The prevalence of stress urinary incontinence among women operated on for abdominal wall hernias

The high co-occurrence of an abdominal wall hernia (AWH) and stress urinary incontinence (SUI) suggests that there is a common factor in the etiopathogenesis of these disorders in these patients.     

Effects of coasting on the outcome of intracytoplasmic sperm injection-embryo transfer cycles

OBJECTIVES: To determine the effects of 'coasting' on the outcome of controlled ovarian hyperstimulation (COH) and intracytoplasmic sperm injection-embryo transfer (ICSI-ET). DESIGN: Retrospective study. SETTING: IVF Centre, Ozel Ege Tup Bebek Merkezi, Izmir, Turkey. SAMPLE: Twenty-six coasted and 52 non-coasted COH and ICSI-ET patients were enrolled in this retrospective study. METHODS: Coasted patients were enrolled consecutively during the study period, and two non-coasted controls were selected from our database for each coasted patient. Coasting was decided when serum oestradiol level was > or = 4000 pg/mL. Groups were compared using chi2 and Mann-Whitney U-tests for statistical analysis. MAIN OUTCOME MEASURES: Number of oocytes collected, metaphase II (MII) oocytes and cleaving embryos, the fertilisation rate and clinical pregnancy rate were the main outcome measures. RESULTS: Number of oocytes collected, number of MII oocytes, number of cleaving embryos, fertilisation rate and clinical pregnancy rate for the coasted and non-coasted groups were 15.5 +/- 5.2 and 14.0 +/- 7.1, 9.7 +/- 4.8 and 9.3 +/- 3.9, 6.8 +/- 3.9 and 5.8 +/- 3.1, 0.85 +/- 0.18 and 0.78 +/- 0.18, 13/26 and 24/52, respectively; these differences were not statistically significant. None of the patients in the coasted group were hospitalised for signs or findings of severe ovarian hyperstimulation syndrome. CONCLUSIONS: Coasting does not adversely affect the number and the function of mature oocytes and the clinical pregnancy rate.     

Different maternal serum hCG levels in pregnant women with female and male fetuses: does fetal hypophyseal--adrenal--gonadal axis play a role?

Fetal gender has a significant effect on maternal and cord blood hCG levels, particularly during the last trimester of the pregnancy. However, the reason for this difference is obscure. The aim of the present study was to investigate whether term fetal hypophyseal - adrenal - gonadal axis differs between female and male fetuses thereby causing different hCG levels. The study consisted of 60 women with singleton pregnancies in the third trimester. Thirty-one pregnant women were carrying female fetuses, whereas 29 were carrying male. Human chorionic gonadotropin (hCG), estradiol, progesterone, testosterone, dehydro-epiandrosteron-sulfate (DHEAS), prolactin and growth hormone levels were measured in maternal serum and umbilical cord blood. In female bearing pregnancies maternal and cord blood hCG levels were significantly higher than in male bearing pregnancies (P<0.001). Maternal and cord blood estradiol, progesterone, testosterone, DHEAS, prolactin and growth hormone levels were not significantly different in either fetal gender. When all patients were considered as a group there were no correlations between fetal hCG levels and any of the measured hormones. Term fetal DHEAS, estrogen, progesterone, testosterone, growth hormone and prolactin levels do not contribute to different hCG levels between female and male fetuses. It is possible that fetal hypophyseal-adrenal gonadal axis does not play a central role as the cause of different hCG levels.     

Solitary splenic metastasis of squamous cell carcinoma of the uterine cervix: a case report and review of the literature

A 45-year-old patient presented with complaints of vaginal bleeding and pelvic pain. Fractioned probe curettage was performed and reported as Stage IIa, grade 3, squamous cell carcinoma of the uterine cervix. The patient underwent radical hysterectomy type III, bilateral salpingo-oophorectomy, omentectomy, appendectomy, and pelvic para-aortic lymph node dissection according to our clinical protocol. Adjuvant radiation therapy was planned. A splenic mass of 8 cm in diameter was revealed on computed tomography at the end of the third year of the disease-free follow-up period. Fine needle aspiration biopsy was performed and reported as metastatic carcinoma correlated to the previous cervical cancer. Debulking surgery was performed. The patient died one year after the second surgical operation. Spleen metastasis in patients with squamous cell carcinoma of the uterine cervix is exceedingly rare. Nonetheless we recommend screening of all intra-abdominal organs including the spleen as a rare metastastic site in follow-up examination protocols.     

The effect of mid-luteal estradiol level on the outcome of ICSI-ET cycles

Methods We investigated if mid-luteal estradiol levels could predict the outcome in intracytoplasmic sperm injection embryo transfer (ICSI-ET) cycles (n=231). Pregnant and non-pregnant women were compared regarding their peak estradiol levels on human chorionic gonadotropin (hCG) injection day, and mid-luteal estradiol levels on the 7th day following oocyte recovery. Pregnancy rates of the groups that were designed according to the "peak/mid-luteal estradiol level" and the mid-luteal estradiol levels were also compared.Results Peak and mid-luteal estradiol levels in pregnant women were higher than in non-pregnant women in all patients, although the difference between peak and mid-luteal estradiol levels were similar in pregnant and non-pregnants. Pregnant women had higher mid-luteal estradiol levels in good responders, but the peak estradiol levels of pregnant and non-pregnant women were similar. In poor responders, pregnant and non-pregnant women were similar with respect to peak and mid-luteal estradiol levels. Both in all patients and good responders, women with mid-luteal estradiol levels <200 pg/ml had lower pregnancy rates than those with >2,000 pg/ml. Peak/mid-luteal estradiol ratios of pregnant and non-pregnant women were not significantly different in all patients, good responders and poor responders; although a tendency for a lower ratio in pregnants was encountered in good responders. Pregnancy rates of the groups according to the "peak/mid-luteal estradiol ratio" were similar; in all patients, good responders and poor responders.Conclusion A relation between the mid-luteal estradiol level and the outcome is encountered only in good responders.     

