The effects of carvedilol on ischemia-reperfusion injury in the rat testis.

OBJECTIVE: To analyze the oxidative damage and histopathological alterations caused by ischemia-reperfusion (I/R) injury and ameliorative effects of carvedilol (CVD) in the rat testis. MATERIALS AND METHODS: Twenty-one male rats were randomized into 3 groups as follows: Group I (n = 7); control (sham) group, Group II (n = 7); I/R group, in which I/R injury was performed by torsing the left testis 720 ° clockwise for 2 hours and detorsing for 2 hours. Group III (n = 7); CVD treatment group; in addition to I/R process, one-dose of CVD was administered (2mg/kg, i.p) 30 min. before detorsion. Levels of antioxidant enzymes, superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) and levels of malondialdehyde (MDA) and protein carbonyl (PC) were determined in testicular tissues and serum of rats. Testicular tissues were also examined histopathologically and Johnsen scores were determined. RESULTS: Activities of SOD and GSH-Px in serum and testicular tissues were increased by I/R, but administration of CVD decreased these levels (p < 0.001 and p = 0.001). Significantly increased MDA levels in serum and testicular tissues were decreased by CVD treatment (p < 0.001 and p = 0.001). Concerning PC levels in serum and testicular tissues, there was no statistically significant difference between the groups (p = 0.989 and p = 0.428). There was not a statistically significant difference in terms of mean Johnsen scores between the groups (p = 0.161). CONCLUSIONS: Administration of CVD decreased oxidative damage biochemically in the rat testis caused by I/R injury, but histopathologically no change was observed betwe¬en all of the groups.

The effects of carvedilol on ischemia-reperfusion injury in the rat testis

Objective: To analyze the oxidative damage and histopathological alterations caused by ischemia-reperfusion (I/R) injury and ameliorative effects of carvedilol (CVD) in the rat testis. Materials and Methods: Twenty-one male rats were randomized into 3 groups as follows: Group I (n = 7); control (sham) group, Group II (n = 7); I/R group, in which I/R injury was performed by torsing the left testis 720º clockwise for 2 hours and detorsing for 2 hours. Group III (n = 7); CVD treatment group; in addition to I/R process, one-dose of CVD was administered (2mg/kg, i.p) 30 min. before detorsion. Levels of antioxidant enzymes, superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) and levels of malondialdehyde (MDA) and protein carbonyl (PC) were determined in testicular tissues and serum of rats. Testicular tissues were also examined histopathologically and Johnsen scores were determined. Results: Activities of SOD and GSH-Px in serum and testicular tissues were increased by I/R, but administration of CVD decreased these levels (p < 0.001 and p = 0.001). Significantly increased MDA levels in serum and testicular tissues were decreased by CVD treatment (p < 0.001 and p = 0.001). Concerning PC levels in serum and testicular tissues, there was no statistically significant difference between the groups (p = 0.989 and p = 0.428). There was not a statistically significant difference in terms of mean Johnsen scores between the groups (p = 0.161). Conclusions: Administration of CVD decreased oxidative damage biochemically in the rat testis caused by I/R injury, but histopathologically no change was observed between all of the groups. .

Renal cell carcinoma with concomitant solid pseudopapillary tumor of the pancreas: A case report.

INTRODUCTION: Solid pseudopapillary tumor (SPT) of pancreas is an unusual low-grade malignant epithelial tumor that usually occurs in young women and can be treated with surgical resection. Renal cell carcinoma (RCC) is the most common solid lesion of the kidney and primarily a disease of the elderly patient. PRESENTATION OF CASE: In this article we present a case of RCC with concomitant SPT of the pancreas who was treated successfully with a radical nephrectomy and distal pancreatectomy. DISCUSSION: RCC with concomitant SPT may associated in ß-catenin gene mutation. But no prior reports have described RCC with concomitant SPT of the pancreas in the same patient. CONCLUSION: To the best of our knowledge, this is the first report of RCC with concomitant SPT of the pancreas in the same patient.

