Person: ŞEKERCİ, ÇAĞRI AKIN
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ŞEKERCİ
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ÇAĞRI AKIN
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Publication Metadata only The effect of intradetrusor botulinum neurotoxin type A on urinary NGF, TGF BETA-1, TIMP-2 levels in children with neurogenic detrusor overactivity due to myelodysplasia(WILEY, 2017) ŞEKERCİ, ÇAĞRI AKIN; Top, Tuncay; Sekerci, Cagri Akin; Isbilen-Basok, Banu; Tanidir, Yiloren; Tinay, Ilker; Isman, Ferruh Kemal; Akbal, Cem; Simsek, Ferruh; Tarcan, TufanAimsThe aim of this study was to determine the value of urine nerve growth factor (NGF), transforming growth factor beta 1 (TGF-Beta-1), tissue inhibitor of matrix metalloproteinase 2 (TIMP-2) levels to predict the urodynamic profile before and after botulinum neurotoxin type A (BoNT-A) treatment in children with myelodysplasia. MethodsThis prospective study included 15 children with myelodysplasia who underwent intradetrusor BoNT-A injections due to neurogenic detrusor overactivity (NDOA). Urine samples of each child were collected before and after BoNT-A injections, specifically at the first and third postoperative months. Urine samples were analyzed with ELISA method and NGF, TGF-Beta-1, and TIMP-2 levels were measured. Urine marker levels and clinical findings were assessed for statistical significance with Wilcoxon Signed Ranks Test and Friedman Test. ResultsA total of 15 children (5 boys and 10 girls) were assigned as the study group. Mean age of the patients was 7.12.5 years (range 2.5-11). A statistically significantly decline was observed in urinary TGF-Beta-1 and NGF levels following BoNT-A injections, compared to the preoperative levels (P<0.05). TIMP-2 levels also tend to decrease following BoNT-A injections but this was not statistically significant compared to the preoperative levels. ConclusionThis preliminary study, suggests urinary TGF-Beta-1 and NGF as a potent marker in children with NDOA, as they decline following BoNT-A injection. Further studies are needed in identifying their special role in assessing treatment success after invasive interventions.Publication Metadata only Melatonin prevents deterioration of erectile function in streptozotocin-induced diabetic rats via sirtuin-1 expression(WILEY, 2020) ŞEKERCİ, ÇAĞRI AKIN; Sahan, Ahmet; Akbal, Cem; Tavukcu, Hasan Huseyin; Cevik, Ozge; Cetinel, Sule; Sekerci, Cagri Akin; Sener, Tarik Emre; Sener, Goksel; Tanidir, YilorenA review of the literature indicated that sirtuin-1 expression, a regulator of nitric oxide bioavailability in erectile dysfunction (ED) after melatonin therapy, has not yet been investigated. The objective of this study was to evaluate the protective effects of melatonin for erectile function with sirtuin-1 protein expression in type 1 diabetic rat models. Fifty male Sprague Dawley rats were placed into five groups. Except for those in the control group (C), each animal received a single dose (60 mg/kg) of streptozotocin to induce diabetes. The animals were placed into the diabetes (D) group, insulin (I) group (6 U/kg/day), melatonin (Mel) group (10 mg kg(-1) day(-1)) and combined treatment (I + Mel) group. Ten weeks later, the serum testosterone levels, intracavernosal pressure (ICP), mean arterial pressure (MAP), malondialdehyde (MDA), cyclic guanosine monophosphate (c-GMP), 8-hydroxydeoxyguanosine (8-OHdG), nitric oxide synthase (NOS), caspase-3 activity, sirtuin-1 and endothelial nitric oxide synthase (eNOS) protein expression and histological findings were assessed. The mean ICP/MAP ratio for the D group was lower than the mean ratios for the other groups. The treatment groups, particularly the I + Mel group, exhibited lower 8-OHdG and MDA levels and caspase-3 activity than the D group. The sirtuin-1 and eNOS expression and cavernosal tissue (CT) histology seemed to have been preserved by the melatonin and/or insulin therapy. These results were indicative of a profound protective effect of melatonin by the activation of sirtuin-1 protein expression against hyperglycemia-induced oxidative CT injury.Publication Open Access Consistency of uroflowmetry analysis in children among observers(2023-01-01) ŞEKERCİ, ÇAĞRI AKIN; TANIDIR, YILÖREN; TARCAN, TUFAN; YÜCEL, SELÇUK; ŞEKERCİ Ç. A., TANIDIR Y., TARCAN T., YÜCEL S.