Babür Kaleli

Relation of intra-abdominal fat distribution to metabolic disorders in nonobese patients with polycystic ovary syndrome

OBJECTIVE To investigate the relation between intra-abdominal fat distribution and metabolic disorders in nonobese patients with the polycystic ovary syndrome (PCOS). DESIGN Prospective case-control study. SETTING University-based hospital. PATIENT(S) Thirty nonobese patients with PCOS and 30 lean women with regular menstrual cycles (controls). All participants had a body mass index < 25kg/m(2). MAIN OUTCOME MEASURES Subcutaneous and intra-abdominal visceral and preperitoneal fat thicknesses were assessed by ultrasonography. Glucose tolerance and insulin sensitivity were evaluated by standard 75-g oral glucose tolerance test and area-under-the-curve analysis. Serum hormones and lipid profile were measured. RESULT(S) The mean preperitoneal and visceral fat thicknesses were significantly greater in nonobese patients with PCOS. Subcutaneous fat mass was similar between the PCOS and control groups. Nonobese patients with PCOS had glucose intolerance, hyperinsulinemia, and dyslipidemia, manifested by high serum levels of triglyceride, total cholesterol, and high-density lipoprotein (HDL) levels and low serum low-density lipoprotein (LDL) levels. No correlation existed between subcutaneous fat thickness and the metabolic variables in nonobese patients with PCOS. However, serum triglyceride levels correlated with visceral fat and preperitoneal fat thickness. The mean HDL level correlated negatively with visceral fat and preperitoneal fat thickness. The area under the curve for insulin and mean fasting insulin levels correlated positively with visceral fat thickness. In multiple regression analysis, visceral fat thickness contributed significantly to high serum triglyceride and fasting insulin levels. CONCLUSION(S) Intra-abdominal preperitoneal and visceral fat accumulation may contribute to the development of glucose and lipid metabolism disorders in nonobese patients with PCOS.

Reperfusion injury after detorsion of unilateral ovarian torsion in rabbits.

OBJECTIVE To determine if reperfusion injury takes place in ovarian tissue following the detorsion of the torsioned ovary. STUDY DESIGN Fifty-four New Zealand mature nonpregnant female rabbits were divided into six groups. One group served to determine the basal values of thiobarbituric acid reacting substance (TBARS) and another group was sham. In the third and fourth groups, ovarian torsions and subsequent oophorectomy were performed in 1 and 3h, respectively. In the fifth and sixth groups, detorsions were carried out after unilateral ovarian torsion lasting 1 and 3h, respectively, then oophorectomies of the detorsioned ovaries were performed 2h after detorsion. The level of TBARS in ovarian tissues was determined in all subjects. Statistical analysis was performed using analysis of variance and Duncans multiple range test. Differences were considered to be significant if P<0.05. RESULTS The levels of TBARS were not different in the basal and sham groups (P>0.05), while ovarian torsion caused significant increase in TBARS in the ovary (P<0.05), and detorsion caused a further significant increase in ovarian TBARS (P<0.05). CONCLUSION Reperfusion injury in ovarian tissue, following the detorsion after the torsion of the ovary lasting up to 3h was demonstrated biochemically in this study.

The effect of L-arginine and pentoxifylline on postoperative adhesion formation

BACKGROUND Postoperative intraperitoneal adhesion formation is a major cause of infertility, pain, intestinal obstruction, and subsequent intraoperative complication. We investigated the effects of L-arginine and pentoxifylline for preventing postoperative adhesion in rats. METHODS Forty Sprague-Dawley rats were subjected to a standardized lesion by serosal trauma of the uterine horn and parietal peritoneal defect. The agents were administered intraperitoneally at the end of surgery. The rats were assigned randomly into control (saline treated), L-arginine, pentoxifylline and L-arginine with pentoxifylline groups. Two weeks after surgery, a second laparotomy was performed and the extent of adhesion formation was determined. The data were analyzed by Mann Whitney U test. RESULTS In L-arginine and pentoxifylline administered groups, adhesion formation scores were significantly lower than the control group (p<0.05). However, the efficacy of L-arginine used together with pentoxifylline is not superior to those of L-arginine or pentoxifylline alone. CONCLUSION This study showed that L-arginine and pentoxifylline administered at the end of surgery reduced adhesion formation.

Antiphospholipid Antibodies in Eclamptic Women

Our purpose was to determine the prevalence of antiphospholipid antibodies (APA) in eclamptic women as well as the rates of intrauterine growth retardation (IUGR) and fetal death in APA-positive and -negative eclamptic women. Thirty-six eclamptic and 30 healthy pregnant women were enrolled in this study. APA in those groups were determined. The prevalences of IUGR and fetal death were determined in APA-positive and -negative eclamptic women. In the eclamptic group, APA were positive in 9 out of 36 patients (25%), where as only 2 out of 30 controls (6.7%) were positive (p < 0.05). Fetal death was encountered in 4 out of 9 (44.4%) APA-positive eclamptic women; this was a significantly larger proportion than that for APA-negative eclamptic women (1/27; p < 0.01). The rates of IUGR in APA-positive and -negative eclamptic women were not significantly different (p > 0.05). Similar conclusions about our results could also be made, when weakly positive anticardiolipin antibodies were regarded as negative in our study group and controls. Our study suggests that positive levels of APA in eclamptic women increase the risk for intrauterine fetal death.

Effects of low-dose 17-β-estradiol plus norethisterone acetate and tibolone on fasting plasma homocysteine levels in postmenopausal women

Background.  Many postmenopausal women currently receive hormone replacement therapy. The use of low‐dose 17β‐estradiol plus norethisterone acetate and tibolone for hormone replacement therapy is not uncommon in postmenopausal women. Homocysteine, which is known to be an independent risk factor for the development of cardiovascular disease, is found in increased levels postmenopause. This study compared the effects of low‐dose 17β‐estradiol plus norethisterone acetate and tibolone on the fasting plasma homocysteine level in healthy postmenopausal women.

Do menopausal hot flashes have any significant effects on arterial blood gas measurements

OBJECTIVES To evaluate the effects of menopausal hot flashes on arterial blood gas measurements. METHODS Twelve postmenopausal women with frequent hot flashes were enrolled in this study. Blood samples from femoral artery were collected before and during menopausal hot flashes in each subject, and all blood samples were analyzed for pH, pCO2, pO2, HCO3 standard, total CO2, and base excess. Arterial blood gas parameters before and during menopausal hot flashes were compared statistically. RESULTS pH measurements decreased significantly during hot flashes (P < 0.05); although the difference was found to be statistically significant, the amount of decrease and the range in which the change took place led us to conclude that this change was clinically insignificant. Other parameters did not show any statistically significant differences between the preflash and flash measurements. CONCLUSIONS Our results indicate that menopausal hot flashes do not have any clinically significant effects on arterial blood gas measurements.