低温、地塞米松对大鼠睾丸扭转复位后生殖细胞凋亡和抗氧化酶活性的影响

目的探讨低温、地塞米松因素对大鼠睾丸扭转复位后的保护作用以及对生殖细胞凋亡的影响。方法本实验采用2×2析因设计。50只健康青春期SD雄性大鼠随机分成五组：A组为扭转组;B组为扭转加低温组;C组扭转加激素组;D组扭转加激素加低温组;E组对照组。每组10只。建立单侧睾丸扭转模型。每组根据设定处理方式的不同分别进行处理。复位后36h,采集左侧睾丸并行生化指标（SOD,CAT活性及MDA含量）检测;免疫组织化学法检测生精细胞凋亡指数（AI）,光镜下观察睾丸组织学变化。结果低温因素与地塞米松因素之间有交互效应。低温、地塞米松因素单独作用时对扭转睾丸有保护作用。结论低温和地塞米松共同作用能更好的减少生精细胞的凋亡,提高抗氧化酶系统的抗氧化能力,改善扭转睾丸的生存能力。     

Duration of symptoms is the only predictor of testicular salvage following testicular torsion in children: A case-control study

ObjectiveTesticular torsion (TT) is an emergency requiring a prompt diagnosis and surgery to avoid irreversible changes and a complete loss of testis. The present study aimed to identify potential factors that may be predict a testicular salvage after TT in pediatric patients.MethodsConsecutive medical records of all children ≤16 years old with surgically confirmed TT over a period of five years (2011–2016) were collected. Patients were divided into 2 groups according to testicular viability and the type of treatment: Orchidectomy and orchidopexy. The differences between the two groups and potential predictors of testicular salvage were analyzed.ResultsThirty-one boys with TT met the inclusion criteria and were included in the study. The mean age was 13.6 years (range, 10 days - 15.8 years). Testicular salvage was possible in 18 (58.1%) patients. The duration of symptoms and a lesser degree of torsion indicated a testicular salvage in children and adolescents with testicular torsion, but in multivariate analysis only duration of symptoms (time to surgical detorsion) was significantly associated with the risk of non-salvage. At follow-up, testicular atrophy affected 73.3% of the patients treated with orchidopexy.ConclusionDuration of symptoms is the only predictor of successful testicular salvage following testicular torsion in children. It is associated with a substantial risk of testicular loss and atrophy.     

The effect of vitamin E on ipsilateral and contralateral testis following unilateral testicular torsion in rats

An experimental study was conducted to investigate the role of lipid peroxidation in ipsilateral and contralateral testicular reperfusion injury following unilateral testicular torsion (TT) and the effect of vitamin E in the management of this injury. Fifty adult male Sprague-Dawley rats were divided into five equal groups. Bilateral orchiectomy was performed immediately in group 1, and 3 h after unilateral TT in group 2. In group 3, both testes were harvested 3 h after a sham operation. In groups 4 and 5, unilateral TT, detorsion after 3 h and bilateral orchiectomy after 6 h were performed. Vitamin E was given before detorsion in group 4 and after detorsion in group 5. The levels of malondialdehyde (MDA) were meas-ured as an index of lipid peroxidation in all testes. There were no significant differences between right and left testes within groups or between right or left testicular MDA values in different groups. The results suggest that lipid peroxidation does not play an important role in ipsilateral and contralateral testicular injury following unilateral TT and that vitamin E given before or after detorsion of testes is not useful in preventing testicular reperfusion injury.     

