Clinicopathological Characteristics of Hepatocellular Carcinoma in Turkey

Dogan, Erkan,Yalcin, Suayib,Koca, Dogan,Olmez, Aydemir Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.6

Background: Hepatocellular carcinoma (HCC), the main malignant tumor of the liver, is very common and highly lethal. The aim of this study was to determine its clinicopathologic characteristics and risk factors in Turkey. Materials and methods: In this study, patients who were diagnosed as suffering from HCC in the period between August 2004 and December 2011 were evaluated retrospectively. Results: A total of 98 patients were included, with a median age 61 (range: 16 to 82). Seventy nine (80.6%) were male 59 (60.2%) were infected with hepatitis B virus (HBV) and 15 (15.3%) with HCV, another 15 (15.3%) being alcohol abusers. Seventy two (73.5%) were at advanced stage and 54 (55.1%) had elevated serum alpha-fetoprotein (AFP). Surgery, chemoembolization, systemic chemotherapy and application of the tyrosine kinase inhibitor sorafenib were the major treatment options. Conclusions: According to our findings HCC is mostly diagnosed in advanced stage and age, being five times more common in males than females. Main risk factors of HCC are HBV infection, HCV infection and alcohol abuse. Elevation in AFP may facilitate early diagnosis of HCC in high risk groups.

Solving design optimization problems via hunting search algorithm with Levy flights

Dogan, Erkan Techno-Press 2014 Structural Engineering and Mechanics, An Int'l Jou Vol.52 No.2

This study presents a hunting search based optimum design algorithm for engineering optimization problems. Hunting search algorithm is an optimum design method inspired by group hunting of animals such as wolves, lions, and dolphins. Each of these hunters employs hunting in a different way. However, they are common in that all of them search for a prey in a group. Hunters encircle the prey and the ring of siege is tightened gradually until it is caught. Hunting search algorithm is employed for the automation of optimum design process, during which the design variables are selected for the minimum objective function value controlled by the design restrictions. Three different examples, namely welded beam, cellular beam and moment resisting steel frame are selected as numerical design problems and solved for the optimum solution. Each example differs in the following ways: Unlike welded beam design problem having continuous design variables, steel frame and cellular beam design problems include discrete design variables. Moreover, while the cellular beam is designed under the provisions of BS 5960, LRFD-AISC (Load and Resistant Factor Design-American Institute of Steel Construction) is considered for the formulation of moment resisting steel frame. Levy Flights is adapted to the simple hunting search algorithm for better search. For comparison, same design examples are also solved by using some other well-known search methods in the literature. Results reveal that hunting search shows good performance in finding optimum solutions for each design problem.

Trastuzumab-based Retreatment after Lapatinib in Heavily Pretreated HER2 Positive Metastatic Breast Cancer: an Anatolian Society of Medical Oncology Study

Uncu, Dogan,Bayoglu, Ibrahim Vedat,Arslan, Ulku Yalcintas,Kucukoner, Mehmet,Artac, Mehmet,Koca, Dogan,Oguz, Arzu,Demirci, Umut,Arpaci, Erkan,Dogan, Mutlu,Kucukzeybek, Yuksel,Turker, Ibrahim,Isikdogan, Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.9

Background: For HER2 positive metastatic breast cancer (MBC), continuing anti-HER2 therapy beyond progression is associated with improved outcome. However retreatment with trastuzumab after lapatinib progression is controversial. We retrospectively analyzed the efficacy of trastuzumab-based chemotherapy in HER2+ metastatic breast cancer patients whose disease progressed after lapatinib. Materials and Methods: Between October 2010 and May 2013, 54 patients whose disease progressed after lapatinib were retreated with trastuzumab-based chemotherapy. Efficacy and toxicity results were evaluated retrospectively. Results: The median age of patients was 46 (range 27-67). Fourteen patients (26%) had metastases at the time of diagnosis. All of the patients had received trastuzumab in an adjuvant or metastatic setting, while 16 (30%) had received two lines of trastuzumab. All patients had received lapatinib plus capecitabine. The median chemotherapy line for the metastatic setting was 2 (range 1-7). Cranial metastases were identified in 27 (50%) patients. 53 patients received trastuzumab-based chemotherapy following lapatinib progression while one patient received trastuzumab monotherapy. Combination chemotherapy consisted of navelbin (n=33), taxane (n=10), gemcitabine (n=2), platinum (n=2) and platinum with taxane (n=6). The median treatment cycle was 5 (range 1-44). Among 49 patients assessed for response 2 (4%) showed CR, 12 (25%) PR, 11 (22%) SD and 24 (49%) disease progression. Asymptomatic cardiotoxicity was reported in 2 (4%) of the patients. At a median follow-up of 9 months (1-39), median progression-free survival was 5 months (95% CI 4.1-5.9) and median overall survival was 10 months (95% CI 6.9-13.0). PFS and OS were not affected by the absence/presence of cranial metastases. Conclusions: Retreatment with trastuzumab-based therapy after lapatinib progression showed efficacy in heavily treated MBC patients.

