Long-term outcomes of cervical cancer patients with complete metabolic response after definitive chemoradiotherapy

Cem Onal,Ozan Cem Guler,Mehmet Reyhan,Ali Fuat Yapar 대한부인종양학회 2021 Journal of Gynecologic Oncology Vol.32 No.5

Objective: We investigated the importance of metabolic parameters measured with18 F-fluorodeoxyglucose positron-emission tomography integrated with computed tomography (FDG-PET/CT) for predicting progression-free survival (PFS) and overall survival (OS) in cervical cancer with complete metabolic response (CMR) after chemoradiotherapy (ChRT). Methods: The clinical data and PET parameters including standardized uptake value (SUV), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of 122 patients having CMR in post-treatment 18F-FDG-PET/CT delivered a median of 3.9 months after ChRT completion were analyzed. Results: With a median follow-up of 8.4 years, 55 patients (45%) presented with disease a median of 19.7 months after ChRT. For SUVp, MTVp, TLGp, SUVln, MTVln, and TLGp, the cut- off values for OS determined by receiver operating curve analysis were 15.8, 48.7 cm3, 552.3, 8.7, 7.0 cm3, respectively. All metabolic PET parameters were significant prognostic factors for OS and PFS in univariate analysis. International Federation of Gynecology and Obstetrics (FIGO) stage was predictive of both OS and PFS, while pelvic and/or para-aortic lymph node metastasis were predictive of OS only. In multivariate analysis, FIGO stage ≥IIB, MTVp ≥49.8 cm3, and TLGp ≥597.4 were predictive of worse OS. Advanced stage, presence of lymph node metastasis, higher TLGp, and larger MTVln were significant factors for poor PFS rates. Conclusion: We found that advanced stage and higher TLGp values were significant predictors for poor survival and higher progression rates. Volumetric PET parameters could be used to predict treatment outcomes in patients with CMR after definitive ChRT.

Mirror Image Gerbode or Partial Atrioventricular Canal Defect?

Cem Ariturk, Ass.Prof.,Ahmet Umit Gullu, Ass.Prof.,Sahin Senay, Ass.Prof.,Eyup Murat Okten, M.D.,Fevzi Toraman,E. Hasan Karabulut, Prof.,Letisya Melengic, M.S.,Cem Alhan, Prof. 대한흉부외과학회 2015 Journal of Chest Surgery (J Chest Surg) Vol.48 No.6

Gebode defect, that can accurately be treated surgical repair, is defined as a true communication between left ventricle and right atrium. A 74-year-old woman with a worsening history of ortophnea and peripheral edema was hospitalised. A communication between right atrium and left ventricle was diagnosed using transeusophageal echocardiography. The defect was repaired and mitral valve was replaced with a biologic valve. It would be beter to tailor surgical strategy for each case with atrioventricular canal defect after preoperative transeusophageal echocardiography and peroperative direct sight.

A multi-institutional analysis of sequential versus ‘sandwich’ adjuvant chemotherapy and radiotherapy for stage IIIC endometrial carcinoma

Cem Onal,Sezin Yuce Sari,Berna Akkus Yildirim,Guler Yavas,Melis Gultekin,Ozan Cem Guler,Serap Akyurek,Ferah Yildiz 대한부인종양학회 2019 Journal of Gynecologic Oncology Vol.30 No.3

Objective: To analyze the outcomes of sequential or sandwich chemotherapy (ChT) and radiotherapy (RT) in patients with node-positive endometrial cancer (EC). Methods: Data from 4 centers were collected retrospectively for 179 patients with stage IIIC EC treated with postoperative RT and ChT (paclitaxel and carboplatin). Patients were either treated with 6 cycles of ChT followed by RT (sequential arm; 96 patients) or with 3 cycles of ChT, RT, and an additional 3 cycles of ChT (sandwich arm; 83 patients). Prognostic factors affecting overall survival (OS) and progression-free survival (PFS) were analyzed. Results: The 5-year OS and PFS rates were 64% and 59%, respectively, with a median followup of 41 months (range, 5–167 months). The 5-year OS rates were significantly higher in the sandwich than sequential arms (74% vs. 56%; p=0.03) and the difference for 5-year PFS rates was nearly significant (65% vs. 54%; p=0.05). In univariate analysis, treatment strategy, age, International Federation of Gynecology and Obstetrics (FIGO) stage, pathology, rate of myometrial invasion, and grade were prognostic factors for OS and PFS. In multivariate analysis, non-endometrioid histology, advanced FIGO stage, and adjuvant sequential ChT and RT were negative predictors for OS, whereas only non-endometrioid histology was a prognostic factor for PFS. Conclusion: Postoperative adjuvant ChT and RT for stage IIIC EC patients, either given sequentially or sandwiched, offers excellent clinical efficacy and acceptably low toxicity. Our data support the superiority of the sandwich regimen compared to the sequential strategy in stage IIIC EC patients for OS.

