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Objective: Tadalafil is a selective phosphodiesterase type-5 inhibitor with a long half-life. It has a dual function in ischaemic and re-perfused tissues, i.e. vasodilatation and anti-oxidant effects. These features of tadalafil distinguish it from other anti-oxidants. We investigated the dual effect of tadalafil on ischaemia and reperfusion injury in the rat ovary. Material and Methods: We established five study groups. Group 1 (n=6): sham-operated; group 2 (n=6): torsion; group 3 (n=6): torsion and Tadalafil; group 4 (n=6): torsion/de-torsion; and group 5 (n=6): torsion/de-torsion and tadalafil. Ovarian samples were harvested from animals and evaluated in terms of histopathologic changes, tissue malondialdehyde (MDA) concentrations, lactate production, and plasma cyclic guanosine monophosphate (cGMP). Results: Follicular degeneration, oedema, haemorrhage, and inflammatory cells were significantly decreased in group 5 in comparison with group 4. Group 2 and group 3 were compared in terms of vascular congestion and haemorrhage; these parameters were significantly decreased in group 3. In addition, significantly decreased MDA and lactate concentrations were observed in group 5 in comparison with group 4. Increased cGMP concentrations were detected in group 3 and group 5. Conclusion: We conclude that tadalafil might be useful in protecting the ovary against ischaemia and reperfusion injury. In the evet of ovarian torsion, it will provide a greater therapeutic effect than only performing de-torsion of the ovary or using other anti-oxidant agents.

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OBJECTIVES: To determine the effects of tamoxifen and hormone replacement therapy in order to assess their role in depressive behavior: MATERIAL AND METHODS: Different protocols of hormone replacement therapies were administered to surgically ovariectomized rats. Intact rats were used for tamoxifen experiments. Properly assigned control groups were used and cognitive processes were studied on animal models of surgical menopause using the Porsolt forced swim test and locomotor activity experiments. RESULTS: In the tamoxifen experiments, an interaction between treatment and days did not reach statistical significance, but indicated a trend in this direction [F(1,26)=3.557, p = 0.071]. The number of repeated movements significantly decreased after the Porsolt test (F(1,44) = 8.483, P < 0.006) in the hormone replacement experiments. In the tamoxifen experiments, the number of repeated movements significantly decreased after the Porsolt test (F(1,26) = 74.410, P < 0.001). CONCLUSIONS: While sequential hormone replacement is found to be protective against depression, tamoxifen seems to augment behavioral despair

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Placenta percreta is one of the life-threatening conditions in modern obstetrics. The rising caesarean section rate means rising placenta percreta rate. Treatment strategies range from a caesarean hysterectomy to leaving the placenta in situ with or without internal iliac artery ligation/uterine artery embolisation and/or methotrexate therapy. We describe a case of placenta previa percreta which we managed successfully with conservative modalities.

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This study investigates the effects of raloxifen on cognition and depression in an animal model.

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OBJECTIVE: To investigate possible detrimental effects on bone tissue induced by ovariectomy and tamoxifen (TMX) using bone densitometry and histomorphologic analysis. STUDY DESIGN: Twenty-four rats were allocated into 4 groups: group 1, intact normal rats (n = 6); group 2, ovariectomized rats (n = 6); group 3, normal female rats that received 1 mg/kg/day TMX dissolved in dimethyl sulfoxide (DMSO) for 2 months (n = 6); group 4, normal female rats that received DMSO for the same duration and with a volume equal to that of TMX (n = 6). Results of histomorphometric analysis for trabecular thickness, number of osteoblasts and osteoclasts, trabecular number, and area and cortical thickness were compared. RESULTS: No significant effects of ovariectomy on femoral or lumbar bone mineral density (BMD) were found. In the TMX group, the value of femoral BMD increased significantly compared to control group cellular and pathologic changes. TMX caused significant decrease in osteoblasts compared to the control group. CONCLUSION: TMX has a positive effect on inorganic bone tissue, but a negative effect on number of osteoblasts and osteoclasts. Future studies investigating estrogenic and antiestrogenic effects of TMX should include cellular parameters related to proliferation using histopathologic and histomorphometric analyses.

