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Öğe Agronomical Screening of OGLE1040/TAM O-301 Oat Genetic Mapping Population(Univ Kebangsaan Malaysia, 2019) Dumlupınar, Ziya; Güngör, Hüseyin; Dokuyucu, Tevrican; Herek, Sevgi; Tekin, Ali; Akkaya, AydınIn recent years, mapping populations have provided improvements for oat genomic researches. A two-year study was conducted in East-Mediterranean conditions using Ogle1040/TAm O-301 pure-line mapping population including 136 individuals and parents. Stem diameter (SD), plant height (PH), panicle length (PL), vegetative period (VP), grain filling period (GFP), days to maturity (DM), grain number per panicle (GNP), grain weight per panicle (GwP), thousand kernel weight (TKW) and grain yield (GY) were investigated in 2014 and 2015 cropping seasons in Kahramanmaras. All the investigated traits were significantly different for years (p<0.01) and genotypes (p<0.05 and p<0.01) except SD and GNP. Genotype x year (G x Y) interaction was significant for PL, VP, GFP, DM and GY (p<0.01). In the first year, the average GY per row was 227.6 g, whilst it was 184.5 g in the second year. In terms of GY, the parents Ogle 1040 and TAM O-301 showed lower performance (154.5 and 111.5 g/row, respectively) compared to Ogle1040/TAm O-301 (OT) population average (206 g/row). OT129 genotype had the highest GY with 360 g/row. Principal component (PC) factor analysis yielded 10 PC explaining 100% of total variance in the data and the chi-square values of the PC1 to PC9 were found significant. According to PC biplot analysis, genotypes with high GY, TKW, GNP, GWP, PL and GFP were located throughout the right quadrants whereas the genotypes with high VP, DM and SD were located throughout the left quadrants. The relationships between PH x GY, GWP x GNP and GWP x TKW were positive and significant.Öğe Can Obstructive Sleep Apnea Syndrome be Associated with Urinary Symptoms and Erectile Dysfunction(2016) Çoban, Soner; Cam, Haydar Kamil; Güleç, Ege Balbay; Tekin, Ali; Öner, Balbay; Kayıkçı, Muhammet AliWe planned to investigate the association between Obstructive Sleep Apnea Syndrome (OSAS) and two common urological problems, namely Lower Urinary Tract Symptoms (LUTS) and Erectile Dysfunction (ED). An overnight polysomnograph test was performed for male patients over the age of 50 who presented to Düzce University Medical Faculty, Department of Chest Diseases with symptoms of OSAS. A total of 11 patients with moderate OSAS whose Apnea-Hypopnea index (AHI) was 15-30 and 18 patients with severe OSAS whose AHI was >30 were included in the study as the first group. The 21 OSAS negative patients with AHI <5 constituted the control group. Patients with diseases that could lead to LUTS and ED were excluded from the study for both groups. Urinary symptoms were evaluated with the International Prostate Symptom Score (IPSS), uroflowmetry, prostate volume. Erectile function was assessed according to the International Index of Erectile Function (IIEF). The groups were similar in terms of age, prostate specific antigen (PSA), prostate volume. No statistically significant difference was found between the groups in terms of IPSS values and uroflowmetry parameters (p>0.05). However, there was a statistically significant difference between the groups for nocturia episodes and IIEF scores (p<0.05). OSAS was not found to be an additional risk factor for LUTS other than nocturia. On the other hand, OSAS was related with ED and nocturia. We therefore believe patients with ED and/or nocturia should be evaluated for OSAS. It is also appropriate to investigate OSAS patients in terms of having ED.Öğe Can Reproductive Characteristics Predict Bladder Cancer in Women with Haematuria?