Preventive and protective effects of Turkish propolis on H2O2-induced DNA damage in foreskin fibroblast cell lines.

The aim of the present study was to evaluate the potential of Turkish propolis extracts if they prevent or protect foreskin fibroblast cells against hydrogen peroxide (H2O2)-induced oxidative DNA damage. Hydrogen peroxide (40 µM) was used as an inducer of oxidative DNA damage. The damage of DNA was evaluated by using the alkaline single cell gel electrophoresis (comet) assay. Turkish propolis extracts at concentrations of 25, 50, 75 and 100 µg/ml were prepared by ethanol. Anti-genotoxicity was assessed before, simultaneously, and after treatment of propolis extract (50 µg/ml) with H2O2. The results showed a significant decrease in H2O2-induced DNA damage in cultures treated with propolis extract. The antioxidant activity of phenolic components found in propolis may contribute to reduce the DNA damage induced by H2O2. Our findings confirmed the chemopreventive activity of propolis and showed that this effect may occur under different mechanisms.

Increased serum anti-carbonic anhydrase II antibodies in patients with Graves' disease.

Carbonic anhydrase II (CA II) has an important role in thyroid hormone synthesis via regulating iodide (I-) transport across thyroidal cell membranes and the existence of autoantibodies against CA I and/or CA II have been shown in sera from patient with various autoimmune diseases such as Sjögren's Syndrome, Systemic Lupus Erythmatosus, type 1 diabetes, primary biliary cirrhosis and ulcerative colitis. The aim of this study was to investigate the presence of anti-CA I and CA II antibodies in autoimmune thyroid disease and the relationships between the autoantibodies and other clinical parameters. We studied 40 autoimmune thyroid patients (20 Hashimoto's thyroiditis, HT and 20 Graves' disease, GD ) and 21 healthy control subjects. Serum anti-CA I and CA II antibodies were screened by ELISA. Positive rate of anti-CA II (25%) antibody was significantly higher in GD patients as compared to HT patients and control subjects (p<0.05). There were no significant changes in positive rate of anti-CA I antibody. In addition, a significant correlation between serum anti-CA antibodies titers and other studied clinical parameters was not found. The results suggest that anti-CA II antibodies may be involved in the pathogenesis of GD.

Iodine status, thyroid function, thyroid volume and thyroid autoimmunity in patients with type 1 diabetes mellitus in an iodine-replete area.

OBJECTIVE: To analyze the prevalence and clinical significance of thyroid autoimmunity, thyroid volume and iodine status in patients with type 1 diabetes mellitus compared with age and sex matched healthy controls, in an iodine-deficiency improved area. METHOD: Fifty-eight patients with type 1 DM, 30 female and 28 male, who attended the pediatric endocrinology clinic of Karadeniz Technical University Hospital were included into the study. They were compared with 58 healthy children matched for sex and age. Routine thyroid function parameters, thyroid autoantibodies (TPOAb, TGAb and TRAb) and urinary iodine excretion were measured and thyroid volume was determined by ultrasonography (US). RESULTS: Twenty-six patients (44.8%) in diabetic patients and 20 subjects (34.5%) in the control group had thyroid autoantibody positivity. TPOAb and TGAb positivity were significantly high in diabetic patients (P=0.01 and P=0.032, respectively). Thyroid US revealed a thyroid volume of 6.6+/-3.5 ml (median 6.4 ml, range 1.117.2 ml) in the diabetic patients compared with 3.7+/-2 ml (median 3.1 ml, range 0.8-8.6 ml) in the control group (P=0.0001). Median urinary iodine levels of both groups were clearly above the threshold level for iodine deficiency, but 26 patients with type 1 DM (44.8%) and 16 controls (27.5%) had urinary iodine excretion below 100 microg/L, and 21 (36.2%) of diabetic patients and two subjects (3.4%) of the control group were consistent with severe iodine deficiency. No significant differences were noted in diabetic patients in terms of age, duration and metabolic control of the disease and thyroid volume when compared according to the autoantibody presence. Additionally, there were no significant differences between the iodine deficient and iodine sufficient diabetic patients in terms of age, sex, duration of disease, HbA1c, thyroid hormones and thyroid volumes. Thyroid autoimmunity was lower in patients with iodine deficiency (38.4% vs. 50%), but not statistically significant. CONCLUSION: We found that type 1 DM patients had larger thyroid volume compared with healthy control groups, and a large portion of them had the markers of autoimmune thyroid disease and iodine deficiency. Surprisingly, we found that a large portion of the healthy children had TRAb positivity. We proposed that TRAb must be considered in community surveys or prevalence studies of autoimmune thyroid disorders in iodine-replete areas. Additionally, prospective longitudinal studies are needed to determine the clinical significance of TRAb positivity in diabetic patients.

