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Demirkiran F, Bese T, Meseci E, Onculoglu C, Erenel H, Sal V, Arvas M. The surgical outcomes of abdominal radical trachelectomy: does transrectal ultrasonography determine the cervical incision site during surgery? EUR J GYNAECOL ONCOL 2014; 35:566-570. [PMID: 25423706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE To evaluate the surgical outcomes of abdominal radical trachelectomy(ART) and the efficacy of transrectal ultrasonography in determining the upper end of cervical incision during this operation. MATERIALS AND METHODS ART was performed in five patients with early-stage cervical cancer in the present clinic. In the first three patients, uterine corpus was transacted blindly at a level of approximately five mm below the internal os. In the last two patients, the authors performed transrectal ultrasonography before vaginal incision to evaluate the distance between upper margin of tumoral mass and internal os of cervical canal. RESULTS Mean follow-up was 21 months. During this period, menstrual abnormality occurred in three patients. The two patients in which transrectal ultrasonographies were taken intraoperatively had 9- and 12-mm postoperative cervical canal length and both of them were asymptomatic postoperatively. CONCLUSIONS ART is usually associated with menstrual abnormality at late postoperative period and transrectal ultrasonograph during this procedure may decrease postoperative morbidity.
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Bese T, Vural A, Ozturk M, Dagistanli F, Demirkiran F, Tuncdemir M, Arvas M, Sanioglu C, Kosebay D. The effect of long-term use of progesterone therapy on proliferation and apoptosis in simple endometrial hyperplasia without atypia. Int J Gynecol Cancer 2006; 16:809-13. [PMID: 16681766 DOI: 10.1111/j.1525-1438.2006.00533.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The aim of this study was to evaluate the effect of long-term use of progesterone treatment on proliferation and apoptosis in simple endometrial hyperplasia without atypia. In this prospective control study, endometrial tissue samples of 19 patients with simple endometrial hyperplasia without atypia (group 1), posttreatment biopsy materials of the patients after 3 months of cyclic progesterone treatment with noretisterone for 10 days (group 2), and 18 endometrial biopsy materials of the control group (group 3) were examined for proliferative and apoptotic activities. There was a statistically significant difference between the median values of the proliferative index of the three groups (P = 0.000). The proliferative index was significantly higher in the endometrial hyperplasia group than in posttreatment group (P = 0.000). But there was no significant difference between posttreatment group and control group. The median value of apoptotic activity was significantly different between three groups (P = 0.000). Apoptotic index was highest in hyperplasia group. A significant decrease in apoptosis was observed after the progesterone treatment (P = 0.002). The lowest apoptotic activity was detected in the control group. In conclusion, 3 months of cyclic progesterone treatment reduces both proliferative and apoptotic activities in endometrial tissue with simple hyperplasia.
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Affiliation(s)
- T Bese
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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Abstract
We report a case of 69-year-old woman who presented with pleural metastasis of a serous papillary adenocarcinoma of the ovary. After chemotherapy and surgery, she had 2 years disease-free survival. After this period of time, she presented with a swollen leg, a cellulitis-like syndrome and erythematous nodules at lower abdominal wall and upper leg skin. The skin biopsy revealed metastasis of adenocarcinoma in the dermis. She died after 4 months of the diagnosis of the skin metastasis. In 20 years experience in our unit, it is the first time that we recognize a cutaneous metastasis in ovarian cancer.
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Affiliation(s)
- Z Yilmaz
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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Abstract
We report a case of 69-year-old woman who presented with pleural metastasis of a serous papillary adenocarcinoma of the ovary. After chemotherapy and surgery, she had 2 years disease-free survival. After this period of time, she presented with a swollen leg, a cellulitis-like syndrome and erythematous nodules at lower abdominal wall and upper leg skin. The skin biopsy revealed metastasis of adenocarcinoma in the dermis. She died after 4 months of the diagnosis of the skin metastasis. In 20 years experience in our unit, it is the first time that we recognize a cutaneous metastasis in ovarian cancer.
