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We planned this experimental study to investigate the effect of carbamazepine (CMZ) on the endometriotic implants. Rats were randomised into four groups after endometriosis surgery. Drinking water was given to the sham group, 0.2 mg/kg oestradiol valerate (EV) to the EV group, 100 mg/kg/day CMZ to the CMZ group, and 0.2 mg/kg EV and 100 mg/kg/day CMZ to the EV-CMZ group. The endometrium of the rats using CMZ stained more intensely with cytochrome P450-3A4 (CYP3A4) enzyme. No endometrial hyperplasia was found in these rats. Endometriotic implants weight was found to be higher in these rats. There was no difference between the groups in terms of staining of the endometriotic implants with CYP3A4 enzyme. Endometriotic implants were less stained with the CYP3A4 enzyme than the endometrium. According to our results, CMZ does not increase the destruction of oestrogen in the endometriotic implants, unlike the endometrium. It may even cause the lesion to enlarge.Impact statementWhat is already known on this subject? Endometriosis is an oestrogen-dependent, progressive disease. Carbamazepine (CMZ) is known to increase oestrogen degradation by activating the cytochrome P450-3A4 (CYP3A4) enzyme. CMZ can be used in the treatment of endometriosis because it increases oestrogen breakdown in tissues.What do the results of this study add? CMZ can protect the endometrium against hyperplasia by increasing the amount of CYP3A4 enzyme in the endometrium. This effect could not be demonstrated in the endometriotic implants. The presence of CYP3A4 enzyme less in the endometriotic implants than in the endometrium may explain this situation. In addition, the fact that CMZ does not increase the enzyme in the endometriotic implants may contribute to this situation.What are the implications of these findings for clinical practice and/or further research? CMZ may not be a suitable alternative in the treatment of endometriosis. However, it may protect against endometrial hyperplasia. Clinical studies are needed for this effect.

Carbamazepine (CMZ) increases estrogen metabolism by inducing cytochrome P450 (CYP3A4). We investigated whether CMZ is protective against endometrial hyperplasia (EH). We used 32 female Wistar albino rats divided into four equal groups: the control group received drinking water, the estradiol valerate (EV) group was given EV, the CMZ group was given CMZ, and the EV + CMZ group was given both EV and CMZ. After 30 days the uteri of the rats were removed and serum estrogen and progesterone levels were measured, and endometrial tissue characteristics were evaluated. CYP3A4 expression was assessed using immunohistochemistry. Serum estrogen levels were lowest in the EV group and highest in the CMZ group. Serum progesterone levels were similar among all groups. Glandular density, a proxy measure of EH, was highest in the EV group and lowest in the EV + CMZ group. EH was detected in six of eight rats (75%) in the EV group and two of eight rats (25%) in the EV + CMZ group. Immunohistochemical staining revealed no significant difference in CYP3A4 expression among the four groups. CMZ reduced the negative effect of high dose estrogen that is not balanced by progesterone on the endometrium in rats. The effect likely is probably due to the CYP3A4 enzyme activator effect. CMZ may be protective against EH in high risk women, although confirmation is required.

To investigate the effect of surgical procedure on the operation's results in patients undergoing emergency peripartum hysterectomy (EPH).The records of patients who underwent EPH due to postpartum hemorrhage between 2010 and 2020 in two tertiary centers with a high crude delivery rate were retrospectively analyzed. Surgical data were compared according to the EPH type.During the study period, 115,709 births occurred in these two centers. EPH was administered for 181 (1.6%) of these patients. Sixty-seven (37%) of the EPH cases involved subtotal EPH (SEPH), and 114 (63%) were total EPH (TEPH). Surgical time (107.3 ± 17.6 vs. 134.2 ± 32.3 min,According to the results, if the bleeding in peripartum hemorrhage requiring EPH can be controlled with SEPH, attempting to remove the cervix completely may be associated with increased surgical time, blood transfusion need, and surgical complications.

Objective: Familial Mediterranean fever (FMF) is an autosomal recessive disease characterized by recurrent, self-limited attacks of fever with serositis. Acute recurrent arthritis is the most commo...

We investigated the protective effect of iloprost against ischemia/reperfusion (I/R) injury in rat ovary. We used 32 female Sprague-Dawley rats randomly allocated to four experimental groups: sham, ischemia, I/R and I/R + iloprost. Ovarian torsion was established in all rats except the sham group. The torsion group was exposed to ischemia for 3 h. The detorsion group was exposed to 3 h ischemia applied + 3 h reperfusion. The detorsion + iloprost group was exposed to ischemia for 3 h + reperfusion for 3 h + intravenous (IV) iloprost infusion for 60 min starting at the beginning of reperfusion. Ovaries were removed and prepared for histopathological evaluation. Reduced glutathione (GSH) and malondialdehyde (MDA) were measured in the blood. The total histopathological injury score and MDA level of the ischemia group were significantly higher than for the sham group. Ovarian injury score and MDA level following I/R increased compared to the ischemia group. Iloprost administration reduced the total injury score and MDA level. The GSH level was higher in the I/R + iloprost group than in the I/R group. We concluded that IV iloprost administration reduces I/R injury in rat ovarian tissue.