Efecto de la obesidad inducida por dieta en el tejido testicular y parámetros de estrés oxidativo en el suero / The Effect of Diet Induced Obesity on Testicular Tissue and Serum Oxidative Stress Parameters

Objetivo: El objetivo de este estudio fue evaluar los efectos de la obesidad inducida por dieta en los parámetros de semen y los valores séricos de enzimas antioxidantes. Material y métodos: Ratas macho de 6 semanas fueron distribuidas aleatoriamente en tres grupos: el grupo 1 (n=10) recibió una dieta controlada; el grupo 2 (n=9), una dieta alta en grasas, y el grupo 3 (n=11), una dieta alta en grasas junto con anastrozol. A las 10 semanas se obtuvieron los tejidos testiculares y se evaluó la espermatogénesis con el sistema de puntuación de Johnson. Se aceptó >9,39 como puntuación normal. Además, se midieron los valores séricos de enzimas antioxidantes, los triglicéridos, el colesterol, la testosterona, la hormona luteinizante (HL), la hormona estimulante del folículo (HEF) y el estradiol en el suero. Resultados: El peso corporal aumentó considerablemente en los ratones alimentados con una dieta alta en grasas en comparación con los que recibieron una dieta normal (p<0,05). Los valores medios de triglicéridos fueron 64,00±20,48, 98,89±27,80 y 95,27±15,02mg/dl en los grupos 1 2 y 3, respectivamente (p<0,05). Las ratas macho alimentadas con una dieta alta en grasas presentaban valores de testosterona considerablemente más bajos en comparación con las que recibieron una dieta controlada (p=0,005). La patología testicular reveló que la puntuación de Johnson fue 9,60±0,15, 8,72±1,81 y 9,29 en los grupos 1, 2 y 3, respectivamente (p=0,169). Además, los valores de óxido nítrico (NO) en el suero fueron mayores en los grupos 2 y 3 que en el 1 (p<0,05). Conclusión: Como resultado, se puede concluir que la obesidad puede provocar estrés oxidativo y la disminución de los valores de testosterona. Estos cambios pueden alterar las funciones testiculares y, por lo tanto, se puede especular que la obesidad puede ser un factor causante importante en la etiología de la infertilidad masculina (AU)

Objective: The aim of this study was to evaluate the effects of diet induced obesity on semen parameters and serum antioxidant enzyme levels. Material and methods: Six-week-old male rats were randomized into three groups are as follows: group 1 (n=10) received a control diet, group 2 (n=9) received a high-fat diet and group 3 (n=11) received high-fat diet plus anastrozole. At the completion of a 10-week period, testicular tissues were obtained and spermatogenesis was evaluated with Johnsen Score System. The normal Johnsen Score was accepted as >9.39. In addition, serum antioxidant enzyme levels, triglyceride, cholesterol, testosterone, luteinizing hormone (LH), follicle stimilating hormone (FSH) and estradiol levels were measured in serum. Results: Body weight were significantly increased in mice fed with a high-fat diet compared to normal diet (P<0.05). The mean triglyceride levels was 64.00±20.48mg/dl, 98.89±27.80mg/dl and 95.27±15.02mg/dl in group 1, group 2 and group 3, respectively (P<0.05). Male rats fed with a high-fat diet had significantly lower levels of testosterone compared with the control diet male rats (P=0.005). Testicular pathology revealed that Johnsen Score System were 9.60±0.15, 8.72±1.81 and 9.29 in group 1, group 2 and group 3, respectively (P=0.169). In addition serum nitric oxide (NO) levels were higher in group 2 and group 3 compared to group 1 (P<0.05). Conclusion: As a result it may be concluded that obesity may induce oxidative stress and decrease testosterone levels. These changes may alter testicular functions and consequently it may be speculated that obesity can be important causative factor in the etiology of the male infertility (AU)

[The effect of diet induced obesity on testicular tissue and serum oxidative stress parameters]. / Efecto de la obesidad inducida por dieta en el tejido testicular y parámetros de estrés oxidativo en el suero.

