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Öğe C-reactive protein in early detection of bacteriemia and bacteriuria after extracorporeal shock wave lithotripsy(Elsevier, 2003) Yilmaz, E; Batislam, E; Tuglu, D; Kilic, D; Basar, M; Ozluk, O; Basar, HObjectives: To evaluate the value of plasma C-reactive protein (CRP) levels in early detection of bacteriuria and bacteriemia after extracorporeal shock wave lithotripsy (ESWL) of calcium and infection stones. Methods: A total of 75 patients who had infection stones (n = 27) and calcium stones (n = 48) were included in the study. All patients had sterile urine before ESWL. The mean age was 41.6 +/- 4.85 and male/female ratio was 2.12. Blood cultures were obtained within 1 hour post-ESWL period. Urine cultures were obtained 3 times just after and on the first and seventh day of ESWL. Results: Post-ESWL evaluations showed 3 positive blood cultures with 2 (2.66%) patients in infection stone and 1 (1.33%) patient in calcium stone groups, whereas urine cultures revealed 6 (8%) positive results in infection stones and 4 (5.33%) in calcium stones. The patients who had positive cultures also had elevated plasma CRP levels when compared to the levels in patients with negative cultures (P = 0.000). Conclusions: Bacteriuria and bacteriemia after ESWL have been well-identified entities and may be responsible from some of the post-ESWL complications. CRP can be useful for early detection of such complications. (C) 2003 Elsevier Science B.V. All rights reserved.Öğe The effects of anesthetic techniques on acute phase response at delivery (anesthesia and acute phase response)(Pergamon-Elsevier Science Ltd, 2003) Buyukkocak, U; Caglayan, O; Oral, H; Basar, H; Daphan, CObjectives: To investigate the effects of anesthetic techniques and delivery types on stress response during uncomplicated delivery. Design and methods: Forty pregnant women at term were divided into four groups. Group-I, cesarean section with general anesthesia; Group-II, section with spinal anesthesia; Group-III, section with epidural anesthesia; and Group-IV, vaginal delivery with epidural analgesia. C-reactive protein and albumin were measured on hospital admission, immediately after delivery and 24 h later. Results: Albumin and CRP levels decreased significantly in Group-II and Group-III, just after delivery. CRP increased significantly in all groups at the 24(th) hour of delivery. The effect of hemodilution on CRP and Albumin, due to volum loading, during spinal and epidural anesthesia disappeared after 24 h. Conclusion: We found no influence of anesthetic techniques on acute phase response except hemodilution effect. In the view of delivery types, vaginal delivery caused less stress response than section. (C) 2003 The Canadian Society of Clinical Chemists. All rights reserved.Öğe Genoprotective role of vitamin E and selenium in rabbits anaesthetized with sevoflurane(Sage Publications Ltd, 2004) Kaymak, C; Kadioglu, E; Basar, H; Sardas, SIn this study, genotoxic effects of repeated sevoflurane anaesthesia were investigated in rabbits with or without antioxidant supplementation. Twenty-one New Zealand male rabbits were included in the study and randomized into three groups as: placebo treated ( Group I), vitamin E supplemented ( Group II) and selenium supplemented ( Group III). Vitamin E and selenium were given intraperitoneally for 15 days before anaesthesia treatment. Anaesthesia was administered using 3% sevoflurane in 4 L/min oxygen for a 3-hour period and continued for 3 days. Blood samples were collected before anaesthesia ( Sample 1), after the first, second and third days of sevoflurane administration ( Sample 2, Sample 3 and Sample 4 respectively) and the last samples were taken 5 days after the last sevoflurane administration ( Sample 5). Genotoxic damage was examined using the comet assay. The degree of damage is assessed by grading the cells into three categories of no migration (NM), low migration (LM) and high migration (HM) depending on the fraction of DNA pulled out into the tail under the influence of the electric field. The number of comets in each sample was calculated ( 1 x number of comets in category NM + 2 x number of comets in category LM + 3 x number of comets in category HM) and expressed as the total