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Kilicarslan N, Demir A, Yeni S, Cicek MC, Saricetin A, Dirican M. The danger of hyperoxia on the rat kidneys: is tadalafil a real shield? Int Urol Nephrol 2023; 55:241-247. [PMID: 36443608 PMCID: PMC9707269 DOI: 10.1007/s11255-022-03416-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 11/14/2022] [Indexed: 12/02/2022]
Abstract
PURPOSE Continuous oxygen therapy to compensate for decreased oxygen saturation in the blood is a life-saving treatment used in case lung involvement. Excess oxygen delivery was reported to be a common situation, in which about 50% of the patients showed hyperoxemia and 4% in severe hyperoxemia. In this work, we investigated the effects of hyperoxia on the rat kidneys and whether tadalafil has an effect to reduce this damage. MATERIALS AND METHODS Three groups of 8 male rats each weighing 300-350 g were formed. The groups were divided into the control group, hyperoxia group, and hyperoxia and tadalafil administered group for 10 days. At the end of the 10th day, blood and kidney samples were taken for biochemical analysis (SOD and NO levels) and histopathological examination. RESULTS While our findings showed that SOD levels were significantly different among the control and experimental groups and within the experimental groups, no statistical difference was found in terms of NO levels among the groups (Table 1). While the glomerular and tubular injury was higher in the Hyperoxia group and the Hyperoxia + Tadalafil group than in the control group (p < 0.001), as a result of the rate of severe glomerular and tubular injury in the hyperoxia group, was 62.5% and 43.8% and in the group given tadalafil was 43.8% and 31.3%, respectively (Table 2). CONCLUSIONS Exposure to hyperoxia condition causes renal glomerular and tubular damage, and tadalafil does not show a protective effect on this damage according to this study's dose and exposure time.
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Affiliation(s)
- Nermin Kilicarslan
- Anesthesia Department, Bursa Yüksek İhtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Aslan Demir
- Urology Department, Medical Faculty, Dragos Hospital, Bezmialam Foundation University, Dragos Hastanesi, Sahil Yolu Sok. No: 16 Maltepe, 34844, Istanbul, Turkey.
| | - Sezgin Yeni
- Urology Department, Medical Faculty, Bursa Uludag University, Bursa, Turkey
| | | | - Aysun Saricetin
- Pathology Department, Veterinary Faculty, Bursa Uludag University, Bursa, Turkey
| | - Melahat Dirican
- Biochemistry Department, Medical Faculty, Bursa Uludag University, Bursa, Turkey
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Yeni S, Demir A, Kilicarslan N, Cicek MC, Saricetin A, Dirican M, Ertan E. Tadalafil against hyperoxia-induced oxidative stress; an experimental study. Andrologia 2022; 54:e14494. [PMID: 35676072 DOI: 10.1111/and.14494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/17/2022] [Accepted: 05/23/2022] [Indexed: 11/28/2022] Open
Abstract
This study aimed to investigate the protective effect of tadalafil on reactive oxygen species induced by a hyperoxia model in rats, both in terms of enzymes such as superoxide dismutase (SOD) and nitric oxide (NO), and its pathological effects on the corpus cavernosum. Overall, 24 rats were divided into three groups. The control group (eight rats) was not exposed to any intervention. The second group (eight rats), was exposed to hyperoxia in a hyperoxia cabinet for 8 h a day for 10 days. The third group (eight rats) was exposed to hyperoxia the same as in the second group, tadalafil at a dose of 10 mg/kg was given orally as a dissolved form in water in the amount of 10-12 ml/100 g/day to the rats placed in separate cages having removed from the hyperoxia cabin. SOD levels differ enough to create a difference, but there was no significant difference in terms of NO levels. The SOD level was highest in hyperoxia conditions and lowest in the group given tadalafil. While corpus cavernosum hyperemia was found to be higher statistically in the experimental groups than in the control group, we found that the severity of hyperemia was less in the group given tadalafil. The corpus cavernosum was found to be statistically more dilated in the experimental groups than in the control group. We determined that hyperoxia status increased the level of SOD and this level decreased with tadalafil administration, which would make a statistical difference.
