21 results on '"Çağ Çal"'
Search Results
2. Long-term Results of Patients with Testicular Tumors Undergoing Testis Sparing Surgery: A Single-center Experience
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Fuat Kızılay, Serdar Kalemci, Adnan Şimşir, Hamed Jafarzadeh Andabil, Banu Sarsık, Sait Şen, Çağ Çal, and İbrahim Cüreklibatır
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Testicular tumor ,Testis-sparing surgery ,Orchiectomy ,Frozen section ,Organ-sparing treatment ,Positive surgical margin ,Surgery ,RD1-811 ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Objective:To determine the clinicopathologic and oncologic outcomes of testis-sparing surgery (TSS) by evaluating the data of patients who underwent TSS in our clinic.Materials and Methods:A total of 24 patients (27 testes) who underwent TSS in the last 16 years were included in the study. All the patients presented with a solitary testicular mass or bilateral testicular mass. Preoperative tumor markers were investigated and scrotal ultrasonography was performed in all patients. Surgery was performed with inguinal incision, temporary clamping of the spermatic cord and frozen section analysis (FSA) of the lesion. Intraoperative data, histopathological findings, and recurrence status were analyzed.Results:The mean follow-up period was 96 months. The mean age of the patients was 29.7 (18-66) years. The mean tumor diameter was 11 mm (2-18). TSS was performed bilaterally in 3 patients and unilaterally in 24 patients. According to the final pathology report, 18 (66.7%) of the masses were benign and 9 (33.3%) were malignant. Intraoperative FSA was performed in 17 patients (70.8%). FSA revealed malign histopathology in 6 patients and complementary orchiectomy was performed in 4 of these patients. 14 patients (51.9%) were detected to have positive surgical margins. Two of these patients had seminoma diagnosis and radical orchiectomy was performed due to recurrence on follow-up in these patients. TSS was performed in all patients without any significant intra-postoperative complications.Conclusion:TSS may have significant functional and cosmetic benefits without worsening oncologic results in appropriately selected patients.
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- 2019
- Full Text
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3. Comparison of Shockwave Lithotripsy and Laser Ureterolithotripsy for Ureteral Stones
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Tuncer Bahçeci, Fuat Kızılay, Ahmet Çağ Çal, and Adnan Şimşir
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ureteral stones ,ureterorenoscopy ,shockwave lithotripsy ,holmium laser ,Surgery ,RD1-811 ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Objective:This study aimed to compare shockwave lithotripsy (SWL) with ureteroscopic lithotripsy (URS) for ureteral stones in terms of stone-free rates, complication rates, and overall treatment costs.Materials and Methods:Data of 886 adult patients who underwent URS or SWL were retrospectively evaluated, of which 184 patients underwent SWL and 702 underwent URS. The groups were compared in terms of patient characteristics, stone-free rates, complications, and costs.Results:No significant differences were found between the groups in terms of age, gender, and relevant sides (p>0.05). A significant difference was observed in favor of SWL for upper ureteral stones
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- 2021
- Full Text
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4. Prostat Kanseri Kök Hücrelerinde Zoledronik Asit Tedavisinin Hücre Adezyon Moleküllerine Etkisi
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Burak Cem SONER, Eda AÇIKGÖZ, Gülperi ÖKTEM, and Çağ ÇAL
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Oncology ,prostate cancer ,cancer stem cell ,zoledronic acid ,cell adhesion molecules ,treatment ,Prostat kanseri ,kanser kök hücresi ,zoledronik asit ,hücre adezyon molekülleri ,tedavi ,Onkoloji - Abstract
Although the diagnosis and treatment of prostate cancer has made a progress, the disease remains fatal for some cases. Every step taken to save patients from death helps to approach the goal but there are still many issues that need to be investigated to reach a result.With the discovery of stem cells, the importance of these cells for human health has been understood and studies on how to use them in treatment have gained great momentum. In the following years, the concept of Cancer Stem Cell has emerged. It has been shown that these cells have stem cell characteristics but metastasize within the tumor tissue. They can cause recurrence after treatment or develop resistance to treatment. The other group of cells with rootedness is the non-cancer stem cell group and are cancer cells that respond to conventional cancer treatment. Adhesion molecules are of great importance in the cancer metastasis and invasion into the surrounding tissue. Studies have shown that adhesion molecules has great importance spesifically in multi-drug resistance and epithelial-mesenchymal transition.The aim of this study is to examine the effect of zoledronic acid application on prostate cancer stem cells on adhesion molecules, which have an important role in the metastasis development process. For this purpose, zoledronic acid treatment was applied to cancer stem cells isolated from DU145 human prostate cancer cell line using a flow cytometry device and CD133/CD44 surface markers. Changes in cancer stem cells have been investigated