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Öğe A rare presentation of Behçet ulcer on the vaginal cuff: Case report(Turkiye Klinikleri, 2015) Yorgunlar, Betül; Özdemir, Suna; Aktün Tamer, Lebriz Hale; Acet, MustafaBehçet Syndrome (BS) is a rare chronic, inflammatory, recurrent and multisystemic disease that is characterised by vasculitis throughout the body. BS is an autoimmune disease that affects the neurological and gastrointestinal systems that is characterized by reoccurring oral and genital aphthosis, arthritis, eye and cutaneous lesions. In BS, genital lesions have been reported at rates of 60-90% in different series. Lesions are observed most commonly on the vulva labium majora, followed by the vagina and uterine cervix in descending order. However, no previous study has reported a lesion on the vaginal cuff of a patient who has undergone total hysterectomy. In this study, for the first time, we defined a rare vaginal cuff ulcer in a patient previously diagnosed with BS. This case study will be the first in literature and contribute to it by revealing the appearance of a genital ulcer on the vaginal cuff caused by BS. Moreover, we think that it should be considered in the differential diagnosis of vaginal lesions.Öğe Abdominal wall endometriosis: A case series and review of the literature(Old City Publishing, 2016) Başaranoğlu, Serdar; Ağaçayak, Elif; Deregözü, Elif; Yılmaz, Deniz; Acet, Mustafa; Tunç Yaman, Senem; Evsen, Mehmet Sıddık; Göl, Talip; Kadanalı, SedatObjective: Abdominal wall endometriosis refers to the presence of endometrial tissue in the abdominal wall following a previous obstetric or gynecologic operation. This study aims to present cases of scar endometriosis in the light of literature data. Case Series: Six patients that were operated for masses in the anterior abdominal wall and reported to have endometriosis after a pathological examination were retrospectively analyzed in this study. Demographic data, history of gynecologic and obstetric operations, symptoms on admission, duration of symptoms, and location and size of the mass were noted in all the patients. It was found that all of the patients (6/6) underwent caesarian section, and one of the patients additionally underwent ovarian cyst removal. The mean duration of symptoms present on admission was 25,8 months. The maximum and minimum mass sizes were 65 mm (30-120) and 49.3 mm (26-100), respectively. Conclusion: It should be kept in mind that presence of pain and masses in the anterior abdominal wall following a gynecologic or obstetric operation might be suggestive of endometriosis. We are of the opinion that increased caesarean section rates and use of different cesarean section techniques by different surgeons might play a role in the increased incidence of endometriosis.Öğe Amylin and preptin regulate glucose homeostasis in infertile women with polycystic ovary syndrome and poor responders undergoing IVF/ICSI(Wiley-Blackwell, 2016) Çelik, Nilüfer; Acet, Mustafa; Kenanoğlu, Osman Nezih; Yardım, Meltem; Acet, Tuba; Çelik, Orçun; Aydın, Sevinç[Abstract Not Available]Öğe DHEA supplementation improves endometrial HOXA-10 mRNA expression in poor responders(Galenos Yayıncılık, 2017) Çelik, Önder; Acet, Mustafa; İmren, Aytaç; Çelik, Nilüfer; Erşahin, Aynur; Aktün, Lebriz Hale; Otlu, Barış; Çelik, Sudenaz; Çalıskan, Eray; Ünlü, CihatObjective: The study was planned to investigate whether DHEA supplementation had an impact on endometrial receptivity in women who were poor responders (POR). Material and Methods: Twenty-eight POR women who were undergoing hysteroscopy and five fertile control subjects were included. The POR women were equally subdivided into two separate groups as patients who were currently using DHEA and those who were not. Endometrial samples of the subjects were obtained during hysteroscopy at the late follicular phase. Expression levels of endometrial HOXA-10, HOXA-11, and LIF mRNA were