Evaluating interleukin-16 expression in patients with grade-3 and grade-4 glial cell tumors and healthy individuals.

Background: This study evaluated the change in IL-16 levels in patients with high-grade glial tumors undergoing radiotherapy (RT) and healthy individuals (control group). Materials and Methods: Serum IL-16 levels of 35 high-grade glioma patients receiving radiotherapy (RT) and 30 healthy individuals were compared. We compared the IL-16 levels before (RT0) and after the (RT1) and IL-16 levels were measured and the relationship of this change with other characteristics such as age, gender, weight, height, and blood test results. Results: The RT0-IL-16 level was approximately 15 pg/ml higher than the RT1 measurement in the patient group. The mean RT0-IL-16 levels in the patient group were approximately 10 pg/ml higher than the mean IL-16 levels in the control group. Likewise, at the RT1 time-point, the mean IL-16 levels for the patient group were approximately 5 pg/ml lower than the mean IL-16 for the control group. The mean RT0-RT1-IL-16 value tended to be higher in female patients than in male patients. Conclusion: The application of RT reduces the overall IL-16 levels, suggesting the efficacy of RT, as well as the role of IL-16 in tumorigenesis.

Investigation of simultaneous effects of noise barriers on near-road noise and air pollutants.

Noise barriers are one of the common solutions to control road traffic noise. Many studies have also shown that noise barriers cause reductions in near-road air pollutant concentrations. In this study, the simultaneous effects of a specific noise barrier application on near-road noise and air pollution at a specific location were investigated. In this context, air pollution, noise, and meteorological parameters were measured simultaneously at two points, road and receptor sides of a 50 m long, 4 m high glass fiber reinforced concrete noise barrier on a highway section. Results indicated that the noise barrier has an average 23 % reduction effect on the NOx concentration in addition to the noise level reduction at the receptor side. Besides, bi-weekly average passive sampler measurement results for BTEX pollutants indicate lower values at the receptor side of the barrier compared to the free field measurement results. In addition to real-time and passive sampler measurements, NOx and noise dispersions were modeled using RLINE and SoundPLAN 8.2 software, respectively. Comparisons of the measurement results with the model results indicated strong correlations. Model-calculated NOx and noise values under the free field conditions are highly compatible with a correlation coefficient (r) of 0.78. Although the noise barrier has a reduction effect on both parameters, it has been observed that their dispersion mechanisms are different. This study showed that noise barriers considerably affect the dispersion of road-sourced air pollutants at the receptor side. Further studies are needed to optimize noise barrier designs with different physical and material properties and application scenarios considering noise and air pollutants together.

Associating IDH and TERT Mutations in Glioma with Diffusion Anisotropy in Normal-Appearing White Matter.

BACKGROUND AND PURPOSE: IDH and TERT mutations might infiltratively manifest within normal-appearing white matter with specific phenotypes such as microstructural changes undetectable by standard MR imaging contrasts but potentially associable with DTI variables. The aim of this retrospective glioma study was to statistically investigate IDH and TERT associations and classifications with DTI reported microstructure in normal-appearing white matter. MATERIALS AND METHODS: Retrospective data from patients imaged between March 2012 and February 2016 were analyzed by grouping them as IDH-TERT subgroups and by IDH and TERT mutation status. DTI variables in the IDH-TERT subgroups were first identified by the Kruskal-Wallis test, followed by Dunn-Sidák multiple comparisons with Bonferroni correction. IDH and TERT mutations were compared with the Mann-Whitney U test. Classification by thresholding was tested using receiver operating characteristic analysis. RESULTS: Of 170 patients, 70 patients (mean age, 43.73 [SD, 15.32] years; 40 men) were included. Whole-brain normal-appearing white matter fractional anisotropy (FA) and relative anisotropy (RA) (P = .002) were significantly higher and the contralateral-ipsilateral hemispheric differences, ΔFA and ΔRA, (P < .001) were significantly lower in IDHonly patients compared with TERTonly, with a higher whole-brain normal-appearing white matter FA and RA (P = .01) and ΔFA and ΔRA (P = .002) compared to double positive patients. Whole-brain normal-appearing white matter ADC (P = .02), RD (P = .001), λ2 (P = .001), and λ3 (P = .001) were higher in IDH wild-type. Whole-brain normal-appearing white matter λ1 (AD) (P = .003), FA (P < .001), and RA (P = .003) were higher, but Δλ1 (P = .002), ΔFA, and ΔRA (P < .001) were lower in IDH mutant versus IDH wild-type. ΔFA (P = .01) and ΔRA (P = .02) were significantly higher in TERT mutant versus TERT wild-type. CONCLUSIONS: Axial and nonaxial diffusivities, anisotropy indices in the normal-appearing white matter and their interhemispheric differences demonstrated microstructural differences between IDH and TERT mutations, with the potential for classification methods.

