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Öğe Are emergency department visits really a teachable moment? Smoking cessation promotion in emergency department(Lippincott Williams & Wilkins, 2010) Ersel, Murat; Kitapcioglu, Gul; Solak, Zeynep Ayfer; Yuruktumen, Aslihan; Karahalli, Eylem; Cevrim, OzgurObjective To compare the effectiveness of smoking cessation counseling in the emergency department (ED) versus in outpatient clinics (OCs) setting. Methods Over a 3-month period, smokers and recent quitters presenting to ED or OCs were questioned about their smoking habits and desire to quit. They also completed the Fagerstrom Test for Nicotine Dependence (FTND) questionnaire and Prochaska's stages of change (PSC) survey. Standardized 5 min counseling session was carried out, and stop smoking pamphlet and phone number of the hospital's smoking cessation unit were given. One month after initial counseling, patients were telephoned, FTND, PSC, desire to quit, and daily cigarette consumption were asked. Data from those unable to be contacted within 6 weeks were excluded from analysis. Results Of the 392 patients (197 ED, 195 OC) counseled initially, 340 (87%) were reached for telephone follow-up. Counseling was effective in both groups: FTND and PSC scores had improved, and daily cigarette consumption decreased significantly (17.17-12.49 cigs/day; P = 0.000). Smokers counseled in the ED were found more inclined to stop smoking compared with smokers who counseled in OCs, after 1 month of the intervention (95% confidence interval = 14.7-7.5%; P = 0.051). Only one patient (0.6%) from the ED and 10 (6.6%) from the OC attended the smoking cessation program. Conclusion ED-based counseling for smoking cessation was as effective as that performed in the OC setting. Referral of smokers from the ED to a smoking cessation program was unsuccessful in our patient population. European Journal of Emergency Medicine 17: 73-79 (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.Öğe Assessment of genetic markers and glioblastoma stem-like cells in activation of dendritic cells(Springer Japan Kk, 2013) Yurtsever, Aysel; Haydaroglu, Ayfer; Avci, Cigir Biray; Gunduz, Cumhur; Oktar, Nezih; Dalbasti, Tayfun; Caglar, Hasan Onur; Attar, Rukset; Kitapcioglu, GulGlioblastoma (GBM) is the most common and aggressive intraparenchymal primary brain tumor in adults. The principal reasons for the poor outcomes of GBM are the high rates of recurrence and resistance to chemotherapy. The aim of this study was to determine the role of tailored cellular therapy for GBM with a poor prognosis and compare the activity of dendritic cells (DCs) that have encountered GBM cells. Detecting the correlations between methylation and expression of MGMT and PTEN genes and GBM cancer stem cells (CSCs) markers after co-cultures with a mononuclear cell cocktail are also aims for this study. Allogenic umbilical cord blood (UCB)-derived DCs were labeled with the CD11a and CD123 for immature DCs, and CD80 and CD11c for mature DCs. CD34, CD45, and CD56 cells were isolated from allogenic UCB for using in DCs maturation. GBM CSCs were detected with CD133/1 and CD111 antibodies after co-culture studies. DC activation was carried out via GBM cells including CD133 and CD111 cells and a mononuclear cells cocktail including CD34, CD45, and CD56 natural killer cells. Real-time PCR was performed to detect the expression and promoter methylation status of PTEN and MGMT genes. The expression of CSCs markers was found in all GBM cases, and a statistically significant correlation was found among them after co-culture studies. The most pronounced affinity of DCs to GBM cells was observed at dilutions between 1/4 and 1/256 in co-cultures. There was a statistically significant correlation between cellularity and granularity ratios for CD123 and CD11c. PTEN and MGMT gene expression and methylation values were evaluated with respect to CSCs expression and no statistical significance was found. Activation of DCs might associate with CSCs and the mononuclear cells cocktail including CD34, CD45, and CD56 cells which were obtained from allogenic UCB.