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Biomedical subjects

Z Kirkali

Publications and source records attributed to Z Kirkali.

At least 73 records · Page 4Linked to original sources
PubMed1994

The effect of extracorporeal shock wave lithotripsy on pancreatic enzymes.

In order to assess the effect of electromagnetic shock waves on pancreatic tissue, we studied serum and urinary amylase and serum lipase levels prior to, 1 hour, 1 day and 1 week after extracorporeal shock wave lithotripsy (ESWL) in 150 patients with upper urinary tract stones. A control group consisted of 22 patients with lower ureteric stones who underwent ESWL. All three parameters increased after ESWL (p < 0.001); however, this increase was within normal laboratory limits. There was no difference between the right and left renal units. In the control group there was no change of pancreatic enzymes after ESWL. High energy shock waves may cause some elevations of pancreatic enzymes, probably due to altered cell membrane permeability, however, ESWL with an electromagnetic shock wave emitter system does not cause significant injury to the pancreatic tissue.

Adult↗
PubMed1994

Open stone surgery: is it still a preferable procedure in the management of staghorn calculi?

We reviewed 43 patients with staghorn calculi to determine the effectiveness of various treatment modalities such as extracorporeal shock wave lithotripsy (ESWL) monotherapy, ESWL and percutaneous nephrolithotomy (PCNL) combined therapy, and open stone surgery. While ESWL monotherapy and ESWL+PCNL were performed in 25 and 8 patients, respectively, 10 patients underwent open stone surgery. Of the 25 patients treated with ESWL, 8 were stone-free, whereas 4 out of 8 patients treated with ESWL+PCNL and 8 out of 10 patients treated with open surgery were stone-free. The complications of ESWL monotherapy consisted of pyelonephritis in one patient, and stone street formation in three. In the group of ESWL+PCNL, one patient developed pyonephrosis, and another perinephritic abscess. No serious complication was noted in patients who underwent open surgery, but an average of 525 ml of blood transfusion was required. We conclude that open stone surgery, although invasive, is still beneficial in the treatment of staghorn calculi.

Adolescent↗
PubMed1994

The effect of extracorporeal electromagnetic shock waves on renal proximal tubular function.

In order to investigate the effect of electromagnetic shock waves on proximal tubular renal function, we measured the urine levels of the lysosomal enzyme N-acetyl-beta-glucosaminidase (NAG) prior to, 1 hour, 1 day, and 1 week after extracorporeal electromagnetic lithotripsy (ESWL) in 50 patients with urinary stone disease. Mean NAG level which was 5.18 + 0.09 U/l prior to ESWL increased to 5.29 + 0.09 U/l in the first hour and to 10.7 + 0.19 U/l on the first day after ESWL (p < 0.001). The level returned to pre-ESWL values one week after ESWL (5.27 + 0.09 U/l). These findings show that extracorporeal electromagnetic shock waves cause significant damage to the proximal tubular epithelium of the kidney; however, these changes return to normal in the first week.

Acetylglucosaminidase↗
PubMed1994

Does respiratory gating improve extracorporeal shockwave lithotripsy results?

The reliability and efficacy of extracorporeal shockwave lithotripsy (SWL) has been established in urinary stone disease. Its combination with respiratory gating might be a useful method to increase the effectiveness of treatment and reduce the number of shocks required. For this purpose, the results of SWL combined with respiratory gating were compared with those of SWL without gating. There was no difference in the stone-free rates of the two groups or in the complication rate. It is concluded that this method neither decreases the number of shockwaves needed nor increases the effectiveness of SWL.

Adult↗
PubMed1993

Are obstructing ureteral stones more difficult to treat with extracorporeal electromagnetic shock wave lithotripsy?

In situ extracorporeal shock wave lithotripsy (ESL) has increasingly become accepted for the treatment of ureteral stones. However, treatment success is negatively affected by stone impaction or associated urinary obstruction. In order to assess the impact of obstruction on the outcome of in situ ESL, we reviewed the results in 503 patients treated in this way. The presence and severity of urinary obstruction was defined prior to ESL, being classified as no or mild obstruction (Group I) and moderate or severe obstruction (Group II). The stone-free rate in the nonobstructed group was 90%, whereas it was 85% in the obstructed group (P > 0.005). While all of our patients were treated on an outpatient basis, two patients in Group I and four patients in Group II required hospitalization with the diagnosis of pyelonephritis. All six patients were treated successfully with appropriate measures. No other serious complication occurred that required hospitalization. We conclude that urinary obstruction does not affect stone disintegration or passage and suggest that in situ ESL should be the treatment of choice in ureteral stones.

