Yazar "Cal C." seçeneğine göre listele
Listeleniyor 1 - 12 / 12
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Biochemical recurrence after radical prostatectomy: Is the Disease or the Surgeon to Blame?(2011) Simsir A.; Cal C.; Mammadov R.; Cureklibatir I.; Semerci B.; Gunaydin G.Purpose: The PSA recurrence develops in 27 to 53% within ten years after radical prostatectomy (RP). We investigated the factors (disease grade and stage or the surgeon's expertise,) more likely to influence biochemical recurrence in men post-radical prostatectomy for organ-confined prostate cancer by different surgeons in the same institution. Materials and Methods: A total of 510 patients that underwent radical prostatectomy were investigated retrospectively. Biochemical recurrence was defined as detection of a PSA level of ? 0.20 ng/mL by two subsequent measurements. The causes, which are likely to influence the development of PSA recurrence, were separated into two groups as those related to the disease and those related to the surgical technique. Results: Biochemical recurrence was detected in 23.5% (120 cases) of 510 cases. The parameters most likely to influence biochemical recurrence were: PSA level (p < 0.0001), T stage (p < 0.0001), the presence of extracapsular invasion prostate (p < 0.0001), Gleason scores (p = 0.042, p < 0.0001) and the presence of biopsy with perineural invasion (p = 0.03). The only surgical factor that demonstrated relevance was inadvertent capsular incision during the surgery that influenced the PSA recurrence (p < 0.0001). Conclusion: The PSA recurrence was detected in 21.6% of patients who had been treated with radical prostatectomy within 5 years, which indicates that the parameters related to the disease and the patient have a pivotal role in the PSA recurrence.Öğe Bowel preparation and peri-operative management for radical cystectomy in Turkey: Turkish Urooncology Association multicenter survey(2011) Aslan G.; Baltaci S.; Cal C.; Turkeri L.; Gunlusoy B.; Adsan O.; Sanli O.; Tansug Z.; Horasanli K.; Uygur C.; Ozen H.Purpose: To investigate the preferences and practice patterns of urooncologic surgeons in Turkey on bowel preparation and peri-operative management for radical cystectomy. Materials and Methods: This study was conducted by Turkish Urooncology Association as a multicenter survey. Participants were asked to fill in questionnaires dispensed at annual oncologic meeting or using internet access to the website of Urooncology Association. The questionnaire consisted of multiple choice or open-ended questions related to frequency of cystectomy, surgical technique and type of diversion, bowel preparation protocol, nasogastric tube applications, antibiotic prophylaxis, and deep vein thrombosis prophylaxis. Collected data from the survey were presented descriptively. Results: Forty-four questionnaires from 44 surgeons of different centers were evaluated. All participants answered that they always perform bowel preparation before cystectomy. Four participants reported that they had an experience of cystectomy without bowel preparation. Bowel preparation methods included long conservative methods, short enema protocols, and Golytely, but there were significant differences in application of each method. Of participants, 88.6% perform diversion by themselves whereas others ask help from a general surgeon. Antibiotic prophylaxis is preferred mostly by 2 agents using third-generation cephalosporins and metronidazole for a period of 5 days or more in the majority. Type, duration, and dosage of deep vein thrombosis prophylaxis differed among participants.Conclusion: There are significant individual differences in peri-operative management of radical cystectomy, which render deficient and sometimes inadequate patient care. There is a need to establish standard protocols for bowel preparation and adequate peri-operative management for radical cystectomy.Öğe Cancer stem cells in urooncology(Begell House Inc., 2019) Yuce Z.; Cal C.The aging of society has led to an increase in the incidence of urological cancers. Surgery, radiotherapy, and chemotherapeutic agents are widely used treatment options, in addition to minimally invasive new therapeutical approaches developed in the past decade. Unfortunately, we are still a long way from preventing mortality due to urological cancers or to achieving long-term progression-free disease control. Extensive research in recent years has established the presence of a relatively small population of cancer stem cells, which may be targeted to reach these goals. Mounting evidence points to the role of CSCs in metastasis, treatment resistance, and recurrence. In this chapter, we review the presence of CSCs in bladder, prostate, and kidney cancers with emphasis on their identification and clinical relevance. © 2019 Begell House, Inc.