Browsing by Author "Uzun, M"

Now showing 1 - 9 of 9
  • No Thumbnail Available
    Item
    Factors Predicting Response in Breast Cancer Receiving Neoadjuvant Therapy and the Role of Ki67 Labeling Index
    Ekinci, F; Uzun, M; Demir, B; Unek, IT; Erdogan, AP
    Objective: To determine the predictive value of Ki67 on pathological complete response (pCR) of breast and axilla regions in breast cancer (BC) patients receiving neoadjuvant therapy (NAT).Study Design: Descriptive study.Place and Duration of the Study: Departments of Medical Oncology, Sirnak State Hospital, Aydin State Hospital, Manisa Celal Bayar University, and Dokuz Eylul University, from November 2010 to July 2022.Methodology: PCR and various histopathological parameters were evaluated for BC patients receiving NAT. The Youden Index method was used to find the cut-off value for the Ki67 variable according to the receiver operating characteristic (ROC) curve. This value was obtained as 77.5. Breast and axillary responses were individually evaluated to assess response to NAT. Univariate and multivariate logistic regression analysis were used to predict both breast and axillary pCR.Results: A total number of 280 females receiving NAT for BC were included in the study. Multivariate analysis for breast pCR to NAT showed that Ki67 index (>77.5 vs <77.5, p=0.047) was statistically significant marker. While Ki67 index was significant for breast pCR in both univariate and multivariate analyses, the same was not observed on axillary response (p=0.387).Conclusion: High Ki67 level was significantly associated with breast pCR in BC patients receiving NAT, but a similar effect was not observed on axillary pCR. These findings suggest that breast and axilla tissues have a biological differences in treatment responses.
  • No Thumbnail Available
    Item
    The evaluation of intraarticular lesions accompanying ACL ruptures in military personnel who elected not to restrict their daily activities: the effect of age and time from injury
    Yüksel, HY; Erkan, S; Uzun, M
    The purpose of this study was to evaluate arthroscopically the type, localization and prevalence of the meniscal and chondral lesions accompanying complete rupture of the anterior cruciate ligament (ACL) in patients who elected not to restrict their daily activities after the initial trauma. The size of the chondral lesions was also evaluated. Our second aim is to analyze the effects of age, time from injury, and both age and time from injury in the presence or absence of accompanying lesions in these patients. The localization and type of the accompanying lesions of 317 knees with complete rupture of the ACL were recorded by the same observer. We applied therapeutic arthroscopy to all patients after their first visit to our clinic. All of the patients were military personnel and their history revealed that they had elected to not restrict their occupational activities after the first trauma causing ACL insufficiency. We defined the first 6 week period after the initial trauma as the acute, 6 weeks to 12 months as the subchronic and 12 months or longer as the chronic period. The average time from injury to arthroscopy for these patients, who were all male, was 19.4 +/- 20.3 months. Eighty-one percent of the patients had at least one meniscal tear, and 45.1% had at least one chondral lesion. The mean ages at the time of surgery of patient groups with or without medial and lateral menisci lesions were compared, and no statistically significant difference was determined. In the chronic period, the relative risk (RR) values of meniscal tears were 7.75 for medial and 2.40 for lateral. The group consisting of patients with chondral lesions was compared with the group of patients without chondral lesions in terms of their ages and the time from injury to arthroscopy, and the difference was statistically significant. The RR value for patients with co-existence of at least two lesions was 1.761 for more than 30 years of age. The RR values for at least two lesions were 2.356 for the subchronic and 14.909 for the chronic group when compared to the acute group. The RR values in patients more than 30 years of age in the chronic group were 13.58 for medial meniscus, 3.21 for lateral meniscus and 71.88 for chondral lesions when compared to patients less than 30 years of age in the acute group. It is important to note that the combined effects of advanced age and prolonged time from injury in patients who elected to not restrict occupational activities are more severe due to the increase in the occurrence of intraarticular lesions accompanying ACL insufficiency as compared to their separate effects.
  • No Thumbnail Available
    Item
    Is CRP/Albumin Ratio (CAR) a New Parameter to be Added to Risk Stratification Systems in Metastatic Renal Cell Carcinoma Patients?
