Ugur Ercin

Gazi University, Engüri, Ankara, Turkey

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Publications (31)131.78 Total impact

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    ABSTRACT: This study aimed to assess the effect of intraoperative PEEP intervention on the healing of colonic anastomoses in rabbits. Thirty-two New Zealand type male rabbits were divided into two groups of sixteen animals each. Following ventilation with tracheostomy, colonic resection and anastomosis were performed in both groups. While 10 cm H2O PEEP level was applied in Group I (PEEP), Group II (ZEEP) was ventilated without PEEP throughout the surgery. Half of the both PEEP and ZEEP group animals were killed on the third postoperative day, while the remaining half on the seventh. Anastomotic bursting pressures, the tissue concentrations in hydroxyproline, and histological assessments were performed. Besides, intraoperative oxygen saturation and postoperative arterial blood gas parameters were also compared. On the first postoperative day, both arterial oxygen tension (PO2) and oxygen saturation (SO2) in the PEEP group were significantly higher than in the ZEEP group. On the seventh postoperative day, the bursting pressures of the anastomoses were significantly higher in the PEEP group, however the hydroxyproline content was significantly lower in the PEEP group than that in the ZEEP group. At day 7, PEEP group was significantly associated with increased neoangiogenesis compared with the ZEEP group. The anastomotic healing process is positively influenced by the intraoperative PEEP application.
    No preview · Article · Jul 2015 · International surgery
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    ABSTRACT: Inadequate healing and high anastomosis leak rates at rectal anastomosis may be due to lack of supportive serosal layer and technical difficulty of low anterior resections. Positive effects of sildenafil on wound healing were observed. The aim of this study was to simulate rectal anastomosis as a technical insufficient anastomosis and investigate the effects of sildenafil on anastomosis healing. Colonic anastomoses were carried out in 64 rats and randomized into four groups, CA-S, complete anastomoses without sildenafil (10mg/kg for 5 days); CA+S, complete anastomoses with sildenafil; IA-S, incomplete anastomoses without sildenafil; IA+S, incomplete anastomoses with sildenafil. Half of the rats in every group were sacrificed on post-operative day (POD) 3, half of them sacrificed on POD 7. Tissues from the anastomoses were used for functional, histochemical, biochemical investigations. Sildenafil treatment resulted in increased bursting pressures in IA+S on POD 7 (p=0.010). Collagen maturity was higher in IA+S on POD 3 and POD 7, CA+S on POD 7 (P=0.010; P=0.010; P<0.007). Collagen content was higher in IA+S on POD 7 (p<0.001). Glutathione, hydroxyproline levels were similar. Malondialdehyde levels were lower in IA+S on POD 3 (p<0.001). Epithelization score was higher in IA+S on POD 7 (p=0.007). Inflammation score was higher in CA-S group on POD 3 and POD 7 (p<0.001; p<0.001). Neutrophil score was lower in CA+S on POD 3 (P=0.005). An increase in collagen content, maturity, and epithelization, a decrease in neutrophil infiltration, oxidative stress and better mechanical strength were observed with the administration of sildenafil. Copyright © 2014. Published by Elsevier Ltd.
    No preview · Article · Dec 2014 · International Journal of Surgery (London, England)
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    ABSTRACT: Objective: The most commonly reported side effects of methylphenidate, which is generally used for attention deficit hyperactivity disorder, are loss of appetite, decrease of body weight and initial growth retardation. Ghrelin, which is dominantly released by the stomach, promotes feeding, decreases energy expenditure and locomotor activity, enhances weight gain and fat mass deposition and also effects gastrointestinal motility. Ghrelin may be related to the metabolic and anorexigenic effects of methylphenidate in children. The aim of this study was to investigate methylphenidate's effect on fasting serum active Ghrelin levels in prepubertal children with attention deficit hyperactivity disorder. We expected to find a difference between pre- and post-treatment ghrelin levels with 18 mg/day methylphenidate administered via an osmotic-controlled release oral delivery system in prepubertal boys. Methods: Thirty-three boys with attention deficit hyperactivity disorder between the ages of 6-12 were recruited for this investigation. In addition to Ghrelin levels, other laboratory findings, body mass index, body mass index percentiles, body weight-height measures and attention deficit-hyperactivity disorder symptom severity findings were analyzed before and after the 60 days of methylphenidate treatment. Results: We could not find a significant alteration in serum active Ghrelin levels with methylphenidate. Methylphenidate improved core inattention, hyperactivity and impulsivity symptoms of attention deficit hyperactivity disorder with no significant alteration in height, body weight and body mass index, without serious side effects. Conclusion: This is the first study which directly aims to determine methylphenidate's effect on serum active Ghrelin levels. Further research with higher methylphenidate doses and/or other stimulants such as atomoxetine and amphetamine should be done as Ghrelin is also associated with obesity, alcohol and drug addiction and reward system pathologies, which are also closely related to attention deficit hyperactivity disorder.
