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Öğe 1-[2-(5-nitro-1H-benzimidazol-1-yl)ethyl]morpholinium chloride(Int Union Crystallography, 2005) Akkurt, M; Türktekin, S; Küçükbay, H; Yilmaz, U; Büyükgüngör, OThe title compound, C13H17N4O+.Cl-, was synthesized from 1( 2-methoxyethyl)-5-nitrobenzimidazole and N-(2-chloroethyl) morpholine hydrochloride in dimethylformamide. The crystal structure has been determined at 100 K and exhibits an intramolecular N - H...Cl, and intermolecular C - H...Cl and C - H ... O interactions.Öğe Auditory event-related potentials in patients with premature ejaculation(Elsevier Science Inc, 2001) Ozcan, C; Ozbek, E; Soylu, A; Yilmaz, U; Guzelipek, M; Balbay, MDObjectives. To investigate in a descriptive manner the P300 component of the event-related potential (ERP), which is related to aspects of cognitive processing, in patients with premature ejaculation (PE) to determine whether there is a cognitive alteration in this condition. Recent studies with short latency evoked potentials such as cortical somatosensory evoked potentials have indicated that afferent sensory inputs from the genital area to the nervous system are increased in PE, However, the cortical neural process of ejaculation has remained poorly understood. Methods. We performed ERPs in 20 patients with PE and in 20 age-matched healthy subjects. ERPs were evoked by an auditory oddball paradigm consisting of 150 tone bursts (80% 1 kHz; 20% 2 kHz). The latencies of the N200 and the P300 waves and the amplitude of the P300 wave were measured. Results. The mean latencies of the N200 and P300 waves were significantly longer in the patients with PE than in the controls (P<0.04 and <0.03, respectively). No significant difference was found in the P300 amplitude between the controls and patients (P>0.05). Conclusions. These data indicate that the greater cortical representation of sensory stimuli from the genital areas that has been shown with somatosensory evoked potential studies might be related to a cognitive/neurobehavioral dysfunction. The dysfunction involves an increased time to evaluate and categorize the stimuli in the central nervous system, with no change in the quality of cognition and neural disinhibition by the prefrontal cortex to early sensory processing in subcortical or primary cortical regions, which are cognitive neural processes underlying ERP generation. UROLOGY 58: 1025-1029, 2001 (C) 2001, Elsevier Science Inc.Öğe Bilateral disruption of corpus cavernosum with complete urethral rupture(Blackwell Publishing Asia, 2004) Soylu, A; Yilmaz, U; Davarci, M; Baydinc, CPenile fracture is a relatively rare condition. We report an unusual case of the bilateral disruption of the corpus cavernosum with complete urethral rupture resulting from blunt trauma during sexual intercourse. The subject underwent emergency surgery with preservation of erectile and voiding functions in the follow-up.Öğe Bladder weight in perimenopausal women aged 50-55(Springer London Ltd, 2004) Ekmekçioglu, O; Aygen, EM; Yilmaz, UThis study aimed to determine whether the preliminary factor for the manifestation of lower urinary tract symptoms (LUTS) in perimenopausal women is age-dependent morphological changes in the bladder or hypoestrogenism. The bladder weights and the effects of bladder weight changes on LUTS were evaluated in three groups of women within and age range of 50-55 years: premenopausal ( n =29), short-term menopausal (less than 5 years) ( n =38) and long-term menopausal (5 years and more) ( n =31). The comparison of LUTS among the groups was made using the International Prostate Symptom Score (IPSS) questionnaire; the ultrasonographically determined bladder weights of all the women and the duration of menopause were evaluated for the presence of any correlation for their ages. The relation between the bladder weights and the symptom scores was also tested. The bladder weight of women with longer duration of menopause was found to be significantly decreased compared with that of women with shorter-duration menopause within the same age group ( p <0.05). There was significant correlation between the increased duration of menopause and the decrease in the bladder weight ( r =0.2, p =0.015). When all the women were taken into account, there was no correlation between the ages and bladder weights ( r =0.03; p =0. 76). There was no significant difference among the groups in terms of symptom scores evaluated as single scores, total symptom scores, total irritative and obstructive scores ( p >0.05 for each). The symptom scores had no correlation with the bladder weights or the ages of patients ( p >0.05 for each). In this age group of women the duration of hypoestrogenism does not seem to cause a difference in the symptom scores. To observe a possible significant difference, it is necessary to evaluate older women or women with a longer duration of hypoestrogenism. These findings suggest the cause for the decreased bladder weight to be the higher duration of hypoestrogenism rather than the older age.