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Gul OO, Sisman P, Cander S, Sarandol E, Ersoy C, Erturk E. PLASMA NEPRILYSIN LEVELS IN PATIENTS WITH POLYCYSTIC OVARY SYNDROME. Acta Endocrinol (Buchar) 2022; 18:35-39. [PMID: 35975244 PMCID: PMC9365417 DOI: 10.4183/aeb.2022.35] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
CONTEXT Insulin resistance has been detected in a majority of patients with polycystic ovary syndrome (PCOS). Elevated neprilysin levels are associated with insulin resistance. OBJECTIVE The present study aims to investigate plasma neprilysin and its relationship with endocrine and metabolic characteristics in patients with PCOS. SUBJECTS AND METHODS Thirty-five premenopausal PCOS patients and 35 healthy volunteers of similar age were included in the study. Demographic characteristics, biochemical and hormonal findings and also plasma neprilysin levels were determined in these patients and healthy controls. RESULTS In our study, HOMA-IR values were significantly higher in PCOS patients (3.3 ± 1.8) compared with the controls [(1.6 ± 1), p<0.01]. Plasma neprilysin levels were significantly higher in the PCOS group compared to the control group (1502.1 ± 1641.2 vs. 764.6 ± 562.6 pg/mL). There was no difference in plasma neprilysin levels when PCOS patients were classified as overweight-obesity (BMI≥25kg/m2) or non-obesity (BMI<25kg/m2). CONCLUSION Our findings revealed significantly higher levels for plasma neprilysin and HOMA-IR values in PCOS patients when compared to controls. No significant differences were noted between obese PCOS patients and non-obese PCOS patients in terms of plasma neprilysin levels.
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Affiliation(s)
- O. Oz Gul
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
| | - P. Sisman
- Medicana Hospital, Endocrinology and Metabolism Clinic, Bursa, Turkey
| | - S. Cander
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
| | - E. Sarandol
- Uludag University Medical School, Department of Biochemistry, Bursa, Turkey
| | - C. Ersoy
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
| | - E. Erturk
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
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Sisman P, Avci M, Akkurt A, Sahin AB, Gul OO, Ersoy C, Erturk E. The effect of primary hyperparathyroidism on pancreatic exocrine function. J Endocrinol Invest 2018; 41:293-298. [PMID: 28770447 DOI: 10.1007/s40618-017-0727-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 10/31/2016] [Accepted: 06/29/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Elastase-1 is a proteolytic enzyme secreted by pancreatic acinar cells, and measurements of the concentration this enzyme are used to evaluate pancreatic exocrine function. We aimed to determine whether pancreatic exocrine function declines due to chronic hypercalcemia by measuring fecal elastase levels. METHODS 75 patients with primary hyperparathyroidism (18 men and 47 women) and 30 healthy subjects (11 men and 19 women) participated in this study. Renal function tests, lipid parameters, bone mineral density, and serum calcium, phosphorus, vitamin D, parathormone, glucose, and thyroid stimulating hormone levels as well as fecal elastase concentrations, were determined in these patients and controls. RESULTS The mean fecal elastase level was 335.3 ± 181.4 μg/g in the PHPT group and 317.4 ± 157.3 μg/g in the control group. There was no significant difference in fecal elastase levels between the two groups (p = 0.5). CONCLUSIONS Chronic hypercalcemia in primary hyperparathyroidism did not decrease the fecal elastase level, which is an indirect indicator of chronic pancreatitis; therefore, chronic hypercalcemia in PHPT may not cause chronic pancreatitis.
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Affiliation(s)
- P Sisman
- Endocrinology and Metabolism Clinic, Harakani State Hospital, Kars, Turkey.
| | - M Avci
- Department Of Internal Medicine, Uludag University Medical School, Bursa, Turkey
| | - A Akkurt
- Endocrinology and Metabolism Clinic, Muradiye State Hospital, Bursa, Turkey
| | - A B Sahin
- Department Of Internal Medicine, Uludag University Medical School, Bursa, Turkey
| | - O O Gul
- Department of Endocrinology and Metabolism, Uludag University Medical School, Bursa, Turkey
| | - C Ersoy
- Department of Endocrinology and Metabolism, Uludag University Medical School, Bursa, Turkey
| | - E Erturk
- Department of Endocrinology and Metabolism, Uludag University Medical School, Bursa, Turkey
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Ongen Z, Erturk E, Kilickiran Avci B, Kucur M, Karadag B. P908Evaluation of pre and post-procedure high sensitive cardiac troponin T values in patients undergoing elective coronary angiography. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p908] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Tanriverdi F, Dokmetas HS, Kebapcı N, Kilicli F, Atmaca H, Yarman S, Ertorer ME, Erturk E, Bayram F, Tugrul A, Culha C, Cakir M, Mert M, Aydin H, Taskale M, Ersoz N, Canturk Z, Anaforoglu I, Ozkaya M, Oruk G, Hekimsoy Z, Kelestimur F, Erbas T. Etiology of hypopituitarism in tertiary care institutions in Turkish population: analysis of 773 patients from Pituitary Study Group database. Endocrine 2014; 47:198-205. [PMID: 24366641 DOI: 10.1007/s12020-013-0127-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [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: 09/23/2013] [Accepted: 11/13/2013] [Indexed: 02/02/2023]
Abstract
Hypopituitarism in adult life is commonly acquired and the main causes are known as pituitary tumors and/or their treatments. Since there are new insights into the etiology of hypopituitarism and presence of differences in various populations, more studies regarding causes of hypopituitarism are needed to be done in different ethnic groups with sufficient number of patients. Therefore, we performed a multi-center database study in Turkish population investigating the etiology of hypopituitarism in 773 patients in tertiary care institutions. The study was designed and coordinated by the Pituitary Study Group of SEMT (The Society of Endocrinology and Metabolism of Turkey). Nineteen tertiary reference centers (14 university hospitals and 5 training hospitals) from the different regions of Turkey participated in the study. It is a cross-sectional database study, and the data were recorded for 18 months. We mainly classified the causes of hypopituitarism as pituitary tumors (due to direct effects of the pituitary tumors and/or their treatments), extra-pituitary tumors and non-tumoral causes. Mean age of 773 patients (49.8 % male, 50.2 % female) was 43.9 ± 16.1 years (range 16-84 years). The most common etiology of pituitary dysfunction was due to non-tumoral causes (49.2 %) among all patients. However, when we analyze the causes according to gender, the most common etiology in males was pituitary tumors, but the most common etiology in females was non-tumoral causes. According to the subgroup analysis of the causes of hypopituitarism in all patients, the most common four causes of hypopituitarism which have frequencies over 10 % were as follows: non-secretory pituitary adenomas, Sheehan's syndrome, lactotroph adenomas and idiopathic. With regard to the type of hormonal deficiencies; FSH/LH deficiency was the most common hormonal deficit (84.9 % of the patients). In 33.8 % of the patients, 4 anterior pituitary hormone deficiencies (FSH/LH, ACTH, TSH, and GH) were present. Among all patients, the most frequent cause of hypopituitarism was non-secretory pituitary adenomas. However, in female patients, present study clearly demonstrates that Sheehan's syndrome is still one of the most important causes of hypopituitarism in Turkish population. Further, population-based prospective studies need to be done to understand the prevalence and incidence of the causes of hypopituitarism in different countries.
