Browsing by Author "Oguz, Elif Kaval"

Now showing 1 - 19 of 19

Active Shrinkage Protects Neurons Following Axonal Transection
(Cell Press, 2023) Aydin, Mehmet Sxerif; Bay, Sadik; Yigit, Esra Nur; Ozgul, Cemil; Oguz, Elif Kaval; Konuk, Elcin Yenidunya; Ozturk, Gurkan
Trauma, vascular events, or neurodegenerative processes can lead to axonal injury and eventual transec(axotomy). Neurons can survive axotomy, yet the underlying mechanisms are not fully understood. Excessive water entry into injured neurons poses a particular risk due to swelling and subsequent death. Using in vitro and in vivo neurotrauma model systems based on laser transection and surgical nerve cut, demonstrated that axotomy triggers actomyosin contraction coupled with calpain activity. As a consequence, neurons shrink acutely to force water out through aquaporin channels preventing swelling and bursting. Inhibiting shrinkage increased the probability of neuronal cell death by about 3-fold. These studies reveal a previously unrecognized cytoprotective response mechanism to neurotrauma and offer fresh perspective on pathophysiological processes in the nervous system.
Antioxidant and Hepatoprotective Effects of Vitamin E and Melatonin Against Copper-Induced Toxicity in Rats
(Pharmacotherapy Group, 2018) Temiz, Mehmet Ali; Temur, Atilla; Oguz, Elif Kaval
Purpose: To determine the preventive effects of vitamin E and melatonin against acute copper toxicity in rats. Methods: A total of 28 Wistar albino rats were randomly divided into four equal groups: control, copper sulfate, copper sulfate + vitamin E, and copper sulfate + melatonin. The following were analyzed in all groups: serum enzymes; activity of the antioxidant enzymes superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx), protein carbonyl (PC) content. Liver histopathology was also evaluated. Results: PC levels decreased in rats administered copper sulfate/vitamin E and copper sulfate/melatonin. The activities of SOD, GPx and CAT increased significantly with melatonin and vitamin E administration when compared with administration of copper sulfate alone. Histopathologic features revealed severe degeneration and necrotic changes in rats administered copper sulfate alone. These changes were observed to a lesser extent in the copper sulfate + melatonin group and only minimally in the copper sulfate + vitamin E group. Conclusion: Vitamin E and melatonin are protective against liver damage caused by copper. Vitamin E, and melatonin may strengthen the antioxidant defense system by inhibiting protein oxidation and enhancing the activity of antioxidant enzymes.
Consequences of Neurite Transection in Vitro
(Mary Ann Liebert inc, 2012) Cengiz, Nurettin; Ozturk, Gurkan; Erdogan, Ender; Him, Aydin; Oguz, Elif Kaval
In order to quantify degenerative and regenerative changes and analyze the contribution of multiple factors to the outcome after neurite transection, we cultured adult mouse dorsal root ganglion neurons, and with a precise laser beam, we transected the nerve fibers they extended. Cell preparations were continuously visualized for 24 h with time-lapse microscopy. More distal cuts caused a more elongated field of degeneration, while thicker neurites degenerated faster than thinner ones. Transected neurites degenerated more if the uncut neurites of the same neuron simultaneously degenerated. If any of these uncut processes regenerated, the transected neurites underwent less degeneration. Regeneration of neurites was limited to distal cuts. Unipolar neurons had shorter regeneration than multipolar ones. Branching slowed the regenerative process, while simultaneous degeneration of uncut neurites increased it. Proximal lesions, small neuronal size, and extensive and rapid neurite degeneration were predictive of death of an injured neuron, which typically displayed necrotic rather than apoptotic form. In conclusion, this in vitro model proved useful in unmasking many new aspects and correlates of mechanically-induced neurite injury.
