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The aim of this study was to investigate the effects of mouth gag used in adenoidectomy / tonsillectomy on temporomandibular joint (TMJ) function and mouth opening with using digital dial type caliper. Mouth opening distance and TMJ function of a total of 50 patients including 30 patients (6-43 yrs, 17 men, and 13 women) who had undergone adenoidectomy / tonsillectomy and 20 patients (19-47 yrs, 12 men and 8 women) of the control group who had undergone septoplasty between November 2015 and November 2016 at ENT Department of tertiary medical center were measured using digital dial type caliper one hour before, and one week, and one month after the operation. Changes in the distance of mouth opening at 4th hour, 1 week and 1 month postoperatively in the adenoidectomy / tonsillectomy group were statistically significant (p=0.001, p0.05). There is 57.5% positive correlation between patients’ age, and range of mouth opening in two groups (r:0.575, p=0.001, p

PubMedID: 27524530 Objectives: To compare the results of the management of the first 25 transperitoneal laparoscopic ureterolithotomies with the first 25 retroperitoneal laparoscopic ureterolithotomies performed by two surgeons who had just completed a laparoscopic training programme. Methods: The retrospective study was conducted at Adana Numune Teaching and Research Hospital and comprised retroperitoneal laparoscopic ureterolithotomies and transperitoneal laparoscopic ureterolithotomies performed by two different surgeons on patients with proximal ureteral stones between November 2011 and March 2013. The transperitoneal and retroperitoneal procedures were categorised as Groups A and B, respectively. Patients in Group A were operated on by the same surgeon (DA) and those in Group B were operated on by the other surgeon (FK). Groups were compared according to operative time, duration of drainage and urethral catheter, hospital stay, stone size, surgical success and complications. Results: There were 50 patients in the study; 25(50%) in each of the two groups. Success rates in Group A and B were 21(84%) and 20(80%), respectively (p>0.05). Complications were seen in 8(32%) and 11(44%) patients in Group A and B, respectively (p>0.05). Conclusion: The transperitoneal approach was more advantageous than the retroperitoneal approach for less-experienced surgeons because it provided a wider operating field, a more familiar anatomy and more convenient suturing. © 2016, Pakistan Medical Association. All rights reserved.

PubMedID: 25433472 Purpose: To compare the quality of life (QoL) of renal cancer patients following laparoscopic and open radical nephrectomy. Materials and Methods: Seventy-two (64.9%) patients who were treated with open radical nephrectomy (ORN group) and 39 (35.1%) patients who were treated with laparoscopic radical nephrectomy (LRN group) were included in this study. QoL was evaluated by Short Form-36 (SF-36) physical domain scores obtained before surgery, 1 and 6 months after surgery. Analgesic requirement and visual analog scale (VAS) pain scores following surgeries were recorded. Results: The demographic features of the groups were similar. There was a significant difference in tumor size between the ORN group (71.59 ± 29.83 mm) and LRN group (57.08 ± 19.33 mm) (P = .011). In the LRN group there was less blood loss, a lower transfusion rate, earlier ambulation, more rapid convalescence and shorter hospitalization; however, the difference in surgical duration between the ORN group (122.86 ± 36.8 min) and LRN group (140.17 ± 50.71 min) was not significant (P = .383). Analgesic requirement and VAS pain scores were similar in both groups. In terms of SF-36 physical domain scores, the general health perception score in the LRN group was higher than that in the ORN group at pre-surgery, 1 and 6 months after surgery. SF-36 physical functioning and general health perception scores in both groups were significantly lower in 1 month after surgery and were higher in 6 months after surgery, as compare to before surgery. Bodily pain scores in LRN group did not change significantly after surgery (P = .376). Conclusion: LRN exhibited some technical advantages, including less blood loss, shorter hospitalization and more rapid recovery. Although the ORN patients had relatively larger tumors, analgesic requirement, postoperative complications, body pain, and physical functioning weren't significantly different between the groups. QoL was higher 6 months after surgery than before surgery in both groups.

