Analysis of the factors determining the type of surgical procedure in mature cystic teratomas

Objectives: It was aimed to evaluate which factors determine the surgical procedure selected by surgeons for cases with mature cystic teratoma (MCT). Material and methods: This study included 50 cases with histopathologically proven MCT between January 2011 and August 2016 at a tertiary reference hospital. Data related to demographic and clinical characteristics were retrieved from medical records. Multivariate logistic regression analysis was conducted to evaluate the independent factors determining the type of surgical procedure to be applied. Results: A higher rate of patients with large cyst size and elevated CA 19-9 was determined in the postmenopausal patients compared to the premenopausal patients (p = 0.033, p = 0.035). Cystectomy and oopherectomy were applied to 72.55% and 27.5% of the cases respectively. No recurrence in the operated ovary was observed in the 1-year follow-up period in any of the cystectomy cases. The major and only independent variable for the preference of cystectomy over oopherectomy was found to be a younger age (≤ 40 years). There was no independent variable which predicted the selection of laparoscopy or laparotomy by surgeons. Conclusions: Cystectomy was seen to be preferred by surgeons in the majority of MCT patients aged ≤ 40 years regardless of the size of the cyst. This is plausible since these patients have greater concerns about future fertility compared to patients > 40 years old. No recurrence was detected in any of the cystectomy cases, which strengthens the feasibility of this procedure. No serious complications developed in laparoscopy which could render it a safe option for undertaking cystectomy/oopherectomy in MCT cases

The role of osteopontin in the pathogenesis of placenta percreta

Objective: This study aims to determine how the expression of osteopontin is altered in the placenta percreta by compar­ing osteopontin expression in normal placentas and placenta percreta tissues. Material and methods: Placental tissues from hysterectomy materials which were histopathologically diagnosed with placenta percreta (study group, n = 20) and placental tissues obtained from normal term pregnancies (control group, n = 20) were immunohistochemically stained with osteopontin antibody. The groups were compared with respect to the intensity of cytoplasmic staining for osteopontin. Results: The study and control groups were similar with respect to age, gravidity, parity, gestational age at birth, number of previous cesarean deliveries and curettages and (p > 0.05 for all). Immediate postoperative hemoglobin was significantly lower and the need for blood transfusion was significantly higher in the study group (p = 0.001 for both). Placental osteo­pontin expression was significantly altered in the study group (p = 0.020). Negative staining for placental osteopontin was significantly more frequent in the placenta percreta group than the control group (9/20 vs 0/20, 45.0% vs 0%, p = 0.037). Conclusion: As reduced placental osteopontin expression was determined in the placenta percreta cases compared to the normal term placenta tissues, osteopontin can be considered to have a role in morbidly adherent placentation. This study is of value as the first study to investigate the changes in osteopontin expression in placenta percreta cases

Evaluation and Interpretation of Female Infertility

Infertility is a problem that affects one out of seven couples and is defined as the inability to achieve pregnancy despite unprotected intercourse for 1 year. One of the most important enemies of infertile patients is time. In order to reveal the possible causes of infertility, importance should be given to the systematic, rapid, and cost-effective evaluation, and the evaluation should be started with the least invasive examinations. In the evaluation of an infertile woman, a detailed medical history, reproductive history, family history, and physical examination are required to reveal the anatomical and physiological causes of infertility. This evaluation process is also the most suitable period for giving pre-pregnancy counseling, providing necessary counseling for preventive medicine practices, and conducting genetic research and consultations if necessary. In the evaluation of infertility, the presence of ovulation, the structure and function of the female genital system, and semen analysis in the male partner should also be evaluated. During all these evaluation processes, the psychological morbidity caused by the inability to have children should also be taken into consideration and the couples should also be supported in this respect. In this review, it was aimed to present the steps to be followed in the evaluation of an infertile woman in the light of current literature

Increased oxidative stress is associated with insulin resistance and infertility in polycystic ovary syndrome

