An Indonesian female with peritoneal tuberculosis mimicking ovarium carcinoma: A rare case.

INTRODUCTION: Peritoneal tuberculosis is rare when patients with abdominal pain need to be considered for tuberculosis testing. CASE PRESENTATION: An Indonesian female, 19 years old, complained of abdominal pain and enlargement. Laboratory examination is abnormal, including thrombocytosis of 687,000/uL and Ca-125 of 3483 U/mL. Ultrasound and CT scan of the abdomen showed cystic lesions in the pelvic cavity, enlargement of the abdominal lymph nodes, and ascites. She was diagnosed with ovarian carcinoma. The patient underwent surgery and obtained nodules such as tuberculoma. Nodule biopsy results showed granulomatous inflammation. The patient was given anti-tuberculosis drug (ATD) category 1 for 2 months and continued with category 2 for 7 months (total 9 months of treatment). The prognosis showed improvement, and weight increased by 15 kg (from 40 kg to 55 kg). DISCUSSION: The challenge of peritoneal tuberculosis is the absence of specific signs and symptoms. Therefore, tuberculosis testing must be considered if tuberculosis is endemic in patients with abdominal pain who do not show a good prognosis when treated according to the developed signs and symptoms. CONCLUSION: Suspicion of tuberculosis infection should be evaluated in endemic tuberculosis because some tuberculosis infections, such as peritoneal tuberculosis, do not have specific signs and symptoms.

Prevalence and association of endocrine disorders in women participating in an in vitro fertilization program / Endokrin kórképek elofordulása és társulása in vitro fertilizációs programban részt vevo nok körében

Introduction: Ovulatory dysfunction associated with endocrine diseases is a common leading or associated cause of female infertility, but at optimal reproductive age, causal or ovulation-induction treatment can usually settle fertility. The leading indications for in vitro fertilization (IVF) treatments are currently andrological and originated from age related ovarian infertility, but other accompanying endocrine dysfunctions affect treatment outcomes. Objective: To investigate the incidence of endocrine diseases in female members of couples participating in IVF program. Method: During aptitude tests prior to the IVF program, from the leading indication independently, a detailed endocrinological examination was performed in 231 women (mean age: 34 years). The studies of hypothalamic and ovarian function, thyroid function and thyroid autoimmunity, adrenal function, carbohydrate metabolism and insulin resistance were covered. In addition to the incidence of each endocrine disease, the frequency of their association was analyzed. Results: The distribution of IVF lead indications was in line with the international trends, it was endocrine nature in 87 cases (37.6%; decreased ovarian reserve in 55 cases and chronic anovulation in 32 cases). Associated endocrine abnormalities were found in 141 cases, and a total of 161 women was affected by endocrine dysfunction (69.7%; mean age: 35 years). Endocrine dysfunction incidences in order of frequency were thyroid dysfunction (32.5%), diminished ovarian reserve (23.8%), thyroid autoimmunity (22.5%), polycystic ovarian syndrome (15.6%), insulin resistance (22.5%), obesity (23.8%), hyperprolactinemia (13.4%). The endocrine disease associations were found in all of the cases above. Hypogonadotropic hypogonadism occurred in 2 cases, congenital adrenal hyperplasia occurred in 1 case. No endocrine abnormalities were found in 70 cases (30.3%). Conclusion: Our study confirms the cumulative appearance of endocrine dysfunctions and frequent association in IVF participants with any lead indication. The detailed endocrine examination and proficiency/skill in reproductive endocrinology of IVF practitioners may contribute to IVF treatment success.

Protective effect of edaravone on cisplatin-induced injury in rat ovary.

