Servet Gençdal

Serum salusins levels are increased and correlated positively with cyst size in ovarian endometrioma

Abstract Objectives: The objective of this study is to evaluate plasma concentrations of salusin-α and salusin-β levels in women with endometrioma and non-endometriotic benign ovarian cysts. Method: Endometrioma patients (n = 14), non-endometriotic ovarian cysts (n = 14), and age-matched normal healthy fertile subjects (n = 14) participated in this study. Plasma salusin-α and salusin-β levels at the time of mid-luteal phase before and 3 months after L/S cystectomy were measured using ELISA and EIA tests, and their relation with demographic parameters was also assessed. Results: The mean salusin-α and salusin-β levels were significantly higher in women with endometrioma before the removal of cyst compared with cases with non-endometriotic cyst and fertile cases. Surgical removal of the endometrioma decreased the mean salusin-α and salusin-β levels to the level of those with non-endometriotic cyst before and after the cystectomy and fertile women, in both unilateral and bilateral endometrioma cases. Plasma salusin-β concentrations were found to be positively correlated with age, size of cyst, bilaterality, and salusin-α levels. Salusin-β values showed no correlations to BMI and size of the ovarian cysts. Conclusions: Plasma salusin-α and salusin-β levels are increased in endometrioma patients and positively correlated with endometrioma size. Laparoscopic removal of the endometrioma by stripping technique decreases the salusin levels to a similar level of fertile women. Chinese abstract 目的：本研究的目的是评估子宫内膜异位囊肿患者及非子宫内膜异位卵巢良性囊肿患者血浆中Salusin-α和Salusin –β的水平。 方法：子宫内膜异位囊肿患者（n=14），非子宫内膜异位卵巢囊肿患者（n=14），以及年龄与之匹配的正常健康生育者（N=14）参加了这项研究。在腹腔镜/经腹卵巢囊肿剔除术前及术后3个月黄体中期采用ELISA 及EIA方法测量血浆中salusin-α和salusin -β水平，并采用人口统计参数评估它们的关系。 结果：在囊肿剔除前，子宫内膜异位囊肿患者平均salusin-α和salusin-β水平均显著高于非子宫内膜异位囊肿患者及健康生育者。不管是单侧或者双侧的子宫内膜异位囊肿，手术切除子宫内膜异位囊肿后，平均salusin -α和salusin-β水平都降低至非子宫内膜异位囊肿患者术前术后的水平及育龄妇女组的水平。血浆salusin-β浓度与年龄、囊肿的大小、双侧囊肿及salusin-α水平呈正相关。salusin -β值与BMI和卵巢囊肿的大小没有相关性。 结论：子宫内膜异位囊肿患者血浆salusin-α及 salusin-β水平增高，并与子宫内膜异位囊肿的大小呈正相关。腹腔镜下子宫内膜异位囊肿剔除术后salusin水平与正常育龄妇女相似。

Prenatal ultrasonography findings of fetus with congenital high airway obstruction (chaos): A case report and review of literature

Congenital high airway obstruction syndrome (CHAOS) is an extremely rare life-threatening condition. The sonographic findings are very characteristic. Generally the diagnosis is made with the 4-chamber view of the fetal heart. Typically, both lungs appear severely enlarged and highly echogenic. The heart points towards the midline of the thorax. Fetal ascites is determined commonly on ultrasound examination. A case of CHAOS, diagnosed antenatally via ultrasound is reported here. Correspondence to: Emre Ekmekci, M.D., Sanliurfa Education and Research Hospital, Department of Obstetrics and Gynecology, Perinatology Unit, Sanliurfa, Turkey, Tel: +90 505 687 56 35; E-mail: dr.ekmekci@hotmail.com

Severe ovarian hyperstimulation syndrome in spontaneous pregnancy treated successfully with cabergoline

Ovarian hyperstimulation syndrome (OHSS) is a relatively common complication in infertile patients treated with exogenous gonadotropins. Ovarian hyperstimulation in spontaneous pregnancies is a rare but possible. The pathogenesis of spontaneous OHSS is not well known. Risk factors for OHSS are young age, polycystic ovaries, low body mass index, high gonadotropin dose, increased estradiol and human chorionic gonadotropin levels, multiple pregnancy, OHSS history, molar pregnancy and hypothyroidism. In this report we present a case of severe spontaneous OHSS with a brief summary of the literature. She was hospitalized and treated in the clinic with the diagnosis of severe OHSS accompanying spontaneous pregnancy.

