Fatih Rüştü Yalçinkaya

The Beneficial Effects of Tadalafil on Renal Ischemia-Reperfusion Injury in Rats

Acute renal failure due to ischemia-reperfusion (I/R) injury is a common complication in cardiovascular surgery. We determined the influence of tadalafil on renal injury in a renal I/R model in rats. For this purpose, 21 male Wistar albino rats were separated into 3 groups: sham, placebo and tadalafil. A right nephrectomy was performed, and the left renal pedicles were occluded for 60 min and reperfused for 60 min in the placebo and tadalafil groups. A single dose of tadalafil (10 mg/kg) through an orogastric tube was administered to the tadalafil group. Tubular atrophy with acute inflammation in renal histology, total oxidant status (TOS) and total antioxidant status (TAS) were determined in tissue homogenates. Compared to the tadalafil group, tubular atrophy and acute inflammation was significant in the placebo group. TAS levels were significantly higher in the tadalafil group compared to the placebo (p = 0.01) and sham groups (p = 0.04). While TOS levels were significantly higher in the placebo group (p = 0.03), tadalafil did not significantly alter the TOS levels. The beneficial effects of tadalafil can be attributed to its protective effects on renal tubular cells and inhibition of leukocyte infiltration in renal tissue. We think that tadalafil treatment has an important role in reducing renal injury resulting from renal I/R.

Protective Effect of Thymoquinone in Experimental Testicular Torsion

Objectives: To investigate the protective role of thymoquinone (TQ) on unilateral testicular ischemia-reperfusion (I/R) injury in mice. Materials and Methods: Experiments were performed on male C57BL/6 mice (8 weeks old, 20–25 g). The animals were divided into 3 groups including 6 mice in each group: control (sham), torsion/detorsion (TD) and TD+TQ. Mice, except the sham-operated group, were subjected to left unilateral torsion (720° rotation in the clockwise direction). The experiments were finished after sham operation time for controls, 120 min torsion and 240 min detorsion for the other groups. In the TD+TQ group 10 mg TQ was injected intraperitoneally 30 min before detorsion. Results: In the TD group total oxidative stress (TOS), oxidative stress index (OSI) and malondialdehyde (MDA) levels were higher than in the controls. TQ treatment decreased MDA, TOS and OSI values, but did not affect the total antioxidant capacity and myeloperoxidase activity in the TD+TQ group. Upon histological examination, mice in the TD group displayed moderate-to-severe disruption of the seminiferous epithelium. Treatment with TQ resulted in significantly reduced histological damage associated with I/R injury. Conclusion: Our results suggested that TQ treatment may have a protective effect on testicular I/R injury.

Protective effect of caffeic acid phenethyl ester on cyclosporine A-induced nephrotoxicity in rats.

Introduction. Cyclosporine A, an immunosuppressive agent, is widely used after organ transplantation such as the liver and kidney. However, its widespread use is restricted because it has serious toxic effects on the kidney. Caffeic acid phenethyl ester (CAPE) is a natural product with potent anti-inflammatory, antitumor, and antioxidant activities, and it attenuates inflammation and lipid peroxidation induced by ischemia-reperfusion injury. The purpose of the present study was to investigate the effects of CAPE on cyclosporine A (CsA)-induced nephrotoxicity. Material and Methods. Rats were divided into four groups and treated with saline, CAPE, CsA, and CsA + CAPE. Control rats were given saline; the CAPE group was given CAPE (10 μmol/kg/day) for 11 days intraperitoneally; the CsA group was given CsA (15 mg/kg/day) for 10 days subcutaneously; and the CsA+CAPE group was given CAPE for 11 days, and rats were s.c. injected with CsA in 0.5 ml of saline once a day for 10 days at the same time. Results. The administration of CsA alone resulted in higher myeloperoxidase (MPO) activity, lipid peroxidation, superoxide dismutase (SOD), and catalase (CAT) than in the control. The enzyme activities except CAT in rats treated with CAPE alone were not changed. CAPE treatment prevented the increase in malondialdehyde (MDA) and increased CAT activity more, but did not affect the activities of MPO and SOD enzymes. Discussion. CsA causes renal injury and CAPE prevents CAT- and lipid peroxidation-mediated nephrotoxicity via inhibition of oxidative process.

