Search

Objective: To determine the shrinkage effect of formalin on renal cell carcinoma. Method: The retrospective study was conducted from October to November 2020 at Tekirdag Namil kemal University, Turkey and comprised all radical and partial nephrectomy cases performed by a single surgeon in a single clinic between January 2014 and August 2020. Preoperative images and postoperative pathology were reviewed by the same clinician. Preoperative longest tumour diameter of radiological images and pathological specimens measured after formalin fixation shrinkage were compared, and the effect of the difference between the two measurements on the circumference of the tumour was examined. The formalin related shrinkage rates of renal tumours according to the tumour size and the tumour types were also analysed. Data was analysed using SPSS 20. Results: Of the 101 cases, 58(57.4%) were of radical and 43(42.6%) of partial nephrectomy. Also, there were 77(76.2%) renal cell carcinoma cases, 22(21.8%) benign renal tumours and 2(1.9%) had other malignant tumours. There were 59(58.4%) males and 42(41.6%) females with an overall mean age of 58.1±12,2 years (range: 30-82 years). The mean radiological size of the renal tumours was 55.3±30.4mm and it was 52.9±31.6mm at pathological examination (p>0.05). Conclusion: Formalin fixation of tissues post-surgery caused a difference between the radiological and pathological dimensions. Though the difference was no significant, under-staging due to the shrinkage post-surgery should be considered. Key Words: Renal tumours, Tissue shrinkage, Formalin, radiological dimension, Pathological dimension. ---Continue

Objective Primary bladder pain syndrome (PBPS) is characterized with suprapubic pain accompanied by at least one lower urinary tract symptoms including frequent urination, urinary urgency and nocturia for more than 6 weeks. While there are many alternative therapies for the treatment of PBPS, the only approved oral medication is PPS (pentosan polysulfate sodium). As it has been associated with retinal toxicity after its widespread use, this study aims to evaluate the relationship between PPS use and maculopathy. Material and Methods The patients diagnosed with PBPS between 2010 and 2020 who may only benefit from PPS use were included into the study after subgroup and phenotype assessment (urinary and non-ulcerative organspecific subgroups). In our study, patients who had history of degenerative maculopathy or diseases predisposing to maculopathy (age-related macular degeneration, diabetes mellitus, hypertension, chronic vascular disorders, central serous chorioretinopathy, retinal dystrophy, epiretinal membrane, and chronic exposure to hydroxychloroquine) were excluded to prevent possible misdirection. Patients underwent best-corrected visual acuity assessment using Snellen chart, anterior segment and fundus examination using slit lamp biomicroscopy, and intraocular pressure measurement. Color vision test (Ishihara test), posterior segment optical coherence examination and 10-2 visual field test were performed, and color images of the fundus and autofluorescence imaging were obtained. Best-corrected visual acuity, color vision results, macular, choroidal and mean retinal nerve fiber thicknesses, mean deviation of the visual field and fundus findings were recorded. Results Out of 15 patients included into the study, 4 (37.5%) were male and 11 (73.3%) were female. The mean age of the patients was 53.3±11.2 years. During the follow-up, the duration of oral PPS use was found to be 33.01±10.59 months, cumulative oral PPS dose to be 216.02±97.63 g and duration of diagnosis to be 66.64±39.37 months. The mean central macular thickness of the patients was measured to be 254.55±33.11 ?m, and the mean choroidal thickness to be 261.82±34.22 ?m. Mean deviation of the visual field of the patients was found to be -1.89 ±-1.25 dB. The mean retinal nerve fiber thickness was measured to be 98.1±17.62 ?m from the fundus autofluorescence images of the patients. Furthermore, in the present study, the ocular findings of the patients who are at below and above the mean cumulative dose and exposure period were compared. Conclusion This study detected no correlation between longterm PPS use and maculopathy. When forming the patient group; it is crucial to exclude patients with comorbidities such as diabetes mellitus and hypertension, and to form a homogeneous group by phenotype and subgroup assessment. Randomized, prospective, multi-center studies are needed to better assess this correlation.

