Testicular torsion in vivo models: Mechanisms and treatments.

BACKGROUND: Testicular torsion is a condition in which a testis rotates around its longitudinal axis and twists the spermatic cord. This in turn results in a significant decrease in blood flow and perfusion of testicular tissue. During Testicular torsion, the testicular tissue is affected by ischemia, heat stress, hypoxia, and oxidative and nitrosative stress. The testicular torsion should be considered an emergency condition and surgical intervention (testicular detorsion ) as the sole treatment option in viable cases involves counter-rotation on twisted testes associated, when possible, to orchipexy, in order to avoid recurrence. Possible testicular detorsion side-effects occur due to reperfusion and endothelial cells injury, microcirculation disturbances, and intense germ cells loss. OBJECTIVES: To discuss testicular torsion surgery-based methods, different time frames for testicular torsion induction, and the associated pathophysiology by emphasizing cellular and molecular events as well as different therapeutic agent applications for testicular torsion. MATERIALS AND METHODS: We reviewed all original research and epidemiological papers related to testicular torsion condition. RESULTS: Testicular torsion causes germ cell necrosis, arrested spermatogenesis, and diminished testosterone levels, with consequent infertility. Among different involved pathophysiological impacts, testicular torsion/detorsion-induced ischemia seems to play the key role by leading the tissue toward other series of events in testis. Numerous studies have used adjuvant antioxidants, calcium channel blockers, anti-inflammatory agents, or vasodilating agents in order to decrease these effects. DISCUSSION AND CONCLUSION: To the best of our knowledge, no previously conducted study examined therapeutical agents' beneficial effects post clinical I/R condition in humans. Different agents targeting different pathophysiological conditions were used to ameliorate the ischemia/reperfusion-induced condition in animal models, however, none of the administrated agents were tested in human cases. Although considering testicular detorsion surgery is still the golden method to reverse the testicular torsion condition and the surgical approach is undeniable, the evaluated agents with beneficial effects, need to be investigated furthermore in clinical conditions. Thus, furthermore clinical studies and case reports are required to approve the animal models proposed agents' beneficial impacts.

Effectiveness of Green Synthesis of Silver/Kaolinite Nanocomposite Using Quercus infectoria Galls Aqueous Extract and Its Chitosan-Capped Derivative on the Healing of Infected Wound.

Kaolinite nanocomposites (NCs) could be utilized as agents for wound healing owing to their efficiency and low toxicity. The present study was conducted to synthesize a novel silver/kaolinite NCs (Ag/Kaol NCs) and investigate their chitosan derivation (Ag/Kaol/Chit NCs) using oak extract. XRD, SEM, EDX, FT-IR, and DLS were employed for the investigation of structural and physio-chemical properties of the synthesized NCs. The obtained results revealed that synthesized Ag/Kaol NCs were mesoporous and spherical with sizes ranging from 7-11 nm. They also demonstrated successful synthesis between silver and kaolinite using the extract. Cytotoxicity and in vitro antibacterial activity were also investigated. The clinical effects of ointments containing the NCs for improving wound healing were studied on the wound area, total bacterial count, histological parameters, and protein expression of some genes. Nanocomposites were safe up to 0.50 mg/mL. The results of in vivo and in vitro antibacterial activity showed that Ag/Kaol NCs, were of antibacterial activity ( ). The results of antioxidant activity indicated that Ag/Kaol NCs have antioxidant structures. Our findings concerning molecular mechanism implied that Ag/Kaol/Chit increased the expression of Wnt/ ß -catenin and collagen ( ). In sum, Ag/Kaol/Chit showed antibacterial activity and improved wound healing by decreasing the inflammation and promoting the proliferative phase. The novel NCs showed wound healing properties by decreasing inflammation and total bacterial count and increasing proliferative phase. The application of Ag/Kaol/Chit was suggested as a green agent for improving infected wound healing.