Müzeyyen Duran

Comparison of standard mammography with digital mammography and digital infrared thermal imaging for breast cancer screening

Breast cancer is the most common malignancy in women. Screen-film mammography (SFM) has been considered the gold standard for breast cancer screening and detection. Despite its recognized value in detecting and characterizing breast disease, mammography has important limitations and its false-negative rate ranges from 4% to 34%. Given these limitations, development of imaging modalities that would enhance, complement, or replace mammography has been a priority. Digital mammography (FFDM) and digital infrared thermal imaging (DITI) are some of these alternative modalities.

Effect of liquid-based gel application during speculum examination on satisfactory level of smear examination

PurposeThe aim was to evaluate the use of liquid-based gel during cytologic follow-up and the effect of liquid-based gel application during speculum examination on satisfactory level of smear.MethodsA total of 1,999 patients were taken into the study. Patients were divided into two groups as gel-applied group and control group. Age and menopausal status of patients, and the physicians taking the smear (resident or specialist) were recorded. In control group, dry speculum was used for the collection of smear sample. All specimens were evaluated for correlation of the cytopathology, the number of “unsatisfactory” samples, and any secondary diagnoses.ResultsAssessment of smear satisfactoriness revealed that 2.2% (43) of them were unsatisfactory. Unsatisfactory smear ratio was significantly high in gel-applied group. Screening done by residents increased unsatisfactory result risk for about 5.5 times. Evaluation of effect of menopausal status on smear adequency revealed no difference between premenopausal and postmenopausal women.ConclusionCervical smear seems to be more accurate without gel application. Experience of the physician is also important. Water-based gel can be used in some women who experience overt pain during speculum examination, but these patients must be warned about unsatisfactory results and the need of repeat test.

Fetal magnetic resonance imaging in obstetric practice.

Ultrasonography (USG) is the primary imaging method for prenatal diagnosis of fetal abnormalities since its discovery. Although it is the primary method of fetal imaging, it cannot provide sufficient information about the fetus in some conditions such as maternal obesity, oligohydramnios and engagement of the fetal head. At this stage, magnetic resonance imaging (MRI) facilitates examination by providing more specific information. The need and importance of fetal MRI applications further increased by the intrauterine surgery which is currently gaining popularity. Some advantages of fetal MRI over USG are the good texture of contrast, a greater study area and visualization of the lesion and neighbourhood relations, independence of the operators. Also it is not affected by maternal obesity and severe oligohydramnios. However, MRI is inadequate in detecting fetal limb and cardiac abnormalities when compared to USG. MRI is not used routinely in pregnancy. It is used in situations where nonionizing imaging methods are inadequate or ionizing radiation is required in pregnant women. It is not recommended during the first trimester. Contrast agent (Godalinium) is not used during pregnancy. It is believed that MRI is not harmful to the fetus, although the biological risk of MRI application is not known. MRI technique is superior to USG in the detection of corpus callosum dysgenesis, third-trimester evaluation of posterior fossa malformations, bilateral renal agenesis, diaphragmatic hernia and assessment of lung maturation. Especially, it is the method of choice for evaluation of central nervous system (CNS) abnormalities. Fetal MRI has a complementary role with USG. It provides important information for prenatal diagnosis, increases diagnostic accuracy, and in turn affects the prenatal treatment, prenatal interventions and birth plan.

Mean Platelet Volume as a Marker of Thrombosis in Patients with Missed Abortion

liability for thrombosis whether an abnormality in the embryo is present or not. We compared MPV values and platelet counts of 100 normal pregnancies resulting in live births and of 100 patients with missed abortions to determine whether MPV and platelet counts are useful tools for the identification of patients with unsuccessful pregnancy. Both groups had a gestational age range of 6–13 weeks. Patients who had anemia, hemoglobinopathy, any systemic or chronic disease, a history of bleeding or coagulation disorder or who were under anti-coagulant therapy Early pregnancy loss is a common pregnancy complication with an incidence ranging between 50 and 70% of all conceptions [1] . The exact cause of it is still unknown. Mean platelet volume (MPV), an accurate measure of platelet size, is considered a marker and determinant of platelet function. Larger platelets with higher MPV values are hemostatically more reactive and produce higher amounts of the prothrombotic factor thromboxane A 2 , increasing the propensity to thrombosis [2, 3] . In the case of a missed abortion, there may be a Received: September 6, 2010 Accepted after revision: November 22, 2010 Published online: January 20, 2011

Does vitamin E prevent tubal damage caused by smoking? A light microscopy and animal study

OBJECTIVE To assess the histomorphological effects of smoking on the cilia of fallopian tubes in mice and the effect of vitamin E on the negative effects of smoke. STUDY DESIGN Eighteen 12-14 week-old Swiss albino type female mice were randomly divided into three groups, each consisting of six mice: Group A: control group; Group B: mice exposed to cigarette smoke; Group C: mice exposed to cigarette smoke together with vitamin E. Groups B and C were exposed to cigarette smoke for 10 weeks. After 10 weeks, tubal excision was performed in all animals. Histopathologic examination of excised tubal tissue was conducted under light microscopy. RESULTS The number of cilia was significantly lower in Group B. Although not statistically significant, the median number of cilia in Group C was measured to be higher than in Group B but lower than in Group A. CONCLUSION Based on the results, it can be concluded that smoking decreases tubal cilia numbers. Supplementation by vitamin E may treat or at least help to slow down the decrease in number of cilia caused by smoking; therefore it could be used therapeutically in the treatment of smoking-related tubal damage.

