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Analgesic Effects of Oligonol, Acupuncture and Quantum Light Therapy on Chronic Nonbacterial Prostatitis
(Zamensalamati Publ Co, 2015) Akdere, Hakan; Oztekin, Ilhan; Arda, Ersan; Aktoz, Tevfik; Turan, Fatma Nesrin; Burgazli, Kamil Mehmet
Background: Chronic Nonbacterial Prostatitis (CNBP) is a condition that frequently causes long-term pain and a significant decrease in the quality of life. Objectives: The present study aimed to examine the analgesic effects of oligonol, acupuncture, quantum light therapy and their combinations on estrogen-induced CNBP in rats. Materials and Methods: This experimental study was conducted in Edirne, Turkey, using a simple randomized allocation. A total of 90 adult male Wistar rats were randomized into 9 groups of 10 rats each: Group I, control; Group II, CNBP, Group III, oligonol only, Group IV, acupuncture only; Group V, quantum only; Group VI, oligonol + quantum; Group VII, acupuncture + oligonol; Group VIII, quantum + acupuncture; Group IX, acupuncture + quantum + oligonol. Oligonol treatment was given at a dose of 60 mg/ day for 6 weeks. Conceptual vessels (CV) 3 and 4, and bilaterally urinary bladder (Bl) 32 and 34 points were targeted with 1-hour acupuncture stimulation. The quantum light therapy was applied in 5-minute sessions for 6 weeks (3-times/a week). For pain measurements, mechanical pressure was applied to a point 2 cm distal to the root of the tail to elicit pain and consequent parameters (peak force, latency time of response and total length of measurement) were assessed. Results: Analgesic effects were observed with all treatment regimens; however, the most prominent median analgesic effect was shown in the quantum light therapy in combination with acupuncture for estrogen-induced CNBP (PF1 = 663.9, PF2 = 403.4) (P = 0.012). Furthermore, we observed that monotherapy with quantum light showed a better analgesic efficacy as compared to oligonol and acupuncture monotherapies (PF1 = 1044.6, PF2 = 661.2) (P = 0.018, P = 0.008, P = 0.018; respectively). Conclusions: All treatment modalities showed a significant analgesic effect on CNBP in rats, being most prominent with the quantum light therapy.
Assessment of the relationship between asymmetric dimethylarginine and severity of erectile dysfunction and coronary artery disease
(Springer, 2010) Aktoz, Tevfik; Aktoz, Meryem; Tatli, Ersan; Kaplan, Mustafa; Turan, Fatma N.; Barutcu, Ahmet; Atakan, Irfan H.
The plasma concentration of asymmetrical dimethylarginine (ADMA), an inhibitor of nitric oxide synthase, has been linked to endothelial dysfunction. We investigated the relation between plasma ADMA concentration and severity of erectile dysfunction (ED) and coronary artery disease (CAD). We measured plasma levels of ADMA in 92 male patients. Patients were divided into three groups: group 1 (n = 41), patients with ED and without CAD; group 2 (n = 29), patients with stable CAD; group 3 (n = 22), control group (patients without CAD or ED). Erectile function was evaluated by the erectile function domain of the international index of erectile function (IIEF-EFD) a validated 15-item self-administered questionnaire. Erectile function is specifically addressed by six questions that form the so-called erectile function domain of the questionnaire. Each question is scored 0-5. ED is defined as any value < 26. Patients with CAD who have stable angina pectoris were selected after coronary angiography. ADMA was analyzed by ELISA method. Group 1 had significantly higher concentrations of plasma ADMA than groups 2 and 3 (respectively, 0.75 +/- A 0.40 vs. 0.50 +/- A 0.30, P = 0.013; 0.75 +/- A 0.40 vs. 0.50 +/- A 0.25, P = 0.021). There was negative correlation between ADMA and IIEF-EFD score in all groups (n = 92) (r = -0.322, P = 0.002). In a multiple logistic regression analysis adjusting for age, hyperlipidemia, ADMA remained independent predictor for severe ED. Odds ratio for plasma ADMA was 14.151 (1.101-181.940; P = 0.042). First of all, this study provides that ADMA concentrations are significantly higher in patients who have ED when compared to patients with CAD and controls. Second, there was a negative correlation between ADMA and severity of ED. Elevating levels of circulating ADMA is an independent risk factor for severe of ED, and ADMA may be a link between CAD and ED.
