Mete Ergenoglu

Protective effect of oxytocin on ovarian ischemia-reperfusion injury in rats

Oxytocin (OT), a neurohypophysial nonapeptide, plays dual role as a neurotransmitter/neuromodulator and a hormone. It has also well known protective properties against ischemia/reperfusion organ damage. This study investigated the effect of OT on experimentally induced ovarian torsion/de-torsion ischemia/reperfusion (I/R) injury in rats. Sprague-Dawley rats were assigned to five treatment groups (n=7/group): Group 1, sham-operated; Group 2, torsion; Group 3, 80 IU/kg of OT administration 30 min prior to torsion; Group 4, torsion/de-torsion; and Group 5, torsion followed by 80 IU/kg of OT administration 30 min prior to de-torsion. OT administration significantly decreased the tissue malondialdehyde (MDA) levels in both the torsion and OT group (Group 3), and torsion/de-torsion OT group (Group 5) in comparison with the torsion-only group (Group 2) and torsion/de-torsion group (Group 4). Histopathological finding scores including follicular degeneration, edema, hemorrhage, vascular congestion, and infiltration by inflammatory cells were found to be significantly decreased in the torsion and OT group (Group 3), and torsion/de-torsion OT group (Group 5) when compared with the torsion-only group (Group 2) and torsion/de-torsion group (Group 4). In conclusion, these results, verified with histopathologic evaluation and biochemical assays, suggest a probable protective role for OT in ischemia and I/R injury in rat ovaries.

Effects of Resveratrol on Ovarian Morphology, Plasma Anti-Mullerian Hormone, IGF-1 Levels, and Oxidative Stress Parameters in a Rat Model of Polycystic Ovary Syndrome

Objective: To evaluate the effects of resveratrol in a rat model of polycystic ovarian syndrome (PCOS). Study Design: After PCOS model was formed by subcutaneous dihydrotestosterone pellets, rats were randomly divided into 2 groups. The first group (n = 7) was treated with 1 mL/kg/d isotonic saline and the second group (n = 7) was treated with 10 mg/kg/d resveratrol. Seven rats were taken as controls without any medication. Results: Our results showed (1) significant reduction in the number of antral follicle counts (P < .01); (2) significantly decreased plasma anti-Mullerian hormone and insulin-like growth factor 1 levels (P < .01 and P < .05, respectively); (3) significantly lower superoxide dismutase activity (P < .05); and (4) significantly increased glutathione peroxidase content (P < .01) following resveratrol treatment. Conclusion: Resveratrol appears to be effective in the treatment of PCOS due to its antioxidant properties. Future clinical studies with different dosages might provide useful implementations to our practice.

Montelukast prevents ischaemia/reperfusion-induced ovarian damage in rats

OBJECTIVE To investigate the efficacy of montelukast for prevention of ischaemia/reperfusion (I/R) injury in rat ovary. STUDY DESIGN Twenty-four female adult rats were included in the study. I/R injury was induced by CO2 pneumoperitoneum in a laparoscopic rat model. The rats were divided at random into three groups: the sham group was subjected to catheter insertion but was not subjected to pneumoperitoneum; the saline group was subjected to 60 min of pneumoperitoneum and 30 min of reperfusion, with 1 mg/kg physiological saline administered 10 min before pneumoperitoneum; and the montelukast group was subjected to 60 min of pneumoperitoneum and 30 min of reperfusion, with 20mg/kg montelukast administered 10 min before pneumoperitoneum. Damage to ovarian tissue was scored by histopathological evaluation. Caspase-3 expression was determined immunohistochemically. Ovarian tissue levels of malondialdehyde and glutathione, and plasma total antioxidant capacity were measured biochemically. RESULTS In comparison with the sham group, ovarian sections in the montelukast group had higher scores for follicular degeneration and oedema (p<0.001). Montelukast treatment prevented tissue damage in ovaries, and this result was significant. Caspase-3 expression was only observed in ovarian surface epithelium in the saline and montelukast groups. However, the mean caspase-3 expression score was higher in the saline group than the montelukast group (p<0.001). Tissue levels of malondialdehyde were higher in the montelukast group than the sham group, but plasma total antioxidant capacity and tissue levels of glutathione were significantly lower. Pretreatment with montelukast reduced lipid peroxidation (p<0.005) and improved antioxidant status in rats (p<0.001). CONCLUSION Montelukast is effective for the prevention of I/R-induced damage in rat ovary.