Aim: In this study, we aimed to evaluate the re-transurethral resection (re-TUR) pathologies and to compare the pathology results between transurethral resection of the bladder (TUR-B) and re-TUR for non-muscle invasive bladder cancer (NMIBC). Additionally, we aimed to assess the factors affecting the re-TUR pathology and try to define more valuable re-TUR patient groups. We also aimed to evaluate the effect of re-TUR on recurrence and progression. Material and Method: We performed re-TUR in intermediate/high-risk NMIBC patients, 4-6 weeks after the index TUR-B. Both TUR-B and re-TUR pathology characteristics, including tumor stage, grade, size, number, lymphovascular invasion (LVI), carcinoma in situ (CIS), variant pathology, and intermediate/high-risk status were analyzed retrospectively. The recurrence and progression rates were also evaluated according to re-TUR. Results: A total of 78 patients with NMIBC were included in the study. The index TUR-B pathologies were Ta-Low: 6 (7,7%), Ta-High: 5 (6,4%), T1-Low: 14 (17,9%), T1-High: 53 (67,9%). Re-TUR positivity was n: 40 (51 %), and upstaging/upgrading at re-TUR was n: 11 (14 %) in all groups. Re-TUR positivity was significantly higher in high-risk compared to intermediate-risk NMIBC (p:0,026). Re-TUR positivity was higher in patients with hydronephrosis, C15. LVI, differentiation, size (>3 cm), and multiple tumor presence (p0,05). Discussion: Residual tumor was common after the index TUR-B, and upstaging after re-TUR was very important Re-TUR is critically important in high-risk NMIBC, presence of hydronephrosis, CIS, LVI, variant pathology, size (>3 cm). and multiple number of tumors.

The COVID-19 pandemic has led to many compulsory alterations at health system. Emergency surgery is an area that is facing the need for many adaptations in health system. In literature, many articles have been published about surgery during the pandemic. In this review, we analysed the articles about the emergency surgery at COVID-19 pandemic period. We presented the emergency surgery patients’ selections. In addition we tried to standardize the preparation of the patient and the surgical team in the pre-operative period, measures for anaesthesia and surgeon in per-operative period, and some basic measures to be taken in the post-operative period., COVID-19 pandemisi sağlık sisteminde birçok zorunlu değişikliğe sebep olmuştur. Bu bağlamda, acil cerrahi müdahaleler için bazı değişiklikler ve stratejiler oluşturulmuştur. Bu amaçla literatürde pandemi süresince cerrahi müdahaleyi konu alan bir çok makale yayınlanmıştır. Biz bu çalışmada pandemi süresince acil cerrahi yaklaşımın nasıl olması gerektiği konusunda literatürü derlemeye çalıştık. Ayrıca acil cerrahi hastasının seçimi, hastanın ve cerrahi ekibin pre-operatif dönemde hazırlanması, ameliyat sırasında anestezi ve cerrahi ekibe yönelik alınması gereken önlemler ve post-operatif dönemde yapılması gerekenleri sunmaya çalıştık.

Aim: Multiple sclerosis (MS) is a chronic and progressive disease of the central nervous system (CNS). The destructive effect of MS on the urogenital system has been demonstrated in many studies especially in young adults. Urodynamic evaluation is recommended in the diagnosis of urogenital system pathologies for MS patients. Unfortunately, there are not enough studies evaluating the urodynamic examinations of MS patients in our country. In this study, urodynamic findings of patients with MS were evaluated. Material and Method: A total of 58 patients (39 female and 19 male) were included in the study. The urodynamic findings of the patients in the same center between January 2011 and October 2017 were evaluated retrospectively. Urodynamic evaluation was performed with 20 ml of infusion per minute according to the International Continence Society standards. Results: The mean age of the patients was 47.4 +/- 8.8 years. The mean duration of multiple sclerosis was 11.8 +/- 7.4 years. When the features of multiple sclerosis were evaluated, 13 (22.4%) patients had a progressive type, 20 (34.5%) had a secondary progressive type, and 25 (43.1%) had relapsing-remitting (with relapses and remissions). The urodynamic findings of the patients are shown in Table 1. Urodynamic evaluations of patients with urinary incontinence are reported as 'Urge type urinary incontinence' was observed in 30 (83.3%), 'stress type urinary incontinence' in 5 (13.9%) and 'mixed type urinary incontinence' in 1 (2.8%) patient. Discussion: Multiple sclerosis is a common neurological pathology which has different urinary system findings. Detrusor overactivity is the most common urinary manifestation, and patients may also have impaired contractility, detrusor sphincter dyssynergia, urodynamic stress incontinence, and bladder outlet obstruction.

