The assessment of the relationship between the vascularity of FIGO Type 4-7 leiomyomas and abnormal uterine bleeding

The current study aimed to analyse and compare the vascularity of FIGO Type 4-7 leiomyoma specimens obtained from women with or without abnormal uterine bleeding (AUB). The records of 31 women who underwent myomectomy for FIGO Type 4-7 leiomyomas in a university hospital setting were analysed. Group I (n = 16) was composed of women that were symptomatic for AUB and group II (n = 15) consisted of asymptomatic cases. The myomectomy material(s) of each case were processed with CD34 staining and evaluated by Image J^® software (Image J 1.52a, Wayne Rasband National Institutes of Health, Bethesda, MD). There was no statistically significant difference between the rates of vascular areas in the specimens of the two groups (p>.05). Although areas with large vessels were higher in group I compared to group II, the difference did not reach statistical significance (p>.05). AUB caused by FIGO Type 4-7 leiomyomas seems to be related to factors other than vascular density.Impact StatementWhat is already known on this subject? Uterine leiomyomas are the most common benign gynaecologic neoplasms with a prevalence of approximately 40% in women of reproductive age. They are most often asymptomatic but when symptomatic, abnormal uterine bleeding (AUB) is one of the most commonly observed symptoms. Although there are some hypothetical explanations, the exact pathogenesis underlying leiomyoma-associated AUB has not yet been elucidated. Almost a century ago, the vascular abnormalities of fibroids were hypothesised as one of the etiopathological factors correlated with clinical symptoms, such as AUB, and current data suggest that the vascular map of leiomyomas consists of an avascular core surrounded by a vascularised capsule. To our knowledge, there are no studies in the literature comparing the histopathological evaluation of the vascularity scores of FIGO Type 4-7 leiomyomas in symptomatic (with AUB) and asymptomatic (without AUB) women.What the results of this study add? The study revealed that there was no statistically significant difference between the vascularity scores of FIGO Type 4-7 leiomyomas excised from the symptomatic and asymptomatic women. Large vessel densities also did not statistically significantly differ between the two groups.What the implications are of these findings for clinical practice and/or further research? This study revealed that AUB caused by FIGO Type 4-7 leiomyomas was related to factors other than vascular density.

Retrospective Analysis of 449 Intracranial Meningioma Patients Operated Between 2007 and 2013 at a Single Institute

AIM

Meningioma literature has many large surgical case series, which have been references of text books and neurosurgical practice. Many of those series were published when stereotactic radiosurgery (SRS) was not so common or these series were in terms of World Health Organization (WHO) 2000 classification. In this study, we aimed to make an update to the current literature using WHO 2007 classification system.

MATERIAL AND METHODS

Four hundred eighty-eight intracranial meningioma patients underwent open surgery in 2007-2013 and 449 of them were included in this study. All pathological specimens were re-evaluated in terms of WHO 2007 classification. All demographical and follow-up records and imaging archives were investigated by using our center"s central automation system and National Central Population Management System. If records were not available or not adequate, investigators made phone calls to patients. Pediatric patients were excluded.

RESULTS

Three hundred twenty-six female (76.2%) and 123 male (27.4%) patients were analyzed. Their ages ranged from 18 to 84 years (mean=51.6±11.9 years). The most common subtype of meningioma was meningothelial meningioma (51.7%), followed by atypical meningioma (20.3%). WHO Grade I meningiomas had statistically random localization distribution, but WHO Grade II meningiomas were more common in the convexity, parasagittal and middle fossa. Younger age was found to be significantly related with tumor recurrence or progression. Seventy-three (16.2%) patients underwent SRS and 64 (14.2%) patients underwent adjuvant radiotherapy (ART) after surgery. Convexity localization was found to be associated with recurrence, mortality and higher WHO 2007 grade.

CONCLUSION

Convexity meningiomas are associated with recurrence, mortality and higher WHO 2007 grade. Convexity meningiomas should be totally resected in order to achieve maximum benefit from surgery.

Changes in circulating adiponectin and tumour necrosis factor-α and their relationship with insulin resistance in periparturient dairy cows

Introduction: The aim of the study was to investigate changes in the serum levels of adiponectin and TNF-α, as well as insulin sensitivity, and to elucidate the possible relationship among the parameters and negative energy balance during the periparturient period of dairy cows.

Material and Methods: Thirty primiparous Holstein dairy cows were selected for the study. Blood samples were collected from each cow seven days before the expected calving date, on the calving day, and 7, 14, and 21 days after calving. Blood non-esterified fatty acids (NEFA), β-hydroxybutyric acid (BHBA), glucose, insulin, adiponectin, and TNF- α levels were measured. Revised Quantitative Insulin Sensitivity Check Index (rQUICKI) was calculated using data on NEFA, insulin, and glucose concentrations.

Results: When compared to prepartum levels, serum concentration of adiponectin significantly increased on day 21 postpartum. The rQUICKI increased and NEFA levels decreased on day 7 after parturition. Insulin and glucose levels decreased on days 7, 14, and 21 postpartum when compared with prepartum levels. BHBA levels decreased on day 21 and TNF- α concentration also decreased on days 7, 14, and 21 postpartum. Adiponectin levels positively correlated with NEFA during the preparturient period. Negative correlation was detected between adiponectin and rQUICKI on calving day and on 14th day after parturition. TNF- α concentration positively correlated with glucose levels on day 7 prepartum and on 21st day postpartum and with rQUICKI on 21st day postpartum. Negative correlation was detected between adiponectin level and insulin sensitivity.

Conclusion: Based on the results of the study, we concluded that adiponectin could possibly increase insulin sensitivity when blood NEFA concentrations are elevated.