in terms of adhesion molecules. The results showed that there was a significant decrease in the number of cancer stem cells after zoledronic acid treatment and this application led to significant changes in CD44, ITGB1, CD29, LAMB1, LAMB3, LAMC1, SPP1, TGFB1, TGFB1, TIMP2, ADAMTS1, ITGB5.In this study, it has been shown that zoledronic acid administration in-vitro has a suppressive effect on cancer stem cell adhesion molecules and that this drug may be used in the treatment of prostate cancer in clinical use in further studies., Prostat kanserinin tanı ve tedavisine yönelik birçok alanda ilerleme sağlanabilmesine rağmen hastalık bazı vakalar için ölümcül olma niteliğini sürdürmektedir. Hastaların ölümden kurtulması için atılan her adım hedefe yaklaşılmasına yardım etse de halen sonuca ulaşmak için araştırılması gereken pek çok konu bulunmaktadır.Kök hücrenin keşfi ile bu hücrelerin insan sağlığı için önemi anlaşılmış ve tedavide nasıl kullanılacağının belirlenmesine yönelik çalışmalar büyük hız kazanmıştır. İlerleyen yıllarda Kanser Kök Hücresi kavramı ortaya çıkmış ve bu hücrelerin, kök hücre özelliklerini taşıyan ancak tümör dokusu içinde metastazı yapan, tedavi sonrası nükse yol açabilen veya tedaviye direnç̧ geliştiren hücreler oldukları belirlenmiştir. Köklülük özelliğine sahip bu hücreler dışında kalan hücre gurubu kanser kök hücresi olmayan hücre gurubudur ve konvansiyonel kanser tedavisine cevap veren kanser hücrelerdir. Kanserin metastaz yapması ve çevre dokuya invazyonunda adezyon moleküllerinin önemi büyüktür. Yapılan çalışmalar özellikle çoklu ilaç direnci ve epitelial mezenşimal geçişte adezyon moleküllerinin büyük önem kazandığını göstermiştir.Bu çalışmanın amacı prostat kanseri kök hücreleri üzerine zoledronik asit uygulaması sonrası, metastaz geliştirme sürecinde önemli rolü olan adezyon molekülleri üzerine etkisinin incelenmesidir. Bu amaçla DU145 insan prostat kanseri hücre hattından akım sitometri cihazı ile CD133/CD44 yüzey belirteçleri kullanılarak izole edilen kanser kök hücreleri üzerine zoledronik asit tedavisi uygulanmıştır. Kanser kök hücresinde oluşan değişiklikler adezyon molekülleri yönü ile araştırılmıştır. Elde edilen sonuçlar zoledronik asit tedavisi sonrası kanser kök hücresi sayısında önemli bir düşüş olduğunu ve bu uygulamanın CD44, ITGB1, CD29, LAMB1, LAMB3, LAMC1, SPP1, TGFB1, TGFB1, TIMP2, ADAMTS1, ITGB5’de önemli değişimlere yol açtığını göstermiştir. Bu çalışmada in-vitro ortamda zoledronik asit uygulamasının kanser kök hücresi adezyon molekülleri üzerine baskılayıcı etki oluşturduğu ve ilerleyen çalışmalarda bu ilacın klinik kullanımda prostat kanseri tedavisinde uygulanabilme olasılığının olduğunu göstermiştir.
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- 2022
5. Functional Roles of miR-625-5p and miR-874-3p in the Progression of Castration Resistant Prostate Cancer
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Çağdaş Aktan, Çağ Çal, Burçin Kaymaz, Nur Selvi Günel, Sezgi Kıpçak, Buket Özel, Cumhur Gündüz, Ali Şahin Küçükaslan, Duygu Aygüneş Jafari, and Buket Kosova
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microRNA-874-3p ,Male ,Deprivation ,Cells ,Proliferation ,Expression ,General Medicine ,General Biochemistry, Genetics and Molecular Biology ,Metastasis ,Gene Expression Regulation, Neoplastic ,Androgen receptor ,MicroRNAs ,Prostatic Neoplasms, Castration-Resistant ,Invasion ,Cell Line, Tumor ,Mechanisms ,Androgens ,Humans ,microRNA-625-5p ,Castration resistant prostate cancer ,General Pharmacology, Toxicology and Pharmaceutics ,Prostate specific antigen ,Migration ,Cell Proliferation - Abstract
Aims: Androgen receptor (AR) signaling is important in normal prostate and prostate tumor tissues. Thus, the new therapeutic strategies targeting ARs may also be important for treatment of prostate cancer (PC) and its biology. The studies have shown that miRNAs to be dysregulated in PC progression. Therefore, in the present study, differentially expressed miRNAs that predictively target the ARs were identified and investigated by in silico analysis. Main methods: Cellular proliferation, qPCR, western blot and apoptosis assays were performed to investigate the molecular mechanism of the selected miRNAs in the PC cells. Key findings: In our miRNA qPCR study, several miRNAs were found to be differentially regulated in castration resistant prostate cancer (CRPC) cells (LNCaP-Abl and LNCaP-104R2) compared with androgen dependent (AD) cells (LNCaP). The expression levels of miR-625-5p and miR-874-3p were significantly increased in LNCaP-Abl (2.62-fold, p = 0.0002; 4.00-fold, p = 0.00002, respectively) and LNCaP-104R2 (2.44-fold, p = 0.0455; 3.77 fold, p = 0.0383, respectively) compared with AD cells. The expression levels of AR and prostate specific antigen were increased in PC cells compared with AD cells. Furthermore, transfection of PC cells with anti-miRs suppressed their proliferation and AR protein levels (p < 0.05). Significance: Several differentially regulated miRNAs were identified in CRPC cells, including miR-625-5p and miR-874-3p that are potentially involved in PC progression. These results may provide novel insights into the molecular mechanism underlying CRPC cells and miRNA applications may constitute a new and alternative method to prevent development of CRPC cells in the future., Ege University Scientific Research Projects Fund [2012/TIP/045], Acknowledgements This study was supported by Ege University Scientific Research Projects Fund which is Grant Number 2012/TIP/045.