Objective: This study aimed to evaluate the parameters affecting the treatment success of conservative surgery in cases with placental invasion anomaly. Methods: Archive files and digital image records of 67 patients with placental invasion anomaly were studied. The patients were divided into two groups, a conservative surgery group and a cesarean hysterectomy group. Demographic data, cervical length, placental localization, placental surface area adhering to previous cesarean section line, preoperative and postoperative hematocrit values, transfused blood products, and surgical complications were compared between the two groups. Results: In the conservative surgery group, the cervical length was longer (p < .001) and the surface area of the placenta in the previous cesarean scar line was smaller (p < .001). For cervical length, the sensitivity and specificity values were 97 and 81%, respectively, when the cut-off value was 35.5 mm. When the cut-off value for the placental surface area in the previous cesarean scar line was 85.5 cm2, the sensitivity and specificity values were 68 and 72%, respectively. In the caesarean hysterectomy group, the preoperative and postoperative hematocrit values were lower (p < .001, p = .003, respectively), and the amount of transfused erythrocyte suspension and fresh frozen plasma were higher (p < .001, p = .001, respectively). Conclusion: In this study, it was concluded that the presence of the nondestructive intact cervical tissue, in the cases with placental invasion anomaly and/or the small size of the placental surface area adhering to the previous cesarean scar line, increase the feasibility of conservative surgery.

Congenital nephrotic syndrome (CNS) is a rare disorder characterized by massive proteinuria and marked edema manifesting in utero or during the first 3 months of life. CNS can be caused by congenital infections, allo-immune maternal disease or due to the genetic defects of podocyte proteins most commonly NPHS1. Here we present a case of Finnish-type congenital nephrotic syndrome along with feeding problems and abdominal distention which was diagnosed during follow-up as a gastric-duplication cyst with a novel mutation in the nephrin gene. CNS feeding problems are attributed mainly to primary disease but in literature there are case reports of patients with CNS and hypertrophic pyloric stenosis. NPHS1 is also expressed in the stomach tissue. Physicians should be aware of this rare extra-renal manifestation or coincidence of this rare disease.

Objective: The aim of this in vitro study was to examine the color changes in resin cements polymerized under lithium disilicate glass ceramic material (IPS Empress 2).Material and methods: A pressable ceramic material (10 mm × 1 mm) placed between the curing unit tip and resin cement was used to simulate the impact of light transmission on restoration. Light-polymerized Variolink II, dual polymerized Variolink II, Multilink Automix, Clearfil Esthetic Cement, Panavia F 2.0, RelyX Veneer, and Nexus 3 resin cement specimens were polymerized by a high-power light-emitting diode curing unit (Demi). A spectrophotometer (Vita EasyShade) was used to measure the colorimetric values of the specimens. Color changes were determined by the CIEL*a*b color system. Total color differences () of the resin cement specimen with or without the ceramic specimen were calculated. Analysis of variance, Tukey’s honestly significant difference and paired t-tests were used to analyze the data (α = 0.05). Results: There wer...

The aim of this study is to evaluate the diagnostic criteria, treatment options and progression of cases who have antenatal or postpartum hemorrhage due to internal myometrial laceration (IML) and to review the literature.The files of eight patients who were diagnosed to have IML between August 2012 and July 2015 were evaluated retrospectively.The patient group consisted of four patients who had an emergency c-section due to massive bleeding during labor and four patients who had an emergency laparotomy due to uncontrolled bleeding after vaginal delivery after evaluation of the patient for signs of 4Ts (trauma, tissue retention, uterine tonus, and trombin). Primary suturation was the first-line treatment in all patients. In two of the patients, hysterectomy was performed after the defined surgical procedures were not successful in controling the bleeding.The presented case series is a pioneering study that describes IM which is a poorly defined reason of postpartum hemorrhage, as the cause of bleeding during labor. Primary suturation is the first-step, further surgery might be required in order to treat this life-threathening condition and the decision should be based on the age and the fertility status of the patient.