(Asian Pacific Organization Cancer Prevention, 2013) Yavuzcan, Ali; Çağlar, Mete; Kayıkçı, Muhammet Ali; Başaran, Ekrem; Tekin, Ali; Özdemir, Enver; Çam, Haydar KamilBackground: Among women with haematuria, defining individuals under high risk for bladder cancer based on reproductive factors prior to cystoscopy would be of great benefit in the management of this condition. The aim of this study was to compare age and reproductive factors such as menopausal status, parity, age at first delivery and age at the last delivery between women who have haematuria with or without bladder cancer. Materials and Methods: A total of 463 patients underwent diagnostic cystoscopy in Duzce University Faculty of Medicine between 1 June 2008 and 1 June 2013. Female patients who presented with persistent microscopic or macroscopic haematuria and underwent standard evaluation for haematuria including urinalysis, urine culture, urine cytology, urinary tract imaging with excretory urography or computerized tomography with contrast enhancement and endoscopic evaluation of the urethra and bladder were included in this study. Exclusion criteria were tobacco use and high risk occupations for bladder cancer such as textile, dry cleaning, painting and etc. Forteen women had hematuria due to benign conditions, and 18 due to bladder cancer. Data were retrospectively retrieved from the medical records of Duzce University Hospital. Results: Patients with haematuria due to benign reasons did not significantly differ from patients who were found to have bladder cancer in terms of age (p=0.28), menopausal status (p=0.29), mean parity (p=0.38), being nulliparous (p=0.57), parity >= 3 (p=0.22), age <= 18 years at first delivery (p=1.00), age >= 30 years at last delivery (p=0.26), age >= 35 years at last delivery (p=0.23) and percentage of the patients with advanced age (>= 65 years) (p=0.18). Conclusions: It is difficult to predict a high risk for developing bladder cancer in women with haematuria based solely on reproductive factors.Öğe Case report: Large adrenal ganglioneuroma(Elsevier Ltd, 2014) Kaçağan, Coşkun; Başaran, Enise; Erdem, Havva; Tekin, Ali; Kayıkçı, Ali; Çam, KamilIntroduction Ganglioneuromas are localized tumors derived from neural crest tissues. Characteristically, they originate in the posterior mediastinum. Pure adrenal gangliomas are extremely rare. PRESENTATION OF CASE A left adrenal mass with the size of 68 mm × 50 mm × 86 mm on magnetic resonance imaging was documented in a 53-year-old female patient. Endocrine tests revealed a non-functioning adrenal mass. The actual size of the mass was macroscopically measured to be 16 cm × 8.5 cm × 6 cm after the surgery. Histopathological examination indicated ganglioneuroma. DISCUSSION Most adrenal ganglioneuromas can incorrectly be diagnosed as other adrenal tumors, since they are rare neurogenic benign tumors with no specific imaging properties. They have a slow growth pattern and usually asymptomatic. Our case represents a huge adrenal ganglioneuroma in a female patient with nondiagnostic flank pain. Radiological imaging showed a large adrenal mass with no differentiation from other adrenal tumors. Endocrine evaluation should be performed for such adrenal masses. Since our case had a relatively large size, open surgery was preferred. Pathology revealed the definitive diagnosis. CONCLUSION This case suggests that ganglioneuromas can wrongly be diagnosed as other adrenal tumors. It is significant that a proper differential diagnosis should be performed by using hormonal and imaging techniques. Nevertheless, pathological examination is usually required for definitive diagnosis. © 2014 The Authors.Öğe Comparison of Early Versus Late Urethral Catheter Removal After Transurethral Resection of the Prostate in Patients with Benign Prostate Hyperplasia(Duzce Univ, Fac Medicine, 2023) Senoglu, Yusuf; Tekin, Ali; Yildirim, Olcay; Baba, Dursun; Yuksel, AlpaslanObjective: Transurethral resection of the prostate (TURP) is considered the standard in the surgical therapy of lower urinary tract symptoms related to benign prostate hyperplasia (BPH). However, there is no consensus on the timing of catheter removal. In this study, we aimed to compare the long-term effects of early and delayed removal of urethral catheters who underwent TURP.Methods: We prospectively analyzed a total of 91 patients who underwent TURP. Patients were randomized into two groups; the early (postop 1st-2nd days) and delayed (7th day) removal of the urethral