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- 2022
6. Ege Üniversitesi Hastanesinde renal kanser hastalarının epidemiyolojisi ve genel sağ kalım özellikleri
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Ayfer Haydaroğlu, Erhan Gokmen, Serdar Özkök, Sait Şen, A. Çağ Çal, Pınar Gürsoy, Burcu Çakar, Ayşe Caner, Erdal Apaydin, and Banu Sarsik Kumbaraci
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medicine.medical_specialty ,Kidney cancer,epidemiology,incidence,overall survival ,business.industry ,Wilms' tumor ,General Medicine ,Chromophobe cell ,Böbrek kanseri,epidemiyoloji,insidans,genel sağ kalım ,medicine.disease ,Gastroenterology ,Primary tumor ,Health Care Sciences and Services ,Renal cell carcinoma ,Internal medicine ,Clear cell carcinoma ,medicine ,Sarcoma ,Sağlık Bilimleri ve Hizmetleri ,business ,Kidney cancer ,Survival analysis - Abstract
Aim: The purpose of this study was to describe the general characteristics, treatment modalities andoverall survival times of kidney cancer patients that diagnosed and treated in between 1992 –andJune 2018 at Ege University Hospital.Materials and Methods: Ege University Cancer Control, Research and Application Centerregistered the collected kidney cancer data in CANREG which is a special computer program forgrouping and analyzing the data in WHO and SEER based systems. Fisher’s Exact Test KaplanMeier survival analyzing technique was used in statistical analysis. Log Rank(Mantel-Cox),Breslow(Generalized Wilcoxon) and Tarone-Ware statistical techniques were used in survivalanalysis. P, Amaç: Ege Üniversitesi Hastanesinde 1992-Haziran 2018 arası kanser tanısı konan ve tedavisiyapılan renal kanser tanılı hastaların genel özellikleri, tedavi modaliteleri ve sağ kalım sürelerinintanımlanması amaçlanmıştır.Gereç ve Yöntem: Ege Üniversitesi Kanserle Savaş Araştırma ve Uygulama Merkezi tarafındantoplanan renal kanser verileri CANREG özel bilgisayar programına kayıt edilmiş, DSÖ ve SEERsistemleri temelinde gruplanarak analizler yapılmıştır. İstatistik analizlerde Fisher’s Exact Test,KaplanMeier sağ kalım analizleri uygulanmıştır. Sağ kalım analizinde Log Rank (Mantel-Cox), Breslow(Generalized Wilcoxon) ve Tarone-Ware istatistikleri kullanılmıştır. İstatistik analizlerde p
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- 2019
7. Impact of Renal Ischemia on Renal Failure After Partial Nephrectomy
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Ahmet Çağ Çal and Yavuz Selim Süral
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Cultural Studies ,medicine.medical_specialty ,Renal ischemia ,business.industry ,medicine.medical_treatment ,Religious studies ,Urology ,Medicine ,business ,Nephrectomy - Published
- 2015
8. Prediction of Response to Androgen Deprivation Therapy and Castration Resistance in Primary Metastatic Prostate Cancer
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Rauf Taner, Divrik, Levent, Türkeri, Ali F, Şahin, Bülent, Akdoğan, Ferhat, Ateş, Çağ, Çal, Sümer, Baltacı, and Cem, Güler
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Male ,Oncology ,medicine.medical_specialty ,Time Factors ,Antineoplastic Agents, Hormonal ,Turkey ,Biopsy ,Urology ,Bone Neoplasms ,Therapeutics ,Drug resistance ,Risk Assessment ,Androgen deprivation therapy ,Prostate cancer ,Castration Resistance ,Predictive Value of Tests ,Risk Factors ,Prostate ,Internal medicine ,medicine ,Humans ,Aged ,Retrospective Studies ,Aged, 80 and over ,Chi-Square Distribution ,business.industry ,Prostatic Neoplasms ,Bone metastasis ,Androgen Antagonists ,Retrospective cohort study ,Middle Aged ,Prostate-Specific Antigen ,medicine.disease ,Logistic Models ,medicine.anatomical_structure ,Drug Resistance, Neoplasm ,Predictive value of tests ,Multivariate Analysis ,Disease Progression ,Neoplasm Grading ,business - Abstract
Purpose: We tried to establish the predictive factors influencing the initial response, as well as its duration, and time to castration resistance (CR) for primary advanced prostate cancer (PC) with bone metastasis. Methods: We evaluated all patients initially receiving androgen deprivation therapy (ADT) for primary advanced PC with bone metastasis. A total of 982 patients with complete medical records available for analysis from 18 centers were included in this study. Age, initial PSA, Gleason score (GS) and extent of bone involvement (EBI) were recorded in a database. Results: Among all the patients, 896 (91.2%) responded to ADT initially. Pretreatment PSA and EBI were significant predictors in the multivariate model. Among the 659 patients who progressed into a CR state, the mean duration of response was 22.4 months. There was a significant correlation between the CR state and nadir PSA (nPSA) level and time to nPSA. Pretreatment PSA, EBI, GS, highest tumor volume in biopsy cores (%), number of positive biopsy cores, percent positive biopsy cores and time to nPSA were proven to be significant to predict a nPSA. Pretreatment PSA, GS and EBI were statistically significant predictors of PSA normalization in multivariate analysis. The limitation of the study depends on the retrospective design and a model was developed for low standardization as a result of using multicenter data. The patients enrolled in this study were from a relatively long period of time (1989–2008). Conclusions: The results of this study indicate that it is possible to predict the initial response to ADT by pretreatment PSA levels and EBI, while the duration of response can be reflected by a multitude of clinical factors including nPSA, TTnPSA, percent positive cores, biopsy GS and EBI.
