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OBJECTIVE: The hypo-osmotic swelling (HOS) test predicts membrane integrity by determining the ability of the sperm membrane to maintain equilibrium between the sperm cell and its environment. The aim of our study was to determine the correlation between selenium and carnitine levels in the seminal fluid with HOS test for sperm membrane in lowgrade varicocele patients. PATIENTS AND METHODS: Study numbered 64 examinees who suffered from low-grade varicocele and were divided into two groups, according tofertility potential and HOS test outcome. The study also included a control group of 64 healthy subjects, with no varicocele. RESULTS: From the Shapiro-Wilk's test, it is clear that carnitine distribution differs significantly from normal (0.938, p = 0.03). In distribution of selenium, Kolmogorov-Smirnov test clearly shows statistically significant deviation from the normal curve (z = 0.225, p < 0.000), likewise Shapiro-Wilk's statistic (0.787, p < 0.000). According to the results, the second group had significantly higher levels of carnitine and selenium than the first group of examinees (p < 0.05); therefore, when we compared epididymal markers with HOS tests outcomes, we found significant differences between the two groups. There were no significant differences between second group and healthy subjects (p > 0.05). CONCLUSIONS: HOS test outcome in varicocele patients is directly proportional to the carnitine and selenium levels, which could play a major role in both determining fertility parameters and in the treatment of its impairment. This result is important for sub-clinical varicocele in infertile patients with normal semen analysis, since there is no evidence of benefit from any treatment sofar. [ABSTRACT FROM AUTHOR]

OBJECTIVE: An aortic aneurysm is a general term for an enlargement (dilation) of the aorta to greater than 1.5 times normal size. Abdominal aortic aneurysm (AAA) primarily affects the population older than 50 years, with a prevalence of approximately 5%. There are a few theories about AAA etiology. Interest in the relationship between blood type and vascular disease has been established. The aim of our study is to evaluate distribution of blood-groups among the patients with abdominal aortic aneurysm (AAA) as well as to identify any kind of relationship between blood type and AAA. MATERIALS AND METHODS: The design of our research is combination of retrospective and prospective case-control study in a sample of population of Montenegro. Statistical analysis was performed in SPPS v 20.0, using the chi-square test for independent samples, with the probability level at p < 0.05 as significant, and p < 0.01 as highly significant. RESULTS: O blood group was the most frequent among the examination group (53.11 %), and A blood group was the most frequent among group without AAA (43.22 %). Presence of AAA in individuals with O blood type was 1.46 higher than for the other blood types. CONCLUSIONS: This finding leads us to suspect that O blood type can be indicator for AAA. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Thyroid disease is the second most common endocrine condition in women of childbearing age. Thyroid hormones are involved in control of menstrual cycle and in achieving fertility affecting the actions of folliclestimulating hormone and luteinizing hormone on steroid biosynthesis by specific triiodothyronine sites on oocytes; therefore, affect all aspects of reproduction. It remains controversial if pregnant women should be screened for thyroid dysfunction. Purpose of this review was to examine recent studies on the assessment of thyroid dysfunction in pregnancy, its treatment and newly perspective of thyroid autoimmunity in pregnant euthyroid women in achieving fertility. METHODS: An electronic search was conducted using the internet medical databases: Medline/PubMed, EMBASE, EBSCO, and the Cochrane library. RESULTS: Thyroid gland faces great challenge in pregnancy when many hormonal changes occur. Precondition for normal follicular development and ovulation is pulsate gonadothropin realizing hormone secretion. Thyroid dysfunction in pregnancy is classified as forms of hypothyroidism (positivity of thyroid autoantibody, isolated hypothyroidism, and subclinical or overt hypothyroidism), hyperthyroidism, and autoimmune disease, but also thyroid nodules and cancer, iodine insufficiency and postpartum thyroiditis. These conditions can cause adverse effects on mother and fetus including pregnancy loss, gestational hypertension, or pre-eclampsia, pre-term delivery, low birth weight, placental abruption and postpartum hemorrhage. There is an evidence that thyroid autoimmunity, in thyroid dysfunction adversely affects conception and pregnancy outcomes, but it is unclear what impact has isolated eumetabolic thyroid autoimmunity in achieving fertility, especially in women undergoing in vitro fertilization. Treatment of euthyroid pregnant women with positive thyroid peroxides antibodies is still controverse, but not few studies show that levothyroxine substitution is able to lower the chance of miscarriage and premature delivery. CONCLUSIONS: Further randomized trials are needed to expand our knowledge of physiologic changes in thyroid function during the pregnancy and to reveal mechanisms by which thyroid autoimmunity in euthyroid women affect fertility, especially the success of assisted reproductive technology in achieving the same and validity of levothyroxine administration in thyroid autoimmunity positive women. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Varicocelectomy is the only effective method of treating varicocele. Nowdays, many techniques for varicocelectomy include retroperitoneal, inguinal, and subinguinal varicocele repairs with or without magnification and laparoscopic repair. The advantages of the microsurgical approach to varicocele repairs are reliable identification and preservation of the vascular structures. Thus, our aim is to compare the efficiency of microsurgery over conventional techniques of varicocele repairs. PATIENTS AND METHODS: We have evaluated 105 man divided into three groups of 35 patients surgically treated with open varicocelectomy in the first group, microsurgical varicocelectomy in the second, and laparoscopic varicocelectomy in the third group. Sperm test improvement and complications were then compared. RESULTS: The testicular volume shows a significant increase after all three types of surgery, the highest one being after the laparascopic varicocelectomy (14.47 ± 6.76 vs. 21.8 ± 7.52), whereas the lowest increase was recorded in open varicocelectomy (14.90 ± 6.26 vs. 17.46 ± 5.89). Regarding motility of spermatozoids, the highest postoperative increase of values is after microsurgical varicocelectomy (4.30 ± 2.19 vs. 15.88 ± 3.13). CONCLUSIONS: Our study shows the lowest degree of postoperative complications among patients treated with microsurgical varicocelectomy, and the most frequent complications in those treated by open varicocelectomy. Sperm test outcomes after microsurgical varicocelectomy was better than those after other conventional techniques: significantly higher improvement of sperm quality, shoter postsurgical clinical treatment, and the lowest rate of postsurgical complications. [ABSTRACT FROM AUTHOR]

