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    Experiences of the Department of Medical Faculty in the Pandemia Process
    (Duzce Univ, 2020) Buken, Bora; Kayikci, Muhammet Ali; Sahin, Idris; Cakar, Nigar Demircan
    Regarding Covid-19 pandemic, the preparatory works were carried out by the Rector's Office, the Dean of the Faculty of Medicine and the Chief Physician of the Hospital. Staff assignments were made and service started with the circular signed by Ministry of Health dated March 17, 2020. Gradual transition was planned by monitoring the rate of increase in the incidence of cases seen in our city. In accordance with the instructions of the Presidency, the Ministry of Health Scientific Committee and the Higher Education Institution (YOK), pandemic tent, pandemic service, pandemic intensive care units were opened and research assistants and lecturers were assigned to these units with decision taken by full harmonic work of the Hospital Administrative Board. Physicians from all branches were appointed with rotation in the pandemic outpatient clinic. The global epidemic caused by Covid-19 (corona virus) brought about serious changes in both education and exam applications in the last period of 2019-2020 academic year. The departments that require applied training, especially the Faculty of Medicine, were more affected from this process. All infrastructure facilities of our university were integrated into the system in a very short time in order to conduct online exams and the exams were successfully applied. Dear Rector, Professor Dr. Nigar Demican Cakar played the most important role in the effective functioning of the process with her directional decisions, administrative audits and continuously supports to the other transactions throughout the whole process.
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    Investigation of rs11568476 Polymorphism in the SLC13A2 Gene in Turkish Patients with Hypocitraturia and Calcium-Containing Kidney Stones
    (Mdpi, 2025) Basaran, Ekrem; Baba, Dursun; Senoglu, Yusuf; Yuksel, Alpaslan; Kayikci, Muhammet Ali; Duzenli, Selma; Tekin, Ali
    Background and Objectives: Hypocitraturia is a major risk factor for calcium-containing kidney stone disease. Citrate inhibits stone formation by binding calcium in the urine. The SLC13A2 gene encodes the sodium-dependent dicarboxylate cotransporter 1 (NaDC1), a membrane transport protein that facilitates citrate reabsorption in the proximal renal tubules. Variants in this gene, such as rs11568476 (V477M), have been shown to significantly impair transporter activity. This study aimed to investigate the presence of the rs11568476 polymorphism in SLC13A2 and its association with hypocitraturia in Turkish patients with calcium-containing kidney stones. To our knowledge, this is the first genetic study evaluating this polymorphism in a Turkish cohort. Materials and Methods: This prospective cross-sectional study included 90 patients diagnosed with calcium-containing kidney stones at D & uuml;zce University Faculty of Medicine, Department of Urology. Based on 24 h urinary citrate levels, patients were divided into two groups: normocitraturic (n = 38) and hypocitraturic (n = 52). Blood and 24 h urine samples were analyzed for biochemical parameters. The rs11568476 polymorphism in SLC13A2 was analyzed using Real-Time PCR. Results: There were no significant differences between the two groups in terms of age, gender, and most biochemical parameters. Serum uric acid levels were significantly higher in the hypocitraturic group (p = 0.002), whereas family history of stone disease was more prevalent in the normocitraturic group (p = 0.024). Genetic analysis revealed no polymorphism in the rs11568476 region; all patients exhibited the homozygous wild-type genotype (GG). Conclusions: No association was observed between the rs11568476 polymorphism and hypocitraturia in this cohort. The absence of the polymorphism suggests that this variant may be rare or absent in the Turkish population. These findings highlight the importance of investigating additional genetic and environmental contributors to hypocitraturia and nephrolithiasis through larger, multicenter studies.