comet score (TCS), which summarizes the damage frequencies. In Group I, a significant increase in the mean TCSs was observed for Samples 3 and 4 as compared with Sample 1. However, there were no significant differences between Samples 1, 2 and 5. The mean TCS of Sample 4 was significantly higher than Sample 1, 2 and 3 in Group II. Group III demonstrated no significant mean TCSs for any experimental conditions. Statistical differences were also observed between the groups with significant P values. This experimental study points out the presence of DNA damage with repeated sevoflurane anaesthesia and the genoprotective role of antioxidant supplementation on DNA damage in mononuclear leukocytes of rabbits by highly sensitive comet assay.Öğe Late-onset ureteric urinoma with intermittent jet flow as a complication of ureterolithotomy(John Wiley & Sons Inc, 2004) Unal, B; Basar, H; Bilgili, MYK; Basar, M; Batislam, E; Erdal, HH; Kara, SWe present the case of a late-onset urinoma in a 47-year-old man with a history of right ureterolithotomy performed 6 months previously, following 2 unsuccessful attempts at extracorporeal shock wave lithotripsy. The ipsilateral kidney was nonfunctional and hydronephrotic. The urinoma did not show enhancement on contrast-enhanced CT and intravenous pyelography. Sonography revealed turbulence in the urinoma and jet flow from the ureter. Lab studies of fluid obtained by percutaneous puncture and aspiration yielded misleading findings for urine and revealed the presence of hemosiderin-laden macrophages. The urinoma was surgically resected and ureteroneocystostomy was performed. (C) 2004 Wiley Periodicals, Inc.Öğe Optimal frequency in extracorporeal shock wave lithotripsy: Prospective randomized study(Elsevier Science Inc, 2005) Yilmaz, E; Batislam, E; Basar, M; Tuglu, D; Mert, C; Basar, HObjectives. To determine the optimal frequency of extracorporeal shock wave lithotripsy of urolithiasis, in terms of efficacy and duration, by comparing three different shock wave frequencies. Methods. A total of 170 patients between the ages of 18 and 69 years with radiopaque kidney stones were included in the study. The patients were randomly separated into three groups. Group 1 (56 patients) received 120 shock waves per minute, group 2 (57 patients) received 90 shock waves per minute, and group 3 (57 patients) received 60 shock waves per minute. The duration, analgesic or sedative requirement, and complications were recorded for each treatment. All patients were evaluated in terms of successful treatment by radiography of the kidneys, ureters, and bladder and abdominal ultrasonography 10 days after the single-session therapy. Results. No statistically significant difference was observed in patients according to age, sex, stone size, side, composition, location in the kidney, total energy level, or number of shocks. The successful therapy rate in groups 2 and 3 was prominently greater compared with that for group 1, and the difference was statistically significant (P=0.032 between groups 1 and 2 and P=0.015 between groups 1 and 3). The analgesic or sedative requirement in groups 2 and 3 was lower than that in group 1, and the difference was statistically significant (P=0.003 between groups 1 and 2 and P=0.001 between groups 1 and 3). The duration was longer in group 3 than in groups 1 and 2, and the difference was statistically significant (P=0.000 between groups 1 and 3 and P=0.009 between groups 2 and 3). Conclusions. The results of our study have shown that the optimal frequency during extracorporeal shock wave lithotripsy is 90 shock waves per minute in terms of duration, efficacy, and analgesic and sedative requirement at the same total energy level.