Öğe Association of heartburn during pregnancy with the risk of gastroesophageal reflux disease(Elsevier Science Inc, 2007) Bor, Serhat; Kitapcioglu, Gul; Dettmar, Peter; Baxter, TimBackground & Aims: Heartburn and gastroesophageal reflux disease (GERD) during pregnancy are accepted as an innocent condition. The effect of heartburn during pregnancy on the initiation or progress of GERD is not known. We aimed to determine the predisposition effect of heartburn during pregnancy for presenting with GERD in the future. Methods: A validated reflux questionnaire was applied to 1180 randomly selected women aged between 18-49 years who had given birth to at least one delivery. Frequent symptoms were defined as a major symptom (heartburn and/or regurgitation) occurring at least once a week or more. Occasional symptoms were defined as an episode of one of the major symptoms occurring less than once a week within the past 12 months. Results: The mean live delivery rate was 2 +/- 1 (range, 1-10). The prevalence of GERD was 7.4%. Whereas the prevalence of GERD for women with a history of just 1 delivery was 1.5%, more than 2 deliveries were accompanied with risk of 15.1% (P <.001). In the group with no heartburn during pregnancy only 5.5% had GERD (P <.00001). If there was heartburn during any of the pregnancies, the risk was 17.7%; and more than 2 pregnancies with a history of heartburn accompanied 36.1% risk of having GERD. Logistic regression analysis showed that the risk is independent from obesity and age. Conclusions: The risk of GERD is increased by the presence of heartburn during pregnancy. This association is independent of obesity and age. Heartburn during pregnancy might not be accepted as an innocent and temporary condition.Öğe Cigarette smoking in primary Sjogren's syndrome: positive association only with ANA positivity(Taylor & Francis Ltd, 2011) Karabulut, Gonca; Kitapcioglu, Gul; Inal, Vedat; Kalfa, Melike; Yargucu, Figen; Keser, Gokhan; Emmungil, Hakan; Gokmen, Nihal Mete; Kocanaogullari, Hayriye; Aksu, KenanSmoking is well known to contribute to the pathogenesis and severity of some systemic autoimmune rheumatic diseases and especially to the production of certain autoantibodies. Primary Sjogren's syndrome (pSS) is an autoimmune disease, affecting primarily the exocrine glands. It may also cause extraglandular involvement in some cases. In this study, we aimed to determine the frequency of smoking habits in our cohort of pSS patients and to investigate whether the frequencies of autoantibody positivity and extraglandular involvement were significantly different between patients with and without smoking. In this cross-sectional study, 207 patients with pSS (F/M 203/4), fulfilling the United States-European Consensus Criteria, and 602 healthy controls (F/M 534/68) were included. Patients and controls were classified into five groups: never smokers, current smokers, former smokers; ever smokers, and passive smokers. The chi(2) and Kruskal-Wallis tests were used for statistical analysis; a p value of less than 0.05 was accepted as statistically significant. While the frequency of current smokers was significantly lower in the pSS group compared with the healthy controls (11.6 vs 22.3%), the frequencies of former smokers (30.4 vs 11.8%), ever smokers (42.0 vs 34.1%), and passive smokers (47.3 vs 37.5%) were significantly higher in the pSS group compared with the healthy controls. In pSS patients, only antinuclear antibody (ANA) positivity was significantly associated with smoking habits, while there was no significant association with other autoantibodies or with the presence of extraglandular involvement. We found that in pSS patients smoking was significantly associated only with ANA positivity. Unlike the deleterious effects of smoking upon disease severity and anti-cyclic citrullinated protein (CCP) antibody production in rheumatoid arthritis, we could not find any association of smoking with extraglandular involvement and/or anti-Ro/anti-La antibody positivity in pSS. These results are indeed in line with the limited number of previous studies reported in the literature. Further studies with higher numbers of pSS patients are required to confirm the seemingly negative association of smoking with pSS.