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H Ozen

Publications and source records attributed to H Ozen.

At least 37 records · Page 2Linked to original sources
PubMed2001

Percutaneous nephrostomy in the management of malignant ureteral obstruction secondary to bladder cancer.

BACKGROUND AND PURPOSE: Malignant ureteral obstruction (MUO) is a common late manifestation of metastatic bladder cancer. We investigated the effectiveness of percutaneous nephrostomy (PN) in our patients with MUO associated with bladder cancer as judged by the serum creatinine concentration in the presence of unilateral or bilateral obstruction and in relation to the treatment results. PATIENTS AND METHODS: The records of 23 consecutive patients with a mean age of 55 years (21 men, 2 women) who underwent PN were retrospectively reviewed. Eleven had unilateral obstruction. We assessed normalization of creatinine concentration, survival, and quality of life after PN in patients with either unilateral or bilateral obstruction. RESULTS: The mean serum creatinine concentration before PN was 6 mg/dL (range 2.1-24.6 mg/dL). Percutaneous nephrostomy provided improvement to normal renal function in 19 patients (83%). The mean survival of patients after PN was 4.9 months (range 1-14 months). No independent factor playing a significant prognostic role was determined. The overall complication rate was 30% (7/23), namely kinking or dislodgment of nephrostomy tubes. After PN, all patients were able to undergo treatment for bladder cancer. CONCLUSIONS: Percutaneous nephrostomy, with a low morbidity rate, is a safe urinary diversion technique in bladder cancer-induced MUO. It relieves at least the devastating effects of uremia and allows appropriate treatment for the malignancy.

Adult↗
PubMed2001

Repeated transurethral resection and intravesical BCG for extensive superficial bladder tumors.

PURPOSE: We report our experience with repeat transurethral resection (TUR) in a group of patients with superficial bladder tumors in whom complete resection in one session was impossible because of the extensive tumor burden. PATIENTS AND METHODS: Only the patients with such extensive (>10 g of resected tissue) tumors that we were unable to perform complete TUR initially were included in the present study. The patients underwent repeat TUR(s) 4 weeks after the previous one until complete resection of the tumor was achieved. After complete TUR, if the pathology examination confirmed superficial disease, the patients received intracavitery immunotherapy and were followed up thereafter. If pathology examination documented muscle-invasive disease, cystectomy was suggested. RESULTS: Of the 43 patients undergoing repeat TUR, 15 needed a second and 5 needed a third session to achieve complete resection. Of the patients, 28 (65%) had stage T1 and 15 (35%) has stage Ta tumor. Eight patients (19%) otherwise regarded as having superficial tumor were found to have muscle-invasive disease following repeat TURs. The mean follow-up of the remaining 35 patients with superficial disease was 34 months (range 1-126 months). Four of the patients with superficial disease progressed to T2 tumor. However, 16 patients achieved a state of complete response with no tumor recurrences during a mean of 38 months (range 4-126 month). The present protocol achieved bladder sparing in a total of 22 (63%) of the 35 patients with superficial disease. CONCLUSIONS: From the presented series, we suggest that one can use the combination of repeat TUR and intravesical immunotherapy in the management of bulky superficial bladder tumors in an effort to preserve the bladder.

Adult↗
PubMed2001

Combined use of prostate-specific antigen derivatives decreases the number of unnecessary biopsies to detect prostate cancer.

The authors evaluated the prostate cancer detection rate in Turkish patients with prostate-specific antigen (PSA) levels of 4 ng/ml to 10 ng/ml and who had normal digital rectal examination (DRE) findings. They also aimed to evaluate the value of PSA density and percent free PSA in minimizing unnecessary prostate biopsies for these PSA ranges. This prospective study included 134 consecutive men referred for early prostate cancer detection or lower urinary tract symptoms. All men underwent transrectal ultrasound with systematic sextant needle biopsies. The ability of PSA density and percent free PSA to improve the power of PSA in the detection of prostate cancer was evaluated with statistical analyses as well as receiver operating characteristics curves. Among the 134 men, 124 (92.5%) had a benign histology and 10 (7.5%) had cancer diagnosed on the initial biopsies. Despite the disappointing results in regard to the sensitivity and specificity of PSA derivatives alone, the combination of PSA density and percent free PSA significantly increased the area under the curve compared with the use of each test alone. To increase the specificity of PSA in this patient population, the authors recommend combining two PSA derivatives in deciding whether to perform a biopsy. In a PSA range of 4 ng/ml to 10 ng/ml and with normal DRE, a percent free PSA < 21% and a PSA density > 0.18 yields highest specificity with 90% sensitivity.

Adenocarcinoma↗
PubMed2000

Is scrotal violation per se a risk factor for local relapse and metastases in stage I nonseminomatous testicular cancer?

