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Biomedical subjects

Y Akman

Publications and source records attributed to Y Akman.

8 recordsLinked to original sources

Mode of administration of international prostate symptom score in patients with lower urinary tract symptoms: physician vs self.

International prostate symptom score (IPSS) was claimed to be complicated for patients. The aim of this study was to measure differences in IPSS when introduced by a physician vs self-administration. Patients with lower urinary tract symptoms completed two IPSS questionnaires: one self-administrated and the other by a physician 1 week apart. Results with 75 patients in each group suggested that there was no statistically significant difference between patient and physician administration, although the mean scores of patients' administration were higher in both groups. In conclusion, when assessing IPSS before treatment, we found no difference between patient administration and physician administration.

Aged↗

Tuberculous orchitis in chronic renal failure.

Tuberculosis confined to the testes with no epididymal involvement is uncommon. Chronic renal failure patients requiring hemodialysis have increased risk for developing tuberculosis. We report a 47-year old chronic renal failure man presenting with right testicular tuberculous orchitis. A high index of suspicion is required to recognize the unusual presentation of tuberculosis in this group of patients, and routine screening for tuberculosis may be recommended in patients undergoing hemodialysis.

Diagnosis, Differential↗

The efficacy of an abbreviated model of the International Prostate Symptom Score in evaluating benign prostatic hyperplasia.

OBJECTIVES: To investigate the acceptability to patients in Turkey of the International Prostate Symptom Score (IPSS) for evaluating benign prostatic hyperplasia (BPH), and to devise a possible abbreviated model, saving time when administered by a physician. PATIENTS AND METHODS: The IPSS questionnaire was initially self-administered in 200 consecutive patients aged> 50 years and with lower urinary tract symptoms. Patients were instructed only to mark questions which they clearly understood. The IPSS was then administered to 500 consecutive patients by the same physician. Subsequently, each of the seven questions was separately correlated with the IPSS and quality-of-life (QoL) score. The first five questions with the highest correlation coefficient for both the total IPSS and QoL score were identified, and every possible combination of these questions produced and correlated. RESULTS: In the first group, 29% of the patients did not complete the form and 44% could not mark at least one item; the effect of educational level was significant (P < 0.05). In the second group a combination of the first three items had a Pearson's correlation of 0.90 with the total IPSS; similarly, four questions combined (2, 3, 6 and 7) also correlated well (r = 0.92). Both combinations took significantly less time to administer (P < 0.05). CONCLUSION: The abbreviated form of the IPSS consisting of three or four items may be used to assess symptoms in patients with BPH, especially in underdeveloped countries.

Aged↗

An experimental study on the application of extracorporeal shock waves in the treatment of tendon injuries: preliminary report.

The use of low-energy extracorporeal shock wave therapy (ESWT) has recently been introduced in pseudoarthrosis, fracture, and wound healing for both clinical and experimental purposes. In this study, we created an experimental rat model to investigate the histopathological and biochemical effects of ESWT in the healing of tendon injury that may accompany fractures. Twenty-eight rats were used for the histopathological investigation. The right achilles tendon of the rat was cut and then sutured, using Modified Kessler stitches method. Five hundred shock waves, set at 14 kV, were applied to the achilles tendon under fluoroscopic guidance. Fourteen rats that underwent a sham operation served as the control group. Biochemical studies were done on 20 rats, divided into four groups of 5 rats in each. The first and second groups received 500 shock waves, at 14 kV, after the cutting and repairing of the Achilles tendon. To measure hydroxyproline levels, the rats in the first and second groups were killed on postoperative days 3 and 9, respectively. The third and fourth groups served as controls. Hydroxyproline levels were found to be high in the study groups. The histopathological findings and the increased hydroxyproline levels revealed that ESWT may facilitate tendon healing after trauma.

Achilles Tendon↗

Penile anatomy under the pubic arch: reconstructive implications.

