[Show abstract][Hide abstract] ABSTRACT: Aim: The aim of this study was to investigate the effect of vitamin C on the growth of experimental endometri-otic cysts. Material and Methods: The endometrium of the uterine horn wall (diameter, 4 mm) was implanted onto the inner surface of the anterior abdominal wall of 40 Wistar albino adult female rats, by laparotomy. The day after the implantation, the rats were randomly assigned into four groups (control group and experimental groups [V1, V2, and V3]) comprising 10 rats each. For 6 weeks, the control group (Group C) received 1 mL distilled water, whereas the experimental groups (Groups V1, V2, and V3) received 0.5 mg, 1.25 mg, and 2.5 mg of vitamin C in 1 mL of distilled water, respectively. The doses were given via oral gavage once per day. At the end of the administration, a second laparotomy was performed and endometriotic cyst volumes and weights of rats among the groups were compared. In addition, the stromal and glandular tissue and the natural killer cell contents of the cysts were compared among the groups. Results: The cyst volume in Group V3 and the cyst weights in Groups V2 and V3 were significantly lower than those in Group C. The natural killer cell content in Groups V1, V2, and V3 was significantly lower than that in Group C. Stromal and glandular tissue contents of the groups were not significantly different. Conclusions: The dose-dependent vitamin C supplementation significantly reduced the volumes and weights of the endometriotic cysts.
[Show abstract][Hide abstract] ABSTRACT: Aim:
The aim of this study was to investigate the effect of vitamin C on the growth of experimental endometriotic cysts.
Material and methods:
The endometrium of the uterine horn wall (diameter, 4 mm) was implanted onto the inner surface of the anterior abdominal wall of 40 Wistar albino adult female rats, by laparotomy. The day after the implantation, the rats were randomly assigned into four groups (control group and experimental groups [V1, V2, and V3]) comprising 10 rats each. For 6 weeks, the control group (Group C) received 1 mL distilled water, whereas the experimental groups (Groups V1, V2, and V3) received 0.5 mg, 1.25 mg, and 2.5 mg of vitamin C in 1 mL of distilled water, respectively. The doses were given via oral gavage once per day. At the end of the administration, a second laparotomy was performed and endometriotic cyst volumes and weights of rats among the groups were compared. In addition, the stromal and glandular tissue and the natural killer cell contents of the cysts were compared among the groups.
The cyst volume in Group V3 and the cyst weights in Groups V2 and V3 were significantly lower than those in Group C. The natural killer cell content in Groups V1, V2, and V3 was significantly lower than that in Group C. Stromal and glandular tissue contents of the groups were not significantly different.
The dose-dependent vitamin C supplementation significantly reduced the volumes and weights of the endometriotic cysts.
Journal of Obstetrics and Gynaecology Research 05/2013; 39(7). DOI:10.1111/jog.12050 · 0.93 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to measure interleukin-6 (IL-6) levels in maternal serum of women undergoing preterm labor without a clear infection.
Twenty two pregnant women with diagnosis of preterm labor who presented to the outpatient clinic of 19 Mayis University Faculty of Medicine from July 2011 through December 2011 were enrolled in the study group. Twenty two healthy pregnant women who were at the same gestational age as the study group were selected as the control group.
Gestational age in the study and control groups varied from 24 weeks and 4 days to 34 weeks and 6 days. In the study group, 11 patients (50%) underwent preterm birth. Pregnant women in preterm labor were compared to healthy pregnant women with regards to serum IL-6 levels. No significant difference was found in the IL-6 levels of maternal serum between the 2 groups.
In this study we have shown that there is no increase in lL-6 levels in patients undergoing preterm labor without clinical or biochemical infection signs.
Ginekologia polska 05/2013; 84(5):368-72. DOI:10.17772/gp/1591 · 0.60 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To evaluate the predictive value of random serum anti-Müllerian hormone (AMH) in the assessment of ovarian response in patients with diminished ovarian reserve (DOR; diagnosed after the observation of elevated baseline levels of early follicular follicle-stimulating hormone [FSH]) who were undergoing intracytoplasmic sperm injection-embryo transfer (ICSI-ET) and to compare the random serum AMH and baseline FSH levels in these patients for the prediction of poor ovarian response.
One hundred and thirty-nine patients who were undergoing ICSI-ET cycles with early follicular FSH level >9 IU/mL.
Poor ovarian response in ICSI-ET cycles.
