TR-Dizin Kapalı Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10757
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Item Treatment Outcomes of Breast Cancer Liver Metastasis Treated with Stereotactic Body Radiotherapy(2018) Onal, Cem; Guler, Ozan Cem; Yildirim, Berna Akkus; https://orcid.org/0000-0002-2742-9021; https://orcid.org/0000-0001-6908-3412; https://orcid.org/0000-0001-6661-4185; 30296648; HOC-5611-2023; AAC-5654-2020; V-5717-2017Background: To assess the outcomes of breast cancer liver metastasis (BCLM) treated with stereotactic body radiotherapy (SBRT) and systemic treatment. Materials and methods: Patients with oligometastasis at the time of liver metastasis (LM) or who became oligometastatic (<= 5 metastases) after systemic treatment were assessed. Twenty-nine liver metastatic lesions were treated with a total of 54 Gy delivered in 3 fractions. The local control (LC), overall survival (OS), and progression-free survival (PFS) rates were calculated using Kaplan-Meier analyses. Results: A total of 22 patients with 29 liver metastatic lesions treated with liver SBRT between April 2013 and September 2017 were retrospectively analyzed. After a median follow-up time of 16.0 months (range 4.4-59.4 months), 18 patients (82%) had disease recurrence, median of 7.4 months (range 1.0-27.9 months) after completion of liver SBRT. The 1- and 2-year OS rates were 85% and 57%, and the 1- and 2-year PFS rates were 38% and 8%, respectively. The 1- and 2-year LC rates were 100% and 88%, respectively. No significant prognostic factors, including disease extension, size of metastasis, number of liver metastasis and timing of liver metastasis, hormonal status affecting OS, PFS and LC were found. No patients experienced Grade 4 or 5 toxicity; furthermore, only one patient experienced rib fracture 6 months after completion of treatment, and one patient had a duodenal ulcer. Conclusion: This study is the first to evaluate the feasibility of SBRT to BCLM patients. Liver SBRT is a conservative approach with excellent LC and limited toxicities. (C) 2018 Elsevier Ltd. All rights reserved.Item The prognostic significance of stage I ovarian clear cell and endometrioid carcinomas arising from endometriotic cysts: is it a myth?(2019) Ayhan, Ali; Akilli, Huseyin; Haberal, Nihan; 30315413PurposeThe aim of this study was to determine the clinicopathologic features and the prognostic significance of Stage I ovarian clear cell and endometrioid carcinomas arising from endometriotic cysts.Materials and methodsPatients with either Stage I ovarian clear cell or endometrioid carcinoma were divided into three groups. *Group 1: Patients with cancers arising from endometriotic cysts *Group 2: Patients with ovarian and pelvic endometriosis *Group 3: Patients without endometriosis Patient characteristics (overall survival and disease-free survival) were compared between groups.ResultsOf the 78 patients who participated in this study, 39 were in group 1, 13 were in group 2, and 26 were in group 3. The mean age in groups 1, 2, and 3 were 46years, 54years, and 48years, respectively (p=0.39). Tumoral characteristics, including capsule rupture, positive cytology, grade, and the presence of synchronous endometrial cancer were similar in both groups. The 5-year overall survival rate in groups 1, 2, and 3 were 100, 90, and 93%, respectively (p=0.4). Moreover, the recurrence rates did not differ significantly between groups. Furthermore, subgroup analysis of clear cell carcinoma and endometrioid adenocarcinoma separately showed no effect of endometriosis on disease-free survival (DFS) or overall survival (OS).ConclusionClear cell or endometrioid ovarian carcinoma arising from ovarian and/or pelvic endometriosis shares the same clinicopathologic characteristics with their counterparts that do not arise from endometriosis and patients have similar overall and disease-free survival.Item Remifentanil based anesthetic management for orchiopexy operation in pediatric patient with congenital hypotonia(2019) Caliskan, Esra; Sener, Mesut; Kirpi, Meltem; Aribogan, Anis; 0000-0001-6497-0610; 30633316; S-8336-2019Item An add-on therapy for neuropathic pain: Infiltration block with diclofenac sodium and lidocaine through the hypertrophic scar