İdris Koçak

Reduction of adhesion formation with cross-linked hyaluronic acid after peritoneal surgery in rats

OBJECTIVE To examine the effectiveness of a cross-linked hyaluronan solution (auto-cross-linked polysaccharide [ACP] gel) for the prevention of postsurgical adhesions. DESIGN A randomized blinded study using a rat model of laparotomy. SETTING Surgical Research Laboratory in a university medical school. ANIMAL(S) Sixty-seven sexually mature rats. INTERVENTION(S) Standardized surgical trauma was induced in the rat uterine horn to induce adhesion formation. After trauma, group-1 animals (n = 23) received no treatment, group 2 (n = 21) received noncross-linked hyaluronic acid (HA), and group 3 (n = 23) received cross-linked HA applied on the lesion. MAIN OUTCOME MEASURE(S) Six weeks after laparotomy, repeat laparotomy was performed and the adhesions were scored according to Blauers scoring system. RESULT(S) Overall, 84% of the untreated animals and 65% of the animals treated with noncross-linked HA presented with severe adhesions. The mean (+/-SEM) increase in the adhesion score was 2.46+/-0.23 in the untreated group, 2.23+/-0.29 in the group receiving noncross-linked HA, and 1.27+/-0.12 in the ACP gel group. CONCLUSION(S) ACP gel holds promise as a novel resorbable biomaterial for the reduction of postoperative adhesions after laparotomy.

The comparison of gonadotropin-releasing hormone agonist therapy and intraperitoneal Ringer's lactate solution in prevention of postoperative adhesion formation in rat models

OBJECTIVE To evaluate gonadotropin-releasing hormone agonists (GnRH-a) therapy and intraperitoneal Ringers lactate solution (RL) for the prevention of postsurgical adhesion formation in rat models. STUDY DESIGN Forty rats were randomized into four groups: Group I was the control; in group II, RL was applied at the surgery; group III and IV received preoperative subcutaneous injections of the GNRH-a leuprolide acetate and only the diluent of the GNRH-a respectively. A standard lesion was created over the uterus of each rat. Adhesions were scored at relaparotomy 3 weeks later. Analysis of variance (Kruskal-Wallis) and Mann-Whitney U-tests were used for the statistical evaluation. RESULTS The average adhesion scores were 2.7+/-0.26, 1.4+/-0.27, 0.9+/-0.18, and 2.5+/-0.34 in groups I, II, III, and IV respectively. There were significant differences between the scores of groups I and II (P<0.01), groups I and III (P<0.001), groups II and IV (P<0.05), and groups III and IV (P<0.01); but not between the scores of groups II and III, and groups I and IV (P>0.05). CONCLUSION GNRH-a was successful in reducing postoperative adhesion formation but was not superior to intraperitoneal RL.

Effects of metformin on insulin resistance, androgen concentration, ovulation and pregnancy rates in women with polycystic ovary syndrome following laparoscopic ovarian drilling.

Aim:  To evaluate the effects of metformin on insulin resistance, androgen concentration, ovulation rates and pregnancy rates in infertile women with polycystic ovary syndrome (PCOS).

Effects of Ringer’s Lactate, Medroxyprogesterone Acetate, Gonadotropin-Releasing Hormone Analogue and Its Diluent on the Prevention of Postsurgical Adhesion Formation in Rat Models

Fifty adult female rats were randomly divided into five groups. Before the standard surgical procedure which consisted of creating a lesion with electrocautery over the uterus, leuprolide acetate (LA) together with its diluent, the diluent alone and medroxyprogesterone acetate (MPA) were injected to the third, fourth, and fifth groups, respectively. Ringer’s lactate (RL) solution was applied intraperitoneally to the second group at the end of the surgery. Group I received no medication. Relaparotomy was performed 3 weeks later to evaluate the adhesions. The mean adhesion scores were (mean ± SD) 2.6 ± 0.7, 1.4 ± 0.8, 0.9 ± 0.6, 2.3 ± 0.8, and 0.8 ± 0.6 in groups I, II, III, IV, and V, respectively. The postsurgical adhesions were significantly less in the groups treated with RL, LA, and MPA.

