Biomedical subjects

Sinan Sözen

Publications and source records attributed to Sinan Sözen.

9 recordsLinked to original sources

PubMed2005

Cortically located collecting duct carcinoma.

Collecting duct carcinoma is a rare, highly aggressive, renal tumor arising from the distal collecting ducts. Various histologic patterns can be found in the same tumor but most demonstrate duct-like or papillary architecture surrounded by desmoplastic stroma. Grossly, these tumors are typically located in the medullary portion of the kidney near the region of the pelvis without extensive hemorrhage. It has a tendency to affect young patients and present at more advanced stages with a poorer prognosis. We describe a case of collecting duct carcinoma with histologic and immunohistochemical findings in a cortically located tumor.

Adult↗

PubMed2004

Complexed prostate specific antigen density is better than the other PSA derivatives for detection of prostate cancer in men with total PSA between 2.5 and 20 ng/ml: results of a prospective multicenter study.

PURPOSE: This prospective, multicenter study was initiated to evaluate the diagnostic performance of PSA, free/total PSA (f/tPSA) and complexed PSA (cPSA) with volume-based parameters for early detection of prostate cancer in patients with PSA between 2.5 and 20 ng/ml. MATERIALS AND METHODS: 408 subjects with serum PSA values between 2.5 and 20 ng/ml regardless of digital rectal examination (DRE) were included in to the study. The diagnostic validity, sensitivity, specificity and cut-off values were evaluated by Receiver Operating Characteristic (ROC) curve analysis. RESULTS: Of 408 patients 77 (18.9%) were positive for prostate cancer. Digital rectal examination was non-suspicious in 86% (351/408) of the patients. Area under curve (AUC) values for cPSA were better than PSA and f/tPSA in patients with PSA values of 2.5-10 ng/ml and 4-10 ng/ml, as well as the whole group. Furthermore, on ROC curve analysis cPSAD was the best predictor of prostate cancer for all PSA ranges regardless of the DRE findings except PSA values between 2.5 and 4 ng/ml. The cut-off value of cPSAD at 90% sensitivity was 0.06 ng/ml/cm(3) with a 35.3% specificity saving 126 unnecessary biopsies in the whole group. CONCLUSION: cPSA might be a better initial test than PSA for prostate cancer detection and measurement of cPSA alone and its derivatives obviate the need for additional fPSA testing.

Adult↗

PubMed2004

Aqueous extract of Urtica dioica makes significant inhibition on adenosine deaminase activity in prostate tissue from patients with prostate cancer.

AIM: Investigation of possible effects of aqueous extract of Urtica dioica leaves on adenosine deaminase activity in prostate tissue from patients with prostate cancer. METHODS: Ten prostate tissues from patients with pathologically proven localized prostate cancer (Gleason scores 4 to 7) were used in the study. In the tissues, ADA activities with and without preincubation with different amounts of Urtica dioica extracts were performed. RESULTS: Aqueous extract of Urtica dioica results in significant inhibition on adenosine deaminase (ADA) activity of prostate tissue. CONCLUSION: ADA inhibition by Urtica dioica extract might be one of the mechanisms in the observed beneficial effect of Urtica dioica in prostate cancer.

Adenosine Deaminase↗

PubMed2003

Extracorporeal shock-wave lithotripsy for treatment of ureteral calculi in paediatric patients.

Our objective was to determine the efficacy of extracorporeal shock wave lithotripsy (ESWL) in the treatment of paediatric ureteral calculous disease. We reviewed the records of 41 (23 boys, 18 girls) paediatric patients admitted to our clinic for the treatment of ureteral calculi between between 1989-2001. Patients' age varied between 4-16 years. The majority of the patients, 38 (92.7%) cases were treated initially with ESWL whereas 3 (7.3%) cases were subjected to ureterolithotomy. The mean age of the patients was found as 12.8+/-3.86 (4-16) years. Most calculi were located at either upper or lower ureter. The mean stone burden was 45.16+/-30.65 mm2 and the mean shock wave number per session and power as 2826.72+/-605.18 and 17.69+/-1.11 kV respectively. Minor complications included skin ecchymosis at the site of entry of shock waves in all cases and renal colic that responded to analgesics and emetics in 3 (7.9%) patients. The overall stone-free rate after ESWL was found to be 81.6%. Two (5.3%) cases have residual fragments that escaped to lower calices after lithotripsy for upper ureteral calculi and are still followed. There were 5 (13.2%) failures who were treated with ureterolitotomy for 1 upper and 1 lower ureteral calculi and with ureteroscopy for the rest. It appears that ESWL is still a good option for the initial treatment of most ureteral calculi in children as it is less invasive than ureteroscopy and has a high success rate as a first-line therapy.

Adolescent↗

PubMed2003

Management of ureteral stones with pneumatic lithotripsy: report of 500 patients.

PURPOSE: To evaluate the results of pneumatic lithotripsy (PL) with ureteroscopy in the treatment of ureteral stones. PATIENTS AND METHODS: We reviewed, retrospectively, the records of 500 patients (366 male, 134 female) with ureteral calculi treated by PL with the Swiss Lithoclast. Of these patients, 124 (24.8%) were treated primarily and 376 (75.2%) were treated secondarily after unsuccessful extracorporeal shockwave lithotripsy (SWL). The results were evaluated 3 months after treatment by excretory urography, ultrasonography, or both. RESULTS: The over-all stone-free and fragmentation rates were 94.6% and 96.8%, respectively. These values were 97.1% and 98.5% for stones 10 mm, respectively. The main complications were stone migration (2.0%), urosepsis (3.0%), and ureteral perforation (1.4%). CONCLUSIONS: While SWL is generally excepted as a first-line treatment option in ureteral stones because of its noninvasive nature, in situ lithotripsy, and especially PL, has higher success rates with minimal morbidity. Thus, PL seems to be a good alternative in patients in whom SWL was unsuccessful or not indicated and in patients who need early stone removal.

