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Biomedical subjects

M Yildiz

Publications and source records attributed to M Yildiz.

At least 19 recordsLinked to original sources

Erectile dysfunction and the effects of sildenafil treatment in patients on haemodialysis and continuous ambulatory peritoneal dialysis.

BACKGROUND: Sexual dysfunction, including erectile dysfunction, is common in patients with uraemia. Despite successful treatment of male sexual dysfunction with sildenafil in non-uraemic population, its efficacy in dialysis patients is unknown. PATIENTS AND METHODS: In this study, 35 male HD patients (mean age 48+/-12 years) and 15 male CAPD patients (mean age 44+/-12 years) were included. In the baseline period, haemoglobin, serum urea, and albumin, Kt/V, several hormonal parameters, Beck depression scale, and penile Doppler blood flow, (peak systolic velocity after intracavernous papaverine administration) were measured. The international index of erectile function (IIEF) form was used to evaluate erectile dysfunction. Sildenafil was given to patients with erectile dysfunction at a dose of 50-100 mg/day twice a week. RESULTS: The percentage of erectile dysfunction was similar between patients on HD (71%) and those on CAPD (80%). Patients with erectile dysfunction were significantly older and had lower free-testosterone serum levels and penile blood flow than those without. In linear regression analysis for baseline IIEF score, penile blood flow was the only independent variable associated with erectile dysfunction. IIEF score increased to a similar extent after sildenafil treatment in both HD patients (from 8.10+/-5.54 to 21.70+/-9.61, P<0.001) and CAPD patients (from 9.90+/-3.87 to 21.60+/-10.18, P=0.011). Changes in IIEF scores after sildenafil treatment were associated with baseline penile blood flow as an independent variable by linear regression analysis. Adverse events observed during sildenafil treatment were dyspepsia in two patients and headache in one patient. CONCLUSION: The rate of erectile dysfunction is high in dialysis patients. Penile blood flow is the most important factor for predicting both the development of erectile dysfunction and the response to sildenafil therapy in such patients. Oral sildenafil is an effective, reliable, well-tolerated treatment for uraemic patients with erectile dysfunction.

Adult↗

Three-headed reversed palmaris longus muscle: a case report and review of the literature.

The palmaris longus muscle (PLM) is extremely variable both in number and form. We present the first reported case of three-headed reversed PLM in a 36-year old woman. The relevant literature is reviewed. Variations of the muscles of the forearm and specifically the PLM are not uncommon. However, different rates are given for the types and agenesis of PLM. In one study, the incidence of agenesis was 12.8% and other anomalies were 9%. 15 cases of reversed PLM have been reported in the literature. In our case, the three-headed PLM was resected. The patient's symptoms resolved and at 1-year follow-up she remains symptom-free.

Adult↗

Effects of growth hormone replacement therapy on lipids, lipoproteins and apolipoproteins: is the increased apolipoprotein A-1/B ratio the only benefit?

BACKGROUND: The aim of the present study was to investigate the controversial role of growth hormone (GH) therapy in lipid regulation. METHODS: We studied serum levels of cholesterol and subgroups, triglyceride and apolipoprotein A-1 and B in 41 GH-deficient children (with subgroups of untreated and short- and long-term treated subjects) and 20 healthy controls. RESULTS: Cholesterol and low-density lipoprotein cholesterol levels (in mmol/L) were found to be 4.92 +/- 1.34 and 3.02 +/- 1.58 in untreated, 4.15 +/- 0.72 and 2.46 +/- 0.65 in short-term (3 month) treated, 4.93 +/- 1.39 and 3.15 +/- 1.38 in long-term (> 1 year) treated and 4.11 +/- 0.5 and 2.0 +/- 0.74 in control subjects, respectively. The apolipoprotein A-1:B ratio was 1.98 +/- 0.5 in long-term treated and 1.6 +/- 0.6 in control subjects. CONCLUSIONS: The improvement of lipid composition with short-term GH therapy is temporary, but the increase in apo A-1:B is not and seems to be the particular benefit of this therapy.

Adolescent↗

2,4-

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Journal Article↗

Electrical activity of the corpus cavernosum in denervated rats.

