Fakülteler / Faculties
Permanent URI for this communityhttps://hdl.handle.net/11727/1395
Browse
13 results
Search Results
Item Evaluation of the Genetic Analysis Results in Infertile Patients with Non-Obstructive Azoospermia(2023) Sen, Erhan; Kizilkan, Yalcin; Duran, Mesut Berkan; Turunc, Tahsin; Sahin, Feride Iffet; Ozkardes, Hakan; 0000-0001-7308-9673; 0000-0002-7277-449X; AAC-7232-2020; AAH-1052-2020Objective: To evaluate the genetic analysis results of patients who referred to our clinic infertility and whom semen analysis revealed non -obstructive azoospermia (NOA).Materials and Methods: Among 994 patients who underwent a microscopic testicular sperm extraction (micro-TESE) operation for NOA, 497 patients who were tested for karyotype analysis and 450 patients who were tested for chromosome Y microdeletion were included in our study. The rates of Klinefelter syndrome (KS) and Y chromosome microdeletion, sperm retrieval rates (SRR) in these genetic anomalies and the factors affecting them were investigated. Additionally, the association between the age, duration of infertility, testicular size, serum follicle stimulant hormone (FSH) and testosterone levels of patients and sperm extraction rates of micro-TESE operations were also evaluated.Results: The overall SRR of NOA patients who underwent micro-TESE was 47.5%. Among 104 patients with KS, sperm was successfully found after micro-TESE in 22 (21.2%). Fourteen patients were diagnosed with the Y chromosome microdeletion and sperm was successfully found in 4 (28.6%) of them; while the duration of infertility did not affect the SRR after micro-TESE (p=0.712); age, testicular volume serum FSH and testosterone levels had a significant effect on the SRR (p<0.005).Conclusion: In this study, the SRR of patients who have chromosome Y microdeletion or KS, was found to be lower than other studies in the literature. This difference could be derived from the genetically tested population's structure, variance in the gene areas used for scanning and different demographic characteristics of different regions.Item Effects of Sacral Neuromodulation on Isolated Urinary Bladder Function in a Rat Model of Spinal Cord Injury(2015) Kumsar, Sukru; Keskin, Ulya; Akay, Alaaddin; Bilgilisoy, Ugur Taylan; Erdem, S. Remzi; Peskircioglu, C. Levent; Ozkardes, Hakan; 0000-0002-7277-449X; 24917133; AAH-1052-2020IntroductionSacral neuromodulation has been considered as an effective treatment option for various types of chronic voiding dysfunction, but the mechanism of action has not been well understood. The aim of this study was to evaluate the effect of chronic sacral neuromodulation on isolated bladder functions in a rat model of spinal cord injury. Materials and MethodsFemale Sprague-Dawley rats (250-300g; N = 20) were assigned to four groups as follows: 1) control group (N = 6); 2) spinal cord transection group (SCT; N = 5); 3) spinal cord transection + sacral neuromodulation group (SCT + SNM; N = 5); 4) sham (spinal cord transection + electrode wire implantation without sacral neuromodulation; N = 4). The rats in the SCT, SCT + SNM, and sham groups were anesthetized with ketamine (60mg/kg, i.p.) and xylazine (7mg/kg, i.p.). The spinal cord was completely transected at T8-T9 level in SCT and SCT + SNM groups. Electrode wires were implanted into S3 dorsal foramina in both sham and SNM groups, but only the SNM group was subjected to electrical stimulation for four hours a day for three weeks. Twenty-one days later, the rats were sacrificed via anesthetic overdose, and isolated longitudinal bladder strip preparations were placed in organ baths for the investigation of their isometric responses to pharmacological agents. ResultsIn isometric contraction experiments, SCT was found to increase the contraction responses of the bladder strips to muscarinic stimulation, and SNM could not prevent this increase. In isometric relaxation experiments, SCT caused a decrease in -adrenergic relaxation responses, and SNM augmented the bladder's -adrenergic relaxation responses. Nitric oxide did not affect the relaxation