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World Journal of Clinical Oncology 2022年第2期13卷 116-124页

作者： Omer Sager Ferrat Dincoglan Selcuk Demiral hakan gamsiz Bora Uysal Fatih Ozcan Onurhan Colak Esra Gumustepe Yelda Elcim Esin Gundem Bahar Dirican Murat Beyzadeoglu Gulhane Medical Faculty Department of Radiation Oncology University of Health SciencesAnkara 0090Turkey

Lung cancer is a global health concern as the leading cause of cancer related mortality worldwide.Small cell lung cancer(SCLC)poses a formidable challenge to the treating physicians with the worst prognosis among all lung cancers.However,limited stage SCLC(LS-SCLC)has a relatively better outcome with multimodality management.Efforts have been focused on optimal integration of treatment modalities to achieve an improved therapeutic ratio for patients with LS-SCLC.While chemotherapy and thoracic radiation therapy(TRT)are primary components of initial management for LS-SCLC,there is no consensus on optimal timing of TRT.Within this context,we herein provide a concise overview of current evidence and future prospects regarding the optimal timing of thoracic irradiation for LS-SCLC in light of the literature.

关键词： Small cell lung cancer Thoracic irradiation Limited stage small cell lung cancer Timing of thoracic radiation therapy Thoracic radiation therapy

Concise review of radiosurgery for contemporary management of pilocytic astrocytomas in children and adults

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World Journal of Experimental Medicine 2022年第3期12卷 36-43页

作者： Omer Sager Ferrat Dincoglan Selcuk Demiral Bora Uysal hakan gamsiz Esra Gumustepe Fatih Ozcan Onurhan Colak Ahmet Tarik Gursoy Cemal Ugur Dursun Ahmet Oguz Tugcu Galip Dogukan Dogru Rukiyye Arslan Yelda Elcim Esin Gundem Bahar Dirican Murat Beyzadeoglu Department of Radiation Oncology Gulhane Medical FacultyUniversity of Health SciencesAnkara 0090Turkey

Pilocytic astrocytoma(PA)may be seen in both adults and children as a distinct histologic and biologic subset of low-grade glioma.Surgery is the principal treatment for the management of PAs;however,selected patients may benefit from irradiation particularly in the setting of inoperability,incomplete resection,or recurrent disease.While conventionally fractionated radiation therapy has been traditionally utilized for radiotherapeutic management,stereotactic irradiation strategies have been introduced more recently to improve the toxicity profile of radiation delivery without compromising tumor control.PAs may be suitable for radiosurgical management due to their typical appearance as well circumscribed lesions.Focused and precise targeting of these well-defined lesions under stereotactic immobilization and image guidance may offer great potential for achieving an improved therapeutic ratio by virtue of radiosurgical techniques.Given the high conformality along with steep dose gradients around the target volume allowing for reduced normal tissue exposure,radiosurgery may be considered a viable modality of radiotherapeutic management.Another advantage of radiosurgery may be the completion of therapy in a usually shorter overall treatment time,which may be particularly well suited for children with requirement of anesthesia during irradiation.Several studies have addressed the utility of radiosurgery particularly as an adjuvant or salvage treatment modality for PA.Nevertheless,despite the growing body of evidence supporting the use of radiosurgery,there is need for a high level of evidence to dictate treatment decisions and establish its optimal role in the management of PA.Herein,we provide a concise review of radiosurgery for PA in light of the literature.

关键词： Pilocytic astrocytoma Radiosurgery Stereotactic irradiation Low-grade glioma Radiation oncology Children

Effect of Ozone Treatment on Microbiological Properties of Stored Wheat

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Food and Nutrition Sciences 2024年第2期15卷 140-150页

作者： Hussein Al-Sahho hakan Kuleaşan Department of Food Engineering Suleyman Demirel University Isparta Türkiye

