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      • KCI등재

        Targeted axillary biopsy and sentinel lymph node biopsy for axillary restaging after neoadjuvant chemotherapy

        Gunay Gurleyik,Sibel Aydin Aksu,Fügen Aker,Kubra Kaytaz Tekyol,Eda Tanrikulu,Emin Gurleyik 대한외과학회 2021 Annals of Surgical Treatment and Research(ASRT) Vol.100 No.6

        Purpose: Accurate restaging of the axilla after neoadjuvant chemotherapy (NAC) is an important issue to ensure deescalating axillary surgery in patients with initial metastatic nodes. We aimed to present our results of targeted axillary biopsy (TAB) combined with sentinel lymph node biopsy (SLNB) for axillary restaging after NAC. Methods: In 64 breast cancer patients who underwent NAC, biopsy-proven positive nodes were marked with clips before NAC, and ultrasound-guided wire localization of clip-marked nodes was performed after NAC. Patients underwent TAB and SLNB for post-NAC axilla restaging. Results: Identification rates of post-NAC TAB and SLNB were 98.4% and 87.5%, respectively (P = 0.033). Histopathology revealed a nodal pathologic complete response (pCR) rate of 47% in which axillary lymph node dissection (ALND) was avoided. TAB alone and SLNB alone detected residual disease in 29 (85.3%) and 20 (58.8%) patients (P = 0.029), respectively. Whereas rates of up to 97% had been achieved with a combination of TAB and SLNB. The pCR rates after NAC were 64.3% for human epidermal growth factor receptor 2 positive and triple-negative tumors and 13.6% in luminal tumors (P = 0.0002). Conclusion: Pathologic analysis following TAB combined with SLNB revealed the pCR rates to NAC in a considerable number of patients that provided de-escalation of axillary surgery. A combination of SLNB and TAB was found to be an accurate procedure in establishing residual nodal disease. This combined procedure in patients with initially positive nodes was a reliable method for post-NAC axillary restaging.

      • KCI등재

        Relationships of the Vitamin D and Platelet Indices in Sjögren's Syndrome

        Gunay, Nahide Ekici,Bugday, Irfan,Akalin, Tayfun Korean Society for Clinical Laboratory Science 2018 대한임상검사과학회지(KJCLS) Vol.50 No.4

        Primer $Sj{\ddot{o}}gren's$ Syndrome (pSS) is an autoimmune/inflammatory illness. The platelet indices (PIs) indicate the inflammatory response and activity/severity of many diseases. A vitamin D deficiency is accompanied by the increased tendency of autoimmune diseases. This study investigated whether the vitamin D levels are related to the altered platelet indices in pSS. A total of 261 individuals were included in this analytical cross-sectional study. The laboratory data of pSS patients were evaluated and the relationship between the PIs and vitamin D status was examined. According to these findings, in patients with pSS, the vitamin D levels were lower than the healthy control group (P<0.05). The vitamin D levels were negatively associated with PDW (P=0.012), but positively correlated with PCT (P<0.001). The cut-off point was obtained with receiver operating characteristics (ROC) curves for PDW: 12.53 (AUC 0.921, sensitivity 90%, specificity 85%), for PCT; 0.29 (AUC 0.660, sensitivity 68%, specificity 55%). In multivariate linear regression analysis, the most significant parameters for the effects of PDW are the following: vitamin D (${\beta}=-0.373$; t=-2.626; sig.=0.013) and plateletcrit (${\beta}=-0.308$; t=-2.13; sig.=0.040). A vitamin D deficiency may be accompanied by changes in PIs in pSS. A higher PDW and lower PCT supports the underlying inflammation, which may be vitamin D related useful parameters to consider in approaching to pSS.

      • KCI등재

        Medical and Surgical Treatment of Idiopathic Granulomatous Lobular Mastitis: A Benign Inflammatory Disease Mimicking Invasive Carcinoma

        Gunay Gurleyik,Ali Aktekin,Fugen Aker,Hikmet Karagulle,Abdullah Saglam 한국유방암학회 2012 Journal of breast cancer Vol.15 No.1

        Purpose: Idiopathic granulomatous lobular mastitis (IGLM) is a rare chronic inflammatory disease of the breast with obscure etiology that mimics invasive carcinoma both clinically and radiologically. The treatment of IGLM remains controversial. The aim of proper management is to use a combination of medical and surgical treatment of this benign condition to achieve a good cosmetic result and low recurrence rate. Methods: A retrospective analysis of 19 patients with IGLM is performed based on the findings of clinical, radiological, and pathological examinations. The results of two treatments are presented: medical treatment with oral corticosteroids, and consecutive surgical excision after a follow-up period of 20 months (range, 6-75 months). Results: The majority of patients treated in this paper were young (mean,34 years) parous women with a history of hormonal medication use. The main clinical finding is large, irregular, and painful mass. Hypoechoic lobulated, irregular tubular or oval shaped masses had been imaged by ultrasound. Mammographic findings were an ill-defined mass, enlarged axillary lymph nodes, asymmetric density, and architectural distortion. Diagnoses of IGLM had been established by cytological or histological examination. Symptoms subside and inflammatory changes regressed with medical treatment. The remaining lesions were excised by consecutive breast conserving surgery. The disease recurred in one patient during the follow-up period. Conclusion: IGLM is an inflammatory breast disease found in young women who present with a large painful irregular mass, which mimics carcinoma, as a physical change. Breast imaging modalities are not helpful to differentiate IGLM from invasive cancer. The correct diagnosis is established by cytological or histological examination. Medical treatment with corticosteroids provides significant regression of the inflammatory disease, allowing more conservative surgery. Consecutive surgical excision of the remaining lesions with good cosmetic results provides definitive treatment and reduces the risk of recurrence.

