Introduction: We aimed to examine the parameters affecting long-term prognosis and survival in pa... more Introduction: We aimed to examine the parameters affecting long-term prognosis and survival in patients diagnosed with early stage cervical cancer and undergoing radical hysterectomy in our Gynecology and Obstetrics Clinic. Material and Method: The files of 86 cervical cancer patients who underwent radical hysterectomy and pelvic paraaortic lymph node dissection for cervical cancer between 2010 and 2021 were retrospectively reviewed. Tumor size, FIGO stage, vagina, endometrium, ovary, parametrium, pelvic lymph node, paraaortic lymph node and deep stromal involvement were examined by examining the files and pathology reports of the patients. Then, the effects of these parameters on pelvic and paraaortic lymph node involvement, postoperative prognosis and survival of the patients were tried to be revealed. Results: The 86 patients included in the analysis had a mean age of 55.2 (range: 38-72) and a median tumor size of 35 mm (range: 2-74). Cell type was squamous cell carcinoma in 81.4...
Polikliniği'ne başvuran ve serviks kanseri taramasına katılan 82 kişi çalışmaya alındı. Servikova... more Polikliniği'ne başvuran ve serviks kanseri taramasına katılan 82 kişi çalışmaya alındı. Servikovajinal sürüntü örnekleri, standart işlem prosedürüne göre toplandı. Geleneksel Pap sitolojisi için slayt hazırlanarak, standart protokollere göre boyandı ve sonuçlar 2004 Bethesda sınıflandırma sistemine göre derecelendirildi. Digene konik fırça örnekleyicisi ile serviksten örnek alındı. Tüm servikal örnekler, Digene® HC2 High-Risk HPV DNA Kiti ile analiz edildi. HPV DNA pozitifliği saptanan örneklere CLART kit ile genotipleme yapıldı. 41 HPV pozitif hasta ve 41 HPV negatif kontrolün doku örneklerinde osteopontin düzeyleri ELISA kiti ile araştırıldı. Bulgular: Osteopontin düzeyleri hasta grubunda 31.55±7.11 ng/ml, kontrol grubunda ise 28.81±5.44 ng/ml olarak saptandı. Hasta grubu ile kontrol grubu arasında istatistiksel olarak anlamlı fark saptandı (p=0.048). Osteopontin düzeyi ile yaş, doğum şekli, hastalık öyküsü, operasyon yöntemi, HPV tipi, preoperatif ve postoperatif patoloji, gravida ve parite arasında istatistiksel olarak anlamlı bir fark bulunmadı (p>0.05). Sonuç: Çalışmamızda, HPV pozitif 41 hastadan yalnızca 5'inde servikal intraepitelyal neoplazi saptanması çalışmamızın kısıtlayıcı yanını oluşturmaktadır. Osteopontin düzeyi, HPV pozitif hastalarda yüksek bulunmasına rağmen, daha geniş sayıda servikal intraepitelyal neoplazi olguları üzerinde yapılacak olan çalışmalara gereksinim olduğunu düşünmekteyiz.
The Journal of Tepecik Education and Research Hospital, 2017
Evde doğum yapan gebelerin gebelik sonuçlarını ve komplikasyonlarının analizini yapmayı amaçladık... more Evde doğum yapan gebelerin gebelik sonuçlarını ve komplikasyonlarının analizini yapmayı amaçladık. Yöntem: Hastanemize 2010-2015 yılları arasında başvuran evde doğum yapan 76 ve hastanede doğum yapan 97 gebenin prenatal muayene ve doğum sonrası dosyaları retrospektif incelendi. Bulgular: Toplam 76 hariçte doğum yapan hasta erken postpartum dönemde başvurmuştur. Evde doğum yapan hastaların yaş ortalaması 30,07±5,50, kontrol grubunda ise 29.88±5.50 olarak bulunmuştur. Evde doğum yapan hastaların büyük çoğunluğu multiparlardan oluşmaktaydı. Parite dağılımı evde doğum yapan hastalarda ortalam 2±1,08 olarak bulundu. Evde doğum yapan 76 hastanın 40'ının (%52,63) evde doğum yapmayı daha önceden planladıkları öğrenildi fakat evde doğum yapan hastaların hiçbirinde Dünya Sağlık Örgütünün evde doğum için önerdiği koşulların tam olarak sağlanmadığı saptandı. Hastaların obstetrik sonuçları incelendiğinde, evde doğum yapan hastaların büyük çoğunluğunun 37 haftadan büyük gebeliğe sahip olduğu ve tamamının baş prezentasyonda olduğu görüldü. Evde doğum yapan hastaların hiçbirinde epizyotomi açılmamış olup, hastaların %57,89'unda 1-2. derece perine laserasyonları oluşmuştur. Kontrol grubunda epizyotomi açılma oranı %59,79, 1-2. derece perine laserasyon oranı ise %40,20'dur. Neonatal sonuçlar açısından gruplar arasında bir fark saptanmamıştır. Sonuç: Obstetrik ve neonatal sonuçlar açısından gruplar arasında bir fark izlenmemekle birlikte, ülkemiz koşullarında Dünya Sağlık Örgütünün önerdiği asgari koşulların sağlanmasının henüz olası olmadığı gerekçesiyle evde planlı veya plansız doğumu önermemekteyiz.
