diyetsel faktörler her türlü tiroid hastalığını tetikleyebilir ve değişik prevalans ve insidansların oluşmasına sebep olabilir.Aim: We investigated the relationship between thyroid dysfunction and seasonal variation in our clinical practice.Methods: The charts of the 2133 patients who presented for the first time to our Internal Medicine Clinic at Düzce University School of medicine between Feb 2006 to Jan 2007 has been evaluated retrospectively. Among these, patient charts with newly diagnosed thyroid dysfunction were classified according to the month of diagnosis.Results: In general, all thyroid dysfunctions were about 50% more common during the cold seasons between Sep to Feb compared to warm seasons between March to Aug. (151 vs 96, respectively, p =0.047). Hypothyoidism was more commonly diagnosed during the cold seasons compared to warm seasons (65 vs 34, respectively, p=0.022). On the other hand, there was not significant difference in new diagnosis of hyperthyrodisim between warm and cold seasons (62 vs 86, respectively, P = 0.29).Conclusion: Dietary and immunologic factors display signicant differences among cold and warm seasons. This might have an impact on thyroid disorders in endemic goiter regions with mild iodine deficiency and dietary iodine replacement program

Metastatik Böbrek Hücreli Karsinomda Ardışık İnterferon, Sunitinib, Sorafenib ve Everolimus tedavilerine Uzun Dönemli Cevap; Vaka Sunumu

Son yıllarda vasküler büyüme faktörleri, reseptörleri ve memeli rapamisin yolağına karşı geliştirilen hedefe yönelik moleküller metastatik böbrek hücreli karsinoma tedavisinde önemli bir yer tutmaktadır. Biz de; interferon alfa 2b, sunitinib, sorefenib ve everolimus ile uzun süreli sağkalım sağlanmış bir metastatik böbrek tümör vakası sunduk. 48 yaş erkek hastaya Nisan 2007’de metastatik böbrek tümörü tanısı konuldu ve yaklaşık 50 ay boyunca tedavi edildi. Hastada tirozin kinaz inhibitörleri (TKI) ile 44 ay genel sağkalım sağlandı (sırasıyla 5 ay sunitinib, 24 ay sorafenib ve 15 ay everolimus). Metastatik böbrek tümörü sıklıkla kür edilemeyen, dekadlar boyunca kötü prognozlu olup az sayıda tedavi seçeneği mevcuttur. Randomize kontrollü çalışmalarda ise daha önceden hem tedavi almış hemde tedavi almamış metastatik böbrek kanserlerinde hedefe yönelik ajanların etkinliği gösterilmişti. Metastatik böbrek tümörünün TKI ve mTOR inhibitörleri ile tedavisi ardı sıra kullanılmadığı taktirde 12 aydan az sağkalım sağlarken bizim vakamızda sırası ile kullanımda 44 aylık ilave bir sağkalım elde edildi.In recent years, targeted therapies directed against vascular endothelial growth factor (VEGF) and its receptor (VEGFR), and mammalian target of rapamycin (mTOR) pathways have replaced immunotherapy in the treatment of metastatic renal cell carcinoma (mRCC). We reported a case who treated with mRCC and had long term survival with interferon alpha 2b, sunitinib, sorafenib, and everolimus sequentially. On April 2007, a 48 year-old man diagnosed with RCC. To date, the patient has received 50 months of treatment. The patients had 44 months of overall survival with tyrosine kinase inhibitors (TKIs), 5 months with sunitinib, 24 months with sorafenib and 15 months for everolimus respectively. Metastatic RCC is commonly incurable and, for decades, patients with this disease had a poor prognosis due to few treatment choices. Randomized controlled trials have demonstrated the clinical benefits of targeted agents in mRCC, for both previously treated and treatment-na&iuml;ve patients. Metastatic RCC treatment with TKIs and mTOR inhibitors usually provide less than 12 months without sequentially design but in this case we had had 44 months of overall survival

Prognostic Value of Volumetric Parameters of PET-CT With Stage IIIB-IV Non-Small Cell Lung Cancer

Annual Congress of the European-Association-of-Nuclear-Medicine -- OCT 15-19, 2016 -- Barcelona, SPAINWOS: 000391802400538...European Assoc Nucl Me