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author:("demirel, T")
1.  Gastric Metastasis of Ectopic Breast Cancer Mimicking Axillary Metastasis of Primary Gastric Cancer 
Ectopic breast tissue has the ability to undergo all the pathological changes of the normal breast, including breast cancer. Gastrointestinal metastasis of breast cancer is rarely observed and it is very difficult to differentiate gastric metastases from primary gastric cancer. We present a case of 52-year-old female, who suffered from abdominal pain. Physical examination showed a palpable mass in the left anterior axilla and computerized tomography revealed gastric wall thickening with linitis plastica. When gastroscopic biopsy showed no signs of malignancy, excisional biopsy was performed in the left axilla. Histological examination revealed invasive lobular carcinoma of the breast, consistent with ectopic breast cancer. Further gastroscopic submucosal biopsies and immunohistochemical studies revealed gastric metastases of invasive lobular carcinoma. Axillary ectopic breast tissue carcinomas can mimic axillary lymphadenopathies. Additionally, gastric metastasis of breast cancer is an uncommon but possible condition. To the best of our knowledge, this is the first report of ectopic breast cancer with gastric metastasis.
doi:10.1155/2014/232165
PMCID: PMC4276682  PMID: 25574403
2.  Relation between inflammatory cytokine levels in serum and bronchoalveolar lavage fluid and gene polymorphism in young adult patients with bronchiectasis 
Journal of Thoracic Disease  2014;6(6):684-693.
Aim
Bronchiectasis develops as a result of genetic and environmental factors and its etiopathogenesis is not still clear. Recent studies have revealed that inflammatory cytokines, which are formed as a result of chronic infection and inflammation, play a role in the pathogenesis of bronchiectasis. For this purpose, the level of inflammatory cytokines in bronchiectasis and the presence or absence of a genetic predisposition with the gene polymorphism of these cytokines was investigated.
Material and methods
A total of 60 patients, 40 study cases and 20 controls, which were monitored with the diagnosis of bronchiectasis were included in the study. In these individuals, cytokine levels [interleukin (IL)-6, IL-8, IL-10, and tumor necrosis factor (TNF)-α] in serum and bronchoalveolar lavage (BAL) fluid, along with the routine blood tests, were determined. Furthermore, the polymorphism in IL-6, IL-8, IL-10, and TNF-α cytokine genes and its frequency were studied in the obtained DNA by the automatic sequence analysis method and the results were compared.
Findings
It was found that in serum and BAL fluid of the patient group, the IL-8 level was high, whereas the IL-10 level was low (P<0.05). No significant difference was detected in the other cytokines (P>0.05). It was found that in cytokine gene polymorphisms IL-8 -251 A/T, IL-10 -592 A/C, and IL-10 -819 T/C genotypes are associated with increased risk of bronchiectasis. It was detected that the IL-8 -251 A/T genotype increased the risk of having the disease by 4.19 fold. (OR =4.19, 95% CI =1.24-14.17, P=0.021). The IL-10 -592 C/A genotype increased the risk of having the disease by 5.71 fold (OR = 5.71, 95% CI =1.35-24.06, P=0.017) and the IL-10 -819 T/C genotype increased the risk of having the disease by 5.06 fold (OR =5.06, 95% CI =1.20-21.27, P=0.048). No significant correlation was found between the other polymorphisms and bronchiectasis.
Conclusions
The IL-8, IL-10 levels and the gene polymorphism of these cytokines differ. In addition to detecting higher levels of pro-inflammatory IL-8 and lower levels of anti-inflammatory IL-10, detection of gene polymorphism related to these two cytokines in bronchiectasis gives rise to the thought that cytokines may have role in a predisposition to bronchiectasis. However, as the number of patients is small, precise remarks could not be made on this subject. There is need for further studies include a larger number of patients.
doi:10.3978/j.issn.2072-1439.2014.04.14
PMCID: PMC4073412  PMID: 24976991
Bronchiectasis; inflammation; cytokine; DNA sequence analysis; gene polymorphism
3.  Evaluation of Quality of Life with the Chronic Obstructive Pulmonary Disease Assessment Test in Chronic Obstructive Pulmonary Disease and the Effect of Dyspnea on Disease-Specific Quality of Life in These Patients 
Yonsei Medical Journal  2013;54(5):1214-1219.
Purpose
The chronic obstructive pulmonary disease (COPD) assessment test (CAT) was recently introduced for use in assessing disease-specific quality of life and follow-up of patients with COPD. The purpose of this study was to evaluate the effect of the dyspnea on disease-specific quality of life detected by CAT score in patients with COPD.