Anti-inflammatory and antioxidant activity of thymoquinone in a rat model of acute bacterial prostatitis

Prostatitis plays a major role in morbidity and mortality related to prostate diseases. The aim of this study was to detect whether thymoquinone (TQ) could ameliorate oxidative damage and the proliferative response induced by Escherichia coli (E. coli) in rats. A total of 42 adult male Wistar rats were used. The rats were randomly divided into seven groups (three treatment groups, three infected groups and one control group). Control group received saline and was killed 24 h after saline administration. Infected rats were killed after 24, 48 and 72 h following direct injection of E. coli into the prostate. Treatment groups were administered with 10 mg/kg dose of TQ intraperitoneally following E. coli injection and after 24 and 48 h following E. coli injection. The rats were killed at 24, 48 and 72 h after the first drug administration. Each group was compared with each other and with the control group. In addition, infected groups were compared with treatment groups. Our findings show that the treatment with TQ has a protective effect against bacterial prostatitis-induced tissue injury. Increase in malondialdehyde levels and histological damage caused by E. coli were improved markedly with TQ treatment. TQ treatment particularly increased the activity of glutathione peroxidase and decreased the activities of catalase and superoxide dismutase. These observations might be attributed, at least in part, to the antioxidant effect of TQ and suggest that it could be a clinically valuable agent in the prevention of acute prostatitis caused by E. coli.

Hereditary Behavior of Varicocele

The inheritance of varicoceles and the potential transmission to first-degree relatives has rarely been investigated. In the present study, we examined the first-degree relatives of men with known varicocele to reveal the familial risk for varicocele. Of the patients with clinical varicocele who presented with infertility, testicular pain, or asymmetrical swelling of the scrotum between June 1, 2008 and May 31, 2009, 49 agreed to have their available first-degree relatives contacted for screening of varicoceles (n = 66). A cohort of 100 consecutive men who applied to the department of internal medicine between 2008 and 2009 for checkup procedure without a history of subfertility or a varicocele were used as a control population. Of the 92 first-degree relatives contacted, 66 (71.7%) decided to participate in this study. Of these 66 men, 21 (33.9%) had a palpable varicocele on physical examination. Compared with a control population (12%), the prevalence of palpable varicocele in the first-degree relatives of patients with known varicocele (33.9%) was approximately 3-fold greater (P < .005). Among the first-degree relatives, 4 (21.1%) of 19 fathers and 17 (36.2%) of 47 brothers had palpable varicocele. As a conclusion, a significant increase in varicocele prevalence is present in the first-degree relatives of men with known varicoceles. Patients should be counseled about this increased risk in male relatives of patients.

Relationship between endothelial dysfunction and nocturia with benign prostatic hyperplasia

Abstract Objective. There are limited data on whether there is an association between nocturia, benign prostatic hyperplasia (BPH) and endothelial dysfunction. The aim of the present study was to evaluate whether there is an association between nocturia and endothelial dysfunction in patients with BPH. Material and methods. Forty-two men with a diagnosis of BPH and 42 age-matched controls were enrolled. All patients were assessed for frequency and duration of nocturia, and prostate volume, completed the International Prostate Symptom Score (IPSS) questionnaire, and underwent brachial flow-mediated dilatation (FMD) evaluation. Results. There was a negative correlation between FMD and frequency of nocturia (r = –0.879, p < 0.0001). Moreover, there was a negative correlation between duration of nocturia and FMD (r = –0.890, p < 0.0001). In addition, FMD was significantly decreased in the BPH group compared with the control group (6.0 ± 0.09 to 7.8 ± 0.10%) (p = 0.0001). Conclusion. In patients with BPH, nocturia is associated with endothelial dysfunction and may be an insidious risk factor for cardiovascular disease.

