Aim: To investigate the effect of pentoxifylline (Ptx) on oxidative and antioxidative status in the renal ischemia and reperfusion (I/R).

Method: Twenty four Wistar albino rats were used for the study. Rats were divided into four categories as control, ischemia, I/R and I/R plus Ptx administration groups. Blood samples and renal tissue specimes  were obtained from rats after the operations. As oxidants malondialdehyde (MDA) and total peroxide levels, and total antioxidants capacity (TAOC) were measured from the samples. The results were analyzed statistically. In addition, renal tissue sepcimens  were examined histopathologically.

Results: Decreased blood and renal tissue MDA and t-prx levels were found to be significantly lower in ptx group when compared with other groups (p<0.05). Blood TAOC levels in Ptx group were significantly lower than control and I/R groups. No significant difference was found in tissue TAOC levels between groups. Histopathologically, in the  I/R group. kidneys were found to be damaged.

Conclusions: The oxidative stress and renal damage after renal I/R were found to be more severe relative to  ischemic harm. However  this damage could be reduced by Ptx administration.

Objective: Free oxygen radicals cause diffuse cellular damage during reperfusion in the tissue. We investigated the effects of short-interval postconditioning in kidney in an animal model of ischemia-reperfusion.

Methods: Twenty-four adult Wistar albino rats equally divided into 3 subgroups: Control (II) and short-interval postconditioning (III) groups had undergone right nephrectomy and left renal ischemia subsequently. We did not expose sham (I) group to ischemia.. In postconditioning group (III), short-interval postconditioning (5 seconds reperfusion - 15 seconds ischemia, for a total of 2 minutes) was perfomed. However, in the control group (II) there was no postconditioning, and blood flow was restored immediately after a period of ischemia. The specimens were evaluated histopatologically for the presence of congestion, inflammation and necrosis. Tissue nitric oxide and glutation reductase, malondialdehyde, catalase, and glutathione levels were measured.

Results: Nitric oxide levels were significantly higher in the control group (p<0.05). Similarly, glutation reductase levels were also higher in the control group (p<0.05). Histopathological examination did not reveal any significant difference between groups (p>0.05).

Conclusion: We conclude that short-interval postconditioning is useful for reperfusion of kidneys, and may prevent renal failure probably caused by oxidative stress,through favourable contribution to the balance between reactive oxygen species and protective mechanisms.

Key words: Renal ischemia, reperfusion injury, oxidative stress

Aim: To investigate the ischemic changes in both ovaries by immunohistochemical method in the early and late postoperative periods after detorsion of the experimental delayed unilateral ovarian torsion.

Material and Method: The study was performed in 4 groups with 6 Wistar-albino rats in each. group.Left ovary was considered as the study group. The other groups were as follows: Group (G) 1 (Control group): left ovarian fixation was performed initially and bilateral oopherectomy was applied after 48 hours. G2 (Torsion group): left ovarian torsion and fixation, followed by oopherectomy 48 hours later. G3 (Evaluation in the early period after detorsion): detorsion at 48th hours following the torsion and bilateral oopherectomy after 48 hours of detorsion. G4 (Evaluation in the late period after detorsion): detorsion at 48th hours following the torsion and then bilateral oopherectomy performed after 21 days. Immunohistochemical staining was performed with double-blind technique using anti-Hsp-70 antibody to show the ischemic changes of the ovaries. Each positive staining was considered as one immunohistochemical staining score (IHSS). One-way ANOVA and post- hoc LSD tests were used for statistical analysis.

Results: IHS scores indicated in parentheses were as follows: G1 (1), G2 (27), G3 (17) and G4 (19). Of the 27 IHSscores in G2, 23 points belonged to the study groups, while 4 points were related to contralateral ovaries. In G4, 11 points were calculated for contralateral and 8 points for the study group ovaries. There was statistically significant difference between Groups 2 and 4 with regard to IHS scores of the ovaries in the study groups (p<0.05).

