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Objective: Peripheral T-cell lymphomas (PTCLs) are an uncommon and quite heterogeneous group of disorders, representing only 10%-15% of all non-Hodgkin lymphomas. Although both molecular and clinical studies have increased in recent years, we still have little knowledge regarding real-life practice with PTCLs. In this study, we aimed to investigate the clinical characteristics and treatment outcomes of a large population-based cohort of patients presenting with systemic non-cutaneous PTCL. Materials and Methods: We conducted a multicenter retrospective analysis of 190 patients consecutively diagnosed and treated with non-cutaneous PTCLs between 2008 and 2016. Results: Considering all first-line treatment combinations, the overall response rate was 65.9% with 49.4% complete remission (n=81) and 16.5% partial response (n=27). The 5-year overall survival and eventfree survival rates were significantly different between the transplant and non-transplant groups (p, Amaç: Periferik T-hücreli lenfomalar (PTHL) nadir görülen, oldukça heterojen bir grup hastalıktır ve tüm non-Hodgkin lenfomaların sadece %10-15’ini oluşturur. Son yıllarda hem moleküler hem de klinik çalışmalar artmış olsa da PTHL’ler üzerindeki gerçek yaşam verileri hakkında hala çok az bilgiye sahibiz. Bu çalışmada, sistemik, kutanöz olmayan PTHL hastaları içeren geniş popülasyon tabanlı hasta grubunun klinik özellikleri ve tedavi sonuçlarını araştırmayı amaçladık. Gereç ve Yöntemler: 2008 ve 2016 yılları arasında kutanöz olmayan PTHL tanısı ile tedavi edilen 190 ardışık hastanın geriye dönük analizini gerçekleştirdik. Bulgular: Tüm birinci basamak tedavi kombinasyonları dikkate alındığında, genel yanıt oranı; tam remisyon (n=81) %49,4 ve kısmi yanıt (n=27) %16,5 olmak üzere %65,9 saptandı. Beş yıllık genel ve olaysız sağkalım oranları, transplant ve transplant olmayan gruplar arasında önemli ölçüde farklıydı (sırasıyla, p

The COVID-19 pandemic has caused many countries to close their borders, and large numbers of people have begun to spend their holidays and vacation time within their own countries rather than traveling abroad. This study assesses the impact of the pandemic on water consumption and wastewater generation in a popular tourist Aegean city (Bodrum, Turkey) and its suburbia where many visitors moved in to live there for an unforeseen future. The effects of the COVID-19 pandemic on water consumption within the residential and commercial areas showed a significant decrease in water consumption in commercial areas (%23) and an increase in the residential areas (%15) during the pandemic period. The wastewater in residential areas had to be treated in a large number of on-site wastewater treatment plants, apart from the central treatment plants which may pose a risk to the groundwater and surface water resources of the region. This shows that the treatment technologies and capacities of wastewater treatment plants need to be revised for situations such as unexpected pandemics.

