Synthesis, antibacterial and antifungal activity of some new thiazolylhydrazone derivatives containing 3-substituted cyclobutane ring

A series of Schiff bases, combining 2,4-disubstituted thiazole and cyclobutane rings, and hydrazone moieties in the same molecule, was synthesized, characterized and evaluated for screening antibacterial and antifungal activities on microorganisms, respectively, on four bacteria and Candida tropicalis. The structures of original compounds were confirmed by analytical and spectroscopic (FT-IR, (1)H NMR and (13)C NMR) methods and elemental analysis. Both the antibacterial and antifungal activities and MIC values of compounds were reported. Among the tested compounds, the most effective compound providing a MIC value of 16 microg ml(-1) are 2 against C. tropicalis and Bacillus subtilis and 3 against B. subtilis only.

4-Bromo-2-[[4-(3-mesityl-3-methylcyclobutyl)thiazol-2-yl]hydrazonomethyl]phenol, with N-H...N, C-H...pi and pi-pi interactions

The title compound, C24H26BrN3OS, crystallizes in the triclinic space group P-1, with two independent molecules in the asymmetric unit. The molecules adopt an E geometry about the azomethine C=N double bond. The structure is stabilized as dimers by N-H...N hydrogen bonding. C-H...pi and pi-pi interactions are also effective in the crystal packing.

Effects on rat testes of the thiosemicarbazone derivative Schiff base (4-(1-phenylmethylcyclobutane-3-yl)-2-(2-hydroxybenzylidenehydrazino)thiazole) and its cadmium(II) complex

The aim of this study was to investigate structural and biochemical changes in testes of rats treated with the thiosemicarbazone derivative thiazole ring Schiff base, (4-(1-phenyl-methylcyclobutane-3-yl)-2-(2-hydroxybenzylidene-hydrazino) thiazole (L), and its Cd(II) complex (CdL(2)). The animals were divided into three groups. Group I was designated as control. The rats in groups II and III were injected subcutaneously with L or CdL(2) respectively at 150-mg kg(-1) doses at 3-day intervals for 15 days. At the end of the study, blood samples were collected for biochemical analysis, and testes were removed for histological examinations. Serum levels of vitamin A, E and MDA of the L-injected group were similar to the control group. While CdL(2) treatment decreased serum vitamin A and E levels, it increased the MDA level compared to other groups. Histologically, the testes structures of L-treated animals were similar to the control. Spermatogenic cells in seminiferous tubules of CdL(2)-treated animals displayed necrosis. Nuclei of spermatogonia and primary spermatocytes were pyknotic and heterochromatic. Homogenous pink particles were present in place of the spermatids. The interstitial areas were oedematous and intertubular vessels were plugged. In conclusion, the present results indicate that L does not cause biochemical and morphological alterations, but its Cd(II) complex has degenerative effects in normal rat testes.

1-Methyl-1-phenyl-3-[1-hydroxyimino-2-(succinimido)ethyl]cyclobutane

In the title compound, C17H20N2O3, the cyclobutane ring is puckered, with a dihedral angle of 19.11 (15) degrees. The 1-phenyl and 3-[1-hydroxyimino-2-(succinimido)ethyl] groups are in cis positions. The molecules are linked by O-H...O and C-H...pi(benzene) interactions, forming a two-dimensional network.

Late complications of incisional hernias following prosthetic mesh repair

BACKGROUND

Incisional hernias still continue to be a serious problem for surgeons. In this study, we aimed to investigate the effects of polypropylene mesh and mersilene mesh, which are frequently employed in incisional hernias, as well as the effects of their application techniques on late complications.

METHODS

Two-hundred-sixty-four open abdominal hernia repairs were performed between 1986--2000, using prosthetic materials: polypropylene mesh and mersilene mesh were used in hernia repair. Mesh was placed as onlay, underlay and sandwich techniques. Follow-up data were obtained from medical records.

RESULTS

Comparisons were made with respect to surgical techniques and to late complications such as recurrence, enterocutaneous fistula, intestinal obstruction, and infections. Enterocutaneous fistulas developed in two patients. Recurrence occurred in 6.4 per cent. Chronic infection and wound sinus formation occurred in 5 per cent. The causes of recurrence included smoking, cellulitis, chronic infection/sinus tract, upper abdominal localization, and obstruction. Fistula formation occurred in patients with no peritoneal prevention, which was statistically significant (p=0.012). Chronic infection/sinus tract was high in patients for whom mersilene mesh was used, and enterocutaneous fistula occurred in 2 patients.

