Person: IŞIK, ÖZGEN
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IŞIK
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ÖZGEN
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Publication Fall of another myth for colon cancer: Duration of symptoms does not differ between right- or left-sided colon cancers(Aves, 2019-08-01) Öztürk, Ersin; Kuzu, Mehmet Ayhan; Öztuna, Derya; Işık, Özgen; Canda, Aras Emre; Balık, Emre; Erkasap, Serdar; Yoldaş, Tayfun; Akyol, Cihangir; Demirbaş, Sezai; Özoğul, Bünyamin; Topcu, Ömer; Gedik, Ercan; Baca, Bilgi; Ergüner, İlknur; Aşoğlu, Oktar; Erkek, Bülent; Yılmazlar, Tuncay; Reis, Erhan; Gençosmanoğlu, Rasim; Aslar, Ahmet Kessaf; Konan, Ali; Öztürk, Ersin; IŞIK, ÖZGEN; YILMAZLAR, AHMET TUNCAY; Tıp Fakültesi; Genel Cerrahi Ana Bilim Dalı; 0000-0002-9541-5035; 0000-0001-8593-5101; 0000-0003-1924-0795; JGW-0566-2023; AAW-9602-2020; CKK-3621-2022Background/Aims: Patients with colorectal cancer continue to present with relatively advanced tumors that are associated with poor oncological outcomes. The aim of the present study was to assess the association between localization, symptom duration, and tumor stage.Materials and Methods: A prospective, multicenter cohort study was conducted on patients newly diagnosed with a histologically proven colorectal adenocarcinoma. Standardized questionnaire-interviews were performed. Data were collected on principal presenting symptoms, duration of symptoms (time to first presentation to a doctor and time to diagnosis) and treatment, diagnostic procedures, tumor site, and stage of the tumor (tumor, node, and metastasis (TNM)).Results: A total of 1795 patients with colorectal cancer were interviewed (mean age: 60.76 +/- 13.50 years, male patients: 1057, patients aged >50 years: 1444, colon/rectal cancer: 899/850, right side/left side: 383/1250, stage 0-1-2/stage 3-4: 746/923). No statistically significant correlations were found between duration of symptoms and either tumor site or stage. Principal presenting symptoms were significantly associated with left colon cancer. Patients who had "anemia," "change in bowel habits," "anal pruritus or discharge," " weight loss," and "tumor in right colon" had a significantly longer symptom time.Conclusion: Symptom duration is not associated with localization, nor is the tumor stage. Diagnosis of colorectal cancer at an earlier stage may be best achieved by screening of the population.Publication Impact of bariatric and metabolic surgery education program on the knowledge and attitude of medical students(Turkish Surgical Assoc, 2022-03-01) Özgüç, Halil; Narmanlı, Mustafa; Işık, Özgen; IŞIK, ÖZGEN; Tıp Fakültesi; Genel Cerrahi Ana Bilim Dalı; 0000-0002-9541-5035; AAW-9602-2020Objective: Bariatric and metabolic surgery (BMS) is the most effective treatment method of morbid obesity. Optimum education of medical students regarding BMS is important for proper assessment of morbidly obese patients in the future.Material and Methods: Medical students from five and six years were determined as the targeted study population. A survey including 17 questions was applied through a web-based survey platform. Students who replied the survey were classified into two groups: distinct bariatric and metabolic surgery education program (BMSEP) (+) and (-). The answers of two groups were compared using Chi-square test.Results: In total, 845 students replied the survey. Surgery referral rates were higher (33.4% vs. 26.5%, p< 0.05), referring to alternative treatment methods were low (4.9% vs. 11.9%, p< 0.05), the answer rate of "absolutely agree" was higher and "have no idea" was lower in questions regarding the indications of BMS for the sample patient with body mass index (BMI)> 40 kg/m(2) and the sample patient with BMI