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Aromatase expression in uterine leiomyomata is regulated primarily by proximal promoters I.3/II
(ENDOCRINE SOC, 2007) Imir, Ayse Gonca; Lin, Zhihong; Yin, Ping; Deb, Santanu; Yilmaz, Bertan; Cetin, Meral; Cetin, Ali; Bulun, Serdar E.
Context: Uterine leiomyomata are common tumors that cause irregular uterine bleeding and pregnancy loss and depend on estrogen for growth. Aromatase catalyzes the conversion of androgens to estrogens. Aromatase expression is regulated via alternatively used promoters in the placenta (I.1 and I.2a), fat (I.4, I.3, and II), bone (I.6), and gonads (II). A prostaglandin E-2/cAMP-dependent pathway regulates coordinately the proximal promoters I.3/II, whereas glucocorticoids and cytokines regulate the distal promoter I.4. Use of each promoter gives rise to a population of aromatase mRNA species with unique 5'-untranslated regions (5'-UTRs). Uterine leiomyoma tissue, but not normal myometrium, overexpresses aromatase leading to estrogen-stimulated cell proliferation. Aromatase inhibitor treatment shrank uterine leiomyomata in a few women. Objective and Design: Promoter I.4 was reported to regulate aromatase expression in uterine leiomyomata from a group of Japanese women. Here, we used two independent techniques to identify the promoters that regulate aromatase expression in uterine leiomyomata (n=30) from 23 African-American, Hispanic, and white women. Results: Rapid amplification of 5'-cDNA ends of aromatase mRNA species revealed the following distribution of promoter usage in leiomyomata: promoters I.3/II, 61.5%; I.2a, 15.4%; I.6, 15.4%; and I.4, 7.7%. Real-time PCR, which quantifies mRNA species with promoter-specific 5'-UTRs, revealed the following distribution for each 5'-UTR as a fraction of total aromatase mRNA: I.3/II, 69.6%; I.4, 7.3%; and other promoters, 23.1%. Conclusions: The primary in vivo aromatase promoter in leiomyoma tissues in non-Asian U.S. women is the prostaglandin E2/cAMP-responsive I.3/II region. Alternative signals may stimulate aromatase expression that is a common biological phenotype in uterine leiomyomata.
Association of microsomal epoxide hydrolase gene polymorphism and pre-eclampsia in Turkish women
(WILEY, 2007) Pinarbasi, Ergun; Percin, Ferda E.; Yilmaz, Meral; Akgun, Egemen; Cetin, Meral; Cetin, Ali
Aim: To assess the association between human epoxide hydrolase exon 3 and 4 polymorphisms and pre-eclampsia by carrying out a case-control study in Turkish women. Methods: DNA was extracted from peripheral blood leukocytes, and genotype distribution of exon 3 and exon 4 of epoxide hydrolase gene (EPHX) was carried out in 271 patients and 155 controls. Results: There was no statistically significant difference in the distribution of genotypes between pre-eclampsia without HELLP and pre-eclampsia plus HELLP cases and controls for the exon 3 and 4 polymorphism of EPHX. However, we found a significant association between the predicted enzyme activity level and pre-eclampsia (P = 0.018). The distribution of subjects with predicted high, intermediate and low microsomal epoxide hydrolase enzyme (EPHX) activity were 23.2, 38.8 and 38% in cases and 12, 47.3 and 40.7% in controls, respectively. Conclusion: Although we could not find any association between genetic variability in exon 3 and 4 of EPHX and pre-eclampsia, genetic variability in these two exons jointly modifies the predicted enzyme activity and may be a risk factor for pre-eclampsia.
