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A rare synchronous tumor combination of primary squamous cell lung cancer and urinary papillary cell carcinoma
(AVES, 2011) Kavut, Ayşe Baççio?lu; Kalpaklio?lu, Füsun; Ayva, Şebnem; Batislam, Ertan
The incidence of primary bladder and lung cancer occurring together is rare. Here, a case of a man who was diagnosed with end stage lung cancer and early stage bladder cancer was discussed with the interesting aspects. Despite the fact that the patient had a cough, weight loss and dyspnea which are the most common symptoms of lung cancer, hematuria was the main complaint that induced the patient to consult the doctor. The case is valuable for the review of the literature about multiple primary malignancies of squamous cell lung carcinoma and urinary bladder transitional cell carcinoma. It is also important for reminding clinicians to keep in mind that smoking is the most important common predisposing factor for both lung and bladder carcinoma in this case.
Anaesthesia and the acute phase protein response in children undergoing circumcision
(Hindawi Ltd, 2005) Büyükkoçak, Ünase; Çağlayan, Fatma; Çağlayan, Osman; Basar, Murat; Çakmak, Murat; Batislam, Ertan; Ulusoy, Sevgi
Concentrations of acute phase proteins (CRP: C-reactive protein, albumin) change during surgery. We investigated the acute phase response to circumcision and the effects of anaesthesia on this response. The children were divided into four groups; group 1 (intratracheal general anaesthesia, n = 40), group 2 (general anaesthesia with mask, n = 20), group 3 (ketamine, n = 20), group 4 (local anaesthesia, n = 35). Blood samples were obtained, 24 hours before circumcision, after premedication, and 24 hours after circumcision. CRP and albumin before circumcision were comparable for all groups. There was no increase in CRP, and albumin remained steady throughout the study. No difference was observed among the groups, and related to anaesthesia. No responsiveness may be explained with the size of injured tissue or anatomical and histological type of preputium.
The antioxidant effect of dexmedetomidine on testicular ischemia-reperfusion injury
(Acta Cirurgica Brasileira, 2015) Tuglu, Devrim; Yuvanc, Ercan; Yilmaz, Erdal; Gencay, Isin Yazici; Atasoy, Pinar; Kisa, Ucler; Batislam, Ertan
PURPOSE: To investigate the protective effect of dexmedetomidine (Dex) on testicular damage induced by ischemia-reperfusion injury in rats. METHODS: Sham group underwent left scrotal exploration only (group 1). The ischemia-reperfusion only group underwent left testicular torsion and detorsion (group 2). The ischemia-reperfusion plus Dex group underwent left testicular torsion, received 50 mu g/kg Dex (group 3) and 100 mu g/kg Dex (group 4) intraperitoneally at minute 180 of ischemia and then underwent detorsion. We determined histopathological findings and performed specific biochemical analyses. RESULTS: Increasing doses of Dex significantly increased TAS, and significantly decreased OSI. Analyzing the antioxidant effects of increasing doses of Dex in torsion and contrlateral testicles: Dex 100 mu g/kg statistically significant increased the tissue total antioxidant status (TAS) and oxidative stress index (OSI) when compared with Dex 50 mu g/kg but not found significantly change on the tissue total oxidant status (TOS). However, Dex did not significantly improve these histological alterations. CONCLUSION: The antioxidant effects of dexmedetomidine on testicular ischemia-reperfusion injury in ipsilateral and contrlateral testis, but in the histopathological level, there was no difference statistically according to Johnsen's scoring system between groups at both sides.
BAG-1 expression in hyperplastic and neoplastic prostate tissue: Is there any relationship with BCL-related proteins and androgen receptor status?