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- 2011
9. Comparison of the Efficacy of Single or Double Intravesical Epirubicin Instillation in the Early Postoperative Period to Prevent Recurrences in Non-Muscle-Invasive Urothelial Carcinoma of the Bladder: Prospective, Randomized Multicenter Study
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Levent, Türkeri, Yılören, Tanıdır, Çağ, Çal, Haluk, Özen, Hayrettin, Şahin, and Haluk, Akpınar
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Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Disease-Free Survival ,Recurrence ,Carcinoma ,Humans ,Medicine ,Postoperative Period ,Aged ,Epirubicin ,Urothelial carcinoma ,Chemotherapy ,Antibiotics, Antineoplastic ,Bladder cancer ,business.industry ,Middle Aged ,medicine.disease ,Surgery ,Administration, Intravesical ,Treatment Outcome ,Urinary Bladder Neoplasms ,Time to recurrence ,Multicenter study ,Female ,Urothelium ,business ,Non muscle invasive ,Follow-Up Studies ,medicine.drug - Abstract
Objectives: To investigate the efficacy of single or double epirubicin instillation during the early postoperative period (EPP) in intermediate-risk non-muscle-invasive urothelial cancer. Methods: Patients with primary and solitary or multiple (3 or less) Ta (grade 2–3) or T1 (grade 1–2) tumors were enrolled. Patients were randomized to receive either a single dose of 100 mg epirubicin instillation within 6 h or a second 100 mg epirubicin instillation during the 12th–18th hours after a complete TUR-BT. At the end of the 60-month follow-up period, the available data were statistically analyzed. The end-points of the study were determined as disease-free survival, progression and recurrence rates, time to recurrence, and time to progression. Results: A total of 299 patients from 24 institutions were randomized between January 2002 and June 2004. There were 143 patients from 18 institutions who met the eligibility criteria. The follow-up and disease-free survival periods were 16.9 months and 16 months, respectively. There was no statistical difference in the demographic properties and the end-points between the groups. Conclusions: A single dose of intravesical 100 mg epirubicin chemotherapy during the early postoperative period for primary intermediate-risk non-muscle-invasive urothelial cancer achieved 16 months of mean disease-free survival. A second intravesical epirubicin instillation did not provide any significant benefit.
- Published
- 2010
10. N-acetyltransferase 2 gene polymorphisms and susceptibility to prostate cancer: a pilot study in the Turkish population
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FATMA ZUHAL EROĞLU, İBRAHİM KADRİ CÜREKLİBATIR, NEJAT TOPÇUOĞLU, CUMHUR GÜNDÜZ, ÇAĞDAŞ AKTAN, RUKİYE ÖZEL, ASLI TETİK, AHMET ÇAĞ ÇAL, VİLDAN BOZOK ÇETİNTAŞ, and BUKET KOSOVA
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Key words: N-Acetyltransferase 2,prostate cancer,acetylator phenotype ,General Medicine - Abstract
To investigate the association between the 3 most frequently observed single nucleotide polymorphisms of the NAT2 gene and the risk of developing prostate cancer in the Turkish population. Materials and methods: A total of 110 unrelated patients with prostate cancer were included in this case-control association study and constituted the study group. The control group also consisted of 150 unrelated but healthy men. Genomic DNA was isolated from peripheral blood leukocytes of all patients and analyzed with a sensitive real-time PCR method. After melting curve analysis genotypes were identified for the NAT2*5A, NAT2*6A, and NAT2*7A/B polymorphisms. Results: Prostate cancer patients had a higher frequency of the mutant NAT2*6A (13.6% versus 4.0%, P = 0.009) and heterozygote NAT2*7A/B (20.9% versus 9.3%, P = 0.008) genotypes when compared with the controls. Conclusion: The NAT2*6A and NAT2*7A/B gene polymorphisms were significantly associated with prostate cancer in the Turkish population. Real-time PCR analysis of the NAT2 acetylator phenotype can therefore be used to recognize individuals with a high risk of developing prostate cancer.
