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Bayram P, Karamese SA, Erol HS, Ozdemir B, Toktay E, Salum C. Protective effects of a natural product, paeoniflorin, on ischemia reperfusion injury on rat ovary tissue: histopathological, immunohistochemical, and biochemical study. J Histotechnol 2023; 46:170-183. [PMID: 37352381 DOI: 10.1080/01478885.2023.2227409] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/14/2023] [Indexed: 06/25/2023]
Abstract
In this study, the main hypothesis is that paeoniflorin may inhibit some cellular processes such as oxidative stress and inflammation. For this reason, we aimed to investigate the potential protective effects of a natural compound, paeoniflorin, on rat model of ovarian ischemia-reperfusion injury by detecting the oxidative stress parameters and inflammatory process parameters. 42 female Wistar-albino rats were divided into 6 random groups. The rats were subjected to 3-hour ischemia and 3-hour reperfusion process. Then, paeoniflorin at doses of 25, 50 and 100 mg/kg were applied 30 min before the reperfusion. The levels of pro-inflammatory (IL-1-β, IL-6, TNF-α) and anti-inflammatory (IL-10, TGF-β) cytokines were measured by ELISA. Similarly, IL-6, IL-10, TNF-α, NF-κB p65) positivity rates were detected by immunohistochemical staining. Additionally, oxidative stress parameters (MDA, GSH, SOD) were measured by tissue biochemistry. Ischemia-reperfusion injury caused significant increase in the levels of SOD, MDA, TNF-α, IL-1-β, IL-6 and NF-κB p65, while paeoniflorin treatments improved the related parameters in a dose-dependent manner. As a conclusion, our findings support the evidence that paeoniflorin has a potential protective effects on ovarian ischemia-reperfusion injury. Further detailed studies should be performed to shed light the molecular mechanism of these protective effects.
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Affiliation(s)
- Pinar Bayram
- Faculty of Medicine, Department of Histology and Embryology, Kafkas University, Kars, Turkey
| | - Selina Aksak Karamese
- Faculty of Medicine, Department of Histology and Embryology, Kafkas University, Kars, Turkey
| | - Huseyin Serkan Erol
- Faculty of Veterinary Medicine, Department of Biochemistry, Kastamonu University, Kastamonu, Turkey
| | - Bengul Ozdemir
- Faculty of Medicine, Department of Histology and Embryology, Kafkas University, Kars, Turkey
| | - Erdem Toktay
- Faculty of Medicine, Department of Histology and Embryology, Kafkas University, Kars, Turkey
| | - Cagatay Salum
- Faculty of Veterinary Medicine, Department of Physiology, Kastamonu University, Kastamonu, Turkey
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Hla A, Harold J, Andikyan V. Isolated torsion of the utero-ovarian ligament. Clin Case Rep 2023; 11:e8114. [PMID: 37908789 PMCID: PMC10613714 DOI: 10.1002/ccr3.8114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/06/2023] [Accepted: 09/12/2023] [Indexed: 11/02/2023] Open
Abstract
Key Clinical Message Isolated utero-ovarian torsion poses a challenge to diagnosing adnexal torsion, as it may not present with imaging findings. Clinicians with high suspicion for torsion but lack of evidence on ultrasonography should proceed to diagnostic laparoscopy. Abstract Adnexal torsion occurs when the ovary rotates around its supporting ligaments, the infundibulopelvic and utero-ovarian (UO) ligaments, often causing disruption of blood supply. This pathology often presents with acute pelvic pain and is a gynecologic surgical emergency. Diagnosis is typically made with Doppler ultrasound, although dual blood supply to the ovary poses additional diagnostic challenges and sensitivity of this tool is debated. In this case study, we present a case of missed torsion due to isolated compromise of UO ligament.
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Affiliation(s)
- Audrey Hla
- Obstetrics and Gynecology ResidencyUniversity of Connecticut Health CenterConnecticutFarmingtonUSA
| | - Justin Harold
- Section of Gynecology Oncology, Department of Obstetrics, Gynecology, and Reproductive ServicesYale University School of MedicineNew HavenConnecticutUSA
| | - Vaagn Andikyan
- Section of Gynecology Oncology, Department of Obstetrics, Gynecology, and Reproductive ServicesYale University School of MedicineNew HavenConnecticutUSA
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Juliette COUTUREAU, Caroline MANDOUL, Fernanda CURROSDOYON, Ingrid MILLET, Patrice TAOUREL. Recognizing the features of Isolated Fallopian Tube Torsion on CT and MRI and interobserver agreement: a cross-sectional study. Eur J Radiol 2022; 157:110607. [DOI: 10.1016/j.ejrad.2022.110607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 10/19/2022] [Accepted: 11/08/2022] [Indexed: 11/15/2022]
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Duan Y, Hoer B, Little A. Twisting Ovaries: Three Cases of Ovarian Torsion. Cureus 2022; 14:e30496. [PMID: 36415430 PMCID: PMC9674204 DOI: 10.7759/cureus.30496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 11/06/2022] Open
Abstract
Ovarian torsion is a medical emergency that should be considered for every female presenting with abdominal pain. This series consists of three cases of females of varying ages presenting with abdominal pain who were all ultimately diagnosed with ovarian torsion. It highlights the variability in presentation, physical examination, and other factors related to the diagnosis.
