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 Open Access Resistant pediatric priapism: A real challenge for the urologist(CANADIAN UROLOGICAL ASSOCIATION, 2015-08-10) ŞEKERCİ, ÇAĞRI AKIN; Sekerci, Cagri Akin; Akbal, Cem; Sener, Tarik Emre; Sahan, Ahmet; Sahin, Bahadir; Baltacioglu, Feyyaz; Simsek, FerruhPriapism in pediatric patients is a rare entity. We present an 8-year-old boy with known cerebral palsy. He came to the emergency department with sustained painful erection for 12 hours. Physical examination showed rigid penis. Blood count and biochemical analysis were normal. Although penile Doppler ultrasound revealed normal arterial and venous flow, cavernosal blood gas was hypoxic. A total of 50 mL of dark blood was aspirated, and 2 mL of 0.001% adrenalin solution was applied to both corpus cavernosum, twice within 20 minutes, which eventually did not achieve detumescence. A distal Winter shunt was performed at the end of which the penis was semi-flaccid. By the 18th hour of surgery, the penis re-gained painful erection status, so an Al-Ghorab shunt was performed. After the Al-Ghorab shunt, the penis was still in the semi-flaccid state. The next day, an angiography was performed and an arteriovenous fistula was discovered and treated by embolization. The flaccid state was achieved and the patient was discharged the day after the embolization.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 Mi̇yelodi̇splazi̇li̇ çocuklarda termi̇nal ve fazi̇k detrusor aşırı akti̇vi̇tesi̇ni̇n üst üri̇ner si̇stemhasarina etki̇si̇(2015-11-28) ŞEKERCİ, ÇAĞRI AKIN; ŞAHİN, BAHADIR; TARCAN, TUFAN; ŞEKERCİ Ç. A., AKBAL C., Sahan A., ŞAHİN B., ŞİMŞEK F., TARCAN T.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 Can We Predict the Surgical Margin Positivity in Patients Treated with Radical Prostatectomy? A Multicenter Cohort of Turkish Association of Uro-Oncology(GALENOS YAYINCILIK, 2015-03-05) ŞEKERCİ, ÇAĞRI AKIN; Bolat, Deniz; Eskicorapci, Saadettin; Karabulut, Erdem; Baltaci, Sumer; Yildirim, Asif; Sozen, Sinan; Ates, Ferhat; Sekerci, Cagri Akin; Kurtulus, Fatih; Dirim, Ayhan; Muezzioglu, Talha; Can, Cavit; Bozlu, Murat; Gemalmaz, Hakan; Ekici, Sinan; Ozen, Haluk; Turkeri, LeventObjective To analyze the parameters that predict the surgical margin positivity after radical prostatectomy for localized prostate cancer. Materials and Methods In this multicenter study, the data of 1607 consecutive patients undergoing radical prostatectomy for localized prostate cancer in 12 different clinics in Turkey between 1993-2011 were assessed. Patients who had neoadjuvant treatment were excluded. We assessed the relationship between potential predictive factors and surgical margin status after radical prostatectomy such as age, cancer characteristics, history of transurethral prostate resection, surgical experience and nerve-sparing technique by using univariate and multivariate Cox regression analyses and t test. Results The overall surgical margin positivity rate was 22.6% (359 patients). In univariate analyses, preoperative prostate specific antigen level, clinical stage, biopsy Gleason score, percentage of tumor involvement per biopsy specimen, transurethral prostate resection history, surgical experience and nerve-sparing technique were significantly associated with positive surgical margin rate. In multivariate analyses, preoperative prostate specific antigen level (OR: 1.03, p=0.06), percentage of tumor involvement per biopsy specimen (OR: 7,14, p<0,001), surgical experience (OR: 2.35, p=0.011) and unilateral nerve-sparing technique (OR: 1.81, p=0.018) were independent predictive factors for surgical margin positivity. Conclusion Preoperative prostate specific antigen level, percentage of tumor involvement per biopsy specimen, surgical experience and nerve-sparing technique are the most important predictive factors of surgical margin positivity in patients undergoing radical prostatectomy for localized prostate cancer.Publication Metadata only Urinary NGF, TGF-beta 1, TIMP-2 and Bladder Wall Thickness Predict Neurourological