Polymorphonuclear (PMN) elastase levels in depressive disorders.

The present study was carried out to determine polymorphonuclear (PMN) elastase levels and to explain whether or not altered levels may be a factor in depression. The patient group included a total of 68 patients with depression (32 with major depression, 36 with dysthymia). The control group included 40 volunteer, healthy subjects. WBC, erythrocyte sedimentation rate (ESR), immunogloblins (Ig A, IG G, IgM), and complements (C3 and C4) levels of the patient and control groups were determined. The mean PMN elastase levels, determined by immunoactivation method, in patients with major depression without and with melancholia, dysthymia and healthy subjects were found to be 99.5 (10.8) microgram(s)/L [arithmetic mean (SEM)], 289.0 (71.3) microgram(s)/L, 55.7(5.5) microgram(s)/L, and (47.3(2.6) microgram(s)/L, respectively. The mean PMN elastase level was found to be statistically higher in patients with depression, especially in patients with major depression, than that of healthy subjects. It was concluded that severe depression is associated with immunological and inflammatory alterations may be showed easily by PMN elastase measurements.

Relationship between lipid peroxidation and disease activity in patients with Behçet's disease.

Behçet's disease is a chronic multi-systemic disorder which is characterized by a relapsing systemic inflammatory process. The alteration of lipid profile and lipid peroxidation resulting from the inflammatory process may he associated with an increased risk for atherosclerosis in patients with Behcet's disease. We investigated lipids, lipoprotein and lipid peroxidation and their inter-relationships considering the disease activity. Eighteen patients (11 male and 7 female) and 20 age-matched healthy subjects (10 male and 10 female) were studied. Lipid profile including total cholesterol, triacylglycerol, HDL-cholesterol, LDL-cholesterol, lipoprotein(a), apoAI and apoB, and acute phase reactants including polymorphonuclear (PMN) elastase, PMN leukocyte count, erythrocyte sedimentation rate (ESR) and complements (C3, C4) were evaluated in patients in active and inactive periods of Behçet's disease and control subjects. The levels of thiobarbituric acid reactive substance (TBARS) were assessed as an indicator of lipid peroxidation. Lipid peroxidation was found to he increased in the active period compared to the inactive period of the disease and control subjects. Also, lipid peroxidation showed correlations of various degrees with atherogenic lipid parameters in both periods of the followed-up patients. In conclusion, patients with Behçet's disease in the active period may be much more susceptible to atherogenic events than those in the inactive period of the disease and control subjects.

Evaluation of lipoprotein (a) [Lp (a)] as a risk factor for coronary artery disease in the Turkish population.

OBJECTIVE: Lipoprotein (a) [Lp (a)] is an atherogenic particle that structurally resembles a low-density lipoprotein (LDL) particle but contains a molecule of apolipoprotein (a) attached to apolipoprotein B-100 by a disulfide bond. Because of the fact that elevated plasma levels of Lp (a) have been shown to be an independent risk factor for coronary artery disease (CAD), we determined plasma Lp(a) levels in CAD for Turkish population, and compared them with previous findings of some developed countries. RESULTS: The mean plasma Lp (a) levels in CAD group (mean +/- SD; 0.41 +/- 0.21, g/L) was found approximately twofold higher than that of the control group (0.21 +/- 0.17 g/L). Also, it was found to be higher than the mean levels of CAD group in the other populations described in previous reports. But CAD prevalence in the Turkish population is lower than in those of developed countries, especially the United States. CONCLUSIONS: We concluded that the interaction between plasma Lp (a) levels and many other factors such as face and heredity affecting development of CAD may show different effects for development of CAD in each of those populations separately.

Plasma polymorphonuclear leukocyte elastase levels and its relation to disease activity in psoriasis.

