Orhun Sinanoglu

The protective effects of spirulina in cyclophosphamide induced nephrotoxicity and urotoxicity in rats.

OBJECTIVE To evaluate the role of Spirulina, a blue-green algae with antioxidant properties in the protection of cyclophosphamide-induced nephrotoxicity and hemorrhagic cystitis in rats. METHODS The control group (C) was sacrificed 24 hours after being given a single dose of saline intraperitoneally (150 mg/kg) on the seventh day of the experiment. The rats in the second group (CP) were sacrificed 24 hours after being given a single dose of cyclophosphamide, intraperitoneally (150 mg/kg) on the seventh day of the experiment. Spirulina was administered to the third group (SP+CP) orally (1000 mg/kg bw/day) for 7 days and a single dose of cyclophosphamide was injected intraperitoneally (150 mg/kg) on the seventh day of the experiment. At the eighth day of the experiment, malondialdehyde, superoxide dismutase, and catalase levels in renal and urinary bladder tissues were measured. Histomorphology in urinary bladder, apoptosis by caspase 3 immunostaining, and TUNEL assay in kidney were also evaluated. RESULTS Tissue levels of malondialdehyde in the SP+CP group were significantly lower versus CP group (P < .05). Tissue levels of superoxide dismutase and catalase in the SP+CP group were significantly higher vs the CP group (P < .05). The histomorphologic alteration in urinary bladder in the SP+CP group was significantly lower vs that in the CP group. In the kidney, apoptosis in the SP+CP group as shown with TUNEL assay and immunohistochemistry was significantly lower vs that in the CP group (P < .05). CONCLUSION Pretreatment with Spirulina protects the rats from cyclophosphamide-induced nephro-urotoxicity via its antioxidant and anti-apoptotic properties.

Protective Effect of Melatonin and 1,25-Dihydroxyvitamin D3 on Renal Ischemia–Reperfusion Injury in Rats

Ischemia–reperfusion (I/R) injury induces the generation of reactive oxygen species (ROS) which affect many organs. This study was designed to investigate the roles of melatonin and 1,25-dihydroxyvitamin D3 (VD3) on renal I/R injury. Thirty male Wistar albino rats were divided into five groups: group 1, control; group 2, right nephrectomy (RN) + I/R in the contralateral kidney; group 3, melatonin + RN + I/R; group 4, VD3 + RN + I/R; and group 5, melatonin + VD3 + RN + I/R. Melatonin (10 mg/kg), VD3 (0.5 μg/kg), and melatonin plus VD3 were injected intraperitoneally for 7 days before renal I/R. After 7 days, right nephrectomy was initially performed and left renal artery was clamped for 45 min. After 45-min reperfusion, the serum and kidney tissue samples were obtained for assays. Melatonin and VD3 had an ameliorative effect on biochemical parameters such as serum creatinine (SCr) and blood urea nitrogen (BUN). Renal tissue malondialdehyde (MDA), glutathione (GSH), nitric oxide (NO) levels, and superoxide dismutase (SOD) activity were determined. Renal I/R decreased the kidney tissue GSH levels and SOD activity and increased the NO levels as compared with control group. However, melatonin and VD3 and melatonin plus VD3 treatment significantly increased the tissue GSH levels and SOD activity and decreased the NO levels compared with those of I/R group. Meanwhile, MDA levels were not different between the control and I/R groups. But, MDA levels decreased in all treated groups compared to I/R and control groups. These data support that melatonin and VD3 have beneficial effects on renal injury.

