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Biomedical subjects

A Akdaş

Publications and source records attributed to A Akdaş.

At least 19 recordsLinked to original sources

The cost and availability of therapeutic options in advanced prostatic carcinoma in Turkey.

Advanced prostatic carcinoma may be treated by a variety of methods of endocrine manipulation which affect the production of androgens. This can either be done by bilateral orchiectomy or by a number of drugs. Orchiectomy has two advantages: low cost and being a once-only procedure. This report outlines the costs of various methods of hormonal treatment and compares them with each other in Turkey.

Androgen Antagonists

Transurethral ultrasonography, fiberoptic cystoscopy and bladder washout cytology in the evaluation of bladder tumours.

The impact of transurethral ultrasonography, fiberoptic cystoscopy and bladder washout cytology on assessment of bladder tumours was investigated in this study. Transurethral ultrasonography had an accuracy rate of 96.5% in diagnosing and staging bladder tumours. The accuracy rates of fiberoptic cystoscopy and washout cytology were 90.9% and 73.7%, respectively, in diagnosis. The efficacy of transurethral ultrasonography was found to be high enough for routine employment in the evaluation of the bladder tumours. Fiberoptic cystoscopy in conjunction with washout cytology as a combination relatively easy to perform can be used especially for follow-up purposes of the bladder tumours.

Carcinoma in Situ

Efficacy of prophylactic gentamicin use in postoperative urinary tract infections after endoscopic procedures of the urinary tract.

In this study, the efficacy of prophylactic antibiotic use was investigated. A total of 110 patients undergoing endoscopic procedures of the urinary tract were enrolled in the study. Fifty-five of the patients were treated with 8-hourly, 80 mg gentamicin sulfate of total three doses. The drug administration began just prior to the operation. Seven postoperative infections (12.7%) were detected, the same number as in the control group of 55 patients. The results confirm that there is no place for gentamicin prophylaxis in endoscopic procedures of the urinary tract.

Cystoscopy

The impact of squamous metaplasia in transitional cell carcinoma of the bladder.

The authors report a case of squamous cell carcinoma of the bladder induced by radiation therapy for transitional cell carcinoma, possibly from sites of squamous metaplasia, which were present at the time of initial diagnosis. Although data in the literature are not sufficient at the moment in terms of implication on prognosis, foci of squamous metaplasia during the initial diagnosis of transitional cell carcinoma must be carefully sought and their presence warrants caution in utilizing irradiation in the management of the disease.

Aged

Serum and urine levels of tumour necrosis factor in patients with genitourinary cancer and their relevance to disease status.

Serum and urine levels of tumour necrosis factor (TNF) which is a lymphokine was measured in patients with genitourinary cancer (either prostatic, bladder or testicular carcinoma) in order to find out whether there were elevated levels of TNF in those patients and if it was related to disease status. Although the preliminary results are not conclusive, further research on TNF may prove this immunoprotein to be a potential diagnostic and therapeutic agent.

Biomarkers, Tumor

Current approaches in the treatment of bladder cancer and policy in Marmara University Hospital.

Bladder cancer is one of the malignancies encountered frequently in urologica practice. Since the three main treatment modalities (surgery, chemotherapy and radiotherapy) may be used alone or together, there are many treatment options. In this paper the current approaches in the treatment of bladder tumours are reviewed and the policy in Marmara University Hospital is described.

Combined Modality Therapy

Ectopic production of human chorionic gonadotropin in transitional cell carcinoma of the bladder. An immunohistochemical study.

A retrospective histopathological and clinical analysis of 43 patients with transitional cell carcinoma of the bladder, attending our institution between March 1986 and April 1989, was performed. The indirect immunoperoxidase method was used for the demonstration of human chorionic gonadotropin production in transitional cell carcinoma cells. Nine of the 16 grade III tumors stained positive for human chorionic gonadotropin, while grade I and grade II tumors remained unstained. Our results suggest that the presence of human chorionic gonadotropin in tumor cells is a strong evidence of dedifferentiation, and its association with patient prognosis needs further investigation, especially in high-grade, low-stage tumors.

Aged

Epidemiological case-control study on the etiology of bladder cancer in Turkey.