Characterization of the physical properties of a self-flowing low-cement castable based on white-fused alumina

Cem Gö tas,Akln Odabasl,Levent Sezera,Filiz Çlnarb,Sule Günerc,Niyazi Eruslua,Necip Ünlü 한양대학교 세라믹연구소 2009 Journal of Ceramic Processing Research Vol.10 No.1

A white-fused low cement refractory castable was prepared from pure refractories that consisted of 77 wt.% white fused alumina, 10 wt.% calcined alumina, 8 wt.% microsilica, 5 wt.% cement and 0.05 wt.% dispersant. Optimum self-leveling flowability was achieved by using 5.6 wt.% water. To determine the effect of the firing temperature on the white-fused low cement refractory castable, studies of apparent porosity (AP), bulk density (BD), water absorption (WA), cold crushing strength (CCS), hardness, X-ray diffraction (XRD) and microstructural-based evaluation using electron probe microanalyser (EPMA) were performed. The present castable heat treated at 1500℃ for 2 h exhibited the following properties: the AP −14%, the BD −3.12 gcm−3, the WA −2.5%, the CCS −2000 kgcm−2 and the hardness −3185 kg㎟. The new white-fused alumina castable presents unique properties that would make it desirable to use in industrial refractory applications. A white-fused low cement refractory castable was prepared from pure refractories that consisted of 77 wt.% white fused alumina, 10 wt.% calcined alumina, 8 wt.% microsilica, 5 wt.% cement and 0.05 wt.% dispersant. Optimum self-leveling flowability was achieved by using 5.6 wt.% water. To determine the effect of the firing temperature on the white-fused low cement refractory castable, studies of apparent porosity (AP), bulk density (BD), water absorption (WA), cold crushing strength (CCS), hardness, X-ray diffraction (XRD) and microstructural-based evaluation using electron probe microanalyser (EPMA) were performed. The present castable heat treated at 1500℃ for 2 h exhibited the following properties: the AP −14%, the BD −3.12 gcm−3, the WA −2.5%, the CCS −2000 kgcm−2 and the hardness −3185 kg㎟. The new white-fused alumina castable presents unique properties that would make it desirable to use in industrial refractory applications.

Are Mannan-binding Lectine Serin Protease-2 and Alpha-1-microglobulin and Bukinin Precursor the Potential Biomarkers of Manic Episode? A Study via Urinary Proetomic Analysis

Cem Cerit,Mehmet Sarıhan,Ö,mer Nart,Murat Kasap,Hilmi Yaş,ar,Gü,rler Akpınar 대한정신약물학회 2021 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.19 No.2

Objective: Investigating the molecular basis of bipolar disorder (BD) is crucial in terms of developing effective treatment strategies as well as objective laboratory-based diagnostic tools for the disease. Methods: We examined the urine samples of BD patients both in manic episode and after remission and compared their urinary protein profiles with the controls. Twelve patients and twelve controls (C group) included to the study. Urinary samples of patients were first collected during manic episode (M group) and then after remission (R group). Two-dimensional gel electrophoresis (2-DE) coupled to MALDI-TOF/TOF massspectrometry approach and Western blot analysis were used. Results: Alpha-1-microglobulin and bukinin precursor (AMBP), Mannan-binding lectine serin protease-2 (MASP-2), and Ig gamma-1-chain displayed significant increases in their abundance in the urine protein pool of M group in comparison to the C and R groups. Alpha-1B glycoprotein and prostaglandin-H2 D-isomerase (PGD2) levels were significantly higher in the urine protein pool of the M and R groups in comparison to the C group. Annexin A1 was downregulated sig-nificantly in the urine protein pool of the M group in comparison to the C group. Conclusion: Intensities of MASP-2 and AMBP proteins discriminated manic episode from remission period and healthy controls indicating that these proteins may be candidate biomarkers for manic episode. The decrease in Annexin A1 and increase in Ig gamma-1 chain levels appeared to be associated with “Manic Episode” while the increase in PGD2 and alpha-1B glycoprotein levels appeared to be associated with “Bipolar Disorder”.

