Diphallus with urethral duplications.

We report a case of glandular diphallus with incomplete urethral duplication associated with rotation anomaly in the right kidney, complete ureteral duplication and ectopic ureteral orifice in the left. The bladder was single with good sphincter control. At operation, the hypoplastic glans was resected and the urethra opening into this glans was anastomosed side by side with the other urethra. Diphallus and incomplete urethral duplication are discussed in the light of evidence in the literature.

Comparison of testicular volumes before and after varicocelectomy.

We attempted to determine the testicular volume changes in patients with unilateral varicocele, before and after varicocelectomy. Testicular volume differences were correlated for each group of varicocele grade. 123 men with a unilateral left varicocele were presented for surgery: 36 had grade I, 49 had grade II, and 38 had grade III varicoceles. A Prader orchidometer was used for testicular volume determination before and after varicocelectomy in each patient. Both left and right testicular volumes were compared. After the repair of grade I varicoceles, an improvement in testicular volumes was noticed, but the difference was not statistically significant (p > 0.05). Both right and left testicular volumes increased significantly after operation in patients with grades II and III varicoceles (p < 0.001). Right testicular volume improved more than left in most of the patients. Men with large varicocele had significantly decreased testicular volumes than men with small varicocele before operation. So testicular growth arrest was more significant in patients with large varicocele and postoperative results indicated a more dramatic improvement.

Burch bladder neck colposuspension, comparison of early and late results.

PURPOSE: Suprapubic or endoscopic Burch colposuspension is a preferred technique for the treatment of stress urinaly incontinence in selective cases. We have attempted to investigate the early and long term results of suprapubic surgery for the treatment of stress incontinence and cystocele. PATIENTS AND METHOD: 98 patients with grade 1-2 stress urinary incontinence and grade 1-2 cystocele were included in this study. Preoperative testing include the Boney test, pad test, cystography, cystometry, leak point pressure, and urethral pressure profile studies. RESULTS: Our success rate was 93% three months after surgery for stress incontinence, 81% after twelve months (range 11 to 14) and 67% after 48 months (range 44-55). Grade 1 cystocele was corrected with a 76% success rate and Grade 2 cystocele was corrected with a 70% success rate 3 months after surgery. Twelve months later, these rates were 68% and 56% respectively. At the time of the last control these rates were 59% and 37% for cystocele, respectively. CONCLUSION: Burch colposuspension is an effective method for the treatment of Grade 1-2 stress incontinence and grade 1 cystocele in the early and late control examinations, but is not effective in patients with grade 2 cystocele in the long-term follow up examinations.

Diphallus with urethral duplication: a rare case.

We report on a case of glandular diphallus with incomplete urethral duplication associated with rotation anomaly in the right kidney, and a bifid pelvis and an ectopic ureteral orifice in the left kidney. The bladder was single with good sphincter control. At operation, the hipoplasic glans was resected and the urethra which opened into this glans anastomosed alongside the other urethra. Diphallus and incomplete urethral duplication are discussed.

[Staphylococcal biotyping and the use of computers]. / Stafilokoklarin biyokimyasal tiplendirilmesi ve bilgisayar kullanimi.

Ninety coagulase negative staphylococci isolated from various clinical specimens in Clinical Microbiology laboratory of Hacettepe University Faculty of Medicine, were biotyped using a special computer program. Types of 30 strains isolated from pus were found to be S. epidermidis (36.7%), S. haemolyticus (20%), S. simulans (13.3%) and S. hominis (10%) respectively. Among the strains isolated from blood S. epidermidis was again the predominant microorganism (40%), followed by S. haemolyticus (20%) and S. simulans (10%).

[Typing by isoelectric focusing of beta-lactamase enzymes in Klebsiella and Enterobacter strains resistant to the new beta-lactam antibiotics]. / Yeni kusak beta-laktam antibiyotiklere dirençli Klebsiella ve Enterobacter suslarinda "Isoelectric Focusing" yöntemi kullanilarak beta-laktamaz enzimlerinin tiplendirilmesi.

