Obturator mononeuropathy due to adenocarcinoma of unknown primary origin.

A 35-year-old woman presented with a three-month history of left groin and thigh pain. Neurological examination and electromyography showed pathological features consistent with obturator nerve involvement. Imaging studies revealed a left retroperitoneal mass, which by pathological examination was shown to be metastatic adenocarcinoma of possible Mullerian origin. Primary tumor could not be detected in a follow-up period of three years. Obturator mononeuropathy can be the first manifestation of cancer. Cancer of unknown primary origin may occasionally be local, well-restricted and carry a good prognosis.

Does pregnancy-induced hypertension affect the electrophysiology of the heart?

Pregnancy-induced hypertension (PIHT) increases both maternal and neonatal mortality and morbidity in pregnant women. We sought to investigate the electrocardiographic findings in pregnant women with PIHT. Seventeen pregnant women (29.4 ± 5 years) with PIHT and 24 pregnant women (27.3 ± 6.1 years) with normal blood pressure (control group) were included in the study. A 12-lead surface electrocardiogram was used to evaluate the electrocardiographic parameters. Pregnant women with PIHT had higher blood pressure (p = 0.001). The Tp-e interval was longer in PIHT pregnant women at 83.5 ± 7.8 ms versus 75.8 ± 8.4 ms in the control group (p = 0.007). The Tp-e/QTc ratio was higher in pregnant women with PIHT than that in healthy controls (0.19 ± 0.02 vs. 0.18 ± 0.02, respectively). This study demonstrated that Pd, QTd and the P wave durations were similar in the PIHT pregnant women and control group, but the Tp-e and Tp-e/QTc ratio were higher in pregnant women with PIHT than in normotensive pregnant women.

The effect of maternal polycystic ovary morphology on first-trimester maternal serum biochemical markers of aneuploidy and fetal nuchal translucency thickness.

OBJECTIVE: To evaluate the effect of maternal polycystic ovary (PCO) morphology on maternal serum free beta-human chorionic gonadotropin (ß-hCG), pregnancy associated plasma protein A (PAPP-A), and nuchal translucency (NT) thickness in the first-trimester. MATERIAL AND METHODS: A total of 92 pregnant women in the first-trimester were included in the study. Of them, 57 had PCO morphology, and 35 women constituted the control group, with apparently normal ovaries. Maternal serum free ß-hCG, PAPP-A, and NT thickness were measured and compared in all patients. RESULTS: The multiples of median (MoM) levels of serum free ß-hCG were significantly higher in the PCO morphology group compared to the normal ovary group (p = 0.024). However, the MoM levels of PAPP-A were similar in both groups (p = 0.947). No difference was found between the groups in terms of fasting glucose levels and NT measurements (p = 0.976 and 0.565, respectively). CONCLUSION: In pregnancies with maternal PCO morphology, the presence of higher maternal serum free ß-hCG levels may require correction in the calculation of risks related to first-trimester screening for chromosomal abnormalities. Larger studies are needed to confirm our preliminary data.

HPV and HPV vaccination: knowledge and consciousness of young women.

AIM: The aim of the study was to explore the knowledge and the awareness of the young Turkish women regarding cervical cancer and human papilloma virus (HPV) vaccines. The authors analyze a probable relationship between the overall knowledge level and a few socio-demographic parameters. MATERIALS AND METHODS: The authors interviewed with students from Canakkale 18 March University and young women that did not continue with school in the same city from January to September 2011. All the students answered the questionnaire voluntarily and independently. RESULTS: The participants had low level of knowledge about the risk factors for cervical cancer. Smoking is the major risk factor that was known by the participants (65%). Proportion of the participants that were aware of pap smear test and HPV were 65% and 17% respectively. A small proportion of young women had knowledge regarding protection from HPV. Educational stream, educational level, family income, and family size had significant association knowledge level (p < 0.05). CONCLUSION: There has not been any improvement in HPV and risk factor of cervical cancer awareness in young women. Health members of the National Cancer Control Programme and delegates of the vaccine corporations have major work in order to increase the level of knowledge so that general public can easily take preventative measures.

