Selçuk BİLGİ, Çağatay Yalçın AYDINER, Mehmet PUL, Erol ÇAKIR, Mustafa İNAN

Deneysel testiküler torsiyon modelinde N-asetilsistein doku hasarını önlemede rol oynayabilir mi?

Amaç. Testis torsiyonu, iskemi reperfüzyon hasarı formunda önemli bir akut skrotum nedenidir.Başarılı ve erken bir detorsiyon yöntemi ile morbidite azaltılabilir. Bu çalışmada deneysel tektaraflı testis torsiyonu ve detorsiyonu modelinde N-asetilsisteinin her iki testise olan etkisininaraştırılması amaçlandı. Yöntem. Çalışmada 32 adet prepubertal erkek Wistar albino sıçankullanıldı. Sıçanlar malondialdehid düzeyi ve histopatolojik hasar araştırılmak üzere kontrol,torsiyon, detorsiyon ve detorsiyon/N-asetilsistein gruplarına ayrıldı. Kontrol grubunda yer alandeneklere torsiyon işlemi uygulanmadan testisleri alındı. Diğer gruplardaki deneklerin sağtestislerine dörder saatlik torsiyon işlemi uygulandı. Detorsiyon/N-asetilsistein grubundadetorsiyondan 15 dk önce intravenöz N-asetilsistein verildi. Detorsiyon ve detorsiyon/N- asetilsistein gruplarında reperfüzyon sonrası dört saat daha beklendi. Deney sonunda tümgruplarda her iki testis de çıkarılarak malondialdehid düzeyleri çalışıldı ve histopatolojik olarakdeğerlendirildi. Malondialdehid sonuçları Kruskal-Wallis varyans analizi ve Mann Whitney Utestleriyle değerlendirildi. Farkın p için 0,05den küçük olduğu değerler anlamlı kabul edildi.Bulgular. Her iki testise ait malondialdehid düzeyleri tüm gruplarda kontrol grubuna göre dahayüksek olarak bulundu (p0,05).İşlem sonrasında kontrol grubu dışındaki tüm grupların torsiyone testislerinde interstisyel hemorajiile seminifer tübül yapılarında düzensizlik gözlendi. Karşı tarafta interstisyel ödem ve bazıolgularda germ hücrelerinin dökülmesi dışında normal histoloji izlendi. Sonuç. Sonuç olarakoluşturduğumuz deneysel testis torsiyonu modelinde detorsiyondan önce intravenöz N-asetilsisteinuygulamasının her iki testiste malondialdehid düzeyleri ve histopatolojik hasar üzerinde biretkisinin olmadığı saptandı.

Can n-acetylcysteine play a role on preventing tissue damage on experimental testicular torsion

Aim. Testicular torsion, which is in the form of ischemia-reperfusion, is an important cause ofacute scrotum. The morbidity could be decreased by an early and successful detorsion procedure.The aim of this study was to determine the effects of N-acetylcysteine on both testes inexperimental rat model of unilateral testicular torsion and detorsion. Method. In this study, 32prepubertal male albino Wistar rats were used. The rats were divided into four groups as control,torsion, detorsion and detorsion/N-acetylcysteine in order to determine the malondialdehyde leveland histopathological damage. Rats in the control group were killed after the testes were removedwithout torsion. Right testes of the rats underwent four hours of torsion in other groups. N- acetylcysteine was injected intravenously 15 min before the detorsion in detorsion/N- acetylcysteine group. Reperfusion was continued for four hours after detorsion in detorsion anddetorsion/N-acetylcysteine groups. Results. At the end of the experiment, both testes were studiedfor their malondialdehyde levels and histopathological evaluations in all groups. Themalondialdehyde results were compared using the Kruskal-Wallis analysis of variance and MannWhitney U-tests with p