This study examined the effects of chronic restraint stress (CRS: 2 hours × 14 days) on gene expression of three antioxidant enzymes, copper, zinc superoxide dismutase (SOD 1), manganese superoxide dismutase (SOD 2) and catalase (CAT) in the rat hippocampus. Also, we examined changes in the activities of SOD 1, SOD 2 and CAT in the hippocampus of chronically stressed rats. Investigated parameters were quantifi ed by using real-time RT-PCR, Western blot analysis and assay of enzymatic activity. We found that CRS did not change mRNA and protein levels of SOD 1 and CAT, but increased mRNA and protein levels of SOD 2. However, CRS treatment increased the enzyme activities of SOD 1, SOD 2 and CAT. Our fi ndings indicate that the increased activity of antioxidant enzymes (SOD 1, SOD 2 and CAT) in the hippocampus may be an important adaptive phenomenon of the antioxidant defense system in chronically stressed rats.

BACKGROUND: Varicocele associated with infertility has been recognized for years. Referential literature provides few papers, even meta-analyses which did not confirm the success of surgery related to the increasing of the semen quality. AIM: The purpose of the presented paper is referred in arising the quantum of knowledge related to usefulness of surgery in varicocele treatment. PATIENTS AND METHODS: The varococele incidence was established in premature age (7-18) in population of 969 boys. In those who suffered from varicocele, we estimated their semen analysis parameters before and three months after the surgery, and followed up the pregnancy rate in surgically treated subjects many years after the treatment. RESULTS: A prevalence of 9.7% in premature age, significantly raising in the group aged 15-18 was showed. After the laparoscopic varicocelectomy, all of the semen parameters (left testicular volume, pH, sperm count, abnormal forms and viability) were improved, since the semen volume and the progressive motility not significantly. Since we observed adolescent varicocele, some of the semen parameters initialy have not been out of reference limits. Following the surgically treated subjects for next 12-17 years, the pregnancy rate is at least 75%, since not all of them have been married yet. CONCLUSIONS: We recorded improvement of two out of three parameters of fertility after the operation in a group of 23 surgically treated patients. This fact encourages those who advocate surgical treatment of varicocele in adolescents, since the early therapy would prevent fertility disorders. [ABSTRACT FROM AUTHOR]

