Browsing by Author "Bayrak, Mehmet"

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Association between antenatal maternal anxiety and fetal middle cerebral artery Doppler depends on fetal gender
(Taylor & Francis, 2021-03-04) Sancak, Arzu; Bayrak, Mehmet; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; DUU-5336-2022; 57210190959
Objective: Several studies have demonstrated that antenatal maternal anxiety (AMA) during pregnancy is associated with an increased risk of abnormal fetal Doppler parameters and adverse perinatal outcomes. Despite these studies, the evidence of the association between them remains inconclusive due in part to the methodological limitations of existing studies. Hence, in the present study, we established strict criteria and excluded patients who may have moderate or confounding variables to investigate the relationship between AMA and fetal Doppler findings and adverse perinatal outcomes. Methods: This was a cross-sectional study of 160 healthy nulliparous pregnant women (gestational age 31-33 weeks) with uncomplicated obstetric histories, who underwent Doppler flow studies on uterine, umbilical and fetal middle cerebral artery (MCA). Maternal anxiety was measured by STAI-State and STAI-Trait inventory. Results: Statistical analyses revealed that STAI-Trait anxiety was associated with lower MCA pulsatility index at 31-33 weeks gestational age and lower birth weight for the female fetus. There were no significant differences in the birth weight of boys of mothers with high anxiety and without high anxiety. Conclusions: The adaptation of the fetus to this hostile environment as AMA differs by gender. Adaptation for the female fetus means the "brain sparing effect" and reduced birth weight. The findings emphasize the potential importance of maternal psychological wellbeing during pregnancy for fetal development.
Omental micrometastasis in endometrial cancer
(Karger, 2019-01-01) Bayrak, Mehmet; Yılmaz, Alpay; Yılmaz, Fatih; İlhan, Olcay; Atalay, Fatma Öz; Ozan, Hakan; Bayrak, Mehmet; Yılmaz, Fatih; İlhan, Olcay; ÖZ ATALAY, FATMA; OZAN, HAKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Jinekolojik Onkoloji Kliniği; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Cerrahi Patoloji Kliniği; 0000-0002-9910-8032; 0000-0002-5820-3754; DUU-5336-2022; C-5252-2015; CXA-2700-2022; JHC-4482-2023; DKZ-4159-2022
Introduction: Although there are several reports on omentum metastasis, limited studies have evaluated omental micrometastases, particularly isolated microscopic metastases in endometrial cancer (EC). We performed this study to assess the frequency of omental micrometastasis in EC, especially when the omentum is the only site of extrauterine spread. Methods: A retrospective study was conducted to assess cases of EC with an omental sample during primary surgical treatment for EC at the Gynecological Oncology Unit, Uludag University Hospital, Bursa, Turkey, between January 2005 and May 2018. Results: In total, 435 patients fulfilled the inclusion criteria, which comprised a complete surgical staging. The prevalence of omental metastases was 5.3% (n = 23), regardless of the subtype or clinical stage. Omental micrometastasis was detected in four cases (17.4%). In half of these patients, the omentum was the only site of disease outside the uterus, with an estimated 0.46% of isolated omental involvement. The grade of the endometrioid tumor was found to be statistically correlated with omental metastases (p = 0.01). There was a significant correlation between omental metastasis and positive peritoneal cytology, as well as adnexal involvement (p = 0.001 and p = 0.03, respectively). Conclusion: We recommend omentectomy routinely in serous EC. In addition, we suggest selective omentectomy in patients with EC who have concomitant adnexal involvement or grade 3 tumors.