PURPOSE: This study was aimed to evaluate the protective effect of edaravone on cisplatin-induced ovarian injury. METHODS: A total 40 female Wistar-Albino rats were utilized to form four groups: Group 1 (control group) (n = 10), no procedure was performed. Group 2 (cisplatin group) (n = 10), single-dose 7.5 mg/kg cisplatin was administered and no procedure was performed. Group 3 (edaravone group) (n = 10), single-dose 1 mg/kg edaravone was administered and no procedure was performed. Group 4 (cisplatin + edaravone group) (n = 10), single-dose 7.5 mg/kg cisplatin and 1 mg/kg edaravone were administered. Seventy-two hours later, ovaries were surgically extirpated in all groups. Malondialdehyde (MDA) levels and nitric oxide (NO) levels were studied in blood samples. In ovarian tissue samples, DNA damage and apoptosis were assessed using TUNEL method. Ovarian tissue damage was evaluated by immunohistochemical staining with caspase 3 and caspase 8. RESULTS: According to the findings obtained from the study, edaravone showed protective properties on ovarian damage due to cisplatin. MDA and NO levels were significantly higher in cisplatin group than other groups. Histopathological ovarian tissue damage in the cisplatin group was significantly higher than other groups. Similarly, DNA damage and apoptosis were higher in cisplatin group and this difference was found to be statistically significant. The immunohistochemical staining which was done using caspase 3 and caspase 8 was revealed that immunoreactive cells were statistically higher in cisplatin group than cisplatin + edaravone group. CONCLUSION: Edaravone seems to be effective in prevention of ovarian damage and short-term treatment.

Histological and biochemical apoptosis changes of female rats' ovary by Zinc oxide nanoparticles and potential protective effects of l-arginine: An experimental study.

BACKGROUND: This research aims to investigate the adverse effects of ZnO NP on ovarian tissue and the follicular and menstrual cycle and the protective effects of l-arginine on the aforementioned tissues. MATERIAL AND METHODS: 30 rats were divided into five groups. The first group was the control group. The second and fourth groups received 100 mg/kg and 200 mg/kg ZnO NP, respectively. The third and fifth groups received the same doses of ZnO NP as the second and fourth groups, respectively. However, the third and fifth groups received an additional dose of 1.3 gr/kg of LA amino acid. ZnO NP and LA are given intraperitoneal for 21 days. Blood samples from each rat and a part of the ovarium were collected to test for gene expression and histological analysis. RESULTS: Compared to levels of housekeeping gene ß-actine, levels of apoptosis effectors such as Bax, Bcl, Caspase 3, and Caspase 9 were significantly increased in all groups. In groups that received doses of LA (three and five), atretic follicle size was smaller compared to groups that did not receive LA (two and four). In addition, in the third group, the secondary and primordial follicle's generated oocytes were smaller compared with groups two, four, and five. Compared with the control group, all groups experienced morphological degeneration of follicles and tissue. CONCLUSION: ZnO NP has inevitable, morphological, and physiological effects on the ovary and can detrimentally impact the tissue. LA can aid in the regeneration of the tissue and block damage induced by stress and toxicity.

Adult granulosa cell tumor with minor foci of juvenile granulosa cell tumor in postmenopausal woman: A rare case report.

INTRODUCTION: Granulosa cell tumor (GCT) is a rare neoplasm that is divided into adult GCT (AGCT) and juvenile GCT (JGCT). Generally, a patient will only have the AGCT or JGCT subtypes. Here, we presented the first case of AGTC accompanied by focal JGTC in a postmenopausal woman. PRESENTATION OF CASE: A 63-year-old postmenopausal woman came with distended abdomen accompanied by postmenopausal bleeding. CT scan shows a solid mass with cystic degeneration. Laparotomy found a solid mass from the right ovary measuring 18 × 15 × 14 cm. The pathological results showed a diffuse tumor representing AGCT, accompanied by Call-Exner bodies and nuclear groove. In addition, minor foci were also found, which consist of well-defined margins tumor and follicular-like structures that resemble JGCT. The patient underwent bilateral salpingo-oophorectomy with a total hysterectomy and no recurrence in three months follow-up. DISCUSSION: Age and clinical symptoms cannot be used as specific differentiators between AGTC and JGTC. Radiological imaging also shows a similar appearance of solid masses tumors with hemorrhagic or fibrotic changes, multilocular cystic lesions, or completely cystic tumors. The concomitant findings of JGCT and AGCT could be distinguished very carefully by anatomical pathology examination. It is crucial to differentiate AGCT from JGCT, especially to see the prognosis. CONCLUSION: The role of pathologists is needed in differentiating AGCT and JGCT, primarily when found simultaneously.