Comparison of Effectiveness of Laminaria versus Vaginal Misoprostol for Cervical Preparation Before Operative Hysteroscopy in Women of Reproductive Age: A Prospective Randomized Trial
(ELSEVIER SCIENCE INC, 2016) Karakus, Savas; Akkar, Ozlem Bozoklu; Yildiz, Caglar; Yenicesu, Gonca Imir; Cetin, Meral; Cetin, Ali
Study Objective: To compare the effectiveness and safety of intracervical laminaria dilator versus intravaginal misoprostol administered before surgery to facilitate cervical dilation before operative hysteroscopy. Design: A prospective randomized study (Canadian Task Force classification 1). Setting: A university hospital. Patients: A total of 150 women were assigned at random to the following groups: laminaria dilation (n = 50), misoprostol dilation (n = 50), and mechanical dilation (n = 50). Interventions: Hysteroscopic surgery of intrauterine lesions. Measurements and Main Results: In this study, 150 women were assigned at random to receive cervical priming with an intracervical laminaria dilator, 200 mu g of intravaginal misoprostol, or a mechanical dilator before operative hysteroscopy. Cervical response, surgical outcome, and complications of operative hysteroscopy were assessed. Visual analog scale (VAS) pain scores were recorded in the misoprostol and laminaria dilation groups. Demographic variables of the study groups were comparable (p = .278.988). The duration of cervical pretreatment was similar with the intracervical larminaria dilator and intravaginal misoprostol (p = .803); however, intravaginal misoprostol was associated with more adverse effects (p = .031). Compared with the misoprostol dilation group, in which all patients required additional cervical dilation, notably fewer patients in the laminaria dilation group required additional cervical dilation after cervical preparation (p = .001). VAS pain scores were significantly higher in the laminaria dilation group, however (p = .001). Conclusion: Cervical priming with an intracervical laminaria dilator before operative hysteroscopy reduces the need for cervical dilation and better facilitates hysteroscopic surgery compared with intravaginal misoprostol. Oral analgesic use may be required before the use of this device. Journal of Minimally Invasive Gynecology (C) 2016 AAGL. All rights reserved.
Comparison of maternal serum vitamin D and paraoxonase 1 levels and neutrophil to lymphocyte ratios of preeclamptic and severe preeclamptic, and normal pregnant women
(E-CENTURY PUBLISHING CORP, 2016) Akkar, Ozlem Bozoklu; Sancakdar, Enver; Karakus, Savas; Yildiz, Caglar; Arslan, Murat; Yucel, Hasan; Ozcelik, Fatma; Yenicesu, Ayse Gonca Imir; Cetin, Meral; Cetin, Ali
Preeclampsia is one of the most common causes of maternal and neonatal morbidity and mortality worldwide. We aimed to evaluate the diagnostic values of maternal serum levels of 25-hydroxyvitamin D and paraoxonase 1 (PON1) and neutrophil to lymphocyte ratio (NLR) in the preeclamptic patients and to assess whether they can be used to distinguish the severity of preeclampsia. This prospective study was conducted in women with preeclampsia (n=34) or severe preeclampsia (n=10) and normal pregnancies (n=36), with at least gestational age of 24 weeks. Maternal serum 25-hydroxyvitamin D and PON1 were measured and NLR was calculated. The 25-hydroxyvitamin D levels of the study groups were found comparable (P > 0.05). The normal pregnancy and preeclampsia groups were comparable (P > 0.05) with regard to the PON1 level; however, their PON1 levels were significantly higher compared to the severe preeclampsia group (P < 0.05). The NLRs of the normal pregnancy and preeclampsia groups were found similar (P > 0.05), but the NLR of severe preeclampsia group was significantly higher compared to the normal pregnancy and preeclampsia groups (P < 0.05). The maternal serum 25-hydroxyvitamin D level is not useful as a marker in the diagnosis of preeclampsia; however, the maternal serum PON1 level and NLR may distinguish the patients with preeclampsia with severe features, but not the patients with preeclampsia without severe features.
Cytoreductive Surgery Followed by Hyperthermic Intraperitoneal Chemotherapy: Morbidity and Mortality Analysis of Our Patients
(ORTADOGU AD PRES & PUBL CO, 2012) Karadayi, Kursat; Turan, Mustafa; Karadayi, Sule; Alagozlu, Hakan; Kilickap, Saadettin; Buyukcelik, Abdullah; Sarkis, Cihat; Yucel, Birsen; Boztosun, Abdullah; Cetin, Meral; Yilmaz, Abdulkerim; Yanik, Ali; Sen, Metin
Objective: The purpose of this study was to analyze the morbidity and mortality of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) and early postoperative intraperitoneal chemotherapy (EPIC) with closed abdomen technique in the treatment of peritoneal surface malignancies. Material and Methods: Twenty-six patients (8 with ovarian cancer, 7 peritoneal mesothelioma, 6 colorectal cancer, 3 uterine sarcoma, 1 peritoneal carcinoma and 1 with gastric cancer) underwent 27 procedures. Peritonectomy was performed with complete removal of all the involved visceral and parietal peritoneum. HIPEC was performed with the closed abdominal technique using preheated (42.5 degrees C) perfusate for 60 minutes. EPIC was continued for postoperative 5 days. Results: All patients underwent resection of the lesions. Total pentonectomy was performed in 12 patients, while subtotal or partial peritonectomy was carried out in 14 according to the spread of carcinomatosis. Completeness of cytoreduction score of our patients was 0 in 18 patients, 1 in 6 patients and 2 in 2 patients. Major morbidity developed in 7 patients (27%). CRS+HIPEC+EPIC yielded acceptable morbidity and mortality rates. Of the 26 patients, 20 (77%) were alive without evidence of disease with a mean follow-up period of 13 6 months. Overall 1 year survival was 60%. Conclusion: Cytoreductive approach combined with intraperitoneal chemotherapy prolongs survival in selected patients with peritoneal carcinomatosis (PC) with acceptable morbidity and mortality.
