Posts made in April, 2016

Analysis of various potential prognostic markers and survival data in clear cell renal cell carcinoma

Vol. 43 (3): 440-454, May – June, 2017

doi: 10.1590/S1677-5538.IBJU.2015.0521


Tastekin Ebru 1, Oz Puyan Fulya 1, Akdere Hakan 2, Yurut-Caloglu Vuslat 3, Sut Necdet 4, Can Nuray 1, Ozyilmaz Filiz 1
1 Department of Pathology, Faculty of Medicine, Trakya University, Edirne, Turkey; 2 Department of Urology, Faculty of Medicine, Trakya University, Edirne, Turkey; 3 Department of Radiation Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey; 4 Department of Biostatistics, Faculty of Medicine, Trakya University, Edirne, Turkey



Purpose: Clear cell renal cell cancers frequently harbor Von Hippel-Lindau gene mutations, leading to stabilization of the hypoxia-inducible factors (HIFs) and their target genes. In this study, we investigated the relationship between vascular endotelial growth factor (VEGF), HIF-1α, HIF-2α, p53 positivity, microvessel density, and Ki-67 rates with prognostic histopathologic factors (Fuhrman nuclear grade, stage, and sarcomatoid differentiation) and survival in clear cell renal cell carcinomas.

Material and Methods: Seventy-two nephrectomy specimens diagnosed as clear cell renal cell carcinoma between 2000 and 2012 were reevaluated. Immunohistochemically VEGF, HIF-1α, HIF-2α, p53, CD34 (for microvessel density evaluation), and Ki-67 antibodies were applied to the tumor areas. The relationships of these antibodies with prognostic factors and survival rates were evaluated with statistical analyses.

Results: Mean survival time was 105.6 months in patients with ccRCC. Patients with high expression of VEGF, HIF-1α and HIF-2α positivity, a high Ki-67 proliferation index, and a high microvessel density evaluation score had a shorter...

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The change in serum Thiol/Disulphide homeostasis after transrectal ultrasound guided prostate biopsy

Vol. 43 (3): 455-461, May – June, 2017

doi: 10.1590/S1677-5538.IBJU.2016.0114


Hüsnü Tokgöz 1, Selim Taş 1, Özlem Giray 2, Soner Yalçınkaya 1, Özlem Tokgöz 3, Cemile Koca 4, Murat Savaş 1, Özcan Erel 4
1 Department of Urology, Antalya Training and Research Hospital, Antalya, Turkey; 2 Department of Biochemistry,  Antalya Training and Research Hospital, Antalya, Turkey; 3 Department of Radiology, Antalya Training and Research Hospital, Antalya, Turkey; 4 Department of Biochemistry, Yildirim Beyazit University, School of Medicine, Ankara, Turkey




Objectives: The aim of this prospective clinical study was to investigate variations in a novel oxidative stress marker (thiol/disulphide homeostasis) in men who underwent transrectal ultrasound guided prostate biopsy (TRUSB).

Materials and Methods: A total of 22 men undergoing TRUSB of the prostate were enrolled in the study. Patients with abnormal digital rectal examination and/or total prostate specific antigen (PSA) over 4ng/mL underwent TRUSB with 12 cores. Serum samples were obtained before and just after the procedure to evaluate the possible changes in thiol/disulphide homeostasis. Mean age, total PSA and free PSA, prostate volume and histopathological data were also recorded.

Results: Mean age of the study population was 65.05±8.89 years. Significant decreases in native and total thiol levels were documented after the biopsy procedure. However, serum disulphide levels and disulphide/native thiol, disulphide/total thiol and native/ total thiol ratios did not significantly change after...

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Lateral decubitus position vs. lithotomy position: which is the best way to minimize patient’s pain perception during transrectal prostate biopsy?

Vol. 43 (3): 462-469, May – June, 2017

doi: 10.1590/S1677-5538.IBJU.2015.0479


Phil Hyun Song 1, Young Hwii Ko 1
1 Department of Urology, College of Medicine, Yeungnam University, Daegu, Korea


Introduction: Considering the distinctive nature in terms of psychological stress and anal tone of position which is generally selected between lithotomy and left lateral decubitus (LLD), we postulated its effect on pain perception during biopsy, and investigated their association.