Ultrasound-Guided Manual Testicular Detorsion in the Emergency Department

BackgroundScrotal ultrasound helps in the rapid diagnosis of complete testicular torsion and assessment of alternative causes of acute scrotal pain. Early detection of torsion of the testis and reperfusion, either manually or surgically, is paramount to preserving testicular viability. Manual detorsion also offers immediate symptom relief by alleviating ischemia. Bedside ultrasound performed by a trained emergency physician (EP) can significantly reduce the time to diagnosis and reperfusion by means of performing an ultrasound-guided manual detorsion in the emergency department (ED).Case ReportWe report two cases of ultrasound-guided manual detorsion of testis that were performed successfully by EPs in the ED. After manual detorsion, both patients underwent nonemergent orchidopexy and recovered well after surgery.Why Should an Emergency Physician Be Aware of This?Manual testicular detorsion is a simple, safe, and effective maneuver that can be performed in the ED by EPs. Bedside ultrasound is helpful in confirming the diagnosis of complete torsion of the testicle (no blood flow) and successful reperfusion after manual detorsion. We recommend EPs be trained to perform scrotal ultrasound and manual detorsion of a torted testicle. We strongly emphasize that manual detorsion of the testes is not a substitute for definitive surgical management and should only be used as a temporary measure for reperfusion to allow more time to organize the logistics of surgery, which can be critical in remote settings.     

超声造影评价多途径联合干预兔睾丸不全缺血再灌注损伤的研究

目的探讨地塞米松、维拉帕米联合持续低流量复灌注保护兔单侧睾丸不全缺血扭转复位后缺血再灌注损伤（IRI）的超声表现及相关机制。 方法30只健康成年雄性兔,随机分成对照组、地塞米松组（DS组）、维拉帕米组（VP组）、30 s持续低流量复灌注后处理组（H组）和联合处理组（L组）,每组6只,在超声监控下制成单侧睾丸不全缺血模型。对照组直接完全复灌注,其他处理组分别于耳缘静脉注射地塞米松、维拉帕米、实行30 s持续低流量复灌注处理及3种方法的联合处理10 min后,完全复灌注。再灌注前和3 d后分别行超声造影,分析峰值强度（PI）、达峰时间（TTP）、平均通过时间（MTT）、曲线下面积（AUC）。3 d后取术侧睾丸组织检测睾丸丙二醛（MDA）含量、超氧化物歧化酶（SOD）活性、黄嘌呤氧化酶（XOD）活性及低氧诱导因子-1α（HIF-1α）蛋白含量。 结果再灌注前,各组术侧睾丸超声造影参数比较,差异均无统计学意义（F_PI=0.85、F_TTP=1.31、F_MTT=1.84、F_AUC=0.60,P值均>0.05）;超声造影时间-强度曲线呈现"慢进慢退"现象。再灌注3 d后,对照组术侧睾丸超声造影呈"快进慢退"现象,L组呈"同进同退"现象。术侧睾丸组织,各处理组MDA含量降低、SOD活性增高、XOD活性降低、HIF-1α蛋白含量增高,差异具有统计学意义（F_MDA=13.62、F_SOD=61.16、F_XOD=9.23、F_HIF-1α=57.64,P值均<0.01）;L组较H组,SOD活性升高、XOD活性降低（t=2.94、4.26,P值均<0.01）,L组较DS组,XOD活性降低、HIF-1α蛋白含量增高（t=2.64,P<0.05;t=6.47,P<0.01）,L组较VP组,HIF-1α蛋白含量增高,差异具有统计学意义（t=3.45,P<0.01）。 结论超声微泡造影可实时动态观察睾丸扭转复位后组织微循环变化,地塞米松、维拉帕米和持续低流量复灌注对睾丸不全扭转复位后IRI的干预效果不同,多种途径联合治疗IRI效果更好。     

药物对大鼠睾丸缺血-再灌流后生精功能的影响

目的探讨药物对大鼠睾丸缺血-再灌流后生精功能的影响。方法雄性SD大鼠32只,随机分成假手术组、扭转组、己酮可可碱组和维拉帕米组,每组8只,建立睾丸扭转动物模型。各组于复位前 15 min分别静脉注射生理盐水、己酮可可碱和维拉帕米,术后24 h留取手术侧睾丸。应用流式细胞术 (FCM)检测各组生精细胞凋亡和各级生精细胞计数,测定组织内丙二醛(MDA)含量、髓过氧化物酶 (MPO)和超氧化物歧化酶(SOD)活性。结果与扭转组相比,已酮可可碱组和维拉帕米组生精细胞凋亡明显减少,单倍体细胞群计数显著增多,超氧化物歧化酶活性回升,丙二醛含量和髓过氧化物酶活性下降, 其差异有显著性(P<0．05)。结论已酮可可碱和维拉帕米对睾丸缺血-再灌流后的生精能力具有明显的保护作用。     