catheter. After the surgery in 1, 3, and 6th months, we evaluated all patients regarding treatment success. In addition, international prostate symptom score (IPSS), quality of life (QoL), maximum flow rate, postvoid residual urine volume, and morbidities (hematuria, infection, urethral stricture, irritative symptoms, need for re-operation) were assessed at all visits.Results: After TURP, there was no statistical difference in urodynamic parameters, complications, IPSS, and QoL in both groups. Only in the 3rd-month, the maximum flow rate was higher in favor of the early group. Despite similar results in both groups, strictures occurred earlier in the early group than delayed group (respectively 1 and 3 months).Conclusions: These results suggest that there are no differences in efficacy and complications in groups of early or delayed urethral catheter removal after TURP. The results of long-term studies with large series should be awaited to reach a more definite conclusion. We have tried to shed light on a topic without consensus on the time of urethral catheterization after TURP.Öğe Determination of Allelic Variation of Karahan-99 × BW3 Bread Wheat Population F4 Individuals Using DNA Markers(Türk Ziraat Yüksek Mühendisleri Birliği, 2023) Yüce, İlker; Topsakal, Münire; Tekin, Ali; Tekin, İmren Çöken; Demirezen, Ayşe Nur; Şenay, Ali; Korucu, BurakhanWheat is the main nutrient that mankind has used since settled life. Plant breeders are making great efforts to increase the yield of wheat plant in parallel with the increasing world population. In this study, 22 F4 lines obtained as a result of crossing Karahan-99 bread wheat variety with BW3 wheat genotypes were characterized with 11 functional DNA markers belong to some agronomic traits. Of the 11 markers used in the study, seven worked (Xgwm18, Xwgp118, Xgwm131, Xgwm47, Sun479, Sun209 and UHW89) in Karahan-99 × BW3 Bread Wheat Population. While the highest number of alleles was obtained from the Sun479 marker (18 bands), the lowest band number was obtained from the markers UHW89 and Xgwmn131 (1 band). The mean number of alleles was 6.71, while the mean polymorphism information content (PIC) was 0.99. Xgwm131 marker encoding Yr39 yellow rust allele was interrogated at Karahan-99_M6_72-10/BW3_F4_3 genotype, while Xgwm18 marker amplified Yr26 stripe rust resistant gene at Karahan-99_M6_72-10/BW3_F4_22.Öğe Effects of combined estrogen and progesterone replacement treatment on detrusor contractility and histology in oophorectomized rats(Wiley-Blackwell, 2011) Sayharman, Sema Etiz; Tosun, Nihan; Aka, Nurettin; Köse, Gültekin; Tekin, Ali; Gören, ZaferAim: The aim of this study was to investigate the effects of estrogen plus progesterone treatment administered after surgical menopause on morphological and muscarinic receptor sensitivity in detrusor muscle bands of rats. Materials and Methods: A total of 40 female Albino-Wistar rats were assigned into two groups to undergo surgical menopause with sham operation (n = 10) and bilateral oophorectomy (n = 30). Thirty oophorectomized rats were assigned into three groups for different treatments administered for 8 weeks beginning from the 7th postoperative day. At the end of the 8th postoperative week, laparotomy was performed in all of them and the urinary bladders were excised and investigated with light microscope. All statistical analysis and graphs were performed using GraphPad Prism version 4. P < 0.05 was considered to be statistically significant. Results: It was determined that average bodyweights were increased to some extent in oophorectomized and sham groups after treatment and while it was more marked in the group receiving estrogen therapy, bodyweights were decreased in the group receiving estrogen plus progesterone therapy. However, this was not statistically significant. No statistically significant difference was determined between the sham, placebo and 17-beta estradiol treatment groups regarding contractile response of urinary bladder tapes to carbachol (P > 0.05). Contractile responses of urinary bladder tapes of the estrogen plus progesterone treatment group were found to be statistically lower than the placebo group (P < 0.05). Conclusion: Our in vitro findings demonstrate that treatment with estrogen plus progesterone decreases muscarinic activity in oophorectomized rats, whereas estrogen-only treatment does not. Our study establishes the basis for further studies to answer whether combination of estrogen and progesterone treatment can restore detrusor overactivity associated with sex hormone defects seen at menopause.