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S Baltaci

Publications and source records attributed to S Baltaci.

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↗
PubMed2001

Combined interferon alpha with levamisole in patients with metastatic renal cell carcinoma.

To evaluate the efficacy and toxicity of interferon alpha-2b (IFN-alpha2b) and levamisole treatment regimen in patients with metastatic renal cell carcinoma (RCC). Seventeen patients with metastatic RCC were treated using recombinant IFN-alpha2b at a dose of 10 MU/m2 body surface subcutaneously three times in a week, for 3 months, with levamisole 50 mg t.d.s orally on days 1-3 on alternate weeks. The mean follow-up period was 10.7 (range 2-23) months. We achieved 1 complete response (lasting for 12+ months) and 1 partial response (lasting for 15 months), for an objective response rate of 11.7%. A further 7 patients (41%) had a stabilization of disease. The overall toxicity was moderate, with mainly grade I or II side effects. Grade III toxicities reported among 3 patients including vomiting (2 patients) and anorexia (1 patient). There was no treatment related death. Although additions of levamisole to IFN-alpha do not result in any significant increase in treatment toxicity, the response rate appears to be no better than IFN-alpha monotherapy reported in the literature.

Adjuvants, Immunologic↗
PubMed2001

P53, bcl-2 and bax immunoreactivity as predictors of response and outcome after chemotherapy for metastatic germ cell testicular tumours.

OBJECTIVE: To evaluate the roles of p53, bcl-2 and bax as determinants of chemosensitivity in testicular cancers and to assess whether immunohistochemical expression of these proteins in testicular germ cell tumours (GCTs) could be used to predict the outcome in patients with metastatic testicular GCTs. PATIENTS AND METHODS: Immunoreactivity for p53, bcl-2 and bax were examined in primary testicular tumours from 24 patients with metastatic GCTs who were treated with bleomycin, etoposide and cisplatin chemotherapy. All immunostaining results were scored for the appropriate percentage of positive tumour cells and relative immunostaining intensity (score range 0-15) and compared with the response of the patients to chemotherapy. RESULTS: Overall, 20 (83%), 13 (54%) and 24 of the 24 GCTs showed > or = 1% immunoreactivity with p53, bcl-2 and bax, respectively. Only the bax immunostaining intensity and score had statistically higher mean values in the nonseminoma than in seminoma GCTs (P = 0.047 and P = 0.027, respectively). Only p53 immunostaining intensity, percentage of p53 immunopositive cells and p53 staining score were sig-nificantly different among the response groups. The median survival after chemotherapy was 30.5 months; however, taking the median values of the immunostaining scores as threshold values for the survival analysis, none of the three proteins were associated with significant differences in survival. CONCLUSIONS: The incidence of p53 and bax immuno-reactivity in testicular GCTs is higher than that of bcl-2 immunoreactivity. However, only p53 immuno-reactivity could be used to predict the response to chemotherapy. P53, bcl-2 and bax scores were not significant prognostic factors for survival after chemotherapy.

Adolescent↗
PubMed2001

Inducible nitric oxide synthase expression in benign prostatic hyperplasia, low- and high-grade prostatic intraepithelial neoplasia and prostatic carcinoma.

OBJECTIVE: To elucidate the incidence of inducible nitric oxide synthase (iNOS) expression in benign prostatic hyperplasia (BPH), low- and high-grade prostatic intraepithelial neoplasia (PIN) and prostatic carcinoma lesions, and to explore the role of iNOS in prostate tumorigenesis. MATERIALS AND METHODS: Immunoreactivity for iNOS was examined in 20 samples each of BPH, high-grade PIN, low-grade PIN and prostatic carcinoma. RESULTS: Positive iNOS immunostaining was detected in all samples from all patients; iNOS was detected in both basal epithelial cells and secretory cells of the glandular epithelium. High-grade PIN and prostatic carcinoma samples had more intense iNOS immunostaining than low-grade PIN and BPH samples. In all samples, smooth muscle cells showed weak or moderate iNOS immunoreactivity and endothelial cells showed moderate immunostaining. CONCLUSIONS: Nitric oxide generated by iNOS may be involved in prostate tumorigenesis and further studies with immunohistochemical and molecular biology are needed to determine the exact role of iNOS in the pathogenesis of prostatic carcinoma.

