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Öğe CD147 expression in uterine smooth muscle tumors, and its potential role as a diagnostic and prognostic marker in patients with leiomyosarcoma(Old City Publishing, 2014) Ozler A.; Evsen M.S.; Turgut A.; Sak M.E.; Tunc S.Y.; Agacayak E.; Alabalik U.Objective: To investigate the role of CD147 expression in uterine smooth muscle neoplasms, as a potential diagnostic and prognostic marker in patients with leiomyosarcoma (LMS). Study Design: We investigated CD147 protein expression in uterine smooth muscle tumor samples from patients diagnosed with leiomyoma (n = 22), atypical leiomyoma (BLM) (n = 5), smooth muscle tumor of uncertain malignant potential (STUMP) (n = 14), and LMS (n = 22). The intensity and extensity of immunohistochemical staining were compared to determine its potential role in differential diagnosis. Spearman's rank correlation tests were performed to determine the relationship between CD147 expression and prognostic clinical and pathological criteria in the patients with LMS. Results: CD147 was strongly expressed in 81.8% (n = 18) of the LMS tissue samples. In fact expression of CD147 in LMS tissues was significantly higher than that of the three other uterine smooth muscle tumor types (p = 0.000). However, high CD147 expression was found in only one BLM sample and one STUMP sample. Furthermore, CD147 percent expression positively correlated with Ki67 percent expression (r = 0.466, p<0.05) and mitotic index (r = 0.554, p<0.05), respectively. Conclusion: Our results suggest that immunohistochemistry may be a helpful tool in determining whether CD147 is a useful marker in the differential diagnosis of certain uterine smooth muscle tumors. CD147 may also have prognostic value for patients with LMS. Yet, in order to determine the extent of this potential marker's utility as a diagnostic and prognostic indicator, a larger randomized multicenter study must be performed. © 2014 Old City Publishing, Inc.Öğe Diploid karyotype partial mole coexisting with live term fetus-Case report and review of the world literature(Via Medica, 2012) Sak M.E.; Soydinc H.E.; Evsen M.S.; Sak S.; Firat U.A partial molar pregnancy of diploid karyotype coexisting with live term fetus is a rare entity. Most instances of partial mole are triploid and only a few cases of diploid partial moles with term delivery have been reported. Here, we report a case of partial mole concomitant with a 37-week live fetus. Postpartum karyotype of the placenta and the fetus revealed both as 46XX. Histological examination of the placenta showed a partial hydatidiform mole. We discuss the diagnosis based on presenting clinical picture and proper management of signs and symptoms of partial molar pregnancy coexisting with live term fetus and diploid karyotype, coupled with a review of the literature. © Polskie Towarzystwo Ginekologiczne.Öğe Effects of genistein, estrogen and progesterone therapies on bladder morphology and M2, M3 receptor expressions in oophorectomized rats(Acta Medica Mediterranea, 2014) Turgut A.; Goruk N.Y.; Sak M.E.; Deveci E.; Akdemir F.; Keles A.N.; Nergiz Y.Aims: 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-ß estradiol, OVX+E+P group received 0.014 mg/kg 17-ß 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 Effects of Malathion in fetal kidney tissues in pregnant rats: Teratogenic effects induced by different doses(Veteriner Fakultesi Dergisi, 2012) Alp H.; Sak M.E.; Evsen M.S.; Firat U.; Evliyaoglu O.; Penbegul N.; Sancaktutar, Ahmet AliThe aim of this study was to investigate the teratogenic effects of Malathion (ML) induced by different doses on fetal kidney tissues in pregnant rats. A total of 28 Sprague-Dawley pregnant rats were randomly divided into 4 groups of 7 rats each. Depending on ML dose, four groups were formed, including (I) control, (II) ML 2.5 (ML 2.5 mg/kg/day, orally), (III) ML 5 (5 mg/kg/day, orally), and (IV) ML 10 (10 mg/kg/day, orally). ML application started when the male and female were put together (when mating started). Daily ML application was continued until birth. It was determined that in parallel with dose of ML, ML resulted in toxic effects on serum enzymes (acetyl-cholinesterase (AChE), amylase and lipase) and kidney tissues of pregnant rats, and also -regardless of ML dose in fetal kidneys- it led to teratogenic effects in all the doses. Biochemical data wasconfirmed by histopathologic data. We concluded that ML leads to kidney damage in both pregnant and fetal rats as a result of its teratogenic and toxic effects.