Relationship between mean platelet volume and recurrent miscarriage: a preliminary study

INTRODUCTION

The aim of the study was to examine the relationship between mean platelet volume (MPV) and recurrent miscarriage in order to illuminate the etiopathogenesis of recurrent miscarriage.

MATERIAL AND METHODS

We retrospectively investigated the data of 120 patients with unexplained recurrent miscarriage (group 1), and compared them with the data of 120 match-paired patients in the control group (group 2). The definition of recurrent miscarriage was accepted as two or more failed clinical pregnancies which were documented by ultrasonography or histopathologic examination. All patients in the recurrent miscarriage group were evaluated with diagnostic tests for the etiology of recurrent miscarriage. Total blood count parameters, including hemoglobin, mean corpuscular volume, red cell distribution width, white blood cells, platelets, and mean platelet volume, were compared.

RESULTS

The average patient age at the time of examination was 29.07 ±2.81 years in group I and 28.53 ±3.5 years in group II (p > 0.05). Mean body mass index (BMI) was similar between group 1 and group 2, 22.54 ±3.17 and 22.99 ±2.38, respectively (p > 0.05). Mean hemoglobin, mean corpuscular volume, red cell distribution width, and white blood cell and platelet levels were similar in both groups (p > 0.05). Mean platelet volume levels were significantly higher in group I (9.45 ±1.09 fl) than in group II (7.63 ±0.52 fl) (p = 0.001).

CONCLUSIONS

Higher MPV values in the study group suggest and support the importance of thromboembolic events in the etiology of recurrent miscarriage.

Changing trends in the incidence of ovarian neoplasia and its relationship with the risk factors: a report of 311 cases from north-eastern anatolia region

OBJECTIVE

Ovarian cancer is one of the most common and lethal gynecologic malignancy. In Turkey, the 8(th) most commonly seen neoplasm is ovarian cancer. The risk factors of ovarian cancer are menstrual reproductive events including gravida, menarche and menopause status, and life style habits such as cigarette smoking and habitat. In this study we aimed to determine the risk factors leading to ovarian cancer in Turkish women population and show the tumor markers in this population.

MATERIALS AND METHODS

This study included 311 ovarian neoplasia cases diagnosed at the Pathology Department of Ataturk University in Erzurum over last seven years extending from 2005 to 2013. This study is a retrospective analysis basing on the pathology reports and accesible patient files. Serum tumor markers of the patients were retrospectively reported from their records. Conventional stained preparations existing in our archive examined by two pathologists as well independent of each other, and histopathologic diagnosis and the distribution of the sub-group was revised.

RESULTS

A total of 311 patients were included in this study in which patients were diagnosed at the Pathology Department of Ataturk University in Erzurum. Serous cystadenoma is the most common ovarian tumor followed by mucinous cystadenoma, germ cell tumors, and dysgerminoma. All of the tumor markers were significantly normal.

CONCLUSION

Upto our knowledge this was the first epidemiological study in Turkey. Analysis of each country's statistical information reflecting its own profile is also important. The relationship between the profiles of patients and types of ovarian neoplasia may give an idea about the risk factors of the disease in its region. Additionally, distribution of tumor markers might be considered for the discriminating of the benign or malign characters of the ovarian neoplasia.

Ischemia-reperfusion damage

Ischemia-reperfusion damage is a complex pathological process that begins with tissue anoxia and continues with the production of free oxygen radicals, expanding with the inflammatory response. The literature suggests the importance of antioxidant and anti-inflammatory treatment to treat ischemia-reperfusion-related tissue damage.

The effect of agomelatine on oxidative stress induced with ischemia/reperfusion in rat ovaries

BACKGROUND

Ovarian ischemia and reperfusion can lead to serious and irreversible health problems.

OBJECTIVES

The aim of this study is to investigate the protective effect of agomelatine against ovarian ischemia/ /reperfusion injury in rats using biochemical methods.

MATERIAL AND METHODS

Thirty female rats were divided into three groups (the number of animals in each group = 10), a control group in which ischemia/reperfusion was established (IRC), an ischemia/reperfusion + agomelatine (IRA) group and a healthy group given a sham operation (SG). Total glutathione (tGSH) and malondialdehyde (MDA) levels and glutathione peroxidase.

