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Turkeri L.,Marmara University | Mangir N.,Marmara University | Gunlusoy B.,Izmir Teaching and Research Hospital | Yildirim A.,Goztepe Teaching and Research Hospital | And 4 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2014

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. © 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. © questionnaire together with NMP-22® (BladderChek®) 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. © 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. © 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. © , 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. © questionnaire with NMP- 22.


Ergen F.B.,Hacettepe University | Gulal G.,Goztepe Teaching and Research Hospital | Yildiz A.E.,Hacettepe University | Celik A.,General Electric | And 2 more authors.
Journal of Computer Assisted Tomography | Year: 2014

OBJECTIVE: The aim of this study was to use the T2*-iterative decomposition of water and fat with echo asymmetry and least squares estimation quantification (IDEAL) technique to estimate vertebral fat fraction (FF) and compare it with bone mineralization levels in females. MATERIALS AND METHODS: Forty-five (mean age, 49.5 years) consecutive women who underwent magnetic resonance imaging and spinal dual-energy x-ray absorptiometry bone mineral density (BMD) examination constituted the study population. Depending on t scores derived from dual-energy x-ray absorptiometry, the vertebrae were classified into 3 groups (1, healthy; 2, osteopenia; and 3, osteoporosis). The Spearman ρ test was used to investigate the presence of correlation between FF and BMD. Analysis of covariance was performed to compare the differences among the groups. The FF cutoff value for the prediction of osteoporosis/ osteopenia was evaluated with the receiver operating characteristic curve analysis. RESULTS: We found a moderate negative correlation between BMD (grams per square centimeter) and FF (r = - 0.42), and it was statistically significant (P < 0.001). The FF mean of age-corrected group 1 (45.17%; SD, 1.3) was lower than that of groups 2 (51.77%; SD, 0.69) and 3 (50.82%; SD, 1.5), and the difference was statistically significant (P < 0.001, P = 0.021). The area under the receiver operating characteristic curve for FF was 0.80 (95% confidence interval, 0.72-0.86). The optimal cutoff point was obtained as 39%, and for this cutoff point, the sensitivity and the specificity were 93% and 60.3%, respectively. CONCLUSIONS: The T2*-IDEAL technique can be used as an alternative technique in estimation of FF, and it is possible to detect reduced bone mineralization of the vertebrae by estimation of FF value with this technique. © 2014 by Lippincott Williams & Wilkins.


Kucukgergin C.,Istanbul University | Isman F.K.,Goztepe Teaching and Research Hospital | Dasdemir S.,Istanbul University | Cakmakoglu B.,Istanbul University | And 3 more authors.
Gene | Year: 2012

The gene variants of the chemokine and chemokine receptor genes associated with inflammation may be involved in cancer initiation and progression. The aim of this study was to explore the possible association of monocyte chemoattractant protein-1 (MCP-1) A2518G, stromal cell derived factor 1 (SDF-1) 3'A and chemokine receptors CCR2A V64I, CCR5 δ32, CCR5 59029 and CXCR4 gene polymorphisms with the risk and clinicopathological characteristics of bladder cancer (BC) in a Turkish population.The genotyping was done by PCR and PCR-Restriction Fragment Length Polymorphism (RFLP) methods in 142 histologically confirmed BC patients and 197 controls.The SDF-1 3'AA genotype conferred significantly increased susceptibility to BC. The carriers with AA genotype or at least one A allele of CCR2 had an increased risk of developing BC. CCR5 wt/δ32 genotype and CCR5 δ32 allele were also observed to be involved in the susceptibility to BC. Additionally, the combination of CCR2 V64I and CCR5 δ32 (i.e., GG-wt/δ32) was found to be associated with BC risk. With respect to the stage of BC, the AA genotype of SDF-1 and at least one T allele of CXCR4 were significantly associated with high T stage as compared to GG genotype of SDF-1 and CC genotype of CXCR4. Furthermore, BC patients with AA genotype or at least one A allele of CCR2 had an increased risk of high grade and stage tumors as compared to those with GG genotype.Our results suggest that the genetic variants of SDF-1 3'A, CCR2A V64I and CCR5 δ32 gene polymorphisms may modify the BC risk. Furthermore, SDF-1 3'A, CCR2A V64I and CXCR4 gene polymorphisms may contribute to the muscle invasive BC in a Turkish population. © 2012 Elsevier B.V.


