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Item Metadata only Survival outcomes of patients with oligometastatic non-small cell lung cancer who were treated with radical therapy: a multicenter analysis(Turkiye Klinikleri, 2023) 0000-0002-1273-1674; Açikgöz, Özgür; Bilici, Ahmet; Tataroğlu Özyükseler, Deniz; Göktaş Aydin, Sabin; Rzazade, Rashad; Ölmez, Ömer Fatih; Başak Çağlar, Hale; N/A; Selçukbiricik, Fatih; Faculty Member; School of Medicine; 202015Background/aim: Oligometastatic disease for nonsmall cell lung cancer (NSCLC) patients is generally thought to represent a better prognosis with a quieter biology, limited number of disease sites and long-term disease control. In this study, we aimed to determine the efficacy of radical treatment options for patients with oligometastatic NSCLC. Materials and methods: This retrospective trial included totally 134 patients with oligometastatic NSCLC. The presence of oncodriver mutation, tumor stages and nodal status, the number of metastases and involved metastatic site, treatment of primary tumor and oligometastasis, response rate, overall survival (OS) and progression-free survival (PFS) were evaluated. Results: Of 134 patients 66.4% were defined as adenocarcinoma, 26.1% were squamous cell carcinoma and 7.5% of patients were in other histology. Based on the treatment of primary tumor, in 36 patients (26.9%) curative surgery has undergone, in addition, 19 (14.2%) patients were received chemotherapy, 73 (54.5%) were treated with chemoradiotherapy, while immunotherapy and targeted therapy were used in 1 (0.7%) and 2 (1.4%), respectively. The preferred treatment for oligometastatic lesions were SBRT in 72.4% of patients, surgery in 10.5%, and both SBRT and surgery in 17.1% of patients. At the median follow up of 31.3 months (range: 9.5–48.5), the median PFS and OS times were 17 and 24.4 months, respectively. Moreover, OS-2 after progression was also 7.2 months. Conclusion: Based on our real-life experience, we demonstrated a significant correlation between good response to first treatment and survival in oligometastatic disease, we also understand that local ablative treatment modalities prolong and also delay both OS and PFS in oligometastatic NSCLC patients OS-2. © TÜBİTAK.Item Metadata only Pallidal deep brain stimulation improves HPCA-Linked (DYT 2) dystonia(Wiley, 2023) 0000-0003-3057-3355; 0000-0001-8952-6866; Samanci, Bedia; Sahin, Erdi; Bilgic, Basar; Atasu, Burcu; Lohmann, Ebba; Hanagasi, Hasmet A.; N/A; N/A; Peker, Selçuk; Samancı, Mustafa Yavuz; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 11480; 275252Item Metadata only The mortality, modes of infection, diagnostic tests, and treatments of marburg virus disease: a systematic review(Wiley, 2023) Alla, Deekshitha; Paruchuri, Sai Sri Hari; Tiwari, Angad; Alla, Sai Santhosha Mrudula; Pillai, Rakesh Thulaseedharan; Bandakadi, Sandeep Kumar Reddy; Pradeep, Anju; Shah, Dhruv JayeshkumarChavda, Sachi; Biziyaremye, Patrick; N/A; Sabıroğlu, Mert; Undergraduate Student; School of MedicineBackground and Aims: Marburg virus (MARV) has regularly affected people since 1967 causing multiple outbreaks. There are presently no authorized therapies for the fatal Marburg virus disease (MVD), which poses an imminent risk to global public health. The MVD has so far claimed the lives of numerous people, with an increased number of cases being seen throughout the African continent. Hence, a review was carried out to analyze the geographical distribution of MVD, mortality, routes of transmission, and diagnostic and treatment modalities.Methods: PubMed, Scopus, Web of Science, Google Scholar, and ProMED servers were used to conduct a systematic search in compliance with the PRISMA guidelines. The results were tabulated and analyzed.Results: A total of 11 studies (7 case reports and 4 case series) were included in the final analysis, and 21 cases of MVD were analyzed. The most frequent symptoms were fever (66.67%), vomiting (57.14%), headache (52.38%), diarrhea (52.38%), and pain (47.62%). The most commonly used diagnostic test was RT-PCR (42.11%). Contact transmission (50%) and zoonotic transmission (37.5%) were the most prevalent routes of transmission. Antibiotics (61.5%) were the first line of treatment. The most common complications were hemorrhage (60%) and coagulopathies (33.3%). The mortality