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    Absence of infrarenal inferior vena cava is not a congenital abnormality
    (Comenius Univ, 2009) Alicioglu, Banu; Kaplan, Mustafa; Ege, Turan
    The absence of inferior vena cava (IVC) is one among infrequent subtypes of IVC abnormalities that are rarely seen in general population. The absence of IVC involves either that of entire IVC or that of infrarenal segment. These two entities are relatively similar but their etiopathogeneses are still controversial. The absence of the entire IVC is thought to be a result of an embryologic disorder, whereas perinatal thrombosis is hypothesised to lead to the development of absent infrarenal IVC, thus the latter is a developmental disorder and the former occurs due to embryologic disorder. We report an adult man with renal-infrarenal absence of IVC, as well as missing common iliac veins. He clinically presented with extensive varicose collateral circulation on the thoracoabdominal wall, right varicocele and severe varices on lower limbs. Calcifications of adrenal glands indicate a hematologic disorder during perinatal period. The etiopathogenesis of this unusual abnormality is emphasized in this case report (Fig. 5, Ref. 10). Full Text (Free, PDF) www.bmj.sk.
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    Akut yan ağrısının nadir görülen bir nedeni: spontan renal pelvis ruptürü
    (2009) Kaplan, Mustafa; Aktoz, Tefvik; Atakan, İrfan Hüseyin
    Spontan renal pelvis rüptürü oldukça nadirdir. Mevcut renal anomaliler rüptür riskini arttırmaktadır. Burada spontan olarak tek taraflı renal pelvis rüptürü gelişen 47 yaşında erkek olgu sunulmaktadır. Hastada herhangi bir batın travması mevcut değildir. Yapılan eksplorasyonda üreteropelvik bileşke darlığına bağlı gelişen ileri derecede hidronefroza sekonder oluşmuş retroperitoneal ürinom görüldü. Olgunun ayırıcı tanı ve tedavisi literatür eşliğinde tartışıldı.
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    Analysis of T1c prostate cancers treated at very low prostate-specific antigen levels
    (Galenos Yayincilik, 2009) Kaplan, Mustafa; Arda, Ersan
    Background:The Prostate Cancer Prevention Trial (PCPT) has challenged the validity of recommended prostate-specific antigen (PSA) thresholds for prostate biopsy (>2.5 ng/ml) given the 17% prostate cancer (pCA) detection rate at PSA of 1.1-2.0. The outcome of patients treated at PSA is poorly defined, and advantages associated with such an early diagnosis are uncertain. Objective: Compare the outcome of patients with Tlc pCA with pretreatment PSA and 2.6-4.0. Design, setting, and participants: Since 1998, 351 patients with clinical stage Tlc and PSA 4.0 have been treated at our institution; 84 (24%) of those patients had PSA 2.5. Clinical information was obtained from a prospective database. Treatment was radical prostatectomy, brachytherapy, and external-beam radiotherapy in 261 (74%), 67 (19%), and 23 (7%) patients, respectively. Measurements: Progression-free probability and pathological end points. Results and limitations: No significant differences between the groups were observed in terms of biopsy (18% vs 22%) or specimen Gleason score 7-8 (44% vs 56%), non organ-confined cancer (11% vs 13%), indolent cancer (34% vs 24%), or 5-yr progression -free probability (89% vs 93%; p > 0.1 for all). More biologically unimportant cancers (defined as pathologically organ-confined and Gleason were identified among patients with PSA (55% vs 41%, p = 0.050), and indolent cancers were three times more frequent than non organ-confined cancers among these patients (p = 0.003). Conclusions: The pathological features and outcome of patients treated at low PSA levels are favorable and similar for patients with PSA versus 2.6-4.0. However, >50% of the former have potentially biologically unimportant cancer. We failed to identify a therapeutic benefit to the diagnosis of cancers below accepted PSA thresholds for biopsy.
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    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.
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    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.
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    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.
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    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.
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    Brakiterapi başarısızlığında tedavi seçenekleri
    (2005) Kaplan, Mustafa; Kleın, Eric A.