Determining the Incidence of Gynecoid Pelvis Using Three-Dimensional Computed Tomography in Nonpregnant Multiparous Women
(KARGER, 2016) Salk, Ismail; Cetin, Meral; Salk, Sultan; Cetin, Ali
Objectives: To determine the incidence of gynecoid pelvis by using classical criteria and measured parameters obtained from three-dimensional computed tomography (3D CT) pelvimetry in nonpregnant multiparous women who delivered vaginally. Subjects and Methods: Our hospital's picture archiving and communication system was reviewed retrospectively. All adult women who had undergone CT examination with routine abdominal protocols were identified. In the pelvic inlet, midpelvis, and pelvic outlet, classical criteria and measured parameters, both alone and in combination, were used to determine the presence of gynecoid pelvis. Results: 3D CT pelvimetry was performed on 226 women aged 23-65 years without any history of cephalopelvic disproportion and who had at least one delivery of an average fetal size (>2,500 g). The median parity was 4, and the mean (+/- SD) birth weight was 3,700 +/- 498 g. Compared to the classical criteria, measured parameters and their combined use with the classical criteria significantly reduced the frequency of gynecoid pelvis (51.3 and 47.8%, respectively, vs. 71.6%; p = 0.001); however, there was no significant difference between the measured parameters and their combined use with classical criteria with regard to the frequencies of gynecoid pelvis (p > 0.05). Conclusions: With the use of measured parameters of 3D CT pelvimetry, the incidence of gynecoid pelvis reduces to a more acceptable level (51.3%) in accordance with obstetric knowledge. Since there is no considerable decrease with the addition of classical criteria, 3D CT pelvimetry alone has merit for determining a woman's pelvic capacity for obstetric needs after the improvement and standardization of measured parameters. (C) 2015 S. Karger AG, Basel
Different serum anti-Mullerian hormone concentrations are associated with oocyte quality, embryo development parameters and IVF-ICSI outcomes
(SPRINGER HEIDELBERG, 2011) Irez, Tulay; Ocal, Pelin; Guralp, Onur; Cetin, Meral; Aydogan, Begum; Sahmay, Sezai
To evaluate the association between different basal serum levels of anti-Mullerian hormone (AMH) and oocyte-embryo quality and IVF outcomes. Two hundred and nine infertile women who underwent in vitro fertilization treatment with intracytoplasmic sperm injection (ICSI) between January 2009 and February 2011 were included in the study. Mean age, BMI, FSH, E(2), inhibin B, duration of infertility, total gonadotropin dose, antral follicle count, morphology of all oocytes, percentage of MII, early cleavage rate, the number of good quality embryos in transfer and ongoing pregnancy (> 12 weeks) rates were evaluated. Six groups were formed according to the percentiles as < 10% (a parts per thousand currency sign0.89 ng/ml; n = 21), 10-25% (0.89-1.40 ng/ml; n = 31), 25-50% (1.40-2.89 ng/ml; n = 53), 50-75% (2.89-4.83 ng/ml; n = 28), 75-90% (4.83-8.06 ng/ml; n = 55), > 90% (> 8.06 ng/ml; n = 21). Central granulation, cytoplasmic granulation, oocyte postmaturity, percentage of embryos, early cleavage and percentage of transferred good quality embryos were significantly different in five groups (ANOVA test). Ongoing pregnancy rate (PR) was the lowest in < 10% (9.5%), and the highest in 50-75% group (39.3%). (P = 0.040) Different AMH levels may predict the quality of oocytes, presence of postmaturity and nucleoli Z score, early cleavage and ICSI outcomes.