Öğe Comparison of Five Survival Models: Breast Cancer Registry Data from Ege University Cancer Research Center(Ortadogu Ad Pres & Publ Co, 2010) Hayat, Elvan Akturk; Suner, Asli; Uyar, Burak; Dursun, Omer; Orman, Mehmet N.; Kitapcioglu, GulObjective: In this study, we aimed to compare the results of the survival analysis of the patients with breast cancer using Weibull, Gamma, Gompertz, Log-Logistic and Log-Normal parametric models. Material and Methods: The data obtained from 5457 patients with breast cancer from Ege University Cancer Research Centre between 1992 and 2007 was used in this study. The patients were divided into two groups with respect to their ages, they were divided into two groups as 49 and below and 50 and above. The Log rank test was applied to compare the survival curves of the two age groups obtained by Kaplan Meier method. A survival analysis was conducted by using Weibull, Gamma, Gompertz, Loglogistic and Lognormal distribution of parametric models. Results: Survival curves of two groups were compared by using a log-rank test and no statistical significant difference was found between the two groups. In the analysis of the survival periods using parametric models, the age variable is taken as the covariate. To determine the best model among parametric models, Akaike Information Criteria (MC) was exploited. The results of the study revealed that the survival model found by the Gompertz distribution was the most appropriate one. Conclusion: By using AIC, the models obtained via Weibull, Loglogistic, Lognormal, Gamma and Gompertz were compared and the most suitable model for the obtained data distribution was determined. Although the AIC values for the five distributions in question were very close to each other, the Gompertz distribution, which had the lowest AIC value, was determined as the most suitable model.Öğe Criteria sets for primary Sjogren's syndrome are not adequate for those presenting with extraglandular organ involvements as their dominant clinical features(Springer Heidelberg, 2017) Kabasakal, Yasemin; Kitapcioglu, Gul; Karabulut, Gonca; Tezcan, Mehmet; Balkarli, Ayse; Aksoy, Adem; Yavuz, Aule; Yilmaz, Sema; Kasifoglu, Timucin; Kalyoncu, Umut; Dalkilic, Ediz; Tufan, Abdurrahman; Mercan, Ridvan; Yildiz, Fatih; Senturk, Taskin; Onen, Fatos; Bes, Cemal; Erken, Eren; Tunc, Ercan; Kamali, Sevil; Tarhan, Emine; Yazici, Ayten; Duzgun, Nursen; Bicakcigil, Muge; Yilmaz, Sedat; Ozmen, Mustafa; Ocal, Lale; Alibaz-Oner, Fatma; Solmaz, Dilek; Cobankara, Veli; Nalbant, Selim; Gunal, Esen Kasapoglu; Kaskari, Derya; Goker, BernaPatients with primary Sjogren's syndrome (pSS) may go undiagnosed or be misclassified due to the insidious nature and wide spectrum of the disease. The available several classification criteria emphasize glandular findings. We aimed to analyze the efficiency of various classification criteria sets in patients diagnosed on the clinical basis by expert opinion and to compare those pSS patients who fulfilled these criteria with those who did not. This is a multicenter study in which 834 patients from 22 university-based rheumatology clinics are included. Diagnosis of pSS was made on the clinical basis by the expert opinion. In this study, we only interviewed patients once and collected available data from the medical records. The European criteria, American-European Consensus Group (AECG) and American College of Rheumatology (ACR) Sjogren's criteria were applied. Majority of the patients were women (F/M was 20/1). The median duration from the first pSS-related symptom to diagnosis was significantly shorter in men (2.5 +/- 2.3 vs 4.3 +/- 5.9 years) (p = 0 < 0.016). When the European, AECG and ACR Sjogren's criteria were applied, 666 patients (79.9%) satisfied at least one of them. In total, 539 patients (64.4%) satisfied the European, 439 (52.6%) satisfied the AECG, and 359 (43%) satisfied the ACR criteria. Among the entire group, 250 patients (29.9%) satisfied all and 168 (20.1%) met none of the criteria. The rates of extraglandular organ involvements were not different between patients who met at least one of the criteria sets and those who met none. There is an urgent need for the modification of the pSS criteria sets to prevent exclusion of patients with extraglandular involvements as the dominant clinical features.