    Etkinliğinin diğer tedavi seçenekleri ile aynı düzeyde olması, brakiterapinin erken evre prostat kanserinde alternatif bir tedavi seçeneği olarak popülarite kazanmasını sağlamıştır. Brakiterapideki gelişmelere rağmen bir grup hastada tedavi başarısızlıkla sonuçlanmaktadır. Brakiterapi başarısızlığı durumunda seçenekler gözlem, hormonal tedavi, radikal prostatektomi ve kriyoterapidir. Bu tedavilerin asıl amacı lokal kontrolü sağlamak ve uzun dönem sağkalım süresini uzatmaktır. Yaşlı ve prostat spesifik antijen ikiye katlanma zamanı yavaş olanlar için gözlem iyi bir seçenektir. Hormonal tedaviye aday olanlar ise yaşlı ve prostat spesifik antijen ikiye katlanma zamanı hızlı hastalardır. Kurtarma radikal prostatektomisinden en çok fayda görecekler erken evre prostat kanseri olan genç hastalardır. Kurtarma kriyoterapisi ise yaşlı ve komorbiditesi olan hastalar için radikal prostatektomiye alternatif olarak iyi bir seçenektir.
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    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.
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    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.
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    Can prostate cancer be prevented?
    (Galenos Yayincilik, 2011) Yuksel, Ilkan; Kaplan, Mustafa
    The result of epidemiyologic researchs shows us prostat cancer is the second common cancer after lung cancer. Because of high incidence of prostat cancer, morbitities of treatment options and high costs, prevention of prostat cancer become popular. After explaning the mechanisms of prostat carcinogenez, the idea of some agents can be usefull to prevent prostat cancer is suggested. Succesfull results get from the resarch with 5 alfa reductase and estrogen receptor antagonists, but the resarchs with nonsteroidal antiinflamtory drugs, selenium, vitamin D, lycopene can't give us absolute results, so we need more researchs with these agents.
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    Case report: Subcutaneous metastasis from small cell carcinoma of the prostate
    (Springer, 2007) Kaplan, Mustafa; Atakan, Irfan H.; Bilgi, Selcuk; Inci, Osman
    Pure primary small cell carcinoma of the prostate (SCCP) is an extremely rare entity. Natural history of this tumor is similar to that of the bronchogenic small cell carcinoma. Several theories of histogenesis have been proposed. Most widely accepted view is that SCCP arises from pluripotent stem cells of the prostate, which have the ability to differentiate into either epithelial or neuroendocrine type carcinomas. SCCP has an aggressive course, and a majority of patients have distant metastasis at presentation. Since it is a rare entity, no standard treatment regimen has been established. A case of primary pure SCCP with multiple subcutaneous metastases is presented.
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    Chondrosarcoma of the pubis imitating bladder tumor radiologically: A case report
    (Springer, 2003) Inci, Osman; Kaya, Esat; Alagol, Bulent; Kaplan, Mustafa; Doganay, Latife
    Chondrosarcoma is a rare tumor that more frequently involves the pelvic bones, the femur, and the humerus [1, 2]. The rareness of the tumor makes the diagnosis difficult. Malignant cartilage tumors typically have an unstable radiographic appearance [3]. In this report we aimed to point out the difficulties of the radiological differentiation of the pelvic chondrosarcoma and bladder tumor.
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    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.
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    The Effects of Taurine, Melatonin and N-Acetylcystein on Cadmium Exposure Bone Changes The Surprising Effect of Taurine
    (Gazi Univ, Fac Med, 2020) Tastekin, Nurettin; Aydogdu, Nurettin; Altun, Gulay Durmus; Erbas, Hakan; Uzunca, Kaan; Birtane, Murat; Kaplan, Mustafa
    Background: Chronic environmental and occupational exposure to cadmium can result in skeletal system changes. The main objective of the present study was to investigate and compare the effects of taurine, melatonin and N-acetyl cysteine on cadmium exposure induced bone density loss. Methods: 90 adult male Sprague-Dawley rats were allocated into four main groups: Group I was the control group; Group II was the cadmium exposure group; Group 3 was cadmium exposure for 3 months + concurrent antioxidant administration group. The concept of Group 4 was cadmium exposure for 3 months + subsequent antioxidant administration. Bone mineral density values were evaluated in all the groups. Serum calcium, phosphorus, alkaline phosphatase (ALP) enzyme activities and 24 hours urine calcium excretion levels were measured. Kruskal-Wallis test was used to compare the all groups. Between two group comparisons, the Mann-Whitney U test was used. Results: There was no significant difference in terms of bone mineral density values only between control group and cadmium exposure group (p 0.05). Mean bone mineral density values obtained in cadmium + concurrent taurine and cadmium + subsequent taurine groups were significantly lower than all the other groups (p<0.05). 24 hours urine calcium excretion levels were significantly higher in groups which taurine and n-asetylcystein were administered after cadmium exposure. Conclusion: Taurine, which is thought to have protective effects as an antioxidant caused a marked bone damage after exposure to cadmium. Further studies are needed to clarify this effect of taurine.