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Affiliation(s)
- F Tanriverdi
- Department of Endocrinology, Erciyes University Medical School, 38039, Kayseri, Turkey,
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Erturk E, Cecener G, Egeli U, Tunca B, Tezcan G, Gokgoz S, Tolunay S, Tasdelen I. 398: Evaluation of microRNA expression profiles in triple-negative (ER, PR and Her2/neu) breast cancer patients with and without germ-line BRCA mutations. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50355-3] [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: 11/27/2022]
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Cakmak HA, Erturk E, Ikitimur B, Karadag B. The rare complication of Behcet's syndrome: concomitance of coronary slow flow with acute coronary syndrome. Case Reports 2012; 2012:bcr-2012-006388. [DOI: 10.1136/bcr-2012-006388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Erturk E, Cecener G, Tunca B, Egeli U, Tezcan G, Gokgoz S, Tasdelen I, Tolunay S, Alder H, Huebner K. 426 Distinct MiRNA Expression Patterns in Among Breast Tumors of Patients Carried and Non-carried Germ-line BRCA Mutations. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71107-3] [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: 11/25/2022]
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Cakmak H, Erturk E, Cimci M, Ikitimur B, Karadag B, Vural V. VP-002 CONCOMITANCE OF CORONARY SLOW FLOW AND ACUTE CORONARY SYNDROME IN A PATIENT WITH BEHCET'S SYNDROME. Int J Cardiol 2012. [DOI: 10.1016/s0167-5273(12)70225-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kiyici S, Cander S, Oz Gul O, Sigirli D, Kaan Unal O, Duran C, Saraydaroglu O, Ersoy C, Tuncel E, Erturk E, Imamoglu S. Preoperative parathyroid hormone levels are correlated with parathyroid adenoma volume and bone mineral density but not serum calcium levels. MINERVA ENDOCRINOL 2011; 36:123-128. [PMID: 21519321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM The aim of this study was to determine the relationship between biochemical parameters, parathyroid adenoma volume, and bone mineral density with respect to intact parathyroid hormone (iPTH) levels in patients with primary hyperparathyroidism. METHODS Data were collected retrospectively from patients with primary hyperparathyroidism who were diagnosed and followed in our clinic between 2005 and 2008. Forty-eight (female/male=42/6) patients with a mean age of 52.8±13.1 years were enrolled into the study. RESULTS Bone pain was the most common presenting feature, seen in 41.7% of patients, while 29.1% of patients were asymptomatic. The mean serum calcium and iPTH concentrations were 2.9±0.6 mmol/L and 657.1±682 ng/L, respectively. The mean total Z/T scores of dual-energy X-ray absorptiometry (DEXA) scan at the femur and lumbar spine were -0.4±1.6/-1.0±1.7 and -1.4±1.6/-2.2±1.5, respectively. Preoperative iPTH levels were correlated with serum phosphate (r=-0.412, P=0.005), alkaline phosphatase (r=0.698, P=0.0001), and femur (r=-0.402, P=0.020) and lumbar spine total Z scores (r=-0.441, P=0.013), whereas parathyroid adenoma volume was correlated with iPTH (r=0.367, P=0.036) and alkaline phosphatase (r=0.570, P=0.001). There was no correlation between iPTH, serum calcium levels and total T scores at the femur and lumbar spine. After excluding patients with 25-OHD insufficiency, there was still no correlation between serum iPTH and calcium levels. Parathyroid adenoma volume, serum iPTH and calcium levels were also not different between patients with and without 25-OHD insufficiency. CONCLUSION These results suggest that serum iPTH level may be useful in predicting parathyroid adenoma volume and it is also well correlated with femur and lumbar spine Z scores.
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Affiliation(s)
- S Kiyici
- Department of Endocrinology and Metabolism, Uludag University, Medical Faculty, Bursa, Turkey.
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Selimoglu H, Duran C, Kiyici S, Ersoy C, Guclu M, Ozkaya G, Tuncel E, Erturk E, Imamoglu S. The effect of vitamin D replacement therapy on insulin resistance and androgen levels in women with polycystic ovary syndrome. J Endocrinol Invest 2010; 33:234-8. [PMID: 19820295 DOI: 10.1007/bf03345785] [Citation(s) in RCA: 117] [Impact Index Per Article: 8.4] [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] [Indexed: 11/24/2022]
Abstract
Insulin resistance (IR) is one of the common features of the polycystic ovary syndrome (PCOS), and recent studies indicate the possible role of vitamin D in the pathogenesis of IR and glucose metabolism. Aim of this study was aimed to determine the effect of vitamin D replacement therapy on glucose metabolism, insulin, and androgen levels in obese, insulin-resistant women with PCOS. Eleven women with PCOS were included in the study. Mean age of the patients was 23.6+/-5.7 yr, body mass index 33.9+/-5.1 kg/m(2). Six patients (54.5%) had acantosis nigricans and 10 (90.9%) oligoamenorrhea. The mean Ferriman Gallwey score was 14.1+/-4.6. Only 2 women were within the normal limits of vitamin D levels as >20 ng/ml. Three weeks after the administration of the single dose of 300,000 units of vitamin D3 orally, 25-hydroxyvitamin D3 significantly increased from 16.9+/-16 ng/ml to 37.1+/-14.6 ng/ml (p: 0.027) and only 2 women were detected to have vitamin D3 levels <20 ng/ml. Although glucose and insulin levels were decreased non-significantly, homeostasis model assessment (HOMA)-IR significantly decreased from 4.41+/-1.38 to 3.67+/-1.48 (p: 0.043). No significant alterations were witnessed at the levels of DHEAS, total and free testosterone, androstenedione. No correlation was found between vitamin D with HOMA and other hormonal parameters. In conclusion, women with PCOS have mostly insufficient vitamin D levels, and vitamin D replacement therapy may have a beneficial effect on IR in obese women with PCOS.
