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Herlyn-Werner-Wunderlich Syndrome—Timely Diagnosis is Important to Preserve Fertility

BACKGROUND Herlyn-Werner-Wunderlich syndrome is an urogenital malformation with uterus didelphys and obstructed hemivagina with ipsilateral renal agenesis. Most of these patients present after the onset of menstruation. We describe two cases diagnosed too late to prevent the complications. CASE The first patient presented with acute abdomen one year after the onset of menstruation and had salpingectomy due to pyosalpinx. The blind hemivagina was not recognized and she had severe endometriosis. She underwent hysterectomy 8 years later. The second patient presented with foul smelling vaginal discharge when she was 21 years old. She had a simple vaginal septum resection. SUMMARY AND CONCLUSION In the presence of uterine cavities in a regularly menstruating girl with dysmenorrhea, the presence of both kidneys should be checked. When unilateral renal agenesis and uterus didelphys coexist the first thing that we should remember is to confirm or refute the presence of a blind vagina.Background: Herlyn-Werner-Wunderlich syndrome is an urogenital malformation with uterus didelphys and obstructed hemivagina with ipsilateral renal agenesis. Most of these patients present after the onset of menstruation. We describe two cases diagnosed too late to prevent the complications. Case: The first patient presented with acute abdomen one year after the onset of menstruation and had salpingectomy due to pyosalpinx. The blind hemivagina was not recognized and she had severe endometriosis. She underwent hysterectomy 8 years later. The second patient presented with foul smelling vaginal discharge when she was 21 years old. She had a simple vaginal septum resection. Summary and Conclusion: In the presence of uterine cavities in a regularly menstruating girl with dysmenorrhea, the presence of both kidneys should be checked. When unilateral renal agenesis and uterus didelphys coexist the first thing that we should remember is to confirm or refute the presence of a blind vagina.

Sağlık çalışanları, tıp öğrencileri ve hemşirelik öğrencilerinde insan papilloma virüsü, servikal kanser ve HPV aşısı farkındalığı

Objectives: Establishment of the knowledge and the need to make conscious in medicine students, nursing students and nurses due to the effective role of updating conscious of the health workers, we aimed to assess the knowledge of nurses and students of Istanbul Bilim University and affiliated hospitals about HPV and cervical cancer. Materials and methods: Because healthcare personnel illuminate and influences the public, the survey was conducted to medicine students of the first three years, nursing students and nurses. The reason of choosing the first three years of medicine students is with the begining of the gynecology courses at the 4th year of education in medical faculty, learning takes the place of awareness. Totally 743 participants were asked to survey but 603 subjects responded (81.2%) then the surveys that was not asked for the identity information were taken into consideration Results: Nurses and students of nursing had better knowledge about smear test when compared to students of medicine (first 3 years) and other healthcare person nel. Only 52% accepted to get a daughter vaccinated. The main reasons for vaccine rejection were the concerns about vaccine safety (41%), cost of the vaccine (10%) and sexual promiscuity (5%) after vaccination. Religious aspects were not considered as an obstacle. Conclusions: The awareness of HPV, cervical cancer and HPV vaccination should be increased. J Clin Exp Invest 2012; 3(3): 318-325

Can quadruple test parameters predict SGA infants

The aim of this study was to investigate the role of quadruple test parameters in predicting the risk of delivering a small for gestational age (SGA) infant. The quadruple test results of patients performed at 16–18 weeks of pregnancy were searched retrospectively. Alpha-fetoprotein (AFP) levels higher than 2 MoM were associated with a risk of delivering an SGA infant (p = 0.025), sensitivity 8%, specificity 98%, positive predictive value 25%, negative predictive value 91%. Other quadruple test parameters were not related to delivery of an SGA infant. The introduction of AFP as a screening test for the detection of SGA infants does not seem feasible, but we suggest clinicians take it into account when counselling the patients about the results of Down syndrome screening tests.

İlk trimester serum PAPP-A düzeyleri ve gebelik yaşına göre küçük bebeklerin tahmin edilmesi

J Clin Exp Invest www.jceionline.org Vol 3, No 2, June 2012 Correspondence: Dr. Nilgün Güdücü İstanbul Bilim University, Department of Obstetrics and Gynecology İstanbul, Turkey, E-mail: nilgun.kutay@gmail.com Received: 06.03.2012, Accepted: 05.05.2012 Copyright

Low-grade fibromyxoid sarcoma of the vagina: A tumor, not previously reported at this site

This report presents the first case of low-grade fibromyxoid sarcoma (LGFMS) arising from the vaginal wall (a rare soft-tissue sarcoma of subfascial planes) and draws attention to differential diagnosis of masses arising from the vaginal wall. A patient presenting with abdominal pain to emergency department was diagnosed to have an ovarian mass filling the Douglas space. At laparoscopy, the origin of the mass was identified as the posterior vaginal wall. After vaginal excision of the gelatinous mass, pathologic diagnosis revealed a rare tumor, LGFMS. We discussed the differential diagnosis of vaginal LGFMS.

Endometriyal polip zemininde gelişen endometriyum kanserleri: 3 yıllık klinik deneyimimiz

Endometrial carcinomas based on polyp: 3 years single center experience Objective: The incidence of endometrial polyp is 16-34% within the whole population nonetheless increases after menopause. The incidence of cancer involvement through the endometrial polyp is 0.8-4.8%. Material and Methods: Study is designed as a retrospective descriptive study. Medical records of the patients which were diagnosed to have endometrial polyp within January 2009-January 2012 were reviewed. The patients which were diagnosed to have malignancy based on endometrial polyp were included. Results: 325 patients were obtained to have endometrial polyp, and 11 of them (3.4%) were found to be appropriate for study. 140 patients (59%) were postmenopousal and 285 patients (41%) were premenopousal 67 (43%) of the postmenopausal patients had endometrial sampling due to thickened endometrium (10mm) although they were asymptomatic. 73 (57%) of the postmanopausal patients were symptomatic. Six of this postmenouposal patients (4.2%) had malignancy based on the endometrial polyp, all of this patients were in symtomatic group. 192 of the 325 patients (59%) were symptomatic and 10 of this patients (5.2%) had malignancy based on endometrial polyp. Only one patient was asymptomatic. Histopathologic type was endometrioid and except one patient who has stage 1B disease, all patients have stage 1A disease. Two patients’ carcinoma were limited to the polyp, endometrial tissue had no sign of malignancy. Conclusion: We conclude that endometrial biopsy should be performed at the patients known to have endometrial polyp after menopause and symptomatic patient, regardless the menopausal status. Eventhoug malign endometrial polyps are diagnosed at eraly stages, with the advanced age grade of the tumor increases.