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    Hydronephrosis of pregnancy associated with torsion of the fallopian tube: a case report
    (Verduci Publisher, 2011) Simsek, Y.; Ustun, Y.; Kaymak, O.; Akbaba, E.; Danisman, N.; Sirvan, L.
    Isolated tubal torsion accompanying pregnancy is an extremely rare condition. Preoperative diagnosis is generally difficult; most of the cases can be diagnosed intraoperatively. Here, we reported a 36-week pregnant with a complaint of acute pain in right lower quadrant that emanating to right lomber region. Abdominal utrasonography showed grade 3 hydronephrosis in right kidney, other findings were normal. A cesarean section was carried out and a twisted right tube were diagnosed. Right ovary was normal in appearance. The torsioned tube compressed the right ureter and caused ureteral dilatation. Right salpingectomy was performed. Postoperative follow-up of the patient was uneventful.
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    Serum lipocalin-2 as an insulin resistance marker in patients with polycystic ovary syndrome
    (Springer, 2011) Cakal, E.; Ozkaya, M.; Engin-Ustun, Y.; Ustun, Y.
    Background: Our aim was to investigate levels of lipocalin-2 and its relationship with metabolic factors in women with polycystic ovary syndrome (PCOS). Materials/Subjects and methods: In this cross-sectional study, two groups of women were studied: group 1 consisted of women with PCOS (no.=30), and group 2 consisted of control women with normal ovulatory function (no.=30). The circulating levels of free testosterone (T), DHEAS, glucose, insulin, triglycerides (TG), HDL, LDL and lipocalin were measured. Insulin resistance was assessed using the homeostasis model assessment (HOMA-IR). In order to determine a lipocalin value indicating insulin resistance, receiver operating characteristic (ROC) curves were established. Results: Serum lipocalin was significantly higher in PCOS subjects (54.26 +/- 15.58 vs 26.09 +/- 7.47 ng/ml, p=0.0001). We found a close correlation between lipocalin and insulin, lipocalin and HOMA-IR, lipocalin and T, and lipocalin and DHEAS. A cut-off level of >39.54 ng/ml for serum lipocalin has a predictive value for insulin resistance of 81% sensitivity and 82.1% specificity. Conclusion: In our study, lipocalin-2 levels were found to be significantly higher in women with PCOS compared to body mass index-matched controls. Serum lipocalin-2 may prove to be a useful marker for insulin resistance in patients with PCOS. (J. Endocrinol. Invest. 34: 97-100, 2011) (C)2011, Editrice Kurtis
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    Severe preeclampsia and fetal virilization in a spontaneous singleton pregnancy complicated by hyperreactio luteinalis
    (Verduci Publisher, 2012) Simsek, Y.; Celen, S.; Ustun, Y.; Danisman, N.; Bayramoglu, H.
    Background: Hyperreactio luteinalis is a rare condition that stems from theca cell hyperplasia in the ovaries due to a high level of human chorionic gonadotropin during gestation. It occurs commonly in pregnant patients with trophoblastic disease, occasionally in multiple pregnancies, and rarely in normal singleton pregnancy. Case Report: A 24-year-old pregnant woman, G3 P0, who was admitted to the Perinatology Clinic with increasing findings of virilization during pregnancy was presented. The patient had bilaterally enlarged multicystic ovaries on sonographic examination and elevated serum androgen levels She was managed conservatively until 38th week of gestation as a presumptive diagnosis of hyperreactio luteinalis. Elevated blood pressure and prominent proteinuria were detected during the follow-up of the patient and labor was induced. She underwent an emergency caesarean delivery because of fetal distress. During caesarean section, ovarian biopsies were taken and a histopathological diagnosis of hyperreactio luteinalis was determined. The female fetus also presented virilization. Conclusion: Although infrequent, hyperreactio luteinalis with both maternal and fetal virilization can occur in women with spontaneous singleton pregnancies. The clinical manifestations in such women may be complicated by severe preeclampsia.