Hidrosefali ile Komplike Olan Bir İntraventriküler Hipotansiyon Vakası

AIM: Intracranial hypotension may have variable clinical presentation. The imaging characteristics of intracranial hypotension are especially well depicted on magnetic resonance imaging studies. Although the clinical and radiological manifestations of spontaneous intracranial hypotension are increasingly recognized in many reports, many other abnormalities in this disorder and complicating cases still exist. MATERIAL and METHODS: A 16-year-old patient suffering from nausea, vomiting and blurred consciousness was admitted to the hospital. MRI showed diffuse pachymeningeal thickening resembling intracranial hypotension and ventricular enlargement like compensated hydrocephalus. The patient was investigated and treated using endoscopic third ventriculostomy. CONCLUSION: The authors presented a case of intracranial hypotension complicated with hydrocephalus. Specific causes for intracranial hypotension as well as additional new treatment options will also be discussed.Wo

Management of Unexplained Infertility

Infertility is defined by the failure to achieve a successful pregnancy after 12 months, timed unprotected intercourse. Almost 13-15 percent of the couples suffer from infertility. Unexplained infertility is the term of determining no abnormalities in sperm analysis, ovulatory and tubal function examinations. The prevalence of unexplained infertility varies between 22 and 28 percent. Immunological, endocrinological and genetic factors which are widely heterogeneus, can cause unexplained infertility. While planning the treatment programme, the options which need lesser resource and have lesser side effects must be chosen at first step. In failure, more aggressive and exhaustive treatment options must be tried. In the management of the unexplained infertility, the initial treatment must be observational approach and changing the life style. It is demonstrated that using only the clomiphene citrate or intrauterine insemination is not effective. For this reason, as the patients age and ovarian reserve considered, after the observational approach, the initial treatment must be the combination of clomiphene citrate and intrauterine insemination. With this approach, pregnancy rate is rises to 10 percent for a cycle. Management wise, choosing the cheapest effective treatment for increased fertilization should be the priority, before moving onto more expensive and aggresive approaches. Apart from the diagnostic work-up, which more or less the same for every patient, treatment protocol should be individualised for every infertile couple. [Archives Medical Review Journal 2014; 23(3.000): 506-518

Early Induction of ADAMTS1,-4,-5 and-9 in IL-Stimulated Mouse Astrocytes

AIM: Astrocytes and extracellular matrix molecules have important roles in regulating synaptic functions between neurons in the central nervous system. However, under pathological conditions, these constituents are activated to form glial scar that is thought to be harmful for neuronal regeneration. The aim of this study was to evaluate the expression pattern of ADAMTS1, -4, -5 and -9 in IL-1 stimulated astrocyte cultures obtained from postnatal day zero mouse brains

Early induction of adamts1, -4, -5 and -9 in il-stimulated mouse astrocytes

AIM: Astrocytes and extracellular matrix molecules have important roles in regulating synaptic functions between neurons in the central nervous system. However, under pathological conditions, these constituents are activated to form glial scar that is thought to be harmful for neuronal regeneration. The aim of this study was to evaluate the expression pattern of ADAMTS1, -4, -5 and -9 in IL-1 stimulated astrocyte cultures obtained from postnatal day zero mouse brains

A Stage 4 Hepatoid Adenocarcinoma of the Endometrium: a Case Report and Review of Literature

We report a case of 72-year-old woman who was hospitalized with vaginal bleeding and abdominal pain. Magnetic resonance imaging showed tumor both in endometrial cavity and ovaries with multiple distant metastasis. Her serum alpha-fetoprotein level was >54000 ng/mL. Total abdominal hysterectomy with bilateral salpingo-oophorectomy, total omentectomy, appendectomy, bilateral pelvic and paraaortic lymph node dissection, a 20 cm ileal resection with ileal anastomosis, metastasectomy were performed and peritoneal washing was obtained. The pathologic diagnosis was endometrial hepatoid adenocarcinoma. Because of her poor medical condition, she received only palliative chemotherapy. After two days of 5-fluorouracil she died within 2 months. Hepatoid adenocarcinomas are extrahepatic neoplasms that exhibit features of hepatocellular carcinoma. It was first reported as gastric neoplasm but is seen in many different organs and its frequency is increasing. To date only 11 cases of hepatoid adenocarcinoma of the endometrium were reported. It has a poor prognosis and there isn’t an effective treatment yet