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Abstract
A patient with cervical non-Hodgkin lymphoma was treated with chemotherapy. Fourteen months after the diagnosis of the lymphoma, an endometrial adenocarcinoma was detected as a secondary malignant tumor. The patient was treated with surgery followed by radiotherapy. Approximately 7 years after the diagnosis of endometrial cancer, vaginal invasive squamous cell carcinoma was diagnosed as the third primary malignancy, and a second-line palliative radiotherapy was applied. Seven months after the last radiotherapy, postradiational sarcoma in the vagina was diagnosed. Congenital and acquired immune system disorders, viral oncogenes, and various human leukocyte antigen (HLA) types were investigated. Total blood count and lymphocyte subset analysis were performed, and CD4+ lymphopenia was detected. Serologic tests were carried out for human immunodeficiency virus, hepatitis B virus, human papillomavirus, Epstein-Barr virus, and herpes simplex virus infection. Epstein-Barr virus viral capsid antigen IgG was found positive. Low-risk human papillomavirus panel was detected by Hybrid Capture method in the cervical smear. The HLA investigation revealed HLA-A2, HLA-A3, HLA-B57, HLA-B35, HLA-B4, HLA-B6, HLA-DR3, HLA-DR1, HLA-DR51, HLA-DR52, HLA-DQ6(1), and HLA-DQ7(3). The patient died because of the disease.
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Affiliation(s)
- B O Goker
- Department of Obstetrics and Gynecology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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Abstract
A patient with cervical non-Hodgkin lymphoma was treated with chemotherapy. Fourteen months after the diagnosis of the lymphoma, an endometrial adenocarcinoma was detected as a secondary malignant tumor. The patient was treated with surgery followed by radiotherapy. Approximately 7 years after the diagnosis of endometrial cancer, vaginal invasive squamous cell carcinoma was diagnosed as the third primary malignancy, and a second-line palliative radiotherapy was applied. Seven months after the last radiotherapy, postradiational sarcoma in the vagina was diagnosed. Congenital and acquired immune system disorders, viral oncogenes, and various human leukocyte antigen (HLA) types were investigated. Total blood count and lymphocyte subset analysis were performed, and CD4+ lymphopenia was detected. Serologic tests were carried out for human immunodeficiency virus, hepatitis B virus, human papillomavirus, Epstein–Barr virus, and herpes simplex virus infection. Epstein–Barr virus viral capsid antigen IgG was found positive. Low-risk human papillomavirus panel was detected by Hybrid Capture method in the cervical smear. The HLA investigation revealed HLA-A2, HLA-A3, HLA-B57, HLA-B35, HLA-B4, HLA-B6, HLA-DR3, HLA-DR1, HLA-DR51, HLA-DR52, HLA-DQ6(1), and HLA-DQ7(3). The patient died because of the disease.
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Guven MA, Bese T, Demirkiran F, Idil M, Mgoyi L. Hydrosonography in screening for intracavitary pathology in infertile women. Int J Gynaecol Obstet 2004; 86:377-83. [PMID: 15325856 DOI: 10.1016/j.ijgo.2004.05.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2004] [Revised: 05/07/2004] [Accepted: 05/10/2004] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We evaluated the value of hydrosonography in screening for intracavitary pathologies in infertile patients. METHODS A total of 93 infertile women with suspected intracavitary lesions on transvaginal ultrasonography (TVS) underwent hydrosonography. Specimens obtained either by dilatation and curettage or hysteroscopic resection were compared with findings on TVS and hydrosonography. RESULTS Pathology confirmed the presence of sonographically diagnosed intracavitary lesions in 40 out of 66 (60%) women. The sensitivity, specificity, positive predictive value, and negative predictive value of TVS for the detection of endometrial cavity lesions were 78%, 38%, 61%, and 59%, respectively. Forty-six out of 71 (65%) women who were found to have intracavitary lesions on hydrosonography were pathologically confirmed. The sensitivity, specificity, positive and negative predictive value of hydrosonography in the detection of endometrial cavity lesions were 90%, 40%, 65%, and 77%, respectively. CONCLUSIONS Hydrosonography is a useful procedure in screening for intracavitary pathologies and allows differentiation of intracavitary, endometrial, and submucosal abnormalities.
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Affiliation(s)
- M A Guven
- Department of Obstetrics and Gynecology, Kahramanmaraş Sütcüimam University, Faculty of Medicine, Kahramanmaras, Turkey.
