Vedat Bakan

Protective effect of tadalafil on ischemia/reperfusion injury of rat ovary.

BACKGROUND/PURPOSE The aim of the study was to evaluate the effects of tadalafil (TDF) on ischemia/reperfusion (I/R) injury in rat ovaries. METHODS Thirty-five female Sprague-Dawley rats were randomly divided into 5 groups (n = 7): sham (S), I/R1, I/R2, TDF1, and TDF2. In the I/R1 and TDF1 groups, 3-hour ischemia was followed by 12-hour reperfusion; and in the I/R2 and TDF2 groups, 3-hour ischemia was followed by 24-hour reperfusion. In the TDF groups, 30 minutes before reperfusion, a single dose of 5 mg/kg TDF was administered intraperitoneally. The ovarian tissue levels of malondialdehyde and nitric oxide (NO), and the activities of superoxide dismutase and catalase were measured biochemically. Tissue damage to ovarian tissue was scored by histopathologic examination. RESULTS The tissue malondialdehyde levels were significantly higher and the catalase and superoxide dismutase activities were significantly lower in the I/R groups compared with the S and TDF groups (P < .05). The NO levels were significantly higher in the TDF1 group than the S and I/R1 groups (P < .05). Although the NO levels were increased in the TDF2 group compared with the I/R2 group, the difference was not significant. Ovarian tissue damage scores of the I/R groups were significantly higher than those of the S group (P < .05). Treatment with TDF significantly decreased the ovarian tissue damage scores in the TDF groups compared with the I/R groups (P < .05). CONCLUSIONS Tadalafil is effective in preventing tissue damage induced by I/R in rat ovaries.

Selenium has a protective effect on ischemia/reperfusion injury in a rat ovary model: biochemical and histopathologic evaluation ☆

BACKGROUND/PURPOSE The aim of the study was to evaluate the effects of selenium (Se) on ischemia/reperfusion (I/R) injury in rat ovaries. METHODS Thirty-five female Sprague-Dawley rats were randomly divided into 5 groups (n = 7): sham (S), I/R1, I/R2, Se1, and Se2. In the I/R1 and Se1 groups, 4 hours of ischemia was followed by 6 hours of reperfusion, and in the I/R2 and Se2 groups, 4 hours of ischemia was followed by 12 hours of reperfusion. In the Se groups, 30 minutes before reperfusion, a single dose of 0.2 mg/kg Se was administered intraperitoneally. The ovarian tissue levels of malondialdehyde (MDA) and nitric oxide (NO), and the activities of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) were measured biochemically. Tissue damage to ovarian tissue was scored by histopathologic examination. RESULTS The I/R groups had significantly higher MDA levels and lower CAT, SOD, and GPx activities than the sham group (P < .05). Although NO levels were significantly higher in the I/R1 group than in the sham group (P < .05), the NO levels in the I/R2 and sham groups were similar. Selenium pretreatment significantly lowered tissue MDA and NO levels and increased tissue SOD and GPx activities in the Se groups, compared with those in the I/R groups (P < .05). Catalase activities were significantly higher in the Se2 group than in the I/R2 group (P < .05). Catalase activities were higher in the Se1 group than in the I/R1 group, but the difference was not statistically significant. Treatment with Se significantly decreased the ovarian tissue damage scores in the Se2 group compared with those in the I/R2 group (P < .05). CONCLUSION Selenium is effective in preventing tissue damage induced by I/R in rat ovaries.

Dorsal Double-Layer Dartos Flap for Preventing Fistulae Formation in the Snodgrass Technique

Introduction: The Snodgrass technique and its modifications have become a preferred method for all varieties of hypospadias in the past decade. However, fistula is the most common complication of this technique. The aim of this study was to investigate the importance of the single and double flap to prevent fistula formation in the Snodgrass procedure. Materials and Methods: Tubularized incised plate urethroplasty, using a single or the double flap, was undertaken in 74 consecutive boys (median age 6.6 years old, range 1–15) within the last 4 years. In the first 29 patients (group 1), a dorsolateral flap was rotated laterally for covering the neourethra and in the remaining 45 patients (group 2) the neourethra was covered with dorsal double dartos flaps. Result: In group 1, fistula in 4 patients and partial glanular dehiscence in 1 patient were detected. There was no fistula formation in group 2. Conclusion: For preventing fistula formation, urethral covering by a well-vascularized dorsal double-layer dartos flap should be the basic part of the Snodgrass procedure.

