Impact of silencing eEF2K expression on the malignant properties of chordoma.

BACKGROUND: Eukaryotic elongation factor 2 kinase (eukaryotic elongation factor 2 kinase, eEF2K) is a calcium calmodulin dependent protein kinase that keeps the highest energy consuming cellular process of protein synthesis under check through negative regulation. eEF2K pauses global protein synthesis rates at the translational elongation step by phosphorylating its only kown substrate elongation factor 2 (eEF2), a unique translocase activity in ekaryotic cells enabling the polypeptide chain elongation. Therefore, eEF2K is thought to preserve cellular energy pools particularly upon acute development of cellular stress conditions such as nutrient deprivation, hypoxia, or infections. Recently, high expression of this enzyme has been associated with poor prognosis in an array of solid tumor types. Therefore, in a growing number of studies tremendous effort is being directed to the development of treatment methods aiming to suppress eEF2K as a novel therapeutic approach in the fight against cancer. METHODS: In our study, we aimed to investigate the changes in the tumorigenicity of chordoma cells in presence of gene silencing for eEF2K. Taking a transient gene silencing approach using siRNA particles, eEF2K gene expression was suppressed in chordoma cells. RESULTS: Silencing eEF2K expression was associated with a slight increase in cellular proliferation and a decrease in death rates. Furthermore, no alteration in the sensitivity of chordoma cells to chemotherapy was detected in response to the decrease in eEF2K expression which intriguingly promoted suppression of cell migratory and invasion related properties. CONCLUSION: Our findings indicate that the loss of eEF2K expression in chordoma cell lines results in the reduction of metastatic capacity.

A Novel Virtue in Stem Cell Research: Exosomes and Their Role in Differentiation.

In the past decade a number of different stem cell types have entered the clinical applications increasingly as a therapeutic option, due to their tissue maintenance capacity at the site where they localize. Although it was initially thought that conferral of resilience to damaged tissue largely depends on the stem cells themselves through orchestration of signaling among the local epithelial and immune systems at the injury site, recent findings point out that the remarkable regenerative capacity of stem cells is rather due to their nanovesicular products that emerge as the new active players of tissue repair processes. Among these extracellular vesicles exosomes generated particularly by stem cells have been receiving a substantial interest both in the fields of stem cell biology and extracellular vesicles. In this chapter fundamental facts about stem cell biology, biogenesis of extracellular vesicles and exosomes, their structure, and function are summarized. Moreover, properties of both tumor-derived exosomes as well as those derived from stem cells are discussed relatively in-depth in terms of their influence on proximal and distal tissue physiology. Last but not the least, among countless studies in an exploding field, we summarize those that attempt to unravel the complex signaling networks through which stem cell-derived exosomes alter the fate of differentiating stem cells as well as the molecular make-up of exosomes released from differentiating stem cells by conducting thorough proteomic and genomic analyses with the ultimate goal of identifying effector gene products mediating exosomal cues in stem cell biology.

Effect of combined oral contraceptive use on serum 25-hydroxy vitamin D levels and ultrasound parameters in patients with polycystic ovary syndrome.

PURPOSE: To investigate if there is an effect of combined oral contraceptive (COC) use on serum 25-hydroxy vitamin D [25(OH)D] levels in patients with polycystic ovary syndrome (PCOS). METHODS: PCOS was defined by the 2003 Rotterdam criteria. All patients with PCOS were treated with a COC containing 0.035 mg ethinylestradiol and 2 mg cyproterone acetate for 6 months. Serum 25(OH)D levels, HOMA-IR, ovarian volume and antral follicule count were measured before and after the treatment. RESULTS: The median 25(OH)D levels were 9.40 (range 4.40-24.50) µg/l and 7.00 (5.00-13.50) µg/l before and after COC use, respectively. Serum 25(OH)D levels decreased after the treatment; however, the difference was not statistically significant (p = 0.055). CONCLUSION: This study seems to be the first prospective trial revealing the effect of COC use on serum 25(OH)D levels in women with PCOS. Although the decrease in serum 25(OH)D levels in patients with PCOS with the use of COC alone, did not reach to statistically significance level after 6 months treatment with COC.

