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Biomedical subjects

K Sarica

Publications and source records attributed to K Sarica.

At least 55 records · Page 3Linked to original sources
PubMed1996

Effect of urinary tract infection on disintegration of calcium-containing stones.

To evaluate the possible effect of urinary tract infection (UTI) on the fragility of calcium-containing stones (calcium-oxalate, calcium-phosphate), the results of extracorporeal shock wave lithotripsy (ESWL) therapy in 81 patients with UTI and 30 patients with no sign of UTI were comparatively evaluated. ESWL parameters (shock wave number, kilovolt value, treatment time) and stone-free status during 3 and 6 months of follow-up were assessed for each patient, and the results were evaluated with respect to stone presence. Our results indicated that the presence of UTI may decrease stone fragility and increase stone clearance time. We believe that deterioration of peristaltic dynamics in the renal pelvis and the ureteral wall may reveal prolonged stone clearance phases in such patients.

Adolescent↗
PubMed1996

Evaluation of ischemia after ESWL: detection of free oxygen radical scavenger enzymes in renal parenchyma subjected to high-energy shock waves.

To evaluate the degree of ischemic formation at the tissue level after high-energy shock wave (HESW) application in a time- and dose-dependent manner, an experimental study in rabbits was performed. Following varying numbers of HESWs (1,000-2,000-3,000 shock waves) under fluoroscopic localization, treated kidneys were removed, by assessing tissue concentrations of two different free-radical scavenger enzymes (superoxide dismutase and catalase) the degree of formation of free oxygen radicals (i.e. ischemia) was evaluated. Evaluation of our results showed a statistically significant (p < 0.05) decrease in tissue scavenger enzyme levels (i.e. formation of free oxygen radicals) after 24 h following HESW application. However, results obtained 7 days after ESWL demonstrated disappearance of ischemia with normalization of tissue enzyme levels (p > 0.05).

Animals↗
PubMed1995

Agenesis of bladder associated with multiple organ anomalies.

Agenesis of the bladder is an extremely rare congenital anomaly, which involves the development of urogenital sinus. Renal agenesis and some other congenital malformations are often associated. We report a 12-year-old girl with absence of bladder and solitary pelvic ectopic kidney together with some other systemic abnormalities.

Abnormalities, Multiple↗
PubMed1995

Human chorionic gonadotropin in serum and neoplastic tissue from patients with bladder carcinoma.

Serum levels and tissue expression of beta subunit of human chorionic gonadotropin were determined in 25 patients with bladder carcinoma. Elevated gonadotropin levels in serum were observed in 5 (20%) patients and immunoreactive cells were found in 5 (20%) tumours. The correlation was poor between serum level and immunohistochemical gonadotropin status. Only one patient showed both elevated serum level and immunohistochemical gonadotropin expression. Our observations suggest that elevated serum levels of gonadotropin may be an indicator of poor prognosis. However, immunohistochemical expression of gonadotropin did not seem to have a similar impact on prognosis in this series.

Adult↗
PubMed1995

Long-term follow-up of renal morphology and function in children after lithotripsy.

Between October 1990 and May 1991, extracorporeal shock wave lithotripsy (ESWL) was performed on 35 children. All the treatments were done with the Dornier MPL 9000 Lithotriptor under sedation. Following treatment all the children were controlled regularly every 6 months, and the long-term follow-up results concerning the renal functional and morphological alterations together with changes in blood pressure values and the rate of stone recurrence were analyzed. Renal functional evaluations using a radiosiotope renogram revealed a transient decrease in renal function in the early follow-up period (0-3 months), which returned to normal limits after this period. Sonographic evaluation of the renal dimensions and morphology did not show any gross pathology in the early and long-term evaluation. Again determination of renal parenchymal thickness together with renal growth showed no statistically significant alteration in the late control of the children. Finally, careful monitoring of blood pressure and the recurrence rate of stone disease revealed no statistically significant changes in these aspects. ESWL seems to be the preferred treatment modality in children due to its safe and effective therapy results. Especially the long-term evaluation of our children proved the safety of this procedure.

Adolescent↗
PubMed1995

Evaluation of cellular immunity following bacillus Calmette-Guérin therapy in patients with superficial bladder cancer.

