Fakülteler / Faculties
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Item Investigation of the Genotoxic Effect of Fluoxetine Hydrochloride in Drosophila melanogaster(KSU TARIM VE DOGA DERGISI-KSU JOURNAL OF AGRICULTURE AND NATURE, 2024-04-17) Oz, Selda; Sarikaya, Zeynep Nur; Larcin, Ozum; Sarikaya, RabiaThis study aimed to determine the potential genotoxic effect of fluoxetine hydrochloride (FLX-HCl), an antidepressant commonly used for treating depression, using Somatic Mutation and Recombination Test (SMART). Third-instar Drosophila melanogaster larvae transheterozygous for the mutations multiple wing hair (mwh) and flare (flr3) were chronically fed in a medium containing different concentrations of FLX-HCl (0.1, 0.5, 1, and 2 mg/mL) in the experimental group. Distilled water, 0.1 mM ethyl methane sulfonate (EMS), and 2% dimethyl sulfoxide (DMSO) were used in negative, positive, and solvent control groups, respectively. The survival percentages were calculated by determining the number of individuals surviving when the larvae completed their development in the experimental and control groups. In all application groups, the wings of 40 individuals with both normal and serrate wing phenotypes were examined under a microscope, and genetic changes were evaluated by counting the mutant clones in the wings. The data obtained show that 1 and 2 mg/mL concentrations of FLX-HCl caused toxic effects in D. melanogaster individuals. Additionally, FLX-HCl showed a negative genotoxic effect at 0.1 mg/mL concentration, insignificant at 0.5 mg/mL concentration, and positive at 1 and 2 mg/mL concentrations in terms of total mutation evaluation and clone induction frequency in D. melanogaster individuals.Item Survival of Root Canal-Treated Teeth Adjacent to An Implant: A Retrospective Case-Control Study(2023) Sisli, S. N.; Gul Ates, E.; Ozcelik, T. B.; Yilmaz, B.; Revilla Leon, M.; 0000-0001-5685-4409; 0000-0002-6166-2601; 37839623; JJF-5618-2023Objectives: To evaluate the survival of root canal treated (RCT) teeth adjacent to an implant compared with that of RCT teeth of the same patient non-adjacent to an implant.Materials and methods: RCT tooth of each patient adjacent to an implant were included in the test group. The control group consisted of another RCT tooth of the same patient; the control RCT tooth was not adjacent to an implant and selected to be of the same type of the RCT tooth in the test group. 72 teeth of 36 patients with at least 4-year follow-up were included. In addition to survival, other clinical and demographic parameters investigated were age, sex, tooth type and position, presence of a crown, presence of retreatment, presence of a post-core, presence of adjacent edentulous area, presence of implant-supported fixed prosthetic restoration on the antagonist tooth and periapical health status. Pearson Chi-Square and Fisher Exact tests were used to compare the test and the control groups with categorical variables (alpha=0.05). Survival curves were obtained by the Kaplan-Meier method, and the Log-rank test was performed to compare the survival probabilities (alpha=0.05).Results: No significant difference in survival rates was observed between the test and the control groups (p = 0.72). Similarly, no significant relationship was found between the investigated clinical variables and the survival rates of RCT teeth (p>0.05). Survival times differed depending on the presence of an adjacent edentulous area (p<0.001) and the periapical health status (p = 0.026).Conclusions: RCT teeth with unhealed periapical tissues had a shorter cumulative survival time. Similarly, those adjacent to an edentulous area had shorter cumulative and complication-free survival times.Clinical Significance: This is the first study to determine the survival outcome of a RCT tooth adjacent to an implant compared to a non-adjacent one in the same patient. Being adjacent to an implant did not have a detrimental effect on the survival time and rate of RCT teeth.Item A Single-Center Retrospective Clinicopathologic Study of Endomyocardial Biopsies After Heart Transplant at Baskent University Hospital in Ankara, 1993-2014(2015) Terzi, Ayen; Sezgin, Atilla; Tunca, Zeynep; Deniz, Ebru; Ayva, Ebru Sebnem; Reyhan, Nihan Haberal; Mulderrisoglu, Haldun; Ozdemir, Binnaz Handan; 0000-0002-2280-8778; 0000-0002-7528-3557; 0000-0002-1225-1320; 0000-0001-9852-9911; 25894188; AAK-1967-2021; X-8540-2019; F-7546-2013; AAK-4587-2021Objectives: The purpose of this study was to investigate the