1997;28(3):125-176.
CONTENTS


ABSTRACTS

Assessment of 145 patients of colon carcinoma

Demir G, Ozguroglu M, Molinas-Mandel N, Demirelli F, Buyukunal E, Serdengecti S, Berkarda B

Cerrahpasa J Med 1997;28:130-134.

BACKGROUND AND DESIGN: To compare the results of 4 different chemotherapy protocols in patients with colon carcinoma, 145 cases with this malignancy (61 males and 84 females), seen in the department of Medical Oncology, Cerrahpasa Faculty of Medicine, were evaluated retrospectively. The evaluation was made according to adjuvant and metastatic basis. RESULTS: Twenty-four percent of the patients were in stage II, 39.3% in stage III, and 36.6% in stage IV. Six percent of the patients were found to have inoperable disease at the time of their admission. The median survival of the patients at each stage was as follows: stage II 1903 days, stage III 1023 days, stage IV 516 days (p=0.03, p=0.0003). The FU+FA+immunomodulation (levamisole+warfarin+trexaminic acid) protocol given in an aduvant basis, was shown to induce the longest survival period of 1512 days. On the other hand, in the metastatic group, there was a longer survival rate in those treated with regimens without cisplatin (p=0.03). CONCLUSION: 5-FU+FA+immunomodulation is beneficial on an adjuvant basis in patients with colon carcinoma. However, there is still the need for more effective treatment protocols.(Return)


The results of postoperative radiotherapy in renal cell carcinoma and prognostic factors

Oner Dincbas F, Sahinler I, Abacioglu U, Senses K, Uygun N, Koca S, Okkan S

Cerrahpasa J Med 1997;28:135-140.

BACKGROUND AND DESIGN: This study was designed to assess the effect of postoperative radiotherapy in renal cell carcinoma and analyze the prognostic factors. RESULTS: Fifty patients with renal cell carcinoma who were treated with postoperative radiotherapy were retrospectively assessed. Median age was 55 years (28-69 years). Patients were irradiated with Co 60 or linear accelerators with opposed anteroposterior fields. Total dose was 46-54 Gy (1.6-1.8 Gy/ fraction). Local recurrence was seen in 5/50 (10%) patients. Five year follow-up revealed a local control rate of 88%, a disease free survival rate of 52% and an overall survival rate of 54%. In univariate analysis there was a significant difference between local control of patients in stage 1, 2, 3 versus stage 4. The disease free survival rate was statistically higher in patients younger than 60 years of age and in the ones who had less than 45 days between surgery and radiotherapy. Overall survival was longer in patients with hemoglobin levels of 10 gr or more and in cases where radiotherapy followed surgery in less than 45 days. According to multivariate analysis none of the parameters acted as a prognostic factor for local control, disease free survival and overall survival. Six patients (12%) had late complications. The majority had symptoms of chronic gastritis. CONCLUSION: Postoperative radiotherapy does not affect overall survival in renal cell carcinoma, however local control rates can be increased in some selected patients.(Return)


Serum cholesterol and depression in the elderly: Preliminary results of a cohort study

Suna Erdincler D, Ertan T, Eker E, Halifeoglu S, Ozmen M, Demiroglu C

Cerrahpasa J Med 1997;28:141-145.

BACKGROUND AND DESIGN: In this paper preliminary results of a cohort study on a population over 50 years of age were reported. The aim of the study was to investigate whether serum cholesterol level was associated with depression and whether lovastatin treatment was causing depression in patients with high serum cholesterol level. 98 patients over 50 years of age participated in the study. None of the patients had any disabling medical problem. 15 patients with serum cholesterol levels greater than 259 mg/dl were administered lovastin 10 mg/day and invited for a second visit three months later. All of the patients were cognitively intact (mini mental state examination score > 20). Hamilton Rating Scale for Depression was used to evaluate depression during pre- and posttreatment periods. RESULTS: Serum cholesterol levels showed a moderate inverse correlation (r:-0.52) with depression in the 50-59 age bracket. No correlation was detected in either of other age groups or the whole study population. However there was a slight decrease in the mean depression after treatment compared to pretreatment scores, the difference was not statistically significant. CONCLUSION: No correlation was detected between serum cholesterol level and depression in the elderly.(Return)


The evaluation of the cases with septicemia in a neonatal unit

Ilikkan B, Vural M, Ozbek S, Yardimci D, Nasiroglu O, Perk Y, Ilter O

Cerrahpasa J Med 1997;28:146-150.

BACKGROUND AND DESIGN: This study was designed to evaluate the frequency of septicemia and its consequences in our neonatal unit in Cerrahpasa Medical Faculty. The charts of newborns treated as septicemia between January 1993 and December 1995 were retrospectively evaluated. RESULTS: There were 97 newborns with septicemia. The incidence of septicemia and mortality in our level 2 and 3 units were 14.2% (97/682),and 38% (27/97) respectively. During the same period, the incidence of septicemia among the babies born in Cerrahpasa Medical Faculty, Maternity Clinic was 0.8% (80/9453). Klebsiella pneumonia was the most frequent responsible microorganism. CONCLUSION: The incidence of septicemia in our center is similar with other reports. The major difference from the units in the developed countries is the dominance of Gram negative pathogens as the causative agent in our newborns with septicemia.(Return)


Velocity measurements of finger flexors by colour Doppler imaging

Cigali BS, Buyruk M, Taskinalp O

Cerrahpasa J Med 1997;28:151-154.