Öğe Clitoral electromyography(Lippincott Williams & Wilkins, 2002) Yilmaz, U; Soylu, A; Ozcan, C; Caliskan, OPurpose: The clitoris has several histomorphological and functional similarities to the penis, In this study we evaluated spontaneous and evoked electromyography activity in the clitoris. Materials and Methods: We evaluated 11 healthy female volunteers with clitoral electromyography using a concentric needle electrode placed intracorporeally. The hand, foot and genital sympathetic skin responses, and spontaneous electrodermal activity were simultaneously recorded with silver surface electrodes. Another concentric needle electrode was placed subdermally on the mons pubis to differentiate clitoral activity from possible artifact. After recording spontaneous electromyography and electrodermal activity the left median nerve was stimulated to record evoked clitoral activity, and the sympathetic skin response in the hand, foot and genital regions. Results: There was spontaneous electromyography activity in the corpus clitoris. All dermal sites, including the hand, foot and genital regions, showed spontaneous electrodermal activity. No spontaneous activity was recorded from the subdermal needle electrode, Distraction of attention and coughing increased the amplitude and frequency of spontaneous clitoral electromyography and electrodermal activity at all sites. After stimulating the left median nerve all sites except that of the subdermal needle electrode showed evoked activity. Conclusions: The demonstrated evoked and spontaneous clitoral electromyography activity seems to indicate a sympathetic tonus of the corpus clitoris, as recorded from the corpus cavernosum of the penis in human males. Clitoral electromyography may be a useful objective assessment tool for evaluating female sexual dysfunction as well as genital autonomic innervation.Öğe Effect of combined treatment with melatonin and methylprednisolone on neurological recovery after experimental spinal cord injury(Springer, 2004) Cayli, SR; Kocak, A; Yilmaz, U; Tekiner, A; Erbil, M; Ozturk, C; Batcioglu, KSpinal cord injury (SCI) results in the loss of function below the lesion. Secondary injury following the primary impact includes a number of biochemical and cellular alterations leading to tissue necrosis and cell death. Methylprednisolone (NIP), by reducing edema and protecting the cell membrane against peroxidation, is the only pharmacological agent with a proven clinically beneficial effect on SCI. Melatonin, known as a free radical scavenger, has been shown to have an effect on lipid peroxidation following experimental SCI. The purpose of this study was to examine the effect of MP and melatonin on neurological, ultrastructural, and electrophysiological recovery. Female albino rats weighing 200-250 g were randomized into five groups of 18 rats each and six rats for the control group. Weight-drop trauma was performed for each group and a 30-mg/kg single dose of NIP for rats in group 1, a 10-mg/kg single dose of melatonin for rats in group 2, and MP and melatonin in the same doses for rats in group 3 were administered immediately after trauma. The rats in group 4 were the vehicle group (treated with ethanol) and group 5 was the trauma group. The motor and somatosensory evoked potentials were recorded at the 4th hour, the 24th hour, and on the 10th day of the study for six rats in each group. Posttraumatic neurological recovery was recorded for 10 days using motor function score and inclined plane test. After electrophysiological study the rats were terminated for an analysis of lipid peroxidation level of the injured site of the spinal cord. Electron microscopic studies were performed to determine the effects of melatonin, MP, and the combined treatment with MP and melatonin on axons, neurons, myelin, nucleus, and intracytoplasmic edema. The groups treated with MP, melatonin, and a combination of both had significantly enhanced electrophysiological, biochemical, and neurological recovery and also showed better ultrastructural findings than the trauma and vehicle groups. Although combined treatment was significantly more effective on lipid peroxidation than melatonin or MP treatments alone, at the 10th day, neurobehavioral, electrophysiological, and ultrastructural recovery were at the same level. In conclusion, MP, melatonin, and MP and melatonin combined treatment modalities improved functional recovery at the same level. Future studies involving different doses of melatonin and different dose combinations with MP could promise better results since each drug has a different anti-oxidative mechanism of action.Öğe The effectiveness of tenoxicam vs isosorbide dinitrate plus tenoxicam in the treatment of acute renal colic(Blackwell Science Ltd, 2000) Kekeç, Z; Yilmaz, U; Sözüer, EObjective To determine the effectiveness of isosorbide dinitrate in combination with tenoxicam compared with tenoxicam alone for the relief of acute renal colic. Patients and methods Fifty patients with acute renal colic were randomly and in a double blind fashion divided into two treatment groups of 25 each. Group 1 received tenoxicam (40 mg intravenously) and group 2 received tenoxicam (40 mg intravenously) plus sublingual isosorbide dinitrate (5 mg). The patients were compared for visual pain scores, heart rate and blood pressure between and within the groups before and after treatment. Results Comparing the groups, group 2 had significantly lower pain scores after treatment (P < 0.05) but no other variables were significantly different (P > 0.05 for each). Within the groups the pain scores were significantly lower after treatment in both groups (P < 0.05). Group 2 also had a significantly lower heart rate and blood pressure after treatment (P < 0.05). There were no side-effects caused by tenoxicam and isosorbide dinitrate in either group. Conclusion The use of tenoxicam alone or combined with isosorbide dinitrate was effective in relieving of renal colic, but the relief obtained with the combination was significantly greater than tenoxicam alone.