Recurrence of rare malignant Brenner ovarian tumor.

OBJECTIVE: Description of the case of recurrence of a rare malignant Brenner ovarian tumour. METHODS: Author observation and literature resources. RESULTS: Occurrence of a rare malignant Brenners tumor in a 66-year-old patient. After radical surgery (abdominal hysterectomy with bilateral adnexectomy, pelvic and paraaortic lymphadenectomy, omentectomy and appendectomy) and after adjuvant chemotherapy, recurrence of the disease was observed after 30 months. CONCLUSIONS: The case report describes rare occurrence of a malignant Brenner tumour and its relapse.

Protective effect of alpha lipoic acid on 4-vinylcyclohexene diepoxide induced primary ovarian failure in female rats.

OBJECTIVE: The effects of alpha lipoic acid (ALA) and its possible mechanisms in treating Primary ovarian failure (POF) model was studied with 4 vinylcyclohexene diepoxide (VCD). MATERIAL AND METHODS: Rats were divided into 4 groups (n = 7) as Control, VCD, VCD + ALA and ALA. POF model was induced by applying VCD intraperitoneally and ALA was administered by oral gavage as 100 mg/day to the VCD + ALA and ALA groups. RESULTS: At the end of 42 days, ovarian and uterine tissues were received. The number of primordial and primary follicles were increased and corpus luteum and cystic follicles were decreased in ovarian tissues in VCD + ALA group compared to VCD group. Caspase-3 immunoreactivity in follicular cells was decreased in VCD + ALA group compared to VCD group. eNOS immunoreactivity and eNOS levels were decreased in VCD group and increased in VCD + ALA group while iNOS immunoreactivity and iNOS levels were increased in VCD group, decreased in VCD + ALA group in ovary and uterine tissue. Plasma FSH and LH hormone levels were increased in the VCD but decreased in VCD + ALA group. Estradiol level decreased in the VCD group compared to the other groups. The MDA values were significantly increased in the VCD + ALA group compared to VCD group. In addition, the levels of GSH values were decreased in VCD + ALA group compared to VCD group. CONCLUSION: Alpha lipoic acid treatment of rats with VCD-induced POF had a beneficial effect on reducing ovarian damage by improving histological, immunohistochemical, hormone level and oxidative stress markers. Our results show that ALA is an effective treatment of VCD-induced POF rats.

Postpartum ovarian vein thrombosis: case report and review of literature.

OBJECTIVE: An analysis of POVT (postpartum ovarian vein thrombosis) case, the importance of prompt diagnosis, antibiotic and anticoagulation therapy management with multidisciplinary team approach. DESIGN: A case report and literature review. SETTING: 1st Department of Gynaecology and Obstetrics, Faculty of Medicine Comenius University and University Hospital, Bratislava, Slovakia. METHODS AND RESULTS: Authors would like to draw attention to the pitfalls of diagnosis and treatment of postpartum ovarian vein thrombosis with combination of antibiotics and anticoagulants after uncomplicated vaginal delivery. CONCLUSION: Due to potentially life-threatening postpartum complications such as sepsis and pulmonary embolism, prompt diagnosis and treatment of POVT are important. To detection of POVT are MRI and CECT associated with higher sensitivity and specificity compared to colour Doppler ultrasound. For symptomatic POVT many authors suggest anticoagulation for 3 to 6 months (until there is radiologically confirmed thrombus resolution) with the addition of antibiotics for 7 to 10 days (in the case of suspected infection). Multidisciplinary approach is important.

Primary synovial sarcoma of the ovary and Fallopian tube - case report and review of the literature.

OBJECTIVE: Case description of advanced biphasic synovial sarcoma in the tubo-ovarian area. DESIGN: Case report. SETTING: Department of Pathology, Znojmo Hospital. METHODS: Own observation, review of the literature. CONCLUSION: The diagnosis of synovial sarcoma must be considered in all spindle cell and undifferentiated tumours in various anatomical sites including female reproductive organs.