RESULTS

Biochemical results revealed MDA levels of 19.1 ± 2.03, 5.8 ± 1.5 and 5.5 ± 1.4 µmol/g protein in ovarian tissue in the IRC, IRA and SG groups, respectively. MPO activity in the IRC, IRA and SG groups was 7.87 ± 2.7, 4.0 ± 2.0 and 3.0 ± 1.0 U/g protein, respectively. tGSH levels were 1.87 ± 1.13, 4.37 ± 1.4 and 5.87 ± 1.64 nmol/g protein, respectively. GPx activity in the IRC, IRA and SG groups was 7.37 ± 1.68, 18.6 ± 3 and 17.75 ± 3.2 U/g protein, and SOD activity 31.1 ± 2.9, 45.3 ± 3.7 and 54 ± 4.2 U/g protein, respectively. The level of 8-OH/ /Gua, a product of DNA damage, was 2.18 ± 0.2 pmol/L in the IRC group, 1.28 ± 0.2 pmol/L in the IRA group and 0.93 ± 0.01 pmol/L in the SG group.

CONCLUSIONS

Agomelatine prevented ovarian ischemia/reperfusion injury.

Bilateral ovarian ischemia/reperfusion injury and treatment options in rats with an induced model of diabetes

OBJECTIVES

This study investigated the effects of melatonin, famotidine, mirtazapine, and thiamine pyrophosphate on ischemia/reperfusion (I/R) injury in diabetic rats and evaluated oxidant and antioxidant marker measurement results. It also examined the effects of the drugs aimed at preventing infertility that may result from I/R injury.

MATERIALS AND METHODS

Diabetic rats were divided into a control group (IRC) to be exposed to I/R, an ovarian I/R + 2.2 mg/kg melatonin (IRML) group, an ovarian I/R + famotidine (IRFA) group, an ovarian I/R + 20 mg/kg mirtazapine (IRMR) group, an ovarian I/R + 20 mg/kg thiamine pyrophosphate (IRTP) group, and a sham operation (SO) group.

RESULTS

In the control group exposed to I/R, the levels of the oxidant parameters Malondialdehyde (MDA) and Myeloperoxidase (MPO) were significantly higher compared with the SO group, while the levels of the antioxidant parameters glutathione (GSH), Glutathione peroxidase (GPO), Glutathione reductase (GSHRd), Glutathione S - transferase (GST), and Superoxide dismutase (SOD) were significantly lower. Melatonin, famotidine, mirtazapine, and thiamin pyrophosphate prevented a rise in oxidant parameters and a decrease in antioxidants in ovarian tissue exposed to I/R. However, apart from thiamin pyrophosphate, none of the drugs were able to prevent infertility caused by I/R injury.

CONCLUSION

Prevention of ovarian I/R injury-related infertility in rats with induced diabetes is not through antioxidant activity. Thiamine pyrophosphate prevents infertility through an as yet unknown mechanism. This study suggests that thiamine pyrophosphate may be useful in the prevention of I/R-related infertility in diabetics.

Tissue damage and oxidant/antioxidant balance

The oxidant/antioxidant balance in healthy tissues is maintained with a predominance of antioxidants. Various factors that can lead to tissue damage disrupt the oxidant/antioxidant balance in favor of oxidants. In this study, disruptions of the oxidant/antioxidant balance in favor of oxidants were found to be a consequence of the over-consumption of antioxidants. For this reason, antioxidants are considered to be of importance in the prevention and treatment of various types of tissue damage that are aggravated by stress.

Investigation of the effects of the chronic administration of some antihypertensive drugs on enzymatic and non-enzymatic oxidant/antioxidant parameters in rat ovarian tissue

OBJECTIVE

In this study, effects of chronic antihypertensive drug (clonidine, methyldopa, amlodipine, ramipril, and rilmenidine) treatment on antioxidant-oxidant parameters were investigated in rat ovarian tissue.

