Variants in taste genes on caries risk and caries activity status.

The aim of this study was to evaluate the role of taste-related gene polymorphisms (CA6, TAS1R1, TAS1R3, TLR2, and TLR4) on dental caries and caries activity in adults. Individuals aged 25-44 years included in the study were assigned to two groups according to the decayed-missing-filled teeth index (DMFT) as the high caries risk (DMFT ≥ 14, n = 100) and the low caries risk (DMFT ≤ 5, n = 100). TaqMan allelic discrimination assays were used for genotyping the gene variants after isolating the DNA from the buccal smears. According to the American dental association caries classification system (ADA CCS), all teeth were scored as initial, moderate or advanced caries. The variant of the gustin (CA6) in saliva was found to be associated with a high caries risk (CA6 rs17032907, P < .001). There was also a statistically significant difference in the dominant model of the same variant (CC vs. TT: P < .001, OR = 5.05, 95% CI: 2.38-10.71). The presence of genotype CC and allele C was less frequent in the advanced caries lesion group (P < .001). This study shows that the CA6 rs17032907 gene variant may be a risk factor for dental caries affecting caries activity. Clinical Trials ID: NCT04066101.

Chronic subdural hematoma following spinal anesthesia for cesarean section.

OBJECTIVE: Intracranial subdural hematoma after spinal anesthesia is a rare and life-threatening complication of spinal anesthesia. The most common complication of spinal anesthesia is the postdural puncture headache. When severe and persistent headache after spinal anesthesia occur, differential diagnosis can be explored. In this report, we aimed to evaluate a patient with persistent headache following spinal anesthesia for cesarean section in a 31-year-old woman ,and emphasize a rare complication of spinal anesthesia which is subdural hematoma.

Effect of Obesity on Clinical Parameters and Pregnancy Rates in Women with Polycystic Ovary Syndrome Undergoing Ovulation Induction Cycles.

OBJECTIVE: To evaluate the effect of obesity on clinical parameters and pregnancy rates in infertile women with polycystic ovary syndrome (PCOS), who have undergone ovulation induction. STUDY DESIGN: This retrospective study included 177 women with PCOS who presented to our gynecological endocrinology outpatient clinic for diagnosed infertility. All of the patients initially received clomiphene citrate (CC), and if CC resistance was noted, gonadotropins were used. The patients were classified into 2 groups according to BMI (<30 kg/m2=control group and ≥30 kg/m2=study group). Pregnancy was assessed by ß-hCG levels and a visible gestational sac in the endometrium. RESULTS: The demographic and hormonal parameters were similar between the groups. The mean duration of infertility was longer in the study group (p<0.05). In the study group, cycle cancellation due to CC resistance (p=0.039) and mean baseline LH levels (p=0.026) was statistically more likely than in the control group. On follow-up, 4 (9.3%) patients in the study group had conceived and 26 (19.4%) patients in the control group had conceived (p=0.041). CONCLUSION: Obesity adversely affects pregnancy rates in women with PCOS who undergo ovulation induction cycles. Clinicians should recommend weight loss in these patients before ovulation induction.

The association between clinical parameters and uterine fibroid size in patients who underwent abdominal myomectomy.

OBJECTIVES: To evaluate if there is an association between neutrophil lymphocyte ratio and tumor markers in patients with uterine fibroids. METHODS: A total of three hundred and fifty seven patients who operated for myomectomy were enrolled this retrospective case control study. Risk factors evaluated were; age, uterine fibroid type, body mass index (BMI), gravidity, parity, preoperative and postoperative hemoglobin difference, neutrophil/lymphocyte ratio (NLR), alpha fetoprotein (AFP), cancer antigen 125 (CA 125), cancer antigen 19-9 (CA 19-9), cancer antigen 15-3 (CA 15-3), carsino embryonic antigen (CEA) levels. Patients divided two groups with regard to the diameter size of the removed fibroids. Group 1 (n=211) determined as the patients whose diameter size of the removed fibroids ≤ 5 cm and group 2 (n=146) determined as patients with > 5 cm diameter size. Groups were compared in terms of their age, bmi, gravidity, parity, preoperative and postoperative hemoglobin difference, nlr, afp, ca 125, ca 19-9, ca 15-3, cea levels. RESULTS: The mean age of the patients in group 1 (n=211) were 38.02 ± 5.38 years and in group 2 were (n=146) 37.80 ± 6.06 years (p = .751). There were no statistically significant differences between groups in terms of age, bmi, uterine fibroid types, cea and afp levels (p > 0.05). Gravidity, parity, preoperative and postoperative hemoglobin differences, nlr, ca 125, ca 19-9, ca 15-3 levels were statically significantly different between groups. CONCLUSIONS: According to this study, we think that multiple parameters affect developing uterine fibroids.