Gönderilen makale şu an hiçbir dergide işlem görmemektedir. 3-6 Mart 2016 Erzurum Palandöken Kadı... more Gönderilen makale şu an hiçbir dergide işlem görmemektedir. 3-6 Mart 2016 Erzurum Palandöken Kadın Doğum Kongresinde Poster olarak sunulmuştur. *Sorumlu Yazar: Yard. Doç. Dr. Mehmet Kulhan Erzincan Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı Erzincan, Türkiye, Telefon numarası: +90 505 491 80 90, E-mail: [email protected] Geliş Tarihi: 07.04.2017, Kabul Tarihi: 27.05.2017 KLİNİK ÇALIŞMA / CLINICAL RESEARCH
Bu çalışmada, sağlıklı gebelerde, gestasyonel diyabetik gebelerde ve üreme çağındaki sağlıklı kad... more Bu çalışmada, sağlıklı gebelerde, gestasyonel diyabetik gebelerde ve üreme çağındaki sağlıklı kadınlarda D vitamini düzeyini belirlemeyi amaçladık. Gereç ve Yöntemler: Yaşları 18-43 yıl arası 28 sağlıklı gebe, 15 gestasyonel diyabetik gebe ve 30 sağlıklı genç erişkin kadından alınan serumlardan immünometrik yöntemle D vitamini ölçümü yapıldı. Bulgular: Tüm gruplarda D vitamini eksik olarak bulundu [sağlıklı gebelerde (11.8±7.4), gestasyonel diyabetik gebelerde (10.6±5.7), ve sağlıklı genç kadınlarda (12.1±5.4) ng/mL]. Gruplar arasında anlamlı bir fark yoktur (p=0.54). Sonuç: Tüm gebelerde ve genç erişkin kadınlarda D vitamini düzeyi yeterli değildir. Dolayısıyla D vitamini takviyesi yapılmalıdır.
Turkiye Klinikleri Journal of Gynecology and Obstetrics, 2017
advanced stage liver failure.1 Menstrual irregularities or amenorrhea has been associated with th... more advanced stage liver failure.1 Menstrual irregularities or amenorrhea has been associated with the decreased fertility in women who have an anovulatory cycle with liver failure.2 However, the rapid recovery of libido, menstrual cycle, and fertility has been reported in the several patients of reproductive age after successful transplantation.3 In the past 25 years, studies on liver transplantation and pregnancy have revealed that pregnancy is well tolerated and the neonatal outcome is satisfactory if the prepregnant recipient graft functions are normal.4 However, hypertension, preeclampsia, preterm birth, low birth weight, anemia, diabetes mellitus, and some infections are more common in these patients.4 In these patients, acute graft rejection and considerable graft dysfunction were not observed, and no specific malformation was observed in neonates.1-4 Another possible problem in pregnancies after transplantation is fetal anomalies, which may be secondary to immunosuppressive agen...
OBJECTIVE: Antibiotic prophylaxis is one of the most important steps to reduce surgical site infe... more OBJECTIVE: Antibiotic prophylaxis is one of the most important steps to reduce surgical site infections. First-generation cephalosporin (cefazolin) is used prophylactically in the majority of operations. Rifamycin is a broad-spectrum semisynthetic antibiotic that is bactericidal against gram (+) and gram (˗) microorganisms. To the best of our knowledge, there are no studies on the use of rifamycin in antibiotic prophylaxis. In this study, we aimed to analyze whether there is a difference between the use of only cefazolin and only rifamycin in terms of surgical site infections. STUDY DESIGN: One hundred patients were included in this case-control study during the last quarter period of 2017. These patients (n=100) were divided into two groups according to their antibiotic use; 50 patients who received only 1 g cefazolin constituted Group 1, 50 patients who received only 250 mg topical rifamycin over the incision line based on surgeon’s preference constituted Group 2. RESULTS: The use...
OBJECTIVES We aimed to investigate the clinical and pathological factors of our patients who were... more OBJECTIVES We aimed to investigate the clinical and pathological factors of our patients who were diagnosed with endometrial cancer in terms of prognosis. With this study, we present our 10 years of surgical experience in endometrial carcinoma cases. MATERIAL AND METHODS Four hundred twelve patients with endometrial carcinoma who applied to our center between 2010-2019 and that we followed up were evaluated retrospectively. RESULTS Most of the tumors were low-grade endometrioid malignancies. Non-endometrioid types accounted for 12.1% of cases. Lymph node dissection was performed in 395 of 412 patients (95.9%). 66 (16.01%) of the 412 patients died during the follow-up period in the study sample. Higher OS and DFS rates were associated with endometrioid histological types, FIGO stage, absence of lymphovascular space invasion, lower grade and less than 50% myometrial invasion (p < 0.05). 5-year OS at stage 1, 2, 3, 4 was found as 88.9 ± 2.2%, 65.5 ± 10.8%, 49.4 ± 0.79% and 23.7 ± 0....
There are many causes of postpartum hemorrhage, including travmatic hemorrhage from perineal inci... more There are many causes of postpartum hemorrhage, including travmatic hemorrhage from perineal incision, coagulation defects and uterine atony. Abnormal adherence of placenta, Cesarean scar pregnancy and gestational trophoblastic disease are other diseases that may cause of postpartum hemorrhage. Three of these clinical entities are associated with high rates of maternal morbidity and mortality. Here we report the case of a woman with a diagnosis of placenta increta that manifested as an unusual lower segment uterine mass, it caused prolonged but not catastrophic bleeding after delivery.
