SARS-CoV-2 Causes Brain Damage: Therapeutic Intervention with AZD8797.

Elevated CX3CL1 is associated with severe COVID-19 and neurologic symptoms. We aimed to investigate the potential protective effects of selective CX3CR1 antagonist AZD8797 on SARS-CoV-2-induced neuronal damage, and to identify the underlying mechanisms. K18-hACE2 transgenic mice (n = 37) were randomly divided into control groups and SARS-CoV-2 groups, with and without intraperitoneal administration of vehicle or AZD8797 (2.5 mg/mL/day), following exposure to either a single dose of SARS-CoV-2 inhalation or no exposure. Object recognition and hole board tests were performed to assess memory function. Postinfection 8 days, brain tissues were analyzed for histopathological changes, viral, glial, apoptotic, and other immunohistochemical markers, along with measuring malondialdehyde, glutathione, and myeloperoxidase activities. Serum samples were analyzed for proinflammatory cytokines. The SARS-CoV-2 group showed significant weight loss, neuronal damage, oxidative stress, and impaired object recognition memory, while AZD8797 treatment mitigated some of these effects, especially in weight, apoptosis, glutathione, and MCP-1. Histopathological analyses supported the protective effects of AZD8797 against SARS-CoV-2-induced damage. The CX3CL1-CX3CR1 signaling pathway could offer a promising target for reducing SARS-CoV-2's neurological impact, but additional research is needed to confirm these findings in combination with other therapies and assess the clinical significance.

A newly developed carrier for the vitrification of prepubertal testicular tissue and its comparison with four different carriers.

RESEARCH QUESTION: The cryopreservation of prepubertal testicular tissue is important for children who are to undergo gonadotoxic treatment. There is ongoing debate around the optimal carrier for an inexpensive and rapid vitrification technique. How efficient would a novel, practical and sterilizable metal brush be when compared with previously used carriers? DESIGN: The testicular tissues of prepubertal rats were vitrified using four different carriers and evaluated by light microscopy and transmission electron microscopy. RESULTS: Nuclei were easily discriminated in the metal brush, aluminium foil and high-security straw groups, but there was decreased discrimination of structures in the metal wire group. Minimal cytoplasmic degeneration, vacuolization and mild reversible degenerative effects were seen in spermatogonial stem cells and Sertoli cells in the metal brush group. Mild to moderate structural changes were found in the aluminium foil group. Severe pyknosis of the nuclei, a high degree of swelling, expansion of the endoplasmic reticulum, and swelling and blurring of the mitochondria were seen in the metal wire and high-security straw groups. The cell viabilities in the metal brush, aluminium foil, metal wire and high-security straw groups were 91.6 ± 3.85%, 83.0 ± 4.06%, 76.0 ± 3.16% and 68.6 ± 4.93%, respectively. CONCLUSIONS: The metal brush is a promising new carrier for prepubertal testis vitrification.

Mass and non-mass breast MRI patterns: a radiologic approach to sick lobe theory.

BACKGROUND: According to sick lobe theory, one or more lobes of the breast are more prone to the development of carcinoma. However, the implications of this theory in breast magnetic resonance imaging (MRI) are unknown. PURPOSE: To evaluate the MRI appearance of mass type (multifocal and multicentric diseases) and non-mass type (non-mass enhancements) sick lobe patterns, together with the histopathology results. MATERIAL AND METHODS: MRI reports of 2015 patients in two tertiary breast imaging centers between June 2012 and June 2018 were retrospectively reviewed for multifocal-multicentric diseases and segmental, linear, and regional enhancements. A total of 113 patients were included. The specimens obtained by thick needle, vacuum, excisional biopsy/lumpectomy or mastectomy after breast MRI scans were pathologically assessed. The pathologic results were categorized as invasive carcinoma, precursor, and benign proliferative lesions according to the 2012 World Health Organization Classification of Tumors. RESULTS: The percentage of underlying benign and precursor invasive lesions was significantly different in patients with mass and non-mass MRI patterns. While the pathology results of mass type patterns were premalignant and malignant in all cases, nearly half of the underlying histologies were benign proliferative subtypes in patients with non-mass type patterns. CONCLUSION: In this study, the mass and non-mass patterns derived from sick lobe theory were related to different risks of malignancy in the pathological examinations.

Milrinone Attenuates Heart and Lung Remote Injury after Abdominal Aortic Cross-Clamping.

