Testis torsiyonundaki iskemi-reperfüzyon hasarını önlemede tek doz ve yedi günlük melatonin ve steroid tedavisinin etkilerinin araştırılması
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Dosyalar
Tarih
2003
Yazarlar
Dergi Başlığı
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Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Testis torsiyonundan sonra oluşan iskemi reperfüzyon hasarını önlemek için yapılan deneysel çalışmalarda antioksidan maddeler tek doz olarak ilk 24 saatte uygulanmıştır. Çalışmamızda tek doz ve 7 gün süre ile günde günde tek doz olarak uygulanan steroid ve melatoninin antioksidan etkilerinin ve her iki tedavi şeklinden hangisinin daha etkili olduğu ortaya koymayı amaçladık. Materyal ve metodlar: Çalışmamızda 100 adet Sprague-Dawley rat kullanarak 10 gruba ayrıldı. Her grupta 10 adet rat kullanıldı. Sol inguinoskrotal keşi ile testise ulaşıldı. Kontrol grubunda (Grup 1) hemen, sham-1 grubunda (Grup-2) 6 saat sonra, sham-2 grubunda ( Grup 3) 7 gün sonra sol orşiektomi yapıldı. Torsiyon grubunda (Grup 4 ) ise sol testis 720° torsiyone edildikten 6 saat sonra sol orşiektomi uygulandı. Torsiyon-detorsiyon gruplarında (Grup 5 ve 6) sol testis torsiyone edildikten 6 saat sonra detorsiyone edildi. Bu gruplardan birine (Grup 5) detorsiyondan 6 saat sonra, diğerine (Grup 6) ise yedi gün sonra sol orşiektomi yapıldı. Tek doz steroid ve melatonin gruplarında (Grup 7 ve 9) detorsiyondan 30 dakika önce 1 mg/kg metil prednizolon ve 17 mg/kg melatonin verildi. Detorsiyondan 6 saat sonra her iki grupta da sol orşiektomi uygulandı. Yedi doz steroid ve melatonin gruplarında (Grup 8 ve 10) detorsiyondan 30 dakika önce ve yedi gün süre ile günde tek doz 1 mg/kg metil prednizolon ve 17 mg/kg melatonin verildi. Testisler 6 saat süre ile detorsiyone edildi ve 7. günün sonunda her iki grupta da sol orşiektomi uygulandı. İskemi-reperfüzyon hasarını değerlendirmek amacıyla orşiektomi sonrası testis dokusunda MDA seviyeleri ve histopatolojik inceleme yapılarak Johnsen skorları belirlendi. Bulgular: MDA seviyelerine göre; torsiyon-detorsiyon-1 grubu (Grup 5) tek doz steroid (Grup 7) ve melatonin (Grup 9) grupları ile karşılaşıldığında, MDA seviyelerinin Grup 7 ve 9da daha düşük olduğu ve farkın anlamlı olduğu görüldü (P<0.05). Johnsen skorları Grup 5, 7 ve 9 da aynı idi (P>0.05). Torsiyon-detorsiyon-2 grubu (Grup 6), yedi doz steroid (Grup 8) ve melatonin (Grup 10) grupları ile karşılaştırıldığında, hem MDA seviyeleri hem de Johnsen skorları açısından aradaki fark anlamlı olup (P<0.05), Grup 8 ve 10 da MDA değerleri daha düşük, Johnsen skorları ise daha yüksekti (Grup 8 ve 10). Tek doz ve yedi doz steroid grupları, tek doz ve yedi doz melatonin grupları kendi içinde karşılaştırıldığında, MDA seviyeleri ve Johnsen skorları açısından aradaki fark anlamlı idi (P<0.05). Yedi doz steroid ve melatonin grupları arasında fark yoktu (P>0.05). 37Sonuçlar: Bu bulgulara göre; tek doz steroid ve melatonin tedavisinin İ-R hasarına biyokimyasal olarak etkili gibi görünmesine rağmen histopatolojik olarak hiçbir olumlu etkisi yoktur. Yedi doz steroid ve melatonin tedavileri ise hem biyokimyasal olarak hem de histopatolojik olarak 1-R hasarını tam olarak önler. ANAHTAR SÖZCÜKLER: Testis torsiyonu, iskemi-reperfüzyon hasarı, steroid, melatonin.