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1. Rowe MI, ONeill JA, Grosfeld JL, Fonkalsrud EW, Coran AG. Essentials of pediatric surgery. St. Louis: Mosby-Year Book Inc, 1995: 457-9.
2. Cadenas E. Mechanisms of oxygen activation and reactive oxygen species detoxification. In: Ahmad S (Ed.). Oxidative stress and antioxidant defences in biology. New York: Chapman and Hall; 1995; pp: 4-47.
3. Prillaman HM, Turner TT. Rescue of testicular function after acute experimental torsion. J Urol 1997; 157: 340-5.
4. Mitchell RN, Cotran RS (Çeviri: U. Çevikbaş). Hücre zedelenmesi, ölümü ve adaptasyonu. Kumar V, Cotran RS, Robbins SL (Eds.). Temel patolojide. 6. Baskı. İstanbul: Nobel Tıp Kitabevi (WB Saunders Co. izniyle); 2000; s: 3-24.
5. Crystal RG, Bast A. Oxidants and antioxidants, pathophysiologic determinants and therapeutic agents. Am J Med 1991; 91: 1-145.
6. De Flora S, Grassi C, Carati L. Attenuation of influenza-like symptomatology and improvement of cell-mediated immunity with long-term N-acetylcysteine treatment. Eur Respir J 1997; 10: 1535-41.
7. James JS. Stanford NAC study: glutathione level predicts survival. AIDS Treat News 1997; No 266: 1-5.
8. Cosentino MJ, Nishida M, Rabinowitz R, Cockett AT. Histopathology of prepubertal rat testes subjected to various durations of spermatic cord torsion. J Androl 1986; 7: 23-31.
9. Ohkawa H, Ohishi N, Yagi K. Assay for lipid peroxides in animal tissues by thiobarbituric acid reaction. Anal Biochem 1979; 95: 351-8.
10. Melekos MD, Asbach HW, Markou SA. Etiology of acute scrotum in 100 boys with regard to age distribution. J Urol 1988; 139: 1023-5.
11. Prater JM, Overdorf BS. Testicular torsion: a surgical emergency. Am Fam Physician 1991; 44: 834-40.
12. Kaplan GW. Scrotal swelling in children. Pediatr Rew 2000; 21: 311-4.
13. Rabinowitz R, Hulbert WC Jr. Acute scrotal swelling. Urol Clin North Am 1995; 22: 101-5.
14. Noseworthy J. Testicular torsion. In: Ashcraft KW (Ed.). Pediatric surgery 3rd ed. Philadelphia: W.B.Saunders Co; 2000; pp: 674-80.
15. Saba M, Morales CR, De Lamirande E, Gagnon C. Morphological and biochemical changes following acute unilateral testicular torsion in prepubertal rats. J Urol 1997; 157: 1149-54.
16. Chen Y, Miles AM, Grisham MB. Pathophysiology and reaktive oxygen metabolites. In: Ahmad S (Ed.). Oxidative stress and antioxidant defences in biology. New York: Chapman and Hall; 1995; pp: 630-80.
17. Lee C, Kerrigan CL, Picard-Ami LA Jr. Cyclophosphamide-induced neutropenia: effect on postischemic skin-flap survival. Plast Reconstr Surg 1992; 89: 1092-7.
18. Stewart RJ, Moore T, Bennett B, Easton M, Newton GW, Yamaguchi KT. Effect of free-radical scavengers and hyperbaric oxygen on random-pattern skin flaps. Arch Surg 1994; 129: 982-7.
19. Kızılcan F, Bernay F, Tanyel FC, Büyükpamukçu N, Bekdik C, Hiçsönmez A. Ipsilateral and contralateral testicular blood flows during unilateral testicular torsion by 133Xe clearance technique. Int Urol Nephrol 1992; 24: 515-20.
20. Kolettis PN, Stowe NT, Inman SR, Thomas AJ Jr. Acute spermatic cord torsion alters the microcirculation of the contralateral testis. J Urol 1996; 155:350-4.
21. Nagler HM, White RD. The effect of testicular torsion on the contralateral testis. J Urol 1982; 128: 1343-8.
22. Tanyel FC, Büyükpamukçu N, Hiçsönmez A. Contralateral testicular blood flow during unilateral testicular torsion. Br J Urol 1989; 63: 522-4.
23. Cerasaro TS, Nachtsheim DA, Otero F, Parsons CL. The effect of testicular torsion on contralateral testis and the production of antisperm antibodies in rabbits. J Urol 1984; 132: 577-9.
24. Krarup T. The testes after torsion. Br J Urol 1978; 50: 43-6.
25. Becker EJ Jr, Turner TT. Endocrine and exocrine effects of testicular torsion in the prepubertal and adult rat. J Androl 1995; 16: 342-51.
26. Turner TT, Caplis LA, Rhoades CP. Testicular vascular permeability: effects of experimental lesions associated with impaired testis function. J Urol 1996; 155: 1078-82.
27. Akgür FM, Kılınç K, Aktuğ T. Reperfusion injury after detorsion of unilateral testicular torsion. Urol Res 1993; 21: 395-9.