Assessment of mean platelet volume of pregnant women wıth gestational diabetes mellitus and impaired glucose tolerance as a marker of future cardiovascular disease risk

Objective: To assess the platelet count and mean platelet volume (MPV) of pregnant women with gestational diabetes mellitus (GDM) or gestational impaired glucose tolerance (GIGT) to find out whether GDM and GIGT are risk factors for future development of cardiovascular disease. Study design: A 50-g oral glucose load (OGL) was administered to all participants and haemotological parameters were studied at 24-28 gestational weeks. When plasma glucose ≥ 140 mg/dl (7.8 mmol/l) was measured following the OGL, a 100-g-3-h oral glucose tolerance test was undertaken. Results: A significant difference was observed for MPV values between the GDM and normal OGL groups. Conclusion: Presence of a high MPV in GDM could demonstrate an increase in the risk for current and future thrombotic complications.

Relation between serum PAPP-A level and umbilical cord thickness during first trimester of pregnancy.

Abstract Purpose: To evaluate the relation between umbilical cord diameter versus pregnancy associated plasma protein-A (PAPP-A) level in first trimester women. Method: Cord diameter were measured and patients were divided into two groups according to frequency distribution analysis as below or above 3.7 mm for free loop diameter (FCD) and below or above 3.4 mm for cord measurement at umbilicus (ACD). Groups were compared with each other. Results: Strong correlations were found between ACD versus PAPP-A. Conclusion: By using strong correlation between ACD versus PAPP-A, it may be possible to reduce unnecessary amniocentesis due to false positive screening results.

Do cigarette smoke and vitamin E affect the development of endometrial pinopods? An animal study

OBJECTIVES To study the effects of cigarette smoke and vitamin E on the development of endometrial pinopods. STUDY DESIGN Eighteen female and 12 male Swiss albino mice, 12-14 weeks old, with a mean weight of 25g (standard deviation 5g) were used in this study. Female mice were divided into three equal groups. Every day for 10 weeks, mice in Group 1 (control group) received normal saline intraperitoneally; mice in Group 2 were exposed to smoke from 20 cigarettes/day using a smoke machine; and mice in Group 3 were exposed to smoke from 20 cigarettes/day using a smoke machine and also received 50mg/kg vitamin E intraperitoneally. After 10 weeks, vaginal smears were taken from the female mice and they were copulated with the 12 male Swiss albino mice on the day of oestrus. Day 0 was defined as the day on which sperm were detected in the vagina by smear test. Mice were killed at the end of Day 5, which was considered to represent the optimal day for implantation. The uteri were removed and the effects of cigarette smoke and vitamin E on the development of endometrial pinopods were studied using an electron microscope. RESULTS The endometrial tissue of the control group appeared morphologically normal, with short microvilli, cytoplasm and pinopods in the form of cytoplasm and cell membrane enlargements in patches. In total, 149 pinopods were counted in the control group using a scanning electron microscope (two histologists performed the analysis and were blinded to each others findings). In the smoke-exposed group, the cytoplasmic structure was degenerated considerably, and fewer pinopods were counted (n=11). The number of pinopods in mice who were exposed to cigarette smoke and vitamin E (n=67) was significantly higher compared with the cigarette-exposed group (p=0.002), but considerably lower compared with the control group (p=0.002). CONCLUSION Smoke exposure led to a significant decrease in the development of endometrial pinopods. Vitamin E, an antioxidant, partially reversed the adverse effects of cigarette smoke. This suggests that cigarettes may have a negative effect on fertility by decreasing the number of pinopods. However, this negative effect can be reduced using vitamin E. More studies should be conducted to support this finding.

İkinci Trimester Gebelikte Uterin Prolapsus Olgusu

148 terin prolapsus, gebelik sırasında görülen nadir bir komplikasyondur.1 Gebelerde servikal kuruluk ve ülserasyon, üriner retansiyon, üriner yol enfeksiyonu, abortus, erken doğum, fetal ölüm ve hatta maternal sepsise yol açabilmektedir.2,3 Uterin prolapsus hastalarında tedavi gebelik haftası ve prolapsusun derecesine göre belirlenmelidir. Hastada serviksin ülserasyonunu ve akut üriner retansiyonu engellemek için manuel olarak doğal yerine itme ya da peser yardımı ile redüksiyon yapılabilir.4 Redüksiyon sonrası uterus tekrar prolabe olabileceği gibi peser yardımı ile yeİkinci Trimester Gebelikte Uterin Prolapsus Olgusu

CRP, HbA1c, lipid, and biochemical parameters and their relation with maternal visceral adipose tissue and subcutaneous fat tissue thickness

BACKGROUND/AIM The aim of this study was to find whether maternal visceral tissue (VAT) or subcutaneous fat tissue (SCFT) thicknesses are associated with CRP, HbA1c, lipid, and biochemical parameters in the first trimester of pregnancy. MATERIALS AND METHODS Ninety pregnant women were enrolled. Body mass index (BMI), VAT, and SCFT were measured. The best cut-off points for grouping subjects were found to be 4 cm for VAT and 2 cm for SCFT. Venous blood samples were collected. RESULTS VAT was higher than 4 cm in all cases with high BMIs. High CRP and HbA1c were found in 45.5% and 18.2% of cases with VAT over 4 cm, respectively. CONCLUSION Besides overall obesity, VAT thickness is the most important parameter. Decreasing obesity may prevent pathologies caused by inflammation during pregnancy as well as decrease the risk for future metabolic and cardiovascular disorders.