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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/3
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Publication Metadata only Gemcitabine-loaded chitosan nanoparticles enhanced apoptotic and ferroptotic response of gemcitabine treatment alone in the pancreatic cancer cells in vitro(Springer, 2024) Ozturk, Kivilcim; Arslan, Fatma Betul; Calis, Sema; Ulusu, Nuriye Nuray; Aydemir, Duygu; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; Graduate School of Health SciencesGemcitabine (GEM) is a first-line treatment for pancreatic ductal adenocarcinoma (PDAC) patients, causing side effects and poor overall survival. Eighty percent of patients often develop resistance rapidly to GEM. Developing therapeutic approaches and increasing sensitivity to gemcitabine in PDAC has become one of the challenges in cancer research. We synthesized GEM-loaded NPs prepared with a method that combines ultrasonication and ionotropic gelation to overcome GEM-related limitations in PDAC. CFPAC-1 cells were treated with increased concentrations of GEM, empty chitosan, and GEM-loaded NPs (0.66, 1.32, 2.64, 5.32 mu g/ml) for up to 48 h. Empty chitosan NPs did not show toxicity on L929 cells. Antioxidant enzyme activities, including glucose 6-phosphate dehydrogenase (G6PD), 6-phosphogluconate dehydrogenase (6-PGD), glutathione reductase (GR), glutathione s-transferase (GST), and glutathione peroxidase (GPx), significantly reduced in GEM-loaded NPs compared to the GEM associated with increased oxidative stress, PPP, and glycolysis. Bcl-xL, NOXA/mcl-1, and Ca2+ levels significantly increased in GEM-loaded NP-administered cells compared to the GEM and control groups. In contrast, JNK, p38, STAT3, Akt, and CREB levels significantly decreased in the GEM-loaded NP group, addressing enhanced apoptotic response compared to the GEM alone. Increased ferroptosis activity in GEM-loaded NP-administered groups has been validated via decreased antioxidant enzyme activities, increased cytosolic Fe, Zn, Mg, and Mn levels, and reduced GPx activity compared to the GEM and control groups. For the first time in the literature, we showed biocompatible GEM-loaded NPs enhanced apoptotic and ferroptotic response in CFPAC-1 cells via downregulation of antioxidant, glycolysis, and PPP metabolism compared to the GEM alone.Publication Metadata only Development and psychometric analysis of care needs scale for mothers of children with congenital heart disease(Elsevier Inc., 2024) Ay, Ayse; Saridag, Kubra Nur Kabakci; Semerci, Remziye; School of NursingPurpose: This cross-sectional study aimed to create and evaluate a care needs scale for mothers of children with congenital heart disease (CHD) to determine its psychometric properties. Design and methods: This methodological research was conducted with 155 mothers whose children were diagnosed with CHD and were treated at a university hospital. The study's methodology included scale development, specialist opinions, and a pilot test. Data analysis involved descriptive statistics, exploratory and con firmatory factor analyses, and reliability assessments. Results: The 11 -item scale was created using component analysis, expert comments, and pilot testing. It was divided into two categories: Information Needs Regarding Disease and Treatment and Needs Regarding Care. The Exploratory Factor Analysis revealed a 2 -factor structure, explaining 41.5% of the variance. Reliability analysis showed reliable dimensions, and Tukey's scalability test indicated the scale requires separate dimension evaluation. The model fi t indices were obtained as CMIN/DF (72.751/41) =1.774, GFI = 0.925, IFI = 0.923, TLI = 0.893, CFI = 0.920, RMSEA = 0.071, SRMR = 0.063. The Cronbach's alpha coef ficient for subdimension 1 was 0.758, and for subdimension 2 was 0.678, indicating reliable dimensions. Conclusion: The developed scale provides a valuable tool for assessing the care needs of mothers of children with CHD, contributing to enhancing maternal support programs in pediatric cardiology clinics. Practice implications: Assessment of the care needs of mothers who have children with CHD is promising for the development of educational programs on this subject and to ensure the competence of mothers for care.Publication Metadata only The impact of the vitamin D and resveratrol administration on the stiffness and elasticity of T2DM rat aorta associated with the trace element and mineral levels(Elsevier