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Objective: We investigated the effects on skeletal muscle of gadolinium based linear and macrocyclic radiocontrast agents applied at experimental intervals using histopathological methods., Methods: Thirty-two male Sprague-Dawley rats were included in the study for histopathological analysis. No procedure was performed on the healthy control group. The sham group received 0.1 ml/kg intravenous (IV) saline solution through the tail vein 4 times weekly for 5 weeks. The gadodiamide group received total 2 mmol/kg IV gadodiamide through the tail vein 4 times weekly for 5 weeks. The gadoteric-acid group received 2 mmol/kg IV gadoteric acid through the tail vein 4 times weekly for 5 weeks., Results: We determined no marked apoptotic myofibrils associated withcaspase-3 expression in these two groups. Furthermore, no calcineurin expression was observed in myofibrils in the two groups. However, quantitative analyses revealed a decrease in muscle-fiber area in the gadodiamide and gadoteric-acid groups compared to the control group (Respectively; p=0.001 and p=0.017)., Conclusion: In our experimental study, linear and macrocyclic GBCAs applied at repeated doses played no role in myofibril damage induced by caspase-3 and calcineurin - nuclear factor of activated T-cells in skeletal muscle tissue., Competing Interests: No conflict of interest was declared by the authors., (© Copyright 2022 by Istanbul Provincial Directorate of Health.)

Damage to the ovaries or tissue torsion can significantly reduce the ovarian reserve and thus cause severe gynecological and hormonal deficiencies. The discovery of new agents is always needed in the treatment of this condition. Metformin (MET) has been shown to be beneficial in attenuating ovarian ischemia-reperfusion injury. Fifty-six female Sprague Dawley rats were divided into seven groups. Group 1 represented the control group (C), Group 2, the ischemia group (I), and Group 3, the ischemia/reperfusion group (I/R). Group 4, the ischemia (I)+250 group, and Group 5, the ischemia (I)+500 group, received 250 mg/kg and 500 mg/kg MET, respectively. Group 6, the ischemia/reperfusion (I/R)+250 group, and Group 7, the ischemia/reperfusion (I/R)+500 group, received 250 mg/kg and 500 mg/kg MET, respectively. Tissue malondialdehyde (MDA), glutathione (GSH), and tumor necrosis factor-alpha (TNF-α) levels in ovarian tissue increased following I/R, while estradiol (E 2 ) levels decreased. Moreover, infiltration and diffuse edematous areas were observed in addition to diffuse vascular congestion and hemorrhage findings. Caspase-3 and nuclear factor kappa B (NF-κβ) expression levels also increased. MDA and TNF-α concentrations decreased in the MET treatment groups, while GSH and E 2 levels increased. The findings showed that I/R causes ovarian damage through the induction of oxidative stress, inflammation, and apoptosis. However, MET application was effective in preventing damage in ovarian tissue by reducing levels of reactive oxygen species, proinflammatory cytokines, caspase-3 and NF-κβ., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Objective: 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., Methods: This prospective study was carried out in a total of 250 women during their 28- and 40-gestational week checks. The Urinary Distress Inventory-6, the Incontinence Impact Questionnaire-7, and International Consultation on Incontinence Questionnaire-Short Form were used to determine LUTS and its effect on quality of life., Results: The mean age and gestational age of the participants were 29.41 ± 5.70 year (range 18-44) and 35.45 ± 2.98 weeks (range 28-40), respectively. The prevalence of LUTS was 81.6%. The prevalence of UI during pregnancy was 37.2%. Stress urinary incontinence, urge urinary incontinence and mixed urinary incontinence were diagnosed as 15.6, 4.8 and 16.8%, respectively. We found that advanced age, smoking and multiparity were risk factors associated with incontinence. Incontinence reduced pregnant women's quality of life., Conclusions: Lower urinary tract symptoms are commonly seen among pregnant women and these symptoms negatively affect the quality of life of pregnant women. Advanced age, smoking and multiparity were risk factors associated with urinary incontinence and LUTS. Obstetricians should be on the lookout for individual urological problems in pregnancy. Resolving any urological issues and cessation of smoking for the affected individuals will help alleviate the problem., (© 2014 Wiley Publishing Asia Pty Ltd.)

