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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/3
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Publication Metadata only Neuro-ophthalmic and neuro-otologic evaluation in individuals with motion sickness susceptibility(Aves, 2024) Aydin, Kubra; Kara, Eyyup; Uzun Adatepe, Nurten; Ataş, Ahmet; School of Medicine; Koç University HospitalBACKGROUND: Since the physiological background of motion sickness is not entirely clear, it was aimed to examine the physiological differences in groups consisting of individuals susceptible and non-susceptible to motion sickness. METHODS: Sixty subjects [motion sickness (MS) group: 33 female, 3 male; 28.8 ± 8.1 years; control group: 19 female, 5 male; 24.5 ± 4.3 years] were included in the study. Near visual acuity test on the treadmill in the presence of visual stimulation, pattern visual-evoked potentials, oculomo-tor tests, and computerized dynamic posturography were applied. Receiver operating characteristic analysis was performed to determine the parameter that provides the excellent discrimination between the groups. RESULTS: The most effective parameter in differentiating the study groups was determined as dynamic visual acuity with 77.8% sensitivity and 95.8% specificity. Significant differences were found in the vestibular (mean ± standard deviation: 0.63 ± 0.17), visual (0.77 ± 0.18), and composite scores (73.11 ± 11.89) of the patients (P = .000) in posturographic evaluation. In the visual-evoked potential examination, a significant decrease was found in the amplitude values between the P100-N145 waves in the binocular (5.0 ± 2.8, P = .002), right eye (7.6 ± 3.2, P = .009) and left eye (7.9 ± 2.9, P = .016) in the symptomatic patients. In binocular oculomotor evaluation, directional asymmetric findings were obtained. CONCLUSION: It has been shown that the most effective test parameter that distinguishes the MS susceptible and non-susceptible individuals is the dynamic visual acuity value. Based on the results of neuro-physiological tests, it was suggested that a possible visual-vestibular integration disorder in individuals susceptible to motion sickness may affect visual and vestibular performance.Publication Metadata only Evidence of mitophagy in lens capsule epithelial cells of patients with pseudoexfoliation syndrome(Lippincott Williams and Wilkins, 2024) N/A; Aydemir, Dilara; Sönmez, Sadi Can; Kısakürek, Zeynep Büşra; Gözel, Merve; Karslıoğlu, Melisa Zişan; Güleser, Ümit Yaşar; Şahin, Afsun; Hasanreisoğlu, Murat; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); Graduate School of Health Sciences; School of Medicine; Koç University HospitalPurpose Pseudoexfoliation Syndrome (PEX) is a condition in which aberrant fibrillary protein builds up in various components of the eye and other extraocular tissues. In this study, we aim to investigate the functionality of intracellular auto-degradative machinery -especially mitophagy- and related genes and proteins in PEX. Methods Anterior lens capsules were obtained from cataracts patients with and without PEX to constitute the PEX group and age-matched controls during microincision cataracts surgery. PINK1-mediated mitophagy markers were evaluated on the transcriptional and translational level via RT-qPCR and immunohistochemistry analysis, respectively. Results The lens epithelial cells of PEX patients were characterized by significantly higher PINK1 gene expression compared to that of the controls (p<0.05). In terms of intensity of staining of expressed proteins, PINK1 (p<0.05), Parkin (p<0.01) and LC3B (p<0.01) were all statistically higher in PEX, compared to the controls. Conclusion Altered auto-degradative response -specifically mitophagy- is a component of increased oxidative stress in PEX patients. The role of this mechanism in emerging complications warrants further research.Publication Metadata only Superior scapular location: an overlooked albeit frequent finding in elastofibroma dorsi(Elsevier Inc., 2024) N/A; Atalay, Hande Özen; Cengiz, Duygu; Atasoy, Kayhan Çetin; School of