Asymmetrical dimethylarginine and severity of erectile dysfunction and their impact on cardiovascular events in patients with acute coronary syndrome
(Termedia Publishing House Ltd, 2010) Aktoz, Meryem; Aktoz, Tevfik; Tatli, Ersan; Kaplan, Mustafa; Turan, Fatma Nesrin; Barutcu, Ahmet; Atakan, Irfan Hueseyin
Introduction: Coronary artery disease (CAD) and vascular erectile dysfunction (ED) are related to endothelial dysfunction. Elevated asymmetrical dimethylarginine (ADMA) levels and ED are common in patients with increased cardiovascular risk. Our aim was to investigate whether ADMA has a predictive role for major adverse cardiovascular events (MACE) in acute coronary syndrome (ACS). The secondary aim of this study was to investigate whether severity of ED predicts MACE in these patients. Material and methods: Follow-up data were available for severity of ED in 71 patients with ACS. Plasma ADMA levels were determined by ELISA in 57 patients. Erectile dysfunction was assessed by the International Index of Erectile Function-6 (IIEF-6) score. Major adverse cardiovascular events (reinfarction, all-cause hospitalisation, stroke and all-cause death) was evaluated after a median of 10 months. Results: Severe ED had no significantly increased hazard ratio for cardiovascular events compared with mild, mild to moderate, and moderate ED (0.259 [95% CI 0.041-1.6], p = 0.147; 0.605 [95% CI 0.095-3.8], p = 0.594; 0.980 [95% CI 0.233-4.1], p = 0.978; and 0.473 [95% CI 0.052-1.3], p = 0.508). The patients who had ADMA levels 0.32 mu mol/l had no significantly increased hazard ratio for cardiovascular events compared with patients who had ADMA levels < 0.32 mu mol/l (2.018 [95% CI 0.615-6.6], p = 0.247). Conclusions: Severity of ED and ADMA did not increase the risk of cardiovascular events in follow-up patients with ACS in our study. Larger prospective studies are necessary to evaluate whether ADMA predicts cardiovascular events in patients with ACS.
Atypical renal and gluteal hydatid cysts: Report of two cases
(2009) Atakan, İrfan Hüseyin; İnci, Osman; Aktoz, Tevfik; Kaplan, Mustafa; Çelik, Aygül Doğan
Kist hidatik hastalığı parazitik bir hastalık olup Echinococcus granulosus'un larva formu tarafından oluşturulmaktadır. Kist hidatik hastalığı sıklıkla karaciğer ve akciğerleri etkilemektedir. Böbrek tutulumu nadir olarak görülmekte olup tüm vakaların 2% kadarını oluşturmaktadır. Birinci olgumuz 44 yaşındaki kadın hastada saptanan ve basit böbrek kisti ile uyumlu radyolojik bulgulara sahip bir kist hidatik olgusudur. İkinci olgumuz 27 yaşında 3 yıldır sağ yan ağrısı ve son bir yıldır gluteal bölgede ağrısı olan kadın hasta olup, bilgisayarlı tomografi ile yapılan inceleme sonucu sağ böbrekte 12x12 cm and 5x5 cm boyutlarında iki adet kist saptanmıştır. Aynı zamanda, internal ve eksternal oblik kaslar arasında 5x5 cm boyutlarında ve sağ gluteal bölgede 12x12 cm boyutlarında kist saptanmıştır. Görüntüleme yöntemlerindeki gelişmelere rağmen bazen basit böbrek kisti görünümünde böbrek kist hidatiği olabilir ve aynı zamanda sık görülen bölgeler dışında da kist hidatik saptanabilir.