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Demirkiran F, Kumbak B, Bese T, Arvas M, Benian A, Aydin S, Uzun H, Sanioglu C, Aydinli K, Kösebay D. Vascular endothelial growth factor in adnexal masses. Int J Gynaecol Obstet 2004; 83:53-8. [PMID: 14511872 DOI: 10.1016/s0020-7292(03)00208-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To determine cyst fluid and serum vascular endothelial growth factor (VEGF) concentrations in patients with ovarian masses and to investigate the efficiency of this modulator in the clinical management of cystic pelvic masses. METHODS Needle puncture for cyst fluid aspiration were performed on 88 cystic ovarian masses intraoperatively. Forty-five patients with benign and 43 patients with malignant ovarian pathology were analyzed for cyst fluid and serum VEGF concentrations. Both cystic fluid and serum VEGF concentration were determined by enzyme-linked immunosorbent assay (ELISA). RESULTS Cyst fluid VEGF levels of malignant cysts (40.65+/-17.69 ng/ml) were significantly higher than those of benign cysts (12.53+/-6.13 ng/ml; P<0.001). Similarly, higher serum VEGF concentrations were found in patients with malignant disease (0.72+/-0.17 ng/ml) compared with benign cysts (0.33+/-0.11 ng/ml; P<0.001). A statistically significant correlation was observed between cyst fluid and serum VEGF levels in both malignant and benign cysts. For serum VEGF, at a cut-off value of 0.41 ng/ml; sensitivity, specificity, PPV, and NPV were 95%, 78%, 80% and 95%, respectively. No significant correlation between cyst fluid VEGF concentration and tumor stage or grade could be found. CONCLUSIONS Significantly higher concentrations of VEGF are present in cyst fluid and serum of patients with malignant ovarian cysts compared with benign ovarian ones. There is no relation between VEGF and tumor stage or grade.
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Affiliation(s)
- F Demirkiran
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
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Guven MA, Bese T, Demirkiran F. Comparison of hydrosonography and transvaginal ultrasonography in the detection of intracavitary pathologies in women with abnormal uterine bleeding. Int J Gynecol Cancer 2004. [DOI: 10.1136/ijgc-00009577-200401000-00007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BackgroundThe aim of the study was to compare the accuracy of hydrosonography with that of transvaginal ultrasonography in detection of intracavitary pathologies in patients with history of abnormal uterine bleeding.Study designProspective, randomized, and unblinded study.Material and methodsA total of 197 women (n = 130 premenopausal and n = 67 postmenopausal) aged between 23 and 71 years (mean age 45.7 ± 8.9) presenting with a history of abnormal uterine bleeding were included into the study. Hydrosonography was carried out by experienced gynecologists, on the same setting in an outpatient clinic immediately after the performance of transvaginal sonography. The finally obtained surgical-pathologic findings were compared with the results obtained from transvaginal sonography and hydrosonography. Sensitivity, specificity, positive, and negative predictive values were calculated for each procedure.ResultsThe surgical-pathologic examination confirmed normal physiologic endometrium in 50 (48%) of 104 women who were said to have normal endometrium on transvaginal sonography. Seventy (75%) of 93 women diagnosed of intracavitary pathologies on transvaginal sonography were confirmed by surgical-pathologic findings. The sensitivity, specificity, positive predictive value, and negative predictive value of transvaginal sonography in the detection of intracavitary pathology were 56, 68, 75, and 48%, respectively. Surgical-pathologic results revealed intracavitary pathologies in 23 (30%) of 76 women who were said to have normal endometrium on hydrosonography. Among 121 women diagnosed of intracavitary pathologies on hydrosonography, 101 (81%) women were confirmed after histological evaluation of the surgical specimens. The sensitivity, specificity, positive predictive value, and negative predictive value of hydrosonography in the detection of intracavitary pathology were 81, 73, 83, and 70%, respectively. Sensitivity and negative predictive value were significantly higher with hydrosonography. There were five cases of endometrial malignancy in which one of the case of malignancy was on polyp and two cases of endometrial hyperplasia with atypia which were not stated on sonographic results.ConclusionHydrosonography is more accurate than transvaginal ultrasography in the detection of intracavitary pathologies in women with abnormal uterine bleeding.
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Tulunay G, Arvas M, Demir B, Demirkiran F, Boran N, Bese T, Ozgul N, Kose MF, Kosebay D. Primary fallopian tube carcinoma: a retrospective multicenter study. EUR J GYNAECOL ONCOL 2004; 25:611-4. [PMID: 15493178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
PURPOSE This retrospective multicenter study aimed to assess the survival and prognostic factors of primary fallopian tube carcinoma. METHODS The medical records of 29 patients with fallopian tube carcinoma from two centers were reviewed for age, stage, surgical intervention, relapse and survival. RESULTS The mean age of the patients was 56 years (range, 37-76). Six patients were in Stage I (20.7%), eight cases in Stage II (27.6%), nine cases in Stage III (31%) and two cases in Stage IV (6.9%). Data on stage was not available in four cases (13.8). Fifteen patients underwent lymph node evaluation. The median follow-up was 29 months (range, 3-122). The median survival was 95 months with a 5-year survival rate of 69.7%. The median progression-free survival was 76 months with a 5-year survival rate of 51.8%. CONCLUSION Age, stage and lymphadenectomy were found to be significant prognostic factors on overall survival.