© 2023 Wiley Periodicals LLC.Aim: The aim of the study is to compare the intra- and inter-observer interpretations of the same uroflowmetry study at two different times. Materials and Methods: Two-hundred children with a voided volume of 50% above the expected bladder capacity were included. All traces were asked to be evaluated by 11 observers two times in a time span of 1 month. These observers consist of pediatric urologists (n = 2), pediatric urology fellows (n = 2), urology residents (n = 5), and certified urodynamics nurses (n = 2). Each uroflowmetry was asked to be assessed for three domains: voided volume (VV), detrusor sphincter dyssynergia (DSD), and flow curve pattern (FCP). Results: Of the 200 patients with a median age of 10 (4–18) years, 128 (64%) were girls and 72 (36%) boys. The maximum flow rate and the median voided volume were found to be 20 (4–61) mL/s and 232 (116–781) mL. The Fleiss\" kappa coefficient of VV, DSD, and FCP in the first assessment was 0.510, 0.501, and 0.346. In the second assessment, κ values were 0.530, 0.422, and 0.373. The best-agreed findings were similar at both times. These were found to be low VV (0.602 and 0.626) and intermittent pattern (0.500 and 0.553). Interpreters were found to have a statistically significant difference in agreement with their own interpretation at different times. Conclusion: Both inter- and intra-observer reliability of the agreement point out the problem in the standardization of uroflowmetry. Inter- and intra-observer reliability of uroflowmetry interpretation can be increased by defining precise numbers and numerical algorithms.Publication Metadata only The comparison of anxiety levels in children who underwent invasive or non-invasive urodynamic studies(2022-05-13) ŞEKERCİ, ÇAĞRI AKIN; TARCAN, TUFAN; YÜCEL, SELÇUK; TANIDIR, YILÖREN; Sekerci C. A., Can Ozkan O., Tanidir Y., Tarcan T., Yucel S.INTRODUCTION AND OBJECTIVE: Urodynamic studies play an important role in the evaluation of children with lower urinary tract dysfunction. In this study, we aimed to examine the effects of invasive and non-invasive urodynamic studies on the anxiety levels of children with the help of an anxiety scale. METHODS: Children aged 8-17 years who were scheduled for uroflowmetry (UF) or filling cystometry (FC) and who agreed to fill out an anxiety scale were included in the study. It was the first UF or FC of all children. “The Screen for Child Anxiety Related Disorders (SCARED)” form consisting of 41 questions was used in the evaluation. All children included in the study filled the form themselves. The SCARED results of children who underwent UF and FC were compared. RESULTS: A total of 56 children with a mean age of 10.85þ/- 2.98 years were included in the study. 31 (55.4%) of the children were females and 25 (44.6%) were males. The number of children who had UF was 26 (46.4%; 8.5 (8-14) years), and 30 (53.6%; 11.5 (8-17) years) had FC. The total SCARED scores of the children who underwent UF and FC were 26.5 (5-75) and 27 (2-57), respectively, and there was no statistical difference (p[0.980) (Table 1). A significant difference was found only in "Separation Anxiety Disorder" among sub-score evaluations (p[0.049) (Table 1). In children who underwent filling cystometry, there was no statistical difference in the total SCARED score between those who did and did not do clean intermittent catheterization (28 (3-41); 27 (2-57), respectively) (p[0.860). CONCLUSIONS: The SCARED scores above 25 indicate an anxiety disorder, and interestingly, in this study, both the invasive and noninvasive urodynamic study groups scored over 25. We consider that non-invasive urodynamic tests may cause stress on children as much as invasive ones.Publication Metadata only Effects of platelet-rich plasma against experimental ischemia/reperfusion injury in rat testis(ELSEVIER SCI LTD, 2017) YARAT, AYŞEN; Sekerci, C. A.; Tanidir, Y.; Sener, T. E.; Sener, G.; Cevik, O.; Yarat, A.; Alev-Tuzuner, B.; Cetinel, S.; Kervancioglu, E.; Sahan, A.; Akbal, C.Background Testicular torsion is a common problem and, to date, there is no agent to preserve testicular function following detorsion. Platelet-rich plasma (PRP), with its rich growth factor composition, has proven beneficial in regenerative therapy. It is believed that PRP has not been studied in testis for ischemia/ reperfusion (I/R) injury. Objective This study investigated the effect of PRP in an I/R rat model 1 month after detorsion. Study design Of 24 adult male Spraguee-Dawley rats, 18 were randomly assigned into three groups, with six in each: control, I/R and I/R + PRP. The PRP was prepared from the remaining six. Each group underwent right orchiectomy. Ischemia was performed by rotating the left testis 720 degrees and fixing with a nylon suture for 4 h. Reperfusion occurred 4 h later by removing the suture, and PRP was administered at a dose of 10 ml (2000 x 10(9)/l) into the left testis via the intra-parenchymal route. Animals were sacrificed at the fourth week, and testes were taken for malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD), myeloperoxidase (MPO), transforming growth factor beta (TGF-beta), and