Many theories have been put forward to explain the mechanism of stone formation and growth. The aim of this study was to investigate the urinary, serum and stone levels of zinc, iron, magnesium, and copper in patients with calcium oxalate stones and to investigate urinary and serum element levels in healthy controls and to find a possible connection between the elements and calcium oxalate stone formation. A total of 104 patients with calcium oxalate stones ranging in age from 3 to 79 years (mean 44.0 +/- 18.1) and 77 healthy controls ranging in age from 18 to 77 (mean 44.2 +/- 17.9) were included in this study. The mean urinary iron and copper levels in stone patients were significantly higher than healthy controls (P = 0.000). The mean urinary zinc and magnesium levels in healthy controls were significantly higher than stone patients (P = 0.000). There was no significant difference in the serum levels of magnesium and copper in stone patients and healthy controls. Serum zinc and iron level were significantly high in healthy controls as compared to stone patients. Each stone had all 4 elements. Zn and Mg have inhibitory effect on calcium oxalate stone formation. Fe and Cu could be promotor of the calcium oxalate stone formation.

The contrast enhancement patterns on DCE-MRI are influenced by tumor angiogenesis, as reflected by elevated microvessel density expression. Therefore, they are valuable indicators for assessing tumor angiogenic activity and tumor neovascularization in bladder cancers.

The aim of this study was to investigate the ability of N-acetylcysteine (NAC) to prevent cadmium (Cd)-induced renal damage and whether NAC would reverse cadmium damage to the kidney. Fifty adult male rats were divided into five experimental groups: group 1 received tap water for 3 months and 7 days, group 2 received cadmium chloride (CdCl(2)) for 3 months, group 3 (NAC cotreatment group) received CdCl(2) and 0.5% NAC in tap water for 3 months, group 4 received CdCl(2) in tap water for 3 months and 3 months later received only tap water for 7 days, and group 5 (NAC posttreatment group) received CdCl(2) in tap water for 3 months and 3 months later received 2% NAC in tap water for 7 days. NAC significantly decreased the elevated kidney malondialdehyde levels, as a marker of lipid peroxidation, in both cotreatment and posttreatment modalities. Cotreatment and posttreatment with NAC significantly increased kidney superoxide dismutase enzyme activity and glutathione level but did not change kidney catalase enzyme activity. NAC decreased fractional excretion of sodium in posttreatment group. Neither Cd nor NAC affected the glomerular filtration rate (GFR). Cotreatment and posttreatment with NAC reduced the effects of Cd on proximal tubules. It was found that NAC showed these effects without changing kidney accumulation of cadmium. Exogenously administrated NAC might reduce toxic effects of Cd on the kidney without any reduction in tissue Cd level.

Reactive oxygen species (ROS) were shown to contribute to the cellular damage induced by ischemia-reperfusion. The purpose of this study was to investigate and compare the efficiency of melatonin and vitamin E in the reduction of injury induced by ROS in a rat model of renal ischemia-reperfusion. Twenty-four Wistar-albino rats were divided into four groups. Rats in the Sham group were given saline 1 mL/kg, intraperitoneally (ip) 72 h, 48 h, 24 h, and 30 min before the sham operation. Rats in ischemia-reperfusion (IR), IR+Melatonin, and IR+Vitamin E groups were given saline (1 mL/ kg), melatonin (10 mg/kg), and vitamin E (100 mg/kg) ip, respectively, 72 h, 48 h, 24 h, and 30 min before the ischemia for 60 min, followed by reperfusion for 60 min. The blood samples and kidney tissues of the rats were taken under anesthesia. Ischemia-reperfusion significantly increased urea, creatinine, and malondialdehyde (MDA) levels, and decreased superoxide dismutase (SOD) and catalase (CAT) activities. Histopathological findings of the IR group confirmed that there was renal impairment by cast formation and tubular necrosis in the tubular epithelium. In the IR+Melatonin group, while MDA levels significantly decreased, SOD activities increased. In the IR+Melatonin group, the level of tubular necrosis and cast formation are significantly decreased than those seen in the ischemia-reperfusion group. Melatonin in particular was effective to reverse hot ischemia of kidney by its antioxidant effects. These results may indicate that melatonin pretreatment protects against functional, biochemical, and morphological damage better than vitamin E in renal ischemia-reperfusion injury.

We assessed the analgesic efficacy of levobupivacaine when administered as an adjuvant to diclofenac sodium in prostate biopsy pain management and effects of prostate biopsy on sexual function. Ninety patients underwent transrectal ultrasound (TRUS)-guided biopsy of the prostate and were randomly assigned to three groups: group D received diclofenac sodium suppository; Group L received periprostatic injection of levobupivacaine; group DL received diclofenac suppository and levobupivacaine in addition. Patients were asked to use a visual analogue scale score (VAS) questionnaire about pain after 10 core prostate biopsy. Sixty-two patients reported to be prostate cancer-free underwent further evaluation with the International Index of Erectile Function-5 (IIEF-5) questionnaire at 1 and 3 months after biopsy. Mean pain scores during prostate biopsy were significantly lower in group DL and were superior to the group L and group D (P < 0.001). Mean IIEF-5 score prior to biopsies was significantly higher when compared with the mean IIEF-5 score 1 month after biopsy (P < 0.0001). Mean IIEF-5 scores 1 month after biopsy were significantly lower when compared with the mean IIEF-5 scores 3 months after biopsy (P = 0.002). TRUS-guided prostate biopsies have a statistically significant impact on short-term erectile function, but this difference is not clinically significant; however, medium-term erectile function is not affected both statistically and clinically.

Fournier's gangrene is a life-threatening disorder in which infection of the perineum and scrotum spreads along fascial planes, causing soft tissue necrosis. If urgent surgery is delayed, the disease will soon result in septic shock, multiorgan failure, and death. In this study, we present 21 patients with Fournier's gangrene who were treated in period between 1994 and 2001. Patients' charts were reviewed retrospectively and are discussed in the light of literature. All patients received aggressive surgical debridment. Penicillin or Ceftriaxone, aminoglicoside and metronidazole were administered intravenously. Of the 21 patients, 5 had scrotal carbuncle, 1 had urethral stricture, 1 had chronic indwelling urethral catheterization, 2 had perirectal abscess, and 1 had hemorrhoidectomy. In eleven patients we couldn't identify any cause. Twelve patients had diabetes mellitus, and two had chronic alcoholism. Escherichia coli was isolated in 12 purulent tissue cultures, and Bacteroides fragilis in eight. Seventeen patients survived, whereas four died. Fourier's gangrene is considered a surgical emergency. Early surgical intervention is essential, as the gangrene can spread rapidly at rates reaching 2 mm per hour. So that Fournier's gangrene is an abrupt, rapidly progressive, gangrenous infection of the external genitalia and perineum and is a real urologic emergency.

No abstract

Pure primary small cell carcinoma of the prostate (SCCP) is an extremely rare entity. Natural history of this tumor is similar to that of the bronchogenic small cell carcinoma. Several theories of histogenesis have been proposed. Most widely accepted view is that SCCP arises from pluripotent stem cells of the prostate, which have the ability to differentiate into either epithelial or neuroendocrine type carcinomas. SCCP has an aggressive course, and a majority of patients have distant metastasis at presentation. Since it is a rare entity, no standard treatment regimen has been established. A case of primary pure SCCP with multiple subcutaneous metastases is presented.