Aim: Histopathological classification is one of the main prognostic factors for non-muscle invasive bladder tumors (NMIBT). Weevaluated the relationship between tumor progression and the ratio of high-grade differentiation plus other routine pathologicalparameters in NMIBT.Materials and Methods: Ninety-two patients diagnosed with high grade NIMBT were analyzed between 2010-2018. Demographicinformation, tumor size, localization, multicentricity, and recurrence/progression situation were evaluated retrospectively. The high/lowgrade percentage ratio of tumor cells, tumor stage, differentiation, necrosis, lamina-propria invasion, lymphovascular invasion, andcarcinoma in-situ presence were also examined by two uro-pathologist. The effect on tumor progression was evaluated with pathologicalfindings.Results: Seventy-four (80.4%) of the patients were reported as T1 and 18 (19.6%) as Ta. The mean ratio of high-grade findings was11.9±8.5% and 69.5±28.1% for Ta and T1 patients, respectively(p25%, >50% and >75% was found to be 67(72.8%),54(58.7%) and 43(46.7%), respectively. The high-grade ratio for >25% was in only 1 Ta patient while it was in 66 of the T1patients(p75%(p50%(p=0.025).Conclusion: When evaluating the nuclear grade, defining tumors solely as high-grade leads to stratifying a highly heterogeneouspopulation in a single group. Higher rate of progression is observed in NIMBT patients with high-grade ratio >50%. KİOMT’de yüksek dereceli hücresel farklılaşma oranı ve diğer rutin patolojik parametrelerin progresyona etkisi değerlendirildi. Materyal ve Metot: Çalışmaya 2010-2018 yılları arasında transüretral mesane rezeksiyonu sonrası yüksek dereceli KİOMT tanısı alan 92 hasta dahil edildi. Hastaların demografik bilgileri, tümör çapı, lokalizasyonu, multisantrisitesi ve nüks/progresyon varlığı-süresi retrospektif olarak değerlendirildi. Ayrıca tümör hücrelerinin yüksek derece/düşük derece yüzdesi, tümör evresi, diferansiyasyon, nekroz, lamina propria invazyonu, lenfovasküler invazyon ve karsinoma in-situ varlığı iki üro-patolog tarafından incelendi. Elde edilen bulguların tümör progresyonu üzerine etkisi araştırıldı. Bulgular: Hastaların 74’ü(%80,4) T1, 18’i(%19,6) Ta olarak rapor edildi. Ta tanılı hastalarda yüksek derece oranı %11,9±8,5 iken, T1’lerde %69,5±28,1 olarak tespit edildi (p%25,>%50 ve>%75 olan hasta sayısının sırasıyla 67(%72,8), 54(%58,7) ve 43(%46,7) olduğu görüldü. Ta olan hastaların sadece 1’inde yüksek derece oranı>%25 olarak gözlenirken, T1 hastalarının 66’sında yüksek derece oranının>%25 olduğu belirlendi (p%75 olduğu görüldü. T1 yüksek derece oranları>%50 olan hastalarda progresyon, patolojik evresi T1 yüksek derece oranları %50 olan hastalarda progresyon anlamlı derecede artmaktadır.

