Tayfur Çift

Serum levels of epidermal growth factor, transforming growth factor, and c-erbB2 in ovarian cancer.

Objective This study aimed to investigate serum levels of epidermal growth factor (EGF), transforming growth factor α (TGF-α), and c-erbB2 in patients with ovarian cancer. Materials and Methods In this retrospective cohort study, the study and control groups were composed of 43 women with a prediagnosis of ovarian cancer and 43 healthy women, respectively. Blood samples from all women were obtained and studied by enzyme-linked immunosorbent assay kits for EGF, TGF-α, and c-erbB2. After surgery of the study group, ovarian cancer was confirmed and compared with control group. Stage, grade, and histological types were defined after histopathologic examination, and subgroups were constructed and compared. Results Serum EGF, TGF-α, and c-erbB2 levels were significantly increased in study group compared with those in the control group (P < 0.001). There were no differences in serum levels of EGF, TGF-α, and c-erbB2 among all stages, grades, and histological types of ovarian cancer. If 47.90 pg/mL was selected as the cutoff value, EGF has an 80% sensitivity and a 65% specificity for detecting ovarian cancer. The cutoff value of 41,095.00 pg/mL for TGF-α has a 90% sensitivity and a 72% specificity for detecting ovarian cancer. The c-erbB2 level of 4.63 pg/mL as the cutoff value has an 83% sensitivity and a 76% specificity for predicting ovarian cancer. Conclusions Serum levels of EGF, TGF-α, and c-erbB2 may be used for diagnosing ovarian cancer.

Effects of amniotic and maternal CD-146, TGF-β1, IL-12, IL-18 and Inf-γ, on adverse pregnancy outcome

Objective: Our aim was to determine the effects of maternal serum and amniotic fluid levels of cluster of differentiation 146 (CD-146), transforming growth factor (TGF)-β1, interleukin (IL)-12, IL-18, and interferon (IFN)-γ on intrauterine growth restriction and preterm labor. Methods: In this retrospective cohort study, we included pregnant women who underwent amniocentesis at Istanbul University Cerrahpasa Medical School. Women were followed up to labor. The study group comprised 23 women with adverse pregnancy outcomes (intrauterine growth restriction and preterm labor), and the control group comprised 105 women with normal pregnancy outcome. Results: The study group was further divided into two subgroups of preterm labor and intrauterine growth restriction. No significant differences were found for IL-12, IFN-γ, TGF-β1, or CD-146 levels in either plasma or amniotic fluid between the study and control groups. Serum IL-18 levels were similar, but the amniotic fluid level of IL-18 was significantly higher in the intrauterine growth restriction subgroup than that in the preterm labor subgroup and that in the control group (p < 0.01). Conclusions: Increased IL-18 level in amniotic fluid may be a predictor for intrauterine growth restriction. IL-12, IFN-γ, TGF-β1, and CD-146 were not related to adverse pregnancy outcome.

Maternal serum autotaxin levels in early- and late-onset preeclampsia

ABSTRACT Purpose: We aimed to compare the serum autotaxin levels in early- and late- preeclamptic and healthy pregnant patients at a university hospital. Methods: A total of 55 singleton preeclamptic women who delivered at Cerrahpasa Medical Faculty were included in the study. The patients were subdivided into two groups: early-onset preeclampsia (n = 31) and late-onset preeclampsia (n = 24). Demographic and clinical data were compared between early-onset and late-onset preeclamptic patients. The control group was composed of 32 healthy pregnant patients. Results: The mean autotaxin levels were 1.16 ± 0.97 and 0.7 ± 0.35 ng/ml in the early- and late-onset preeclampsia groups, respectively. Autotaxin levels were significantly higher in early-onset preeclampsia group compared with late-onset preeclampsia group. Autotaxin levels were found to be significantly higher in preeclamptic patients compared with control group. Serum autotaxin levels showed a significant positive correlation with maternal systolic, diastolic blood pressures and uric acid levels. Conclusion: Autotaxin might be a promising marker for detecting early-onset preeclampsia. However, further studies are necessary to confirm this hypothesis.

Nuchal translucency measurement: who is right, who is not?