Effects of different postmenopausal hormone therapy regimens on cerebral blood flow and cognitive functions
(SPRINGER, 2009) Guvenal, Tevfik; Durna, Aysenur; Erden, Omur; Guvenal, Feray; Cetin, Meral; Cetin, Ali
The purpose of this study was to compare the effects of different postmenopausal hormone therapy regimens, namely conjugated equine estrogens (CEE), CEE plus medroxyprogesterone acetate (MPA), tibolone, and raloxifene on cerebral blood flow and cognitive functions. A total of 64 healthy postmenopausal women admitted to the Department of Obstetrics and Gynecology, Cumhuriyet University, Turkey were included in this study. Patients were divided into five groups with respect to the treatment protocols: CEE 0.625 mg/day (n=13); CEE 0.625 mg/day + MPA 2.5 mg/day (n=14); tibolone 2.5 mg/day (n=11); raloxifene 60 mg/day (n=9); and control (n=17). The CEE group included only women with surgical menopause. Those who were on hormonal therapy, who had previously used hormonal therapy, who had neurological disorders, or who did not accept the longterm follow-up were excluded from the study. Demographic and clinic characteristics were recorded. Before starting the therapy regimens, cerebral blood flow was evaluated by internal carotid artery and middle cerebral artery peak systolic velocity, and pulsatility index measurements via Doppler ultrasonography. Cognitive functions were evaluated by the Standardized Mini-Mental Test. The mean follow-up period was 10.9 +/- 2.4 months, ranging between 8 and 16 months. After the follow-up period, the cerebral blood flow, and cognitive function of each woman was re-evaluated. Demographic and clinical characteristics of the women were not significantly different between the study groups (P > 0.05). There were no significant differences between the pretreatment and posttreatment values for cerebral blood flow indices and cognitive function scores in any of the study groups (P > 0.05). Different postmenopausal hormone therapy regimens have not revealed any significant effects on either cerebral blood flow or cognitive function.
Effects of formoterol and BRL 37344 on human umbilical arteries in vitro in normotensive and pre-eclamptic pregnancy
(ELSEVIER SCIENCE INC, 2007) Karadas, Baris; Kaya, Tijen; Cetin, Meral; Parlak, Ahmet; Durmus, Nedim; Bagcivan, Ihsan; Gulturk, Sefa
Alterations in vascular responses to beta-adrenoceptor agonists in normotensive pregnancy and pre-eclampsia are not fully understood. Thus, we studied changes in vasodilator responses to beta(2)-adrenoceptor agonist formoterol and beta(3)-adrcnoceptor agonist BRL 37344 on umbilical arteries isolated from normotensive (n = 12) and pre-eclamptic (n = 12) pregnant women. Changes in the relaxant effect of formoterol and BRL 37344 were investigated by measuring isometric tensions in endothelium-denuded strips of umbilical arteries in the presence or absence of metoprolol, ICI 118.551 and SR 59230A (beta(1), beta(2), beta(3)-adrenoceptor antagonists, respectively, 10(-6) mol/L). Effects of formoterol and BRL 37344 on cAMP levels of umbilical arteries were evaluated by radioimmunoassay kits. Formoterol (10(-10)-10(-4) mol/L) and BRL 37344 (10(-10)-10(-4) men) caused concentration-dependent relaxation of the contraction induced by phenylephrine (10(-5) mol/L) in umbilical artery strips isolated from both groups. E-max values of formoterol and BRL 37344 (for normotensive pregnant women: 87.33 +/- 0.87 and 53.25 +/- 1.17 vs. for pre-eclampsia: 73.68 +/- 1.58 and 43.64 +/- 1.19, n=12, P > 0.05, respectively) were significantly smaller in strips from pre-eclamptic women (P < 0.05), with no significant change in pD(2) values. E-max values of formoterol were significantly higher than those of BRL 37344 in both tissue (P < 0.05). ICI 118.551 and SR 59230A, but not metoprolol, antagonized the relaxant effects of formoterol and of BRL 2,7344 on umbilical artery strips isolated from normotensive and pre-eclamptic pregnant women. Formoterol and BRL 37344 increased cAMP levels in both groups, but less significant in pre-eclamptic strips (P < 0.05). These results suggest that the relaxation caused in human umbilical arteries by formoterol and BRL 37344 is mediated by a mixed population of beta(2)- and beta(3)-adrenoccptor subtypes, with contribution of cAMP. Umbilical arteries from subjects with pre-eclampsia showed a weaker beta(2)- and beta(3)-receptor-mediated relaxation to formoterol and BRL 37344, suggesting that the reduced action of formoterol and BRL 37344 may be partly due to a decreased effect of cAMP. (c) 2007 Elsevier Inc. All rights reserved.
