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Sancar Bayar

Publications and source records attributed to Sancar Bayar.

13 recordsLinked to original sources
PubMed2004

Association of Streptococcus bovis bacteremia with colonic neoplasia and extracolonic malignancy.

BACKGROUND: The association between Streptococcus bovis bacteremia and colonic neoplasia is well described; however, the relationship between S bovis and neoplasia outside the colon has not been well evaluated. HYPOTHESIS: S bovis bacteremia may be associated with colonic neoplasia and extracolonic malignancy. DESIGN: Retrospective review of all documented cases of S bovis bacteremia identified by a search of computerized bacteriology records. SETTING: One tertiary referral hospital and 1 community hospital located in the same city. PATIENTS: Forty-five patients (41 adults, 4 children) with documented S bovis bacteremia during a 12-year period were identified. MAIN OUTCOME MEASURES: Available patient records were reviewed to identify the presence of colonic neoplasia, the use of gastrointestinal endoscopy, and the presence of gastrointestinal or extraintestinal malignancies. RESULTS: Seventeen patients (41% of adult patients) underwent colonoscopy. Colonic neoplasia was present in 16 patients (39% of adults), with 3 of these patients having invasive colorectal cancer (7% of adults). Invasive cancer was present in 13 patients (32% of adults). Eight patients had malignant lesions arising within the gastrointestinal tract, and 5 patients had extraintestinal malignancies. CONCLUSION: S bovis bacteremia is associated with both colonic neoplasia and extracolonic malignancy.

Adult↗
PubMed2003

Malpositioning of Hickman catheters, left versus right sided attempts.

BACKGROUND: Central venous catheters (CVC) are frequently used for stem cell collection and recurrent therapeutic hemapheresis procedures for patients with poor peripheral venous access. There is a tendency to prefer a right sided approach for insertion of a CVC via the subclavian route. We designed a sequential randomized study to examine the issue of catheter insertion side and analyzed all the technical data on surgical skill and observed complications. METHOD: Seventy-five patients who are candidates for stem cell collection and high dose chemotherapy underwent placement of Hickman catheters via the percutaneous subclavian vein (SCV) route. One experienced surgeon inserted 12F, double lumen, tunnelled, silicon based catheters in the operation room via fluoroscopic control. All of the procedure related complications, morbidity and mortality were analyzed on the basis of the side of catheter insertion. RESULTS: The total rate of malpositioning in this series was 14.66%. The Jugular vein was the most common malpositioning site (66.6%). We observed a statistically significant difference in malpositioning between left versus right sided attempts, at 5.55% versus 20.51%, respectively (p = 0.032). The routes of malpositioning encountered for left sided attempts were the right SCV and the left internal jugular vein, the right internal jugular vein (n = 5), the left SCV vein (n = 2), and one left internal jugular vein. There was no significant difference between the right and left sided attempts for mechanical complications other than malpositioning (p < 0.05). CONCLUSION: In this study the rate of malpositioning was greater in the right sided approach (p = 0.032) and the other mechanical complication rates did not differ for the two methods. Our results indicate that there is no need for hesitancy in using left sided attempts at CVC insertion.

Adolescent↗
PubMed2003

Does folinic acid have a choleretic effect on humans?

BACKGROUND/AIMS: The aim of this study was to clarify whether folinic acid has any choleretic effect in humans, as observed by Kajiyama et al. in both clinical and experimental studies. METHODS: The choleretic effect of folinic acid was analyzed prospectively in a subgroup of patients who had external biliary catheters with periampullary tumors causing complete biliary obstruction. Folinic acid (50mg/day) was administered twice with a 24-hour interval between each dose. Daily bile volume was then recorded on the three consecutive days following the first dose of folinic acid. Mean bile flows (basal output=mean bile volume of four days) before and after (fifth, sixth and seventh days) the initiation of folinic acid administration were then compared. RESULTS: Mean bile volumes were determined as baseline output: 669.20+/-235.18, 5th day=: 668.63+/-235.26, sixth day: 670.45+/-235.08, and seventh day: 670.00+/-235.11. No significant difference in daily bile volumes before and after folinic acid administration was detected (p>0.05). CONCLUSION: No choleretic effect of intravenous folinic acid administration was observed in this prospective clinical study. This finding was contrary to our previous study on this subject.

Adult↗
PubMed2002

Preoperative staging of rectal cancer using magnetic resonance imaging with external phase-arrayed coils.