    No preview · Article · Jun 2014 · Bulletin of Clinical Psychopharmacology
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    ABSTRACT: Background: Radiation therapy is an essential therapeutic modality in the management of a wide variety of tumors. We aimed to investigate the short-term effects of pelvic irradiation on the healing of colon anastomoses and to determine the potential protective effects of β-glucan in this situation. Material and methods: Sixty Wistar albino rats were randomized into three experimental groups: a control group (n = 20), an irradiation (IR) group (n = 20), and an irradiation+β-glucan (IR+β-glucan) group (n = 20). Only segmental colonic resection and anastomosis were performed on the control group. The IR group underwent the same surgical procedure as the control group 5 days after pelvic irradiation. In the IR+β-glucan group, the same procedure was applied as in the IR group after β-glucan administration. The groups were subdivided into subgroups according to the date of euthanasia (third [n = 10] or seventh [n = 10] postoperative [PO] day), and anastomotic colonic segments were resected to evaluate bursting pressures and biochemical and histopathological parameters. Results: Bursting pressure values were significantly lower in the IR group (p < .001). Malondialdehyde (MDA) levels were significantly higher in the IR group, whereas β-glucan significantly decreased MDA levels on the third PO day (p < .001). Granulation tissue formation scores were significantly lower in the IR+β-glucan group compared with the control group and the IR group (p < .001). Conclusions: The results of this study indicate that irradiation has negative effects on the early healing of colon anastomoses. The administration of β-glucan ameliorates these unfavorable effects by altering bursting pressures and biochemical parameters.
    No preview · Article · Jun 2014 · Journal of Investigative Surgery
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    ABSTRACT: To investigate the correlation between advanced oxidation protein products (AOPP) levels and biochemical and histopathological findings in patients with nonalcoholic steatohepatitis (NASH). Sixty biopsy-proven NASH patients and 60 individuals with ultrasonographically healthy liver (the control group) were included in the study. AOPP levels were determined in all the participants and liver histopathological examination based on liver biopsy was performed in NASH patients. The NASH activity score (NAS), hepatosteatosis, liver inflammation and fibrosis were evaluated. Serum AOPP level was significantly higher in the NASH group than that in the control group (461.8 ± 201.9 μmol/L vs 191.7 ± 152.5 μmol/L, P < 0.001). The receiver operating characteristic (ROC) curve revealed a sensitivity of 73.3% and a specificity of 88.3% for the diagnosis of NASH with an AOPP cut-off value of 332 μmol/L (the area under ROC curve 0.88, 95% confidence interval 0.82-0.94, P < 0.01). AOPP levels were positively correlated with NAS (r = 0.27, P = 0.035), fibrosis (r = 0.27, P = 0.037) and inflammation (r = 0.34, P = 0.008), but not the grade of steatosis (r = 0.02, P = 0.83) or ballooning (r = 0.02, P = 0.55). AOPP levels are significantly higher in patients with NASH than in those with ultrasonographically healthy liver. AOPP levels are positively correlated with biochemical and histopathological findings (NAS, liver inflammation and fibrosis), indicating that AOPP may play a role in the development of liver fibrosis and inflammation and may predict liver histopathology in NASH.
