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Objective: To evaluate the effects of coronavirus disease-2019 (COVID-19) infection on clinical and laboratory features;maternal and fetal outcomes. Material and Methods: In this retrospective study, the patients diagnosed with COVID-19 by positive severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) reverse transcription polymerase chain reaction (RT-PCR) and delivered at Koru Hospital (Ankara, Turkey) between March 2020 and February 2021 were included. We obtained demographic, clinical, laboratory features, obstetric and delivery history, maternal and perinatal outcomes from medical records.

Angiogenesis is required in cancer, including gynecological cancers, for the growth of primary tumors and secondary metastases. Development of anti-angiogenesis therapy in gynecological cancers and improvement of its efficacy have been a major focus of fundamental and clinical research. However, survival benefits of current anti-angiogenic agents, such as bevacizumab, in patients with gynecological cancer, are modest. Therefore, a better understanding of angiogenesis and the tumor microenvironment in gynecological cancers is urgently needed to develop more effective anti-angiogenic therapies, either or not in combination with other therapeutic approaches. We describe the molecular aspects of (tumor) blood vessel formation and the tumor microenvironment and provide an extensive clinical overview of current anti-angiogenic therapies for gynecological cancers. We discuss the different phenotypes of angiogenic endothelial cells as potential therapeutic targets, strategies aimed at intervention in their metabolism, and approaches targeting their (inflammatory) tumor microenvironment. ispartof: BIOCHIMICA ET BIOPHYSICA ACTA-REVIEWS ON CANCER vol:1875 issue:1 ispartof: location:Netherlands status: published

Human papillomavirus (HPV) infection is one of the most common sexually transmitted diseases worldwide and a prime cause of cervical cancer. The HPV DNA is detected in approximately 80-90% of all cervical cancers, with HPV 16 and 18 being the high risk conferring human carcinogens. DNA damage and diminished DNA repair mechanisms are potential biological surrogates of HPV infection that warrant further research in different tissues and populations. Notably, we do not know the extent to which the high risk HPV 16 and 18 differentially affect cervical cells versus other systems such as peripheral blood lymphocytes (PBLs). We evaluated DNA damage and repair in women who tested positive for HPV 16 or HPV 18 and healthy control women without HPV 16 or HPV 18 infection. We found that the DNA damage as measured by the Comet assay was markedly greater in cervical cells of women with HPV 16 (mean: 8.1 as% DNA in tail, 95% CI: 7.6-8.7) or HPV 18 infection (mean: 9.6, 95% CI: 8.9-10.2) than controls (mean: 6.7, 95% CI: 6.2-7.4) (p0.05). We observed, however, the DNA repair capacity, as measured by the X-ray induced challenge (XRC) assay, was significantly impaired in PBLs from women with HPV 16 or 18 infection compared to controls (p

Isolated partial duplication of the long arm of chromosome 11 is very rare. The main features are dysmorphic facial features, pre/postnatal growth retardation, speech delay, mental retardation, hypotonia, microcephaly, and cardiac, vertebral, limb and genital anomalies. In this case, we report a patient with partial trisomy of 11q13.5 -> qter due to a de novo rearrangement consisting of the whole X chromosome and part of chromosome 11; 46,X,der(X)(Xqter -> Xp22.33::11q13.5 -> 11qter). Additional findings were a separated clavicle, lacrimal duct stenosis and prenatally detected renal hypoplasia. SNP array results revealed a duplication between 11q13.5 and 11qter, measuring 58 Mb, from nucleotide 76,601,607 to 134,926,021. As a result, molecular karyotyping could be performed in such cases in order to establish a definite phenotype-genotype correlation using conventional or molecular cytogenetics techniques. (C) 2013 Elsevier B.V. All rights reserved.

Lower urinary tract obstruction (LUTO) which is most commonly caused by posterior urethral valves or urethral atresia, is often associated with high perinatal mortality and morbidity and long-term childhood renal dysfunction or even renal failure. LUTO is an uncommon clinical entity that can be diagnosed by ultrasonographic examination and is particularly presented by enlarged bladder, hydronephrosis, hydroureter and oligohydramnios. Despite being a rare pathology of the genitourinary tract, detection rates of it is higher than other congenital abnormalities with ultrasonography. Moreover, ultrasonography has become the most widely used diagnostic tool in the diagnosis of LUTO. Pulmonary hypoplasia resulting from severe oligohydramnios is the most common cause of death. Bladder drainage has a critical role on perinatal survival in fetuses with LUTO especially in those predicted to have a poor prognosis. Further interventions and observations of renal therapies may be required in childhood.

