Cemil Bilir - Academia.edu (original) (raw)

Papers by Cemil Bilir

Journal of Pharmacy & Pharmaceutical Sciences

Purpose: Toll-like receptor 4 (TLR4) is over-expressed in breast tumors and thus contributing to ... more Purpose: Toll-like receptor 4 (TLR4) is over-expressed in breast tumors and thus contributing to the tumor progression and metastasis. Natural products have drawn attention in cancer immunotherapy due to their various biological activities. Curcumin is well investigated in different types of cancer. However, the mechanisms underlying its anti-inflammatory actions have not been extensively elucidated. For this purpose, we explored the inhibitory effects of curcumin on lipopolysaccharide (LPS)-induced TLR4 dependent TRIF signaling pathway in two subtypes of breast cancer cell lines (MCF-7 and MDA-MB-231) in this study. Methods: In this context, the cytotoxicity of curcumin and LPS alone and the combination of curcumin with LPS on these cells was evaluated by WST-1 assay. The expression level of TLR4 and the release of type I interferon (IFN) levels were determined after treatment with curcumin and/or LPS by RT-PCR and ELISA analysis, respectively. Furthermore, the subcellular locali...

Journal of Oncological Sciences

Clinical Cases in Mineral and Bone Metabolism

Introduction. There are controversial results in the risk of atrial fibrillation as well as arrhy... more Introduction. There are controversial results in the risk of atrial fibrillation as well as arrhythmogenic potential of bisphosphonates. Method. 37 patients and 40 healthy controls were evaluated prospectively with regard to the cardiac side effects related to the use of zoledronic acid (ZA) and its effects on electrocardiography (ECG) parameters. Result. As the basal ECG results of the patients diagnosed with cancer compared with the control group, it was determined that QT maximum was significantly lower, QT minimum was significantly higher. However; it was determined that QT disp, P max, P min, and P disp values were not significantly different. There was no statistically significant difference in P max, P min, P disp, QT max, QT min, QT disp values of the ECG parameters measured from cancer patients, before and 60 minutes after ZA therapy. Conclusion. There were no significant alterations in ECG in the acute period, indicated that ZA had no arrhythmia potential in the early period in patients with no underlying cardiac disease. However: patients receiving ZA should be monitored more closely because of the risk of arrhythmia which may ensue due to hypocalcemia, hypomagnesemia, or other chemotherapeutics.

Current Medical Imaging Reviews, 2017

Cancer Investigation, 2017

There are insufficient predictive markers for renal cell carcinoma (RCC). A total of 308 metastat... more There are insufficient predictive markers for renal cell carcinoma (RCC). A total of 308 metastatic RCC patients were analyzed retrospectively. The increased hemoglobin (Hb) group had significantly higher progression-free survival and overall survival (OS) compared with the decreased Hb group at 11.5 versus 6.35 months (p < .001) and 21.0 versus 11.36 months (p < .001) respectively. The 1- and 3-year OS rates were higher in the Hb increased group, i.e., 84% versus 64% and 52% versus 35% respectively. The present study showed that increased Hb levels after tyrosine kinase inhibitor therapy could be a predictive marker of RCC.

Journal of B.U.ON. : official journal of the Balkan Union of Oncology

Small bowel adenocarcinoma (SBA) is a rare tumor of the gastrointestinal system with poor prognos... more Small bowel adenocarcinoma (SBA) is a rare tumor of the gastrointestinal system with poor prognosis. Since these are rarely encountered tumors, there are limited numbers of studies investigating systemic treatment in advanced SBA. The purpose of this study was to evaluate the prognostic factors and systemic treatments in patients with advance SBA. Seventy-one patients from 18 Centers with advanced SBA were included in the study. Fifty-six patients received one of the four different chemotherapy regimens as first-line therapy and 15 patients were treated with best supportive care (BSC). Of the 71 patients, 42 (59%) were male and 29 (41%) female with a median age of 56 years. Median follow- up duration was 14.3 months. The median progression free survival (PFS) and overall survival (OS) were 7 and 13 months, respectively (N=71). In patients treated with FOLFOX (N=18), FOLFIRI (N=11), cisplatin-5-fluorouracil/ 5-FU (N=17) and gemcitabine alone (N=10), median PFS was 7, 8, 8 and 5 month...