measured with the using real-time polymerase chain reaction. Spontaneous clinical pregnancy rates were also noted. Results: Compared with POR women who were not given DHEA, upregulated endometrial HOXA-10 (7.33-fold) and HOXA-11 (2.39-fold) mRNA expression were detected in POR women on DHEA. The increase in HOXA-10 mRNA was significant (p<0.03). The fold increase in HOXA-11 mRNA was found as 2.39, which indicated a positive upregulation. However, this fold increment was insignificant (p<0.45). An insignificant increase in spontaneous clinical pregnancy rates in POR women on DHEA (53.3%) was observed compared with POR women who were not given DHEA (43.8%). Conclusion: Oral DHEA supplementation in POR upregulates endometrial HOXA-10 mRNA expression, which is known to positively modulate endometrial receptivity.Öğe Disturbed endometrial NF-?B expression in women with recurrent implantation failure(Verduci Publisher, 2016) Erşahin, Aynur Adeviye; Acet, Mustafa; Acet, Tuba; Yavuz, YaseminOBJECTIVE: This study was planned to investigate whether expression levels of endometrial NF-?B1 and NF?B p65 changes in women with recurrent implantation failure (RIF). PATIENTS AND METHODS: The study group consists of 30 RIF patients having at least three previous failed IVF cycles. The control group comprises of 30 patients having one or no previous failed attempt. Endometrial samples were obtained from all participants during hysteroscopy at the late follicular phase. Samples underwent ELISA analysis and immunohistochemical staining. The semi-quantitative H-Score method was used for analyzing the intensity of endometrial NF-?B p65 expression. RESULTS: The concentrations of endometrial NF-?B1 were found to be significantly increased when compared to control subjects. Likewise, significantly increased NF-?B p65 immunoreactivity was detected in the cytoplasm of luminal and glandular epithelial cells. The H-Score of NF- ?B p65 in RIF women was found to be significantly increased when compared to control group. CONCLUSIONS: Increased levels of NF-?B1 and NF-?B p65 in the endometrium of RIF women can disturb physiological inflammation which is known to be positive modulator of endometrial receptivity.Öğe Disulfiram, as a candidate NF-kappa B and proteasome inhibitor, prevents endometriotic implant growing in a rat model of endometriosis(Verduci Publisher, 2016) Çelik, Önder; Erşahin, Aynur; Acet, Mustafa; Çelik, Nilüfer; Baykuş, Yakup; Deniz, Rulin; Özerol, Elif; Özerol, İbrahimOBJECTIVE: Disulfiram (DSF) exerts its therapeutic effects through oxidative, proteasome, and nuclear factor kappa beta (NF-kappa B) pathways. The study was planned to test the impact of DSF on growing of endometriotic implants in rats with experimentally induced endometriosis. PATIENTS AND METHODS: Thirty rats were labeled as the control (n = 8), sham (n = 6), GnRH-agonist (n = 8) and the DSF (n = 8) groups. The rats in the group 3 exposed to single dose leuprolide acetate. The rats in group 4 were treated with DSF for 21 days. The serum activity of oxidant and antioxidant markers, total oxidant status (TOS), total antioxidant status (TAS), interleukin-1 beta, and tumor necrosis factora (TNF-alpha) were determined. Implants were processed for NF-kappa B, PCNA, and CD34 immunostaining. RESULTS: The serum concentration of malondialdehyde in the DSF group was significantly higher than those in other groups. The concentration of TAS, TNF-alpha, and interleukin-1 beta in the DSF group considerably decreased compared to control group. Following treatment with DSF while the percentage of Grade 1 and 2 implants increased the percentage of Grade 3 and 4 implants decreased. The implants disappeared totally in two cases in the DSF group and one case in the GnRH-agonist group. The mean H-Scores of implant NF-kappa B and PCNA in DSF treated animals were found to significantly lower than those of the control group. CONCLUSIONS: By decreasing NF-kappa B expression, angiogenesis, and cell proliferation DSF prevents the growth of endometriotic implants.