The effects of radiotherapy on arterial diameters in patients with high-grade glial tumors who have undergone adjuvant radiotherapy.

Background and Aims: Our purpose was to evaluate the M2 branch of the middle cerebral artery (MCA) in high-grade glial tumor patients who undergo adjuvant radiotherapy (RT). For this purpose, the diameter of the M2 branch was measured and evaluated by means of contrast-enhanced magnetic resonance imaging (CE-MRI) before and after RT. Post-radiotherapeutical measurements were made 1, 3, 5, and 7 months after the procedure; and vascular diameter alterations were evaluated. Materials and Methods: CE-MRI examinations were performed on the 32 patients enrolled in the study, who had undergone radiotherapy of the temporoparietal region. MRI examinations were performed prior to RT (RT0) and 1 (RT1), 3 (RT2), 5 (RT3), and 7 (RT4) months after RT. The M2 branch of the MCA was evaluated on MRI images, and the vessel diameter was measured in millimeters (mm), and then comparisons were made. Results: Statistically significant results were obtained during RT0-RT1, RT0-RT2, RT0-RT3, RT0-RT4, RT1-RT2, RT2-RT4, and RT3-RT4, and comparisons of the diameters of the M2 branch of the right MCA were performed (P < 0.05). When the same measurements and comparisons were made for the M2 branch of the left MCA, statistically significant results were found for the RT1-RT2, RT1-RT3, and RT1-RT4 comparisons (P < 0.05). Conclusion: Our study showed that the MCA M2 branch diminished in size following RT. This was demonstrated by means of CE-MRI controls performed up to 7 months after the completion of the RT procedures.

COVID-19: booster(s) vs. hospitalization and Intensive Care Unit admission.

OBJECTIVE: As the pandemic continues, different vaccine protocols have been implemented to maintain the protection of vaccines and to provide protection against new variants. The aim of this study was to assess hospitalized patients' vaccination status and document the efficacy of boosters. PATIENTS AND METHODS: The patients that were hospitalized due to COVID-19 were enrolled from 28 hospitals in Turkey for five months from September 2021. 5,331 confirmed COVID-19 patients from collaborating centers were randomly enrolled to understand/estimate the distribution of vaccination status in hospitalized patients and to compare the efficacy of vaccination/booster protocols. RESULTS: 2,779 men and 2,552 women of which 2,408 (45.2%) were admitted to Intensive Care Units participated in this study. It was found that the highest risk reduction for all age groups was found in groups that received 4 doses. Four doses of vaccination for every 3.7 people under 50 years of age, for every 5.7 people in the 50-64 age group, and for every 4.3 people over 65 years of age will prevent 1 patient from being admitted to intensive care. Regardless of the type of vaccine, it was found that the risk of ICU hospitalization decreased in those who were vaccinated compared to those who were not vaccinated. Regardless of the type of vaccine, the ICU risk was found to decrease 1.25-fold in those who received 1 or 2 doses of vaccine, 1.18-fold in those who received 3 doses, and 3.26-fold in those who received 4 doses. CONCLUSIONS: The results suggested that the addition of a fourth dose is more effective in preventing intensive unit care even in disadvantaged groups.

Evaluation of IL-17A expressions in high-grade glial tumors receiving radiotherapy.

Aim: In this study, we aimed to investigate the interleukin-17A (IL-17A) levels in patients with high-grade glial tumors before receiving radiotherapy, immediately after radiotherapy, and 3 months after radiotherapy. Patients and Methods: A total of 33 patients who applied to Adana City Training and Research Hospital, Department of Radiation Oncology between December 2016 and May 2018 was included in this study. A total of three blood samples was taken from each patient to assess IL-17A levels before and after radiotherapy and 3 months after the completion of radiotherapy. Results: The differences in IL-17A levels between genders were not statistically significant. IL-17A levels progressively decreased after the radiotherapy and 3 months after the radiotherapy as compared to the levels before radiotherapy. However, this was not statistically significant. IL-17A levels in the non-surviving patients were high before and after radiotherapy as compared to the surviving ones, but this was also not statistically significant. Conclusion: As compared to the period before radiotherapy, IL-17A levels tend to decrease in the period of acute and chronic phases of radiotherapy in all patient groups.

