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Öğe Bilateral simultaneous percutaneous nephrolithotomy: Our initial experience(2003) U?raş M.Y.; Güneş A.; Yilmaz U.; Soylu A.; Baydinç C.Introduction: Percutaneous nephrolithotomy is a minimally invasive method of stone disease surgery, defined in 1976 and is being applied for a variety of indications since than. This surgery is a routine in our clinic for treatment of one kidney in a single session for adults and children since 1998. In May 2001, we have performed our first bilateral simultaneous percutaneous nephrolithotomy operation. In this manuscript, we have evaluated our surgical results in patients who underwent this operation, regarding surgical outcomes, success and complication rates and secondary methods of treatment for residual fragments. We have also investigated renal functional changes in early postoperative period by means of renal functional tests. Material and Methods: We have evaluated success, complication, auxiliary and secondary procedure rates, catheterization and hospitalization times in six patients who underwent this operation. At the same time, we noted BUN and creatinine changes between preoperative period and 6th and 48th postoperative hours. A fragment that is 4mm in largest diameter was rendered as "clinically insignificant". We have also summarized our experience in patients who underwent surgery for one kidney at a single session, with special emphasis on success and complications in a table. Since the data is not suitable, we did not perform any statistical tests for comparison. Results: Four of the 12 renal units had staghorn and another four had multiple stones initially. Mean stone surface area was 542 mm2 and 568 mm2 in right and left kidneys, respectively. Nine kidneys were operated via single nephrostomy tract while two and three tracts were created for two and one kidney units, respectively. In four renal units, at least one nephrostomy tract needed to be created between 11th and 12th ribs. Of the six patients operated, four rendered stone free or with clinically insignificant stone fragments in both kidneys. Of the patients with residual stone fragments, one was cleared by ESWL followed by ureterorenoscopy. So, our initial success rate was 66,6% and success after secondary procedures was 83,3%. A residual stone fragment persisted in one patient. Mean time of surgery was 225 minutes and mean hemoglobin decrease was 2,75 mg/ml. The second side was operated at a mean of 80 minutes. Mean body temperature decrease was 1,7°C during the operation. One patient needed blood transfusion. Measurements at 6th postoperative hour revealed a mild increase in BUN and creatinine in three patients, but no clinical sign of renal insufficiency was ever realized in any patients. These changes returned to preoperative values at 48th hour. Mean time of urethral catheterization was 1 day and mean time to nephrostomy removal was 3,6 days. Patients were hospitalized for a mean of 5,5 days. Conclusion: Although we have experience in unilateral operations, bilateral simultaneous operation is a new and limited experience for us; larger series may be more suitable to derive strict knowledge on efficacy and safety. Our data reveals that bilateral simultaneous percutaneous nephrolithotomy may be a safe and efficient operation in patients with suitable indications and with experienced surgeons.Öğe Case report: Percutaneous nephrolithotomy for an ectopic kidney with stone disease(Akademiai Kiado Rt., 2002) Güneş A.; U?raş M.; Yilmaz U.; Bozkurt A.; Gürpinar T.[No abstract available]Öğe Comparison of efficiency and safety of two rigid ureterorenoscopes with different sizes(2003) U?raş M.; Güneş A.; Kiliç S.; Yilmaz U.; Baydinç Y.C.Introduction: Ureterorenoscopes with different features are being produced by various companies for the treatment of ureteric stone disease. Independent and objective evaluations of efficiency and safety are needed for these equipments while purchasing. Material and Methods: Retrospective evaluation of 142 and 115 operations for ureteric stones using 11.5F and 10F rigid ureterorenoscopes respectively was done, noting stone free rates, application of intracorporeal lithotripsy, need for auxilary procedures or open surgery and complications. Efficiency coefficient (EC) was calculated for each equipment, and inter-group statistical analysis was performed. Results: The ureterorenoscope with a smaller diameter had a higher EC, lower need for auxilary procedures and open surgery. Complications showed different dispersion for each equipment and only some of them revealed statistical significance. Conclusion: We think that ureterorenoscopes with smaller diameter are more efficient and safe, but may have some unexpected complications. Although not mentioned in this article, it should be considered that knowledge, experience and habits of the surgeon are as much effective as these objective criteria on the results.Öğe Crystal structure of dichlorobis[1-pentyl-1H-benzimidazole-?N3]cobalt(II)(Japan Society for Analytical Chemistry, 2007) Akkurt M.; Pinar S.; Yilmaz U.; Küçükbay H.; Şahin E.The title compound, CoCl2(C12H16N2)2, was synthesized from 1-pentylbenzimidazole and cobalt dichloride in ethanol. It crsytalizes in the trigonal space group R-3. The unit-cell parameters at room temperature are a=26.9966(2), c=18.7665(2)Å, V=11844.92(18)Å3, Dx=1.278 g/cm3, Z = 18. The crystal structure is stabilized by intermolecular C7-H7···Cl1 hydrogen interactions. 