Methabolic Evaluation and Medical Aspects of Recurrent Urinary Tract Calcium Stones

Recurrent Stone formation in the urinary tract is a common and important problem. The most important component in the medical treatment of stones is establishing the correct metabolic diagnosis. Unfortunately a significant proportion of patients with recurrent stones do not undergo proper metabolic evaluation. Dietary modification still remains one of the most important strategies for therapy. Recent studies suggest that severe calcium restriction is not useful in patients with recurrent calcium nephrolithiasis. New studies imply the significant role of oxalate, salt and animal protein dietary restrictions in the prevention of calcium stone recurrence. When dietary modification is unsuccessful in controlling stone formation or in the presence of severe metabolic derangements, a pharmacologic treatment may be necessary

Association between bactericidal/permeability increasing protein (BPI) gene polymorphism (Lys216Glu) and inflammatory bowel disease

Background: Increasing Increasing evidence suggests that innate immune system may have a key role in the pathogenesis of the inflammatory bowel disease (IBD). Bactericidal/permeability increasing protein (BPI) has an important role in the recognition and neutralization of gram-negative bacteria by host innate immune system. The polymorphism on BPI gene called Lys216Glu is on the suspected list of IBD pathogenesis. Methods: We studied the Lys216Glu polymorphism on BPI gene, in a Turkish IBD patient population. A total of 238 IBD patients; 116 Crohn's disease (CD) and 122 ulcerative colitis (UC), besides 197 healthy controls were included in this study. Results: The Glu/Glu genotype and allele frequencies were found to be statistically higher compared to healthy control group not only in CD patients [P: 0.03, OR: 1.87 (CI 95% 1.02-3.42) and P: 0.00001 (OR: 2.07 CI 95% 1.47-2.91) respectively] but also in UC patients [P: 0.0002, OR: 2.71 (CI 95% 1.53-4.80) and P: 0.00002 (OR: 2.71 CI 95% 1.53-4.80) respectively]. Conclusions: BPI polymorphism (Lys216Glu) is associated both to CD and UC. Our findings differ from the two Western European studies; one without any association and the other indicating an association only with CD. Our study is the first one reporting a novel association between BPI gene mutation (Lys216Glu) and UC. (C) 2010 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved

Bactericidal Permeability Increasing Protein Gene Polymorphism is Associated with Inflammatory Bowel Diseases in the Turkish Population

Background/Aims: Inflammatory bowel disease, a chronic inflammatory disease with unknown etiology, affects the small and large bowel at different levels. It is increasingly considered that innate immune system may have a central position in the pathogenesis of the disease. As a part of the innate immune system, bactericidal permeability increasing protein has an important role in the recognition and neutralization of gram-negative bacteria. The aim of our study was to investigate the involvement of bactericidal permeability increasing protein gene polymorphism (bactericidal permeability increasing protein Lys216Glu) in inflammatory bowel disease in a large group of Turkish patients. Patients and Methods: The present study included 528 inflammatory bowel disease patients, 224 with Crohn's disease and 304 with ulcerative colitis, and 339 healthy controls. Results: Bactericidal permeability increasing protein Lys216Glu polymorphism was found to be associated with both Crohn's disease and ulcerative colitis (P = 0.0001). The frequency of the Glu/Glu genotype was significantly lower in patients using steroids and in those with steroid dependence (P = 0.012, OR, 0.80; 95% confidence interval [CI]: 0.68-0.94; P = 0.0286, OR, 0.75; 95% CI: 0.66-0.86, respectively). There was no other association between bactericidal permeability increasing protein gene polymorphism and phenotypes of inflammatory bowel disease. Conclusions: Bactericidal permeability increasing protein Lys216Glu polymorphism is associated with both Crohn's disease and ulcerative colitis. This is the first study reporting the association of bactericidal permeability increasing protein gene polymorphism with steroid use and dependence in Crohn's disease

Serum levels of soluble receptor for advanced glycation endproducts (sRAGE) are higher in ulcerative colitis and correlate with disease activity