STUDY DESIGN

Chronic drug administration for 30 days and at the end, biochemical examinations (total glutathione (tGSH), glutathione peroxidase (GPO), glutathione reductase (GR), glutathione s-transferase (GST), superoxide dismutase (SOD), nitric oxide (NO), catalase (CAT), malondialdehyde (MDA), and myeloperoxidase (MPO) analyses) were performed.

RESULTS

The levels of glutathione (GSH) and NO, and the activities of GPO, GR, GST, SOD, and CAT were measured the lowest in ramiprile group. Also in ramiprile group, the level of MDA and the activity of MPO was the highest.

CONCLUSION

We divided the drugs into four groups according to their biochemical side effect potentials in ovarian tissue: (I) Drugs which have no clear negative effect on ovarian tissue: clonidine, rilmenidine; (II) Drugs which have mild negative effect on ovarian tissue: methyldopa; (III) Drugs which have moderate negative effect on ovarian tissue: amlodipine; (IV) Drugs which have severe negative effect on ovarian tissue: ramipril. These data might be useful in the selection of the least toxic antihypertensive drug in pregnant and/or normal females.

Role of adrenal gland hormones in the anti-inflammatory effect mechanism of tamoxifen, a partial antagonist for oestrogen receptors, and relation with COX levels

OBJECTIVE

There is limited study about anti-inflammatory effect mechanism of tamoxifen. We aimed to investigate the anti-inflammatory activity of tamoxifen to see whether adrenal gland hormones have roles in the anti-inflammatory effect mechanism of tamoxifen and to evaluate the relationship between anti-inflammatory activity and cyclooxygenase (COX) level.

STUDY DESIGN

Effects of tamoxifen, indomethacin and prednisolon on carrageenan-induced inflammatory paw oedema were investigated in intact and adrenalectomised rats. Also blood adrenalin and corticosterone levels and paw tissue COX levels determined biochemically.

RESULTS

Tamoxifen (5, 10 and 20 mg/kg), indomethacin (5, 10 and 20 mg/kg) and prednisolon (5 mg/kg) produced anti-inflammatory effects in intact rats, however, they could not in adrenalectomized rats. 20 mg/kg tamoxifen produced low anti-inflammatory effect. Tamoxifen and indomethacin decreased COX-2 levels in intact rats, but not in adrenalectomised rats. Tamoxifen produced anti-inflammatory effects by decreasing adrenalin levels, as indomethacin does. 20 mg/kg tamoxifen decreased corticosterone levels.

CONCLUSIONS

Tamoxifen was seen to suppress carrageenan-induced inflammation significantly. The dose of tamoxifen that decreases adrenalin levels maximally and decreases corticosterone levels minimally was found to produce the most potent anti-inflammatory effect. The reason why indomethacin is more potent in high doses may be that it decreases adrenalin levels strongly at these doses, without decreasing corticosterone levels.

Investigation of the relationship of some antihypertensive drugs with oxidant/antioxidant parameters and DNA damage on rat uterus tissue

BACKGROUND

In this study, we investigated the effects of treatment with chronic antihypertensive drugs (clonidine, methyldopa, amlodipine, ramipril and rilmenidine) on oxidant-antioxidant parameters and toxic effects on DNA in rat uterus tissue. In addition, uterus tissues were examined histopathologically.

MATERIALS AND METHODS

A total of 36 albino Wistar rats were divided into the following six groups: 0.075 mg/kg clonidine group; 100 mg/kg methyldopa group; 2 mg/kg amlodipine group; 2.5 mg/kg ramipril group; 0.5 mg/kg rilmenidine group; and the healthy group. Rats underwent chronic drug administration for 30 days and at the end, biochemical and histopathological examinations were performed. All data were subjected to one-way ANOVA test.

RESULTS

We divided these drugs into the following three groups according to their effects on rat uteri: (I) mild negative effects (clonidine), (II) moderate negative effects (rilmenidine, methyldopa) and (III) drugs which had severe negative effects (amlodipine, ramipril).

CONCLUSION

These data may help with selection of antihypertensive drugs, in order to determine which drugs have the lowest toxicity in pregnant and non-pregnant (pre-pregnancy) women.