Discussion: Immunohistochemical methods have shown that viable ovarian tissue can be detected when detorsion was performed even after 48 hours of experimental ovarian torsion. Tissue injury due to ischemia significantly decreases ipsilaterally during the late postdetorsion period On the contrary, it was observed that tissue injury occurred at the contralateral ovary most probably as a consequence of ischemia/reperfusion. The results of the present study suggested that detorsion may be recommended for pediatric cases with delayed referrals after ovarian torsion.

Aim: Adnexial pathologies are rarely seen in children. Together with more common etiological factors,  adnexial masses should also be considered in the  differential diagnosis of  girls having abdominal pain or masses. The present study evaluated age distribution, presenting symptoms, operative findings and histopathology results of children operated on for adnexial lesions.

Methods: Patient files, operation logs and histopathology reports of all surgically treated patients between the years 1999-2009 were retrospectively reviewed.

Results: During the assessed time period, 60 ovarian units were surgically treated for adnexial pathologies in 54 patients aged between 2 days-16 years. Fourteen patients were younger than 1 year, 22 were between 1-12 years and 18 were older than 12 years of age. The most common presenting symptom was abdominal pain (69 %). The abdominal mass was right-sided in 30, left-sided in 18 and bilateral in 6 patients retrospectively. A total of 46 units had ovarian and  seven had paraovarian cysts/masses, six had torsioned but normal appearing ovaries and one had isolated tubal torsion. Among those with a cyts or a mass, the ovaries were found to be torsioned in 24 cases. Oopherectomy was performed in 16, salphingoopherectomy in 15 and salphingectomy in one case, respectively. Various organ preserving surgical methods were employed in the remaining 28 units. Histopathology revealed that the most commonly encountered neoplastic lesions were mature teratomas as detected in 12 units. Malignant or potentially malignant lesions were detected in 3 (5 %) units.

Conclusion: Most children with adnexial lesions apply with acute abdominal complaints. Even though the etiological factors of these pediatric cases are diverse, they are mostly benign especially in younger patients. Therefore, the simplest and organ preserving interventions like cystectomy should be the preferred method of treatment and future fertility should potentially be preserved.

Aim: In this comparative study, we retrospectively evaluated ovarian and paraovarian cysts.

Patients and Methods: Thirty-four children with ovarian and paraovarian cysts were evaluated according to age, clinical and imaging findings, treatment modality, lenght of hospital stay (LOS) and complications. Cysts less than 5 cm were not operated. Patients diagnosed as  intrauterine ovarian and paraovarian cysts were evaluated after birth. Detorsion was performed in patients with torsion. The gonads were preserved  excepting cases with marked ovarian necrosis. Cysts were evacuated, and their epithelium was peeled off.

Results: The median age of the patients was 13 years (3 days-17 years). Ultrasonography and abdominal CT revealed cysts more than 5 mm or torsioned cysts  in all patients but two. Each patient with acute abdomen and abdominal mass underwent laparoscopy without any finding at imaging modality. Twenty-two patients were operated laparoscopically, and 12 with open surgery. We detected ovarian/tubal torsion in 17, ovarian cysts in 12, paraovarian cysts in 4, concomittant ovarian and retroperitoneal cysts in 1 patient, respectively. The largest diameters of the cysts were 6-30 cm. Oopherectomy was performed in 7 patients. Each one patient had prolonged ileus and intraoperative bleeding. No further complication was seen. One patient with open surgery had a mature cystic teratoma, whereas all other patients had simple cysts. The mean duration of laparoscopic surgery (TOS) was significantly decreased (Open surgery 88.1±13.3 min and laparoscopic surgery 72.8±13.5 min) (p<0.05). Although there was no significant difference between open and laparoscopic surgery with respect to the  length of hospital stay (LOS) and onset of oral intake and other complications (superficial surgical site infection, postoperative fever and pain), the mean LOS (open surgery 3.33 days and laparoscopic surgery 2.69 days) and TOS of the patients with laparoscopic surgery was shorter.

Conclusion: Laparoscopic surgery is effective and safe in children with ovarian and paraovarian cysts with a shorter postoperative LOS and TOS.