Pretreatment with melatonin protects against cyclophosphamide‐induced oxidative stress and renal damage in mice

Cyclophosphamide (CP) is widely used in treatment of different cancers. Nephrotoxicity is one of the dose‐limiting side effects of CP. This study was carried out to investigate the effect of melatonin (MEL) on CP‐induced nephrotoxicity in mice. In this study, 50 Swiss albino mice (20–25 g) were randomly divided into five groups. Mice were pretreated with MEL intraperitoneally (i.p) in doses of 5, 10 and 20 mg/kg for five consecutive days, and CP (200 mg/kg, i.p) was administrated on the 5th day 1 h after the last dose of MEL. Then on day 6, blood samples were collected to determine serum creatinine (Cr) and blood urea nitrogen (BUN) levels. The kidneys were used for histological examination, biochemical assays and real‐time PCR studies. Malondialdehyde (MDA), glutathione (GSH), protein carbonyl (PC), nitric oxide (NO) level, catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx) and myeloperoxidase (MPO) activity were assessed in renal tissue. In addition, the expression of SOD2 and PGx1 was measured using real‐time PCR method in renal tissue. Results showed that CP administration significantly increases Cr, BUN, MDA, PC, NO level and MPO activity. It also decreases renal GSH level, SOD, GPx and CAT activity. Pretreatment with MEL (especially 20 mg/kg, i.p.) for 5 days prevented these changes; however, it did not affect the SOD activity. Our results revealed that MEL might be useful for prevention of the nephrotoxicity induced by CP through ameliorative effects on biochemical indices and oxidative stress parameters.     

彩色多普勒超声对睾丸扭转后存活力的预测价值

目的 探讨彩色多普勒超声(CDU)预测睾丸存活力的临床价值.方法 比较42例睾丸扭转患者的临床表现、术中所见及手术前后阴囊CDU表现,将术中睾丸活力分为A～D级,保留A～C级活力睾丸,切除D级活力睾丸.将CDU随访的术后睾丸存活力分为Ⅰ～Ⅲ级,Ⅰ～Ⅱ级睾丸存活,III级睾丸萎缩.结果 42例中睾丸复位17例,切除25例.复位组睾丸存活7例,术中睾丸活力分别为A级2例,B级3例,C级2例,术前CDU主要表现为:睾丸实质回声均匀,血供减少或消失;睾丸局部片状或放射状低回声,大部分实质尚存血供.萎缩10例,术中睾丸活力分别为C级8例,D级2例,术前CDU(包括切除组25例)主要表现为睾丸大片放射状低同声或弥漫性明显回声不均匀,无或仅睾丸边缘少量血供.复位组与切除组的健侧睾丸CDU随访无明显异常发现.结论 阴囊CDU检查能够预测复位后睾丸的存活力,CDU评价后及时手术是提高扭转睾丸存活力的关键.     

超声造影在评价缺血后处理对兔睾丸完全扭转复位后保护效应中的应用

目的 评价缺血后处理对兔睾丸完全扭转的保护效应及超声造影的应用价值.方法 40只成年健康大白兔随机分成对照组、直接复灌组(R组)、缺血后处理组(IP1组,IP2组,IP3组),每组8只.将R、IP1、IP2、IP3各组左侧睾丸血流完全阻断4h后,R组给予直接灌流,IP1组行复灌15 s/再缺血15 s,IP2组行复灌30 s/再缺血30 s,IP3组行复灌45 s/再缺血45 s,各组反复3次.于术前及术后3d行超声造影,分析各组造影参数,包括速度参数(β)、达峰时间(TTP)、峰值基础强度差(PBD)、峰值减半时间(DT/2)的变化,3d后检测术侧睾丸组织丙二醛(MDA)含量及超氧化物歧化酶(SOD)活性,Tunel法检测细胞凋亡指数(AI),电镜下观察睾丸组织超微结构,并对各组进行对比研究.结果 R、IP1、IP2、IP3组术侧睾丸DT/2均较对照组显著延长(P＜0.05),IP1、IP2组PBD较对照组升高(P＜0.05),R、IP3组PBD与对照组无显著差别(P＞0.05).IP1、IP2组MDA含量显著低于R、IP3组(P＜0.05),SOD活性显著高于R、IP3组(P＜0.05).光镜下Johnsen's评分IP1、IP2组间无显著差别(P＞0.05),并且均显著高于R、IP3组(P＜0.05),R组高于IP3组,差别有统计学意义(P＜0.05).IP1组AI略低于IP2组,差别有统计学意义(P＜0.05),且两组均明显低于R、IP3组(P＜0.05).电镜观察,各组超微结构损伤程度无明显差别.结论 缺血后处理可明显改善完全扭转睾丸复灌后微循环功能,减轻再灌注损伤.超声造影可对缺血后处理的效果进行评价.     