frequency and prognostic importance of acute cellular rejection after heart transplant. Materials and Methods: All 84 heart transplant patients at our center from January 1993 to January 2014, including all 576 endomyocardial biopsies, were evaluated with retrospective review of clinical records and endomyocardial biopsies. Routine and clinically indicated endomyocardial biopsies after heart transplant were graded for acute cellular rejection (2005 International Society for Heart and Lung Transplantation Working Formulation). Survival analysis was performed using Kaplan-Meier method. Results: There were 61 male (73%) and 23 female recipients. Median age at heart transplant was 29 years (range, 1-62 y). Posttransplant early mortality rate was 17.9% (15 patients). In the other 69 patients, 23 patients died and 46 patients (66.7%) were alive at mean 69.3 +/- 7.2 months after heart transplant. Mean follow-up was 35.4 +/- 29.8 months (range, 0.07-117.5 mo). Mean 8.4 +/- 4.2 endomyocardial biopsies (range, 1-19 biopsies) were performed per patient. Median first biopsy time was 7 days (range, 1-78 d). The frequency of posttransplant acute cellular rejection was 63.8% (44 of 69 patients) by histopathology; 86% patients experienced the first episode of acute cellular rejection within 6 months after transplant. There were 18 patients with acute cellular rejection >= grade 2R on >= 1 endomyocardial biopsy in 44 patients with acute cellular rejection. No significant difference was observed between survival rates of patients with grade 1R or >= grade 2R acute cellular rejection, or between survival rates of patients with or without diagnosis of any grade of acute cellular rejection. Acute cellular rejection was not related to any prognostic risk factor. Conclusions: Acute cellular rejection had no negative effect on heart recipient long-term survival, but it was a frequent complication after heart transplant, especially within the first 6 months.Item Results of Liver Transplant in Elderly Patients: A Single Center Experience(2015) Akdur, Aydincan; Fidan, Cihan; Soy, Ebru Ayvazoglu; Kirnap, Mahir; Karakayali, Feza Yarbug; Torgay, Adnan; Yildirim, Sedat; Moray, Gokhan; Haberal, Mehmet; 0000-0002-5735-4315; 0000-0002-9093-1524; 0000-0002-8726-3369; 0000-0002-3462-7632; 0000-0002-1874-947X; 0000-0002-0993-9917; 0000-0003-2498-7287; 0000-0002-6829-3300; 25894140; AAF-4610-2019; AAH-9198-2019; F-5830-2019; AAA-3068-2021; AAJ-8097-2021; AAB-3888-2021; AAC-5566-2019; AAE-1041-2021; AAJ-5221-2021Objectives: With the increased life span, the need for liver transplant for elderly patients also increased in the world. In this study, we reviewed our experience to determine the outcomes and problems of patients aged > 60 years who had liver transplants. Materials and Methods: Data of recipients aged > 60 years were reviewed retrospectively. We analyzed 16 elderly patients who had liver transplant for chronic liver disease between 2001 and 2014 in our center. Results: In our series, there were 5 women and 11 men between age 60 and 65 years. The mean Child-Pugh score was 7.9 +/- 1.7 and Model for End-Stage Liver Disease score was 14.1 +/- 5.1. Primary liver disease was hepatitis B in 9 patients (34.5%), most of them with hepatocellular carcinoma. The other causes of liver failure were hepatitis C (n = 4), alcoholic cirrhosis (n = 2), and cryptogenic cirrhosis (n = 2); 1 patient had both hepatitis B and hepatitis C virus, and 1 patient had both hepatitis B virus and alcoholic cirrhosis. There were 9 patients who had hepatocellular carcinoma. Mortality was observed in 4 patients. The reasons for mortality were sepsis (n=3) and hepatocellular carcinoma (n=1). Conclusions: Liver transplant can be safely performed and has acceptable long-term outcomes in low-risk elderly recipients. Age alone should not be a contraindication for liver transplant in elderly patients.Item Docetaxel, Cisplatin, and Fluorouracil Combination in Neoadjuvant Setting in The Treatment of Locally Advanced Gastric Adenocarcinoma: Phase II NEOTAX Study(2014) Ozdemir, Nuriye; Abali, Huseyin; Vural, Murat; Yalcin, Suayib; Oksuzoglu, Berna; Civelek, Burak; Oguz, Dilek; Bostanci, Birol; Yalcin, Bulent; Zengin, Nurullah; https://orcid.org/0000-0001-5596-0920; 25234436; D-7660-2016This phase II trial aimed to evaluate the efficacy and safety of docetaxel, cisplatin, and fluorouracil (DCF) combination in neoadjuvant setting in patients with locally advanced gastric adenocarcinoma. Fifty-nine patients with resectable or