Öğe The Effects of Medical Treatments Used for Benign Prostatic Hyperplasia on Ejaculation(Galenos Yayincilik, 2015) Kayıkçı, Ali; Kaçağan, Coşkun; Tekin, AliIn men, significant lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) requiring treatment increase with aging. Though declining with aging, many individuals in this population sustain their sexual activities. Many drugs commonly used to treat LUTS may have significant adverse effects on sexual functions including ejaculatory function. Among alpha 1 adrenergic receptor (alpha 1-AR) blockers, the most commonly used drugs for treatment of BPH, silodosin and tamsulosin have been associated significantly with ejaculatory dysfunction. Silodosin and tamsulosin lead to ejaculatory problems respectively 32.5 (p<0.0001) and 8.6 times (p=0.006) higher than placebo does. Other drugs in this class such as terazosin, alfuzosin and doxazosin have minimal effects on ejaculation. There seems to be a positive association between development of ejaculatory dysfunction and therapeutic efficacy of the a1-AR blockers. In addition to alterations in libido and penile erection, 5-alpha reductase inhibitors (5ARI) can cause ejaculatory dysfunction. The rate of abnormal ejaculation with finasteride and dutasteride is similar and three times more than placebo (p<0.0001). Abnormal ejaculation is more common with combination therapy of alpha 1-AR blockers and 5ARI than treatment with the individual class of these drugs. In conclusion, treatment with alpha 1-AR blockers, 5ARI or combination of both can cause ejaculatory dysfunction with varying degrees. As this may have a significant impact on quality of life, individuals for whom medical treatment are planned to relieve LUTS due to BPH should be informed and counseled for drug choice.Öğe Enflamasyonun Etiyopatogenez ve Tedavi Hedefi Olarak Benign Prostat Hiperplazisindeki Rolü(Galenos Yayincilik, 2015) Tekin, Ali; Yüksel, AlpaslanBenign prostat hiperplazisinin (BPH) etiyopatogenezi henüz tam olarak aydınlatılmamış olmakla birlikte, güncel literatür bilgileri prostatik enflamasyonun etiyolojide önemli olabileceğini ve tedavi hedefi olarak bir potansiyel olabileceğini işaret etmektedir. Sadece prostatik enflamasyonun varlığı değil, aynı zamanda bunun derecesi ve şiddeti, Uluslararası Prostat Semptom Skoru ile yakın ilişkili olup, BPH progresyonunu (semptom artışı, akut üriner retansiyon, cerrahi gerekliliği) belirleyici özelliğe sahiptir. Enflamasyonun hangi mekanizma ile BPH oluşumuna neden olduğu tam olarak aydınlatılmamıştır. Bununla birlikte, yaşlanmaya bağlı immünite zayıflaması ve ortaya çıkan hormonal değişikliklerin rolü olabilir. Oksidatif stres, androjen bağımlı genler ve tümör growth faktör-β1 kaskad genlerinin artışı, prostatik antijenleri görmemeyi sağlayan baskılayıcı hücrelerin azalması, IL-6, IL- 8, IL-15 gibi proenflamatuvar sitokinler ile siklooksigenaz-2 ekspresyonu etkisiyle yıkıcı enflamatuvar hücrelerin infiltrasyonu sonucu gelişen zincirleme olaylar da BPH oluşumuna katkı sağlayabilir. Kanıta dayalı veriler nonsteroid anti-enflamatuvar ilaç kullanımının enflamasyonu baskılayıcı mekanizma üzerinden prostat büyümesini, alt üriner sistem yakınmalarının progresyonunu, idrar akım hızında azalmayı ve prostatspesifik antijen yükselmesini engelleyebileceğini veya geciktirebileceğini göstermektedir. Bunun yanında, D vitamini agonistleri, serenoa repens ve fosfodiesteraz-5 inhibitörlerinin BPH tedavisindeki etkinliklerinin bir kısmından enflamasyonu baskılamaları sorumlu olabilir. Sonuç olarak prostatik enflamasyon BPH patogenezinde ve progresyonunda önemli bir role sahip gibi görünmektedir. Anti-enflamatuvar etkili ilaçların yakın gelecekte BPH’nın medikal tedavisinde daha fazla yer alması beklenmelidir.