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Biomedical subjects

Ahmet Soylu

Publications and source records attributed to Ahmet Soylu.

13 recordsLinked to original sources

Removal of fractured balloon catheter using another balloon inflation in coronary artery: case report.

In this report, a novel management to the problem of a fractured balloon catheter which is a very rarely seen complication and has not yet been reported in the nature as in our case during percutaneous transluminal coronary interventions is presented. We inserted a second balloon catheter to the space between the previous fractured balloon and the wall of right coronary artery, and then by inflating the second balloon catheter at low pressure, the guide-wire of fractured balloon catheter and the second sound balloon catheter gently and cautiously removed together into the guiding catheter. Subsequently, the whole system was taken out of the body without complication.

Catheterization↗

Sympathetic skin responses in Type-1 diabetic children: relationship to urodynamic findings.

AIMS: Cystopathy is an important problem in diabetes mellitus (DM) when diabetes is not well-controlled. In most cases of diabetic csytopathy, autonomic involvement is responsible, which develops insidiously over a long time. We investigated the hand and genital sympathetic skin responses (SSRs) and its relation to urodynamic abnormalities in this group of patients. METHODS: We performed hand and genital SSRs in 24 children with Type-1 DM, whose hemoglobin A1C values were above normal limits. We also recruited 19 healthy children for SSRs measurements. Cystometry was performed in 24 children with Type-1 DM. Based on cystometry findings, these children were classified into two groups as normal (n:6) and abnormal (n:18). The amplitude and latency of hand and genital SSRs of 24 children with Type-1 DM and 19 healthy children were compared. RESULTS: Hand and genital SSRs were obtained from all of the diabetic and healthy children. The mean genital SSRs amplitude in diabetic children was significantly lower than the controls. There was no difference in the mean values of all investigated parameters between the normal group and controls. When compared to the controls, there was prolonged latency and decreased amplitude of genital SSRs and decreased hand SSRs amplitude in abnormal group. CONCLUSIONS: SSR is a non-invasive test for the evaluation of autonomic sympathetic involvement. Our study revealed differences in genital SSR before the manifestations of cystopathy. Children with abnormal urodynamic findings had changes in both hand and genital SSRs. These findings suggest that SSR tests may have a place in the evaluation of diabetic cystopathy in the early asymptomatic period.

Adolescent↗

Validation of 2001 Partin tables in Turkey: a multicenter study.

OBJECTIVE: Although Partin tables were developed in United States to predict the stage of prostate cancer preoperatively, they are used by many clinics throughout the world assuming that these figures apply to their population as well. However the predictive value of current Partin tables, which was updated in 2001, has not been validated in most of the countries as well as in Turkey. Therefore, we evaluated the validity of 2001 Partin tables, for the ability to predict the pathological stage in Turkish patients. PATIENTS AND METHODS: The clinical and pathological findings of 1043 patients who have had radical prostatectomy were assessed. Serum PSA values, clinical stage, biopsy Gleason score and the pathological features of the radical prostatectomy specimens were collected from each clinic and evaluated. The predictive value of Partin nomogram and pathological findings of prostatectomy specimens were compared and analyzed according to Receiver Operating Characteristics (ROC) analysis. RESULTS: Median age of the patients was 60 (45-74). In the presented study, percentage of patients with clinical stage T1c was 43%. Patients with Gleason score of 2-4 in biopsy constituted 23.4% of the study group. In the present study, the ratio of the patients with serum PSA higher than 10 ng/ml was 39.6%. Organ confined disease, seminal vesicle involvement, lymph node metastases ratios were 64.7%, 10.3%, 1.8% respectively. Area Under Curve (AUC) values for organ confined disease, seminal vesicle involvement and lymph node involvement were calculated as 0.665, 0.733 and 0.759 respectively. CONCLUSION: It appears that Partin tables have a reasonable predictive value for the final pathological features like organ confined disease, seminal vesicle and lymph node involvement in Turkish patients. This multicenter study showed that current Partin tables could also be used in Turkish patients with comparable accuracy.

Biomarkers↗

Bilateral kidney stones with ureteropelvic junction obstruction.

BACKGROUND: A 56-year-old male with bilateral flank pain was admitted following diagnosis of bilateral kidney stone disease. He had previously undergone four separate pyelolithotomy sessions (two per kidney), the latest being 14 years prior. At presentation the patient had two stones in the right kidney and seven in the left kidney. The right renal pelvis was dilated, indicating obstruction of the ureteropelvic junction. INVESTIGATIONS: Plain radiography, ultrasonography, intravenous pyelography, retrograde ureteropyelography and spiral tomography. DIAGNOSIS: Bilateral kidney stones and obstruction of the right ureteropelvic junction. MANAGEMENT: Bilateral percutaneous nephrolithotomy and simultaneous right endopyelotomy; intraoperative antegrade nephrogram; preoperative and postoperative measurement of hemoglobin, blood urea nitrogen and creatinine; postoperative nephrostograms, plain X-ray, diuretic renogram and intravenous pyelography.

