Erdogan Aslan

Intima-media thickness of the carotid arteries is related to serum osteoprotegerin levels in healthy postmenopausal women

Abstract Osteoprotegerin (OPG) regulates bone mass by inhibiting osteoclast differentiation and activation, and also plays a role in vascular calcification. The objective of this study was to evaluate the relationship between serum OPG levels, and carotid artery intima-media thickness (IMT) and carotid plaque formation in healthy postmenopausal women. We recruited 68 healthy postmenopausal women for the study. Carotid plaque presence and IMT were evaluated by high resolution B-mode ultrasound. IMT was positively correlated with presence of plaque, age, menopause age and OPG, and inversely correlated with Apolipoprotein A1 (Apo A1). Serum OPG level was positively correlated with IMT (r = 0.366; p < 0.003) and age (r = 0.324; p < 0.008), and negatively correlated with Apo A1 (r = –0.481; p < 0.0001). We did not observe any significant relation between plaque occurrence and levels of serum OPG. In regression analysis OPG (p < 0.02) and menopause age (p < 0.05) were independent risk factors for IMT, and age (p < 0.05) and IMT (p < 0.05) were independent risk factors for plaque formation. Although the role of OPG in the vascular biology is poorly understood, our results suggest that elevated levels of serum OPG is associated with IMT and may play a role in the pathogenesis of atherosclerotic disease.

Elevated plasma homocysteine levels in gestational diabetes mellitus

Objective.  This prospective study investigated the occurrence of hyperhomocysteinemia in a population of patients with gestational diabetes. The aim was to determine whether elevated plasma homocysteine is associated with gestational diabetes in Turkish women.

Vulvar syringoma aggravated by pregnancy

Syringoma is a benign tumors of eccrine sweat gland. They appear as multiple, tiny, firm, skin-colored papules. Vulvar involvement of syringoma is rare. Only 24 cases with vulvar syringoma have been previously reported in the literature. The majority of patients with vulvar syringomas are asymptomatic. A case of syringoma of the vulva exacerbated during pregnancy is presented. The case appears remarkable for the experienced aggravated pruritic symptoms of the patient during her pregnancy.

Fructus agni casti and bromocriptine for treatment of hyperprolactinemia and mastalgia

Hyperprolactinemia is the most common endocrine disorder of the hypothalamic–pituitary axis w1x. Research has proven that there is a causal connection between latent hyperprolactinemia and mastalgia w2x. The aim of this study was to investigate fructus agni casti as treatment for mild hyperprolactinemia and for mastalgia, and to compare its efficacy with that of bromocriptine (dopamine agonist ) therapy. This prospective study involved 40 women with cyclic mastalgia (Group 1) and 40 with mild hyperprolactinemia(Group 2). With respect to mastalgia, the exclusion criteria were purulenthemorrhagic breast discharge, severe endocrinopathy, malignancy, and requirement for breast surgery, simultaneous treatment with analgesics or non-steroidal antiphlogistics, pregnancy, lactation. With respect to hyperprolactinemia, the exclusion criteria were macroadenoma, other forms of endocrinopathy, and iatrogenic hyperprolactinemia due

Expression of vascular endothelial growth factor (VEGF), hypoxia inducible factor 1 alpha (HIF-1α), and transforming growth factors β1 (TGFβ1) and β3 (TGFβ3) in gestational trophoblastic disease

The aim of this study was to investigate the relationship between the expression of vascular endothelial growth factor (VEGF), transforming growth factor beta (TGF-beta1 and TGF-beta3), and hypoxia inducible factor 1 alpha (HIF-1alpha) in gestational trophoblastic diseases to highlight the possible histogenesis. Twenty-one partial hydatidiform moles (PHM), 19 complete hydatidiform moles (CHM), 13 choriocarcinomas, and 20 nonhydropic spontaneous abortions (control group) were evaluated with immunohistochemistry using VEGF, HIF-1alpha, TGFbeta1, and TGFbeta3. The extent of immunohistochemical positivity (0%=0, 1-24%=1, 25-49%=2, 50-74%=3, and greater than 75%=4) and intensity (no staining=0, weak staining=1, medium staining=2, and strong staining=3) were recorded. The expression of VEGF in spontaneous abortions and choriocarcinoma was higher than the expression in PHM and CHM. HIF-1alpha was strongly expressed in the choriocarcinomas compared to the other subgroups. Nonhydropic spontaneous abortions (control group) showed the highest TGFbeta1 expression levels among the case subgroups, followed by PHM, CHM, and choriocarcinoma (p<0.001). The expression of TGFbeta3 was seen in all groups, but the highest level of expression was observed in both CHM and choriocarcinoma. We conclude that higher levels of VEGF, HIF-1alpha, and TGFbeta3 expression in choriocarcinoma might be involved in the development of trophoblastic diseases.