A case-control study of 194 patients with bladder cancer and the same number of age- and sex-matched hospital controls were interviewed to estimate the role of various factors on the etiology of bladder cancer in Turkey. There was a significant difference between the case and control groups on cigarette smoking (p less than 0.001), alcohol intake (p less than 0.001), Turkish coffee consumption (p = 0.01), and artificial sweeteners (p less than 0.05). The risks for alcohol and tobacco users increased in correlation with the duration of exposure. The risk of bladder cancer increased directly with the quantity and frequency of alcohol intake. Alcohol and coffee drinking was found to be a promoting factor when adjusted to smoking habits (p less than 0.05). No statistical comparisons could be made to clarify the risks attributed by occupation and place of residence due to small figures in each group. However, in farmers, there was a significant difference between the cases and controls on the use of artificial fertilizers and insecticides (p less than 0.01). People who were exposed to unspecified chemical substances were more prone to develop bladder cancer (p less than 0.001). We conclude that both personal habits and exogenous carcinogens play a role in the etiology of bladder tumors.

Adult

Present status of undergraduate urological education in Turkey: is standardization necessary?

23 medical faculties exist in Turkey at the moment and 2 others are being established. Considering that all these faculties run their own programs independently, different education systems might effect the standard of doctors and health care. All of the new graduates in this country face a centralized examination for postgraduate posts in teaching hospitals or start an obligatory service under the authority of the Ministry of Health and Social Welfare. This necessitates standardization in medical education to provide equal facilities and opportunities to all young doctors. Questionnaires, replied to by the urology departments of medical faculties, reflect a wide range of teaching periods in urology with a broad spectrum of topics. Under these circumstances it is advisory to agree on both the time period and content of a standard urology program, as well as other subjects, for better health care and equal chances in centralized examinations.

Curriculum

Urethral caruncle in an unusual location occurring in prepubertal girl.

Urethral caruncles are the most frequent benign tumors of the female urethra; the great majority occur after the menopause. Caruncles in prepubertal girls are quite rare and location other than the posterior lip of the urethra is quite rare too. In this paper we report a case with these rare properties.

Child

Bladder agenesis.

Agenesis of the bladder is an extremely rare anomaly with only approximately 40 such cases reported in the literature. We report on a 30-year-old female patient who also had right renal agenesis.

Abnormalities, Multiple

Unusual metastases of renal cell carcinoma.

The case of a 55-year-old white male with recurrent metastases in the oral cavity and maxillary sinuses, as well as other organs, is presented. Local excision of the lesions, hormonal treatment and palliative measures for other metastases were used. The patient is alive 10 years after the initial diagnosis.

Carcinoma, Renal Cell

Association between HLA antigens and bladder tumors.

HLA antigen type was studied in 55 patients with transitional cell carcinoma of the bladder. The results showed high HLA-B5 and low HLA-BW35 frequencies. Histological grade, stage, and recurrence rate of tumors were also evaluated separately. The results were more significant in recurrent tumors.

Adult

The role of delay in stage III testicular tumours.

Twenty-nine patients with stage III testicular tumours seen between 1979 and 1984 were analysed for the relation between delay in both diagnosis and chemotherapy, and prognosis. The complete response (CR) rate was 40% for patients who were treated within 6 months from onset of symptoms, and 26.3% for patients who had an interval longer than 6 months. We believe that delay in diagnosis and chemotherapy may affect the response to treatment. Health education of the male population for self-examination of the testes is an important factor to minimize this delay.

Antineoplastic Combined Chemotherapy Protocols

The effect of ergobromocriptine on serum testosterone and prolactin levels in patients with carcinoma of the prostate.

The effect of Ergobromocriptine treatment on serum testosterone and prolactin levels in 15 patients with prostatic carcinoma and 15 patients with benign prostatic hyperplasia was examined. The prolactin levels which were elevated in patients with prostatic carcinoma showed a significant decrease after suppression with Ergobromocriptine. The selective effect of Ergobromocriptine on prolactin levels of patients with prostatic carcinoma may control the progression of the disease.

Adult

Prognostic factors in superficial bladder cancer.

A retrospective analysis of 91 patients with superficial transitional cell carcinoma (stages Ta and T1) is reported. In all of the patients transurethral resection was the treatment of choice. With the recurrence rate as the primary endpoint of interest it appeared that the number of tumours at presentation, invasion of the lamina propria, and histological grade were to be of prognostic importance. The frequency of tumour progression in our group was found to be 10 per cent. All of the patients who developed muscle invasion had lamina propria invasion at presentation.

Adult