Endometrial polyps are one of the most common etiologies of abnormal genital bleeding in both pre... more Endometrial polyps are one of the most common etiologies of abnormal genital bleeding in both premenopausal and postmenopausal women. They are hyperplastic overgrowths of endometrial glands and stroma that form a projection from the surface of the endometrium. They may also be asymptomatic. The great majority of endometrial polyps are benign, but malignancy occurs in some women. Single or multiple polyps may occur and range in diameter from a few millimeters to several centimeters. Giant endometrial polyps associated with tamoxifen and raloxifene use. Here we presented a giant endometrial polyp in a postmenopausal woman without any complaints and hormone or drug use.
Aim: Early detection of endometrial cancer is important for the prognosis of the disease. In our ... more Aim: Early detection of endometrial cancer is important for the prognosis of the disease. In our study, the effect of myometrial invasion and histological grade on lymph node metastasis was investigated in patient with early stage endometrium cancer . Material and Method: A total of 249 patients from the last 10 years who underwent systemic lymphadenectomy for staging in our hospital were retrospectively examined. The pathologies of these patients were limited to the uterine corpus. The effect of histological grade of tumor and myometrial invasion on lymph node metastasis was evaluated statistically. Results: The average lymph node collected from patients was 27.7 (11-78). Lymph node metastasis was detected in 4.1% of patients with histological grade 1-2 and
Methotrexate (MTX) is a commonly used folic acid antagonist for the treatment of neoplasia and so... more Methotrexate (MTX) is a commonly used folic acid antagonist for the treatment of neoplasia and some autoimmune diseases. Resveratrol has important anti-inflammatory, antioxidant and immunomodulatory properties. The aim of this study was to investigate the effects of resveratrol on MTX-induced ovary-damage and oxidative stress in rats. We hypothesized that supplement of resveratrol could counteract MTX-induced cytotoxicity in rat ovary. Albino Wistar female rats were randomly divided into three groups: Healthy control (HC), resveratrol + methotrexate (RMTX) and methotrexate (MTX) group. Their ovaries were removed. Biochemical and histopathological methods were utilized for evaluation of the oxidative ovary-damage. MDA was found to be higher but tGSH and SOD were lower in the ovarian tissue of the rat group administered MTX, but it is observed that these ratios are reversed in HC and in RMTX groups. MTX treatment induced ovary damage and especially pre-treatment with resveratrol provided protective effect against this MTXinduced ovary-damaged.
Laparoscopic surgery shortens the hospitalization duration and allows the patient to return to da... more Laparoscopic surgery shortens the hospitalization duration and allows the patient to return to daily life earlier. These benefits apply within the interventions required during pregnancy. Nowadays laparoscopy has become a surgical technique that can now be used in pregnancy. A number of studies on the use of laparoscopic techniques in pregnancy have been reviewed in this review. Besides the minimum requirements for the protection of the unborn baby, limitations and differences in the surgical technique have been revealed.
Objectives: An investigation of the importance of hematological inflammatory markers on the progn... more Objectives: An investigation of the importance of hematological inflammatory markers on the prognosis of first trimester pregnancies and their role in predicting threatened abortion and early pregnancy loss. Material and methods: This study was carried out in the Obstetrics and Gynecology Department of the Faculty of Medicine in our University between January 2018 and May 2019. Three-hundred individuals, 100 of them diagnosed with early pregnancy loss (EPL), 100 diagnosed with threatened abortion (TA) and 100 healthy control patients (HC), participated in the study. Results: There were no statistically significant differences in terms of hemoglobin, platelet, neutrophil count and NLR between the three groups. The RBC counts were significantly lower in EPL and TA compared to HC. Similarly, it was determined that the MPV value was significantly lower in EPL compared to HC. On the other hand, there was no difference in MPV between TA and HC. The PLR was higher in EPL and TA. Conclusions: MPV, RBCs and PLR values were strongly associated with first-trimester miscarriage. These economical and easily measurable platelet indices can be used to predict fetal losses.
GİRİŞ: Bu çalışmada epitelyal over kanserlerinden rezeke edilen tümör spesmenlerinde, CD 44 ve CD... more GİRİŞ: Bu çalışmada epitelyal over kanserlerinden rezeke edilen tümör spesmenlerinde, CD 44 ve CD 24’ün ekpresyonları analiz edilerek, bu ekspresyon ve klinikopatolojik parametreler arasındaki ilişkiyi analiz edilmiştir.GEREÇ VE YÖNTEMLER: Bu çalışma, Kliniğimizin Jinekolojik Onkoloji Anabilim Dalı'nda tedavi edilen primer over kanseri olan 31 hastayı içermektedir.BULGULAR: Anti-CD24 için incelenen 14 seröz karsinomlu spesmende; 6 örnekte şiddetli (+++) immünoreaktivite, 4 örnekte orta / şiddetli (++ / +++) immünoreaktivite, 2 numunede orta / şiddetli (++ / +++) immünoreaktivite, 2 örnekte hafif / orta (+ / + +) immünoreaktivite gözlendi. Bu 14 hasta CD 44 için incelendiğinde; 3 örnekte (++) modereta immünoreaktivitesi, 2 örnekte + / ++ (hafif / orta) immünoreaktivite, 9 örnekte + (hafif) immünoreaktivite gözlendi.SONUÇ: CD44 immünoreaktivitesinin boyanma yoğunluğunun over epitelyal kanserlerinde sağkalım oranı ile ilişkili olduğu, ancak istatistiksel olarak anlamlı olmadığı tes...