rate was 57.1%.Conclusion: To avoid disastrous consequences, it is essential to reiterate the necessity of early diagnosis and treatment of MVD.Item Metadata only Stereotactic radiosurgery for Koos grade IV vestibular schwannoma in young patients: a multi-institutional study(Springer, 2022) 0000-0003-3057-3355; 0000-0001-8952-6866; Dumot, Chloe; Pikis, Stylianos; Mantziaris, Georgios; Xu, Zhiyuan; Anand, Rithika Kormath; Nabeel, Ahmed M.; Sheehan, Darrah; Sheehan, Kimball; Reda, Wael A.; Tawadros, Sameh R.; Karim, Khaled Abdel; El-Shehaby, Amr M. N.; Eldin, Reem M. Emad; Peker, Selcuk; Samanci, Yavuz; Kaisman-Elbaz, Tehila; Speckter, Herwin; Hernandez, Wenceslao; Isidor, Julio; Tripathi, Manjul; Madan, Renu; Zacharia, Brad E.; Daggubati, Lekhaj C.; Moreno, Nuria Martinez; Alvarez, Roberto Martinez; Langlois, Anne-Marie; Mathieu, David; Deibert, Christopher P.; Sudhakar, Vivek R.; Cifarelli, Christopher P.; Icaza, Denisse Arteaga; Cifarelli, Daniel T.; Wei, Zhishuo; Niranjan, Ajay; Barnett, Gene H.; Lunsford, L. Dade; Bowden, Greg N.; Sheehan, Jason P.; N/A; N/A; Peker, Selçuk; Samancı, Mustafa Yavuz; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 11480; 275252Purpose Surgery is the treatment of choice for large vestibular schwannomas (VS). Stereotactic radiosurgery (SRS) has been suggested as an alternative to resection in selected patients. However, the safety and efficacy of SRS in Koos grade IV patients <= 45 years old has not been evaluated. The aim of this study is to describe the clinical and radiological outcomes of Koos grade IV in young patient managed with a single-session SRS. Methods This retrospective, multicenter analysis included SRS-treated patients, <= 45 years old presenting with non-life threatening or incapacitating symptoms due to a Koos Grade IV VS and with follow-up >= 12 months. Tumor control and neurological outcomes were evaluated. Results 176 patients [median age of 36.0 (IQR 9) and median tumor volume of 9.3 cm(3) (IQR 4.7)] were included. The median prescription dose was 12 Gy (IQR 0.5). Median follow-up period was 37.5 (IQR 53.5) months. The 5- and 10-year progression-free survival was 90.9% and 86.7%. Early tumor enlargement occurred in 10.9% of cases and was associated with tumor progression at the last follow-up. The probability of serviceable hearing preservation at 5- and 10-years was 56.8% and 45.2%, respectively. The probability of improvement or preservation of facial nerve function was 95.7% at 5 and 10-years. Adverse radiation effects were noted in 19.9%. New-onset hydrocephalus occurred in 4.0%. Conclusion Single-session SRS is a safe and effective alternative to surgical resection in selected patients <= 45 years old particularly those with medical co-morbidities and those who decline resection. Longer term follow up is warranted.Item Metadata only Fluorescence-guided extended pelvic lymphadenectomy during robotic radical prostatectomy(Springer Nature, 2023) 0000-0001-9706-1587; 0000-0002-5189-0600; N/A; 0000-0003-2003-7567; 0000-0001-9804-0454; 0000-0003-4527-5983; N/A; 0000-0002-6071-1539; 0000-0001-8906-1595; 0000-0003-0784-8605; 0000-0001-6534-5403; 0000-0002-9947-848X; 0000-0002-5196-653X; 0000-0002-0961-9374; 0000-0003-1079-0088; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; Balbay, Mevlana Derya; Köseoğlu, Ersin; Aykanat, İbrahim Can; Kulaç, İbrahim; Armutlu, Ayşe; Falay, Fikri Okan; Barçın, Erinç; Tarım, Kayhan; Sarıkaya, Ahmet Furkan; Baydar, Dilek Ertoy; Özkan, Arif; Kordan, Yakup; Canda, Abdullah Erdem; Esen, Tarık; Çil, Barbaros Erhan; Faculty Member; Faculty Member; Doctor; Faculty Member; Teaching Faculty; Teaching Faculty; Master Student; Researcher; Researcher; Faculty Member; Doctor; Faculty Member; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine; N/A; School of Medicine; School of Medicine; School of Medicine; Graduate School of Health Sciences; School of Medicine; School of Medicine; School of Medicine; N/A; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; 153320; 350876; N/A; 170305; 133567; 246484; N/A; 327605; 327615; 8025; 289255; 157552; 116202; 50536; 169993We evaluated and described the impact of prostatic indocyanine green (ICG) injection on extended pelvic lymph node (LN) dissection (ePLND) in robotic-assisted radical prostatectomy (RARP). Between January 2019 and December 2021, we included consecutive 50 PCa patients who underwent ePLND during RARP with (n = 25) or without (n = 25) prostatic ICG injection. ICG injection was performed during abdominal port placement and robot docking. Pelvic LNs reflecting green color were initially excised and then the template was completed. The outcomes of two groups were compared. Overall, nine (36%) and five (20%) of the patients had metastatic LN involvement in the ICG and non-ICG groups, respectıvely. Of the 509 dissected LNs in the ICG group, 122 (23.9%) were fluorescence active. 