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O Göğüş

Publications and source records attributed to O Göğüş.

At least 19 recordsLinked to original sources
PubMed2002

DNA ploidy and S-phase fraction as predictive factors of response and outcome following neoadjuvant methotrexate, vinblastine, epirubicin and cisplatin (M-VEC) chemotherapy for invasive bladder cancer.

OBJECTIVE: To investigate the value of DNA ploidy and S-phase fraction (SPF) as factors that could predict response and outcome of invasive transitional cell carcinoma (TCC) of the bladder to neoadjuvant methotrexate, vinblastine, epirubicin and cisplatin (MVEC) chemotherapy. MATERIALS AND METHODS: Twenty-four patients with localized invasive TCC of the bladder (stages T3 to T4a, NoMo) were treated with neoadjuvant MVEC chemotherapy. DNA flow cytometry was performed in paraffin-embedded tissue obtained by transurethral resection before chemotherapy. Radical cystectomy specimens were utilized for complete pathologic staging. The tumors were subdivided into high- and low-SPF tumors according to their SPF value. DNA ploidy status was evaluated into two groups (diploidy and nondiploidy). RESULTS: DNA ploidy was not correlated to the response to chemotherapy (p = 0.67), and overall or disease-free survival (p = 0.27 and p = 0.69, respectively). Major response (pathologic complete response and partial response) was more often found in the high SPF group than among tumors with low SPF (p = 0.02). High SPF tumors were significantly associated with increased overall and disease-free survival (p = 0.0056 and p = 0.0059, respectively). CONCLUSION: A high SPF, but not DNA ploidy, may be helpful to identify patient likely to respond and survive longer following neoadjuvant MVEC chemotherapy in the treatment of invasive bladder cancer.

Aged↗
PubMed2001

A nonrefluxing, serous lined extramural tunnel for ureteroileal anastomosis in ileal conduit urinary diversion: first clinical experience in 10 patients.

PURPOSE: We report the surgical technique and functional outcome of a new application for serous lined, anti-refluxing ureteroileal anastomosis in ileal conduit urinary diversion. Reflux prevention relies on the construction of a serous lined extramural ileal tunnel. MATERIALS AND METHODS: A 25 cm. distal ileal segment was isolated. The proximal 7 cm. of the ileal segment was folded and the 2 proximal 7 cm. segments were joined by seromuscular sutures. The antimesenteric borders of these 7 cm. segments were incised and the medial edges of each ureter were joined. A mesenteric window was opened at the level of ileal folding and the ureters were passed through it. They were inlaid within the trough and the conjoined ureteral end were anastomosed to the intestinal mucosa. The tunnel was then closed over the implanted ureters. The lateral limbs of the detubularized ileal segment were then joined. The technique was performed in 10 patients with a mean followup of 9.9 months (range 3 to 19). The patients were evaluated clinically and radiologically. RESULTS: None of the 10 patients had reflux on x-ray of the loop. One patient had previously undergone unilateral nephrectomy. Excretory urography showed a stabilized or improved upper tract in 18 renal units. Left ureterohydronephrosis was present in 1 renal unit because of ureteroileal stenosis. CONCLUSIONS: The initial clinical results of the serous lined extramural ileal tunnel technique for ureteroileal anastomosis in ileal conduit cases are promising. The technique appears effective and reliable.

Aged↗
PubMed2000

Effect of microsurgical subinguinal varicocele ligation to treat pain.

OBJECTIVES: The traditional treatment for a painful varicocele consists of conservative measures followed by varicocelectomy. We report our results with microsurgical subinguinal varicocele ligation to treat pain. METHODS: From 1996 to 1999, a total of 119 men underwent subinguinal microsurgical varicocele ligation for painful varicocele. The diagnosis of varicocele was based on the findings of both physical examination and color Doppler ultrasound. Patients described pain with testicular discomfort as scrotal heaviness or a dull ache. While waiting for the operation (range 3 to 5 weeks), all the patients underwent a preoperative trial of conservative management for pain. RESULTS: Of 119 men, 82 (69 %) were available for follow-up 3 months postoperatively. Of those 82 patients, 72 (88%) reported complete resolution of pain, 4 patients (5%) partial resolution, 5 patients (6%) no change, and 1 patient (1%) epididymal discomfort that resolved with conservative measures. Of the 9 patients with partial or no change, 2 patients had reflux recurrence as seen on color Doppler ultrasound. CONCLUSIONS: Subinguinal microsurgical varicocele ligation is an effective treatment for painful varicocele when performed in selected patients.