Degenerative Effect of Ankaferd Blood Stopper® on Mice Peripheral Sensory Neurons in Vitro
(Termedia Publishing House Ltd, 2018) Ustun, Ramazan; Oguz, Elif Kaval
Ankaferd Blood Stopper (R) (ABS) is a licensed medicinal herbal extract that ensures effective hemostasis on external, internal, postoperative and dental bleeds. Dorsal root ganglia (DRG) harbor cell bodies of peripheral sensory neurons. DRG neurons receive peripheral information and regularly send projections to nuclei in the brainstem and the spinal cord. These neurons play critical roles in neural development. Neuronal dysfunctions were reported due to ABS use in surgical interventions. The purpose of this experiment was to investigate the degenerative effects of the ABS on mice DRG cells in vitro. DRG neurons were isolated from adult mice and cultured in vitro. The neurons were incubated with various concentrations of ABS for 24 h. At the end of 24 hours, under fluorescence microscopy, cell viability was determined with the fluorescent dye calcein-AM, and cell death was determined with the fluorescent dye propidium iodide. The behavior of the cells was displayed with time-lapse video microscopy for 12 hours from the time of treatment. ABS killed both neurons and non-neuronal cells via necrosis at a concentration of 25 mu l/ml or more. ABS has the degenerative effect on mice peripheral sensory neurons, depending on the ABS level.
Effects of Chlorpyrifos on Primary Gill Cell Culture of Lake Van Fish (Alburnus Tarichi Guldenstaadt 1814)
(Oxford Univ Press, 2020) Oguz, Ahmet Regaib; Oguz, Elif Kaval; Ozok, Necati
Lake Van fish (Alburnus tarichi Guldenstadt 1814) is the only fish that can adapt to the extreme conditions (pH 9.8 salinity 0.2% and alkalinity 151.2 meq/L) of Lake Van. In this study, it was aimed to determine the cytotoxic and genotoxic effects of chlorpyrifos (CPF) on Lake Van fish primary gill cell culture. Gill epithelium from Lake Van fish was isolated enzymatically and grown in primary culture on Leibovitz's L-15 medium. After different doses (0.01, 0.1, 1, and 10 mu M) of CPF were applied to the gill cells, the total oxidant status (TOS), total antioxidant status (TAS), malondialdehyde (MDA), and DNA damage levels (8-hydroxyguanine (8-OHdG)) were examined at the end of 24 and 48 h. It was determined that the TOS, MDA, and 8-OHdG levels increased in the cells exposed to high doses (1 and 10 mu M) of CPF and the TAS was decreased (P < 0.05). It was revealed from this study that CPF administered at a dose higher than 1 mu M can cause oxidative stress and DNA damage in the primary gill cell culture of Lake Van fish. In addition, the findings showed that Lake Van fish primary gill cell culture was useful in determining the effects of toxic substances likely to be the contaminants of a lake. [GRAPHICS]
Effects of Salinity on Gill Histology in Sailfin Velifera (Poecilia Velifera)
(Springer, 2024) Oguz, Ahmet R.; Sepil, Ahmet; Alkan, Zehra; Azizoglu, Burcu Ergoz; Sen, Fazil; Oguz, Elif Kaval
Fish live in aquatic areas with varying salinity from fresh water to seawater. Gills are one of the most important osmoregulatory organs for maintaining the salt-water balance. In this study, changes in the gills of velifera (Poecilia sphenops) acclimated to 20, 30, 40, and 50 ppt of saline in the laboratory were examined histologically and immunohistochemically. Mucus cells (MCs), proliferating cell nuclear antigen (PCNA), mitochondria-rich cells (MRCs), and heat shock proteins (HSP70) + cells were marked in the gill tissue, which underwent routine histological procedures, and the severity of histological alterations increase with the increase of the salinity. When the gills were examined histologically, it was determined that there was an increase in cells due to hyperplasia, especially in the primary lamellae. A rapid increase in MC and HSP70 + cell numbers was observed in the 20 and 30 ppt groups. Although PCNA + cells were present in each salinity group, they were observed in the salinity group up to 50 ppt. An increase in the number and volume of MRCs was observed with increasing salinity. Based on the histological and immunohistochemical results, it is thought that the cytological and molecular arrangements of cells in gills of sailfin velifera under different levels of salinity are essential for the regulation of ion and salt balance.
