Haluk Ceylan

Temporary stretch of the testicular pedicle may damage the vas deferens and the testis

BACKGROUND/PURPOSE The authors aimed to investigate the effects of temporary stretching of the spermatic cord, a commonly performed manipulation during inguinal surgery, on the vas deferens and the testis. METHODS Forty adult male Wistar-Albino rats were divided equally into 4 groups. The right spermatic cord and testis were exposed via a transverse suprascrotal incision. In the study groups, a continuous horizontal stretch force was applied to the vas deferens and vessels in a distal direction for 60 seconds. In group 1 (G1) a 1.25-Newton (N), and in group 2 (G2) a 0.75-N stretch force was applied. Group 3 (G3) and group 4 (G4) served as sham and control groups, respectively. The animals were killed 28 days later. Sections of the vas deferens were examined histologically and their dimensions measured. Both testes were excised, weighed, and examined microscopically. Kruskal-Wallis test and Mann-Whitney U test were used to compare means in the different groups. RESULTS The mean wall thickness of the vas deferens was 378 +/- 133 mum in G1 and was significantly diminished compared to G2, G3, and G4, in which the mean wall thickness was 497 +/- 142 mum, 500 +/- 10 mum and 521 +/- 95 mum, respectively (P <.05). The mean right testicular weights were 1.18 +/- 0.10 g and 1.23 +/- 0.17 g in G1 and G2, respectively, and each was significantly lower than in G3 (1.23 +/- 0.09 g) and G4 (1.25 +/- 0.08 g; P <.05). The mean right testicular weights showed no difference between G1 and G2 (P >.05). Necrosis was seen in the right testes in 50.0% and 42.9% of the animals in G1 and G2, respectively. No histopathologic alterations were observed in the vas deferens in all groups. Microscopic examination of the left testes was normal. CONCLUSIONS In an experimental animal model, temporary stretching of the spermatic cord resulted in significant thinning of the smooth muscle layer of the vas deferens and testicular atrophy.

Protective Effects of Dexpanthenol and Y-27632 on Stricture Formation in a Rat Model of Caustic Esophageal Injury

BACKGROUND This experimental study was conducted to investigate the effect of dexpanthenol (converted in the body to pantothenic acid) and Y-27632 (a selective Rho-kinase inhibitor) on stricture formation after caustic (alkaline) esophageal injury in rats. MATERIALS AND METHODS Sixty male Wistar albino rats were randomly allocated into six groups. In group 1 (sham) the distal esophagus was isolated and cannulated but no caustic injury was induced. In all remaining groups, a caustic esophageal burn was induced with 50% sodium hydroxide solution for 90 s and drug treatment was given by daily intraperitoneal injection, beginning 24 h after injury and continuing for 21 d. In group 2 (controls), animals were treated with 0.9% saline; in groups 3 and 4, with 50 and 500 mg/kg/d of dexpanthenol, respectively; and in groups 5 and 6, with 0.3 and 3 mg/kg/d of Y-27632, respectively. Rats were sacrificed 22 d after caustic injury and the distal esophagus was isolated for histopathology and biochemical investigation. RESULTS Stenosis index and collagen deposition scores were significantly lower in both the dexpanthenol and Y-27632 treated groups (P<0.05). Dexpanthenol and Y-27632 treatment markedly depressed esophageal tissue malondialdehyde and hydroxyproline levels. CONCLUSION In this experimental model of caustic esophageal stricture, dexpanthenol and Y-27632 significantly attenuated esophageal stricture formation. These findings indicate that inhibition of Rho-kinase or dexpanthenol administration may offer novel therapeutic approaches in the treatment of caustic esophageal injury.

Psychological evaluation of children with idiopathic constipation and their parents

Abstract Background : Constipation is one of the most common problems in childhood. In idiopathic constipation it is not possible to identify primary cause in every case. Child behavioral problems and disturbances in parent–child relationships have been cited as causes of constipation. Constipation is a source of anxiety to the child and to the family. The purpose of the present study was to evaluate psychological characteristics of constipated children and their parents.

Blunt renal injuries in Turkish children: a review of 205 cases

A retrospective analysis of the medical records of 205 children with renal injuries secondary to blunt abdominal trauma is used to make recommendations regarding the initial diagnostic and therapeutic approaches in this type of patient. It was found that the absence of hematuria on initial urinalysis does not exclude a serious renal injury. Thus, following blunt abdominal trauma, all children should undergo imaging procedures to exclude renal injury, whether they have hematuria or not. Ultrasound is a good initial screening procedure in all patients. Computed tomography is recommended for the definitive evaluation of suspected major renal injuries. Since even major renal injuries may heal without surgical intervention, conservative management is the recommended initial treatment of choice. Surgery is reserved for those children who are hemodynamically unstable and those that develop complications.

Congenital scaphoid megalourethra: report of two cases.

Abstract  Congenital megalourethra is a rare congenital malformation of the penile urethra. It is defined as the diffuse dilatation of the anterior urethra due to the absence of development of the erectile tissue of the penis. Since the initial description, nearly 80 cases with megalourethra have been reported in English literature. Congenital megalourethra has been classified into scaphoid and fusiform types and is usually associated with additional urinary tract and other system anomalies, irrespective of its type and severity. We report two rare cases of scaphoid megalourethra without any associated anomaly.

Simple testicular cyst: A rare cause of scrotal swelling in infancy

A simple testicular cyst is a rare cause of scrotal swelling in infancy. Only 10 cases have been reported in children less than two years of age in the English literature. Pathogenesis of the lesion is unclear. Preoperative diagnosis is possible using ultrasonography (US). Testis‐sparing surgery with simple enucleation of the cyst has a favorable outcome. We report two patients with a simple testicular cyst, who were 9 and 8 months of age. The first case was referred with a presumptive diagnosis of hydrocele, and the second infant was admitted with a history of testicular swelling. Ultrasonography provided accurate preoperative diagnosis in both of the cases. The patients were successfully treated with testis‐sparing surgery with outstanding long‐term results. This unusual lesion of infancy should be considered in the differential diagnosis of a scrotal mass.

