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    Antioxidant and antiapoptotic effects of erdosteine in a rat model of ovarian ischemia-reperfusion injury
    (Mashhad Univ Med Sciences, 2017) Ugurel, Vedat; Cicek, Ahmet Cagatay; Cemek, Mustafa; Demirtas, Selim; Kocaman, A. Tuba; Karaca, Turan
    Objective(s): To evaluate the protective effect of erdosteine, an antiapoptotic and antioxidant agent, on torsion-detorsion evoked histopathological changes in experimental ovarian ischemia-reperfusion (IR) injury. Materials and Methods: Eighteen female Wistar albino rats were used in control, IR, and IR+Edosteine (IR-E) groups, (n=6 in each). The IR-E group received the erdosteine for seven days before the induction of torsion/retorsion, (10 mg/kg/days). The IR and IR-E groups were exposed to right unilateral adnexal torsion for 3 hr. Three hours later, re-laparotomy was performed, and the right ovaries were surgically excised. Oxidant and antioxidants levels were determined in serum. The ovarian tissue samples were received and fixed with 10% neutral buffered formalin. The sections were stained with H&E, anti-PCNA, and TUNEL. Results: The IR group were showed severe acute inflammation, polynuclear leukocytes and macrophages, stromal oedema and haemorrhage. Treatment with erdosteine in rats significantly retained degenerative changes in the ovary PCNA (+) cell numbers were significantly decreased in the IR and IR-E groups unlike the control group. However, its numbers were significantly increased in the IR-E group unlike the IR group. TUNEL (+) cell numbers were significantly increased in the IR group unlike the control and the IR-E groups. In erdosteine treated group, TUNEL (+) cells were detected significantly less than the IR group (P<0.05). Conclusion: In conclusion, erdosteine maybe a protective agent for ovarian damage and decreasing lipid peroxidation products and leukocytes aggregation after adnexal torsion in animals.
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    The attitudes of fertile and infertile women to Oocyte donation in a Muslim and Secular population
    (Professional Medical Publications, 2017) Aslan, Mehmet Musa; Ugurel, Vedat; Elter, Koray
    Objective: To determine general attitudes of fertile and infertile women to oocyte donation in a Muslim and secular population. Methods: The participants consisted of fertile women (n=133) who had at least one healthy living child spontaneously conceived without any fertility treatment and infertile women (n=133) who were diagnosed with primary infertility. Both groups were evaluated with charts comprised of 34 questions addressing demographic characteristics and the social aspects of oocyte and sperm donation. Results: Although the age of fertile women was significantly greater than infertile women, there was no significant difference in terms of duration of marriage, education level, or employment status between the two groups. Most of the women in each group reported that they did not have enough knowledge about oocyte donation to make a decision. Only 12% of fertile women and 18% of infertile women declared that they would have oocytes from another woman if they did not have or could not have a child (p=0.004). Only 9.0% of fertile women and 18.8% of infertile women declared that they would donate oocytes to anyone who is infertile (p=0.021). Conclusion: Despite improvement in health care, most fertile and infertile women are still against oocyte donation. This situation may be related to the conservative leanings of Turkish society in recent decades.
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    A Case of Maternal Spina Bifida Associated with Tethered Spinal Cord and Mode of Delivery
    (Gazi Univ, Fac Med, 2012) Ugurel, Vedat; Tuncel, Sedat; Varol, Fusun
    Tethered spinal cord syndrome (TCS) or occult spinal dysraphism sequence refers to a group of neurological disorders related to malformations of the spinal cord. Spinal lipomas and cutaneous stigmata are the most common manifestations of the occult spinal dysraphic lesions. The spinal cord normally hangs loose in the spinal canal, free to move up and down with growth, bending and stretching, while a tethered cord is held taut at the end. A 41 year-old 35 weeks and 4 days pregnant woman with a lumbosacral giant lipoma associated with spina bifida and tethered cord syndrome was admitted to our clinic, an uneventful vaginal birth was achieved, and this rare case is hereby presented with MRI findings.
