We retrospectively analyzed 294 patients with primary soft tissue sarcoma followed between 1996 and 2002 in Ankara Oncology Hospital. There were 170 male and 124 female patients with the age range of 16-80 years. The primary tumor was in the extremity in 72.9% of the patients. We determined lung metastasis in 102 (85%) out of the 120 patients as distant metastasis. The most common adult sarcomas were liposarcoma (16.3%), malignant mesenchymal tumor (MMT) (13.9%), malignant fibrous histiocytoma (MFH) (11.2%), rhabdomyosarcoma (10.2%) and synovial sarcoma (10.2%). Seventeen patients (5.3%) had grade 1 tumor, 143 patients (52.2%) had grade 2 tumor, and 112 patients (41.4%) had grade 3 tumor. In 45 patients (15.3%), the grade of the tumors is unknown. The tumor size was 0 to <5 cm in 54 cases (19.4%), 5-10 cm in 117 cases (41.9%) and >10 cm in 108 cases (38.7%). In 15 cases (5.1%), tumor size was unknown. Ninety-five patients (32.4%) were treated with adjuvant chemotherapy, and 125 patients (42.7%)) were treated with palliative chemotherapy. Prognostic factors influencing the overall survival were tumor size, grade, adjuvant radiotherapy and chemotherapy. Adjuvant radiotherapy had influence on disease-free survival. While tumor grade and size showed a significant value for predicting local recurrence, grade, localization of tumor, adjuvant chemotherapy and radiotherapy had an impact on metastasis development. The 1-year overall survival for all patients was 73.4%, 3-year overall survival was 51.8%, and 5-year overall survival was 45.1%.

ÖZETAmaç: Metabolik sendrom artmış kardiyovasküler mortalite ve morbidite ile ilişkili olabilir. Fakat metabolik sendromun QT sürelerinin uzamasına neden olduğu halen belirsizdir. Bu çalışmanın amacı metabolik sendromla birlikte bulunan uzamış QT süresinin sıklığını araştırmak ve varsa aralarındaki ilişkiyi göstermektir. Bu amaçla geniş bir hasta grubunda metabolik sendromun QT uzaması ile ilişkisini araştırmayı amaçladık. ABSTRACTObjectives: Metabolic syndrome may be associated with increased cardiovascular mortality and morbidity. However, prolongation of QT intervals due to metabolic syndrome is still unclear. The purpose of this study was to investigate the incidence prolonged QT intervals in patients with metabolic syndrome and also demonstrate the relationship between them. Therefore, we aimed to investigate the relationship between metabolic syndrome and the QT prolongation in a large patient group. Materials and methods:A total of 1009 individuals were enrolled in this study. Metabolic syndrome was defined according to the IDF criteria and the QTc intervals were measured by using Bazett Formula. QT ≤ 0.44 second was accepted as normal.Results: Totally, 278 male and 731 female individuals of 1009 cases were enrolled in this study. The average duration of corrected QT of men according to the Bazzett formula were found as 0,448±0,04 second and QT interval of women were 0,449±0,05 second. QT intervals of both women and men with metabolic syndrome were significantly higher than normal limits of QT interval (p<0,01). Conclusion:Metabolic syndrome found as associated with a prolonged QTc. Results of our study suggest that QTc interval length was increased in patients with metabolic syndrome.

Objective: We investigated the effect of intravenous levosimendan on QT dispersion compared with intravenous dobutamine in patients with acute decompensated heart failure. Methods: This prospective cohort study included 38 patients who were admitted with acute decompensated heart failure (New York Heart Association functional class III-IV). Twenty-five patients (11 men, 14 women; mean age 70.5±11.13 years) were treated with levosimendan infusion and 13 patients (5 men, 8 women; mean age 71.08±6.86 years) were treated with dobutamine infusion. Intravenous levosimendan was administered with an initial bolus dose of 12 µg/kg for 10 min, followed by a continuous infusion of 0.1 µg/kg/min for 1 hour and 0.1 µg/kg/min 23 hours. Intravenous dobutamine was administered with a continuous dose of 10 µg/kg /min for 24 hours. Transthoracic echocardiography was performed and electrocardiograms were obtained before and after drug infusions. QTc dispersion was defined as the difference between the 16 ÖZET Amaç: Biz bu çalışmada, akut dekompanse kalp yetersizliği ile başvuran hastalarda levosimendan ve dobutamin infüzyonunun QT dispersiyonu üzerine olan etkisini araştırdık. Yöntemler: Bu prospektif kohort çalışmasında, akut dekompanse kalp yetersizliği tanısıyla yatırılan, New York Kalp Derneği (NYHA) sınıflama-sına göre sınıf III-IV kalp yetersizliği olan 38 hastadan, 25 hastaya (11'i erkek, 14'ü kadın, ortalama yaş: 70.5±11.13 yıl) levosimendan infüzyonu ve 13 hastaya (5'i erkek, 8'i kadın, ortalama yaş: 71.08±6.86 yıl) dobutamin infüzyonu verildi. İntravenöz levosimendan ilk 10 dakika 12 µg/kg/dk ile yükleme, sonraki 50 dakikada 0.1 µg/kg/dk, takiben 23 saatte ise 0.2 µg/kg/dk ile idame tedavisi şeklinde verildi. İntravenöz dobutamin ise 24 saat boyunca 10 mg/kg/dk dozunda verildi. İnfüzyon öncesi ve sonrasında hastaların transtorasik ekokardiyografileri yapıldı ve elektrokardiyografileri çekildi. QT dispersiyonu, maksimum QT ve minimum QT süresi arasındaki fark olarak tanımlandı ve bulunan değer kalp hızına göre düzeltildi. Verilerin analizinde Ki-kare Testi, Wilcoxon Testi ve Mann-Whitney U Testi kullanıldı. Bulgular: Hem levosimendan hem de dobutamin alan hasta grubunda, tedavi öncesi ve sonrasında kalp hızına göre düzeltilmiş minimum QT değerleri, maksimum QT değerleri ve QT dispersiyonları arasında istatistiksel olarak anlamlı fark bulunmadı (levosimendan grubunda sırası ile tedavi öncesi ve 24. saat değerleri 0.43±0.04 sn, 0.44±0.04 sn; 0.49±0.05 sn, 0.50±0.05 sn; 0.06±0.03 sn, 0.06±0.03 sn; dobutamin grubunda ise 0.39±0.05 sn, 0.41±0.05 sn; 0.45±0.05 sn, 0.48±0.05 sn; 0.06±0.04 sn, 0.06±0.04 sn) (p>0.05). Her iki tedavi grubunda takip süresince ilaçlara bağlı yan etki görülmedi. Sonuç: Tedavi dozlarında levosimendan infüzyonunun, dobutamin infüzyonu ile karşılaştırıldığında, akut dekompanse kalp yetersizliği hastaların-da aritmi gelişme olasılığının bir göstergesi olabilen QT parametreleri üzerine anlamlı bir etkisi görülmedi.

Abst ract RS3PE (remitting seronegative, symmetric synovitis with pitting edema) is a benign, seronegative syndrome, with an acute onset of pitting edema on the dorsum of both hands and feet, which affects predominantly peripheral joints such as wrists and ankles symmetrically. A 58-year-old man presented with acute symmetrical polysynovitis of the wrists and ankles associated with pitting edema on the dorsum of the both hands and feet. He responded well to low-dose corticosteroids. There was no evidence of erosion radiologically. The clinical manifestations of the patient were consistent with RS3PE syndrome. Here, we present a case of RS3PE and review the literature. (Turk J Rheumatol 2010; 25: 88-90

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