Krukenberg carcinoma metastasized from stomach resembling mucinous cystadenocarcinoma of the ovary.

The ovaries are common site of metastasis in a variety of primary neoplasms. Multiple tumors such as breast, lung, and pancreas have been reported to metastasize to the ovary, however; the colon and stomach are the most common primary cancer sites that of ovarian metastasis. An ovarian mass mostly originates from its self-tissue, but sometimes it can be a metastasis of a gastrointestinal system tumor. Such cases are often misdiagnosed as primary ovarian cancers. A 42-year-old woman was admitted to our hospital with pelvic pain. She had a history of her complaints for two months. Bilateral large ovarian mass was detected in transvaginal ultrasound. Laparotomy was performed, the pathologist suggested inspection of the stomach after the frozen section analysis; therefore, an irregular mass on the stomach was detected. The general surgeon was attended to the operation, and an inoperative stomach tumor was reported by the general surgeon. After that due to the partial obstruction of jejunum, a gastrojejunostomy was performed. It is in fact difficult to distinguish between metastatic mucinous carcinomas and primary mucinous carcinomas of the ovary, due to the similar appearance of as cystic tumors on gross examination. The clinicians should be aware of the likely concomitant gastrointestinal system tumor when a large and bilaterally mass was detected on physical examination. This case also reminds that a systemic examination is necessary even if the large ovarian tumors suspicious of primary malignancy were noticed.

Unilateral angiokeratoma of vulva: a rare clinic entity.

The aim of this study is to present a very rare dermatologic condition of the vulva. Angiokeratoma is a benign dilation of ectatic thin-walled blood vessels and congested capillaries in the superficial dermal layer of skin. It occurs predominantly in men and extremely rare in women. Angiokeratoma presents as single or multiple papular lesions on the vulva with smooth or verrucous surface. These lesions are easily confused with infectious disease, inflammatory lesions, and epithelial tumors. In this report, we presented a 42 year old unmarried woman who was admitted to our clinic with complaints of two papuler lesions of the right labium majus with vaginal discharge, vulvar pruritis, and vulvar edema. She had been previously treated with different local or systemic antiinfectious agents and her screening tests for sexually transmitted disease were negative. The genital examination showed a very thinned, hyperemic and edematous vulvar skin with two lesions measured 0,5-1 cm in diameter on the right labium majus. The surface of the lesions was partly uneven and partly veined. A local excision was performed. Histological examination showed hyperkeratosis, papillomatosis and acanthosis with dilated vascular areas in the dermis and the specimen revealed angiokeratoma. In conclusion, we should be aware of this clinical entity to make the differential diagnosis of a lesion on the vulva.

Risk factors for adenomyosis, leiomyoma and concurrent adenomyosis and leiomyoma.