OBJECTIVE: The aim of this study was to evaluate the effects of diet induced obesity on semen parameters and serum antioxidant enzyme levels. MATERIAL AND METHODS: Six-week-old male rats were randomized into three groups are as follows: group 1 (n=10) received a control diet, group 2 (n=9) received a high-fat diet and group 3 (n=11) received high-fat diet plus anastrozole. At the completion of a 10-week period, testicular tissues were obtained and spermatogenesis was evaluated with Johnsen Score System. The normal Johnsen Score was accepted as >9.39. In addition, serum antioxidant enzyme levels, triglyceride, cholesterol, testosterone, luteinizing hormone (LH), follicle stimilating hormone (FSH) and estradiol levels were measured in serum. RESULTS: Body weight were significantly increased in mice fed with a high-fat diet compared to normal diet (P<.05). The mean triglyceride levels was 64.00±20.48 mg/dl, 98.89±27.80 mg/dl and 95.27±15.02 mg/dl in group 1, group 2 and group 3, respectively (P<.05). Male rats fed with a high-fat diet had significantly lower levels of testosterone compared with the control diet male rats (P=.005). Testicular pathology revealed that Johnsen Score System were 9.60±0.15, 8.72±1.81 and 9.29 in group 1, group 2 and group 3, respectively (P=.169). In addition serum nitric oxide (NO) levels were higher in group 2 and group 3 compared to group 1 (P<.05). CONCLUSION: As a result it may be concluded that obesity may induce oxidative stress and decrease testosterone levels. These changes may alter testicular functions and consequently it may be speculated that obesity can be important causative factor in the etiology of the male infertility.

Sarcomatous carcinoma with osteosarcomatoid differentiation of the bladder with simultaneous sigmoid colon adenocarcinoma.

Sarcomatoid carcinoma is a rare tumor of the urinary bladder and accounts for approximately 0.3% of all bladder malignancies. In these tumors, histogenesis and biological behaviour remains controversial. Herein, we report a case of sarcomatoid carcinoma with osteosarcomatoid differentiation of the urinary bladder with simulataneous sigmoid colon adenocarcinoma.

Heart rate variability in diabetes patients.

Diabetes mellitus can cause cardiovascular autonomic neuropathy and is associated with increased cardiovascular deaths. We investigated cardiovascular autonomic neuropathy in diabetics and healthy controls by analysis of heart rate variability. Thirty-one diabetics and 30 age- and sex-matched controls were included. In the time domain we measured the mean R - R interval (NN), the standard deviation of the R - R interval index (SDNN), the standard deviation of the 5-min R - R interval mean (SDANN), the root mean square of successive R - R interval differences (RMSSD) and the percentage of beats with a consecutive R - R interval difference > 50 ms (pNN50). In the frequency domain we measured high-frequency power (HF), low-frequency power (LF) and the LF/HF ratio. Diabetes patients had lower values for time-domain and frequency-domain parameters than controls. Most heart rate variability parameters were lower in diabetes patients with chronic complications than in those without chronic complications.

The role of HLA molecules in susceptibility to chronic rheumatic heart disease.

Only a small fraction of the streptococcal pharyngitis progress to rheumatic carditis, which implies that environmental, host and microbial factors interact to cause an aberrant immune response against the antigens of the microorganism that cross-react with cardiac tissues. Although there are numerous studies and a general consensus on the relation between human leucocyte antigen (HLA) class II antigens and rheumatic heart disease (RHD), the details and the culprit antigens are still controversial. The study was undertaken to examine 100 patients with chronic RHD and 100 controls for HLA class I and class II antigens for differences in prevalence. All samples were typed at the HLA-DRB1/3/4/5 and DQB1 loci by the sequence-specific primer (PCR-SSP) method at low resolution. For HLA class I antigens, HLA-B13 frequency was marginally increased in patients with RHD compared to controls without reaching statistical significance. For class II antigens, RHD patients had higher frequencies for HLA-DRB1*01 (RHD 24%, controls 10%), DRB1*04 (RHD 35%, controls 26%), DRB1*07 (RHD 18%, controls 11%) and HLA-DQB1*02 (RHD 32%, controls 17%) without reaching statistical significance, and significantly lower frequencies for DRB1*13 (Pc < 0.003, OR: 5.69), DRB5* (Pc < 0.003, OR: 33) and DRB3* (Pc = 0.03, OR: 2.66) compared to controls. It was concluded that host, microbial and environmental factors collude to create acute rheumatic fever (RF) and chronic rheumatic valve disease. The HLA-DRB1*13, DRB5* and DRB3* were protective against the development of rheumatic valve damage.

Effects of amlodipine and fosinopril on heart rate variability and left ventricular mass in mild-to-moderate essential hypertension.

