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Khullar V, Lemmon B, Acar O, Abrams P, Vahabi B. Does COVID-19 cause or worsen LUT dysfunction, what are the mechanisms and possible treatments? ICI-RS 2023. Neurourol Urodyn 2024. [PMID: 38506116 DOI: 10.1002/nau.25441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 02/27/2024] [Indexed: 03/21/2024]
Abstract
INTRODUCTION Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) and produced a worldwide pandemic in 2020. There have been 770,875,433 confirmed cases and 6,959,316 attributed deaths worldwide until September 19, 2023. The virus can also affect the lower urinary tract (LUT) leading to bladder inflammation and producing lower urinary tract symptoms (LUTS) in both the acute and chronic phases of disease. METHODS At the 2023 meeting of the International Consultation on Incontinence-Research Society (ICI-RS), the literature relating to COVID-19 and bladder dysfunction was reviewed. The LUTS reported, as well as the pathophysiology of these bladder symptoms, were the subject of considerable discussion. A number of different topics were discussed including lower LUTS reported in COVID-19, how SARS-CoV-2 may infect and affect the urinary tract, and proposed mechanisms for how viral infection result in new, worsened, and in some persisting LUTS. CONCLUSIONS The workshop discussed the interaction between the virus and the immune system, covering current evidence supporting theories underlying the causes of acute and chronic LUTS related to COVID-19 infection. Research questions for further investigation were suggested and identified.
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Affiliation(s)
- Vik Khullar
- Department of Urogynaecology, St Mary's Hospital, Imperial College, London, UK
| | - Berni Lemmon
- Department of Urogynaecology, St Mary's Hospital, Imperial College, London, UK
| | - Omer Acar
- Department of Urology, University of Illinois, Chicago, Illinois, USA
| | - Paul Abrams
- Bristol Urological Institute, Southmead Hospital Bristol, Bristol, UK
| | - Bahareh Vahabi
- School of Applied Sciences, University of the West of England, Bristol, UK
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Tarcan T, Hashim H, Malde S, Sinha S, Sahai A, Acar O, Selai C, Agro EF, Abrams P, Wein A. Can we predict and manage persistent storage and voiding LUTS following bladder outflow resistance reduction surgery in men? ICI-RS 2023. Neurourol Urodyn 2024. [PMID: 38477358 DOI: 10.1002/nau.25435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024]
Abstract
AIMS Lower urinary tract symptoms (LUTS) persist in up to 50% of patients after bladder outflow resistance reduction surgery (BORRS) in men. Our think tank aims to address the predictive factors for persistent LUTS after BORRS and to propose the recommendations for future research to enable improved better patient counseling and selection by more accurate prediction of treatment outcome. METHODS A think tank of ICI-RS gathered in 2023, Bristol, UK, to discuss the pre and postsurgical clinical and urodynamic evaluation of men undergoing BORRS and whether it is possible to predict which men will have persistent LUTS after BORRS. RESULTS Our think tank agrees that due to the multifactorial, and still not fully understood, etiology of male LUTS it is not possible to precisely predict in many men who will have persistent LUTS after BORRS. However, severe storage symptoms (overactive bladder, OAB) in association with low volume and high amplitude detrusor overactivity and low bladder capacity in preoperative urodynamics, increase the likelihood of persistent OAB/storage symptoms after BORRS. Furthermore, patients who are clearly obstructed and have good bladder contractility on preoperative pressure flow studies do better postoperatively compared to their counterparts. However, the benefit of pressure flow studies is decreased in patients who do not acceptably void during the study. Poor voiding after BORRS may occur due to persistent obstruction or detrusor underactivity. CONCLUSION Future research is needed to increase our understanding of why male LUTS persist after surgery, and to enable better patient selection and more precise patient counseling before BORRS.
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Affiliation(s)
- Tufan Tarcan
- Department of Urology, Marmara University School of Medicine, Istanbul, Turkey
- Department of Urology, Koc University School of Medicine, Istanbul, Turkey
| | - Hashim Hashim
- Bristol Urological Institute, Southmead Hospital, Bristol, UK
| | - Sachin Malde
- Department of Urology, Guy's and St Thomas' NHS Foundation Trust & King's College London, London, UK
| | - Sanjay Sinha
- Department of Urology, Apollo Hospital, Hyderabad, India
| | - Arun Sahai
- Bristol Urological Institute, Southmead Hospital, Bristol, UK
| | - Omer Acar
- Department of Urology, Koc University School of Medicine, Istanbul, Turkey
- College of Medicine, Department of Urology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Caroline Selai
- University College London - Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery/UCLH NHS Foundation Trust, London, UK
| | - Enrico Finazzi Agro
- Department of Surgical Sciences, University of Rome Tor Vergata and Urology Unit, Policlinico Tor Vergata University Hospital, Rome, Italy
| | - Paul Abrams
- Bristol Urological Institute, Southmead Hospital, Bristol, UK
| | - Alan Wein
- Desai Sethi Urology Institute, University of Miami, Miller School of Medicine, Miami, Florida, USA
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Acar O, Ayhan M, Demir B, Ekinci F, Aytac A, Erdogan AP. HALP Score as a New Prognostic Factor for Patients with Metastatic Bladder Cancer. J Coll Physicians Surg Pak 2023; 33:1405-1409. [PMID: 38062597 DOI: 10.29271/jcpsp.2023.12.1405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023]
Abstract
OBJECTIVE To investigate the effect of the haemoglobin, albumin, lymphocyte, and platelet (HALP) score (Haemoglobin, Albumin, Lymphocyte, Platelet count) on survival as a new prognostic factor in metastatic bladder cancer. STUDY DESIGN Descriptive study. Place and Duration of the Study: Department of Medical Oncology, Celal Bayar University, Manisa, Turkey, and Adnan Menderes University, Aydin, Turkey, from 2010 to 2020. METHODOLOGY The medical charts of patients with metastatic bladder cancer were reviewed retrospectively. Prognostic value of the HALP score as a marker of overall survival was examined through a receiver operating characteristic (ROC) curve analysis. RESULTS The cut-off value for the HALP score in the ROC curve analysis was 29. The median overall survival (OS) was 19 months when the HALP score was less than 29, and the median OS was 40 months when the HALP score was 29 or greater, and this finding was statistically significant (p = 0.003). CONCLUSION The HALP score is closely related to prognosis in metastatic bladder cancer. A high HALP score is associated with better survival outcomes. KEY WORDS HALP score, Metastatic bladder cancer, Overall survival.
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Affiliation(s)
- Omer Acar
- Department of Medical Oncology, Celal Bayar University, Manisa, Turkey
| | - Murat Ayhan
- Department of Medical Oncology, Adiyaman Training and Research Hospital, Adiyaman, Turkey
| | - Bilgin Demir
- Department of Medical Oncology, Aydin State Hospital, Aydin, Turkey
| | - Ferhat Ekinci
- Department of Medical Oncology, Sirnak State Hospital, Sirnak, Turkey
| | - Ali Aytac
- Department of Medical Oncology, Aydin Adnan Menderes University, Aydin, Turkey
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Millman A, Gabela A, Morgantini L, Acar O, Kocjancic E. Patients' perspectives on informational needs surrounding gender-affirming vaginoplasty. Int J Impot Res 2023:10.1038/s41443-023-00783-5. [PMID: 37880503 DOI: 10.1038/s41443-023-00783-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 09/23/2023] [Accepted: 10/12/2023] [Indexed: 10/27/2023]
Abstract
This study aimed to investigate the informational preferences of patients undergoing gender-affirming vaginoplasty during their surgical journey. An anonymous survey was sent to 30 such patients who had the procedure between September 2018 and September 2020. The survey included Likert-scale questions about the importance of various topics and inquired about their preferred sources and formats for receiving this information. The responses of 17 individuals (56.7% response rate) were analyzed using descriptive statistics and qualitative thematic analysis. Key findings indicated that all topics in the survey were rated as moderately important or higher. Specifically, for 29 out of 30 pre-operative topics (96.7%), participants preferred written information, and for 27 topics (90.0%), they favored receiving information directly from their surgeon. Thematic analysis revealed five main themes: recovery process, satisfaction, trust in healthcare providers, information delivery, and neovaginal dilation and depth. In conclusion, individuals undergoing gender-affirming vaginoplasty have significant informational needs. They prefer to receive information from their surgical team, supplemented by written resources and verbal discussions. Notably, the importance of understanding neovaginal dilation and being aware of possible complications emerged as a key concern. The study also highlighted the importance of cultural competence and trust-building with healthcare providers, underscoring the need for more inclusive care practices.
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Affiliation(s)
- Alexandra Millman
- Department of Urology, University of Illinois at Chicago, Chicago, IL, USA
- Department of Urology, Women's College Hospital, Toronto, ON, Canada
| | - Armin Gabela
- Department of Urology, University of Illinois at Chicago, Chicago, IL, USA
| | - Luca Morgantini
- Department of Urology, University of Illinois at Chicago, Chicago, IL, USA.
| | - Omer Acar
- Department of Urology, University of Illinois at Chicago, Chicago, IL, USA
| | - Ervin Kocjancic
- Department of Urology, University of Illinois at Chicago, Chicago, IL, USA
- Department of Urology, University of Chicago, Chicago, IL, USA
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Wacholder A, Parikh SB, Coelho NC, Acar O, Houghton C, Chou L, Carvunis AR. A vast evolutionarily transient translatome contributes to phenotype and fitness. Cell Syst 2023; 14:363-381.e8. [PMID: 37164009 PMCID: PMC10348077 DOI: 10.1016/j.cels.2023.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 01/30/2023] [Accepted: 04/06/2023] [Indexed: 05/12/2023]
Abstract
Translation is the process by which ribosomes synthesize proteins. Ribosome profiling recently revealed that many short sequences previously thought to be noncoding are pervasively translated. To identify protein-coding genes in this noncanonical translatome, we combine an integrative framework for extremely sensitive ribosome profiling analysis, iRibo, with high-powered selection inferences tailored for short sequences. We construct a reference translatome for Saccharomyces cerevisiae comprising 5,400 canonical and almost 19,000 noncanonical translated elements. Only 14 noncanonical elements were evolving under detectable purifying selection. A representative subset of translated elements lacking signatures of selection demonstrated involvement in processes including DNA repair, stress response, and post-transcriptional regulation. Our results suggest that most translated elements are not conserved protein-coding genes and contribute to genotype-phenotype relationships through fast-evolving molecular mechanisms.
