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    Asymptomatic Giant Right Renal Oncocytoma: A Case Report
    (Springernature, 2023) Cevik, Gokhan; Tozsin, Atinc; Erdogan, Ezgi G.; Cakici, Hakan; Akdere, Hakan
    Renal oncocytoma is usually detected incidentally. It can be considered as a renal cell carcinoma (RCC) on preoperative imaging. They usually present as small masses and usually look like benign tumors. Giant oncocytomas are rare. A 72-year-old male patient was seen in the outpatient department for left scrotal swelling. Ultrasound (US) showed a giant mass compatible with RCC in the right kidney which was incidentally detected. Abdominal computed tomography (CT) revealed a mass with an axial diameter of 167x146 mm, compatible with RCC, a heterogeneous mass of soft tissue density with central necrosis. There was no evidence of tumor thrombus in the right renal vein or inferior vena cava. Open radical nephrectomy was performed through an anterior subcostal incision. Pathological examination revealed a 17x15 cm renal oncocytoma. The patient was discharged on the sixth day postoperatively. Clinically or radiologically, renal oncocytoma and renal cell carcinoma usually cannot be distinguished, although oncocytoma may be suspected if a central scar with fibrous extensions is seen, the so-called spoke-wheel appearance. The treatment decision should be made according to the clinical aspects. Radical/partial nephrectomy or thermal ablation can be considered as treatment options. In this article, we review the literature on the radiological and pathological features of renal oncocytoma.
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    The Effect of Pirfenidone on Peyronie Plaques and Erectile Function in a Peyronie's Rat Model
    (Coll Physicians & Surgeons Pakistan, 2023) Cevik, Gokhan; Tozsin, Atinc; Tastekin, Ebru; Dursun, Murat; Aktoz, Tevfik; Kadioglu, Ates
    Objective: To investigate the anti-fibrotic effects of pirfenidone on Peyronie's disease in an experimental rat model with intracavernosal injection of TGF-ss and whether pirfenidone improves erectile function. Study Design: Experimental study. Place and Duration of the Study: Faculty of Medical Experimental Animals and Research Laboratory, Trakya University, from January to March 2021. Methodology: In this study, 27 male Sprague Dawley rats were used, and three groups were randomly identified. The rats in Group 1 served as the control group. Group 2 was not treated, and Group 3 was treated with pirfenidone therapy. The rats in Group 3 were administered pirfenidone 30 mg/kg/day by oral gavage, every day for four weeks, three weeks after the start of the experiment. At the end of seven weeks, a haemodynamic study was performed with cavernosal nerve stimulation to evaluate the erectile function, the rats were sacrificed, and the penile tissues were evaluated immunohistochemically. Results: MeICP/MIBP values were found to be higher in treated rats compared to rats in the untreated group but no statistically significant difference was found in MeICP/MIBP values between the control, Peyronie model, and treatment groups (p=0.25). According to the histopathological examination, the rate of fibrosis with H&E staining was mild (100%) in the control group, severe (100%) in the Peyronie group, and severe (87.5% severe and 12.5% moderate) in the Peyronie + treatment group. Conclusion: In the study, pirfenidone used in the treatment of Peyronie's disease had a positive effect on erectile function, though not considered statistically significant. It has been shown that it has no histopathological effect on Peyronie's plaques.
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    A Modified Left Ileal Conduit in the Presence of a Left Short Ureter Following an Urgent Radical Cystectomy: A Case Report
    (Springernature, 2023) Cakici, Hakan; Tozsin, Atinc; Cevik, Gokhan; Akdere, Hakan
    The ileal conduit is the most common method performed for urinary diversion following radical cystectomy. The prepared conduit is usually placed on the right abdominal wall. There is not enough experience and literature on left-sided ileal conduits. Here, we report a case of a left-sided ileal conduit with a modified method and describe the surgical technique. A 68-year-old male patient had undergone an urgent radical cystectomy operation one year ago due to bladder cancer and gross hematuria. However, urinary diversion was not performed, and a bilateral nephrostomy was inserted. An ileal conduit was planned for the patient after oncological stabilization. On preoperative evaluations, bilateral ureters were observed to be short, with the left being prominent. The prepared ileal conduit was passed under the sigmoid mesentery due to the short ureters and placed on the left abdominal wall. There were no major complications during follow-ups. We emphasize that the method we performed is a safe option in mandatory situations.
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    Open Partial Nephrectomy in Giant Papillary Renal Cell Carcinoma: Presentation of 2 Cases
    (Galenos Publ House, 2023) Tozsin, Atinc; Deger, Muslim Dogan; Ibrahim, Muhidin Hassan; Aktoz, Tevfik
    Radical nephrectomy is still considered the standard treatment for clinical T2 (cT2) tumors, but available data mention the potential role of partial nephrectomy in large renal tumors (=cT2) in selected cases. Because of the increased risk of complications in large masses, the decision for partial nephrectomy should be taken together with an experienced surgeon and a multidisciplinary team. We report two cases with giant renal tumor, that partially resected and final histopathological examination revealed papillary renal cell carcinoma. Considering the risk of developing kidney failure secondary to diabetes and hypertension in both our patients, partial nephrectomy was initially considered and successfully treated with nephron-sparing surgery.
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    The Role of Artificial Intelligence in Medical Education: A Systematic Review
    (Sage Publications Inc, 2024) Tozsin, Atinc; Ucmak, Harun; Soyturk, Selim; Aydin, Abdullatif; Gozen, Ali Serdar; Al Fahim, Maha; Guven, Selcuk
    Background To examine the artificial intelligence (AI) tools currently being studied in modern medical education, and critically evaluate the level of validation and the quality of evidence presented in each individual study.Methods This review (PROSPERO ID: CRD42023410752) was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. A database search was conducted using PubMed, Embase, and Cochrane Library. Articles written in the English language between 2000 and March 2023 were reviewed retrospectively using the MeSH Terms AI and medical education A total of 4642 potentially relevant studies were found.Results After a thorough screening process, 36 studies were included in the final analysis. These studies consisted of 26 quantitative studies and 10 studies investigated the development and validation of AI tools. When examining the results of studies in which Support vector machines (SVMs) were employed, it has demonstrated high accuracy in assessing students' experiences, diagnosing acute abdominal pain, classifying skilled and novice participants, and evaluating surgical training levels. Particularly in the comparison of surgical skill levels, it has achieved an accuracy rate of over 92%.Conclusion AI tools demonstrated effectiveness in improving practical skills, diagnosing diseases, and evaluating student performance. However, further research with rigorous validation is required to identify the most effective AI tools for medical education.