Dynamic thiol/disulphide homeostasis and ischemic modified albumin levels in isolated oligohydramnios.

OBJECTIVE: Oligohydramnios is defined as amniotic fluid index in ultrasonographic measurement is less than 5 percentile according to gestational age, the amniotic fluid volume is ≤ 5 cm, or if the single deepest dial is < 2 cm. The condition of oligohydramnios that not with fetal structural/chromosomal abnormalities, intrauterine growth retardation, intrauterine infection and maternal disease is described as isolated oligohydramnios (IO). The aim of this study is to examine whether oxidative stress and reactive oxygen species (ROS) have a place in the pathophysiology of IO. MATERIALS AND METHODS: In this prospective case-control study, a total of 126 participants were included. The patient group consisted of 65 patients who were diagnosed IO, and the control group consisted of 61 healthy normal pregnants. Native thiol (-SH), total thiol (-SH + -SS), dynamic disulfide (-SS), IMA values from maternal serum were measured and compared between groups. RESULTS: Maternal serum -SH and -SH + -SS values were significantly lower in the IO group than in the control group (409.47 ± 55.36 µmol/L vs. 437.40 ± 48.68 µmol/L, p = 0.03 and 457.40 ± 63.01 µmol/L vs. 484.59 ± 52.75 µmol/L, p = 0.01). In the IO group when -SS/-SH and -SS/-SH + -SS ratio was found to be statistically significantly higher than control group (5.84 ± 1.1 vs 5.41 ± 0.71, p = 0.01 and 5.2 ± 0.88 vs 4.8 ± 0.58, p = 0.01), -SH/-SH + -SS ratio was significantly lower (89.56 ± 1.7 vs 90.24 ± 1.16, p = 0.01). There was no significant difference in terms of -SS value (p = 0.66). IMA value was significantly higher in the IO group than control group (0.76 ± 0.10 ABSU vs 0.68 ± 0.06, p < 0.01). It is seen as a result of ROC analysis that -SH, -SH + -SS, -SS/-SH, -SS/-SH + -SS, -SH/-SH + -SS and IMA values have a diagnostic value for IO (p < 0.05). CONCLUSION: The thiol/disulfide balance shifted towards oxidative stress in IO compared to control group. So oxidative stress and ROS have a place in the pathophysiology of IO.

Should the visceral peritoneum be closed over mesh in abdominal sacrocolpopexy?

INTRODUCTION AND HYPOTHESIS: Peritonisation of mesh during Abdominal sacrocolpopexy is generally advocated to prevent adhesions to the viscera; however, randomized clinical trials are lacking. In this study; we aimed to investigate whether the mesh peritonisation is clinically significant or not. MATERIAL METHOD: Thirty-four patients who were operated for the reason of pelvic organ prolapse were included in the study. Patients were divided into two groups by retrospective scanning from the files and surgical reports. Group 1 patients consisted of those who underwent peritonisation and group 2 patients consisted of those who did not in abdominal sacrocolpopexy. RESULTS: Operative time and the amount of blood lost were statistically less in the group 2. Postoperative pain and analgesic drug requirements were obviously higher in the group 1. Postoperative De novo dyspareunia and urinary urgency were higher in the group 1. There were no statistical differences between the groups in terms of other complications. CONCLUSION: We noticed that there was no difference between the patients who were peritonized and those who were not in terms of postoperative complications.

Oxidative and antioxidative status in the endometrium of patients with benign gynecological disorders.

AIM: Oxidative stress and impaired antioxidative system are implicated in the development of many disease states including gynecological diseases. In the present study, we aimed to investigate the oxidative-antioxidative status in endometrium of patients diagnosed with benign gynecological disorders. METHODS: Samples of endometria and blood were obtained from 65 patients admitted to our center for abnormal uterine bleeding or postmenopausal bleeding. Endometrial biopsy was performed for the evaluation of histopathology and oxidative-antioxidative status in endometrial tissue. Based on histological examination, subjects were divided into groups as follows: normal controls (n=15); patients with endometrial polyps (n=20); patients with uterine myoma (n=10) patients with chronic endometritis (n=10), and patients with atrophic endometrium (n=10). Activities of superoxide dismutase (SOD), catalase (CAT), glutathione reductase (GR) and total antioxidant status (TOS), total oxidant status (TAS) were assessed. RESULTS: Compared to the normal controls, nonsignificant changes (decrease or increase) were detected in antioxidant enzyme activities, TAS and TOS in the examined groups. Additionally, between TAS and TOS, we also found a strong positive correlation in normal and chronic endomethritis groups and a moderate positive correlation uterine myoma, endometrial polyps and endometrial atrophy groups. CONCLUSION: Even though, our results do not allow to conclude how oxidative and antioxidative status are influenced in benign gynecological disorders, these findings may provide a basis for the further researches.