responses. ConclusionIn our rat model of SCT, SNM seemed to alter adrenergic receptor function in the urinary bladder. Further studies are required to clarify the mechanism of these alterations at the level of bladder receptors following sacral neuromodulation.Item Skin-to-Stone Distance Has No Impact on Outcomes of Percutaneous Nephrolithotomy(2014) Gonulalan, Umut; Akand, Murat; Coban, Gokcen; Cicek, Tufan; Kosan, Murat; Goktas, Serdar; Ozkardes, Hakan; https://orcid.org/0000-0002-4010-2883; https://orcid.org/0000-0002-0784-9926; https://orcid.org/0000-0002-7277-449X; 24481206; P-7533-2014; AAH-1052-2020Objective: Skin-to-stone distance (SSD) is a stronger factor than body mass index in predicting the success of shock wave lithotripsy. We aimed to evaluate the impact of SSD on outcomes of percutaneous nephrolithotomy (PCNL). Materials and Methods: The medical records of 1,280 patients who had undergone PCNL between April 2007 and February 2012 were evaluated retrospectively. 192 patients who had had preoperative non-contrasted computed tomography and single renal access were included the study. According to this median SSD value, patients were divided into two groups: group 1 (SSD <= 94 mm) (n = 92) and group 2 (SSD >94 mm) (n = 90). The groups were compared according to operative and postoperative parameters. Results: We found no significant differences between the two groups with regard to stone-free rate, operation time, fluoroscopy time, hospitalization time, visual analog score of pain, stone burden, transfusion rates and complication rates. On the other hand, the mean body mass index of group 1 was significantly lower than that of group 2 (p < 0.05). Conclusions: In this retrospective review of patients undergoing PCNL, we found that SSD has no impact on operative and postoperative outcomes. These results were in accordance with the safety of PCNL in obese patients. (c) 2014 S. Karger AG, BaselItem Role of Tumor-Associated Macrophages in The Heximl and TGF Beta/SMAD Pathway, and Their Influence on Progression of Prostatic Adenocarcinoma(2016) Atilgan, Alev Ok; Ozdemir, B. Handan; Akcay, Eda Yilmaz; Demirkan, Ozlem Ataol; Tekindal, M. Agah; Ozkardes, Hakan; https://orcid.org/0000-0001-8595-8880; https://orcid.org/0000-0002-7528-3557; https://orcid.org/0000-0001-6831-9585; https://orcid.org/0000-0002-4060-7048; https://orcid.org/0000-0002-7277-449X; AAK-3333-2021; X-8540-2019; AAK-1960-2021; U-9270-2018; AAH-1052-2020Background: Hexamethylene bisacetamide-inducible protein 1 (Heximl) regulates transforming growth factor-beta (TGF beta) activity and turnover of SMAD proteins in a cyclin-dependent kinase 9-dependent way. It does so specifically through inhibiting function of this enzyme and by inhibiting the transcriptional activity of positive transcription elongation factor b (P-TEFb). Tumor-associated macrophages (TAMs) play a role in the progression of prostate adenocarcinomas. We investigated the clinicopathological significance of Heximl, TGF beta, SMAD2, and SMAD7 expression in prostate adenocarcinoma cells, and assessed associations between TAMs density and these proteins. Methods: The cases of 100 patients diagnosed with prostate acinar adenocarcinoma who had undergone radical prostatectomy were retrospectively examined. Each was reviewed for Gleason score, cancer stage, and specific histopathological features. Original slides were re-examined, and new slides were prepared and immunostained with Heximl, TGF beta, SMAD2, SMAD7 and CD68. Results: Heximi expression was positively correlated with Gleason score, cancer stage, lymphovascular invasion, perineural invasion, extracapsular extension, and positive surgical margin. TAMs density was positively correlated with Gleason score, cancer stage, perineural invasion, extracapsular extension, and positive surgical margin. TAMs density was positively correlated with Heximl expression and TGF beta expression. More advanced cancer stage, lymphovascular invasion, perineural invasion, and extracapsular extension were correlated with strong Heximl expression, strong SMAD2 