AIM: To evaluate the risk factors for adenomyosis, leiomyoma and concomitant adenomyosis and leiomyoma in patients with treatment-resistant menometrorrhagia. METHODS: A retrospective study was conducted on 129 women who underwent abdominal hysterectomy for treatment-resistant menometrorrhagia. The patients were divided into four groups according to the postoperative histopathology: concomitant adenomyosis and leiomyoma (n = 33), adenomyosis only (n = 26), leiomyoma only (n = 48) and controls (n = 22). Patients without any organic uterine pathology constituted the control group. RESULTS: Age at menarche was higher in the concomitant adenomyosis and leiomyoma group compared to the adenomyosis only group (P = 0.006). The mean age (P = 0.007), age at menarche (P = 0.001) and gravidity (P = 0.001) were higher in the concomitant adenomyosis and leiomyoma group compared to the leiomyoma only group. Preoperative hemoglobin was lower in the concomitant adenomyosis and leiomyoma, adenomyosis only, and leiomyoma only groups than the control group (P < 0.008). On receiver operating characteristic analysis, hemoglobin <10.9 mg/dL had a sensitivity and specificity of 77% and 70%, respectively, in discrimination of any uterine organic pathology, including adenomyosis only, leiomyoma only, and concomitant adenomyosis and leiomyoma, from the control group. Patients in the adenomyosis group were older (OR, 1.20; 95%CI: 1.05-1.50) and had a lower age at menarche (OR, 0.42; 95%CI: 0.19-0.89) than the other groups. CONCLUSIONS: Preoperative anemia may be a useful predictor of adenomyosis. Older patients, and patients who had a lower age at menarche, were also more likely to have adenomyosis.

Associations between adipocyte fatty acid-binding protein and clinical parameters in polycystic ovary syndrome.

PURPOSE: We evaluated a possible association between serum adipocyte fatty acid-binding protein (A-FABP) levels and clinical parameters in women with polycystic ovary syndrome (PCOS). METHODS: Our study included 86 women: 49 with PCOS (study group), 37 with non-PCOS (control group). We recorded and analyzed age, body mass index [BMI = weight (kg)/height (m)(2)], waist circumference, and blood pressure and follicle-stimulating hormone (FSH), luteinizing hormone (LH), LH/FSH, free testosterone (fT), dehydroepiandrosterone sulfate, 17-OH progesterone, insulin, glucose, triglyceride, high-density lipoprotein, low-density lipoprotein, very low density lipoprotein, HOMA-IR, and A-FABP levels. RESULTS: The mean BMI, waist circumference, and levels of serum LH, fT, LH/FSH, fasting insulin, and HOMA-IR were significantly higher in PCOS patients (p < 0.05). Pearson correlation analysis showed positive correlations of A-FABP levels with BMI and HOMA-IR levels and a negative correlation between A-FABP and fT levels. A ROC curve analysis found that BMI, waist circumference, and levels of fT, A-FABP, and HOMA-IR were discriminative parameters. CONCLUSION: Serum A-FABP levels may be a good prognostic marker in predicting metabolic syndrome and cardiovascular diseases in PCOS patients.

The association between endometrial polyps and metabolic syndrome: a case-control study.

BACKGROUND: Endometrial polyps are common benign gynaecologic disorders. The etiopathogenesis of this condition remains unclear, however obesity is an important risk factor for the development of endometrial polyps. AIM: The aim of the study was to evaluate a possible association between endometrial polyps and clinical parameters of metabolic syndrome (MetS). MATERIALS AND METHODS: Forty-five women with endometrial polyps (study group) and 45 without (control group) were included in this cross-sectional study. The main parameters evaluated between the groups were age, BMI (body mass index), waist circumference (WC), blood pressure, serum lipid profiles, fasting glucose levels and homeostatic model assessment of insulin resistance (HOMA-IR). RESULTS: There was a significant difference between the groups in terms of BMI, WC, insulin levels and HOMA-IR (P < 0.05). The MetS was present in 32 (71.1%) of women in the study group and in 6 (13.3%) in the control group (P < 0.001). Logistic regression demonstrated that MetS was a significant risk factor for endometrial polyps. ROC curve analysis also showed that MetS was the most significant discriminative risk factor in the study group with an AUC of 0.789 (0.691-0.887; CI 95%). CONCLUSION: Our study suggests that there may be a relationship between endometrial polyps, MetS and insulin resistance. Further studies are required to explain the role of this relationship in the pathogenesis of the disease.

A rare case of acute abdomen: torsionated ovarian myoma.

