Analysing the genetic diversity and population structure of five native Turkish cattle breeds using SNP data.

The conservation and sustainable utilization of cattle genetic resources necessitate a comprehensive understanding of their genetic diversity and population structure. This study provides an analysis of five native Turkish cattle breeds: Anatolian Black (ANB), Turkish Grey (TUR), Anatolian Southern Yellow (ASY), East Anatolian Red (EAR), and South Anatolian Red (SAN) using 50 K SNP data. These breeds were compared with three European breeds, Simmental (SIM), Holstein (HOL), and Jersey (JER), and three Asian Zebu breeds: Arabic Zebu (ZAR), Nelore (NEL), and Red Sindhi (RSI). Genetic diversity indices demonstrated moderate heterogeneity among the breeds, with TUR exhibiting the highest observed heterozygosity (Ho = 0.35). Wright's Fst values indicated significant genetic differentiation, particularly between Turkish breeds and both European (Fst = 0.035-0.071) and Asian breeds (Fst = 0.025-0.150). Principal component analysis distinguished the unique genetic profiles of each breed cluster. Admixture analysis revealed degrees of shared genetic ancestry, suggesting historical gene flow between Turkish, European, and Asian breeds. Analysis of molecular variance (AMOVA) attributed approximately 58% of the variation to population differences. Nei's genetic distances highlighted the closer genetic relatedness within Turkish breeds (distance ranges between 0.032 and 0.046) and suggested a more relative affinity of TUR with European breeds. The study's phylogenetic assessments elucidate the nuanced genetic relationships among these breeds, with runs of homozygosity (ROH) analysis indicating patterns of ancestral relatedness and moderate levels of inbreeding, particularly evident in Turkish breeds. Our findings provide valuable insights into the genetic landscape of Turkish cattle, offering a crucial foundation for informed conservation and breeding strategies aimed at preserving these breeds' genetic integrity and heritage.

Assessment of the association of the MOGAT1 and MOGAT3 gene with growth traits in different growth stages in Holstein calves.

The members of the monoacylglycerol acyltransferase (MOGAT) family are essential candidate genes that influence economic traits associated with triglyceride synthesis, dietary fat absorption, and storage in livestock. In addition, the MOGAT gene family may also play an essential function in human polygenic diseases, like type 2 diabetes and obesity. The present study was conducted on Holstein calves to find the association between MOGAT1, MOGAT3/g.A229G, and MOGAT3/g.G1627A and growth traits. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was performed for genotyping the MOGAT1, MOGAT3/g.A229G, and MOGAT3/g.G1627A genes' locus using the TaqI, MspI, and BsuRI restriction enzyme. The allele frequency of A and G of the MOGAT1 locus was 0.79 and 0.21, respectively, while the genotype frequency was 0.65, 0.28, and 0.07 for AA, AG, and GG, respectively. While the allele and genotype frequencies of the MOGAT3/g.A229G locus were 00.57( A 1 ), 0.43( G 1 ), 0.35( A 1 A 1 ), 0.45( A 1 G 1 ), and 0.20( G 1 G 1 ), the allele and genotype frequencies of the MOGAT3/g.G1627A locus were 0.49( A 2 ), 0.51( G 2 ), 0.25( A 2 A 2 ), 0.49( A 2 G 2 ), and 0.26( G 2 G 2 ). Chi-square analysis showed that MOGAT3/g.G1627A distribution was at the Hardy-Weinberg disequilibrium ( p   <  0.05), and MOGAT1 and MOGAT3/g.A229G distribution was at the Hardy-Weinberg equilibrium ( p   >  0.05). In total, two statistical methods (general linear model (GLM) and PROC MIXED) were used to identify an association between gene locus and growth traits. An association analysis showed a statistically significant difference between the MOGAT1 and body weight, body length, and chest circumference, MOGAT3/g.A229G with average daily gain (ADG) and withers height, and MOGAT3/g.G1627A with body weight and body length ( p   <  0.05). The results confirmed that the MOGAT1, MOGAT3/g.A229G, and MOGAT3/g.G1627A locus are strong candidate genes that could be considered molecular markers for growth traits in cattle breeding.

Safety and Efficacy of RIRS in Geriatric Patients: A Comparative Evaluation on an Age Based Manner.

