Brain Metastases, Large Cell Neuroendocrine Carcinomas and Prognosis

Objective: Pulmonary large cell neuroendocrine carcinomas (LNECs) are not common but brain metastases are common in LNEC patients. Because of their rarity, there are no randomized controlled trials on optimal treatment. Generally available data are based on case reports and retrospective studies. For this reason, we retrospectively analyzed patients with LNEC that we followed up for brain metastases to contribute to the literature. Methods: Between 2009 and 2020, 38 patients with brain metastases diagnosed with LNEC in our center were reviewed retrospectively. Results: 38 patients were evaluated. The mean survival time was 5.17 months (95% confidence interval (CI) : 3.17-7.13). In multivariate analysis showed us that; shorter overal survival is associated with age (p=0.001), uncontrol of primary cancer (p=0.014), presence of metachronous metastases (p=0.003), poor Eastern Cooperative Oncology Group (ECOG) performance score (p=0.025), and high uric acid level (p=0.001) and high lactate dehydrogenase (LDH) levels (p=0.009). Conclusion: LNECs are rare but aggressive cancers. LNECs often metastasize to the brain. According to our study, high LDH, high uric acid, poor ECOG performance score, ≥65 years, metachronous metastasis, uncontrolled primary tumor are associated poor prognosis. LDH, uric acid, age, presence of metachron metastasis, controbility of primary tumor can be used as easy and inexpensive biomarkers to determine the prognosis and in the follow-up and treatment of patients with LNECs with brain metastases as metastases seen of other cancers

First-line treatment of patients with HER2-positive metastatic gastric and gastroesophageal junction cancer

Fluoropyrimidine+cisplatin/oxaliplatin+trastuzumab therapy is recommended for the first-line treatment of HER2-positive metastatic gastric adenocarcinoma. However, there is no comprehensive study on which platinum-based treatment should be preferred. This study aimed to compare the treatment response and survival characteristics of patients with HER2-positive metastatic gastric or gastroesophageal junction (GEJ) cancer who received fluorouracil, oxaliplatin, and leucovorin (mFOLFOX)+trastuzumab or cisplatin and fluorouracil (CF)+trastuzumab as first-line therapy. It was a multicenter, retrospective study of the Turkish Oncology Group, which included 243 patients from 21 oncology centers. There were 113 patients in the mFOLFOX+trastuzumab arm and 130 patients in the CF+trastuzumab arm. The median age was 62 years in the mFOLFOX+trastuzumab arm and 61 years in the CF+trastuzumab arm (P = 0.495). 81.4% of patients in the mFOLFOX+trastuzumab arm and 83.1% in the CF+trastuzumab arm had gastric tumor localization (P = 0.735). The median progression-free survival (PFS) was significantly higher in the mFOLFOX+trastuzumab arm (9.4 months vs. 7.3 months, P = 0.024). The median overall survival (OS) was similar in both groups (18.4 months vs. 15.1 months, P = 0.640). Maintenance trastuzumab was continued after chemotherapy in 101 patients. In this subgroup, the median OS was 23.3 months and the median PFS was 13.3 months. In conclusion, mFOLFOX+trastuzumab is similar to CF+trastuzumab in terms of the median OS, but it is more effective in terms of the median PFS in the first-line treatment of HER2-positive metastatic gastric and GEJ cancer. The choice of treatment should be made by considering the prominent toxicity findings of the chemotherapy regimens