Relationship between Pulmonary Artery Stiffness and Functional Capacity in Patients with Heart Failure with Reduced Ejection Fraction

Erkan Yildirim,Murat Celik,Uygar Cagdas Yuksel,Mutlu Gungor,Baris Bugan,Deniz Dogan,Yalcin Gokoglan,Hasan Kutsi Kabul,Suat Gormel,Salim Yasar,Mustafa Koklu,Cem Barcin 대한심장학회 2017 Korean Circulation Journal Vol.47 No.6

Background and Objectives: Functional capacity varies significantly among patients with heart failure with reduced ejection fraction (HFrEF), and it remains unclear why functional capacity is severely compromised in some patients with HFrEF while it is preserved in others. In this study, we aimed to evaluate the role of pulmonary artery stiffness (PAS) in the functional status of patients with HFrEF. Methods: A total of 46 heart failure (HF) patients without overt pulmonary hypertension or right HF and 52 controls were enrolled in the study. PAS was assessed on parasternal short-axis view using pulsed-wave Doppler recording of pulmonary flow one centimeter distal to the pulmonic valve annulus at a speed of 100 mm/sec. PAS was calculated according to the following formula: the ratio of maximum flow velocity shift of pulmonary flow to pulmonary acceleration time. Results: PAS was significantly increased in the HFrEF group compared to the control group (10.53±2.40 vs. 7.41±1.32, p<0.001). In sub-group analysis of patients with HFrEF, PAS was significantly associated with the functional class of the patients. HFrEF patients with poor New York Heart Association (NYHA) functional capacity had higher PAS compared those with good functional capacity. In multivariate regression analysis, NYHA class was independently correlated with PAS. Conclusion: PAS is associated with functional status and should be taken into consideration as an underlying pathophysiological mechanism of dyspnea in patients with HFrEF.

Experience of the Endoscopists Matters in Endoscopic Retrograde Cholangiopancreatography in Billroth II Gastrectomy Patients

Erkan Caglar,Deniz Atasoy,Mukaddes Tozlu,Engin Altınkaya,Serkan Dogan,Hakan Senturk 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.1

Background/Aims: Altered anatomy is a challenge in endoscopic retrograde cholangiopancreatography (ERCP) for patients withBillroth II anastomosis. In this study, we investigated the overall success and role of endoscopist experience. Methods: Data of patients who underwent ERCP between 2014 and 2018 after a previous Billroth II operation were retrievedretrospectively from 2 tertiary ERCP centers. The procedures were performed by 2 endoscopists with different levels of experience. Clinical success was defined as extraction of the stone, placement of a stent through a malignant stricture, and clinical and laboratoryimprovements in patients. Results: Seventy-five patients were included. The technical success rate was 83% for the experienced endoscopist and 75% for theinexperienced endoscopist (p=0.46). The mean (±standard deviation) procedure time was 23.8±5.7 min for the experienced endoscopistand 40.68±6.07 min for the inexperienced endoscopist (p<0.001). In total, 3 perforations (4%) were found. The rate of afferent loopperforation was 6.25% (1/16) for the inexperienced endoscopist and 0% (0/59) for the experienced endoscopist (p=0.053). Conclusions: ERCP in patients who had undergone Billroth II gastrectomy was time consuming for the inexperienced endoscopistwho should beware of the unique adverse events related to ERCP in patients with altered anatomy.