PURPOSE: In this retrospective study, we aimed to comparatively evaluate the efficacy and safety of RIRS procedure on an age-based manner in patients younger and above 65 years. MATERIALS AND METHODS: A total of 165 patients undergoing RIRS procedure for renal stones were divided into two groups on an age-based manner namely; Group 1 (n=122) patients aging < 65 years and Group 2 (n=43) patients aging above 65 years. Demographic and clinical data regarding the stone free rates, complication rates and need for secondary procedures were retrospectively evaluated. RESULTS: Of all the patients undergoing RIRS for kidney stones, 122 were below the age of 65 (73.9%) and 43 were above the age of 65 (26.1%). Mean age value for the patients aging more than 65 years was 74.16 ± 5.03 years and in addition to higher percentage of comorbidities, serum creatinine levels as well as ASA scores were also higher in this group when compared with younger counterparts. Although there was no statistically significant difference with respect to the operative duration, stone-free rates (SFR) and hospitalization period between the two groups, both complication rates and the need for additional interventions were higher in the older patient group (p = 0.038; p = 0.032). All complications noted in the both groups were minor (Grade I) complications according to the Clavien classification system. CONCLUSION: RIRS procedure can be applied as an effective and safe treatment alternative for the minimal invasive management of renal stones in relatively older patients (> 65 years) with similar hospitalization as well as stone free rates noted in the younger patients. No procedure related severe complication was noted in these cases.

Antegrade stent placement in laparoscopic upper urinary tract surgery. Is there an easy way?

INTRODUCTION: Antegrade placement of double J stents in laparoscopy is considered a challenging and time-consuming process due to limitations regarding stent flexibility. AIM: To describe the method we used to facilitate the antegrade placement of intracorporeal stents in laparoscopic upper urinary tract (LUUT) surgery and report its results. MATERIAL AND METHODS: Data obtained from 42 consecutive patients who had stents placed antegradely in laparoscopic pyeloplasty or in laparoscopic ureterolithotomy for middle-upper ureteral stones were retrospectively evaluated. The mean age of the patients was 30.1 ±18.6 (10 months-68 years) and 13 patients were in the paediatric age group. All patients in the paediatric age group underwent laparoscopic pyeloplasty. RESULTS: The mean operative time for the 42 total cases, of which 32 underwent laparoscopic dismembered pyeloplasty and 10 laparoscopic ureterolithotomy, was 126.9 ±33.5 (70-200) min and the intraoperative stent placement time was calculated as 2.61 ±0.8 (1.5-5) min. The patients, who had a mean hospitalization time of 2.8 ±0.9 (2-5) months, required no additional interventions and no complications were encountered intraoperatively. In the patient series that had a mean follow-up time of 17.4 ±11.3 (1-35), it was determined only in 1 patient that the distal tip of the stent had not been in the bladder. CONCLUSIONS: The described modified antegrade stent placement technique is a practical method that is safe for all LUUT cases in both paediatric and adult age groups and it has been shown to produce successful outcomes and to be time-saving.

Paraneoplastic hyperbilirubinemia in metastatic prostate cancer and review of the current literature.

Paraneoplastic syndromes are functional clinical disorders caused by the direct effect of the primary tumor or metastasis. The initial presenting symptom of the patients may be associated with paraneoplastic manifestations. Paraneoplastic cholestasis is most frequently defined in association with renal cell carcinoma (Stauffer's syndrome), but it is an extremely rare clinical entity seen in association with prostate cancer. Etiology of cholestasis was investigated in the case diagnosed as metastatic prostate cancer who applied to the gastroenterology outpatient clinic due to complaints of ascites and jaundice that established the diagnosis of paraneoplastic hyperbilirubinemia. We observed improvement of his cholestasis with hormonotherapy used for prostate cancer.

Can routine peripheral blood counts like neutrophil-to-lymphocyte ratio be beneficial in prediagnosis of testicular cancer and its stages?