Benign prostate hyperplasia (BPH) is the most common benign tumor in elderly men for which the HPC2/ELAC2 and SRD5A2 genes are known genetic factors. The HPC2/ELAC2 gene features Ser217Leu and Ala541Thr polymorphisms and the SRD5A2 gene Ala49Thr and Val89Leu polymorphisms. The aim of this study was to examine relationships between these polymorphisms and BPH in Turkish men using amplification by the polymerase chain reaction (PCR) method. Polymorphisms were determined by using restriction fragment length polymorphism (RFLP) with suitable restriction: TaqI alpha, Fnu4HI, Mwo I and Rsa I. We found statistically significant relationship between the SRD5A2 gene Ala49Thr (OR=2.3; CI 95%, 1.04-5.1; p=0.01

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Congenital neck masses in children and their embryologic and clinical features. Neck masses of congenital origin can be diagnostic and therapeutic challenges for internists, paediatricians and surgeons. Treatment modalities of congenital neck masses are different depending on their nature, symptoms and location. Differential diagnosis includes a variety of diseases that can cause cervical masses such as infectious and neoplastic neck tumours. Our objective is to review the embryologic and clinical features of some of the most common congenital neck masses such as the haemangioma, branchial cleft anomalies, thyroglossal duct cyst, ectopic thyroid, congenital midline cervical cleft, congenital cervical teratoma, lymphangioma, cervical thymic cyst, dermoid cyst and congenital muscular torticollis.

Introduction: Currently, most of the urinary tract stones can successfully be treated with endourologic procedures, namely, shock wave lithotripsy, ureteroscopy, flexible ureterorenoscopy and percutaneous nephrolithotomy. When these modalities either failed or not indicated, a minimally invasive approach is needed as an alternative to open surgery. Laparoscopic surgery achieved a great progression within the last two decades and it has been shown that almost all kind of open stone surgeries can be performed laparoscopically. Laparoscopy has definite advantages over open surgery and it should not solely be considered as a salvage procedure, but also a first choice in select cases in the treatment of urinary stone disease. Current status of the laparoscopic urinary stone surgery will be reviewed in the light of the literature and our experiences will be presented.

[No abstract available]

PubMedID: 15844777 A child with Beckwith-Wiedemann Syndrome and posterior urethral valves: Beckwith-Wiedemann syndrome is a somatic overgrowth syndrome characterized by a variable incidence of congenital anomalies, including hemihypertrophy omphalocele, macroglossia and renal malformations. We report a child with Beckwith-Wiedemann syndrome and posterior urethral valves. Urethral valve resection was successfully performed under general anesthesia after voiding cystourethrography. This is the first report of Beckwith-Wiedemann syndrome associated with posterior urethral valves.

Introduction: Laparoscopic techniques were introduced as alternatives to many open urologic procedures. In pediatric urology, one of the main applications of laparoscopy is the evaluation and treatment of nonpalpable testis. We are presenting our initial experience with laparoscopy in patients with nonpalpable testis. Materials and Methods: Laparoscopy was performed under general anesthesia on 10 patients from December 2000 to July 2001. If the internal spermatic vessels and vas deferens made their way into the internal inguinal ring, the inguinal canal was dissected. Laparoscopic orchiopexy or orchiectomy was performed in cases with intra-abdominal testis. If the internal spermatic vessels terminated within blind end intraperitoneally, making it impossible to identify the testis, the case was judged to be vanishing testis. Results: Ten boys, aged from 18 months to 25 years (median 9.8 years) were identified with 17 nonpalpable testes. Of 17 nonpalpable testes, in 11 the vas and vessels entered an open internal ring. The inguinal region was explored in all the 11 testes. Orchiopexy was performed on 10 testes and orchiectomy was performed on one testis. Four of 17 testes were intra-abdominal. Laparoscopic orchiopexy was performed in two testes and laparoscopic orchiectomy was performed in two testes. In one boy with bilateral nonpalpable testes neither vas and vessels nor testes were visualized and this case was diagnosed as vanishing testis. Conclusion: Diagnostic laparoscopy is a very helpful minimally invasive technique in the diagnosis of nonpalpable testes especially when ultrasonography and/or computed tomography are not informative. In addition, orchiectomy and orchiopexy can be done as laparoscopically in the patients with intraabdominal testes. Therefore, the laparoscopy has an important role in the diagnosis and treatment of nonpalpable testes.

Objectives: Simple renal cyst is the most common benign disease of the kidney. It requires treatment only when it can not be distinguished from a malignant processor if it causes pelvicaliceal obstruction and/or hypertension. In this study, laparoscopy and open surgery; both used in the treatment of symptomatic simple renal cysts are compared considering duration of procedure, outcome, cost and complications. Material and Methods: In our clinic, between October 1993 and February 2002, 21 patients (15 male, 6 female) (group I), had laparoscopic renal cyst excision and 40 (19 male, 21 female) (group II) had open surgery for cyst removal. Both were done under general anesthesia. Mean ages in group I and II were 53.5 years (25-74) and 48.4 years (29-70) respectively. In the group I; transperitoneal approach was preferred in 10 patients, and retroperitoneal in 11. Results: Mean duration of operation was 154±69 minutes in the first; and 125±43 minutes in the second group. Mean hospital stay was 18 hours for the first; and 4.8 days for the second group. In the two patients (9.5%) of the first group, the procedure was switched to open surgery because of bleeding. In one patient (4.5%) of the second group postoperative bleeding became. The cost in the first group was 1109 USD and 358 USD in the second group. Conclusion: Even though the cost is high, we conclude that laparoscopic surgery is an effective method in the treatment of symptomatic simple renal cysts because hospital stay is shorter and therefore loss of work-days is less and the operation sear is much smaller.