Although some increased enzyme activities in PMN leukocytes isolated from the circulation of psoriatic patients have been previously described, none of these enzymes had been studied in plasma for determination of disease activity. The purpose of this study was to evaluate whether plasma PMN elastase levels might be a good marker for determination of disease activity of psoriatic patients. Plasma PMN elastase and some acute phase reactants including alpha-1 antitrypsin, alpha-2 macroglobulin, fibrinogen, erythrocyte sedimentation rate(ESR), and transferrin were studied in thirty-nine patients with psoriasis, including 16 controlled patients, and forty healthy control subjects. PMN elastase and the acute phase reactants except transferrin were found to be significantly higher in the psoriatic patients than in control subjects. The PMN elastase level in the patients was about 6-fold higher than that of the control group. The PMN elastase levels in the patients in the inactive period was two-fold higher than in the control subjects. PMN elastase was found to correlate significantly with PMN leukocyte count and alpha-1 antitrypsin in active and inactive periods of the disease, but with fibrinogen and psoriasis area and severity index (PASI) only in the active period of the disease. We conclude that plasma PMN elastase level may be a more specific and sensitive inflammatory marker than alpha-1 antitrypsin, alpha-2 macroglobulin, ESR, and may be a good marker for diagnosis and follow up of the disease activity of the psoriatic patients.

Polymorphonuclear leukocyte elastase levels in patients with Behçet's disease.

Behçet's disease is a chronic multisystem disorder characterized by a relapsing inflammatory process of unknown aetiology. The increased activity of polymorphonuclear leukocytes (PMN) in Behçet's disease has been intensively studied. PMN elastase, an acute phase reactant, was investigated to determine whether it may serve as a biochemical marker in Behçet's disease. Erythrocyte sedimentation rate, protein electrophoresis, immunoglobulins (IgA, IgG, IgM), complement components (C3, C4) as well as PMN elastase were evaluated in 42 patients with Behçet's disease and 40 healthy subjects. The mean PMN elastase levels were found to be 244.2 micrograms/l (median 210 micrograms/l, S.D. 126.8) in patients with Behçet's disease and 44.3 micrograms/l (median 45, S.D. 19.2) in healthy subjects (P < 0.001). In addition, the mean PMN elastase levels were found to be 321.5 micrograms/l (median 300, S.D. 117.9) in the acute phase and 159 micrograms/l (median 162, S.D. 59.3) in remission (P < 0.001). It was concluded that PMN elastase may be a good biochemical marker for diagnosis and therapy control in patients with Behçet's disease.

The significance of autoantibodies against oxidatively modified low-density lipoprotein (LDL) in patients with psoriasis.

Psoriasis is associated with changes in plasma lipid and lipoproteins, which may play a role in the development of occlusive vascular disease. The oxidation of low-density lipoprotein (LDL) is considered a key event in the development and progression of atherosclerosis. Autoantibodies against oxidized LDL (auAb-oxLDL) may contribute to understanding the relationship between oxidative processes and development of atherosclerosis. Thirty-three patients with psoriasis and 30 matched control subjects were investigated. LDL oxidation was evaluated as the presence of autoantibodies against LDL oxidatively modified with Cu++, by an ELISA system in the patients and control sera. AuAb-ox LDL levels of the patients were found to be significantly increased compared with a control group. 42% of the patients and 3.3% of the control subjects had higher auAb-ox LDL levels than the cut-off point (352 mU/ml). The levels of auAb-ox LDL were found to be correlated with PASI score (r = 0.67, p < 0.01). Also, The antibody level was found to be correlated with polymorphonuclear elastase and alpha-1 antitrypsin levels (r = 0.58, p < 0.05; r = 0.51, p < 0.05, respectively). It was concluded that increased levels of auAb-oxLDL in the psoriatic patients may be a consequence of the interaction between imbalance of oxidant-antioxidant system and lipoproteins, and the measurement of auAb-oxLDL in the patients may mirror in vivo occurrence of oxidative processes.

Decreased neutrophil antioxidative enzyme activities and increased lipid peroxidation in hyperlipoproteinemic human subjects.

