Biomedical subjects

Murat Tunc

Publications and source records attributed to Murat Tunc.

10 recordsLinked to original sources

PubMed2006

Topical cyclosporine-a combined with mitomycin C for conjunctival and corneal squamous cell carcinoma.

PURPOSE: To determine the efficiency of topical cyclosporine-A (CSA) combined with mitomycin C (MMC) as an adjunctive treatment in diffuse conjunctival and corneal squamous cell carcinoma (CCSC). DESIGN: Interventional case reports. METHODS: Two patients who had positive margins following surgical excision of CCSC were treated by topical CSA (0.05%) four times a day for 12 weeks, and topical MMC (0.01%) four times a day was combined with CSA at the second, fourth, and sixth weeks of the treatment. We controlled the tumor recurrence, vision, and ocular surface healing during the follow-up. RESULTS: There was no tumor recurrence during the follow up of 18 months. Limbal vascularization regressed considerably and the vision improved without any ocular surface problems in both patients. CONCLUSIONS: As an adjunctive treatment, topical CSA (0.05%) combined with MMC (0.01%), may prevent tumor recurrence and provide excellent ocular surface healing in diffuse CCSC.

Administration, Topical↗

PubMed2006

Should prostate cancer status be determined in patients undergoing radical cystoprostatectomy?

INTRODUCTION: We estimate the frequency of prostate cancers detected incidentally in radical cystoprostatectomy specimens and discuss whether the prostate cancer status should be determined in patients undergoing radical cystoprostatectomy. MATERIALS AND METHODS: A total of 97 radical cystoprostatectomies without evidence of prostate cancer on digital rectal examination were performed for transitional cell carcinomas of the bladder between January 2001 and May 2004. The mean patient age at the time of surgery was 66.9 +/- 9.52 (range 49-75) years. RESULTS: The overall incidence of prostate cancer detected in radical cystoprostatectomy specimens was 21.6% (21/97 specimens). The mean tumor volume was found to be 0.93 +/- 0.81 ml. The tumor volume was >0.5 ml in 12 cases (57.1%). The surgical margin was negative in all cases, and the disease was organ confined in 20 patients (95.2%). Capsular invasion was evident in 2 patients (9.5%), 1 of whom had lymph-node-positive disease. CONCLUSIONS: Despite the high prevalence of incidental prostate carcinomas among patients with bladder cancer undergoing cystoprostatectomy, the vast majority of the cancers are organ confined. However, the prostate cancer status should be determined on the basis of digital rectal examination and prostate-specific antigen in patients undergoing radical cystoprostatectomy - especially if prostate-sparing cystectomy is planned.

Adenocarcinoma↗

PubMed2005

Posterior sub-Tenon's capsule triamcinolone injection combined with focal laser photocoagulation for diabetic macular edema.

PURPOSE: To investigate the efficacy of posterior sub-Tenon's capsule triamcinolone injection (PSTI) combined with focal laser (FL) photocoagulation in treatment of diffuse clinically significant diabetic macular edema (CSME). DESIGN: Prospective randomized clinical study. PARTICIPANTS: Sixty patients with diffuse CSME. METHODS: We randomized the patients who had CSME into 2 treatment groups. A total of 30 eyes received macular focal and grid laser photocoagulation (MP), and the second group of 30 eyes received FL photocoagulation combined with PSTI (FL + PSTI). Clinical and visual evaluations were performed at baseline and 12 and 18 weeks after treatment, and the results were compared by statistical methods. MEAN OUTCOME MEASURES: Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity (VA) scores and clinical changes in macular edema. RESULTS: Before treatment, mean ETDRS VA scores were 45.9+/-12.7 (mean +/- standard deviation [SD]; range, 24-66) in MP (focal + grid laser) and 44.5+/-12.6 (range, 22-66) in the FL + PSTI group. Early Treatment Diabetic Retinopathy Study scores at 18 weeks were 46.4+/-14.2 (range, 20-70) after MP and 52.5+/-17.5 (range, 22-82) after FL + PSTI. Early Treatment Diabetic Retinopathy Study scores significantly improved in eyes that received FL + PSTI (P = 0.0001, paired t test). The FL + PSTI group had an increase of 12.4+/-7.1 (range, 5-26) ETDRS letters, and the MP group had an increase of 7.8+/-3.1 (range, 5-15) letters (P = 0.04, unpaired t test). Twelve of 30 (40%) cases in the MP group and 24 of 30 (80%) cases in the FL + PSTI group showed clinical improvement in macular edema according to the stereoscopic evaluation of fundus and fluorescein angiography (P = 0.003). CONCLUSION: Posterior sub-Tenon's capsule application of triamcinolone may improve early visual outcome in diffuse diabetic macular edema when combined with FL photocoagulation.

