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Biomedical subjects

O Atahan

Publications and source records attributed to O Atahan.

At least 19 recordsLinked to original sources
PubMed2000

Prostate electromyography: a new concept.

Knowledge of the pharmacological and electrophysiological properties of prostatic smooth and striated muscle myofibres are necessary in order to determine whether the dynamic component of benign prostatic hyperplasia (BPH). To our knowledge prostate electromyography have not previously been applied in any type of prostate disorder. The purpose of the present study is to evaluate the electrical activity of the prostatic muscle fibers. We were able to evaluate the features of prostatic muscle action potentials (PMAP) in 15 of the 16 patients from the area around the prostate capsule. Prostate was palpated in the knee-chest position then concentric needle electrode was inserted into the prostate tissue under digital guidance. Needle tip position in the prostate was confirmed with transabdominal ultrasonography. PMAPs were analysed with multi-motor unit action potential analysis (MMA) algorithm. Whenever the PMAPs were unsuitable for analysing with MMA software the amplitude trigger line method was used. Further studies with a large number of patients are needed to establish the correlation between the electrical activity of prostatic muscle fibers and dynamic component of patients with symptomatic BPH.

Adult↗
PubMed1998

Modified four corner bladder neck suspension in anatomical stress incontinence with moderate cystocele.

We aimed to evaluate the efficacy and the short- and long-term results of the modified four corner bladder neck suspension (FCBNS) procedure in the correction of type 2 stress urinary incontinence with moderate cystocele. We studied retrospectively 26 consecutive patients who underwent modified FCBNS procedure during a 2-year period at our institution. The modifications that were made were the distal sutures starting from the midurethra as a coil fashion of three centimetres to the bladder neck and its fixation to the pubic bone. Preoperative questionnaires, hospital and clinical records, and postoperative questionnaires were reviewed to assess comparative outcome among the patients. Patient follow-up ranged from 22 to 47 months (mean 33.5). The mean age at the time of surgery was 55.3 +/- 11.6, and mean parity was 3.2 +/- 1.3. Twenty-five of 26 women (96%) were cured after six months and 24 of 26 (92%) were cured after twenty-one months. Cystoceles were completely reduced. Complications occurred in 15% of the patients. The modified FCBNS is a useful and effective operation in treating anatomical stress urinary incontinence and an associated moderate cystocele since it elevates and supports midurethra as well in selected patients and it is associated with a low incidence of postoperative complications.

Adult↗
PubMed1998

Experiences with clam ileocystoplasty.

Clam ileocystoplasty was performed in 18 patients with urge incontinence, total incontinence or enuresis with instable detrusor. Although the persistence of detrusor instability was observed in 33.33% of the patients, complete clinical cure was found in 72.23 and symptomatic improvement was 22.22%.

Adult↗
PubMed1998

Is apolipoprotein-(a) an important indicator of vasculogenic erectile dysfunction?

We aimed to investigate whether high peripheral and cavernosal plasma levels of apolipoprotein-(a) [Lp (a)] is an indicator for vasculogenic erectile dysfunction. We determined Lp (a), total cholesterol (TC), triglyceride (TG) and high density lipoprotein (HDL) levels in peripheral and cavernosal blood in 39 patients with erectile dysfunction. Thirty-nine impotent patients have been divided into two groups: vasculogenic erectile dysfunction (VED) and nonvasculogenic erectile dysfunction (NVED), according to colour Doppler ultrasonic flowmetry, dynamic infusion cavernosometry, and the pressure difference between the brachial arterial systolic pressure and cavernosal arterial systolic pressure measurements. Biochemical values were compared in both groups. Lp (a) and TC levels were higher in both peripheral and cavernosal samples of VED group than in NVED group, with no differences between peripheral and cavernosal blood levels within the same groups. There were no significant changes in TG and HDL levels in either group. The detection of more than 31 mg/dl in Lp (a) level solely shows the vascular origin with a sensitivity and specificity of 95 and 82.3%, respectively. High Lp (a) levels can be considered an indicator of vasculogenic erectile dysfunction.

Adult↗
PubMed1998

Requirement of analgesia for extracorporeal shock wave lithotripsy and efficacy of a nonsteroidal antiinflammatory drug: piroxicam.

OBJECTIVE: In this study, the requirement of analgesia and the analgesic efficacy of a long-acting nonsteroidal antiinflammatory drug (NSAID), piroxicam, were investigated in patients with renal stone disease treated with extracorporeal shock wave lithotripsy (ESWL). METHODS: This randomized, placebo-controlled study included 60 patients. Patients were divided into two groups randomly. A single dose of saline (2 ml) was given to the patients in group 1 (n = 20) and 2 ml of 40 mg piroxicam to the patients in group 2 (n = 40). All injections were administered into the gluteal muscle 45 min before ESWL. A verbal rating scale (VRS) was used to evaluate the pain. Groups were compared according to age, sex, weight, height, stone size, number of shock waves, duration of ESWL and VRS scores. RESULTS: There was no statistically significant difference between both groups in demographic data, stone size, number of shock waves and duration of ESWL procedure (p > 0.05). However mean VRS scores were significantly lower in group 2 than in group 1 during and after the ESWL procedure. CONCLUSION: We considered that analgesic agents should be used to control the pain in second-generation lithotriptors. Piroxicam has clinically significant effects on the pain and also antiinflammatory effects, inhibits ureteric activity, and helps in stone passage.