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    Laparoscopic Extraperitoneal Radical Prostatectomy
    (Galenos Yayincilik, 2020) Tekin, Ali; Yuksel, Alpaslan; Taskiran, Arda Taskin; Senoglu, Yusuf; Kayikci, Muhammet Ali
    Radical prostatectomy (RP) involves removing the entire prostate with its capsule intact and the seminal vesicles (SV). In this video article, we summarized the extraperitoneal laparoscopic RP with pelvic lymph node dissection procedure along with a video presentation of a case. The patient is placed in a Trendelenburg position. Through a small transverse infraumblical incision, the anterior rectus aponeurosis is identified and incised. The extraperitoneal surgical field is developed bluntly by a balloon dilator, and a 10 mm trocar is placed for the camera. CO2 insufflation at a 12-15 mmHg pressure is established, and the remaining trocars are placed. The fatty tissue is swept laterally to create a wide operative field. The endopelvic fascia is incised on both sides. The levator ani muscle fibers are separated from the lateral surface of the prostate. Dorsal vascular complex (DVC) is ligated with 2 consecutive sutures. Identification of the bladder neck (BN) is critical for proper dissection between the prostate and the BN. BN is incised until the catheter is seen. The urethral catheter is removed and a Bougie dilator is inserted through the urethra to elevate the prostate. With posterior oblique dissection, the vasa deferentia are exposed and clip-ligated, and SVs are identified and freed. Then, lateral pedicles are ligated with hemoclips and divided. Lateral dissection proceeds with an anterolateral incision from the base to the prostatic apex. The neurovascular bundles lie posterolateral to the prostate. Apical dissection and division of the DVC and urethra is a critical step to ensure a safe surgical margin and good postoperative erectile function and continence. The urethra is divided with a small rim on the prostate. The gland is totally freed, put into an endobag, and extracted. The vesicourethral anastomosis is done using two 3-0 monocryl sutures in a running fashion, starting from the posterior in both direction and tied together at the 12 o'clock position, anteriorly.
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    Optimizing Prostate Cancer Diagnosis: A Prospective, Randomized Comparison of 12-core vs. 20-core Biopsy for Detection Accuracy and Upgrading Risk
    (Galenos Publ House, 2025) Baba, Dursun; Coban, Soner; Caliskan, Ahmet; Senoglu, Yusuf; Kayikci, Muhammet Ali; Tekin, Ali
    Objective: This study compares the diagnostic efficacy of 12-core and 20-core transrectal ultrasound (TRUS)-guided prostate biopsy protocols in detecting prostate cancer (PCa) and evaluates the clinical significance of extended biopsy protocols. Materials and Methods: A prospective, randomized, single-center study was conducted with 511 patients who underwent TRUS-guided prostate biopsy for suspected PCa. Patients were randomly assigned to either a 12-core biopsy group (n=248) or a 20-core biopsy group (n=263). The primary endpoint was the cancer detection rate, while secondary endpoints included clinically significant cancer detection [International Association of Urological Pathology (ISUP) grade >= 2], biopsy-pathology correlation, upgrade rates, and complication assessment. Results: The 20-core biopsy group had a significantly higher cancer detection rate (39.2%) compared to the 12-core group (28.6%). However, clinically significant cancer detection rates were similar between the groups. The 20-core protocol reduced the likelihood of ISUP grade 1 cancer being upgraded after radical prostatectomy, improving diagnostic accuracy. A strong correlation was observed between tumor burden in biopsy and radical prostatectomy specimens. Prostate-specific antigen density analysis identified an optimal cutoff value of 0.1058, providing 66.1% diagnostic accuracy. Complication rates were comparable between the protocols [5.65% (n=14), 6.46% (n=17)]. Conclusion: The 20-core biopsy protocol enhances overall cancer detection and reduces unnecessary upgrading in low-risk PCa cases, improving diagnostic precision. While multiparametric magnetic resonance imaging (MRI)-guided fusion biopsy offers high accuracy, its limited availability makes extended biopsy protocols a viable alternative, particularly in centers without MRI-based targeting methods. Further multicenter studies are needed to refine biopsy strategies for clinical practice.