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    The Application of Kidney Injury Molecule-1 to Determine the Duration Between Shockwave Lithotripsy Sessions
    (Mary Ann Liebert, Inc, 2016) Aydin, Hasan R.; Irkilata, Lokman; Aydin, Mustafa; Daggulli, Mansur; Taskin, Mehmet H.; Demirel, Huseyin C.; Adanur, Senol
    Purpose: We aimed to evaluate the role of kidney injury molecule-1 (KIM-1) in determining the intervals between shockwave lithotripsy (SWL) sessions. Patients and Methods: This was a prospective, controlled study. It included 40 patients with unilateral kidney stones and 40 healthy persons of a similar age group as controls. The patients' midflow urine samples were collected before SWL and 1 hour, 1 day, 1 week, and 1 month after the procedure. Results: The average age in the SWL and control groups was 4514 and 39 +/- 15 years, respectively (P=0.336). The average KIM-1 value before SWL was 0.74 +/- 0.35ng/mL, which was significantly higher than that of the control group (0.51 +/- 0.14ng/mL) (P<0.001). Similarly, the average values of the urine samples after SWL were higher than those of the control group (P<0.001). When the KIM-1 values of the patients given SWL were compared within the group, the KIM-1 values 1 hour (1.06 +/- 0.51) and 1 day (0.99 +/- 0.67) after the procedure were statistically clearly higher than those before the procedure (P<0.001) and statistically clearly higher than those of the control group (P=0.005). The KIM-1 values 1 week and 1 month after the procedure were not significantly different than the preprocedure values (P=0.652 and P=0.747, respectively). Conclusion: KIM-1 is a noninvasive biomarker that may be used to show renal damage because of stones and early-stage renal damage linked to SWL. In addition, post-SWL KIM-1 values may be used to determine the interval between SWL sessions.
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    Extracorporeal shock wave lithotripsy in the primary treatment of encrusted ureteral stents
    (Springer, 2015) Irkilata, Lokman; Ozgur, Berat Cem; Sancaktutar, Ahmet Ali; Akdeniz, Ekrem; Aydin, Mustafa; Demirel, Huseyin Cihan; Aydin, Hasan Riza
    Double pigtail (JJ) ureteral stents, are the most commonly used method of urinary diversion in the ureteral obstructions. Encrustations may occur as a result of prolonged exposure due to forgetting these stents in the body. Removing these materials might be an annoyance. Forty-four patients from three tertiary referral centres with forgotten JJ stents left in them between the years 2007 and 2014 were included in the study. Stents could not be removed by attempted cystoscopy. As an alternative approach, extracorporeal shock wave lithotripsy (ESWL) was the first choice since it is minimally invasive. The results of that treatment are presented along with the relevant demographic data. JJ stenting for urolithiasis was performed in 36 patients, after open surgery in five patients, and for oncological reasons in three patients. ESWL was applied to stents or to any suspicious region adjacent to the stent. In 29 of 44 patients, the stents were easily removed under cystoscopic procedures while in one patient the fragmented residual stent was spontaneously excreted. In eight patients, ureteroscopy was required; in five patients, percutaneous nephrolithotripsy was required; and in one patient, open surgery was required in order to remove stents. ESWL can be considered as a first-line treatment when a forgotten JJ stent is detected despite all precautions after any kind of urological intervention involving insertion of ureteral stents.
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    PLASMA TOTAL HOMOCYSTEINE, LIPOPROTEIN (A) AND VON WILLEBRAND FACTOR LEVELS IN ASSESSMENT OF METABOLIC CONTROLS OF CHILDREN WITH TYPE I DIABETES MELLITUS
    (Nobel Ilac, 2014) Ertugrul, Sabahattin; Sen, Yasar; Yilmaz, Erdal; Aydin, Mustafa; Ustundag, Bilal
    Objective: Diabetes is a significant risk factor for early onset of atherosclerosis. In this study, it was aimed to determine whether total homocysteine (tHcy), lipoprotein(a) [Lp(a)] and von Willebrand factor (vWF) levels have an early predictive value like glycolysated hemoglobin (HbA1c) levels in assessment of metabolic condition of children with type I diabetes. Material and Method: Study group consisted of 65 children and adolescents who had type I diabetes but not clinical findings of microvascular and macrovascular complications and 20 healthy children and adolecents with the same age group and gender Blood samples were obtained from diabetic patients, treatments were arranged and patients were followed up (Group I diabetic patients). Patients were re-evaluated at the end of 1 year and blood samples were obtained again (Group H diabetic patients). Results: A statistically significant difference was found between the first (11.1 +/- 3.3 mu mol/L) and the second tHcy levels (10.2 +/- 1.7 mu mol/L) of diabetic patients and tHcy levels of control group (8.9 +/- 2 mu mol/L)(p<0.05 and <0.01, respectively). A statistically significant difference was found between the first (10.4 +/- 5.4 mg/dl) and the second Lp(a) levels (9.0 +/- 4.3 mg/dl) of diabetic patients and Lp(a) levels of control group (5.3 +/- 2.8 mg/dl)(p<0.01 and <0.001, respectively). A statistically significant difference was not found when vWF levels of diabetic groups I and II and control group were compared (p>0.05). A statistically significant positive correlation was found between tHcy and HbA1c, microalbumin in Group I diabetic patients (r=0,389, p=0,02; r=0,286, p=0,034, respectively). A statistically significant positive correlation was found between HbA1c and homocysteine, vWF, microalbumin (r=0,428, p=0,001; r=0,328, p=0,024; r=0,742, p=0,001, respectively) and vWF and microalbumin levels (r=0,560, p=0,001) in Group II diabetic patients. Conclusion: In conclusion, that tHcy and Lp(a) could be beneficial for assessment of metabolic control of diabetes, treatments toward reducing the complications of diabetes or the outcomes of additions to diet.