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Öğe EFFECTS OF GENISTEIN, ESTROGEN AND PROGESTERONE THERAPIES ON BLADDER MORPHOLOGY AND M2, M3 RECEPTOR EXPRESSIONS IN OOPHORECTOMIZED RATS(Carbone Editore, 2014) Turgut, Abdulkadir; Goruk, Neval Yaman; Sak, Muhammet Erdal; Deveci, Engin; Akdemir, Fatih; Keles, Ayse Nur; Nergiz, YusufAims: Investigating the effects of estrogen, estrogen/progesterone combination and genistein therapy on the expression of M2 and M3 receptors located on bladder walls and comparing the morphological and degenerative changes exerted on bladder walls. Materials and methods: A total of 50 adult Sprague-Dawley female rats were randomly divided into five groups. Rats other than the sham group were ovariectomized. OVX group (control group) received water, OVX+G group received 10 mg/kg genistein, OVX+E group received 0.014 mg/kg 17-beta estradiol, OVX+E+P group received 0.014 mg/kg 17-beta estradiol plus 0.028 mg/kg drospirenone per day. Results: When compared with the sham group, in the OVX group higher collagen fibre (CF): smooth muscle (SM) ratio, relatively increased fibrosis, oedema, space between detrusor smooth muscle fascicles, cytoplasmic vacuoles, and total M2, and M3 expression were observed. Relative to the OVX group, decreased CF: SM ratio and fibrosis in the OVX+G, OVX+E, and OVX+E+P groups, decreased oedema, spaces between detrusor muscle fascicles and cytoplasmic vacuoles in the OVX+G group and lesser total M2, and M3 expression in the OVX+G, OVX+E and OVX+E+P groups were observed. Conclusion: Genistein therapy regresses unfavourable morphological changes effecting postmenopausal bladder and increases in M2 and M3 receptor expression more effectively than estrogen and estrogen/progesterone combination. Besides, genistein therapy almost completely regresses degenerative changes; however, estrogen and estrogen/progesterone combination therapies do not improve these degenerative changes except for fibrosis. We think that genistein will favourably contribute both to the conduction of more comprehensive studies in the future concerning its use in postmenopausal urinary incontinence where estrogen and estrogen/progesterone combination therapies do not provide any improvement and etiopathogenesis of urinary incontinence.Öğe Evaluation of the Protective Effects of CoQ10 on Ovarian I/R Injury: An Experimental Study(Karger, 2013) Ozler, Ali; Turgut, Abdulkadir; Goruk, Neval Yaman; Alabalik, Ulas; Basarali, Mustafa Kemal; Akdemir, FatihBackground: The aim of this study was to investigate the protective effects of coenzyme Q(10) (CoQ(10)) on ovarian ischemia/reperfusion injury in an experimental rat adnexal torsion model. Methods: 48 female adult Wistar albino rats, weighing 220-250 g, were randomly equally divided into six groups (n = 8): sham, torsion, detorsion, sham+CoQ(10), torsion+CoQ(10), and detorsion+CoQ(10) groups. Bilateral adnexal torsion was performed for 3 h in all groups, except the sham and sham+CoQ(10) groups. Bilateral adnexal detorsion was performed on the detorsion and detorsion+CoQ(10) groups. CoQ(10) was injected intraperitoneally 30 min before the sham operation, torsion, and detorsion. Results: The torsion and detorsion groups had significantly higher histologic evaluation scores, as well as higher MDA levels, TOS values, and oxidative stress index values than the sham group. A strong correlation between total histologic evaluation scores for ischemia/reperfusion injury and the oxidative stress index was found. The mean oxidant marker levels and histopathologic scores for the ovarian tissue significantly decreased after using CoQ(10), which is a potent antioxidant. Conclusions: Conservative surgery (detorsion) was found to provide inadequate protection to ovarian tissue. The results of this study suggest that CoQ(10) could be useful for the protection of ovarian tissue before conservative surgery. (C) 2013 S. Karger AG, BaselÖğe Misoprostol-induced termination of second-trimester pregnancy in women with a history of cesarean section: A retrospective analysis of 56 cases(Studio K, 2013) Turgut, Abdulkadir; Ozler, Ali; Goruk, Neval Yaman; Karacor, Talip; Yalinkaya, AhmetObjective: To assess the effectivity and safety of misoprostol induced termination of pregnancy in the second trimester in women with a history of previous caesarean section. Materials and Methods: Retrospective analysis of case records from the obstetrics and gynecology department of a tertiary care center between January 2009 and February 2012 was performed. Data derived from 219 women, who underwent a second