Urine iodine levels in preeclamptic and normal pregnant women

The aim of this study was to investigate the urine iodine concentration in women with severe preeclampsia and in healthy women in Erzurum, Turkey. Urine specimens were obtained from 40 severe preeclampsia and 18 healthy pregnant women. Urinary iodine levels were determined by the Foss method based on the Sandell-Kolthoff reaction. The urinary iodine level for women with severe preeclampsia was 4.25 +/- 2.7 microg/dL, lower than 20.89 +/- 6.4 microg/dL of urinary iodine for healthy pregnant women (p < 0.001). Blood magnesium concentration was found to be 1.63 +/- 0.05 mg/dL for women with severe preeclampsia, which is lower than that of healthy pregnant women (1.87 +/- 0.05 mg/dL; p < 0.001). There was a positive correlation between urinary iodine level and blood magnesium level in pregnant women with preeclampsia (Pearson correlation coefficient = 0.43; p < 0.01). However, there was no correlation between urinary iodine level and blood magnesium level in healthy pregnant women. There was no difference in thyroid hormone levels (T4, TSH, FT4) between women with severe preeclampsia and healthy pregnant women. However, there was a difference in T3 thyroid hormone levels between women with severe preeclampsia (1.86 +/- 0.4 microg/dL) and healthy pregnant women (1.45 +/- 0.3 microg/dL; p < 0.001). There was also a difference in FT3 between women with severe preeclampsia (2.77 +/- 0.4 pg/mL) and healthy pregnant women (2.41 +/- 0.5 microg/dL; p < 0.01). Urinary iodine excretion is currently the most convenient laboratory marker of iodine deficiency. The method is useful for the rapid and low-cost assessment of iodine deficiency. Our results suggested that urinary iodine concentration might be a useful marker for prediagnosing preeclamptic women. In addition, iodine supplementation may also be considered for preeclamptic therapy.

Effects of female sex hormones on caffeine-induced epileptiform activity in rats

Research on female sex hormones has demonstrated that estrogen aggravates epileptogenesis. Theoretically, this means that the frequency of epileptic attacks should be decreased in epileptic women during menopause. However, although epilepsy attacks are reported to decrease in some women during menopause, they may not change in others. Increases in attack frequency have even been reported during menopause in some epileptic women. This study has investigated the effects of estrogen, progesterone, luteinizing hormone (LH) and follicle stimulating hormone (FSH) on caffeine-induced epileptiform activity in rats. Estrogen was found to increase epileptiform activity in a dose-dependent manner via its own receptors. In contrast, progesterone had no effect on epileptiform activity. FSH and LH suppressed epileptiform activity at low doses; however, at high doses they enhanced it. In conclusion, we suggest that the occurrence or aggravation of epilepsy, despite estrogen deficiency in the menopausal or post-menopausal period, is related to excessive accumulation of FSH and LH.

Acute mesenteric venous thrombosis due to protein S deficiency in a pregnant woman

Acute mesenteric venous thrombosis is a rare and potentially fatal disease, which often occurs in medically compromised elderly patients. Isolated mesenteric venous thrombosis may be encountered in young women who have underlying hypercoagulable disease. We report a case of mesenteric venous thrombosis in a young pregnant woman in whom protein S deficiency was diagnosed at a later stage. The patient underwent extensive bowel resection. On follow-up she had developed an obstruction on the intestinal anastomosis. The anastomosis was revised, but the patient died of intervening complications 3 months after the operation. Early management of acute mesenteric venous thrombosis relies on early diagnosis, which requires a high index of suspicion. The condition must be considered during evaluation of persistent abdominal pain in pregnant women with hypercoagulable disorder.

Helicobacter pylori seropositivity and its relationship with serum malondialdehyde and lipid profile in preeclampsia

OBJECTIVE

To investigate Helicobacter pylori seropositivity rate in preeclamptic and healthy pregnants. Additionally, we compared serum malondialdehyde (MDA) levels and lipid profile between H. pylori-positive and negative cases.

METHOD

This study included 53 preeclamptic and 30 healthy pregnants. Serum levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C), MDA, and H. pylori Ig G antibodies were measured.

