Murat Aktan

Treatment of intestinal reperfusion injury using antioxidative agents

BACKGROUND/PURPOSE A number of antioxidants are present in human tissues, which comprise the secondary defence system against the oxygen-free radicals and oxidative stress. Therefore, this study was undertaken in an animal model to investigate the effects of antioxidants such as vitamin E, vitamin C, methyl prednisolone, and mannitol, on the treatment of intestinal reperfusion injury when given during ischemia. METHODS The study was performed on six groups of animals, each composed of six rabbits: Group I, mesenteric ischemia group; group R, ischemia-reperfusion group; group E, ischemia-reperfusion plus Vitamin E treatment; group C, ischemia-reperfusion plus vitamin C treatment; group CS, ischemia-reperfusion plus corticosteroid treatment; and Group M, ischemia-reperfusion plus mannitol treatment. Malondialdehyde (MDA) and glutathione (GSH) levels of the intestinal mucosa were assayed to reflect the free radical formation. RESULTS Mucosal injury scores in the M and C groups were significantly lower than the R group (P< .01 and P< .01, respectively), and in the E and CS groups, mucosal injury scores were not significantly different from R group. MDA levels in the M and C groups were significantly lower than the R group (P < .01 and P < .01, respectively). GSH levels in the E, C, and M groups, were significantly higher than R group (P < .01, P < .05, and P < .01, respectively). CONCLUSION The results of this study showed that antioxidant drugs, such as vitamin C and mannitol, may play a role in attenuating reperfusion injury of the gut demonstrated by depression of tissue MDA levels and by elevation of tissue GSH levels.

Comparison of Pregnancy Outcomes of Progesterone or Progesterone + Estradiol for Luteal Phase Support in ICSI-ET Cycles

Objective: To find out the effect of estradiol with progesterone for luteal phase support in IVF-ICSI cycles. Materials and Methods: Patients were accepted for treatment in the ART unit of Selcuk University, Meram Faculty of Medicine, between January 2001 and March 2003. The study was done in a prospective manner. The age range of 252 women was 19–41 years and the total number of cycles was 310. All patients were treated with a long ovulation induction protocol. Patients were treated and divided into two groups in a randomized manner: group I used only 600 mg/day divided into three equal doses of micronized progesterone vaginally, and group II used transdermal estradiol 100 µg/day + 600 mg/day vaginal micronized progesterone. Results: 310 ICSI cycles were carried out in 252 infertile couples between January 2001 and March 2003. From 22 of these cycles, oocytes were retrieved but no embryos were developed. In the remaining 288 cycles there were embryo transfers. All embryo development was achieved by ICSI treatment. In 148 out of 288 cycles, the luteal phase was supported only by vaginal micronized progesterone (group I). On the other hand, the remaining 140 cycles received vaginal micronized progesterone plus transdermal estradiol 100 µg/day (group II). The number of β-hCG-positive results in group I and group II were 20 (13.5 %) and 54 (38.5%) respectively. Conclusion: Adding estradiol to progesterone for luteal phase support in ICSI-ET cycles may increase implantation and pregnancy rates.

Incidence of Chromosome 8, 10, X and Y Aneuploidies in Sperm Nucleus of Infertile Men Detected by FISH

We studied the frequency of aneuploidy in sperm nuclei of six infertile men with abnormal semen profile and normal karyotype, using fluorescence in situ hybridization (FISH) with DNA probes for chromosomes 8, 10, X and Y. The control group consisted of four healthy fertile men with normal karyotype and semen profiles. The purpose of this study was to determine whether there are differences between infertile male donors and control donors for: (1) the incidence of sex chromosome aneuploidy, and (2) the number of disomies for chromosomes 8, and 10 cosegregating with chromosomes X and Y. FISH analysis showed no significant differences of sex ratios of the sperm nuclei in and between infertile and control groups. The most significant abnormalities in the infertile group were clusters of sperm nuclei bearing XY and XYY. In addition, the incidence of disomic sperm nuclei for chromosomes 8 and 10 consegregating with sex chromosomes was not significantly different beween the patient and control groups, nor within them. However, the total frequency of aneuploid sperm nuclei was significantly different beween the infertile group and the control group. We observed a significant excess of sperm nuclei bearing chromosome 10 along with disomy for chromosome Y (10YY). In conclusion, our results from FISH analysis demonstrate a significantly increased frequency of aneuploidy for the sex chromosomes in sperm nuclei from infertile men. Therefore it may be concluded that infertility is a risk factor for sex chromosome aneuploidy in sperm nuclei.

