Biomedical subjects

Deniz Acar

Publications and source records attributed to Deniz Acar.

10 recordsLinked to original sources

PubMed2005

Protective effect of vascular endothelial growth factor on histologic changes in testicular ischemia-reperfusion injury.

OBJECTIVE: To evaluate the efficacy of vascular endothelial growth factor (VEGF) on long-term histologic damage in testicular ischemia-reperfusion injury. DESIGN: Controlled experimental study using rats. SETTING: University of Mersin School of Medicine, Mersin, Turkey. ANIMAL(S): Sixteen adult male Wistar rats. INTERVENTION(S): Five rats underwent 2 hours of testicular torsion. Six rats received VEGF injection into the testis before detorsion. Five rats underwent sham operation. MAIN OUTCOME MEASURE(S): Mean seminiferous tubular diameter (MSTD), germinal epithelial cell thickness (GECT), mean testicular biopsy score (MTBS), and apoptosis (caspase-3-positive cells). RESULT(S): Testicular torsion-detorsion caused a significant decrease in MSTD, GECT, and MTBS and a significant increase in the mean value of caspase-3-positive cells in ipsilateral testes but not in the contralateral testes. The MSTD, GECT, and MTBS of the ipsilateral testes were significantly higher in the group treated with VEGF than in the torsion-detorsion group. The animals treated with VEGF had a significant decrease in the mean value of ipsilateral testicular caspase-3-positive cells compared with the torsion-detorsion group. CONCLUSION(S): Vascular endothelial growth factor might have a role in testicular damage caused by ischemia-reperfusion. Administering VEGF before reperfusion might have the potential to decrease the long-term histologic damage after testicular torsion.

Animals↗

PubMed2005

Is catheter cause of subjectivity in sensations perceived during filling cystometry?

OBJECTIVES: To investigate the impact of the catheter on perceptions of filling. In our previous study, we demonstrated that some patients perceived sensations despite a lack of filling during cystometry. METHODS: The study included 45 patients with lower urinary tract symptoms attributed to benign prostatic hyperplasia. The average patient age was 57.9 years (range 48 to 79). Patients were draped to keep them from seeing their penis and the filling bag, pump, and screen process. In the first phase, the catheter was fixed to the penile skin without introducing it through the urethra, and the patient was told the test had begun. At the end of the first phase, the bladder was emptied. Before the second phase, an 8F urodynamic catheter was introduced, but during the test, nothing was infused. During the third phase, filling cystometry was performed with a 50-mL/min pump speed. The bladder was emptied after all three phases. The times that elapsed until each sensation was perceived, in seconds, were used to compare the sensations. RESULTS: In the first phase, 21 patients reported a first sensation, 10 reported first desire, and 4 reported normal desire, despite a lack of catheterization. No statistically significant difference was found between the mean first sensation/first desire, first sensation/normal desire, first desire/normal desire ratios of the patients who perceived sensations in the three phases and the strong desire/normal desire ratios of the patients in the second and third phases (P >0.05 for all). CONCLUSIONS: Although the perceptions were reported in the first and second phases, the catheter could not be the sole cause of the subjectivity.

Aged↗

PubMed2005

Adolescent varicocele repair: long-term results and comparison of surgical techniques according to optical magnification use in 100 cases at a single university hospital.

PURPOSE: We review the long-term results of varicocele repair, and compare the complication rates of varicocelectomy techniques according to optical magnification use in adolescents with varicocele at a single university hospital. MATERIALS AND METHODS: We prospectively studied 100 males 7 to 19 years old with clinical palpable varicocele. Of the patients 52 (52%) underwent left unilateral varicocelectomy and 48 (48%) underwent bilateral varicocelectomy. Varicocelectomy was performed using a microscope in 49 patients (79 sites), loupe magnification in 25 (35 sites) and no magnification in 26 (34 sites) using either a subinguinal or inguinal approach. Postoperative complications were compared in all patients based on technique. Preoperative and postoperative serum hormone values and semen parameters were compared in 33 patients. RESULTS: Mean postoperative followup was 30.4 +/- 13.06 months (12 to 65). Total motile sperm count increased from 22.6 million +/- 5.16 million to 64.53 million +/- 12.3 million postoperatively, which was statistically significant (p = 0.002). Postoperative recurrence rates were 0% in cases managed by microsurgical varicocelectomy, 2.9% in those where loupe magnification was used and 8.8% in those where no magnification was used. Postoperative hydrocele rates in these cases were 0%, 2.9% and 5.9%, respectively. The highest rates of recurrence and hydrocele were observed in cases where no magnification was used, compared to those managed by microsurgery (p = 0.03 and p = 0.116, respectively). CONCLUSIONS: Adolescent varicocele repair improves semen parameters and is a safe method with low recurrence and low complication rates. Our study suggests that the postoperative complication rate significantly decreases with use of higher magnification, such as microscopy. Microsurgical varicocele repair is the best technique with the lowest postoperative rates of recurrence and hydrocele in the treatment of adolescent varicoceles.