expression, and mild SMAD7 expression, respectively. Strong Heximl expression, strong TGF beta expression, and mild SMAD7 expression were associated with higher Gleason score. Strong Heximl expression was correlated with strong TGF beta expression and mild SMAD7 expression. Strong Heximi expression, strong SMAD2 expression, and mild expression of SMAD7 were associated with disease progression. Strong SMAD2 expression was associated with shorter disease-free survival. Conclusion: The results suggest that greater TAMs density, strong Heximl expression, strong SMAD2 expression, and mild SMAD7 expression play important roles in the progression of prostate adenocarcinoma. Further investigation of these proteins will help facilitate the definitive prognosis of prostate adenocarcinomas. Ultimately, these proteins may be therapeutic targets for patients with prostate cancer. (C) 2015 Elsevier GmbH. All rights reserved.Item Clinical Use of Tumor Markers for the Detection and Prognosis of Bladder Carcinoma: A Comparison of CD44, Cytokeratin 20 and Survivin(2016) Yikilmaz, Taha Numan; Dirim, Ayhan; Ayva, Ebru Sebnem; Ozdemir, Handan; Ozkardes, Hakan; https://orcid.org/0000-0003-2898-485X; https://orcid.org/0000-0002-2280-8778; https://orcid.org/0000-0002-7528-3557; https://orcid.org/0000-0002-7277-449X; 27351322; AAJ-5689-2021; AAK-1967-2021; X-8540-2019; AAH-1052-2020Purpose: To investigate the role of CD44, cytokeratin 20 (CK20) and survivin for the detection and prognosis of patients with urothelial carcinoma of the bladder. Materials and Methods: The study included 82 patients who underwent transurethral resection of bladder tumors between 2009 and 2014. The patient and tumor characteristics with relevance to age, tumor size and focality, grade and stage, recurrence and progression were noted. Patients with carcinoma in situ, those who had at more than 3 sites of lesions and greater than 3 cm tumors were excluded. All cases were ex-smokers. All histological samples stained with hematoxylin and eosin were re-evaluated according to the 2004 World Health Organization/International Society of Urological Pathology (WHO/ISUP) classification system and immunohistochemically stained for CD44, CK20 and survivin. Results: The study group comprised 57 (69.5%) males and 25 (30.5%) females with a mean age of 60 years (range, 26-87 years). All were newly-diagnosed patients with bladder tumors. Immunohistochemical evaluation revealed that there was a statistically significant correlation between the grade and stage of the tumor with CK20 and survivin positivity (P < .05). As the grade and stage increased CD44 immunoreactivity significantly decreased (P = .002, P = .0001, respectively). However, relationship of protein expressions with recurrence and progression remained insignificant (P > .05). Conclusion: In cases of bladder urothelial carcinoma positivity for CD44, CK20, and survivin has significant relation with the tumor grade and stage while no significant relationship was determined in terms of recurrence and progressionItem Does Bipolar Transuretral Resection of Prostate Increase the Incidence of Urethral Stricture?(2021) Hasirci, Eray; Kervancioglu, Enis; Ozkardes, Hakan; 0000-0002-4147-2966; 0000-0003-3465-9092; AAI-7997-2021; AAM-4475-2021Objective: Transurethral resection of the prostate (TURP) remains the gold standard surgical method for patients with benign prostate obstruction. The aim of this study was to compare the efficacy and complication rates of bipolar TURP applied with saline and monopolar TURP applied with glycine, performed by the same surgeon. Design: Retrospective study Setting: Department of Urology, Baskent University, Ankara, Turkey Subjects: Ninety-two patients who were scheduled for monopolar and bipolar TURP Intervention: All the surgical procedures were applied under spinal anesthesia and the procedure was done by the same surgeon. The cases were compared in respect of the time of the procedure, the amount of resected tissue, the speed of resection, length of hospital stay, irrigation duration, changes in serum