Inc., 2024) Anapali-Aykac, Merve; Ulutin, Turgut; Komurcu-Bayrak, Evrim; Kaya-Dagistanli, Fatma; Department of Mechanical Engineering; Ulusu, Nuriye Nuray; Aydemir, Duygu; Salman, Naveed; Karimzadehkhouei, Mehrdad; Alaca, Burhanettin Erdem; Department of Mechanical Engineering; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); Koç University Surface Science and Technology Center (KUYTAM) / Koç Üniversitesi Yüzey Teknolojileri Araştırmaları Merkezi (KUYTAM); n2STAR-Koç University Nanofabrication and Nanocharacterization Center for Scientifc and Technological Advanced Research; School of Medicine; Graduate School of Health Sciences; College of EngineeringBackground: Type 2 diabetes mellitus (T2DM) is directly associated with increased aortic stiffness, reduced aortic elasticity, and aortic dissection, which are independent risk factors for cardiovascular death. Since Vit D and resveratrol have been reported due to their cardioprotective effects, in this study, we aim to evaluate the impact of Vit D and resveratrol treatment alone or in combination on the aortic health associated with trace element and mineral levels in a high-fructose diet/streptozotocin-induced T2DM model. Methods: We investigated biomechanical changes of the aorta samples via a custom-built stretcher, where trace element and mineral levels in aorta samples were determined via inductively coupled plasma mass spectrometry (ICP-MS) following acidic microwave digestion. Results: Vitamin D treatment ameliorated the adverse effects of T2DM on aortic stiffness, aortic elasticity, and relaxation modulus in diabetic rats. Trace element and mineral levels correlated with cardiovascular homeostasis, including Fe, Cu, Zn, Se, and Na, have been regulated upon Vit D treatment in diabetic and healthy rats. On the other hand, resveratrol treatment alone or in combination with Vit D did not show any positive effects on biomechanical properties and trace element metabolism of diabetic or healthy rats, according to our data. Conclusion: Vit D can be used in T2DM patients to protect their cardiovascular health and should be considered a promising targeted therapy approach via nanoparticles to target cardiovascular diseases in the future.Publication Metadata only Expert opinion on screening, diagnosis and management of diabetic peripheral neuropathy: a multidisciplinary approach(Frontiers Media SA, 2024) Atmaca, Aysegul; Sahin, Ibrahim; Sengun, Ihsan Sukru; Oner, Ramazan Ilyas; Tilki, Hacer Erdem; Adas, Mine; Soyleli, Hatice; Demir, Tevfik; Ketenci, Ayşegül; School of MedicineThe proposed expert opinion aimed to address the current knowledge on conceptual, clinical, and therapeutic aspects of diabetic peripheral neuropathy (DPN) and to provide a guidance document to assist clinicians for the best practice in DPN care. The participating experts consider the suspicion of the disease by clinicians as a key factor in early recognition and diagnosis, emphasizing an improved awareness of the disease by the first-admission or referring physicians. The proposed "screening and diagnostic" algorithm involves the consideration of DPN in a patient with prediabetes or diabetes who presents with neuropathic symptoms and/or signs of neuropathy in the presence of DPN risk factors, with careful consideration of laboratory testing to rule out other causes of distal symmetric peripheral neuropathy and referral for a detailed neurological work-up for a confirmative test of either small or large nerve fiber dysfunction in atypical cases. Although, the first-line interventions for DPN are currently represented by optimized glycemic control (mainly for type 1 diabetes) and multifactorial intervention (mainly for type 2 diabetes), there is a need for individualized pathogenesis-directed treatment approaches for DPN. Alpha-lipoic acid (ALA) seems to be an important first-line pathogenesis-directed agent, given that it is a direct and indirect antioxidant that works with a strategy targeted directly against reactive oxygen species and indirectly in favor of endogenous antioxidant capacity for improving DPN conditions. There is still a gap in existing research in the field, necessitating well-designed, robust, multicenter clinical trials with sensitive endpoints and standardized protocols to facilitate the diagnosis of DPN via a simple and effective algorithm and to track progression of disease and treatment response. Identification of biomarkers/predictors that would allow an individualized approach