Öğe Free Prostate-specific Antigen Is a Better Tool Than Total Prostate-specific Antigen at Predicting Prostate Volume in Patients With Lower Urinary Tract Symptoms(Elsevier Science Inc, 2012) Kayıkçı, Ali; Çam, Kamil; Kaçağan, Coşkun; Tekin, Ali; Ankaralı, HandanOBJECTIVE To evaluate the relationships among age, total prostate-specific antigen level (PSA), free PSA level, and prostate volume. METHODS A total of 656 patients complaining of lower urinary tract symptoms who attended our urology outpatient department were enrolled. The standard assessment for lower urinary tract symptoms was applied, including serum total and free PSA determinations and transabdominal prostate volume measurement. Patients with a history of transurethral surgery, prostate cancer, and conditions other than benign prostatic hyperplasia that could affect the PSA levels were excluded. A linear regression model was used to estimate the prostate volume. Receiver operating characteristic curves were constructed to evaluate the ability of serum PSA and free PSA to estimate threshold prostate volumes and to select the optimal serum PSA and free PSA cutoff values. RESULTS The linear regression model included age (P < .000), total PSA (P < .006), and free PSA (P < .000) as independent predictors of prostate volume. Consequently, an easy to use equation was developed to estimate the prostate volume. Free PSA performed better than total PSA at predicting the prostate volume. An area under the curve of 0.668 +/- 0.022 at predicting prostate volume >40 cm(3) with total PSA increased to 0.721 +/- 0.021 with free PSA. Moreover, free PSA with a cutpoint of 0.495 ng/mL correctly estimated a prostate volume of >40 and <40 cm(3) in 71% and 66% of the cases, respectively. CONCLUSION The prostate volume can be estimated using easily obtained serum PSA levels, and free PSA had a better performance. UROLOGY 80: 1088-1092, 2012. (C) 2012 Elsevier Inc.Öğe High Power Diode Laser Vaporization of the Prostate: Preliminary Results for Benign Prostatic Hyperplasia(Elsevier Science Inc, 2009) Erol, Ali; Çam, Kamil; Tekin, Ali; Memik, Ömür; Çoban, Soner; Özer, YavuzPurpose: Vaporization techniques using lasers have gained wide acceptance for benign prostatic hyperplasia as an alternative to transurethral prostate resection. The high power, 980 nm wavelength diode laser is a new promising alternative with a more rapid ablation rate and excellent hemostatic properties, as shown in ex vivo and in vivo animal models. We prospectively evaluated vaporization efficiency of the high power, 980 nm diode laser for bladder outlet obstruction due to benign prostatic hyperplasia. Materials and Methods: A total of 47 consecutive patients were included in the study. Inclusion criteria were maximal flow rate 12 ml per second or less with voided volume 150 ml or greater, International Prostate Symptom Score 12 or greater and quality of life score 3 or greater. Patients with a history of neurogenic voiding dysfunction, chronic prostatitis, or prostate or bladder cancer were excluded from analysis. Preoperative maximal flow rate, post-void residual urine, International Prostate Symptom Score, quality of life, International Index of Erectile Function-5, prostate specific antigen and prostate volume were compared with values at 3 and 6 months. Complications were assessed. Results: Month 3 assessment revealed that the mean +/- SD International Prostate Symptom Score decreased significantly from 21.93 +/- 4.88 to 10.31 +/- 3.79 (p = 0.0001). The mean maximal flow rate increased significantly from 8.87 +/- 2.18 to 17.51 +/- 4.09 ml per second (p = 0.0001). Quality of life score changed considerably compared to baseline. All of these values showed slight improvement at month 6. There was no deterioration in erectile function according to the International Index of Erectile Function-5 short form. Post-void residual urine decreased significantly. Prostate volume and prostate specific antigen reductions were also significant. The