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Kartal B, Bozkurt MF, Alimoğullari E, Saçık U. The protective effect of erythropoietin on ischemia- reperfusion injury caused by ovarian torsion-detorsion in the experimental rat model. J Histotechnol 2022; 46:57-64. [DOI: 10.1080/01478885.2022.2122653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Bahar Kartal
- Medical Faculty, Department of Histology and Embryology, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Mehmet Fatih Bozkurt
- Department of Pathology, Faculty of Veterinary Medicine, Afyon Kocatepe University, Afyon, Turkey
| | - Ebru Alimoğullari
- Department of Histology and Embryology, Medical Faculty, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Uygar Saçık
- Department of Histology and Embryology, Medical Faculty, Ankara Yıldırım Beyazıt University, Ankara, Turkey
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Onder Dirican A, Doganay M, Inal HA, Yurtcu E, Togrul C, Bektas G, Caydere M. The role of trimetazidine in ischemia/reperfusion damage treatment in an ovary torsion model experimentally induced in rats. J OBSTET GYNAECOL 2022; 42:2170-2177. [PMID: 35170380 DOI: 10.1080/01443615.2022.2035332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of this experimental animal study was to investigate the histopathological and biochemical efficacy of trimetazidine (TMZ) in decreasing ovary damage in an ovary ischaemia/reperfusion (I/R) model in the rat. A total of 35 Wistar albino female rats were randomly separated into five groups, n = 7 per group: Group 1: Sham (S) was only given a laparotomy procedure. Group 2: Ischaemia (I) group with 2-hour ischaemia using a vascular sutur. Group 3: Ischaemia/Reperfusion (I/R) group with 2 hour ischaemia and 2-hour reperfusion. Group 4: Sham + 10 mg/kg orally TMZ (S + TMZ). Group 5: I/R + 10 mg/kg oral TMZ (I/R + TMZ) group with 2 hours ischaemia and 2 hours reperfusion after the administration orally 10 mg/kg oral TMZ. Two daily doses of TMZ were orally administered to Group 4 (S + TMZ) and Group 5 (I/R + TMZ) for three days. TMZ significantly decreased vascular congestion, haemorrhage, and polymorphonuclear leukocyte infiltration in group 5 compared to group 3 (p < .05). Despite TMZ decreased the malondialdehyde, total oxidant status, and oxidative stress index values, these decreases were not statistically significant (p > .05). TMZ which is an antioxidant agent can efficiently prevent in I/R damage in rat ovaries but further studies are necessary in order to implement it in the clinical settings.IMPACT STATEMENTWhat is already known on this subject? Adnexial torsion is the most common gynecological emergency and there are no specific clinical, laboratories, or radiological findings for adnexal torsion. Unfortunatelly, the currently accepted treatment is adnexal detorsion. Cytoprotective effects of Trimetazidine (TMZ), an antianginal drug, are well-defined and it has been demonstrated to improve oxidative stress markers and limits membrane damage induced by reactive oxygen species and protects tissues from free radicals with its antioxidant effects. The aim of this study is to investigate the effects of TMZ in experimentally induced adnexal torsion in rats and to investigate possible effects in maintaining ovarian reserve to prevent I/R damage or reperfusion damage.What do the results of this study add? Our study showed that TMZ significantly decreased vascular congestion, haemorrhage, and PMNL infiltration. TMZ decreased the malondialdehyde, total oxidant status, and the oxidative stress index values, but these decreases were not statistically significant.What are the implications of these findings for clinical practice and/or further research? Although various antioxidant drugs and chemicals have been used to protect the ovaries against I/R damage, they have not been demostrated to prevent it completely. TMZ, an antioxidant efficacy agent, has been shown to prevent ovarian I/R damage by suppressing inflammation in terms of histopathological parameters. Further studies involving a greater number of experimental animals are required before using TMZ for the treatment of humans with I/R damage in the clinical setting.