PubMedID: 12583440 The case of a 65-year-old male with pheochromocytoma arising in the urinary bladder is presented. Clinical evaluation included ultrasonography, intravenous pyelography and computerized tomography (CT) scan. Transurethral resection of an exophytic tumor 1 cm in diameter was performed. The histological diagnosis was pheochromocytoma of the bladder. The evaluation and management of this type of tumor is discussed.

WOS: 000176951200014 PubMed ID: 12119443 A case of retroperitoneal Castleman's disease - a benign lymphoid tumor - is reported. The tumor is excised totally. A 34-month follow-up period is disease free and uneventful. The preoperative workup presented, its clinical behavior and management are discussed. Copyright (C) 2002 S. Karger AG, Basel.

PubMedID: 11989570 Purpose: To describe the angiographic signs found using scanning laser ophthalmoscopy for the early diagnosis of vitreoretinal interface syndrome. This method is useful to visualize the inner retinal layers, being more sensitive than fundus biomicroscopy. Material: 61 patients with vitreoretinal interfase syndrome were evaluated. All of them had evidence of this disease using scanning laser ophthalmoscopy but four patients were referred without diagnosis of vitreoretinal interfase syndrome. These patients showed no biomicroscopic signs and diagnosis was made with SLO. Methods: Confocal scanning infrared laser ophthalmoscope (Heidelberg Retinal Angiograph assembled by Heidelberg Engineering). This SLO uses an infrared diode laser source of 795 nm. Conclusion: Patients included were referred with another diagnosis and with this method the correct diagnosis was made. In conclusion scanning laser ophthalmoscopy allows early diagnosis of this pathology for follow-up and treatment.

In this study, advantages of the endoscopes in retrosigmoid-suboccipital approach (RSSOA) were presented on 35 cases with acoustic neuroma (AN). The endoscopes facilitated surgery by needing less bone drilling and direct vision of the internal acoustic canal (IAC) for tumor residual, neuro-vascular structures during resection and opened air cells at the end; Further, hearing preservation could be achieved safely by using endoscopes.

Purpose: Percutaneous nephrostomy (PCN) is a safe and useful procedure used in urinary tract obstruction and its insertion was done by the help of radiologists in some hospitals. By the use of an ultrasound and fluoroscopy which are today available in most of the urology departments there is no longer need to radiologists. The aim of this study is to evaluate the results of PCN procedures performed by the urologists alone. Methods: In a five-year period between 1990-1994, a total of 116 PCNs were inserted in 93 patients (55 male and 38 female). Their ages were ranging from 40 days to 75 years (mean 41.3 years). Ultrasound and fluoroscopic guidance were used in the urinary access. Nephrostomy tubes were inserted because of urinary obstructions in 74 (63.8%), intrapelvic malignancies in 35 (30.2%), obstruction in transplanted kidneys in 4 (3.4%) and vesicoureteral reflux in 3 (2.6%). Results: Hemorrhage was observed in 3 (2.6%) patients but surgical intervention was done only in one patient (0.9%) in the early post-procedure period to control the massive hemorrhage from the puncture sites on parenchyma. Conclusion: The urologists perform different kinds of endourologic procedures and insertion of nephrostomy catheter is a simple procedure which can be done solely by urologists who are deciding for the PCN indication and able to treat the complications which may arise, and must be handled by the urologist.

In the leishmaniasis focus of Sanliurfa, south-east Turquey, phlebotomine sandflies catches in houses and stables seem to confirm the parasitological data with an urban cycle due to Leishmania tropica transmitted by Phlebotomus sergenti. The incidence could be reduce drastically by intradomiciliar and stables insecticide pulverisations.

In the leishmaniasis focus of Sanliurfa, south-east Turquey, phlebotomine sandflies catches in houses and stables seem to confirm the parasitological data with an urban cycle due to #Leishmania tropica$ transmitted by #Phlebotomus sergenti$. The incidence could be reduce drastically by intradomiciliar and stables insecticide pulverisations. (Résumé d'auteur)