Emine Seda dağ Güven

Is resveratrol a potential substitute for leuprolide acetate in experimental endometriosis

OBJECTIVE Resveratrol, a phytoalexin polyphenol, has anti-angiogenic, antioxidant, anti-inflammatory properties. We aimed to compare the anti-inflammatory and anti-angiogenic effects of resveratrol and leuprolide acetate (LA) in an experimental endometriosis model. STUDY DESIGN A prospective experimental study was conducted in a University Surgical Research Center. Thirty-three non-pregnant female Sprague-Dawley rats, in which experimental model of endometriosis were surgically induced were randomly divided into four groups. Group 1 was administered 30 mg/kg resveratrol i.m. for 14 days, group 2 was given 1mg/kg s.c. single dose LA, group 3 was administered both resveratrol and LA, and group 4 had no medication. After two weeks medication rats were sacrificed and size, histopathology and immunreactivity to matrix metalloproteinase (mmp)2, mmp9, vascular endothelial growth factor (VEGF) of the endometriotic implants were evaluated. Plasma and peritoneal fluid levels of interleukin (IL)-6, IL-8, and tumor necrosis factor-α (TNF-α) were analyzed. RESULTS The endometriotic implant volumes, histopathological grade and immunreactivity to mmp2, mmp9 and VEGF were significantly reduced (p<0.001), and plasma and peritoneal fluid levels of IL-6, IL-8 and TNF-α were significantly decreased in group 1 and group 2 in comparison to group 3 and group 4 (p < 0.001). CONCLUSION Resveratrol alone is a potential agent for the treatment of endometriosis and may be an alternative to LA. In contrast, the combination of LA and resveratrol decreased the anti-inflammatory and anti-angiogenic effects of each agent. Since resveratrol is widely used as an alternative therapy for a variety of conditions, it can undermine the effectiveness of LA. Therefore, caution should be exercised when used in combination with other agents.

The Role of Hypoxia at Primary Dysmenorrhea, Utilizing a Novel Hypoxia Marker—Scube1

STUDY OBJECTIVE To determine the SCUBE1 levels in adolescents with primary dysmenorrhea. DESIGN A prospective cross-sectional study. SETTING A university hospital outpatient clinic, Rize, Turkey. PARTICIPANTS A total of 40 adolescent girls, 15 on menses and 25 not on menses. INTERVENTIONS AND MAIN OUTCOME MEASURES Demographic features and menstrual history of the participants were assessed and blood samples were obtained for detecting the platelet volume, platelet counts, and SCUBE1 levels of the participants. RESULTS No difference was detected between the 2 groups in mean platelet volume, platelet count, and SCUBE1 levels. CONCLUSION Future trials are required to investigate the relation between SCUBE1 levels and primary dysmenorrhea.

Lower Urinary Tract Symptoms and Urinary Incontinence During Pregnancy

Lower urinary tract symptoms (LUTS) can frequently be seen in pregnant women. Pregnancy and delivery have been considered as risk factors in the occurrence of pelvic floor dysfunction and determinants of LUTS. The main associated risk factor is parity. In the present study, we aim to determine the frequency of LUTS and urinary incontinence (UI) during pregnancy and the associated risk factors.

Urinary Incontinence in Premenopausal Women: Prevalence, Risk Factors and Impact on Quality of Life

To determine the prevalence and risk factors of urinary incontinence (UI), and assess its impact on the quality of life (QOL) in premenopausal women.

Spontaneous intraamniotic hemorrhage in the second trimester mimicking an abdominal wall defect.

We report here a case of spontaneous intraamniotic haemorrhage in the second trimester which mimicked an abdominal wall defect. The ultrasound and magnetic resonance imaging findings are discussed and a review of the literature regarding differential diagnosis of bleeding and abdominal wall defects is made.

Brenner tumor of the ovary revealed by cyst aspiration in a patient undergoing in vitro fertilization

Brenner tumors are uncommon, solid (mostly) neoplasms of the ovary. The majority are benign and they can be bilateral [1,2]. Ovarian cyst cytology confirmed by histology in patients undergoing in vitro fertilization (IVF) has been reported rarely in the literature [3]. The present case describes a Brenner tumor of the ovary revealed following basal cyst aspiration. A 40-year-old woman with primary infertility was scheduled to undergo IVF in February, 2012. The patients partner suffered from severe oligoasthenozoospermia. Owing to poor ovarian reserve (day 3 follicle stimulating hormone: 19 IU/mL; anti-Mullerian hormone: 0.12 ng/mL), a microdose flare-up regimen for the first IVF cycle was selected. On the first day of gonadotropin injections, transvaginal ultrasound revealed a left ovarian simple cyst measuring 18 x 17 mm (Fig. 1a). Subsequently, the patient underwent ovarian cyst aspiration and the aspirated fluid (clear yellowish) was sent for cytological evaluation. There was no follicular growth or increase in serum estradiol level after 9 days of gonadotropin injections. The IVF cycle was canceled owing to ovarian unresponsiveness. The cytopathology report, available 10 days after cyst aspiration, described the microscopic findings as a suspicious malignancy (only a few atypical epithelial cells with high nucleus/cytoplasm ratio). Serum tumor marker levels and an abdomen/thorax computed tomography evaluation were unremarkable. The patient underwent midline laparotomy for possible occult ovarian cancer. A left ovarian salpingo-oophorectomy was performed and a frozen section of the ovary revealed an occult Brenner tumor. Exploration of other intra-abdominal organs and cytological evaluation of abdominal washing fluid failed to show any evidence of malignancy. The final pathology supported the diagnosis of an occult ovarian pure benign Brenner tumor (Fig. 1b,c) measuring 10 mm in diameter at the edge of the ovarian cyst. A baseline ovarian cyst in IVF patients may result from the persistence of a follicular cyst formed in a previous cycle, endometriosis, or neoplastic process. Before starting gonadotropin injections, aspiration of such cysts may assist in the final stage of folliculogenesis, block the mechanical effect of the ovarian cyst, and increase the area of follicular development, thereby increasing local angiogenesis [4]. In the present case the patients history, pelvic examination findings, and transvaginal sonographic appearance were not suggestive of a neoplastic change. Cyst aspiration was performed to increase IVF cycle outcome, however subsequent cytological evaluation of the aspirate revealed the Brenner tumor.

Pregnancy in the Setting of Asymptomatic Non-Cirrhotic Chronic Portal Vein Thrombosis Complicated by Pre-Eclampsia

Portal vein thrombosis (PVT) can be chronic or acute in nature; it is characterized by a thrombus formation in the main portal vein and/or its right or left branches. Herein, we present a 36-year-old woman with asymptomatic noncirrhotic chronic PVT who developed preeclampsia in the later stage of pregnancy. This report will emphasize the clinical differential diagnosis, outcome, and management of pregnancies complicated by noncirrhotic PVT.

Appendix and uterus metastasis of squamous cell carcinoma arising from mature cystic teratoma of the ovary.

Mature cystic teratoma of the ovary rarely undergoes malignant transformation. There is no consensus for a treatment modality because of the rarity of the disease. Herein we present a case of squamous cell carcinoma (SCC) arising in a mature cystic teratoma (MCT) in a 66-year-old patient. The patient underwent total hysterectomy and bilateral salpingo-oophorectomy, omentectomy, appendectomy, and bilateral pelvic + paraaortic lymph node dissection. The histopathological examination revealed malignant invasion of the appendix and uterus. The patient, who refused the continuation of treatment initiated with the administration of a single dose of cisplatin, died 5 months later because of the disease. It is imperative that gynecologists consider appendectomy in SCC arising from MCT cases.