Disruption of the E cadherin mediated complex due to loss or depletion of E cadherin results in epithelial abnormalities and serious developmental impairment in varioustissues and organs. The present study aims to determine E cadherin and ? catenin expression in patients diagnosed with benign prostatic hyperplasia (BPH) and prostatecarcinoma (PCa) based on Gleason scores and investigate the association of these proteins with PSA levels and Gleason scoring. Immunohistochemical staining for Ecadherin and ? catenin was performed in 59 patients diagnosed with PCa and 30 patients with BPH. Mean E cadherin expression was 3.00 in patients diagnosed with BPHand 2.38±0.5 in patients with PCa, with a statistically significant difference between these values (p

Aim: The aim of the study was to evaluate possible factors predicting stone-free status at retrograde intrarenal surgery for renal stones.Materials and Methods: A retrospective multicenter study was performed using data from 513 patients treated between February 2016 and January 2020 at four referral centers in Turkey. The patients were divided into two groups whether they had no residual stone over 3mm (Group 1) or had residual stones (Group 2). Pre and peroperative parameters were compared in both groups (Table 1). Univariateand multivariate analyzes were performed to identify any factors affecting the stone-free rate (Table 2).Results: Overall stone-free rate was 88.5% (454/513). Lower calyx stones and multipl stones were significantly higher in Group 2 (p=0.006, p=0.02, respectively). Also access sheathless procedure rate was significantly higher and the basket catheter useage rate was significantly lower in Group 2 (p=0.04, p

INTRODUCTIONEnuresis nocturna (EN) is one of the mostunpleasant problem in childhood. Functional problems thought to be the majoritypart of etiology instead of structural, medical or neurological problems.Psychological disorders, such as attention deficit hyperactivity disorder, oppositional defiant disorderor depression may be accompanying with enuresis nocturna. Internalisingproblems such as separation anxiety, social anxiety, specific phobia,generalised anxiety, depression, conduct disorders and attention deficithyperactivity disorder can accompany with EN. In this study, we aimed to investigate the sleep habits and psychologicaldisturbances in children with EN. METHODSThe fourty children (27 boys and 13girls) with EN who had been admitted to Pediatrics and Urology outpatientsdepartments and 113 (54 boys and 58 girls) age-matched healthy controls arecomprised fort he study. Participants received ‘Strengths and DifficultiesQuestionnaire’ (SDQ), and ‘Children’sSleep Habits Questionnaire’ (CSHQ).RESULTSThe frequency of sleep problems was 59% and 85% in thecontrol and in enuretic groups. Thetotal problem score was significantly higher in the EN group according to thescores of the SDQ parent-report form. The EN groups with regard to bedtimeresistance, sleep-anxiety, night-waking, parasomnias, breathing-relatedproblems and daytime sleepiness showed significantly higher scores in CSHQcomparing to control group.CONCLUSIONThe childrenwith EN need to be evaluated in regarding to sleep and psychological aspect.

Günümüzde böbrek tümörü tedavisinde cerrahi altın standart tedavi seçeneğidir. Böbrek tümörü cerrahisi, açık radikal nefrektomi, açık parsiyel nefrektomi, laparoskopik radikal nefrektomi veya laparoskopik parsiyel nefrektomi şeklinde yapılabilmektedir. Her tekniğin kendi içinde avantaj ve dezavantajları bulunmaktadır. Çalışmamızda, kliniğimizde uygulanan böbrek tümörü cerrahi teknikleri ve hastalardan elde edilen onkolojik verilerin değerlendirilmesi amaçlanmıştır. Surgery is the gold standard therapy method in renal tumors. Renal tumor surgery can be performed as open radical nephrectomy, open partial nephrectomy, laparoscopic radical nephrectomy or laparoscopic partial nephrectomy.Each technique has its own advantages and disadvantages. In this research, it was aimed to evaluate the renal tumor surgery techniques in our clinic and the oncologic data obtained from the patients.

