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  • Küçük Resim
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    Bakri balloon placement effectively treats uterine atony and placenta previa
    (Taylor and Francis Ltd., 2017) Tahaoğlu, Ali Emre; Balsak, Deniz; Erdoğdu, Emre; Bakır, Mehmet Sait; Aksin, Şerif; Bala, Mesut; Toğrul, Cihan; Yalınkaya, Ahmet
    The aim of this study was to explore the success rates of Bakri balloon placement in patients with placenta previa and uterine atony. In addition, we compared bilateral internal iliac artery ligation (B-IIAL) and Bakri balloon placement in terms of their ability to inhibit haemorrhage in postpartum placenta previa patients. The hospital reports filed annually from 2010 to 2015 were reviewed. In total, 54 patients were evaluated: 42 patients with placenta previa and uterine atony were treated with Bakri balloons, and 12 placenta previa patients with postpartum haemorrhage underwent B-IIAL when medical treatment failed. The results showed that the success rates of Bakri balloon placement rate in placenta previa and uterine atony patients were 71.4% and 89.2%, respectively. The comparative analysis of placenta previa patients treated via Bakri balloon placement and B-IIAL showed that the requirements for packed red blood cell and fresh frozen plasma, pre- and post-partum haemoglobin levels, pre- and post-partum platelet counts, and hospitalization times differed significantly between the two groups (all p < 0.05). Bakri balloon tamponade could be considered an effective treatment for placenta previa and uterine atony. The technique is minimally invasive and can serve as a second-line treatment for patients with postpartum haemorrhage when medical procedures fail.
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    Effects of Potentilla fulgens as a Prophylactic Agent for Ischemia/Reperfusion Injury in the Rat Ovary
    (Sci Printers & Publ Inc, 2015) Togrul, Cihan; Balsak, Deniz; Ekinci, Cenap; Seckin, Kerem Doga; Ekinci, Aysun; Tahaoglu, Ali Emre; Bademkiran, Hanefi
    OBJECTIVE: To investigate the effects of Potentilla fulgens as a prophylactic agent on ischemia/reperfusion (I/R) injury in the rat ovary. STUDY DESIGN: A total of 32 Wistar rats were divided into 4 equal groups: (I) sham, (II) ischemia, (III) ischemia+reperfusion, and (IV) I/R+Potentilla fulgens. In groups I and II, ovary torsion was not performed and no drug was administered. In group III, 1 hour of ischemia and 2 hours of reperfusion were performed and no drug was given. Group IV received 400 mg/kg/day Potentilla fulgens intraperitoneally 5 days before I/R injury. RESULTS: The detorsion group showed preantral ovarian follicles and corpus luteum around the blood vessels and positive expression of vascular endothelial growth factor (VEGF). In the Potentilla fulgens group (IV) the stromal vascular endothelium with weak expression of VEGF was detected in small areas, and the ovarian follicles and the corpus luteum showed negative expression of VEGF. In the detorsion group the theca cells and apoptotic cells in preantral follicles showed positive expression of E-cadherin in the ovarian surface epithelium. Moreover, the E-cadherin expression was found to be positive in terms of follicular development, theca cells, granulosa cells, and corpus luteum. Potentilla fulgens, given after ischemic injury and apoptosis, was seen to decrease the effect of Bcl-2 expression. CONCLUSION: These results provide compelling evidence that the expression of E-cadherin in the ovary is an important component of ovarian function.
  • Küçük Resim
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    Expression of PECAM-1 and E-cadherin in the umblical cords of gestational diabetic mothers
    (Soc Chilena Anatomia, 2015) Tahaoǧlu, Ali Emre; Toğrul, Cihan; Külahçıoğlu, Mehmet İrfan; Bademkıran, Muhammed Hanifi; Balsak, Deniz; Mavigök, Erkan; Ekinci, Cenap; Deveci, Engin
    The purpose of this study is to examine the changes in the umbilical cord in women diagnosed with gestational diabetes mellitus In this study, as a control group human placental tissues from normotensive pregnancies was collected from diabetic women at 28-35 weeks of gestation. Gestational diabetes (n= 20) and normal umbilical cord (n= 20) for a total of 40 units were received. GDM groups compared to the control group was significantly higher values was detected (p<0.01). In GDM group, light microscopy showed erosion of the endothelium and complete rupture of the umbilical vessels resulting in extravasation of blood within Wharton's jelly. it was observed that the cytoplasmic fragments and cell infiltration of the spill to the subepithelial layer of apoptotic cell PECAM-1 positive reaction showed. E-Cadherin in endothelial side surface of diabetes group showed weak expression in the nucleus and showed positive reaction in smooth muscle.
