PubMed Health⌕ Search

Biomedical subjects

K Sarica

Publications and source records attributed to K Sarica.

At least 19 recordsLinked to original sources
PubMed2006

Pediatric urolithiasis: etiology, specific pathogenesis and medical treatment.

Pediatric urolithiasis is an endemic disease in certain parts of the world, namely Turkey and the Far East. As a recurrent pathology which may reveal functional as well and morphologic changes in the urinary tract, environmental factors together with urogenital abnormalities should be evaluated thoroughly in each patient. The aims of management should be complete clearance of stones, treatment of urinary tract infections, preservation of renal function and prevention of stone recurrence. In addition to certain minimally invasive stone removal procedures, treatment of pediatric urolithiasis requires a detailed metabolic evaluation in all patients on an individual basis. Obstructive pathologies have to be corrected immediately and children with a positive family history should be followed carefully with respect to a high likelihood of stone re-growth and recurrence. Although specific management of each metabolic abnormality seems to be the key factor in the medical management of stone disease, as general advice each child should be forced to adequate fluid intake which will reveal the urine volume increase in accordance with the body mass index. Moreover, medical therapeutic agents which increase urine citrate levels should be encouraged.

Child↗
PubMed2001

Renal tubular injury induced by hyperoxaluria: evaluation of apoptotic changes.

In order to evaluate the injurious effect of hyperoxaluria on renal tubular epithelium, as judged by apoptotic changes in the renal parenchyma, we performed an experimental study in 20 rabbits. In the experimental group animals (n = 10) severe hyperoxaluria was induced by continuous ethylene glycol (EG; 0.75%). Histologic alterations, including crystal formation, together with apoptotic changes were evaluated after 7 and 28 days. Control group animals (n = 10) received normal distilled drinking water. Following 7- and 28-day periods, tissue sections obtained from kidneys were examined histopathologically under light microscopy for the presence and the degree of crystal deposition in the tubular lumen. Apoptotic changes in renal tubular cells were examined using the terminal deoxynucleotidyl transferase (TdT)-mediated dUTP in situ nick and labeling (TUNEL) method during the same follow-up period. Crystal deposition was evident in the tubular lumen of tissue sections obtained during the 7-day examination period. During the 28-day examination period, however, these findings were found to be either limited or to have disappeared. In relation to apoptotic changes, the percentage of positive nuclei stained using the TUNEL method was from 11 to 20% in the experimental group and 5.6% in the control group. Our findings indicate that both calcium oxalate (CaOx) crystals and hyperoxaluria itself may be injurious to renal tubular cells, as indicated by apoptotic changes. These changes may be responsible for the pathologic course of urolithiasis.

Animals↗
PubMed2001

Unilateral testicular torsion: evaluation of bcl-2, p-53 and PCNA expression in contralateral testes.

OBJECTIVES AND METHODS: The present study aims to evaluate the histologic as well as apoptotic changes indicated by PCNA, p-53 and bcl-2 expression in the contralateral testes after a period of unilateral testicular torsion of 4 h. RESULTS: Regarding the histologic changes, while some significant alterations such as complete or incomplete spermatocytic arrest as well as sertoli cell only formation have to some extent been noted after the detorsion procedure, reasonably better preserved histology could be demonstrated following the orchiectomy procedure both in the early and late follow-up. Thus, the orchiectomy procedure was found to be limiting enough on the severity of the histologic changes in the contralateral testes after a certain period of time following the torsion procedure. On the other hand, however, in relation to the apoptotic events indicated by the three markers, while PCNA activity was found to be significantly different depending on the procedure performed (detorsion or orchiectomy), p-53 and bcl-2 positivity did not exhibit any difference in this aspect. Increased PCNA activity (especially after the detorsion procedure) together with marked positivity of p-53 both in the early and late follow-up indicated the increased cell turnover in the contralateral testes, which in turn may be accepted as a sign of increased apoptosis in these testes. In addition to these findings, bcl-2 expression has been found to be consistently negative in all specimens evaluated both in the early and late follow-up. CONCLUSION: Taking into account the strong inhibitory effect of bcl-2 during apoptotic events, these findings again support the likelihood of increased apoptosis in the contralateral testes.