Adenocarcinoma↗
PubMed2001

Collecting duct carcinoma.

Collecting duct carcinoma of the kidney is a rare variant of renal cell carcinoma. Hematuria is the most common presenting symptom. This tubulopapillary tumor arises from or differentiates forward to medullary collecting tubules. It is typically centered on the medulla of the kidney and extends into the cortex with a desmoplastic reaction. There are few reports documenting the clinical presentation and long-term prognosis. We describe a case of this uncommon tumor with clinical, histological and immunohistochemical features and review the literature.

Aged↗
PubMed2000

Palliative analgesic effect of Re-186 HEDP in various cancer patients with bone metastases.

UNLABELLED: The clinical picture of bone metastases is manifested by pain and loss of mechanical stability. Standard treatment options for bone metastases include external beam radiotherapy and the use of analgesics. Due to a large number of lesions in many patients, the use of radionuclide therapy with beta emitters may be preferable. Re-186 hydroxyethylidene diphosphonate (Re-186 HEDP) is one of the radiopharmaceuticals suitable for palliative treatment of metastatic bone pain. The aim of this study was to investigate palliative and side effects of Re-186 HEDP in patients with different types of cancers. MATERIAL & METHOD: Thirty one (17 male, 14 female) patients with various cancers (10 prostate, 10 breast, 4 rectum, 5 lung, 2 nasopharynx) and bone metastases were included in the study. Therapy was started with a fixed dose of 1295 MBq of Re-186 HEDP. If necessary, the same dose was repeated at least 3 times after an interval of 10-12 weeks; A total of 40 standard doses were given; 6 patients received repeated doses (3 doses in 3 patients, 2 doses in 3 patients). The patients with bone marrow suppression were excluded from the study. The pain relief was assessed the Eastern Cooperative Oncologic Group (ECOG) and the Karnofsky status index. All patients were evaluated with standard evaluation forms filled in daily for a maximum of 10 weeks. RESULTS: The mean response rate was 87.5% in patients with breast and prostate cancer, 75% in patients with rectum cancer and 20% in patients with lung cancer. The overall response rate was 67.5%. The palliation period varied between 6 and 10 weeks, with a mean of 8.1+/-1.3 weeks. The maximal palliation effect was observed between the 3rd and 7th weeks. No serious side effects were seen except mild hematologic toxicity. DISCUSSION & CONCLUSION: It is concluded that Re-186 HEDP is a highly effective agent in the palliation of metastatic bone pain in patients with prostate, breast and rectum cancer, but not effective in lung cancer. On the other hand, Re-186 seems to be a good alternative to Sr-89 because of its preferable physical characteristics (such as short half life and gamma energy emission), low side effect profile, early response and repeatability.

Adult↗
PubMed2000

Leiomyoma of the epididymis.

Tumours of the epididymis, both primary and secondary, whether benign or malignant are very rare. We report a case of leiomyoma of the epididymis and discuss the treatment of this tumour.

Epididymis↗
PubMed2000

Bcl-2 proto-oncogene expression in low- and high-grade prostatic intraepithelial neoplasia.

OBJECTIVE: To determine the incidence of bcl-2 protein expression in low- and high-grade prostatic intra-epithelial neoplasia (PIN) lesions, and to explore the role of bcl-2 in prostatic tumorigenesis. Materials and methods Immunoreactivity for bcl-2 was examined in 10 samples of benign prostatic hyperplasia (BPH), 13 of primary prostatic adenocarcinoma, 15 of high-grade PIN and 18 of low-grade PIN. All immunostaining results were scored for the approximate percentage of positive tumour cells and relative immunostaining intensity (score range 0-12). RESULTS: In all BPH samples, bcl-2 staining was detected consistently in the basal cell layer of the ducts and acini, but no staining was ever apparent in luminal cells. The immunoreactivity for bcl-2 was heterogeneous in the prostatic carcinomas and bcl-2 protein expression was present in six samples. In these six bcl-2-positive tumours, the mean (range) staining score was 1.15 (1-6). There was detectable expression of bcl-2 in low- and high-grade PIN in all cell layers; immunoreactivity was present in 10 of 15 high-grade PIN lesions, with a mean (range) score of 1.14 (1-4), and in 12 of 18 samples of low-grade PIN, with a mean (range) score of 1.77 (1-6). CONCLUSIONS: The high incidence of bcl-2 protein expression in low- and high-grade PIN lesions suggests that bcl-2 protein expression is associated with early prostate tumorigenesis.

