Investigation of the Effects of N-acetylcysteine and Selenium on Vesicoureteral Reflux Nephropathy: An Experimental Study.

INTRODUCTION: This study aimed to investigate the effects of N-acetylcysteine (NAC) and selenium (Se) on vesicoureteral reflux (VUR) nephropathy. METHODS: A total of 44 rabbits in 7 groups, namely group 1 (Control), group 2 (VUR + sterile urine), group 3 (VUR + sterile urine + NAC), group 4 (VUR + sterile urine + Se), group 5 (VUR + infected urine), group 6 (VUR + infected urine + NAC) and group 7 (VUR + infected urine + Se), were used. 99mTc Dimercaptosuccinic acid renal scan (DMSA), cystogram and urine culture were performed both at the beginning and end of the study. Left VUR was created surgically, and E. coli was inoculated in infected urine groups. NAC and Se were administered daily for 21 days. Malondialdehyde (MDA) measurement, inflammatory response scores (IRSs), and cicatrization response scores (CRSs) in renal tissues were evaluated. RESULTS: VUR did not reduce left renal uptake values in neither group 2 nor group 5. MDA levels of the left kidney were significantly higher in group 5 compared to group 1 (p = 0.001). There was no significant difference in MDA levels between group 5 and group 6, and between group 5 and group 7. Left kidney IRSs were found to be higher in all other groups except group 2 compared to the control group (p < 0.001). Left kidney CRSs were significantly higher in group 5 compared to group 2 (p = 0.026), group 6 (p < 0.001) and group 7 (p = 0.006). CONCLUSION: A decrease in renal functions was not observed in VUR, even if there was infection. When CRSs were evaluated, NAC and Se had protective effects in terms of scar formation in VUR nephropathy. TYPE OF STUDY: Experimental animal study. LEVELS OF EVIDENCE: N/A.

The Effect of Preoperative Carbohydrate-containing Fluid Consumption on Maternal Oxidative Stress Markers During Elective Cesarean Delivery.

PURPOSE: The purpose of this study was to evaluate the effect of carbohydrate loading prior to the cesarean surgery under spinal anesthesia on thiols and ischemia-modified albumin (IMA) levels. DESIGN: Prospective, randomized placebo-controlled study. METHODS: Seventy-nine pregnant women planned for cesarean sections under spinal anesthesia at Karaman Training and Research Hospital were randomized into a control group (group C) (n = 42), and an oral carbohydrate preloading group (group OCH) (n = 37). OCH loading requires consuming 400 mL the night before surgery and 200 mL up to 2 hours before anesthesia. Group OCH consumed an oral carbohydrate-rich beverage (Nutricia-Fantomalt), and group C consumed an equal volume of water. This study investigated thiol-disulfide homeostasis after preoperative carbohydrate consumption. Preoperative gastric fluid, volume, antral cross-sectional area, hypotension following the birth, and fetal blood gas parameters were compared across groups. FINDINGS: Thiols and IMA levels did not differ across groups before and after surgery (P > .05). Gastric ultrasonography showed similar antral cross-sectional area and stomach volume between groups (P = .172, P = .128, respectively). When surgery caused hypotension, group OCH received more ephedrine for surgery-induced hypotension, although this difference is not statistically significant (P = .704). A clustered error bar (95% confidence interval) plot with an interpolation line was used for a time-based comparison of mean differences in heart rate and mean arterial pressure between the groups. CONCLUSIONS: This study supports that mothers' thiols and IMA levels were unaffected by preoperative OCH loading before cesarean surgery. We did not examine thiol and its derivatives in umbilical cord blood; hence, we can not comment on thiol/disulfide homeostasis levels in neonates.

The effects of orchiectomy and steroid on fertility in experimental testicular atrophy.