Kucukgergin C.,Istanbul University | Isman F.K.,Goztepe Teaching and Research Hospital | Cakmakoglu B.,Istanbul University | Sanli O.,Istanbul University | Seckin S.,Istanbul University
DNA and Cell Biology | Year: 2012

The aim of our study was to determine the effect of monocyte chemotactic protein-1 (MCP-1), CC chemokine receptor 2 (CCR2), and CC chemokine receptor 5 (CCR5) gene polymorphisms on the susceptibility and clinicopathological characteristics of prostate cancer. Genotyping was performed by polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) method in 156 histopathologically confirmed prostate cancer patients and 152 healthy subjects. Individuals with AA genotype or at least one A allele of CCR2 V64I gene polymorphism had a higher risk for prostate cancer as compared with those with GG genotype (p=0.010 and p=0.028, respectively). CCR5 Δ32/wt genotype and CCR5 Δ32 allele were also found to be involved in the susceptibility to prostate cancer (p=0.028 and p=0.030, respectively). However, there was no significant association between MCP-1-2518 A/G gene polymorphism and prostate cancer risk. Prostate cancer patients carrying AA genotype or at least one A allele of CCR2 V64I had significantly increased risk for high stage disease (p=0.002 and p=0.039, respectively) and metastasis (p=0.004 and p=0.022, respectively). The CCR2 A allele (64I allele) was significantly associated with high T stage (p=0.001) and metastasis (p=0.005) as compared with CCR2 G allele (64V allele). Our data indicate that gene polymorphism of CCR2 V64I may influence the susceptibility and clinicopathological characteristics of prostate cancer and CCR5 Δ32 allele may also be an important risk factor for prostate cancer in Turkish men population. © Copyright 2012, Mary Ann Liebert, Inc.


Yildiz M.,Goztepe Teaching and Research Hospital | Guvenis A.,Bogazici University | Guven E.,Bogazici University | Talat D.,Bogazici University | Haktan M.,Bogazici University
Journal of Medical Systems | Year: 2011

Bone age assessment is a tedious procedure carried out for assessing growth disorders of children using the left hand radiograph. The purpose of this work was to implement and evaluate a web-based software based on the Tanner and Whitehouse method in a pediatric endocrine department of a social security hospital processing 600-1,000 radiographs per year. The system was evaluated by using a statistical technique for comparing mesurement methods in order to test the performance of the procedure and a time study to assess its feasibility under local conditions. It was found that the intra-observer variation for the web-based Tanner and Whitehouse method was smaller (95% confidence limits, -0.77 to 0.97 vs. -0.45 to 0.37) then the conventional Greulich and Pyle manual method and the average net time required for an age assessment was 2.4 min. We therefore concluded that the web-based system should be adopted for its higher precision and relatively low turnaround time for cases requiring serial readings on the same patient. The statistical method demonstrated in this study can also serve as an example for evaluating similar biomedical parameter assessing software. © 2010 Springer Science+Business Media, LLC.


In the present study, we aimed to investigate the association between SDF1-3'A and CXCR4 gene polymorphisms and the susceptibility and clinicopathological development of prostate cancer. SDF1-3'A and CXCR4 gene polymorphisms were assessed by polymerase chain reaction restriction-fragment length polymorphism (PCR-RFLP) in 149 healthy subjects and 152 patients with prostate cancer. There were no significant differences in the distributions of SDF-1 and CXCR4 genotypes between controls and prostate cancer patients. However, the patients with AA genotype of SDF1-3'A gene presented a higher risk for developing an advanced disease status as compared to patients with GG homozygotes (aOR = 2.02; 95 % CI = 1.05-3.90; P = 0.035). In addition, the distribution of AA genotype of SDF1-3'A gene was found significantly increased in the patients with bone metastasis in comparison to those without bone metastasis (aOR = 2.94; 95 % CI = 1.26-6.82; P = 0.012). On the other hand, CXCR4 gene polymorphism was not associated with the clinicopathological characteristics of prostate cancer. Our results suggest that SDF1-3'A and CXCR4 gene polymorphisms may not be risk factors for the susceptibility to prostate cancer. However, SDF1-3'A gene polymorphism may be associated with the progression and bone metastasis of prostate cancer in a Turkish men population.


PubMed | Goztepe Teaching and Research Hospital
Type: Journal Article | Journal: Molecular biology reports | Year: 2012

In the present study, we aimed to investigate the association between SDF1-3A and CXCR4 gene polymorphisms and the susceptibility and clinicopathological development of prostate cancer. SDF1-3A and CXCR4 gene polymorphisms were assessed by polymerase chain reaction restriction-fragment length polymorphism (PCR-RFLP) in 149 healthy subjects and 152 patients with prostate cancer. There were no significant differences in the distributions of SDF-1 and CXCR4 genotypes between controls and prostate cancer patients. However, the patients with AA genotype of SDF1-3A gene presented a higher risk for developing an advanced disease status as compared to patients with GG homozygotes (aOR = 2.02; 95 % CI = 1.05-3.90; P = 0.035). In addition, the distribution of AA genotype of SDF1-3A gene was found significantly increased in the patients with bone metastasis in comparison to those without bone metastasis (aOR = 2.94; 95 % CI = 1.26-6.82; P = 0.012). On the other hand, CXCR4 gene polymorphism was not associated with the clinicopathological characteristics of prostate cancer. Our results suggest that SDF1-3A and CXCR4 gene polymorphisms may not be risk factors for the susceptibility to prostate cancer. However, SDF1-3A gene polymorphism may be associated with the progression and bone metastasis of prostate cancer in a Turkish men population.


