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    Factors Affecting Successful Vaginal Birth Following Dinoprostone Administration in Post-term Pregnancies
    (Turkiye Klinikleri, 2020) Bademkiran, Muhammed Hanifi; Bademkiran, Cihan; Ege, Serhat; Peker, Nurullah; Oglak, Suleyman Cemil
    Objective: This study will determine the success rates of the predictive factors of vaginal birth in the post-term labor induction of the cervical ripening slow-release insert dinoprostone. Material and Methods: All patients who underwent labor induction were post-term pregnant patients. Post-term pregnancy was defined as lasting >= 42+0 weeks of gestation. Dinoprostone insertion into the posterior fornix was performed according to the Bishop score (<= 6) and maintained for a maximum of 24 hours. Parity, Bishop score, maternal age, fetal gender, and induction time were identified as candidate predictors. The traditional logistic regression method was used to examine the relationship between the outcome and candidate predictors. Discrimination in the model was evaluated by calculating the c-index. Results: Of the 25,678 deliveries that occurred during the study period, 361 (1.4%) women underwent post-term delivery; of these, 293 (81%) succeeded, and 68 (19%) failed to achieve cervical ripening using the dinoprostone slow-release vaginal insert. Three predictors were strongly associated with dinoprostone vaginal delivery success: multiparity (2.88[1.38-6.01]), fetal gender (1.69[0.9-3.0]), and Bishop score (OR: 1.59 [1.45-1.70]). Conclusion: The success of vaginal delivery can be predicted by evaluating factors, including fetal gender, parity, and the Bishop score in post-term pregnancies. Including these factors in the management protocol for labor induction with cervical ripening could improve care quality.
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    The Immunohistochemical and Bioinformatics Analysis of the Placental Expressions of Vascular Cell Adhesion Protein 1 (VCAM-1) and High Mobility Group Box 1 (HMGB1) Proteins in Gestational Diabetic Mothers
    (Georg Thieme Verlag Kg, 2024) Oglak, Suleyman Cemil; Asir, Firat; Yilmaz, Emine Zeynep; Bolluk, Gokhan; Korak, Tugcan; Agacayak, Elif
    Objective We aimed to examine both the expression levels of high mobility group box 1 (HMGB1) and vascular cell adhesion molecule-1 (VCAM-1) proteins in the placentas of pregnant women with gestational diabetes mellitus (GDM) and control groups by immunohistochemical (IHC) method. Material and methods An experimental case-control study was conducted, including 40 pregnant women complicated with GDM and 40 healthy pregnant women. Placental tissues obtained following cesarean delivery were subjected to routine tissue monitoring. The placental sections were stained with VCAM-1 and HMGB1 immunostains and subjected to IHC examination under a light microscope. H-score (HS) was used to evaluate the results of IHC staining by semi-quantitative analysis. Pathway analysis in Cytoscape software identified GDM-associated proteins within HMGB1 and VCAM-1 interaction networks, followed by GO analysis to explore associated biological processes. Results Placental HGMB1 expression was significantly increased in the GDM group compared to the control group (p<0.001). However, placental VCAM-1 expression was found to be statistically similar in GDM and control groups (p=0.584). The shared 19 proteins were identified between HMGB1 and GDM, and 13 between VCAM-1 and GDM, with notable GO biological process terms such as immune system activation for HMGB1 and interleukin-6 regulation for VCAM-1 associated with GDM. Conclusion We consider that GDM-related inflammation and oxidative stress may contribute to tissue damage and inflammation by increasing placental HMGB1 expression. The blockade of HMGB1 and its receptors might represent a promising therapeutic approach to control inflammation in GDM. Understanding the distinct roles of HMGB1 and VCAM-1 may provide valuable insights for the development of targeted therapies aimed at mitigating the inflammatory processes associated with GDM and improving maternal and fetal outcomes.
