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    Association of Helicobacter pylori infection with systemic inflammation in preeclampsia
    (Taylor & Francis Ltd, 2010) Ustun, Yusuf; Engin-Ustun, Yaprak; Ozkaplan, Esra; Otlu, Baris; Tekerekoglu, Mehmet Sait
    Methods. Forty patients with preeclampsia and 40 normotensive pregnant women of similar age and body mass index at the third trimester of gestation were selected for the study. Chlamydia pneumonia IgM and IgGs, Helicobacter pylori IgAs and concentrations of CRP and TNF-alpha were measured. Results. Concentrations of CRP and TNF-alpha were significantly higher in patients with preeclampsia than in control subjects. In the preeclamptic group, positivity rate for Helicobacter pylori IgA was significantly higher as compared to controls (p = 0.034). CRP and TNF-alpha levels were higher in Helicobacter pylori seropositive subjects. Conclusion. We demonstrated high levels of serum CRP and TNF-alpha in preeclamptic women who were seropositive to Helicobacter pylori in comparison with those in seronegative subjects.
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    Effect of Intranasal Estrogen on Vocal Quality
    (Mosby-Elsevier, 2009) Firat, Yezdan; Engin-Ustun, Yaprak; Kizilay, Ahmet; Ustun, Yusuf; Akarcay, Mustafa; Selimoglu, Erol; Kafkasli, Ayse
    The objective of this study was to evaluate the effect of intranasal estrogen therapy on female vocal quality. Thirty-two women who had surgically induced menopause were included into the study group and examined through hall year for this study. Estrogen treatment was proposed to all of the patients. Twenty-three of them accepted the treatment protocols including oral (n = 12) (2 mg estradiol; Estrofem; Novo Nordisk, Denmark) and intranasal (n = 11) (300 mcg 17beta-estradiol; Aerodiol; Servier, Chambray-les-Tours, France) form of estrogen. The rest of patients refused estrogen treatment and those patients constituted the control group (n = 9). Vocal changes were evaluated with Voice Handicap Index (VHI) and acoustic analysis of voice variations (fundamental frequency [F0], SD F0, jitter, shimmer, normalized voice energy, and harmonics-to-noise ratio) at baseline and after 1-year follow-up. According to VHI, while voice improvement was not clear in oral estrogen group, it was significant at intranasal estrogen group. Voice quality in patients treated with hormone replacement therapy (HRT) was significantly higher than patients without HRT. But between two treatment groups, there were no any statistical discrepancy. According to acoustic analysis, vocal stability among the women who use HRT was significantly better than those who did not use. Intranasal estrogen exerted the most significant effects on vocal stability. The data of our study support that voice undergoes changes in lack of estrogen in surgically induced menopausal women. Taken together with the relevant studies, while oral estrogen replacement therapy shows a favorable influence on voice quality, it seems to be more pronounced with intranasal estrogen than oral form.
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    Effect of metformin on serum visfatin levels in patients with polycystic ovary syndrome
    (Elsevier Science Inc, 2010) Ozkaya, Mesut; Cakal, Erman; Ustun, Yusuf; Engin-Ustun, Yaprak
    Objective: To evaluate serum visfatin levels and to determine the effects of metformin treatment on visfatin levels in patients with polycystic ovary syndrome (PCOS). Design: Cross-sectional study. Setting: University hospital. Patient(s): Nineteen patients with PCOS and 21 controls. Intervention(s): Metformin was given to patients with PCOS, and serum visfatin levels were measured before and after treatment. Main Outcome Measure(S): Glucose, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, DHEAS, total T, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), and visfatin levels were measured. Result(s): Serum visfatin levels were significantly higher in women with PCOS than in controls. Visfatin could differentiate between women with and without increased diabetogenic risk at a cut-off value of 19.24 ng/mL, with a sensitivity of 93.3% and a specificity of 84%. In bivariate analysis of subjects, T, insulin, and waist circumference were significantly and positively correlated with visfatin. Treatment resulted in a significant decrease in body mass index and a decrease in visfatin concentration. After therapy, statistically significant decreases in HOMA-IR, fasting insulin, free T, and DHEAS concentrations were observed for the PCOS group. Conclusion(s): Circulating visfatin levels were higher in patients with PCOS than healthy controls, and metformin treatment significantly reduced circulating visfatin concentrations after 3 months of therapy. (Fertil Steril (R) 2010:93:880-4. (C)2010 by American Society for Reproductive Medicine.)
