Cyst of the canal of nuck: A rare cause of inguinal swelling in women.

Among various reasons of swellings in the female inguinal region nuck canal cysts are rare entities. Abnormal persistence of procesus vaginalis opening cause this formation. Presentation at adults can lead misdiagnosis. Inguinal hernia, tumors (benign or malign), cysts, lymphadenopathies and endometriosis are other common reason for female groin swelling. Once diagnosed surgical excision is definitive treatment.

Appendectomy in the surgical treatment of benign ovarian mucinous cystadenomas - is it necessary?

OBJECTIVES: To determine if appendectomy as an adjunctive procedure is necessary in the surgical treatment of benign ovarian mucinous cystadenomas. MATERIAL AND METHODS: Retrospective analysis of clinical data: in a research hospital, obstetrics and gynecology depart-ment setting, 63 cases of benign ovarian mucinous cystadenomas confirmed in the pathological evaluation were revised. 59 had the complete clinical, final pathological and follow-up data available and were included. RESULTS: 20.6% (13/59) went through an appendectomy. Basic characteristics of patients with different appendiceal pathologies did not show any significant differences. In the study group the mean age, parity, adnexial mass size were (40.1 ± 12.4); (1.3 ± 1.1) and (9.1 ± 5.3 cm), respectively. Patients were either operated laparoscopically (20), laparotomically (39) to perform a unilateral salpingoopherectomy/cystectomy. In 7 patients, oopherectomy was an additional procedure with: 2 abdominal hysterectomies, 4 cesarean sections and 1 total laparoscopic hysterectomy. 2 synchronous appendiceal pathologies (mucinous cystadenomas of the appendix) were defined in appendectomies performed. In these cases, the ovarian tumour sizes were: 7 cm and 4 cm. CONCLUSIONS: In the presence of a benign or borderline unilateral ovarian mucinous tumour as defined during the operation and especially if it is larger than 10-12 cm and with normal peritoneal and appendiceal gross morphology, appendectomy is not a necessary adjunctive procedure.

Blepharophimosis, Ptosis, and Epicanthus Inversus Syndrome: Expanding the Phenotype.

We present a 3-month-old girl who displayed typical clinical characteristics of blepharophimosis, ptosis, and epicanthus inversus syndrome (BPES). She was referred to our clinic with an initial diagnosis of Down syndrome. Clinical features of elevated follicle stimulating hormone and low estradiol levels in the case were diagnosed as BPES syndrome and were consistent with BPES type 2. To date, there are no cases of BPES with cleft palate and cardiomyopathy, suggesting that these novel findings can be part of this condition.

Preparation, characterization and physico-chemical properties of solid lipid nanoparticles (SLN) and nanostructured lipid carriers (NLC): their benefits as colloidal drug carrier systems.

Solid lipid nanoparticles (SLN) have attracted increasing attention by various research groups and companies since the early 1990s. Their advantages over existing traditional carriers have been clearly documented. In addition, modified SLN have been described which are nanostructured lipid carriers (NLC) composed of liquid lipid blended with a solid lipid to form a nanostructured solid particle matrix. NLC combine controlled release characteristics with some advantages over SLN. This paper reviews the production techniques, characterization and physical stability of these systems including destabilizing factors and principles of drug loading, then considers aspects and benefits of SLN and NLC as colloidal drug carriers.

Comparing the moisturizing effects of ascorbic acid and calcium ascorbate against that of tocopherol in emulsions.

Calcium ascorbate (CAAS), which is a hydrophilic and stable derivative of ascorbic acid (vitamin C) (AA), is commonly used in foods as an antioxidative agent. There are very limited reports on its dermatological use in the literature. In this paper, it is reported that CAAS could be used in place of ascorbic acid, which has chemical stability problems in topicals due to degradation by oxidation. The aim of this study was to investigate the skin-hydrating effect of CAAS compared to those of ascorbic acid and tocopherol (vitamin E) (T), which is a potential skin moisturizer and commonly used in dermocosmetics. Vitamins are incorporated into two kinds of base creams (o/w and w/o emulsion creams), alone and in combinations. Formulations were applied to the inner forearms of volunteers, and skin conductance was measured by using a corneometer. Data obtained were statistically evaluated. It was found that the skin-hydrating effect of CAAS was higher than that of AA and lower than that of T. However, its effect was very close to that of T.

