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Öğe THE EFFECT OF ADIPOSE TISSUE STROMAL VASCULAR FRACTION COMBINED WITH PLATELET-RICH PLASMA ON IRRADIATION-INDUCED CAPSULAR CONTRACTURE AROUND SILICONE IMPLANTS(Medknow Publications & Media Pvt Ltd, 2014) Gundeslioglu, Ayse Ozlem; Inan, Irfan; Tezcan, Yilmaz; Toy, Hatice; Emlik, Dilek; Aktan, Murad; Duman, SelcukThe exact reason and pathogenesis of capsule formation around breast implant after cosmetic and reconstructive breast enhancement is still unclear. However, recent studies and clinical observations regarding the application of adipose-derived mesenchymal stem cells around implanted biomaterials have shown encouraging results. In this study, the effects of the adipose-derived stromal vascular fraction combined with platelet-rich plasma on capsule formation around silicone implants were investigated in irradiated rats. After implantation of silicones implants bilaterally on the rat dorsal area, both sides were irradiated with 10-Gy as single fraction electron beam irradiation. Following radiation, the mixture of stromal vascular fraction and platelet-rich plasma was injected to right sides of the animals. Left sides were injected with same amount of saline as a control. On day 30, capsule around the implants was evaluated in regarding the capsular thickness by ultrasonography, histopathology and immunohistochemical examination. The results demonstrated that there is no statistically significant difference between the treated and non-treated groups in ultrasonographic, histopathologic, and immunohistochemical evaluations. These preliminary results demonstrated that adipose-derived stem cells with platelet rich plasma do not have efficiency for integration of tissue and silicone implants and to reduce capsule formation and further studies are requiredÖğe Outcomes of reirradiation in the treatment of patients with multiple brain metastases of solid tumors: a retrospective analysis(Ame Publ Co, 2015) Aktan, Meryem; Koc, Mehmet; Kanyilmaz, Gul; Tezcan, YilmazBackground: Patients with multiple brain metastases are often treated with whole brain radiation therapy (WBRT). Second course of WBRT is an important treatment option for patients with clinical or radiological intracranial disease progression. This study examines the outcomes in patients with multiple brain metastases who underwent reirradiation. Methods: We examined the medical records of 34 patients with multiple brain metastases who were treated WBRT. The median dose for the first course of WBRT was 30 Gy (range, 25-30 Gy) and for the second course 25 Gy (range, 20-30 Gy). Statistical analyses were performed with using Cox regression analyses, log-rank test and Kaplan-Meier method. Results: The median Karnofsky performance status (KPS) was 80 (range, 50-100) before reirradiation. Patients with KPS of >70 had a median survival of 11.4 months, compared to 2.2 months with KPS of <= 70 (P=0.012) and patients who have severe symptoms at the time of reirradiation with median survival 2.2 months while those with mild symptoms had a median of 4.8 months survival (P=0.08). The median overall survival for all patients after diagnosis of metastases was 24.7 months, after the re-irradiation WBRT (re-WBRT) it was 5.3 months (95% CI, 4.08-6.62) and from the diagnosis of primary tumor was 27.1 months (95% CI, 17.75-37.04). Conclusions: In select patients who have good performance status and who do not have severe symptoms might benefit from re-WBRT and re-WBRT seems to be associated with minimal toxicity in patients treated with lower palliation doses.