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Affiliation(s)
- Aylin Onder Dirican
- Departmant of Obstetrics and Gynecology, University of Health Sciences, Konya Training and Research Hospital, Konya, Turkey
| | - Melike Doganay
- Departmant of Obstetrics and Gynecology, University of Health Sciences, Zekai Tahir Burak Womens Health and Research Hospital, Ankara, Turkey
| | - Hasan Ali Inal
- Departmant of Obstetrics and Gynecology, University of Health Sciences, Konya Training and Research Hospital, Konya, Turkey
| | - Engin Yurtcu
- Departmant of Obstetrics and Gynecology, Karabuk University School of Medicine, Karabuk, Turkey
| | - Cihan Togrul
- Departmant of Obstetrics and Gynecology, Hitit University School of Medicine, Corum, Turkey
| | - Gizem Bektas
- Departmant of Obstetrics and Gynecology, University of Health Sciences, Ankara Training and Research Hospital, Ankara, Turkey
| | - Muzaffer Caydere
- Departmant of Pathology, University of Health Sciences, Ankara Training and Research Hospital, Ankara, Turkey
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Incidence of Adnexal Torsion in the Republic of Korea: A Nationwide Serial Cross-Sectional Study (2009-2018). J Pers Med 2021; 11:jpm11080743. [PMID: 34442387 PMCID: PMC8398360 DOI: 10.3390/jpm11080743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/24/2021] [Accepted: 07/28/2021] [Indexed: 11/17/2022] Open
Abstract
Background: This study aimed to evaluate the incidence and risk factors of adnexal torsion (AT) in the Korean population from 2009 to 2018 (10 years). Methods: We analyzed the 2009−2018 data obtained from the Health Insurance Review and Assessment Service National Inpatient Sample (HIRA-NIS) database. AT was identified by both diagnosis codes and surgery codes of adnexal surgery. Results: A total of 6,262,910 women were recorded in the database. The incidence of AT was 6 per 100,000 women (95% confidence interval (CI), 6−6). The incidence of AT tended to decrease with age after peaking in the late 20s to early 30s. In the weighted logistic regression analysis, women of childbearing age, especially in their 20s and 30s, had the highest AT incidence. Corpus luteal cyst (p < 0.001) and benign neoplasm (p < 0.001) increased the incidence of AT. Low socioeconomic status (SES), Charlson comorbidity index (CCI), and pregnancy were unrelated to AT. Conclusion: The incidence of AT is 6 per 100,000 women and peaks in the 20s to early 30s.
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Adnexal torsion in the third trimester of pregnancy: a case report and diagnostic value of MR imaging. BMC Med Imaging 2020; 20:19. [PMID: 32066402 PMCID: PMC7027050 DOI: 10.1186/s12880-020-00422-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 02/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The torsion of normal adnexa is rare during pregnancy, especially in the third trimester. Nonspecific symptoms and signs as well as the limitations of ultrasound (US) make the diagnosis difficult, resulting in the loss of adnexa and fetal compromise. The magnetic resonance imaging (MRI) features of the torsion of normal adnexa are not classically described during pregnancy and only reported in a few cases. We find some different MRI features of the torsion of normal adnexa in late pregnancy and its diagnosis and treatment values are discussed in our report. CASE PRESENTATION A 27-year-old woman at 31 + 5 weeks' gestation presented to the emergency department with a three-day history of the left lower abdominal pain. US discovered a mass of 87 × 61 mm in the left abdomen, but did not show whether the mass originated from the left ovary or the uterus. MRI showed the left ovary was increased in size to 82 × 42 × 85 mm with peripheral follicles. On fat-suppressed T2-weighted images, the signal intensity of the lesion was significantly decreased compared with the right ovary. The adjacent fallopian tube was found to be thickened. The radiologists diagnosed ovary infarction secondary to adnexal torsion. With the provisional diagnosis of adnexal torsion, the patient was taken to surgery. The left adnexal torsion was found during surgery. There was extensive hemorrhage and necrosis, so a left salpingo-oophorectomy was performed. The histopathology confirmed an extensively hemorrhagic fallopian tube and ovary with partial necrosis. CONCLUSION We believe MRI is helpful where US is indeterminate in diagnosis of the torsion of normal adnexa in advanced pregnancy. We found that aside from hyperintensity on fat-saturated T1-weighted images, the low signal intensity on T2-weighted images can also reflect adnexal hemorrhage in conjunction with the torsion of normal adnexa.