20 LNs (3.9%) were metastatic in this group, 9 (45%) of which were ICG+. 408 LNs were resected on the non-ICG group with 8(1.9%) being metastatic. Eight (88.9%) of nine pN+ patients were florescent positive in the ICG group. Out of six patients with pN+ disease, Ga68 PSMA-PET/CT detected positive LNs preoperatively. In addition to preoperative Ga68 PSMA-PET/CT investigation, ICG-guided ePLND might increase identification and removal of metastatic LNs duirng RARP. Improvements ın stagıng and oncologıc outcomes may also be seen ın intermediate- and high-risk patients. © 2022, The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.Item Metadata only The heat is on: the impact of excessive temperature increments on complications of laser treatment for ureteral and renal stones(Springer Science and Business Media Deutschland Gmbh, 2023) 0000-0001-6534-5403; Tonyali, Senol; von Bargen, Maximilian Ferry; Miernik, Arkadiusz; N/A; Özkan, Arif; Doctor; N/A; Koç University Hospital; 289255Objective: Technological advancements in the field of urology have led to a paradigm shift in the management of urolithiasis towards minimally invasive endourological interventions, namely ureteroscopy and percutaneous nephrolithotomy. However, concerns regarding the potential for thermal injury during laser lithotripsy have arisen, as studies have indicated that the threshold for cellular thermal injury (43 °C) can be exceeded, even with conventional low-power laser settings. This review aims to identify the factors that contribute to temperature increments during laser treatment using current laser systems and evaluate their impact on patient outcomes. Materials and methods: To select studies for inclusion, a search was performed on online databases including PubMed and Google Scholar. Keywords such as 'temperature' or 'heat' were combined with 'lithotripsy', 'nephrolithotomy', 'ureteroscopy', or 'retrograde intrarenal surgery', both individually and in various combinations. Results: Various strategies have been proposed to mitigate temperature rise, such as reducing laser energy or frequency, shortening the duration of laser activation, increasing the irrigation fluid flow rate, and using room temperature or chilled water for irrigation. It is important to note that higher irrigation fluid flow rates should be approached cautiously due to potential increases in intrarenal pressure and associated infectious complications. The utilization of a ureteral access sheath (UAS) may offer benefits by facilitating irrigation fluid outflow, thereby reducing intrapelvic pressure and intrarenal fluid temperature. Conclusion: Achieving a balance between laser power, duration of laser activation, and irrigation fluid rate and temperature appears to be crucial for urologists to minimize excessive temperature rise. © 2023, The Author(s).Item Metadata only Is there no need to discuss adjuvant chemotherapy in stage II colon cancer patients with high tumor budding and lymphovascular invasion?(Springer, 2023) 0000-0001-6749-8518; 0000-0001-5751-1133; 0000-0003-0316-6818; 0000-0002-1308-3701; 0000-0002-6668-3006; Zenger, Serkan; Gurbuz, Bulent; Can, Ugur; Erginoz, Ergin; Yilmaz, Serpil Postgil; Peker, Onder; N/A; N/A; N/A; N/A; N/A; Özata, İbrahim Halil; Balık, Emre; Buğra, Dursun; Adsay, Nazmi Volkan; Taşkın, Orhun Çığ; Teaching Faculty; Faculty Member; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; 177151; 18758; 1758; 286248; 166686PurposeThe aim of this study is to evaluate the clinicopathologic associations of tumor budding (Bd) as well as other potential prognosticators including lymphovascular invasion (LVI) in T3/4aN0 colon cancer patients and to investigate their impact on the outcome.MethodsThe patients were enrolled in three groups according to the number of budding as Bd1 (0-4 buds), Bd2 (5-9 