Müslim Yurtçu

Effects of melatonin on spermatogenesis and testicular ischemia-reperfusion injury after unilateral testicular torsion-detorsion

PURPOSE This study aimed to determine the effect of melatonin in preventing ischemia-reperfusion (I-R) injury-induced tissue damage and on spermatogenesis after experimental testicular torsion (TT). METHODS Forty peripubertal rats were divided into 4 groups each containing 10 rats: control (C), sham (S), torsion plus detorsion (TD), and torsion plus melatonin (M). The left testes were rotated 720 degrees for 6 hours and detorsed for 6 hours thereafter. Serum inhibin B (IB) levels were measured in blood samples taken from all groups. Left orchiectomies were performed to determine the tissue levels of Johnsens scores (JS) and malondialdehyde (MDA). RESULTS Serum IB levels in the S and TD groups were significantly lower compared with that in the C group, whereas they were higher in the M group compared with the TD group. The MDA levels were significantly lower in the C, S, and, M groups compared with the TD group. Johnsens scores were significantly higher in the C, S, and M groups compared with the TD group. CONCLUSIONS Our results suggested that melatonin is a potent antioxidant agent in preventing testicular I-R injury, as shown by increased IB levels and JS.

Efficacy of antioxidant treatment in the prevention of testicular atrophy in experimental testicular torsion

BACKGROUND/PURPOSE This study aimed to compare dose schedules of the antioxidant treatment (melatonin and steroid) used as 1 dose and as once a day for 7 days in terms of salvage of the testes in the late period. METHODS Sixty prepubertal rats were divided into 6 groups each containing 10 rats: sham (S), torsion-detorsion (TD), 1-dose melatonin (M(1)), 1-dose steroid (ST(1)), 7-dose melatonin (M(7)), and 7-dose steroid (ST(7)) groups. The left testes were rotated 720 degrees for 6 hours and detorsed for 6 hours thereafter. In the treatment groups, 17 mg/kg melatonin and 1 mg/kg steroid were injected 15 minutes before detorsion. Left orchiectomies were performed to determine testicular weights and Johnsen scores 3 months later. RESULTS Testicular weights and Johnsen scores in the M(1), ST(1), and TD groups were significantly lower compared with those in the S group, and atrophy developed in these groups, whereas they were higher in the M(7) and ST(7) groups compared with the TD group. Testicular atrophy did not develop in the M(7) or ST(7) groups. CONCLUSIONS Our results suggested that antioxidant agents used once a day for 7 days prevent testicular atrophy and are effective in terms of salvage of the testes.

The healing effects of tissue glues and healing agent locally applied on esophageal anastomoses.

OBJECTIVE This study aimed to investigate the effects of cyanoacrylate (C), fibrin glue (FG), and natrium hyaluronate (NH) on the healing of esophageal anastomosis (EA). METHODS Twenty-four rabbits were divided equally into 4 groups: primary anastomosis (PA), C, FG, and NH. A 1-cm-length of the cervical esophagus was resected through a cervical incision and then anastomosis was performed. C, FG, and NH were instilled into anastomosis lines in the respective groups. The animals were fed orally on postoperative day 7 on the condition that there was no esophageal leakage. The rabbits were sacrificed 8 weeks later to evaluate bursting pressure (BP), tissue hydroxyproline (HP) levels and wound healing scores (WHSs) in the anastomosis lines. RESULTS BP was significantly higher in the C group than in the PA, FG, and NH groups, and HP was significantly lower than in the other groups. WHSs in the PA and NH groups were lower than in the C and FG groups. CONCLUSIONS C and NH appear to be beneficial in EA healing with respect to increased BP and decreased HP when they are used simultaneously with PA prophylactically to prevent esophageal leakages and stricture.

The effect of cyanoacrylate in esophagocutaneous leakages occurring after esophageal anastomosis

OBJECTIVE Esophageal leakage (EL) continues to be a challenging pediatric surgical problem. The aim of this study was to investigate the effect of cyanoacrylate (Cy) in EL followed esophageal repair (ER). METHODS Twelve rabbits were divided into control (C) and leakage (L) groups. A 1cm-length transverse esophageal incision at the level of the cervical region was made. In both groups, feeding was started orally 24h after the surgery for leakage creation. On postoperative day 7, primary repair was carried out in the C group and Cy instillation was performed in the L group. Esophagographic analysis was carried out on postoperative day 9 and the animals were fed orally on the same day on the condition that there was no esophageal leakage. The rabbits were sacrificed to measure diameters of the OR line, bursting pressure (BP), and hydroxyproline (HP) levels in the repaired cervical esophageal segment (RCES) 2 months later. RESULTS The values of BP and HP in the C group were significantly higher than those in the L group. The diameters of the OR line in the L group were significantly greater compared to those in the C group. CONCLUSIONS Cy glue instillation seems to be the ideal treatment for esophageal anastomosis leakages as shown by increased diameters of the OR line and decreased HP levels.

DYSGERMINOMA IN A CHILD WITH ATAXIA–TELANGIECTASIA

Ataxia–telangiectasia is an autosomal recessive disease characterized by progressive cerebellar ataxia, oculocutaneous telangiectasia, immunodeficiency, high incidence of cancer, and increased sensitivity to ionizing radiation. The authors report a case of dysgerminoma in a child with high α-fetoprotein, CA125 and β-human chorionic gonadotropin, who has been followed-up for ataxia–telangiectasia for 2 years.