Serum zonulin level is not elevated in patients with polycystic ovary syndrome without metabolic syndrome

Aim Polycystic ovary syndrome (PCOS) is a complex disorder with gynecological, metabolic and carcinogenic effects. Increased intestinal permeability is related with obesity, insulin resistance, type 1 and 2 diabetes mellitus. The existence of such a relationship between PCOS and intestinal permeability has come to an end. Zonulin can change intestinal permeability, and this effect is reversible. We studied the relation between zonulin and the hormonal and metabolic parameters of PCOS. Method A total of 45 women with PCOS and 17 healthy women were included in the study. Histories were taken from all the participants, body mass indexes were calculated, and biochemical tests and suprapubic over ultrasonography were made. Zonulin was studied with enzyme-linked immunosorbent assay. Results Serum zonulin levels were similar between PCOS and control groups (p = 0.893). In all participants, there were negative correlations between zonulin and the total cholesterol, LDL-cholesterol, triglycerides and non-HDL-cholesterol (respectively, p = 0.00, 0.018, 0.004, 0.002), there were boundary correlations with age and total cholesterol/HDL-cholesterol (respectively, p = 0.052 and 0.058). No statistically significant was detected in the PCOS group except negative correlation between zonulin and age (p = 0.046), boundary correlation between zonulin and total cholesterol/HDL-cholesterol (p = 0.064). Conclusion PCOS patients did not have metabolic syndrome. Zonulin was not higher in PCOS then controls, and it had only negative relation with age. The negative relation between zonulin and some metabolic parameters in all participants was not detected in PCOS group. So zonulin is not a useful molecule for the diagnosis of PCOS without metabolic syndrome

A Case of intracranial Hypotension Complicated with Hydrocephalus

ABSTRACT AIM: Intracranial hypotension may have variable clinical presentation. The imaging characteristics of intracranial hypotension are especially well depicted on magnetic resonance imaging studies. Although the clinical and radiological manifestations of spontaneous intracranial hypotension are increasingly recognized in many reports, many other abnormalities in this disorder and complicating cases still exist. MATeRIAL and MeTHodS: A 16-year-old patient suffering from nausea, vomiting and blurred consciousness was admitted to the hospital. MRI showed diffuse pachymeningeal thickening resembling intracranial hypotension and ventricular enlargement like compensated hydrocephalus. The patient was investigated and treated using endoscopic third ventriculostomy. CoNCLUSIoN: The authors presented a case of intracranial hypotension complicated with hydrocephalus. Specific causes for intracranial hypotension as well as additional new treatment options will also be discussed. KeywoRdS: Intracranial hypotension, Triventricular hydrocephalus, Lumbar puncture, Herniation ÖZ AMAç: İntrakranial hipotansiyon farklı klinik bulgular verebilen bir antitedir. MRI bulguları literatürde ayrıntılı olarak tarif edilmekle birlikte, nöroşirürji pratiğinde her zaman akla gelmemektedir. Aynı bulguların farklı sinir sistemi hastalıklarında da görülebilmesi, vakaları komplike hale getirmektedir. yÖNTeM ve GeReç: 16 yaşında bayan hasta bulantı-kusma ve bilinç bulanıklığı nedeniyle hastanemize yatırıldı. MRI intrakranial hipotansiyonla uyumlu difüz pakimeningeal kalınlaşma ve kontrast tutulumu ve eşlik eden triventriküler genişleme gösterdi. Hasta ayrıntılı olarak incelendi ve endoskopik yolla 3. ventrikülostomi yapılarak tedavi edildi. SoNUç: Yazarlar, arrest hidrosefali ile komplike olan bir intrakranial hipotansiyon vakasını sunmuş ve tedavi yöntemi ile birlikte tartışmışlardır. Endoskopik 3. ventrikülostomi, bu vaka için tanı koydurucu ve emniyetli bir seçenek olmuştur