Adult↗
PubMed1997

Cyproterone acetate monotherapy in advanced prostatic carcinoma.

Cyproterone acetate was given as monotherapy to 18 patients with advanced prostatic carcinoma at a weekly dose of 300 mg. Progression was observed in all of the patients; median time to progression was 35 months and median survival time was 48 months. Partial response, stabilization, progression and exitus rates by years also showed favourable results, as compared with other forms of therapy in advanced prostatic carcinoma.

Aged↗
PubMed1997

Electrical activity of corpus cavernosum in vasculogenic and non-vasculogenic erectile dysfunction.

We aimed to compare the electrical activity of corpus cavernosum before and after intracavernous papaverine injection and to determine the blood lipid profile in vascular and non-vascular erectile dysfunction, and also to assess whether vascular pathology and abnormal blood lipid levels impair cavernosal smooth-muscle relaxation. We determined total cholesterol (TC), triglyceride (TG) and high-density lipoprotein (HDL) levels in peripheral and cavernosal blood in 39 patients with erectile dysfunction. Electromyography of the corpus cavernosum was performed before and after an intracavernous injection with 60 mg of papaverine in all patients. Thirty-nine impotent patients have been divided into two groups: vasculogenic erectile dysfunction (VED) and non-vasculogenic erectile dysfunction (NVED), according to colour Doppler ultrasonic flowmetry, dynamic infusion cavernosometry and the pressure difference between the brachial arterial systolic pressure and cavernosal arterial systolic pressure measurements. Biochemical values and amplitude changes were compared in both groups. The TC level was higher in both peripheral and cavernosal samples of the VED group than in the NVED group (p = 0.000), with no differences between peripheral and cavernosal blood levels within the same groups (p > 0.05). There were no significant changes in TG and HDL levels in any of the groups (p > 0.05). The mean amplitude differences before and after papaverine injection (delta A) were found to be 2.05 +/- 0.78 microV in the VED group and 4.68 +/- 2.53 microV in the NVED group, showing that the relaxation response to papaverine was more significant in the NVED than in the VED group (p = 0.003). The moderate decreases in the amplitude of electrical activity of corpus cavernosum and the higher TC levels found in the VED group can be accepted as the parameters of impairment in the relaxation of corpus cavernosum, showing the role of hypercholesterolaemia and vascular pathologies in erectile dysfunction.

Adult↗
PubMed1997

Import catheter in erectile dysfunction.

PURPOSE: We propose an alternative technique for intracavernous self-injection of sodium nitroprusside for erectile dysfunction by inserting a Medtronic ImPort* catheter with a valved tip. MATERIALS AND METHODS: A silicone catheter was implanted in 3 patients with psychogenic impotence. The reservoir, which is used for vasoactive agent injection, was implanted laterally to the anterosuperior iliac spine and the distal tip of the catheter was inserted into the corpora cavernosa via a subcutaneous tunnel. The injection technique was taught to the patient and the initial injection was performed 1 week later. RESULTS: All patients and partners were satisfied with the technique and quality of erections at a mean followup of 14 months. There were no major local complications due to catheter implantation and no systemic complications due to sodium nitroprusside injection. CONCLUSIONS: An alternative technique for intracavernous pharmacotherapy of inserting an ImPort catheter prevented the complications of intracavernous injections in patients with erectile dysfunction.

Adult↗
PubMed1996

Multifactorial evaluation of diabetic erectile dysfunction.

We determined arterial venous and sinusoidal factors in 20 patients with insulin dependent diabetes mellitus and erectile dysfunction by performing dynamic infusion cavernosometry (DIC), colour flow Doppler ultrasonography, penile biothesiometry and corpus cavernosum electromyography (CCE). DIC, colour flow Doppler ultrasonography and penile biothesiometry were done in standard fashion except for CCE. Paradoxical increase in the electrical activity of corpus cavernosum after intracavernous (IC) papaverine was called a discoordination that was due to cavernous smooth muscle contraction instead of relaxation. Arterial and accompanying pathologies were found in 10 (50%) patients. In 3 (15%) of them pure arterial pathology, in 6 (30%) patients arterial and veno-occlusive dysfunction (VOD) and in one patient arterial pathology with abnormal biothesiometry were found. VOD and accompanying pathologies were found in 12 (60%) patients. In 6 (30%) of them VOD and arterial, in 4 (20%) patients VOD and discoordination and in 2 (10%) patients VOD and abnormal biothesiometric values were present. A higher frequency and coexistence of VOD and discoordination pattern were observed. In conclusion, patients with diabetic impotence show a wide range pathophysiology of erection and the evaluation of these patients must include multistep techniques.