Animals↗
PubMed2000

Evaluation of human leukocyte antigen expression in patients with prostate cancer.

OBJECTIVE: The aim of this prospective study was to evaluate the possible relationship between human major histocompatibility antigens [human leukocyte antigen (HLA)] and prostatic adenocarcinoma. MATERIAL AND METHODS: This clinical study was performed in 30 patients with histologically proven prostatic adenocarcinoma and 102 healthy men. HLA A, B and DR groups were evaluated in all patients. RESULTS: Of the HLAs examined, A2, A10, A28, A14, DR6, DR7 and DR9 were found to be accumulated significantly in patients with prostatic cancer in comparison with the healthy subjects. Apart from HLA A2 and DR7, the relative risk has been found to be over 2 in patients demonstrating these antigens. CONCLUSIONS: Although there was a statistically significant difference with respect to HLA accumulation between patients with prostate cancer and healthy subjects, larger series of patients including other parameters are needed.

Adenocarcinoma↗
PubMed2000

Ureteral displacement due to a migrated intrauterine contraceptive device.

Perforation of the uterus is rare but potentially fatal. During puerperium when the uterus is small and its wall is thin, the risk of perforation increases. We report a rare complication from an intrauterine contraceptive device (IUD) which caused deviation of the right ureter in a 31-year-old woman who presented with complaints of insomnia and abdominal pain. Our case shows that perforation of the uterus by an IUD can cause a silent urological complication. The possibility of ureteral involvement and displacement should be kept in mind in a woman in whom a missing IUD is encountered.

Adult↗
PubMed2000

Effect of varicocelectomy on seminal plasma transferrin values: a comparative clinical trial.

The possible effects of varicocele and of the varicocelectomy procedure on Sertoli cell function were investigated. Transferrin concentrations in seminal plasma in men with varicocele before and 3 months after the operation were evaluated. Concentrations were measured in 10 normozoospermic fertile men as a control group and 32 oligozoospermic men with varicocele. Also, sperm analysis before and 3 months after the operation was performed. The mean transferrin level in seminal plasma was 108.4 +/- 17.5 micrograms ml-1 in normoozoospermic men and 58.1 +/- 14.4 micrograms ml-1 in patients with varicocele before the operation (P < 0.0001). Mean sperm concentration, motility and normal morphology ratio showed significant improvement 3 months after the operation (P < 0.0001). Although the mean transferrin level increased slightly (to 60.8 +/- 16.2 micrograms ml-1; P = 0.2), there was a statistically significant correlation between the change in transferrin concentration and the change in sperm concentration after the operation (r = 0.56, P = 0.0008). These results showed that elevated transferrin secretion after the treatment seems to be associated with an increase in sperm concentration after varicocelectomy. The finding of improvements in seminal parameters after the operation but insignificant changes in seminal transferrin levels indicates that varicocelectomy results in a greater improvement in sperm quality than in Sertoli cell function.

Adult↗
PubMed1999

Penile epithelioid sarcoma: MR imaging findings.

Magnetic resonance imaging findings of a 38-year-old man with epithelioid sarcoma of the penis is presented. It started as a firm, painless and slowly growing nodule at the base of his penis 6 months previously which caused pain radiating to the testis during coitus. It has been well known that sarcomas may well mimic reactive processes. Initial presentation of epithelioid sarcoma may provoke considerable diagnostic difficulty, and its differentiation from benign lesions, such as Peyronie's disease and chronic inflammation, may be a clinical problem. In our present report the MR findings are compared with those of the epithelioid sarcomas of various locations reported in the literature and differential diagnosis of the entity is discussed. To our knowledge, this is the first report regarding the MR findings of the epithelioid sarcoma of penis.

Adult↗
PubMed1999

Comparative study of long-term stone recurrence after extracorporeal shock wave lithotripsy and open stone surgery for kidney stones.

