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Öğe 46, XX, t(8;9)(q22;p24) BALANCED TRANSLOCATION CARRIER WITH HYPOGONADOTOPIC HYPOGONADISM(Galenos Yayincilik, 2010) Akbas, Halit; Yalinkaya, Ahmet; Alp, M. Nail; Budak, TurgayBalanced autosomal translocations are unusually observed in the patients with hypogonadotropic hypogonadism. The patient with hypogonadotropic hypogonadism had balanced reciprocal translocation involving chromosomes 8 and 9. The patient's father, two brothers and a sister have the same chromosomal translocation with no apparent physicial abnormalities. In this case report; the relation of autosomal translocations mentioned above and hypogonadotropic hypogonadism are discussed.Öğe Amniotic fluid paraoxonase-1 activity, thyroid hormone concentration and oxidant status in neural tube defects(Wiley-Blackwell, 2016) Sak, Sibel; Agacayak, Elif; Tunc, Senem Yaman; Icen, Mehmet Sait; Findik, Fatih Mehmet; Sak, Muhammet Erdal; Yalinkaya, AhmetAimThe aim of this study was to investigate the potential association between neural tube defects and paraoxonase-1 activity in amniotic fluid. We studied total oxidant status, total antioxidant capacity, paraoxonase-1 activity and thyroid hormone amniotic fluid concentration in fetuses with neural tube defects. MethodsThe present study was performed at the Department of Obstetrics and Gynaecology and the Department of Clinical Biochemistry of Dicle University between September 2011 and June 2013. The study group included 37 amniotic fluid samples from pregnant women (16-20 weeks of gestation) with fetuses affected by neural tube defects. The control group consisted of 36 pregnant women who were diagnosed with a high-risk pregnancy according to first or second trimester aneuploidy screening and were later confirmed on amniocentesis to have genetically normal fetuses. ResultsAmniotic fluid paraoxonase-1 activity and total oxidant status were significantly higher (P = 0.023, P = 0.029, respectively) whereas free T4 was significantly lower (P = 0.022) in fetuses with neural tube defects compared with control subjects. In fetuses with neural tube defects, amniotic fluid paraoxonase-1 activity correlated positively with total oxidant status (r = 0.424**, P = 0.010), and amniotic fluid total antioxidant capacity correlated positively with free t4 (r = 0.381*, P=0.022). ConclusionThis is the first study in the literature to show an association between paraoxonase-1 activity and thyroid hormone concentration and neural tube defects.Öğe A case of bifocal endometriosis involving a pfannenstiel incision(Studio K, 2011) Sidik, Evsen Mehmet; Erdal, Sak Muhammet; Yalinkaya, Ahmet; Firat, Ugur; Nur, Caca FatmaA 25-year-old woman was referred to our clinic for atypical cyclic pain and masses at both ends of a Pfannenstiel incision scar Ultrasound of the anterior abdominal wall showed two masses. Both masses were hypoechoic, heterogeneous lesions located at opposite ends of the scar The lesions were surgically excised with. Microscopic examination revealed endometrial gland structures with endometrial stroma in fibroadipose tissue in sections of both specimens indicative of endometriosis. Incisional endometriosis (IE) is a form of extrapelvic endometriosis especially in scars of obstetric or gynecologic surgery IE may be multifocal at surgical scars. We report the a case of bifocal incisional endometriosis in Pfannesteil scar Whole scar evaluation should be done for incisional endometriosis and surgical excision should be performed for treatment.Öğe Chronic Myeloid Leukemia In a Pregnant Woman: A Case Report(Cukurova Univ, Fac Medicine, 2015) Tokmak, Aytekin; Guzel, Ali Irfan; Yalinkaya, AhmetChronic myeloid leukemia (CML) is a rare disease in pregnancy. Our aim is to present a 37 weeks of pregnant woman with chronic myelogenous leukemia. A 27 Years in multigravi (gravida 5, parity: 4), at 37 weeks gestation was admitted with the diagnosis of painful pregnancy and CML. Physical examination findings were normal, complete blood count and peripheral blood smear results were consistent with CML. The patient was diagnosed CML in the 30th week of pregnancy and were treated with hydroxyurea and interferon. Treatment depends on the mother and the fetus did not develop any side effects. Our patient with CML is interesting due to lack of perinatal effects and take the diagnosis at an early age. CML diagnosed during pregnancy requires a multidisciplinary approach and hydroxyurea and interferon treatment on the mother and fetus are at low risk of inducing adverse effects.