Original ArticleExpression of vascular endothelial growth factor (VEGF), hypoxia inducible factor 1 alpha (HIF-1α), and transforming growth factors β1 (TGFβ1) and β3 (TGFβ3) in gestational trophoblastic disease

The aim of this study was to investigate the relationship between the expression of vascular endothelial growth factor (VEGF), transforming growth factor beta (TGF-beta1 and TGF-beta3), and hypoxia inducible factor 1 alpha (HIF-1alpha) in gestational trophoblastic diseases to highlight the possible histogenesis. Twenty-one partial hydatidiform moles (PHM), 19 complete hydatidiform moles (CHM), 13 choriocarcinomas, and 20 nonhydropic spontaneous abortions (control group) were evaluated with immunohistochemistry using VEGF, HIF-1alpha, TGFbeta1, and TGFbeta3. The extent of immunohistochemical positivity (0%=0, 1-24%=1, 25-49%=2, 50-74%=3, and greater than 75%=4) and intensity (no staining=0, weak staining=1, medium staining=2, and strong staining=3) were recorded. The expression of VEGF in spontaneous abortions and choriocarcinoma was higher than the expression in PHM and CHM. HIF-1alpha was strongly expressed in the choriocarcinomas compared to the other subgroups. Nonhydropic spontaneous abortions (control group) showed the highest TGFbeta1 expression levels among the case subgroups, followed by PHM, CHM, and choriocarcinoma (p<0.001). The expression of TGFbeta3 was seen in all groups, but the highest level of expression was observed in both CHM and choriocarcinoma. We conclude that higher levels of VEGF, HIF-1alpha, and TGFbeta3 expression in choriocarcinoma might be involved in the development of trophoblastic diseases.

Moclobemide in the treatment of hot flashes in postmenopausal women

This randomized, prospective, double-blind study evaluated the efficacy and tolerability of moclobemide, a reversible, selective inhibitor of monoamine oxidase-A, in reducing the frequency and severity of hot flashes. Thirty post-menopausal women were enrolled, and 28 were allocated to 5 weeks of treatment with moclobemide 150 mg (group 1, n = 10), moclobemide 300 mg (group 2, n = 11), or placebo (group 3, n = 9). Data on hot flashes were recorded in a daily diary. Mean reductions in the hot flash severity score were 24.4% in the placebo group, 69.8% in group 1, and 35.0% in group 2. This large difference suggests that the beneficial effects were not due to a placebo effect. Moclobemide may be a new nonhormonal option for reducing the incidence, severity, and duration of hot flashes in postmenopausal women who do not wish to take estrogen or have contraindications to its use.

Spontaneous Regression and Reaccumulation of Pleural Effusion in a Fetus

Isolated pleural effusion is rare and occurs when varying degrees of fluid surround the fetal lung without concomitant hydrops. The effusion may regress spontaneously, remain stable in size, or progress to involve both sides of the chest causing fetal hydrops. This may result in pulmonary hypoplasia and fetal or neonatal demise. In this article, we report a case in which spontaneous resolution of an isolated right-sided fetal pleural effusion occurred at 23 weeks of gestation and reappeared bilaterally at 34 weeks. Serial ultrasonographic evaluation of the fetus should be continued even if a spontaneous resolution of a preexisting pleural effusion has occurred.

Effects of lumbar disc surgery on bone mineral density in women with lumbar disc disease.

This prospective study evaluated 60 reproductive-age and postmenopausal women with lumbar disc disease to demonstrate the short-term effects of lumbar disc surgery on bone mineral density (BMD). Lumbar BMD was measured preoperatively and 3 months postoperatively by dual-energy X-ray absorptiometry (DEXA). Surgery was performed at only one level (L3-L4) and consisted of partial hemilaminectomy, discectomy, and, if necessary, partial facetectomy. Before surgery, 50% of the patients had osteopenia, and 31.7% had osteoporosis. After surgery, BMD decreased 5.5% in L3 vertebrae (P=.07), 14% in L4 vertebrae (P=.003), and 4.6% in L1-L4 (P=.039). Six of 11 patients with normal BMD before surgery became osteopenic postoperatively; 9 of 30 women with osteopenia fulfilled criteria for osteoporosis after surgery. Reproductive-age and postmenopausal women undergoing surgery for lumbar disc disease are at risk of bone loss and should be spared an extensive procedure, which can further increase the amount of bone lost. All women for whom a surgical intervention is planned should be evaluated by DEXA preoperatively and postoperatively.