Süleyman Kılıç

Increased prevalence of varicocele in patients with coronary artery ectasia.

BackgroundCoronary artery ectasia (CAE) is defined as localized or diffuse non-obstructive lesions of the epicardial coronary arteries with a luminal dilation exceeding the 1.5-fold of normal adjacent segment or vessel diameter. Varicocele is the dilatation of the pampiniform plexus. Recently increased prevalence of peripheral varicose veins has been shown in patients with CAE. In this study we aimed to assess the prevalence of varicocele, which is dilatation of another venous system, in patients with CAE. Materials and methodsThirty-five male consecutive patients with coronary artery ectasia in combination with or without coronary artery disease (CAD) and 63 male, age-matched patients with coronary artery disease were included in the study. All patients were evaluated for the presence of varicocele. ResultsTwenty-one patients with CAE were found to have varicocele (62% of group I patients). In patients with CAD, 24 patients (38%) were found to have varicocele. The difference between the two groups in respect to presence of varicocele was statistically significant (P=0.02; odds ratio=1.57; 95% confidence interval 1.05– 2.3). ConclusionWe have shown that patients with coronary artery ectasia have an increased prevalence of varicocele compared to those with coronary artery disease. The mechanism underlying coronary artery ectasia might further increase the prevalence of varicocele in susceptible patients.

The effects of irrigation fluid volume and irrigation time on fluid electrolyte balance and hemodynamics in percutaneous nephrolithotripsy

Objective: to determine fluid-electrolyte andhemodynamics changes and complicationsassociated with irrigation fluid volume andtime in percutaneous nephrolithotripsy in that0.9% NaCI was used as irrigant.Methods: Standard anaesthetic procedureswere performed to 6 women and 16 men. Meanarterial pressure, heart rate, central venouspressure, Na+, K+, osmolality,haemoglobin, haematocrit were recorded before,during and after irrigation every 10 minutes.Creatinine and blood urea nitrogen weredetermined before and after irrigation.Moreover, the operation and irrigation times,irrigation fluid volume, total fluid outputversus input, blood transfusions andcomplications were recorded.Results: Mean arterial pressure, heartrate, central venous pressure, Na+,K+, osmolality did not changesignificantly during and after irrigation andno relationship was observed between those withirrigation volume and time. Creatinine andblood urea nitrogen values during and afterirrigation did not change significantly versusthose before irrigation. Although no bloodtransfusion was needed for any case during theprocedure, it was necessary for two cases afterthe procedure. One case with pneumothorax thatdeveloped during procedure was treated byinserting a thoracic tube.Conclusion: There were no significantchanges in fluid-electrolyte balance andhemodynamics related to both irrigation fluidvolume and irrigation time when 0.9% NaCI wasused in PNL.

Lipid peroxidation and antioxidant enzyme activities in cancerous bladder tissue and their relation with bacterial infection: a controlled clinical study

It is well known that antioxidants and reactive oxygen species play an important role in carcinogenesis. In this sudy, we attempted to evaluate antioxidant enzyme activities and lipid peroxidation levels in cancerous bladder tissue and to determine their relationship with bacterial infection. Bacterial culture was made from all urine samples using Blood and Eosin Methylene Blue agars for checking the presence of bacterial infections. We measured thiobarbituric acid reactive substances (TBARs) and activities of xanthine oxidase (XO), superoxide dismutase (SOD), glutathione peroxidase (GSH‐PX), and catalase (CAT) in cancerous tissues of 25 bladder cancer patients, in noncancerous adjacent bladder tissues of 13 out of these 25 patients, and in control bladder tissues of 15 patients with a non‐neoplastic genitourinary disease. TBARs levels increased and XO, SOD, GSH‐PX, and CAT activities decreased significantly in cancerous bladder tissues. TBARS, XO, and SOD levels were not significantly different between noncancerous adjacent tissue and control bladder tissue. Statistically significantly lower GSH‐PX and higher CAT activities were observed in noncancerous adjacent bladder tissue compared with cancerous tissue. GSH‐PX level of tumor tissue was correlated significantly with tumor grade (r=−0.425, P=0.034). Results suggested that pathway activity of free radicals were accelerated in the cancerous human bladder tissues via increased TBARs levels and decreased enzyme activities of XO, SOD, GSH‐PX, and CAT, which implicated a severe exposure of cancerous tissues to oxidative stress. J. Clin. Lab. Anal. 24:25–30, 2010.

Color Doppler sonography examination of partially obstructed kidneys associated with ureteropelvic junction stone before and after percutaneous nephrolithotripsy: Preliminary report

Abstract  Aim: To evaluate resistive index (RI) changes before and after unilateral percutaneous nephrolithotripsy in chronic partially obstructed kidneys due to ureteropelvic junction (UPJ) stones.

Case report of a giant renal oncocytoma.

This report represents the third largest renaloncocytoma in English literature. The tumor wasconsidered as a renal cell carcinomapreoperatively based on the physicalexamination and radiographic findings.

Prospective evaluation of the alterations in the morphology and vascular resistance of the renal parenchyma with color Doppler ultrasonography after percutaneous nephrolithotomy.