After a short review of impotence, the definitions of erectants and aphrodisiacs are presented. The Authors propose division of arthropods according to the places of effect. The description of particular arthropods with their pictures and nomenclature, is followed by certain or probable mechanisms of achieving the aphrodisiac and sometimes toxic effect, that were available in the literature since 1929 till nowadays. We mention the most usual locations, mainly in Asia, where they are found and consumed, but also, we describe the manner of preparing and intake. The review includes the following arthropods: lobster, Arizona bark scorpion, deathstalker, banana spider, Mediterranean black widow, Burmeisters triatoma, giant water bug, diving-beetle, Korean bug, diaclina, flannel moth, Spanish fly, migratory locust, red wood ant and honeybee. [ABSTRACT FROM AUTHOR]

Background and Objectives: Serenoa repens extracts (SrE) have been used for centuries in the treatment of benign prostatic hyperplasia (BPH). According to recommendations that each product should be examined separately, including its tolerability and toxicity, we conducted this study in order to broaden the current cognition about tolerability and toxicity of SrE, in particular of German brand ProstamolunoR. Materials and Methods: Twenty-four adult male Wistar rats were randomly distributed into 4 groups of 6 animals. The first control group (O) received water (1 ml/kgBW) and second control group (OO) received olive oil (1 ml/kgb.w.) every day for 30 days. The third and fourth group of rats (SR5 and SR10) were treated with SrE (150 and 300 mg/kgb.w. daily) dissolved in olive oil. Tolerability and toxicity of SrE were estimated on the basis of daily monitoring of behavior, body weight gain (BWG), relative weight of liver, left kidney, prostate and left testis, and values of general biochemical parameters. Total liver proteins (TLP) and glutathione content in hepatocyte suspension were also determined. Results: BWG was significantly unchanged in SR5 and SR10 compared to both controls in all intervals of measurement and at the end of treatment (p > 0.05). LW/BW ratio was significantly higher in SR10 compared with O (p < 0.01). Creatinine and potassium were significantly higher in SR5 compared to O (p < 0.05), but in SR10 were significantly higher compared to both control groups (p < 0.01). TLP content was significantly higher in SR5 compared to OO (p < 0.01). The content of glutathione in homogeneous suspension of hepatocytes didn't alter significantly. Conclusions: Obtained results have expanded the current state of knowledge about the tolerability and toxicity of SrE, in particular of Prostamol-unoR. For the adoption of a more precise conclusion about its tolerability and toxicity, it should be excluded possible limiting factors that we identified in this study. [ABSTRACT FROM AUTHOR]

BACKGROUND: A small amount of data is already presented in the relevant literature related to the medical facts of scorpionism caused by Yellow scorpion (Mesobuthus gibbosus: M. gibbosus). Undoubtedly, it is considered as dangerous to human health. This paper presents an unusual case of scorpionism after the sting in vein. CASE REPORT: A 25 year old male was bitten by M. gibbosus. He experienced extremely severe intermittent pain in the right feet, followed by pulsating and glowing sensations, cold sweat and paleness. 15 minutes after the sting, the pain started to spread through the medial side of the leg, up to the inguinal region. Patient became excited, and experienced occasional spasms of leg muscles. A month after, the bitten vein of dorsal arch of the foot and v. sephena magna became non-uniformly tortuously spread through the entire length. On physical examination four years after the sting, the enlargement of the veins still exists, periodical tingling, and occasional muscle twitches during the night. CONCLUSIONS: M. gibbosus is endemic in Mediterranean area and represents a real hazard for local inhabitants and tourists. The medical treatment of this type of scorpionism is exclusively symptomatic. [ABSTRACT FROM AUTHOR]

Our study investigated whether antibiotic therapy in infertile tobacco users with sterile leukocytospermia and a history of former sexual transmitted disease (STD) has an advantage over cessation of smoking alone. For this study, 80 male infertile smokers were divided into two subgroups. The first group numbered 40 patients treated with a two week course of doxycycline, 100 mg, twice daily, while the second group simply ceased smoking. A control group of 20 patients with chronic abacterial prostatitis (CPPS III a) were treated with the same antibiotic for two weeks. Patients from the first group exhibited significantly higher values in semen volume, total motility, and progressive motility of spermatozoa, when compared with the second group, two weeks post treatment. The latter two measures persisted during the 12 week follow up period. In both groups of patients, the correlation coefficient between the number of leukocytes and progressive motility was determined as statistically significant. However, in the control group the correlation was not statistically significant; however progressive motility, total motility, and vitality were significantly improved after a two week course of antibiotics. Our study implies that antibiotic treatment is perhaps effective in treating sterile leukocytospermia in smokers with a former STD and is a more effective treatment option in improving sperm parameters over smoking cessation alone., Abbreviations: STD: sexual transmitted disease; CPPS IIIa: chronic abacterial prostatitis; PSA: prostatic specific antigen; EPS: expressed prostatic secretion; WBC: white blood count; LUTS: lower urinary tract symptoms; PPMT: pre-massage and post-massage urine test; VAS: visual analogue scale.