Guattari'nin Makineleri ve Özgün Perspektifler

Although Felix Guattari extensively incorporated the terminology from the Freud-Lacan line of psychoanalysis, he employs those terms in a revolutionary way in his philosophical outlook. Besides central concepts such as desire, libido and Oedipus, he employed the machine as a core concept to form an original perspective. A term reflecting the multiplicity and political novelty, its psychoanalytic background is an indispensable aspect for Guattari’s machines’ origins, their function and temporal progression. Through Freud’s and Lacan’s theories, psychoanalytic political line and related criticisms are investigated in this thesis to provide a background for Guattari’s machines. Then, the particularities of the machine concept are followed in Guattari’s texts to see what kind of problems and original solutions it addresses. Those insights indicate that the machinic approach itself functions in a machinic fashion to develop the multiplicity in the relatively rigid field of psychoanalysis. Additionally, the thesis strives to answer the question “How does Guattari and his machine concept manage to construct an original perspective?” To answer these questions, the final part of the thesis will investigate the theoretical approaches to physics corresponding to Freud’s, Lacan’s and Guattari’s peculiarities along with their views on time and temporality. The ultimate aim of the study is to discuss the background of philosophically original perspectives brought about by Guattari’s machine concept and its machinic function through the field of psychoanalysis.Terminolojisini Freud-Lacan psikanaliz geleneğinden almış olmasına karşın, Felix Guattari bu terimleri devrimci bir şekilde kullanır. Arzu, libido, Oidipus gibi terimlere ek olarak makine kavramını da kendi özgün bakış açısını oluşturmak için temel bir terim olarak kullanmıştır. Çeşitlilik ve politik çoğulculukla ilişkili bir kavram olarak makinelerin, kaynağı, işlevi ve zamansal değişimini ortaya koymak için psikanalitik arka plan önem arz eder. Bu tez için; Freud ve Lacan’ın teorilerinden ortaya çıkan psikanalitik politik tutum ve bu tutuma yönelik eleştiriler, Guattari’nin makineleri için arka planı oluşturmak üzere incelenecektir. Sonrasında, makine konseptinin kendine has özellikleri Guattari’nin metinleri boyunca şekilde takip edilecektir. Bu bölümlerden edinilen çıktılar makinesel yaklaşımın da psikanalizin nispeten katı alanı boyunca bir analiz ve çoğulculuğu geliştirme yöntemi olarak makinesel işlev gösterdiğini ortaya koymaktadır; diğer yaklaşımlar ile yapılan karşılaştırma da bu iddiayı örnekler. Ek olarak, tez şu soruya da cevap vermeye çalışır: “Guattari ve kendisinin makine kavramı orijinal bir perspektif oluşturmayı nasıl başarmıştır?” Bu soruya cevap verebilmek için, tezin son bölümünde Freud, Lacan ve Guattari’nin özgün görüşlerine karşılık gelen fizik alanındaki teorik yaklaşımlar, düşünürlerin zaman ve zamansallık üzerine görüşleriyle birlikte tartışılmaktadır. Tezin nihai amacı, Guattari’nin makine kavramı ve psikanaliz alanındaki makinesel işlevinin ortaya koyduğu özgün felsefi perspektifi arka planıyla ortaya koymaktır.M.A. - Master of Art

Relationship between brain metastasis and thyroid transcription factor 1

Abstract Brain metastases (BMs) are common in lung adenocarcinomas (ACs). Thyroid transcription factor 1 (TTF-1) is important in the diagnosis of AC. This study aimed to examine the relationship between TTF-1 and BM for the first time in literature. The data of 137 patients with AC that developed BM between 2009 and 2020 were retrospectively analyzed. A total of 137 patients, 120 (87.6%) male, and 17 (12.4%) female were examined. Their mean age was 59.78 ± 0.82 years. The Eastern Cooperative Oncology Group (ECOG) performance score was 0–1 (< 2) for 39 (28.5%) patients and 2–4 (≤ 2) for 98 (71.5%). TTF-1 was positive in 100 (73%) patients and negative in 37 (27%). More than five BMs were present in 102 (74.4%) patients and less than five in 35 (25.6%). All the patients received whole-brain radiotherapy. None of the patients was suitable for surgery or radiosurgery. The median survival time was 6.4 [95% confidence interval (CI), 5.67–7.1] months. The survival time was 7 (95% CI, 5.91–8.09) months for the TTF-1 (+) patients and 5.8 (95% CI, 4.1–7.5) months for the TTF-1 (−) patients. In the univariate analysis, there was a significant relationship between survival time and age (p = 0.047), TTF-1 (p = 0.024), and ECOG performance score (p = 0.002). The multivariance analysis revealed a significant relationship between survival and TTF-1 (p = 0.034) and ECOG score (p = 0.007). We found a correlation between survival time and ECOG performance score and TTF-1. TTF-1 can be used as a biomarker to monitor prognosis in the follow-up and treatment of patients with AC that develop BM