OBJECTIVE: Despite our understanding of Sertoli cell function and the state of spermatogenesis, the underlying mechanisms remain unclear. This study was conducted to compare the effects of orchiectomy and steroid treatment on fertility in testicular atrophy occurring after testicular torsion. METHODS: Thirty-three rats were divided into four groups. The atrophy, orchiectomy, and atrophy-steroid groups each contained nine rats, while the control group contained six. The left testes were rotated 720º, and atrophy was observed. In the atrophy-steroid rats, orchiectomy was performed after atrophy, and 1 mg/kg steroid was injected. Each male rat was housed with five female rats for 6 days. The fertility of the male rats was evaluated based on the pregnancy of the female rats. Left and right orchiectomies were performed to determine the tissue Johnsen score (JS) and the serum inhibin B (IB) level. RESULTS: JS values were significantly lower in the atrophy, orchiectomy, and atrophy-steroid groups than in the control group (p<0.05), while no significant difference was observed in JS between the atrophy and orchiectomy groups (p>0.05). Similarly, no significant differences in IB level or fertility percentage were found between the atrophy and orchiectomy rats (p>0.05). CONCLUSION: In unilateral testicular atrophy, which can occur in the prepubertal period due to various causes, orchiectomy does not appear to benefit fertility, as indicated by IB, JS, and the fertility percentage.

Effect of Vitamin D on YKL-40: Rat Hypercholesterolemia Model.

BACKGROUND AND OBJECTIVES: YKL-40 is considered to be associated with cardiovascular disease (CVD). In this study, the effect of serum 25(OH) vitamin D [25(OH)VitD] differences between groups on YKL-40 was evaluated on a hypercholesterolemia rat model. METHODS: Thirty-two male rats (wistar albino) were equally divided into 4 groups. The first group was the control group; the second group was high-cholesterol (H-CH) adequate vitamin D (VitD) group (H-AdeVD). The third group was the H-CH deficient VitD group (H-DefVD), and the last group was designed with the H-CH supplement VitD (H-SupVD). The feeding process consisted of 2 stages. At the first stage (5 months), the H-DefVD group was fed on VitD deficient chow, while the other groups (control, H-AdeVD, H-SupVD) were fed on standard chow. At the second stage (3 months), the H-AdeVD and the H-SupVD groups were fed on the H-CH chow, whereas the H-DefVD group was fed on the H-CH-VitD deficient chow. Moreover, the H-SupVD group was given 100 IU/kg/day VitD along with the H-CH chow. RESULTS: Compared with the control group, interleukin-6 (IL-6), soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), and YKL-40 values in the H-DefVD groups increased significantly (p<0.001, p<0.001, p=0.009, p=0.005; sequentially). CONCLUSION: It can be concluded that VitD can suppress the YKL-40, thus, it will prevent CVD development in rat. Therefore, further clinical studies related with human will reveal the effect of VitD and YKL-40 on CVD development.

Role of thiol-disulfide hemostasis in early diagnosis of acute mesentery ischemia: An experimental study.

BACKGROUND: Acute mesenteric ischemia (AMI) is a rarely observed acute abdominal disease that may be mortal and is difficult to diagnose early. The aim of our study is to assess the role of Thiol-Disulphide Haemostasis (TDH), a new method for AMI which still has no specific biochemical markers for early diagnosis, and to assess it together with Ischemia-Modified Albumin (IMA) which has previously proven reliability for AMI. METHODS: The study included 32 Wistar albino rats in four groups. The 1st group (n=8) was the control group, 2nd group (n=8) was the sham group, 3rd group (n=8) had 3 h of arterial mesentery ischemia and the 4th group (n=8) had 6 h of arterial mesentery ischemia. TDH, IMA, and serum lactate values were measured at h 0, 1, 3, and 6. RESULTS: In the 3rd and 6th h, serum total thiol and native thiol values significantly reduced (p<0.001), while serum disulfide, IMA, and lactate values clearly increased (p<0.001). Serum thiol values were observed to reduce from the 1st h. CONCLUSION: TDH changes in the early period of AMI. The TDH parameters can be used with IMA as diagnostic parameters for patients with suspected AMI in the early period.

