Tayfun Alper

Maternal and umbilical serum levels of interleukin-6, interleukin-8, and tumor necrosis factor-α in normal pregnancies and in pregnancies complicated by preeclampsia

Objectives. The aim of this study was to investigate the relationship of maternal and umbilical cord interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α) serum levels with the existence and severity of preeclampsia. A particular objective was the comparison of normal umbilical serum levels to preeclamptic values. Materials and Methods. The study group consisted of 24 patients with third trimester singleton pregnancies complicated by preeclampsia (15 severe and 9 mild preeclampsia). The gestational age-matched 19 healthy pregnant women were compared by study group. Maternal and umbilical serum IL-6, IL-8, and TNF-α were calculated by using enzyme-linked immunosorbent assay. Results. Significantly increased maternal and umbilical serum levels of IL-6, IL-8, and TNF-α were found in preeclamptic patient group in comparison with the control group. Maternal serum IL-8 and TNF-α concentration were significantly higher in patients with severe preeclampsia than in mild preeclampsia. Increased umbilical serum levels of IL-6 and IL-8 were found in severe preeclampsia than in mild preeclampsia. There were significantly higher levels of maternal serum IL-8 and TNF-α in patients with preeclampsia with IUGR than in patients with preeclampsia with normal fetal growth. Conclusion. Our findings suggest that increased concentrations of IL-6, IL-8, and TNF-α in the maternal and umbilical serum play a significant role in pathogenesis of preeclampsia. Alterations in maternal and umbilical serum levels of IL-6, IL-8, and TNF-α may also play role in preeclampsia complicated by intrauterine growth retardation. These associations may offer insight into the etiology and pathogenesis of preeclampsia.

Estimation of the amniotic fluid volume using the Cavalieri method on ultrasound images

Objectives: Presently, a design‐based and practical method for measuring amniotic fluid volume (AFV) for routine clinical examinations has not been proposed. In this study we describe a new method, which combines the Cavalieri method with ultrasound imaging to estimate AFV. Methods: We measured the AFVs of 14 women in the third trimester of pregnancy, and repeated our measurements three times for each woman. Parallel planimetric ultrasonographic images were obtained at every 2 cm along the longitudinal uterine axis. AFVs were calculated as the total of the multiples of the estimated cut surface areas by the section thickness. Results: The mean estimated AFV was 380.5 cm3. The coefficient of error of each measurement was calculated and the mean was 0.108. The coefficient of correlation between the amniotic fluid index and our AFV estimations was 0.87. Conclusions: Design‐based and efficient estimation of AFV is possible with the combination of consecutive ultrasound images and the Cavalieri method.

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.

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.

Effect of vitamin C on the growth of experimentally induced endometriotic cysts

The aim of this study was to investigate the effect of vitamin C on the growth of experimental endometriotic cysts.

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.

Intravaginal foreign body of over 25 years' duration

C Acta Obstet Gynecol Scand 79 (2000) foreign bodies of different duration (1–3). Wittich & Murray had removed a 4¿3¿3 cm plastic cup-like structure from the vagina of a woman who had complaints of foul-smelling bloody vaginal discharge and pelvic pain of probably more than 4 years’ duration (1). Mobus et al. reported a 29-year-old patient with a handle of iron forceps of fifteen years’ duration in the vagina (2). Le Sy et al. had presented a 21-year-old patient with the complaints of dyspareunia and malodorous vaginal discharge for about 5 years, who had a plastic bottle cap (3.2¿2.2 cm) deeply embedded in scar tissue in the posterior vagina (3). Such patients are unwilling to consult a physician either because of embarrassment, or because they are unaware of the presence of a vaginal foreign body or have completely forgotten it. On the other hand, chronic intravaginal foreign bodies may present with bloody or foul-smelling discharge and may be complicated by fistulas (4).

Comparison of maternal serum levels of interleukin-10, interleukin-12, and interleukin-2 in normal and preeclamptic pregnancies

OBJECTIVE The aim of this study was 2 fold: (1) to compare the maternal serum levels of IL-10, IL-12, and IL-2 in preeclamptic and normal pregnant women, and (2) to study the serum levels of these cytokines in preeclamptic pregnancies with and without intrauterine growth retardation. STUDY DESIGN Forty women with singleton pregnancies complicated by preeclampsia (32 severe and 8 mild) and 29 normotensive healthy pregnant women were included in the study. Preeclamptic patients were further divided into 2 groups according to the presence or absence of intrauterine growth retardation. Maternal serum levels of IL-10, IL 12, and IL-2 were compared between these groups using enzyme-linked immunosorbent assays. RESULTS Maternal serum levels of IL-10 were significantly higher in the preeclampsia group than in controls (p<0.001). There were no statistically significant differences in maternal serum concentrations of IL-2 and IL-10 between the study and control groups (p>0.05). Serum levels of IL-2 and IL-10 in the patients with preeclampsia complicated by IUGR were elevated in comparison with the uncomplicated preeclampsia group. These differences were statistically significant (p<0.05 for both). CONCLUSIONS IL-10 may be involved in the pathologic process of preeclampsia. Increased serum levels of IL-10 and IL-2 in preeclampsia complicated with IUGR suggests a possible role of these cytokines in IUGR.

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.

Tibolone versus four estrogen replacement therapy protocols and plasma lipid levels in postmenopausal women

Objectives: To compare tibolone therapy with four different estrogen replacement therapy protocols, with regard to the effects on plasma lipid profiles. Methods: The plasma lipid levels of 178 postmenopausal women in five different therapy groups were compared with each other as well as their baseline levels with 6‐month intervals during 2‐year follow‐up. Students t‐test, paired t‐test and Pearson correlation analysis were utilized for statistical analysis. Results: HDL cholesterol levels increased significantly from baseline in groups using oral estrogen (P<0.05) but a slight non‐significant decrease was seen in tibolone therapy (P>0.05). LDL cholesterol levels significantly decreased at the end of the second year in oral estrogen and tibolone users (P<0.05). Triglyceride levels increased non‐significantly with estrogen therapy (P>0.05), whilst decreased significantly in the tibolone group (P<0.05). Conclusion: Tibolone may be a good alternative to estrogen replacement therapy in postmenopausal women, as it has beneficial effects on LDL cholesterol and triglyceride levels, which play important role in atherosclerosis.