Simender MESCİ HAFTACI, Mustafa ALBAYRAK, Şerif DEMİR, Ümran YILDIRIM, Handan ANKARALI, Fatih KESKİN

RAT OVERİNDE OLUfiTURULAN ADNEKSİYAL TORSİYON MODELİNDE PERİOPERATİF SELENYUM VE C VİTAMİNİ UYGULAMASININ OVARYAN NEKROZ ÜZERİNE ETKİNLİĞİNİN DEĞERLENDİRİLMESİ

Giriş: Ovaryan torsiyon jinekolojik onkolojide adneksiyal kitlelerin komplikasyonu olabilen, konservatif yaklaşım olarak ilgili segmentlerin detorsiyonunu içeren ciddi bir jinekolojik problemdir. Torsiyon, ovaryan hasar ve fertilite kaybı ile kendini gösterir ve detorsiyon hasarın artmasında en önemli faktörlerden biridir. Torsiyon/Detorsiyon şeklinde görülen ovaryan hasar diğer organlarda gözlenen iskemi/reperfüzyon (I/R) hasarıyla benzerlik göstermektedir. Amaç: Bu deneysel çalışmada amaç rat overinde, iskemi/reperfüzyon hasarında C vitamini ve selenyumun etkilerini değerlendirmektir. Gereç ve Yöntem: Bu çalışmada 48 adet wistar cinsi rat kullanıldı. Sham grubunda (grup 1) sadece laparotomi uygulandı. İskemi (Grup 2) grubunda ovaryan iskemi oluşturuldu ve sağ over 4 saat sonra çı- karıldı. İskemi/Reperfüzyon (Grup 3) grubunda 4 saatlik iskemik periodun ardından, 1 saat reperfüzyon uygulandı ve sağ over çıkarıldı. Grup4, Grup5 ve Grup6’da 4 saatlik iskemik periodun ardından sırasıyla C vitamini, selenyum, selenyum+C vitamini, reperfüzyon öncesi infüzyonla verildi, 1 saatlik reperfüzyonun ardından sağ over çıkarıldı. Overler daha sonra histopatolojik olarak değerlendirildi. Bulgular: Sham grubunda nekroz bulgusu görülmezken, hücre hasarı en çok selenyum ve C vitaminin beraber uygulandığı grupta gözlendi. İskemi grubunda iskemi/reperfüzyon grubuna göre daha az hücre hasarı görüldü. C vitamini ve selenyumun tek başına verildi- ği gruplar iskemi grubuyla benzerlik gösterirken; iskemi/reperfüzyon grubundan aha az hücre hasarı izlendi. Sonuç: C vitamini ve selenyum iskemi/reperfüzyon hasarını azaltmada etkilidir.

Anahtar Kelimeler:

‹skemi, Reperfüzyon, Over, Selenyum, C Vitamini, ‹skemi/reperfüzyon Hasar›.

Introduction: Ovarian torsion is a serious gynaecologic problem in gynecologic oncology where conservative management includes detorsion of the involved segments. Torsion has been implicated in ovarian damage and loss of fertility, and detorsion in one of the most important factors in further injury. Ovarian injury resulting from torsion/detorsion resembles that caused by ischemia/reperfusion (I/R) injury observed in other organs. Aim: In this experimental study, the aim is to examine the effects of Vitamin C and selenium on ischemia-reperfusion injury in the rat ovary. Materials and Methods: In this study 48 female Wistar rats were used. In the Sham group(Group 1) only laparotomy was performed. In group 2 (ischemia) ovarian ischemia was produced and the right ovary was surgically removed 4 h later. In group 3(ischemia/reperfusion ) an ischemic period of 4 h was followed by reperfusion for 1 h, the right ovary was removed. In groups 4,5 and 6, after 4h of ischemia, either vit C, selenium, selenium+vit C respectively were infused before reperfusion; after 1 h of reperfusion the right ovary was removed. The ovaries were examined by histopathologic evaluation. Results: There was no cell injury in the Sham group but we determined significant difference in the group of Vit C and selenium infused together. In the ischemia group we determined cell injury was less than ischemia/reperfusion group. The groups that have been infused Vit C and selenium respectively, were similar with ischemia group, but less than ischemia/reperfusion group. Conclusion: We concluded that Vit C and selenium are effective in decreasing ischemia/reperfusion injury