(Sage Publications Ltd, 2005) Bozdoğan, Önder; Atasoy, Pınar; Bozdoğan, Nazan; Erekul, Selim; Batislam, Ertan; Yılmaz, Erdal; Basar, M. Murad
Aims and background: To evaluate the function and distribution of BAG-1 protein in hyperplastic and neoplastic prostate tissue and establish the relationship between this protein and BCL-related proteins (BCL-2 and BAX), androgen receptor (AR) expression and chromogranin A. Methods: Twenty-eight prostatic adenocarcinomas and 16 prostate hyperplasias were included in this retrospective study. BAG-1, BCL-2, BAX, androgen receptor and chromogranin A immunostaining was performed by means of standard avidin-biotin peroxidase methods. The M30 antibody was used to identify preapoptotic and apoptotic cells. The immunohistochemical histological score (HSCORE) semi-quantative system was used to evaluate immunohistochemical staining. Results: Statistical analysis showed a significant difference in HSCOREs of BAX, M30 and AR between the carcinoma and hyperplasia groups. Carcinomas expressed higher HSCOREs of these markers than hyperplasias. There were significant differences in nuclear and cytoplasmic BAG-1 positivity between high and low-grade carcinomas. BAG-1 expression was higher in low-grade carcinomas. In the carcinoma group there was a positive correlation (Pearson) between BCL-2 and cytoplasmic/nuclear BAG-1. In the hyperplasia group there was a negative correlation between BAX and BCL-2, and between AR and M30. We also detected a positive correlation between AR and nuclear/cytoplasmic BAG-1 and between nuclear and cytoplasmic BAG-1 in hyperplasias. BAG-1 showed the same specific basal cell localization as BCL-2 in hyperplastic and normal glands. Conclusions: The BAG-1 protein showed a distinct distribution pattern in hyperplastic and neoplastic prostate. BAG-1 in association with BCL-2 inhibits apoptosis and may prolong the life of neoplastic cells and give them a chance to gain new oncogenic features in early carcinogenesis.
Can prilocaine infiltration alone be the most minimally invasive approach in terms of anesthesia during extracorporeal shock wave lithotripsy?
(Elsevier Science Inc, 2006) Yilmaz, Erdal; Batislam, Ertan; Başar, Murad; Tuğlu, Devrim; Yuvanc, Ercan
Objectives. To evaluate the analgesic effect and utility of prilocaine infiltration alone for minimal morbidity during extracorporeal shock wave lithotripsy. Methods. A total of 114 patients with kidney stones, aged 18 to 69 years, were randomly separated into two groups. The 58 patients in group 1 received intramuscular diclophenac 30 minutes before extracorporeal shock wave lithotripsy, and the 56 patients in group 2 received prilocaine infiltration into the 30 cm(2) area below the 12th rib right before the session. A visual analog scale (0 to 100 mm) was used to evaluate pain. Results. The visual analog scale scores for group 2 were statistically lower at 1, 10, and 20 minutes compared with the scores for group 1 (P = 0.006, P = 0.005, and P = 0.006, respectively). However, no difference was detected at the end of the procedure. The requirement for additional analgesic was less in group 2 (P = 0.007). Conclusions. Prilocaine infiltration alone can be used for analgesic purposes efficiently and safely during extracorporeal shock wave lithotripsy with minimal morbidity.
Case Report: Incidental Testicular Tumor
(Wiley-Blackwell, 2014) Tuglu, Devrim; Bal, F.; Yuvanc, E.; Kirdağ, Mustafa Koray; Atasoy, Pınar; Yılmaz, Erdal; Batislam, Ertan
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Citrate levels in fresh tomato juice: A possible dietary alternative to traditional citrate supplementation in stone-forming patients
(Elsevier Science Inc, 2008) Yilmaz, Erdal; Batislam, Ertan; Basar, Murad; Tuglu, Devrim; Erguder, Imge
OBJECTIVES To detect citrate levels in fresh tomato juice, to reveal whether it can be studied for prevention of recurrent hypocitraturic nephrolithiasis. METHODS Juices of tomato, orange, lemon, and mandarin were extracted and blended with a hand blender, and 10 samples of 100 mL were taken from each. Citrate, oxalate, calcium, phosphorus, magnesium, sodium, potassium, chloride, and pH levels were examined in these. The same variables were re-evaluated after the samples were stored at +4 degrees C for 1 week. RESULTS In fresh tomato juice, higher citrate and magnesium levels as well as lower sodium and oxalate levels were detected as compared with the other juices. No differences were observed with regard to all variables among fresh orange, lemon, and mandarin juices. The level of citrate in the fresh tomato juice was higher at a statistically significant level than that in tomato juice that was stored for 1 week. The amount of oxalate increased in stored tomato juice. CONCLUSIONS Fresh tomato juice is considered a rich source of citrate. Furthermore, a high level of magnesium and a low level of sodium and oxalate content were detected in fresh tomato juice, the usability of which in recurrent hypocitraturic nephrolithiasis can be investigated in clinical studies.