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Affiliation(s)
- H Selimoglu
- Division of Endocrinology, Malatya State Hospital, Malatya, Turkey
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Kiyici S, Gul OO, Baskan EB, Hacioglu S, Budak F, Erturk E, Imamoglu S. Effect of levothyroxine treatment on clinical symptoms and serum cytokine levels in euthyroid patients with chronic idiopathic urticaria and thyroid autoimmunity. Clin Exp Dermatol 2009; 35:603-7. [DOI: 10.1111/j.1365-2230.2009.03642.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kiyici S, Ersoy C, Oz Gul O, Sarandol E, Demirci M, Tuncel E, Sigirli D, Erturk E, Imamoglu S. Total and Acylated Ghrelin Levels in Type 2 Diabetic Patients: Similar Levels Observed after Treatment with Metformin, Pioglitazone or Diet Therapy. Exp Clin Endocrinol Diabetes 2009; 117:386-90. [DOI: 10.1055/s-0029-1220936] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Cekic B, Geze S, Ulusoy H, Coskun I, Erturk E. Postoperative repeated respiratory insufficiency and thyrotoxicosis in molar pregnancy. Ir J Med Sci 2009; 181:281-3. [PMID: 19350345 DOI: 10.1007/s11845-009-0328-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2008] [Accepted: 03/11/2009] [Indexed: 12/01/2022]
Abstract
Following the removal of a hydatiform mole in a 34-year-old, 14-week pregnant patient, thyrotoxicosis and respiratory insufficiency attacks were twice unexpectedly repeated. The symptoms were resolved with the administration of plasmapheresis, antithyroid and β-blocker drugs and non-invasive mechanical ventilation; however, she was again operated due to prolonged elevated β-hCG.
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Affiliation(s)
- B Cekic
- Department of Anesthesiology and Critical Care, Faculty of Medicine, Farabi Hospital, Karadeniz Technical University, 61080, Trabzon, Turkey
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Duran C, Tuncel E, Ersoy C, Ercan I, Selimoglu H, Kiyici S, Guclu M, Erturk E, Imamoglu S. The investigation of the efficacy of insulin glargine on glycemic control when combined with either repaglinide or acarbose in obese Type 2 diabetic patients. J Endocrinol Invest 2009; 32:69-73. [PMID: 19337019 DOI: 10.1007/bf03345682] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [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] [Indexed: 11/26/2022]
Abstract
Combinations of insulin and oral antidiabetic drugs (OAD) are often prescribed instead of insulin alone. In this study, the effects of insulin glargine (IG) in combination with repaglinide or acarbose on glycemic parameters were investigated. Obese Type 2 diabetic patients with fasting blood glucose (FBG) levels >or= 7.7 mmol/l [corrected] and hemoglobin glycated (A1C) >or=9% under maximal OAD combination therapy were enrolled. Previous therapies were discontinued, and patients were randomized into 2 groups. The combinations of IG and repaglinide were administered to group 1, and of IG and acarbose to group 2 for 13 weeks. Twenty patients in group 1 and 18 patients in group 2 completed the study. A1C levels were significantly decreased from 10.9+/-1.4% to 7.7+/-1.1% in group 1 and 11.0+/-1.4% to 8.1+/-1.4% in group 2. FBG levels were significantly decreased from 11.9+/-2.7 to 7.1+/-2.3 mmol/l in group 1 and 11.1+/-2.5 to 6.8+/-1.4 mmol/l in group 2. Post-prandial glucose levels were significantly decreased from 15.3+/-3.8 to 10.3+/-3.0 mmol/l in group 1 and 14.0+/-3.1 to 8.9+/-2.2 mmol/l in group 2. Intergroup comparisons indicated no significant differences. More weight gain was detected in group 1, compared to the baseline. Symptomatic hypoglycemia incidence was similar in both groups. Severe hypoglycemic attacks were seen in two patients in group 1. Flatulence incidence was higher in acarbose group. Conclusively, repaglinide and acarbose were equally effective when combined with IG for obese Type 2 diabetic patients controlled inadequately with OAD alone. Furthermore, acarbose seems to have advantages over repaglinide concerning weight gain and severe hypoglycemic attacks.
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Affiliation(s)
- C Duran
- Division of Endocrinology, Konya Education and Research Hospital, Meram Konya 42000, Turkey.
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Haberal I, Kaplan M, Zorman Y, Aksoy T, Erturk E, Akyildiz M. Carotid artery disease development after traumatic injury inflicted by a Ram's Horn. Heart Surg Forum 2008; 11:E260-2. [PMID: 18782709 DOI: 10.1532/hsf98.20081020] [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: 11/20/2022]
Abstract
A 36-year-old man presented for treatment of headache, paresthesis, and weakness of his right arm and leg. Examination revealed an atherosclerotic plaque in the left common carotid artery, lying to the left internal carotid artery and resulting in 99% stenosis. The plaque was removed successfully by carotid endarterectomy. Pathological examination of the tissue confirmed the diagnosis of an atherosclerotic plaque. Detailed investigation of risk factors led to the conclusion that the stenosis of the carotid artery was due to blunt trauma caused by an injury that had occurred 30 years previously when the patient was gored by a ram's horn.
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Affiliation(s)
- I Haberal
- Maltepe University School of Medicine, Maltepe, Turkey.
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Senel A, Ukinc O, Erturk E. 725. Comparison of Ropivacaine Versus Ropivacaine + Tramadol or Ropivacaine + Ketamine on Axillary Approach Brachial Plexus Block Anesthesia. Reg Anesth Pain Med 2008. [DOI: 10.1136/rapm-00115550-200809001-00216] [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: 11/04/2022]
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Cengiz M, Erturk E, Dogan A, Ulger S, Colak F, Ozyigit G, Yildiz F, Selek U, Zorlu F. Stereotactic Body Radiosurgery versus Intracavitary Brachytherapy for Cervical Cancer: A Dosimetric Comparison Study. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.183] [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: 11/30/2022]
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Cardin AL, Marshall J, Bhatt S, Erturk E, Wu G, Dogra VS. Antopol-Goldman lesion of the kidney diagnosed by radiology: a case report of observation. Acta Radiol 2008; 49:715-7. [PMID: 18568566 DOI: 10.1080/02841850802056009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Antopol-Goldman lesions are extremely rare and are characterized by subepithelial hematoma in the renal pelvis. There have been at least 28 case reports in the literature, with all being diagnosed histologically after partial or total nephrectomy for a presumed malignancy. We report the first case in the literature to be diagnosed by radiological imaging and followed on an observatory basis.
