To evaluate the five year survival outcomes of breast cancer patients treated at our department and to assess the prognostic factors that affect survival parameters. All patients underwent our department’s routine procedure for breast cancer. All patients received RT to the breast or chest wall using 3D conformal technique with 2 Gy fraction doses, five days a week with two opposite tangential fields. If necessary, ipsilateral supraclavicular fossa field was added to the treatment field. Anthracycline-based chemotherapy was primarily used, patients with estrogen receptor- positive disease received hormonal therapy and patients with Her-2 receptor-positive disease received trastuzumab. The primary end points of this study were to evaluate the overall survival (OS) and the disease-free survival (DFS) of the patients. The secondary end points of this study were to assess the prognostic factors that affect the survival outcomes. Statistical analysis were carried out using SPSS Statistic program version 13. Between 11.02.2010 and 01.05.2016, 559 patients with breast cancer who had been irradiated postoperatively were included in this retrospective study. 2 and 5 year OS rates were 97% and 84%; 2 and 5 year DFS rates were 97% and 71%, respectively. According to multivariate analysis, ≥70 year, to have triple (-) hormonal status, to have T3-4 disease, to have N2-3 nodal stage and to have locoregional recurrence or distant metastasis were the independent prognostic factors that affect OS. Also, to have N2-3 nodal stage and to have triple (-) hormonal status were independent prognostic factors that affect DFS. Breast cancer is the most common cancer among women. Its incidence has been increasing but mortality has been decreasing in the last 10-15 years. In the light of current treatment modalities, to know the prognostic factors that affect survival outcomes is very important for both choosing the most appropriate treatment modality and the prediciton of treatment response.

Aim: The aim of this study was to evaluate the prognosis value of tumor size and preoperative albumin levels in gastric cancer patients treated with postoperative chemoradiotherapy. Patients and Methods: Patients records reviewed retrospectively. Clinicopathologic features were analyzed. 199 patients who applied to our clinic between 15.1.2010-31.12.2016 were included in this study. The primary end points of this study were to evaluate the overall survival (OS) and the disease free survival(DFS). Results: Mean follow up time was 20.43 months. Distant metastases devoloped in 50 patients and 102 patients were alive. In multivariate analyses , advanced T stage, history of smoking, preoperative albumin level less than 3.5 gr/dl and tumor size more than 8 cm were found to have poor prognostıc effect on OS. Lymphovascular invasion (LVI) and tumor size were showed negative effects on DFS. For statistical analyses SPSS( statistical package for social sciences) 21.0 statistical package was used. Conclusions: Despite recent treatment modalities the prognosis of gastric cancer is still poor and novel prognostic factors together with the current ones may be helpful to predict decision of proper treatment modalities and survival of the patients

Multiple myelom (MM) is a plasma cell malignancy and is characterized by anemia, recurrent infections, serum and/or urine monoclonal protein, osteolytic bone lesions, hypercalcemia and renal failure. The prevalence of nephropathy varies between 20 and 50% in MM. In this study, the prevalence of nephropathy and related factors were aimed to investigate in MM patients who admitted to the Hematology and Nephrology clinics of Meram Faculty of Medicine, Necmettin Erbakan University. A total of 104 MM patients (F/M: 55/49) were retrospectively examined who were administered in the last five years. The mean follow up duration was 29 months. The mean age was 64±10.6 years. During the follow-up period, 30.8% of our patients died and 58% were still alive. The fate of the 10.6% of the patients could not be learned. Patients with serum creatinine ≥2 mg/dL were considered as patients with nephropathy. The vincristine-adriamycindexamethasone or melfelan-methylprednisolone (for patients >65 years) were administered as initial therapy. Statistical analysis was performed with SPSS 15.0. Renal involvements were observed in 33 patients (31.7%). Hyperuricemia (p=0.002), hypercalcemia (p=0.037), hypovolemia (p<0.001) and oliguria (p<0.001) were found to be higher in patients with creatinine ≥2 mg/dL. In 31 patients (29.8%), hemodialysis (HD) treatment was required, 19 of these (61.2% of HD patients, 18.2% of all patients) were treated with HD permanently. Mortality rates were found as %42 in patients with nephropathy and %25.3 without nephropathy (p=0.034). Renal failure is a poor prognostic marker in multiple myeloma. In this study one-third of MM patients had nephropathy requiring HD. Although renal insufficiency is mainly due to monoclonal light chain nephropathy, reversible causes such as hypovolaemia should be carefully evaluated. We think that particular attention should be paid to this group because of the increased risk of mortality.

Abstract

Aim: Since clinical and prognostic heterogeneity is observed in diffuse large B-cell lymphoma (‎DLBCL) patients, it is vital to determine its prognostic and predictive factors. The frequency of these factors varies geographically and ethnically. We aimed to reevaluate and discuss the prognostic and predictive ‎factors of DLBCL patients who have been treated with R-CHOP in our ‎center based on the WHO 2017 revised 4^th edition.‎ We also investigated the incidence of EBV in DLBCL-NOS.

