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Biomedical subjects

A Karadeniz

Publications and source records attributed to A Karadeniz.

13 recordsLinked to original sources

Dosimetric analysis of thyroid doses from total cranial irradiation.

The purpose was to estimate the radiation dose to the thyroid from total cranial irradiation with parallel opposed lateral fields of 1.25 MeV gamma rays of (60)Co, to represent the current treatment modality, and with 6 MV photon beams derived from a linear accelerator. The mean thyroid doses were measured using thermoluminescence dosemeters in the Rando phantom with two cranial irradiation set-ups: (1) the lateral beams were angled by rotating the collimator to avoid irradiation of the lens and healthy tissues and (2) the lateral beams were not angled, and shielding blocks were used to protect the lens and healthy tissues. For a cranial dose of 18 Gy, thyroid doses for child patients for (60)Co with the open and blocked fields were 0.27 and 0.32 Gy, respectively. With 6 MV, the thyroid dose was less than the doses for (60)Co open and blocked cranial fields by 17 and 10%, respectively. Unblocked cranial fields and a high-energy photon beam should be preferred for cranial irradiation of children.

Adult↗

Treatment results and prognostic factors in oral tongue cancer: analysis of 80 patients.

Treatment results and prognostic factors for 80 patients with oral tongue cancer admitted to Istanbul University Oncology Institute between 1987 and 2000 were retrospectively analysed. The patients were treated by surgery and postoperative or curative radiotherapy. Median age was 55 (22-93) out of which 41 patients (51%) were male and 39 (49%) were female. One patient (1%) had stage I disease, 28 patients (36%) stage II, 18 patients (23%) stage III and 32 patients (40%) stage IVA disease. Nineteen patients (24%) were medically inoperable or refused surgical treatment, so were treated with curative radiotherapy to a total dose of 70Gy (group A). The remaining 61 patients (76%) were treated with surgery and postoperative external beam radiotherapy (group B). The median follow-up time was 44 months. The 5-year overall and loco-regional disease-free survival rates were 42% and 46%, respectively. The 5-year overall survival rates were 16% in group A and 49% in group B (P=0.0002). The 5-year disease-specific survival rate was 23% in group A while in group B it was 49%; the difference was statistically significant (P=0.02). Combined treatment improves overall and disease-free survival in patients with stage II, III and IVA oral tongue cancer. In patients who are not candidates for surgery, the effect of radiotherapy may be increased with the use of brachytherapy.

Adult↗

Multiple primary neoplasms at a single institution: differences between synchronous and metachronous neoplasms.

During the 10-year period (1987-1996) of our study, 26,255 patients with cancer were admitted to our clinic and, of these, 271 (1%) patients had multiple primary malignant tumors. Ninety-two (34%) patients had synchronous tumors (synchronous group), and 179 (66%) patients had metachronous tumors (metachronous group). The mean age at first diagnosis was higher in the former group. The ratio of men to women was 1.36 in the synchronous group and 0.74 in the metachronous group (p = 0.018). Smokers and drinkers were more common in the synchronous group. Breast cancer and lung cancer were most prevalent, and associations between head/neck and lung cancer and between breast and breast cancer were the most frequent associations in both the synchronous and the metachronous group. The frequency of aerodigestive tumors was higher and that of mesenchymal tumors was lower in the synchronous group than in the metachronous group. Localization in the medial region and in the head/neck was more frequent in the synchronous group than in the case of metachronous secondary tumors.

Age Factors↗

A scholarship project for the children of leprosy patients in Turkey.

Most of the leprosy patients in Turkey live in the rural areas of Eastern and South-Eastern Anatolia. Those living in the suburbs of the big cities of the Western parts of the country have come there by immigration. Nearly all patients are very poor; they have no land, or only a small amount of soil for cultivation. The incidence of deformities in our patients is high, excluding them from regular employment and a source of income. In Turkey, it is obligatory to attend primary school, but after that education has to be paid for, and the poor families of leprosy patients find it difficult to continue the education of their children. As the 'Society for the Struggle Against Leprosy', based in the Istanbul Leprosy Hospital at Bakirköy, we have developed a project to enable patients to continue sending their children to school, whilst at the same time asking the mothers to seek advice and guidance on family planning. The outset objective of this project was to enable children and young people, who otherwise have almost no chance of continuing education, to pursue education at secondary, high school and university levels. It was envisaged that in the long term educated children would be able to find a job and provide effective care and support for parents and other members of the family. This paper describes the administrative and other measures adopted and the results of the project from 1995 to 1998, during which a total of 545 children have been supported at an overall cost of US$107,378. The scholarship project has so far been remarkably successful in Turkey and it is hoped that it may provide a model for similar approaches in other countries. An unexpected and extremely encouraging finding has been that females now exceed males in this project and are increasing at all levels, including university entrance.

