Prognostic factors and treatment outcomes in surgically­staged non­invasive uterine clear cell carcinoma: a Turkish Gynecologic Oncology Group study

Mustafa Erkan Sarı,Mehmet Mutlu Meydanlı,Osman Türkmen,Günsü Kimyon Cömert,Ahmet Taner Turan,Alper Karalök,Hanifi Şahin,Ali Haberal,Eda Kocaman,Özgür Akbayır,Baki Erdem,Ceyhun Numanoğlu,Kemal Güngördü 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.4

Objective: To assess the prognosis of surgically-staged non-invasive uterine clear cell carcinoma (UCCC), and to determine the role of adjuvant therapy. Methods: A multicenter, retrospective department database review was performed to identify patients with UCCC who underwent surgical treatment between 1997 and 2016 at 8 Gynecologic Oncology Centers. Demographic, clinicopathological, and survival data were collected. Results: A total of 232 women with UCCC were identified. Of these, 53 (22.8%) had surgically-staged non-invasive UCCC. Twelve patients (22.6%) were upstaged at surgical assessment, including a 5.6% rate of lymphatic dissemination (3/53). Of those, 1 had stage IIIA, 1 had stage IIIC1, 1 had stage IIIC2, and 9 had stage IVB disease. Of the 9 women with stage IVB disease, 5 had isolated omental involvement indicating omentum as the most common metastatic site. UCCC limited only to the endometrium with no extra-uterine disease was confirmed in 41 women (73.3%) after surgical staging. Of those, 13 women (32%) were observed without adjuvant treatment whereas 28 patients (68%) underwent adjuvant therapy. The 5-year disease-free survival rates for patients with and without adjuvant treatment were 100.0% vs. 74.1%, respectively (p=0.060). Conclusion: Extra-uterine disease may occur in the absence of myometrial invasion (MMI), therefore comprehensive surgical staging including omentectomy should be the standard of care for women with UCCC regardless of the depth of MMI. Larger cohorts are needed in order to clarify the necessity of adjuvant treatment for women with UCCC truly confined to the endometrium.

Estimation of seismic effective energy based parameter

Ömer Faruk Nemutlu,Ali Sarı,Bilal Balun 국제구조공학회 2022 Structural Engineering and Mechanics, An Int'l Jou Vol.82 No.6

The effect of earthquakes in earthquake resistant structure design stages is influenced by the highest ground acceleration value, which is generally a strength-based approach in seismic codes. In this context, an energy-oriented approach can be suggested as an alternative to evaluate structure demands. Contrary to the strength-based approach, the strength and displacement demands of the structure cannot be evaluated separately, but can be evaluated together. In addition, in the energyoriented approach, not only the maximum effects of earthquakes are taken into account, but also the duration of the earthquake. In this respect, it can be said that the use of energy-oriented earthquake parameters is a more rational approach besides being an alternative. In this study, strength and energy-oriented approaches of earthquake parameters of 11 different periods of single degree of freedom systems were evaluated over 28 different earthquake situations. The energy spectra intended to be an alternative to the traditional acceleration spectra were created using the acceleration parameter equivalent to the input energy. Two new energy parameters, which take into account the effective duration of the earthquake, are proposed, and the relationship between the strength-oriented spectral acceleration parameters and the energy parameters used in the literature is examined by correlation study. According to the results obtained, it has been seen that energy oriented earthquake parameters, which give close values in similar period situations, will be a good alternative to strength oriented earthquake parameters. It was observed that the energy parameters were affected by the effective duration of the earthquake, unlike the strength-based parameters. It has been revealed that the newly proposed energy parameters considering the effective duration give good correlations. Finally, it was concluded that the energy parameters can be used in the design, and the newly proposed effective energy parameters can shorten the analysis durations.

