Relevance of Pulmonary Alveolar Echinococcosis / Relevancia de equinococosis alveolar con afectación pulmonar

BACKGROUND: Pulmonary alveolar echinococcosis (PAE) is a chronic disease caused by Echinococcus multilocularis with very low incidence in developed countries. METHODS: This single-center, retrospective study included 34 patients who were diagnosed with PAE between January 2001 and February 2019 (15 males, 19 females, mean age: 52.4 ± 15.8 years, age range: 28-78 years) in Ataturk University Medical School, Erzurum, Turkey. RESULTS: The liver was the primary involved organ in all cases. Pulmonary involvement was detected in 13.0% (34/261) of all cases with hepatic alveolar echinococcosis (AE), and three patients (8.8%) had both pulmonary metastasis and brain metastasis. The route of spread to the lungs based on radiological data was hematogeneous in 25 patients (73.5%), transdiaphragmatic in three patients (8.8%) and both hematogeneous and transdiaphragmatic in six patients (17.7%). AE showed bilateral involvement in 19 patients (55.9%), whereas only the right lung was involved in 12 patients (35.3%) and the left lung in three patients (8.8%). Of the patients, five underwent surgery due to PAE and 29 patients received medical therapy with albendazole. A total of three patients died during the follow-up period (2, 5 and 10 years after the diagnosis of PAE), while 31 patients continued with follow-up and treatment for a mean duration of 5.4 ± 3.8 years (1-14 years). CONCLUSIONS: Patients with hepatic AE must, as a matter of course, be screened for possible lung involvement. Albendazole therapy may slow down disease progression in patients with widespread pulmonary involvement who are not eligible for surgery

INTRODUCCIÓN: La equinococosis alveolar con afectación pulmonar (PAE) es una enfermedad crónica causada por Echinococcus multilocularis, cuya incidencia es muy baja en los países desarrollados. MÉTODOS: Estudio unicéntrico, retrospectivo en el cual se diagnosticaron 34 pacientes con PAE entre enero de 2001 y febrero de 2019 (15 varones y 19 mujeres, edad media: 52,4 ± 15,8 años, rango de edad: 28-78 años) en la Escuela Médica Univesitaria de Ataturk, Erzurum, Turquía. RESULTADOS: En el total de los casos incluidos en el estudio el hígado fue el principal órgano afectado. La afectación pulmonar se detectó en el 13% (34/261) de los casos con equinococosis alveolar (AE), y 3 pacientes (8,8%) presentaron tanto metástasis pulmonar como cerebral. De acuerdo con los datos radiológicos, la propagación a los pulmones fue por vía hematógena en 25 pacientes (73,5%), transdiafragmática en 3 pacientes (8,8%) y tanto hematógena como transdiafragmática en 6 pacientes (17,7%). Diecinueve pacientes (55,9%) presentaron PAE con afectación pulmonar bilateral, mientras que 12 pacientes (35,3%) presentaron afectación solo del pulmón derecho y 3 (8,8%) solo del izquierdo. De todos los pacientes, 5 fueron sometidos a cirugía debido a la PAE y 29 recibieron tratamiento médico con albendazol. Tres pacientes fallecieron durante el período de seguimiento (2,5 y 10 años después del diagnóstico de PAE), mientras que 31 continuaron con el seguimiento y el tratamiento durante 5,4±3,8 años de media (1-14 años). CONCLUSIONES: Los pacientes con AE hepática se deben cribar de manera rutinaria para detectar una posible afectación pulmonar. El tratamiento con albendazol puede ralentizar la progresión de la enfermedad en pacientes con afectación pulmonar extendida que no son aptos para cirugía

Relevance of Pulmonary Alveolar Echinococcosis.

BACKGROUND: Pulmonary alveolar echinococcosis (PAE) is a chronic disease caused by Echinococcus multilocularis with very low incidence in developed countries. METHODS: This single-center, retrospective study included 34 patients who were diagnosed with PAE between January 2001 and February 2019 (15 males, 19 females, mean age: 52.4±15.8 years, age range: 28-78 years) in Ataturk University Medical School, Erzurum, Turkey. RESULTS: The liver was the primary involved organ in all cases. Pulmonary involvement was detected in 13.0% (34/261) of all cases with hepatic alveolar echinococcosis (AE), and three patients (8.8%) had both pulmonary metastasis and brain metastasis. The route of spread to the lungs based on radiological data was hematogeneous in 25 patients (73.5%), transdiaphragmatic in three patients (8.8%) and both hematogeneous and transdiaphragmatic in six patients (17.7%). AE showed bilateral involvement in 19 patients (55.9%), whereas only the right lung was involved in 12 patients (35.3%) and the left lung in three patients (8.8%). Of the patients, five underwent surgery due to PAE and 29 patients received medical therapy with albendazole. A total of three patients died during the follow-up period (2, 5 and 10 years after the diagnosis of PAE), while 31 patients continued with follow-up and treatment for a mean duration of 5.4±3.8 years (1-14 years). CONCLUSIONS: Patients with hepatic AE must, as a matter of course, be screened for possible lung involvement. Albendazole therapy may slow down disease progression in patients with widespread pulmonary involvement who are not eligible for surgery.

