Akın Usta

Expression of matrix metalloproteinase-1 in round ligament and uterosacral ligament tissue from women with pelvic organ prolapse

To evaluate the matrix metalloproteinase-1 (MMP-1) expression in different parts of pelvic connective tissue in postmenopausal women with and without pelvic organ prolapse (POP). Ninety-one samples were obtained from only postmenopausal women (42 with POP and 49 non-POP subjects). All women were evaluated by pelvic organ prolapse quantitation. The POP group had stage 2 or more, and the controls had stage 1 or less. Round ligament (RL) and uterosacral ligament (USL) biopsies were obtained from women with POP and controls. Immunohistochemistry for MMP-1 was performed on formalin-fixed and paraffin-embedded sections. The two groups were matched for age, body mass index, parity and postmenopausal status. MedCalc Statistical Software Programme Version 12.0.5 was used for statistical analysis. Expression of MMP-1 were significantly higher in both RL and USL tissue from postmenopausal women with POP, compared with controls. MMP-1 immunoreactivities were identified in both RL and USL biopsies from all women with and without POP. The expression pattern of MMP-1 were similar in these ligaments and were significantly higher in POP group compared with control subjects. These changes indicate a possible relation between MMP-1 expression of RL and USL in women with and without POP.

Frequency of fetal macrosomia and the associated risk factors in pregnancies without gestational diabetes mellitus

Introduction There has been an increased incidence of macrosomic newborns in the world and most of the macrosomic newborns are born from non-GDM pregnant women. The objective of this study was to determine the frequency and the associated risk factors of fetal macrosomia in non-GDM pregnant women. Methods A total 4246 consequtive pregnant women who had no GDM was included the study population. Data was collected from hospital database of Balikesir State Hospital between January 2014 and January 2015. Statistical analysis was carried out using the independent samples t-test and chi-squared test. Logistic regression analysis was used to determine the relationships between associated risk factors and the presence of fetal macrosomia. In this analysis, fetal macrosomia was taken as the dependent variable and associated risk factors were taken as independent variables. Results are shown as odds ratios (ORs) (95% CI) in the logistic regression analysis. Results 366 of the 4246 pregnant women were diagnosed with fetal macrosomia (8.6%). Compared the control women, a statistically significant correlation between fetal macrosomia and pre-pregnancy body mass index (BMI), gestational weight gain (GWG), parity, advanced maternal age, and male fetal sex was found. Maternal BMI, and GWG were the two risk factors most strongly associated with macrosomia. Conclusion The prevalance of fetal macrosomia is rising among Turkish women. High pre-pregnancy BMI and GWG represent main modifiable risk factors for macrosomia and need more attention from health care providers.

The Expression of Cyclophilin A in Ovarian Endometrioma: Its Correlation with Recurrence and Vascularity

Endometriosis is defined as the presence of functional endometrial tissues outside of the uterine cavity. Ovarian endometrioma is the most common type of endometriosis. It is an estrogen-dependent inflammatory disease that frequently causes infertility and chronic pelvic pain. Cyclophilin A (CyPA) is secreted from various types of cells in response to inflammatory stimuli. Many previous studies have shown that the increased expression and/or heightened plasma levels of CyPA exacerbates inflammation. The aim of this study is to evaluate CyPA immunoreactivity in ovarian endometrioma cyst wall. In this cross-sectional study, CyPA immunoreactivity in endometrial tissue samples obtained from uterine cavity and in endometrioma cyst walls of 44 consecutive women with ovarian endometrioma were compared with control endometrial tissue samples obtained from uterine cavity of 40 women without endometrioma. All endometrioma samples were confirmed via histopathological examination. Finally, the relationship between CyPA immunoreactivity and the clinicopathological findings related to endometrioma were evaluated. The CyPA expression rates in glandular cells, stromal cells, and the capillary endothelium were significantly higher in endometrioma cyst walls of women with ovarian endometrioma than in the control endometrial tissue of women without endometrioma (p = 0.0002, p = 0.0417 and p = 0.0067, respectively). The correlation analysis demonstrated that glandular CyPA expression was correlated with endometrioma recurrence (p = 0.0267). However, stromal and vascular endothelial CyPA expression were correlated with dysmenorrhea recurrence (p = 0.0023 and p = 0.0003, respectively). In conclusion, the increased expression of CyPA in ectopic endometrial tissue is associated with endometrioma recurrences and vascularity.