trimester termination of pregnancy was analyzed in terms of demographics, clinical findings, laboratory and procedural data. The study group consisted of 56 women with a previous caesarean section and the control group was composed of 163 women without such a history Termination of pregnancies was conducted by administration of misoprostol at doses of 50-600 mcg intravaginally or by surgical evacuation in cases of failure of medical measures. Results: There was no statistically significant difference between two groups in terms of demographics such as age, menarche, number of pregnancies or live births, smoking habit and co-morbidities. Necessity for blood transfusion (p=0.05) and additional procedure for abortion (p=0.056) were found to be similar in both groups. However, laparotomy (p=0.004), uterine rupture (p=0.016), hysterotomy (p<0.001) were performed more frequently in the study group; while abortion was more likely to occur within 24 hours in the control group (p=0.031). Conclusion: Medical abortion must be carefully used for the termination of second trimester pregnancies in women with a history of CS. Increased possibility of uterine rupture and requirement of interventions such as laparotomy or hysterotomy is more likely in these patients.Öğe Multiple repeat caesarean deliveries: do they increase maternal and neonatal morbidity?(Taylor & Francis Ltd, 2017) Tunc, Senem Yaman; Agacayak, Elif; Sak, Sibel; Basaranoglu, Serdar; Goruk, Neval Yaman; Turgut, Abdulkadir; Tay, HayrettinObjective: The aim of the present study is to evaluate the effects of the increased number of caesarean deliveries (CDs) in cases of multiple repeat caesarean deliveries (MRCDs) on maternal and neonatal morbidity. Methods: MRCDs admitted to our hospital between January 2013 and September 2014 were analysed retrospectively. A total number of 1133 women were included in the study and were divided into 4 groups. Group 1: second CDs (n=329); Group 2: third CDs (n=225); Group 3: fourth CDs (n=447); Group 4: fifth CDs (n=132). The clinical, demographic, intraoperative and postoperative data of the patients were registered upon the review of patient files. Results: The differences among the groups were found to be statistically significant in terms of mean maternal age, gravida, APGAR (Activity, Pulse, Grimace, Appearance, Respiration) scores, hospital stay and operation time. In addition, the difference was also statistically significant for severe adhesion, bladder injury and premature birth. No statistically significant difference was observed among the groups with respect to placenta previa, placenta accreta, caesarean hysterectomy, uterine scar rupture. Conclusions: According to our findings, MRCDs seem to increasing the maternal and neonatal morbidity even though they are not life-threatening.Öğe PREDISPOSING FACTORS IN THE OCCURRENCE OF COMPLICATIONS AFTER VAGINAL HYSTERECTOMY(Galenos Yayincilik, 2013) Sak, Muhammet Erdal; Ozler, Ali; Sak, Sibel; Goruk, Neval Yaman; Karacor, Talip; Gul, TalipObjective: To investigate the predisposing risk factors in the occurrence of complications after vaginal hysterectomy. Material and methods: The data obtained from 223 patients, admitted to tertiary care center that underwent vaginal hysterectomy due to benign pathology between January 2006 and March 2012 were retrospectively analyzed. Chisquare test was used to evaluate variables in categorized groups. Results: Group variables occurred age, number of pregnancies and abortion, parity, stage according to pelvic organ prolapse classification (POP-Q), periods of hospitalization and urinary catheterization. The main complications were hemorrhage, febrile morbidity and vaginal vault prolapse. Advanced age (> 60), pelvic prolapse, long-term hospitalization and urinary catheterization, were predisposing factors for the presence of complications. Conclusion: Vaginal hysterectomy is a safe and effective method, although not completely devoid of intraoperative or postoperative complications. Advanced age (> 60), POP-Q stage 3-4 pelvic prolapse, prolonged hospitalization and urinary catheterization were seem to be predisposing conditions for the existence of complications. Appropriate preoperative planning and meticulous postoperative care may be helpful to reduce the rate of complications.