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Effects of Lycopene Attenuating Injuries in Ischemia and Reperfusion. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:9309327. [PMID: 36246396 PMCID: PMC9568330 DOI: 10.1155/2022/9309327] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/25/2022] [Accepted: 09/15/2022] [Indexed: 11/18/2022]
Abstract
Tissue and organ ischemia can lead to cell trauma, tissue necrosis, irreversible damage, and death. While intended to reverse ischemia, reperfusion can further aggravate an ischemic injury (ischemia-reperfusion injury, I/R injury) through a range of pathologic processes. An I/R injury to one organ can also harm other organs, leading to systemic multiorgan failure. A type of carotenoid, lycopene, has been shown to treat and prevent many diseases (e.g., rheumatoid arthritis, cancer, diabetes, osteoporosis, male infertility, neurodegenerative diseases, and cardiovascular disease), making it a hot research topic in health care. Some recent researches have suggested that lycopene can evidently ameliorate ischemic and I/R injuries to many organs, but few clinical studies are available. Therefore, it is essential to review the effects of lycopene on ischemic and I/R injuries to different organs, which may help further research into its potential clinical applications.
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Ogbetere FE. Traumatic testicular torsion: A call to look beyond the obvious. Urol Ann 2021; 13:431-433. [PMID: 34759658 PMCID: PMC8525482 DOI: 10.4103/ua.ua_159_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 04/02/2021] [Indexed: 11/05/2022] Open
Abstract
Blunt scrotal trauma results in different forms of injuries such as hematoma, rupture of the testis, and testicular torsion. The diagnosis of trauma-induced testicular torsion in patients with blunt scrotal trauma requires a high index of suspicion. As early diagnosis and management of traumatic testicular torsion obviate testicular losses, an urgent testicular scan is necessary in cases of suspected traumatic torsion, and if not readily available or indeterminate, scrotal exploration is promptly indicated. Reported herein is a case of traumatic testicular torsion which was managed as a straightforward blunt scrotal trauma in a private health facility. He eventually had an orchidectomy when he presented to us 4 months later on account of a marked reduction in testicular volume. This case report reiterates the need to look beyond the obvious in patients with blunt scrotal trauma and the necessity of testicular scan and scrotal exploration in testicular salvage in suspected trauma-induced testicular torsion.
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Affiliation(s)
- Friday Emeakpor Ogbetere
- Department of Surgery, Edo University, Iyamho.,Department of Surgery, Edo Specialist Hospital, Benin City, Edo State, Nigeria
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Laher A, Ragavan S, Mehta P, Adam A. Testicular Torsion in the Emergency Room: A Review of Detection and Management Strategies. Open Access Emerg Med 2020; 12:237-246. [PMID: 33116959 PMCID: PMC7567548 DOI: 10.2147/oaem.s236767] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 09/21/2020] [Indexed: 11/23/2022] Open
Abstract
Testicular torsion is a challenging and time-sensitive diagnosis that is encountered frequently in daily practice, especially in the emergency room. A thorough history, the presence of a painful and swollen testis and testicular ultrasonography plays a vital role in the prompt diagnosis of testicular torsion. Prompt diagnosis is essential to prevent complications of testicular torsion which include testicular infarction, necrosis, and sub/infertility. This can be challenging as there are various other conditions that may mimic the presentation of testicular torsion. Since testicular torsion is an extremely time-sensitive diagnosis, it may also be a subject of many medicolegal challenges. This review article serves as a guide for clinicians involved with the diagnosis and management of testicular torsion. We review and discuss detection and management strategies based on their validity, statistical significance, and effectiveness in enabling prompt diagnosis and management of testicular torsion. Medicolegal implications of testicular torsion are also highlighted.
