Ayşe Güler Okyay

Protective Effect of Colchicine on Ovarian Ischemia–Reperfusion Injury An Experimental Study

Objective: The aim of the present study is to investigate the efficiency of colchicine in the experimental rat ovarian torsion model in the light of histological and biochemical data. Study Design: A total of 35 Wistar albino female rats were randomly divided into 5 groups, group 1: (control-sham operated, n = 7); group 2: (torsion/detorsion, n = 7) 2 hours of ischemia and 2 hours of reperfusion; group 3: (torsion/detorsion, n = 7), 2 hours of ischemia and 5 days of reperfusion; group 4: (torsion/detorsion, n = 7) 2 hours of ischemia and 2 hours of reperfusion and a signal dose of oral 1 mL/kg colchicine; and group 5: (torsion/detorsion, n = 7), 2 hours of ischemia and 5 days of reperfusion and 5 days of oral 1 mg/kg colchicine. Histopathologic evaluation was performed by a scoring that assesses congestion, bleeding, edema, and cellular degeneration in the ovarian tissue. Catalase, tissue malondialdehyde (MDA), and protein carbonyl levels were calculated. Results: The histopathologic scores, MDA, and protein carbonyl levels in the control and colchicine groups were significantly lower than groups 2 and 3 (P < .001). Catalase activities were significantly higher in the control and colchicine groups than in groups 2 and 3 (P < .001). The results of the histopathologic parameters and biochemical markers showed that protective effects of colchicine treatment persisted up to 5 days. Conclusion: Our study results revealed that colchicine reduced ovarian ischemia–reperfusion injury in experimental rat ovarian torsion model. As the ovarian detorsion is the first choice of the treatment modality in the early phase, antioxidant and anti-inflammatory treatment modalities like colchicine might be used to reduce ovarian ischemia–reperfusion injury.

Protective Effects of Colchicine in an Experimental Rat Endometriosis Model Histopathological Evaluation and Assessment of TNF-α Levels

Objective: Endometriosis is an estrogen-dependent chronic inflammatory disease observed in reproductive period. The aim of the present study is to assess the efficacy of colchicine, widely used to treat many inflammatory diseases, in an experimental rat endometriosis model. Study Design: Experimental endometriosis was constituted with implantation of autogenous endometrial tissue. Rats were divided randomly into 2 groups as colchicine group (n = 8) and control group (n =8). Although oral 0.1 mg/kg colchicine was administered 4 weeks to the colchicine group, the same amount of saline solution was administered to the control group. Before and after 30 days of treatment period, peritoneal and tissue tumor necrosis factor α (TNF-α), the volumes and histopathological properties of the implants were evaluated. Results: Although the implant volume decreased significantly in the colchicine group (89.2 ± 13.4 mm3 to 35.2 ± 4.5 mm3, P < .05), the implant volume increased in the control group (85.1 ± 14.2 mm3 to 110.3 ± 10.5 mm3, P < .05). When compared to the control group, the colchicine group had significantly lower histopathologic sores (1.4 ± 0.2 vs 2.6 ± 0.4, P < .001). Although peritoneal fluid TNF-α levels were significantly decreased in the colchicine group (45.2 ± 5.3 pg/mL vs 12.1 ± 5.2 pg/mL, P < .001), the peritoneal fluid TNF-α levels were significantly increased in the control group after the treatment (44.2 ± 3.5 pg/mL vs 61.3 ± 12.2 pg/mL; P < .001). Tissue TNF-α levels were significantly lower in the colchicine group when compared to the control group (45.4 ± 8.6 pg/mL vs 71.3 ± 11.2 pg/mL; P < .001). Conclusion: Colchicine resulted in regression of endometrial implant volumes in experimental rat endometriosis model and decreased peritoneal and tissue TNF-α levels.