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Affiliation(s)
- Aaron Wacholder
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA; Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Saurin Bipin Parikh
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA; Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA; Integrative Systems Biology Program, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Nelson Castilho Coelho
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA; Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Omer Acar
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA; Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA; Joint CMU-Pitt PhD Program in Computational Biology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Carly Houghton
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA; Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA; Joint CMU-Pitt PhD Program in Computational Biology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Lin Chou
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA; Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA; Integrative Systems Biology Program, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Anne-Ruxandra Carvunis
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA; Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA.
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Kahraman S, Erul E, Seyyar M, Gumusay O, Bayram E, Demirel BC, Acar O, Aksoy S, Baytemur NK, Sahin E, Cabuk D, Basaran G, Paydas S, Yaren A, Guven DC, Erdogan AP, Demirci U, Yasar A, Bayoglu İV, Hizal M, Gulbagci B, Paksoy N, Davarci SE, Yilmaz F, Dogan O, Orhan SO, Kayikcioglu E, Aytac A, Keskinkilic M, Mocan EE, Unal OU, Aydin E, Yucel H, Isik D, Eren O, Uluc BO, Ozcelik M, Hacibekiroglu I, Aydiner A, Demir H, Oksuzoglu B, Cilbir E, Cubukcu E, Cetin B, Oktay E, Erol C, Okutur SK, Yildirim N, Alkan A, Selcukbiricik F, Aksoy A, Karakas Y, Ozkanli G, Duman BB, Aydin D, Dulgar O, Er MM, Teker F, Yavuzsen T, Aykan MB, Inal A, Iriagac Y, Kalkan NO, Keser M, Sakalar T, Menekse S, Kut E, Bilgin B, Karaoglanoglu M, Sunar V, Ozdemir O, Turhal NS, Karadurmus N, Yalcin B, Nahit Sendur MA. Treatment efficacy of ribociclib or palbociclib plus letrozole in hormone receptor-positive/HER2-negative metastatic breast cancer. Future Oncol 2023; 19:727-736. [PMID: 37133230 DOI: 10.2217/fon-2022-1287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
Background: Ribociclib, palbociclib and abemaciclib are currently approved CDK4/6 inhibitors along with aromatase inhibitors as the first-line standard-of-care for patients with hormone receptor-positive, HER2-negative metastatic breast cancer. Methods: The authors report retrospective real-life data for 600 patients with estrogen receptor- and/or progesterone receptor-positive and HER2-negative metastatic breast cancer who were treated with ribociclib and palbociclib in combination with letrozole. Results & conclusion: The results demonstrated that the combination of palbociclib or ribociclib with letrozole has similar progression-free survival and overall survival benefit in real life for the patient group with similar clinical features. Specifically, endocrine sensitivity may be a factor to be considered in the treatment preference.
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Affiliation(s)
- Seda Kahraman
- Department of Medical Oncology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, 06800, Turkey
| | - Enes Erul
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, 06590, Turkey
| | - Mustafa Seyyar
- Department of Medical Oncology, Kocaeli University Medical Faculty Hospital, Kocaeli, 41000, Turkey
| | - Ozge Gumusay
- Department of Medical Oncology, Acibadem University, School of Medicine, Istanbul, 34750, Turkey
| | - Ertugrul Bayram
- Department of Medical Oncology, Cukurova University, Adana, 01330, Turkey
| | - Burcin Cakan Demirel
- Department of Medical Oncology, Pamukkale University Hospital, Denizli, 20160, Turkey
| | - Omer Acar
- Department of Medical Oncology, Manisa Celal Bayar University Hospital, Mersin, 45120, Turkey
| | - Sercan Aksoy
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, 06590, Turkey
| | | | - Elif Sahin
- Department of Medical Oncology, Kocaeli University Medical Faculty Hospital, Kocaeli, 41000, Turkey
| | - Devrim Cabuk
- Department of Medical Oncology, Kocaeli University Medical Faculty Hospital, Kocaeli, 41000, Turkey
| | - Gul Basaran
- Department of Medical Oncology, Acibadem University, School of Medicine, Istanbul, 34750, Turkey
| | - Semra Paydas
- Department of Medical Oncology, Cukurova University, Adana, 01330, Turkey
| | - Arzu Yaren
- Department of Medical Oncology, Pamukkale University Hospital, Denizli, 20160, Turkey
| | - Deniz Can Guven
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, 06590, Turkey
| | - Atike Pinar Erdogan
- Department of Medical Oncology, Manisa Celal Bayar University Hospital, Mersin, 45120, Turkey
| | - Umut Demirci
- Department of Medical Oncology, Ankara Memorial Hospital, Ankara, 06520, Turkey
| | - Alper Yasar
- Department of Medical Oncology, Marmara University Pendik Research & Application Hospital, Istanbul, 34899, Turkey
| | - İbrahim Vedat Bayoglu
- Department of Medical Oncology, Marmara University Pendik Research & Application Hospital, Istanbul, 34899, Turkey
| | - Mutlu Hizal
- Department of Medical Oncology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, 06800, Turkey
| | - Burcu Gulbagci
- Department of Medical Oncology, Sakarya University School of Medicine, Sakarya, 54187, Turkey
| | - Nail Paksoy
- Department of Medical Oncology, Istanbul University, Istanbul, 34093, Turkey
| | - Sena Ece Davarci
- Department of Medical Oncology, Afyonkarahisar Health Sciences University, Afyonkarahisar, 03200, Turkey
| | - Funda Yilmaz
- Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training & Research Hospital, Ankara, 06200, Turkey
| | - Ozlem Dogan
- Department of Medical Oncology, Ankara Etlik City Hospital, Ankara, 06170, Turkey
| | - Sibel Oyucu Orhan
- Department of Medical Oncology, Uludag University, Bursa, 16059, Turkey
| | - Erkan Kayikcioglu
- Department of Medical Oncology, Suleyman Demirel University, Isparta, 32260, Turkey
| | - Ali Aytac
- Department of Medical Oncology, Aydin Adnan Menderes University Training & Research Hospital, Aydin, 09100, Turkey
| | - Merve Keskinkilic
- Department of Medical Oncology, Dokuz Eylül University Research & Application Hospital, Izmir, 35340, Turkey
| | - Eda Eylemer Mocan
- Department Of Medical Oncology, Ankara University, Ankara, 06080, Turkey
| | - Olcun Umit Unal
- Department of Medical Oncology, Tepecik Training & Research Hospital, Izmir, 35180, Turkey
| | - Esra Aydin
- Department of Medical Oncology, Recep Tayyip Erdoğan University Training & Research Hospital, Rize, 53020, Turkey
| | - Hakan Yucel
- Department of Medical Oncology, Gaziantep University, Gaziantep, 27580, Turkey
| | - Deniz Isik
- Department of Medical Oncology, Kocaeli Medical Park Hospital, Kocaeli, 41140, Turkey
| | - Onder Eren
- Department of Medical Oncology, Selcuk University Medical Faculty Hospital, Konya, 42250, Turkey
| | - Basak Oyan Uluc
- Department of Medical Oncology, Acibadem University, School of Medicine, Istanbul, 34750, Turkey
| | - Melike Ozcelik
- Department of Medical Oncology, Umraniye Training & Research Hospital, Istanbul, 34764, Turkey
| | - Ilhan Hacibekiroglu
- Department of Medical Oncology, Sakarya University School of Medicine, Sakarya, 54187, Turkey
| | - Adnan Aydiner
- Department of Medical Oncology, Istanbul University, Istanbul, 34093, Turkey
| | - Hacer Demir
- Department of Medical Oncology, Afyonkarahisar Health Sciences University, Afyonkarahisar, 03200, Turkey
| | - Berna Oksuzoglu
- Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training & Research Hospital, Ankara, 06200, Turkey
| | - Ebru Cilbir
- Department of Medical Oncology, Ankara Etlik City Hospital, Ankara, 06170, Turkey
| | - Erdem Cubukcu
- Department of Medical Oncology, Uludag University, Bursa, 16059, Turkey
| | - Bulent Cetin
- Department of Medical Oncology, Suleyman Demirel University, Isparta, 32260, Turkey
| | - Esin Oktay
- Department of Medical Oncology, Aydin Adnan Menderes University Training & Research Hospital, Aydin, 09100, Turkey
| | - Cihan Erol
- Department of Medical Oncology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, 06800, Turkey
| | - Sadi Kerem Okutur
- Department of Medical Oncology, Istanbul Arel University, Bahcelievler Memorial Hospital, Istanbul, 34537, Turkey
| | - Nilgun Yildirim
- Department of Medical Oncology, Firat University Hospital, Elazig, 23200, Turkey
| | - Ali Alkan
- Department of Medical Oncology, Muğla Sıtkı Koçman University Training & Research Hospital, Mugla, 48000, Turkey
| | - Fatih Selcukbiricik
- Department of Medical Oncology, Koç University Hospital, Istanbul, 34010, Turkey
| | - Asude Aksoy
- Department of Medical Oncology, Elazig Fethi Sekin City Hospital, Elazig, 23280, Turkey
| | - Yusuf Karakas
- Department of Medical Oncology, Acıbadem Bodrum Hospital, Mugla, 48420, Turkey
| | - Gulhan Ozkanli
- Department of Medical Oncology, Canakkale Onsekiz Mart University Research & Practice Hospital, Canakkale, 17100, Turkey
| | - Berna Bozkurt Duman
- Department of Medical Oncology, Adana City Training & Research Hospital, Adana, 01230, Turkey
| | - Dincer Aydin
- Department of Medical Oncology, Kocaeli Derince Training & Research Hospital, Kocaeli, 41310, Turkey
| | - Ozgecan Dulgar
- Department of Medical Oncology, Kahramanmaras Necip Fazil City Hospital, Kahramanmaras, 46050, Turkey
| | - Muhammed Muhiddin Er
- Department of Medical Oncology, Necmettin Erbakan University Meram Medical Faculty Hospital, Konya, 42080, Turkey
| | - Fatih Teker
- Department of Medical Oncology, Gaziantep University, Gaziantep, 27580, Turkey
| | - Tugba Yavuzsen
- Department of Medical Oncology, Dokuz Eylül University Research & Application Hospital, Izmir, 35340, Turkey
| | - Musa Baris Aykan
- Department of Medical Oncology, Gulhane Training & Research Hospital, Ankara, 06010, Turkey
| | - Ali Inal
- Department of Medical Oncology, Mersin City Hospital, Mersin, 96015, Turkey
| | - Yakup Iriagac
- Department of Medical Oncology, Namik Kemal University Health Application & Research Hospital, Tekirdag, 59030, Turkey
| | - Nurhan Onal Kalkan
- Department of Medical Oncology, Van Yüzüncü Yıl University Dursun Odabas Hospital, Van, 65090, Turkey
| | - Murat Keser
- Department of Medical Oncology, Tepecik Training & Research Hospital, Izmir, 35180, Turkey