The effect of intratesticular dexpanthenol on experimentally-induced testicular ischaemia/reperfusion injury.

INTRODUCTION: Testis torsion is a urological emergency and a serious situation that may cause testis atrophy, testicular dysfunction and infertility due to ischaemia/reperfusion(I/R) injury even with early intervention. OBJECTIVE: To assess the protective effect of dexpanthenol administered intratesticular after detorsion against testis I/R injury. STUDY DESIGN: Twenty-seven rats were randomly divided into 3 groups containing 9 rats each. The 1st group comprised the sham group with no procedure performed. The 2nd group had only torsion applied, while the 3rd group had torsion + dexpanthenol applied. Rats had 720° clockwise rotation applied to the left testis. After 2 h of ischaemia, testes were de-torsioned and the dexpanthenol group had 500 mg/kg dexpanthenol administered intratesticular after detorsion. After 4 h of reperfusion, rats had blood samples taken and orchiectomy was performed for histologic assessment. RESULTS: A significant difference was detected in all parameters [necrosis(p:<0.001), Cosentino grade (p < 0.001), congestion (p:0.005), fibrosis (p:<0.001), interstitial oedema (p:0.017), JTBS score (p:<0.001), apoptosis (p < 0.001) and testosterone levels (p:0.006)] when the sham, torsion, and torsion + dexpanthenol groups were compared. Significant differences were observed for fibrosis (p:0.010), Cosentino score (p < 0.001), JTBS score (p:<0.001), apoptosis (p:0.001) and total testosterone levels (p:0.013) when torsion and torsion + dexpanthenol groups were compared. The torsion + dexpanthenol group was identified to have more preservation of testis function observed histologically and hormonally compared to the torsion group. DISCUSSION: Dexpanthenol is used in many areas due to both epithelizing and antioxidant effects and lack of clear side effects. In spite of use of many chemical and biological agents to protect against testis I/R injury, none have entered routine use. This study showed that dexpanthenol, which can be easily injected intratesticular during detorsion surgery, has protective effect against histological and functional injury that may develop linked to testis I/R injury. The main limitations of the study are short duration of follow-up due to being a rat experiment and lack of comparison of lipid peroxidation products. CONCLUSION: This study identified that dexpanthenol with clinically easy use by intratesticular injection after detorsion during surgery had a protective effect against histological and functional injury that will develop linked to I/R injury in the testis.

Inhibition of Fatty Acid Binding Protein 4 in Obese Male Mice Adversely Affects Reproductive Parameters.

BACKGROUND: As obesity is increasing worldwide, obese people use various methods to get rid of excess weight. BMS309403 (A drug) is a specific inhibitor of fatty acid binding protein 4. In this study, the effects of the BMS309403 on serum biochemical markers, testis tissue spermatogenesis and apoptotic markers were investigated in male mice. METHODS: Balb/c mice (total=56, each group n=14) were divided into control, obese control, obese solvent and obese drug groups. The obese control, obese solvent and obese drug groups were fed on the high sucrose diet to lead to obesity. After the development of obesity, BMS309403 was orally administered to the obese drug group for six weeks. It was performed in testicular tissues (Johnson Score and apoptosis markers) and biochemical tests (total testosterone, sex hormone binding globulin, inhibin-B tests and free androgen index) were used to evaluate reproductive parameters. The p<0.05 was considered to indicate a statistical significance. RESULTS: Serum fatty acid binding protein 4 levels were higher in obese control group and obese solvent group, compared to control (p<0.05) and obese drug groups (p<0.001). Serum total testosterone, free androgen index, inhibin-B, sex hormone binding globulin levels, testicular tissue B-cell lymphoma-2 expression level and Johnson Score parameters were lower in all obese groups compared with the control group. Inhibin-B levels and Johnson Score results were lower in obese drug group compared to other two obese groups (p<0.05). CONCLUSION: Contrary to expectations, the use of BMS309403 negatively affected male reproductive parameters. Negative changes in reproductive parameters may be a result of the increased lee index of obesity.