haemoglobin, changes in maximum flow rate, changes in amount of post-voiding residual urine and complications. Main Outcome Measure: Urethral stricture Results: The operating time was longer in the bipolar group and associated with that, the resection speed was lower. Urethral stricture was found to be greater in the bipolar group (11 cases of the 58 bipolar TURP patients (18.96%) and in 2 cases of the 34 monopolar TURP patient (5.88%), P=.045). Conclusions: Bipolar TURP is as effective a technique as conventional TURP. However, urethral strictures significantly exist in bipolar group, even if it was done by the same surgeon.Item No Tumor Suppressor Role for LKB1 in Prostate Cancer(2021) Koseoglu, Hikmet; Celebi, Asuman; Galamiyeva, Gunay; Dalay, Nejat; Ozkardes, Hakan; Buyru, Nur; 34370601To elucidate the pathogenesis of prostate diseases, following in silico analysis, the LKB1 gene was selected for further investigation. The LKB1 gene has been associated with poor prognosis and is frequently mutated in different types of cancers. In this study, 50 benign prostatic hyperplasia (BPH) and 57 prostate cancer (PCa) tissues, including matched normal tissue for the patients, were analyzed by qRT-PCR and DNA sequencing for LKB1 expression and the mutation profile, respectively. Expression of LKB1 was increased in 60.7% of the PCa tissues compared with noncancerous tissue samples (p <= 0.001). However, LKB1 expression was lower when compared with normal tissues in BPH (p = 0.920). Four coding sequence alterations were detected in BPH. Three silent mutations were located in codons 9, 32, and 275 and a missense mutation was observed in codon 384. Six alterations were identified in the intronic regions of the LKB1 gene in both PCa and BPH. Five mutations were observed in both patient groups. A new alteration in intron 6 was observed in a patient with PCa. The LKB1 gene may be associated with benign transformations rather than the tumors in prostate pathogenesis when its expression and mutation status are considered. However, the mechanism of LKB1 in PCa needs further studies.Item The Effects of Transobturator Tape Surgery on Sexual Functions in Women With Stress Urinary Incontinence(2020) Kizilkan, Yalcin; Tohma, Yusuf Aytac; Senel, Samet; Gunakan, Emre; Oguzulgen, Ahmet Ibrahim; Aktas, Binhan Kagan; Bulut, Suleyman; Gokkaya, Cevdet Serkan; Ozden, Cuneyt; Ozkardes, Hakan; Ayhan, Ali; 32891593Introduction: Stress urinary incontinence (SUI) can adversely affect the patient's sexual function. Aim: To evaluate the sexual functions in women who underwent transobturator tape (TOT) surgery because of stress urinary incontinence and factors affecting the treatment results. Methods: The study was conducted in 2 tertiary level clinics between 2013 and 2019 and included sexually active patients with a diagnosis of SUI who underwent TOT operation. The preoperative and postoperative (6 months after surgery) Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12) scores of the patients were evaluated. The patients were evaluated according to the score changes of an increased score (benefited) and the same or lower score (did not benefit). The PISQ-12 questionnaire has 3 subdomains of behavioral-emotive (Q: 1-4), physical (Q: 5-9), and partner-related (Q: 10-12). Each question is scored from 0 to 4, giving a total ranging from 0 to 48. A higher PISQ-12 score indicates better sexual function. Main Outcome Measure: PISQ-12. Results: The study included 117 patients with a median age of 52 years (range, 32-67 years), and 51.3% of the patients were postmenopausal. When the preoperative and postoperative PISQ-12 scores were evaluated in the whole group, there was a statistically significant improvement (from 24.66 to 26.52, P = .001). In the analysis of domains, there was a statistically significant improvement in physical score (from 11.68 to 13.53, P < .001), whereas behavioral-emotive and partner-related scores did not significantly change. In the multivariate analysis of menopausal status, parity and presence of diabetes mellitus were all independently and