Adult↗
PubMed1993

Place of double-J stents in extracorporeal shock wave lithotripsy.

Although double-J stents (DJS) are used to reduce complications following extracorporeal shock wave lithotripsy (ESWL), there has recently been a tendency to limit their use because of complications. We retrospectively reviewed 351 patients with renal stones larger than 30 mm to determine the effectiveness and the complications of DJS. While DJS were inserted prior to ESWL in 85 patients, 266 patients were treated without. The stone-free rate in the stented group was not significantly different from the non-stented group (31 and 30%). While the auxiliary treatment rate for the steinstrasse was 15% in the stented group, it was 18% in the non-stented group. Additionally, 4 of the stented patients (5%) were treated endoscopically because of encrustation or migration of the stent. Half of the patients in the stented group complained of mild bladder discomfort and disturbances which were relieved after removal of the DJS. We believe that DJS neither enhance stone passage nor reduce complications following ESWL, and therefore suggest their use only under certain conditions such as patients with solitary kidneys.

Adult↗
PubMed1993

Relationship of blood groups and transitional cell carcinoma of the bladder.

Blood groups of 50 patients with transitional cell carcinoma of the bladder, who were followed up for a minimum of 3 years, were analyzed. The blood group distribution of the patients reflected that of the general population. There was no relationship between blood groups and stage and grade of the tumour at initial presentation. However, patients with blood group O had worse prognosis than the others.

Adult↗
PubMed1993

Periureteric effects of electromagnetic shock waves.

The effect of electromagnetic shock waves on the ureter and periureteric soft tissue was investigated in 10 patients who underwent extracorporeal shock wave lithotripsy (ESWL) for lower ureteric stones. Seven patients were males and 3 females, their ages ranged between 15 and 52. The number of shock waves applied varied between 3000 and 6000, at a mean of 19 kV. The patients were examined after their first ESWL. Magnetic resonance imaging (MRI) was performed within 6 hours of treatment by a Magnetom 1 Tesla Unit. No haematoma, fluid collection or abnormality was detected in the periureteric space, muscle or surrounding structures by MRI. Although subcapsular, intra- or perirenal haematomas can be observed in patients with kidney stones treated with ESWL, it appears to be safe for lower ureteric stones.

Adolescent↗
PubMed1991

Carcinoma of the bladder in patients less than 40 years old.

Records of fifteen patients less than 40 years old with carcinoma of the bladder are reviewed. Fourteen patients with transitional cell carcinoma had well or moderately differentiated superficial papillary tumours. One patient with adenocarcinoma died within 4 months with progressive disease. Four patients experienced recurrences and 9 patients had no recurrence of tumour after a mean follow-up of 55 months. It is concluded that the fate of patients younger than 40 years with bladder cancer is not different from those in older age groups.

Adenocarcinoma↗
PubMed1991

Carcinoma of the prostate and HLA antigens.

A possible association between HLA antigens and carcinoma of the prostate was searched for in 20 patients and 200 healthy kidney donors. HLA antigens A26, A28, B13, B14, B40, Bw4 and Cw4 were more common in patients with carcinoma of the prostate. The relative risk for HLA B14 was 7.78 (95% confidence interval 7.60-8.13). The relative risk for patients carrying the above antigens (except A28) was higher than 2. This study shows that certain HLA antigens may be more frequent in patients with carcinoma of the prostate. Before drawing any conclusions from these findings, they have to be confirmed by other studies.

Adenocarcinoma↗
PubMed1991

Urological aspects of Behçet's disease.

Behçet's disease, affecting mostly young males in the Mediterranean countries and Japan, is a multi-system disease with urological manifestations. In this prospective study of 100 consecutive patients with newly diagnosed Behçet's disease, we found that 89% of the males had experienced scrotal ulceration and 6% had epididymitis. We also observed sterile urethritis in 3%. Other urological abnormalities appeared to be coincidental findings.