    Uzun, M; Yildirim, EC; Ekinci, F; Semiz, HS
    Objective: To evaluate the effect of pretreatment C-reactive protein (CRP)/Albumin ratio (CAR) on prognosis and its association with IMDC (International metastatic renal cell carcinoma database consortium) risk score and overall survival (OS) in metastatic renal cell carcinoma (mRCC) patients. Study Design: Descriptive study. Place and Duration of Study: Department of Medical Oncology, Dokuz Eylul University, Izmir, Turkey, between 2007 and 2020. Methodology: Clinico-pathological and treatment-related data of mRCC patients were retrospectively evaluated and included in the study. CAR was used as a prognostic inflammatory score. CAR threshold value for OS has been obtained by ROC analysis. The prognostic value of CAR was tested using Kaplan-Meier and Cox-regression models. IMDC-CAR model was created by adding CAR to IMDC risk stratification. Results: OS was 91 months in patients with CAR below the threshold value of 0.072 (<0.072), while OS was 51 months in patients with CAR of 0.072 and above (p=0.005). According to IMDC risk stratification, intermediate and poor risk groups showed similar survival times (p>0.05). However, when CAR was added to the IMDC risk score in the intermediate group, it was divided into 3 subgroups with different prognoses (p=0.02). Conclusion: CAR is an independent predictor of OS in mRCC patients. In this study, it has been demonstrated that more accurate prognosis prediction could be made by adding CAR to IMDC indicators in the intermediate risk group, which constitutes a highly heterogeneous group according to IMDC risk stratification.
  • No Thumbnail Available
    Item
    Multicenter evaluation of crystal violet decolorization assay (CVDA) for rapid detection of isoniazid and rifampicin resistance in Mycobacterium tuberculosis
    Coban, AY; Akbal, AU; Bicmen, C; Albay, A; Sig, AK; Uzun, M; Selale, DS; Ozkutuk, N; Surucuoglu, S; Albayrak, N; Ucarman, N; Ozkutuk, A; Esen, N; Ceyhan, I; Ozyurt, M; Bektore, B; Aslan, G; Delialioglu, N; Alp, A
    The aim of this multicenter study was to evaluate the performance of the crystal violet decolorization assay (CVDA) for detection of multidrug resistant tuberculosis (MDR-TB). This study was performed in 11 centers in two phases. A total of 156 isolates were tested for INH and RIF resistance. In the phase I, 106 clinical isolates were tested in the Center 1-7. In the phase 2, 156 clinical isolates were tested in the center 1-6, center 8-11. Eighty six of 156 tested isolates were the same in phase I. Agreements were 96.2-96.8% for INH and 98.1-98.7% for RIF in the phase I-II, respectively. Mean time to obtain the results in the phase I was 14.3 +/- 5.4 days. In the phase II, mean time to obtain the results was 11.6 +/- 3.5 days. Test results were obtained within 14days for 62.3% (66/106) of isolates in the phase I and 81.4% (127/156) of isolates in the phase II. In conclusion, CVDA is rapid, reliable, inexpensive, and easy to perform for rapid detection of MDR-TB isolates. In addition, it could be adapted for drug susceptibility testing with all drugs both in developed and developing countries.
  • No Thumbnail Available
    Item
    Multicenter Evaluation of the Indirect Nitrate Reductase Assay for the Rapid Detection of Multidrug-Resistant Tuberculosis
    Çoban, AY; Tastekin, B; Uzun, M; Kalayci, F; Ceyhan, I; Biçmen, C; Albay, A; Sig, AK; Özkütük, N; Sürücüoglü, S; Ozkütük, A; Esen, N; Albayrak, N; Aslantürk, A; Saribas, Z; Alp, A
    Multidrug-resistant tuberculosis (MDR-TB) is defined as resistance to at least isoniazid (INH) and rifampicin (RIF), and it complicates the implementation of tuberculosis control programmes. The rapid detection of MDR-TB is crucial to reduce the transmission of disease. The nitrate reductase assay (NRA) is one of the colorimetric susceptibility test methods for rapid detection of MDR-TB and based on the ability of reduction of nitrate to nitrite by Mycobacterium tuberculosis. The aim of this study was to evaluate the performance of the NRA for the rapid detection of MDR-TB. A total of 237 M.tuberculosis complex (MTC) isolates that were identified by the same method (BD MGIT (TM) TBc Identification Test, USA) from nine different medical centers in Turkey were included in the study. The susceptibility results of the isolates against INH and RIF obtained by reference test (Bactec MGIT (TM) 960, BD, USA) were then compared with NRA. In order to ensure consistency between centers, Lowenstein-Jensen (LJ) medium with antibiotics and without antibiotics (growth control) and Griess reagent solution were prepared in a single center (Ondokuz Mayis University School of Medicine, Medical Microbiology Department) and sent to all participant centers with the standardized test procedure. After the inoculation of bacteria into the test tubes, the tubes were incubated at 37 degrees C, and after seven days of incubation, 500 mu l Griess reagent was added to the LJ medium without antibiotics. If a color change was observed, an equal volume of Griess reagent was added to test LJ media with antibiotics. When a color change was observed in LJ media with antibiotics, it was considered that the isolate was resistant to tested antibiotics. Among 237 MTC isolates, 16 were resistant only to INH and nine were resistant only to RIF; 93 isolates (39.2%) were resistant (MDR) and 119 isolates (50.2%) were susceptible to both of the drugs determined with the reference susceptibility test. In the study, five INH-resistant isolates determined with reference method were found susceptible with NRT and eight INH-susceptible isolates determined with reference method were found resistant with NRT. In contrast, one RIF-resistant isolate determined with reference method was found susceptible with NRT and three RIF-susceptible determined isolates were found resistant with NRT. Accordingly, the concordance rate between the reference method and NRA were estimated as 94.5% for INH and 98.3% for RIF. The sensitivity, specificity, positive and negative predictive values of NRA were detected as 95.4%, 93.7%, 92.8% and 96% for INH, and 99%, 97.8%, 97.1% and 99.2% for RIF, respectively. The results of the 111 isolates were obtained on the seventh day, while the rest of the results were obtained between 10-14 days. In conclusion, the data of this multicenter study showed that NRA is a reliable, relatively inexpensive and practical method to perform for the rapid detection of MDR-TB.