BACKGROUND: Phosphodiesterase enzymes play a pivotal role in the pathogenesis of ischemia/reperfusion (IR). We examined the role of milrinone (MIL), a phosphodiesterase 3 inhibitor, on remote injury of the heart and lung after abdominal aortic cross-clamping. DESIGN: Experimental study. METHODS: Twenty-one Wistar rats were divided into 3 groups: (1) control (C, n = 7), underwent laparotomy and exploration of abdominal aorta only; (2) IR (n = 7), normal saline was applied intraperitoneally (i.p) before IR induced by clamping of the abdominal aorta for 1 hr and then allowing reperfusion for 1 hr; and (3) MIL + IR (n = 7), MIL was given (0.5 mg/kg, i.p) before IR. After sacrification, the lungs and hearts were taken out for analyses and the tissue malondialdehyde (MDA) and glutathione (GSH) were studied. All tissues were examined under light microscopy and transmission electron microscopy (TEM). Expressions of caveolin (Cav)-1 in the lung and Cav-1 and Cav-3 in the heart were examined immunohistochemically. RESULTS: The MIL + IR group had significantly a lower magnitude of oxidative stress than the IR group both in the lung and heart (lung: P = 0.03 for MDA and 0.001 for GSH and heart: P = 0.002 for MDA and 0.000 for GSH). In light microscopy, the MIL + IR group had statistically a lower total injury score than the IR group for both the lung and heart tissue (P = 0.03 and P = 0.04, respectively). In TEM, regression of mitochondrial degeneration and lamellar bodies in type II pneumocytes in the lungs and obvious improvements in disruption at the intercalated discs and mitochondrial degeneration in the hearts in the MIL + IR group were detected compared with the IR group. The expression of both Cav-1 and Cav-3 in the MIL + IR group was improved compared with the IR group (P = 0.03 for both). CONCLUSIONS: MIL attenuates remote injury of heart and lung in lower body IR by inhibiting oxidative stress. Moreover, Cav-1 and Cav-3 might have a potential role in MIL-induced cardioprotection.

Bacterial cellulose tubes as a nerve conduit for repairing complete facial nerve transection in a rat model.

PURPOSE: Functionality of the facial nerve is cosmetically important. While many techniques have been investigated, early and effective treatment for traumatic facial nerve paralysis remains challenging. Here, we aim to examine bacterial cellulose (BC) as a new tubularization material for improving facial nerve regeneration. METHODS: Our study was performed on 40 female Sprague Dawley rats. Rats were randomly divided into four groups, with 10 rats per group. In all rats, the main trunk of the facial nerve was completely cut 8 mm before the branching point. For repairing the facial nerve, in group 1, the nerve was left to recover spontaneously (control group); in group 2, it was repaired by primary suturing (8.0 Ethilon sutures, Ethicon); in group 3, BC tubes alone were used to aid nerve repair; and in group 4, both BC tubes and primary sutures (8.0 Ethilon sutures) were used. After 10 weeks, the facial nerve regeneration was evaluated by the whisker movement test and electrophysiologically (nerve stimulation threshold and compound muscle action potential). Nerve regeneration was assessed by calculating the number of myelinated nerve fibers, and by microscopically evaluating the amount of regeneration and fibrosis. RESULTS: No significant difference was observed among the groups in terms of whisker movement and electrophysiological parameters (P > 0.05). We found that the numbers of regenerating myelinated fibers were significantly increased (P < 0.05) when BC tubes were used as a nerve conduit. CONCLUSIONS: BC can be easily shaped into a hollow tube that guides nerve axons, resulting in better nerve regeneration after transection.

Can tissue elemental analysis be used to differentiate sarcoidosis and tuberculous lymphadenitis?

