Biomedical subjects

Turgut Alkibay

Publications and source records attributed to Turgut Alkibay.

7 recordsLinked to original sources

PubMed2006

Can serum Inhibin B and FSH levels, testicular histology and volume predict the outcome of testicular sperm extraction in patients with non-obstructive azoospermia?

INTRODUCTION: In our study, we evaluated the diagnostic accuracy of serum follicle stimulating hormone (FSH), Inhibin B, testicular volumes and distribution of testicular sperm extraction (TESE) outcome according to the histological diagnosis in men with non-obstructive azoospermia. MATERIALS AND METHODS: Between February 2001 and April 2002, 66 men presenting with infertility of at least 1 year were found to have non-obstructive azoospermia. Serum FSH and Inhibin B levels, testicular volumes and pathological analysis were reviewed retrospectively using medical records of these patients. RESULTS: Of 66 patients, 52 were enrolled into the study and sperm extraction was successful in 31 of 52 patients (59.6%). There was no statistically significant difference between the patients who had successful and unsuccessful TESE in terms of mean serum Inhibin B, FSH levels and testicular volumes (P>0.05). The area under ROC analysis for serum Inhibin, serum FSH and testicular volume was 0.557, 0.523 and 0.479, respectively. For Inhibin B, the best cut-off value for discriminating between successful and failed TESE at 90% sensitivity was 6.25 with a very low level of specificity (14%) and diagnostic accuracy that was 53.8. CONCLUSION: Besides the controversies about the direct marker role of serum Inhibin B in determination of spermatogenesis, it does not seem to give a clue about the prediction of sperm presence before TESE. Because of the conflicting results in the literature, the potential role of serum Inhibin B as a marker for prediction of sperm presence in testis is yet to be determined.

Adult↗

PubMed2006

Is pelvicaliceal anatomy a risk factor for stone formation in patients with solitary upper caliceal stone?

OBJECTIVES: To investigate the effect of pelvicaliceal anatomy on stone formation in patients with solitary upper caliceal stones. METHODS: The records of patients with solitary upper caliceal stones between 1996 and 2004 were reviewed. After the exclusion of patients with hydronephrosis, major anatomic abnormalities, noncalcium stones, metabolic abnormalities, history of recurrent stone disease, multiple stones, and previous renal surgery, 42 patients (24 male, 18 female) and 42 healthy subjects (22 male, 20 female) with normal results on intravenous pyelography (IVP) were enrolled into the study. With a previously described formula, upper pole infundibulopelvic angle (IPA), infundibular length (IL) and width (IW), and pelvicaliceal volume of the stone-bearing and contralateral normal kidney of patients and bilateral normal kidneys of healthy subjects were measured from IVP. RESULTS: Forty-two stone-bearing and 126 normal kidneys (42 contralateral, 84 healthy) were assessed. The mean stone size was 153.47 mm2 (range, 20 to 896 mm2). There were no statistically significant differences in terms of upper caliceal specifications between stone-bearing and normal kidneys. The mean (+/- standard deviation) pelvicaliceal volume of 42 stone-bearing and 126 normal kidneys was 2455.2 +/- 1380.2 mm3 and 1845.7 +/- 1454.8 mm3, respectively (P = 0.019). These values were 2114 +/- 2081.5 mm3 (P = 0.34) and 1709.5 +/- 989.1 mm3 (P = 0.001) for contralateral normal kidneys (n = 42) and normal kidneys of healthy subjects (n = 84), respectively. CONCLUSIONS: Explanation of the etiology of the upper caliceal stone by the anatomic features is very difficult, and these caliceal anatomic variables (IPA, IL, IW) seem not to be a significant risk factor for stone formation in the upper calyx.

Adult↗

PubMed2006

Relation between cyclooxygenase-2 expression and clinicopathologic parameters with patient prognosis in transitional cell carcinoma of the bladder.

OBJECTIVE: To evaluate the correlation between cyclooxygenase-2 (Cox-2) expression and clinicopathologic findings with the effect of these variables on prognosis of bladder cancer. METHODS: Cox-2 expression was examined immunohistochemically in paraffin blocks of 99 patients. Correlations between Cox-2 expression and variables like cancer stage and grade, number of mitoses, angiolymphatic invasion, number and size of the lesions were determined. RESULTS: Cox-2 expression was detected in 52 (52.5%) patients. Univariate regression analysis between Cox-2 expression and clinicopathologic findings showed a significant correlation only in the pathologic stage of the patients (p = 0.048) (OR =2.64, CI = 0.97-7.81). Multivariate regression analysis in stage T1 revealed an increasing number of mitoses as an independent prognostic factor for recurrence (p = 0.002) (OR = 1.5, CI = 1.16-1.92) and progression (p = 0.030) (OR = 8.23, CI = 1.22-55.27) although a prognostic factor was not found for progression in stage T2. CONCLUSION: Univariate analysis showed that only the pathologic stage correlated significantly with Cox-2 expression. Cox-2 expression revealed a significant relation with patient prognosis in stage T2 but not in stage T1. These results support the fact that Cox-2 inhibitors may play a role in progression of invasive bladder tumors.

Aged↗

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↗

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↗

PubMedDate not supplied

The impact of pelvicaliceal anatomical variation between the stone-bearing and normal contralateral kidney on stone formation in adult patients with lower caliceal stones.

OBJECTIVE: We aimed to investigate the effect of pelvicaliceal anatomical differences on the etiology of lower caliceal stones. MATERIALS AND METHODS: Records of adult patients between January 1996 and December 2005 with solitary lower caliceal stone were reviewed. After exclusion of patients with hydronephrosis, major renal anatomic anomalies, non-calcium stones, history of recurrent stone disease and previous renal surgery, 78 patients were enrolled into the study. Lower pole infundibulopelvic angle (IPA), infundibulovertebral angle (IVA), infundibular length (IL), width (IW), number of minor calices and cortical thickness of the lower pole together with other caliceal variables obtained from the whole pelvicaliceal anatomy of both stone-bearing and contralateral normal kidneys were measured from intravenous pyelogram of the patients. Total pelvicaliceal volume was also calculated by a previously described formula for both kidneys. RESULTS: There were statistically significant difference between two kidneys in terms of IW (p < 0.001) and IL (p = 0.002) of the upper calyx, IW (p = 0.001) and IVA (p < 0.001) of the lower calyx), pelvicaliceal volume (p < 0.001), IPA of middle calyx (p = 0.006) and cortical thickness over the lower pole (p < 0.001). However there was no difference between stone-bearing and contralateral normal kidneys in terms of lower pole IPA (p = 0.864) and IL (p = 0.568). CONCLUSION: Pelvicaliceal volume but not lower caliceal properties seem to be a risk factor for stone formation in lower calyx.

Adult↗