| | - Teoman Sakalar
- Department of Medical Oncology, Kahramanmaras Necip Fazil City Hospital, Kahramanmaras, 46050, Turkey
| | - Serkan Menekse
- Department of Medical Oncology, Manisa City Hospital, Manisa, 45040, Turkey
| | - Engin Kut
- Department of Medical Oncology, Manisa City Hospital, Manisa, 45040, Turkey
| | - Burak Bilgin
- Department of Medical Oncology, Konya City Hospital, Konya, 42020, Turkey
| | - Muge Karaoglanoglu
- Department of Medical Oncology, Ordu State Hospital, Ordu, 52200, Turkey
| | - Veli Sunar
- Department of Medical Oncology, Aydin Ataturk State Hospital, Aydin, 09020, Turkey
| | - Ozlem Ozdemir
- Department of Medical Oncology, Izmir Bozyaka Training & Research Hospital, Izmir, 35170, Turkey
| | - Nazim Serdar Turhal
- Department of Medical Oncology, Anadolu Medical Center, Istanbul, 34758, Turkey
| | - Nuri Karadurmus
- Department of Medical Oncology, Gulhane Training & Research Hospital, Ankara, 06010, Turkey
| | - Bulent Yalcin
- Department of Medical Oncology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, 06800, Turkey
| | - Mehmet Ali Nahit Sendur
- Department of Medical Oncology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, 06800, Turkey
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Acar O, Alcantar J, Millman A, Naha U, Cedeno JD, Morgantini L, Kocjancic E. Outcomes of penile inversion vaginoplasty and robotic‐assisted peritoneal flap vaginoplasty in obese and nonobese patients. Neurourol Urodyn 2022. [DOI: 10.1002/nau.25077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 10/17/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Omer Acar
- Department of Urology University of Illinois Health and Science Chicago Illinois USA
| | - Jonathan Alcantar
- Department of Urology University of Illinois Health and Science Chicago Illinois USA
| | - Alexandra Millman
- Department of Surgery Women's College Hospital Toronto Ontario Canada
| | - Ushasi Naha
- Department of Urology University of Illinois Health and Science Chicago Illinois USA
| | - Juan Diego Cedeno
- Department of Urology Baptist Health Medical Group Homestead Florida USA
| | - Luca Morgantini
- Department of Urology University of Illinois Health and Science Chicago Illinois USA
| | - Ervin Kocjancic
- Department of Surgery The University of Chicago Medicine Chicago Illinois USA
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8
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Huang JB, Lai A, Morgantini LA, Smith JB, Millman AL, Cedeno JD, Crivellaro S, Acar O, Kocjancic E. Gender‐affirming vaginoplasty: Technical considerations in patients with genital skin deficiency. Neurourol Urodyn 2022. [DOI: 10.1002/nau.25091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 10/22/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Jason B. Huang
- Department of Urology University of Illinois at Chicago Chicago Illinois USA
| | - Andrew Lai
- Department of Urology University of Illinois at Chicago Chicago Illinois USA
| | - Luca A. Morgantini
- Department of Urology University of Illinois at Chicago Chicago Illinois USA
| | - John B. Smith
- Department of Urology University of Illinois at Chicago Chicago Illinois USA
| | - Alexandra L. Millman
- Department of Urology University of Illinois at Chicago Chicago Illinois USA
- Department of Surgery Women's College Hospital Toronto Ontario Canada
| | - Juan D. Cedeno
- Department of Urology University of Illinois at Chicago Chicago Illinois USA
| | - Simone Crivellaro
- Department of Urology University of Illinois at Chicago Chicago Illinois USA
| | - Omer Acar
- Department of Urology University of Illinois at Chicago Chicago Illinois USA
| | - Ervin Kocjancic
- Department of Urology University of Illinois at Chicago Chicago Illinois USA
- Department of Surgery The University of Chicago Medicine Chicago Illinois USA
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9
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Senturk A, Sahin AT, Armutlu A, Kiremit MC, Acar O, Erdem S, Bagbudar S, Esen T, Ozlu N. Quantitative Phosphoproteomics Analysis Uncovers PAK2- and CDK1-Mediated Malignant Signaling Pathways in Clear Cell Renal Cell Carcinoma. Mol Cell Proteomics 2022; 21:100417. [PMID: 36152754 PMCID: PMC9637947 DOI: 10.1016/j.mcpro.2022.100417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 08/23/2022] [Accepted: 09/19/2022] [Indexed: 01/18/2023] Open
Abstract
Clear cell Renal Cell Carcinoma (ccRCC) is among the 10 most common cancers in both men and women and causes more than 140,000 deaths worldwide every year. In order to elucidate the underlying molecular mechanisms orchestrated by phosphorylation modifications, we performed a comprehensive quantitative phosphoproteomics characterization of ccRCC tumor and normal adjacent tissues. Here, we identified 16,253 phosphopeptides, of which more than 9000 were singly quantified. Our in-depth analysis revealed 600 phosphopeptides to be significantly differentially regulated between tumor and normal tissues. Moreover, our data revealed that significantly up-regulated phosphoproteins are associated with protein synthesis and cytoskeletal re-organization which suggests proliferative and migratory behavior of renal tumors. This is supported by a mesenchymal profile of ccRCC phosphorylation events. Our rigorous characterization of the renal phosphoproteome also suggests that both epidermal growth factor receptor and vascular endothelial growth factor receptor are important mediators of phospho signaling in RCC pathogenesis. Furthermore, we determined the kinases p21-activated kinase 2, cyclin-dependent kinase 1 and c-Jun N-terminal kinase 1 to be master kinases that are responsible for phosphorylation of many substrates associated with cell proliferation, inflammation and migration. Moreover, high expression of p21-activated kinase 2 is associated with worse survival outcome of ccRCC patients. These master kinases are targetable by inhibitory drugs such as fostamatinib, minocycline, tamoxifen and bosutinib which can serve as novel therapeutic agents for ccRCC treatment.
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Affiliation(s)
- Aydanur Senturk
- Department of Molecular Biology and Genetics, Koc University, Istanbul, Turkey
| | - Ayse T. Sahin
- Department of Molecular Biology and Genetics, Koc University, Istanbul, Turkey
| | - Ayse Armutlu
- Department of Pathology, Koc University School of Medicine, Istanbul, Turkey
| | - Murat Can Kiremit
- Department of Urology, Koc University School of Medicine, Istanbul, Turkey
| | - Omer Acar
- Department of Urology, Koc University School of Medicine, Istanbul, Turkey
| | - Selcuk Erdem
- Department of Urology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Sidar Bagbudar
- Department of Pathology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Tarik Esen
- Department of Urology, Koc University School of Medicine, Istanbul, Turkey
| | - Nurhan Ozlu
- Department of Molecular Biology and Genetics, Koc University, Istanbul, Turkey,Koc University Research Center for Translational Medicine (KUTTAM), Omics Laboratory, Istanbul, Turkey,For correspondence: Nurhan Ozlu
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10
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11
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Millman A, Morgantini L, Acar O, Kocjancic E. Revision Clitorolabiaplasty and Urethroplasty After Gender-Affirming Vaginoplasty. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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12
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Acar O, Millman A, Morgantini L, Schechter L, Kocjancic E. Revision Vaginoplasty with Abdominal Full-Thickness Skin Graft. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Acar O, Millman A, Morgantini L, Schechter L, Kocjancic E. Gender-Affirming Phalloplasty with Anterolateral Thigh Flap. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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14
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Kocjancic E, Chung E, Garzon JA, Haylen B, Iacovelli V, Jaunarena J, Locke J, Millman A, Nahon I, Ohlander S, Pang R, Plata M, Acar O. International Continence Society (ICS) report on the terminology for sexual health in men with lower urinary tract (LUT) and pelvic floor (PF) dysfunction. Neurourol Urodyn 2022; 41:140-165. [PMID: 34989425 DOI: 10.1002/nau.24846] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION The terminology for sexual health in men with lower urinary tract (LUT) and pelvic floor (PF) dysfunction has not been defined and organized into a clinically based consensus terminology report. The aim of this terminology report is to provide a definitional document within this context that will assist clinical practice and research. METHODS This report combines the input of the members of sexual health in men with LUT and PF Dysfunction working group of the International Continence Society (ICS), assisted at intervals by external referees. Appropriate core clinical categories and a sub-classification were developed to give coding to definitions. An extensive process of 18 rounds of internal and external review was involved to exhaustively examine each definition, with decision-making by collective opinion (consensus). The Committee retained evidence-based definitions, identified gaps, and updated or discarded outdated definitions. Expert opinions were used when evidence was insufficient or absent. RESULTS A terminology report for sexual health in men with LUT and PF dysfunction, encompassing 198 (178 NEW) separate definitions, has been developed. It is clinically based with the most common diagnoses defined. Clarity and user-friendliness have been key aims to make it interpretable by practitioners and trainees in all the different speciality groups involved. Conservative and surgical managements are major additions and appropriate figures have been included to supplement and clarify the text. Emerging concepts and measurements, in use in the literature and offering further research potential, but requiring further validation, have been included as an appendix. Interval (5-10 years) review is anticipated to keep the document updated. CONCLUSION A consensus-based terminology report for sexual health in men with LUT and PF dysfunction has been produced to aid clinical practice and research. The definitions that have been adopted are those that are most strongly supported by the literature at this time or are considered clinical principles or consensus of experts' opinions.
