The renal protective efficacy of ketamine vs. propofol vs. ketofol against renal ischemia / reperfusion injury: An experimental rat study

The purpose of this study was to investigate the renal protective efficacy of propofol, ketamine, and ketofol in an ischemia/reperfusion injury (IRI) model experimentally induced in rats. Thirty-five male Sprague-Dawley rats were randomly assigned into five groups: sham (Group 1), control (Group 2), ketamine (Group 3), propofol (Group 4), and ketofol (Group 5). Following administration of intramuscular ketamine hydrochloride anesthesia, the left renal hilum was exposed to 60-minutes clamping. Ketamine (Group 3), propofol (Group 4), and ketofol (Group 5) were administered 15 min prior to reperfusion. After six hours of reperfusion, the left kidneys were harvested for histological injury scoring. Mean histopathology scores were 0.42±0.53 in group 1 (Sham), 2.97±0.21 in group 2 (Control), 2.68±0.15 in group 3 (Ketamine), 2.40±0.16 in group 4 (Propofol), and 2.51±0.22 in group 5 (Ketofol). The score in group 4 (Propofol) was significantly lower than those in groups 2 (control) and 3 (Ketamine) (P=.002 and P=.0120, respectively), but did not differ significantly from that in group 5 (Ketofol) (P=.347). The score in group 5 (Ketofol) was significantly lower compared to group 2 (control) (P=.006), but no significant difference was determined with Group 3 (Ketamine) (P=.137). No significant difference was also observed between Group 3 (Ketamine) and Group 2 (control) (P=.021). The study results indicated no superiority of ketofol over ketamine or propofol against renal IRI. However, the renal protective effect of propofol against IRI was greater than that of ketamine.

Effect of atorvastatin on spermatogenesis in rats: A stereological study

Purpose: To investigate the effects of oral atorvastatin on spermatogenesis in a rat model.Methods: Rats were equally assigned into control and study groups, the latter receiving atorvastatin (20 mg/kg/day). At the end of 12 weeks, spermatogenetic activity was evaluated using stereological and optical fractionator methods. Serum follicle-stimulating hormone (FSH), total testosterone (TT), and luteinizing hormone (LH) levels were measured using micro–ELISA kits. Total cholesterol, triglyceride (TG), low-density lipoprotein cholesterol (LDL - C), and high-density lipoprotein cholesterol levels were also measured by enzymatic colorimetric assays.Results: Testicular stereological analysis revealed that atorvastatin reduced Sertoli cell numbers (p < 0.001), spermatogonia (p < 0.001), spermatocytes (p < 0.001), and seminiferous tubule diameters (p < 0.001). LDL – C (p = 0.01) and TG (p = 0.01) values were significantly lower in the study group compared with the control group. There was no significant difference in FSH (p = 0.44), LH (p = 0.48),and TT (p = 0.06) levels between the groups.Conclusion: The findings show that atorvastatin causes deleterious effects on rat spermatogenesis. It should therefore be used with caution in clinical practice owing to its potential adverse effects, especially on male fertility. Keywords: Statin, Atorvastatin, Spermatogenesis, Stereology, Testis

Pure large cell neuroendocrine carcinoma of the bladder without urological symptoms

Neuroendocrine carcinoma is one of the uncommonly seen pathologies of the urinary bladder. Macroscopic hematuria is frequently encountered symptom in patients with neuroendocrine carcinoma. We report a 45-year-old man with left solitary kidney and oliguria for five days the development of acute renal failure (ARF) with the impaired general condition. The underlying cause being identified as pure type large-cell neuroendocrine carcinoma of the bladder. Large-cell neuroendocrine carcinoma of the bladder is an uncommon fatal tumor. No macroscopic hematuria or urological symptom was observed in our case. Advanced ectasia was not observed in the kidney, and the patient's clinical status was complicated with ARF. It must not be forgotten that in some bladder tumors, the patient's general condition may be impaired without urological symptoms.

Application of autogenous periosteum as a membrane in sinus lifting

AIM

To evaluate the success level of autogenous periosteum in sinus lifting as a barrier membrane which contributes positively to wound healing and is effective in bone formation without the risk of tissue rejection.

MATERIALS AND METHODS

In this study, 32 male New Zealand rabbits were used and were divided into four groups, in which eight rabbits were placed randomly. Sinus lifting with lateral window technique was applied bilaterally to all rabbits. In the first group, the upper face of the graft materials applied was left open. In the second group, the removed bone walls were placed back over the graft materials. In the third group, synthetic membranes were placed over the graft materials. In the fourth group, the autogenous periosteums obtained from tibias of the rabbits were placed over the graft materials. After 6 weeks, the rabbits in all groups were sacrificed, and the operated regions were examined histologically, and stereological assessments were conducted regarding new bone formation, connective tissue, and osteoblasts.