Gene Expression↗
PubMed2000

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Journal Article↗
PubMed2000

Influence of tumor stage, size, grade, vascular involvement, histological cell type and histological pattern on multifocality of renal cell carcinoma.

PURPOSE: We assessed the influence of clinical and pathological factors on multifocality of renal cell carcinoma. MATERIALS AND METHODS: Between June 1995 and September 1999 radical nephrectomy was performed in 71 men and 32 women with a mean age of 56.5 years. The 103 removed kidneys with renal cell carcinoma were sectioned at 3 mm. intervals and inspected microscopically for satellite carcinomas. We evaluated pathological stage, grade, cell type, histological pattern, vascular involvement, tumor size and the incidence of multifocality. To determine cell type we used several classification systems. RESULTS: The primary tumor was 2 to 20 cm. (mean plus or minus standard deviation 7.10 +/- 3.48). Overall satellite carcinomas were present in 22 of the 103 cases (21.4%). When the predominant lesion was 5 cm. or smaller, the incidence of multifocality was 19%. The incidence of multifocality was statistically higher in patients with stage pT3 than in those with stage pT1 or pT2 disease (p = 0.022). Multiple logistic regression analysis demonstrated that only primary tumor pathological stage was a significant predictor of renal cell carcinoma multifocality in stages T3 versus T1 and T3 versus T2 cancer (odds ratio 3.45, 95% confidence interval 1.15 to 10.39 and 5.75, 1.31 to 25.29, respectively). Other parameters, such as tumor size, grade, vascular invasion, cell type and histological pattern, did not correlate with multifocality. CONCLUSIONS: Our results imply that primary tumor stage is a significant factor for multifocal disease. Therefore, more precise preoperative staging of the primary lesion is required if nephron sparing surgery is indicated.

Adult↗
PubMed2000

Determination of transition zone volume by transrectal ultrasound in patients with clinically benign prostatic hyperplasia: agreement with enucleated prostate adenoma weight.

PURPOSE: Accurately estimating transition zone volume is important for the medical or surgical management of symptomatic benign prostatic hyperplasia and determination of prostate specific antigen density of the transition zone. We evaluated whether preoperative transrectal ultrasound measurements of the transition zone predict enucleated adenoma weight. MATERIALS AND METHODS: We measured transition zone volume preoperatively using transrectal ultrasound and the prolate ellipsoid method in 50 patients with presumed benign prostatic hyperplasia who underwent suprapubic prostatectomy. Transition zone volume corresponds to the adenoma. Enucleated adenoma weight was then correlated with preoperatively determined transition zone volume. RESULTS: As measured by transrectal ultrasound, mean transition zone volume plus or minus standard deviation was 80.88 +/- 37.42 cc (range 31 to 200). Mean enucleated adenoma weight was 68.70 +/- 36.26 gm. (range 18 to 180). There was a statistically significant correlation of estimated transrectal ultrasound volume of the transition zone with enucleated prostate adenoma weight (r = 0.95, p <0.001). However, when prostate adenoma weight was determined using the formula, prostate adenoma weight = -6.00 + 0.92 x transition zone volume, we noted a significant difference in mean prostate adenoma weight and mean transition zone volume (p <0.001). Since the regression coefficient of transition zone volume was significantly different from 1, we identified no agreement of prostate adenoma weight with estimated transrectal ultrasound volume of the transition zone. CONCLUSIONS: These data reveal a significant difference in mean prostatic adenoma weight and mean transition zone volume. Although transition zone volume measurements are well described, clear agreements on such measurements should be obtained to determine transition zone volume more precisely.

Aged↗
PubMed1999

Evaluation of serum arginase activity in benign prostatic hypertrophy and prostatic cancer.

Activities of arginase, prostatic acid phosphatase (PAP) and prostate specific antigen (PSA) were determined in sera of healthy male controls, benign prostatic hypertrophy (BPH) and prostatic cancer patients. Serum arginase activity in the cancer group (22.8+/-11.6 U/l) was significantly lower than in both the control (33.64+/-16.19 U/l) and the BPH group (58.8+/-11.6 U/l) (p<0.001, respectively), while the BPH group had significantly higher levels compared to the controls (p<0.05). However, serum arginase levels in all groups had no statistically significant correlation with PAP and PSA. Serum arginase activity correlated inversely with the Gleason grades. These results suggest that serum arginase assay may be used for the pretreatment evaluation of patients with prostatic diseases.

