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Aim: : To measure obestatin levels in the blood and saliva samples of normal-weight patients with polycystic ovary syndrome (PCOS) in comparison with normal-weight healthy controls, and to determine whether there were relationships between blood and/ or salivary obestatin levels and other measured parameters. Materials and Methods: Fifteen healthy women and 15 patients with PCOS, all of which had normal weight, were included in the study. Participants' age, height, weight, menstrual characteristics, hormone levels, body mass index, waist/hip ratio, and modifed Ferriman-Gallwey (FG) scores were recorded. Obestatin levels were measured in both fasting blood and saliva samples. Homeostasis Model Assessment (HOMA-IR) was used to predict insulin resistance. Results: In the PCOS group, menstrual cycle duration and FG scores were signifcantly higher (P-value, <0.001, <0.001, respectively). The levels of luteinizing hormone, total testosterone and androstenedione were signifcantly higher in the PCOS group than in the control group (P-value, 0.001, 0.009, 0.004, respectively). In the PCOS group, blood obestatin level was 1265.2 ± 221.9 pg/ml, salivary obestatin level was 3095.33 ± 310.2 pg/ml; whereas the control group demonstrated lower levels of 939.66 ± 72.3 pg/ml and 2611.20 ± 217.1 pg/mL, respectively. However, no statistically signifcant difference was found between the PCOS and control groups when comparing obestatin levels in blood or saliva (P-value, 0.218, 0.369, respectively). No correlation was found between blood and salivary obestatin levels in either group. Finally, obestatin levels were not associated with any of the other measured parameters. Conclusion: Our results suggest that increased levels of obestatin, albeit in a small amount that would not be statistically signifcant in normal weight patients with PCOS, may have signifcant effects on weight control in these patients. In addition, our fndings show that saliva sample can be used as an alternative to blood sample in the measurement of obestatin level in patients with PCOS. [ABSTRACT FROM AUTHOR]

Objective. To determine the effects of Mullerian inhibiting substance (MIS) treatment on endometriosis cells through study of apoptosis and autophagy. Design. Experimental in vitro study. Setting. University research laboratory. Cell Line. CRL-7566 endometriosis cell line. This line was established from a benign ovarian cyst taken from a patient with endometriosis. Interventions. In vitro treatment with MIS. Main Outcome Measures. The main outcome measures were cellular viability, proliferation, cell-cycle arrest, and induction of apoptosis and autophagy in endometriotic cells. Results. MIS treatment inhibited proliferation of endometriosis cells and induced apoptosis, as indicated by Annexin V staining, and induced caspase-9 cleavage and cell-cycle arrest, as evidenced by increased expression of p27 CDK-inhibitor. MIS treatment also induced autophagy in endometriosis cells as demonstrated by a significant increase in LC3-II induction, a hallmark of autophagy. Conclusions. MIS inhibits cell growth and induces autophagy, as well as apoptosis, in ectopic endometrial cell lines. Our results suggest that MIS may have a potential as a novel approach for medical treatment of endometriosis. Further studies may be needed to test the efficacy of MIS treatment in animal models and to develop MIS treatment specifically targeted to the endometriosis. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is commonly characterised by obesity, insulin resistance (IR), hyperandrogenemia and hirsutism. Nesfatin-1 a recently discovered hormone, acts upon energy balance, glucose metabolism, obesity and probably gonadal functions. This study was to evaluate the circulating levels of nesfatin-1 in patients with PCOS ( n = 30) and in age and body mass index (BMI)-matched controls ( n = 30). PCOS patients had significantly lower levels of nesfatin-1 (0.88 ± 0.36 ng/mL) than healthy controls (2.22 ± 1.14 ng/mL). PCOS patients also had higher gonadotropin and androgen plasma concentrations, Ferriman-Gallwey scores, blood glucose levels and a homeostasis model of assessment-IR index (HOMA-IR) index than in healthy women. Correlation tests in PCOS subjects detected a negative correlation between nesfatin-1 levels and BMI, fasting blood glucose, insulin levels and a HOMA-IR index. Lower nesfatin-1 concentration may plays a very important role in the development of PCOS. [ABSTRACT FROM AUTHOR]

Objective: To investigate ghrelin and obestatin expression in serous ovarian tumours. Materials and methods: Preparations of deparaffinized blocks obtained from the pathology archives of a total of 47 previously diagnosed cases of benign serous tumour ( n = 20), borderline serous tumour ( n = 7) and malignant serous tumour ( n = 20) were subjected to immunohistochemical examination to find out ghrelin and obestatin expressions. Results: Mean ghrelin expressions decreased significantly in the benign group, relative to the malignant group ( p < 0.05), while there was no significant change in mean obestatin expression. It was established that rates of preparations with moderate and severe ghrelin and obestatin expression displayed a significant increase from benign to malignant ones ( p < 0.05). Conclusion: The fact that rates of preparations with severe expression correlated with an increase in malignancy suggests that ghrelin and obestatin may be effective in the malignant transformation in at least some cases. [ABSTRACT FROM AUTHOR]

