Browsing by Author "Almali, Necat"

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Cdkn1a (P21 Gene) Polymorphisms Correlates With Age in Esophageal Cancer
(Springer, 2022) Kaya, Zehra; Karan, Burak Mugdat; Almali, Necat
Background CDKN1A gene encoding p21 is an important tumour supressor involved in the pathogenesis of cancers. A few studies have been devoted to the association between CDKN1A single nucleotide polymorphisms (SNPs) and esophageal cancer (EC) in China, India and Iran. The aim of this case-control study was to investigate the association of CDKN1A polymorphisms with EC risk in the Turkey population for the first time. Methods In the present study, CDKN1A SNPs (rs1801270 C > T, rs1059234 C > A and rs3176352 C > G) were genotyped with the use of TaqMan SNP genotyping assays in 102 patients and 119 controls. Results The genotypes and alleles of CDKN1A SNPs were not significantly different among patients and controls. However, TT-genotype and T-allele of the rs1059234, the rs1801270 CC-genotype and rs3176352 G-allele were significantly associated with EC risk for <= 55 age (p < 0.05). In those over 55 age, CC-genotype and C-allele of the rs1059234 was significantly associated with EC (p < 0.05). The rs1059234 T-carriers had a higher risk of high globulin level (p = 0.017) and low albumin/globulin ratio (p = 0.019) when compared to non-T carriers (CC). The rs3176352 CC-genotype carriers had a higher risk of esophageal adenocarcinoma (EAC) subtype when compared to CG-genotype carriers and CG-genotype carriers had a higher risk of squamous cell carcinoma (ESCC) subtype (OR/95% CI = 4.00/1.06-15.08, p = 0.04). The rs3176352 CC-genotype is also a risk factor for the higher BMI (p = 0.04) and the higher CA-19-9 level (p = 0.009). Conclusion Our study suggests that the CDKN1A polymorphisms may play an important role in EC risk in relation to age. Future studies are needed to validate our findings.
Comparison of Dexmedetomidine-Propofol and Ketamine-Propofol Administration During Sedation-Guided Upper Gastrointestinal System Endoscopy
(Lippincott Williams & Wilkins, 2020) Tekeli, Arzu Esen; Oguz, Ali Kendal; Tuncdemir, Yunus Emre; Almali, Necat
Background: Dexmedetomidine and ketamine popular sedative agents that result in minimal respiratory depression and the presence of analgesic activity. We aimed to compare the effectiveness and safety of a dexmedetomidine-propofol combination and a ketamine-propofol combination during upper gastrointestinal system endoscopy. Methods: The study commenced after receiving approval from the local ethics committee. Patients between 18 and 60 years in the American Society of Anesthesiologists (ASA) I and II groups were included. Patients who had severe organ disease, who had allergies to the study drugs, and who refused to participate were excluded. Cases were randomized into a dexmedetomidine-propofol group (Group D, n = 30) and a ketamine-propofol group (Group K, n = 30). Cardiac monitoring, peripheral oxygen saturation, and bispectral index (BIS) monitoring were performed. Group D received 1 mg/kg dexmedetomidine + 0.5 mg/kg propofol intravenous (IV) bolus, 0.5 mu g/kg/h dexmedetomidine + 0.5 mg/kg/h propfol infusion. Group K received 1 mg/kg ketamine + 0.125 mL/kg propofol iv bolus, 0.25 mg/kg/h ketamine + 0.125 mL/kg/h propfol infusion. Patients were followed up with a Ramsay Sedation Scale (RSS) of >= 4. Means, standard deviations, lowest and highest frequency values, and ratio values were used for descriptive statistics, and the SPSS 22.0 program was used for statistical analyses. Results: In Group K, recovery time and mean blood pressure (MBP) values were significantly shorter. Furthermore, coughing rate, pulse, and BIS values were higher than in Group D (P < .05). Although there were no significant differences between the groups in terms of endoscopic tolerance and endoscopist satisfaction, we observed that the dexmedetomidine group experienced more comfortable levels of sedation. Conclusion: Dexmedetomidine-propofol and ketamine-propofol combinations may be suitable and safe for endoscopy sedation due to their different properties. It was observed that the dexmedetomidine-propfol combination was superior in terms of sedation depth and that the ketamine-propofol combination was superior in terms of early recovery. As a result, we suggest the dexmedetomidine-propofol combination for upper gastrointestinal system endoscopy sedation due to hemodynamic stability and minimal adverse effects.