Methylphenidate Induced Lip and Tongue Biting

Cem Gokcen,Mehmet Karadag,Ihsan Aksoy 대한정신약물학회 2018 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.16 No.2

Attention deficit hyperactivity disorder (ADHD) is a life-long neurodevelopmental disorder and treatment depends on pharmacotherapy because of its biological origin. Stimulant drugs are the most commonly used treatment for ADHD and they have various side effects. Herein, we report a case who bit off the tip of her tongue with Osmotic Release Oral System methylphenidate (OROS MPH) 36 mg/day, bit the tip of her lower lip with immediate release (IR) MPH 10 mg/day and lateral part of her tongue with IR MPH 20 mg/day. A diagnosis of epilepsy was unlikely because of the normal neurological examination and electroencephalography findings. This case was considered as an atypical side effect of MPH such as perseverative/compulsive behaviours and movement disorders. Clinicians should be aware of that stimulant medications may cause lip and tongue biting behavior and this may effect treatment compliance tremendously.

Future of the EU Influence in Asia: EU Foreign Policy Options between the BRI and Global Dynamics

( Cem Nalbantoglu ) 한국EU학회 2021 Asia-Pacific Journal of EU Studies Vol.19 No.1

This article elaborates on the future of the European Union’s political and economic influence in Asia. It detects three main dynamics challenging the region’s political status quo; US Asia Policy, Brexit, and Belt and Road Initiative. In this setting, it examines those dynamics’ possible implications for the EU influence in the region under the framework of local and global elements. The further analysis discusses contemporary US Asia Policy and Brexit to narrow down the EU sphere of influence in Asia. However, it perceives the Belt and Road Initiative to offer EU opportunities, especially regarding the projections of US Asia Policy and Brexit for EU in Asia. This article concludes by charting possible road maps for the EU to consolidate further and grow its influence in Asia.

A single horn endometrial carcinoma of a uterus bicornis unicollis

Cem Dane,Zeynep Tatar,Banu Dane,Murat Erqinbas,Ahmet Cetin 대한부인종양학회 2009 Journal of Gynecologic Oncology Vol.20 No.3

In this report, we describe a case of endometrial carcinoma arising in one horn of a bicornuate uterus. The diagnosis of this rare combination can be missed unless an unrecognized postmenopausal bleeding alerts the gynecologist to make a careful search for both endometrial cavities that may be curetted. Physicians should remember the possible existence of a separate uterine cavity when endometrial cancer is clinically suspected but histology fails to confirm the diagnosis. In this report, we describe a case of endometrial carcinoma arising in one horn of a bicornuate uterus. The diagnosis of this rare combination can be missed unless an unrecognized postmenopausal bleeding alerts the gynecologist to make a careful search for both endometrial cavities that may be curetted. Physicians should remember the possible existence of a separate uterine cavity when endometrial cancer is clinically suspected but histology fails to confirm the diagnosis.

Preparation of ultra-homogeneous mullite precursor and evaluation of mullite formation

Cem ÖZGÜR,Remzi GÖREN 한양대학교 세라믹연구소 2015 Journal of Ceramic Processing Research Vol.16 No.3

The objective of this study is to present firstly the preparation of atomically ultra-homogeneous mullite precursors by ultrasonic spray pyrolysis technique and then to investigate the evaluation of mullite formation via calcination temperature and soaking time. At a temperature of as low as 500 o C for 15 days, the temperature was very close to the formation temperature of mullite (477 o C) is energetically possible; the structure of the precursor has been preserved as amorphous. It is possible to obtain single phase of mullite crystals at a temperature of 1000 o C without soaking time, while the crystallization required a temperature of 900 o C for 12 hours.

Effects of Long-term Administration of the Antiaging Hormone Dehydroepiandrosterone Sulfate on Rat Prostates and Testes as Androgen-Dependent Organs

Cem Sah,Ibrahim Atilla Aridogan,Volkan Izol,Seyda Erdogan,Saban Doran 대한비뇨의학회 2013 Investigative and Clinical Urology Vol.54 No.3

Purpose: This study aimed to determine the effects of the long-term use of dehydroepiandrosterone sulfate (DHEAS) on rat prostates and testes as well as on serum testosterone and DHEAS levels. Materials and Methods: Thirty male rats aged 4 to 5 months were studied. A DHEAS suspension of 5 mg/kg per rat was administered orally to the 15 rats in the experimental group 5 times a week, whereas saline was administered concurrently to the 15 rats in the control group. Intracardiac blood samples were drawn to determine hormone levels,and histological samples of prostate and testes were evaluated under light microscopy. Results: At the end of the 6-month study period, histological examinations performed on prostate preparations showed that the atrophy score of the experimental group was significantly lower than the scores of the sham and control groups (p<0.001 and p <0.001, respectively). The serum total testosterone and DHEAS levels of the rats in the study group were significantly increased (p<0.001). Conclusions: In our study, we determined that the long-term use of DHEAS does not have any detrimental effects on the prostate or the testis; on the contrary, it protects the prostate from atrophy, which is imperative for the continuation of fertility as well as for increasing serum testosterone and DHEAS levels.