Hyperemesis gravidarum and its relation with maternal body fat composition.

The objective of this study was to determine if maternal body fat composition and body mass index were associated with hyperemesis gravidarum (HG) in the first trimester of pregnancy. Healthy pregnant women (n = 30) without nausea and vomiting (control group) and women with HG (n = 54; study group), all with singleton pregnancy at 6-14 weeks gestational age, were included. Body mass index was measured before and during pregnancy. Visceral adipose tissue (VAT) and subcutaneous fat thickness were measured during pregnancy. Comparison of the groups revealed that VAT and pre-pregnancy body mass index but not subcutaneous fat thickness were significantly higher in the HG group versus controls. VAT and pre-pregnancy body mass index predicted 83.8% and 67.1% of HG cases, respectively. VAT and pre-pregnancy body mass index were correlated with the development of hyperemesis gravidrum and hence could be considered as predictive markers for HG.

Gut satiety hormones and hyperemesis gravidarum.

UNLABELLED: Hyperemesis gravidarum (HG) is described as unexplained excessive nausea and vomiting during pregnancy. Some gut hormones that regulate appetite may have important role in etiopathogenesis of HG and weight changes during pregnancy. In this study, levels of gut satiety hormones were evaluated in pregnant women with HG. METHODS: This prospective case-control study was conducted in 30 women with HG and 30 healthy pregnant women without symptoms of HG. Fasting venous blood samples were taken from all subjects for measurement of plasma gut hormone levels; obestatin (pg/mL), peptide YY (PYY), pancreatic polypeptide (PP) and cholecystokinin (CCK). RESULTS: Plasma PYY and PP levels were significantly higher in HG group. The most important parameter in diagnosis of HG was plasma PP level. Simple use of PP level led to the diagnosis 91.1 % of HG cases correctly. The single most important parameter in the prediction of HG was also PP level. CONCLUSION: Anorexigenic gut hormones might have important role in etiopathogenesis of hyperemesis gravidarum and weight changes during pregnancy.

Antiadhesive role of human amniotic fluid on peritoneal adhesion formation in a rat model. Experimental study.

OBJECTIVE: To determine the role of human amniotic fluid (HAF) in preventing or reducing postoperative adhesions. STUDY DESIGN: Uterine horn adhesion model was carried out in 24 female Wistar rats. The animals were randomized into 4 groups: (1) control, (2) Ringer's lactate, (3) whole HAF, and (4) HAF depleted from cells and proteins. Adhesion grade and histologic findings of adhesion-carrying tissues were evaluated and groups were compared according to these parameters. RESULTS: Rats treated with whole HAF had less adhesion grade when compared to the control group, but the difference was not statistically significant. On the other hand, centrifuged amniotic fluid treatment significantly reduced peritoneal adhesion grade, fibrosis and inflammation (p < 0.05). CONCLUSION: Whole HAF seems to have no beneficial effect on peritoneal adhesion formation, but HAF depleted of protein and cells does have a positive effect on reducing adhesion formation.

Effect of vitamin D on postoperative adhesion formation in a rat uterine horn adhesion model.

OBJECTIVE: To determine the role of vitamin D for preventing or reducing postoperative adhesions. STUDY DESIGN: The uterine horn adhesion model was carried out in 24 female Wistar rats. The animals were randomized into 4 groups: (1) control, (2) Ringer's lactate, (3) olive oil, and (4) vitamin D. Adhesion grade and histologic findings of adhesion-carrying tissues were evaluated, and groups were compared according to these parameters. RESULTS: Rats treated with vitamin D had less adhesion and lower inflammation grade when compared to the control and Ringer's lactate groups, and the results were statistically significant (p < 0.05). On the other hand, no difference was detected between the groups according to the fibrosis score. CONCLUSION: Vitamin D decreased postsurgical adhesion scores by both visual scores and histologic analyses in a rat model. Further experimental and clinical trials are required to confirm these results.

