Biomedical subjects

T Erdogru

Publications and source records attributed to T Erdogru.

10 recordsLinked to original sources

PubMed2006

Prospective validation of a current algorithm including bedside US performed by emergency physicians for patients with acute flank pain suspected for renal colic.

OBJECTIVE: The purpose of this study was to validate an algorithm recommended by current literature for the patients with acute flank pain and evaluate the validity of bedside ultrasonography (US) performed by emergency physicians (EP) as a part of this algorithm. MATERIALS AND METHODS: This prospective validation study was carried out over a 5 month period in a tertiary care hospital adult emergency department (ED) with annual attendance of 55,000. Adult patients presenting to the ED with unilateral acute flank pain during the study period were enrolled into the study consecutively. Oral consent was obtained after the protocol was briefly explained to the patient and before the administration of analgesia. A protocol form was recorded for each patient enrolled into the study, and patients were followed up under the guidance of a previously designated algorithm in the ED. Data were analysed with SPSS software. The chi2 test was used to compare the dichotomised data of patients, diagnosed with and without stones, and to select the significant parameters to be used in the logistic regression. RESULTS: Of the 227 patients enrolled, 176 were proven to have urinary tract stones. There were 122 patients discharged from ED without further investigation except urinalysis and bedside US. Of these 122 directly discharged patients, 99 had a urinary stone, and the others did not have a life threatening disorder. Four of the 227 patients were admitted to the hospital. The remaining 51 patients did not have stones detected, and their pain subsided. Having a previous history of stones, radiation of pain to the groin, accompanying nausea, and detection of pelvicalyceal dilatation using bedside US performed by the EPs were found to be the most significant parameters in determining urinary stones in logistic regression analysis. Sensitivity and specificity of these parameters were: previous history of stones 59% and 66%, radiating pain to the groin 68% and 49%, nausea 71% and 51%, and detection of pelvicalyceal dilatation by bedside US 81% and 37%. CONCLUSION: Bedside US performed by EPs could be used safely in the evaluation of patients with acute flank pain as a part of a clinical algorithm. Previous history of urinary stones, radiation of pain to the groin, accompanying nausea. and detection of pelvicalyceal dilatation are major parameters and symptoms of urinary stone disease, and could be used in the algorithms.

Acute Disease↗

PubMed2004

Transperitoneal laparoscopic radical prostatectomy: ascending technique.

BACKGROUND AND PURPOSE: To demonstrate the operative steps of transperitoneal laparoscopic radical prostatectomy with the ascending approach (Heilbronn technique). PATIENTS AND METHODS: The technique is based on our experience with more than 1000 cases of clinically localized prostate cancer from March 1999 to April 2004. The technical steps, instrumental requirements, patient data, complications, and reintervention rate were reviewed. RESULTS: The principles of the technique include the routine use of a voice-controlled robot (AESOP) for the camera, exposure of the prostatic apex with 120 degree retracting forceps, free-hand suturing for Santorini plexus control, application of 5-mm clips during the nerve-sparing technique, control of the prostatic pedicles by 12-mm Hem-o-Lock clips, the bladder neck-sparing technique in patients with stage T1c and T2a tumors, and use of interrupted sutures for the urethrovesical anastomosis. A considerable improvement was observed when comparing the first 300 with the most recent 300 cases (mean operating time 280 v 208 minutes; conversion rate 2.7% v 0.3%; reintervention rate 3.7% v 1.0%). CONCLUSIONS: Through our experience with more than 1000 cases, transperitoneal access for laparoscopic radical prostatectomy has proven to be feasible and transferable with results comparable to those of the original open approach. Besides the well-known advantages of minimally invasive surgery, the video endoscopic approach may offer further benefits in permitting optimization of the technique by video assessment.

Adult↗

PubMed2002

Penile scintigraphy with 99mTc-human immunoglobulin G: a novel method for distinguishing the unstable and stable phases of Peyronie's disease.

