Biomedical subjects

Adalet Demir

Publications and source records attributed to Adalet Demir.

8 recordsLinked to original sources

PubMed2006

Assessment of molecular events in squamous and non-squamous cell lung carcinoma.

Although considerable knowledge exists on the tumor biology of lung cancer, there is still a need to assess molecular events for the clinical management of the disease. We studied the pattern of chromosomal imbalances in 45 non-small cell lung carcinomas (NSCLC) by comparative genomic hybridization (CGH) and correlated the results with clinicopathological features including immunohistochemical (IHC) expression of the epidermal growth factor receptor (EGFR). Twenty-one tumors were squamous cell carcinomas (SCC) and 24 non-squamous cell lung carcinomas (NSCC) comprising 9 adenocarcinomas (ADC), 9 large cell carcinomas (LCC), 4 sarcomatoid carcinomas and 2 adenosquamous carcinomas. The mean number of individual imbalances was 7.1 for SCC (mean gains, 3.8; mean losses, 3.4) and 6.4 for NSCC (mean gains, 4.5; mean losses, 1.9). Several individual imbalances correlated significantly with increasing number of imbalances, that were +1q, -3p, +3q, -5q, -8p, +8q, +7p, +12p, and +14q. Altogether, the most frequent imbalances were +3q (49%), +5p (49%), -5q (36%), +8q (29%), -8p (24%), -3p (22%), +7p (22%), +12p (22%), +14q (20%), +18p (20%), +1q (18%), and +7q (18%). Among these, +3q and +18p correlated significantly with SCC, and +5p and +14q with NSCC. Remarkably, overlapping imbalances included +3q26, +7p11 in SCC and +1q21, +3q24, +12p11, and +14q12 in NSCC. EGFR expression was higher in SCC than in NSCC and correlated with +3q in the entire series. In addition, +12p correlated significantly with disease progress with the exception of nodal involvement in NSCC as well as with disease progress, regardless of nodal involvement, in the entire series. In conclusion, the present study contributes to the molecular biological characterization of NSCLC histological subtypes and through evaluation of molecular events to the recently emergent focus on novel markers for lung cancer treatment.

Adult↗

PubMed2006

Surgical treatment of pulmonary hydatid disease: a comparison of children and adults.

BACKGROUND: Hydatid cyst still remains an important health problem in our country as in many Mediterranean countries. The disease may affect children, and its treatment may be challenging in this age group. Surgery is the primary way of treatment. In the current study, the features unique to childhood pulmonary hydatid disease are emphasized. METHODS: Between 1992 and 2003, 301 patients were operated on because of pulmonary hydatid cyst in our hospital; 44 of them were 14 years or younger. They were categorized as pediatric patients. We retrospectively evaluated the clinical data of the patients. RESULTS: The mean age of the patients was 10.6 +/- 3.7 years (5-14 years) in children and 32.2 +/- 14 years (16-75 years) in adults. The rate of intact cyst was 71% in children and 57% in adults (P = .07). The mean diameter of the cyst was 8.5 +/- 3.1 cm (3-15 cm) and 6.6 +/- 3 cm (2-16 cm) in children and adults, respectively (P < .001). The rate of parenchyme-saving procedures was 84.1% in children, whereas 94.9% in adults. Lobectomy was performed in 16% of children, whereas it was performed in 1.5% of adults (P < .001). Morbidity rates were 13.6% in children and 11.6% in adults. No children but 1 adult died. Long-term follow-up revealed the recurrence rates as 4.5% in children and 4.3% in adults. CONCLUSIONS: Surgery, the primary method of treatment of hydatid cyst, is safe. Parenchyma-saving procedures such as cystotomy and capitonnage should be performed as much as possible. Nevertheless, hydatid cyst can reach relatively larger dimensions in children than in adults, which causes parenchyme destruction eventually leading to lung resection.

Adolescent↗

PubMed2006

Role and outcome of surgery for pulmonary tuberculosis.

The need and outcome of surgical intervention in patients with pulmonary tuberculosis were assessed retrospectively. Between 1993 and 2003, 72 major surgical procedures were performed in 57 patients with pulmonary tuberculosis. There were 44 males and 13 females with a mean age of 34 years. Indications for surgery were: trapped lung in 18 (31.6%), multidrug-resistant tuberculosis in 10 (17.5%), aspergilloma in 10 (17.5%), destroyed lung in 5 (8.8%), massive hemoptysis in 4 (7%), bronchopleural fistula in 3 (5.3%), persistent cavity in 2 (3.5%), and undiagnosed nodule in 5 (8.8%) patients. The most common procedure was lobectomy (31.9%). Other procedures included decortication, wedge resection, pneumonectomy, segmentectomy, and myoplasty. There were 28 complications in 18 patients, including prolonged air leak in 12 (21.1%), residual space in 7 (12.3%), empyema in 5 (8.8%), hematoma in 2 (3.5%), chylothorax and bronchopleural fistula in 1 (1.8%) each. There was no operative death, but one patient died from sepsis late in the follow-up period (mortality, 1.8%). As morbidity and mortality rates are acceptable, surgical intervention can be considered safe and effective in patients with pulmonary tuberculosis.

Adolescent↗

PubMed2006

Analysis of surgical treatment for pulmonary aspergilloma.