Adolescent↗
PubMed2000

Three dimensional conformal radiotherapy in patients with T2a-b, N0, M0 prostatic carcinoma.

The current study was undertaken to evaluate the Prostate Specific Antigen (PSA) relapse free survival and the prognostic factors in a total of 38 patients with stages of T2a-b, N0, M0 prostate carcinoma treated with three-dimensional conformal radiotherapy (3D-CRT). Mean 69.63 Gy was given with 3D-CRT, the mean follow up time was 13.89 months, and the mean prebiopsied PSA level was 25.12 ng/ml. The 2-year PSA relapse free survival was 47.37% for the entire group. The 2-year PSA relapse free survival rates were 100% and 44.74% for the patients with Gleason score < or = 7 and greater than 7 (p < or = 0.05). Patients with prebiopsied PSA level < or = 10 ng/ml and the stages of T2a or T2b did not show any significant differences (p > or = 0.05). Although the few case number and short term follow up, in this study 3D-CRT was a new effective technique to prostate cancer for our institutes and the Gleason score was important predictor of PSA relapse free survival.

Adenocarcinoma↗
PubMed1999

Role of magnetic resonance imaging in children with voiding dysfunction: retrospective analysis of 81 patients.

OBJECTIVES: To investigate the role of magnetic resonance imaging (MRI) in children with voiding dysfunction and a normal neuro-orthopedic assessment. The differential diagnosis of neurogenic and non-neurogenic voiding dysfunction, particularly in children with occult neurogenic pathologic findings without a clinically demonstrable neurologic defect, is a commonly encountered problem. METHODS: Eighty-one children with voiding dysfunction, including a history of diurnal incontinence, frequency, urgency, urge incontinence, incomplete bladder emptying, recurrent urinary tract infection, and persistent vesicoureteral reflux, constituted our study group. A detailed neuro-orthopedic evaluation was performed in all patients. The urologic evaluation consisted of a detailed history (including bowel function disturbances), renal sonography or excretory urography, spinal x-ray, urinalysis and culture, voiding cystourethrography, and multichannel water cystometry. In all cases, lumbosacral spinal axial and sagittal T1- and T2-weighted MRI performed with a 1.5-Tesla surface coil was reviewed by one neuroradiologist. RESULTS: MRI revealed pathologic findings in 17 (38.6%) of 44 patients who had voiding dysfunction and a normal neuro-orthopedic assessment. All these patients underwent early surgical intervention in our pediatric neurosurgery department. In the postoperative period, objective and/or subjective improvement in voiding symptoms within short (6 months) and long (14 months) periods was observed in 8 (47.0%) and 5 (29.4%) patients, respectively. Ten (58.8%) of those 17 patients had a history of voiding dysfunction refractory to conservative management. CONCLUSIONS: Our results revealed that MRI of the lower spinal cord is a valuable tool in the diagnosis of occult spinal cord disorders, especially in patients with voiding dysfunction refractory to conservative management strategies and normal neurologic and orthopedic assessments.

Adolescent↗
PubMed1999

Relationship among pediatric voiding dysfunction and vesicoureteral reflux and renal scars.