Preventive effects of fraxin on ischemia/reperfusion-induced acute kidney injury in rats.

AIM: Kidney ischemia reperfusion (IR) injury is an important health problem resulting in acute kidney failure. The oxidative stress and inflammatory process are the underlying mechanisms of IR injury. It has been purposed in this study to research the possible protective effects of fraxin on kidney injury induced by IR. MATERIAL AND METHODS: 32 Sprague Dawley male rats were divided into 4 groups. The groups were organized as follows; sham, IR, IR + fraxin 10 mg/kg, and IR + 50 mg/kg fraxin groups. Some oxidant, antioxidant and inflammatory parameters were evaluated in kidney tissues removed at the end of our experimental study. KEY FINDINGS: It was detected that the oxidant and proinflammatory markers increased and antioxidant parameters decreased in IR group but the results significantly reversed in treatment groups compared to IR group. And also, 8-OHdG, NF-κB, HAVCR1 immunopositivities were at severe levels and these results attenuated in IR fraxin + 10 mg/kg, and IR + fraxin 50 mg/kg groups. SIGNIFICANCE: These presented results have shown that fraxin performed protective effects against kidney injury induced by IR.

Radiation interaction parameters for blood samples of breast cancer patients: an MCNP study.

The main goal of this study was to determine radiation interaction parameters such as mass attenuation coefficients, effective atomic numbers, and effective electron densities depending on element concentrations (Na, K, Cu, Zn, Al, Ca, Mg Cr, Fe, Se) in blood samples of patients with breast cancer. Eighty blood samples were collected and analyzed in this study (40 from breast cancer patients and 40 from healthy patients). The determination of element concentrations of the samples was performed with inductively coupled plasma-mass spectrometry (ICP-MS) and inductively coupled plasma-optical emission spectrometry (ICP-OES) after which the element concentrations were normalized to percentage. Mass attenuation coefficients were calculated by Monte Carlo simulation method. In addition, effective atomic numbers and effective electron density values of the blood samples were calculated with the ZXCOM program. One of the most important results of this study is that differences in radiation interaction parameters between the two groups were observed. More specifically, the mass attenuation coefficients of the healthy group's blood samples were higher than those of the cancerous group at photon energies of 50 keV, 100 keV, 250 keV and 500 keV, while they were lower at 1 MeV. All the MCNP results were consistent with the results obtained from ZXCOM. As the main result of this study it is concluded that photon atomic parameters such as mass attenuation coefficient, effective atomic number and electron density may be considered in cancer diagnosis or treatment modalities.

Pulmonary metastasectomy with laparotomy in alveolar echinococcosis.

Pulmonary alveolar echinococcosis is a tumor-like parasitic disease that occurs typically after hepatic involvement. In this article, we present a case of metastatic pulmonary alveolar echinococcosis that underwent laparotomy for hepatic involvement, in which we performed pulmonary metastasectomy with transdiaphragmatic intervention. Thoracic computed tomography revealed a metastatic nodule of approximately 1 cm in the superior segment of the right lung lower lobe. Approximately 7x3 cm diaphragmatic resection was performed due to diaphragmatic invasion. Pulmonary wedge resection for lung metastasis was performed intraabdominally from diaphragmatic defect. We believe that this technique can be applied safely in carefully selected patients with pulmonary involvement.

Evaluation of the Relationship between Carcinoembryonic Antigen and TNM Stage in Colorectal Cancer.

OBJECTIVE: We aimed to examine the relationship between carcinoembryonic antigen (CEA) levels in the preoperative period and TNM (T: primary tumor, N: lymph node, M: distant metastasis or metastasis) staging in patients with colorectal cancer in our region. MATERIALS AND METHODS: In the present study, 752 cases diagnosed with colorectal cancer between January 1992 and December 2010 we analyzed retrospectively. RESULTS: Data of 752 patients diagnosed with colorectal cancer between 1992 and 2010 were evaluated; of the 752 patients, 427 (56.8%) were males and 325 (43.2%) were females with the mean age of 56.8±14.9 years. CEA levels of 316 cases were measured; 52.2% of the samples were within normal limits. Cases with CEA ≤5 ng/mL were majorly in Stage III, whereas those with CEA >5 ng/mL were predominantly in Stage IV. The TNM stage, tumor diameter, and differentiation levels were defined, and no statistically significant relationship was detected between these parameters and CEA levels. CONCLUSION: While the CEA levels of 52.2% of participating cases were within normal limits, there was no statistically significant relationship between the CEA levels and differentiation level of tumor, tumor diameter, and TNM staging. According to the data, CEA levels may be within normal limits in the majority of patients with colorectal cancer. Therefore, normal levels of CEA will not rule out colorectal cancer diagnosis, and it can be concluded that these patients should be investigated in detail.