Adolescent↗

PubMed2002

Microstaging of pT1 transitional cell carcinoma of the bladder. Does it really differentiate two populations with different prognoses? (pT1 subcategory).

INTRODUCTION: Our objective was to evaluate the feasibility and value of microstaging in pT1 transitional cell carcinoma (TCC) of the bladder in a well-defined group of patients treated with transurethral resection (TUR) only. MATERIALS AND METHODS: The clinical records of 152 patients who underwent TUR for the treatment of primary superficial TCC of the bladder between 1983 and 1997 were reviewed. Patients with primary carcinoma in situ and who received adjuvant intravesical treatments were excluded from study. We subclassified the pT1 tumors into two groups according to muscularis mucosae (MM) invasion (pT1 and pT1b). The recurrence and progression rate of cancers was analyzed according to the stage, grade, multiplicity and tumor size. Mean follow-up was 68 months. Estimation of the cumulative distribution of the disease-free interval in separate groups was calculated according to the Kaplan-Meier method. Multivariate analysis of the data was performed by using Cox regression method. A value of p < 0.05 was taken to be statistically significant with odds ratios. RESULTS: Of the 152 patients, tumor stage was pTa in 62 (40.8%) patients and pT1 in 90 (59.2%) patients. Among those pT1 tumors, MM was identified in 50 (55.5%) of cases (pT1a = 34, pT1b = 16). In the remaining 40 (44.5%) patients, MM could not be assessed. Kaplan-Meier analysis revealed that recurrence and progression were statistically significant for stage, multiplicity and grade of tumor. However, multivariate analysis revealed that stage was the only prognostic factor for recurrence and progression (p = 0.0001). CONCLUSION: The present study underscores the fact that pT1b tumors have a distinct natural history. If initial conservative treatment is selected, the patients must be followed very cautiously.

Adult↗

PubMedDate not supplied

The importance of re-evaluation in patients with cystitis glandularis associated with pelvic lipomatosis: a case report.

Pelvic lipomatosis is a rare, proliferative disease involving an overgrowth of normal fat in the pelvic retroperitoneal space. Cystitis glandularis, cystitis cystica, or cystitis follicularis can be observed in 75% of patients with pelvic lipomatosis. We describe a 58-yr-old man with pelvic lipomatosis in whom adenocarcinoma of the bladder was diagnosed in the second transurethral resection of the bladder 1 month after the first operation. This proliferative disease can cause obstruction of the bladder drainage leading to a proliferative cystitis because of an altered environment rich in protein fluid. Because the association of this proliferative disease with adenocarcinoma of the bladder is frequent, we recommend close follow-up of these patients to detect the associated adenocarcinoma of the bladder.

Adenocarcinoma↗

PubMedDate not supplied

Renal tuberculosis mimicking xanthogranulomatous pyelonephritis: ultrasonography, computed tomography and magnetic resonance imaging findings.

The incidence of tuberculosis has been increasing in recent years, and its treatment has also become challenging. The diagnosis of renal tuberculosis is often difficult and delayed. Early and correct diagnosis of tuberculosis with different organ system involvement is very important and can be easier with ultrasonography, computed tomography and/or magnetic resonance imaging. Although renal tuberculosis is the result of hematogenous spread more commonly from the lungs, less than 5%, of patients with urinary tract tuberculosis have active pulmonary disease. Renal tuberculosis may show variable radiological findings depending on the stage of the infection. Although an end-stage "autonephrectomized" kidey in tuberculosis is classically defined to be small in size, enlargement may on rare occasions be observed, which is the case in our patient. This form greatly mimics diffuse xanthogronulomatous pyelonephritis. Both diseases show thickening of the perirenal fasciae and spread of inflammation into the adjacent organs. Computed tomography and magnetic resonance imaging may show some specific features to differentiate these two entities.

Adolescent↗

PubMedDate not supplied

Serum interleukin-18 and nitric oxide activity in bladder carcinoma.

BACKGROUND: Both interleukin-18 and nitric oxide are multifunctional molecules that are involved in the different steps of carcinogenesis. METHODS: In the present study, we measured serum interleukin-18 and nitric oxide activity in 51 bladder cancer patients with different tumor stage and grade, and in 8 healthy controls. Serum nitrite-nitrate levels were measured as an index of nitric oxide generation. RESULTS: Serum interleukin-18 levels were significantly higher in bladder cancer patients when compared to the control subjects (p > 0.05). Serum interleukin-18 levels were found to be higher in patients with Ta stage than patients with T1 and T2, T3, T4 stages and in patients with grade 1 tumors than patients with grade 2 and grade 3 tumors, but this was not statistically significant (p > 0.05). There was no significant difference in serum nitrite + nitrate levels between bladder cancer patients and control subjects. CONCLUSIONS: Elevated serum interleukin-18 levels in bladder carcinoma patients may be a result of host defence mechanism against the growth and progression of bladder cancer cells.

Adult↗