    No preview · Article · Mar 2014 · Journal of Digestive Diseases
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    Full-text · Article · Oct 2013 · Journal of the American College of Cardiology
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    Full-text · Article · Oct 2013 · Journal of the American College of Cardiology
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    Full-text · Article · Oct 2013 · Journal of the American College of Cardiology
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    Full-text · Article · Oct 2013 · Journal of the American College of Cardiology
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    ABSTRACT: Abstract Purpose: In this study, we investigated the efficacy of systemic and intravitreal (IV) infliximab treatments and compared these 2 different treatment modalities in an experimental model of endotoxin-induced uveitis (EIU). Methods: Twenty-four white New Zealand rabbits were equally divided into 4 groups. Group 1 received IV injection of lipopolysaccharide (LPS), group 2 received IV injections of LPS and saline, group 3 received IV LPS and IV 2 mg/0.1 cc infliximab, and group 4 received IV LPS and 5 mg/kg intravenous infliximab. Inflammation was determined with objective and subjective tests. The subjective test was clinical determination of uveitis, the objective tests were determination of protein concentrations and tumor necrosis factor alpha (TNF-α) levels and histopathology. Results: Clinical examination score was lower in group 3 and group 4 (4±0.6 and 3.5±1.6, respectively) when compared with group 1 (P=0.02; P=0.04, respectively) and group 2. In group 3 and 4, the aqueous and vitreous protein and TNF-α concentration measured significantly lower than group 1 and 2. In histopathologic examination, there was no statistically significant difference between group 1, 2, and 3 (3.5±0.5, 3.6±0.5, 3.6±0.5, respectively). However, the lowest histopathologic inflammation was determined in group 4 (2.5±0.5) (compared with group 1 and group 3, respectively; P=0.03; P=0.014). Conclusion: In a rabbit model of experimental EIU, intravenous administration of infliximab was more effective than IV route in an acute period.
    No preview · Article · Oct 2013 · Journal of ocular pharmacology and therapeutics: the official journal of the Association for Ocular Pharmacology and Therapeutics
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    ABSTRACT: Pycnogenol(R) has excellent radical scavenging properties and enhances the production of antioxidative enzymes which contributes to the anti-inflammatory effect of the extract. Irradiation delivered to the abdominal region, typically results in severe damage to the intestinal mucosa. The effects of ionizing radiation are mediated by the formation of free radicals through radiolysis. Irradiation has local effects on tissues. These local effects of irradiation on the bowel are believed to involve a two-stage process which includes both short and long term components. In our study we aimed to investigate the short term effects of Pycnogenol(R) on the healing of colon anastomoses in irradiated bowel. Sixty male Wistar-Albino rats were used in this study. There were three groups: Group I, control group (n = 20); group II which received preoperative irradiation (n = 20); group III which received per oral Pycnogenol(R) before irradiation (n = 20). Only segmeter colonic resection and anastomosis was performed to the control group (Group I). The other groups (Group II, III) underwent surgery on the 5th day after pelvic irradiation. On postoperative days 3 and 7, half of the rats in each group were sacrificed and then relaparotomy was performed. There was no statistical difference between groups with respect to biochemical parameters. Bursting pressure was significantly higher in the Control and Group III compared with the Group II. In conclusion, the present study showed that preoperative irradiation effect negatively on colonic anastomoses in rats by means of mechanical parameters and administration of Pycnogenol(R) preoperatively ameliorates this unfavorable effect.
    Full-text · Article · Jun 2013 · International Journal of Surgery (London, England)
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    ABSTRACT: Background: The data about cardiovascular changes in patients with asymptomatic primary hyperparathyroidism (PHPT) are scarce. Aim: The aim of this study is to compare cardiac structure and functions in patients with asymptomatic PHPT and controls by using tissue Doppler echocardiography. Subjects and Methods: Thirty-eight patients with asymptomatic PHPT and 31 sex- and age matched with similar cardiac risk factors controls were evaluated. Results: There was no significant difference in ejection fraction (EF) between the patients and the controls [64±5.95 vs. 62±3.25 %; (p=0.094)]. Left ventricular mass index (LVMI) was significantly higher in the patients than the controls [105.96 (66.45-167.24) vs. 93.79 (64.25-139.25) g/m2; p=0.014]. There was significant correlation between LVMI and serum calcium (Ca) (r=0.240, p<0.005). Myocardial performance index (MPI) was significantly higher in the patients compared to controls [0.49 (0.35-0.60) vs. 0.39 (0.33-0.62); p<0.001]. There was positive correlation between the MPI and serum Ca levels (r=0.505, p<0.001), PTH levels (r=0.464, p<0.001) and LVMI (r=0.270, p<0.005). When the normotensive patients and controls were evaluated, the difference between the groups remained statistically significance considering LVMI and MPI [109 (66.45-167.24) g/m2 vs 94.17 (64.25-75.10) g/m2 p=0.03; and 0.49 (0.35-0.60) vs 0.39 (0.33-0.62) p<0.01 respectively]. There were significant correlations between MPI and Ca (r=0.566, p<0.001), PTH (r=0.472, p<0.001). Conclusions: Our study results showed that cardiac morphology and diastolic functions are altered in the patients with asymptomatic PHPT. High serum PTH and Ca levels may have an impact on these cardiovascular changes. Whether these subtle cardiovascular changes would affect cardiac systolic functions and mortality in patients with asymptomatic PHPT should be investigated in further prospective studies.
