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Objective: In the present study, we investigated the efficacy of bladder hydrodistension combined with pentosan polysulfate (PPS) treatment in interstitial cystitis (IC)/bladder pain syndrome (BPS)., Methods: In this study, 339 patients diagnosed with IC/BPS were categorized into two groups. The first group only received 300 mg/day PPS, while the second group received 300 mg/day PPS following bladder hydrodistension. The results were evaluated at the 3rd, 6th, and 12th months after the first dose using the interstitial cystitis symptom index (ICSI), international cystitis problem index (ICPI), visual analog scale (VAS), and female sexual function index (FSFI)., Results: PPS treatment started just after hydrodistension was significantly more effective than PPS treatment alone and combined treatment significantly reduced the rate of non-compliance such that, at the end of the 3rd month, 12.1% patients in Group-1 did not continue their treatment whereas only 1.9% of patients in Group-2 did not continue., Conclusions: The study results indicate that PPS treatment started just after hydrodistension yields significantly better results in terms of both symptom improvement and treatment compliance in patients with IC/BPS.

Objective: To estimate the prevalence of urinary incontinence (UI), overactive bladder (OAB), and other lower urinary tract symptoms (LUTS) in the Czech Republic, Russia, and Turkey., Methods: Stage one of this population-based survey consisted of computer-assisted telephone interviews to obtain prevalence estimates of storage, voiding, and post-micturition LUTS. Stage two face-to-face interviews evaluated subjects with mixed urinary incontinence (MUI), stress urinary incontinence (SUI) or OAB (case group) and a control group (subjects with other incontinence or LUTS complaints, or no symptoms)., Outcome Measure: Prevalence of LUTS categories were determined for each country based on International Continence Society (ICS) criteria., Results and Limitations: A total of 3130 individuals agreed to participate in the survey, which found high rates of LUTS (men 80%; women 84%) and OAB (men 18%; women 28%). Duration of urinary symptoms was relatively brief (approximately 60% ≤ 3 years) and was associated with relatively modest effects on quality of life and work performance in the majority of individuals. Forty percent had consulted with a healthcare provider about their urinary symptoms, of whom 37% had consulted with a physician and 34% with an urologist, and 12% had been treated with a prescription medication. Drug therapy, while uncommon, was associated with a high degree of self-reported improvement (96%). Because of between-country population differences, aggregate results may not always be representative of results for each of the three countries individually. Study limitations include reliance on patient self-report, and potential bias introduced by patients who declined to participate in the survey., Conclusions: The results of this epidemiologic survey found high rates of LUTS and OAB, but low levels of medical consultation and very low use of medication treatment, despite high levels of improvement when medications were used.

Circularly permuted green fluorescent protein (cGFP) was inserted into the hyperthermophilic maltose binding protein at two different locations. cGFP was inserted between amino acid residues 206 and 207, or fused to the N-terminal of maltose binding protein from Thermotoga maritima. The cloned DNA constructs were expressed in Escherichia coli cells, and purified by metal chelate affinity chromatography. Conformational change upon ligand binding was monitored by the increase in fluorescence intensity. Both of the fusion proteins developed significant fluorescence change at 0.5 mM maltose concentration, whereas their maltose binding affinities and optimum incubation times were different. Fluorescent biosensors based on mesophilic maltose binding proteins have been described in the literature, but there is a growing interest in biosensors based on thermostable proteins. Therefore, the developed protein constructs could be models for thermophilic protein-based fluorescent biosensors.