Blind-ending duplicate ureter with giant cystic dilatation
(Aves, 2009) Kaplan, Mustafa; Alicioglu, Banu; Aktoz, Tevfik; Altaner, Semsi; Inci, Osman
Blind-ending ureter is a rare ureteric duplication anomaly. Most cases are asymptomatic and are detected incidentally. Blind-ending ureter with a huge cystic dilatation is extremely unusual. A 46-year-old man with a complaint of low back pain was referred from the neurosurgery department upon demonstration of a large cystic mass in the retroperitoneum by lumbar magnetic resonance imaging. Ultrasonography showed a large cystic mass filling the right side of the abdomen and the entire pelvis. Intravenous urography showed malrotation and lateral deviation of the right kidney with grade 1 hydronephrosis, severe dilatation of the ureter with proximal kinking, and medial deviation of the ureter. Computed tomography revealed a huge cystic mass beginning at the medial aspect of the upper pole of the right kidney, filling the right half of the abdomen and all the pelvis. The cyst had septations in the pelvis. Cyst aspiration yielded no atypical cells. During surgical exploration, it was noted that the cyst extended to the level of the upper pole of the right kidney and opened into the bladder with an ectopic orifice superior to the right ureter, suggesting the presence of a blind-ending ureter. The normal ureter was dilated and compressed. During resection of the cystic mass, the right ureter was injured and ureteroneocystostomy was performed. Histopathologic identification of the cystic lesion was made as uroepithelial cells. No complication was seen in postoperative period.
Burned-out testis tümörü: Olgu sunumu
(2008) Kaplan, Mustafa; Aktoz, Tevfik; Alataner, Şemsi; Çaloğlu, Murat; İnci, Osman; Karagöl, Hakan
“Burned-out” testis tümörü ender bir antitedir. “Burned-out” kelimesi kendini retroperitoneal bölge, mediasten, supraklavikuler, servikal ve aksiller lenf nodlarına metastaz ile gösteren, kendiliğinden ve tamamen regrese olmuş testis tümörünü ifade etmektedir. Primer ekstragonadal testis tümörlerinden daha farklı bir antite olup daha ender görülür. Patoloji uzmanlarının çoğu metastatik germ hücre tümörlü hastalarda “burned-out” testis tümörü bulguları konusunda çok az bilgiye sahiptir. Burada “burned-out” testis tümörü tanısı konulan 2 olgu sunularak klinik, radyolojik ve histopatolojik özellikleri tartışıldı. Retroperitoneal lenf nodu metastazı olan ve histolojisi germ hücre tümörü gelen, ayrıca testiste kitle ele gelmeyen olgularda “burned-out” testis tümörü akla gelmelidir. Metastazlar tümör histolojisi ve uygun evreye göre tedavi edilmelidir. “Burned-out” tümörü olanlarda persistan testis tümör olasılığı nedeniyle orşiyektomi yapılmalıdır.
BURNED-OUT TUMOR OF THE TESTIS: CASE REPORT
(Aves, 2008) Kaplan, Mustafa; Karagol, Hakan; Altaner, Semsi; Aktoz, Tevfik; Caloglu, Murat; Inci, Osman
Introduction: Burned-out testicular tumor is a rare entity. The term burned-out tumor of the testis describes a spontaneously and completely regressed testicular tumor which presents by its metastases to retroperitoneum, mediastinum, lymph nodes such as supraclavicular, cervical and axillary. This condition is different and less common from the primary extragonadal germ cell tumors. Many pathologists are not familiar with the findings that support a diagnosis of burned-out primary in a patient with metastatic germ cell tumor. We report 2 cases of burned-out testicular tumors to illustrate the clinical, radiological and histopathological features. Burned-out testicular tumor must be considered in a patient with retroperitoneal lymph node involvement and histology of germ-cell tumor in the absence of palpable testicular tumor. Metastases should be treated according to the histology and clinical stage of the tumor. Radical orchiectomy must be performed because of the high rate of persistent testicular tumor.
Contrary effects of coenzyme Q10 and vitamin E after testicular ischemia/reperfusion in a rat model validated with glucose metabolism imaging
(Sage Publications Ltd, 2021) Arda, Ersan; Yuksel, Ilkan; Akdere, Hakan; Akdeniz, Esra; Yalta, Tulin D.; Aktoz, Tevfik; Altun, Gulay D.