Acid Phosphatase↗
PubMed1999

Does the position of the patient affect the presence and/or degree of reflux in an ileal conduit urinary diversion?

OBJECTIVE: To assess the effect of patient position (supine, sitting or standing) on ileo-ureteric reflux in patients with an ileal conduit urinary diversion, in whom such reflux is normally detected when they are supine during a retrograde loopogram. PATIENTS AND METHODS: The study included 10 patients with an ileal conduit as a primary urinary diversion; a loopogram was obtained with the patient upright or supine and a further film taken with the patient supine but at 45 degrees to the ground. RESULTS: When supine, free ileo-ureteric reflux occurred into both ureterorenal units in eight patients. The remaining two patients, who had previously undergone unilateral nephrectomy, also had reflux into their existing renal units. Of the 18 units, 15 had grade III and three had grade IV reflux. In the upright and 45 degrees position, reflux still occurred in al ureterorenal units. The patient's position did not affect the degree of reflux in 16 units, but in one unit with grade IV reflux and another with grade III reflux, the reflux was one grade less severe. CONCLUSIONS: Ileo-ureteric reflux is common after ileal conduit diversion and may contribute to the likelihood of renal deterioration. The presence and/or degree of reflux is generally not affected by the position of the patient.

Adult↗
PubMed1999

The prognostic value of peripheral blood lymphocyte subsets in patients with bladder carcinoma treated using neoadjuvant M-VEC chemotherapy.

OBJECTIVES: To assess the prognostic value of peripheral blood lymphocyte subsets in patients with bladder cancer who were treated with neoadjuvant chemotherapy. PATIENTS, SUBJECTS AND METHODS: Thirty patients with a histological diagnosis of invasive bladder transitional cell carcinoma and 30 age-matched controls with no evidence of cancer and immunological disorders were evaluated. Peripheral blood samples were assessed in both groups using monoclonal antibodies. Patients with bladder cancer who achieved complete or partial responses and those who had progression of the disease after systemic chemotherapy with methotrexate, vinblastine, epirubicin and cisplatin were compared according to the pretreatment values of the peripheral blood lymphocyte subsets. RESULTS: There were no significant differences in B lymphocyte levels between the groups. In patients with bladder cancer, the percentages of T lymphocytes (P<0.01), natural killer (NK) cells (P<0.05) and the CD4+/CD8+ ratio (P<0.05) were significantly lower than in the control group. In patients who responded to the chemotherapy regimen, the pretreatment values of T lymphocytes (P<0.001), the CD4+/CD8+ ratio (P<0.01) and NK cell levels (P<0.01) were significantly higher than in the patients who did not. CONCLUSION: In patients with invasive bladder carcinoma, cell-mediated immunity may have a role in the resistance to this malignancy and in these patients the pretreatment levels of T lymphocyte subsets may be an indicator of the potential response to chemotherapy.

Adult↗
PubMed1998

Failure of ureteral replacement with Gore-Tex tube grafts.

OBJECTIVES: To evaluate the role of polytetrafluoroethylene (Gore-Tex) as a ureteral substitute in dogs after resection of a 5 to 8-cm-long middle segment. METHODS: Five mongrel dogs underwent resection of the middle segment of the left ureter and segmental replacement of the resected part with segments of Gore-Tex over a double-J catheter. The double-J stents were removed at 21 days and the dogs were evaluated by excretory urography and abdominal ultrasonography 12 weeks after surgery. They were then killed and the ureters and the kidneys examined both grossly and microscopically. RESULTS: There was radiologic evidence of advanced hydronephrosis on the left side in all 5 dogs. Grossly, the left kidneys showed marked pelvic and proximal ureteral dilatation and atrophy of parenchyma. Severe stricture at the anastomotic sites and marked fibrous tissue around the prostheses were found. No cellular lining was found in the Gore-Tex lumen. CONCLUSIONS: There is no potential for ureteral replacement by Gore-Tex tube graft.

Animals↗