Öğe Evoked cavernous activity(Lippincott Williams & Wilkins, 2002) Yilmaz, U; Soylu, A; Ozcan, C; Kutlu, R; Gunes, APurpose: Corpus cavernosum electromyography has been widely done to evaluate autonomic dysfunction in patients with erectile dysfunction. We assessed the value of corpus cavernosum electromyography, evoked cavernous activity and penile sympathetic skin responses for their accuracy in determining autonomic involvement in cases of erectile dysfunction. Materials and Method: We evaluated 75 men with erectile dysfunction by corpus cavernosum electromyography, evoked cavernous activity and penile sympathetic skin response tests at our neurourology laboratory. The etiology of dysfunction was vascular, neurogenic, psychogenic or mixed based on a detailed medical and sexual history, physical examination, electrophysiological and laboratory studies, penile color Doppler ultrasonography, and cavernosography and/or cavernosometry. Autonomic involvement was clinically assessed by systemic findings, such as orthostatic hypotension, impaired gastrointestinal motility, sinus dysrhythmia and secretomotor changes. A concentric electromyography needle placed in the right cavernous body was used to record corpus cavernosum electromyography and evoked cavernous activity. The right median nerve was stimulated electrically with 13 to 16 mA. to determine evoked cavernous activity and the penile sympathetic skin response. The latter response was recorded with silver disc electrodes placed on the left cavernous body. All tests were performed using an electromyography/ evoked potential machine. We determined the relationships among corpus cavernosum electromyography, evoked cavernous activity and penile sympathetic skin response tests in respect to etiological factors. Results: The 56 patients with normal corpus cavernosum electromyography activity had also evoked cavernous activity and a penile sympathetic skin response except for 1 with no penile sympathetic skin response but evoked cavernous activity. None of these patients had autonomic neuropathy. Of the 19 patients without corpus cavernosum electromyography activity 11 had evoked cavernous activity, including 10 with no autonomic neuropathy. The remaining 8 patients had no evoked cavernous activity, of whom 7 had autonomic neuropathy. A penile sympathetic skin response was recorded in 18 men with absent corpus cavernosum electromyography. Conclusions: Due to false-negative results on corpus cavernosum electromyography and penile sympathetic skin response testing evoked cavernous activity seems more reliable for determining autonomic involvement in the pathophysiology of erectile dysfunction.Öğe Percutaneous nephrolithotomy for pediatric stone disease - Our experience with adult-sized equipment(Informa Healthcare, 2003) Gunes, A; Ugras, MY; Yilmaz, U; Baydinc, C; Soylu, AObjective: We evaluated the outcomes and complications of percutaneous nephrolithotomy (PNL) operations performed in pediatric patients using adult-sized surgical equipment at our center. Material and Methods: The medical and surgical records of 23 children who underwent a total of 25 PNL operations using 24 or 26 F rigid nephroscopes were evaluated retrospectively. The following aspects were considered: stone burden; duration of surgery and complications; details concerning recovery, success, residual fragments and auxiliary procedures; and follow-up details. Results: The success rate of a single PNL session was 70.8%; with the use of auxiliary procedures this was increased to 91.6%. Perioperative and early postoperative complications were excessive bleeding and transfusion in two patients, hydro-pneumothorax in one, perforation of the collecting system in three and urinoma in one. Complications were more common in children aged <7 years or with staghorn stones. The mean time to catheter removal was 3.4 days and the mean hospitalization time was 4.8 days. Idiopathic hypercalciuria, hypocitraturia, cystinuria and hyperoxaluria were diagnosed in two, two, one and three patients, respectively. Conclusion: Performing PNL with adult-sized equipment is associated with significant complications in children aged <7 years or with staghorn stones. This treatment should not be considered in routine clinical practice. As all stone-removal methods are associated with complications, PNL should be used only if other methods fail or are unavailable.