Texas Heart Institute Journal from the Texas Heart Institute of St Luke S Episcopal Hospital Texas Children S Hospital, Feb 1, 2006

A 56-year-old woman presented with a congenital atrial septal aneurysm (ASA) that was found incid... more A 56-year-old woman presented with a congenital atrial septal aneurysm (ASA) that was found incidentally on routine echocardiographic evaluation. The echocardiographic images mimicked a left atrial tumor. She had hypertension, and she had been taking amlodipine for 5 years. There was no audible murmur. The chest radiograph and electrocardiogram were normal. Two-dimensional echocardiography showed rheumatic valvular disease and a mobile mass in the left atrium that resembled a cyst or cor triatriatum sinister. Further evaluation by other echocardiographic views confirmed the ASA. The presence of a left-to-right shunt was excluded by 2-dimensional, color-flow Doppler and contrast echocardiography (Figs. 1A and 1B). Multiple parasternal long-and short-axis, apical 4-chamber, and modified echocardiographic evaluations revealed that the circular cyst-like image was a cross-section of an interatrial septal aneurysm (Figs. 1B and 1C). Color-flow Doppler echocardiography showed moderate tricuspid regurgitation, mild mitral stenosis, and mild aortic regurgitation. The mitral valve area was 2.5 cm 2. Systolic pulmonary artery pressure was calculated by continuous-wave Doppler echocardiography as 55 mmHg. It appeared that elevated right atrial pressure was causing continuous rightto-left bowing of the atrial septal aneurysm into the left atrium. To the best of our knowledge, this is the 1st report of an interatrial septal aneurysm mimicking a left atrial tumor. An ASA is a localized segment of the atrial septum that bulges into the right or left atrium. It can be found as an isolated lesion or in association with other cardiac anomalies, such as patent foramen ovale, atrial septal defect, or mitral valve prolapse. 1-5 Such aneurysms are readily detected by 2-dimensional and transesophageal echocardiography. They are occasionally mobile, in which instance they can be seen moving between the atria during the cardiac cycle. 3 Most ASAs are clinically silent, and they are an incidental finding in 1% of the general population. 6 Although an ASA is considered clinically benign, there can be clinical consequences, such as cardiogenic embolism. 3 Embolism can result from left-atrial thrombus formation within the aneurysm, or it can occur as a paradoxical embolism. 7-9 Another complication is a right-to-left interatrial shunt, which occurs in 90% of ASAs. 3 Rarely, some ASAs mimic a right atrial cyst or tumor. 8

Medicinski Glasnik, Aug 1, 2013

To analyze the results of chemotherapy applied at the Bülent Ecevit University School of Medicine... more To analyze the results of chemotherapy applied at the Bülent Ecevit University School of Medicine, Department of Medical Oncology, to elderly patients with metastatic gastric cancer (GC). The study retrospectively investigated hospital records including pathological reports, imaging records, chemotherapy regimens, response and toxicity profile. All patients received systemic chemotherapy for pathologically proven metastatic GC at the Bülent Ecevit University School of Medicine, Department of Medical Oncology. From 2005 to 2012, 23 metastatic GC patients older than 70 years were treated with systemic chemotherapy as a first-line therapy. As the first-line chemotherapy, 17 (74%) patients received polychemotherapy and the remaining six (26%) patients received monotherapy. Overall, 113 cycles were administered. The median progression free survival (PFS) for the first-line chemotherapy was 6 months (95% CI, 0-16) and the median overall survival (OS) was 14 months (95% CI, 3-30). Multivariate analysis revealed that decreased OS was significantly associated with poor Eastern Cooperative Oncology Group (ECOG) performance status (p=0.045), elevated carcinoembryonic antigen (CEA) levels at the diagnosis time (p = 0.040) and decreased number of chemotherapy cycles (p=0.019) with R-Sq (adj) = 41, 6%. One patient had a complete response with docetaxel, cisplatin and fluorouracil combined (DCF) regimen and had 12 months of disease free survival (DFS). This is the first study investigating the outcomes of chemotherapy in Turkish elderly metastatic GC patients. Docetaxel, cisplatin and fluorouracil combination were the most common regimen, which is a tolerable and effective choice in elderly patients who had good performance status.