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Affiliation(s)
- Abdullah Laher
- Department of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shavania Ragavan
- Division of Urology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Puja Mehta
- Division of Urology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ahmed Adam
- Division of Urology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Sertkaya Z, Koca O, Ozturk M, Akyuz M, Gumrukcu G, Kutluhan MA, Karaman MI. Protective Effect of Udenafil Against Ischemia Reperfusion Injury Due to Testicular Torsion/Detorsion in Rat Model. Eurasian J Med 2020; 52:115-119. [PMID: 32612416 DOI: 10.5152/eurasianjmed.2020.19229] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 09/29/2019] [Indexed: 11/22/2022] Open
Abstract
Objective Testicular torsion causes migration of neutrophils to the ischemic region and formation of free oxygen radicals that have a critical effect on ischemic reperfusion (I/R) injury. Udenafil is a selective, strong, and reversible inhibitor of phosphodiesterase type enzyme. In our study, we evaluate the protective effect of udenafil against reperfusion injury due to I/R. Materials and Methods Twenty-one male, adult, Wistar-Albino rats aged 8 months were randomly divided into three groups; sham, I/R, and I/R+udenafil. One hour before the detorsion operation, the sham and I/R groupssaline, and I/R+udenafil groups were administered 2 mg/kg udenafil intraperitoneally. Blood samples were collected to evaluate the inflammatory mediators. Spermatogenic factors were evaluated according to Johnsen criteria. Results Histopathological and molecular parameters from all groups were compared. Mean values of TNF-α and IL-1β in venous blood samples were calculated. We observed that TNF-a values were statistically significantly increased in the I/R group than those in sham groups, and these values were decreased with udenafil treatment Furthermore, the glutathione peroxidase (GPx) level was statistically significantly decreased in the I/R group, and treatment with udenafil prevented this decrease. Evaluation of spermatogenesis using the Johnsen scoring system showed no statistically significant difference in mean scores between the groups. Conclusion We concluded that deterioration of biochemical and histopathological parameters are reversed, and injury due to I/R in testicle tissue may be decreased with udenafil treatment. Results of this experimental study show that efficacy of the udenafil treatment in testis torsion should be investigated.
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Affiliation(s)
- Zulfu Sertkaya
- Department of Urology, Memorial Hospital, Diyarbakir, Turkey
| | - Orhan Koca
- Department of Urology, Medistate Hospital, Istanbul, Turkey
| | - Metin Ozturk
- Department of Urology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Akyuz
- Department of Urology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Gulistan Gumrukcu
- Department of Pathology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Musab Ali Kutluhan
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
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Damasceno AVBS, Barros CAVD, Percario S, Ribeiro Junior RFG, Monteiro AM, Gouveia EHH, Henriques HYB. Remote ischemic conditioning protects against testicular ischemia∕reperfusion injury in rats. Acta Cir Bras 2020; 35:e202000203. [PMID: 32348402 PMCID: PMC7184938 DOI: 10.1590/s0102-865020200020000003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/03/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the effect of remote ischemic conditioning associated to N-acetylcysteine (NAC) on testicular ischemia∕reperfusion (I∕R) injury in rats. Methods Twenty-five adult male Wistar rats were randomly distributed into five experimental groups (n=5), as follows: Sham, I∕R, Perconditioning (PER), NAC and PER+NAC. Two-hour ischemia was induced by rotating the left testis 720° to clockwise direction, followed by 4 hours of reperfusion. Perconditioning was performed by three I/R cycles of 10 min each on the left limb, 30 min before reperfusion. N-acetylcysteine (150 mg∕kg) was administered 30 min before reperfusion. Results Statistical differences were observed in MDA levels between I/R group with all groups (p<0.01), in addition there was statistical difference between PER and Sham, and PER+ NAC groups (p<0.05) in plasma. Conclusions The protective effect of perconditioning isolated in the reduction of lipid peroxidation related to oxidative stress was demonstrated. However, when Perconditioning was associated with NAC, there was no protective effect against testicular injury of ischemia and reperfusion.