Öğe Detection of Helicobacter pylori in bladder biopsy specimens of patients with interstitial cystitis by polymerase chain reaction(Springer Verlag, 2004) Atuğ F.; Turkeri L.; Atug O.; Cal C.The cause of interstitial cystitis (IC) is still unknown. Several features suggest that it may be an infectious disease and it has compelling similarities to chronic gastritis. The identification of Helicobacter pylori as the cause of chronic gastritis focused attention on this organism. Many studies have been done investigating the role of H. pylori in the etiology of IC. Previous studies mostly determined the presence of H.pylori with antibodies in the serum samples of IC patients, but these methods may lead to false positive or negative results. We therefore investigated the presence of H. pylori in bladder biopsy specimens by using polymerase chain reaction (PCR), which is accepted as the most sensitive and specific test for detecting this organism. A total of 32 patients with IC were enrolled into the study. The PCR assay was performed on cold cup bladder biopsies of IC patients. Both positive and negative controls were included in each set of PCR reactions. Gastric biopsy specimens of peptic ulcer patients with proven H. pylori infection were used as positive controls. Bladder biopsies of all IC patients were negative for H. pylori DNA. PCR showed the presence of H. pylori in the positive controls in each cycle demonstrating that the PCR assay was working properly. Thus, there is no evidence that IC is the result of H. pylori infection. This study does not negate the possibility that other infectious agents may play a role in the etiology of IC. © Springer-Verlag 2004.Öğe Follow-up results of radical prostatectomy(2000) Cal C.; Keskin D.; Delibas M.; Ozyurt C.; Gunaydin G.; Yurtseven O.Purpose: To evaluate the efficacy of radical prostatectomy and its complications in localised prostate cancer patients. Patients and methods: Fifty-six patients with primary bilateral pelvic lymphadenectomy and radical retropubic prostatectomy for clinically localised prostate cancer (stage ?T2c) were retrospectively evaluated. The mean duration of follow-up was 30 months (range 6-47 months). All patients were subjected to digital rectal examination (DRE), transrectal ultrasonography (TRUS), serum prostatic specific antigen (PSA) determination, abdominal computerized tomography (CT) and TRUS-guided prostate biopsy. Bone scan was performed if PSA level was >20 ng/ml. The TNM staging system and Gleason's grading system were used. Patients were followed postoperatively via DRE and PSA estimations every 3 months during the first 2 years, and at least biannually thereafter. Peri and postoperative complications were recorded. Results: The histological evaluation of radical prostatectomy specimens revealed T1, T2, T3 and T4 tumors in 8 (14.3%), 21 (37.5%), 18 (32.1%) and 9 (16.1%) patients, respectively. Locally advanced disease occurred in 32.1% and node positive disease in 16.1% of the patients. No patient died during surgery or in the perioperative period. Adjuvant hormonotherapy and/or radiotherapy was administered in 12 of the pT3-T4 patients. Local recurrence was observed in 5 of the pT1 and in 3 of pT2 patients. The most common postoperative complication was impotence (53.57%), followed by incontinence (12.5%) and anastomotic stricture (16.07%). Conclusion: Radical prostatectomy is an effective treatment modality with zero mortality and acceptable morbidity. When applied to patients with appropriate prognostic factors, it can provide equal survival compared to same age groups of men without prostate cancer.Öğe Impact of residual fragments following endourological treatments in renal stones(2012) Acar C.; Cal C.Today, shock wave lithotripsy (SWL), percutaneous nephrolithotomy (PCNL), and flexible ureterorenoscopy (URS) are the most widely used modalities for the management of renal stones. In earlier series, treatment success of renal calculi assessed with KUB radiography, ultrasound, or intravenous pyelography which are less sensitive than CT that leads to be diversity of study results in reporting outcome. Residual fragments (RFs) after interventional therapies may cause pain, infection, or obstruction. The size and location of RFs following SWL and PCNL are the major predictors for clinical significant symptoms and stone events requiring intervention. There is no consensus regarding schedule for followup of SWL, PCNL, and flexible URS. Active monitoring can be recommended when the stones become symptomatic, increase in size, or need intervention. RFs 4mm after SWL and 2mm after PCNL and flexible URS could be actively monitored on an annual basis with CT. Early repeat SWL and second-look endoscopy are recommended after primary SWL and PCNL, respectively. There is insufficient data for flexible URS, but RFs can be easily treated with repeat URS. Finally, medical therapy should be tailored based on the stone analysis and metabolic workup that may be helpful to prevent regrowth of the RFs. Copyright © 2012 Cenk Acar and Cag Cal.