Citrate, oxalate, sodium, and magnesium levels in fresh juices of three different types of tomatoes: evaluation in the light of the results of studies on orange and lemon juices
(Taylor & Francis Ltd, 2010) Yılmaz, Erdal; Batislam, Ertan; Kaçmaz, Murat; Erguder, İmge
Fruit and vegetable juices containing citrate may be recommended as an alternative in mild to moderate level hypocitraturic calcium stone formers who cannot tolerate pharmacological treatment. Tomato has been proved a citrate-rich vegetable. Tomato juice usage as citrate sources in hypocitraturic recurrent stone formers were evaluated in the light of the results of studies on orange and lemon juices. Ten 100 ml samples were prepared from three different tomato types processed through a blender. These samples were examined in terms of citrate, oxalate, calcium, magnesium, and sodium contents. No difference was detected between the parameters tested in three different tomato juices. Fresh tomato juice may be useful in hypocitraturic recurrent stone formers due to its high content of citrate and magnesium, and low content of sodium and oxalate. As the three different types of tomatoes did not differ in terms of citrate, magnesium, sodium, and oxalate content, they may be useful for clinical use if also supported by clinical studies.
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, Halil
Purpose: 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.
Comparison of Effects of Dexmedetomidine-ketamine and Dexmedetomidine-midazolam Combinations in Transurethral Procedures
(Elsevier Science Inc, 2012) Köse, Emine Arzu; Honca, Mehtap; Yılmaz, Erdal; Batislam, Ertan; Apan, Alpaslan
OBJECTIVE To compare the effects of dexmedetomidine-ketamine and dexmedetomidine-midazolam combinations on the recovery time, hemodynamic and respiratory variables, and side effects in patients undergoing transurethral procedures. METHODS Sixty patients scheduled for elective outpatient transurethral procedure were randomized into 2 groups. In the group K, a ketamine-dexmedetomidine combination was administered, and in the group M, midazolam-dexmedetomidine was administered, to provide sedation/analgesia. Pain and sedation levels were assessed using visual analog score (VAS) and Ramsey Sedation Scale, respectively. The recovery time was assessed with the scale of Aldrete. Time was measured and recorded to the moment at which patient responses brought the Aldrete score to 10 points. Time to eye opening and length of stay in the recovery room were recorded. RESULTS Group M showed significantly lower mean arterial pressure (MAP) values at 5 and 10 minutes during the procedure when compared with group K (P = .02 and P = .01, respectively). Visual analogue scale scores were greater in group M than in group K at 5 and 10 minutes for the transurethral procedure (P = .039 and P = .028, respectively). Sedation scores were similar between groups during the procedure. Time to eye opening and length of recovery room stay were shorter (P < .001 and P < .001, respectively), and Aldrete scores were greater in group K than group M. CONCLUSION Both combinations provided satisfactory sedation levels, but the dexmedetomidine-ketamine combination provided better analgesia and hemodynamic stability, with less nausea and vomiting and shorter recovery time, than the dexmedetomidine-midazolam combination. UROLOGY 79: 1214-1219, 2012. (c) 2012 Elsevier Inc.