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OBJECTIVES: The aim of this study is to determine if the depression in perimenopausal women is symptomatologically different than depression in premenopausal women, and if these depressive women are under more risk for depression when factors like premenstrual dysphoric syndrome, socio-economical status, vasomotor symptoms and familial inclination to depression are considered. METHODS: Fifty major depressive women with hormonally established perimenopause (follicle stimulating hormone (FSH) levels over 20IU/l and estrogen levels lower than 40IU/l) and who were not taking any psychotropic or hormone replacement therapy, were enrolled in the study. In order to investigate the characteristic clinical features of perimenopausal depression, a drug free control group consisting of 48 pre-perimenopausal women with a diagnosis of major depression was formed. Another control group was formed with 53 non-depressive perimenopausal women in order to investigate the risk factors of perimenopausal depression. RESULTS: The depressive and non-depressive groups did not differ from each other according to level of education, marital and economical status and comorbid physical problems. No major symptomatological difference between perimenopausal depression and pre-perimenopausal depression was found. No correlation was found between the severity of vasomotor symptoms and severity of depression. CONCLUSIONS: Findings of our study suggest that vasomotor symptoms and socio-economical status do not predict the severity and existence of perimenopausal depression. Episodes of major depression are not necessarily the normal result of such vasomotor symptoms. Therefore, the evaluation and management of perimenopausal depression should be carried out as carefully as is done in episodes of depression seen in the rest of women's life span.

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OBJECTIVES: Leptin has a significant role in body weight regulation and energy balance. We examined the effect of tibolone on the body weight and serum leptin levels in postmenopausal women. STUDY DESIGN: Twenty women (aged 43-60 years) participated in this prospective study. All women in this study protocol received 2.5 mg/day of tibolone. Absolute and body mass index (BMI)-corrected serum leptin concentrations and BMI values were measured at baseline, after 3 months, and after 6 months of the tibolone therapy. RESULTS: Tibolone did not affect absolute and BMI-corrected serum leptin levels, and BMI values during the treatment. A significant linear correlation between BMI values and serum leptin levels was observed (p<0.05, r=0.67). CONCLUSIONS: Tibolone seems not to affect serum leptin levels, body weight and BMI values of postmenopausal women. There is a significant correlation between serum leptin levels and BMI values.

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OBJECTIVE: To evaluate the effects of two barriers, one solution, and two pharmacologic agents, in single or in combined use, for preventing postsurgical adhesion formation in the rat model. DESIGN: A randomized, prospective study to evaluate the ability of leuprolide acetate, oxidized regenerated cellulose, medroxyprogesterone acetate, sodium hyaluronate, sodium hyaluronate/carboxymethyl cellulose, in single or in combined use, for preventing adhesion formation in a rat model. ANIMAL(S): Wistar female rats. SETTING: University animal laboratory. INTERVENTION(S): Intramuscular injection of pharmacologic agents before surgery and intraperitoneal application of barriers and solution at the end of surgery. MAIN OUTCOME MEASURE(S): Two weeks after surgery, a second laparotomy was performed and the extent of adhesion formation was determined. RESULT(S): All the treatment groups had fewer, less severe adhesions when compared with controls. The combination of medroxyprogesterone acetate and oxidized regenerated cellulose did enhance the adhesion-reducing capacity of oxidized regenerated cellulose. The performance of sodium hyaluronate solution for adhesion prevention was statistically significant, when compared with oxidized regenerated cellulose alone, or sodium hyaluronate used with carboxymethyl cellulose film. CONCLUSION(S): Pharmacologic agents, barriers, or solutions result in significant reduction of postsurgical adhesions. The sodium hyaluronate solution alone and medroxyprogesterone acetate treatment alone had the least adhesion prevention scores. However, neither monotherapy nor combined therapy proved to be significantly more beneficial.

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