Interaction of the receptor for advanced glycation endproducts (RAGE) with its ligands results in expression of inflammatory mediators, activation of NF-kappa B, and induction of oxidative stress, all of which have been implicated in the pathogenesis of inflammatory bowel diseases (IBD). Soluble receptor for advanced glycation endproducts (sRAGE) has recently emerged as a reliable biomarker of inflammation in numerous RAGE-mediated disorders. Objective: To assess sRAGE levels in adult patients with IBD. Method: Serum was collected from adult patients with Crohn's disease (CD, 56 patients), ulcerative colitis (UC, 60 patients), and healthy controls (HC, 113 subjects). Levels of sRAGE were determined by enzyme-linked immunosorbent assay. Results: Serum sRAGE levels were elevated in IBD compared to HC and were higher in UC patients compared to CD and HC. Levels of sRAGE were significantly higher in the serum of UC patients with active disease compared to patients with inactive disease, but no association with the Montreal Classification was evident. Serum sRAGE was lower in CD patients with biological therapies. Conclusions: These findings suggest that serum levels of sRAGE are altered in patients with intestinal inflammation and may reflect distinct immunoinflammatory pathogenesis of UC and (C). 2011 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved

The applications of robotic surgery in urology

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Robotların cerrahi teknolojiye dahil olması nispeten yeni bir gelişmedir. Robot eşliğinde yapılan ameliyatlar erken dönemlerinde olmasına karşın cerrahideki kullanım endikasyonları giderek genişlemektedir. Her geçen gün yeni robotik cerrahi uygulamaları ve teknikleri geliştirilmekte ve bildirilmektedir. Gelecekte kullanımlarının artması ve yeni teknolojik gelişmelerin robotik sistemlere dahil edilmesi ile birlikte, daha iyi hasta sonuçlarının elde edileceği yeni cerrahi yaklaşımlar geliştirilecektir. Bu yazı robotların ürolojideki kullanımının tarihçesini ve gelişmelerini gözden geçirmekte, günümüzdeki uygulanımlarını vurgulamaktadır.The incorporation of robots into surgical technology is a relatively recent development. The robot-assisted surgery is in its early years today, however indications for its use in surgery are rapidly expanding. New robotic surgical applications and techniques are being developed and reported everyday. With the increase in their use and incorporation of new technological advances into robotic systems in the future, there will be continued development of new surgical approaches with improved patient outcomes. This paper reviews the history and developments of the use of robots in urology, and emphasizes its current applications

No association between the functional cannabinoid receptor type 2 Q63R variants and inflammatory bowel disease in Turkish subjects

Background/Aims: The endocannabinoid system can exert beneficial effects on gastrointestinal inflammation, and cannabinoid receptor-2 (CB2) agonists may represent a new therapeutic approach in inflammatory bowel disease (IBD). A functional CB2 Q63R polymorphism (rs35761398) in the CNR2 gene has been shown to affect the immunomodulating properties of the CB2 receptor. We sought to investigate whether the functional CB2 Q63R polymorphism (rs35761398) is associated with IBD susceptibility in a Turkish clinical sample. Materials and Methods: A total of 202 IBD patients, comprising 101 Crohn's disease (CD) patients and 101 ulcerative colitis (UC) patients, and 101 healthy controls were included in the study. The CB2 Q63R polymorphism was genotyped using real-time PCR. Results: There were no significant differences in the genotype frequencies of the three study groups. The odds ratio of the minor Q allele for CD relative to the common R allele was not significant (OR = 1.02, 95% CI = 0.67-1.56, p=0.99). Similarly, the odds ratio of the minor Q allele for UC relative to the common R allele did not reach statistical significance (OR = 1.10, 95% CI = 0.72-1.68, p=0.75). Moreover, the genotype frequencies did not show any significant association with the disease extent in either CD (p=0.71) or UC patients (p=0.59). Conclusion: These pilot findings suggest that CB2 Q63R polymorphism does not play a major role in genetic susceptibility to IBD or in its disease phenotypes among Turkish subjects