Objectives: Evaluation of the effect of lymphadenectomy in disease-free and overall survival on t... more Objectives: Evaluation of the effect of lymphadenectomy in disease-free and overall survival on the low risk corpus cancer. Material and methods: Between 1994 and 2012, a total of 257 patients with endometrioid type, grade 1 or 2, myometrial invasion < 1/2, no intraoperative evidence of macroscopic extrauterine spread was treated surgically. Pelvic lymphadenectomy was performed in 184 cases, and not performed in 73 cases. Results: There was no difference between two groups about tumor sizes. Also lymphovascular space invasion and histologic grade of two groups were similar. Omission of LA did not worsen DFS and OS in early stage low risk corpus cancer. Conclusions: Patients who have low risk corpus cancer, can be treated optimally with hysterectomy only.
Why most women can clear human papillomavirus (HPV) infections while others can develop permanent... more Why most women can clear human papillomavirus (HPV) infections while others can develop permanent infections. The stimulation of immunotolerance of the immune system of the host by the persistent HPV infection may be the answer to this question. Interleukin-33 (IL-33) may play a role in the pathogenesis of HPV infection, this hypothesis was thought to be due to the rapid release of IL-33 from damaged cells following tissue damage, necrosis, and activation of the inflammasome. Thus, in this study, the role of IL-33/suppressor of tumorigenicity 2 (ST2) was emphasized in HPV positive and HPV negative cervical tissues. A total of 80 were assessed. The reduced levels of IL-33 and ST2 are associated with cervical HPV infections. There was a statistically significant 42% positive correlation between IL-33 and ST2 in the HPVpositive group. Surprisingly, our data showed no significant difference between the expression levels of IL-33 or ST2 and working status, type of delivery, pre-and post-operative pathology, cigarette, educational status, locality, birth control method, gynecological, and colposcopic findings. We found that as a result of our study; low IL-33 and ST2 levels were associated with HPV infections ARTICLE HISTORY
Introduction: Premature rupture of the membranes (PROM) refers to rupture of the fetal membranes ... more Introduction: Premature rupture of the membranes (PROM) refers to rupture of the fetal membranes prior to the onset of regular uterine contractions. Premature rupture of the membranes continues to be one of the most vexing issues of obstetrics due to increased maternal and fetal morbidity and mortality. Many studies have focused on how management should be in these cases. The purpose of this study was to investigate whether dinoprostone (PGE 2 analogue) administration is necessary for cervical ripening and labor induction in term women with premature rupture of membranes (PROM) and to compare maternal and neonatal outcomes between oxytocin usage and dinoprostone usage in PROM. Material and methods: A total of 224 nulliparous singleton pregnant women at term, with PROM ≥ 12 h, vertex presentations, no prior uterine surgery, reactive non-stress test and Bishop scores ≤ 6 (unfavorable cervixes) were reviewed. Participants were divided into two groups as oxytocin and dinoprostone groups. The primary outcome was vaginal delivery within 24 h. Results: The women in the oxytocin group were significantly younger than in the dinoprostone group (22.85 ±4.10 years vs. 25.99 ±4.94 years; p = 0.001). There were significant differences in vaginal delivery rates within 24 h. It was 72 of 112 (64.3%) vs. 53 of 112 (47.3%), p = 0.023 for oxytocin and dinoprostone groups, respectively. Conclusions: Vaginal dinoprostone appears to be a relatively inefficient method of inducing labor compared with oxytocin in term pregnancies with PROM and unfavorable cervixes. However, dinoprostone may maintain uterine contractions as effectively as oxytocin once uterine contractions are established.
Journal of Clinical and Experimental Investigations, 2017
The aim of this study was to evaluate both the frequency of Asn680Ser polymorphism of follicle st... more The aim of this study was to evaluate both the frequency of Asn680Ser polymorphism of follicle stimulating hormone receptor (FSHR) and whether this polymorphism is associated with polycystic ovary syndrome (PCOS) in a Turkish population. Patients and Methods: 100 patients with PCOS and 100 controls were recruited from Eastern Turkey. Venous blood samples were obtained for genetic study, hormone profile, glucose and insulin assays. Asn680Ser polymorphism of FSHR was analyzed by polymerase chain reaction (PCR) amplification and direct DNA sequencing. Two groups were compared for body mass index (BMI), modified Ferriman-Gallwey (mFG) score, fasting glucose, fasting insulin, insulin resistance, hormone and lipid status. Then, all patients were divided into subgroups for genotypes of FSHR polymorphism. These subgroups were also compared for these mentioned parameters. Results: The difference between women with PCOS and controls in allelic frequencies for Asn680Ser polymorphism of FSHR were not significant. When this single nucleotide polymorphism (SNP) at codon 680 was separately analyzed, no significant difference was found in the genotype frequency among the Asn680Asn, Asn680Ser, andSer680Ser subgroups. There were no significant differences in BMI, mFG score, levels of fasting glucose and fasting insulin, HOMA-IR, and also levels of FSH, luteinizing hormone, estradiol, prolactin, thyroid stimulating hormone, total testosterone among the PCOS patients carrying different genotypes of Asn680Ser polymorphism Conclusion: there is no association between Asn680Ser polymorphism of FSHR and PCOS in Turkish women from eastern provinces of Turkey. In addition, this SNP seems not to be associated with BMI, IR and PCOS-associated endocrine hormones.
