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Giornale Italiano di ostetricia e ginecologia

The difference between HE4 expression in urine of women with ovarian cyst and women with normal ovary

Original Article, 151 - 157
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The aim of this research was to determine differences in HE4 urine levels in women with ovarian cyst and normal ovary. This research is a comparative analytic, using case control design. This research was conducted in RSUP H. Adam Malik Medan, dr. Pirngadi
Medan and the networking hospitals of the Department of Obstetrics and Gynecology of Faculty of Medicine University of North Sumatera from September 2017 to February 2018. The sample is ovarian cyst patients which met the inclusion and exclusion criteria,
compared to control group which are women with normal ovary.
The mean rank of HE4 level of ovarian cyst patient is 56,35, with the median of 76,41, and min-max 42,40-92,80. Meanwhile in patient with normal ovary, the mean rank of urine HE4 is 24,64, with the median of 49,11, and min-max 30-69. With Mann-Whitney test,
p value is 0,000 (p<0,05), showing a significant differences. The mean urine HE4 levels of ovarian cyst are significantly higher than that of in normal ovary.

Serum prokineticin-1 (endocrine gland vascular endothelial growth factor) as an alternative marker for assessing endometrium receptivity

Original Article, 158 - 164
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Backgrounds. A total of ± 85-90% fertile couple will be able to conceive within one year. However, if there is no pregnancy within this period, even though the conjugal relationship is carried out regularly and without the use of contraception, a case of primary infertility occurs.
Endometrium receptivity plays an important role in implantation process of conception product, and an optimal understanding about its function is crucial in infertility management.
Purpose. The purpose of this study was to determine the relationship between serum levels of PROK1 (EG-VEGF) to the expression of αvβ3 integrins in endometrial tissue to assess endometrial receptivity of fertile women with normal menstrual cycles.
Method. This study used a cross-sectional study design. This study was conducted in the outpatient unit of the Fertility and Reproductive Endocrinology Division (FER) of the Central General Hospital (RSUP) Dr. H. Adam Malik Medan, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sumatera Utara and Adenin Adenan Hospital Medan, starting in February 2017.
Result. 42 samples were obtained in this study, with the majority of them came from age group of 20-35 years with 38 subjects (90.5%), normoweight BMI with 31 subjects (73.8%), age of menarche more at age <13 years with 28 subjects (66.7%), and the duration of menstruation for 3-7 days with 40 subjects (95.2%). There were no significant differences in αvβ3 integrin expression based on age, BMI, age of menarche and duration of menstruation (p> 0.05). There were no significant differences in PROK-1 levels based on age, BMI, age of menarche and duration of menstruation (p> 0.05). There was a significant correlation between integrin expression of αvβ3 and PROK1 (EG-VEGF) with a value (p <0.001, r = 0.526).
Conclusion. There is no significant difference in the expression of PROK1 based on age, BMI, age of menarche and duration of menstruation but there is a significant correlation between PROK1 (EGVEGF) serum level and integrin αvβ3 in fertile women.

Association between the ratio of matrix metallo proteinase-2 (MMP-2) to tissue inhibitor of MMP-2 (TIMP-2) level and the expression of collagen type-III in endopelvic fascia of menopausal women with pelvic organ prolapse

Original Article, 165 - 171
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Objective. Pelvic organ prolapse (POP) is one of the most disturbing conditions reported by menopausal women. It has been understood that the balance of MMP-2 and TIMP-2 level play an important role in degradation of collagen type-III in endopelvic fascia which is known as underlying mechanism of POP. This study aimed to investigate the association between ratio of MMP-2 to TIMP-2 level and the expression of collagen type-III in endopelvic fascia of menopausal women with POP.
Method. This was a case-control study involved menopausal women who visited Urogynecology unit of Department of Obstetric and Gynecology, Adam Malik General Hospital from July 2017 to the date till the number of minimal sample was achieved. MMP-2 and
TIMP-2 level and the expression of collagen type-III were measured from biopsy specimen taken during hysterectomy and also from blood serum.
Result. We recruited 45 menopausal women with POP as case group and 47 menopausal women without POP as control group. The mean of ratio of MMP-2 to TIMP-2 level in case group (1,53) was higher than control group (1,02). There was negative correlation between the ratio of MMP-2 to TIMP-2 level and the expression of collagen type-III with r value = 0,638 (close to 0).
Conclusion. This study found that higher ratio of MMP-2 to TIMP-2 level was associated with lower expression of collagen type- III in fascia endopelvic of menopausal women.

