Effectiveness of myo-inositol oxygenase in the early diagnosis of experimental acute kidney injury

OBJECTIVES

The effectiveness of the myo-inositol oxygenase (MIOX) enzyme was investigated in the diagnosis of acute kidney injury (AKI).

METHODS

In total, 40 rats were divided into 5 groups (n = 8, for each group) while left kidney ischemia-reperfusion was implemented in groups 2, 3, 4 and 5. Group 1 was the control group. Group 2 underwent 1‑hour ischemia and 2‑hour reperfusion. Group 3 underwent 1‑hour ischemia and 4‑hour reperfusion. Group 4 underwent 2‑hour ischemia and 2‑hour reperfusion. Group 5 underwent 2‑hour ischemia and 4‑hour reperfusion.

RESULTS

Serum creatinine and blood urea nitrogen levels in all ischemia-reperfusion groups were higher than in the control group (p<0.001). Serum MIOX level was higher in groups 2, 3 and 4 than in group 1 (p=0.002). Tissue MIOX level was lower in groups 2, 4, and 5 than in group 1 (p=0.039). Serum and tissue neutrophil gelatinase-associated lipocalin levels were not significantly different between the groups. The injury level in histopathologic examination was as follows: group 1<group 3<group 2=group 4<group 5.

CONCLUSION

The serum MIOX level increases in the early stages of AKI, however, decreases subsequently. Therefore, the serum MIOX may be a potential promising biomarker in the early diagnosis of AKI (Tab. 5, Fig. 6, Ref. 30).

The ameliorative effects of Ginkgo biloba on apoptosis, LH-R expression and sperm morphology anomaly in testicular torsion and detorsion

Torsion/detorsion (T/D) induces testicular damages in both germinal epithelial and interstitial tissues. Ginkgo biloba extract (GbE) exerts antioxidant and free radical scavenger. We investigated the effect of GbE on testicular tissues, Leydig and sperm cells in rats injured with T/D. Twenty-eight Wistar albino rats were randomly assigned into four groups (Control, GbE, Treatment: T/D+GbE, T/D). T/D performed to the rats in torsion, treatment received GbE (50 mg/kg) 1 hr before T/D, GbE group received only GbE (50 mg/kg) and control was defined as sham group. After T/D, the testes along with epididymis were removed and processed. LH-R expression, apoptosis, sperm morphology and histopathological damage scores were determined for each group. Testicular T/D caused significant increases in apoptosis and sperm morphology anomaly, and a significant decrease in Johnsen's testicular biopsy scores, LH-R expression of Leydig cell and normal sperm cell count. GbE ameliorated testicular histopathology and caused significant increases in LH-R expression, normal sperm cell count in the treated and particularly GbE group. Consequently, GbE may prevent testicular injury and enhance Leydig and sperm cell activity following both T/D and normal situation owing to its antioxidant, anti-apoptotic, free radical scavenger and anti-inflammatory effects.

Ureterorenoscopy with stenting and its effect on male sexual function: A controlled randomised prospective study

Seventy-two male patients, who were included in this study, underwent ureteroscopic stone surgery (study group). Forty-two healthy males were enrolled as control group. Changes in sexual function were evaluated using International Index of Erectile Function questionnaire in pre-operative, first and third postoperative terms. Overall satisfaction in relation to the age, operation time, presence of stents, body mass index, educational status, previous operations, International Index of Erectile Function score, International Prostate Symptom Score, Quality of Life, income status, Male Sexual Health Questionnaire, stone-free rates and Beck's depression scale were evaluated. Erectile and ejaculatory functions, quality of life and lower urinary tract symptoms were negatively affected due to ureteroscopic stone surgery, while educational status, psychogenic aspect and income status remained stable. In conclusion, ureteroscopic stone surgery with JJ catheterisation seems to have a progressively decreasing negative effect on male sexual function and whenever possible, stenting should be avoided. If JJ stenting is necessary, patients should be informed that they may experience sexual dysfunction at least for 3 months and if stenting proves necessary the indwelling should be kept as short as possible.

The effects of carvedilol on ischemia-reperfusion injury in the rat testis

OBJECTIVE

To analyze the oxidative damage and histopathological alterations caused by ischemia-reperfusion (I/R) injury and ameliorative effects of carvedilol (CVD) in the rat testis.

MATERIALS AND METHODS

Twenty-one male rats were randomized into 3 groups as follows: Group I (n = 7); control (sham) group, Group II (n = 7); I/R group, in which I/R injury was performed by torsing the left testis 720 ° clockwise for 2 hours and detorsing for 2 hours. Group III (n = 7); CVD treatment group; in addition to I/R process, one-dose of CVD was administered (2mg/kg, i.p) 30 min. before detorsion. Levels of antioxidant enzymes, superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) and levels of malondialdehyde (MDA) and protein carbonyl (PC) were determined in testicular tissues and serum of rats. Testicular tissues were also examined histopathologically and Johnsen scores were determined.