Adolescent↗
PubMed1991

Cysts of the prostate, seminal vesicles and diverticulum of the ejaculatory ducts.

The close proximity of the prostate, vas deferens, seminal vesicles and ejaculatory ducts are a diagnostic challenge to the cysts located in that region. Three patients with diverticulum of the ejaculatory ducts, 2 with prostate cysts and 1 patient with seminal vesicle cyst are presented. Transrectal ultrasound, computed tomography and magnetic resonance imaging together with aspiration of the cyst establish diagnosis and probably prevent unnecessary exploration.

Adult↗
PubMed1990

Androgen receptors in transitional cell carcinoma.

Androgen receptors were measured in transitional cell carcinoma tissues obtained from 13 patients with bladder tumours and 3 patients with ureteric tumours. Scatchard analysis of binding of mibolerone, a synthetic androgen, was used for receptor measurement. None of the patients were receptor positive. This study suggests that human male hormones do not play any direct role in the malignant transformation of human transitional cell epithelium.

Aged↗
PubMed1990

Tunica vaginalis: an aid in hypospadias surgery.

Despite the improvements that have been made in equipment and in the techniques of hypospadias repair, some patients still present with failed repairs and urethral fistulas. In such patients the lack of prepuce leads to difficulty in obtaining adequate tissue for further reconstruction. In 14 patients with hypospadias who had already undergone surgery, a tube was formed from proximal penile or scrotal skin and wrapped by pedicled tunica vaginalis; 4 patients with urethral fistulas were treated in the same way after primary repair of the fistulas. Excellent cosmetic and functional results were achieved in all but 1 case. The technique is simple, has few complications and is recommended in the treatment of patients with failed hypospadias repair and urethral fistulas.

Adolescent↗
PubMed1990

Silent testicular metastasis from carcinoma of the prostate.

Secondary testicular tumours are rare, but metastasis of prostatic carcinoma to the testis is being reported more frequently. While this may not reflect a true increased incidence, more cases are detected by bilateral orchiectomy. Of 916 patients with carcinoma of the prostate diagnosed and treated over a period of 10 years, 124 underwent bilateral orchiectomy. Three patients were found to have testicular metastasis, 1 being bilateral. The route of spread seems to be through the lumen and/or lymphatics of the vas deferens. Although it is a sign of advanced disease, the prognostic significance is undetermined.

Aged↗
PubMed1990

HLA antigens and transitional cell carcinoma of the bladder.

A possible association between HLA antigens and transitional cell carcinoma of the bladder was searched for in 56 patients and 200 healthy kidney donors. Statistical analysis showed that HLA antigens A23, A25, A28, BW4, BW21, BW22 and CW4 are more common in bladder tumor patients, whereas B27 and BW6 were more common in the control group. The relative risk for HLA CW4 was 2.07 (95% confidence interval 1.51-2.48). Except for CW4, these findings are inconsistent with previous reports. We believe this to be due to various misleading factors, and thus not conclusive. Even if such a statistical association exists, this appears to be clinically not relevant and, therefore, should not alter standard practice.

Carcinoma, Transitional Cell↗
PubMed1990

Epidemiological case-control study on the etiology of bladder cancer in Turkey.

A case-control study of 194 patients with bladder cancer and the same number of age- and sex-matched hospital controls were interviewed to estimate the role of various factors on the etiology of bladder cancer in Turkey. There was a significant difference between the case and control groups on cigarette smoking (p less than 0.001), alcohol intake (p less than 0.001), Turkish coffee consumption (p = 0.01), and artificial sweeteners (p less than 0.05). The risks for alcohol and tobacco users increased in correlation with the duration of exposure. The risk of bladder cancer increased directly with the quantity and frequency of alcohol intake. Alcohol and coffee drinking was found to be a promoting factor when adjusted to smoking habits (p less than 0.05). No statistical comparisons could be made to clarify the risks attributed by occupation and place of residence due to small figures in each group. However, in farmers, there was a significant difference between the cases and controls on the use of artificial fertilizers and insecticides (p less than 0.01). People who were exposed to unspecified chemical substances were more prone to develop bladder cancer (p less than 0.001). We conclude that both personal habits and exogenous carcinogens play a role in the etiology of bladder tumors.

Adult↗