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Affiliation(s)
- Sezgin Yeni
- Medical Faculty, Urology Department, Bursa Uludag University, Bursa, Turkey
| | - Aslan Demir
- Medical Faculty, Urology Department, Bezmialem Vakıf University, İstanbul, Turkey
| | - Nermin Kilicarslan
- Bursa Yüksek İhtisas Training and Research Hospital, Anesthesia Department, University of Health Sciences, Bursa, Turkey
| | | | - Aysun Saricetin
- Veterinary Faculty, Pathology Department, Bursa Uludag University, Bursa, Turkey
| | - Melahat Dirican
- Medical Faculy, Biochemistry Department, Bursa Uludag University, Bursa, Turkey
| | - Erol Ertan
- Medical Faculy, Anatomy Department, Bursa Uludag University, Bursa, Turkey
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Kaygısız O, Yeni S, Turan L, Cicek MC, Coskun B, Kilicarslan H. Ureterorenoscopic lithotripsy for pediatric kidney stones using Holmium: YAG laser devices: 15 W versus 30 W. J Endourol 2022; 36:916-920. [PMID: 35166132 DOI: 10.1089/end.2021.0922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction We aimed to compare the effectiveness of 15Watt (W) and 30 W Holmium: yttrium-aluminum-garnet (Ho: YAG) laser devices used in the treatment of pediatric kidney stones. Methods: Eighty-six consecutive pediatric patients who underwent retrograde intrarenal surgery between February 2010 and August 2020 were enrolled in the study. After exclusion criteria, the data of 79 children were evaluated retrospectively. Patients were divided into two groups according to the laser device power 15W (Group 15: N=30) and 30W (Group 30: N=49). The groups were compared according to demographic, stone feature, and clinical efficacy. Results The age, gender, height, weight, stone characteristics were similar between the groups. The mean operation time was shorter in Group 30. The stone-free rate after the first RIRS session (SF1) was 66.7% in Group 15 and 83.3% in Group 30. SF1 rate after the first RIRS procedure for 20 mm or larger kidney stones was found 0% in Group 15 and 62.5% in Group 30. However, there was no statistically significant difference between the two groups in terms of stone-free rate. Conclusion: In pediatric kidney stone treatment, 30 W Ho:YAG laser devices should be preferred as they shorten the operation time compared to 15 W devices and provide final stone-free with fewer procedures, especially in large kidney stones.
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Affiliation(s)
- Onur Kaygısız
- Bursa Uludağ University, Faculty of Medicine, Urology, Bursa, Turkey;
| | - Sezgin Yeni
- Bursa Uludag University, 37523, Bursa Uludag University Faculty of Medicine Hospital, Department of Urology, Bursa, Turkey, 16059;
| | - Levent Turan
- Bursa Uludağ University, Faculty of Medicine, Urology, Bursa, Turkey;
| | | | - Burhan Coskun
- Bursa Uludag University, Faculty of Medicine, urology, Bursa, Turkey;
| | - Hakan Kilicarslan
- Bursa Uludag University, Faculty of Medicine, Urology, Bursa, Turkey;
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Kırlı EA, Bülbül E, Kaygısız O, Yeni S, Can G, Tutar O, Onal B. Ureteral wall thickness at the stone site: A critical predictor of success and complications in children undergoing semi-rigid ureteroscopy. J Pediatr Urol 2021; 17:796.e1-796.e8. [PMID: 34750075 DOI: 10.1016/j.jpurol.2021.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/03/2021] [Accepted: 10/07/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We retrospectively assessed the role of ureteral wall thickness (UWT) at the ureteral stone site in predicting the stone-free status and the complication rates in children undergoing semi-rigid ureterorenoscopy (URS). PATIENTS AND METHODS The children who underwent URS and had undergone non-contrast abdominal computerized tomography before the URS were included in the study. The following protocol was used to determine the outcome. Immediately before removing the stent, all children were evaluated by ultrasound (US) and plain film (KUB) for residual stones in the upper urinary tract and after removing the double J stent, the presence of stone fragments in the ureter was checked with URS. The children were considered stone-free if no residual fragments were identified in radiologic imaging and the evaluation of the ureter by URS. The case was accepted as a failure if any fragments were seen on immediate US, KUB, and/or during URS just after the stent removal. The patients who could not complete the standard primary URS procedure due to stone-related reasons (patients for whom we could not pass the safety guidewire behind the stone and/or the procedure was terminated due to pyuria during the procedure) were also accepted as a failure. The possible factors related to the patient, stone, ureter, and the operation that could affect the outcome and the complications following the URS were evaluated. RESULTS The children's median age was six years (1-17 years). Among the 89 children