Adolescent↗

PubMed2004

How reliable are bladder perceptions during cystometry?

AIMS: Sensory input is important for bladder control in daily life. It has been reported that perceptions during cystometry are subjective. To help refine this subjectivity, objective and semi-objective tests (e.g., sensory thresholds of electrical stimulation) have been recommended by The International Continence Society. However, the reliability of such studies has not been established. This study was designed to evaluate the reliability of bladder perceptions during cystometry. METHODS: The study included 59 patients with urologic complaints. The average age of 40 male and 19 female patients was 58.1 years (range: 14-83). After insertion of an 8F double lumen catheter, patients were blinded to the pump and screen process. During Phase I nothing was infused. In Phase II, filling cystometry was performed with 50 ml/min pump speed and then the bladder was emptied. Phase III was performed with the same method used in Phase I. The time that each sensation was perceived, in seconds, was used to compare sensations. The bladder volume, at which sensations were perceived, was recorded at Phase II. RESULTS: Except for strong desire, there were no statistically significant differences between the mean times in seconds elapsed till sensations in Phases I and III, but they were different from those in Phase II. The time elapsed until strong desire was not different in each of the three phases. However, there was strong a correlation in the ratios of sensations to strong desire between Phase I and II (r = 1, P = 0.01), Phase I and III (r = 0.99, P = 0.01), and Phase II and III (r = 0.98, P = 0.01). CONCLUSIONS: Proprioception of the bladder filling during cystometry is subjective. This data shows that sensations noticed by the patient during filling cystometry may be related to stimuli other than bladder filling.

Adolescent↗

PubMed2004

Inhibition of poly(adenosine diphosphate-ribose) polymerase decreases long-term histologic damage in testicular ischemia-reperfusion injury.

OBJECTIVES: To evaluate the effect of 3-aminobenzamide, an inhibitor of poly(adenosine diphosphate-ribose) polymerase (PARP), on the long-term histologic damage in testicular ischemia-reperfusion injury. PARP inhibitors have been used successfully to decrease ischemia-reperfusion injury in several organ systems. METHODS: Adult male Wistar rats were divided into four groups of 7 rats each. One group underwent 2 hours of testicular torsion; one received pretreatment with vehicle (dimethyl sulfoxide) before detorsion; one received pretreatment with 3-aminobenzamide, an inhibitor of PARP, before detorsion; and one group underwent a sham operation. All rats underwent bilateral orchiectomy 60 days after the experiment. The mean seminiferous tubular diameter, germinal epithelial cell thickness, and mean testicular biopsy score were determined by histologic examination of each testis. RESULTS: Testicular torsion-detorsion caused a significant decrease in the mean seminiferous tubular diameter, germinal epithelial cell thickness, and mean testicular biopsy score in the ipsilateral testes (P <0.001), but not in the contralateral testes. The animals treated with 3-aminobenzamide had a statistically significant increase in these histologic parameters compared with the torsion-detorsion group (P <0.01). CONCLUSIONS: The results of this study show that PARP may have a role in the testicular damage caused by ischemia-reperfusion. Administering PARP inhibitors before reperfusion may have the potential to decrease the long-term histologic damage that occurs after testicular torsion.

Animals↗

PubMed2004

Can the outcome of transurethral resection of the prostate be predicted preoperatively?