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 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 Internal iliac artery ligation for severe postpartum hemorrhage(Via Medica, 2012) Evsen Mehmet S.; Sak M.E.; Soydinc H.E.; Basaranoglu S.; Bakir C.; Sak S.; Gul T.Objective: To evaluate the outcomes of bilateral internal iliac artery ligation (IIAL) in severe postpartum hemorrhage (PPH). Design: Multi-center, retrospective study. Methods: The study was performed from January 2005 to December 2010, at the Obstetrics and Gynecology Clinic, Dicle University Medical Faculty and Maternity Hospital, Diyarbakir, Turkey. Life-threatening cases of severe postpartum hemorrhage, which could not be controlled with conservative medical and surgical treatments and finally managed with IIAL, were retrospectively evaluated. Results: Totally 53 patients who underwent IIAL procedures were included in the study. All patients were hemodynamically unstable. The mean shock index and transfused units of blood were 1.17±0.46, 5.49±3.04, respectively. Uterine atony was the leading cause of severe postpartum hemorrhage and the need for IIAL. Coagulopathy developed in 26 (49.1%) patients during the postoperative follow-up period. Uterus was preserved in 17 (32.0%) cases. Three patients died of complications and/or morbidity associated with hemorrhage. Conclusion: Serious PPH is most frequently associated with uterine atony and IIAL should be considered in cases with severe PPH unresponsive to other treatment modalities. If, in the antenatal period, patients have risk factors of postpartum hemorrhage, they must be transferred to appropriate centers to prevent a possibly fatal outcome. © Polskie Towarzys two Ginekologiczne.Öğe Serum levels of neopterin, tumor necrosis factor-alpha and Interleukin-6 in preeclampsia: relationship with disease severity.(2012) Ozler A.; Turgut A.; Sak M.E.; Evsen M.S.; Soydinc H.E.; Evliyaoglu O.; Gul T.There are many studies evaluating the role of inflammation in the pathogenesis of preeclampsia. However, little is known about the relationship between the severity of inflammation and the severity of preeclampsia due to insufficient of studies reporting this matter. To investigate the maternal serum concentrations of IL-6, TNF-alpha and Neopterin in patients with mild preeclampsia and severe preeclampsia and HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome in preeclampsia and determine their association with the severity of the disease. Patients, hospitalized with the diagnosis of preeclampsia between October 2011 and March 2012, were included in the study. The patients with preeclampsia were divided into three groups as mild preeclampsia, severe preeclampsia and HELLP syndrome. The control group was comprised of normotensive and uncomplicated pregnant women. The serum levels of IL-6, TNF-alpha and Neopterin (NEO) were determined, using enzyme-linked immunosorbent assay. Spearman's rank correlation tests were used for the correlations between the serum levels of inflammatory markers and the severity of preeclampsia. There was no observed significant difference among mean serum TNF-alpha and IL-6 levels of four groups (p > 0.05). The median serum concentration of NEO in subjects with mild preeclampsia of 14.1 nmol/L and severe preeclampsia of 14.8 nmol/L was significantly higher than that of 10.3 nmol/L in normotensive controls (p = 0.013; p = 0.000 respectively). In addition, the median serum concentration of NEO was detected to be highest in subjects with HELLP syndrome. The serum levels of NEO was well correlated with the severity of preeclampsia (r = 0.533, p = 0.000). The serum levels of NEO, an important marker of cellular immunity, associated with severity of disease in patients with preeclampsia.Öğe Unusual case of extraovarian granulosa cell tumor.(2012) Soydinc H.E.; Sak M.E.; Evsen M.S.; Bozkurt Y.; Keles A.We present a case of adult type extraovarian granulosa cell tumor in 22 years old woman. The pelvic and radiographic examination revealed right adnexial solid mass in patient who complaining from menstrual disregulation and pelvic pain. The patient underwent exploratory laparotomy which showed pelvic mass adjacent urinary bladder and fixed to the behind of pubic bone at pre-peritoneal area.
