Dilek Benk Silfeler

Mature cystic teratomas in our series with review of the literature and retrospective analysis

PurposeMature cystic teratomas are the most common benign ovarian neoplasms. Our aim is to analyse these cases by pathologic and clinical findings in our centre with the view of updated knowledge.Materials and methodsIn our study, 50 case reports diagnosed as mature cystic teratoma (or dermoid cyst) in Mustafa Kemal University Pathology Laboratory between 2005 and 2010 have been reviewed.ResultsOf 50 cases, the findings on mature cystic teratomas were as follows: the number of tumours located at the right ovary was 22, the left ovary, 23, with 5 cases bilaterally. Age range was 14–58 with mean rate 35.4. In two cases, tumour markers were high, one case presented with torsion; one case was obtained incidentally during delivery.ConclusionMature cystic teratomas are benign neoplasms with low malign transformation rate. Our series are low in number but our findings show the dynamic nature of these tumours.

Relationship of red cell distribution width with the presence and severity of preeclampsia.

Aim: Although the relationship between red cell distribution width (RDW) and hypertension has been well documented, there is an absence of data on the association between RDW and preeclampsia. In the present study, we have aimed to investigate the correlation of RDW with preeclampsia and its severity. Methods: The study population consisted of 52 (35 mild and 17 severe) patients with preeclampsia and 50 control pregnancy patients. For the entire study population, baseline RDW was measured using an automatic blood counter. Results: Although there were no significant differences between the preeclampsia group and the control group in terms of hemoglobin and platelet counts, the RDW (14.1 ± 1.1 vs 16.9 ± 1.7, P < .001), systolic and diastolic blood pressure, proteinuria, white blood cell, and high-sensitivity C-reactive protein levels were significantly higher in the preeclampsia group. Moreover, subgroup analysis revealed that RDW levels were significantly increased in patients with severe preeclampsia when compared to the patients with mild preeclampsia (18 ± 1.5 vs 16.4 ± 1.5, P < .001). Conclusion: Our study results revealed that RDW levels were associated with both the presence and the severity of preeclampsia.

Protective Effects of Colchicine in an Experimental Rat Endometriosis Model Histopathological Evaluation and Assessment of TNF-α Levels

Objective: Endometriosis is an estrogen-dependent chronic inflammatory disease observed in reproductive period. The aim of the present study is to assess the efficacy of colchicine, widely used to treat many inflammatory diseases, in an experimental rat endometriosis model. Study Design: Experimental endometriosis was constituted with implantation of autogenous endometrial tissue. Rats were divided randomly into 2 groups as colchicine group (n = 8) and control group (n =8). Although oral 0.1 mg/kg colchicine was administered 4 weeks to the colchicine group, the same amount of saline solution was administered to the control group. Before and after 30 days of treatment period, peritoneal and tissue tumor necrosis factor α (TNF-α), the volumes and histopathological properties of the implants were evaluated. Results: Although the implant volume decreased significantly in the colchicine group (89.2 ± 13.4 mm3 to 35.2 ± 4.5 mm3, P < .05), the implant volume increased in the control group (85.1 ± 14.2 mm3 to 110.3 ± 10.5 mm3, P < .05). When compared to the control group, the colchicine group had significantly lower histopathologic sores (1.4 ± 0.2 vs 2.6 ± 0.4, P < .001). Although peritoneal fluid TNF-α levels were significantly decreased in the colchicine group (45.2 ± 5.3 pg/mL vs 12.1 ± 5.2 pg/mL, P < .001), the peritoneal fluid TNF-α levels were significantly increased in the control group after the treatment (44.2 ± 3.5 pg/mL vs 61.3 ± 12.2 pg/mL; P < .001). Tissue TNF-α levels were significantly lower in the colchicine group when compared to the control group (45.4 ± 8.6 pg/mL vs 71.3 ± 11.2 pg/mL; P < .001). Conclusion: Colchicine resulted in regression of endometrial implant volumes in experimental rat endometriosis model and decreased peritoneal and tissue TNF-α levels.

Evaluation of Mean Platelet Volume values in lean women with polycystic ovary syndrome.

Objective: Mean Platelet Volume (MPV) is an important indicator of platelet activation. It is known that MPV increases in patients with coronory artery disease, diabetes mellitus, atherosclerosis and Polycystic ovary syndrome (PCOS). Our aim was to measure the MPV in lean patients with polycystic ovary syndrome. Methods: The present study was designed to examine the platelet function by measuring MPV in non-obese women with PCOS. A total of 50 outpatients with PCOS were included. The control group consisted of 50 healthy subjects. Serum platelet, MPV, and white blood cell (WBC) levels were compared and evaluated retrospectively in all participants. These values were compared by statistical analysis. Results: There were no statistically significant difference in between groups regarding MPV (p═0.357), WBC (p═0,414) and platelet (p═0,666). Conclusion: There are studies implying MPV increase in PCOS patients, in our patients MPV levels did not correlate with PCOS except for patients with obesity. We think that PCOS itself has no effect on MPV levels and obesity changes MPV levels.