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    Evaluation of asymmetric dimethylarginine, nitric oxide levels and associated independent variables in obese and lean patients with polycystic ovarian syndrome
    (Taylor & Francis Ltd, 2011) Turkcuoglu, Ilgin; Engin-Ustun, Yaprak; Turan, Fahri; Kali, Zercan; Karabulut, Aysun Bay; Meydanli, Mutlu; Kafkasli, Ayse
    Objective. To evaluate the asymmetric dimethylarginine (ADMA) and nitric oxide (NO) levels in obese and lean patients with polycystic ovarian syndrome (PCOS) and find out their relation with hormonal and metabolic parameters. Methods. Twenty-two obese, 18 lean patients with PCOS and 11 obese, 24 lean healthy control patients were enrolled prospectively. Plasma ADMA and NO levels and arginine/ADMA ratio were evaluated on 3rd day of menstrual cycle after at least 10 h overnight fasting. Results. Plasma ADMA, NO levels and arginine/ADMA ratio were similar in the groups. ADMA level did not correlate with the hormonal and metabolic parameters in patients with PCOS. However, NO correlated inversely with fasting insulin (r = -0.353, p = 0.041) and homeostasis model of insulin resistance (HOMA-IR) (r = -0.379, p = 0.027). Arginine/ADMA ratio also correlated inversely with fasting insulin (r = -0.339, p = 0.050). In multinomial regression analysis the risk of low NO was associated independently with high fasting insulin (OR = 1.19, 95% CI 1.001-1.42, p = 0.049) and high HOMA-IR in patients with PCOS (OR = 2.26, 95% CI 1.03-4.98, p = 0.042). Conclusions. Insulin resistance may be the underlying mechanism of endothelial dysfunction through NO pathway in PCOS.
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    Ischemia-modified albumin as an oxidative stress marker in preeclampsia
    (Taylor & Francis Ltd, 2011) Ustun, Yusuf; Engin-Ustun, Yaprak; Ozturk, Ozlem; Alanbay, Ibrahim; Yaman, Halil
    Methods. aEuro integral Serum ischaemia-modified albumin levels were measured in 18 normotensive and 36 preeclamptic pregnant women by enzyme linked immuno-sorbent assay. Patients were subdivided as having either mild (n == 18) or severe preeclampsia (n == 18). Receiver operating characteristic curve was constructed, and sensitivity and specificity were calculated based on the best cut-off. Results. aEuro integral IMA levels were significantly higher in the mild and severe preeclamptic groups than in the control group. IMA with a cut-off point of 0.31 identified women with preeclampsia with sensitivity 80%% and specificity 77.8%%. Conclusion. aEuro integral Our study demonstrates that serum levels of IMA correlate with severity of preeclampsia.
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    Meydanli Compression Suture: New surgical procedure for postpartum hemorrhage due to uterine atony associated with abnormal placental adherence
    (Wiley, 2008) Meydanli, Mehmet Mutlu; Turkcuoglu, Ilgin; Engin-Ustun, Yaprak; Ustun, Yusuf; Kafkasli, Ayse
    Aim: To inform about the clinical results of a new uterine compression suture technique used in the surgical management of postpartum hemorrhage due to uterine atony associated with abnormal placental adherence. Methods: Postpartum hemorrhage due to uterine atony associated with abnormal placental adherence was diagnosed in seven out of 1819 (0.38%) cesarean sections performed between January 2004 and February 2007, and a new uterine compression suture technique was used for surgical management. Age, parity, gestational age and cesarean section indications, amount of transfusion performed, length of hospital stay, postoperative complications, and number of patients in whom the uterus was preserved were evaluated. Results: The mean age of the cases was 30.5 +/- 3.7 (24-35) years. Cesarean indications were previous cesarean section plus placenta previa totalis in three cases (43%), previous cesarean section in two cases (29%), a twin pregnancy as a result of in vitro fertilization-embryo transfer in one case (14%) and preterm premature rupture of membranes in one case (14%). Six out of seven cases (85%) were successfully treated with the Meydanli compression suture and the uterus was preserved. Conclusion: The Meydanli compression suture seems to be a simple, quickly applicable and safe uterine compression suture technique, which decreases maternal mortality and peripartum hysterectomy rates.