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Öğe The anxiety-pain intensity relation in extracorporeal shock wave lithotripsy treated patients(2003) Yılmaz Erdal; Batislam Ertan; Tuğlu Devrim; Başar Murad M.; Boratav C.; Başar H.Introduction: To clarify the negative effect of anxiety on pain intensity in patients, who underwent Extracorporeal Shock Wave Lithotripsy (ESWL). Patients and Method: ASA physical status I and II 71 patient with the age ranging 10 to 64 were included the study. Patients divided into two groups randomly. Detailed information about ESWL session was given to the patients in Group I and patients in Group II did not receive any descriptive information. All procedures were performed by a third generation electrohydraulic Stone Litho3pter (PCK™). Intravenous fentanyl 1?gr/kg was administered 2 minutes before the procedure for analgesic purposes. Pains intensity was evaluated by 0-100 mm Visuel Analog Scala (VAS) at the first minute and every 10 minutes of the treatment. Conditional and continual anxiety were assessed by State/Trait Anxiety Inventory-Trait Anxiety (STAI-TA), and State/Trait Anxiety Inventory-State Anxiety (STAI-SA). Results: There was no correlation between STAI-SA and pain intensity. However, patients with higher STAI-TA scores needed higher doses of supplement analgesics because of higher pain intensity. Patients, who had received information, had lower scores of STAI-TA and pain intensity. Young female patients between 20-29 years old had the highest anxiety with high pain intensity. Conclusion: ESWL is an anxiety promoting procedure. The more intense pain and anxiety negatively effected the overall patient satisfaction. Detailed information of patients about the procedure and the knowledge of pain intensity has been higher in young female patients may be advantageous for patients and care givers.Öğe Apoptosis in testicular tissue of rats after vasectomy: Evaluation of eNOS, iNOS immunoreactivities and the effects of ozone therapy(AVES Ibrahim Kara, 2014) Alpcan S.; Başar H.; Aydos T.R.; Kul O.; Kısa Ü.; Başar M.M.Objective: We aimed to investigate the changes in endothelial nitric oxide synthase (eNOS) and inducible nitric oxide synthase (iNOS) expression and apoptotic index in rat testicular tissue, as well as serum and seminal plasma sex hormone levels after vasectomy, and the effect of ozone therapy (OT).Material and methods: Adult male Wistar rats were used (n=6 per group). Control (G1), sham for 4 weeks (G2) or 6 weeks (G3), orchiectomy at the 4th (G4) or 6th (G5) week after left vasectomy, orchiectomy at the 4th (G6) or 6th (G7) week after bilateral vasectomy, orchiectomy after 6 weeks OT following left (G8) or bilateral (G9) vasectomy, orchiectomy after 6 weeks OT (G10).Results: In the left testes, while there were increases in eNOS and iNOS immunoreactivity and apoptotic indexes in G4 and G5, no changes were observed in contralateral testis. These values increased in G6 and G7, while OT inhibited these parameters in the left testis of G8 and both testes of G9. Sex hormone levels did not show any changes after vasectomy and ozone therapy.Conclusion: While OT was found to be protective against some parameters mentioned above under stress conditions, it seemed to cause some harmful effects when used in healthy conditions. © 2014 by Turkish Association of Urology.Öğe Comparison of epidural ropivacaine 0.2% and ropivacaine 0.2% in combination with sufentanil 0.75 microg mL-1 for postcaesarean analgesia.(2008) Kaya T.; Büyükkoçak U.; Başar H.; Sağsöz N.Analgesic techniques after c-section must be effective producing early mobilisation to enable mothers to care effort their babies. In this study, the comparison of ropivacaine 0.2% alone, with ropivacaine 0.2%+sufentanil 0.75 microg mL-1 for patient controlled epidural analgesia (PCEA) was aimed. Fifty women (ASA-I) were enrolled in the study. All patients had combined spinal-epidural anaesthesia. Infusion of analgesic solutions was started when sensory level decreased by two dermatome levels. The patients randomly assigned, into two groups (n=25). In Group-I, ropivacaine 0.2% and sufentanil 0.75 microg mL-1, in Group-II, ropivacaine 0.2% alone were applied (bolus 1.25 