Introduction: We aimed to examine the parameters affecting long-term prognosis and survival in pa... more Introduction: We aimed to examine the parameters affecting long-term prognosis and survival in patients diagnosed with early stage cervical cancer and undergoing radical hysterectomy in our Gynecology and Obstetrics Clinic. Material and Method: The files of 86 cervical cancer patients who underwent radical hysterectomy and pelvic paraaortic lymph node dissection for cervical cancer between 2010 and 2021 were retrospectively reviewed. Tumor size, FIGO stage, vagina, endometrium, ovary, parametrium, pelvic lymph node, paraaortic lymph node and deep stromal involvement were examined by examining the files and pathology reports of the patients. Then, the effects of these parameters on pelvic and paraaortic lymph node involvement, postoperative prognosis and survival of the patients were tried to be revealed. Results: The 86 patients included in the analysis had a mean age of 55.2 (range: 38-72) and a median tumor size of 35 mm (range: 2-74). Cell type was squamous cell carcinoma in 81.4...
Polikliniği'ne başvuran ve serviks kanseri taramasına katılan 82 kişi çalışmaya alındı. Servikova... more Polikliniği'ne başvuran ve serviks kanseri taramasına katılan 82 kişi çalışmaya alındı. Servikovajinal sürüntü örnekleri, standart işlem prosedürüne göre toplandı. Geleneksel Pap sitolojisi için slayt hazırlanarak, standart protokollere göre boyandı ve sonuçlar 2004 Bethesda sınıflandırma sistemine göre derecelendirildi. Digene konik fırça örnekleyicisi ile serviksten örnek alındı. Tüm servikal örnekler, Digene® HC2 High-Risk HPV DNA Kiti ile analiz edildi. HPV DNA pozitifliği saptanan örneklere CLART kit ile genotipleme yapıldı. 41 HPV pozitif hasta ve 41 HPV negatif kontrolün doku örneklerinde osteopontin düzeyleri ELISA kiti ile araştırıldı. Bulgular: Osteopontin düzeyleri hasta grubunda 31.55±7.11 ng/ml, kontrol grubunda ise 28.81±5.44 ng/ml olarak saptandı. Hasta grubu ile kontrol grubu arasında istatistiksel olarak anlamlı fark saptandı (p=0.048). Osteopontin düzeyi ile yaş, doğum şekli, hastalık öyküsü, operasyon yöntemi, HPV tipi, preoperatif ve postoperatif patoloji, gravida ve parite arasında istatistiksel olarak anlamlı bir fark bulunmadı (p>0.05). Sonuç: Çalışmamızda, HPV pozitif 41 hastadan yalnızca 5'inde servikal intraepitelyal neoplazi saptanması çalışmamızın kısıtlayıcı yanını oluşturmaktadır. Osteopontin düzeyi, HPV pozitif hastalarda yüksek bulunmasına rağmen, daha geniş sayıda servikal intraepitelyal neoplazi olguları üzerinde yapılacak olan çalışmalara gereksinim olduğunu düşünmekteyiz.
The Journal of Tepecik Education and Research Hospital, 2017
Evde doğum yapan gebelerin gebelik sonuçlarını ve komplikasyonlarının analizini yapmayı amaçladık... more Evde doğum yapan gebelerin gebelik sonuçlarını ve komplikasyonlarının analizini yapmayı amaçladık. Yöntem: Hastanemize 2010-2015 yılları arasında başvuran evde doğum yapan 76 ve hastanede doğum yapan 97 gebenin prenatal muayene ve doğum sonrası dosyaları retrospektif incelendi. Bulgular: Toplam 76 hariçte doğum yapan hasta erken postpartum dönemde başvurmuştur. Evde doğum yapan hastaların yaş ortalaması 30,07±5,50, kontrol grubunda ise 29.88±5.50 olarak bulunmuştur. Evde doğum yapan hastaların büyük çoğunluğu multiparlardan oluşmaktaydı. Parite dağılımı evde doğum yapan hastalarda ortalam 2±1,08 olarak bulundu. Evde doğum yapan 76 hastanın 40'ının (%52,63) evde doğum yapmayı daha önceden planladıkları öğrenildi fakat evde doğum yapan hastaların hiçbirinde Dünya Sağlık Örgütünün evde doğum için önerdiği koşulların tam olarak sağlanmadığı saptandı. Hastaların obstetrik sonuçları incelendiğinde, evde doğum yapan hastaların büyük çoğunluğunun 37 haftadan büyük gebeliğe sahip olduğu ve tamamının baş prezentasyonda olduğu görüldü. Evde doğum yapan hastaların hiçbirinde epizyotomi açılmamış olup, hastaların %57,89'unda 1-2. derece perine laserasyonları oluşmuştur. Kontrol grubunda epizyotomi açılma oranı %59,79, 1-2. derece perine laserasyon oranı ise %40,20'dur. Neonatal sonuçlar açısından gruplar arasında bir fark saptanmamıştır. Sonuç: Obstetrik ve neonatal sonuçlar açısından gruplar arasında bir fark izlenmemekle birlikte, ülkemiz koşullarında Dünya Sağlık Örgütünün önerdiği asgari koşulların sağlanmasının henüz olası olmadığı gerekçesiyle evde planlı veya plansız doğumu önermemekteyiz.