OBJECTIVES: To analyze the relationship among non-neurogenic voiding dysfunction, vesicoureteral reflux (VUR), and renal scarring, taking into consideration whether the reflux was unilateral or bilateral. VUR is a common problem in the pediatric age group. Although unilateral reflux is usually due to primary insufficiency of the vesicoureteral junction, bilateral reflux can also be the result of underlying voiding dysfunction. METHODS: Between 1993 and 1998, 80 children, 52 girls and 28 boys, median age 5.7 years (range 3.8 to 14), were evaluated because of VUR. Eighteen patients who presented with associated anomalies and obvious neuropathic bladder dysfunction were excluded from the study. Complete urologic, neurologic, and urodynamic investigations were performed in all patients. RESULTS: Of 62 patients, 25 (40.3%) had unilateral and 37 (59.6%) had bilateral reflux. Voiding dysfunction was found in 7 patients (28%) with unilateral reflux and in 27 patients (72.9%) with bilateral reflux (P <0.01 ). Two (25%) of the 8 patients with unilateral reflux and renal scarring had voiding dysfunction but no demonstrable urinary tract infection, and 10 (55.5%) of the 18 patients with bilateral reflux and renal scarring had voiding dysfunction and no demonstrable urinary tract infection (P <0.01). CONCLUSIONS: If VUR is bilateral, the prevalence of existing underlying voiding dysfunction seems to be higher. The first step in management should be a detailed evaluation of bladder function to choose an appropriate treatment modality and to prevent renal deterioration.

Adolescent↗
PubMed1999

The significance of testicular reactive oxygen species on testicular histology in infertile patients.

This study was designed to investigate the relationship between the effects of testicular reactive oxygen species (ROS) levels and testicular histology on infertile patients with the aid of xanthine oxidase system and testicular tissue malondialdehyde levels. Forty patients with idiopathic infertility constituted our study group. Bilateral testicular biopsies were performed and spermatogenesis was assessed histopathologically. Patients were divided into 4 groups according to spermatogenic pattern (normal spermatogenesis; hypospermatogenesis; maturation arrest; Sertoli cell only syndrome). Testicular tissue xanthine oxidase and malondialdehyde (MDA) concentrations were analyzed in each sample by spectrophotometric assay and thiobarbituric acid reaction assay, respectively. Testicular tissue MDA and xanthine oxidase concentrations were not statistically different in patients having normal spermatogenesis, with respect to Sertoli cell only syndrome, maturation arrest and hypospermatogenesis, respectively. As a result of our study we think that there are still some factors other than ROS which may be important contributors to spermatogenetic injury that need to be examined.

Adult↗
PubMed1999

Significance of serum FSH levels and testicular morphology in infertile males.

OBJECTIVES: To determine the relationship between plasma levels of FSH and testicular spermatogenic patterns. METHODS: Testicular biopsies were obtained from 99 infertile men. Biopsies were performed either in order to distinguish the type of azoospermia (obstructive/non-obstructive) or because of severely subnormal semen variables. Serum FSH was measured by immunoassay (normal range is less than 7 mIU/ml). RESULTS: Statistically significant difference was detected between patients with Sertoli cell only syndrome and normal spermatogenesis, hypospermatogenesis and maturation arrest (p<0.01, p<0.01, p<0.05, respectively). No statistically significant differences were found between normal spermatogenesis, hypospermatogenesis and maturation arrest. CONCLUSION: Our study revealed that elevation of serum FSH correlates only with the appearance of Sertoli cell only syndrome. We think that azoospermic or severely oligoasthenoteratozoospermic patients with highly elevated plasma FSH levels (three times the normal) could be excluded from separate testicular biopsy, because these patients are not suitable for conventional treatments. If he is willing to undergo an IVF program the sperm will often be present, no matter what the testicular histology is to be used for assisted reproductive techniques, particularly ICSI.

Adult↗
PubMed1999

Transmurally absorbed intravesical chemotherapy with dimethylsulfoxide in an animal model.