Functional and Structural Neurodegenerative Activities of Ankaferd Bloodstopper in a Mouse Sciatic Nerve Model
(Spandidos Publ Ltd, 2024) Ustun, Ramazan; Oguz, Elif Kaval; Seker, Ayse; Taspinar, Filiz
Traumatic and postoperative hemorrhages are life-threatening complications. Ankaferd BloodStopper (ABS) is a potent topical hemostatic agent to stop bleeding. However, ABS is associated with nerve toxicity. The present study aimed to investigate the functional and structural neurodegenerative effects of ABS in a mouse model. A total of 30 male BALB/c mice, aged 6-8 weeks, were randomly divided into control group (no treatment), a sham group (treated with saline) and an experimental group (treated with ABS). In the saline and the ABS groups, the right sciatic nerve was surgically exposed and treated with saline or ABS, respectively. No surgical procedure was performed in the control group. On day 7 post-treatment, functional changes of the sciatic nerve were evaluated by a horizontal ladder rung walking task. Structural changes were assessed with immunohistochemistry. In the horizontal ladder rung walking test, the gait impairment was proportional to the severity of sciatic nerve damage, with the ABS group showing a significantly higher rate of errors than the control and saline groups. Immunohistochemistry demonstrated extensive degeneration and deformation in the axons and myelin sheath of the sciatic nerve in the ABS group. The results provide compelling evidence for the neurotoxicity of ABS.
Histopathological Alterations in Van Fish (Alburnus Tarichi Guldenstadt, 1814) Exposed To Tebuconazole
(Taylor & Francis Ltd, 2022) Oguz, Elif Kaval; Ergoz, Burcu; Oguz, Ahmet R.
Tebuconazole (TEB) is one of the most commonly used fungicides in the Lake Van Basin in the Eastern Anatolia Region, Turkey, which is one of the largest alkaline lakes in the world. In this study, the effects of TEB on the Van fish, the only vertebrate species living in Lake Van were investigated. The TEB was administered at a dose of 2.5 mg/L to the Van fish, which were examined histologically via the gill, liver, and kidney tissues after 24, 48, 72 and 96 h of exposure to TEB. Normal histological structure was observed in the gill, liver, and kidney tissues in the control group. Epithelial hyperplasia, epithelial necrosis, epithelial lifting, lamellar fusion, and an increase in mucus cell counts were observed in the gill tissues of the fish exposed to TEB. Dilatation and congestion of the sinusoids, melano-macrophages aggregation, and, focal necrosis were detected in the liver tissues of the fish exposed to TEB. Bleeding in the kidney tissues, hyaline droplet degeneration, contraction of the glomerulus and enlargement of the space within the Bowman's capsule were observed. The findings of the present study indicated that sublethal concentrations of TEB result in histopathologic changes in the gill, liver, and kidney.
Histopathological Determination of Changes in Tissues of Lake Van Fish (Alburnus Tarichi (Güldenstädt, 1814)) Exposed To Esfenvalerate
(Taylor & Francis Ltd, 2024) Oguz, Elif Kaval; Alkan, Zehra; Oguz, Ahmet Regaib; Azizoglu, Burcu Ergoz; Orgi, Elif
Esfenvalerate is a widely used pesticide of the pyrethroid insecticide group. It is a hydrophobic pesticide with toxic effects on many aquatic organisms. In this study, the damage caused by esfenvalerate 0.158 mu g/L administered sublethally to the gills, liver, and kidneys of Lake Van fish was determined histopathologically. Lesions such as necrosis, hyperplasia, epithelial lifting, hypertrophy, and haemorrhage were observed in the gills exposed to esfenvalerate. Gill goblet cells increased after 24 h and decreased on the other days of esfenvalerate exposure. Histopathological changes such as haemorrhage, hypertrophy, necrosis, and cloudy degeneration were observed in the liver. In the kidneys, lesions such as haemorrhage, necrosis, cell degeneration, Bowman's capsule enlargement, and glomerulus atrophy were detected. These lesions increased in tissues depending on the length of application of esfenvalerate. As a result of this study, it was determined that esfenvalerate caused damage to the gills, liver, and kidneys in Lake Van fish depending on time. These anomalies observed in the gills, liver, and kidneys can be used as a bioindicator of esfenvalerate contamination in Lake Van.