  • No Thumbnail Available
    Item
    A new colorimetric method for rapid detection of ethambutol and streptomycin resistance in Mycobacterium tuberculosis: crystal violet decolorization assay (CVDA)
    Coban, AY; Akbal, AU; Ceyhan, I; Uzun, M; Selale, DS; Aslan, G; Delialioglu, N; Ozyurt, M; Bektore, B; Bicmen, C; Aslanturk, A; Ucarman, N; Albay, A; Sig, AK; Ozkutuk, N; Surucuoglu, S
    Streptomycin (STR) and ethambutol (EMB) are important drugs used for the treatment of tuberculosis. There is a need for fast, reliable and inexpensive methods for detecting resistance to these drugs. The aim of this study was to evaluate the performance of the crystal violet decolorization assay (CVDA) for the detection of STR and EMB resistance that is important drugs in tuberculosis treatment. In this study, drug susceptibility testing was performed on 140 Mycobacterium tuberculosis isolates provided from nine centers. Three tubes were used for each isolate. One of the tubes had a concentration of 2mg/L STR and the other 5mg/L EMB. The third was drug-free control tube. Sensitivity, specificity, positive predictive value (PPD), negative predictive value (NPD) and agreement for STR were found to be 81.8%, 94.6%, 87.8%, 91.5% and 90.57%, respectively. For EMB, sensitivity, specificity, PPD, NPD, and agreement were found to be 76%, 98.23%, 90.47%, 94.87% and 94.2%, respectively. The results were obtained in 11.3 +/- 2.7days (8-21days). CVDA is rapid, reliable, inexpensive, and easy to perform for rapid detection of STR and EMB resistance, and it could be adapted for drug susceptibility testing.
  • No Thumbnail Available
    Item
    Multicenter evaluation of AYC.2.2 agar for the isolation of mycobacteria from clinical samples
    Coban, AY; Ceyhan, I; Uzun, M; Genc, GE; Bicmen, C; Ozkutuk, N; Surucuoglu, S; Yanar, O; Aslan, G; Kurnaz, N; Cayci, YT
    Purpose: The aim of this multicenter study is to evaluate AYC.2.2 agar for the isolation of mycobacteria from clinical samples. Methods: Totally 5559 media were tested in 7 centers. AYC.2.2 agar media for the study were prepared by C1 and sent to other centers under appropriate conditions. Other media except AYC.2.2 agar were purchased commercially. The media were subjected to routine laboratory operations in the center where they were sent. After the samples received for routine processing (in all centers, samples were processed with the same method (NALC-NaOH)), they were cultivated on routine media and AYC.2.2 agar afterward. Results: C1: Average growth time was determined as 12.74 +/- 3.74 days with MGIT 960 system; 24.42 +/- 4.75 days with LJ and 24.37 +/- 4.96 days with AYC.2.2 agar. C2: Average growth time was determined as 18.25 +/- 9.32 days with TK-Medium, 28.73 +/- 7.44 days with LJ, and 31.72 +/- 6.35 days with AYC.2.2 agar. C3: Average growth time was determined as 20.48 +/- 7.24 days with Ogawa medium, 20.74 +/- 7.12 days with LJ, and 20.26 +/- 7.43 days with AYC.2.2 agar. C4: Average growth time was determined as 15.27 +/- 6.37 days with MGIT 960 system, 22.14 +/- 9.1 days with LJ, and 22 +/- 8.45 days with AYC.2.2 agar. C5: Average growth time was determined as 13 +/- 4.24 days with MGIT 960 system, 32.16 +/- 6.23 days with LJ, and 33 +/- 5.73 days with AYC.2.2 agar. C6: Average growth time was determined as 9 +/- 3.11 days with MGIT 960 system, 18.68 +/- 5.32 days with LJ, and 18.34 +/- 4.63 days AYC.2.2 agar. C7: Average growth time was determined as 14.74 +/- 7.65 with MGIT 960 system, 26.01 +/- 8.21 days with LJ, and 26.24 +/- 7.88 days with AYC.2.2 agar. Conclusions: In conclusion, similar results were obtained with LJ and Ogawa media and AYC.2.2 agar. Furthermore, more studies should be conducted for isolation of M. tuberculosis and performing antibiotic susceptibility tests using AYC.2.2 agar before it can be used as a routine media in the laboratories.