OBJECTIVES: To establish a formula for predicting the outcome of transurethral resection of the prostate using noninvasive parameters of preoperative evaluation. METHODS: The data of 54 men with a mean age of 57 years (range 43 to 78) were retrospectively analyzed. The International Prostate Symptom Score, quality-of-life score of the International Prostate Symptom Score questionnaire, maximal flow rate (Qmax) recorded during uroflowmetry, age, prostate volume calculated by transrectal ultrasonography, postvoid residual urine volume, and results of pressure-flow studies were evaluated to find a formula that would predict the outcome of transurethral resection of the prostate. The patients were evaluated by uroflowmetry, postvoid residual urine volume determination, and International Prostate Symptom Score questionnaire at 3 months postoperatively. Four different success criteria were investigated with the calculated equations. RESULTS: According to the discriminant analysis, two new scores were calculated as S(1) = (0.169 x age) - (0.0075 x Qmax) and S2 = (0.168 x age) - (0.095 x Qmax) - (0.007 x detrusor pressure at Qmax). For the four success criteria, the optimal cutoff, obtained from the receiver operating characteristic curves of S(1) and S(2), was 8.83 and 9.21, respectively. A statistically significant difference was not found between S1 and S2. The S1 formula had a sensitivity between 71.8% and 85.2%, specificity between 71.4% and 86.7%, and positive predictive value between 72.2% and 92.9% for the four different criteria using two simple variables (Qmax of uroflowmetry and age). CONCLUSIONS: Because urodynamic parameters did not add benefit to the formula consisting of age and Qmax of uroflowmetry with considerable sensitivity and specificity, performing urodynamic studies might not be useful for predicting the outcome of transurethral resection of the prostate.

Adult↗

PubMed2004

The prevalence of female sexual dysfunction and potential risk factors that may impair sexual function in Turkish women.

OBJECTIVES: To detect the prevalence of sexual dysfunction, and also to investigate possible risk factors that may cause sexual dysfunction in the Turkish women. MATERIALS AND METHODS: The study consisted of 179 women between the ages of 18 and 66 years living in households from different sociocultural areas. The women were divided into 5 groups according to their ages: 18-27 years (n = 23), 28-37 years (n = 55), 38-47 years (n = 43), 48-57 years (n = 44) and 58-67 years (n = 14). Female sexual function was evaluated with a detailed 19-item questionnaire to assess desire, arousal, lubrication, orgasm, satisfaction and pain. The prevalence of sexual dysfunction was calculated for each domain and compared among the groups. In addition, demographic characteristics and medical risk factors were assessed in all women, and the findings were compared between the women with and without sexual dysfunction. RESULTS: Based on total sexual function score, 84 (46.9%) out of 179 women had sexual dysfunction. The prevalence of female sexual dysfunction was 21.7% in the ages of 18-27 years, 25.5% in the ages of 28-37 years, 53.5% in the ages of 38-47 years, 65.9% in the ages of 48-57 years and 92.9% in the ages of 58-67 years. The prevalence of sexual dysfunction for each domain also increased with age. To investigate various factors that may cause female sexual dysfunction, no significant differences were detected in smoking history (p = 0.14), marriage age (p = 0.7), the presence of previous pelvic surgery (p = 0.09), and contraception methods used (p = 0.31). However, sexual dysfunction was observed as significantly higher in the presence of older age (p = 0.001), lower educational level (p = 0.012), unemployment status (p = 0.017), chronic disease (p = 0.032), multiparity (p = 0.0027) and menopause status (p = 0.0001). CONCLUSIONS: The prevalence of female sexual dysfunction including desire, arousal, lubrication, orgasm, satisfaction and pain problems increases with age. In addition, the presence of a lower educational level, unemployment status, chronic diseases, multiparity and menopause status are important risk factors that may cause sexual dysfunction.

Adolescent↗

PubMed2003

Botulinum toxin type A may improve bladder function in a rat chemical cystitis model.

The purpose of this study was to investigate the effect of botulinum toxin type A on bladder function and histology in a rat chemical cystitis model. The study included 41 female Sprague-Dawley rats with chemical cystitis induced by intravesical instillation of hydrochloric acid. The acid instillation was repeated monthly to maintain chronic inflammation. The treatment group (n=21) received 2-3 units of botulinum toxin type A injected into the bladder detrusor at the 3, 6, 9 and 12 o'clock positions, and the control group (n=20) underwent saline injection into the bladder detrusor at the same positions. Urodynamic studies were performed in all rats before the treatment and at death. The rats were killed at 1 week, 2 weeks, 1 month and 2 months after treatment. The bladders were removed and examined histologically for mast cells and inflammatory changes. The cystometric findings showed that, at the beginning and end of the experiment, the increases in the maximum bladder capacity and compliance were significantly higher in the treatment group than in the control group (P=0.000 and P=0.025, respectively). The histological studies revealed similar mast cell counts and leukocyte infiltration for the treatment and control groups. In conclusion, in this rat chemical cystitis model, botulinum toxin type A injected into the bladder detrusor led to a functional improvement. Thus, botulinum toxin type A injection may be an alternative, minimally invasive choice to other surgical treatment options in the treatment of a chronic inflammatory condition to improve deteriorated bladder function.