Ticari levhaların rengi, konumu ve bir araya geliş şekli görsel kirliliğe neden olmaktadır. Ülkemizde ticari alanlarda sokak boyunca yaşanan bu görsel kirlilik her ne kadar alışılan ve yadırganmayan bir durum olsa da, konuya bilimsel çalışmalar ile dikkat çekmekte fayda vardır. Bu çalışmada görsel kirliliğin önlenmesi adına yapılan sokak düzenlenmelerinin estetik yargıyı ve alışveriş için tercih edilebilirliği ne şekilde etkilediğinin incelenmesi hedeflenmiştir. Çalışma kapsamında Google Sketch Up programı kullanılarak 8 ticari sokağın sanal modeli oluşturulmuştur. Bilgisayar ortamında modellenen bu ticari sokaklar üç fiziksel özellik açısından farklılık göstermişlerdir: (1) ticari tabela ve levhaların uyumu (tek X çok renkli levhalar), (2) bina cephesine asılı tentelerin varlığı ve (3) kaldırımlara / yaya yollarına taşan tanıtım levhalarının, sergilerin, masa ve sandalyelerin varlığı. Yaşları 20 ila 26 arasında değişen ve Dokuz Eylül Üniversitesi Şehir ve Bölge Planlama Bölümü’nde eğitim görmekte olan toplam 36 öğrenci (27 kız, 9 erkek) hazırlanan sanal mekâna ait fotoğrafları mekansal estetik değerlerine (uyum, karmaşıklık ve genel beğeni) ve alışveriş için tercih edilebilirliklerine yönelik olarak değerlendirmişlerdir. Elde edilen bulgular, bu üç fiziksel özelliğin arasından estetik yargıyı en çok etkileyen özelliğin ticari tabela ve levhaların uyumu olduğunu göstermiştir., The location and color of commercial signs and the way they come together causes visual pollution. Such kind of visual pollution is common on most of the commercial streets in Turkish cities. Yet, it is necessary to highlight the main causes of visual pollution and the influence of visual pollution on people’s behavior via empirical studies. This study aims to investigate how commercial street design with precautions to prevent visual pollution influences people’s environmental aesthetic evaluations and preference to shop. Eight commercial streets were developed with a three-dimensional computer-modeling program (Google Sketch Up). The virtual environments differ on three physical features: (1) color coherence of commercial signs (single versus multiple color commercial signs), (2) presence of sun blinds on building facades, (3) presence of pop-up cafes and displays on the sidewalks. Thirty six students (27 females, 9 males) studying at Dokuz Eylul University City and Regional Planning Department volunteered to participate in the study. Their age varied between 20-26. Participants evaluated each commercial street on coherence, complexity, liking and preference for shopping. Results showed that among three physical features (color coherence of commercial signs, presence of sun blinds and presence of pop-up cafes and displays) that could be manipulated to diminish visual pollution, color coherence of commercial signs was the most influential one on people’s aesthetic evaluations and preference to shop on specific street.

Small cell carcinoma (SCC) of the prostate is a rare and extremely aggressive malignant disease. It constitutes less than 1% of all prostatic neoplasms. Frequently it presents at advanced stage with nodal or visceral metastasis and has a poor prognosis. From the existing data it is difficult to define an optimum treatment strategy for SCC of the prostate. Here, we present a case of SCC of the prostate with a brief review of the literature., Prostatın küçük hücreli karsinomu (KHK) nadir ve son derece saldırgan bir tümördür. Tüm prostat kanserlerinin %1'den daha azını oluşturur. Sıklıkla nodal veya visseral metastazlarla birlikte ileri evrede prezente olur ve kötü bir prognoza sahiptir. Mevcut verilerden yola çıkılarak prostat KHK için optimal bir tedavi şeklinin belirlenmesi zordur. Biz burada bir prostat KHK olgusunu literatür bilgileri ile birlikte sunuyoruz.

The aims of the present study were to test activity and tolerability of cisplatin and etoposide in advanced non-small cell lung cancer (NSCLC) patients aged 70 years or higher. Twenty-four patients were enrolled. Cisplatin was given at a dose of 60 mg/m2 on day 1 and etoposide at a dose of 120 mg/m2 on days 1-3. Total 116 courses were administered. Twelve patients (50%) completed all six cycles of treatment. Three patients (12.5%) obtained a partial response, as well as 12 (50%) stable disease and 9 (37.5%) progressive disease. The median survival was 48.5 ± 6.06 weeks, and the 1 year survival rate was 38%. Grade 3-4 neutropenia occurred in 16.6% of patients, grade 4 thrombocytopenia in %4.1, and grade 1-2 neuropathy in 25%. One patient discontinued treatment due to grade 3 nephrotoxicity. In conclusion, cisplatin and etoposide regimen is active and relatively well-tolerated in the treatment of elderly NSCLC patients. New, active and well-tolerated combination regimens could improve present results., Bu çalışmanın amaçları 70 yaş ve üzeri ileri evre küçük hücreli dışı akciğer kanseri (KHDAK) hastalarında sisplatin ve etoposid tedavisinin aktivitesini ve tolerabilitesini araştırmaktı. Yirmi dört hasta çalışmaya alındı. Sisplatin 60 mg/m2 dozunda 1. günde ve etoposid 120 mg/m2 dozunda 1-3. günlerde verildi. Toplam 116 siklus uygulandı. On iki (%50) hasta altı siklus tedaviyi tamamladı. Üç hastada (%12.5) kısmi yanıt elde edilirken, 12 hastada (%50) stabil hastalık ve 9 hastada (%37.5) progresyon mevcuttu. Ortalama sağ kalım 48.5 ± 6.06 hafta ve 1 yıllık sağ kalım oranı %38'di. Grade 3-4 nötropeni hastaların %16.6'ında, grade 4 trombositopeni %4.1'nde ve grade 1-2 nöropati %25'inde görüldü. Bir hastada grade 3 nefrotoksisite nedeniyle tedavi sonlandırıldı. Sonuç olarak sisplatin ve etoposid yaşlı KHDAK hastalarının tedavisinde aktiftir ve nisbeten iyi tolere edilmektedir. Yeni, aktif ve iyi tolere edilen rejimler mevcut sonuçları iyileştirebilir.

