Laminin receptor 1 expression in premalignant and malignant squamous lesions of the cervix.

Laminin receptor 1 (LAMR) may have a role in the progression of premalignant squamous epithelial lesions to cervical cancer. Therefore, we aimed to investigate the expression of laminin receptor 1 (LAMR) in normal, premalignant, and malignant tissues of the uterine cervix. Paraffin blocks of 129 specimens with the diagnoses of normal cervical tissue (n = 33), cervical intraepithelial neoplasia (CIN) 1 (n = 30), CIN 2 (n = 14), CIN 3 (n = 28), and squamous cell carcinoma (n = 24) were immunohistochemically stained with LAMR antibody and its expression percentage, pattern, and intensity in these tissues were assessed. Compared to the other groups, the nonstaining with LAMR was highest in low grade squamous intraepithelial lesion (LSIL) (p < 0.0001). LAMR expression, which was positive in less than 50% of cells with weak staining, increased significantly between normal cervical epithelium and high-grade squamous intraepithelial lesion (HSIL) or invasive carcinoma, as well as between LSIL and HSIL (p < 0.0001). Between LSIL and invasive carcinoma, a significant increment was also observed for weak staining in less than 50% of cells (p < 0.001). LAMR expression, which was positive in more than 50% of cells with strong staining, was significantly higher in normal cervical tissue compared to the other groups (p < 0.0001). Disease progression related gradual increment of LAMR expression from normal cervical epithelium or LSIL towards HSIL or cervical cancer reveals that LAMR may play an important role in the transition from premalignant to malignant state in cervical lesions.

Could maternal serum MFG-E8 level predict adverse first trimester pregnancy outcome? A preliminary study.

BACKGROUND: Milk fat globule-epidermal growth factor 8 (MFG-E8) is expressed in the endometrial epithelium and its expression increases during the implantation process. Due to this knowledge, we aimed to investigate the maternal serum MFG-E8 levels on both healthy pregnant women in the first trimester and pregnant women complicated with missed abortion and threatened abortion in the first trimester. METHODS: This prospective, cross-sectional study was conducted in a tertiary referral hospital, department of obstetrics between July 2020 and February 2021 after ethical committee approval. The study population was consisted of 30 healthy pregnant women (HP) in the first trimester, 30 pregnant women suffering from threatened abortion (TA) in the first trimester and 30 pregnant women suffering from missed abortion (MA) in the first trimester. Maternal serum MFG-E8 levels were analyzed with enzyme linked immunosorbent assay. Delivery and neonatal outcomes of the study population was evaluated. The continuous variables were compared among three groups with variance analysis with post hoc tests. The categorical variables were compared with chi-square and Fisher's exact tests where applicable. RESULTS: The mean age of the study population was 29.36 ± 5.31 years. There was no significant difference among three groups for parameters of age, body mass index, parity number, and gestational week. Despite being within normal ranges, the mean neutrophil and international normalized ratio values of the three groups showed statistically significant difference (p < 0.05). The mean maternal serum MFG-E8 levels of MA, TA, and HP groups were 270 ± 152.3, 414.7 ± 236.7, and 474 ± 222.5 ng/mL, respectively (p = 0.001). It was found that mean of MFG-E8 of the MA group was statistically significantly lower than those of the other two groups (p < 0.05). DISCUSSION: Although maternal serum MFG-E8 level seems to be a parameter that differ between live and nonlive pregnancies, studies with large number of cases are needed to discuss our results and to determine a cut-off value for prediction.

Expression of laminin-1 and matrix metalloproteinase-9 in benign and malignant endometrium.