Correlation between Na/K ratio and electron densities in blood samples of breast cancer patients.

The main purpose of this study was to investigate the relationship between the electron densities and Na/K ratio which has important role in breast cancer disease. Determinations of sodium and potassium concentrations in blood samples performed with inductive coupled plasma-atomic emission spectrometry. Electron density values of blood samples were determined via ZXCOM. Statistical analyses were performed for electron densities and Na/K ratio including Kolmogorov-Smirnov normality tests, Spearman's rank correlation test and Mann-Whitney U test. It was found that the electron densities significantly differ between control and breast cancer groups. In addition, statistically significant positive correlation was found between the electron density and Na/K ratios in breast cancer group.

Eighteen Years' Retrospective Review of Colorectal Cancer Cases in Eastern Population.

OBJECTIVE: We aimed to determine the demographic characteristics of colorectal cases and changes in cancer localization according to years in our region. MATERIALS AND METHODS: In the present study, 752 patients diagnosed with colorectal cancer between January 1992 and December 2010 were included. RESULTS: Of all the patients, 427 (56.8%) were males and 325 (43.2%) were females, with a male/female ratio of 1.3/1. The mean age was 56.2±14.9 years. The most commonly encountered complaint at the first application was rectal bleeding (38.4%). The most commonly encountered tumor localizations were in the rectum (55%) and sigmoid colon (18%). In general, tumors were observed to be localized in the right colon at 16.1% and in the left colon at 83.9%. When tumor localizations were compared in the first 10 years of the study with the second 10 years in the present study, it was observed that tumor numbers in the right colon were increased. Cases in our study were diagnosed as Stage IV according to the tumor, node, metastasis (TNM) classification, and liver metastasis was encountered most commonly. CONCLUSION: Although colorectal cancer cases have been most commonly encountered in the rectum, it has been recently determined that right colon tumor percentages were increased. It was defined that they were generally diagnosed at later stages. Therefore, colorectal cancer incidence may be decreased by the widespread use of endoscopic techniques in the determination of precancerous lesions.

ERCC1 Expression in Non-Small Cell Lung and Esophageal Cancer.

OBJECTIVE: "Excision Repair Cross-Complementation Group 1" (ERCC1) enzyme is a vitally important basic protein required for DNA repair. Recent studies suggest that ERCC1 is involved in resistance to antracycline-based chemotherapy regimens. In this study, we aimed to analyze ERCC1 expression in lung and esophageal cancer patients. We also aimed to investigate the possible correlation between the ERCC1 expression levels and patient demographic information. MATERIALS AND METHODS: Twenty esophageal and 20 non-small cell lung cancer (NSCLC) patients diagnosed between December 2009 and December 2010, via either endoscopic, bronchoscopic or tru-cut biopsy, were included in this study. The ERCC1 expression levels were analyzed by the reverse transcriptase-polymerase chain reaction (RTPCR) method in RNA samples extracted from pathological biopsy specimens. The patient demographic information was also recorded. RESULTS: There was no significant correlation between the ERCC1 expression level and demographic parameters, including the tumor, node, metastatis (TNM) staging, World Health Organization (WHO) grading, age, gender, hemoglobin level and albumin level, in the patient groups. The mean ERCC1 expression levels in the NSCLC and esophageal cancer patients were 0.71±0.85 and 0.62±0.78, respectively. The ERCC1 expression level was elevated in 15% of each patient group. CONCLUSION: Analysis of the ERCC1 expression in NSCLC and esophageal cancer patients prior to chemotherapy would be useful for personalized chemotherapy regimens and would provide more accurate prognostic information for the patient.

The frequency of complications and the etiology of disease in patients with liver cirrhosis in erzurum.

OBJECTIVE: This study included 100 patients diagnosed with liver cirrhosis who presented at Atatürk University Faculty of Medicine Gastroenterology clinic and polyclinic. MATERIALS AND METHODS: The etiology of liver cirrhosis and the incidence of its complications have been investigated. RESULTS: The etiological classification of liver cirrhosis in our patients was as follows: 47 hepatitis B virus hepatitis, 11 hepatitis C virus hepatitis, 5 HBV+HDV hepatitis, 4 Budd Chiari syndrome, 2 chronic alcohol abuse, 2 ischemic heart disease, 1 autoimmune hepatitis, 1 sclerosing cholangitis, 1 hydatid cyst. In 26 patients we could not find any etiological condition. These patients were called cryptogenic cirrhosis patients.When we examined the complications of liver cirrhosis, it appeared that there were ascites in 83 patient. In 56 patients, esophageal variceal bleeding occurred. There was spontaneous bacterial peritonitis in 42 patients. Hepatorenal syndrome occurred in 26 patients. Finally, in 3 patients we detected hepatorenal syndrome. CONCLUSION: The most common causes in the etiology of liver cirrhosis are viral, especially HBV. Many of the patients were in decompensated phase when diagnosed. We found that there was a close relation between the frequency of complications and mortality in liver cirrhosis.