Cannabinoid compounds in combination with curcumin and piperine display an anti-tumorigenic effect against colon cancer cells.

Currently, use of cannabinoids is limited to improve adverse effects of chemotherapy and their palliative administration during treatment is curiously concomitant with improved prognosis and regressed progression in patients with different tumor types. Although, non-psychoactive cannabidiol (CBD) and cannabigerol (CBG) display antineoplastic effects by repressing tumor growth and angiogenesis both in cell line and animal models, their use as chemotherapeutic agents is awaiting further investigation. Both clinical and epidemiological evidence supported by experimental findings suggest that micronutrients such as curcumin and piperine may present a safer strategy in preventing tumorigenesis and its recurrence. Recent studies demonstrated that piperine potentiates curcumin's inhibitory effect on tumor progression via enhancing its delivery and therapeutic activity. In this study, we investigated a plausible therapeutic synergism of a triple combination of CBD/CBG, curcumin, and piperine in the colon adenocarcinoma using HCT116 and HT29 cell lines. Potential synergistic effects of various combinations including these compounds were tested by measuring cancer cell proliferation and apoptosis. Our findings revealed that different genetic backgrounds of HCT116 and HT29 cell lines resulted in divergent responses to the combination treatments. Triple treatment showed synergism in terms of exhibiting anti-tumorigenic effects by activating the Hippo YAP signaling pathway in the HCT116 cell line.

Secondary cytoreductive surgery outcomes of selected patients with paclitaxel/platinum sensitive recurrent epithelial ovarian cancer.

OBJECTIVE: The aim of this study was to evaluate the effect of secondary cytoreductive surgery (SCRS) on survival and to determine prognostic factors that may predict surgical and survival outcome. STUDY DESIGN: Between 1999 and 2011, data of 67 patients who had SCRS for epithelial ovarian cancer were evaluated. Factors that had an impact on survival were determined by statistical analysis. RESULTS: Univariate analysis showed that the number of chemotherapy cycles after primary surgery, CA 125 level at SCRS, number of recurrent tumors, recurrence before SCRS, disease dissemination, and number of chemotherapy cycles after SCRS were significantly associated with disease free survival after SCRS. In multivariate analysis, serum CA125 level, tumor dissemination, and number of chemotherapy cycles after SCRS were significantly associated with disease free survival. Moreover, univariate analysis showed that recurrence before SCRS was significantly associated with overall survival. CONCLUSION: SCRS may be beneficial for first relapsed, localized paclitaxel/platinum sensitive epithelial ovarian tumors and patients with a low serum CA 125 level and those who will receive ≥ 6 chemotherapy cycles after SCRS. This procedure should be considered in selected patient populations.

Impact of adrenal versus ovarian androgen ratio on signs and symptoms of polycystic ovarian syndrome.

The aim of this study was to examine the effect of adrenal versus ovarian androgen (dehydroepiandrosterone sulfate/total testosterone [DHEAS/TT]) on clinical presentation and related metabolic disturbances in Turkish women with polycystic ovarian syndrome (PCOS). Two hundred eighty PCOS cases were taken into the study. For all cases, the DHEAS/TT ratio was calculated. The median value of this ratio was 4.40. Patients with an androgen ratio lower than 4.40 were included in Group 1 and cases with a ratio higher than 4.40 were Group 2. The two groups were compared in terms of hormonal, biochemical and clinical parameters. Body mass index and waist circumference were lower, the Ferriman-Gallwey score was higher and the cycle length was shorter in Group 2. High DHEAS level was associated with better lipid profiles and lower levels of inflammatory markers, meaning good metabolic control in these women, in spite of increased hirsutism rates. In patients with PCOS, both androgens are usually high in proportion to each other. Therefore, it would be more meaningful to use the DHEAS/TT ratio for an assessment of the metabolic and phenotypic effects of PCOS.