BACKGROUND: Extracorporeal shock wave lithotripsy (ESWL) has become the treatment of choice for most calculi of upper urinary tract and the need for open stone surgery (OSS) have considerably reduced. However, stone recurrence is often encountered as a long-term problem requiring re-treatment. METHODS: In the present retrospective study, the recurrence rates of ESWL and OSS were compared in the treatment of kidney calculi. During the 1 year period of the present study, 43 patients were treated by OSS and 400 underwent ESWL (the Dornier MPL 9000 lithotriptor). The recurrence of stone was defined as reappearance of the stone on plain abdominal radiography during the follow-up period. RESULTS: Complete removal of all stone fragments was achieved in 51.2% of patients (n = 22) treated with OSS. In the ESWL group, the stone free rate was 56.7% (n = 237). The recurrence rate was 31.8% within a mean of 40 months (range 32-48 months) in the OSS group, whereas this figure was 13.9%, with a mean period of 46 months (range 42-48 months) in the ESWL group (P < 0.05). The mean periods of recurrence in ESWL and OSS groups were 20 (range 6-42 months) and 11 months (range 8-44 months), respectively (P < 0.05). However, the mean stone burdens of both groups were different (2.9 +/- 0.8 vs 1.4 +/- 1.1 cm). For comparable stone burdens, the recurrence rate was similar. In the ESWL group, stones in the lower calyx, multiple stones and larger stones showed a higher recurrence rate. The recurrence after OSS was also influenced by stone burden. CONCLUSIONS: The results of the present study demonstrate that stone burden may be the primary risk factor for stone recurrence after ESWL and OSS.

Adolescent↗
PubMed1999

The place of diuretic enhanced Doppler sonography in distinguishing between obstructive and non-obstructive hydronephrosis in children.

OBJECTIVE: In an attempt to differentiate obstructive from non-obstructive dilation of the renal collecting system in children, a prospective clinical study was carried out. MATERIAL AND METHODS: During duplex Doppler sonography examination in 23 children resistive index (RI) and pulsatility index (PI) and RI ratio values before and after intraverous furasemide administration were compared with the findings obtained with diuretic renogram examination (t(1/2)). RESULTS: Evaluation of the results demonstrated that diuresis RI and PI determination may aid differentiation of severely obstructed renal units from those with slight (equivocal) or no obstruction. CONCLUSION: Kidneys with severe UPJ obstruction tended to have more elevated RI and PI values than the non-obstructed or equivocally obstructed ones. Again, determination of RIR values for each kidney showed the same elevation in severely obstructed kidneys, while non-obstructive or indeterminately obstructed ones demonstrated statistically insignificant changes.

Child↗
PubMed1999

Limitation of shockwave-induced enhanced crystal deposition in traumatized tissue by verapamil in rabbit model.

OBJECTIVE: To evaluate the possible protective effect of verapamil (a calcium channel blocking agent) against the traumatizing effects of high-energy shockwaves (HESW) and new stone formation, as indicated by crystal deposition in the renal parenchyma, an experimental study was performed in rabbits. METHODS: A total of 65 rabbits were included. During severe hyperoxaluria induced by continuous ethylene glycol (EG) (0.75%) administration, animals in the first group (N = 15) received EG only, and animals in the second group underwent administration of 500 to 1500 shockwaves, animals in the third group (N = 15) received verapamil (0.1 mg/kg) for 3 days prior to HESW application, a control group (N = 15) received various numbers (500 to 1500) of shockwaves alone. Sham-treated animals (N = 5) constituted the last group in our study. Three months after shockwave application, tissue sections obtained from treated and untreated kidneys were evaluated histopathologically under light microscopy and transmission electron microscopy (TEM) for the presence and degree of crystal deposition in the cortical parenchymal region subjected to HESW. RESULTS: Whereas crystal deposition was evident in the intercellular region and intratubular parts of the parenchyma in animals receiving EG and HESW, especially in those receiving relatively higher numbers of shockwaves), animals receiving verapamil demonstrated limited or no crystal formation. No significant crystal deposition could be noted in specimens from animals undergoing either EG or SWL alone, and sham-treated animals demonstrated no significant alteration, as expected. CONCLUSION: Using this model, the traumatic effects of HESW could be evaluated as a factor in new stone formation after SWL. Verapamil has been found to be protective against crystal deposition.

Animals↗
PubMed1999

Immunologic aspect of testicular torsion: detection of antisperm antibodies in contralateral testicle.

