Browsing by Author "Tuzel, Emre"

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Association of metallothionein expression and clinical response to cisplatin based chemotherapy in testicular germ cell tumors
(2015) Tuzel, Emre; Yorukoglu, Kutsal; Ozkara, Esra; Kirkli, Ziya; 25914837
Introduction The protective roles of metallothioneins (MT) against metal toxicity suggest that MT may have a functional role in cisplatin resistance. The aim of this study was to investigate the expression of MT in specimens of germ cell tumors and compare it with clinical sensitivity to cisplatin based chemotherapy. Material and methods Tissue blocks of primary GCT specimens obtained from 39 patients were examined immunohistochemically for MT expression. Staining intensity was evaluated according to the percentage of MT positive cells and graded as [-], [+] and [++]. The staining characteristics were compared with the clinical response to chemotherapy. Results Of the 39 tumors, 3 evidenced no MT expression while 26 and 10 specimens showed [+] and [++] staining, respectively. Although seminomas tend to stain weaker than non-seminomas, the difference of staining between them was not significant (p = 0.19). Of the 39 patients, 23 underwent cisplatin based chemotherapy. Of those, 6 progressed and 17 achieved complete remission. Of the non-responders, 5 showed [+] and 1 showed [++] staining. Six of the responders showed [+], 10 had [++] and 1 showed no staining. No association was found between MT staining and chemo-sensitivity (p = 0.53). Conclusions MT expression in primary germ cell tumors did not differ between responding and non-responding patients and therefore may not be useful in predicting response to chemotherapy.
The Effect of Local Anesthetic Infiltration Around Nephrostomy Tract on Postoperative Pain Control After Percutaneous Nephrolithotomy
(2014) Tuzel, Emre; Kiziltepe, Gunes; Akdogan, Bulent; 24990067
The objective of the study was to investigate the effect of a long acting local anesthetic infiltration around nephrostomy tract on pain control after percutaneous nephrolithotomy. Forty-six patients with kidney stones of > 2 cm undergoing single access subcostal percutaneous nephrolithotomy (PCNL) were enrolled in the study. Patients were randomized to levobupivacaine (Group I) and saline (Group II) infiltration groups. Group I patients (n = 23) had 75 mg/30 cc levobupivacaine infiltration around the access site after placement of nephrostomy catheter. Group II patients had 30 cc saline infiltration. Postoperatively the patients were given narcotics on demand. Pain scores were collected using a visual analog scale (VAS) at 2, 4, 6, 8, 12 and 24 h postoperatively. The VAS scores, time to analgesic demand, ambulation, and duration of nephrostomy tube were compared between two groups. The mean age was 44 and 45 years in group I and II patients. There were no significant differences between the two groups with regard to demographics, surgery or stone characteristics. Comparison of pain scores at all postoperative time points was not statistically significant between the two groups. Time to first analgesic demand and total narcotic analgesic dose per patient were 1.2 +/- A 1.05 and 4.04 +/- A 1.57 h; and 96 and 112 mg for group I and II patients (p = 0.009 and p = 0.41, respectively). Ambulation time and duration of nephrostomy tube were also similar. Infiltration of nephrostomy tract site with levobupivacaine does not have a superior effect compared to saline on postoperative pain control in patients undergoing PCNL.To prolong analgesia, the effect of intermittent tract injections or continuous infusion of local anesthetics for the postoperative maintenance of the local anesthetic effect seems worth to investigate in future studies.
Effects of Dilatation Types During Percutaneous Nephrolithotomy for Less Radiation Exposure: A Matched-Pair Pilot Study
(2016) Yildirim, Bunyamin; Ates, Mutlu; Karalar, Mustafa; Akin, Yigit; Keles, Ibrahim; Tuzel, Emre; 25854903
To evaluate exposure to radiation during percutaneous nephrolithotomy (PCNL) by comparing balloon-type renal dilatation (BTRD) and amplatz-type renal dilatation (ATRD). Retrospectively, 454 patients were documented and matched-pair analyses were performed. According to matched-paired criteria, in Group 1 (n = 78) BTRDs were used and in Group 2 (n = 78) ATRDs were used. Demographic, operative, and postoperative data including complications were recorded. Criteria for matched-pair analyses included age, gender, stone burden and localization, body mass index, presence of obstruction in intravenous urography, diabetes mellitus, previous extracorporeal shock wave lithotripsy and/or renal surgery even open and/or PCNL. The mean follow-up was 11.9 +/- 1.1 months, and mean age was 44.8 +/- 13.7 years. Time to provide accessing into kidney, total time of exposure to X-ray, and time of exposure to X-ray until accessing into kidney were significantly lower in Group 1 than Group 2 (p < 0.003, 0.006, and 0.039, respectively). BTRD may provide shorter exposure to radiation than ATRD for patients as well as operating room staff. Additionally, BTRD can provide rapid access into kidney than ATRD without significantly shorter operation time.
Spontaneous Corpus Cavernosum Abscess in a Healthy Man Using Long-Term Androgenic Anabolic Steroids
(2015) Tuzel, Emre; 25927061
Abscess formation of the corpus cavernosum is very rare. Here, we report a case of long-term anabolic androgenic steroid (AAS) abuse that is suspected to have facilitated the development of a corpus cavernosum abscess in a healthy bodybuilder. Cultures obtained from the abscess contained Staphylococcus epidermidis, a microorganism that almost exclusively affects immuno-compromised patients. Therefore, prompt drainage of pus from cavernosal bodies should be the primary aim of the treatment. This case illustrates the potential danger of AAS suppressing the immune system and causing a serious infection.