Öğe Protective Effect of L-Glutamine as an Antioxidant Against the Toxic Effects of the Pesticide Deltamethrin in the Rat Ovary(Sci Printers & Publ Inc, 2016) Agacayak, Elif; Tunc, Senem Yaman; Goruk, Neval Yaman; Ekinci, Aysun; Basaranoglu, Serdar; Ekinci, Cenap; Deveci, EnginOBJECTIVE: To investigate the potential protective effect of L-glutamine as an antioxidant against the toxic effects of the pesticide deltamethrin (DLM) by examining biochemical and histopathological parameters in the rat ovary. STUDY DESIGN: The rats included in this study were divided into 4 groups (n= 10) as follows: Group I, controls (distilled water, 10 mL/kg, p.o.); Group II, Lglutamine (1.5 g/kg, p.o.); Group III, DLM ( 35 mg/kg, p.o.); and Group IV, DLM (35 mg/kg, p.o.)+ Lglutamine (1.5 g/kg, p. o.). Biochemical measurements were taken and apoptotic changes were determined in ovarian tissue. Immunohistochemical expression of proliferating cell nuclear antigen and CD34 were assessed. RESULTS: Histopathological examination revealed germinal epithelial thinning and degeneration in antral follicles as well as apoptotic changes in the DLM group. The same examination showed significantly elevated estradiol (E2) levels and decreased total oxidant status levels in the DLM+ L-glutamine group as compared to the control group ( p= 0.047 and p= 0.048, respectively). Bivariate analysis resulted in the observation that E2 levels correlated negatively with follicular degeneration and vascular hemorrhage (r=-0.471* [ p= 0.036] and r=-0.482* [ p= 0.031], respectively) as well as with CD34 expression in pre-antral and antral follicles (r=0.537** [ p= 0.005]). CONCLUSION: L-glutamine as an antioxidant might alleviate the toxic effect of the pesticide DLM. (Anal Quant Cytopathol Histpathol 2016; 38: 331-342)Öğe Protective effects of honokiol on ischemia/reperfusion injury of rat ovary: an experimental study(Dove Medical Press Ltd, 2016) Tunc, Senem Yaman; Agacayak, Elif; Goruk, Neval Yaman; Icen, Mehmet Sait; Turgut, Abdulkadir; Alabalik, Ulas; Togrul, CihanAim: The purpose of this study was to investigate the protective effect of honokiol on experimental ischemia/reperfusion injury of rat ovary. Materials and methods: A total of 40 female Wistar albino rats were used in this study. The rats were divided into five groups as follows: sham (Group I), torsion (Group II), torsion + detorsion (Group III), torsion + detorsion + saline (Group IV), and torsion + detorsion + honokiol (Group V). Bilateral adnexa in all the rats except for those in the sham group were exposed to torsion for 3 hours. The rats in Group IV were administered saline, whereas the rats in Group V were administered honokiol by intraperitoneal route 30 minutes before detorsion. Tissue and plasma concentrations of malondialdehyde and nitric oxide were determined. Ovarian tissue was histologically evaluated. Data analyses were performed by means of Kruskal Wallis test and Mann-Whitney U-test (Bonferroni correction) in SPSS 15.0 (Statistical Package for Social Sciences; SPSS Inc., Chicago, IL, USA). Results: The torsion and detorsion groups had higher scores in vascular congestion, hemorrhage, and inflammatory cell infiltration compared with the sham group (P<0.005). In addition, total histopathological scores were significantly higher in the torsion and detorsion groups compared with the sham group (P<0.005). A significant reduction was observed in hemorrhage, inflammatory cell infiltration, and cellular degeneration scores, of all histopathological scores, in the honokiol group (P<0.005). Ovarian tissue concentrations of malondialdehyde were significantly higher in the torsion and detorsion groups compared with the sham and honokiol groups (P<0.005). Ovarian tissue concentrations of nitric oxide, on the other hand, were significantly higher in the torsion group compared with the sham, saline, and honokiol groups (P<0.005). Conclusion: Honokiol has a beneficial effect on ovarian torsion-related ischemia/reperfusion injury.Öğe Role of inflammation and oxidative stress in the etiology of primary ovarian insufficiency(Galenos Yayincilik, 2016) Agacayak, Elif; Goruk, Neval Yaman; Kusen, Hakan; Tunc, Senem Yaman; Basaranoglu, Serdar; Icen, Mehmet Sait; Yildizbakan, AhmetObjective: The aim of this study was to elucidate the etiology and treatment of primary ovarian insufficiency, which is of unknown cause in 95% of the cases. Materials and Methods: Thirty patients aged 18-40 years who presented to Dicle University Faculty of Medicine Clinic of Obstetrics and Gynecology between June 2012 and January 2014 and were diagnosed as having primary ovarian insufficiency based on their clinical and endocrinologic data, and 30 healthy controls were included in this study. Results: No significant differences were found between patients with primary ovarian insufficiency and control subjects in demographic