Continuous 900-megahertz electromagnetic field applied in middle and late-adolescence causes qualitative and quantitative changes in the ovarian morphology, tissue and blood biochemistry of the rat.

PURPOSE: The purpose of this study was to use histological and biochemical methods in order to evaluate changes taking place in the ovarian of rats exposed to the effect of a 900-megahertz (MHz) electromagnetic field (EMF) in middle and late adolescence. MATERIALS AND METHODS: Twenty-four 34-d-old female Sprague-Dawley rats were assigned equally to control, sham and EMF groups. EMF group rats were exposed to the effect of a 900-MHz EMF for 1 h a day, at the same time every day between postnatal days 35 and 59, while inside an EMF cage. Sham group rats were kept inside the EMF cage for the same time between postnatal days 35 and 59 without being exposed to any EMF effect. At the end of the study, rats' ovarian were removed and blood specimens were taken. Right ovarium tissues were subjected to routine histological procedures and stained with hematoxylin and eosin, periodic acid shift and Masson's trichrome. Follicles were counted in ovarian sections stained with hematoxylin and eosin. The TUNEL method was used to evaluate apoptosis. Left ovarian tissue and blood specimens were investigated biochemically. RESULTS: Histopathological examination of EMF group ovarian tissue revealed thinning in the zona granulosa and theca layers, shrinking in granulosa cells, reduced mitotic activity and leukocyte infiltration in the follicles and stroma. Secondary follicle numbers in the EMF group were significantly lower than in the other groups. In terms of biochemistry, EMF and sham group superoxide dismutase, catalase and anti-Mullerian hormone levels and EMF group 3-nitrotyrosine values increased significantly compared to the control group. EMF and sham group serum catalase and 8-hydroxy-deoxiguanosine values increased significantly compared to the control group, and EMF group total oxidant status and oxidative stress index values were significantly higher compared to the sham and control groups. CONCLUSIONS: A total of 900-MHz EMF applied in middle and late adolescence may cause changes in the morphology and biochemistry of the rat ovarium.

[The myo-inositol is beneficial in the therapy of pregnancy with insulin-dependent type 2 diabetes and polycystic ovary syndrome]. / A mio-inozitol jótékony hatása inzulint igénylo 2-es típusú cukorbetegséghez társuló polycystás ovarium szindrómás várandós terápiájában.

Authors would like to demonstrate the beneficial effect of myo-inositol supplementation in a pregnant woman with insulin-dependent type 2 diabetes mellitus and polycystic ovary syndrome. Insulin and metformin treatment could not achieve normalization of glucose homeostasis for 3 years, and hypoglycemic episodes were frequent. Myo-inositol and folic acid supplementation added to the basic treatment resulted in improved glucose levels in 2 months. At this time she became pregnant. During pregnancy serum glucose levels still improved in the next 2 months. The amniotic membrane ruptured at the 19th gestational week, and pregnancy had to be finished. Developmental disturbances were excluded by the pathologist. She became pregnant again and gave birth to a premature male neonate at the 29th gestational week. The aim of the report was to demonstrate that myo-inositol supplementation may improve the efficacy of the therapy in type 2 diabetes mellitus. Orv. Hetil., 2017, 158(14), 541-545.

Transvaginal laparoscopy: A minimally invasive approach to obtain brush cytology of the Fallopian tube.

OBJECTIVE: To evaluate in a prospective pilot study the feasibility of cytobrushing of the fimbrial end using a transvaginal endoscopic access. STUDY DESIGN: Prospective feasibility study. The procedure was performed in a consecutive series of 15 infertile women referred for a transvaginal laparoscopy as part of their fertility investigation. Tubal cells were collected using a 5Fr cytobrush. Cytology and immunocytochemistry was done. RESULTS: In all patients enough cell material was obtained for analysis, without traumatizing the fimbrial end. Specimens showed the presence of a sufficient amount of cells enabling standard cytologic examinations and immunocytochemistry (Ki 67, p53). CONCLUSION: Fimbrial cytobrushing using the transvaginal approach is an easy and minimally invasive procedure. The easy accessibility of the fimbrial end and the distal ampullary part at TVL allows an accurate collection of tubal epithelial cells. In view of the recent data reporting the Fallopian tube and more specifically the fimbrial end as a possible origin of ovarian carcinoma, further research is needed to evaluate the potential of this technique as a possible screening method for patients at risk for ovarian cancer.

