Murat Mehmet Rifaioglu

Protective effect of ebselen on experimental testicular torsion and detorsion injury.

Ebselen is used as a drug in clinical trials against stroke, reperfusion injury with anti‐atherosclerotic and renoprotective effects. The aim of this study is to investigate the protective effect of ebselen, on torsion/detorsion (T/D)‐induced biochemical and histopathological changes in experimental testicular ischaemia/reperfusion injury. A total of 28 male Wistar Albino rats were divided into four groups: group 1(sham‐operated group, n = 7), group 2(ebselen group, n = 7), group 3(torsion/detorsion + saline, n = 7) and group 4(T/D + 10 mg kg−1 ebselen group, n = 7). The tissue homogenate samples were used for immediate nitric oxide (NO), malondialdehyde (MDA), superoxide dismutase, catalase and glutathione measurement. Testes in all groups were evaluated for the biochemical assay and histopathological examinations. To evaluate spermatogenesis, Johnsen scoring system was used. Testicular tissue MDA and NO levels in group 3 were significantly higher than in group 1 and 4. In histological evaluation of the testicular tissues, ebselen administration improved tubular histology significantly compared with T/D group. Significant increase in histological score was observed in the testis of group 3 compared with group 1 and 2. Histological score in group 4 significantly decreased compared with group 3. Johnson score was significantly lower in T/D group compared with all other three groups, ebselen administration increased the score significantly compared with T/D group. Ebselen reduced oxidative biochemical and histopathological damage in our testicular T/D rat model.

The Investigation of Total PSA, Free PSA, and Free/Total PSA Ratio in Patients With Liver Cirrhosis Patients According to Child-Pugh Score

OBJECTIVE To investigate the total prostate-specific antigen (tPSA), free PSA (fPSA), and free/total PSA (fPSA/tPSA) ratio in patients with liver cirrhosis (LC) according to the severity of hepatic insufficiency. METHODS Eighty-two male patients with LC were studied. The severity of liver disease was categorized by Child-Pugh score (Child-Pugh A, B, and C). Forty-two age-matched healthy subjects were used as a control group. The tPSA, fPSA, fPSA/tPSA ratio, total prostate volume (TPV), total testosterone (TT), and total protein (TP) were measured. The LC group was compared with the control group in terms of these parameters. In addition, intra-comparison and inter-comparison was made between all the Child-Pugh groups and normal subjects, in terms of these parameters. RESULTS The tPSA and fPSA levels in LC cases, Child-Pugh A, Child-Pugh B, and Child-Pugh C groups were significantly decreased compared with the control group. The ratio of fPSA/tPSA in the LC subjects and Child-Pugh A groups significantly increased compared with the control group. TT, TP levels, and TPV in patients with LC were significantly lower compared with the control group and the results were significantly correlated with the Child-Pugh score. CONCLUSION The present study reveals that tPSA and fPSA were decreased in patients with LC in comparison to healthy subjects in terms of 3 mechanisms. First, it might be due to shrunken prostatic volume. Second, it also resulted in decreased levels of testosterone because of the abnormality of hypothalamic-pituitary-testicular axis. Third, it might be the diminished serum protein level in the composition of the PSA.

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.

Protective effects of caffeic acid phenethyl ester on the dose‐dependent acute nephrotoxicity with paraquat in a rat model

Paraquat (PQ), which is used extensively as a potent herbicide throughout the world, is highly toxic in humans. We aimed to determine PQ‐induced biochemical and histologic changes in the kidneys, and to evaluate the ability of the protective effects of caffeic acid phenethyl ester (CAPE) against PQ‐induced injury in rats. Forty‐eight rats were divided into eight groups of six: Group 1: Control; Group 2: 10 μmol/kg CAPE; Group 3: 15 mg/kg PQ; Group 4: 30 mg/kg PQ; Group 5: 45 mg/kg PQ; Group 6: 15 mg/kg PQ+CAPE; Group 7: 30 mg/kg PQ+CAPE; Group 8: 45 mg/kg PQ+CAPE. PQ and CAPE were injected intraperitoneally. The levels of the total oxidant status (TOS) and total antioxidant status (TAS) were determined in the supernatants of the excised left kidney. Right kidney tissue of each rat was removed to obtain a histologic score. When PQ‐administrated (15, 30, 45) groups compared with other groups, TOS values were found to be significantly higher (p < 0.01). PQ (15, 30, 45) groups had significantly diminished values of TAS than the other groups (p < 0.001). Of histologic score evaluation, only the PQ45 group had a significantly higher value than the sham, and CAPE groups (p < 0.05). Moreover, in CAPE+PQ45 group, the level of histologic score was decreased compared to PQ45 group (p < 0.001). In conclusion, the evaluation of the data suggests that CAPE can be used to prevent the acute effects of PQ nephrotoxicity.

Mean Platelet Volume—A Predictive Factor for the Diagnosis of Nonsymptomatic Prostatitis Results of Univariate and Multivariate Models

Mean platelet volume (MPV) has been reported to be related to inflammation. Prostate-specific antigen (PSA) is a protein produced by the prostate, and this protein may be elevated for several reasons, including prostatitis, benign prostatic hyperplasia, and/or cancer. The aim of the current study was to investigate the predictive effect of MPV values on nonsymptomatic prostatitis diagnosis and the relation between MPV and PSA. A total of 275 patients, 89 affected by benign prostate hyperplasia, 94 by prostate adenocancer, and 92 by prostatitis were included in the current study. PSA, total blood count parameters, and urine analysis were investigated. Findings were compared with the groups. The correlation between MPV and the other parameters were analyzed. Univariate and multivariate logistic regression analysis was performed to determine independent predictors of nonsymptomatic prostatitis diagnosis. MPV was significantly higher in patients with nonsymptomatic prostatitis than the other groups. There were negative correlations between MPV and age, total PSA or free PSA (r = −.123; p = .042, r = −.235; p < .001, r = −.184; p = .006, respectively). According to multivariate regression model, only MPV was identified as the predictive factor for nonsymptomatic prostatitis (odds ratio: 1.451, 95% confidence interval [1.116, 1.887], p = .005). MPV, in the absence of other reasons that increased the MPV level, was significantly increased in cases with nonsymptomatic prostatitis; this increase is significantly higher than elevated PSA level in nonsymptomatic prostatitis patients. MPV could have a predictive value for the diagnosis of nonsymptomatic prostatitis.

Changes in retinal vessels related to varicocele: a pilot investigation

The aim of this study was to investigate whether retinal vasculature changes had occurred (retinal artery diameter, retinal vein diameter and artery/vein ratio) in patients with varicocele. This pilot study included 50 healthy subjects with any eye disease apart from slight refractive errors and 55 patients with varicocele. Retinal arteriolar and venular diameters were measured and summarised as central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE). Retinal microvascular diameters and the arteriolar–to‐venular ratio (AVR) were assessed with a digital retinal camera. All measurements and calculations were performed using a computer‐based program. The mean CRAE value was 151.8 ± 3.6 μm in the study group and 150.4 ± 4.5 μm in the control group. Mean CRVE value was 209.4 ± 5.9 μm in the study group and 200.1 ± 8.7 μm in the control group. AVR was found 0.72 ± 0.02 in the study group and 0.75 ± 0.03 in the control group. There were significant differences between groups in terms of CRVE and AVR. There were no significant differences between groups in terms of CRAE. The results of this study showed that the patients with varicocele showed significant changes on retinal vascular diameter.