PubMed | Goztepe Teaching and Research Hospital
Type: Comparative Study | Journal: Journal of medical systems | Year: 2011

Bone age assessment is a tedious procedure carried out for assessing growth disorders of children using the left hand radiograph. The purpose of this work was to implement and evaluate a web-based software based on the Tanner and Whitehouse method in a pediatric endocrine department of a social security hospital processing 600-1,000 radiographs per year. The system was evaluated by using a statistical technique for comparing measurement methods in order to test the performance of the procedure and a time study to assess its feasibility under local conditions. It was found that the intra-observer variation for the web-based Tanner and Whitehouse method was smaller (95% confidence limits, -0.77 to 0.97 vs. -0.45 to 0.37) then the conventional Greulich and Pyle manual method and the average net time required for an age assessment was 2.4 min. We therefore concluded that the web-based system should be adopted for its higher precision and relatively low turnaround time for cases requiring serial readings on the same patient. The statistical method demonstrated in this study can also serve as an example for evaluating similar biomedical parameter assessing software.


PubMed | Goztepe Teaching and Research Hospital
Type: Journal Article | Journal: Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis | Year: 2013

We aimed to evaluate the efficacy of acute peritoneal dialysis (PD) and clinical outcomes in neonates with acute kidney injury (AKI) and hypernatremic dehydration. The medical records of 15 neonates with AKI and hypernatremic dehydration who were treated with acute PD were reviewed. The diagnoses were AKI with hypernatremic dehydration with or without sepsis in 13 patients and AKI with hypernatremia and congenital nephropathy in 2 patients. The main indications for PD were AKI with some combination of oligoanuria, azotemia, hyperuricemia, and metabolic acidosis unresponsive to initial intensive medical treatment. The mean age of the patients at dialysis initiation was 11.9 9 days, and the mean duration of PD was 6.36 4.8 days. In 7 patients (46.7%), hypotension required the use of vasopressors, and in 6 patients (40%), mechanical ventilation was required. Peritoneal dialysis-related complications occurred in 7 patients (46.7%), the most common being catheter malfunction (n = 6). Four episodes of peritonitis occurred in the 15 patients (26.7%), 2 episodes in patients with congenital renal disease and 2 episodes in patients with sepsis and multiorgan failure, who did not survive. Congenital renal disease, septicemia, and the need for mechanical ventilation were important factors influencing patient survival. All patients with no pre-existing renal disease or sepsis recovered their renal function and survived. In neonates with AKI and hypernatremic dehydration, PD is safe and successful, and in patients without congenital renal disease or sepsis, the prognosis is good. Peritoneal dialysis should be the treatment of choice in neonates with AKI and hypernatremic dehydration who do not respond to appropriate medical treatment.


Erguven M.,Goztepe Teaching and Research Hospital | Yildiz M.,Goztepe Teaching and Research Hospital | Ozdogan T.,Goztepe Teaching and Research Hospital
Peritoneal Dialysis International | Year: 2013

Objective: We aimed to evaluate the efficacy of acute peritoneal dialysis (PD) and clinical outcomes in neonates with acute kidney injury (AKI) and hypernatremic dehydration. Methods: The medical records of 15 neonates with AKI and hypernatremic dehydration who were treated with acute PD were reviewed. The diagnoses were AKI with hypernatremic dehydration with or without sepsis in 13 patients and AKI with hypernatremia and congenital nephropathy in 2 patients. The main indications for PD were AKI with some combination of oligoanuria, azotemia, hyperuricemia, and metabolic acidosis unresponsive to initial intensive medicaltreatment. Results: The mean age of the patients at dialysis initiation was 11.9 ± 9 days, and the mean duration of PD was 6.36 ± 4.8 days. In 7 patients (46.7%), hypotension required the use of vasopressors, and in 6 patients (40%), mechanical ventilation was required. Peritoneal dialysis-related complications occurred in 7 patients (46.7%), the most common being catheter malfunction (n = 6). Four episodes of peritonitis occurred in the 15 patients (26.7%), 2 episodes in patients with congenital renal disease and 2 episodes in patients with sepsis and multiorgan failure, who did not survive. Congenital renal disease, septicemia, and the need for mechanical ventilation were important factors influencing patient survival. All patients with no pre-existing renal disease or sepsis recovered their renal function and survived. Conclusions: In neonates with AKI and hypernatremic dehydration, PD is safe and successful, and in patients without congenital renal disease or sepsis, the prognosis is good. Peritoneal dialysis should be the treatment of choice in neonates with AKI and hypernatremic dehydration who do not respond to appropriate medical treatment. © 2013 International Society for Peritoneal Dialysis.

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