Histopathology and Immunohistochemistry of Gills of Van Fish (Alburnus Tarichi Guldenstadt, 1814) Infected With Myxosporean Parasites
(Taylor & Francis Ltd, 2020) Oguz, Ahmet Regaib; Oguz, Elif Kaval
The Van fish are a cyprinid species endemic to Turkey's largest soda lake, Lake Van, and have great economic value because they are a food source. Once a year, the fish take part in reproductive migration to the fresh waters flowing into the lake. The fish migrate from an extreme environment with high salinity (2.2%) and high pH (9.8). These fish are unable to reproduce in this alkaline environment and must migrate to fresh water during their breeding season. The aim of the present study is to report the presence of the myxosporean parasites on the gills and the pathological changes. Changes in gill histopathology, mucocytes, mitochondria-rich cells, expression of Heat Shock Protein 70 (Hsp70), and ATPase (NKA) were observed in the gill tissue. As a result of the histopathological changes in gills, infected fish had abundant plasmodia with different sizes. Plasmodia were found on gill filaments inside white ovoid-shaped structures. It was observed that plasmodia were contained on the primary filament which changed the histological structure of the gill tissue to a large extent. It was determined that the density and size of mucocytes in the infected areas of the gill tissue increased, whereas the number of mitochondria-rich cells decreased. Hsp70, an indicator of stress, was not different between normal and infected fish.
An in Vitro Model for Conditioning Lesion Effect
(Springer/plenum Publishers, 2019) Oguz, Elif Kaval; Ozturk, Gurkan
Axons of a peripheral nerve grow faster after an axotomy if it attains a prior injury a few days earlier. This is called conditioning lesion effect (CLE) and very much valued since it may provide new insights into neuron biology and axonal regeneration. There are established in vivo experimental paradigms to study CLE, however, there is a need to have an in vitro conditioning technique where CLE occurs in a maximally controlled environment. Mouse primary sensory neurons were isolated from lumbar 4-5 dorsal root ganglia and incubated at 37 degrees C on a silicon-coated watch glass that prevents cell attachment. After this conditioning period they were transferred to laminin coated culture dishes. Similar cultures were set up with freshly isolated neurons from control animals and from the animals that received a sciatic nerve cut 3days earlier. All preparations were placed on a live cell imaging microscopy providing physiological conditions and photographed for 48h. Axonal regeneration and neuronal survival was assessed. During the conditioning incubation period neurons remained in suspended aggregates and did not grow axons. The regeneration rate of the in vitro conditioned neurons was much higher than the in vivo conditioned and control preparations during the first day of normal incubation. However, higher regeneration rates were compromised by progressive substantial neuronal death in both types of conditioned cultures but not in the control preparations. By using neutralizing antibodies, we demonstrated that activity of endogenous leukemia inhibitory factor is essential for induction of CLE in this model.
Lignosus Rhinocerotis Protects Axotomized Sensory Neurones in Vitro
(Wiley-blackwell, 2016) Ustun, Ramazan; Oguz, Elif Kaval
Neuromuscular Degenerative Effects of Ankaferd Blood Stopper® in Mouse Sciatic Nerve Model
(Taylor & Francis Ltd, 2017) Ustun, Ramazan; Oguz, Elif Kaval; Delilbasi, Cagri; Seker, Ayse; Taspinar, Filiz; Oncu, Mehmet Resit; Oguz, Ahmet Regaip
Purpose: Ankaferd Blood Stopper((R)) (ABS), a licenced medicinal herbal extract, is commonly used as an effective topical haemostatic agent. This study is designed to investigate whether topical ABS application may cause peripheral nerve degeneration and neuromuscular dysfunction in a mouse sciatic nerve model.Methods: Twenty mice were randomly divided into two groups; an ABS treated experimental group and a saline-treated control group. Left sciatic nerves were treated with 0.3ml of ABS in the experimental group and 0.3ml of sterile saline in the control group for 5min. Peripheral nerve degeneration and neuromuscular dysfunction were evaluated by behavioural tests, electrophysiological analysis and weight ratio comparison of target muscles.Results: The motor function, assessed by the sciatic function index, was significantly impaired in ABS-treated animals as compared to the animals treated with saline. Motor coordination, evaluated with the rotarod test, was significantly decreased (-42%) in ABS-treated animals compared to the saline-treated animals. The degree of pain, assessed by the reaction latency to thermal stimuli (hot-plate test), was significantly prolonged (313%) in ABS-treated mice when compared to the saline-treated mice. ABS-treated mice showed a significant reduction in motor nerve conduction velocity (MNCV) (-52%) and the compound muscle action potential (CMAP) (-47%); however, it significantly prolonged onset latency (23%). The gastrocnemius muscles weight ratio of the ABS group was considerably lower than that of the control group.Conclusions: These findings demonstrate that ABS triggers peripheral nerve degeneration and functional impairment and, thus promotes a deterioration of sciatic nerves.
