Reproductive Outcome After Surgical Treatment of Endometriosis – Retrospective Analytical Study

Objective: The aim of the study was to investigate the reproductive outcomes of patients after surgical treatment of endometriosis. Material and Methods: The study included 100 infertile women, aged 21 to 41 years, who underwent surgical treatment of endometriosis. From January 2007 to January 2012, excision of endometriosis was performed by operative laparoscopy or laparotomy. Demographic, clinical, surgical and reproductive outcomes of 52 patients were retrospectively analyzed. Result: Twenty-three pregnancies (44%) were obtained in 52 patients, resulting in 16 term pregnancies, 4 spontaneous abortions under 16 weeks gestation, 2 spontaneous abortions at 20 gestational weeks and 1 ectopic pregnancy. Twenty nine patients did not achieve pregnancy and 68.9% (20/29) of them were treated with IVFICSI. Spontaneous pregnancies were obtained within 7 months after the surgery, whereas IVF-ICSI pregnancies were obtained within the period of 11 months. Seven patients were stage I, 14 patients stage II, 19 patients stage III, and 12 patients stage IV according to the American Fertility Society (AFS) Classification of Endometriosis. The pregnancy rate was 57% in stages I-II, 47% in stage III, 16% in stage IV endometriosis; and the rate of term pregnancies was 83%, 66%, and 0%, respectively. Seven pregnancies (7/14) were obtained in patients with bilateral endometriosis and 5 of them resulted in term pregnancy. Sixteen pregnancies (16/38) were obtained in patients with unilateral endometriosis and 11 of them resulted in term pregnancy. Conclusion: After surgical treatment of endometriosis, the pregnancy and live birth rates seem to be improved. Reproductive outcome is closely associated with the AFS score. Bilaterality of endometriosis does not affect pregnancy outcome

The usefulness of p16 and COX-2 expression on the prediction of progression to endometrial cancer

Objectives. Endometrial cancer (EC) is the most commonly diagnosed gynecological cancer. Endometrial hyperplasia (EH) is a more common diagnosis than EC. Endometrial hyperplasia is found in approximately 1.5% of all women presenting with abnormal bleeding. Endometrial hyperplasia progresses to EC, and especially, cancer risk increases in cases with atypical hyperplasia. p16, one of the tumor suppressor proteins involved in the cell cycle, and COX-2, one of the key enzymes of prostaglandin synthesis, are important markers for the diagnosis of both EH and EC. There is lack of consensus in the classification, diagnosis and treatment of EH. The subject of changes in the cell cycle in the progression of endometrial pathologies may help to identify and prevent these affected pathways in the treatment stage. The aim of this study is to investigate the expression of p16 and COX-2 during the development of EC from EH. Material and methods. We investigated COX-2 and P16 expressions in patients with proliferative endometrium, complex/simple endometrial hyperplasia and endometrioid adenocarcinoma. Results. p16 expression increased in EH and EC (p50% of myometrial invasion, this increase was not statistically significant. Conclusions. More detailed studies are needed to investigate the prognostic significance of the COX-2 molecule. COX-2 might be a potential biomarker for the prognosis of endometrial cancer and a potential therapeutic target for EC treatment. Also, it might be used to prevent the progression of precursor lesions to invasive EC

Benign paroxysmal positional vertigo after radiologic scanning: a case series

<p>Abstract</p> <p>Introduction</p> <p>Benign paroxysmal positional vertigo (BPPV) is the most common type of vertigo. It is frequently seen in elderly patients, and the course of the attack may easily mimic cerebrovascular disease. A BPPV attack after a radiologic examination has not been reported previously. We report the cases of two patients who had BPPV attacks after radiologic imaging.</p> <p>Case presentation</p> <p>The first patient with headache and tremor was admitted to the radiology department for cranial computed tomography (CT) imaging. During scanning, she was asked to lie in the supine position with no other head movements for approximately 10 minutes. After the cranial CT imaging, she stood up rapidly, and suddenly experienced a vertigo attack and nausea. The second patient was admitted to the radiology department for evaluation of his renal arteries. During the renal magnetic resonance angiography, he was in the supine position for 20 minutes and asked not to move. After the examination, he stood up rapidly with the help of the technician and suddenly experienced a vertigo attack with nausea and vomiting. The results of standard laboratory analyses and their neurologic examinations were within normal limits and Dix-Hallpike tests showed rotatory nystagmus in both cases. An Epley maneuver was performed to the patients. The results of a control Dix-Hallpike tests after 1 Epley maneuver were negative in both patients.</p> <p>Conclusion</p> <p>Radiologists and clinicians must keep in mind that after radiologic imaging in which the patient is still for some time in the supine position and then helped to stand up rapidly, a BPPV attack may occur.</p