Öğe Induced growth inhibition, cell cycle arrest and apoptosis in CD133+/CD44+prostate cancer stem cells by flavopiridol(Spandidos Publications, 2014) Soner B.C.; Aktug H.; Acikgoz E.; Duzagac F.; Guven U.; Ayla S.; Cal C.; Oktem G.Flavopiridol is a flavone that inhibits several cyclin-dependent kinases and exhibits potent growth-inhibitory activity, apoptosis and G1-phase arrest in a number of human tumor cell lines. Flavopiridol is currently undergoing investigation in human clinical trials. The present study focused on the effect of flavopiridol in cell proliferation, cell cycle progression and apoptosis in prostate cancer stem cells (CSCs). Therefore, cluster of differentiation 133 (CD133)+high/CD44+highprostate CSCs were isolated from the DU145 human prostate cancer cell line. The cells were treated with flavopiridol in a dose- and time-dependent manner to determine the inhibitory effect. Cell viability and proliferation were analyzed and the efficiency of flavopiridol was assessed using the sphere-forming assay. Flavopiridol was applied to monolayer cultures of CD133high/CD44highhuman prostate CSCs at the following final concentrations: 100, 300, 500 and 1000 nM . The cultures were incubated for 24, 48 and 72 h. The half maximal inhibitory concentration (IC50) value of the drug was determined as 500 nM for monolayer cells. Dead cells were analyzed prior and subsequent to exposure to increasing flavopiridol doses. Annexin-V and immunofluorescence analyses were performed for the evaluation of apoptotic pathways. According to the results, flavopiridol treatment caused significant growth inhibition at 500 and 1000 nM when compared to the control at 24 h. G0/G1analysis showed a statistically significant difference between 100 and 500 nM (P<0.005), 100 and 1000 nM (P<0.001), 300 and 1000 nM (P<0.001), and 500 and 1000 nM (P<0.001). Flavopiridol also significantly influenced the cells in the G2/M phase, particularly at high-dose treatments. Flavopiridol induced growth inhibition and apoptosis at the IC50dose (500 nM), resulting in a significant increase in immunofluorescence staining of caspase-3, caspase-8 and p53. In conclusion, the present results indicated that flavopiridol could be a useful therapeutic agent for prostate CSCs by inhibiting tumor growth and malignant progression, and inducing apoptosis.Öğe Is it possible to predict sepsis, the most serious complication in prostate biopsy?(S. Karger AG, 2010) Simsir A.; Kismali E.; Mammadov R.; Gunaydin G.; Cal C.Objective: Prostate biopsy for the diagnosis of prostate cancer by transrectal ultrasonography (TRUS) is a common procedure used in daily urology practice with a low complication rate and easy applicability. In this study, the precipitating factors and prophylaxis for sepsis, the worst complication of the procedure, were assessed. Patients and Methods: 2,023 patients with suspected prostate cancer who underwent biopsy by TRUS in one center were assessed retrospectively. The relationship between sepsis and age, serum total prostate-specific antigen (PSA) level, PSA density, prostate volume, number of biopsies, number of repeated biopsies, accompanying diagnosis of prostatitis, presence of urethral catheter, and presence of diabetes mellitus was assessed. Data were analyzed using the t test and logistic regression analysis. Results: Of the 2,023 patients, 62 (3.06%) developed sepsis within 5 days after biopsy. There was no significant relationship between the biopsy and the above parameters using the logistic regression analysis. Using the t test, it was found that the number of biopsy cores (p < 0.001), presence of urethral catheter (p < 0.0001), and presence of diabetes mellitus (p < 0.0001) were predictive factors for sepsis. Conclusion: Sepsis is a rare but life-threatening complication after prostate biopsy by TRUS. Although preoperative prophylactic oral antibiotics and enema before biopsy have proven to be effective in decreasing urinary tract infection rates, patients with urethral catheter, diabetes mellitus or those to undergo biopsy from more sites than ten cores should be closely monitored after biopsy. © 2010 S. Karger AG, Basel.Öğe Percutaneous Nephrolithotomy: Variables That Influence Hemorrhage(2007) Turna B.; Nazli O.; Demiryoguran S.; Mammadov R.; Cal C.Objectives: Renal hemorrhage is one of the most common and worrisome complications of percutaneous nephrolithotomy (PCNL). This study attempted to identify variables that might influence hemorrhage during PCNL to help urologists establish preventative and treatment strategies for bleeding during PCNL procedures. Methods: The data of 193 patients (193 PCNL procedures) were retrospectively analyzed. Hemorrhage was estimated by the postoperative decrease in hematocrit factored by the quantity of any blood transfusion. Various preoperative and operative factors were assessed for their association with blood loss using univariate, forward multivariate regression and correlation analysis. Results: The mean patient age was 45.7 ± 14.4 years (range 5 to 74). The overall stone-free rate was 85.4%. The average hematocrit decrease was 8.7% ± 5.39% (range 0.3 to 24.7). Forward multivariate regression analysis identified five significant variables that influenced PCNL-related hemorrhage: stone type (P = 0.003), number of tracts (P = 0.010), method of dilation (P = 0.010), diabetes (P = 0.022), and stone surface area (P = 0.049). A statistically significant difference was found in relation to the occurrence