The differences between long-acting dihydropyridines and angiotensin-converting enzyme inhibitors with regard to their long-term effects on 24-h heart rate variability (HRV) and left ventricular (LV) mass are less clear in mild-to-moderate essential hypertension. We studied the long-term effects of amlodipine and fosinopril on 24-h HRV and LV mass in mild-to-moderate essential hypertension. In this study, 27 patients with never treated mild-to-moderate essential hypertension were randomised to receive either amlodipine or fosinopril once daily as monotherapy. At baseline and at the end of the third and sixth months, each of the patients underwent 24-h HRV and ambulatory systolic (SBP) and diastolic (DBP) blood pressure analysis. LV mass index was calculated from echocardiographic examination at baseline and at the end of the sixth month. In amlodipine group (n = 14), 24-h SBP/DBP (mmHg) decreased from 144 +/- 8/94 +/- 4 to 128 +/- 6/83 +/- 3 at the end of the third month and to 125 +/- 5/81 +/- 2 at the end of the sixth month (p < 0.0001). In fosinopril group (n = 13), the respective changes were 143 +/- 9/97 +/- 7, 132 +/- 6/87 +/- 5 and 127 +/- 6/82 +/- 3 (p < 0.0001). At the end of the sixth month, LV mass index (g/m(2)) decreased from 122 +/- 26 to 105 +/- 21 in amlodipine group (p < 0.0001) and from 118 +/- 23 to 101 +/- 14 in fosinopril group (p < 0.0001). There were no significant changes in HRV parameters in both the groups. It was concluded that both drugs caused significant decrease in SBP and DBP, and LV mass in patients with mild-to-moderate essential hypertension did not have significant long-term effects of either amlodipine or fosinopril on 24-h HRV parameters reflecting sympathetic or parasympathetic activity in these patients.

Effect of left atrial size and function on P-wave dispersion: a study in patients with paroxysmal atrial fibrillation.

BACKGROUND: Paroxysmal atrial fibrillation (PAF), a common arrhythmia, is caused by the fractionated and nonhomogeneous propagation of sinus impulse. HYPOTHESIS: This study was undertaken to examine the effect of left atrial (LA) dimension and function on P-wave dispersion (deltaP) in unselected patients with PAF and health controls. METHOD: In this study, 62 consecutive patients with PAF (32 men, 30 women, mean age 55+/-11 years) and 62 age- and gender-matched healthy controls (33 men, 29 women, mean age 52+/-13 years) were studied to compare the effect of LA size, volume, and function on deltaP (difference between maximum and minimum P-wave duration on 12-lead electrocardiogram). RESULTS: P-wave dispersion in patients with PAF and normal LA diastolic diameter (LAD) was longer than that in controls with normal LA size (53+/-8 vs. 34+/-8 ms, p < 0.001). P-wave dispersion increased in patients with PAF (62+/-12 vs. 53+/-8 ms, p = 0.003) and controls (40+/-7 vs. 34+/-8 ms, p = 0.005) with increased LAD. Presence or absence of PAF did not interact with LAD for their effect on deltaP (2 x 2 analysis of variance test p = 0.20). In the PAF group, deltaP correlated with LAD (r = 0.43, p = 0.002), LA diastolic volume (r = 0.6, p < 0.001), and LA ejection fraction (AEF) (r = - 0.33, p = 0.05). The AEF was preserved when LAD increased in the patients without PAF (0.52+/-0.07 vs. 0.57+/-0.10, p = NS), however was significantly decreased in the PAF group (0.37+/-0.12 vs. 0.49+/-0.10, p = 0.01). On multivariate logistic regression analysis, only deltaP retained significance on development of PAF. CONCLUSION: It was concluded that deltaP increased in patients with PAF and normal LA size. In controls with increased LA size, deltaP increased but did not reach the levels attained in patients with PAF. The AEF was decreased in patients with PAF but was preserved in those without PAF. These findings can be explained by the changes in LA microarchitecture which concurrently decreased atrial myocardial contraction, increased deltaP, and predisposed to PAF.

Cardiac and intestinal amyloidosis in a renal transplant recipient with familial Mediterranean fever.

In Turkey, familial Mediterranean fever (FMF) is an important cause of nephrotic syndrome and endstage renal disease due to renal deposition of AA type amyloid. We report a case of living-related donor renal transplant recipient with FMF and renal AA type amyloidosis, who died of progressive heart failure due to cardiac involvement. The patient also had intractable diarrhea caused by biopsy-proven intestinal amyloidosis. The patient was on 1 mg/day colchicine. Although he was attack-free throughout the post-transplant period, intestinal and clinically significant cardiac amyloidosis, which implied the presence of sustained inflammation and continuing amyloid deposition, appeared three years after renal transplantation. Cardiac deposition of AA amyloid may cause clinically significant heart disease, leading to cardiovascular mortality after renal transplantation for end-stage renal disease in FMF patients.

