Recurrent spontaneous ovarıan hyperstımulatıon ın a virgın girl

Ovarian hyperstimulation syndrome (OHSS) develops due to the release of vasoactive mediators induced by excessively luteinized and enlarged ovaries. Most OHSS cases are iatrogenic subsequent to ovulation induction. We report the first case of recurrent OHSS developed during normal menstral cycle in a virgin girl, diagnozed with ultrasonography and magnetic resonance imaging

Dziedziczna trombofilia a nawracające utraty ciąż u tureckich kobiet – prawdziwy fenomen?

Objectives: To determine the prevalence and the role of hereditary thrombophilia caused by Factor V Leiden (G1691A), prothrombin G20210A or methylenetetrahydrofolate reductase (MTHFR) C677T gene mutations in recurrent pregnancy loss. Material and methods: One hundred and nine patients, who were admitted to the 3rd Obstetrics and Gynecology Outpatient Clinic in Goztepe Training and Research Hospital between 2006 and 2008, were included into the study. The study group consisted of fi fty-seven patients with a history of 3 miscarriages before 20 weeks of gestation and the control group consisted of forty-seven patients with at least one live birth without any history of miscarriage or pregnancy complications. The maternal blood was evaluated for Factor V Leiden (G1691A), prothrombin G20210A and MTHFR C677T gene mutations. Results: No statistically signifi cant diff erence was found between the study and the control groups in terms of the prevalence of Factor V Leiden (G1691A), prothrombin G20210A and MTHFR C677T gene mutations (p=0.534/ p=0.452/p=0.656, respectively and pCel pracy: Celem pracy była ocena częstości występowania i roli dziedzicznej trombofilii związanej z mutacją genu czynnika V Leiden (G1691A), protrombiny G20210A lub reduktazy methylenotetrahydrofolianowej (MTHFR) C677T u pacjentek z nawracającymi poronieniami. Materiał i metody: Do badania włączono 109 pacjentek, które przyjęto do Poradni Położniczo-Ginekologicznej w Goztepe Training and Research Hospital w latach od 2006 do 2008. Grupa badana składała się z 57 pacjentek z 3 poronieniami w wywiadzie przed 20 tygodniem ciąży, grupę kontrolną stanowiło 47 pacjentek z przynajmniej jednym żywym urodzeniem i bez poronień czy innych komplikacji w wywiadzie. Zbadano krew matek pod kątem mutacji genu czynnika V Leiden (G1691A), protrombiny G20210A i MTHFR C677T. Wyniki: Nie znaleziono istotnej różnicy pomiędzy grupą badaną a kontrolną w odniesieniu do częstości występowania mutacji genu czynnika V Leiden (G1691A), protrombiny G20210A i MTHFR C677T (p=0,534/p=0,452/p=0,656 przy

The correlation between immunohistochemical expression of MMP-2 and the prognosis of epithelial ovarian cancer

Objectives: The Objectives: The goal of the study was to evaluate the correlation of matrix metalloproteinase-2 (MMP-2) expression with tumor spread, metastasis, survival and recurrence in early and advanced-stage Epithelial Ovarian Cancer (EOC). Material and methods: Medical records of patients, hospitalized at the Department of Obstetrics and Gynecology, İzmir Ataturk Training and Research Hospital between 2003 and 2008, were reviewed. Patient age, tumor size, localization, histologic type and tumor grade, stage, metastasis status, patient outcomes and follow-up data were obtained from the records of the obstetrics and gynecology clinic, as well as during face-to-face or telephone interviews. Results: The percentage of MMP-2 staining (expression) in the epithelial cells was not significantly associated with tumor stage and grade, histologic type, tumor diameter, recurrence and overall survival (p>0.05). A significant correlation was found between the percentage of MMP-2 staining (expression) and metastasis status (p0.05), but was with histologic type (p0,05). Stromal staining (expression) of MMP-2 was not significantly correlated with tumor stage and grade, histologic type, tumor diameter and outcomes (p>0.05), but was with recurrence and presence of metastasis (p0.05), total score (p>0.05) and staining intensity (p>0.05). The association of disease-free survival with the percentage of MMP-2 staining (p>0.05), total score (p>0.05), staining intensity (p>0.05) and stromal staining (p>0.05) was not statistically significant. The survival of patients with positive stromal staining was significantly shorter compared to cases with negative stromal staining (