Restless legs syndrome is related to obstructive sleep apnea symptoms during pregnancy

BackgroundTo investigate the relation between restless legs syndrome (RLS) and obstructive sleep apnea symptoms during pregnancy.MethodsA questionnaire consisting of diagnostic criteria of restless legs syndrome, demographic characteristics, personal behavior, muscle cramps during pregnancy, past medical illnesses, family history of RLS, and the major symptoms of obstructive sleep apnea syndrome was administered during a face-to-face interview. Pregnant women with and without RLS were compared in terms of serum hemoglobin, hematocrit, calcium, phosphor, iron, folate, vitamin B12 levels, and obstructive sleep apnea symptoms.ResultsThere were statistically significant differences between two groups in terms of two of the obstructive sleep apnea symptoms (witnessed apnea and fatigue) (p < 0.01). No statistically significant difference was found with regard to serum calcium, magnesium, iron, hemoglobin, hematocrit, vitamin B12, phosphor, and folate levels; however, there were significant differences in terms of total iron-binding capacity.ConclusionsIncreasing awareness of restless legs syndrome among obstetricians is essential as it might be related to obstructive sleep apnea syndrome, which is associated with adverse pregnancy outcomes.

Attenuation of Ischemia/Reperfusion- Induced Ovarian Damage in Rats: Does Edaravone Offer Protection?

Aim: The aim of this study was to investigate whether prophylactic treatment with edaravone prevents ischemia/reperfusion (I/R)-induced ovarian damage during pneumoperitoneum in an experimental rat model. Methods: Twenty-eight female Sprague Dawley rats were allocated randomly to 4 groups. The sham group (group 1) was only subjected to catheter insertion, not to pneumoperitoneum. Group 2 received a 1 mg/kg dose of 0.9% sodium chloride by the intraperitoneal route for 10 min before pneumoperitoneum. Groups 3 and 4 received 6 and 12 mg/kg edaravone, respectively, by the intraperitoneal route for 10 min before pneumoperitoneum. After 60 min of pneumoperitoneum, the gas was deflated. Immediately after the reperfusion period, both ovaries were excised for histological scoring, caspase-3 immunohistochemistry and biochemical evaluation including glutathione (GSH) and malondialdehyde (MDA) levels. Also, total antioxidant capacity (TAC) was measured in plasma samples to evaluate the antioxidant effect of edaravone. Results: Ovarian sections in the saline group revealed higher scores for follicular degeneration and edema (p < 0.0001) when compared with the sham group. Administration of different doses of edaravone in rats significantly prevented degenerative changes in the ovary (p < 0.0001). Caspase-3 expression was only detected in the ovarian surface epithelium in all groups, and there was a significant difference between the treatment groups and the saline group (p < 0.0001). Treatment of rats with edaravone reduced caspase-3 expression in a dose-dependent manner. Moreover, biochemical measurements of oxidative stress markers (MDA, GSH and TAC) revealed that prophylactic edaravone treatment attenuated oxidative stress induced by I/R injury. Conclusion: These results indicate that prophylactic treatment with edaravone prevents I/R-induced ovarian damage during pneumoperitoneum in an experimental rat model.

Recurrent uterine rupture after hysterescopic resection of the uterine septum

INTRODUCTION Uterine rupture after hysteroscopic septum resection is a rare complication, and its frequency is reported to be approximately 1-2.7%. Uterine perforation and monopolar resection during hysteroscopy are well-known risk factors for subsequent uterine rupture during pregnancy. PRESENTATION OF CASE We present a case of recurrent uterine ruptures during consecutive pregnancies in a patient who had undergone hysteroscopic septum resection for recurrent pregnancy loss. DISCUSSION Recurrent uterine rupture due to hysteroscopic septum resection in pregnancy is a very rare condition. In the present case we noted that the first two uterine ruptures resulted from uterine contractions; however, the third rupture occurred spontaneously and earlier in gestation. As each uterine rupture occurred earlier than the rupture in the previous gestation, a history of uterine rupture during pregnancy should raise provider suspicion about the possibility of earlier uterine rupture recurrence. CONCLUSION Uterine rupture may occur in pregnancies after hysteroscopic resection of the uterine septum. However, if a patient has a history of uterine rupture during previous pregnancies, the risk of uterine rupture may increase for earlier gestational ages in subsequent pregnancies. The patient must be informed about both the risks of uterine rupture during pregnancy after hysteroscopic septum resection and that recurrent ruptures may occur at earlier gestational weeks than during previous pregnancies.

Paratubal Borderline Tumor Diagnosed In The Adolescent Period: A Case Report And Review of The Literature

BACKGROUND Borderline paratubal cysts are rare entities. These tumors are identified as epithelial proliferation without stromal invasion. CASE A 19-year-old virgin patient was admitted to our clinic with abdominal pain and nausea. The sonographic evaluation showed a left adnexal mass 89 × 80 mm in diameter with solid tissue projections. Doppler examination revealed no significant blood supply. At surgery, a torsed left paratubal cyst 10 cm in diameter and normal bilateral ovaries were encountered. Cystectomy was performed and of frozen section revealed a borderline Fallopian tube neoplasm. Final pathology review was reported as a serous borderline paratubal tumor. CONCLUSION The evaluation of the structure of cyst by ultrasound and the performance of intraoperative frozen section analysis are two important issues to diagnose the nature of a cyst. Fertility-sparing surgery is the main point of management.