Adult↗
PubMed1996

Electrical activity of the corpus cavernosum in patients with corporal veno-occlusive dysfunction.

OBJECTIVE: To determine whether the pattern of discoordination (an increase in electrical activity of the corpus cavernosum after an intracavernous injection with papaverine and which results in the contraction of the cavernous smooth muscles instead of relaxation) is an aetiological factor in veno-occlusive dysfunction (VOD). PATIENTS AND METHODS: Electromyography of the corpus cavernosum was performed before and after an intracavernous injection with 60 mg papaverine in 45 patients diagnosed as having venogenic erectile dysfunction by colour Doppler ultrasonic flowmetry and dynamic infusion cavernosometry and cavernosography. Cavernosometric values were compared in patients with and with no pattern of discoordination. RESULTS: A pattern of discoordination occurred in 14 patients (31%). There were significant differences in the cavernosometric values of patients with and with no discoordination. A poor response to papaverine and greater venous leakage were observed in the patients showing discoordination. CONCLUSION: The pattern of discoordination diagnosed by electromyography after injection with papaverine may explain some aspects of VOD and highlights the importance of performing electromyography of the corpus cavernosum in the diagnostic evaluation of VOD.

Adult↗
PubMed1996

Urinary glycosaminoglycan excretion in bladder carcinoma.

The urinary glycosaminoglycan (GAG) excretion in 35 patients with bladder cancer was significantly greater than that in 30 normal persons. In the cancer patients, the results were analysed according to tumour characteristics. Statistically significant differences were found, with increased GAG levels paralleling tumour size, multifocality, stage and grade. These preliminary data suggest that, parallel with established clinical parameters, measurement of urinary GAG excretion provides an indicator of repair of the bladder epithelium.

Adult↗
PubMed1996

Acute bioeffects of electromagnetic lithotripsy.

Acute effects of extracorporeal shock wave lithotripsy (ESWL) with Siemens Lithostar on kidney and surrounding tissues were examined on 42 patients with unilateral kidney stones in the Department of Urology, Gazi University, Medical Faculty, Ankara, Türkiye. Radiological examinations were done and 24-h urine and blood samples were obtained a day before, the day after and 30 days after ESWL. Urinary excretion of proteins, glycosaminoglycan, and immunoglobulin G were significantly elevated the day after ESWL. Thirty days after excretion levels of these were statistically insignificant in regard to pretreatment levels. Creatinine clearance of the patients was significantly lowered the day after ESWL. One month later differences were insignificant. Excretory urography detected 12 (29%) kidneys with abnormalities the day after ESWL. Thirty days after only 3 (7%) of the kidneys had persistent abnormalities. The number of abnormalities with ultrasonography 24 h and 30 days after ESWL were 15 (36%) and 5 (12%) respectively. With CT-scanning kidney abnormalities 24 h after and 30 days after ESWL were 24 (57%) and 6 (14%) respectively. There was not any statistically significant difference between patients with either radiological or functional changes after ESWL and with patients without these changes in regard to patient age, sex, stone burden and shock wave number. In conclusion, electromagnetic lithotripsy induces acute renal morphologic and functional changes. Functional changes are transient and subside within a month but although decreasing either in size or number some morphologic changes persist during this period.

Adult↗
PubMed1996

Electromyographic changes of corpus cavernosum due to papaverine and nitroprusside in veno-occlusive dysfunction.

PURPOSE: We compared electrical activity of the corpus cavernosum after intracavernous papaverine and nitroprusside injections. Some aspects of the androgen modulator system in patients with veno-occlusive dysfunction are discussed. MATERIALS AND METHODS: Electromyography of the corpus cavernosum was performed before and 1 day after intracavernous injection of 60 mg. papaverine and 400 micrograms. sodium nitroprusside in 22 patients with veno-occlusive dysfunction. Changes in duration and amplitude of electromyographic potentials were compared in groups with and without incoordination patterns. RESULTS: The decreases in electrical amplitude and duration in 15 patients with a negative incoordination pattern, and increases in 7 with a positive pattern were more significant with intracavernous sodium nitroprusside than with papaverine injections. CONCLUSIONS: Electromyographic changes were more prominent with nitroprusside than with papaverine, which demonstrates the use of nitroprusside when performing corpus cavernosum electromyography.

Electromyography↗
PubMed1995

Dynamic infusion cavernosometry and cavernosography in diagnosing and classifying venoocclusive dysfunction.

Dynamic infusion cavernosometry and cavernosography (DICC) were performed in 22 patients who were referred with symptoms of partial erection and transient erection and who were diagnosed as deep dorsal venous leakage by means of colour Doppler ultrasonography. We reached the diagnostic values for corporovenous leakage (CVL), also classified them and showed the veins that need to be ligated. With these advantages, DICC is a very cost-effective and safe technique that can be performed routinely in the diagnosis of corporovenous leakage.

Adult↗