Tekin Ahmet Serel

Acupuncture Therapy in the Management of Persistent Primary Nocturnal Enuresis: Preliminary Results

OBJECTIVE This study aimed to assess the comparative therapeutic efficacy of traditional Chinese acupuncture. MATERIAL AND METHODS During the period from January 1997 to April 1999, 50 children (23 boys, 17 girls) suffering from primary persistent nocturnal enuresis, aged 9-18 years, were included in the study. The response rate was monitored at 2 and 4 weeks, and then every 3 months by recording dry nights on a calendar. RESULTS The efficacy of treatment, which was expressed as a percentage of dry nights, was high. Within 6 months, 43 (86%) patients were completely dry and 2 (10%) patients were dry on at least 80% of nights. CONCLUSIONS Treatment using acupuncture in patients with persistent enuresis nocturna appeared to be most efficacious both in terms of the percentage of dry nights at the end of treatment and in relation to the stability of results, even after the end of the study.Objective: This study aimed to assess the comparative therapeutic efficacy of traditional Chinese acupuncture. Material and Methods: During the period from January 1997 to April 1999, 50 children (23 boys, 17 girls) suffering from primary persistent nocturnal enuresis, aged 9-18 years, were included in the study. The response rate was monitored at 2 and 4 weeks, and then every 3 months by recording dry nights on a calendar. Results: The efficacy of treatment, which was expressed as a percentage of dry nights, was high. Within 6 months, 43 (86%) patients were completely dry and 2 (10%) patients were dry on at least 80% of nights. Conclusions: Treatment using acupuncture in patients with persistent enuresis nocturna appeared to be most efficacious both in terms of the percentage of dry nights at the end of treatment and in relation to the stability of results, even after the end of the study.

Risk Factors for the Formation of a Steinstrasse after Shock Wave Lithotripsy

Introduction: We studied the various stone, renal, and therapy factors that could affect steinstrasse formation after shock wave lithotripsy (SWL) to define their predictive value. Patients and Methods: Between May 1999 and September 2002, 563 patients were treated with a Stonelight V3 lithotriptor. A steinstrasse was recorded in 46 patients. All patient data, stone and renal characteristics, and data of SWL were reviewed. Statistical analyses of patients, stones, and therapy characteristics in correlation with the incidence of steinstrasse formation were performed to assign factors that had a significant impact on the formation of this complication. Results: The overall incidence of a steinstrasse was 8.17%. The steinstrasse was in the pelvic ureter in 84.3% of the cases, in the iliac ureter in 7.84% of them, and in pelvic and iliac ureter in 7.84% of the patients. The incidence of a steinstrasse significantly correlated with stone size and site. The incidence rates of a steinstrasse in renal stones <1 cm, 1–2 cm, and >2 cm were 4.46, 15.87, and 24.3% respectively. The incidence rates of this complication in ureteral stones <1 cm and 1–2 cm were 3.37 and 9.52%, respectively. The incidence rates of a steinstrasse in stones located in upper calices, middle calices, lower calices, and renal pelvis were 6.12, 10.52, 6.36, and 19.32%, respectively. Conclusions: Stone size and site are the significant factors predicting the formation of a steinstrasse. If a patient has a high probability of steinstrasse formation, close follow-up with early intervention or prophylactic pre-SWL ureteral stenting is indicated.