BACKGROUND: The purpose of the present study was to investigate the hypothesis that dimethylsulfoxide (DMSO) enhances the absorbtion of the intravesical chemotherapeutics. METHODS: Fifty male Wistar rats received 1.5 mg N-methyl-N-nitrosourea (MNU) intravesically every other week (weeks 0, 2, 4, 6 and 8) for a total of five doses. After week 14, rats underwent intravesical installation of either epirubicin (1 mg) or epirubicin + DMSO (50%) every other week (weeks 14, 16, 18, 20 and 22). The absorbtion of epirubicin was estimated histologically by observing its fluorescence in the bladder. RESULTS: We observed papiller and/or hyperplastic formations in rat bladders (10/50 rats) due to installation of MNU. Epirubicin fluorescence was observed in the entire bladder wall of normal or hyperplastic regions in rats that were given DMSO prior to epirubicin. However, epirubicin was observed only in normal-appearing mucosa or in superficial layers of hyperplastic regions. CONCLUSIONS: The concomittant addition of DMSO with intravesical epirubicin enhances the absorbtion of epirubicin to the entire bladder wall. In this way, epirubicin cytotoxicity and antitumor activity can be potentiated. This can be useful for both the treatment of superficial bladder cancer (especially in local recurrence and progression) and invasive bladder cancer (especially in regional chemotherapy).

Administration, Intravesical↗
PubMed1999

Penile epithelioid sarcoma.

Epithelioid sarcoma is a rare mesenchymal neoplasm. We had the opportunity to report a case of epithelioid sarcoma of the penis.

Adult↗
PubMed1998

Evaluation of basal membrane antibody (immunoglobulin G) formation after high-energy shockwave application in rats.

To evaluate the immune pathologic effects of high-energy shockwave (HESW) application on glomerular and tubular basal membrane antibody (IgG) formation, an experimental study on rats has been performed. Following application of different numbers of shockwaves (100-200-500), the presence of antibody was examined with the direct immunofluorescent technique 2 weeks and 3 months postprocedure. Whereas specimens examined after 2 weeks showed antibody formation in only one animal (500 HESWs), being located in the tubular tissues, all treated kidneys demonstrated various degrees of antibody formation in both tubular and glomerular tissues after 3 months. Antibody formation had a close relation to the number of HESWs applied and the time of examination after shockwave application. Apart from the well-defined functional and morphologic side effects of shockwave therapy, the possibility of immunologic alterations after this form of therapy has to be evaluated thoroughly in both clinical and experimental studies.

Animals↗
PubMed1997

Preservation of shock-wave-induced renal histologic changes by dermatan sulfate.

OBJECTIVES: To evaluate the protective effects of glycosaminoglycan (GAG) administration on shock-wave-induced renal histologic alterations, an experimental study using dermatan sulfate administration (DS) in rabbits was performed. METHODS: The study included 45 white New Zealand rabbits; 36 were divided into two groups before shock-wave application. Animals in the first group (n = 18) received no specific medication before or after shock-wave treatment; animals in the second group (n = 18) received subcutaneous DS administration for a period of 2 months, beginning 2 weeks before shock-wave application. Following different numbers of shock-wave application (500, 1000, or 1500 shock waves), histopathologic evaluation of treated kidneys was made under light microscopy after 24 hours and 3 months. Nine animals were used for the control group. RESULTS: During 24-hour examination, most of the kidneys in both groups demonstrated varying degrees of histopathologic alterations, depending on the number of shock waves applied. Among the most prominent pathologic features were protein deposition with free erythrocytes in the tubular lumen, glomerular hemorrhage, tubular dilation and degeneration, protein in Bowman's capsule, hyperemia, and mononuclear cell infiltration at the interstitial level. As opposed to the 24-hour evaluation findings, long-term (3-month) follow-up examination revealed histopathologic alterations that decreased but did not totally disappear in animals receiving no DS. Glomerular basement membrane thickening, mononuclear cell infiltration and limited protein deposition in some tubules, together with cortical interstitial fibrosis, were observed to some extent in these animals. On the other hand, no severe histopathologic alteration with normal glomerular basement membrane appearance was noted in animals receiving DS medication. CONCLUSIONS: Our results indicated a long-term favorable protective effect of DS administration on morphologic abnormalities in rabbits undergoing shock-wave treatment. Although tubular alterations persisted to some extent, mononuclear cell infiltration has been limited and the natural appearance of the basement membrane has been well preserved in most of the treated animals.

Animals↗
PubMed1997

High dose rate transurethral brachytherapy as a boost dose for localized adenocarcinoma of the prostate.