First-trimester reference ranges for decidual thickness and its relation to progesterone levels.

AIMS: The present study aimed to provide normal reference ranges for decidual thickness measured ultrasonographically in healthy first-trimester pregnancies and to evaluate whether there was a relationship between decidual thickness and serum progesterone levels. METHODS: Decidual thickness of 173 women with a healthy gestation between 6+0 and 9+6 weeks was measured ultrasonographically and serum progesterone concentration was determined. Distribution of decidual thickness at each gestational week and its relation with serum progesterone levels was evaluated. RESULTS: Mean decidual thickness was 6.8, 5.7, 5.5, and 6.1 mm at 6th, 7th, 8th, and 9th gestational weeks, respectively. Decidual thickness showed a mild negative correlation with gestational week (ρ=-0.207, P=0.006) and a mild positive correlation with serum progesterone concentrations (ρ=0.191, P=0.021). CONCLUSION: The present study provided normal reference ranges for decidual thickness in healthy pregnancies in the first trimester. The association found between decidual thickness and progesterone levels might shed light on further studies investigating the predictive factors of pregnancy loss and might lead to changes in the management of threatened miscarriage.

Comparison of low-dose oxytocin and dinoprostone for labor induction in postterm pregnancies: a randomized controlled prospective study.

AIMS: The aim of this study was to compare the efficacy of oxytocin and dinoprostone in achieving successful labor induction and vaginal delivery in postterm women with an unfavorable cervix. METHODS: Postterm women with an uncomplicated pregnancy and a Bishop score of ≤6 were randomized to receive either dinoprostone vaginal pessary (Propess®) or low-dose oxytocin. The primary outcomes were the length of the induction-to-delivery period and the incidence of vaginal delivery. RESULTS: A total of 144 women were available for the analysis. The overall vaginal delivery rates were 75% (54/72) for the dinoprostone group and 80.6% (58/72; p = 0.35) for the oxytocin group; the mean induction-to-vaginal delivery interval was 13.3 and 10.3 h in the dinoprostone and the oxytocin group, respectively (p = 0.003). Uterine hyperstimulation was 7.4% compared with 6.8% (p = 0.8), and abnormal fetal heart rate was 26.4% compared with 18% (p = 0.2), respectively. CONCLUSION: Both oxytocin and dinoprostone seem to have similar obstetric outcomes in postterm pregnancies with an unfavorable cervix, except for a significant superiority of oxytocin for delivery in a shorter period.

Effect of liquid-based gel application during speculum examination on satisfactory level of smear examination.

PURPOSE: The aim was to evaluate the use of liquid-based gel during cytologic follow-up and the effect of liquid-based gel application during speculum examination on satisfactory level of smear. METHODS: A total of 1,999 patients were taken into the study. Patients were divided into two groups as gel-applied group and control group. Age and menopausal status of patients, and the physicians taking the smear (resident or specialist) were recorded. In control group, dry speculum was used for the collection of smear sample. All specimens were evaluated for correlation of the cytopathology, the number of "unsatisfactory" samples, and any secondary diagnoses. RESULTS: Assessment of smear satisfactoriness revealed that 2.2% (43) of them were unsatisfactory. Unsatisfactory smear ratio was significantly high in gel-applied group. Screening done by residents increased unsatisfactory result risk for about 5.5 times. Evaluation of effect of menopausal status on smear adequency revealed no difference between premenopausal and postmenopausal women. CONCLUSION: Cervical smear seems to be more accurate without gel application. Experience of the physician is also important. Water-based gel can be used in some women who experience overt pain during speculum examination, but these patients must be warned about unsatisfactory results and the need of repeat test.

What is the impact of cervical invasion on lymph node metastasis in patients with stage IIIC endometrial cancer?