Objective: Nectins are immunoglobulin-like adhesion molecules, and they play important role in cell proliferation and tumor metastasis. The objective in this study was to compare the expression of Nectin-4 in normal endometrium and in ectopic endometriotic tissues., Materials and Methods: Nectin-4 expression was investigated in ovarian endometriosis (n = 20), peritoneal endometriosis (n = 20), endometrium of endometriosis (n = 20), and in a control group (having no endometriosis) (n = 20) by immunohistochemical method., Results: Nectin-4 expression, when compared with control group, was higher in endometriotic lesions of patients having ovarian endometriosis and peritoneal endometriosis (p = 0.003 and p = 0.009, respectively). This difference was significant in the endometrium of patients having endometriosis (p = 0.011)., Conclusion: The authors believe that Nectin-4 molecule may contribute to the pathogenesis of endometriosis. For this reason, the use of medicines developed against this molecule in the treatment of endometriosis may be useful.

Obesity, insulin resistance (IR), inflammation, and hyperandrogenism may lead to polycystic ovary syndrome (PCOS) and hypertension. Nesfatin-1 (N1) may be related to IR, obesity, and hypertension. Furthermore, a vitamin D (VD) deficiency is associated with hypertension and PCOS. We aimed to investigate N1 and VD levels in PCOS that have an effect on systolic and diastolic blood pressure (BP) and heart rate (HR).This study included 54 patients with PCOS and 48 age-body mass index (BMI)-matched healthy controls. PCOS was diagnosed according to clinical practice guidelines. Ferriman-Gallwey scores (FGS) were calculated, while N1, VD, and other hormonal and biochemical parameters were measured for all subjects. Systolic and diastolic BP was measured as well. HR was calculated using an electrocardiogram.The levels of N1 (p < 0.001), high-sensitivity C-reactive protein (hs-CRP) (p = 0.036), homeostasis model assessment as an index of insulin resistance (HOMA-IR) (p < 0.001), systolic (p < 0.001) and diastolic (p < 0.001) BP and HR (p < 0.001) in the PCOS group were significantly higher than in the control group. However, the VD levels of the PCOS group were lower than the control group (p = 0.004). N1 had a strong positive correlation with BMI, HOMA-IR, hs-CRP, luteinizing hormone, systolic and diastolic BP, and HR. VD levels were negatively correlated with HOMA-IR and luteinizing hormone.Elevated N1 and decreased VD levels may be related to the presence of high-normal BP or hypertension in PCOS subjects.  N1 level may be associated with an increased BP due to its relation to inflammation and IR.

This retrospective study compared maternal and fetal outcomes after labour induction, using a dinoprostone vaginal pessary (Propess(®)) in midwife-led and obstetrician-led labour management. Labour induction outcomes, delivery mode and rates of admission to the neonatal intensive care unit were compared. A total of 405 women, 40.5% (n = 164) from midwife-led units and 59.5% (n = 241) from an obstetrician-led unit, participated. There was no statistically significant difference between the two groups in caesarean section rate or neonatal intensive care unit admission rates (p = 0.789 and 0.769, respectively). Non-reassuring fetal non-stress test and uterine hyperstimulation risks were higher in the obstetrician-led unit (p = 0.003 and 0.001, respectively, and odds ratio (OR) 0.165, 95% CI: 0.117-0.232 and OR 0.218, 95% CI: 0.078-0.611, respectively). Postpartum blood transfusion rate was higher in the midwife-led units (p = 0.002, OR 8.082, 95% CI: 1.879-39.292). Labour induction with Propess(®) is safe during both midwife-led and obstetrician-led labour management.

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., (Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.)