Although it is well known that numerical and structural chromosomal aberrations are common in leukemic cells, tetraploidy and near-tetraploidy is a rare entity in acute myeloid leukemia (AML) [1-4]. We describe a rare case of AML-M0 with near-tetraploidy and superior vena cava syndrome (SVCS) due to a large mediastinal granulocytic sarcoma (GS). A 25-year-old male was admitted to our hospital with a progressive non-productive cough, dyspnea, pain on the left upper extremity and weight loss. One month ago, he was treated with a diagnosis of venous thrombosis because of the pain and swelling on his left upper extremity. At the time of admittance, physical examination revealed dyspnea, facial edema, swelling of the neck and upper extremities and dilated jugular and superficial veins of the chest. Peripheral lymph node or organomegaly was absent. His hematological findings were: hemoglobin, 14.1 g dl−1; hematocrit, 41.6%; MCV, 87.5 fl; WBC, 15.3 × 109 l−1 with 15% polymorphonuclear cells; 22% bands; 37% lymphocytes; 26% resembling blastic cells; and platelets 284 × 109 l−1. The chest X-ray showed enlarged mediastinum and thorax computed tomography (CT) demonstrated a multi-lobar mass with a diameter of 9 × 5 cm in the anterior mediastinum which also compressed the superior vena cava (Figure 1A). Abdominopelvic CT scan was normal. Mediastinoscopy was performed for definite diagnosis. The biopsy specimens from mediastinal mass revealed diffuse malignant infiltration in lipomatous tissue, which consisted of round, large sized cells. Nuclei were large, vesicular and contained two or three nucleolus. Cytoplasm was moderate in amount and clear. The specimens showed negativity for all of the antibodies and staining except for myeloperoxidase (MPO), CD34 and TdT (Figure 1B). Bone marrow aspirate revealed the presence of large blasts with a relatively low nuclear-cytoplasmic ratio, moderate chromatin pattern, two-to-three prominent nucleoli, no cytoplasmic granules and few cytoplasmic vacuolization. Most of the cells had heterogeneous shaped nuclei. No Auer rod was seen (Figure 1C). Cytochemistry revealed negativity for MPO, Sudan black B, periodic acid Schiff, combined esterase and acid phosphatase. Flow cytometric studies of the bone marrow cells revealed positivity for CD13, CD33, CD34, CD45, CD7 and HLA-DR. Cytogenetic analysis showed near tetraploidy (Figure 1D). Results of cytogenetic analysis of 20 metaphases of the bone marrow cells were as follows; 102, XXYY, +13, +14, +14, +15, +16, +18, +19, +21, +21, +22 [6] / 104, XXYY, +X, +Y, +3, +4, −7, −8, +10, +11, +13, +13, −14, +15, +15, +19, +21, +21, +22, +22 [9] / 98, XXYY, +3, +4, −6, +8, −11, +13, +14, −16, +19, +20, +21, +21 [5]. Neither apparent structural rearrangement nor normal clone was identified. Upon establishing the diagnosis (AML-M0/near tetraploidy+/mediastinal GS+) [5], he was given an induction chemotherapy consisting of daunorubicin (45 mg m−2 per day, days 1–3) and cytarabine (100 mg m−2 per day continuous infusion, days 1–7) and bone marrow remission was achieved. Then, he received the first consolidation chemotherapy consisting of idarubicin (10 mg m−2 per day, days 1–3) and cytarabine (1000 mg m−2 per day, days 1–6), followed by second consolidation chemotherapy consisting of cytarabine (6 gr m−2 per day, days 1–3) and 1800 cGy radiotherapy on mediastinum. The symptoms of SVCS improved gradually after the 5th day of induction chemotherapy. Likewise, the mediastinal mass decreased in size by 30% after induction chemotherapy, 70% after consolidation chemotherapies and disappeared completely after the completion of radiotherapy (Figures 1E and F). Presently, he is in the 10th month of his complete remission without any recurrence in the disease or GS.

