Search

Cutaneous amyloidosis (CA) is defined by the accumulation of amyloid in the dermis; it might be primary or secondary. The diagnosis is based on histopathological findings with the demonstration of amyloid deposits, confirmed by Congo red stain under the polarized light. Studies on other diagnostic markers are ongoing in the literature. The aim of this study was to demonstrate the utility of C4d staining in the recognition of amyloid in CA and using it as an alternative or substitute marker for the diagnosis. In this retrospective study, 199 skin biopsies with a clinical provisional diagnosis of CA were analyzed, the Congo red stain was performed, and, in a subgroup (n = 97) with histopathological findings probably for CA, C4d immunohistochemistry was assessed. Forty-eight cases of CA were detected. Congo red birefringence was positive in all cases, whereas in 14 cases, it was faded. In these 14 cases, the diagnosis of CA was made by means of Congo red fluorescence and Thioflavin T because the histopathological findings were highly suggestive for CA. All CA cases were positive with C4d, and in 12 of the 49 inflammatory dermatoses, C4d was positive. The interpretation of C4d immunohistochemistry can be performed more easily and rapidly than Congo red evaluation. The sensitivity and specificity of C4d were 100% and 75.5%, respectively. In our experience, C4d staining was a useful method for detecting amyloid deposits in CA. Although Congo red staining is the gold standard for amyloid detection, we propose C4d immunohistochemistry as a routine screening method or hybrid transition while further investigations are completed.

Amac: Ege Universitesi Hastanesi’nde (EUH) Erkek Genital Sistem Kanseri (EGSK) tanisi ile tedavileri yapilan 5.634 kayitli olgunun epidemiyolojik ve genel sag kalim (GSK) ozelliklerini istatistiksel acidan degerlendirmektir. Gerec ve Yontem: Siniflandirmalarda ve sag kalim analizlerinde “Surveillance, Epidemiology, and End Results” (SEER) verileri goz onune alinmistir. CANREG-4 programi ile kaydedilen veriler SPSS programina aktarilmistir. Istatistik analizde Ki-kare yontemi ve dogrusal modellemeler yapilmis ve p

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

WOS: 000484342000003, Objective: The aim of this study was to evaluate the relationship between prognostic factors and cancer-specific survival (CSS) in renal tumors larger than ten centimeters. Materials and Methods: We evaluated the data of 126 patients who underwent open radical nephrectomy due to a renal mass larger than 10 cm between January 2010 and June 2016. Kaplan-Meier analysis or Cox regression was used to analyze the relationship between CSS and variables. Pairwise group comparisons were also evaluated with the Log-Rank test. A p-value

12th Congress of the Turkish-Transplantation-Centers-Coordination-Association (TTCCA) -- OCT 18-21, 2018 -- Trabzon, TURKEY, Sen, Sait/0000-0002-1100-6657; Gokalp, Cenk/0000-0003-3909-7973, WOS: 000500179300016, PubMed: 31101175, Introduction. Significant improvements in patient and graft survival and reductions in the frequency of acute rejection were obtained in the early period after renal transplantation, but this success was not sufficiently reflected in the long term. Allograft kidney losses in the long term remain a significant problem. in this study, we investigated the specific causes of graft losses in patients who had a good clinical course in the first year but developed graft loss in the long term. Methods. A total of 118 patients who underwent kidney transplantation in 2005 and 2006 in the Organ Transplantation Center of Ege University Medical Faculty Hospital were evaluated. the inclusion criteria were to be older than 18 years and have a serum creatinine value of, Turkish Transplantat Ctr Coordinat Assoc

Background: Kidney involvement is a common manifestation that contributes to morbidity and mortality in systemic amyloidosis. Amyloid load can be predicted by histopathological grading of amyloid deposits in kidney biopsy specimens. Our aim was to determine the relationship of renal amyloid deposition grade with clinical manifestations and outcomes in patients with biopsy proven renal non-AA amyloidosis. Methods: This retrospective cohort study included 74 subjects with renal non-AA amyloidosis (52 AL amyloidosis and 22 unclassified amyloidosis). Baseline characteristics and follow-up data were recorded. Pattern and quantity of amyloid deposition in glomeruli, interstitium, vessels and tubulointerstitial changes were scored. Renal Amyloid Prognostic Score (RAPS) was obtained by addition of all scores and divided into three grades (RAPS grade I, II, III). Results: In AL amyloidosis group, median follow-up was 11 (4-45 months). Among 52 patients, 17 received autologous stem cell transplantation and 29 received bortezomib based chemotherapy. Baseline eGFR was significantly lower among patients with RAPS grade III. Renal survival was significantly lower among patients with RAPS grade III. Patient survival was not significantly different according to RAPS grade. Type of amyloid could not be determined in 22 patients. In this group, baseline eGFR was significantly lower in patients with RAPS grade III. Conclusions: In patients with AL amyloidosis, baseline kidney functions are associated with RAPS grade. Renal survival is significantly lower in patients with highest RAPS grade. However, patient survival is not significantly different according to RAPS grade.

Aim: The aim of this study is to evaluate the epidemiological, treatment modality and survival characteristics of 4792 patients with Prostate Cancer(PC) who were treated at Ege University Hospital (EUH).Methods and Materials: The data were recorded using the CANREG programme. WHO (World Health Organization) and SEER (Surveillance, Epidemiolgy, and End Results) system were considered for classification and survival analysis. Chi-square test, General Linear Model and Kaplan-Meier survival analysis were done. Log Rank (Mantel-Cox), Breslow (Generalized Wilcoxon) and Tarone-Ware models were used for Kaplan-Meier survival analyses. p value, Amaç: Ege Üniversitesi (EÜ) Hastanesinde 1992-2017 arası kanser tanı ve tedavisi yapılan prostat kanseri (PK) tanılı 4792 hastanın epidemiyolojik özellikleri, tedavi modaliteleri ve sağkalım özelliklerinin tanımlanması amaçlanmıştır.Gereç ve Yöntem: EÜ Kanserle Savaş Araştırma ve Uygulama Merkezi tarafından toplanan PK verileri CANREG özel bilgisayar programına kaydedilmiş, DSÖ (Dünya Sağlık Örgütü) ve SEER (Surveillance, Epidemiolgy, and End Results) sistemleri temelinde gruplanarak analizler yapılmıştır. İstatistiksel analizlerde Kikare, General Linear Model, Kaplan Meier sağkalım analizleri uygulanmıştır. Kaplan-Meier Sağkalım analizinde Log Rank(Mantel-Cox), Breslow(Generalized Wilcoxon) ve Tarone-Ware istatistikleri kullanılmıştır. İstatistiksel analizlerde p

