Aydin, H. | Yencilek, F. | Erihan, I.B. | Okan, B. | Sarica, K.

Article | 2011 | Urological Research39 ( 6 ) , pp.451 - 458

Both the prevalence of cardiovascular risk factors and event rate are increased in patients with urolithiasis. Screening is recommended to all patients who have high cardiovascular risk. The aim of this study was to document 10-year risk of cardiovascular disease and mortality in asymptomatic patients with urolithiasis. Consecutive 200 patients with calcium oxalate urolithiasis were compared with 200 age- and sex-matched healthy controls. Ten-year cardiovascular disease risk was calculated with the Framingham Risk Score and mortality risk with SCORE risk score. Calcium, oxalate, and citrate excretion were studied as urinary stone ri . . .sk factors. The results indicate that patients with urolithiasis had higher total cholesterol (p < 0.0001), lower HDL-cholesterol (p < 0.0001), and higher systolic blood pressure (p < 0.0001) and hsCRP (p < 0.0001) compared with controls. Patients with urolithiasis had a higher Framingham Risk Scores [OR 8.36 (95% CI 3.81-18.65), p = 0.0001] and SCORE risk score [OR 3.02 (95% CI 1.30-7.02), p = 0.0006] compared with controls. The Framingham and SCORE risk score were significantly correlated with urinary calcium (p = 0.0001, r = 0.460, and p = 0.005, r = 0.223, respectively) and oxalate excretion (p = 0.0001, r = 0.516, p = 0.001, r = 0.290, respectively). In multiple linear regression analysis, urinary calcium and oxalate excretion, age, sex, total cholesterol, HDL-cholesterol, hsCRP and smoking were the independent predictors of 10-year cardiovascular disease risk and urinary calcium and oxalate excretion, age, sex, total cholesterol, fasting blood glucose for 10-year cardiovascular mortality. In conclusion, patients with calcium oxalate urolithiasis carry high risk of cardiovascular disease and mortality. All patients should be screened at the initial diagnosis of urolithiasis for the risk factors. © 2011 Springer-Verlag Daha fazlası Daha az

Yencilek, F. | Erturhan, S. | Canguven, O. | Koyuncu, H. | Erol, B. | Sarica, K.

Article | 2010 | Urological Research38 ( 3 ) , pp.195 - 199

The objective of this study is to assess the efficacy of an alpha-1 adrenergic receptor blocking agent on the spontaneous passage of proximal ureteral calculi ?10 mm. 92 patients having single radio-opaque proximal ureteral stone ?10 mm were randomized into two groups. Group 1 patients (n = 50) were followed with classical conservative approach and patients in Group 2 (n = 42) additionally received tamsulosin, 0.4 mg/day during 4 weeks follow-up. The stone passage rates, stone expulsion time, VAS score, change in colic episodes, and hospital re-admission rates for colicky pain were compared. The patients were furthermore stratified . . .according to stone diameters Daha fazlası Daha az

Ateş, F. | Eryildirim, B. | Öztürk, M.I. | Turan, T. | Gürbüz, C. | Ekinci, M.O. | Sarca, K.

Article | 2012 | Urological Research40 ( 5 ) , pp.537 - 542

The objective of the study is to investigate the effect of doxazosin, administered to the subjects who underwent SWL due to upper ureteral stones, on therapeutic outcomes. The study enrolled the patients with a radio-opaque stone ?5 mm in upper ureter. Patients were randomized into two groups: the first group underwent SWL following the diagnosis and they were recommended to receive oral hydration. The second group underwent SWL after initiating alpha blocker (doxazosin controlledrelease tablet 4 mg/day) and drug therapy was continued until that the patient has been stone free. Parameters of SWL procedure, Steinstrasse, pain score a . . .t admission, time to stone passage, the complications developed, the additional procedures that were administered and number of hospital visits done due to pain during the treatment were recorded. A total of 79 patients were enrolled to the study. The subjects evaluated included 35 patients, who received an alpha blocker and 44 patients who did not receive an alpha blocker. For both groups, the level of energy applied per SWL session, the diameter of the stone, the number of hospital visits done due to pain, pain score and the need for analgesia were found to be similar (p > 0.05). The group of doxazosin was more advantageous in terms of stone-free rate, the need for additional procedures and Steinstrasse (p < 0.05). In conclusion, the addition of doxazosin to SWL therapy administered for upper ureteral stones reduces Steinstrasse, and thereby, the need for additional procedures and increases post-treatment stone-free rate. A positive effect of doxazosin on the time to stone passage was not shown. © Springer-Verlag 2012 Daha fazlası Daha az

Göktaş, C. | Horuz, R. | Akça, O. | Çetinel, A.C. | Albayrak, S. | Sarıca, K.

