Yazar "Akman, Yavuz" seçeneğine göre listele
Listeleniyor 1 - 10 / 10
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Alt üriner sistem yakınmaları ile başvuran hastalarda prostat kanseri erken tanısı ve hastaların yıllık takip protokolüne uyumu(2001) Akman, Yavuz; Çam, Kamil; Erol, AliProstat kanseri erken tanısında 50 yaş üzerindeki erkeklerde yıllık prostat spesifik antijen (PSA) ve parmakla rektal muayene (PRM) uygulaması önerilmektedir. Bu çalışmada alt Üriner sistem yakınmaları ile başvuran hastalarda prostat kanseri erken tanısı ve benign prostat hiperplazisi tanısı ile tedavi edilen hastaların prostat kanseri açısından yıllık takip protokolüne uyumu araştırıldı. Bir yıl içerisinde toplam 779 hasta alt Üriner sistem yakınmaları ile üroloji polikiniğimize başvurdu. Tüm hastalarda PRM ve PSA ile prostat kanseri taraması yapıldı. Sonuçları normal olan tüm hastalar benign prostat hiperolazisine yönelik hangi tedavi alırlarsa alsınlar yıllık takip gerekliliği konusunda bilgilendirilerek takip protokolüne alındı. PSA 4 ng/ml üzeri ve/veya PRM sonucu anormal olan toplam 156 hastaya prostat biyopsisi uygulandı ve sonuçta alt Üriner sistem yakınmaları ile başvuran hastalarda %4 (30/779) oranında prostat kanseri saptandı. Klinik evrelendirme sonucunda 20 hastada metastatik, 10 hastada ise lokal prostat kanseri belirlendi. Öte yandan, prostatektomi yapılan 115 hastanın sadece 14'ünün (%12) 1. yılda bu amaçla kontrole geldiği görüldü. Uzun dönem (bir yıldan uzun) medikal tedavi önerilen hastaların (toplam 33) ise daha büyük oranda (14 hasta, %42) prostat kanseri taraması için geldikleri izlendi, îlk biyopsi sonucu benign olan hastaların bile (125 hasta) sadece 39'nun (%31,2) kontrole geldiği saptandı. Sonuç olarak bu çalışmada, alt Üriner sistem yakınmaları ile başvuran hastalarda PSA ve PRM kombinasyonu ile %4 oranında prostat kanseri saptanmıştır. Ancak hastaların çoğunluğunun küratif tedavi sınırlarının dışında olduğu görülmektedir. Öte yandan prostat kanseri takip protokolü (yıllık PSA+PRM) önerilen hastaların büyük çoğunluğu birinci yıldaki kontrollerine dahi gelmemişlerdir. Bu oran özellikle prostatektomi grubunda oldukça yüksektir. Dolayısıyla prostat kanseri taraması gündeme geldiğinde kamuoyuna yönelik bilgilendirme çalışmalarına gereksinim duyulmaktadır.Öğe Contemporary approach in the medical treatment for benign prostatic hyperplasia(2003) Çiçekçi, Bülent; Çam, Kamil; Akman, Yavuz; Erol, AliBenign prostatic hyperplasia (BPH) contemporarily constitutes one of the major public health problems as its incidence increases with aging. Surgical treatment modalities were the main stay in the management of BPH. However, several medical treatment alternatives have been developed and extensively utilised especially during the last decade. Consequently, medical treatment alternatives have decreased the number of surgeries for BPH all over the world. In this review, current medical treatment approaches in the management of BPH were discussed.Öğe The efficacy of an abbreviated model of the International prostate symptom score in evaluating benign prostatic hyperplasia(Wiley, 2003) Çam, Kamil; Şenel, Ferda; Akman, Yavuz; Erol, AliOBJECTIVES To investigate the acceptability to patients in Turkey of the International Prostate Symptom Score (IPSS) for evaluating benign prostatic hyperplasia (BPH), and to devise a possible abbreviated model, saving time when administered by a physician. PATIENTS AND MEATHODS The IPSS questionnaire was initially self-administered in 200 consecutive patients aged> 50 years and with lower urinary tract symptoms. Patients were instructed only to mark questions which they clearly understood. The IPSS was then administered to 500 consecutive patients by the same physician. Subsequently, each of the seven questions was separately correlated with the IPSS and quality-of-life (QoL) score. The first five questions with the highest correlation coefficient for both the total IPSS and QoL score were identified, and every possible combination of these questions produced and correlated. RESULTS In the first group, 29% of the patients did not complete the form and 44% could not mark at least one item; the effect of educational level was significant (P < 0.05). In the second group a combination of the first three items had a Pearson's correlation of 0.90 with the total IPSS; similarly, four questions combined (2, 3, 6 and 7) also correlated well (r = 0.92). Both combinations took significantly less time to administer (P < 0.05). CONCLUSION The abbreviated form of the IPSS consisting of three or four items may be used to assess symptoms in patients with BPH, especially in underdeveloped countries.