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Abstract
Chronic orchialgia is a vexing condition defined as chronic or intermittent scrotal pain lasting at least three months that significantly interferes with daily activities. There are currently no guidelines regarding the diagnosis and management of this condition despite it being the cause of 2.5-4.8% of urologic clinic visits. Men often present with chronic orchialgia in their mid to late 30s, although the condition can present at any age. A broad differential diagnosis of chronic orchialgia includes epididymitis, testicular torsion, tumors, obstruction, varicocele, epididymal cysts, hydrocele, iatrogenic injury following vasectomy or hernia repair, and referred pain from a variety of sources including mid-ureteral stone, indirect inguinal hernia, aortic or common iliac artery aneurysms, lower back disorders, interstitial cystitis, and nerve entrapment due to perineural fibrosis; approximately 25-50% of chronic orchialgia is idiopathic in nature. In such cases, it is reasonable to consider psychological and psychosocial factors that may be contributing to chronic pain. Invasive testing is not recommended in the work-up of chronic orchialgia.
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Affiliation(s)
| | - Alexander W Pastuszak
- Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX, USA.,Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA
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Chi KK, Zhang WH, Chen Z, Cui Y, He W, Wang SG, Zhang C, Chen J, Wang GC. Comparison of quercetin and resveratrol in the prevention of injury due to testicular torsion/detorsion in rats. Asian J Androl 2017; 18:908-912. [PMID: 26620457 PMCID: PMC5109887 DOI: 10.4103/1008-682x.167720] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Quercetin (QE) and resveratrol (RSV) are powerful antioxidants with the potential to protect the testes against ischemia/reperfusion (I/R) injury. We compared their effects in testicular torsion/detorsion (T/D) in adult rats. Twenty-four male Wistar rats were divided into four groups: sham (group A), T/D (group B), T/D treated with QE (group C), and T/D treated with RSV (group D). QE (20 mg kg−1) and RSV (20 mg kg−1) were injected intra-peritoneally at 60 min of torsion. After 90 min of surgically induced torsion, the testicular cord was restored to its anatomical position. Twenty-four hour after torsion, blood and tissue samples were obtained for further examination. Testicular tissue malondialdehyde (MDA) and nitric oxide (NO) levels and serum total oxidant status (TOS) were higher in group B than in group A (P < 0.05). Group A had higher serum total antioxidant status (TAS) than group B. (P < 0.05) QE and RSV significantly lowered MDA, NO, and TOS levels and TAS consumption (P < 0.05). QE reduced the MDA and TOS levels more than RSV (P < 0.05), but their effects on NO reduction and TAS consumption were similar (P > 0.05). Group A had normal testicular architecture (grade 1). Groups C (mean grade 2.60) and D (mean grade 3.00) had lower testicular injury grades than group B (mean grade 3.45) (P < 0.05). Group C had lower testicular injury grade than group D (P < 0.05). Treatment with QE and RSV protects against I/R injury after testicular T/D. QE may exhibit better function than RSV at the doses tested in this study.
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Affiliation(s)
- Kai-Kai Chi
- Department of Urology, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450000, Henan, China
| | - Wen-Hui Zhang
- Department of Hematology, Henan Provincial People's Hospital, Zhengzhou 450002, Henan, China
| | - Zhu Chen
- Department of Urology, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450000, Henan, China
| | - Yong Cui
- Department of Urology, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450000, Henan, China
| | - Wei He
- Department of Urology, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450000, Henan, China
| | - Suo-Gang Wang
- Department of Urology, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450000, Henan, China
| | - Chan Zhang
- Department of Urology, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450000, Henan, China
| | - Jie Chen
- Department of Urology, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450000, Henan, China
| | - Guang-Ce Wang
- Department of Urology, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450000, Henan, China
