The assessment of the relationship between the vascularity of FIGO Type 4-7 leiomyomas and abnormal uterine bleeding.

The current study aimed to analyse and compare the vascularity of FIGO Type 4-7 leiomyoma specimens obtained from women with or without abnormal uterine bleeding (AUB). The records of 31 women who underwent myomectomy for FIGO Type 4-7 leiomyomas in a university hospital setting were analysed. Group I (n = 16) was composed of women that were symptomatic for AUB and group II (n = 15) consisted of asymptomatic cases. The myomectomy material(s) of each case were processed with CD34 staining and evaluated by Image J® software (Image J 1.52a, Wayne Rasband National Institutes of Health, Bethesda, MD). There was no statistically significant difference between the rates of vascular areas in the specimens of the two groups (p>.05). Although areas with large vessels were higher in group I compared to group II, the difference did not reach statistical significance (p>.05). AUB caused by FIGO Type 4-7 leiomyomas seems to be related to factors other than vascular density.Impact StatementWhat is already known on this subject? Uterine leiomyomas are the most common benign gynaecologic neoplasms with a prevalence of approximately 40% in women of reproductive age. They are most often asymptomatic but when symptomatic, abnormal uterine bleeding (AUB) is one of the most commonly observed symptoms. Although there are some hypothetical explanations, the exact pathogenesis underlying leiomyoma-associated AUB has not yet been elucidated. Almost a century ago, the vascular abnormalities of fibroids were hypothesised as one of the etiopathological factors correlated with clinical symptoms, such as AUB, and current data suggest that the vascular map of leiomyomas consists of an avascular core surrounded by a vascularised capsule. To our knowledge, there are no studies in the literature comparing the histopathological evaluation of the vascularity scores of FIGO Type 4-7 leiomyomas in symptomatic (with AUB) and asymptomatic (without AUB) women.What the results of this study add? The study revealed that there was no statistically significant difference between the vascularity scores of FIGO Type 4-7 leiomyomas excised from the symptomatic and asymptomatic women. Large vessel densities also did not statistically significantly differ between the two groups.What the implications are of these findings for clinical practice and/or further research? This study revealed that AUB caused by FIGO Type 4-7 leiomyomas was related to factors other than vascular density.

Molecular investigation of bacterial and protozoal pathogens in ticks collected from different hosts in Turkey.

BACKGROUND: The emergence of tick-borne disease is increasing because of the effects of the temperature rise driven by global warming. In Turkey, 19 pathogens transmitted by ticks to humans and animals have been reported. Based on this, this study aimed to investigate tick-borne pathogens including Hepatozoon spp., Theileria spp., Babesia spp., Anaplasma spp., Borrelia spp., and Bartonella spp. in tick samples (n = 110) collected from different hosts (dogs, cats, cattle, goats, sheep, and turtles) by molecular methods. METHODS: To meet this objective, ticks were identified morphologically at the genus level by microscopy; after DNA isolation, each tick sample was identified at the species level using the molecular method. Involved pathogens were then investigated by PCR method. RESULTS: Seven different tick species were identified including Rhipicephalus sanguineus, R. turanicus, R. bursa, Hyalomma marginatum, H. anatolicum, H. aegyptium, and Haemaphysalis erinacei. Among the analyzed ticks, Hepatozoon spp., Theileria spp., Babesia spp., and Anaplasma spp. were detected at rates of 6.36%, 16.3%, 1.81%, and 6.36%, respectively while Borrelia spp. and Bartonella spp. were not detected. Hepatozoon spp. was detected in R. sanguineus ticks while Theileria spp., Babesia spp., and Anaplasma spp. were detected in R. turanicus and H. marginatum. According to the results of sequence analyses applied for pathogen positive samples, Hepatozoon canis, Theileria ovis, Babesia caballi, and Anaplasma ovis were identified. CONCLUSION: Theileria ovis and Anaplasma ovis were detected for the first time to our knowledge in H. marginatum and R. turanicus collected from Turkey, respectively. Also, B. caballi was detected for the first time to our knowledge in ticks in Turkey.

Retrospective Analysis of 449 Intracranial Meningioma Patients Operated Between 2007 and 2013 at a Single Institute.

AIM: Meningioma literature has many large surgical case series, which have been references of text books and neurosurgical practice. Many of those series were published when stereotactic radiosurgery (SRS) was not so common or these series were in terms of World Health Organization (WHO) 2000 classification. In this study, we aimed to make an update to the current literature using WHO 2007 classification system. MATERIAL AND METHODS: Four hundred eighty-eight intracranial meningioma patients underwent open surgery in 2007-2013 and 449 of them were included in this study. All pathological specimens were re-evaluated in terms of WHO 2007 classification. All demographical and follow-up records and imaging archives were investigated by using our center"s central automation system and National Central Population Management System. If records were not available or not adequate, investigators made phone calls to patients. Pediatric patients were excluded. RESULTS: Three hundred twenty-six female (76.2%) and 123 male (27.4%) patients were analyzed. Their ages ranged from 18 to 84 years (mean=51.6±11.9 years). The most common subtype of meningioma was meningothelial meningioma (51.7%), followed by atypical meningioma (20.3%). WHO Grade I meningiomas had statistically random localization distribution, but WHO Grade II meningiomas were more common in the convexity, parasagittal and middle fossa. Younger age was found to be significantly related with tumor recurrence or progression. Seventy-three (16.2%) patients underwent SRS and 64 (14.2%) patients underwent adjuvant radiotherapy (ART) after surgery. Convexity localization was found to be associated with recurrence, mortality and higher WHO 2007 grade. CONCLUSION: Convexity meningiomas are associated with recurrence, mortality and higher WHO 2007 grade. Convexity meningiomas should be totally resected in order to achieve maximum benefit from surgery.