mL, lockout 30 min, with 2.5 mL h-1 background infusion). Pain (Visual Analog Scale), motor blockage (Bromage scale) and sedation (Four point scale) were evaluated during 24 hours after Caesarean, using the scales of visual analogue, bromage, and four-point, respectively. Haemodynamic and respiratory parameters, side effects, total drug consumption and additional analgesic need, were recorded. Statistical analysis included student-t, chi-square, and Mann Whitney U tests. There was no difference in demographic data, sedation scores, haemodynamic and respiratory parameters, between the groups. Motor block and pain scores were significantly higher in Group-II than in Group-I at 2 and 4. h. Total drug consumption was 65.24+/-4.20 mL for Group-I and 81.1+/-6.44 mL for Group-II, (P<0.05). Four patients in Group-I and 21 patients in Group-II received additional analgesic. Pruritus was observed more frequently in Group-I. The addition of sufentanil 0.75 microg mL-1 to ropivacaine 0.2% for PCEA after Caesarean led to more effective analgesia and less motor weakness when compared to ropivacaine 0.2% alone, especially during early postoperative period.Öğe The effects of lactated ringer and hes solutions in differing combinations to prevent hypotension due to spinal anesthesia(2006) Şahin Ş.; Sari F.; Apan A.; Başar H.Objective: The aim of this study was to assess the effectiveness of preloading with crystalloid and colloid fluids on hypotension following spinal anaesthesia. Method: One hundred ASA Class I-II patients were randomly assigned to the study and divided into five groups. Group I: Lactated Ringer (LR) 1000 mL 30 minutes before spinal anaesthesia, Group II: HES %6 500 mL solution before the procedure, Group III: 500 mL RL before and HES %6 250 mL within 15 minutes after the procedure. Group IV and Group V received RL 500 mL + 500 RL mL, and HES %6 250 mL + HES %6 250 mL respectively, using the same timing protocol. Systolic, diastolic and mean arterial pressures and heart rates were measured at 1 minute intervals in the first 20 minutes and then every 5 minutes. Results: With the exception of the differences in diastolic blood pressures at the 2nd, 3rd, and 5th minutes, there was no difference in arterial blood pressures and heart rates between Group III and IV or Group IV and V. Conclusion: While significant correlation was found between spinal block level and the incidence of spinal hypotension, no difference was observed regarding the type, dosage, and timing of loading solutions before spinal anaesthesia.Öğe Effects of repeated sevoflurane anesthesia on renal function: An animal study(2004) Kaymak Ç.; Başar H.; Kurtipek Ö.; Şentürk Z.; Bomba F.; Sürücü S.; Erdemli E.Purpose: The effect of repeated administrations of sevoflurane in rats was evaluated with free inorganic plasma fluoride concentrations and the effect of sevoflurane on the kidneys. Methods: Thirty-five rats were divided into two groups. The control group consisted of 7 rats, and the sevoflurane group consisted of 28 rats. The sevoflurane group was divided equally into 4 subgroups according to the time of sacrifice (S1, S3, S5, S10). All rats in the sevoflurane group were administered 3% sevoflurane for 30 minutes for 5 days. After anesthesia, the rats were sacrificed at the end of the 1st, 3rd and 5th days. The other 7 were kept without anesthesia for 5 days and they were sacrificed at the end of the 10th day. Plasma inorganic fluoride concentrations were measured by ion-selective electrode methods in aspirated heart blood samples. Renal biopsies were taken just after sacrifice and the renal histopathologic effects of sevoflurane were investigated under light and transmission electron microscopy (TEM). Results: Plasma fluoride concentrations were significantly different between the sevoflurane and control groups. However, there was no statistical difference between the sevoflurane subgroups. Plasma BUN levels did not differ between the control and sevoflurane groups, except on the 10th day. Ultrastructurally, the sevoflurane subgroups (S-3, S-5, S-10) showed significant tubular histopathologic changes compared to the control group. However, these changes showed a significant regression on the 10th day. Conclusion: Repeated sevoflurane administration is a safe procedure since histopathological changes showed significant regression.