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Öğe The comparison and efficacy of 3 different alpha 1-adrenergic blockers for distal ureteral stones(Elsevier Science Inc, 2005) Yılmaz, Erdal; Batislam, Ertan; Basar, Mehmet Murad; Tuğlu, Devrim; Ferhat, Mehmet; Basar, HalilPurpose: alpha 1-Adrenergic blockers have recently been shown to increase the rate of spontaneous passage of distal ureteral stones. We compared efficacy of 3 different alpha 1-adrenergic blockers for this purpose. Materials and Methods: A total of 114 patients between 18 and 65 years old who had lower ureteral stones were included in the study. Patients were randomly divided into 4 groups. Group 1 consisted of 28 patients and acted as the control group. Group 2 comprised 29 patients who received tamsulosin, group 3 was 28 patients receiving terazosin and group 4 was 29 patients receiving doxazosin. These agents were given for up to a month and hydration was also recommended simultaneously. Every week patients were controlled with x-rays of the kidneys, ureters, bladder and urinary ultrasonography. Meanwhile the number of pain episodes, analgesic dosage and the number of days for spontaneous passage of the calculi through the ureter were also recorded. Results: There were no differences between the groups with respect to age, weight, height, sex and stone size. The calculi passed through the ureter spontaneously in 15 patients in group 1 (53.57%), in 23 patients in group 2 (79.31%), in 22 patients in group 3 (78.57%), and in 22 patients in group 4 (75.86%). In groups 2 to 4 the number of pain episodes, expulsion time and analgesic dosage were found to be lower compared with those in group 1. Conclusions: alpha 1-Adrenergic blockers increase the frequency of spontaneous passage of the distal ureteral calculi. All 3 agents tested were equally efficacious.Öğe The effect of varicocele on seminal plasma and serum inhibin-B levels in adolescent and adult men(Springer, 2010) Basar, M. Murad; Kisa, Ucler; Tuglu, Devrim; Kacmaz, Murat; Basar, HalilIn the present study, the relationship between serum/seminal plasma and serum FSH and seminal parameters was evaluated in adults and adolescent varicocele patients and compared with normal fertile cases. A total of 50 adult patients with varicocele (Group-1) and 50 adolescents with varicocele (Group-2) were enrolled into the study. Fifty fertile cases without any scrotal pathology were accepted as control group (Group-3). Serum gonadotropin, sex steroids and serum and seminal plasma inhibin-B levels were measured, and semen analysis was performed after 2 and 5 days of sexual abstinence. All parameters were compared among three groups by using one-way ANOVA test. There were statistically significant differences among three groups on seminal parameters due to disturbed spermatogenesis in patients with varicocele (P < 0.05). However, there were not statistical differences between serum and seminal plasma Inhibin-B levels among groups. In varicocele patients, serum inhibin-B levels showed negative and significant correlation only with FSH levels (r = -0.253, P = 0.011). On the contrary, neither serum nor seminal plasma inhibin-B levels showed significant correlation with seminal parameters. While varicocele affects different mechanisms in the regulation of spermatogenesis in testes, serum and seminal plasma inhibin-B have not any role in decreased spermatogenesis in varicocele.Öğe Effectiveness of eutectic mixture of local anesthetic cream and occlusive dressing with low dosage of fentanyl for pain control during shockwave lithotripsy(Mary Ann Liebert, Inc, 2005) Yilmaz, Erdal; Batislam, Ertan; Basar, M. Murad; Tuglu, Devrim; Özcan, Şaziye; Basar, HalilBackground and Purpose: To investigate the effect and usefulness of Eutectic Mixture of Local Anesthetic (EMLA) applied with an occlusive dressing and used simultaneously with a low dose of fentanyl during shockwave lithotripsy (SWL). Patients and Methods: One hundred sixty patients with kidney stones, aged between 19 and 68 years, were randomly, divided