tissue(2019) Eker, Hatice Evren; Yalcin Cok, Oya; Bozdodan Ozyilkan, Nesrin; Aribodan, Anis; 30633313In some situations, the cause of the supposed neuropathic pain might be related to abnormal tissue recovery such as scar formation due to wound retraction that might create mechanical compression on the nerve tissue. In this report we describe infiltration block with diclofenac sodium and lidocaine through the hypertrophic scar tissue to reduce mechanical stress in 3 patients. The infiltration technique might resolve the tension of the contracted scar tissue by tearing the adhesions and the eliminated mechanical compression would reduce the pressure on nerve tissue and hence neuropathic pain symptoms.Item Assessment of patients with von Willebrand disease with ISTH-BAT and PBQ scores(2019) Belen, F. B.; Umit, E. G.; Zengin, Y.; Evim, M.S.; Unal, E.; Ozbas, H. M.; Acipayam, C.Item Multifunctional Phototherapy Device Design(2019) Aksahin, MehmetToday, phototherapy devices are used to treat newborn jaundice. However, there are some cases that the commercial phototherapy devices are inadequate. Most of the device are controlled only at the certain interval that prevents instantaneous monitoring the newborn's vital parameters. For other cases, devices are one-way lighting. In addition, when the baby is taken away from the device, unnecessary lighting causes the decrease in LED's lifetime. In the scope of the study, intensive phototherapy device was developed to eliminate deficiencies that are mentioned above. Properties of the developed phototherapy device are; Automatic detection of newborn's presence, double-sided illumination, continuous monitoring with IP webcam, temperature measurement of the environment and also newborn's body temperature. The light intensity of the device was measured with a photometer as 28.6 mu W/cm(2)/nm that was obtained from 460nm wavelength LED illumination in both top and bottom in accordance with the American Academy of Pediatrics (AAP) guideline.Item Levels of depression, anxiety and quality-of-life of kidney and liver donors in a university hospital in Ankara(2019) Karagol, Arda; ABE-8882-2020Objective: The psychosocial assessments of live kidney and liver donor candidates constitutes an important issue whereas many studies has drawn attention to the donation's correlation with anxiety and depression as well as the unwanted psychosocial outcomes. There are studies that find psychiatric disorders that appear in the post-operative period after donation lower or higher compared to the normal population. Altruism is considered as a concept that ensures vital stress management and is defined as 'the degree of obligation felt in situations where you are supposed to help others'. It is believed that altruistic behavior is a mature defense mechanism, which prevents the development of psychiatric disorders such as anxiety disorder and depression and protects the individual against those psychiatric disorders. Methods: Our study included 51 participants who were donors of kidney and liver at Ankara Hospital of Baskent University between the years 2016 and 2017, and who accepted to participate in the study. The participants were given the Beck Depression Inventory, Beck Anxiety Inventory, SF-36 Quality-of-Life Scale and a Sociodemographic Questionnaire. Results: When the donors who participated in the study were compared with the Turkish society standards, the patient group was found to obtain significantly higher scores than the society average in the quality-of-life subscales 'physical function', 'difficulty in physical role', 'mental health' and 'pain', therefore, they were found to have a higher quality-of-life. Among the donors who participated in our study, the rate of those with moderate to severe depression was found to be 3.9% and of those with moderate to severe anxiety was found to be 'zero'. Discussion: Organ donation may be an altruistic behavior acting as a defensive mechanism that protects the individual against mental disorders such as depression and anxiety and increasing the quality-of-life.Item SAPS III or APACHE IV: Which score to choose for acute trauma patients in intensive care unit?