Clinical symptoms and diagnostic tools that are related to infertility and hydrosalpinx formation in women with advanced stage endometriosis complicated by endometrioma

Objectives: The study included patients suffering from stage III-IV endometriosis complicated by an endometrioma (OMA). We investigated the association between age, presence of dysmenorrhea/dyspareunia, preoperative CA 125 level, size of OMA on ultrasonographic exam and infertility, as well as the risk of intraoperative detection of hydrosalpinx that was not suspected on pre-operative assessment. Materials and Methods: The study included patients with stage III-IV endometriosis complicated by OMA who underwent a laparoscopic or open surgery due to pre-diagnosis of infertility or adnexal mass. Results: Dysmenorrhea had statistically significant association with infertility (p=0.031). There was no statistically significant relation between age, dyspareunia, preoperative CA 125 level, size of OMA on ultrasonographic exam and infertility (p=0. 203, p=0.561, p=0.561 and p=0.668, respectively). No statistically significant relation was found between age, CA 125 level, dysmenorrhea, dyspareunia and detection of an unilateral/bilateral hydrosalpinx, that was not suspected on pre-operative assessment (p=0.179, p=0.295, p=0.895, p=0.424, respectively). There was an association between OMA size (p=0.023) and detection of unilateral/bilateral hydrosalpinx. Conclusions: Patients who desire to have children but suffer from severe dysmenorrhea must be preoperatively informed about the possibility of having stage III-IV endometriosis. Infertile patients who are about to undergo an operation, especially due to a large OMA, may turn out to have hydrosalpinx. These patients should be informed preoperatively about the possibility of having salpingectomy or the proximal tubal surgery for improving fertility

Mean Platelet Volume, Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio in Severe Preeclampsia

Objectives: The aim of the study was to compare the changes in the values of leukocytes, neutrophils, lymphocytes, mean platelet volume (MPV), and systemic inflammatory response (SIR) markers (neutrophil-lymphocyte ratio/platelet-lymphocyte ratio) in patients with severe preeclampsia (PE) of healthy pregnant and non-pregnant women. Material and methods: Hematological parameters including MPV, and SIR markers [neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR)] were compered between the between three groups comprising of women with severe PE, healthy pregnant women and healthy non-pregnant women. Results: MPV and PLR did not show statistically significant differences between the three groups (p=0.081, p=0.098). NLR showed a statistically significant difference between the three groups (p=0.000). NLR values of patients with severe PE were statistically significantly higher than healthy non-pregnant women (p=0.000). No statistically significant difference was found between patients with severe PE and healthy pregnant women (p=0.721). The cut-off value of the leukocyte number for severe PE was 7.6 x 103/ml, with 76.7% sensitivity and 60.6% specificity. The cut-off value of neutrophil number was 6.4 x 103/ml for the group with severe PE, with 76.7% sensitivity and 69% specificity. Conclusions: Our results showed that MPV level did not differ among patients with severe PE, healthy pregnant women and non-pregnant women. NLR cannot be used to identify patients with severe PE. PLR measured before termination of pregnancy is not an effective marker for severe PE, either

The Omega-3 Polyunsaturated Fatty Acid Supplementation and Female Infertility

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Using Vacuum- Assisted Closure Technique For Wound Failure After Cytoreductive Surgery: A Case Report