into seven groups that were treated as follows: group 1: fentanyl 1 mu g/kg by intravenous infusion (IV); group 2: IV fentanyl 0.25 mu g/kg; group 3: occlusive dressing and IV fentanyl 0.25 mu g/kg; group 4: placebo cream and IV fentanyl 0.25 mu g/kg; group 5: EMLA cream and IV fentanyl 0.25 mu g/kg; group 6: placebo cream and IV fentanyl 0.25 mu g/kg with an occlusive dressing; and group 7: EMLA cream and IV fentanyl 0.25 mu g/kg with an occlusive dressing. The mean arterial pressure (MAP), heart rate, ventilatory rate, and oxygen saturation (SpO(2)) were recorded on all patients. A visual analog scale 0-100 mm (VAS) was used for the evaluation of pain. The skin integrity was inspected to detect any lesions after SWL. Results: The SPO2 in group I was lower statistically than in the other groups. The VAS score in group 7 was clearly lower than in the others in the first, tenth, and twentieth minutes and at the end of SWL. In groups 6 and 7, additional fentanyl doses were lower than in the other groups, but only in group 7 was the total fentanyl dosage low. Skin lesions were not seen only in groups 3, 6, and 7. Conclusion: Use of EMLA and an occlusive dressing with low doses of fentanyl during SWL provides appropriate analgesia with minimal morbidity.Öğe Giant abdominal wall abscess dissecting into thorax as a complication of ESWL(Elsevier Science Inc, 2005) Ünal, Birsen; Kara, Simay; Bilgili, Yasemin; Basar, Halil; Yiılmaz, Erdal; Batislam, ErtanAbscess as a complication of extracorporeal shock wave lithotripsy is a rare condition, We present the computed tomography findings of an abdominal wall abscess that occurred after extracorporeal shock wave lithotripsy for which prophylactic antibiotics had not been given. The abscess destroyed the posterior abdominal wall muscles and dissected into the thorax. The muscles were thickened and showed enhancement. A parenchymal defect in the right kidney adjacent to a caliceal stone, with strands extending from this defective region to the abscess, was observed, and was thought to be the result of parenchymal destruction caused by the shock waves. Other parts of the kidney and psoas muscle were normal. Microbiologic examination revealed Escherichia coli. UROLOGY 65: 389.e16-389.e18, 2005. (C) 2005 Elsevier Inc.Öğe Local anesthesia in transrectal ultrasound-guided prostate biopsy: EMLA cream as a new alternative technique(Informa Healthcare, 2005) Basar, Hülya; Basar, M. Murad; Özcan, Şaziye; Akpinar, Serpil; Basar, Halil; Batislam, ErtanObjectives. The aims of the present study were to evaluate the efficacy of eutectic mixture of local anesthetics ( EMLA) cream in transrectal-guided prostate biopsy and to compare its effect with that of other injectable anesthetic procedures. Material and methods. Eighty male patients with prostate-specific antigen (PSA) levels >4 ng/ml or who had prostate nodules on digital rectal examination were randomly divided into four groups. In Group 1 ( controls), prostate biopsy was performed after application of a placebo cream. In Group 2, local surface anesthesia with EMLA cream was performed 15 min before biopsy. Periprosthetic nerve blockade was performed with 1% prilocaine and 1% lidocaine in Groups 3 and 4, respectively. Pain was evaluated using a visual analog scale (VAS) after each core biopsy. In addition, blood pressure, heart rate and oxygen saturations were recorded after each biopsy and then at 5-min intervals for 15 min. Results. Average VAS scores in Groups 1-4 were 5.5, 2.9, 2.4 and 2.2, respectively. There was a statistically significant difference in VAS scores between the treatment groups and the placebo group (p=0.000). There were no statistically significant differences in VAS scores between the three treatment groups (p(2-3) = 0.126, p(2-4) = 0.303, p(3-4) = 0.537). We detected no statistically significant differences between the groups based on the hemodynamic data (p(MAP) = 0.899). Moreover, these measurements did not show statistically significant changes with time in any of the groups (p > 0. 