Despite its marked effectiveness in the prevention of tumor recurrences, a great deal of information on the mode of action of Bacillus Calmette-Guérin (BCG) as an antitumor therapy modality is still lacking. In this prospective study, by performing lymphocyte subset analysis and quantitative assessment of delayed hypersensitivity skin reactions before transurethral resection of the detected tumor and 3-6 months after intravesical BCG administration in 23 patients with superficial bladder carcinoma, we tried to demonstrate the immunostimulatory effect of BCG therapy. We had 4 recurrences at 6 months' follow-up. Evaluation of lymphocyte subset analysis readings in our group revealed a statistically significant difference (p < 0.05) in CD4+/CD8+ ratio between baseline values and that obtained following BCG administration at 3 and 6 months. However, there was no statistically significant increase of this value in 4 patients who had tumor recurrences. Evaluation of delayed hypersensitivity skin test score results revealed a statistically significant increase in the whole group at 3 months of follow-up (p < 0.05) but the same evaluation at 6 months of follow-up showed no statistically significant difference with respect to this evaluation. Again, no statistically significant difference was found in 4 patients who had tumor recurrences. These results support the idea that BCG-associated antitumor activity is an immune-mediated reaction and the assessment of T-lymphocyte subsets together with quantitative evaluation of delayed hypersensitivity skin reactions would give us a definite idea about the immunotherapeutic effects of BCG in such patients.

Administration, Intravesical↗
PubMed1995

Urological evaluation of Behçet patients and the effect of colchicine on fertility.

Behçet's disease is a multisystem disorder in which urogenital involvement mainly consists of genital aphthous ulcers, epididymitis, urethritis and recurrent cystitis. Colchicine is commonly used in these patients for the prevention of arthritic episodes. In this prospective study, 62 male patients under colchicine therapy for Behçet's disease underwent a complete urogenital evaluation. 33 (53.2%) had no urologic complaints. Physical examination revealed genital aphthous ulcers in 42 patients (67.7%) and epididymitis in 5 (8.1%). Analysis of urine specimens demonstrated proteinuria in 54.8% and hematuria in 30.6%. To establish any possible adverse effects of colchicine administration on male fertility, sperm analysis was performed: 23 patients (37.1%) had oligonecrospermia, 2 patients (3.2%) had azoospermia. Penile color flow Doppler sonography revealed arterial insufficiency in 17 patients (27.4%). Other urological findings were interpreted as coincidental. Our results indicate that urologic manifestations of Behçet's disease, and especially the possible adverse effects of colchicine administration on the reproductive potential of the treated patients should be carefully monitored.

Adult↗
PubMed1994

Extracorporeal shockwave lithotripsy in anomalous kidneys.

Traditionally, stones in anomalous kidneys have been removed by open or percutaneous surgery. Extracorporeal shockwave lithotripsy (SWL) with the Dornier MPL 9000 lithotripter was performed in seven patients with horseshoe kidneys, four with pelvic ectopic kidneys, and six with malrotated kidneys. Twelve patients (71%) needed repeated treatments. A total of 11 patients (65%) in all the groups were stone free, and four patients had asymptomatic residual fragments no more than 5 mm in diameter. In the remaining two patients, no sign of stone disintegration was observed, and they underwent open surgery. Extracorporeal lithotripsy is the treatment of choice for stones in horseshoe or malrotated kidneys but is not useful for stones in most pelvic kidneys.

Female↗
PubMed1994

The place of acupuncture in the management of psychogenic impotence.

Successful sexual functioning is a complex process involving psychological and social responses as well as neurological, biochemical and vascular processes. Today it is believed that more than 50% of the sexual dysfunction cases have an organic etiology. Reflecting the controversy over the management of psychogenic impotence, there are several different methods which are currently in clinical use. In this prospective study we aimed to evaluate the curative effects of acupuncture therapy in men with purely psychogenic impotence. Of the 29 patients treated with this procedure 20 patients demonstrated successful erections following a varying number of acupuncture sessions. In the light of our findings we may conclude that acupuncture may be an effective alternative in the management of purely psychogenic impotence.

Acupuncture Therapy↗
PubMed1994

Multidisciplinary evaluation of diabetic impotence.

Patients referring to the Urology and/or Endocrinology Departments of Ankara Medical School with complaints of diabetes mellitus (DM) and related complications were evaluated during the last year. A detailed history was obtained and all of the patients were questioned especially about sexual function problems. Following this evaluation, all patients were divided into two main groups, i.e. patients with sexual disorders, and those with normal sexual function. Factors such as BPH, cerebrosclerosis and other important vascular-neurologic pathologies which may play a role in the etiology of impotence were excluded from the study and 38 patients with sexual dysfunction and 15 with normal sexual activities have undergone further evaluation. Following routine blood and urine analyses, serum hormone levels (testosterone, FSH, LH, prolactin) were determined. Penile color-flow doppler analysis, cavernosometry, cavernosography, bulbocavernous reflex latency time and evaluation of somatosensory evoked potentials were performed. Additionally, all patients were evaluated from the psychiatric aspect using the Hamilton depression scale and MMPI questionnaire. The presence of vascular or neurologic pathology in 89.4% of our patients and of both pathologies in 39.4% of the patients, indicated the importance of multifactorial evaluation of diabetic impotence in order to plan a complete and efficient therapy program.

