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Biomedical subjects

H Ozen

Publications and source records attributed to H Ozen.

At least 109 records · Page 6Linked to original sources
PubMed1996

Six chromophobe cell carcinomas and one mixed renal cell carcinoma with chromophobe cell features: clinical and pathological implications.

OBJECTIVE: To determine the incidence and clinical and pathological features of chromophobe cell carcinoma (CCC) among renal cell carcinomas (RCCs). MATERIALS AND METHODS: The records and nephrectomy samples from 166 patients who were operated on and followed up thereafter with a diagnosis of RCC were re-evaluated. New sections were cut and specific staining performed when deemed necessary. RESULTS: Of 166 patients with RCC, six were diagnosed as having CCC and, unusually, one patient had a mixed RCC with areas of CCC. Neither the symptoms nor radiological features of these seven patients differed from those of the patients with RCC; the serum ferritin levels of these seven patients were also within the normal range. These patients appeared to have a favourable clinical course. CONCLUSION: Chromophobe cell carcinoma is a distinct entity and must be distinguished particularly from oncocytoma and other variants of RCC. Although it seems to have a low malignant potential, metastatic CCC may have a worse prognosis.

Adenocarcinoma↗
PubMed1996

Primary carcinoid of the kidney.

A rare case of primary renal carcinoid tumour is presented. The diagnosis was based on immunohistochemically diffuse cytoplasmic positivity for chromogranin A and neuron-specific enolase, in addition to histologic findings. Only 14 previous cases of this tumour have been documented in the literature.

Adult↗
PubMed1996

Bladder cancer.

For many years it has been apparent that transitional cell carcinomas are a heterogeneous group of neoplasms with two clinical forms that exhibit distinctly different prognoses. Approximately 20% of the tumors are invasive at presentation, which is associated with poor prognoses. The remaining carcinomas are superficial, and an excellent outcome can be expected in the majority of patients treated with local therapies. However, 20% of the latter will progress to muscle invasive disease during the follow-up. The problem is to identify those who will progress and to distinguish those tumors likely to respond to therapy. Genetic changes that identify the subgroups of these tumors may be the key issue. During the past decade, studies of human cancer have begun to yield molecular information on the identity of multiple genetic changes that underline development and progression. Attention was focused initially on oncogenes and more recently on tumor-suppressor genes.

Carcinoma, Transitional Cell↗
PubMed1995

How significant are serial bone scans in monitoring advanced prostatic cancer?

We report a total of 169 serial bone scan studies conducted in 21 patients with histologically proven metastatic cancer of the prostate. Aim of the study was to investigate the concordance of findings on bone scans with serum acid phosphate (AP) levels and the clinical performance status (CPS) of the patients, and to see how important bone scan is by itself in determining the metastatic progression in the follow-up. Eighty-seven and 86% of scans demonstrated changes concordant with AP and CPS levels subsequently. It was also found that 100% of the progressions on bone scans along with elevated levels of AP had been confirmed as metastatic progression, whereas only 41% of progressions on bone scans solely had been shown to be metastases in the follow-up investigations. Findings on bone scans not in correlation with clinical findings and serum AP levels are mostly misleading. Use of bone scans in conjunction with serum AP levels and most probably with prostate-specific antigen and CPS is the most reliable and therefore treatment modality changes should not be based on bone scans only.

Acid Phosphatase↗
PubMed1995

Clinical significance of serum ferritin in patients with renal cell carcinoma.

OBJECTIVES: We examined the serum ferritin levels in 158 patients with renal cell carcinoma and 101 healthy control subjects between 1987 and 1994 to investigate the value of this intracellular protein as a tumor marker. METHODS: Preoperative and postoperative serum ferritin values were analyzed and the patients were stratified to three groups accordingly: group 1, patients with normal values (N-N); group 2, those with preoperative high and postoperative normal (H-N); and group 3, those with preoperative normal or high with postoperative high ferritin levels (H-H). RESULTS: The mean serum ferritin level in 101 healthy control subjects was 85.7 +/- 63.6 ng/mL (range, 3.7 to 265.2). The upper limit of normal, which was calculated by adding 2 standard deviations to the mean was 219.9 ng/mL. Mean serum ferritin in patients with renal cell carcinoma was 274.2 +/- 276.3 ng/mL, which was significantly higher than that of control values (P < 0.01). The sensitivity, specificity, and overall accuracy rate for ferritin increase was 94%, 50%, and 61%, respectively. Multivariate analysis showed that the aforementioned grouping and stage of the disease were the two independent prognostic parameters. Preoperative ferritin levels lost its significance on multivariate analysis. CONCLUSIONS: Our study shows that although serum ferritin was a useful tool in diagnosing and staging patients, it was not ideal in early stages. However serum ferritin seems to be more valuable for follow-up; postoperative values, indeed, predict the prognosis.