Öğe A Different Perspective on Macroscopic Sampling of Cholecystectomy Specimens(Korean Society Pathologists, 2013) Argon, Asuman; Yagci, Ayse; Tasli, Funda; Kebat, Tulu; Deniz, Senem; Erkan, Nazif; Kitapcioglu, Gul; Vardar, EnverBackground: Because there may be interdepartmental differences in macroscopic sampling of cholecystectomy specimens, we aimed to investigate differences between the longitudinal sampling technique and our classical sampling technique in cholecystectomy specimens in which there was no obvious malignancy. Methods: Six hundred eight cholecystectomy specimens that were collected between 2011 and 2012 were included in this study. The first group included 273 specimens for which one sample was taken from each of the fundus, body, and neck regions (our classical technique). The second group included 335 specimens for which samples taken from the neck region and lengthwise from the fundus toward the neck were placed together in one cassette (longitudinal sampling). The Pearson chi-square, Fisher exact, and ANOVA tests were used and differences were considered significant at p<.05. Results: In the statistical analysis, although gallbladders in the first group were bigger, the average length of the samples taken in the second group was greater. Inflammatory cells, pyloric metaplasia, intestinal metaplasia, low grade dysplasia, and invasive carcinoma were seen more often in the second group. Conclusions: In our study, the use of a longitudinal sampling technique enabled us to examine a longer mucosa and to detect more mucosal lesions than did our classical technique. Thus, longitudinal sampling can be an effective technique in detecting preinvasive lesions.Öğe The Effectiveness of the Liquid-Based Preparation Method in Cerebrospinal Fluid Cytology(Karger, 2013) Argona, Asuman; Uyaroglu, Mehmet Ali; Nart, Deniz; Veral, Ali; Kitapcioglu, GulObjectives: Since malignant cells were first detected in the cerebrospinal fluid (CSF), numerous methods have been used for CSF examination. The cytocentrifugation and liquid-based cytology (LBC) methods are two of these. We aimed to investigate whether the results from the LBC method were different from the results of the cytological diagnosis of the CSF materials that were prepared using the cytocentrifugation method. Materials and Methods: A retrospective analysis was conducted using the pathological records of 3,491 (cytocentrifugation on 1,306 and LBC on 2,185) cytological specimens of CSF which were diagnosed over a 4-year period between January 2007 and December 2011. The Fisher exact test was used to compare the results of the LBC and cytocentrifugation methods. Results: While there was a noticeable decrease in nondiagnostic diagnosis and a slight decrease in suspicious diagnosis, there was an increase in malignant and benign diagnosis with the LBC method in comparison to the centrifugation method. Statistically, the decrease in nondiagnostic diagnosis was considered significant (p < 0.0001). Discussion: The LBC method seems like a better option than the cytocentrifugation method, because of many preparatory, screening and diagnostic advantages, especially in pathology departments where materials come from far away and large volumes are examined. Copyright (c) 2013 S. Karger AG, BaselÖğe The Effectiveness of the Liquid-Based Preparation Method in Cerebrospinal Fluid Cytology(Karger, 2013) Argona, Asuman; Uyaroglu, Mehmet Ali; Nart, Deniz; Veral, Ali; Kitapcioglu, GulObjectives: Since malignant cells were first detected in the cerebrospinal fluid (CSF), numerous methods have been used for CSF examination. The cytocentrifugation and liquid-based cytology (LBC) methods are two of these. We aimed to investigate whether the results from the LBC method were different from the results of the cytological diagnosis of the CSF materials that were prepared using the cytocentrifugation method. Materials and Methods: A retrospective analysis was conducted using the pathological records of 3,491 (cytocentrifugation on 1,306 and LBC on 2,185) cytological specimens of CSF which were diagnosed over a 4-year period between January 2007 and December 2011. The Fisher exact test was used to compare the results of the LBC and cytocentrifugation methods. Results: While there was a noticeable decrease in nondiagnostic diagnosis