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Affiliation(s)
- Ervin Kocjancic
- Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Eric Chung
- Department of Urology, Greenslopes Private Hospital, Brisbane, Queensland, Australia
| | | | - Bernard Haylen
- Department of Gynaecology, University of New South Wales, Sydney, New South Wales, Australia
| | - Valerio Iacovelli
- Department of Urology, San Carlo di Nancy General Hospital-GVM Care and Research, Tor Vergata University of Rome, Rome, Italy
| | - Jorge Jaunarena
- Division of Urology, Centro de Urologia CDU, Instituto Alexander Fleming, Buenos Aires, Argentina
| | - Jennifer Locke
- Department of Urology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Alexandra Millman
- Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Irmina Nahon
- Discipline of Physiotherapy, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Samuel Ohlander
- Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Ran Pang
- Department of Urology, Guang An Men Hospital, Beijing, China
| | - Mauricio Plata
- Department of Urology, Universidad de los Andes School of Medicine, Fundación Santa fe de Bogotá University, Bogotá, Colombia
| | - Omer Acar
- Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
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15
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Patel DP, Goodwin IA, Acar O, Kocjancic E, Hotaling JM. Masculinizing gender-affirming surgery for trans men and non-binary individuals: what you should know. Fertil Steril 2021; 116:924-930. [PMID: 34404544 DOI: 10.1016/j.fertnstert.2021.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/24/2021] [Accepted: 07/06/2021] [Indexed: 11/30/2022]
Abstract
Gender dysphoria, the discordance between one's gender identity and anatomy, affects nearly 25 million people worldwide, and the prevalence of transgender and non-binary identities is increasing because of greater acceptance and awareness. Because of the improved accessibility to gender-affirming surgery (GAS), many providers will care for patients during and after gender transition. For trans men (female-to-male), GAS represents a combination of procedures rather than a single surgery. The particular combination of masculinizing procedures is chosen on the basis of informed patient-provider discussions regarding the patient's goals and anatomy and implemented through a multidisciplinary team approach. In this review, we describe the common procedures comprising masculinizing GAS to improve delivery of specialized care for this patient population.
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Affiliation(s)
- Darshan P Patel
- Division of Urology, University of Utah School of Medicine, Salt Lake City, Utah
| | - Isak A Goodwin
- Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Omer Acar
- Department of Urology, University of Illinois at Chicago, Chicago, Illinois
| | - Ervin Kocjancic
- Department of Urology, University of Illinois at Chicago, Chicago, Illinois
| | - James M Hotaling
- Division of Urology, University of Utah School of Medicine, Salt Lake City, Utah.
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16
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Senturk A, Sahin AT, Armutlu A, Kiremit MC, Acar O, Erdem S, Bagbudar S, Esen T, Tuncbag N, Ozlu N. Quantitative Proteomics Identifies Secreted Diagnostic Biomarkers as well as Tumor-Dependent Prognostic Targets for Clear Cell Renal Cell Carcinoma. Mol Cancer Res 2021; 19:1322-1337. [PMID: 33975903 DOI: 10.1158/1541-7786.mcr-21-0004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/12/2021] [Accepted: 04/30/2021] [Indexed: 11/16/2022]
Abstract
Clear cell renal cell carcinoma (ccRCC) is the third most common and most malignant urological cancer, with a 5-year survival rate of 10% for patients with advanced tumors. Here, we identified 10,160 unique proteins by in-depth quantitative proteomics, of which 955 proteins were significantly regulated between tumor and normal adjacent tissues. We verified four putatively secreted biomarker candidates, namely, PLOD2, FERMT3, SPARC, and SIRPα, as highly expressed proteins that are not affected by intratumor and intertumor heterogeneity. Moreover, SPARC displayed a significant increase in urine samples of patients with ccRCC, making it a promising marker for the detection of the disease in body fluids. Furthermore, based on molecular expression profiles, we propose a biomarker panel for the robust classification of ccRCC tumors into two main clusters, which significantly differed in patient outcome with an almost three times higher risk of death for cluster 1 tumors compared with cluster 2 tumors. Moreover, among the most significant clustering proteins, 13 were targets of repurposed inhibitory FDA-approved drugs. Our rigorous proteomics approach identified promising diagnostic and tumor-discriminative biomarker candidates which can serve as therapeutic targets for the treatment of ccRCC. IMPLICATIONS: Our in-depth quantitative proteomics analysis of ccRCC tissues identifies the putatively secreted protein SPARC as a promising urine biomarker and reveals two molecular tumor phenotypes.
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Affiliation(s)
- Aydanur Senturk
- Department of Molecular Biology and Genetics, Koc University, Istanbul, Turkey
| | - Ayse T Sahin
- Department of Molecular Biology and Genetics, Koc University, Istanbul, Turkey
| | - Ayse Armutlu
- Department of Pathology, Koc University School of Medicine, Istanbul, Turkey
| | - Murat C Kiremit
- Department of Urology, Koc University School of Medicine, Istanbul, Turkey
| | - Omer Acar
- Department of Urology, Koc University School of Medicine, Istanbul, Turkey
| | - Selcuk Erdem
- Department of Urology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Sidar Bagbudar
- Department of Pathology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Tarik Esen
- Department of Urology, Koc University School of Medicine, Istanbul, Turkey
| | - Nurcan Tuncbag
- Department of Chemical and Biological Engineering, Koc University, Istanbul, Turkey.,Koc University Research Center for Translational Medicine (KUTTAM), Istanbul, Turkey
| | - Nurhan Ozlu
- Department of Molecular Biology and Genetics, Koc University, Istanbul, Turkey. .,Koc University Research Center for Translational Medicine (KUTTAM), Istanbul, Turkey
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17
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Vakirlis N, Acar O, Hsu B, Coelho NC, Van Oss SB, Wacholder A, Medetgul-Ernar K, Bowman RW, Hines CP, Iannotta J, Parikh SB, McLysaght A, Camacho CJ, O'Donnell AF, Ideker T, Carvunis AR. Author Correction: De novo emergence of adaptive membrane proteins from thymine-rich genomic sequences. Nat Commun 2021; 12:200. [PMID: 33398071 PMCID: PMC7782721 DOI: 10.1038/s41467-020-20609-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Nikolaos Vakirlis
- Smurfit Institute of Genetics, Trinity College Dublin, University of Dublin, Dublin 2, Ireland
| | - Omer Acar
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA.,Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Brian Hsu
- Department of Medicine, Division of Medical Genetics, University of California San Diego, La Jolla, CA, 92093, USA
| | - Nelson Castilho Coelho
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA.,Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - S Branden Van Oss
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA.,Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Aaron Wacholder
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA.,Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Kate Medetgul-Ernar
- Department of Medicine, Division of Medical Genetics, University of California San Diego, La Jolla, CA, 92093, USA
| | - Ray W Bowman
- Department of Biological Sciences, University of Pittsburgh, Pittsburgh, PA, 15260, USA
| | - Cameron P Hines
- Department of Medicine, Division of Medical Genetics, University of California San Diego, La Jolla, CA, 92093, USA
| | - John Iannotta
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA.,Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Saurin Bipin Parikh
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA.,Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Aoife McLysaght
- Smurfit Institute of Genetics, Trinity College Dublin, University of Dublin, Dublin 2, Ireland
| | - Carlos J Camacho
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Allyson F O'Donnell
- Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA. .,Department of Biological Sciences, University of Pittsburgh, Pittsburgh, PA, 15260, USA.
| | - Trey Ideker
- Department of Medicine, Division of Medical Genetics, University of California San Diego, La Jolla, CA, 92093, USA.
| | - Anne-Ruxandra Carvunis
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA. .,Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
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18
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Acar O, Izydorczyk M, McMillan T, Yazici M, Ozdemir B, Cakmak I, Koksel H. An investigation on minerals, arabinoxylans and other fibres of biofortified hull-less barley fractions obtained by two milling systems. J Cereal Sci 2020. [DOI: 10.1016/j.jcs.2020.103098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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19
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Tarim K, Kilic M, Koseoglu E, Canda AE, Kordan Y, Balbay MD, Acar O, Esen T. Feasibility, safety and efficacy of argon beam coagulation in robot-assisted partial nephrectomy for solid renal masses ≤ 7 cm in size. J Robot Surg 2020; 15:671-677. [DOI: 10.1007/s11701-020-01158-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 10/05/2020] [Indexed: 10/23/2022]
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20
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Kocjancic E, Acar O, Talamini S, Halgrimson W, Morgantini L, Sofer L. Modified pubovaginal sling with adjustable tensioning mechanism for female stress urinary incontinence. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34210-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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21
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Acar O, Dobbs RW, Kocjancic E. AUTHORS' REPLY. Urology 2020; 138:173. [DOI: 10.1016/j.urology.2019.11.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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22
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Acar O, Sofer L, Dobbs RW, Greenwald DT, Halgrimson WR, Crivellaro S, Kocjancic E. Single Port and Multiport Approaches for Robotic Vaginoplasty With the Davydov Technique. Urology 2020; 138:166-173. [DOI: 10.1016/j.urology.2019.11.043] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 11/05/2019] [Accepted: 11/07/2019] [Indexed: 10/25/2022]
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23
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Kocjancic E, Acar O, Talamini S, Schechter L. Masculinizing genital gender-affirming surgery: metoidioplasty and urethral lengthening. Int J Impot Res 2020; 34:120-127. [PMID: 32203431 DOI: 10.1038/s41443-020-0259-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 02/27/2020] [Accepted: 03/06/2020] [Indexed: 11/09/2022]
Abstract
Metoidioplasty denotes the creation of a neophallus out of the hormonally hypertrophied clitoris. Construction of an esthetically acceptable male-like genitalia while enabling micturition in standing position are the primary goals. Herein, we aim to review the literature regarding masculinizing gender-affirming genital surgery in the form of metoidioplasty, focusing on the steps related to urethral lengthening and reconstruction, and describe the authors' preferred surgical technique. Clitoral release, division of the urethral plate, native urethral lengthening with anterior vaginal wall flap, and neourethral tubularization using a combination of buccal mucosa graft and labia minora flap(s) seem to provide the best result in terms of urinary outcomes. This is reflected in a greater urethral length, higher probability of standing micturition, and lower incidence of fistula. Urethral complications, which can be encountered in up to 15% of the patients, may necessitate additional procedures. Some of the studies have reported successful penetrative intercourse following metoidioplasty. Case series about different metoidioplasty techniques do not allow head-to-head comparison due to non-standardized reporting and outcome assessment. Metoidioplasty can be offered to transgender men with sufficiently hypertrophied clitoris who wish to avoid a complicated, multistage, flap-based total phalloplasty, or for those individuals considering phalloplasty at a later date.
