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Öğe Brucellosis is a major problem: A five years experience(Acta Medica Mediterranea, 2013) Dal T.; Celen M.K.; Ayaz C.; Dal M.S.; Kalkanli S.; Mert D.; Yildirim N.Brucellosis is a chronic granulomatous infection which is endemic in Mediterranean countries and Turkey. The aim of this study is to analyze the clinical, laboratory findings and therapeutic features in patients with brucellosis. A retrospective study was conducted with 91 patients who developed brucellosis between 2005 to 2009. The diagnosis was based on clinical findings compatible with brucellosis, serological tests positive, and/or isolation of Brucella species from blood, or other tissues. The mean age was 33 years (16-67 years). Sixty-threes of patients (69.2%) were male. Forty (44%) cases had an occupational history relevant for Brucella exposure and 85 (93%) cases consumption with contaminated animal product. The mean diagnostic delay was 15 days, much longer in focal brucellosis. A total of 77 (85 %) cases had acute brucellosis. The focal brucellosis complications were observed in 39 (42.8%) cases: osteoarticular involvement 32 (82%), epididymo-orchitis 4 (10%), and central nervous system involvement 3 (8%). Chronic brucellosis occurs in 3 (3.3%) cases. Clinical manifestations included non-specific symptoms such as fever (95%), sweats (90%), arthralgia and lower back pain (63%). Of the patients 84 (92%) had serological titre =1/160 and 28 (31%) blood cultures were positive. All of the patients were cured by antibiotic therapy (Doxycycline+rifampicin/streptomycine, streptomycine+rifampicin/Doxycycline, ceftiraxone/rifampicin). Relapse was observed in 5 (5.4%) patients. Brucellosis is an infection with multiple presentations. Its early diagnosis was mandatory to avoid severe complications.Öğe Effects of adnexal torsion on the fallopian tube in rats: A histologic and immunohistochemical study(Science Printers and Publishers Inc., 2014) Tunç S.Y.; Ağaçayak E.; Yaman N.S.; Deveci E.; Kalkanli S.; Özler A.Objective: To investigate histopathological and immunohistochemical changes in the Fallopian tube structure following ovarian torsion. Study design: Thirty fertile, female, adult Wistar albino rats, weighing 200-220 g, were randomly divided into 3 equal groups (n=10): sham, torsion, and detorsion. In the torsion and detorsion groups, bilateral adnexal torsion (3-hour ischemia) was carried out. Bilateral adnexal detorsion (3-hour reperfusion) was performed in the detorsion group. Fallopian tube sections were stained hematoxylin and eosin, periodic acid-Schiff, Mallory-Azan and immunohistochemically-stained desmin, ? smooth actin, and CD68 antibodies. Results: In the sections of the ischemic group, degeneration of epithelium, loss of cilia, dilation of blood vessels, and hemorrhages were observed. Image analysis of the studied Fallopian section revealed a significant decrease in density of desmin in the torsion group. Moreover, strong positive cytoplasmic CD68 expression was observed in the torsion group. Conclusion: The use of effective antiinflammatory treatments may contribute to the conservative surgery in preservation of ovarian reserve and tubal structure. © Science Printers and Publishers, Inc.Öğe Expression of beta human chorionic gonadotropin in the placenta of gestational diabetic mothers: An immunohistochemistry and ultrastructural study(2013) Sak M.E.; Deveci E.; Evsen M.S.; Kalkanli S.; Baran O.; Özekinci S.; Şeker U.Objective: To investigate morphologic differences of the placenta in pregnancies complicated by gestational diabetes compared to nondiabetic pregnancies. Study Design: This was a comparative morphological study of the placentas from 20 women with gestational diabetes and 20 healthy pregnancies at 28-35 weeks of gestation. Results: The presence of lesions such as fibrinoid necrosis, villous edema, syncytial knot and vascular lesions like chorangiosis was apparent, mainly in the diabetes group. There was an apparent decrease in the intensity of the human chorionic gonadotropin (hCG) immunostaining in the syncytiotrophoblast from the 28th to 35th weeks of gestation in the placentas of the healthy control group. No hCG immunostaining was observed in the villous or intervillous areas of any of the placentas. In diabetic placentas the expression of hCG was homogeneous with a moderate to intense immunoreactivity in the syncytiotrophoblast. Several syncytiotrophoblast cells showed dilations of both rough and smooth endoplasmic reticulum and loss and alteration of microvilli, and large vacuoles were observed just below the plasma membrane, as well as irregularities in the mitochondria. Conclusion: Syncytial cells play an important role in the placental transition. Increased expression of ß- hCG, deterioration, degeneration of organelles and cell structure and the basal membrane disorder in chorionic vessels were seen in placentas with gestational diabetes. These changes can affect placental transfer. However, further studies are needed to clarify this issue. © Science Printers and Publishers, Inc.