Adolescent↗

Utility of the serum tumor markers: CYFRA 21.1, carcinoembryonic antigen (CEA), and squamous cell carcinoma antigen (SCC) in squamous cell lung cancer.

The aim of this study is to assess the clinical usefulness of serum assays of carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC), and CYFRA 21.1 in the diagnosis of squamous cell lung cancer. Sixty patients with squamous cell, and twenty-four patients with nonsquamous cell histology of nonsmall cell lung cancer were enrolled in this study. Serum CEA, SCC, and CYFRA 21.1 levels were obtained by commercially available kits. Upper cutoff levels were 10 ng/ml, 3.5 ng/ml, and 3.5 ng/ml, respectively. In squamous cell lung cancer, percentages and 95% confidence interval (CI) of the patients with elevated levels were as follows: for CEA 23.3% (13-36), for SCC 20.0% (10-32), and for CYFRA 21.1 85.0% (73-93). The positivity rate of CYFRA 21.1 was more significant than CEA and SCC in both squamous and nonsquamous cell lung cancer. None of the markers were significant in differentiating squamous/nonsquamous histology. Only tumor marker CEA was significantly elevated in metastatic squamous cell lung cancer (p=0.004). A novel tumor marker CYFRA 21.1 can be used as a reliable tumor marker in diagnosing squamous cell lung cancer. In addition, CEA has an important role in determining metastatic disease.

Adult↗

A phase II trial, feasibility of combination of daily cisplatinum and accelerated radiotherapy via concomitant boost in stage III non-small cell lung cancer.

PURPOSE: A prospective phase II trial was conducted by the Institute of Oncology, Istanbul University in December 1994 on patients with locally-advanced non-small cell lung cancer to assess acute toxicity and the feasibility of a combination of radiosensitizer and accelerated radiotherapy with concomitant boost. MATERIALS AND METHODS: Patients were irradiated using 'large' fields (primary tumour and locoregional lymph nodes) with 1.8 Gy per fraction, five fractions a week. Reduced 'boost' fields (primary and involved nodes only) were also irradiated twice-weekly 1.8 Gy per fraction in ten fractions concomitantly 6 h after the administration of large field. Total radiation dose was 63 Gy in 5 weeks (45 Gy 'large' fields and 18 Gy 'boost'). The maximum allowed dose to the spinal cord was 3750 cGy. Cisplatinum, 6 mg/m2 was given daily just before 'large' field irradiation. RESULTS: As of January 1997, 15 patients were evaluated (median follow-up of 12.5 months with a range of 5.5-23 months). The overall acute toxicity rate was 38% and Grade 3 acute toxicity was 8%. Grade 4 or greater acute toxicities were not observed. The overall rate of cisplatinum-induced nausea and vomiting was 80% (severe in 60%), but all were easily treated with antiemetics. Complete response rate (clinical and radiological) was 40% and an overall response rate was 73%. Median survival was 16 months and progression-free survival was 5.5 months (range of 2.5-21 months). CONCLUSIONS: Toxicity was well tolerated and no treatment-related death occurred with this combined treatment regimen. Although it appears that better local control rates can be achieved, additional phase II/III studies are needed.

Adult↗

Low dose cyclosporin A treatment in generalized pustular psoriasis.

Generalized pustular psoriasis is a rare form of psoriasis, seldom seen in children. Three patients with generalized pustular psoriasis are presented, two of whom were a sister and brother and whose grandfather also had pustular psoriasis. Lesions consisted of pustular, erythematous, scaly, follicular papules located on the trunk, scalp, and extremities. The pustules in some areas coalesced to form lakes. Histologic examination of several biopsy specimens revealed the changes of pustular psoriasis, which were parakeratosis, elongation of the rete ridges, and deep spongioform pustules and Munro abscesses. All patients were treated with cyclosporin A for periods of 2-12 months. The doses ranged from 1 to 2 mg/kg/day. Clearance of psoriatic lesions occurred after 2-4 weeks of therapy.

Child↗