Objectives: The present study aims to investigate the role of oxidant-antioxidant status in young women with polycystic ovary syndrome (PCOS).Material and methods: Seventy-one women with PCOS and 53 healthy controls are compared in aspect of demographic characteristics, biochemical data, hormones, and oxidant-antioxidant status.Results: The PCOS group had significantly lower zinc, higher malondialdehyde and gluthathione peroxidase and lower serum catalase levels than the control group (p = 0.016, p < 0.001, p = 0.043 and p = 0.025 respectively). The PCOS patients with IR had significantly higher malondialdehyde, lower catalase and serum zinc levels than the PCOS patients without IR (p = 0.015, p = 0.010, p = 0.001 respectively). The infertile PCOS patients had significantly higher malondialdehyde, lower catalase and serum zinc levels than the fertile PCOS patients (p = 0.022, p = 0.045,p = 0.001 respectively). There was a statistically significant and positive correlation between HOMA-IR and malondialdehyde values (r = 0.523, p = 0.001), between HOMA-IR and glutathione peroxidase values (r = 0.468, p = 0.001) and between HOMA-IR and zinc values (r = 0.601, p = 0.001). There was a statistically significant and negative correlation between HOMA-IR and catalase values (r = –0.493, p = 0.001).Conclusions: The patients with PCOS are under oxidative stress and this oxidative stress seems to be the highest in patients with IR and with infertility. Despite the prominent increase in the oxidative stress, there was a variation in the antioxidant response

FIB4 score is increased in severe preeclampsia

This study aims to investigate how the fibrosis index based on four factors (FIB-4) is altered in preeclampsia and whether the FIB-4 score differs with respect to the severity of preeclampsia and the presence of fetal and maternal adverse outcomes

A Case of Secondary Infertility Due to Retention of Fetal Bones in Cervix

A case of secondary infertility related with prolonged retention of fetal bones in cervix is presented. A 34-year-old nulliparous woman admitted to hospital with chronic pelvic pain, dyspareunia and 12-yearlong secondary infertility following an induced abortion due to fetal demise. Transvaginal ultrasonography (USG) revealed a linear echogenic area around the posterior cervical wall. Hysteroscopic examination confirmed the existence of an irregular calcified mass embedded in cervix. The mass turned out to be conglomerated fetal bone fragments which probably acted as an intrauterine device. After removal of the cervical mass, the patient conceived spontaneously within four months. The present case report emphasizes the significance of detailed history and through evaluation by transvaginal USG in case of secondary infertility following an induced or spontaneous abortion

Servikste fetal kemik kalıntılarına bağlı sekonder İnfertilite olgusu

A case of secondary infertility related to prolonged retention of fetal bones in the cervix is presented. A 34-year-old nulliparous woman was admitted to the hospital with chronic pelvic pain, dyspareunia, and 12-year-long secondary infertility following an induced abortion due to fetal demise. Transvaginal ultrasonography (USG) revealed a linear echogenic area around the posterior cervical wall. An hysteroscopic examination confirmed the existence of an irregular calcified [Pass embedded in the cervix. The mass turned out to be conglomerated fetal bone fragments which probably acted as an intrauterine device. After removal of the cervical mass, the patient conceived spontaneously within four months. The present case report emphasizes the significance of a detailed history and a thorough evaluation by transvaginal USG in the case of secondary infertility following an induced or spontaneous abortion

Knowledge and attitudes towards digital radiography and CBCT among orthodontists

The aim of this study was to evaluate knowledge of and attitudes towards digital radiography and Cone Beam Computed Tomography (CBCT) among orthodontists. A questionnaire with 24 questions was emailed to orthodontists practising in Turkey. The questionnaire comprised sections pertaining to demographic characteristics and clinical specialties, attitudes towards digital imaging, and knowledge of CBCT. Data from 366 questionnaires were analysed. The mean age of responders was 35 years (range: 24-68 years); 294 orthodontists (87.5%) preferred digital radiography for all procedures, with 49.4% reporting that they had learned about CBCT from seminars. A total of 206 respondents (56.3%) used CBCT during orthodontic diagnosis. The most frequently cited indication for CBCT was determination of impacted teeth and other oral abnormalities (80.9%), followed by cleft lip and palate (57.4%); 196 orthodontists (53.6%) believed that CBCT lectures should be included in the clinical phase of dental education, with 282 (77%) indicating a willingness to learn more about CBCT. Our data indicate that digital radiography is widely used by orthodontists; the preference for CBCT for evaluation of oral and craniofacial anomalies will likely increase commensurate with greater technical competence