unresectable locally advanced gastric and gastroesophageal cancer were recruited in this multicenter, single-arm, open-label, local clinical phase II study conducted at three centers from Turkey between June 2006 and March 2012. Patients had T3-4 or lymph node-positive disease. After staging with imaging and laparotomy or laparoscopy, they received three cycles of DCF with lenograstim. Imaging studies were repeated after the last two cycles. Patients who underwent surgery were followed up for at least 1 year after the surgery. Toxicity and response were evaluated in accordance with NCI-CTC version3.0 and RECIST 1.0. At baseline, 66.1 % of patients were considered resectable. In 47 patients evaluable, partial response in 16 (34.0 %), stable disease in 27 (57.5 %), and progressive disease in four (8.5 %) were observed. Forty-six patients underwent surgery. In 38 (64.4 %; 95 % confidence interval (CI) 52.2-76.6 %) out of 59 patients, complete resection (R0) was achieved. Median overall and disease-free survival were 19.1 months (95 % CI 13.5-24.7) and 11.6 months (95 % CI 5.9-17.4), respectively. The most frequent grade 3-4 adverse events were neutropenia (52.5 %), febrile neutropenia (11.9 %), leukopenia (39.0 %), and diarrhea (10.5 %). One patient died from an unknown cause. Classical DCF triplet with lenograstim showed a good clinical response with acceptable safety profile in the treatment of locally advanced gastric and gastroesophageal cancer with a significant R0 rate and manageable toxicity.Item Outcomes of Patients With Hepatocellular Carcinoma After Liver Transplant(2015) Moray, Gokhan; Kirnap, Mahir; Akdur, Aydincan; Soy, Ebru; Tezcaner, Tugan; Boyvat, Fatih; Ozdemir, Handan; Haberal, Mehmet; 0000-0002-0993-9917; 0000-0002-8726-3369; 0000-0002-3462-7632; 0000-0002-3641-8674; 0000-0003-2498-7287; 0000-0002-7528-3557; 26640906; AAC-5566-2019; AAA-3068-2021; AAJ-8097-2021; AAD-9865-2021; F-4230-2011; AAH-9198-2019; AAE-1041-2021; X-8540-2019Objectives: Liver transplant is one of the few effective treatments for hepatocellular carcinoma. Our aim in this study was to evaluate the risk factors for hepatocellular carcinoma recurrence after liver transplant. Materials and Methods: In this retrospective study, conducted between October 1988 and March 2015, four hundred seventy-three liver transplants were performed at our institution. Of these, 231 were pediatric and 242 were adult. Among these patients, liver transplant was performed in 58 patients (12.3%) for treatment of hepatocellular carcinoma. Results: Hepatocellular carcinoma recurrence was detected in 14 patients (24.1%). Overall 5-year and 10-year survival rates of patients underwent liver transplant beyond the Milan criteria for hepatocellular carcinoma were 50.3% and 43.1%. Overall, 5- and 10-year survival rates of patients underwent liver transplant within the Milan criteria for hepatocellular carcinoma were 78.4% and 72.6%. The main predictive variable was whether the tumor had expensed beyond the Milan criteria. Conclusions: As expected, outcomes were significantly better in the Milan criteria group. Although the overall- and disease-free survival rates were promising in such a group of patients who had no better chance, it could be asserted that liver transplant is a safe and effective treatment option with promising results, even if the tumor expanse is beyond the Milan criteria.Item Stereotactic Body Radiotherapy and Tyrosine Kinase Inhibitors in Patients with Oligometastatic Renal Cell Carcinoma: A Multi-Institutional Study(2023) Onal, Cem; Oymak, Ezgi; Guler, Ozan Cem; Tilki, Burak; Yavas, Guler; Hurmuz, Pervin; Yavas, Cagdas; Ozyigit, Gokhan; https://orcid.org/0000-0002-2742-9021; 36450836; HOC-5611-2023Purpose Few studies have determined the viability of stereotactic body radiotherapy (SBRT) and tyrosine kinase inhibitors (TKIs) in the treatment of metastatic renal cell carcinoma (mRCC). We examined the results of RCC patients who had five or fewer lesions and were treated with TKI and SBRT.Methods The clinical data of 42 patients with 96 metastases treated between 2011 and 2020 were retrospectively evaluated. The prognostic factors predicting overall survival (OS) and progression-free survival (PFS) were assessed in uni-and multivariable analyses.Results Median follow-up and time between TKI therapy and SBRT were 62.3 and 3.7 months, respectively. The 2-year OS and PFS rates were 58.0% and 51.3%, respectively, and 2-year local control rate was 94.1% per SBRT-treated lesion. In univariable