Neuronal Survival of Drg Neurons After Neurite Transection in Vitro Promotes by Nerve Growth Factor and Brain Derived Neurotrophic Factor
(C M B Assoc, 2018) Oguz, Elif Kaval
Neurotrophic factors are growth factors that promote neuronal survival, regulate synaptic function and neurotransmitter release, and promote the plasticity and growth of axons in the peripheral and central nervous systems. This study focused on the roles of nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) in the survival of adult dorsal root ganglion (DRG) neurons following axotomy. To investigate this, we cultured adult mouse DRG neurons and administered NGF or BDNF to the culture medium at different doses before transection. After determining the optimal doses of NGF and BDNF, these factors were then applied in combination. Axotomy was performed using a precise laser beam and neuronal death was visualized through cell observer microscopy system, by adding propidium iodide to the culture medium. The results demonstrate that the optimal doses of NGF and BDNF for neuronal survival are 150 ng/mL, and 50 ng/mL, respectively. The highest level of neuronal survival was observed in the cells treated with a combination of NGF and BDNF. In conclusion, NGF and BDNF have a positive effect, both individually and in combination, on the survival of DRG neurons following neurite transection.
Oxidative and Genotoxic Effects of Bisphenol a on Primary Gill Cell Culture of Lake Van Fish (Alburnus Tarichi Guldenstadt, 1814)
(Taylor & Francis Ltd, 2018) Oguz, Elif Kaval; Arihan, Okan; Oguz, Ahmet R.
Lake Van is the largest lake in Turkey. The lake limits lifespan due to its high pH and brackish water. For this reason, only a single species of fish (Van Fish) is living in the lake that has been adapted to these conditions. In the present study, we investigated the total oxidant status (TOS), total antioxidant status (TAS), malondialdehyde (MDA) level and DNA damage effect of bisphenol A (BPA) (10(-7), 10(-6) and 10(-5)M) on primary gill cell culture of Van Fish for 24 and 48h of incubation periods. TAS levels were not changed when compared to those of the control group, but TOS levels were decreased in both 24 and 48h. The MDA level increased only at the highest concentration (10(-5)) at the end of 12 and 24h (p<.05). DNA damage increased only at the 10(-5)M concentration after 48h. At the end of the experiment, BPA exposure caused lipid peroxidation and genotoxic effect. These results indicate that high levels of BPA exposure induced oxidative stress and DNA damage by time- and concentration-dependent fashion in the gill cell culture of Van Fish. Gill cell culture is a useful model for the rapid identification of the harmful effects of chemicals in the aquatic environment.
Polyclonal Antibody-Based Immunoassay of Vitellogenin in Van Fish (Alburnus Tarichi)
(Taylor & Francis Ltd, 2021) Oguz, Elif Kaval; Ozdemir, Kerem; Unal, Guler; Oguz, Ahmet R.
Van Lake is the third largest closed lake in the world and the biggest lake in Turkey. An ELISA method has developed with the aim of determining the pollution caused by estrogens and estrogen-like chemicals that have come to the lake Van in recent years. First, the vitellogenin in estrogen-treated male fish plasma was purified by ion exchange chromatography, injected into rats, and the obtained polyclonal antibodies were tested for specificity by Western blot and immunohistochemical methods. Immunohistochemical labeling of the vitellogenin-synthesized liver resulted in the intense marking of the liver of the animals injected with estrogen, while no markings were observed in the control group. The limit of detection of the developed enzyme-linked immunosorbent assay was 4.6 mu g L-1, and the working range was 7.8 to 2000 mu g L-1. Intra- and inter-assay variations were 13.0 % and 13.3%. The highest level of vitellogenin in male fishes measured was 23.56 mu g mL(-1).