buds), and Bd3 (> 10 buds). These groups were retrospectively compared in terms of demographic features, other tumor characteristics, operative outcomes, recurrences, and survival. The mean follow-up time was 58 +/- 22 months.ResultsA total of 194 patients were divided as follows: 97 in Bd1, 41 in Bd2, and 56 in Bd3 groups. The Bd3 group was associated with significantly higher LVI and larger tumor size. The rate of recurrence increased progressively from 5.2% in Bd1 to 9.8% in Bd2 and to 17.9% in Bd3 group (p = 0.03). More importantly, the 5-year overall survival (OS: Bd1 = 92.3% vs. Bd2 = 88% vs. Bd3 = 69.5%, p = 0.03) and disease-free survival (DFS: Bd1 = 87.9% vs. Bd2 = 75.3% vs. Bd3 = 66%, p = 0.02) were significantly worse in Bd3 group. In addition, in the subgroup of patients with the presence of Bd3 and LVI together, the 5-year OS (60% vs. 92%, p = 0.001) and DFS (56.1% vs. 85.4%, p = 0.001) were significantly worse. In multivariate analysis, Bd3+LVI was significantly associated with poor OS and DFS (p < 0.001).ConclusionIn patients with T3/4aN0 colon cancer, high tumor budding negatively affects long-term oncological outcomes. These findings strongly suggest that adjuvant chemotherapy be considered for the patients with Bd3 and LVI together.Item Metadata only A novel scoring system for the early detection of anastomotic leakage: bedside leak score-a pilot study(Frontiers Media Sa, 2023) 0000-0001-6749-8518; 0000-0001-5751-1133; N/A; 0000-0002-3610-7390; 0000-0002-9227-9015; 0000-0001-7971-3772; N/A; 0000-0002-9371-6811; 0000-0003-1617-3953; 0000-0003-0316-6818; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; Özata, İbrahim Halil; Balık, Emre; Sucu, Serkan; Karahan, Salih Nafiz; Camcı, Furkan; Bozkurt, Emre; Çetin, Feyza; Özoran, Emre; Ağcaoğlu, Orhan; Buğra, Dursun; Teaching Faculty; Faculty Member; Researcher; Researcher; Undergraduate Student; Doctor; Undergraduate Student; Teaching Faculty; Faculty Member; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; N/A; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; 177151; 18758; 327623; 337050; N/A; N/A; N/A; 307296; 175476; 1758Background: Anastomotic leakage is a major complication in colorectal surgery, resulting in significant morbidity and mortality rates. Despite substantial progress in surgical technique, anastomotic leakage rates remain stable. An early diagnosis of anastomotic leaks was proven to reduce adverse outcomes and improve survival. Objective: This study aims to find a novel scoring system for detecting anastomotic leaks using inflammatory and nutritional indicators after colorectal surgery. Our purpose was to analyze the diagnostic accuracy of leak scores ((CRP POD3)/(CRP POD1)*preoperative albumin level) in predicting postoperative complications. Design: The study included colorectal cancer patients who underwent curative surgery at Koc University Hospital between 2014 and 2018. Patients were categorized into two groups depending on the presence of anastomotic leaks and compared in terms of preoperative albumin levels, CRP levels in postoperative days 1 and 3, anastomotic leakage rates, length of hospital stay, and CRP quotient, which was calculated by dividing POD 3 CRP level to POD 1 CRP level. The bedside leak score is calculated by dividing the CRP quotient by the preoperative albumin level. The predictive value of bedside leak score, CRP quotient, and preoperative albumin levels in estimating anastomotic leakage was analyzed, and a cutoff value for the leak score was calculated. Results: A total of 184 patients were included in the study. The leak score, CRP POD 3-1 ratio, and preoperative albumin levels were found to successfully detect anastomotic leakage. The area under the curve for the leak score was calculated as 0.78. The optimal cutoff value was found to be 50.3 for the bedside leak score, which shows 90.9% sensitivity and 59.3% specificity. Conclusion: The leak score may represent a valuable diagnostic tool for detecting patients at risk for anastomotic leakage after colorectal surgery and planning a better strategy to reduce morbidity and mortality rates and associated costs. However, further multicenter studies with large cohorts are necessary to confirm these results.Item Metadata only Meeting report: the 2023 FSHD international research congress(Elsevier Ltd, 2023) 