Evaluation of Treatment Efficacy of Tyrosine Kinase Inhibitors in Rare Single EGFR Exon 21 L861Q Mutation: Single Center Experience

OBJECTIVE: Epidermal growth factor receptor mutations are the second most common oncogenic driver event in non-small cell lung cancer. We aimed to compare the first generation erlotinib treatment with the second generation afatinib treatment in patients with non-small cell lung cancer with epidermal growth factor receptor exon 21 L861Q mutation. MATERIAL AND METHODS: Progression-free survival and overall survival of 30 non-small cell lung cancer patients treated with erlotinib or afatinib due to single epidermal growth factor receptor L861Q positivity were compared retrospectively. The number of patients included in the first, second, and third treatment line was 15 (50.0%), 11 (36.7%), and 4 (13.3%), respectively. RESULTS: There were 23 patients in the erlotinib arm and 7 patients in the afatinib arm. Median progression-free survival was 12.8 months in the erlotinib group and 9.3 months in the afatinib group. Median overall survival in erlotinib and afatinib groups was 77.9 months and 30.3 months, respectively. No statistically significant difference was found in the comparison of these survival times. CONCLUSION: Survival times of erlotinib and afatinib treatment are similar in patients with a single epidermal growth factor receptor L861Q mutation. In patients receiving tyrosine kinase inhibitors treatment, the female gender has a positive effect on progression-free survival, and being a non-smoker has a positive effect on overall survival. In patients with rare mutation exon 21 L861Q positivity, both first-generation and second-generation tyrosine kinase inhibitors should be considered

İmplant Yerleşimli Biyosensör Ve Antibakteriyel Ajan İçerikli Nanokapsül Uygulaması

Tıp alanında, vücuda yerleştirilen diş, çene, kalp, kemik gibi ortopedik implantlara entegre olan biyosensör, biyosensörün piozoelektrik seçici tanıma mekanizması aracılığıyla birkaç adet bakteri varlığını dahi algılaması ve kablosuz sistem üzerinden vücut dışına veri gönderiminin sağlanması ve erken dönemde bakteri varlığının tespiti, tedavi aşamasında implant üzerinde bulunan içeriğinde antibakteriyel ajan bulunan nanokapsüllerin bakteri tarafından salgılanan enzimler aracılığıyla parçalanması ve içindeki antibakteriyel ajanları ortama salarak bakterilerin erken dönemde yokedilmesini sağlayan implant yerleşimli biyosensör ve antibakteriyel ajan içerikli nanokapsül uygulaması ile ilgili olan bu buluş genel olarak; vücuda uygulanan protez uygulamalarında kullanılan implant(1), implant yüzeyine yerleştirilen ferroelektrik ve/veya piozoelektrik sensör devreleri üzerinde bakteri ağırlık tespiti sağlayan biyosensör (2), implant (1) ve biyosensör (2) yüzeyinde içinde antibakteriyel ajan bulunan bakterilerin salgıladığı enzim ile yüzeyi parçalanan nanokapsül (3), biyosensörde (2) bakteri varlığı verisi oluştuğunda verinin kablosuz iletişim yoluyla aktarıldığı hasta takip sisteminden (4) oluşmaktadır

Prostat kanseri hücrelerinde MAP kinaz gen ekspresyonlarını yukarı doğru regüle eden disodyum pentaborat dekahidrat

Ege Üniversitesi, Tıp FakültesiAvrasya Üniversitesi, Fen - Edebiyat FakültesiPamukkale <üniversitesi, Tıp FakültesiCelal Bayar Üniversitesi, Tıp FakültesiObjectives: This study aims to investigate the expressions of MAP2K3, MAP3K7, and MAPK8 genes after disodium pentaborate decahydrate (DPD) treatment in DU-145 cells. Materials and methods: Effect of DPD treatment on expressions of MAP2K3, MAP3K7, and MAPK8 genes were determined by qRT-PCR. Results: We determined that disodium pentaborate decahydrate treatment increased the expressions of MAP2K3, MAP3K7, and MAPK8 genes in terms of mRNA levels. Conclusion: The reason of increased apoptosis might be associated with high expression levels of MAP2K3, MAP3K7, and MAPK8 genes after DPD treatment. Our novel findings suggest that DPD may be an important agent in the treatment of prostate cancer by inducing apoptosis against mitogenic and environmental stress.Amaç: Bu çalışmada DU-145 hücrelerinde disodyum pentaborat dekahidrat (DPD) uygulamasının ardından MAP2K3, MAP3K7 ve MAPK8 genlerinin ekspresyonları araştırıldı. Gereç ve yöntemler: Disodyum pentaborat dekahidrat uygulamasının MAP2K3, MAP3K7 ve MAPK8 genlerinin ekspresyonlarına olan etkisi qRT-PCR ile belirlendi. Bulgular: Disodyum pentaborat dekahidrat uygulamasının MAP2K3, MAP3K7 ve MAPK8 genlerinin mRNA seviyelerini artırdığı belirlendi. Sonuç: Apoptoz artışının, MAP2K3, MAP3K7 ve MAPK8 genlerinin DPD uygulaması sonrasında yükselen ekspresyon seviyelerine bağlı olarak gerçekleştiği düşünülmektedir. Güncel bulgularımız DPD’nin prostat kanseri tedavisinde mitojenik ve çevresel strese karşı apoptoza neden olan önemli bir etken olabileceğini öngörmektedir