RESULTS

Activities of SOD and GSH-Px in serum and testicular tissues were increased by I/R, but administration of CVD decreased these levels (p < 0.001 and p = 0.001). Significantly increased MDA levels in serum and testicular tissues were decreased by CVD treatment (p < 0.001 and p = 0.001). Concerning PC levels in serum and testicular tissues, there was no statistically significant difference between the groups (p = 0.989 and p = 0.428). There was not a statistically significant difference in terms of mean Johnsen scores between the groups (p = 0.161).

CONCLUSIONS

Administration of CVD decreased oxidative damage biochemically in the rat testis caused by I/R injury, but histopathologically no change was observed betwe¬en all of the groups.

Erectile dysfunction in patients with psoriasis: potential impact of the metabolic syndrome

BACKGROUND

Psoriasis is a chronic inflammatory skin disease that affects up to 5.5% of world population and is associated with erectile dysfunction (ED). Aim of the present study was to investigate impact of metabolic syndrome (MetS) on association between psoriasis and ED as well as to improve our understanding of this association via studying other possible causes of ED such as psychological factors and disease effects.

PATIENTS AND METHODS

The patient group included 37 male psoriasis patients and control group 28 healthy men. Severity of psoriasis was determined using Psoriasis Area and Severity Index (PASI), and ED was evaluated using International Index of Erectile Function (IIEF) Scale. Psychiatric state of the patients were determined using Beck Depression Inventory (BDI). MetS was diagnosed using the National Cholesterol Education Program Adult Treatment Panel III criteria.

RESULTS

MetS, ED prevalence and BDI score were significantly higher in psoriasis patient group (p = 0.032, p = 0.018 and p < 0.001). Average IIEF score of psoriasis patients with and without MetS, on the other hand, was not different (p = 0.073). IIEF score had negative correlations with age, BDI and PASI scores. In multiple linear regression analysis, BDI score, old age and smoking (but not MetS) were found to be independent predictors of ED.

CONCLUSIONS

ED, MetS and depression frequencies were significantly higher in psoriasis patient group. In addition, psoriasis severity and ED parameters were closely associated. Depression, old age and smoking were found to be independent risk factors for ED.

Prospective, randomized, double-blinded comparison of the effects of caudally administered levobupivacaine 0.25% and bupivacaine 0.25% on pain and motor block in children undergoing circumcision surgery

BACKGROUND

Caudal anesthesia is widely used as intraoperative and postoperative analgesia in children's subumbilical surgeries such as on the urogenital system, lower extremities and lower abdomen to reduce the stress response to surgery and to facilitate the general anesthesia.

AIM

The purpose of this study was to compare the effects of caudally administered bupivacaine and levobupivacaine of equal volume and concentration on motor block and postoperative pain in children undergoing circumcision surgery.

PATIENTS AND METHODS

The prospective, randomized, double-blind study included 60 patients with ages ranging from 1-10 years and ASA (American Society of Anesthesiologists) physical status of I-II who underwent elective circumcision surgery. The patients were divided into two groups: group B received 0.5 ml/kg of bupivacaine 0.25% caudally and group L received 0.5 ml/kg of levobupivacaine 0.25% caudally. Postoperative pain was assessed by children's and infant's postoperative pain scale and motor block was assessed by the Bromage scale.

RESULTS

The mean children's and infant's postoperative pain scale of group B was significantly lower than that of group L (p < 0.001). Three patients in group B and seven patients in group L needed additional analgesia after the incision. There was no significant difference between groups in terms of Bromage scores and in both groups the residual motor block was found to be zero at the 150th minutes.

CONCLUSION

According to these findings, bupivacaine has an adequate quality of analgesia than levobupivacaine. We suggest that bupivacaine for caudal block at the concentration of 0.25% (0.5 ml/kg) provides an adequate level of analgesia for outpatient circumcision surgery.

[The effect of diet induced obesity on testicular tissue and serum oxidative stress parameters]

OBJECTIVE

The aim of this study was to evaluate the effects of diet induced obesity on semen parameters and serum antioxidant enzyme levels.

MATERIAL AND METHODS

Six-week-old male rats were randomized into three groups are as follows: group 1 (n=10) received a control diet, group 2 (n=9) received a high-fat diet and group 3 (n=11) received high-fat diet plus anastrozole. At the completion of a 10-week period, testicular tissues were obtained and spermatogenesis was evaluated with Johnsen Score System. The normal Johnsen Score was accepted as >9.39. In addition, serum antioxidant enzyme levels, triglyceride, cholesterol, testosterone, luteinizing hormone (LH), follicle stimilating hormone (FSH) and estradiol levels were measured in serum.

RESULTS

Body weight were significantly increased in mice fed with a high-fat diet compared to normal diet (P<.05). The mean triglyceride levels was 64.00±20.48 mg/dl, 98.89±27.80 mg/dl and 95.27±15.02 mg/dl in group 1, group 2 and group 3, respectively (P<.05). Male rats fed with a high-fat diet had significantly lower levels of testosterone compared with the control diet male rats (P=.005). Testicular pathology revealed that Johnsen Score System were 9.60±0.15, 8.72±1.81 and 9.29 in group 1, group 2 and group 3, respectively (P=.169). In addition serum nitric oxide (NO) levels were higher in group 2 and group 3 compared to group 1 (P<.05).