In this study, ozone gas was applied to samples of durum wheat stored in four experimental groups (durum wheat without any treatment for comparison, durum wheat treated with ozone, purified durum wheat, and purified durum wheat treated with ozone). Two groups were treated with ozone gas at 3 ppm concentration for 1 hour. Groups were then placed in air-tight glass jars and stored for 6 months at variable temperatures between 24.7°C to 34.8°C. Microbiological (total count bacteria, yeast/molds and coliform) and physical properties (moisture, color and ash) evaluated. Ozone application statistically caused a significant reduction in the numbers of bacteria, yeast, molds and coliforms. Ozone application, washing process and storage temperature are the major factors affecting the microbial counts. No significant differences were determined in moisture and ash contents of samples after ozone treatment. The color measurement results showed that color values of wheat samples were affected by ozone treatment, storage and washing.

关键词： Wheat Storage Ozone Application Wheat Impurities Microbial Enumeration

Breathing adapted radiation therapy for leukemia relapse in the breast: A case report

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World Journal of Clinical Oncology 2019年第11期10卷 369-374页

作者： Omer Sager Ferrat Dincoglan Selcuk Demiral Bora Uysal hakan gamsiz Fatih Ozcan Onurhan Colak Yelda Elcim Bahar Dirican Murat Beyzadeoglu Department of Radiation Oncology Gulhane Medical Faculty University of Health SciencesAnkara

BACKGROUND Infiltration of the breast by leukemic cells is uncommon but may manifest as an oncological emergency requiring prompt management.Extramedullary relapse of T-cell acute lymphoblastic leukemia(T-ALL)within the breast is exceedingly rare and there is paucity of data in the literature regarding this entity.No consensus exists on management of isolated extramedullary breast relapses of T-ALL.Herein,we report a case of isolated extramedullary breast relapse of T-ALL treated with breathing adapted radiation therapy(BART)using the active breathing control(ABC)system.CASE SUMMARY The patient was a 33-year-old female with diagnosis of T-ALL.She received intensive systemic chemotherapy that resulted in complete remission of her disease,and then underwent allogeneic hematopoietic stem cell transplantation.After a 15 mo period without symptoms and signs of progression,the patient presented with palpable masses in both breasts.She complained from severe pain and swelling of the breasts.Imaging workup showed bilateral breast lesions,and diagnosis of breast infiltration by leukemic cells was confirmed after immunohistopathological evaluation.The patient suffering from severe pain,discomfort,and swelling of both breasts due to leukemic infiltration was referred to the Radiation Oncology Department for symptomatic palliation.Whole breast irradiation was delivered to both breasts of the patient with BART using the ABC system.The patient had complete resolution of her symptoms after treatment with BART.CONCLUSION BART with the ABC system resulted in complete resolution of the patient’s symptoms due to leukemic infiltration of both breasts with T-ALL.This contemporary treatment technique should be preferred for radiotherapeutic management of patients with leukemic infiltration of the breasts to achieve effective symptomatic palliation.

关键词： T-cell acute lymphoblastic leukemia Breast relapse Breathing adapted radiation therapy Active breathing control Case report

Adaptive radiation therapy of breast cancer by repeated imaging during irradiation

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World Journal of Radiology 2020年第5期12卷 68-75页

作者： Omer Sager Ferrat Dincoglan Selcuk Demiral Bora Uysal hakan gamsiz Fatih Ozcan Onurhan Colak Yelda Elcim Esin Gundem Bahar Dirican Murat Beyzadeoglu Department of Radiation Oncology Gulhane Medical FacultyUniversity of Health SciencesEtlikAnkara 06018Turkey

Breast cancer is the most frequent cancer among females and also a leading cause of cancer related mortality worldwide.A multimodality treatment approach may be utilized for optimal management of patients with combinations of surgery,radiation therapy(RT)and systemic treatment.RT composes an integral part of breast conserving treatment,and is typically used after breast conserving surgery to improve local control.Recent years have witnessed significant improvements in the discipline of radiation oncology which allow for more focused and precise treatment delivery.Adaptive radiation therapy(ART)is among the most important RT techniques which may be utilized for redesigning of treatment plans to account for dynamic changes in tumor size and anatomy during the course of irradiation.In the context of breast cancer,ART may serve as an excellent tool for patients receiving breast irradiation followed by a sequential boost to the tumor bed.Primary benefits of ART include more precise boost localization and potential for improved normal tissue sparing with adapted boost target volumes particularly in the setting of seroma reduction during the course of irradiation.Herein,we provide a concise review of ART for breast cancer in light of the literature.