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Affiliation(s)
- Ervin Kocjancic
- University of Illinois at Chicago, College of Medicine, Department of Urology, Chicago, IL, USA
| | - Omer Acar
- University of Illinois at Chicago, College of Medicine, Department of Urology, Chicago, IL, USA.
| | - Susan Talamini
- University of Illinois at Chicago, College of Medicine, Department of Urology, Chicago, IL, USA
| | - Loren Schechter
- Weiss Memorial Hospital, Center for Gender Confirmation Surgery, Division of Plastic and Reconstructive Surgery, Chicago, IL, USA
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24
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Vakirlis N, Acar O, Hsu B, Castilho Coelho N, Van Oss SB, Wacholder A, Medetgul-Ernar K, Bowman RW, Hines CP, Iannotta J, Parikh SB, McLysaght A, Camacho CJ, O'Donnell AF, Ideker T, Carvunis AR. De novo emergence of adaptive membrane proteins from thymine-rich genomic sequences. Nat Commun 2020; 11:781. [PMID: 32034123 PMCID: PMC7005711 DOI: 10.1038/s41467-020-14500-z] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 12/20/2019] [Indexed: 11/14/2022] Open
Abstract
Recent evidence demonstrates that novel protein-coding genes can arise de novo from non-genic loci. This evolutionary innovation is thought to be facilitated by the pervasive translation of non-genic transcripts, which exposes a reservoir of variable polypeptides to natural selection. Here, we systematically characterize how these de novo emerging coding sequences impact fitness in budding yeast. Disruption of emerging sequences is generally inconsequential for fitness in the laboratory and in natural populations. Overexpression of emerging sequences, however, is enriched in adaptive fitness effects compared to overexpression of established genes. We find that adaptive emerging sequences tend to encode putative transmembrane domains, and that thymine-rich intergenic regions harbor a widespread potential to produce transmembrane domains. These findings, together with in-depth examination of the de novo emerging YBR196C-A locus, suggest a novel evolutionary model whereby adaptive transmembrane polypeptides emerge de novo from thymine-rich non-genic regions and subsequently accumulate changes molded by natural selection. There is increasing evidence that protein-coding genes can emerge de novo from noncoding genomic regions. Vakirlis et al. propose that sequences encoding transmembrane polypeptides can emerge de novo in thymine-rich genomic regions and provide organisms with fitness benefits.
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Affiliation(s)
- Nikolaos Vakirlis
- Smurfit Institute of Genetics, Trinity College Dublin, University of Dublin, Dublin, 2, Ireland
| | - Omer Acar
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, United States.,Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, United States
| | - Brian Hsu
- Department of Medicine, Division of Medical Genetics, University of California San Diego, La Jolla, CA, 92093, United States
| | - Nelson Castilho Coelho
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, United States.,Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, United States
| | - S Branden Van Oss
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, United States.,Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, United States
| | - Aaron Wacholder
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, United States.,Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, United States
| | - Kate Medetgul-Ernar
- Department of Medicine, Division of Medical Genetics, University of California San Diego, La Jolla, CA, 92093, United States
| | - Ray W Bowman
- Department of Biological Sciences, University of Pittsburgh, Pittsburgh, PA, 15260, United States
| | - Cameron P Hines
- Department of Medicine, Division of Medical Genetics, University of California San Diego, La Jolla, CA, 92093, United States
| | - John Iannotta
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, United States.,Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, United States
| | - Saurin Bipin Parikh
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, United States.,Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, United States
| | - Aoife McLysaght
- Smurfit Institute of Genetics, Trinity College Dublin, University of Dublin, Dublin, 2, Ireland
| | - Carlos J Camacho
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, United States
| | - Allyson F O'Donnell
- Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, United States. .,Department of Biological Sciences, University of Pittsburgh, Pittsburgh, PA, 15260, United States.
| | - Trey Ideker
- Department of Medicine, Division of Medical Genetics, University of California San Diego, La Jolla, CA, 92093, United States.
| | - Anne-Ruxandra Carvunis
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, United States. .,Pittsburgh Center for Evolutionary Biology and Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, United States.
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25
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Acar O, Sanal T, Köksel H. Effects of wheat kernel size on hardness and various quality characteristics. Quality Assurance and Safety of Crops & Foods 2019. [DOI: 10.3920/qas2019.1552] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- O. Acar
- Food Technology Department, Field Crops Central Research Institute, Şehit Cem Ersever Cad. 9, Yenimahalle, 06170 Ankara, Turkey
| | - T. Sanal
- Food Technology Department, Field Crops Central Research Institute, Şehit Cem Ersever Cad. 9, Yenimahalle, 06170 Ankara, Turkey
| | - H. Köksel
- Food Engineering Department, Hacettepe University, Beytepe, 06510 Ankara, Turkey
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Kiremit MC, Koseoglu E, Acar O, Kilic M, Kordan Y, Canda AE, Balbay MD, Esen T. Distal ureteral stone formation over migrated Hem-o-lok clip after robot-assisted partial nephrectomy. Int J Surg Case Rep 2019; 58:201-204. [PMID: 31078991 PMCID: PMC6514724 DOI: 10.1016/j.ijscr.2019.03.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 03/03/2019] [Accepted: 03/19/2019] [Indexed: 11/30/2022] Open
Abstract
Foreign bodies, such as suture materials, mesh, cotton swab, Hem-o-lok clips, metallic clips, coils used for angioembolization etc. are rare causes of urinary tract stone disease. Clinicians should be aware of the possibility of migrated hem-o-lok clips serving as a nidus for urinary tract stone formation in patients who have undergone endoscopic PN. Attention to suture tension during endoscopic partial nephrectomy may reduce the risk of clip migration. Laser lithotripsy of the calculous cortical rim around the Hem-o-lok clip(s) and removal of the denuded foreign body under direct endoscopic visualization are strongly advisable, since Hem-o-lok clips are usually SWL-resistant.
Introduction Hem-o-lok clip migration into the ipsilateral collecting system and formation of a distal ureteral stone after robot-assited partial nephrectomy (PN) is a rare condition of stone disease. Presentation of case A 48-year-old male presented with hematuria. Physical examination was unremarkable. Urinalysis showed presence of red blood cells. Serum multiple analysis and ultrasonography were within normal limits. Contrast enhanced abdominal computerized tomography scan revealed an 8-mm right distal ureteral stone, which was not associated with ipsilateral hydronephrosis. Discussion With the widespread adoption of minimally invasive surgery, it is not uncommon to utilize foreign bodies as surgical facilitators which also have the potential to migrate to the urothelium-lined urinary tract and act as a stone nidus when used for endoscopic PN Conclusion Clinicians should be aware of the possibility of migrated hem-o-lok clips serving as a nidus for urinary tract stone formation in patients who have undergone endoscopic PN.
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Affiliation(s)
| | - Ersin Koseoglu
- Department of Urology, Koc University Hospital, Istanbul, Turkey.
| | - Omer Acar
- Department of Urology, Koc University, School of Medicine, Istanbul, Turkey
| | - Mert Kilic
- Department of Urology, VKF Amerikan Hospital, Istanbul, Turkey
| | - Yakup Kordan
- Department of Urology, Koc University, School of Medicine, Istanbul, Turkey
| | | | | | - Tarık Esen
- Department of Urology, Koc University, School of Medicine, Istanbul, Turkey
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Kiremit MC, Acar O, Sag AA, Koseoglu E, Kilic M, Kordan Y, Balbay MD. Minimally Invasive Management of Zinner's Syndrome with Same-Session Robot-Assisted Seminal Vesiculectomy and Ipsilateral Nephroureterectomy Using a Single Geometry of Trocars. J Endourol Case Rep 2018; 4:186-189. [PMID: 30410997 PMCID: PMC6222210 DOI: 10.1089/cren.2018.0066] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Seminal vesicle cyst is an extremely rare condition, which is frequently congenital and associated with Zinner's syndrome. This syndrome represents a constellation of seminal vesicle cyst, ipsilateral or contralateral renal agenesis or renal dysplasia, ureteral ectopia, and ejaculatory duct obstruction. We report a young symptomatic patient undergoing robot-assisted laparoscopic excision of a huge seminal vesicle cyst during which an atrophic ipsilateral kidney was discovered incidentally and managed by nephroureterectomy in the same session without changing trocar positions. Case Presentation: A 23-year-old male patient presented with a 2-year history of lower urinary tract symptoms, perineal pain, and recurrent urinary tract infections. Ultrasonography revealed the absence of left kidney and a fluid-filled cystic lesion located behind the bladder on the left side, which was consistent with cystic dilatation of the left seminal vesicle. MRI confirmed the diagnosis of a huge cystic structure originating from the left seminal vesicle and identified the presence of a rudimentary left ureter without an associated renal unit. Cystoscopy revealed bulging of the bladder neck at 6 o'clock position and the ureteral orifices at normal positions and configurations. Based on these findings, the clinical diagnosis was established as Zinner's syndrome. The present case was performed by Da Vinci Si robotic platform using the 5-trocar technique. Conclusion: Robot-assisted laparoscopic excision is a safe and feasible option to treat large seminal vesicle cysts, which may be a component of Zinner's syndrome. Simultaneous upper urinary tract interventions, such as nephroureterectomy, can be employed by redocking the robot and repositioning the patient, using the same layout of robotic trocars.