单侧睾丸扭转后对侧睾丸损伤的超声造影实验研究

目的 探讨超声造影在单侧睾丸扭转后对侧睾丸损伤诊断中的应用价值.方法 28只新西兰雄性家兔,随机分为对照组、3 h复位组、6 h复位组、24 h复位组、不复位组,对照组8只,其他组每组5只.扭转组于扭转前、扭转后即刻、复位前、复位后即刻及延迟时段(复位后6～12 h,不复位组亦于相应时间)各进行一次实时超声造影;对照组于手术前、后各进行一次实时超声造影.绘制时间一强度曲线,分析造影显影时间(AT)、达峰时间(TTP)、峰值强度(PI)及峰值降半时间(HT)等时间一强度曲线参数的变化.结果 ①对照组手术前、后比较,对侧睾丸AT、TTP、PI、HT的差别均无统计学意义(P＞0.05);②扭转组扭转后与扭转前比较,对侧睾丸灌注增加,主要表现为PI增高(P＜0.05);③单侧睾丸扭转时间越长,对侧睾丸灌注增加越明显.结论 超声造影时间一强度曲线分析对研究单侧睾丸扭转后对侧睾丸的损伤情况有重要价值.     

Oxidative stress in patients with asthma and its relation to uncontrolled asthma

This study aims to evaluate markers of oxidative stress in Tunisian asthmatic patients and investigate whether their markers are correlated with uncontrolled asthma.This prospective cohort study was conducted on 48 healthy subjects and 60 patients with asthma (34 patients with controlled asthma and 26 patients with uncontrolled asthma). The levels of malondialdehyde (MDA), advanced oxidation protein products (AOPP), and glutathione (GSH), as well as the activities of glutathione peroxidase (GPx) and superoxide dismutase (SOD), were estimated in plasma by spectrophotometry.Asthmatic patients have significantly higher plasmatic levels of MDA and AOPP than healthy controls (p < 0.001). Lower GSH level and GPx activity were found in patients with asthma compared to controls (p < 0.001). In contrast, higher SOD activity was noted in asthmatic patients (p < 0.001).The comparison among the patients with controlled asthma and uncontrolled asthma revealed increased MDA and AOPP levels and SOD activity (p < 0.001) as well as a decreased GSH level and GPx activity (p = 0.004, p = 0.019) in patients with uncontrolled asthma. Spirometry level was significantly correlated with SOD activity (r = 0.447; p = 0.010), whereas no significant correlations were found with the other parameters (MDA, AOPP, GSH, and GPx).Asthmatic patients, especially those with uncontrolled asthma, suffer a high degree of reactive oxygen species (ROS) formation causing considerable oxidative stress. Increased MDA level and SOD activity and reduced GPx activity were predictors of poorly controlled asthma.     

