Mehmet B. Cetinkaya

Comparison of the effects of raloxifene and anastrozole on experimental endometriosis.

OBJECTIVE To compare the efficacies of anastrozole and raloxifene on endometriosis. STUDY DESIGN A randomized, placebo-controlled, single-blind, experimental study was performed on 45 adult Wistar female rats in the Experimental Surgery Laboratory at Ondokuz Mayis University in Turkey. Endometrial tissues were implanted on the abdominal peritoneum in 45 rats. Six weeks later, the implant volumes were measured (volume-1) by performing a second laparotomy. Rats were randomized to one of three equal study groups. Saline solution (0.1 cc/rat/week, subcutaneously) was administered to group 1 (control group), anastrozole (0.004 mg/rat/day, orally) to group 2 (anastrozole group), and raloxifene (0.24 mg/rat/day, orally) to group 3 (raloxifene group) for 8 weeks. At the end of administration, a third laparotomy was performed to remeasure implant volumes (volume-2), and implants were totally excised for histopathologic examination. Volume-1 and volume-2 within the groups, as well as stromal and glandular tissues between the groups, were compared. RESULT(S) In the anastrozole and raloxifene groups, volume-2 values were significantly lower than those of volume-1. When compared to the control group, in both anastrozole and raloxifene groups, while glandular tissue scores were found significantly lower, stromal tissue scores were not different than that of the control group. There was no significant difference between both the GT and ST scores of the anastrozole and raloxifene groups. CONCLUSION(S) Anastrozole and raloxifene were seen to have caused equally the regression of the experimental endometriosis statistically significantly.

Comparison of the effects of transdermal estrogen, oral estrogen, and oral estrogen-progestogen therapy on bone mineral density in postmenopausal women

Abstract. It is now clear that estrogen intervention reduces bone loss in postmenopausal osteoporosis. The aim of this study was to investigate whether the route of estrogen administration or addition of progesterone changes this positive effect. Transdermal estrogen (T-E), oral estrogen (E), and oral estrogen plus progestogen (E-P) were administered to 15, 18, and 17 postmenopausal women, respectively, who all had normal bone mineral density (BMD) before hormone replacement therapy (HRT). Calcium (500 mg/day) was routinely added to all HRT regimens. The BMD of the lumbar spine (L2–L4) was measured initially and at the end of the first and second years of treatment. The paired-sample t test, independent-sample t test, and Pearson correlation analysis were used for the statistical evaluation. The initial BMD measurements and the values at the end of the first and second years of the therapy were not significantly different either within or among the groups (P > 0.05). These results indicate a similar therapeutic value of each HRT regimen in the prevention of bone loss in postmenopausal women.

Comparison of the effects of cetrorelix, a GnRH antagonist, and leuprolide, a GnRH agonist, on experimental endometriosis

Aim:  In the present study, we aimed to compare the effects of cetrorelix and leuprolide on endometriosis.

Evaluation of Urethrovesical Angle by Ultrasound in Women with and without Urinary Stress Incontinence

Abstract: Our aim was to investigate the role of ultrasonographic imaging in the evaluation of genuine stress incontinence (GSI). The posterior urethrovesical angles (PUVA) of each of 50 incontinent (group I) and 50 control cases (group C) were measured by both transperineal and transvaginal ultrasonography (TP-USG, TV-USG). In group I the angles were 94.9 ± 10.9 at rest and 102.7 ± 16.1 by TP-USG (P<0.001), and 100.6 ± 11.1 at rest and 103.3 ± 9.6 during Valsalva by TV-USG (not significant). In the control group these measurements were 93 ± 5.3, 96.2 ± 7.9 (P<0.001) and 98 ± 8.8, 101.1 ± 10.3 (P=0.001) by TV-USG, respectively. The degree of alteration of the angle, originating with Valsalva maneuver (D-PUVA) was 7.7 ± 11.8 in group I and 3.2 ± 4.95 in group C (P=0.014) by TP-USG, and 2.7 ± 11.8 and 3.2 ± 6.16 by TV-USG (NS). Our data reveal that PUVA and D-PUVA have important roles in GSI pathophysiology; however, ultrasonography, especially by the transvaginal route, cannot be a reliable useful method as a diagnostic tool in the evaluation of GSI.

CA‐125 levels in ruptured and unruptured tubal ectopic pregnancies

Aim:  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.

Peritoneal tuberculosis in premenopausal patients with elevated serum CA 125

IntroductionPeritoneal 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.Materials and methodsThe 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.ResultsAmong these 13 patients, 8 patients received/are receiving anti-tuberculous therapy after they were incidentally diagnosed with peritoneal tuberculosis.ConclusionIncreased 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.

Conjoined twins: Historical perspective and report of a case

In this article we review the historically important cases of conjoined twins (Biddenden Maids, Siamese twins, Blazek sisters) and contemporary knowledge regarding incidence, etiopathogenesis, antenatal diagnosis, antenatal management, and outcome of conjoined twins. We also present a case of male cephalothoracoomphalopagus, which is extremely rare.

Markedly elevated serum alkaline phosphatase level in an uncomplicated pregnancy.

In normal pregnancy, although maternal serum alkaline phosphatase increases and reaches the two-fold of non-pregnant serum level, above this level, hepatic, renal, osteal diseases and malignancies should be kept in mind. We report a case of 28-year-old pregnant woman with increased maternal serum level of alkaline phosphatase activity (17-fold) due to an increased level of placental isozyme. She delivered vaginally a healthy female baby. After delivery, maternal serum alkaline phosphatase activity returned to normal reference range. The aim of this case report is to show this exaggerated isozyme activity of alkaline phosphatase in pregnancy, and to differentiate it from other causes of elevated level of alkaline phosphatase.

Do basal inhibin A and inhibin B levels have value in the diagnosis of polycystic ovary syndrome

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 ⩾ 2 mm in both ovaries. Results were evaluated using Students 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.

Serum leptin and body composition in polycystic ovarian syndrome

Background The role of leptin in polycystic ovarian syndrome (PCOS) is unclear. We investigated the relationship between serum leptin levels, body composition and insulin resistance in polycystic ovarian syndrome (PCOS). Methods We analyzed differences between 27 patients with PCOS and 25 control subjects in serum glucose and leptin levels, insulin resistance, body fat mass, lean body mass, and water volume. Results Serum leptin was significantly correlated with basal insulin levels, BMI and IR in both groups (P<0.01). Fat mass, fat percentage, lean mass and water volumes were positively correlated and lean percentage and water percentage were negatively correlated with leptin levels (P<0.05). Leptin levels were significantly different between the groups in a multivariate regression analysis after correcting for the difference in BMI and body fat percentage (P<0.05). When the effects of fat percentage on serum leptin were eliminated, the levels were significantly different between the PCOS and control groups, and were statistically more powerful than BMI (P<0.01). Conclusion These findings support the idea that factors other than excess fat mass or fat-free mass might be important in the regulation of serum leptin levels in PCOS.