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N Zengin

Publications and source records attributed to N Zengin.

15 recordsLinked to original sources

Treatment of advanced soft tissue sarcomas with ifosfamide and doxorubicin combination chemotherapy.

Our objective was to assess the efficacy of a standard dose ifosfamide and doxorubicin containing regimen in the treatment of advanced soft tissue sarcomas. Forty consecutive patients with a median age of 35.5 years were treated. Ifosfamide was administered at a dose of 2.5 g/m(2)/day as 72-hour continuous infusion with mesna at the same dosage and schedule. Doxorubicin was given at the dose of 60 mg/m(2)/day as 2-hour infusion on day 1. Six patients had a complete response (15%), and 9 (22.5%) had a partial response, fourteen patients (35%) stable disease, and 11 (27.5%) did not respond to chemotherapy. The median duration of response was 13 and 5 months for the complete and partial responders, respectively. The median survival was 37 months. Febrile neutropenia was encountered in 9 cases (22.5%). The present ifosfamide and doxorubicin combination is a moderately effective and well-tolerable regimen in the treatment of advanced soft tissue sarcomas.

Adolescent↗

The significance of the bone marrow biopsy pattern in chronic lymphocytic leukemia: a prognostic dilemma.

Although bone marrow biopsy pattern (BMBP) has long been suggested to be an independent prognostic factor in chronic lymphocytic leukemia (CLL), conflicting reports continue to appear in the literature. To investigate this issue we retrospectively reviewed 70 CLL patients who had undergone bone marrow biopsy at the time of diagnosis in a multivariate Cox regression analysis together with other prognostic factors. There were 51 (72.8%) males and 19 (27.2%) females with a median age of 60 years (range, 38-77). The median follow-up time was 24 months (range, 1-76), and median survival was 44 months. Thirtyfour patients (48.6%) had diffuse and 36 patients (51.4%) had nondiffuse BMBP (14 nodular, 11 interstitial, and 11 mixed). The median survival for diffuse and nondiffuse BMBP groups were 17 and 53 months, respectively (P= 0.05). Sixteen patients (22. 9%) had stage A, 28 (40.0%) stage B, and 26 (37.1%) stage C disease according to the Binet system, and four patients (5.7%) had low-risk, 39 (55.7%) intermediate-risk, and 27 (38.6%) high-risk disease according to the modified Rai staging system. The difference between the median survivals of patients in different stages was statistically significant (P < 0.0001). The BMBP and staging systems that are thought to be significant predictors of prognosis were used to build a multivariate Cox proportional hazard model. BMBP was not found to add additional information to the prognostic value of the staging systems. Our results underline two points: first, the significance of BMBP must be investigated in multivariate analysis including the stage, and second, BMBP is not a dynamic prognostic parameter, it is an index of tumor burden and does not add any prognostic information beyond that provided by clinical stage.

Adult↗

Acute lymphoblastic leukaemia presenting with arthritis in an adult patient.

The earliest manifestations of leukaemia often include rheumatic signs and symptoms. Arthritis is a well recognised complication of leukaemia in children, but acute and chronic leukaemia may also cause arthritis in adults. Leukaemic arthritis may occur at any time during the course of leukaemia and may be the presenting manifestation. It should therefore be considered in the differential diagnosis of both childhood and adult rheumatic disease. We present an adult patient presenting with arthritis due to acute leukaemia.

Adult↗

Primary neuroendocrine tumor of the breast.

Adult neuroendocrine tumors may present with a wide range of clinical symptoms that share specific ultrastructural and biochemical features. A 63-year-old post-menopausal female patient was admitted to the hospital with a mass in her right breast and the diagnosis was primary neuroendocrine tumor of the breast. Although neuroendocrine tumors can originate in various parts of the body and breast carcinoma with neuroendocrine differentiation has been described, primary neuroendocrine tumor of the breast is very unusual. This case is now presented and the current literature is reviewed.

Breast Neoplasms↗

Maintenance therapy with alpha-interferon following first-line VAD in multiple myeloma.

The aim of this study was to evaluate the response characteristics of vincristine, adriamycin and dexamethasone (VAD) as a first-line chemotherapy and to determine the efficacy of maintenance alpha-interferon (alpha-IFN) in multiple myeloma (MM). Between January 1985 and December 1994, a prospective trial was performed in stage II and III MM patients. The study population received only VAD with no maintenance therapy before 1990 (n=31), and those recruited after 1990 (n=33) were planned to be maintained with alpha-IFN (5 mU, 3 times per wk) during the plateau to a maximum of 2 yr. Median follow-up duration (44 vs. 39 months), time to response (3.4 vs. 3.5 months) and rate of objective response (61.3%, 19/31 and 63.6%, 21/33) were similar in VAD-only and VAD+IFN groups, respectively. The survival analyses revealed higher median progression-free (39.6 vs. 12 months) and overall survival (65+ vs. 24 months) durations in VAD+IFN group compared to VAD-only group. VAD regimen was well tolerated and IFN-related side effects were reversible. These findings denote that IFN maintenance prolongs the duration of response obtained by VAD.

Adolescent↗

Tear film and meibomian gland functions in psoriasis.