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Affiliation(s)
| | - Omer Acar
- Department of Urology, Koc University, Istanbul, Turkey
| | - Alan Alper Sag
- Division of Interventional Radiology, Department of Radiology, Eastern Virginia School of Medicine, Norfolk, Virginia
| | - Ersin Koseoglu
- Department of Urology, Koc University Hospital, Istanbul, Turkey
| | - Mert Kilic
- Department of Urology, Amerikan Hospital, Istanbul, Turkey
| | - Yakup Kordan
- Department of Urology, Koc University, Istanbul, Turkey
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Abdizadeh H, Tamer YT, Acar O, Toprak E, Atilgan AR, Atilgan C. Increased substrate affinity in the Escherichia coli L28R dihydrofolate reductase mutant causes trimethoprim resistance. Phys Chem Chem Phys 2018; 19:11416-11428. [PMID: 28422217 DOI: 10.1039/c7cp01458a] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Dihydrofolate reductase (DHFR) is a ubiquitous enzyme with an essential role in cell metabolism. DHFR catalyzes the reduction of dihydrofolate to tetrahydrofolate, which is a precursor for purine and thymidylate synthesis. Several DHFR targeting antifolate drugs including trimethoprim, a competitive antibacterial inhibitor, have therefore been developed and are clinically used. Evolution of resistance against antifolates is a common public health problem rendering these drugs ineffective. To combat the resistance problem, it is important to understand resistance-conferring changes in the DHFR structure and accordingly develop alternative strategies. Here, we structurally and dynamically characterize Escherichia coli DHFR in its wild type (WT) and trimethoprim resistant L28R mutant forms in the presence of the substrate and its inhibitor trimethoprim. We use molecular dynamics simulations to determine the conformational space, loop dynamics and hydrogen bond distributions at the active site of DHFR for the WT and the L28R mutant. We also report their experimental kcat, Km, and Ki values, accompanied by isothermal titration calorimetry measurements of DHFR that distinguish enthalpic and entropic contributions to trimethoprim binding. Although mutations that confer resistance to competitive inhibitors typically make enzymes more promiscuous and decrease affinity to both the substrate and the inhibitor, strikingly, we find that the L28R mutant has a unique resistance mechanism. While the binding affinity differences between the WT and the mutant for the inhibitor and the substrate are small, the newly formed extra hydrogen bonds with the aminobenzoyl glutamate tail of DHF in the L28R mutant leads to increased barriers for the dissociation of the substrate and the product. Therefore, the L28R mutant indirectly gains resistance by enjoying prolonged binding times in the enzyme-substrate complex. While this also leads to slower product release and decreases the catalytic rate of the L28R mutant, the overall effect is the maintenance of a sufficient product formation rate. Finally, the experimental and computational analyses together reveal the changes that occur in the energetic landscape of DHFR upon the resistance-conferring L28R mutation. We show that the negative entropy associated with the binding of trimethoprim in WT DHFR is due to water organization at the binding interface. Our study lays the framework to study structural changes in other trimethoprim resistant DHFR mutants.
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Affiliation(s)
- Haleh Abdizadeh
- Faculty of Engineering and Natural Sciences, Sabanci University, Istanbul, Turkey.
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Demirkol MO, Kiremit MC, Acar O, Falay O, Ucar B, Esen T. Local Salvage Treatment of Post-brachytherapy Recurrent Prostate Cancer via Theranostic Application of PSMA-labeled Lutetium-177. Clin Genitourin Cancer 2017; 16:99-102. [PMID: 29074285 DOI: 10.1016/j.clgc.2017.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 09/17/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Mehmet Onur Demirkol
- Department of Nuclear Medicine and Molecular Imaging, Koc University School of Medicine, Istanbul, Turkey; Department of Nuclear Medicine and Molecular Imaging, VKF American Hospital, Istanbul, Turkey
| | | | - Omer Acar
- Department of Urology, Koc University School of Medicine, Istanbul, Turkey
| | - Okan Falay
- Department of Nuclear Medicine and Molecular Imaging, Koc University Hospital, Istanbul, Turkey
| | - Burcu Ucar
- Department of Nuclear Medicine and Molecular Imaging, VKF American Hospital, Istanbul, Turkey
| | - Tarik Esen
- Department of Urology, Koc University School of Medicine, Istanbul, Turkey
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Cetiner B, Acar O, Kahraman K, Sanal T, Koksel H. An investigation on the effect of heat-moisture treatment on baking quality of wheat by using response surface methodology. J Cereal Sci 2017. [DOI: 10.1016/j.jcs.2017.01.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Acar O, Mutlu HH, Uzunlulu M, Telci Caklili O, Oguz A. Effects of the Beginning of the Academic Year on Hospital Mortality: Is the July Phenomenon Real? Cyprus J Med Sci 2017. [DOI: 10.5152/cjms.2016.116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Afsar B, Kiremit MC, Sag AA, Tarim K, Acar O, Esen T, Solak Y, Covic A, Kanbay M. Corrigendum to "The role of sodium intake in nephrolithiasis: Epidemiology, pathogenesis, and future directions" [Eur J Intern Med 35 (2016) 16-19]. Eur J Intern Med 2017; 37:90. [PMID: 27899242 DOI: 10.1016/j.ejim.2016.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Baris Afsar
- Division of Nephrology, Department of Medicine, Konya Numune State Hospital, Konya, Turkey
| | - Murat C Kiremit
- Department of Urology, Koc University School of Medicine, Istanbul, Turkey
| | - Alan A Sag
- Division of Interventional Radiology, Department of Radiology, Koc University School of Medicine, Istanbul, Turkey
| | - Kayhan Tarim
- Division of Nephrology, Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Omer Acar
- Department of Urology, Koc University School of Medicine, Istanbul, Turkey
| | - Tarik Esen
- Department of Urology, Koc University School of Medicine, Istanbul, Turkey
| | - Yalcin Solak
- Department of Nephrology, Sakarya Training and Research Hospital, Sakarya, Turkey
| | - Adrian Covic
- Nephrology Clinic, Dialysis and Renal Transplant Center, 'C.I. PARHON' University Hospital, and 'Grigore T. Popa' University of Medicine, Iasi, Romania
| | - Mehmet Kanbay
- Division of Nephrology, Department of Medicine, Koc University School of Medicine, Istanbul, Turkey.
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Afsar B, Kiremit MC, Sag AA, Tarim K, Acar O, Esen T, Solak Y, Covic A, Kanbay M. The role of sodium intake in nephrolithiasis: epidemiology, pathogenesis, and future directions. Eur J Intern Med 2016; 35:16-19. [PMID: 27444735 DOI: 10.1016/j.ejim.2016.07.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 06/20/2016] [Accepted: 07/01/2016] [Indexed: 12/23/2022]
Abstract
The prevalence of nephrolithiasis has doubled over the last decade and the incidence in females now approaches that of males. Since dietary salt is lithogenic, a purported mechanism common to both genders is excess dietary sodium intake vis-a-vis processed and fast foods. Nephrolithiasis has far-reaching societal implications such as impact on gross domestic product due to days lost from work (stone disease commonly affects working adults), population-wide carcinogenic diagnostic and interventional radiation exposure (kidney stone disease is typically imaged with computed tomographic imaging and treated under imaging guidance and follow-up), and rising healthcare costs (surgical treatment will be indicated for a number of these patients). Therefore, primary prevention of kidney stone disease via dietary intervention is a low-cost public health initiative with massive societal implications. This primer aims to establish baseline epidemiologic and pathophysiologic principles to guide clinicians in sodium-directed primary prevention of kidney stone disease.
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Affiliation(s)
- Baris Afsar
- Division of Nephrology, Department of Medicine, Konya Numune State Hospital, Konya, Turkey
| | - Murat C Kiremit
- Department of Urology, Koc University School of Medicine, Istanbul, Turkey
| | - Alan A Sag
- Division of Interventional Radiology, Department of Radiology, Koc University School of Medicine, Istanbul, Turkey
| | - Kayhan Tarim
- Division of Nephrology, Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Omer Acar
- Department of Urology, Koc University School of Medicine, Istanbul, Turkey
| | - Tarik Esen
- Department of Urology, Koc University School of Medicine, Istanbul, Turkey
| | - Yalcin Solak
- Department of Nephrology, Sakarya Training and Research Hospital, Sakarya, Turkey
| | - Adrian Covic
- Nephrology Clinic, Dialysis and Renal Transplant Center, 'C.I. PARHON' University Hospital, and 'Grigore T. Popa' University of Medicine, Iasi, Romania
| | - Mehmet Kanbay
- Division of Nephrology, Department of Medicine, Koc University School of Medicine, Istanbul, Turkey.
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Abdizadeh H, Acar O, Furkan Guclu T, Talha Tamer Y, Altinusak Batur T, Toprak E, Rana Atilgan A, Atilgan C. Computational Assessment of Trimethoprim Resistance in Dihydrofolate Reductase. Biophys J 2016. [DOI: 10.1016/j.bpj.2015.11.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Acar O, Esen T, Colakoglu B, Camli MF, Cakmak YO. Improving testicular blood flow with electroacupuncture-like percutaneous nerve stimulation in an experimental rat model of testicular torsion. Neuromodulation 2014; 18:324-8; discussion 328. [PMID: 25284428 DOI: 10.1111/ner.12246] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 08/06/2014] [Accepted: 08/25/2014] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The purpose of this study was to determine the blood-flow-enhancing effect of electroacupuncture (EA) in an experimental rat model of testicular torsion. METHODS At the first stage, 3D color Doppler ultrasound (3D-CDUS) scans were made to detect baseline perfusion of each testicle in 12 male albino Wistar rats. Then, the left testicles of all rats were twisted 180° clockwise, and 3D-CDUS recordings were repeated. In the next step, 10-Hz EA was applied for 5 min over the T13 and L4 dermatome territories in the study group of six rats. In the control group of six rats, acupuncture needles were inserted in the same manner, but EA was not applied. Baseline, posttorsion, and postintervention (EA and manual needling) 3D-CDUS perfusion recordings were interpreted as volumetric data, and group comparisons were performed. RESULTS After EA, we observed statistically significant perfusion improvements in both the ipsilateral torsed and contralateral nontorsed testicles. In the control group, testicular perfusion did not show a significant change after manual needling. CONCLUSION EA can improve testicular blood flow bilaterally in a rat model of unilateral testicular torsion at 180°.
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Affiliation(s)
- Omer Acar
- Department of Urology, VKF American Hospital, Istanbul, Turkey
| | - Tarik Esen
- Department of Urology, VKF American Hospital, Istanbul, Turkey.,Department of Urology, School of Medicine, Koc University, Istanbul, Turkey
| | - Bulent Colakoglu
- Department of Radiology, VKF American Hospital, Istanbul, Turkey
| | - Mehmet Fatih Camli
- Non-Invasive Brain Stimulation Lab, Department of Anatomy, School of Medicine, Koc University, Istanbul, Turkey
| | - Yusuf Ozgur Cakmak
- Non-Invasive Brain Stimulation Lab, Department of Anatomy, School of Medicine, Koc University, Istanbul, Turkey
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Cakiroglu B, Eyyupoglu SE, Tas T, Esen T, Acar O, Aksoy SH. Renal papillary attenuation differences between primary and recurrent idiopathic calcium stone disease patients. MINERVA UROL NEFROL 2014; 66:107-112. [PMID: 24988201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM The aim of this paper was to investigate whether renal papillae of patients with nephrolithiasis are more radiodense than that of control patients and to evaluate the predictability of urolithiasis using papillary density differences between stone and non-stone formers. METHODS Renal papillary Hounsfield Unit (HU) measurements were conducted at the level of upper pole, middle region and lower pole of both kidneys in a total of 126 primary (group 1), 133 recurrent (group 2) stone disease patients and 108 controls (group 3). RESULT Mean patient age did not differ significantly between groups (P>0.05). Mean stone diameters (±SD) were 5.0±3.1 mm (3-9 mm) and 6.1±3.3 mm (3-15 mm) for primary and recurrent groups, respectively and group distributions and variances were similar (P>0.05). Mean papillary attenuation values (±SD) were 27.26±9.30 (4.00-56.00) in group 1, 30.42±9.88 (12.00-64.00) in group 2 and 25.83±2.72 (20.30-32.56) in the control group. The difference between the mean papillary attenuation value of the primary stone disease group and the control group was statistically insignificant (P=0.104). When the control group and the recurrent stone group was compared without variances, in terms of the mean renal papillary attenuation value, a statistical significance was achieved (P=0.000). CONCLUSION With increasing renal papillary HU values, the risk of recurrent calcium stone disease is increased.