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Affiliation(s)
- A. L. Cardin
- Department of Radiology and Urology, University of Rochester, Rochester, New York, USA
| | - J. Marshall
- Department of Radiology and Urology, University of Rochester, Rochester, New York, USA
| | - S. Bhatt
- Department of Radiology and Urology, University of Rochester, Rochester, New York, USA
| | - E. Erturk
- Department of Radiology and Urology, University of Rochester, Rochester, New York, USA
| | - G. Wu
- Department of Radiology and Urology, University of Rochester, Rochester, New York, USA
| | - V. S. Dogra
- Department of Radiology and Urology, University of Rochester, Rochester, New York, USA
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Duran C, Ediger D, Ersoy C, Coskun NF, Selimoglu H, Ercan I, Kiyici S, Guclu M, Saglam DA, Erturk E, Tuncel E, Imamoglu S. Frequency of atopy and allergic disorders among adults with Type 1 diabetes mellitus in the southern Marmara region of Turkey. J Endocrinol Invest 2008; 31:211-5. [PMID: 18401202 DOI: 10.1007/bf03345592] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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] [Indexed: 10/25/2022]
Abstract
AIM Autoimmune disorders are considered to be associated with a Th1 immune response whereas allergic diseases with a Th2 response. Studies mainly performed on children revealed conflicting results regarding the association of atopy/allergic disease and autoimmune disorders. Therefore, we aimed to investigate the prevalence of allergic diseases in adult Type 1 diabetic patients. METHODS Eighty-nine Type 1 diabetic patients and 64 controls were enrolled into the study. Skin-prick test and European Community Respiratory Health Survey questionnaire were performed on all cases. Patients who gave at least one positive answer to questions about asthma in the questionnaire underwent pulmonary function test and methacholine challenge test. RESULTS Patients' mean age were similar in diabetic patients and controls (28.2+/-8.9 and 28.1+/-5.2 yr; respectively). In skin-prick test, the rate of positive response to at least one allergen was not significantly different in diabetes (29.2%) and in the control group (31.3%). In European Community Respiratory Health Survey questionnaire, diabetic patients waked up by an attack of cough more than controls did. The rate of physician-diagnosed asthma was similar in both groups. There was no difference between the 2 groups based on the answers of other questions about asthma and other allergic diseases such as allergic rhinitis, eczema, and drug allergy. CONCLUSION We found that atopy frequencies were similar in an adult population of Type 1 diabetic patients and controls. Although asthmatic symptom prevalence is increased in diabetic patients, the incidence of current asthma was similar in both groups.
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Affiliation(s)
- C Duran
- Division of Endocrinology and Metabolism, Konya Education and Research Hospital, Konya, Turkey.
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Erturk E, Bostan H, Geze S, Saracoglu S, Erciyes N, Eroglu A. Total intravenous anesthesia for evacuation of a hydatidiform mole and termination of pregnancy in a patient with thyrotoxicosis. Int J Obstet Anesth 2007; 16:363-6. [PMID: 17459690 DOI: 10.1016/j.ijoa.2006.12.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [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: 05/01/2006] [Revised: 09/01/2006] [Accepted: 12/01/2006] [Indexed: 02/07/2023]
Abstract
Clinical hyperthyroidism is found in approximately 5% of women with a hydatidiform mole, as human chorionic gonadotropin secreted by molar tissue is structurally similar to thyroid-stimulating hormone. A hydatidiform mole occasionally presents with a co-existing viable fetus. Surgical evacuation may be indicated for significant hemorrhage or preeclampsia. Perioperative management in the presence of hyperthyroidism may be complicated by a thyroid storm. We report a case of total intravenous anesthesia with propofol and remifentanil, combined with an esmolol infusion, to control sympathetic hyperactivity during surgery.
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Affiliation(s)
- E Erturk
- Karadeniz Technical University, Medical Faculty, Department of Anesthesiology, Trabzon, Turkey.
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Erturk E, Senel A, Ukinc O, Duman E. 575 COMPARISON OF THE EFFECTS OF ROPIVACAINE VERSUS ROPIVACAINE + TRAMADOL OR ROPIVACAINE + KETAMINE ON AXILLARY APPROACH BRACHIAL PLEXUS BLOCK IN HAND SURGERY. Eur J Pain 2006. [DOI: 10.1016/s1090-3801(06)60578-8] [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: 10/23/2022]
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Joseph JV, Rosenbaum R, Madeb R, Erturk E, Patel HRH. Robotic extraperitoneal radical prostatectomy: an alternative approach. J Urol 2006; 175:945-50; discussion 951. [PMID: 16469589 DOI: 10.1016/s0022-5347(05)00340-x] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2005] [Indexed: 11/15/2022]
Abstract
PURPOSE Laparoscopic radical prostatectomy with or without a robot has been increasingly performed worldwide, primarily using a transperitoneal approach. We report our experience with daVinci(R) robot assisted extraperitoneal laparoscopic radical prostatectomy. MATERIALS AND METHODS A total of 325 patients underwent robot assisted extraperitoneal laparoscopic radical prostatectomy for clinically localized prostate cancer at our center during a 2-year period. Perioperative data, and oncological and functional results were prospectively recorded. RESULTS Perioperative demographics included mean age, PSA and Gleason score, which were 60 years (range 42 to 76), 6.6 ng/ml (range 0.6 to 26) and 6 (range 5 to 9), respectively. Preoperative clinical stage was 81%, 16% and 3% for T1c, T2a and T2b, respectively. Average total operative time was 130 minutes (range 80 to 480). Intraoperative data included a mean blood loss of 196 cc with no open conversions. Bilateral, unilateral and nonnerve sparing prostatectomy was performed in 70%, 24% and 6% of patients, respectively. Of the patients 96% were discharged home within 8 to 23 hours of surgery. Pathological stage was pT2a, pT2b, pT3a and pT3b in 18%, 63%, 14% and 5% of all radical prostatectomy specimens, respectively, with an overall positive surgical margin rate of 13%. Two of 92 patients had positive nodal disease after lymph node dissection. Continence and erectile function were measured. CONCLUSIONS The extraperitoneal approach offers the advantages of improved dexterity and visualization of the robot, while avoiding the abdominal cavity and potential associated morbidity. As surgeons gain more experience with this new technology, the extraperitoneal approach simulating the standard open retropubic technique is likely to gain popularity.
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Affiliation(s)
- J V Joseph
- Section of Laparoscopic and Robotic Surgery, Department of Urology, University of Rochester Medical Center, Rochester, New York 14642-8656, USA.