and a slight decrease in suspicious diagnosis, there was an increase in malignant and benign diagnosis with the LBC method in comparison to the centrifugation method. Statistically, the decrease in nondiagnostic diagnosis was considered significant (p < 0.0001). Discussion: The LBC method seems like a better option than the cytocentrifugation method, because of many preparatory, screening and diagnostic advantages, especially in pathology departments where materials come from far away and large volumes are examined. Copyright (c) 2013 S. Karger AG, BaselÖğe Efficacy of SLZ and MTX (alone or combination) on the treatment of active sacroiliitis in early AS(Springer Heidelberg, 2009) Kabasakal, Yasemin; Kitapcioglu, Gul; Yargucu, Figen; Taylan, Ali; Argin, Mehmet; Gumusdis, GurbuzSacroiliitis is an important sign of spondylarthritis (SpA) of which the prototype disease is ankylosing spondylitis. The radiographic changes required for diagnosing AS occur as late as 8-11 years after the onset of clinical symptoms. Nonsteroid anti-inflammatory drugs (NSAIDs) have been the main treatment for spondylitis of AS. For patients refractory or intolerant to NSAIDs, disease-modifying antirheumatic drugs (DMARDs) have been used as a second-line approach. Sulphasalazine (SLZ) is known as the best DMARD in treatment of peripheral arthritis; also methotrexate (MTX) is currently one of the most widely used DMARDs. But there was no objective information about inflammation of sacroiliac joints during treatment with these DMARDS that are the first places of the beginning point of SpA. For this purpose, in this study, the effect of SLZ and MTX, which are used alone and combination in 6 months, on treatment of active sacroiliitis, which is shown by dynamic magnetic resonance and acute phase reactants in laboratory has been investigated. 55 patients (F:M = 34:21) with active sacroiliitis [mean age = 37.05 + 13.03 year (n = 55)] were evaluated and determined by dynamic magnetic resonance imaging in this study. The better response in the SLZ treatment group than the other two groups has been obtained. Nevertheless, those changes were not statistically found different. In conclusion, the ratio of treatment of active sacroiliitis, especially early period, with SLZ as a DMARD is better than MTX or MTX + SLZ, but this difference is not statistically significant. A prospective study of the treatment of active sacroiliitis by DMARDs may be more illustrative.Öğe Efficacy of SLZ and MTX (alone or combination) on the treatment of active sacroiliitis in early AS(Springer Heidelberg, 2009) Kabasakal, Yasemin; Kitapcioglu, Gul; Yargucu, Figen; Taylan, Ali; Argin, Mehmet; Gumusdis, GurbuzSacroiliitis is an important sign of spondylarthritis (SpA) of which the prototype disease is ankylosing spondylitis. The radiographic changes required for diagnosing AS occur as late as 8-11 years after the onset of clinical symptoms. Nonsteroid anti-inflammatory drugs (NSAIDs) have been the main treatment for spondylitis of AS. For patients refractory or intolerant to NSAIDs, disease-modifying antirheumatic drugs (DMARDs) have been used as a second-line approach. Sulphasalazine (SLZ) is known as the best DMARD in treatment of peripheral arthritis; also methotrexate (MTX) is currently one of the most widely used DMARDs. But there was no objective information about inflammation of sacroiliac joints during treatment with these DMARDS that are the first places of the beginning point of SpA. For this purpose, in this study, the effect of SLZ and MTX, which are used alone and combination in 6 months, on treatment of active sacroiliitis, which is shown by dynamic magnetic resonance and acute phase reactants in laboratory has been investigated. 55 patients (F:M = 34:21) with active sacroiliitis [mean age = 37.05 + 13.03 year (n = 55)] were evaluated and determined by dynamic magnetic resonance imaging in this study. The better response in the SLZ treatment group than the other two groups has been obtained. Nevertheless, those changes were not statistically found different. In conclusion, the ratio of treatment of active sacroiliitis, especially early period, with SLZ as a DMARD is better than MTX or MTX + SLZ, but this difference is not statistically significant. A prospective study of the treatment of active sacroiliitis by DMARDs may be more illustrative.