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    The Investigation of Caspase-3 and Tumor Necrosis Factor-Alpha Expression in Placentas of Patients with Preterm Premature Rupture of Membranes
    (Imr Press, 2023) Ermis, Isilay Sezen; Asir, Firat; Oglak, Suleyman Cemil; Kaplan, Ozge; Aydeniz, Gul Ebru; Deveci, Engin
    Background: Caspase-3 is involved in the execution of apoptosis and is widely used as an apoptotic marker. Tumor necrosis factor-& alpha; (TNF-& alpha;) released from activated macrophages has various functions such as modulation of cell growth and differentiation, immunoreg-ulation, coagulation, and regulation of endothelial cell function. This study investigated the immunohistochemical staining of caspase-3 and TNF-& alpha; expression in the placentas of pregnant women with preterm premature rupture of membranes (PPROM). Methods: Placen-tas of 25 healthy, and 25 women with PPROM were processed for routine histological tissue processing. Placentas were stained with hematoxylin-eosin, caspase-3, and TNF-& alpha; immunostaining. Results: Normal placental histology was observed in the control group. Amniotic epithelium, vascular structures, and fibrinoid accumulation were histologically normal. Leukocyte infiltration, thinned vessel walls with dilatation and congestion, syncytial nodes, and fibrinoid accumulation were increased in the PPROM group. The immune activity of caspase-3 expression was mainly negative in placental components such as syncytial nodes, vascular endothelium, fibrinoid accumulation, and macrophages in the control group. In the PPROM group, caspase-3 positive reaction was increased in the amniotic membrane and epithelium, endothelial cells, fibrinoid accumulation, and areas of inflammatory cell infiltration. In the control group, negative TNF-& alpha; expression was observed in the placental membranes and structures. In the PPROM group, TNF-& alpha; expression was in-creased in inflammatory cells, endothelial cells, and syncytial nodes. Conclusions: Placentas of patients with PPROM showed loss and weakened membranes with increased placental pathology, and increased expression of caspase-3 and TNF-& alpha;. We suggest that caspase-3 and TNF-& alpha; signaling pathways can be used as a marker in the progression of PPROM.
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    Placental Vimentin Expression in Preeclampsia and Gestational Diabetes Mellitus
    (2024) Asır, Fırat; Oglak, Suleyman Cemil; Korak, Tugcan; Tas, Fatih; Yılmaz, Mehmet; Erdemcı, Fikri; Sahın, Firat
    OBJECTIVE: This study investigated vimentin expression in placentas of patients with preeclampsia and gestational diabetes mellitus (GDM). STUDY DESIGN: Placentas of preeclamptic women (n=25), women with GDM (n=25), and control cases (n=25) were enrolled in this study. Placental samples were fixed in zinc-formalin and further processed for paraffin wax tissue embedding. Demographic and laboratory parameters of patients were recorded. Vimentin immune activity was analyzed in the placental sections with immunohistochemistry. Sections were imaged and analyzed under a light microscope. A semiquantitative measurement was done be- tween groups by comparing the Vimentin signal and significance was calculated. Network construction and pathway enrichment analysis were conducted using Cytoscape (v3.10.1) and ShinyGO, respectively. RESULTS: Vimentin expression was high in the placental sections of the control group. The preeclamp- sia group showed positive Vimentin expression in cytotrophoblast and syncytiotrophoblast cells and con- nective tissue of placental villi in the preeclampsia group. Vimentin expression was generally recorded as negative in placental villi, fibrinoid substances, and connective tissue cells in the GDM group. Bioinformatic analysis showed that the AGE-RAGE signaling pathway and cancer-related pathways were mainly observed in Vimentin-associated pathways, which finally activate inflammatory pathways in both preeclampsia and GDM. CONCLUSION: Vimentin expression patterns in placental tissue sections reveal nuanced regulatory mechanisms, emphasizing the need for further exploration into the functional roles of vimentin in pla- cental physiology and pathology.