Biomarkers, Tumor↗
PubMed1995

Recent studies in bladder cancer.

The progression of carcinoma in situ of the bladder to invasive bladder carcinoma has been shown to be essentially regulated by p53 overexpression. In another study, however, loss of heterozygosity of chromosome 9 has also been shown to be essential for progression to muscle invasive disease. Routine random biopsies for predicting prognosis and deciding on adjuvant intravesical therapy should be abandoned because of the results of a well-designed trial on 1745 patients. The aforementioned study showed that the recurrence and progression rates could be only slightly improved at a cost of more intravesical therapy if random biopsies were done routinely. The survival of patients undergoing radical cystectomy was shown to be strongly affected by the primary tumor stage even in those patients with positive nodes. Radical cystectomy and lymph node dissection alone could be beneficial in node-positive patients if the tumor was confined to the bladder. Neoadjuvant chemotherapy and bladder sparing could be recommended only on selected patients with significant reduction in tumor size after chemotherapy. The response to adjuvant chemotherapy could be prolonged if consolidation surgical intervention is performed on responders. With the help of new prognostic parameters obtained from molecular genetic analysis, the already increasing survival trends in bladder carcinomas will hopefully continue to improve in the near future.

Carcinoma in Situ↗
PubMed1995

Beneficial effects of dexamethasone in children with pneumococcal meningitis.

Fifty-six children older than 2 years with meningitis caused by Streptococcus pneumoniae were enrolled in a prospective, double blind, placebo-controlled trial to evaluate the efficacy of dexamethasone therapy in addition to antimicrobial therapy. Twenty-nine of 56 received dexamethasone (0.6 mg/kg/day iv, divided into 4 daily doses for 4 days) and the remaining 27 received placebo. At the beginning of therapy the clinical and laboratory characteristics of the patients in the treatment groups were comparable, except for the Glasgow coma score (P = 0.004), which was lower in the dexamethasone group. Patients were examined daily during hospitalization and 6 weeks after discharge from the hospital. Hearing was assessed 6 weeks after discharge by means of pure tone audiometry. Two patients in the dexamethasone group and one patient in the placebo group died. There were no differences between the two groups with regard to the duration of fever, the incidence of secondary fever and electrolyte imbalance, seizure activities occurring during hospitalization and rash. Although the differences were statistically insignificant, moderate or severe unilateral or bilateral sensorineural hearing loss at 6 weeks and the overall neurologic sequelae, including hearing loss, at 1 year were higher in the placebo group, at 23% vs. 7.4% (P = 0.11) and 26.9% vs. 7.4% (P = 0.062), respectively. At 3 months after discharge, because of the improvement in hearing loss in one dexamethasone-treated patient the incidence of hearing impairment was significantly less than that in the placebo group, at 3.7% vs. 23%, respectively (P = 0.044). No improvement in hearing loss was observed after 3 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Surveillance-only policy in clinical stage-I non-seminomatous germ-cell tumors of the testis.

With the advanced imaging techniques, the sensitive assays for tumor markers and the curability of small-volume metastatic disease with cis-platinum-based chemotherapy, surveillance has gained popularity in clinical stage-I non-seminomatous germ-cell tumors. This study reports our experience on 58 patients who have been included in a surveillance protocol. Patients with normal tumor-marker levels following surgery, no evidence of metastases on the CT scans of the abdomen and the chest and no residual tumor at the surgical margin were followed. Relapsing patients were treated with cis-platinum-based combination chemotherapy. Of the 58 patients, 17 relapsed (29.3%) in a period of 2-18 months (median 5 months). None of the relapsing patients later presented with evidence of disease in the follow-up period 14-79 months (median 39 months) after chemotherapy. Prognostic factors were evaluated by univariate analysis and the data for risk factors, such as the presence of embryonal carcinoma, absence of yolk-sac elements and scrotal violation, were evaluated by multivariate analysis. Statistical analysis showed that none of the risk factors were significantly different in predicting the relapse. Of the 6 relapsing patients with preorchiectomy elevated tumor-marker levels, 4 had shown a slower decline in tumor-marker levels than expected and they all relapsed with elevated levels of the same tumor markers. A surveillance-only policy actually seems to be a safe and logical approach if the patients are properly selected and cooperate fully.

Adolescent↗
PubMed1994

Detection of urinary interleukin-2, interleukin-2 receptor, and tumor necrosis factor levels in patients with superficial bladder tumors after intravesical BCG immunotherapy.

