Does diffusion weighted imaging have a prognostic value in differentiating gynecological diseases?

INTRODUCTION: Apparent diffusion coefficient (ADC) values are effective in the diagnosis of different gynecological lesions. METHODS: A retrospective evaluation was made of 12 patients with uterine cervix carcinoma and 151 patients with uterine lesions, comprising endometrial cancer, endometrial polyps, carcinosarcoma, submucous myoma, adenomyosis, endometrial hyperplasia, gestational trophoblastic neoplasm (GTN), and leiomyomas. As a control group, 20 healthy volunteers with normal endometrium and normal cervix were also evaluated. In three series, one-shot, spin echo, echo planar, b = 1000 s/mm2 value and diffusion-weighted imaging (DWI) were applied to all subjects and ADC values were obtained. RESULTS: The mean ADC values of Group 1 (Endometrial carcinoma) were lower than those of all the other groups (P < 0.001) and the mean ADC value of group 6 (GTN) was higher than that all other groups (P < 0.001). A statistically significant difference was found between the groups in terms of the lesion-myometrium ADC ratios (P < 0.001). CONCLUSION: There are few studies in literature related to ADC measurements in GTN. The ADC values of GTN were found to be significantly higher than the other uterine lesions. These results will aid in the design of future studies and might be used to guide management of patients with GTN. IMPLICATIONS FOR PRACTICE: Diffusion-weighted MRI seems to be a promising imaging technique in differentiating different uterine lesions.

Serum oxidative stress, visfatin and apelin in healthy women and those with premenstrual syndrome.

The aim of this study was to investigate whether there is a relationship between premenstrual syndrome and oxidative stress, visfatin and apelin. The study included 40 women with premenstrual syndrome and 40 healthy women. In all subjects, serum visfatin, apelin and oxidative stress parameters were studied in venous blood samples. The oxidative stress parameters were higher in the premenstrual syndrome group than among the controls, but this difference did not reach statistical significance (p > 0.05). It was found that total antioxidant capacity was similar in both groups. For the insulin-serotonin cycle markers, no significant difference was found between groups in terms of visfatin level (p = 0.893), although apelin was found to be significantly higher in the premenstrual syndrome group when compared with the controls (p < 0.001). According to our results, apelin can be used as an ancillary laboratory test in the diagnosis of premenstrual syndrome.

Oxidative stress parameters and ceruloplasmin levels in patients with severe preeclampsia.

BACKGROUND: Oxidative stress is believed to have a role in the development of preeclampsia (PE). It is known that an increased ceruloplasmin (CP) level is also associated with PE. The aim of this study was to investigate the relationship between oxidative stress parameters and CP levels in patients with severe PE. PATIENTS AND METHODS: Sixty patients with severe PE and 60 healthy pregnant women were recruited to the study. All study subjects were divided into 2 groups; group 1(n=60) consisted of patients with severe PE, and group 2 (n=60) consisted of healthy pregnant subjects. Blood samples were obtained to measure CP, total antioxidant status and total oxidant status from all subjects. Oxidative stress index was calculated. RESULTS: Compared to group 2; group 1 had significantly higher CP, total oxidant status, oxidative stress index and lower total antioxidant status levels (p<0.001, p<0.001, p=0.001, p=0.008, respectively). Serum CP levels were significantly correlated with oxidative stress index levels (r=0.385, p=0.002). CONCLUSION: The present study demonstrated that both oxidative stress and CP levels increased in patients with PE, and increased CP levels seem to be a consequence of oxidative stress.

Oxidative stress and prolidase activity in women with uterine fibroids.

The aim of this study was to investigate oxidative stress markers and prolidase activity in serum and tissue samples of women with uterine fibroids, with further analysis on position and size. Lipid hydroperoxide, ceruloplasmin, catalase, arylesterase, free sulfhydryl group activity and prolidase activity levels were measured in fibroid tissue, myometrial tissue and serum of the same patients (n = 51), at the same time. Results show that ceruloplasmin, catalase, arylesterase, free sulfhydryl group and prolidase activities were higher in fibroid tissue than those in myometrial tissue (p = 0.003, 0.009, 0.004, 0.02, 0.008, respectively). Serum levels of catalase and prolidase were lower, and arylesterase and free sulfhydryl groups were higher in the fibroid group than those in the control group (p < 0.001 for all). Fibroid volume in submucosal subgroup of the fibroid group yield significant correlation with ceruloplasmin, catalase, arylesterase and prolidase activities (r = 0.84, p = 0.02; r = 0.93, p < 0.001; r = 0.63, p = 0.049 and r = 0.87, p = 0.01, respectively). Despite the lack of statistical significance, the highest levels of prolidase activity were found in fibroid samples, especially in submucosal ones. It is concluded that this study demonstrated increased antioxidative repair system in the fibroid tissue compared to the myometrium and serum of the same patients. Additionally, higher pathophysiological potential of the submucosal fibroids over intramural and subserosal fibroids were shown with the levels of oxidative stress markers and prolidase activity levels.

Umbilical metastasis of serous component as a first sign of mixed type epithelial ovarian cancer.

Umbilical metastasis (Sister Mary Joseph's nodule) of malignant neoplasms is a rare condition. These nodules usually arise from the gastrointestinal or genitourinary tract and may present the first sign of a previously unknown primary tumor. We describe a 49-year-old woman presenting with Sister Mary Joseph's nodule as the first sign of an extremely aggressive Stage IV mixed type epithelial ovarian carcinoma, who died 15 months after the initial diagnosis. This is the first case of a Sister Mary Joseph's nodule from a serous component of a Stage IV mixed type epithelial ovarian cancer.