CONCLUSION

To prevent late complications, it is necessary to avoid the contact of mesh with bowel.

Dehydroepiandrosterone Prevents Oxidative Injury in Obstructive Jaundice in Rats

We investigated the effect of dehydroepiandrosterone (DHEA) on oxidative injury in obstructive jaundice using three groups of rats: sham-operated group; common bile duct (CBD) group — the CBD was ligated; and DHEA group — DHEA administration followed CBD ligation. Liver function tests were performed using blood samples, and malondialdehyde concentration (MDA), superoxide dismutase activities (SOD), glutathione peroxidase (GPx), and total glutathione (tGSH) concentrations were measured in liver tissue. Serum alkaline phosphatase, γ-glutamyltransferase and alanine aminotransferase activity were significantly elevated in the CBD group compared with the other groups. Serum aspartate aminotransferase and total bilirubin were highest in the CBD group; the MDA concentration was higher in the CBD group than the sham group. There were no significant differences in GPx activity among the groups. SOD activity and tGSH concentration were significantly lower in the CBD group than the other groups. DHEA may protect hepatic tissue against oxidative injury in obstructive jaundice by decreasing MDA concentration and increasing SOD activity and tGSH concentration.

Serum paraoxonase levels in gastric cancer

BACKGROUND/AIMS

Serum paraoxonase (PON) is a calcium-dependent esterase that is known to contribute to the antioxidant protection conferred by high-density lipoprotein (HDL) on low-density lipoprotein (LDL) oxidation. Serum PON activity was shown to be reduced in patients with diseases such as myocardial infarction, diabetes mellitus, etc in comparison to healthy subjects. However, the relation of serum PON levels to cancer is still not known. So, we intended to measure serum PON, HDL, LDL and very low-density lipoprotein (VLDL) levels and to investigate the relation of serum PON to plasma lipoproteins in the patients with gastric cancer.

METHODOLOGY

We measured serum PON, HDL, LDL and VLDL levels in 20 patients with gastric cancer and in 20 age-and gender-matched healthy controls. We investigated the relationship between PON and HDL, PON and LDL, and PON and VLDL.

RESULTS

Serum HDL levels were lower in the patients than in controls (33.10 +/- 7.75 mg/dL, and 47.30 +/- 6.65 mg/dL, respectively) (p<0.0001). Serum VLDL levels were lower in the patients than in controls (21.65 +/- 6.92 mg/dL, and 33.10 +/- 6.09 mg/dL, respectively) (p<0.0001). Serum LDL levels measured in the patients were not significantly different from those of the controls. Serum PON levels were lower in the patients than in controls (67.10 +/- 17.92 U/L, and 87.50 +/- 23.39 U/L, respectively) and there was a positive correlation between serum PON and HDL levels (r: 0.52, p<0.05).

CONCLUSIONS

We concluded that the patients with gastric cancer had low serum PON, HDL, and VLDL levels compared to healthy controls. The importance of PON as a predictive risk factor for cancer should be assessed in future studies.

Serum paraoxonase levels in pancreatic cancer

BACKGROUND/AIMS

Serum paraoxonase (PON) is a calcium-dependent esterase that is known to contribute to the antioxidant protection conferred by high-density lipoprotein (HDL) on low-density lipoprotein (LDL) oxidation. Serum PON activity was shown to be reduced in patients with diseases such as myocardial infarction, diabetes mellitus, etc in comparison to healthy subjects. However, the relation of serum PON levels to cancer is still not known. So, we intended to measure serum PON, HDL, LDL and very low-density lipoprotein (VLDL) levels and to investigate the relation of serum PON to plasma lipoproteins in the patients with pancreatic cancer.

METHODOLOGY

We measured serum PON, HDL, LDL, and VLDL levels in 20 patients with pancreatic cancer and in 20 age-and gender-matched healthy controls. We investigated the relationship between PON and HDL, PON and LDL, and PON and VLDL.

RESULTS

Serum HDL levels were lower in the patients than in controls (40.21 +/- 13.82 mg/dL, and 47.30 +/- 6.65 mg/dL, respectively) (p<0.05). Serum LDL and VLDL levels measured in the patient group were not significantly different from those of the control group. Serum PON levels were lower in the patients than in controls (61.57 +/- 22.44 U/L, and 87.50 +/- 23.39 U/L, respectively) (p<0.005). There was a positive correlation between serum PON and HDL levels (r: 0.69, p<0.05).