Öğe An eleven year old forgotten ureteral stent: A serious dilemma in the management(2003) Çam, Kamil; Çiçekçi, Bülent; Akman, Yavuz; Erol, AliUreteral stents play a major role in the endourological management of a vide spectrum of urological disorders and have been utilised tremendously almost in all urology clinics. Although, duration of various stents may vary they should usually be removed in six months. Otherwise, the management of forgotten stents may constitute a major dilemma. Here, we report three cases of forgotten stents. One of them had duration of eleven years-the longest time in the literature and required open surgery with multiple incisions.Öğe An experimental study on the application of extracorporeal shock waves in the treatment of tendon injuries: Preliminary report(Springer Japan, 2001) Orhan, Zafer; Alper, Murat; Akman, Yavuz; Yavuz, Özlem; Yalçıner, AltanThe use of low-energy extracorporeal shock wave therapy (ESWT) has recently been introduced in pseudoarthrosis, fracture, and wound healing for both clinical and experimental purposes. In this study, we created an experimental rat model to investigate the histopathological and biochemical effects of ESWT in the healing of tendon injury that may accompany fractures. Twenty-eight rats were used for the histopathological investigation. The right achilles tendon of the rat was cut and then sutured, using Modified Kessler stitches method. Five hundred shock waves, set at 14kV, were applied to the achilles tendon under fluoroscopic guidance. Fourteen rats that underwent a sham operation served as the control group. Biochemical studies were done on 20 rats, divided into four groups of 5 rats in each. The first and second groups received 500 shock waves, at 14kV, after the cutting and repairing of the Achilles tendon. To measure hydroxyproline levels, the rats in the first and second groups were killed on postoperative days 3 and 9, respectively. The third and fourth groups served as controls. Hydroxyproline levels were found to be high in the study groups. The histopathological findings and the increased hydroxyproline levels revealed that ESWT may facilitate tendon healing after trauma.Öğe Extensive cutaneous metastasis of transitional cell carcinoma of the bladder(Blackwell Publishing Asia, 2003) Akman, Yavuz; Çam, Kamil; Kavak, Ayşe; Alper, MuratCutaneous metastasis of bladder carcinoma is extremely rare. Iatrogenic implantations have been the main cause in the majority of cases of transitional cell carcinoma with cutaneous metastasis. Otherwise, primary cutaneous metastasis is accepted as the late manifestation of systemic spread. The present paper describes a case of relatively early and extensive skin metastasis of transitional cell carcinoma in a 78-year-old man. The patient had a histopathological diagnosis of poorly differentiated (grade III) muscle invasive transitional cell carcinoma with a staging of T2NOMO 6 months prior to presenting. He presented to our outpatient clinic with a 3-month history of skin lesions as multiple, rubbery subcutaneous nodules. Radiological reinvestigation revealed no other metastatic site (including bone and lung), except for a metastatic nodule in the liver. The present paper reports an interesting and rare case of extensive skin metastasis of transitional cell carcinoma as the primary complaint.Öğe Mode of administration of international prostate symptom score in patients with lower urinary tract symptoms: physician vs self(Nature Publishing Group, 2004) Çam, Kamil; Akman, Yavuz; Çiçekçi, Bülent; Şenel, Ferda; Erol, AliInternational prostate symptom score (IPSS) was claimed to be complicated for patients. The aim of this study was to measure differences in IPSS when introduced by a physician vs self-administration. Patients with lower urinary tract symptoms completed two IPSS questionnaires: one self-administrated and the other by a physician 1 week apart. Results with 75 patients in each group suggested that there was no statistically significant difference between patient and physician administration, although the mean scores of patients' administration were higher in both groups. In conclusion, when assessing IPSS before treatment, we found no difference between patient administration and physician administration.