Browsing by Author "Taneli, C"

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    Evaluation of the relation between interstitial cells of cajal (CD117) and serotonin receptor (5HT-3A) with postfundoplication dysphagia
    Ozcan, CU; Yilmaz, O; Gurer, DE; Ayhan, S; Taneli, C; Genc, A
    Objective: The aim of the present study is to investigate the effect of Nissen fundoplication to the pacemaker cells of an intestinal system and the serotonin receptors on an ICC membrane. Methods: Sixteen adult male rats were taken into study. Rats were divided in to the following two groups. Nissen fundoplication was performed to study group (Group 1) and no surgical procedures were applied to control group (group 2). The rats who were subjected to surgery and the rats without surgery were sacrificed on to postoperative 14 days. Specimens for the pathologic analysis were obtained from upper esophagus (group A) and esophagogastric junction (EGJ) (group B). Distribution of ICC and 5HT-3A were evaluated separately. Results: There was a significant difference (p = 0.01, p = 0.02, respectively) regarding number of cells stained with CD117 between the group 1B-2B and group 2A-2B. Also there was a significant difference between (p = 0.01, p = 0.01 respectively) number of cells stained with 5HT-3A in groups 1A-1B and 2A-2B. However, no correlation was detected between group 1B-2B for 5HT-3A. Conclusion: A reduction in the number of ICC was observed in esophagogastric junctions of the fundoplication group but 5HT-3A distribution did not show a significant difference. A decrease in the number of ICC may be effective at postfundoplication dysphagia. (C) 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
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    CAN URINARY BIOMARKERS SUCCEED DIAGNOSTIC VALUE OF RENAL SCINTIGRAPHY IN PATIENTS WITH URETEROPELVIC JUNCTION DISRUPTION?
    Gürer, DE; Yilmaz, Ö; Ertan, P; Eser, E; Taneli, F; Aras, F; Oran, A; Genç, A; Günsar, C; Sencan, A; Gürer, E; Taneli, C
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    Assessment of the efficacy of absorbable adhesion barriers on dissection in esophagus operations
    Yilmaz, O; Genc, A; Taneli, F; Demireli, P; Deliaga, H; Taneli, C
    Objective: During childhood, recent repeated operations for esophagus are normally conducted if long gap esophageal atresia exists. During multistaged extrathoracic esophageal elongation procedure, the dissection of the esophagus poses severe problems due to adhesion. However, Gore-Tex membrane may simplify esophagus dissection. The most popular adhesion barriers used today are sodium hyaluronate, (Seprafilm(R); Genzyme Corp., Cambridge, MA) and oxidized regenerated cellulose (Interceed(R); Johnson Et Johnson Medical Inc., New Brunswick, NJ). The purpose of this study is to investigate the efficacy of adhesion barriers on esophagus dissection. Methods: In the study, 21 Wistar albino adult male rats were worked on. The rats were randomly divided into three groups, each including seven rats. About 1 cm-segment of the esophagus, located just behind the trachea, was dissected from the surrounding tissues through blunt dissection. Rats in group 1 were wrapped with Seprafilm(R), and in group 2 with Interceed(R). But the rats in group 3 underwent only esophagus dissection. Three weeks later, during esophagus dissection, adhesion scoring was performed and esophagus was divided into two parts: one for the assessment of hydroxyproline level, and the other for histological examination. Results: When the adhesion scores of the three groups were compared, there was not a significant difference between the groups (p = 0.75). In terms of tissue hydroxyproline levels, mean scores of hydroxyproline revealed no significant difference between the three groups (p = 0.19). When the histopathological results were examined, esophagus looked normal and no connective tissues were seen around esophagus. Conclusion: Seprafilm(R) and Interceed(R) had no effect on esophagus dissection. Although Seprafilm(R) had the best mean score, this was statistically insignificant. Gore-Tex might play a better role than Interceed(R) in preventing adhesion formation; however, it is still not certain whether adhesion barrier should be used in such organs as esophagus having no serosa. Published by Elsevier Ireland Ltd.