Background and Aims The transient receptor potential ion channels (TRPC) are non-selective Ca+ 2 permeable cation channels and are widely expressed in the tissues of vertebrates. They become active in response to signal transduction pathways associated with phospholipase C stimulation. TRPC6 is expressed in podocytes and is a component of the slit diaphragm. In genetic and acquired glomerular kidney diseases, TRPC6 overactivation causes podocyte damage by pathological Ca+ 2 entry. TRPC1, TRPC2, TRPC4, and TRPC5 interact with a protein called stromal-interacting molecule 1 (STIM 1), which is susceptible to intracellular calcium storage content. As a result of binding with this protein, TRPC channels bind to calcium-releasing zone in endosomes. The aim of the study was to investigate different expression profiles of TRPC family members in renal biopsy specimens in patients with clinically considered glomerulonephritis. Method This study was conducted with 108 patients admitted to Ege University Faculty of Medicine Nephrology Clinic who underwent a kidney biopsy with a preliminary diagnosis of glomerulonephritis and 37 patients who underwent a nephrectomy in urology clinic with a diagnosis of primary kidney tumour as a control case. PKD2, NPHS2, TRPC1, TRPC3, TRPC6, STIM-1 and Orai-1 mRNA levels were studied in the biopsy samples. Results When we compared the patient and the control group, the gender distribution of both groups was similar. The frequency of diabetes and hypertension was similar. The control group was statistically significantly older and glomerular filtration rates were higher than the patient group. In pathological examination, glomerulonephritis (57.5%) was diagnosed in the majority of patients. The most common etiologic factors were membranous nephropathy 23.1%, IgA nephropathy 13%, Amyloidosis 11.2%, focal segmental glomerulosclerosis 7.1%, proliferative glomerulonephritis 4.6%, minimal change disease 2.8% and membranoproliferative glomerulonephritis was 1.9%. 7.4% of the patients were diagnosed with diabetic nephropathy by renal biopsy. When we compared the TRPC expression profiles of the patient and the control group, the TRPC1, TRPC6, PKD2, NPHS2, STIM-1 and ORAi-1 mRNA levels of the patient group were statistically significantly higher than those of the control group (Figure). In contrast, TRPC3 mRNA levels were significantly lower in the patient group compared to the control group. When we performed subgroup analysis, the TRPC1, TRPC6 and STIM1 levels of the diabetic group were statistically significantly higher compared to the non-diabetic group of patients. We could not find any difference between TRPC expression profiles between the patients according to pathological diagnosis. Similarly, there was no difference between the amount of proteinuria (nephrotic level versus nephritic level). In correlation analysis, there was a negative correlation with TRPC6 and STIM1 levels with positive C4d staining of glomeruli in renal biopsy. Positive correlation was found between ORAI and glomerular sclerosis rate. Conclusion As a result, we found that other than TRPC3 mRNA level, other TRPC and related protein channels mRNA levels were statistically significantly increased in proteinuric kidney patients compared to healthy kidney tissue. We did not find a positive relationship between proteinuria severity and TRPC expression profiles. We found that TRPC6 and STIM1 expression levels were increased in diabetic patients, which supports the knowledge that intracellular calcium pathways were activated in podocyte damage. In our study, there were significantly increased STIM1 and ORAi-1 expression levels in proteinuric patients compared to the control group and their increase was closely related to TRPC6. From this we can conclude that these proteins play an important role in proteinuric kidney damage.

Background Allograft biopsy that is done as indicated by clinical and laboratory clues about graft rejection provides a definitive diagnosis. Noninvasive methods that may be useful for predicting or diagnosing rejection are important for early diagnosis of possible rejection. Purpose The aim of this study is to investigate the relationship between changes in shear wave velocity (SWV) values and renal allograft kidney biopsy findings. Material and Methods Thirty-four end-stage renal failure patients who underwent living donor renal transplantation between January 2015 and July 2015 were enrolled in this prospective cohort study. Implantation, sixth-month protocol, and biopsies that were performed with suspicion of acute rejection were evaluated with renal Doppler ultrasound and elastography findings of recipients’ preimplantation donor ultrasonography findings. Results Comparison of renal ultrasound and elastography findings of 2 groups revealed a significant elevation in the resistive index (0.81 vs 0.63, P = .005) and pulsatility index (2.08 vs 1.20, P = .008) values in the rejection group, and no significant difference in the SWV values between the 2 groups. Delta (Δ)-SWV was calculated using the difference between acute rejection values and preimplantation, implantation, and sixth-month values showed a positive correlation between acute rejection (Δ-sixth month, r = 0.498, P = .030), tubulitis (Δ-pretransplant, r = 0.509, P = .037), and inflammation (Δ-pretransplant, r = 0.657, P = .004) scores. However, there were no correlations between Δ-SWV values and glomerulitis and peritubular capillaritis score. Conclusion Changes in SWV may predict acute rejection in kidney transplantation patients if the reference measurements were done at a more stable time after the transplantation.

Purpose Renal involvement is associated with significant morbidity and mortality in AA amyloidosis. Extend of amyloid deposition in kidney biopsies may be predictive for clinical manifestations and outcomes. the aim of our study is to assess clinical features of patients with biopsy-proven renal AA amyloidosis and to evaluate the relationship between histopathological scoring and grading of renal amyloid deposition with clinical findings and outcomes. Methods the study included 86 patients who were diagnosed with renal AA amyloidosis. the demographic and clinical features at the time of biopsy and follow-up data were retrospectively collected. Amyloid deposition in glomeruli, interstitium, vessels and tubulointerstitial findings were scored and renal amyloid prognostic score (RAPS) was assigned by adding all scores. RAPS was further divided into three grades (RAPS grade I, II, III). Results Median age was 50 (36-59) years. Familial Mediterranean fever was the leading cause. RAPS grade and interstitial inflammatory infiltration were associated with baseline eGFR and glomerular amyloid deposition was associated with proteinuria. During the follow-up period (median 50 months), 39 patients developed ESRD. Extensive (involving > 50%) glomerular amyloid deposition, baseline eGFR and proteinuria were independent risk factors for progression to end stage renal disease. Death censored renal survival was significantly lower among patients with RAPS grade III compared to those with RAPS grade I and II. Patient survival rate was not different according to RAPS grade. Conclusions Degree of renal amyloid accumulation is associated with renal function and outcome. the scoring and grading system may be predictive in clinical outcome and contribute to understanding of disease mechanism.

