Metabolic feature of ischemia/reperfusion caused by ovarian torsion/detorsion
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StatusThe thesis was presented on the 17 February, 2021Approved by NCAA on the 25 June, 2021 Abstract – 1.55 Mb / in romanian – 1.34 Mb / in englishThesisCZU 618.11-008.9:618.11-007.59-005.4-092.9(043.2)
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Keywords
experimental ovarian torsion, ischemia/reperfusion injury, controlled reperfusion, oxidative stress, reactive oxygen species, antioxidant systeSummary
The aim of the research was to study the metabolic changes caused by ischemia/reperfusion in experimental ovarian torsion/detorsion to highlight specific diagnostic indices of ovarian tissue lesions and to argue treatment strategies that would reduce reperfusion lesions.
Research objectives: 1. Ascertainment of metabolic features of lesions caused by ischemia/reperfusion in the ovaries in experimental ovarian torsion/detorsion. 2. Study of blood biochemical expression of ischemia/reperfusion lesions caused by ovarian torsion/detorsion. 3. Assessment of correlations of blood and tissue biochemical changes in experimental ovarian torsion/detorsion. 4. Evaluation of the controlled reperfusion method on tissue and blood biochemical indices in experimental ovarian torsion/detorsion.
Scientific research methodology A preclinical, experimental study was performed, respecting all scientific rigors and ethical principles of institutional, national and international research. The study was performed on white laboratory rats (Rattus albicans), modeling the ovarian torsion, with subsequent detorsion/reperfusion, also applying the controlled reperfusion technique (on-off model). To achieve the objectives of the thesis, the homogenates of ovarian tissue and blood serum were investigated to assess the metabolic indices of ischemia, oxidative stress and antioxidant system.
The Research Ethics Committee positive decision was obtained on 08.02.2016, approval number 27, at number 24.
The novelty and scientific originality of the obtained results The research revealed important data including metabolic indices that ensure the functioning of ovarian cells in conditions of induced ischemia. The biochemical changes that take place in the experimental ovarian torsion/detorsion, the depth of the disorders and their blood reflection were appreciated. The indices of ischemic damage, oxidative stress and antioxidant protection were measured both at the tissue and blood level, with the determination of the presence of blood-tissue correlations of the evaluated parameters.
Hypotheses have been made about the conditions that favor the resistance of the ovaries to ischemia, the connection between tissue and blood metabolic changes. A spectrum of laboratory indices from the blood serum with diagnostic value in OT was identified, but also for monitoring after detorsion. Certain therapeutic interventions have been proposed, for a more effective result of the surgical treatment of OT with preservation of the ovaries.
The study deepened the knowledge regarding ovarian metabolism in ovarian torsion after simple and controlled reperfusion.
The theoretical significance of the work. Our research revealed important data regarding ovarian metabolism in physiological conditions and in ischemia/reperfusion syndrome within ovarian torsion, with the assessment of the effects of classical and controlled reperfusion.
The applicative value of the research. In our study, laboratory investigation methods were applied that ensured the obtaining of high precision results that allowed us to argue the possibility of using laboratory indices (lactate, ischemia modified albumin, lactate dehydrogenasepyruvate) in the differential diagnosis of ovarian torsion and in monitoring of treatment outcomes (malondialdehyde, advanced oxidation protein products, advanced glycation end products). The comparative evaluation of metabolic changes in ovarian tissue and blood serum after classical and on-off detorsion highlighted the advantage of controlled reperfusion in preventing the worsening
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of tissue lesions induced by oxidative stress in the surgical treatment of OT with preservation of ovaries, the application of which is easy and no additional costs required.
Implementation in practice – in the university and postgraduate teaching process at the Department of Biochemistry and Clinical Biochemistry of ”Nicolae Testemițanu” State University of Medicine and Pharmacy.
Approval of scientific results. The research results were presented, analyzed, discussed and approved at several national and international scientific forums: 6th International Medical Congress for Students and Young Doctors MedEspera, SUMPh “Nicolae Testemiţanu”, Chişinău, Moldova, May 12-14, 2016; IMU Annual Scientific Conference of young specialists „Performanţe şi perspective în urgenţe medico-chirurgicale”, Institute of Emergency Medicine, Chişinău, Moldova, May 20, 2016; Zilele Universității și Conferinţa ştiinţifică anuală consacrată aniversării a 90-a de la naşterea ilustrului medic şi savant Nicolae Testemiţanu, SUMPh “Nicolae Testemiţanu”, Chișinău, Moldova, October 18-20, 2017; Annual Young Medical Scientists' Conference 2017, Bogomolets National Medical University, Kiev, Ukraine, October 27-29, 2017; IBC – SOFIA 2017, 2nd INTERNATIONAL BIOMEDICAL CONGRESS of SOFIA 2017, Medical University – Sofia, Bulgaria, November 17-19, 2017; Conference „Biological markers in fundamental and applied biology. From theory to practice”, European Scientific Center "Biomarker", Brno, Czech Republic, January 10, 2018; Conference „Modern technologies of diagnostics and monitoring of therapy in experimental, clinical medicine and pharmacy”, European Scientific Center "Biomarker", Brno, Czech Republic, January 15, 2018; Scientific and practical conference „Theoretical and practical aspects of the use of biological markers in fundamental and applied medicine and biology”, European Scientific Center "Biomarker", Prague, Czech Republic, March 27-29, 2018 (was awarded a grant for publication of the results: https://escbm.org/page/view/grants); 7th International Medical Congress for Students and Young Doctors MedEspera, SUMPh “Nicolae Testemiţanu”, Chişinău, Moldova, May 3-5, 2018; Zilele Universității și Conferinţa ştiinţifică anuală a cadrelor științifico-didactice, doctoranzilor, masteranzilor, rezidenților și studenților, SUMPh “Nicolae Testemiţanu”, Chișinău, Moldova, October 18, 2018 and October 17, 2019; VI Bukovinian International Medical Congress, BIMCO 2019, Bukovinian State Medical University, Chernivtsi, Ukraine, April 2-5, 2019; VII Bukovinian International Medical Congress, BIMCO 2020, Bukovinian State Medical University, Chernivtsi, Ukraine, April 7-10, 2020.
Publications related to doctoral thesis. 19 scientific papers have been published, including 7 articles, of which 2 in journals from international databases (SCOPUS, IFCiteScore2019: 0,6 and Web of Science, IFISI: 0,8), 3 articles in journals from the National Register of profile journals, B category, including 1 article in Moldovan Journal of Health Sciences (Revista de Științe ale Sănătății din Moldova), 2 articles in international collections and 12 theses in the proceedings of national and international scientific conferences and congresses.
The structure of the thesis. 143 pages which include: list of abbreviations, list of figures, list of tables, introduction, 3 chapters, general conclusions, practical recommendations, bibliography, information regarding the valorization of research results, 3 annexes, declaration on accountability.
Keywords: experimental ovarian torsion, ischemia/reperfusion injury, controlled reperfusion, oxidative stress, reactive oxygen species, antioxidant system
Oficial Reviewers
- Valentin Gudumac
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova - Mihai Popovici
doctor habilitat, professor, Medical-Sanitary Public Institution Institute of Cardiology - Veaceslav Moşin
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Council's Members
- Leonid Lîsîi, president
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova - Olga Tagadiuc, member
doctor habilitat, professor - Ana Mişina, member
doctor habilitat, associate professor (docent) - Silvia Stratulat, member
doctor, associate professor (docent)
Theses