Öğe Effects of the treatment modalities in Bartholin's abscess(Edizioni Minerva Medica, 2016) Başaranoğlu, Serdar; Ağaçayak, Elif; Deregözü, Ayşegül; Karaköse, Yüksel; Acet, Mustafa; Koyuncu, Diler; İnegöl Gümüş, İlnur; Kadanalı, SedatBACKGROUND: Bartholin's abscess is a gynecological pathology commonly observed in the reproductive period. The etiology attributes this pathology to a wide range of factors. Even though there is more than one treatment option, there has yet to emerge a consensus regarding the ideal method. The present study aims to present patients operated on due to the presence of Bartholin's abscess. METHODS: The data pertaining to 15 patients that had applied to our clinic with various complaints and had been subject to silver nitrate treatment upon the diagnosis of Bartholin's abscess (Group 1) and to 21 patients that had been subject to surgical excision after the same diagnosis (Group 2) were reviewed retrospectively. The review was followed by the recording of age, gravidity, parity, presenting symptoms, mass sizes and locations, operative durations, and observed complications of the patients. The data thus compiled were evaluated through statistical analyses. RESULTS: In the specified timeframe, 36 patients were observed to have been operated upon, 15 patients to have been subject to silver nitrate treatment (Group 1) and 21 patients to have been subject to surgical excision (Group 2). All operated patients were in the reproductive period. Mass locations tended to be in the right side in both groups (93.3% and 90.5%). No statistically significant difference was observed between the operated groups in mass sizes (P=0.892). The operative durations were significantly shorter among patients in Group 1 (P=0.001). Any increase in mass size and operative duration was observed to increase the risk of complications. CONCLUSIONS: Increased mass size and extended operative duration are the two most important risk factors in the emergence of complications. It should be kept in mind that an effective course of treatment can be secured with minimum side effects through the performance of the operation in the shortest duration possible and with the use of suitable techniques. We are of the opinion that appropriate results can be achieved upon the consideration of minimally invasive treatment modalities in all aspects.Öğe Follicular fluid cerebellin and betatrophin regulate the metabolic functions of growing follicles in polycystic ovary syndrome(Korean Society for Reproductive Medicine, 2017) Adeviye Erşahin, Aynur; Acet, Mustafa; Erşahin, Suat Suphan; Acet, Tuba; Yardım, Meltem; Kenanoğlu, Ömer; Aydın, SüleymanObjective The aim of this study was to assess the changes of follicular fluid (FF) and serum levels of cerebellin precursor protein 1 (cbln1) and betatrophin in patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) with a gonadotropin-releasing hormone (GnRH) antagonist protocol. Methods Twenty infertile women with PCOS and 20 control women diagnosed as poor responders undergoing ovarian stimulation with a GnRH antagonist were included. Blood samples were obtained during ovum pick-up. Follicular fluid from a dominant follicle was collected from the subjects. Using enzyme-linked immunosorbent assays, FF and serum levels of cbln1 and betatrophin were measured in both groups of participants. Metabolic and hormonal parameters were also determined and correlated with each other. Results Both groups of women had similar serum and FF betatrophin levels (55.0±8.9 ng/mL vs. 53.1±10.3 ng/mL, p=0.11). The serum and FF betatrophin levels of poor responders were found to be similar (49.9±5.9 ng/mL vs. 48.9±10.7 ng/mL, p=0.22). Conversely, the FF cbln1 levels of PCOS women were found to be significantly higher than the serum cbln1 levels (589.1±147.6 ng/L vs. 531.7±74.3 ng/L, p < 0.02). The FF cbln1 levels of control participants without PCOS were significantly higher than their serum cbln1 levels (599.3±211.5 ng/L vs. 525.3±87.0 ng/L, p=0.01). Positive correlations were detected among body mass index, insulin resistance, serum insulin, total testosterone, and betatrophin levels in the PCOS group. Conclusion Follicular fluid betatrophin and cbln1 concentrations may play a pivotal role on follicular growth in PCOS subjects undergoing IVF/ICSI with an antagonist protocol.