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    Chromosomal abnormalities in non-obstructive azoospermic men prior to employment of assisted reproduction in Southeast Turkey
    (Japan International Cultural Exchange Foundation, 2015) Balkan M.; Atar M.; Kemal Hatipo?lu N.; Nuri Bodakçi M.; Çakmakçi S.; Yildiz I.; Siddik Evsen M.
    Objective: The causes of male infertility are heterogeneous but more than 50% of cases have a genetic defect. Chromosomal abnormalities that affect on gametogenesis are one of the principle genetic factors in male infertility. The aim of this study is to determine the frequency and type of chromosomal abnormalities in non-obstructive azoospermic men with severe male factor infertility to give appropriate genetic counseling before assisted reproduction techniques. Materials and Methods: A total of 114 azoospermic infertile males were studied for the cytogenetic evaluation prior to use of assisted reproduction techniques. A detailed history was taken for each man. Karyotyping was performed on peripheral blood lymphocytes according to standard methods. Results: The overall incidence of chromosomal abnormalities was about 22.8% (26/114), including the sex chromosome abnormality 19.3% and the autosomal chromosome abnormality 3.5%. Twenty one of 22 patients with sex chromosome abnormality had classic Klinefelter karyotype. There were 2 mosaic cases involving X and Y chromosomes. Of the four cases with autosomal chromosome anomalies, three cases had balanced reciprocal translocations and one case with inversion. FSH, LH and testosterone levels showed significant increase in azoospermic patients with abnormal karyotype when compared with the normal karyotype (P < 0.05). Conclusions: Our findings are generally in accordance with those from other surveys and confirm that the XXY aneuploidy is the most frequent chromosomal abnormality in azoospermic individuals. The occurrence of chromosomal anomalies among infertile males suggests the need for genetic screening and proper genetic counselling before initiation of assisted reproduction treatment. © 2015 Japan Health Sciences University.
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    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.
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    Translocated intrauterine contraceptive device: Experiences of two medical centers with risk factors and the need for surgical treatment
    (2013) Ender Soydinc H.; Siddik Evsen M.; Çaça F.; Erdal Sak M.; Zeki Taner M.; Sak S.
    OBJECTIVE: To present experiences of 21 patients with a translocated intrauterine contraceptive device (IUD) who required surgical treatment and to discuss the diagnosis, surgical management, and complications of such cases. STUDY DESIGN: The cases of 21 patients who were hospitalized with the diagnosis of translocated IUD and had surgical treatment were analyzed retrospectively. RESULTS: The mean age of the patients was 25.7 (range, 20-35). Of the 21 patients, 17 (81%) were in puerperium. IUDs were inserted by trained midwife nurses in 17 cases (81%). Severe lower abdominal pain was reported by 16 patients (76%) during the insertion procedure. At the time of diagnosis, 13 patients (62%) presented with lower abdominal pain. Surgical treatments included laparoscopic surgery (67%), laparotomy, colpotomy, and hysteroscopy. All of the removed IUDs were TCu-380A models. The most frequent complication due to translocation of the IUD was pelvic abscess (38%). CONCLUSION: The incidence of IUD translocations was significantly high in the puerperal period and for insertions performed by educated midwife nurses. Uterine perforation must be taken into consideration when there are complaints of unusually severe abdominal pain during the insertion procedure. Surgical treatment is necessary because of the potential complications of extracavitary IUDs. © Journal of Reproductive Medicine®, Inc.