included in the study, 69 (78%) were stone-free, and 20 (22%) presented residual stone after the first URS session. The ROC analysis revealed that a UWT value of 4.5 mm (sensitivity 60%, specificity 92%) was the optimal cut-off value predictive of the URS outcome. The regression analysis revealed UWT >4.5 mm (p = 0.006) and multiple stone presentation (p = 0.005) as independent risk factors for residual stone. Complications were detected in 15 (17%) children. Thick ureteral wall (p = 0.012) and longer operative time (p = 0.016) were defined as the independent risk factors for complications. DISCUSSION Increased UWT is associated with the adverse outcomes of URS due to tissue hypertrophy, edema, and mucosal bleeding may cause difficulty in removing the stone. The thick ureteral wall might increase the risk of complications due to the necessity of manipulating the instruments or the involuntary forceful use of instruments while removing the stone. CONCLUSION UWT was the only independent variable affecting both increased failure and complication rates in children undergoing URS.
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Affiliation(s)
- Elif Altınay Kırlı
- Istanbul University- Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Urology, Turkey.
| | - Emre Bülbül
- Istanbul University- Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Urology, Turkey.
| | - Onur Kaygısız
- Uludağ University Faculty of Medicine Department of Urology, Turkey.
| | - Sezgin Yeni
- Uludağ University Faculty of Medicine Department of Urology, Turkey.
| | - Günay Can
- Istanbul University- Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Public Health, Turkey.
| | - Onur Tutar
- Istanbul University- Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Radiology, Turkey.
| | - Bulent Onal
- Istanbul University- Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Urology, Turkey.
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Gunseren KO, Cicek MC, Bolat D, Yeni S, Vuruskan H, Oz Gul O, Yavascaoglu I. Is laparoscopic adrenalectomy for pheochromocytoma safe and effective in geriatric patients? Int J Clin Pract 2021; 75:e14427. [PMID: 34081829 DOI: 10.1111/ijcp.14427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 05/24/2021] [Accepted: 05/27/2021] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES The study aimed to assess the haemodynamic changes of laparoscopic adrenalectomy (LA) in geriatric patients with pheochromocytoma (PHEO). To the best of our knowledge, this is the first study to evaluate the haemodynamic outcomes of LA in this patient population. METHODS Data of 350 patients who underwent single-side transperitoneal LA between 2000 and 2020 were reviewed retrospectively. Patients with a histopathological diagnosis of PHEO were included in the study and classified into two groups according to their ages at the date of surgery. Patients older than 65 years were accepted as elderly according to the World Health Organisation (WHO) recommendations. RESULTS A total of 54 patients underwent LA for PHEO. Fifteen patients were enrolled in the elderly and 39 in the young groups. There were no significant differences in terms of the operation site (0.564), tumour size (0.878), perioperative results such as mean anaesthesia; operation times, blood loss and haemodynamic changes. There were no significant differences in mean hospitalisation and intensive care unit times. One patient in both groups had grade 1 complication according to Clavien Dindo classification (prolonged ileus, managed with medical treatment and transfusion during surgery, respectively). CONCLUSION Young and elderly patients had similar outcomes in terms of haemodynamic changes that occurred with LA. LA in elderly patients with PHEO is as safe and effective as in younger patients.
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Affiliation(s)
- Kadir Omur Gunseren
- Department of Urology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Mehmet Cagatay Cicek
- Department of Urology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Deniz Bolat
- Department of Urology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Sezgin Yeni
- Department of Urology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Hakan Vuruskan
- Department of Urology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Ozen Oz Gul
- Department of Endocrinology and Metabolism, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Ismet Yavascaoglu
- Department of Urology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
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Bülbül E, Kırlı E, Kaygısız O, Yeni S, Can G, Tutar O, Onal B. Ureteral wall thickness at the stone site: A critical predictor of success and complications in children undergoing semi-rigid ureteroscopy. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01441-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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