Varicocele is a major entity defined within male infertility. In this report we have studied the influence of laparoscopic varicocelectomy on semen quality, biochemical parameters of seminal plasma and sperm DNA fragmentation. In this study, the semen samples from patients with left-side varicocele of grade II-III before and after laparoscopic varicocelectomy were compared to healthy individuals and separated into three groups. The volume of semen, sperm concentration (106/ml), motility (%), viability (%) and normal morphology (%) were assessed. Total antioxidant capacity (TAC), catalase (CAT), superoxide dismutase (SOD) and malondialdehyde (MDA) together with other biochemical substances in seminal plasma as alpha-glucosidase (α-Glu), fructose (Fr) and citric acid (CA) were determined by ELISA method. The spermatozoa activity including ion-transports through sodium, potassium ATPase (Na+, K+-ATPase) and calcium, magnesium ATPase (Ca2+, Mg2+-ATPase) were determined by using spectrophotometry. In addition, flow cytometry method for detection of sperm DNA fragmentation was used. The results showed, that three months after varicocelectomy such intervention led to significant postoperative improvement in volume of semen (p<0.001), total sperm count (p<0.001), sperm motility (p<0.001) and spermatozoa with normal morphology (p<0.001). We found decreased α-Glu levels due to varicocelectomy (p<0.05). There has been shown a high positive correlation between Na+, K+-ATPase and Ca2+, Mg2+-ATPase activity with total number of spermatozoa (p<0.05). The TAC levels and DNA fragmentation values after varicocelectomy can be considered as significant indicators of good prognosis after surgical intervention. It has to be emphasized that α-Glu levels and total sperm count expressed statistically significant both positive and negative predictive values for semen assessment. Varicocelectomy may lead to significant improvement of semen quality although the observations must be correlated with clinical pregnancies observed thereafter.
Responding to the need for the verification of some experimental animal studies showing the involvement of oxidative stress in germ cell damage in the heat-induced testis, we investigated the possibility of a direct relationship between seminal oxidative stress markers (total antioxidant capacity, catalase activity, superoxide dismutase activity, and malondialdehyde concentration) and ejaculated sperm chromatin/DNA integrity (DNA fragmentation and chromatin condensation abnormalities) in distinct groups of men exposed and not exposed to prolonged scrotal hyperthermia. A statistical increase in the proportion of sperm with DNA fragmentation was observed in all the studied subgroups compared to the fertile men. In turn, the groups subjected to heat stress as professional drivers or infertile men with varicocele presented greater disturbances in the oxidative stress scavenging system than men not exposed to genital heat stress. Based on the comparative analysis of the studied parameters, we can conclude that alterations in the seminal oxidative stress scavenging system are directly engaged in the pathogenesis of ejaculated sperm DNA damage regardless of the intensity of the impact of thermal insult. To the best of our knowledge, this study, for the first time, revealed the co-existence of oxidative stress and sperm DNA damage in the semen of professional drivers.
Отримані результати свідчать про високу інформативність біМРТ в діагностиці раку передміхурової залози. Застосування ВКД дозволило диференціювати клінічно значущий і незначущий варіанти пухлинного процесу, а також доброякісні зміни в тканинах передміхурової залози і може розглядатись у якості потенційного променевого маркеру РПЗ.
Development and progression of chronic kidney disease (CKD) in patients with renal cell carcinoma (RCC) after radical nephrectomy remains an extremely pressing contemporary issue. Postoperative changes of the ultrasound resistance index (RI) in the contralateral kidney not affected by the tumor after surgical treatment of RCC, as well as correlations between changes in IR and in glomerular filtration rate (GFR) remain far from being comprehensively investigated. The RI changes in the parenchyma of the intact (unaffected by the tumor) kidney before and after surgical treatment for RCC, and establishing correlations between RI changes and creatinine-dependent GFR remain unexplored issues.
In order to determine ADC, a region of interest (ROI) was established on the ADC map above the required area (prostatic neoplasm, lymph node or normal tissue) with the lowest ADC value identified as the zone with the largest hypo-intensity of MR signal. Taking into consideration that DWIs are morpho-functional images with limited morphological information, in order to improve the accuracy of anatomical comparisons of suspicious areas, we additionally performed mutual overlap of axial T2-WIs and DWIs using RadiAnt DICOM Viewer 2020.2.3 software package, obtaining a color map, where color intensities corresponded to the degrees of diffusion restriction, allowing for accurate spotting of the abnormal lesions detected on DWIs. To obtain the precise ROI position above the area of the lymph node analyzed on ADC maps, we copied the ROI from the respective slice of axial T1-WIs or T2-WIs, which have served as a precise anatomical landmark. In addition to that, to ensure more precise identification of lymph nodes, we proposed a DWIbased method of pelvic lymph node mapping using a maximum intensity projection algorithm, which facilitated spatial identification of lymph nodes and preoperative preparation (Fig. 1). No significant differences were observed when comparing mean sizes of N+ and N– pelvic lymph nodes (p > 0.05). At the same time, when comparing mean ADC values for N+ and N– pelvic lymph nodes, we did observe a tatistically significant difference: in metastatic lymph node involvement, this value was 0.74 ± 0.09 × 10-3 mm2/s, while in lymph nodes without metastatic involvement this value was 1.05 ± 0.23 • 10-3 mm2/s (p < 0.001). Such findings reflect diffusion restriction of hydrogen molecules in N+ lymph nodes due to the increased cellular density in their tissues, which is the case in the development of malignant tumors (Fig. 2). The ROC-analysis using the ADC of DWI MRI for differentiation of N+ and N– pelvic lymph nodes in PCa has shown that in a threshold cut-off value of 0.87 •
10-3 mm2/s, the sensitivity and specificity were 87% and 75%, respectively, with a high accuracy of the method, area under the curve = 0.933; 95% confidence interval (CI) = 0.852–1.0; p < 0.001 (Fig. 3)