PURPOSE: The aim of this study was to evaluate whether the presence of cervical invasion has altered the site of lymph node (LN) metastasis in stage IIIC endometrial cancer (EC) patients. METHODS: Fourty-six patients who had systematic pelvic and para-aortic lymphadenectomy surgery for EC and staged as IIIC were included in the study. Patients with cervical invasion were defined as Group A and patients without cervical invasion were defined as Group B. The groups were compared according to surgical-pathologic characteristics. Chi-square and Annova table test were used to examine the effect of cervical invasion on LN metastasis. RESULTS: The mean age of patients was 59 years (range 38-81) and tumor size was 47 mm (range 10-80). Twenty-three patients had cervical involvement (Group A) and 23 had no cervical metastasis (Group B). Groups were not different with regard to cell type, grade, depth of myometrial invasion, tumor size, adnexal involvement, peritoneal metastasis and lymphovascular space invasion. Among 46 patients obturator LN was the most involved site of LN metastasis, however, when there is cervical metastasis external iliac LN was found to be the most involved LN site. Patients without cervical invasion had 21.7% of external iliac LN metastasis while patients with cervical invasion had 60.9% of external iliac LN metastasis. Also, cervical invasion has increased the risk of pelvic LN and obturator LN involvement from 82.6 to 95.7% and 39.1 to 52.2%, respectively. CONCLUSION: Cervical invasion may have an effect on lymphatic spread and change the site of metastatic LNs. Large prospective studies are needed to clarify the alteration of LN metastasis in cervix invaded EC patients.

A prospective evaluation of lymphatic dissemination in endometrial cancer: is it adequate to perform lymph node dissection up to the inferior mesenteric artery?

OBJECTIVE: This study aimed to assess para-aortic metastases relative to the inferior mesenteric artery (IMA). In addition, the clinicopathologic features of these patients are discussed. MATERIALS AND METHODS: Between 2007 and 2009, a total of 78 consecutive patients who had open systematic pelvic and para-aortic lymphadenectomy surgery for endometrial cancer extending to the renal vessels and who were treated at the gynecologic oncology department were included in this prospective study. The para-aortic lymph nodes (PALNs) removed from these patients were classified as supramesenteric (between the renal vein and the IMA) or inframesenteric (between the IMA and the presacral). Patients' clinical data, pathologic tumor characteristics, and operative and early postoperative data were recorded after surgery. Descriptive statistics were calculated using the SPSS 17.0 package program. RESULTS: Of these 78 patients, 18 (21.3%) had metastatic nodal involvement. From a total of 12 patients with PALN metastasis, 7 had only supramesenteric and 1 had only inframesenteric nodal involvement, whereas 4 had both supramesenteric and inframesenteric metastases. Of the 5 patients in the inframesenteric±supramesenteric group, none had a grade 1 tumor. On the other hand, of the 7 patients with only supramesenteric metastasis, 57.1% (n=4) had a grade 1 tumor and 42.8% (n=3) had less than half of myometrial invasion. CONCLUSIONS: In the case of well-defined risk factors in which a lymphadenectomy is indicated according to current guidelines from the International Federation of Gynecology and Obstetrics, a PALN dissection should be extended up to the renal vessels. We also conclude that tumor grade, histologic type, and myometrial invasion cannot be used as markers to decide on supramesenteric lymphadenectomy in endometrial cancer.

Partial molar pregnancy and coexisting fetus with diploid karyotype.

OBJECTIVES: To evaluate cases of partial hydatidiform mole coexisting with a live fetus, including an observation of our own, and to discuss the proper antenatal management of women wishing to continue with a partial molar pregnancy. METHOD: A PubMed search was then undertaken, extending over the time period from 1975 to 2006, using the keywords 'partial hydratidiform mole', 'hydatidiform mole' and 'coexisting fetus'. RESULTS: At 16 weeks of gestation, an ultrasonographic examination revealed a normal fetus with an extremely large, multicystic placenta. The woman was informed of future risks but wished to continue with the pregnancy. The pregnancy progressed until 28 weeks without any complication but ended spontaneously with a vaginal delivery; the fetus had died in utero. Pathologic examination of the placenta revealed areas of hydropic degeneration and necrosis. Including our own observation, 17 cases of partial hydatidiform mole associated with a fetus of normal karyotype have been documented. CONCLUSION: Although the rate of adverse perinatal outcome is high, we still believe that if amniocentesis or fetal blood sampling reveals a normal karyotype, then continuing the affected pregnancy with close follow-up in tertiary centers is a feasible choice.