Prenatal diagnosis of Cantrell pentalogy in first trimester screening: case report and review of literature.

Pentalogy of Cantrell is a heterogeneous and rare thoraco-abdominal wall closure defect with the estimated prevalence of 1/65.000 to 1/200.000 births. Supraumbilical midline wall defect (generally omphalocele), deficiency of the anterior diaphragm and diaphragmatic peritoneum, defect of the lower sternum and several intracardiac defects are the components of Cantrell pentalogy. Etiology is unknown but a defect on the lateral mesoderm during the early stage of pregnancy is the most accepted hypothesis. Nowadays both 2- dimensional (2D) and 3-dimensional (3D) sonography are commonly used in diagnosis. In our case, a fetus with 11 weeks of gestation was reported as Cantrell pentalogy during first trimester screening. Additionally, unilateral limb defect and lumbar lordoscoliosis were detected through 3D sonography. Pregnancy was terminated according to parental desire. Karyotype was 46 XY. Early diagnosis is feasible in the first trimester if ectopia cordis and omphalocele exist. Additionally, development in ultrasound technology provides us with better visualization and early diagnosis. Prognosis seems to be poor in patients with complete Cantrell syndrome and patients with associated anomalies. Termination is the choice of treatment. Early diagnosis gives us a chance to reduce maternal morbidity and mortality related to termination.

Octreotide protects ovary against ischemia–reperfusion injury in rats: Evaluation of histological and biochemical parameters

This study investigated the efficacy of octreotide for prevention of ischemia–reperfusion injury in rat ovary.

Vulvar lymphangioma circumscriptum

⁎ Corresponding author. Tel.: +90 5059113736. E-mail address: volkanturan@yahoo.com (V. Turan). Lymphangioma circumscriptum is a benign malformation of inner lymphatic channels that can extend to the dermis, the subcutaneous layers, and rarely the muscle. Although it is frequently seen on the proximal sites of extremities, vulvar and oral mucosal presentation is rare. A 51-year-oldwomanwas referredwith bilateral itching/oozing vulvar lesions and bilateral leg edema. Upon vulvar examination, groups of vesicleswere found to be infected (Fig.1). Therewasnohistory of sexually transmitted disease, filariasis, tuberculosis, trauma, or Crohns disease. Histologic examination revealed multiple dilated lymphatic vessels containing mostly of fibrin, with a small number of erythrocytes, in the papillary dermis. The vessels were lined by a thin wall comprising endothelial cells and an inflammatory infiltrate. Acanthosis and papillomatosis were present in the epidermis. The patient refused surgical removal andwas treatedmedically. Subsequently, the pruritus and oozing regressed but the vulvar mass remained. There are 3 types of lymphangioma—circumscriptum, cavernous, and cystic. The most common type is lymphangioma circumscriptum, which is frequently seen in females and usually develops as congenital and unilateral lesions. This disorder is characterized by a localized group of thin-walled vesicles, and the diameter of the lesions—which are filled with translucent fluid—ranges from 1 mm to 5 mm. Lymphangioma circumscriptum can be further characterized as classic or localized. The former is more common, presenting at birth or before 30 years of age, with a lesion diameter of more than 1 cm. The latter is not age specific and the lesion diameter is less than 1 cm. Risk factors for acquired lymphangioma circumscriptum are radical surgery, genital tuberculosis, pelvic radiation, and Crohns disease. In the differential diagnosis of vulvar lymphangioma circumscriptum, infections such as herpes zoster, molluscum contagiosum, genital warts, angiomyofibroblastoma, and aggressive angiomyxoma must be considered; furthermore, biopsy of the lesion is required for diagnosis. Two cases of lymphangiosarcoma arising from lymphangioma circumscriptum have been reported [1,2]. In both cases, the pre-existing lesion was exposed to extensive X-ray therapy, indicating that radiation therapy for lymphangiomas should be avoided. Emanuel et al. [2] reported a Dabska tumor with lymphangioma circumscriptum; during a follow-up of 9 years, subsequent to a full excision, the lymphangioma circumscriptum recurred, but without evidence of Dabska tumor recurrence ormetastasis. Short and Peacock [3] reported a case of lymphangioma circumscriptum involving the vulvar and perianal areas, which recurred after surgery and seemed to predispose Fig. 1. Vulvar lymphangioma circumscriptum in a 51-year-old patient.