The protective effect of selenium on ipsilateral and contralateral testes in testicular reperfusion injury

This study was designed to investigate the effect of selenium on ipsilateral and contralateral testicular damage after unilateral testicular torsion/detorsion (T/D). Thirty-two male rats were divided into four groups, each containing eight rats. Torsion was created by rotating the right testis 720° in a clockwise direction. Group 1 underwent sham operation to determine basal values for biochemical and histopathological evaluation. Sham operation was performed in group 2, and sodium selenate (0.2 mg/kg) was given intraperitoneally. Group 3 served as a T/D group, receiving 4-h torsion and 4-h detorsion. Similarly, in group 4 sodium selenate (0.2 mg/kg) was injected intraperitoneally 20 min before detorsion. Bilateral orchiectomies were performed for measurement of tissue malondialdehyde (MDA) levels and superoxide dismutase (SOD) activities and histopathologic examination. The results were compared statistically. The highest MDA and the lowest SOD values were determined in both testes in group 3. There were statistically significant differences in MDA levels and SOD activities in group 3 compared with group 4. Specimens from group 3 had a significantly greater histologic injury than other groups. These results suggest that ischemia-reperfusion injury occurred in both testes after unilateral testicular T/D and that selenium administration before detorsion prevents reperfusion injury in testicular torsion.     

Resveratrol reduces ischemia reperfusion injury after experimental testicular torsion.

The aim of the study was to evaluate the effects of resveratrol on testicular ischemia reperfusion injury. Forty Wistar albino rats were divided into 4 groups. Torsions (ischemia) were created by rotating the right testis 720 degrees in a clockwise direction for 4 hours in all groups except the control group. In the torsion group after 4 hours' ischemia bilateral orchiectomy was performed. In the detorsion group, saline was injected by an intraperitoneal route, 30 min before detorsion (reperfusion). In the resveratrol group, 30 mg/kg resveratrol was injected by an intraperitoneal route, 30 min before detorsion. In the detorsion and resveratrol groups, the bilateral testes were removed after 20 hours of detorsion. In all groups, the tissue levels of malondialdehyde (MDA) and glutathione (GSH) and histological changes were determined. In rats treated with resveratrol, MDA levels (138 +/- 25 nmol/mg protein) were significantly decreased compared with torsion (426 +/- 178 nmol/mg protein) and detorsion (370 +/- 76 nmol/mg protein) groups (p < 0.05). GSH levels (6.54 +/- 0.8 micromol/g wet tissue) were significantly increased compared with torsion (4.61 +/- 0.4 micromol/g wet tissue) and detorsion groups (5.24 +/- 0.9 micromol/g wet tissue) (p < 0.05). The mean testicular tissue injury score in the resveratrol group was significantly lower than in torsion and detorsion groups (p < 0.05). The present study demonstrates that intraperitoneal administration of resveratrol in rats may protect testis against injury associated with reperfusion.     

Rosuvastatin Prevents No-Reflow Phenomenon Due to Detorsion of Testicular Torsion

PurposeTreatment of testicular torsion by detorsion may further damage the testis due to ischemia/reperfusion (I/R) injury. After reestablishment of blood flow, the blood flow diminishes after a while, which is called as the no-reflow phenomenon. Rosuvastatin, a HMG-CoA reductase inhibitor, has “pleiotropic” vasculoprotective effects that include anti-inflammatory and antioxidant effects. This study was designed to determine the effect of rosuvastatin pretreatment on the I/R injury induced no-reflow phenomenon encountered after detorsion of testicular torsion.Material and MethodsWistar albino rats were used in the study. Blood flow of testis were measured before the torsion (baseline value), before the detorsion and 1 hour after detorsion using Laser Doppler flowmetry. Rats were divided into three groups. Sham group (n = 5): Basal blood flow, flow before detorsion, and flow after detorsion of the testis was determined. Torsion/detorsion group (n = 8): After 2 hours torsion of the testis, blood flow before and after detorsion was determined. Torsion/detorsion + rosuvastatin group (n = 8): After measurement of the basal blood flow, Rosuvastatin (10 mg/kg) was injected intraperitoneally 30 minutes before the detorsion of 2 hour torsion and blood flow before and after detorsion was determined.ResultsThere was no significant difference between the the baseline blood flow values of the groups. Blood flow decreased significantly after the torsion. One hour after the detorsion, mean blood flow of the torsion/detorsion + Rosuvastatin group was found significantly higher than the torsion/detorsion group.ConclusionsPretreatment with Rosuvastatin before detorsion prevents reperfusion injury induced no-reflow phenomenon after detorsion of testicular torsion.     

