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Carcinoma Endometrioide/cirugía , Carcinoma de Células Transicionales/patología , Neoplasias Primarias Múltiples/cirugía , Neoplasias Ováricas/patología , Neoplasias Uterinas/cirugía , Carcinoma Endometrioide/patología , Carcinoma de Células Transicionales/cirugía , Femenino , Humanos , Histerectomía , Hallazgos Incidentales , Persona de Mediana Edad , Neoplasias Primarias Múltiples/diagnóstico , Neoplasias Primarias Múltiples/patología , Neoplasias Ováricas/cirugía , Ovariectomía , SalpingectomíaAsunto(s)
Adenocarcinoma/diagnóstico , Neoplasias Endometriales/diagnóstico , Neoplasias Primarias Múltiples/diagnóstico , Neoplasias Ováricas/diagnóstico , Tumores de los Cordones Sexuales y Estroma de las Gónadas/diagnóstico , Femenino , Humanos , Hallazgos Incidentales , Persona de Mediana Edad , PosmenopausiaRESUMEN
BACKGROUND: In this study, we investigated the inhibitory effects of desflurane and sevoflurane on oxytocin-induced contractions of isolated human myometrium. METHODS: Following delivery of the infant and placenta, a small segment of myometrium was excised from the upper incisional surface of the lower uterine segment and 20 strips, randomly assigned into two groups (n = 10), were obtained from 20 non-laboring term parturients. The study protocol consisted of a 60-min period of spontaneous contractions, control recording with oxytocin 2 x 10(9) m (10-min period), washout interval of 10 min, volatile administration (three times per 15-min period) of 0.5, 1 and 2 minimum alveolar concentration (MAC), response to oxytocin (10-min period), a further washout interval (10-min period) and subsequent control recording with oxytocin without anesthetics. RESULTS: After oxytocin administration, the frequency and amplitude of contractions increased (P < 0.05) and the duration decreased (P < 0.05). The frequency and amplitude of contractions induced with oxytocin decreased significantly at 0.5, 1 and 2 MAC of desflurane and sevoflurane (P < 0.05). The amplitude of contractions was significantly different at 1 MAC between the two groups (P < 0.05). The duration of contractions at 2 MAC decreased in both groups (P < 0.05). CONCLUSIONS: Desflurane and sevoflurane at 0.5, 1 and 2 MAC inhibit the frequency and amplitude of myometrial contractions induced with oxytocin in a dose-dependent manner. However, desflurane inhibits the amplitude less than sevoflurane at 1 MAC. We suggest that 0.5 MAC of both agents and 1 MAC of desflurane may be safely used in the presence of oxytocin following delivery of the infant and placenta during Cesarean section without fear of uterine atony and hemorrhage.
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Anestésicos por Inhalación/farmacología , Isoflurano/análogos & derivados , Éteres Metílicos/farmacología , Miometrio/efectos de los fármacos , Oxitocina/farmacología , Contracción Uterina/efectos de los fármacos , Adulto , Desflurano , Femenino , Humanos , Técnicas In Vitro , Isoflurano/farmacología , Embarazo , SevofluranoRESUMEN
OBJECTIVE: To differentiate benign from malignant ovarian tumors based on sonographic detection of a solid component. METHOD: Sixty-three women with ovarian masses were evaluated preoperatively by gray scale and power/color Doppler ultrasonographic examination, with specific predefined criteria for the solid component. Sensitivity, specificity, and positive and negative predictive values were calculated and assessed against the histopathologic outcome. The contribution of cancer antigen (CA) 125 levels to the diagnostic accuracy was also assessed. RESULT: Sensitivity, specificity, and positive and negative predictive values were 100%, 95.2%, 91.3% and 100%, respectively, with two false-positive results. Had an elevated CA 125 level (>35 U/mL) been included in the malignancy criteria, the false-positive results would have been eliminated, giving an accuracy of 100%. CONCLUSION: Sonographic evaluation with predefined specific criteria for the detection of a solid tumor component is an accurate method of preoperative discrimination between benign and malignant ovarian tumors. A serum CA 125 assay may assist in eliminating false-positive results.