For the identification of women at risk of cycle cancellation, an AMH cut-off level ≤1.2 ng/mL had 97.3 % sensitivity, 31.3 % specificity, 33.9 % positive predictive value, and 96.9 % negative predictive value in the women with high baseline FSH levels. An AMH cut-off level ≥1 ng/mL had a sensitivity of 58.7 % and specificity of 95.1 % for prediction of retrieval of 4 or more oocytes. By using a serum AMH cutoff level of 1.5 ng/mL, the ongoing pregnancies were predicted with 83.3 % sensitivity and 82.5 % specificity and yielded a positive predictive value of 31.2 % and a negative predictive value 98.1 %.
Measurement of random serum AMH level is a useful tool in the prediction of ovarian response in patients with high serum early follicular FSH levels.
Journal of Assisted Reproduction and Genetics 05/2012; 29(8):797-802. DOI:10.1007/s10815-012-9794-y · 1.72 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To investigate if it was necessary to dilate the cervix routinely during elective cesarean section and to determine the effects of this traditional maneuver on maternal morbidity.
A total of 150 patients meeting eligibility criteria were enrolled in this prospective, randomized controlled study. Patients were allocated randomly into cervical dilatation group or non-dilated group. In the cervical dilatation group, the surgeon performed cervical dilatation by inserting a double-gloved index finger into the cervical canal of the patients after extraction of placenta and membranes. Endometrial cavity thickness of the patients at postoperative 24 h, development of postoperative febrile-infectious morbidity and postoperative hemoglobin levels were evaluated and compared between the groups.
The two groups were comparable with regard to demographic and clinical properties. Mean postoperative endometrial cavity thickness of the dilated group was significantly less than the non-dilated group (6.87 ± 2.50, 9.51 ± 3.35 respectively, p < 0.0001). The level of hemoglobin reduction was comparable between the groups (p = 0.37). Febrile morbidity was seen in one patient in the dilated group. Endometritis or wound infection was not encountered in either group during the puerperium.
Cervical dilatation seems to be an unnecessary intervention during the cesarean section.
Archives of Gynecology 07/2011; 284(1):85-9. DOI:10.1007/s00404-010-1608-9 · 1.36 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We present a case of squamous cell carcinoma arising in the neovagina of a woman in whom we performed vaginoplasty 20 years before. To the best of our knowledge, this is the 23rd case of total carcinoma arising in the neovagina constructed because of vaginal agenesis, and the 3nd case of carcinoma arising in the neovagina performed without using a graft.
European journal of gynaecological oncology 01/2011; 32(5):588-9. · 0.61 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Peritoneal tuberculosis predominantly involves the omentum, intestinal tract, liver, spleen, and genitourinary tract and occurs in 1-4% of patients with pulmonary tuberculosis. Peritoneal tuberculosis may mimic a pelvic mass in imaging studies and also may increase CA-125 levels. Peritoneal tuberculosis may also produce massive ascites, and intraperitoneal gross appearance might be similar to the peritoneal carcinomatosis. Therefore, peritoneal tuberculosis is often confused with advanced-stage epithelial carcinoma because of similar clinical, radiologic, and laboratory findings and later intraoperative findings.
The pathology records between January 2000 and August 2008 were retrospectively reviewed at 19 Mayis University Hospital. Twenty-two patients were found to have peritoneal caseating necrosis. A total of 13 out of 22 patients were found to have high CA 125 level.
Among these 13 patients, 8 patients received/are receiving anti-tuberculous therapy after they were incidentally diagnosed with peritoneal tuberculosis.
Increased CA 125 levels should be evaluated carefully prior to aggressive surgical approach, especially in premenopausal women and frozen section evaluation should be done before extensive surgical procedure if there is any suspicion.
Archives of Gynecology 12/2010; 282(6):639-42. DOI:10.1007/s00404-009-1283-x · 1.36 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to investigate the relationship of maternal and umbilical cord interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-alpha) serum levels with the existence and severity of preeclampsia. A particular objective was the comparison of normal umbilical serum levels to preeclamptic values.
The study group consisted of 24 patients with third trimester singleton pregnancies complicated by preeclampsia (15 severe and 9 mild preeclampsia). The gestational age-matched 19 healthy pregnant women were compared by study group. Maternal and umbilical serum IL-6, IL-8, and TNF-alpha were calculated by using enzyme-linked immunosorbent assay.
Significantly increased maternal and umbilical serum levels of IL-6, IL-8, and TNF-alpha were found in preeclamptic patient group in comparison with the control group. Maternal serum IL-8 and TNF-alpha concentration were significantly higher in patients with severe preeclampsia than in mild preeclampsia. Increased umbilical serum levels of IL-6 and IL-8 were found in severe preeclampsia than in mild preeclampsia. There were significantly higher levels of maternal serum IL-8 and TNF-alpha in patients with preeclampsia with IUGR than in patients with preeclampsia with normal fetal growth.
