Huseyin Kilincaslan

Methylene blue attenuates renal ischemia–reperfusion injury in rats

BACKGROUND AND PURPOSE In our study, we investigated the effects of methylene blue (MB) on histopathological changes in renal ischemia/reperfusion (I/R) injury rat model. MATERIAL AND METHODS Twenty-one Sprague-Dawley male rats were divided equally into three groups. Group 1 (control) was administered intraperitoneal saline solution. In Groups 2 (untreated group) and 3 (MB treatment), the renal arteries were clamped, and ischemia (for 1 hour) and then reperfusion (for 4 hours) were applied. Thirty minutes before ischemia, the untreated group received physiological saline, whereas the treatment group was administered 30 mg/kg MB through an intraperitoneal route. Blood samples were drawn, and renal specimens were harvested 5.5 hours after physiologic saline injection in the control and immediately after the reperfusion period in the other groups. The levels of tissue superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), total oxidant status (TOS), total antioxidant status (TAS), plasma urea, creatinine and ischemia modified albumin (IMA) were measured. Moreover, the histopathological damage score of the renal tissue was determined. RESULTS MB significantly alleviated the severity of histopathological damage by increasing the levels of tissue SOD and TAS and decreasing TOS concentrations in the renal I/R model (p<0.05). CONCLUSION Administration of MB in renal I/R damage may play a protective role.

Tubularized incised plate urethroplasty with dorsal inlay graft prevents meatal/neourethral stenosis: a single surgeon's experience

To the Editor, We read the article by Shimotakahara et al [1] with great interest. In this article, the authors are evaluating of the effectiveness of dorsal inlay graft (DIG) urethroplasty for preventing meatal/neourethral stenosis (M/N-S) after hypospadias repair. For this purpose, they have compared the outcomes of snodgrass urethroplasty (SUP) and SUP plus DIG. Finally, they reported that using DIG during SUP is significantly decreasing the M/N-S, and therefore, they strongly recommend the routine use of this technique. However, there are some limitations of the study that need to be clarified. The main drawback of the study is the use of DIG in cases with shallow groove as indicated in the “Methods” section. Although the authors are using this technique in only select cases, it is not wise to strongly recommend the routine use of DIG during every SUP. If the indication of this technique is limited to the patients with narrow or shallow glans, unless randomized studies have been conducted in hypospadiac patients, the suggestion of the routine use of DIG should be avoided. The other technical factor when considering the routine use of DIG from the inner preputial skin is perhaps the severity of the hypospadias. The safe use of DIG in distally located primary hypospadias cases have been previously reported [2,3]. However, in the present study, the meatus of the penis is proximally located in almost half of the children preoperatively. Especially in this group of patients, the preputial skin is generally saved and is used to cover the corpora of the penis, which is exposed and lengthened after the degloving and chordectomy phases. Therefore, sometimes it might be technically difficult to sacrifice a large portion of the inner preputial skin to cover the incised urethra. In that special group of cases, we suggest that harvesting a buccal mucosa for the preparation of the inlay graft would be a better choice of treatment instead of using an inner preputial skin. We also have an experience of using DIG prepared from the inner prepuce in 15 primary distal hypospadias cases at our institution. After a mean follow-up of 9.1

Pure laparoscopic management of a giant ovarian cyst in an adolescent.

Patient: Female, 16 Final Diagnosis: Ovarian cyst Symptoms: — Medication: — Clinical Procedure: Laparoscopic surgery Specialty: Surgery Objective: Rare disease Background: The use of the laparoscopic approach versus open approach for the management of giant ovarian cysts is controversial. Exclusion of malignant conditions has critical importance in the laparoscopic management of these cases. However, in some cases, the possibility of malignancy and the ovarian origin of a cyst cannot be excluded during the preoperative period. Case Report: Herein we present the case of a 16-year-old girl with a giant ovarian cyst. The abdominal cavity was laparoscopically explored, and no signs suggestive of malignancy were encountered; the ovarian origin of the cyst was confirmed. A Veress needle was inserted percutaneously, and the cyst was drained and laparoscopically excised. No complications were encountered at follow-up visits 3 and 6 months after surgery. Conclusions: In addition to the well-known advantages of laparoscopic surgery (e.g., decreased postoperative pain, length of hospital stay, and wound infection), perfect cosmetic results are particularly important for young women. The pure laparoscopic management of giant ovarian cysts is safe and feasible.