caspase-3 measurements. Results Ischemia/reperfusion caused a significant increase in MDA, MPO and caspase-3 activity, and significant decrease in GSH levels and SOD activity. The PRP treatment helped correct the alterations in SOD, caspase-3, and MPO activities and MDA levels. However, the mean MDA level and MPO activity were not totally restored compared with the controls. Serum testosterone levels of the I/R group were significantly lower compared with the control and I/R + PRP groups. TGF-b and caspase-3 protein expressions were significantly higher in the I/R group compared with the control group and were low with PRP administration compared with I/R groups (summary Table). Discussion The findings of the present study suggest that PRP, by inhibiting neutrophil infiltration and oxidative stress and increasing antioxidant defense, exerts protective effects on testicular tissues against I/R. This study had some limitations: a scoring system was not used in the assessment of spermatogenesis in the histopathological findings and specific testis cell types were not histologically assessed. Conclusions In light of the biochemical, histological and, especially, hormonal findings, intraparenchymal PRP injection may have a protective effect in testicular tissue against I/R injury.Publication Open Access Efficacy and Predictive Factors of the Outcome of Extracorporeal Shock Wave Lithotripsy: A Review of One-thousand-nine-hundredninety-seven Patients(GALENOS YAYINCILIK, 2019-09-01) ŞEKERCİ, ÇAĞRI AKIN; Kocakgol, Huseyin; Yilmaz, Ali Haydar; Yapanoglu, Turgut; Ozkaya, Fatih; Sekerci, Cagri Akin; Bedir, Fevzi; Kocaturk, Huseyin; Tanidir, YilorenObjective: The aim of this study was to evaluate the efficacy and safety of extracorporeal shock wave lithotripsy (SWL) in a large patient group treated with SWL due to kidney stone. Materials and Methods: Data of 1997 patients, who underwent SWL due to renal stone in the at Ataturk University Medical Faculty Clinic of Urology between 2008 and 2013, were evaluated retrospectively. The effect of age, gender, stone location, size and opacity on SWL success, additional procedure requirement and complication rates were evaluated. Results: Six hundred eighty-six patients were female and 1311 were male. The overall rate of success of SWL was found to be 82.6%. The rate of success of SWL was 82.1% in female patients and 82.9% in male patients (p>0.05). Gender, stone location, stone size and opacity were significant predictive factors for the success of SWL (p<0.05). The complication rate in stones >15 mm was 5.8% (p<0.05). Age, gender, stone size, stone location and stone opacity were not predictive factors for additional treatment after SWL (p>0.05). Conclusion: Although SWL is less preferred today with the increase of endourological interventions, it remains an effective treatment method in appropriate patients.Publication Metadata only Experience with Treatment of Retroperitoneal Fibrosis: Collaboration of Urology and Nephrology Departments for 26 years in Marmara University(TURK NEFROLOJI DIYALIZ TRANSPLANTASYON DERGISI, 2017) ŞEKERCİ, ÇAĞRI AKIN; Sekerci, Cagri Akin; Tanidir, Yiloren; Ozgen, Mahir Bulent; Koc, Mehmet; Akbal, Cem; Simsek, FerruhOBJECTIVE: Retroperitoneal fibrosis (RPF) is a rare condition characterized by the presence of inflammation and fibrosis in the retroperitoneum. This study describes our multidisciplinary approach and our results. MATERIAL and METHODS: Patients diagnosed with RPF at Marmara University between January 1990 and May 2007 were evaluated. Etiologies, demographic characteristics, renal functions, treatments and prognoses of each patient were recorded and data were analyzed. RESULTS: Of all patients, five were female, 15 were male and the mean follow-up was 11.3 years (1-18 years). Six patients were operated unilaterally and five were operated bilaterally with ureterolysis. Median creatinine values at diagnosis were 2.75 mg/dl (0.7-6.9 mg/dl) in females, 3.2 mg/dl (0.84-7.2 mg/dl) in males and 3.11 mg/dl (0.7-7.2 mg/dl) in the whole group. Median baseline creatinine level after surgery (n=11) was found to decrease from 3.63 mg/dl (1.4-7.2 mg/dl to 1.46 mg/dl (0.8-2.6 mg/dl). Baseline and drop in creatinine were compared among patients treated with either surgical or pharmacological methods, and no statistical significance was found. CONCLUSION: Retroperitoneal fibrosis can be treated surgically and pharmacologically. Our study has shown similar success for both methods. Treatment should be specific for each patient in a multidisciplinary fashion.Publication Open Access Outcomes and lessons learnt from practice of retrograde intrarenal surgery (RIRS) in a paediatric setting of various age groups: a global study across 8 