Gönderilen makale şu an hiçbir dergide işlem görmemektedir. 3-6 Mart 2016 Erzurum Palandöken Kadı... more Gönderilen makale şu an hiçbir dergide işlem görmemektedir. 3-6 Mart 2016 Erzurum Palandöken Kadın Doğum Kongresinde Poster olarak sunulmuştur. *Sorumlu Yazar: Yard. Doç. Dr. Mehmet Kulhan Erzincan Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı Erzincan, Türkiye, Telefon numarası: +90 505 491 80 90, E-mail: [email protected] Geliş Tarihi: 07.04.2017, Kabul Tarihi: 27.05.2017 KLİNİK ÇALIŞMA / CLINICAL RESEARCH
Bu çalışmada, sağlıklı gebelerde, gestasyonel diyabetik gebelerde ve üreme çağındaki sağlıklı kad... more Bu çalışmada, sağlıklı gebelerde, gestasyonel diyabetik gebelerde ve üreme çağındaki sağlıklı kadınlarda D vitamini düzeyini belirlemeyi amaçladık. Gereç ve Yöntemler: Yaşları 18-43 yıl arası 28 sağlıklı gebe, 15 gestasyonel diyabetik gebe ve 30 sağlıklı genç erişkin kadından alınan serumlardan immünometrik yöntemle D vitamini ölçümü yapıldı. Bulgular: Tüm gruplarda D vitamini eksik olarak bulundu [sağlıklı gebelerde (11.8±7.4), gestasyonel diyabetik gebelerde (10.6±5.7), ve sağlıklı genç kadınlarda (12.1±5.4) ng/mL]. Gruplar arasında anlamlı bir fark yoktur (p=0.54). Sonuç: Tüm gebelerde ve genç erişkin kadınlarda D vitamini düzeyi yeterli değildir. Dolayısıyla D vitamini takviyesi yapılmalıdır.
Turkiye Klinikleri Journal of Gynecology and Obstetrics, 2017
advanced stage liver failure.1 Menstrual irregularities or amenorrhea has been associated with th... more advanced stage liver failure.1 Menstrual irregularities or amenorrhea has been associated with the decreased fertility in women who have an anovulatory cycle with liver failure.2 However, the rapid recovery of libido, menstrual cycle, and fertility has been reported in the several patients of reproductive age after successful transplantation.3 In the past 25 years, studies on liver transplantation and pregnancy have revealed that pregnancy is well tolerated and the neonatal outcome is satisfactory if the prepregnant recipient graft functions are normal.4 However, hypertension, preeclampsia, preterm birth, low birth weight, anemia, diabetes mellitus, and some infections are more common in these patients.4 In these patients, acute graft rejection and considerable graft dysfunction were not observed, and no specific malformation was observed in neonates.1-4 Another possible problem in pregnancies after transplantation is fetal anomalies, which may be secondary to immunosuppressive agen...
OBJECTIVE: Antibiotic prophylaxis is one of the most important steps to reduce surgical site infe... more OBJECTIVE: Antibiotic prophylaxis is one of the most important steps to reduce surgical site infections. First-generation cephalosporin (cefazolin) is used prophylactically in the majority of operations. Rifamycin is a broad-spectrum semisynthetic antibiotic that is bactericidal against gram (+) and gram (˗) microorganisms. To the best of our knowledge, there are no studies on the use of rifamycin in antibiotic prophylaxis. In this study, we aimed to analyze whether there is a difference between the use of only cefazolin and only rifamycin in terms of surgical site infections. STUDY DESIGN: One hundred patients were included in this case-control study during the last quarter period of 2017. These patients (n=100) were divided into two groups according to their antibiotic use; 50 patients who received only 1 g cefazolin constituted Group 1, 50 patients who received only 250 mg topical rifamycin over the incision line based on surgeon’s preference constituted Group 2. RESULTS: The use...
OBJECTIVES We aimed to investigate the clinical and pathological factors of our patients who were... more OBJECTIVES We aimed to investigate the clinical and pathological factors of our patients who were diagnosed with endometrial cancer in terms of prognosis. With this study, we present our 10 years of surgical experience in endometrial carcinoma cases. MATERIAL AND METHODS Four hundred twelve patients with endometrial carcinoma who applied to our center between 2010-2019 and that we followed up were evaluated retrospectively. RESULTS Most of the tumors were low-grade endometrioid malignancies. Non-endometrioid types accounted for 12.1% of cases. Lymph node dissection was performed in 395 of 412 patients (95.9%). 66 (16.01%) of the 412 patients died during the follow-up period in the study sample. Higher OS and DFS rates were associated with endometrioid histological types, FIGO stage, absence of lymphovascular space invasion, lower grade and less than 50% myometrial invasion (p < 0.05). 5-year OS at stage 1, 2, 3, 4 was found as 88.9 ± 2.2%, 65.5 ± 10.8%, 49.4 ± 0.79% and 23.7 ± 0....
There are many causes of postpartum hemorrhage, including travmatic hemorrhage from perineal inci... more There are many causes of postpartum hemorrhage, including travmatic hemorrhage from perineal incision, coagulation defects and uterine atony. Abnormal adherence of placenta, Cesarean scar pregnancy and gestational trophoblastic disease are other diseases that may cause of postpartum hemorrhage. Three of these clinical entities are associated with high rates of maternal morbidity and mortality. Here we report the case of a woman with a diagnosis of placenta increta that manifested as an unusual lower segment uterine mass, it caused prolonged but not catastrophic bleeding after delivery.