Evaluation of Ki-67 Immunostaining in the Differential Diagnosis of Low Grade Squamous Intraepithelial Lesion and Normal Cervix
(Galenos Yayincilik, 2007) Arici, Sema Dilek; Imir, Gonca; Ozer, Hatice; Elagoz, Sahande; Simsek, Gulay; Cetin, Meral
Objective: Ki-67 immunostaining is used as an adjunct in the differential diagnosis of squamous intraepithelial lesions (SILs) of the cervix. The aim of this study was to determine an index for positive Ki-67 staining and the Ki 67-positive cell clusters for distinguishing normal cervix and low-grade squamous intraepithelial lesions (low-grade SILs). Materials and Methods: Thirty-four cervical specimens, in which 17 were previously diagnosed as normal and 17 low-grade SILs were included in the study. Ki-67 immunohistochemical staining was performed using avidin biotin complex. Results: After reevaluating the cases by means of histo-pathological and Ki-67 immunostaining features, 21 of 34 cases were diagnosed as normal cervix and 13 were diagnosed as low-grade SILs. Ki-67 index was higher in low-grade SILs (p<0.05). Although Ki-67 positive cell clusters was not observed in normal cervix, 77% of 13 low-grade SILs had positive cell clusters (p<0.05). Discussion: Ki-67 immunostaining may be considered as an easy and reproducible technique in differential diagnosis of normal cervix and low-grade SIL.
Evaluation of ovarian reserve using anti-mullerian hormone and antral follicle count in Sjogren's syndrome: Preliminary study
(WILEY, 2017) Karakus, Savas; Sahin, Ali; Durmaz, Yunus; Aydin, Huseyin; Yildiz, Caglar; Akkar, Ozlem; Dogan, Mansur; Cengiz, Ahmet; Cetin, Meral; Cetin, Ali
AimThe aim of this study was to determine ovarian reserve status using anti-mullerian hormone (AMH) level and antral follicle count (AFC) in patients with Sjogren's syndrome (SS). MethodsTwenty-four women with SS diagnosed according to the classification criteria proposed by the American-European Consensus Group and 25 healthy women as controls were enrolled in this study. Ovarian reserve was assessed on clinical findings, AFC, and serum AMH and reproductive hormone levels. ResultsCompared with the healthy controls, in the SS patients, the duration of menstrual cycle was significantly shorter (P = 0.043); serum AMH (P = 0.001) and AFC (P = 0.001) were significantly lower, and serum luteinizing hormone (LH) was significantly higher (P = 0.019). The right (P = 0.555) and left ovarian (P = 0.386) volumes were also lower but this did not reach statistical significance. Serum follicle-stimulating hormone (P = 0.327), estradiol (P = 0.241), and prolactin (P = 0.55) were similar between the two groups. ConclusionsOvarian reserve may be reduced in SS patients. For the assessment of ovarian reserve, serum AMH and ovarian AFC with serum LH may be useful. Further studies with long-term follow-up are required to determine the course of ovarian reserve abnormalities and best possible biomarkers of reduced ovarian reserve in SS patients.
Idiopathic Spontaneous Hemoperitoneum During Early Postpartum Period: Case Report
(ORTADOGU AD PRES & PUBL CO, 2012) Boztosun, Abdullah; Sumer, Dincer; Cetin, Meral; Cetin, Ali
We present a 25 year-old woman who was examined for abdominal pain after uncomplicated spontaneous delivery. An intraabdominal hemorrhage was suspected and laparotomy was performed after the delivery. Postpartum spontaneous hemoperitoneum can be associated with vascular malformations, ectopic decidualization and avulsion of pelvic uterine adhesion band. Full exploration of abdominal cavity, including intraabdominal and retroperitoneal organs, revealed no source of hemorrhage. To best of our knowledge, this is a very rare case of idiopathic spontaneous hemoperitoneum at early postpartum period.