Öğe Evaluation of infectious diseases and clinical microbiology specialists' preferences for hand hygiene: analysis using the multi-attribute utility theory and the analytic hierarchy process methods(Bmc, 2017) Suner, Asli; Oruc, Ozlem Ege; Buke, Cagri; Ozkaya, Hacer Deniz; Kitapcioglu, GulBackground: Hand hygiene is one of the most effective attempts to control nosocomial infections, and it is an important measure to avoid the transmission of pathogens. However, the compliance of healthcare workers (HCWs) with hand washing is still poor worldwide. Herein, we aimed to determine the best hand hygiene preference of the infectious diseases and clinical microbiology (IDCM) specialists to prevent transmission of microorganisms from one patient to another. Methods: Expert opinions regarding the criteria that influence the best hand hygiene preference were collected through a questionnaire via face-to-face interviews. Afterwards, these opinions were examined with two widely used multi-criteria decision analysis (MCDA) methods, the Multi-Attribute Utility Theory (MAUT) and the Analytic Hierarchy Process (AHP). Results: A total of 15 IDCM specialist opinions were collected from diverse private and public hospitals located in Izmir, Turkey. The mean age of the participants was 49.73 +/- 8.46, and the mean experience year of the participants in their fields was 17.67 +/- 11.98. The findings that we obtained through two distinct decision making methods, the MAUT and the AHP, suggest that alcohol-based antiseptic solution (ABAS) has the highest utility (0.86) and priority (0.69) among the experts' choices. Conclusion: In conclusion, the MAUT and the AHP, decision models developed here indicate that rubbing the hands with ABAS is the most favorable choice for IDCM specialists to prevent nosocomial infection.Öğe Evaluation of Insulin Resistance by the Homeostasis Model Assessment in Female Patients with Primary Sjogren's Syndrome(Kuwait Medical Assoc, 2011) Karabulut, Gonca; Sarac, Fulden; Kitapcioglu, Gul; Yilmaz, Candeger; Kabasakal, YaseminObjective: To evaluate insulin resistance in Primary Sjogren's Syndrome (pSS) using homeostasis model assessment (HOMA) method Design: Cross-sectional study conducted between January 2006 and December 2008 Setting: Ege University Faculty of Medicine, Izmir, Turkey Subjects: Thirty-five female patients with pSS fulfilling the US-European Consensus Criteria Interventions: A brief clinical history, demographic, anthropometric, clinical and laboratory profiles were recorded Main Outcome Measures: HOMA-IR and serum lipid levels Results: Mean level of HOMA-IR was 1.8 +/- 0.7 in patients with pSS. Mean levels of plasma fasting glucose and insulin were 90.6 +/- 7.1 mg/di, 7.8 +/- 2.5 microU/1, respectively. A statistically significant difference was detected between ANA positivity and HOMA-IR values (p = 0.016). Four patients with pSS had high HOMA values (> 2.7) and all these patients had ANA positivity. A statistically significant positive correlation was detected between HOMA-IR values and HDL-C levels (R = 0,450 p = 0.009). However, a statistically significant difference was detected between extraglandular involvement and LDL-C (p = 0.01) and total cholesterol levels (p = 0.01). Patients who had no extraglandular involvement had higher levels of total cholesterol and LDLC levels. Lower triglyceride levels were seen in patients with anti-La antibodies (p = 0.01) but not other antibodies (p > 0.05). Patients with ANA positivity and pSS had lower LDLC levels (p = 0.009). Conclusion: Autoimmune mechanisms may play a role in insulin resistance in pSS. Metabolic alterations should be taken into account in their management.