Öğe Frozen embryo transfer prevents the detrimental effect of high estrogen on endometrium receptivity(Galenos Yayıncılık, 2017) Erşahin, Aynur Adeviye; Acet, Mustafa; Erşahin, Suat Süphan; Dokuzeylül Güngör, NurObjective: To investigate whether serum levels of estradiol affect reproductive outcomes of normoresponder women undergoing fresh embryo transfer (ET) versus frozen-thawed ET (FET). Material and Methods: Two hundred fifty-five normoresponder women underwent fresh ET in their first or second in vitro fertilization cycle. Ninety-two women with negative pregnacy test results underwent FET. Clinical and ongoing pregnancy rates, implantation, and live birth rates of women undergoing fresh ET versus FET were compared. Results: One hundred forty-seven (57.65%) out of the 255 normoresponder women receiving FET had positive beta-human chorionic gonadotrophin (hCG) results. The remaining 108 women had negative beta-hCG results. The clinical pregnancy rates of the fresh ET group were found as 55.69% (n=142). Ninety-two of the 108 women with failed pregnancies underwent FET; 72.83% had positive beta-hCG results (n=67), and 70.65% had clinical pregnancy (n=65). Both biochemical and clinical pregnancy rates of women undergoing FET increased significantly (p<0.012 and p<0.013, respectively). Ongoing pregnancy (60.87% vs. 52.94%) and live birth rates (59.87% vs. 48.63%) were similar in both fresh and FET groups. Serum E2 levels of women who failed to conceive were significantly higher than those women did conceive. Serum progesterone levels of women who conceived versus those that did not were similar. Conclusion: The detrimental effect of high serum estradiol levels on endometrial receptivity could be prevented by FET.Öğe Gestational diabetes mellitus screening and outcomes(Turkish-German Gynecological Education and Research Foundation, 2015) Aktün, Hale Lebriz; Uyan, Derya; Yorgunlar, Betül; Acet, MustafaObjective: To verify the usefulness of the World Health Organization criteria for the diagnosis of gestational diabetes mellitus in pregnant women and its effectiveness in the prevention of maternal and neonatal adverse results in women younger than 35 years without apparent risk factors for gestational diabetes mellitus. Material and Methods: This is a retrospective study based on population involving 1360 pregnant women who delivered and who were followed-up in a university hospital in Istanbul. All women underwent the 75-g oral glucose tolerance test screening, usually in between the 24 th- 28 th weeks of pregnancy. In all cases, the identification of gestational diabetes mellitus was determined in accordance with the World Health Organization criteria. Results: Approximately 28% of the pregnant women aged younger than 35 years with no risk factors for gestational diabetes mellitus were diagnosed with the oral glucose tolerance test in this study. In the gestational diabetes mellitus group, the primary cesarean section rate was importantly higher than that in the non-gestational diabetes mellitus group. Preterm delivery was also associated with gestational diabetes mellitus. The diagnosis of gestational diabetes mellitus was strongly associated with admittance to the neonatal intensive care unit. Neonatal respiratory problems didn’t showed any significant deviation between the groups. There was a moderate association between gestational dia - betes mellitus and metabolic complications. Conclusion: Pregnant women with no obvious risk factors