Browsing by Author "Yilmaz, Y"

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Assessment of Testicular Cytology by Fine-Needle Aspiration and the Imprint Technique: Are They Reliable Diagnostic Modalities
(Blackwell Science Ltd, 1997) Odabas, O; Ugras, S; Aydin, S; Yilmaz, Y; Atilla, MK
Objective To investigate whether testicular cytology may be considered diagnostic in the evaluation of infertile men. Patients and methods Specimens of testicular tissue obtained either surgically (imprint smear) or through fine-needle aspiration (FNA) were used as a source of cytological smears; 58 testes from 24 men with azoospermia or severe oligospermia and from five men with advanced prostate cancer were evaluated cytologically and compared with the histological diagnosis. Results FNA caused no apparent trauma, The results from FNA smears generally agreed with the histological findings but four patients with no spermatozoa in the FNA smears were diagnosed histologically as hypospermatogenic and two others judged histologically as having Sertoli-cell-only (SCO) syndrome and spermatogenic arrest had detectable spermatozoa in their FNA smears. There was complete agreement between the results of imprint smears and histological findings in those patients with SCO syndrome and spermatogenic arrest, There were no evident differences in sperm counts between hypospermatogenesis and normal spermatogenesis on the imprint slides, but FNA smears detected this difference. Conclusion FNA of the testis is a relatively non-invasive and reproducible technique for evaluating qualitative and quantitative cytology. However, it is insufficient for diagnosing some testicular pathologies. Imprint smears supplement the histological diagnosis, especially if the histological slides are stained unsatisfactorily.
Combined Bladder, Urethral and Uterine Rupture After a Normal, Spontaneous Vaginal Delivery at Home - a Case Report
(Sci Printers & Publ inc, 2005) Zeteroglu, S; Bayrakli, H; Yilmaz, Y; Sahin, HG
BACKGROUND: Uterine rupture and associated injury to the maternal bladder and urethra have been rarely reported. All those cases were associated with a scarred uterus or augmentation of labor. We report a case of simultaneous bladder, urethral and uterine rupture in an unscarred uterus following delivery at home. CASE: A 22-year-old woman was referred front a peripheral hospital to the emergency unit of the Medical Faculty, Yuzuncu Yil University, after delivering at home. On vaginal examination, the bladder neck and proximal one third of the urethra were ruptured. Intraoperatively it appeared that the posterior wall of the bladder and bladder base had ruptured and separated from the level of the interureteric ridge. An extensive rupture of the lower uterine segment to the left sidewall of the uterus was seen. CONCLUSION: To prevent these complications, uneducated, traditional birth attendants should be replaced by at least midwives, and the rate Of unsupervised home delivery should be reduced.
Diagnostic Value of Cytokeratin-18 as a Tumor Marker in Bladder Cancer
(Pergamon-elsevier Science Ltd, 2002) Sekeroglu, MR; Aydin, S; Dülger, H; Yilmaz, Y; Bayrakli, H; Noyan, T
Objectives: The aim of the study was to compare serum levels of cytokeratin-18 of patients with bladder cancer with those of the healthy controls, and to investigate the relation between cytokeratin level and the tumor stage. Design and methods: Serum cytokeratin-18 levels of 38 patients with bladder cancer and of 25 healthy people were determined. Tumor stage was T-1 in 12 patients, T-2 in 9 patients, T-3 in 10 patients and T-4 in 7 patients. The serum cytokeratin-18 levels in these cases were analyzed with respect to the stage of the tumor. Results: Cytokeratin- 18 level in the patient group was found to be significantly higher than that of the control group (p < 0.010) when the groups were totally compared. However, when the levels in patients with different tumor stages were compared with that of the controls, the difference was not significant in patients with stage I and 2 tumors (p > 0.05). Regarding the cut off value as 4.0 ng/mL, sensitivity and specificity for serum cytokeratin-18 were found to be 53% and 72% respectively. When sensitivity was calculated with respect to tumor stages, it was 8% for T-1, 33% for T-2, 90% for T-3 and 100% for T-4. On the other hand, considering higher stage (T-3 and T-4) tumors only, the sensitivity was calculated as 94%, but the sensitivity for lower stage (T-1 and T-2) tumors was 19%. Conclusions: It is clear that serum cytokeratin- 18 level increases in patients with bladder cancer. However, it can only be useful as a tumor marker in the diagnosis of T-3 and higher staged tumors. This study indicated that cytokeratin- 18 does not have any diagnostic value in lower stage bladder cancers. (C) 2002 The Canadian Society of Clinical Chemists. All rights reserved.