of hemorrhage between patients with caliceal stones and partial staghorn stones (P = 0.008) and complete staghorn stones (P = 0.006), single tracts and multiple tracts (P = 0.038), balloon dilators and Amplatz dilators (P = 0.007), patients with small stones (1000 mm 2 or smaller) and large stones (greater than 1000 mm 2; P = 0.018) on univariate analysis. Also, the stone surface area (P = 0.019) and number of tracts (P = 0.024) showed a positive correlation with the mean hematocrit decrease. Conclusions: Staghorn stones, multiple tracts, the presence of diabetes, and large stones were associated with increased renal hemorrhage during PCNL on multivariate analysis. However, balloon dilation was associated with decreased hemorrhage. © 2007 Elsevier Inc. All rights reserved.Öğe Renal cell carcinoma: Overview(Springer, 2008) Kirkali Z.; Cal C.Renal cell carcinoma (RCC) accounts for 3% of all adult cancers. The incidence rates for kidney cancer are highest in European and Scandinavian countries and North America (1). It is estimated that 36,160 new cases of kidney and renal pelvis cancer were diagnosed in 2005, with an estimated 12,660 resulting deaths in the United States (2). There has been a 30% increase in incidence in the last 20 years. Although this increased incidence is partly a result of more widespread and aggressive imaging, current reports show a real increase in incidence. Renal cell carcinoma is a tumor of adults occurring primarily after the 5th decade of life. It occurs one-and-a-half times as often in men as in women (3:2) (3). Childhood RCC is uncommon, representing only 2% to 6% of all renal tumors in children. Bilateral tumors are identified in 2% to 5% of the patients. © 2008 Springer-Verlag London.Öğe Staging errors in localised prostate cancer(1999) Cal C.; Keskin D.; Delibac M.; Ozyurt C.; Nazli O.; Cureklibatir I.Purpose: Prostate cancer is potentially curable when diagnosed and treated in early stage, and if the histologic examination reveals organ-confined tumour, the patient has equal survival within his age group. Accurate clinical staging of prostate cancer is a prerequisite for the selection of appropriate therapy. The purpose of this study was to determine the discrepancies between clinical and pathological stages in patients with clinically early prostatic cancer. Patients and methods: 49 patients with clinical diagnosis of localised prostatic cancer (T1 9 patients, T2 40 patients), and who underwent retropubic radical prostatectomy (RRP) with pelvic lymph node dissection were evaluated retrospectively. Clinical examination, digital rectal examination (DRE) and serum prostatic specific antigen (PSA), along with transrectal ultrasonography (TRUS) and pelvic computerized tomography (CT) were used for the clinical staging of the patients. Results: The mean PSA value of the patients was 18.3 ng/ml. Clinical and pathological stages were in accordance in 25 (51%) of the patients. Of the remaining patients, 2 (4.08%) were clinically overstaged and 22 (44.89%) downstaged. Lymph node involvement was seen in 4 (8.16%) patients. There was a significant correlation between serum PSA level and pathological stage. Conclusion: Almost half of the patients with prostatic carcinoma were downstaged by clinical staging. Better combinations of the existing clinical staging procedures should be used in order to better define the clinical stage preoperatively.Öğe Zoledronic acid effects interleukin-6 expression in hormone-independent prostate cancer cell lines(2008) Asbagh L.A.; Uzunoglu S.; Cal C.Objective: To investigate the inhibitory effects of zoledronic acid (ZA) on tumor related growth factor IL-6 in hormone resistant prostate cancer cell lines. The association between apoptosis and IL-6 inhibition was also assessed. Materials and Methods: PC-3 and DU145 cell lines were treated with different concentrations of ZA (1-100µM) at various intervals (24-72 h.). The cell viability was investigated by XTT assay and apoptotic effect was evaluated by cell death detection ELISA kit. Caspase 3/7 activity assay was performed to confirm apoptosis. IL-6 levels were measured by ELISA in the supernatant, and these data were also confirmed by IL-6 mRNA analysis using RT-PCR. Results: PC-3 and DU145 cell lines were sensitive to ZA mediated cytotoxicity in a dose- and time-dependent manner. However, the apoptotic effect was significantly different among PC-3 and DU145 cells (p < 0.05). IL-6 secretion was significantly lower in both cell lines, compared to the untreated control cells (p < 0.05). Although the increased inhibition of IL-6 secretion was associated with increased apoptosis in DU145 cells (p = 0.002), there was no similar association for PC-3 cell line (p = 0.347). When compared to the untreated controls, the number of cDNA copies was significantly lower in the ZA treated DU145 cell line at doses of 30 and 90µM (p < 0.05), suggesting a reduced expression of IL-6 mRNA. Conclusion: ZA exhibited a time- and dose-dependent apoptotic effect on PC-3,and DU145 prostate cancer cell lines and this effect was associated with inhibited secretion of IL-6 in DU145 cell line.