INTRODUCTION: Sarcoidosis and tuberculous lymphadenitis are granulomatous inflammatory diseases. Differentiating lymph node involvement in these two diseases can be challenging. This study evaluated whether elemental analysis of tissue samples could facilitate the differentiation of these histopathologically and clinically similar diseases. MATERIALS AND METHODS: A total of 152 tissue samples were included: 57 caseating granulomatous inflammation, 58 non-caseating granulomatous inflammation, and 37 reactive lymph node specimens. The tissue samples were analyzed for calcium, magnesium, iron, copper, zinc, chrome, molybdenum, nickel and selenium with inductively coupled plasma-optical emission spectroscopy (ICP-OES). RESULT: Comparison of element levels in the three groups revealed that caseating granulomatous inflammation had higher calcium content (662.6 ± 4.6 ppm, p< 0.001) and lower iron content (48.7 ± 83 ppm, p< 0.001) compared to non-caseating granulomatous inflammation. Compared to reactive lymph tissue, caseating granulomatous inflammation had higher calcium and lower iron and magnesium content while non-caseating granulomatous inflammation had higher levels of iron and lower magnesium; however, these differences were not statistically significant. In caseating granulomatous inflammation, a calcium cut-off value of 207 ppm yielded 85% specificity and 63% sensitivity. For iron, a cut-off value of 51 ppm had 74% specificity and 58% sensitivity. CONCLUSIONS: High calcium and low iron levels in lymph tissue may be suggestive of caseating granulomatous inflammation and tuberculosis. In cases where differentiating between sarcoidosis and tuberculous lymphadenitis is difficult, performing tissue elemental analysis may provide additional supportive evidence for differential diagnosis.

Cervical Thymic Cyst Around Hypoglossal Nerve.

Cervical thymic cyst is rare lesions leading to cervical mass. As it is a rare entity, it might be confused with other congenital neck masses or neoplastic lesions. Preoperative diagnosis is almost impossible. In the present study, a patient who was operated with prediagnosis of branchial cyst and diagnosed with thymic cyst according to the histopathologic examination was presented. A 16-month-old girl was admitted to our clinic with the complaint of growing right neck mass that was realized about 4 months ago. Magnetic resonance imaging (MRI) of the neck demonstrated a rim-enhanced hypointense cystic lesion in the posterior aspect of the submandibular gland, without tracheal right lateral and mid plane on MRI, curving common carotid artery to the medial. Patients underwent surgery under general anesthesia in company with existing findings. Hypoglossal nerve was surrounded by the mass, and the mass was totally resected. The final pathology result was reported as thymic cyst. Cervical thymic masses might be unnoticed in the differential diagnosis of the cervical mass as they are rarely seen entities. Histopathologic examination of the thymus tissue was performed for diagnosis. Surgical excision is the ideal treatment approach and no postoperative recurrence has been reported.

The effect of surgical specimen-derived phosphorus and lead concentrations in non small cell lung cancer patients on disease course.

INTRODUCTION: Lung cancer is one of the leading causes of cancer-related mortality. There are many exogenic and endogenic factors associated with the development of lung cancer. One of these factors is trace elements. Under- or overabundance of trace elements can disrupt cellular functions and lead to the formation of cancer. In this study we conducted elemental analysis of lung cancer tissue and normal lung tissue to investigate the role of tissue trace element concentrations in lung cancer. MATERIALS AND METHODS: Elemental analysis was performed on 30 lung cancer tissue samples and a control group of 15 normal lung tissue samples, all taken from patients diagnosed, treated and followed at our hospital between 2005 and 2010. The solubilized tissue samples were analyzed for the presence of 19 elements using inductively coupled plasma-optical emission spectroscopy (ICP-OES). Total element amounts in the tissue were calculated. RESULT: Concentrations of magnesium, potassium, zinc, manganese, lead, boron, chromium and phosphorus were significantly higher in the patient group compared to the control group. Deceased patients had significantly lower phosphorus concentrations and significantly higher lead concentrations than the other patients. CONCLUSIONS: Elevated levels of magnesium, potassium, zinc, manganese, lead, boron, chromium and phosphorus in lung cancer tissue indicate that these elements may play a role in the development of lung cancer. The results of our evaluation of the association between trace elements and lung cancer suggest that, together with other factors, low phosphorus concentration and high lead concentration in tumor tissue may influence disease course.

Effects of Myrtus communis extract treatment in bile duct ligated rats.