Background Because of the inadequate number of deceased kidney donors, living kidney donation remains an important issue for kidney transplantation. Previous studies have shown that living donation does not differ life expectancy and progression to end-stage renal disease compared with the normal population. In this study, we investigated short-term cardiovascular changes after donor nephrectomy. Methods Thirty-four patients who underwent donor nephrectomy between January 2015 and July 2015 at Ege University Renal Transplantation Unit were included in the study. Arterial stiffness, multifrequency bioimpedance analysis, renal ARFI elastography, and echocardiography performed prior to the donor nephrectomy and 6 months after nephrectomy. Results A total of 34 kidney donors were enrolled in this study. Twenty donors were female (59%) and 14 donors were male (41%). The pathological evaluation of donor kidneys using implantation renal biopsy sample revealed mean Karpinski Renal Score of 1.5 and the mean glomerulosclerosis ratio was 5% for all donated kidneys. Arterial stiffness, systolic and diastolic blood pressure measures, body fluid composition, and left atrial size did not change significantly during the follow-up. However, interventricular septum thickness of donors increased by 1 mm during a 6-month period (9.6 mm vs 10.6 mm, P = .002). Conclusion We observed an increase in interventricular septum thickness in kidney donors during a 6-month follow-up. In order to evaluate the net effect of this change on donor morbidity, prospective studies investigating an increased number of donors with long-term follow-up should be needed.

Introduction: Human polyomaviruses (BK virus and JC virus) establish a latent infection in kidney (BKV) and brain (JCV) after primary infection. In case of immunosuppression, reactivation may occur causing clinical conditions. Quantitative viremia and viruria are gold standarts in diagnosing polyomavirus associated urethral stenosis and nephropathy in renal transplant recipients. In case of posttransplant nephropathy dose of the immunosupressive therapy should be increased. In polyomavirus nephropathy (PVN) on the contrary the dose of immunosupression should be reduced. The cause of nephropathy is important to adjust the dose of immunosupression in posttransplant renal transplant recipients. Materials and Methods: Two hundred seventy three plasma and urine samples of 65 renal tranplant recipients collected posttransplant at months 0, 3, 6, and 12 were investigated for quantitative polyomavirus DNA by a real-time PCR (LightCycler-LC PCR). In real-time PCR primers and probes were designed to target polyomavirus T antigen gene. BKV and JCV were identified by melting curve analysis. At pretransplant month 0, posttransplantation months 3, 6 and 12 renal biopsy specimens were investigated for BK virus infected cells by immunohistochemical methods. Results: In all of the urine samples BKV-DNA was 26.79%, 31.03%, 28.57%, and 23.53% positive, and JCV DNA was 33.93%, 51.72%, 39.29%, and 47.06% positive at months 0, 3, 6, and 12 posttransplant, respectively. When the results were compared with the healthy control group, the results of month 0 for polyomavirus DNA, JCV-DNA results of the post transplant period and BKV-DNA results of the 12 month were statistically not significant. When the results of the healthy control group and posttransplant 3 and 6 months BKV-DNA results of the renal transplant urine samples were compared we found a significant difference statistically (p= 0.014 and p= 0.025 respectively). These differences at posttransplant month 3 and 6 for BKV show a reactivation period because of intensive immunosuppression. Conclusion: In our study, BKV nephropathy was not detected in 65 renal transplant recipients with clinical, laboratory and histopathological findings. Because BKV nephropathy is found in 1-7% of renal transplant recipients a greater number of renal transplant recipients should be investigated for BKV nephropathy to find the correct incidence for our renal transplantation recipients.

Aim Lupus nephritis (LN) is an important complication of systemic lupus erythematosus (SLE). The aim is to use indication and protocol biopsies to determine clinicopathological findings and outcomes of patients with LN undergoing kidney transplantation (KTx). Methods Patients who underwent KTx due to LN were retrospectively analyzed. Recurrent LN (RLN) was diagnosed by transplant kidney biopsy. Results Among 955 KTx patients, 12 patients with LN as the cause of end-stage renal disease were enrolled. Five patients were male. Mean follow-up time was 63 ± 34 months. At the last follow-up visit, mean levels of serum creatinine and proteinuria were 137.0 ± 69.0 µmol/L and 0.26 ± 0.26 g/day, respectively. Eighteen indication and 22 protocol biopsies were performed; 27 biopsies were additionally evaluated by immunofluorescence. In two recipients, subclinical RLN was confirmed by protocol biopsies. Clinical recurrence occurred in four patients. Among patients with RLN, time from diagnosis of LN to KTx was significantly shorter and use of ATG as induction treatment was significantly lower. Graft loss occurred in two recipients who had clinical RLN. Five-year overall graft survival was 85.7%. Conclusion Kidney transplantation is a reasonable option for patients with ESRD secondary to SLE. However, recurrence of LN is common if protocol biopsies are included in post-transplantation surveillance.

PubMed ID: 25921627, Angiomyolipoma (AML) of the kidney is the most common benign neoplasm encountered indaily clinical practice. Typical AMLs comprise three elements: mature adipose tissue, bloodvessels, and smooth muscle. Since classic AMLs contain considerable amount of adiposetissue, they are easily recognized on computed tomography (CT) and magnetic resonanceimaging (MRI) [1]. On the other hand, some AMLs comprise too little fat to be detected withunenhanced CT. These lesions are called ''fat poor AMLs'' that may be misdiagnosed asrenal cell carcinoma (RCC) on cross sectional imaging [2,3]. Angiomyolipoma with epithelialcysts (AMLEC) is an extremely rare subtype of fat poor AML, which contains epithelial-linedcysts. According to best of our knowledge imaging findings of AMLEC is very scarce and onlya total of 18 cases have been reported so far [4-8]. Herein, we aimed to report the MRIfeatures of AMLEC that resembles Bosniak category III lesion on MRI and emphasize thepotential role of dual gradient-echo imaging in detecting small amount of fat in AMLEC. © 2015 Published by Elsevier Masson SAS on behalf of the Editions francaises de radiologie.