significantly associated with poor PISQ-12 outcome (OR: 2.60, 95% CI: 1.41-4.81, P = .002; OR: 1.59, 95% CI: 1.03-2.47, = .034; and OR: 2.42, 95% CI: 1.28-4.58, P = .007, respectively). Conclusion: Both physical and psychological statuses should be taken into consideration when planning treatment in patients with urinary incontinence, and it should be noted that postsurgical sexual function status may not be positively affected in postmenopausal, multiparous, and diabetic patients. Kizilkan Y, Tohma YA, Senel S, et al. The Effects of Transobturator Tape Surgery on Sexual Functions in Women With Stress Urinary Incontinence. Sex Med 2020;8:777-782. Copyright (c) 2020, The Authors. Published by Elsevier Inc. on behalf of the International Society for Sexual Medicine. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Item Parameters predicting sperm retrieval rates during microscopic testicular sperm extraction in nonobstructive azoospermia(2019) Kizilkan, Yalcin; Toksoz, Serdar; Turunc, Tahsin; Ozkardes, Hakan; 0000-0002-7277-449X; 31583760; AAH-1052-2020The aim of this study was to investigate the predictive value of the parameters that might have an effect on the success of microscopic testicular sperm extraction (micro-TESE) in infertile patients with nonobstructive azoospermia (NOA). Between 2003 and 2014, 860 patients with NOA were retrospectively analysed. The effect of age, infertility duration, history of varicocelectomy, herniorrhaphy or orchiopexy, presence of solitary testis, tobacco use, previous testicular biopsy results, history of orchitis, usage of human chorionic gonadotropin in the past three months, presence of undescended or retractile testis, presence of varicocele, testicular volume, levels of serum follicle-stimulating hormone, luteinising hormone, and testosterone, presence of Klinefelter syndrome and micro-deletion of Y chromosome on sperm retrieval rates were evaluated. In 45.8% (n = 394) of the patients who underwent micro-TESE, spermatozoon was adequately obtained. Multiple logistic regression analysis demonstrated that previous successful testicular biopsy (OR = 15.346; GA = 5.45-43.16; p < .001) and higher testicular volumes significantly increase sperm retrieval rate in micro-TESE. The testicular volume cut-off as 11 ml was found to be the most significant factor. Although currently testicular biopsy result is not being used as a diagnostic method, it is significantly associated with micro-TESE result.Item Comparison of Cajal-like cells in pelvis and proximal ureter of kidney with and without hydronephrosis(2015) Balikci, Omer; Turunc, Tahsin; Bal, Nebil; Celik, Huseyin; Ozkardes, Hakan; 26742978Objectives: To evaluate effects of Cajal-like cells on human renal pelvis and proximal ureter on peristalsis. Materials and Methods: 63 patients submitted to nephrectomy due to atrophic non- functional kidney associated with hydroureteronephrosis were included as study group and 30 cases with nephrectomy due to other reasons were included as control group. Samples from renal pelvis and proximal ureters were obtained and sections of 5 mu form paraffin blocks of these samples were prepared; layers of lamina propria and muscularis mucosa were examined by immune-histochemistry using CD117 in order to determine count and distribution of Cajal-like cells. Results: During immune-histochemical examinations of sections, obtained from renal pelvis and proximal ureter of hydronephrotic kidneys by CD117, Cajal-like cells number determined in lamina propria and muscularis propria was statistically significantly lower compared to control group (p<0.001). Distribution of Cajal-like cells in renal pelvis and proximal tubulus was similar under examination by light microscope, and also both groups were not different from each other regarding staining intensity of Cajal-like cells by c-kit. Conclusion: Significantly reduced number of Cajal-like cells in study group compared to control group, shows that these cells may have a key role in regulation of peristalsis at level of renal pelvis and proximal ureter in urinary system.