Medicine; Koç University HospitalPurpose: To explore the frequency of superior scapular elastofibroma dorsi in a large patient series with elastofibroma dorsi. Methods: 136 chest CTs from January 2016 to July 2022 reporting elastofibroma dorsi were retrospectively analyzed. Three radiologists assessed the number, size, and location of elastofibroma dorsi. Continuous variables underwent two-tailed t-tests with p < 0.05. Inter-observer agreement was assessed by using Cohen's Kappa values. Results: In 136 patients (mean age, 75.9 +/− 9.8 years; 117 female), 330 elastofibroma dorsi were found. Six (4.4 %) patients had single, 87 (64 %) double, 22 (16.2 %) triple and 21 (15.4 %) quadruple lesions. All single and double lesions were in the inferior scapular regions. 43 (31.6 %) patients had superior scapular lesions in addition to inferior scapular elastofibroma dorsi. Inferior scapular elastofibroma dorsi was significantly larger than superior scapular elastofibroma dorsi. The probability of a right superior lesion was significantly higher in patients with a larger right inferior lesion. Inter-observer agreement was very good for experienced radiologist (κ = 94.1) and good for other radiologists (κ = 79.4 and κ = 78). Conclusion: In contrast to current belief, superior scapular elastofibroma dorsi accompanying the typical inferior scapular lesions is not uncommon and can even manifest bilaterally. To the best of our knowledge, this is the first case series reporting prevalence of quadruple elastofibroma dorsi.Publication Metadata only Letter to the editor: total hip arthroplasty in a patient with facioscapulohumeral dystrophy(Elsevier Inc., 2023) N/A; Çalışkan, Emrah; Gedik, Cemil Cihad; Eren, İlker; School of MedicineN/APublication Metadata only Posterior video-assisted trans pedicular surgery for calcified midline thoracic disc herniation(Elsevier B.V., 2024) Sasani, Hadi; Hekimoglu, Mehdi; Başak, Ahmet Tulgar; Sasani, Mehdi; Akgün, Mehmet Yiğit; Öktenoğlu, Bekir Tunç; Ateş, Özkan; Özer, Ali Fahir; School of Medicine; Koç University HospitalBackground: In the treatment of patients with calcified midline thoracic disc herniation (CMTDH), the posterior video-assisted transpedicular surgery (VATPS) technique is employed. Both anterior and posterior surgical approaches for treating CMTDH carry a significant risk of surgical complications and potential morbidity. This technical note introduces a surgical procedure that avoids the drawbacks associated with these approaches. Methods: The VATPS technique presents a comprehensive approach for treating thoracic disc herniation, combining both microscopic and endoscopic stages. The microscopic phase entails a small thoracoscopic incision, muscle release, hemilaminotomy, facet joint resection, and vertebra removal, culminating in creating a corpectomy cavity for endoscope access. Careful separation of adhesions between the dura and ligaments marks this stage. Transitioning to the endoscopic phase, an endoscope is inserted into the cavity, allowing for precise visualization and separation of residual adhesions, removal of calcified disc fragments using specialized instruments, and ensuring complete discectomy. Results: Fourteen patients underwent VATPS for CMTDH. During the procedure, evoked responses were reduced in one patient. However, no postoperative neurological deficits were observed. We also noted significant improvements in the Oswestry Disability Index (ODI) and the Visual Analog Scale (VAS) scores when comparing the preoperative and postoperative assessments. Conclusion: VATPS, a minimally invasive technique, offers excellent anterior visibility comparable to that of the anterolateral approach, all while avoiding the adverse effects associated with thoracotomies and the complications resulting from spinal cord encroachment often seen in the posterolateral approach. Moreover, it is a safer alternative to conventional endoscopic posterior thoracic surgery. The cavity formed within the vertebral corpus provides ample working space for the use of an endoscope.Publication Metadata only ICS educational module: the practice of uroflowmetry in adults(Elsevier B.V., 2024) Agarwal, Mayank Mohan; Rubilotta, Emanuele; De Nunzio, Cosimo; Rosier, Peter; Tarcan, Tufan; Acar, Ömer; School of MedicineAim: To present the body of evidence behind the International Continence Society (ICS) educational module on “Practice of uroflowmetry in adults” which consists of a PowerPoint® presentation. Methods: This evidence review has been prepared by a working group instituted by the ICS Urodynamics Committee. The method used included systematic literature review, consensus formation by the members of the Working Group, and review by members of the ICS Urodynamics Committee core panel. Results: A total of 104 articles were included in this systematic review. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Evidence analysis was conducted along the following themes: physiology of voiding, pathophysiology of lower urinary tract dysfunction, technique of uroflowmetry, quality check of the uroflowmetry test, interpretation and reporting of uroflowmetry findings. Conclusions: Uroflowmetry is the most commonly utilized diagnostic test in the evaluation of adults presenting with lower urinary tract symptoms. The practice of uroflowmetry exhibits variations which might lead to inconclusive or inaccurate assessments. The ICS educational module on the Practice of Uroflowmetry in Adults provides up-to-date and evidence-based guidance in an effort to establish standards in the technique, interpretation, and reporting of uroflowmetry.Publication Metadata only Feasibility of next-generation sequencing of liquid biopsy (circulating tumor DNA) samples and tumor tissue from patients with metastatic prostate cancer in a real-world clinical setting in germany(Elsevier B.V., 2024) Mandel, Philipp; Hoeh, Benedikt; Humke, Clara; Doering, Claudia; Wenzel, Mike; Cano Garcia, Cristina; Fuhr, Nina; Koll, Florestan; Fassl, Anne; Steuber, Thomas; Faull, Iris; Jeroch, Jan; Ebner, Silvana; Schmitt, Christina; Reis, Henning; Köllermann, Jens; Kokkaliaris, Konstantinos D.; Demes, Melanie C.; Chun, Felix K.H.; Wild, Peter J.; Tilki, Derya; School of MedicineBackground and objective: With European Medicines Agency approval of PARP inhibitors in metastatic castration-resistant prostate cancer and ongoing trials in metastatic hormone-sensitive prostate cancer, detection of genetic alterations in BRCA1/2 and other homologous recombination repair genes has gained an important role. Our aim was to investigate the feasibility and comparability of comprehensive next-generation sequencing (NGS) of liquid biopsy (LB; circulating tumor DNA) and tumor tissue (TT) samples in a real-world clinical setting. Methods: The study cohort consisted of 50 patients with metastatic prostate cancer (mPC) who had TT NGS performed for BRCA1/2 alterations and consent for additional LB NGS. The Oncomine Comprehensive Assay v3 (Thermo Fisher Scientific, Waltham, MA, USA) was used for TT NGS. The Guardant360 83-gene assay (Guardant Health, Palo Alto, CA, USA) was used for LB NGS, including all types of somatic alterations, microsatellite instability, and blood tumor mutational burden. We calculated BRCA1/2 alteration rates and the negative percentage agreement (NPA) and positive percentage agreement (PPA) between TT and LB results. Key findings and limitations: TT NGS was successful in 44/50 patients (88%), with pathogenic BRCA1/2 alterations detected in four (9%). LB NGS was successful in all 50 patients (100%), with BRCA1/2 alterations detected in ten (20%). In a subgroup analysis for the 44 patients with successful TT NGS, NPA was 85% and PPA was 50%. The median time between TT sample collection and blood sampling for NGS was 132 wk (IQR 94–186). The limited sample size and differences in the time of NGS assessment are limitations. Conclusions and clinical implications: LB NGS resulted in a higher detection rate for BRCA1/2 alterations in comparison to conventional TT NGS (20% vs 9%). Ideally, BRCA1/2 testing should be based on both approaches to identify all patients with mPC eligible for PARP inhibitor therapy. Patient summary: Our