Role of inflammation and oxidative stress in the etiology of primary ovarian insufficiency.

OBJECTIVE: The aim of this study was to elucidate the etiology and treatment of primary ovarian insufficiency, which is of unknown cause in 95% of the cases. MATERIALS AND METHODS: Thirty patients aged 18-40 years who presented to Dicle University Faculty of Medicine Clinic of Obstetrics and Gynecology between June 2012 and January 2014 and were diagnosed as having primary ovarian insufficiency based on their clinical and endocrinologic data, and 30 healthy controls were included in this study. RESULTS: No significant differences were found between patients with primary ovarian insufficiency and control subjects in demographic data and lipid profile levels, thyroid- stimulating hormone, prolactin, and glucose. However, the neutrophil to lymphocyte ratio and levels of follicle-stimulating hormone, luteinizing hormone, total antioxidant status, total oxidant status, and oxidative stress index were significantly higher in patients with primary ovarian insufficiency than in control subjects. In the correlation analysis, follicle-stimulating hormone exhibited a positive correlation with total oxidant status, oxidative stress index, and the neutrophil to lymphocyte ratio (r=0.573** p<0.001, r=0.584** p<0.001, r=0.541 p<0.001, respectively) and correlated negatively with total antioxidant status (r=-0.437** p<0.001). CONCLUSION: The neutrophil to lymphocyte ratio, total oxidant status, and oxidative stress index levels are elevated in primary ovarian insufficiency. Therefore, anti-oxidative and anti-inflammatory treatment might be administered to patients in the early stage of primary ovarian insufficiency. However, larger studies are needed to clarify whether these elevated levels are a cause or a consequence of primary ovarian insufficiency.

Atherosclerosis and the role of immune cells.

Atherosclerosis is a chronic inflammatory disease arising from lipids, specifically low-density lipoproteins, and leukocytes. Following the activation of endothelium with the expression of adhesion molecules and monocytes, inflammatory cytokines from macrophages, and plasmacytoid dendritic cells, high levels of interferon (IFN)-α and ß are generated upon the activation of toll-like receptor-9, and T-cells, especially the ones with Th1 profile, produce pro-inflammatory mediators such as IFN-γ and upregulate macrophages to adhere to the endothelium and migrate into the intima. This review presents an exhaustive account for the role of immune cells in the atherosclerosis.

Effects of adnexal torsion on the Fallopian tube in rats: a histologic and immunohistochemical study.

OBJECTIVE: To investigate histopathological and immunohistochemical changes in the Fallopian tube structure following ovarian torsion. STUDY DESIGN: Thirty fertile, female, adult Wistar albino rats, weighing 200-220 g, were randomly divided into 3 equal groups (n = 10): sham, torsion, and detorsion. In the torsion and detorsion groups, bilateral adnexal torsion (3-hour ischemia) was carried out. Bilateral adnexal detorsion (3-hour reperfusion) was performed in the detorsion group. Fallopian tube sections were stained hematoxylin and eosin, periodic acid-Schiff, Mallory-Azan and immunohistochemically-stained desmin, α smooth actin, and CD68 antibodies. RESULTS: In the sections of the ischemic group, degeneration of epithelium, loss of cilia, dilation of blood vessels, and hemorrhages were observed. Image analysis of the studied Fallopian section revealed a significant decrease in density of desmin in the torsion group. Moreover, strong positive cytoplasmic CD68 expression was observed in the torsion group. CONCLUSION: The use of effective antiinflammatory treatments may contribute to the conservative surgery in preservation of ovarian reserve and tubal structure.

Human placental macrophages (Hofbauer cells) in severe preeclampsia complicated by HELLP syndrome: immunohistochemistry of chorionic villi.

