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Öğe Blood pressure diurnal rhythm is related with hematological indices in gestational diabetes mellitus patients(Acta Medica Mediterranea, 2013) Soydinc S.; Oylumlu M.; Yuksel M.; Turgut A.; Soydinc H.E.Objective: Gestational diabetes mellitus (GDM) is related with cardiovascular risk factors. Non-dipping blood pressure pattern and high mean platelet volume, which is an indicator of increased platelet activation, are associated with cardiovascular morbidity and mortality. The aim of our study is to determine circadian variation of blood pressure and to study the impact of hematological indices on blood pressure dipping and non-dipping patterns in patient with GDM. Material and methods: A total of 42 patients who were diagnosed with GDM and 33 patients with healthy pregnancies were included into the study. Patients' blood pressures were monitored and were grouped due to their blood pressure circadian pattern. If the blood pressure while sleeping decreased more than 10% from the blood pressure while awake, the patient was classified as a "dipper". If the decrease was less than 10%, the patient was classified as a "non-dipper". Biochemical and hematological parameters were measured and clinical features were recorded for all study groups. Results: Ambulatory blood pressures monitoring of two groups revealed that average systolic and diastolic blood pressures as well as the day-phase diastolic and night-phase systolic and diastolic blood pressures of GDM patients were significantly increased than those of the control group. Besides, control patients had a more significant decrease in night-phase systolic and diastolic blood pressures than GDM patients (p<0.001). There was no significant difference between hematological indices and dipping status, except for mean platelet volume (MPV). MPV in non-dippers was significantly higher than dippers one (p<0.001). Step-wise multivariate linear regression demonstrated that MPV and GDM can be used as independent predictors of non-dipping status. Conclusion: According to our results the circadian variation of blood pressure is impaired and MPV is increased in GDM patients. Increasing in MPV is associated with non-dipping status of blood pressure. It is possible that non-dipping status and increased MPV levels may be additional risk factors for increased cardiovascular disease events in gestational diabetes patients.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 Cesarean scar pregnancy: A tertiary center case series and literature review(Duzce University Medical School, 2015) Turgut A.; Özler A.; Goruk N.Y.; Tunç S.Y.; Başaranoğlu S.; Yalìnkaya A.Aim: To examine the characteristics, management and outcomes of cesarean scar pregnancies at a single tertiary obstetric centre over a three-year period. Method: A retrospective study was performed on 8 cases of cesarean scar pregnancy identified between January 2009 and June 2012 from the medical files. Results: The mean gestational age was 58.2 days (35-120). The average time for ?-hCG levels to return to normal values after treatment for cesarean scar pregnancy was 3.4 weeks (2-6). The mean number of previous cesarean sections was 1.9 (1-4) and the mean interval time after the last cesarean section was 20 months (10-48). Laparotomy with excision of the sac and primary repair (n=5) and methotrexate (n=3) were the modalities of management. Conclusion: Cesarean scar pregnancy is a potentially life-threatening complication of pregnancy that constitutes a diagnostic and therapeutic challenge. Decision on treatment modality should be determined on individualized basis depending on factors such as gestational age, ?-hCG levels, fetal cardiac activity, desire of future fertility and the experience and facilities available. Key words: Cesarean scar; complication; cesarean scar pregnancy; ectopic pregnancy. © 2012 Düzce Medical Journal.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 Hydronephrosis during pregnancy: How to make a decision about the time of intervention?(Medical Association of Zenica-Doboj Canton, 2014) Bodakci M.N.; Hatipoglu N.K.; Ozler A.; Turgut A.; Hamidi C.; Hatipoglu N.; Alan B.Aim To evaluate the role of doppler ultrasonographorin managing hydronephrosis during pregnancy. Methods The study included 27 pregnant patients with unilateral symptomatic persistent hydronephrosis (group 1) and 38 pregnant patients with physiological hydronephrosis of pregnancy (group 2). All pregnant patients underwent Doppler Ultrasonography to determine the Resistive Index (RI) and the difference between the RI of the corresponding and contralateral kidney (Delta Resistive Index = ?RI). Results There were no statistical differences between the two groups in terms of age, mean gestational period, or number of pregnancies. The mean renal RI of the hydronephrosis side was 0.68±0.05 in group 1 and 0.60±0.05 in group 2 (p<0.001). The mean ?RI of group 1 was significantly higher than the mean ?RI of group 2 (0.07±0.03 versus 0.02±0.01, respectively, p<0.001). The RI and ?RI were considered positive with values of ?0.70 and ?0.04, respectively, and the RI was sensitive in 44.4% and specific in 92.1% for intervention treatment. The corresponding values for ?RI were 88.9% and 89.5%. The positive predictive value and negative predictive value of ?RI for intervention were 85.7% and 91.9%, respectively. Conclusion It is much better to consider ?RI than RI when deciding on interventional treatment in hydronephrosis during pregnancy.Öğe The immunohistochemical and ultrastructural evaluation of pericytes in human full term placentas of gestasyonal diabetes mellitus(Acta Medica Mediterranea, 2013) Deveci E.; Söker S.; Turgut A.; Aktaş A.; Ayaz E.; Sak S.; Şeker U.Pericytes, vessel wall plays a stabilizing role in the regulation of blood flow in the microcirculation. The purpose of this study is based on non-diabetic pregnancies complicated by gestational diabetes pregnancies to investigate the morphological structure of pericyte cells. In this study, as a control group human placental tissues from normotensive pregnancies was collected from diabetic wome at 28-35 weeks of gestation. Pericytes with smooth alpha-actin positive cells, endothelial cells, and painted like a belt was surrounded. Pericytes, capillary plexus and endothelial cells of large vessels in the mesenchyme around the middle shows desmin positive reaction. Placental microvessels examined by transmission electron microscopy showed many pericytes. Placentas of gestational diabetes group, heterochromatin nucleus hypertrophy, dilatation of endoplasmic reticulum, mitochondria cristae in length, shortening was observed thickening of the filamentary structure. The contractile function of the barrier formed by endothelial cells, pericytes and can increase the contractions were considered.Öğe Misoprostol-induced termination of secondtrimester pregnancy in women with a history of cesarean section: A retrospective analysis of 56 cases(Via Medica, 2013) Turgut A.; Özler A.; Görük N.Y.; Karaçor T.; Yalinkaya A.Objective: 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 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.