We developed a fluorescent protein construct by genetically fusing green fluorescent protein (GFP) to aspartate dehydrogenase from Thermotoga maritima. The fusion protein was cloned, heterologously expressed in Escherichia coli cells, and purified by Ni-chelate affinity chromatography. It was then introduced into a measurement cuvette to monitor its fluorescence signal. Aspartate dehydrogenase functioned as the biorecognition element, and aspartate-induced conformational change was converted to a fluorescence signal by GFP. The recombinant protein responded to l-aspartate (l-Asp) linearly within the concentration range of 1-50 mM, and it was capable of giving a fluorescence signal in 1 Min. Although a linear response was also observed for l-Glu, the fluorescence signal was 2.7 times lower than that observed for l-Asp. In the present study, we describe two novelties: development of a genetically encoded fluorescent protein construct for monitoring of l-Asp in vitro, and employment of aspartate dehydrogenase scaffold as a biorecognition element. A few genetically encoded amino-acid biosensors have been described in the literature, but to our knowledge, a protein has not been constructed solely for determination of l-Asp. Periplasmic ligand binding proteins offer high binding affinity in the micromolar range, and they are frequently used as biorecognition elements. Instead of choosing a periplasmic l-Asp binding protein, we attempted to use the substrate specificity of aspartate dehydrogenase enzyme., (© 2013 International Union of Biochemistry and Molecular Biology, Inc.)

Background and Purpose: To assess the results of shockwave lithotripsy (SWL) for renal calculi in upper, middle, and lower calices according to the stone burden., Patient and Methods: A series of 52 female and 66 male patients with a mean age of 47.8 years and isolated single caliceal stones who underwent SWL monotherapy were enrolled. Stone burden, stone location, number of sessions/shockwaves, and auxiliary procedures were noted for each patient. Stones were located in the upper, middle, and lower calices of 35, 43, and 40, patients respectively, with mean stone burdens of 81.4 mm2, 75.2 mm2, and 96.3 mm2, respectively. Patients were evaluated with intravenous urography, plain film, or ultrasonography. Success was determined 3 months after the last session. Re-treatment rates were calculated. The effect of anatomic factors on the success of treatment for lower-caliceal stones also was determined., Results: The mean stone burden, median number of treatment sessions, and mean number of shockwaves were 84.2 mm2, 2, and 4344, respectively. The auxiliary procedure rate was 16.1%, and the re-treatment rate was 71.2%. Failure was noted in 26 patients (22%). The stone-free rates for stones in the upper, middle, and lower calices were 82.8%, 83.4%, and 67.5%, respectively (P = 0.14). The stone-free rates for stones <100 mm2 and 100 to 200 mm2 were 91.2% and 65.5%, respectively (P = 0.001). The efficiency quotient was 49.8, 44.8, and 32.5 for upper-, middle-, and lower-caliceal stones, respectively. Infundibular length (P = 0.006) and infundibular width (P + 0.036) were significant in determining the stone-free rate after treatment of lower-caliceal stones., Conclusions: We recommend SWL as the first choice for treatment of stones <200 mm2 in the upper and middle calices. Extracorporeal lithotripsy is one of the options for lower-caliceal stones <200 mm2 but has high re-treatment and auxiliary-procedure rates in these cases.

Leydig cell tumors of the testis are rare, mostly presenting as a testicular mass or as endocrinological symptoms. Here, three patients who were admitted for investigation of primary infertility and one patient presenting with a testicular mass are reported. The histological features were reviewed and an immunohistochemical study was done using a panel of antibodies against cytokeratin, vimentin, inhibin A, S-100, Ki-67, follicle-stimulating hormone, luteinizing hormone, prolactin, p53, bcl-2, and c-erbB2. The latter case (lost during follow up of metastatic disease) demonstrated massive tumor necrosis, extension through the tunica albuginea, and a high mitotic activity and MIB-1 score. Only this malignant case was bcl-2 positive. Of the two oncogenic markers studied, none of the cases were positive for c-erb2, while p53 was positive in more than 50% of cells in the malignant case and in one case of infertility with a large tumor, hemorrhage, focal necrosis and atypical cytological features. We recommend the evaluation of infertile men for Leydig cell tumors, and we believe that a panel of antibodies, including Ki-67, p53 and bcl-2, used for immunohistochemical analysis could be of diagnostic value in the identification of malignant and borderline cases of Leydig cell tumor.