2007 © The Japan Society for Analytical Chemistry.Öğe Effects of glucagon as a neurohormone on the central nervous system and glucose homeostasis(Verduci Editore s.r.l, 2024) Tanbek K.; Yilmaz U.; Gul S.; Koç A.; Gul M.; Sandal S.OBJECTIVE: This study aimed to elucidate the possible effects of the acute/ long-term infusion of glucagon in the brain as the regulatory role on the endocrine secretions of the pancreas. MATERIALS AND METHODS: Ninety male Wistar albino rats were divided as Control, artificial Cerebrospinal Fluid (aCSF) (120 min), Glucagon (120 min), pancreatic denervation (PD)+aCSF (120 min), PD+Glucagon (120 min), aCSF (7 days), Glucagon (7 days), PD+aCSF (7 days) and PD+Glucagon (7 days). Glucagon and solvent (aCSF) were administered after pancreatic denervation (PD) by Hamilton syringe and osmotic mini pump (1 µg/10 µl/min) in the third ventricle of the brain. RESULTS: Acute intracerebroventricular (icv) administration of glucagon resulted in an elevation of glucagon levels and a concurrent reduction in blood glucose levels. Furthermore, in both the PD+aCSF (7 days) and PD+Glucagon (7 days) groups, there was a notable decrease in propiomelanocortin (POMC) and agouti-related protein (AgRP). Significant changes were observed in feed consumption and body weight, as well as pancreatic glucagon levels, with a simultaneous decrease in insulin levels in the PD (7 days), Glucagon (7 days), and PD+Glucagon (7 days) groups. These alterations were statistically significant when compared to the control group (p<0.05). CONCLUSIONS: The research outcomes established that pancreas-secreted glucagon functions as a neurohormone within the brain, activating central pathways linked to blood glucose regulation. The presence of glucagon led to a decrease in POMC levels. Surprisingly, this reduction in POMC resulted in the suppression of AgRP. Contrary to expectations, the suppression of AgRP led to an increase in food intake rather than a decrease. As already highlighted in the results section, it was emphasized that POMC may play a more significant role than AgRP in influencing feeding behavior. © 2024 Verduci Editore s.r.l. All rights reserved.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 Investigation of the Effect of Astaxanthin on Autophagy in Renal Ischemia-reperfusion Modeled Rats(Galenos Publishing House, 2024) Kisaoglu A.; Kose E.; Yilmaz N.; Tanbek K.; Yildiz A.; Yilmaz U.; Cirik R.H.Objective: The aim of this study was to investigate the effect of various astaxanthin (ATX) doses on oxidative damage and autophagy in renal ischemia-reperfusion (I/R) injury-modeled rats. Methods: The rats were divided into five groups: sham group (n=8), I/R (n=8), I/R + 5 mg/kg ATX (n=8), I/R + 10 mg/kg ATX (n=8), and I/R + 25 mg/ kg ATX (n=8) groups. ATX was dissolved in 5 mg/kg, 10 mg/kg, and 25 mg/ kg olive oil for 7 days and administered to the rats in the experimental group. Sham and I/R groups were also administered ATX solution (olive oil) via oral gavage for 7 days. Renal ischemia reperfusion was induced in all rats except the sham group after the last dose was administered on the 7th day. Reperfusion was conducted for 24 hours after 45 minutes of ischemia. Results: Blood samples were collected, and kidney tissue were incised for biochemical and histological analyses. Superoxide dismutase (SOD) and total antioxidant status (TAS) were significantly lower in the I/R group than in the sham group (p<0.05), whereas malondialdehyde (MDA) and total oxidant status (TOS) values were higher (p<0.05). It was determined that SOD and TAS increased and MDA and TOS decreased in the ATX-administration groups compared with the I/R group, independent of the dose (p<0.05). In the 25 mg/kg ATX + I/R group, Beclin-1 and LC3? immunoreactivities were significantly higher than those in the other groups (p<0.05). The lowest p62 immunoreactivity was observed in the 25 mg/kg ATX + I/R group. Conclusions: ATX had a protective effect on kidney function and against oxidative damage. Furthermore, high-dose ATX administration protected kidney tissue via autophagy induction in this study. © 2024 The Author.Öğe Single session endoscopic management of intrinsic ureteropelvic junctionobstruction and concomitant renal stone disease in a child: A case report(BioMed Central Ltd., 2002) Ugras M.; Gunes A.; Yilmaz U.; Baydinc C.Background: Percutaneous nephrolithotomy is a well known therapeutic modality for stone diseases of childhood. Antegrade and retrograde endopyelotomies are also well defined options of treatment for secondary ureteropelvic junction obstruction. Yet there are few reports regarding endoscopic therapy of intrinsic ureteropelvic junction obstruction. To our knowledge, there exist only a few reports of endosurgical treatment of children with stone disease and with concomitant intrinsic ureteropelvic junction obstruction, in the literature. Case presentation: We present the endoscopic management of stone disease and concomitant intrinsic ureteropelvic junction obstruction of a child in one session. Conclusion: Percutaneous nephrolithotomy and antegrade endopyelotomy is combined safely with successful outcome in a child.
