Naci Kemal Kuscu

Oxidative stress but not endothelial dysfunction exists in non‐obese, young group of patients with polycystic ovary syndrome

Objective. To determine if oxidative stress and endothelial dysfunction exist at the same time in a young, non‐obese group of patients with polycystic ovary syndrome (PCOS). Design. Cross‐sectional study. Setting. Celal Bayar University, School of Medicine, Manisa, Turkey. Sample. Thirty‐one young, non‐obese patients with PCOS and 23 age‐ and body mass index‐matched controls. Methods. Following clinical and biochemical diagnosis, malonyldialdehyde (MDA), superoxide dismutase (SOD), von Willebrand Factor (vWF), and nitric oxide (NO) levels of patients and controls were measured and compared. Main outcome measures. To find out oxidative stress and endothelial dysfunction parameters. Results. MDA (0.12±0.03 vs 0.10±0.03, p = 0.01) and SOD (8.0±0.7 vs 7.28±0.8, p = 0.001) levels were significantly higher in PCOS group while there was no difference in vWF (527.2±280.1 vs 568.1±276.8, p>0.05) and NO levels (169.9±47.4 vs 168.9±80, p>0.05). When the results of the PCOS patients were divided into two subgroups in terms of insulin resistance (IR– and IR +), the IR– subgroup had significantly higher MDA levels compared to the control (0.125±0.03 vs 0.101±0.03, p = 0.03). Though IR+ group also had higher MDA than the control group, it did not reach to a significant level (0.117±0.05 vs 0.101±0.03, p>0.05). Both IR– and IR+ groups had significantly higher SOD levels compared with control group (7.99±0.7 vs 7.28±0.8, p = 0.009 and 8.22±0.8 vs 7.28±0.8, p = 0.03, respectively). vWF and NO levels were not different among these three groups (p>0.05). Conclusions. Oxidative stress is prominent while endothelial dysfunction does not exist in young, non‐obese patients with PCOS.

Tear function changes of postmenopausal women in response to hormone replacement therapy.

OBJECTIVE The goal of this study was to search the effect of hormone replacement therapy (HRT) on tear function changes in postmenopausal women. METHODS Following initial ophtalmic evaluation and tear sample collection, the subjects were given daily 0.625 mg conjugated estrogen, and either continuous combined or cyclic 5 mg medroxyprogesterone acetate was added. Eye examination included visual acuity, slit-lamp examination, fundus examination, tonometry, Schirmers test, and break up time (BUT) evaluation. Six months later, control examination was done and repeat tear samples were obtained. Tear immune globulin A (IgA) and lysozyme levels were measured by gel electrophoresis. The pictures of the bands were evaluated by digital image analysis with Scion Image program. RESULTS Conjunctival vascular congestion, laxity and corneal desquamation did not change before and after HRT (P>0.05). A significant improvement was noted in meibomian gland inflammation (P=0.034). We have not observed any significant difference in burning, foreign body sensation, and tearing (P>0.05). In addition, no significant difference was noted in BUT (P=0.370) and Schirmers test values (P=0.271). Though both lysozyme and IgA levels were elevated following the therapy, only IgA levels increased significantly (P=0.04). CONCLUSION HRT decreased meibomian gland inflammation and increased tear lysozyme and IgA levels in postmenopausal women.

Interleukin-6 levels in hyperemesis gravidarum.

Introduction.Hyperemesis gravidarum (HG) is associated with higher levels of serum β-hCG levels and hyperthyroidism. Interleukin-6 (IL-6), a pro-inflammatory cytokine, is reported to enhance secretion of β-hCG from trophoblastic cell line.Methods.We measured serum levels of IL-6, thyroid hormones and β-hCG of hyperemetic patients and gestational age-matched controls to search for a difference between the two groups.Results.There was a significant difference in β-hCG (p=0.028), though IL-6 levels were higher in the hyperemetic group, it did not reach a significant level. Interleukin-6 positively correlated with β-hCG (r=0.38 and p=0.13).

Rupture of rudimentary horn pregnancy at the 15th week of gestation: a case report

A patient with acute abdomen at 15th week of gestation underwent an emergency laparatomy. A ruptured rudimentary horn pregnancy was diagnosed, and the rudimentary part including the fetus and the accessories was resected. The mother survived without any complications.

Increased vascular surface density in ovarian endometriosis.