28. Akgür FM, Kılınç K, Aktuğ T. Is ipsilateral testis mandatory for the occurrence of contralateral intratesticular biochemical changes indicative of hypoxia after unilateral spermatic cord torsion? Eur Urol 1995; 28: 143-6.
29. Gürdal M, Tekin A, Erol A, Onmuş H, Konukoğlu D, Şengör F. Torsiyone rat testisinde gelişen iskemi-reperfüzyon hasarında pentoksifilinin antioksidan etkisi. Türk Üroloji Dergisi 2002; 28: 260-3.
30. Filho DW, Torres MA, Bordin AL, Crezcynski-Pasa TB, Boveris A. Spermatic cord torsion, reactive oxygen and nitrogen species and ischemia-reperfusion injury. Mol Aspects Med 2004; 25: 199-210.
31. Akgür FM, Kilinç K, Aktuğ T, Olguner M. The effect of allopurinol pretreatment before detorting testicular torsion. J Urol 1994; 151: 1715-7.
32. Orhan İ, Hayıt H, Duksal İ, Özercan İH, Fırdolaş F, Semerciöz A. Tek taraflı testis torsiyonunda PAF antagonistinin karşı taraf testisinin iskemik hasarındaki koruyucu etkinliği. Türk Üroloji Dergisi 2004; 30; 11-6.
33. Can C, Töre F, Tunçel N, Uysal O, Gürer F, Ak D, Tunçel M. Protective effect of vasoactive intestinal peptide on testicular torsion-detorsion injury: association with heparin-containing mast cells. Urology 2004; 63: 195-200.
34. Bozlu M, Acar D, Cayan S, Tunckiran A. Protective effect of trapidil on long- term histologic damage in a rat model of testicular ischemia-reperfusion injury. World J Urol 2009; 27: 117-22.
35. Orozco TJ, Wang JF, Keen CL. Chronic consumption of a flavanol- and procyanindin-rich diet is associated with reduced levels of 8-hydroxy-2'- deoxyguanosine in rat testes. J Nutr Biochem 2003; 14: 104-10.
36. Ozkan KU, Boran C, Kilinç M, Garipardiç M, Kurutaş EB. The effect of zinc aspartate pretreatment on ischemia-reperfusion injury and early changes of blood and tissue antioxidant enzyme activities after unilateral testicular torsion- detorsion. J Pediatr Surg 2004; 39: 91-5.
37. Uz E, Söğüt S, Sahin S, Var A, Ozyurt H, Güleç M, Akyol O. The protective role of caffeic acid phenethyl ester (CAPE) on testicular tissue after testicular torsion and detorsion. World J Urol 2002; 20: 264-70.
38. Palmer JS, Cromie WJ, Lee RC. Surfactant administration reduces testicular ischemia-reperfusion injury. J Urol 1998; 159: 2136-9.
39. Yamada T, Taguchi T, Hirata Y, Suita S, Yagi H. The protective effect of hyperbaric oxygenation on the small intestine in ischemia-reperfusion injury. J Pediatr Surg 1995; 30: 786-90.
40. Kolski JM, Mazolewski PJ, Stephenson LL, Texter J, Grigoriev VE, Zamboni WA. Effect of hyperbaric oxygen therapy on testicular ischemia-reperfusion injury. J Urol 1998; 160: 601-4.
41. Turan C, Küçükaydin N, Bekerecioğlu A, Kazez A, Doğan P, Küçükaydin M. The effect of vitamin E on ipsilateral and contralateral testis following unilateral testicular torsion in rats. Res Exp Med 1996; 196: 243-6.
42. Koku N, İlhan H, Tokar B, Kara E, Çolak Ö. Testis dokusunda metilen mavisinin reperfüzyon hasarına etkisi. Pediatrik Cerrahi Dergisi 2002; 16: 64-8.
43. Blank ML, O'Neill PJ, Steigman CK, Cobb LM, Wilde RA, Havenstein PJ, Chaudry IH. Reperfusion injury following testicular torsion and detorsion in prepubertal rats. Urol Res 1993; 21: 389-93.
44. Savas C, Dindar H, Bilgehan A, Ataoglu O, Yucesan S. Pentoxifylline attenuates reperfusion injury in testicular torsion. Scand J Urol Nephrol 2002; 36: 65-70.
45. Uzun H, Kalkan M, Tunç B, Aktaş Ş, Çetinkaya M, Alıcı B. Testiküler torsiyonda hiperbarik oksijen tedavisinin etkinliği. Türk Üroloji Dergisi: 2004; 30: 273-8.
46. Akgür FM, Kılınç F, Tanyel FC, Büyükpamukçu N, Hiçsönmez A. Ipsilateral and contralateral testicular biochemical acute changes after unilateral testicular torsion and detorsion. Pediatric Urol 1994; 44: 413-8.
47. Chance B, Sies H, Boveris A. Hydroperoxide metabolism in mammalian tissues. Physiol 1979; 59: 527-605.
48. Anderson JB, Williamson RC. Testicular torsion in Bristol: a 25-year review. Br J Surg 1988; 75: 988-92.
49. Nguyen L, Lievano G, Ghosh L, Radhakrishnan J, Fornell L, John E. Effect of unilateral testicular torsion on blood flow and histology of contralateral testes. J Pediatr Surg 1999; 34: 680-3.
50. Barkley C, York JP, Badalament RA, Nesbitt JA, Smith JJ, Drago JR. Testicular torsion and its effects on contralateral testicle. Urology 1993; 41: 192-4.