Background. Endometrium carcinoma ranks fourth among female carcinomas. Therefore, early diagnosis of endometrium pre-malignant lesions is emphasised, and attempts are made to identify the risk factors. Since hyperplasias, particularly those with atypia, are held responsible for the development of the most common endometrium carcinomas, it is important to definitely distinguish between well-differentiated carcinomas and hyperplasia with atypia. In the present study, we aimed to explore whether ghrelin expression had a role in distinguishing between benign, pre-malignant and malignant lesions of endometrium. Methods. Tissue ghrelin expressions of a total of 60 cases, who were diagnosed in the Pathology Department Laboratory of Fıırat University Medical School, and of whom 10 were in the proliferation phase, 10 had simple hyperplasia without atypia, 10 had simple hyperplasia with atypia, 10 had complex hyperplasia without atypia, 10 had complex hyperplasia with atypia and 10 had endometrioid carcinoma cases, were examined using immunohistochemical method. Additionally, tissue samples were homogenised to analyse tissue ghrelin levels in the supernatants according to RIA method. Samples from the parotid glands were used as positive control for ghrelin. Cells that exhibited cytoplasmic staining with ghrelin antibody were evaluated as positive. Results. Immunohistochemical examination showed that ghrelin expression increased markedly in the proliferation phase, relative to hyperplasias and carcinoma. These results were parallel to ghrelin levels in tissue supernatants. Immunohistochemical and RIA analysis results indicate that ghrelin expression either markedly decreases or is entirely depleted in endometrial carcinomas. Conclusions. Therefore, we think that ghrelin expression can be useful in differentiating not only endometrium carcinomas from benign lesions but also complex hyperplasias with atypia, which pose diagnostic difficulties. [ABSTRACT FROM AUTHOR]

To investigate the severity of pain and circadian changes in uterine artery blood flow in primary dysmenorrhea cases. The study included 27 cases diagnosed as primary dysmenorrhea and 25 individuals who had no dysmenorrhea complaint. Bilateral uterine artery systole/diastole rates (S/D), pulsatility indices (PI) and resistance indices (RI) of all cases were measured using transvaginal colour Doppler at 12.00–02.00 p.m. and 12.00–02.00 a.m. Severity of pain was evaluated in dysmenorrhea cases at the same hours using a verbal pain assessment scale. Doppler measurements of dysmenorrhea cases conducted at 12.00–02.00 p.m. showed right uterine artery S/D: 3.37 ± 0.26, RI: 0.73 ± 0.07, PI: 2.38 ± 0.34 and left uterine artery S/D: 3.33 ± 0.37, RI: 0.74 ± 0.14, PI: 2.41 ± 0.15, while measurements carried out at 12.00–02.00 a.m. showed right uterine artery S/D: 3.88 ± 0.12, RI: 0.87 ± 0.14, PI: 2.94 ± 0.21 and left uterine artery S/D: 3.90 ± 0.27, RI: 0.92 ± 0.12, PI: 2.93 ± 0.21. Comparisons revealed significantly higher Doppler indices at night ( P < 0.05) than in the day in dysmenorrhea cases. There was not any significant circadian difference in individuals who did not have dysmenorrhea ( P > 0.05). Pain score in the verbal pain assessment of dysmenorrhea cases was found 3.6 ± 1.4 in the day and 5.8 ± 1.7 at night. The difference was found significant ( P < 0.05). Uterine artery blood flow is reduced at night in dysmenorrhea cases. In correlation with this, the cases feel more pain at night. Our results may be important on the planning of working hours and their quality of life. [ABSTRACT FROM AUTHOR]

To determine the prevalence of primary dysmenorrhea and attitudes and behavior toward dysmenorrhea in the female students of an university toward this problem. A total of 1,266 female university students were anonymously surveyed by doctors. It was found that mean age of the surveyed students was 21.02 ± 2.13 years, mean menarche age was 13.3 ± 1.4 years, and menstruation frequency was 32.58 ± 19.8 days. Of the students, 45.3% were found to suffer pain in each menstruation, 42.5% in some and 12.2% in none. Of those with primary dysmenorrhea, 66.9% were established to take analgesic drugs. Prevalence of primary dysmenorrhea was found higher than that cited in the literature. It was established that although the rate of consultation with health professionals about menstruation and related changes was low, use of agents known to be effective in primary dysmenorrhea treatment was highly common. [ABSTRACT FROM AUTHOR]