Assessment of Circulating Biochemical Markers in Mice Receiving Cinnamon and Glycyrrhizin Under Carbon Tetrachloride Induced Hepatic Injury

The study evaluated the hepatoprotective activity of plant extracts of cinnamon and glycyrrhizin in distinct dosage ways to minimize the oxidative stress induced by carbon tetrachloride (CCl₄) in BALB/cJ inbred albino mice. Fifteen albino mice were divided into five groups, each group containing three mice. Group A was referred as positive control while group B, C, D and E were injected intraperitoneally with 1 mL/kg body weight of CCl₄ twice a week for 1 month. Group C and D were treated orally with isolated extracts of cinnamon @50 mg/kg and glycyrrhizin @50 mg/kg respectively on daily basis for 1 month. However, group E was treated orally with combination dose of cinnamon @50 mg/kg + glycyrrhizin @50 mg/kg body weight. The increase in the levels of alanine transaminase (ALT), aspartate transaminase (AST) and alkaline phosphatase (ALP), triglyceride (TG), malondialdehyde (MDA) and glucose were recorded in CCl₄ induced liver injury in mice while there is decrease in the levels of total protein (TP), reduced glutathione (GSH), Superoxide dismutase (SOD) and catalase (CAT) in CCL₄ intoxicated mice. Isolated therapy of plant extracts of cinnamon and glycyrrhizin decreased the levels of ALT, AST, ALP, MDA, TG and glucose whereas increase in TP, GSH, SOD and CAT was observed in plant extracts treated mice. The best restoration of all the above said parameters near to control was observed in group of mice treated with combination dose of cinnamon and glycyrrhizin @50 mg/kg. Therefore, the present study declared the antioxidative, anti-inflammatory and hepatoprotective activity of standardized extracts of cinnamon and glycyrrhizin and their potent defensive property.

     

牛磺酸对大鼠睾丸缺血再灌注损伤的影响

目的：睾丸扭转复位后的损伤是一种缺血再灌注损伤。本研究旨在探讨牛磺酸对睾丸缺血再灌注损伤的影响。方法60只成年雄性SD大鼠随机分为三组，对照组作左侧睾丸假手术；缺血再灌注组作左侧睾丸扭转，2h后复位；治疗组与缺血再灌注组用一样的外科手术，治疗组术后给予牛磺酸静脉注射，复位后4h或3个月行睾丸切除术，分析睾丸髓过氧化物酶活性（反映中性粒细胞数目的指标）、丙二醛水平（活性氧标志）和睾丸生精功能。结果单侧睾丸扭转复位引起该侧睾丸髓过氧化物酶活性、丙二醛水平明显升高，睾丸生精功能显著降低，牛磺酸治疗后睾丸髓过氧化物酶活性和丙二醛水平得到降低，睾丸生精功能得到显著提高。结论牛磺酸对睾丸缺血再灌注损伤具有明显的保护效应，该效应可能与减少睾丸内中性粒细胞数目和活性氧产生有关。     

超声技术在治疗睾丸扭转/复位损伤中的作用

最新研究发现,药物治疗可减轻早期睾丸扭转/复位的缺血再灌注损伤,减少后期睾丸萎缩发生率,但损伤严重的扭转侧睾丸仍然必须手术切除.超声有助于判断睾丸扭转的损伤程度,并能预测复位后睾丸功能恢复的可能性,对睾丸扭转的治疗有指导作用.     

Effect of DHA+EPA on oxidative stress and apoptosis induced by ischemia‐reperfusion in rat kidneys

Apoptosis, as well as necrosis, has an important role in post‐ischemic renal pathology. The effect of pretreatment with Docosahexaenoic acid+Eicosapentaenoic acid (DHA+EPA) on renal injury and apoptotic protein expression was evaluated. Right nephrectomy was completed on male Wistar rats (255–300 g). The rats received DHA+EPA (200 mg/kg/day) of distilled water orally for 14 days before ischemia reperfusion (IR) or sham operation. A total of 81 rats were divided into three main groups with 6, 24 and 48 h of post‐operation or reperfusion period. Serum creatinine (SCr), BUN, creatinine clearance (CCr) and fractional excretion of sodium (FE_Na) were measured. Tissue levels of malondialdehyde (MDA), superoxide dismutase (SOD) and catalase (CAT) activities, Bax and Bcl‐2 protein expressions and renal histological injury were determined. SCr, BUN and FE_Na increased 6–48 h of reperfusion (P < 0.01). Tissue MDA content and Bax expression increased (P < 0.01) and CAT and SOD activities decreased (P < 0.05) in the IR group. DHA+EPA decreased SCr and BUN, FE_Na, tissue MDA levels (P < 0.05 vs. IR) and increased CAT and SOD activities and Bcl‐2 expression (P < 0.05 vs. IR) for 6–48 h after ischemia. IR induced mild (6 h, P < 0.05) and severe (24–48 h, P < 0.01) tissue damage. Mild‐to‐moderate tissue damage was observed in DHA+EPA groups from 6 to 48 h of reperfusion period (P < 0.05 vs. IR, 24–48 h). In conclusion, the results suggest that pre‐ischemic exposure to DHA+EPA could improve the outcome of early graft function by inhibition of IR‐induced oxidative stress and apoptosis.     