WOS: 000435081200008, PubMed ID: 29722904, ObjectivesLipodystrophy syndromes are a group of heterogeneous disorders characterized by adipose tissue loss. Proteinuria is a remarkable finding in previous reports. Study designIn this multicentre study, prospective follow-up data were collected from 103 subjects with non-HIV-associated lipodystrophy registered in the Turkish Lipodystrophy Study Group database to study renal complications in treatment naive patients with lipodystrophy. MethodsMain outcome measures included ascertainment of chronic kidney disease (CKD) by studying the level of proteinuria and the estimated glomerular filtration rate (eGFR). Kidney volume was measured. Percutaneous renal biopsies were performed in 9 patients. ResultsSeventeen of 37 patients with generalized and 29 of 66 patients with partial lipodystrophy had CKD characterized by proteinuria, of those 12 progressed to renal failure subsequently. The onset of renal complications was significantly earlier in patients with generalized lipodystrophy. Patients with CKD were older and more insulin resistant and had worse metabolic control. Increased kidney volume was associated with poor metabolic control and suppressed leptin levels. Renal biopsies revealed thickening of glomerular basal membranes, mesangial matrix abnormalities, podocyte injury, focal segmental sclerosis, ischaemic changes and tubular abnormalities at various levels. Lipid vacuoles were visualized in electron microscopy images. ConclusionsCKD is conspicuously frequent in patients with lipodystrophy which has an early onset. Renal involvement appears multifactorial. While poorly controlled diabetes caused by severe insulin resistance may drive the disease in some cases, inherent underlying genetic defects may also lead to cell autonomous mechanisms contributory to the pathogenesis of kidney disease., NIHUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [RO-1DK88114], NIH, Grant/Award Number: RO-1DK88114

Introduction Renal transplantation is undoubtedly considered the best renal replacement therapy. Graft nephrectomy can be performed in patients with renal transplantation because of complications associated with the failed graft. We aimed to retrospectively investigate the characteristics of patients who underwent graft nephrectomy. Materials and Methods Between January 2000 and November 2013, the records of 757 patients who had renal transplantation in Ege University Faculty of Medicine Hospital Nephrology-Transplantation outpatient clinic were examined. Sixty-four patients who underwent graft nephrectomy were included in the study. Patients were divided into 2 groups according to the timing of graft nephrectomy. The group of 30 patients who underwent graft nephrectomy in the first 56 days after the renal transplantation was referred to as the “early group” and the group of 34 patients who underwent graft nephrectomy after 56 days was referred to as “late group.” Results In our study, we found the body mass index to be significantly higher in those with early graft loss (P = .02). We found that there was a difference between the groups in terms of sex (P = .012). When the mortality and morbidity rates after graft nephrectomy were examined, mortality was observed in 3 of the 64 patients in the study and morbidity in 1 patient. Conclusion According to our study, the body mass indices and ages of the subjects who need early graft nephrectomy are higher. However, male sex was significantly more prevalent in patients who underwent graft nephrectomy in the late period compared with the early period.

Renal transplant scintigraphy, performed in a 23-year-old man who had renal graft from a living donor, showed nearly normal perfusion and moderately low function of the graft. But the margins of the graft were blurred, and it was interestingly appearing enlarged late in the study. Ultrasound demonstrated a hypoechoic rim surrounding the whole kidney. Biopsy revealed necrosis besides normal cortical tissue. Necrosis was thought to be limited to the subcapsular cortical area. It should be considered that these scintigraphic findings could be due to greatly reduced and delayed perfusion of edematous subcapsular necrotic area of the graft even in normal perfusion images.

WOS: 000437166500001, PubMed ID: 29997433, Introduction: Bladder cancer is responsible for more than 130,000 deaths annually worldwide. Intravesical delivery of chemotherapeutic agents provides effective drug localization to the target area to reduce toxicity and increase efficacy. This study aimed to develop ail intravesical delivery system of gemcitabine HC1 (Gem-HCl) to provide a sustained-release profile, to prolong residence time, and to enhance its efficiency in the treatment of bladder cancer. Materials and methods: For this purpose, bioadhesive microspheres were successfully prepared with average particle size, encapsulation efficiency, and loading capacity of 98.4 mu m, 82.657%+/- 5.817%, and 12.501 +/- 0.881 mg, respectively. For intravesical administration, bioadhesive microspheres were dispersed in mucoadhesive chitosan or in situ poloxanier gels and characterized in terms of gelation temperature, viscosity, mechanical, syringeability. and bioadhesive and rhcological properties. The cytotoxic effects of Gem-HCl solution, Gem-HCl microspheres, and Gem-HCl microsphere-loaded gel formulations were evaluated in two different bladder cancer cell lines: T24 (ATCC HTB4TM) and RT4 (ATCC HTB2TM). Results: According to cell-culture studies. Gem-HCl microsphere-loaded poloxamer gel was more cytotoxic than Gem-HCl microspliere-loaded chitosan gel. Antitumor efficacy of newly developed formulations were investigated by in vivo studies using bladder-tumorinduced rats. Conclusion: According to in vivo studies, Gem-HCl microspliere-loaded poloxamer gel was found to be an effective and promising alternative for current intravesical delivery-system therapies., Scientific and Technological Research Council of TurkeyTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [TUBITAK-112/S/293]; TR Prime Ministry State Planning Organization FoundationTurkiye Cumhuriyeti Kalkinma Bakanligi [09/DPT/001], This study was supported by the Scientific and Technological Research Council of Turkey (grant TUBITAK-112/S/293). The authors would also like to thank the TR Prime Ministry State Planning Organization Foundation (project 09/DPT/001).

To describe an interesting subtype of familial partial lipodystrophy (FPLD).The phenotype of this distinctive FPLD subtype was studied in three Turkish female siblings.Mutation testing was negative for the genes associated with lipodystrophy syndromes. In MRI studies, fat loss was prominent in the posterior aspects of the proximal lower limbs, whilst some fat was preserved in the anterior, medial and lateral aspects. Remarkably, fat tissue was preserved in the distal part of the limbs. Local fat accumulation was observed in the mons pubis area. Asymmetrical fat loss was also remarkable in the upper extremities. All three patients had severe insulin resistance associated with diabetes mellitus, acanthosis nigricans, hypertriglyceridemia and hepatic steatosis. Abnormal amounts of proteinuria were detected in all three subjects. Renal biopsy showed mild tubular atrophy, interstitial fibrosis, irregular thickening and wrinkling of glomerular basal membranes, small areas of segmental sclerosis and pedicel effacement.We reported a form of FPLD characterized by a striking pattern of highly selective partial fat loss and proteinuria.