RESULTS

Preeclampsia group had higher serum MDA levels compared with healthy pregnants (P<0.001). While the rate of H. pylori seropositivity was 43/53 (81%) in the preeclampsia group, this was 18/30 (% 60) in normal pregnants (odds ratio (OR), 2.86; 95% confidence interval (CI), 1.05-7.82; P=0.036). We further divided the preeclampsia group as H. pylori-positive and H. pylori-negative subgroups. In H. pylori-positive group, serum TC (P<0.01) and LDL-C (P<0.01) levels were significantly higher than those of H. pylori-negative group. Mean MDA concentration was higher in H. pylori-positive group than that of H. pylori-negative group (P<0.001).

CONCLUSION

H. pylori-positive pregnants may have a high risk for preeclampsia and H. pylori may be one of the causes for high MDA levels in preeclampsia.

Effect of acute and chronic administration of progesterone, estrogen, FSH and LH on oxidant and antioxidant parameters in rat gastric tissue

This study was conducted to investigate whether gastro-protective and gastro-toxic effects of acute and chronic administration of progesterone, estrogen, FSH and LH were related to oxidant and antioxidant parameters. Chronic administration of progesterone at a low dose (1mg/kg), which probably could not stimulate progesterone receptors (PRs), inhibited oxidative stress of FSH in gastric tissue by suppressing FSH. Progesterone (5mg/kg) may have been caused oxidative stress as reflected by PR stimulation. FSH may have decreased antioxidant parameters and increased oxidant parameters via PRs. Chronic administration of low dose of estrogen (1mg/kg) inhibited LH and but could not stimulate alpha-2 adrenergic receptors, which resulted in oxidative stress in gastric tissue. The higher dose of estrogen (5mg/kg), however, could stimulate alpha-2 receptors, exhibited antioxidant activity in acute and chronic administration. While antioxidant activity of estrogen and LH was blocked with yohimbine (an alpha-2 adrenergic receptor blocker), mifepristone prevented the oxidative stress of progesterone and FSH in gastric tissue. It is concluded that low doses of progesterone may inhibit FSH, whereas high doses of estrogen may stimulate alpha-2 receptors, suggesting that LH could have protective and antioxidant hormone effects.

Prenatal MRI findings of polycystic kidney disease associated with holoprosencephaly

Holoprosencephaly (HPE) and polycystic kidney disease (PKD) are genetically heterogeneous anomalies which can make up part of various syndromes or chromosomal anomalies. Due to the rapid lethality prognosis, early and precise prenatal diagnosis would be of great value. This case report describes extensive PKD involvement, already present in utero, in a patient with HPE and subdural effusion visible by MR imaging. The detailed anatomic information obtained by the MR imaging can guide the surgical planning and can aid antenatal counseling.

Primary hypogonadism, partial alopecia, and Mullerian hypoplasia: report of a third family and review

Two sisters presented with partial alopecia, primary hypergonadotropic hypogonadism and Mullerian hypoplasia associated with mild mental retardation, microcephaly, flat occiput, sparse eyebrows, absence of breast tissue, absent ovaries, mild-moderate dorsal kyphosis, thin upper lip and unilateral sensorioneural deafness in one of them. They were the product of a Turkish consanguineous marriage. The clinical course for our patients is similar to two families reported by Al-Awadi et al. [Al-Awadi et al. (1985) Am J Med Genet 22:619-622] and Megarbane et al. [Megarbane et al. (2003) Am J Med Genet Part A 119A:214-217]. This report supports the literature by proposing an autosomal recessive syndrome which was firstly reported by Al-Awadi et al. [Al-Awadi et al. (1985) Am J Med Genet 22:619-622]. This condition may be due to a founder mutation.

The protective effect of dehydroepiandrosterone on ovarian tissues after torsion-detorsion injury: a stereological and histopathological study

OBJECTIVE

Ovarian torsion is a rare problem in pre-pubescent girls that must be included in the differential diagnosis of patients with abdominal or pelvic pain. Current advice for treatment to support ovary preservation considers the macroscopic appearance of the ovary, but this is not a reliable indicator of the degree of injury in cases of ovarian torsion. The aim of this study was to determine the effects of dehydroepiandrosterone (DHEA) treatment on the rat ovary after torsion-detorsion injury using a histopathological approach and stereological methods.

