Serum creatine kinase enzyme levels in the early diagnosis of spermatic cord torsion

Ulman, İbrahim; Sakalli, Ümit; Avanoğlu, Ali; Çelik, Ahmet; Ulman, Cevval; Fadiloğlu, Meral; Gökdemir, A.

doi:10.1007/bf00389788

Cited by 3 publications

(4 citation statements)

References 8 publications

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“…It has been reported that CK and its isoenzymes have a diagnostic value in tissue ischaemia, especially in testicular torsion 2,6,27 . Serum CK levels in rats in the early period following spermatic cord torsion increased significantly before necrosis of the testicular tissue 6 .…”

Section: Discussionmentioning

confidence: 95%

“…The deleterious effect of the toxic oxygen free radicals released during reperfusion can be ameliorated by the administration of free radical scavengers 1–4 . Malondialdehyde (MDA) is widely used as an indicator of oxidative stress induced by I/R in testicular tissue 1,5 and creatine kinase (CK) may have a diagnostic value for determining of the level of tissue ischaemia 2,6 …”

Section: Introductionmentioning

confidence: 99%

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Methylene Blue Increases Contralateral Testicular Ischaemia–reperfusion Injury After Unilateral Testicular Torsion

İnan

Başaran²,

Dökmeci³

et al. 2007

Clin Exp Pharma Physio

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1. Testicular ischaemia-reperfusion injury is commonly seen in childhood. Infertility occurs in 25% of patients after unilateral testicular ischaemia. It is has been reported that methylene blue has a positive effect in the reparation of ischaemia-reperfusion injury in different tissues. Therefore, we hypothesized that methylene blue may prevent the hazardous effects of ischaemia-reperfusion injury in testicular tissue after unilateral testicular torsion. 2. Thirty-two prepubertal Wistar-albino rats were divided into four groups. Testicular torsion was created by rotating the right testis 720 degrees in a clockwise direction for 5 h in all groups except for Group C, which was the sham control group. In Group T, bilateral orchiectomy was performed following the torsion period. In Group TD, both testes were removed 5 days after the torsion period. In Group MB, methylene blue (1 mg/kg, i.p.) was administered 40 min before detorsion and once daily over 5 days; then, both testes were harvested. Tissue levels of malondialdehyde (MDA), serum levels of creatine kinase (CK), mean testicular biopsy score (MTBS) and mean seminifer tubule diameter (MSTD) were determined. 3. There was a significant difference in MTBS between Groups T and TD (P < 0.05) in both ipsilateral and contralateral testes. In the contralateral testis, treatment with methylene blue decreased MTBS and MSTD (P < 0.05) and increased MDA levels (P < 0.05). In Group T, mean serum CK concentrations were higher than in any of the other groups (P < 0.05). 4. After 5 h of unilateral testicular torsion and a 5 day reperfusion period, serious tissue damage occurred on both the ipsilateral and contralateral sides. Serum CK concentrations may be an indicator for ischaemia, but not for ischaemia-reperfusion injury. Contrary to our hypothesis, methylene blue increased contralateral testicular damage after unilateral testicular torsion and exacerbated oxidative events.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Methylene Blue Increases Contralateral Testicular Ischaemia–reperfusion Injury After Unilateral Testicular Torsion

İnan

Başaran²,

Dökmeci³

et al. 2007

Clin Exp Pharma Physio

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“…Receiver operating characteristic (ROC) curve comparing interleukin-6 (IL-6) and creatine phosphokinase (CPK) for discriminating epididymitis from testicular torsion with area-under-the-curve (AUC) analysis. 4,5 The source of CK-MM elevation was thought to be cremaster muscle infarction. Our study did not reproduce their findings.…”

Section: Discussionmentioning

confidence: 99%

“…Three serologic markers of potential utility have been evaluated in previous models in the diagnosis of acute scrotum: creatine phosphokinase-MM (CPK-MM), 4,5 interleukin-6 (IL-6), 6 and interleukin-1 (IL-1). 7,8 The purpose of this study was to evaluate IL-1, IL-6, and CPK-MM in men presenting with acute scrotal pain.…”

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confidence: 99%

The Clinical Utility of Serologic Markers in the Evaluation of the Acute Scrotum

Rivers

Stricker

et al. 2000

Academic Emergency Medicine

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Abstract. Objective: To examine the presence of interleukin-1 (IL-1), interleukin-6 (IL-6), and creatine phosphokinase-MM (CPK-MM) in patients with acute scrotal pain and assess their clinical utility in the diagnosis of testicular torsion (TT) and epididymitis. Methods: Twenty-five patients with acute scrotal pain were prospectively enrolled over a two-year period. History, physical examination, complete blood count, urinalysis, and scrotal ultrasound were performed. Testicular torsion was confirmed by surgical exploration. Epididymitis was diagnosed using physical examination, scrotal ultrasound, and positive urinalysis. Venous blood was assayed for IL-1, IL-6, and CPK-MM in triplicate during the routine drawing of blood in the emergency department. The data are reported as medians Ϯ interquartile ranges (IQRs). Results: Twenty-five patients with acute scrotal pain were evaluated; 11 with TT, three with torsion of the appendix testis (TAT), ten with epididymitis, and one with varicocele. One patient had both TT and epididymitis. Interleukin-1 was not detectable in either group. The CPK-MM values between TT and epididymitis were virtually identical at 99.8 and 100 IU/L, respectively. The median value for IL-6 was 1.03 (IQR = 0.19 to 2.86) vs 20.86 (IQR = 2.14 to 65.50) pg/mL in the torsion and epididymitis groups, respectively. The 97.5% CI for the difference of medians of 19.9 was 0.4 to 65.1, p = 0.02. Using receiver operating characteristic (ROC) curve analysis for IL-6, the area under the curve was 0.82 for torsion and 0.67 for epididymitis. Using a cutoff value of IL-6 Ն 1.41 pg/mL, the positive predictive value of IL-6 in diagnosing epididymitis was 78.6%, with a negative predictive value of 100% for TT. There were no cases of missed TT on follow-up. Conclusions: This preliminary investigation of serologic markers demonstrates that IL-6 is significantly elevated in epididymitis as compared with TT. Creatine phosphokinase-MM and IL-1 were not found to be of diagnostic utility. The small sample size of this study precludes a definitive conclusion as to the utility of these markers in the emergency department. However, IL-6 may be clinically useful as an additional element in differentiating the causes of acute scrotal pain, and further study is warranted.

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The Nontraumatic, Acute Scrotum

Marcozzi¹,

Suner²

2001

Emergency Medicine Clinics of North America

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Serum creatine kinase enzyme levels in the early diagnosis of spermatic cord torsion

Cited by 3 publications

References 8 publications

Methylene Blue Increases Contralateral Testicular Ischaemia–reperfusion Injury After Unilateral Testicular Torsion

Methylene Blue Increases Contralateral Testicular Ischaemia–reperfusion Injury After Unilateral Testicular Torsion

The Clinical Utility of Serologic Markers in the Evaluation of the Acute Scrotum

The Nontraumatic, Acute Scrotum

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