Neuroendocrine tumors most commonly occur in the gastrointestinal tract, lungs and pancreas. Primary testicular neuroendocrine tumors are rare, constituting 0.23% of all testicular tumors. A 35-year-old man presented to urology department with a painless left scrotal mass. He had no history of trauma. Scrotal Doppler ultrasonography revealed a 2×1.5 cm, well-circumscribed, solid lesion. Tumor marker levels were normal and staging computed tomography demonstrated no evidence of metastasis. The patient subsequently underwent left radical orchiectomy. The orchiectomy material, grossly showed a 1.4x1.2 cm, well-circumscribed, yellow, solid mass. On histopathologic examination, primary testicular carcinoid tumors cannot be distinguished from well-differentiated neuroendocrine carcinoma. The diagnosis of a primary testicular carcinoid tumor was made after ruling out an extratesticular neuroendocrine tumor using clinical and radiological data. This rare case is presented with clinical, morphological and immunohistochemical features., Nöroendokrin tümörler, sıklıkla gastrointestinal sistem, akciğer ve pankreas gibi organlarda görülmektedir. Primer testiküler nöroendokrin tümörler son derece nadir olup, tüm testis tümörlerinin %0.23’ünü oluşturur. 35 yaşındaki hasta, sol skrotumda ağrısız şişlik şikayeti ile üroloji kliniğine başvurdu. Hastada travma hikayesi bulunmamaktaydı. Skrotal Doppler ultrasonograsinde sol testis alt polde 2x1.5 cm boyutlarında düzgün sınırlı solid kitle izlendi. Tümör markerları ve bilgisayar tomografi taramaları normaldi ve hastada metastaz izlenmedi. Hastaya sol radikal orşiektomi uygulandı. Orşiektomi materyali, makroskobik olarak 1.4x1.2 cm boyutlarda düzgün sınırlı, sarı solid kitle olarak izlendi. Histopatolojik incelemede primer testiküler karsinoid tümör, iyi diferansiye nöroendokrin karsinomdan ayırt edilemedi. Primer testiküler karsinoid tümör tanısı, klinik ve radyolojik olarak ekstratestiküler nöroendokrin tümör dışlanarak yapıldı. Bu nadir olgu, morfolojik ve immunhistokimyasal özellikleri ile sunulmuştur.

Background Obesity and related kidney diseases have become a global epidemic problem. However, the underlying pathogenesis of obesity-related renal diseases has not been clearly understood. In this study, we explored the link between renal volume (RV) determined by computed tomography (CT) and renal histology together with functional parameters in an obese population. Materials and methods Eighty-two kidney donors who underwent CT for the measurement of kidney volume and zero-hour renal biopsy for renal histology were included in this cross-sectional study. Protein creatinine clearance and eGFR were evaluated in 24-h urine specimens as indicators of renal function. Results Mean body mass index (BMI) was 28 ± 4·2 kg/m2; 32·9% (n = 27) were obese. Mean RV was 196 ± 36 cm3. RV was positively correlated with BMI, body surface area and creatinine clearance and negatively with HDL-cholesterol in the whole population. Renal function parameters of obese subjects were better, and their renal volumes were higher compared with the nonobese subjects. In obese subjects, corrected RV was positively correlated with glomerular filtration rate (r = 0·46, P = 0·01) and negatively with sclerotic glomeruli (r = −0·38, P = 0·04) and chronicity index (r = −0·43, P = 0·02). In adjusted ordinal logistic regression analysis, corrected RV was significantly associated with chronicity index (OR: 0·96; P = 0·01). Conclusions In obese cases, decreased RV determined by CT is associated with worse renal histology. In this population, kidney imaging techniques may provide important clues about renal survival.

WOS: 000406446700015, PubMed ID: 28094762, Persistent Mullerian duct syndrome is the result of either anti-Mullerian hormone (AMH) deficiency or AMH receptor resistance. A long tubular structure was palpated during the physical examination of a 13-month-old male patient who had presented with bilateral undescended testes. At physical examination, the testes were not palpable. The patient's karyotype was XY, SRY (+), and his AMH level was 22 ng/mol. Structures suggestive of ovaries, a uterus, and fallopian tubes were observed during the laparoscopic examination of the ectopic testis. AMHR2 gene sequence analysis performed with a preliminary diagnosis of AMH receptor resistance revealed a previously unreported homozygous c.24G > A (p. W8X) mutation. The patient was assessed as a case of AMH receptor resistance. Orchiopexy was performed.

WOS: 000404812600011, PubMed ID: 28044303, Intraductal carcinoma of prostate has been previously described in radical prostatectomies. It's rarely encountered in needle biopsies in the absence of infiltrative carcinoma. But, both histogenesis and nomenclature of the lesion is still controversial. Among the pure intraductal carcinoma of prostate cases, a different solid patern was described with smaller nuclei at the center of the ducts. However, there is a lack of information about the association of those cases with acinar prostate adenocarcinoma. Herein, we describe a case of acinar adenocarcinoma with predominant non-neuroendocrine TTF-1 positive small cell intraductal component.