Impact of social contacts on SARS-CoV-2 exposure among healthcare workers.

BACKGROUND: Healthcare workers (HCWs) have an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection due to occupational exposure. Strict measures generally focus on the patient-to-HCW contacts. However, interactions between the HCWs also pose a high risk for SARS-CoV-2 exposure. AIMS: This study was aimed to investigate the effect of social contacts on the level of SARS-CoV-2 exposure risk among workers by broadening the current risk assessment algorithm. METHODS: Contact tracing records of the workers in a large university hospital between 19th March and 31st December 2020 were analysed. Multivariate conditional logistic regression models were estimated to evaluate factors associated with high-risk exposure for contacts among workers. RESULTS: Of the 329 exposed clusters, 260 (79%) were HCW-to-HCW contacted clusters. High-risk exposure was higher in the HCW-to-HCW contacts (44%), when compared to the patient-to-HCW contacts (5%) (P < 0.001). A total of 1827 HCWs contacted a laboratory-confirmed COVID-19-positive co-worker. Among the HCW-to-HCW contacts, high-risk exposure was higher in the support staff (49%, P < 0.001), in non-patient care settings (47%, P < 0.001) and in the social contacts (57%, P < 0.001). Social contacts between workers increased the high-risk exposure (adjusted odds ratio: 3.50, 95% confidence interval 2.62-4.69) in multivariate analysis. CONCLUSIONS: A significant association between social contacts among workers and high-risk exposure of SARS-CoV-2 was observed. The results of the study emphasize the need for policies regarding the improved protection of HCWs in social settings in addition to patient care services.

Vitamin D Receptor Polymorphisms Among the Turkish Population are Associated with Multiple Sclerosis.

Multiple sclerosis (MS) is an inflammatory disease characterized by demyelination and axonal degeneration affecting the central nervous system. Among the genetic factors suggested to be associated with this disease are polymorphisms to the vitamin D receptor (VDR) gene. We tested the hypothesis that polymorphisms in the vitamin D receptor (VDR) gene are associated with MS. The aim of the study was to investigate the relationship of MS with the VDR gene Fok-I, Bsm-I and Taq-I polymorphisms among the Turkish population. This study contains 271 MS patients and 203 healthy controls. Genomic DNA was isolated from the samples and the VDR gene Fok-I, Bsm-I and Taq-I polymorphism regions were amplified by polymerase chain reaction (PCR). The PCR products were digested, and the genotypes were determined based on size of digested PCR products. Our results demonstrate associations between MS and the distribution of the VDR gene Fok-I T/T polymorphism genotype in a dominant model, VDR gene Fok-I T allele frequency, distribution of VDR gene Taq-I C/C polymorphism genotype in a dominant model and VDR gene Taq-I C allele frequency (Pearson test, p<0.05). However, there was no association between MS and the VDR gene Bsm-I polymorphisms for the genotype distribution (Pearson test, p>0.05) or allele frequency (Pearson test, p>0.05). Fok-I and Taq-I VDR gene polymorphisms are significantly associated with MS in dominant, homozygote and heterozygote inheritance models among the Turkish population.

Does the plasma application time affect the tensile bond strength between PMMA and a silicone-based denture liner?

AIMS: This study evaluated the effect of oxygen plasma and argon plasma treatments with different application times on tensile bonding of a silicone-based denture liner to polymethylmetacrylate (PMMA). METHODS: Seven groups (n = 5) were prepared and six of them treated by argon plasma or oxygen plasma with 30s, 60s, and 120s, respectively; one group was left untreated served as control. After processing of denture liner, the specimens were deflasked and stored dry for 24 h, and they were then subjected to tensile bond strength testing. Differences in tensile bond strength values were determined using one-way ANOVA (α = 0.05). RESULTS: Highest tensile bond strengths were observed in the oxygen plasma groups, followed by untreated group and argon plasma groups in turn in order. Tensile bond strenght were increased with time for both type of plasma applications tested. CONCLUSION: This study suggests that the adhesion between PMMA and denture liner is improved under conditions of oxygen plasma treatment with extended exposure time rather than argon plasma treatment.

Silibinin and ellagic acid increase the expression of insulin receptor substrate 1 protein in ultraviolet irradiated rat skin.

