Biomedical subjects

Ahmet Kiper

Publications and source records attributed to Ahmet Kiper.

5 recordsLinked to original sources

PubMed2006

The prognostic importance of prostate specific antigen in the monitorisation of patients undergoing maximum androgen blockade for metastatic prostate cancer.

INTRODUCTION: The changes in serum prostate specific antigen (PSA) concentrations can be used as a prognostic factor in patients undergoing maximum androgen blockade for metastatic prostate cancer. MATERIAL AND METHOD: A total of 149 patients followed up in our department were classified into 4 groups on the basis of PSA changes: group 1; those with normalisation of PSA levels within the first 3 months, group 2; those with normalisation PSA between months 3 and 6, group 3; those with a decrease in PSA but not reaching normal range, group 4; those with no decrease. The gleason scores and the number of bone metastases were also compared between the groups. RESULT: The time to progression was significantly delayed in group 1 (mean: 23.3 months) compared to those with group 2 (mean: 16.9 months) (P<0.02). The time to progression in group 3 (mean: 8.45 months) was significantly shorter compared to the first two groups (P<0.001). Also, in patients with gleason scores 5-7 (grades 2) and gleason scores over 7 (grade 3) and group 1, the time to progression (mean: 21.2 months) was significantly delayed compared to those with the same gleason scores but with group 2 (mean: 13.4 months) (P<0.001). CONCLUSION: The decrease in PSA level is more important than gleason scores in determining the time to progression. Early normalisation of PSA delays the time to progression, and when combined with gleason scores, PSA is an important prognostic factor in predicting the success of the therapy.

Aged↗

PubMed2005

The prognostic importance of prostate-specific antigen in monitoring patients undergoing maximum androgen blockage for metastatic prostate cancer.

The changes in serum prostate-specific antigen (PSA) concentrations can be used as a prognostic factor in patients undergoing maximum androgen blockage for metastatic prostate cancer. A total of 149 patients followed in our department were classified into 4 groups on the basis of PSA changes: group 1, those with normalisation of PSA levels within the first 3 months; group 2, those with normalisation of PSA between months 3 and 6; group 3, those with a decrease in PSA, but not reaching normal range; group 4, those with no decrease. The gleason scores and the number of bone metastases were also compared between the groups. Again time to progression in patients with Gleason scores 5-7 (grade 2) and over 7 (grade 3) whose PSA levels decreased between first and 3rd months (mean 21.2 months) were significantly longer than the patients with same gleason scores whose PSA levels decreased between 3rd and 6th months (mean 13.4 months) (p< 0.001). The decrease in PSA level is more important than gleason scores in determining the time to progression. Early normalisation of PSA delays the time to progression and when combined with gleason scores, PSA is an important prognostic factor in predicting the success of the therapy.

Aged↗

PubMed2005

Rib resection for live-donor nephrectomy.

INTRODUCTION: Living-related kidney transplants yield more favorable results than cadaveric kidney transplant. Although multiple techniques have been described for living-related donor nephrectomy, operation is generally performed subcostally in lateral decubitis position or by an 11th or 12th rib resection. Recently laparoscopic donor nephrectomy is getting popular. The aim of this study is to determine the rib resection increase the morbidity or not. MATERIALS AND METHODS: Between 1997 and 2004 in our center 118 living donor nephrectomies were performed. 15 of these patients did not come to follow-up controls. This study consists of 103 patients: 11th rib resection (30 patients) determined as group I, 12th rib resection (52 patients) determined as group II, subcostal incision (21 patients) determined as group III. All these three groups were compared with each other according to operation time, pleural or peritoneal defect, pneumothorax, blood transfusion, wound infection, length of hospital stay, postoperative analgesic requirement, return to threshold activities and incisional hernia. RESULTS: Patients whose 11th rib was removed had the shortest operation time. But pain due to surgery continued more than others in this group of patients. The risk of developing incisional hernia was seen most in patients who had subcostal incision. In this group of patients incidence of incisional hernia was 4 (19%). None of the patients had wound infection. We also did not experience any pneumothorax and blood transfusion requirement. Peritoneal or pleural opening occurred in 4 out of 103 patients accidentally and there was no difference between groups. There was also no difference between groups in terms of returning back to daily activation. CONCLUSION: Morbidity of nephrectomy done with removal of 12th rib was less compared with other groups. Resection of 11th should be reserved for patients with high residing kidneys and also for those with a polar artery of the upper pole.

Adult↗

PubMed2005

The comparison of artificial urinary sphincter implantation and endourethral macroplastique injection for the treatment of postprostatectomy incontinence.

OBJECTIVES: To compare the effectiveness of macroplastique injection with artificial urinary sphincter implantation (AUS) for treatment of postprostatectomy incontinence (PPI). METHODS: A prospective randomized clinical trial including 45 patients with PPI was performed secondary to radical retropubic prostatectomy (RRP), transvesical prostatectomy (TVP), transurethral prostatectomy (TURP), and TURP with TVP, in 12, 16, 16, 1 patients respectively. Patients were divided into two groups as minimal (group I) and total incontinence (group II) according to the severity of incontinence. Respectively, Group I (n = 21) and group II (n = 24) patients were randomized as AUS implantation (n = 11, n = 11) and macroplastique injection (n = 10, n = 13). Follow-up period was 48 (6-84) months in patients with macroplastique injection and 60 (8-120) months in AUS implantation. The success of the treatment was evaluated by calculating the average number of pads used by the patient per day, the weight of the pads and score of quality of life survey scale for each group both in the preoperative and in the postoperative period. RESULTS: There were statistically significant differences between preoperative and postoperative average pad weight, average number of pads and quality of life scores, both in patients with minimal and total incontinence. In group I there was no statistically significant difference between the two techniques. However, in group II there was a significant difference favoring AUS implantation. CONCLUSIONS: Endourethral injection should be the treatment of choice for patients with minimal incontinence, whereas AUS implantation as the first choice for patients with total incontinence.

Aged↗

PubMed2005

Subureteral dextranomer/hyaluronic acid copolymer injection for vesicoureteral reflux in transplant candidates.

BACKGROUND AND PURPOSE: Endoscopic subureteral injection of tissue-augmenting substances has become an alternative to antibiotic prophylaxis and open surgery for the management of vesicoureteral reflux (VUR). Several injectable materials have been tried for this purpose. In this study, we tried to determine the efficacy of dextranomer/hyaluronic acid copolymer (Dx/HA) injection for the treatment of VUR in renal-transplant candidates. PATIENTS AND METHODS: A total of 21 transplant candidates (29 ureteral units; 13 females, 8 males) with a mean age of 20.2 years (range 14-26 years) underwent endoscopic correction of VUR with Dx/HA. Diagnosis of VUR was made by voiding cystourethrography. The efficacy of the treatment was assessed with voiding cystourethrography at 3 months and 1 year postoperatively. Renal transplantation with living related donor organs was performed in 11 of the 21 patients. RESULTS: Endoscopic treatment was performed without complication in all cases. Higher success rates were obtained in patients with low-grade reflux, the overall success rate in the series being 82.7%. The mean follow- up after renal transplantation was 21.8 months (range 5-45 months). In one patient, reflux recurred after renal transplantation and was treated successfully by a repeat Dx/HA injection. The urine cultures of all patients remained sterile. CONCLUSION: Transplant candidates with VUR can be treated with Dx/HA, which cured the majority of our patients after one or two treatments with few low side effects. Endoscopic subureteral injection of Dx/HA has become an alternative treatment for VUR in transplant candidates. Long-term results are needed before making a final statement about its value.

Administration, Intravesical↗