from a potentially disease-modifying perspective may provide opportunities for novel treatments that would be efficacious in early stages of DPN, and may modify the natural course of the disease. This expert opinion document is expected to increase awareness among physicians about conceptual, clinical, and therapeutic aspects of DPN and to assist them in timely recognition of DPN and translating this information into their clinical practice for best practice in the management of patients with DPN.Publication Metadata only The effect of progressive muscle relaxation exercises on sleep quality in cancer patients undergoing chemotherapy: a randomized controlled study(Elsevier Inc., 2024) Sarı, Ebru; Gündogdu, Fatma; Semerci, Remziye; School of NursingObjectives: This study aimed to evaluate the effect of progressive muscle relaxation exercises (PMRE) on sleep quality in patients undergoing chemotherapy treatment and experiencing disturbed sleep. Methods: The prospective randomized controlled study was conducted between March and September 2022 with 69 patients (intervention group: 34 patients, control group: 35 patients) in a hospital chemotherapy unit. During the data collection process, the “Personal Information Form” and “Pittsburgh Sleep Quality Index (PSQI)” were utilized. Patients in the intervention group performed PMRE twice a day for 8 weeks. Patients in the control group received routine care at the clinic without additional intervention. For data analysis, Student's t-test, Mann–Whitney U test, Fisher's exact test, and chi-square test were used. Results: The sociodemographic attributes of patients within both the intervention and control groups exhibited comparability. However, notable distinctions emerged in the PSQI Global sleep score and PSQI subdimension scores, encompassing sleep latency and duration, subjective sleep quality, habitual sleep efficiency, sleep disturbance, and daytime dysfunction between the two groups. The study found a notable difference in scores between the patients in the intervention group and those in the control group. The patients who received the intervention had significantly lower scores (P <.001). Conclusion: The study revealed that PMRE was beneficial in improving sleep quality in cancer patients undergoing chemotherapy who had poor sleep quality. Implications for Nursing Practice: Oncology nurses may consider using PMRE to improve the sleep quality of cancer patients receiving chemotherapy.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 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 Predictive potential of pan-immune-inflammation value / hemoglobin index as biomarker for osteoradionecrosis risk in locally advanced nasopharyngeal carcinomas(Elsevier, 2024) Yılmaz, Büşra; Somay, Efsun; Topkan, Erkan; Pehlivan, Berrin; Besen, Ali Ayberk; Mertsoylu, Hüseyin; Selek, Uğur; School of MedicineObjective: We aimed to investigate whether the Pan-Immune-Inflammation-Value/Hemoglobin (PIV/Hb) index could predict the risk of osteoradionecrosis (ORN) in patients receiving concurrent chemoradiotherapy (CCRT) for locally advanced nasopharyngeal cancer (LA-NPC). Materials and methods: This retrospective analysis included LA-NPC patients who underwent CCRT and preCCRT oral exams at our institution's Departments of Radiation Oncology and Dentistry between January 2010 and December 2022. The relationship between ORN rates and PIV-Hb levels was explored using receiver operating characteristic curve analysis. The primary objective was to establish a correlation between pre-CCRT PIV-Hb levels and ORN rates, while the secondary objective was to identify other risk factors for ORN. Results: Of 249 eligible patients, 21 (8.4 %) were diagnosed with ORN. The optimal pre-CCRT PIV/Hb cutoff was 73.8, which divided patients into two subgroups with distinctive ORN risk estimates: Group 1: PIV/ Hb < 73.8 (N = 206), and Group 2: PIV/Hb >= 73.8 (N = 43). The results of the comparative analysis indicated that the cohort with PIV/Hb >= 73.8 exhibited substantially higher rates of ORN than the PIV/Hb < 73.8 cohort (44.2 % vs. 1.0 %; P < 0.001). The multivariate logistic regression analysis indicated that the pretreatment PIV/ Hb >= 73.8 was independently associated with higher ORN rates (P < 0.001). Conclusion: The results of our current investigation indicate that higher levels of pretreatment PIV/Hb were associated with a significant independent increase in ORN rates in LA-NPC patients who received CCRT.