Immunohistochemistry with apoptotic-antiapoptotic proteins (p53, p21, bax, bcl-2), c-kit, telomerase, and metallothionein as a diagnostic aid in benign, borderline, and malignant serous and mucinous ovarian tumors
(BIOMED CENTRAL LTD, 2012) Ozer, Hatice; Yenicesu, Goncalmir; Arici, Sema; Cetin, Meral; Tuncer, Ersin; Cetin, Ali
Background: In many tumors including ovarian cancer, cell proliferation and apoptosis are important in pathogenesis and there are many alterations in most of the genes related to the cell cycle. This study was designed to evaluate immunohistochemistry with apoptotic-antiapoptotic proteins (p53, p21, bax, and bcl-2), c-kit, telomerase, and metallothionein as a diagnostic aid in typing of benign, borderline, and malignant serous and mucinous ovarian tumors. Methods: Total of 68 ovarian tumors, 25 benign [13 (19.1%) serous and 12 (17.6%) mucinous], 16 borderline [9 (13.2%) serous and 7(10.3%) mucinous], and 27 malignant ovarian tumors [24 (35.3%) serous and 3 (4.4%) mucinous tumors] were included in the study. Immunohistochemical expression of p53, p21, bax, bcl-2, telomerase, c-kit, and metallothionein were evaluated. Results: When all 68 cases were evaluated as benign, borderline, and malignant ovarian tumors without considering histopathological subtypes, the p53, p21, bax and metallothionein showed significantly higher staining scores in the borderline and malignant ones (p < 0.05). After evaluation of all 68 cases, the serous tumors showed significantly higher staining scores of p53, p21, c-kit, and metallothionein compared to the mucinous ones (p < 0.05). For differentiation of benign and borderline and malignant tumors combined, p53 was not used because all benign tumors has no staining, and p21, bax, and metallothionein was determined the significant predictors for borderline and malignant tumors combined (p < 0.05). For differentiation of borderline and malignant tumors, only p53 was determined the significant predictor for malignant tumors (p < 0.05). Conclusions: In conclusion, p53, p21, bax, c-kit, and metallothionein may be helpful for the typing of ovarian tumors as benign, borderline and malignant or serous and mucinous. p53, p21, bax, c-kit, and metallothionein may have different roles in the pathogenesis of ovarian tumor types. p53 and metallothionein may be helpful in the typing of borderline and malignant ovarian tumors. The immunohistochemical staining with bcl-2 and telomerase may not provide meaningful contribution for the typing of ovarian tumors.
Impact of intrauterine devices on microbiota in women: Identification of bacterial colonization
(Bayrakol Medical Publisher, 2025) Takci, Tahsin; Genc, Serife Ozlem; Cetin, Meral
Aim: The intrauterine device (IUD) is the second most widely used contraceptive method globally due to its effectiveness, affordability, and reliability. There are two primary types: copper and hormonal. However, IUDs are associated with potential complications, including ectopic pregnancy, uterine perforation, and pelvic inflammatory disease. This study aims to assess and compare the safety and complication rates of copper and hormonal IUDs, with a focus on their impact on vaginal microbiota. Material and Methods: The study included 233 women who had their IUDs removed at our clinic. The IUDs were analyzed using Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) to identify the microbiota present on the devices. Results: Participants' ages ranged from 20 to 70 years, with a mean age of 39.64 +/- 8.37. The majority (84.4%) used copper IUDs, while 15.6% used levonorgestrel-releasing IUDs. Among the patients, 41.2% reported vaginal discharge, 39.5% experienced dyspareunia, and 18.5% had a history of pelvic inflammatory disease or tubo-ovarian abscess. Discussion: IUD use significantly impacts vaginal microbiota, with Escherichia coli being a common pathogen in both copper and hormonal IUD users. Regular gynecological check-ups, sterile insertion practices, and patient education on infection symptoms are crucial for mitigating risks. Probiotics may help maintain microbiota balance during IUD use. Future studies should investigate long-term microbiota changes, compare different IUD types, and explore infection prevention strategies. This research is a vital contribution to understanding the effects of IUDs on vaginal microbiota.
Investigation of the effects of heparin and low molecular weight heparin on E-cadherin and laminin expression in rat pregnancy by immunohistochemistry
(OXFORD UNIV PRESS, 2006) Erden, Omer; Imir, Ayse; Guvenal, Tevfik; Muslehiddinoglu, Ahmet; Arici, Sema; Cetin, Meral; Cetin, Ali
BACKGROUND: Heparin and low molecular weight heparin (LMWH) are used widely to improve the pregnancy outcome in women with thrombophilia, miscarriage, recurrent miscarriage and fetal death. This study was designed to investigate the effects of heparin and LMWHs, enoxaparin and tinzaparin, on E-cadherin and laminin expression in placental and decidual tissues in rat pregnancy. METHODS: Wistar albino female rats (n = 48) were randomly assigned to four study groups (normal saline, heparin, enoxaparin and tinzaparin) in the preconceptional period. Tissue sections of placenta and decidua were immunohistochemically examined for the expression of E-cadherin and laminin. RESULTS: E-cadherin placental staining score of heparin group was significantly lower and E-cadherin decidual staining score of heparin and enoxaparin groups were significantly lower than control group. There were no significant differences in placental and decidual laminin staining scores among the study groups. CONCLUSIONS: Heparin and enoxaparin can reduce E-cadherin expression but not laminin expression in rat pregnancy. They might modulate trophoblast invasion. We suggest that this is the possible underlying mechanism involving in improvement of trophoblast invasion by the use of heparin and LMWH in patients with the history of miscarriage.