  • No Thumbnail Available
    Item
    Comparison of the efficacy of sunitinib and pazopanib in patients with advanced non-clear renal cell carcinoma
    Yildirim, HC; Bayram, E; Chalabiyev, E; Majidova, N; Avci, T; Güzel, HG; Kapar, C; Uzun, M; Perkin, P; Akgül, F; Yildirim, SS; Sali, S; Yildiz, A; Kazaz, SN; Hendem, E; Arcagok, M; Tufan, G; Yildirim, U; Akgul, OF; Arslan, C; Taban, H; Sahin, E; Caglayan, M; Esen, R; Öksüzoglu, B; Guven, DC; Kaplan, MA; Araz, M; Basaran, M; Cubukcu, E; Gokmen, E; Cicin, I; Algin, E; Semiz, HS; Tural, D; Ozturk, B; Erdogan, AP; Sari, M; Kara, O; Erman, M
    Non-clear cell renal cell carcinoma (non-ccRCC) is a highly heterogeneous disease group, accounting for approximately 25% of all RCC cases. Due to its rarity and especially heterogeneity, phase III trial data is limited and treatment options generally follow those of clear cell RCC. In the literature, there exists a number of studies with sunitinib, cabozantinib, and everolimus, but data on the efficacy of pazopanib are limited. Our aim in this study was to compare the efficacy of pazopanib and sunitinib, in a multicenter retrospective cohort of non-ccRCC patients. Our study included patients diagnosed with non-ccRCC who received pazopanib or sunitinib treatment as first-line therapy from 22 tertiary hospitals. We compared the progression-free survival (PFS), overall survival (OS), and response rates of pazopanib and sunitinib treatments. Additionally, we investigated prognostic factors in non-ccRCC. PFS and response rates of sunitinib and pazopanib were found to be similar, while a numerical difference was observed in OS. Being 65 years and older, being in the intermediate or poor risk group according to the International Metastatic Renal Cell Carcinoma Database Consortium, having liver metastases, presence of a sarcomatoid component, and having de novo metastatic disease were found to be significantly associated with shorter PFS. Pazopanib treatment appears to have similar efficacy in the treatment of non-ccRCC compared to sunitinib. Though randomized controlled trials are lacking and will probably be never be available, we suggest that pazopanib could be a preferred agent like sunitinib and cabozantinib. Pazopanib and sunitinib treatments show similar progression free survival, overall survival and objective response rate.IMDC risk group, liver metastasis, sarcomatoid component and de novo metastatic disease were determined as prognostic factors
  • No Thumbnail Available
    Item
    The electrocardiogram of the Pekin duck
    Cinar, A; Bagci, C; Belge, F; Uzun, M
    In this study, standard limb lead electrocardiograms (EGG) were recorded in 50 Pekin ducks. The ECG exhibited P, R, S, and T waves. A Q wave was observed in 30% of leads aVR aVL. All waves in lead I were of very low amplitude or almost isoelectric. The P wave was 20% negative, 80% positive in lead aVR and always positive in other leads. The duration and amplitude of P wave were 0.025 sec and 0.17 mV, respectively and the P-R interval was 0.06 sec in lead II. A Q wave was observed in 30% of leads aVR and aVL but was invisible in other leads. The duration of QRS complex was 0.036 sec and its amplitude was 0.069 mV. The S wave (rS) was greater than the R wave in leads III and aVE The R and S waves were equal in lead III (66%). The mean duration and amplitude of T wave were 0.05 sec and 0.22 mV, respectively. The T wave was negative in leads aVR and aVL and positive in other leads. The Q-T interval was 0.10 sec. The mean heart rate was 281.3 (220-375) beats/min. The average value of the mean electrical axis was +147 degrees (+95 degrees to -160 degrees).