WOS: 000276265100012, PubMed ID: 19593578, The aim of this study was to evaluate the effects of hormone replacement therapy (HRT) on carbohydrate and lipid metabolisms and cardiovascular risk parameters in healthy postmenopausal women. Forty women receiving and 38 women not receiving HRT were included and baseline and sixth month blood pressure, weight, body mass index, waist/hip ratio, blood lipid profile, inflammatory markers (homocysteine, C-reactive protein (CRP) and fibrinogen), hemoglobin A1c (HbA1c) and insulin, and oral glucose tolerance test (OGTT) results were evaluated. The mean age was 52.6 +/- A 4.9 and 52.2 +/- A 5.0 years in the HRT and Control Groups, respectively. Whereas there was no change in the Controls, the weight, waist/hip ratio, and BMI increased and diastolic blood pressure decreased in the HRT patients. LDL-c, VLDL-c and lipoprotein (a) levels were significantly higher in the HRT Group in the sixth month; however, total cholesterol and LDL-c increased in the Controls but VLDL-c and lipoprotein (a) did not. CRP and homocysteine significantly increased and fibrinogen decreased, whereas in the Control Group no significant change was detected. A significant improvement in HbA1c and OGTT was found in both the groups, whereas a significant reduction was measured only in the HRT Group. In response to 6 months of HRT, there was an increase in weight, BMI, and waist/hip ratio as known cardiovascular risk factors, but no significant impact on lipid profile and glucose metabolism could have been clearly demonstrated. A mixed effect profile of HRT on the state of inflammation (increase in CRP and homocysteine, decrease in fibrinogen) was observed.

The relationship of homocyteine, B12 and folic acid with osteoporosis has already been studied in various populations. We compared the important factors in the metabolism of homocysteine, such as homocysteine, B12 and folic acid levels, of Turkish postmenopausal women, and their relationship with the femur and lumbar spine bone mineral density.This cross-sectional study was conducted at Gazi University, Department of Obstetrics and Gynecology. The study group consisted of 178 postmenopausal women. Serum homocysteine, folic acid and Vitamin B12 were measured. BMD was measured using DEXA at the right femoral neck and lumbar spine (L1-L4).Upon evaluation of both the femur and lumbar spine, it was determined that osteoporosis could be associated with a homocysteine level above the median and with a B12 value under the lowest quintile value.Plasma Hcy and vitamin B12, but not folate levels, were associated with osteoporosis. Future interventional studies are needed to determine methods to reduce Hcy levels with dietary supplements and extra vitamin B12, which will restore bone health and reduce risk of fractures.

Summary Purpose: We aimed to define the morphologic effects of valproate (VPA) and oxcarbazepine (OXC) on ovarian folliculogenesis in rats. Methods: Forty female wistar rats (21–24 days old and weighted between 46.4 and 55.3 g) were divided equally into 4 experimental groups, which were applied tap water (control group), 300 mg/kg/day VPA, 100 mg/kg/day OXC, and both VPA and OXC via gavage for 90 days. Ovaries of the rats on proestrous and diesterous phase of estrous cycle according to daily vaginal smear were taken out and placed in a fixation solution. Immunohistochemical and apoptosis (TUNEL) staining protocols were applied. Results: The number of follicles decreased and that of corpora lutea increased significantly in OXC, VPA, and OXC+VPA treated groups compared with control group (p < 0.05). The number of TUNEL positive ovarian follicles was 1.40 ± 0.52 in control group, but it significantly increased to 3.50 ± 0.53, 3.50 ± 0.53, and 4.90 ± 0.88 in VPA, OXC, and VPA+OXC groups (p < 0.0001). The increase in the number of TUNEL positive granulosa cells was also significant for OXC and VPA+OXC groups (p < 0.0001). Immunohistochemical HSCORE decreased for TGFβ1 and IGF1 staining and increased for P53 staining in all drug groups compared with control group (p < 0.001). Intensity of P53 labeling increased, while intensity of TGFβ1, IGF-1, and GDF-9 immunoreactivity decreased significantly in all drug groups compared with control group (p < 0.001). Conclusion: Long-term treatment with VPA or OXC from prepuberty to adulthood causes apoptosis and deterioration of folliculogenesis in rat ovarian follicles.

AIM: Our aim was to evaluate the frequency of C. Trachomatis - a microorganism held responsible in the etiopathogenesis of tubal infertility factor- in the turkish infertile population, using the PCR procedure on endocervical smear samples. MATERIALS-METHODS: In 61 patients presenting with infertility to Gazi University Faculty of Medicine, Obstetrics and Gynecology Department, samples were taken prior to the Hysterosalphingography (HSG) procedure. These samples were then checked for C. Trachomatis via PCR and positive test results were later compared with HSG outcomes. RESULTS: 27 (44%) of the patients were primary infertile and 34 (56%) were classed as being secondary infertile. 5 patients (18%) in the primary infertile group, and 8 patients (23%) in the secondary infertile group tested PCR positive for C.trachomatis in their endocervical samples. Out of the 16 patients with a tubal infertility factor evident with HSG, 3 patients (18.7%) tested positive for C. Trachomatis, and out of the 45 patients showing no tubal pathology 10 patients (22.2%) were positive for C. Trachomatis. When patients with proximal and distal tubal obstruction were individually evaluated; of the 9 patients with distal tubal obstruction, 3 (33,3%) patients had a positive PCR result for C. Trachomatis and all of the 7 patients with proximal tubal obstruction tested PCR negative for C.trachomatis. When patients with a distal tubal pathology were evaluated alone, this test showed a sensitivity of 33.3%, a spesificity of 77.7%, a positive predictive value of 23% and a negative predictive value of 85,3%. Results: The evaluation of C.trachomatis with PCR in infertile patients showed low sensitivity but high specificity and positive predictive value in finding distal tubal pathologies