Öğe The postejaculatory refractory period: a neurophysiological study in the human male(Blackwell Science Ltd, 2000) Yilmaz, U; Aksu, MObjective To investigate changes in the penile sensory threshold, and the variables of cortical somatosensory evoked potential and sacral evoked response tests in the early postejaculatory period in the human male. Subjects and methods Twenty healthy volunteers (mean age 25.3 years, range 17-32) were evaluated before and after ejaculation for penile sensory threshold values, and the variables of sacral evoked response and cortical somatosensory evoked potential tests. Results Three subjects were excluded from the statistical analyses because there were significant differences among the repeated tests. In the remaining 17 subjects the penile sensory threshold was significantly greater in the postejaculatory period (P<0.05). There were no significant changes in the other variables of both the sacral evoked response and cortical somatosensory evoked potential tests after ejaculation (P>0.05). Conclusion The postejaculatory refractory period in the human male is accompanied by a greater penile sensory threshold but with no change in the values of the sacral evoked response and cortical somatosensory evoked potential.Öğe Re: Transcutaneous electrocavernosography: A tool for recording the electromyographic activity of the corpora cavernosa(Lippincott Williams & Wilkins, 2006) Yilmaz, U; Soylu, A[Abstract Not Available]Öğe Role of penile electrodermal activity in the evaluation of autonomic innervation of corpus cavernosum(Nature Publishing Group, 2004) Soylu, A; Yilmaz, U; Ozcan, C; Sarier, M; Baydinc, CElectrodiagnostic tests measuring the activities of cavernous smooth muscle and sudomotor structures of penile skin are used in order to evaluate autonomic innervation of the penis. Owing to closeness of these tissues, the interference of sympathetic activity during recording is a possibility. In this study, we investigated this possibility in 10 patients whose cavernosal tissues were destroyed during penile prosthesis implantation by comparing the pre- and postoperative penile skin electrodermal activities. Penile electrodermal activities were recorded with surface electrodes before and after the operation. All of the patients had spontaneous and evoked penile electrodermal activity (EDA). The mean amplitude of evoked EDA decreased from 2159 +/- 700 to 1413 +/- 515 muV following penile prosthesis surgery ( P = 0.017). The decrease in the amplitude of penile-evoked EDA following penile prosthesis implantation suggests the contribution of cavernous smooth muscle activity to the sudomotor responses prior to operation. Although corpus cavernosum sympathetic activity contributes to the penile skin recordings, these recordings are mostly the result of penile skin sudomotor sympathetic activity. Therefore, surface potentials recorded from penile skin should not be used for the evaluation of autonomic innervation of corpus cavernosum.Öğe Sympathetic skin responses in type-1 diabetic children: Relationship to urodynamic findings(Wiley, 2006) Soylu, A; Akinci, A; Yilmaz, U; Sarier, M; Aslan, M; Oman, CAims: Cystopathy is an important problem in diabetes mellitus (DM) when diabetes is not well-controlled. In most cases of diabetic csytopathy, autonomic involvement is responsible, which develops insidiously over a long time. We investigated the hand and genital sympathetic skin responses (SSRs) and its relation to urodynamic abnormalities in this group of patients. Methods: We performed hand and genital SSRs in 24 children with Type-1 DM,whose hemoglobin A1C values were above normal limits. We also recruited 19 healthy children for SSRs measurements. Cystometry was performed in 24 children with Type-1 DM. Based on cystometry findings, these children were classified into two groups as normal (n:6) and abnormal (n:18). The amplitude and latency of hand and genital SSRs of 24 children with Type-1 DM and 19 healthy children were compared. Results: Hand and genital SSRs were obtained from all of the diabetic and healthy children. The mean genital SSRs amplitude in diabetic children was significantly lower than the controls. There was no difference in the mean values of all investigated parameters between the normal group and controls. When compared to the controls, there was prolonged latency and decreased amplitude of genital SSRs and decreased hand SSRs amplitude in abnormal group. Conclusions: SSR is a non-invasive test for the evaluation of autonomic sympathetic involvement. Our study revealed differences in genital SSR before the manifestations of cystopathy. Children with abnormal urodynamic findings had changes in both hand and genital SSRs. These findings suggest that SSR tests may have a place in the evaluation of diabetic cystopathy in the early asymptomatic period.Öğe Urothelial carcinoma featuring lipid cell and plasmacytoid morphology with poor prognostic outcome(Elsevier Science Inc, 2005) Soylu, A; Aydin, NE; Yilmaz, U; Kutlu, R; Günes, AAn aggressive urothelial carcinoma classified as lipid cell variant with plasmacytoid features was diagnosed in a 67-year-old man. His overall survival was 18 months after limited surgery followed by chemotherapy. The histopathologic features were the same in the recurrences. (c) 2005 Elsevier Inc.