Administration of honey to prevent peritoneal adhesions in a rat peritonitis model

AIM We investigated the effects of intraperitoneal honey on the development of postoperative intra-abdominal adhesions and oxidative stress in a model of bacterial peritonitis. METHODS Bacterial peritonitis was induced in 18 rats by cecal ligation and puncture. The rats were randomly assigned to three groups. Group 1 (n=6) received honey intraperitoneally, group 2 (n=6) received 5% dextrose intraperitoneally, and the third group received no fluid or medicine intraperitoneally one day after cecal ligation and puncture procedure. All animals were killed 14 days later so we could assess the adhesion score. Tissue antioxidant levels were measured in 1-g tissue samples taken from the abdominal wall. RESULTS Adhesion scores of honey treated group were significantly lower according to the control group (P<0.05) and statistically significant. Adhesion scores of honey were lower from 5% dextrose but not statistically significant (P>0.05). Malondialdehyde values of honey group were significantly lower from the control group (P<0.05) and levels in 5% dextrose group was higher than the honey group. Catalase levels were high in control and 5% dextrose groups. Superoxide dismutase levels were higher in the control group than the honey group (statistically significant). CONCLUSIONS Intraperitoneal honey decreased the formation of postoperative intra-abdominal adhesions without compromising wound healing in this bacterial peritonitis rat model. Honey also decreased the oxidative stress during peritonitis.

Effect of Zofenopril on regeneration of sciatic nerve crush injury in a rat model

Background Zofenopril is an antioxidant agent which has been shown to have beneficial effects in hypertension and heart failure. The aim of this study was to test the effects of Zofenopril on nerve regeneration and scarring in a rat model of peripheral nerve crush injury. Methods Twenty-one adult Sprague-Dawley rats underwent a surgical procedure involving right sciatic nerve crush injury. 15 mg/kg Zofenopril was administered orally to seven rats in group Z for seven days. Seven rats in group S received saline orally for seven days. Seven rats in the control group C received no drug after crush injury. Fourteenth and 42nd days after injury, functional and electromyography assessments of nerves were performed. Functional recovery was analyzed using a walking track assessment, and quantified using the sciatic functional index (SFI). After these evaluations, all rats were sacrificed and microscopic evaluations were performed. Results The Sciatic functional Index (SFI) in group Z on 14th day is different significantly from group S and group C (p = 0.037). But on 42nd day there was no difference between groups (p = 0.278). The statistical analyses of electromyelographic (EMG) studies showed that the latency in group Z is significantly different from group S (p = 0.006) and group C (p = 0.045). But on 42nd day there was no difference between groups like SFI (p = 0.147). The amplitude was evaluated better in group Z than others (p < 0.05). In microscopic evaluation, we observed the highest number of nerve regeneration in the group Z and the lowest in the group C. But it was not significant statistically. Conclusion Our results demonstrate that Zofenopril promotes the regeneration of peripheral nerve injuries in rat models.

Ureteroscopic Stone Management in Prepubertal Children

Introduction: We retrospectively assessed our experience with ureteroscopy (URS) for ureteric calculi in prepubertal children. Patients and Methods: The records of all children who underwent URS at our institution for ureteral calculi between September 2007 and July 2009 were retrospectively reviewed. Patient demographics, stone location and size, pre- and postoperative stenting, intraoperative active dilatation, stone-free rates and complications were noted. Results: A total of 26 patients (20 males and 6 females; mean age 59.9 months) underwent 30 URS procedures with rigid ureteroscopes for 31 ureteral calculi. The mean size of ureteral stones was 8.6 mm. A total of 18 URS procedures were performed without any active ureteral dilatation, and 8 patients underwent 12 passive dilatations of initially inaccessible ureters. Stents remained in place for 2–4 weeks. The stone-free rate was 84.6% for all patients and all procedures. Postoperatively, 12 patients (46%) had stent placement for 2–5 days because of stone burden, edema of the ureteral orifice and hematuria. Conclusions: URS treatment of ureteral stones without active dilatation can be performed safely and effectively in prepubertal children. Passive ureteral dilatation might be necessary in some cases to enable ureteral access.

The histopathological investigation of the effect on regional and systemic tissues of the application of Medicinal Plant Extract Ankaferd Blood Stopper in deep tissue injuries in Rats

BACKGROUND This study was planned to evaluate both the histopathological changes under light microscope as well as the systemic organ effects following application of Ankaferd Blood Stopper® (ABS) (a mixture of five plant extracts) in an animal model of deep tissue hemorrhage. METHODS A total of 50 Wistar Albino rats were divided into five groups of 10 rats each. The rats underwent femoral vein puncture and were treated with ABS tampon, ABS spray, or Surgicel, and one group was left untreated. After two weeks, each group underwent partial tissue excision from the same femoral region as well as from the brain, heart, kidney, and liver. RESULTS The specimens from all groups were obtained from the femoral region after two weeks and evaluated under light microscope. The light microscope revealed no histopathological changes in neurovascular structures or in deep connective tissues in any of the groups. CONCLUSION ABS provided hemostasis and was observed to stop bleeding. There were no histopathological changes at the tissue level and no pathological effects in other organs tissues under light microscope, and the remote organ tissue remained clear.