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    Sonic hedgehog, TBX18, and TSHZ3 proteins involved in pyeloureteral motility development are overexpressed in ureteropelvic junction obstruction An immunohistochemical, histopathological, and clinical comparative study
    Yilmaz, O; Nese, N; Dalgic, M; Kesici, GP; Genc, A; Taneli, C; Gunsar, C; Sencan, A; Cayirli, H; Isisag, A
    Objectives: To compare pathological samples obtained from cases that underwent surgery for ureteropelvic junction (UPJ) obstruction with samples obtained during autopsies of subjects. Methods: Retrospectively, 42 patients who had undergone surgery due to UPJ obstruction (group 1) were included in the study. Histopathological and immunohistochemical features for sonic hedgehog (SHH), TBX18, and TSHZ3 of UPJ were evaluated and findings were compared with 20 autopsy cases (group 2). Results: In group 1, the scores were statistically significantly higher in terms of cytoplasmic SHH, nuclear TBX18, cytoplasmic and nuclear TSHZ3 staining. Statistically, no correlation was found between age and the staining scores belonging to these 3 antibodies in group 1 and group 2. Intense inflammation was found to be related with nuclear staining for TBX18. Conclusion: Gene product expressions of SHH, TBX18 and TSHZ3 are statistically higher in patients with UPJ obstruction, when compared with control group. The explanation may be the reactivation of the processes, which had shown their effects in the embryological period, due to the chronic inflammation and long-term micro-trauma created by the disease.
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    LAPAROSCOPIC TRANSPERITONEAL DISMEMBERED PYELOPLASTY BY UTILIZING V-LOC BARBED SUTURE
    Yilmaz, O; Taneli, C; Ertan, P; Gurer, E; Genc, A
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    Long-term effect of pentoxifylline and NG-nitro-L-arginine methyl ester on testicular function in spermatic artery ligation
    Yilmaz, O; Genc, A; Taneli, F; Demireli, P; Kocakoc, ID; Sencan, A; Gunsar, C; Mir, E; Taneli, C
    Objective. To investigate long-term testicular function in pentoxifylline- and NG-nitro-L-arginine methyl ester (L- NAME)treated rats prior to spermatic artery ligation by assessing serum inhibin B concentration, a reliable endocrine marker of spermatogenesis. Material and methods. Forty prepubertal rats were randomly divided into four equal groups. Right orchiectomy was performed in all rats. Intraperitoneal pentoxifylline and L- NAME were administered to Groups 1 and 2, respectively. Rats in Group 3 did not receive any medication. The spermatic arteries of the left testes were ligated in all groups with the exception of the sham controls ( Group 4). One month postoperatively, a histopathologic evaluation was performed and serum inhibin B concentrations were assessed in all groups. Results. There were no statistically significant differences in testis size or serum inhibin B concentration between Groups 1, 2 and 3. However, the testes were significantly smaller (p(1) = 0.01, p(2) = 0.01, p(3) = 0.01) and serum inhibin B levels were significantly decreased (p(1) = 0.01, p(2) = 0.01, p(3) = 0.01) when Groups 1 - 3 were compared with Group 4. Histopathological evaluations revealed necrosis and calcification in all specimens with the exception of the sham-operated group. Conclusions. The long-term outcomes of spermatic artery ligation were poor and testicular atrophy developed in rat testes in all study groups. Testicular atrophy could not be reversed by preoperative administration of pentoxifylline and L- NAME.