PURPOSE: We have previously defined the anatomy of the neurovascular bundle in the normal and hypospadiac penis. These studies were based on analysis of the fetal penis distal to the pubic arch without total inclusion of the crural bodies. To our knowledge the neuroanatomy beneath the pubic arch has not been well described. We defined the nerve distribution under the pubic arch and the relationship of the nerves to the crural bodies, corporeal bodies and urethra of the penis. MATERIALS AND METHODS: Eight normal human fetal penile specimens (at 17.5 to 29 weeks of gestation and 1 hypospadiac specimen at 32 weeks were serially sectioned and stained with Masson's trichrome, and the neuronal markers protein gene product 9.5 and S-100. These specimens were unique in that they contained the whole penis from the glans to the crural bodies beneath the pubic arch. Older specimens were decalcified before fixation. Computer reconstruction with commercially available graphics software allowed 3-dimensional analysis of the nerves and crural bodies in relation to the pubic arch and surrounding structures. RESULTS: The nerves of the penile shaft and glans surrounded the corporeal bodies, extending from the junction of the urethral spongiosum to the classic 11 and 1 o'clock positions with a paucity of nerves at the 12 o'clock position in the dorsal midline. Beneath the pubic arch the nerves to the penis were an extension of the dorsal neurovascular bundle of the prostate. The nerves formed 2 bundles following a path just under the pubic arch in close proximity to the bone, superior to the urethra and medial to the origin of the crural bodies. The nerve bundles joined the corporeal bodies at the proximal origin, where the 2 crural bodies fused together. At this point perforating branches into the corporeal bodies from the cavernous nerves were documented. As the dorsal nerves joined the dorsal aspect of the corporeal bodies, they immediately began to fan out along the surface of the corporeal tissue to the junction of the urethral spongiosum. Three-dimensional reconstruction showed the relationship of the nerves to the pubic arch and urethra in multiple views. CONCLUSIONS: A precise understanding of penile anatomy beneath the pubic arch and at the origin of the crural bodies is important for preserving neuronal structures. This anatomy is especially germane in children undergoing posterior urethral reconstruction secondary to trauma, intersex requiring feminizing genitoplasty and severe hypospadias.

Fetus↗

Effects of distilled water and mixture of sorbitol-mannitol irrigation fluids on fluid-electrolyte balance in patients undergoing transurethral prostatectomy.

This study aimed to compare two various irrigation fluids used in transurethral prostatectomy (TURP) with respect to changes in fluid-electrolyte balance and to evaluate the blood loss during TURP. TURP was performed in 50 patients using distilled water and in 42 patients using a mixture of sorbitol and mannitol solution (2.7% sorbitol and 0.54% mannitol) as irrigation fluid. Fluid-electrolyte changes and blood loss were evaluated. None of the patients had transurethral resection syndrome. Decline in serum sodium level was more significant in patients who were operated on with the sorbitol plus mannitol irrigation fluid in contrast to its clinical insignificance (p < 0.05). Decrease in serum sodium concentration in patients with more than 15 g of tissue resected was greater than in patients with less than 15 g of tissue resected (p < 0.05). Blood loss was greater in the distilled water group (p < 0.05). Blood loss was 145.5 +/- 3.4 ml in patients given a blood transfusion. In conclusion, a fluid containing mainly sorbitol must be the irrigation fluid preferred over distilled water because of its non-haemolytic nature, but although not important clinically, it can cause hyponatraemia more than distilled water. Furthermore, it is useful to determine blood loss during TURP before deciding to give a blood transfusion.

Aged↗

Partial bladder reconstruction with pedicled rectus and gracilis muscle flaps: an experimental study in dogs.

OBJECTIVE: To investigate the functional, anatomical and histopathological results of partial bladder reconstruction with skeletal muscle flaps. MATERIALS AND METHODS: Partial bladder reconstruction with gracilis or rectus muscle flaps was performed in 10 mongrel dogs. Bladder compliance and uninhibited contractions were investigated in five female dogs. Pre-operative and post-operative cystograms were performed in four female dogs. The dogs were killed 8-12 weeks after the operation. Bladders and muscle flaps were grossly examined and removed for histopathological examination. RESULTS: There was no extravasation on post-operative cystography. Bladder compliance was normal and uninhibited contractions were not present. Severe contracture and atrophy of the muscle flaps were observed in all dogs at necropsy. Bladder volumes were not changed significantly (P > 0.05). Histopathological examination revealed severe mesenchymal metaplasia in all of the flaps. CONCLUSION: Partial reconstruction of the bladder with skeletal muscle flaps did not result in extravasation and bladder function was not altered. However, bladder volume could not be increased because of contracture and atrophy of the flaps.

Animals↗

Hyperaccumulation of nickel by Alyssum Linnaeus (Cruciferae).

Herbarium specimens of all except one of the 168 recognized species of Alyssum Linnaeus have been analysed for their nickel content in order to identify hyperaccumulators (greater than 1000 microgram per g dry mass) of nickel. A further 31 hyperaccumulators (all in section Odontarrhena) were discovered in addition to the 14 European species reported earlier. Pot trials on the non-accumulator A. serpyllifolium Desfontaines and the hyperaccumulator A. pintodasilvae Dudley in ed. involving addition of nickel to the medium in which the plants were growing, showed that not all species of of section Odontarrhena were able to act as hyperaccumulators of nickel. Hyperaccumulation occurred almost exclusively in the eastern Mediterranean area and Turkey. There appeared to be a definite correlation between species diversity, proliferation and endemism on the one hand, and extremely high nickel concentrations (greater than 1%) on the other. The data have been used to assess the evidence for promoting section Odontarrhena to generic rank.

Biological Transport↗