05). Conclusion. Intrarectal application of EMLA cream provides equal anesthesia to periprostatic nerve blockade with prilocaine and lidocaine.Öğe Magnetic Resonance Imaging (MRI) in penile metastases of extragenitourinary cancers(Springer, 2006) Kendi, Tuba; Batislam, Ertan; Basar, M. Murad; Yılmaz, Erdal; Altınok, Deniz; Basar, HalilBackground: The aim of present study is to evaluate the efficacy of magnetic resonance imaging (MRI) in different types of penile metastases. Materials and methods: In this report, we present three cases of penile metastases that have been developed secondary to extragenitourinary malignancies. Two of them did not have any primary malignancy history. Results: Penile biopsies were performed in all patients and metastatic penile tumours were found due to extragenitourinary malignancies. Penile MRI was performed before biopsies. The findings of MRI were correlated with histopathologic diagnosis. Moreover, penile MRI was found to be more sensitive in the evaluation of the lesions than ultrasonography. Conclusion: MRI can be accepted as a reliable non-invasive method for the evaluation of the extent of penile metastases and involvement of tunica albuginea or urethral.Öğe Prevalence of primary tethered cord syndrome associated with occult spinal dysraphism in primary school children in Turkey(Karger, 2006) Bademci, Gülşah; Saygun, Meral; Batay, Funda; Çakmak, Aytul; Basar, Halil; Anbarci, Hüseyin; Ünal, BirsenThe prevalence and associated factors of primary tethered cord syndrome (PTCS) in primary school children were investigated. A cross-sectional study was performed in four demographically different primary schools in Turkey. Demographic, familial and physical data were collected from 5,499 children based on enuresis as a predominant symptom and dermatologic and orthopedic signs as clues of occult spinal dysraphism. Statistical analysis and input of the data were carried out with the SPSS package program 10.00, and logistic regression analysis was used to identify discriminating factors between enuretic children with or without neurologic signs. Of 5,499 analyzed children, 422 (7.7%) had enuresis nocturna, and 19.9% of 422 children had also daytime incontinence. Sixteen of these 422 enuretic children (3.8%) had several dermatologic signs. Five of them had spina bifida on plain radiographies, and 4 of them had cord tethering on lumbar MRI. Fifteen of 422 enuretic children (3.7%) had gait disturbances and orthopedic anomalies without cutaneous manifestations. Six of 15 children had spina bifida on plain graphies and 2 of them had tethered cord syndrome on MRI. The general prevalence of PTCS was found to be 0.1% of 5,499 analyzed children and 1.4% of enuretic children. A good outcome after untethering was found in 83.0% in this series. Practitioners should be aware of these clues of occult spinal dysraphism and resort to further radiologic and neurosurgical assessment. Early surgical intervention may halt the progression of the neurologic deficits and stabilize or reverse symptoms. Copyright (c) 2006 S. Karger AG, Basel.Öğe Significance of p57Kip2 Down-Regulation in Oncogenesis of Bladder Carcinoma: An Immunohistochemical Study(Sage Publications Ltd, 2008) Bozidogan, Oender; Atasoy, Pinar; Batislam, Ertan; Basar, M. Murad; Basar, HalilAims and background. Cyclin-dependent kinase inhibitors have important roles in the oncogenesis of various tumors including urothelial cancer. The aim of this study was to establish the importance of p57(Kip2), a unique cyclin-dependent kinase inhibitor, in the oncogenesis of bladder carcinoma. This article also focused on another cyclin-dependent kinase inhibitor, p27(Kip1), and telomerase enzyme and examined the relationship between these proteins. Material and methods. Thirty-one patients with urothelial carcinomas of the bladder and 7 cases with normal urinary bladder mucosa were included in the study. Immunohistochemical study was performed by monoclonal antibodies of p27(Kip1), p57(Kip2), and the telomerase subunit (hTERT). All immunohistochemical preparations