西地那非对大鼠单侧睾丸扭转后对侧睾丸的影响及作用研究

目的 探讨大鼠单侧睾丸扭转后对侧睾丸的损伤以及西地那非（万艾可）的保护机理.方法 将72只健康雄性SD大鼠,随机分为假手术组、安慰剂组、西地那非组.3组分别在假手术/左侧睾丸扭转复位术后4 h、24 h、2周时,各组各处死8只大鼠.分别观察右侧睾丸组织病理学变化、测定右侧睾丸组织中MDA、NO/NOS含量.结果 术后4 h,各组间组织病理学变化、MDA、NOS含量无明显差异,睾丸组织未见损伤,但NO在两地那非组较假手术组、安慰剂组明显增加（P〈0.05）.术后24 h,假手术组右侧睾丸组织损伤最小,西地那非组较严重,安慰剂组最为严重;与假手术组比,其余两组MDA、NO/NOS含量明显升高（P〈0.05）;西地那非组NO/NOS含量与安慰剂组相比明显下降（P〈0.05）;术后2周时,睾丸组织损伤有不同程度恢复,但仍以安慰剂组最为严重;与假手术组比,其余两组MDA、NO/NOS含量仍然升高（P〈0.05）;西地那非组NO/NOS含量与安慰剂组相比明显下降（P〈0.05）.结论 大鼠单侧睾丸扭转复位后,对侧睾丸组织术后4 h时.睾丸组织未见损伤.12 h后睾丸组织明显损伤,并且持续至2周后.早期应用适量西地那非（万艾可）可促局部NO增加,扩血管作用加强,拮抗交感神经缩血管作用,进而保护对侧睾丸.     

Effect of Lomodex–MgSO4 in the prevention of reperfusion injury following unilateral testicular torsion: an experimental study in rats

Fertility in patients treated for unilateral testicular torsion has been shown to be significantly reduced in all the reported series to date, implying that the present-day treatment requires further refinement in the form of adjunct pharmacotherapeutic intervention (Lomodex and MgSO₄) in addition to scrotal exploration. Prepubertal Holtzman strain rats (35 days old) were used for our study. Two sets were formed with six groups of rats in each set. Rats were treated as follows: group 1, sham-operated group; group 2, torsion (4 h); group 3, torsion + detorsion (1 h); group 4, torsion + ATP–MgCl₂ + detorsion; group 5, torsion + Lomodex–MgSO₄ + detorsion; group 6, torsion + normal saline + detorsion. Whereas the first set of animals was sacrificed immediately at the end of experiment, animals in set 2 were sacrificed 8 weeks after the end of the experiment to look for the development of antisperm antibodies. Parameters studied were thiobarbituric acid reductase (TBAR) assay, histology of testicular tissue, and sperm agglutination test. Students t-test was used for significance. With detorsion (149.95±30.68) there was a significant rise in the TBAR values (P<0.05) compared with torsion (57.39±14.47). Treatment with both Lomodex–MgSO₄ (40.74±6.39) and ATP–MgCl₂ (48.30±18.35) yielded TBAR levels comparable to those in the sham group (31.35±11.96). Similar injury was also seen on the contralateral testis, with detorsion (114.28±10.68) much more detrimental than torsion (40.59±15.02) and rescue seen following treatment with Lomodex–MgSO₄ (27.55±8.64) as well as ATP–MgCl₂ (38.61±12.23). Regarding th histology, with detorsion there was evidence of severe distortion of tubules, with almost all the tubules showing maturation arrest and a few tubules completely devoid of any germinal cells. Treatment with Lomodex–MgSO₄ as well as ATP–MgCl₂ showed preservation of tubular morphology. Our study failed to document the presence of agglutinating antibodies (antisperm antibodies) in any of the groups. Unilateral testicular torsion has bilateral effects and is a form of ischemia–reperfusion injury. Treatment of torsion by detorsion alone does not prevent testicular damage. The results of the present study show that administration of Lomodex + MgSO₄ prior to detorsion results in prolonged testicular salvage with a potential of subsequent improvement in semen quality and fertility and reduction in long-term morbidity. The presence of agglutinating antibodies could not be detected in the present study.     