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Hortu I, Ilgen O, Sahin C, Akdemir A, Yigitturk G, Erbas O. Losartan ameliorates ovarian ischaemia/reperfusion injury in rats: an experimental study. J OBSTET GYNAECOL 2020; 40:1148-1154. [PMID: 31955629 DOI: 10.1080/01443615.2019.1701639] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This study aimed to investigate the protective and antioxidant role of losartan in ovarian ischaemia and ischaemia/reperfusion injury in an experimental ovarian torsion model. Thirty adult female rats were used. Rats were separated randomly into five groups; Group 1: sham group (abdominal wall was only opened and closed), Group 2: torsion group with 3-hour ischaemia using atraumatic vascular clips. Group 3: torsion + losartan group with 3-hour ischaemia 30 minutes after the administration of 40 mg/kg of losartan via oral gavage. Group 4: torsion-detorsion group with 3-hour ischaemia and 3-hour reperfusion (vascular clips were removed). Group 5: torsion-detorsion + losartan group with 3-hour ischaemia followed by administration of 40 mg/kg of losartan 30 minutes prior to a 3-hour detorsion/reperfusion. Ovarian tissue damage was scored by histopathological analysis. Ovarian tissue malondialdehyde (MDA) and plasma pentraxin 3 (PTX 3) levels were measured biochemically. In comparison with the sham group, both the torsion and torsion-detorsion groups had significantly higher scores for follicular degeneration, vascular congestion, oedema, haemorrhage, and leukocyte infiltration (p < .05). The aforementioned parameters significantly decreased in the torsion-detorsion + losartan group (p < .01) compared to those in the torsion-detorsion group. MDA and plasma PTX 3 levels were notably higher both in the torsion and torsion-detorsion groups compared with those in the sham group (p < .01). The current experimental ovarian torsion study suggests a protective role for losartan upon ischaemia and ischaemia/reperfusion injury in rat ovaries. Losartan may be a novel agent for decreasing ovarian ischaemia/reperfusion injury in ovaries.Impact statementWhat is already known on this subject? Among gynaecological emergencies, the diagnosis of ovarian torsion is highly difficult. A delayed diagnosis may lead to ovarian necrosis and subsequent loss of ovaries if timely surgical intervention is not performed, which is essential for the fertility and protection of ovarian functions in young patients. However, reperfusion of the ischaemic tissue might leads to more serious damage to the tissue than the damage caused by ischaemia.What the results of this study add? This study found that losartan, an Ang II type 1 receptor blocker which has been currently used for regulation of blood pressure, could be used experimentally to alleviate I/R injury in ovary through improving histological parameters, reducing tissue MDA and plasma PTX3 levels. To date, there is no study regarding the usage of losartan for alleviating I/R on ovary due to torsion.What the implications are of these findings for clinical practice and/or further research? Losartan may be suggested to have therapeutic value in patients with ovarian torsion. Further large clinical studies are necessary to prove the beneficial effect of losartan to prevent I/R injury on human ovaries.
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Affiliation(s)
- Ismet Hortu
- Department of Obstetrics and Gynaecology, School of Medicine, Ege University, Izmir, Turkey
| | - Orkun Ilgen
- Department of Obstetrics and Gynaecology, School of Medicine, Dokuzeylul University, Izmir, Turkey
| | - Cagdas Sahin
- Department of Obstetrics and Gynaecology, School of Medicine, Ege University, Izmir, Turkey
| | - Ali Akdemir
- Department of Obstetrics and Gynaecology, School of Medicine, Ege University, Izmir, Turkey
| | - Gurkan Yigitturk
- Department of Histology and Embryology, School of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Oytun Erbas
- Department of Physiology, School of Medicine, Istanbul Bilim University, Istanbul, Turkey
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Topcu A, Balik G, Atak M, Mercantepe T, Uydu HA, Tumkaya L. An investigation of the effects of metformin on ovarian ischemia-reperfusion injury in rats. Eur J Pharmacol 2019; 865:172790. [PMID: 31730761 DOI: 10.1016/j.ejphar.2019.172790] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 11/04/2019] [Accepted: 11/07/2019] [Indexed: 01/08/2023]
Abstract
Damage to the ovaries or tissue torsion can significantly reduce the ovarian reserve and thus cause severe gynecological and hormonal deficiencies. The discovery of new agents is always needed in the treatment of this condition. Metformin (MET) has been shown to be beneficial in attenuating ovarian ischemia-reperfusion injury. Fifty-six female Sprague Dawley rats were divided into seven groups. Group 1 represented the control group (C), Group 2, the ischemia group (I), and Group 3, the ischemia/reperfusion group (I/R). Group 4, the ischemia (I)+250 group, and Group 5, the ischemia (I)+500 group, received 250 mg/kg and 500 mg/kg MET, respectively. Group 6, the ischemia/reperfusion (I/R)+250 group, and Group 7, the ischemia/reperfusion (I/R)+500 group, received 250 mg/kg and 500 mg/kg MET, respectively. Tissue malondialdehyde (MDA), glutathione (GSH), and tumor necrosis factor-alpha (TNF-α) levels in ovarian tissue increased following I/R, while estradiol (E2) levels decreased. Moreover, infiltration and diffuse edematous areas were observed in addition to diffuse vascular congestion and hemorrhage findings. Caspase-3 and nuclear factor kappa B (NF-κβ) expression levels also increased. MDA and TNF-α concentrations decreased in the MET treatment groups, while GSH and E2 levels increased. The findings showed that I/R causes ovarian damage through the induction of oxidative stress, inflammation, and apoptosis. However, MET application was effective in preventing damage in ovarian tissue by reducing levels of reactive oxygen species, proinflammatory cytokines, caspase-3 and NF-κβ.
