Gokhan Gokce

Relation of microvessel density with microvascular invasion, metastasis and prognosis in renal cell carcinoma

To clarify the significance of microvessel density (MVD) in a retrospective investigation the relationship between the pattern of MVD (reflecting angiogenesis), and tumour stage, grade, size, and occurrence of microvessel invasion (MVI), metastasis, and cancer‐specific survival (CSS) in patients who had surgery for renal cell carcinoma (RCC).

Prognostic value of the expression of Ki-67, CD44 and vascular endothelial growth factor, and microvessel invasion, in renal cell carcinoma

To determine if use of cell proliferation, cell adhesion, level of angiogenesis‐related factors and presence of microscopic vascular invasion (MVI) could better predict the biological behaviour of renal cell carcinoma (RCC), which has a widely variable clinical outcome despite the use of conventional prognostic factors (staging and grading).

A comparison of sedation with dexmedetomidine or propofol during shockwave lithotripsy: a randomized controlled trial.

BACKGROUND:Dexmedetomidine, because it has both sedative and analgesic properties, may be suitable for conscious sedation during painful procedures. Extracorporeal shockwave lithotripsy (ESWL) is a minimal to mildly painful procedure that requires conscious sedation. We thus evaluated the utility of dexmedetomidine compared with propofol during an ESWL procedure. METHODS:Forty-six patients were randomly allocated into two groups to receive either dexmedetomidine or propofol for elective ESWL. Dexmedetomidine was infused at 6 &mgr;g · kg−1 · h−1 for 10 min followed by an infusion rate of 0.2 &mgr;g · kg−1 · h−1. Propofol was infused at 6 mg · kg−1 · h−1 for 10 min followed by an infusion of 2.4 mg · kg−1 · h−1. Fentanyl 1 &mgr;g/kg IV was given to all patients 10 min before ESWL. Pain intensity was evaluated with a visual analog scale at 5-min intervals during ESWL (10–35 min). Sedation was determined using the Observers Assessment of Alertness/Sedation. The Observers Assessment of Alertness/ Sedation scores and hemodynamic and respiratory variables were recorded regularly during ESWL (35 min) and up to 85 min after. RESULTS:Forty patients were evaluated. Visual analog scale values with dexmedetomidine were significantly lower than those with propofol only at the 25–35 min assessments (P < 0.05). During sedation, the respiratory rate with dexmedetomidine was significantly slower but Spo2 was significantly higher than with propofol (P < 0.05). Other clinical variables were similar (P > 0.05). CONCLUSION:A combination of dexmedetomidine with fentanyl can be used safely and effectively for sedation and analgesia during ESWL.

Genitourinary tuberculosis: a review of 174 cases.

In 174 cases of genitourinary tuberculosis diagnosed and treated in our clinic we evaluated, retrospectively, age and sex distributions, symptoms, physical and laboratory findings, primary focus, surgical and medical treatments. Flank pain and non-specific urinary complaints, e.g. dysuria, were the major symptoms. Although some authors prefer short-term medical therapy for the treatment of genitourinary tuberculosis, the relapse rate in our series after 12 months of therapy was 19% and we therefore suggest that therapy should be continued for at least 12 months. The poor nutritional status and social conditions characteristic of subjects from our region may, however, have influenced this high relapse rate.

Efficacy of tolterodine as a first-line treatment for non-neurogenic voiding dysfunction in children

To assess the effect of antimuscarinic treatment with tolterodine combined with behavioural modification as a first‐line treatment, before invasive investigation, in children with non‐neurogenic voiding dysfunction but no obvious anatomical or neurogenic cause.

Thoracic paravertebral block for postoperative pain management in percutaneous nephrolithotomy patients: a randomized controlled clinical trial.