Mean platelet volume and platelet distribution width can be related to bone mineralization.

UNLABELLED: Platelets functions are related to bone resorption and formation. The present study aimed at studying the association between platelet function and bone mineralization. We showed that mean platelet volume (MPV) and platelet distribution width (PDW) levels in osteoporosis patients increased. The study also showed that PDW and age independently associated with bone mineralization. INTRODUCTION: MPV and PDW are widely used for assessing platelet function. Recently, authors argued that platelet function has an important role in bone mineralization. However, only one study has investigated the relationship between MPV and osteoporosis. We aimed to study the levels of MPV and PDW in postmenopausal osteoporosis. METHODS: We investigated 320 bone mineral density (BMD) measurements between the years 2012 and 2013 retrospectively in our clinic. Eighty patients whom chronic diseases are absent and all laboratory findings are complete enrolled in this study. Patients were divided in three groups as an osteoporosis, osteopenia, and normal BMD group. MPV and PDW levels were investigated in these groups. We performed correlation test and linear regression analysis to determine whether there is a relationship between platelet function markers and BMD measurements. RESULTS: Eighty patients were divided as an osteoporosis, osteopenia, and normal BMD group. MPV levels and PDW levels in the osteoporosis group were lower than the normal BMD group. PDW was positively correlated with femur total T (FTT) score and lumbar 1-4T (L1-4T) scores. Linear regression analysis showed that age and PDW were independently related to FTT and LTT scores. CONCLUSION: Platelet functions are related to the bone mineralization. PDW and MPV have a significant role in the development of postmenopausal osteoporosis.

Can the addition of a paracervical block to systemic or local analgesics improve the pain perceived by the patient during hysterosalpingography?

The aim of the present study was to investigate whether the addition of a paracervical block to local intrauterine anaesthesia or the use of an intramuscular non-steroidal anti-inflammatory drug was effective for pain control during and at 30 min after hysterosalpingography (HSG). A total of 120 patients undergoing hysterosalpingography were randomised into four groups. Patients received intramuscular dexketoprofen trometamol with or without a paracervical block or intracavitary lidocaine instillation with or without paracervical block. The primary outcome was the overall pain score from the four stages of the procedure. The lowest pain scores were observed in the patients receiving dexketoprofen trometamol with a paracervical block, whereas the highest pain scores were observed in patients with intracavitary lidocaine instillation without a paracervical block (p = 0.021). No beneficial effect was found when a paracervical block (PCB) was added to either systemic or local analgesics. The combination of intramuscular dexketoprofen and a paracervical block with plain lidocaine produced the best pain relief during the three specified steps and at up to 30 min after the HSG procedure.

Combined effects of ACE and MMP-3 polymorphisms on migraine development.

Migraine is a primary headache disorder which involves both genetic and environmental components. Since angiotensin-converting enzyme (ACE) and matrix metalloproteinase (MMP) share the same homology, we investigated whether the MMP-3 and ACE I/D gene variants are involved in migraine risk and whether the ACE variant might act in combination with the MMP-3 genetic variant in patients with migraine. This is the first study to evaluate the association between MMP-3 and ACE polymorphisms, and migraine. Genotypes were determined by polymerase chain reaction. The frequencies of 5A5A genotypes of the MMP-3 and D allele of ACE were significantly elevated, but II genotypes of the ACE and 6A allele of MMP-3 significantly decreased in all patients. The combined DD/5A5A and ID/5A5A genotypes increased the risk of migraine. Individuals who were homozygous for the deletion (D) allele showed increased ACE activity. Subjects with the 5A5A genotype and/or D allele or with the combined DD/5A5A or ID/5A5A might be more susceptible to migraine development. In contrast, subjects with the II and/or 6A6A genotypes may be protected from migraine development. The greater activity of the 5A5A and DD genotypes might result in vascular reactivity that is more pronounced in migraine. Taken together, our data suggest that numerous genes may influence ACE activity. Discovery of new genes might better clarify the pathogenesis of migraine and open an avenue to therapeutic strategies against migraine.

Bronchobiliary fistula due to hydatid disease of the liver: a case report.