BACKGROUND: Laminin-1 and matrix metalloproteinase (MMP)-9 may play roles in the progression from benign to malignant endometrium, so we aimed to investigate their levels of expression in these tissues. METHODS: This case-control study was conducted at a tertiary care center between January 2014 and December 2016. Paraffin blocks of 50 specimens of benign endometrium with proliferative (n = 20), secretory (n = 11), and atrophic (n = 5) endometrium; simple endometrial hyperplasia without atypia (n = 12); and endometrial polyp (n = 2) histology and 49 specimens of malignant endometrium with endometrioid (n = 40), serous (n = 7), clear cell (n = 1), and undifferentiated (n = 1) types were immunostained with laminin-1 and MMP-9 antibodies and assessed for basement membrane continuity for laminin-1 and the percentage and intensity of MMP-9 expression in epithelial cytoplasm. RESULTS: : Laminin-1 continuity in the basement membrane was higher in benign (92%) compared to malignant (16.3%) endometrium (p < 0.0001) without any difference between the subgroups within each group (p > 0.05). All atrophic endometria and endometrial polyps and 23.5% of low grade endometrioid and none of the other endometrial cancers showed uninterrupted basement membrane staining with laminin-1. All cases in malignant endometrium expressed MMP-9 with either low or high immunoreactivity while none of the cases in benign endometrium showed a high staining with MMP-9 (p < 0.01). Proliferative and hyperplastic endometrium together with grade 1 endometrioid cancer expressed MMP-9 better than the atrophic endometrium (p < 0.05). The immunoreactivity with MMP-9 increased gradually from secretory to hyperplastic endometrium and serous carcinoma (p < 0.05). MMP-9 expression in all types of cancers except grade 1 endometrioid and clear cell compared to proliferative endometrium was significantly higher (p < 0.05) and increased from proliferative to grade 2 endometrioid, grade 3 endometrioid, serous and undifferentiated endometrial carcinoma. DISCUSSION: Gradual increments in MMP-9 expression and basement membrane laminin-1 discontinuity may indicate progression from normal to hyperplastic and to low- and high-grade cancerous endometrium.

Expression of Laminin Receptor 1 in Normal, Hyperplastic, and Malignant Endometrium.

Laminin receptor 1 may have a role in the progression from endometrial hyperplasia with or without atypia to endometrial cancer. Therefore, we aimed to investigate the pattern, percentage, and intensity of laminin receptor 1 expression in normal, hyperplastic, and neoplastic endometrium. Paraffin blocks of 131 specimens with the diagnoses of normal endometrium (n=25), endometrial hyperplasia with atypia (n=21) or without atypia (n=55), and endometrial cancer (n=30) were immunostained with laminin receptor 1 antibody, and its expression percentage, pattern, and intensity in the epithelial cytoplasm, basement membrane, and endometrial stroma of these tissues were assessed. When compared with hyperplasia with or without atypia and endometrial cancer, the percentage of nonstaining with laminin receptor 1 in the epithelial basement membrane was higher (96%), and the percentage of <50% staining with laminin receptor 1 was lower (4%) in the normal endometrium (P=0.001). While a progressive increment in staining percentage and density of epithelial cytoplasm and basement membrane was noted through an orderly progression from normal endometrium to endometrial hyperplasia without atypia, endometrial hyperplasia with atypia, and cancer of endometrium (P<0.001), such a relationship was not found for the staining percentage and density of endometrial stroma (P>0.05). Disease progression-related gradual increment in laminin receptor 1 expression in the epithelial basement membranes of hyperplastic endometrium with or without atypia and cancer of endometrium reveals that it may play a substantial role in the transition from premalignant to the malignant state of endometrial lesions.

Short-term results of changes in existing and de novo lower urinary tract symptoms after robot-assisted laparoscopic uterosacral ligament suspension and sacrocolpopexy.

OBJECTIVE: This study presents short-term outcomes related to changes in existing and de novo lower urinary tract symptoms (LUTS), pelvic pain, and bowel function following robot-assisted laparoscopic uterosacral ligament suspension (RALUSLS) and sacrocolpopexy (RALSC). METHODS: Observational data for RALUSLS (n = 23) and RALSC (n = 25) collected between August 2014 and March 2016 from a single institute (The University of Texas Medical Branch) were evaluated retrospectively. Patient characteristics, concomitant procedures, and the occurrence of lower urinary tract, pelvic pain, and bowel symptoms were compared between patients undergoing RALUSLS and RALSC. RESULTS: There was no significant difference in background characteristics between the 2 groups, except for parity, which was high in the RALUSLS group. In the RALUSLS group, patients experienced significant resolution of urinary urgency (P < .001) and frequency, urge and mixed incontinence, and pelvic pain (P < .05). In the RALSC group, there was significant resolution of nocturia, mixed incontinence, pelvic pain, and dyspareunia (P < .05). There was no significant difference in the occurrence of de novo symptoms in the RALUSLS and RALSC groups (P > .05), although newly appearing urinary urgency or frequency and stress or urge incontinence were more common after RALSC. CONCLUSION: Mixed incontinence and pelvic pain improved significantly in patients after RALUSLS or RALSC. In RALUSLS patients, urgency, frequency, and urge incontinence also improved, whereas additional improvement in nocturia and dyspareunia was evident only in RALSC patients. De novo LUTS developing after these procedures, especially after RALSC, necessitate careful patient consultation prior to surgery.