Article | 2012 | Urological Research40 ( 4 ) , pp.383 - 387

We aimed to evaluate the success rates, auxiliary procedures and complications after ureteroscopic lithotripsy (URS) during which the fragments left in situ for spontaneous passage after complete disintegration into a acceptable (

Papatsoris, A. | Sarica, K.

Review | 2012 | Urological Research40 ( 6 ) , pp.639 - 646

The last decade flexible ureteroscopy has progressed from an awkward diagnostic procedure with limited visualization to a precise surgical intervention allowing access to the entire collecting system. In this review, we present the current status and future perspectives of the ureterorenoscopic management of urolithiasis and nonstone- related upper tract pathologies. © Springer-Verlag 2012.

Goktas, C. | Coskun, A. | Bicik, Z. | Horuz, R. | Unsal, I. | Serteser, M. | Sarıca, K.

Article | 2012 | Urological Research40 ( 5 ) , pp.569 - 573

Extracorporeal shockwave lithotripsy (ESWL) has dramatically changed the treatment of urinary lithiasis and has been the first treatment option for the majority of patients for more than two decades. Despite its significant benefits, it induces acute renal injury that extends from the papilla to the outer cortex. We evaluated the severity of the inflammatory response to ESWL by measuring the urinary excretion of the cytokines TNF-?, IL-1?, and IL-6. The study included 21 selected patients and 14 control subjects. All patients underwent the same ESWL procedure (2,500 shockwaves at 100 shockwaves/min and 0.039 J from the lithotripter) . . .. Urine TNF-?, IL-1?, and IL-6 levels were measured using standard ELISA kits. In the study population (patients and controls), we did not detect TNF-? in the urine samples. The levels of both IL-1? (2.5 pg/ml) and IL-6 (3.8 pg/ml) measured before ESWL were not significantly different from the control group (2.5 and 5.2 pg/ml, respectively; p > 0.05). Twenty-four hours after ESWL, in contrast to IL-1? (4 pg/ml), urine IL-6 (19.7 pg/ml) increased significantly (p < 0.05). Fourteen days after ESWL, IL-1? increased to 5 pg/ml, while IL-6 (7 pg/ml) decreased to the control level. Urine cytokine levels may be used to evaluate the inflammatory response to ESWL. After ESWL, IL-6 levels increased in the early phase, while IL-1? levels increased later. These two markers may be used to measure the severity of inflammation. In contrast to IL-1? and IL-6, urine TNF-? excretion was not increased by ESWL. We believe that the inflammatory response to ESWL can be detected by the urinary excretion of IL-1? for up to 14 days. © Springer-Verlag 2012 Daha fazlası Daha az

Koyuncu, H.H. | Yencilek, F. | Eryildirim, B. | Sarica, K.