HYPOTHESIS: Rectal cancer can be accurately staged preoperatively by magnetic resonance imaging (MRI) with external phase-arrayed coils. DESIGN: Comparison of MRIs with pathologic staging. SETTING: University hospital. PATIENTS: Twenty-eight consecutive patients with biopsy-proven rectal cancer who did not undergo irradiation. INTERVENTION: Patients underwent imaging using a 1.5-T MRI scanner with external phase-arrayed surface coils. Streaking of the perirectal fat and disruption of the bowel wall margin were interpreted as transmural invasion. Lymph nodes were defined as metastatic when they had a diameter of at least 0.5 cm. Tumors were staged according to the TNM staging system (American Joint Committee on Cancer guidelines) as confined to the bowel wall (T1-T2) and invading through the bowel wall (T3-T4). Patients underwent anterior resection (n = 15), abdominoperineal resection (n = 11), or local excision (n = 2). MAIN OUTCOME MEASURES: Calculation of sensitivity, specificity, and accuracy for invasion through the bowel wall and lymph node status. RESULTS: Sensitivity of MRI in detecting invasion through the bowel wall was 89% (16/18), specificity was 80% (8/10), and accuracy was 86% (24/28). Sensitivity for malignant lymphadenopathy was 67% (8/12), specificity was 71% (10/14), and accuracy 69% (18/26). CONCLUSION: Although more costly and not as accurate as endoscopic ultrasound, MRI with phase-arrayed coils had excellent sensitivity at detecting transmural penetration of rectal cancer.

Adult↗
PubMedDate not supplied

Long-term survival after regional chemotherapy for liver metastases from breast cancer. A case report.

The prognosis of patients with liver metastases from breast cancer has to be regarded as rather unfavorable. A 45-year-old woman with cancer of the left breast and multiple simultaneous liver metastases was initially treated with cyclophosphamide, methotrexate, and 5-fluorouracil. After two treatment cycles a sonogram of the left breast revealed reduction of the tumor size and she underwent a modified radical mastectomy and hepatic artery catheterization. There was no change in the multiple lesions of the liver on abdominal ultrasonography. One week later a regional chemotherapy regimen was given through a hepatic arterial catheter with subcutaneous implanted reservoir. After completion of the seventh course of chemotherapy, ultrasonography revealed that the multiple liver metastases had regressed completely. To date (July 2001) there has been no relapse during the seven-year follow-up period. In conclusion, we suggest that intra-arterial regional chemotherapy may have an important role to play in the management of breast cancer patients with isolated liver metastases.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Regional chemotherapy-induced cure for pancreatic head carcinoma.

Pancreatic carcinoma has a devastating prognosis. The only hope for cure for many patients is still surgery while the disease is at the early stages. Chemotherapy (systemic/regional) or radiotherapy has been shown to be helpful in the palliation of the disease but not for cure. We reported a pancreatic head carcinoma, which was cured only by regional chemotherapy. To the best of our knowledge this is the first case in the literature.

Adenocarcinoma↗
PubMedDate not supplied

Regional chemotherapy for advanced pancreatic carcinoma.

BACKGROUND/AIMS: Since 1990, 14 patients with advanced pancreatic cancer were treated by regional chemotherapy. Five patients had locally advanced unresectable cancer and 9 had locally advanced disease with liver metastasis. METHODOLOGY: Fourteen patients underwent laparotomy, splenic artery catheterization and received a mean therapy of 3.8 cycles and 3 patients had completed 6 cycles of chemotherapy. Every cycle given monthly consisted of 5-fluorouracil 600 mg/m2 3 days, mitomycin 10 mg/m2 1 day, and cisplatinum 60 mg/m2 1 day. Tumor response was evaluated on the basis of imaging methods, tumor markers and life quality marker pain relief. RESULTS: Four patients had stabilization, 4 had partial response, 5 had progression and 1 had complete response. Median survival was 8 months for the whole group. Palliation for pain was successful and 71.4% of the patients had pain palliation. One patient had complete, 1 patient had partial, 8 patients had stable pain relief. Four patients had poor response to treatment and had progressive pain. Side effects, mainly leukopenia and thrombocytopenia, occurred in 5 patients and responded to medical measures. Mild to moderate nausea and vomiting was common and they responded well to antiemetic treatment. CONCLUSIONS: Although the objective response rate of regional chemotherapy for overall survival is low, in an individual patient it may produce an adequate response and acceptable toxicity so that the patient experiences overall improvement in symptoms, and rarely as in one case in our group may be cured by this method.

Adult↗
PubMedDate not supplied

Octreotide inhibits hepatic fibrosis, bile duct proliferation and bacterial translocation in obstructive jaundice.