Öğe Postoperative magnesium sulphate infusion reduces analgesic requirements in spinal anaesthesia(Greenwich Medical Media Ltd, 2004) Apan, A; Buyukkocak, U; Ozcan, S; Sari, E; Basar, HBackground and objectives: Magnesium sulphate infusion during general anaesthesia reduces anaesthetic consumption and analgesic requirements. The aim of this study was to assess the effects of postoperative magnesium infusion on duration of block, sedation and analgesic consumption after spinal anaesthesia. Methods: Fifty ASA I-II patients were included in the randomized double blind study. Spinal anaesthesia was performed at L3-4 or L4-5 interspace with 12.5 mg 0.5% heavy bupivacaine, using a 25G Quincke needle. Patients received a 5 mg kg(-1) bolus of magnesium sulphate followed by a 500 mg h(-1) infusion or saline in the same volumes for 24 h. Time to first pain, analgesic request, return of motor function, visual analogue pain and sedation scores were evaluated every 4 h during the 24 h postoperative period. The t- and U-tests were used for statistical analyses. Data were expressed as mean +/- SD, with P < 0.05 being considered significant. Results: Vital signs were stable during spinal anaesthesia and postoperative period. When compared to the control group, time to analgesic need was increased and total analgesic consumption was reduced in the magnesium group (meperidine consumption 60.0 +/- 73.1 mg control group, 31.8 +/- 30.7 mg magnesium group, P = 0.02). Conclusions: Magnesium sulphate infusion may be used as an adjunct for reducing analgesic consumption after spinal anaesthesia.Öğe Prevalence and treatment of Chlamydia trachomatis, Ureaplasma urealyticum, and Mycoplasma hominis in patients with non-gonococcal urethritis(Natl Inst Infectious Diseases, 2004) Kilic, D; Basar, MM; Kaygusuz, S; Yilmaz, E; Basar, H; Batislam, EThe aim of present study was to evaluate the occurrence of Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum in non-gonococcal urethritis (NGU) and to determine the bacterial resistance to six antibiotics in order to determine the most suitable treatment strategy. A total of 50 patients were enrolled into the study. Urethral samples were taken with a dacron swab placed into urethra 2-3 cm in males, and vaginal samples were taken from the endocervical region in women. The patient samples that did not grow Neisseria gonorrhoeae were accepted as NGU. Direct immunofluorescence technique was used for the investigation of C. trachomatis. Mycoplasma IST was used for the isolation of M. hominis and U. urealyticum. U. urealyticum was isolated from 24 patients. Thirteen of them had only U. urealyticum, and the rest had mixed pathogen organisms (7 U. urealyticum + M. hominis; 3 U. urealyticum + C. trachomatis, and 1 U. urealyticum + M. hominis + C. trachomatis). C trachomatis was detected in 12 patients. While 8 patients had C. trachomatis only, the rest had a mixture of the pathogen organisms listed above. Partner examinations could be performed for only 22 patients' partners. In the evaluation of antibiotic susceptibility, higher resistance was obtained against ofloxacin in U. urealyticum, and against erythromycin with M. hominis. Our results indicated that doxycycline or ofloxacin should be the first choice when empirical treatment is necessary.Öğe Primary bilateral spermatocele(Blackwell Publishing Asia, 2003) Basar, H; Baydar, S; Boyunaga, H; Batislam, E; Basar, MM; Yilmaz, EWe report the case of a bilateral, relatively huge, multilocular spermatocele diagnosed at sonography with surgical and pathological correlation. A 45-year-old man presented with bilateral, large inguinoscrotal masses. He had had the masses since his adolescence and their size gradually increased in the past 5 years. Scrotal ultrasonographic examination showed cystic fluid masses that were 65 x 45 x 50 mm in size on the right and 55 x 45 x 40 mm in size on the left side in multilocular spaces. The cystic masses were excised via bilateral inguinoscrotal incision staying near the body of the epididymis. The patient had fathered three children with no fertility problem.Öğe Psychological trauma of circumcision in the phallic period could be avoided by using topical steroids(Blackwell Publishing Asia, 2003) Yilmaz, E; Batislam, E; Basar, MM; Basar, HObjective: The objective of our study was to assess the efficacy of topical steroids in the treatment of phimosis and evaluate patients using the Diagnostic and Statistical Manual-III-Revised (DSM-III-R) test with the aim of eliminating castration anxiety of circumcision in the phallic period. Methods: One hundred and forty-nine children with phimosis who required circumcision were included the study. The average age of the children was 4.47 years. All children underwent the DSM-III-R test and their parents were questioned. Patients were separated randomly into three groups. Group