CONCLUSIONS

We concluded that the patients with pancreatic cancer had low PON and HDL levels compared to healthy controls. The importance of PON as a predictive risk factor for cancer should be assessed in future studies.

The effect of different cooking procedures on microbiological and chemical quality characteristics of Tekirdağ meatballs

In this research, the effects of different cooking processes (grilling, oven, and microwave cooking) on microbial flora and chemical composition of the raw and cooked meatballs as consumed in Tekirdağ were investigated. Microbial flora of the raw meatballs was as follows: total bacteria, 6.02 x 10(6) cfu/g; psychrophilic bacteria, 1.3 x 10(5) cfu/g; yeast and mould, 2.4 x 10(5) cfu/g; coliforms, 1.1 x 10(5) cfu/g; Escherichia coli, 1.0 x 10(2) cfu/g; total staphylococcae, 3.3 x 10(2) cfu/g; Staphylococcus aureus, 85 cfu/g. While Salmonella was found in only one sample, none of the samples contained Clostridium perfringens. The cooking processes clearly decreased the microbial flora (2-3 log cycles in grilling (71 degrees C) and oven-cooked (79 degrees C), 3-4 log cycles in microwave (97 degrees C) heating) of the meatballs. However, because of the crust formation and high moisture losses from the meatball surface in microwave heating, some sensorial defects were observed in the final product. Also, fat and moisture losses were higher in microwave cooking compared to the other cooking processes. In conclusion, it is advised to use slightly higher temperatures than used in the grilling or conventinal cooking procedures to increase microbial quality of the meatballs studied in this research.

Importance of psychiatric intervention in intolerances in endoscopic procedures

Despite the fact that pre-medication, in a number of different drug combinations, has been used for a long time in endoscopy units, and has been subject to extended clinical studies, it is still not possible to claim that it has attained an ideal state with regard to patient tolerance to endoscopy procedures. In this clinical study, we have investigated the effects of psychological intervention in addition to medication, which we used on patients with intolerance to endoscopy. Intolerance was very high in all endoscopic procedures (15.8% total). It was observed that average midazolam doses were significantly higher in intolerant than in tolerant patients. It was found that in patients who had received psychiatric intervention, the decrease in midazolam dose was statistically significant in a subsequent endoscopy procedure.

Effects of carbon dioxide pneumoperitoneum on free radical formation in lung and liver tissues

BACKGROUND

The purpose of this study was to investigate the possible effects of carbon dioxide (CO2) pneumoperitoneum on free radical formation and lipid peroxidation in the lung and liver tissues of rats.

METHODS

For this study, 50 male Sprague-Dawley rats were divided into five equal groups: control (group 1); sham operation (group 2); 5, 10, or 15 mmHg (group 3, 4, or 5) pneumoperitoneum with CO2 groups. At the end of the procedures, the rats were killed, and perfusion was performed via vena jugularis with cold Ringer's lactate. After the perfusion procedure, the lung and liver were harvested, and the supernatant fractions of the lungs and livers were assayed for superoxide dismutase (SOD), catalase (CAT), and malondialdehyde (MDA).

RESULTS

Both the lung and liver CAT activities were elevated consistently and significantly in the order of the study groups, as compared with the previous groups (p < 0.01 for all comparisons). The lung and liver SOD levels were elevated in groups 4 and 5, as compared with the other groups (p < 0.05). The lung MDA was significantly higher in groups 3 and 4, but not in group 5. Significant elevation in liver MDA was noted only in the 5-mmHg pnemoperitoneum group (p < 0.05).

CONCLUSIONS

These results indicate that CO2 pneumoperitoneum applied with 5, 10, or 15 mmHg pressure increases the formation of free oxygen radicals, which is counterbalanced by increased SOD and CAT activities of the lung and liver tissues. This effect of CO2 pneumoperitoneum on free radicals and lipid peroxidation appears to be pressure dependent in rats. The mechanism underlying this pressure dependency is still under investigation.

Leptin does not play a major role in platelet aggregation in obesity and leptin deficiency

OBJECTIVE

A recent study suggested that high concentrations of leptin enhance platelet aggregations. Therefore, the aim of this study was to investigate whether platelet aggregation is altered in patients with leptin gene mutations compared with obese subjects or controls.