Skin moisturizing effect and skin penetration of ascorbyl palmitate entrapped in solid lipid nanoparticles (SLN) and nanostructured lipid carriers (NLC) incorporated into hydrogel.

This study was performed as a complimentary to our previous study regarding the chemical stability of ascorbyl palmitate (AP) in solid lipid nanoparticles (SLN), nanostructured lipid carriers (NLC) and for comparison, in nanoemulsion (NE) incorporated into a hydrogel produced by high pressure homogenization. AP is known as an effective antioxidant that protects tissue integrity similar to vitamin C. Recently, its moisturizing activity in conventional topical formulations was found to be high. The aim of the present study was to investigate the moisturizing potential of AP in SLN and NLC incorporated into hydrogel as colloidal carrier systems. It has been known that SLN and NLC have occlusive effects, but AP incorporation moisturized skin significantly better than placebo in short-term (p < 0.001) and long-term trials (p < 0.01) for both SLN and NLC. In the second part of the study, SLN and NLC were found to sustain the penetration of AP through excised human skin about 1/2 and 2/3 times compared to NE (p < 0.001 and p < 0.01), respectively, due to the solid state of Witepsol E85 in the lipid phase.

Solid lipid nanoparticles (SLN) and nanostructured lipid carriers (NLC) for application of ascorbyl palmitate.

The aim of this study was to improve the chemical stability of ascorbyl palmitate (AP) in a colloidal lipid carrier for its topical use. For this purpose, AP-loaded solid lipid nanoparticles (SLN), nanostructured lipid carriers (NLC) and for comparison, a nanoemulsion (NE) were prepared employing the high pressure homogenization technique and stored at room temperature (RT), 4 degrees C and 40 degrees C. During 3 months, physical stability of these formulations compared to placebo formulations which were prepared by the same production method, was studied including recrystallization behaviour of the lipid with differential scanning calorimetry (DSC), particle size distribution and storage stability with photon correlation spectroscopy (PCS) and laser diffractometry (LD). After evaluating data indicating excellent physical stability, AP-loaded SLN, NLC and NE were incorporated into a hydrogel by the same production method as the next step. Degradation of AP by HPLC and physical stability in the same manner were investigated at the same storage temperatures during 3 months. As a result, AP was found most stable in both the NLC and SLN stored at 4 degrees C (p > 0.05) indicating the importance of storage temperature. Nondegraded AP content in NLC, SLN and NE was found to be 71.1% +/- 1.4, 67.6% +/- 2.9 and 55.2% +/- 0.3 after 3 months, respectively. Highest degradation was observed with NE at all the storage temperatures indicating even importance of the carrier structure.

Influence of surfactants on the physical stability of solid lipid nanoparticle (SLN) formulations.

The choice of surfactant or surfactant mixtures at suitable concentrations contributes to the stability of solid lipid nanoparticles (SLN). In this study, it was found that 1.5% TegoCare 450 was the most effective stabilizer for the Witepsol E85 SLN dispersion compared to Tween 80, Tyloxapol and Pluronic F68 according to the data obtained from differential scanning calorimetry (DSC), zeta potential (ZP) measurements and particle size analysis.

Moisturizing potentials of ascorbyl palmitate and calcium ascorbate in various topical formulations.

The aim of this study was to use two of Vitamin C derivatives, lipophilic ascorbyl palmitate and hydrophilic calcium ascorbate to determine their skin-hydrating effects for the first time. For this purpose, anhydrous cream, gel and w/o emulsion were prepared and applied to the volunteers' inner forearms. A commercial topical preparation containing a known moisturizer, Vitamin E, was also chosen and used for comparison. Moisture contents of the skin were measured by using corneometer.