Objective: To evaluate the efficacy of antioxidants in cellular-level post-ischemia/reperfusion injury of the testis and to validate these effects with F-18-fluorodeoxyglucose positron emission tomography. Methods: Fifty-six adult male rats were randomly divided into seven groups-Group 1: sham; Group 2: ischemia/reperfusion only group; Group 3: ischemia was induced and vitamin E (100 mg/kg) was administered intraperitoneally 30 min before reperfusion; Group 4: vitamin E was given intraperitoneally without ischemia/reperfusion; Group 5: ischemia was induced and coenzyme Q10 (10 mg/body weight) was administered intraperitoneally 30 min before reperfusion; Group 6: coenzyme Q10 was administered intraperitoneally without ischemia/reperfusion; Group 7: ischemia was induced and coenzyme Q10 + vitamin E was administered intraperitoneally 30 min before reperfusion. After detorsion, fluorodeoxyglucose was applied to all groups according to the animals' weight and fluorodeoxyglucose positron emission tomography was performed after 1 h. In pursuit of imaging, orchiectomy was performed for histopathological and biochemical evaluations. Results: A significant effect of group on catalase, maximum standardized uptake value, and seminiferous tubule diameters (p < 0.005) was observed. According to this, combining ischemia/reperfusion with vitamin E increased the maximum standardized uptake value significantly higher than in all other groups; in addition, catalase was significantly higher than in Groups 4-6. Histopathological outcomes revealed that sham had significantly larger seminiferous tubule diameter than Groups 2-4. Also, ischemia/reperfusion was the only group which had significantly smaller seminiferous tubule diameters than Groups 6 and 7. Conclusion: In contrast to vitamin E, coenzyme Q10 provided remarkable regression of oxidative stress-induced enzymes and revealed consistent effects on histopathological outcomes, which were validated with fluorodeoxyglucose positron emission tomography imaging.
The effect of melatonin on cadmium-induced renal injury in chronically exposed rats
(Aves, 2009) Kaplan, Mustafa; Atakan, Irfan Huseyin; Aydogdu, Nurettin; Aktoz, Tevfik; Puyan, Fulya Oz; Seren, Gulay; Tokuc, Burcu
Objective: This study was designed to investigate the effects of melatonin as an antioxidant, in prevention and treatment of cadmium (Cd)-induced renal toxicity in rats. Materials and methods: Fifty adult male Sprague-Dawley rats weighing 340 to 370 g were used. Renal toxicity was induced with the use of 200 mu g/ml of cadmium chloride in tap water. Ten rats were assigned to receive only tap water as the control group for three months and seven days. Two study groups were designed. To investigate the ability of melatonin to prevent Cd damage (Study 1), 10 rats received Cd and 10 rats received Cd plus 0.02% co-treatment melatonin in tap water for three months. To test whether melatonin would reverse CD-induced damage to the kidney (Study 2), 10 rats received Cd in tap water for three months+7 days, and 10 rats received Cd for three months followed by administration of high-dose (0.08%) melatonin in tap water for seven days. Results: Cadmium exposure significantly increased the kidney malondialdehyde (MDA) levels, as a marker of lipid peroxidation, decreased the kidney superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) activities, increased Cd concentrations in the renal cortex, but did not change glomerular filtration rate (GFR) and fractional excretion of sodium (FE-Na). In Study 1, melatonin decreased MDA levels, increased SOD, CAT and GSH-Px activities. In Study 2, melatonin decreased the kidney MDA levels, increased the SOD activity, but did not change the CAT and GSH-Px activities. Kidney accumulation of Cd did not change in both melatonin-treated groups. Histopathologically, Cd intake affected proximal tubules of the nephron more than the glomerular parts. Melatonin did not change these alterations. Conclusion: Our findings suggest that Cd-induced renal toxicity is related with oxidative stress and exogenously administrated melatonin might reduce the toxic effects of Cd on kidney without any reduction in tissue Cd burden.