were diagnosed with gestational diabetes mellitus using the World Health Organiza - tion criteria. The treatment of these women potentially reduced their risk of adverse maternal and neonatal hyperglycemia-related events, such as cesarean section, polyhydramnios, preterm delivery, admission to neonatal intensive care unit, large for gestational age, and higher neonatalÖğe Ghrelin action on GnRH neurons and pituitary gonadotropes might be mediated by GnIH-GPR147 system(Walter De Gruyter Gmbh, 2016) Çelik, Önder; Çelik, Nilüfer; Aydın, Süleyman; Aygün Kumbak, Banu; Haberal Tuştaş, Esra; Kuloğlu, Tuncay; Ulaş, Mustafa; Aktün, Lebriz Hale; Acet, Mustafa; Çelik, SudenazAcylated ghrelin (AG) effect on GnRH secretion is mediated, at least in part, by GH secreta-gogue receptor (GHS-R) which is present in the GnRH neurons. As the acylation is mandatory for binding to GHS-R, unacylated isoform of ghrelin (UAG) action on gonadotropin secretion is likely to be mediated by other receptors or mediators that have not been identified yet. UAG, therefore, may act partially via a GHS-R-independent mechanism and inhibitory impact of UAG on GnRH neurons may be executed via modulation of other neuronal networks. Ghrelin and gonadotropin inhibitory hormone (GnIH), two agonistic peptides, have been known as important regulators of reproductive events. Potential impact of ghrelin on the activity of GnIH neurons is not exactly known. Both GnIH and ghrelin are potent stimulators of food intake and inhibitors of gonadotropin release. By binding G-protein coupled GnIH receptor (GnIH-R), GPR147, which is located in the human gonadotropes and GnRh neurons, GnIH exerts an inhibitory effect on both GnRH neurons and the gonadotropes. The GnIH-GPR147 system receives information regarding the status of energy reservoir of body from circulating peptides and then transfers them to the kisspeptin-GnIH-GnRH network. Due to wide distribution of this network in brain GnIH neurons may project on ghrelin neurons in the arcuate nucleus and contribute to the regulation of UAG's central effects or vice versa. Together, the unidentified ghrelin receptor in the hypothalamus and hypophysis may be GnIH-R. Therefore, it is reasonable that ghrelin may act on both hypothalamus and hypophysis via GnIH-GPR147 system to block gonadotropin synthesis and secretion.Öğe Hiperemezis gravidarumda helicobacteria pylori seropozitifliği(Fırat Üniversitesi, 2014) Aktün, Lebriz Hale; Yorgunlar, Betül; Acet, MustafaAmaç: Bu çalışma da Helicobacteria pylori ile hiperemezis gravidarum arasındaki ilişkinin ortaya konması amaçlandı. Gereç ve Yöntem: Çalışmamıza 82 hiperemezis gravidarum tanısı almış gebe ile 98 gebe kontrol grubu olarak alındı. ELİSA tekniği ile 180 hastanın Helicobacteria pylori IgG, H. pylori Cytotoxin associated gene A (Cag A) pozitifliğine bakıldı. Bulgular: Hiperemezis gravidarum ve kontrol grubunda Helicobacteria pylori seropozitifliği açısından istatistiksel olarak anlamlı fark bulunamadı. Literatürde bu konuda kısıtlı sayıda çalışmaların çelişkili sonuçlar vermesi gebelikte Helicobacteria pylori taraması yapmak Türkiye koşullarında hem pratik değil hem de oldukça masraflı görünmektedir. Sonuç: Helicobacteria pylori ye karşı oluşmuş spesifik antikorların yüksek oranda pozitif olması nedeniyle,risk faktörü taşıyan kadınlara (önceki gebeliklerinde şiddetli hiperemezis gravidarum öyküsü veya gastrointestinal yakınmaları olanlar)bir sonraki gebeliklerinden önce Helicobacteria pyloritaramasının yapılması ve pozitif çıkanlara tedavinin verilmesi, hem gebelikteki şikayetlerinin azalmasında hemde risk faktörü taşıyan grubun aile fertlerininde taranarak, tedavisi, Helicobacteria pylori eleminasyonu açısından önerilebilir.