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Affiliation(s)
- G Tulunay
- Department of Gynecologic Oncology, SSK Ankara Maternity and Women's Health Teaching Hospital, Ankara (Turkey)
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Guven MA, Bese T, Demirkiran F. Comparison of hydrosonography and transvaginal ultrasonography in the detection of intracavitary pathologies in women with abnormal uterine bleeding. Int J Gynecol Cancer 2004; 14:57-63. [PMID: 14764030 DOI: 10.1111/j.1048-891x.2004.14105.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The aim of the study was to compare the accuracy of hydrosonography with that of transvaginal ultrasonography in detection of intracavitary pathologies in patients with history of abnormal uterine bleeding. STUDY DESIGN Prospective, randomized, and unblinded study. MATERIAL AND METHODS A total of 197 women (n = 130 premenopausal and n = 67 postmenopausal) aged between 23 and 71 years (mean age 45.7 +/- 8.9) presenting with a history of abnormal uterine bleeding were included into the study. Hydrosonography was carried out by experienced gynecologists, on the same setting in an outpatient clinic immediately after the performance of transvaginal sonography. The finally obtained surgical-pathologic findings were compared with the results obtained from transvaginal sonography and hydrosonography. Sensitivity, specificity, positive, and negative predictive values were calculated for each procedure. RESULTS The surgical-pathologic examination confirmed normal physiologic endometrium in 50 (48%) of 104 women who were said to have normal endometrium on transvaginal sonography. Seventy (75%) of 93 women diagnosed of intracavitary pathologies on transvaginal sonography were confirmed by surgical-pathologic findings. The sensitivity, specificity, positive predictive value, and negative predictive value of transvaginal sonography in the detection of intracavitary pathology were 56, 68, 75, and 48%, respectively. Surgical-pathologic results revealed intracavitary pathologies in 23 (30%) of 76 women who were said to have normal endometrium on hydrosonography. Among 121 women diagnosed of intracavitary pathologies on hydrosonography, 101 (81%) women were confirmed after histological evaluation of the surgical specimens. The sensitivity, specificity, positive predictive value, and negative predictive value of hydrosonography in the detection of intracavitary pathology were 81, 73, 83, and 70%, respectively. Sensitivity and negative predictive value were significantly higher with hydrosonography. There were five cases of endometrial malignancy in which one of the case of malignancy was on polyp and two cases of endometrial hyperplasia with atypia which were not stated on sonographic results. CONCLUSION Hydrosonography is more accurate than transvaginal ultrasography in the detection of intracavitary pathologies in women with abnormal uterine bleeding.
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Affiliation(s)
- M A Guven
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kahramanmaras Sutcuimam University, Kahramanmaras, Turkey
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Abstract
The aim of this study was to document a case of tamoxifen-associated extensive pelvic endometriosis and attract the attention to this side effect of tamoxifen use in the postmenopausal patient. A 74-year-old woman with a history of breast carcinoma who received tamoxifen therapy for 2 years was admitted with uterine bleeding. Hysteroscopic polypectomy revealed a hyperplastic polyp. Extensive pelvic endometriosis was detected at the operation and due to dense adhesions, subtotal hysterectomy and bilateral salpingo-oophorectomy were performed. The patient continued to use tamoxifen. A supracervical pelvic mass was detected 14 months later. The cervix, rectum, and the accompanying mass were resected. Histopathologic examination revealed endocervical adenocarcinoma and endometriosis involving cervix uteri and the rectal muscular wall. The patient had two normal cervical smears within the last 3 years and no abnormal appearance was detected within the cervical canal in the hysteroscopic examination. As cervical cancer occurred in a short period, it might be speculated that tamoxifen might have stimulated the proliferative and mitotic activity of cervical endometrial tissue which has progressed into invasive cancer in time.
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Affiliation(s)
- T Bese
- Department of Obstetrics and Gynecology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey.