Öğe The frequency and the type of different etiological factors in primary amenorrhea(Acta Medica Mediterranea, 2014) Agacayak E.; Icen M.S.; Tunc S.Y.; Siddik Evsen M.; Kalkanli S.; Basaranoglu S.Aim: Primary amenorrhea (PA) is defined as the absence of menarche by the age of 14 without the development of secondary sexual characteristics or lack of menstruation by the age of 16 despite the existence of normal growth with the appearance of secondary sexual characteristics. We carried out a retrospective study, with the purpose of establishing the frequency and the type of different etiological factors among patients with primary amenorrhea. Material and method: A total of 108 subjects, age ranged from 14 to 33 years were included in the study. A complete physical examination, blood tests for hormonal profile, pelvic ultrasonography and magnetic resonance imaging were performed to all patients. Besides, genotypic evaluations were also performed for the patients who got the indication. Results: Out of the 108 patients presenting with primary amenorrhea, 40 (37,0%) had gonadal dysgenesis, 25 (23,1%) had Mullerian agenesis and 14 (12,9%) patients had hypogonadotropic hypogonadism. The genotypic evaluation revealed that 77.5 % (n=31) of cases had normal chromosome composition whereas 22.5% (n=9) had chromosomal abnormalities. Conclusion: In conclusion, we have determined the 3 most common causes of primary amenorrhea are ovarian dysgenesis, Mullerian agenesis and hypogonadotropic hypogonadism; this data is compatible with the literature. Abnormalities in chromosomal analysis were determined in 22,5% of patients, which is also compatible with the literature. Determining etiology, in this large range of diseases may be confusing in clinical practice. During evaluation of patients with primary amenorrhea; these results should be kept in mind in order to establish an algorithm.Öğe Human placental macrophages (Hofbauer cells) in severe preeclampsia complicated by HELLP syndrome(2013) Evsen M.S.; Kalkanli S.; Deveci E.; Sak M.E.; Ozler A.; Baran O.; Erdem E.OBJECTIVE: To evaluate Hofbauer cells in the placentas of women diagnosed with HELLP syndrome. STUDY DESIGN: The present study compared 20 patients with HELLP syndrome and 20 control patients with respect to demographics, hematological parameters and the presence of Hofbauer cells in placental samples. CD-68 antibody was used for immunohistochemical examination. The total number and size of Hofbauer cells were measured in the placental villi, and the proportion of Hofbauer cells relative to the vascular structure was also compared between groups. RESULT: The patient and control groups were similar according to baseline obstetric characteristics. White blood cell counts in patients with HELLP syndrome and the control group were 15,139 ± 4,169 and 10,806 ± 2,888, respectively, and were significantly increased among patients with HELLP syndrome (p<0.001). Hofbauer cell numbers in the placental villi of patients with HELLP syndrome were significantly elevated in comparison to normotensive controls (p=0.046). The proportion of Hofbauer cells in the placental villi according to proximity to the vascular structure were 3.85±1.66 in the HELLP group and 1.75±1.12 in controls (p<0.001). Sizes of the Hofbauer cells were not statistically different between groups. CONCLUSION: Increased Hofbauer cells may be associated with increased inflammation or may have an adaptive mechanism at the fetal site of the placenta in patients with HELLP syndrome. (Anal Quant Cytopathol Histopathol 2013;35:283-288). © Science Printers and Publishers, Inc.Öğe Quantitative analysis of t(8,21) and inv(16) via RT-PCR in patients with acute myeloid leukemia(2005) Ayyildiz O.; Kalkanli S.; Batun S.; Işikdo?an A.; Söker M.; Yurt M.; Müftüo?lu E.It has been showed that there is a relation between chromosomal abnormality and prognosis in acute myeloid leukemia (AML). There are many chromosomal abnormalities in AML patients and it is known that t(8;21) and inv(16) are good prognostic abnormalities. Recently the treatment has been planned according to these abnormalities. We investigated t(8,21) and inv(16) abnormalities by quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) in 19 patients with AML. Morever conventional cytogenetic method was applied for all patients. Of whom 9 were men and 10 women. Age of avarage was 19 to 58 years. FAB morphologic classification follows as; 5 AML-M1, 8 AML-M2, 5 AML-M4, 1 AML-M5. Complete remission was obtained in eighteen patients with first induction regimen, whereas in one patient after second induction. t(8;21) has been found in 1 patient with cytogenetic method and confirmed with RT-PCR. In this study, we aim to search t(8;21) and inv(16) abnormalities in AML cases.