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    The role of hysterosalpingography in the evaluation of infertile women without risk factors for tubal pathology
    (2016) Gül, Talip; Özler, Ali; Küllahçıoğlu, Mehmet İrfan; Balsak, Deniz; Sakar, Mehmet Nafi
    Amaç: Kadın infertilite tanısında tubal açıklığın değerlendirilmesi önemli rol oynar. Histerosalpingografi ve kromopertubasyonlu laparoskopi, tubal açıklığın değerlendirilmesinde geleneksel olarak kullanılmaktadır. Risk faktörü değerlendirilmesine göre tubal faktör olabileceğini düşündüğümüz infertil kadınlarda doğrulama açısından histerosalpingografinin gerekli olup olmadığını belirlemeyi amaçladık.Gereç ve yöntem: Bu prospektif vaka-kontrol çalışmasına infertilite polikliniğine çocuk sahibi olamama şikayetiyle başvuran 174 infertil olgu dahil edildi. Hastaların yaşı, evlilik süresi, cinsel ilişki durumu, reprodüktif öyküsü kaydedildi. Hastalar tubal faktör infertilitesine neden olabilecek risk faktörleri açısından sorgulandı ve mevcut risk faktörleri kaydedildi. Tubal risk faktörü taşıyıp taşımamalarına göre hastalar 2 gruba ayrıldı. Grup 1 risk faktörü taşıyanlar, Grup 2 ise risk faktörü taşımayanlardı. Bulgular: Olgularda abdominal cerrahi öyküsü en sık (%82.97) bulunan risk faktörüydü. Grup1'de 47 olgunun 35 (%74.46)'inde herhangi bir tubada geçiş varken, Grup 2'de 127 olgunun 118 (%92.91)'inde herhangi bir tubada geçiş vardır. Grup 1'de 47 olgunun 12 (%25.53)'sinde, Grup 2'de ise 127 olgunun 9 (%7.08)'unda bilateral tubal tıkanıklık tespit edildi. Her iki grup arasında bulunan fark anlamlıdır (p=0.001). Sonuç: Histerosalpingografi, tubal patoloji için risk faktörü taşımayan infertil kadın değerlendirmesinde yapılmayabilir. Böylece herhangi bir tubal risk faktörü taşımayan olgular, anlamlı katkıyı sağlamayan, ağrılı ve radyasyon tehlikesi göz ardı edilemeyen histerosalpingografi işleminden korunmuş olacaktır. Bu veriyi doğrulayacak daha geniş ölçekli çalışmalara ihtiyaç vardır.
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    Severe pre-eclampsia complicated by HELLP syndrome alterations in the structure of the umbilical cord (morphometric and immunohistochemical study)
    (Taylor & Francis Ltd, 2015) Balsak, Deniz; Togrul, Cihan; Ekinci, Cenap; Cavus, Yunus; Tahaoglu, Ali Emre; Deveci, Engin; Gul, Talip
    The aim of this study was to evaluate the morphometric and immunohistochemistry in umbilical cords from patients with severe pre-eclampsia with and without haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome. The patient and control groups were similar according to baseline obstetric characteristics. White blood cell count in patients with HELLP syndrome and the control group was significantly increased among patients with HELLP syndrome (p < 0.001). Morphometric examination and endothelial core length were significantly different between the groups. In the umbilical cord cross-section of the HELLP group, endothelial cell degeneration in the vessel wall and basement membrane thickening were observed. In the muscle layer of blood vessels, the following disorders were found: increased collagen fibres in the muscle cell, hyperplasia and separation of muscle fibres as well as edema in the intermediate connective tissue. Immunohistochemical analysis showed that endothelial cells, basal membrane and fibroblast cells in the HELLP group expressed high levels of CD44. Vessel wall and amniotic epithelial basement membrane thickening were observed in the HELLP group. Matrix metalloproteinase 9 (MMP9) was expressed. Fibroblast and smooth muscle cells were fusiform and showed a positive reaction to immunohistochemical staining of alpha-actin smooth muscle.