Comparison of Melatonin and Ozone in the Prevention of Reperfusion Injury Following Unilateral Testicular Torsion in Rats

OBJECTIVE To compare the efficacy of ozone with melatonin, shown as the most powerful antioxidant in attenuation of testicular ischemia/reperfusion injury, in an experimental rat model of testicular torsion/detorsion. METHODS Twenty-four male Wistar rats were divided into 4 groups: sham-operated, torsion/detorsion, torsion/detorsion plus melatonin, and torsion/detorsion plus ozone. Melatonin (10 mg/kg) and ozone (4 mg/kg) were intraperitoneally injected daily beginning 15 minutes before detorsion for the following 7 days. At the seventh day, blood and tissue samples were obtained. Johnsen score, malondialdehyde, inhibin B, glutathione plasma total sulfhydryl group (RSH) levels, and total nitric oxide were studied. RESULTS Torsion/detorsion caused increase in tissue malondialdehyde and total nitric oxide along with a decrease in Johnsen score, tissue and plasma inhibin B, RSH, and glutathione levels. Melatonin prevented the rise in malondialdehyde and total nitric oxide levels and improved Johnsen score, tissue and plasma inhibin B, and tissue glutathione levels, along with a decrease in plasma RSH level. Ozone showed similar results except for the total nitric oxide level. Concomitantly, in contralateral testis, melatonin and ozone induced similar changes for Johnsen score, malondialdehyde, and inhibin B (not significant) and in glutathione (significant). Melatonin decreased the total nitric oxide level in both testes and ozone increased the same parameter. CONCLUSION On different pathways, ozone was comparable with melatonin in the amelioration of ischemia/reperfusion injury. Protective effects of ozone were associated with nitrous oxide. The potential for ozone as a treatment for torsion/detorsion therefore deserves to be further elucidated.

Postoperative Outcomes of Plasmakinetic Transurethral Resection of the Prostate Compared to Monopolar Transurethral Resection of the Prostate in Patients With Comorbidities

OBJECTIVE To compare the 12-month postoperative clinical data in patients with comorbidities undergoing plasmakinetic enucleation of the prostate (PK-TURP) and monopolar transurethral resection of the prostate (M-TURP) for symptomatic benign prostatic hyperplasia (BPH). METHODS The data of 165 patients undergoing either PK-TURP or M-TURP from September 2006 to December 2010 were retrospectively evaluated in terms of erectile function. Decrease in Hb level at 24-hour follow-up, variations in serum Na(+) at 2-hour follow-up, and 12 month postoperative International Prostate Symptom Score (IPSS), Q(max.), postoperative International Index of Erectile Function (IIEF) scores and urethral stricture rates were evaluated. RESULTS A total of 85 patients underwent M-TURP and 80 patients PK-TURP. In all, 62 patients in M-TURP group and 71 patients in PK-TURP group had one or more comorbidities (P = .01). The operative times were 59.8 ± 17.8 versus 60.3 ± 23.8 (P = 0.539). The postoperative 12-month IIEF scores of PK-TURP patients were significantly higher than those of M-TURP patients (M-TURP; 14.5 ± 6.9, PK-TURP; 17.4 ± 8.9, P = .04). IPSS and Q(max.) were similar in both the M-TURP and PK-TURP treatment arms (10.9 ± 8.1 versus 9 ± 7.9, P = .187 and 18.9 ± 4.8 versus 18.8 ± 6.4, P = .905). Urethral stricture rate was 3/62 in M-TURP versus 8/71 in PK-TURP treatment arm, P = .171). CONCLUSION Both modalities yielded similar results with respect to IPSS and Q(max.). The postoperative IIEF in BPH patients with comorbidities appeared to be significantly higher in the PK-TURP group. Although urethral stricture rates seemed higher in the PK-TURP arm, the difference was not statistically significant.