Resistance to new generation beta-lactam antibiotics in Gram-negative bacteria is increasing worldwide. This resistance is due to EBS enzymes in Klebsiella spp., and Type-I chromosomal enzymes in Enterobacter spp., Citrobacter, P. aeruginosa, Providencia, M. morganii and S. marcescens. In this study, the types of beta-lactamases in 16 Klebsiella spp. and 15 Enterobacter spp. which are resistant to newer beta-lactam antibiotics was investigated by isoelectric focusing. The results of the study showed that TEM-1 enzymes are prevalent in these isolates. pI (isoelectric point) values and antibiotic susceptibility test results suggest that there are EBS enzymes in Klebsiella spp., and Type-I enzymes in Enterobacter spp. These results have to be supported by further investigations.

Campylobacter and enterohaemorrhagic Escherichia coli (EHEC) associated gastroenteritis in Turkish children.

From May 1989 to April 1990, stool specimens of 677 children less than 15-years old who were admitted to the Hacettepe University outpatient department of Pediatrics with acute enteritis were collected to search for four common enteric pathogens: Salmonella, Shigella, Campylobacter, and enterohaemorrhagic Escherichia coli (EHEC). At least one of the three bacteria was detected in 107 (15.8%) of the patients. Campylobacter was found in 72 (10.6%) of the samples. Shigella and Salmonella spp. were isolated in 26 (3.8%) and 11 (1.6%) children respectively. EHEC was not isolated from any of the stool samples. None of the 100 healthy children examined as a control group yielded any of the four pathogens in their stools. Campylobacter should be considered as an important aetiological agent of diarrhoeal diseases in Turkey, where EHEC is not a common pathogen.

[Group B streptococcal endocarditis]. / B grubu streptokokkal endokardit.

In this article, a case of group B streptococcal endocarditis in a diabetic patient, taking immunosuppressive therapy because of dermatomyositis is reported.

[Activity of cefoperazone and cefoperazone-sulbactam against gram-positive and gram-negative bacteria]. / Cefoperazone ve cefoperazone-sulbactam'in gram-positif ve gram-negatif bakteriler üzerine etkisi.

The activity of cefoperazone-sulbactam combination against 79 gram-positive and 205 gram-negative microorganisms was tested and compared with that of cefoperazone alone. Cefoperazone-sulbactam combination was active against gram-positive and gram-negative microorganisms than cefoperazone.

[In vitro activity of aztreonam, cefoperazone and ceftriaxone against gram-negative bacteria]. / Aztreonam, cefoperazone ve ceftriaxone'un gram-negatif bakteriler üzerine in vitro aktiviteleri.

In this study, the in vitro activity of aztreonam was compared with that of cefoperazone and ceftriaxone against 1000 gram-negative bacilli. Among gram-negative bacteria, resistance to aztreonam, cefoperazone and ceftriaxone were noted 2.7%, 11.3%, 11.5% respectively. The results obtained in this study indicate that aztreonam is highly effective against gram-negative bacilli.

[Comparison of the in vitro antibacterial activity of ofloxacin and nalidixic acid]. / Ofloxacin ve nalidixic acidin in vitro antibakteriyel aktivitelerinin karsilastirilmasi.

The in-vitro activity of ofloxacin and nalidixic acid was determined against 964 Gram-negative and 66 Gram-positive isolates from different clinical specimens. Ofloxacin showed excellent in vitro activity against Enterobacteriaceae. The compound was significantly more potent than nalidixic acid against Pseudomonas spp. Acinetobacter spp. and Staphylococcus spp. We conclude from our studies that ofloxacin could be a valuable therapeutic agent with a variety of indications.

[In vitro antibiotic susceptibility of staphylococci]. / Stafilokoklardaki in-vitro antibiotik duyarliligi.