PURPOSE To evaluate the kidneys with color Doppler ultrasonography (CDUS) to determine whether percutaneous nephrolithotomy (PNL) causes renal parenchymal damage. PATIENTS AND METHODS In 24 patients who underwent unilateral PNL with single renal pole access, cortical thickness, echogenicity, and resistive index (RI) were measured in each pole of the operated and contralateral kidney separately before and at postoperative day (POD) 1, and at 3, 6, and 12 months after PNL. RESULTS The mean age of the patients was 36.67 +/- 14.68 years. The serum creatinine level increased significantly immediately after PNL but diminished to the preoperative level at POD 1. Changes in serum blood urea nitrogen and electrolyte levels were insignificant. Mean cortical thickness increased significantly in the access pole and contralateral kidney and insignificantly in the nonaffected pole. No statistically significant change was recorded in parenchymal echogenicitiy. Statistically significant differences in cortical thickness between the access pole and the contralateral kidney and between the nonaffected pole and the contralateral kidney disappeared 3 months later. Differences in mean cortical thickness between the access pole and the nonaffected pole were insignificant at all examination periods. Echogenicity was greater in the access pole and the nonaffected pole than in the contralateral kidney only at POD 1. No significant difference was noted in the echogenicity between the access pole and the nonaffected pole. Mean RIs were lower than the universally accepted pathologic RI level (0.70) at all periods. There was no statistically significant difference between the mean RI values of the access pole, nonaffected pole, and contralateral kidney. CONCLUSION PNL does not cause obvious renal dysfunction and significant parenchymal scarring, which is indicated by the decrease in cortical thickness and increases in cortical echogenicity and intrarenal RI.

Can the levels of nitric oxide in the urine, serum and tumor tissue be putative markers for bladder cancer?

Aim: To determine nitric oxide (NO) levels in serum, urine, tumor tissue and non‐malignant adjacent tissue in bladder cancer patients compared with those in patients with a non‐neoplastic genitourinary disease and to evaluate postoperative serum and urine NO change.

Polypoid cystitis unrelated to indwelling catheters

Since polypoid cystitis (PC) is generally caused by indwelling catheter use, in order to evaluate the patients with PC unrelated to a intravesical catheter, a retrospective analysis of the records of the Pathology Department of Turgut Özal Medical Center was performed and this revealed 8 patients. Mean age of the 2 female and 6 male patients was 48 years (28 to 70). None of the patients had bacterial growth in urine cultures. All cases were diagnosed incidentally by radiologic and cystoscopic examinations in the evaluation of different conditions, such as hematuria, ovarian abscess, bladder carcinoma, erectile dysfunction, neurogenic bladder, benign prostate hyperplasia and unexplained dysuria. At the beginning, all patients were diagnosed mistakenly as bladder carcinoma. The definitive diagnosis was made after histopathologic examinations of transurethrally resected specimens. Patients were followed for 6 months to 2 years after first diagnosis. No recurrence was established during follow-up. The final urologic examinations which were done currently, were normal.In conclusion, PC is a benign lesion and should be considered in the differential diagnosis of transitional cell carcinoma of the bladder.

Venous leg symptoms in patients with varicocele: A multicenter assessment study (VEIN-TURKEY study)

Objective The aim of this study is to evaluate chronic venous disease symptoms by using the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms (VEINES-QoL/Sym) questionnaire in varicocele patients. Material and methods The study was designed as a prospective, case controlled study and conducted in four hospitals from Turkey. A total of 600 patients who admitted to urology outpatient clinic were enrolled to the study. After the exclusion of 44 patients who do not match the inclusion criteria, the remaining 556 patients were examined for the presence and grade of varicocele and subsequently examined clinically for the presence of chronic venous disease findings. Finally, patients were asked to answer the VEINES-Sym questionnaire consisting of 10 items. All patients’ demographic parameters, cardiovascular risk factors, other co-morbid diseases and drug usage were noted. Results Patients were classified into two groups: varicocele (+) group (n = 269) and varicocele (−) group (n = 287). VEINES-Sym scores of varicocele patients were lower compared to patients without varicocele (41.41 ± 5.21, 43.19 ± 3.22, respectively, p < 0.001). Grades of varicocele significantly but inversely correlated with VEINES-Sym score (r = 0, −206, p = 0.001). Logistic regression analysis revealed that presence of varicocele irrespective of grading significantly and independently associated with the presence of aching (odds ratio: 2.054, 95% confidence interval: 1.265–3.338, p = 0.004) and throbbing (odds ratio: 2.586, 95% confidence interval: 1.353–4.943, p = 0.004). Conclusion Varicocele patients have lower VEINES-Sym scores compared to patients without varicocele and this finding is inversely correlated with the degree of the varicocele. This association supports the hypothesis that there may be a systemic vessel wall abnormality in venous disease patients. Patients with symptoms related to vascular dilatation in any territory may deserve to be assessed systematically with the support of further clinical studies.

Unusual Giant Adrenal Myelolipoma with Chronic Mild Postprandial Pain

DOI: 10.4328/JCAM.1083 Received: 09.05.2012 Accepted: 18.06.2012 Printed: 01.07.2015 J Clin Anal Med 2015;6(4): 513-5 Corresponding Author: Haluk Soylemez, Dicle Universitesi, Tip Fakultesi, Uroloji Anabilim Dali, Diyarbakir, Turkiye. T.: +90 4122488583 F.: +90 4122488440 E-Mail: drhaluks@yahoo.com Ozet Adrenal miyelolipomlar, lipom ve liposarkom gibi diger adrenal tumorlerden histopatolojik olarak farklilik gosteren nadir, kucuk, benign, nonfonksiyonel tumorlerdir. Cogunlukla rastlantisal olarak otopsi, radyolojik tetkikler veya laparotomi sirasinda tani alirlar. Bazen, retroperitoneal kanama, sistemik semptomlar veya enfeksiyon gibi nedenlerle akut semptomlarla ortaya cikabilirler. Ayirici tanida Manyetik Rezonans Goruntuleme, doku orjinini ve cevre organ iliskilerini gostermesi nedeniyle faydalidir. Biz bu yazida, klinik olarak yemek sonrasi kronik karin agrisi ile ortaya cikan dev boyutlu bir adrenal miyelolipomlu altmis alti yasinda erkek hastayi kisa bir literature bilgisi esliginde sunmayi amacladik.