study shows that genetic tests for both tumor tissue and blood samples results in higher rates of detection of BRCA1/2 gene alterations in patients with metastatic prostate cancer.Publication Metadata only EAU-EANM-ESTRO-ESUR-ISUP-SIOG guidelines on prostate cancer—2024 update. Part i: screening, diagnosis, and local treatment with curative intent(Elsevier B.V., 2024) Cornford, Philip; van den Bergh, Roderick C.N.; Briers, Erik; Van den Broeck, Thomas; Brunckhorst, Oliver; Darraugh, Julie; Eberli, Daniel; De Meerleer, Gert; De Santis, Maria; Farolfi, Andrea; Gandaglia, Giorgio; Gillessen, Silke; Grivas, Nikolaos; Henry, Ann M.; Lardas, Michael; van Leenders, Geert J.L.H.; Liew, Matthew; Linares Espinos, Estefania; Oldenburg, Jan; van Oort, Inge M.; Oprea-Lager, Daniela E.; Ploussard, Guillaume; Roberts, Matthew J.; Rouvière, Olivier; Schoots, Ivo G.; Schouten, Natasha; Smith, Emma J.; Stranne, Johan; Wiegel, Thomas; Willemse, Peter-Paul M.; Tilki, Derya; School of MedicineBackground and objective: The European Association of Urology (EAU)-European Association of Nuclear Medicine (EANM)-European Society for Radiotherapy and Oncology (ESTRO)-European Society of Urogenital Radiology (ESUR)-International Society of Urological Pathology (ISUP)-International Society of Geriatric Oncology (SIOG) guidelines provide recommendations for the management of clinically localised prostate cancer (PCa). This paper aims to present a summary of the 2024 version of the EAU-EANM-ESTRO-ESUR-ISUP-SIOG guidelines on the screening, diagnosis, and treatment of clinically localised PCa. Methods: The panel performed a literature review of all new data published in English, covering the time frame between May 2020 and 2023. The guidelines were updated, and a strength rating for each recommendation was added based on a systematic review of the evidence. Key findings and limitations: A risk-adapted strategy for identifying men who may develop PCa is advised, generally commencing at 50 yr of age and based on individualised life expectancy. The use of multiparametric magnetic resonance imaging in order to avoid unnecessary biopsies is recommended. When a biopsy is considered, a combination of targeted and regional biopsies should be performed. Prostate-specific membrane antigen positron emission tomography imaging is the most sensitive technique for identifying metastatic spread. Active surveillance is the appropriate management for men with low-risk PCa, as well as for selected favourable intermediate-risk patients with International Society of Urological Pathology grade group 2 lesions. Local therapies are addressed, as well as the management of persistent prostate-specific antigen after surgery. A recommendation to consider hypofractionation in intermediate-risk patients is provided. Patients with cN1 PCa should be offered a local treatment combined with long-term intensified hormonal treatment. Conclusions and clinical implications: The evidence in the field of diagnosis, staging, and treatment of localised PCa is evolving rapidly. These PCa guidelines reflect the multidisciplinary nature of PCa management. Patient summary: This article is the summary of the guidelines for “curable” prostate cancer. Prostate cancer is “found” through a multistep risk-based screening process. The objective is to find as many men as possible with a curable cancer. Prostate cancer is curable if it resides in the prostate; it is then classified into low-, intermediary-, and high-risk localised and locally advanced prostate cancer. These risk classes are the basis of the treatments. Low-risk prostate cancer is treated with “active surveillance”, a treatment with excellent prognosis. For low-intermediary-risk active surveillance should also be discussed as an option. In other cases, active treatments, surgery, or radiation treatment should be discussed along with the potential side effects to allow shared decision-making.Publication Metadata only Efficacy and perioperative safety of different future liver remnant modulation techniques: a systematic review and network meta-analysis(Elsevier B.V., 