Hippokratia

This study aimed to investigate the effects of folinic acid and fluorouracil (bolus FUFA regimen)... more This study aimed to investigate the effects of folinic acid and fluorouracil (bolus FUFA regimen) chemotherapy on right ventricle (RV) functions. Thirty-four gastrointestinal (GI) cancer patients treated with antineoplastic drugs were included the study. All participants received FUFA chemotherapy protocol for colorectal, gastric and pancreatic cancer (i.e. fluorouracil 400-425 mg/m(2) intravenous day 1-5 + folinic acid 20-25 mg/m2 intravenous day 1-5 every 28 days x6 cycles) with or without radiation therapy according to the cancer and patient status. All participants have undergone complete physical and laboratory examination and complete echocardiographic evaluation including detailed right ventricle functional evaluations before the onset of chemotherapy and 6 months after the start of treatment. Mean RV thickness was 0.49 cm before chemotherapy and 0.62 cm at the end of the treatment (p=0.29). Mean tricuspid annular plane systolic excursion (TAPSE) values were 2.08 ± 0.3 and 2....

Kimura is a chronic inflamatuary disease at oral mucosa which presents as large subcutaneous nodu... more Kimura is a chronic inflamatuary disease at oral mucosa which presents as large subcutaneous nodules or masses on the head or neck of adulthood males. The lesions characteristics are eosinophilia in lymphocytic infiltration, fibrosis and diffuse vascularity. Eosinophilia and elevated blood IgE can be peresent. A 62 years old female with inguinal mass and itching was presented.

Bisphosphonates are the drugs which modulate bone turnover and reduce bone reabsorbsion. Hence, t... more Bisphosphonates are the drugs which modulate bone turnover and reduce bone reabsorbsion. Hence, they are used in postmenopausal osteoporosis , multiple myeloma or osteolisis associated with malign cancer. The rare complications are appearing more often now because of their wide use in treatments. Most important possible adverse effects belong to gastrointestinal systems; esophagitis, gastric ulcers, dyspepsia, heartburn and rarely oral ulcers, osteonecrosis on jaws and esophagial stricturs are illustrated

Turkish Journal of Medical Sciences

Aim: Thrombomodulin (TM) and endothelial protein C receptor (EPCR) are 2 transmembrane proteins t... more Aim: Thrombomodulin (TM) and endothelial protein C receptor (EPCR) are 2 transmembrane proteins that are thought to play an important role in cancer. We aimed to discover whether these 2 proteins are prognostic indicators in colorectal cancer. Materials and methods: Plasma TM and EPCR levels were measured using the ELISA method in 50 patients in different tumor stages that had been recently diagnosed with colorectal cancer and in a healthy control group of 50 people. Results: In colorectal cancer patients, higher plasma TM (21.3 +/- 22.8 ng/mL, 13.2 +/- 16.2 ng/mL, P = 0.010) and plasma EPCR levels (149.9 +/- 79.6, 113.3 +/- 49.3, P = 0.007) were determined compared to the control group. No statistically significant relationship was present between plasma TM, EPCR levels and tumor stage, tumor localization, tumor differentiation, lymphovascular invasion state, microvascular thrombus existence, and thrombosis progression (P > 0.05). Conclusion: We think that these 2 proteins are r...

Background: Methyltetrahydrofolate reductase (MTHFR) defect is a result of a mutation in the enco... more Background: Methyltetrahydrofolate reductase (MTHFR) defect is a result of a mutation in the encoding gene where thymidine is replaced by cytosine (C667T). Prevalence of the mutation varies in different societies. Resulting thermo labile MTFHR enzyme results in hyperhomocysteinemia which itself is a risk factor for thrombosis. Elevated plasma homocysteine levels also can result in neural tub defects, fetal death, abruption

Clinical and investigative medicine. Médecine clinique et experimentale, 2009

Propylthiouracil is one of the thionamides used in the treatment of Graves' disease. The drug... more Propylthiouracil is one of the thionamides used in the treatment of Graves' disease. The drug has serious side effects and long-term treatment might be needed to achieve remission. We designed this study to evaluate the clinical and thyroid Doppler characteristics that might predict time to remission and treatment failure in propylthiouracil treated Graves' patients. 26 patients, among 134 presenting to our university hospital outpatient clinic between Feb -July 2007 and with first time diagnosis of clinical thyroid dysfunction, were clinically and ultasonographically diagnosed with Graves' disease. Doppler parameters, serum thyrotropin, free thyroxine and free triiodothyronine were measured at the beginning of the study and thyroid studies were repeated every 4 weeks until remission. Propylthiouracil 300 mg/day was started for each patient at the time of diagnosis and doses were titrated according to repeat thyroid studies. Patients were treated and followed up for 18 m...