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Affiliation(s)
- Atilla Topcu
- Recep Tayyip Erdogan University, Faculty of Medicine, Department of Pharmacology, 53100, Rize, Turkey.
| | - Gulsah Balik
- Recep Tayyip Erdogan University, Faculty of Medicine, Department of Gynecology and Obstetrics, 53100, Rize, Turkey
| | - Mehtap Atak
- Recep Tayyip Erdogan University, Faculty of Medicine, Department of Medical Biochemistry, 53100, Rize, Turkey
| | - Tolga Mercantepe
- Recep Tayyip Erdogan University, Faculty of Medicine, Department of Histology and Embryology, 53100, Rize, Turkey
| | - Huseyin Avni Uydu
- Recep Tayyip Erdogan University, Faculty of Medicine, Department of Medical Biochemistry, 53100, Rize, Turkey
| | - Levent Tumkaya
- Recep Tayyip Erdogan University, Faculty of Medicine, Department of Histology and Embryology, 53100, Rize, Turkey
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Levin G, Knigin D, Porat S, Abu-Daya M, Mankuta D, Gil M, Rottenstreich A. An unusual case of ovarian torsion in a pregnant woman with prior history of ipsilateral salpingectomy. J OBSTET GYNAECOL 2019; 39:870-871. [PMID: 31020880 DOI: 10.1080/01443615.2019.1581749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Gabriel Levin
- a Department of Obstetrics and Gynecology , Hadassah University Hospital , Jerusalem , Israel
| | - David Knigin
- a Department of Obstetrics and Gynecology , Hadassah University Hospital , Jerusalem , Israel
| | - Shay Porat
- a Department of Obstetrics and Gynecology , Hadassah University Hospital , Jerusalem , Israel
| | - Mushira Abu-Daya
- a Department of Obstetrics and Gynecology , Hadassah University Hospital , Jerusalem , Israel
| | - David Mankuta
- a Department of Obstetrics and Gynecology , Hadassah University Hospital , Jerusalem , Israel
| | - Moran Gil
- a Department of Obstetrics and Gynecology , Hadassah University Hospital , Jerusalem , Israel
| | - Amihai Rottenstreich
- a Department of Obstetrics and Gynecology , Hadassah University Hospital , Jerusalem , Israel
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Ozlem K, Birkan Y, Mustafa K, Emin K. Protective effect of Vaccinium myrtillus on ischemia- reperfusion injury in rat ovary. Taiwan J Obstet Gynecol 2018; 57:836-841. [DOI: 10.1016/j.tjog.2018.10.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2018] [Indexed: 10/27/2022] Open
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The Protective Effects of Glycyrrhetinic Acid and Chrysin against Ischemia-Reperfusion Injury in Rat Ovaries. BIOMED RESEARCH INTERNATIONAL 2018; 2018:5421308. [PMID: 29862276 PMCID: PMC5976983 DOI: 10.1155/2018/5421308] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 04/03/2018] [Accepted: 04/10/2018] [Indexed: 11/17/2022]
Abstract
Objective To evaluate the protective effects of glycyrrhetinic acid (GA) and chrysin (CH) on experimental ischemia-reperfusion (I/R) injury in rat ovaries using tissue oxidative stress marker levels, hormone levels, and histopathological scores. Methods Sixty healthy rats were randomly divided into six equal groups: control, I/R, I/R + CH (50 mg/kg/day), I/R + GA (100 mg/kg/day), CH (50 mg/kg/day), and GA (100 mg/kg/day). Biochemical, hormonal, and histopathological evaluations were performed on blood and tissue samples 14 days after CH and GA treatment. Results The antioxidant defense system parameters were significantly higher in the ovarian tissues of the I/R + CH and I/R + GA groups than in those of the I/R group. Serum follicle-stimulating hormone levels were significantly reduced, and serum anti-Müllerian hormone levels were significantly increased in rats treated with CH and GA compared with those in the I/R group. Additionally, the histopathological scores of the I/R + CH and I/R + GA groups were significantly improved compared with those of the I/R group. Conclusions The significant improvements in tissue oxidative stress parameters, serum hormone levels, and histological scores observed in this study indicate that treatment with CH or GA may be a conservative approach to prevent I/R injury in adnexal torsion cases after the ovarian detorsion procedure.
