Fulya Oz-Puyan

Recurrent solitary fibrous tumor of the pleura: significant response to radiotherapy

Solitary fibrous tumor (SFT) of the pleura is an uncommon neoplasm with non-specific symptoms and non-pathognomonical radiological findings. Surgery allows establishment of a definitive diagnosis as well as a cure of the disease. The role of radiotherapy or chemotherapy in the management of the disease is unclear because of the rarity of the disease and the successful results of the surgical treatment. Long-term clinical follow-up may be useful for the patients with SFT because of the potential adverse biological behavior of this tumor, which may lead to repeated recurrences and/or malignant transformation. We reported a 66-year-old woman with recurrence of SFT in the right lung, which had significant response to external thoracic radiotherapy.

Histopathological and scintigraphic comparisons of the protective effects of L-carnitine and amifostine against radiation-induced late renal toxicity in rats.

1 The aim of the present study was to compare the protective effects of l‐carnitine and amifostine against radiation‐induced late nephrotoxicity using technetium‐99m diethylenetriaminepentaacetic acid scintigraphy and histopathological examination. 2 Seventy‐one Albino rats were randomly divided into six groups as follows: (i) AMI + RAD (n = 15), 200 mg/kg, i.p., amifostine 30 min prior to irradiation (a single dose of 9 Gy); (ii) LC + RAD (n = 15), 300 mg/kg, i.p., l‐carnitine 30 min prior to irradiation; (iii) LC (n = 10), 300 mg/kg, i.p., l‐carnitine 30 min prior to sham irradiation; (iv) AMI (n = 10), 200 mg/kg, i.p., amifostine 30 min prior to sham irradiation; RAD (n = 11), 1 mL/kg, i.p., normal saline 30 min prior to irradiation; and (vi) control (n = 10), 1 mL/kg, i.p., normal saline 30 min prior to sham irradiation. Scintigraphy was performed before treatment and again 6 months after treatment. Kidneys were examined by light microscopy and a histopathological scoring system was used to assess the degree of renal damage. 3 The main histopathological findings were proximal tubular damage and interstitial fibrosis. Glomerular injury was similar in all groups. Tubular degeneration and atrophy were less common in the AMI + RAD group than in the RAD group (P = 0.011 and P = 0.015, respectively), as well as in the LC + RAD group compared with the RAD group (P = 0.028 and P = 0.036, respectively). Interstitial fibrosis in the AMI + RAD and LC + RAD groups was significantly less than that in the RAD group (P = 0.015 and P = 0.015, respectively). The highest total renal injury score (9) was seen in the RAD group. On scintigraphy, there were significant differences in post‐treatment time to peak count (Tmax) and time from peak count to half count (T½) values (P = 0.01 and 0.02, respectively) between groups in the right kidney. In the control and RAD groups, the T½ of the right kidney was 8 ± 2 and 21 ± 2 min, respectively. The Tmax values for the AMI + RAD and LC + RAD groups (2.8 ± 0.2 and 3.2 ± 0.2 min, respectively) were similar to those in the control group (2.5 ± 0.3 min). 4 Based on the results of the present study, l‐carnitine and amifostine have comparable and significant protective effects against radiation‐induced late nephrotoxicity.

Evaluation of Cardiovascular Risk Factors in Women with Uterine Leimyoma: Is There a Link with Atherosclerosis?

OBJECTIVE Both uterine leimyoma (UL) and cardiovascular disease are public health problems affecting women at different age ranges. Smoking, obesity, and hypertension have been shown to be associated with UL in different random studies. However cardiovascular risk factors have not been evaluated systematically in patients with UL. Accordingly, we aimed to evaluate the cardiovascular risk factors and their relation with the presence of UL. MATERIAL AND METHODS One hundred and eighty nine patients with the pathological diagnosis of UL and one hundred and eighty nine age matched control subjects without UL were retrospectively included in the study from our data base of the pathology and gynecology departments. Controls were patients with intact uteri who had visited the same physicians for a routine checkup that included a pelvic examination and uterine sonogram and without mention of physical findings consistent with UL. The following clinical and demographic parameters were recorded; age, sex, hypertension, diabetes mellitus, and hypercholesterolemia. Current cigarette smoking was defined as active smoking within the past 12 months. RESULTS Comparison of cardiovascular risk factors between with and without UL revealed that the presence of hypertension (80 (42.3%) vs 53 (28%) p=0.004) diabetes mellitus (33 (17.4%) vs. 16 (8.4%) p=0.009), smoking (31 (16.4%) vs. 11 (5.8%) p=0.001), were significantly higher in patients with UL than in control subjects. The mean-age and presence of hyperlipidemia were comparable between the two groups. Logistic regression analysis revealed an independent and positive association of UL with the presence of hypertension (odds ratio 2.02 CI: 1.25-3.27 p=0.004), diabetes mellitus (odds ratio 2.43 CI: 1.23-4.79 p=0.010), and smoking status (odds ratio 3.46 CI: 1.65-7.22 p=0.001). CONCLUSION We have shown that major cardiovascular risk factors namely, hypertension, diabetes mellitus and smoking are significantly and independently associated with UL. Our findings highlight the possible association of UL with atherosclerosis.