OBJECTIVE: To evaluate the immunologic etiology in unilateral testicular torsion, an experimental study in rats was carried out. MATERIALS AND METHODS: 75 adult Wistar rats included in the study program were divided into six different groups according to a torsion-detorsion procedure. Torsion degree was kept constant for all animals (720 degrees ). Anti-rat immunoglobulin G (IgG) antibodies against spermatozoa antigens were identified in contralateral testicular tissue after 1 month following detorsion and/or orchiectomy of the twisted testicle. RESULTS: We revealed antibody formation in animals subjected to unilateral torsion for 12 and 24 h, which then followed by detorsion of the testicle. IgG was identified especially on basal membrane of the tubules. CONCLUSIONS: As the controversy on the exact mechanism of testicular damage in unilateral torsion still continues, our findings showed that a possible immunological etiology may play an important role in this respect.

Animals↗
PubMed1999

Epitheloid sarcoma of the penis.

We report a case representing the clinical as well as histopathologic features of epitheloid sarcoma. Both a clinical review and the results of definitive treatment together with the follow-up data are presented.

Adult↗
PubMed1999

Unilateral testicular torsion: protective effect of verapamil on contralateral testicular histology.

In this experimental study, it was our aim to reduce the effects of ischemic insults to the contralateral testicle after unilateral testicular torsion. The protective effect of a calcium channel blocking agent (verapamil) on the histology and the tubular diameter of contralateral testicle was evaluated. Following a definite period of unilateral testicular torsion (i.e., 4 h), the protective effect of this specific medication was evaluated both after detorsion and orchiectomy procedures. The results of our study demonstrated the protective effect of verapamil on both parameters, especially in animals undergoing orchiectomy. The majority of the specimens demonstrated normal histologic findings together with preserved tubular structures after a 1-week period under verapamil medication.

Animals↗
PubMed1999

Semiquantitative evaluation of testicular histology after testicular torsion: protective effect of external cooling.

To evaluate the protective effect of external cooling on testicular histology and tubular diameter, an experimental study was performed on rat testes that underwent a torsion procedure for a defined period of time (4 h). In a second group of animals external cooling for 90 min was performed during the torsion procedure. Evaluation of both the semiquantitative testicular histology and tubular diameter demonstrated a relatively well-preserved histology and tubular diameter. However, significant changes were noted in testes that underwent the torsion procedure without any protective measure. Our results indicate the protective effects of hypothermia in ischemic testes undergoing torsion with regard to both histologic and tubular alterations.

Animals↗
PubMed1998

Calyceal stones: fate of shock wave therapy with respect to stone localization.

In a retrospective analysis the results of extracorporeal shock wave lithotripsy (ESWL) treatment were evaluated in patients with renal stones according to calyceal localization of treated stones. The 198 patients who underwent ESWL with the Dornier MPL 9000 were analyzed for success rate, complication rate, residual fragments, regrowth and recurrence rates. Totally 210 calyceal calculi located in different portions of the kidney have been comparatively evaluated. No major complications were noted during or after ESWL. Some minor complications such as flank pain, renal colic, haematuria were observed. Flank pain was observed during ESWL treatment especially in patients with upper calyceal stones. Although stone-free and residual fragment rates were similar in pelvic, upper and middle calyces, patients with lower calyceal and pelvicalyceal stones had high residual fragment rate and lower stone-free rate. Patients with stones in the lower calyces or pelvicalyces had high recurrence and regrowth rates (p < 0.05). ESWL has been considered as the optimal treatment modality for most upper urinary tract calculi. It is especially effective in patients with pelvic, upper and middle calyceal stones. Patients with lower calyceal stones often failed to eliminate the fragments, hence had high recurrence and regrowth rates.

Adolescent↗
PubMed1998

Xanthogranulomatous pyelonephritis: report of four cases.

We report 4 patients with xanthogranulomatous pyelonephritis (diagnosed and treated between 1992 and 1996), aged 16 to 55 years (mean age 37 years). All had urolithiasis, pyonephrosis and nonfunctioning kidneys prior to surgical intervention, and underwent total nephrectomy. Clinical, laboratory and radiologic findings are discussed in the light of the cases reported in the literature.

Adolescent↗