Prevention of infertility induced by ovarian ischemia reperfusion injury by benidipine in rats: Biochemical, gene expression, histopathological and immunohistochemical evaluation.

INTRODUCTION: Benidipine has been reported to prevent the ischemia/reperfusion (I/R) damage in heart tissue and to suppress oxidant and proinflammatory cytokine production, increased by I/R. However, There was no information about the effects of benidipine on I/R injury in the ovary and the damage of I/R-induced infertility. OBJECTIVES: The aim of the study was to investigate the effects of benidipine on bilateral ovarian I/R injury and whether or not effective in the treatment of I/R-induced infertility in rats. METHOD: Forty-eight females, albino Wistar rats were randomly divided into 4 groups: IRC group (ovarian I/R group, n=12), IRB-2 group (ovarian I/R+2mg/kg benidipine group, n=12), IRB-4 group (ovarian I/R+4mg/kg benidipine group, n=12) and HG group (healthy group with sham operation, n=12). In IRB-2 and IRB-4 groups, two hours ischemia and two hours reperfusion was performed following orally benidipine administration. After this I/R procedure, 6 rats from each group performed bilateral overectomy. Ovarian levels of malondialdehyde (MDA) and total glutathione (tGSH), ovarian gene expressions of interleukin-1 beta (IL-1ß) and tumor necrosis factor-alpha (TNF-α) and also apoptosis were evaluated. The other 6 rats from each group were put in together with six male rats in separated cages for 2 months in order to reproduce. During this period, rats which did not become pregnant were accepted as infertile. RESULTS: MDA levels, expressions of TNF-α and IL-1ß in IRC group were significantly higher than in the SGA group and tGSH was decreased. In total, 4mg/kg benidipine has better prevented ovaries from the increase of oxidants and proinflammatory cytokines, the decrease of antioxidants than 2mg/kg benedipine. In the histopathological examination hemorrhage, congestion, follicle degeneration, neutrophil infiltration and necrosis were seen in ovarian tissue of IRC group. Only dilated and congested blood vessels were found in the IRB-2 group. No histopathological finding was encountered in the IRB-4 group. I/R caused infertility in rats. In total, 4mg/kg benidipine prevented from infertility better than the dose of 2mg/kg benedipine. CONCLUSION: In total, 4mg/kg benidipine reduced I/R injury and I/R-related infertility more significantly compared to 2mg/kg benedipine in rat ovaries.

En-bloc pelvic resection with concomitant rectosigmoid colectomy and immediate anastomosis as part of primary cytoreductive surgery for patients with advanced ovarian cancer.

OBJECTIVE: To assess the authors' experiences in en bloc pelvic resection with concomitant rectosigmoid colectomy and primary anastomosis as a part of primary cytoreductive surgery for patients with advanced ovarian cancer. MATERIALS AND METHODS: Atotal of 22 patients with FIGO Stage IIB-IV epithelial ovarian cancer who underwent en bloc pelvic resection with anastomosis were retrospectively reviewed. Data analyses were carried out using SPSS 10.0 and descriptive statistics, Kaplan-Meier survival curves, and Log Rank (Mantel-Cox) test were used for statistical estimations. RESULTS: Median age was 58.8 years. FIGO stage distribution of the patients was; one (4.5%) IIB, three (13.7%) IIC, three (13.7%) IIIA, six (27.3%) IIIB, and nine (40.9%) IIIC. Median peritoneal cancer index (PCI) was 8 (range 5-22) and optimal cytoreduction was achieved in 18 patients (81.8%) of whom 13 (59.1%) had no macroscopic residual disease (complete cytoreduction). There was no perioperative mortality. A total of nine complications occurred in seven (31.8%) patients. Anastomotic leakage was observed in one (4.5%) patient. There was no re-laparotomy. Mean follow-up time was 60 months. There were 15 (68.2%) recurrences of which 12 (80%) presented in extra-pelvic localizations. Mean disease-free survival (DFS) and overall survival (OVS) were estimated as 43.6 and 50.5 months, respectively. Patients with complete cytoreduction had a better DFS (p = 0.006) and OVS (p = 0.003) than those with incomplete cytoreduction. CONCLUSION: En bloc pelvic resection, as a part of surgical cytoreduction, seems to be a safe and effective procedure in many patients with advanced ovarian cancer if required. Despite relatively high general complication rate, anastomosis-related morbidity of this procedure is low as 0.8%. Nevertheless, surgical plan and perioperative care should be personalized according to medical and surgical conditions of the patient.