Selected maternal, fetal and placental trace element and heavy metal and maternal vitamin levels in preterm deliveries with or without preterm premature rupture of membranes.

AIM: To compare maternal, fetal and placental trace element (magnesium, zinc and copper) and heavy metal (cadmium and lead) and maternal vitamin (retinol, α [alpha]-tocopherol, vitamin D3 , 25-hydroxyvitamin D3 and 1,25-dihydroxyvitamin D3 ) levels in preterm deliveries with and without preterm premature rupture of membranes (PPROM). METHODS: Sixty-eight patients giving birth preterm were grouped into preterm deliveries with PPROM (n = 35) and without PPROM (n = 33). Following delivery, maternal and umbilical cord blood sera and placental tissue samples were obtained. While magnesium, zinc, copper, cadmium and lead levels were measured in all samples, the levels of retinol, α-tocopherol, vitamin D3 , 25-hydroxyvitamin D3 and 1,25-dihydroxyvitamin D3 were measured only in maternal serum. RESULTS: While magnesium level in maternal serum and zinc levels in both maternal and umbilical cord sera were lower, placental magnesium level was higher in preterm deliveries with PPROM (P < 0.01). Umbilical cord serum magnesium, placental tissue zinc and maternal and umbilical cord sera and placental tissue copper, cadmium, and lead levels did not differ between the groups (P > 0.05). In preterm deliveries with PPROM, 25-hydroxyvitamin D3 and retinol levels were higher, while vitamin D3 and 1,25-dihydroxyvitamin D3 levels were lower in maternal serum (P < 0.05). Maternal serum α-tocopherol levels were similar between the groups. CONCLUSION: Compared to spontaneous preterm births, PPROM is associated with low maternal serum together with high placental tissue magnesium and low maternal and umbilical cord sera zinc levels. Higher retinol and 25-hydroxyvitamin D3 and lower vitamin D3 and 1,25-dihydroxyvitamin D3 maternal serum levels are also evident in these patients.

Chemerin level in pregnancies complicated by preeclampsia and its relation with disease severity and neonatal outcomes.

The aims of this prospective study were to detect maternal serum chemerin level in patients with preeclampsia and investigate its association with disease severity and neonatal outcomes. Maternal serum chemerin levels were significantly elevated in severe preeclamptic women (394.72 ± 100.01 ng/ml) compared to mild preeclamptic women (322.11 ± 37.60 ng/ml) and healthy pregnant women (199.96 ± 28.05 ng/ml) (p = .001). Maternal serum chemerin levels were positively correlated with systolic and diastolic blood pressure, C-reactive protein levels, homeostasis model assessment of insulin resistance, proteinuria, AST, ALT, and duration of hospitalisation. Gestational week at delivery, birthweight, and APGAR scores at 1 and 5 min were negatively correlated with maternal serum chemerin level. A maternal serum chemerin level of >252.0 ng/ml indicated preeclampsia with 95.5% sensitivity and 95.7% specificity. There was a positive correlation between maternal serum chemerin level and severity of preeclampsia. Additionally, adverse neonatal outcomes were significantly associated with high maternal serum chemerin levels.

An analysis on the roles of angiogenesis-related factors including serum vitamin D, soluble endoglin (sEng), soluble fms-like tyrosine kinase 1 (sFlt1), and vascular endothelial growth factor (VEGF) in the diagnosis and severity of late-onset preeclampsia.