Tear secretion, tear film stability, and meibomian gland function (plugging, volume, and thickness) were assessed in patients with psoriasis vulgaris (n = 70). As compared to that of the healthy controls (n = 125) mean Schirmer I value of psoriatic patients was found to be in normal ranges, whereas tear film break-up time was significantly lowered. When evaluating meibomian gland function, psoriatic patients were found to have higher plugging and thickness indices but a normal volume of meibomian gland secretion. These findings suggested an obstructive type of meibomian gland dysfunction in psoriatic patients which might result from increased turnover of the epithelia lining the meibomian gland duct.

Adult↗

Cavernous hemangioma with cone dysfunction.

We report a 13-year-old male who complained of strabismus and low visual acuity in the right eye. Saccular aneurysms filled with dark-colored blood were noted in the upper nasal quadrant of the right fundus. Ishihara color plates and Lanthony's new color test revealed a red-green color defect. Cone response and 30-Hz flicker responses were nearly absent. Cavernous hemangioma of the retina is a rare vascular hamartoma; the associated findings show cone dysfunction concomitant with this peripheral lesion.

Adolescent↗

High-dose ifosfamide by infusion with Mesna in advanced refractory sarcomas.

Twenty patients with advanced sarcomas entered a pilot study with ifosfamide (IF) and mercaptoethane sulfonate sodium (Mesna) as a second-line treatment for six planned cycles. All patients had received prior doxorubicin- and cyclophosphamide-based chemotherapies. IF was administered at a dose of 3 g/m2 given as continuous intravenous infusion for 24 hr on day 1-5 with Mesna. In the absence of disease progression, chemotherapy was planned to be repeated every 4 weeks for six consecutive cycles. Following chemotherapy, only 2 patients (11%) achieved partial response with response durations of 6 and 9 months. There was no complete response. When considered for only high-grade tumors, the response rate reached up to 22%. Toxicity was reported for 48 cycles and the dose-limiting toxicities were myelosuppression (22%) and encephalopathy (17%). Chemotherapy protocol was changed after two or three courses in 16 patients with stable or progressive disease. IF/Mesna chemotherapy at this dose and schedule was not found to be very promising in refractory sarcomas as a second-line chemotherapy.

Adult↗

Meibomian gland dysfunction and tear film abnormalities in rosacea.

In order to determine the relationship between meibomian gland dysfunction and tear film abnormalities in rosacea, tear film flow and stability and meibomian gland function were assessed in 43 consecutive patients. Schirmer, tear film break-up time, and meibomian gland function values in patients with ocular rosacea (n = 28) were found to be significantly decreased as compared with those of the patients with only cutaneous involvement and control patients (p > 0.05). In patients with dermatologic rosacea (n = 15) these values were not different from those of the age- and sex-matched controls (p > 0.05). The effects of tetracycline and meibomian gland expression therapy also were investigated in patients with ocular rosacea. Neither meibomian gland expression therapy nor tetracycline administration had beneficial effects on decreased tear secretion, but tetracycline improved the break-up time values. Our findings showed a positive relationship between tear film abnormalities and meibomian gland dysfunction in patients with rosacea. Decreased tear secretion in patients with ocular rosacea would seem to be a result of structural changes secondary to meibomian gland dysfunction, and short break-up time might be due to an abnormal meibum composition.

Adult↗

The effect of dacryocystorhinostomy on tear film flow and stability in patients with chronic dacryocystitis.

In 30 patients suffering from chronic dacryocystitis, tear film flow and stability were assessed by means of Schirmer I and break-up time tests before and after dacryocystorhinostomy. When compared with those of healthy individuals, mean values of Schirmer I tests were found to be decreased before dacryocystorhinostomy, but reached normal levels after a successful operation. Break-up time levels were found to be within normal limits before and after surgery and no statistically significant difference was observed between patients and control group. These findings not only confirm the previous findings, that tear secretion in patients with chronic dacryocystitis was reduced and break-up time was not affected, but also indicate that the reduction of tear secretion can be eliminated by a successful dacryocystorhinostomy.

Adult↗

Traumatic globe luxation.

A case of globe luxation which followed a relatively slight trauma is presented. The luxation was accompanied by laceration of the conjunctiva in this case. After achieving reposition in the emergency room, the patient underwent a surgical exploration of extraocular muscles and conjunctival fornices where many eyelashes were removed. The clinical features and management of globe luxation is discussed, importance of surgical exploration is emphasized.

Child, Preschool↗

Pattern-reversal electroretinograms and visual evoked potentials in branch retinal vein occlusion.

We recorded pattern electroretinograms and visual evoked potentials in a group of selected patients with unilateral uncomplicated branch retinal vein occlusion. To document the effects of preexisting risk factors, patients were divided into three groups: diabetes mellitus, hypertension with hyperlipidemia and no systemic disease. The transient and steady-state pattern electroretinogram and visual evoked potential amplitudes were significantly reduced and visual evoked potential peak times were delayed relative to the fellow eyes and age-matched normal subjects. There was a second amplitude reduction relative to the other patient groups in both the affected and fellow eyes of the diabetes mellitus group, which was indicative of an additive effect of diabetes mellitus.

Aged↗