Prolonged erection is a rare problem in urology but it must be treated effectively. The most common etiological factor is intracavernosal vasoactive agent injection for diagnosis or treatment of erectile dysfunction. The aim of this study was to evaluate the efficacy of intracavernosal adrenalin injection alone in the treatment of priapism. Nineteen patients with prolonged erection were evaluated. Seventeen out of the 19 prolonged erections were due to intracavernosal vasoactive agent injection and the remaining two were idiopathic. In all cases 2 ml adrenalin (1/100 000) was injected in each cavernosal body. In the patients who did not respond to the first injection, repeated adrenalin injections were performed at 20 min intervals. Blood pressure and heart rate were monitored during the injections. Detumescence was achieved in ten (53%) patients after the first injection. Repeated adrenalin injections (2-5 injections) were required in nine patients and eight (42%) of them achieved detumescence. Only one (5%) patient who had 26-h prolonged erection could not achieve detumescence. There was no significant difference in blood pressure and heart rate during the monitoring of the patients when compared to the initial values. No standard treatment method has yet been described for prolonged erection. Repeated aspirations and irrigations for treatment of prolonged erection are problematical applications both for patients and urologist. Intracavernosal adrenalin injection alone can be used with high efficacy and safety for the treatment of prolonged erection especially in patients with a short duration of erection.

Objective: To determine the sensitivity of drug-resistant prostate cancer cell lines to doxazosin-mediated cell death, and the effects of combining doxazosin and chemotherapeutic agents on these cell lines. Materials and methods The cytotoxic effect of doxazosin was initially evaluated in the prostate carcinoma cell lines DU145 and PC-3. Doxazosin was combined either with adriamycin, etoposide or paclitaxel after its cytotoxic effects were detected in these cell lines. The tetrazolium dye (MTT) assay and trypan blue dye-exclusion tests were used to determine drug-mediated cytotoxicity. Experiments were performed at least three times and representative data are presented., Results: Both cell lines were sensitive to doxazosin-mediated cytotoxicity and the maximum cytotoxicity was achieved after 72 h. While cell death increased with increasing concentrations of doxazosin, 60 micromol/L doxazosin killed more than half of the cells in these cell lines. The combination of doxazosin with both adriamycin and etoposide resulted in significant synergistic cytotoxic activity at subtoxic concentrations of the drugs. Interestingly, the combination of doxazosin and paclitaxel resulted in antagonistic activity., Conclusion: Doxazosin-mediated cytotoxicity in the drug-resistant human prostate carcinoma cell lines was confirmed. Combinations of doxazosin with either adriamycin and etoposide, but not paclitaxel, had synergistic cytotoxic activity in these tumour cell lines. These results suggest that doxazosin could be a new cytotoxic agent, either used alone or combined, in the treatment of prostate cancer.

Objective: In this study we aimed to show the efficacy of extracorporeal shock wave lithotripsy (ESWL) for urinary stone disease in the pediatric age group and to evaluate the complications encountered after the treatment., Methods: 67 children with 109 stones underwent ESWL, using a Dornier MPL 9000 lithotriptor. Styrofoam boards were used to protect the lungs. KUB and chest radiographs were taken on the day after treatment. If stone-free status was achieved, the patient was followed with ultrasonography and urine analysis every 6 months for 2 years. If fragments < 4 mm were present, follow-up was repeated every 3 months., Results: Stone size ranged from 0.5 to 3.5 cm. 71 renoureteral units underwent a total of 129 ESWL sessions. Retreatment was required in 28 patients. The mean number of sessions per unit was 1.8. A stone-free status was achieved in 60 renoureteral units. The overall success rate was 88.6%. The composition of the stone was mixed calcium oxalate and phosphate in the majority of the patients. Auxiliary procedures used were push-back, ureteroscopic stone removal, and open surgery. Hematuria, colics and fever over 38 degrees C were the complications encountered after the treatment., Conclusions: ESWL is the first-line treatment for renal and upper ureteral calculi. However, larger stones which will require several ESWL sessions and consecutively increased number of shock waves are best treated with percutaneous nephrolithotomy plus ESWL. Patients with congenital anomalies necessitating surgical reconstruction are the best candidates for operation.

