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Öğe EVALUATION OF SERUM LEVELS OF IMMUNOGLOBULINS (IgA, IgE, IgG, IgM), COMPLEMENTS (C3, C4) AND C-REACTIVE PROTEIN IN BLADDER CANCER: A CONTROLLED PROSPECTIVE CLINICAL TRIAL(Aves, 2005) Kilic, Suleyman; Bayraktar, Mehmet; Bayraktar, Nihayet; Ergin, Huseyin; Beytur, Ali; Egri, MucahitIntroduction: During the management of a patient with bladder cancer, the aim of a clinician is to diagnose the tumor with a most sensitive and least invasive method. Cystoscopy and urine cytology are standard practice in following these patients; however, cystoscopy is invasive, and urine cytology has low sensitivity. Therefore, this study aims to evaluate the diagnostic and prognostic value of the humoral immunity in the bladder cancer patients by means of measuring serum levels of immunoglobulins, complements and Creactive protein pre and postoperatively compared with controls. Materials and Methods: Blood and urine samples were taken from both tumor and control patients preoperatively and from only tumor patients at postoperative 1 and 3 months. Urine samples were examined immediately for microscopic examination and culturing. Serum samples were stored at -80 degrees C in a deep freeze till processing and assessed blindly by same person at the end of the study. Patients who preoperatively received intravesical BCG instillation therapy, radiotherapy or chemotherapy for their bladder carcinoma diseases were not included in tumor group. Patients who underwent a transurethral procedure for a nonneoplastic genitourinary disease and did not have any documented cancer, served as controls. Results: Mean ages of tumor (20 pts; 1 female, 19 males) and control (41 pts; 3 females, 38 males) patients were 64.2+/-9.9 and 63.7+/-8.9, respectively (p=0.846). All tumor patients completed 3 months of follow-up. There was no statistical difference in urinary infection incidences between tumor and control groups. Serum IgA, IgE, IgG, C3 and CRP levels were statistically significantly higher in tumor group than in control group, while lower C4 and indifferent IgM levels were present in tumor group compared to control. However following tumor resection, all of them decreased very significantly. All serum levels, except C4, of 6 patients with visible tumor in their bladders at postoperative 3rd month were similar to those of tumor-negative patients. Although preoperative high levels of IgA, IgE, IgG, C3 and CRP appeared as sensitive, specific and predictive in primary bladder tumor diagnosis, post-treatment levels of any of those above were not found as useful in follow-up, suggesting that these were not diagnostic and prognostic parameters for bladder tumor. No correlation was established between infection and serum levels in both groups since there were not statistically significant differences in serum immunoglobulins, complements and CRP levels between the patients with and without urinary infection in each group. Pathologic stage and grade of the tumor did not correlate with immunoglobulin and C4 levels. However, there was a significant positive correlation between stage and C3 or CRP. There were no differences between the 3rd month serum levels of patients who took no therapy (6 pts) or chemotherapy (5 pts) or intravesical BCG (9 pts) after resections, except C4 which was higher in patients who took chemotherapy than in those who took BCG. Conclusion: Although serum immunoglobulins, complements and CRP appear to be nondiagnostic for primary bladder carcinoma, wider studies with longer follow-up and higher patient population are necessary for more definitive conclusions.Öğe Lipid Peroxidation and Antioxidant Enzyme Activities in Cancerous Bladder Tissue and Their Relation with Bacterial Infection: A Controlled Clinical Study(Wiley, 2010) Bayraktar, Nihayet; Kilic, Suleyman; Bayraktar, Mehmet Refik; Aksoy, NurtenIt is well known that antioxidants and reactive oxygen species play an important role in carcinogenesis. In this sudy, we attempted to evaluate antioxidant enzyme activities and lipid peroxidation levels in cancerous bladder tissue and to determine their relationship with bacterial infection. Bacterial culture was made from all urine samples using Blood and Eosin Methylene Blue agars for checking the presence of bacterial infections. We measured thiobarbituric acid reactive substances (TBARs) and activities of xanthine oxidase (XO), superoxide dismutase (SOD), glutathione peroxidase (GSH-PX), and catalase (CAT) in cancerous tissues of 25 bladder cancer patients, in noncancerous adjacent bladder tissues of 13 out of these 25 patients, and in control