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Honokiol Decreases Intra-Abdominal Adhesion Formation in a Rat Model

Aim: The purpose of this study was to investigate the effectiveness of honokiol, a natural molecule that was shown to have antioxidant effects, in prevention of intra-abdominal adhesion formation in a rat model. Material and Method: This study was conducted on a total of 40 non-pregnant Sprague-Dawley rats, which were divided into 4 groups as follows: sham, control, saline, and honokiol groups. Both uterine horns of the rats in control, saline, and honokiol groups were exposed and a 2-cm segment of the anti-mesenteric surface of both uterine horns was traumatized by a scalpel. The saline group was administered 2 ml of saline/day intraperitoneally for 5 days after the operation. The honokiol group, on the other hand, was administered honokiol intraperitoneally at a dose of 1 mg/kg/day for 5 days after the operation. On postoperative day 14, 3 ml of intracardiac blood sample was taken from the rats for biochemical analyses, and the rats were sacrificed this way. Results: Adhesion and inflammation scores were significantly lower in the honokiol group compared with the saline and control groups (p < 0.008). Similarly, fibrosis score was significantly lower in the honokiol group compared with the saline group (p < 0.008). Conclusion: Honokiol was found to be effective in prevention of intra-abdominal adhesion formation in a rat model. However, larger studies are needed to shed light on the exact role of honokiol in intra-abdominal adhesion formation and to determine the molecular aspects of the promising results found in this study.

Oxidant/antioxidant status, paraoxonase activity, and lipid profile in plasma of ovariectomized rats under the influence of estrogen, estrogen combined with progesterone, and genistein

Introduction The aim of this study was to investigate whether estradiol (E2), E2 combined with progesterone (Prog) (E2/Prog), and genistein (Gen) treatment had antioxidative and anti-hyperlipidemic effects in the plasma of ovariectomized (OVX) rats. Materials and methods Adult female Sprague–Dawley rats were divided into five groups. Rats in all groups, except for those in a sham group, underwent bilateral ovariectomy under general anesthesia. The groups were as follows: sham group; control OVX group; group treated with estrogen (0.014 mg/kg 17-β E2); group treated with a combination of E2 and Prog (0.014 mg/kg 17-β E2 plus 0.028 mg/kg drospirenone), and group treated with Gen (10 mg/kg/day). Plasma of rats of each treatment group was analyzed to determine the total antioxidant status, total oxidant status, paraoxonase activity, lipid profile, high-density lipoprotein (HDL-chol), low-density lipoprotein (LDL-chol), total cholesterol (Total-C), triacylglycerols, lipoprotein (a), and oxidative stress index. Results Plasma Total-C levels and body weight increased in all the OVX groups compared with the sham group (P<0.005). The group treated with E2 had significantly elevated total oxidant status, oxidative stress index, LDL-chol, and Total-C compared with the control group (P<0.005). Gen treatment might lead to lower LDL-chol and Total-C levels compared with E2 treatment. Conclusions Gen treatment might be preferred to E2 treatment for treatment of menopausal symptoms in patients at risk for cardiovascular diseases. However, considering the small sample size of this study, larger studies are needed in this area.

Role of inflammation and oxidative stress in the etiology of primary ovarian insufficiency

Objective: The aim of this study was to elucidate the etiology and treatment of primary ovarian insufficiency, which is of unknown cause in 95% of the cases. Materials and Methods: Thirty patients aged 18-40 years who presented to Dicle University Faculty of Medicine Clinic of Obstetrics and Gynecology between June 2012 and January 2014 and were diagnosed as having primary ovarian insufficiency based on their clinical and endocrinologic data, and 30 healthy controls were included in this study. Results: No significant differences were found between patients with primary ovarian insufficiency and control subjects in demographic data and lipid profile levels, thyroid- stimulating hormone, prolactin, and glucose. However, the neutrophil to lymphocyte ratio and levels of follicle-stimulating hormone, luteinizing hormone, total antioxidant status, total oxidant status, and oxidative stress index were significantly higher in patients with primary ovarian insufficiency than in control subjects. In the correlation analysis, follicle-stimulating hormone exhibited a positive correlation with total oxidant status, oxidative stress index, and the neutrophil to lymphocyte ratio (r=0.573** p<0.001, r=0.584** p<0.001, r=0.541 p<0.001, respectively) and correlated negatively with total antioxidant status (r=-0.437** p<0.001). Conclusion: The neutrophil to lymphocyte ratio, total oxidant status, and oxidative stress index levels are elevated in primary ovarian insufficiency. Therefore, anti-oxidative and anti-inflammatory treatment might be administered to patients in the early stage of primary ovarian insufficiency. However, larger studies are needed to clarify whether these elevated levels are a cause or a consequence of primary ovarian insufficiency.