关键词： Breast cancer Adaptive radiation therapy Tumor bed boost Computed tomography Imaging Replanning

A concise review of immunotherapy for glioblastoma

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Neuroimmunology and Neuroinflammation 2018年第6期5卷 18-28页

作者： Omer Sager Ferrat Dincoglan Selcuk Demiral Bora Uysal hakan gamsiz Bahar Dirican Murat Beyzadeoglu Department of Radiation Oncology University of Health SciencesGulhane Medical FacultyAnkara 06018Turkey

Glioblastoma(GB)is the most common and aggressive form of primary brain tumors in adults with a universally poor prognosis despite multimodal management including surgery,chemotherapy and radiation therapy.Among the novel therapeutic strategies,immunotherapy deserves particular attention with its potential to evoke biologic response and harness the host immune system.Considerable success achieved for other tumors has elicited great enthusiasm and prompted research on immunotherapy for GB.While the central nervous system has traditionally been thought of as an immune-privileged site,our understanding is being refined with emerging evidence.Several studies have been conducted and more are under way to establish the role of immunotherapy in management of GB.Immunotherapy of GB has yet resulted in mixed success with conflicting research findings,emphasizing the need for extensive study before its integration into routine clinical practice.Although there is a lot of room for improvement,immunotherapy for GB may be feasible and serve as a viable management strategy broadening and strengthening the therapeutic armamentarium to combat this deadly disease.Herein,we present a concise review of immunotherapy for GB.

关键词： Glioblastoma immunotherapy glioma vaccine passive immunotherapy active immunotherapy cytokine therapy central nervous system

Concise review of stereotactic irradiation for pediatric glial neoplasms:Current concepts and future directions

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World Journal of Methodology 2021年第3期11卷 61-74页

作者： Omer Sager Ferrat Dincoglan Selcuk Demiral Bora Uysal hakan gamsiz Onurhan Colak Fatih Ozcan Esin Gundem Yelda Elcim Bahar Dirican Murat Beyzadeoglu Department of Radiation Oncology Gulhane Medical FacultyUniversity of Health SciencesAnkara 06018Turkey

Brain tumors,which are among the most common solid tumors in childhood,remain a leading cause of cancer-related mortality in pediatric population.Gliomas,which may be broadly categorized as low grade glioma and high grade glioma,account for the majority of brain tumors in children.Expectant management,surgery,radiation therapy(RT),chemotherapy,targeted therapy or combinations of these modalities may be used for management of pediatric gliomas.Several patient,tumor and treatment-related characteristics including age,lesion size,grade,location,phenotypic and genotypic features,symptomatology,predicted outcomes and toxicity profile of available therapeutic options should be considered in decision making for optimal treatment.Management of pediatric gliomas poses a formidable challenge to the physicians due to concerns about treatment induced toxicity.Adverse effects of therapy may include neurological deficits,hemiparesis,dysphagia,ataxia,spasticity,endocrine sequelae,neurocognitive and communication impairment,deterioration in quality of life,adverse socioeconomic consequences,and secondary cancers.Nevertheless,improved understanding of molecular pathology and technological advancements may pave the way for progress in management of pediatric glial neoplasms.Multidisciplinary management with close collaboration of disciplines including pediatric oncology,surgery,and radiation oncology is warranted to achieve optimal therapeutic outcomes.In the context of RT,stereotactic irradiation is a viable treatment modality for several central nervous system disorders and brain tumors.Considering the importance of minimizing adverse effects of irradiation,radiosurgery has attracted great attention for clinical applications in both adults and children.Radiosurgical applications offer great potential for improving the toxicity profile of radiation delivery by focused and precise targeting of well-defined tumors under stereotactic immobilization and image guidance.Herein,we provide a concise review of stereotactic irradiation for