AIM: The aim of this study was to evaluate the roles of proangiogenic factors including serum vitamin D and vascular endothelial growth factor (VEGF) and anti-angiogenic factors including soluble endoglin (sEng) and soluble fms-like tyrosine kinase 1 (sFlt1) in the diagnosis and severity of late-onset preeclampsia. MATERIALS AND METHODS: The study was conducted at Yuzuncu Yil University Research and Education Hospital Department of Gynecology and Obstetrics. The study included a patient group of 40 women with late-onset preeclampsia who were pregnant at ≥32 weeks of gestation according to the last menstrual period (LMP) or ultrasonographic fetal biometric measurement and a control group of 40 healthy pregnant women who presented to our clinic for routine pregnancy examination and were at the same age and gestational period with those in the patient group. The two groups were compared in terms of maternal age, gravida, parity, week of gestation, systolic/diastolic blood pressure, total protein in spot urine sample, 24-h urine protein, white blood cell (WBC), hemoglobin (Hgb), platelet count, urea, creatinine, liver function tests (AST, ALT, LDH), vitamin D3, 25(OH) vitamin D3, 1,25(OH) vitamin D3, sEng, sFlt1, and VEGF levels, mode of delivery, the infant APGAR score at 1 and 5 min after delivery, and infant weight at delivery. RESULTS: The groups were similar in terms of age, gravida, parity, week of gestation, serum vitamin D3, 25(OH) vitamin D3, 1,25(OH)2 vitamin D3 and VEGF levels, and infant weight at delivery (p > 0.05). Systolic/diastolic blood pressure, total protein in spot urine sample, 24-h urine protein, WBC, Hgb, serum urea, creatine, AST, ALT, and LDH were significantly higher in the preeclamptic group compared to the healthy group (p < 0.05). However, thrombocyte level and the APGAR score at 1 and 5 min after delivery were significantly lower in the preeclamptic group compared to the healthy group (p < 0.05). No significant correlation was found between serum sEng, sFlt1, VEGF, vitamin D3, 25(OH) vitamin D3, and 1,25(OH)2 vitamin D3 levels. The sEng level was higher in the women with severe preeclampsia compared to the women with mild preeclampsia (p < 0.05) and no significant difference was observed in serum sFlt1, VEGF, vitamin D3, 25(OH) vitamin D3, and 1,25(OH)2 vitamin D3 levels between the subgroups of preeclampsia (p > 0.05). CONCLUSION: Both sEng and sFlt1 levels are remarkably high in patients with late-onset preeclampsia; however, only sEng may be a useful tool in the determination of the severity of preeclampsia.

The Relationship Between Hearing Thresholds and Hyperandrogenism in Polycystic Ovary Syndrome.

BACKGROUND The purpose of our study was to investigate the association between polycystic ovary syndrome (PCOS) and hearing thresholds. MATERIAL AND METHODS Forty women diagnosed with PCOS (mean age, 24.33±6.38 years) and 40 healthy women controls (mean age, 26.38±6.75 years) were included in prospective study. Each case was tested with low (250, 500, 1000, and 2000 Hz), high (4000, 6000, and 8000 Hz) and extended high (EH) (9000-20000 Hz) frequency audiometry. The fasting plasma glucose, insulin, FSH, LH, total testosterone, and sex hormone-binding globulin were measured in all patients. RESULTS The mean hearing thresholds at EH frequencies were statistically significantly higher in the PCOS group than in the control group (p=0.001 right ear and p=0.015 left ear). There were significant positive correlations among free testosterone index (FTI) values and hirsutism scores with EH frequency hearing thresholds. CONCLUSIONS At pure-tone audiometry (PTA) EH frequencies, we detected significantly higher hearing thresholds in PCOS patients than in controls. We also determined that elevated FTI and hirsutism score were positively correlated with elevated hearing thresholds in EH frequencies. These findings support that hyperandrogenism can play a role in the elevation of hearing thresholds in PCOS.

Management of Neuraxial Anaesthesia for Emergent Caesarean Section for Placenta Previa.

Abnormal placental attachments, such as placenta accreta, increta or percrata, can result in increased morbidity and mortality because of the risk of severe postpartum haemorrhage. We aimed to present the management of spinal anaesthesia and surgical approach for emergent caesarean section because of vaginal bleeding in a multiparous pregnant woman with placenta previa at 36 weeks' gestation. Hyperbaric bupivacaine 12 mg, fentanyl 10 µg and morphine 150 µg were intrathecally administered for spinal anaesthesia. Oxytocin, methyl ergonovin and tranexamic acid were administered after umbilical cord clamping. Breech delivery of the baby was provided by a vertical incision to the uterus for avoiding placental harm. Subtotal hysterectomy was performed leaving the placenta in situ. Two units of red blood cells were transfused during the operation, lasting approximately 40 min. The patient was uneventfully discharged on the postoperative fourth day. In conclusion, a single-shot spinal anaesthesia was successfully maintained without conversion to general anaesthesia until the end of the hysterectomy in the patient in whom placenta increta was observed during caesarean delivery.