Direct pelvic access percutaneous nephrolithotomy in management of ectopic kidney stone: a case report and literature review

Percutaneous nephrolithotomy (PNL) is an effective procedure for the treatment of patients with large or complex stones. PNL is challenging in anomalous kidneys, certain patients, such as those with renal ectopia. It is unable to undergo PNL in conventional technique safely in these cases. We presented a case report of laparoscopic-assisted PNL via direct pelvic puncture in a pelvic kidney stone and discussed previous published literature. A 49-year-old man presented with right lower quadrant pain and hematuria. Intravenous pyelography and three-dimensional computerized tomography revealed an opaque 2.7 × 1.7 cm pelvis renalis stone in a right side ectopic pelvic kidney with grade III hydronephrosis. Laparoscopic-assisted tubeless PNL was performed to remove the calculus. Laparoscopic-assisted PNL as a minimally invasive therapy in ectopic kidney has many advantages. Our case showed that, in pelvic ectopic kidney with pelvic stones greater than 1.5 cm in size, laparoscopic-assisted PNL via direct pelvis puncture is a safe and effective technique.Abstract Percutaneous nephrolithotomy (PNL) is an effective procedure for the treatment of patients with large or complex stones. PNL is challenging in anomalous kidneys, certain patients, such as those with renal ectopia. It is unable to undergo PNL in conventional technique safely in these cases. We presented a case report of laparoscopic-assisted PNL via direct pelvic puncture in a pelvic kidney stone and discussed previous published literature. A 49-year-old man presented with right lower quadrant pain and hematuria. Intravenous pyelography and three-dimensional computerized tomography revealed an opaque 2.7 × 1.7 cm pelvis renalis stone in a right side ectopic pelvic kidney with grade III hydronephrosis. Laparoscopic-assisted tubeless PNL was performed to remove the calculus. Laparoscopic-assisted PNL as a minimally invasive therapy in ectopic kidney has many advantages. Our case showed that, in pelvic ectopic kidney with pelvic stones greater than 1.5 cm in size, laparoscopic-assisted PNL via direct pelvis puncture is a safe and effective technique.

Metastatic prostate adenocarcinoma presenting as supraclavicular lymphadenopathy: a report of two cases

Clinical examination is very important in the practice of medicine. In patients presenting with a supraclavicular mass, a number of diseases including cancer should be ruled out. Two patients who presented with a bulky left supraclavicular mass were evaluated. Their medical history revealed complaints attributed to lower urinary tract infection. We performed histopathological examination of the lymph nodes with radiological evaluation of the thorax and abdomen. The final diagnoses were prostate cancer in both patients. It should always be kept in mind that prostate cancer is the most frequent cancer in elderly men, and although very unusual, the presenting finding can be cervical or supraclavicular lymphadenopathy; thus clinicians should be aware of urological examinations in such cases.

Üriner sistem taşlarında iki senelik şok dalgası ile taş kırma tedavisi sonuçları

Objectives: To evaluate the results of the extracorporeal electro shockwave lithotripsy (SWL) therapy in urinary system stone disease and to investigate the factors that affects the success. Results: In our study, of 101 patients, 68 (67.3%) male and 33 (32.7%) female patients, who had complaints with urolithiasis, were analyzed. The success rates when com- pare the localization of the stone formation independent of stone size were found 52.4%, 68%, 100% and 76.5% at lower, middle, upper calices and pelvis of kidney, re- spectively. In our study, the success rate according to stone size was 73.7%, 75%, 25% and 50% in lower than 100 mm2, 100-200 mm 2 , 200-300 mm 2 and higher than 300 mm 2 in diameter, respectively. For ureteral localiza- tions, the success rate was 75%, 76.9% and 71.4% in upper, middle and lower ureter, respectively. Conclusions: In SWL therapy, success depends on size and localization of the stone. Our success rate was al- tered in terms of stone size and localization similar to pre- vious reports.