Patients and Methods: Patients with DLBCL-NOS diagnosed previously in our hospital between 2007-2017 and treated with ‎R-CHOP were included in the study. We evaluated the expressions of CD10, CD5, CD30, BCL-2, BCL-6, MUM-1, MYC, LMP-1, EBNA-2, Ki-67, and p53, by immunohistochemistry, and EBV encoded RNA by in situ hybridization in 104 cases of DLBCL-NOS. The Revised International Prognostic Index (R-IPI) score and the overall survival time ‎was ‎calculated.

Results: The study included 56 men (53.8%) and 48 women (46.2%). The median age was 64.5 years. In 59.6% of the patients, the disease had a nodal beginning, whereas in 40.4% of the patients it had an ‎extranodal presentation. High ‎stage (III-IV) was present in 26.5% of the GCB subtype and 43.6% of non-GCB subtype (p=0.049). A high ‎R-IPI score was observed in 40% of GCB subtype and 54.5% of non-GCB subtype (p=0.028). Survival was significantly lower in the non-GCB subtype (log-rank test p=0.003).‎ The EBV frequency was about 3% as it is reported in Western populations. The frequency of DEL status was 8.7%, indicating that it was associated with inferior survival (p=0.045). De novo CD5⁺ DLBCL ratio as 13% and it was also associated with inferior survival (p=0.013).  We also found CD30⁺ DLBCL ratio as 11.5%, but we could not establish a significant relationship with prognosis.

Conclusion: DLBCL-NOS requires detailed subtyping and elaboration of prognostic factors. ‎The frequency of DEL status and De novo CD5⁺ DLBCL indicated that it was associated with inferior survival. However, we could not establish ‎a meaningful relationship of CD30⁺ DLBCL with prognosis.‎ Three EBV positive cases were identified and two of them were classified as ‘EBV positive large B cell lymphoma’ according to the WHO 2017 revised 4^th edition.

Keywords: Diffuse Large-Cell Lymphoma; Prognostic Factors; Survival

Aim: The aim of the present study was to evaluate the general characteristics, survival time and prognostic factors affecting the high grade glial tumor after radiotherapy and chemotherapy. Patients and Methods: Data of 166 patients were retrospectively analyzed. Included histopathologically confirmed cases were grade 3 anaplastic astrocytoma and grade 4 glioblastoma multiforme. Patients were treated with curative radiotherapy and simultaneous ± adjuvant Temozolamide. Results: 73% of the patients were male, 27% were female and the median age was 57 years. 21% were anaplastic astrocytomas, 79% were glioblastom multiforme. 40% of the patients were total, 49% of the patients were subtotally operated and 11% of the patients had only biopsy for diagnostic purposes. The median Karnofski performance score of the patients before radiotherapy was 90. 3-dimensional conformal radiotherapy was applied to 37% of the patients, 63% of the patients were treated with intensity-adjusted radiotherapy technique. Simultaneous Temozolamide was administered with 92% of patients’ radiotherapy. The median follow-up time was 15 months. Overall survival rates were 82 months for anaplastic astrocytoma and 15.5 months for glioblastome multiforme (p <0.001). Overall survival rates at 1, 2, and 5 years were 77%, 59%, and 55% for anaplastic astrocytoma and 59%, 33%, and 4% for glioblastome multiforme, respectively. Median overall survival in patients aged <50 years was 39.3 months, while age ≥50 years was 12.4 months (p <0.001). Overall survival according to operation pattern was 33.2 months in total exposures, 13.8 months in subtotal resections, and 4.9 months in biopsies (p = 0.00). Overall survival was 8.1 months with a performance of <70, while overall survival was 22.3 22.3 months with ≥70 (p = 0.00). Overall survival was 12.9 months in patients who underwent three-dimensional conformal radiotherapy and 21.5 months in patients undergoing intensity-adjusted radiotherapy (p = 0.005). Overall survival was 7.8 months when applied to radiotherapy dose <60 Gy and 21.7 months when given 60 Gy (p = 0.00). Median survival was 18.4 months and 7.2 months, respectively, using concurrent Temozolamide (p = 0.03). Conclusion: In conclusion, the patient’s diagnosis, age, operative form, performance, radiotherapy dose, chemotherapy usage and survival were positive and our results are compatible with the literature.