Is there a Difference in Platelet-Rich Plasma Application Method and Frequency to Protect Against Urethral Stricture?

PURPOSE: To determine the efficacy of instillation frequency and submucosal injection of platelet-rich plasma (PRP) after urethral trauma to prevent urethral inflammation and spongiofibrosis. MATERIALS AND METHODS: Sixty-five rats were used in the study; 50 rats were randomized into 5 groups with 10 rats in each group and 15 rats were allocated for PRP preparation. The urethras of all rats were traumatized with a pediatric urethrotome knife at 6 and 12 o'clock positions, except in the sham group. Group 1 was the sham group and had only urethral catheterization daily for 15 days, Group 2 was given 0.9% saline (physiologic saline [(UI+PS]) once a day after urethral injury (UI+ PS), Group 3 was injected with PRP submucosally after urethral injury, Group 4 was given PRP once a day as intraurethral instillation using a 22 Ga catheter sheath with urethral injury, and Group 5 was given PRP twice a day as intraurethral instillation using a 22 Ga catheter sheath with urethral injury. Each administration of PRP was administered as 300 million platelets/150 microliters. On day 15, the penises of the rats were degloved to perform penectomy. Histopathologic evaluation was made for spongiofibrosis, inflammation, and congestion in vascular structures. RESULTS: When the sham group, UI+PS, UI+PRPx1, UI+PRPx2 and UI+PRPs groups are compared in total, there were significant differences identified for parameters other than edema. When the UI+PS, UI+PRPx1, UI+PRPx2 and UI+PRPs groups are compared, the UI+PS group was observed to have significantly more inflammation (mucosal inf. 2.42 ± 0.53) and spongiofibrosis (2.42 ± 0.53). All the PRP groups were identified to have significantly less mucosal inflammation (UI+PRPs 1 ± 0, UI + PRPx1; 1.4 ± 0.51, PRPx2; 1.33 ± 0.5) and spongiofibrosis (UI+PRPs; 1.57 ± 0.53, PRPx1; 1.2 ± 0.42, PRPx2; 1.55 ± 0.52). The group with the lowest spongiofibrosis was the PRPx1 group. CONCLUSION: This study showed that PRP significantly reduced mucosal inflammation and spongiofibrosis, independent of the administration route, when applied to the urethra after urethral trauma.

Histopathologic Evaluation of the Effects of Intraurethral Platelet Rich Plasma in Urethral Trauma Experimentally Induced in Rat Model.

OBJECTIVE: To determine the efficacy of platelet rich plasma applied early initialization after urethral trauma for preventing inflammation and spongiofibrosis. MATERIALS AND METHODS: Twenty-three rats were randomized and divided into 3 groups, with 10 rats in 2 groups. Only sham group had 3 rats. The urethras of all rats were traumatized with a pediatric urethrotome knife at 6- and 12-o'clock. For 15 days, group I was given platelet rich plasma (PRP) once a day without urethral injury (sham group), group II (n = 10) was not given any medical treatment only urethral injury group (UI-PRP), group III (n = 10) was given PRP once a day intraurethrally as instillation using a 22 ga catheter sheath with urethral injury (UI+PRP). On day 15, the penises of the rats were degloved to perform penectomy. RESULTS: A significant difference was detected in all parameters when the sham, UI-PRP, UI+PRP groups were compared (respectively, P = .001, / <.001, / .008 / .007) and a significant difference was observed among mucosal inflammation, fibrosis, and edema parameters when UI-PRP and UI+PRP groups were compared. (Respectively; P <.001, / <.001 / .006). CONCLUSION: In this study, it was shown that intraurethral PRP applied after urethral trauma significantly decreased mucosal inflammation, spongiofibrosis, and edema. Depending on the results we acquired in this study, we think that PRP may be a promising option in urethral stricture treatment.