1 Izmir Bozyaka Training and Research Hospital, Department of Nephrology, Izmir, Turkey 2 Izmir Bozyaka Training and Research Hospital, Department of Internal Medicine, Izmir, Turkey 3 Kahramanmaras State Hospital, Department of Nephrology, Kahramanmaras, Turkey 4 Izmir Bozyaka Training and Research Hospital, Department of Pathology, Izmir, Turkey 5 Ege University Faculty of Medicine, Department of Pathology, Izmir, Turkey 6 Ege University Faculty of Medicine, Department of Nephrology, Izmir, Turkey doi: 10.5262/tndt.2014.1002.10

Introduction: Nephrotic syndrome (NS) and arterial stiffness (AS) have each been linked with increased risk for cardiovascular diseases. However, there is no data in the literature up-to-date on AS in adult patients with NS. Thus, in this study, we aimed to evaluate the potential associations between AS, volume and nutritional status in patients with NS in comparison to a healthy control group. Methods: 34 adult patients with newly diagnosed but untreated NS and 34 healthy controls were studied. AS was assessed by carotid-femoral PWV (cf-PWV) and body composition, nutritional status by multi-frequency bioelectric impedance analysis (BIA). Results: Mean age was 44.6 +/- 18.7 years (18 - 72). Mean cf-PWV was 8.3 +/- 2.5 m/s in patients with NS and 6.7 +/- 1.1 m/s in controls (p = 0.002). In univariate analysis, cf-PWV and positively correlated with age, systolic blood pressure, mean arterial pressure (MAP), pulse pressure, body mass index, body fat ratio, waisthip ratio, creatinine, uric acid and negatively with creatinine clearance. In linear regression analysis, only age and MAP predicted arterial stifffiess. Total body fluid, extracellular water (ECW), ECW/Height, ECW/body surface area and third space volumes were higher in patients with NS. Conclusion: Patients with NS have increased AS and are more hypervolemic compared to the healthy subjects.

In hepatic amyloidosis (HA), the relationships between the pattern and extent of amyloid deposition, morphologic changes, associated diseases and clinical data have not yet been demonstrated. In this study, we sought the correlation between the above mentioned parameters in HA. Liver biopsies of 34 HA were retrospectively analyzed for the type, distribution, and intensity of amyloid deposition and associated morphologic changes. AA and nonAA types were classified on the basis of immunohistochemistry. Follow-up clinical and laboratory findings were reviewed. Twenty-three out of 34 patients (67.6%) had AA, and 11 out of 34 patients (32.4%) had nonAA amyloidosis. The predominant localization pattern in AA amyloidosis was vascular (91.3%), and in nonAA amyloidosis it was mixed with other patterns (72.7%). We confirmed that nonAA amyloid involves the hepatic artery, as well as the portal and central vein, but deposition occurred more frequently in the sinusoidal areas. We detected a portal stromal pattern only in cases of nonAA amyloidosis with a mixed pattern of amyloid deposition. The pattern of amyloid deposition in liver differs between the AA and nonAA type amyloidosis. The distribution of amyloid within the liver is not a reliable method for distinguishing AA from nonAA amyloidosis. However, the histological pattern provides strong clues as to the etiology of the amyloid deposits, and could provide information on the clinical status and prognosis of these patients.

Persistent hypercalcemia after kidney transplantation (KTx) may cause nephrocalcinosis and graft dysfunction. The aim of this study was to evaluate patients with hypercalcemia and assess its effect on tubulointerstitial calcification. A total of 247 recipients were enrolled. Transient and persistent hypercalcemia was defined as hypercalcemia (corrected serum calcium >10.2 mg/dL) persisting for 6 and 12 months after KTx, respectively. The severity of calcification in the 0-h, 6- and 12-month protocol biopsies of patients with transient (n = 8) and persistent hypercalcemia (n = 20) was compared with a matched control group (n = 28). Twenty-eight patients were hypercalcemic at 6 months posttransplantation. Serum calcium levels were normalized in eight of them at the end of the first year. Dialysis duration was a positive predictor of persistent hypercalcemia. Tubulointerstitial calcification was detected in 70.6 and 90 % of patients with persistent hypercalcemia at 6 and 12 months posttransplantation, respectively. In 20 % of patients with transient hypercalcemia, severity of calcification regressed at 12 months posttransplantation along with normalization of serum calcium levels. Graft functions and histopathological findings (ci, ct, ci + ct, cv, ah, percentage of sclerotic glomeruli) were not different at 6 and 12 months posttransplantation. Hypercalcemia and persistent hyperparathyroidism are not rare after KTx. Tubulointerstitial calcification is more common and progressive among patients with persistent hypercalcemia. Normalization of calcium levels may contribute to regression of calcification in some patients.

Small cell carcinoma (SmCC) is a rare and aggressive neuroendocrine carcinoma of the bladder. Neuroendocrine carcinomas expressing somatostatin receptors (SSTR) in other viscera such as lung, pancreas, and gastrointestinal system respond to therapy with somatostatin analogs. In the present study, expressions of SSTRs 1 to 5 including type 2A are investigated by immunohistochemistry (IHC) and their relationship with clinicopathologic factors was evaluated. Hundred primary bladder SmCC cases were collected from 12 centers in Turkey. Forty-three cases were pure SmCC. Other cases had mostly papillary urothelial carcinoma as a second component. The percentage of the SmCC component ranged from 5% to 100%. SSTR-2A expression was membranous, whereas the other receptors showed cytoplasmic staining. The percentages of positive cases for SSTR-1, SSTR-2A, SSTR-3, SSTR-4, and SSTR-5 were 4% (3/75), 61.4% (54/88), 2.4% (2/84), 24.4% (20/82), and 6.25% (5/80), respectively. The percentage of SmCC component was positively correlated with the percentage of SSTR-2A expression (P=0.003) while negatively correlated with patient age (P=0.032). SSTR-2A expression was correlated with survival as a bad prognostic factor (P=0.018). SSTR-1, SSTR-3, SSTR-4, and SSTR-5 expressions did not show any statistical significance with any parameter. In conclusion, although the limited number of cases with adequate term follow-up, SSTR-2A expression could be a prognostic factor and somatostatin analogs therapeutic candidate for SmCCs of the bladder as these tumors show high percentage of SSTR-2A expression. © 2016 Wolters Kluwer Health, Inc. All rights reserved.