From September 1989 to February 1993, 11 patients with localized adenocarcinoma of the prostate were treated with pelvic external-beam radiation therapy followed by high dose rate (HDR) transurethral brachytherapy as a boost dose. External-beam radiation therapy was administered through opposed pelvic fields using a 60Co teletherapy unit to a tumor dose of 46-50 Gy in 23-25 fractions and followed by three fractions of transurethral brachytherapy, delivered using a 60Co HDR remote afterloading equipment. The treatment time was calculated using the prostatic capsule as the reference point. The dose calculated to be delivered to the capsule was 5 Gy/fraction, making a total of 15 Gy. The follow-up period ranged from 11 to 65 months, with a median follow-up time of 30 months. Local control was achieved in all patients. The prostate-specific antigen levels were normalized within 3 months of radiotherapy in 9 patients and within 3-6 months in the remaining 2. Transurethral brachytherapy appears to be a simple and feasible form of brachytherapy. Preliminary local control and radiotherapy-related morbidity rates are comparable to those of other forms of brachytherapy. Further follow-up is required for assessment of long-term local control and delayed radiotherapy-related morbidity.

Adenocarcinoma↗
PubMed1997

Immunohistochemical determination of p53 protein in prostatic cancer and prostatic intraepithelial neoplasms.

A role of genetic alterations in the p53 tumor suppressor gene has been implicated in many types of human malignancies. In this study, we examined the prevalence of immunohistochemically detectable p53 accumulation in prostatic tissues obtained from patients with prostatic adenocarcinoma, benign prostate hyperplasia and prostatic intraepithelial neoplasms. Six of 36 (16.7%) cancer cases and 2 of 11 (18.2%) cases of high-grade prostatic intraepithelial neoplasms showed p53 expression while no nuclear staining was observed in normal and hyperplastic prostatic tissues. Correlation of p53 expression with cancer stage, Gleason score and serum prostate-specific antigen level demonstrated that there was no statistically significant relationship between p53 expression and these clinicopathological parameters. Also, no significant association between p53 expression and prognosis was observed.

Adenocarcinoma↗
PubMed1997

Influence of experimental spermatic cord torsion on the contralateral testis in rats. Evaluation of tissue free oxygen radical scavenger enzyme levels.

To evaluate the degree of ischemia formation in the contralateral testicle following unilateral testicular torsion, free oxygen radical formation after detorsion or an orchiectomy procedure in terms of superoxide dismutase (SOD) and catalase activities was detected in adult male Wistar rats. Animals were divided into 4 groups and following 2 and 6 h of unilateral torsion, the orchiectomy or detorsion procedures were performed and free radical scavenger enzyme activities (SOD, catalase) were measured in the contralateral testes after 24 h, 1 week and 1 month. Evaluation of our results revealed no meaningful ischemia formation in the contralateral testes of rats undergoing 2 h of unilateral testicular torsion. However, animals undergoing 6 h of unilateral testicular torsion demonstrated a statistically significant alteration with respect to enzyme concentrations. Alterations in the contralateral testes were more prominent in animals that had undergone the detorsion procedure following 6 h of testicular torsion. Our results indicate that preservation of twisted testes through a detorsion procedure could cause further deterioration by way of reperfusion injury, indicating the importance of removal of the damaged testicle to minimize long-term histopathologic alterations in the contralateral testes.

Animals↗
PubMed1996

Effects of extracorporeal shock wave lithotripsy on stone forming risk factors.

It has been reported in some definite studies that ESWL causes transient deterioration in renal haemodynamics and function. Again certain parameters in blood and urine have been used in order to assess this functional deterioration and different results are reported. In our present study we aimed to describe the adverse effects of shock waves on the excretion of urinary metabolites such as electrolytes, oxalate and citrate. Evaluation of our results in 30 patients revealed that although exposure to shock waves during ESWL for symptomatic renal calculi causes a slight increase in the urinary level of metabolites, all of these changes remained in normal range and no statistically significant changes in the urinary level of the aforementioned parameters could be demonstrated.

Adolescent↗