analysis, the time between TKI therapy and SBRT and treatment response were significant prognostic factors for OS and PFS. In multivariable analysis, a time between TKI therapy and SBRT of less than 3 months and complete response were significant predictors of better OS and PFS. Only 12 patients (28.6%) had a systemic treatment change at a median of 18.2 months after SBRT, mostly in patients with a non-complete treatment response after this therapy. Two patients (4.8%) experienced grade III toxicity, and all side effects observed during metastasis-directed therapy subsided over time.Conclusion We demonstrated that SBRT in combination with TKIs is an effective and safe treatment option for RCC patients with <= 5 metastases. However, distant metastasis was observed in 60% of the patients, indicating that distant disease control still has room for improvement.Item Aiding and Abetting Survival: Americanizing Robinson Crusoe through Adaptation(2022) Tutan, Defne ErsinDaniel Defoe's Robinson Crusoe (1719) has been insistently adapted to both the big screen and TV throughout the 20th century and well into the 21st, the earliest version dating back to 1902 and the most recent to 2016. Although a full list of all versions would be elusive and also redundant, almost 50 adaptations are readily available for viewing and/or for analysis. Moving away from the`fidelity' criticism in the earlier vein of adaptation studies and proceeding from the argument that all adaptations are essentially rewritings, alternative ways in which the source text may be reconstructed in an ultimately intertextual framework, this paper scrutinizes American screen adaptations of Robinson Crusoe, namely Robinson Crusoe on Mars (Dir. Byron Haskin, 1964), Lt. Robinson Crusoe, U.S.N. (Dir. Byron Paul, 1966), and Cast Away (Dir. Robert Zemeckis, 2000). Far from shedding new light on an almost-exhausted source text, these rewritings reflect more about their own discourses, relating to the historical and social contexts of their own making. In so doing, they `Americanize' Robinson Crusoe. As such, three centuries after its publication, Robinson Crusoe is still being repeatedly reinvented and reconstructed in film, and this analysis investigates the dialogical relations among these adaptations while, at the same time, emphasizing how every new adapted version of a work of literature aids and abets the survival of its source text.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 Impact of Presence and Degree of Pretreatment Weight Loss in Locally-Advanced Pancreatic Cancer Patients Treated with Definitive Concurrent Chemoradiotherapy(2016) Yildirim, Berna Akkus; Ozdemir, Yurday; Colakoglu, Tamer; Topkan, Erkan; 0000-0001-6661-4185; 0000-0002-2218-2074; 0000-0001-8120-7123; 27029854; V-5717-2017; AAG-5629-2021; AAG-2213-2021Background: To assess the impact of the presence and degree of pretreatment weight loss (WL) on the survival of locally-advanced pancreas cancer (LAPC) patients treated with concurrent chemoradiotherapy (C-CRT). Methods: Seventy-three patients who received 50.4 Gy C-CRT were analyzed. All patients underwent laparoscopy (n = 18) or laparotomy (n = 55), and biopsies were obtained for histologic examination of the primary tumor and enlarged/metabolically active regional lymph nodes. Pretreatment WL and percentage WL (PWL) were calculated by utilizing data obtained 6 months prior to and during hospital admission. The primary objective was to assess the influence WL status on overall survival (OS), and the secondary objective was the identification of a PWL cut-off value, if available. Results: Forty-five (61.6%) patients had WL. Median OS was 14.4 months for the entire study population which was significantly longer in the non-WL than the WL cohort (21.4 vs. 11.3 months; p < 0.003). On further analysis a cut-off value of 3.1% was identified for WL. Accordingly, patients with WL < 3.1% had significantly longer OS than those with WL >= 3.1% (25.8 vs. 10.1 months; p < 0.001). In multivariate analysis, both the WL status (p < 0.001) and PWL (p = 0.002) retained their independent significance. Conclusion: Both the presence and degree of WL prior to C-CRT had strong adverse effects on the survival of LAPC patients, even if they presented with a BMI > 20 kg/m(2). Additionally, a WL of >= 3.1% in the last 6 months appeared to be a strong cut-off for the stratification of such patients into distinctive survival groups.(C) 2016 IAP and EPC. Published by Elsevier B.V. All rights reserved.