Pentraxin-3 (PTX3) a cytokine-inducible molecule is released from various tissues. Its level increases as a response to different inflammatory conditions. Polycystic Ovary Syndrome (PCOS) is considered as a proinflammatory state. The aim of this study was to investigate the association between PTX3 and various metabolic and hormonal parameters in PCOS patients. This study included 64 new diagnosed PCOS patients who had been never treated previously with PCOS and 46 healthy controls with matched age and body mass index (BMI). PTX3, biochemical and hormonal parameters of both groups were measured. The patients were divided into obese and non-obese subgroups according to BMI (above or lower than 25 kg/m²). PTX3, HOMA-IR and high sensitive C-reactive protein (hs-CRP) levels of these subgroups were compared. Serum PTX3 (p=0.013), hs-CRP (p=0.015) and HOMA-IR (p=0.023) levels of PCOS patients were significantly higher than the control group. Serum PTX3 has been found to have negative correlations with BMI (r=-0.318, p < 0.001), waist circumference (r=-0.306, p < 0.001), HOMA-IR (r=-0.324, p < 0.001) and hs-CRP (r=-0.206, p=0.031). Subgroup analysis revealed PCOS women with obesity to have significantly higher serum PTX3 level than non-obese PCOS subjects (p=0.012), non-obese controls (p=0.015) and obese controls (p=0.002). Women with new diagnosed PCOS especially obese subjects had significantly lower serum PTX3 than the control group. PTX3 has been found to be negatively correlated with BMI and insulin resistance. Low PTX3 level may have a role in the etiology of PCOS and in the formation of atherosclerotic diseases by stimulation of chronic inflammation.

Primary fallopian tube carcinoma is a rare clinical entity that constitutes a diagnostic challenge in gynecological practice. Patients generally suffer from the three symptoms: vaginal bleeding, pelvic pain, and vaginal discharge; however, this is usually not sufficient for confirming the diagnosis preoperatively in most circumstances. In this case report, we present a 49-year-old woman whose cervical smear raised a suspicion for fallopian tube carcinoma. All preoperative examination measures such as ultrasonography, hysteroscopy, and endometrial aspiration were normal. Repeated cervical smears were consistent with adenocarcinoma presumably ensourcing from the fallopian tube. The patient underwent laparatomy,total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic para-aortic lymph node dissection. The primary serous papillary adenocarcinoma of the right fallopian tube was detected at the histopathological analysis, and the patient was referred for adjuvant chemotherapy. Cervical smear findings can be the only clue for the diagnosis of fallopian tube carcinoma.

Objective: The aim of this study was to compare the serum levels of fibroblast growth factor 21 (FGF-21) between patients with polycystic ovary syndrome (PCOS) and control subjects and to assess the possible relation with the hormonal and metabolic parameters., Methods: A total of 91 patients with PCOS and 53 age- and body mass index (BMI)-matched healthy controls were included in the study. We evaluated anthropometric, hormonal and metabolic parameters in all the cases. Serum FGF-21 and high sensitive C-reactive protein (hsCRP) levels were measured by ELISA., Results: Mean fasting glucose and insulin, homeostasis model assessment insulin resistance index (HOMA-IR), triglyceride, total cholesterol, low density lipoprotein cholesterol, total testosterone, dehydroepiandrosterone sulfate (DHEAS) levels were significantly higher in PCOS patients. Serum FGF-21 levels were similar in PCOS (236.8 ± 171.2 pg/ml) and the control (224.6 ± 128.9 pg/ml) group (p = 0.654). FGF-21 level had no correlation with BMI, waist circumference, HOMA-IR, hsCRP and lipid parameters. However there was a significant negative correlation between FGF-21 and DHEAS levels (r = - 0.309, p = 0.003)., Conclusion: FGF-21 levels were similar in women with PCOS compared with those of age- and BMI- matched controls.