most common postoperative complications were retrograde ejaculation (13 of 41 patients or 31.7%) and irritative symptoms (11 of 47 or 23.4%), which subsided in the maximal flow rate at 2 weeks. Recatheterization was necessary in 2 patients due to urinary retention after catheter removal. Two patients had temporary combined urge and stress incontinence for 2 weeks. Late bleeding in 1 patient 4 weeks postoperatively necessitated catheterization and irrigation. Conclusions: The high power diode laser provided significant improvements in International Prostate Symptom Score and the maximal flow rate with low morbidity. Thus, these results of prostate vaporization with the high power diode laser, representing what is to our knowledge the first clinical study in the literature, are encouraging.Öğe Investigation of the Relationship of Two-Glass Test with Prostate Biopsy and Presence and Grade of Asymptomatic Prostate Inflammation in Men with Serum Prostate-Specific Antigen Level Between 2.5-10 ng/ml(Duzce Univ, Fac Medicine, 2024) Yuksel, Alpaslan; Tekin, Ali; Senoglu, Yusuf; Baba, Dursun; Gamsizkan, MehmetObjective: Prostate-specific antigen (PSA) is utilized as a marker to detect prostate cancer. Elevated PSA levels often lead to prostate biopsy to assess the potential presence of cancer. However, PSA elevation is not specific to cancer and can be caused by various conditions, including benign prostatic hyperplasia (BPH), urinary tract infections, and chronic prostatitis. Notably, approximately 66% of patients undergoing biopsy do not have prostate cancer, leading to unnecessary procedures and associated complications. Chronic prostatitis is detected in around 40% of these biopsies. The two-glass test involves examining urine before and after a rectal examination to diagnose chronic prostatitis. This study aims to investigate the effectiveness of the two-glass test in predicting prostatitis and inflammation in patients with PSA levels between 2.5-10 ng/ml who have undergone prostate needle biopsy. Materials and Methods: The study included fifty-two male patients aged between 50 and 78 years with PSA levels between 2.5 and 10 ng/ml who presented to our clinic. All patients underwent the EPS-two-glass test and prostate biopsy. EPS (expressed prostatic secretion) is obtained by collecting fluid from the urethra after prostate massage, while VB-3 (voided bladder-3) is urine collected after a massage. These samples are used to detect prostate infection. Prostate inflammation was deemed significant if >= 10 leukocytes were observed under the microscope. Patients were categorized into three groups based on pathology results: prostate cancer, BPH, and chronic prostatitis. The chronic prostatitis group was further classified based on histopathological calcification described by Nickel. Results: Chronic prostatitis was detected in 38% of the study participants. VB3 positivity was significantly higher in the chronic prostatitis group compared to the other groups (p = 0.028). Although no significant difference was observed in the prevalence of inflammation and PSA elevation, PSA levels were higher in the multifocal inflammation subgroup compared to the focal inflammation group. Conclusions: The relationship between chronic prostatitis and PSA elevation remains unclear. Although this study did not find a statistical relationship between inflammation and PSA elevation, the significant correlation between chronic prostatitis and VB3 positivity suggests a potential link. These findings can serve as a foundation for further research aimed at reducing unnecessary biopsies.