别嘌呤醇对睾丸扭转的治疗作用

目的 研究睾丸扭转以后组织的受损情况，观察别嘌呤醇药物对睾丸扭转的治疗意义。方法 以大鼠为研究对象，测定一侧睾丸扭转后两侧睾丸组织的脂质过氧化物含量。按扭转时间分组，分析睾丸扭转、复位、药物应用以后局部的损伤变化情况。结果 单侧睾丸扭转以后，两侧组织的脂质过氧化物含量都明显上升。脂质过氧化物的含量与扭转时间有关。别嘌呤醇应用后，能降低扭转2h以内的两侧睾丸脂质过氧化物产量，以及扭转6h以内的对侧睾丸脂质过氧化物含量。结论 别嘌呤醇对改善睾丸扭转损伤有治疗意义，临床上应提倡早期用药。     

The testes after unilateral incarcerated inguinal hernia in prepubertal rats

The ipsilateral and contralateral testes after unilateral incarcerated inguinal hernia were evaluated, and compared to the contralateral testis after unilateral testicular torsion in 30 prepubertal rats. Control, torsion and detorsion at 24 hours, and incarcerated inguinal hernia and reduction in the 24 hour groups, each consisting of ten rats were established. The testes were harvested after 15 days. Mean seminiferous tubular diameters (MSTD) and mean testicular biopsy scores (MTBS) were determined and compared. A decrease in MSTD and depression in MTBS, which was more prominent in the ipsilateral testes, were found in both ipsilateral and contralateral testes following unilateral incarcerated inguinal hernia. The testicular damage encountered after unilateral incarcerated inguinal hernia was similar to the contralateral testicular damage following unilateral testicular torsion with the utilized parameters.     

PAF antagonist BN-52021 reduces intercellular adhesion molecule-1 expression and oxidative stress in rats with reperfusion damage due to unilateral testicular torsion

The aim of this study was to determine the effects of specific platelet-activating factor (PAF) antagonist BN-52021 on intercellular adhesion molecule-1 (ICAM) expression and oxidative stress in rats with reperfusion damage due to unilateral testicular torsion. Thirty male Sprague–Dawley rats were separated into three groups, each containing ten rats. A sham operation was performed in group 1 (control). In group 2 [ischemia-reperfusion (I-R)/untreated], 1-h detorsion of the testis was performed after 6 h of unilateral testicular torsion. In group 3 (I-R/BN-52021), after performing the same surgical procedures as in groups II, BN-52021 was given intravenously at the starting time of reperfusion. In all experimental rats, ipsilateral orchiectomies were performed for histological examination and measuring the tissue levels of malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px). MDA values and the testicular injury score decreased and SOD, CAT and GSH-Px values increased in the I-R/BN-52021 treated group compared to in the I-R/untreated group. Most of the specimens in the I-R/BN-52021 treated group showed grade-I testicular injury. However, the injuries in the I-R/untreated rats varied between grades III and IV. An ICAM-1 expression was intensive in the interstitial spaces and basement membrane of the tubuli seminiferi, of testicular tissue in the I-R/untreated group. However, an ICAM-1 expression was mild in the I-R/BN-52021 group. BN-52021 may play an important role in the immunohistochemical expression of adhesion molecule ICAM-1 and may reduce oxidative stress in rats with reperfusion damage due to unilateral testicular torsion.     