(2019) Toker, Melike Korkmaz; Gulleroglu, Aykan; Karabay, Ayse Gul; Bıcer, Ilhan Guncey; Demiraran, Yavuz; 31135940BACKGROUND: The aim of the present study was to evaluate the effectiveness of the Simplified Acute Physiology Score (SAPS) III and the Acute Physiology and Chronic Health Evaluation (APACHE) IV in the prediction of in-hospital mortality in surviving multi-trauma patients. METHODS: This study was conducted in the 13-bed intensive care unit (ICU) of a tertiary hospital. A retrospective review of multi-trauma patients whose care was managed in the ICU was performed. Data collection included details of age, gender, ICU admission, and outcome. APACHE IV and SAPS III scores, as well as the predicted mortality rate (PMR), were calculated using web-based calculators. RESULTS: Of the 90 patients 20% (n= 18) were female and 80% (n= 72) were male. The overall mortality rate was 25.6%. The mean APACHE IV, Acute Physiology Score (APS) and SAPS III score was 69.27 +/- 34.51, 66.42 +/- 33.72, and 26.36 +/- 27.14, respectively. The mean PMR according to the APACHE IV and the SAPS III was 26.36 +/- 27.14 and 17.07 +/- 24.88, respectively. The area under the curve result of receiver operating characteristic curve analysis was 0.87 for the APACHE IV and 0.93 for the SAPS III. CONCLUSION: The performance of the SAPS III was more sensitive and discriminative than the APACHE IV scoring system for multi-trauma ICU patients.Item Investigation of beta globin gene mutations in Syrian refugee patients with thalassemia major(2019) Cevirici, Hatice; Acipayram, Can; Yenilmez, Ebru Dundar; Belen, Fatma Burcu; Pekpak, Esra; Yaman, Yontem; Tuli, AbdullahObjectives: This study, detection of beta globin gene mutations in thalassemia major patients who migrated from Syria to Kahramanmaras region were planned. Materials and methods: The study included 35 Syrian national beta thalassemia major patients. Beta globin gene mutations were detected by ARMS (Amplification Refractory Mutation System) method, RFLP (Restriction Fragment Length Polymorphism) method and DNA sequence analysis. Codon 15, codon 9/10, codon 5 and codon 8 mutations, which we could not detect with other methods in our study, were detected by sequence analysis. Results: In beta thalassemia major patients, 16 types of mutations were detected, the most common being IVS-I-110 (n = 8). Other mutations are according to frequency order IVS-II-745 (n = 3), codon 44 (n = 3), codon 15 (n = 3), IVS-I-110/IVS-I-1 (n = 3), codon 5 (n = 2), IVS-I-1 (n = 2), codon 8/IVS-II-1 (n = 2), codon 44/codon 15 (n = 2), IVS-II-1 (n = 1), codon 39 (n = 1), IVS-I-6/codon 5 (n = 1), codon 9/10 (n = 1), IVS-I-110/codon 39 (n = 1), IVS-I-5/IVS-II-1 (n = 1), codon 39/IVS-II-745 (n = 1). Conclusions: According to the results of our study betathalassemia mutations in Syrian immigrant groups show heterogeneity and mutation types of mutation map is similar to Turkey. The conclusion is to prevent families to have a second patient child by genetic counseling.Item Oncological Outcomes of Stage IIIA Endometrioid Type Endometrial Cancer: A Multicenter Study(2019) Sahin, Hanifi; Yalcin, Ibrahim; Sari, Mustafa Erkan; Sahin, Eda Adeviye; Aslan, Koray; Aglamis, Ozgur; Gulseren, Varol; Gungorduk, Kemal; Meydanli, Mehmet Mutlu; Ayhan, AliThe objective of this retrospective study was to evaluate Stage IIIA endometrioid type endometrial carcinomas (ECCs) and to analyze clinical and pathological determinants of prognosis in three tertiary hospitals between January 2007 and January 2017. Forty-seven patients with a median age of 61 (range: 31 to 76) years were diagnosed with Stage IIIA disease. Median follow-up was 45 (range: 6 to 116) months. The five-year disease-free survival (DFS) rate was 57.2%, and the overall survival (OS) rate was 59.7%. In the univariate analysis, age and grade of the disease (1-2 versus 3) disease were found to be significant factors for DFS. Univariate analysis also revealed the presence of cervical stromal involvement and grade of the disease were associated with decreased OS. In the multivariate analysis, however, only patients with an advanced histological grade had a reduced risk for OS (hazard ratio [FIR] 2.9; 95% confidence interval [CI] 1.020-8.615; p= 0.040). In conclusion, histological grade seems to be an independent prognostic factor for OS in patients with Stage IIIA ECCs.