The Effect of Pirfenidone on Peyronie Plaques and Erectile Function in a Peyronie's Rat Model
(Coll Physicians & Surgeons Pakistan, 2023) Cevik, Gokhan; Tozsin, Atinc; Tastekin, Ebru; Dursun, Murat; Aktoz, Tevfik; Kadioglu, Ates
Objective: To investigate the anti-fibrotic effects of pirfenidone on Peyronie's disease in an experimental rat model with intracavernosal injection of TGF-ss and whether pirfenidone improves erectile function. Study Design: Experimental study. Place and Duration of the Study: Faculty of Medical Experimental Animals and Research Laboratory, Trakya University, from January to March 2021. Methodology: In this study, 27 male Sprague Dawley rats were used, and three groups were randomly identified. The rats in Group 1 served as the control group. Group 2 was not treated, and Group 3 was treated with pirfenidone therapy. The rats in Group 3 were administered pirfenidone 30 mg/kg/day by oral gavage, every day for four weeks, three weeks after the start of the experiment. At the end of seven weeks, a haemodynamic study was performed with cavernosal nerve stimulation to evaluate the erectile function, the rats were sacrificed, and the penile tissues were evaluated immunohistochemically. Results: MeICP/MIBP values were found to be higher in treated rats compared to rats in the untreated group but no statistically significant difference was found in MeICP/MIBP values between the control, Peyronie model, and treatment groups (p=0.25). According to the histopathological examination, the rate of fibrosis with H&E staining was mild (100%) in the control group, severe (100%) in the Peyronie group, and severe (87.5% severe and 12.5% moderate) in the Peyronie + treatment group. Conclusion: In the study, pirfenidone used in the treatment of Peyronie's disease had a positive effect on erectile function, though not considered statistically significant. It has been shown that it has no histopathological effect on Peyronie's plaques.
Embarking with laparoscopic radical prostatectomy and dealing with the complications and collateral problems: A single-center experience
(Aves, 2020) Akdere, Hakan; Aktoz, Tevfik; Arikan, Mehmet Gurkan; Atakan, Irfan Huseyin; Veneziano, Domenico; Gozen, Ali Serdar
Objective: The aim of the present study was to report our single-center initial experience in laparoscopic radical prostatectomy (LRP) with special emphasis on the complications and collateral problems and their management. Material and methods: A total of 48 patients (mean age 64 years) underwent LRP in our institution between August 2014 and July 2018. Two surgeons completed a fellowship training program for LRP before. Mentored operations started after the first 10 cases. The patients were divided in two groups of 30 (group I) and 18 (group II) patients. Demographic, preoperative, peroperative, and postoperative data were collected prospectively. Anesthesiology and nurses' team performances, as well as problems and their management, were reviewed. Results: The demographic data for both groups (group I vs. group II) were similar. Estimated blood loss (695.5 +/- 139.23 vs. 398 +/- 339.39 mL) and intraoperative complication rates (36.66% vs. 5.55%) were significantly (p<0.05) higher in group I. Conversion to open surgery occurred in 7 (20%) patients in group I and in 1 (5.55%) patient in group II. Continence rates at 12 (83%) months were similar in both groups. Positive surgical margins were 8.33% for pT2 and 27.1% for pT3 stages. Conclusion: A validated fellowship program before starting LRP and performing the first cases under mentorship are helpful. The complication and conversion rates decrease after 30 cases in addition to the improved experience also with improved cooperation with the anesthesiologist and scrub nurse.