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    Testis fixation in prepubertal rats
    Sencan, A; Cenç, A; Günsar, C; Daglar, Z; Yilmaz, Ö; Ulukus, Ç; Özer, E; Taneli, C; Mir, E
    Experimental studies have shown that different suture materials used in testis fixation cause some degree of inflammation in the testis. This study was planned to compare the histological changes that were caused by fibrin glue which is a tissue sealant and by silk and polypropylene for transparenchymal testis fixation. 28 prepubertal rats were divided into 4 groups. Testis was fixed to the tunica vaginalis by fibrin glue in group 1, by silk in group 2 and by polypropylene in group 3. Group 4 was planned as a control. Testicular inflammation and seminiferous tubular diameter were evaluated for histological changes. The least inflammation was observed in the fibrin glue group, while the most inflammation occurred in the silk group. Seminiferous tubular diameter was 241.55 +/- 45.90 in the fibrin glue group, 151.90 +/- 8.34 in the silk group and 161.36 +/- 9.96 in the polypropylene group. In conclusion, fibrin glue, when used for testis fixation, causes less inflammation and less destruction of seminiferous tubular diameter compared with silk and polypropylene.
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    Does sucralfate prevent apoptosis occurring in the ischemia/reperfusion-induced intestinal injury?
    Sencan, A; Yilmaz, Ö; Özer, E; Günsar, C; Genç, K; Ulukus, Ç; Taneli, C; Mir, E
    Background/Purpose: We have shown in a previous study that sucralfate is beneficial in the prophylaxis and treatment of hypoxia/reoxygenation-induced intestinal injury. The aim of this study is to investigate whether sucralfate has any effect on the prevention of apoptosis in the ischemia/reperfusion (I/R)-induced intestinal injury. Methods: Rats were randomized into three groups. Group 1 and 2 were subjected to I/R. Group 1 (treatment group) received sucralfate while group 2 (treatment control group) did not. Group 3 served as a normal control group (sham group). The terminal ileum was harvested for histopathologic investigation by light microscopy. The presence of apoptotic enterocytes (DNA fragmentation in cell nuclei) was detected by terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick-end-labeling (TUNEL) reaction. Results: In treatment control group, 3 of 7 rats had severe inflammation. None of the sucralfate-treated rats showed severe inflammation, 6 of them only showed mild inflammatory changes (p < 0.05). The apoptotic percentage was found to be 37.1 +/- 9.4 in the sucralfate-treated group (group 1), whereas it was 45.4 +/- 3.9 in the untreated group (group 2) (p < 0.05). The sham group had a completely normal intestinal architecture. Conclusions: The present study shows that 1) the experimental model of I/R-induced intestinal injury induces enterocyte apoptosis; 2) sucralfate decreases enterocyte apoptosis in the experimental model of I/R-induced intestinal injury which may play a key role in the pathophysiological events leading to failure of the intrinsic gut barrier defense mechanisms.
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    Successful outcomes in laparoscopic pyeloplasty using knotless self-anchoring barbed suture in children
    Yilmaz, O; Tanriverdi, HI; Cayirli, H; Ertan, P; Sencan, A; Genc, A; Taneli, C
    Introduction Laparoscopic pyeloplasty for ureteropelvic junction obstruction in children has gained increasing importance over the last decade. Intracorporeal knot tying still remains a technical challenge for the surgeon. Self-anchoring suture incorporates a new concept for tissue approximation and reduces intracorporeal knot tying problems. There are very few reports on self-anchoring knotless suture and its application for laparoscopic pyeloplasty in children. We present our results of a series of consecutive children undergoing laparoscopic pyeloplasty with knotless barbed sutures. Material and method We prospectively evaluate 15 consecutive patients who underwent laparoscopic pyeloplasty with knotless barbed sutures (VLoc (TM), Covidien) for ureteropelvic anastomosis. The decision of the operation was given by pediatric nephrology-urology-radiologic imaging diagnostic team, and all patients were operated by a single surgeon. Pyeloplasty was performed without pelvic reduction, and the anastomosis was made by barbed sutures using running fashion. Results The mean age of the patients were 5.39 (3 months-17 years). Two cases had undergone a right-sided pyeloplasty, and thirteen had undergone a left-sided pyeloplasty. The duration of the operative procedure was 60-110 min. Neither intraoperative nor postoperative complication was encountered in any of the cases. Patients were followed by ultrasonographic evaluation. The anteroposterior diameter (AP) diameter of renal pelvis and hydronephrosis grade Society for Fetal Urology (SFU) are significantly different when compared with pre-operative and postoperative period (p = 0.001 and p = 0.001, respectively). Owing to the renal parenchymal thickness change by age pre-operative and postoperative thickness comparison is adjusted by age, because age is considered as a covariate (confounder variable). We observed statistically significant (p = 0.003) difference in parenchymal thickness in all cases. Follow-up periods of the 15 consecutive pediatric pyeloplasty cases were 6-54 months. Conclusion In the present study, successful outcome of the laparoscopic pyeloplasty using barbed suture was shown for the first time in children in literature. We believe that successful outcome of laparoscopic pyeloplasty could be achieved by eliminating knots and less manipulation on the wound edge also minimizes tissue injury during the procedure.