OBJECTIVE: To evaluate Hofbauer cells in the placentas of women diagnosed with HELLP syndrome. STUDY DESIGN: The present study compared 20 patients with HELLP syndrome and 20 control patients with respect to demographics, hematological parameters and the presence of Hofbauer cells in placental samples. CD-68 antibody was used for immunohistochemical examination. The total number and size of Hofbauer cells were measured in the placental villi, and the proportion of Hofbauer cells relative to the vascular structure was also compared between groups. RESULT: The patient and control groups were similar according to baseline obstetric characteristics. White blood cell counts in patients with HELLP syndrome and the control group were 15,139 +/- 4,169 and 10,806 +/- 2,888, respectively, and were significantly increased among patients with HELLP syndrome (p < 0.001). Hofbauer cell numbers in the placental villi of patients with HELLP syndrome were significantly elevated in comparison to normotensive controls (p = 0.046). The proportion of Hofbauer cells in the placental villi according to proximity to the vascular structure were 3.85 +/- 1.66 in the HELLP group and 1.75 +/- 1.12 in controls (p < 0.001). Sizes of the Hofbauer cells were not statistically different between groups. CONCLUSION: Increased Hofbauer cells may be associated with increased inflammation or may have an adaptive mechanism at the fetal site of the placenta in patients with HELLP syndrome.

Effects of formaldehyde and vimentin expression in rat skin / Efectos del formaldehído y expresión de vimentina en la piel de rata

The Wistar rats ( 9 weeks old, 180­200 g body weight) used in these trials were divided into two groups of 16 animals each (Control group and Experimental group). 100x65x100 in the sizes of the experimental group were taken into a glass vase. During the time period of 8 weeks, 5 days a week with 8 hours the inhalation of 10 ppm formaldehyde was made. Skin was removed and placed in 10% formaline. Sections were stained with Hematoxylene-Eosine, Trichrome-Masson and observed under light microscope. In this study, histopathological and immunohistochemical techniques due to the impact of the changes in formaldehyde and examined the distribution of vimentin.

En este ensayo se utilizaron ratas Wistar (9 semanas de edad, 180-200 g de peso corporal) que se dividieron en dos grupos de 16 animales cada uno (grupos control y experimental). Los animales del grupo experimental fueron colocados en un vaso de vidrio de tamaño 100x65x100. Durante un período de tiempo de 8 semanas, 5 días a la semana con 8 horas se expuso a la inhalación de 10 ppm de formaldehído. Se retiró la piel y se colocó en formalina al 10%. Las secciones fueron teñidas con Hematoxilina-Eosina y Tricrómico de Masson, y fueron observadas al microscopio óptico. Las técnicas histopatológicas e inmunohistoquímicas y el impacto en la piel provocado por el formaldehído permitieron examinar la expresión de vimentina.

Efficacy and safety of tenofovir disoproxil fumarate in pregnancy for the prevention of vertical transmission of HBV infection.

AIM: To evaluate the effects of tenofovir disoproxil fumarate (TDF) use during late pregnancy to reduce hepatitis B virus (HBV) transmission in highly viremic mothers. METHODS: This retrospective study included 45 pregnant patients with hepatitis B e antigen (+) chronic hepatitis B and HBV DNA levels > 107 copies/mL who received TDF 300 mg/d from week 18 to 27 of gestation (n = 21). Untreated pregnant patients served as controls (n = 24). All infants received 200 IU of hepatitis B immune globulin (HBIG) within 24 h postpartum and 20 µg of recombinant HBV vaccine at 4, 8, and 24 wk. Perinatal transmission rate was determined by hepatitis B surface antigen and HBV DNA results in infants at week 28. RESULTS: At week 28, none of the infants of TDF-treated mothers had immunoprophylaxis failure, whereas 2 (8.3 %) of the infants of control mothers had immunoprophylaxis failure (P = 0.022). There were no differences between the groups in terms of adverse events in mothers or congenital deformities, gestational age, height, or weight in infants. At postpartum week 28, significantly more TDF-treated mothers had levels of HBV DNA < 250 copies/mL and normalized alanine aminotransferase compared with controls (62% vs none, P < 0.001; 82% vs 61%, P = 0.012, respectively). CONCLUSION: TDF therapy during the second or third trimester reduced perinatal transmission rates of HBV and no adverse events were observed in mothers or infants.

A case of complete tetraploidy in amniocentesis with normal karyotype in subsequent cordocentesis.