BACKGROUND: The aim of our study was to investigate the antifibrotic and antioxidant effects of Myrtus communis subsp. communis (MC) extract against liver injury and fibrosis occurring in rats with biliary obstruction. MATERIALS AND METHODS: The rats were randomized into four groups (n = 8). Control group (C), MC-administrated group (MC), the bile duct ligation (BDL), and BDL + MC groups. MC was administered at a dose of 50 mg/kg a day orally for 28 days. In blood samples, total bilirubin, direct bilirubin, alanine aminotransferase, aspartate aminotransferase levels, tumor necrosis factor-α, and interleukin-1ß measurement were measured. Oxidative injury was examined by measuring luminol and lucigenin chemiluminescence, malondialdehyde and glutathione levels, superoxide dismutase and myeloperoxidase activities. Transforming growth factor-beta and hydroxyproline levels were measured for analyzing fibrosis. The hepatic injury was also analyzed microscopically. RESULTS: Plasma total bilirubin, direct bilirubin, alanine aminotransferase, aspartate aminotransferase, tumor necrosis factor-α, and interleukin-1ß levels were found significantly high in the BDL group, while these values significantly decreased in the BDL group treated with MC. On the other hand, the glutathione and superoxide dismutase values significantly decreased in the BDL group compared to the control group but increased markedly in BDL + MC group compared to the BDL group. Malondialdehyde levels, myeloperoxidase activity, tissue luminol, lucigenin, transforming growth factor-beta, and hydroxyproline levels when compared with the control group increased dramatically in the BDL group and reduced the MC + BDL group. CONCLUSIONS: Our results suggest that MC protects the liver tissues against oxidative damage following BDL via its radical scavenging and antioxidant activities, which appear to involve the inhibition of tissue neutrophil infiltration.

Papillary Lesions of Breast.

INTRODUCTION: Papillary breast lesions constitute a pathological heterogeneous group and are characterized by growth in the milk ducts. In this study, we aimed to present in view of literature patients who underwent lumpectomy due to breast mass and with papillary lesion in histopathological examination. MATERIAL METHOD: The pathology records and informations of 42 patients who were operated between 2006-2014 in our clinic and considered to have papillary lesion in histopathological examination were examined retrospectively. The patients were evaluated for age, gender, complaints, lesion localizations, performed surgery, histopathological type, follow-up period and the lesions occurring during follow-up. FINDINGS: The excisional biopsy in the form of lumpectomy was made to 34 patients who were reported as benign papillary lesion in coreneedle biopsy performed. The lesion in 11 patients were marked preoperatively by radiology clinic. 33 patients who had benign papillary lesion in excisional biopsy were followed. Modified radical mastectomy was performed to a total of 9 patients including 1 patient with malignant papillary lesion in excisional biopsy and 8 patients with malignant papillary lesion in coreneed lebiopsy. RESULT: Histopathological diagnosis should be confirmed by performing definitely excisional biopsy in patients who detected benign papillary lesions by coreneedle biopsy and strict clinical follow-up should be made for developing malignancies in patients who detected benign papillary lesions.

Evaluation of the effects of fulvestrant and micronized progesterone on the post-operative adhesion formation and ovarian reserve in rat model with immunohistochemical and biochemical analysis.

OBJECTIVE: To evaluate the effects of fulvestrant and micronized progesterone on post-operative adhesion formation and ovarian reserve in a rat uterine horn adhesion. METHODS: In this prospective randomized controlled trial, 32 female Wistar albino rats were randomly divided into four groups including control group (Group 1), the control adhesion group (Group 2), 1 mg/kg daily intramuscular fulvestrant received group (Group 3) and 1 mg/kg daily oral micronized progesterone received group (Group 4). The extent and severity of adhesions were scored and samples were taken from adhesion areas to investigate the grades of adhesions according to the immunohistochemical scoring system. Ovarian reserves were measured with anti-Müllerian hormone (AMH) and histological ovarian follicles count. RESULTS: The extent, severity and total adhesion scores were reduced in all treatment groups compared to control adhesion group (Group 2). Similarly, immunohistochemical adhesion scores were lower in the treatment groups. AMH and follicle count were significantly found lower in adhesion groups compared with control group. However, treatment groups were found to have higher ovarian reserve compared to control adhesion group (Group 2). CONCLUSIONS: Fulvestrant and micronized progesterone were found to reduce post-operative adhesion formations and have decreased detrimental effects of adhesion formation on ovarian reserve.

The influence of low-level laser therapy with alendronate irrigation on healing of bone defects in rats.