JİNEKOLOJİK LAPAROSKOPİK CERRAHİDE TEK YÖNLÜ BARBED SÜTUR

With the developments in technology, lots of innovation were represents in medical society. Suture material including barb technology (V-Lock) is one of them and it is important for doctors who have not enough experience about laparoscopic intracorporeal knotting. In this Article; the advantages and disadvantages of this useful absorbabl suture material and utilization during laparoscopic operations will be mentioned.Gelişen teknolojiyle birlikte birçok yenilikler tıbbın hizmetine sunulmuştur. Barb teknolojisi içeren sutur materyali (V-Lock) bunlardan bir tanesidir ve intrakorporal düğüm atma deneyimine sahip olmayan doktorlar için önemli bir materyaldir. Makalede, absorbabl ve kullanışlı bu sutur materyalinin laparoskopik işlemlerde kullanımı, avantajları ve dezavantajlarını göz önünde bulunduracağız

Prevention of Pazopanib-Induced Prolonged Cardiac Repolarization and Proarrhythmic Effects

Background: Pazopanib (PZP) may induce prolonged cardiac repolarization and proarrhythmic effects, similarly to other tyrosine kinase inhibitors. Objectives: To demonstrate PZP-induced prolonged cardiac repolarization and proarrhythmic electrophysiological effects and to investigate possible preventive effects of metoprolol and diltiazem on ECG changes (prolonged QT) in an experimental rat model. Methods: Twenty-four Sprague-Dawley adult male rats were randomly assigned to 4 groups (n = 6). The first group (normal group) received 4 mL of tap water and the other groups received 100 mg/kg of PZP (Votrient® tablet) perorally, via orogastric tubes. After 3 hours, the following solutions were intraperitoneally administered to the animals: physiological saline solution (SP), to the normal group and to the second group (control-PZP+SP group); 1 mg/kg metoprolol (Beloc, Ampule, AstraZeneca), to the third group (PZP+metoprolol group); and 1mg/kg diltiazem (Diltiazem, Mustafa Nevzat), to the fourth group (PZP+diltiazem group). One hour after, and under anesthesia, QTc was calculated by recording ECG on lead I. Results: The mean QTc interval values were as follows: normal group, 99.93 ± 3.62 ms; control-PZP+SP group, 131.23 ± 12.21 ms; PZP+metoprolol group, 89.36 ± 3.61 ms; and PZP+diltiazem group, 88.86 ± 4.04 ms. Both PZP+metoprolol and PZP+diltiazem groups had significantly shorter QTc intervals compared to the control-PZP+SP group (p < 0.001). Conclusion: Both metoprolol and diltiazem prevented PZP-induced QT interval prolongation. These drugs may provide a promising prophylactic strategy for the prolonged QTc interval associated with tyrosine kinase inhibitor use

Pelvik kitleler ve gebelik: Olgu sunumu ve literatürün gözden geçirilmesi

After daily use of practical pregnancy tests and widespread use of ultrasonography, pregnancy controls starts in early weeks and the number of adnexial masses which diagnosed in pregnancy increased. in this report, we presented 32 years-old women with 18 gestational weeks and adnexial mass at 9x10cm on the left adnexial area. After laparotomy, histopathological result was microinvasiv serous borderline tumor. Adnexal mass with pregnancy can be treated surgically or conservative. the measures of the mass, gestational weeks and the USG findings effect the decision of treatment wayGünlük hayatta kullanılan pratik gebelik testlerinin ve ultrasonografi kullanımının yaygınlaşması sonucu gebelik takiplerine erken haftalarda başlanması, gebelikte saptanan pelvik kitle sayısında artışa neden olmuştur. Makalemizde 32 yaşında 18. gebelik haftasında tekil gebeliği ve sol adneksiyel bölgede 9x10 cm boyutlarında kitlesi bulunan, operasyon sonrasında mikroinvaziv seröz hudut tümör tanısı almış bir olgu sunulmuştur. Bu kitlelere yaklaşım konservatif veya cerrahi yönde olabilmektedir. Bu karar verilirken de kitlenin büyüklüğü, gebelik haftası ve USG bulguları dikkate alınmalıdır