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Öğe A Different Approach to the Percutaneous Nephrostomy by Urologists(Ene Ediciones Sl, 2012) Kocoglu, H.; Alan, C.; Malkoc, E.; Eskin, M. B.; Kurt, H. A.; Ersay, A. R.Introduction: Percutaneous nephrostomy (PCN) tube placement is generally performed in radiologic departments worldwide. However, there are a few urologist-directed studies about PCN performed with ultrasound guidance. Needle direction using a convex abdominal ultrasound probe might be difficult in unexperienced hands. In order to perform this procedure easily, we propose that a probe placed on flank or intercostal region and a long grooved needle director that never allows needle movement would be useful. We considered a transrectal ultrasound (TRUS) probe was suitable to resolve this issue. Material and method: From January 2007 to April 2011, a total of 113 percutaneous renal access (PRA) were performed using a TRUS probe in 102 patients, aged 20 to 84 years old. Because of the insufficient imaging capability of the TRUS probe in obese patients whose body mass index (BMI) greater than 30 kg/m(2) were excluded. Forty two PRA were performed under local anesthesia and this group was named local anesthesia (LA) group. Seventy one PRA were performed for nephrostomy insertion under local anesthesia supplemented by deep sedation and this cluster was named deep sedation (DS) group. Results: Targeted calyx puncture and guide wire placement was performed in all patients (100%) but success rate of tube insertion in each group was different. Successful PCN insertion rate was 69.1% (29 of 42 cases) in LA group and 95.8% (68 of 71 cases) in DS group. No major vascular injury and/or adjacent organ injury to bowel, liver, spleen or lung was seen in any patient. Conclusion: Guidance of TRUS probe, deep sedation, and modified dilators may offer a high success rate to the urologists with little experience in PCN insertion which they would find it difficult to perform. (c) 2011 AEU. Published by Elsevier Espana, S.L. All rights reserved.Öğe EFFECTS OF ALPHA-BLOCKER AGENTS USED TO TREAT BENIGN PROSTATIC HYPERTROPHY ON ENDOTHELIAL FUNCTIONS AND METABOLIC PARAMETERS(Elsevier Ireland Ltd, 2011) Kirilmaz, B.; Dogan, H.; Alan, C.; Saygi, S.; Asgun, H. F.; Celik, H.; Ozturk, O.[Anstract Not Available]Öğe PENTRAXIN-3 LEVEL IN ARTERIOGENIC ERECTILE DSYFUNCTION(Wiley-Blackwell, 2016) Ersay, A. R.; Eren, A. E.; Alan, C.; Basturk, G.; Demirci, E.[Anstract Not Available]Öğe Role of twinkling artifact in characterization of urinary calculi(Ene Ediciones Sl, 2011) Alan, C.; Kocoglu, H.; Kosar, S.; Karatag, O.; Resit Ersay, A.; Erhan, A.Introduction: Stone characterization is becoming important before decision of treatment such as percutaneous nephrolithotomy (PCNL) and extracorporeal shock wave lithotripsy (ESWL). Some studies have reported that the twinkling artifact (color-flow ultrasonography artifact) may be useful to detect urinary stones. This study aims to determine whether the presence or absence of the twinkling artifact is correlated with the chemical composition of the stones. Material and method: Patients with renal stones >= 0.5 cm were included in a prospective study. Sixty patients were examined with x-ray film, intravenous pyelography, non-contrast computerized tomography, and color and spectral doppler ultrasonography. The artifact was considered grade 1 when occupied only one portion of the acoustic shadowing and when the artifact occupied the entire acoustic shadowing was considered grade 2. Patients with stones smaller than 2 cm were treated with SWL and patients with stones larger than 2 cm were treated with PCNL. Results: No artifact (grade 0) was detected in 11 subjects, grade 1 in 25 and grade 2 in 24. Significant relationship was found between the increase in twinkling artifact and stone size (p < 0.001). When the relation between the composition of the stones and the twinkling artifact was analyzed, artifact was detected nearly in all of the calcium oxalate dihydrate and calcium phosphate stones; whereas the artifact was detected in more than half of the calcium oxalate monohydrate and uric acid stones. In ESWL group it was observed that as the grade of the twinkling artifact increases, the number of required ESWL sessions decreases (p < 0.001). In PCNL group twinkling artifact was found in all of the patients (100%) with roughly surfaced stones. Conclusion: The roughness of stone surface is the most important factor in terms of formation of the twinkling artifact in kidney stones. This artifact can beat use in anticipating the breakability of the stones of those patients to be treated with applied ESWL. One might anticipate that cases where the size of the stone is larger than 2 cm but no twinkling artifact is detected are calcium oxalate monohydrate, which is one of the stones with highest level of breakability. (C) 2011 AEU. Published by Elsevier Espana, S.L. All rights reserved.