BACKGROUND/AIMS: The protective effect of octreotide on bacterial translocation, bile duct epithelial proliferation and hepatic fibrosis was studied in an experimental obstructive jaundice model. METHODOLOGY: Forty-five healthy Wistar albino rats were randomly divided into three groups. Group I (n = 15): Median laparotomy and common bile duct manipulation performed (Sham group). Group II (n = 15): Laparotomy and common bile duct ligation performed. Group III (n = 15): After laparotomy and common bile duct ligation octreotide (Sandostatin, sandoz) was given. Simultaneously group I and II received 3 cc 0.9% NaCl and group III received 20 micrograms/kg/daily octreotide subcutaneously every 8 hours during 9 days. Two days after the procedure all rats were opened under ether anesthesia and sterile conditions. Group I had simple laparotomy but group II and III also had common bile duct ligation by 5/0 prolene. Seven days after the surgery (9th day after treatment) all rats underwent laparotomy and tests for bacterial translocation, liver biochemical tests and histopathologic analysis of liver and small bowel were carried out. RESULTS: In group II cecal population levels of bacteria were significantly higher than group I and group III (p < 0.05). In group II there was also statistically significant bacterial translocation to the mesenteric lymph nodes. Pathological changes were found in terminal ileum samples in group II which seemed to improve in group III. Hepatocyte function was preserved with octreotide treatment which also significantly decreased bile duct proliferation and periportal fibrosis in response to biliary obstruction. CONCLUSIONS: This experimental study showed that octreotide is effective in preventing bacterial translocation, bile duct proliferation and hepatic fibrosis in obstructive jaundice.

Animals↗
PubMedDate not supplied

Intraperitoneal hyperthermic perfusion may induce bacterial translocation.

BACKGROUND/AIMS: Intraperitoneal hyperthermic perfusion (IPHP) has been used widely in oncologic practice. Hyperthermia is known to decrease the interstitial pressure. Also intraperitoneal hyperthermia may alter the intestinal mucosal barrier and the intestinal bacterial flora. These changes may lead to bacterial translocation (BT). To the best of our knowledge, there is no data about the possible role of IPHP on BT. METHODOLOGY: Fifty-one rats were divided into two groups. Group I (n=36) received IPHP by heated isotonic salt solution at a temperature of of 43.0 degrees C and group II (n=15) received intraperitoneal normothermic lavage by isotonic salt solution at 37.0 degrees C. Each group was divided into three subgroups which were sacrificed at 1st (Ia, IIa), 3rd (Ib, IIb) and 7th (Ic, IIc) days. Mesenteric lymph nodes (MLN), spleen and liver were sampled and cecal aspirates were obtained. The presence of viable bacteria in samples was noted. Cecal bacterial population levels (CBPL) were reported as colony forming units (CFU). Groups were compared in terms of BT and CBPL. RESULTS: BT was not detected in the Ia (IPHP, 1st day) and IIa,b,c (all control groups). However, statistically significant BT was observed in group Ib and Ic (83.3% and 66.6%, respectively) in comparison to control group (p<0.01). Also there was positive correlation between CBPL and BT. CONCLUSIONS: Intraperitoneal hyperthermia causes remarkable BT. This may explain septic complications after IPHP. Further studies are necessary to better understand the effects of IPHP on the pathophysiology of BT.

Animals↗
PubMedDate not supplied

Pelvic perfusion for locally recurrent unresectable rectal tumors.

BACKGROUND/AIMS: Pelvic perfusion evolved as a palliative and curative treatment modality for advanced pelvic tumors and literature data support its use in different steps of the disease. METHODOLOGY: 15 patients with recurrent rectal tumor, without any systemic metastases were included in the study. Mean age was 49.7 years, 12 males, 3 females. Mean survival was 18 months. RESULTS: 15 unresectable rectal cancer patients were included in this study. Three (20%) complete response, 6 (40%) partial response, 2 stable disease (13.3%) and 4 (26.7%) progression were seen after pelvic perfusion. Mean survival is 26.54 months after perfusion (median=10). In multivariate analysis response rate to isolated perfusion and tumor size are significant factors effecting survival (p<0.05). The patients who did not receive chemotherapy after detection of pelvic recurrence did better (p=0.0086). Response to isolated pelvic perfusion (IPP) is an important factor for survival of locally advanced rectal tumors in log-rank test (p=0.0001). CONCLUSIONS: Isolated pelvic perfusion is a good alternative for non-resectable pelvic malignancies and should be considered as an important part of the multidisciplinary approach for these tumors.

Adenocarcinoma↗