Öğe Evaluation of quality of life in relation to anxiety and depression in primary Sjogren's syndrome(Taylor & Francis Ltd, 2010) Inal, Vedat; Kitapcioglu, Gul; Karabulut, Gonca; Keser, Gokhan; Kabasakal, YaseminThe aim of this study was to evaluate health-related quality of life (HR-QOL) in patients with primary Sjogren's syndrome (pSS) using both Short-Form 36 (SF-36) and World Health Organization Quality of Life Assessment-BREF (WHOQOL-BREF) questionnaires and to determine the effects of anxiety and depression on HR-QOL using the Hospital Anxiety-Depression Scale (HADS). In this cross-sectional study, 107 female patients with pSS (mean age 54.10 +/- A 10.2 years), fulfilling US-European Consensus Criteria and 109 female controls (mean age 53.4 +/- A 10.9 years) were included. Student's t test, Mann-Whitney U test, and analysis of variance (ANOVA) were used for statistical analysis. P values > 0.05 were accepted as significant. All domains of the SF-36, with the exception of "Vitality", and all domains of the WHOQOL-BREF with the exception of "Environment", were significantly lower in pSS patients compared with healthy controls. In pSS patients having anxiety according to HADS, the scores of all domains of WHOQOL-BREF were significantly lower, and in patients having depression according to HADS, three of four domains of WHOQOL-BREF were significantly lower compared with the rest of the group. However, the scores of two domains of the SF-36, namely "Role-Physical" and "Role-Emotional" domains, were significantly higher in pSS patients having depression according to HADS. We confirmed the presence of impaired HR-QOL in pSS. Whereas the presence of anxiety and/or depression generally showed a negative affect on HR-QOL, interestingly, depression seemed to improve the scores of "Role-Physical" and "Role-Emotional" domains of the SF-36. This surprising finding might be related to adaptation to changing health. Social support based upon cultural traditions might also have contributed.Öğe Expression of Cyclin D1 and Its Relationship to Hormone Receptors and Survival in Breast Cancer(Kare Publ, 2017) Alanyali, Senem; Yeniay, Levent; Demir, Derya; Aydin, Barbaros; Zekioglu, Osman; Ozdemir, Necmettin; Kitapcioglu, Gul; Haydaroglu, AyferOBJECTIVE The aim of the present study was to evaluate rate of cyclin D1 expression and examine its relationship to clinicopathological factors and impact on prognosis in breast cancer patients. METHODS Total of 85 estrogen receptor (ER)-positive breast cancer patients were included. Expression of cyclin D1, ER, progesterone receptor (PR), and Ki-67 were determined using immunohistochemistry evaluation. RESULTS Patients' median age was 49 years (range: 27-83 years) and cyclin D1 was positive in 90.5% of the patients. Cyclin D1 expression was positively correlated with rate of ER positivity and Ki-67 expression (r=0.4; p<0.0001 and r=0.3; p=0.001, respectively). Five-year disease-free and overall survival (OS) rates were not different between patients with or without cyclin D1 expression (81% vs 79% and 93% vs 87%; p=0.8 and 0.4, respectively). High modified Bloom-Richardson grade (p=0.04), high nuclear grade (p=0.021), and PR negativity (p=0.011) were found to be poor prognostic factors for OS rate in univariate analysis. CONCLUSION In this study, cyclin D1 was not found to be prognostic factor; however, it is correlated with ER positivity and Ki-67 expression in breast cancer patients.Öğe Invitro fertilization-induced pregnancies predispose to gastroesophageal reflux disease(Sage Publications Inc, 2016) Turan, Ilker; Kitapcioglu, Gul; Goker, Ege Tavmergen; Sahin, Gulnaz; Bor, SerhatBackground Women conceiving following invitro fertilization (IVF) likely have a variety of risk factors that predispose them to gastroesophageal reflux disease (GERD) in the future. Objective We aimed to investigate whether pregnancy through IVF may predispose to subsequent GERD compared with pregnancies without IVF. We also evaluate whether twin IVF pregnancies lead to additional risk for having GERD compared with singleton IVF pregnancies. Methods A validated reflux questionnaire was administered to 156 women with singleton (n=102) or twin (n=54) IVF birth (IVF group) and 111 women with a naturally conceived singleton birth (control group). All women included in the study were primiparas who had given birth at least 1 year prior to data collection. The diagnosis of GERD was based on the occurrence of typical symptoms (heartburn, regurgitation, or both) at least once a week. Results The prevalence of GERD was 13.5% and 4.5% in IVF and control groups (p=0.015); in the IVF group, this was slightly higher, but not statistically significant, in women with twin compared with singleton pregnancies (14.8% vs. 12.7%, p=0.749). Logistic regression analysis showed that IVF was strongly associated with subsequent GERD (OR, 3.30; 95% CI 1.20-9.04; p=0.02). Conclusion The risk of developing GERD at least 1 year after delivery increased following IVF. Long-term follow-up studies are required to determine whether therapy during pregnancy can prevent this risk.