I comprised 51 children who would undergo circumcision; group II comprised 50 children who would be treated with a topical corticosteroid (0.05% bethamethasone cream) twice daily for 1 month; and group III comprised 48 children who would be treated with a topical placebo cream. On the 5th day of treatment, parents were told to retract the prepuce and were given hygiene routine instructions. Patients were seen immediately after treatment and again 2 months later. Results: In group II, 16 of the 50 children had non-retractable prepuce. Forty-two cases of phimosis were corrected after treatment. Eight patients received further monthly treatment and five benefited from the second course of treatment. In group III, 17 of the 48 patients had non-retractable prepuce and four had satisfactory results. Forty-four patients received placebo treatment for another month and eventually, 40 children underwent circumcision in this group. DSM-III-R test results showed a significant shift to anxiety in the circumcision group. The were no significant differences in the other groups. Conclusion: Topical steroids for the treatment of phimosis is a highly effective treatment alternative to surgery. It avoids or delays circumcision and can be practised during the phallic period to decrease castration anxiety. The treatment is suitable for patients from any religious or cultural background.Öğe Testicular tissue nitric oxide and thiobarbituric acid reactive substance levels: evaluation with respect to the pathogenesis of varicocele(Springer, 2004) Kisa, U; Basar, MM; Ferhat, M; Yilmaz, E; Basar, H; Caglayan, O; Batislam, EThe aim of the present study is to evaluate tissue nitric oxide (NO) and thiobarbituric acid reactive substance (TBARS) levels in testicular tissue, and to determine their relationship with seminal parameters in order to explain possible effects on varicocele pathophysiology.Ten adult male Wistar rats at 8 weeks old underwent partial left renal vein ligation. A sham operation was performed on control rats in a second group of another ten rats. All animals were killed 4 weeks after surgery. The testes were removed and histological changes were observed by light microscopy with haematoxylin and eosin stain on half of each testis. The rest of testis was used for the evaluation of testicular tissue NO and TBARS levels. Epididymal aspirated seminal plasma was used for semen analysis and morphological analysis was carried out according to Kruger's criteria. Statistical analysis was performed by using Mann-Whitney U-tests and Spearman rank correlations between the two groups for NO and TBARS levels and for seminal parameters. Testicular tissue NO and TBARS levels (mean+/-SEM) were 62.8+/-10.1 mumol/g protein and 4.7+/-0.3 nmol/g protein in group 1. These parameters were 16.9+/-2.2 mumol/g protein and 3.1+/-0.2 nmol/g protein in the group 2 controls. There were significant differences between these parameters (P-NO=0.000, P-TBARS=0.001). Although a positive and significant correlation between testicular tissue NO and TBARS levels was found (r(s)=0.739, P=0.014), there was only a strong negative correlation between NO levels and sperm motility in group 1 (r(s)=-0.815, P=0.004). We found that this effect of NO on sperm motility was independent from TBARS levels after regression analysis (r(2)=-0.687, beta=0.825, P=0.034). Although there were statistically significant differences in seminal parameters between the two groups, there was no difference between them in the histopathological examination. We found that sperm motility was significantly related to testicular tissue NO levels only. Thus, we suggest that NO is an important mediator in the pathogenesis of varicocele. TBARS and other substances have been effective via NO pathways.Öğe Torsion of an epididymal cyst(Wiley, 2004) Yilmaz, E; Batislam, E; Bozdogan, O; Basar, H; Basar, MMTorsion of an epididymal cyst is a very rare condition. We present a case of torsion of an epididymal cyst in a 13-year-old boy. The patient presented with acute scrotal pain. Scrotal ultrasonography showed a 38 x 35 x 30 mm fluid-filled mass within the caput of the left epididymis. Histologically, the cells of the epididymal duct were necrotic. To our knowledge, this is the second case report in the literature.