The occurrence of double aneuploidy is a relatively rare phenomenon. The clinical presentations are variable depending on the predominating aneuploidy or a combination effect of both. We report the cytogenetic data on products of conception from miscarriages over a period of 5 years. A total of 403 miscarriages were karyotyped and the tissues were villi in all cases. Of 403 cases, 54 cases with single aneuploidy and 2 cases of first-trimester miscarriages with double trisomies were found. These 2 cases with the karyotypes of 48, XXY,+15 and 48, XX,+ 5,+ 7 were cited for the first time in this study. Copyright (C) 2008 S. Karger AG, Basel.

OBJECTIVE: To evaluate reproductive age women’s level of knowledge on and attitude towards emergency contraception. Design: Questionnaire study Setting and participants: 300 women between the ages of 15-49 who applied to two “Mother-Child Health Care and Family Planning Centers” in Ankara and to Gazi University Hospital Obstetrics and Gynecology Department outpatient clinics were enrolled into the study. Materials-METHODS: A questionnaire including questions about descriptive properties, current contraceptive use and level of knowledge on and attitude towards emergency contraception were applied to participants via face-to-face interviews. RESULTS: Among all participants, 102 women (41%) told that it was possible to prevent a probable pregnancy after unprotected sexual intercourse, 46 women told (18.5%) nothing could be done thereafter and 101 women (40.6%) had no idea about the subject. 83 women (37.9%) had already heard about morning-after pills. 21 women (7%) claimed they had previously needed such a method, and 17 women (5.7%) declared that they had used morning-after pills before. CONCLUSION: These findings demonstrate that our population is in need of emergency contraception but lack enough knowledge. Thus, we think that education about emergency contraception should be rendered available for all women and women should be able to use this important way of contraception whenever they require.

OBJECTIVE: To evaluate adolescent girls’ requirement of knowledge on sexuality and to form data for training programs that will be designed to educate adolescents aout sexuality Design: Questionnaire study Setting and participants: 128 adolescent girls between 10 and 19 years old, as defined by World Health Organization, who applied to “Mother – Child Health Care and Family Planning Center, number 9” in Ankara for any reason between 01.01.2005 and 01.02.2005 were enrolled in this study. Materials-METHODS: Participants were applied a questionnaire including questions about their demographic properties, their level of knowledge on sexuality and their requirement of knowledge on sexuality. RESULTS: 85 adolescents (66.4%) declared they did not have any educational programs on sexuality. Of those who had an educational program on sexuality, 34.7% found it inadequate, 16.5% found it adequate and 24.0% found it partially adequate. CONCLUSION: This study demonstrates that adolescents require educational programs on sexuality and points to important topics that should be covered by such a program

As raloxifene is a mixed estrogen receptor agonist and antagonist, it exerts different effects on apoptosis in different tissues. In this study, we aimed to evaluate apoptosis in the peripheral lymphocytes of postmenopausal women treated with raloxifene and compare it with untreated control subjects. In this way, we expected to deduce some results about the effect of raloxifene on the immune system and to serve as a guide for future studies on this newly proposed effect of a well-known agent. Twenty osteoporotic postmenopausal women treated with raloxifene for 12 months were included in this study. Another 20 osteoporotic postmenopausal women matched for age and postmenopausal years, but without any medication, were chosen as the control group. Apoptosis was evaluated using a morphological and DNA fragmentation assay, in the peripheral lymphocytes of these women. Our results revealed a decrease in the apoptosis percentages of the patients treated with raloxifene (14.6%) with respect to the control subjects (15.8%), but the difference was not statistically significant (p = 0.467). This study indicated that raloxifene treatment had no apoptotic effect on peripheral human lymphocytes compared to controls. (c) 2006 International Federation for Cell Biology. Published by Elsevier Ltd. All rights reserved.

We report a case of prenatally diagnosed intracranial hemorrhage and hydrops in the fetus of a mother with a past history of surgical and medical treatment for gastric lymphoma and having high platelet counts thereafter. To the best of our knowledge, such a complication of maternal thrombocythemia has not been described in the literature. In our opinion, the possible pathophysiology of the disease is based on placental insufficiency due to infarctions and related fetal platelet dysfunction, leading to intracranial hemorrhage with subsequent hydrops fetalis. The trigger in this event appears to be trauma to the maternal abdomen. Certain measures for high-risk mothers such as avoidance of trauma to the abdomen and platelet-lowering medications like interferon-alpha may be useful for preventing such fetal complications. Copyright (c) 2007 S. Karger AG, Basel.

