Gokhan Ozer

Failure of ureteral replacement with gore-tex tube grafts

OBJECTIVES To evaluate the role of polytetrafluoroethylene (Gore-Tex) as a ureteral substitute in dogs after resection of a 5 to 8-cm-long middle segment. METHODS Five mongrel dogs underwent resection of the middle segment of the left ureter and segmental replacement of the resected part with segments of Gore-Tex over a double-J catheter. The double-J stents were removed at 21 days and the dogs were evaluated by excretory urography and abdominal ultrasonography 12 weeks after surgery. They were then killed and the ureters and the kidneys examined both grossly and microscopically. RESULTS There was radiologic evidence of advanced hydronephrosis on the left side in all 5 dogs. Grossly, the left kidneys showed marked pelvic and proximal ureteral dilatation and atrophy of parenchyma. Severe stricture at the anastomotic sites and marked fibrous tissue around the prostheses were found. No cellular lining was found in the Gore-Tex lumen. CONCLUSIONS There is no potential for ureteral replacement by Gore-Tex tube graft.

Value of urinary NMP-22 in patients with renal cell carcinoma

OBJECTIVES: To investigate the preoperative and postoperative levels of urinary nuclear matrix protein-22 (NMP-22) in patients with renal cell carcinoma (RCC) and compare them with those of control patients. We also investigated and reported the relationship of NMP-22 with the pathologic grade and stage of RCC tumors. Urinary NMP-22 is currently used for monitoring patients with transitional cell carcinoma of the bladder. METHODS: The preoperative and postoperative urinary NMP-22 levels were measured in 23 patients with RCC and 20 control patients in whom solid renal masses were ruled out by either computed tomography or renal ultrasonography. The control group consisted of patients with benign conditions from the urology, gastroenterologic surgery, and cardiovascular surgery departments. Of the 23 patients with RCC, 21 underwent radical nephrectomy and 2 underwent partial nephrectomy. RESULTS: The preoperative urinary NMP-22 levels were significantly higher in the RCC group than in the control group (10.65 +/- 5.49 U/mL and 4.64 +/- 3.10 U/mL, respectively, P <0.001). Ten days postoperatively, the urinary NMP-22 levels had decreased from 10.65 +/- 5.49 U/mL to 5.98 +/- 3.86 U/mL in the RCC group, which was statistically significant (P <0.001). The postoperative urinary NMP-22 levels were not different from those of the control group (5.98 +/- 3.86 U/mL versus 4.64 +/- 3.10 U/mL, P = 0.176). CONCLUSIONS: The results of this study are promising for the use of urinary NMP-22 in the evaluation of patients who are at risk of RCC because the relationship between urinary NMP-22 and the presence of RCC has been shown.

Potential Value of Soluble Intercellular Adhesion Molecule-1 in the Serum of Patients with Bladder Cancer

Introduction: The potential value of serum levels of intercellular adhesion molecule-1 (ICAM-1) in the staging and pathological nature of bladder cancer was investigated in this study. Materials and Methods: A total of 90 patients (mean age 64.5 ± 7.1) having transitional cell carcinoma of the bladder and 30 control patients (mean age 64.0 ± 5.5) were enrolled in the study. The serum samples of the patients were obtained on the day before surgery, at the same hour of the day. Results: The preoperative sICAM-1 levels were found to be 46.2 ± 14.7 and 28.0 ± 7.8 ng/ml in the tumor group and the control group respectively, which is significantly higher (p = 0.00). The ICAM-1 levels were not different in the invasive tumor group (36 patients) and the superficial tumor group (54 patients; 47.3 ± 13.8 ng/ml in the invasive group and 45.5 ± 15.3 ng/ml in the superficial tumor group; p = 0.520). The serum levels of sICAM-1 were significantly higher in grade III tumors than grade I and II tumors (62.0 ± 8.7, 38.4 ± 11.9 and 42.2 ± 8.2 ng/ml respectively; p = 0.000). The mean serum sICAM-1 levels in tumors >3 cm and <3 cm were found to be 52.6 ± 15.8 and 40.7 ± 11.0 ng/ml respectively which is statistically significant (p = 0.000). Conclusions: In this study, serum ICAM-1 levels were found to be related to tumor presence, grade and size. Larger series are needed for the thorough understanding of the role of ICAM-1 in bladder cancer.

Long-Term Outcome of a Patient with Intrascrotal Extratesticular Malignant Schwannoma

We have the opportunity to present a rare case of late local recurrence after treatment of intrascrotal extratesticular malignant schwannoma with rhabdomyoblastic features in an adult man. As our case is the first in the literature, we want to inform the reader about the long-term follow-up of our patient and suggest that these tumors may have a long survival and late recurrences may occur even after 5 years postoperatively.

830Validation of 2001 partin tables in Turkey: A multicenter study

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 10 ng/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.

The value of urinary NMP-22 in patients with renal cell carcinoma

OBJECTIVES To investigate the preoperative and postoperative levels of urinary nuclear matrix protein-22 (NMP-22) in patients with renal cell carcinoma (RCC) and compare them with those of control patients. We also investigated and reported the relationship of NMP-22 with the pathologic grade and stage of RCC tumors. Urinary NMP-22 is currently used for monitoring patients with transitional cell carcinoma of the bladder. METHODS The preoperative and postoperative urinary NMP-22 levels were measured in 23 patients with RCC and 20 control patients in whom solid renal masses were ruled out by either computed tomography or renal ultrasonography. The control group consisted of patients with benign conditions from the urology, gastroenterologic surgery, and cardiovascular surgery departments. Of the 23 patients with RCC, 21 underwent radical nephrectomy and 2 underwent partial nephrectomy. RESULTS The preoperative urinary NMP-22 levels were significantly higher in the RCC group than in the control group (10.65 +/- 5.49 U/mL and 4.64 +/- 3.10 U/mL, respectively, P <0.001). Ten days postoperatively, the urinary NMP-22 levels had decreased from 10.65 +/- 5.49 U/mL to 5.98 +/- 3.86 U/mL in the RCC group, which was statistically significant (P <0.001). The postoperative urinary NMP-22 levels were not different from those of the control group (5.98 +/- 3.86 U/mL versus 4.64 +/- 3.10 U/mL, P = 0.176). CONCLUSIONS The results of this study are promising for the use of urinary NMP-22 in the evaluation of patients who are at risk of RCC because the relationship between urinary NMP-22 and the presence of RCC has been shown.