Serum levels of neopterin, inflammatory markers and oxidative stress indicators in hyperemesis gravidarum.

To investigate whether serum levels of neopterin and inflammatory markers including C‐reactive protein (CRP), tumor necrosis factor‐α (TNF‐α), interleukin‐6 (IL‐6) and oxidative status indicators were altered in patients with hyperemesis gravidarum (HG) compared to asymptomatic pregnant women.

Protective effects of honokiol on ischemia/reperfusion injury of rat ovary: an experimental study

Aim The purpose of this study was to investigate the protective effect of honokiol on experimental ischemia/reperfusion injury of rat ovary. Materials and methods A total of 40 female Wistar albino rats were used in this study. The rats were divided into five groups as follows: sham (Group I), torsion (Group II), torsion + detorsion (Group III), torsion + detorsion + saline (Group IV), and torsion + detorsion + honokiol (Group V). Bilateral adnexa in all the rats except for those in the sham group were exposed to torsion for 3 hours. The rats in Group IV were administered saline, whereas the rats in Group V were administered honokiol by intraperitoneal route 30 minutes before detorsion. Tissue and plasma concentrations of malondialdehyde and nitric oxide were determined. Ovarian tissue was histologically evaluated. Data analyses were performed by means of Kruskal–Wallis test and Mann–Whitney U-test (Bonferroni correction) in SPSS 15.0 (Statistical Package for Social Sciences; SPSS Inc., Chicago, IL, USA). Results The torsion and detorsion groups had higher scores in vascular congestion, hemorrhage, and inflammatory cell infiltration compared with the sham group (P<0.005). In addition, total histopathological scores were significantly higher in the torsion and detorsion groups compared with the sham group (P<0.005). A significant reduction was observed in hemorrhage, inflammatory cell infiltration, and cellular degeneration scores, of all histopathological scores, in the honokiol group (P<0.005). Ovarian tissue concentrations of malondialdehyde were significantly higher in the torsion and detorsion groups compared with the sham and honokiol groups (P<0.005). Ovarian tissue concentrations of nitric oxide, on the other hand, were significantly higher in the torsion group compared with the sham, saline, and honokiol groups (P<0.005). Conclusion Honokiol has a beneficial effect on ovarian torsion-related ischemia/reperfusion injury.

Evaluation of predisposing factors, diagnostic and treatment methods in patients with translocation of intrauterine devices

The purpose of this study was to evaluate the diagnostic methods, predisposing risk factors and surgical treatment options in patients with translocation of intrauterine devices (IUD).

The Diagnostic Accuracy of Endometrial Sampling in Endometrial Hyperplasia

Objective: Endometrial hyperplasia is a premalignant lesion characterized with hyperplastic changes in endometrial gland and stromal structures. Its incidence is not exactly known. This study evaluated the accuracy of endometrial sampling of the patients whose pathological results were endometrial hyperplasia and had undergone hysterectomy (paraffin sections). Study Design: Patients that diagnosed with endometrial hyperplasia by endometrial biopsy and/or hysterectomy at Dicle University School of Medicine Department of Obstetrics and Gynecology between January 2006 and July 2014 were retrospectively evaluated. Sensitivity, specificity, and positive and negative predictive values of endometrial biopsy to predict postoperative hysterectomy result were calculated. Discrete results in endometrial sampling and hysterectomy were recorded separately. Statistical analyses were conducted with corresponding appropriate methods. Results: Mean ages of pre and postmenopausal patients were 42.6±4.8 (28-50) and 57.7±7.7 (50-79) years, respectively. For the efficiency of endometrial sampling to predict definite pathologic diagnosis, sensitivity was 71.9%, specificity was 87.5%, positive predictive value was 79.3%, and negative predictive value was 82.3%. When the accuracy of endometrial sampling with the pathologic diagnosis was evaluated, 38 patients had accurate (47.5%), and 42 patients had discrete (52.5%) results. Conclusion: The presence of atypia determines the treatment in patients with endometrial hyperplasia. Hysterectomy should not be the first option in endometrial hyperplasia patients without atypia, and medical treatment and curettage options should be considered. Experienced staff should perform and evaluate endometrial samplings. We consider that this will increase the success in diagnosis, and could change treatment options.

