Survival Results and Prognostic Factors in T4 N0-3 Non-small Cell Lung Cancer Patients According to the AJCC 7^th Edition Staging System

Arslan, Deniz,Bozcuk, Hakan,Gunduz, Seyda,Tural, Deniz,Tattli, Ali Murat,Uysal, Mukremin,Goksu, Sema Sezgin,Bassorgun, Cumhur Ibrahim,Koral, Lokman,Coskun, Hasan Senol,Ozdogan, Mustafa,Savas, Burhan Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.6

Background: The American Joint Committee on Cancer (AJCC) published a new staging system ($7^{th}$ edition) in 2009. In our study, we evaluated the survival results and prognostic factors among T4 local advanced non-small cell lung cancer (LA-NSCLC) patients in a large heterogeneous group, in accordance with this new system. Materials and Methods: We retrospectively evaluated the files of 122 T4 N0-3 M0 LA-NSCLC patients, identified according to the new staging system, treated at two centers between November 2003 and June 2012. Variables correlating with univariate survival at p<0.20 were later included in multivariate Cox regression analysis. Here, selection of relevant predictors of survival was carried out in accordance with the likelihood ratio formula with p<0.05 regarded as significant. Results: The median age was 60 and the median follow-up period was 17.4 months. Median overall survival (OS) was 18.3 months, the 1 year overall survival (OS) rate was 72%, and the 5 year OS rate was 28%. Statistically significant predictors of survival were (p<0.20) ECOG-PS (Eastern Cooperative Oncology Group Performance Status), age, T4 factor subgroup, stage and primary treatment in OS univariate analysis. On multivariate analysis for OS ECOG-PS (p=0.001), diagnostic stage (p=0.021), and primary treatment (p=0.004) were significant. In the group receiving non-curative treatment, the median OS was 11.0 months, while it was 19.0 months in the definitive RT group and 26.6 months in the curative treatment group. There was a significant difference between the non-curative group and the groups which had definitive RT and curative operations (respectively p<0.001 and p=0.001) in terms of OS, but not between the groups which had definitive RT and curative operations. The median event free survival (EFS) rate was 9.9 months, with rates of 46% and 19% at 3 and 5 years, respectively. On univariate analysis of EFS rate with ECOG-PS, weight loss and staging, statistical significance was found only for thorax computerized tomography (CT)+18F-fluorodeoxy-glucose positron emission tomography-CT (PET-CT) use, stage and primary treatment (p<0.20). In multivariate analysis with EFS, only the primary treatment was statistically significant (p=0.001). In the group receiving non-curative treatment, the median EFS was 10.5 months while in the curative operation group it was 14.7 months. When all the primary treatment groups were taken into consideration, grade III/IV side effect swas observed in 57 patients (46.6%). Esophagitis was most prominent among those that received definitive radiotherapy. Conclusions: Independent prognostic factors among these 122 heterogeneous LA-NSCLC T4 N0-3 M0 patients were age at diagnosis, ECOG-PS, stage and primary treatment, the last also being a significant prognostic indicator of EFS. Our findings point to the importance of appropriate staging and a multidisciplinary approach with modern imaging methods in this patient group. In those with T4 lesions, treatment selection and the effective use of curative potential should be the most important goal of clinical care.

Cancer Pain Prevalence and its Management

Arslan, Deniz,Koca, Timur,Akar, Emre,Tural, Deniz,Ozdogan, Mustafa Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.20

Pain is a public health problem affecting more than half of cancer patients. Despite the success of the protocols currently used, pain cannot still be reduced satisfactorily in the large majority of patients. In order to improve pain management, all healthcare professionals involved with pain should have sufficient knowledge on pain assessment and treatment, and should inform patients to prevent patient-related barriers. In this compilation, the prevalence values and the treatment methods of cancer pain, and the barriers to pain management have been assessed.

Increase in the Rate of HPV Positive Oropharyngeal Cancers During 1996-2011 in a Case Study in Turkey

Tural, Deniz,Elicin, Olgun,Batur, Sebnem,Arslan, Deniz,Oz, Buge,Serdengecti, Suheyla,Uzel, Omer Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.10

Background: Primary aim of this study is to assess whether or not there is an increase at rate of HPV positive oropharyngeal cancers during 1996-2011 in Turkey, for comparison with prior reports from Western countries. Materials and Methods: A total of 138 newly diagnosed patients with oropharyngeal cancer were identified, 39 of which had no primary tumor specimen available and 18 patients with invalid HPV status, therefore HPV status for remaining 81 patients was evaluated. The presence and type of HPV DNA were determined with formalin-fixed paraffin embedded specimens, using an HPV DNA-based multiplex PCR assay. Associations between HPV status and clinicopathological characteristics were evaluated using a two-sample t-test for the continuous variables and the categorical variables were compared by chi-square test. Overall survival (OS) periods were calculated with Kaplan-Meier method. Results: The proportion of HPV-positive cancer has continued to increase during 2004-2011 as compared with 1996-2003. Notably, 33% (6/18) of the cases were HPV-positive in 1996-1999, 43% (9/21) in 2000-2003, 55% (11/20) in 2004-2007 and 70% (16/23) in 2008-2011. Thus, when we compared the results obtained during the 2004-2011with results of 1996-2003 period, we found that increase at HPV-positivity ratio was statistically significant (38% vs 64% p=0.012). Conclusions: This study demonstrated that HPV positive oropharyngeal cancers are increasing in Turkish patients as in the Western world.