RESULTS

After a 6-week recovery period, synthetic membrane showed the highest success rate regarding new bone formation. Autogenous periosteum, which achieved the second highest success rate regarding new bone formation, was the first in the number of osteoblasts.

CONCLUSION

Autogenous periosteum was considered to have the potential to be an alternative to synthetic membranes.

Effect of a Carbohydrate-Rich Diet on Rat Detrusor Smooth Muscle Contractility: An Experimental Study

OBJECTIVES

We aimed to investigate the effect of a carbohydrate-rich diet on detrusor contractility in rats.

MATERIALS AND METHODS

Sprague-Dawley rats were randomized into two groups. The control group received regular food and water. The study group received carbohydrate-rich diet for six weeks. The rats' detrusor muscle was isolated for pharmacological and histopathological examinations.

RESULTS

In the control and study groups, mean body weights were 431.5 ± 27.6 g and 528.0 ± 36.2 g, respectively (p < 0.001). Electrical stimulation of the detrusor strips of the control group resulted in gradual contraction. A decreased contractile response was shown in the study group. Acetylcholine in 10-7-10-3 molar concentration produced a decreased contractile response in the study group, compared to the control group (p < 0.01). The study group showed marked subepithelial and intermuscular fibrosis in the bladder.

CONCLUSION

Carbohydrate-rich diet causes marked subepithelial and extracellular fibrosis and changes in contractility in the detrusor within a six-week period. Changes have higher costs in therapeutic choices and correction of these changes remains difficult. Putting an end to carbohydrate-rich diet would seem to be more cost-effective than dealing with the effects of consuming it in high proportions which should be the national policy worldwide.

Pathological Investigation of Childhood Foreskin: Are Lichen Sclerosus and Phimosis Common?

OBJECTIVE

To evaluate histopathological results of foreskin removed during circumcision in the pediatric age group and the relationship between these and the degree of phimosis.

STUDY DESIGN

Cross-sectional study.

PLACE AND DURATION OF STUDY

Department of Urology, Samsun Training and Research Hospital, Samsun, Turkey, from June to December 2014.

METHODOLOGY

Male children undergoing planned circumcision were examined for the presence and degree of phimosis which was recorded before the operation. After circumcision, the preputial skin was dermatopathologically investigated. Pathological investigation carefully evaluated findings such as acute inflammation, chronic inflammation, increased pigmentation and atrophy in addition to findings of Lichen Sclerosus (LS) in all specimens. The pathological findings obtained were classified by degree of phimosis and evaluated.

RESULTS

The average age of the 140 children was 6.58 ±2.35 years. While 61 (43.6%) children did not have phimosis, 79 (56.4%) patients had different degrees of phimosis. Classic LS was not identified in any patient. In a total of 14 (10%) children, early period findings of LS were discovered. The frequency of LS with phimosis was 12.6%, without phimosis was 6.5% (p=0.39). The incidence of histopathologically normal skin in non-phimosis and phimosis groups was 37.7% and 22.7%, respectively. In total, 41 (29.3%) of the 140 cases had totally normal foreskin.

CONCLUSION

Important dermatoses such as LS may be observed in foreskin with or without phimosis. The presence of phimosis may be an aggravating factor in the incidence of these dermatoses.

[Primitive neuroendocrine/ectodermal kidney tumor]

PNET of the kidney are rare, aggressive tumors that occur mainly in adolescents. The diagnosis of PNET is difficult, but is possible with pathognomonic radiological findings. Since a radical nephrectomy is generally not sufficient for PNET of the kidney, early diagnosis and treatment is essential for successful recovery.

Vascular leiomyoma of an extremity: Report of two cases with MRI and histopathologic correlation

Vascular leiomyoma is a benign, usually solitary tumor arising from the tunica media of the vein. It can occur anywhere in the body wherever smooth muscle is present. These masses are commonly found in the uterus, urogenital tract and gastrointestinal tract but also less commonly in the extremities. They occur more often in the lower extremities than the upper extremities. Females are more affected than males and are generally seen in the third and fourth decades of life. We present magnetic resonance imaging, and histopathologic features of two pathology proven subcutaneous vascular leiomyomas of the hand and lower leg.