The Effect of Erythropoietin in Preventing Ischemia–Reperfusion Injury in Ovarian Tissue Transplantation

Condensation Erythropoietin improved the survival of follicles in ovarian grafts most likely by reducing ischemic injury, by improving neoangiogenesis, and by its antioxidant effects. Objective: Ovarian tissue cryopreservation and transplantation are the only options accepted for prepubertal girls and women requiring immediate chemotherapy. Ischemia–reperfusion injury is the main obstacle for ovarian tissue transplantation. In the present study, we aimed to evaluate the effects of recombinant human erythropoietin (EPO) on tissue viability in autotransplanted rat ovaries. Study Design: Seventeen female rats were randomized into 3 groups as sham control group (n = 5), EPO-treated group (n = 6), and EPO-untreated group (n = 6). Both ovaries were excised and transplanted into a subcutaneous pouch formed at the anterior abdominal wall in the EPO-treated and untreated groups. In the EPO group, 5000 U/kg EPO was applied as local injection to the site that ovarian tissue was placed and the dose was repeated with the same route at the end of the fourth week. After 2 months, ovaries were removed and blood samples were obtained. Levels of estradiol (E2), vascular endothelial growth factor (VEGF), VEGF-C, and lipid hydroperoxidase (LPO) and the activity of glutathione peroxidase (GPX), superoxide dismutase (SOD), and catalase (CAT) were measured both in blood and tissue samples. Histopathological and morphometric analyses were also performed on tissue samples. Results: Considering serum levels, mean CAT was significantly higher (P = .003) and mean SOD (P = .033), LPO (P = .050), VEGF (P = .001), and VEGF-C (P = .024) were significantly lower in the EPO-treated group than in the untreated group. Mean serum GPX levels were similar. Significantly higher levels of E2 were determined in the EPO group than in the untreated group. Highest serum E2 levels were found in the sham group (P = .001). Tissue levels of GPX (1.23) and CAT (53.17) were significantly higher in the EPO group (P = .002 and P = .001, respectively). However, tissue levels of SOD and LPO, VEGF, and VEGF-C levels were significantly lower in the EPO group than those in the untreated group (P = .033, P = .050, P = .002, and P = .003, respectively). In tissue examination, the highest values of x, y axis and epithelial height were in the sham group. Mean value of the EPO group was found statistically significantly higher than that of the untreated group (P ≤ .05). In terms of antral follicle count, ordering was found as sham > EPO-treated > EPO-untreated group. Follicle counts in the EPO group were significantly higher than those in the untreated group (P ≤ 0.05). Conclusion: Erythropoietin improved the survival of follicles in ovarian grafts most likely by reducing ischemic injury, by improving neoangiogenesis, and by its antioxidant effects.

Evaluation of vaginal agenesis treated with the modified McIndoe technique: A retrospective study

OBJECTIVE Retrospective analysis of cases that have undergone neovagina operation because of congenital vaginal agenesis was objected. MATERIAL AND METHODS Seven cases applying with the complaints of primary amenorrhea or inability to have sexual intercourse were in the study. The cases were diagnosed with congenital vaginal agenesis and operated at Mustafa Kemal University Training and Research Hospital between 2011 and 2014. Vaginoplasty by the modified McIndoe method was performed in all cases. The main complaint, chromosomal analysis, duration of operation, preoperative and postoperative vaginal length, complications, postoperative treatment, and satisfaction from the sexual intercourse were all evaluated. RESULTS Average age of our patients was 28.14±8.61 (19-39) years. One patient was 46XX-45X0 mosaic Turner syndrome), 1 patient was 46XY (testicular feminization), and other 5 patients were 46XX. The average duration of operation was 2.7±0.56 (2-3.5 h). Postoperative infection was observed in 1 patient. In this infected patient, graft failure occurred and debridement was performed in reoperation. No early complications were seen in the others. Preoperative and postoperative average vaginal lengths were 1.85±0.62 (1-3 cm) and 8.71±1.11 (7-10 cm), respectively. Dyspareunia occurred in 2 cases that were not able to use dilatator regularly: 1 because of cancelation of marriage and the other because of postoperative infection; regular sexual life was achieved in remaining 5 (71%) cases. CONCLUSION Although there is no consensus about the ideal method of making a functioning vagina among different specialties. The modified McIndoe technique is the most applied method by gynecologists and simple, minimally invasive and with low morbidity.