CONCLUSION

As a result it may be concluded that obesity may induce oxidative stress and decrease testosterone levels. These changes may alter testicular functions and consequently it may be speculated that obesity can be important causative factor in the etiology of the male infertility.

Sarcomatous carcinoma with osteosarcomatoid differentiation of the bladder with simultaneous sigmoid colon adenocarcinoma

Sarcomatoid carcinoma is a rare tumor of the urinary bladder and accounts for approximately 0.3% of all bladder malignancies. In these tumors, histogenesis and biological behaviour remains controversial. Herein, we report a case of sarcomatoid carcinoma with osteosarcomatoid differentiation of the urinary bladder with simulataneous sigmoid colon adenocarcinoma.

A rare complication after circumcision: keloid of the penis

Keloids are benign hyperproliferative growths of dermal collagen that usually result from excessive tissue response to skin trauma. Although benign, they may be seen as a painful and/or pruritic lesions. A 15-year-young boy was admitted to our clinic with an enlarged scar and pain on the penis for about 1 year after a routine circumcision operation. Complete surgical resection of the lesion was done and histopathological examination revealed keloid of the penis.

Hemangiopericytoma arising from the wall of the urinary bladder

Hemangiopericytoma (HPC) arising from within the urinary bladder is exceptionally rare. A 45-year-old man having the symptoms of left groin pain, vague suprapubic discomfort and frequency was admitted to our clinic. Pelvic tomography revealed a tumor in the bladder wall measuring 4 x 3 cm and was not clearly distinct from the lower abdominal wall. Partial cystectomy was performed and the histopathological examination confirmed the hemangiopericytoma. Three thousand rad exterior beam irradiation was performed after operation. Partial cystectomy and adjuvant radiotherapy may be a simple and effective alternative operation for the patient with HPC.

Alcock's canal releasing for pudendal artery syndrome resulting from gunshot injury

A 21-y-old man applied to hospital with a complaint of erectile dysfunction, which started soon after a gunshot injury. The entry of the bullet was at the middle right gluteal region without any exit hole. A pelvic X-ray revealed the bullet and the scattered particles. On penile Doppler ultrasonography, the peak systolic velocities (PCV) of the right and the left cavernosal arteries were 19 and 29 cm/s, respectively. Pudendal angiography revealed poor visualization of the right pudendal artery below the level of the bullet. The patient underwent a right-sided Alcock's canal releasing surgery. After the operation, on control penile Doppler ultrasonography, PCV on the right and the left cavernosal arteries were 53 and 35 cm/s, respectively. The control angiography revealed a normal right pudendal artery. The patient was fully potent 2 y after the operation. Not only the entrapment of pudendal nerve but also the pudendal artery may cause Pudendal canal syndrome. A gunshot injury may cause such a condition due to the reaction caused by the bullet. Pudendal canal decompression is a simple and effective treatment for pudendal canal syndrome.

Hydatid disease of the kidney caused by Echinococcus multilocularis: a rare clinical entity

Hydatid disease of the urinary tract is extremely rare and constitutes approximately 4% of all cases of hydatid disease. The Echinococcus multilocularis is a relatively rare form of echinococcus as the cause of renal hydatid disease. We describe a patient who had renal hydatidosis which is rarely caused by the E. multilocularis.

Microsurgical inguinal varicocele repair in azoospermic men

OBJECTIVES

To evaluate the efficacy of microsurgical inguinal varicocele repair in nonobstructive azoospermic men with palpable varicocele and to determine predictive parameters of outcome.

METHODS

After standard diagnostic evaluation, 24 pellet (-) completely azoospermic men and 14 pellet (+) virtually azoospermic men underwent microsurgical inguinal varicocele repair. Testicular core biopsy was also performed perioperatively in all patients. The outcome was assessed in terms of improvement in semen parameters and spontaneous pregnancy.

RESULTS

After a mean follow-up of 13.4 +/- 4.7 months, motile sperm in the ejaculate could be identified in 5 (21%) of the completely azoospermic patients, and these patients were rescued from invasive sperm extraction techniques when referred to intracytoplasmic sperm injection. Testicular histopathology of these patients with postoperative improvement revealed maturation arrest at spermatid stage (n = 3), Sertoli-cell-only (SCO) pattern with focal spermatogenesis (n = 1), and hypospermatogenesis (n = 1). None of the patients with pure SCO pattern or maturation arrest at spermatocyte stage had improvement after varicocele repair. However, improvement in semen parameters was observed in 12 (85.7%) patients with virtual azoospermia, 4 (28.6%) achieved a total motile sperm count greater than 5 million, and spontaneous pregnancy occurred with 3 (21.4%) of them.

CONCLUSIONS

Microsurgical inguinal varicocele repair offers completely azoospermic men the chance to provide motile sperm via ejaculate in 21%. Moreover, 28.6% of virtually azoospermic men are rescued from ICSI procedures as an initial treatment modality. Results of varicocele repair in azoospermic men also reveal that a certain threshold of spermatogenesis, requiring the presence of at least spermatids, is necessary for effective varicocele repair.