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Öğe Bacterial translocation to kidney in rats with intestinal obstruction and the role of nitric oxide.(2009) Özbek E.; Ilbey Y.O.; Cekmen M.; Şimşek A.; Tekerekoglu M.; Sahin M.; Balbay M.D.Objective: Bacterial translocation (BT) is the passage of viable indigenous bacteria from one site to another, such as from gastrointestinal tract to the normally sterile regional mesenteric lymph nodes and than other internal organs. In this study we aimed to investigate the BT to kidney and the protective effect of nitric oxide (NO) inhibition. Material and methods: A total of 40 adult male Wistar albino rats weighing 320-350g were divided into four equal groups. Group 1 (n= 10): control group, group-2 (n = 10) sham control, group-3 (n = 10) simple obstruction, in which ileum was ligated 1-2 cm proximal to the ileocecal valve, group-4 (n = 10), simple obstruction and treated with L-NAME. Twenty four hour after the operation rats were sacrificed and kidneys were removed by sterile manner and trunk blood obtained for NO analysis. BT was defined as any positive culture from the blood and kidney. Results were compared with Mann- Whitney U test. Results: NO levels in control, sham group, simple obstruction group and obstruction plus L-NAME treated group were 14.04 ± 0.65 ?mol/L, 13.03 ± 0.080 ?mol/L, 31.17 ± 0.40 ?mol/L and 12.24 ± 0.70 ?mol/L, respectively. Renal culture results were negative in all controls and sham operated rats. However, all culture results were positive in obstruction group and in 4 in L-NAME-treated group. The most common microorganism that translocated was E. coli. Conclusion: This experimental study shows that BT to rat rat kidneys occurs in bowel obstruction and this can be inhibited by a NO inhibitor, L-NAME. Further studies are needed to define the clinical significance of these findings on urinary tract infection.Öğe Comparison of screening of vesicoureteral reflux with renal ultrasound and voiding cystourethrography(Akademiai Kiado Rt., 1998) Balbay M.D.; Özsan Ö.; Özbek E.; Özkan S.; Güneş A.Purpose: To suggest a different method for diagnosing vesicoureteral reflux (VUR) in lieu of voiding cystourethrography (VCU), in order to prevent radiation exposure. Materials and methods: Fifty-two ureterorenal units of 26 patients were evaluated ultrasonographically for visualizing the renal collecting systems, both before and after filling up the bladder with saline infusion. Every patient also underwent evaluation with VCU. Results: All patients with Grade 2 or higher degrees of VUR on VCU can be identified by ultrasound (USG). Overall sensitivity and specificity of this technique were 66.7% and 93.48%, respectively, in our patient group. Conclusion: After being diagnosed with VCU initially a VUR patient can be effectively followed up by USG in order to prevent radiation exposure. Considering the clinical management of a patient with Grade 1 VUR which could not be detected with USG, it is concluded that failure to detect Grade 1 VUR will not be a handicap.Öğe Evrim Bougie: A new instrument in the management of urethral strictures(2001) Yilmaz U.; Gunes A.; Soylu A.; Balbay M.D.Background: In this study a new instrument and technique is described for the endoscopic treatment of complete posterior urethral strictures, which may result in serious complications and sometimes require troublesome treatments. Methods: Three patients with complete posterior urethral obstruction were treated endoscopically with the guidance of a new instrument: Evrim Bougie. Evrim Bougie looks like a Guyon Bougie, has a curved end, which facilitates getting into the bladder through the cystostomy tract and with a built in channel of 1.5 mm in diameter for a sliding needle exiting at its tip. Having confirmed fluoroscopically and endoscopically that the sliding needle had passed across the strictured segment, the strictured segment was incised with internal urethrotomy, distal to the strictured segment, and urethral continuity was accomplished. At the end of the operation a Foley urethral catheter was easily placed into the bladder per urethra. Patients were instructed in self-catheterization after removal of the urethral catheter. All patients achieved normal voiding at postoperative 7th month follow-up evaluation. Conclusion: Internal urethrotomy could be performed under the guidance of the sliding needle of Evrim Bougie advanced from above the posterior urethral strictures, which to our knowledge was described for the first time in the English literature. We also believe that there may be other possible indications of Evrim Bougie for different procedures in urethral surgery.Öğe Treatment of premature ejaculation with sertralin(Akademiai Kiado Rt., 1998) Balbay M.D.; Yildiz M.; Salvarci A.; Özsan Ö.; Özbek E.To evaluate the efficacy of oral sertralin in the treatment of premature ejaculation, out of 22 patients with premature ejaculation 16 received oral sertralin, 50 mg a day for at least 2 weeks. Four patients were lost to follow-up. Two patients interrupted treatment due to side effects of sertralin. Out of 16 patients who completed at least a two-week period of treatment 14 (87.5%) responded clinically. Clinical response was achieved in the first week of treatment in 11 of 16 responders (68.75%). We conclude that low dose oral sertralin may be useful with a reasonable side effect rate in the treatment of patients suffering from premature ejaculation.