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Abstract
PURPOSE To characterize the effect of operator experience and type of anesthesia on treatment outcome when switching from the Dornier HM3 to the third-generation Dornier U/50 lithotripter. PATIENTS AND METHODS A population of 370 consecutive patients treated by 15 urologists was divided into two groups. Group I (N = 225) included patients treated during the initial 3 months with our new lithotripter. Group II (N = 145) included patients treated during the last 3 months. Changes were made during the intervening 6 months in focusing technique, anesthesia type, coupling technique, and shockwave delivery. Information was collected regarding success of stone treatment (defined as complete clearance of stone or fragments < 3 mm at 1 month). RESULTS There were no differences between the two groups with regard to age, sex, fluoroscopic time or maximal shockwave intensity used. Group I had a slightly higher percentage of upper ureteral stones (20% v 13%); however, the difference was not significant. Upper ureteral stones in Group II were on average significantly larger (9.4 mm v 7.3 mm; P = 0.003). Intravenous sedation was used frequently in Group I (111 patients; 49%) and not at all in Group II. General anesthesia was used more frequently in Group II than in group I (34% v 24%; P < 0.02). Spinal anesthesia also was utilized more frequently in Group II patients (66% v 28%; P < 0.0001). Overall, general or regional anesthesia was received by 100% of the patients in Group II but only 52% of the patients in group I. The success rate of stone treatment was much better for Group II than for Group I (78% v 51%; P < 0.0001). CONCLUSION The transition from a Dornier HM3 lithotripter to a third-generation lithotripter can be difficult, but if adequate anesthesia is given to minimize patient movement and balloon pressures are optimized, stone targeting can be accurate and similar stone clearance rates can be obtained.
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Affiliation(s)
- L Eichel
- Department of Urology, University of Rochester School of Medicine, New York 14642, USA
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McNally ML, Erturk E, Oleyourryk G, Schoeniger L. Laparoscopic cyst decortication using the harmonic scalpel for symptomatic autosomal dominant polycystic kidney disease. J Endourol 2001; 15:597-9. [PMID: 11552783 DOI: 10.1089/089277901750426364] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Management of acute and chronic pain in patients with autosomal dominant polycystic kidney disease (ADPKD) has, until recently, been limited to oral narcotic regimens, percutaneous drainage, open decortication, or nephrectomy. PATIENTS AND METHODS Five women and two men with a mean age of 44 (range 20-55) years underwent laparoscopic cyst decortication with the Harmonic Scalpel. All patients had end-stage renal disease secondary to ADPKD and pain attributed to their cyst disease. Two patients had simultaneous bilateral, one had staged bilateral, and remaining four patients had unilateral decortication. The mean follow-up was 14 months (range 2-29 months). Preoperative and postoperative pain was assessed using a standardized scale. RESULTS There were no intraoperative complication, and visible cysts were decorticated in a total of 10 renal units. There was a significant reduction in the pain scale, from a mean of 7.4/10 preoperatively to 2.3/10 on follow-up for the entire group (P < 0.0001). One patient reported recurrence of pain at 4 months, and bilateral nephrectomy was performed. Major complications included postoperative bleeding in two patients and readmission for ileus in one. CONCLUSION Laparoscopic decortication of painful renal cysts in ADPKD patients is a feasible procedure for symptomatic relief. The Harmonic Scalpel is a useful tool; however, it may not be adequate in preventing delayed bleeding.
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Affiliation(s)
- M L McNally
- Department of Urology, University of Rochester School of Medicine, New York 14642, USA.
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Zand MS, Strang J, Dumlao M, Rubens D, Erturk E, Bronsther O. Screening a living kidney donor for polycystic kidney disease using heavily T2-weighted MRI. Am J Kidney Dis 2001; 37:612-9. [PMID: 11228187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) accounts for approximately 8% of those awaiting renal transplantation. Living related kidney donors for these patients require screening for ADPKD, most commonly by ultrasonography. Ultrasound has a negative predictive value (NPV) of 100% in patients aged older than 30 years, but only 96% for donors aged 20 to 30 years. This case shows that heavily T2-weighted magnetic resonance imaging (HT2MRI) may be a more sensitive screening method for ADPKD in younger kidney donors. Despite a normal screening ultrasound result, a kidney donor with a family history of ADPKD was found to have renal cysts intraoperatively, and the transplantation was canceled. Afterward, the donor was imaged with HT2MRI. In addition, the mathematical relationship between sensitivity, specificity, and NPV for ADPKD screening tests was derived. After the canceled transplantation, a second ultrasound still could not identify renal cysts. However, HT2MRI showed multiple small ( approximately 3-mm) cysts in both kidneys and a 2.5-cm cyst on the right kidney. Mathematical analysis showed that the NPV of a screening test for ADPKD was most closely related to sensitivity and that only tests with 100% sensitivity would have a 100% NPV. We conclude that ultrasound is not a sufficiently sensitive screening test for ADPKD in younger living related renal donors. HT2MRI has improved sensitivity and may be the best screening test for ADPKD in this population.
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Affiliation(s)
- M S Zand
- Department of Medicine, Nephrology Unit, Division of Solid Organ Transplantation, University of Rochester Medical Center, Rochester, NY, USA.
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Affiliation(s)
- L Eichel
- Department of Urology, University of Rochester School of Medicine, New York, USA
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27
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Maines MD, Mayer RD, Erturk E, Huang TJ, Disantagnese A. The oxidoreductase, biliverdin reductase, is induced in human renal carcinoma--pH and cofactor-specific increase in activity. J Urol 1999; 162:1467-72. [PMID: 10492239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
PURPOSE Biliverdin reductase is an oxidoreductase unique among all enzymes characterized to date in having dual pH/dual cofactor requirement - NADH and NADPH at 6.7 and 8.7, respectively. The protein shows extensive microheterogeneity that is caused by post-translational modification. The reductase converts the heme degradation product, biliverdin, to bilirubin. Bilirubin has been shown to inhibit responses of human lymphocytes, including phytohemagglutinin-induced proliferation, interleukin-2 production, and antibody dependent and independent cell mediated cytotoxicity. In addition to acting as an antioxidant, it inhibits protein phosphorylation and activity of enzymes such as protein kinase C and NADPH oxidase. This research was to evaluate whether renal cell carcinoma differs from normal tissue in regard to the expression and activity of the reductase. MATERIALS AND METHODS Kidney tissue with or without visible renal carcinoma and normal kidney tissue from a brain dead patient were frozen at -80C shortly after removal. Ten microm. tissue sections were used for immunostaining of biliverdin reductase, pooled isolated tumors and surrounding tissue that did not contain visible tumor were used for Northern blot analysis of mRNA and Western blot analysis of protein. Enzyme activity was also measured in these preparations at pH 6.7 with NADH, and at pH 8.7 with NADPH. Ten additional formalin fixed specimens of renal cell carcinoma were also used for immunostaining. RESULTS There was a striking increase in the reductase protein levels, as visualized by immunostaining in tumor tissue cells. The increase was also evident by Western blotting, and involved in increased transcription of biliverdin reductase as suggested by Northern blot analysis. The protein would also be detected in the infiltrating monocytes, macrophages, T cells and neutrophils as well as in circulating lymphocytes. The enzyme activity was nearly doubled in the tumor tissue, but selectively with NADH as the cofactor. CONCLUSION Increases in biliverdin reductase expression and activity only with NADH is found in renal cell carcinoma. The net effects of this change are uncertain at present but several pathways, which could be affected by the reductase, may alter local physiology. Biliverdin reductase as a zinc metalloprotein may directly interact with other regulatory proteins, generation of increased bilirubin may alter immune function and increased enzyme activity may deplete NADH with contrasting consequence of blocking free radical formation and depleting cellular ATP. To the benefit of the host, the latter could culminate in tumor cell death.