2024) Sijberden, Jasper P.; Kasai, Meidai; Abu Hilal, Mohammad; Bozkurt, Emre; Koç University HospitalBackground: In daily clinical practice, different future liver remnant (FLR) modulation techniques are increasingly used to allow a liver resection in patients with insufficient FLR volume. This systematic review and network meta-analysis aims to compare the efficacy and perioperative safety of portal vein ligation (PVL), portal vein embolization (PVE), liver venous deprivation (LVD) and associating liver partition and portal vein ligation for staged hepatectomy (ALPPS). Methods: A literature search for studies comparing liver resections following different FLR modulation techniques was performed in MEDLINE, Embase and Cochrane Central, and pairwise and network meta-analyses were conducted. Results: Overall, 23 studies comprising 1557 patients were included. LVD achieved the greatest increase in FLR (17.32 %, 95% CI 2.49–32.15), while ALPPS was most effective in preventing dropout before the completion hepatectomy (OR 0.29, 95% CI 0.15–0.55). PVL tended to be associated with a longer time to completion hepatectomy (MD 5.78 days, 95% CI -0.67–12.23). Liver failure occurred less frequently after LVD, compared to PVE (OR 0.35, 95% CI 0.14–0.87) and ALPPS (OR 0.28, 95% CI 0.09–0.85). Discussion: ALPPS and LVD seem superior to PVE and PVL in terms of achieved FLR increase and subsequent treatment completion. LVD was associated with lower rates of post hepatectomy liver failure, compared to both PVE and ALPPS. A summary of the protocol has been prospectively registered in the PROSPERO database (CRD42022321474). © 2024 International Hepato-Pancreato-Biliary Association Inc.Publication Metadata only CPAP may promote an endothelial inflammatory milieu in sleep apnoea after coronary revascularization(Elsevier B.V., 2024) Behboudi, Afrouz; Redline, Susan; Lyu, Jing; Wei, Ying; Gottlieb, Daniel J.; Jelic, Sanja; Peker, Yüksel; Çelik, Yeliz; School of MedicineBackground: Continuous positive airway pressure (CPAP) has failed to reduce cardiovascular risk in obstructive sleep apnoea (OSA) in randomized trials. CPAP increases angiopoietin-2, a lung distension-responsive endothelial proinflammatory marker associated with increased cardiovascular risk. We investigated whether CPAP has unanticipated proinflammatory effects in patients with OSA and cardiovascular disease. Methods: Patients with OSA (apnoea-hypopnea index [AHI] ≥15 events/h without excessive sleepiness) in the Randomized Intervention with CPAP in Coronary Artery Disease and OSA study were randomized to CPAP or usual care following coronary revascularization. Changes in plasma levels of biomarkers of endothelial (angiopoietin-2, Tie-2, E-selectin, vascular endothelial growth factor [VEGF-A]) and lung epithelial (soluble receptor of advanced glycation end-products [sRAGE]) function from baseline to 12-month follow-up were compared across groups and associations with cardiovascular morbidity and mortality assessed. Findings: Patients with OSA (n = 189; 84% men; age 66 ± 8 years, BMI 28 ± 3.5 kg/m2, AHI 41 ± 23 events/h) and 91 patients without OSA participated. Angiopoietin-2 remained elevated whereas VEGF-A declined significantly over 12 months in the CPAP group (n = 91). In contrast, angiopoietin-2 significantly declined whereas VEGF-A remained elevated in the usual care (n = 98) and OSA-free groups. The changes in angiopoietin-2 and VEGF-A were significantly different between CPAP and usual care, whereas Tie-2, sRAGE and E-selectin were similar. Greater 12-month levels of angiopoietin-2 were associated with greater mortality. Greater CPAP levels were associated with worse cardiovascular outcomes. Interpretation: Greater CPAP levels increase proinflammatory, lung distension-responsive angiopoietin-2 and reduce cardioprotective angiogenic factor VEGF-A compared to usual care, which may counteract the expected cardiovascular benefits of treating OSA. Funding: National Institutes of Health/ National Heart, Lung, and Blood Institute; Swedish Research Council; Swedish Heart-Lung Foundation; ResMed Foundation.