关键词： Radiosurgery Stereotactic irradiation Stereotactic radiosurgery Pediatric glioma Gamma knife Linear accelerator

Infectious causes of fever of unknown origin in developing countries: An international ID-IRI study

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Journal of Intensive Medicine 2024年第1期4卷 94-100页

作者： hakan Erdem Jaffar AAl-Tawfiq Maha Abid Wissal Ben Yahia George Akafity Manar Ezzelarab Ramadan Fatma Amer Amani El-Kholy Atousa Hakamifard Bilal Ahmad Rahimi Farouq Dayyab Hulya Caskurlu Reham Khedr Muhammad Tahir Lysien Zambrano Mumtaz Ali Khan Aun Raza Nagwa Mostafa El-Sayed Magdalena Baymakova Aysun Yalci Yasemin Cag Umran Elbahr Aamer Ikram Department of Infectious Diseases&Clinical Microbiology Gulhane School of MedicineTurkish Health Sciences UniversityAnkaraTurkey Specialty Internal Medicine and Quality and Patient Safety Department Johns Hopkins Aramco HealthcareDhahranSaudi Arabia Division of Infectious Diseases Indiana University School of MedicineIndianapolisINUSA Department of Infectious Diseases Farhat Hached University HospitalIbn El Jazzar Medical SchoolUniversity of SousseSousseTunisia Internal Medicine Department Farhat Hached University HospitalIbn El Jazzar Medical SchoolUniversity of SousseSousseTunisia Cape Coast Teaching Hospital Cape CoastGhana Medical Parasitology Faculty of MedicineSuez UniversitySuezEgypt Department of Medical Microbiology and Immunology Faculty of MedicineZagazig UniversityZagazigEgypt Department of Clinical Pathology Faculty of MedicineCairo UniversityGizaEgypt Department of Infectious Diseases School of MedicineIsfahan University of Medical SciencesIsfahanIran Department of Infectious Diseases Kandahar University Medical FacultyTeaching HospitalKandaharAfghanistan Department of Infectious Diseases Mohammed Bn Khalifa Bn Salman Alkhalifa Specialist Cardiac CenterAwaliBahrain Department of Infectious Diseases and Clinical Microbiology Faculty of MedicineIstanbul Medeniyet UniversityIstanbulTurkey Department of Pediatric Oncology National Cancer Institute–Cairo UniversityChildren Cancer Hospital EgyptCairoEgypt Department of Medicine Federal General HospitalIslamabadPakistan Institute for Research in Medical Sciences and Right to Health(ICIMEDES) Scientific Research Unit(UIC)Faculty of Medical Sciences(FCM)National Autonomous University of Honduras(UNAH)TegucigalpaHonduras National Institute of Health IslamabadPakistan Shaukat Khanum Memorial Cancer Hospital and Research Center LahorePakistan Medical Parasitology Department Research Institute of OphthalmologyGizaEgypt Department of Infectious Diseases Military Medical AcademySofiaBulgaria Department of Infecti

Background:Fever of unknown origin(FUO)in developing countries is an important dilemma and further research is needed to elucidate the infectious causes of FUO.Methods:A multi-center study for infectious causes of FUO in lower middle-income countries(LMIC)and lowincome countries(LIC)was conducted between January 1,2018 and January 1,2023.In total,15 participating centers from seven different countries provided the data,which were collected through the Infectious DiseasesInternational Research Initiative platform.Only adult patients with confirmed infection as the cause of FUO were included in the study.The severity parameters were quick Sequential Organ Failure Assessment(qSOFA)≥2,intensive care unit(ICU)admission,vasopressor use,and invasive mechanical ventilation(IMV).Results:A total of 160 patients with infectious FUO were included in the study.Overall,148(92.5%)patients had community-acquired infections and 12(7.5%)had hospital-acquired infections.The most common infectious syndromes were tuberculosis(TB)(n=27,16.9%),infective endocarditis(n=25,15.6%),malaria(n=21,13.1%),brucellosis(n=15,9.4%),and typhoid fever(n=9,5.6%).Plasmodium falciparum,Mycobacterium tuberculosis,Brucellae,Staphylococcus aureus,Salmonella typhi,and Rickettsiae were the leading infectious agents in this study.A total of 56(35.0%)cases had invasive procedures for diagnosis.The mean qSOFA score was 0.76±0.94{median(interquartile range[IQR]):0(0–1)}.ICU admission(n=26,16.2%),vasopressor use(n=14,8.8%),and IMV(n=10,6.3%)were not rare.Overall,38(23.8%)patients had at least one of the severity parameters.The mortality rate was 15(9.4%),and the mortality was attributable to the infection causing FUO in 12(7.5%)patients.Conclusions:In LMIC and LIC,tuberculosis and cardiac infections were the most severe and the leading infections causing FUO.