Öğe Hypothesis: Co-transfer of genuine embryos and implantation promoting compounds via artificial containers improve endometrium receptivity(Churchill Livingstone, 2017) Çelik, Önder; Acet, Mustafa; Çelik, Sudenaz; Şahin, Levent; Koç, Önder; Çelik, NiluferAs with other organs endometrial functions are altered with the advancing age. Age related decrease in reproductive functions leads to decline in the number of oocytes retrieved and the synthesis of endometrial receptivity molecules. Despite the significant improvement in assisted reproductive technologies we do not have so many options to enhance endometrial receptivity. Due to lack of drugs having endometrium receptivity enhancement properties, oocyte donation seems to be the only solution for women with implantation failure. The euploid oocytes come from young and healthy donors may overcome age associated endometrial receptivity defect. Nevertheless, many reasons restrict us from using oocyte donation in women with implantation failure. We, therefore, hypothesized that by mimicking a young blastocyst's effect on endometrium, the transfer of genuine embryos and implantation-promoting compounds together might be the new treatment option for infertile women with recurrent implantation failure. Artificial beads, MI or GV oocytes, and empty zona can be used as a container for intrauterine replacement of implantation-promoting compounds.Öğe Impact of endometrioma resection on eutopic endometrium metabolite contents: Noninvasive evaluation of endometrium receptivity(Sage Publications Inc, 2017) Erşahin, Aynur; Çelik, Önder; Acet, Mustafa; Erşahin, Süphan; Acet, Tuba; Kara Bozkurt, Duygu; Yavuz, Yasemin; İlhan, SelçukThe aim of this study was to determine whether endometrioma resection alters most commonly defined endometrial metabolites, lactate (Lac), N-acetylaspartate (NAA), creatine 1 (Cr1), creatine 2 (Cr2), and choline (Cho) during the window of implantation. Twenty patients with uni- or bilateral endometrioma and 7 patients having nonendometriotic benign ovarian cyst were included. Midluteal phase magnetic resonance spectroscopy analysis of eutopic endometrium was performed before surgery. Second spectrum of endometrium was obtained 3 to 5 months after laparoscopic endometrioma resection. Pre- and postoperative endometrial peaks of Lac, NAA, Cr, and Cho were measured in units and denominated in parts per million (ppm). Compared to preoperative peak values, significantly decreased NAA, Lac, and Cr1 signals were noted in patients undergoing endometrioma surgery. Nearly 5-fold decline in the NAA signal occurred after endometrioma surgery (1.94 +/- 3.24 vs 0.37 +/- 0.55). Likewise, 2.5-fold decline in Lac signals was noted after endometrioma resection (2.81 +/- 2.64 vs 1.06 +/- 1.88). Both uni- and bilateral endometrioma affected endometrium signals the same. The peak intensity of Cho, Cr1, Cr2, NAA, and Lac did not alter significantly after nonendometriotic cyst surgery. Endometrioma surgery straightens endometrial NAA, Lac, and Cr1 peaks, suggesting improvement in endometrial receptivity.Öğe Irisin immunostaining characteristics of breast and ovarian cancer cells(C M B Assoc, 2016) Kuloğlu, Tuncay; Çelik, Önder; Aydın, Süleyman; Özercan, Hanifi; Acet, Mustafa; Aydın, Yalçın; Artaş, Gökhan; Türk, Ahmet; Yardım, Meltem; Ozan, Gonca; Yalçın, Mehmet Hanifi; Kocaman, NevinTo determine expression pattern of irisin in tissues obtained from human ovarian cancer, breast cancer, and cervix cancer. Tissue samples obtained from subjects with breast cancer, ovarian cancer cervix cancer, simple endometrial hyperplasia, complex atypical endometrial hyperplasia. At least five sections from each subject were immunohistochemically stained with irisin antibody, and H-score method was used to evaluate irisin intensity. Tissues obtained from healthy breast tissues, proliferative phase endometrium adenomyosis and benign ovarian tumors were accepted as control. Irisin activity was not detected in control breast tissues significantly increased irisin staining was detected in invasive lobular, intraductal papillary, invasive ductal, invasive papillary, and mucinous carcinomas compared to control tissues. Also, significantly increased irisin immunoreactivity was detected in both ovarian endometriosis and mucinous carcinomas compared to benign tumors. However irisin staining was not observed at the papillary carcinoma of the ovary while sections obtained from simple and complex atypical endometrial hyperplasia, and cervix carcinoma demonstrated irisin immunoreactivity. Increased irisin immunoreactivity in tissues obtained from breast, ovary, cervix carcinomas, and endometrial hyperplasia suggest critical role of this peptide during carcinogenesis.