BACKGROUND: We evaluated the electrical activity of the corpus cavernosum after intracavernous papaverine injection in rats that had been denervated experimentally. METHODS: Twenty-four male adult Sprague Dawley rats were divided into three groups: (i) controls (n=8) (ii) unilateral cavernous nerve resection on the right side (n=8); and (iii) bilateral cavernous nerve resection (n=8). Through a suprapubic incision, the urinary bladder was retracted laterally to locate the major pelvic plexus on the lateral surface of the prostate. The major branch of the cavernous nerve, running caudally from the pelvic plexus, was isolated and excised using an operating microscope. Three weeks later, recording of the electrical activity of the corpus cavernosum (EACC) was performed by using a Neuropack-2 EMG unit (Nihon Kohden, Tokyo, Japan) and coencentric needle electrode. Changes in amplitude were evaluated before and after intracavernosal papaverine injection. The results in the flaccid state and after papaverine injection were compared by using the Mann Whitney U-test in all three groups and paired t-test between groups. RESULTS: In the flaccid penis, the mean (+/- SD) amplitude of electrical activity of the corpus cavernosum was 17.42+/-2.05, 12.42+/-1.88, 9.71+/-1.59 and 5.85+/-0.96 microV in control rats, in unilaterally denervated rats (in which the cavernous nerve was intact on the left side), in unilaterally denervated rats in which the cavernous nerve was resected on the right side and in bilaterally denervated rats, respectively. In the flaccid state, EACC is lower in the bilaterally denervated group than in the control and unilaterally nerve-resected groups (P < or = 0.05). The recording of electrical activity of the corpus cavernosum was continued for 20 min after papaverine injection. In the control group and in both groups of unilaterally denervated rats, we observed a significant decrease in the electrical activity of the corpus cavernosum in the first 5 min after papaverine injection (P < or = 0.05). However, no difference was observed in bilaterally denervated rats after injection (P > or = 0.05). CONCLUSIONS: We conclude that electrical activity of the corpus cavernosum continues after unilateral nerve injury in rats. Cross-innervation may play a role in penile innervation and corpus cavernosum electromyography shows electrical activity in denervated rats.

Animals↗

Histopathological changes and nitric oxide synthase activity in corpus cavernosum from rats with neurogenic erectile dysfunction.

OBJECTIVE: To investigate changes in histology and nitric oxide synthase (NOS) activity in cavernosal tissues from rats with neurogenic erectile dysfunction induced experimentally. MATERIALS AND METHODS: Twenty-four adult male Sprague-Dawley rats were divided equally into three groups and underwent a sham operation (control, group 1), unilateral (group 2) or bilateral (group 3) cavernosal nerve resection. Three months later they were killed and the cavernosal tissues analysed histologically by light and transmission electron microscopy, with NOS activity detected using an NADPH-diaphorase staining technique. RESULTS: On light and electron microscopy, while penile nerves and cavernosal smooth muscle cells had a normal morphological appearance in the eight control rats, there were degenerative changes of the myelinated penile nerves and axonal fibrosis in groups 2 and 3. However, these changes were not significant. Using NADPH-diaphorase staining, NOS activity was detected in all three groups in endothelial cells and cavernosal structures. However, the staining was more intense in endothelial cells and cavernosal muscles of rats in group 2 than in the other groups. CONCLUSION: NOS activity was increased in the cavernosal tissue after cavernosal denervation, but the pharmacological action of nitric oxide may be impaired.

Animals↗

Comparison of sertraline to fluoxetine with regard to their efficacy and side effects in the treatment of premature ejaculation.

OBJECTIVE: In the present study, two different serotonin re-uptake inhibitors were compared with regard to their efficacy and side effects in the treatment of premature ejaculation. METHODS: Fifty-seven patients with complaint of premature ejaculation were included in the study. Patient ages ranged from 21 to 45 years (mean age 32 +/- 2.6). They had a regular sexual life and were normal after GRISS psychological test and psychiatric evaluation. The patients were randomized into two groups according to the drugs given. Twenty-six patients aged between 21 to 36 years (mean age 27 +/- 1.1) received fluoxetine 20 mg/day for one week and 40 mg/day thereafter (group I). Thirty-one patients aged between 21 to 45 (mean age 34 +/- 1.7) received sertraline 50 mg/day (group II). All the patients and partners were re-evaluated 4 and 8 weeks after the treatment. The results were classified as unsuccessful, improvement and cure. Mann Whitney-U and Pearson chi-square tests were used for statistical analysis. RESULTS: In the fluoxetine group, 8 (30.8%) patients cured, improvement in 11 (42.3%) and failure in 7 (26.9%). In the sertraline group, 12 (38.7%) patients cured, improvement in 10 (32.3%) and failure in 9 (29%). Side effects in group I were nausea in 3, headache in 1 and insomnia in 2 (total 6 patients, 23%). In group II, we observed nausea in 2 and mouth dryness in 6 (total 8 patients, 25.8%). No patients were excluded from the study due to side effects. CONCLUSION: Our results show that different serotonin re-uptake inhibitors have the same efficacy and side effects in the treatment of premature ejaculation.