Öğe MEFV gene full DNA sequence analysis in familial Mediterranean fever (FMF) and healthy controls(Clinical & Exper Rheumatology, 2009) Dirican, Ahmet; Kitapcioglu, Gul; Berdeli, Afig; Kabasakal, YaseminÖğe MEFV gene full DNA sequence analysis in familial Mediterranean fever (FMF) and healthy controls(Clinical & Exper Rheumatology, 2009) Dirican, Ahmet; Kitapcioglu, Gul; Berdeli, Afig; Kabasakal, YaseminÖğe Portal Hyperfusion or Hepatic Venous Congestion: Which One Affects Kupffer Cell Function More?(Baskent Univ, 2009) Firat, Ozgur; Mutlukoca, Nadide; Makay, Ozer; Yilmaz, Funda; Omur, Ozgur; Kitapcioglu, Gul; Yuzer, YildirayObjectives: Because of their effects on the liver parenchyma after surgery, portal hyperperfusion and hepatic venous congestion are challenging problems for hepatobiliary surgeons. However, the effects of those conditions on Kupffer cells have not been established. The aim of this study was to investigate the effects of vascular streams modified by portal hyperperfusion and hepatic venous congestion on Kupffer cell function. Materials and Methods: Thirty rats were allocated into 3 groups of 10 rats each and were subjected to right portal vein ligation to induce hyperperfusion in the left lobe of the liver (group 1), occlusion of the right hepatic vein to produce venous congestion (group 2), or sham operation (controls; group 3). After 72 hours, the right and left liver lobes of the subjects were submitted separately for scintigraphic and histopathologic evaluation, and the radiocolloid uptake per gram of liver tissue and the number of Kupffer cells per square millimeter were calculated. Results: The mean technetium-99m labeled sulfur colloid uptake values of the liver tissue per gram were 0.126 +/- 0.038 for group 1, 0.106 +/- 0.032 for group 2, and 0.110 +/- 0.031 for group 3. Portal hyperperfusion significantly increased the technetium-99m labeled sulfur colloid uptake of the liver tissue per gram (P = .043). The mean number of Kupffer cells per square millimeter was calculated for each group as follows: 321 +/- 094 x 10-6 for group 1, 369 083 x 10-6 for group 2, and 355 +/- 096 x 10-6 for group 3. Both vascular streams produced no significant effects on the number of Kupffer cells (P > .05). Conclusions: In this experimental model, portal hyperperfusion affected Kupffer cell function more than did hepatic venous congestion.Öğe Prevalence of Alcohol in Blood Samples From Traffic Accident Cases in Turkey(Lippincott Williams & Wilkins, 2011) Akgur, Serap Annette; Ertas, Hasan; Altintoprak, A. Ender; Ozkan, Meral; Kitapcioglu, GulAlcohol is one of the main causes of traffic accidents worldwide. With a population of 70 million, 12 million vehicles, and 18 million drivers (16% women), Turkey is one of the European countries that has a high incidence of road traffic accidents. In accordance with Turkish laws, subjects were considered to be positive when alcohol blood concentration exceeded 50 mg/100 mL. The objective of the present study was to obtain reliable and comparable data about alcohol use in traffic cases in Turkey. All cases are admitted to the emergency department at Ege University Medical Faculty. The cases from police officers are described as traffic control cases. Alcohol was detected in the blood of about 54.4% of the traffic-related cases during October 2005 to March 2007. It has been observed that, in 17.4% of the traffic accident cases, the blood alcohol level was 50 mg/dL or less, which is the legal limit in Turkey for car drivers. Alcohol prevalence was 57.2% in male cases and 43.6% in female cases. In alcohol-positive cases; the ratios for males were 1.73 times more frequent in traffic-related cases. Prevalence data will help traffic safety professionals to adequately allocate resources and plan future efforts in reducing drinking-and-driving behavior and thereby reduce traffic accidents.