Administration of N-Acetylcysteine Reduces Germ Cell-Specific Apoptosis and Oxidative Injury Following Testicular Torsion in Rats

PurposeTesticular torsion/detorsion (T/D) RESULTS in enhanced formation of free radical species, which contribute to the pathophysiology of tissue damage. Numerous studies in recent years have shown protective effects of N-acetylcysteine (NAC) on cardiac and renal tissue damage following ischemia/reperfusion. We assessed the effectiveness of systemic administration of NAC – at therapeutic doses – in a rat model one-hour 720° testicular T/D. We chose the dose of NAC that reduced general ischemia/reperfusion syndrome in patients who had undergone abdominal aortic aneurysmectomy.Materials and MethodsSprague-Dawley rats were divided into 5 groups, 14 animals in each. Group 1 underwent sham operation as the control group. In group 2, rats underwent T/D and received vehicle injections. Animals in groups 3, 4 and 5 received intraperitoneal injections of 150 mg/kg NAC, 30 minutes before torsion, after torsion and after detorsion, respectively. Markers of oxidative stress as well as germ cell apoptosis indices were determined 4 and 24 hours after detorsion, respectively.ResultsApoptosis indices were significantly higher in group 2 compared to control group. Four hours after detorsion, testicular level of lipid peroxidation was significantly increased and antioxidant enzymes activities were significantly decreased in group 2 in comparison with controls. Administration of NAC either 30 minutes before or after torsion (group 3 and 4), significantly improved the germ cell apoptosis indices and oxidant/antioxidant balance. Administration of NAC after detorsion had no significant effects on oxidant/antioxidant balance or germ cell apoptosis.ConclusionsAdministration of NAC prior to torsion or detorsion, but not after detorsion, is protective against ischemia/reperfusion tissue damage in the rat model of testicular torsion. Since NAC has an established safety after almost 40 years of clinical use as mucolytic agent and antidote of acetaminophen toxicity, one can suggest this agent as an adjunct therapy for “testicular torsion rescue”. Supplying intracellular glutathione as well as anti-oxidant and anti-inflammatory properties of NAC could be the possible mechanisms of this protective effect.     

Dexpanthenol attenuates lipid peroxidation and testicular damage at experimental ischemia and reperfusion injury

Prevention of tissue damage after testicular torsion caused by I/R injury is still a clinical and experimental problem. There are many experimental studies made with several chemicals in the literature for decreasing the effect of reactive oxygen species after ischemia and reperfusion. Dexpanthenol (Dxp) is the biologically active alcohol of pantothenic acid. Pantothenic acid increases the content of reduced glutathione, Coenzyme A and ATP in cell. We studied the effect of Dxp on lipid peroxidation and testicular damage. Forty adult rats were separated randomly into five groups: group Sh, Sham-operation; group TD, torsion–detorsion; group NS, torsion–normal saline-detorsion; group D, torsion–Dxp 250 mg/kg detorsion; group D2, torsion–Dxp 500 mg/kg detorsion group. Serum MDA levels were taken before detorsion, after torsion at the first and fifth minute and at the first hour. Tissue sample was taken at the first hour. The alterations of I/R injury on testis were histological graded. Serum MDA levels were significantly lower in group D2 compared to all groups. The histopathology score of group D2 was significantly lower than groups TD, NS and D. Histopathological score and serum MDA levels are strikingly compatible. Dxp attenuated lipid peroxidation and tissue damage at I/R injury. This effect depends on its antioxidant effect with increasingly reduced glutathione, Coenzyme A and ATP. The effect of Dxp on I/R injury has been shown for the first time in the experimental testicular torsion.     