Fiber bragg ızgara tabanlı optik sensörler ile kaynak proses kontrol sistemi

Başvuru konusu buluş, kaynak torcuna bağlanan fiber bragg ızgara tabanlı optik sensör sistemi kullanılarak alınan zamana bağlı konum (pozisyon) bilgisinin kaynak kalitesinin tahmini ve/veya kontrolü ile ilgilidir. Kaynak proses parametreleri ve torcun zamana bağlı konumu torcun mekanik yapısını değiştirmeden sistemin çalışmasını engellemeyecek şekilde yapılmaktadır. Önerilen sistemle kaynak operasyon parametreleri ile birlikte torcun işleme parçasına göre uzaydaki konumu da dikkate alınarak kaynak kalitesi kestirimi için daha isabetli bir korelasyon kurulmaktadır

Mediating role of social support in resilience and quality of life in patients with breast cancer: structural equation model analysis

Objective: This study aimed to investigate the mediating role of social support in the relationship between resilience and quality of life (QoL) among Turkish patients with early-stage breast cancer. Methods: The study used a descriptive and cross-sectional design and was carried out in the oncology ward of a hospital in the Central Anatolia region of Turkey. A demographic-disease survey, the Turkish version of the Connor–Davidson Resilience Scale 25, the Multidimensional Perceived Social Support Scale, the European Organization for Research and Treatment of Cancer QoL Questionnaire Core, and the QoL Questionnaire Breast Cancer 23 were used to interview 113 patients with breast cancer. Results: Social support played a partial mediator role in the relationship between resilience and functional QoL. There was a negative correlation between functional QoL Questionnaire Breast Cancer 23 and psychological resilience and social support (P < 0.005). The mediation effect ratio was 10.2% (R2 = 0.102). Social support was found to not have a mediating role in the relationship between psychological resilience and general QoL (P < 0.05). Conclusions: Patients do not want social support to end, and their weakness in the eyes of others may have a negative impact on their QoL and resilience

Recurrence of retroperitoneal localized perivascular epithelioid cell tumor two years after initial diagnosis: case report

<div><p>ABSTRACT CONTEXT: Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal tumors. Adjuvant radiotherapy and/or chemotherapy are administered according to the patient’s clinical characteristics. CASE REPORT: A 42-year-old female patient was operated to treat a retroperitoneal mass. The diagnosis was established as PEComa with benign behavior. Two years after the diagnosis, chest and abdominal computed tomography scans showed intra-abdominal recurrence and lymphangioleiomyomatosis in the lung. Treatment with everolimus was started. The disease stabilized in the third month of treatment, according to the response evaluation criteria in solid tumors. CONCLUSION: PEComas are tumors with unpredictable behavior. Therefore, these patients require long-term follow-up, even in cases of correct diagnosis and benign PEComa.</p></div

Epidermal growth factor receptor expression and adjuvant chemoradiotherapy in rectal cancer Epidermal growth factor recepto in operated rectal cancer

Aim: Epidermal Growth Factor Receptor (EGFR) is a trans-membrane protein with tyrosine kinase activity and is expressed in 25-80% of colon cancer cases. EFGR expression is prognostic in patients with metastatic colorectal cancer, and anti-EGR- based therapies are routinely used in the treatment of patients with metastatic colorectal cancer. To the best of our knowledge, the relationship between EGFR expression and prognosis in directly operated patients who did not receive neoadjuvant treatment and subsequently received chemo-radiotherapy is unknown. Therefore, we retrospectively evaluated patients with stage 3 rectal cancer who underwent surgery without any preoperative treatment in our center and aimed to investigate the relationship between EGFR expression and prognosis in patients who received adjuvant chemoradiotherapy. Material and Methods: The data of patients who underwent surgery for rectal cancer and received chemoradiotherapy between 2010 and 2016 at Manisa State Hospital were retrospectively analyzed. Results: According to EGFR expression, it was 127.01 (95% CI, 85.43-168.59) months in the group with 10% less staining and 47.44 (95% CI, 26.77-68.12) months in the group with 10% or more staining. Lymphovascular invasion (p=0.032), perineural invasion (p=0.023), histologic grade (p=0.004) and EGFR expression percentage (p=0.005) were significantly associated with survival in multivariate analyses Discussion: The presence of 10% or more EGFR expression, LVI, PNI, and histological grade are significantly associated with survival in stage 3 rectal cancer patients who have undergone surgery and received postoperative chemotherapy. These markers can be used as prognostic biomarkers in the follow-up and treatment of these patients