Carbamazepine-induced sperm disorders can be associated with the altered expressions of testicular KCNJ11/miR-let-7a and spermatozoal CFTR/miR-27a

Male infertility is a global health problem, and the underlying molecular mechanisms are not clearly known. Ion channels and microRNAs (miRNAs), known to function in many vital functions in cells, have been shown to play a significant role in male infertility through changes in their expressions. The study aimed to evaluate the alterations of testicular and/or spermatozoal potassium voltage-gated channel subfamily J member 11 (KCNJ11), Cystic fibrosis transmembrane conductance regulator (CFTR), miR-let-7a and miR-27a expressions in carbamazepine-related male infertility. Here, we showed that carbamazepine reduced sperm motility, increased abnormal sperm morphology, and impaired hormonal balance as well as increased relative testis weight and decreased relative seminal vesicle weight. On the other hand, downregulated KCNJ11 and upregulated miR-let-7a expressions were determined in testis (p < .05). Also, downregulated KCNJ11 and upregulated CFTR and miR-27a expressions were found in spermatozoa (p < .05). Interestingly, altered testicular KCNJ11 and miR-let-7a expressions were correlated with decreased sperm motility and elevated sperm tail defect. Besides, spermatozoal CFTR and miR-27a expressions positively correlated with sperm tail defects. The results indicated a significant relationship between ion channel and/or miRNA expression alterations and impaired sperm parameters due to carbamazepine usage.     

A closer look at iatrogenic hypospadias

Almost all surgical repair techniques for hypospadias include dissection of the glans penis, and covering the neo-urethra with the glans tissue circumferentially. Surprisingly, the presence of the “septum glandis” in the ventral midline has been overlooked for decades. A careful examination of six patients with iatrogenic hypospadias (IH) revealed direct indications of the septum glandis. All patients were treated with long-term urethral catheterisation in the paediatric intensive care unit due to neurologic and/or metabolic diseases. The glans was disrupted in all patients due to ventral midline compression of the urethral catheter, which resulted in a tear in the septum glandis. A remnant of the septum glandis was clearly observed in patients with an incomplete tear. Further injuries caused tear in the frenulum and corpus spongiosum, exposed the glanular urethra and made its vertical elliptical shape, the “fossa navicularis”, visible. Intact contours of the separated glans wings were observed in all patients. The glans wings merge ventrally in the midline, but are separated by a fine connective tissue (septum glandis) in conjunction with the frenulum, which is involved in the formation of the ventral wall of the glanular urethra. IH provides further insight into the structural anatomy of the normal human glans and glanular urethra.     

Evaluation of the effect of shift working and sleep quality on semen parameters in men attending infertility clinic

We aimed to evaluate the effect of shift work on semen parameters together with the effect of sleep quality in men attending infertility clinic. The participants were divided into two groups as follows: 104 shift worker men (Group 1) and 116 nonshift worker men (Group 2). Groups were compared in terms of semen parameters, Depression Anxiety Stress Scale-21 (DASS-21), and Pittsburg Sleep Quality Index (PSQI) scores. A higher rate of oligozoospermia and poor sleep quality and a lower mean normal morphology percentage was observed in shift workers than nonshift workers (p = .006, .039 and .036 respectively). In addition, a positive correlation was seen between sleep duration and sperm concentration, while a negative correlation was found between sleep latency and total sperm count. Shift working together with high PSQI score was also a significant association with oligozoospermia when controlling for the other variables of age, total testosterone, DASS-21 stress score, smoking and varicocele (OR = 2.11, 95% CI 1.03–4.34 and OR = 1.18, 95% CI 1.01–1.39 respectively). In this study, infertile shift workers had a lower percentage of normal morphology and higher rates of oligozoospermia and poor sleep quality. Considering that shift workers have lower sleep quality, it seems that shift working negatively affects the circadian rhythm.     

Radiologic and Demographic Characteristics of Patients With Plantar Calcaneal Spur

Many people with heel pain in the general population are often diagnosed with plantar calcaneal spurs (PCS). The aim of this study was to evaluate the radiological and demographic characteristics of PCS patients and to compare the differences with the control group. In 2018, 420 patients with weightbearing lateral ankle X-ray images were included in the study. The patients were divided into 2 groups as PCS group and control group. Groups were compared age and age group (20-29, 30-39, 40-49, 50-59, 60-69, 70 and over) weight, height, body mass index (<25, 25-30, >30), chronic diseases as demographically and were also compared radiologically as calcaneal inclination angle (CIA), lateral talocalcaneal angle (LTCA), Bohler angle and Gissane angle. A statistically significant relationship was found between gender and PCS. Plantar calcaneal spur is more common in females than in males (X²:8.101, p < .03). PCS was less common in patients with BMI <25 and 25-29.9, whereas PCS is more common in patients with BMI >30 (X²:7.698, p < .021). Although the CIA angle was within normal limits in both groups, it was significantly lower in patients with PCS than in the control group(p < .05). There was no statistically significant difference between the 2 groups in terms of age, chronic disease, LTCA, Bohler angle, Gissane angle. Female gender and obesity are among the risk factors for PCS formation. CIA may have an important role in PCS formation. In order to clarify the etiology and pathophysiology of PCS, further studies with radiological features are needed.     

Retrorectal tumors: A challenge for the surgeons

Retrorectal or presacral tumors are rare lesions located in the presacral area and considered as being derived from multiple embryological remnants. These tumors are classified as congenital, neurogenic, osseous, inflammatory, or miscellaneous. The most common among these are congenital benign lesions that present with non-specific symptoms, such as lower back pain and change in bowel habit. Although congenital and developmental tumors occur in younger patients, the median age of presentation is reported to be 45 years. Magnetic resonance imaging plays a crucial role in treatment management through accurate diagnosis of the lesion, the evaluation of invasion to adjacent structures, and the decision of appropriate surgical approach. The usefulness of preoperative biopsy is still debated; currently, it is only indicated for solid or heterogeneous tumors if it will alter the treatment management. Surgical resection with clear margins is considered the optimal treatment; described approaches are transabdominal, perineal, combined abdominoperineal, and minimally invasive. Benign retrorectal tumors have favorable long-term outcomes with a low incidence of recurrence, whereas malignant tumors have a potential for distant organ metastasis in addition to local recurrence.     

人胚胎期小肠六种肽能神经发生的研究

采用免疫组织化学ＰＡＰ法，对５３例不同胎龄的人胚胎小肠的亮氨酸脑啡肽（Ｌ－Ｅｎｋ）、Ｐ物质（ＳＰ）、神经肽Ｙ（ＮＰＹ）、降钙素基因相关肽（ＣＧＲＰ）、血管活性肠肽（ＶＩＰ）和甘丙素（ＧＡＬ）等６种肽能神经的发生发育过程进行观察，并与ＡＣｈ能神经和膀胱的肽能神经的发生做了对比研究。结果表明，人胚胎小肠神经中ＡＣｈ能神经发生早于肽能神经；同一个体不同器官肽能神经并非同时发生。本文观察到的小肠肽能神经的