OBJECTIVES: To determine the risk of local recurrence and relapse in patients with Stage I nonseminomatous testicular cancer with scrotal violation. METHODS: From 1983 to 1998, 75 patients with clinical Stage I nonseminomatous testicular cancer who were initially treated with orchiectomy and surveillance alone were retrospectively reviewed. RESULTS: Of 75 patients with Stage I nonseminomatous testicular cancer, 13 had scrotal violation. The surgical margins and the spermatic cords were free of tumor in all patients. Five patients (38%) in the scrotal violation group and 17 patients (27%) in the inguinal orchiectomy group experienced relapses. The difference was not significant (P = 0.41). Local recurrence was not observed in either group. All relapses, except one in the standard inguinal orchiectomy group, were treated successfully with chemotherapy and postchemotherapy surgery, if needed. The progression rate and survival were not significantly different between the two groups. CONCLUSIONS: Scrotal violation without positive surgical margins and tumor spillage does not adversely affect relapse rate and survival. Therefore, scrotal violation per se is not an exclusion criterion for the surveillance-only policy in patients with Stage I nonseminomatous testicular germ cell cancer.

Adolescent↗
PubMed2000

Glycogen storage disease type Ia: frequency and clinical course in Turkish children.

The aim of this study was to determine the relative frequency of type Ia in glycogen storage disease (GSD) with prominent liver involvement and to determine its clinical and laboratory findings and prognosis in Turkish children. From 1980 to 1998, 45 out of 100 GSD patients (27 male) with liver involvement had been diagnosed for type Ia. The files were retrospectively evaluated and clinical and laboratory features were documented. In addition to routine laboratory evaluations, urine albumin, calcium excretions, and plasma biotinidase activity were measured. Breast-feeding was continued in all infants. After 6 months of age, uncooked cornstarch was administered to the patients. The relative frequency of type Ia in GSD with liver involvement was 45%. The diagnosis was made in 71% of patients before 2 years of age (median 1 year). Main complaint was abdominal protruding (57.8%), and main physical finding was hepatomegaly (100%). Forty percent of the patients had growth retardation at diagnosis. Among laboratory parameters, hypertriglyceridemia (97.8%) and hypertransaminasemia (95.6%) were the most frequent findings following plasma biotinidase activity, which was elevated in all patients. Microalbuminuria was determined in 52.8% of the patients and hypercalciuria in 23.8%. Histopathological findings of the liver included fibrosis (75.6%), steatosis (37.8%), mosaicism (24.4%) and nuclear hyperglycogenation (15.6%). During follow-up period, the ratio of patients with growth retardation did not change. Transaminases were decreased in 48.7% of the patients. Although triglyceride and cholesterol levels decreased in the majority of the patients, they did not normalise. The prevalence of type Ia in GSD with prominent liver involvement was found higher than the other reports. Microalbuminuria was also higher than the previous reports.

Adolescent↗
PubMed2000

Short-term effect of captopril on microalbuminuria in children with glycogen storage disease type Ia.

Early signs of renal dysfunction in glycogen storage disease type Ia (GSD Ia) are glomerular hyperfiltration and proteinuria. In a non-randomized study, the effect of captopril on the improvement of proteinuria in GSD Ia patients with microalbuminuria was investigated. A positive effect has been shown for the insulin-dependent diabetes mellitus patients. Microalbuminuria was defined as albumin/creatinine ratio (mg/mmol) more than 2.5 in spot urine. Nineteen (52.7%) out of 36 patients had microalbuminuria, and 8 patients received captopril at a dose of 1 mg/kg per day. Microalbuminuria was evaluated periodically during the follow-up period. Of the captopril-treated patients, one was lost to follow-up. In the remaining 7 patients, urinary albumin excretion normalized in 3 patients (42.9%) and decreased at least by 50% in another 3 patients (42.8%) after 6 months of treatment. One patient, who was the oldest, did not have any benefit. In untreated patients, only two patients had a decrease in microalbuminuria of more than 50%. Patients with microalbuminuria had significantly higher blood lactate (p < 0.05) and plasma triglyceride (p < 0.01) concentrations and significantly lower blood bicarbonate concentration (p < 0.05) than those patients without it. Additionally, the patients with microalbuminuria had been diagnosed earlier than those without microalbuminuria (p < 0.05). Patients with microalbuminuria have more severe clinical and laboratory findings than those without microalbuminuria. Captopril at a dose of 1 mg/kg per day seems to be effective in at least 50% of GSD Ia patients with microalbuminuria.

Adolescent↗
PubMed2000

Adjuvant chemotherapy for non-organ confined disease after radical cystectomy.

Of 50 patients with pT3b, pT4 and/or pN+ disease after cystectomy, 27 were administered adjuvant four cycles of cisplatin, methotrexate and vinblastine (CMV) and 23 were followed expectantly (no-treatment group). Median follow-up was 14 months in CMV group and 11 months in no-treatment group. Median recurrence-free survival was 21 months in CMV group and 17 months in no-treatment group (p = 0.573). Median overall survival was 41+ months in CMV group and 84+ months in no-treatment group, respectively (p = 0.501). In our experience, adjuvant chemotherapy after cystectomy seemed not to provide a survival advantage.

Adult↗