This study investigates the effects of anticoagulant therapy on pregnancy outcomes in 204 patients with thrombophilia and previous poor obstetric outcomes. Patients with poor obstetric history (pre-eclampsia, intrauterine growth retardation, fetal death, placental abruption, recurrent pregnancy loss) and having hereditary thrombophilia were included in this study. Poor obstetric outcomes were observed more frequently in patients who had not taken anticogulant therapy compared with treated group. Live birth rate, gestational age at birth and Apgar scores were significantly higher in the treated group when compared with the untreated group. There were no significant differences in terms of birthweight, mode of delivery and admission rates to the neonatal intensive care unit (NICU). Low-molecular-weight heparin (LMWH) plus acetylsalicylic acid (ASA) had higher gestational age at birth, Apgar scores, live birth rate and a lower abortion rates when compared with controls; in contrast, no significant difference was observed in terms of birthweight, mode of delivery, obstetric complications and admission rates to NICU. There were no significant differences between control group and both LMWH only and ASA only groups in terms of gestational age at birth, Apgar scores, birthweight, mode of delivery, obstetric complications and admission rates to NICU. Only LMWH group had higher live birth rate as compared with control group. The use of only ASA did not seem to affect the perinatal complication rates and outcomes. In conclusion, anticoagulant therapy with both LMWH and ASA seems to provide better obstetric outcomes in pregnant women with thrombophilia and previous poor obstetric outcomes. Blood Coagul Fibrinolysis 26: 267-273 Copyright (C) 2015 Wolters Kluwer Health, Inc. All rights reserved.

To assess the oxidative effects of raloxifene use in postmenopausal women by investigating protein carbonyl levels in the plasma.Nineteen osteoporotic postmenopausal women treated with raloxifene for 12 months were included in the study. Another seventeen postmenopausal women matched for age and postmenopausal years, without any medication were chosen as a control group. Protein carbonyl levels were determined as oxidative stress markers by the use of Levine's method in the plasma of these women.Serum protein carbonyl levels of postmenopausal women treated with raloxifene (1.27 +/- 0.32 nmol/mg protein) were significantly lower than the control group (2.18 +/- 0.27 nmol/mg protein) (p0.05).Oxidative stress has been found responsible for several diseases including cancer. Protein carbonyl levels, which are the products of protein oxidation, are one of the indicators of oxidative stress. Therefore, the decline in protein carbonyl levels in this study revealed the decreasing oxidative stress. According to our results, it might be interpreted that raloxifene does not cause oxidative stress, and it may even have protective effects in long-term use.

In recent years, there has been growing interest in estimating the degree of heating caused by the diagnostic ultrasound in clinical practice. Both theoretical and experimental methods have been suggested for estimating the heating potential, or thermal hazard, of diagnostic ultrasound. Aim of this study was to evaluate in vivo effects of ultrasound exposure of variable duration (from 10 up to 20 min) with commercially available imaging systems commonly used for diagnostic imaging. Numerical results related to the thermal effect are obtained by simulation program based on B-mode (scanning) and Doppler (non-scanning). To investigate the biological effects of the ultrasound exposure to the brain and liver tissues, the antioxidant enzyme activity and thiobarbituric acid reactive substances (TBARS) of the tissues were evaluated. In liver tissue, as a lipid peroxidation index, TBARS levels very significantly increase in Doppler group compared to control. However, in B-mode, TBARS levels are the same with the control group. Use of B-mode in foetal tissue is more reliable than Doppler mode because temperature rise is very small compared to the Doppler mode. On the other hand, the antioxidant enzyme activities tend to increase in B-mode and Doppler groups compared to the control group as a defensive mechanism. In the brain tissue, lipid peroxidation is increased slightly in B-mode compared to the control group. This situation is related to the molecular structure of the brain tissue because of its high lipid concentration. In brain tissue, the antioxidant enzyme activities and lipid peroxidation were significantly increased, such as liver tissue in Doppler groups. Doppler ultrasound may produce harmful effects in rat foetus liver and brain tissues as a result of the high temperature rises.

Miscarriage (early pregnancy failure) is a pregnancy-related disease, the pathophysiology of which is still not completely understood. Lipid peroxidation and alterations in antioxidant enzyme activities may be of importance in the pathogenesis of this disorder. This study was planned to investigate the possible relation between free radical scavenging enzyme activities and lipid peroxidation levels in placenta tissues with miscarriage. Placental tissue samples were obtained from 21 patients who had miscarried and 25 normal pregnant women undergoing elective abortion as a control group. Total superoxide dismutase (T-SOD), glutathione peroxidase (GSH-Px), and catalase (CAT) enzyme activities and levels of thiobarbituric acid reactive substances (TEARS), antioxidant potential (AOP), and nonenzymatic superoxide radical scavenger activity (NSSA) were measured in the placental tissues. GSH-PX, CAT activities, and YEARS levels were found to be significantly increased, while T-SOD and NSSA values decreased in patients with early pregnancy failure when compared with women undergoing elective abortion (control group). However, there were no significant differences in AOP levels between the groups. Our results reflect oxidative stress in placenta tissues of early pregnancy failure, as the oxidative processes seem to be counteracted by the physiologic activation of antioxidant enzymes such as CAT and GSH-Px. Moreover, a compensatory mechanism might be developed against possible oxidative damage in patients with miscarriage.

