T. Ahmet Serel

Analysis of the trace element contents of inner nucleus and outer crust parts of urinary calculi.

In this study, the lead, cadmium, nickel, and aluminum concentrations were analyzed in inner nucleus and outer crust parts of various kinds of urinary calculi, and the results obtained were statistically compared. Significant differences were found among the element concentrations in the different stone groups. In general, higher element concentrations were found in the nuclei as compared with the crust parts. In addition, some significant intra- and intercorrelations were established among the elements analyzed. The results suggest that some trace elements, including lead, cadmium, nickel, and aluminum, together with other factors may have as yet no clarified functions in the stone precipitation process in the urinary tract.

Bone mineral content and related biochemical variables in patients with ileal bladder substitution and colonic Indiana pouch

OBJECTIVES To evaluate the effects of ileal bladder substitution or colonic Indiana pouch on skeletal bone density and various biochemical parameters related to bone metabolism. PATIENTS AND METHODS In 27 patients with urinary diversion and 14 controls with benign urologic disease, bone mineral density (BMD), assessed by dual-photon absorptiometry; serum electrolyte, creatinine, alkaline phosphatase and parathyroid hormone levels were determined, and capillary blood gas analysed. BMD was measured in the lumbar spine and the femur neck. The mean time since surgery was 33.6+/-10.1 months in 17 patients with an ileal bladder substitution and 56+/-9.1 months in 10 patients with a colonic Indiana pouch (p=0.001). RESULTS Although BMD did not change in the colonic Indiana pouch group, it was reduced in the patients with ileal bladder substitution compared to control group. The mean pH value was not statistically significant different in the both groups from the control group (p>0.2). The mean base excess value reduced in the substitution group (p<0.01). While alkaline phosphatase levels increased in both groups compared to control group (p<0.05), the mean parathyroid hormone level decreased only in the patients with ileal bladder substitution (p<0.05). The other biochemical parameters were similar in patients and control subjects. There was a statistically significant correlation between the base excess values and BMD values of the patients in both groups. CONCLUSION Although there is decreased BMD in patients with an ileal bladder substitute, there is no change in BMD in the patients with Indiana pouch. Alkaline phosphatase levels increased in both patient groups indicating increased bone turnover.

Tension-free vaginal tape for surgical treatment of stress urinary incontinence: Two years follow-up

Background: The objective was to study prospectively the effectiveness of tension‐free vaginal tape as an ambulatory and minimal invasive operation for the treatment of female stress incontinence.

Effect of Ultrasound in the Treatment of Primary Nocturnal Enuresis

Objective: This study aimed to determine the efficacy of ultrasound therapy in patients with primary nocturnal enuresis. Material and methods: Thirty-five patients with enuresis were included the study. Patients were divided into two groups: 27 patients with enuresis were treated with ultrasound with irradiation and heating, and eight patients with enuresis were treated with ultrasound without irradiation or heating (placebo group). Ultrasound therapy was performed using the Therasonic 350 machine. The ultrasound therapy was applied to the skin of lumbosacral region. A treatment course of ultrasound comprised 10 sessions of 0.8 W/cm2 intensity applied daily for 8 min. Symptoms were evaluated 1 week, and 3, 6 and 12 months after the treatment. Results: Twenty-two (81.5%) patients responded to the ultrasound therapy at the first week after the treatment. The effect of ultrasound started immediately after the treatment and continued during the 12 months of the follow-up period. Conclusion: Ultrasound therapy seems to be effective in the treatment of primary nocturnal enuresis in the 1 year follow-up period.

Magnetic resonance imaging for stress incontinence: evaluation of patients before and after surgical correction

OBJECTIVE The purpose of this study was to evaluate the accuracy of magnetic resonance imaging (MRI) in the pre and postoperative assessment of stress urinary incontinence. METHODS Fifteen female patients with clinical evidence of stress urinary incontinence were included in this prospective study. All the patients underwent MRI in the supine position both preoperatively and postoperatively. For imaging, we used a 1.0 T magnet, T2-weighted images were obtained in the midline sagittal plane with patients at rest. Images were evaluated for anatomical stress urinary incontinence alterations, such as the increased distance between the pubococcygeal line and the bladder base and the posterior urethro-vesical angle and the urethral inclination angle changes. Wilcoxon signed rank test allowed comparisons of pre and postoperative results. RESULTS Compared with postoperative measurements, the bladder base was lowered significantly by an average of 9.4+/-4.0 mm (P<0.01), posterior urethro-vesical angle was significantly increased by an average of 127.8+/-11.4 degrees (P<0.01), and the urethral inclination angle was significantly increased by an average of 54.9+/-10.1 degrees (P<0.01) preoperatively. CONCLUSION Our results suggest that MRI can play a major role in the preoperative and postoperative assessment of stress urinary incontinence. It can reliably detect anatomical urinary incontinence alterations. MRI should be considered in failed surgery, complex prolapse, and in differentiating genuine stress incontinence resulting from malposition of the bladder neck from stress incontinence due to intrinsic urethral damage.