Öğe Investigation the Relationship of Lower Urinary Tract Symptoms withVascular Risk Factors(2015) Çoban, Soner; Altuner, M. Şakir; Cander, Soner; Türkoğlu, Ali Rıza; Güzelsoy, Muhammet; Gül, Özen Öz; Tekin, AliOur aim was to investigate the relationship between lower urinary tract symptoms (LUTS) in terms of vascular risk factors include diabetes. In a prospective study, a total of 116 men aged 40 years or more who presented to the outpatient clinics of urology or endocrinology between January 2012 and April 2013 were included. After receiving a detailed medical history, fasting blood glucose, serum lipids including total cholesterol, HDL and triglyceride, HbA1c, creatinine, total testosterone and total prostate-specific antigen were measured. Urinalysis and uroflowmetry were done. Postvoiding residual urine and prostate volume were measured by suprapubic ultrasonography. International Prostate Symptom Score (IPSS) of the patients were determined. Existence of vascular risk factors including hypertension, hyperlipidemia, diabetes mellitus, coronary artery disease and obesity as well as age, body mass index (BMI), weight, waist circumference and body fat percentage values were recorded. Of the patients, 41 (35.3%) had hypertension, 54 (46.6%) dyslipidemia, 68 (58.6%) diabetes mellitus, 34 (29.3%) coronary artery disease and 39 (33.6%) obesity. When the patients were grouped according to the presence of the risk factors (no risk [14 patients], mild to moderate [1-2 risk factor] [65 patients] and severe [3 or more risk factors] [37 patients]), there was no a significant difference among the groups in terms of IPSS (p 0.76). The results of this prospective study show that vascular risk factors and diabetes may not be related to LUTS.Öğe Laparoscopic Extraperitoneal Radical Prostatectomy(Galenos Yayincilik, 2020) Tekin, Ali; Yuksel, Alpaslan; Taskiran, Arda Taskin; Senoglu, Yusuf; Kayikci, Muhammet AliRadical 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.Öğe Leiomyoma of the urinary bladder in asymptomatic women(2012) Erdem, Havva; Yıldırım, Ümran; Tekin, Ali; Kayıkçı, Ali; Uzunlar, Ali Kemal; Şahiner, CemMost bladder tumors are derived from the urothelium. Benign mesenchymal tumors are rare. Leiomyomas account for less than 0.43% of all bladder tumors. Genitourinary leiomyomata may arise in any anatomic structure containing smooth muscle. They have been reported to involve single or multiple organs. Since they may also mimic malignant lesions, they should always be considered in the differential diagnosis of any pelvic mass, with a possibility of being asymptomatic and discovered incidentally by radiographic imaging. We, herein, report a case illustrating clinical and pathological features in particular immunohistochemistry, and discuss its etiology and differential diagnosis.Öğe Mast cells numbers and peritumoral microvessel density of the prostatic adenocarcinomas and correlation with prognostic parameters(2013) Erdem, Havva; Kayıkçı, Muhammet Ali; Oktay, Murat; Uzunlar, Ali Kemal; Tekin, Ali; Şener, Ebru; Kadıoğlu, NilüferAim To determine the utility of mast cell numbers and microvascular density (MVD) in evaluating acinar type of prostatic adenocarcinoma (PCa), and to ascertain a relationship between the number of mast cells with prognostic parameters (larger tumor volume, high Gleason score, lymphovascular, perineural, seminal vesicles invasion, metastatic lymph node). Methods The study comprised 97 radical prostatectomy specimens. The paraffin sections were stained with anti-CD31, anti- CD34 and Toluidine Blue. The numbers of positive staining of cells and microvessels in 10 high-power fields were counted systematically. Results A statistically significant relationship was found between MVDn and number of MC (r=0.218 and p=0. 032). There was no correlation between age and MC and MVD (p=0.406 and p=0.671, respectively). Conclusion A correlation between mast cell number and microvascular density cannot depend on tumor angiogenesis or this relationship can be an independent parameter. More comprehensive studies could reveal relationship with prognostic parameters.Öğe Myxoma of the renal sinus: case report and literature review(2012) Yıldırım, Ümran; Erdem, Havva; Kayıkçı, Ali; Uzunlar, Ali Kemal; Tekin, Ali; Kuzey, Mehmet AkifMiksoma nadir görülen benign mezankimal tümör olup literatürde sıklıkla kalp ve deride rapor edilmiştir. Böbrekte görülen mezankimal tümörler içerisinde miksoma oldukça nadir izlenmekte olup literatürde bugüne kadar 11 olgu bildirilmiştir. Bunlardan bir tanesi renal sinüs yerleşimlidir. 