Decreased Vitamin B12 Levels in Children with Nocturnal Enuresis

Objectives. Nocturnal enuresis is a common pediatric problem, the etiology of which is unclear. In the present study, vitamin B12 and folate levels were measured in children with nocturnal enuresis and compared with those in healthy control group children to investigate whether there was any relation with enuresis and neurogenic maturation as a first time in the literature. Methods. In this cross-sectional study, we included thirty children (16 girls, 14 boys) who had presented with primary nocturnal enuresis (PNE) complaints in the study group and 31 children (13 girls, 18 boys) in the control group. Body weight and height measurements were obtained and complete blood counts and vitamin B12 and folate levels were measured in all children. Results. No difference was found in age, height, and weight between study and control groups. Also the mean levels of the hemoglobin, hematocrit, and mean corpuscular volume (MCV) were not different between the two groups. Significantly lower mean vitamin B12 and folate levels were found in the enuresis group compared with the control group. Conclusions. Further studies are needed to clarify B12 and folate deficiency in larger series so that these tests can be included in routine investigations of enuretic children.

Anaesthetic Management of a Neonate with Giant Cystic Hygroma.

Cystic hygroma, which originates from embryonic lymphoid tissue, is a benign tumour without any potential for malignancy. It is commonly located in the neck area. Anaesthetic management of a large neck mass may be challenging due to difficulty in intubation and the severe haemodynamic effects of surgical removal of a giant tumour. Serious consequences such as sudden airway occlusion resulting in hypoventilation and hypoxemia may arise. We present the anaesthetic management of a 15-day-old infant who underwent surgical removal of a cystic hygroma located on the left side of the neck. Anaesthesia was induced by mask ventilation with sevoflurane in 100% oxygen and intubation was carried out while maintaining spontaneous ventilation. The endotracheal tube was sutured to the tip of the right lip to avoid movement or extubation. In addition to arterial cannulation for invasive blood pressure monitoring, central venous catheterization for perioperative fluid management was put in place. After 6 hours of surgery, the infant was transported to the neonatal intensive care unit and was extubated without difficulty the next day. Facial nerve injury was observed to be temporary.

A Case with Wolfram (DIDMOAD) Syndrome

Ozet Wolfram sendromu 1/770000 oraninda gorulen patogenezi tam olarak bilinme- yen otozomal resesif kalitimli, dismorfogenetik bir hastaliktir. DIDMOAD sendro- mu (Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy, and Deafness) olarak da isimlendirilen bu sendrom baslica diabetes insipitus, diabetes mellitus, optik at- rofi ve sagirlikla karakterizedir. Hastalar ilk olarak diabetes mellitus tanisi alir ve ardindan ilk onyilda optik atrofi, ikinci on yilda tabloya diabetes insipitus ve sen- sorinoral sagirlik eklenir. Daha sonra sirasiyla ucuncu on yilda uriner sistem ano- malileri ve dorduncu on yilda multipl norolojik anomaliler gorulur. Bu yazida, Wolf- ram sendromu tanisi konulup takip edilen 14 yasinda bir erkek hasta sunuldu. Olgu 9 yildir tip 1 diabetes mellitus tanisiyla izlenmekte iken, yapilan muayene ve la- boratuar tetkiklerinde norojen mesane, isitme ve gormede azalmanin eslik ettigi tespit edildi. Wolfram sendromu otozomal resesif gecis gosteren bir hastalik ol- dugundan, olgumuz, erken tani ve aile taramasinin oneminin vurgulanmasi ama- ciyla sunuldu. Abstract Wolfram syndrome, seen in 1/770000 of the population is an autosomal recessive dysmorphogenetical disease with unknown pathogenesis. It is characterized with the association of diabetes insipidus, diabetes mellitus, optic atrophy and deaf- ness, and also known as DIDMOAD (Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy, and Deafness). Patients demonstrate diabetes mellitus followed by optic atrophy in the first decade, diabetes insipidus and sensorineural deafness in the second decade, dilated renal outflow tracts early in the third decade, and multip - le neurological abnormalities early in the fourth decade. We present a boy 14 ye- ars old who had been followed-up with the diagnosis of Wolfram syndrome in this article. He had been followed-up with juvenile-onset diabetes mellitus for 9 years. Physical and laboratory exam revealed neurogenic bladder, deafness and optic de- fect. We emphasize the importance of family screening regarding the early diag- nosis of Wolfram syndrome in the other individuals of the family since the disea- se shows an autosomal recessive inheritance.