Difference in expression of 17 beta-hydroxysteroid dehydrogenase type 1 in uterine fibroid and normal myometrium

Clinical Case, 172 - 177
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Background. Uterine fibroid is a gynecological problem that frequently occurs to women in reproductive age. Based on World Health Organization (WHO), in 2010, uterine fibroid was estimated occurred in approximately 20-25% women worldwide, while in Indonesia, the incidence was 2.39-11.7%. Estrogen is one of the things that takes a role in uterine fibroid development. 17β-hydroxysteroid dehydrogenase type 1 (17β-HSD1) is a type of 17β-HSD enzyme that most often is associated in estrogen metabolism.
Objective. To determine the difference in expression of 17β-HSD1 enzyme in uterine fibroid and normal myometrium.
Methods. This study is a case control study that was conducted in each 20 tissues of uterine fibroid and normal myometrium of the same uterine that were randomly taken from September to November 2017 in Adam Malik General Hospital. The data were subsequently analyzed using Wilcoxon Signed Rank test.
Results. It was found that patients with obese body mass index, multiparity, and submucous uterine fibroid type were the largest groups in this study. Strongly positive expression was found highest in uterine fibroid group (75%). There is a difference in expression of 17β-HSD1 in uterine fibroid and normal myometrium with p<0.05.
Conclusion. The results of this study demonstrate a statistically significant difference between uterine fibroid and normal myometrium.

Proposal of “fertility-sparing” surgery technique for ovarian endometriosis

Methods, Techniques, Drugs, 178 - 183
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Endometriosis is a chronic disease defined by the presence of endometrial-like tissue outside the uterus. Ovarian endometriotic cysts (endometriomas) are found in 20% of patients with endometriosis and are frequently associated with a severe algic symptomatology.
There are many laparoscopic techniques for treatment, but most used are cystectomy by stripping or puncture with electrocoagulation of the cyst capsule. Generally, stripping procedure of ovarian cyst wall is followed by hemostasis by means of bipolar electrocoagulation or simple suturing of the residual ovarian parenchyma. This type of surgery represents a prospective damage of ovarian reserve. The damage is due to healthy or peri-cystic ovarian parenchyma alteration caused by an incautious stripping, an electro-hemostasis overdone or a too tightened hemostatic suture that implicate a tissue ischemia.
The aim of this study is to evaluate the effect of a laparoscopic techniques for treatment of ovarian endometriomas, that provide for a modular stripping by unsticking the cysts, a coagulation of vascular connection directly on the cystic capsule and the use of a hemostatic-sealant (FloSeal® - Baxter HC). For the post- surgery examination of ovarian reserve, we utilized an ultrasound marker: the antral follicle count (AFC).
We utilized this surgery procedure on 30 women between the ages of 21 and 38 years (E.M: 28,47) with a conceive desire. Women analyzed arise an ovarian endometrioma mono- or bilateral with 4 centimeters diameter as minimum. All of them suffering of dysmenorrhea, deep dyspareunia or chronic pelvic pain.
After 3 months from surgery, Transvaginal Ultrasonogram it has been done. The result of this exam was:
- Patient with unilateral Ovarian Endometrioma presents an AFC variation between 5 and 9 (Mean: 6.45);
- Patient with bilateral Endometrioma the AFC variation was between 4 and 7 (Mean: 5.42).
In conclusion, we retain that the technique we have structured and that we use in tackling the endometrioma surgically, respects the Ovarian Follicular Reserve to preserve the fertile ability of afflicted woman.

Relationship between the administration of estradiol valerate 2 mg and norgestrel 0.5 mg and cognitive function which assessed with IQCODE on menopausal paramedic at Adam Malik General Hospital Medan