As a complication of hydatid cyst disease of the liver, bronchobiliary fistula is a rare condition and manifests as bilioptysis. We report the case of a 34 year-old man with echinococcosis of the liver who developed a bronchobiliary fistula which manifested as chronic cough and bile stained sputum. A chest X-ray showed an unilateral infiltrate in the costodiaphragmatic angle. Bronchoscopy revealed bile filling the right basal bronchi. Magnetic resonance cystography revealed that the hepatic bile ducts communicated with the right basal pleural space. Percutaneous transhepatic drainage was applied. When the patient was reevaluated, the hydatid cyst had eroded into the pleural space, and a pleural effusion had developed. The condition of the patient deteriorated. Hence, surgical therapy was performed. After surgery, the condition of the patient improved. He was discharged from the hospital in good condition.

Effects of cigarette smoking on the circadian rhythm of heart rate variability.

BACKGROUND: The effects of cigarette smoking on the circadian rhythm of heart rate variability (HRV) are not known. METHODS: We studied the effects of cigarette smoking on the circadian rhythm of HRV in 24 smoking and 21 non-smoking healthy subjects. Twenty-four hour ambulatory electrocardiograms were recorded and time domain parameters of HRV (SDNN [standard deviation of all R-R intervals], SDANN [standard deviation of the averages of R-R intervals in all 5-minute segments of the entire recording], RMSSD [the square root of the mean of the sum of the squares of differences between adjacent R-R intervals]) were determined for the entire 24-hour period and for each 3-hour period. RESULTS: In total, SDNN and SDANN were significantly lower in smokers than non-smokers (116 +/- 26 vs 136 +/- 27, p < 0.05 for SDNN, 109 +/- 25 vs 121 +/- 24, p < 0.05 for SDANN). However, there were no statistical differences between smokers and non-smokers in heart rate (81 +/- 9 vs 76 +/- 10, p > 0.05) and RMSSD (32 +/- 12 vs 37 +/- 18, p > 0.05). These HRV parameters showed a circadian variation: they increased at night and decreased during the day in both groups. The parameters were lower in smokers than non-smokers during daytime (especially, between 8-14 hours). However, no differences were detected during night-time. CONCLUSIONS: Time domain parameters of HRV (SDNN, SDANN and RMSSD) in both smoking and non-smoking healthy subjects have a circadian rhythm. SDNN and SDANN were lower in smokers than non-smokers during daytime.

Relapsing polychondritis.

In this article, we report on a 40-year-old man with relapsing polychondritis (RP) of the tracheobronchial tree without clinical manifestations of other systems including nasal septum and earlobe cartilage involvement. The illness was diagnosed histologically, and treatment with procaine penicillin was successful. RP is an unusual systemic disorder characterized by widespread inflammation and destruction of cartilage tissues. The main cause is usually autoimmune. In RP various clinical manifestations including nasal chondritis, arthritis, scleritis, damage to tracheal and bronchial cartilage, and aortic, cardiac, and renal involvement may occur. Isolated tracheobronchial involvement is very rare. The diagnosis must be based on a combination of clinical and pathologic features. If diagnosed early, appropriate treatment may prevent life-threatening airway obstruction.

Ethanol fermentation in a yeast immobilized tubular fermentor.

In this article, a mathematical model describing the kinetics of ethanol fermentation in a whole cell immobilized tubular fermentor is proposed. Experimental results show reasonable agreement with the proposed model. A procedure for treating the fermentation data for determining the ethanol inhibition constants k(1) and k(2) is described. The ethanol productivity of the immobilized cell fermentor is compared with those of traditional fermentors. Experimental studies indicate that with Saccharomyces cerevisiae (NRRL Y132) culture, ethanol productivity in the range 21.2-83.7 g ethanol L(-1) h(-1) at ethanol concentration of 76-60 g/L can be achieved. This is comparable to or higher than those reported in the literature for yeast. The product yield factor of 0.5 g ethanol/g glucose was obtained. The immobilized cell fermentor does not show washout at dilution rates of 7 h(-1) and shows good stability over a 650-h operating period.