Objective: To evaluate the efficacy of Extracorporeal shock wave lithotripsy (ESWL) in renal anomalies., Material and Methods: From 1991 to May 1995. 53 patients with calculi in anomalous kidneys presented to our clinic for treatment with ESWL. Average patient age was 39 years, a range of 6-66 years. These patients (32 male and 21 female) underwent ESWL treatments. ESWL was performed in 27 patients with urolithiasis in duplex system, 18 with horse-shoe kidneys, 4 with unilateral renal agenesis, 2 with pelvic ectopic kidneys, 1 with sigmoid kidney and 1 with L-shaped kidney., Results: Among patients who completed ESWL the rate free of stones was 60.4% and the rate of clinically insignificant residual fragments was 30.2%. No sign of stone disintegration was observed in 2 patients. They underwent open surgery. The shock waves per therapy varied between 811 and 18,101. Double-J stents were placed in 13 patients., Conclusion: Most patients with calculi in anomalous kidneys can be managed primarily with ESWL.

Sixty unpremedicated outpatients undergoing elective extracorporeal shockwave lithotripsy (SWL) using a Dornier MPL 9000 lithotripter were randomly assigned to receive either propofol-alfentanil (PA group; N = 30) or midazolam-alfentanil (MA group; N = 30) by a patient-controlled analgesia (PCA) device for sedation and analgesia. Although pain intensity scores were lower after 20 minutes and sedation was more pronounced in the MA group, both drug regimens produced satisfactory sedation and analgesia and allowed the maximum number of shockwaves to be given. Alfentanil consumption was less in the MA group (P < 0.05). Both groups were hemodynamically stable. The patients in the MA group had slower ventilation rates, lower oxygen saturation, and higher end-tidal carbon dioxide levels. Use of MA was associated with more episodes of oxygen desaturation to < 90% (30% vs. 11%; P < 0.05). One patient in the PA group and three patients in the MA group developed bradypnea (< 10 breaths/min). Patient satisfaction was very high with the two sedative-analgesic techniques. Propofol and midazolam, when given in combination with alfentanil using a PCA pump, may provide safe, effective analgesia and sedation during lithotripsy. Patient-controlled sedation and analgesia may provide optimal conditions for SWL of urinary tract stones and is a useful alternative to other forms of anesthesia and analgesia.

A case of renal carcinoma in a giant solitary renal cyst is reported. Ultrasonography and CT showed an apparently benign left renal cyst except for wall irregularity. Cytological examination and fat analysis of the cyst content were negative but the fluid was haemorrhagic in nature. Frozen section of the cyst wall revealed malignancy and further histopathologic examination indicated renal cell carcinoma.

Eosinophilic cystitis is an unusual form of cystitis which is characterized by irritative voiding symptoms and haematuria. In the report herein two adult cases of eosinophilic cystitis treated with intravesical Mitomycin-C instillations for prophylaxis of bladder carcinoma are presented and the literature is reviewed.

Objective: To show that the fluids obtained from spermatoceles and epididymal cysts are not infected, even though they may be present for long periods, and that these fluids have bactericidal activity., Materials and Methods: Sixteen patients, 13 with a spermatocele and three with an epididymal cyst, were included in the study. Protein, glucose, chloride, inorganic phosphorus, calcium and magnesium contents were measured and cultures of the fluids were carried out. Bactericidal activity against the Escherichia coli NTCC 10418 clone was tested in different dilutions., Results: Biochemical analysis showed that the protein, glucose and ionic content of the fluids was lower than that of serum, except for chloride. Microbiological cultures were negative for all samples. A significant bactericidal effect was obtained with 1/1 dilution and no reproduction was seen with this dilution., Conclusion: These findings indicate that the fluids within spermatoceles and epididymal cysts do not become infected under normal circumstances.

In this study antifungal effects of tioconazole which is prepared in aerosol forms were investigated. For this purpose, the formulations which have and have not active material were sprayed on petri dishes inoculated with Candida albicans and Aspergillus niger. Because of non growth in dishes with formulations containing active material, formulations with active material were sprayed on to the pregrowth Candida albicans and Aspergillus niger in order to detect if the effect is fungicide or not. At the end of application time, the samples taken from these dishes were inoculated by the direct way. The lack of growth had confirmed the realization of the formulations with fungicide effects.