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    Evaluation of pregnancy rates in infertile women after application of ovulation induction and intrauterine insemination
    (Cukurova Univ, Fac Medicine, 2020) Okten, Sabri Berkem; Dolgun, Zehra Nihal; Ugurel, Vedat; Elter, Koray
    Purpose: The aim of this studywas to investigate the effects of these factors on pregnancy rates in infertile patients following ovulation induction and intrauterine insemination. Materials and Methods: The study was performed retrospectively that investigated examination reports and laboratory results of 201 infertile patients with unexplained infertility, male factor and anovulation. Women were subdivided into two groups according to the ovary-stimulating agent used as gonadotropin or clomiphene citrate. A semen sample was obtained from all men participants. Results: There were 239 cycles of unexplained infertility (77.9%), 39 cycles in ovulatory dysfunction (12.7%) and 29 cycles in male factor (9.4%) groups. The clinical pregnancy rates per cycle according to infertility type were found as 18.4% (n:44) for unexplained infertility, 17.9% (n:7) for ovulatory dysfunction and 13.8% (n:4) for malefactor. In regression analyses, follicle (diameter>10mm) count on the day of hCG administration and inseminated total motile sperm count (ITMSC) were independently affected pregnancy rate. ITMSC area value under the curve (0.63) was significantly different from 0.5. Conclusion: Follicle count on the day of hCG administration and ITMSC independently affect the pregnancy rate. Additionally, the intrauterine insemination method should be attempted in appropriate cases that have an acceptable successful pregnancy rate.
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    Low Levels of Protein Z Are Associated With HELLP Syndrome and its Severity
    (Sage Publications Inc, 2011) Kaygusuz, Isik; Firatli-Tuglular, Tulin; Toptas, Tayfur; Ugurel, Vedat; Demir, Muzaffer
    Protein Z (PZ) was found to be associated with pregnancy complications. There are no data implying an association between hemolysis (H), elevated liver enzymes (EL), and low platelet counts (LP) (HELLP) syndrome and changes in plasma levels of PZ. The aim of this study is to investigate whether HELLP syndrome is associated with plasma concentrations of PZ. Protein Z levels in 29 women with HELLP syndrome were compared with 29 healthy, nulliparous and 25 normal pregnant women. The median PZ levels in patients with HELLP syndrome were found to be significantly lower than those of pregnant women. No significant difference was found between HELLP and healthy groups. Protein Z levels correlated with platelet counts, lactate dehydrogenase (LDH), and aspartate aminotransferase (AST) levels in patients with HELLP syndrome. Median PZ level was higher in partial HELLP than in complete HELLP. We calculated 1330 ng/mL as a cutoff value for PZ level to discriminate HELLP syndrome from normal pregnancy. Low PZ levels are associated with the pathobiology of HELLP syndrome.
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    A Rare Case of Rectovaginal Fistula Following Consensual Vaginal Intercourse
    (Wiley-Blackwell, 2014) Ugurel, Vedat; Ozer, Dilek Pinar; Varol, Fusun
    IntroductionPostcoital nonobstetric vaginal lacerations due to consensual sexual act are generally minute mucosal tears. In some cases, the vaginal mucosa is lacerated deeper and the bleeding may require suturing of opened vessel ends or even transfusion. AimThe aim of this case report is to present a rare case of acute fistula formation by penile penetration through the full thickness of the rectovaginal wall after consensual vaginal intercourse and to its management in emergency settings. MethodsWe report a rare case of isolated rectovaginal laceration sparing anal sphincters and perineum in a 24-year-old woman following her second consensual vaginal intercourse with her new partner. Speculum examination demonstrated a 4cm laceration on the left posterior vaginal wall forming a fistula between the rectum and vagina, 2cm above the hymenal ring and not extending to the posterior fornix or perineum. Three layer suturing of rectal, vaginal mucosa, and rectovaginal septum was enough to treat the acute fistula in this case. ResultsAfter 2 months follow-up, we observed the complete healing of the rectovaginal laceration with no fistula formation and the patient resumed her sexual activity. Long term follow-up of patients is necessary to observe complete healing and to ensure the absence of a chronic fistula formation. ConclusionSimple suturing of rectal and vaginal mucosa, appropriate antiseptic precautions, and antibiotic coverage are enough to treat acutely formed low rectovaginal fistulas resulting from coitus. Decision to form colostomy and diversion of feces in the repair of such injuries should be taken cautiously. Uurel V, ozer DP, and Varol F. A rare case of rectovaginal fistula following consensual vaginal intercourse. J Sex Med 2014;11:1345-1348.