Journal of B.U.ON. : official journal of the Balkan Union of Oncology

Hepatocellar carcinoma (HCC) remains a major health problem being the third leading cause of deat... more Hepatocellar carcinoma (HCC) remains a major health problem being the third leading cause of deaths due to cancer worldwide. Because HCC is known to be highly resistant to conventional systemic therapies, single-agent or combination of systemic therapies have been investigated. Today, sorafenib, a multikinase inhibitor, is the only approved systemic agent for the first line treatment of advanced HCC. In this study, we aimed to investigate the influence of different concentrations of cisplatin, doxorubicin, pegylated doxorubicin (PLD), oxaliplatin and gemcitabine by applying these agents either single or in combinations on mahlavu cell line. HCC mahlavu cell line was used for the experiments. Cell death was measured by flow cytometry at 48 hrs after incubation with various concentrations (0.1 μg/ml, 1.0 μg/ml and 10 μg/ml) of the drugs. Cell death due to gemcitabine was found to be significantly higher than cell deaths caused by the other single agents including cisplatin, oxaliplati...

Oncology Letters, 2015

Obesity appears to be associated with an increased risk of breast cancer (BC) and an inferior onc... more Obesity appears to be associated with an increased risk of breast cancer (BC) and an inferior oncological outcome at the time of diagnosis, with poor outcomes most prominent in cases of triple-negative BC (TNBC). The present study analyzed serum tumor necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) and TNF receptor associated factor-6 (TRAF) protein expression levels in 48 patients with non-metastatic BC and 26 obese control patients (without BC). The mean age of the cohort was 52.5 years (range, 35-78 years) and the patients had a median body mass index of 33.5 kg/m 2 (range, 30-47 kg/m 2). In the study population, 27.1% of BC patients were triple negative and 70.8% were hormone receptor (HR)-positive. Median serum TRAF6 expression was 0.90 ng/ml (range, 0.55-1.53 ng/ml) in the 13 TNBC patients and 0.63 ng/ml (range, 0.49-1.22 ng/ml) in the 35 HR-positive BC patients; thus, TRAF6 expression was significantly higher in the TNBC patients compared with the obese control group (0.90 vs. 0.73 ng/ml; P=0.033). Furthermore, median serum TRAF6 expression levels were significantly higher in HR-negative patients compared with HR-positive patients (0.83 vs. 0.62 ng/ml; P=0.002). The present study demonstrated that serum TRAF6 expression levels were increased in TNBC and HR-negative patients with non-metastatic BC compared with HR-and human epidermal growth factor receptor 2-positive cases or the obese healthy control group. Therefore, elevated TRAF6 expression may be a poor prognostic factor in non-metastatic BC. In addition, we propose that progesterone (PR) negativity may be a more useful poor prognosis factor than estrogen receptor (ER) negativity, as TRAF6 expression levels were higher in the PR-negative patients compared with the ER-negative patients.

Journal of the Turkish German Gynecological Association, 2011

In this study we investigate the possible relation of thyroid dysfunction and thyroid antibodies ... more In this study we investigate the possible relation of thyroid dysfunction and thyroid antibodies to hyperemesis gravidarum. Thirty-seven patients with hyperemesis gravidarum and 33 healthy controls have been included in this study. Thyroid dysfunction was significantly more common than in controls (38% vs 6%, p=0.002). Thyroglobulin antibodies were also significantly more common in patients with hyperemesis gravidarum than controls (54 IU/mL vs. 14 IU/mL, p=0.03). Hyperemesis gravidarum can be a risk factor for postpartum thyroid dysfunction. Thyroid antibodies must be checked in the hyperemesis population in an endemic goitre region and/or iodine replacement regions.