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- 2014
11. Prevalence of prostate cancer among men aged 40+ living in Osman Gazi health care district
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Esin, Çeber, Adnan, Şimşir, Dilek Çakır, Umar, Ali Osman, Karababa, Gürhan, Günaydın, Çağ, Çal, and Gülsün, Özentürk
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Adult ,Male ,Turkey ,Prevalence ,Humans ,Mass Screening ,Prostatic Neoplasms ,Middle Aged ,Prostate-Specific Antigen ,Prognosis ,Social Environment ,Delivery of Health Care ,Digital Rectal Examination - Abstract
Prostate cancer is a risk for men aged 40+ even if it is rarely seen among men under the age of 50. It is asymptomatic disease in its early period and if the person does not have an enlarged prostate it will be overlooked without screening. Consequently, the only way to diagnose prostate cancer in its early period is to determine the serum PSA (prostate-specific antigen) level of men aged 40+ and to do a digital rectal examination (DRE).The aim of this study is to determine the prevalence of prostate cancer among men aged 40+, to mention the significance of DRE and PSA by means of a training to be done with the aid of a booklet about early diagnosis, and to encourage men to consult a doctor and get the right treatment at the right time.The research was a descriptive field study. carried out among 660 men aged 40+ out of 3,285 men who live in Osman Gazi Health Care District, connected with the Presidency of Training and Research Health Group of Bornova. This group was selected as the smallest sample size by the systematic sampling method within the frame of setting the prevalence of prostate cancer at 10%, the confidence interval as 95%, the standard error as 2%. A total of 264 men of the sample group (participation rate 40%) agreed to a survey of International Prostate Symptom Score (I-PSS) projected by the study, and underwent DRE and PSA with a blood sample.Increase in the serum PSA level (4 ng/mL) was determined in 10 men. Nodules were detected in 3 men together with the increase in PSA. One further nodule was detected only in DRE one examination of 12 participants. In the light of these data, it was decided to conduct a biopsy on 25 people, who had an increase in PSE and/or whose abnormalities were detected during DRE, in company with TRUS, and prostate cancer was detected in the biopsies of 5 people (1.89%).It can be thought that before a decision is made on routinizing prostate cancer screening, it may be more suitable to make randomized controlled screening trials for prostate cancer.
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- 2010
12. A survey of patient preparation and technique of ultrasound-guided prostate biopsy: A multicenter study of urooncological association
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Murat Bozlu, Bülent Akduman, Uğur Mungan, Haluk Özen, Sümer Baltacı, Levent Türkeri, Ziya Kırkalı, Akif Akdaş, Öztuğ Adsan, Bülent Akdoğan, Mert Altınel, Süleyman Ataus, Semih Ayan, Cenk Yücel Bilen, Çağ Çal, Mete Çek, Mehmet Dündar, Cüneyt İşeri, Murat Koşan, Murat Lekili, Talha Müezzinoğlu, Gökhan Özer, Yaşar Özkök, Hakkı Perk, Bülent Soyupak, Sedat Soyupek, Ahmet Soylu, Sinan Sözen, Feridun Şengör, Zühtü Tansuğ, Ali Tekin, Asıf Yıldırım, and Sivas Cumhuriyet Üniversitesi
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Üroloji ve Nefroloji - Abstract
Ultrasonografî kılavuzluğunda yapılan prostat biyopsisi prostat kanseri tanısı için standart yöntemdir. Bu anketin amacı, Türkiye'deki üroloji uzmanları arasında ultrasonografî kılavuzluğunda yapılan prostat biyopsilerindeki hasta hazırlığı ve biyopsi teknikleriyle ilgili farklılıkların araştırılmasıdır. Temmuz 2004'te prostat biyopsi protokollerini sorgulamak amacıyla, Üroonkoloji Derneği Üyeleri'nin e-posta adresine bir anket formu gönderildi. Anket formundaki sorular çoktan seçmeli olup, prostat biyopsilerindeki hasta hazırlığı ve teknikleri sorguluyordu. Cevaplar yine aynı yolla toplandı ve değerlendirildi. Ankete 24 merkezden 32 üroloji uzmanı katıldı. Bu merkezlerde prostat biyopsileri sadece üroloji uzmanları (%54.16), üroloji ve radyoloji uzmanı beraber (%37.5) ve sadece radyoloji uzmanları (%8.33) tarafından yapılıyordu. Ultrasonografî kılavuzluğunda yapılan prostat biyopsileri büyük çoğunlukla transrektal yolla yapılıyordu. Merkezlerin %50'si biyopsi yapmak için PSA eşik değeri olarak 4 ng/ml'yi kullanıyordu. Biyopsi öncesi hazırlıkta bütün merkezler antibiyotik başlarken; yaklaşık yarısı bağırsak hazırlığı yapmaktaydı. Merkezlerin %37.5'i işlem sırasında analjezik kullanmazken; %29.1'i ağrıyı azaltmak için periprostatik sinir blokajı uyguluyordu. Üroloji uzmanlarının çoğu ilk biyopsilerde 10 veya 12 odaktan biyopsi alırken; %20.8'i rutin olarak transizyonel zon biyopsisi yapıyordu. Bu anket, Türkiye' deki üroloji uzmanları arasında ultrason kılavuzluğunda yapılan prostat biyopsilerinde hasta hazırlığı ve biyopsi teknikleriyle ilgili bir standardizasyon olmadığını ve bunun için bir kılavuz gerektiğini göstermektedir., Introduction: Ultrasound-guided prostate biopsy is the standard method for the diagnosis of prostate cancer. The aim of the present survey is to assess the variability in patient preparation and technique of ultrasound-guided prostate biopsy among Turkish Urologists. Materials and Methods: In July 2004, a questionnaire was sent out to e-mail addresses of the members of Urooncological Association, asking about the details of prostate biopsy protocol of the members. The survey consisted of multiple choice questions about the patient preparation and prostate biopsy technique. Responses were acquired via e-mail and analyzed in detail.Results: Thirty two urologists from 24 centers responded. The biopsy procedure was performed by the urologist only in 54.16% of the centers, both urologist and radiologist in 37.5%, and radiologist only in 8.33%. Transrectal route was the most common method for ultrasound-guided prostate biopsy. A half of the responders performed biopsy when PSA was greater than 4 ng/ml. All of the centers administered antibiotic and a half of them used enema before the procedure. Approximately 37% of responders did not administer any type of analgesia, but 29.1% of all responders administered a periprostatic nerve block for reducing painduring the procedure. Most urologists obtained 10 or 12 biopsy cores and only 20.8% of them obtained routine transitional zone biopsy during the initial biopsy session. Conclusion: This survey demonstrated that patient preparation and technique of ultrasound-guided prostate biopsy is not standardized among Turkish Urologists, and a guideline on prostate biopsy is needed.