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    Efficacy of levobupivacaine wound infiltration with and without intravenous lornoxicam for post-varicocoele analgesia - A randomized, double-blind study
    (Adis Int Ltd, 2008) Memis, Dilek; Hekimoglu, Sevtap; Kaya, Gaye; Atakan, Huseyin I.; Kaplan, Mustafa
    Background and objective: The oxicam NSAID lornoxicam is a potent analgesic with excellent anti-inflammatory properties in a range of painful and/or inflammatory conditions, including postoperative pain. Levobupivacaine, the S-(-)-isomer of bupivacaine, is a long-acting local anaesthetic that can be infiltrated into wounds for management of postoperative pain. We assessed the analgesic efficacy of lornoxicam when administered as an adjuvant to levobupivacaine wound infiltration after varicocoele operation. Methods: Sixty patients who underwent varicocoele surgery were randomly assigned to three different treatment groups. Before skin closure, patients received the following treatments: group I (n = 20) patients received normal saline 20 mL wound infiltration and intravenous lornoxicam (Xefo(R), Nycomed Pharma AS, Roskilde, Denmark) 2 mL (8 mg); group II (n = 20) patients received 0.25% levobupivacaine (Chirocaine(R), Abbott Scandinavia AB, Solna, Sweden) 10mL with normal saline 10 mL wound infiltration and intravenous normal saline 2 mL; group III (n = 20) patients received 0.25% levobupivacaine 10 mL with normal saline 10 mL wound infiltration and intravenous lornoxicam 2 mL (8 mg). Pain scores and total pethidine (meperidine) consumption were measured at 1, 2, 4, 6, 12 and 24 hours postoperatively. Time to first analgesic requirement and patient satisfaction were also compared post-surgery. Results: Pain scores during the first 6 hours postoperatively were significantly lower in group III than in group I and group II (p < 0.01). Total pethidine consumption was significantly lower in group HI (34.0 +/- 28.0 mg) than in group I (74.0 +/- 25 mg) and group II (76.0 +/- 29 mg) [p < 0.01]. Time to first analgesic was also significantly longer in group III (14.8 +/- 8.4 hours) than in group I (6.2 +/- 5.2 hours) and group II (5.8 +/- 7.1 hours) [p < 0.01]. The incidence of postoperative nausea and vomiting was significantly lower in group III than in group I and group II (p < 0.05). More patients in group III described their analgesia as good or excellent than in group I or group II (p < 0.01). Conclusion: In this study, levobupivacaine wound infiltration with adjuvant intravenous lornoxicam administration was associated with better postoperative analgesia during the early postoperative hours after varicocoele surgery than that induced by lornoxicam alone or levobupivacaine wound infiltration alone.
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    Factors affecting local control, distant recurrence and survival in patients with locally advanced bladder cancer treated by definitive radiotherapy or chemoradiotherapy
    (Kare Publ, 2006) Caloglu, Murat; Yurut-Caloglu, Vuslat; Saynak, Mert; Cosar-Alas, Rusen; Karagol, Hakan; Kaplan, Mustafa; Ibis, Kamuran
    OBJECTIVES Treatment results of 34 patients with bladder cancer admitted to Department of Radiation Oncology, Medicine Faculty of Trakya University between October 1997 and June 2005 were retrospectively analyzed. Prognostic factors associated with survival were determined. METHODS Their median age was 69 years (range 44-93). Thirty patients (88%) were male and 4 patients (12%) were female. Histopathological diagnosis was transitional cell carcinoma in 20 (59%) patients. Chemotherapy was administered concomitantly with radiotherapy to the 11 (32.35%) of the patients. The median radiotherapy dose was 62.5 (35-68) Gy. The median follow-up was 22 months (5-76 months). Median survival and median disease-free survival were 14.2 months (3.8-57.5) and 10 months (0-55), respectively. RESULTS Three years loco-regional control, metastasis free survival, disease free survival and overall survival rates were 76.59 , 72.2%, 55% and 41.1%, respectively. Epidermoid carcinoma histopathology (p=0.002), not performing concomitant chemotherapy (p=0.003), applying carboplatin instead of cisplatin with radiotherapy (p=0.004) and not conducting complete TURB (p=0.008) were significant poor prognostic factors on loco-regional control. Undifferentiated cell type (p=0.012) and not performing concomitant chemotherapy (p=0.046) were significant adverse factors on distant metastases. Factors that affect overall survival were tumor in stage T-4 (p=0.05), hemoglobin value below 10 g/dl (p=0.032) and not performing concomitant chemo-radiotherapy (p=0.017) and complete TURB (p=0.049). CONCLUSION Complications of radiotherapy were acceptable. For the treatment of muscle invasive locally advanced bladder cancer, RT combined with cisplatin is an acceptable treatment option. Moreover, complete TURB before RT is important both for local control and for survival.