Öğe The effects of repeated sevoflurane anesthesia on renal tubular enzymes in rabbits(2003) Başar H.; Büyükkoçak Ü.; Kaymak Ç.; Özcan Ş.; Tüzüner F.Sevoflurane, one of new inhalation agents, is metabolized to organic and inorganic fluoride metabolites. Nephrotoxicity is due to free fluoride. In this study; we investigated the renal effects of repeated and different concentrations of sevoflurane anesthesia, experimentally. Sensitive urinary indicators n-asetil-d- glukozaminidaz (NAG), alkalen phosfatase (ALP), and gamma glutamil transferase (GGT) were assessed. This study was performed in 14, male New Zelland rabbits. Rabbits were divided into two groups (n=7). Group I (n=7) received sevoflurane 1% and Group II (n=7) 3% sevoflurane with O2+N2O (4 Lmin-1) 3 hours a dayfor 3 days Urine samples were collected via a special apparatus for 24 hours preoperative and after anesthesia. Urine samples were taken five days after the last administration of anesthesia and NAG, ALP and GGT levels in urine were determined. Blood samples taken from ear veins were obtained to determine BUN and Creatine. In Group II, urinary NAG levels increased significantly on the third day and a significant increase in GGT was observed on second and third days. There was no significant change in BUN, Cre and urinary ALP. NAG and GGT levels returned to normal on the 9th day. We concluded that, the effects of repeated sevoflurane administration on renal system are temporary.Öğe Orexin expression in different prostate histopathologic examinations: Can it be a marker for prostate cancer? A preliminary result(AVES, 2013) Mehmet Başar M.; Han Ü.; Çakan M.; Alpcan S.; Başar H.Objective: The aim of this study was to evaluate the expression of the orexin receptor in different prostate pathologies, including prostate adenocarcinoma, benign prostate hyperplasia and chronic prostatitis. Material and methods: A total of 90 patients (mean age 64.01±7.2 years) were enrolled in the study. The patients were divided into three groups of equal numbers based on their histopathologic findings: prostate cancer (Group 1), benign prostate hyperplasia (Group 2) and chronic prostatitis (Group 3). All the tissues were incubated with a primary antibody recognizing the Orexin receptor. The specific cytoplasmic immunoreactivity of the Orexin receptor was semiquantitatively scored for intensity and distribution based on a grading scale. The staining intensity and orexin expression were evaluated using Pearson ?2 test. Results: A heterogeneous staining pattern of the Orexin receptor was observed between the groups. The expression rates were 90% (27/30) in Group 1, 53.3% (16/30) in Group 2 and 26.7% (8/30) in Group 3. While 5 patients (9.3%) in Group 1 showed strong staining, all samples from the other 2 groups showed only weak staining. There were significant differences in staining intensity between the three groups. The expression and distribution of the Orexin receptor was more widespread in Group 1 than in the other groups and was higher in patients with poorly differentiated malignancy. However, there was no significant difference based on Gleason score. Conclusion: Orexin receptors are found in human prostate tissues and their expression is widespread in prostate cancer and in patients with a higher Gleason score. Therefore, we believe that Orexin immunoreactivity can be considered to be an indicator of poor prognosis and of poorly differentiated prostate cancer cases. © 2013 by Turkish Association of Urology.Öğe Seminal vesicle cysts causing hemospermia in adult polycystic kidney disease (APKD)(2003) Yilmaz E.; Başar M.M.; Tuğlud D.; Başar H.; Batislam E.Introduction: A 42 year- old man with adult policystic renal disease admitted to Urology out-patient with men hemospermia without any other symptoms. Result: After detailed evaluation including transrectal ultrasonography (TRUS) and specific and nonspecific cultures, multiple seminal vesicle cysts were detected. After treatment with anti-inflammatory and antiboitics, hemospermi was resolved and did not recurrence in 6 months follow up.