Berberine inhibits the ischemia-reperfusion induced testicular injury through decreasing oxidative stress

PurposeThe aim of this study was to investigate the effect of berberine (BBR) on oxidative stress in an experimental testicular I/R injury model.MethodsEighteen rats were divided into three groups: control group, torsion-detorsion (T/D) group, and BBR + T/D group. In the pre-treatment of the BBR group, 200 mg/kg BBR was given intraperitoneally 30 min before detorsion. Tissue malondialdehyde (MDA), total oxidant status (TOS), and total antioxidant status (TAS) levels were determined using colorimetric methods. Histological evaluation of the tissue samples was evaluated using hematoxylin-eosin staining.ResultsIn T/D group, tissue MDA, TOS, and oxidative stress index levels were higher than control group. These increases were significantly reversed with BBR pre-treatment. Although Johnsen scores were lower in T/D group than the control group, BBR pre-treatment recovered the Johnsen scores.ConclusionThese results suggest that BBR can inhibit I/R-induced testicular injury by suppressing oxidative stress. Further studies may prove that BBR is a useful agent as an adjunctive treatment in surgical repair in human cases.     

人参皂甙Rg1对大鼠海马神经元缺糖氧/复糖氧后氧化损伤的保护作用

目的观察人参皂甙Rg1 对大鼠海马神经元缺糖氧/复糖氧后谷胱甘肽(GSH)和谷胱甘肽过氧化物酶(GPx)的影响。方法海马神经元培养8~10 d,随机分为正常对照组、模型组、人参皂甙Rg1 低、中、高剂量组(5 μmol/L, 20 μmol/L, 60 μmol/L)。建立大鼠海马神经元缺糖氧/复糖氧模型,复糖氧后6 h 以生物化学法观察各组海马神经元GSH含量和GPx活性的变化;复糖氧后24 h 以Hochest 染色法检测细胞凋亡,并检测各组海马神经元四甲基偶氮唑盐(MTT)代谢率。结果与模型组相比,人参皂甙Rg1中、高剂量组海马神经元GSH含量、GPx活性显著升高,凋亡显著减少,MTT代谢率显著提高(P<0.001),人参皂甙Rg1 低剂量组变化不明显(P>0.05)。结论人参皂甙Rg1 可通过提高缺糖氧神经元GSH含量和GPx活性,发挥脑保护作用。     

左旋精氨酸对兔肺缺血/再灌注损伤时细胞凋亡的影响

目的观察左旋精氨酸对免肺缺血／再灌注损伤中细胞凋亡的影响。方法复制单侧免肺缺血／再灌注损伤模型．随机分为三组：对照组（C组）、缺血／再灌注组（I／R组）和左旋精氨酸组（L—Arg组），每组10只。再灌注180min时取肺组织，观察超氧化物歧化酶（SOD）活性、丙二醛（MDA）浓度、一氧化氮（NO）含量、肺湿干比（W／D）、肺泡损伤数定量评价指标（IQA）及肺组织细胞凋亡指数（At）。结果I／R组与C组比较，SOD活性、NO含量明显降低（P〈0．01），MDA、W／D、IQA、AI明显升高（P〈0．01），L—Arg组与I／R组相比较，SOD活性、NO含量均明显升高（P〈0．01），MDA、W／D、IQA、AI不同程度降低（P〈0．05）。结论左旋精氨酸可通过提高体内NO水平、降低氧自由基水平、减轻脂质过氧化反应，抑制肺组织细胞凋亡，从而减轻肺损伤。     