Objective: To investigate the effect of thoracic paravertebral block (PVB) on pain control and morphine consumption in percutaneous nephrolithotomy operations. Subjects and Methods: This randomized controlled clinical study was performed on 60 American Society of Anesthesiologists (ASA) I-II patients between the ages of 18 and 60 years who underwent percutaneous nephrolithotomy with approval of the ethical committee and written consent of the patients. Patients were randomly allocated into two groups: group P had 4 ml of 0.5% levobupivacaine injected at each of the T10, T11, and T12 paravertebral spaces and a standard PVB, and group C received 4 ml of 0.9% NaCl solution. All patients were given standard general anesthesia. The follow-up of saturation, heart rate, peripheral oxygen, and blood pressure values was recorded before induction, intraoperatively, and postoperatively. At postoperative 1, 2, 6, 12, and 24 h, the visual analog scale (VAS), Ramsey sedation score, respiratory rate, and 24-hour total morphine consumption were recorded. In addition, side effects and satisfaction of patients were recorded. Results: VAS scores and total morphine consumption were lower in group P than in group C: 2.3 vs. 4.3 and 22.3 vs. 43.2 mg, respectively (p < 0.05). The level of satisfaction was higher in group P than group C. Differences between groups in other parameters were not significant. Conclusions: Thoracic PVB with levobupivacaine provided a good postoperative analgesia and increased patient satisfaction for those who underwent percutaneous nephrolithotomy.

Urinary nuclear matrix protein 22 for diagnosis of renal cell carcinoma

Objective To determine the incidence of positive urinary nuclear matrix protein 22 (NMP22) values, which are currently used to detect transitional cell carcinoma of the bladder, in renal cell carcinoma (RCC). Material and methods Urinary NMP22 values were determined preoperatively in 41 patients in whom a solid renal mass had been detected using CT and who were scheduled for radical nephrectomy; 38 of these patients were diagnosed with RCC. Two patients had xanthogranulomatous pyelonephritis and one had metastasis of a small cell adenocarcinoma to the kidney; these patients were excluded from the study. A total of 30 patients with kidney stones and simple renal cysts were used as controls. Results The urinary NMP22 values of the RCC patients were significantly higher than those of the controls. Of the 38 patients with RCC, 23 (60.5%) had positive urinary NMP22 values ≥10 U/ml. There were four measurements above this cut-off level in the control group. Urinary NMP22 values increased with an increase in pathologic tumor stage, but the correlation was not statistically significant. There was no correlation between grade and urinary NMP22 or between tumor burden and urinary NMP22. Conclusions The urinary NMP22 test may help to diagnose RCC and may also result in an increase in the incidental discovery of RCC. As elevated urinary NMP22 levels have also been found to occur in RCC, patients with suspected bladder cancer and positive urinary NMP22 levels should be more broadly evaluated. Specific NMP assays for renal tumor cells may increase the utility of the test for RCC.

K-Ras mutation in transitional cell carcinoma of urinary bladder

In the present study it was aimed to investigate the frequency of K-RAS mutation in the human bladder transitional cell carcinoma. For thispurpose, tissue specimens obtained from the patients with bladder tumors.Genomic DNAs were isolated and then PCR-SSCP analysis of K-RAS genewere performed. A heterozygous deleted mutation was detected in K-RAS oncogene (exon 2) in agorose gel electrophoresis in one patient andpoint or substitution mutations are detected using single strandconformational polymorphism (SSCP) in other different patients withbladder cancer (4/14). In conclusion, the frequency of K-RAS mutationis not rare and the role of this mutation in oncogenesis and in infiltrationof the urinary bladder wall needs to be confirmed in a larger study.

The evaluation of the effects of renal failure on erectile dysfunction in a rabbit model of chronic renal failure.

To determine whether chronic renal failure (CRF) reduces nitrergic relaxant responses in a rabbit model.

Adenomatoid tumors of testis and epididymis: a report of two cases.

Adenomatoid tumors are rare benign tumors of female and male genital tracts. In this paper, we reported an epididymal and a testicular adenomatoid tumor in two patients presented with enlarged intrascrotal mass.