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Arvas M, Demirkiran F, Bese T, Ozturk E, Calay Z, Sanioglu C, Aydinli K, Kosebay D. PROGNOSTIC FACTORS IN SURGICALLY TREATED CERVICAL CARCINOMA: LVSI AND DEPTH OF INVASION. Int J Gynecol Cancer 2003. [DOI: 10.1136/ijgc-00009577-200303001-00351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Demirkiran F, Ocal P, Idil M, Bese T, Arvas M, Cepni I, Akbas H, Kosebay D. THE ROLE OF SALINE INFUSION HYSTEROSONO-GRAPHY(SIS) IN DIFFERENTIAL DIAGNOSIS OF ENDOMETRIAL PATHOLOGY. Int J Gynecol Cancer 2003. [DOI: 10.1136/ijgc-00009577-200303001-00272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Demirkiran F, Bese T, Arvas M, Kumbak B, Aydin S, Uzun H, Benian A, Sanioglu C, Aydinli K, Kosabay D. CYST FLUID CYSTAIN C AND LDH VALUES CAN BE USED AS A MARKER FOR THE DISCRIMINATION OF ADNEXAL MASSES. Int J Gynecol Cancer 2003. [DOI: 10.1136/ijgc-00009577-200303001-00172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Bese T, Nomir SK. The importance of serum insulin-like growth factor-I level determination in the follow-up of patients with epithelial ovarian cancer. EUR J GYNAECOL ONCOL 2002; 22:372-6. [PMID: 11766744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
PURPOSE OF INVESTIGATION The aim of our study was to assess whether serum levels of serum insulin-like growth factor-I (IGF-I) could be used for the follow-up of the patients with epithelial ovarian cancer and to identify whether it was superior to serum CA 125. METHODS Our study group consisted of 28 patients diagnosed with epithelial ovarian cancer who had initial high serum CA 125 levels and have received chemotherapy following the operation. Preoperatively and before each chemotherapy administration, serum CA 125 and IGF-I levels were measured. RESULTS The mean value of preoperative serum CA 125 was 364.0 +/- 152.9 U/ml. Serum CA 125 levels decreased with chemotherapy (Spearman rs= - 0.641, p=0.000). The mean preoperative serum IGF-I concentration was 58.04 +/- 52.7 ng/ml, and it showed a slight increase with chemotherapy. (Spearman rs=0.3 18, p=0.001). We observed that there was a weak-moderate negative correlation between the two markers, and when chemotherapy was administered serum CA 125 levels which were initially high started to decrease while serum IGF-I levels showed a mild increase (Spearman rs= - 0.350, p=0.000). CONCLUSION The measurement of serum IGF-I does not provide any additional benefit in monitoring the response of the disease to chemotherapy.
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Affiliation(s)
- T Bese
- Department of Obstetrics and Gynecology, Cerraphasa Medical School, University of Istanbul, Istanbul, Turkey
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Abstract
Cortical blindness in pre-eclampsia due petechial hemorrhages, ischemia, focal edema and infarction of the occipital cortex, is mostly reversible.
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Affiliation(s)
- S O Ozkan
- Department of Obstetrics and Gynecology, Cerrahpasa School of Medicine, Istanbul University
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Cepni I, Bese T, Ocal P, Budak E, Idil M, Aksu MF. Significance of yolk sac measurements with vaginal sonography in the first trimester in the prediction of pregnancy outcome. Acta Obstet Gynecol Scand 1997; 76:969-72. [PMID: 9435738 DOI: 10.3109/00016349709034911] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The purpose of this prospective clinical study was to determine and evaluate the prognostic value of secondary yolk sac diameter of the embryo on pregnancy outcome. METHODS One hundred and thirty pregnant women in the first trimester were included in the study. Crown-rump length (CRL) and yolk sac diameters were measured in every patient and the outcome of the pregnancies were compared with the measurements. Intact normal pregnancy (group A), threatened abortion (group B) and missed abortion (group C) were diagnosed in 67, 43 and 20 pregnancies, respectively. RESULTS We detected a significant linear correlation between secondary yolk sac diameter and gestational age in group A (r = 0.5085; p < 0.0001) and a moderate correlation in group B (r = 0.4048; p = 0.007) and C patients (r = 0.3478; p = 0.1333). When the groups were evaluated irrespective of gestational age, a significant difference in secondary yolk sac diameters among the groups was noted (p = 0.037). When confidence intervals for secondary yolk sac diameters of intact normal pregnancies (group A) were calculated by linear regression, two patients in group B were below the 5% confidence interval. However, in group C patients, the yolk sac diameter of six patients were detected below the 5% confidence interval, while two of the measurements were above 95% confidence interval. Therefore, eight measurements (40%) of group C patients were outside the 5-95% confidence interval. CONCLUSION In the first trimester, when discrepancy is detected between secondary yolk sac diameter and gestational age, additional sonographic investigation should be performed one or two weeks later, in order to estimate the pregnancy outcome.
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Affiliation(s)
- I Cepni
- Department of Obstetrics and Gynecology, Cerrahpaşa Medical Faculty, University of Istanbul, Turkey
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