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Ozmerdiven G, Coskun B, Kaygisiz O, Vuruskan BA, Asiltas B, Kilicarslan H. The protective effect of L-arginine, tadalafil, and their combination in rat testes after ischemia and reperfusion injury. Can Urol Assoc J 2017; 11:E19-E25. [PMID: 28163808 DOI: 10.5489/cuaj.3872] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Nitric oxide (NO) plays an important role in the ischemia and reperfusion process. In this study, we aimed to examine the effect of L-arginine, tadalafil, and their combination for prevention of the ischemia reperfusion injury after testis torsion in rats. METHODS A total of 40 adult, male Sprague-Dawley rats were allocated into five groups. Three hours of left testicular torsion was performed in each group, excluding the control group. While the ischemia reperfusion (I/R) group had no treatment, I/R + Arg group received L-arginine, I/R + Td group received tadalafil and I/R + Arg + Td group received tadalafil and L-arginine 30 minutes before the detorsion. Then the left testis was untwisted for four hours of reperfusion. After bilateral orchiectomy, lipid peroxidation (LPx) and glutathione (GSH) activities were examined in testicular tissue. Spermatogenesis was evaluated with Johnsen's score. RESULTS LPx levels of the I/R group were found to be significantly higher than for groups that received drugs for both testes (p<0.001). GSH levels of the combination group were higher than I/R group in ipsilateral testis (p<0.01) and it was significantly higher than other groups for contralateral testis (p<0.001 for I/R group, p<0.01 for I/R + Arg, p<0.05 for I/R + Td). Mean Johnsen's score of the I/R group was found to be significantly lower than treatment groups in ipsilateral testis (p<0.001 for I/R + Arg + Td group, p<0.01 for other treatment goups) and contralateral testis (p<0.001). The mean Johnsen score of the combination group was significantly higher than that of other treatment groups in ipsilateral testis (p<0.05) and it was significantly higher than in the I/R + Td group in the contralateral testis (p<0.05). CONCLUSIONS L-arginine, tadalafil, and combination of these two molecules showed protective effect against ischemia/reperfusion injury for both testes after unilateral testis torsion.
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Affiliation(s)
- Gokhun Ozmerdiven
- Department of Urology; Uludag University, School of Medicine, Bursa, Turkey
| | - Burhan Coskun
- Department of Urology; Uludag University, School of Medicine, Bursa, Turkey
| | - Onur Kaygisiz
- Department of Urology; Uludag University, School of Medicine, Bursa, Turkey
| | | | - Burak Asiltas
- Department of Biochemistry; Uludag University, School of Medicine, Bursa, Turkey
| | - Hakan Kilicarslan
- Department of Urology; Uludag University, School of Medicine, Bursa, Turkey
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Sılay MS, Toklu H, Özağarı A, Aydın M, Tetik Ş, Şener G, Miroğlu C, Kendirci M. Montelukast prevents testes against ischemia-reperfusion injury through suppression of iNOS expression. Turk J Urol 2015; 40:221-7. [PMID: 26328182 DOI: 10.5152/tud.2014.61587] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 08/21/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To elucidate the mechanism of a possible protective effect of montelukast against testicular ischemia/reperfusion (I/R) injury. MATERIAL AND METHODS Fifty-one adult male Wistar-Albino rats were randomly assigned into 6 groups; sham + saline (S), sham + montelukast (M), I/R + S, I/R + S 30', I/R + M and I/R + M 30'. Saline or montelukast (10 mg/kg) was intraperitoneally administered 30 minutes prior to (S 30', M 30') and during detorsion (I/R + S, I/R + M) in the I/R groups. The I/R groups underwent 2 hours of ischemia followed by 4 hours (early-term) of reperfusion in unilateral testes. Half of the rats underwent 24 hours (late-term) of reperfusion to investigate long-term effects. Testicular tissue samples were examined for biochemical and histopathological parameters. Germ cell apoptosis was evaluated using apoptosis-activating factor 1 (Apaf-1). Inducible nitric oxide synthase (iNOS) activity was analyzed in late-term reperfusion groups. Spermatogenic functions were assessed for each testis based on the Johnsen criteria. RESULTS Unilateral I/R caused a significant increase in serum TNF-α levels in the early-term group compared to the sham groups. Malondialdehyde levels and myeloperoxidase activity were found to be elevated in the I/R groups and accompanied with a significant decrease in glutathione levels when compared to the sham groups. I/R significantly increased iNOS activity and germ cell apoptosis compared to the sham groups. Montelukast treatment significantly reversed all of these parameters and achieved comparable results with the sham groups. Finally, spermatogenic indices were similar for the bilateral testes between all groups. CONCLUSION Montelukast exerts protective effects against testicular I/R injury by inhibiting neutrophil activity, reversing the oxidative stress markers, decreasing iNOS activity and attenuating apoptosis.