- Published
- 2007
13. Urchus adenocarcinoma: A case report and review of the literature
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Yüksel Küçükzeybek, Ercüment Cengiz, Bülent Karabulut, Murat Sezak, Çağ Çal, Rüçhan Uslu, and Ege Üniversitesi
- Subjects
Onkoloji - Abstract
Urakus karsinomu oldukça nadir bir tümördür. Mesane kanserlerinin % 0,17-0,34’ünü oluşturur. Bu grup tümörlerde histopatolojik tanıların çoğu adenokarsinomdur. 28 yaşında kadın hasta makroskobik hematüri şikayeti ile hastanemize başvurdu. Vezikoüreteral reflüye bağlı nonfonksiyonel böbrek nedeniyle sol nefrektomi öyküsü vardı. Ultrasonografi, bilgisayarlı tomografi ve sistoskopi tetkikleri sonrasında mesane kubbesinde tümöral oluşum saptandı. Transuretral rezeksiyon uygulandı. Histopatolojik inceleme sonrasında adenokarsinoma saptandı. Uzak metastaz taraması sonrasında radikal sistektomi ve üriner diversiyon operasyonu uygulandı. Urasil-tegafur ve karboplatin içeren kombinasyon şeması adjuvan tedavi olarak uygulandı. Olgu sunumu yapıldığı sırada, olgumuzun 9 aylık hastalıksız sağkalımı devam etmekteydi. Bu olgu sunumu, urakus tümörünün genç yaşta saptanması ve tanı anında uzak metastaz saptanmaması nedeni ile bildirilmiştir., Urachal carcinoma is an extremely rare tumor, comprising 0.17-0.34% of all bladder tumors. Most of the histhopathological diagnosis is adeno carcinoma in this group of tumour. A 28-year-old woman patient complaining of macrohematuria was admitted to our institute. She has a history of left nephrectomy because of vesicourethral reflux and nonfunctional kidney. Ultrasonography, computed tomography and cystoscopy demonstrated a tumor at the bladder dome. Transurethral resection was performed. Adenocarcinoma was determined at the hystopathologic examination of the specimen. After distant metastases scanning, radical systectomy and urinary diversion operation was performed. Uracil-tegafur and carboplatin combination regimen was administered as an adjuvan treatment. Patient is alive and disease free for 9 months when this case was reported. This case, because of younger age and lack of distant metastases at the time of the diagnosis, is being reported.
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- 2006
14. The single or combined use of urine cytology, NMP22 test and telomerase test sufficient to detection of the recurrent superficial bladder tumors?
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Çağ Çal, Özgür Erdoğan, Buket Kosova, Fatih Ekren, Ali Veral, Mustafa Delibaş, and Ege Üniversitesi
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Üroloji ve Nefroloji - Abstract
Çalışmamızda, mesanenin yüzeyel değişici epitel kanseri nedeniyle tedavi uygulanmış olguların izlemlerinde gelişebilecek nükslerin belirlenmesinde; idrar sitolojisi, idrar NMP22 testi ve idrar telomeraz düzeylerinin tek ya da birlikte kullanımlarının nüksü belirlemedeki yeterliliğinin sistoskopik bakıyla karşılaştırılması amaçlanmıştır. Yüzeyel mesane tümörü tedavisi sonrasında nüks açısından izlenen 30 olgunun idrar örneklerinde NMP22 varlığı araştırılarak telomeraz düzeyi ölçüldü ve sitolojik değerlendirme yapıldı. Veriler özgünlük, duyarlılık testleri ve Spearman korelasyon testi ile değerlendirildi. Tanısal performans ROC eğrileriyle saptandı. NMP22 testinin nüksü saptamadaki duyarlılık ve özgünlük oranları sırasıyla %50 ve %94 olarak belirlendi. Özgünlük oranları telomeraz testi ve sitolojide daha yüksek olmakla birlikte, duyarlılık oranları sırasıyla %16 ve %8 düzeyine gerilemektedir. Korelasyon değerlendirmesinde; NMP22 testi sonuçlarının, sistoskopiyle korelasyonu istatistiksel anlamlı bulundu. Telomeraz testi ve sitoloji birlikte kullanıldığında elde edilen sonuçların sistoskopiyle uyumlu olmasına karşın, NMP22 testi sonuçlarıyla uyumluluk bulunmamaktadır. NMP22 testi, telomeraz testi ve sitolojinin tek başlarına kullanıldıklarında tanısal performans değerleri istatistiksel anlamlı değildir. Telomeraz testi ve sitolojinin birlikte kullanımının tanısal performansı anlamlı olmamakla beraber NMP22 testinin tanısal performansı, telomeraz ve sitoloji ile ikili ve üçlü kombine kullanımlarında istatistiksel anlamlı sonuçlar vermektedir. Tümör nüksünü tam yeterlilikte saptayabilecek bir test tanımlanana kadar tümör belirleyicilerin tanı aşamasında yol gösterici olarak kullanımı ve tedavi sonrası izlemde düzenli aralıklarla yapılacak sistoskopik bakının standart yöntem olarak tercih edilmesi akılcı olacaktır., Introduction: In this study we aimed to compare the effectiveness of single or combined use of urine cytology, urine NMP22 test and urine telomerase level assessment in estimating recurrence in patients treated for superficial transitional epithelial carcinoma of the bladder with cystoscopy. Materials and Methods: 30 patients with superficial bladder tumors treated and followed for recurrence were included in the study. Existence of NMP22, telomerase levels in urine was investigated. Additionally, cytological evaluation of urine was performed before cystoscopy. Specificity and sensitivity of the single or combined use of NMP22, urine telomerase level and cytology were determined. Diagnostic