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Biomedical subjects

H A Ozen

Publications and source records attributed to H A Ozen.

At least 19 recordsLinked to original sources
PubMed1995

Sequential bilateral germ cell tumours of the testis.

Bilateral germ cell tumours of the testis are rare but a rise in their incidence is expected since with the new therapeutic possibilities a significant improvement in prognosis has been achieved even in patients with advanced metastatic spread. Of the 210 patients treated for malignant germ cell tumours at our Department, six (2.9%) developed a contralateral testicular tumour. All patients had metachronous tumours and the second tumours occurred after an interval ranging between 1 and 22 years. The epidemiology, histology, diagnosis, therapy and prognosis are discussed, and the significance of regular self-examination of the remaining testis in patients with testicular tumour is emphasized.

Adult↗
PubMed1994

Postchemotherapeutic surgery for metastatic testicular germ cell tumors: results of extended primary chemotherapy and limited surgery.

OBJECTIVE: Postchemotherapy surgery has become an increasingly important treatment for residual masses in germ cell tumors of the testis. However, it is still a challenge to find the optimal combination of chemotherapy and surgery for better survival and cure rates with lowest morbidity. This study evaluated the effectiveness of extended chemotherapy followed by surgery resecting only the residual masses. METHODS: After an extended course (one or two additional courses after there is no decrease in tumor size and/or after the normalization of tumor markers) of combination chemotherapies with cisplatin-based regimens, 32 patients underwent surgery for metastatic germ cell tumors of the testis. Complete excision of radiologically determined residual masses and macroscopically suspicious neighboring nodes was performed rather than a conventional retroperitoneal lymph node dissection. RESULTS: Histopathologic examination of the resected specimens revealed teratoma in 17 (55%), fibrosis and/or necrosis in 9 (26.5%), and active residual tumor in 8 (23.5%) of the patients. The patients with residual tumor have been treated with additional chemotherapy. In the follow-up (mean, 28.5 months) 4 patients have relapsed, and 1 died. None of the patients with residual teratomas have shown relapse. Only 1 of the 32 patients has had retrograde ejaculation. CONCLUSIONS: A more conservative approach, such as excision of the residual masses after an extended course of chemotherapy, has given excellent results both in the outcome of the patients in the follow-up and in the rate of retrograde ejaculation. We therefore suggest that this approach would be a good alternative to nerve-sparing surgery following chemotherapy.

Adult↗
PubMed1993

Bleomycin lung toxicity detected by technetium-99m diethylene triamine penta-acetic acid aerosol scintigraphy.

In this study we investigated bleomycin-induced pulmonary toxicity in patients with germ-cell tumour by means of technetium-99m diethylene triamine penta-acetic acid aerosol scintigraphy. Twenty untreated patients who had no clinical or radiological evidence of pulmonary disease received four courses of etoposide, cisplatin and bleomycin chemotherapy. Aerosol lung scintigraphy and pulmonary function tests were performed in all patients before bleomycin treatment and after administration of 180 and 360 mg bleomycin. On the basis of the scintigrams the percentage decline in activity per minute (Kep) was evaluated, which represented an accurate parameter of lung membrane permeability. Pretreatment Kep values (0.891 +/- 0.286) were significantly lower than those obtained following 180 and 360 mg bleomycin treatment (1.176 +/- 0.336 and 1.389 +/- 0.477, respectively; P < 0.0005). The Kep values obtained with 180 and 360 mg bleomycin treatments were also significantly different (P < 0.005). In contrast, no significant change was observed in the results of pulmonary function tests. Our results demonstrate that evaluation of the pulmonary clearance of 99mTc-DTPA represents a useful means of monitoring the functional status of the lung epithelial membrane during bleomycin treatment. Further prospective studies are needed to assess the relationship between increase in permeability and development of lung toxicity in order to decide which patients should discontinue bleomycin therapy.

Adult↗
PubMed1993

Intravesical ureteric plication and reimplantation for megaureters in children.

Historically, megaureters have always been a surgical dilemma for paediatric urologists. However, the evolution of modern diagnostic and surgical methods such as tailoring, folding and plication have made it possible to ensure successful correction in most patients. We report 17 megaureters (11 refluxing and 6 obstructing) in 11 children who were treated with intravesical plication and the trans-trigonal advancement technique between January 1986 and April 1991. Results were excellent in 11 ureters and satisfactory in 4. In one ureter additional surgery was needed because of obstruction at the implantation site and in another ureter reflux persisted. Intravesical plication and reimplantation is a good alternative procedure for grossly dilated ureters owing to its low morbidity and high success rate.

Child↗
PubMed1993

Calculi in a blind-ending limb of a duplicated ureter.

An unusual case with a blind-ending ureteral duplication containing stones is reported. A patient who had undergone two consequent unsuccessful operations attempted to extract a lower ureteral stone was later found to have the missing stone in the blind-ending branch of a duplicated ureter. The clinical significance of such malformation is discussed in light of the literature.

Adult↗
PubMed1991

Immunohistochemical detection of beta-human chorionic gonadotropin in urothelial carcinoma.

Histologic sections from the specimens of 60 patients with urothelial carcinoma were stained immunohistochemically to search for beta-human chorionic gonadotropin (B-HCG) production. There were 6 doubtful, 5 weak and 1 strong positive B-HCG stainings among 65 sections from 60 patients. De novo acquisition of B-HCG production capability of tumour cells seemed to be predictive for early haematogenous dissemination of the disease, but the data obtained in this particular study were insufficient to suggest B-HCG as a routine prognostic marker.