CD10 Expression in Urothelial Bladder Carcinomas: A Pilot Study

Objectives: The aims of this study were to investigate the expression of CD10 in normal bladder tissue and urothelial bladder carcinomas and to clarify its association with histopathological variables. Materials and Methods: A total of 79 urothelial bladder carcinomas were selected from routine archival material. All cases were reevaluated histopathologically and graded according to the World Health Organization (WHO) 1973, WHO/ISUP 1998, and WHO 1999 systems. The TNM system was used for their pathological staging. CD10 immunohistochemical staining was performed in selected slides. Results: Tumoral cases consisted of 74 men (93.7%) and 5 women (6.3%). According to the pathological stage, 25 (31.6%), 33 (41.8%), and 21 (26.6%) cases had pTa, pT1, and pT2–3 carcinomas, respectively. 34 of 79 (43%) urothelial carcinomas and only 1 of 11 (9.1%) nontumoral cases showed positive CD10 immunostaining. It was a cytoplasmic diffuse or granular immunostaining pattern both in nontumoral and tumoral urothelia. There was no statistically significant difference between tumoral and nontumoral cases with respect to CD10 reactivity (p = 0.051), but there was a trend toward significance. In urothelial tumors, there was a significant inverse correlation between pathological stages and CD10 immunoreactivity (p = 0.036, r = –0,237). There was also a statistically significant difference between pTa and pT2–3 urothelial tumors in relation to the CD10 expression (p = 0.034). No association was detected between CD10 expression and grades according to all systems used (p > 0.05). Conclusions: According to our findings, the CD10 expression in noninvasive carcinomas showed a higher level than that in invasive carcinomas, and it is inversely correlated with the pathological stage. CD10 may play an important role in the progression of urothelial bladder carcinomas, and downregulation probably facilitates invasion, especially muscle invasion.

Antegrade extraperitoneal approach to radical cystectomy and ileal neobladder.

Background: We describe a new operative technique for the surgical treatment of bladder cancer.

Association between Mast Cells and Bladder Carcinoma

Introduction: The aim of this study was to determine whether there are quantitative variations in the numbers of mast cells (MCs) in bladder carcinoma tissue associated with the histopathological grading of tumours. Materials and Methods: Specimens of 56 bladder carcinomas were stained with toluidine blue and histologically staged using the Mostofi system. The MC counts were assessed within tumour tissue and lamina propria of the bladder. The MCs in the adjacent ‘normal bladder tissue’ of 14 specimens from patients who underwent cystectomy and of 10 specimens from patients having interstitial cystitis were also determined. The results were analyzed by using the Student t test, the Wilcoxon signed-rank test, and the Spearman correlation (rs). Results: The mean MC concentration was 0.57 within the tumour tissue and 3.36 in the lamina propria. The difference between the two MC groups was statistically significant (p < 0.0001); there were no correlations between mean MC counts in tumour tissue and histopathological tumour grade and between mean MC counts in lamina propria and histopathological tumour grade. Statistically significant differences were also observed between tumour group and interstitial cystitis group (p = 0.029) and between tumour group and normal ‘adjacent’ tissue group (p = 0.037). Conclusions: Our findings suggest that MCs aggregate in small numbers in the lamina propria of bladder carcinomas and that the MC count is related to tumour differentiation. The number of MCs may be a useful prognostic indicator in patients with bladder carcinoma.

Treatment with neodymium: YAG laser in patients with chronic prostatitis: A preliminary reprot

A group of 30 patients with chronic abacterial prostatitis or prostatodynia, all of whom were unresponsive to conventional treatments, underwent transurethral neodymium: YAG laser therapy. The patients were evaluated with both objective and subjective parameters before and after treatment.Following treatment, the preliminary results at six months showed positive response (complete plus partial) rates in subjective parameters ranging from 47% to 86%. On the other hand, objective parameters including mean international prostate symptom scores (IPSS), mean quality of life indexes (QoL), mean uroflowmetric measurements and mean leukocyte count in expressed prostatic secretions showed marked improvements which were meaningful statistically. In 4 of 7 patients who underwent needle biopsy of the prostate, histology revealed definite inflammatory infiltration changes. Control biopsies following treatment showed almost complete disappearance of these changes. These preliminary results open up a new treatment modality in the management of this condition which has so far responded poorly to conventional therapy.