Assessment of left atrial appendage function and its relationship to pulmonary venous flow pattern by transesophageal echocardiography.

We evaluated left atrial appendage function and its relationship to pulmonary venous flow in 53 patients divided into four groups. Group 1 consisted of 10 normal subjects. Group 2 included 15 patients with significant pure mitral stenosis in sinus rhythm. In group 3, there were 13 patients with pure significant mitral stenosis and atrial fibrillation. Group 4 consisted of 15 patients with normal mitral valve and atrial fibrilltion. We found significant decrease in left atrial appendage ejection fraction and maximum emptying flow velocity, velocity time integral of systolic pulmonary venous flow in Groups 2, 3 and 4 in comparison with normal subjects. Systolic pulmonary venous flow velocity was significantly decreased in Groups 3 and 4. There was significant correlation between left atrial appendage ejection fraction and peak emptying flow velocity (r = 0.62, P < 0,001). Systolic peak pulmonary venous flow velocity was significantly correlated with left atrial appendage ejection fraction and maximum emptying flow velocity (r = 0.67, P = 0,01; r = 0.58, P < 0,001, respectively). There was also significant correlation between systolic pulmonary venous flow velocity time integral and left atrial appendage ejection fraction (r = 0.66, P = 0.001). When normals were excluded from analysis, all the correlations were still significant. We concluded that left atrial appendage is a contractile structure, and that systolic pulmonary venous flow velocity is influenced by left atrial appendage dysfunction. Therefore left atrial appendage function needs to be considered when interpreting Doppler transmitral and systolic pulmonary venous flow patterns.

Surgical treatment of cardiac echinococcosis: report of eight cases.

Cardiac involvement of hydatid disease is uncommon, and establishing a diagnosis is difficult because the presenting symptoms are variable. Between 1985 and 1997, eight patients ranging in age from 8 to 56 years underwent surgical excision of cardiac hydatid cysts, located in the interventricular septum in two, the right atrium in one, and the intrapericardium in five. There was one hospital death due to septic shock, but the other seven patients recovered uneventfully.

Effect of Valsalva maneuver on surface electrocardiographic P-wave dispersion in paroxysmal atrial fibrillation.

The purpose of this study was to investigate the effect of the Valsalva maneuver on P-wave durations and dispersion. After the Valsalva maneuver, we found that maximum P-wave duration increased, minimum P-wave duration decreased, and P-wave dispersion increased in controls, whereas the opposite was true for unselected patients with paroxysmal AF. It was concluded that patients with paroxysmal AF performing the Valsalva maneuver normalized their P-wave dispersion, thereby correcting the inhomogeneous intra-atrial conduction.

Left ventricular hydatid cyst: an unusual location of Echinococcus granulosus with multiple organ involvement.

Cardiac Echinococcus is rare but usually associated with fatal complications. An unusual case of cardiac hydatid cyst with multiple organ involvement is presented in which transesophageal echocardiography provided additional information and confirmed transthoracic echocardiographic findings.

Metabolic, hematological, and cardiac effects of long-term isradipine treatment in mild-to-moderate essential hypertension.

Twenty-four patients with mild-to-moderate hypertension (19 women, 5 men; mean age of 49 +/- 9.1 years) completed a 2-week washout phase followed by 1 week of single-blind placebo. Patients were then given isradipine at 2.5 mg twice daily, which was increased to up to 7.5 mg twice daily according to the blood pressure response, over a 12-month period. Thirteen patients completed the trial. The supine and sitting blood pressure decreased to normal levels within 6 weeks of starting active treatment. Heart rate remained unchanged. Plasma cholesterol and triglycerides did not change significantly. Plasma high-density lipoprotein (HDL) cholesterol increased significantly (p less than 0.05) and a decrease (NS) was observed in low-density lipoprotein (LDL) cholesterol and in the LDL/HDL cholesterol ratio. Very-low-density lipoprotein (VLDL) cholesterol did not change, nor did other biochemical laboratory tests, or electrocardiographic and echocardiographic parameters. The most notable side effects were headache (n = 1), flushing (n = 1), palpitations (n = 3), and pretibial edema (n = 1). In conclusion, our results indicate that isradipine is safe and effective in the long-term treatment of mild-to-moderate hypertension. It also appears to have beneficial effects on lipid metabolism.