İstanbul Sağlık ve Teknoloji Üniversitesi Kurumsal Akademik Arşivi
DSpace@İSTÜN, Üniversite mensupları tarafından doğrudan ve dolaylı olarak yayınlanan; kitap, makale, tez, bildiri, rapor, araştırma verisi gibi tüm akademik kaynakları uluslararası standartlarda dijital ortamda depolar, Üniversitenin akademik performansını izlemeye aracılık eder, kaynakları uzun süreli saklar ve telif haklarına uygun olarak Açık Erişime sunar.
Güncel Gönderiler
Clinicopathological features and oncological outcomes in breast cancer presenting with nipple discharge
(Springer Nature Link, 2026) Mollavelioğlu, Baran; Özgen, Atılay; Özgen, Ecem Hazal; Bender, Ömer; Balcı, Fatih Levent; Erözgen, Fazilet; Emiroğlu, Selman; Tükenmez, Mustafa; Yılmaz, Ravza
Background Nipple discharge may indicate subareolar or nipple–areola complex (NAC) involvement in nipple discharge-associated breast cancer, which has important implications for surgical planning and prognosis. This study aimed to analyze the clinicopathological features, radiological findings, and oncological outcomes of breast cancer patients presenting with nipple discharge. Methods Patients who presented with nipple discharge and underwent surgery with a histopathological diagnosis of breast cancer between January 2005 and January 2020 at three tertiary referral centers were retrospectively reviewed. Demographic, clinical, radiological, and pathological data were collected. Demographic, clinical, radiological, and pathological data were retrospectively collected. Results A total of 205 patients were included. Of those, 71.8% presented with bloody discharge. Most patients had early-stage disease (pTis/T1: 78.8%). Overall, pathological NAC involvement was identified in 26.5% of cases, whereas it was estimated as 34.5% in mastectomy cases, and 60% in patients with MRI-suspicious find ings and 48.7% in those with a non-luminal pathology. MRI demonstrated the highest diagnostic accuracy (AUC 0.756, p < 0.001) for detecting NAC involvement independent predictors of NAC involvement were non-luminal subtype (OR 3.15, 95% CI, p = 0.004) and retroareolar mass (OR 2.57, 95% CI, p = 0.012). At a median follow-up of 68 months, locoregional and distant recurrence rates were 2.9% and 9.3%, respectively. No significant differ ences in disease-free or disease-specific survival were observed between patients undergoing breast-conserving surgery and those treated with mastectomy, or between patients with and without NAC involvement. Lympho vascular invasion and nodal positivity were associated with reduced DFS. Conclusion Breast cancers associated with nipple discharge are most often diagnosed at an early stage. Careful clinical and radiological evaluation of nipple–areola complex (NAC) involvement is essential in these patients due to the high NAC involvement in clinical and imaging suspicious cases and aggressive tumor biology. When NAC involvement is excluded, breast-conserving surgery and nipple-sparing mastectomy can be considered in appropriately selected patients, with comparable oncological outcomes.
Uterus-preserving laparoscopic lateral suspension provides durable anatomical and functional success in apical pelvic organ prolapse: Long-term results from a single-center study
(Via Medica, 2026) Şahin, Turan; Tekin, Arzu Bilge; Şahin, Hanifi; Tuğ, Niyazi; Perkyürek, Şahin; Doğan, İlker Orhan
Objectives: To evaluate the long-term anatomical, functional, and patient-reported outcomes of uterus-preserving laparoscopic lateral suspension (LLS) in women with apical pelvic organ prolapse (POP). Material and methods: This retrospective cohort study included 98 women with symptomatic apical POP who underwent uterus-preserving LLS between January 2018 and December 2021 at a single tertiary center. All patients had at least 24 months of follow-up (mean: 40.6 ± 10.8 months). Anatomical outcomes were assessed using the POP-Q system, functional outcomes with POP-SS, P-QOL, M-ISI, and FSFI, and patient satisfaction with the PGI-I scale. The primary endpoint was composite clinical success, defined as anatomical success (POP-Q stage 0–1 in all compartments), absence of reoperation, and a positive PGI-I response. Results: The mean age was 48.1 ± 10.5 years, mean BMI was 27.0 ± 3.5 kg/m², and 42.9% were postmenopausal. Concomitant procedures were performed in 44.9% of cases. At long-term follow-up, significant improvements were observed in all POP-Q points (Ba from 0.6 to –3.4 cm, C from 0.3 to –2.5 cm, and Bp from –1.7 to –3.6 cm; all p < 0.001). POP-SS, P-QOL, and M-ISI scores improved markedly (all p < 0.001). FSFI showed significant improvement in the pain domain. Composite clinical success was achieved in 93.9% of patients, with anatomical success rates of 98.0% (apical), 98.0% (anterior), and 96.9% (posterior). Patient satisfaction was high, with 96.9% reporting “very much better” or “much better” on PGI-I. Reoperation was required in 3.1% of cases. Intraoperative complications included bladder injury (2.0%) and bleeding requiring transfusion (1.0%). Late complications were rare, with mesh exposure in 2.0% and dyspareunia in 3.1%. Conclusions: Uterus-preserving LLS provides durable long-term anatomical and functional success, high patient satisfaction, and low complication rates, representing a safe and effective alternative to sacrocolpopexy in the surgical management of apical POP.