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    Outcomes of children with isolated antenatal hydronephrosis
    Onder, ENA; Yilmaz, O; Taneli, C; Ertan, P
    BackgroundAntenatal hydronephrosis (ANH) is one of the most common abnormalities detected during prenatal ultrasound. There is significant variability in the postnatal management of ANH. Our objective was to report the outcomes of patients with ANH, spontaneous resolution rates, surgical intervention rates, and factors contributing to these parameters.MethodsA total of 227 patients and 264 renal units with ANH were included in this study. We used the renal pelvis anteroposterior diameter and the Society for Fetal Urology grading system to classify and compare ANH as mild, moderate, and severe.ResultsThe patients' median follow-up period was 48 months (with a minimum of 6 months and a maximum of 136 months). Of the 264 renal units, 123 (46.6%) had mild, 101 (38.26%) had moderate, and 40 (15.15%) had severe antenatal hydronephrosis. The spontaneous resolution rate was 91.9% in the mild hydronephrosis group (n = 113), 81.2% (n = 82) in the moderate hydronephrosis group, and 37.5% (n = 15) in the severe hydronephrosis group. The patients with higher hydronephrosis grades required a longer time to resolve. Only one patient with a posterior urethral valve had reduced estimated glomerular filtration. None of the patients had proteinuria or hypertension.ConclusionAlthough the outcome of the patients with mild hydronephrosis was excellent, there was a progression of the disease, especially within the first 6 months, and 6% of our cases required surgical intervention. Additional prospective studies are needed to define the risk of urinary tract abnormalities with any degree of ANH.
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    Effect of alarm treatment on bladder storage capacities in monosymptomatic nocturnal enuresis
    Taneli, C; Ertan, P; Taneli, F; Genç, A; Günsar, C; Sencan, A; Mir, E; Onag, A
    Objective: Despite a great number of studies, very little is known about the mechanism of action of enuresis alarm systems. Nevertheless, as a result of this treatment many children are able firstly to wake up before urination occurs and then, in time, to sleep through the night without voiding. The aim of this study was to investigate the effect of enuresis alarms on bladder storage capacities. Material and Methods: A total of 28 children aged >7 years who were not polyuric but who voided once every night, slept alone in their own bedroom and who were willing, along with their family members, to cooperate were recruited. Patients were asked to record their urine output using a frequency/volume chart for two consecutive days. After these records and the results of physical and laboratory examinations were taken into consideration, treatment was instituted with the bell-and-pad ( alarm) system for a period of 12 weeks. At the end of this period, patients were asked to complete another frequency/volume chart. Results: The pre- and post-treatment maximum functional bladder capacity was 178.35 +/- 87.86 ml and 243.03 +/- 102.84 ml, respectively and the pre- and post-treatment mean day-time bladder capacity was 111.11 +/- 45.87 and 148.445 +/- 7.68 ml. Both of these differences were statistically significant (p < 0.0001 and < 0.0001, respectively). The maximum nocturnal bladder capacity was found to be increased from 177.85 +/- 84.95 to 255.25 +/- 124.52 ml after treatment (p < 0.0001). Conclusion: Treatment with the alarm system for a period of 12 weeks was seen to be associated with a significant increase in bladder storage capacities ( maximum nocturnal bladder capacity, maximum functional bladder capacity and mean day-time bladder capacity).