The prognostic factors, the outcome and the most favorable treatment regimen are not entirely known for children with membranoproliferative glomerulonephritis (MPGN). MPGN is a rarely observed disease more prevalent in adolescents, so we aimed to review the clinical and histological properties, treatments and the outcome of our patients who were diagnosed as MPGN.Fifty-one children - diagnosed with MPGN - were selected from biopsy records in Dr. Sami Ulus Maternity and Children's Hospital Pediatric Nephrology Department from January 1999 to January 2011. A retrospective analysis was made of 33 regularly followed children.Thirty-three patients were identified, 13 female and 20 male. Their age groups at presentation ranged from 4 to 15 years. The following duration was 26-144 months (mean 74). Following the initial treatment, 20 (60%) patients achieved complete remission. Six patients with nephrotic syndrome and one with non-nephrotic proteinuria showed partial remission. The condition of one patient with nephrotic syndrome was unchanged with the persisting symptoms. The one patient with nephrotic syndrome and four others with non-nephrotic proteinuria did not respond to initial treatment as their renal functions decreased gradually.We concluded that only degree of tubulointerstitial damage on the initial biopsy is determinative for prognosis of childhood MPGN. If the patient receives high doses of steroid therapy in the early stages, their treatment is more likely to be successful. The effect of immunosuppressive treatment on MPGN is not clear.

Identifying the risk factors is important in prevention of urinary tract infections (UTIs) in children. The aim of this study is to evaluate the association of UTI and idiopathic hypercalciuria (IHC).Two hundred and twenty-four children aged between 1 month and 16 years and diagnosed to have UTI were evaluated for urinary calcium excretion. The children were diagnosed to have IHC if their urinary calcium/creatinine ratios in at least two different spot urine samples were0.6 between 0-1 year old and ≥0.21 over 1 year or daily calcium excretion4 mg/kg.The frequency of IHC was found to be 16.7%. Family history of urolithiasis, parental consanguinity, presentation with abdominal pain, loss of appetite, and discomfort were found to be significantly higher in the IHC group. No association was found between IHC and the recurrence of UTI, presence of vesicoureteral reflux, renal scar formation, and the prognosis.IHC should be considered among the risk factors for UTI and should be investigated particularly in patients with family history of urinary stones and suggestive complaints of IHC.

Oxidative stress has not been adequately investigated in acute glomerulonephritis (AGN); therefore, we aimed to evaluate the oxidative stress (OS) status in children with AGN both at acute and remission stages.Seventeen children (mean +/- SEM, age 9.0 +/- 0.5 years) with AGN and 17 healthy controls were included. In addition to routine laboratory investigations, two blood samples were obtained from patients, at admission and after 6-10 weeks, to measure erythrocyte superoxide dismutase (SOD) activity and plasma malondialdehyde (MDA) level.Significantly elevated MDA levels (5.11 +/- 0.28 vs. 3.15 +/- 0.25 nmol/mL; p0.001) were found in acute stage of AGN compared with the controls; however there was no significant difference in SOD activities (3732 +/- 193 vs. 4035 +/- 142 U/gHb; p0.05) between acute stage-AGN and control subjects. Significantly elevated SOD activities (3985 +/- 195 U/gHb, p = 0.034) and decreased MDA levels (4.01 +/- 0.38 nmol/mL, p = 0.001) were found at remission stage when compared with the acute stage. MDA levels and SOD activities of remission phase were similar to those of controls (p0.05). A significantly positive correlation was found between MDA levels and SOD activities in remission period (r = 0.654, p = 0.004). Patients with and without impaired renal functions had similar MDA levels and SOD activities (p0.05). No significant correlation was found between glomerular filtration rates (GFR) and MDA levels (p0.05) and between GFR and SOD (p0.05) activities in acute stage-AGN.Oxidative stress may play important role in the pathogenesis of AGN and not be correlated with renal functions. Further research is needed to determine magnitude of OS and indications for antioxidants in other glomerulopathies.

Considering the importance of nitric oxide generation in the regulation of vessel tone, reduced endothelial nitric oxide synthase (eNOS) expression in alveolar macrophages exposed to short-term silica (Si) suggests the possibility of Si-induced changes in endothelial functions. In this experimental study, the functional changes of the endothelial cells were investigated in the aortic rings of rats subjected to 50 mg Si/kg body weight in their drinking water for 8 days. Norepinephrine elicited contractility and dilation response to acetylcholine (ACh) was significantly high in the aortic rings of Si-treated group. Alteration in receptor-independent endothelial response to A23187 in the aortic rings of Si-exposed rats was less obvious, but sodium nitroprusside (SNP)-elicited dilation was reduced significantly. A23187-induced relaxation was fully eliminated with N-nitro-L-arginine methyl ester (L-NAME) pretreatment, whereas 19.24 +/- 4.36% of ACh response was L-NAME resistant and eliminated with 10-5 M tetraethylammonium (TEA). Despite a significant reduction in the share of NO, the contribution of indomethacine (IND)-sensitive relaxation to ACh response remained unchanged in Si group. As a result, our findings demonstrated that Si both modifies the characteristics of endothelial relaxants and attenuates smooth muscle cell responsiveness to NO. Si-induced reduced NO association with elevated endothelium-derived hyperpolarizing factor (EDHF) in response to ACh, together with reduced NO sensitization, might have clinical importance in cardiovascular pathology.