Effects of metformin on insulin resistance, androgen concentration, ovulation and pregnancy rates in women with polycystic ovary syndrome following laparoscopic ovarian drilling THIS ARTICLE HAS BEEN RETRACTED

Aim:  To evaluate the effects of metformin on insulin resistance, androgen concentration, ovulation rates and pregnancy rates in infertile women with polycystic ovary syndrome (PCOS).

Serum Nitric Oxide and Glutathione Levels in Preeclamptic and Normotensive Women during Labor

This study was performed on 38 preeclamptic women, including 26 severely preeclamptic and eclamptic cases, as well as 50 normotensive pregnant controls. Twenty cases in the preeclamptic group and 34 cases in the control group were in labor. Serum nitric oxide levels were measured as total nitrites after reduction of nitrates to nitrites. Among the control subjects, nitric oxide levels were significantly lower in the cases in labor when compared to those not in labor (p < 0.05), but glutathione levels were not significantly different (p >0.05). Among the preeclamptic patients, although nitric oxide levels were not significantly different between the cases in and not in labor (p > 0.05), glutathione levels were significantly higher in the latter group (p < 0.05). Thus, in preeclamptic patients there might be a compensatory increase in nitric oxide production during labor in order to maintain the systemic circulation. Glutathione levels might also be increased to compensate for the marked oxidative stress.

ANGIOMYOFIBROBLASTOMA OF THE VULVA : CASE REPORT

Anglomyxomas are a group of relatively rare mesenchymal myxold tumors. Three types of angiomyxomas have been Identltled: superflciat anglomyxoma, aggresslve anglomyx‐oma and anglomyoflbroblastoma. These tumors have a predllection for occurring in the perineum of middie‐aged femaies and are often clinically diagnosed as Bartholins cyst A case of a 42‐year‐old female with a perineal angiomy‐ofibrobtastoma mimicking a Bartholins cyst is presented. The pathological and clinical characteristics of this tumor are discussed.

A Retrospective Study of Balanced Chromosomal Translocations in a Turkish Population

Abstract The balanced translocations are accepted as chromosomal rearrangements that do not generally reflect any phenotypic evidence. However, phenotypical influences can be seen in children of balanced translocation carriers due to the formation of partial monosomy and partial trisomy of any related chromosome. In this study, 25 cases that detected to have balanced translocation by cytogenetic analyses were evaluated with regard to their phenotypic features. Karyotype analyses of cases were taken out by using conventional peripheral blood culture method. It is estimated that 14 (56%) of these balanced translocation carriers had recurrent miscarriage, 5 (20%) had children with mental retardation, 3 (16%) had infertility, 2 (8%) had amenorrhea and 1 (4%) had mental retardation. When the cases were examined, it is understood that the increase in the frequency of miscarriage is the most frequent phenotypic feature in balanced translocation carriers as a result of the formation of unbalanced gametes.

Advanced tubal pregnancy at 30 weeks

A case of advanced tubal pregnancy at 30 weeks is described. The placenta was implanted on the salpinx. Most tubal pregnancies become symptomatic within the first 12 weeks. A small number of tubal pregnancies have progressed beyond this. We present this unusual case of a 30‐week tubal pregnancy situated in the proximal half of the tube that created a diagnostic dilemma.

Disruption of HDX gene in premature ovarian failure.

We present a case of a 19-year-old phenotypically normal girl with premature ovarian failure. Cytogenetic analysis using G banding and fluorescence in situ hybridization (FISH) from cultured peripheral blood lymphocytes of the patient and the family revealed a de novo X;15 translocation and the imbalance to be 46,X,t(X;15)(Xpter → Xq21::15q11 → 15qter;15pter → 15q11::Xq21 → Xqter). ish (CEPX+, wep15+, ISNRPN+, PML+, D15S10+, wcp15-, SNRRN-, PML-)[20]. The X chromosome inactivation (XCI) assay revealed a completely skewed XCI pattern in which selective pressure favors an active maternal allele. The Affymetrix 2.7 M cytogenetics whole-Genome array confirmed the chromosomal imbalance and identified disruption of the HDX gene at Xq21, the translocation breakpoint.