In this study, we looked the distribution and prognostic significance of ventricular arrhythmias (VA) in patients with essential hypertension. Fifty patients with essential hypertension were included. After physical and laboratory exa-mination, interventricular septum (IVS) and left ventricular posterior wall (LVPW) thickness were measured in M-mode echo to detect left ventricular hypertrophy (LVH). Patients were classified into 2 main group according to presence or absence of LVH. Halter monitoring was performed and VAs seen in Halter were defined according to Lawn clas-sification_ All of the patients were followed clinically at least 6 months by 2 monthly intervals. All types of VAs were more common in LVH group, but only Lawn IVA group VA was sig-nificantly higher occurence. There were no malign VA and sudden death while Lawn IA group VAs were more common in the two group of patients.

Localized solitary fibrous tumor of the pleura is a rarely seen tumor of the pleura beyond It’s unclear histogenesis, differantiation, malignity potential, and clinical behaviour. They are usually seen in 5-8. decades and more than 50 % of the cases are asymptomatic. The most important prognostic factors are the size, cellularity, and resectability of the tumor. For these reasons in surgical treatment wide resection is advised. İn this article, two female patients who were 48 and 53 year-old are reported with the diagnosis of localized solitary fibrous tumor originated from diaphragmatic pleura. The tumors removed successfully and the patients did not have any complication postoperatively. Because of the rareness of localized solitary fibrous tumor of the pleura it is thought to be worth reporting.

Aim : İn this study vve aimed at determining the prognostic factors and some risk factors in perforating eye in­ juries which have important role in preventable blindness. Method: VVe retrospectively evaluated data from a total of 157 patients, admitted to Fırat University Medical School, Department of Ophthalmology with perforated eye injuries, betvveen 1994-1999. One or two surgical interventions were performed in ali cases. They were eva­ luated with respect to patients’ age, sex and occupation; etiology of trauma, affected tissue, accompanying pat- hological findings, performed surgical intervention, delay betvveen the injury and surgery, Vision level before and after surgery and complication. Result: Of the total 157patients included in this study, 77.7% was male; 22.3 % female; and mean age of patients was 25.25 (4-85) years old. Perforated eye injuries vvere frequently seen (40.1%) in young patients (0-12 years old). This ratio was found to be 19.1% in vvorkers and 15.3 % in farmers. Among the most frequently injured tissues, cornea vvas the first (62.4%) and knives and Sharp tools were res- ponsible from most of the perforations (22.9%). Of the cases 76% vvas received surgical intervention in the first 24 hours' period. Before operation, visual level frequently found to be betvveen perception and projection (15.9). Most frequent complication among the follovv up period vvas ubnormal shaped pupil (29%) and corneal leukoma (25.9%). Conclusion: İt is knovvn that in perforated eye injury treatments, prevention of injuries is more important th an cure. Therefore prevention al public health Services ar e essential. Our results suggest that, urg en t admission to the hospital and possible early surgical intervention is important determinants of visual prognosis after per­ forated eye injuries.

Aim: Hypoxemia is a vital criterion used to determine prognosis in coronavirus disease (COVID-19)
cases. This study thus examined the effectiveness of capillary refill time (CRT) in defining hypoxiadependent
disease severity in COVID-19 patients.
Patients and Methods: This prospective study was conducted with COVID-19 patients and an agematched
healthy group. The optimum test ambiance was provided, and a stable smartphone platform
was used to record the measurements (in ms) to standardize our method. The captured videos were then
evaluated using a video processing program.
Results: In total, 39 patients with COVID-19 and 40 control groups participated in this study. The patients
were further divided into the moderate (n = 25) or severe group (n = 14) according to disease severity.
The mean oxygen saturation of both moderate/severe groups was above 94%. Per disease severity, the
CRT measurements were higher in the severe group than in the moderate group (p = 0.009). In patients
without lymphopenia (n = 18), CRT values were found to be increased in the severe group (p = 0.008).
The use of CRT in patients with Covid-19 was practicable (AUC: 0.91; 95% CI 0.848-0.978; P = 0.001).
Conclusions: Our results show that CRT prolongation can occur in patients with COVID-19. In patients
without lymphopenia and with normal O2 levels, detecting CRT prolongation may be a criterion for early
admission to ICU.

Ani işitme kaybı, hiperbarik oksijen tedavisi, prognostik faktörler

Acute pancıeatitis is the inflanırnation of this retcoperitoneal organ with various etiological factors varying in severity from slight edema tn peripancreatic necrosis that may deteriorate ta death. In this actiele, we eı'aluated the recolyis of 28 pa-tients with acute pancreatitis ı-etrospectively who adrnitted ta University of Selçuk. General Surgery Department, hetween .lanuaty 1992 and Novembeı-1995. Etiological factoı-s weı-e gallstone in 15, al-cohol in 2. lipe•lipidemia in one and pancreas head cancer in one. There was no identifiable cause in 9 patients. Six patients died of disease_ Three patients underwent lapaı-atomy. FollovıLtıp of the casus sho-wed good correlation with the lmrie prognosticcriterias tiCcriterias criteılas