The Effect of Pretreatment Neutrophil/Leucocyte Ratio on Survival in Patients With Locally Advanced Esophageal Cancer Receiving Chemoradiotherapy
(Carbone Editore, 2017) Karaca, Feryal; Afsar, Cigdem Usul; Almali, Necat; Karabulut, Senem; Karabulut, Mehmet; Keskin, Siddik; Akbulut, Serkan
Introduction: Esophageal cancer (EC) is a highly lethal malignancy. The majority of esophageal cancers are squamous cell or adenocarcinomas. Although the incidence of squamous cell carcinoma (SCC) is decreasing in the United States, the incidence of adenocarcinoma arising out of Barrett's esophagus is rising dramatically, although less so in the last few years. Treatment in locally advanced EC (LA-EC) must be multidisciplinary. There are only few factors which affects the prognosis. Our aim was to investigate the prognostic and predictive roles of pretreatment neutrophil/leucocyte (neu/leu) ratios in LA-EC patients receiving chemoradiotherapy (CRT). Materials and methods: Sixty patients with non-metastatic EC (youngest 31 years old) who applied to our hospital between 2011 and 2015 were included in this study. Neu/leu ratios were calculated before CRT and after CRT. The Kaplan-Meier method was used for estimating the survival function from lifetime data. In addition, Cox regression model was also used to explore the relationship between the survival of a patient and several explanatory variables. Results: There was statistical significance between neu/leu ratio before CRT and OS (p=0.047). One unit increase in neu/leu ratio, increases the probability of being alive 2.725 times (1/0.367). There was statistical significance between neu/leu ratio before CRT and progression-free survival (PFS) (p=0.046). One unit increase in neu/leu ratio, increases the probability of no relapse 3.559 (1/0.281) times. This means that the patients with higher neu/leu ratio before CRT have a lower risk of relapse. Discussion and conclusion: Multimodal therapeutic strategies combining chemotherapy, radiation therapy and surgery have been shown to be feasible and to have a positive impact on outcomes by decreasing the risk of locoregional recurrence and often by increasing overall survival. The overall survival (OS) and disease-free survival (DFS) of patients is too short in patients with LA-EC. Our study shows that patients with LA-EC who had higher pretreatment neu/leu ratios have better OS and PFS.
Evaluation of Celiac Disease With Uniphasic and Multiphasic Dynamic Mdct Imaging
(Springer, 2021) Goya, Cemil; Dundar, Ilyas; Ozgokce, Mesut; Turkoglu, Saim; Turko, Ensar; Ozkacmaz, Sercan; Almali, Necat
Purpose An analysis of dynamic contrast MRI has been shown to provide valuable information about disease activity in Crohn's disease and Celiac disease (CD). However, there are no reports of dynamic multi-detector computer tomography use in patients with CD. The aim of this study is to determine and compare the perfusion dynamics of the patients treated with control subjects and the perfusion dynamics in patients with untreated CD, using dynamic contrast in MDCT and compare studying contrast dynamics in Marsh types as well. Methods In this retrospective study, uniphasic and multiphasic MDCT, untreated, treated, incompatible CD patients and healthy control group duodenum wall thickness and HU values were compared in terms of patient groups and modified Marsh types. Result In dynamic CT, the highest contrast curve was observed in the untreated group and Marsh type 1. While the contrast curve of the untreated and non-compliant patients increased rapidly and showed wash out, the type 4 contrast curve was observed, whereas the treated and control group slowly increased type 5 contrast curve. In the contrast-enhanced CT in the venous phase, in the ROC analysis between Marsh 1-2 and Marsh 3a-c, the sensitivity was 97% and the specificity was 87% when the cut off was taken as 4.45 mm for wall thickness (p: 0.005). Conclusion Contrast-enhanced single-phase and dynamic MDCT imaging in CD patients may be useful in evaluating the inflammatory and pathological process in the small intestine. [GRAPHICS] .
Inflammatory Myofibroblastic Tumor: a Rare Cause of Invagination in Adults
(Professional Medical Publications, 2016) Kiziltan, Remzi; Yilmaz, Ozkan; Almali, Necat; Peksen, Caghan
Inflammatory myofibroblastic tumor (IMT) is a distinct pseudosarcomatous lesion arising in the soft tissues and interior organs of children and young adults. It is rarely seen in adults. It was first described in lungs. IMT can occur in any location in the body. However, it is seen most commonly in lungs, intestinal mesentery and liver. Non-mesenteric alimentary tract IMT's are quite rare. The presented case is an ileal IMT that caused small bowel invagination. A 38 year-old male patient presented to the emergency department with the complaint of diffuse abdominal pain, distension and no passage of gas or stools for two days. An abdominal examination revealed distension and tenderness in the abdomen with no guarding or rebound tenderness. Computerized tomography (CT) of the abdomen was ordered. CT revealed an image compatible with invagination of the right lower quadrant of the abdomen and a mass inside the lumen measuring 4x3x3cm. The mass causing invagination was detected during the surgical operation. A segmentary small bowel resection and ileoileal anastomosis was performed. The patient was discharged uneventfully on the postoperative sixth day. The diagnosis of IMT was confirmed histologically and immunochemically.