Sleep deprivation in the last trimester of pregnancy and inadequate vitamin D: Is there a relationship?

BACKGROUND: Disturbed sleep is a significant health issue for pregnant women. Inadequate vitamin D intake is common among pregnant women and can affect many bodily systems. The purpose of this cross-sectional study was to test the hypothesis that serum vitamin D levels are low in pregnant women who have poor sleep quality in their last trimester. METHODS: We enrolled 92 pregnant women who were admitted to the Maternity Clinic of Turgut Ozal University (Ankara, Turkey) in their last trimester. Venous blood sampling was performed to determine serum 25-hydroxyvitamin D levels. Sleep quality was measured by the Pittsburgh Sleep Questionnaire. The Student t test and Chi-square test were used to evaluate the relationships between variables. Logistic regression analysis was used to identify independent predictors of the vitamin D level. RESULTS: The median score of the Pittsburgh Sleep Questionnaire was 6.2 ± 3.3 (range, 1-17). We determined that 43.5% (40) of participants had poor sleep quality. The mean number of sleep hours at night was 8.6 ± 1 hours (range, 6.30-11 hours), and the mean sleep latency was 20.3 ± 12.7 minutes (range, 5-60 minutes). Vitamin D levels were measured for 87 participants; the median serum level of 25 (OH) vitamin D was 22.9 ± 16.2 ng/mL (range, 4.9-99 ng/mL). Among all patients, we did not determine any significance between the vitamin D-deficient group and the non-vitamin D-deficient group with regard to the Pittsburgh Sleep Questionnaire Inventory (PSQI) total score and subcomponents scores of the questionnaire (p > 0.05). Among 37 patients with poor sleep quality and for whom the vitamin D level was measured, 56.8% (21) women had vitamin D deficiency, and 81% (30) women had vitamin D insufficiency. However, we did not find any significance between participants with poor sleep and participants with good sleep quality with regard to age, occupational status, relationship with her partner, prepregnancy body mass index (BMI), weight gain during pregnancy, being primiparus, length of labor, and mode of delivery. Our findings further showed that being in a low income family was associated with poor sleep quality. CONCLUSION: Inadequate vitamin D and poor sleep quality are prevalent in pregnant women, but low levels of vitamin D are not associated with poor sleep quality. Further studies with larger sample sizes and studies that include preterm deliveries and special sleep disorders should be performed to understand this issue better.

Effects of curcumin on ovarian ischemia-reperfusion injury in a rat model.

Ischemia-reperfusion injury is a significant problem following reperfusion treatment for ovarian torsion. It is generally caused by reactive oxygen species-induced damage. Antioxidant agents, such as curcumin, may protect ovaries from this adverse effect. The aim of the present randomized, controlled study was to evaluate the short-term protective effect of curcumin on a rat model of ovarian ischemia-reperfusion injury. A total of 30 female Wistar albino rats, weighing 160-230 g, were divided into 2 groups depending upon the time of unilateral, left ovary ischemia/reperfusion (group 1, 2 h ischemia/2 h reperfusion and group 2, 4 h ischemia/4 h reperfusion). These groups were subdivided into 3 subgroups (sham, control and curcumin). The sham subgroups were not subjected to ischemia/reperfusion. Control and curcumin subgroups were performed under ischemia for 2 h plus 2 h reperfusion or 4 h ischemia plus 4 h reperfusion. Curcumin, 200 mg/kg, was intraperitoneally administered simultaneously with reperfusion to the curcumin subgroups. Serum nitric oxide (NO), NO synthase (NOS), xanthine oxidase (XO), total antioxidant status (TAS), total oxidant status (TOS) and histological scores were measured and compared between subgroups. For group 1, no significant differences were observed between NO, NOS, XO, TAS or TOS. The left ovary histological grade was significantly higher in the control and curcumin subgroups compared with the sham subgroup (P=0.036). For group 2, TOS was significantly higher in the control group compared with the sham and curcumin groups (P=0.023). However, TAS was also significantly higher in the control subgroup compared with the other 2 subgroups (P=0.005). Left ovary histological grade was significantly higher in the control and curcumin subgroups compared with the sham subgroup (P=0.038). No significant differences were observed between NO, NOS or XO between the group 2 subgroups. The results showed that curcumin exerted no major significant protective effect on ischemia-reperfusion injury in the rat ovary.