between 35-40 kg/m2 in the BMSEP (+) group (p< 0.05). However, the two groups were comparable for the answers given for the sample patient of BMI 30-35 kg/m(2) with uncontrolled diabetes. The rate of first-degree relative referral to BMS when indicated was higher in the BMSEP (+) group. Effectiveness of surgery, cost and risk perception were comparable between the two groups.Conclusion: This study showed that medical students who have a distinct BMSEP in their medical school have better level of knowledge and comparable risk perception regarding BMS. Structured education programs in BMS may directly improve knowledge, perception, and attitude of medical students and indirectly increase the role of primary care physicians in patient referral to BMS and long-term follow-up.Publication The effect of enteral glutamine on hepatic regeneration, hepatic functions and bacterial translocation in rats following partial hepatectomy(Aves, 2010-09-01) KILIÇTURGAY, SADIK AYHAN; Aktaş, Hikmet; Kılıçturgay, A. Sadık; Öztürk, Ersin; Şehitoğlu, İbrahim; Işık, Özgen; IŞIK, ÖZGEN; Tıp Fakültesi; Patoloji Ana Bilim Dalı; 0000-0002-9541-5035; AAW-9602-2020; P-5779-2019; ABF-8955-2021Purpose: The effects of enteral glutamine on bacterial translocation and hepatic regeneration have been investigated in this study.Materials and Methods: Thirty female Wistar-Albino rats were divided into three groups: 1. Sham Group (n=10); laparotomy followed by liver exploration, was performed and then abdomen was closed. For the following 7 days, the rats were fed with standard food and water. 2. Control group (n=10); following 70% hepatectomy, the rats were fed with standard food and water for 7 days. 3. Trial group (n=10) following 70% hepatectomy, the rats were fed with standard food and water for 7 days and in addition with 0.5gr/kg/day glutamine via orogastric catheter. On the 7th day, the rats were sacrificed. Hepatic regeneration and enterocyte proliferation were evaluated by tissue Ki-67 immune-histochemistry. To evaluate the macroscopic hepatic growth rate, the wet weight of remnant liver tissue was measured. Serum AST/ALT were measured. Bacterial translocation was evaluated by blood samples taken from portal vein and, tissue samples from mesenteric lymph nodes, liver, spleen and lungs. Group values were compared using Kruskal- Wallis (for comparison of three groups) or Mann-Whitney U tests (for comparison of two groups). P<0,05 was accepted as significant.Results: Liver Ki-67 proliferation index (PI) showed significant difference between groups (p=0,001). It was higher in the trial group when compared with the control group (p<0,01). It was also higher in the control group when compared with the sham group (p<0,05). Small intestine Ki-67 PI was significantly higher in the trial group than other groups (p<0,01). The weight of remnant liver tissue was significantly higher in the trial group than in the control group (p<0,01). AST\ALT levels and bacterial translocation rates were comparable between groups.Conclusion: Positive effects of enteral glutamine supplementation on hepatic regeneration was observed. However, no effect was noted on liver functions or bacterial translocation.Publication Risk factors affecting oncological outcomes of surgical resections for middle and lower rectal cancer(Turkish Surgical Assoc, 2023-09-01) Tırnova, İsmail; Işık, Özgen; Yılmazlar, Ahmet Tuncay; Tırnova, İsmail; IŞIK, ÖZGEN; YILMAZLAR, AHMET TUNCAY; Tıp Fakültesi; Genel Cerrahi Ana Bilim Dalı; Kolorektal Cerrahi Bilim Dalı; 0000-0003-4488-1607; 0000-0002-9541-5035; AAW-9602-2020; ISB-9235-2023; T-7494-2017; JOH-0415-2023Objective: In our study, it was aimed to evaluate the factors affecting oncological outcomes in resections for rectal cancer.Material and Methods: Between January 2010 and December 2014, patients with rectal tumors were analyzed retrospectively. Demographic and pathological data and oncological outcomes were analyzed as disease-free survival, overall survival, and local recurrence.Results: A total of 158 patients' data were obtained. Median age was 60 (22-83). Fifty-three patients were older than 65 years of age (138). Ninety-five (60%) patients were males, and 63 (40%) were females. Eighty patients (50.4%) had middle rectal, and 78 (49.6) patients had lower rectal cancer. There was no effect of tumor localization on oncological outcomes. Univariate analyses revealed the effects of age (p= 0.003), operation type (p< 0.001), nodal status (p< 0.001), malignant lymph node ratio (p< 0.001), stage of the disease (p< 0.001), distal resection margin (p= 0.047), perineural invasion (p< 0.001), lymphatic invasion (p< 0.001), venous-vascular invasion (p= 0.025), local recurrence (p< 0.001) and distant metastasis (p< 0.001) on overall survival rates. Univariate analyses revealed the effects of nodal status (p= 0.007), malignant lymph node ratio (p= 0.005), stage of the disease (p= 0.008), perineural invasion (p= 0.004) and venous-vascular invasion (p< 0.001) on disease-free survival rates. Univariate analyses revealed the effects of anastomotic leak (p= 0.015) and venous-vascular invasion (p= 0.001) on local recurrence rates.Conclusion: Older age, advanced nodal status, and distant metastasis were detected as independent risk factors for overall survival. Perineural and venous-vascular invasion were detected as independent risk factors for disease-free survival. Lastly, anastomotic leak and venous-vascular invasion were detected as independent risk factors for local recurrence.Publication Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (eagle): Pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries(Oxford Univ Press, 2023-11-29) Koklucan, A.; İnce, Gülberat; Kural, Said; Sen, M.; IŞIK, ÖZGEN; AKESEN, SELCAN; YILMAZLAR, AHMET TUNCAY; Tıp Fakültesi; 0000-0002-9541-5035; JZU-5283-2024; ISL-1970-2023; DQT-0384-2022; AAW-9602-2020; DAV-0921-2022; ELR-9087-2022; CKK-3621-2022Background: Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks.Methods: The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned.Results: A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31).Conclusion: Completion of globally available digital training by engaged teams can alter anastomotic leak rates.Publication Colorectal cancer surgery in octogenarians(Turkish Surgical Assoc, 2018-01-26) Gülcü, Barış; Yılmazlar, Tuncay; Işık, Özgen; Öztürk, Ersin; Gulcu, Baris; YILMAZLAR, AHMET TUNCAY; IŞIK, ÖZGEN; Öztürk, Ersin; Tıp Fakültesi; Genel Cerrahi Ana Bilim Dalı; 0000-0002-9541-5035; 0000-0002-9754-8755; 0000-0003-1924-0795; 0000-0001-8593-5101; AAW-9602-2020; T-7494-2017; JII-0241-2023; CKK-3621-2022; JGW-0566-2023Objective: The incidence of colorectal cancer becomes higher among octogenarians as the life expectancy increases. Whether advanced age is a risk factor for colorectal surgery is a matter of debate. In the present study, the clinical results of octogenarians who underwent colorectal cancer surgery are discussed to find an answer to this question.Material and Methods: Data of 63 octogenarians who were operated in a tertiary colorectal surgery department between January 1, 2010 and December 31, 2013 were reviewed retrospectively. Demographic data and preoperative, peroperative, and postoperative parameters were evaluated.Results: Overall, 57.2% of the patients were men, The median age was 81 (80-89) years, Cancer was located at the right colon in 17.5%, left colon in 50.2%, and rectum in 31.7%, Eleven patients underwent emergency surgery (17.5%). The most common surgical procedure