An infant with pentalogy of Cantrell and limb defects diagnosed prenatally

We present a case of pentalogy of Cantrell which was diagnosed prenatally on routine ultrasound examination. There were several associated limb defects. We discuss the differential diagnosis and conclude that our case probably had a variant form of this syndrome.     

The comparison of the oxidative stress effects of different gases and intra-abdominal pressures in an experimental rat model

BACKGROUND: Laparoscopy is used for almost all types of abdominal surgery because of its advantages, which include shorter postoperative hospital stay. However, pneumoperitoneum used to facilitate the visual field has severe metabolic, hemodynamic, and inflammatory consequences depending on the pressure level and the gas used. Helium (He), an inert gas, has been recommended for establishment of pneumoperitoneum since it does not alter the blood pH and PCO(2). Yet the oxidative response after He insufflation remains unknown. This study was undertaken to compare the levels of free radical production and antioxidant status following He and CO(2) pneumoperitoneum at different intra-abdominal pressure values. MATERIALS AND METHODS: The subjects were 40 Sprague-Dawley male rats randomized to the following groups: He 10 (n = 8) was subjected to He pneumoperitoneum at 10 mm Hg for 60 minutes; He 15 (n = 8) was subjected to He pneumoperitoneum at 15 mm Hg for 60 minutes; CO(2) 10 (n = 8) was subjected to CO(2) pneumoperitoneum at 10 mm Hg for 60 minutes; CO(2) 15 (n = 8) was subjected to CO(2) pneumoperitoneum at 15 mm Hg for 60 minutes; and Control (n = 8) was subjected to sham operation without pneumoperitoneum. At the end of the experiment blood samples were obtained and plasma malondialdehyde, carbonyl, and sulphydryl levels were measured. RESULTS: CO(2) pneumoperitoneum produced higher malondialdehyde and carbonyl responses and sulphydryl consumption compared to He, especially at 15 mm Hg (P = 0.01, P = 0.01, and P = 0.059, respectively). CONCLUSION: Helium seems to limit the postoperative oxidative response following laparoscopy.     

A case of pulmonary hyalinizing granuloma associated with posterior uveitis

A 48-year-old male was admitted to our hospital because of abnormal pulmonary shadows and a decrease in visual acuity. He had a history of tuberculosis 20 years ago. The chest roentgenogram showed multiple pulmonary nodules throughout both lung fields. No definitive diagnosis was established either by brushing cytology or biopsy through bronchoscopy or percutaneous needle biopsy. Pathological examination of open lung biopsy specimen revealed that extensive, hyalinized lamellar collagen bundles arranged in whorls, parallel arrays. Plasma cells and lymphocytes were found between the collagen bands and germinal centers were seen at the periphery of the lesion. A definitive diagnosis of pulmonary hyalinizing granuloma was made on the basis of these histopathological findings. Although there is no established treatment for pulmonary hyalinizing granuloma, during 1 month of follow-up, posterior uveitis mildly resolved with glucocorticoid treatment and there had been a slight increase in visual acuity.     

Effects of short-term adaptation to new complete dentures on perception thresholds for interocclusal thickness in experienced and non-experienced denture wearers

Background The ability of patients to discriminate thickness can change with time after the insertion of new complete dentures, and this adaptation may differ according to the experiences of the patients. If so, an education program to reinforce the oral functions may be needed. This study was to evaluate patients’ ability to discriminate thickness by comparing experienced and non-experienced denture wearers after the insertion of new complete dentures. Methods Forty edentulous patients with a skeletal Class Ⅰ jaw relationship without any temporomandibular disturbances were in the study. After insertion of new complete dentures, all patients were tested for discrimination threshold for interocclusal thickness. The thickness perception test was repeated on days 1, 7, and 30 after the insertion of new dentures. The discriminatory ability was assessed with steel and aluminium foils placed between the upper and lower central incisor teeth. The records included the duration of wearing dentures. The data were subjected to statistical analysis of two-way ANOVA, multiple comparison test and Student’s t test.Results Discrimination of tactile ability significantly increased over 30 days in experienced denture wearers as compared with non-experienced patients (P&lt;0.001). The difference in thickness perception threshold was statistically significant between the two groups (P&lt;0.001). Conclusion Adaptation and denture experience can affect thickness discrimination of complete denture wearers.     

Oligodontia associated with femoral bifurcation, tibial hemimelia and cleft hand

Oligodontia, the congenital absence of more than one tooth in the primary dentition and/or the permanent dentition, is a rare developmental dental anomaly commonly associated with syndromes and systemic abnormalities. Femoral bifurcation is rare and is usually associated with tibial aplasia, food deformity, and congenital deformities of the contralateral lower extremity.