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R Asci

Publications and source records attributed to R Asci.

5 recordsLinked to original sources

Is Bone-wax an injectable urologic material?

OBJECTIVE: Injection of endoscopic material for reflux and incontinence therapies became popular in urology because of its simplicity and repeatability. Research is going on to develop an ideal injectable material. In this experimental study we investigated whether the bone wax used for osteotomy hemostasis in orthopedic and neurosurgical operations could be used as an injectable material. MATERIALS AND METHODS: A total of 20 rabbits were included in the study: 6 underwent a sham operation, and in the remaining 14 rabbits, 0.5 ml bone wax liquefied with n-butyl acetic acid was injected submucosally via a 20-gauge needle at three different points on the anterior bladder wall. Cystectomy was performed on the 15th day in 2 rabbits (group I), on the 60th day in 2 (group II) and on the 150th day in 10 (group III). 0.20 ml bone wax was also injected subcutaneously and intramuscularly 7 days before cystectomy in group III. Bladders were examined macroscopically and histopathologically. All animals' lungs, livers, kidneys, spleens and brains were also removed and examined histologically. RESULTS: Submucosal swellings of bone wax maintained their localizations and shapes in all groups and all of the 42 bone-wax injection sites could be easily identified. Histologically, slight edema around the implant was seen in group I. In group II, collagen was increased around the implants and minimal hyperplasia of the epithelium overlaying bone wax was noted. 150 days after the injections, moderate collagen production and a mild increase in vascularity were seen around the implants. There was no macroscopic or microscopic evidence that implants migrated to locations other than the injection sites. CONCLUSIONS: When injected to the bladder submucosa, bone wax seems to be inert and biocompatible, encouraging further research to develop it as an alternative agent in the endoscopic treatment of vesicoureteral reflux and sphincteric incontinence.

Animals↗

p53 and bcl-2 overexpression as associated risk factors in patients 40 years old or less with transitional cell carcinoma of the bladder.

OBJECTIVES: Transitional cell carcinoma (TCC) of the bladder in younger patients has historically a favourable prognosis. bcl-2 and p53 genes are implicated in cell cycle regulation with roles on programmed cell death. Presence of nuclear accumulation of p53 and cytoplasmic accumulation of bcl-2 were proposed to confer a growth advantage to tumour cells. In this study, we investigated the roles of p53 and bcl-2 as prognostic factors in TCC of bladder in patients younger than 40 years. PATIENTS AND METHODS: From 1986 to 1998, 25 patients younger than 40 years were treated for TCC of bladder in our hospital. Of the tumour specimens, 24 were adequate for evaluating p53 and bcl-2 oncoproteins (group I). As a control (group II), we randomly selected 30 patients older than 50 years treated for bladder cancer in this period. Two oncoproteins were detected by immunohistochemical analysis in paired tumour tissue specimens in both groups. Retrospectively obtained clinical follow-up data were available, with a mean follow-up of 44 and 25.5 months in groups I and II, respectively. Relations between tumour recurrences and progression with positivity of bcl-2 and p53 were investigated. RESULTS: Expression of bcl-2 was observed in 13 (54.1%) and 11 (36.7%) and nuclear p53 accumulation in 9 (37.5%) and 17 (56.7%) of groups I and II, respectively. In the presence of p53 expression, tumours showed significantly more progression in group I (55 vs. 6.7%) and group II (41.1 vs. 0%). Recurrence rates were not significantly different in tumours with and without nuclear p53 overexpression in both groups. Also, recurrence and progression rates were not significantly different in tumours with and without cytoplasmic bcl-2 overexpression in both groups. Grade (G) and stage appeared as important prognostic factors in both groups since 60% of GIII tumours showed progression in group I, but none of GI and GII tumours. Similarly, 75% of T3 tumours progressed, while these rates were 25 and 25% for T1-T2 tumours in group I. In group II, 31.2, 25 and 0% of GIII, GII and GI tumours progressed, while 50, 41.6 and 0% of T3, T2 and T1 tumours progressed, respectively. CONCLUSIONS: Nuclear p53 expression in TCC appears to be associated with a poorer prognosis in both younger and older patients. Although cytoplasmic bcl-2 overexpression is found in the majority of tumours in the younger group, it is not associated with tumour progression and recurrence.

Adult↗

The management of vesical calculi with combined optical mechanical cystolithotripsy and transurethral prostatectomy: is it safe and effective?