Antinociceptive Effect of Chlorogenic Acid in Rats with Painful Diabetic Neuropathy

Deniz Bagdas,Hasret Yucel Ozboluk,Nilufer Cinkilic,Mine Sibel Gurun 한국식품영양과학회 2014 Journal of medicinal food Vol.17 No.6

The present study aimed to evaluate possible antinociceptive effects of chlorogenic acid in streptozotocininduced diabetic neuropathic pain in rats. Chlorogenic acid (100 mg/kg) was administered daily for 14 days. Our study showed for the first time that both single and chronic chlorogenic acid treatments produced significant antinociceptive effects in diabetic rats. In contrast, single dose of chlorogenic acid showed no signs of an antinociceptive effect, but chronic treatment exerted antinociceptive potential in nondiabetic rats. Additionally, chronic treatment effectively reduced hyperglycemia that induced by diabetes. In conclusion, chlorogenic acid has beneficial effects for the management of diabetic neuropathic pain.

Mercury Promotes Catecholamines Which Potentiate Mercurial Autoimmunity and Vasodilation: Implications for Inositol 1,4,5-Triphosphate 3-Kinase C Susceptibility in Kawasaki Syndrome

Deniz Yeter,Richard Deth,Ho-Chang Kuo 대한심장학회 2013 Korean Circulation Journal Vol.43 No.9

Previously, we reviewed biological evidence that mercury could induce autoimmunity and coronary arterial wall relaxation as observed in Kawasaki syndrome (KS) through its effects on calcium signaling, and that inositol 1,4,5-triphosphate 3-kinase C (ITPKC) susceptibility in KS would predispose patients to mercury by increasing Ca 2+ release. Hg 2+ sensitizes inositol 1,4,5-triphosphate (IP3) receptors at low doses, which release Ca 2+ from intracellular stores in the sarcoplasmic reticulum, resulting in delayed, repetitive calcium influx. ITPKC prevents IP3from triggering IP3 receptors to release calcium by converting IP3 to inositol 1,3,4,5-tetrakisphosphate. Defective IP3 phosphorylation re-sulting from reduced genetic expressions of ITPKC in KS would promote IP3, which increases Ca 2+ release. Hg 2+ increases catecholamine levels through the inhibition of S-adenosylmethionine and subsequently catechol-O-methyltransferase (COMT), while a single nucleotide polymorphism of the COMT gene (rs769224) was recently found to be significantly associated with the development of coronary artery le -sions in KS. Accumulation of norepinephrine or epinephrine would potentiate Hg 2+ -induced calcium influx by increasing IP3 production and increasing the permeability of cardiac sarcolemma to Ca 2+ . Norepinephrine and epinephrine also promote the secretion of atrial natri-uretic peptide, a potent vasodilator that suppresses the release of vasoconstrictors. Elevated catecholamine levels can induce hypertension and tachycardia, while increased arterial pressure and a rapid heart rate would promote arterial vasodilation and subsequent fatal throm-boses, particularly in tandem. Genetic risk factors may explain why only a susceptible subset of children develops KS although mercury ex-posure from methylmercury in fish or thimerosal in pediatric vaccines is nearly ubiquitous. During the infantile acrodynia epidemic, only 1in 500 children developed acrodynia whereas mercury exposure was very common due to the use of teething powders. This hypothesis mirrors the leading theory for KS in which a widespread infection only induces KS in susceptible children. Acrodynia can mimic the clinical picture of KS, leading to its inclusion in the differential diagnosis for KS. Catecholamine levels are often elevated in acrodynia and may also play a role in KS. We conclude that KS may be the acute febrile form of acrodynia.

Number of FoxP3+ regulatory T-cells are associated with recurrence in vulvar squamous cell carcinoma

Deniz Arık,Tutku Benli,Elçin Telli 대한부인종양학회 2023 Journal of Gynecologic Oncology Vol.34 No.2