Our findings suggest that increased concentrations of IL-6, IL-8, and TNF-alpha in the maternal and umbilical serum play a significant role in pathogenesis of preeclampsia. Alterations in maternal and umbilical serum levels of IL-6, IL-8, and TNF-alpha may also play role in preeclampsia complicated by intrauterine growth retardation. These associations may offer insight into the etiology and pathogenesis of preeclampsia.
The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 05/2010; 23(8):880-6. DOI:10.3109/14767051003774942 · 1.37 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Fetal mediastinal cystic masses occur rarely. We present a case in which a large fetal mediastinal cystic mass was visualized at the first antenatal visit in the third trimester of pregnancy. A 4-week ultrasonographic follow-up demonstrated the slow growth of the mass until delivery, when the fetus was considered to he mature. Removal of the entire cyst was performed 8 h after abdominal delivery, and the newborn did well postoperatively. The histopathologic examination of the removed cystic mass showed an enteric cyst. We also reviewed the differentia! diagnosis of the fetal mediastinal masses.
Journal of Maternal-Fetal and Neonatal Medicine 07/2009; 3(1):14-17. DOI:10.3109/14767059409017257 · 1.37 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Congenital mesoblastic nephroma is a rare renal tumor of early infancy with a favorable outcome after complete surgical removal. It consists of a heterogeneous group of spindle cell tumors. Early and accurate prenatal diagnosis of the renal tumor may improve the outcome of affected pregnancies by implementing the best strategy for prenatal management and delivery. But detection of congenital mesoblastic nephroma in a fetus is rare. To the authors' knowledge, there are fewer than 30 reports of a prenatal diagnosis of a mesoblastic nephroma in the literature. This case describes the prenatal sonographic diagnosis of cellular congenital mesoblastic nephroma.
Journal of Diagnostic Medical Sonography 03/2009; 25(2):112-115. DOI:10.1177/8756479309333107
[Show abstract][Hide abstract] ABSTRACT: This prospective, single-blind and controlled clinical study aimed to research if CA-125 levels could be a useful test in the differential diagnosis of intact and ruptured tubal ectopic pregnancy.
Sixty-five women with tubal ectopic pregnancy of 5-10 weeks' duration (27 women with ruptured tubal ectopic pregnancy [REP] and 38 women with unruptured tubal ectopic pregnancy [UREP]) and 65 women with normal intrauterine pregnancy (NIUP) of the same gestational age were studied prospectively. Serum CA-125 levels were measured in all women and these levels were compared among the REP, UREP, and NIUP groups.
The mean CA-125 levels didn't show any significant difference between the REP and NIUP groups (P > 0.05). The mean CA-125 levels of these two groups were higher than that in the UREP group (P < 0.01, P < 0.001, respectively). The dispersion ratios of the CA-125 levels had a statistically significant difference between the REP and UREP groups (chi(2): 42.44, P < 0.0001). CA-125 levels weren't correlated with gestational weeks in the REP and UREP groups (r: 0.005, P > 0.05; r: 0.008, P > 0.05, respectively).
In intact tubal ectopic pregnancies, expectant or managed with medical treatment, the increase of CA-125 levels in the serial measurements could be a supplementary test for an early diagnosis of tubal rupture.
Journal of Obstetrics and Gynaecology Research 08/2006; 32(4):422-7. DOI:10.1111/j.1447-0756.2006.00424.x · 1.07 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To analyze the cause of changing maternal mortality ratios (MMRs) in a tertiary women's health center in Turkey in the last eight years.
Charts of patients seen between 1998 and 2005 were retrospectively reviewed. Statistical analysis was performed using the Chi-square test. The results were accepted to be significant when the p value was <0.05.
During this period, 27 pregnancy-related deaths were identified via hospital death records. The MMR was found to have decreased in rate by approximately 50% from 822.2/100,000 live births in the previous report including the years 1978-1997 to 412.0/100,000 during the last eight years (p < 0.01). Pregnancy-induced hypertension was still the most frequent cause of maternal death. The decrease in MMR was due to the decrease in the ratio of maternal infection (26.4% in 1978-1997 to 7.4% in 1998-2005, p < 0.01).
Although treatment in the antenatal care and health service has decreased maternal deaths, it was discovered that the MMR has not reached the optimum levels found in developed countries in the last eight years. Also the percentage of direct obstetric deaths (with the exception of those caused by infection) showed no change and was similar to that found in the previous report (1978-1997).