OBJECTIVES: To investigate the effectiveness and reliability of the combination of optical mechanical cystolithotripsy (OMC) and transurethral prostatectomy (TURP) for the treatment of bladder calculi and obstructive benign prostatic enlargement (BPE). PATIENTS AND METHODS: From December 1990 to December 1996, 61 patients who had bladder stones and BPE or bladder neck contracture were treated with combined OMC and TURP; 32 patients who had bladder stones with no infravesical obstruction were treated with OMC alone. The records of a random selection of 97 patients with obstructive BPE who were treated with TURP only in the same period were used as the control. The operative duration time, the length of hospital stay, the duration of urethral catheterization, outcome and complications of the procedures for each patients were reviewed. The Mann-Whitney U-test and chi-square tests were used for statistical analysis. RESULTS: The mean duration of surgery, hospital stay and urethral catheterization were significantly longer with combined OMC and TURP than with OMC alone (P<0.05). Stone-free rates were 94% after OMC alone and 93% after combined OMC and TURP. The postoperative mean peak flow rates were 14.3 mL/s after the combined procedure and 15.2 mL/s after TURP alone. The complication rates were 21% for the combined procedure and 13% for OMC alone. The complication rate of TURP was 5%, significantly lower than that for the combined procedure (P<0.05). CONCLUSION: Bladder stones were associated with infravesical obstruction in two-thirds of patients. Simultaneous treatment with OMC and TURP did not change the effectiveness of these procedures, but caused additional morbidity.

Adolescent↗

The effects of experimental varicocele on testicular histology and fertility in monorchic adult rats.

OBJECTIVE: To determine the effects of a left-sided experimental varicocele on testicular morphology and fertility in right hemicastrated adult rats. MATERIALS AND METHODS: A double-controlled experimental study was carried out using mature Sprague-Dawley rats, with 12 rats in each treated group and five corresponding controls. Group 1 underwent right orchidectomy, group 2 right orchidectomy and a left varicocele, and group 3 only a left varicocele; each control group underwent a corresponding sham operation. Two months after surgery each rat was placed with two mature female rats for one month to assess fertility. All the rats were then killed and their testes weighed; the mean testicular weight was calculated for each group and the mean seminiferous tubule diameter (STD) measured. Johnsen scores and histological abnormalities were evaluated for each testis using light microscopy. RESULTS: The mean (SEM) testicular weight and STD in group 2 were significantly lower, at 1311 (100) mg and 225 (11) microm, respectively, than in group 1, at 1771 (28) mg and 255 (4) microm (P<0.05). The mean weights of both testes in rats in group 3 were significantly lower than those in group 1 (P<0.05) and although both mean STDs were less than in group 1, the differences were not significant (P>0.05). There were no differences between the Johnsen scores in groups 2 and 3. There were severe histological abnormalities in the left testes in three of nine and two of eight animals in group 2 and 3, respectively; in group 3, changes in the right testis were detected in one rat. Six of nine and seven of eight rats were fertile in group 2 and 3, respectively. CONCLUSION: Experimental left varicocele decreased the left testicular weight and STD in both hemicastrated and intact adult rats. However, the presence of the right testis is important for preserving fertility.

Animals↗

Somatic angiotensin converting enzyme in varicocele.

The ACE is found as two isozymes in the body. A somatic isozyme found in blood and several other tissues, and a testis-specific isozyme found only in developing spermatids and mature sperm. In this study, we investigated the ACE activity in left spermatic vein blood samples of infertile patients with varicocele and its correlation to spermatologic parameters. The somatic ACE activities were determined in the peripheral and left spermatic vein blood samples from 31 infertile patients who underwent variococelectomy, and 11 fertile control subjects underwent left inguinal herniorraphy. The somatic ACE activity was measured by kinetic spectrophotometric assay. Semen analyses were performed according to WHO guidelines. The mean somatic ACE activities of peripheral and left spermatic veins of the varicocele group were 60.3 +/- 23.0 and 60.2 +/- 23.2 U/L, respectively. In control group, peripheral and left spermatic vein ACE activities were found as 56.8 +/- 17.1 and 56.5 +/- 15.5 U/L, respectively. There was no significant difference between the ACE activity in peripheral and left spermatic vein blood sample from the varicocele and control group. There was no statistically significant correlation between the spermatologic parameters and ACE activities in the spermatic and peripheral vein in both of varicocele and control groups. As a result, it may be suggested that the somatic ACE has no causative role in pathophysiology of varicocele and varicocele related infertility.

Follicle Stimulating Hormone↗