Deneysel Tek Taraflı Üreter Obstrüksiyonu Oluşturulan Ratlarda Dimetilsülfoksit Ve Pirasetam’ın Böbrek Hasarına Etkisi
(2018) Yuvanç, Ercan; Tuğlu, Devrim; Kısa, Üçler; Bozdoğan, Önder; Bakar, Bülent; Batislam, Ertan; Yılmaz, Erdal
Amaç: Dimetil Sülfoksit (DMSO) ve Pirasetam’ın deneysel unilateral üreter obstrüksiyonu (UÜO) oluşturulan ratlarda böbrek hasarını azaltıcı etkilerinin incelenmesi. Gereç ve Yöntem: Çalışma her biri 6 Sprague-Dawley rattan oluşan 4 deney grubunda yürütüldü. Grup 1: sham, Grup 2: UÜO (kontrol grubu), Grup 3: UÜO DMSO 3.8 g/kg grubu, Grup 4: UUO Piracetam 500 mg/kg grubu olarak tanımlandı. Total antioksidan kapasite (TAK) ve total oksidan seviye (TOS) ölçümleri ve histopatolojik inceleme için doku ve kan örnekleri alındı. Doku örnekleri histopatolojik olarak da incelendi. Bulgular: Biyokimyasal ve histopatolojik böbrek hasarı incelendi. Doku Total Antioksidan Kapasite (TAK) düzeyleri değerlendirildiğinde Grup 1 ve Grup 2’ye göre Grup 3 ve 4’de istatiksel olarak anlamlı bir artış olduğu görüldü. Grup 3 ve Grup 4 arasında ise istatiksel olarak anlamlı bir artış olduğu saptandı (p0.001). Doku Total Oksidan Seviye (TOS) değerleri incelendiğinde Grup 1 ve Grup 2’ye göre Grup 3 ve Grup 4’de oksidan düzeyinde istatiksel olarak anlamlı bir azalma olduğu; aynı zamanda Grup 3 ve Grup 4 arasında da istatiksel olarak anlamlı bir azalma olduğu saptandı (p0.001). Doku Oksidatif Stres Indeksi (OSI) parametresi incelendiğinde Grup 1 ve Grup 2’ye göre Grup 3 ve 4’de OSI değerlerinde istatiksel olarak anlamlı bir azalma olduğu tespit edildi. Histopatolojik inceleme de böbrek dokusunda Grup 2’ye göre Grup 3 ve 4’te histopatolojik olarak istatistiksel olarak bir fark saptanmadı. Sonuç: Dokuda biyokimyasal düzeyde DMSO ve Pirasetam’ın antioksidan etkili olduğu aynı etkinin histolojik olarak koruyucu etkinlik oluşturmadığı saptanmıştır. Bununla birlikte bu ilaçların farklı doz ve sürelerle yapılacak çalışmalar ile doku antioksidan özelliklerinin saptanabileceği düşünülmektedir.
Deneysel Testis Torsiyonu Sonrası İskemi/Reperfüzyon Hasarında İloprost Ve Düşük Doz Metotreksat’ın Koruyucu Etkisi
(2017) Yuvanç, Ercan; Tuğlu, Devrim; Kısa, Üçler; Bozdoğan, Önder; Batislam, Ertan; Yılmaz, Erdal
Amaç: Testis torsiyonunda cerrahi olarak detorsiyone edilen testiste gelişen iskemi/reperfüzyon (I/R) hasarı üzerine İloprost ve düşük doz Metotreksat’ın koruyucu etkilerini araştırmak. Gereç ve Yöntem: Ratlar rastgele 4 gruba ayrıldı. Grup 1 (sham), Grup 2 İskemi/Reperfüzyon, ilaç verilmedi. Grup 3 İskemi/Reperfüzyon İloprost (10 µg/kg) ve Grup 4 İskemi/Reperfüzyon Düşük doz Metotreksat (6 mg/kg). Torsiyon/iskemi ve detorsiyon/reperfüzyon süreleri 4’er saat olarak belirlenmiştir. Medikasyonlar intraperitoneal yolla testis torsiyonunu takiben 3. saatte verilmiştir. Her 4 grupta işlemin başlangıcından 8 saat sonra detorsiyone sağ testis çıkarılmıştır. Bulgular: Çalışmamızda, iloprost ve düşük doz metotreksat verilmesinin total antioksidan kapasiteyi (TAK) istatistiksel olarak anlamlı arttırdığını, oksidan kapasite markırı olan total oksidan kapasite (TOK) ve oksidatif stres indeks oranını (OSI) ise istatistiksel olarak anlamlı düzeyde azalttığını belirledik. İskemireperfüzyon grubu testislerde testis grupları arasında Johnsen skorlama sistemine göre istatistiksel farklılık saptanmadı. Sonuç: Bizim düşüncemize göre iloprost ve düşük doz metotreksat tedavisi, testis örneklerinde antioksidan aktiviteyi arttırmış, oksidan aktiviteyi de baskılamıştır. Ancak, histopatolojik incelemede ve spermatogenes skorlarında bir değişime neden olmamıştır.