Materials and Methods: A prospective study for comparison of two biopsy positions which were perform in a different working day was conducted for 208 men (lithotomy position=86, LLD=122). The decision on the position was made solely based on the patient’s preference for the biopsy day, and all procedures were performed according to the identical protocol (12-core biopsy with intrarectal lidocaine gel), probe, and needle.

The maximal degree of pain during the entire process was assessed using a visual analogue scale (VAS), immediately after biopsy. After propensity matching, a total of 152 patients were finally selected (lithotomy group=76, LLD=76), then peri-biopsy parameters were compared.

Results: Between groups, no differences were observed across all variables including age, obesity, prostate volume, serum PSA, international prostate symptom score, and cancer detection rate, except mean (±standard deviation) VAS score (3.89±2.01 vs. 4.58±2.22, p=0.049). VAS score showed significant association solely with patient’s position (Pearson’s coefficient=-0.165, p=0.042). In multiple linear regression models regarding the effect of clinical variables on VAS score, patient position was a single...

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Impact of personalized three-dimensional (3D) printed pelvicalyceal system models on patient information in percutaneous nephrolithotripsy surgery: a pilot study

Vol. 43 (3): 470-475, May – June, 2017

doi: 10.1590/S1677-5538.IBJU.2016.0441


Hasan Anil Atalay 1, H. Lütfi Canat 1, Volkan Ülker 2, İlter Alkan 1, Ünsal Özkuvanci 3, Fatih Altunrende 1
1 Department of Urology, Okmeydani Training and Research Hospital, Sisli, Istanbul, Turkey; 2 Department of Urology, İzmir Tepecik Training and Research Hospital, Izmir, Istanbul, Turkey; 3 Department of Urology, Istanbul Medical School, Çapa, Istanbul, Turkey


Objective: To investigate the impact of personalized three dimensional (3D) printed pelvicalyceal system models on patient information before percutaneous nephrolithotripsy surgery.

Material and Methods: Patients with unilateral complex renal stones with indicatation of percutaneous nephrolithotripsy surgery were selected. Usable data of patients were obtained from CT scans as Digital Imaging and Communications in Medicine (DICOM) format.

Mimics software version 16.0 (Materialise, Belgium) was used for segmentation and extraction of pelvicalyceal systems. DICOM format were converted to Stereolithography file format. Finally, fused deposition modeling was used to create plasticine 3D models of pelvicalyceal systems. A questionnaire was designed for patients to assess personalized 3D models effect on patient’s understanding their conditions before percutaneous nephrolithotripsy surgery (PCNL). The day before surgery, each patient was seen by a urologist to deliver information about surgery. Questionnaire forms were asked to patients complete before and after presentation of 3D models and the results of the questions were compared.

Results: Five patient’s anatomically accurate models of the human renal collecting system were...

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Evaluation of the Spies™ modalities image quality

Vol. 43 (3): 476-480, May – June, 2017

doi: 10.1590/S1677-5538.IBJU.2016.0324


Esteban Emiliani 1, Michele Talso 1, Mohammed Baghdadi 1, Aarón Barreiro 1, Andrea Orosa 1, Pol Serviàn 1, Pavel Gavrilov 1, Silvia Proietti 1, Olivier Traxer 1,2
1 Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie – Paris VI, Paris, France; 2 GRC lithiase (Grouped Recherche Clinique) Université Paris VI, Pierre et Marie Curie, Paris, France



Introduction: The Spies™ system (Karl-Storz®) was introduced into digital ureteroscopy to improve endoscopic vision. To date, there is no data to either indicate which of the Spies modalities is better for improving diagnosis and treatment procedures, nor to compare the modalities in terms of image quality. The aim of this study was to evaluate and compare the image quality of five Spies™ modalities (SM) to the standard white light in an in-vitro model.

Materials and Methods: Two standardized grids and 3 stones of different composition were recorded in white light and the 5SM (Clara, Chroma, Clara+Chroma), Spectra A and B) using 4 standardized aqueous scenarios. Twelve templates were done in order to simultaneously compare the same objective in the different modalities. Six urologists, five medical students, five urology residents, and five persons not involved with urol­ogy evaluated each video on a scale of 1 (very bad) to 5 (very good).

Results: Comparing white light to SM, subjects scored better the quality of Clara and Clara+Chroma than white light (p=0.0139 and p<0.05) and scored worse Spectra A and B (p=0.0005 and p=0.0023)). When comparing Clara to the other SM, it was ranked equivalent to...

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