Objective: Surgical management is essential in early-stage vulvar squamous cell carcinoma (SCC), but these surgical procedures often cause significant morbidity. Immunotherapy may be a new treatment option in these patients. FoxP3+ Tregs suppress anti-tumor immune responses. High intratumoral FoxP3+ Treg infiltration has been reported to be associated with poor prognosis in most solid tumors. However, there are also conflicting results. We evaluated FoxP3+ lymphocyte infiltration in vulvar SCC and aimed to determine its relationship with prognosis and clinicopathological parameters. Methods: Cases diagnosed with vulvar SCC in our department were retrospectively reviewed. The paraffin block that best reflects the morphology was selected, and immunohistochemical studies were performed in accordance with the manufacturer’s instructions. FoxP3+ lymphocyte counts were made in tumoral stroma and within tumoral cell islands separately in hot-spot areas. Results: We found a positive correlation between high FoxP3+ lymphocyte count and good prognostic parameters. There was less recurrence in the group with high FoxP3+ lymphocyte counts in tumoral cell islands. Overall survival was not statistically different between these groups. Less lymphovascular invasion was observed in the group with high lymphocyte count in the tumoral stroma. Conclusion: In vulvar SCC, FoxP3+ Treg infiltration into the tumor stroma and into tumoral cell islands is associated with good prognostic features. In these tumors, stage appeared as the only independent prognostic parameter. Studies to be conducted in larger series may reveal whether Tregs can be targeted in cancer treatment.

Prevalence of Daytime Urinary Incontinence and Related Risk Factors in Primary School Children in Turkey

Deniz Bolat,Ismail Cenk Acar,Ali Ersin Zumrutbas,Saadettin Eskicorapci,Eyup Burak Sancak,Mehmet Zencir,Tahir Turan,Zafer Sinik 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.3

Purpose: Urinary incontinence is one of the major urinary symptoms in children andadolescents and can lead to major distress for the affected children and their parents. In accordance with the definitions of the Standardization Committee of theInternational Children’s Continence Society, daytime urinary incontinence (DUI) isuncontrollable leakage of urine during the day. The aim of this cross-sectional studywas to investigate the prevalence and associated risk factors of DUI in Turkish primaryschool children. Materials and Methods: The questionnaire, which covered sociodemographic variablesand the voiding habits of the children, was completed by the parents of 2,353 childrenwho were attending primary school in Denizli, a developing city of Turkey. The children’svoiding habits were evaluated by use of the Dysfunctional Voiding andIncontinence Symptoms Score, which is a validated questionnaire. Children with a historyof neurological or urological diseases were excluded. Results: The participation rate was 91.9% (2,164 people). The overall prevalence of DUIwas 8.0%. The incidence of DUI tended to decrease with increasing age and was notsignificantly different between genders (boys, 8.8%; girls, 7.3%; p=0.062). Age, maternaleducation level, family history of daytime wetting, settlement (urban/rural), historyof constipation, urinary tract infection, and urgency were independent risk factors ofDUI. Conclusions: Our findings showed that DUI is a common health problem in primaryschool children. In an effort to increase awareness of children’s voiding problems andthe risk factors for urinary dysfunction in the population, educational programs andlarger school-based screening should be carried out, especially in regions with low socioeconomic status.

Seismic-Stratigraphic study of the northern East China Sea shelf basin : Basin structure and igneous activity

DENIZ CUKUR,GWANG HOON LEE,HYUN CHUL HAN,KANG MOO HEE,KYUNG O KIM 대한지질학회 2008 대한지질학회 학술대회 Vol.2008 No.

Submarine landslides along the western margin of the Ulleung Basin, East Sea

Deniz Cukur,Seong-Pil Kim,Gee-Soo Kong,Jang-Jun Bahk,Senay Horozal,In-Kwon Um,Gwang-Soo Lee,Tae-Soo Chang,Hun-Jun Ha,David Volker 대한지질학회 2016 대한지질학회 학술대회 Vol.2016 No.10

Effects of calcium silicate cements on neuronal conductivity

Deniz-Sungur Derya,Onur Mehmet Ali,Akbay Esin,Tan Gamze,Daglı-Comert Fügen,Sayın Taner Cem 대한치과보존학회 2022 Restorative Dentistry & Endodontics Vol.47 No.2

Objectives This study evaluated alterations in neuronal conductivity related to calcium silicate cements (CSCs) by investigating compound action potentials (cAPs) in rat sciatic nerves. Materials and Methods Sciatic nerves were placed in a Tyrode bath and cAPs were recorded before, during, and after the application of test materials for 60-minute control, application, and recovery measurements, respectively. Freshly prepared ProRoot MTA, MTA Angelus, Biodentine, Endosequence RRM-Putty, BioAggregate, and RetroMTA were directly applied onto the nerves. Biopac LabPro version 3.7 was used to record and analyze cAPs. The data were statistically analyzed. Results None of the CSCs totally blocked cAPs. RetroMTA, Biodentine, and MTA Angelus caused no significant alteration in cAPs (p > 0.05). Significantly lower cAPs were observed in recovery measurements for BioAggregate than in the control condition (p < 0.05). ProRoot MTA significantly but transiently reduced cAPs in the application period compared to the control period (p < 0.05). Endosequence RRM-Putty significantly reduced cAPs. Conclusions Various CSCs may alter cAPs to some extent, but none of the CSCs irreversibly blocked them. The usage of fast-setting CSCs during apexification or regeneration of immature teeth seems safer than slow-setting CSCs due to their more favorable neuronal effects.