BACKGROUND: The purpose of this study was to assess the diagnostic role of preoperative hematological parameters, especially neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) in germ cell testicular malignancies and their prediagnostic role in staging of testicular cancer. MATERIALS AND METHODS: In this cross-sectional retrospective study, we analyzed 39 patients who underwent radical orchiectomy due to a testicular cancer (Group 1) and 82 patients on whom varicocelectomy procedure was performed as control group (Group 2) between January 2006 and January 2016 in our clinic. Evaluation of the preoperative hematological parameters in both groups and also the subgroups in malignancy group according to histopathological stages was conducted in this study. RESULTS: When the hematological parameters were compared, a statistically significant difference was found between the two groups in terms of neutrophil counts, NLR, PLR, and MPV. NLR and PLR were significantly higher and MPV was significantly lower in testicular cancer group compared to the control group. NLR was 3.1 ± 1.4 and 2.0 ± 1.5, PLR was 141.3 ± 53.2 and 115.7 ± 44.8, and MPV was 8.9 ± 1.0 and 9.3 ± 1.1 for testicular cancer and control groups, respectively (P < 0.05). Furthermore, differences were observed between only mean corpuscular volume, mean corpuscular hemoglobin, and MPV (P < 0.05) in different stages of malignancy. CONCLUSION: In accordance with these findings, NLR, PLR, and MPV may be helpful for prediagnosis of testicular malignancies. Hematological parameters will become important in the preoperative assessment for those patients.

In vitro evaluation of nebivolol effects on nonadrenergic noncholinergic responses in rabbit corpus cavernosum.

The purpose of this study was to compare the effects of nebivolol on nonadrenergic noncholinergic (NANC) relaxation functions that are mediated by electric field stimulation (EFS) in rabbit corpus cavernosum smooth muscle by comparison with other beta-adrenergic receptor blockers and show the level on which its effects through nitric oxide take place. After the effects of nebivolol on the isolated corpus cavernosum tissues that were contracted through the alpha-adrenergic pathway and application of L-NAME' (NG -nitro-L-arginine methyl ester) which is a competitive inhibitor of nitric oxide synthase (NOS), the changes that occurred were recorded. Following the effect on the tissue that was contracted with phenylephrine in the presence of atropine and guanethidine that was created by EFS, nebivolol and other beta-blockers were added and the changes were recorded. After receiving relaxation responses with EFS-mediated NANC, no difference was observed between the relaxation responses due to addition of nebivolol and other beta-adrenergic blockers (p > 0.05). The finding that nebivolol which has a NO-mediated relaxation effect did not have an effect on EFS-mediated NANC relaxation but created relaxation on the tissue that was contracted by phenylephrine and the effect was reversed by L-NAME, shows that its effects are on a postsynaptic level.

The Effect of Local Anesthetic Agent Infiltration Around Nephrostomy Tract On Postoperative Pain Control After Percutaneous Nephrolithotomy: A single-centre, randomised, double-blind, placebocontrolled clinical trial.

PURPOSE: Insufficient alleviation of pain after percutaneous nephrolithotomy causes patient dissatisfaction and generates additional morbidity factors by preventing early mobilization. This study investigated the effects of bupivacaine infiltration with two different doses around the nephrostomy tract after percutaneous nephrolithotomy. MATERIALS AND METHODS: Patients who underwent subcostal single entrance percutaneous nephrolithotomy were randomly divided into 3 groups of 20 patients. While the first and second group were planned to receive bupivacaine at rates of 0.5% and 0.25% respectively, the third group was planned to receive a placebo agent to preserve the doubly blinded nature of the study. RESULTS: A statistically significant difference was found in the number of patients using tramadole. The frequency of analgesic administration was found lower in the two groups that received bupivacaine in comparison to the group that did not, while the time of the first analgesic administration in the group that received high dose bupivacaine was significantly later than the other groups. Although there was no difference between the groups in terms of total amount of analgesic usage, patients who received higher concentrations of bupivacaine were likely to requirea lower amount of narcotic agent. The frequency of analgesic administration decreased significantly in patients of both groups that received bupivacaine. Moreover, by administering bupivacaine at a 0.5% rate, fewer patients (50%) required narcotic analgesia and the first time of analgesic administration was found to be significantly later. CONCLUSION: Administering bupivacaine at a 0.5% rate around the nephrostomy tract after surgery was demonstrated to be more effective.

Laparoscopic dismembered pyeloplasty combined with port entrance flexible renoscopic lithotripsy.