MATERIALS AND METHODS

Fifteen adult female Sprague Dawley rats were divided into three groups: sham operated (Control; n=5), torsion-detorsion with saline (Saline; n = 5), and torsion-detorsion with DHEA (DHEA; n = 5). Rats in the sham-operated group underwent a surgical procedure similar to the other groups, but the adnexa were not torsioned. The DHEA group was injected intraperitoneally 3 hours before detorsion and saline was administered to the saline group. After 24 h of adnexal detorsion, the rats in all groups were sacrificed and the adnexa were removed. The volume of ovarian stroma and edema were estimated using the Cavalieri Principle and were applied to serial paraffin sections. Ovary sections were also evaluated histopathologically.

RESULTS

The volume of ovarian edema was 35.4% lower in the saline group compared to the control group (p> 0.05). The volume of ovarian edema increased by 73.4% in the DHEA group (p<0.05). In the experimental groups, stromal volume was 41.0% higher in the saline group and 52% higher in the DHEA group in comparison to the control group. Statistically significant differences were found when comparing the volume of both ovarian edema and stroma between experimental groups (Detorsion/Saline group - Detorsion/DHEA group; p< 0.01). Histopathologically, mononuclear cell infiltration and vascular dilatation, perivascular edema and common necrotic changes were obvious in the torsion-detorsion damaged ovary. These changes were partially ameliorated by DHEA treatment.

CONCLUSIONS

The present study shows that administration of DHEA has beneficial effects in the prevention of ischemia-reperfusion injuries of the ovaries.

Role of alpha-2 adrenergic receptors in anti-ulcer effect mechanism of estrogen and luteinising hormone on rats

OBJECTIVE

To evaluate anti-ulcer effect of estrogen and luteinising hormone (LH) on indomethacin-induced ulcer model in female rats.

STUDY DESIGN

Ovariectomy in healthy adult famale rats. Acute administration of estradiol to ovariectomised rats. Acute administration of LH to intact rats. Combined administration of tamoxifen with estradiol or LH to intact rats. Combined administration of yohimbin with estradiol or LH to intact rats. Combined administration of piperoxan with estradiol or LH to intact rats. Indomethacin administration to all rats.

RESULTS

Results have shown that LH exerted anti-ulcer activity at all doses we used but estradiol at 5 and 10 mg/kg. In rats administered yohimbine and piperoxan estradiol and LH could not prevent indomethacin-induced ulcers. In rats administered tamoxifen, estradiol and LH could prevent indomethacin-induced ulcers.

CONCLUSIONS

LH is a very potent endogen anti-ulcer factor, and the anti-ulcerative activities of estrogen and LH are mediated via alpha-2 adrenergic receptors, but not es receptors. The resistance of gastric mucosa to aggressive factors may decrease as a result of LH inhibition when estrogen is secreted chronically in the human body.

Iodine and magnesium levels in maternal and umbilical cord blood of preeclamptic and normal pregnant women

The objective of this study was to investigate the relationship between preeclampsia and iodine levels and magnesium concentration in the blood of subjects in the northeast Anatolia region where iodine deficiency is common. Blood specimens were obtained from 24 preeclamptic and 16 healthy pregnant women. Iodine levels in blood were determined by the Foss method based on the Sandell-Kolthoff reaction. Serum protein-bound iodine (PBI) levels and magnesium concentration in maternal blood were lower in patients with severe preeclampsia compared to normal pregnant women (8.46 +/- 1.22 vs. 11.46 +/- 1.71 microg/dL, p < 0.001, 1.63 +/- 0.05 vs. 1.86 +/- 0.05 mg/dL, p < 0.001, respectively). Serum PBI levels and magnesium concentration in umbilical cord blood were higher in patients with severe preeclampsia than in normal pregnant women (8.84 +/- 1.9 vs. 7.33 +/- 1.07 microg/dL, p < 0.05, 2.48 +/- 0.03 vs. 2.02 +/- 0.01 mg/dL, p < 0.001, respectively). There was a positive correlation between the serum PBI levels in maternal blood and magnesium concentration in maternal blood in patients with severe preeclampsia (r = 0.41, p < 0.05). Thus, iodine may be one factor contributing to the pathophysiology of preeclampsia. Iodine supplementation may be effective therapy in preeclamptic in pregnant women.