Öğe Is caesarean myomectomy a safe procedure? A comparative study(2016) Başaranoğlu, Serdar; Ağaçayak, Elif; Deregözü, Ayşegül; Gümüş İnegöl, İlknur; Acet, Mustafa; Gül, TalipOBJECTIVE: Uterine myomas are the most common benign pelvic tumours observed during the reproductive period.Increased risks of haemorrhage and postoperative morbidity lead professionals to avoidmyomectomy at the time of Cesarean (C-section). The present study retrospectively analysed the dataof patients who had undergone C-section only and those that had undergone C-section and simultaneous myomectomy. STUDY DESIGN: The data of 42 patients (Group 1) who had underwent caesarean myomectomy andof 50 patients underwent C-section only (Group 2) out of 92 patients that had been taken into C-sectionon the basis of obstetric indications were retrospectively analysed in this study. The relevant patient datawere recorded with the inclusion of demographic data, gestational week, and preoperative and postoperative laboratory findings. Types, locations and sizes (the largest diameter) of individual myomas wereidentified and noted.RESULTS: The mean diameter of myomas was 66.3±30.2 mm. Ten patients that had underwent caesarean myomectomy (23.8%) developed a need for intensive care. No statistically significant differencewas found in laboratory parameters between Group 1 and Group 2.CONCLUSION: Caesarean myomectomy, when performed by experienced obstetricians, does not leadto a significant increase in maternal morbidity and mortality. Although the short-term effects of this procedure are known, there is a need for the conduct of more comprehensive studies to establish its longterm effects on fertility or how it will affect the next pregnancy processesÖğe Nuclear factor-kappa B expression in the endometrium of normal and overweight women with polycystic ovary syndrome(Taylor & Francis Ltd., 2017) Koç, Önder; Özdemirici, Şafak; Acet, Mustafa; Soytürk, Ümmügülsüm; Aydın, SüleymanThe aim of this study was to investigate whether the expression levels of endometrial NF kappa B p65 differ between normal weight and overweight PCOS women and to compare them with BMI-matched control subjects without PCOS. The study group comprised 20 normal weight (BMI: 18.5-24.9 kg/m(2)) and 15 overweight PCOS women (BMI: 25-29.9 kg/m(2)) with infertility. Healthy fertile women without PCOS were recruited as the control group. The patients in the normal weight PCOS group and control group were age and BMI-matched. Endometrial samples were obtained during the mid-luteal phase for immunohistochemical staining. The H-Score method was used to evaluate NF-kappa B p65 (Rel A) expression. Both normal and overweight PCOS women demonstrated significantly higher endometrial NF-kappa B p65 expression than the women without PCOS. The H-scores of endometrial NF-kappa B p65 expression were similar in both groups of PCOS women. NF-kappa B p65 was positively correlated with serum insulin, HOMA-IR and total testosterone levels in PCOS women. By leading to pathological inflammation, an increase in NF-kappa B p65 expression in the endometrium of normal and overweight PCOS women may contribute to PCOS-related subfertility. IMPACT STATEMENT What is already known on this subject: Although the pathogenesis of PCOS has not yet been clarified, low-grade chronic inflammation is gradually being established as an important pathogenetic factor. Increased