Comparision of uroflow parameters before and after hypospadias surgery

Aim: Uroflow investigation is used to identify whether stenosis has developed in the constituted neourethra after hypospadias repair. It is not clear whether a functional partial stenosis in the urethra in hypospadias cases is related to surgery or is present before the surgery. We aimed to investigate whether the obstructive pattern found in the urethra was related to the surgery or was present previously by performing a uroflow investigation before and after surgery in children operated for hypospadias and also in children with normal urethra as a control group in this study.Materials and methods: A total of 47 pediatric cases operated on and followed up with a diagnosis of hypospadias at the Ankara Child Health and Diseases, Hematology Oncology Training and Research Hospital’s Pediatric Surgery Clinic between January 2010 and June 2013 and a control group of 32 healthy children without symptoms of hypospadias or other urinary system problems were included in the study. Uroflowmetric investigations (maximum urine flow rate, mean urine flow rate, urination amount, urination duration, duration of reaching maximum speed) of the cases before and after surgery and uroflowmetric investigation of the control group together with the residual urine amount as examined by ultrasonography were compared. We evaluated 47 pediatric hypospadias cases in terms of age at surgery, meatus localization, type of surgery, and number of surgeries.Results: The mean age was 6.1 years for the patients operated with a diagnosis of hypospadias and 7.78 years for the control group. The most common uroflow flow curve in the preoperative study group and the control group was bell-type flow (57.4 and 43.8%). Bell-type flow was again most common postoperatively, but there was a significant decrease in plateau-type flow. Comparison of the uroflowmetry measurements of the hypospadias and control groups showed that the preoperative flow rates were low and some cases had residual urine in the bladder in the first group. When the postoperative measurements were used for the comparison, a significant difference was observed between the hypospadias and control groups in the flow rate and residual urine amount, whereas there was no difference compared with the preoperative evaluation. No significant relationship was found between the type of surgery used and uroflowmeter evaluations in our study.Conclusion: We found that the urination dynamics and partial urethral obstruction of hypospadias cases were present from the beginning and did not improve with surgery.Keywords: children, hypospadias, uroflowmetr

Volume CXVIII, Number 8, November 10, 2000

Objective: The aim of this study is to investigate the degree of variation of hydronephrosis by hydration in patients with ureteropelvic junction obstruction (UPJO). Material and Methods: Patients with antenatally diagnosed UPJO who admitted in a three months period were evaluated in terms of variation in sonographic findings for hydronephrosis. Serial renal ultrasounds were carried out before and after hydration considering parameters for hydronephrosis. Parameters evaluated on each ultrasound included degree of hydronephrosis, maximum anteroposterior diameter of the renal pelvis (mAPD) and anteroposterior pelvic diameter at hilum (hAPD), renal parenchymal thickness, dimensions of both kidneys, grade of hydronephrosis and the volume of the bladder. Results: Eleven children with unilateral hydronephrosis due to UPJO were evaluated. There were 10 males and 1 female at a mean age of 10.3 (3-30) months. The mean value of mAPD before hydration was 19.3±4.3 and increased to 21.3±4.6 mm (9.6% increase) after hydration showing a statistically significant difference (p=0.006). The corresponding measurements for hAPD before and after hydration were 14.5±3.6 mm and 14.6±3.4 mm respectively (p=0.846). Parenchymal thickness before and after hydration were 7.2±0.53 and 6.9±0.44 respectively which also showed no statistical significance (p=0.335). Hydration was found to have no significant effect on the parameters examined of contralateral kidney. Conclusion: The commonly used ultrasonographic parameters in the follow-up examination of hydronephrotic kidneys are prone to hydration effects. Among these parameters hAPD seems to be less affected. Copyright © 2013 by Türkiye Klinikleri

Preliminary data on COVID-19 in patients with hemoglobinopathies : A multicentre ICET-A study

Objectives: This study aims to investigate, retrospectively, the epidemiological and clinical characteristics, laboratory results, radiologic findings, and outcomes of COVID-19 in patients with transfusion-dependent β thalassemia major (TM), β-thalassemia intermedia (TI) and sickle cell disease (SCD). Design: A total of 17 Centers, from 10 countries, following 9,499 patients with hemoglobinopathies, participated in the survey. Main outcome data: Clinical, laboratory, and radiologic findings and outcomes of patients with COVID-19 were collected from medical records and summarized. Results: A total of 13 patients, 7 with TM, 3 with TI, and 3 with SCD, with confirmed COVID-19, were identified in 6 Centers from different countries. The overall mean age of patients was 33.7±12.3 years (range:13-66); 9/13 (69.2%) patients were females. Six patients had pneumonia, and 4 needed oxygen therapy. Increased C-reactive protein (6/10), high serum lactate dehydrogenase (LDH; 6/10), and erythrocyte sedimentation rate (ESR; 6/10) were the most common laboratory findings. 6/10 patients had an exacerbation of anemia (2 with SCD). In the majority of patients, the course of COVID-19 was moderate (6/10) and severe in 3/10 patients. A 30-year-old female with TM, developed a critical SARS-CoV-2 infection, followed by death in an Intensive Care Unit. In one Center (Oman), the majority of suspected cases were observed in patients with SCD between the age of 21 and 40 years. A rapid clinical improvement of tachypnea/dyspnea and oxygen saturation was observed, after red blood cell exchange transfusion, in a young girl with SCD and worsening of anemia (Hb level from 9.2 g/dl to 6.1g/dl). Conclusions: The data presented in this survey permit an early assessment of the clinical characteristics of COVID 19 in different countries. 70% of symptomatic patients with COVID-19 required hospitalization. The presence of associated co-morbidities can aggravate the severity of COVID- 19, leading to a poorer prognosis irrespective of age

BOLITA, an Arabidopsis AP2/ERF-like transcription factor that affects cell expansion and proliferation/differentiation pathways

The BOLITA (BOL) gene, an AP2/ERF transcription factor, was characterized with the help of an activation tag mutant and overexpression lines in Arabidopsis and tobacco. The leaf size of plants overexpressing BOL was smaller than wild type plants due to a reduction in both cell size and cell number. Moreover, severe overexpressors showed ectopic callus formation in roots. Accordingly, global gene expression analysis using the overexpression mutant reflected the alterations in cell proliferation, differentiation and growth through expression changes in RBR, CYCD, and TCP genes, as well as genes involved in cell expansion (i.e. expansins and the actin remodeling factor ADF5). Furthermore, the expression of hormone signaling (i.e. auxin and cytokinin), biosynthesis (i.e. ethylene and jasmonic acid) and regulatory genes was found to be perturbed in bol-D mutant leave