Preparation, thermal properties and thermal reliability of eutectic mixtures of fatty acids/expanded vermiculite as novel form-stable composites for energy storage

Ali Karaipekli,Ahmet Sarı 한국공업화학회 2010 Journal of Industrial and Engineering Chemistry Vol.16 No.5

This paper deals with the preparation, characterization, thermal properties and thermal reliability of novel form-stable composite phase change materials (PCMs) composed of eutectic mixtures of fatty acids and expanded vermiculite for thermal energy storage. The form-stable composite PCMs were prepared by incorporation of eutectic mixtures of fatty acids (capric–lauric, capric–palmitic and capric–stearic acids) within the expanded vermiculite by vacuum impregnation method. The composite PCMs were characterized by SEM and FTIR techniques. Thermal properties of the composite PCMs were determined by differential scanning calorimeter (DSC) method. DSC results showed that the melting temperatures and latent heats of the prepared composite PCMs are in the range of 19.09–25.64 8C and 61.03–72.05 J/g, respectively. The thermal cycling test including 5000 heating and cooling process was conducted to determine the thermal reliability of the composite PCMs. The test results showed that the composite PCMs have good thermal reliability and chemical stability. Furthermore, thermal conductivities of the composite PCMs were increased by adding 10 wt% expanded graphite. Based on all results, the prepared form-stable composites can be considered as promising PCMs for low temperature thermal energy storage applications due to their satisfactory thermal properties, good thermal reliability, chemical stability and thermal conductivities. 2010 The Korean Society of Industrial and Engineering Chemistry. Published by Elsevier B.V. All rights reserved.

Immobilization of Glucose Oxidase Attached to New Nanospheres Including Azomethine

Nurbanu Özdem,Nurşen Sarı,Elvan Hasanoğlu Özkan,Fatma Arslan,Hayrettin Tümtürk 한국고분자학회 2014 Macromolecular Research Vol.22 No.12

New nanosphere supports were prepared and characterized for the immobilization of glucose oxidasefrom Aspergillus niger. Nanoparticles ((APS-tio), (APS-tioCH3), and (APS-tioCl)) modified (aminomethyl)polystyrene(APS) with some tyophenealdehyde derivatives were synthesized by means of condensation and we investigated the enzymaticproperties of glucose oxidase enzyme (GOx) immobilized on them. Modified polystyrene was characterized by IRspectra, gel permeation chromatography and scanning electron microscopy. Immobilized GOx on (APS-tioCH3) showed aoptimum pH, whereas immobilized GOx on (APS-tio) and (APS-tioCl) performed the optimum condition at two pHs.

Fragility Analysis of Atmospheric Storage Tanks by Observational and Analytical Data

Fırat Bezir,Sezer Öztürk,Ali Sarı,Kayahan Akgül 한국강구조학회 2022 International Journal of Steel Structures Vol.22 No.1

In this research, seismic fragility analysis of storage tanks is carried out with a large damage database from past earthquakes and analytical studies. At the fragility analysis, a new damage state has been defi ned. Peak ground acceleration is employed as an intensity measure. Epistemic and aleatory uncertainties are considered. At the observational fragility analysis, logit, probit and cumulative lognormal model and maximum likelihood method are utilized. In this research, Finite Element Analysis is also performed. As a result, new seismic fragility curves for storage tanks obtained and compared with the existing tank fragility curves in the literature.

Design Principles for Wind Turbine Earthquake and Wind Load Combinations

Elif Altunsu,Onur Gunes,Ali Sarı 한국강구조학회 2022 International Journal of Steel Structures Vol.22 No.3

With the ongoing changes in the modern world, the usage of renewable energy sources is increasing. The negative impact of fossil fuels on global warming has led to the search for clean energy sources. Wind energy, which is the most widely used of those sources, is discussed in this study. Numerous studies have been undertaken in this regard, but seismic eff ects are only newly being considered. In addition to having strong wind zones, Turkey is located in a geographical position through which active fault lines pass. The presence of high wind zones overlapping with these fault lines necessitates seismic analysis for turbines planned to be built in the country. Analysis of wind and seismic load simulation is diffi cult with traditional structural design programs. In this study, coeffi cients including wind loads are suggested for civil engineers who plan to analyze wind turbines with only seismic eff ects. For this purpose, a horizontal axis steel wind turbine with a 5 MW scale is analyzed in this work considering a series of wind and seismic loads in the area around Gelibolu. These environmental eff ects are evaluated under diff erent operating conditions of the turbine, including normal operation with no earthquake loads, park condition with earthquake loads, idling condition with wind loads, normal operation with earthquake loads, and idling condition with earthquake and wind loads. The full system model of the turbine is developed with the FAST fi nite element program employing a special code for wind turbines developed by the National Renewable Energy Laboratory. As a result of the analysis, it is concluded that seismic loads acting with the wind signifi cantly change the internal forces. Damping eff ects occur when seismic and wind loads act at the same time. For this reason, wind loads need to be reduced by a certain coeffi cient in some cases. Coeffi cients are proposed here for application in initial designs and load combinations for certain wind and earthquake conditions.