Albumin/creatinine ratio for prediction of 24-hour albumin excretion of > or =2 g in manifest preeclampsia

PURPOSE OF INVESTIGATION

To compare whether albumin/creatinine ratios obtained from random or 8-hour urine collected in different periods of day differ in prediction of albumin excretion > or =2 g in 24-hour urine collection in preeclampsia.

METHODS

From a total of 70 women, 24-hour urine collected by three consecutive periods of eight hours and three random urine samples were taken before each period. The variation of albumin-creatinine ratios in samples across the day was analyzed by the Friedman and inter-assay coefficient variation. For each sample, receiver operator characteristic (ROC) curves were constructed to determine an optimal albumin/creatinine ratio value in the prediction of albuminuria > or =2 g.

RESULTS

The albumin/creatinine ratio did not vary significantly over time when all samples pooled. However, there was considerable intra-individual variation in both random and timed urine samples. On ROC analysis, the albumin/creatinine ratio in both random and timed urine samples predicted the 24-hour urine results and there was no difference between samples in prediction of albuminuria > or =2 g. A single optimal cut-off point was not available between samples. The positive and negative predictive values for optimal cut-offs ranged from 48%-88% and 94%-100%, respectively.

CONCLUSIONS

The random urine albumin/creatinine ratio was a poor predictor for proteinuria a 2 g in patients with preeclampsia.

Difficulty of the surgical management of a case with placenta percreta invading towards parametrium

A 37-year-old woman was admitted due to vaginal bleeding at 25 weeks of gestation to our gynecology unit. Placenta percreta, which stems from posterior wall of the uterus, forming a mass in Douglas cavity and invading towards right parametrium was clinically diagnosed by exploration. Bilateral internal iliac artery ligation and supracervical hysterectomy could not prevent bleeding. A right radical parametrectomy was necessary to remove invaded parametrium and to control bleeding. The placenta percreta invading parametrium may need an extended hysterectomy procedure. Excess bleeding may be prevented by leaving the placenta in situ during surgery if the placenta percreta is diagnosed before termination of pregnancy, A classical incision may help leaving placenta is situ during operation.

Protective effects of amlodipine on ischemia-reperfusion injury of rat ovary: biochemical and histopathologic evaluation

OBJECTIVE

To evaluate the effects of amlodipine as an antioxidant and analyze the histopathologic changes in experimental ischemic and ischemic-reperfusion (I/R) injury in rat ovaries.

DESIGN

Experimental study.

SETTING

Experimental surgery laboratory.

ANIMAL(S)

Forty-two rats with experimentally induced ovarian torsion.

INTERVENTION(S)

Group 1: sham operation; group 2: bilateral ovarian ischemia; group 3: 3-hour period of ischemia plus 3 hours of reperfusion; groups 4 and 5: amlodipine administration at 3 and 5 mg/kg respectively before one half hour of ischemia, and then bilateral ovarian ischemia. The ovaries were removed at the third hour of ischemia. Groups 6 and 7: 3-hour period of bilateral ovarian ischemia. Two and a half hours after the induction of ischemia, the rats received amlodipine. At the end of a 3-hour period of ischemia, 3 hours of reperfusion was continued; then the ovaries were removed.

MAIN OUTCOME MEASURE(S)

Ovarian tissue superoxide dismutase and nitric oxide activity; histopathologic examination of all ovarian rat tissue.

RESULT(S)

Ischemia and I/R increased the inducible nitric oxide synthase activity while decreasing the superoxide dismutase activity significantly in comparison with the sham group. Both doses of amlodipine before ischemia and I/R reversed the trend in nitric oxide synthase activities and reversed the trend in the rat's ovary.

CONCLUSION(S)

Conservative treatment with amlodipine is effective in reducing tissue damage induced by ischemia, I/R, or both in ovaries.