Purpose: The aim of our study was to evaluate the platelet function in unexplained recurrent miscarriage and to investigate whether any hematologic changes detectable by simple complete blood count have a diagnostic value for the prediction of unexplained recurrent miscarriage., Methods: A prospective study based on the comparison of 74 patients with unexplained recurrent first-trimester pregnancy loss with 208 control subjects matched for age. The two groups were compared in terms of platelet indices., Results: There was a significant difference in platelet distribution width in patients with unexplained recurrent miscarriage compared to healthy control subjects. Platelet distribution width values in the patient group were statistically higher (P < 0.001) than the control group., Conclusion: Our study provides an evidence that platelet distribution width gradually increases in women with recurrent miscarriage compared to control group. Patients with unexplained recurrent miscarriage have significantly increased platelet aggregation. This data may provide an empirical rationale for the use of anticoagulants in the management of this clinical condition.

Posterior reversible encephalopathy syndrome (PRES) is a cliniconeuroradiological entity presenting with headache, confusion, visual disturbances or blindness, and seizures. Parieto-occipital white matter changes due to vasogenic oedema can be observed on imaging modalities. It rarely occurs without seizures and after delivery. We report a 33-year-old multigravida with a history of preeclampsia in term pregnancy complicated by PRES without seizures at the postpartum period. Clinical improvement with complete resolution without any complications was observed on the 6th day after delivery. Posterior reversible encephalopathy syndrome is reversible when early diagnosis is established and appropriate treatment is started without delay.

Background: Endometrial cancers are the most common gynecologic cancers. Endometrial sampling is a preferred procedure for diagnosis of the endometrial pathology. It is performed routinely in many clinics prior to surgery in order to exclude an endometrial malignancy. We aimed to investigate the accuracy of endometrial sampling in the diagnosis of endometrial pathologies and which findings need intra-operative frozen sections., Materials and Methods: Three hundred nine women applying to a university hospital and undergoing endometrial sampling and hysterectomy between 2010 and 2012 were included to this retrospective study. Data were retrieved from patient files and pathology archives., Results: There was 17 patients with malignancy but endometrial sampling could detect this in only 10 of them. The endometrial sampling sensitivity and specificity of detecting cancer were 58.8% and 100%, with negative and positive predictive values of 97.6%, and 100%, respectively. In 7 patients, the endometrial sampling failed to detect malignancy; 4 of these patients had a preoperative diagnosis of complex atypical endometrial hyperplasia and 2 patients had a post-menopausal endometrial polyps and 1 with simple endometrial hyperplasia., Conclusions: There is an increased risk of malignancy in post-menopausal women especially with endometrial polyps and complex atypia hyperplasia. Endometrial sampling is a good choice for the diagnosis of endometrial pathologies. However, the diagnosis should be confirmed by frozen section in patients with post-menopausal endometrial polyps and complex atypia hyperplasia.

Here, we report a numerical experiment in which submicrometer particle entrainment in a periodic flow that matches those existing in the alveolus in the human lung was simulated for both sedentary and light activity. A spherical cavity with a prescribed velocity profile at the inlet was used to simulate the time-dependent periodical flow of air in the alveolus. Expansion and contraction of the alveolus were simulated by setting a conceptual permeable wall as the outer surface of the model and adjusting the boundary conditions in order to match the continuity of the flow. The simulations were conducted for breathing periods of 5 and 3 s, which match sedentary and light activity conditions, respectively, and the results were extrapolated to the real lung. It was found that, most of the particles mainly followed a straightforward path and reached the opposite side of the alveolar wall in both breathing conditions. The concentration patterns obtained are consistent with the fact that the flow within the alveolus is mainly diffusive and does not greatly depend on the flow velocity. It was found that the particles which are heavier than air move out of phase with the periodic airflow that crosses the alveolus entrance, and that these particles are significantly caught within the alveolus. Particle entrapment increases with breathing rate in accordance with experimental values and indicates that increase in breathing frequency in environments with high concentration of submicrometer particles has the consequence of increasing particle entrapment by several times with respect to normal breathing rate.