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Affiliation(s)
- B Cakiroglu
- Hisar Intercontinental Hospital Deparment of Urology, Umraniye Istanbul, Turkey -
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Acar O, Esen T, Bavbek S, Peker O, Musaoğlu A. Port site and peritoneal metastases after robot-assisted radical prostatectomy. Int J Surg Case Rep 2014; 5:131-4. [PMID: 24531016 DOI: 10.1016/j.ijscr.2014.01.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 01/17/2014] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Port site metastasis after minimally invasive urologic surgery is a rare event despite the widespread utility of laparoscopic techniques in the management of urologic malignancies. Herein, we report a case of port site metastasis after robot-assisted radical prostatectomy. PRESENTATION OF CASE A currently 77-year-old male patient, who was diagnosed with cT2c, Gleason 7 (4+3) prostate adenocarcinoma in our clinic back in 2009, had undergone robot-assisted radical prostatectomy elsewhere. Histopathological examination revealed pT3a, Gleason 9 (4+5) disease. Lymph nodes were negative, however surgical margins were positive on the right side. PSA recurred after 9 months and maximal androgen blockade was initiated. Despite antiandrogenic manipulations, PSA reached 0.83ng/ml, 33 months postoperatively. Concurrently, we noticed a palpable anterior abdominal mass which demonstrated metabolic hyperactivity on PET scanning. Percutaneous biopsy of the lesion confirmed the presence of metastatic adenocarcinoma. PSA did not normalize after the complete excision of the metastatic focus. Repeated PET scan revealed multiple implants on the peritoneal surfaces of various organs. DISCUSSION Port site and peritoneal metastasis of prostate cancer after robot-assisted radical prostatectomy has not been reported so far. This peculiar dissemination pattern is most probably the result of tumor biology and perioperative factors. CONCLUSION Although encountered extremely rarely, surgeons should be aware of the possibility of port site and/or peritoneal metastases after minimally invasive radical prostatectomy.
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Affiliation(s)
- Omer Acar
- Department of Urology, VKF American Hospital, Nisantasi, 34365 Istanbul, Turkey.
| | - Tarık Esen
- Department of Urology, VKF American Hospital, Nisantasi, 34365 Istanbul, Turkey; School of Medicine, Koc University, Rumelifeneri Yolu, 34450 Istanbul, Turkey
| | - Sevil Bavbek
- Department of Medical Oncology, VKF American Hospital, Nisantasi, 34365 Istanbul, Turkey
| | - Onder Peker
- Department of Pathology, VKF American Hospital, Nisantasi, 34365 Istanbul, Turkey
| | - Ahmet Musaoğlu
- Department of Urology, VKF American Hospital, Nisantasi, 34365 Istanbul, Turkey
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Oktar T, Salabas E, Acar O, Atar A, Nane I, Ander H, Ziylan O. Residual valve and stricture after posterior urethral valve ablation: how to evaluate? J Pediatr Urol 2013; 9:184-7. [PMID: 22364895 DOI: 10.1016/j.jpurol.2012.01.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2011] [Accepted: 01/24/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate the clinical and radiological parameters of posterior urethral valve (PUV) patients with residual valve or strictures after primary valve ablation. PATIENTS AND METHODS A total of 127 PUV patients were treated in our clinic between 1986 and 2009. We retrospectively reviewed the records of 101 patients, who had at least 1 year of follow-up data, regarding the presence of valve remnants or urethral strictures after PUV ablation. RESULTS A total of 21 patients (20.8%) underwent repeat-urethroscopy and, of these, residual valve leaflets or stricture were detected in 10 patients (10/101, 9.9%). In 2 of these 10 (20%), the urethra had been found to be normal on the first voiding cystourethrogram following ablation. However, these two boys underwent re-urethroscopy due to persistent vesicoureteral reflux in one and persistent hydroureteronephrosis in the other, and valve remnants were detected. The remaining 8 cases had radiological signs consistent with persistent infravesical obstruction in the early period. Obstruction was due to urethral stricture and residual valve remnants in 2 and 6 cases, respectively. CONCLUSIONS There was clinical suspicion of residual valve in about 20% of the cases and in half of these the urethra was found to be normal on urethroscopy. The possible presence of residual valve remnants after primary valve ablation should be confirmed by careful clinical, radiological and endoscopic evaluation.
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Affiliation(s)
- Tayfun Oktar
- Department of Urology, Istanbul Faculty of Medicine, Istanbul University, 34093 Capa, Istanbul, Turkey.
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Oktar T, Acar O, Sancaktutar A, Sanlı O, Tefik T, Ziylan O. Endoscopic treatment of vesicoureteral reflux in children with posterior urethral valves. Int Urol Nephrol 2012; 44:1305-9. [PMID: 22767179 DOI: 10.1007/s11255-012-0240-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2012] [Accepted: 06/22/2012] [Indexed: 11/29/2022]
Abstract
PURPOSE We reviewed the clinical outcome of endoscopic injection therapy in children with vesicoureteral reflux persisting after posterior urethral valve ablation. METHODS We retrospectively reviewed the charts of 16 patients with posterior urethral valves who have undergone endoscopic injection to correct persistent reflux after successful relief of urethral obstruction. Breakthrough urinary tract infections, persistent high-grade reflux and failed ureteroneocystostomy were the indications of endoscopic antireflux surgery. RESULTS Reflux was grade I in 1, grade II in 3, grade III in 11 and grade IV in 4 ureters. Mean age at injection was 6.9 ± 3.8 years and the mean interval from initial intervention to injection was 4.3 ± 2.4 years. Injected material was dextranomer/hyaluronic acid in the majority (87.5 %) of cases. Reflux was resolved or downgraded in 12 ureters (63.1 %) after a single injection. All failed cases had urodynamically documented bladder dysfunction. CONCLUSION More than half of the patients with vesicoureteral reflux, persisting after initial valve ablation, showed complete resolution or significant downgrading in their reflux grade after endoscopic injection. Given the technical difficulties and potential complications of open surgical reimplantation in valve patients, endoscopic subureteral injection can be considered as an effective alternative to cure persistent vesicoureteral reflux.
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Affiliation(s)
- Tayfun Oktar
- Department of Urology, Istanbul Faculty of Medicine, Istanbul University, 34093 Capa, Istanbul, Turkey.
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Esen T, Acar O, Peker K, Sarman K, Musaoglu A, Tefekli A. Malignant mesothelioma of the tunica vaginalis: presenting with intermittent scrotal pain and hydrocele. Case Rep Med 2012. [PMID: 22851974 DOI: 10.1155/2012/189170.epub] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023] Open
Abstract
Paratesticular mesotheliomas are very rare tumors. In this paper, we present the management of a 38-year-old male patient with paratesticular malignant mesothelioma who was initially misdiagnosed and treated as recurrent epididymitis. After the final pathology report defining paratesticular mesothelioma during scrotal exploration, he underwent radical orchiectomy and hemiscrotal excision as a complementary, secondary procedure. His metastatic workup did not show any dissemination. Therefore, he did not receive any adjuvant treatment and remained disease-free for more than 2 years.
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Affiliation(s)
- Tarık Esen
- School of Medicine, Koc University, 34450 Istanbul, Turkey
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Uluocak N, Oktar T, Ander H, Ziylan O, Acar O, Rodoplu H, Erkormaz U. Which method is the most reliable in determination of bladder capacity in children with idiopathic overactive bladder? A comparison of maximum voided volume, uroflowmetry and maximum cystometric capacity. J Pediatr Urol 2009; 5:480-4. [PMID: 19342301 DOI: 10.1016/j.jpurol.2009.03.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2008] [Accepted: 03/03/2009] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare uroflowmetry, maximum cystometric capacity and maximum voided volume in terms of bladder capacity (BC) estimation in children with idiopathic overactive bladder. MATERIALS AND METHODS A total of 84 children with idiopathic overactive bladder were enrolled. Bladder diaries were kept by parents to measure maximum voided volume. The sum of voided volume and post-void residual urine represented uroflowmetric BC. Maximum cystometric capacity was recorded for each patient. Patients with and without urge incontinence and both sexes were compared, and correlations were tested between estimated capacities, patient age and continence status. RESULTS Mean age was 10.88 (range 6-16) years. There were 52 females and 32 males. A total of 48 patients had urge incontinence (group 1), and the remaining 36 (group 2) did not. Mean bladder capacities were 165.44ml for uroflowmetry, 204.37ml for cystometry and 260.07ml for bladder diary. Maximum cystometric capacity and capacity in terms of maximum voided volume by diary were significantly higher in patients without urge incontinence. There were significant correlations between age and all other variables, and between the presence of urge incontinence and all variables except maximum cystometric capacity. There were significant differences between bladder capacities estimated by the three methods; however, on age-adjusted re-analysis this significance was lost. CONCLUSION There is no significant difference between BCs estimated by uroflowmetry, maximum cystometric capacity and maximum voided volume in children with idiopathic overactive bladder. Bladder diary is a reliable and non-invasive way of estimating BC in this patient population.