We report a case of complete tetraploidy in amniotic fluid culture obtained at 17 wk of pregnancy. Amniocentesis was performed in this pregnancy because of a high-risk maternal serum screening result and abnormal ultrasound findings. Amniotic fluid was cultured in two flasks. Growth was very slow in one culture with no growth in the other. Harvest was possible after 3 wk, which revealed tetraploidy in all studied plates. Subsequent cordocentesis was performed to confirm the diagnoses of amniocentesis. Chromosomal analysis of the cordocentesis revealed a normal karyotype with 46,XY. A healthy male infant was born at term. This case illustrates that abnormal karyotypes in poor growth cultures could be misleading and should be confirmed by another technique, such as cordocentesis.

Parental decisions regarding a prenatally detected fetal chromosomal abnormality and the impact of genetic counseling: an analysis of 38 cases with aneuploidy in Southeast Turkey.

This study investigated parental decision-making to terminate or continue a pregnancy after prenatal diagnosis of a chromosomal abnormality among a sample of patients in Southeast Turkey. Between 2004 and 2007, 1068 amniocentesis tests were performed in the Medical Biology and Genetic Department Laboratory at Dicle University. Aneuploidy was found in 38 cases (3.56%). Genetic counseling was provided for the couples that received abnormal results, and they were later interviewed and asked if they had continued or interrupted the pregnancy after the diagnosis. When confronted with autosomal aneuploidy in which a severe prognosis was expected, 85% of cases decided to terminate the pregnancy. When confronted with sex chromosome aneuploidy with a low risk of an abnormal clinical phenotype 60% of cases decided to continue the pregnancy. Among the diagnoses with aneuploidy, pregnancy was continued in 21.1% of cases due to religious beliefs regardless of whether there was a low or severe risk of an abnormal clinical phenotype. These findings indicate that both severity of abnormality and religiosity play an important role in genetic counseling patients' decision-making processes and outcomes in Turkey. In addition, the findings suggest the need for legislation that reduces the differences in approaches between the physicians and institutions regarding parental decision-making to terminate or continue a pregnancy in our country.

Factor V Leiden mutation in venous thrombosis in southeast Turkey.

Venous thrombosis (VT) is a common disease, with an annual incidence in the general population of approximately 1 per 1,000. Factor V Leiden mutation (G1691A) (FVL) is the most common risk factor in venous thrombosis. The prevalence of FVL for thrombosis varies greatly in different regions of the world. FVL mutation has been identified both by conventional method and fluorescence resonance energy transfer (FRET) with the LightCycler. Sixty-one patients with VT, different in age and sex, were consecutively entered into this study to assess the prevalence of FVL in VT in southeast Turkey. FVL mutation was found in 24.6% (15/61). Fourteen individuals were heterozygous and 1 homozygous, a rate of 22.9% and 1.6%, respectively. In conclusion, the authors suggest that FVL mutation is common in patients with venous thrombosis in southeast Turkey.

Prothrombin G20210A gene mutation with LightCycler polymerase chain reaction in venous thrombosis and healthy population in the southeast of Turkey.

Venous thrombosis (VT) is a common disease, with an annual incidence in the general population of approximately 1 per 1000. The prevalence of genetic risk factors for thrombosis varies greatly in different parts of the world. Prothrombin G20210A (PT G20210A) gene mutation has been recently identified as a common risk factor in venous thrombosis. Sixty-one patients with VT, differing in age and sex, and 340 healthy subjects were consecutively enrolled into our study to determine the prevalence of PT G20210A in VT and in the healthy population of the southeast of Turkey. The mutation was identified with fluorescence resonance energy transfer (FRET) with the LightCycler polymerase chain reaction. The PT G20210A mutation was found to be 6.5% (4/61) in the VT group and 1.2% (4/340) in the healthy group ( P = 0.021). Three patients with VT had a heterozygous PT G20210A mutation, and the other patient with VT had both Factor V Leiden and PT G20210A mutations. We showed that this method may be used safely for detection of the PT G20210A gene mutation, and the prevalence of PT G20210A mutation is significantly higher in patients with VT than in the healthy population in the southeast of Turkey.