Introduction: Acute aortic type III dissection is one of the most catastrophic events, with in-hospital mortality ranging between 10% and 12%. The majority of patients are treated medically, but complicated dissections, which represent 15% to 20% of cases, require surgical or thoracic endovascular aortic repair (TEVAR). For the best outcomes adequate blood transfusion support is required. Interest in the relationship between blood type and vascular disease has been established. The aim of our study is to evaluate distribution of blood groups among patients with acute aortic type III dissection and to identify any kind of relationship between blood type and patient's survival., Material and Methods: From January 2005 to December 2014, 115 patients with acute aortic type III dissection were enrolled at the Clinic of Vascular and Endovascular Surgery in Belgrade, Serbia and retrospectively analyzed. Patients were separated into two groups. The examination group consisted of patients with a lethal outcome, and the control group consisted of patients who survived., Results: The analysis of the blood groups and RhD typing between groups did not reveal a statistically significant difference ( p = 0.220)., Conclusions: Our results indicated no difference between different blood groups and RhD typing with respect to in-hospital mortality of patients with acute aortic dissection type III., Competing Interests: The authors declare no conflict of interest.

The aim of this study is to investigate changes in the vascular system and hemodynamics between patients with organic erectile dysfunction (ED) (DM type I and II), as well as to compare the quality of sexual life between those two groups after the treatment with vacuum erection device (VED). Study enrolled 50 males with DM, aged from 35 to 67 years, who have attended the urologic clinic due to inability to attain and maintain an erection of the penis sufficient to permit satisfactory sexual intercourse. Patients were using VED and six months later were assessed for therapy results. The International Index of Erectile Function (IIEF) was used to quantify erectile dysfunction. Alprostadil injection test was also used, with Doppler color flow imaging system, to evaluate the peak systolic velocity (PSV) and diameter of cavernosal artery (DCA). Significantly higher values of PSV were obtained in patients with DM type II. Also, DCA showed significant difference between two groups of patients. There was significant improvement in three items of IIEF after six months of treatment among both groups of examinees. Patients with DM type I had more serious risk for development of arteriogenic ED. VED could be a good alternative therapy for patients who denied peroral therapy.

The aim of this study is to establish the scientific benefit of royal jelly (RJ) on prostatic-specific antigen (PSA), post-void residual (PVR) volume and International Prostate Symptom Score (IPSS) in benign prostatic hyperplasia. For the study, a group of 40 men were administered 38 mg of RJ over a period of three months, their PSA values, prostate volumes and the volumes of their transitory prostate zones, PVR and IPPS values were measured at the end of the first month, and at the end of the third month. The results of this study confirm the potential of RJ in reducing PSA scores and improving IPSS values. Since the use of RJ did not lead to any significant reduction in PVR, prostate volume, or to any involution of the transitory zone, it appears that it may only affect the blood marker of prostatic hyperplasia and to improve quality-of-life (QoL) in those patients. Overall, in comparison to phytotherapy and conventional therapy, RJ had similar positive effects on QoL in patients with BPH, however it exhibited markedly better effects on reducing PSA levels in blood. The therapeutical use of RJ exhibited no side effects.

Introduction: In-hospital mortality of acute aortic type III dissection ranged about 12%. Complicated dissections represent about 18% of all cases, and require open surgery or TEVAR. More morphological predictors of in hospital mortality are needed to differentiate patients who should be selected for immediate, surgical or endovascular intervention., Methods: From January 2009 to December 2014, 74 patients with acute aortic type III dissection were enrolled at Clinic of Vascular and Endovascular Surgery in Belgrade Serbia and retrospectively analyzed. Every MSCT was observed in regard to morphologic characteristics of dissection., Results: By analyzing morphologic parameters in patients between survival and non-survival group only localization of intimal tear showed statistical significance (p=0,020). The size of the intimal tear didn't reach statistical significance with the tendency of doing so in a larger sample of patients (p=0,063) with the cut-off value of 9.55mm. The shape of the true lumen was on the border of statistical significance (p=0,053)., Conclusion: Inner curvature intimal tear localization, huge intimal tear as well as elliptic shape of the true lumen together should raise awareness to a subgroup at risk for in hospital mortality. More liberal endovascular treatment in this subgroup of patients is advocated.