Journal of Pharmacy & Pharmaceutical Sciences

Purpose: Toll-like receptor 4 (TLR4) is over-expressed in breast tumors and thus contributing to ... more Purpose: Toll-like receptor 4 (TLR4) is over-expressed in breast tumors and thus contributing to the tumor progression and metastasis. Natural products have drawn attention in cancer immunotherapy due to their various biological activities. Curcumin is well investigated in different types of cancer. However, the mechanisms underlying its anti-inflammatory actions have not been extensively elucidated. For this purpose, we explored the inhibitory effects of curcumin on lipopolysaccharide (LPS)-induced TLR4 dependent TRIF signaling pathway in two subtypes of breast cancer cell lines (MCF-7 and MDA-MB-231) in this study. Methods: In this context, the cytotoxicity of curcumin and LPS alone and the combination of curcumin with LPS on these cells was evaluated by WST-1 assay. The expression level of TLR4 and the release of type I interferon (IFN) levels were determined after treatment with curcumin and/or LPS by RT-PCR and ELISA analysis, respectively. Furthermore, the subcellular locali...

Journal of Oncological Sciences

Clinical Cases in Mineral and Bone Metabolism

Introduction. There are controversial results in the risk of atrial fibrillation as well as arrhy... more Introduction. There are controversial results in the risk of atrial fibrillation as well as arrhythmogenic potential of bisphosphonates. Method. 37 patients and 40 healthy controls were evaluated prospectively with regard to the cardiac side effects related to the use of zoledronic acid (ZA) and its effects on electrocardiography (ECG) parameters. Result. As the basal ECG results of the patients diagnosed with cancer compared with the control group, it was determined that QT maximum was significantly lower, QT minimum was significantly higher. However; it was determined that QT disp, P max, P min, and P disp values were not significantly different. There was no statistically significant difference in P max, P min, P disp, QT max, QT min, QT disp values of the ECG parameters measured from cancer patients, before and 60 minutes after ZA therapy. Conclusion. There were no significant alterations in ECG in the acute period, indicated that ZA had no arrhythmia potential in the early period in patients with no underlying cardiac disease. However: patients receiving ZA should be monitored more closely because of the risk of arrhythmia which may ensue due to hypocalcemia, hypomagnesemia, or other chemotherapeutics.

Current Medical Imaging Reviews, 2017

Cancer Investigation, 2017

There are insufficient predictive markers for renal cell carcinoma (RCC). A total of 308 metastat... more There are insufficient predictive markers for renal cell carcinoma (RCC). A total of 308 metastatic RCC patients were analyzed retrospectively. The increased hemoglobin (Hb) group had significantly higher progression-free survival and overall survival (OS) compared with the decreased Hb group at 11.5 versus 6.35 months (p < .001) and 21.0 versus 11.36 months (p < .001) respectively. The 1- and 3-year OS rates were higher in the Hb increased group, i.e., 84% versus 64% and 52% versus 35% respectively. The present study showed that increased Hb levels after tyrosine kinase inhibitor therapy could be a predictive marker of RCC.

Journal of B.U.ON. : official journal of the Balkan Union of Oncology

Small bowel adenocarcinoma (SBA) is a rare tumor of the gastrointestinal system with poor prognos... more Small bowel adenocarcinoma (SBA) is a rare tumor of the gastrointestinal system with poor prognosis. Since these are rarely encountered tumors, there are limited numbers of studies investigating systemic treatment in advanced SBA. The purpose of this study was to evaluate the prognostic factors and systemic treatments in patients with advance SBA. Seventy-one patients from 18 Centers with advanced SBA were included in the study. Fifty-six patients received one of the four different chemotherapy regimens as first-line therapy and 15 patients were treated with best supportive care (BSC). Of the 71 patients, 42 (59%) were male and 29 (41%) female with a median age of 56 years. Median follow- up duration was 14.3 months. The median progression free survival (PFS) and overall survival (OS) were 7 and 13 months, respectively (N=71). In patients treated with FOLFOX (N=18), FOLFIRI (N=11), cisplatin-5-fluorouracil/ 5-FU (N=17) and gemcitabine alone (N=10), median PFS was 7, 8, 8 and 5 month...