Effects of Spirulina on Cyclophosphamide-Induced Ovarian Toxicity in Rats: Biochemical and Histomorphometric Evaluation of the Ovary

Cyclophosphamide (Cyc) is known to cause ovotoxicity and infertility in women. Our aim is to investigate the possible ovotoxic effects of Cyc and possible antioxidant and protective effects of blue-green algae, Spirulina (Sp), in rat ovaries. Eighteen rats were given: group I (n = 6, control); group II (n = 6, CP), a single dose Cyc; group III (n = 6, Sp+Cyc), 7 days Sp+single dose Cyc. Tissue malondialdehyde (MDA) levels, superoxide dismutase (SOD), and catalase (CAT) activities are assessed biochemically. Normal and atretic primordial and primary follicle counts for all sections obtained for each ovary are calculated. Mean number of follicle counts for each group are compared. In Sp+Cyc group, tissue MDA levels were significantly lower than those in the CP and higher than those in the C group (CP > Sp+Cyc > C). Tissue SOD activity was significantly higher in Sp+Cyc group than that in the CP group and lower than that in the C group (C > Sp+Cyc > C). No statistically significant difference was found between the ovarian CAT activities in any group. Histomorphometrically, there was also no significant difference between the mean numbers of normal and atretic small follicle counts. Our results suggest that single dose Cyc has adverse effects on oxidant status of the ovaries and Sp has protective effects in Cyc-induced ovotoxicity.

The Effect of Tamsulosin on Pain and Clearance According to Ureteral Stone Location After Shock Wave Lithotripsy

Background Medical expulsion therapy has shown encouraging results in facilitating spontaneous clearance of ureteral stones after extracorporeal shock wave lithotripsy. However, no other study has yet determined the benefit of medical expulsion therapy for stones in different ureteral locations. Objective The aim of the study was to evaluate tamsulosin as adjunctive therapy to extracorporeal shock wave lithotripsy (SWL) in terms of pain clearance of stones in the upper, middle, and lower ureter. Methods Between June 2008 and July 2011, patients with a solitary ureteral stone that was ≥6 mm up to 15 mm and located in the upper, middle, or lower ureter undergoing SWL were evaluated. The patients were randomly allocated to a conservative treatment (group 1) and a tamsulosin treatment group (group 2). Administration of the drug was started immediately after SWL and was continued for a maximum of 28 days. Patients were evaluated for stone clearance, time to stone clearance, and number of SWL sessions. The pain intensity was evaluated by visual analog scale. Results There were 64 patients in the control group and 59 in the tamsulosin group. The average stone sizes were 10.70 (3.20) mm and 11.40 (3.01) mm (P = 0.24). Group 1 and group 2 received 2507 (984) and 2759 (775) shock waves (P = 0.86), 1.53 (0.8) and 1.49 (0.75) sessions (P = 0.85), respectively. Mean visual analog scale scores and times to clearance were 3.81 (2.74) and 2.73 (2.28) (P = 0.00) and 12.59 (8.63) days and 8.34 (7.60) days (P = 0.00), respectively, for all stones in groups 1 and 2. Only the clearance time of upper ureteral stones between groups showed statistical significance (13.54 [8.32] days vs 7.10 [6.40] days; P = 0.00). Conclusions Tamsulosin may help in the treatment of all ureteral stones after SWL, particularly stones in the upper ureter, with a shorter time to clearance and less need for analgesic drugs.

Melatonin with 1,25-Dihydroxyvitamin D3 Protects against Apoptotic Ischemia–Reperfusion Injury in the Rat Kidney

This study was designed to evaluate the preventive role of melatonin (Mel) and 1,25-dihydroxyvitamin D3 (VD3) in biochemical and apoptotic events leading to tissue injury and renal dysfunction after ischemia–reperfusion (I/R). Thirty male Wistar rats were divided into five groups: sham-operated, I/R, Mel + I/R, VD3 + I/R, and Mel + VD3 + I/R. The rats were intraperitoneally administered with Mel (10 mg/kg), VD3 (0.5 μg/kg), or Mel (10 mg/kg) plus VD3 (0.5 μg/kg) each day at 1 week prior to ischemia. Right nephrectomy was initially performed and left renal I/R injury was induced by 45 min of bilateral renal ischemia followed by 45 min of reperfusion. After reperfusion, kidneys and blood were obtained for histopathologic and biochemical evaluation. Mel and VD3 had an ameliorative effect on biochemical parameters such as serum creatinine, blood urea nitrogen, alanine aminotransferase, aspartate aminotransferase, and apoptosis (caspase-3 and terminal deoxynucleotidyl transferase-mediated dUTP–biotin nick end labeling staining) in the kidneys against renal I/R injury in rats. Additionally, VD3 combined with Mel significantly reduced apoptotic and histological alterations when compared with Mel or VD3 alone. This preventive effect on renal tubular apoptosis was remarkable when Mel was combined with VD3.

