Neutrophil to lymphocyte and platelet to lymphocyte ratios increase in ovarian tumors in the presence of frank stromal invasion.

OBJECTIVE: The aim of this study was to assess the predictive value of neutrophil/lymphocyte and platelet/lymphocyte ratios for borderline, malignant ovarian tumors, and borderline cases with microinvasion. METHODS: Totally 275 women with sonographically detected ovarian tumor were enrolled for this study. All subjects underwent gynecological surgery via endoscopic or conventional approach and ovarian masses were all evaluated histopathologically by the same pathologist. All study population was divided into three groups as group with borderline tumors, benign tumors, or malignant tumors according to the histopathological diagnosis. Just before surgical intervention, a blood sample was obtained from each participant to analyze CA125 level, neutrophil, platelet, and lymphocyte count. RESULTS: Neutrophil/lymphocyte ratio (AUC = 0.604, P = 0.02) was a significant predictor for malignant cases. Optimal cutoff value for the neutrophil/lymphocyte ratio was found to be 2.47 with 63.4% sensitivity and 63.5% specificity for malignancy prediction. Odds ratio of high neutrophil/lymphocyte ratio for malignancy risk was 2.5 (95% CI 1.3-4.8, P = 0.004). Platelet/lymphocyte ratio (AUC = 0.621, P = 0.007) was a significant predictor for malignant cases. Platelet/lymphocyte ratio (AUC = 0.568, P = 0.05) was also predictive for cases without a benign mass. Optimal cutoff value for the platelet/lymphocyte ratio was found to be 144.3 with 54% sensitivity and 59% specificity for malignancy prediction. Odds ratio of high platelet/lymphocyte ratio for malignancy risk was 2.1 (95% CI 1.1-3.8, P = 0.02). CONCLUSION: Neutrophil/lymphocyte and platelet/lymphocyte ratios are predictors for malignant ovarian tumors but not borderline tumors even in case of microinvasion.

Levonorgestrel-releasing intrauterine device use as an alternative to surgical therapy for uterine leiomyoma.

OBJECTIVE: To evaluate the efficacy of the levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of leiomyoma related menorrhagia and to assess the effect of LNG-IUS on uterine, leiomyoma, and ovarian volume. MATERIALS AND METHODS: In this prospective before and after study, LNG-IUS was inserted in 38 women with myoma-related menorrhagia. The patients were evaluated for serum levels of hemoglobin, hematocrit and uterine, leiomyoma, and ovarian volume at the time of insertion and at six months. RESULTS: Significant reduction in the Pictorial Blood Loss Assessment Chart (PBAC) score and increases in serum hemoglobin levels and in amenorrhea was observed within three months. However, there was no statistically significant reduction in the myoma and uterine volume. Ovarian volume, also, did not changed significantly. CONCLUSION: The use of LNG-IUS is effective in reducing menorrhagia associated with leiomyomas with improvement in hemoglobin levels and may be a simple and effective alternative to surgical treatment of leiomyoma-related abnormal uterine bleeding (AUB-L) without significant influence on the volume of leiomyoma and ovarian and uterine volume.

Effectiveness of thymoquinone in the treatment of experimental asthma.

BACKGROUND: Thymoquinone (TQ), the main active constituent of the volatile oil extracted from Nigella sativa's seeds, is used for the treatment of inflammatory diseases and exhibits a variety of pharmacological effects. METHODS: Twenty-eight BALB/c female mice were divided into four groups: I (sham-operated control group), II, III, and IV. All groups except for the sham-operated group were sensitized and challenged with ovalbumin. The sham-operated group received nebulized saline in challenge period. Mice in groups III and IV were administered TQ at a dose of 3 mg/kg and dexamethasone 1 mg/kg, respectively, intraperitoneally once a day for the final 5 days of the challenge period. Animals were sacrificed 24 h after the last drug administration and the airway samples were evaluated histologically by light microscopy. RESULTS: All histological parameters in Group III, similar to Group IV, were improved when compared to Group II. All variables except numbers of goblet cells were found to be significantly better in Group III and Group IV compared to Group II. CONCLUSIONS: In our study, we demonstrated that TQ administration alleviates the pathological changes of chronic asthma. TQ might be a promising therapy for asthma in the.