Penile Necrosis: an Unexpected Complication Following Transurethral Resection of the Prostate

A 69-year-old man who had undergone a transurethral resection of the prostate for benign prostatic hyperplasia developed necrosis of the glans penis following traction of the urethral catheter

Protective effect of theophylline on renal functions in experimental pneumoperitoneum model

Abstract Our objective in this experimental study is to research the effect of the intra-abdominal pressure which rises following pneumoperitoneum and whether Theophylline has a possible protective activity on this situation. In our study, 24 Wistar Albino rats were used. Rats were divided into two groups. The first group was set for only pneumoperitoneum model. The second group was given 15 mg/kg of Theophylline intraperitoneally before setting pneumoperitoneum model. Then urea, creatinine, cystatin-C, tissue and serum total antioxidant capacity, total oxidant capacity and oxidative stress index in two groups were measured and compared with each other. Apoptosis and histopathological conditions in the renal tissues were examined. The differences between the groups were analyzed with the Mann–Whitney U test. Results were considered significant at p < 0.05. No statistically significant difference was determined between tissue and serum averages in two groups in terms of TAS, TOS and OSI values (p > 0.05). The mean value of urea were similar in pneumoperitoneum and pneumoperitoneum + theophylline groups (p = 0.12). The mean cystatin-C value was 2.2 ± 0.3 µg/mL in pneumoperitoneum, 1.74 ± 0.33 µg/mL in pneumoperitoneum + theophylline (p = 0.002). According to our study, lower cystatin-C levels in the group, where Theophylline was given, are suggestive of lower renal injury in this group. However, this opinion is interrogated as there is no difference in terms of tissue and serum TAS, TOS, OSI and urea values between the groups.

Cancer detection rates of different prostate biopsy regimens in patients with renal failure

Abstract We aimed to evaluate the cancer detection rates of 6-, 10-, 12-core biopsy regimens and the optimal biopsy protocol for prostate cancer diagnosis in patients with renal failure. A total of 122 consecutive patients with renal failure underwent biopsy with age-specific prostate-specific antigen (PSA) levels up to 20 ng/mL. The 12-core biopsy technique (sextant biopsy + lateral base, lateral mid-zone, lateral apex, bilaterally) performed to all patients. Pathology results were examined separately for each sextant, 10-core that exclude parasagittal mid-zones from 12-cores (10a), 10-core that exclude apex zones from 12-cores (10b) and 12-core biopsy regimens. Of 122 patients, 37 (30.3%) were positive for prostate cancer. The cancer detection rates for sextant, 10a, 10b and 12 cores were 17.2%, 29%, 23.7% and 30.7%, respectively. Biopsy techniques of 10a, 10b and 12 cores increased the cancer detection rates by 40%, 27.5% and 43.2% among the sextant technique, respectively. Biopsy techniques of 10a and 12 cores increased the cancer detection rates by 17.1% and 21.6% among 10b biopsy technique, respectively. There were no statistical differences between 12 core and 10a core about cancer detection rate. Adding lateral cores to sextant biopsy improves the cancer detection rates. In our study, 12-core biopsy technique increases the cancer detection rate by 5.4% among 10a core but that was not statistically different. On the other hand, 12-core biopsy technique includes all biopsy regimens. We therefore suggest 12-core biopsy or minimum 10-core strategy incorporating six peripheral biopsies with elevated age- specific PSA levels up to 20 ng/mL in patients with renal failure.

Dermoid cyst in bony pelvis that coexists with pheochromocytoma: report of a case and review of the literature.

A 42-year-old man presented with right lower quadrant abdominal pain and dysuria. The bladder was displaced to the right side of the pelvis in excretory urography. Abdominal CT revealed a mass in right adrenal gland, measuring 8 cm in diameter. There was also a cystic mass; filling left half of the bony pelvis and displacing bladder to the right, measuring 14.5 × 10, 5 × 7 cm. The patient underwent right adrenalectomy and pelvic mass excision. Pathologic examination showed that the adrenal mass was pheochromocytoma and pelvic mass was dermoid cyst. This case is the first one in literature that an intrapelvic dermoid cyst is not derived from an organ coexists with pheochromocytoma.