A Rare Gestational Trophoblastic Disease: Placental Site Trophoblastic Tumor

Placental site trophoblastic tumor (PSTT) is a highly rare form of gestational trophoblastic diseases that arise from intermediate trophoblastic cells. By presenting this case, we aimed to review the treatment and diagnosis, approach to PSTT. A 31-year-old (G2P1A1L1) patient had abnormal vaginal bleeding. Serum s-HCG was 5.82 mIU/ml and the transvaginal USG detected a polypoid mass in uterine cavity. Probe curettage was performed. Histopathologic specimens were confirmed as PSTT. No metastasis was detected. A total abdominal hysterectomy was performed. PSTT is a rare tumor. In contrast to other trophoblastic tumors, PSTT produces a small amount of s-HCG and it is relatively insensitive to chemotherapy. Adjuvant chemotherapy is suggested to follow surgical treatment in the cases with metastasis.

Uterine Abscess Caused by the Use of Intrauterine Device in a 26-Year-Old Patient: A Case Report

Pelvic Inflammatory Disease (PID) refers to an infection of upper female genital tract, including uterus, fallopian tubes and ovaries, which might involve adjacent pelvic structures. It is generally caused by a sexually transmitted infection. It occurs due to migration of an infection up to the genital tract during a transcervical intervention or pregnancy. The prevalence of PID has decreased in USA in the last decade. Almost 106,000 patients presenting to hospitals in USA in a year are diagnosed with PID, and 60,000 of them require hospitalization. The primary risk factor for PID is sexual intercourse. The risk of developing PID is non-existent in virgin women. On the other hand, women having one sexual partner rarely develop PID in the long term. Having multiple sexual partners is the biggest risk factor for developing PID. Young age, history of chlamydia or PID, and having a sexual partner who has a sexually transmitted disease can be listed among the other risk factors. Methods of contraception affect the frequency of PID. Specifically, barrier methods provide protection from PID whereas the use of intrauterine device (IUD) increases the risk.

Single intrauterine demise in twin pregnancies: Analysis of 29 cases

Objective: To evaluate the maternal and fetal demographic features and clinical aspects of twin pregnancies with single intrauterine demise. Materials and Methods: This retrospective study was conducted in Dicle University Faculty of Medicine, Department of Gynecology and Obstetrics between January 2008 and December 2013. There were a total of 594 twin deliveries in our hospital between the given dates. Twenty-nine of these cases were referred to our hospital by another health center because of a preliminary diagnosis of single intrauterine demise. Maternal age, parity, chorionicity, week of fetal death, gestational week at delivery, mode of delivery, birth weight, Activity, pulse, grimace, appearance, respiration scores, maternal fibrinogen levels at delivery and during pregnancy, stay in the neonatal intensive care unit, and obstetric complications were explored in these 29 cases of single intrauterine demise. Results: The mean age of the 29 patients who were provided antenatal follow-up and delivery services in our hospital was 29.9±6.5 years. Thirteen (44.8%) of the patients were monochorionic, whereas 16 (55.2%) were dichorionic. Intrauterine fetal death occurred in the first trimester in 6 pateints and in the second or third trimester in 23. In addition, 20 (69%) patients underwent cesarean section, whereas 9 (31%) had spontaneous vaginal delivery. Lastly, none of the patients had a maternal coagulation disorder. Conclusion: Twin pregnancies with single intrauterine death can lead to various complications for both the surviving fetus and the mother. Close maternal and fetal monitoring, and proper care and management can minimize complications.