Combined Modality Therapy↗

PubMed2005

Should high-grade prostatic intraepithelial neoplasia change our approach to infravesical obstruction?

OBJECTIVES: To investigate whether coexistence of high-grade prostatic intraepithelial neoplasia (HPIN) should change our therapeutic approach to infravesical obstruction. MATERIAL AND METHODS: Of 505 patients who underwent sextant transrectal ultrasonography (TRUS)-guided prostate biopsy, 65 (12.8%) had HPIN and 29 of them underwent prostatectomy (23 transurethral resection of prostate (TURP), 6 open) due to obstructive urinary symptoms. Patients without carcinoma were followed up with semiannual prostate-specific antigen (PSA) and digital rectal examination. After a follow-up of 24.8 +/- 11.0 months, 19 of 29 patients who accepted our call had another sextant biopsy. RESULTS: Mean age and initial mean PSA values of 29 patients were 67.6 +/- 6.7 years and 9.26 +/- 5.91 ng/ml, respectively. The final pathological evaluation of the surgical specimens revealed 2 prostatic adenocarcinomas both in the TURP group. The remaining 27 (93.2%) patients were found to have benign prostatic hyperplasia (BPH) and their serum PSA levels declined from 9.26 +/- 5.91 to 4.59 +/- 2.0 ng/ml 3 months after prostatectomy. Of the 19 patients who had another biopsy with a mean PSA value of 4.06 +/- 4.61 ng/ml, 15 and 4 of them had BPH and HPIN respectively. CONCLUSIONS: Our preliminary data indicate that the presence of HPIN on TRUS-guided biopsies is not a factor to delay an indicated surgical intervention for infravesical obstruction.

Adenocarcinoma↗

PubMed2004

Contrast-enhanced 3D MR voiding urethrography: preliminary results.

Contrast-enhanced 3D MR voiding urethrography (CE 3D MRVU) was performed on 5 healthy volunteers and 18 patients with urethral disease. After intravenous injection of 0.3 ml/kg gadolinium, the images of the three consecutive acquisitions of the 3D MRVU technique were obtained during voiding. The raw data were reconstructed on all patients for visual analysis. The image quality of the volunteers was technically sufficient to demonstrate normal urethral anatomy. Contrast-enhanced 3D MR voiding urethrography of the urethral strictures was compared with conventional retrograde urethrography (n = 10) and urethroscopy (n = 12). The urethral pathologies including strictures and other obstructive causes of impaired urethral flow were correctly identified on CE 3D MRVU.

Adult↗

PubMed2003

A new mutation of the fukutin gene in a non-Japanese patient.

Fukuyama-type congenital muscular dystrophy (FCMD), Walker-Warburg syndrome, and muscle-eye-brain disease are clinically similar autosomal recessive disorders characterized by congenital muscular dystrophy, cobblestone lissencephaly, and eye anomalies. FCMD is frequent in Japan, but no FCMD patient with confirmed fukutin gene mutations has been identified in a non-Japanese population. Here, we describe a Turkish CMD patient with severe brain and eye anomalies. Sequence analysis of the patient's DNA identified a homozygous 1bp insertion mutation in exon 5 of the fukutin gene. To our knowledge, this is the first case worldwide in which a fukutin mutation has been found outside the Japanese population. This report emphasizes the importance of considering fukutin mutations for diagnostic purposes outside of Japan.

Amino Acid Sequence↗

PubMed2003

Hypercoagulable states and central retinal vein occlusion.

Central retinal vein occlusion is a common cause of permanent visual loss. Work up and laboratory evaluation of patients requires the clinician to rule out hypertension, diabetes, hyperlipidemia, and glaucoma. Patients without an identifiable risk factor are often subject to extensive testing for primary and secondary thrombophilias. The purpose this paper is to review the literature to determine which of these tests is associated with central retinal vein occlusion. Antiphospholipid antibodies and elevated plasma homocysteine levels appear to be the tests associated most commonly in patients with central retinal vein occlusion in most controlled studies. Primary thrombophilias are found rarely when screening patients with central retinal vein occlusion. Extensive testing for thrombophilias is not warranted in the vast majority of patients with central retinal vein occlusion. Older patients with any of the common vascular risk factors do not require thrombophilic screening. By carefully selecting the patients who are evaluated for thrombophilias, the likelihood of finding true-positive tests is increased.