The impact of oral feeding on the severity of acute pancreatitis

BACKGROUND In the management of acute pancreatitis, oral feeding is prohibited and either enteral or parenteral feeding is commenced for the patients in an effort to not increase the secretion of the pancreatic enzymes. PURPOSE This study was undertaken in an attempt to determine the impact of oral feeding on the severity of acute pancreatitis and to compare this impact with that of parenteral feeding. MATERIALS AND METHODS Twenty-four female Sprague-Dawley rats were divided into two groups. In both groups, acute pancreatitis was induced by ligation of the main biliopancreatic duct. The rats in group I were fed orally and the rats in group II were fed parenterally. The rats were sacrificed at 48 hours, and blood samples were obtained from the heart upon exposure of the abdominal and thoracic cavities. The pancreas and the left lung were removed for histopathological examination. The levels of lactic dehydrogenase (LDH), serum glutamic oxaloacetic transaminase (SGOT), glucose, calcium and blood urea nitrogen, base deficit, partial oxygen pressure, leukocyte count, and hematocrit level among Ranson criteria and the level of amylase were measured. The pancreas and the lung were examined under a light microscope. RESULTS The levels of LDH, SGOT, and calcium for the rats in group I were significantly higher when compared with the rats in group II (P <0.05). Similarly, the levels of amylase for the rats in group I were found to be higher when compared with the rats in group II, but the difference was not significant. Inflammatory changes observed in the pancreas were less severe whereas inflammatory changes observed in the lung were more severe for the rats in group I when compared with the rats in group II. CONCLUSION The blood levels of the enzymes were adversely affected for the rats fed orally. In contrast, inflammatory changes observed in the pancreas were more severe for the rats fed parenterally. The study suggests that certain hormones released from the duodenum upon stimulation by oral nutrient intake lessens the severity of pancreatitis through protective effects on the pancreas, whereas the elevated levels of the enzymes cause endothelial damage resulting in destruction in distant organs such as the lung.

Influence of cumulus cell coculture and cumulusaided embryo transfer on embryonic development and pregnancy rates.

OBJECTIVE In this study, we aimed to evaluate the influence of autologous cumulus oocyte complex (COC) coculture on embryonic development and quality, and investigate the implantation and pregnancy rates after cumulus-aided embryo transfer in the ICSI-ET cycles. MATERIAL AND METHODS Ninety five consecutive infertile women undergoing their first cycle of IVF teratment were included in the study. The cases were divided into two groups. Group 1 consisted of 48 women undergoing ICSI, along with autologous cumulus embryo coculture and cumulus-aided emryo transfer. Group 2 comprised 47 consecutive patients who consented to undergo ICSI and in whom autologous cumulus embryo coculture and cumulus-aided embryo transfer were not performed. Implantation and pregnancy rates were compared between the two groups. RESULTS The demographic data and controlled ovarian hyperstimulation parameters were similar in the two groups. The fertilization and cleavage rates were found to be higher in group 1 when compared with group 2 (p=0.03 and 0.001, respectively). There were no statistical significant differences for the implantation and clinical pregnancy rates between the two groups. CONCLUSION Usage of autologous COCs as coculture may improve fertilization and cleavage rates. However, cumulus-aided embryo transfer does not produce an increase in implantation and pregnancy rates.

The evaluation of recombinant LH supplementation in patients with suboptimal response to recombinant FSH undergoing IVF treatment with GnRH agonist down-regulation

Abstract We aimed to evaluate the clinical efficacy of r-LH supplementation to r-FSH in patients with suboptimal response to ovarian stimulation undergoing assisted reproduction with GnRH-a downregulation and stimulation with r-FSH. One-hundred thirty-seven patients were included in the study; among them 52 showed normal ovarian response to stimulation and composed the control group (Group 1), and 85 showed suboptimal response to stimulation and were divided into two groups. For Group 2 (n = 50), 75 IU/L r-LH was added to the treatment, for Group 3 (n = 35) r-FSH dose was increased by 75 IU/L. IVF results were compared between the groups. Implantation rates were 34.8% in control group, and 36.1% and 15% in LH supplementation group and increased-dose r-FSH group, respectively. Implantation rates were statistically significantly higher in Groups 1 and 2 compared to Group 3 (p < 0.02). Pregnancy rate was noticed in 64.7% of Group 1, 57.8% of Group 2 and at 32.4% of Group 3. Pregnancy rate was significantly higher in Group 2 than Group 3 (p < 0.05). r-LH supplementation is an option for improving IVF outcome in patients with suboptimal ovarian response to ovulation induction with r-FSH during GnRH agonist down-regulation. Particularly, r-LH is recommended as it may have a beneficial action on implantation in selected group.