Texas Heart Institute Journal from the Texas Heart Institute of St Luke S Episcopal Hospital Texas Children S Hospital, Feb 1, 2006

A 56-year-old woman presented with a congenital atrial septal aneurysm (ASA) that was found incid... more A 56-year-old woman presented with a congenital atrial septal aneurysm (ASA) that was found incidentally on routine echocardiographic evaluation. The echocardiographic images mimicked a left atrial tumor. She had hypertension, and she had been taking amlodipine for 5 years. There was no audible murmur. The chest radiograph and electrocardiogram were normal. Two-dimensional echocardiography showed rheumatic valvular disease and a mobile mass in the left atrium that resembled a cyst or cor triatriatum sinister. Further evaluation by other echocardiographic views confirmed the ASA. The presence of a left-to-right shunt was excluded by 2-dimensional, color-flow Doppler and contrast echocardiography (Figs. 1A and 1B). Multiple parasternal long-and short-axis, apical 4-chamber, and modified echocardiographic evaluations revealed that the circular cyst-like image was a cross-section of an interatrial septal aneurysm (Figs. 1B and 1C). Color-flow Doppler echocardiography showed moderate tricuspid regurgitation, mild mitral stenosis, and mild aortic regurgitation. The mitral valve area was 2.5 cm 2. Systolic pulmonary artery pressure was calculated by continuous-wave Doppler echocardiography as 55 mmHg. It appeared that elevated right atrial pressure was causing continuous rightto-left bowing of the atrial septal aneurysm into the left atrium. To the best of our knowledge, this is the 1st report of an interatrial septal aneurysm mimicking a left atrial tumor. An ASA is a localized segment of the atrial septum that bulges into the right or left atrium. It can be found as an isolated lesion or in association with other cardiac anomalies, such as patent foramen ovale, atrial septal defect, or mitral valve prolapse. 1-5 Such aneurysms are readily detected by 2-dimensional and transesophageal echocardiography. They are occasionally mobile, in which instance they can be seen moving between the atria during the cardiac cycle. 3 Most ASAs are clinically silent, and they are an incidental finding in 1% of the general population. 6 Although an ASA is considered clinically benign, there can be clinical consequences, such as cardiogenic embolism. 3 Embolism can result from left-atrial thrombus formation within the aneurysm, or it can occur as a paradoxical embolism. 7-9 Another complication is a right-to-left interatrial shunt, which occurs in 90% of ASAs. 3 Rarely, some ASAs mimic a right atrial cyst or tumor. 8

Medicinski Glasnik, Aug 1, 2013

To analyze the results of chemotherapy applied at the Bülent Ecevit University School of Medicine... more To analyze the results of chemotherapy applied at the Bülent Ecevit University School of Medicine, Department of Medical Oncology, to elderly patients with metastatic gastric cancer (GC). The study retrospectively investigated hospital records including pathological reports, imaging records, chemotherapy regimens, response and toxicity profile. All patients received systemic chemotherapy for pathologically proven metastatic GC at the Bülent Ecevit University School of Medicine, Department of Medical Oncology. From 2005 to 2012, 23 metastatic GC patients older than 70 years were treated with systemic chemotherapy as a first-line therapy. As the first-line chemotherapy, 17 (74%) patients received polychemotherapy and the remaining six (26%) patients received monotherapy. Overall, 113 cycles were administered. The median progression free survival (PFS) for the first-line chemotherapy was 6 months (95% CI, 0-16) and the median overall survival (OS) was 14 months (95% CI, 3-30). Multivariate analysis revealed that decreased OS was significantly associated with poor Eastern Cooperative Oncology Group (ECOG) performance status (p=0.045), elevated carcinoembryonic antigen (CEA) levels at the diagnosis time (p = 0.040) and decreased number of chemotherapy cycles (p=0.019) with R-Sq (adj) = 41, 6%. One patient had a complete response with docetaxel, cisplatin and fluorouracil combined (DCF) regimen and had 12 months of disease free survival (DFS). This is the first study investigating the outcomes of chemotherapy in Turkish elderly metastatic GC patients. Docetaxel, cisplatin and fluorouracil combination were the most common regimen, which is a tolerable and effective choice in elderly patients who had good performance status.