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Enfermedades de los Anexos/diagnóstico por imagen , Antígeno Ca-125/sangre , Neoplasias Ováricas/diagnóstico por imagen , Ultrasonografía Doppler , Enfermedades de los Anexos/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Diagnóstico Diferencial , Reacciones Falso Positivas , Femenino , Humanos , Persona de Mediana Edad , Neoplasias Ováricas/diagnóstico , Valor Predictivo de las Pruebas , Cuidados Preoperatorios , Sensibilidad y Especificidad , Ultrasonografía Doppler/normasRESUMEN
PURPOSE: To investigate the frequency of human papillomavirus (HPV) infection among low-risk women for cervical cancer in our region. METHODS: In one year period, 230 consecutive women at low risk of developing cervical cancer were enrolled to the study. HPV DNA testing was performed by Hybrid Capture-I System (HC-I) and groups were constituted by HPV-positive and HPV-negative women. A comparison of the groups according to age, obstetric history and age at the beginning of sexual intercourse was made. Statistical analysis was performed. RESULTS: The frequency rate of HPV infection was demonstrated to be 6.1% (n = 14) in our study (5.9% in women < or = 45 years and 7.7% in women > 45 years). Age-dependent differences were not observed between groups. There was no significant difference between HPV-positive and negative women regarding obstetric characteristics and mean age at first intercourse. CONCLUSION: This study provided significant information on the frequency of HPV infection of low-risk women in our region. When considered with studies performed in other countries, our study may give some help on the natural history of HPV infection and cervical squamous lesions.
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Papillomaviridae , Infecciones por Papillomavirus/epidemiología , Neoplasias del Cuello Uterino/epidemiología , Adulto , Colposcopía , Femenino , Humanos , Persona de Mediana Edad , Infecciones por Papillomavirus/patología , Prevalencia , Factores de Riesgo , Turquía/epidemiología , Neoplasias del Cuello Uterino/patología , Neoplasias del Cuello Uterino/virologíaRESUMEN
Tumor necrosis factor alpha (TNF-alpha) and other cytokines have been implicated in the pathogenesis of ovarian hyperstimulation syndrome (OHSS). Pentoxifylline, a methylxanthine derivative, was found to inhibit TNF-alpha synthesis. The aim of this study was to evaluate whether the use of pentoxifylline would prevent the occurrence of OHSS in a rabbit model. Thirteen rabbits were divided into two groups. The first group (n = 6) were given pentoxifylline 15 mg/kg intravenously and the second group (n = 7) were given physiological serum 15 mg/kg before ovulation induction. Ovarian hyperstimulation was induced in rabbits by 200 IU equine chorionic gonadotropin on day 1 and 100 IU human chorionic gonadotropin on day 3. Blood samples were analyzed for TNF-alpha on days 1, 3 and 5. All animals were autopsied on day 6 to evaluate the ovarian weight, ascites formation and histopathological changes. There was no difference between groups regarding weight gain, ascites formation and plasma TNF-alpha levels (p < 0.05). Ovarian weight and number of ovulations were significantly lower in the pentoxifylline group than the control group (p < 0.05). Pentoxifylline did not prevent ascites formation despite the observed decrease in ovarian weight and number of ovulations in OHSS in a rabbit model.
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Síndrome de Hiperestimulación Ovárica/tratamiento farmacológico , Pentoxifilina/uso terapéutico , Animales , Gonadotropina Coriónica/administración & dosificación , Femenino , Tamaño de los Órganos , Síndrome de Hiperestimulación Ovárica/inducido químicamente , Ovario/anatomía & histología , Inducción de la Ovulación , Conejos , Factor de Necrosis Tumoral alfa/análisis , Factor de Necrosis Tumoral alfa/antagonistas & inhibidoresRESUMEN
BACKGROUND: The aim of this study was to measure the circulating levels of androgens in the third trimester of pregnancy and six weeks after delivery and to discuss androgen contribution in the pathogenesis of preeclampsia. METHODS: Twenty-two preeclamptic and 20 normotensive women completed this prospective study. Blood samples were drawn in the third trimester (28-32 gestational weeks) and six weeks after delivery. Serum total testosterone (T), free testosterone (fT) dehydroepiandrosterone sulfate (DHEAS), androstenodione (A), sex hormone binding globulin (SHBG) and estradiol (E2) levels were measured. The statistical analyses of the data were performed by using Wilcoxon Rank test within the groups, Student unpaired t test and Chi-square test between the groups with the SPSS program. RESULTS: T and fT levels were found to be significantly higher (p<0.05) in preeclamptic women in the third trimester compared to the values of normotensive controls. However, there were significant decreases (p<0.05) in T and fT levels six weeks after delivery, reaching values not significantly different from normotensive subjects (p>0.05). Furthermore, SHBG, DHEAS, A and E2 levels were not significantly different (p>0.05) between the groups in the third trimester or six weeks after delivery. CONCLUSION: We conclude that higher blood androgen levels measured in preeclamptic patients may be implicated in the pathogenesis of preeclampsia.