Öğe Short-term subjective efficacy of doxazosin in predicting probability of prostatectomy in the management of benign prostatic hyperplasia in patients with severe symptoms(Blackwell Publishing Asia, 2003) Çam, Kamil; Akman, Yavuz; Kayıkçı, Ali; Şenel, Ferda; Erol, AliBackground. The severity of symptoms still constitutes the major indication for transurethral prostatectomy, despite the extensive utilization of medical treatments. The aim of the study presented here was to investigate the impact of doxazosin on symptoms in relation to the probability of consequent surgery in severely symptomatic patients. Methods. Patients with an International Prostate Symptom Score (IPSS) between 18 and 35 were included in the study. The patients received 4 mg/day doxazosin, and subjective efficacy was assessed by IPSS at the first and third months. In addition, the patients were classified at the third month according to a single question regarding satisfaction with medical treatment in terms of symptom relief as 'ineffective, no change, and effective'. Results. A total of 178 patients constituted the study group. Mean total symptom scores were 24, 19 and 17 at baseline, first and third months, respectively (P < 0.05). According to results of the questionnaire, 23% of the patients claimed the treatment was ineffective, and subsequently, the majority of this group (93%) underwent prostatectomy in a year. In addition, 33% of the patients reported no change in their symptoms, while 44% reported that the medication was effective. However, after 1 year, 59% and 15% of these cases underwent surgical treatment, respectively. The probability of surgery in the 'ineffective' group was significantly higher compared to the remaining groups (P < 0.05). Conclusion. The majority of patients with severe symptoms who were not satisfied with the medication at the 3rd month underwent surgery. This observation may provide a predictor for subsequent probability of prostatectomy. Therefore, reassessment of patients would be a cost-effective approach for the treatment of BPH in severely symptomatic patients.Öğe Surgical treatment alternatives in the management of benign prostatic hyperplasia(2003) Kayıtçı, M. A.; Çam, Haydar Kamil; Akman, Yavuz; Erol, AliBenign prostatic hyperplasia (BPH) contemporarily constitutes a major public health problem especially in developed countries as its incidence increases with aging. Although several medical treatment alternatives have been developed, surgical management still provides the most successful clinical outcome. Trans-urethral prostate resection (TUR-P) is accepted as the gold standard in the management of BPH. However, in considering the relatively high rate of morbidity of TUR-P, several minimally invasive surgical treatment alternatives have been developed. In this review, we discussed the surgical treatment alternatives in the management of BPH.Öğe Tendon iyileşmesinde ekstrakorporeal şok dalgası tedavisi: Sıçanlarda deneysel çalışma(2001) Orhan, Zafer; Alper, Murat; Yavuz, Özlem; Akman, Yavuz; Yalçıner, AltanAmaç: Düşük enerjili ekstrakorporeal şok dalgası tedavisinin (ESWT) kırıklara eşlik edebilen tendon dokularındaki zedelenmelerin iyileşmesine etkileri sıçanlar üzerinde araştırıldı. Çalışma planı: Histopatolojik tetkik için 28 sıçan kullanıldı. Sıçanların sağ aşil tendonları kesilerek modifiye Kessler yöntemi ile sütüre edildi. Aşil tendonlarına skopi kontrolünde 14 kV gücünde 500 şok dalgası uygulandı. Cerrahi onarım yapılan ve ESWT uygulanmayan 14 sıçan kontrol grubuna alındı. Biyokimya çalışması için de 20 sıçan beşerli dört gruba ayrıldı. Sıçanların aşil tendonları kesilip sütüre edilerek birinci ve ikinci gruba 14 kV gücünde 500 şok dalgası uygulandı. Birinci grup üçüncü günde ikinci grup dokuzuncu günde öldürülerek hidroksiprolin düzeyleri ölçüldü. Üçüncü ve dördüncü grup kontrol grubunu oluşturdu. Sonuçlar: Histolojik incelemede, ESWT uygulanan grupta ikinci haftada granülasyon dokusu belirgin olarak daha selüler, daha vaskülarize ve yoğun iltihabi infiltrasyon içermekteydi ve çok sayıda multinükleer dev hücre vardı. Üçüncü haftada ESWT grubunda iyileşmenin kontrol grubuna göre daha iyi ve düzenli olduğu, fibrillerde düzensizliğin, yoğun lenfosit ve histiosit infiltrasyonunun azaldığı ve çok daha az sayıda multinükleer dev hücre içerdiği görüldü. Deney grubunda hidroksiprolin düzeylerinin yükseldiği görüldü. Çıkarımlar: Deney grubundaki histopatolojik bulgular ve artmış hidroksiprolin düzeyleri ESWT uygulamasının tendon iyileşmesini hızlandırdığını gösterdi.
