محمد اصل زارع

A range of diseases can result in end-stage renal disease (ESRD), characterized by a gradual decline in kidney function and associated with significant morbidity and mortality. Currently, renal transplantation as the most effective treatment for managing ESRD. Tissue engineering presents a considerable opportunity to expand the available supply of donor organs for kidney transplants. The aim of this research was to develop a suitable technique for preparing decellularized kidney scaffolds from human tissues.

The present study was carried out from April 2019 to August 2019 in Mashhad University of Medical Sciences. In this study, two decellularization protocols were compared using sections of human kidney tissue. Therefore, two human kidneys which collected from Ghaem and Imam Reza hospitals were used. In the first protocol, detergents such as 1% Triton X-100 (1A) and 1% SDS (Sodium Dodecyl Sulfate) (1B) were employed, followed by the application of DNase I. The second protocol utilized 0.5% SDS (2A) and 1% SDS (2B). The effectiveness of these techniques was evaluated using hematoxylin and eosin (H&E) staining, 4',6-diamidino-2-phenylindole (DAPI), DNA quantification, and immunohistochemistry (IHC).

 Based on H&E staining results, comparison of the decellularized and native human kidney tissues showed a successful elimination of cell nuclei and the ameliorate extracellular matrix preservation in triton-treated scaffolds (1A) in comparison with the SDS-treated scaffolds (1B) at all times protocols. Furthermore, DNA quantification illustrated triton X-100 in removing DNA was more effective in eliminating DNA from kidney tissues compared to other protocols in renal tissues. In addition, IHC staining demonstrated that the expression of collagen IV and laminin was preserved throughout the decellularization process with Triton X-100 on day fifth. Also, IHC staining indicated human leukocyte antigen (HLA) was completely eliminated in the cortex-medulla of human scaffolds treated with Triton X-100 within day fifth.

Our results demonstrated that triton X-100 outperformed SDS as a detergent for decellularizing human kidneys. Meanwhile these results indicate suitable method for decellularization of human kidneys to produce functional kidneys.

Premature ejaculation is one of the problems which men are facing. This disorder can affect the quality of life and in many cases, the fertility of couples. Recent studies have shown that the dapoxetine mechanism affects the spermatogenesis. However, so far, no study has been conducted on the impact of dapoxetine on sexual hormones and spermatogenesis. Therefore, the present study was performed with aim to examine the effects of dapoxetine on sexual hormones and spermatogenesis.

In this study, 32 male albino desert rats weighing 200 to 250 gr were used. The rats were randomly divided into four groups. The first group received saline solution (1mg/kg) via gavage. Groups 2 to 4 were subjected to intervention with dapoxetine at doses of 1, 2, and 4 ml/kg, respectively, administered through gavage. Pathological changes in the testicular, levels of luteinizing hormones, follicle-stimulating hormone, and testosterone were investigated in this study. Data analysis was done using SPSS software (version 22) and ANOVA, Fisher and post hoc tests. P<0.05 was considered statistically significant.

Regarding the results of sexual hormones such as testosterone (p<0.001), luteinizing hormones (p=0.007), and follicle-stimulating hormone (p<0.001), there were significant differences between the mentioned four groups. The results showed that there was no evidence of hyperplasia, necrosis, edema, or maturation arrest in any of the testicular cells from the rat groups. However, spermatogenesis was observed in all rats from each of the four groups.

In general, the use of dapoxetine changes the level of sexual hormones; however, it had no effect on the pathology of testicular cells.

Aphallia is a very rare urogenital anomaly with incidence rate of 1 in 30,000,000. It usually coexists with other anomalies such as cardiovascular anomalies which are incompatible with normal life, and therefore infants are delivered stillbirth or live for a very short period of time.

We present an 18 months old boy with aphallia associated with congenital urethrorectal fistula, bladder and urethral stones. All stones were removed endourologically, recto-urethral fistula was repaired and perincal urethrostomy was performed.

The stones were composed of calcium phosphate colonized by klebiella pneumonia and proteus mirabilis. Urethrorectal fistula repairment was confirmed by cystography. Patient was discharged without a urinary catheter.

In developed countries, management of such patients is to raise them as females. However, we must consider socio-cultural conditions, parents preference and patients tendency in management of aphallia.