The Effect of Sterilization Methods of Endoscopic Instruments on the Body: A Study on Rat Model

ABSTRACT Purpose: Laparoscopy is widely used in many surgical areas for diagnosis and treatment. The need for sterilization of reusable instruments is an important issue. Ensuring patient safety, preventing infection, and protecting the functionality of the instruments are the most important points to be considered. We aimed to investigate two sterilization methods and their effects generated by their distribution into intra-abdominal tissues during insufflation. Materials and Methods: 21 rats were used in the study. The Control Group (Group 1) received anesthesia for 1 hour; Group 2 (Glutaraldehyde (GA)-Pneumoperitoneum Group) received anesthesia for 1 hour; Group 3 (Ethylene Oxide (EO)-Pneumoperitoneum Group) received anesthesia for 1 hour. After 24 hours, the animals were sacrificed, and the kidneys and omentum of the animals were analyzed in a histopathological manner. Blood samples were analyzed at preoperative 24th hour and at postoperative 24th hour. Results: There was a statistically significant difference in omentum, endothelium, and glomerular scores between the groups (p < 0.001 for all groups). Endothelial and glomerular scores were different at a statistically significant level in the EO and GA groups compared to the Control Group. The total score was higher at a statistically significant level in the EO and GA groups compared to the Control Group (p < 0.001 for both groups). Conclusion: It was determined in our study that sterilization methods such as EO and GA cause damage in intra-abdominal tissues. In the light of these results, we consider that the most ideal laparoscopic surgery set is the single-use laparoscopy set. However, this does not seem possible especially in developing countries in practice.

The effects of prolonged CO 2 insufflation on kidney function in a rat pneumoperitoneum model

Introduction Pneumoperitoneum (PP) is known to cause ischemia in kidneys and other intra-abdominal organs because of decreased splanchnic blood flow. Aim We aimed to determine the degree of renal injury that occurs due to a PP and prolonged PP. We measured renal injury biomarkers and made a histopathological evaluation to estimate the degree of injury and assessed the correlation of biomarkers with histopathological findings. Material and methods Twenty-one female Sprague Dawley rats were separated randomly into three groups. Group 1 was the control group and was given anesthesia for 3 h. In group 2, a PP was administered under anesthesia for 1 h. A pneumoperitoneum was administered under anesthesia to animals in group 3 for 3 h. Results Pathological analysis showed a significant statistical difference between the 3 groups. In particular, neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C (Cys C) levels at the 24th h and preoperative mean urea levels showed a significant difference between the groups. The 24th-hour NGAL level in group 3 was significantly higher than that of group 1. The preoperative Cys C level was higher in group 1 than in either group 2 or 3. Cys C was decreased significantly in group 1 and increased significantly in both groups 2 and 3. Conclusions The increase in NGAL and Cys C levels directly correlated with the duration of PP and intra-abdominal pressure, and they are therefore good biomarkers in diagnosing acute renal injury in the early phase. Serum creatinine level is not a good biomarker in the early phase of renal injury.

Male Circumcision: Unending Debate

Circumcision, foreskin surrounds the penis called the glans prepusyum, mucous-covered means the removal by cutting a piece of skin. This process is probably the most discussed in the history of the world, is one of the oldest surgical procedures. Circumcision is primarily due to religious and cultural beliefs in certain parts of the world, while it is sometimes carried out in the absence of various medical indications. In this article, in our country, circumcision is being done very widely in the literature by examining the latest information on are summarized, and especially the debate about circumcision is intended to examine issues of.

Buschke-Löwenstein tumor: Three pediatric cases.

Buschke–Löwenstein tumor (BLT) is a verrucous lesion that grows slowly, causing regional infiltration and deformity. It is very rare during childhood and usually has a benign course. It is related to the human papilloma virus type 6 and type 11. Poor hygiene, chronic irritation, diabetes and impaired cellular immunity are other factors thought to play a role in the etiology of the disease. The first‐choice treatment modality is total surgical excision. Herein we describe three cases to illustrate the success of total surgical excision via electrocautery in the treatment of BLT, and the excellent cosmetic outcome of the method.

Beneficial effects of methylene blue on the acute phase of corrosive esophageal burn in rats.

INTRODUCTION The aim of the article is to investigate the beneficial effects of methylene blue (MB) on the acute phase of experimental corrosive esophageal burns. MATERIALS AND METHODS A total of 21 male Sprague-Dawley rats were allocated into three groups with an equal number in each group. In Group 1 (control), the esophageal lumen was irrigated with saline. In Groups 2 (untreated) and 3 (MB treatment), the distal esophagus was burned with 30% NaOH solution. In Group 3, MB was applied locally on the distal esophageal lumen (30 mg/kg) 90 minutes after the burn. In all the groups, animals were humanely killed at the end of the 7th day. Distal esophageal specimens were obtained for histopathological and biochemical examinations. RESULTS MB increased the tissue superoxide dismutase levels and the total antioxidant status, whereas it decreased the levels of the total oxidant status with significant attenuation of histopathological damage. CONCLUSION MB might have reduced the tissue damage in corrosive esophagitis because of its antioxidant effects.