Effect of Indapamide on Urinary Calcium Excretion in Patients With and Without Urinary Stone Disease
(Sage Publications inc, 2005) Ceylan, K; Topal, C; Erkoc, R; Sayarlioglu, H; Can, S; Yilmaz, Y; Gonulalan, H
Background: Indapamide is an anti hypertensive agent similar to thiazides, but with some different effects. Thiazide and thiazide-like diuretics are useful in preventing recurrent urinary stone formation due to their hypocalciuric effects. OBJECTIVE: To determine the hypocalciuric and other effects on certain laboratory parameters of indapamide 1.5 mg in different patient groups. METHODS: Four groups of patients recruited from urology and nephrology outpatient departments were experiencing non-hypercalciuric urinary stone disease (group 1), idiopathic hypercalciuria (group 2), urinary stone disease with hypercalciuria (group 3), and essential hypertension (group 4). In all patients, fasting serum uric acid, calcium, sodium, potassium, cholesterol, triglyceride, parathyroid hormone (PTH) values, and morning second-spot urine calcium and creatinine levels were assessed before and 8 weeks after treatment with indapamide. RESULTS: Urinary calcium excretion was reduced significantly in all groups: group 1 from 0.10 +/- 0.02 to 0.07 +/- 0.03 (mean +/- SD; 30% reduction; p < 0.001), group 2 from 0.30 +/- 0.15 to 0.15 +/- 0.10 (50% reduction; p < 0.001), group 3 from 0.35 +/- 0.15 to 0.20 +/- 0.10 (43% reduction; p < 0.001), and group 4 from 0.10 +/- 0.03 to 0.08 +/- 0.02 (20% reduction; p < 0.0010). These results should be interpreted with caution since no control group was included in this study. Mean serum uric acid and triglyceride levels were significantly increased, and mean PTH and potassium levels and diastolic and systolic blood pressure were significantly decreased in all groups. Few temporary adverse effects, such as dizziness and fatigue, were noticed and none of them caused discontinuation of treatment. CONCLUSIONS: Indapamide 1.5 mg/day is effective in decreasing calciuria in patients with non-hypercalciuric urinary stone disease, idiopathic hypercalciuria, urinary stone disease with hypercalciuria, and essential hypertension. This could be achieved with few adverse effects similar to those of thiazides and indapamide 2.5 mg. Indapamide decreased the PTH levels in all groups. Long-term clinical benefits of these effects should be evaluated prospectively with further randomized studies.
Effects of Sildenafil Citrate, Acetylcholine. and Sodium Nitroprusside on the Relaxation of Rabbit Cavernosal Tissue in Vitro
(Elsevier Science inc, 2001) Aydin, S; Özbek, H; Yilmaz, Y; Atilla, MK; Bayrakli, H; Çetin, H
Objectives. To investigate the effect of sildenafil together with the influence of sodium nitroprusside and acetylcholine and further discuss its mechanism of action in vitro. Methods, Isolated strips of rabbit corpus cavernosum were stimulated isometrically with phenylephrine. Graded relaxations were induced using increasing concentrations of acetylcholine, sodium nitroprusside, and sildenafil alone and in combination. Results, The agents all relaxed the rabbit corpus cavernosal strips in a dose-dependent manner. The inhibitory potentials of the test agents were ranked (from least inhibitory to most inhibitory) as follows: sildenafil, acetylcholine plus sildenafil, sodium nitroprusside, sodium nitroprusside plus sildenafil, acetylcholine. The presence of sodium nitroprusside in the medium reduced the median effective dose for the sildenafil-induced relaxation of the cavernosal tissue from 3.65 x 10(-5) M to 2.73 x 10(-7) M, and the presence of acetylcholine reduced it to 9.79 x 10(-6) M. Conclusions. Sildenafil enhances the relaxing effect of both sodium nitroprusside and acetylcholine on the phenylephrine-induced contraction of rabbit cavernosal tissue. UROLOGY 58: 119-124, 2001. (C) 2001, Elsevier Science Inc.
The Efficacy of Fluoxetine in the Treatment of Premature Ejaculation: a Double-Blind Placebo Controlled Study
(Williams & Wilkins, 1996) Kara, H; Aydin, S; Agargun, MY; Odabas, O; Yilmaz, Y
Purpose: The efficacy of the selective serotonin re-uptake inhibitor fluoxetine in the treatment of premature ejaculation was examined. Materials and Methods: The study comprised 17 patients with premature ejaculation who presented to the urology clinic of our medical school. In this double-blind study the patients were randomized into treatment groups receiving 20 mg. fluoxetine daily for 1 week and 40 mg. daily afterward (group 1) or 1 capsule placebo daily for 1 week and 2 capsules daily afterward (group 2). The groups were evaluated according to the latent period of intravaginal ejaculation. Results: The latent period of intravaginal ejaculation in group 1 was significantly longer than that in group 2. Nausea, headache and insomnia were reported side effects. Conclusions: Fluoxetine may be regarded as a safe and effective alternative in the treatment of premature ejaculation.