The aim of this study was to investigate the effects of alendronate (Aln) irrigation with low-level laser therapy (LLLT) on the healing of bone defects in rats. Sixty Wistar rats weighing 250 to 300 g were randomly divided into three groups of 20 animals each: (1) control group, (2) Aln group, and (3) Aln with LLLT group. The distal epiphysis of all rats was perforated with a surgical bone drill. Twenty rats served as control. The bone defects of 40 rats received local alendronate sodium trihydrate irrigation (1 mg/ml) at the time of surgery. LLLT was applied to the bone defects of 20 rats immediately after Aln irrigation, and repeated on days 2, 4, 6, and 8 with a total dose of 10 J/cm(2) (2 J/cm(2) × 5). Continuous wave of GaAlAs laser (808 nm) was used with a power density of 0.1 W/cm(2). Laser energy was applied for 20 s (0.1 W × 20 s/1 cm(2)) per session. Control group, Aln group, and Aln with LLLT group rats were sacrificed at days 10 and 20 to compare the bone healing of each group histologically. There were significant differences between the three groups regarding union, substantia spongiosa, cortex formation, and in sum of histologic scores on days 10 and 20 (P < 0.0001). Our findings demonstrated that Aln has a more positive effect with LLLT on bone healing in rats. It was concluded that combining LLLT (808 nm laser at 10 J/cm(2)) with Aln irrigation has a beneficial effect in bone repair. It was demonstrated experimentally that Aln irrigation during the surgery had a significant effect to enhance bone formation, and LLLT significantly potentiated the osseous healing effects of Aln on bone defects. This administration method is able to minimize the dose of Aln in order to avoid both systemic and local adverse effects as well as the local injection times during the bone healing process.

Correlation of diffusion MRI with the Ki-67 index in non-small cell lung cancer.

BACKGROUND: The primary objective of the study was to evaluate the association between the minimum apparent diffusion coefficient (ADCmin) and Ki-67, an index for cellular proliferation, in non-small cell lung cancers. Also, we aimed to assess whether ADCmin values differ between tumour subtypes and tissue sampling method. METHODS: The patients who had diffusion weighted magnetic resonance imaging (DW-MRI) were enrolled retrospectively. The correlation between ADCmin and the Ki-67 index was evaluated. RESULTS: Ninety three patients, with a mean age 65 ± 11 years, with histopathologically proven adenocarcinoma and squamous cell carcinoma of the lungs and had technically successful DW-MRI were included in the study. The numbers of tumour subtypes were 47 for adenocarcinoma and 46 for squamous cell carcinoma. There was a good negative correlation between ADCmin values and the Ki-67 proliferation index (r = -0.837, p < 0.001). The mean ADCmin value was higher and the mean Ki-67 index was lower in adenocarcinomas compared to squamous cell carcinoma (p < 0.0001). There was no statistical difference between tissue sampling methods. CONCLUSIONS: Because ADCmin shows a good but negative correlation with Ki-67 index, it provides an opportunity to evaluate tumours and their aggressiveness and may be helpful in the differentiation of subtypes non-invasively.

Roles of Ki-67, p53, transforming growth factor-ß and lysyl oxidase in the metastasis of lung cancer.

BACKGROUND AND OBJECTIVE: Most lung cancer (LC) patients have metastatic disease at time of diagnosis, which influence the treatment regimen and is the most important prognostic factor. The main purpose of our study was to evaluate the relationship between cell proliferation (Ki-67 label index), p53, transforming growth factor-ß (TGF-ß) and lysyl oxidase (LOX), and the metastatic stages of different lung cancers. The secondary aim was to correlate these parameters with the standardized uptake value (SUVmax) of the primary lesion during positron emission tomography-computed tomography (PET-CT). METHODS: Eighty-five treatment-naive patients with LC were enrolled. All patients were examined with PET-CT. Ki-67, p53, TGF-ß and LOX were evaluated histopathologically. RESULTS: Small cell lung cancer (SCLC) showed the most intense staining in all parameters. A well-differentiated adenocarcinoma (AC) demonstrated a more diffuse and intense staining than squamous cell carcinoma (SCC). There was no statistically significant relationship between the four parameters and metastases of SCLC and SCC. However, a significant relationship between TGF-ß, LOX and metastatic AC was demonstrated with regards to diffusivity and intensity. p53 and Ki-67 did not show a significant relationship. No correlation between SCLC and SCC and SUVmax was found. However, in AC, the diffusivity and intensity of the LOX and p53 staining showed a statistically significant relationship to the SUVmax. CONCLUSIONS: LOX and TGF-ß may play roles in metastatic AC. LOX and TGF-ß may become markers of metastatic disease and inhibition could be explored for treatment.

Renal epithelioid angiomyolipoma mimicking urothelial carcinoma of the upper urinary tract.

