Histopathology of ipsilateral and contralateral ovaries and plasma interleukin 6 levels after unilateral ovarian torsion.

OBJECTIVE: The aim of the present study was to evaluate the time-dependent histopathologic changes in both ovaries and to determine the time-dependent levels of plasma interleukin 6 (IL-6) after unilateral ovarian torsion. MATERIALS AND METHODS: An experimental animal study included 48 female Sprague-Dawley rats which were distributed to six groups: control group (Group 1), sham-operated control group (Group 2), and four unilateral ovarian torsion groups with torsion duration of three, six, 12, and 24 hours (Group 3, 4, 5, and 6, respectively). Histopathologic criteria (follicular degeneration, vascular congestion, hemorrhage, inflammatory cell infiltration, and total tissue damage score) were evaluated in both ovaries, and plasma IL-6 levels were measured. RESULTS: At 24 hours after torsion began, mean total tissue damage score was similar between ovaries that had torsion and contralateral ovaries. Mean plasma IL-6 level did not change during the 24 hours after torsion began (p = 0.584). CONCLUSIONS: In addition to ovaries that had torsion, histopathologic abnormalities also occurred in contralateral ovaries. These results suggest that contralateral ovaries are not quiescent after unilateral ovarian torsion. Plasma IL-6 levels did not change significantly during the 24 hours after ovarian torsion began, resulting in a limitation of its diagnostic use in the early course of the disease.

Does pregnancy-induced hypertension affect the electrophysiology of the heart?

Pregnancy-induced hypertension (PIHT) increases both maternal and neonatal mortality and morbidity in pregnant women. We sought to investigate the electrocardiographic findings in pregnant women with PIHT. Seventeen pregnant women (29.4 ± 5 years) with PIHT and 24 pregnant women (27.3 ± 6.1 years) with normal blood pressure (control group) were included in the study. A 12-lead surface electrocardiogram was used to evaluate the electrocardiographic parameters. Pregnant women with PIHT had higher blood pressure (p = 0.001). The Tp-e interval was longer in PIHT pregnant women at 83.5 ± 7.8 ms versus 75.8 ± 8.4 ms in the control group (p = 0.007). The Tp-e/QTc ratio was higher in pregnant women with PIHT than that in healthy controls (0.19 ± 0.02 vs. 0.18 ± 0.02, respectively). This study demonstrated that Pd, QTd and the P wave durations were similar in the PIHT pregnant women and control group, but the Tp-e and Tp-e/QTc ratio were higher in pregnant women with PIHT than in normotensive pregnant women.

The effect of maternal polycystic ovary morphology on first-trimester maternal serum biochemical markers of aneuploidy and fetal nuchal translucency thickness.

OBJECTIVE: To evaluate the effect of maternal polycystic ovary (PCO) morphology on maternal serum free beta-human chorionic gonadotropin (ß-hCG), pregnancy associated plasma protein A (PAPP-A), and nuchal translucency (NT) thickness in the first-trimester. MATERIAL AND METHODS: A total of 92 pregnant women in the first-trimester were included in the study. Of them, 57 had PCO morphology, and 35 women constituted the control group, with apparently normal ovaries. Maternal serum free ß-hCG, PAPP-A, and NT thickness were measured and compared in all patients. RESULTS: The multiples of median (MoM) levels of serum free ß-hCG were significantly higher in the PCO morphology group compared to the normal ovary group (p = 0.024). However, the MoM levels of PAPP-A were similar in both groups (p = 0.947). No difference was found between the groups in terms of fasting glucose levels and NT measurements (p = 0.976 and 0.565, respectively). CONCLUSION: In pregnancies with maternal PCO morphology, the presence of higher maternal serum free ß-hCG levels may require correction in the calculation of risks related to first-trimester screening for chromosomal abnormalities. Larger studies are needed to confirm our preliminary data.

HPV and HPV vaccination: knowledge and consciousness of young women.

AIM: The aim of the study was to explore the knowledge and the awareness of the young Turkish women regarding cervical cancer and human papilloma virus (HPV) vaccines. The authors analyze a probable relationship between the overall knowledge level and a few socio-demographic parameters. MATERIALS AND METHODS: The authors interviewed with students from Canakkale 18 March University and young women that did not continue with school in the same city from January to September 2011. All the students answered the questionnaire voluntarily and independently. RESULTS: The participants had low level of knowledge about the risk factors for cervical cancer. Smoking is the major risk factor that was known by the participants (65%). Proportion of the participants that were aware of pap smear test and HPV were 65% and 17% respectively. A small proportion of young women had knowledge regarding protection from HPV. Educational stream, educational level, family income, and family size had significant association knowledge level (p < 0.05). CONCLUSION: There has not been any improvement in HPV and risk factor of cervical cancer awareness in young women. Health members of the National Cancer Control Programme and delegates of the vaccine corporations have major work in order to increase the level of knowledge so that general public can easily take preventative measures.

A large pedunculated leiomyoma with two-sided cystic degenerations mimicking a bilateral ovarian malignancy: a case report.

The authors present an unusual case of a large, pedunculated uterine leiomyoma with two-sided cystic degenerations, which mimicked a bilateral malignant ovarian tumor on ultrasonography and magnetic resonance imaging (MRI). A 32-year-old unmarried female patient presented to our outpatient clinic with complaints of abdominal distention and a palpable abdominal mass extending into the upper abdomen. Ultrasonography and MRI revealed a large solid mass with bilateral cystic areas extending into both uterine adnexa. The patient then underwent a laparotomy. Gross examination revealed normal ovaries and a pedunculated mass with two-sided prominent cystic structures originating from the uterine fundus. The tumor was excised through the peduncle and pathologic evaluation revealed a uterine leiomyoma with cystic degenerations. In conclusion, a large, pedunculated leiomyoma with two-sided cystic degenerations can mimic a bilateral malignant ovarian neoplasm on imaging studies. Therefore, uterine leiomyomas with bilateral cystic degenerations should be considered during the differential diagnosis of malignant ovarian masses.