Effects of gabexate mesilate on ischemia-reperfusion-induced testicular injury in rats

The aim of this study was to determine the effects of a synthetic serine protease inhibitor, gabexate mesilate (GM), in rats with ischemia-reperfusion (I-R) damage due to unilateral testicular torsion. Thirty male Sprague-Dawley rats were separated into three groups, each containing ten rats. A sham operation was performed in group 1 (control). In group 2 (I-R/untreated), 1 h detorsion of the testis was performed after 6 h of unilateral testicular torsion. In group 3 (I-R/GM), after performing the same surgical procedures as in group II, gabexate mesilate was given intravenously. In all experimental rats, ipsilateral orchiectomies were performed for histological examination and measuring the tissue levels of malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px). MDA values and the testicular injury score decreased and SOD, CAT and GSH-Px values increased in the GM-treated group compared to the I-R/untreated group. The Tc-99m pertechnetate uptake ratio and the perfusion index were significantly decreased in the group 2 compared to the group 1 and 3 rats. In group 3, these values were significantly increased compared to group 2. Most of the specimens in the GM-treated group showed grade-I testicular injury. However, the injuries in the I-R/untreated rats varied between grade-III and grade-IV. The results of this study show that GM may play a role in reducing the injury caused by I-R.     

The protective effect of dexpanthenol on testicular atrophy at 60th day following experimental testicular torsion

Despite the prompt diagnosis and treatment of testicular torsion (TT), there are problems with fertility and atrophy after testicular salvage. Dexpanthenol (Dxp) is the biologically active alcohol of pantothenic acid (PA). Dxp is converted to PA in tissues. PA increases the content of reduced glutathione (GSH), Coenzyme A and ATP synthesis in cells. GSH and glutathione-dependent peroxidases (GPX) are the major defense systems against oxidative stress. GPX-4 is the major antioxidant in testicular tissue. However, the activity of GPX-4 appeared and increased only after puberty. We investigated the effect of Dxp on testicular atrophy after TT at the 60th day. Rats were separated randomly into four groups. Group C: control group, group Td: torsion + detorsion, group Sal: torsion + saline + detorsion, group Dxp: torsion + Dxp + detorsion. The left testis was rotated 720° for 2 h. In group Sal, normal saline and in group Dxp, Dexpanthenol were injected intraperitonally, 30 min before detorsion. After 60 days, the testicular weights and volumes were measured. Histopathology of the left testis was evaluated with mean seminiferous tubular diameter (MSTD) and mean testicular biopsy score (MTBS). The left (torsed) testicular weight and volume of groups Td and Sal were significantly lower compared to group Dxp. The MSTD and MTBS of group Td and Sal were significantly lower than group Dxp. Contralateral testicular weight and volume of groups Td, Sal and Dxp had no significant difference compared to the control group. Dxp significantly prevented testicular atrophy after 60 days of TT. Dxp has FDA approval, is safe, cost effective and readily available. Its relevance for clinical trials may especially be for the problem of testicular atrophy catastrophe, seen very frequently following testicular salvage.     

Resveratrol may reduce apoptosis of rat testicular germ cells after experimental testicular torsion.

The aim of the study is to evaluate the effects of resveratrol on apoptosis of testicular germ cells after experimental testicular torsion. Thirty Wistar albino rats were divided into 3 groups. Torsions were created by rotating the right testis 720 degrees in a clockwise direction for 4 h in all groups except the control group (group 1). They were then repaired by counter-rotation and replaced into the scrotum. In group 2, saline was infused 30 min before detorsion. In group 3, 30 mg/kg resveratrol was infused 30 min before detorsion. In groups 2 and 3, the bilateral testes were removed to determine germ cell apoptosis after 20 h of detorsion. The number of apoptotic cells was evaluated using the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling (TUNEL) technique and caspase 3. Mean apoptotic score of ipsilateral testes in group 3 was lower than that of group 2 (p < 0.05). Mean apoptotic score of the contralateral testes in group 3 was not different from that of group 2 (p > 0.05). The present study demonstrates that intraperitoneal administration of resveratrol in rats may decrease germ cell apoptosis in the ipsilateral testes.     