Linking Cdh1 Snps To Gastric Cancer Risk: a Comprehensive Analysis of Rs16260, Rs13689, and Rs9929218
(Springer, 2024) Aslan, Firat; Almali, Necat; Kaya, Zehra; Guven, Mustafa; Sahin, Elif Sena; Ozdemir, Abdulselam; Uygur, Serhat
Objective Single nucleotide polymorphisms (SNPs) are linked to carcinogenesis. Pathogenic variants in the CDH1 gene are associated with gastric cancer. This study examines the genotype and allele frequencies of three SNPs (rs16260, rs13689, and rs9929218) in the CDH1 gene and their relationship with gastric cancer risk. Materials and methods The study involved 105 gastric cancer patients with pathology results and 105 healthy controls. Clinical, histopathological, and demographic data were collected and compared between the two groups. Results No significant differences were found for rs16260 (- 160 C > A) and rs9929218 (G > A) between patients and controls (p > 0.05). For rs13689 (T > C), the T allele frequency was 90% in patients versus 69% in controls, while the C allele frequency was 10% in patients versus 31% in controls. A significant difference was observed for this SNP, with a higher T allele frequency in patients (OR = 4.03 CI95% 2.4-6.7, p < 0.0001) compared with controls, suggesting a fourfold increased risk of gastric cancer. Genotype frequencies were 80% wild-type (TT) and 20% heterozygous-type (TC) in patients, and 58% TT, 22% TC, and 20% mutant-type (CC) in controls (p < 0.0001). The frequencies of non-C allele carriers (TT) were present in 80% of patients versus 58.1% of controls (OR = 2.88 CI95% 1.56-5.34, p = 0.0006). Conclusion This study is the first to link the rs13689 SNP's T allele and TT genotype with increased gastric cancer risk. Our results suggest that the rs13689 T allele may contribute significantly to disease susceptibility, while the rs16260 CC genotype and rs9929218 GG genotype may influence risk in smokers.
Retrospective Evaluation of the Pancreatic Cancer Patients Who Received Chemoradiotherapy
(derman Medical Publ, 2015) Karaca, Feryal; Afsar, Cigdem Usul; Oktem, Ozcan; Almali, Necat; Yilmazer, Gokhan; Keskin, Siddik; Tali, Ali Murat
Aim: Pancreatic cancer is a highly lethal malignancy and in locally advanced disease, chemotherapy (CT) or chemoradiotherapy (CRT) are implemented. The aim of this retrospective study was to investigate the general characteristics and survival of our patients receiving CRT. Material and Method: Between the years 2009-2013, 62 pancreatic cancer patients were taken into study who admitted to Van Training and Research Hospital. Eight patients who had whipple operation received radiotherapy (RT) with concurrent CT. Fifty-four patients who were considered to be inoperable underwent CRT. As adjuvant treatment dose, 45 Cy (1,8 Gy/fx/day) radiotherapy was administered to pancreas and regional lymph nodes. In patients who had taken definitive CRT, average 50.4 Cy (1.8 Gy/fx/day) dose was given. Statistical analysis was carried out using SPSS 19 software package; Kaplan-Meier analysis method was used for survival and log-range test for comparisons. Results: Twenty-four patients (38.7%) were female and 38 (61.3%) were wale. Eleven patients (1 7.7%) were at stage IA, 15 (25.8%) were stageI9,13 (20.9%) were stage HA, 8 (12.9%) were stage IIB and 14 (22.5%) were staged as stage HI. Two-year disease free survival (DES): time from the date of biopsy until the date of recurrence was approximately 436 days and the median DFS was found to be 362 days. The average overall survival (OS) time; time from the date of biopsy until the date of death were found to be approximately 854 days, the median survival time was found to be 916 days. Survival due to tumor localization (head, body and tail) showed no significant difference statistically (log-range chi-square=0.366;p=0.833). Discussion: According to our single center experience, our data in pancreatic cancer patients were parallel with international data. In preclinical experiments, effective drug therapies for curative modalities are under investigation for pancreatic cancer patients.