Mediterranean spotted fever (MSF), Boutonneuse fever, is a tick-borne disease caused by Rickettsia conorii and is endemic in the Mediterranean region. Although MSF is usually a benign infectious disease, unusual manifestations that have been mainly reported in severe forms, typically among elderly patients or those with underlying diseases, complicate the diagnosis. A 39-year-old woman, a resident of Bursa, Turkey, was admitted with a 5-day history of fever, headache, and malaise and a 3-day history of rash. Physical examination showed fever and maculopapular rash involving the trunk, extremities, palms, and soles. Hematological findings were as follows: Hb 10.8 g/dL, WBC 1.7  109/L with 62% polymorphonuclear cells; 9% bands; 20% lymphocytes; 6% metamyelocytes; 3% myelocytes;and platelet count 46.8  109/L. Laboratory studies revealed an elevated CRP (13 mg/L), accelerated ESR (60 mm/h), hypoalbuminemia (2.5 mg/L),and slightly elevated serum aspartate aminotransferase (53 UI/L) and lactate dehydrogenase (386 UI/L). Bone marrow smear showed hypercellular marrow with activation of myeloid cells. After 3 days of hospitalization, we learned that she has a dog in her yard. A ‘‘tache noire,’’ the typicaleschar at the site of the tick bite, was observed on the right inguinal region with more elaborate physical examination. Treatment with doxycycline (200mg/day) was started. Resolution of fever and normalization of haematological findings were observed on the 4th and the 6th days of treatment, respectively.

We read with great interest the article by Disel and colleagues [1] in a recent issue of Leukemia Research that described a case of acute myelogeneous leukemia (AML) with bilateral ear neutrophil poor Sweet's syndrome (SS). We would like to describe and share our experience in a patient with AML who developed bilateral eyelid SS and add some points concerning the SS. Sweet's syndrome, also referred to as febrile neutrophilic dermatosis, is characterized by fever, neutrophilic leukocytosis, painful red papules, nodules and plaques that respond readily to corticosteroid therapy [2], [3]. Although SS has been linked to hematologic malignancies, the frequency of SS with leukaemia is even lower in patients with neutropenia [4].

There are conflicting data about the effects of cisplatin on erythropoietin (EPO) response to anemia. Aim of our study was to investigate whether endogenous EPO response to anemia in cisplatin treated patients was insufficient in comparison to the anemic chemotherapy-naive cancer patients and non cancer patients with iron deficiency anemia. Patients who had hemoglobin (Hb) levels of less than 110 g/l were included in the study. Fifteen chemotherapy-naive cancer patients were enrolled in Group A. Group B consisted of 15 patients who had been treated with three cycles of cisplatin chemotherapy and then became anemic and in Group C were included 15 patients who had iron deficiency anemia, without any malignancy. The mean Hb values were not different between all groups (102.8 +/- 39.8 g/l, 103.1 +/- 2.5 g/l and 99.3 +/- 3.6 g/l in Group A, Group B and Group C, respectively). However, EPO levels were found to be significantly lower in Group A and Group B than Group C (29.63 +/- 9.09 mU/ml, 20.87 +/- 2.43 mU/ml and 85.38 +/- 25.72 mU/ml, respectively; p=0.017 Group A vs. Group C, p=0.005 Group B vs. Group C). No significant difference was found between Group A and B (p=0.917). Opposite the iron deficiency anemia, cancer anemia is associated with an inadequate EPO response to anemia and administration of cisplatin does not lead to it further deterioration.