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Özsoy AZ, Nursal AF, Arıcı A, Bütün İ, Uysal M, Irmak Sapmaz H, Kunt İşgüder Ç, Yılmaz Doğru H, Taş U. Effects of carvedilol on an ischemia/reperfusion model: Biochemical, histopathological and immunohistochemical evaluation. J Obstet Gynaecol Res 2016; 42:1132-40. [PMID: 27170505 DOI: 10.1111/jog.13028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 02/15/2016] [Accepted: 03/12/2016] [Indexed: 01/19/2023]
Abstract
AIM The aim of this study was to investigate the effects of carvedilol (CVD) on experimentally induced ovarian ischemia/reperfusion (I/R) injury in rats. METHODS An ovarian I/R model was applied to rats, classified into three groups: 1 (n = 7), sham operated (control); 2 (n = 7), 3 h ischemia + 3 h reperfusion (I/R); 3 (n = 7), 3 h ischemia + CVD + 3 h reperfusion (I/R + CVD). Malondialdehyde (MDA) levels and glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) activities in ovarian tissues and serum were measured. Tissue damage was examined histopathologically; Bax and caspase-3 expression was determined immunhistochemically. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay was performed to show apoptotic cell death. RESULTS MDA levels in ovarian tissues were significantly increased in the I/R group compared with the control. CVD administration significantly decreased tissue MDA levels in the I/R + CVD in comparison with the I/R group. GSH-Px activities in serum were higher in the I/R + CVD than in the I/R group. SOD activities in tissue and serum were significantly decreased in the I/R compared with the control group. Histological examination showed a significant improvement in ovarian morphology in the I/R + CVD compared with the I/R group. Bax and caspase-3 protein was more strongly expressed in the I/R group compared with the control and I/R + CVD groups. Apoptotic index detected by TUNEL assay was significantly increased in the I/R and decreased in the I/R + CVD group. CONCLUSION Our results suggest that CVD reduces the deleterious effects of oxidative damage on ovaries in a rat I/R model.
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Affiliation(s)
- Asker Zeki Özsoy
- Faculty of Medicine, Department of Obstetrics and Gynecology, Gaziosmanpaşa University, Tokat, Turkey.
| | - Ayşe Feyda Nursal
- Faculty of Medicine, Department of Medical Genetic, Giresun University, Giresun, Turkey
| | - Akgül Arıcı
- Faculty of Medicine, Department of Medical Pathology, Gaziosmanpaşa University, Tokat, Turkey
| | - İlknur Bütün
- Faculty of Medicine, Department of Medical Biochemistry, Gaziosmanpaşa University, Tokat, Turkey
| | - Murat Uysal
- Faculty of Medicine, Department of Anatomy, Gaziosmanpaşa University, Tokat, Turkey
| | - Hilal Irmak Sapmaz
- Faculty of Medicine, Department of Anatomy, Gaziosmanpaşa University, Tokat, Turkey
| | - Çiğdem Kunt İşgüder
- Faculty of Medicine, Department of Obstetrics and Gynecology, Gaziosmanpaşa University, Tokat, Turkey
| | - Hatice Yılmaz Doğru
- Faculty of Medicine, Department of Obstetrics and Gynecology, Gaziosmanpaşa University, Tokat, Turkey
| | - Ufuk Taş
- Faculty of Medicine, Department of Anatomy, Gaziosmanpaşa University, Tokat, Turkey
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Yildirim N, Yigitturk G, Sahingoz Yildirim AG, Akdemir A, İlgen O, Yeniel O, Ergenoglu M, Erbas O. Octreotide protects ovary against ischemia-reperfusion injury in rats: Evaluation of histological and biochemical parameters. J Obstet Gynaecol Res 2015. [DOI: 10.1111/jog.12770] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Nuri Yildirim
- Department of Obstetrics and Gynecology; Ege University; Izmir Turkey
| | - Gurkan Yigitturk
- Department of Histology and Embryology; Ege University; Izmir Turkey
| | | | - Ali Akdemir
- Department of Obstetrics and Gynecology; Ege University; Izmir Turkey
| | - Orkun İlgen
- Department of Obstetrics and Gynecology; Ege University; Izmir Turkey
| | - Ozgur Yeniel
- Department of Obstetrics and Gynecology; Ege University; Izmir Turkey
| | - Mete Ergenoglu
- Department of Obstetrics and Gynecology; Ege University; Izmir Turkey
| | - Oytun Erbas
- Department of Physiology; Bilim University; Istanbul Turkey
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Histological study on the effect of vitamin C on ischemia–reperfusion injury in the adult rat ovary. ACTA ACUST UNITED AC 2014. [DOI: 10.1097/01.ehx.0000452614.96818.85] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Sanfilippo JS. Ovarian torsion and bilateral? J Pediatr Adolesc Gynecol 2014; 27:121. [PMID: 24814527 DOI: 10.1016/j.jpag.2014.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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19
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Akdemir A, Erbas O, Gode F, Ergenoglu M, Yeniel O, Oltulu F, Yavasoglu A, Taskiran D. Protective effect of oxytocin on ovarian ischemia-reperfusion injury in rats. Peptides 2014; 55:126-30. [PMID: 24630974 DOI: 10.1016/j.peptides.2014.02.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Revised: 02/24/2014] [Accepted: 02/25/2014] [Indexed: 01/14/2023]
Abstract
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.