Meckel Gruber Syndrome diagnosed in two consecutive pregnancies

Meckel Gruber syndrome is a lethal, autosomal recessive, multisystemic disorder that is associated with a mutation affecting ciliogenesis. In this report, we present two consecutive pregnancies of a woman complicated with MKS. In the first pregnancy with MKS, the amniotic fluid index was under 1 cm with bilateral polycystic fetal kidneys. Postabortion macroscopic examination of the first fetus revealed multiple congenital anomalies including occipital encephalocele, axial polydactyly and pes equinovarus. Ultrasound examination during the second gestation revealed a singleton pregnancy complicated by MKS. There were multiple congenital anomalies including an occipital encephalocele, polycystic and horseshoe shaped kidneys, axial polydactyly, cleft lip and palate.

Prenatal diagnosis of fetal acrania using two and three dimensional ultrasound

Malformations of the central nervous system are one of the most common congenital anomalies of the fetus. In this report we aimed to summarize a case of fetal acrania diagnosed in the first trimester and the use of two and threedimensional ultrasound in early diagnosis of the disease.

The second case of Horn Kolb Syndrome in the same woman in Turkey, diagnosed prenatally at 16 weeks of pregnancy

Background Acheiropodia is a rare form of skeletal dysplasias. It is characterized by the amputation of the upper and lower extremities and with aplasia of the hands and feet. Acheiropodia formerly was known as a disease affecting only people of Brazilian ancestry. The first case out of Brazil was reported from our clinic in 2012. In the present report, we summarize the second case of acheiropodia, which was diagnosed prenatally in the same patient. Case

The Evaluation of Patient with Diagnosis of Ectopic Pregnancy in Our Clinic

Objective: To retrospectively evaluate risk factors, demographic features, findings, and treatment aspects in women hospitalized in our clinic with ectopic pregnancy. Methods: A total of 42 women who were diagnosed as having an ectopic pregnancy at Kafkas University Medicine Faculty Health Research and Practice Center between March 2013 and May 2014 were enrolled in this study. During investigation of the records, age, obstetric history, last menstrual period, complaint, physical signs, risk factors, contraception method, β-HCG levels, fetal cardiac activity, and diameter of the ectopic mass in the transvaginal ultrasonography and treatment methods were evaluated. Results: The mean age of the patients was 30.6 (20±44) years; 11 patients applied with pain (26%), 5 (12%) applied with delay of menstrual bleeding, and 8 (19%) applied with vaginal bleeding. Mean β-HCG level was 3541 mIU/mL (20029611). Mean gestational age was 6 (6±1.8). With the transvaginal ultrasonography, ectopic foci were detected in 27 (64.2%) patients. The mean diameter of ectopic foci was 37 mm (15-54). In 4 (9.6%) patients, fetal cardiac activity was obtained. As we looked to treatment procedures, 33 (78.5%) patients had surgery, 4 (9.5%) were treated medically, and 5 (12%) patients were managed expectantly. Among 33 patients who had surgery, 26 (78.8%) patients had laparoscopic surgery, and 7 (21.2%) had a laparotomy. All patients were discharged with complete recovery. No complications were observed. Conclusion: Ectopic pregnancy is still an important issue because of the high mortality, morbidity, and influenced on fertility. The treatment of ectopic pregnancy should be individualized, and all treatment procedures and future reproductive performance must be argued with patients. (JAREM 2014; 4: 93-6)