data and lipid profile levels, thyroid-stimulating hormone, prolactin, and glucose. However, the neutrophil to lymphocyte ratio and levels of follicle-stimulating hormone, luteinizing hormone, total antioxidant status, total oxidant status, and oxidative stress index were significantly higher in patients with primary ovarian insufficiency than in control subjects. In the correlation analysis, follicle-stimulating hormone exhibited a positive correlation with total oxidant status, oxidative stress index, and the neutrophil to lymphocyte ratio (r=0.573** p < 0.001, r=0.584** p < 0.001, r=0.541 p < 0.001, respectively) and correlated negatively with total antioxidant status (r=-0.437** p < 0.001). Conclusion: The neutrophil to lymphocyte ratio, total oxidant status, and oxidative stress index levels are elevated in primary ovarian insufficiency. Therefore, anti-oxidative and anti-inflammatory treatment might be administered to patients in the early stage of primary ovarian insufficiency. However, larger studies are needed to clarify whether these elevated levels are a cause or a consequence of primary ovarian insufficiency.Öğe Single intrauterine demise in twin pregnancies: Analysis of 29 cases(Galenos Yayincilik, 2015) Tunc, Senem Yaman; Agacayak, Elif; Goruk, Neval Yaman; Icen, Mehmet Sait; Findik, Fatih Mehmet; Evsen, Mehmet Siddik; Turgut, AbdulkadirObjective: To evaluate the maternal and fetal demographic features and clinical aspects of twin pregnancies with single intrauterine demise. Materials and Methods: This retrospective study was conducted in Dicle University Faculty of Medicine, Department of Gynecology and Obstetrics between January 2008 and December 2013. There were a total of 594 twin deliveries in our hospital between the given dates. Twenty-nine of these cases were referred to our hospital by another health center because of a preliminary diagnosis of single intrauterine demise. Maternal age, parity, chorionicity, week of fetal death, gestational week at delivery, mode of delivery, birth weight, Activity, pulse, grimace, appearance, respiration scores, maternal fibrinogen levels at delivery and during pregnancy, stay in the neonatal intensive care unit, and obstetric complications were explored in these 29 cases of single intrauterine demise. Results: The mean age of the 29 patients who were provided antenatal follow-up and delivery services in our hospital was 29.9 +/- 6.5 years. Thirteen (44.8%) of the patients were monochorionic, whereas 16 (55.2%) were dichorionic. Intrauterine fetal death occurred in the first trimester in 6 pateints and in the second or third trimester in 23. In addition, 20 (69%) patients underwent cesarean section, whereas 9 (31%) had spontaneous vaginal delivery. Lastly, none of the patients had a maternal coagulation disorder. Conclusion: Twin pregnancies with single intrauterine death can lead to various complications for both the surviving fetus and the mother. Close maternal and fetal monitoring, and proper care and management can minimize complications.Öğe Uterine rupture revisited: Predisposing factors, clinical features, management and outcomes from a tertiary care center in Turkey(Professional Medical Publications, 2013) Turgut, Abdulkadir; Ozler, Ali; Evsen, Mehmet Siddik; Soydinc, Hatice Ender; Goruk, Neval Yaman; Karacor, Talip; Gul, TalipObjective: To determine the predisposing factors, modes of clinical presentation, management modalities and fetomaternal outcomes of uterine rupture cases at a tertiary care center in Turkey. Methodology: A 14-year retrospective analysis of 61 gravid ( >20 weeks of gestation) uterine rupture cases between January 1998 to March 2012 was carried out. Results: The incidence of ruptured uteri was calculated to be 0.116%. Persistence for vaginal delivery after cesarean was the most common cause of uterine rupture (31.1%). Ablatio placenta was the most common co-existent obstetric pathology (4.9%). Bleeding was the main symptom at presentation (44.3%) and complete type of uterine rupture (93.4%) was more likely to occur. Isthmus was the most vulnerable part of uterus (39.3%) for rupture. The longer the interval between rupture and surgical intervention, the longer the duration of hospitalization was. Older patients with increased number of previous pregnancies were likely to have longer hospitalization periods. Conclusion: Rupture of gravid uterus brings about potentially hazardous risks. Regular antenatal care, hospital deliveries and vigilance during labor with quick referral to a well-equipped center may reduce the incidence of this condition.