Perforation of Meckel's diverticulum by a button battery: report of two cases.

Ingested button battery perforation of Meckels diverticulum is extremely rare, with only two reported cases in the recent literature. Two additional preschool children who accidentally swallowed an alkaline button battery and developed a perforated Meckels diverticulum are reported. Surgeons should be aware of this rare complication. Careful clinical, radiologic and laboratory monitoring of children who ingest a button battery is advisable.

Protective activity of ischemic preconditioning on rat testicular ischemia: Effects of Y-27632 and 5-hydroxydecanoic acid

BACKGROUND/PURPOSE The aim of this study was to investigate the role of ischemic preconditioning (IPC) on ischemia/reperfusion (I/R)-induced injury of rat testis and determine the effects of 5-hydroxydecanoic acid (5-HD), a selective K(ATP) channel antagonist, and Y-27632, a selective Rho kinase inhibitor, on IPC. METHODS I/R injury was induced by 180 min ischemia and 60 min reperfusion of testis. There were 5 groups. Group 1 served as untreated controls. The rats in Group 2 were subjected to I/R only. In Group 3, 3 cycles of IPC (5 min transient ischemia plus 5 min reperfusion) were performed prior to I/R. In groups 4 and 5, the rats were treated as in Group 3 but received intraperitoneal injections of 0.3 mg/kg Y-27632 or 10 mg/kg 5-HD prior to IPC, respectively. RESULTS I/R led to severe histopathological lesions in the rat testis and significantly lowered the scoring. I/R resulted in significant elevation in tissue lipid peroxide levels, myeloperoxidase (MPO) activity, and total antioxidative capacity (TAC), total oxidative status, and oxidative stress index levels. Protective effects of IPC on I/R-induced testicular injury of rats were observed with the significant recovery in these biochemical parameters. Y-27632 treatment led to a significant decrease in MPO activity, but there were no significant changes in the remaining parameters. Effects of IPC were blocked by 5-HD except in the TAC levels. CONCLUSION Our results showed that IPC protected rat testis against I/R-induced injury via activation of KATP channels. Additionally, Rho kinase inhibition preserved the effects of IPC in testis.

The comparison of dextranomer/hyaluronic acid and polyacrylate-polyalcohol copolymers in endoscopic treatment of vesicoureteral reflux

BACKGROUND Dextranomer/hyaluronic acid (Dx/Ha;Dexell®) and polyacrylate-polyalcohol copolymer (PPC;Vantris®) are the popular tissue-augmenting substances using for the endoscopic injections of vesicoureteral reflux (VUR). The aim of the study is to evaluate and compare Dx/Ha and PPC in terms of effectiveness, injection techniques and complications with special emphasis on vesicoureteral junction obstruction (VUJO). METHODS A total of 95 patients who underwent endoscopic VUR treatment between 2009 and 2015 were retrospectively reviewed. The patients were divided into two groups: group 1: Patients underwent endoscopic treatment with PPC (n=50 patients, 70 renal refluxing units) group 2: Patients underwent endoscopic treatment with Dx/Ha (n=45 patients, 74 renal refluxing units). RESULTS The overall resolution rates based on the number of renal refluxing units studied was 88.6% and 70.3% in group 1 and group 2, respectively. Resolution rates were significantly better in group 1 compared to group 2. VUJO requiring ureteral reimplantation or stent insertion developed in 7 patients in group 1. No VUJO was observed in group 2. VUJO in group 1 was markedly higher than that in group 2. CONCLUSIONS Endoscopic treatment of VUR with PPC promises better resolution rates but higher VUJO rates compared to Dx/Ha.

Protective effects of Y-27632 on hypoxia/reoxygenation-induced intestinal injury in newborn rats

BACKGROUND/PURPOSE Necrotizing enterocolitis (NEC) is a major cause of mortality in neonates and is associated with a disruption in the protective intestinal barrier. The precise cause of NEC is elusive. However, ischemia/reperfusion injury of the intestine has been considered a major contributing factor. We examined the role of Y-27632, a selective Rho-kinase inhibitor, on a hypoxia/reoxygenation (H/R)-induced intestinal injury of newborn rat pups. METHODS Hypoxia/reoxygenation was achieved by placing rat pups in an airtight chamber aerated with 95% N(2) + 5% CO(2) for 10 minutes followed by 10-minute 100% oxygen. Forty newborn rat pups were randomly allocated into 4 groups. Group 1 served as untreated controls. The pups in group 2 were subjected to H/R only. In groups 3 and 4, the rats were treated with intraperitoneal injection of 0.3 and 3 mg kg(-1) day(-1) of Y-27632 for 5 days following H/R, respectively. The pups were killed 6 days following the H/R injury. Intestine specimens were evaluated for histopathology and biochemical investigation. RESULTS The microscopic lesions in H/R rat pups were virtually the same as those seen in neonatal NEC, with severe destruction of villi and crypts. Hypoxia/reoxygenation resulted in significant elevation in malondialdehyde levels, but decreased tissue nitric oxide levels (P < .05). Protective effects of Y-27632 on H/R-induced intestinal injury of newborn rat pups were observed with a significant decrease in the intestinal injury score, suppression in malondialdehyde levels, and increase in nitric oxide levels (P < .05). CONCLUSIONS In this experimental study, Y-27632 significantly attenuated H/R-induced intestinal injury. These findings indicate that inhibition of Rho-kinase may offer a novel therapeutic approach in the treatment of NEC.