was low anterior resection m elective (22.2%) and Hartmann's procedure in the emergency setting (9.5%). Stoma creation was more frequent among patients undergoing emergency procedures (42% vs, 6.8%; p=0.0018), Histopathological diagnosis was adenocarcmoma in 90.5% of the patients, and 34.9% of the patients had stage IIIB disease. Surgical morbidity was significantly higher among patients who underwent rectal resection (66% vs, 10.2%; p=0.0124). Medical morbidity was observed in 10 (15.9%) patients, Preoperative blood transfusion was a risk factor for morbidity (83.4% vs, 29.2%; p=0.0170). Length of total hospital stay was 14 (3-39) days, Surgical (p=0.0004) and medical (p=0.0282) morbidity prolonged the length of total hospital stay. The overall mortality rate was 1.6%.Conclusion: Colorectal surgery may be safely performed in octogenarians with acceptable morbidity and mortality in specialized centers.Publication Correlation between ubiquitin e3 ligases (siahs) and heat shock protein 90 in breast cancer patients(Iranian Scientific Society Medical Entomology, 2022-08-01) Takanlou, Leila Sabour; Çeçener, Gülşah; Takanlou, Maryam Sabour; Nazlioglu, Hulya Ozturk; Unlu, Havva Tezcan; Isik, Ozgen; Egeli, Unal; Tunca, Berrin; Çubukcu, Erdem; Tolunay, Sahsine; Gokgoz, Mustafa Sehsuvar; Cecener, Gulsah; ÇEÇENER, GÜLŞAH; Nazlioglu, Hulya Ozturk; ÖZTÜRK NAZLIOĞLU, HÜLYA; Isik, Ozgen; IŞIK, ÖZGEN; Egeli, Unal; EGELİ, ÜNAL; Tunca, Berrin; TUNCA, BERRİN; Çubukcu, Erdem; ÇUBUKÇU, ERDEM; Tolunay, Sahsine; TOLUNAY, ŞAHSİNE; 0000-0002-1928-992X; 0000-0002-3820-424X; 0000-0002-1590-4833; 0000-0002-0910-4258; 0000-0002-9541-5035; 0000-0001-7904-883X; 0000-0002-1619-6680; KGL-6846-2024; AAH-1420-2021; GRE-6268-2022; AAW-9602-2020; GYU-0252-2022Background: Breast cancer is a heterogeneous disease and differences in the expression levels of the ER, PR, and HER2 the triplet of established biomarkers used for clinical decision-making have been reported among breast cancer patients. Furthermore, resistance to anti-estrogen and anti-HER2 therapies emerges in a considerable rate of breast cancer patients, and novel drug therapies are required. Several anomalous signaling pathways have been known in breast cancer have been known; heat shock protein 90 (HSP90) is one of the most plenty proteins in breast cells. The family of ubiquitin ligases such as SIAH1 and SIAH2 is known to specifically target misfolded proteins to the proteasome; also, they have been illustrated to play a role in RAS signaling and as an essential downstream signaling component required for EGFR/HER2 in breast cancer.Methods: The expression of SIAH2, HSP90, and HER2 was assessed by quantitative Real-Time PCR in 85 invasive ductal carcinoma breast tumor samples at Uludag University Hospital in Turkey during the years 2018-2019, and its association with the clinicopathologic variables of patients was evaluated.Results: HSP90, SIAH1, and SIAH2 were significantly (P=0.0271, P=0.022, and P=0.0311) upregulated tumor tissue of patients with breast cancer. Moreover, this study observed a significant association between the high expression of SIAH2/ HSP90 with ER status, high expression of HSP90 with Recurrence/ Metastasis, and high expression of SIAH2 with Ki-67 proliferation index.Conclusion: The HSP90 and SIAH2 expressions play a significant role in breast cancer development by combining the experimental and clinical data obtained from the literature.Publication Long-term results of laser ablation of the tract in the anal fistula: A considerable option in sphincter preservation(Lippincott Williams & Wilkins, 2020-06-01) Işık, Özgen; Gülcü, Barış; Öztürk, Ersin; IŞIK, ÖZGEN; Öztürk, Ersin; Tıp Fakültesi; Cerrahi Ana Bilim Dalı; 0000-0001-8593-5101; IYI-0751-2023; FSN-3324-2022