Findings in Children with Myelodysplasia(ELSEVIER SCIENCE INC, 2014) ŞEKERCİ, ÇAĞRI AKIN; Sekerci, Cagri Akin; Isbilen, Banu; Isman, Ferruh; Akbal, Cem; Simsek, Ferruh; Tarcan, TufanPurpose: Dimercapto-succinic acid scintigraphy and urodynamic studies are gold standards to evaluate renal scarring and neurogenic bladder dysfunction, respectively. We sought to establish the value of bladder wall thickness together with urine NGF, TGF-beta 1 and TIMP-2 to predict the urodynamic profile and upper urinary tract damage in children with myelodysplasia. Materials and Methods: A total of 80 children with myelodysplasia underwent urodynamic investigation, bladder wall thickness measurement and dimercaptosuccinic acid scintigraphy with basic neurourological evaluation. Two study and 2 control groups were created according to presence or absence of renal scarring on dimercapto-succinic acid scan (study and control groups 1) and according to detrusor leak point pressure greater or less than 40 cm H2O (study and control groups 2). Urine samples were analyzed with ELISA. Results: The study population consisted of 44 girls and 36 boys with a median +/- SD age of 7.2 +/- 3.6 years (range 2 to 17). Study and control groups 1 consisted of 35 and 45 children with abnormal and normal dimercapto-succinic acid scan findings, respectively. Study and control groups 2 included 30 and 50 children with detrusor leak point pressure greater and less than 40 cm H2O, respectively. Bladder wall thickness and urinary levels of TGF-beta 1, NGF and TIMP-2 were significantly increased in both study groups compared to controls. Conclusions: Urine markers and bladder wall thickness measurement may predict urinary tract impairment in children with myelodysplasia. Such markers may differentiate at risk patients with either renal scarring or high detrusor leak point pressure, and decrease the need for urodynamics and renal scintigraphy.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.Publication Open Access Are There Any Differences in the Neural and Extracellular Matrix Proteins Density Between Children and Adults with Intrinsic Ureteropelvic Junction Obstruction?(GALENOS YAYINCILIK, 2017-12-27) KAYA, CEVDET; Sahin, Bahadir; Kaya, Cevdet; Talibzade, Farhad; Tanidir, Yiloren; Ercan, Feriha; Demirci, Elif Kervancioglu; Sekerci, Cagri Akin; Akbal, Cem; Simsek, FerruhObjective: To compare changes in connective, neural and muscle tissues, and extracellular matrix in child and adult patients so that we can create a more objective view on the timing of surgery. Materials and Methods: Twenty-six patients, who were operated for ureteropelvic junction (UPJ) obstruction in our clinic between September 2014 and May 2016, were included in the study. For the evaluation of connective tissue, Masson's trichrome staining was used. Muscle, extracellular matrix elements and neural tissue were evaluated with immunohistochemistry using alpha-smooth muscle actin (a-SMA), Tenascin C and S100, respectively. Microscopically, the tissues were scored according to their staining density (0: No staining; 1: Minor; 2: Moderate, 3: Dense). Results: There were 12 children and 14 adults in the study groups. The initial evaluation showed no statistically significant difference between studied tissue types with respect to staining density for all parameters (Masson: p=0.414, a-SMA: p=0.204, Tenascin-C: p=0.264, S100: p=0.534). There was no statistically significant correlation between staining density and renal function percentage of the affected kidney (Masson: r=0.454, p=0.051, alpha-SMA: r=-0.323, p=0.177 -Tenascin-C: r=0.290, p=0.229 -S100: r=-0.080, p=0.744). Conclusion: Our preliminary study showed some structural changes between adult and child patients but there is no statistically significant difference between the groups with respect to staining density scores. These results state that although UPJ obstruction is an ongoing process, there is no correlation between the histological deterioration degree of the UPJ segment and the loss on renal function for both children and adults.