    No preview · Article · May 2013 · Journal of endocrinological investigation
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    ABSTRACT: Obstructive jaundice is one of the most important surgical causes of childhood jaundices. The aim of this study is to investigate effects of ginger (Gingiber officinalis) extracts on liver damage in experimental obstructive jaundice produced by main bile duct ligation. Forty two Wistar-albino rats were randomly allocated into 7 groups (n = 6). Nothing was performed in the control (C) group. Only laparatomy was performed in the sham (Sh) group. The ginger 1 and 2 (G1 and G2) groups received only 100 and 200 mg/kg/day doses of ginger extract for 1 week orally. In study group, common bile duct ligation was done. In treatment 1 and 2 (T1 and T2) groups common bile duct ligation was followed by administration of 100 and 200 mg/kg/day doses of ginger extract for 1 week orally from the third post operative day, respectively. Blood samples and liver were harvested in order to evaluate the serum aspartate aminotransferase (AST), alanine amino transferase (ALT), gama glutamyltransferase (GGT), total bilirubin (bil), superoxide dismutase (SOD), glutathione (GSH), malondialdehyde (MDA) and liver tissue SOD, GSH, MDA levels and liver apoptosis. Results were analyzed by Mann-Whitney U test statistically. Ginger administration did not result in any differences of serum or tissue levels of the studied parameters and liver apoptosis between the groups statistically (except AST levels in group T2). Tissue GSH and serum SOD levels were only mildly increased in groups receiving ginger alone. There is no evidence for protective, inhibitive and decreasing effects of ginger extract on liver injury in experimental obstructive jaundice with these findings.
    No preview · Article · Feb 2013 · Acta chirurgica Belgica
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    ABSTRACT: Background: Laparoscopic cholecystectomy (LC) still leads to significant postoperative nausea and vomiting (PONV) and pain. Our aim was to evaluate the efficacy of dexamethasone or pheniramine hydrogen maleate, either alone or combined, in reducing the stress response and symptoms after LC. Methods: Patients were randomly assigned to 1 of 4 groups, each consisting of 20 patients: control, dexamethasone (8 mg/2 mL), pheniramine hydrogen maleate (45.5 mg/2 mL), and the combined group. The drugs were given before anesthesia induction. Results: C-reactive protein levels (CRP) and visual analog scale (VAS) scores were significantly less in the dexamethasone (P = .003) and combined groups (P < .001). Both dexamethasone (P < .001) and pheniramine hydrogen maleate (P = .005) significantly reduced PONV. Conclusions: Dexamethasone significantly reduced postoperative pain and the systemic acute-phase response, whereas these effects were only partially attained with pheniramine hydrogen maleate. Both dexamethasone and pheniramine hydrogen maleate significantly reduced PONV. An additive effect seemed to occur if these drugs were used in combination.
