Adjunctive hyperbaric oxygen therapy in radiation-induced non-healing wound.
Explore the source record for details and available documents.
Aged↗
Biomedical subjects
Dursun Bugra
Publications and source records attributed to Dursun Bugra.
Clinical and therapeutic considerations of rectal lymphoma: a case report and literature review.
Primary rectal lymphoma is a rare presentation of gastrointestinal lymphomas. Its clinical presentation is indistinguishable from that of rectal carcinoma. Although surgical resection is often technically feasible, optimal therapy for colorectal lymphoma has not yet been identified. We report a case of primary rectal lymphoma (non-Hodgkin's large cell lymphoma of type B) with high-grade features that disappeared completely after chemo-radiotherapy. This case underlines that primary treatment with systemic chemotherapy and involved-field radiotherapy can be successful for rectal lymphoma, with surgery reserved for complications and chemotherapy failures.
Adult↗
Timing of death from tumor recurrence after curative gastrectomy for gastric cancer.
In Western literature, there are few studies investigating the predictors of early versus late recurrence after curative gastrectomy for gastric cancer. The current study analyzed (1) patients who died of recurrent gastric cancer and (2) prognostic factors, which can be applied to timing of death from tumor recurrence. Of 492 patients who underwent curative resection (R0) for gastric cancer in the Department of Surgery, Medical Faculty of Istanbul between 1994 and 2000, 142 patients who died of recurrence were included into study. None of the patients had received postoperative adjuvant treatment. The patients were divided into 2 groups: an early recurrence group that included 102 patients who recurred and died within 2 years after surgery, and a late recurrence group, which included 40 patients who died of recurrence more than 2 years after surgery. Clinicopathologic findings were compared between the early and late recurrence groups. Multivariate analysis was performed to investigate the independent factors, which are predictive for early versus late recurrence, and prognostic factors independently associated with the survival period. In multivariate analysis, the early recurrence group, when compared with the late recurrence group, was characterized by lymph node metastasis (N1-3 versus N0; P = 0.002). Overall survival was influenced by nodal status (N1-3 versus N0; P = 0.003), type of operation performed (radical total versus radical subtotal gastrectomy; P = 0.003), Eastern Cooperative Oncology Group performance status (PS 3-4 versus PS 1-2; P = 0.004), and tumor localization (cardia versus corpus and antrum; P = 0.046). In contrast, T stage of the disease was not prognostic for survival, although it was close to statistical significance (P = 0.066). Multivariate analysis showed that poorer performance status at initial presentation (P = 0.001) and lymph node metastasis (P = 0.032) independently correlated with overall survival (P = 0.002). Lymph node status was the most important factor predictive for early versus late recurrence and patients with lymph node metastases were at more risk of death within 2 years after curative operation for gastric cancer. Postoperative chemoradiotherapy should be especially recommended for patients at high risk of recurrence of adenocarcinoma of the stomach or who have undergone curative resection.
Adenocarcinoma↗
ERCP in the diagnosis and management of complications after surgery for hepatic echinococcosis.
BACKGROUND: Surgery for liver hydatidosis can result in serious morbidity and mortality. The role and efficacy of ERCP in the management of these complications was reviewed. METHODS: Retrospective analysis of 79 patients with liver hydatidosis who underwent ERCP for postoperative complications. RESULTS: All patients with biliary fistulas (n = 50) were managed by endoscopic sphincterotomy, although 9 (18%) also required a biliary endoprosthesis. Surgical reintervention was avoided in 46 (92%) patients with subsequent surgery required in only in 4 (8%). The mean time to fistula closure was 13.3 days. Patients with daughter cysts in the bile ducts (n = 7) were also treated by endoscopic sphincterotomy and evacuation of obstructing cyst material. Seven patients with elevated liver enzymes or biliopancreatic symptoms but normal ERCP findings also underwent endoscopic sphincterotomy with normalization of biochemical tests. CONCLUSIONS: ERCP is valuable for detecting and treating postoperative biliary complications after surgery for hepatic echinococcal disease. In the majority of patients, endoscopic sphincterotomy allows healing of postoperative external biliary fistulas, and should be performed as early as possible. In some cases, a biliary prosthesis may be required. Endoscopic sphincterotomy also enables clearing of the bile ducts of hydatid remnants.