Neutrophils have the capacity to produce free radicals. Free radicals are associated with hyperlipoproteinemia and atherosclerotic processes. For this reason, neutrophil superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), glutathione reductase (GR), catalase (Cat) activities and thiobarbituric acid reactive substances (TBARS), as an index of lipid peroxidation, have been studied in hyperlipoproteinemic (HLP) and age-matched normolipidemic groups. Lipid parameters including triglycerides, total cholesterol, plasma TBARS, HDL-cholesterol, LDL-cholesterol, apo A-I, apo B have also been determined. Forty subjects (females 18, males 22) with HLP (mean age 43.8+/-8.7 (S.D.)) and 40 normolipoproteinemic subjects (females 17, males 23; mean age 46.4+/-11) were included in the study. Neutrophils were isolated by Percoll gradient centrifugation from venous blood samples. Methods used were as follows: INT method for SOD, UV method at 340 nm based on oxidation of NADPH for GSH-Px and GR, UV method at 240 nm based on degradation of hydrogen peroxide for catalase, and a method based on reaction with thiobarbituric acid for TBARS. Neutrophil SOD, GSH-Px, and catalase activities were found to be significantly low in the hyperlipoproteinemic group compared with the normolipoproteinemic group. GR activity did not differ between both groups. The mean TBARS level in the neutrophil fraction was found to be significantly higher in hyperlipoproteinemics than in that of the normolipoproteinemics. It was concluded that decreased neutrophil antioxidant enzyme activities in hyperlipoproteinemics may lead to insufficient detoxification of free radicals produced in these cells and contribute to increased lipid peroxidation.

Aqueous humour and serum zinc and copper concentrations of patients with glaucoma and cataract.

Serum and aqueous humour zinc and copper concentrations of 44 patients with glaucoma and cataract were determined. Serum values were found within normal ranges. The highest mean copper concentration was seen in the glaucoma group. In addition there was a significant negative correlation between the aqueous humour levels of zinc and copper in patients with glaucoma. It was concluded that an increased copper value together with a low zinc value might be of importance in patients with glaucoma.

Prevalence of diabetes, obesity and hypertension in a Turkish population (Trabzon city).

OBJECTIVE: The objectives of this study were to determine the prevalence of diabetes mellitus in Trabzon city, Turkey, using standardized diagnostic criteria, and to evaluate associated factors. METHODS: A total of 3000 eligible study subjects were selected. Of those, 2646 subjects participated in the study. Individuals aged > or =20 years were selected from their family health cards and were invited to the health station. Anthropometric and demographic data were obtained for each subject. Plasma glucose was measured by an autoanalyser. People without previously diagnosed diabetes were categorized according to WHO diagnostic criteria as follows. Diabetes: a fasting plasma glucose (FPG)> or =140 mg/dl or 2-h plasma glucose > or =200 mg/dl after a 75-g oral glucose load. RESULTS: The overall prevalence of diabetes in those > or =20 years of age was 6.0% (n=160). Among diabetic subjects, 69 were newly diagnosed diabetes mellitus. Age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP) and FPG were higher in diabetic subjects than in non-diabetic subjects. The prevalence of diabetes showed significant association with increased age (P<0.0001). The overall prevalence of obesity was 19.2%. The combined prevalence of both overweight and obesity was 60.6%. The prevalence of obesity was 27.4% among women and 10.7% among men (P<0.0001). Prevalence of diabetes increased with degree of obesity (P<0.0001). The rate of obesity in diabetic subjects was 35.6%. In the study population as a whole, the prevalence of obesity increased with age, being highest in the 50-59 years age group, but lower again in the 60+ age group. Prevalence of SBP> or =140 mmHg was 12.0% and of DBP> or =90 mmHg was 8.2%.

Effects of antidepressant treatments on polymorphonuclear elastase levels in patients with depression.

BACKGROUND: We have previously reported that severe depression is associated with immunological and inflammatory alterations and these alterations may be showed easily by polymorphonuclear elastase (PMNE) measurements. The purpose of the present study is to show how PMN elastase levels change before and after antidepressant treatment. METHODS: Fifty-five patients with depression (40 with major depression [MD], 15 with dysthymic disorder [DD]) were included in the study. Blood samples were drawn prior to drug treatment, and 3 months after the treatment. Severity of depression was measured by 24-item Hamilton depression rating scale (HDRS). RESULTS: There was a positive correlation between Delta PMNE levels and Delta HDRS in patients with MD, but not in patients with DD. Twenty-eight patients were given moclobemide, and 27 patients were given imipramine. It was seen that PMN elastase levels were significantly reduced after 3-month antidepressant treatment period only in patients with MD. CONCLUSION: These findings suggest that PMNE activity is a state dependent parameter and improvement of depressive symptoms due to antidepressant treatment may lead to decrement of PMNE levels. CLINICAL IMPLICATION AND LIMITATIONS: PMN elastase measurements may be used as a sensitive biological marker to follow the time-course of the disease activity in patients with major depression.