Daily exposure to ultraviolet (UV) light induces inflammation and tumorigenesis in the skin. Silibinin and ellagic acid are natural products that exhibit anti-inflammatory and anti-tumorigenic properties. Insulin receptor substrate protein 1 (IRS1) is important for skin homeostasis and physiology, but its activity following UV radiation remains unclear. We investigated the effects of ellagic acid and silibinin on IRS1 expression in ultraviolet A (UVA) and ultraviolet B (UVB) irradiated rat skin. Forty-two female Wistar rats were divided randomly into six groups of seven animals. The dorsal skin of rats was exposed to UVA + UVB, then treated with ellagic acid and silibinin by gavage. IRS1 expression in skin tissues was determined by western blot analysis. IRS1 expression increased significantly following treatment with ellagic acid and silibinin in UVA + UVB irradiated skin compared to the UVA + UVB only group. After UVA + UVB treatment, ellagic acid effected greater induction of IRS1 expression than silibinin. Our findings suggest that the photoprotective roles of ellagic acid and silibinin may be due to induction of IRS1 expression in UVA + UVB treated rat skin.

The dynamics of prehospital/hospital care and modes of transport during civil conflict and terrorist incidents.

OBJECTIVE: Prehospital and hospital care during incidents of mass violence and civil conflict involve a number of aspects that distinguish it from care during times of peace. We aimed to analyze the dynamics and outcomes of prehospital and hospital care during ongoing conflicts. STUDY DESIGN: Multicentric prospective observational study. METHOD: Patients enrolled in the study, which was conducted in Turkey, were all injured in armed conflict and taken to level 1 trauma centers. On admittance, patients were requested to complete a semistructured questionnaire containing questions on patient demographics, transport type, weapons used, injury severity score (ISS), and other incident-related factors. We analyzed patient outcomes (mortality, morbidity, complications, and length of hospital stay) and transfers of patients between hospitals. The present study evaluated the cases of 390 victims enrolled over a 9-month period and followed up for 6 months. RESULTS: The majority of patients were transported by ambulances (n = 334, 85.6%); other transport modes were helicopters (n = 32, 8.2%) and private vehicles (n = 24, 6.2%). Nearly half of patients (48.7%) did not benefit by changing hospitals. During transport to hospitals, 4.1% of the vehicles in the study were involved in accidents. Using multiple regression analysis, only ISS (odds ratio [OR]: 1.098, 95% confidence interval [CI]: 1.044-1.156) and the Glasgow Coma Scale (OR: 0.744, 95% CI: 0.639-0.866) were found to affect mortality. In Receiver-operator characteristic analysis, a cutoff value of 22.5 for ISS had a sensitivity of 100% and a specificity of 89.6% for mortality. CONCLUSIONS: Despite lower ISS values, patient outcomes were worse in terror incidents/civil conflicts. Transport modes did not significantly affect outcomes, whereas hospital transport was found to be inefficiently used.

Complete upper urinary tract obstruction caused by penetrating pellet injury of the ureterintroduction.

Ureteral injuries due to gunshots are tend to be misdiagnosed because of concomitant vascular and intraabdominal organ wounds. Our case is a 23-year-old man who was admitted to the hospital with multiple abdominal gunshot wounds. Laboratory findings showed worsening anemia, and the computed tomography (CT) scan showed multiple lead bullets inside the abdomen and retroperitoneum. Patient was then taken to the operation room for laparatomy. There were many intestinal injuries and also a stable retroperitoneal hematoma. There was no ureteral injury mentioned in the operation note or the initial CT report. Two weeks after this operation, the patient developed significant urine leakage from the abdominal wounds. Ureteral J stent placement was our first choice of treatment. This was complicated with a late ureteral obstruction. The final treatment was an ureteroureterostomy. Diagnosing ureteral injuries due to traumatic causes can be hard in most of the cases. Physicians should consider early evaluation of the patient for ureteral leakage if there is suspicion about ureteral injury.

Serum soluble lectin-like oxidized low-density lipoprotein receptor-1 levels in patients with restless legs syndrome.