OBJECTIVE: To investigate the value of penile scintigraphy using 99mTc-human immunoglobulin G (IgG) to differentiate the unstable (acute) and stable (chronic) phases of Peyronie's disease (PD). PATIENTS AND METHODS: Thirty-two consecutive patients (25 with PD and seven without) were evaluated using a detailed sexual history, serum chemistry panel, colour Doppler ultrasonography during simultaneous intracavernosal injection of 50 mg papaverine and stimulation, and 99mTc-IgG scanning. When indicated, nocturnal penile tumescence monitoring, dynamic infusion cavernosometry, cavernosonography and cavernosal artery systolic occlusion pressure were measured. After administering 370 MBq of 99mTc-IgG, images were taken at 30 min, 1, 2, 3 and 4 h. The scans were considered positive if there was any focal accumulation of radiopharmaceutical consistent with PD plaque formation. RESULTS: Eleven of the 25 patients with PD (mean age 56 years, sd 8) were in the unstable phase, the remaining 14 being in the stable phase. There was a localized increase in 99mTc-IgG activity in 10 patients who had unstable PD. There was complete resolution of increased activity in two patients at 12 and 13 months of follow-up. Of the 14 patients in the stable phase, 12 (at > 1 year) showed neither increased nor decreased 99mTc-IgG activity. In the remaining two patients there was increased activity on the plaque side. There was no local increase in activity in the control group. CONCLUSION: Inflammatory reactions can develop at various intervals during the unstable phase of PD. Medical methods should be used during the unstable phase and surgery delayed until the stable phase of the disease begins. An objective method of differentiating between the phases is therefore important. Penile 99mTc-IgG imaging is a new diagnostic approach for confirming the unstable phase of PD.

Acute Disease↗

PubMed2001

Relationship between apoptosis regulator proteins (bcl-2 and p53) and Gleason score in prostate cancer.

Cellular proliferation programmed cell death (apoptosis) are associated with tumor growth in general, and prostate cancer growth in particular. The aim of this study was to examine the expression of the apoptosis regulating genes bcl-2 and p53 and Gleason score in core needle biopsy specimens of prostate cancer using immunohistochemistry. We studied bcl-2 and p53 expression in 12 cases of low grade (Gleason score 2-5), 12 cases of intermediate grade (Gleason score 6-7) and 8 cases of high grade (Gleason score 8-10) prostate cancer. Overexpression of bcl-2 was noted in 3 of 32 patients (9.32%). One of them was high grade; others were intermediate grades. Expression of p53 was observed in 3 of low grades; others were high grade. The statistical analysis of present data suggest that there is no significant relation between p53 and bcl-2 expression and Gleason score in prostate cancer.

Adenocarcinoma↗

PubMedDate not supplied

Relationship between mast cell and iNOS expression in testicular tissue associated with infertility.

The objective of this study was to investigate mast cells and iNOS expression in testis tissue, and to correlate these results with spermatogenic disorders. A total of 136 testicular biopsies were obtained from the testes of 80 patients with infertility. Their age ranged from 21 to 45 years. The biopsy specimens were immunohistochemically stained with antihuman tryptase for mast cells. In each section, all interstitial fields were evaluated for the total number of mast cells as well as the total number of Leydig cells. The number of mast cells per Leydig cell was calculated and recorded as mast cell index. Immunohistochemical iNOS staining was evaluated semiquantitatively according to intensity and the proportion of the stained cells. There was a significant increase of the mast cell index in all groups with testicular disorder compared with normal spermatogenesis group (p < 0.05). Increase of the index was in the order of hypospermatogenesis, maturation arrest and SCO, and index of SCO group was especially higher, i.e, more than twice than other groups. iNOS score was significantly higher in the SCO group than in the men with normal spermatogenesis, hypospermatogenesis, and maturation arrest (p < 0.05). Finally, a significantly statistical correlation was found between the iNOS score and mast cells index (r = 0.758, p = 0.001). Increase of mast cell index was observed in the groups of infertile testis, and high expression of iNOS in Leydig cells was associated with the highest mast cell index in SCO, the lesion with the most severe damage of the germ cell.

Adult↗

PubMedDate not supplied

The treatment of non-gonococcal urethritis with single dose oral azithromycin.

In an uncontrolled study, the efficacy of azithromycin in the treatment of non-gonococcal urethritis was assessed in 41 male patients aged between 20 and 40 years with a mean age of 27 +/- 5 years. Clinical and microbiological diagnosis confirmed that 28 men were found positive for Chlamydia trachomatis, 10 for Ureaplasma urealyticum and three for both C. trachomatis and U. urealyticum. All patients received 1 g azithromycin orally (four 250 mg capsules). The length of time between the treatment and following visits were 7-10 days and 14-21 days for second and third visits, respectively. Complete eradication was achieved in 27 out of 41 patients. Of the remaining 14, six were found positive for C. trachomatis and were excluded as they did not return for the follow-up visit, one patient did not achieve complete eradication, one patient infected with both C. trachomatis and U. urealyticum failed to achieve complete eradication, and six patients infected with U. urealyticum failed to be completely cured. No adverse effects were reported in any patient. Single dose administration of 1 g azithromycin appears to be an effective and well-tolerated treatment for chlamydial urethritis and an advantage in terms of patient compliance.