Antioxidative enzyme activities and lipid peroxidation in major depression: alterations by antidepressant treatments.

BACKGROUND: Reactive oxygen species (ROS) may play a role in some neuropsychiatric disorders. There is some evidence that the activation of immune-inflammatory process, increase of monoamines catabolism, and abnormalities in lipid compounds may cause overproduction of ROS and, in turn, antioxidative enzyme activities (AEAs) and lipid peroxidation (LP), and that these phenomena may be related to pathophysiology of major depression. METHODS: The aims of this study were (i) to examine the AEAs and LP levels of the major depressed (MD) patients, and to compare these with healthy controls; and (ii) to investigate the effect of subchronic treatment with selective serotonin reuptake inhibitors (SSRIs) on AEAs and LP levels in MD subjects. Thirty MD patients, and 32 healthy controls (HC) participated in this study. AEAs and LP levels were determined by measuring several antioxidative enzymes and malondialdehyde (MDA) levels in plasma and/or in red blood cells. RESULTS: Major depressed patients, especially melancholic patients, had higher AEA and LP levels than those of healthy controls. After treatment for 3 months with SSRIs, AEA and LP levels of the patients were significantly decreased to normal levels. CONCLUSION: These findings suggest that (i) major depression, especially with melancholia, is associated with elevated AEAs and LP, and that (ii) subchronic treatment with SSRIs may have a suppressive effect on AEA and LP. CLINICAL IMPLICATION AND LIMITATION: AEAs might be used for monitoring SSRIs effects.

Distribution of serum lipoprotein (a) concentrations in a healthy Turkish population.

Serum lipoprotein (a) [Lp (a)] concentrations are highly skewed in different populations. We measured serum Lp (a) by quantitative enzyme-linked immunosorbent assay (ELISA) in 248 healthy Turkish subjects (127 male, 121 female). The mean Lp (a) value was 0.21 g/L and values did not differ between the sexes. The Lp (a) frequency distribution showed less skewness than those of Asian and Western populations but it clearly deviated from a Gaussian distribution. Plasma Lp (a) concentration did not correlate significantly with age, total cholesterol, low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, apolipoprotein A-1 and B or triglyceride concentration.

Plasma endothelin-1 levels in Behçet's disease.

Plasma concentrations of endothelin-1 (ET-1), a vasoconstrictor peptide released from vascular endothelial and synovial cells, were measured by radioimmunoassay in 27 patients with Behçet's disease (BD) and 18 healthy controls. The plasma ET-1 concentrations were found to be significantly increased in patients with BD (121.15 +/- 11.6 fmol/dl) compared with the healthy subjects (89.37 +/- 8.03 fmol/dl p < 0.05). The elevation of ET-1 did not correlate with the disease duration, gender, ocular or articular involvement. Whether the elevated ET-1 level is a direct result of its increased synthesis from injured vascular endothelial cells or whether its presence in high concentrations may be responsible, together with other factors for both vascular and articular complications in patients with BD is uncertain.

Hydrocephalus, corneal opacities, deafness, left ventricle hypertrophy, clinodactyly in an adolescent patient. A new syndrome associated with glucocerebrosidase deficiency.

We report a 12-year-old girl with an unusual phenotype of Gaucher disease type 3. Liver glucocerebrosidase activity was 20% of the normal. In addition to common manifestations such as hepatomegaly, she showed primary communicating hydrocephalus, corneal opacities, deafness, left ventricle hypertrophy, and clinodactyly of hands and feet. We suspect cardiomyopathy to be due to myocardiac infiltration with Gaucher cells, and corneal opacities to result from an accumulation of lipid-like inclusions into the posterior stromal keratinocytes. We were only able to find one previously published sibship disclosing similar features, which could allow the delineation of a new clinical variant of Gaucher disease.

