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Öğe Erkek infertilitesinde rekonstrüktif cerrahi: Teknik ve prediktif ölçütler(2006) Tezer, H. Murat; Güven, Selçuk; Ersay, Ahmet; Erol, Bülent; Kadıoğlu, Ateşİnfertil erkeğin değerlendirilmesinde amaç, infertilite etiyolojisinin açıklanması ve etiyolojiye spesifik tedavinin planlanmasıdır. Spesifik tedavi yapılamadığında üremeye yardımcı tekniklere başvurulmaktadır. Ancak erkek infertilitesinin etiyolojiye spesifik tedavisi, üremeye yardımcı tekniklere göre hem maliyet/fayda açısından daha avantajlı, hem de oluşan gebelikler üremeye yardımcı tekniklerin riskinden uzak olmaktadır. Sperm taşıyan kanalların obstrüksiyonu, erkek infertilitesinin düzeltilebilir sebepleri arasında yer alır ve tedavi seçenekleri, obstrüksiyonun lokalizasyonuna göre değişmektedir. Distal ejakülatör kanal patolojilerinde TUR-ED, proksimal obstrüksiyonlarda ise rekonstrüktif cerrahi (vazovazostomi/epididimovazostomi) birinci seçenek tedavilerdir. Operasyon sonrasında tekrar obstrüksiyon gelişebilme ihtimali bulunduğundan hastalara perop sperm dondurma önerilmektedir. Duktal sistemin rekonstrüktif cerrahisi yıllar içinde teknik olarak gelişme gösterirken, bu gelişmeye paralel olarak ameliyat başarısında da artış sağlanmıştır. Ameliyatın başarısı duktal açıklığın (patens) ve gebeliğin sağlanmasıdır. Cerrahi tekniklerdeki dönüm noktası, ameliyat mikroskobunun kullanılmasıdır. Ameliyat mikroskobu ile obstrüksiyon daha iyi yerleştirilebilirken, anatomiye uygun anastomozlar yapılabilmektedir. Sonuçta ameliyat başarısı da artmaktadır. Ameliyatın başarısı, tekniklerdeki gelişmenin yanında ameliyat için doğru hastanın seçilebilmesine bağlıdır. Yapılan çalışmalarda ameliyat başarısını öngörebilmek için ölçütler belirlenmeye çalışılmış, ameliyat öncesinde ve ameliyat sırasında bazı ölçütlerin prediktif önemi olduğu belirtilmiştir.Öğe Oxybutynin effects on Staphylococcus epidermidis biofilm production(Lippincott Williams & Wilkins, 2008) Gedik, Abdullah; Ersay, Ahmet; Atmaca, Selahattin; Sener, AlperBackground: Oxybutynin is a tertiary amine and has chemical similarities like prolamine sulfate. Protamine sulfate's effect on bacterial viability has been shown in some studies; however, there is scanty data regarding the effect of oxybutynin on bacterial viability. Accordingly, the aim of the present study was to investigate the effect of oxybutynin on bacterial viability. Methods: Twenty of Staphylococcus epidermidis (S. epidermidis) strains were isolated from patients who had catheter-associated urinary tract infection. These strains were exposed to 5 different concentrations of oxybutynin in tryptic soy broth (TSB) media (max: 5 mg/mL, min: 0.05 mg/mL). Quantitative growth patterns were measured by spectrophotometer. Under the same media conditions, biofilm production of individual strains was measured by Deighton's micromethod at the end of the 6-hour incubation period. Results: After the incubation period, weak and strong slime-producing bacteria groups were obtained and both groups' slime productions were extensively low at 5 mg/mL concentration of oxybutynin. Slime production of S. epidermidis was inversely correlated with oxybutynin concentrations. Conclusion: Although there was a dose-dependent reduction of biofilm production, there seemed to be no bactericidal effect of oxybutynin on S. epidermidis.Öğe Reconstructive surgery in male infertility: The technique and predictive parameters(2006) Tezer, H. Murat; Güven, Selçuk; Ersay, Ahmet; Erol, Bülent; Kadio?lu, AteşIntroduction: The aim of infertile male evaluation is to unveil the etiology of infertility and plan the specific treatment according to the etiology. In case there is not a specific treatment the aim is to refer to assisted reproductive techniques. However the etiology specific treatment of male infertility, compared to the assisted reproductive techniques is more cost effective and it does not have the risks of assisted reproductive techniques. Materials and Methods: The obstruction of the sperm ducts is one of the correctable causes of male infertility and the treatment varies according to the localization of obstruction. When there is distal ejaculatory duct pathology the treatment choice is TUR-ED while in proximal ejaculatory duct patologies reconstructive treatment is the preferred choice (vasovasostomy/epididymovasostomy). Peroperative semen freezing is offered to the patient as there is a risk of recurrence. Results: The reconstructive surgery of ductal system has been improved through years and so has the operation success. The success of the operation is to provide a ductal patency and pregnancy. The milestone of operative technique is the use of the microscope. With the use of the microscope the obstruction is localized more effectively and the anastomoses are made according to the anatomy. Consecuently, the success of the operation is higher. Conclusion: The success rate of the operation, on behalf of the development of the operational technique, depends on the choice of the right patient. In order to predict the success of the operation some parameters were tried to be established in some studies. It was stated that some preoperative and peroperative parameters have predictive importance.Öğe RECONSTRUCTIVE SURGERY IN MALE INFERTILITY: THE TECHNIQUE AND PREDICTIVE PARAMETERS(Aves, 2006) Tezer, H. Murat; Gusven, Selcuk; Ersay, Ahmet; Erol, Bulent; Kadioglu, AtesIntroduction: The aim of infertile male evaluation is to unveil the etiology of infertility and plan the specific treatment according to the etiology. In case there is not a specific treatment the aim is to refer to assisted reproductive techniques. However the etiology specific treatment of male infertility, compared to the assisted reproductive techniques is more cost effective and it does not have the risks of assisted reproductive techniques. Materials and Methods: The obstruction of the sperm ducts is one of the correctable causes of male infertility and the treatment varies according to the localization of obstruction. When there is distal ejaculatory duct pathology the treatment choice is TUR-ED while in proximal ejaculatory duct patologies reconstructive treatment is the preferred choice (vasovasostomy/epididymovasostomy). Peroperative semen freezing is offered to the patient as there is a risk of recurrence. Results: The reconstructive surgery of ductal system has been improved through years and so has the operation success. The success of the operation is to provide a ductal patency and pregnancy. The milestone of operative technique is the use of the microscope. With the use of the microscope the obstruction is localized more effectively and the anastomoses are made according to the anatomy. Consecuently, the success of the operation is higher. Conclusion: The success rate of the operation, on behalf of the development of the operational technique, depends on the choice of the right patient. In order to predict the success of the operation some parameters were tried to be established in some studies. It was stated that some preoperative and peroperative parameters have predictive importance.