Ovarian leiomyoma is a rare ovarian tumor and also rare cause of acute abdomen. A 64 year old, postmenopausal woman applied to our clinic with severe acute abdominal pain. On abdominal examination, there were abdominal tenderness, defense and rebound. On ultrasonographic examination, we detected a 6 cm of pelvic mass. Because she had acute abdomen we performed laparotomy by midline incision and excised a 6cm ovarian mass on right ovary. The mass had been reported as ovarian leiomyoma on frozen section by pathology department.

Incidentally detected ectopic right kidney following total abdominal hysterectomy and bilateral salpingoophorectomy.

Congenital organ anomalies in surgical patients can be incidentally detected during operation. A pelvis located right kidney was found incidentally in 54 year-old women after total abdominal histerectomy and bilateral salpingoophorectomy. The clinical importance of pelvic kidney detected during the surgery was discussed in this case report.

Pain experienced during and after office hysteroscopy with and without intracervical anesthesia.

We designed this study to evaluate if intracervical anesthesia reduces pain experienced during and after office hysteroscopy (OH). Two hundred women undergoing OH were randomized into two groups. Group I received intracervical anesthesia (10 ml %2 prilocaine), group II did not receive any anesthesia before procedure. The intensity of pain during procedure, 30 and 60 minutes later on visual analog scale (VAS) was assessed. Groups were similar in age, parity, previous number of vaginal delivery, or presence of menopausal status. The mean of pain scores during OH was less in group I (0.82 ± 0.11) than in group II (0.86 ± 0.09) and the difference was statistically significant (p = 0.04). But, the difference of mean pain scores 30 and 60 minutes after procedure between the groups were not statistially significant. In conclusion, intracervical anesthesia reduces pain experienced during OH, but this effect does not last longer.

Hemangiopericytoma of the uterus: a rare case of pelvic mass.

Hemangiopericytoma (HPC) is an uncommon perivascular tumor which may arise from anywhere in the body accounts for 1% of primary vascular tumors. Uterine hemangiopericytomas are usually low grade malignancies with better prognosis. The primary treatment is usually total hysterectomy and bilateral salpingo-oophorectomy. In this report, we aimed to evaluate the clinical characteristics of an 83 years of woman admitted to our clinic with pelvic mass who underwent laparotomy and underwent total hysterectomy and bilateral salpingo-ooforectomy. Postoperative pathology was hemangiopericytoma.

Retention of fetal bones 8 years following termination of pregnancy.

Foreign bodies; in particular, fetal bones may present with a variety of clinical symptoms and signs including infertility, vaginal discharge, disparonia, pelvic pain, abnormal uterine bleeding. Many case reports were described post- abortal removal of retained fetal bone at varying time intervals from the previous (D&E), ranging from weeks to years. In our case, a 34-year-old woman presented with abnormal uterine bleeding and secondary infertility, her only pregnancy being a termination 8 years previously at 15 weeks' gestation. A transvaginal ultrasound revealed a normal-sized, normal-shaped uterus with an echogenic scarred endometrium. After then office hysterescopy revealed fragments of the immature bone. All the immature bones were removed by operative hysterescopy. Significant numbers of patients may have endometrial pathology; the differential diagnosis of such unusual findings on ultrasound examination includes intrauterine contraceptive devices, foreign bodies, calcified submucous fibroids and Asherman's syndrome, as well as rarities such as heterotopic bone. The presence of this pathology may be a causal or contributory factor to subfertilty, and will remain undetected if the endometrium is not routinely evaluated. Indeed, these cases highlight the advantage of performing a hysteroscopy at the same time as the more invasive laparoscopy and dye insufflation, in selected cases.

Maternal serum amyloid A levels in pregnancies complicated with preterm prelabour rupture of membranes.