Objective: Fetal nuchal translucency (NT) measurement at first trimester provides prediction for fetal aneuploidy and cardiac anomalies. Performance of NT as a screening marker has not been consistent in studies. Measurement of NT has high intraand interobserver variability. Radiologists, obstetricians and perinatology experts measure the NT. There is no consensus about who should perform the NT measurement. In this study we compared the correlation of NT measurement in three groups depend on mean thickness and distribution of NT. Methods: A total of 929 participants were recruited for this study. 7 radiologists, 8 obstetricians and 1 perinatology expert measured NT. Crown-rump length (CRL), mean NT and NT distribution were calculated for each group. Results: Perinatology expert’s mean NT measurement was significantly higher than that of radiologists and obstetricians (p<0.05). Measurements of the perinatal expert also had significantly different distribution than other groups (p<0.05). There was no significant difference between the groups in terms of CRL values. Interobserver reliability coefficients with 95% confidence intervals for CRL and NT were 0.967 (0.910–0.987, p<0.001) and 0.596 (0.455–0.845, p<0.001), respectively. Conclusion: There are statistically significant differences for mean NT value and distribution in three groups. Measurements of the perinatal expert has higher mean thickness and distribution. It is obvious that there is a need for standardization in NT measurement and it is necessary to evaluate the perinatal outcomes of these three groups and to approximate the two groups with the most accurate result group.

Relationship between endometrial thickness and neutrophil/lymphocyte ratio with endometrial malignancy in 386 postmenopausal uterine bleeding cases

Introduction: In our study, endometrial thickness with neutrophil/lymphocyte ratio and endometrial sampling results were compared in terms of outcome in women with postmenopausal bleeding. In addition, we aimed to determine the predictive value of endometrial thickness and neutrophil/lymphocyte ratio for predicting endometrial carcinoma. Material and methods: Our single-centered study was performed retrospectively. The study included 386 postmenopausal women admitted to our gynecology outpatient clinic for abnormal uterine bleeding between January 2015 and June 2017 and subjected to endometrial sampling. Results: The mean endometrial thickness for endometrial hyperplasia was calculated as 13 mm (min. 4 mm, max. 20 mm) and for endometrial carcinoma 17.19 mm (min. 8 mm, max. 27 mm). The neutrophil count and neutrophil/lymphocyte ratio (NLR) were significantly higher and the lymphocyte count was lower in the group with endometrial malignancy (p = 0.002, p < 0.001 and p = 0.011, respectively). None of the patients with endometrial thickness < 8 mm received an endometrial carcinoma diagnosis. The optimal cut-off value of endometrial thickness for detecting endometrial carcinoma was ≥ 13.50 mm, at which the sensitivity was 75% and specificity was 83.6%. The optimal cut-off value of NLR for detecting endometrial carcinoma was ≥ 2.20, at which the sensitivity was 81.3% and specificity was 60.5%. Conclusions: Co-evaluation of NLR with endometrial thickness determined by transvaginal sonography might be useful for predicting endometrial carcinoma.

Risk factors for relaparotomy after cesarean delivery and related maternal near-miss event due to bleeding

Abstract Aim: To define the risk factors for relaparotomy after cesarean delivery (RLACD) and related maternal near-miss event due to bleeding. Methods: In this retrospective descriptive case-control study, women who underwent RLACD (n = 46) only for bleeding between 2012 and 2017 were reviewed. Factors that could predict relaparotomy and related near-miss event were evaluated. Maternal characteristics, laboratory findings and surgical features were compared with a control group (n = 230) that included noncomplicated cesarean deliveries (CD). Logistic regression analysis was used to identify independent factors for relaparotomy. Results: RLACD for bleeding was required in 0.26% of patients and the incidence increased gradually over years (0.16% in 2013 versus 0.44% in 2017). Mean interval between CD and subsequent relaparotomy was 15.7 ± 3.2 hours. The sources of bleeding in descending order of frequency included; uterine fundus and placental bed (39.1%), cervix (21.7%), undetermined (17.3%), superior epigastric artery (13%), superficial epigastric artery (8.1%). Longer duration of CD (adjusted odd ratio (aOR) 1.82, 95% CI 1.02–2.53), increased number of prior CDs (aOR 2.51, 95% CI 1.09–5.78), preeclampsia (aOR 3.48, 95% CI 1.21–7.19) were found to be independent risk indicators for RLACD. Moreover, longer duration of interval between CD and relaparotomy (p = .005), longer relaparotomy duration (p = .012) and greater drop in hemoglobin level (p = .001) were found to be the predictors of maternal near-miss event. Conclusions: Patients with identified risk factors should be managed properly in order to prevent relaparotomy and near-miss event after CD. Also, urgent decision of surgical intervention might reduce the risk of maternal near-miss event.