Bone resorption starts at 14 days of treatment with gonadotropin-releasing hormone agonist in in vitro fertilization cycles.

The effect of gonadotropin-releasing hormone agonist (GnRH-a) use on bone turnover was investigated in a prospective cohort study of female patients undergoing in vitro fertilization (IVF) treatment. In 46 couples diagnosed with male-factor infertility, the women underwent a long step-down ovulation induction protocol. Urinary cross-linked N-telopeptide (uNTx) level was used to demonstrate bone turnover rate and was measured at the first day of GnRH-a administration, the first day of gonadotropin administration, the day after human chorionic gonadotropin injection and 12 days after embryo transfer. Urinary NTx levels (mean+/-standard deviation (SD)) were 71+/-34, 81+/-40, 81+/-50 and 83+/-47 nmol BCE/mmol creatinine (BCE, bone collagen equivalents), respectively. There was no statistically significant difference between the four measurements (p = 0.28). In 19 women GnRH-a was administered for > or = 14 days. Urinary NTx values of this group and the remaining 27 patients after GnRH-a treatment were 96.2+/-40.7 and 71.5+/-36.8 nmol BCE/mmol creatinine (mean+/-SD), respectively. The difference between these groups was statistically significant (p=0.038). These findings suggest that < 14 days' use of GnRH agonist in IVF patients has no effect on bone metabolism. To our knowledge, this is the first study demonstrating that the effect of agonists on bone metabolism starts as soon as estradiol suppression has started.

Effect of vehicles and penetration enhancers on the in vitro percutaneous absorption of celecoxib through human skin.

The aim of this study was the comparison of three different formulations (gel, o/w emulsion, oleagenous cream) and two penetration enhancers (oleic acid and menthol) as vehicle systems for celecoxib in respect of release and penetration through excised human skin in vitro. The influence of the vehicle on the release rate was studied in vitro using a cellulose acetate membrane. The release rate could be increased by up to 6.5 and 2.5 times with gel and o/w emulsion compared to oleagenous cream respectively. Further in vitro penetration measurements using human skin on Franz diffusion cells were performed with and without oleic acid and menthol as enhancers. It was shown that the penetration rate is strongly dependent upon the enhancer type and concentration but not on the vehicle itself and could be increased by 48% when 5% oleic acid was used in oleagenous cream. In all formulations tested, celecoxib was released and penetrated into human skin more quickly and to a greater extent from the gel formulations. There is no topical formulation available of celecoxib and its penetration properties through human skin have not been investigated. Since celecoxib creates some gastrointestinal disturbances, topical formulations of celecoxib preferably in gel form including 5% oleic acid could be suggested as an alternative.

Toxicity of chemotherapeutical protocols in the treatment of uterine sarcomas (Vincristine, actinomycin D, Cyclophosphamide VAC versus ifosfamide).

OBJECTIVE: Uterine sarcomas are rare tumors which account for 1% of all genital tract malignancies. They have a poor prognosis with an overall survival of under 50% at 2 years. The benefit of chemotherapy is unclear and different chemotherapy protocols are used for the treatment of uterine sarcomas. But there is little experience about their toxicity because of the limited case series. So we compared VAC protocol and ifosfamiide for toxic effects. MATERIAL AND METHOD: We reviewed 13 cases which were diagnosed as uterine sarcomas and treated with surgery plus chemotherapy at The Department of Obstetrics and Gynecology, Akdeniz University School of Medicine from 1990 to 1995. Data were obtained from patient files. RESULTS: Mean age was 55.7 (range 38-70), 7 (53.8%) patients had malignant mixed mullerian tumors and 6 (46.1) had leiomyosarcomas. A total of 32 courses of chemotherapy were given -20 ifosfamide and 12 VAC therapy. Leucopenia, hepatic dysfunction and peripheral neuropathy were more frequent in the VAC group as 75%, 16.6%, versus 30%, 0%, 0%, in the iFosfamide group respectively. However, urothelial toxicity (35%) was more common in the ifosfamide group. CONCLUSION: VAC protocol is more toxic for the liver, hematopoietic and peripheral neurologic system. On the other hand the major toxicity of ifosfamide was on the urinary tract. Ifosfamide may be a good choice with less toxicity than VAC therapy in the treatment of uterine sarcomas.