Eighteen-Month Follow-Up of Cystovaginoplasty: a New Augmentation Operation for Repair of Vesicovaginal Fistulae
(Scandinavian University Press, 1997) Yilmaz, Y; Atan, A; Odabas, O; Aydin, S; Gurel, SA; Aydin, M
We present an 18-month follow-up of a cystovaginoplasty case. Surgery was performed because of a large vesicovaginal fistula. A new technique using the vagina as a pouch was utilized.
Free Hydatid Cyst Only Covered With Germinative Membrane Disrupted From Fibrotic Capsule in the Peritoneal Cavity: a Case Report
(Assoc Soc Scientifique Med Belges, 1998) Arslan, H; Sakarya, ME; Bozkurt, M; Dilek, FH; Yilmaz, Y; Dilek, ON; Er, R
Echinococcosis, an endemic disease on the Asian continent, is caused by ecinococcus granulosus and rarely ecinococcus alveolaris. Although it occurs frequently in the liver and the lung, it can be localized in all tissues and organs. The purpose of this study is to report a rare localization and the complication of hydatid cyst in the pelvis : it pushed forward and upward the urine bladder and there was bilateral hydroureteronephrosis causing uraemia because of outflow obstruction. To our knowledge, a similar case has not been published before in English literature.
A Further Study of Seminal Plasma: Lactate Dehydrogenase and Lactate Dehydrogenase-X Activities and Diluted Semen Absorbance
(Walter de Gruyter & Co, 1997) Aydin, S; Yilmaz, Y; Odabas, O; Sekeroglu, R; Tarakcioglu, M; Atilla, MK
Activities of total lactate dehydrogenase, which plays an important role in providing energy for cell metabolism, lactate dehydrogenase-X, an isoenzyme of lactate dehydrogenase supposed to be specific for germinal epithelium activity, diluted semen absorbance and some other properties have been measured in 51 seminal plasma samples. Aiming to study its clinical use as a marker of seminiferous epithelium activity, determination of isoenzyme-X and investigation of correlation between it and the spermiogram properties were carried out. Besides lactate dehydrogenase and lactate dehydrogenase-X activity, their ratio and diluted semen absorbance were correlated with the different properties of the spermiogram, the best correlation of the enzymes being obtained with the total sperm count and motile sperm count. Correlation of diluted semen absorbance with the total sperm count and motile sperm count was also noted, whereas it did not correlate with sperm concentration and motility rate. The data suggests the clinical utility of these properties as reliable markers for both germinal activity and spermatozoid quality when ''total sperm count'' and ''motile sperm count'' are used to define sperm properties instead of just sperm concentration and motility rate.
Luteinizing Hormone Pulse Frequency and Amplitude in Azoospermic, Oligozoospermic and Normal Fertile Men in Turkey
(Wolters Kluwer Medknow Publications, 2002) Odabas, Ö; Atilla, MK; Yilmaz, Y; Sekeroglu, MR; Sengül, E; Aydin, S
Aim: To investigate the LH pulse frequency and amplitude in azoospermic and oligozoospermic patients and to compare them with normal fertile subjects. Methods: In this controlled clinical study, 10 normal fertile male volunteers and 20 infertile patients (10 oligozoospermic and 10 azoospermic) were enrolled. Blood samples were taken every 30 minutes for 12 hours. FSH, LH and T levels were determined. LH was observed at all the blood samples, but FSH and testosterone only at the first, middle and last samples. Results: The mean LH levels were significantly different between all the groups, but there was no statistical difference in the FSH levels between the fertile and oligozoospermic groups. The mean LH levels increased from the fertile towards the azoospermic groups (P<0.01). The LH pulse amplitude and frequency were significantly different between all the 3 groups. The former increased while the latter decreased from the fertile to the azoospermic groups. The T levels were different statistically only between the fertile and the azoospermic groups. Conclusion: The more prominent is the testicular defect, the lower will be the LH pulse frequency and the higher the amplitude.