Serum caveolin-1 levels in patients with preeclampsia

Abstract Aim: The expressions of caveolin-1 have only been examined in the placental tissue of patients with preeclampsia and were reported to be low. Therefore, we decided to investigate the maternal serum levels of caveolin-1 in patients with preeclampsia. Material and methods: This cross-sectional study was conducted including 87 pregnant women; 32 with normal pregnancy and 55 with preeclampsia. Maternal serum levels of caveolin-1 were measured by using enzyme-linked immunosorbent assay kit (ELISA). Results: The mean serum caveolin-1 level was significantly lower in women with preeclampsia (PE) compared with the control group (11.48 ± 0.92 versus 12.94 ± 1.36 ng/ml) and being lowest in the early onset PE group (11.24 ± 0.74 ng/ml). Serum caveolin-1 concentrations did not correlate with maternal age and BMI. However, caveolin-1 concentrations were negatively correlated with systolic blood pressure (r = –0.467, p = .001) and diastolic blood pressure (r = –0.441, p = .001) as well as with umbilical artery resistance index (r = –0.275, p = .01). Conclusion: Maternal serum caveolin-1 levels are significantly lower in patients with PE than controls. The serum caveolin-1 levels inversely correlate with blood pressure and umbilical artery Doppler parameters.

Serum collectrin levels in patients with early- and late-onset preeclampsia

Abstract Aim: The aim of this study is to investigate the maternal levels of collectrin in early-onset preeclampsia (EOPE) and late-onset preeclampsia (LOPE). To assess the correlation between serum collectrin levels and blood pressure in humans. Material and methods: This cross-sectional study was conducted including 79 pregnant women, 27 with normal pregnancy, 30 with EOPE and 22 with LOPE. Maternal serum levels of collectrin were measured by using enzyme-linked immunosorbent assay kits. Results: The mean serum collectrin level was significantly lower in women with PE compared with the control group (8.49 ± 3.12 ng/ml (EOPE), 9.69 ± 3.01 ng/ml (LOPE) versus 11.51 ± 4.33 ng/ml) and was found to be the lowest in the EOPE group (8.49 ± 3.12 ng/ml). The mean serum urea and uric acid levels were significantly higher in the PE group than the control group. Serum collectrin concentrations did not correlate with maternal age, BMI and serum creatinine levels. However, collectrin concentrations were negatively correlated with systolic blood pressure (r = −0.284, p = .011) and diastolic blood pressure (r = −0.275, p = .014) as well as with maternal serum urea (r = −0.269, p = .017) and uric acid (r = −0.219, p = .049) concentrations. Conclusion: Maternal serum collectrin levels are significantly lower in patients with preeclampsia than in the control group. There is an inverse correlation between serum collectrin levels and blood pressure.

Hyperandrogenism In Postmenopausal Woman: Is Surgery Reasonable For Diagnosis And Treatment ?

DOI: 10.4328/JCAM.5493 Received: 08.11.2017 Accepted: 01.12.2017 Publihed Online: 05.12.2017 Printed: 01.03.2018 J Clin Anal Med 2018;9(2): 164-7 Corresponding Author: Tayfur Çift, Department of Gynecology and Obstetrics, Bursa Yüksek İhtisas Training and Research Hospital, 16140, Bursa, Turkey. T.: +905325521928 E-Mail: tayfur_cift@yahoo.com Abstract Hyperandrogenism with severe signs of virilism is rare in postmenopausal period. Androgenic drug intake, malign and benign androgen-secreting tumors, gonadotropin depending ovarian stromal disorders have been reported as causes of hyperandrogenism after menopause. We present a 78-year-old woman referred to our gynecology department with hirsutism, male pattern baldness, and deepening voice. Bilateral ovarian enlargement was noted in the gynecologic examination. There was no evidence of adrenal or ovarian tumor with magnetic resonance imaging. The patient’s clinic and laboratory data pointed out an ovarian origin. Total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed. Both frozen and histopathologic evaluation revealed bilateral ovarian stromal hyperplasia and right ovarian stromal luteoma. The patient was discharged. Three months later, patient’s serum total testosterone level was normal and symptomatic improvement was obtained. Surgery may be reasonable for definitive diagnosis and appropriate treatment of hyperandrogenism of ovarian origin in postmenopausal women who completed childbearing age.

Oocyte Pick Up Day Mucus Removal: Does it have a positive effect on pregnancy rates?

1 Semih Kaleli1, Tayfur Çift2, Sinan Güngör3, Hülya Şenol4, Birsen Yıldız5, Ertan Kervancıoğlu1 1Department of Gynecology and Obstetrics Division of Artificial Reproductive Technics Units, Cerrahpasa Medical School, İstanbul, 2Department of Gynecology and Obstetrics, Bursa Yüksek İhtisasTraining and Research Hospital, Bursa, 3Department of Gynecology and Obstetrics, Süleymaniye Training and Research Hospital, İstanbul, 4Department of Gynecology and Obstetrics, Division of Artificial Reproductive Technics Units, Biologist. Cerrahpasa Medical School, İstanbul, 5Department of Gynecology and Obstetrics, Nurse, Cerrahpasa Medical School, Division of Artificial Reproductive Technics Units, İstanbul, Turkey Cervical mucus removal Oocyte pick up day mucus removal: Does it have a positive effect on pregnancy rates?