Melahat Yildirim

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.

Unexpected fetal demise despite the reactive nonstress test during the conservative management of acute pancreatitis in pregnancy.

Highlights • Dealing with acute pancreatitis in pregnancy is a challenging problem.• Even in the presence of reassuring NST and biophysical profile assessment, an unpredictable fetal loss can occur during the medical management of the pregnancies complicated with mild acute pancreatitis.• Acute pancreatitis (AP) is a potentially life threatening inflammatory condition of the pancreas with a high mortality and morbidity rates.• We report a complicated case of mild acute pancreatitis induced by gallbladder sludge in a pregnant woman whose pregnancy ended up with unexpected fetal demise at 34 weeks of her gestation.

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.

Dynamic Thiol-Disulphide Status in Polycystic Ovary Syndrome and Its Association with the Pathogenesis of the Disease.

Background/Aims: This study aims to examine the differences in plasma thiol-disulphide levels that are related to oxidative stress among obese and nonobese women with polycystic ovary syndrome (PCOS) and their age/body mass index (BMI)-matched healthy controls. Methods: The participants were divided into 4 groups based on BMI (nonobese and obese). Serum thiol and disulphide levels were compared among groups. Results: Serum thiols were found higher in the obese PCOS group than those in the obese control group in the study (thiol: 407.33 ± 46.25 vs. 365.67 ± 67.03 µmol/l, p = 0.014). Disulphide levels were observed to be decreased in the obese PCOS group relative to its control (21.39 ± 1.33 vs. 23.53 ± 8.47 µmol/l, p = 0.021). Serum thiol levels were found to be higher in the nonobese PCOS group compared to nonobese controls (thiol: 434.7 ± 46.92 vs. 422.94 ± 46.61 µmol/l, p = 0.031). Significant differences of disulphide levels between the nonobese PCOS group and the nonobese control group were observed (18.07 ± 1.93 vs. 20.68 ± 3.79 µmol/l, p = 0.027). Conclusion: High antioxidant levels in women with PCOS may be related to either mechanisms involving anovulation, multiple follicular development, and apoptosis or to their compensatory system against oxidative load arising from obesity and overweightness.

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.

Acknowledgement to the Reviewers

The editors greatly appreciate the support of all reviewers whose comments and scientific evaluation of submitted manuscripts are invaluable for ensuring the scientific quality of this journal. In addition to the listed permanent members of the Editorial Board, the following distinguished clinicians and scientists listed below acted as reviewers for Gynecologic and Obstetric Investigation from the beginning of November 2013 to the end of October 2014. The Editors hereby express their sincere gratitude for and their appreciation of the work done as well as the support given to this journal.

Contents Vol. 78, 2014

M.A. Belfort, Provo, Utah J. Bornstein, Nahariya H.L. Brown, Durham, N.C. C. Chapron, Paris J. de Haan, Maastricht G.A. Dekker, Adelaide, S.A. J.A. Deprest, Leuven K. Hecher, Hamburg S. Kahhale, São Paulo H. Kliman, New Haven, Conn. J.A. Kuller, Raleigh, N.C. M.J. Kupferminc, Tel Aviv H. Minkoff, Brooklyn, N.Y. J. Moodley, Congella J.M. Mwenda, Nairobi H. Odendaal, Tygerberg J.T. Repke, Hershey, Pa. G.R. Saade, Galveston, Tex. B.M. Sibai, Cincinnati, Ohio S.K. Smith, London I.E. Timor-Tritsch, New York, N.Y. S. Uzan, Paris Johan Verhaeghe, Leuven J.J. Walker, Leeds G.D. Wendel, Dallas, Tex. R.A. Wild, Oklahoma City, Okla. G. Zador, Södertälje M.B. Zimmerman, Iowa City, Iowa Gynecological Ultrasound and Imaging George Condous, St. Leonards, N.S.W.