Introduction: Gallbladder polyps (GBPs) are generally harmless, but the planning of diagnosis and treatment of the GBP is of clinical importance due to the high mortality risk of delays in the diagnosis of gallbladder carcinomas that show polypoid development. Materials and methods: GBPs are usually incidentally detected during ultrasonographic (USG) examinations of the abdomen. The risk of carcinoma development from polypoid lesions in the literature is reported as 0-27%. There is no consensus about the management of the GBPs. Herein, we reviewed the contemporary data to update our knowledge about diagnosis and treatment of gallbladder polyps. Results: Polyps can be identified in five different groups, primarily as neoplastic and non-neoplastic. Cholesterol polyps account for 60% of all cases. The most common (25%) benign polypoid lesions after cholesterol polyps are adenomyomas. Conclusion: Ultrasonography and endoscopic ultrasonography seems to be the most important tool in differential diagnosis and treatment. Ultrasonography should be repeated in every 3-12 months in cases that are thought to be risky. Nowadays, the most common treatment approach is to perform cholecystectomy in patients with polyps larger than 10 mm in diameter. Radical cholecystectomy and/or segmental liver resections should be planned in cases of malignancy.
Objective: Uterine perfusion, particularly the endometrial blood flow, may have an important role in endometrial receptivity. In order to assess the contribution of sub endometrial blood flow in the etiopathogenesis of unexplained infertility mid luteal-peri-implantation period spiral artery transvaginal color Doppler parameters were measured and compared with fertile controls.
Material and Methods: Forty-two consecutive patients admitted toIzmir Katip Celebi University Ataturk Training and Research Hospital, Department of Obstetric and Gynecology with the diagnosis of unexplained infertility after standard diagnostic work up constituted the study group and they were compared with a fertile control group admitted to hospital with non specific gynecological complaints or for check-up in the same period. Mid luteal transvaginal color Doppler ultrasonography was applied to each patient by the same radiologist who was blind to the diagnosis of the particular patient and, RI (resistance index) and PI (pulsatility index) values were calculated.Results: There were no significant differences between the two groups, in respect to age, body mass index, basal hormonal and mid luteal progesterone levels (p>0.05). For the fertile control group, mid luteal-peri-implantation phase endometrial spiral artery mean RI values were calculated as 0.48±0.08 SD and mean PI values as 0.65±0.18 SD. For the study group, mean RI values were calculated as 0.54±0.07 SD, PI values were calculated as 0.80±0.16 SD. The differences for RI (p=0.009) and PI (p=0.004) were statistically significant.
Conclusion:According to Doppler parameters, unexplained infertility patients have high impedance blood flow in spiral arteries which means that peri-implantation blood flow in these patient is lower than fertile controls. These findings suggest that endometrial perfusion may have an important contribution to etiopathogenesis of unexplained infertility. (J Turkish-German Gynecol Assoc 2012; 13: 169-71) Key words: Unexplained infertility, endometrial blood flow, endometrial receptivity, transvaginal ultrasonograhy, colored Doppler Received: 13 June, 2012 Accepted: 21 July, 2012 Amaç: Endometrial kan akımının, endometrial implantasyonda önemli rol oynadığı düşünülmektedir. Biz çalışmamızda subendometrial kan akımının açıklanamayan infertilitedeki önemini belirleyebilmek için mid-luteal-periimplantasyon dönemindeki kan akımını TVUSG doppler ile ölçerek fertil kontrol grubu ile karşılaş-tırdık.
Gereç ve Yöntemler: Çalışmamıza İzmir Katip Çelebi ÜniversitesiAtatürk Eğitim ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum Kliniği'ne infertilite nedeni ile başvurmuş ve yapılan tetkikler sonucunda açıklanamayan infertilite olarak tanı almış 42 hasta ile fertilite dışındaki jinekolojik şikayetler ile başvurmuş fertil hastaların midluteal dönemindeki endometrial kan akımı değerlendirildi. Ölçüm-ler; rezistans indeksi ve pulsatilite indeksi, hastaların hangi gruba ait olduğunu bilmeyen tek radyolog tarafından yapıldı.
Abstract ÖzetOriginal Investigation ...
Our results showed that atrophic gastritis may cause hyperhomocysteinemia, which is an independent risk factor for atherosclerosis and cardiovascular diseases. However, when compared with controls, carotid intima-media thickness of the atrophic gastritis patients was found to be higher but did not reach statistically significant levels.
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