Biomarkers↗

PubMed2002

A retrospective review of 307 men with Peyronie's disease.

PURPOSE: We discuss the clinical appearance and natural outcome of Peyronie's disease. MATERIALS AND METHODS: During an 8-year period 307 men with Peyronie's disease were evaluated, and clinical characteristics, risk (factors), penile deformities, erectile status and outcome were analyzed. RESULTS: Mean patient age plus or minus standard deviation was 52.8 +/- 9.3 years (range 23 to 76). Penile deformity, pain on erection and palpable nodule were the most common (85%) presenting symptoms, usually in different combinations. The remaining 15% of men (mean age 59.4 +/- 6.5 years) were not aware of the penile deformity and were diagnosed during standard evaluation for erectile dysfunction. Dorsal (45.6%) and lateral (29.3%) were the most common curvatures. The degree of deformity was less than 30 degrees in 42.7% of patients, 31 to 60 degrees in 38.8% and greater than 60 degrees in 18.6%. At least 1 risk factor for systemic vascular disease was identified in 67.5% of patients, and hypercholesterolemia and diabetes were the most common. Patients with at least 1 risk factor had a significantly higher risk for severe penile deformity. Of the men 54.4% complained of erectile dysfunction and the probability of diminished erectile capacity was 86.7% in patients older than 60 years, with Peyronie's disease for more than 12 months and at least 1 risk factor. Of 63 patients presenting with the acute phase of disease penile deformity deteriorated in 30.2%, did not change in 66.7% and resolved spontaneously in 3.2% without any treatment after a mean followup of 8.4 months. CONCLUSIONS: Our data show that penile deformities are disabling (greater than 30 degrees) in 62.5% of cases. Risk factors, such as serum lipid abnormalities, diabetes and hypertension, seem to have significant impact on the severity of symptoms and outcome. Patients must be informed that Peyronie's disease is progressive in 30.2% without treatment and spontaneous resolution is rare.

Adult↗

PubMed2002

A prospective, randomized protocol to examine the efficacy of postinternal urethrotomy dilations for recurrent bulbomembranous urethral strictures.

OBJECTIVES: The high recurrence rate is still the major complication of endoscopic treatment of urethral stricture disease. To compare the outcome of patients who underwent direct vision internal urethrotomy (DVIU) and then followed a protocol that randomized them to either our urethral dilation protocol or consecutive DVIUs for the treatment of their urethral stricture. METHODS: A total of 37 patients, who had undergone at least two DVIUs to treat their recurrent urethral strictures, were enrolled in this study. They were randomized into two groups. The etiology and location of the strictures were similar, and their length ranged from 0.5 to 2 cm in each group. In group 1 (n = 18), the patients were observed by regular visits and uroflowmetry profiles after the initial DVIU and consecutive DVIUs were considered when the stricture recurred. In group 2 (n = 19), patients received urethral dilations with Benique dilatators (maximal 21F) under intraurethral anesthesia, beginning 10 days after the initial internal urethrotomy, according to the following protocol: weekly for the first month, once after 3 and after 6 months, and then once each year. RESULTS: After a median follow-up of 30 months, the urethral stricture recurred within 12 months in 55.6% (n = 10) of group 1, and consecutive DVIUs were indicated. During the same follow-up period, recurrence was observed in 2 patients (10.5%), 9 months and 2 years after randomization, in group 2 (P <0.05). The mean maximal urinary flow rate in groups 1 and 2 at last follow-up was 7.8 +/- 3.7 and 21.0 +/- 8.7 mL/s, respectively (P <0.01). CONCLUSIONS: We suggest a regular, simple urethral dilation protocol for patients with recurrent bulbomembranous urethral stricture shorter than 2 cm, because this significantly allays the stricture recurrence rate, possibly eliminates the need for consecutive DVIU, and reduces morbidity.

Adult↗

PubMed1999

Ossifying fibroma of the lateral orbital wall in an adult.

Orbital ossifying fibroma is an extremely rare condition, especially in adults. This rare tumor mostly develops at the medial wall of the orbit. We report a histopathologically confirmed ossifying fibroma involving the lateral orbital wall in an adult. This case suggests that orbital ossifying fibroma should be considered in the differential diagnosis of orbital bony lesions in adults and that unusual presentations may occur.

Journal Article↗