Materials and Methods
In this study, 90 stable patients with COPD as defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria were included. The level of dyspnea was assessed with the Medical Research Council (MRC) dyspnea scale, and disease-specific quality of life was assessed with CAT score.
Results
The mean±SD age was 68.5±10.9 (range 41-97) years. A significant relationship was established between CAT score, MRC dyspnea scale score and GOLD stage in patients with COPD. There was also a positive correlation between dyspnea scale scores and GOLD stage in the patients (p<0.001), as well as positive correlation between CAT score and dyspnea scale score (p<0.001). CAT score showed a significant correlation with hospitalization and exacerbations (p<0.05).
Conclusion
Dyspnea is an important symptom that may impact quality of life in patients with COPD. CAT was shown to be a simple, fast and intelligible measurement of disease-specific quality of life, and was correlated with levels of dyspnea in patients with COPD.
doi:10.3349/ymj.2013.54.5.1214
PMCID: PMC3743182  PMID: 23918572
Chronic obstructive pulmonary disease; dyspnea; quality of life
4.  The Relationship of Orthodontic Treatment Need with Periodontal Status, Dental Caries, and Sociodemographic Factors 
The Scientific World Journal  2012;2012:498012.
The aim of this study was to determine the relationship of orthodontic malocclusion with periodontal status, dental caries, and sociodemographic status. Our study population consisted of a sample of 836 school children (384 male and 452 female, aged 11–14 years). Four experienced orthodontists and two experienced periodontists performed the clinical examinations. The Treatment Priority Index (TPI), Community Periodontal Index of Treatment Needs (CPITN), decayed, missing, filled teeth (DMFT) scores, and a questionnaire that surveyed socio-demographic status of students were used. Spearman's rank correlation coefficients were used to measure the association between variables. TPI scores showed that 36.4% of the students had normal occlusion, while 41.2% had slight, 15.7% had definite, 4% had severe, and 2.7% had very severe malocclusion. TPI values did not show any significant differences between pupils in different age, gender, socioeconomic status groups, and CPITN scores, whereas there was a significant relationship between TPI and DMFT scores. The orthodontic treatment need was not significantly correlated with CPITN or socio-demographic status; however, the correlation coefficient showed a significant relationship between TPI and DMFT scores.
doi:10.1100/2012/498012
PMCID: PMC3485904  PMID: 23193381
5.  Efficacy of serum chitotriosidase activity in early treatment of patients with active tuberculosis and a negative sputum smear 
Background
The results of sputum culture for Mycobacterium tuberculosis must be awaited in most cases, which delays the start of treatment in patients with sputum smear-negative pulmonary tuberculosis. We investigated whether plasma chitotriosidase activity is a strong marker for early diagnosis of tuberculosis in patients for whom a bacillus smear is negative and tuberculosis culture is positive.
Methods
Clinical, radiological, and laboratory features were evaluated in 75 patients, 17 of whom were diagnosed as having active tuberculosis by negative acid-fast bacillus smear and positive culture, 38 as having sequel tuberculosis which was radiologically and microbiologically negative, and 20 who served as healthy controls. Serum chitotriosidase activity levels were measured in both cases and controls.
Results
The mean age of the cases with active pulmonary tuberculosis, cases with sequel lesions, and controls was 23 ± 2.4 years, 22 ± 1.7 years, and 24 ± 2.1 years, respectively. Serum chitotriosidase levels were 68.05 ± 72.61 nmol/hour/mL in smear-negative, culture-positive pulmonary tuberculosis cases (Group A) and 29.73 ± 20.55 nmol/hour/mL in smear-negative, culture-negative sequel pulmonary tuberculosis cases (Group B). Serum chitotriosidase levels from patients in Group A were significantly higher than in Group B and Group C. There was no statistically significant difference in serum chitotriosidase levels between cases with sequel pulmonary tuberculosis (Group B, smear-negative, culture-negative) and healthy controls (Group C).
