Distinct Postsurgical Management in Young and Elderly Breast Cancer Patients Results in Equal Survival Rates

Background: Although breast cancer (BC) is one of the most common malignant diseases in women, the majority of the studies describing the characteristics of BC in elderly patients have been limited to survival assessments or tumor features, without using younger BC patients as a reference group. The aim of our study was to describe and compare tumor characteristics and management patterns in elderly versus younger breast cancer patients in Turkey. Materials and Methods: We retrospectively analyzed 152 patients with invasive breast cancer who underwent surgery in our institution between 2002 and 2012. Patients were divided into 2 groups according to age at the time of diagnosis. Results: There were 62 patients in the elderly group (>= 65 years) and 90 patients in the younger group (0.001). There were no significant differences regarding histology, localization, lymph node involvement, or types of surgical procedures between the 2 groups. Comorbidities were more common in elderly patients (p<0.001). In addition, elderly patients were more likely to receive hormonal therapy (p<0.001) and less likely to receive radiotherapy (p=0.08) and chemotherapy (p=0.003). There was no difference in survival and locoregional recurrence rates between the groups. Conclusions: The results of this study demonstrate that breast cancer in elderly patients has more favorable tumor features, warranting less aggressive treatment regimens after surgery

Bare dorsal thoracic fascial flap for esophageal defects: an experimental study with dogs

Background Reconstruction of esophageal defects has challenged reconstructive surgeons for a long time. Problems that affect the continuity of the orogastic tract influence the patient's quality of life and general health. Bare free fascial flaps are used to restore soft tissue defects of the oral cavity because they provide thin, pliable tissues with a high capacity for epithelialization to preserve the local anatomy. An experimental study was planned to investigate reconstruction of anterior cervical esophageal defects using a pedicled dorsal thoracic fascial flap

Alpha-1 protease inhibitor and antichymotrypsin levels in acute pancreatitis

BACKGROUN

Alpha-1 protease inhibitor and antichymotrypsin levels in acute pancreatitis

BACKGROUN

Primary extrahepatic bile duct lymphoma mimicking Klatskin’s tumor, dramatic response to chemotherapy

Introduction: Non- Hodgkin’s lymphoma (NHL) mimicking Klatskin’s tumor is rare but possible. It can be confused with tumors for which major surgery is needed. Imaging modalities have similar features in Klatskin’s tumor and non-Hodgkin’s lymphoma. Presentation of Case: We herein report a patient who was first thought having a Klatskin’s tumor and prepared for major surgery. A month later, obstructive jaundice developed and a second magnetic resonance-magnetic resonance cholangiopancreotography showed a doubling size of the tumor in one month. In terms of tumor behavior, lymphoma was suspected and a tru-cut biopsy was performed by interventional radiology. Pathological examinations revealed non-Hodgkin’s lymphoma large B-cell type. After 4 cycles of chemotherapy by hematology-oncology department, complete cure was achieved. Discussion: Since the radiologic and clinical features are confusable in Klatskin’s tumor and non-Hodgkin lymphoma. Tumor biologic behavior and other biochemical parameters together may put a suspicion in mind. Upon suspicion biopsy must be done radiologically. Conclusion: Primary liver lymphoma arising from the bile ducts is extremely rare and radiologic imaging features do not differ from cholangiocarcinoma. A strong suspicion may prevent unnecessary surgery. Since the treatment of non-Hodgkin’s lymphoma is mainly chemotherapy

Hepatitis C virus infection in hemodialysis patients is not associated with insulin resistance, inflammation and atherosclerosis

Background: Hepatitis C virus (HCV) infection is associated with increased levels of inflammatory markers and is also a significant risk factor for the development of Type 2 diabetes mellitus (DM) in the general population. In attempt to address this issue in chronic hemodialysis (HD) patients, we evaluated the relation of HCV infection with inflammatory markers, endothelial dysfunction, insulin resistance and atherosclerosis. Methods: In a cohort of 72 HD patients (36 (50%) had a positive HCV EIA test and 36 (50%) had a negative anti-HCV test), we examined HCV antibody status, insulin resistance (HOMA-IR) and beta-cell function (HOMA-beta), serum inflammatory parameters (high sensitive C-reactive protein (CRP), fibrinogen and procalcitonin), and performed echocardiography, high-resolution brachial artery ultrasound and B-mode carotid Doppler examination to assess the vascular functions and atherosclerosis. Results: There were no differences in age, gender, body mass index (BMI), primary disease, duration of dialysis, smoking status, laboratory parameters except glucose, total cholesterol and LDL cholesterol between anti-HCV positive and anti-HCV-negative groups. The serum concentrations of glucose, total cholesterol and LDL cholesterol were significantly lower in the anti-HCV-positive patients than anti-HCV-negative patients (p = 0.04, p = 0.02, p = 0.01, respectively). There were no significant differences in inflammatory parameters, total insulin secretion (HOMA-beta, p = 0.76) and insulin resistance (HOMA-R, p = 0.91) between anti-HCV-positive and negative patients. The intima media thickness, carotid plaque score and brachial artery endothelium-dependent dilatation did not differ significantly between the two groups (p = 0.44, 0.45, and 0.17, respectively). Conclusion: HCV infection was not related to atherosclerosis and insulin resistance in hemodialysis patients. Since hemodialysis patients had a large number of uremia-related cardiovascular risk factors, the effect of HCV infection could disappear in this group of patients

HDL-C levels in newly diagnosed type 2 diabetes in Turkey

In this study, we aimed to investigate whether HDL-C levels of non-diabetic and type 2 diabetic Turks are as low as those of non-diabetic Turks reported in Turkish Heart Study (THS) and Turkish Adult Risk Factor Sudy (TEKHARF)

The Effects of Local and Systemic Administration of Proline on Wound Healing in Rats

Purpose: Wound healing consists of a sequence of complex molecular and cellular events. Collagen is composed mainly of proline and hydroxyproline. Proline and hydroxyproline constitute 1/3 of the amino acids in collagen, which makes up approximately 30% of the proteins within the body. The hydroxylation of proline found in collagen determines the stability of the triple helical structure of collagen. In this study, we examined the effects of local and systemic administration of proline on wound healing. Materials and Methods: 24 female Sprague-Dawley rats were used in the study and divided into three groups. Group 1: The defect created in the backs of the subjects was left to secondary healing. Group 2: 200 µl proline per day was administered topically for 30 days on the defect in the backs of the subjects. Group 3: 200 µl per day was administered intraperitoneally for 30 days on the defect in the backs of the subjects. Results: On day 21, there was a statistically significant difference between the groups in terms of the mean re-epithelialization score. On days 7 and 14, there was a statistically significant difference between the groups in terms of the mean granulation score. On days 7, 14, and 21, there was a statistically significant difference between the groups in terms of the mean collagen accumulation score. On day 30, there was a statistically significant difference between Groups 1 and 3 in terms of the mean E-mode score on mechanical tensile test. Conclusion: Our study confirmed that proline has positive effects on wound healing. However, it revealed that systemic administration of proline is more effective than local administration of proline