Gebeliğin ilk üç ayında rubella ve toxoplazma enfeksiyonlarının taranması

Amac: Rubella ve toxoplazma enfeksiyonlari konjenital anomalilerin baslica sebepleri arasinda yer almaktadir. Bu calismanin amaci gebelikte rubella ve toxoplazma gondii enfeksiyon oranin degerlendirilmesi ve enfeksiyonlar ile iliskili risk faktorlerinin tespitidir. Gerec ve Yontem: Bu retrospektif calismada Ocak 2014 – Aralik 2014 arasinda onceden rubella ve toxoplazma acisindan serolojik durumu bilinmeyen 2947 gebenin sonuclari degerlendirildi. Hastalarin calismaya dahil edilme kriteri olarak gebeligin ilk trimesterinde rubella ve toxoplazma enfeksiyon taramasi icin IgG ve IgM antikorlari ile degerlendirilmis olmasi alindi. Taranma icin standart bir protokol kullanildi. Bu protokolde gebelerden alinan serum orneklerinde rubella ve toxoplazma antijenine karsi IgG ve IgM antikor seviyeleri olculdu. Bulgular: Calismaya dahil edilen hastalarin hicbirinde tek basina IgM antikor pozitifligine rastlanmadi. IgM antikoru artmis olan 55 gebenin yapilan avidite degerlendirmesinde 52’sinde yuksek avidite tespit edildi ve akut enfeksiyon dislandi. Bununla birlikte rubella IgG ve IgM antikoru yuksek tespit edilen 2 gebede avidite sonucunun dusuk oldugu ve toxoplazma IgG ve IgM antikoru yuksek tespit edilen 1 gebenin avidite sonucu sinirda dusuk oldugu ve akut enfeksiyon ihtimali tespit edildi. Gebelik sonuclari acisindan degerlendirildiginde ise toxoplazma seropozitivitesi olan hastalarda abortus oranin yuksek oldugu tespit edildi. Sonuc: Gebelik oncesi serolojik durumu bilinmeyen hastalarda akut rubella ve toxoplasma gondii enfeksiyonlarinin tespiti icin enfeksiyon ajanlarina karsi IgG ve IgM antikorlarinin degerlendirilmesi ve supheli sonuclar varligimda IgG avidite testinin yapilmasi kabul edilebilir bir yaklasimdir.

Osteogenesis imperfecta Type IV: a newly identified variant at position c.560 (G > T; p.Gly187Val) in the COL1A2 gene

Osteogenesis imperfecta is a clinically heterogenous disease caused by defective collagen syntesis associated with a mutation in the COL1A1 or COL1A2 genes. In this report, we present a case of osteogenesis imperfecta (OI) type IV, seen in a female fetus with incurved femurs at 18 weeks of gestation. Molecular analysis of the newborn revealed a novel mutation at position c.560 (c.560 G > T) of the exon 12 in the COL1A2 gene; which lead to the glycine modification with valine (p.Gly187Val) at codon 187. The pregnancy follow-up was uneventful. After delivery, the newborn underwent biphosponat therapy and no fracture was detected until 1 year old.

The diagnostic value of frozen section for borderline ovarian tumours

Borderline ovarian tumours (BOTs) are characterised histologically by a low degree of cellular proliferation and nuclear atypia in the absence of infiltrative growth or stromal invasion. Surgical treatment has been a crucial component of BOT therapy. Surgical decisions are established intraoperatively via the frozen section. We evaluated the accuracy of frozen section diagnosis. The rate of correct diagnosis, underdiagnosis and overdiagnosis of BOTs with frozen sections was 78%, 17% and 5%, respectively. The sensitivity and positive predictive values for the diagnosis of BOTs with frozen sections were 82.3% and 93.3%, respectively. The positive likelihood ratio was 0.82 (95% CI: 0.85–0.96). The histological classification of BOTs had a significant effect on the accuracy of diagnosis (p = 0.001). Frozen section diagnosis is not suitable to be considered as the gold standard for a definitive diagnosis. Clinicians should be aware that using frozen sections is insufficient for the accurate staging of BOTs.

A rare coexistence of villoglandular papillary adenocarcinoma of the uterine cervix and brenner tumor of the ovary.

Synchronous primary gynecological cancers have been reported to be seen rarely in the literature. In this report, we aimed to describe a 51-year-old patient with the coexistence of villoglandular papillary adenocarcinoma of the cervix uteri and Brenner tumor in the right ovary. She successfully underwent radical hysterectomy, bilateral salphing-oopherectomy and pelvic and para-aortic lymphadenectomy.