INTRODUCTION: Ureteropelvic junction obstruction and concomitant calculus disease may coexist. We demonstrate our use of flexible renoscopy during laparoscopic pyeloplasty for caliceal stone removal. PATIENT AND METHODS: A 28-year-old female patient presented with recurrent attacks of flank pain of two years duration. When noncontrast-CT and DTPA were performed, the patient was diagnosed with ureteropelvic junction stenosis and 3 stones with a total burden of 14mm in the lower pole of right kidney. After pneumoperitoneum was established in right flank position, three 10mm trocars were placed including one camera port. 5mm trocar was placed for convenience to retraction and dissection. The surgery was uneventful, with no operative complications or evidence of intra-abdominal bleeding. RESULTS: The duration of the surgery was 110 minutes. The amount of bleeding was 30ml. On the postoperative 2nd day, the urethral catheter was removed and the patient was discharged on the fourth day postoperatively. Stent removal was done on the 3rd postoperative week and retrograde pyelogram showed normal ureter. Post-operative follow-up with ultrasound showed that hydronephrosis had regressed. Conclusions: Laparoscopic pyeloplasty and concomitant flexible renoscopy through lowermost trocar with basket extraction is a simple, attractive alternative for the simultaneous treatment of ureteropelvic junction obstruction presenting with coexisting nephrolithiasis. This method is useful and feasible, with minimal invasiveness and an early post-operative recovery.

Laparoscopy-assisted micropercutaneous choledocholithotripsy with holmium laser in a cholecystectomized patient: an initial report.

We present a novel minimally invasive technique, laparoscopy-assisted micropercutaneous choledocholithotripsy, for choledocholithiasis that cannot be treated with other endoscopic techniques. This technique includes standard laparoscopic exploration of the common bile duct, combined with an all-seeing needle and holmium laser lithotripsy. As is known, an all-seeing needle is used in micropercutaneous nephrolithotomy for middle-sized renal stones. In this technique, an all-seeing needle was inserted into the dilatated common bile duct under laparoscopic vision and then a lithotripsy procedure was performed with a holmium laser behind the biliary stent. A cholecystectomized female patient with a 21-mm stone in the common bile duct who previously underwent an unsuccessful endoscopic retrograde cholangiopancreatography procedure was operated on in our service with laparoscopy-assisted micropercutaneous choledocholithotomy without a T-tube. This novel procedure was completed uneventfully and the patient was discharged without any complications. In the future, this procedure will hopefully be a treatment modality in choledocholithiasis that cannot be treated by other minimally invasive techniques.

Microperc Versus Miniperc for Treatment of Renal Stones Smaller Than 2 cm in Pediatric Patients.

PURPOSE: Pediatric stone disease is an important clinical problem in pediatric urology practice. We aimed to compare mini-percutaneous nephrolithotomy (miniperc) and micro-percutaneous nephrolithotomy (microperc) in pediatric patients who underwent unsuccesful SWL procedure. MATERIALS AND METHODS: A number of 43 pediatric patients, aged 17 years or younger, were treated with miniperc or microperc procedures due to renal calculi by a single surgeon. In group 1, there were 27 patients who underwent miniperc procedure. In group 2, 16 patients were treated by microperc. RESULTS: Mean age of the patients were 9.5 (3-17) years in group 1 and 7.9 (2-16) years in group 2 (P = .25). Stone burden was similar between the two groups. Mean operation duration was 74.1 (40-110) minutes in miniperc group and 37.2 (20-55) minutes in microperc group (P < .01). Patients who underwent microperc were discharged from clinic earlier. Hyperthermia without bacteraemia was observed in 2 children in the miniperc group and was treated by using a single dose of paracetamol and also 2 children in the same group needed blood transfusion. There was a tendency for low haemoglobin decrease in microperc group compared to miniperc (P > .05). CONCLUSION: The management of pediatric stone disease has evolved with improvements in techniques and minimalisation of surgical instruments and thus, it can be effectively and safely used in children by experienced surgeons. .

Giant malignant pheochromocytoma with palpable rib metastases.