Lack of association between the CYP11B2 gene polymorphism and preeclampsia, eclampsia, and the HELLP syndrome in Turkish women
(ELSEVIER SCIENCE BV, 2006) Percin, Ferda E.; Cetin, Meral; Pinarbasi, Ergun; Akgun, Egemen; Gurlek, Fatma; Cetin, Ali
Objectives: It is possible that altered control of aldosterone synthase gene (CYP11B2) expression or translation may be responsible for. hypertension. Hypertension is one of the major components of preeclampsia. We present here a study investigating the association between the CYP11B2 gene polymorphism in the promoter region at the position of -344 and preeclampsia. Study design: We analyzed a group of Turkish women for preeclampsia (n = 143), eclampsia (n = 36), and the HELLP syndrome (n = 55) and compared them with controls (n = 147). Genotypes for CYP11B2 were determined by polymerase chain reaction followed by digestion with BsuRI restriction enzyme. Results: The -344T/T, -344C/T, and -344C/C genotypes were found at comparable frequencies among the study groups, between the study and control groups, and between the study groups combined and the control group (p > 0.05). We combined the genotypes of TC and CC (polymorphic) and compared them with the TT (wild-type) genotype. There was no significant difference in the frequency of the TC plus CC genotypes among the study groups, between the study and control groups, and between the study groups combined and the control group (p > 0.05). There was no association of the CYP11B2 polymorphism among the preeclampsia, eclampsia, and HELLP groups and controls. Conclusions: The CYP11B2 gene polymorphism is not directly associated with preeclampsia, eclampsia, and the HELLP syndrome in women with these conditions. Therefore, this polymorphism may not be a risk factor for these disorders, at least not in the Turkish population. (C) 2005 Elsevier Ireland Ltd. All rights reserved.
Pelvimetry by Three-Dimensional Computed Tomography in Non-Pregnant Multiparous Women Who Delivered Vaginally
(INT SCIENTIFIC INFORMATION INC, 2016) Salk, Ismail; Cetin, Ali; Salk, Sultan; Cetin, Meral
Background: We assessed retrospectively the reference values of pelvic dimensions by 3D CT performed for nonobstetrical indications in non-pregnant multiparous women with a successful vaginal delivery. We further aimed to evaluate the impact of maternal short stature on these parameters. Material/Methods: The 3D CT pelvimetry was performed retrospectively in 203 non-pregnant women selected consecutively if they had at least one singleton term delivery with head presentation and if there was no history of maternal or fetal birth trauma or cerebral palsy after childbirth. With standard sagittal and reformatted axial-oblique views, anteroposterior including three conjugates of pelvic inlet, transverse, posterior sagittal diameters of pelvic inlet, the plane of greatest diameter, the plane of least diameter, and pelvic outlet were measured. Selected obstetric parameters were collected. Results: Overall, the pelvises had transverse oval appearance in inlet and size of the female pelvis. The diagonal conjugate was at least 15 mm longer than the obstetric conjugate. Women with short stature had lower maximal birth weight, and this was in accordance with their somewhat lower pelvic diameters. Conclusions: The findings of this study present the reference values of the main planes of the true pelvis by 3D CT pelvimetry in a relatively large group of multiparous women who passed a trial of labor successfully. Overall, the pelvises had features of female pelvic bony structure although pelvic diameters were somewhat lower in multiparous women with short stature. The 3D pelvimetry with CT applications may be used as an adjunct to clinical and ultrasonographic examinations to rule out cephalopelvic dystocia in selected cases.
A Prospective Case-Control Study Analyzes 12 Thrombophilic Gene Mutations in Turkish Couples with Recurrent Pregnancy Loss
(WILEY, 2010) Yenicesu, Gonca Imir; Cetin, Meral; Ozdemir, Ozturk; Cetin, Ali; Ozen, Filiz; Yenicesu, Cem; Yildiz, Caglar; Kocak, Nadir
Problem Recurrent pregnancy loss (RPL) is a heterogeneous disorder. The contribution of specific thrombophilic genes to the pathophysiology of RPL has remained controversial. We evaluated the prevalences of 12 thrombophilic gene mutations among homogenous Caucasian couples with RPL and fertiles. Method of study This was a prospective case-control study evaluating 272 women with RPL and 152 of their male partners, and a control group of 56 fertile couples. We investigated mutations including FV Leiden, factor V H1299R, factor II prothrombin G20210A, F XIII V34L, beta-fibrinogen -455G > A, plasminogen activator inhibitor-1, GPIIIa L33P (HPA-1 a/b L33P), MTHFR C677T, MTHFR A1298C, ACE I/D, Apo B R3500Q, and Apo E. Results Overall, heterozygous mutations of FV Leiden, FXIII V34L, GPIIIa L33P, Apo E4, and prothrombin G20210A and homozygous mutations of PAI-1and MTHFR C677T were associated with RPL. There was no meaningful association between RPL and other studied genes. Conclusion In contrast to the other mutations and polymorphisms, FV Leiden, FXIII V34L, GPIIIa L33P, Apo E, prothrombin G20210A, PAI-1 and MTHFR C677T gene mutations may help to identify the couples at risk for recurrent pregnancy loss.