Investigation of tyrphostin AG 556 for testicular torsion-induced ischemia reperfusion injury in rat

ObjectiveTo investigate the effects of tyrphostin AG 556, a tyrosine kinase inhibitor (TKI) in an experimental model of testicular ischemia–reperfusion (I/R) injury.Material and methodsTwenty-four adult male rats were randomly divided into four groups (n = 6): sham, torsion/detorsion (T/D), T/D + dimethylsulfoxide (DMSO) (vehicle group), and T/D + DMSO + tyrphostin AG 556. Testicular torsion was achieved by rotating the left testis 720° clockwise for 4 h. Thirty minutes before detorsion, 3 mg/kg tyrphostin AG 556 was injected transperitoneally in the AG 556 group and DMSO was injected transperitoneally in the DMSO group. After 2 h of reperfusion arterial blood samples were collected for biochemical analysis for malondialdehyde (MDA), ischemia modified albumin (IMA), SCUBE1 (signal peptide-CUB [complement C1r/C1s, Uegf, and Bmp1] and EGF [epidermal growth factor] like domain-containing protein 1), total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index (OSI) parameters, and ipsilateral orchiectomies were performed for histopathological examination based on the semi-quantitative Johnsen's mean testicular biopsy score (MTBS) in all groups.ResultsTyrphostin AG 556 exhibited a protective effect against I/R injury in testicular torsion. Of the biochemical parameters evaluated as a result of testicular I/R, IMA, MDA, and TOS levels were significantly elevated. There was no significant difference in terms of these biochemical parameters between the sham and AG 556 groups. Significant histopathological injury was determined by comparing the T/D and sham groups. According to histopathological injury scores, significant differences were determined between T/D and AG 556 groups and between AG 556 and sham groups. AG 556 had a superior improving effect on Johnsen's scores than DMSO.ConclusionsOur results suggest that the use of tyrphostin AG 556 prior to testicular reperfusion has a protective effect against testicular I/R injury.     

Effect of unilateral testicular torsion on contralateral testis in a rat model

The aim of this study was to investigate the function of the contralateral testis after unilateral testicular torsion (UTT) and its possible mechanism. 56 rats were randomly divided into four groups: Group A: Sham operation, Group B: Testicular torsion (TT)+normal saline (NS), Group C: Testicular torsion (TT)+cyclosporine, Group D: Testicular torsion (TT)+NG-Monomethyl-l-arginine (l-NMMA). The right testes were removed 1 week and 8 weeks after surgery, respectively. Biochemistry and histopathologic evaluations were used to evaluate the germ cell damage. Compared with Group A, the levels of malondialchehyche (MDA) and nitric oxide (NO)/nitricoxide synthase (NOS) were increased remarkably in Group B. Significant differences were shown between histopathological damages and density and motility of sperm in two groups. Compared with Group B, the levels of MDA and NO/NOS in Group D decreased significantly while mean seminiferous tubule diameter (MSTD) and mean testicular biopsy scoring (MTBS) maintained in a better condition. The levels of major histocompatibility complex (MHC) peptide-tetramer complex in Group C and Group D decreased significantly than Group B, while sperm density and motility were significantly higher than Group B. It was also known that the histopathological damages in Group C and Group D were less than those in Group B in the 8 weeks after operation. UTT can cause impairment of contralateral testicular function and decrease of spermatogenic function. The mechanism may be related to ischemia–reperfusion (IR) in early stage and autoimmune response in late stage.     