Animals↗

PubMed2002

The effect of varicocele repair on testicular volume in children and adolescents with varicocele.

PURPOSE: We investigated the effect of varicocele repair on testicular volume according to age in children and adolescents and review the long-term results of varicocele surgery. MATERIALS AND METHODS: The study included 39 boys 11 to 19 years old with clinical palpable varicocele who underwent varicocele surgery with at least 1 year of postoperative followup. Preoperative and postoperative testicular volumes were monitored and measured with an ellipsoid Prader orchidometer. Physical examination findings (testicular volumes and testicular consistency) in all boys, and serum hormone values and semen parameters in 16 adolescents were recorded and compared before and after surgery. RESULTS: Left unilateral varicocelectomy was done in 29 boys (74%) and bilateral varicocelectomy in 10 (26%). While no postoperative hematoma, infection or testicular atrophy was observed, 1 boy (2.5%) had varicocele recurrence and 2 boys (5.1%) had minimal hydroceles that required no intervention. Significant increases were observed in postoperative sperm concentration (p = 0.01), total motile sperm count (p = 0.009), testis volume (p = 0.000) and serum testosterone level (p = 0.014). All 15 boys with preoperative soft testis had normal testicular consistency postoperatively. Of the 19 boys with preoperative testicular atrophy 10 (53%) did regain normal testicular growth, while 9 (47%) retained testicular volume loss after surgery. When comparing preoperative to postoperative increase in testicular volume according to age in all boys, the mean was statistically significantly higher in boys younger than 14 years (left testis p = 0.037, right testis p = 0.000). CONCLUSIONS: Testicular consistency achieved normal firmness after varicocelectomy in all boys with preoperative soft testis. While there was catch-up growth in comparison to the contralateral testis, testicular consistency improved but testicular volumes may not increase significantly after varicocele repair at ages older than 14 years. However, in these adolescents postoperative semen parameters and serum hormone values may significantly improve regardless of testicular volume. Therefore, boys with varicocele and their families should be fully informed in light of these findings.

Adolescent↗

PubMed2002

Diagnosis of pediatric varicoceles by physical examination and ultrasonography and measurement of the testicular volume: using the prader orchidometer versus ultrasonography.

INTRODUCTION: The differentiation of unilateral versus bilateral varicoceles and testicular volume measurements are important in determining the need for adolescent varicocele surgery and also in following patients after varicocelectomy. The aim of this study was to prospectively compare the findings of physical examination and color Doppler ultrasonography in the diagnosis of pediatric varicoceles and to compare the findings using the Prader orchidometer and scrotal ultrasonography in the measurement of testicular volumes. PATIENTS AND METHODS: This study included 68 boys with varicoceles, ranging in age from 8 to 19 years. Varicoceles were diagnosed using both physical examination and scrotal color Doppler ultrasonography. The testicular volumes of 136 testicles were measured using the Prader orchidometer and scrotal ultrasonography. A difference of more than 10% or 2 ml in each testicular volume was considered significant. RESULTS: The mean age of the boys was 13.5 +/- 2.3 years. On physical examination, a left unilateral varicocele was diagnosed in 46 boys (67.6%). The other 22 boys (32.4%) had bilateral varicoceles. Color Doppler ultrasonography detected bilateral varicoceles in 4 of the 46 boys (8.7%) who were diagnosed by physical examination as having only left unilateral varicoceles (grade 3 in 3 patients and grade 2 in 1 patient). A different of more than 10% or 2 ml in testicular volume using the Prader orchidometer versus scrotal ultrasonography was detected in 3 out of 136 testicles (2.2%). The correlation between ultrasonography and Prader orchidometer results in the measurement of testicular volumes was statistically highly significantly consistent using the intraclass correlation test (r = 0.997 and p < 0.001 for the left testis; r = 0.998 and p < 0.001 for the right testis). CONCLUSIONS: Although the management of subclinical varicoceles remains controversial, these data show that color Doppler ultrasonography may be necessary in the diagnosis of bilateral varicoceles, especially in boys with high-grade left varicoceles. In contrast, scrotal ultrasonography, if considered the gold standard, did not show superiority over the Prader orchidometer in measuring testicular volumes.

Adolescent↗