Administration, Oral↗

PubMedDate not supplied

Evaluation of penile arteries in papaverine-induced erection with color Doppler ultrasonography.

OBJECTIVE: Color Doppler ultrasonography is a useful method in the evaluation of small vessels and vascular anatomy and in demonstrating dynamic changes of blood flow. The detrimental effects of different risk factors of erectile dysfunction such as diabetes mellitus, hypertension, hypercholesterolemia on the penile arterial system were investigated. METHOD: 180 patients with erectile dysfunction underwent functional evaluation of the arterial system by combined intracavernous injection of 60 mg papaverine and stimulation test and color Doppler ultrasonography. RESULTS: There were 64 patients (35.55%) whose vascular findings were normal. A total of 36 patients (20.00%) had arterial insufficiency and 42 patients (23.33%) had mixed-arteriogenic-venogenic impotence. Combination of hypertension and hypercholesterolemia was found to be more detrimental to the penile arterial system than hypertension alone, the presence of hypertension and diabetes mellitus together, diabetes alone and hypercholesterolemia. CONCLUSION: Color Doppler ultrasonography depends on variables such as equipment, operation and software version in the functional evaluation of the penile arterial system. The combination of hypertension and hypercholesterolemia was found to be more detrimental to the penile arterial system. Further studies based on larger patient populations are required in order to determine the effects of erectile dysfunction contributing disease on the penile arterial system.

Arteries↗

PubMedDate not supplied

Combined intracavernous injection of papaverine and stimulation (CIS) test.

The inhibitory effect of the overactivity of the sympathetic nervous system that results from outpatient clinical conditions leads to poor erectile response to intracavernous injection of papaverine. The effects of self manual genital stimulation for improvement of erectile quality in insufficient papaverine response were investigated in 171 impotent men. Twenty-nine (63.04%) of 46 patients who had a normal vascular system showed partial response to papaverine. Following self manual genital stimulation, full erection was achieved in all of them. Better erections were achieved in 28 of 42 patients with arterial disease. In patients subclassified as having slight, moderate, and severe arterial disease, improved erections were noted in 100%, 71.42%, and 64.28%, respectively. In the mixed vascular (arterial+venous) disease group (n = 46), the combined intracavernous injection of papaverine and stimulation (CIS) test led to a better erection in only 41.30%, whereas in the pure venogenic group (n = 37), this percentage was 66.66%. The inhibitory effect of the overactivity of the sympathetic nervous system is significantly reduced by the CIS test.

Adolescent↗

PubMedDate not supplied

The effects of diabetes on penile somato-afferent system.

The direct evaluation of the autonomic nervous system to detect the neurogenic component of erectile dysfunction in men is not possible. Biothesiometry, a vibration perception test, is a simple method for the assessment of the penile somato-afferent system. A nomogram for the evaluation of somato-afferent system has been developed utilizing the biothesiometer in healthy men. This nomogram was used to compare the biothesiometric values of potent and impotent diabetic patients. According to our data, the radix penis is selectively damaged by diabetes mellitus in the first stage of the disease, whereas the glans penis is damaged later on when the disease reaches the stage of impotence.

Adolescent↗

PubMedDate not supplied

The correlation of end-diastolic flow velocity and cavernosometry results in the diagnosis of venous leakage.

OBJECTIVES: Cavernosometry is a conventional and reliable method used in the diagnosis of caverno-venous incompetence. Recently, cavernosal artery end-diastolic blood flow velocity more than 5 cm/sec during the rigid phase and after 10 minutes with duplex ultrasonography has been considered as veno-occlusive dysfunction. METHODS: Fifteen patients with erectile dysfunction aged 20 to 56 years (mean age 35.8) were evaluated by dynamic infusion cavernosometry and duplex ultrasonography which measured end-diastolic blood flow velocity during the rigid phase of erection and after 10 minutes. RESULTS: Dynamic cavernosometry was considered the gold standard during this comparative study. The sensitivity of duplex ultrasonography was found to be 100%, its specificity was 71.42%, positive predictive value 80% and its negative predictive value was 100% in the detection of caverno-venous incompetence.

Adult↗