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Affiliation(s)
- M D Maines
- Department of Biochemistry and Biophysics, University of Rochester School of Medicine, New York 14642, USA
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Gottlieb RH, Zusman E, Hartley DF, Rubens DJ, Voci SL, Robinette W, Melendez L, Morris TW, Ojha S, Chengazi V, Erturk E, Messing EM. Effect of angiotensin converting enzyme inhibition on the Doppler waveform in dogs with renal artery stenosis. J Ultrasound Med 1999; 18:481-487. [PMID: 10400051 DOI: 10.7863/jum.1999.18.7.481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Our objective was to investigate whether the angiotensin converting enzyme inhibitor enalaprilat improves detection of hemodynamically significant renal artery stenoses in dogs. Renal artery stenoses of 50 to 99% were surgically created unilaterally in five dogs. Doppler ultrasonographic evaluation was performed at baseline (no stenosis), after creation of the stenosis, and after the administration of enalaprilat. The resistive index increased in the nonstenotic kidney (P < 0.01) but not in the stenotic kidney after administration of enalaprilat. The difference in resistive indices between nonstenotic and stenotic kidneys increased significantly (P < 0.05) after administration of enalaprilat. Measurement of the resistive index after administration of an angiotensin converting enzyme inhibitor in humans may improve the performance of Doppler ultrasonography in detecting hemodynamically significant renal artery stenoses.
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Affiliation(s)
- R H Gottlieb
- Department of Radiology, University of Rochester Medical Center, New York 14642, USA
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Erturk E, Burzon DT, Waldman D. Treatment of transplant ureteral stenosis with endoureterotomy. J Urol 1999; 161:412-4. [PMID: 9915414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
PURPOSE The safety and efficacy of treating renal transplant ureteral stenosis with the Acucise endoureterotomy catheter are described. MATERIALS AND METHODS We treated 4 women and 3 men 31 to 63 years old (mean age 45) with Acucise endoureterotomy for distal (6) and proximal (1) ureteral stenosis. Diagnosis was based on increasing serum creatinine and hydronephrosis on ultrasound, and confirmed by antegrade nephrostogram. One patient had recurrence and, therefore, 8 procedures were performed. Mean followup was 13 months (range 7 to 21). RESULTS Technical success was 100%. One patient had a recurrent stricture and was successfully re-treated. Of the patients 3 had chronic rejection and renal failure, and 4 had stable renal function. All ureters remain patent to date. CONCLUSIONS Treatment of short ureteral stenosis with Acucise endoureterotomy in a renal transplant is safe and effective. Furthermore, it can be performed in an ambulatory setting with minimal morbidity. This procedure should be considered as the initial approach for distal ureteral stenosis in the transplanted kidney.
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Affiliation(s)
- E Erturk
- Department of Urologic Surgery, University of Rochester, New York, USA
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Abstract
We retrospectively reviewed dynamic ACTH and cortisol responses to insulin hypoglycemia in 193 subjects with suspected ACTH deficiency to ascertain the predictive values of various diagnostic criteria. Based on the achievement of a peak cortisol level of 18 micrograms/dL or above, 133 subjects were classified as having an intact hypothalamic-pituitary-adrenal (HPA) axis, and 60 subjects were determined to have ACTH deficiency. Baseline and peak cortisol concentrations were strongly correlated (r = 0.63; P < 0.0001). Peak cortisol increased in parallel to ACTH increments, but plateaued at approximately 22 micrograms/dL at peak ACTH levels above approximately 75 pg/mL (r = 0.61; P < 0.0001). Basal cortisol values above 17 micrograms/dL or below 4 micrograms/dL were highly predictive of an intact or impaired HPA axis, respectively, but intermediate values had only limited sensitivity and specificity. The criteria of HPA axis integrity, defined as an increment in plasma cortisol of more than 7 micrograms/dL above the baseline or as a doubling of the baseline cortisol value, were associated with high false positive and false negative rates. We conclude that 1) the baseline morning serum cortisol concentration has very limited predictive power in differentiating between normal and impaired HPA function; 2) the use of criteria based on incremental changes in serum cortisol from baseline leads to unacceptably high false positive and false negative rates; and 3) insulin hypoglycemia is still the best indicator of the integrity of the response of the HPA axis to stress.
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Affiliation(s)
- E Erturk
- Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109, USA
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Erturk E, Burzon DT, Orloff M, Rabinowitz R. Outcome of patients with vesicoureteral reflux after renal transplantation: the effect of pretransplantation surgery on posttransplant urinary tract infections. Urology 1998; 51:27-30. [PMID: 9610554 DOI: 10.1016/s0090-4295(98)00065-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES We evaluated the relation of vesicoureteral reflux, pretransplant nephrectomy, and prior ureteral reimplant with respect to posttransplant urinary tract infection and graft survival. METHODS From 1984 to 1995, 820 renal transplants were performed. Thirty-six (4%) patients had documented vesicoureteral reflux. The patients were divided into three groups: Group I, N = 10 (28%) underwent ureteral reimplantation prior to transplantation; Group II, N = 8 (22%) had bilateral nephrectomy prior to transplantation; and Group III, N = 18 (50%) had persistent reflux at the time of transplantation. RESULTS Graft survival at 3 years was 50% (18/36). Patient survival was 94% (34/36). The overall incidence of urinary tract infection was 56% (20/36). Complicated urinary tract infection was seen in 28% (10/36) and uncomplicated urinary tract infection in 47% (17/36) of the patients. The incidence of both complicated and uncomplicated urinary tract infection was lower in Group I. However, graft survival was lower in Group I patients. Overall graft survival was significantly lower in patients with vesicoureteral reflux compared with the rest of the group. CONCLUSIONS The incidence of urinary tract infection did not appear to be altered significantly whether the patients had bilateral nephrectomy or persistent vesicoureteral reflux. However, those patients who had ureteral reimplantation had fewer episodes of infection. Nephrectomy prior to transplantation should be performed selectively.
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Affiliation(s)
- E Erturk
- Department of Urology, The University of Rochester Medical School, New York, USA
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Abstract
Long-term effects of extracorporeal shockwave lithotripsy (SWL) on female fertility remain a concern. Thirty-nine women of childbearing age who were treated for distal ureteral stones were surveyed. The mean age of these women was 33 years, and the average stone size was 6.9 mm. The mean calculated radiation exposure to the ovaries and the uterus was 7.53 and 10.9 mSv, respectively. Ten women (26%) attempted to become pregnant. No fertility problems were noted in these women, and 11 healthy babies were delivered. These preliminary findings provide further information regarding the safety of SWL in the treatment of distal ureteral stones in women of reproductive age.