    No preview · Article · Aug 2012 · American journal of surgery
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    ABSTRACT: Toxoplasma gondii is a very common obligate single-cell protozoan parasite which induces overproduction of interferon (IFN)-gamma and of other proinflammatory cytokines. Although immunomodulatory role of IFN-gamma favors tryptophan (Trp) degradation via indoleamine-2,3-dioxygenase (IDO) activity and is related with nitric oxide (NO) synthesis, the mechanism of antitoxoplasma activity is complex. In order to characterize the Trp degradation pattern during the acute T. gondii infection, serum Trp, kynurenine (Kyn), and urinary biopterin levels of mice were measured. The possible oxidative status was evaluated by the liver, spleen, brain, and serum malondialdehyde (MDA) and NO levels. Increased free radical toxicity may cause elevation in tissue MDA in T. gondii-infected mice, while unchanged serum MDA might indicate the increased oxidative stress due to T. gondii infection restricted to intracellular area. Elevated serum NO most probably might be due to the formation of reactive nitrogen radicals. The Kyn/Trp ratio was higher in T. gondii-infected mice compared to healthy animals (p < 0.05); however, it was not correlated with urinary biopterin. These results suggested that Trp degradation might be promoted by a pathway other than IDO during T. gondii infection and the reduction of Trp concentration favors the local immunosuppression and systemic tolerance.
    Full-text · Article · Jul 2012 · Parasitology Research
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    ABSTRACT: Fas/Fas ligand system contributes to the programmed cell death induced by myocardial ischemia. We investigated whether serum soluble Fas ligand (sFasL) level is independently related with the severity and extent of angiographically assessed coronary artery disease (CAD). We included 169 patients in this study. Two groups were formed based on the existence of a lesion on coronary angiography. First group included patients with normal coronary arteries (NCA; = 53). Patients with atherosclerotic lesions were included in the second group ( = 116). We used the coronary vessel score (the number of the coronary arteries with a lesion leading to ≥ 50% luminal obstruction) and the Azar score to determine the extent and the severity of CAD. Standard enzyme-linked immunosorbent assay kits were used to measure serum sFasL levels. The serum sFasL level was higher in patients with CAD than in patients with NCA (0.52 ± 0.23 mU/mL vs. 0.45 ± 0.18 mU/mL, = 0.023). The sFasL level correlated with Azar score ( = 0.231, = 0.003) and with coronary vessel score ( = 0.269, < 0.001). In the multivariate analysis, we found that age (beta: 0.188, = 0.008), gender (beta: 0.317, < 0.001), diabetes mellitus (DM; beta: 0.195, = 0.008), and sFasL level (beta: 0.209, = 0.003) were independently related with Azar score. When we used coronary vessel score as the dependent variable, we found that age ( = 0.020), gender ( < 0.001), DM ( = 0.006), and sFasL level ( = 0.001) were independent predictors. Serum sFasL level is associated with angiographically more severe CAD. Our findings suggest that sFasL level may be a biochemical surrogate of severe coronary atherosclerosis.
    Full-text · Article · Mar 2012 · International Journal of Angiology
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    ABSTRACT: Alterations of thyroid hormones in colorectal surgery were previously studied. The aim of the present study was to determine the effects of triiodothyronine (T3) supplementation on anastomotic healing after segmental colectomy. Thirty male Wistar albino rats were divided into sham (n = 6), control (n = 12), and experimental (n = 12) groups. Sham group rats were immediately sacrificed after segmental colonic resection. Control and experimental group rats underwent resection and anastomosis. Experimental group rats received a single dose of T3 (400 μg/100 g) in postoperative day 1. Half of both control and experimental group rats were sacrificed on postoperative d 3 and the remaining half were sacrificed on postoperative d 7. Hydroxiproline (HP), myeloperoxidase (MPO), thyroid stimulating hormone (TSH), free T3 (FT3), and free thyroxine (FT4) levels, bursting pressure, and histologic analyses of the anastomotic segments were compared. FT3 levels significantly decreased in control groups rats compared with the sham group (P < 0.01). However, T3 hormone given rats had no decline in FT3 levels. Anastomotic bursting pressure was significantly higher in the experimental group rats on postoperative d 7 (P = 0.015). Histopathologic analyses of the anastomotic segments determined significantly more severe edema and necrosis in control group rats (P < 0.05). Collagen deposition in the anastomotic tissue was significantly higher in experimental group rats on postoperative d 7 (P = 0.015). Anastomosis after colon resection is associated with decreased FT3 level. T3 supplementation ameliorates the reduction in FT3 and seems to provide constructive therapeutic effects on anastomotic healing.