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    Biochemical analysis of urethral collagen content after tubularized incised plate urethroplasty: an experimental study in rabbits
    Taneli, F; Ulman, C; Genc, A; Yilmaz, O; Taneli, C
    The aim of the present study was the biochemical analysis of tissue hydroxyproline levels in incised urethral plates in order to show the total collagen content after the Snodgrass operation in the hypospadiac rabbit model. The study comprised 21 male New Zealand rabbits, (2.2-2.4 kg). The animals were randomly allocated to three groups each containing seven rabbits as follows: group 1, the ventral urethra was completely excised and a model of hypospadias formed. A full-thickness incision was made on the distal dorsal urethra, a feeding tube was placed as an urethral catheter and both urethral wings were sutured ventrally. Group 2, inserting an iris knife into the urethra, the ventral wall was incised mimicking an urethrotome. Group 3 consisted of normal control rabbits to determine the basal tissue hydroxyproline level. A slight increase in the hydroxyproline level was observed in the ventral part of the urethral tissue compared to the dorsal part in both groups 1 and 2; however, these differences were not significant. After the Snodgrass operation in the rabbit model, no significant differences were observed in the hydroxyproline levels of the dorsal and ventral parts of the urethra or between these and of the controls. Further studies are required in order to determine the mechanism underlying urethral healing through normal re-epithelization without excess collagen deposition after incised urethral plate urethroplasty.
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    Inflammatory Myofibroblastic Tumor of the Colon with an Unusual Presentation of Intestinal Intussusception
    Appak, YC; Sahin, GE; Ayhan, S; Taneli, C; Kasirga, E
    Inflammatory myfibroblastic tumor (IMT), also known as inflammatory pseudotumor is unusual, benign solid tumor. This tumor is commonly reported in the lungs but can be present in extrapulmonary sites as well. We present the case of a 7-year-old girl with IMT in an unusual location. The patient was admitted with abdominal pain, and ultrasound showed a solid mass in the abdomen. She was operated and colocolic intussusception secondary to a mass was found. Histologic evaluation of mass revealed IMT.
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    Early postoperative small bowel obstruction is a different clinical entity than postoperative adynamic ileus
    Sencan, A; Sencan, A; Taneli, C; Günsar, C; Genç, A; Ayhan, S; Mir, E
    Early postoperative small bowel obstruction is a rare clinical entity different from postoperative adynamic ileus. The cases were presented to emphasize the differences between early postoperative small bowel obstruction and postoperative adynamic ileus. In this study, a 14-year-old patient who developed early postoperative (post op. 2. Day) small bowel obstruction after appendectomy was presented. Re-laparotomy was performed on the 7th postoperative day. It was observed that early postoperative small bowel obstruction was due to adhesions which caused significant intestinal loss. Ileostomy was performed and the patient was discharged from hospital uneventfully on the 25th postoperative day after stoma closure. Since symptoms, and signs of early postoperative small bowel obstruction can be confused with those of postoperative adynamic ileus, long term conservative follow-up may result in significant intestinal loss. For this reason, it is important not to delay the re-laparotomy decision
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    Urethral meatal dilatation using topical EMLA cream for anaesthesia
    Genç, A; Tekin, I; Arslan, OA; Taneli, C; Mir, E
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    Evaluation of the location of the anus by a modified technique in the neonate
    Genç, A; Taneli, C; Tansug, N; Kasirga, E; Yilmaz, D; Küçükoglu, T; Onag, A
