Ayşe Filiz Yavuz

Evaluation of oxidative stress markers and intra-extracellular antioxidant activities in patients with endometriosis.

OBJECTIVE The aim of the study is to evaluate alterations in intracellular and extracellular antioxidant enzymes activities and serum oxidative stress markers in patients with endometriosis. STUDY DESIGN The current prospective study consisted of 31 female patients with endometriosis and 27 healthy controls. Serum total thiol, native thiol, disulphide, catalase, myeloperoxidase, and ceruloplasmin concentrations were measured. Laboratory and clinical data of all participants were recorded to compare the differences between the study and the control groups. RESULTS Serum native thiol and total thiol levels in the study group were significantly lower than those in the control group [(p=0.009, p=0.03, respectively)]. Serum catalase levels are significantly higher in patients with endometriosis comparing to the control group (p=0.009). CONCLUSIONS The finding that significant differences in serum total thiol, native thiol, and catalase levels observed in endometriotic patients supports that oxidative stress carries weigh in the pathophysiological aspects of endometriosis. Also significantly low levels of extracellular antioxidants and significantly high levels of intracellular antioxidants in endometriotic patients may arise from differences of free radicals in endometriosis and the activity levels of endometriosis. These non-invasive serum markers might give us an opportunity to monitor the diseases progress during the treatment.

Is postmenopausal endometrial fluid collection alone a risk factor for endometrial cancer

Objective: To determine the usefulness of single-layer, ultrasonographic measurement of endometrial fluid collection (EFC) volume to predict endometrial pathology in asymptomatic postmenopausal patients. Methods: One hundred fifty asymptomatic postmenopausal women were analysed retrospectively from January 2012 to December 2016. After patients with endometrial hyperplasia/neoplasia were included in Group-I, and those with insufficient tissue, endometrial atrophy, or endometritis were included in Group-II; Groups one and two were compared with respect to primary (correlations between endometrial thickness and EFC volume) and secondary (correlations between demographic characteristics and EFC volume) outcomes. Results: There was no correlation between EFC volume and single-layer endometrial thickness (P = 0.36). Likewise, demographic characteristics were not related to EFC (P > 0.05). However, both EFC volume and single-layer endometrial thickness were thicker in Group-I compared to Group-II (4.8 ± 1.9 mm vs. 3.7 ± 2.5 mm; and 5.7 ± 9.4 mm vs. 2.7 ± 2.5 mm, respectively) (P values were < 0.05). Conclusion: Although a cutoff value for endometrial thickness and EFC volume could not be recommended based on our study findings, it should be noted that 2% is a clinically significant rate of malignancy. Thus, postmenopausal patients with EFC should be evaluated for endometrial sampling.

The prognostic significance of preoperative serum cancer antigen 15-3 levels in endometrial carcinomas

Objectives: To determine the associations between serum cancer antigen 15-3 levels and prognostic factors in patients with endometrial carcinomas. Additionally, we investigated the clinical utility of serum cancer antigen 15-3 levels in the selection of low-risk patients with endometrioid type, tumor size <2 cm, myometrial invasion ≤50%, and histological grade 1-2. Methods: Ninety-six patients, who were surgically staged at Ankara Yildirim Beyazit University, Ankara, Turkey, between 2007 and 2016, were retrospectively analyzed. Demographic, clinical, and surgical characteristics were retrieved from the patients’ hospital records. A p<0.05 was considered significant. Results: Fifteen patients had advanced (≥Stage II) disease, 14 patients had Type 2 histology, 20 patients had Grade 3 tumors, 23 patients had lymphovascular space invasion, and 10 patients had positive lymph node involvement. Serum cancer antigen 15-3 levels were significantly higher in patients with advanced (≥Stage II) disease, Type 2 histology, Grade 3 tumors, lymp°hovascular space invasion, and positive lymph node involvement (p<0.05). Serum cancer antigen 15-3 levels were also significantly correlated with tumor size (p=0.006). Serum cancer antigen 15-3 levels were significantly lower (95% confidence interval: 0.57−0.79; p=0.03) in low-risk patients compared to other endometrial carcinoma patients. A cutoff of 25.0 IU/mL was used to identify high-risk patients with a specificity of 100%. Conclusion: Serum cancer antigen 15-3 levels significantly correlated with prognostic factors and were a useful diagnostic tool for endometrial carcinomas.

Soluble urokinase-type plasminogen activator receptor (suPAR) and interleukin-6 levels in hyperemesis gravidarum

Background: The aim was to compare serum soluble urokinase‐type plasminogen activator receptor (suPAR) levels as well as interleukin‐6 levels (IL‐6) in pregnant women with hyperemesis gravidarum (HG) and asymptomatic pregnant women. Methods: Our study population consists of voluntary first trimester‐pregnant women who applied to the outpatient clinic of the department of obstetrics and gynecology of Ankara Ataturk Training and Research Hospital. Between February and May 2016, 60 pregnant women were included in our prospective study. Serum suPAR and IL‐6 levels were evaluated with the ELISA method. Twenty‐nine pregnant women with HG and 31 asymptomatic pregnant women were included in the study. Results: Serum suPAR level in the HG group was measured as 0.36 ± 0.56 ng/ml, whereas this level in the healthy pregnant control group was measured as 0.15 ± 0.15 ng/ml (p < 0.05). The interleukin‐6 level in the HG group was 5.69 ± 2.16 pg/ml, whereas in the control group it was measured as 3.88 ± 0.28 pg/ml (p < 0.05). Conclusion: Serum suPAR and IL‐6 levels proved to be high in the HG group. It is likely that suPAR could play a role in the etiopathogenesis of hyperemesis gravidarum.

Sonographic measurement of the fetal thymus: Relationship with maternal obesity

The purpose of this study was to evaluate the influence of maternal obesity on the size of the fetal thymus.

Altered Maternal Serum Dynamic Thiol-Disulfide Interchange Reactions in Pregnant Women with Gestational Diabetes Mellitus

OBJECTIVE: We aimed to evaluate the alteration of dynamic thiol/disulfide homeostasis which basically shows the oxidative stress in body in pregnant women with gestational diabetes mellitus (GDM) by using a newly developed and automated analysis method. STUDY DESIGN: Study population consisted of body mass index and gestational age-matched pregnant women. Patients were subdivided into 3 groups based on their response to glucose challenge test (GCT) and oral glucose tolerance test (OGTT) results: (1) control group (normal GCT test results n= 87); (2) Impaired glucose tolerance (IGT) group ( n= 37); (3) GDM group (n=25). Maternal serum thiol and disulphide levels were compared among three groups. RESULTS: Maternal serum thiol values were found decreased and maternal serum disulphide levels were increased in GDM groups were compared to control and IGT groups (Thiols for controls: 398.19±30.49 µmol/L, for IGT group 395.92±35.52 µmol/L, and for GDM group 371.89±41.14 µmol/L p= 0.002). Disulphides for controls; 17.47±4.38 µmol/L, for IGT; 19.27±3.34 µmol/L, for GDM group; 25.46±4.21 µmol/L, (p=0.001). Disulphide/thiol ratio was found to be increased in GDM group comparing to other groups (Disulphide/thiol ratio: 0.044±0.012 for controls, 0.049±0.009 for IGT group, 0.068±0.0103 for GDM group p=0.001) CONCLUSION: Thiol- disulphide balance has shifted to the oxidative side in pregnant women with GDM. So blood glucose regulation is extremely crucial for reducing the oxidative stress which may lead to damages to vital organs of a mother or possibly to development of a fetus in women with GDM.