Is There a Relationship Between Pelvic Organ Prolapse and Tissue Fibrillin-1 Levels?

PURPOSE: Pelvic organ prolapse is a multifactorial disorder in which extracellular matrix defects are implicated. Fibrillin-1 level is reduced in stress urinary incontinence. In Marfan syndrome, which is associated with mutations in Fibrillin-1, pelvic floor disorders are commonly observed. We hypothesize that Fibrillin-1 gene expression is altered in pelvic organ prolapse. METHODS: Thirty women undergoing colporrhaphy or hysterectomy because of cystocele, rectocele, cystorectocele, or uterine prolapse were assigned to a pelvic prolapse study group, and thirty women undergone hysterectomy for nonpelvic prolapse conditions were assigned to a control group. Real-time polymerase chain reaction was conducted on vaginal tissue samples to measure the expression of Fibrillin-1. Expression levels were compared between study and control groups by Mann-Whitney U test with Bonferroni revision. RESULTS: Fibrillin-1 gene expression was not significantly lower in the study group than in the control group. Similarly, no significant correlation between Fibrillin-1 levels and grade of pelvic prolapse was found. Age over 40 years (P=0.018) and menopause (P=0.027) were both associated with reduced Fibrillin-1 levels in the pelvic prolapse group, whereas the delivery of babies weighing over 3,500 g at birth was associated with increased Fibrillin-1 expression (P=0.006). CONCLUSIONS: The results did not indicate a significant reduction in Fibrillin-1 gene expression in pelvic prolapse disorders; however, reduced Fibrillin-1 may contribute to increased pelvic organ prolapse risk with age and menopause. Increased Fibrillin-1 gene expression may be a compensatory mechanism in cases of delivery of babies with high birth weight. Further studies are needed for a better understanding of these observations.

Effect of Hypericum perforatum on intraperitoneal adhesion formation in rats.

INTRODUCTION: The aim of this study was to evaluate the efficacy of Hypericum perforatum for prevention of adhesion formation in rats. MATERIAL AND METHODS: Twenty-four female wistar rats underwent left uterine horn adhesion model. Rats were randomised into 4 groups. Group 1 (Control): Closure of abdominal incision without any agent administration. Group 2: Closure of incision after administration of intraperitoneal (i.p.) Ringer's lactate solution. Group 3: Closure of incision after administration of i.p. olive oil (diluent of H. perforatum). Group 4: Hypericum perforatum extract (Ecodab(®)) was administered i.p. before the closure of incision. Fourteen days later, relaparatomy was performed and surgical adhesion scores, inflammation and fibrosis scores were noted. Groups were compared according to these scores. RESULTS: There was statistical significant difference between ringer's lactate group and olive oil group according to surgical adhesion score (p = 0.009). However, groups were not different according to inflammation and fibrosis scores (p > 0.05). CONCLUSIONS: Despite antiinflammatory, antioxidants and antimicrobial properties of H. perforatum, our results revealed no positive effect of H. perforatum on the prevention of intraperitoneal adhesion formation.