were evaluated by an immunohistochemical histological score. Results. p57(Kip2) and p27(Kip1) expression were seen in all of the cases of normal mucosa. carcinoma cases, 8 of 31 (25.8%) showed p57(Kip2) nuclear positivity and 20 of 31 (64.5%) expressed nuclear p27(Kip1). HSCOREs of carcinoma cases showed lower scores of nuclear p57(Kip2) and p27(Kip1) than normal mucosa, but only HSCOREs of nuclear p57(Kip2) (p = 0.001) showed statistical significance. Despite unknown significance, cytoplasmic p57(Kip2) and p27(Kip1) were also evaluated. Immunohistochemical analysis showed that carcinomas expressed higher HSCOREs of hTERT than normal mucosa, and there was a significant difference (P = 0.026) between muscle invasive carcinomas and normal mucosa. Conclusions. The data showed that p57(Kip2) down-regulation along with p27(Kip1) is a well-established feature of urothelial carcinoma. Probably, this down-regulation of cyclin-dependent kinase inhibitors supports the proliferation phase of oncogenesis. In the study, we also showed that hTERT expression was up-regulated in higher stages of urothelial carcinoma.Öğe Testicular nitric oxide and thiobarbituric acid reactive substances levels in obstructive azoospermia: A possible role in pathophysiology of infertility(Hindawi Ltd, 2006) Basar, M. Murad; Kısa, Üçler; Tuğlu, Devrim; Yılmaz, Erdal; Basar, Halil; Cağlayan, Osman; Batislam, ErtanObjective. The aim of the study is to evaluate the levels of nitrite/nitrate and thiobarbituric acid reactive substances (TBARS) and their relationship with seminal parameters in experimental obstructive azoospermic rats to explain the possible mechanism of impaired sperm quality in obstructive azoospermia. Methods. A total of 10 male Spraque-Dawley rats underwent bilateral vas resection and ligation (Group-1 = vasectomy group). The findings were compared with control group (Group-2 = sham group, n = 10). Animals were sacrificed 8 weeks after surgery. Testes were removed and used for the evaluation of nitrate/nitrite and TBARS levels and for histology. Epididymal-aspirated seminal plasma was used for semen count and morphological analysis according to the Kruger criteria. Results. Testicular tissue nitrate/nitrite and TBARS levels were 35.7 +/- 3.1 mu mol/g protein and 3.7 +/- 0.1 nmol/g protein in Group-1, and 19.3 +/- 0.7 mu mol/g protein and 3.1 +/- 0.1 nmol/g protein in Group-2, respectively. Both parameters showed statistical differences between the two groups. Testicular tissue nitrate/nitrite and TBARS levels showed negative and statistically significant correlations with sperm motility and morphology. Conclusions. The present study showed that testicular nitrate/nitrite and TBARS levels were increased in obstructive azoospermia. For that reason, we concluded that antioxidant treatment can be recommended to patients before sperm extraction for artificial reproduction due to obstructive infertility after vasectomy reversal. Copyright (c) 2006 M. Murad Basar et al.Öğe Window technique on circumcision(Springer, 2006) Basar, Halil; Yılmaz, Erdal; Basar, Mehmed Murat; Batislam, Ertan; Tuglu, DevrimObjective: To remove the preputium by using a simple, quick and safe method without damaging glans, frenulum and urethra as well as with a good cosmetic result. Patients and methods: The procedure, remind the guillotine technique at first, but completely different from it. Basically, a long haemostat is applied onto preputium and skin and subdermal tissue were incised; a small window is opened at dorsal of preputial mucosa and it is excised, while observing glans and frenulum. Results: The circumcisions were performed in a quick, safe and pretty bloodless way. There was no case with glans amputation, frenulum short cut or urethral damage, even if a clamp includes the foreskin with a part of glans or excess frenulum unnoticedly. Conclusion: This technique is simple, quick, relatively bloodless operation with cosmetically good result. Morever it is quite safe against to amputation of glans, frenular short cut or urethral fistula formation.