BACKGROUND AND DESIGN: The purpose of this study is to measure of tendon gliding velocity of flexor pollicis longus muscle and flexor digitorum profundus muscle by the technique of colour Doppler imaging. RESULTS: The results obtained from all fingers are compared with the other side. There were no statistically significant difference between the two sides and high correlation was found. CONCLUSION: This technique may be used for the post-operative control of tendon repairs or transfer.(Return)


The effect of basic fibroblast growth factor on venous flap survival

Cerkes SN, Agir H, Mersa B, Aydin A

Cerrahpasa J Med 1997;28:155-158.

BACKGROUND AND DESIGN: Neovascularization and plasmatic imbibiton through the recipient bed plays and important role on venous flap survival. In this study we tested the effect of a very potent angiogenic support on the survival rate of the venous flap. For this aim inferior epigastric venous flap of the rats were used. Forty rats were divided into two groups: group A: with flaps infiltrated with bFGF beneath; group B: with silicon sheath applied between recipient bed and flap. The same flaps were also prepared and arranged contralaterally in 20 rats as control groups. Plannimetric scale was used to compare the differences between survived flaps. RESULTS: Flaps which infiltrated their bed with bFGF showed a higher survival rate, but the results were not statistically significant. CONCLUSION: Further investigations are needed to solve the problems about starting and maintenance therapy of this factor. (Return)


Evaluation of the activities of Internal Medicine Outpatient Department of Cerrahpasa Medical Faculty in 1995

Tunckale A, Erginoz E, Karter Y, Tamer A, Vehit S, Yaldiran A, Sipahioglu F, Ozturk E

Cerrahpasa J Med 1997;28:159-162.

BACKGROUND AND DESIGN: Patients seen at the General Internal Medicine Outpatient Department of Cerrahpasa Medical Faculty in 1995, were evaluated regarding their gender, age and diagnosis. RESULTS: 6125 patients were evaluated. The most frequent diagnoses were hypertension (18.5%), non-specific abdominal pain (8.1%), upper respiratory tract infection (6.9%), diabetes mellitus (6.3%), non-specific myalgia and arthralgias (4.8%), anemia (4.4%), lipid disorders (4.4%), low back pain (4.3%), acute bronchitis (4.2%), osteoarthrosis (4.1%), urinary infection (3.7%), coronary arterial disease (2.7%), thyroid diseases (2.4%) and chest pain (2.2%). CONCLUSION: More than 50% of the patients seen at our outpatient department could have been treated at the primary and secondary health care services of the referral chain.(Return)


Atrophodermia vermiculata-like scarring in discoid lupus erythematosus: A case report

Tuzun B, Kaner G, Simsek ZG, Gorgulu A

Cerrahpasa J Med 1997;28:163-165.

BACKGROUND: Discoid lupus erythematosus is characterized by disc shaped erythematous, slightly infiltrated plaques and thick, adherent scales. Older lesions leave atrophic scars. OBSERVATION: A case with discoid lupus erythematosus characterized by comedo-like follicular plugs and worm-eaten depressed scar is reported. Other findings of the patient were cicatricial alopecia and nonspecific dermatitis. The patient also had a diagnosis of thyroiditis. Differential diagnosis was made between atrophodermia vermiculata and discoid lupus erythematosus.(Return)


A rare skin tumour: Leiomyosarcoma

Aygit AC, Aydin Y, Baycin HN, Guzel MZ

Cerrahpasa J Med 1997;28:166-169.

BACKGROUND: Leiomyosarcoma is a very rare soft tissue tumour and the differential diagnosis is difficult. Leiomyosarcoma is seen most frequently in intraabdominal and retroperitoneal regions. Second most frequent location is the skin and subcutaneous tissues. Superficial leiomyosarcomas usually occur on the extremities and show a predilection for hair bearing extensor surfaces. OBSERVATION: We report a case of leiomyosarcoma located on the lateral aspect of the right thigh, in a 71-year-old woman. She had undergone excision of this mass (5-6 cm) elsewhere one year ago. Histopathological diagnosis was malignant fibrous histiocytoma. The patient was admitted to our clinic because of the recurrence of the mass 4 months after the operation. Tumor was excised with 3 cm normal tissue margins. Defect was covered by split skin grafting. The excisional specimen showed the features of leiomyosarcoma histologically. No clinical signs and radiological evidence of tumour recurrence were observed after one year of follow-up. Diagnosis and treatment of this rare tumour were discussed on the basis of the literature data.(Return)


New criterias in the diagnosis of infective endocarditis and some suggestions in the anatomo-pathological study

Karpuz V, Keser N

Cerrahpasa J Med 1997;28:170-173.

BACKGROUND: Infective endocarditis is still a common and serious disease. Despite the several criteria proposed, its diagnosis with certainty remains difficult in a considerable proportion of cases. This brief article reports the difficulties faced in the diagnosis of endocarditis, especially when blood cultures are negative. It emphasizes the respective roles of the microbiology and pathology laboratories for the processing of cardiac valves removed by surgery. It precises the morphological characteristics of the endocarditis. (Return)