Ipsilateral Testicular Catch-Up Growth Rate Following Microsurgical Inguinal Adolescent Varicocelectomy

Objective. To evaluate the ipsilateral catch-up growth rates compared to contralateral testicular growth in adolescents with varicocele undergoing microsurgical inguinal varicocelectomy. Materials and Methods. Between December 2005 and May 2007, 39 adolescent patients with grade 2-3 varicocele admitted to our clinic with complaints of pain and/or testicular asymmetry were operated. Preoperative mean age was 14.5 ± 1.96 (9–17). Testicular volumes were assessed with ultrasound every 3 months. The available followup was 39 months. Results. In our series, mean testicular preoperative volumes were 9.07 ± 3.19 mL for the right and 5.90 ± 1.74 mL for the left. Mean testicular volumes at the end of follow up were 13.97 ± 3.42 mL for the right and 12.20 ± 4.05 mL for the left. The testicular catch-up growth approximately begins after the 9th month and significant catch-up occurred in the 12–24 months (P < 0.05). Conclusion. Since testicular volume is the primary method of assessing testicular function in adolescents, testicular size can predict future fertility status significantly 9 months after surgical varicocele correction.

Comparison of plasmakinetic transurethral resection of the prostate with monopolar transurethral resection of the prostate in terms of urethral stricture rates in patients with comorbidities

Purpose To compare urethral stricture rates in comorbid patients undergoing plasmakinetic transurethral resection of the prostate (PK-TURP) and monopolar transurethral resection of the prostate (M-TURP) for benign prostatic hyperplasia. Methods The data of 317 patients with comorbidities undergoing either PK-TURP or M-TURP from September 2008 to December 2012 were retrospectively evaluated. Preoperative and postoperative 12-month International Prostate Symptom Score, maximal flow rate, postoperative International Index of Erectile Function scores, and urethral stricture rates were evaluated. Results A total of 154 patients underwent M-TURP and 163 patients underwent PK-TURP. Urethral stricture rates were 6/154 in the M-TURP treatment arm and 17/163 in the PK-TURP treatment arm (P=0.000). In the presence of hypertension and/or coronary artery disease and/or diabetes mellitus, the risk of urethral stricture complication was significantly higher in the PK-TURP group than in the M-TURP group (P=0.000). Conclusions The risk of urethral stricture increases with PK-TURP in elderly patients with a large prostate and concomitant hypertension and/or coronary artery disease and/or diabetes mellitus. Therefore, PK-TURP should be performed cautiously in this group of benign prostatic hyperplasia patients.

The effect of varicocelectomy on sperm parameters in subfertile men with clinical varicoceles who have asthenozoospermia or teratozoospermia with normal sperm density.

Background. To compare preoperative and postoperative sperm parameters such as sperm count, motility, and morphology in patients with normal sperm concentration with teratozoospermia and asthenozoospermia. Materials and Methods. Hundred and six patients with varicocele associated with male infertility over a 5-year period were included into the study. Pre- and postvaricocelectomy seminal fluid parameters evaluation according to the World Health Organization (WHO) criteria was performed at 4–6-month intervals. Results. One hundred and six patients met the criteria. The mean age of patients was 24.53 ± 8.13. The mean duration of infertility was 3.6 years (range: 1.5–6.3). Only the sperm motility of patients with normospermia showed a significant improvement postoperatively. Conclusions. No significant improvement in sperm morphology may be obtained in patients with clinical varicocele and preoperative normospermia.