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Affiliation(s)
- Nihat Uluocak
- Gaziosmanpasa University, School of Medicine, Department of Urology, Tokat, Turkey
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Acar O, Akinci M, Uluocak N, Akbulut F, Kilicaslan I, Gokce O. Paratesticular metastasis of malignant melanoma: a case report. Kaohsiung J Med Sci 2008; 24:315-8. [PMID: 18635417 DOI: 10.1016/s1607-551x(08)70158-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
We report a case of multimetastatic malignant melanoma that was diagnosed after histopathologic examination of the excised paratesticular mass. Our patient initially visited the neurosurgery clinic due to low back pain. After preliminary evaluation, he was referred to our clinic due to a right scrotal mass. We excised the paratesticular mass and testis. The histopathologic findings were consistent with malignant melanoma. He was referred to the oncology department for adjuvant treatment. The patient died during the third month of chemotherapy. Our case was unique because the malignant melanoma was widely metastatic and involved primarily paratesticular tissues without any invasion of the testis and epididymis.
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Affiliation(s)
- Omer Acar
- Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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Abstract
Plasmacytomas of the urethra are extremely rare neoplasias; they may occur as isolated tumors or concomitantly with generalized multiple myeloma. Herein, we describe the clinical presentation and characteristics of a patient with primary plasmacytoma of the urethra. A 51-year-old man presented with terminal hematuria and a palpable penile mass. Magnetic resonance urethrography revealed a 3-cm long stenotic segment along which the urethral mucosa was found to be irregular. On urethroscopy, papillary mucosal projections extending to the presphincteric area were noted. Lesions were found to be composed primarily of neoplastic plasma cells capable of producing mainly lambda light chain. Upon diagnosis, the patient received external beam radiation therapy targeting the pelvic region. The lesion diminished in size progressively during the treatment course. He was disease-free after 6 months. Although it is a relatively rare disease, primary urethral plasmacystoma should be considered in the differential diagnosis of urethral tumors and radiation therapy should be an integral part of the treatment strategy.
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Affiliation(s)
- Ozgur Gokce
- Department of Urology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Sanli O, Kadioglu A, Atar M, Acar O, Nane I, Kadioglu A. Grading of Classical Testicular Microlithiasis Has No Effect on the Prevalence of Associated Testicular Tumors. Urol Int 2008; 80:310-6. [DOI: 10.1159/000127348] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2006] [Accepted: 05/09/2007] [Indexed: 11/19/2022]
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Sanli O, Acar O, Celtik M, Oktar T, Kilicaraslan I, Ozcan F, Tunc M, Esen T. Should prostate cancer status be determined in patients undergoing radical cystoprostatectomy? Urol Int 2007; 77:307-10. [PMID: 17135779 DOI: 10.1159/000096333] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2005] [Accepted: 05/09/2006] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We estimate the frequency of prostate cancers detected incidentally in radical cystoprostatectomy specimens and discuss whether the prostate cancer status should be determined in patients undergoing radical cystoprostatectomy. MATERIALS AND METHODS A total of 97 radical cystoprostatectomies without evidence of prostate cancer on digital rectal examination were performed for transitional cell carcinomas of the bladder between January 2001 and May 2004. The mean patient age at the time of surgery was 66.9 +/- 9.52 (range 49-75) years. RESULTS The overall incidence of prostate cancer detected in radical cystoprostatectomy specimens was 21.6% (21/97 specimens). The mean tumor volume was found to be 0.93 +/- 0.81 ml. The tumor volume was >0.5 ml in 12 cases (57.1%). The surgical margin was negative in all cases, and the disease was organ confined in 20 patients (95.2%). Capsular invasion was evident in 2 patients (9.5%), 1 of whom had lymph-node-positive disease. CONCLUSIONS Despite the high prevalence of incidental prostate carcinomas among patients with bladder cancer undergoing cystoprostatectomy, the vast majority of the cancers are organ confined. However, the prostate cancer status should be determined on the basis of digital rectal examination and prostate-specific antigen in patients undergoing radical cystoprostatectomy - especially if prostate-sparing cystectomy is planned.
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Affiliation(s)
- Oner Sanli
- Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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Tunc M, Sanli O, Kandirali E, Tefekli A, Oktar T, Esen T, Acar O, Uysal V. Should high-grade prostatic intraepithelial neoplasia change our approach to infravesical obstruction? Urol Int 2005; 74:332-6. [PMID: 15897699 DOI: 10.1159/000084433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2004] [Accepted: 12/23/2004] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To investigate whether coexistence of high-grade prostatic intraepithelial neoplasia (HPIN) should change our therapeutic approach to infravesical obstruction. MATERIAL AND METHODS Of 505 patients who underwent sextant transrectal ultrasonography (TRUS)-guided prostate biopsy, 65 (12.8%) had HPIN and 29 of them underwent prostatectomy (23 transurethral resection of prostate (TURP), 6 open) due to obstructive urinary symptoms. Patients without carcinoma were followed up with semiannual prostate-specific antigen (PSA) and digital rectal examination. After a follow-up of 24.8 +/- 11.0 months, 19 of 29 patients who accepted our call had another sextant biopsy. RESULTS Mean age and initial mean PSA values of 29 patients were 67.6 +/- 6.7 years and 9.26 +/- 5.91 ng/ml, respectively. The final pathological evaluation of the surgical specimens revealed 2 prostatic adenocarcinomas both in the TURP group. The remaining 27 (93.2%) patients were found to have benign prostatic hyperplasia (BPH) and their serum PSA levels declined from 9.26 +/- 5.91 to 4.59 +/- 2.0 ng/ml 3 months after prostatectomy. Of the 19 patients who had another biopsy with a mean PSA value of 4.06 +/- 4.61 ng/ml, 15 and 4 of them had BPH and HPIN respectively. CONCLUSIONS Our preliminary data indicate that the presence of HPIN on TRUS-guided biopsies is not a factor to delay an indicated surgical intervention for infravesical obstruction.
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Affiliation(s)
- Murat Tunc
- Department of Urology, Istanbul Faculty of Medicine, University of Istanbul, Istanbul, Turkey
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Culha M, Acar O, Mutlu B, Ozdamar S, Mutlu N, Kömür O, Gökalp A. Prosthesis culture 6 months after implantation and the effect of haematogenous seeding in a rat model. Int J Impot Res 2004; 16:231-4. [PMID: 15184914 DOI: 10.1038/sj.ijir.3901142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The aim of this study was to investigate the role of haematogenous seeding in late prosthesis infection. In all, 45 male Wistar albino rats were divided into three equal groups. A small piece of silicone prosthesis was implanted into the scrotum of all rats under sterile condition and antibiotic prophylaxis. In the first group, all silicones were removed after 6 months without any complication and were cultured for bacterial growth. In the second group, a disc, which was saturated with Staphylococcus epidermidis, was inoculated subcutaneously in the legs of the rats in the 6th month, revealing a nodule formation 4-5 days after the inoculation and treated with an appropriate antibiotic after the nodule formation. In the third group, the same disc was inoculated, but all rats were treated immediately from the inoculation time onwards. The silicones of the second and third group were also removed at the end of the 6th month and were cultured to observe the bacterial growth. There was no evidence of prosthesis infection in any of the three groups. In the first group, three cultures were positive and revealed approximately 10 000 colonies of S. epidermidis in two and Proteus mirabilis in the remaining. Three and four cultures were positive in the second and third group, respectively. Low colonies of four different organisms (Escherichia coli, S. aureus, S. epidermidis, Pseudomonas aeruginosa) were identified in these cultures. There was no statistical significance of positive cultures in the three groups. Based on our results, there does not appear to be a true significance of haematogenous seeding on late prosthesis infection.
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Affiliation(s)
- M Culha
- Department of Urology, Kocaeli University, School of Medicine, Istanbul, Turkey.
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Arikan P, Acar O, Acar R, Aycik GA, Cetiner MA, Demirel H, Efe N, Golge T, Gurellier R, Kirmaz R, Tulumen S, Yucel H, Zararsiz A, Agus Y. Establishment of a quality system for nuclear analytical laboratories. J Radioanal Nucl Chem 2004. [DOI: 10.1023/b:jrnc.0000020906.46609.9e] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Acar O, Demirtas M, Kacar S, Vural P, Devecioglu Y, Saroglu M, Culha M, Gökalp A. Gastrocystoplasty in pigs and effect of selective antral vagotomy on acid secretion of the reconstructed bladder. Urol Int 2003; 71:211-4. [PMID: 12890964 DOI: 10.1159/000071850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2002] [Accepted: 07/22/2002] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of this study was to investigate the outcome of gastrocystoplasty and the effects of selective antral vagotomy (SAV) on the postprandial gastrin secretion from the antrum as well as on the acid secretion from the augmented bladder. MATERIALS AND METHODS In this study on 12 male pigs, we applied subtotal cystectomy plus gastric augmentation plus SAV to the study group and the same procedure without SAV to the control group. The animals were followed up for 3 months with respect to feeding, weight, and urine output. The urine pH levels and the gastrin levels of the pigs in the two groups were then followed up and compared. RESULTS The use of gastric segments in bladder reconstruction was found to be appropriate in terms of both gastric function and urinary system function. Nevertheless, regarding the effect of SAV, the differences between either the urinary pH levels or the gastrin levels of the pigs in the two groups were statistically significant. CONCLUSIONS Although gastric segments in the bladder reconstruction were found to be appropriate in terms of both gastric function and urinary system function, SAV did not prevent postprandial gastrin secretion and the resulting increase of the urine acidity.
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Affiliation(s)
- O Acar
- Department of Urology, Kocaeli University Medical Faculty, Kocaeli, Turkey.
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Acar O, Schwizer W, Hauri D. Demonstration of acid secretion in the gastric pouch through the pentagastrin stimulation test. Urol Int 2003; 70:178-80. [PMID: 12660453 DOI: 10.1159/000068771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2002] [Accepted: 06/14/2002] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of this study is to determine the relationship of hydrochloric acid secretion in gastric pouch (GP), an orthotopic neobladder using a stomach segment, to gastrin. MATERIAL AND METHOD Pentagastrin (PG) stimulation test (PGST) was applied in 10 patients who had had GP surgery 5-70 months ago, and their urinary pH changes in the next 2 h were observed. RESULTS Significant pH decreases (from 6.6 +/- 0.6 to 2.9 +/- 1.0 in the mean) 30-75 min after injection of PG, demonstrating gastrin-triggered acid secretion in GP were observed in all patients. The pH values were normalized in 2 h (6.6 +/- 1.0 in the mean). CONCLUSION In PGST, urinary pH decreases, demonstrating the close relationship between gastrin release and acid secretion in the GP. Inhibition of gastrin by any means may be useful in keeping the urinary pH on physiological levels.
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Affiliation(s)
- O Acar
- Department of Urology, Medical Faculty, Kocaeli University, Kocaeli, Turkey
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