Micro-Spoon Technique in Estimation of Sperm Concentration in Rat Epididymis
(Tohoku Univ Medical Press, 2000) Odabas, Ö; Timurkan, H; Atilla, MK; Yilmaz, Y; Sengül, E; Aydin, S
Several technical procedures mere described for estimation of epididymal sperm concentration until today. In all of the described techniques, epididymal material was drawn into a micro-pipette before counting procedure. We aimed to proceed this stage without using any pipette because of the difficulty in aspirating very viscous epididymal material into a micro-pipette. For measuring epididymal material we used a 2 mu l reservoir which me named as a micro-spoon. It was filled with the epididymal material and layered in a tube with Ringer's solution of 2 mi containing sodium hyaluronate. Then, it was mixed in order to obtain 1/1000 diluted suspension. Sperm cells in this suspension were counted on a Makler chamber under a light microscope. The procedure was easy and time saving, compared to the other techniques. (C) 2000 Tohoku University Medical Press.
New Drainage Technique in the Ureteropelvic Junction Obstructions -: Side-To Ureterocalicostomy (Or Ureterocaliceal By-Pass) Preserving Renal Pelvis and Ureteropelvic Junction
(Scandinavian University Press, 1998) Yilmaz, Y; Odabas, Ö; Aydinioglu, A; Atilla, MK; Atan, A; Aydin, S
We present a new ureterocalicostomy technique in a patient with intrarenal pelvis together with renal artery compression on the pelvis and ureteropelvic junction (UPJ). The patient had grade ii hydronephrosis in the left kidney and angulation at the ureteropelvic junction. We performed side-to-side ureterocalicostomy between the ureter and lower calyx of the kidney.
A Suspected Case of Bilateral Crossed Renal Ectopia or Bilateral Jet Effect
(Karger, 1996) Aydin, S; Odabas, O; Yilmaz, Y; Bozkurt, M; Atilla, MK; Onur, D; Dogdu, GA
Crossed renal ectopia is a relatively unusual congenital anomaly. Bilateral crossed renal ectopia is considered the rarest form of this anomaly. A 19-year-old girl with intermittent flank pain was admitted to our department. Various clinical and laboratory examinations were carried out. Excretory urography showed a normal upper urinary tract anatomy, whereas the distal ends of the ureters crossed each other in the pelvis, which suggested bilateral crossed renal ectopia.
Undescended Testes in Adults: Clinical Significance of Resistive Index Values of the Testicular Artery Measured by Doppler Ultrasound as a Predictor of Testicular Histology
(Williams & Wilkins, 1997) Atilla, MK; Sargin, H; Yilmaz, Y; Odabas, O; Keskin, A; Aydin, S
Purpose: We evaluated the clinical significance of arterial impedance as a predictor of testicular histology in adults with undescended (inguinal) testes. Materials and Methods: We performed arterial impedance and testicular diameter measurements with the use of color Doppler ultrasonography on 22 adults with undescended testes. Arterial impedance of the contralateral descended testes served as controls. All patients later underwent inguinal orchiectomy and the testes were examined histologically. Results: Of the 22 undescended testes, 7 had arterial impedance values below 0.50, and the other 15 had values equal to or above 0.50. All testes with arterial impedance values below 0.50 had histologic scores between 2 and 3, whereas the others had scores of 3 and 8. Arterial impedance values and testicular volumes in the contralateral testes were significantly higher than the undescended testes. Although some of the testes with arterial impedance values above 0.50 had histologic score 3, testes with arterial impedance values below 0.50 never exceeded score 3. Volume differences of the undescended testes were not statistically significant. Conclusions: Arterial impedance of an undescended testis may have a predictive value and provide more accurate information about its histology than the volume measurement itself.
Utilising an Ileal Segment in the Posterior Urethral Replacement Procedures Using Anal Sphincter To Provide Continence in Dogs
(Tohoku Univ Medical Press, 1998) Yilmaz, Y; Aydin, M; Bakir, B; Atilla, MK; Odabas, Ö; Aydin, S
We aimed to replace an ileal segment in the place of posterior urethra using the anal sphincter as a continence mechanism. The experiment was carried on three male street dogs. In the first stage, only urethral replacement with an ileal segment was done and pulled through the anal sphincter in a male dog to see if anal sphincter would do any help for continence. A protruding stoma was created on the perineum. Perineal end of the ileal segment was sutured to the bulbous urethra in the other two male dogs to provide urethral patency in the second step of the operation. The dog in which the first operation was made gained continence on the 12th postoperative day. The other two male dogs, in which ileourethral anastomosis were made, became continent on the postoperative 12th and 15th days. No residual urine was found by catheterisation performed after urination. In controls, neither the stoma nor the anastomosis sites developed stenosis. This procedure may be applied in patients with complete incontinence who can not be corrected by any other surgical procedures, and a very good cosmetic result may be obtained.