Purpose: In experimental studies to prevent the l-R damage after testicular torsion, antioxidant agents were used as one-dose for the first 24 hours. In this study, we tried to determine the antioxidant effects of steroid and melatonin, which were injected as one dose in group 7 and 9, and once a day for seven days in group 8 and 10. Materials and methods: A hundred peripubertal male Sprague-Dawley rats were devided into 10 groups each containing 10 rats. Testicles were identified by left inguinoscrotal skin incision. Left orchiectomies were performed in the shortest time in group 1, after 6 hours in group 2 (sham 1), and after 7 days in group 3 (sham 2). In torsion group (group 4), torsion was created by rotating the left testicles in a clockwise direction for 6 hours. Then, left orchiectomies were performed. In group 5 and 6 (torsion-detorsion groups), 6 hours of torsion-6 hours of detorsion were created. In one of these groups (group 5) left orchiectomies were created after 6 hours of torsion-6 hours of detorsion. In other group, left orchiectomies were performed seven days later. In group 7 and 9 (10 dose steroid and melatonin groups) 1 mg/kg metilprednisolon and 17 mg/kg melatonin were injected before 30 minutes from detorsion. In both of these groups, left orchiectomies were performed after 6 hours of detorsion. In group 8 and 10 (7 dose steroid and melatonin groups) 1 mg/kg metilprednisolon and 17 mg/kg melatonin were injected before 30 minutes from detorsion and once a day for 7 days, and at the end of 7 days, left orchiectomies were performed in both of these groups. Histopathologic examination were performed, and MDA levels and Johnsen's scores of testicular tissue were determined. Results: MDA levels in group 7 and 9 (T-D-Tek S, T-D-Tek M) were significantly less compared with group 5 (T-D-1) (P<0.05). Johnsen's scores were the same as in group 5, 7 and 9 (T-D-1, T-D-Tek S, T-D-Tek M) (P>0.05). Both MDA levels and Johnsen's scores in group 6 (T-D-2) were significantly different compared with group 8 (T-D-7 S) and 10 (T-D-7 M). MDA levels were less and Johnsen's scores were higher in group 8 (T-D-7 S) and 9 (T- D-7 M). MDA levels and Johnsen's scores in group 7 (T-D-Tek S) and 8 (T-D-7 S) were significantly different (P<0.05). Also, these parameters were the same for group 9 (T-D-Tek M) and 10 (T-D-7 M) (P<0.05). There was no difference in group 8 (T-D-7 S) and 10 (T-D-7 M). Conclusions: According to these data, the treatment of one-dose steroid and melatonin are effective against the l-R damage biochemically, but not histopathologically. The treatments of 7 dose steroid and melatonin, however significantly prevents l-R damage both biochemically and histopathologically. INDEX WORDS: Testicular torsion, ischemia-reperfusion, steroid, melatonin.
Purpose: In experimental studies to prevent the l-R damage after testicular torsion, antioxidant agents were used as one-dose for the first 24 hours. In this study, we tried to determine the antioxidant effects of steroid and melatonin, which were injected as one dose in group 7 and 9, and once a day for seven days in group 8 and 10. Materials and methods: A hundred peripubertal male Sprague-Dawley rats were devided into 10 groups each containing 10 rats. Testicles were identified by left inguinoscrotal skin incision. Left orchiectomies were performed in the shortest time in group 1, after 6 hours in group 2 (sham 1), and after 7 days in group 3 (sham 2). In torsion group (group 4), torsion was created by rotating the left testicles in a clockwise direction for 6 hours. Then, left orchiectomies were performed. In group 5 and 6 (torsion-detorsion groups), 6 hours of torsion-6 hours of detorsion were created. In one of these groups (group 5) left orchiectomies were created after 6 hours of torsion-6 hours of detorsion. In other group, left orchiectomies were performed seven days later. In group 7 and 9 (10 dose steroid and melatonin groups) 1 mg/kg metilprednisolon and 17 mg/kg melatonin were injected before 30 minutes from detorsion. In both of these groups, left orchiectomies were performed after 6 hours of detorsion. In group 8 and 10 (7 dose steroid and melatonin groups) 1 mg/kg metilprednisolon and 17 mg/kg melatonin were injected before 30 minutes from detorsion and once a day for 7 days, and at the end of 7 days, left orchiectomies were performed in both of these groups. Histopathologic examination were performed, and MDA levels and Johnsen's scores of testicular tissue were determined. Results: MDA levels in group 7 and 9 (T-D-Tek S, T-D-Tek M) were significantly less compared with group 5 (T-D-1) (P<0.05). Johnsen's scores were the same as in group 5, 7 and 9 (T-D-1, T-D-Tek S, T-D-Tek M) (P>0.05). Both MDA levels and Johnsen's scores in group 6 (T-D-2) were significantly different compared with group 8 (T-D-7 S) and 10 (T-D-7 M). MDA levels were less and Johnsen's scores were higher in group 8 (T-D-7 S) and 9 (T- D-7 M). MDA levels and Johnsen's scores in group 7 (T-D-Tek S) and 8 (T-D-7 S) were significantly different (P<0.05). Also, these parameters were the same for group 9 (T-D-Tek M) and 10 (T-D-7 M) (P<0.05). There was no difference in group 8 (T-D-7 S) and 10 (T-D-7 M). Conclusions: According to these data, the treatment of one-dose steroid and melatonin are effective against the l-R damage biochemically, but not histopathologically. The treatments of 7 dose steroid and melatonin, however significantly prevents l-R damage both biochemically and histopathologically. INDEX WORDS: Testicular torsion, ischemia-reperfusion, steroid, melatonin.
Açıklama
Anahtar Kelimeler
Testis torsiyonu, İskemi-reperfüzyon, Steroid, Melatonin, Testicular torsion, Ischemia-reperfusion
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Yurtçu, M. (2003). Testis torsiyonundaki iskemi-reperfüzyon hasarını önlemede tek doz ve yedi günlük melatonin ve steroid tedavisinin etkilerinin araştırılması. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Çocuk Cerrahisi Anabilim Dalı, Konya.