Hippokratia

This study aimed to investigate the effects of folinic acid and fluorouracil (bolus FUFA regimen)... more This study aimed to investigate the effects of folinic acid and fluorouracil (bolus FUFA regimen) chemotherapy on right ventricle (RV) functions. Thirty-four gastrointestinal (GI) cancer patients treated with antineoplastic drugs were included the study. All participants received FUFA chemotherapy protocol for colorectal, gastric and pancreatic cancer (i.e. fluorouracil 400-425 mg/m(2) intravenous day 1-5 + folinic acid 20-25 mg/m2 intravenous day 1-5 every 28 days x6 cycles) with or without radiation therapy according to the cancer and patient status. All participants have undergone complete physical and laboratory examination and complete echocardiographic evaluation including detailed right ventricle functional evaluations before the onset of chemotherapy and 6 months after the start of treatment. Mean RV thickness was 0.49 cm before chemotherapy and 0.62 cm at the end of the treatment (p=0.29). Mean tricuspid annular plane systolic excursion (TAPSE) values were 2.08 ± 0.3 and 2....

Kimura is a chronic inflamatuary disease at oral mucosa which presents as large subcutaneous nodu... more Kimura is a chronic inflamatuary disease at oral mucosa which presents as large subcutaneous nodules or masses on the head or neck of adulthood males. The lesions characteristics are eosinophilia in lymphocytic infiltration, fibrosis and diffuse vascularity. Eosinophilia and elevated blood IgE can be peresent. A 62 years old female with inguinal mass and itching was presented.

Bisphosphonates are the drugs which modulate bone turnover and reduce bone reabsorbsion. Hence, t... more Bisphosphonates are the drugs which modulate bone turnover and reduce bone reabsorbsion. Hence, they are used in postmenopausal osteoporosis , multiple myeloma or osteolisis associated with malign cancer. The rare complications are appearing more often now because of their wide use in treatments. Most important possible adverse effects belong to gastrointestinal systems; esophagitis, gastric ulcers, dyspepsia, heartburn and rarely oral ulcers, osteonecrosis on jaws and esophagial stricturs are illustrated

Turkish Journal of Medical Sciences

Aim: Thrombomodulin (TM) and endothelial protein C receptor (EPCR) are 2 transmembrane proteins t... more Aim: Thrombomodulin (TM) and endothelial protein C receptor (EPCR) are 2 transmembrane proteins that are thought to play an important role in cancer. We aimed to discover whether these 2 proteins are prognostic indicators in colorectal cancer. Materials and methods: Plasma TM and EPCR levels were measured using the ELISA method in 50 patients in different tumor stages that had been recently diagnosed with colorectal cancer and in a healthy control group of 50 people. Results: In colorectal cancer patients, higher plasma TM (21.3 +/- 22.8 ng/mL, 13.2 +/- 16.2 ng/mL, P = 0.010) and plasma EPCR levels (149.9 +/- 79.6, 113.3 +/- 49.3, P = 0.007) were determined compared to the control group. No statistically significant relationship was present between plasma TM, EPCR levels and tumor stage, tumor localization, tumor differentiation, lymphovascular invasion state, microvascular thrombus existence, and thrombosis progression (P > 0.05). Conclusion: We think that these 2 proteins are r...

Background: Methyltetrahydrofolate reductase (MTHFR) defect is a result of a mutation in the enco... more Background: Methyltetrahydrofolate reductase (MTHFR) defect is a result of a mutation in the encoding gene where thymidine is replaced by cytosine (C667T). Prevalence of the mutation varies in different societies. Resulting thermo labile MTFHR enzyme results in hyperhomocysteinemia which itself is a risk factor for thrombosis. Elevated plasma homocysteine levels also can result in neural tub defects, fetal death, abruption

Clinical and investigative medicine. Médecine clinique et experimentale, 2009

Propylthiouracil is one of the thionamides used in the treatment of Graves' disease. The drug... more Propylthiouracil is one of the thionamides used in the treatment of Graves' disease. The drug has serious side effects and long-term treatment might be needed to achieve remission. We designed this study to evaluate the clinical and thyroid Doppler characteristics that might predict time to remission and treatment failure in propylthiouracil treated Graves' patients. 26 patients, among 134 presenting to our university hospital outpatient clinic between Feb -July 2007 and with first time diagnosis of clinical thyroid dysfunction, were clinically and ultasonographically diagnosed with Graves' disease. Doppler parameters, serum thyrotropin, free thyroxine and free triiodothyronine were measured at the beginning of the study and thyroid studies were repeated every 4 weeks until remission. Propylthiouracil 300 mg/day was started for each patient at the time of diagnosis and doses were titrated according to repeat thyroid studies. Patients were treated and followed up for 18 m...