RESEARCH METHODS AND PROCEDURES

Four men (one homozygous man and his three heterozygous brothers) carrying a leptin gene mutation; 20 age-matched, healthy, unrelated men; and 18 age-matched obese men were enrolled in the study. Adenosine diphosphate (ADP)-, collagen-, and epinephrine-induced platelet aggregation were evaluated in all individuals.

RESULTS

Our results show that patients with the leptin gene mutation (both the homozygous and heterozygous patients) had significantly higher ADP-induced (78.3 +/- 3.4% vs. 57.9 +/- 9.3%, p = 0.001), collagen-induced (78.1 +/- 2.9% vs. 56.7 +/- 9.3%, p = 0.007), and epinephrine-induced (76.5 +/- 9.2% vs. 59.5 +/- 7.70%, p = 0.003) platelet aggregation compared with controls. However, ADP-, collagen-, or epinephrine-induced platelet aggregations were similar to those in obese patients. Platelet aggregation responses to a combination of pretreatment with leptin at concentrations of 20, 50, 100, or 500 ng/mL for 5 minutes and ADP at concentrations of 2 micromol/liter also were evaluated. However, we did not find significant increases in platelet aggregation even at high concentrations of leptin (100 or 500 ng/mL) in leptin-deficient patients, obese subjects, or controls.

DISCUSSION

Our data show that similar to findings in obese humans, homozygous or heterozygous leptin deficiency is associated with increased platelet aggregation compared with controls, and that higher concentrations of leptin do not increase platelet aggregation.

The effect of carbon dioxide pneumoperitoneum on free radicals

BACKGROUND

Carbon dioxide is usually preferred as the insufflating agent for laparoscopic surgery because it is readily available, noncombustible, and chemically stable. It is still questionable, however, if CO2 pneumoperitoneum has any effect on free radicals and lipid peroxidation. The purpose of this study was to investigate the possible effects of CO2 pneumoperitoneum on free radicals and lipid peroxidation in the erythrocytes of rats.

METHODS

Fifty male Sprague-Dawley rats were divided into five equal groups: controls, a sham-operation group, and three groups of 5, 10, or 15 mmHg pneumoperitoneum with CO2. At the end of the procedure, blood was collected and the erythrocytes were separated from the plasma. The resultant supernatant fractions of erythrocytes were assayed for superoxide dismutase (SOD), catalase (CAT), and malondialdehyde (MDA).

RESULTS

SOD activities of the 5 and 10 mmHg pneumoperitoneum groups were significantly lower than those of the sham operation group. SOD activity was greater in the 15 mmHg pneumoperitoneum group than in any of the other groups, and this activity was significantly different from that seen in the 5 and 10 mmHg pneumoperitoneum groups (p < 0.05). No significant changes were observed in the CAT activities of the study groups (p > 0.05). MDA level was increased in the 5 mmHg pneumoperitoneum group; this result was statistically different from the control and 15 mmHg pneumoperitoneum groups (p < 0.05). No significant differences were found in the CAT activities for the study groups. On the other hand, the SOD activities of the 5 and 10 mmHg pneumoperitoneum groups were significantly lower than those of the sham and the 15 mmHg pneumoperitoneum group (p < 0.05 for all comparisons).

CONCLUSIONS

These results indicate that CO2 pneumoperitoneum applied with 5-10 mmHg pressure increases the formation of free oxygen radicals by inhibiting SOD activity and that the accumulation of free radicals elevates the level of MDA, a metabolite of lipid peroxidation. The effect of CO2 pneumoperitoneum on free radicals and lipid peroxidation is pressure-dependent in rats. The mechanism underlying this pressure dependency is still under investigation.

Adhesion formation after microlaparoscopic and laparoscopic ovarian coagulation for polycystic ovary disease

STUDY OBJECTIVE

To compare the effects of microlaparoscopy and decreased CO2 exposure on peritoneal microcirculation and potential adhesion formation after ovarian surgery with those of conventional operative laparoscopy.

DESIGN

Prospective, randomized study (Canadian Task Force classification I).

SETTING

Teaching hospital.

PATIENTS

Eighteen women with polycystic ovary disease.

INTERVENTIONS

Microlaparoscopic or laparoscopic ovarian coagulation of the ovaries.

MEASUREMENTS AND MAIN RESULTS

Approximately 10 to 12 coagulation points were applied to each ovary. Two to 3 weeks after the initial surgery second-look microlaparoscopy was performed to determine the extent of adhesions in both groups. The frequency of adhesion formation and changes in glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH) levels were studied in homogenized peritoneal tissues obtained during surgery in each group.

