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  • Küçük Resim
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    Can serum matrix metalloproteinase-9 and SMAD-2 levels predict lamina propria invasion in bladder urothelial carcinoma?
    (WILEY, 2021) Yitgin, Yasin; Erdem, Selcuk; Serilmez, Murat; Duranyildiz , Derya; Verep, Samed; Gasimov, Kamranbay; Tefik, Tzevat; Sanli, Oner; Ozcan, Faruk
    Introduction: Matrix metalloproteinase-9 (MMP-9) has a role in the destruction of lamina propria (LP) of the bladder wall and SMAD-2 promotes cell-to-cell adhesion. This study aimed to investigate the association between LP invasion and serum protein and mRNA expression levels of MMP-9 and SMAD-2 in bladder cancer (BC) patients. Methods: Serum samples were taken from 57 patients with suspicious BC before TUR-BT (Group 1) and 20 patients with benign diseases as control (Group 2). The mRNA expression and serum protein levels of MMP-9 and SMAD-2 were analyzed using Real-Time PCR and ELISA methods, respectively. The comparison of protein and mRNA expression levels of MMP-9 and SMAD-2 were done statistically between Group 1 and 2, as well as for different T stages of BC. Results: The protein levels of MMP-9 (2448 vs 637.5 pg/mL, P = .0001) and SMAD-2 (6.85 vs 1.61 P = .0001) were significantly higher in Group 1 compared to Group 2. The mRNA expression levels of MMP-9 (P = .89) and SMAD-2 (P = .99) did not significantly differ between the groups. The protein levels of MMP-9 in T1 patients were significantly higher from both of pTa patients (P = .018) and pT2 (P = .02). The protein levels of SMAD-2 were not statistically different between T stages. Similarly, the mRNA expression levels of MMP-9 and SMAD-2 were not different between T stages. Conclusions: The protein levels of MMP-9 and SMAD-2 were increased in BC patients while mRNA expressions were not different. Furthermore, the increased protein level of MMP-9 in T1 patients was more pronounced which may be related to LP invasion of the tumor.
  • Küçük Resim
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    Is access sheath essential for safety and effective retrograde intrarenal stone surgery ?
    (MedGen, 2021) Yitgin, Yasin; Yitgin, Emine; Verep, Samed; Gasimov, Kamranbay; Tefik, Tzevat; Karaköse, Ayhan
    Objective: To evaluate the results of retrograde intrarenal surgery (RIRS) with flexible ureteroscope (f-URS), using ureteral access sheath and without the sheath. Study Design: Descriptive study. Place and Duration of the Study: Kesan State Hospital, Edirne, Turkey, between February 2019 and May 2020. Methodology: Patients treated with RIRS for renal and proximal ureteral stone were evaluated. Two groups were formed that used ureteral access sheath or not. Operation and fluoroscopy times, postoperative complications and stone-free rates were compared. Results: Group 1 consisted of 51 patients were operated with, using ureteral access sheath; and Group 2 having 62 patients, were operated without using ureteral access sheath. The mean volume of the stones was 1135 mm3 (73-7491 mm3) in the group without access sheath and 1273 mm3 (251-3635 mm3) in the group with access sheath. The mean operation time was 55 minutes (20-115 min) in the group without access sheath, and 70 minutes (30-125 min) in the group with access sheath. Postoperative febrile UTI was found in 5 (8%) of the patients without access sheath, and in 4 (8%) of the patients with access sheath (p=0.733). The stone-free rate of the patients with radiological controls was 58 (93%) in the group without access sheath and 46 (90%) in the group with access sheath (p=0.306). Fluoroscopy timings were 2.7 seconds (0-8 sec) in the group without access sheath and 8.4 seconds (2-20 sec) in the group with access sheath (p=0.001). Conclusion: UAS usage has no marked impact on SFR, complication rate and operation time. RIRS can be performed safely and effectively without using UAS.