Evaluation and surgical approach of surrenal masses: experience of Trakya University
(Aves, 2011) Inci, Osman; Aktoz, Tevfik; Bilir, Betl Ekiz; Atakan, Irfan Huseyin; Tugrul, Armagan
Objective: In this study, patients with adrenal masses treated with surgery in our clinic were evaluated for endocrinological and surgical aspects, and open surgical techniques were compared. Materials and methods: Between January 2003 and January 2011, we retrospectively evaluated 31 patients who underwent surgical exploration for adrenal masses in Trakya University Urology Department following consultations with Endocrinology Department. There were 21 (67.7%) female and 10 (32.3%) male with a mean age of 47.2 years (range 16-74 years). Adrenal mass was detected on the right side in 9 (29%) patients and on the left side in 22 (71%) patients. We performed open retroperitoneal approach in 17 (54.8%) cases and open transperitoneal (Chevron) approach in 14 (45.2%) cases. Results: Fifteen of the cases were functionally active. Of the functional cases, 9 had Cushing syndrome, 3 had pheochromocytoma, and 3 had aldosterone producing adenoma. Sixteen of these cases were not producing hormones and non-functional as a result of preoperative endocrinological evaluation. Conclusion: Adrenal masses should be considered endocrinologically before surgical treatment, and endocrine evaluation must be completed preoperatively. Preoperative, peroperative, and postoperative evaluation of hormone active cases has particular importance. Surgical success is proportional to the multidisciplinary study.
Giant unilateral abdominoscrotal hydrocele in an adult: Case report
(Springer, 2006) Kaplan, Mustafa; Atakan, Irfan H.; Aktoz, Tevfik; Inci, Osman
Abdominoscrotal hydrocele (ASH) is an apparently highly uncommon clinical entity especially in childhood. While hydrocele is among the commonest inguinal anomaly in adult, its extreme form ASH is infrequently reported form. ASH consists of two large sacs, both abdominal and scrotal, connecting with the inguinal canal. Surgical correction is mandatory. We present a 34-year-old man with giant ASH. He was treated with excision of hydrocele sac through an inguinal approach.
Global Web Trends Analysis of Minimally Invasive Urinary Stone Treatment in the Last Decade and During the COVID-19 Pandemic
(Mary Ann Liebert, Inc, 2022) Madendere, Serdar; Deger, Muslim Dogan; Aktoz, Tevfik
With the rising incidence of urinary stone disease, web searches for stone treatments are increasing. Google Trends (GT) data for a 10-year period and during the coronavirus disease 2019 (COVID-19) pandemic were used to investigate the trend variations for the most popular minimally invasive stone therapies based on time and region. GT can create a line graph that shows how interest in various territories has risen or decreased over time. Search terms were generated for extracorporeal shockwave lithotripsy (SWL), percutaneous nephrolithotomy (PCNL), retrograde intrarenal surgery (RIRS), ureterorenoscopy (URS), and laparoscopic pyelolithotomy/ureterolithotomy. Using the global inquiry category, the data were included worldwide from January 1, 2009 to December 31, 2021. In recent years, Google and YouTube searches for total minimally invasive stone treatments have increased. RIRS, URS, and PCNL trends revealed a substantial rise in the regression analysis (p < 0.05), but SWL trends showed a significant reduction (p < 0.05). RIRS was the main intervention with interest growing most over time. Web searches for stone treatments decreased in the first period of the COVID-19 pandemic. To a rising degree of involvement, patients and physicians from all over the world utilize the internet to search for minimally invasive stone operations. RIRS, URS, and PCNL are becoming more popular in web trends and SWL still has the highest trend despite the decline in popularity recently. The number of trustworthy web-based tools about stone treatments should be increased, and patients and physicians should be directed to these sources.
İleri yaştaki bir olguda alışılmadık bir prostatizm nedeni: Seminal vezikül kisti
(2009) Kaplan, Mustafa; Alıcıoğlu, Banu; Aktoz, Tevfik
Seminal vezikül kistleri seyrektir ve nadiren semptom verir. Genellikle cinsel aktivitenin arttığı genç yaşlarda ortaya çıkar. Altmış iki yaşında, prostatizm semptomları ile başvuran bir hastada transrektal ultrasonografi ve bilgisayarlı tomografi ile sağ seminal vezikülde kalın ve düzensiz duvarlı kistik kitle saptandı. Kist içeriği transrektal olarak aspire edildi. Patolojik incelemede kitlenin benign olduğu belirlendi. Üçüncü ay kontrolünde hastanın semptomlarının gerilediği görüldü. İleri yaştaki olgularda prostatizm kliniği ayırıcı tanısında seminal vezikül kisti de düşünülmelidir.