Pheochromocytoma is a rare and usually benign neuroendocrine neoplasm. Only 10% of all these tumors are malignant and there are no definitive histological or cytological criteria of malignancy. Single malignancy criteria are the presence of advanced locoregional disease or metastases. We report a case, with a giant retroperitoneal tumor having multiple metastases including palpable rib metastases, who was diagnosed as a malignant pheochromocytoma. The patient was treated with surgery. The literature was reviewed to evaluate tumor features and current diagnostic and therapeutic approaches for patients with metastatic or potentially malignant pheochromocytoma.

In-vitro effects of PDE5 inhibitor and statin treatment on the contractile responses of experimental MetS rabbit's cavernous smooth muscle.

OBJECTIVE: Hypercholesterolaemia promotes erectile dysfunction through increased superoxide formation and decreased nitric oxide bioactivity in cavernosal tissue. The role of nitric oxide on erectile function is well known. Statins have lipid lowering properties and can modulate endothelial nitric oxide bioavailability. Sildenafil, enhances smooth muscle relaxation in corpus cavernosum. We investigated in-vitro effects of sildenafil and rosuvastatin on nonadrenergic, non-cholinergic and nitric oxide mediated cavernosal smooth muscle relaxation in metabolic syndrome rabbits, since alterations in this pathway are recognised in diabetic and hypercholesterolemic erectile dysfunction. METHODS: Ten male rabbits were fed a standard diet as control group, fourty male rabbits were fed a hypercholesterolemic diet for 12 weeks. Hypercholesterolemic group were divided for without treatment, rosuvastatin treatment, sildenafil treatment, and rosuvastatin + sildenafil treatment (N = 10 per groups). RESULTS: Serum levels of cholesterol and glucose were significantly higher in the experimental group than in the control group (p < 0.05). After therapy no differences were found among the groups in relaxation responses to sodium nitroprusside. The relaxation responses to carbachol and EFS were significantly reduced in metabolic syndrome group to control group (p < 0.05), but there were no differences between the other groups and control group. There was a significantly lower in-vitro relaxation response in the metabolic syndrome rabbits than in controls and the others (p < 0.05). CONCLUSION: Both agents improve in-vitro relaxation responses of erectile tissue from metabolic syndrome rabbits to endothelial non-adrenergic, non-cholinergic and nitric oxide. This finding supports to the results of other clinical studies with these drugs.

Effect of Strontium Chloride on Experimental Bladder Inflammation in Rat.

Introduction. Strontium salts are anti-irritants for chemically induced sensory irritation. Interstitial cystitis is a painful disease without definitive therapy. The aim of the study was to determine the effect of strontium in bladder with experimental interstitial cystitis model. Material and Methods. Rats' bladders in control group were instilled with NaCl. Second group was instilled with E. coli LPS. Third group was instilled with strontium. Fourth group was initially instilled with strontium and then LPS. Fifth group was instilled with LPS initially and then strontium. Urine of rats was collected at the beginning and end of the study. Results. Histamine and TNF-α changes were statistically significant in the second group but were not significant in the third group. When we compared the histamine levels of second via fourth and fifth groups the changes were statistically not significant. When we compared the TNF-α levels of second via fourth and fifth groups the changes were statistically significant. Conclusions. In our model, strontium did not make any significant changes in histopathology or histamine levels; however, it significantly reduced the levels of TNF-α. Given the role of TNF-α in the physiopathology of interstitial cystitis, these results suggested that further studies are required to evaluate the potential use of strontium in the management of interstitial cystitis.

Contractile responses of urinary bladder in an experimental model of chronic renal failure.

Chronic kidney disease is a public health problem with increasing prevalence caused by diabetes, hypertension and glomerulonephritis. Number of publications investigate the lower urinary tract dysfunction due to CKD is limited. There is a high incidence of bladder dysfunction of different degrees in patients with renal failure. Mechanism of the lower urinary tract dysfunction in these patients is not well known. In this study, we aimed to investigate the effects of CKD on detrusor function in a rat model of CKD. In our study, 20 Wistar Albino rats have been divided into two groups as CKD and control groups. To the experiment group, left partial nephrectomy and right nephrectomy have been applied. CKD confirmation has done with the BUN and creatinin values from the blood of the rats. The bladder strips were prepared from the CKD and control groups and its contractile responses were evaluated in-vitro. There wasn't a considerable difference with the contractile responses caused by carbachol, KCL. There was a considerable increase in the contractile responses caused by ATP, ADP and electrical field stimulation on the behalf of the CKD group. The present study demonstrated that isolated DSM of CKD group showed significantly increased contraction responses to purinergic agonists ADP, ATP and atropine resistant component in electrical field stimulation-induced contractions as compared to those of the control group. Bladder overactivity and reduced bladder volume in CKD patients might be due to the change in purinergic system.