performance of the test results was evaluated by ROC curves and Spearman correlation test was performed. Results: The sensitivity and specificity of urine NMP22 levels in the detection of superficial bladder tumors recurrence were 50% and 94%, respectively. Although the specificity of urine telomerase assessment and cytology were the highest (%100), their sensitivities were 16% and 8%, respectively. The sensitivity of NMP22 test increased when combined with telomerase assay or cytology. However, no difference was detected in the specificity of NMP22 with any combinations. The sensitivity and specificity of triple combination of tests were 66% and 94%, respectively. Statistical correlation was detected between NMP22 and cystoscopy (p=0.008). The double or triple combinations of NMP22 test with telomerase test and cytology were also in correlation with tumor recurrence (p0.05). The diagnostic performance of double or triple combination of NMP22 with telomerase assessment or cytology NMP22 was statistically significant (p
- Published
- 2006
15. Effect of stone burden on PNL outcomes
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Burak Turna, Mehmet Umul, Ahmet Barış Altay, Ahmet Çağ Çal, Oktay Nazlı, and Ege Üniversitesi
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Üroloji ve Nefroloji - Abstract
Yayınlarda artan taş yükünün perkütan nefrolitotomi (PNL) tedavisinin başarısı ve istenmeyen yan etki oranlarına etkisini inceleyen çalışma sayısı oldukça azdır. Bu çalışmamızda, artan taş boyutunun PNL tedavisindeki başarı ve istenmeyen yan etki oranları üzerine olan etkisini inceledik. Retrospektif olarak 234 hastanın (234 PNL işlemi) verileri incelendi. Hastalar taş boyutuna göre iki gruba ayrıldı. Gruplar, taş boyutuna göre, tedavi başarısı, istenmeyen yan etki oranları, ek tedavi gereksinimleri, trakt sayısı, hematokrit düzeyindeki düşüş ve kan transfüzyonu gereksinimi açısından karşılaştırıldı. PNL için son taşsızlık oranı %87.1 ve istenmeyen yan etki oranı ise %34.6 olarak belirlendi. Artan taş boyutu ile taşsızlık oranları azalırken (p=0.001), istenmeyen yan etki oranlarının arttığı (p=0.0001) görüldü. Ortalama ameliyat süresi (p, Introduction: Studies reporting percutaneous nephrolithotomy (PNL) outcomes in relation to stone burden are very limited in the literature. We therefore examined our data to analyze our stone-free rates and complication rates of PNL with regards to stone surface area. Materials and Methods: Data of 234 patients who underwent 234 PNL procedures were retrospectively analyzed. Patients were stratified with respect to stone burden into two groups. Groups were compared with respect to the success of therapy, complications, requirement of secondary procedures, number of tracts, drop in hematocrit level and blood transfusion requirement in relation to stone burden. Results: The overall stone-free rate for PNL was 78.6% with a complication rate of 34.6%. Stone-free rates decreased with increasing stone burden (p=0.001). The total number of complications rose with increasing stone surface area (p=0.0001). The mean operative time increased with increasing stone burden (p
- Published
- 2006
16. The mechanisms of the resistance to androgen ablation treatment in prostate cancer cells
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Çağ Çal, Adnan Şimşir, and Ege Üniversitesi
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Üroloji ve Nefroloji - Abstract
Prostat kanseri, ileri yaştaki erkeklerde daha sık görülen önemli bir sağlık sorunudur. Metastatik prostat kanserinde standart tedavinin androjen ablasyonu olmasına rağmen, olguların önemli bir bölümünde zamanla tedaviye direnç gelişecektir. Bu hastalarda etkin bir tedavi yöntemi ise bulunmamaktadır. Bu nedenle tedaviye direnç gelişiminin önlenebilmesi için prostat kanser hücrelerinde oluşan değişimin belirlenmesi zorunludur. Androjenler prostat bezinin gelişiminde önemlidir ve prostat kanserinin tedavisinde androjen ablasyonu ve reseptör blokajı etkin yöntemlerdir. Bundan dolayı, hormonal tedavilere direnç gelişimde androjen reseptörlerinin rol oynaması kaçınılmazdır. Yine de prostat kanseri gibi heterojen bir hastalık söz konusu olduğunda hastalığın seyrini etkileyebilecek birden fazla mekanizmanın araştırılmasında yarar vardır., Introduction: Prostate neoplasm is an important health problem, which is especially common in older age men. Although the standard treatment of metastatic prostate neoplasm is androgen ablation, the resistance to the treatment will develop in most of the patients, in time. There is no efficient treatment modality for these patients. It is required to determine the changes in prostate cancer cells to prevent the development of treatment resistance. Androgens are important in prostate development, and the androgen ablation and receptor blockade are effective treatment modalities in prostate cancer. For these reasons, it is inevitable for androgen receptors to play a role in the development of resistance to hormonal treatment. Since prostate cancer is a heterogeneous disease, it is necessary to investigate the different mechanisms which may have a role in e disease progression.