OBJECTIVE: The aim of this study was to assess the predisposition for atherosclerosis in patients with RLS through serum sLOX-1 (serum Lectin-Like Oxidized Low-Density Lipoprotein Receptor-1) measurements. BACKGROUND: Recent epidemiological studies have suggested an association of RLS with certain chronic conditions such as diabetes mellitus (DM), obesity, hypertension (HT), and hyperlipidemia. LOX-1 is expressed in endothelial cells, macrophages, and in smooth muscle cells under the effect of proatherogenic conditions. METHODS: This study was a prospective, cross-sectional, case-controlled. We measured the serum sLOX-1 levels in 37 restless legs syndrome patients and 38 controls. RESULTS: Serum sLOX-1 level was significantly lower in the patient group. The two groups were similar in glucose, HbA1c, creatinine, LDL cholesterol, TG, HDL, total protein, albumin, AST, ALT, GGT, ALP, HGB, HCT, MCV, transferrin saturation rate (TSR), ferritin, CRP, TSH, FT4, FT3, B12, and folic acid levels. Also the two groups were similar with respect to age at menarche, number of previous births, number of abortions and/or curettage, total duration of breastfeeding, percentage of patients in menopause, and age at menopause. CONCLUSION: Our results may suggest a lower atherosclerotic risk among RLS patients as compared to the general population (Tab. 3, Ref. 33).

Pulmonary embolism and hematologic outcome in cancer patients initiating chemotherapy.

Purpose: The aim of this study was to determine the relationship between chemotherapy use and the frequency of pulmonary embolism (PE) and associated mortality, clinical, and biochemical parameters. An additional aim was to analyze computed tomography pulmonary angiography findings. Materials and Methods: The study population comprised 65 of 368 consecutive patients diagnosed with PE who underwent chemotherapy in the Medical Oncology Department. The study population had cancer of various origins, including breast, colorectal, lung, gynecological, gastric and pancreatic, lymphatic, and other sites. The patients' clinical records were reviewed for leukocyte and platelet count, mean platelet volume (MPV), neutrophil to lymphocyte ratio, and level of mortality. As the parameters were normally distributed, the correlation coefficients and their significance were calculated using Pearson's test. One-way analysis of variance was used to compare the leukocyte counts among the cancer groups. A t-test was used to compare the means of the platelet and leukocyte counts between the patients. A Chi-square test was used to compare binary outcomes for categorical variables. Patients who died in the 1 st year and others (survivors and patients who died after the 1 st year) were compared using multinomial logistic regression analysis. Results: When the patients who died in the 1 st year and the survivors were compared, there was a statistically significant difference in the platelet count between the two groups. The platelet count, MPV, and leukocyte count of the patients with PE were significantly high. The leukocyte count was also significantly high in patients with breast, colorectal, lung, and gynecological cancers. Conclusion: Our results indicate that in cancer patients with PE who undergo chemotherapy, the platelet count, MPV, and leukocyte count are significantly high.

Neutrophil to lymphocyte ratio is superior to platelet to lymphocyte ratio as an early predictor of moderate/severe ovarian hyperstimulation syndrome.

Ovarian hyperstimulation syndrome (OHSS) is a state of exaggerated inflammatory response during controlled ovarian hyperstimulation (COH). Neutrophil:lymphocyte ratio (NLR) and platelet:lymphocyte ratio (PLR) are known to reflect systemic inflammation. The aim of this study was to investigate whether these inflammatory markers could be used as reliable markers in the early prediction of moderate-to-severe OHSS. The study group consisted of 54 patients who developed moderate-to-severe OHSS and the control group was 54 patients who did not develop OHSS undergoing IVF/ICSI. NLR and PLR were calculated from complete blood counts before the COH. NLR and PLR were significantly elevated in the OHSS group compared with the controls (3.2 ± 0.9 and 182.9 ± 49.8 vs 1.8 ± 0.5 and 160.6 ± 48.5, respectively) (p < 0.05, for all). However, only NLR had positive associations between OHSS risk factors (p < 0.05, for all). NLR was superior to PLR as an early predictor of OHSS with an area under the ROC curve of 0.91 (sensitivity = 85% and specificity = 78%). In conclusion, we found that NLR can be used as an early marker of OHSS.

Comprehensive characterization of chitosan/PEO/levan ternary blend films.

Ternary blend films of chitosan, PEO (300,000) and levan were prepared by solution casting method and their phase behavior, miscibility, thermal and mechanical properties as well as their surface energy and morphology were characterized by different techniques. FT-IR analyses of blend films indicated intermolecular hydrogen bonding between blend components. Thermal and XRD analysis showed that chitosan and levan suppressed the crystallinity of PEO up to nearly 25% of PEO content in the blend, which resulted in more amorphous film structures at higher PEO/(chitosan+levan) ratios. At more than 30% of PEO concentration, contact angle (CA) measurements showed a surface enrichment of PEO whereas at lower PEO concentrations, chitosan and levan were enriched on the surfaces leading to more amorphous and homogenous surfaces. This result was further confirmed by atomic force microscopy (AFM) images. Cell proliferation and viability assay established the high biocompatibility of the blend films.

