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Öğe 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, BurcuObjective: 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.Öğe 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 SerdarObjective: 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.Öğe Evaluation and surgical approach of surrenal masses: experience of Trakya University(Aves, 2011) Inci, Osman; Aktoz, Tevfik; Bilir, Betl Ekiz; Atakan, Irfan Huseyin; Tugrul, ArmaganObjective: 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.Öğe Multiple primary malignant neoplasms in urologic patients(Springer, 2003) Inci, Osman; Kaya, Esat; Alagol, Bulent; Atakan, Irfan Huseyin; Aydin, Sabahattin; Ereselli, HasanMethods: Second primary cancers constitute approximately 9-10% of malignancies diagnosed in the United States. We aimed to show the risk and incidance of second primary tumor occuring associated to urologic tumors and show the distrubution of tumors in Tracia region. We retrospectively examined the patients' files with the diagnosis of malignant disease between the years 1985-2000. Hazard function analysis was performed to estimate the relative risk of secondary malignancy occuring. Age, sex and tumor number were examined to find out if they affect on mortality rate. Results: A total number of 25 MPMNs were diagnosed. In 52 percent of the cases the second primary neoplasm developed within six months. The relative risk of development of a second neoplasm is found as increasing 1.111 times per month. The incidence of secondary malignancy occuring in the patients with one tumor was found as 6.31%. Age (p < 0.001) and tumor number (p < 0.001) are found as statistically effective predictor on mortality rate where the sex is not. Conclusions: In the patients with a primary tumor not only the metastasis must be investigated but also second primary tumors should be taken in to consideration.Öğe PENILE AND PROSTATIC METASTASIS FROM PRIMARY RENAL SARCOMA(Aves, 2007) Kaplan, Mustafa; Alicioglu, Banu; Usta, Ufuk; Aktoz, Tevfik; Atakan, Irfan Huseyin; Inci, OsmanIntroduction: Urological sarcomas are rare. Renal sarcomas represent 1% to 2% of all malignant renal tumors and their prognosis is worse than other urogenital sarcomas. High grade sarcomas commonly metastasize, with the lungs, lymph nodes, and liver being a primary site of spread. Penile and prostatic metastases of renal sarcomas are extremely rare, and are generally accepted as a manifestation of systemic spread and survival after their presentation is limited. We report the first case of simultaneous penile and prostatic metastases from a primary sarcoma of the kidney.Öğe Protective Effect of Quercetin Against Renal Toxicity Induced by Cadmium in Rats(Galenos Publ House, 2012) Aktoz, Tevfik; Kanter, Mehmet; Uz, Yesim Hulya; Aktas, Cevat; Erboga, Mustafa; Atakan, Irfan HuseyinObjective: The aim of the present study was to examine the protective effect of quercetine (QE) against cadmium (Cd)-induced renal toxicity. Material and Methods: A total of 24 male Wistar albino rats were divided into three groups: control, Cd-treated and Cd-treated with QE; each group containing 8 animals. The Cd-treated group was injected subcutaneously with CdCl2 dissolved in saline in the dose of 2 ml/kg/day for 30 days, resulting in a dosage of 1 mg/kg Cd. The rats in the QE treated groups were given QE (15 mg/kg body weight) once a day intraperitoneally starting 2 days prior to Cd injection during the study period. Results: The renal histology in Cd-treated rats showed mesangial expansion, thickening of capsular basement membranes, glomerular basement membranes and tubular basement membranes, characterized by an increase in periodic acid Schiff (PAS)-positive areas as compared with control animals. With the QE treatment, despite the presence of only a few swollen glomeruli, we noticed a marked protection of renal structure when compared with the Cd-treated rats. Furthermore, QE pretreatment resulted in increased proliferating cell nuclear antigen (PCNA) immunoreactivity and decreased the activity of Terminal Transferase dUTP Nick End Labeling (TUNEL). Conclusion: These findings suggest that QE may attenuate Cd-induced renal toxicity.Öğe The protective effects of melatonin and vitamin E against renal ischemia-reperfusion injury in rats(Taylor & Francis Ltd, 2007) Aktoz, Tevfik; Aydogdu, Nurettin; Alagol, Bulent; Yalcin, Omer; Huseyinova, Gulara; Atakan, Irfan HuseyinReactive oxygen species (ROS) were shown to contribute to the cellular damage induced by ischemia-reperfusion. The purpose of this study was to investigate and compare the efficiency of melatonin and vitamin E in the reduction of injury induced by ROS in a rat model of renal ischemia-reperfusion. Twenty-four Wistar-albino rats were divided into four groups. Rats in the Sham group were given saline 1 mL/kg, intraperitoneally (ip) 72 h, 48 h, 24 h, and 30 min before the sham operation. Rats in ischemia-reperfusion (IR), IR+Melatonin, and IR+Vitamin E groups were given saline (1 mL/ kg), melatonin (10 mg/kg), and vitamin E (100 mg/kg) ip, respectively, 72 h, 48 h, 24 h, and 30 min before the ischemia for 60 min, followed by reperfusion for 60 min. The blood samples and kidney tissues of the rats were taken under anesthesia. lschemia-reperfusion significantly increased urea, creatinine, and malondialdehyde (MDA) levels, and decreased superoxide dismutase (SOD) and catalase (CAT) activities. Histopathological findings of the IR group confirmed that there was renal impairment by cast formation and tubular necrosis in the tubular epithelium. In the IR+Melatonin group, while MDA levels significantly decreased, SOD activities increased. In the IR+Melatonin group, the level of tubular necrosis and cast formation are significantly decreased than those seen in the ischemia-reperfusion group. Melatonin in particular was effective to reverse hot ischemia of kidney by its antioxidant effects. These results may indicate that melatonin pretreatment protects against functional, biochemical, and morphological damage better than vitamin E in renal ischemia-reperfusion injury.