Effects of jnk inhibitor on inflammation and fibrosis in the ovary tissue of a rat model of polycystic ovary syndrome.

OBJECTIVE: In our study, we aimed to investigate the effects of Jun N-terminal kinase inhibitor (SP600125) on fibrosis and inflammation in rats with polycystic ovary syndrome (PCOS). METHOD: 50 Wistar-albino rats were divided into five groups (n=10 each): control group, sham group, PCOS group, SP600125+ PCOS group and SP600125 group. In the estradiol valerate (EV)-treated group in which PCOS was injected with a single 4 mg/kg i.p. of EV in 0.2 ml sesame oil and the rats were sacrificed on day 60. The estradiol valerate (EV)-treated + SP600125-treated group was injected with a single 4 mg/kg i.p. of EV in 0.2 ml sesame oil. As of day 60, the treatment group was additionally given 15 mg/kg i.p. of SP600125 once daily for 4 consecutive days and the rats were sacrificed on day 65. Histopathological findings (ovarian morphology, edema, inflammatory cell infiltration, vascular congestion and hyperemia) and collagen type IV immunoexpression were assessed. RESULTS: The SP600125+ PCOS group showed a significant level of improvement in ovarian follicle morphology, edema, inflammatory infiltrate, vascular congestion and hyperemia as compared with the PCOS group. Furthermore, collagen type IV immunoexpression showed a significant reduction in staining intensity on the theca cell layer and ovary stroma as compared to the PCOS group. CONCLUSION: This study demonstrates the therapeutic effect of SP600125 in the prevention of PCOS in an experimental model.

Clinical and perinatal outcomes in eclamptic women with posterior reversible encephalopathy syndrome.

PURPOSE: To compare the clinical and perinatal outcomes in eclamptic women with and without posterior reversible encephalopathy syndrome (PRES). METHODS: This single-center, retrospective, cohort study was conducted between 2008 and 2013. The clinical and perinatal outcomes of eclamptic patients were obtained from hospital records. Magnetic resonance imaging was used for the diagnosis of PRES. Eighty-one eclamptic women were divided into two groups: 45 and 36 patients were included in the PRES and non-PRES groups, respectively. RESULTS: In the PRES group, headache and visual impairment together (60.0 %) were the most common presenting symptoms. In the non-PRES group, only headache was the most common (50 %) presenting symptom. Occipital and parietal lobes were the most frequently affected areas in the PRES group. Women in the PRES group had a higher body mass index value (p = 0.005), longer hospitalization time (p = 0.001), and higher level of proteinuria (p = 0.012) than those in the non-PRES group. Women in the non-PRES group had higher Apgar scores (p = 0.002) than those in the PRES group. CONCLUSIONS: This study indicates that PRES manifests predominantly with headache and visual impairment together. Adverse neonatal outcomes are also common in these patients.

Herlyn-Werner-Wunderlich syndrome: merits of sonographic and magnetic resonance imaging for accurate diagnosis and patient management in 13 cases.

STUDY OBJECTIVE: To review the main sonographic and magnetic resonance imaging manifestations of Herlyn-Werner-Wunderlich syndrome, characterized by uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis, and to discuss the value of techniques for its diagnosis and treatment. PARTICIPANTS: Thirteen patients with Herlyn-Werner-Wunderlich syndrome referred to our department with acute abdomen were identified for the period from 2009-2012. DESIGN: Retrospective chart review. SETTING: Two tertiary academic centers. INTERVENTIONS: None. MAIN OUTCOME MEASURES: The evaluation of the clinical features, ultrasonography and magnetic resonance imaging findings, and the treatment protocols. RESULTS: Ultrasonographic evaluation of didelphic or double uterus in 10 and bicornuate-bicollis uterus in 3 patients with hematocolpos or hematometrocolpos associated with agenesis of the ipsilateral kidney revealed the diagnosis. In 10 patients, magnetic resonance imaging provided extra information. In 1 patient, a 25-week pregnancy was additionally detected and follow-up was suggested. Seven patients underwent surgical excision of the septum and drainage of the obstructed vagina. Total hysterectomy and hemicolpectomy were performed in 1 patient with 2 children suffering from severe chronic pelvic pain due to pelvic inflammatory disease. CONCLUSIONS: Despite its rarity, accurate diagnosis and morphologic description of Herlyn-Werner-Wunderlich syndrome with radiologic modalities are of importance in relieving the clinical complaints by enabling the suitable surgical treatment to be identified.