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Affiliation(s)
- Ali Akdemir
- Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey
| | - Oytun Erbas
- Department of Physiology, Ege University School of Medicine, Izmir, Turkey
| | - Funda Gode
- Department of Obstetrics and Gynecology, Kent Hospital, Izmir, Turkey.
| | - Mete Ergenoglu
- Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey
| | - Ozgur Yeniel
- Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey
| | - Fatih Oltulu
- Department of Histology and Embryology, Ege University School of Medicine, Izmir, Turkey
| | - Altug Yavasoglu
- Department of Histology and Embryology, Ege University School of Medicine, Izmir, Turkey
| | - Dilek Taskiran
- Department of Physiology, Ege University School of Medicine, Izmir, Turkey
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Blockade of endothelin receptors with bosentan limits ischaemia/reperfusion-induced injury in rat ovaries. Eur J Obstet Gynecol Reprod Biol 2013; 170:458-63. [PMID: 23880599 DOI: 10.1016/j.ejogrb.2013.06.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Revised: 04/10/2013] [Accepted: 06/28/2013] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To investigate the role of endothelin receptors in ovarian ischaemia/reperfusion (I/R) injury in rats using the endothelin receptor antagonist bosentan. STUDY DESIGN Group 1: sham operation; Group 2: sham operation and bosentan 60 mg/kg; Group 3: bilateral ovarian ischaemia; Group 4: 3-h period of ischaemia followed by 3h of reperfusion; Groups 5 and 6: bosentan 30 and 60 mg/kg, respectively, with bilateral ovarian ischaemia applied 30 min later; the bilateral ovaries were removed after 3h of ischaemia; Groups 7 and 8: 3h of bilateral ovarian ischaemia was applied, with bosentan 30 and 60 mg/kg, respectively, administered 2.5h after the induction of ischaemia; following the 3-h period of ischaemia, 3h of reperfusion was applied, after which the ovaries were removed. RESULTS Ischaemia and I/R decreased superoxide dismutase (SOD) activity and the level of glutathione (GSH) in ovarian tissue, but increased the level of malondialdehyde (MDA) significantly compared with the sham operation group. Bosentan 30 and 60 mg/kg before ischaemia and I/R decreased the MDA level and increased SOD activity and the GSH level in the experimental groups. The serum levels of the inflammatory cytokines interleukin (IL)-1β, IL-6 and tumour necrosis factor-α were also measured in the I/R injury model in rat ovaries. The levels of these cytokines were significantly higher in the ischaemia and I/R groups compared with the sham operation and sham operation plus bosentan groups. The histopathological findings also demonstrated the protective role of bosentan against I/R-induced injury in rat ovaries. CONCLUSION Administration of bosentan protects the ovaries against oxidative damage and I/R-induced injury.
