Abdullah Gedik

The diagnosis and treatment of penile fracture: our 19-year experience

BACKGROUND The aim of this study was to retrospectively evaluate our approach to the diagnosis and treatment of penile fracture. METHODS We retrospectively evaluated the results of 107 patients with penile fracture treated in our clinic between January 1990 and January 2009. Patient age, etiology of each fracture, history, physical examination results, radiologic findings, type of treatment, and postoperative complications were recorded. In 5 cases cavernosography was performed and in 8 cases retrograde urethrography. RESULTS The most common etiologies of penile fracture were coitus and manually bending the penis for detumescence. Diagnoses were made based on history and physical examination in 102 patients and cavernosography in 5 patients. In order to evaluate urethral injury in 8 cases, retrograde urethrography was performed. Rupture was repaired surgically in 101 patients, but 6 patients were treated conservatively. Among the 6 conservatively treated patients, 3 developed penile curvature 6 months post-treatment; no complications occurred in the surgically treated patients. CONCLUSION Cavernosography should be performed only when history and physical examination are insufficient for diagnosis, and retrograde urethrography should be performed when urethral injury is suspected. In order to prevent the development of penile curvature and to ensure rapid recovery, early surgical repair is advised.

Efficacy of peripheral lidocaine application (neural therapy) in the treatment of neurogenic detrusor overactivity in multiple sclerosis patients.

Many agents and treatments are used in the treatment of neurogenic detrusor overactivity (NDO) in MS patients, but no study has been conducted on the use of peripheric lidocaine (neural therapy—NT) on MS patients. We evaluated the effects of local administration of lidocaine on NDO in Multiple Sclerosis (MS) patients.

Histopathologic and Urodynamic Effects of the Anticholinergic Drugs Oxybutynin, Tolterodine, and Trospium on the Bladder

This study aimed to evaluate the effects of intravesical instillation of the anticholinergic drugs oxybutynin, tolterodine, and trospium on bladder capacity and histopathological changes in the bladder mucosa.

Expression of E-Cadherin, Cox-2, P53 and BCL-2 in Prostate Carcinomas: Correlation with Tumor Differentiation and Metastatic Potential

ABSTRACT Prognostic factors of prostate cancer such as PSA, stage, Gleason grade, and surgical margins have limitations; they are inable to indicate metastatic potential. The aim of this study was to investigate expression of e-cadherin, cox-2, p53 and bcl-2 in prostate carcinomas, and to search association with tumor differentiation and metastatic potential. Eighty-seven prostate cancer specimens were retreived from tissue blocks embedded in parafin, and expression patterns of e-cadherin, cox-2, p53 and bcl-2 were investigated by immunoperoxidase method. Gleason scoring system was used for tumor grading, and expression patterns of these antibodies were compared among different tumor grades. Seven cases (8%) had well-differentiated, 39 (45%) had moderately differentiated, and 41 (47%) had poorly differentiated tumors. Metastases were present in 31 patients (35%). There was a statistically significant association between tumor differentiation and expression of e-cadherin or bcl-2 (p<0.01); however no association was found between tumor differentiation and expression of cox-2 or p53 (p>0.01). There was no association between expressions of e-cadherin, cox-2, p53 or bcl-2 and metastasis. E-cadherin expression is less frequent in poorly differentiated tumors; whereas bcl-2 expression is more frequent. However there is no relation with metastatic potential and expression of these markers. Expression of cox-2 and p53 is neither related to the degree of differentiation nor to the metastatic potential.

Dev üreter tası: olgu sunumu

The articles about various pneumoconiosis in dental technicians who work in inconvenient conditions have been increasing in recent years. Exposure to dust and fume that occur during the dental procedure may play role in pneumoconiosis of dental technicians. A 53 years old male patient conveyed that he has worked in dental prosthesis procedures for 22 years (1968-1990).Environmental asbestosis was not established in the history of the case but there were calcified pleural plaques in the chest x-ray graphy.There were appearance of calcific asbest plaques in many section of thorax CT.A case of pneumoconiosis in dental technician who work in unadequate preventive conditions was reported in this paper. Probably ,exposure to the asbest fibers that occurs during the procedure of dental prosthesis were the main reason for developing calcific pleural lesions.The aim of this study was to investigate the efficacy of occlusion treatment on different age group patients with anisometropic amblyopia. Occlusion treatment was applied to 34 patients, 15 preschool children (age between 4-6 years), and 19 school age children (7-11 years). Daily duration of occlusion was minimum 6 hours. Best corrected visual acuity of patients was measured initially, at the end of 1st, 3rd and 6th months. Data belonging to amblyopia groups was compared with one another and with the controls. Initial visual acuity of two amblyopia groups were similar, however there was a significant difference between the amblyopia groups and the controls (PChest pain is a frequently encountered problem in childhood. In this study we aimed to asses the relationship between exertional chest pain and asthma by using the peek expiratory flow rate measurements. For this study, 64 otherwise healthy children with chest pain (chest pain group), 9-16 years of age (mean 11.9) and 58 healthy (control group), 8-11 years (mean 11.5) were compared with the use of peak flow-meter. Ages, weights, heights, systolic-diastolic blood pressures, pulses recorded. Preexertional and postexertional peak flow measurements (PEFR) at 2, 5 and 10 minutes determined. There was a decrease more than 15% in PEFR measures in 7 (10.9%) of chest pain group and in 1 (1.7%) of control group children (p

