The prenatal differential diagnosis of cloacal dysgenesis sequence from other urinary obstructive diseases was essential regarding fetal prognosis, prenatal, and neonatal management. The bladder outlet obstruction and pulmonary hypoplasia due to reduced amniotic fluid and/or kidney disease were considered prognostic factors for neonatal death. Termination of pregnancy is almost always recommended instead of intrauterine shunt procedures; but if we take into consideration one of our cases and a few reported cases who survived in the neonatal period, the prenatal management of these pregnancies needs to be reevaluated.
Limb body wall complex is a spectrum of multiple severe anomalies. The etiopathogenesis and clinical classification are still under discussion. In our article, while reviewing previous etiopathogenetical hypothesis, we propose a new clinical classification regarding embryological theories and pheneotypical features. According to the Van Allen diagnostic criteria, the findings of 6 affected fetuses are presented. Prenatal diagnosis was performed in 5 of 6 cases. Craniofacial malformations were present in only 1 case. Thoracic defect and abdominoschisis (either infraumbilical or supraumbilical) associated with visceral eventration, placental-umbilical cord anomalies, and limb defects were detected in the other 5 cases. Aberrant development of each of the 4 embryonic folds (cephalic, 2 lateral abdominal, and caudal) associated with faulty umbilical ring development and placental formation were considered responsible for development of various malformations. In previous clinical classifications, existence or absence of the craniofacial malformation was utilized as an unique discriminating criterion while multiple anomalies exist. In this report, we propose a new clinical classification concerning almost all anomalies caused by defective placental attachment and maldevelopment of the 4 folds.
Bu araştırmanın amacı, ergenlerin cinsiyet ve öğrenim kademesine göre bilişsel esneklik düzeyleri ile karar stratejileri arasında anlamlı bir fark olup olmadığını incelemektir. Araştırmanın örneklemi, 15-20 yaşları arasında, 538 kız, 472 erkek öğrenci olmak üzere toplamda 1010 öğrenciden oluşmaktadır. Araştırmada Bilişsel Esneklik Ölçeği ve Karar Stratejileri Ölçeği kullanılmıştır. Katılımcıların cinsiyet değişkeni açısından bilişsel esneklik düzeylerine göre mantıklı ve kararsızlık stratejileri alt ölçeği puanları aritmetik ortalamaları arasında anlamlı farklılıklar olduğu, içtepisel ve bağımlı karar verme alt ölçeği puanları aritmetik ortalamaları arasında anlamlı farklılıklar olmadığı görülmektedir. Katılımcıların öğrenim kademesi değişkeni açısından bilişsel esneklik düzeylerine göre içtepisel, mantıklı ve bağımlı karar verme stratejileri alt ölçeği puanları aritmetik ortalamaları arasında anlamlı farklılıklar olduğu, kararsızlık stratejisi alt ölçeği puanları aritmetik ortalamaları arasında anlamlı farklılıklar olmadığı görülmektedir. Araştırma sonucunda bilişsel esneklik düzeyleri arttıkça mantıklı karar verme puanlarının da arttığı; ancak bilişsel esneklik düzeyi arttıkça içtepisel, bağımlı ve kararsızlık stratejileri puanlarının azaldığı görülmektedir. Katılımcıların cinsiyet ve öğrenim kademesi değişkenlerinin bilişsel esneklik düzeylerinin ortak etkileşiminin ise karar stratejileri puanları aritmetik ortalamaları üzerinde anlamlı bir farklılık oluşturmadığı görülmektedir.
We report a case of a rare, unusual benign tumor, the cotyledonoid leiomyoma or Sternberg tumor, detected incidentally in a 67-year-old woman who underwent total hysterectomy and bilateral salpingo-oophorectomy because of a persisting left ovarian cyst of 5 cm. This is the 14th case of cotyledonoid leiomyoma and 2nd case which had no intrauterine portion but had extrauterine extensions. At laparotomy, it was detected that a deep red nodular papillary tumor had been dissecting the posterior leaf of the left broad ligament, projecting into the abdominal cavity just near the left cornu of the uterus, and extending in downward direction. The remaining portion was lying between the layers of the left broad ligament and arose from the subserosa of the left side of the uterine isthmus. Although the bizarre and unusual shape was in favor of malignity, the frozen-section examination revealed a benign histology. Although the cotyledonoid leiomyoma is a benign entity, it may suggest a malignant disease owing to its unusual sarcomatoid appearance and its rarity. Therefore, awareness of obstetricians and gynecologists regarding this rare entity will prevent unnecessary anxiety and interventions.
A 29-year-old female patient who was being followed up for differentiated papillary thyroid carcinoma was referred to us for exploration of any possible metastasis since her serum thyroglobulin levels were high. The patient underwent an F-18 fluorodeoxyglucose positron emission tomography study, and a pathologically increased FDG uptake at the left lower abdomen was detected corresponding to a solid, cystic lesion on CT images. The patient had a history of primary amenorrhea and, together with the magnetic resonance imaging findings of absent uterus, short and blind end vagina, a diagnosis of androgen insensitivity syndrome was made. The patient underwent laparoscopic left pelvic mass resection, and the histopathology of the lesion revealed Sertoli-Leydig cell tumor.
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