bladder tissues of 15 patients with a non-neoplastic genitourinary disease. TBARs levels increased and XO, SOD, GSH-PX, and CAT activities decreased significantly in cancerous bladder tissues. TBARS, XO, and SOD levels were not significantly different between noncancerous adjacent tissue and control bladder tissue. Statistically significantly lower GSH-PX and higher CAT activities were observed in noncancerous adjacent bladder tissue compared with cancerous tissue. GSH-PX level of tumor tissue was correlated significantly with tumor grade (r = -0.425, P = 0.034). Results suggested that pathway activity of free radicals were accelerated in the cancerous human bladder tissues via increased TBARs levels and decreased enzyme activities of XO, SOD, GSH-PX, and CAT, which implicated a severe exposure of cancerous tissues to oxidative stress. J. Clin. Lab. Anal. 24:25-30, 2010. (C) 2010 Wiley-Liss, Inc.Öğe RESULTS OF 78 INTRAUTERINE INSEMINATION (IUI) CYCLES WITH HUSBAND SPERM IN INFERTILITY AND FACTORS AFFECTING IUI SUCCESS: A RETROSPECTIVE STUDY(Aves, 2005) Kilic, Suleyman; Beytur, Ali; Altunoluk, Bulent; Beytur, Leyla; Oguz, Fatih; Atmaca, RusenIntroduction: Intrauterine insemination (IUI) with or without controlled ovarian hyperstimulation is a widely used therapeutic option for a variety of causes of infertility. Compared to in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), IUI is efficient and more cost-effective than the others for the treatment of unexplained and nonsevere male factor infertility. In this retrospective study, we aimed to determine our IUI outcomes and the variables influencing IUI success. Materials and Methods: To determine the influence of several parameters (age, duration and type of infertility, semen parameters, presence of varicocele, varicocelectomy and smoking histories) on the outcome of IUI in 35 women undergoing ovarian stimulation with clomiphen citrat, a retrospective review of 78 IUI cycles, which were done for the treatment of infertility using fresh husband sperm, was performed for approximately 1 year on data from the IUI program. Results of Pre-IUI evaluations were normal in all women and all men had normal semen analyses results. Discontinuous gradient centrifugation (DGC) with Sil-Select Plus was used for sperm preparation. Maximum number of IUI cycles per couple was three. In statistical analysis, chi(2), Fisher's exact and Mann-Whitney U tests for in-and between-group comparisons and Pearson and Spearman tests for correlation analyses were used. Results: Primary and secondary infertility were determined in 25 and 10 couples, respectively. Fourteen men had varicocelectomy history. Ten men were smoking cigarette. Seven men had left varicocele at physical examination. Means of man and woman age and infertility duration were 29.94+/-4.72 (23-46) years, 27.46+/-4.55 (20-38) years and 63.23+/-30.88 (15-123) months, respectively. The pregnancy rate was 8.97% (7/78) per treatment cycle, 20% (7/35) per patient, 5.71% (2/35) for first cycle, 10.34% (3/29) for second cycle and 14.3% (2/14) for third cycle. All pregnancies were normal. No miscarriage, tubal pregnancy, birth defect and prematurity were observed. Difference between the pregnancy rates of each cycle was statistically insignificant (p=0.697). There were statistically significant negative correlations between the pregnancy rate and mean ages of the men and especially women (p=0.041, p=0.009, respectively). However, no correlation was found between pregnancy rate and infertility duration (p=0.108). DGC procedure increased percents of the sperms moving with a slow, meandering forward progression (grade 2) and in a straight line with high speed (grade 4) and decreased percent of sperms with no movement (grade 0) very significantly, without changing the percent of those with sluggish or nonprogressive movement (grade 1). However no-one of the pre and post-DGC semen analysis parameter was found to have influence on pregnancy rate. Pregnancy rates in the primary and secondary infertile couples were statistically indifferent. Pregnancy rates achieved in patients without varicocele or with a history of successful varicocelectomy were higher than those with untreated varicocele and with a history of unsuccessful varicocelectomy. There was not any statistically significant difference between the pregnancy rates in the patients with and without smoking history. Conclusion: The most significant predictors of success of IUI with fresh husband sperm in infertile couples were age of the woman and man. Absence of varicocele and treatment of it seemed to have affirmative effect on pregnancy rate.