Testicular torsion

Each year, testicular torsion affects one in 4,000 males younger than 25 years. Early diagnosis and definitive management are the keys to avoid testicular loss. All prepubertal and young adult males with acute scrotal pain should be considered to have testicular torsion until proven otherwise. The finding of an ipsilateral absent cremasteric reflex is the most accurate sign of testicular torsion. Torsion of the appendix testis is more common in children than testicular torsion and may be diagnosed by the "blue dot sign" (i.e., tender nodule with blue discoloration on the upper pole of the testis). Epididymitis/orchitis is much less common in the prepubertal male, and the diagnosis should be made with caution in this age group. Doppler ultrasonography may be needed for definitive diagnosis; radionuclide scintigraphy is an alternative that may be more accurate but should be ordered only if it can be performed without delay. Diagnosis of testicular torsion is based on the finding of decreased or absent blood flow on the ipsilateral side. Treatment involves rapid restoration of blood flow to the affected testis. The optimal time frame is less than six hours after the onset of symptoms. Manual detorsion by external rotation of the testis can be successful, but restoration of blood flow must be confirmed following the maneuver. Surgical exploration provides definitive treatment for the affected testis by orchiopexy and allows for prophylactic orchiopexy of the contralateral testis. Surgical treatment of torsion of the appendix testis is not mandatory but hastens recovery.     

Effects of aminoguanidine and melatonin on intestinal ischemia/reperfusion injury in rats: An assessor-blinded, controlled experimental study

Background: The reactive oxygen and nitrogen species generated during reperfusion of tissue are characteristic of intestinal ischemia and reperfusion (IIR) injury.Objective: This study was designed to assess whether the administration of aminoguanidine (AG), a selective nitric oxide synthase inhibitor, and/or melatonin has protective potential in IIR injury.Methods: Male Wistar albino rats (age, 3–4 weeks; weight, 100–150 g) were divided in a nonrandom fashion into 5 groups of equal size: group 1, IIR injury + AG 100 mg/kg; group 2, IIR injury + melatonin 10 mg/kg; group 3, IIR injury + AG 100 mg/kg + melatonin 10 mg/kg; group 4, sham operation; and group 5, IIR injury alone. Sixty minutes of intestinal ischemia and 4 hours of reperfusion were carried out in all but the sham-operation group. Ileal specimens were obtained from all rats to determine the extent of histologic changes, measure tissue concentrations of malondialdehyde (MDA) and protein carbonyl (PC), and assess the activity of superoxide dismutase (SOD) and glutathione peroxidase (GPx). Specimens were also assessed and scored by a pathologist blinded to the experiment and the data.Results: Forty rats were divided into 5 groups of 8 each; all 40 survived until study end. In the IIR injury-alone group, mean (SD) MDA concentration and PC content were significantly higher than that of the sham-operation group, and SOD and GPx activity were significantly lower: MDA concentration, 0.86 (0.03) versus 0.54 (0.01) mmol/g protein, respectively; PC content, 0.60 (0.02) versus 0.34 (0.01) mmol/g protein; SOD activity, 104.33 (43.14) versus 2954.72 (109.55) U/g protein; and GPx activity, 10.44 (0.63) versus 24.34 (1.77) U/g protein (all, P < 0.001). Administration of AG, melatonin, and the AG/melatonin combination was associated with significantly higher SOD (1802.31 [102.35], 1776.50 [58.41], and 1924.28 [98.10] U/g protein, respectively) and GPx (17.36 [1.23], 15.96 [1.08], and 18.06 [1.72] U/g protein) activity and significantly lower MDA concentration (0.62 [0.02], 0.64 [0.02], and 0.56 [0.01] mmol/g protein) and PC content (0.53 [0.03], 0.51 [0.01], and 0.49 [0.02] mmol/g protein) compared with the IIR injury-alone group (P < 0.001). Mean intestinal mucosal injury scores were significantly lower in the 3 treatment groups (2.12 [0.35], 1.75 [0.46], and 1.12 [0.35]) compared with the IIR injury-alone group (3.87 [0.35]; all, P < 0.001).Conclusion: In this study, AG, melatonin, or both administered in combination were associated with improvements in oxidative markers in this rat model of IIR injury.