The aim of this study was to determine the incidence of stress urinary incontinence among women at the age of 15 and above who applied to the primary health care centers in Ankara, Turkey. We applied the urinary stress incontinence questionnaire to 2,601 women at the age of 15 or above who consulted to the "mother-child health care and family planning centers" in January 2002. To evaluate the urinary incontinence status with respect to age groups and other risk factors, chi-square test was used. Stress incontinence prevalence was 16.1% in our population. Age was a statistically significant risk factor affecting the incidence of stress incontinence. As the number of gravida increases, the frequency of stress incontinence increases (p < 0.05). Presence of a systemic disease was also an important risk factor (p < 0.05). Alcohol use and smoking were not found to affect the incidence of urinary stress incontinence (p > 0.05). As urinary incontinence greatly influences life quality and social and psychological status of the person, and also creates economic burden, predisposing factors of stress incontinence should be well defined and measures should be taken to encourage women experiencing this problem to visit a doctor and to get an efficient treatment.

A case of severe Pemphigoid Gestationis (PG), persisted postpartum despite high-dose corticosteroid therapy was reported. Small for gestational age, premature birth, and neonatal convulsions with confirmed central nervous system pathology occurred as an adverse fetal outcome. Is the disease as innocent as described earlier?

Objective: To evaluate the possible DNA damage in peripheral blood leukocytes of postmenopausal women under different hormone replacement therapies (HRT), comet assay, a standard method for assessing genotoxicity has been used. Method: 46 women were categorized in three groups—Group A: 15 surgical menopausal women who underwent surgery for benign conditions, receiving conjugated equine estrogen, 0.625 mg/day (CEE) for 2.3 ± 1.5 years, Group B: 16 spontaneous menopausal women receiving conjugated equine estrogen, 0.625 mg/day plus medroxyprogesteron acetate, 5 mg/day (CEE + MPA) for 2.4 ± 1.0 years and Group C: 15 spontaneous menopausal women receiving tibolone, 2.5 mg/day for 2.4 ± 1.3 years. Control group consisted of 15 spontaneous menopausal women who never had HRT. Results: Significant differences in terms of DNA damage were observed between Group A and B with controls as mean total comet scores 23.93 ± 5.84, 19.44 ± 6.19 and 10.07 ± 2.40, but no significance ( P > 0.05) were detected between Group C and controls as mean total comet scores 12.07 ± 3.65 and 10.07 ± 2.40, respectively. Conclusion: Reduced DNA damage were observed with tibolone compared to CEE or CEE + MPA therapy. Studies of this approach are needed.

OBJECTIVE: To present the success and morbidity rates of the patients who underwent total laparoscopic hysterectomy associated with laparoscopic Burch colposuspension operation. Design: Retrospective. Setting: Gazi University, Faculty of Medicine, department of Obstetrics and Gynecology. Patients: The patients who were subjected to the hysterectomy due to benign disease, and having stress incontinence coccomitantly. Interventions: Total laparoscopic hysterectomy plus transperitoneal laparoscopic Burch colposuspension with non-absorbable sutures. Main outcome measures: Feasibility of procedure, and success and morbidity rates. RESULTS: Overall 12 patients were included. The mean age at the time of operation was 48 (range 42-55). All procedures were completed laparoscopically without intraoperative or postoperative complications. Operative time ranged from 160 to 200 minutes (mean, 173 minutes). Mean operative time was 130 minutes (range, 120-150) for total laparoscopic hysterectomy, 43 minutes (range, 35-50) for Burch procedure. Estimated blood loss ranged from 300 to 600 ml (mean, 450). Ultrasonographically estimated volume of the uterus was 73 cm3 (range, 40-167). Mean weight of the hysterectomy specimens was 279 gram (range, 153-350). All patients were discharged from the hospital within 48 to 72 hours. For all patients, catheterization was not required more than 2 days. Mean follow-up period was 16 months (range, 12-24). Ten of 12 (83,4%) patients were cured completely, and 1 (8,3%) was improved for stress incontinence. The remaining one patient (8,3%) did not have any improvement in her complaints. CONCLUSION: Total laparoscopic hysterectomy plus laparoscopic Burch procedure is feasible and effective for patients who underwent hysterectomy and having stress incontinence additionally.