Can the addition of a paracervical block to systemic or local analgesics improve the pain perceived by the patient during hysterosalpingography?

The aim of the present study was to investigate whether the addition of a paracervical block to local intrauterine anaesthesia or the use of an intramuscular non-steroidal anti-inflammatory drug was effective for pain control during and at 30 min after hysterosalpingography (HSG). A total of 120 patients undergoing hysterosalpingography were randomised into four groups. Patients received intramuscular dexketoprofen trometamol with or without a paracervical block or intracavitary lidocaine instillation with or without paracervical block. The primary outcome was the overall pain score from the four stages of the procedure. The lowest pain scores were observed in the patients receiving dexketoprofen trometamol with a paracervical block, whereas the highest pain scores were observed in patients with intracavitary lidocaine instillation without a paracervical block (p = 0.021). No beneficial effect was found when a paracervical block (PCB) was added to either systemic or local analgesics. The combination of intramuscular dexketoprofen and a paracervical block with plain lidocaine produced the best pain relief during the three specified steps and at up to 30 min after the HSG procedure.

Histologic changes caused by nonabsorbable sutures after ovarian suspension.

PURPOSE: To evaluate intraovarian histologic changes caused by polypropylene and silk sutures that commonly are used in ovarian suspension. MATERIALS AND METHODS: Twenty-four female rats were randomly allocated to three study groups: a sham group receiving no ovarian suspension; the other two groups that had right ovarian suspension with polypropylene and silk sutures. At 90 days after surgery, the histologic changes and ovarian weight reduction in the suspended ovaries and severity of pelvic adhesions were evaluated. RESULTS: There were no differences between study groups in focal inflammation, cystic structures, or vascularity. Adhesion severity and ovarian weight reduction in suspended ovaries and cysts around the suspended ovary were significantly greater in the silk than sham group. The frequency of hematoma within the suspended ovary was significantly greater in the polypropylene than sham group. CONCLUSIONS: Polypropylene suture caused less adhesion severity or ovarian weight reduction than silk suture. This suggests that polypropylene suture may be the better suture for ovarian suspension procedures.

Low molecular weight heparin and first trimester maternal PAPP-A and hCG levels, fetal nuchal translucency in the first trimester of pregnancy.

PURPOSE OF INVESTIGATION: We studied the relation of first trimester nuchal translucency and first trimester biochemical markers using low molecular weight heparin (LMWH) at 11-14 weeks of gestation. METHODS: This retrospective study was conducted at our university between January 2007 and July 2009. Ninety-six patients were treated with low-dose LMWHs (enoxaparine 40 mg) from the beginning of pregnancy to 36 weeks of gestation and low-dose aspirin (100 mg) to 32 weeks (group 1) and 100 control subjects (group 2) were included in the study. Transabdominal ultrasound examination was performed to diagnose any major fetal defects and for measurement of crown rump length (CRL) and fetal nuchal translucency (NT) thickness. Blood samples were drawn from each women PAPP-A and free beta hCG levels. RESULTS: There were no significant differences with respect to age, gestational age at the first trimester, and gestational age at birth between the groups. The mean birth weight of babies in the LMWH group was lower than the control (p = 0.026). There were also no significant differences with respect to CRL, serum PAPP-A and hCG at 11-14 weeks of gestation. However, NT of group 1 was significantly lower than group 2 (p = 0.000). In the Spearman correlation, LMWH was negatively correlated with only NT (r = -0.298, p = 0.000). NT in the first trimester (95% CI -0.632-0.230, p = 0.000) was an independent parameter related to using LMWH. CONCLUSION: Women who used LMWH during pregnancy had decreased NT compared with unaffected women.

In vitro effects of ritodrine, magnesium sulfate and their combination on spontaneous contractions of myometrial strips of pregnant rat uteri.

OBJECTIVE: To investigate in vitro effects of ritodrine, magnesium sulfate and their combination on spontaneous contractions of myometrial strips obtained from pregnant rat uteri. METHOD: A total of 13 pregnant Sprague Dawley rats with weights between 180-200 g were used in this study. Three strips from each rat were kept in an organ bath containing 20 ml Krebs-Henseleit solution (pH: 7.4 and 37 degrees C). 10(-8) 10(-6) and 10(-4) M concentrations of ritodrine, magnesium sulfate and the combination was applied over myometrial strips in Groups I (n: 10), II (n: 10) and III (n: 8), respectively. Amplitude and frequency of spontaneous myometrial contractions, which were recorded at the beginning of each experiment, were considered as reference values. Amplitude and frequency changes in spontaneous myometrial contractions were calculated at approximately ten-minute intervals right after the application of drugs as the percentage of difference at the first reference response. RESULTS: Magnesium sulfate application did not lead to any significant difference on the amplitude and frequency of contractions at any of its concentrations. 10 and 10(-4) M concentrations of ritodrine caused a significant decrease in the amplitude of contractions. It was also found that ritodrine significantly decreased the frequency values at all concentrations. A significant decrease in amplitude was observed at 10(-8) and 10(-6) M concentrations in the combination group. No significant decrease in frequency values was found at any concentration in the combination group. CONCLUSION: The tocolytic effect of ritodrine is superior to that of magnesium sulfate.