Serum anti-Mullerian hormone and antral follicle count as predictive markers of OHSS in ART cycles
(SPRINGER/PLENUM PUBLISHERS, 2011) Ocal, Pelin; Sahmay, Sezai; Cetin, Meral; Irez, Tulay; Guralp, Onur; Cepni, Ismail
Objective To evaluate predictive role of day-3 serum anti-Mullerian hormone (AMH) levels and antral follicle count (AFC) in ovarian hyperstimulation syndrome (OHSS) in patients undergoing IVF/ICSI cycles. Materials and methods Forty-one women with moderate/severe OHSS and 41 age matched women without OHSS were compared to evaluate the predictive value of certain risk factors for OHSS. AFC, and E(2), FSH, LH, AMH, inhibin-B levels measured on day 3 of the menstrual cycle before controlled ovarian hyperstimulation. Results Mean FSH was significantly lower (p < 0.0001); and mean LH, AFC and AMH were significantly higher in women with OHSS compared to women without OHSS (p = 0.049, p < 0.0001 and p < 0.0001, respectively). There was no significant difference in inhibin B (p = 0.112) and estradiol (p = 0.706) between the groups. The ROC area under curve (AUC) for AMH presented the largest AUC among the listed risk factors. AMH (AUC = 0.87) and AFC (AUC = 0.74) had moderate accuracy for predicting OHSS while Inhibin B (AUC = 0.58) and LH (AUC = 0.61) had low accuracy. The cut-off value for AMH 3.3 ng/mL provided the highest sensitivity (90%) and specificity (71%) for predicting OHSS. It's positive (PPV) and negative predictive values (NPV) were 61% and 94%, respectively. The cut-off value for AFC was 8 with 78% sensitivity, 65% specificity, 52% PPV and 86% NPV. Conclusion Measurement of basal serum AMH and AFC can be used to determine the women with high risk for OHSS.
Serum Bcl-2, caspase-9 and soluble FasL levels as perinatal markers in late preterm pregnancies with intrauterine growth restriction
(Turkish J Pediatrics, 2019) Genc, Serife Ozlem; Karakus, Savas; Cetin, Ali; Cetin, Meral; Dogan, Halef Okan; Korgali, Elif Unver
Intrauterine growth restriction (IUGR) is the inability of the fetus to grow and develop in the expected pattern. It occurs in about 5% of pregnancies and is associated with severe fetal mortality and morbidity. Affected infants are also highly vulnerable to diseases such as perinatal asphyxia, cerebral palsy, meconium aspiration syndrome, coagulation disorders, and immune system disorders that require long-term treatment. Apoptosis is thought to play a key role in the etiopathogenesis of IUGR. In conclusion, fetal complications are thought to be related to the severity of apoptosis in pregnancies complicated with IUGR. The aim of the study was to test the measurability of the severity of apoptosis using Bcl-2, caspase-9, soluble Fas ligand (sFasL) markers and the maternal blood sample in addition to the diagnostic methods commonly used to diagnose IUGR; and to decrease the rates of adverse perinatal outcomes due to IUGR and to evaluate the fetal well-being status without feeling a need for invasive procedures. One hundred and fifty-nine late preterm pregnancies were included in the study. Eighty were diagnosed with IUGR and the others were the control group. During delivery, maternal and umbilical cord blood samples were taken. Bcl-2, caspase-9, sFasL marker levels in maternal and umbilical cord sera were determined using ELISA method. Bcl-2 levels were found to be significantly high in the maternal and umbilical cord sera in the IUGR group. There was also no significant difference between umbilical cord sera of the two groups in terms of sFasL and caspase-9 levels. The results suggest that maternal serum Bcl-2 levels may also be helpful in the diagnosis of IUGR when used besides the ultrasonographic findings. Multicenter studies with large patient groups will increase knowledge in this area.

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