Peritoneal Tüberküloz: İki olgu sunumu

Gelismekte olan ulkelerde pelvik tuberkuloz hala onde gelen asit nedenlerinden biridir. Asitle birlikte adneksiyal kitle ve Ca 125 yuksekligi olan hastalar cogu zaman hemen over kanseri olarak degerlendirilmektedir. Oysa pelvik tuberkuloz ve over kanseri semptom ve bulgulari birbirine cok benzemesine ragmen tedavileri cok farklidir. Tani koymada ilk adim hastaligin farkinda olmak ve taniyi akla getirmektir. Bu yazida peritoneal tuberkuloz tanisi konulan 2 olgu sunulmustur. Olgularin sunumundaki amac over kanseri ile sikca karistirilan TB peritonitin tani konma surecine dikkat cekmek ve dogru tani ve tedavinin hastanin kaderini nasil degistirdigini vurgulamaktir.

Spontaneous pneumothorax and pneumomediastinum in pregnancy: A case report

Spontan akut pnömotoraks subplevral bleb veya büllerin spontan rüptürü sonucu gelişebilen ve gebelikte son derece nadir görülen bir durumdur. İki günlük dispneyi takiben toraks üst kısımlarda ve boyunda gelişen ağrı ve şişlik şikayeti ile başvuran genç bir gebede bilateral pnömotoraks ve pnömomediastinum teşhis edildi. Tedavide on günlük hospitalizasyon süresince gerek duyuldukça nazal oksijen, anljezikler ve antiemetikler kullanıldı. Bu süre sonunda, fizik muayene bulguları, akciğer filmi ve oksijen saturasyonunda iyileşme kaydedildi. Destekleyici tedaviler yeterli olduğundan cerrahi ya da toraks tüpü gibi invaziv tedavilere gerek duyulmadı. Nadir görülmesine rağmen, dispne ve göğüs ağrısı şikayeti olan her gebede pnömotoraks akla getirilmeli ve diğer durumlardan ayırt etmek için tanı radyografik olarak doğrulanmalıdır. Bu raporda, 10 haftalık bir primigravid gebede spontan akut pnömotoraks ve pnömomediastinum olgusu sunulmuştur. J Turk Soc Obstet Gynecol 2014;2:131-33 Anahtar Kelimeler: Pnömomediastinum, pnömotoraks, gebelik Abstract

Biomechanical effects of menopause in ovariectomized rats’ femurs

Abstract Objective: To demonstrate the biomechanical changes in rat bones occurred by surgical menopause and to search for correlation between biomechanical test results and bone mineral density (BMD) measurements. Methods: Thirty female Wistar-albino rats aged ∼6 months and weighed ∼250–300 g were randomized into ovariectomy, sham and control groups. After 6 months, rats were sacrificed and right femurs were extracted. BMD measurements and three point bending biomechanical tests were made in femurs. Results: The difference among the mean BMD measurements of three groups were found to be statistically significant (Pr > F value <0.0001). Mean elastic module, maximum elongation and femoral diameters were also found to be statistically significantly different (Pr > F value <0.05). Ovariectomised and sham-operated groups were significantly different in terms of elastic modulus. Ultimate force did not differ among the groups significantly. The difference between ultimate strain and maximum elongation of the ovariectomy and sham operated group was statistically significant. Conclusions: Bone quality was deteriorated and fragility was increased in rats 6 months after surgical menopause. Sole BMD measurement might not be reliable in evaluation of osteoporosis and fracture risk. Biomechanical quality of bone is more important than its mineral content in determining fragility.