Surgery for pulmonary aspergilloma is reputed to be risky. The results of surgical treatment of pulmonary aspergilloma in 41 patients between 1988 and 2003 were evaluated retrospectively. Hemoptysis occurred in 31 patients (75.6%) and it was massive (> 300 mL in 24 hr) in 3. The underlying lung disease was tuberculosis in 35, bullous lung disease in 2, hydatid cyst in 2, and lung carcinoma in 2 patients. Lobectomy, bilobectomy, wedge resection, and pneumonectomy were performed in 27, 4, 6, and 4 patients respectively. The postoperative complication rate was 24.4%. One patient, who had a right pneumonectomy, died due to respiratory failure; the mortality rate was 2.4%. Recurrent hemoptysis was observed in only one patient. Early surgical treatment of patients with pulmonary aspergilloma resulted in a satisfactory outcome with acceptable morbidity, low mortality, and effective prevention of recurrent hemoptysis. Pneumonectomy has a high morbidity, thus it should be avoided if possible.

Adolescent↗

PubMed2006

Lobar torsion after pulmonary resection; report of two cases.

Lobar torsion is a rare complication after pulmonary resection. We report a case of right middle lobe torsion following a right upper lobectomy, and left lower lobe torsion following a left upper lobectomy. Careful postoperative clinical observation, chest radiography, fiberoptic bronchoscopy (FOB), and computed tomography (CT) are crucial for precise diagnosis of lobar torsion following pulmonary resection. Both patients underwent re-thoracotomy; a middle lobectomy and completion pneumonectomy were performed. In the clinical management of lobar torsion urgent diagnosis and conclusive surgical resection is needed to avoid mortality and morbidity.

Adenocarcinoma↗

PubMed2005

A giant endobronchial inflammatory polyp.

Bronchial inflammatory polyps are defined as tumor-like lesions. They are usually related to chronic inflammatory processes in the adult. Because they may cause complications, they should be surgically removed. A 55-year-old male patient had been followed for recurrent pulmonary infections for 40 years. His main symptoms were orthopnea and hemoptysis upon admission to our hospital. A chest computerized tomography (CT) revealed bronchiectasis located at the right middle lobe and lower lobe and obstruction of the main bronchus at the level of carina. In bronchoscopy a mobile polypoid pinkish lesion protruding to the trachea was observed. We performed an inferior bilobectomy. The pathological examination revealed an endobronchial fibroepithelial polyp. The presence of a giant endobronchial polyp with chronic respiratory symptoms over an extended period of time and the rarity of information pertaining to these lesions in the literature provoked intrigue and constituted a worthy presentation.

Bronchial Neoplasms↗

PubMed2005

The role of CYP1A1 Msp1 gene polymorphisms on lung cancer development in Turkey.

Polymorphisms for genes encoding the metabolic enzymes cytochrome P450 1A1 (CYP1A1) might contribute to the variability in individual susceptibility to lung cancer. The role of CYP1A1 in lung carcinogenesis might be more important at low levels of exposure to carcinogens. In our study, CYP1A1 gene polymorphisms were investigated in healthy subjects and lung cancer patients in Turkish population. This case-control study encompassed 31 lung cancer patients and randomly selected 37 healthy individuals in control group. DNA samples, extracted from the whole blood were amplified using polymerase chain reaction (PCR) method. The prevalence of CYP1A1 Msp1 (-/+ or +/+) polymorphism in the lung cancer patients was 19.4%, compared to 16.2% in control group but the result was not statistically significant (OR= 1.24, 95% CI= 0.36-4.32, p= 0.74). Another important result obtained in this study is that 16.2% of Turkish population carries a CYP1A1 Msp1 polymorphism. The analysis of patients by histological type of lung cancer showed no association between histopathologic type of lung cancer and CYP1A1 Msp1 polymorphism (p= 0.6). Genetic researches using specific biomarkers are expected to be helpful in monitorizing the risk of lung cancer. Multicenter cohort studies are necessary to be able to obtain reliable and correct statistical information.

Adult↗

PubMedDate not supplied

Is routine mediastinoscopy indicated for patients with T1 non-small cell lung cancer?

OBJECTIVE: Mediastinoscopy is gold standard in the staging patients with non-small cell lung cancer (NSCLC) patients. Yet, its necessity in every patient is being questioned as new data is being collected. In the present study, we compared pathology reports of the cases with T1 NSCLC both after mediastinoscopy and thoracotomy, and discussed about the necessity of mediastinoscopy. METHODS: We retrospectively reviewed the records of 74 patients (73 patients with pathologic T1 NSCLC patients who underwent pulmonary resection and one patient clinically T1 who did not undergo pulmonary resection), between 1996 and 2002. Clinically 80% of the cases were at T1 stage, and the rest were at T2 stage. The distribution of clinical lymph node status was NO in 85%, 15% N2. RESULTS: Fifty-three (71.6%) cases underwent mediastinoscopy. Mediastinoscopy showed that one patient had contralateral lymph node involvement and the remaining cases had no lymph node metastases. No mortality occurred and morbidity rate was 1.9%. Lobectomy was performed in 60 cases, pneumonectomy in seven, wedge resection in five, and segmentectomy in one. The histopathologic types were; squamous cancer in 40 (55%) cases, adenocarcinoma in 29 (40%), and large cell carcinoma in four (5%). Only two cases (2.7%) who had no detectable lymph node metastases at mediastinoscopy were found to have N2 disease after thoracotomy. In rest of the cases, NO was observed in 48 (66%) and N1 in 23 (31.5%). Five-year survival of the cases was calculated to be 73%. The two cases with N2 disease are alive at seven and four years after the operation. CONCLUSION: Routine mediastinoscopy does not appear to be necessary for patients with clinical T1 non-small cell carcinoma having no enlarged lymph nodes on computerised tomography.

Adult↗