WOS: 000230206400004 PubMed: 16019370 Aim. This study was designed to examine the relationship between homocysteine (Hcy), lipoprotein levels and insulin resistance in obese and non-obese patients with polycystic ovary syndrome (PCOS). Materials and methods. Eighty-five patients (38 obese, 47 non-obese) with PCOS and 50 healthy subjects (25 obese, 25 nonobese) were included in the study. PCOS was defined according to the Homburg criterion. Serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), dehydroepiandrosterone sulfate (DHEA-S), insulin, 17-hydroxyprogesterone, free testosterone, androstenedione, vitamin B-12 and folate were measured. Also, serum concentrations of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), lipoprotein (a) (Lp(a)), apoprotein B (Apo B) and apoprotein A (Apo A) were determined. Plasma Hey levels were measured. Insulin resistance was evaluated by homeostasis model assessment (HOMA). Results. Plasma Hey levels were significantly higher in women with PCOS than in healthy women. HOMA-R (insulin resistance) was significantly higher in women with PCOS compared with healthy women. Serum fasting TC, LDL-C, TG, Apo B, vitamin B-12 and folate levels were similar between PCOS and control groups. Lp(a) levels were higher in PCOS patients than in control subjects, whereas HDL-C and Apo A levels were lower. Compared with obese PCOS subjects, nonobese PCOS subjects had low HOMA-R, TC, LDL-C, TG, Apo B, Lp(a) and androgen levels. Plasma Hey levels, serum HDL-C and Apo A levels were similar between obese and non-obese women with PCOS. Levels of HDL-C and Apo A were lower in both obese and non-obese PCOS patients than in obese and non-obese control subjects, whereas Lp(a) levels were higher. No correlation was observed between Plasma Hey, body mass index, HOMA-R, serum androgen levels, TC, LDL-C, HDL-C, Apo A, Apo B and Lp(a) levels. Conclusion. These results showed that elevated insulin resistance and plasma Hey levels, and changes in serum lipid profile, which are possible risk factors for cardiovascular disorders, play important roles in the development of cardiovascular disease in both obese and non-obese patients with PCOS.

We report a prenatal case of double aneuploidy (consisting of chromosome 7 and X) with the features of Potter sequence. Of the stillborn fetus, skin fibroblast cultures were performed and fluorescence in situ hybridization (FISH) technique was also used for further investigation. On physical examination; the fetus was found to have malformed ears, micrognatia, hypertelorism, abnormal extremities, rocker-bottom feet and abnormal external genitalia and polycystic right kidney was seen after an extensive autopsy. As amniocentesis and cordocentesis materials revealed X chromosome mosaicism, trisomy 7 was detected in the skin fibroblast culture of the ex fetus and karyotype evaluated as composite; 46 similar to 47,X,+7,-X[cp18]. FISH results confirmed the double aneuploidy and also revealed XX and XXXX cell lines. Comparison with the previously reported cases of trisomy 7 with Potter syndrome suggests a possible link (if not coincidental) between trisomy 7 and Potter syndrome in our case. This is the first reported case of double aneuploidy involving trisomy 7 with the features of Potter syndrome. (c) 2005 Elsevier SAS. All rights reserved.

The effect of the use of an oral contraceptive (OC) on the frequency of sister chromatid exchanges (SCEs) and on the response in the alkaline comet assay (single-cell gel electrophoresis (SCGE)) was investigated in 18 women taking contraceptive pills daily for 24 months. As controls, fertile women were included with regular menstrual cycles who received no OC drugs. A significant increase in the number of lymphocytes with DNA migration and an increased frequency of SCE per metaphase were observed in OC users as compared with their age-matched untreated controls (P < 0.005). As higher incidences of spontaneous SCEs in peripheral blood lymphocytes have been reported to occur in females during pregnancy due to profound changes in the levels of certain sex hormones such as progesterone and estrogen, particularly during the last trimester, 17 pregnant women served as positive controls in this study in order to test the rate of genetic damage due to those changes. Higher frequencies of SCEs and comet responses were observed in pregnant women than in their matched controls. However, no statistically significant difference in DNA damage was observed between OC users and pregnant women (P > 0.05). This study underscores the fact that prolonged and extensive use of these drugs in our daily life may be hazardous and also, that OC users should be aware of multifactorial risk factors (environmental, genetic and life style patterns) that may be responsible for additional DNA damage. (C) 2002 Elsevier Science B.V. All rights reserved.