Biomarkers, Tumor↗
PubMed1991

The fate of contralateral ureter after ipsilateral reimplantation in unilateral vesicoureteric reflux.

Four patients out of 23 girls and 7 boys who were treated by successful ureteroneocystostomies for unilateral reflux had postoperative contralateral reflux (13.33%). Three of these 4 refluxing ureters resolved with medical treatment. A second surgery was needed in only 1 case (3.33%) who did not respond to medical treatment. There was no correlation between the preoperative severity of ipsilateral reflux, intravenous urography findings and the onset of contralateral reflux after unilateral reimplantations. Data from this study and previous works indicated that bilateral reimplantations are not warranted for unilateral refluxing renal units unless there are position and shape anomalies at the ureterovesical angle and a very careful preoperative evaluation of the patients is mandatory in this regard.

Child↗
PubMed1991

Histopathological pattern in prostatic adenocarcinomas: is it a prognostic criterion?

A total of 152 patients with prostatic carcinoma were evaluated retrospectively. Sections prepared from paraffin blocks were examined and all cases were scored according to the Gleason grading system. Prostatic adenocarcinomas were categorized into 3 different groups of histopathological patterns; acinar, ductal and mixed. The relationships between histopathologic pattern and symptoms, clinical findings, clinical stage, Gleason scores and local or systemic progression were investigated. It was found that patients with mixed pattern tumours presenting at later stages with more severe symptoms of prostatism had higher Gleason scores and higher progression rates compared to patients with tumours having acinar pattern.

Adenocarcinoma↗
PubMed1991

Correlation between intracavernous papaverine injection, Doppler analysis and cavernosography in impotent patients.

Forty-four patients with impotence were evaluated by intracavernous papaverine injection, penile brachial index (PBI) determination and dynamic cavernosography. The correlation between these diagnostic procedures and their diagnostic value were investigated. It was concluded that the papaverine test is an efficient diagnostic procedure and can be used as the first step for the routine work-up of impotent patients.

Erectile Dysfunction↗
PubMed1990

The effect of post-pubertal varicocele on testicular volume.

Paediatric varicocele is a well known entity but its effect on adult infertility has not been adequately clarified. Since measurement of testicular volume is currently the best method of estimating the male reproductive potential, 945 boys aged between 13 and 18 years were examined with regard to testicular volume and the incidence of varicocele. The average volumes for right and left testes were 15.087 +/- 0.237 and 14.514 +/- 0.347 ml respectively, and the incidence of varicocele was 16.7%. The incidence increased from 14.5 to 21.7% as the ages increased from 14 to 18. The differences in volume of the 2 testes in boys with varicocele were statistically significant when compared with the normal group, but this significance failed to become more pronounced when the slight varicocele group (grade I) was included with the normal group and compared with the severe varicocele group (grades II and III). There may be no significant differences between the volumes of the 2 testes in boys with varicocele when careful measurement and strict statistical analyses are applied. However, some boys in the varicocele group were found to have testicular volumes below the confidence interval (mean - SE) or under 1 SD, and the 2 testicular volumes differed in certain age groups. This group requires further follow-up. The results of this study have added further contradictory findings to the issue of paediatric varicocele in terms of testicular atrophy, estimation of potential fertility and the indications for immediate surgery. There is a need for further prospective controlled trials.

Adolescent↗
PubMed1990

DMSA renal scanning versus urography for detecting renal scars in vesicoureteral reflux.

32 children admitted to Hacettepe University Hospital for surgical treatment of vesicoureteral reflux (VUR) between 1987 and 1988 were included in this prospective double-blind study. All patients underwent intravenous urography (IVU), voiding cystouretrography and 99mTc DMSA renal scanning. The sensitivity and specificity of the DMSA scan and IVU for detecting renal scarring were investigated. With regard to the presence of renal scarring, the sensitivity and specificity of IVU and DMSA were not found to be statistically different. But when the scars were scored, DMSA was found to have a higher scoring index compared to IVU. In patients who were candidates for surgical management of VUR, renal scars could be detected both by IVU and DMSA scan but, for the follow-up, the DMSA scan was found to be the investigation of choice.

Adolescent↗
PubMed1987

Scope and limitations of the MAGPI hypospadias repair.

Results and complications are reported in 67 boys who underwent a modified MAGPI procedure for hypospadias between 1981 and 1986. Excellent cosmetic and functional results were achieved in 91% of the patients. Some degree of chordee can be corrected by this procedure but severe degrees of chordee were associated with an increased complication rate.

Adolescent↗
PubMed1987

Does the severity of presentation in children with vesicoureteric reflux relate to the severity of the disease or the need for operation?

The presenting symptoms, number of previous urinary tract infections, grade of reflux and incidence of renal scarring, together with an analysis of the need for reimplantation of the ureters, were assessed retrospectively in 222 patients with vesicoureteric reflux. The grade of reflux was found to be as severe in patients presenting after a single urinary tract infection as in those presenting after more than one infection. Regardless of whether patients presented with mild, moderate or severe symptoms, the degrees of reflux and renal scarring remained similar. There was no relationship between the severity of presenting symptoms and the eventual need for ureteric reimplantation. All children should be investigated when they present for the first time with a urinary tract infection, irrespective of age, sex or severity of symptoms.

Adolescent↗
PubMed1986

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↗