Epithelioid angiomyolipoma is a rare mesenchymal tumor arising mainly in the kidney that can potentially behave aggressively. Epithelioid angiomyolipoma can often resemble sarcomatoid renal cell carcinoma, high grade renal carcinoma or sarcoma. Its similarity to renal cell carcinoma has been emphasized in most of the cases reported in literature. With the purpose of contributing to the awareness of this similarity, a 32-year-old female patient with renal epitelioid angiomyolipoma in the left kidney which radiologically mimicked urothelial cell carcinoma of the upper urinary tract is presented.

The role of infliximab on paracetamol-induced hepatotoxicity in rats.

Paracetamol has a reasonable safety profile when consumed in therapeutic doses. However, it could induce hepatotoxicity and even acute liver failure when taken at an overdose. Infliximab is tumor necrosis factor alpha (TNF-α) inhibitor agent, which has been developed as a therapeutic agent for TNF-α-mediated disease. It acts by binding and neutralizing TNF. The aim of our study was to evaluate the hepatoprotective activity of infliximab on paracetamol-induced hepatotoxicity and to understand the relationship between the TNF-α and paracetamol-induced liver injury. Fifty-six rats were divided into eight groups as each composed of seven rats: (1) intact, (2) 7 mg/kg infliximab, (3) 140 mg/kg NAC, (4) 2 g/kg paracetamol, (5) 2 g/kg paracetamol + 140 mg/kg NAC, (6) 2 g/kg paracetamol + 3 mg/kg infliximab, (7) 2 g/kg paracetamol + 5 mg/kg infliximab and (8) 2 g/kg paracetamol + 7 mg/kg infliximab groups. Liver function tests including lipid peroxidation levels were analyzed and histopathological changes of liver were also observed. There were statistically significant increases in the activities of aspartate aminotransferase (AST), alanine aminotransferase (ALT), levels of TNF-α and malondialdehyde (MDA) and decreases in the activity of superoxide dismutase (SOD) and level of glutathione (GSH) in the group treated with paracetamol. Infliximab administration dramatically reduced serum ALT, AST and TNF-α level. Also, it restored GSH, SOD and decreased MDA levels in liver. Liver histopathological examination showed that infliximab administration antagonized paracetamol-induced liver pathological damage. The results of present study suggest that infliximab has significant hepatoprotective activity on paracetamol-induced hepatotoxicity.

Bilateral parotid swelling with blindness.

We report a case of a 32-year-old woman who presented with bilateral parotid gland enlargement. She had no systemic symptoms such as fever, cough, and weight loss. She had bilateral blindness for a long time. The results of a physical examination revealed a bilateral firm, painless mass in the parotid region. A computed tomographic scan showed no clear lymphadenopathy in the neck but showed localized infiltrates and multiple pulmonary nodules with enlargement of the mediastinal and axillary lymph nodes in the chest. The patient underwent a superficial parotidectomy. A histopathologic finding revealed an epithelioid noncaseating granuloma, which is consistent with sarcoidosis. In summary, this current study shows that sarcoidosis should be considered in the differential diagnosis of all painless swelling of the parotid gland, especially in women, which could be an earlier complaint.

Evidence for residual SARS-CoV-2 in corpus cavernosum of patients who recovered from COVID-19 infection.