[Genetic and epigenetic factors of polycystic ovary syndrome]. / Genetikai és epigenetikai faktorok polycystás ovarium szindróma esetén.

The development of polycystic ovary syndrome and its exact pathophysiological mechanism is still unclear, but environmental and genetic factors likely play a role. Exposition to teratogenic effects during the prenatal development can lead to chronic diseases in the postnatal period. This finding confirms the common familial aggregation as well. A literature search was conducted up to January 1, 2016 for articles dealing with the genetic or epigenetic factors of polycystic ovary syndrome. This review will discuss the current understanding of the genetic basis and clinical presentation of this disease. Orv. Hetil., 2016, 157(32), 1275-1281.

[Importance of the interdisciplinary, evidence-based diagnosis of polycystic ovary syndrome]. / A polycystás ovarium szindróma interdiszciplináris, bizonyítékokon alapuló diagnózisának fontossága.

Polycystic ovary syndrome is recognized as the most common hormonal and metabolic disorder of women. This heterogeneous endocrinopathy characterized by clinical and/or biochemical hyperandrogenism, oligo- or amenorrhoea, anovulatory infertility, and polycystic ovarian morphology. The prevalence, clinical feature and the risk of co-morbidity vary depending on the accuracy of the diagnosis and the criteria used. Evidence suggests that those women are at high risk who fulfil the criteria based on National Institute of Health. The complex feature of the syndrome and the considerable practice heterogeneity that is present with regards to diagnostic testing of patients who are suspected to have polycystic ovary syndrome require an interdisciplinary, evidence-based diagnostic approach. Such a method can ensure the patient safety and the effectiveness and efficiency of the diagnosis. This paper summarises the highest available evidence provided by well-designed studies, meta-analysis and systematic reviews of the clinical feature and the clinical implications of the diagnostic criteria of polycystic ovary syndrome.

[Body image and quality of life in women with polycystic ovary syndrome]. / A testkép és életminoség vizsgálata polycystás ovarium szindrómában.

INTRODUCTION: Polycystic ovary syndrome is the most common endocrine disease in women. Psychic consequences are significant; patients have difficulties to be pregnant and the disease disturbs the quality of life. Due to complications associated with polycystic ovary syndrome, studies on psychological state and disease perception of patients appear to be important. AIM: The aim of the authors was to assess how the disease influences quality of life and changes in body image. METHOD: The authors used the Illness Intrusiveness Ratings Scale, Health-Related-Quality-of-Life Questionnaire for Women with Polycystic Ovary Syndrome and their own body image questionnaire. 121 women took part in the study. RESULTS: There was a negative correlation between illness intrusiveness and quality of life (r = -0.353) and a positive correlation between body image and quality of life (r = 0.614). A significant difference was observed in body satisfaction between patients who had visible body changes and those who had metabolic disturbances (p<0.05). Overweight patients who lost weight with lifestyle changes had significantly better quality of life (p<0.05). CONCLUSIONS: These results appear to be convincing in that in addition to gynecological care, psychotherapy could be offered to patients with polycystic ovary syndrome.

N-acetylcysteine improves morphologic and functional aspects of ovarian grafts in rats

