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    Comparison of growth factor levels in patients with normal and hypospadiac prepuce
    (Tubitak Scientific & Technical Research Council Turkey, 2011) Soyer, Tutku; Ayva, Ebru Sebnem; Atasoy, Pinar; Aslan, Mustafa Kemal; Cakmak, Ahmet Murat
    Aim: To compare the growth factor levels in patients with normal and hypospadiac prepuce. Materials and methods: Patients who underwent hypospadias repair were included in the study. The prepuce was excised after achieving successful hypospadias repair with satisfactory functional and cosmetic appearance. The patients who underwent preputial reconstructions and complicated repairs were excluded. The control group consists of boys without hypospadias. Elective circumcision was performed to have normal preputial samples. The VEGF levels, VEGF receptor (VEGFR) and TGF-beta receptor (TGF-beta-R) expressions were evaluated in preputial tissues by immunohistochemical analysis. Results: Fifteen patients were included in each group. The mean age of patients with normal and hypospadiac prepuce was 4.33 +/- 1.39 and 4.07 +/- 1.58, respectively (P>0.05). Although VEGF, VEGFR, and TGF-beta-R levels were decreased in hypospadiac prepuce, statistical significance was detected only in VEGF levels (P<0.05, Mann-Whitney U test). Conclusion: The decreased levels of VEGF obtained from patients with hypospadiac prepuce suggest a structural anomaly related with angiogenesis. This structural difference can be considered one of the factors causing impaired wound healing and recurrent complications after preputial reconstructions in hypospadias repair.
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    Comparison of the effect of contrast medium, air, and ozone on ischemia/reperfusion injury due to experimental intussusception model
    (Tubitak Scientific & Technical Research Council Turkey, 2013) Senyucel, Mine Fedakar; Ayva, Ebru Sebnem; Aslan, Mustafa Kemal; Boybeyi, Ozlem; Soyer, Tutku; Aksoy, Nurkan; Cakmak, Ahmet Murat
    Aim: To compare effects of contrast medium, air, and ozone on ischemia/reperfusion injury due to intussusception. Materials and methods: Thirty Wistar rats were allocated into five groups (n = 6). In the control group (CG), 2 cm of colonic segment, 5 cm distal to ileocecal valve, was removed. Intussusception was performed at 5 cm distal to the ileocecal valve by pushing a proximal intestinal segment distally by stile in experimental groups. One hour later, in the sham-operated group (SG), manual reduction was performed. In the reduction groups, reduction of intussusception was performed by contrast medium (CMG, 1/1 diluted omnipaqueR, infusion rate 2 mL/min), by air (AG, Pmax = 60 mmHg), or by ozone (OG, 10 mu g/mL, 0.5 mg/kg, Pmax = 60 mmHg). One hour after reduction, 2 cm of colonic segment was removed. Colonic tissues were evaluated for histopathological grades and oxidative injury markers (malondialdehyde [MDA], nitric oxide [NO], and total sulfhydryl [T-SH] values). Results: Mucosal injury score was significantly higher in AG then in CG or SG (P < 0.05). There was no difference regarding mucosal injury between the other groups (P > 0.05). MDA levels were significantly higher and NO levels were significantly lower in CMG, OG, and AG than in CG (P < 0.05). There was no difference between OG and the other experimental groups in both MDA and NO levels (P > 0.05). Conclusion: None of the reduction methods in intussusception have superiority over others in preventing ischemia/reperfusion injury.
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    The effect of extracorporeal shock wave lithotripsy on distribution of interstitial cells of Cajal in rabbit renal pelvis and proximal ureter
    (Tubitak Scientific & Technical Research Council Turkey, 2015) Boybeyi, Ozlem; Fedakar Senyucel, Mine; Ayva, Ebru Sebnem; Soyer, Tutku; Aslan, Mustafa Kemal; Basar, Mehmet Murad; Cakmak, Ahmet Murat
    Background/aim: An experimental study was performed to evaluate the effect of extracorporeal shock wave lithotripsy (ESWL) on the distribution of interstitial cells of Cajal (ICC) in rabbit renal pelvis and proximal ureter. Materials and methods: Six New Zealand rabbits were included. Right kidneys were exposed to a total of 3000 shock waves (14 kV) by using an electrohydraulic-type ESWL device. Right sides were allocated as the ESWL group (EG, n = 6) and left sides as the control group (CG, n = 6). Tissues were harvested on day 7. Tissues were examined histopathologically for the presence of edema, inflammation, congestion, hemorrhage, fibrosis, and vascularization. Mast cell tryptase and CD117 (c-kit) staining was performed for ICC distribution. Results: Although increased tissue edema in renal pelvises and increased inflammation in ureters were observed in EG, no statistical difference was detected between groups (P > 0.05). In CG, positive CD117 staining was detected in 2 renal pelvises and ureters. None of the EG samples showed CD117 staining and no statistical difference was detected between groups (P > 0.05). Conclusion: Rabbit does not appear to be a good model for investigating ICCs. ESWL may cause histopathological alterations in the renal pelvis and ureter. Since it has not been statistically proven, reduced contractility of the ureter after ESWL may not be attributed to altered distribution of ICCs in the renal pelvis and ureter.
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    Prevention of the harmful effects of free oxygen radicals by using N-acetylcysteine in testicular torsion
    (ELSEVIER SCI LTD, 2020) Tangul, Sevgi Ulusoy; Cakmak, Ahmet Murat; Caglayan, Osman; Bozdogan, Onder
    Introduction Testicular torsion is a urological emergency both in childhood and in adult life. Many studies on experimental testicular torsion have demonstrated biochemical and pathological ischemia reperfusion injury and the efficacy of some drugs have been investigated to prevent this damage. N-acetylcysteine (NAC) promotes glutathione synthesis and acts as a glutathione precursor because of the fact that it increases the glutathione-reductase activity by transporting sulfhydryl groups. Aim In this experimental study, the authors aimed to investigate the effectiveness of NAC in preventing ischemia-reperfusion injury following testicular torsion and detorsion. Study design For this experimental study, 36 albino Wistar-male rats were used. The rats were randomly divided into 4 groups: sham (n = 8), ischemia-reperfusion (n = 8), ischemia-NAC -reperfusion (n = 10), and ischemia-NAC-reperfusionNAC (n = 10) groups. Two hours of torsion and 4 h of detorsion were created in the left testis. After 4 h of detorsion, the rats were sacrificed. Each tissue was divided into two sections for biochemical and pathological examinations. Results There was a statistically significant difference between the study groups in terms of the total-sulfhydryl level, nitric oxide level, and the malondialdehyde values. Histopathological examination revealed that NAC was effective in preventing reperfusion injury in the testis but ineffective in preventing the reduction in the spermatid count. Discussion The results of this experimental study support that NAC can histopathologically maintain the structure of seminiferous tubules against ischemis reperfusion injury and prevent damage to the germinative cells. However, it was unable to prevent the reduction in spermatid count. There was no significant difference in the prevention of ischemiareperfusion injury between NAC administration during the first hour of ischemia and NAC administration during reperfusion. Although NAC can prevent tissue damage from ischemia reperfusion injury, it is not effective against the reduction in the spermatid count. Conclusion N-acetylcysteine may be biochemically effective in preventing ischemia-reperfusion injury after testicular torsion and detorsion. NAC is a readily available and easy to use agent that can be used during testicular ischemia.