Urine and serum free IGF-1 levels in patients with bladder cancer: a brief report

Insulin-like growth factor (IGF)-1, a mitogenic and anti-apoptotic peptide, can affect the proliferation of epithelial cells, and is thought to play a role in cancer development. The free IGF-1 represents the biologically active fraction of IGF-1. We hypothesised that there is a difference in free IGF-1 levels in the urine and serum from patients with TCC and normal subjects. Urine and blood samples were collected from 30 cases of superficial TCC and an equal number control subjects without malignancy. Free IGF-1 levels were measured in duplicate by radioimmunoassay. Specimens of bladder carcinoma were staged histopathologically using the Mostoffi grading system. Statistical analyses were performed using the Mann-Whitney U-test, Pearson correlation and covariate analysis. There was no significant difference in urine and serum free IGF-1 levels between the two groups. The correlation between urine and serum free IGF-1 levels and age was not significant. There was also no significant relationship between free IGF-1 levels and histopathological grading. The results of this pilot study reveal that the free IGF-1 level does not help predict tumour marker in the patients with bladder cancer.

Free insulin-like growth factor-1 and unilateral complete ureteral obstruction in the rat

OBJECTIVES To determine the effect of unilateral ureteral obstruction on renal free insulin-like growth factor-1 (IGF-1) content in the kidneys and the possible role of free IGF-1 in compensatory growth in the nonobstructed kidney in an experimental model. METHODS The content of free IGF-1 and total protein in the obstructed and nonobstructed kidneys were measured 7 days after unilateral ureteral obstruction. The weights of the kidneys were also determined. The results were compared with those of the sham-operated animals. RESULTS The mean renal free IGF-1 level of the obstructed kidneys was significantly lower than the mean renal free IGF-1 level of the sham-operated kidneys (P = 0.03), and the mean renal free IGF-1 level of the nonobstructed kidneys was significantly higher than the mean renal free IGF-1 level of the sham-operated kidneys (P <0.0001). The serum free IGF-1 levels in the two groups were not different. The mean weight of the obstructed and nonobstructed kidneys was significantly higher than those of the sham-operated kidneys (1.49 +/- 0.09 and 1.03 +/- 0.03 versus 0.88 +/- 0.02 g, P <0.0001 and P = 0.006, respectively). The obstructed kidneys had significantly lower mean protein content than the nonobstructed kidneys and had significantly higher mean protein content than the sham-operated kidneys (P <0.0001 and P = 0.0004, respectively). CONCLUSIONS Our results reveal that compensatory renal growth is driven by a rise in the free IGF-1 concentration after unilateral ureteral obstruction.

Megacystis secondary to myenteric plexus pathology. Presentation of two cases.

Herein, 2 cases of megacystis secondary to myenteric plexus pathology are reported. Unlike the entity of visceral myopathy, there was ganglion cell loss both in the bladder and in the colon of these 2 cases. Moreover, they did not present any gastrointestinal symptoms. Megacystis was the common pathology in these patients, whereas 1 of them suffered from unilateral vesicoureteral reflux. We could not find any similar report dealing with this phenomenon up to this time in the literature.

Contents Vol. 67, 2001

G.L. Andriole, St. Louis, Mo. G. Anselmo, Treviso M. Bagshaw, Stanford, Calif. P. Bassi, Padova M. Butz, Nürnberg P. Caione, Roma K. Dreikorn, Bremen M.J. Droller, New York, N.Y. A. Elbadawi, New York, N.Y. D. Fontana, Torino P. Fornara, Halle J.P. Gearhart, Baltimore, Md. C. Giberti, Savona P. Groscurth, Zürich U. Haller, Zürich H. zur Hausen, Heidelberg Ph. Heitz, Zürich A. Hofstetter, München C. Iselin, Genève G. Jakse, Aachen G. Janetschek, Linz K.-P. Jünemann, Mannheim J.R. Kalden, Erlangen J.N. Krieger, Seattle, Wash. V.R. Marshall, Adelaide M.J. Mihatsch, Basel U. Mödder, Düsseldorf M. Motta, Catania G. Muzzonigro, Ancona J. Nordling, Herlev Y. Okada, Shiga R.T.D. Oliver, London A.T. Porter, Detroit, Mich. A. Rossier, Genève H. Rübben, Essen R. Scarpa, Cagliari B. Schmitz-Dräger, Fürth F.P. Selvaggi, Bari M.S. Soloway, Miami, Fla. T. Sulser, Basel E.A. Tanagho, San Francisco, Calif. A. Trinchieri, Milano A. Tubaro, L’Aquila Vol. 67, 2001

Soliter Böbrekli Hastada Parapelvik Kist Nedeniyle Gelişen Komple Üst Üriner Sistem Obstrüksiyonu

SuleymanDemirel Universitesi TIP FAKULTESI DERGISI: 1997 Eylul; 4(4) Soliter Bobrekli Hastada Parapelvik Kist Nedeniyle Gelisen Komple Ust Uriner Sistem Obstruksiyonu T.Ahmet Serel Ahmet Ozturk Alim Kosar Meltem Cetin Ozet Bobrekte parapelvik kistler sik olarak rastlanilan benign lejyonlardandir. Kistlerin pelvise basi yaparak komplet obstruksiyona neden olmalari nadir gorulen komplikasy onlar indandir. Bu makalede soliter bobrekli 58 yasindaki bir hastada parapelvik kist nedeni ile gelisen komplet ust uriner sistem obstruksiyonuna bagli olarak ortaya cikan akut bobrek yetmezlikti bir hasta takdim edilmekte ve literatur esliginde tartisilmaktadir. Anahtar Kelimeler: Parapelvik kist, Uriner obstruksiyon, Soliter bobrek