To examine the efficacy of venlafaxine, which is used as an antidepressant, in the treatment of stress urinary incontinence. The study was designed as a placebo-controlled, double-blind and randomized clinical study. Patients in Group 1 ( n = 20) were administered 75 mg venlafaxine, those in Group 2 ( n = 20) were administered placebo for 12 weeks. All the cases were evaluated in terms of weekly incontinence episode frequency (IEF), change in void interval (VI), the Incontinence Quality of Life (I-QOL) in weeks 0, 4, 8 and 12. Additionally, PGI-S was assessed at baseline and was followed by PGI-I evaluations in weeks 4, 8 and 12. Evaluations in weeks 0, 4, 8 and 12 did not show any significant difference in IEF, VI, IQOL and PGI-I values of placebo group ( p > 0.05). However, in the patients who were administered venlafaxine declines in IEF and PGI-I values as well as the elevations in VI and IQOL scores showed significant changes parallel to the increasing follow-up period ( p < 0.05). Nausea was observed in 40% of cases in venlafaxine group, and 15% of those in placebo group ( p < 0.05). It was seen in our study that efficacy of venlafaxine started early and the clinical efficacy associated with the use of the drug continued in the following months. Venlafaxine should be considered a clinically efficient alternative drug in the treatment of SUI. [ABSTRACT FROM AUTHOR]

Since sex hormones are reported to have important roles in the regulation of immune function, this study was designed to investigate the effects hormone replacement therapy (HRT) and raloxifene (RAL) on serum cytokine concentrations in healthy postmenopausal women. Fifty-three healthy postmenopausal women were randomly assigned and treated by RAL (Group I, [RAL 60 mg daily and continuously], n = 16), HRT (Group II, [2 mg estradiol valerat + 2 mg dienogest, continuously] n = 18) or placebo (Group III, n = 19). Two fasting morning blood samples were obtained from each participant before and 3 months after the treatments. Serum concentration of interleukin (IL)-4 (as a Th2 cytokine) and transforming growth factor-beta (TGF-β)1 (as a Th3 cytokine), were measured by using commercially available enzyme-linked immunosorbent assay kits. Kruskal–Wallis analysis of variance, Mann–Whitney U, and Wilcoxon Signed-Ranks Tests were used as necessary. At the beginning of the study, the chronological ages, menopausal ages, years of amenorrhea, weights, body mass indexes, and blood pressures were not significantly different between groups ( P < 0.05). RAL treatment caused a significant decrease on serum IL-4 concentration ( P < 0.001). Although HRT caused a 14% decrease in serum IL-4 concentration, this decrease was not statistically significant ( P > 0.05). Serum TGF-β1 concentrations were significantly decreased by HRT when compared to basal value ( P < 0.001), and to control ( P < 0.05). RAL treatment has no significant effect on serum TGF-β1 concentration ( P > 0.05). It seems that RAL treatment might cause a decrease in serum IL-4 concentration while valerate plus dienogest treatment as HRT seems to cause a Th3 tendency in healthy postmenopausal women. [ABSTRACT FROM AUTHOR]

Aim. The present study was designed to investigate the effects of two aromatase inhibitors on steroid hormone levels, bone mineral density (BMD) and bone turnover markers in intact female rats. Methods. Letrozole and anastrazole at two different dose levels were investigated for their effect on serum levels of estradiol, androstenedione, testosterone, dehydroepiandrosterone and dehydroepiandrosterone sulfate, BMD of femur and dorsal spine, and osteocalcin and pyridinoline levels as bone turnover markers. Fifty intact female rats were randomly divided in five groups (group 1 (n = 10): control, 2 ml saline; group 2 (n = 10): letrozole 1 mg/kg; group 3 (n = 10): letrozole 2 mg/kg; group 4 (n = 10): anastrazole 0.1 mg/kg; group 5 (n = 10): anastrazole 0.2 mg/kg), and oral gavages were applied for a period of 16 weeks. Results. Both doses of letrozole and anastrazole did not change femoral and vertebral BMD. Serum estradiol levels were reduced significantly at all dose levels by both agents (p < 0.001); all androgen levels were significantly elevated by letrozole (p < 0.05), although anastrazole increased only androstenedione (p < 0.05). The higher dose of letrozole increased osteocalcin levels (p < 0.05), while pyridinoline levels were increased (p < 0.05) by the higher dose of anastrazole. Conclusion. Our results indicate that short-term use of letrozole and anastrazole had no clear effects on BMD in intact rats. Further investigations are needed to understand their effects on bone metabolism in intact females. [ABSTRACT FROM AUTHOR]

Primitive neuroectodermal tumors of uterus (PNET) are extremely rare in tumors of the female genital system and therefore there is no sufficient information about their diagnosis, treatment, and follow-up. The case is a 32-year-old, operated in emergency conditions due to intra-abdominal hemorrhage, and discusses our diagnosis and treatment approaches in the light of literature data. To the best of our knowledge, this is first report of uterine PNET that presented with intraabdominal hemorrhage due to uterine rupture. Despite advances in therapy, the prognosis is poor. The low number of these cases precludes accurate standardization of therapy. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which discusses a medical case study of a 72-year-old woman who has a basal cell carcinoma and its treatment.