levels of inflammatory cytokines such as IL-6 and TNF-alpha. have been reported in women with PCOS. Causes of pathological endometrial inflammation may arise from either a local endometrial disease or linked to diseases which are located in a distant reproductive tissue. Nevertheless, possible role of endometrial NF-kappa B, basic cellular regulatory of inflammation, in the pathophysiology of PCOS related implantation defect has not been elucidated yet. What do the results of this study add: This study provides first and novel insights into the relationship between PCOS related infertility and pathological endometrial inflammation. We demonstrated that there is a close association between PCOS and pathological endometrial inflammation. Moreover, we clearly showed that pathological endometrial inflammation occurs in both normal and overweight women with PCOS. Further, endometrial NF-kappa B p65 (Rel A) expression were found to be positively correlated with serum insulin levels and hyperandrogenism in overweight PCOS women. What are the implications of these findings for clinical practice: If we can analyse pathological endometrial inflammation by measuring endometrial NF-kappa B p65 (Rel A) expression, treatment could be directed towards eliminating the source of pathological endometrial inflammation.Öğe Ozone (03)-Oxygen mixture therapy inhibits endometrial implant growth(CIC Edizioni Internazionali s.r.l., 2016) Aktün, Lebriz Hale; Atılgan, Remzi; Karaca, Nilay; Acet, Mustafa; Yorgunlar, Betül; Can, Behzat; Dağlı, Adile Ferda; Gül, Hüseyin Fatih; Kumbak, Banu; İrban, Arzu[Abstract Not Available]Öğe Ozone (03)-oxygen mixture therapy inhibits endometrial implant growth(E-Century Publishing Corp, 2016) Aktün, Lebriz Hale; Acet, Mustafa; Atılgan, Remzi; Karaca, Nilay; Yorgunlar, Betül; Can, Behzat; Dağlı, Adile Ferda; Gül, Hüseyin Fatih; Kumbak, Banu; İrban, ArzuThe aim of this study was to investigate potential therapeutic efficiency of ozone therapy in the treatment of experimental endometriosis in rats. Fifteen rats were divided into three groups, which were labeled as the (1) sham control, (2) the ozone (treated with intraperitoneal ozone-oxygen mixture) and (3) the GnRH-agonist (given single dose (1 mg) leuprolide acetate depot formulation) group. Endometrial implant activity of superoxide dismutase (SOD), malondialdehyde (MDA), interleukin-1 beta (IL-1 beta), IL-6, tumor necrosis factor-alpha (TNF-alpha), and vasculary endothelial growth factor (VEGF) were measured after ozone-therapy. Furthermore, peritoneal fluid activity of SOD, MDA, and TNF-alpha were also measured before and after ozone-therapy. Serum AMH levels of the rats those were given ozone-therapy and control groups were measured. The rats given ozone-therapy showed significantly reduced endometriotic implant volumes. After ozone-therapy, a significant increase in activity of SOD in peritoneal fluid was detected. Conversely, implant levels of SOD in rats given ozone therapy was found to be significantly decreased. Both peritoneal fluid and implant levels of MDA were significantly decreased after ozone-therapy. Implant levels of TNF-alpha, IL-1 beta, and IL-6 were significantly increased following ozone-therapy. VEGF levels of implant was found to be unchanged after ozone-therapy. Serum AMH levels of animals were given ozone-therapy and control groups were similar. The number of both primordial and preantral follicles were significantly decreased after ozone-therapy. However, the number of atretic follicles were similar in ozone-therapy and control groups. Repeated administration of ozone-oxygen therapy in non-toxic doses inhibits growth of endometrial implants.Öğe Ozone (O3)-oxygen mixture therapy inhibits endometrial implant growth(Taylor & Francis Ltd, 2016) Aktün, Lebriz Hale; Atılgan, Remzi; Karaca, Nilay; Acet, Mustafa; Yorgunlar, Betül; Can, Behzat; Dağlı, Ferda; Gül, Fatih; Kumbak, Banu; İrban, Arzu[Abstract Not Available]
