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Öğe Characteristics of the admissions of cancer patients to emergency department(Zerbinis Medical Publ, 2012) Yucel, N.; Erkal, H. Sukru; Akgun, F. Sinem; Serin, M.Purpose: To identify the characteristics of admission of patients with cancer in the emergency department of a university hospital. Methods: The medical records of 468 emergency department admissions of 336 cancer patients due to medical conditions that were related either to their cancer or its treatment were reviewed and retrospectively analysed. Results: There were 226(67%) males and 110 females (37%), with a median age of 60 years (range 17-93). Regarding cancer staging, 156 (46%) patients had locoregional disease and 180 (54%) metastatic disease. Regarding performance status (PS), 321 (69%) were Eastern Cooperative Oncology Group (ECOG) 1-2, and 147 (31%) were ECOG 3-4. The main causes of emergency department admission were cancer progression in 188 (40%) patients, cancer-related signs and symptoms in 203 (43%) and treatment-related complications in 77 (16%). The most common primary cancer sites were the thorax, the gastrointestinal system and the genitourinary system. The medical condition necessitating emergency department admission was local tumor compression in 144 (31%) admissions, infection in 86 (19%) and end-of-life support in 63 (13%). Conclusion: Cancer patients seeking nonscheduled medical care and admitting to emergency departments present many challenges to the emergency physician. Due to the associated high morbidity and mortality, initial evaluation of the patient in the emergency department and therapy have utmost importance in the outcome of the patient. Accurate diagnosis and appropriate treatment of cancer-related problems can improve the quality of life dramatically in patients with cancer.Öğe Chondroradionecrosis in two patients with laryngeal carcinoma(Kulak Burun Boğaz İhtisas Dergisi, 2007) Fırat, Yezdan; Kızılay, Ahmet; Fırat, Ahmet Kemal; Serin, M.; Erkal, H.S.Postradiotherapy necrosis in the larynx is a rare but serious complication. It must be differentiated from tumor recurrence with radiological and histopathological studies. Herein, we presented two patients with stage II and stage IV larynx carcinoma who developed chondroradionecrosis following radiotherapy. The first patient did not accept surgical treatment and was treated with curative radiotherapy at a dose of 70 Gy. The other one received adjuvant radiotherapy at a dose of 46 Gy following total laryngectomy and bilateral functional neck dissection. The two patients were evaluated with computed tomography and magnetic resonance imaging, respectively. Pathologic examination of multiple biopsies taken from both cases showed coagulation necrosis without malignancy. The first patient had grade IV radionecrosis according to the Chandler classification and underwent total laryngectomy because of non-functional larynx. Histopathologically, there were no malignant cells, but widespread fibrosis and coagulation necrosis. The other patient was treated with conservative treatment and local debridement.Öğe Histopathological efficiency of amifostine in radiation-induced heart disease in rats(Comenius Univ, 2018) Gurses, I; Ozeren, M.; Serin, M.; Yucel, N.; Erkal, H. S.OBJECTIVE: Amifositine is a phosphorylated thiol that holds its radioprotective actions by several indirect mechanisms. The purpose of this study was to evaluate histopathologically whether amifositine administration prior to irradiation would have a long-term protective effect on heart tissue in an experimental rat model. METHODS: Single dose of 18 Gy radiation and sham radiation exposure were used in related groups. A dose of 200 mg/kg of amifostine was injected intraperitoneally 30 min prior to radiation exposure. Analyses were performed 6 months after irradiation. RESULTS: Vascular damage and vasculitis were significantly decreased in amifositine treatment group. At the same time, significant thickening of the medial layer was accompanied by vascular damage in irradiated groups. The number and severity of myocyte necrosis were diminished with amifostine. Nevertheless, it could not prevent epicardial and myocardial fibrosis. Severe myocardial fibrosis was observed prominently in three regions, particularly on the apex, tips of papillary muscles and in sites adjacent to the atrioventricular valves. The anti-inflammatory effect of amifostine was not seen. CONCLUSION: The development of vascular damage and vasculitis were prevented by the use of amifostine. There was a correlation between vascular damage and fibrosis development. According to histopathological results, amifostine could be used as a protective agent against the side effects of radiotherapy (Tab. 4, Fig. 2, Ref. 22).Öğe Histopathological efficiency of amifostine in radiation-induced heart disease in rats(Comenıus unıv, sch medıcıne, spıtalska 24, bratıslava ı, sk-813 72, slovakıa, 2018) Gurses, I; Ozeren, M; Serin, M.; Yücel, N; Erkal, HSOBJECTIVE: Amifositine is a phosphorylated thiol that holds its radioprotective actions by several indirect mechanisms. The purpose of this study was to evaluate histopathologically whether amifositine administration prior to irradiation would have a long-term protective effect on heart tissue in an experimental rat model. METHODS: Single dose of 18 Gy radiation and sham radiation exposure were used in related groups. A dose of 200 mg/kg of amifostine was injected intraperitoneally 30 min prior to radiation exposure. Analyses were performed 6 months after irradiation. RESULTS: Vascular damage and vasculitis were significantly decreased in amifositine treatment group. At the same time, significant thickening of the medial layer was accompanied by vascular damage in irradiated groups. The number and severity of myocyte necrosis were diminished with amifostine. Nevertheless, it could not prevent epicardial and myocardial fibrosis. Severe myocardial fibrosis was observed prominently in three regions, particularly on the apex, tips of papillary muscles and in sites adjacent to the atrioventricular valves. The anti-inflammatory effect of amifostine was not seen. CONCLUSION: The development of vascular damage and vasculitis were prevented by the use of amifostine. There was a correlation between vascular damage and fibrosis development. According to histopathological results, amifostine could be used as a protective agent against the side effects of radiotherapy (Tab. 4, Fig. 2, Ref. 22).