OBJECTIVE: The aim of the study was to investigate a possible association between maternal serum amyloid A levels (SAA) and maternal and fetal parameters in pregnancies complicated with preterm prelabor rupture of membranes (PPROM). MATERIAL AND METHODS: A total of 88 pregnant women (PPROM group, n = 44 and control group, n = 44) were included into this prospective case control study Serum blood samples for SAA were obtained from both groups within 1 h since the rupture of the membranes and before administration of any medicine. The samples were kept frozen at -70 degrees C until the analysis. The recorded risk factors were: age, gravidity parity delivery mode, gender; fetal birth weight, APGAR scores, white blood cell count, microCRRF neutrophil/lymphocyte ratio (NLR), and maternal serum SAA levels. RESULTS: Demographic characteristics showed no statistically significant differences between the groups (p > 0.05). The mode of delivery mode was cesarean section: 41% and 43.2% in the study and the control group, respectively and this difference was statistically significant between the groups (p < 0.05). Fetal parameters also showed statistically significant differences (p < 0.05). There was a statistically significant difference between the groups in terms of micro CRP NLR and SAA. SAA levels were higher in the PPROM group (p < 0.005). SAA levels at a cut-off 95.63 ng/ml. CONCLUSION: We are of the opinion that second trimester maternal serum SAA level may be a predictive marker for PPROM. However further studies with more participants are required.

Report of a pregnant woman underwent radical hysterectomy for cervical cancer.

Cervical cancer during pregnancy has an incidence of about 1 to 10 in 10.000 individuals and is one of the most common malignancies occurring during pregnancy. In this report, we aimed to evaluate a pregnant women with cervical cancer underwent radical hysterectomy and pelvic and paraaortic lymphadenectomy at our clinic. A 47 years of pregnant woman (G8, P7) with an intrauterine pregnancy of 4 weeks 6 days of gestation admitted to our high risk pregnancy department with vaginal bleeding complaint. On vaginal examination, we detected a 4 cm of lesion protruding from the cervix. Biopsy of the lesion was proved as microinvasive squamous carcinoma of the cervix. Subsequently radical hysterectomy and pelvic and paraaortic lymphadenectomy was performed. Postoperative pathology was large cell keratinizing squamous cell carcinoma of the cervix. In conclusion, although its rarity, clinicians should suspect of cervical cancer in a pregnant woman complaining of vaginal bleeding.

Targeting the anaphase-promoting complex/cyclosome (APC/C) enhanced antiproliferative and apoptotic response in bladder cancer.

Improving the chemotherapy sensitivity of bladder cancer is a current clinical challenge. It is critical to seek out effective combination therapies that include low doses of cisplatin due to its dose-limiting toxicity. This study aims to investigate the cytotoxic effects of the combination therapy including proTAME, a small molecule inhibitor, targeting Cdc-20 and to determine the expression levels of several APC/C pathway-related genes that may play a role in the chemotherapy response of RT-4 (bladder cancer) and ARPE-19 (normal epithelial) cells. The IC20 and IC50 values were determined by MTS assay. The expression levels of apoptosis-associated (Bax and Bcl-2) and APC/C-associated (Cdc-20, Cyclin-B1, Securin, and Cdh-1) genes were assessed by qRT-PCR. Cell colonization ability and apoptosis were examined by clonogenic survival experiment and Annexin V/PI staining, respectively. Low-dose combination therapy showed a superior inhibition effect on RT-4 cells by increasing cell death and inhibiting colony formation. Triple-agent combination therapy further increased the percentage of late apoptotic and necrotic cells compared to the doublet-therapy with gemcitabine and cisplatin. ProTAME-containing combination therapies resulted in an elevation in Bax/Bcl-2 ratio in RT-4 cells, while a significant decrease was observed in proTAME-treated ARPE-19 cells. Cdc-20 expression in proTAME combined treatment groups were found to be decreased compared to their control groups. Low-dose triple-agent combination induced cytotoxicity and apoptosis in RT-4 cells effectively. It is essential to evaluate the role of APC/C pathway-associated potential biomarkers as therapeutic targets and define new combination therapy regimens to achieve improved tolerability in bladder cancer patients in the future.

Comparative effect of lornoxicam and paracetamol in pain relief in endometrial sampling.