Giriş: İnsan polyomavirüsleri (BK virüs ve JC virüs) primer infeksiyon sonrası böbrekte (BKV) ve beyinde (JCV) latent olarak kalır. İmmünsüpresyon durumunda reaktivasyonla klinik tablolara neden olur. Renal transplantasyon alıcılarında latent polyomavirüsün reaktivasyonunun neden olduğu üretral stenoz ve nefropati tanısında kantitatif viremi ve virürinin saptanması altın standarttır. Transplantasyon sonrası immünsüpresyon dozunun ayarlanması açısından polyomavirüse bağlı nefropati tanısının konması organ kaybının önlenmesi için çok önemlidir. Transplantasyon sonrası görülen akut rejeksiyon atağında immünsüpresyon dozu artırılmalı, polyomavirüse bağlı nefropati (PVN)'de ise immünsüpresyon dozu azaltılmalıdır. Materyal ve Metod: Çalışmamızda renal transplantasyon alıcısı 65 hastaya ait transplantasyon öncesi 0. ay ve transplantasyon sonrası 3, 6 ve 12. aylarda alınan toplam 273 plazma ve idrar örneğinde polyomavirüs DNA'sı kantitatif olarak gerçek zamanlı (real-time) PCR (LightCycler-LC PCR) ile araştırıldı. Gerçek zamanlı PCR'de hedef bölge olarak polyomavirüs T antijeni gen bölgesine uygun primer ve problar kullanıldı. BKV ve JCV ayrımı erime eğrisi analizi ile yapıldı. Transplantasyon öncesi 0. ay, transplantasyon sonrası 3, 6 ve 12. aylarda yapılan protokol biyopsi örneklerinden immünhistokimyasal yöntemle BK virüs infekte hücreler araştırıldı. Bulgular: Tüm idrar örnekleri incelendiğinde BKV-DNA 0, 3, 6 ve 12. aylarda sırasıyla %26.79, %31.03, %28.57 ve %23.53, JCVDNA ise 0, 3, 6, ve 12. aylarda sırasıyla %33.93, %51.72, %39.29 ve %47.06 pozitif bulundu. Sağlıklı kontrol grubu ile sonuçlar karşılaştırıldığında, 0. ayda her iki örnekte polyomavirüs DNA sonuçları, transplantasyon sonrası örneklerde JCV-DNA sonuçları ve 12. ay örneklerinde BKV-DNA sonuçları ile anlamlı bir fark saptanmadı. Transplantasyon sonrası 3. ve 6. ay idrar BKV-DNA sonuçları ile kontrol grubu arasında istatistiksel olarak anlamlı bir fark bulundu (sırasıyla; p= 0.014, p= 0.025). Bu fark BKV'nin tranplantasyon sonrası 3. ve 6. ayda immünsüpresyonun yoğun olduğu dönemde reaktivasyonunun göstergesidir. Çalışmamızda 65 olguda klinik, laboratuvar ve histopatoloji ile BKV nefropatisi saptanmadı. Sonuç: BKV nefropatisi renal transplant alıcılarında %1-7 oranında görüldüğü için daha çok sayıda renal transplant alıcısı ile yapılacak bir çalışmanın BKV nefropati görülme sıklığını daha net göstereceğini düşünüyoruz., Introduction: Human polyomaviruses (BK virus and JC virus) establish a latent infection in kidney (BKV) and brain (JCV) after primary infection. In case of immunosuppression, reactivation may occur causing clinical conditions. Quantitative viremia and viruria are gold standarts in diagnosing polyomavirus associated urethral stenosis and nephropathy in renal transplant recipients. In case of posttransplant nephropathy dose of the immunosupressive therapy should be increased. In polyomavirus nephropathy (PVN) on the contrary the dose of immunosupression should be reduced. The cause of nephropathy is important to adjust the dose of immunosupression in posttransplant renal transplant recipients. Materials and Methods: Two hundred seventy three plasma and urine samples of 65 renal tranplant recipients collected posttransplant at months 0, 3, 6, and 12 were investigated for quantitative polyomavirus DNA by a real-time PCR (LightCycler-LC PCR). In real-time PCR primers and probes were designed to target polyomavirus T antigen gene. BKV and JCV were identified by melting curve analysis. At pretransplant month 0, posttransplantation months 3, 6 and 12 renal biopsy specimens were investigated for BK virus infected cells by immunohistochemical methods. Results: In all of the urine samples BKV-DNA was 26.79%, 31.03%, 28.57%, and 23.53% positive, and JCV DNA was 33.93%, 51.72%, 39.29%, and 47.06% positive at months 0, 3, 6, and 12 posttransplant, respectively. When the results were compared with the healthy control group, the results of month 0 for polyomavirus DNA, JCV-DNA results of the post transplant period and BKV-DNA results of the 12 month were statistically not significant. When the results of the healthy control group and posttransplant 3 and 6 months BKV-DNA results of the renal transplant urine samples were compared we found a significant difference statistically (p= 0.014 and p= 0.025 respectively). These differences at posttransplant month 3 and 6 for BKV show a reactivation period because of intensive immunosuppression. Conclusion: In our study, BKV nephropathy was not detected in 65 renal transplant recipients with clinical, laboratory and histopathological findings. Because BKV nephropathy is found in 1-7% of renal transplant recipients a greater number of renal transplant recipients should be investigated for BKV nephropathy to find the correct incidence for our renal transplantation recipients.

WOS: 000384578200025 PubMed ID: 27222134 p21 and p27 are members of cyclin-dependent kinase family, which function as tumor suppressors and they are involved in development and progression of several malignancies. We investigated their expression in upper urinary tract urothelial carcinoma (UUTUC). Radical nephroureterectomy materials of 34 patients were assessed by immunohistochemistry to evaluate expression of p21 and p27 in UUTUC. Results were correlated with various clinicopathological variables as age, gender, tumor grade and stage, tumor architecture, multifocality, subsequent bladder carcinoma development and clinical outcome. p21 and p27 expression was observed in 52.9 % (n = 18) and 88.2 % (n = 30), respectively. A total of 21 tumors (61.7 %) showed either total loss of p21 expression (n = 16, 47 %) or lower expression (n = 5, 14.7 %). No correlation was found between p21 expression and clinicopathologic variables. Cases showing total loss or lower p27 expression (11.7 % and < 25.6 %, respectively) (n = 19, 55.8 %) constituted 67.6 % (n = 23) of the cases totally. This loss or lower p27 expression correlated with a shorter overall survival in both univariate and multivariate analysis (p = 0.039 and p = 0.037, respectively). None of the noninvasive tumors (papillary and nodular tumors) showed loss of p27 (p = 0.016) while 33.3 % of invasive ones showed p27 loss. Noninvasive tumor architecture also correlated with subsequent bladder carcinoma development (p = 0.032) while invasive tumor architecture correlated with advanced stage (T3 and T4) (p = 0.003). p27 is widely expressed in UUTUC, while p21 expression is observed in half of the cases. Loss of p27 expression correlated with tumor architecture and overall survival in UUTUC. However, further research is needed to assess their role in UUTUC.