RESULTS

Clinical profiles were similar between groups. Mean exposure, amount, and pressure of CO2 were significantly less in the microlaparoscopy group (p <0.05). The laparoscopy group had significantly more adhesions than the microlaproscopy group (24% vs 48%, p <0.05). The GSH-Px, SOD, CAT, and GSH levels were significantly lower in the laparoscopy group (0. 425 micromol, 1.2 ng, 37.55 micromol, and 0.9 nmol vs 0.755 micromol, 2.l ng, 625 micromol, and 2.6 nmol, respectively).

CONCLUSION

Reduced exposure to and amount of CO2 during microlaparoscopy may result in decreased adhesion formation compared with conventional laparoscopy. This effect may possibly be due to lack of or minimal adverse effects on peritoneal microcirculation and cell-protective systems, which are proposed mechanisms for adhesion formation and closely related to peritoneal injury. In addition, microlaparoscopy may be a cost-effective alternative to conventional laparoscopy. (J Am Assoc Gynecol Laparosc 6(2):159-163, 1999)

Normative data of sympathetic skin response and RR interval variation in Turkish children

Sympathetic skin response (SSR) and RR interval variation (RRIV) are used commonly for the assessment of sympathetic and parasympathetic nervous system function, respectively. We determined the normal values of SSR and RRIV in 23 (14 females, nine males) Turkish children aged 5 to 14 (mean 9.86, SD 2.48) years. SSR was recorded on the hands and feet during the electrical stimulation of both median and posterior tibial nerves, respectively. Similar response was elicited on both feet during the stimulation of the right median nerve. RRIV testing was performed during rest on the supine position and deep inspiration at a frequency of 6 times/min. The SSR was elicited in all children. The mean SSR latencies recorded on the feet during the stimulation of median or posterior tibial nerve were significantly more prolonged than those recorded at the hands (P < 0.001). There was no significant difference between the mean latencies of SSR recorded at the ipsilateral and contralateral palms or soles. The mean latencies recorded at the sole during stimulation of the median nerve were not significantly different compared to those that recorded at the sole during the posterior tibial nerve (P > 0.05). The SSR amplitudes were not assessed because of great variability and rapid habituation. The mean RRIV (46.54+/-11.29%) during deep breathing was significantly increased as compared to that (35.90+/-10.63%) during rest (P < 0.003). As a result, SSR and RRIV are preferred non-invasive tests for evaluation of autonomic nervous system in children. The SSR is useful and reliable if it is obtained in the optimum technical conditions. Further research is necessary to establish strict criteria for abnormality.

The effects of twisted ischaemic adnexa managed by detorsion on ovarian viability and histology: an ischaemia-reperfusion rodent model

This prospective controlled follow-up study was designed to examine the effects of adnexal torsion on long-term ovarian histology and radical scavenger (FRS) activity, and subsequent viability following the detorsion of twisted ischaemic adnexa, in a primate centre of a university clinic. Adnexal torsion/occlusion was created by twisting the adnexa three times and fixing on to the side wall or by applying vascular clips in cycling female rats at 70 days of age. Following an ischaemic period of 4 to 36 h, the twisted adnexas were surgically removed and fixed. In the second group of rats, following the above ischaemic periods, the torsion/occlusion were relieved by detwisting or removing the vascular clips. Then the animals were reperfused for a week and adnexas were extirpated. After both ischaemia and reperfusion, the removed adnexas were examined histologically and tissue concentrations of glutathione peroxidase, superoxide dismutase, catalase and glutathione were determined. Regardless of the ischaemia time, all the twisted adnexas were black-bluish in appearance. Despite the gross ischaemic-haemorrhagic features, histological sections revealed negligible changes, with intact ovarian structure similar to controls in 4-24 h groups. Though decreased compared with controls, the change in tissue concentrations of FRS was not significant in 4-24 h groups. Only the 36 h group showed prominent congestion on all sections and a significant decrease in all radical scavenger concentrations studied. While no long-term reperfusion injury was observed histologically in 4-24 h groups, the 36 h group ended with adnexal necrosis. Our findings support the importance of early diagnosis and conservative surgical management (detorsion) in adnexal torsion. Lack of histological changes and unimpaired FRS metabolism are consistent with the recent data that vascular compromise is caused by venous or lymphatic stasis in early torsion and that adnexal integrity is not correlated with gross ischaemic appearance, thus providing evidence of adnexal resistance against ischaemia.