82 yaşında erkek hasta, parsiyel üriner obstrüksiyon semptomlarıyla hastanemize kabul edildi. Yapılan abdominal bilgisayarlı tomografide sol böbrek hilusunda yerleşim gösteren hipodens, parankimle sınırları net olarak seçilemeyen, 9 cm boyutunda solid kitle tespit edildi. Böbrekte kitle nedeniyle sol renal nefrektomi yapılan hastanın gross incelemesinde, renal sinüs kaynaklı sınırları net olarak seçilemeyen jelatinöz görünümde tümör dokusu izlendi. Mikroskopik olarak bol mukoid materyal içerisinde dağılmış, iğsi sitoplazmalı, bazıları yıldızsı görünümde hücrelerden oluştuğu gözlendi. Tümör hücreleri vimentin ile pozitif, düz kas aktini ile fokal pozitiflik gösterirken, S-100 protein, epitelyal membran antijeni ve pansitokeratin ile negatif boyanma göstermiştir. Biz burada renal sinüs kaynaklı ikinci olguyu sunduk.Öğe Myxoma of the renal sinus: Case report and literature review(Federation of Turkish Pathology Societies, 2012) Yıldırım, Ümran; Erdem, Havva; Kayıkçı, Ali; Uzunlar, Ali Kemal; Tekin, Ali; Kuzey, Mehmet AkifMyxoma is a rare mesenchymal tumor and it is mainly seen in heart and skin. Renal myxoma is extremely rare. To date, eleven cases of kidney myxomas have been reported in the literature. One of them is myxoma of the renal sinus. Our case was an 82-year-old man admitted to our hospital symptoms related to the urinary tract obstruction. Abdominal computerized tomography revealed a solid, hypodense mass 9 cm in diameter infiltrating the renal parenchyma in the renal pelvis. Te patient underwent nephrectomy. Te resected kidney contained gelatinous tumor with indistinct borders. Te tumor was composed of slender, bland, spindle-shaped cells with large amounts of mucoid material. Tumor cells were positively stained with vimentin, focally stained positive for smooth muscle actin and had negative reactivity for S-100 protein, epithelial membrane antigen and pancytokeratin. Herein we report the second case of renal myxoma arising from the renal sinus.Öğe Öğe Post-Prostatic Massage Examination for Prediction of Asymptomatic Prostatitis in Needle Biopsies: A Prospective Study(Elsevier Science Inc, 2009) Tekin, Ali; Yüksel, Alpaslan; Tekin, Soner; Gümrükçü, Gülistan; Aslan, Ahmet Rüknettin; Şengör, FeridunPurpose: Although asymptomatic prostatitis is the most common noneancer diagnosis as demonstrated histologically by biopsies, screening and identification before biopsy remain unclear. In this study we prospectively evaluate the efficacy of examination of post-prostatic massage urine for prediction of asymptomatic prostatitis in biopsies. Materials and Methods: A total of 161 consecutive men 50 to 80 years old with serum prostate specific antigen 4.1 to 10.0 ng/ml, normal digital rectal examination, no evidence of clinical prostatitis or urinary tract infection, who underwent 8 or 10-core prostate biopsies under transrectal ultrasonography guidance were included in the study. Immediate pre-biopsy leukocyte count in post-prostatic massage urine was determined per high power field (400 X). We selected 5, 7 and 10 leukocytes per high power field as cutoffs, and urine was examined for prediction of histological prostatitis. Results: Histological diagnosis was prostatitis, benign prostatic hyperplasia and prostate cancer in 66 (41.0%), 63 (39.1%) and 32 (19.9%) patients, respectively. The mean number of leukocytes and percentage of positive post-prostatic massage urine microscopy for all cutoffs were significantly higher in subjects with prostatitis than in those without prostatitis (p<0.0001). Histological prostatitis was predicted most accurately by the 5 leukocyte cutoff (sensitivity 68.2%, specificity 82.1% and area under the receiver operating characteristics curve 0.75). Conclusions: In asymptomatic men with mild increases of prostate specific antigen histological evidence of prostatic inflammation is common. The leukocyte count in post-prostatic massage urine appears to be useful for screening of this condition before biopsy. Our data suggest that 10 leukocytes per high power field in post-prostatic massage urine, the usually applied cutoff, may be too high for the definition of prostatic inflammation.