Influence of N-acetylcysteine on renal toxicity of cadmium in rats
(Springer, 2008) Kaplan, Mustafa; Atakan, Irfan H.; Aydogdu, Nurettin; Aktoz, Tevfik; Ozpuyan, Fulya; Seren, Guelay; Tokuc, Burcu
The aim of this study was to investigate the ability of N-acetylcysteine (NAC) to prevent cadmium (Cd)-induced renal damage and whether NAC would reverse cadmium damage to the kidney. Fifty adult male rats were divided into five experimental groups: group 1 received tap water for 3 months and 7 days, group 2 received cadmium chloride (CdCl2) for 3 months, group 3 (NAC cotreatment group) received CdCl2 and 0.5% NAC in tap water for 3 months, group 4 received CdCl2 in tap water for 3 months and 3 months later received only tap water for 7 days, and group 5 (NAC posttreatment group) received CdCl2 in tap water for 3 months and 3 months later received 2% NAC in tap water for 7 days. NAC significantly decreased the elevated kidney malondialdehyde levels, as a marker of lipid peroxidation, in both cotreatment and posttreatment modalities. Cotreatment and posttreatment with NAC significantly increased kidney superoxide dismutase enzyme activity and glutathione level but did not change kidney catalase enzyme activity. NAC decreased fractional excretion of sodium in posttreatment group. Neither Cd nor NAC affected the glomerular filtration rate (GFR). Cotreatment and posttreatment with NAC reduced the effects of Cd on proximal tubules. It was found that NAC showed these effects without changing kidney accumulation of cadmium. Exogenously administrated NAC might reduce toxic effects of Cd on the kidney without any reduction in tissue Cd level.
Is It Possible to Draw a Risk Map for Obturator Nerve Injury During Pelvic Lymph Node Dissection? The Heilbronn Experience and a Review of the Literature
(Mary Ann Liebert, Inc, 2015) Goezen, Ali Serdar; Aktoz, Tevfik; Akin, Yigit; Klein, Jan; Rieker, Philip; Rassweiler, Jens
Objective: Obturator nerve injury (ONI) is a rare complication during pelvic lymph node dissection (PLND), in extraperitoneal laparoscopic radical prostatectomy (e-LRP), and/or extraperitoneal robotic-assisted laparoscopic radical prostatectomy (e-RALP). It is important to recognize ONI during the initial operation, maximizing the feasibility of simultaneous repair. Here we report our experience with ONI during e-LRP/e-RALP procedures and draw an injury risk map. Materials and Methods: Between December 1999 and November 2014, 2531 e-LRPs and 1027 e-RALPs were performed. Five patients (3 during e-LRP, 2 during e-RALP) experienced ONI in the proximal part of the nerve. Obturator nerves were clipped during the 3 e-LRP cases. Clips were immediately removed, and patients received physiotherapy with medical treatments in the postoperative period. During e-RALP, two obturator nerves were transected and subsequently repaired using the robotic Da Vinci((R)) Surgical System (Intuitive Surgical, Inc., Sunnyvale, CA). ONI types were investigated in detail in these patients, and current published studies were analyzed in order to draw a risk map. Results: Mean follow-up was 18.82.7 months. In total, 3558 cases (2531 e-LRPs, 1027 e-RALPs) were performed. ONI occurred in 3 e-LRP (0.1%) and 2 e-RALP (0.1%) patients. Simultaneous repair was performed successfully in all cases, as clips were removed in e-LRP cases and obturator nerves were repaired using 6/0 polypropylene (Prolene((R)); Ethicon, Somerville, NJ) suture in e-RALP cases. There was no complication associated with obturator nerve functions such as adductor function and/or neurologic deficiency during long-term follow-up. In view of published studies in the literature, the proximal part of the obturator nerve is at highest risk for injury during PLND, representing 77.8% of reported cases of ONI. Conclusions: According to our ONI risk map, the proximal part of the obturator nerve is at higher risk for injury during PLND. Careful dissection and a good knowledge of pelvic anatomy are essential for preventing ONI. Successful ONI management can be performed simultaneously in experienced hands.