Endometrial Na+, K+-ATPase pump function and vasopressin levels during hysteroscopic surgery in patients pretreated with GnRH agonist

STUDY OBJECTIVE

To investigate the effects of gonadotropin-releasing hormone (GnRH) analog pretreatment on endometrial Na+, K+-adenosine triphosphatase (ATPase) pump function and peripheral blood vasopressin levels, and their role in fluid absorption and mechanisms of hyponatremia in patients undergoing hysteroscopic endometrial ablation.

DESIGN

Prospective, randomized, placebo-controlled study (Canadian Task Force classification I).

SETTING

University-affiliated hospital.

PATIENTS

Seventeen women with dysfunctional uterine bleeding.

INTERVENTION

Nine women received a GnRH analog and eight received saline approximately 6 to 8 weeks before hysteroscopic ablation by electrosurgery.

MEASUREMENTS AND MAIN RESULTS

Both before randomization and immediately before surgery, endometrial biopsy samples were obtained and numbered consecutively without patient identification. Operative hysteroscopy was performed with glycine 1.5% mixed with 2% alcohol. The amount of irrigant and irrigant deficit; blood levels of albumin and ethanol; hematocrit and hemoglobin; changes in sodium levels; and central venous pressure were compared. The Na+, K+-ATPase pump activity was significantly increased in the GnRH analog group compared with the saline group and correlated with decreased estradiol levels (0.4 +/- 0.08 vs 0.26 +/- 0.06 micro mol/min/ml). Vasopressin levels were significantly lower in the GnRH group (3.2 +/- 0.9 vs 7.6 +/- 1.7 micro mol/L). Mean volume of irrigant used and operating time were similar in both groups. Volume deficit, decrease in protein, and hematocrit were less in GnRH than in the saline group. Blood ethanol levels, decrease in sodium, and irrigant deficit were significantly lower in GnRH group.

CONCLUSION

Pretreatment with GnRH analogs may prevent the adverse effects of estradiol on endometrial Na+, K+-ATPase and creates a protective mechanism against iatrogenic hyponatremia, which is more critical in women than men in case of absorption of irrigating fluid. Moreover, created hypoestrogenism may enhance Na+, K+-ATPase activity in brain as well as endometrium, thus decreasing women's susceptibility to hyponatremic complications and brain damage. Suppressed vasopressin levels may be protective against fluid absorption in GnRH analog-treated patients.

The effects of duration of CO2 insufflation and irrigation on peritoneal microcirculation assessed by free radical scavengers and total glutathion levels during operative laparoscopy

STUDY OBJECTIVE

To investigate the effects of peritoneal exposure to carbon dioxide (CO2) on peritoneal microcirculation and free radical scavenger (FRS) metabolism, and its role in potential adhesion formation after operative laparoscopy.

DESIGN

Randomized, controlled study (Canadian Task Force classification I).

SETTING

University-affiliated hospital.

PATIENTS

Twenty-eight women undergoing operative laparoscopy for adnexal masses.

INTERVENTION

For each patient, a 1 x 1-cm sidewall peritoneal flap was excised at the end of laparoscopy and numbered randomly. Similar flaps obtained from 24 women immediately after entering the abdomen during laparotomy served as controls.

MEASUREMENTS AND MAIN RESULTS

Changes in glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH) levels were studied in homogenized peritoneal tissues. The duration of CO2 exposure and amount of CO2 used were correlated with levels of free radical scavengers and compared with controls. Mean CO2 exposure, amount of CO2 used, and CO2 pressure (15 mm Hg) was similar between low irrigation and irrigated laparoscopy (118.3 +/- 25 and 39.2 +/- 8.81 min and 125 +/- 20 and 44.5 +/- 6.81 min, respectively). The change in FRS levels was significantly correlated with duration and amount of CO2 exposure (r = -0.92). Levels of GSH-Px, SOD, CAT, and GSH were significantly lower in the CO2 exposure group than in controls (0.57 micro mol, 1.8 ng, 48.5 micro mol, 1.5 nmol vs 0.8 micro mol, 2.6 +/- 0.4 ng, 79 micro mol, 3.6 nmol, respectively).

CONCLUSION

Exposure to CO2 has adverse effects on peritoneal microcirculation and cell-protective systems, which are proposed mechanisms in adhesion formation. Avoiding long CO2 exposure and copiously irrigating the abdominal cavity throughout surgery may lessen these effects. The potential role of the peritoneal FRS system on postoperative adhesion formation and its relation to estrogen status mandates further studies.