The effect of coenzyme Q and selenium on kidney in rats with partial unilateral ureteral obstruction
(Aves, 2019) Kirdag, Mustafa Koray; Tuglu, Devrim; Yuvanc, Ercan; Kisa, Ucler; Balci, Mahi; Batislam, Ertan; Yilmaz, Erdal
Objective: In this study, we aimed to investigate the antioxidant effects of selenium and coenzyme Q on renal damage in a partial unilateral ureteral obstruction (PUUO) in a rat model. Material and methods: A total of 24 Sprague-Dawley rats were divided into four groups as Group 1 Control Group, Group 2, PUUO Group, Group 3 PUUO + coenzyme Q group, Group 4 PUUO + selenium group. Paraoxonase (PON), total antioxidant capacity (TAC), and total oxidant levels (TOS) were analyzed biochemically from tissue and blood samples. Tissue samples were examined histopathologically. Results: The TAC in the tissues was found to be statistically significantly increased in Groups 3 and 4, compared to Group 2. Tissue TOS was found to be significantly reduced in Groups 3 and 4, compared to Group 2. Serum PON levels were significantly increased in Group 3 and 4, compared to Group 1 and 2. Histopathological examination showed that interstitial inflammation and congestion were lesser in the coenzyme Q and selenium groups than in the PUUO group. A more significant decrease was found in the selenium group than in the coenzyme Q group. Conclusion: Our study results showed that coenzyme Q and selenium reduced the oxidation and the damage in tissue in PUUO in rats.
Effect of SWL on renal hemodynamics: could a change in renal artery contraction-relaxation responses be the cause?
(Springer, 2012) Yilmaz, Erdal; Mert, Cagatay; Keskil, Zuhal; Tuglu, Devrim; Batislam, Ertan
The aim of this study was to reveal the effect of shock wave lithotripsy (SWL) on renal artery contraction-relaxation responses and the relation of this effect with renal hemodynamics. Twenty-four rabbits are divided into six different groups. The first two groups evaluated as the control groups. After isolating the kidneys, we applied phenylephrine (Ph) and acetylcholine (Ach) in the first group and sodium nitroprusside (SNP) and histamine (H) in the second group. In the third, fourth, fifth and sixth groups, 14.5 kV shock wave (SW) was focused on the left kidneys. We adjusted the number of shocks to a total of 500, 1,500, and 3,000 SW, in the third, fourth and fifth groups, respectively. After isolating the kidneys, Ph, Ach was given in groups 3, 4 and 5. In the sixth group, to get the SNP and the H responses, 3,000 shocks modality was utilized. Marked contractile responses were obtained by phenylephrine in the control group. In kidneys that were exposed to 500 shocks SWL procedures, a decrease in contractile responses and hence, in perfusion pressures in different concentrations of phenylephrine was noted. However, a notable change in relaxation responses occurred after 3,000-shock applications. No difference in relaxation responses to nitroprusside, a direct vasodilating agent, was observed in any group, compared to the control group. Another cause of deterioration of renal hemodynamics after SWL can be attributed to the reduction in renal artery contraction-relaxation responses that result in the vascular smooth muscle and endothelial damage.
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, Halil
Background 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.