Adult↗
PubMed1993

Histopathologic effects of extracorporeal shock wave lithotripsy on rabbit kidney.

Despite the widespread clinical use of the lithotriptor, the margin of safety for the kidney during shock wave application is substantially unknown. Although a series of pilot studies have been performed in laboratory animals, long-term follow-up is mandatory to establish the effect of extracorporeal shock wave lithotripsy (ESWL) and subsequent dose-dependent changes on the kidneys. An experimental study was performed in 45 rabbits; to define and compare the early and late complications of ESWL in the kidneys. The rabbits were divided into three groups of 15 animals each that received 1000, 1500 or 3000 shock waves respectively at 15-20 kV. The rabbits in each group were killed and necropsy performed within 24 h for the first 5 animals, 1 week for the second 5 animals and 2 months post-ESWL for the last 5 animals. Dose-dependent moderate damage (subcapsular hemorrhage, interstitial hemorrhage, capsular tension and perirenal hemorrhage) were noted in all kidneys at 24 h after treatment. Evidence of permanent changes (some fibrosis, tubular and glomerular damage, chronic inflammatory alterations) was noted in long-term follow up. Complete necrosis of the treated kidney was not encountered in this study.

Animals↗
PubMed1993

Evaluation of renal morphology and vascular function by color flow Doppler sonography immediately after extracorporeal shock wave lithotripsy.

Thirteen male and seven female patients with renal calculi were evaluated by color flow Doppler sonography (CFDS) for renal morphology and function before and after receiving 1000 to 2350 shocks with the Dornier MPL 9000 lithotripter. No significant morphologic change was encountered except for renal enlargement thought to be secondary to edema induced by shock wave application. Similarly, no significant differences were recorded in the systolic and diastolic flow rates or pulsatility (PI) or resistive (RI) indices of the renal vessels before and after treatment (P > 0.05). Color flow Doppler sonography appears to be a safe, noninvasive, and reliable means of evaluating kidneys subjected to extracorporeal shock wave lithotripsy.

Adolescent↗
PubMed1993

Treatment of renal stones in a solitary functioning kidney with extracorporeal shock wave lithotripsy.

Forty extracorporeal shock wave lithotripsy (ESWL) sessions were performed in the treatment of 36 stones in 22 solitary functioning kidneys between October 1990 and October 1991. We inserted a double-J catheter in all patients preoperatively and no serious obstruction such as stone street formation was observed after treatments. Following ESWL therapy, at the end of 3 months follow-up, 14 patients (63.6%) were completely stone free while in 5 patients ESWL therapy was unsuccessful. ESWL became the treatment of choice for stones in solitary kidneys as a result of its highly effective, safe and encouraging outcome.

Adolescent↗
PubMed1993

Extended vein ligation: a new aspect of the surgical treatment of varicocele.

Conventional varicocelectomy is complicated by a postoperative recurrence rate of 5-20% in patients with varicocele. On the other hand, the exact location and relationship of the internal, external and gubernacular veins, arteries and lymphatics within the inguinoscrotal portion of the spermatic cord have not been well described. The results of detailed intraoperative observations and surgical dissection of the spermatic cord and gubernaculum are presented in 32 patients with clinically palpable varicocele. Following the identification of all veins within and around the spermatic cord and gubernaculum, dilated veins originating from the testis and traversing the gubernaculum were observed in 31% of the patients. External spermatic veins were present in 70% of all spermatic cords evaluated. The majority of patients (> 65%) had more than 3 internal spermatic veins. An average of 3.1 lymphatics per spermatic cord was identified and preserved during dissection of the cord. A solitary testicular artery was observed in 55% of the patients treated. In 3 patients with recurrent varicocele, by using intraoperative venography, we tried to demonstrate the relationship between the gubernacular, external spermatic veins and the plexus pampiniformis. Our results indicate that by giving a precise attention to varicocele anatomy and performing an extended vein ligation, better results together with decreased recurrence rates may be obtained.

Adult↗
PubMed1993

Efficiency of extracorporeal shockwave lithotripsy on calcium-oxalate stones: role of copper, iron, magnesium and zinc concentrations on disintegration of the stones.

Clinical use of extracorporeal shockwave lithotripsy (ESWL) in the noninvasive management of urinary calculi is highly effective and practical. But its results vary in relation to several factors including localization, size and the chemical composition of the stones. Moreover, the anatomy of the kidneys treated is another contributing factor to the success rate of ESWL in upper urinary tract stones. Currently, except cystine and struvite stones, the efficiency of ESWL has been proved and has become the most outstanding therapy for calculi in a great number of stone centers. In this study, the efficiency of ESWL treatment in respect to the concentrations of 4 different trace elements (Cu, Fe, Mg and Zn) in the chemical composition of Ca-oxalate monohydrate stones have been evaluated in 20 patients.

Adult↗