| 1. |
- Aydogdu, Özgu, 1978, et al.
(författare)
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Does the diameter of dextranomer microspheres affect the success in endoscopic treatment of vesicoureteral reflux?
- 2012
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Ingår i: Urology. - : Elsevier BV. - 1527-9995 .- 0090-4295. ; 80:3, s. 703-6
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate whether the polymer microsphere diameter affects the success rate in the endoscopic treatment of vesicoureteral reflux.In our consecutive series, 56 patients underwent subureteral injection with Dexell and 60 patients were treated with Deflux. Patients were evaluated with pediatric lower urinary tract scoring system, uroflowmetry, and a residual urine volume and voiding diary at the time of injection and control. Patients with grade V reflux, duplex systems, paraureteral diverticula, or refractory lower urinary tract symptoms were excluded. The numbers of renal units with grade II-III vesicoureteral reflux were 78 and 73 in the first (Deflux) and second (Dexell) groups, respectively. The numbers of renal units with grade IV reflux were 24 and 17 in the first and second groups, respectively. The resolution rate was determined by voiding cystourethrogram at the third postoperative month. Postoperative febrile urinary tract infections and de novo scars in dimercaptosuccinic acid were noted. Groups were compared by the χ(2) test.Mean follow-up time and mean age of the children were not significantly different. The number of nondilating and dilating renal units was not significantly different. Resolution rates were similar between the groups (79.5 and 78%, respectively). There was no significant difference in terms of resolution rates when dilating and nondilating urinary systems were separately analyzed. The average volumes used per renal unit were 0.9 and 1.6 mL in the first and second groups, respectively (P < .005). Postoperative febrile urinary tract infection and de novo scar formation rates were similar.The diameter of dextranomer microsphere does not affect the short-term success rate in endoscopic treatment of vesicoureteral reflux. Multicentric, randomized and prospective studies are required for long-term clinical results.
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| 2. |
- Aydogdu, Özgu, 1978, et al.
(författare)
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Near infrared spectroscopy to diagnose experimental testicular torsion: comparison with Doppler ultrasound and immunohistochemical correlation of tissue oxygenation and viability.
- 2012
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Ingår i: The Journal of urology. - : Ovid Technologies (Wolters Kluwer Health). - 1527-3792 .- 0022-5347. ; 187:2, s. 744-50
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Tidskriftsartikel (refereegranskat)abstract
- Near infrared spectroscopy measures tissue oxygenation even when there is complete cessation of blood flow. We evaluated near infrared spectroscopy to diagnose testicular torsion and blindly compared its accuracy with that of Doppler ultrasound. We also compared it by immunohistochemical evaluation of hypoxia and cell viability.Rats were randomized to 4 groups, including group 1-720-degree unilateral torsion, group 2-360-degree unilateral torsion, group 4-sham operation and group 4-720-degree unilateral torsion followed by surgical torsion reduction at minute 180. Near infrared spectroscopy and Doppler ultrasound were done blindly at minutes 0, 5, 30, 60, 180 and 400. All torsed and contralateral testicles were excised for pathological examination using hypoxia inducible factor-α for hypoxia and the TUNEL test for apoptosis. We compared all groups with the contralateral testis and the sham operated group.All blinded, near infrared spectroscopy measurements correctly identified the torsed testis after minute 5. Median oxygen saturation in groups 1 and 2 was significantly different compared to that in the sham operated group after minute 5. In group 4 near infrared spectroscopy detected detorsion with the loss of a significant oxygen saturation difference between the affected and the contralateral testicle after detorsion. At minute 400 median oxygen saturation in group 4 was not statistically different compared to that in the sham operated group (p = 0.09) but it was significantly different compared to that in groups 1 and 2 (p <0.001). In each torsed testis oxygen saturation was at least 18.75% lower than in the contralateral testis. In groups 1 and 2 hypoxia inducible factor-α staining in torsed testicles was significantly greater than that in the contralateral organ and the sham operated group. In group 4 hypoxia inducible factor-α staining after detorsion was significantly decreased compared to that in groups 1 and 2. There was no significant difference in the apoptotic index between the experimental and the contralateral testis or the sham operated group.Near infrared spectroscopy is as effective but quicker than Doppler ultrasound for detecting testicular torsion without a radiologist. Near infrared spectroscopy accurately reveals oxygen saturation, which is more vital than blood flow, on which Doppler ultrasound focuses.
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| 3. |
- Burgu, Berk, et al.
(författare)
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When is it necessary to perform nuclear renogram in patients with a unilateral neonatal hydronephrosis?
- 2012
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Ingår i: World journal of urology. - : Springer Science and Business Media LLC. - 1433-8726 .- 0724-4983. ; 30:3, s. 347-52
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Tidskriftsartikel (refereegranskat)abstract
- To examine whether anteroposterior(AP) pelvic diameter on postnatal renal ultrasound scan (US) can predict both initial differential renal function (DRF) and deterioration in DRF in patients with prenatally diagnosed hydronephrosis.One hundred and thirty-three patients diagnosed with a unilateral prenatal hydronephrosis, confirmed postnatally, were evaluated. We tried to find the cutoff values for initial AP diameter and change in AP diameter based on initial DRF and renal outcome. Reduction of 5% or more was considered as deterioration in function. All patients had an initial US scan at a mean age of 1.62 weeks (1-4) and nuclear renogram at 13.24 weeks (7-21). All patients had a second US at a mean age of 10.58 weeks (6-19). 119 patients had a second renogram.Initial mean pelvic diameter was 20.86 (11-49) mm. When AP pelvic diameter was less than 20 mm, 98.6% of all renal units had a function of ≥40%. The cutoff point for AP pelvic diameter was 19.05 when DRF was ≥45% (P < 0.001). When the reduction in hydronephrosis in pelvic diameter was analyzed to predict the initial renal function, a cutoff point of 1.3 mm decrease was found when initial renal function was ≥40% (P < 0.001). The reduction in AP pelvic diameter was 2.1 mm when initial DRF was ≥45% (P = 0.009). For all patients except 3 individuals, if there was a reduction in AP diameter or the AP diameter was stable, then no reduction in function was observed.When the AP pelvic diameter is less than 20 mm at presentation, DRF is normal. If the AP diameter is stable or decreases, there is unlikely to be a significant deterioration in renal function. Consequently, in selected patients, congenital unilateral hydronephrosis can be followed with serial ultrasounds.
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