The Use of Nontreated Fiber Obtained from Washingtonia filifera for Dye Removal from Aqueous Phases by Adsorption

Olcayto Keskinkan,Buket Karabaş,Bülent Sarı,Behzat Balcı,Hasan Kıvanç Yeşiltaş 한국섬유공학회 2023 Fibers and polymers Vol.24 No.10

This is the first study to show the use of fibers from the Washingtonia filifera palm tree as an adsorbent for the removal of Crystal Violet (CV) dyestuffs from aqueous solutions by adsorption. The research on new materials to prevent the contamination of pollutants is of great importance. CV is a dye that is known to have toxic and carcinogenic effects and is used in many industries. In this study, the effects of parameters such as initial adsorbate concentration, adsorbent dose, and pH on the adsorption efficiency were investigated. The highest removal efficiency was 95.55% and the maximum adsorption capacity was found to be 85.91 mg/g. The maximum adsorption capacity of the fibers used reached a pH of 8. The BET surface area of the adsorbent was 4.1484 m2/g and the average pore width 6.8563 nm. The average pore volume was 0.00413 cm3/g for mesopores and 0.00017 cm3/g for micropores. Stegmata structures, also called silica bodies, were observed in SEM images. Langmuir, Freundlich, Temkin, and Dubinin-Radushkevich (D-R) isotherms were studied. The Temkin isotherm (R2=0.9692) best explained the results in the stirring experiments. The Freundlich isotherm (R2=0.9643) best explained the stationary phase systems without stirring. It was determined that the equation that best explained the dye removal kinetics was the pseudo-second-order kinetic model.

Impact of lymph node ratio on survival in stage III ovarian high-grade serous cancer: a Turkish Gynecologic Oncology Group study

Ali Ayhan,Nazlı Topfedaisi Ozkan,Mustafa Erkan Sarı,Husnu Celik,Murat Dede,Özgür Akbayır,Kemal Güngördük,Hanifi Şahin,Ali Haberal,Tayfun Güngör,Macit Arvas,Mehmet Mutlu Meydanlı 대한부인종양학회 2018 Journal of Gynecologic Oncology Vol.29 No.1

Objective: The purpose of this study was to investigate the prognostic value of lymph node ratio (LNR) in patients with stage III ovarian high-grade serous carcinoma (HGSC). Methods: A multicenter, retrospective department database review was performed to identify patients with ovarian HGSC at 6 gynecologic oncology centers in Turkey. A total of 229 node-positive women with stage III ovarian HGSC who had undergone maximal or optimal cytoreductive surgery plus systematic lymphadenectomy followed by paclitaxel plus carboplatin combination chemotherapy were included. LNR, defined as the percentage of positive lymph nodes (LNs) to total nodes recovered, was stratified into 3 groups: LNR1 (<10%), LNR2 (10%≤LNR<50%), and LNR3 (≥50%). Kaplan-Meier method was used to generate survival data. Factors predictive of outcome were analyzed using Cox proportional hazards models. Results: Thirty-one women (13.6%) were classified as stage IIIA1, 15 (6.6%) as stage IIIB, and 183 (79.9%) as stage IIIC. The median age at diagnosis was 56 (range, 18–87), and the median duration of follow-up was 36 months (range, 1–120 months). For the entire cohort, the 5-year overall survival (OS) was 52.8%. An increased LNR was associated with a decrease in 5-year OS from 65.1% for LNR1, 42.5% for LNR2, and 25.6% for LNR3, respectively (p<0.001). In multivariate analysis, women with LNR≥0.50 were 2.7 times more likely to die of their tumors (hazard ratio [HR]=2.7; 95% confidence interval [CI]=1.42–5.18; p<0.001). Conclusion: LNR seems to be an independent prognostic factor for decreased OS in stage III ovarian HGSC patients.