Prevention of uterine perforation during intracavitary brachytherapy of cervical cancer
(Termedia Publishing House Ltd, 2021-01-01) Bayrak, Mehmet; Abakay, Candan Demiröz; Bayrak, Mehmet; DEMİRÖZ ABAKAY, CANDAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Jinekolojik Onkoloji Kliniği; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyasyon Onkolojisi Kliniği; 0000-0001-8407-0169; 0000-0001-5380-5898; DUU-5336-2022; AAH-3855-2021
Purpose: Intracavitary brachytherapy (ICBT) is a part of standard treatment for loco-regionally advanced cervical cancers. ICBT requires a tandem applicator insertion through cervical canal into uterine cavity. Accurate placement through cervical canal, which is distorted by cancer, is crucial to successful treatment. The objective of this study was to investigate actual complication rate of a Smit sleeve insertion performed by experienced gynecologists in a tertiary referral center.Material and methods: Clinical data of 328 patients with cervical cancer treated using ICBT, between January 2013 and August 2019, were retrospectively evaluated. Predisposing factors that could have increased the risk of uterine perforation were recorded. Pre-operative ultrasound was carried out for visualization of uterine curvature and selection of an appropriate Smith sleeve length. All applications were performed by a gynecologic oncology fellow or an expert gynecologist.Results: 317 patients were suitable for analysis. Only one (0.3%) applicator placement resulted in uterine perforation. In two patients, Smit sleeve dislocated after first brachytherapy and reinserted. Adequate applicator placement was achieved, and treatment was completed as planned in 316 cases.Conclusions: A cervical sleeve technic, which reduced the need for multiple insertions and placement of this instrument by an expert gynecologist minimize the risk of complication relative to historical controls.
Prognostic significance of c-erbB2 overexpression in patients with metastatic gastric cancer
(Springer, 2013-04) Bayrak, Mehmet; Ölmez, Ömer Fatih; Kurt, Ender; Çubukçu, Erdem; Evrensel, Türkkan; Kanat, Özkan; Manavoǧlu, Osman; Uludağ Üniversitesi/Tıp Fakültesi/Onkoloji Anabilim Dalı.; 0000-0002-9732-5340; AAJ-1027-2021; 57210190959; 26435400000; 7006207332; 53986153800; 6603942124; 55881548500; 6602587152
Overexpression of the gene c-erbB2, which encodes a receptor tyrosine kinase, has been associated with prognosis and response to therapy in several solid tumors. This study was designed to test whether c-erb-B2 overexpression can be related to prognosis of patients with metastatic gastric cancer. Between 2005 and 2010, 46 cases of metastatic gastric cancer were evaluated immunohistochemically for c-erb-B2 overexpression. Overall survival (OS) and time-to-progression (TTP) served as the main outcome measures. c-erbB2 was overexpressed in 19 (41.3 %) cases and 8 patients (17.4 %) had a c-erbB2 score of 3+ (a strong complete membrane staining observed in > 10 % of the tumor cells). c-erbB2 expression was not associated with the clinicohistological characteristics of the study participants. The mean OS was 11.48 +/- A 1.03 months, whereas the mean TTP was 8.28 +/- A 0.8 months. Compared with patients with a score of 2+ or less (n = 38), those with a c-erbB2 score of 3+ (n = 8) had both a significantly lower OS (15.55 +/- A 1.63 vs. 8.22 +/- A 0.88 months, respectively, p < 0.05) and TTP (10.72 +/- A 1.81 vs. 6.11 +/- A 0.61 months, respectively, p < 0.05). After allowance for potential confounders, Cox regression analysis identified a c-erbB2 score of 3+ as an independent predictor of both OS (hazard ratio = 1.9; 95 % confidence interval = 1.1-3.7, p < 0.05) and TTP (hazard ratio = 1.8; 95 % confidence interval = 1.1-4.1, p < 0.05). Our results suggest that c-erbB-2 overexpression may have a prognostic significance in patients with metastatic gastric cancer.
Recurrence of borderline ovarian tumors: Clinical and pathological risk factors
(Imr Press, 2021-06-15) Şahin, Hacı Öztürk; Yılmaz, Alpay; Bayrak, Mehmet; Pek, Eren; Özerkan, Kemal; Ozan, Hakan; ÖZERKAN, KEMAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı; K-2269-2016; AAH-9791-2021
Objective: The objective of this study was to determine the impact of several clinic pathologic factors on the rate of recurrence of borderline ovarian tumors (BOT). Method: Patients, who were diagnosed in our clinic between October 1996 and April 2016 with a final diagnosis of BOT, were retrospectively investigated. Only patients with a primary diagnosis of BOT were included. A total of 147 patients were diagnosed with BOT and underwent surgical treatment. The pathological reports, medical records and operation notes of the included patients were obtained from the gynecological oncology electronic database system. Results: While 51.7% of all our patients had BOTs of serous histology, 34.6% had mucinous BOTs and 13.6% had sero-mucinous BOTs, and their bilaterality was 11.8%, 2% and 5%, respectively. After treatment, the clinical conditions of 96 patients could be followed and recurrence was observed in six (6.3%) of them. The median follow-up time was 66 months (range: 12-266 months). The median time to recurrence was 46 months (range: 14-10o months). For non-recurrence and recurrence cases, the median age was 42.0 years (range: 17-86) years and 29.oyears (range: 18-3zyears), respectively a statistically significant difference (p = 0.005). Thirteen percent of the patients who underwent conservative surgery had recurrence, whereas no recurrence was observed in patients without conservative surgery (p = 0.009). While no recurrence was observed in patients who were surgically staged as stager, recurrences developed in cases with stage 2 and 3 disease (p= 0.040). In this cohort histologic type, surgical staging, presence of implants, size of the tumor, presence of micropapillary variants, and lymphadenectomy were not associated with recurrence. Conclusion: We found the recurrence of BOT is associated with younger age at diagnosis and conservative surgery. Although we found no statistically significant association of BOT recurrences with surgical staging, among those who were surgically stage recurrences only occured in patients with stage 2 or 3 disease.