Methods, Techniques, Drugs, 184 - 189
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Background. Menopause is the cessation of menstruation at least 12 months, begins at the age of 45-50 years and is accompanied by the declined of estrogen and progesterone hormones, causing complaints such as the decline in cognitive function. Hormone replacement therapy such as estradiol valerate and norgestrel can reduce complaints and reduce the risk of dementia.
Objective. To assessed the difference in cognitive function with the administration of estradiol valerate 2 mg and norgestrel 0.5 mg which assessed by IQCODE on menopausal paramedics.
Methods. This study is an experimental quasi research with prepost design conducted in July-December 2017. The study subjects were 40 menopausal paramedics at H. Adam Malik General Hospital and selected by consecutive sampling. Study subjects were asked to fill out the IQCODE questionnaire and will be excluded if the result is improvement and no change. Study subjects were asked to consume estradiol valerate 2 mg and norgestrel 0.5 mg for 3 months then cognitive function will be revalued. Data were analyzed using T-paired test.
Results. Out of the 40 study subjects, 2 had improvement and no change, while the other 2 subjects were excluded due to tachycardia and loss to follow-up. The most often encountered characteristics of study subjects were the 50-59 years group (72.2%), multiparous (91.7%), overweight (63.9%) with duration of menopause for 2 years (36.1%).
The mean score of IQCODE before and after intervention was 3.59 ± 0.26 and 3.18 ± 0.29 and there was a relationship between administering estradiol valerate and norgestrel with cognitive function.
Conclusion. There was a significant association between administering estradiol valerate 2 mg and norgestrel 0.5 mg with cognitive function (p < 0,05).

Vol. XL (No. 4) 2018 Ottobre - Dicembre

  1. The difference between HE4 expression in urine of women with ovarian cyst and women with normal ovary
    Kumalasari C., Rusda M., Sidabutar E.R., Ardiansyah E., Simanjuntak R.Y., Aldiansyah D.
  2. Serum prokineticin-1 (endocrine gland vascular endothelial growth factor) as an alternative marker for assessing endometrium receptivity
    Adenin I., Lutan D., Tandjung T., Suheimi H.K., Siregar M.F.G
  3. Association between the ratio of matrix metallo proteinase-2 (MMP-2) to tissue inhibitor of MMP-2 (TIMP-2) level and the expression of collagen type-III in endopelvic fascia of menopausal women with pelvic organ prolapse
    Tala M.R.Z., Siregar M.F.G, Akbari Ganie R., Budi Putra I., Hasan Purwa B., Iqbal Pahlevi M., Mutiara E.
  4. Difference in expression of 17 beta-hydroxysteroid dehydrogenase type 1 in uterine fibroid and normal myometrium
    Siregar M.F.G, Arthit T.L., Munthe I.G., Haryono H.L., Sidabutar E., Rivany R.
  5. Proposal of “fertility-sparing” surgery technique for ovarian endometriosis
    Bardi M., Pezzetti G., Laquintana R., Petretto R., Marforio M.G., Chiesa A., Gangarossa G., Augello M.L., Iliakis A., Rosaschino P.
  6. Relationship between the administration of estradiol valerate 2 mg and norgestrel 0.5 mg and cognitive function which assessed with IQCODE on menopausal paramedic at Adam Malik General Hospital Medan
    Utari R.A.D., Siregar M.F.G, Hartono H., Nasution S.A., Rivany R., Haryono H.L.
Last Viewed articles: la lista degli ultimi x visitati.
  1. Relationship between the administration of estradiol valerate 2 mg and norgestrel 0.5 mg and cognitive function which assessed with IQCODE on menopausal paramedic at Adam Malik General Hospital Medan
    Utari R.A.D., Siregar M.F.G, Hartono H., Nasution S.A., Rivany R., Haryono H.L.
  2. Proposal of “fertility-sparing” surgery technique for ovarian endometriosis
    Bardi M., Pezzetti G., Laquintana R., Petretto R., Marforio M.G., Chiesa A., Gangarossa G., Augello M.L., Iliakis A., Rosaschino P.
  3. Difference in expression of 17 beta-hydroxysteroid dehydrogenase type 1 in uterine fibroid and normal myometrium
    Siregar M.F.G, Arthit T.L., Munthe I.G., Haryono H.L., Sidabutar E., Rivany R.
  4. Association between the ratio of matrix metallo proteinase-2 (MMP-2) to tissue inhibitor of MMP-2 (TIMP-2) level and the expression of collagen type-III in endopelvic fascia of menopausal women with pelvic organ prolapse
    Tala M.R.Z., Siregar M.F.G, Akbari Ganie R., Budi Putra I., Hasan Purwa B., Iqbal Pahlevi M., Mutiara E.
  5. Serum prokineticin-1 (endocrine gland vascular endothelial growth factor) as an alternative marker for assessing endometrium receptivity
    Adenin I., Lutan D., Tandjung T., Suheimi H.K., Siregar M.F.G
  6. The difference between HE4 expression in urine of women with ovarian cyst and women with normal ovary
    Kumalasari C., Rusda M., Sidabutar E.R., Ardiansyah E., Simanjuntak R.Y., Aldiansyah D.
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