Our goal in this study was to investigate the presence of angiogenesis-related factors in endometriomas by evaluating their vascular surface densities. Thirty ovarian samples were included in the study. Of these ,ten were histologically confirmed endometriomas ,ten were ovarian specimens in the follicular phase and ten were ovarian specimens in the luteal phase ,serving as controls. Histological specimens were immunostained for von Willebrand factor (vWF: factor VIII-related antigen) and CD34. The area with the highest microvessel density in endometriosis and in the normal ovary was evaluated by using an intercept grid. All microvessels in a specific field (× 100 magnification) were counted and vascular surface density was measured ,as 164.01 ± 21.26 vs. 125.15 ± 11.28 and 117.44 ± 9.27 by using vWF ,and as 172.97 ± 25.64 vs. 138.65 ± 32.21 and 120.34 ± 18.40 by using CD34 in endometriotic ,follicular and luteal ovarian samples ,respectively (p < 0.001). The mean vascular surface density was significantly higher in endometriosis than in the ovarian samples of the follicular phase or the luteal phase. No significant difference was seen between normal ovarian samples. Endometriosis was associated with angiogenic properties. Having demonstrated elevated angiogenic factors in endometriotic samples ,we concluded that activation of angiogenesis might be a key factor in the pathogenesis of endometriosis.

Laser therapy in chronic cervicitis

Abstract Chronic cervicitis is one of the common disorders encountered in daily practice. To overcome this problem first step should be antibiotic therapy in acute phase. If this fails, the infection becomes chronic and may spread to internal genital organs leading to pelvic inflammatory disease and eventually to infertility. Chronic form of infection may necessitate tissue destruction to prevent the development of dysplasia and neoplasm. Various methods such as electrocautery, loop diathermy, cryotherapy or laser are used to destroy the inflamed area. In this study we present 26 cases of chronic cervicitis managed with Nd-YAG laser with a success rate of 93%. We advice this method to block the development of cervical intraepithelial neoplasm.

Collagenase treatment of sore nipples

Lesions that occur on the areola and the nipple of a breast-feeding mother during the immediate postpartum period may lead to infection, and the mother may find breast-feeding too painful to continue 1 . Approximately 65% of lactating women experience severe nipple pain with lesions 2 . Various treatment regimens have been applied to sore nipples. In this study, we compared the effectiveness of collagenase in preventing and healing sore nipples, and compared to dexpanthenol and a control group. Sixty-six primiparous mothers were randomized to one of three groups to receive either collageŽ . Ž . nase group C Novuxol, Knoll , or dexpanthenol Ž . Ž . group D Bepanthene, Roche , or only warm Ž . water and soap group W . They used their agents after breast-feeding sessions qid for 2 weeks. The lesions were evaluated just before the treatment and prior to discharge by a physician blind to

Assessment of serum chemerin, vaspin and omentin-1 levels in patients with polycystic ovary syndrome

Objective To determine serum chemerin, vaspin and omentin-1 in overweight and normal weight patients with polycystic ovary syndrome (PCOS) and investigate the possible relationship between these adipokines and metabolic syndrome. Methods This cross sectional study enrolled women with PCOS and healthy women. Serum chemerin, vaspin and omentin-1 were assessed by enzyme-linked immunosorbent assay methods. Results Forty patients with PCOS and 30 healthy controls were included in the study. In the PCOS group, 18 women were overweight (body mass index [BMI] = 25.0–29.9 kg/m2) and 22 had normal weight (BMI = 18.5–24.9 kg/m2). Chemerin, total cholesterol, dehydroepiandrosterone sulphate and free androgen index (FAI) were significantly higher; and high-density lipoprotein cholesterol and sex hormone binding globulin were significantly lower in overweight PCOS patients compared with normal weight PCOS patients. A positive correlation was found between chemerin and BMI, triglyceride, insulin, homeostatic model assessment of insulin resistance and FAI in the PCOS group. There was no difference in serum chemerin, vaspin and omentin-1 between PCOS patients and healthy controls. Conclusion Circulating chemerin was increased in overweight compared with normal weight PCOS patients. The most predictive variables for circulating chemerin in PCOS patients were BMI, FAI and age.

Clomiphene citrate does not adversely affect endometrial leukemia inhibitory factor levels

The aim of this study was to compare endometrial leukemia inhibitory factor (LIF) levels in spontaneous and clomiphene citrate (CC)-induced cycles of patients with unexplained infertility. The patients were followed in two consecutive cycles. Endometrial samples were obtained 7 days after ultrasonographic evidence that ovulation has occurred during the spontaneous cycle, then the patients were induced with CC from day 5 to day 9 during the subsequent cycle with 50 mg/day, and ovulation monitoring and endometrial biopsy were performed in the same manner. The samples were obtained using a Pipelle biopsy device without using local anesthesia, and kept in formaldehyde solution until the day of measurement. Then they were homogenized in phosphate buffered distilled water, and LIF levels were detected in the homogenized fluid by ELISA method. Endometrial LIF levels were 470 ± 52 and 501 ± 45 pg/1 gram wet tissue in spontaneous and CC-induced cycles respectively, revealing no significant difference. Ovulation induction with CC did not adversely affect endometrial LIF levels.

Immunohistochemical staining of IGF‐I, IGF‐binding proteins‐1 and ‐3, and transforming growth factor beta‐3 in the umbilical cords of preeclamptic patients

Background.  To detect the immunoreactivity of insulin‐like growth factor‐I, insulin‐like growth factor‐binding proteins‐1 and ‐3 and transforming growth factor beta‐3 in the umbilical cords of normal and preeclamptic patients.