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    Association of maternal serum high sensitive C-reactive protein level with body mass index and severity of pre-eclampsia at third trimester
    (Wiley, 2010) Ertas, Ibrahim E.; Kahyaoglu, Serkan; Yilmaz, Bulent; Ozel, Murat; Sut, Necdet; Guven, Melih A.; Danisman, Nuri
    Aim: To assess a maternal serum level of high sensitive C-reactive protein (hs-CRP) as a useful clinical parameter in prediction of pre-eclampsia severity and, to evaluate the correlation between hs-CRP and body mass index (BMI). Material & Methods: Using cross-sectional study design, CRP was measured by a high sensitive immunoturbidimetric method between 24 and 40 weeks of gestation in normotensive controls (n = 115), in mild (n = 63) and severe (n = 34) pre-eclamptic patients. The receiver operating characteristic analysis was used to estimate the optimal threshold score of hs-CRP. Results: For disease severity evaluation, a hs-CRP concentration of 9.66 mg/L was determined as cut-off point with 88% sensitivity, 81% specificity, 71% positive predictive value and 92% negative predictive value. When all three groups of patients were adjusted for gestational age [24 degrees/7-27,6/7 28 degrees/7-33,6/7 34 degrees/7-406/7] and BMI, hs-CRP levels of severe pre-eclamptic patients were significantly higher than mild ones and controls in the study group with BMI < 25 kg/m2 (P < 0.001). In the study group with BMI >= 25 kg/m2, only severe pre-eclamptic patients between 28 degrees/7 and 336/7 weeks of gestation had significantly higher hs-CRP levels when compared with control and mild pre-eclamptic group (P < 0.001). When the patients were subgrouped as high (>= 9.66 mg/L) and low hs-CRP group (< 9.66 mg/L), adverse outcomes for hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome and intrauterine growth-restricted baby were statistically significant higher in high hs-CRP group (P = 0.004 and P < 0.001, respectively). Conclusion: Elevated level of hs-CRP is a useful parameter in the severity of clinical risk of pre-eclampsia in patients with BMI < 25 kg/m2 at third trimester.
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    Comparison of Ki-67 proliferative index between eutopic and ectopic endometrium: A case control study
    (Elsevier Taiwan, 2012) Kahyaoglu, Inci; Kahyaoglu, Serkan; Moraloglu, Ozlem; Zergeroglu, Sema; Sut, Necdet; Batioglu, Sertac
    Objective: In this study, the Ki-67 proliferative indices among the stages of the endometriosis were compared to clarify whether the proliferation was increased with increasing disease stage. Materials and Methods: Thirty-eight patients who underwent surgery either by laparotomy or by laparoscopy with the diagnosis of endometriosis and 21 patients, as controls, who underwent hysterectomy with the diagnosis of myoma uteri and without any endometrial pathology at our hospital between 2005 and 2007 were studied. Biopsy specimens of endometriotic foci and endometriomas in study group, and eutopic endometrium of hysterectomy specimens of control group were studied. Results: Fifty-nine patients were divided into Group 1 (21 patients in control), Group 2 (19 patients in stage I and II of endometriosis), and Group 3 (19 patients in stage III and IV). A moderate correlation between the stage of endometriosis and the degree of Ki-67 staining was found. When Ki-67 immunohistochemical staining was considered according to the threshold value for CA-125 (35 U/mL), Ki-67 positivity was increased with the increase in CA-125 value, but this increase was not statistically significant. Conclusion: Endometriosis shows some characteristics of tumors such as high rate of invasion, getting autonomy, and proliferation as the disease progresses with subsequent damage to target organs. When the stage of the disease increases, environment becomes more suitable for increased proliferation and invasion. In this study, the increase in proliferative activity as the severity increases is shown by the increase in Ki-67 index. As more studies are being conducted in this field, pathogenesis will be clarified, which could help in the development of new treatment modalities. Copyright (C) 2012, Taiwan Association of Obstetrics & Gynecology. Published by Elsevier Taiwan LLC. All rights reserved.
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    DIAGNOSTIC VALUE AND TIMING OF SERUM ANTICHLAMIDIAL ANTIBODY LEVEL EVALUATION DURING INFERTILITY WORKUP AMONG INFERTILE WOMEN IN WHOM TUBAL FACTOR WAS DETECTED WITH DIAGNOSTIC LAPAROSCOPY
    (Galenos Yayincilik, 2012) Kahyaoglu, Serkan; Kahyaoglu, Inci; Sut, Necdet; Aydin, Mehmet; Mollamahmutoglu, Leyla; Ozcan, Utku
    Objectives: With normal hysterosalpingography (HSG) results, selecting suitable candidates for the laparoscopic treatment of probable pelvic adhesions following previous pelvic inflammatory disease, it would be wise to investigate serum antibody screening against chlamidia trachomatis. It is worth to evaluate whether it is useful to detect a negative antichlamidial antibody disease for cancelling laparoscopy for a while with abnormal HSG findings. These two subjects have been investigated in study. Material and methods: For detecting diagnostic value of serum antichlamidial antibody, in our infertility clinic, postoperative blood samples of 80 patients who were hospitalized for diagnostic laparoscopy to investigate infertility ethiology between May 2004 and November 2005 have been tested with microelisa method for antichlamidial IgM and IgG antibodies. HSG films of the patients performed at least one year were evaluated. Venous blood was drawn from these patients during postoperative early period for studying serum IgM and IgG antibodies of chlamidia trachomatis and the results were compared with operative findings. Results: According to the antichlamidial antibody levels 60 (75%) patients have not been infected with chlamidia and 20 (25%) patients have been infected previously. When the patients were divided to two groups; normal and abnormal; based on preoperative HSG films; 18 (30%) of the 60 patients with abnormal HSG films and 2 (10%) of the 20 patients with normal HSG films had positive antichlamidial antibody levels respectively. Conclusion: The relationship between chlamidia trachomatis infection and tubal infertility has been demonstrated among 85% of patients with positive antichlamidial antibody levels and 46.7% of patients with negative levels who had tubal passage defects detected during diagnostic laparoscopy.