Comparison of the protective roles of L-carnitine and amifostine against radiation-induced acute ovarian damage by histopathological and biochemical methods.

PURPOSE The aim of this study was to compare the radioprotective efficacies of L-carnitine (LC) and amifostine against radiation-induced acute ovarian damage. MATERIALS AND METHODS Forty-five, 3-month-old Wistar albino rats were randomly assigned to six groups. Control (CONT, n = 7); irradiation alone RT: radiation therapy (RT, n = 8); amifostine plus irradiation (AMI + RT, n = 8); LC plus irradiation (LC + RT, n = 8); LC and sham irradiation (LC, n = 7); and amifostine and sham irradiation (AMI, n = 7). The rats in the AMI + RT, LC + RT and RT groups were irradiated with a single dose of 20 Gy to the whole abdomen. LC (300 mg/kg) and amifostine (200 mg/kg) was given intraperitoneally 30 min before irradiation. Five days after irradiation, both antral follicles and corpus luteum in the right ovaries were counted, and tissue levels of malondialdehyde (MDA) and advanced oxidation protein product (AOPP) were measured. RESULTS Irradiation significantly decreased antral follicles and corpus luteum (P: 0.005 and P < 0.0001). LC increased the median number of antral follicles and corpus luteum (P: 0.009 and P < 0.0001, respectively). Amifostine improved median corpus luteum numbers but not antral follicle (P < 0.000, P > 0.05). The level of MDA and AOPP significantly increased after irradiation (P = 0.001 and P < 0.0001, respectively). MDA and AOPP levels were significantly reduced by LC (P: 0.003, P < 0.0001) and amifostine (P < 0.0001, P: 0.018). When comparing CONT group with AMI + RT and LC + RT groups, MDA and AOPP levels were similar (P > 0.005). The levels of both MDA and AOPP were also similar when LC + RT is compared with AMI + RT group (P > 0.005). CONCLUSIONS L-carnitine and amifostine have a noteworthy and similar radioprotective effect against radiation-induced acute ovarian toxicity.

Inguinal lymph node as the only evidence of progressive lung cancer

Tumours that metastasise to groin nodes most frequently originate in genital and reproductive organs, skin, rectum or anus, or urinary bladder. However, rare cases of inguinal metastases from tumours above the diaphragm have been reported and only three of them had an inguinal metastasis which was recognised antemortem and reported in detail in the English medical literature. The primary tumours of these cases were malignant mesothelioma, salivary duct and breast carcinoma. In this paper, we report a case of carcinoma of the lung metastatic to an inguinal lymph node as the only evidence of progressive lung cancer.

The effects of irradiation on bone fracture healing: Can it promote mineralization at low doses?

This experimental study investigated the hypothesis that low dose irradiation can enhance fracture healing and mineralization. Standardized transverse femur fractures were created and intramedullary fixed with open technique to forty young adult, male Sprague-Dawley rats and randomized to RT (treatment with 1 Gy) and C (controls, sham treatment) groups. At third and sixth week after fracture, high resolution Bone Mineral Density (BMD) analysis, bone scintigraphy and radiographic examination with a mammography device were performed and rats were sacrificed for histopathological examinations. Statistically significant differences were found at sixth week; as BMD index was found to be higher in RT group (p = 0.006) and BMD value was found lower in the non-fracture region of the irradiated femurs (p = 0.005). No statistically significant differences were found between groups for other parameters. The results showed increased mineralization at the fracture site only when compared with irrradiated non-fractured bone region, which cannot be regarded as a basis for clinical practice. However, when applications like heterotopic ossification prophylaxis are considered, the issue remains to be solved by molecular techniques, especially for doses between 1 and 5 Gy.

Prognostic factors for renal cell carcinoma: Trakya University experience from Turkey

The purpose of the present study is to evaluate the prognostic factors of patients with renal cell carcinoma. The treatment results such as distant metastasis-free survival and overall survival of 59 previously untreated patients were retrospectively analysed. Median follow-up was 17.5 months (3.8-88.5 months). Overall survival was 22.4 months (3-87 months). Distant metastasis developed in 35 (59%) patients. The Eastern Cooperative Oncology Group (ECOG) performance status (P=0.022), tumour size (P=0.025) and lymphatic invasion (P<0.0001) were significantly effective prognostic factors for distant metastasis-free survival on multivariate analysis. Related to overall survival, gender (P=0.025), ECOG performance status (P=0.027), nuclear grade (P=0.002), tumour size (P=0.029), T stage (P=0.044), nodal involvement (P=0.003), surgical margin (P=0.046), renal sinus invasion (P<0.0001), perineural growth (P=0.001) and lymphatic invasion (P<0.0001) were significant prognostic factors on univariate analysis. Gender (P=0.008), ECOG performance status (P=0.027), tumour size (P=0.025) and lymphatic invasion (P<0.0001) retained their significance on multivariate analysis. We concluded that the most important prognostic factors for patients with renal cell carcinomas are ECOG performance status, tumour size and lymphatic invasion.