Conclusion
In patients with active tuberculosis and a negative sputum smear for acid-fast bacillus, plasma chitotriosidase activity seems to be a strong marker for diagnosis of active disease which can be used while awaiting culture results.
doi:10.2147/TCRM.S31752
PMCID: PMC3431959  PMID: 22956876
pulmonary tuberculosis; serum chitotriosidase; diagnosis; antituberculous treatment; disease activity
6.  Comparison of the Data Classification Approaches to Diagnose Spinal Cord Injury 
In our previous study, we have demonstrated that analyzing the skin impedances measured along the key points of the dermatomes might be a useful supplementary technique to enhance the diagnosis of spinal cord injury (SCI), especially for unconscious and noncooperative patients. Initially, in order to distinguish between the skin impedances of control group and patients, artificial neural networks (ANNs) were used as the main data classification approach. However, in the present study, we have proposed two more data classification approaches, that is, support vector machine (SVM) and hierarchical cluster tree analysis (HCTA), which improved the classification rate and also the overall performance. A comparison of the performance of these three methods in classifying traumatic SCI patients and controls was presented. The classification results indicated that dendrogram analysis based on HCTA algorithm and SVM achieved higher recognition accuracies compared to ANN. HCTA and SVM algorithms improved the classification rate and also the overall performance of SCI diagnosis.
doi:10.1155/2012/803980
PMCID: PMC3306787  PMID: 22474539
7.  A Radar-Enabled Collaborative Sensor Network Integrating COTS Technology for Surveillance and Tracking 
Sensors (Basel, Switzerland)  2012;12(2):1336-1351.
The feasibility of using Commercial Off-The-Shelf (COTS) sensor nodes is studied in a distributed network, aiming at dynamic surveillance and tracking of ground targets. Data acquisition by low-cost (<$50 US) miniature low-power radar through a wireless mote is described. We demonstrate the detection, ranging and velocity estimation, classification and tracking capabilities of the mini-radar, and compare results to simulations and manual measurements. Furthermore, we supplement the radar output with other sensor modalities, such as acoustic and vibration sensors. This method provides innovative solutions for detecting, identifying, and tracking vehicles and dismounts over a wide area in noisy conditions. This study presents a step towards distributed intelligent decision support and demonstrates effectiveness of small cheap sensors, which can complement advanced technologies in certain real-life scenarios.
doi:10.3390/s120201336
PMCID: PMC3304115  PMID: 22438713
Doppler radar; wireless sensor mote; autonomous sensor network; surveillance; tracking
8.  Gingival Hyperplasia as an Early Diagnostic Oral Manifestation in Acute Monocytic Leukemia: A Case Report 
European Journal of Dentistry  2007;1(2):111-114.
Acute Myeloblastic Leukemia (AML) is a malignant disease of bone marrow. Due to its high morbidity rate, early diagnosis and appropriate medical therapy is essential. Rapidly forming gingival hyperplasia is usually the first sign of this disease. This case report describes a 17-year-old female who presented rapid gingival overgrowth together with gingival bleeding in only two weeks time. A medical consultation was asked from hematology clinics and after a detailed medical examination Acute Monocytic Leukemia (FAB M5) was rendered. Chemotherapy was the choice of treatment. The patient responded well to chemotherapeutic induction regimen and after two months of medical therapy disease remised and gingival hyperplasia regressed. This case report shows that the gingival hyperplasia may represent an initial manifestation of an underlying systemic disease. Also, early medical therapy in acute monocytic leukemia may resolve the gingival hyperplasia that companies the disease progression.
PMCID: PMC2609944  PMID: 19212486
Acute monocytic leukemia; Gingival hyperplasia
9.  Salvage high-dose chemotherapy for children with extragonadal germ-cell tumours 
British Journal of Cancer  2005;93(4):412-417.
We reviewed the European Group for Blood and Marrow Transplantation (EBMT) experience with salvage high-dose chemotherapy (HDC) in paediatric patients with extragonadal germ-cell tumour (GCT). A total of 23 children with extragonadal GCT, median age 12 years (range 1–20), were treated with salvage HDC with haematopoietic progenitor cell support. The GCT primary location was intracranial site in nine cases, sacrococcyx in eight, retroperitoneum in four, and mediastinum in two. In all, 22 patients had a nongerminomatous GCT and one germinoma. Nine patients received HDC in first- and 14 in second- or third-relapse situation. No toxic deaths occurred. Overall, 16 of 23 patients (70%) achieved a complete remission. With a median follow-up of 66 months (range 31–173 months), 10 (43%) are continuously disease-free. Of six patients who had a disease recurrence after HDC, one achieved a disease-free status with surgical resection followed by chemotherapy and radiotherapy. In total, 11 patients (48%) are currently disease-free. Eight of 14 patients (57%) with extracranial primary and three of nine patients (33%) with intracranial primary GCT are currently disease-free. HDC induced impressive long-term remissions as salvage treatment in children with extragonadal extracranial GCTs. Salvage HDC should be investigated in prospective trials in these patients.
doi:10.1038/sj.bjc.6602724
PMCID: PMC2361583  PMID: 16106248
extragonadal germ cell tumour; high-dose chemotherapy; salvage therapy; children

Results 1-9 (9)