The efficacy of serum carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 15-3 (CA15-3), alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG) levels in determining the malignancy of solitary pulmonary nodules.

We investigated the utility of the tumour markers carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 15-3 (CA15-3), alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG) for the differential diagnosis of benign and malignant solitary pulmonary nodules in 42 hospitalized patients. Routine medical history and physical examination of each patient was performed and each patient also had a chest X-ray and a thoracic computed tomography scan. The following diagnostic procedures were also undertaken: bronchoscopy, transthoracic needle aspiration biopsy, sputum cytology and culture, analysis of sputum acid-fast bacilli and thoracotomy. Measurement of serum levels of tumour antigens by Immulite 2000 radioimmunoassay found that three tumour markers, CEA, CA125 and CA15-3, could be used in the diagnosis of malignant solitary pulmonary nodules. More research is now required involving a larger group of patients.

Pitfalls in the diagnosis of complicated pulmonary hydatid disease.

The aim of this study was to present the pitfalls in the diagnosis of complicated pulmonary hydatid disease and to discuss the unusual radiological presentations of this endemic disorder in Turkey. We retrospectively evaluated 34 patients (12 females) aged between 8 and 64 years, who were operated on at our centre between 1991 and 1998 and diagnosed with complicated pulmonary hydatid cyst histopathologically. Computerized tomography (CT) scans of these patients were reviewed double-blind by two radiologists. The patients were then divided into two groups: group 1: initial radiological impression is pulmonary hydatid cyst and group 2: initial radiological impression is not pulmonary hydatid disease. These two groups were evaluated in terms of symptoms, radiographical presentation and laboratory tests. The presence of cystic appearance, water-lily sign, ring enhancement concomitant with intact cysts unanimously led the radiologists to the diagnosis of complicated pulmonary hydatid cyst, whereas solid appearance and presence of bronchial obliteration made the diagnosis unlikely. In such circumstances patient history, laboratory findings and bronchoscopic evaluation helped the diagnosis. In conclusion, in endemic regions like Turkey, atypical radiological presentation of complicated pulmonary hydatid disease should be considered in the differential diagnosis of solid pulmonary lesions.

Review of cases with cystic hydatid lung disease in a tertiary referral hospital located in an endemic region: a 10 years' experience.

BACKGROUND: Echinococcus disease is endemic in sheep-and cattle-raising areas world wide. Its prevalence is also high in the Mediterranean region including Turkey. OBJECTIVE: To determine the presentation, approach to surgical treatment and outcome of hydatid disease in an endemic region. METHODS: From January 1989 to December 1998 288 patients, aged between 1 and 71 years with a mean age of 31 years (134 female, 154 male), were operated on for pulmonary hydatidosis. Clinical charts of the patients were reviewed retrospectively in a tertiary referral hospital. RESULTS: Of 288 patients, 30 patients were asymptomatic, the rest (89%) were symptomatic, cough and chest pain being the most common symptoms. Fifty-three patients (18%) had associated liver hydatid cysts. Bilateral lung hydatid cysts were present in 18 patients (6%). Recurrent hydatid cysts were observed in 33 patients (11%). Seventy-seven patients (27%) presented with complicated hydatid cysts. Postoperative morbidity was observed in 3 patients [bronchopleural fistula (2), infection of the cyst space (1)] and postoperative mortality in 1 patient who presented with hydatid lung disease associated with liver and brain cysts. In the remaining 98. 6%, no complications were noted. CONCLUSIONS: In conclusion, hydatidosis is still an important public health problem in Turkey and in an endemic country such as Turkey hydatid lung disease should be considered initially in a patient presenting with a corresponding chest roentgenogram and a compatible epidemiologic history. Surgery is indicated in all symptomatic and/or enlarging or infected cysts. When necessary lobectomy or wedge resection can be the procedure of choice. Single-stage combined resection is preferred in hydatid lung disease with associated liver hydatid cysts. Total postoperative complication and mortality rate is low and we recommend a close follow-up of the operated cases to diagnose postoperative recurrence early in its course.