The most important cause of erectile dysfunction (ED) among aging men is organic disease due to vascular disturbance that is often caused by atherosclerosis. Recently, studies have shown that atherosclerosis can manifest as an active inflammatory process rather than as passive vascular injury caused by lipid infiltration. Our study aimed to examine the association of ED with the neutrophil/lymphocyte ratio (NLR) and the platelet/lymphocyte ratio (PLR), both of which are markers of inflammation. Between December 2014 and May 2015, 101 male patients aged 40-70 years who were seen at our institute due to ED were included in this study. Thirty-one sexually active men with similar clinical and demographic characteristics without ED were included in our study as a control group. The control and patient groups were compared with respect to their NLR and PLR values as well as other hormonal, biochemical, hematological parameters. The median ages of the patient and control groups were 49 (40-69) and 48 (43-65) years old, respectively. Comorbidities such as hypertension, diabetes, chronic obstructive pulmonary disease (COPD), and coronary artery disease were not significantly different between the groups (p > 0.05). The neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios were significantly higher in the patient group than in the control group (p < 0.05). Furthermore, the detected CRP levels were also significantly higher in the patient group than in the control group (p < 0.001). In the correlation analysis, the NLR, PLR, and CRP levels were negatively correlated with the IIEF-5 scores. A multivariate analysis was performed to determine the independent predictors of ED. PLR was identified as an independent predictor for ED. The neutrophil-to-lymphocyte and especially platelet-to-lymphocyte ratios are correlated with a diagnosis of ED, and these ratios could serve as practical parameters that will not elicit additional costs.

Objective: To evaluate the diagnostic value of serum inflammation markers derived from complete blood count in diagnosis of prostate cancer (PCa). Methods: We retrospectively analyzed the data of 621 patients who underwent prostate biopsy between March 2013 and April 2018. Age, prostate specific antigen (PSA), free PSA, platelet count, neutrophil count, lymphocyte count, monocyte count, prostate volume (PV) and pathology result of the patients were recorded. Patients were grouped as benign prostatic hyperplasia (BPH), prostatitis and PCa. Patients were also grouped according to PSA values, as PSA < 4 , PSA 4-10 and PSA > 10 ng/dl. Results: The mean lymphocyte-to-monocyte ratio (LMR) value of the patients with PCa was significantly lower in the entire cohort (p = 0.047). In the PSA 4-10 ng/dl range, LMR value wassignificantly lower in patients with PCa than those with BPH or prostatitis (p = 0.012). In this PSA range, free/total PSA ratio and LMR were significant factors to predict PCa. The cut-off values of LMR, free/total PSA were 3.05 and 0.15 respectively. The sensitivities, spesificities, positive predictive values (PPV) and negative predictive values using LMR cut-off, free/total PSA cut-off and their combination were assessed. Specificity and PPV of the combination group were higher (97.2%, 83.3% respectively) compared to free/total PSA cut-off group (91.6%, 76.6%) and LMR cut-off group (67.8%, 43.7%).Conclusions: LMR is a useful tool at detecting PCa especially in patients with PSA value between 4 and 10 ng/dl. The combination of free/total PSA ratio and LMR improves the diagnostic accuracy more than the use of free/total PSA ratio alone.

Objectives. The total antioxidant capacity (TAC) of a sample can be measured with a ferric reducing antioxidant power (FRAP) assay. There are commercially available kits for FRAP assays, however they are more expensive than in-house kits. We aimed to evaluate a FRAP direct measurement method under our laboratory conditions using a microplate reader and establish reference values to use in future research projects. Methods. An inhouse microplate adaptation of the FRAP method was evaluated. Reference values of FRAP were established for one hundred and twenty subjects aged between 25-55 years. FRAP levels were estimated in 30 serum samples with high glucose concentration, 44 hyperbiluribinemic neonatals and 16 patients receiving renal replacement therapy (RRT). Results. The mean FRAP level was 890±235 µmol/L. The median TAC level was 904 µmol/L. This method was found to be linear up to at least 2000 µmol/L. The intra-and inter-assay coefficients of variation were 2.7-6.7% and 5.3-10.1%, respectively. The mean FRAP level was lower than normal in diabetes and RRT patients and higher in hyperbiluribinemic neonatals (687±209 µmol/L, 609±250 µmol/L and 945±187 µmol/L, respectively). Conclusions. Our reference values give comparable results with the literature. This method is simple, reliable, and inexpensive. It could be used for studies of oxidative stressrelated diseases.Eur Res J 2016;2(2):126-131

Spermatic cord liposarcoma is very rare and characterized by a painless inguinal or scrotal mass. This is a case report of a 66-yearold man presenting with a mass in his left scrotum. Inguinal orchiectomy was performed and the histopathological examination revealed a liposarcoma of the spermatic cord.