Effect of power arm length and attachment configuration on maxillary molar mesialization with clear aligners: A finite element analysis
(BioMed Central, 2026) Çavuşoğlu, Ahmet; Erdem, Buket
Background Maxillary molar mesialization with clear aligners is challenging because achieving controlled root movement without excessive mesial tipping remains difficult. Although power arms can modify the force system, the combined effects of power-arm length and attachment configuration on molar displacement and tipping remain insufficiently characterized. This study evaluated the effects of 6-, 8-, and 10-mm power arms combined with two attachment configurations during maxillary first molar mesialization using three-dimensional finite element analysis. Methods The attachment configurations were selected to represent two clinically distinct approaches to integrating a vertical attachment with a power arm: a palatal vertical attachment combined with a buccal cut-out and a buccal vertical attachment with direct power-arm integration. Six three-dimensional finite element models were constructed by combining three power arm lengths (6, 8, and 10 mm) with two attachment configurations: a palatal vertical attachment with a buccal cut-out, and a buccal vertical attachment without a cut-out. A mesial force of 200 g was applied from a temporary anchorage device (TAD) to the power arm. Displacements were measured along the X (bucco–palatal), Y (mesio–distal), and Z (occluso–gingival) axes. Peak von Mises stress values in the periodontal ligament and aligner deformation were evaluated. Results In all models, maxillary first molar displacement occurred predominantly in the mesial and gingival directions. Mesial crown displacement ranged from 0.068 to 0.074 mm, while distal displacement at the root apex ranged from 0.011 to 0.012 mm. Mesial tipping angles ranged from 0.155° to 0.170°, with higher tipping observed in models with shorter power arms. Increasing power arm length was consistently associated with reduced mesial tipping and lower periodontal ligament stress, but with reduced mesial crown displacement. Shorter power arms generated higher periodontal ligament stress, whereas longer power arms were associated with greater aligner deformation. Conclusions Power arm length and attachment configuration were associated with differences in initial tooth displacement patterns, periodontal ligament stress distribution, and aligner deformation during maxillary first molar mesialization with clear aligners. Longer power arms were associated with reduced mesial tipping and lower periodontal ligament stress, but also with reduced mesial crown displacement. The buccal vertical attachment configuration consistently produced lower mesial rotation than the palatal vertical attachment with buccal cut-out configuration at each corresponding power-arm length; this difference should be interpreted as a configuration dependent finding within the initial biomechanical response.
Electrophoretic approaches for investigating plant-derived compound interactions with dna and proteins
(Wiley, 2026) Aydemir, Zeynep; Kaya, Beril Sena; Bakırcı, Meysera; Al Faysal, Abdullah; Kalaycıoğlu, Zeynep; Gölcü, Ayşegül
Plant-derived compounds are increasingly recognized as promising therapeutic agents due to their broad biological activities and structural diversity, making their interactions with DNA and proteins central to understanding mechanisms of action and guiding drug discovery. Electrophoretic techniques probe these interactions by tracking changes in electrophoretic mobility, conformation, complex formation, and biopolymer integrity. This review surveys electrophoretic strategies for characterizing plant-derived compound-DNA and -protein interactions, covering fundamental DNA-binding modes (intercalation, groove binding, electrostatic association, cleavage), representative phytochemicals and extracts, and analytical challenges of complex plant matrices, including chemical heterogeneity, synergistic and antagonistic effects, and active-constituent identification. Particular attention is given to capillary electrophoresis-based approaches (affinity CE, CE, and pressure-assisted frontal analysis) and gel-based methods (agarose gel electrophoresis, native PAGE, SDS-PAGE). The literature shows capillary electrophoresis excels at quantifying binding affinity, stoichiometry, and specificity, whereas gel electrophoresis better visualizes ligand-induced changes in DNA topology and protein behavior. HSA and BSA dominate as model proteins, while advanced methods remain underapplied to chemically complex extracts, gaps pointing toward broader protein targets and natural-product systems. Integrating mass spectrometry, advanced detection, and data-driven approaches could further strengthen the mechanistic and quantitative reach of electrophoretic analysis in this field.
Quantifying controller preference reliability under uncertainty in a rotary inverted pendulum benchmark
(Springer Nature Link, 2026) Coşkun, Yusuf; Özyılmaz, Lale; Aydın, Muhammet
Simulation-based controller comparisons can report a single winner even when score differences are too small to justify a unique engineering preference. We assessed preference reliability for five fixed controllers on a numerically verified nonlinear rotary inverted pendulum model using two independent Latin-hypercube realizations across matched ± 10%, ± 15%, and ± 20% uncertainty bands (30,000 closed-loop simulations). A four-metric score and a prespecified 5% practical margin quantified controller separation. Under the common uncertainty score, PID had the lowest controller robustness index in every band, but the four leading indices remained within 3.87%. In the pooled ± 15% domain, all ten paired comparisons were detectable after Holm correction, yet 69.40% of 2,000 scenario blocks lacked a unique practical preference. PID retained rank one in 99.95% of paired-bootstrap replicates but only 63.16% and 43.06% under two weight-variation analyses. Post-review sensitivity analyses showed that the principal practical-separation conclusion was robust to the tested CRI coefficient, realization-specific median normalization, and heavier-tail dependence models, while command delay altered separation among near-tied controllers. These findings are specific to the fixed control ler portfolio, score definition, RIP model, and simulated uncertainty domain.