关键词： Developing countries Fever of unknown origin Infection

Effect of size on biaxial flexural strength for cement-based materials by using a triangular plate method

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Frontiers of Structural and Civil Engineering 2022年第8期16卷 1017-1028页

作者： hakan T TURKER Department of Civil Engineering Bursa Uludag UniversityBursa 16059Turkey

The effect of size on the biaxial flexural strength(BFS)of Portland cement mortar was investigated by using the recently proposed triangular plate method(TPM).An experimental program was conceived to study the size effect by keeping a constant water-cement ratio of 0.485,cement-sand ratio of 1:2.75,and using unreinforced triangular mortar plates of five different thicknesses and seven different side lengths.The BFS of the produced specimens was tested,and variations of BFS depending on specimen thickness and side length were determined.The results indicated that increases in triangular plate specimen side length and specimen thickness led to a decrease in the BFS of Portland cement mortar.The effect of specimen length increase on BFS was more significant than on the effect of the specimen thickness.The variations in specimens’thickness indicated a deterministic Type I size effect,while the variations in specimens’length showed an energetic-statistical Type I size effect.

关键词： testing apparatus&methods plain concrete tensile properties biaxial flexural strength triangular plate method

Bladder calculi concomitant with benign prostatic enlargement:is prostate surgery mandatory in patients who have never received medical therapy?

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Asian Journal of Andrology 2023年第5期25卷 604-607页

作者： hakan Anil Umut Unal Kaan Karamik Ferhat Ortoglu hakan Ercil Department of Urology Adana City Training and Research HospitalAdana 01000Turkiye Department of Urology Korkuteli State HospitalAntalya 07000Turkiye

The historical dogma that bladder calculi comprise the main indication for prostatic surgery has recently been questioned.In this study,we aimed to predict which patients should undergo simultaneous prostate and bladder calculi surgery or only bladder calculi removal by evaluating preoperative risk factors.One hundred and seventeen men with bladder stones and concomitant benign prostate enlargement(BPE)who had not received medical treatment before were included in the study.In the first step,only the bladder calculi of patients were removed and medical treatment was given for BPE.The patients who benefited from medical treatment during the follow-up were defined as Group 1 and the patients who required prostate surgery for any indication comprised Group 2.Risk factors for prostate surgery requirements were determined by comparing preoperative characteristics between the two groups with a cox regression model.In the follow-up of 117 patients with bladder stones removed and medical treatment initiated,49(41.9%)patients had prostate surgery indications.The indication for 33(67.3%)of 49 patients was medical treatment failure.The presence of intravesical prostatic protrusion(IPP;hazard ratio:2.071,95%confidence interval[Cl]:1.05-4.05,P=0.034),and high postvoiding residual urine volume(hazard ratio:1.013,95%Cl:1.007-1.019,P<0.001)were found to be preoperative risk factors for needing future prostate surgery.In patients who have not received medical treatment for BPE before,bladder calculi developing secondary to BPE do not always constitute an indication for prostate surgery.

关键词： benign prostate hyperplasia bladder calculi intravesical prostatic protrusion medical therapy prostate surgery