Effect of angiotensin-converting enzyme inhibition and angiotensin II type 1 receptor blockade on apoptotic changes in contralateral testis following unilateral testicular torsion.

OBJECTIVES: In this experimental study, our aim was to determine whether angiotensin-converting enzyme (ACE) inhibition and angiotensin II type 1 (AT1) receptor blockade affect the apoptotic changes in contralateral testis following unilateral testicular torsion (UTT). METHODS: Study groups consisted of 30 adult male Wistar rats. The rats were randomly separated into five groups. Group 1 was maintained as control without manipulation. Group 2 underwent the sham operation. Torsion was created by rotating the left testis 720 degrees clockwise for 4 h and maintained by fixing the testis to the scrotum in the other groups. Group 3 underwent torsion and detorsion, with saline administration after detorsion. In group 4, the same surgical procedure was done as in the detorsion group, but AT1 receptor blocker (losartan 30 mg/kg) was injected intraperitoneally for 60 min before detorsion. In group 5, the same surgical procedure was done as in the detorsion group, but ACE inhibitor (lisinopril 50 mg/kg) was injected intraperitoneally for 60 min before detorsion. Bilateral testes were removed from each rat 24 h after surgery. Apoptosis was assessed in paraffin-embedded sections stained for TUNEL method. Reticulum staining was performed to evaluate the extracellular changes semiquantitatively. Testicular biopsy score counts were performed on these sections according to Johnsen. RESULTS: The mean apoptotic scores of group 1, group 2 and group 3 were significantly higher than that of the other groups. There was no difference between the apoptotic scores of groups 1, 2, 4 and 5. Reticulum stain was increased in group 3 as compared to other groups. The mean Johnsen biopsy score of group 3 was significantly lower than that of the other groups. CONCLUSION: ACE inhibition and AT1 receptor blockade reduced the tubular damage and apoptosis in the contralateral testes after UTT. The beneficial effect of these drugs may arise from inhibition of ischemic process resulting from increased sympathetic activity and elimination of insults subsequent to dysregulation of RAS. These results suggest that ACE inhibitors and AT1 receptor blockers may be of potential value in patients with UTT.

A comparison of sedation with dexmedetomidine or propofol during shockwave lithotripsy: a randomized controlled trial.

BACKGROUND: Dexmedetomidine, because it has both sedative and analgesic properties, may be suitable for conscious sedation during painful procedures. Extracorporeal shockwave lithotripsy (ESWL) is a minimal to mildly painful procedure that requires conscious sedation. We thus evaluated the utility of dexmedetomidine compared with propofol during an ESWL procedure. METHODS: Forty-six patients were randomly allocated into two groups to receive either dexmedetomidine or propofol for elective ESWL. Dexmedetomidine was infused at 6 microg x kg(-1) x h(-1) for 10 min followed by an infusion rate of 0.2 microg x kg(-1) x h(-1). Propofol was infused at 6 mg x kg(-1) x h(-1) for 10 min followed by an infusion of 2.4 mg x kg(-1) x h(-1). Fentanyl 1 microg/kg IV was given to all patients 10 min before ESWL. Pain intensity was evaluated with a visual analog scale at 5-min intervals during ESWL (10-35 min). Sedation was determined using the Observer's Assessment of Alertness/Sedation. The Observer's Assessment of Alertness/ Sedation scores and hemodynamic and respiratory variables were recorded regularly during ESWL (35 min) and up to 85 min after. RESULTS: Forty patients were evaluated. Visual analog scale values with dexmedetomidine were significantly lower than those with propofol only at the 25-35 min assessments (P < 0.05). During sedation, the respiratory rate with dexmedetomidine was significantly slower but Spo2 was significantly higher than with propofol (P < 0.05). Other clinical variables were similar (P > 0.05). CONCLUSION: A combination of dexmedetomidine with fentanyl can be used safely and effectively for sedation and analgesia during ESWL.

