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Öğe The Effect of Erythropoietin in Preventing Ischemia-Reperfusion Injury in Ovarian Tissue Transplantation(Sage Publications Inc, 2018) Kolusari, Ali; Okyay, Ayse Guler; Kockaya, Evrim ArzuCondensation Erythropoietin improved the survival of follicles in ovarian grafts most likely by reducing ischemic injury, by improving neoangiogenesis, and by its antioxidant effects. Objective: Ovarian tissue cryopreservation and transplantation are the only options accepted for prepubertal girls and women requiring immediate chemotherapy. Ischemia-reperfusion injury is the main obstacle for ovarian tissue transplantation. In the present study, we aimed to evaluate the effects of recombinant human erythropoietin (EPO) on tissue viability in autotransplanted rat ovaries. Study Design: Seventeen female rats were randomized into 3 groups as sham control group (n = 5), EPO-treated group (n = 6), and EPO-untreated group (n = 6). Both ovaries were excised and transplanted into a subcutaneous pouch formed at the anterior abdominal wall in the EPO-treated and untreated groups. In the EPO group, 5000 U/kg EPO was applied as local injection to the site that ovarian tissue was placed and the dose was repeated with the same route at the end of the fourth week. After 2 months, ovaries were removed and blood samples were obtained. Levels of estradiol (E-2), vascular endothelial growth factor (VEGF), VEGF-C, and lipid hydroperoxidase (LPO) and the activity of glutathione peroxidase (GPX), superoxide dismutase (SOD), and catalase (CAT) were measured both in blood and tissue samples. Histopathological and morphometric analyses were also performed on tissue samples. Results: Considering serum levels, mean CAT was significantly higher (P = .003) and mean SOD (P = .033), LPO (P = .050), VEGF (P = .001), and VEGF-C (P = .024) were significantly lower in the EPO-treated group than in the untreated group. Mean serum GPX levels were similar. Significantly higher levels of E-2 were determined in the EPO group than in the untreated group. Highest serum E-2 levels were found in the sham group (P = .001). Tissue levels of GPX (1.23) and CAT (53.17) were significantly higher in the EPO group (P = .002 and P = .001, respectively). However, tissue levels of SOD and LPO, VEGF, and VEGF-C levels were significantly lower in the EPO group than those in the untreated group (P = .033, P = .050, P = .002, and P = .003, respectively). In tissue examination, the highest values of x, y axis and epithelial height were in the sham group. Mean value of the EPO group was found statistically significantly higher than that of the untreated group (P .05). In terms of antral follicle count, ordering was found as sham > EPO-treated > EPO-untreated group. Follicle counts in the EPO group were significantly higher than those in the untreated group (P 0.05). Conclusion: Erythropoietin improved the survival of follicles in ovarian grafts most likely by reducing ischemic injury, by improving neoangiogenesis, and by its antioxidant effects.Öğe Should we use urinary catheter routinely at cesarean delivery?(2007) Kolusari, Ali; Zetero?lu, Şahin; Şahin, H. Güler; Ramazan, Sürücü; Kamaci, MansurOBJECTIVE: The aim of the study was to compare intraoperative complications and postoperative morbidity of patients to whom urinary catheter were performed or not in cesarean deliveries. STUDY DESING: This study was designed as a prospective randomised study. Fifty patients (Group 1) who delivered with cesarean section after spontaneous mixture were compared with fifty patients (Group 2) to whom Foley urinary catheter were performed before the opertaion for intraoperative complications and postoperative morbidity. FINDINGS: There were no significant differences between the groups for age, gravity, parity, cesarean indications, factors those could increase postoperative infectious risks and operative time. No intraoperative complications were noticed in both groups. Postoperative mobilization was significantly earlier in Group 1 (6.58±1.69 hours vs 12.52±4.48 hours). The average time to first void was 5.24±3.53 hours in Group 1. In Group 2, two patients (% 4) who had glob vesicate required urinary catheter drainage (Both of them had epidural anesthesia). Urinary catheter was removed at 12.08±4.42 hours in Group 2 patients. There were no urinary tract infections in group 1, four in group 2 patients which reached statistical significance. CONCLUSION: Use of urinary catheter at cesarean delivery increases postoperative urinary tract infections. We think that use of urinary catheter at cesarean delivery is ineffective.Öğe Umbilical Artery Erythropoietin Levels in Preeclamptic Pregnancies(Galenos Yayincilik, 2006) Sahin, H. Guler; Surucu, Ramazan; Zeteroglu, Fiahin; Ustun, Y. Engin; Ustun, Yusuf; Kamaci, Mansur; Kolusari, AliObjective: The aim of this study was to determine the levels of umbilical artery erythropoietin (EPO) levels and to evaluate its relation with clinical findings. Material and Methods: In this prospective study, 26 normal (Group I), 25 mild preeclamptic (Group II) and 17 severe preeclamptic (Group III) pregnant women whose gestational ages were between 37-42 weeks were enrolled. After the delivery, blood samples were taken from the umbilical artery of double clamped umbilical cord and umbilical artery EPO levels and blood gas parameters were analyzed. Sociodemographic findings, labor properties and physical examination of neonates were recorded. The blood gas parameters, EPO levels, their relationships with clinical findings of the groups were evaluated. Statistical analyses were performed by SPSS 9.05 statistical package program. Results: There were no statistical differences between gravidity, parity and gestational ages of the groups (p> 0.05). Maternal ages were significantly higher in the second group when compared with the others (p< 0.05). Systolic and diastolic blood pressures were statistically different in the groups (p< 0.05), and the highest levels were found in the third group. Birth weights were; 3480.76 +/- 431.75, 3373.20 +/- 846.83 and 2497.05 +/- 859.83 grams in group I, group II and group III, respectively (p< 0.05). First minute Apgar scores were 8 (ranges between 7-10) in the first group, 8 (ranges between 3-9) in the second group and 6 (ranges between 3-9) in the third group (p< 0.05). Umbilical cord pH levels were 7.35 +/- 0.06, 7.25 +/- 0.11 and 7.19 +/- 0.09; base excess (BE) levels were -4,71 +/- 2,02, -6.53 +/- 3.98 and -9.29 +/- 3.82 mmol/L; EPO levels were 30.0 (9.2-122), 62.5 (11.0-549) and 167.4 (10.1-908) mU/ml, respectively, and the differences between the groups were statistically significant (p< 0.05). In the Spearman bivariate correlation analysis, there was no significant relation between maternal age and EPO levels. There was significant positive correlation between EPO levels and systolic, diastolic blood pressures, pCO2 levels, and, significant negative correlation between first, fifth minute Apgar scores, birth weight, umbilical cord blood pH and BE levels. Conclusions: After delivery umbilical artery EPO levels showed significant correlation with severity of preeclampsia and, clinical and biochemical determinants of perinatal hypoxia. Our results support that erythropoietin can be used as a biochemical determinant of chronic fetal hypoxia that is caused by preeclampsia.