Plasma lipoprotein (a) concentrations in hypothyroid, euthyroid and hyperthyroid subjects.

OBJECTIVE: Alterations of the lipid profile are a well known phenomenon in thyroid dysfunction. Thyroid hormones regulate lipid metabolism through various mechanisms, but a key role is played by the LDL receptor pathway. Thyroid hormone influence on lipoprotein (a) [Lp(a)] metabolism is known. METHODS AND RESULTS: Therefore we studied Lp(a) concentrations in a group of 16 hypothyroid patients and in a group of 22 hyperthyroid patients. Twenty-six euthyroid subjects were used as a control group. Plasma Lp(a) concentrations in hyperthyroid patients (23.2 +/- 28.1 mg/dl) were significantly lower than those of the hypothyroid patients (27.1 +/- 19.2, p < 0.05). There were negative correlations between plasma Lp(a) concentrations and total T4 levels in patients with hyperthyroidism and hypothyroidism (r: -0.49, p < 0.05; r: -0.40, p < 0.05, respectively). Also, decreased HDL-C levels, increased LDL-C, total cholesterol and apo B levels in the hypothyroid patients according to euthyroid subjects were observed (p < 0.05). Decreased LDL-C levels, increased HDL-C and apo Al levels in the hyperthyroid patients according to euthyroid subjects were determined (p < 0.05). CONCLUSIONS: It was concluded that plasma Lp(a) concentrations increase in hypothyroid patients and the observed relationships between thyroid status and Lp(a) levels can be explained by impaired catabolism of apo B and Lp(a) in hypothyroidism.

Plasma lipoprotein (a) levels in Turkish NIDDM patients with and without vascular diabetic complications.

OBJECTIVE: Plasma concentrations of lipoprotein (a) [Lp(a)], an independent risk factor for atherosclerosis, were measured in 59 non-insulin-dependent diabetes mellitus (NIDDM) patients with and without vascular complications, and 21 non-diabetic healthy subjects. RESULTS: The plasma log Lp(a) levels were found to be significantly increased in the NIDDM patients (1.40 +/- 0.36) compared with the healthy subjects (1.02 +/- 0.53; p < 0.05). Plasma Lp(a) levels in NIDDM patients with diabetic vascular complications (1.51 +/- 0.27) were significantly higher than those of the NIDDM patients without diabetic vascular complications (1.23 +/- 0.43) and healthy subjects (p < 0.05). There were significant correlations between plasma log Lp(a) levels and apolipoprotein B (apo B) in all NIDDM patients (r: 0.68, p < 0.05). No correlation was observed between Lp(a) levels and age, sex, duration of diabetes, fasting blood glucose, haemoglobin Alc, the mode of treatment, triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and apolipoprotein Al levels in all patients. CONCLUSIONS: It was concluded that Lp(a) was a risk factor for angiopathy in NIDDM patients and the patients who have a high plasma Lp(a) concentration should be kept under strict glycaemic control.

The effect of ATP-MgCl(2) on prevention of reperfusion injury after unilateral testicular torsion.

This study was designed to investigate the effect of ATP-MgCl(2) administered before and after detorsion on the prevention of reperfusion injury after unilateral testicular torsion. The rats were divided into six groups, each containing six rats. Torsion was created by rotating the left testes 720 degrees in a clockwise direction. Group 1 functioned as a control group. Torsion only was carried out in Group 2. Detorsion was carried out in Group 3. ATP-MgCl(2) (100 micromol/kg) was injected intravenously immediately before detorsion in Group 4. ATP-MgCl(2) (100 micromol/kg) was injected intravenously immediately after detorsion in Group 5. Saline was injected intravenously immediately after detorsion in Group 6. The effect of ATP-MgCl(2) on reperfusion injury was investigated by determining the levels of thiobarbituric acid-reactive substances (TBAR) and resulting lipid peroxidation in the bilateral testicular tissue. Testicular torsion and detorsion caused a significant increase in the TBAR levels in the bilateral testicular tissue. TBAR levels decreased to approximately normal levels in Groups 4 and 5. It is concluded that if reperfusion injury has occurred in both testes after unilateral testicular torsion, ATP-MgCl(2) administered before or after detorsion may prevent reperfusion injury in testicular torsion.