Relation of microvessel density with microvascular invasion, metastasis and prognosis in renal cell carcinoma.

OBJECTIVE: To clarify the significance of microvessel density (MVD) in a retrospective investigation the relationship between the pattern of MVD (reflecting angiogenesis), and tumour stage, grade, size, and occurrence of microvessel invasion (MVI), metastasis, and cancer-specific survival (CSS) in patients who had surgery for renal cell carcinoma (RCC). PATIENTS AND METHODS: Vessels were labelled in sections of formalin-fixed, paraffin-embedded tissues from 54 RCCs by CD34 immunohistochemistry. The mean MVD, expressed as the number of vessels per 10 high-power fields (HPF, x400) were measured for each case. In addition, all pathological slides were reviewed for the presence and absence of MVI. The prognostic value of MVD and MVI was then evaluated, and correlated with the usual prognostic variables, tumour metastasis and CSS. RESULTS: In a univariate analysis of CSS, the MDV tended to be lower as stage increased from pT1 to pT3, and as grade increased from G1 to G4, although it was statistically significant only for stage (P < 0.001 and 0.050, respectively). The mean MVD was higher in 42 nonmetastatic than in 12 metastatic tumours, and in 33 tumours associated with MVI than in 21 with no MVI (P < 0.001). The mean MVD was also lower and significantly different for 28 large than 26 small tumours (P = 0.005). The survival rate of patients with tumours that were small, low-stage, of higher MVD, with no MVI and metastasis was significantly higher than that of patients with large, high-stage, low MVD, with MVI and metastatic tumours (all P < 0.001). MVI was significantly more common with a decreasing trend in MVD and the presence of metastasis (Spearman rank correlation r(s) = -0.68, P = 0.01, and r(s) = 0.39, P = 0.01, respectively). Independent prognostic factors in a multivariate analysis were: in all patients with RCC, tumour stage (P = 0.013) and metastasis (P = 0.028); in those with low MVD, MVI (P = 0.004) and metastases (P = 0.016); in those with no MVI, stage (P = 0.020); in those with MVI, MVD (P = 0.001); in those with no metastases, stage (P = 0.045); and in those with metastases, MVD (P < 0.001). No independent predictor was identified in patients with high MVD. In patients with no metastases there was a significantly shorter median CSS time in RCCs with low MVD and with MVI (P = 0.004 for both). Similarly, patients who had grade 3-4 tumours, vs those with lower MVD and with MVI, had a significantly shorter median CSS (P = 0.020 for MVD, and 0.01 for MVI). CONCLUSIONS: This study suggested that MVD in RCC was inversely associated with MVI, tumour metastasis, patient survival and tumour diameter and stage, from the usual prognostic variables, but MVD was not an independent prognostic factor in multivariate analysis for all patients with RCC. Low MVD and the presence of MVI appears to be a marker for identifying patients with an adverse prognosis.

SRY and AZF gene variation in male infertility: a cytogenetic and molecular approach.

AIM: The aim of this study was to identify the genetic effects of Y chromosome and azoospermia factor (AZF) gene variation in men with infertility and to elucidate the molecular mechanism responsible for the identified point mutation. METHODS: Chromosome analysis was performed according to standard methods on lymphocyte cultured cells and genomic DNA was extracted from the peripheral blood. Three sets of primers were used encompassing the AZFb, AZFc and SRY14 gene regions. Products were genotyped with single-strand comformational polymorphisim (SSCP) analysis. RESULTS: The profiles of the mutated genes were detected in five of three azoospermic and two oligoasthenozoospermic infertile males. The SSCP variability of the AZFc gene was detected in all of the cases, while sex-determining region Y (SRY) gene variation was detected in two of the current cases. Three cases with oligoasthenozoospermia showed mutated SSCP profiles in both their SRY and AZFc gene regions. No AZFb variation was detected in the presented cases. CONCLUSION: The AZF locus is assumed to contain the genes responsible for spermatogenesis in human. Deletions in these genes are thought to be involved in male infertility associated with azoospermia, oligozoospermia and/or both. AZF microdeletions and variations that are seen in infertile males suggest the need for molecular screening of such cases. Advance studies are also needed to detect of these variations and their relevance to male infertility before using assisted reproduction techniques in such cases.