Effect of phospodiesterase 5 inhibitors on apoptosis and nitric oxide synthases in testis torsion: an experimental study

To investigate the effects of phosphodiesterase (PDE) 5 inhibitors, sildenafil citrate and vardenafil HCl, on testicular germ cell apoptosis and also on the expressions of eNOS and iNOS within the bilateral testis after a unilateral torsion in a rat model. Forty-eight Wistar Albino rats, weighing between 210 and 262 g, were housed in individual cages. The rats were randomly assigned into four main groups and each group received drugs. Saline, sildenafil citrate and vardenafil HCl were given to each for 1 month and the last received no drug. After 1 month, testicular torsion was created for 1 h of ischemia and the left testis was untwisted and replaced to the scrotum for 2 h of reperfusion. At the end of 3 h, contralateral and ipsilateral testes were removed for histopathologic and biochemical examinations. Under light microscopy; the histopathological patterns of the contralateral testes in all groups were not affected. Mean apoptotic cell, eNOS and iNOS levels were increased in saline study group. The rats treated with vardenafil and sildenafil (groups 2s and 3s) showed significantly increased apoptotic cell, eNOS and iNOS values in ipsilateral testis (P < 0.05). Sildenafil citrate and vardenafil HCl caused an exaggerated testicular apoptosis after IR injury in rats. Additionally these drugs increased the NOSs levels in the testicular tissue.     

Electrophysiological evaluation of cremasteric reflex in experimental testicular torsion.

AIM: The aim of the study was the electrophysiological evaluation of the cremasteric reflex after experimental testicular torsion. MATERIAL AND METHODS: Ten male Wistar rats were enrolled into the study. Genitofemoral nerve (GFN) motor conduction and cremasteric reflex (CR) responses were evaluated electrophysiologically after being subjected to anesthesia with intramuscular ketamin hydrochloride. Testicular torsion was performed by rotating the right testicle 720 degrees in a clockwise direction from a midscrotal incision. Electrophysiological evaluations were repeated in the early (30 minutes) and late (90 minutes) periods of testicular torsion. Subsequently, detorsion of the testicles was performed and electrophysiological recordings were completed after 60 minutes of detorsion. The CR was also evaluated clinically before each electrophysiological evaluation. The latency and duration of GFN motor conduction and CR responses was compared for base, early torsion, late torsion and detorsion recordings. Friedman's test for repeated measurements was used for statistical analysis. RESULTS: The CR, which was detected clinically before torsion and after detorsion, was not detected during torsion. When base, early torsion, late torsion and detorsion recordings were compared, there was no statistical difference with respect to both latency and duration of GFN motor conduction and CR responses (p > 0.05). CONCLUSION: Although CR was not detected clinically during testicular torsion, the electrophysiological parameters of the reflex did not differ in the early and late periods of torsion in rats. The GFN motor conduction parameters also showed no differences. In conclusion, the absence of the CR after testicular torsion could not be confirmed by electrophysiological studies.     

The efficacy of conservative treatment for late term ovarian torsion.

BACKGROUND/PURPOSE: Recent reports have focused on detorsion after ovarian torsion in the literature. The aim of the study was to investigate late term changes in both ovaries after delayed detorsion following ovarian torsion in rats. MATERIALS: Female, prepubertal, Wistar albino rats were divided into four groups (n = 6/group). The left ovaries were used for the study and the right ovaries were kept as the control. The groups were constituted as follows: Group 1: left ovarian fixation, bilateral oophorectomy 48 hours later; Group 2: left ovarian torsion and fixation, bilateral oophorectomy 48 hours later; Group 3: detorsion 48 hours after torsion and bilateral oophorectomy after another 48 hours; Group 4: detorsion 48 hours after torsion and bilateral oophorectomy after 21 days. The total injury score (TIS) was compiled histologically in a double-blind fashion. Congestion, edema, bleeding and polymorphonuclear lymphocyte infiltration were assessed for TIS. RESULTS: The TIS was found to be 8 points in Group 1; 38 in Group 2; 28 in Group 3 and 12 in Group 4, respectively. The TIS was based on results from the left ovaries in Group 1, whereas 31 points were attributable to the left ovaries and 7 to the right ovaries in Group 2. In Groups 3 and 4, TIS points were the same in both study and control ovaries. The difference between the left ovaries of Groups 1 and 2 and the left ovaries of Groups 2 and 4 was statistically significant (p < 0.05). CONCLUSION: Viable ovarian tissue can be detected even after 48 hours of torsion, which is a relatively long period of ischemia. Tissue injury decreases significantly after detorsion during late recovery. In view of previous case reports in the literature and the present findings, detorsion is recommended in children with ovarian torsion regardless of the ischemic period and/or macroscopic appearance.     

