Investigating paraoxonase-1 gene Q192R and L55M polymorphism in patients with renal cell cancer.

Increased oxidative stress can help promote carcinogenesis, including development of renal cell carcinoma. The enzyme protects low-density lipoproteins from oxidation and can be a factor in this process. PON1 Q192R and L55M paraoxonase gene polymorphisms were assessed in 60 renal cell carcinoma patients and 60 healthy controls. Genotypes were examined by PCR; the restriction enzyme AlwI was used to examine the Q192R polymorphism and Hsp92II for the L55M polymorphism. Significant differences in the PON1 Q192R polymorphism were found between patients and controls. The Q allele was more frequent in the patient group than in controls, while the R allele was more frequent in the control group. No significant differences were found in the L55M polymorphism. Additionally, there were no significant differences in L and M allele frequencies. We conclude that the R allele may protect against renal cell carcinoma.

Comparison of two different microsurgical methods in the treatment of varicocele.

We reviewed records from patients who underwent two different microsurgical varicocelectomy methods: 147 (high inguinal (MHIV) and 65 sub-inguinal (MSIV) microsurgery) to compare the therapeutic activity and complications. Patients who had 2 different microsurgical varicocelectomies were compared according to preoperative connected vein, number of designated arteries, postoperative semen and improvement degree in hormone parameters, increased ratio related with pregnancy and complications. The ratio of improvement of postoperative semen parameters in patients where MHIV and MSIV were performed was, 42% and 38% (p > 0.05). Pregnancy was achieved in MHIV at a ratio of 41% (34/82) and 33% (22/65) in MSIV (p > 0.05). There was no significant difference according to mean operation periods, the vein connected between the groups. The number of testicular arteries were significantly higher than the ones in MHIV (p < 0.01). However, as a postoperative complication, hydrocele was not seen in any of the patients, while relapses occurred in 1 MHIV and 2 MSIV patients. MHIV and MSIV techniques are effective methods to treat varicocele. However, the excess number of connected veins due to the anatomic feature of MSIV increases the possibility of relapses and the technical difficulty during surgical intervention.

Secondary ejaculatory duct obstruction: management by secondary transurethral resection of ejaculatory duct.

Distal ejaculatory duct obstruction (EDO) is a relatively rare but surgically treatable cause of male infertility. Transrectal ultrasonography (TRUS) has been commonly used in infertility evaluation in recent years. These pathologies are more common than expected and treated with transurethral resection of ejaculatory duct (TURED). Although TURED is the recommended routine procedure for all cases of EDO, it has complications, such as iatrogenic obstruction, in 4% of the cases. Herein, we evaluated a patient who had developed EDO secondary to TURED.

Seminal plasma cytokine levels in the diagnosis of chronic pelvic pain syndrome.

BACKGROUND: Chronic non-bacterial prostatitis/chronic pelvic pain syndrome (CPPS) are frequently encountered clinical entities characterized by painful and irritative voiding symptoms often referable to the prostate. Diagnosis usually depends on the symptoms and treatment mainly consists of reassurance, anti-inflammatory medications and antibiotics in the absence of a documented infection. To have objective diagnostic criteria, we determined the possible roles and diagnostic efficacies of soluble cytokines interleukin-1beta (IL-1beta), tumor necrosis factor-alpha (TNF-alpha), IL-2R, IL-6 and IL-8 in the seminal plasma of patients with different forms of CPPS. METHODS: Seminal plasma was obtained from a total of 30 subjects who were evaluated in three groups. Each group comprised 10 patients having inflammatory CPPS, non-inflammatory CPPS and control subjects, respectively. The levels of IL-1beta, IL-2R, TNF-alpha, IL-6 and IL-8 were measured in seminal plasma using chemiluminescence. RESULTS: The level of IL-2R in all three groups was below measurable values. Interleukin-1beta, TNF-alpha, IL-6 and IL-8 levels were elevated significantly in the two groups with CPPS compared with the control group (P < 0.05). Soluble cytokines showed a slight difference between patients with inflammatory CPPS and non-inflammatory CPPS, but this was not statistically significant (P > 0.05). CONCLUSION: Although there are individual variables between the discrimination of inflammatory and non-inflammatory CPPS, cytokines are frequently present and elevated in the expressed prostatic secretions from men with CPPS. Our results indicate that several soluble cytokines can be used to identify this chronic and long-term disease.

Paravertebral abscess formation due to brucellosis in a patient with ankylosing spondylitis.

It is occasionally difficult to distinguish the features of spinal brucellosis from those of ankylosing spondylitis (AS), and the resultant delayed diagnosis may allow insidious progression of the complications of the brucella infection. The case of a 33-year-old male HLA-B27-positive patient with known diagnosis of AS for 7 years, who developed a paravertebral abscess in the left erector spinae muscle due to brucellosis, is presented in this paper. This case report illustrates two important points; first, co-occurrence of AS and brucellosis in the same patient, and second, posterior element involvement with abscess formation in erector spinae muscle, which has not been previously reported. Magnetic resonance imaging is a sensitive method for detecting spinal brucellosis and extent of infection throughout paravertebral structures. Clinicians serving patients from areas with endemic brucellosis should not overlook the possibility of this infection in the presence of axial musculoskeletal symptoms, even among patients with AS.