A 26-year-old male presented to the emergency center having been shot in the neck. Multislice computed tomography angiography revealed injury of the right internal carotid artery at level of the carotid bifurcation with hematoma and injury of right internal jugular vein. Under general anesthesia, transposition of internal carotid artery to external carotid artery, with ligation of internal jugular vein, was successfully performed. This case emphasizes the value of "old fashion" surgical treatment in modern endovascular age., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: Male infertility is a common and complex problem and, despite much research in this field, the major cause of infertility unfortunately remains unknown. Genital infection and varicocele are important causes of infertility., Aims: To compare the influence of genital infection and varicocele individually on male infertility based on semen analysis., Study Design: Cross-sectional study., Methods: The study included 120 infertile patients divided into two groups according to the presence of genital infection or varicocele. The first group included 60 examinees with proven genital infection, but without varicocele formation. The second included 60 patients with varicocele, regardless of the varicocele grade, but without genital infection. The fertile parameters were compared and an assessment was performed on the impact on quality of spermatogenesis due to infection and varicocele., Results: There is a statistically significant difference regarding abnormal forms of spermatozoids (45.94±9.79 vs. 25.27±6.54) and progressive motility (8.15±1.24 vs. 24.95±7.2), between two groups of patients. However, acidity of ejaculates, minimum sperm concentration, total spermatozoid motility and ejaculate volume showed no statistically significant difference., Conclusion: The study showed a stronger negative influence of genital infection on fertile parameters over varicocele. The significance of our study is the lack of contemporary researches comparing varicocele and genital infection influence on male infertility individually.

Introduction: The aim of this study is to test the hypothesis that the cessation of sports training in young athletes reduces the prevalence of varicocele., Material and Methods: 1,013 young males were divided into three age-matched groups based on their sport activity. The first group consisted of 305 athletically active boys in basketball, volleyball, handball, or football; the second of 44 active water-polo players, and the third of 664 sport-inactive controls. All participants had been initially examined for the presence of varicocele, and positive ones were submitted to orchidometry and seminal fluid analysis. Those with varicocele were then asked to cease all sport activity for the following six months, and the reassessing was performed., Results: The results showed a significantly higher percentage of varicocele present in the first group than in the control group (p < 0.49), while the percentage of young males diagnosed with varicocele in the second proved to be even lower than that of the control group (9.09% vs. 12.35%). After the 6-month period of cessation and abstention from all sporting activity, every parameter of the seminal fluid analysis improved in the first group, wherein statistical significance for both sperm concentration (p < 0.001) and sperm motility (p < 0.023) was found. The testicular volume was found not to have increased significantly in either group (p > 0.05)., Conclusions: The study shows that sport-associated varicocele has a positive prognosis when diagnosed early and upon the cessation of sports training.

Objective: Nitric oxide (NO) is a well-known oxidative stress agent that directly inhibits mitochondrial respiration and the synthesis of DNA. A case-control study of the concentration of NO in infertile patients with varicocele versus car-accident controls was performed. The concentration of NO in infertile patients with varicocele, and its correlation with the sperm fertility test named the hypo-osmotic swelling (HOS) test for sperm membranes and semen analysis, was also examined., Material and Methods: A spectrophotometric method was used to measure the concentration of NO in infertile subjects, and the HOS test was carried out according to Jeyendran's original protocol. NO values from left testicular vein and left cubital vein of 19 infertile patients with left-sided varicocele were compared to 15 patients in the control group who underwent explorative laparoscopies after car accidents. Semen analysis and the HOS test were performed only in the left-sided varicocele group and compared to the NO outcomes., Results: The results indicate that the concentration of NO was significantly higher in the testicular vein than in the peripheral veins of patients with varicocele, as well as being significantly higher than in the testicular vein of control patients. An increased NO concentration in the testicular vein, higher sperm count and higher sperm motility in infertile patients with varicocele followed negative or suspicious findings of the HOS test for sperm membranes. There was also a significant correlation between NO concentration and sperm count in patients with varicocele., Conclusions: Further studies with more patients, related to NO concentrations and the HOS test are needed to verify these results.