Endometrial polyps are one of the most common etiologies of abnormal genital bleeding in both pre... more Endometrial polyps are one of the most common etiologies of abnormal genital bleeding in both premenopausal and postmenopausal women. They are hyperplastic overgrowths of endometrial glands and stroma that form a projection from the surface of the endometrium. They may also be asymptomatic. The great majority of endometrial polyps are benign, but malignancy occurs in some women. Single or multiple polyps may occur and range in diameter from a few millimeters to several centimeters. Giant endometrial polyps associated with tamoxifen and raloxifene use. Here we presented a giant endometrial polyp in a postmenopausal woman without any complaints and hormone or drug use.
Aim: Early detection of endometrial cancer is important for the prognosis of the disease. In our ... more Aim: Early detection of endometrial cancer is important for the prognosis of the disease. In our study, the effect of myometrial invasion and histological grade on lymph node metastasis was investigated in patient with early stage endometrium cancer . Material and Method: A total of 249 patients from the last 10 years who underwent systemic lymphadenectomy for staging in our hospital were retrospectively examined. The pathologies of these patients were limited to the uterine corpus. The effect of histological grade of tumor and myometrial invasion on lymph node metastasis was evaluated statistically. Results: The average lymph node collected from patients was 27.7 (11-78). Lymph node metastasis was detected in 4.1% of patients with histological grade 1-2 and
Methotrexate (MTX) is a commonly used folic acid antagonist for the treatment of neoplasia and so... more Methotrexate (MTX) is a commonly used folic acid antagonist for the treatment of neoplasia and some autoimmune diseases. Resveratrol has important anti-inflammatory, antioxidant and immunomodulatory properties. The aim of this study was to investigate the effects of resveratrol on MTX-induced ovary-damage and oxidative stress in rats. We hypothesized that supplement of resveratrol could counteract MTX-induced cytotoxicity in rat ovary. Albino Wistar female rats were randomly divided into three groups: Healthy control (HC), resveratrol + methotrexate (RMTX) and methotrexate (MTX) group. Their ovaries were removed. Biochemical and histopathological methods were utilized for evaluation of the oxidative ovary-damage. MDA was found to be higher but tGSH and SOD were lower in the ovarian tissue of the rat group administered MTX, but it is observed that these ratios are reversed in HC and in RMTX groups. MTX treatment induced ovary damage and especially pre-treatment with resveratrol provided protective effect against this MTXinduced ovary-damaged.
Laparoscopic surgery shortens the hospitalization duration and allows the patient to return to da... more Laparoscopic surgery shortens the hospitalization duration and allows the patient to return to daily life earlier. These benefits apply within the interventions required during pregnancy. Nowadays laparoscopy has become a surgical technique that can now be used in pregnancy. A number of studies on the use of laparoscopic techniques in pregnancy have been reviewed in this review. Besides the minimum requirements for the protection of the unborn baby, limitations and differences in the surgical technique have been revealed.
Objectives: An investigation of the importance of hematological inflammatory markers on the progn... more Objectives: An investigation of the importance of hematological inflammatory markers on the prognosis of first trimester pregnancies and their role in predicting threatened abortion and early pregnancy loss. Material and methods: This study was carried out in the Obstetrics and Gynecology Department of the Faculty of Medicine in our University between January 2018 and May 2019. Three-hundred individuals, 100 of them diagnosed with early pregnancy loss (EPL), 100 diagnosed with threatened abortion (TA) and 100 healthy control patients (HC), participated in the study. Results: There were no statistically significant differences in terms of hemoglobin, platelet, neutrophil count and NLR between the three groups. The RBC counts were significantly lower in EPL and TA compared to HC. Similarly, it was determined that the MPV value was significantly lower in EPL compared to HC. On the other hand, there was no difference in MPV between TA and HC. The PLR was higher in EPL and TA. Conclusions: MPV, RBCs and PLR values were strongly associated with first-trimester miscarriage. These economical and easily measurable platelet indices can be used to predict fetal losses.
GİRİŞ: Bu çalışmada epitelyal over kanserlerinden rezeke edilen tümör spesmenlerinde, CD 44 ve CD... more GİRİŞ: Bu çalışmada epitelyal over kanserlerinden rezeke edilen tümör spesmenlerinde, CD 44 ve CD 24’ün ekpresyonları analiz edilerek, bu ekspresyon ve klinikopatolojik parametreler arasındaki ilişkiyi analiz edilmiştir.GEREÇ VE YÖNTEMLER: Bu çalışma, Kliniğimizin Jinekolojik Onkoloji Anabilim Dalı'nda tedavi edilen primer over kanseri olan 31 hastayı içermektedir.BULGULAR: Anti-CD24 için incelenen 14 seröz karsinomlu spesmende; 6 örnekte şiddetli (+++) immünoreaktivite, 4 örnekte orta / şiddetli (++ / +++) immünoreaktivite, 2 numunede orta / şiddetli (++ / +++) immünoreaktivite, 2 örnekte hafif / orta (+ / + +) immünoreaktivite gözlendi. Bu 14 hasta CD 44 için incelendiğinde; 3 örnekte (++) modereta immünoreaktivitesi, 2 örnekte + / ++ (hafif / orta) immünoreaktivite, 9 örnekte + (hafif) immünoreaktivite gözlendi.SONUÇ: CD44 immünoreaktivitesinin boyanma yoğunluğunun over epitelyal kanserlerinde sağkalım oranı ile ilişkili olduğu, ancak istatistiksel olarak anlamlı olmadığı tes...
