B. Artunc Ulkumen

The effects of sunitinib on endometriosis

Abstract The aim of the present study was to evaluate the effect of sunitinib on endometriotic implants and adhesions in a rat endometriosis model. An experimental endometriosis model was created in 21 rats. These rats were randomly divided into three groups: Group 1 (control group, 7 rats) was given no medication; Group 2 (sunitinib group, 7 rats) was given 3 mg/kg per day of oral sunitinib; and Group 3 (danazol group, 7 rats) was given 7.2 mg/kg per day of oral danazol. The volume of endometriotic implants was calculated. The extent and severity of adhesions were evaluated. The groups were compared by the Students t-test, analysis of variance (ANOVA) and the Mann–Whitney U test. There was no statistically significant difference in the mean volume of endometriotic implants before medication between three groups. The volume of implants and extent, severity, total score of adhesions were significantly decreased after medication in Group 2 and Group 3. We noted that the volume of the endometriotic implants and adhesion formation were decreased both after sunitinib and danazol treatment. As a result, sunitinib seems to be effective for endometriotic peritoneal lesions. The effects of sunitinib in rat models give hope for improving the treatment of human endometriosis and prevention of pain symptoms.

The alteration in placental volume and placental mean grey value in growth-restricted pregnancies assessed by 3D ultrasound: (Growth Restriction & 3D Ultrasonography)

Abstract We aimed to evaluate the volumetric and echogenic alterations in placentas between the intrauterine growth restriction (IUGR) and normal pregnancies using three-dimensional ultrasound and virtual organ computer-aided analysis (VOCAL) software. This case–control prospective study consisted of 48 singleton pregnancies complicated by IUGR and 60 healthy singleton pregnancies matched for maternal age, gestational age and parity. Placental volume (PV) and placental volumetric mean grey values (MGV) were evaluated. PV (cm3) was analysed using the VOCAL imaging analysis program, and 3D histogram was used to calculate the volumetric MGV (%). PV was 278.50 ± 63.68 and 370.98 ± 97.82 cm3 in IUGR and control groups, respectively (p = 0.004). MGV of the placenta was 38.24 ± 8.41 and 38.24 ± 8.41 in IUGR and control groups, respectively (p = 0.30). receiver operator curve (ROC) curve analysis revealed that area under curve was 0.731 for PV. Correlation analysis revealed that PV was significantly associated with estimated fetal weight (r = 0.319, p = 0.003), biparietal diameter (r = 0.346, p = 0.002), head circumference (r = 0.269, p = 0.019), abdominal circumference (r = 0.344, p = 0.002) and femur length (r = 0.328, p = 0.004). PV was inversely related to the umbilical artery pulsatility index (r = − 0.244, p = 0.017). To the best of our knowledge, this is the first study evaluating volumetric MGV in IUGR placentas by comparing them with healthy pregnancies. Our study showed that PV diminishes significantly in IUGR pregnancies, whereas volumetric MGV does not alter significantly.

Posterior reversible encephalopathy syndrome: An atypical complication of postpartum wound infection

Posterior reversible encephalopathy syndrome (PRES) was first described in 1996 (Hinchey et al. 1996). The syndrome has a unique neuroradiological diagnosis of vasogenic oedema in the brain and clinical symptoms, including headache, vomiting, confusion, altered mental function, seizure motor signs, paresis and visual abnormali-ties. Oedema is the predominant characteristic of this syndrome, especially in the parieto-occipital regions of the cerebral hemispheres of the white matter in the brain on computed tomography (CT) and magnetic resonance imaging (MRI) (Hinchey et al. 1996).PRES is associated with a variety of underlying conditions, includ-ing hypertensive encephalopathy, thrombotic thrombocytopenia purpura, systemic lupus erythematosus, immunosuppressive treat-ment, cancer chemotherapy, central nervous system infections and renal failure (Hinchey et al. 1996; Vaughan and Delanty 2000). It has also been described in the context of infections and severe sepsis (Bartynski et al. 2006). For pregnant and postpartum women, pre-eclampsia or eclampsia is an important reason of PRES (Chang and Keane 1999; Kumai et al. 2002).PRES is generally characterised by reversibility of the radiological and clinical abnormalities when the underlying condition process is resolved. Since there is no specific treatment; stabilisation of the haemodynamics, eradication of the infection and control of seizures are the mainstay of management of this syndrome (Fugate et al. 2010; Servillo et al. 2007).We report a case of PRES in a peripartum patient after wound infection. To the best of our knowledge, an association between wound infection and PRES has not been reported previously.