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- 2005
17. Validation of 2001 Partin tables in Turkey: a multicenter study
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Haluk Akpinar, Gokhan Toktas, Reha Alpar, Hayrettin Şahin, Saadettin Eskicorapci, Levent Türkeri, Murat Lekili, Sinan Sözen, Selami Albayrak, Sümer Baltaci, Erdem Karabulut, Ahmet Soylu, Haluk Ozen, Çağ Çal, Resit Tokuc, and Gökhan Özer
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Male ,medicine.medical_specialty ,Turkey ,Urology ,medicine.medical_treatment ,Biopsy ,Population ,Prostate cancer ,Predictive Value of Tests ,medicine ,Health Status Indicators ,Humans ,Stage (cooking) ,education ,Lymph node ,Neoplasm Staging ,education.field_of_study ,Receiver operating characteristic ,Prostatectomy ,business.industry ,Prostate ,Prostatic Neoplasms ,Nomogram ,Prostate-Specific Antigen ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Partin Tables ,business ,Biomarkers - Abstract
Objective: Although Partin tables were developed in United States to predict the stage of prostate cancer preoperatively, they are used by many clinics throughout the world assuming that these figures apply to their population as well. However the predictive value of current Partin tables, which was updated in 2001, has not been validated in most of the countries as well as in Turkey. Therefore, we evaluated the validity of 2001 Partin tables, for the ability to predict the pathological stage in Turkish patients. Patients and Methods: The clinical and pathological findings of 1043 patients who have had radical prostatectomy were assessed. Serum PSA values, clinical stage, biopsy Gleason score and the pathological features of the radical prostatectomy specimens were collected from each clinic and evaluated. The predictive value of Partin nomogram and pathological findings of prostatectomy specimens were compared and analyzed according to Receiver Operating Characteristics (ROC) analysis. Results: Median age of the patients was 60 (45–74). In the presented study, percentage of patients with clinical stage T1c was 43%. Patients with Gleason score of 2–4 in biopsy constituted 23.4% of the study group. In the present study, the ratio of the patients with serum PSA higher than 10ng/ml was 39.6%. Organ confined disease, seminal vesicle involvement, lymph node metastases ratios were 64.7%, 10.3%, 1.8% respectively. Area Under Curve (AUC) values for organ confined disease, seminal vesicle involvement and lymph node involvement were calculated as 0.665, 0.733 and 0.759 respectively. Conclusion: It appears that Partin tables have a reasonable predictive value for the final pathological features like organ confined disease, seminal vesicle and lymph node involvement in Turkish patients. This multicenter study showed that current Partin tables could also be used in Turkish patients with comparable accuracy.
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- 2004
18. Biochemical recurrence after radical prostatectomy: is the disease or the surgeon to blame?
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Adnan Simsir, Cag Cal, Rashad Mammadov, Ibrahim Cureklibatir, Bulent Semerci, and Gurhan Gunaydin
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prostatectomy ,prostate cancer ,recurrence ,prostate-specific antigen ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
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.
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- 2011
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19. Bowel Preparation and Peri-operative Management for Radical Cystectomy in Turkey: Turkish Urooncology Association Multicenter Survey
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Bulent Gunlusoy, Levent Turkeri, Cag Cal, Sumer Baltaci, Guven Aslan, and Oztug Adsan
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urinary bladder neoplasm ,urinary diversion ,perioperative care ,postoperative complications ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
PURPOSE: To investigate the preferences and practice patterns of urooncologicsurgeons in Turkey on bowel preparation and peri-operative management forradical cystectomy.MATERIALS AND METHODS: This study was conducted by Turkish Uro oncology Association as a multicenter survey. Participants were asked to fill in questionnairesdispensed at annual oncologic meeting or using internet access to the website of Urooncology Association. The questionnaire consisted of multiplechoice or open-ended questions related to frequency of cystectomy, surgicaltechnique and type of diversion, bowel preparation protocol, nasogastric tubeapplications, antibiotic prophylaxis, and deep vein thrombosis prophylaxis.Collected data from the survey were presented descriptively.RESULTS: Forty-four questionnaires from 44 surgeons of different centerswere evaluated. All participants answered that they always perform bowelpreparation before cystectomy. Four participants reported that they had anexperience of cystectomy without bowel preparation. Bowel preparationmethods 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 askhelp from a general surgeon. Antibiotic prophylaxis is preferred mostly by 2agents using third-generation cephalosporins and metronidazole for a periodof 5 days or more in the majority. Type, duration, and dosage of deep veinthrombosis prophylaxis differed among participants.CONCLUSION: There are significant individual differences in peri-operativemanagement of radical cystectomy, which render deficient and sometimesinadequate patient care. There is a need to establish standard protocols forbowel preparation and adequate peri-operative management for radicalcystectomy.
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- 2011
20. Zoledronic acid effects interleukin-6 expression in hormone-independent prostate cancer cell lines
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Layka A. Asbagh, Selim Uzunoglu, and Cag Cal
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prostate cancer ,zoledronic acid ,interleukin-6 ,experimental ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
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.
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- 2008
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21. Impact of Residual Fragments following Endourological Treatments in Renal Stones
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Cenk Acar and Cag Cal
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Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
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
- Published
- 2012
- Full Text
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