Adolescent↗
The inhibitory effect of octreotide on experimental colorectal carcinogenesis.
PURPOSE: This study was conducted to investigate the effect of octreotide on colorectal carcinogenesis by administering octreotide either alone or combined with polyglactin, which is a well-known suture material, on chemically induced colorectal cancer development in rats. METHODS: A total of 72 rats were divided into six groups. Two groups were subjected to a colotomy and repair using polyglactin. Another two groups underwent a sham procedure. The fifth group received octreotide alone and the sixth group served as a control. Both groups of rats in the polyglactin and sham groups received octreotide additionally. Methylnitrosourea was administered rectally to all the animals at a dose of 4 mg/kg per week for 20 weeks to induce carcinogenesis. Octreotide was injected twice a day at a total daily dose of 100 microg/kg. The thymidine labeling index was used to assess the synthesis phase fraction in order to measure the cell proliferation rate. RESULTS: The mean number of tumors per rat was significantly higher in the polyglactin group than in both the sham and control groups. It was significantly lower in the octreotide and polyglactin + octreotide groups than in the control and polyglactin groups, respectively. All the animals in the octreotide group had one tumor, while 66.6% of the control group had multiple tumors. The number of multiple tumors was significantly lower in the polyglactin + octreotide and sham + octreotide groups than in the polyglactin and sham groups, respectively. The mean tumor size in the octreotide group was significantly smaller than in the control group, whereas it was larger in the polyglactin group in comparison with the sham and control groups. It was also reduced in the polyglactin + octreotide group in comparison with the polyglactin group. The thymidine labeling index was significantly higher in the polyglactin group compared with both the sham and control groups, whereas it was lower in the octreotide group in comparison with the control group. The addition of octreotide administration to the polyglactin usage and the sham procedure significantly decreased the thymidine labeling indexes. CONCLUSION: These results indicate that octreotide reduces the frequency of tumor occurrence and has an inhibitory effect on its development in chemically induced experimental colorectal cancer. Octreotide can also reduce the enhancing effect of polyglactin on colorectal carcinogenesis when it is combined with polyglactin.
Alkylating Agents↗
Adjuvant intraperitoneal chemotherapy with cisplatinum, mitoxantrone, 5-fluorouracil, and calcium folinate in patients with gastric cancer: a phase II study.
Gastric carcinoma remains one of the leading causes of cancer-related death in the world. Clinical studies have revealed that approximately two thirds of the patients seek treatment for early recurrence within the abdominal cavity. The aim of this phase II study was to evaluate the toxicity, feasibility, and efficacy of adjuvant intraperitoneal chemotherapy (IPCT) with cisplatin, mitoxantrone, 5-fluorouracil (5-FU), and folinic acid in patients with stage II-III gastric cancer. Patients with stage II and III gastric cancer aged between 15 and 70 years, after curative resection, with adequate liver, renal, and cardiac function were included in the study. The chemotherapy regimen consisted of cisplatin 60 mg/m2, mitoxantrone 12 mg/m2, 5-FU 600 mg/m2, and folinic acid 60 mg/m2, delivered intraperitoneally, diluted in 2 l normal saline. Intraperitoneal fluid was not drained. Each course of IPCT was repeated every 4 weeks for a total 6 cycles. Thirty-nine patients were enrolled in the study. Twenty-eight of the 39 patients (71.8%) completed six courses of the planned schedule. One patient (2.6%) died after a fourth cycle of IPCT from an undetermined reason. The major nonhematologic toxicity from IPCT was grade I-III nausea and/or vomiting experienced by 27 patients (69.2%). Twenty-four (61.5%) patients reported abdominal discomfort. Median follow-up was 23 (range: 3-105) months. Twenty-five patients (64.1%) were dead. Median disease-free survival and overall survival were 12 (CI 95%; 8.3-15.7 months) and 19 months (CI 95%; 10.5-27.5 months), respectively. The cumulative 5-year disease-free survival and overall survival were 24.7% and 30.7%, respectively. The regimen was generally associated with acceptable toxicity. However, adjuvant IPCT has similar survival rates in comparison to no adjuvant treatment; thus, it cannot be currently recommended outside the context of a clinical trial.
Adult↗
Soft-tissue images. Diffuse cavernous rectal hemangioma.
Explore the source record for details and available documents.
Adult↗