An unusual cause of dyspnea in a pregnant woman: supraglottic hemangioma.

Dyspnea is a common complaint among pregnant women; upper airway obstruction is a rare cause of it. We report a case of supraglottic hemangioma in a 20-year-old pregnant woman who presented with increasing dyspnea and hoarseness at 40 weeks of gestation. She gave birth to a healthy 3,100-g girl by caesarean delivery under epidural anesthesia. She was able to breathe easily during the postpartum period. This case represents a rare instance of dyspnea caused by a supraglottic hemangioma in a pregnant woman.

The effects of pre-pregnancy obesity on fetal cardiac functions.

Obesity is a substantial public health problem with a rapidly increasing prevalence in numerous industrialized nations. The objective of this study was to evaluate the effects of maternal pre-pregnancy obesity on fetal cardiac functions. We studied 55 fetuses of obese mothers and 44 fetuses of healthy mothers at 26-38 weeks of gestation. Cardiac functions were evaluated by M-mode, pulsed-wave, and tissue Doppler echocardiography. The two groups were similar in terms of maternal age, gravidity, parity, gestational age, estimated birth weight, serum lipids, and systolic-diastolic blood pressure. Fetal heart rate, diameters of the aortic and pulmonary valve annulus, aortic and pulmonary peak systolic velocities, ventricular systolic function, and cardiothoracic ratio were similar in the two groups. Pulsed-wave Doppler-derived E/A ratios in the mitral and tricuspid valves were similar in the two groups. The deceleration time of early mitral inflow was prolonged in the fetuses of the obese mothers. In the interventricular septum, left ventricle posterior wall, and right ventricle free wall, the E a and A a were higher, and E a/A a ratios were significantly lower in the study group than in the control group. The E/E a ratio was higher in the obese group than in the control group. The isovolumic relaxation time and the right and left ventricle myocardial performance indices were higher in the fetuses of the obese mothers than in the fetuses of the healthy mothers. We believe that maternal obesity has an important influence on fetal cardiac diastolic functions.

Metastin levels in pregnancies complicated by pre-eclampsia and their relation with disease severity.

AIMS: To evaluate the role of metastin levels in the pathophysiology of pre-eclampsia and to determine whether there is a relationship between the severity of the disease and Doppler velocimetry measurements. METHODS: This cross-sectional study included 89 pregnant women (50 healthy normotensive pregnant women, 15 patients with mild pre-eclampsia, and 24 patients with severe pre-eclampsia) at the third trimester of pregnancy. The maternal levels of plasma metastin were determined by enzyme-linked immunosorbent assay. The umbilical artery and uterine artery blood flow velocities were measured by transabdominal color and pulsed Doppler ultrasound. RESULTS: Plasma metastin levels were lower in patients with pre-eclampsia than those in the normotensive pregnant women. Four patients with mild pre-eclampsia and seven patients with severe pre-eclampsia had abnormal Doppler velocimetry findings. Metastin levels of pre-eclamptic patients with abnormal Doppler velocimetry findings were significantly lower than those in patients with normal Doppler velocimetry findings. Plasma metastin levels negatively correlated with proteinuria in 24 hours and with mean arterial pressure in the cases of pre-eclampsia. CONCLUSIONS: The findings suggest that decreased maternal concentrations of plasma metastin may be involved in the pathogenesis of pre-eclampsia. Plasma metastin levels may be useful in the assessment of the severity of pre-eclampsia. However, further trials are needed to clarify the role of metastin in pre-eclampsia.

Evaluation of the relationship between adenosine deaminase, myeloperoxidase, cholinesterase, preeclampsia severity, and neonatal outcomes.