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Morton MJ, Masterson M, Hoffmann B. Case report: ovarian torsion in pregnancy - diagnosis and management. J Emerg Med 2013; 45:348-51. [PMID: 23810116 DOI: 10.1016/j.jemermed.2012.02.089] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2011] [Revised: 09/01/2011] [Accepted: 02/12/2012] [Indexed: 10/26/2022]
Abstract
BACKGROUND Ovarian torsion (OT) is one of the most common gynecologic surgical emergencies. All age groups can be affected, but ovarian stimulation, as found during early pregnancy or infertility treatment, is a major risk factor. OBJECTIVE Diagnosing OT in early pregnancy can be challenging. Patients frequently present with abdominal pain and non-specific symptoms. Missed diagnosis of OT could lead not only to ovarian necrosis and sepsis, but also threaten the pregnancy. The objective of this article is to present a case of OT in early pregnancy and to review its epidemiology, diagnosis, and treatment. CASE REPORT A 30-year-old woman at 10 weeks gestational age presented to the Emergency Department (ED) with 2 h duration of abdominal pain, nausea, and vomiting. The patient was not on ovarian stimulation treatments. A bedside ED ultrasound showed an enlarged edematous right ovary with a large cyst, but without flow on color Doppler. Immediate obstetric consultation was initiated. Eventual radiology ultrasound showed decreased but present flow in the right ovary. The patient underwent emergent laparoscopic surgery, during which the necrotic right ovary was removed. She was placed on progesterone therapy upon hospital discharge and eventually delivered a healthy term infant. CONCLUSIONS Ovarian torsion in pregnancy is increasing in frequency due to the growing prevalence of ovarian stimulation treatment. Although diagnostic ultrasound is a frequently used imaging tool in patients with suspected OT, the mere presence of blood flow on Doppler ultrasonography of the adnexa has a poor negative predictive value. A high clinical suspicion and early laparoscopic management correlate with favorable maternal and fetal outcomes.
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Affiliation(s)
- Melinda J Morton
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA
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22
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Lazaridis A, Maclaran K, Behar N, Narayanan P. A rare case of small bowel obstruction secondary to ovarian torsion in an IVF pregnancy. BMJ Case Rep 2013; 2013:bcr2013008551. [PMID: 23417952 PMCID: PMC3603835 DOI: 10.1136/bcr-2013-008551] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 39- year-old woman, who conceived following in vitro fertilisation (IVF) treatment, presented at 12 weeks gestation with symptoms of ovarian hyperstimulation syndrome (OHSS), abdominal pain, vomiting and diarrhoea. Subsequent investigations found small bowel obstruction secondary to ovarian torsion. Surgical management to remove a necrotic ovary and fallopian tube led to a good recovery from the acute illness. A postoperative ultrasound scan confirmed a viable pregnancy and the patient was discharged. Her case demonstrates a rare complication of OHSS and ovarian torsion leading to small bowel obstruction.
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Ságodi L, Schmidt I, Vámosi I, Barkai L. [Peripubertal ovarian cyst torsion as an early complication of undiagnosed polycystic ovarian syndrome]. Orv Hetil 2013; 154:113-7. [PMID: 23315226 DOI: 10.1556/oh.2013.29520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of the authors is to present two cases which raise the possibility of an association between polycystic ovarian syndrome/hyperandrogenism and ovarian cyst torsion in peripubertal girls. Androgen excess may cause more frequently ovarian cyst formation in premenarcheal or young adolescents with undiagnosed polycystic ovarian syndrome than in adults. The authors recommend that polycystic ovarian syndrome as well as late onset congenital adrenal hyperplasia should be considered in peripubertal adolescents with ovarian cyst torsion. In case polycystic ovarian syndrome is confirmed, adequate management according to age and pubertal development of the patients should be commenced.
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Affiliation(s)
- László Ságodi
- Borsod-Abaúj-Zemplén Megyei Kórház és Egyetemi Oktató Kórház, Tanszék Miskolc.
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Kara M, Daglioglu YK, Kuyucu Y, Tuli A, Tap O. The effect of edaravone on ischemia–reperfusion injury in rat ovary. Eur J Obstet Gynecol Reprod Biol 2012; 162:197-202. [DOI: 10.1016/j.ejogrb.2012.02.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 01/07/2012] [Accepted: 02/28/2012] [Indexed: 01/07/2023]
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25
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Sayyah-Melli M, Rashidi MR, Kaseb-Ganeh M, Rashtchizadeh N, Taghavi S, Ouladsahebmadarek E, Ghojazadeh M. The effect of erythropoietin against oxidative damage associated with reperfusion following ovarian detorsion. Eur J Obstet Gynecol Reprod Biol 2012; 162:182-6. [DOI: 10.1016/j.ejogrb.2012.02.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Revised: 12/21/2011] [Accepted: 02/17/2012] [Indexed: 10/28/2022]
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26
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Wilkinson C, Sanderson A. Adnexal torsion — A multimodality imaging review. Clin Radiol 2012; 67:476-83. [DOI: 10.1016/j.crad.2011.10.018] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Revised: 10/21/2011] [Accepted: 10/27/2011] [Indexed: 10/14/2022]
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Mawaldi L, Gupta C, Bakhsh H, Saadeh M, Abolfotouh MA. Validity of Ultrasound in Patients with Acute Pelvic Pain Related to Suspected Ovarian Torsion. ACTA ACUST UNITED AC 2011. [DOI: 10.4236/ss.2011.26069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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