Objectives: Evaluation of the effect of lymphadenectomy in disease-free and overall survival on t... more Objectives: Evaluation of the effect of lymphadenectomy in disease-free and overall survival on the low risk corpus cancer. Material and methods: Between 1994 and 2012, a total of 257 patients with endometrioid type, grade 1 or 2, myometrial invasion < 1/2, no intraoperative evidence of macroscopic extrauterine spread was treated surgically. Pelvic lymphadenectomy was performed in 184 cases, and not performed in 73 cases. Results: There was no difference between two groups about tumor sizes. Also lymphovascular space invasion and histologic grade of two groups were similar. Omission of LA did not worsen DFS and OS in early stage low risk corpus cancer. Conclusions: Patients who have low risk corpus cancer, can be treated optimally with hysterectomy only.
Why most women can clear human papillomavirus (HPV) infections while others can develop permanent... more Why most women can clear human papillomavirus (HPV) infections while others can develop permanent infections. The stimulation of immunotolerance of the immune system of the host by the persistent HPV infection may be the answer to this question. Interleukin-33 (IL-33) may play a role in the pathogenesis of HPV infection, this hypothesis was thought to be due to the rapid release of IL-33 from damaged cells following tissue damage, necrosis, and activation of the inflammasome. Thus, in this study, the role of IL-33/suppressor of tumorigenicity 2 (ST2) was emphasized in HPV positive and HPV negative cervical tissues. A total of 80 were assessed. The reduced levels of IL-33 and ST2 are associated with cervical HPV infections. There was a statistically significant 42% positive correlation between IL-33 and ST2 in the HPVpositive group. Surprisingly, our data showed no significant difference between the expression levels of IL-33 or ST2 and working status, type of delivery, pre-and post-operative pathology, cigarette, educational status, locality, birth control method, gynecological, and colposcopic findings. We found that as a result of our study; low IL-33 and ST2 levels were associated with HPV infections ARTICLE HISTORY
Introduction: Premature rupture of the membranes (PROM) refers to rupture of the fetal membranes ... more Introduction: Premature rupture of the membranes (PROM) refers to rupture of the fetal membranes prior to the onset of regular uterine contractions. Premature rupture of the membranes continues to be one of the most vexing issues of obstetrics due to increased maternal and fetal morbidity and mortality. Many studies have focused on how management should be in these cases. The purpose of this study was to investigate whether dinoprostone (PGE 2 analogue) administration is necessary for cervical ripening and labor induction in term women with premature rupture of membranes (PROM) and to compare maternal and neonatal outcomes between oxytocin usage and dinoprostone usage in PROM. Material and methods: A total of 224 nulliparous singleton pregnant women at term, with PROM ≥ 12 h, vertex presentations, no prior uterine surgery, reactive non-stress test and Bishop scores ≤ 6 (unfavorable cervixes) were reviewed. Participants were divided into two groups as oxytocin and dinoprostone groups. The primary outcome was vaginal delivery within 24 h. Results: The women in the oxytocin group were significantly younger than in the dinoprostone group (22.85 ±4.10 years vs. 25.99 ±4.94 years; p = 0.001). There were significant differences in vaginal delivery rates within 24 h. It was 72 of 112 (64.3%) vs. 53 of 112 (47.3%), p = 0.023 for oxytocin and dinoprostone groups, respectively. Conclusions: Vaginal dinoprostone appears to be a relatively inefficient method of inducing labor compared with oxytocin in term pregnancies with PROM and unfavorable cervixes. However, dinoprostone may maintain uterine contractions as effectively as oxytocin once uterine contractions are established.
Journal of Clinical and Experimental Investigations, 2017
The aim of this study was to evaluate both the frequency of Asn680Ser polymorphism of follicle st... more The aim of this study was to evaluate both the frequency of Asn680Ser polymorphism of follicle stimulating hormone receptor (FSHR) and whether this polymorphism is associated with polycystic ovary syndrome (PCOS) in a Turkish population. Patients and Methods: 100 patients with PCOS and 100 controls were recruited from Eastern Turkey. Venous blood samples were obtained for genetic study, hormone profile, glucose and insulin assays. Asn680Ser polymorphism of FSHR was analyzed by polymerase chain reaction (PCR) amplification and direct DNA sequencing. Two groups were compared for body mass index (BMI), modified Ferriman-Gallwey (mFG) score, fasting glucose, fasting insulin, insulin resistance, hormone and lipid status. Then, all patients were divided into subgroups for genotypes of FSHR polymorphism. These subgroups were also compared for these mentioned parameters. Results: The difference between women with PCOS and controls in allelic frequencies for Asn680Ser polymorphism of FSHR were not significant. When this single nucleotide polymorphism (SNP) at codon 680 was separately analyzed, no significant difference was found in the genotype frequency among the Asn680Asn, Asn680Ser, andSer680Ser subgroups. There were no significant differences in BMI, mFG score, levels of fasting glucose and fasting insulin, HOMA-IR, and also levels of FSH, luteinizing hormone, estradiol, prolactin, thyroid stimulating hormone, total testosterone among the PCOS patients carrying different genotypes of Asn680Ser polymorphism Conclusion: there is no association between Asn680Ser polymorphism of FSHR and PCOS in Turkish women from eastern provinces of Turkey. In addition, this SNP seems not to be associated with BMI, IR and PCOS-associated endocrine hormones.
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Papers by Mehmet Kulhan