Aim: Carotid artery intima media thickness (CA-IMT) measurement has been shown to be a safe and reproducible method to assess severity of atherosclerosis. The association between nephrosclerosis and systemic atherosclerosis is not clear. In this study, we investigated the association between CA-IMT and nephrosclerosis in a group of kidney transplant donors. Methods: Forty seven potential kidney transplant donors were included. CA-IMT was measured by B-Mode ultrasonography. Kidney allograft biopsy samples were obtained during the transplantation operation and chronic glomerular, vascular and tubulointertitial changes were semiquantitatively scored according to the Banff classification. Results: Mean age was 52 ± 12 years and 55% of the cases were younger than 55 years. Mean CA-IMT was 0.74 ± 0.19 mm and 48% had IMT values > 0.75 mm. Chronicty index was ≥5 in 55% of the cases. Chronicity index was higher in cases older than 55 years. Age and CA-IMT were significantly correlated with chronic vascular changes and chronicity index. CA-IMT > 0.75 mm had a 46% sensitivity and 90% specificity to predict nephrosclerosis. Positive and negative predictive values were 85% and 57%, respectively. Conclusion: Aging leads to detrimental changes in every part of the vasculature of the human body. CA-IMT is correlated with the level of nephrosclerosis. Measurement of CA-IMT reflects nephrosclerosis especially in older patients.

The clinical management of tumor patients is often strongly infuenced by the tumor grade. The presence of heterogeneity is well recognized in a variety of tumors. Overall grade is based on highest grade area identified within a tumor. Urothelial carcinoma often contains different histological grades within the same tumor. This study investigates the impact of a combined grading system on the reproducibility of papillary urothelial neoplasms. A set prepared for an earlier study consisting of ten cases of each category (papillary urothelial neoplasm of low malignant potential (PUNLMP), LGPUC, and HGPUC) was used. Agreement between pairs of pathologists was evaluated using kappa statistics for the combined scoring system. Interobserver agreement was fair to substantial as reflected by kappa values ranging from 0.24 to 0.74 (mean kappa = 0.43). The combined scores of 2 and 3 which included PUNLMP showed the lowest degree of agreement and when this category was excluded from the analysis, interobserver agreement increased significantly (mean kappa = 0.65; ranging from 0.43 to 0.92) in terms of combined scores of 4, 5, and 6. PUNLMP has been shown to be the least reproducible component of a combined scoring system even among experienced observers. Exclusion of PUNLMP from grading scheme seems to improve interobserver variability.

Upper urinary tract urothelial carcinomas are relatively rare malignancies. The aim of this study was to investigate the factors affecting prognosis of patients undergoing nephroureterectomy.Data of 140 patients undergoing nephroureterectomy were retrospectively analyzed. Age of patients, gender, focality and localization of tumor, clinical and pathological stage, relationship with bladder cancer (prior, synchronous, after), and history of smoking were retrospectively recorded. The condition of local recurrence, metastases to distant organs, and requirement of adjuvant treatment were evaluated.The disease-specific and recurrence-free 5-year survival rate was determined as 78.9 and 68.4%, respectively. Bladder recurrence was determined in 20 of the patients after a mean of 21 months (7-37 months). Relationship between the duration of recurrence and variables showed that patients with T2 and higher stages (P = 0.014), with high-grade tumors (P = 0.028), with multifocal tumors (P0.001), and patients who were cigarette smokers (P = 0.010) had significantly shorter durations of recurrence. The mean survival of the 19 (18.1%) patients who had distant metastases was 19 months. Pathological stage T2 and higher tumors (P = 0.006), nodal involvement (P = 0.04), high-grade urothelial carcinoma (P0.001), multifocal tumors (P0.001), and tumors localized in the ureter (P0.001) were observed to have shorter duration of metastatic development.Presence of T2 and higher-stage tumors, high-grade tumors, and multifocality are combined risk factors for urinary bladder recurrence and distant organ metastasis. Patients with the additional risk factors of cigarette smoking (urinary bladder recurrence) and nodal disease (distant organ metastasis) should be followed up closely after surgery.

PubMed ID: 21258795, Chronic interstitial cystitis (IC), mostly affecting middle-aged women, is a very rare manifestation of primary Sjögren's syndrome (pSS). Hereby, we report a 42-year-old woman with pSS, presenting with dysuria, urinary frequency, and suprapubic pain. She was diagnosed to have chronic IC, based upon the cystoscopic biopsy finding of chronic inflammation in the bladder wall. Systemic corticosteroid and azathioprine treatments together with local intravesical therapies were not effective. Therefore, cyclosporine (CSA) therapy was initiated. Initial low dose of CSA (1.5 mg/kg/d) improved the symptoms of the patient, with no requirement for dose increment. After 4 months of therapy, control cystoscopic biopsy showed that bladder inflammation regressed and IC improved. This case suggests that even low doses of CSA may be beneficial for treating chronic IC associated with pSS syndrome. © 2011 Springer-Verlag.

WOS: 000296212300028, Objective: Prostate cancer is a multifactorial inherited disease affecting one in six men in industrial countries. A number of mutations in key proteins of the cell cycle machinery or signal transduction pathways have already been associated with prostate cancer; but recently, a number of polymorphisms in proteins that function in less popular cellular pathways have been investigated as possible risk factors. In this study, we evaluated the effects of two gene polymorphisms in enzymes functioning in distinct metabolic pathways on prostate cancer susceptibility. Material and Methods: Allele and genotype associations of the COMT Val108/158Met and MTHFR C677T gene polymorphisms were studied in a total of 112 Turkish prostate cancer patients who constituted our study group while 145 healthy males constituted our control group. Genomic DNA was isolated from the peripheral blood leukocytes of the subjects and analyzed by two different real-time polyrnerase chain reaction assays. Results: The frequency of the heterozygous COMT G/A and the homozygous MTHFR TIT genotypes were higher in the study group compared to the control group (47.3% versus 34.5%; and 14.3% versus 7.6%, respectively). Prostate cancer subjects with the heterozygous MTHFR C/T genotype had higher prostate specific antigen values. Nevertheless, no statistically significant association was found between these polymorphisms alone or in combination and the risk of developing prostate cancer. Conclusion: We suggest that functional gene polymorphisms in metabolic proteins predispose subjects to increased risk of developing cancer; but, not as strong as mutations in proto-oncogenes or tumor-suppressor genes.