The protective effects of trimetazidine on testicular ischemia and reperfusion injury in rats

This study was designed to investigate the protective effect of trimetazidine [TMZ; 1-(2, 3, 4-trimethhoxibenzyl)-piperazine dihydrochloride], as an antioxidant agent, on torsion–detorsion-induced biochemical and histopathological changes in experimental testicular ischemia/reperfusion injury in rats. Twenty-seven male Wistar rats weighing 180–220 g were divided into five groups: control (C, n = 4), sham-operated (S, n = 4), ischemia (I, n = 6), ischemia–reperfusion (I/R, n = 6) and ischemia–reperfusion + trimetazidine (I/R + TMZ; n = 7). Control rats were used for basal normal values. In group I, 2 h torsion of the left testis was performed. In I/R and I/R + TMZ groups, following 2 h of torsion, 4 h detorsion of the testis was performed. In ischemia and I/R groups, physiologic saline was administered orally for 7 days, and the rats in I/R + TMZ group were pretreated orally with 5 mg/kg day TMZ for 7 days before inducing ischemia. At the end of each experiment, ipsilateral orchiectomies were performed for the tissue levels of malondialdehyde (MDA), glutathione peroxidase (GPx) enzyme activities and histopathological examinations in all groups. MDA levels were significantly reduced and GPx enzyme activities were significantly increased in testes in I/R+TMZ pretreated group compared to group I and I/R. The mean seminiferous tubular diameter (MSTD) and Johnsen’s score were significantly better in I/R+TMZ group than groups I and I/R. Pretreatment with TMZ decreased germ cell apoptosis and caspase-3 expression in the ischemic testis. The present results show that TMZ has a protective activity in the testicular injury caused by I/R, and provide the first evidence of the role of TMZ for the prevention of I/R-induced testicular injury.     

TSEG-2基因在小鼠睾丸扭转复位模型中的表达特征

目的 探讨睾丸特异表达基因2(testis specific expressed gene 2,TSEG-2)在小鼠睾丸扭转复位模型中的表达特征.方法 昆明小鼠36只,随机分组为对照组(6只)、假手术组(6只)、单侧睾丸扭转复位实验组(24只).实验组分为2组,每组12只,左侧睾丸扭转720°维持2 h,分别于复位后1、7 d取扭转侧睾丸.采用HE染色、原位末端标记技术(TUNEL)观察睾丸组织形态改变;黄嘌呤氧化酶法、硫代巴比妥酸比色法测定超氧化物歧化酶(SOD)、丙二醛(MDA)活性;原位杂交法观测TSEG-2在睾丸生精细胞内的表达定位;实时定量PCR法检测TSEG-2基因在睾丸组织中的表达水平.结果 对照组和假手术组生精上皮排列规则,扭转复位后1、7 d的睾丸组织内生精上皮结构松散,出现生精细胞凋亡,Johnsen's评分分别降低23.4%、64.1%(P<0.01),SOD活性降低11.6%、22.2%(P<0.05),MDA活性升高69.6%、93.2%(P<0.01).TSEG-2基因表达定位于小鼠睾丸生精小管的精原细胞和精母细胞.与对照组比较,扭转复位1、7 d后睾丸组织内TSEG-2表达水平分别上调2.2倍、6.6倍(P<0.01).结论 成功建立小鼠睾丸扭转复位模型,TSEG-2表达上调可能与抗氧化酶活性下降、生精细胞凋亡有关.