Laparoscopic ureteroureterostomy for retrocaval ureter
(Aves, 2010) Tepeler, Abdulkadir; Aktoz, Tevfik; Binbay, Murat; Muslumanoglu, Ahmet Yaser; Tefekli, Ahmet Hamdi
Retrocaval ureter is a rare congenital anomally with an approximate incidence of one in 1,000 live births. This anomally results from the atrophy failure of the posterior cardinal vein during development of the infarenal vena cava and leads to upper tract stasis and S or fishhook deformity of the ureter. It requires operative repair in the setting of functionally significant obstruction. Standart surgical correction involves excision of the retrocaval segment with relocation and ureteroureteral or ureteropelvic reanastomosis. Herein, a retrocaval ureter case managed with laparoscopic ureteroureterostomy is presented.
Mesane tümörlerinde insülin benzeri büyüme etkeni-I ekspresyonunnun önemi
(2008) Aktoz, Tevfik; Atakan, İrfan Hüseyin; İnci, Osman; Usta, Ufuk; Özbakır, Fikret; Kaplan, Mustafa
İnsülin benzeri büyüme etkeni-I peptid yapıda bir hormon olup aşırı ekspresyonunun anormal hücre proliferasyonuna ve malin transformasyona neden olmaktadır. Mesane tümörlerinin malinite potansiyelini gösterebileceği düşünülmektedir. Bu çalışmamızdaki amacımız mesane tümörlü hastalarda tümör dokusunda insulin benzeri büyüme faktörü-I ekspresyonu ile tümör derece, evre ve nüks arasındaki ilişkiyi incelemektir.Çalışmaya 2002-2007 yılları arasında mesane tümörü nedeniyle transüretral rezeksiyon veya radikal sistektomi yapılan 53 hasta alındı. İnsülin benzeri büyüme faktörü-I tayini immünohistokimyasal olarak tümör dokusunda bakıldı. Sonrasında insulin benzeri büyüme faktörü-I ekspresyonu ile tümör derece, evre ve nüks ilişkisini araştırdık.Yaş ortalaması 64.4±11.9 olup hastaların 32’sinin düşük derece, 21’inin yüksek derece; 35’inin yüzeyel, 18’inin de kas invaziv tümörü mevcuttu. Yüzeyel tümörlü 35 hastadan 25’inin ortalama 21.9±8.1 ay takibi vardı. Düşük dereceli tümörler ile yüksek dereceli tümörler arasında IGF-I boyanma derecesi açısından anlamlı fark saptanmadı. Ayrıca yüzeyel tümörlerde IGF-I boyanma derecesi invaziv tümörler ile aynı saptandı. İzlenebilen hastalarda ise nüks ile IGF-I boyanması arasında bir ilişki görülmedi.Mesane tümörü dokusunda insulin benzeri büyüme etkeni-I boyanma derecesinin tümör derece, evre ve nüksü ile belirleyici ilişkisi olmadığı sonucuna vardık.
A Mild and Rare Form of Klippel-Trenaunay Syndrome Presenting With Urethral Bleeding Due To Penile Hemangioma
(Elsevier Science Inc, 2011) Tepeler, Abdulkadir; Yesilolva, Yavuz; Kilinc, Ali; Aktoz, Tevfik; Oenen, Abdurrrahman
Klippel-Trenaunay syndrome (KTS) is characterized by a triad of cutaneous port-wine capillary malformations, hemihypertrophy, and varicose veins. Intermittent gross painless hematuria is usually the first clinical sign. An 8-year-old boy with multiple hemangiomas, including glans penis, and associated with KTS presented with urethral bleeding. Radiologic and endoscopic evaluation revealed neither intra-abdominal nor intravesical hemangioma. Urethral bleeding was thought to be related to glanular hemangioma extending to the anterior penile urethra. Although we were able to manage the case conservatively, many patients require endoscopic or surgical interventions. Radiologic and endoscopic evaluations and careful follow-up is essential for diagnosis and prompt treatment. UROLOGY 77: 463-465, 2011. (C) 2011 Elsevier Inc.

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