centres(2022-05-01) ŞEKERCİ, ÇAĞRI AKIN; TANIDIR, YILÖREN; Lim E. J., Traxer O., Quiroz Madarriaga Y., Castellani D., Fong K. Y., Chan V. W., Bujons Tur A., Pietropaolo A., Ragoori D., Shrestha A., et al.Purpose To analyse and report the practice, outcomes and lessons learnt from a global series of retrograde intrarenal surgery (RIRS) in a paediatric multicentre series. Methods A retrospective review of anonymized pooled data gathered globally from 8 centres in paediatric patients ( 10 years (Group C). Overall, post-operative complication rate was 13.7%. Chi-square comparisons were used for categorical variables; analysis of variance (ANOVA) or Kruskal-Wallis tests were used for continuous variables. Results 314 patients were analysed. The mean age was 9.54 +/- 4.76 years. Groups A, B and C had 67 (21.3%), 83 (26.4%) and 164 (52.2%) patients, respectively. Mean stone size was 10.7 +/- 4.62 mm. Pre-stenting was performed in 155 (49.4%) of patients, ureteral access sheaths (UAS) was used in 54.5% of patients with majority (71%) utilizing holmium laser for stone fragmentation. All complications were minor (Clavien-Dindo grade 1 and 2). SFR was 75.5%. Conclusions RIRS is acceptable as a first-line intervention in the paediatric population with reasonable efficacy and low morbidity. Complications are slightly higher in patients < 5 years of age, which should be taken into account while counselling patients.Publication Open Access Outcomes of fluoroscopy-free retrograde intrarenal surgery and predictive factors of stone-free(2021) ŞEKERCİ, ÇAĞRI AKIN; Kocakgol, Huseyin; Aydin, Hasan Riza; Guctas, Ahmet Ozgur; Sekerci, Cagri Akin; Ozturk Kocakgol, Deniz; Aksoy, Hamit Zafer; Tanidir, Yiloren; Kocakgol, HuseyinOBJECTIVE: To evaluate the outcomes of flouroscopy-free retrograde intrarenal surgery (ffRIRS) and to investigate the factors that may affect stone-free rate. MATERIALS AND METHODS: The charts of patients who underwent ffRIRS between January 2017 and August 2019 were reviewed retrospectively. Patients with missing preoperative imaging and patients with kidney anomalies were excluded from the study. Age, gender, stone size, stone localization, stone density, laterality, operation time, stone-free rate, complications and auxiliary procedures were recorded and analyzed. RESULTS: Study group involved 44 (43.1%) female and 58 (56.8%) male patients. Stone-free rate in a single-session ffRIRS were found to be correlated with stone localization (p = 0.003), stone volume (p = 0.004), and stone density (p = 0.009) but not with age (p = 0.950). Patients with multiple calyceal stones and a stone burden over 520 mm3 were found to be less stone-free. The complication rate in female gender (n = 7) was significantly higher compared to male (n = 1) (p = 0.011). No major complications such as ureteral injury or avulsion were observed. Overall, 13 patients (12.7%) needed auxiliary procedures. The operation time seemed to be affected by stone size and gender (p = 0.005; p = 0.044, respectively). CONCLUSIONS: Stone-free rate in ffRIRS were found to be affected by stone density, size, and localization. Patients with multiple caliceal stones and high stone burden (< 520 mm3) have been found to have low stone-free rate, so one can speculate that having fluoroscopy assistance in RIRS might help us to improve surgical success.Publication Metadata only Differentiation of ureteral stones and phleboliths using Hounsfield units on computerized tomography: a new method without observer bias(SPRINGER, 2017) ŞEKERCİ, ÇAĞRI AKIN; Tanidir, Yiloren; Sahan, Ahmet; Asutay, Mehmet Kazim; Sener, Tarik Emre; Talibzade, Farhad; Garayev, Asgar; Tinay, Ilker; Sekerci, Cagri Akin; Simsek, FerruhTo differentiate ureteral stones and phleboliths by measuring density [as Hounsfield unit (HU)] and volume (as mm(3)) of the opacities in the bony pelvis on unenhanced computerized tomography (U-CT). A total of 52 patients, who underwent semirigid ureteroscopy and laser lithotripsy for distal ureteral stone and had isochoronous phleboliths in U-CT, were included. Images were reviewed for density and volume of the opacities. Data were compared, and a cut-off value was defined with receiver operating characteristics curve analysis to differentiate the nature of the opacity. Using the cut-off values of 171 mmA(3) for volume (sensitivity 75 %, specificity 100 %) and 643 HU for density (sensitivity 75 %, specificity 93 %), differentiation between stone and phlebolith was achieved. Differentiation of pelvic opacities needs meticulous observation with certain signs on U-CT. On the other hand, our study offers a new method, with certain cut-off values, such as 643 HU and 171 mm(3), which can be used to precisely predict the actual nature of opacities of interest.