Effects of statin treatment on serum sex steroids levels and autonomic and erectile function
(Elsevier Science Inc, 2008) Dogru, M. Tolga; Basar, M. Murad; Simsek, Ali; Yuvanc, Ercan; Guneri, Mahmut; Ebinc, Haksun; Batislam, Ertan
OBJECTIVES To investigate the effect of statin treatment on serum sex steroid levels, heart rate variability, erectile function, and libido in patients with hyperlipidemia. METHODS A total of 74 patients (mean age 44.7 +/- 7.1 years) with hyperlipidemia were enrolled into this study. After a cardiac examination, the serum lipid levels were measured, and the 24-hour Holter monitoring, heart rate variability, and autonomic test results were also evaluated. Erectile function was assessed using the International Index of Erectile Function (IIEF) questionnaire. Later, atorvastatin 40 mg/day was initiated in all patients and used for the subsequent 12 months. All diagnostic tests (cardiac, biochemical, and autonomic and the IIEF questionnaire) were performed again at 6 and 12 months of follow-Lip. RESULTS A statistically significant decrease was found in the serum lipid levels at 6 months (P<0.05). In contrast, the average IIEF scores (24.7 +/- 6.4 at baseline) had increased to 25.0 +/- 4.9 and 26.1 +/- 5.9 at 6 and 12 months of follow-up, respectively. Although the parasympathetic activities increased and sympathetic activities decreased with atorvastatin treatment, these changes were not statistically significant (P>0.05). In paired comparison, significant differences were found among the IIEF scores of the three periods (P = 0.013). The difference was more evident after 6 months of treatment (IIEF1vs2 = 0.475; IIEF1vs3 = 0.027; IIEF2vs3 = 0.012). CONCLUSIONS Although improvement in the lipid profile occurred early during the statin treatment, restoration of erectile function appeared later, which Could be attributed to the restoration of endothelial functions by lowered serum lipid levels.
Effects of vardenafil on intraocular pressure and orbital hemodynamics
(Mary Ann Liebert, Inc, 2007) Taner, Pelin; Başar, M. Murad; Ünal, Birsen; Batislam, Ertan
\Purpose: The aim of this study was to investigate the effects of vardenafil on systemic blood pressure, intraocular pressure (IOP), and orbital hemodynamics. Methods: Twenty-one (21) volunteers suffering erectile dysfunction, with an average age of 51.5 +/- 6.2 years, were enrolled into the study. Brachial blood pressures and IOP were measured, the peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) of the ophthalmic, central retinal, and posterior ciliary arteries were evaluated by color Doppler ultrasonography (CDU) before vardenafil intake. All measurements were repeated after 20 min of vardenafil intake. A paired Student t test was used to evaluate the changes. Results: Systolic blood pressure did not change significantly where diastolic blood pressure decreased significantly (P = 0.043) after drug ingestion. There was no significant change in IOP. Increase in EDV of CRA was significant (P = 0.04), but the increase of orbital blood flow velocities of OA and PCA were insignificant. Conclusions: The recommended dose of vardenafil has no negative effects on orbital hemodynamics and IOP in patients with erectile dysfunction.
The efficacy of sildenafil in different etiologies of erectile dysfunction
(2001) Başar, Murat; Tekdoğan, Ümit Y.; Yılmaz, Erdal; Başar, Halil; Atan, Ali; Batislam, Ertan
Purpose: The aim of this study was to evaluate the efficacy of sildenafil and success of treatment in particular etiological causes in erectile dysfunction lasting more than 3 months. Material and methods: A total of 141 patients between 27 and 78 years old without any cardiac compromise, despite controversial, which precludes sildenafil (Viagra®) treatment, were included in this study. All patients had only International Index of Erectile Capacity Form (IIEF) for pre-treatment evaluation and 50 mg sildenafil was started. Patients were assessed monthly for 6 months thereafter. Erectile capacity changes were questioned by IIEF on each follow-up and 100 mg sildenafil was given in patients without a response and monthly follow-up was scheduled. All patients had SMA-12, hormonal analyses and penile colour Doppler ultrasonography during the treatment course. The difference between IIEF score of each patient was displayed by Paired-t test and p-values less than 0.05 was applied as significant. Results: The average beginning IIEF score of 141 patients was 11.80 ± 0.47 [6-22], and increased to 20.70 ± 0.62 [6-30] after a month of 50 mg sildenafil treatment. The mean increase was 75.4% and found to be significant (p = 0.000, p < 0.05). The average IIEF scores were recorded as 22.57 ± 0.69 after 3, and 22.12 ± 0.24 after 6 months. There was no difference between these values and 2nd month controls (p3 month = 0.5675, p6 month month = 0.6138, p > 0.05). A positive response was recorded in 102 patients (72.3%) and 39 (27.7%) patients were unresponsive. Doubled doses of sildenafil (100 mg) was effective in additional 17 patients. After overall treatment, 119 (84.4%) patients had benefit from sildenafil. Penile Doppler ultrasonography displayed arterial insufficiency in 79 (56.03%), veno-occlusive dysfunction in 14 (9.93%), mixt vascular pathology in 14 (9.93%) patients. Normal ultrasonographic findings in 32 patients (22.7%) were classified as psychogenic dysfunction. Among the organic causes, sildenafil was found to be most effective in arterial insufficiency group. Conclusion: Sildenafil is a successful management modality in erectile dysfunction with minimal pre-treatment evaluation. As far as etiological causes concerned, sildenafil was found to be most effective in arterial insufficiency group and psychogenic group. The efficacy of sildenafil treatment has not been changed with the treatment time, since IIEF scores were stable during follow-up controls.