Article | 2010 | Urological Research38 ( 2 ) , pp.105 - 109

The aim of this study was to evaluate the possible effect of a positive family history on the age at the onset of urinary stone disease and the frequency of subsequent symptomatic episodes relating to the disease. Between March 2006 and April 2009, patients with either a newly diagnosed or a previously documented stone disease were included in the study program. They were required to fill in a questionnaire and divided into two groups according to the positive family history of stone disease; group I comprised patients with a family history for urinary calculi and group II those without. Depending on the data obtained from questionn . . .aires, all patients were evaluated in detail with respect to the age at the onset of the stone disease, stone passage and interventions over time, time to first recurrence (time interval between the onset of the disease and the first recurrence), number of total stone episodes and recurrence intervals. 1,595 patients suffering from urolithiasis with the mean age of 41.7 (14-69 years) were evaluated with respect to their past history of the disease. There were 437 patients in group I and 1,158 in group II. There was no statistically significant difierence between the mean age value of two groups (P = 0.09). When both genders in group I were analyzed separately, female patients tended to have higher rate of family history positivity than males. Comparative evaluation of the age at the onset of the disease between the two groups did reveal that stone formation occured at younger ages in patients with positive family history [P = 0.01 (males), P = 0.01 (females)] and the mean age of onset of the disease was lower in males than females in group I (P = 0.01). Patients in group I had relatively more stone episodes from the onset of the disease [P < 0.01 (2-4 episodes), P < 0.01 (?5 episodes)]. Male patients were associated with higher number of stone episodes (P = 0.01). Mean time interval between recurrences was noted to be significantly shorter in group I patients when compared with patients in group II [P < 0.01 (males), P = 0.02 (females)]. In conclusion, our results showed that urinary stone formation may occur at younger ages and that the frequency of symptom episodes may be higher in patients with a positive family history. We believe that the positive family history for urinary stone disease could give us valuable information concerning the onset as well as the severity of the disease. © The Author(s) 2009 Daha fazlası Daha az

Tanriverdi, O. | Telci, D. | Aydin, M. | Ekici, I.D. | Miroglu, C. | Sarica, K.

Article | 2012 | Urological Research40 ( 1 ) , pp.17 - 25

An experimental study in rats was performed to evaluate the presence and the degree of both tubular apoptotic changes and crystallization at cortical, medullar and papillary regions of the kidney during hyperoxaluric phase and assess the possible protective effects of vitamin E and verapamil on these pathologic changes (particularly in papillary part of the affected kidneys). A total of 32 rats have been included into the study program. Hyperoxaluria was induced by continuous administration of ethylene glycol (0.75%). In addition to hyperoxaluria induction, animals in Groups 2 and 3 did receive a calcium channelblocking agent (verap . . .amil) and vitamin E, respectively. Histologic alterations of the kidneys including crystal formation together with apoptotic changes were evaluated on days 1, 14 and 28, respectively. Both apoptotic changes and the presence and degree of crystallization were assessed separately in renal cortical region, medulla and particularly papillary parts of the removed kidneys. Although verapamil did well limit the degree of crystal formation and apoptosis and brought it to the same levels observed in control group animals in all parts of the kidneys during intermediate phase, addition of vitamin E was failed to show the same protective effect during both intermediate and late phase evaluations. As demonstrated in our study, the limitation of both crystal deposition and apoptotic changes might be instituted by calcium channel-blocking agents. Clinical application of such agents in the prophylaxis of stone disease might limit the formation of urinary calculi, especially in recurrent stone formers. © Springer-Verlag 2011 Daha fazlası Daha az

Sarıca, K. | Aydin, H. | Yencilek, F. | Telci, D. | Yılmaz, B.

Article | 2012 | Urological Research40 ( 5 ) , pp.461 - 466

Oxalate is the most common component of kidney stones and elevated urinary levels induce renal tubular cell toxicity and death which is essential for crystal attachment. Endothelial cells, in some studies have been shown to regulate certain functions of renal proximal tubule cells. The aim of this study was to evaluate the effect of endothelial cells on tubular cell apoptosis in a coculture system mimicking the in vivo renal physiological settings. The human umbilical vein endothelial cells (HUVEC) and human renal proximal tubule epithelial cells (RPTEC) were exposed to increasing concentrations (0-1.0 mM) of oxalate with or without . . . 10 µM PDTC pretreatment for 24 h. In HUVEC, RPTEC and HUVEC-RPTEC co-cultures, the cell viability was measured using the WST-1 assay and cell death with the TUNEL analysis using the flow cytometry. The treatment of RPTECs with oxalate lead to 8.9-26.2% cell death which was reduced to 0-1.6% with the PDTC pretreatment. The death rate of RPTECs was significantly increased by 15-19% at different oxalate concentrations when co-cultured with HUVECs. In contrast, cell viability was not substantially altered in PDTC pretreated RPTECs that were co-cultured with HUVECs. Apoptosis was the way of cell death as similar rate of apoptosis was observed in cell culture systems. Although cell viability of RPTECs was further reduced when co-cultured with HUVECs, it was restored with the pretreatment of PDTC. This is the first study focusing on the role of endothelial cells on RPTEC apoptosis following hyperoxaluria. © Springer-Verlag 2012 Daha fazlası Daha az