A generative sampling system for profile designs with shape constraints and user evaluation

Dogan, Kemal Mert,Suzuki, Hiromasa,Gunpinar, Erkan,Kim, Myung-Soo Elsevier 2019 Computer aided design Vol.111 No.-

<P><B>Abstract</B></P> <P>A sampling approach is proposed for deriving profiles of an existing product design using profile similarities and primitive shapes, such as circles, triangles, and ellipses, as constraints. A common approach for a designer is to generate or collect sketches to create a design space. The design space can be explored to retrieve the samples directly based on requirements or crossing over them to obtain new design variations. In this stage, the proposed method can be used to derive a large number of samples from a design image to work with. First, the user clicks on the image to define each design feature as cubic Bézier curve segment. The primitive shapes are then constructed for each segment and used as constraints, such that the control points can move only to where these shapes allow. Moreover, the design similarities are computed using the triangles based on their anisotropy ratios, which are measures of the deformation between corresponding triangles and which are used to ensure that they are highly related samples in the example design. Modified Hausdorff distances are also computed between the biarc approximations of the samples. There is diversity provided that these distances are large enough. A customized sampling algorithm that fulfills our constraints is executed several times synchronously via parallel programming to create a design space. Finally, the user-specified number of distinct samples is retrieved from the design space by minimizing the Audze–Eglais potential energy. We provide an additional tool with which the users can adjust the weights for each control point to guide the sampling process and record the chosen samples. The main goal of this study is to generate samples, which are diverse but still convey the key features of the supplied shape. Using the settings related to similarity, a designer can derive samples sticking to their initial idea to explore its better version or more creative results that they could not imagine on their own. The proposed system offers simplicity automating every step that must be done by the user. Thus even inexperienced users without needing any programming skill can vary shapes defined using a set of points in a matter of seconds, and experienced users can even focus on specific shape features weighting them without dealing any constraint or rule definition requirements. Besides, the proposed system allows partial modifications, in which users can select a specific region to modify while the rest of the shape maintains the original appearance and functionality of the exemplary design.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Diverse sampling of profile curves using similarity measures. </LI> <LI> Efficient sampling from single image using parallel chain algorithm. </LI> <LI> Comprehensive representation of constraints using primitive geometries. </LI> <LI> Easy to use prototype system for inexperienced users. </LI> </UL> </P>

An improved particle swarm optimizer for steel grillage systems

Erdal, Ferhat,Dogan, Erkan,Saka, Mehmet Polat Techno-Press 2013 Structural Engineering and Mechanics, An Int'l Jou Vol.47 No.4

In this paper, an improved version of particle swarm optimization based optimum design algorithm (IPSO) is presented for the steel grillage systems. The optimum design problem is formulated considering the provisions of American Institute of Steel Construction concerning Load and Resistance Factor Design. The optimum design algorithm selects the appropriate W-sections for the beams of the grillage system such that the design constraints are satisfied and the grillage weight is the minimum. When an improved version of the technique is extended to be implemented, the related results and convergence performance prove to be better than the simple particle swarm optimization algorithm and some other metaheuristic optimization techniques. The efficiency of different inertia weight parameters of the proposed algorithm is also numerically investigated considering a number of numerical grillage system examples.

Multicenter Epidemiologic Study on Hepatocellular Carcinoma in Turkey

Can, Alper,Dogan, Erkan,Bayoglu, Ibrahim Vedat,Tatli, Ali Murat,Besiroglu, Mehmet,Kocer, Murat,Dulger, Ahmet Cumhur,Uyeturk, Ummugul,Kivrak, Derya,Orakci, Zuat,Bal, Oznur,Kacan, Turgut,Olmez, Sehmus,T Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.6