Keywords:

Ischemia, Reperfusion, Ovary, Selenium, Vit C, Ischemia/reperfusion Injury.,

PDF

___

1. Hibbard L. (1985) Adneksiyal torsion. Am. J. Obstet. Gynecol.1985; 152, 456-461.
2. Bayer A.I. and Wiskind, A.K. Adnexal torsion: can the adnexa be saved? Am. J. Obstet. Gynecol.1994; 171: 1506-1510.
3. Mashiach S, Bider D, Moran O, Goldenberg M, Ben-Rafael, Z. Adnexal torsion of hyperstimulated ovaries in pregnancies after gonadotropin therapy. Fertil Steril.1990; 53: 76-80.
4. Oelsner G, Bider D, Goldenberg M, Admon D and Mashiach, S. Long term follow-up of the twisted ischemic adnexa managed by detorsion. Fertil Steril. 1993; 60: 976-979.
5. Wagaman R and Williams R. S. Conservative therapy for adnexal torsion. A case report. J Reprod. Med. 1990; 35: 833-834.
6. McHutchinson L L, Koonings P P, Ballard C A. and d‘Ablaing G. Preservation of ovarian tissue in adnexal tissue with florescein. Am J. Obstet. Gynecol. 1993; 168: 1386-1388.
7. Sussman M S. and Bulkley G B. Oxygen-derived free radicals in reperfusion injury. Methods Enzymol. 1990; 186: 711-742.
8. Rangan U. And Bulkley G.B. Prospects for treatment for free radical-mediated tissue injury. Br. Med. Bull. 1993; 49: 700-718.
9. Das D.K. and Maulik N. Antioxidant effectiveness in ischemia-reperfusion tissue injury. Methods Enzymol. 1994; 233: 601-610.
10. Zimmerman B J and Granger D N. Mechanisms of reperfusion injury. Am. J. Med. Sci. 1994; 307: 284-292.
11. Yoshida S, Inoh S, Asano T, Sano K, Kubota M, Shimazaki H. And Ueta N. Effect of transient ischemia on free fatty acids and phospholipds in the gerbil brain. J. Neurosurg. 1980; 53: 323-331.
12. Jolly S.R, Kane W.J, Bailie M.B, Abrams G.D. and Lucchesi B.R. Canine myokardial reperfusion injury its reduction by the combined administration of superoxide dismutase and catalase. Circ. Res. 1984; 54: 227-285.
13. McCord, J.M. Oxygen-derived free radicalsin postischemic tissue injury. N. Eng. J. Med. 1985; 312: 159-163.
14. Fridovich I. Superoxide radical: an endogenous toxicant. Annu. Rev. Pharmacol. Toxicol. 1983; 23: 239-257.
15. Slater T F. Free radical mechanisms in tissue injury. Biochem. J. 1984; 222:1-15.
16. Gutteridge J.M.C. Lipid peroxsidasyon and antioxidants as biomarker of tissue damage. Clin. Chem. 1995; 41: 1819-1828.
17. Yoshida S, Abe K, Busto R, Watson B D, Kogure K, Ginsberg M D. Influence of transient ischemia on lipidsoluble antioxidants, free fatty acids and energy metabolites in rat brain. Brain Res. 1982; 245: 307-316.
18. Taflk›n Ö, Birincio¤lu M, Ayd›n A, Buhur A, Burak F, Y›lmaz and Wheeler, J.M. The effects of twisted ischaemic adnexa managed by detorsion on ovarian viability and histology: an ischaemi-reperfusion rodent model. Human Reprod. 1998; 13, 2823-27.
19. Nevin S, Üçler K and Alpaslan A. Ischaemia-reperfusion injury of rat ovary and the effects of vitamin C, mannitol and verapamil. Human Reproduction. 2002; 17(11): 2972-76.
20. Rodrigo R, Vinay J, Castillo R, Cereceda M, Asenio R, Zamorano J, Araya J, Castillo-Koch R, Espinosa J, Larrain E. Int J Cardiol. 2010; 138(3): 221-8.