Journal of B.U.ON. : official journal of the Balkan Union of Oncology

Hepatocellar carcinoma (HCC) remains a major health problem being the third leading cause of deat... more Hepatocellar carcinoma (HCC) remains a major health problem being the third leading cause of deaths due to cancer worldwide. Because HCC is known to be highly resistant to conventional systemic therapies, single-agent or combination of systemic therapies have been investigated. Today, sorafenib, a multikinase inhibitor, is the only approved systemic agent for the first line treatment of advanced HCC. In this study, we aimed to investigate the influence of different concentrations of cisplatin, doxorubicin, pegylated doxorubicin (PLD), oxaliplatin and gemcitabine by applying these agents either single or in combinations on mahlavu cell line. HCC mahlavu cell line was used for the experiments. Cell death was measured by flow cytometry at 48 hrs after incubation with various concentrations (0.1 μg/ml, 1.0 μg/ml and 10 μg/ml) of the drugs. Cell death due to gemcitabine was found to be significantly higher than cell deaths caused by the other single agents including cisplatin, oxaliplati...

Oncology Letters, 2015

Obesity appears to be associated with an increased risk of breast cancer (BC) and an inferior onc... more Obesity appears to be associated with an increased risk of breast cancer (BC) and an inferior oncological outcome at the time of diagnosis, with poor outcomes most prominent in cases of triple-negative BC (TNBC). The present study analyzed serum tumor necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) and TNF receptor associated factor-6 (TRAF) protein expression levels in 48 patients with non-metastatic BC and 26 obese control patients (without BC). The mean age of the cohort was 52.5 years (range, 35-78 years) and the patients had a median body mass index of 33.5 kg/m 2 (range, 30-47 kg/m 2). In the study population, 27.1% of BC patients were triple negative and 70.8% were hormone receptor (HR)-positive. Median serum TRAF6 expression was 0.90 ng/ml (range, 0.55-1.53 ng/ml) in the 13 TNBC patients and 0.63 ng/ml (range, 0.49-1.22 ng/ml) in the 35 HR-positive BC patients; thus, TRAF6 expression was significantly higher in the TNBC patients compared with the obese control group (0.90 vs. 0.73 ng/ml; P=0.033). Furthermore, median serum TRAF6 expression levels were significantly higher in HR-negative patients compared with HR-positive patients (0.83 vs. 0.62 ng/ml; P=0.002). The present study demonstrated that serum TRAF6 expression levels were increased in TNBC and HR-negative patients with non-metastatic BC compared with HR-and human epidermal growth factor receptor 2-positive cases or the obese healthy control group. Therefore, elevated TRAF6 expression may be a poor prognostic factor in non-metastatic BC. In addition, we propose that progesterone (PR) negativity may be a more useful poor prognosis factor than estrogen receptor (ER) negativity, as TRAF6 expression levels were higher in the PR-negative patients compared with the ER-negative patients.

Journal of the Turkish German Gynecological Association, 2011

In this study we investigate the possible relation of thyroid dysfunction and thyroid antibodies ... more In this study we investigate the possible relation of thyroid dysfunction and thyroid antibodies to hyperemesis gravidarum. Thirty-seven patients with hyperemesis gravidarum and 33 healthy controls have been included in this study. Thyroid dysfunction was significantly more common than in controls (38% vs 6%, p=0.002). Thyroglobulin antibodies were also significantly more common in patients with hyperemesis gravidarum than controls (54 IU/mL vs. 14 IU/mL, p=0.03). Hyperemesis gravidarum can be a risk factor for postpartum thyroid dysfunction. Thyroid antibodies must be checked in the hyperemesis population in an endemic goitre region and/or iodine replacement regions.