BACKGROUND: The COVID-19 is an ongoing health problem with millions of cases and deaths worldwide. Although the virus is transmitted with droplets through the respiratory system, the involvement of different organs has been reported. OBJECTIVES: The pandemic caused urological procedures to be postponed when patient is infected with SARS-CoV-2. However, the reliability of 1 month postpone period and long-term complications of the virus, such as a possible erectile dysfunction (ED) is not clarified. We aimed to compare the corpus cavernosum of patients 1 and 7 months after COVID-19 infection with control patients who had not COVID-19 and search for SARS-CoV-2 in tissues using immunohistochemistry and electron microscopy. MATERIALS AND METHODS: Three groups of subjects underwent penile prosthesis implantation and Nesbit procedure for Peyronie's disease 1 and 7 months after COVID-19 infection and control group without previous COVID-19 infection. We searched for SARS-CoV-2 in penile tissue using RT-PCR, electron microscopy and immunohistochemistry. RESULTS: Electron microscopy and immunohistochemical staining showed SARS CoV-2 virus in the penile corpus cavernosum of patients 1 month after COVID-19 recovery. Immunohistochemical staining intensity correlated with the severity of previous infection. Transmission electron microscopy revealed intracellular virtual particles of about 80 nm with a typical morphology of prominent spikes and electron-dense dots of nucleocapsid in addition to vesicles filled with virus-like particles. Cells showed increased membrane trafficking. The 1 month after COVID-19 group showed an increased number of fibroblasts. The 7 months after COVID-19 group had similar morphology and immunoreactivity as control group. DISCUSSION: This is the first study of late post-COVID examination of penis and the second study of early post-COVID examination of corpus cavernosum. For 1 month post-COVID patients, the aetiology of ED could be the viral infection that is also affecting corpora cavernosa. We hypothesize that viral infection affects the endocytic and exocytic pathways, hence the metabolic activity of cells that can be the reason of altered functions in some post-COVID patients. CONCLUSION: This study is important because it did not detect any virus residue in the tissue samples at the seventh month. In addition, we can say that the penile surgeries should be postponed more than 1 month after the COVID infection according to this study. But, there is a need for new studies with large series and high levels of evidence that can show how long the virus remains in the corpus cavernosum. Patients should be followed in this respect.

Aortic ischemia-reperfusion injury and potency of fluoxetine.

Objectives: Due to cross-clamping of the aorta during aortic aneurysm surgeries, ischemia-reperfusion (IR) develops, and it may cause damage to the aorta itself or even to remote organs by oxidative stress or inflammation. Fluoxetine (FLX) which might be used in the preoperative period for its tranquilizing effect also has antioxidant effects in short-term use. The purpose of our study is to examine whether FLX protects aorta tissue, against the damage caused by IR. Materials and Methods: Three groups of Wistar rats were formed randomly. 1) Control group (sham-operated), 2) IR group (60 min ischemia+120 min perfusion), and 3) FLX+IR group (FLX dose was 20 mg/kg for 3 days IP before IR). At the end of each procedure, aorta samples were collected, and oxidant-antioxidant, anti-inflammatory, and anti-apoptotic status of the aorta were evaluated. Histological examinations of the samples were provided. Results: Levels of LOOH, MDA, ROS, TOS, MPO, TNFα, IL-1ß, IL-6, NF-kB, MMP-9, caspase-9, 8-OHdG, NO, and HA were found to be significantly increased in the IR group compared with control (P<0.05) and SOD, GSH, TAS, and IL-10 levels were significantly lower (P<0.05). FLX significantly decreased LOOH, MDA, ROS, TOS, MPO, TNFα, IL-1ß, IL-6, NF-kB, MMP-9, caspase-9, 8-OHdG, NO, and HA levels in the FLX+IR group compared with IR group (P<0.05) and increased IL-10, SOD, GSH, and TAS (P<0.05). FLX administration prevented the deterioration of aortic tissue damage. Conclusion: Our study is the first study that demonstrates FLX-mediated suppression of IR injury in the infrarenal abdominal aorta by antioxidant, anti-inflammatory, and anti-apoptotic properties.

Sonographic measurement of cervical length and risk of preterm delivery.

AIM: To study the relationship between cervical lengths measured by ultrasound and risk of preterm delivery. MATERIAL & METHODS: We examined 209 women with singleton pregnancies. The inclusion criteria were women who presented with regular and painful contractions (≥2 contractions at intervals of 10 min for at least 1 h). Transvaginal scan was performed to measure the cervical length. The clinical management of the women, including hospitalization and administration of tocolytics, was determined by the attending obstetricians, who were blinded about cervical length. The primary outcome was delivery within 7 days of presentation. RESULTS: Delivery within 7 days of presentation occurred in 19/209 (9%) of pregnancies who were presenting with regular and painful uterine contraction at 31 weeks of gestation, and this was inversely related to cervical length. Logistic regression analysis demonstrated that cervical length and history of abortion remain as significant contributors to predicting delivery within 7 days. Of the patients who presented with threatened preterm labor, 117 (56%) received tocolytics, and 92 (44%) did not. In the group with a cervical length of <15 mm, delivery within 7 days occurred in 15/21 (71.4%) who were treated with tocolytics and 2/5 (40%) that were managed expectantly. CONCLUSION: Women with threatened preterm labor and a cervical length of <15 mm at presentation are at high risk of delivering preterm within 7 days. Sonographic measurement of cervical length helps to avoid over-diagnosis of preterm labor.