Does Polycystic Ovary Syndrome Itself Have Additional Effect on Apelin Levels

Objective. The present study was designed to compare serum levels of apelin between lean PCOS women and healthy women with regular menses. Study Design. A total of 30 lean patients with PCOS and 30 healthy subjects were included in this study. Serum apelin levels were compared between groups. Results. Serum apelin levels in lean PCOS patients were not significantly different from the control subjects. Conclusion. Our findings indicate that PCOS itself does not seem to change apelin levels. Further investigation on a large number of subjects will need to be conducted to prove the consistent or variable association in PCOS.

Increased density of Demodex folliculorum mites in pregnancies with gestational diabetes.

Objective: To investigate the presence of Demodex in patients with gestational diabetes and the impact of glucose regulation on Demodex density in gestational diabetes. Subjects and Methods: The study population consisted of 33 patients with gestational diabetes and 30 pregnant women without gestational diabetes (control group). The age, parity, gestational age, and BMI of the study group were recorded and the patients were divided into 2 groups, i.e. those with regulated and unregulated glucose levels, according to their postprandial 1st- and 2nd-hour glucose values. A standardized skin surface biopsy method was used to determine if patients had Demodex folliculorum infestation (>5 mites/cm2 of skin). Results: Patients with gestational diabetes had a statistically significantly higher Demodex density compared to the control group (24.2 vs. 3.3%; p < 0.001). Furthermore, a significantly higher proportion of gestational diabetes patients with unregulated glucose levels had a higher Demodex density compared to those in the regulated subgroup (6/19 vs. 2/14; p = 0.001). Conclusion: Our study revealed that the Demodex density was increased in gestational diabetes patients. Further, poor glucose regulation could be the mechanism responsible for the increased Demodex density in gestational diabetes patients with unregulated glucose levels compared to those with regulated glucose levels.

The incidence of preeclampsia in ICSI pregnancies.

Objective: We aimed to evaluate the association between infertility etiology in ICSI pregnancies and preeclampsia; besides, we aimed to discuss the effect of the paternal factor in the pathogenesis of preeclampsia. Hypothesis:We hypothesized that preeclampsia is more common in ICSI pregnancies with male factor. It is known that maternal exposure to paternal sperm cells over a time period has a protective effect against preeclampsia. Male partners with azospermia have no sperm cells in their seminal fluid, whose female partners will not be able to develop some protective immunity against preeclampsia. We hypothesized that the infertile couples with male factor (partner with azoospermia and also oligospermia) would be an ideal model to test the partner-specific protective immunity against preeclampsia, as the women had no chance to develop adequate protective immunity via the partner’s sperm exposure. Methods: This Single-center, retrospective study included 508 infertile couples admitted to our IVF center between January 2001 and March 2008. The data regarding the maternal age, etiology of the infertility, the pregnancy rates, abortus ratio and viable pregnancy rates was collected from the case files. Antenatal complications such as preeclampsia, placenta previa, abruptio placenta, premature rupture of membranes, premature labor, oligohydramnios, gestational diabetes, postmaturity, postpartum complications and neonatal outcomes were evaluated via the file records and phone interviewing. The study population was divided into two main groups according to the etiology of infertility. 301 of the study population (group 1) was infertile due to male factor and 207 of the study population (group 2) was female factor and unexplained infertility cases.Group 1 patients were divided further into two subgroups: group 1a included 56 cases in which TESE (testicular sperm extraction) was used to obtain the sperm cells as the male factor was severe and as there was no sperm cells in seminal fluid. Group 1 b consists of 245oligospermic cases who obtained sperm cells via conventional methods. Results: The mean ages of women in Group one and two were 30.22±5.06 and 31.58±4.36 years respectively (p=0.001). 129 cases (42,8%) from group one and 106 cases (51,2%) from Group two ended in first trimester and early second trimester (<24 gestational weeks) pregnancy loss. In group one, only 172 cases of 301 pregnancies passed over 24 weeks of gestational age, whereas in group two, 101 cases of 207 patients passed over 24 gestational weeks. There was no significant difference between two groups regarding chemical pregnancies and early pregnancy loss (p=0.314). There was no significant difference between the groups regarding placenta previa, gestational diabetes, oligo hydramnios and intrauterine growth retardation. One one pregnancy was 1.5 times more vulnerable for preeclampsia. Conclusion: Pregnancies with azoospermic and oligospermic partners had an increased risk for developing preeclampsia.

Zofenopril attenuates injury induced by ischemia‐reperfusion on rat ovary

The aim of the study was to investigate the effectiveness of zofenopril in an experimental model of ovarian torsion in rats with histologic and biochemical assessments.

Menopausal cardiomyopathy: Does it really exist? A case-control deformation imaging study

We aimed to evaluate and compare the left ventricular (LV) functions of pre‐ and postmenopausal women at similar ages with none of the known cardiovascular risk factors, by both conventional and advanced echocardiographic methods such as 2‐D strain imaging via speckle tracking echocardiography.

HELLP Syndrome Complicated by Subcapsular Hematoma of Liver: A Case Report and Review of the Literature

Subcapsular liver hematoma (SLH) is a rare complication of severe preeclampsia and HELLP syndrome. These patients must be followed up in intensive care unit for advanced medical support with infused fluid, replacement of blood products, and treatment of underlying disorders. There are a lot of therapeutic options varying from conservative management to surgical treatment including hepatic resection, hepatic artery ligation, and liver transplantation. In this report we aimed to present a 26-year-old woman with SLH secondary to HELLP syndrome.