Endogenous sex steroids and bone mineral density in healthy men
(Elsevier France-Editions Scientifiques Medicales Elsevier, 2006) Keles, ışık; Aydin, Gülümser; Basar, M. Murad; Hayran, Mutlu; Atalar, Ebru; Orkun, Sevim; Batislam, Ertan
Objective. - To evaluate the role of endogenous sex steroids on bone mineral density (BMD) in healthy Turkish men. Methods. - Serum total testosterone (TT), free testosterone (FT), dehydroepiandrosterone sulfate and estradiol levels were assayed in 174 healthy men of 240 volunteers, aged 22-76 years. Dual-energy X-ray absorptiometry was used to measure the BMD (g/cm(2)) of lumbar spine, femoral neck and non-dominant proximal and distal radius-ulna sites. Linear regressions were conducted using each BMD site as the dependent variable and each sex. steroid as the independent variable. Four models were run for each bone site and sex steroid; crude, age-adjusted, adjusted for age and body mass index (BMI), and adjusted for age, BMI and cigarette-smoking. Results. - The mean age and BMI of men enrolled in the study were 47.7 +/- 13.7 years and 26.9 +/- 3.6 kg/m(2). Log of FT was significantly associated with the BMD of distal forearm in all models analyzing the crude and adjusted effects. Dehydroepiandrosterone sulfate effect on BMD of proximal forearm came closer to the level of statistical significance when adjusted with age, BMI and cigarette-smoking. Estradiol and TT levels were not found to be associated with BMD of any sites measured. Conclusion. - Among the endogenous sex steroids in men, predominantly FT seems to be one of the determinants of BMD. Therefore a decrease in serum levels of testosterone in aging male or secondary causes may negatively affect BMD. (c) 2005 Published by Elsevier SAS.
Evaluation of pheniramine maleate and zofenopril in reducing renal damage induced by unilateral ureter obstruction. An experimental study
(Termedia Publishing House Ltd, 2021) Yuvanc, Ercan; Tuglu, Devrim; Ozan, Tunc; Kisa, Ucler; Balci, Mahi; Batislam, Ertan; Yilmaz, Erdal
Introduction: Obstruction of the ureter may occur due to congenital, iatro-genic or other reasons. This can cause hydronephrosis in the early stage and can lead to cellular inflammation, necrosis and atrophy in the kidney tissue. The aim of this paper is to evaluate the protective effect of pheniramine maleate (PM) and zofenopril on renal damage caused by hydronephrosis due to unilateral partial ureter obstruction. Material and methods: Twenty-four female Sprague Dawley rats were divided into 4 groups. Group 1: sham group, group 2: partial unilateral ureteral obstruction (PUUO) group, group 3: PUUO + PM group, group 4: PUUO + zofenopril group. Paraoxonase (PON), total antioxidant status (TAS) and total oxidant status (TOS) of tissue and blood samples were measured and calculated. Tissue samples were evaluated histopathologically. Results: An increase in tissue TAS and a decrease in tissue TOS and OSI levels were detected in groups 3 and 4 compared to group 2 (both: p < 0.01). Tissue PON levels showed an increase in groups 3 and 4 compared to groups 1 and 2 (both: p < 0.01). Histopathological evaluation showed a decrease in interstitial inflammation and congestion in groups 3 and 4 compared to the control group (p < 0.001). The decrease was observed to be more significant in group 4 compared to group 3 (p < 0.01). Conclusions: In our experimental study, we observed that PM and zofenopril reduce the oxidation and tissue damage caused by unilateral partial obstruction.

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