    Purpose: The aim of the current study was to bring to notice the anterior displacement of the anus and to recommend the measurement of anal position index in the neonate by a modified method. Methods: Sixty newborns (34 girls and 26 boys) were taken into study, and the anal position index (API), which is the ratio of anus-fourchette (scrotum) distance to coccyx fourchette (scrotum) distance, was measured. To obtain the measurement, a transparent adhesive tape was placed along the midline on the long axis, covering the anus. The upper and lower tips and the center of the anal circle was marked and measured using a caliber. Results: API was found as 0.46 (SD +/- 0.08) and 0.53 (SD +/- 0.05) in female and male neonates, respectively. Because an index of 0.34 in girls and 0.46 in boys are considered abnormal, the 3 female babies in the study group with API indices of 0.18, 0.28, and 0.33 were subjected to further examination. The abnormality was seen not to be rare in the Aegean region. Conclusions: An abnormal index alone cannot be the sole cause of constipation mentioned in the literature and therefore not an indication for operation, Anal position index in the neonates could be measured more accurately by the current modified method. If an anterior location of the anus is found early in infancy the baby should undergo follow-up accordingly. J Pediatr Surg 37:80-82. Copyright, (C) 2002 by W B. Saunders Company.
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    The ureteral diameter ratio as a predictive factor in renal scarring associated with primary vesicoureteral reflux
    Onder, ENA; Ensari, E; Ozkol, M; Yilmaz, O; Taneli, C; Ertan, P
    Introduction The ureteral diameter ratio (UDR) is reported to be effective in predicting the outcomes of vesicoureteral reflux (VUR) in several studies. Objective The objective of the current study was to compare the risk of scarring in patients with VUR relative to UDR and the VUR grade. We also aimed to demonstrate other associated risk factors in scarring and investigate the long-term complications of VUR and their relationship with UDR. Study design Patients diagnosed with primary VUR were retrospectively enrolled in the study. UDR was calculated by dividing the largest ureteral diameter (UD) by the distance between L1-L3 vertebral bodies. Demographic and clinical data, laterality, VUR grade, UDR, delayed upper tract drainage on voiding cystourethrogram, recurrent urinary tract infections (UTI), and long-term complications of VUR were compared between the patients with and without renal scars. Results A total of 127 patients and 177 renal units were included in the study. There was a significant difference between the patients with and without renal scars according to age at diagnosis, bilaterality, reflux grade, UDR, recurrent UTI, bladder bowel dysfunction, hypertension, decreased estimated glomerular filtration rate, and proteinuria. The logistic regression analysis revealed that UDR had the highest odds ratio among the factors affecting scarring in VUR. Discussion VUR grading based on the evaluation of the upper urinary tract is one of the most important predictors for treatment options and prognosis. However, it is more likely to reflect ureterovesical junctional anatomy and function, which play a crucial role in the pathogenesis of VUR. Conclusion UDR measurement seems to be an objective method that can help clinicians predict renal scarring in patients with primary VUR.
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    Follow up of renal outcomes in children with solitary kidney
    Onder, ENA; Yilmaz, O; Taneli, C; Ertan, P
    Background: Solitary kidney (SK) affects 1/1000 people worldwide, and there are controversies concerning renal outcomes in these patients. This study aimed to investigate clinical findings and renal outcomes in children with SK and to compare the results for congenital (CSK) and acquired SK (ASK) groups.Methods: The study included patients that presented to our pediatric nephrology department with SK between January 2010 and January 2021. Demographic and clinical data were recorded retrospectively.Results: Of the 101 patients with SK, 71 had CSK (55 had unilateral renal agenesis and 16 had a multicystic dysplastic kidney) and 30 had ASK (17 had previously undergone unilateral nephrectomy due to a renal tumor and 13 had urological structural anomalies). There were nine patients (9%) with renal injury. The serum uric acid level was significantly higher and the estimated glomerular filtration rate was significantly lower in the patients with ASK compared with those with CSK (p = 0.005 and p < 0.001, respectively). There was a positive correlation between renal injury and the uric acid level (p < 0.001, r = 0.45).Conclusion: In addition to the management of blood pressure and proteinuria, it is important to control uric acid levels in patients with SK, especially those with ASK, to prevent renal injury. The ASK group has a greater risk of renal injury than the CSK group. There is a need for new markers to predict early stage renal damage in SK.