We conducted a study to compare the analgesic effect of oral lornoxicam and oral paracetamol before endometrial sampling for benign conditions. This prospective, double-blind, randomized study was conducted on sixty women underwent endometrial sampling for benign indications, from November 2010 to April 2011. The patients were divided into two groups (lornoxicam and paracetamol group) and both administered drugs (8 mg oral lornoxicam or 500 mg oral paracetamol) one hour before the procedure. Pain scores, by VAS (Visual analog scale) pain score, were recorded 0, 30 and 60 minutes after the procedure and compared. All patients gave informed consent to the study. Statistical analyses were carried out by using the statistical packages for SPSS 15.0 for Windows (SPSS Inc., Chicago, IL, USA). There was no statistically significant difference between the groups about the demographic parameters (p > 0.05). Lornoxicam group showed lower VAS pain score than the paracetamol group (p < 0.05). A total of thirteen patients took additional analgesic in two groups (p < 0.05). According to the current study, oral lornoxicam is more effective in pain relief than oral paracetamol in patients underwent endometrial sampling.

Factors affecting the degree of hirsutism in patients with polycystic ovary syndrome.

PURPOSE: To investigate the clinical features of patients with polycystic ovary syndrome (PCOS) and compare the patients with hirsutism to those without. METHODS: In total, 304 consecutive females with PCOS were evaluated. The cases were divided into two groups of hirsute or non-hirsute. The risk factors recorded were age, age at menarche, body mass index (BMI), luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol, prolactin, and total testosterone (tT) levels and hirsutism scores. Statistical analyses were performed using the Student's t test and logistic regression. RESULTS: Of all the cases, 224 were hirsute (hirsutism score ≥ 8). No significant difference was observed between the groups for age or age at menarche. BMI and hormone levels, including LH, FSH, estradiol and tT, were higher in hirsute patients than those in non-hirsute patients (p < 0.05). The logistic regression model showed that BMI, tT, LH, and estradiol were significant risk factors with odds ratios and 95% confidence intervals of 5.81 (2.22-15.18), 4.57 (2.34-8.90), 2.61 (1.73-3.94), and 2.29 (1.30-4.05), respectively. CONCLUSIONS: Hirsute patients with PCOS have different clinical characteristics from those that are non-hirsute in terms of BMI, LH, FSH, estradiol, and tT levels. We also determined the odds ratios of these different parameters. BMI was the most important risk factor for the degree of hirsutism.

Comparison of the risk factors for adverse perinatal outcomes in adolescent age pregnancies and advanced age pregnancies.

OBJECTIVES: To evaluate clinical outcomes of pregnancies in adolescent, advanced and reproductive women maternal age. MATERIALS AND METHODS: A total of 187 pregnant women were included into the study 51 (27.27%) were adolescent pregnancies, mean age 17.7 +/- 3.3 years (range, 14-18 years), 40 (21.29%) advanced maternal age pregnancies, mean age 41.4 +/- 2.6 years (range, 39-50 years) and 96 (51.33%), healthy controls, mean age 28.8 +/- 4.3 years (range, 19-37 years). The majority of the adolescent pregnant women were nulliparous, while all of the advanced age pregnant women were multiparous (mean gravidity 4.5 +/- 2.4; range, 6-12). Mean gravidity of the control group was 3.6 +/- 1.7 (range, 1-12). RESULTS: There was statistically significant difference among the groups regarding demographic characteristics. According to the Bonferroni method, there was statistically significant difference among the three groups. Adverse fetal features were statistically different among the groups and the odd ratios were higher in the advanced maternal age group. The odds ratios (95% CI) for lower Apgar scores (Apgar score 1 and 5) and low birth weight in adolescent maternal age and advanced maternal age group were as follows: 1.88 (1.27-2.78) vs. 2.46 (1.55-3.85), 2.17 (1.18-4.00) vs. 4.79 (3.02-6.69) and 1.39 (1.14-1.68) vs. 3.06 (1.59-5.88), respectively Gestational age at birth showed minimal risk for adolescent age group but no risk was noted in the advanced age group. CONCLUSIONS: The present study showed that pregnancies in adolescent maternal age, advanced maternal age and reproductive maternal age are different from each other in terms of clinical characteristics. According to this study advanced maternal age pregnancies are more risky and more likely to have adverse fetal outcome.