Portal Hypertension in Children: A Tertiary Center Experience in Turkey

Emine Nur Sunar Yayla,Sinan Sarı,Neslihan Gürcan Kaya,Ödül Eğrİtaş Gürkan,Hakan Sözen,İbrahim Onur Özen,Aydın Dalgıç,Buket Dalgıç 대한소아소화기영양학회 2023 Pediatric gastroenterology, hepatology & nutrition Vol.26 No.6

Purpose: Portal hypertension (PH) and its complications have a significant impact on morbidity and mortality. This study aimed to evaluate the etiology; clinical, laboratory, and endoscopic findings; treatment approaches; long-term outcomes; and prognosis of pediatric PH. Methods: This retrospective study included 222 pediatric patients diagnosed with PH between 1998 and 2016, and data encompassing clinical, laboratory, and radiological features; treatments; and complications were analyzed. Results: The most common causes of PH were portal vein thrombosis (20.3%), progressive familial intrahepatic cholestasis (18.9%), and biliary atresia (12.2%). Among the enrolled patients, 131 (59.0%) were included in the cirrhotic group and 91 (41.0%) in the noncirrhotic group. Hepatomegaly and increased transaminase levels were more frequent in the cirrhotic group than in the non-cirrhotic group. Additionally, portal gastropathy, esophageal varices, and variceal bleeding were more frequent in the non-cirrhotic group, whereas ascites, hepatopulmonary syndrome and hepatic encephalopathy were more common in the cirrhotic group. The incidence of hepatomegaly was higher in the presinusoidal group than in the prehepatic group (p<0.001). Hyperbilirubinemia was more frequent in the prehepatic group (p=0.046). The frequency of esophageal varices was similar between the prehepatic and presinusoidal groups; however, variceal bleeding was more frequent in the prehepatic group (p=0.002). Conclusion: Extrahepatic portal vein obstruction, genetic-metabolic diseases, and biliary atresia were the most prevalent causes of PH in our country. In patients with PH, hepatomegaly, increased transaminase levels, and synthesis dysfunction were suggestive of cirrhotic PH. Notably, PH in patients without cirrhosis might be more severe than that in those with cirrhosis.

Effects of Oxcarbazepine and Levetiracetam on Calcium, Ionized Calcium, and 25-OH Vitamin-D3 Levels in Patients with Epilepsy

Duygu Aksoy,Betül Tekin Güveli,Pelin Doğan Ak,Hüseyin Sarı,Dilek Ataklı,Baki Arpacı 대한정신약물학회 2016 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.14 No.1

Objective: The primary objective of the present study was to further elucidate the effects of oxcarbazepine (OXC) and levetiracetam (LEV) monotherapies on the bone health status of patients with epilepsy. Methods: This study included 48 patients who attended our epilepsy outpatient clinic, had a diagnosis of epilepsy, and were undergoing either OXC or LEV monotherapy and 42 healthy control subjects. The demographic and clinical features of the patients, including gender, age, onset of disease, daily drug dosage, and duration of disease, were noted. Additionally, the calcium, ionized calcium, and 25-OH vitamin-D3 levels of the participants were prospectively evaluated. Results: The 25-OH vitamin-D3, calcium, and ionized calcium levels of the patients taking OXC were significantly lower than those of the control group. These levels did not significantly differ between the patients taking LEV and the control group, but there was a significant negative relationship between daily drug dose and ionized calcium levels in the LEV patients. Conclusion: In the present study, anti-epileptic drugs altered the calcium, ionized calcium, and 25-OH vitamin-D3 levels of epilepsy patients and resulted in bone loss, abnormal mineralization, and fractures. These findings suggest that the calcium, ionized calcium, and 25-OH vitamin-D3 levels of patients with epilepsy should be regularly assessed.