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Andrógenos/sangre , Preeclampsia/sangre , Adulto , Sulfato de Deshidroepiandrosterona/sangre , Estradiol/sangre , Femenino , Humanos , Embarazo , Tercer Trimestre del Embarazo , Estudios Prospectivos , Globulina de Unión a Hormona Sexual/metabolismo , Testosterona/sangreRESUMEN
The purpose of this study was to investigate the occurrence rate of APC resistance (APC-R) with severe preeclampsia in Turkish women. Thirty-two consecutive women having severe preeclampsia were included in the study. Thirty-two healthy pregnant women served as the control group. APC-R assays were performed in the third trimester of pregnancy, and 3 and 9 months after delivery. APC-R was demonstrated in the third trimester, 3 months and 9 months after delivery in 27 (84.4%), 23 (71.9%) and 5 (15.6%) of 32 preeclamptic patients, respectively. APC-R rates were significantly higher in preeclamptic group than in normal pregnant women in the third trimester of pregnancy (p < 0.05). Decreased mean APC activity and also increased APC-R rate was still persisting in preeclamptic group for 3 months after delivery. Nine months after delivery, the mean APC activity and also APC-R rates approached to the normal pregnant women; however, there was a significant difference between both groups (p < 0.05). Our results indicate that acquired APC-R may be a contributory factor in the pathogenesis of preeclampsia.
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Resistencia a la Proteína C Activada/complicaciones , Preeclampsia/etiología , Resistencia a la Proteína C Activada/sangre , Adulto , Antitrombina III/metabolismo , Pruebas de Coagulación Sanguínea , Femenino , Humanos , Preeclampsia/sangre , Embarazo , Proteína C/metabolismo , Proteína C/fisiología , Proteína S/metabolismo , Proteína S/fisiología , TurquíaRESUMEN
The purpose of our study was to compare the effects of cyclical versus continuous transdermal oestrogen replacement therapy on lipoprotein (a) (Lp(a)) and nitric oxide levels. The patients were randomly assigned into two groups. The first group received transdermal 17-beta oestradiol 50 microg/day for 21 days and the second group the same treatment on a continuous basis. Medroxyprogesterone acetate (10 mg/day orally) was added between the 14th and 25th days to each group. Lipoprotein (a) and nitric oxide levels were measured before the study and after six months. These values were compared using the Wilcoxon rank test within the groups and the unpaired t-test between the groups. Lipoprotein (a) levels decreased significantly in each group at the sixth month (p < 0.05). When compared between the groups, the decrease of lipoprotein (a) levels in the second group was more prominent at the sixth month (p < 0.05). Nitric oxide levels increased in each group after six months (p < 0.05). No difference in nitric oxide levels was observed between the groups before and after the therapy (p > 0.05). Continuous transdermal estradiol had a better effect on lipoprotein (a) levels than cyclical therapy The seven day pause in the 21-day administration did not affect nitric oxide levels negatively after six months.
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Estradiol/farmacología , Terapia de Reemplazo de Estrógeno , Lipoproteína(a)/efectos de los fármacos , Óxido Nítrico/sangre , Administración Cutánea , Administración Oral , Esquema de Medicación , Estradiol/administración & dosificación , Femenino , Humanos , Lipoproteína(a)/sangre , Acetato de Medroxiprogesterona/administración & dosificación , Persona de Mediana Edad , Posmenopausia , Resultado del TratamientoRESUMEN
OBJECTIVE: To determine the long-term effects of estrogen replacement therapy on sex hormone binding globuline (SHBG) and free testosterone (fT) levels in surgical postmenopausal women. STUDY DESIGN: Forty patients with surgical menopause were enrolled in this prospective study. The women were randomly divided into two groups. The first group received oral therapy (continuous conjugated equine estrogens (CEE) - 0.625mg per day) and the second group received transdermal therapy (patches delivering continuous 17beta-estradiol (E2)--0.05mg per day). Serum SHBG and fT levels were determined at baseline and after first and second years of treatment. Two-way repeated measures analysis of variance with Bonferroni adjusted post-hoc test and unpaired-t-test were performed for statistical analysis with SPSS program. RESULTS: Serum SHBG levels increased significantly with oral CEE after first year of treatment (P<0.05) and remained at this level for the next year. Transdermal therapy did not affect SHBG levels after first and second years (P<0.05). Serum fT levels did not change significantly in either group at the end of the first or second years (P<0.05) although there was a significant difference between the groups after 2 years (P<0.05). CONCLUSION: Oral conjugated estrogens increased SHBG levels during therapy. This effect may balance the increased estrogen and androgen stimulation on breast tissue and may be more beneficial to the cardiovascular system in postmenopausal women.