Atesli silah ile penis ve skrotum yaralanması ve basarılı tamiri

Aim: Completion thyroidectomy is required at situations such as recurrent nodular goiter and malignant findings at histopathology after primary operation for noduler goiter. The aim of this study was to investigate the indications for the completion thyroidectomy and the effect of the operation timing on morbidity. Materials and Methods: Thirty-one consecutive patients (26 females and 5 males) with a mean age of 36.5p7.7 years (range, 23-55 yrs) that underwent completion thyroidectomy were investigated. The patients, who needed re-operation for recurrence with diagnosis of histopathologically proven malignancy or re-operated for recurrence, were included. Results: Seventeen patients had the second operation performed within 10 days or more than 90 days after initial operation (group 1). Fourteen patients had re-operation between 10 and 90 days after the first procedure (group 2). Histopathological examination after the completion thyroidectomy revealed remnant tumour in 7 patients (23%), two of them in the contralateral lobe. One patient suffered from a permanent hypoparathyroidism in group 1 and a permanent vocal cord paralysis in group 2. Conclusion: Our results suggest that other treatment modalities except total thyroidectomy are insufficient, since remnant tumour was seen over 20% of the histopathological specimens of the completion thyroidectomy. Timing of completion thyroidectomy had no effect on the thyroid cancer development. Total thyroidectomy can be preferred in the surgical management of tiroid cancers or benign nodular goiter.A 10 years old boy admitted to Ophthalmology Clinic with the complaint of low vision. His ophthalmologic examination showed decreased visual acuity as counting fingers from 2 meters in both eyes. Biomicroscopic examination of his both eyes was normal. Optic atrophy was apparent in his both eyes on fundoscopic examination. He has been followed with the diagnosis of diabetes mellitus type 1 for the last two years and had nocturnal enuresis. He was diagnosed as Wolfram (DIDMOAD) syndrome based on the results of clinical and laboratory examinations. His medical management has been carried out carefully however he was no longer able to attend his school. His IQ was within normal ranges and he was referred to a school which educates visually disabled children. Wolfram syndrome can easily be diagnosed in outpatient clinics since it does not require a genetic analysis. Physicians should keep in mind this diagnosis during their daily practice and provide the best management to the patient by achieving interdisciplinary co-operation.Cerebral salt wasting syndrome (CSW) has been reported in cases with subarachnoid haemorrhage, infections, head injury, brain tumours, transsphenoidal pituitary surgery, and neurosurgery. It is characterized by extracellular fluid depletion and hyponatraemia caused by progressive natriuresis with concomitant diuresis. The relationship between tuberculous menengitis and CSW in children has been desciribed rarely. We describe a case of CSW in an eight years old child with tuberculous meningitis in Pediatric Intensive Care Unit (PICU) whose main biochemical findings were low serum sodium, excessive urine sodium loss and clinical evidence of a contracted extracellular fluid volume. It is essential that in any child with hyponatremia and meningitis in PICU, an evaluation to be undertaken to differentiate between syndrome of inappropriate antidiuretic hormone secretion (SIADH) and CSW. A wrong diagnosis might lead to inappropriate fluid restriction and worsen the hypovolemia in children with CSW. Supplements of sodium chloride and mineralocorticoids may be useful in managing children with CSW. PICU professionals must be aware of the clinical and laboratory features that distinguish CSW from SIADH.

A retroperitoneal abscess with cutaneous fistula developed after stercoral fistula operation: a case report.

A 25-year-old male patient presented to our clinic with purulent discharge from the right lumbar area in May 1994. He had a gunshot wound and his ascending colon had been repaired primarily by tube caecostomy in May 1992. In November 1992 he had a stercoral fistula and following this he had a right hemicolectomy and ileotransversostomy and tube ileostomy with anal dilatation. One month postoperatively he had purulent discharge from the right lumbar area and was treated conservatively. The patient presented to our clinic after two years and on physical examination he had a fistula 1 cm in diameter with purulent discharge and had a median incision scar. An anterior right pararenal retroperitoneal abscess 3 • 7 cm large was detected by computed tomography (Fig. 1). His right retroperitoneal abscess was drained via a flank incision. Eight grape seeds were found in the pouch of the abscess (Fig. 2).