Primary pure choriocarcinoma of the ovary in reproductive ages: a case report.

Choriocarcinoma is an aggressive tumor with cyto- and syncytiotrophoblastic cells. It arises gestationally or nongestationally. Nongestational choriocarcinoma of the ovary can be pure or mixed with other germ cell tumors. Pure type is less frequent than mixed type and the diagnosis of nongestational choriocarcinoma of the ovary is very difficult in the reproductive period. A case of a 20-year-old woman with pure choriocarcinoma of the ovary is presented with a review of the literature and discussion of its origin.

Intravaginal naproxen in preterm labour: a preliminary study.

In a preliminary study, the possibility that local inhibition of postaglandin formation may inhibit preterm labour was examined. An intravaginal cyclo-oxygenase inhibitor, naproxen sodium, 500 mg was used in cases of preterm labour. The gestational ages of the patients were between 27 and 34 weeks, and they included a triplet pregnancy unresponsive to beta-sympathomimetic therapy. Treatment with intravaginal naproxen sodium was associated with prolongation of pregnancy for more than 6 days in five out of seven patients. No untoward fetal or maternal side-effects were detected.

Radionuclide hysterosalpingography with radiolabeled spermatozoa.

OBJECTIVE: To evaluate the efficiency of radionuclide hysterosalpingography (HSG) by using 99mTc hexamethyl propyleneamine oxime (HMPAO)-labeled human spermatozoa in the assessment of fallopian tube patency in infertile couples. DESIGN: Fifteen infertile female patients were inseminated with their husbands' radiolabeled spermatozoa immediately after cessation of menses. SETTING: University-based academic hospital. MAIN OUTCOME MEASURE(S): The time course of radioactivity and scintigraphic images of the uterus and the parauterine tissues implying tubal patency were evaluated and compared by using laparoscopy and HSG. RESULT(S): We demonstrated Tmax (time to peak radioactivity at periovarian sites) for right and left tubes to be 6.74 +/- 2.66 and 5.91 +/- 2.93 minutes (means +/- SD), respectively. We also found 72% sensitivity and 75% specificity of spermatozoa labeled radionuclide HSG compared with laparoscopic findings for tubal patency. CONCLUSION(S): Radionuclide HSG with the husband's spermatozoa seems to be a potentially useful method of assessing patency of the fallopian tubes. The safety dose of this procedure is comparable to conventional HSG. However, more comparative studies are needed to evaluate advantages and disadvantages of this technique.

Induction of labor with intravaginal misoprostol versus intracervical dinoprostone.

Sixty five pregnant women who had the indication for labor induction were randomized in a clinical trial to receive 100 micrograms intravaginal misoprostol or intracervical gel of 0.5 mg dinoprostone. The mean time from induction to delivery for the misoprostol group was 7.6 +/- 1.9 versus 8.2 +/- 5.9 (hours +/- SD) for the dinoprostone group. There were no significant differences between groups in gestational age, induced labor rates, type of delivery, fetal outcome and maternal complications. We found that intravaginal misoprostol tablet is as effective as intracervical dinoprostone for inducing second and third trimester labor.

A rare case of Turner's syndrome with 45,X/46,X,Dic (X) (qter----p11.1::p11.4----qter).

This paper presents a female patient with clinical features of Turner's Syndrome and the chromosomal constitution of 45,X/46,X,dic (X) (qter----p11.1::p11.4----qter). This abnormal X chromosome was compared with similar-structured dic(X).