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    Giant bladder stone in children: case report
    (Int Scientific Literature, Inc, 2008) Aktoz, Tevfi K.; Kaplan, Mustafa; Atakan, Irfan H.; Inci, Osman
    Background: Pediatric urolithiasis is an endemic disease in certain parts of the world, namely Turkey and Far East. Metabolic and environmental factors, in addition to urogenital abnormalities, should be evaluated thoroughly each patient. The aims of management should be complete clearance of stones, treatment of urinary tract infections, preservation of renal function and prevention of stone recurrence. The giant bladder stone is not very common and it is usually associated with nutritional factors. Case Report: A 3 year-old boy was admitted to our clinic with a 2-year history of recurrent urinary tract infections and urinary complaints like intermittent and painful voiding with terminal hematuria and sharp lower abdominal pain. On physical examination, the weight and height were 10 kg (below the 3rd percentile), and 85 cm (below the 3rd percentile), respectively. Direct urinary system X-ray study and intravenous urography (IVU) showed a giant bladder stone. In this case, we think that giant bladder stone is associated with nutritional factors and we were unable to find an underlying metabolic abnormality. Open surgery was performed to this patient. The bladder stone was 3.1 x 2.0 x 1.7 cm in diameter. Biochemical analysis showed that it was calcium oxalate stone. Conclusions: Treatment of pediatric urolithiasis requires a metabolic and environmental evaluation of all patients. Obstructive pathologies have to be corrected and metabolic abnormalities should be treated. Also nutritional factors related with bladder stones must be considered. Open surgery remains the main treatment of giant bladder stones in children.
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    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.
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    Identification of Patients with Microscopic Hematuria who are at Greater Risk for the Presence of Bladder Tumors Using a Dedicated Questionnaire and Point of Care Urine Test - A Study by the Members of Association of Urooncology, Turkey
    (Asian Pacific Organization Cancer Prevention, 2014) Turkeri, Levent; Mangir, Naside; Gunlusoy, Bulent; Yildirim, Asif; Baltaci, Sumer; Kaplan, Mustafa; Bozlu, Murat
    In patients with microscopic hematuria there is a need for better identification of those who are at greater risk of harbouring bladder tumors. The RisikoCheck (c) questionnaire has a strong correlation with the presence of urothelial carcinoma (UC) of the bladder and in combination with other available tests may help identify patients who require detailed clinical investigations due to increased risk of presence of bladder tumors. This study aimed to evaluate the efficacy of RisikoCheck (c) questionnaire together with NMP-22 (R) (BladderChek (R)) as a point-of-care urine test in predicting the presence of bladder tumors in patients presenting with microscopic hematuria as the sole finding. In this multi-institutional prospective evaluation of 303 consecutive patients without a history of urothelial carcinoma (UC), RisikoCheck (c) risk group assessment, urinary tract imaging and cystourethroscopy as well as urine cytology and Nuclear Matrix Protein-22 (NMP-22 BladderChek) testing were performed where available. The sensitivity, specificity, negative predictive value (NPV), and positive predictive values (PPV) for the risk adapted approach were calculated. All patients underwent cystoscopy, and tumors were detected in 18 (5.9%). Urine cytology and NMP-22 was positive for malignancy in 9 (3.2%) and 12 (7.5%) of patients, respectively. A total of 43 (14%) patients were in the high risk group according to the RisikoCheck (c) questionnaire. The sensitivity and specificity of the questionnaire in detecting a bladder tumor was 61.5 % and 84.0 % in the high risk group. In patients with either a positive NMP-22 test or high risk category RisikoCheck (c), 23.6% had bladder tumors with a corresponding sensitivity of 54.2% and specificity of 88.6%. If both tests were negative only 3.3% of the patients had bladder tumors. The results of our study suggest that the efficacy of diagnostic evaluation of patients with microscopic hematuria may be further enhanced by combining RisikoCheck (c) questionnaire with NMP-22.