Prostatın küçük hücreli karsinomu (KHK) nadir ve son derece saldırgan bir tümördür. Tüm prostat kanserlerinin %1’den daha azını oluşturur. Sıklıkla nodal veya visseral metastazlarla birlikte ileri evrede prezente olur ve kötü bir prognoza sahiptir. Mevcut verilerden yola çıkılarak prostat KHK için optimal bir tedavi şeklinin belirlenmesi zordur. Biz burada bir prostat KHK olgusunu literatür bilgileri ile birlikte sunuyoruz. Small cell carcinoma (SCC) of the prostate is a rare and extremely aggressive malignant disease. It constitutes less than 1% of all prostatic neoplasms. Frequently it presents at advanced stage with nodal or visceral metastasis and has a poor prognosis. From the existing data it is difficult to define an optimum treatment strategy for SCC of the prostate. Here, we present a case of SCC of the prostate with a brief review of the literature

We read with great interest the article by Ault et al1 in a recent issue of Journal of Clinical Oncology, describing the results of pregnancy among patients with chronic myeloid leukemia (CML) treated with imatinib. We would like to add some points and bring attention to some questions concerning imatinib and pregnancy. Tyrosine kinases (TKs) are one of the most critical groups of signaling molecules for the cellular regulation of proliferation, differentiation, survival, function, and motility, and various tumors overexpress TKs, leading to uncontrolled mitogenic signals to the neoplastic cells. Imatinib (Gleevec or Glivec; Novartis, Basel, Switzerland) is a small-molecule tyrosine kinase inhibitor active against BCR-ABL, c-ABL, ARG, PDGF-r, and c-KIT.2 Although imatinib has been used primarily for cancers such as CML, use of imatinib has demonstrated that tyrosine kinase inhibitors can have a wide therapeutic window and heralds the era of targeted cancer and noncancer disease therapy. Information about the effects of drugs on the developing embryo is derived primarily from animal experiments and case reports describing the outcomes of pregnancies complicated with drug. Some drugs can be teratogenic in some animal species, but not in humans. In preclinical studies imatinib was found to be teratogenic in rats, but not in rabbits, and impaired spermatogenesis was observed in rats, dogs, and monkeys; however, there was no evidence that imatinib was genotoxic. These observations lead to concerns that men treated with imatinib may have reduced sperm counts. Clinical experience has not shown this to be true because male patients who were receiving treatment of imatinib were partners in 18 pregnancies and four healthy infants. Owing to teratogenicity data in rats (causing exencephaly or encephalocele, and absent or reduced frontal and absent parietal bones), it is recommended that women treated with imatinib be aware of the potential teratogenicity of imatinib, and effective contraception should be used during imatinib therapy to prevent pregnancy.2 Hensley and Ford2 reported 26 pregnancies (15 in clinical trials, 11 in nonclinical trials) among women taking imatinib. Most of the patients opted for elective therapeutic abortions, and only three patients carried their pregnancies to term. Two infants were healthy, and one infant had hypospadias. Recently, eight patients with CML who became pregnant while receiving imatinib therapy were reported from different areas of the world.3-7 All of the fetuses had been exposed to imatinib during the first trimester, and four fetuses have also been exposed to imatinib during the second and third trimesters. Six of the reported eight pregnancies proceeded to term with healthy infants, and two were terminated with unsatisfactory outcomes—one had spontaneous abortion4 and the other had a dead fetus with meningocele.7 More recently, Ault et al1 reported their experience on 19 pregnancies involving 18 patients (10 female and eight male patients) who conceived while receiving imatinib for the treatment of CML. Three pregnancies (involving two female patients and one male patient) ended in spontaneous abortion, and one patient had an elective abortion. All other pregnancies were uneventful. Two of 16 infants had minor abnormalities at or shortly after birth (hypospadias in one and rotation of small intestine in another) that were surgically repaired.