Öğe A rare cause of acute flank pain: spontaneous rupture of the renal pelvis(Aves, 2009) Kaplan, Mustafa; Aktoz, Tevfik; Atakan, Irfan HuseyinSpontaneous rupture of the renal pelvis is very rare. A pre-existing renal abnormality increases the risk of rupture. We present a 47-year-old man with spontaneous rupture of a unilateral renal pelvis. During the exploration a retroperitoneal urinoma was seen which was caused by high grade hydronephrosis due to ureteropelvic junction obstruction. Differential diagnosis and treatment of this case are discussed and the literature is reviewed.Öğe Renal angiomyolipoma with malignant transformation, simultaneous occurrence with malignity and other complex clinical situations(Springer, 2006) Inci, Osman; Kaplan, Mustafa; Yalcin, Omer; Atakan, Irfan Huseyin; Kubat, HuseyinRenal angiomyolipoma is a benign kidney tumor, which is characterized by the presence of mature or immature fat tissue, thick-walled blood vessels, and smooth muscles. However, there is a rare possibility of transformation to a malignancy. This transformation could be toward sarcoma. And also angiomyolipoma could be associated with renal adenocarcinorna in the same kidney. The aim of this study is to show the association of angiomyolipoma with complex clinical situations such as malign transformation, simultaneous occurrence with adenocarcinoma, bilateral tumors with tuberous sclerosis or Wunderlich Syndrome. Findings of clinical presentation, pathological evaluation, urography, ultrasonography, and computerized tomography of 19 patients who were diagnosed angiomyolipoma in our clinic during 1994-2003 were examined retrospectively. Our records indicated that radical nephrectomy was performed in three cases of angiomyolipoma in which the differential diagnosis from adenocarcinorna could not be made and in another case of angiomyolipoma, which was associated with adenocarcinoma. Simple nephrectomy was performed in four symptomatic angiomyolipoma cases with tumor size larger than 4 cm and partial nephrectomy in another case. In one case, renal angiomyolipoma was associated with adenocarcinoma in the same kidney. In one case, post-operative recurrence of angiomyolipoma developed 7 months after nephrectomy. This patient was diagnosed low-grade leiomyosarcoma. Angiomyolipoma is regarded as a benign tumor of the kidney; however, it may also show aggressive behaviors and rarely transform to sarcoma. It may also exist in the same kidney along with adenocarcinorna or sarcoma.Öğe RETROPERITONEAL MALIGNANT SCHWANNOMA(Aves, 2008) Aktoz, Tevfik; Kaplan, Mustafa; Caloglu, Murat; Atakan, Irfan Huseyin; Inci, OsmanIntroduction: Malignant schwannoma, recently renamed malignant peripheral nerve sheat tumors, represents 0.01 % of retroperitoneal tumors. Radical surgical excision is considered the best treatment for these neoplasms for poor responsiveness to chemotherapy and radiation therapy. We report a 66-year-old man who was operated for three times.Öğe SIGNIFICANCE OF INSULIN-LIKE GROWTH FACTOR-I EXPRESSION IN BLADDER TUMORS(Aves, 2008) Ozbakir, Fikret; Kaplan, Mustafa; Usta, Ufuk; Aktoz, Tevfik; Atakan, Irfan Huseyin; Inci, OsmanIntroduction: Insulin-like growth factor-I is a mitogenic peptide which overexpression involved in the aberrant cell proliferation and malign transformation. It was thought that it can show the malign behavior of bladder tumors. Our aim in this study is to investigate the relationship between insulin like growth factor expression and tumor grade, stage and recurrence in patients with bladder tumor. Materials and Methods: 53 patients that performed transurethral tumor resection or radical cystectomy between 2002 and 2007 were included in this study. Insulin like growth factor-I staining was determined by immunohistochemically from the bladder tumor tissue. Then we investigated the relationship between insulin like growth factor expression in bladder tumor tissue and tumor grade, stage, and recurrence. Results: The mean age was 64.4+/-11.9, 32 patients have low grade, 21 have high grade; 35 have superficial, 18 have muscle invasive tumor. Of 35 patients with superficial tumors, 25 patients have regular follow-up and the mean follow-up duration was 21.9+/-8.1 month. There was no significant difference in insulin-like growth factor-I staining degree between low grade and high grade tumors. Insulin-like growth factor-I staining degree was same in both superficial and muscle invasive tumors. We found no relationship between recurrence and insulin-like growth factor-I staining degree. Conclusion: We found no association between tumor grade, stage, and recurrence and insulin-like growth factor-I staining degree in bladder tumors.