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Affiliation(s)
- E Erturk
- University of Rochester Department of Urology, Strong Memorial Hospital, NY 14642, USA
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McKenna BA, Pabico RC, Bronsther OL, Morris MC, Orloff MS, Erturk E. Tacrolimus (FK 506): a whole blood assay as measured on the Abbott IMx analyzer. Transplant Proc 1996; 28:988-90. [PMID: 8623491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- B A McKenna
- Department of Medicine, University of Rochester School of Medicine and Dentistry, New York, USA
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Abstract
OBJECTIVE The authors evaluated the potential use of nonheartbeating (NHB) cadaver donors as an additional source to the current supply of brain-dead cadaver donors. SUMMARY BACKGROUND DATA The numbers of cadaveric donors has not increased significantly during the last 5 years, despite a rising need for transplantable organs. Any improvement in cadaveric organ procurement will depend on the use of previously unrecognized potential donors. METHODS During a 2-year period, 24 kidneys were retrieved from 12 NHB donors. Nineteen kidneys were transplanted. RESULTS These kidneys sustained a mean warm ischemia time of 26 minutes (range 20-35 min). A mean lowest creatinine level of 2.0 mg/dL, (range 1.1-3.0 mg/dL), the rate of postoperative dialysis (22%), and a 1-year graft survival rate of 76% for kidneys from NHB-donated kidneys compare favorably to expected results achieved nationally from brain-dead cadaveric donors. CONCLUSIONS Nonheartbeating donor kidneys can yield acceptable graft function and be of no disadvantage to recipients of cadaver transplants.
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Affiliation(s)
- M S Orloff
- Department of Surgery, University of Rochester Medical Center, New York 14642-8410
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Abstract
We report on formation of bilateral renal calculi secondary to sulfasalazine therapy for juvenile rheumatoid arthritis. The condition was successfully treated with extracorporeal shock wave lithotripsy. Analysis of the fragments with thin layer chromatography and nuclear magnetic resonance revealed acetylsulfapyridine, a metabolite of sulfasalazine.
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Affiliation(s)
- E Erturk
- Department of Urology, University of Rochester, New York 14642
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Abstract
A retrospective analysis of distal ureteral calculi treated by extracorporeal shock wave lithotripsy (ESWL*) as the primary mode of therapy was performed. Using the Dornier HM3 unit 312 patients underwent a total of 326 ESWL procedures. Several pretreatment procedures, including placement of ureteral catheters were used to help with stone localization. Early fragmentation and 3-month stone-free rates were analyzed. Of the patients 81% were stone-free at 3 months. We reviewed 27 failures, revealing a higher incidence of impacted stones and stones greater than 1 cm. Complications were few and minor. ESWL is a safe and effective treatment option for distal ureteral calculi.
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Affiliation(s)
- E Erturk
- Department of Urology, University of Rochester, Strong Memorial Hospital, New York
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Nakada SY, Erturk E, Monaghan J, Cockett AT. Role of extracorporeal shock-wave lithotripsy in treatment of urolithiasis in patients with medullary sponge kidney. Urology 1993; 41:331-3. [PMID: 8470317 DOI: 10.1016/0090-4295(93)90589-3] [Citation(s) in RCA: 8] [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] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In an effort to identify the role of extracorporeal shock-wave lithotripsy (ESWL) in the treatment of patients with medullary sponge kidney, a retrospective review of our experience with the Dornier HM-3 lithotriptor is presented. From 1986-1991 17 patients with medullary sponge kidney ranging in age from twenty-eight to fifty-eight years received 31 treatments to a total of 24 renal units. Follow-up ranged from four to fifty-six months with an average follow-up of twenty-five months. ESWL appears to have a role in the treatment of symptomatic urolithiasis in patients with medullary sponge kidney. There may also be some benefit in treating parenchymal calcifications. No significant side effects from the treatment were noted.
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Affiliation(s)
- S Y Nakada
- Department of Urology, University of Rochester, School of Medicine and Dentistry, New York
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Paprocki S, Kruk R, Erturk E, Cerilli J. A technique for successful transplantation of organs from non-heartbeating cadaver donors. Transplantation 1992; 54:381-3. [PMID: 1496550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- S Paprocki
- Department of Surgery, University of Rochester Medical Center, New York 14642
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39
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Affiliation(s)
- E Erturk
- Department of Surgery, University of Rochester
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40
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Erturk E. Biopsies of renal allografts. Transplantation 1991; 51:1140. [PMID: 2031274 DOI: 10.1097/00007890-199105000-00047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Bretan PN, Baldwin N, Martinez A, Stowe N, Scarpa A, Easley K, Erturk E, Jackson C, Pestana J, Novick AC. Improved renal transplant preservation using a modified intracellular flush solution (PB-2). Characterization of mechanisms by renal clearance, high performance liquid chromatography, phosphorus-31 magnetic resonance spectroscopy, and electron microscopy studies. Urol Res 1991; 19:73-80. [PMID: 1853517 DOI: 10.1007/bf00368180] [Citation(s) in RCA: 10] [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] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A number of new intracellular renal flush solutions have been found to be more efficacious than Collins-2 (C-2) solution in extending organ viability during simple cold storage. However, the mechanism of action of these solutions remains poorly understood. To delineate better underlying intracellular mechanisms, we studied a modified, simple, hypothermic, intracellular (340 mOsm/kg) flush solution (PB-2). The development of PB-2 solution is based on the ability of some of its individual components to minimize ischemic adenine nucleotide (AN) catabolism and endothelial post "reperfusion injury." Preliminary results in 10 canine autorenal transplants show a significant (P less than 0.02) improvement in renal recovery and viability (recipient posttransplant inulin clearance and survival) after 50 h of cold storage compared with 10 canine kidneys similarly preserved using conventional C-2 flush solution. High performance liquid chromotography (HPLC) studies show a significant (P less than 0.01) loss of AN using C-2, while PB-2 was associated with regeneration of AN within 45 min of reperfusion. Magnetic resonance spectroscopy using phosphorus 31 (31P-MRS) showed more high energy phosphorus metabolites (phosphomonoester and nicotinamide-adenine-dinucleotide phosphate: P less than 0.001) at 50 h cold storage using PB-2 compared with C-2. Electron micrographs (EM) revealed normal microcapillary morphology for the PB-2 group; however, moderate vascular red and white blood cell clumping was observed in the C-2 group. Characterization of the basic preservation mechanisms by HPLC, 31P-MRS, and EM studies indicates that PB-2 solution enhances renal preservation by diminution of both reperfusion injury and the loss of intracellular high energy metabolites that are necessary for viability.