PURPOSE: To evaluate morphological and functional aspects of the ovarian graft in transplanted rats treated with NAC. METHODS: Female Wistar rats, virgin, 3 to 4 months old, weighing 200-250 grams were used in experiments. The rats have been kept in proper sanitary conditions, receiving food and water ad libitum. Five groups (n=10, each) were constituted: 4 groups treated subcutaneously with NAC, at doses of 150, 300, 600 and 1200 mg/kg (NAC150, NAC300, NAC600 and NAC1200, respectively), one hour of before the ovarian transplantation and control group (GTx) - treated with physiological solution and submitted to ovarian transplantation. The rats were anesthetized and submitted to autologous left ovarian transplantation, without anastomosis in retroperitoneum, and contralateral oophorectomy. During follow-up of 4 or 15 days, the estrous cycle was evaluated by vaginal smears to determine cycle regularity. At the end of 4th or 15th days, rats were re-anesthetized and blood and graft were obtained to estradiol analysis and morphological assessment. Data were analysed by One Way Analysis of Variance (ANOVA) or ANOVA on ranks complemented by Student-Newman-Keuls test. RESULTS: At 4th day, viable follicles in the graft did not altered by NAC treatments. The NAC300 and NAC600 groups showed increasing in follicle atresia (p=0.012) compared to GTx and NAC1200 group. At 15th day, 50% of GTx, NAC150, and NAC300 rats showed regular oestrous cycle; 83% of NAC600 and 100% of NAC1200 rats returned to regular cycle. NAC1200 group showed increasing in primordial follicle compared to GTx, NAC150 or NAC300 (p=0.011). NAC did not interfere in estradiol levels after 4 or 15 days of transplantation. CONCLUSION: In autologous ovarian transplantation, high dose of NAC promotes graft viability with recovery of estrous cycle. .

Migración de un dispositivo intrauterino al ovario / Migration of a intrauterine device to ovarium

Los dispositivos intrauterinos constituyen el método anticonceptivo más empleado en países en vías de desarrollo. No exentos de complicaciones y, al igual que cualquier otro cuerpo extraño implantado en el organismo, puede migrar. Se realiza la presentación de una paciente en la que se diagnostica la migración de un DIU al ovario, una de las localizaciones más infrecuentes, y su exitosa remoción por cirugía videoasistida. Se recomienda este método como proceder de elección para la extracción de estos dispositivos translocados a la cavidad abdominal en los casos no complicados

The intrauterine devices (IUD) are the more used contraceptive method in developing countries. Not exempt of complications and just like other foreign body inserted in the organism, may migrate. This the case of a patient diagnosed with migration DIU to ovarium, one of the more frequent locations and its successful removal by means of video-assisted surgery. Authors recommended this method as a choice procedure to removal of theses translocated devices to abdominal cavity in non-complicated cases

Migración de un dispositivo intrauterino al ovario / Migration of a intrauterine device to ovarium

Los dispositivos intrauterinos constituyen el método anticonceptivo más empleado en países en vías de desarrollo. No exentos de complicaciones y, al igual que cualquier otro cuerpo extraño implantado en el organismo, puede migrar. Se realiza la presentación de una paciente en la que se diagnostica la migración de un DIU al ovario, una de las localizaciones más infrecuentes, y su exitosa remoción por cirugía videoasistida. Se recomienda este método como proceder de elección para la extracción de estos dispositivos translocados a la cavidad abdominal en los casos no complicados(AU)

The intrauterine devices (IUD) are the more used contraceptive method in developing countries. Not exempt of complications and just like other foreign body inserted in the organism, may migrate. This the case of a patient diagnosed with migration DIU to ovarium, one of the more frequent locations and its successful removal by means of video-assisted surgery. Authors recommended this method as a choice procedure to removal of theses translocated devices to abdominal cavity in non-complicated cases(AU)

Observation effect for cancer factor exhausted during chemotherapy intermittent for drinking, food and oxygenic sport interference to patients suffered from ovarium cancer / 中国基层医药

Objective To explore cancer factor exhausted during chemotherapy intermittent for drinking, food and oxygenic sport interference to patients suffered from ovarium cancer. Method 92 patients suffered from ovarium cancer with drinking, food and oxygenic sport interference and taking self-comparison method. Simple tired Assessment Form, European cancer treatment and research origination questionnaire (EORTC-QLQ-C30) are as-sessed for the patients suffered from cancer tied and life quality situation before interference and after interference of 30 d so as to observe the tired relieving degree and life quality of the patients before and after interference. Results Using nursing interference and then the patients relive their tiredness greatly to have statistical significance (P <0.01). The comparison before and after interference and the life quality has statistic significance(P <0.01). Con-clusion The drinking, food and oxygenic sport interference can relieve the fired degree of the patients suffered from ovarium cancer effectively to improve the life quality of the patients.