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Affiliation(s)
- Mesrur Selçuk Sılay
- Department of Urology, Bezmialem Vakif University Faculty of Medicine, İstanbul, Turkey
| | - Hale Toklu
- Department of Pharmacology, Marmara University School of Pharmacy, İstanbul, Turkey
| | - Ayşim Özağarı
- Department of Pathology, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
| | - Mustafa Aydın
- Department of Urology, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
| | - Şermin Tetik
- Department of Biochemistry, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Göksel Şener
- Department of Pharmacology, Marmara University School of Pharmacy, İstanbul, Turkey
| | - Cengiz Miroğlu
- Department of Urology, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
| | - Muammer Kendirci
- Department of Urology, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
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Baruga E, Guyton Munabi I. Case series on testicular torsion: an educational emergency for sub-Saharan Africa. Pan Afr Med J 2013; 14:18. [PMID: 23504299 PMCID: PMC3597862 DOI: 10.11604/pamj.2013.14.18.1736] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 09/11/2012] [Indexed: 11/11/2022] Open
Abstract
Testicular torsion remains a common surgical emergency of adolescent males presenting with sudden onset of intense scrotal pain in Africa. While the magnitude of testicular torsion is not known it has been identified as a cause of male infertility. Testicular loss in Africa is directly related to delay in surgery and the referral patterns at the point of first contact with health workers. This paper sets out to demonstrate the importance of the patient's age in the diagnosis of testicular torsion. A surgical audit was made of patients records collected over the last 30 years, for presentation of testicular related symptoms and analyzed to identify changes in the patterns of diagnosis over time and in different countries. There were 305 records found, for patients with an age range of 9-56 years. There were 195/305 (64%) with orchitis and 110/305 (36%) with testicular torsion. Testicular torsion is more common under the age of 18 years while orchitis was more common after 18 years of age (rho = -0.834, p value > 0.001 one tailed). This paper supports the development of educational interventions that promote the use of age in a simple diagnostic rule of the thumb for communities and lower cadre health workers in low resource settings.
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Ozbal S, Ergur BU, Erbil G, Tekmen I, Bagrıyanık A, Cavdar Z. The effects of α-lipoic acid against testicular ischemia-reperfusion injury in Rats. ScientificWorldJournal 2012. [PMID: 23193380 PMCID: PMC3488399 DOI: 10.1100/2012/489248] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Testicular torsion is one of the urologic emergencies occurring frequently in neonatal and adolescent period. Testis is sensitive to ischemia-reperfusion injury, and, therefore, ischemia and consecutive reperfusion cause an enhanced formation of reactive oxygen species that result in testicular cell damage and apoptosis. α-lipoic acid is a free radical scavenger and a biological antioxidant. It is widely used in the prevention of oxidative stress and cellular damage. We aimed to investigate the protective effect of α-lipoic acid on testicular damage in rats subjected to testicular ischemia-reperfusion injury. 35 rats were randomly divided into 5 groups: control, sham operated, ischemia, ischemia-reperfusion, and ischemia-reperfusion +lipoic acid groups, 2 h torsion and 2 h detorsion of the testis were performed. Testicular cell damage was examined by H-E staining. TUNEL and active caspase-3 immunostaining were used to detect germ cell apoptosis. GPx , SOD activity, and MDA levels were evaluated. Histological evaluation showed that α-lipoic acid pretreatment reduced testicular cell damage and decreased TUNEL and caspase-3-positive cells. Additionally, α-lipoic acid administration decreased the GPx and SOD activity and increased the MDA levels. The present results suggest that LA is a potentially beneficial agent in protecting testicular I/R in rats.
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Affiliation(s)
- Seda Ozbal
- Department of Histology and Embryology, School of Medicine, Dokuz Eylül University Inciralti, 35340 İzmir, Turkey.
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Abstract
Torsion of the testicle is a well-recognized urological emergency. Torsion of the cryptorchid testicle, however, is described in the urology literature, but not well recognized in the emergency department. We discuss a case of a torsed cryptorchid testicle and review the pathophysiology, imaging modalities, and prognosis.
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