BackgroundTesticular reperfusion is believed to be the mechanism by which testicular injury occurs in the ischemic testis. This study was performed to determine the therapeutic efficacy of lumbrokinase for treating ischemia-reperfusion (IR) injury-induced bilateral testicular torsion.MethodsTwenty-four male rats were equally divided into the following groups: torsion only (T), torsion plus lumbrokinase (TL), torsion-detorsion only (TD) and torsion-detorsion plus lumbrokinase (TDL) groups. The right testicle in each groups sample was rotated 720° for 4 h, followed by orchiectomy. The rats in the TD (TD and TDL) groups additionally underwent detorsion for 1 h after the initial rotation. Testicular tissues were collected for measuring anti-apoptotic B-cell lymphoma-2 (BCL-2) and pro-apoptotic BCL-2-associated X protein (BAX) gene expression levels using real-time polymerase chain reaction.ResultsPro- and anti-apoptotic gene expression levels were increased in the TD groups. Lumbrokinase was significantly effective in lowering BAX expression levels, particularly those in the TDL group compared with those in the TD group (P<0.05). Lumbrokinase did not significant change BCL-2 expression levels.ConclusionThe administration of lumbrokinase before orchiectomy can protect against IR-induced testicular damage by reducing pro-apoptotic gene expression levels.
Objective: To described a needle renal lifting technique using an 18-gauge needle to adjunct ureterorenoscopy (URS) in the management of complicated proximal ureteral stones. Case(s) Presentation: A 46 years old man presented with right flank pain for 1 month. This patient was diagnosed with ureteral stone and ureteral kinking that prohibits access to the proximal side of the ureter. Due to difficult access to the proximal ureter, we perform a needle renal lifting technique which is initialized by puncturing the middle renal calyx with 18-gauge needle. Then, the proximal end of the needle was pushed to the caudal direction to move the kidney to the cephalic direction and straighten the kinked ureter. After that procedure, the URS sheat can easily enter the proximal ureter to the stone site. Discussion: The success rate of this procedure is based on the operator skills to access the calyx and perform URS simultaneously. Like a previous technique, needle renal lifting is effective only when the kidney is mobile. Conclusion: The needle renal lifting technique can be used to adjunct URS in the management of complicated ureteral stones which prohibited access to the proximal ureter.
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