Special Designed Routing Device To Ease Endoscopic Transforaminal Lumbar Disc Surgery: A Cadaveric Study

Background Data: Fully endoscopic lumbar disc (FELD) surgery via transforaminal (TF) approach may be more demanding to adopt for surgeons experienced with conventional microdiscectomy, due to the necessity of a new anatomic orientation and understanding. We designed a routing device to facilitate access to safe anatomic triangle defined by Kambin at the level of foramen in cadavers. Purpose: To show that the transforaminal route for endoscopic lumbar disc herniations is safely applicable with the aid of a new routing device. Materials and Methods: Ten cadavers between the ages 18-75, with no history of lumbar spinal surgery or trauma, with previous abdominal computed tomography (CT) scans included in our study. Postmortem abdominal CT scans were performed. Images were examined and transforaminal entrance angles without causing damage to retroperitoneal structures for each lumbar disc space and anatomical differences were recorded. TF approach was performed in cadavers using the angles measured from abdominal CTs and the entry point determined with the help of routing device. Results: L1-L2, L2-L3, L3-L4, L4-L5 disc spaces were operated in ten cadavers. Kambin’s triangle was successfully reached with help of routing device using data obtained from CT (X’, ?) and C-arm fluoroscopy (X, Y, Y’). Y’ marker with protractor on routing device, and the metal rod on this Y’ marker with an opening through which only the punction needle could pass were very important in reaching the target. The metal bar horizontal movement and fixation to this mechanism contributed to operation of device. Entrance points and angles calculated with the help of CT scans were found to be compatible with the images obtained from fluoroscopy and endoscopy during operation. Conclusions: In this study, it has been showed that TF approach can be safely performed with help of the new designed routing device

Special designed routing device to ease endoscopic transforaminal lumbar disc surgery: A cadaveric study

Background Data: Fully endoscopic lumbar disc (FELD) surgery via transforaminal (TF) approach may be more demanding to adopt for surgeons experienced with conventional microdiscectomy, due to the necessity of a new anatomic orientation and understanding. We designed a routing device to facilitate access to safe anatomic triangle defined by Kambin at the level of foramen in cadavers. Purpose: To show that the transforaminal route for endoscopic lumbar disc herniations is safely applicable with the aid of a new routing device. Materials and Methods: Ten cadavers between the ages 18-75, with no history of lumbar spinal surgery or trauma, with previous abdominal computed tomography (CT) scans included in our study. Postmortem abdominal CT scans were performed. Images were examined and transforaminal entrance angles without causing damage to retroperitoneal structures for each lumbar disc space and anatomical differences were recorded. TF approach was performed in cadavers using the angles measured from abdominal CTs and the entry point determined with the help of routing device. Results: L1-L2, L2-L3, L3-L4, L4-L5 disc spaces were operated in ten cadavers. Kambin’s triangle was successfully reached with help of routing device using data obtained from CT (X’, α) and C-arm fluoroscopy (X, Y, Y’). Y’ marker with protractor on routing device, and the metal rod on this Y’ marker with an opening through which only the punction needle could pass were very important in reaching the target. The metal bar horizontal movement and fixation to this mechanism contributed to operation of device. Entrance points and angles calculated with the help of CT scans were found to be compatible with the images obtained from fluoroscopy and endoscopy during operation. Conclusions: In this study, it has been showed that TF approach can be safely performed with help of the new designed routing device