Adult↗

Anomalous digital nerve loop: a case report.

In this case, a digital nerve loop was observed during the dissection of the digital nerves to the third web space; the common digital artery was passing through this loop. This rare case is presented and its importance is discussed.

Adult↗

Replantation in children.

The rates of survival of the amputated part and the functional outcomes were studied retrospectively after 13 replantations and 12 revascularizations in 25 children. The ages of the patients ranged from 2 to 15 years (mean, 6.4 years). The average duration of follow-up was 4.2 years (range, 2 to 7 years). The survival rate was higher after revascularization (94.6%) than after replantation (84.6%). Sensory recovery of all digits was satisfactory. The mean growth rate of replanted digits relative to contralateral digits was 80%. Functional results were rated as excellent in 11 cases, good in 8 cases, moderate in 2 cases, and poor in 1 case. In order to prevent functional and growth disturbances and due to cosmetic reasons, replantation or revascularization should definitely be tried for children.

Adolescent↗

Treatment of premature ejaculation with sertralin.

To evaluate the efficacy of oral sertralin in the treatment of premature ejaculation, out of 22 patients with premature ejaculation 16 received oral sertralin, 50 mg a day for at least 2 weeks. Four patients were lost to follow-up. Two patients interrupted treatment due to side effects of sertralin. Out of 16 patients who completed at least a two-week period of treatment 14 (87.5%) responded clinically. Clinical response was achieved in the first week of treatment in 11 of 16 responders (68.75%). We conclude that low dose oral sertralin may be useful with a reasonable side effect rate in the treatment of patients suffering from premature ejaculation.

1-Naphthylamine↗

Electron microscopic findings of penile tissues in veno-occlusive dysfunction: is penile biopsy necessary?

In this study, we examined the biopsy patterns of penile tissues taken during operation from patients subjected to surgical treatment for veno-occlusive dysfunction, and evaluated the importance of penile biopsy. We evaluated the findings from 17 patients with venous impotence. Fourteen of them underwent total vein ligation and the rest penile prosthesis implantation. Tissue specimens taken from superficial and deep dorsal veins, tunica albuginea and corpus cavernosum during operation were examined under electron microscope. Tissue specimens taken from 3 cadavers were used as the control group. Although the deep and superficial vein specimens of all patients did not show significant differences, oedema and increase of fibroblasts in collagen fibres of the corpus cavernosum and tunica albuginea were demonstrated. We concluded that penile biopsy as an invasive method does not give enough information about the choice of treatment for erectile dysfunction.

Adult↗

Scrotal myiasis.

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Adult↗

The effect of age in the usage of alpha receptor blocker treatment in prostate patients.

Age was considered in the usage of alpha receptor blocker in the treatment of prostate patients. Ninety patients with prostatism were treated with alpha 1 receptor blockers (Doxazocin 4 mg/day) for 8 weeks. Before and after treatment, the patients in two groups according to their age, above and below 60 years, were evaluated using International Prostate Symptom Score (IPSS). The patients younger than 60 years of age had more significant relief compared to those older than 60 years of age.

Adrenergic alpha-Antagonists↗

Phaeochromocytoma in pregnancy: a case report.

A twenty-eight years old patient with phaeochromocytoma in pregnancy is reported. In the second trimester, she was admitted to hospital for complaints of headache, fever, palpitation and weakness. A phaeochromocytoma was diagnosed. Alpha and beta blockers were given to regulate arterial blood pressure until foetal maturity was reached. Delivery was by caesarean section and the operation was continued with a right adrenalectomy. Pathological examination revealed a phaeochromocytoma.

Adrenal Gland Neoplasms↗

Urethral sleeve advancement in repairement of distal hypospadias.

Thirtyfive boys with distal hypospadias were operated on using urethral sleeve advancement procedure between 1990 and 1994. Early complications such as hematoma and wound infection, and late complications such as fistula formation and meatal retraction were not seen in the patients except meatal stenosis in first month control in only eight patients. Four of them underwent dilatation and meatotomy was performed in the rest. Both cosmetic and functional results were excellent in the patients in sixth month control.

Adolescent↗

Isolated dislocation of all five carpometacarpal joints.

Fracture-dislocation of all five carpometacarpal joints is extremely rare, only ten cases having been reported since 1873. A case of isolated dislocation of all five carpometacarpal joints is presented. A good result was obtained 1 year after open reduction and internal fixation. This case is the only isolated dislocation of all five carpometacarpal joints in the English literature.

Adult↗