Spor esnasmda meydana gelen ~ene-yi.iz kJrlklantravmatik kmkJann yakla~lk% 3'iinti olu§turur. Eu olduk~ayOksek bir orandlr. Eu nedenle spor hekimligi a

Murat AKGÜLYüksek Lisans Tezi (Özet)AVRUPA BİRLİĞİNE ÜYE VE ADAY ÜLKELERİN EKONOMİK AÇIDAN ÇOK DEĞİŞKENLİ İSTATİSTİKSEL YÖNTEMLERLE İNCELENMESİYapılan çalışmada, Türkiye ile AB-AB adayı ülkeler, objektif verilere uygulanan istatistiksel yöntemlerle karşılaştırarak, Türkiye nin diğer ülkeler arasındaki yeri belirlenmeye çalışılmıştır. Bu çalışmada; kişisel, taraflı, politik degerlendirmeler özellikle devre dışı bırakılarak tarafsız bir sonuca ulaşılmak amaç edinilmiştir.Çalışmanın birinci bölümünde; Avrupa birliğinin tanımı, oluşumu, tarihi gelişimi, kurumsal yapısı ve Türkiye nin AB'ile ilişki süreci hakkında bilgiler, ikinci ve üçüncü bölümünde; uygulamada kullanılan çok değişkenli istatistiksel analizlerden, Temel Bileşenler Analizi, Faktör Analizi ve Kümeleme Analizi hakkında bilgiler verilmiş olup, dördüncü bölümünde ise uygulamaya yer verilmiştir.Yapılan uygulamada AB'ye üye ve aday ülkelerin ekonomik göstergelerini ifade eden 11 değişken öncelikle Faktör Analizine tabi tutularak değişkenler dört faktöre atanmış, elde edilen sonuçlara Varimax, Quartimax, Equamax döndürmesi uygulanmıştır. Gerek kavramsal anlamlılığın, gerekse değişkenlerin faktörlere atanmasındaki netliğin sağlanması açısından Equamax döndürmesiyle elde edilen sonuçların en uygun olduğu tespit edilmiştir. Daha sonraki aşamada üye ve aday ülkelerin, ekonomik faktörler açısından benzerlikleri Kümeleme Analizi ile incelenmiştir. Analiz öncelikle 11 ekonomik değişkenle, daha sonra faktör analizi sonucu elde edilen faktör skorları ile yapılarak, sonuçlar değerlendirilmiştir. Analizlerde hiyerarşik ve hiyerarşik olmayan kümeleme yöntemleri kullanılmıştır. Kümeleme Analizinde en iyi sonuçlar döndürülmesiz faktör skorları ile yapılan analizler sonucunda elde edilmiş olup, hiyerarşik ve hiyerarşik olmayan yöntemlerle elde edilen sonuçlar benzer çıkmıştır. Çalışma sonucunda Türkiyenin her iki yöntem ile yapılan analizde de tek başına bir kümede kaldığı ve farklı yapı gösterdiği görülmüştür.Murat AKGÜLMaster thesis (abstract)AN ECONOMIC STUDY OF EU MEMBER AND CANDIDATE STATES WITH MULTIVARIATE STATISTICAL METHODSIn the study, Turkey and EU/EU candidate states have been examined with statistical methods applied to objective data and Turkey's place has been tried to be uncovered. During the study, personal, political and one-sided evaluations have been tried to be put aside and an impartial result is desired.The first chapter covers the EU's definition, formation, historical breakthrough, structural edifice and Turkey's EU marathon. The second and third chapters cover some of the analysis methods that are utilized in the study such as Principal Components Analysis, Factor Analysis, Cluster Analysis and in the fourth chapter the methods are practised. In the application, eleven variables-which are the economic indicators of EU member and candidate states- are subjected to factor analysis, the variables are tied to four factors, and Varimax, Qartimax, Equamax rotations are applied to the outcome. To attain conceptual meaningfulness and removal of vagueness that may have appeared during variable designation, with the Equamax rotation the most appropriate outcome are observed.In the following stage, member and candidate states are examined with respect to similitude between economic factors with cluster analysis. The analysis is made preliminarily with eleven economic variable and later with factor scores that are achieved with factor analysis and results are evaluated. In the anlyses, hierarchical and non-hierarchical cluster methods are utilized. The most appropriate results of cluster analyses are non-rotated results of factor scores and have similarities with hierarchical and non-hierarchical results.As a result of the study, utilizing either analysis methods, Turkey is found to be in a cluster by herself showing structural difference.