In this study in vitro activities of different antimicrobial drugs against 1000 staphylococci were evaluated. Tested staphylococci were isolated from the clinical material of out patient and in patient sections. Susceptibility tests were done according to NCCLS Disk Diffusion Technic. The antimicrobial drugs evaluated in this study were; Vancomycin, ofloxacin, sulbactam-ampicillin, co-trimoxazole, tetracycline, erythromycin, tobramycin, methicillin, first and third generation cephalosporins and penicillin. Vancomycin was the drug of choice against resistant staphylococci. Ofloxacin, sulbactam-ampicillin, first generation cephalosporins and some aminoglycosides were more effective than others.

[Campylobacter bacteremia]. / Bir Campylobacter bakteriemisi.

In this article, Campylobacter bacteremia in a diabetic and last stage kidney patient has been reported.

[Resistance of gram negative bacteria to new generation cephalosporins and the role of beta-lactamases in this type of resistance]. / Gram negatif bakterilerin yeni kusak cephalosporin'lere direnç orani ve bu dirençte beta-laktamazlarin rolü.

In this study, by using the microbroth dilution method, in vitro susceptibilities of gram negative bacteria to new generation cephalosporins were examined, and among these, 40 bacteria which showed resistance against at least two antibiotics were tested for beta-lactamase production. Beta-lactamase production was positive in all of them. However, this type of resistance could not be transferred to susceptible recipients by conjugation experiments. Our results suggest that the resistance to beta-lactam antibiotics in these strains are related with chromosomally mediated beta-lactamases.

[The identification and comparison of gram-negative Enterobacteriaceae and non-fermentative bacteria by the conventional manual method and the Quantum II microbiology system]. / Gram-negatif enterobakterilerin ve non-fermentatif bakterilerin klasik manuel yöntem ve Quantum II Mikrobiyoloji sistemi ile tanimlanarak karsilastirilmasi.

In this study a total of 1065 clinically isolated enteric and non-fermentative bacteria were tested and compared with a commercially manufactured "Quantum II Microbiology System", and the conventional manual biochemical tests. We are able to say that, "Quantum II Microbiology System" will be very useful in clinical laboratories due to making an identification in a very short time and in species level when an attentive study is made.

[Fluoroquinolones]. / Fluoroqinolon'lar.

We reviewed, the structure, pharmacokinetic properties, mode of actions, antibacterial spectrum, therapeutic dosage and side effects of fluoroquinolones in this article.

[Comparison of the in vitro effectiveness of sulbactam/ampicillin and ampicillin]. / (Sulbactam + ampicillin) ve ampicillin'in in vitro etkinliklerinin karsilastirilmasi.

In this study, we compared the effectiveness of Sulbactam + Ampicillin compound and Ampicillin against to 1168 clinical isolates by means of disk diffusion technic. We observed that Sulbactam + Ampicillin compound is enhanced and regained the antibacterial activity of Ampicillin against some bacteria such as S. aureus, S. epidermidis and some gram negative microorganisms.

[Immunoelectrophoretic analysis of Escherichia coli strains (EPEC, ETEC, EIV and UPEC) (1)]. / Escherichia coli (EPEC-ETEC-EIV ve UPEC) Suslarinin immünoelektroforetik analiz örnekleri (1).

Water extracts of Escherichia coli "O" and "K" antigen test strains (EPEC, ETEC, EIEC, UPEC) were examined in immunodiffusion and immunoelectrophoresis tests. The precipitation arcs corresponding to the O-antigen specificity and to the thermostable polysaccharide K antigen were easy to identify. All strains gave an O antigen precipitation arc found either on the anodic or the cathodic side of application basin and close to this. The so-called enteropathogenic types (from infantile diarrhoea) had a cathodic O antigen arc type; from dysentery-like disease had a negatively charged O-antigen, but no special thermostable K-antigen. Thus E. coli strains which may invade the tissues when conditions allow have a negatively charged surface antigen, either O-antigen lipopolysaccharide or both. Acidic components were found in the anodic O-antigen.

[Aminoglygoside nephrotoxicity]. / Aminoglikosid nefrotoksisitesi.

Aminoglycoside nephrotoxicity is a big problem to all physicians and patients. In this review, prevention of nephrotoxicity, monitoring of the aminoglycoside therapy and also clinical laboratory findings during therapy are discussed.