Background: Hepatocellular cancer (HCC) is one of the important health problems in Turkey, being very common and highly lethal. The aim of this study was to determine clinical, demographic features and risk factors. Materials and Methods: Nine hundred and sixth-three patients with HCC from 13 cities in Turkey were included in this study. Results: Only 205 (21%) of the 963 patients were women, with a male:female predominance of 4.8:1 and a median age of 61 years. The etiologic risk factors for HCC were hepatitis B in 555 patients (57.6%), 453 (81%) in men, and 102 (19%) in women, again with male predominance, hepatitis C in 159 (16.5%), (14.9% and 22.4%, with a higher incidence in women), and chronic alcohol abuse (more than ten years) in 137 (14.2%) (16.8% and 4.9%, higher in males). The Child-Pugh score paralleled with advanced disease stage amd also a high level of AFP. Conclusions: According to our findings the viral etiology (hepatitis B and hepatitis C infections) in the Turkish population was the most important factor in HCC development, with alcohol abuse as the third risk factor. The Child-Pugh classification and AFP levels were determined to be important prognostic factors in HCC patients.

Slide Session : OS-ONC-07 ; Oncology : Violence Among Cancer Patients in Eastern Turkey

( Hanim Guler Sahin ),( Gulnihal Guvendi ),( Huseyin Avni Sahin ),( Dilek Kusaslan ),( Erkan Dogan ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Health-care providers generally remain unaware of violence In Turkey and there are limited numbers of studies focuses on violence and there is no data regarding violence among cancer patients in Eastern Turkey. The aim of this study was to estimate the prevalence of violence and to investigate its related factors in Eastern Turkey. Methods: This cross-sectional descriptive study was performed in medical school of Yuzuncu Yil University, in Turkey. All patients who attended the medical oncology clinics were included in the study. The patients were interviewed face to face by a physician in complete privacy. Data were evaluated by using SPSS computer software version 21. Results: Between May and June 2014, all cancer patients attending the major tertiary hospital were included in this descriptive study. Of the 100 participants 61 (61%) were women 39 (39%) were men. 61 (%61) of the respondents were not able to read and write. 62 patients (62 %) were aware of his/her disease and 59 (96.7 %) of them had learned the disease from a physician. Main supporters were the daughters/son (41%) and couples (38%) during the illness. Although 16% were threatened to be abandon, 79% were afraid of being abandon. 45% of the patients thought that they were neglected. Only female patients stated physical violence and before the illness rate was 18% (100% by the male partner) and it decreased to 8% (87.5% by the partner and 12.5 % by the son) after the illness. Conclusions: Even though violence rate among cancer patients decreased during the illness period it is still a serious public health problem. Health-care providers should increase their awareness to protect the cancer patients from violence. Education and improvements in economic autonomy and society`s attitudes may also reduce violence towards cancer patients.

Clinicopathological Features in Bilateral Breast Cancer

Baykara, Meltem,Ozturk, Selcuk Cemil,Buyukberber, Suleyman,Helvaci, Kaan,Ozdemir, Nuriye,Alkis, Necati,Berk, Veli,Koca, Dogan,Coskun, Ugur,Oksuzoglu, Berna,Uncu, Dogan,Arpaci, Erkan,Ustaalioglu, Basak Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.9

Introduction and Purpose: The frequency of bilateral breast cancer is 1.4-11.0% among all breast cancers. It can present as synchronous (SC) or metachronous (MC). Data regarding clinical course of bilateral breast cancer are scarce. In this study, we therefore evaluated demographic, pathological and clinical characteristics, treatments and responses in bilateral breast cancer cases; making distinctions between metachronous-synchronous and comparing with historic one-sided data for the same parameters. Materials and Methods: One hundred fifty bilateral breast cancer cases from ten different centers between 2000 and 2011 were retrospectively scanned. Age of the cases, family history, menopausal status, pathological features, pathological stages, neoadjuvant, surgery, adjuvant and palliative chemotherapy/radiotherapy were examined in the context of the first and second occurrence and discussed with reference to the literature. Results: Metachronous and synchronous groups showed similar age, menopausal status, tumor type, HER2/neu expression; the family history tumor grade, tumor stage, ER-negativity rate, local and distant metastases rates, surgery, adjuvant chemotherapy application rates were identified as significantly different. Palliative chemotherapy response rate was greater in the metachronous group but median PFS rates did not differ between the groups. Conclusion: Although bilateral breast cancer is not frequent, MC breast cancer is different from SC breast cancer by having more advanced grade, stage, less ER expression, more frequent rates of local relapse and distant metastasis and better response to chemotherapy in case of relapse/metastasis.