Humans↗

Topographic abnormalities in event-related potentials in children with monosymptomatic nocturnal enuresis.

AIMS: A functional maturational delay in the central nervous system is dwelled upon in the pathogenesis of monosymptomatic nocturnal enuresis (MNE). In this study we studied whether according to controls N200 and P300, components of the event-related potential (ERP), which is related to aspects of cognitive processing, showed any difference in its topographic distribution in children within the age group 10-13 with monosymptomatic nocturnal enuresis and discussed its relation to the pathogenesis of MNE. METHODS: We performed P300 in 18 patients with MNE and in 16 age-matched healthy subjects. P300 were evoked by an auditory oddball paradigm consisting of 150 tone bursts (80% 1 kHz; 20% 2 kHz). The latencies of the N200 and the P300 waves and the amplitude of the P300 wave were measured. RESULTS: There was no statistical difference between the enuretic group and the controls in N200 and P300 latency and amplitude in the midline frontal (Fz), central (Cz), and parietal (Pz) recording site of the 10-20 International System. In the enuretic group while P300 amplitude in the Fz site was significantly less than the P300 amplitude in the Cz site, there was no statistical difference between the Fz and Pz P300 amplitude values. CONCLUSIONS: When different levels of maturational delay are considered in MNE, it may be claimed that maturational delay in children whose enuresis lasts until older ages will be different from those whose enuresis ends at an early age. The determination of P300 amplitude in parietal records being less in enuretics when compared to the controls may show that there are regional differences in stimuli processing rate/quality.

Acoustic Stimulation↗

Bilateral disruption of corpus cavernosum with complete urethral rupture.

Penile fracture is a relatively rare condition. We report an unusual case of the bilateral disruption of the corpus cavernosum with complete urethral rupture resulting from blunt trauma during sexual intercourse. The subject underwent emergency surgery with preservation of erectile and voiding functions in the follow-up.

Anastomosis, Surgical↗

The influence of aldosterone on the development of left ventricular geometry and hypertrophy in patients with essential hypertension.

The identification of risk factors for the initiation of left ventricle hypertrophy (LVH), which is an independent risk factor for cardiovascular mortality and morbidity in hypertensive patients, is very important. The objective of the present study was to identify the relationship of aldosterone with LVH and different geometrical patterns of left ventricle that develop in patients with essential hypertension. A total of 83 patients with essential hypertension (44 females, mean age, 51 +/- 8 years, 39 males, mean age, 57 +/- 10 years) were included in this study. Thirty-two had LVH. When evaluated according to the geometrical patterns of LVH, 18 patients had concentric LVH, 14 had eccentric LVH, and 17 had concentric remodeling. Thirty-four patients had normal left ventricle geometry. Two weeks after the cessation of antihypertensive medications, sodium, potassium, and proteinuria in 24-hour urine samples and plasma aldosterone levels and plasma renin activity were measured. Plasma aldosterone levels of the patients with LVH were found to be significantly higher (9.92 +/- 6.34 ng/dL versus 5.83 +/- 3.5 ng/dL, P < 0.01). The difference between plasma renin activities was not statistically significant. Linear regression analysis revealed that plasma aldosterone level and age were independent parameters increasing left ventricle mass index. The plasma aldosterone levels of patients with concentric hypertrophy of the left ventricle were significantly higher than those of patients with normal geometry and concentric remodeling. There was no significant difference between plasma renin activities. Twenty-four hour urine protein concentrations of the patients with LVH were found to be significantly higher and sodium to be significantly lower. Plasma aldosterone levels seem to be correlated with LVH especially with concentric hypertrophy of the left ventricle in patients with essential hypertension.

Aged↗

Percutaneous nephrolithotomy for pediatric stone disease--our experience with adult-sized equipment.