Summary This study aimed to find a relationship between vitamin D concentration and thiol-disulfide homeostasis in the pathophysiology of overactive bladder (OAB) syndrome in postmenopausal women. A total of 76 postmenopausal women, referred for routine controls, were recruited between January and March 2018 to participate in this study. Participants with an overactive bladder questionnaire (OAB-q) score of >11 (n = 34) were included in the OAB syndrome group, while those with a score of <5 (n = 42) were included in the control group. Serum total antioxidant capacity, ischemiamodified albumin, C-reactive protein, 25-hydroxy vitamin D levels, and thiol-disulfide homeostasis were measured. Patients with OAB syndrome had waist circumferences of 106 ± 11 cm, and their body mass indexes (BMIs) were 30.8 ± 4.8 kg/m2. The control groups’ waist circumferences were 102 ± 11 cm and their BMIs were 28.9 ± 4.3 kg/m2 (p = 0.069 and p = 0.098, respectively). The level of vitamin D in the control group was 33.7 (IQR: 30.7) nmol/L and 27.0 (IQR: 27.5) nmol/L (p = 0.081) in the OAB syndrome group.Conclusion: We were not able to demonstrate with certainty any significant relationships between serum 25-hydroxy vitamin D levels and thiol-disulfide homeostasis parameters and OAB syndrome.

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To compare the efficacy of the middle calyx access (MCA) and lower calyx access (LCA) in the treatment of lower pole kidney stones. Materials and Methods: The data of patients with isolated lower pole kidney stones who underwent percutaneous nephrolithotomy via MCA or LCA between 2009 and 2019 were evaluated retrospectively. Pre-, peri-, and postoperative parameters of the groups (LCA group and MCA group) were compared. A value of p < 0.05 was considered significant. Results: A total of 601 patients with lower pole kidney stones were included in the study. LCA was performed for the initial tract in 400 patients, and MCA was performed in 201 patients. There were no significant differences in terms of age, gender, laterality, body mass index, previous operation history, stone burden, duration of fluoroscopy, and stone-free rate between the groups. Operation time was significantly longer in the LCA group (p = 0.041). In the LCA group, additional access was required in 50 cases, which was significantly higher than in the MCA group (p = 0.013). Clinically insignificant residual fragments (CIRF) were present in 28 patients (7%) in the first group (sig-nificantly higher vs. MCA: p = 0.044). There were no statistically significant differences in terms of overall complication and transfusion rates. Conclusions: MCA had superior outcomes in terms of operation time, CIRF rate, hemoglobin drop, and requirement of an additional tract compared to LCA. Further studies evaluating the efficacy of MCA in lower pole kidney stones should be performed to verify our results.

Objective: In the management of benign prostatic hyperplasia (BPH), urology guide- lines recommend medical or surgical treatments according to different prostate volumes (PV). The aim of this study was to analyze the relationships between PV and age, total and free prostate specific antigen (tPSA, fPSA) and fPSA/tPSA ratio in patients without histologically proven prostate cancer. Materials and methods: A retrospective analysis was made of the data of 1334 patients who underwent transrectal ultra- sound (TRUS)-guided prostate biopsy between January 2016 and October 2018. A total of 438 patients with available data for age, tPSA and fPSA levels and PV calculated by TRUS were enrolled in the study. Patients with chronic prostatitis pathology in addition to BPH were also noted and evaluated as a separate group. Results: There were significant correlations between PV and age, tPSA, fPSA, fPSA/tPSA ratio (r = 0.210, r = 0.338, r = 0.548, r = 0.363 respectively). In multivariate linear regression analysis, fPSA was found to be the only predictor for PV (p < 0.001) when compared to age (p = 0.097), tPSA (p = 0.979) and fPSA/tPSA ratio (p = 0.425). In patients with chronic prostatitis pathology there were significant correla- tions between PV and age, tPSA, fPSA, fPSA/tPSA ratio (r = 0.279, r = 0.379, r = 0.592, r = 0.359, respectively). The multivariate linear regression analysis showed a signifi- cant correlation only between PV and tPSA and fPSA/tPSA ratio but not with fPSA and age (p = 0.008, p = 0.015, p = 0.430, p = 0.484, respectively). In men with only BPH pathology there were significant correlations between PV and age, tPSA, fPSA, fPSA/tPSA ratio (r = 0.223, r = 0.385, r = 0.520, r = 0.287, respectively) In multivariate linear regression model the significant correlation was shown only between PV and fPSA (p < 0.001). Conclusions: Although tPSA was significantly correlated with PV in patients without prostate cancer, the correlation between fPSA and PV was much stronger. However, it should be kept in mind that the efficacy of fPSA may be limited in patients with clinically unknown prostatic inflammation.