An additional derivative chromosome 8 was found in the cytogenetic analyses of the chorionic villus biopsy specimen of a balanced reciprocal translocation carrier mother. This was a 3:1 segregation of the unbalanced product of the balanced maternal 8:9 translocation. The chromosomes of the carrier of the balanced reciprocal translocation pair with their matching homologous segments at meiosis I, a quadrivalent figure is formed and chromosomes segregate from this configuration. Increased nuchal tranaslucency was also determined on fetal sonography at the 13(rd) week of gestation. The final karyotype was 47,X Y,+der(8)t(8;9)(q11.2;p22) mat, and the parents were informed about this tertiary trisomy. After genetic counseling, the parents decided to terminate the pregnancy. The presented case is a reminder of the probability of the unbalanced products of the 3:1 segregation, rather than the common 2:2 segregation.Dengeli resiprokal translokasyon taşıyıcısı annenin, koryon villüs biyopsi materyalinden yapılan sitogenetik analizinde, ek olarak derivatif 8. kromozom belirlenmiştir. Bu dengesiz durum, 8. ve 9. kromozomlar arasında dengeli resiprokal translokasyon içeren annenin, 3:1 gamet ayrışımından kaynaklanmaktadır. Resiprokal dengeli translokasyon taşıyıcılarının kromozomları, mayoz 1’de homologları ile eşleşebilmek için quadrivalen yapıyı oluşturmakta ve buradan kromozomların segregasyonu sözkonusu olmaktadır. Gebeliğin 13. haftasında yapılan fetal ultrasonografide ayrıca nukkal kalınlık artışı saptanmıştır. Fetüsün karyotipi 47,XY,+der(8)t(8;9)(q11.2;p22) mat olarak rapor edilmiş ve tersiyer trizomi hakkında aileye bilgi verilmiştir. Aile genetik danışmanlık sonrası gebeliğini sonlandırmaya karar vermiştir. Burada sunulan olgu, resiprokal translokasyon taşıyıcılarının dengesiz gamet oluşumunda 2:2 segregasyonun yanısıra, daha az oranda da olsa 3:1 segregasyon olasılığının da olduğunu hatırlatması açısından önemlidir.

Primary hyperparathyroidism during pregnancy is a rare condition, and the diagnosis may be confounded by pregnancy related conditions. Since the appropriate management reduces the maternal and fetal complications; differential diagnosis becomes quite crucial.Clinical course of a patient with hyperparathyroid crisis will be discussed with the review of the literature. A 22-year- old, (gravida 2, para 1) woman was presented with hyperparathyroid crisis at the 11th weeks' gestation. She was hospitalized twice due to hyperemesis gravidarum. When she was admitted to the hospital for the third time due to increased vomiting and weight-loss, serum biochemistry panel was performed and it revealed severe hypercalcemia that serum Ca was 17.59 mg/dl, and she was referred to our hospital as parathyroid crisis. Maternal hypercalcemia was resolved after urgent parathyroidectomy. She was diagnosed as preeclampsia at the 30 weeks' gestation and delivered a male infant weighing 1,090 g at 33 weeks' gestation with APGAR scores 6 at 1 min, and 7 at min 5, without evidence of neonatal hypocalcemia or tetany.Urgent parathyroidectomy is the definite treatment in symptomatic patients with hyperparathyroidism during pregnancy. Resolving maternal hypercalcemia prevents neonatal tetany and hypocalcemia.Hyperemesis may lead to hypercalcemic crisis in patients with hyperparathyroidism, so serum Ca level should be checked in patients with hyperemesis gravidarum especially who detoriate rapidly. Although they share some common pathogenetic mechanisms, there is not enough evidence for attributing preeclampsia to primary hyperparathyroidism.

Study Objective: Menorrhagia is an important health problem in women of reproductive age. The aims of this study were to assess the prevalence of menorrhagia and hemostatic abnormalities associated with menorrhagia in university students. Methods: The pictorial blood assessment chart (PBAC) was used to identify students with menorrhagia. Those with a PBAC score > 100 were examined by pelvic ultrasound and laboratory tests including complete blood count, levels of clotting factors, von Willebrand factor antigen, and ristocetin cofactor activity and Platelet Function Analyser-100 (PFA-100). Platelet aggregation was studied in students with prolonged PFA-100 closure time. Results: Menorrhagia was identified in 82 (21.8%) of 376 students. Six of 82 students who had pelvic pathologies were excluded. Eleven (14.5%) of the remaining 76 students were found to have bleeding disorders, including von Willebrand disease in five (6.5%), platelet function disorder in four (5.2%), and clotting factor deficiencies in two (2.6%). Conclusions: Menorrhagia is a common but mostly unrecognized and untreated problem among university students. Underlying bleeding disorders are not rare and require comprehensive hemostatic evaluation for identification.