0000-0001-8202-5313; Arjomand, Jamshid; Gabellini, Davide; Voermans, Nicol; Belayew, Alexandra; Bosnakovski, Darko; Eichinger, Katy; Monforte, Mauro; Oflazer, Piraye; Rosa, Alberto Luis; N/A; Oflazer, Piraye; Faculty Member; School of MedicineFacioscapulohumeral muscular dystrophy (FSHD) is one of the most common inherited muscular dystrophies. As part of the FSHD Society's commitment to promote global communication and collaboration among researchers, the Society collaborated with FSHD Europe and convened its 30th annual International Research Congress (IRC) on June 15–16, 2023, in the city of Milan, Italy. Over 240 researchers, clinicians, patients and pharmaceutical company representatives from a wide geographical background participated to hear about the latest developments and breakthroughs in the field. The meeting was structured to provide a mix of basic and clinical research in five sessions: 1. Discovery research & genetics; 2. Outcome assessments; 3. Disease mechanisms & interventional strategies; 4. Clinical studies & trial design; and 5. Pediatric FSHD. The keynote speakers were Professor Baziel van Engelen (on the importance of incorporating the patient's voice to help refine and improve basic laboratory and clinical research) and Dr. Bénédict Chazaud (on the role of the immune system in normal muscle regeneration and in Duchenne muscular dystrophy). The FSHD IRC was preceded by the Industry Collaborative for Therapeutic Development in FSHD meeting and followed by the World FSHD Alliance network of national patient groups and advocacy organizations for FSHD summit. The Congress concluded with the announcement for the 2024 International Research Congress, which will take place on June 13–14, 2024 in Denver, Colorado, USA, and followed by the FSHD Society's flagship educational conference for the FSHD community, the Patient Connect Conference, on June 15–16, 2024. © 2023Item Metadata only Voiding cystourethrogram before pyeloplasty: to do or not to do?(Elsevier Inc., 2023) 0000-0001-7719-2440; Selvi, Ismail; Dönmez, M. İrfan; Değirmenci, Enes; Zoroğlu, Hatice; Ziylan, Orhan; N/A; Oktar, Tayfun; Doctor; N/A; Koç University HospitalOBJECTIVE: To assess the incidence of concomitant vesicoureteral reflux (VUR) in unilateral cases of ureteropelvic junction obstruction (UPJO) and to identify factors that predict VUR. METHODS: Files of 381 pediatric patients who underwent unilateral pyeloplasty between 2000 and 2017 were retrospectively reviewed. A total of 270 patients with available data and ≥5 years of follow-up were eligible for this study. Demographic parameters, preoperative hydronephrosis grade, renal pelvis anteroposterior diameter (APD), renal parenchymal thickness (PT), split renal functions on MAG-3 scan and VUR status were noted. The patients were divided into two groups: those with concomitant VUR (group I, n: 24, 8.9%) and those without VUR (group II, n: 246, 91.1%). RESULTS: Among 270 patients (205 boys, 75.9%) with a median age of 4 months (2-98), 197 (72.9%) had antenatal hydronephrosis. Median follow-up was 11 years (5-22). Among 24 patients with concurrent VUR, 6 (25%) had grade II VUR, whereas grade III-V VUR was detected in 18 (75%). Of these, 12 (50%) had ipsilateral VUR, 3 (12.5%) had contralateral, and 9 (37.5%) had bilateral VUR. In a median 137-month follow-up, spontaneous VUR resolution was observed in 6 (25%) patients, whereas 15 (62.5%) patients underwent endoscopic subureteral injection and 3 (12.5%) patients ureteroneocystostomy, respectively. Preoperative APD [35.5, (Inter Quantile Range) IQR (27.6-36.0) vs 26.5 IQR (25.0-35.0), P = .004] were significantly higher in group I, whereas group I had significantly lower PT [3.7, IQR (3.4-6.4) vs 5.8 IQR (4.4-6.1), P = .026]. Predictive factors for concomitant VUR were presentation with febrile UTI (odds ratio (OR): 2.769, P = .048), PT <3.95 mm (OR: 1.367, P = .043), and APD >28.8 mm (OR: 1.035, P = .001). CONCLUSION: Our results indicated that concomitant VUR and UPJO might be detected in 1 out of every 11 patients undergoing pyeloplasty, while some type of surgical intervention for VUR was required in 75% of these patients. Thus, voiding cystourethrogram prior to pyeloplasty may be limited in those presenting with febrile urinary tract infection, having higher APD and lower PT on preoperative urinary ultrasonography. © 2023 Elsevier Inc.