Ata Önvural

Effects of HRT on serum levels of IGF-I in postmenopausal women

OBJECTIVES It is thought that insulin-like growth factor-1 (IGF-I) stimulates bone formation. We aimed to determine the effects of oral and transdermal hormone replacement therapy (HRT) on serum IGF-I levels and to investigate the effects of basal IGF-I levels on the levels obtained at the end of the therapy. METHODS Sixty-six postmenopausal women were administered either oral (n=44) or transdermal (n=22) HRT for 6 months. Serum levels of IGF-I were determined before and after HRT in all subjects. Groups were divided into two subgroups according to the median value of serum IGF-I levels (basal IGF-I levels above or below the median value). The increase of IGF-I levels after HRT were calculated (%) for all women. Mean increases of subgroups were compared. Furthermore, study groups were divided into three subgroups according to the changing of IGF-I (increase>25%, between 25% increase and 25% decrease and decrease>25%). Mean basal IGF-I levels of these three subgroups were compared. RESULTS Mean serum levels of IGF-I before and after HRT were not significantly different in both oral and transdermal groups (P>0.05). Mean increases of IGF-I after HRT for the patients with low basal IGF-I levels, were 65% in oral and 77% in transdermal groups. However, mean increase of the patients with high basal IGF-I levels were -8 and -16% respectively. Moreover, mean level of basal IGF-I was significantly low in women who have more than a 25% increase after HRT (P<0.05). CONCLUSION HRT seems to significantly increase serum levels of IGF-I in postmenopausal women with low basal levels of IGF-I.

Prospective comparison of tissue trauma after laparoscopic hysterectomy types with retroperitoneal lateral transsection of uterine vessels using ligasure and abdominal hysterectomy

ObjectiveThe aim of this study was to evaluate the level of tissue trauma after laparoscopic and total laparoscopic hysterectomy with retroperitoneal lateral transsection of uterine vessels using ligasure as compared with abdominal hysterectomy.Study designA total of 45 women with various indications for hysterectomy were randomized into laparoscopic hysterectomy, total laparoscopic hysterectomy and abdominal hysterectomy. Laparoscopic and total laparoscopic hysterectomy with retroperitoneal lateral transsection of uterine vessels was performed by four-puncture laparoscopy and pre-, postoperative and postoperative 24th hour levels of interleukin-6 (IL-6) and C-reactive protein (CRP), the mean operative time, drop in hemoglobin concentration, weight of removed uterus, VAS scores, hospitalization period and major and minor operative complications were analyzed prospectively.ResultsCRP and IL-6 levels were significantly higher in the abdominal hysterectomy group compared to either laparoscopy groups at the postoperative 24th hour. There were no significant differences in the levels of CRP and IL-6 between the two laparoscopy groups. The longest operative times were observed in the total laparoscopic hysterectomy group.ConclusionLaparoscopic surgery causes less tissue trauma than the conventional open surgery; however, we observed no difference between the laparoscopic hysterectomy groups concerning the postoperative inflammatory response. We may prefer laparoscopic hysterectomy instead of total laparoscopic hysterectomy under suitable conditions, since laparoscopic hysterectomy causes the same level of tissue trauma as total laparoscopic hysterectomy, but has the advantage of a significantly shorter operative time. Meanwhile, hysterectomy done by laparoscopy with retroperitoneal lateral transsection of uterine vessels using ligasure is an effective and safe procedure.

The values of urinary NTx in postmenopausal women undergoing HRT; the role of additional alendronate therapy

OBJECTIVE To determine the changes in levels of urinary NTx at the end of the 6th month of oral and transdermal hormone replacement therapy (HRT) and the effects of additional alendronate therapy for osteoporotic women. METHOD Of 66 postmenopausal women 23 were treated with oral estradiol+norethisterone acetate (E+P), and 22 were treated with transdermal estradiol+norethisterone acetate. The third group consisted of 21 women with osteoporosis (bone mineral density < 100 mg/cm(3)) and treated with oral E+P plus alendronate 10 mg/day. RESULT Significant decreases of urinary NTx levels were seen after HRT in all study groups (P < 0.05). But the decline of NTx levels was not different between the oral and transdermal HRT groups (P > 0.05). There was no additional decrease in the levels of NTx with alendronate therapy (P > 0.05) but NTx excretion diminished more in patients with high baseline levels. CONCLUSION The decline of NTx at the end of the 6th month of HRT reflects the decrease of bone resorption and it is not related to the route of administration.

Prolactin and amniotic fluid electrolytes.

Prolactin (PRL) levels and Na+. K+, Cl−. Ca+ concentrations in maternal serum and amniotic fluid from 64 women in normal term pregnancy were measured by immunoenzymetric assay and flame photometry. The mean amniotic fluid PRL concentration was 597.7 (SE 31.5) ng/ml and the mean amniotic fluid Na+, K+, Cl− and Cd++ levels were 125.6 (SE 0.9) mmol/l, 4.5 (SE 0.1) mmol/l, 109.3 (SE 1.3) mmol/l and 2.0 (SE 7.5 E‐02) mmol/l, respectively. There was no correlation between PRL levels in maternal scrum and amniotic fluid. and the electrolyte concentrations in amniotic fluid. A close correlation was found between the concentrations of Na+ and Cl− in maternal serum and amniotic fluid. Thus, even though PRL may participate in the regulation of electrolytes in the amniotic fluid compartments, our findings provide indirect evidence for the existence of other regulatory mechanisms.

Maternal, fetal and amniotic fluid prolactin levels in term and post‐term pregnancies

Prolactin (PRL) levels in maternal serum, amniotic fluid and mixed cord blood from 11 women with post‐term pregnancies and 64 women with normal term pregnancies were measured by immunoenzymetric assay in order to investigate their possible role in the onset of labor. No differences were found between term and post‐term pregnancies, and it is concluded that PRL probably has no function in triggering labor.