Effect of thyroid hormone replacement therapy on ovarian volume and androgen hormones in patients with untreated primary hypothyroidism

Background and Objectives: Primary hypothyroidism may be associated with ovarian enlargement and/ or cyst formation. We evaluated the effect of thyroid hormone replacement therapy on hormonal changes, ovarian volume and sonographic appearance. Design and Setting: Open, prospective study of women admitted to university gynecology clinic. Patients and Methods: The study included 26 patients with untreated hypothyroidism who had polycystic (n=10) or normal-appearing (n=16) ovaries and 20 euthyroidic controls. Basal serum total testosterone, free testosterone, androstenedione, dehydroepiandosterone-sulfate, prolactin, estradiol, luteinizing hormone, follicle-stimulating hormone, free T3, free T4 and thyroid-stimulating horone, together with ovarian volumes, were determined and repeated after euthyroidism was achieved. Results: Ovarian volumes of patients with hypothyroidism were significantly greater compared with controls, and their magnitudes diminished significantly during thyroid hormone replacement therapy. Hypothyroidic patients with polycystic ovaries had significantly higher serum free testosterone and dehydroepiandosterone-sulfate, but lower androstenodione levels compared with those who had normal-appearing ovaries. Serum total testosterone concentrations were significantly higher in hypothyroidic patients without polycystic ovaries, and thyroid hormone replacement therapy achieved a significant reduction in total as well as free testosterone. Conclusion: Severe longstanding hypothyroidism leads to increased ovarian volume and/or cyst formation. A decrease in ovarian volume, resolution of ovarian cysts and reversal of the polycystic ovary syndrome-like appearance, together with improvement in serum hormone levels, occurred after euthyroidism was achieved

Evaluation of protective effects of GnRH agonist or antagonist on ovarian reserve with anti-Müllerian hormone and histological analysis in a rat model using cisplatin

Introduction: The aim of this prospective trial was to evaluate the ovarian reserve with anti-Müllerian hormone (AMH), which is the best predictor of ovarian reserve, and perform histological analysis after exposure to cisplatin with a GnRH agonist or antagonist. Material and methods: Twenty-four Wistar albino rats were randomly divided into three groups, each consisting of eight rats. In the GnRH agonist group (group 1), rats received a single dose of 50 mg/m2 cisplatin with 1 mg/kg triptorelin. In the GnRH antagonist group (group 2), rats received a single dose of 50 mg/m2 cisplatin with 1 mg/kg cetrorelix. In the control group (group 3), rats received 50 mg/m2 cisplatin. Ovarian reserve was assessed by AMH and histology. Results: Primary follicle counts were higher in group 2 (4.50 ±1.47 vs. 3.50 ±1.70 vs. 3.00 ±3.54) and secondary follicle counts were higher in group 1 (2.96 ±1.11 vs. 1.74 ±1.03 vs. 1.37 ±3.11). Numbers of tertiary follicles were higher both in groups 1 and 2 than the control group (1.36 ±0.83 vs. 0.84 ±0.99 vs. 0.50 ±0.75). The total follicle count of the study groups were significantly higher compared with the control group (14.32 ±5.96 vs. 12.48 ±4.12 vs. 10.63 ±6.80). AMH was significantly higher in groups 1 and 2 compared with the control group (18.56 ±25.33 vs. 16.48 ±24.66 vs. 9.37 ±26.54). Conclusions: This is the first prospective randomized controlled study showing the protective effects of GnRH agonist and antagonist on ovarian reserve after cisplatin exposure in an animal model

Evaluation of the Results of Cases Prenatally Diagnosed as VSD

Objective: In this study, our aims were to monitor the change in ventricular septal defects (VSD) during pregnancy, to present the result of post-natal evaluation results and to document associated anomalies

Evaluation of the Results of Cases Prenatally Diagnosed as VSD

Objective: In this study, our aims were to monitor the change in ventricular septal defects (VSD) during pregnancy, to present the result of post-natal evaluation results and to document associated anomalies

Assessment of the effect of mineralogy on the geotechnical parameters of clayey soils: A case study for the Orta County, Çankırı, Turkey

The purpose of this study is to investigate and relate the geotechnical parameters with the mineralogical properties of the Miocene and Plio-Quaternary (Pliocene to Quaternary) lacustrine and fluvial sediments, particularly clayey soils in the Orta County, cankiri. The study area is located about 110 km northeast of Ankara which is the capital city of the Republic of Turkey and Orta is a small county of cankiri. The study area is a structural depression in the northern part of the Orta plain which is filled by fault-controlled continental sedimentation. In order to correlate the geotechnical and mineralogical characteristics and to establish a relation between these properties, comprehensive geotechnical laboratory studies have been performed. For correlation purposes, disturbed and undisturbed soil samples were collected from twenty-two locations of the study area. On these samples, mineralogical (i.e., methylene blue absorption, specific surface area determination, X-ray powder diffraction (XRD) and scanning electron microscope (SEM-EDAX)) analysis and geotechnical (i.e., sieve analysis, hydrometer, Atterberg (consistency) limits, oedometer and swelling) tests were implemented. By the aid of the statistical analysis, cross-correlation of the soil properties was established by the regression analyses performed. In particular, the plasticity index was correlated with cation exchange capacity, specific surface area, clay content, percent of fines, smectite and smectite/kaolinite ratio (SKR). There was a direct relationship between PI and smectite percentage as well as between PI and SKR. Additionally, the liquid limit was correlated with the clay content and the effect of the specific surface area on the swelling characteristics was studied. The effects of the mineralogical properties of the Orta clays together with the geological history on geotechnical parameters were investigated by considering the relationships mentioned. The results of the study revealed that the mineralogical characteristics had a significant effect on the geotechnical behavior of clayey soils of the Orta County which was demonstrated by regression analyses. Finally it was identified that the geotechnical properties of clayey soils can be approximated and more reliably determined if the mineralogical character and composition of clay is accurately investigated and well developed

The effect of Kristeller maneuver on maternal and neonatal outcome

Objective: The use of fundal pressure in management of the second stage of labor is controversial. The aim of this study was both to evaluate the effectiveness of fundal pressure in shortening the second stage of labor and to examine the re- lated neonatal and maternal outcomes. Materials and Methods: Patients were randomly allocated to Kristeller maneuver (KM) intervention group (n = 145) and control group (n = 140). Umbilical artery blood gas analysis, creatinine kinase (CK), CK with myocardial specific isoform, aspartate amino transferase, alanine amino transferase, lactate dehydrogenase and lactic acid were assessed. Vaginal laceration, cervical laceration, length of episiotomy and vagina before and after delivery and duration of the second stage of labor in minutes were recorded. Neonatal information included: Infant birth weight, Apgar scores, babies requiring pediatric help, and admission to neonatal intensive care units (NICU) were examined. Results: KM leads to elongation of episiotomy incision. Vaginal lacerations were similar between control and intervention groups; however the cervical laceration rate was higher in intervention group. Gestational week, Apgar scores, birth weight, NICU admission, babies requiring pediatrician help or healthy babies were not different between the two groups. Conclusions: The possibility of lacerations to the perineum and cervix is increased by using KM. On the other hand, fundal pressure seems safe for the fetus. [Arch Clin Exp Surg 2015; 4(1.000): 29-35