OBJECTIVES: To investigate the presence of urinary cytokines, after bacillus Calmette-Guérin (BCG) therapy, in order to provide further insight into the mechanisms of action of intravesical BCG therapy. METHOD: Urine levels of interleukin-2 (IL-2), interleukin-2 receptor (IL-2R), and tumor necrosis factor alpha (TNF alpha) levels were determined in 34 patients with superficial bladder tumors after a six-week course of intravesical BCG therapy. The urine samples were obtained at the fifth hour following the sixth course of therapy and the determinations were made by using an (enzyme-linked immunosorbent assay (ELISA)) technique. RESULTS: The pre-BCG levels of IL-2, IL-2R, and TNF (32.1 ng/L, 21.1 ng/L, 37.6 micrograms/L, respectively) were increased significantly after therapy (175.2 ng/L, 54.4 ng/L, 625.9 micrograms/L, respectively). These levels remained significantly increased after all patients were stratified according to tumor and patient characteristics. CONCLUSION: The results of this study provide further evidence for the immunologic basis of the mechanism of action of intravesical BCG therapy.

Administration, Intravesical↗
PubMed1994

Transitional cell carcinoma of the bladder.

Approximately 70% to 85% of patients with transitional cell carcinoma of the bladder present with tumors that are confined to the mucosa or submucosa. Recent articles have proposed that these tumors should be classified in one major group and treated in a similar fashion. Although a number of molecular and biologic markers can be used to segregate more aggressive tumors from those with little mortal threat, it is almost impossible to predict the outcome of patients individually. Unless such categorization is available, recommending a more radical or more liberal approach is prone to errors. Current available data suggest that selected cohorts of patients with limited lymph node involvement may benefit from pelvic lymph node dissection with radical cystectomy. To obtain sustained survival advantage, however, more efficacious chemotherapy regimens are needed because sole-dose intensification in the standard protocols will not be sufficient to achieve this goal.

Carcinoma, Transitional Cell↗
PubMed1994

[Mesoblastic nephroma in adults: a clinical case].

Mesoblastic nephroma is the most common renal tumor in infancy but is infrequent in the adult. It has a typical histological pattern but its histogenesis is unknown. We report a case of mesoblastic nephroma in an eighteen year old man who was treated by conservative surgery.

Adolescent↗
PubMed1994

Bilateral adrenal metastases of renal cell carcinoma: a case report.

We report a case of renal cell carcinoma presenting with bilateral adrenal masses diagnosed by ultrasonography four years after nephrectomy. The histopathological examination of the trucut biopsy specimens obtained percutaneously by ultrasound guidance revealed bilateral adrenal mestastases of renal cell carcinoma.

Adrenal Gland Neoplasms↗
PubMed1993

Cisplatin, methotrexate and vinblastine plus surgical restaging for patients with advanced transitional cell carcinoma of the urothelium.

Chemotherapy with cisplatin, methotrexate and vinblastine (CMV) is active in advanced transitional cell carcinoma of the urothelium. Aggressive surgical resection of residual disease following responses produced by CMV was incorporated into a combined modality approach. Between 1982 and 1990, 64 patients were entered into the study. Of 55 patients evaluable for response 11 (20%) had a pathological complete response, 14 (25%) achieved a complete response following resection of residual disease and 5 (9%) whose disease was not surgically restaged had a clinical complete response. The overall complete response rate was 55%. Patients with liver, lung or bone involvement had significantly decreased survival compared to patients without visceral disease (p = 0.002). With a median followup exceeding 50 months, 14 patients (22% of all patients entered into the study) were free of disease at 23 to 98+ months. There were no deaths related to treatment. CMV produced high rates of response in patients with advanced disease, including those with distant metastases. Surgical resection of residual disease following responses produced by chemotherapy proved to be feasible, without treatment related mortality, and may have prolonged survival in selected cases.

Adult↗
PubMed1993

Advances in bladder cancer.

Intravesical chemotherapy and immunotherapy are administered to patients with bladder cancer in the hope of decreasing the rate of recurrence and, more importantly, reducing the rate of progression. So far, bacille Calmette-Guérin is the only agent to decrease progression rate and thus increase survival. Bacille Calmette-Guérin has been shown to achieve this outcome by selectively sparing certain sequences during fibronectin degradation; these critical fragments were shown to have motility-stimulating activity, which may then enhance tumor invasion. In vivo and in vitro studies have shown that cathepsin B inhibitors prevent degradation of human basement membrane laminin, which is the first step of tumor invasion. Cathepsin B inhibitors either alone or in combination with bacille Calmette-Guérin may be valuable in preventing the progression of superficial bladder tumors in the future. Clinical studies on bacille Calmette-Guérin have repeatedly shown that a second course of bacille Calmette-Guérin to patients with local failure did not jeopardize patient survival. Adjuvant chemotherapy for patients with locally advanced disease and for those with regionally involved lymph nodes improves progression-free survival. Further controlled studies will establish the verdict for adjuvant chemotherapy. With the advancement of molecular genetic studies relevant to modern technology, our understanding of tumor behavior improves dramatically, and classic knowledge becomes more outdated every day.

Aged↗