The impact of ki-67 index, squamous differentiation, and several clinicopathologic parameters on the recurrence of low and intermediate-risk endometrial cancer
(Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2021-01-01) Ocak, Birol; Atalay, Fatma Oz; Sahin, Ahmet Bilgehan; Ozsen, Mine; Dakiki, Bahar; Ture, Seray; Mesohorli, Merve; Odman, Hikmet Utku; Tanriverdi, Ozgur; Ocakoglu, Gokhan; Bayrak, Mehmet; Ozan, Hakan; Demiroz, Candan; Sali, Seda; Orhan, Sibel Oyucu; Deligönül, Adem; Çubukcu, Erdem; Evrensel, Turkkan; Ocak, Birol; OCAK, BİROL; Sahin, Ahmet Bilgehan; ŞAHİN, AHMET BİLGEHAN; Atalay, Fatma Oz; ÖZ ATALAY, FATMA; Ozsen, Mine; ÖZŞEN, MİNE; Dakiki, Bahar; DAKİKİ KORUCU, BAHAR; Ture, Seray; TÜRE AYDIN, SERAY; Mesohorli, Merve; Odman, Hikmet Utku; Ocakoglu, Gokhan; OCAKOĞLU, GÖKHAN; Bayrak, Mehmet; Ozan, Hakan; OZAN, HAKAN; Demiroz, Candan; DEMİRÖZ ABAKAY, CANDAN; Sali, Seda; SALİ, SEDA; Orhan, Sibel Oyucu; OYUCU ORHAN, SİBEL; Deligonul, Adem; DELİGÖNÜL, ADEM; Cubukcu, Erdem; ÇUBUKÇU, ERDEM; Evrensel, Turkkan; EVRENSEL, TÜRKKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Onkoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0001-7537-1699; 0000-0002-7188-6115; 0000-0002-7846-0870; 0000-0002-5771-7649; 0000-0001-9255-2475; 0000-0002-1114-6051; 0000-0003-1600-333X; AEC-2238-2022; ABA-2897-2021; AAH-5180-2021; AAM-4927-2020; AAJ-8314-2021
Endometrial endometrioid carcinoma (EEC) represents approximately 75-80% of endometrial carcinoma cases. Three hundred and thirty-six patients with EEC followed-up in the authors' medical center between 2010 and 2018 were included in our study. Two hundred and seventy-two low and intermediate EEC patients were identified using the European Society for Medical Oncology criteria and confirmed by histopathological examination. Recurrence was reported in 17 of these patients. The study group consisted of patients with relapse. A control group of 51 patients was formed at a ratio of 3:1 according to age, stage, and grade, similar to that in the study group. Of the 17 patients with recurrent disease, 13 patients (76.5%) were Stage 1A, and 4 patients (23.5%) were Stage 1B. No significant difference was found in age, stage, and grade between the case and control groups (p > 0.05). Body mass index, parity, tumor size, lower uterine segment involvement, squamous differentiation (SqD), and Ki-67 index with p<0.25 in the univariate logistic regression analysis were included in the multivariate analysis. Ki-67 was statistically significant in multivariate analysis (p = 0.018); however, there was no statistical significance in SqD and other parameters. Our data suggest that the Ki-67 index rather than SqD needs to be assessed for recurrence in patients with low- and intermediate-risk EEC.