AMAC: Bu calismanin amaci Turk kadinlari arasindaki menstruel periyot farkliliklarini ortaya koymak ve bu amacla piktorial kartin kullanilip kullanilamayacaginin ortaya konmasidir. MATERYAL-METOD: Bu calismaya 600 kadin dahil edilmistir. Kadinlarin adet donemlerindeki kanama paternlerini ortaya koymak icin bir anketle birlikte piktorial kart uygulanmistir. Piktorial kart lekelenmis pedlerin, tamponlarin ve pihtilarin gorulmesiyle degerlendirilir. BULGULAR: Katilimcilarin piktorial skorlari degerlendirildiginde 218 hastanin (%36.3) 50’den dusuk, 100 hastanin (%16.7) 50 ile 70 arasi, 129 hastanin (%21.5) 70 ile 100 arasi ve 153 hastanin (%25.5) 100’den yuksek puan aldiklari tespit edilmistir. Gunde 5 veya daha fazla ped kullananlarin %79’unun, ic camasirinda lekelenme olan hastalarin %67’sinin ve hasta bezi kullananlarin %76’sinin piktorial skorlarinin 50’den yuksek oldugu bulunmustur. SONUC: Menoraji tanisini koymada ve tedavi seceneklerini degerlendirmede piktorial kartin kullanilmasini onermekteyiz.OBJECTIVE: The aim of this study was to detect the personal changes during menstrual periods among Turkish women, and to search whether a pictorial blood assessment chart could be used for such a purpose. METHOD: 600 women were included in this study. Along with a questionnaire, pictorial blood assessment chart (PBAC) was applied to investigate the women’s bleeding pattern during the menstrual period. The PBAC is based on the visual appearance of stained towels, tampons and the presence of clots. RESULTS: When the pictorial scores of the participants were evaluated, 218 patients (36.3%) had a score lower than 50, 100 patients (16.7%) had between 50-70, 129 patients (21.5%) had between 70-100 and 153 (25.5%) patients had a pictorial score greater than 100. 79% of women using 5 or more pads during menstruation had a pictorial score greater than 50, 67% of women having blood on their underwear had a pictorial score greater than 50 and 76% of women using big sized pads had a pictorial score greater than 50. CONCLUSION: We recommend the use of pictorial blood assessment chart for the diagnosis of menorrhagia and evaluation of the treatment outcomes.

Gastroschisis is a rare anomaly and it is usually not associated with other syndromic or nonsyndromic anomalies. The first case of gastroschisis with aneuploidy (Turner syndrome) is presented. A fetal huge cystic hygroma was diagnosed by prenatal sonography at 12 weeks of pregnancy and chorionic villi sampling (CVS) was performed. Cytogenetic analysis revealed 45, X0. The pregnancy was terminated by induction of labor at 16 weeks of pregnancy. The female fetus had a big membrane of cystic hygroma surrounding the fetal neck. Additionally, a full abdominal thickness defect with multiple loops of bowel outside the abdomen, which could not be diagnosed on prenatal ultrasound scan, was detected on postnatal examination. Copyright (c) 2007 S. Karger AG, Basel.

OBJECTIVE: To report a case of diastematomyelia diagnosed prenatally at 20th gestational week. Design: Antenatal surveillance and delivery of the fetus with the diagnosis of diastematomyelia were successfully achieved in our clinics. Setting: Gazi University Faculty of Medicine Obstetrics and Gynecology Department, Besevler, Ankara Patient: Fetus with a prenatal diagnosis of diastematomyelia at 20th gestational week. Intervention: The patient, diagnosed to have a fetus with diastematomyelia at 20th gestational weeks, delivered at 41 weeks by vaginal route. Main outcome measures: Condition of the fetus from 20th weeks till birth and health status of both the mother and the newborn after delivery were assessed. RESULTS: No neurological deficits existed in the baby delivered at 41th gestational weeks by the vaginal route. The newborn weighed 3160 grams and the apgar scores were 9/10. The mother and the newborn, being in good health, were discharged form the hospital on the second postpartum day with the advices of regular neurological examination of the baby. CONCLUSION: Diastematomyelia is a rare skeletal system anomaly. It can be diagnosed antenatally which renders early surgical correction possible, resulting in a good prognosis.

OBJECTIVE: This study is designed to determine the level of knowledge of pregnant women on sexual organs, contraceptive methods and sexually transmitted diseases. METHOD: 54 pregnant women who applied to Gazi University Obstetrics and Gynecology Department were included. They were applied a questionnaire including questions about their demographic properties and their level of knowledge related to sexual organs,contraceptive methods and sexually transmitted diseases. RESULTS: Mean age of the participants was 27.5±4.08. When they were asked about contraceptive methods, 61.2 % had knowledge about oral contraceptives, 78.7 % about preservatives, and 38 % had knowledge about tube ligation. 96.1 % of patients cited AIDS, 39.2 % hepatitis B and C, 29.4 % gonorrhea, 3.9 % chlamydia, 9.8 % herpes virus, 11.8 % HPV (genital wart) and 27.5 % syphilisis as sexually transmitted diseases. CONCLUSION: The reason why this study is performed with pregnant women is that they have a sexual life, they are under the risk of sexually transmitted diseases and they need contraception. Finding out that pregnant women don’t have enough knowledge is important in regard to education of the population and preventive medicine.

Long segment laryngo-tracheal atresia is rare, and is usually incompatible with life in neonates. We report a case of an infant with Fraser syndrome that had not been diagnosed in the prenatal period who presented with impossible intubation due to severe long segment laryngeal atresia in the delivery room. Antenatal diagnostic features of Fraser syndrome and emergency airway management are discussed. (c) 2004 Elsevier Ireland Ltd. All rights reserved.