Journal of Maternal-Fetal and Neonatal Medicine 07/2006; 19(6):353-6. DOI:10.1080/14767050600647571 · 1.37 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In the present study we aimed to investigate whether basal inhibin A and B levels in women with polycystic ovary syndrome (PCOS) would be used in diagnosis of the condition. Forty women with PCOS and 40 women with normal cycles (control group) were evaluated. There was no statistically significant difference in mean age and mean body mass index between the two groups (p > 0.05). Serum levels of inhibin A and B, follicle-stimulating hormone (FSH), luteinizing hormone and total testosterone, and total ovarian volume, were determined in the PCOS group and the control group on day 3. In the PCOS group, total follicle number was obtained by counting follicles of diameter > or =2 mm in both ovaries. Results were evaluated using Student's t test, Pearson correlation and regression tests. There was no significant difference in mean basal inhibin A or inhibin B levels between the two groups. Basal inhibin B levels showed a statistically significant negative correlation with basal FSH levels and a positive correlation with total follicle number in the PCOS group (p < 0.05 and p < 0.01, respectively). We conclude that basal inhibin A or B levels cannot be used in the diagnosis of PCOS.
[Show abstract][Hide abstract] ABSTRACT: In this abdominal pregnancy, the dead fetus was delivered through an abdominal incision at the 36th gestational week. The placenta invaded the small intestine and the omentum was left in situ. The placental degeneration was monitored using serial serum beta-human chorionic gonadotropin values. In certain periods, the follow up of the placental regression was carried out using the Cavalieri method with abdominal ultrasound. It was seen that the placental volume had decreased by 83% at the end of 1 year. To the best of our knowledge, this is the first time this method has been used for this purpose.
Journal of Obstetrics and Gynaecology Research 03/2005; 31(1):22-6. DOI:10.1111/j.1447-0756.2005.00236.x · 1.07 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In this prospective clinical single blind study, we aimed to investigate whether day 3 serum inhibin B levels in women with polycystic ovarian syndrome(PCOS) are of predictive value for the estimation of the ovarian response to gonadotropins.
Ovulation induction with low dose step-up gonadotropin protocol, starting with 75 IU/day, was performed for 30 cycles on 25 patients with PCOS. Day 3 serum inhibin B, follicle-stimulating hormone(FSH) and estradiol, and midluteal serum progesterone levels were measured during each cycle. The correlations between day 3 inhibin B levels and day 3 FSH, day 3 estradiol and midluteal progesterone measurements, as well as the amount of gonadotropin required to provide an ovulatory cycle were investigated.
Five (27.8%) out of 18 cycles with day 3 inhibin levels <50.0 pg/ml; and 11 (91.7%) out of 12 cycles with levels > or = 50.0 pg/ml were ovulatory (chi(2)=9.38, p<0.01). Moreover, day 3 inhibin B levels had statistically significant negative correlation with the gonadotropin used; and significant positive correlation with the midluteal progesterone levels (p<0.05). There wasn't any significant relation between day 3 FSH and estradiol levels with the gonadotropin used and progesterone levels.
It has been observed that as day 3 serum inhibin B levels increased in women with PCOS, the ovulatory response to gonadotropins and the rate of ovulatory cycles increased significantly.
Archives of Gynecology and Obstetrics 01/2005; 270(4):255-9. DOI:10.1007/s00404-003-0557-y · 1.36 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Uterine rupture during labor, when it is in the immediate vicinity of the cervix, frequently extends transversely or obliquely. Usually the tear is longitudinal when it occurs in the portion of the uterus adjacent to the broad ligament. We report an unusual case of uterine rupture through posterior vaginal fornix of the posterior lower uterine segment.
Journal of Maternal-Fetal and Neonatal Medicine 12/2004; 16(5):295-6. DOI:10.1080/14767050400018171 · 1.37 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The object of this study was to compare the effects of oral conjugated estrogen (CEE) alone, CEE plus medroxyprogesterone acetate (MPA) and tibolone on lipid profiles, and investigate whether these effects change in time. Plasma lipid levels were studied for CEE (n = 49), CEE + MPA (n = 50) and tibolone (n = 51). Mean per cent changes at certain intervals were compared with their previous intervals for each therapy. Paired t-test was used for statistical analysis. CEE alone had raised high-density lipoprotein (HDL) and triglyceride levels and lowered total cholesterol and low-density lipoprotein (LDL) levels at the end of the 2-year study period. Addition of MPA to the CEE regimen weakened the effect on HDL and triglyceride, augmented the decrease in total cholesterol and did not affect LDL. The tibolone group revealed similar but more prominent effects in total cholesterol and LDL levels. HDL and triglyceride levels were significantly below baseline in the first 6 months, but HDL changes vanished and triglyceride levels remained decreased at the end of 2 years. These data did not support a correlation between lipid levels and the biphasic incidence of cardiac events that were observed in the Heart and Estrogen/progestin Replacement Study (HERS), but revealed period-dependent changes in the tibolone group.