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Affiliation(s)
- P N Bretan
- Department of Urology, Case Western Reserve University, Cleveland, Ohio
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Abstract
Six patients are presented who underwent secondary renal revascularization for recurrent renal artery stenosis. The initial pathologic diagnosis was fibrous dysplasia in three patients and atherosclerosis in three patients. All patients had initially undergone a successful aortorenal bypass operation. Recurrent renal artery stenosis and hypertension developed 11 to 120 months later (mean, 58 months). Secondary revascularization operations included renal autotransplantation (2 patients), hepatorenal bypass (2), iliorenal bypass (1), and aortorenal bypass (1). Hypertension was relieved, and renal function was stabilized or improved in all cases. If hypertension recurs after renal revascularization, a recurrent but correctable lesion should be suspected.
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Erturk E, Bretan P, Pestana J, Steinmuller D, Stowe NT, Novick AC. The relative effects of aztreonam versus gentamicin on nephrotoxicity induced by warm ischemia in the presence and absence of cyclosporine. Transplant Proc 1989; 21:932-3. [PMID: 2705261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- E Erturk
- Department of Urology, Cleveland Clinic Foundation, Ohio
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Erturk E, Erturk E, Sheinfeld J, Davis RS. Metaplastic cystitis complicated with Von Brunn nests, cystitis cystica, and intestinal type of glandular metaplasia. Urology 1988; 32:165-7. [PMID: 3400142 DOI: 10.1016/0090-4295(88)90323-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
It is well documented that under certain stimuli the bladder epithelium can undergo metaplasia. The origin of glandular epithelium, which may be found in the bladder, is somewhat controversial. Endoscopic and histopathologic features of an eighty-one-year-old white man with proliferative metaplastic cystitis are presented. This case demonstrates that glandular differentiation was due to progressive cystitis rather than congenital intestinal rest.
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Affiliation(s)
- E Erturk
- Department of Urology, University of Rochester School of Medicine and Dentistry, New York
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Erturk E, Lange PH, Hulbert JC. Percutaneous and extracorporeal management of urolithiasis. Invest Radiol 1987; 22:995-1004. [PMID: 3326857 DOI: 10.1097/00004424-198712000-00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- E Erturk
- Department of Urologic Surgery, University of Minnesota Hospital and Clinic, Minneapolis 55455-0321
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Abstract
Epidermal growth factor (EGF) is excreted in urine in high concentrations and thus incubates with bladder epithelial cells continuously. However, it is not known whether any urothelial cells can bind urinary EGF or respond to it. Using a monoclonal antibody (528) to the binding portion of the human EGF receptor, immunoperoxidase staining demonstrated that the basal cell layer of normal urothelium is richly endowed with cell surface EGF receptors while the superficial cell layer is not. Alternatively, superficial cells of premalignant and malignant urothelium have many surface EGF receptors. Intravesical EGF induces in vivo activity of ornithine decarboxylase and DNA synthesis in rat bladders, with nuclear thymidine incorporation being limited to the basal epithelial cell layer. These studies indicate that urothelium can respond to urinary EGF and that this response parallels the distribution of EGF receptors. These findings combined with the difference in EGF-receptor expression between malignant and normal cells indicate that urinary EGF may play a role in bladder tumor development and/or growth.
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Affiliation(s)
- E M Messing
- Department of Surgery and Human Oncology, University of Wisconsin School of Medicine, Madison
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Lee K, Erturk E, Mayer R, Cockett AT. Efficacy of antitumor chemotherapy in C3H mice enhanced by the antiangiogenesis steroid, cortisone acetate. Cancer Res 1987; 47:5021-4. [PMID: 2441860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The effect of "antiangiogenesis" therapy using cortisone acetate (CA) with or without heparin on tumor growth as well as in combination with chemotherapy was investigated. C3H mice were implanted intradermally with N-[4-(5-nitro-2-furyl)-thiazolyl]formamide induced undifferentiated transitional cell carcinoma, MBT-2, in the right flank. The treatment was initiated 9 to 10 days after tumor inoculation. Daily injections of CA (250 mg/kg s.c.) suppressed tumor growth significantly in a dose dependent fashion. Administration of heparin (Elkins-Sinn) at the concentration of 200, 400, or 1000 units/ml in drinking water for 3 to 6 days was neither additive nor detrimental to the effect of CA. Chemotherapy was combined with CA; 3 days of administration of 250 mg/kg of CA in tapering doses was used. The chemotherapeutic agent was injected once 24 h before the initial CA. Combinations of chemotherapy (Adriamycin, 2.5-7.5 mg/kg i.v; cisplatin, 3-9 mg/kg i.p.; cyclophosphamide, 50-150 mg/kg i.p.; cis-(diammino)(1,1-cyclobutanedicarboxylate)platinum(II) (JM-8), 60-150 mg/kg i.p.; mitomycin C, 3-4.5 mg/kg i.p.) with CA showed additive suppression of tumor growth. Mice tolerated chemotherapy alone, CA alone, and both in combination. CA combined with JM-8 was not tolerated. Mice tolerated 100 to 150 mg/kg of JM-8, whereas the addition of CA to JM-8 resulted in a 66% (6 of 9) to 89% (8 of 9) mortality rate. CA at a concentration of 5 and 25 micrograms/ml showed no direct cytotoxic activity against MBT-2 cells in vitro. However, 3 days of administration of 250 mg/kg of CA inhibited tumor angiogenesis generated by MBT-2 cells in C3H mice using a dorsal air sac assay. The data suggest that CA alone inhibits tumor angiogenesis in C3H mice and that antiangiogenesis therapy enhances the antitumor efficacy of chemotherapeutic agents without increasing host toxicity (except for JM-8).
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Abstract
After years of decline to near disappearance, there recently has been an increasing incidence of syphilis in America. New cases of tertiary neurosyphilis are being reported which often have associated significant urologic sequelae. For the first time in the English literature, the uro-dynamic findings of a patient with tabes dorsalis are presented. Our findings indicate that treatment of urinary retention associated with tabes dorsalis is better managed by intermittent catheterization than by prostate surgery because of the impaired detrusor activity. A review of neurosyphilis and its urologic implications and urodynamic findings are presented. Prompt recognition of this entity should encourage a full urodynamic evaluation prior to a commitment to prostatic surgery.
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Erturk E, Haberal M, Piskin E. Towards the commercialization of hemoperfusion column. Part II. Coating of activated carbon. Biomater Artif Cells Artif Organs 1987; 15:633-54. [PMID: 3440136 DOI: 10.3109/10731198709117560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
This paper reports the studies of coating of activated carbon. Spherical petroleum-based bead activated carbon with a size range of 0.4-1.0 mm was the adsorbent used in this study. These activated carbon granules were coated with cellulose nitrate of different thickness.
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Affiliation(s)
- E Erturk
- Chemical Engineering Department, Hacettepe University, Ankara, Turkey
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