    No preview · Article · Dec 2011 · Journal of Surgical Research
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    ABSTRACT: Erythropoietin has been shown to induce neovascularization and protect against ischemic vascular injury. We investigated whether a higher serum erythropoietin (EPO) level is related to better coronary collateral vessel grade. Ninety-nine patients with stable angina pectoris who have at least 1 coronary stenosis of equal to or greater than 70% at coronary angiography were prospectively enrolled. Serum EPO and vascular endothelial growth factor (VEGF) levels were studied. Coronary collateral degree was graded according to the Rentrop method. Patients with grade 2-3 collateral degree were included in the good collateral group and formed Group I. The patients with grade 0-1 collateral degree were included in the poor collateral group and formed Group II. The serum EPO level was significantly higher in the good collateral group (17.3 ± 9.3 mU/mL vs 11.7 ± 5.0 mU/mL; P < 0.001). There was also a positive correlation between serum EPO level and Rentrop score (r = 0.39; P < 0.001). In multivariate analysis, serum EPO level (odds ratio [OR] 1.336; 95% confidence interval [CI], 1.120-1.593; P = 0.001), oxygen saturation (OR 0.638; 95% CI, 0.422-0.963; P = 0.033) and presence of chronic total occlusion (CTO) (OR 26.7; 95% CI, 3.874-184.6; P = 0.001) were independently related to well-developed coronary collaterals. Higher serum EPO level is related to better coronary collateral development. Erythropoietin may have a positive effect on the development of collaterals and may provide a new agent for the treatment strategies to enhance coronary collateral vessel development.
    Full-text · Article · Jul 2011 · The Canadian journal of cardiology
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    ABSTRACT: We investigated whether serum monocyte chemoattractant protein-1 (MCP-1) level predicted coronary atherosclerotic burden in patients with stable coronary artery disease and its relationship with coronary collateral grade. We prospectively included 196 patients (103 males, 93 females; mean age 59 ± 11 years) who underwent coronary angiography for stable angina pectoris. Serum MCP-1 levels were determined before coronary angiography. Coronary atherosclerotic burden was measured by the Gensini score, and coronary collateral development was assessed by the Rentrop classification. The patients were divided into four groups: those with normal coronary arteries (NCA); those with coronary lesions of <70% luminal obstruction; and those with coronary lesions of ≥ 70% luminal obstruction accompanied by a good or poor collateral grade. The mean serum MCP-1 level was higher in patients with coronary lesions compared to patients with NCA (129 ± 130 vs. 102 ± 55 pg/ml, p=0.048). Although there were no significant differences in the MCP-1 levels of patients with NCA, with <70% luminal obstruction, and those with a significant luminal obstruction and a poor collateral grade, patients with significant luminal obstruction and a good collateral grade had significantly higher MCP-1 levels compared to the remaining groups (p=0.016). However, in multivariate regression analysis, MCP-1 level was not independently associated with the Gensini score. Our findings suggest that serum MCP-1 level is higher in patients with coronary atherosclerosis, without a significant and independent association with coronary atherosclerotic burden. Significantly increased serum MCP-1 levels in patients with a good collateral grade may be an interesting issue of investigation.
    Full-text · Article · Jun 2011 · Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir
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    ABSTRACT: Although assisted reproductive techniques have made most causes of both male and female infertility treatable, uterine factor infertility is not able to therapy. Therefore, transplantation of the uterus has been suggested as a future possible cure. Organ preservation solutions seek to reduce reperfusion injury. Since iloprost is an antioxidant with cytoprotective properties, we investigated its potential positive effects in histidine-tryptophan-ketoglutarate (HTK) solution after 4 or 24 h cold storage period of the rat uterus. We divided 24 female Wistar-albino rats into four groups: Group 1 had the uterus tissue stored in HTK solution at 4 °C for 4h. Group 2, the tissue was stored in HTK solution combined with iloprost (10(-8) M) for 4h at 4 °C. The same procedures were repeated for 24 h for Groups 3 and 4 respectively. Tissue levels of malondialdehyde (MDA) and nitric oxide (NO), as indicators of oxidative stress were determined with histopathological evaluations. MDA and NO levels were compared between the group 1 vs 3; and 2 vs 4. No significant difference was observed between the groups. Cold storage for 24 h produced alterations in histological appearances that were mitigated by the addition of iloprost to HTK solution. In conclusion, addition of iloprost to HTK solution reversed the histological alterations after 24h-cold storage of the rat uterus.
    No preview · Article · Jun 2011 · Transplantation Proceedings