Maternal Serum Interleukin-10, Interleukin-2 and Interleukin-6 in Pre-Eclampsia and Eclampsia

PROBLEM

The aim of the study was to investigate and compare the concentrations of interleukin (IL)-2, IL-6, and IL-10 in serum of women with mild pre-eclampsia, severe pre-eclampsia, eclampsia, and normotensive pregnancy.

METHOD OF STUDY

A total of 69 consecutive cases, 38 mild pre-eclampsia, 20 severe pre-eclampsia, 11 eclampsia, and 20 normotensive controls were included in this study. Serum IL-2, IL-6, and IL-10 levels were determined using enzyme-linked immunosorbent assay method.

RESULTS

Gestational age (P = 0.210) and body mass index (P = 0.214) between the groups were similar. The mean concentration of serum IL-2 and IL-6 were not different between the groups (P = 0.261, P = 0.141 respectively). The median concentrations of serum IL-10 in patients with mild and severe pre-eclampsia were similar (P < 0.282) and was significantly lower than those of controls (P < 0.001) and patients with eclampsia (P < 0.001). In patients with eclampsia, the median concentration of IL-10 was significantly higher than that of all other groups (P < 0.001 for each comparison).

CONCLUSION

Pre-eclampsia is associated with a deficiency serum IL-10. High serum IL-10 is correlated with the presence of eclampsia.

Placental tissue iodine level and blood magnesium concentration in pre-eclamptic and normal pregnancy

OBJECTIVE

To assess iodine concentration in the placental tissue and magnesium concentration in the blood of women with severe pre-eclampsia in northeast Anatolia and compare these values with those of healthy pregnant women from the same region.

METHODS

Placental tissue and blood specimens were obtained from 20 severely pre-eclamptic and 15 healthy pregnant women. Iodine levels in placental tissue were determined by the Foss method based on the Sandell-Kolthoff reaction.

RESULTS

Placental tissue iodine levels were lower in women with severe pre-eclampsia than in healthy pregnant women (4.30+/-1.36 ng of iodine/mg protein vs. 7.71+/-2.84 ng of iodine/mg tissue protein; P<0.001), as were blood magnesium levels (1.63+/-0.05 mg/dL vs. 1.87+/-0.05 mg/dL; P<0.001). There was a positive correlation between placental tissue iodine levels and blood magnesium levels in women with severe pre-eclampsia (r=0.55, P<0.05), but no such correlation was observed in healthy pregnant women (r=0.23, P=0.41).

CONCLUSION

Magnesium assimilation is known to be defective when iodine levels are insufficient. In northeast Anatolia, where iodine deficiency is common, clinical trials of iodine supplementation should be considered for pre-eclamptic therapy.

Elevated plasma homocysteine concentrations in severe preeclampsia and eclampsia

Homocysteine is an essential amino acid required for the growth of cells and tissues in the human body. Maternal hyperhomocysteinemia is associated with a number of placenta-mediated diseases such as preeclampsia. The aim of this study was to evaluate the plasma level of homocysteine and its association with severity of preeclampsia. A case-control study was performed with 32 mild preeclamptic patients, 25 severe preeclamptic patients, 16 eclamptic patients and 34 controls. Maternal plasma homocysteine concentration was measured prospectively at antenatal period by high-performance liquid chromatography. There were no significant differences in demographic characteristics between the study and control groups. Mean plasma levels of homocysteine in women with severe preeclampsia (16.7 +/- 10.1 micromol/l, mean +/- S.D., n = 25) and eclampsia (16.5 +/- 9.6 micromol/l, mean +/- S.D., n = 16) were significantly higher than those in mild preeclampsia (7.7 +/- 2.4 micromol/l, mean +/- S.D., n = 32) and controls (6.7 +/- 1.6 micromol/l, mean +/- S.D., n = 34) (p < 0.0001). It should be noted that plasma levels of homocysteine are not significantly different between mild preeclampsia and controls. In conclusion, plasma homocysteine concentrations are increased in severe preeclampsia and eclampsia, but not in mild preeclampsia.