Thymoquinone Prevents Cisplatin Neurotoxicity in Primary Drg Neurons
(Elsevier Science Bv, 2018) Ustun, Ramazan; Oguz, Elif Kaval; Seker, Ayse; Korkaya, Hasan
Chemotherapy-induced peripheral neuropathy (CIPN) is a substantial, dose-limiting adverse effect that occurs in cancer patients. Cis-dichlorodiamine (II) platinum (CDDP, cisplatin) is a platinum-based chemotherapeutic agent that causes severe acute and chronic peripheral neuropathies in 30% of cancer patients. Thymoquinone (TQ), a leading bioactive constituent of Nigella sativa seeds, has been reported to have antioxidant, anti-inflammatory, anti-neoplastic and neuroprotective properties. Dorsal root ganglia (DRG) include different classes of primary sensory neurons, such as nociceptors, mechanoreceptors, and proprioceptive neurons. Here, we investigated the neuroprotective activity of TQ against cisplatin neurotoxicity in cultured DRG neurons. We prepared neuronal cultures from DRGs of adult mice, pre-treated them with or without varying doses of TQ prior to exposure of cells to cisplatin. The preparations were viewed under the scope before and after the treatment at 24 h, 48 h, and 72 h time points. We analyzed neuronal cell viability and neurite outgrowths, and evaluated morphologic changes of neuronal or non-neuronal cells. TQ significantly increases the ability to extend neurites and neuronal cell viability when compared to the culture conditions which were treated with cisplatin only. Although we provide compelling evidence for the protective activity of TQ against chemotherapy-induced neurotoxicity, further detailed investigations in preclinical settings are warranted for its clinical use.
Thymoquinone Protects Drg Neurons From Axotomy-Induced Cell Death
(Taylor & Francis Ltd, 2018) Ustun, Ramazan; Oguz, Elif Kaval; Seker, Ayse; Korkaya, Hasan
Objective: Peripheral nerve injury (PNI) is a significant health problem that is linked to sensory, motor, and autonomic deficits. This pathological condition leads to a reduced quality of life in most affected individuals. Schwann cells (SCs) play a crucial role in the repair of PNI. Effective agents that promote SC activation may facilitate and accelerate peripheral nerve repair. Thymoquinone (TQ), a bioactive component of Nigella sativa seeds, has an antioxidant, anti-inflammatory, immunomodulatory, and neuroprotective properties. In the present study, the neuroprotective efficacy of TQ was investigated by using a laser microdissection technique in a mouse PNI model. Methods: Single cells were isolated from dorsal root ganglions (DRGs) of 6-8-week-old mice, maintained in defined culture conditions and treated with or without TQ at different concentrations. Axons were cut (axotomy) using a controllable laser microbeam to model axonal injury in vitro. Under fluorescence microscopy, cell viability was evaluated using the fluorescent dyes. The behavior of the cells was continuously monitored with time-lapse video microscopy. Results: TQ significantly increased neuronal survival by promoting the survival and proliferation of SCs and fibroblasts, as well as the migration of SCs. Furthermore, TQ improved the ability to extend neurites of axotomized neurons. The regenerative effect of TQ was dose-dependent suggesting a target specificity. Our studies warrant further preclinical and clinical investigations of TQ as a potential regenerative agent to treat peripheral nerve injuries. Conclusion: TQ exhibits a regenerative potential for the treatment of damaged peripheral nerves.
Tissue Damage in Kidney, Adrenal Glands and Diaphragm Following Extracorporeal Shock Wave Lithotripsy
(Sage Publications inc, 2014) Gecit, Ilhan; Kavak, Servet; Oguz, Elif Kaval; Pirincci, Necip; Gunes, Mustafa; Kara, Mikail; Tanik, Serhat
This study was designed to investigate whether exposure to short-term extracorporeal shock wave lithotripsy (ESWL) produces histologic changes or induces apoptosis in the kidney, adrenal glands or diaphragm muscle in rats. The effect of shock waves on the kidney of male Wistar rats (n = 12) was investigated in an experimental setting using a special ESWL device. Animals were killed at 72 h after the last ESWL, and the tissues were stained with an in situ Cell Death Detection Kit, Fluorescein. Microscopic examination was performed by fluorescent microscopy. Apoptotic cell deaths in the renal tissue were not observed in the control group under fluorescent microscopy. In the ESWL group, local apoptotic changes were observed in the kidney in the area where the shock wave was focused. The apoptotic cell deaths observed in the adrenal gland of the control group were similar to those observed in the ESWL groups, and apoptosis was occasionally observed around the capsular structure. Apoptotic cell deaths in the diaphragm muscle were infrequently observed in the control group. Apoptosis in the ESWL group was limited to the mesothelial cells. This study demonstrated that serious kidney, adrenal gland and diaphragm muscles damage occurred following ESWL, which necessitated the removal of the organ in the rat model. It is recognized that the ESWL complications related to the kidney, adrenal gland and diaphragm muscles are rare and may be managed conservatively.