We aimed to evaluate whole blood adenosine deaminase (ADA), myeloperoxidase (MPO), butyrylcholinesterase (BChE), and acetylcholinesterase (AChE) activities and to investigate whether there was a correlation between these enzymes and severity of preeclampsia and neonatal outcomes. Sixty-one pregnant women with mild (n = 31) or severe (n = 30) preeclampsia and 50 healthy controls were included in this study. Whole blood adenosine deaminase, myeloperoxidase, butyrylcholinesterase, and acetylcholinesterase activities were measured. Adenosine deaminase and myeloperoxidase activities were significantly higher in both mild and severe preeclamptic women than they were in the controls. There was also a significant difference between the severe and the mild preeclamptic groups with respect to these enzyme activities. Although BChE activity was lower in the severe preeclamptic women than it was in the healthy controls (P < .05), AChE activity was similar in all groups (P > .05). We noted an inverse correlation between ADA activity and birth weight (r = -0.337) (P < .05) and between MPO activity and Apgar scores at 1 and 5 minutes (r = -0.438 and r = -0.475, respectively, P < .01). We concluded that elevated ADA and MPO but not AChE activities may correlate with disease severity and neonatal outcomes in preeclamptic women. Further studies are needed to elucidate the exact roles of ADA and MPO in the pathophysiology of preeclampsia.

Serum myeloperoxidase and adenosine deaminase activities in polycystic ovary syndrome.

OBJECTIVE: To evaluate serum myeloperoxidase (MPO) and adenosine deaminase activities and to investigate whether there was a correlation between these and sex hormones, and lipids in polycystic ovary syndrome. DESIGN AND METHODS: Forty-five women with polycystic ovary syndrome and 40 healthy controls were included in this study. Leukocyte counts, serum MPO and adenosine deaminase activities, and high-sensitive C-reactive protein (hs-CRP), sex hormone and lipid levels were assessed. RESULTS: Leukocyte counts and serum MPO activities were higher (p < 0.01 and p < 0.05, respectively) and there was a significant correlation between serum adenosine deaminase and hs-CRP level in women with polycystic ovary syndrome (r = 0.853, p < 0.01). Serum MPO and adenosine deaminase levels did not correlate with sex hormones or lipid profiles in these patients. CONCLUSION: Polycystic ovary syndrome may involve an inflammatory process by increasing serum MPO activity independent of sex hormones, body mass index and lipid profiles.

Evaluation of the relationship between endogenous gonadotropins and female sexual function and psychological status in predialysis and hemodialysis patients.

OBJECTIVES: To evaluate sexual function and psychological state and the factors affecting female sexual dysfunction in predialysis and hemodialysis patients. DESIGN AND METHODS: Forty-seven women with chronic renal failure including 22 predialysis patients, 25 hemodialysis patients, and 30 healthy controls were included in this study. Demographic and clinical variables of the patients were recorded. The sexual functions and psychological states of the patients, assessed by the Arizona Sexual Experiences Scale (ASEX) and Beck Depression Inventory (BDI), respectively, were compared between the groups. RESULTS: Total ASEX scores, ability to reach orgasm, and BDI scores were significantly higher in predialysis and hemodialysis patients than controls, reflecting sexual dysfunction. The patients in the predialysis group were 6 and 3.8 times more likely to develop depressive symptoms compared to the controls and hemodialysis patients, respectively. The predialysis patients who showed depressive symptoms were 24 times more likely to develop sexual dysfunction compared to those without depression. Serum FSH and LH levels were also positively correlated with arousal and erection/lubrication scores in the predialysis patients with depressive symptoms. CONCLUSION: Female predialysis rather than dialysis patients might be more likely to develop depression. Those patients with depressive symptoms may also be at greater risk of developing sexual dysfunction in which increased gonadotropin levels and age may also be contributing factors. Therefore, psychiatric and gynecologic consultations may be beneficial.

Spontaneous rupture of the imperforate hymen in an adolescent girl with hematocolpometra.

Background. Imperforate hymen is usually treated with hymenotomy, and the management after its spontaneous rupture is not very well known. Case. In this paper, we present spontaneous rupture of the imperforate hymen in a 13-year-old adolescent girl with hematocolpometra just before a planned hymenotomy operation. The patient was managed conservatively with a satisfactory outcome. Conclusion. Hymenotomy may not be needed in cases with spontaneous rupture of the imperforate hymen if adequate opening for menstrual discharge is warranted.