Investigation of histopathologic changes in the ureter walls in vesicoureteral reflux

PURPOSE This study aimed to determine the histopathologic changes in ureteral walls (UWs) in children with vesicoureteral reflux (VUR). METHODS Twenty ureteral specimens taken from children were divided into 2 groups, refluxing (R) and control (C) groups, each containing 10 specimens. Wall thickness of the ureter, tunica muscularis of the ureter, mucosal thickness of the ureter (uroepithelium), collagen thickness of the ureter, mucosal change, and inflammation were evaluated in resected distal UWs in children with VUR. RESULTS The mean wall thickness of the ureter, mean tunica muscularis of the ureter, and mean uroepithelium values of the UWs in the R group were not significantly lower compared to those in the C group. Collagen thickness values in the R group were significantly lower than those in the C group. CONCLUSIONS Our data suggest that wall thickness (tunica muscularis and uroepithelium) was not significantly decreased, but collagen thickness of the ureter was decreased in the UWs of children with VUR.

Investigation of histopathologic changes in the ureter walls in experimental congenital obstructive uropathy.

BACKGROUND/PURPOSE The aim of this study is to determine the histopathologic changes in the ureter wall in experimental urinary bladder hypoplasia and agenesis. METHODS Timed pregnant rats were randomly divided and received intraperitoneal Adriamycin (ADR) at 2 mg/kg on gestational days (GD) 6 to 9 (ADR group) and saline at 2 mL/kg on GD 6 to 9 (SF group). The control (C) group did not receive any medication in their pregnancy. Fetuses were harvested near term on GD 21 and dissected under a dissecting microscope and examined for urinary system abnormalities. RESULTS Diameter of ureter lumen was significantly increased, but wall thickness, tunica muscularis, and epithelial thickness of the ureter were decreased in the ADR group as compared with the C and SF groups. CONCLUSIONS Diameter of the ureter lumen was increased, but wall thickness, tunica muscularis, and uroepithelium of the ureter were decreased in the ADR group in the intrauterine period. The diameter of the ureter lumen and wall thickness of ureter (tunica muscularis of ureter and uroepithelium) were increased following obstructive uropathy after the birth.

The effects of early and late feeding on healing of esophageal anastomoses: An experimental study

OBJECTIVE To investigate the effects of postoperative late and early feeding on the healing of experimental esophageal anastomosis (EA). METHODS Twelve New Zealand rabbits were divided equally into 2 groups: late feeding (LF) and early feeding (EF). A 1-cm-length of the cervical esophagus was resected through a cervical incision, and then anastomosis was performed. The LF group was fed parenterally for 6 days and orally (per oral route) after esophagography on postoperative day 7 as long as there was no esophageal leakage. The EF group was fed orally (per oral route) 24h after esophageal repairs (ERs), and esophagography was carried out on postoperative day 7 to check the ERs. The rabbits were sacrificed to evaluate bursting pressure (BP), diameter of the esophageal lumen (DOTEL), tissue hydroxyproline (HP), and wound healing scores (WHSs) in the anastomosis lines 8 weeks later. RESULTS In the LF group, BP and DOTEL were significantly lower than they were in the EF group, and HP was significantly higher than it was in the EF group. WHSs in the LF group were not higher than they were in the EFgroup. CONCLUSIONS Early feeding is superior after EA as shown by increased DOTEL and BP levels, but causes decreased HP levels.

Migration of intra-articular K-wire into the contralateral pelvis after surgery for developmental dysplasia of the hip: a case report

Transarticular fixation of femoral head into acetabulum with K-wire is a seldomly used surgical method in difficult cases of developmental dysplasia of the hip (DDH). This paper presents a child with intrapelvic transvesicular migration of a K-wire without any symptoms after treatment of DDH. Eight years old girl who had multiple surgeries 4 years ago due to bilateral DDH applied to the orthopedics clinic with limping. She had good range of motion of both hips. At the pelvis radiograph, there was an intrapelvic K-wire standing between two hemipelvises like a bridge. She did not have any enteral and urological symptoms after the previous operations. We planned to remove the K-wire in cooperation with the pediatric surgery department. On the cystoscopy, K-wire was seen passing through the urinary bladder. Wire was cut at the middle point and taken out of the body by laparotomy. The patient was discharged without any postoperative complications. K-wire retention in the body has high chance of migration. Early postoperative removal of the K-wire is necessary to prevent possible complications.

Surgical management with or without a nasogastric tube in esophageal repairs

OBJECTIVE The aim of the study was to compare surgical management with or without a nasogastric tube (NGT) to prevent anastomotic stricture that occurred following esophageal repairs (ERs). METHODS Twelve New Zealand rabbits were divided equally into 2m: with a NGT (experimental group) and without a NGT (control group). A 1-cm-length of the cervical esophagus was resected through a cervical incision and then anastomosis was performed using the NGT and keeping it in place for 6 days in the experimental group. The same procedures were performed in the control group. Both groups were fed parenterally for 6 days and orally after esophagography on postoperative day 7 as long as there was no esophageal leakage. The rabbits were sacrificed to evaluate diameter of the esophageal lumen (DOTEL), bursting pressure (BP), tissue hydroxyproline (HP) and wound healing scores (WHSs) in the anastomosis lines 8 weeks later. RESULTS In the experimental group, DOTEL, BP, and HP were significantly lower than they were in the control group. WHSs in the experimental group were not higher than they were in the control group. CONCLUSIONS Surgical management without a NGT is more effective than management with a NGT in ERs as shown by increased DOTEL, BP, and HP levels.