Yara yeri iyileşmesindeki başarısızlıklar yüksek maliyet ve uzun tedavi süresi gibi olumsuz sonuçları beraberinde getirmektedir. Vakum asiste kapatma tekniği (VAK) yara ortamını steril tutan ve yarayı koruyucu örtülerin sık değişmesini engelleyen bir tekniktir. Vakum sistemi negatif basınç ile mekanik gerilim oluşturarak; yara kenarlarını küçültür, granülasyon formasyonunu hızlandırır, hücresel proliferasyonu ve neoanjiogenezi arttırır. Jinekoloji ve obstetri pratiğinde VAK kullanımı ile ilgili sınırlı sayıda olgu serileri ve vaka sunumları mevcuttur. Bu raporda berrak hücreli ovaryen karsinom nedeniyle sitoredüktif cerrahi yapılan obes bir hastada insizyon yerinin yüzeyel ayrılmasının VAK ile tedavisi sunulmuşturWound failures in healing brings negative results such as high cost and along duration of treatment. The vacuum -assisted closure technique ( VAK) is a technique that keeps the wound environment under sterile condition and decreases the frequency of changing protective covers of wound. By creating mechanical stress with negative pressure of the vacuum system; wound edges diminish, granulation formation accelerates, cellular proliferation and neoangiogenesis increases. There are only a limited number of case series and case reports are available on the use of VAK in obstetrics/gynecology practices. In this report, we presented superficial wound separation treated with VAK in an obese patient having a cytoreductive surgery for clear cell ovarian carcinom

Prophylactic ligation of uterine arteries at its origin in laparoscopic surgical staging for endometrial cancer

Aim The aim of this study was to compare the surgical outcomes between patients who were staged laparoscopically for early-stage endometrioid-type endometrial cancer (EC) between those who underwent prophylactic ligation of uterine arteries (UAs) prior to pelvic lymphadenectomy and the patients who were operated with standard procedure. Methods This retrospective study was conducted in women diagnosed with early-stage and low/intermediate-risk endometrioid-type EC. The control group included patients who underwent standard laparoscopic pelvic lymphadenectomy and the study group concerned patients who underwent prophylactic ligation of UA prior to pelvic lymphadenectomy. The prophylactic ligation of UA procedure was performed at a point just proximal to its origin. Results The mean lymph node count dissected in the study group was higher in terms of statistical significance (17.5 +/- 2.2 vs. 19.8 +/- 3.6, p = 0.003 and p < 0.05). The rate of the patients who had a positive pelvic lymph node detected did not differ between groups (7.4% vs. 16.7%, p = 0.258 and p < 0.05). The operation time (OT) of the patients in the study group did not differ between groups (p = 0.546 and p < 0.05). Hemoglobin drop (-0.5 +/- 0.7) and hematocrite drop (-0.8 +/- 0.9) values in the study group were found to be lower in the study group (p = 0.000, p = 0.000, and p < 0.05). Conclusions Performing prophylactic ligation of UA at its origin prevents unwanted bleeding and facilitates the laparoscopic pelvic lymphadenectomy procedure.WOS:0007002433000012-s2.0-85115674696PubMed: 3457156

The Treatment of Giant Periurethral Condyloma in Pregnancy Using an Ultrasonic Thermal Scalpel: A Case Report and New Single Session Treatment Option

Multiple large polypoid lesions with exophytic appearance occurring in anal and perineal region as a result of human papilloma virus (HPV) infection are referred to as giant condyloma acuminatum (GCA). The conventional treatment of these lesions involves the use of surgical excision, laser, electrocautery, and/or application of trichloroacetic acid. A 28-year-old primigravid patient at 22 weeks of pregnancy presented to the hospital complaining of vaginal bleeding and palpable mass in the vulva. The physical examination revealed a 60 × 35 mm broad-based, fragile, and patchy hemorrhagic polypoid lesion originating 1 cm below the clitoris and completely occupying urethral orifice and partially occluding vaginal vestibule. The patient underwent excision of GCA in the midtrimester using an ultrasonic thermal scalpel (Harmonic Scalpel) without any additional treatment and subsequently delivered a single live healthy baby. The excision of GCA occurring during pregnancy using Harmonic Scalpel can be regarded as a new successful method. Prospective, randomized, and controlled studies are warranted in order to provide clear evidence of the efficiency and safety of HS in the treatment of GCA