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    Unusual Association of Omphalocele and Wandering Spleen
    Yilmaz, Ö; Genc, A; Ozcan, T; Aygoren, RS; Taneli, C
    A wandering spleen is a rare anomaly and its association with omphalocele has been reported in the literature only once. We present a female infant that has a wandering spleen associated with omphalocele. The patient was admitted with the diagnosis of omphalocele. Primary repair was performed and the patient was discharged on the 6th postoperative day. Nine months later, the girl was referred to our emergency unit with complaints about abdominal distention and restlessness. After 2 days of clinical observation, an immobile, firm abdominal mass was palpated. Ultrasono-graphic evaluation revealed that the mass was the spleen and it was found exactly under the left side of the umbilicus, instead of its original location. During the operation, the spleen was beneath the left side of the umbilicus, with its upper surface completely adhered to the peritoneum, and it was rotated 180 clockwise. Then the spleen was rotated back and placed in its normal anatomic location. At 1 month postoperatively, a radionuclide scan was performed and splenic perfusion was evaluated to be normal. In conclusion, herniations and eventrations of organs through defects on the abdominal wall may either result in restriction of normal rotations of the stomach and the spleen or in inefficient fusion after the rotation has been completed. Copyright (C) 2008 S. Karger AG, Basel
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    The effect of spermatic vessel ligation on testicular nitric oxide levels and germ cell-specific apoptosis in rat testis
    Taneli, F; Vatansever, S; Ulman, C; Yilmaz, Ö; Giray, G; Genç, A; Taneli, C
    Management of high testis may vary but the most popular method in surgical treatment is the Fowler-Stephens maneuver. The aim of the present study was to investigate the effects of spermatic vessel ligation on testicular nitric oxide (NO) levels, expression of inducible nitric oxide synthase (iNOS), and endothelial nitric oxide synthase (eNOS) and germ cell-specific apoptosis in both ipsilateral. and contralateral. testes in rats. Twenty-eight animals were randomly allocated into four groups (n = 7 each). The spermatic vessels were ligated as a simulation of the Fowler-Stephens maneuver. The groups of animals were sacrificed at 2 h (group 1), 4 In (group 2) and 24h (group 3) after ligation, respectively. Sham-operated animals served as controls (group 4). Biochemical. assessment of testicular NO levels was performed by the Griess method. iNOS and eNOS expression and apoptosis were studied in ipsilateral. and contralateral, testes. Testicular NO levels at 24h after the simulated Fowler-Stephens maneuver were found to be significantly increased in both ipsilateral. and contralateral testes when compared with the sham-operated group. eNOS expression was clearly increased in ipsilateral testes, whereas. moderate expression was detected in the contralateral seminiferous tubules at 24 h after ligation. Mild focal iNOS immunostaining was also observed in seminiferous tubules of the ipsilateral. testis at 24 h after the simulated Fowler-Stephens maneuver. Apoptosis was dramatically increased in ipsilateral. testes; however, it was only detected in single cells in the contralateral. side at 24 h after ligation. In conclusion, the simulated Fowler-Stephens maneuver induces testicular nitric oxide synthesis and germ cell-specific apoptosis in the ipsilateral testis. These results suggest that high levels of NO induce apoptosis and may impair spermatogenesis thus explaining the unsuccessful outcome of the Fowler-Stephens maneuver. (c) 2004 Elsevier GmbH. All rights reserved.