OBJECTIVE: We evaluated the outcomes and complications of percutaneous nephrolithotomy (PNL) operations performed in pediatric patients using adult-sized surgical equipment at our center. MATERIAL AND METHODS: The medical and surgical records of 23 children who underwent a total of 25 PNL operations using 24 or 26 F rigid nephroscopes were evaluated retrospectively. The following aspects were considered: stone burden; duration of surgery and complications; details concerning recovery, success, residual fragments and auxiliary procedures; and follow-up details. RESULTS: The success rate of a single PNL session was 70.8%; with the use of auxiliary procedures this was increased to 91.6%. Perioperative and early postoperative complications were excessive bleeding and transfusion in two patients, hydro-pneumothorax in one, perforation of the collecting system in three and urinoma in one. Complications were more common in children aged <7 years or with staghorn stones. The mean time to catheter removal was 3.4 days and the mean hospitalization time was 4.8 days. Idiopathic hypercalciuria, hypocitraturia, cystinuria and hyperoxaluria were diagnosed in two, two, one and three patients, respectively. CONCLUSION: Performing PNL with adult-sized equipment is associated with significant complications in children aged <7 years or with staghorn stones. This treatment should not be considered in routine clinical practice. As all stone-removal methods are associated with complications, PNL should be used only if other methods fail or are unavailable.

Adolescent↗

Clitoral electromyography.

PURPOSE: The clitoris has several histomorphological and functional similarities to the penis. In this study we evaluated spontaneous and evoked electromyography activity in the clitoris. MATERIALS AND METHODS: We evaluated 11 healthy female volunteers with clitoral electromyography using a concentric needle electrode placed intracorporeally. The hand, foot and genital sympathetic skin responses, and spontaneous electrodermal activity were simultaneously recorded with silver surface electrodes. Another concentric needle electrode was placed subdermally on the mons pubis to differentiate clitoral activity from possible artifact. After recording spontaneous electromyography and electrodermal activity the left median nerve was stimulated to record evoked clitoral activity, and the sympathetic skin response in the hand, foot and genital regions. RESULTS: There was spontaneous electromyography activity in the corpus clitoris. All dermal sites, including the hand, foot and genital regions, showed spontaneous electrodermal activity. No spontaneous activity was recorded from the subdermal needle electrode. Distraction of attention and coughing increased the amplitude and frequency of spontaneous clitoral electromyography and electrodermal activity at all sites. After stimulating the left median nerve all sites except that of the subdermal needle electrode showed evoked activity. CONCLUSIONS: The demonstrated evoked and spontaneous clitoral electromyography activity seems to indicate a sympathetic tonus of the corpus clitoris, as recorded from the corpus cavernosum of the penis in human males. Clitoral electromyography may be a useful objective assessment tool for evaluating female sexual dysfunction as well as genital autonomic innervation.

Adult↗

Evoked cavernous activity.

PURPOSE: Corpus cavernosum electromyography has been widely done to evaluate autonomic dysfunction in patients with erectile dysfunction. We assessed the value of corpus cavernosum electromyography, evoked cavernous activity and penile sympathetic skin responses for their accuracy in determining autonomic involvement in cases of erectile dysfunction. MATERIALS AND METHOD: We evaluated 75 men with erectile dysfunction by corpus cavernosum electromyography, evoked cavernous activity and penile sympathetic skin response tests at our neurourology laboratory. The etiology of dysfunction was vascular, neurogenic, psychogenic or mixed based on a detailed medical and sexual history, physical examination, electrophysiological and laboratory studies, penile color Doppler ultrasonography, and cavernosography and/or cavernosometry. Autonomic involvement was clinically assessed by systemic findings, such as orthostatic hypotension, impaired gastrointestinal motility, sinus dysrhythmia and secretomotor changes. A concentric electromyography needle placed in the right cavernous body was used to record corpus cavernosum electromyography and evoked cavernous activity. The right median nerve was stimulated electrically with 13 to 16 mA. to determine evoked cavernous activity and the penile sympathetic skin response. The latter response was recorded with silver disc electrodes placed on the left cavernous body. All tests were performed using an electromyography/evoked potential machine. We determined the relationships among corpus cavernosum electromyography, evoked cavernous activity and penile sympathetic skin response tests in respect to etiological factors. RESULTS: The 56 patients with normal corpus cavernosum electromyography activity had also evoked cavernous activity and a penile sympathetic skin response except for 1 with no penile sympathetic skin response but evoked cavernous activity. None of these patients had autonomic neuropathy. Of the 19 patients without corpus cavernosum electromyography activity 11 had evoked cavernous activity, including 10 with no autonomic neuropathy. The remaining 8 patients had no evoked cavernous activity, of whom 7 had autonomic neuropathy. A penile sympathetic skin response was recorded in 18 men with absent corpus cavernosum electromyography. CONCLUSIONS: Due to false-negative results on corpus cavernosum electromyography and penile sympathetic skin response testing evoked cavernous activity seems more reliable for determining autonomic involvement in the pathophysiology of erectile dysfunction.

Adult↗