Is there any diagnostic value of serum protease-activated receptor-1 (PAR1) levels on determination of epithelial ovarian carcinoma?

The role of molecular markers in ovarian cancer is still a matter of debate. Protease-activated receptor-1 (PAR1) might be a good marker in some types of malignant tumors and might provide useful information in diagnosis and prognosis. The objective of this study was to evaluate the serum levels of PAR1 in regard to diagnostic, predictive, and prognostic value in epithelial ovarian cancer (EOC) patients. Forty-four EOC patients were enrolled in this study. Serum PAR1 levels were determined by enzyme-linked immunosorbent assay (ELISA) method. Twenty-five age- and sex-matched healthy controls were included in the analysis. The median age of patients was 58 years old, ranging from 22 to 83 years, where most of them had advanced disease (stage III-IV) (n = 40, 91%). The median serum PAR1 values were significantly elevated in patients compared to healthy controls (1.52 ng/ml vs. 1.13 ng/ml) (p = 0.03), whereas any clinical variables including response to chemotherapy did not associate with serum assay (p > 0.05). Progression-free survival (PFS) and overall survival (OS) of patients who did not respond to chemotherapy nor had platinum resistance in relapsed disease were poorer in the analyses. On the other hand, serum PAR1 levels showed no significant adverse effect on either PFS or OS (p = 0.43 and p = 0.49, respectively). These results proved that baseline serum PAR1 levels of patients with EOC were significantly higher than those of healthy people. However, these assays suggested no predictive or prognostic value in this group of patients.

Effect of storage and insect infestation on the mineral and vitamin contents of wheat grain and flour.

The objective of this study was to evaluate how storage and Sitophilus granarius L. infestation affects mineral and vitamin (thiamin and riboflavin) contents of wheat grain and flour obtained from the wheat. Wheat samples were infested with nonsexed S. granarius at a rate of two adults per kilogram, and stored for 6 mo at 30 +/- 1 degrees C and 70 +/- 5% relative humidity. Every 30 d, samples of wheat were collected and evaluated for insect population, mineral, thiamin, and riboflavin contents. Flour milled from these wheat samples was also evaluated for mineral, thiamin, and riboflavin contents. None of the analyses performed on the uninfested wheat and flour samples showed any noticeable change during the storage period. The insect population of the infested wheat samples increased during the storage period. The ratio of the mineral contents to dry matter significantly increased in the infested wheat and flour samples during the infestation period, whereas thiamin and riboflavin contents considerably decreased. The feeding habits of S. granarius and the distribution of minerals and vitamins in the wheat grain caused the changes observed in the levels of these compounds. The effects of infestation were greatest in the latter stages, during which the insect population increased greatly.

Modified DCF (mDCF) regimen seems to be as effective as original DCF in advanced gastric cancer (AGC)

PURPOSE: The aim of this retrospective study (from January 2007 to December 2011) was to investigate the efficacy and tolerability of mDCF schedule for chemotherapy-naïve AGC patients. PATIENTS: Patients (n = 54) with locally inoperable or distant metastasis and performance status of 0-2 were eligible. The triplet combination chemotherapy consisting of docetaxel 60 mg/m(2) on day 1, cisplatin 60 mg/m(2) on day 1, and 5-fluorouracil 600 mg/m(2) for 5 days of continuous infusion were administered every 21 days, up to nine cycles. Prophylactic G-CSF was not allowed. RESULTS: In all, 36 (67 %) patients were male and 18 (33 %) were female; median age was 59 years. The majority of patients (n = 46, 85 %) had metastatic disease and 8 (15 %) of them had locally advanced disease. Liver metastasis and peritonitis carcinomatosa were found in 20 (43 %) and 18 (39 %) of the 46 cases, respectively. The median cycle of chemotherapy was 6. In assessing 50 patients for response evaluation, one had complete response. Partial response was achieved in 27 (54 %) patients. Seventeen patients (34 %) had stable disease and 5 (10 %) had progressive disease, while 4 % (n = 2) and 11 % (n = 6) of the patients developed severe (grade 3-4) neutropenia and anemia, respectively. During the median follow-up time (6.9 months, range 0.4-24), 28 (52 %) patients died. The overall and progression-free survival were 10.7 [95 % CI 8.9-12.4] and 6.8 [95 % CI 5.8-7.8] months, respectively. CONCLUSIONS: Although this was not a prospective comparative study, the mDCF regimen seems to be as effective as the original DCF in AGC with acceptable and manageable side effects (AU)