      • KCI등재

        Impact of Public Information Arrivals on Cryptocurrency Market: A Case of Twitter Posts on Ripple

        Gunay, Samet Korea Institute for International Economic Policy 2019 East Asian Economic Review Vol.23 No.2

        Public information arrivals and their immediate incorporation in asset price is a key component of semi-strong form of the Efficient Market Hypothesis. In this study, we explore the impact of public information arrivals on cryptocurrency market via Twitter posts. The empirical analysis was conducted through various methods including Kapetanios unit root test, Maki cointegration analysis and Markov regime switching regression analysis. Results indicate that while in bull market positive public information arrivals have a positive influence on Ripple's value; in bear market, however, even if the company releases good news, it does not divert out the Ripple from downward trend.

      • KCI등재

        Tumor Characteristics Influencing Non-Sentinel Lymph Node Involvement in Clinically Node Negative Patients with Breast Cancer

        Gunay Gurleyik,Fugen Aker,Ali Aktekin,Abdullah Saglam 한국유방암학회 2011 Journal of breast cancer Vol.14 No.2

        Purpose: The negative sentinel lymph node (SLN) biopsy avoids conventional axillary dissection in patients with breast cancer with clinically negative axilla. Despite negative SLN, there is a risk of leaving involved non-SLN behind in the axilla. We investigated the predictive power of tumor characteristics for non-SLN metastasis. Methods: Lymphatic mapping with blue dye method for SLN biopsy and level 1-2 axillary dissections were performed to establish axillary status in 59 patients with T1 and T2 breast cancer and clinically negative axilla. Tumor’s characteristics were histopathologically established to assess their association with non-SLN metastasis. Results: The axilla was malignant in 23 (39%) patients. The SLN alone was metastatic in 10, both SLN and non-SLN in 9, and non-SLN alone in 4 (7%) patients. The false negative rate for SLN biopsy was 10% in our series. The rate of positive non-SLN was found as 0% in T1a-b, 19% in T1c, and 40% in T2 tumors (p=0.035). Lymphovascular invasion was positive in 14 (61%) patients with axillary metastasis (p<0.001), and in 10 (77%) patients with non-SLN involvement (p<0.001). Conclusion: We concluded that there was a small risk of involved non-SLN despite negative SLN. Tumor size (near or greater than 2 cm) was significantly associated with non-SLN metastasis. Peritumoral lymphovascular invasion was a positive predictor of the metastatic involvement in non-SLNs.

      • KCI등재
      • SCOPUSKCI등재

        A Characterization of Involutes and Evolutes of a Given Curve in 𝔼<sup>n</sup>

        Ozturk, Gunay,Arslan, Kadri,Bulca, Betul Department of Mathematics 2018 Kyungpook mathematical journal Vol.58 No.1

        The orthogonal trajectories of the first tangents of the curve are called the involutes of x. The hyperspheres which have higher order contact with a curve x are known osculating hyperspheres of x. The centers of osculating hyperspheres form a curve which is called generalized evolute of the given curve x in n-dimensional Euclidean space ${\mathbb{E}}^n$. In the present study, we give a characterization of involute curves of order k (resp. evolute curves) of the given curve x in n-dimensional Euclidean space ${\mathbb{E}}^n$. Further, we obtain some results on these type of curves in ${\mathbb{E}}^3$ and ${\mathbb{E}}^4$, respectively.

      • SCIESCOPUS

        Buckling lengths of unbraced multi-storey frame columns

        Ozmen, Gunay,Girgin, Konuralp Techno-Press 2005 Structural Engineering and Mechanics, An Int'l Jou Vol.19 No.1

        In several design codes and specifications, simplified formulae and diagrams are given for determining the buckling lengths of frame columns. It is shown that these formulae may yield rather erroneous results in certain cases. This is due to the fact that, the code formulae utilise only local stiffness distributions. In this paper, a simplified procedure for determining approximate values for the buckling loads of multi-storey frames is developed. The procedure utilises lateral load analysis of frames and yields errors in the order of 10%, which may be considered suitable for design purposes. The proposed procedure is applied to several numerical examples and it is shown that all the errors are in the acceptable range and on the safe side.

      • KCI등재
      • Knowledge and Attitudes of Medical and Non-Medical Turkish University Students about Cervical Cancer and HPV Vaccination

        Borlu, Arda,Gunay, Osman,Balci, Elcin,Sagiroglu, Mehmet Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.1

        Background: This study was conducted to determine knowledge, attitudes and practices about cervical cancer and HPV vaccination of students studying in various faculties of Erciyes University. Materials and Methods: The study was performed among the first and fourth grade students of Medicine, Theology, Education and Economics and Administrative Sciences (FEAS) faculties of Erciyes University. It was aimed to reach 1,073 students and 718 were evaluated. A questionnaire consisting of 48 questions related to the socio-demographic characteristics, knowledge, attitude and practices about cervical cancer and HPV vaccination was administered to the students. The chi-square test and logistic regression were used for the statistical analyses. Results: Of the students, 78.3% were aware of cervical cancer, while 36.1% of them were aware of the HPV vaccine. The percentage hearing about cervical cancer and HPV vaccination was significantly higher among the students of the medical faculty than the others and among fourth grade students comparing with the first grade. The marital status and the presence of a health worker in the family had no significant impact on the knowledge level of the students. The acceptability of the HPV vaccination was low among all students. Conclusions: The knowledge levels of the university students about cervical cancer and HPV vaccination are inadequate. This deficiency is more pronounced among the non-medical students and there is no significant increase during the faculty years. Non-medical students must be provided with information about important public health issues by elective courses. HPV vaccination could provide many benefits for men and women by decreasing the morbidity and mortality of cervical, anal, and penile cancers.

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