Öğe The comparison of endogenous angiogenesis inhibitors in normotensive and preeclamptic placentas: an immunohistochemical study(Informa Healthcare, 2014) Ayaz, Ercan; Nergiz, Yusuf; Tunik, Selcuk; Yalinkaya, AhmetObjective: Recently, it has been reported that endogenous angiogenesis inhibitors play a key role in the pathophysiology of preeclampsia. Thrombospondin-1, angiostatin and vasostatin are endogenous angiogenesis inhibitors and so far have not been shown in placenta at the immunohistochemical level. The aim of this study was to compare staining patterns of these endogenous angiogenesis inhibitors immunohistochemically in placentas of preeclamptic and normotensive pregnant women. Methods: Into the study, placentas from 20 preeclamptic and 20 normotensive pregnant women were included. Central and peripheral tissues were taken from both sides of placentas. Paraffin tissue blocks were prepared and stained for immunohistochemical analysis. Slides were evaluated for syncytiotrophoblasts, cytotrophoblasts, extra-villous throphoblasts and decidual cells. The degree of staining of slides were classified as negative, weak, moderate and strong. Results: Samples from preeclamptic patients were compared with those of normotensive. Staining of thrombospondin-1 was observed to increase in decidual cells, syncytiotrophoblasts in chorionic and stem villi and stroma of stem villi. Increased staining of thrombospondin-1 was only significant in the amniotic epithelium of the central sections. In addition, increased staining intensity of angiostatin was detected in the amniotic epithelium and chorionic plate of central sections of placenta. In peripheral sections, staining of angiostatin also increased in decidual cells but decreased in chorionic plate. Vasostatin staining in decidual cells, decidual stroma and chorionic villous stroma from peripheral sections decreased, but any difference was not observed in the central sections. Conclusion: Our results suggest that thrombospondin-1, angiostatin and vasostatin may play a role in the pathophysiology of preeclampsia. Further molecular studies are required to understand this role.Öğe Continuous amnioinfusion via an epidural catheter following spontaneous membrane rupture: A case report(Galenos Yayincilik, 2013) Turgut, Abdulkadir; Katar, Selahattin; Sak, Muhammet Erdal; Turgut, Fethiye Gulden; Sahin, Alparslan; Basaranoglu, Serdar; Yalinkaya, AhmetPreterm premature rupture of membranes (PPROM) is seen in 3% of all pregnancies, and is a frequent cause of preterm birth, neonatal mortality and morbidity. The most important complications are maternal and foetal infection, prematurity, umbilical cord compression, hypoxia or asphyxia due to cord prolapse, pulmonary hypoplasia and extremity deformities. The basic approach to PPROM therapy aims to prevent premature birth and the development of foetal distress, and decrease the risk of maternal and foetal infection, and amniotic fluid loss. In compliance with these objectives, alternatives of PPROM therapy demonstrate a wide spectrum, including watchful waiting, amniopatch application, recurrent amnioinfusions and emergency birth. However, repeated amnioinfusions in cases of fluid loss, especially within 6 hours of therapy, provides only minimal benefit. In this case presentation, we attempted to describe a different and cost-effective continuous amnioinfusion technique performed to confer survival benefit for an immature anhydramniotic foetus affected by PPROM at the border of viability.Öğe DIAGNOSTIC VALUE OF DILATATION AND CURETTAGE TO DETECT INTRAUTERINE LESIONS IN WOMEN WITH ABNORMAL UTERINE BLEEDING(Galenos Yayincilik, 2008) Hakverdi, Sibel; Gungoren, Arif; Hakverdi, Ali Ulvi; Dolapcioglu, Kenan; Ciftci, Sinasi; Kaya, Zozan; Yalinkaya, AhmetObjective: To evaluate the diagnostic inadequacy of dilatation and curettage (D&C) by comparing histologic findings derived from D&C with histologic findings obtained after hysterectomy procedure retrospectively. Material and methods: Files of 259 patients with abnormal uterine bleeding who underwent hysterectomy within two months of a diagnostic D&C were analyzed. All patients had gynecologic and ultrasonographic examination, then they underwent D&C procedure under anesthesia. Hysterectomy was performed accordingly due to the histologic findings or persistence of the symptoms. Histologic diagnosis in D&C and after hysterectomy for each patient were compared. Results: 54.5% of the women had no pathology in D&C techniques. 59.5% of remaining patients had the same the pathologic findings in the hysterectomy specimens. In 105 of 259 patients, D&C failed to detect intrauterine disorders subsequently found at hysterectomy. After hysterectomy, in 227 of 259 patients were found additional pathologic abnormalities besides the histologic diagnosis in D&C specimens. Conclusions: D&C involves additional hospital costs and risk of complications; uterine perforation, infection and laceration of the cervix. If there are lesions in the uterus, dilatation and curettage is an inadequate diagnostic tool. D&C missed 40.5% of major intrauterine disorders and endometrial lesions were still present in the removed uterus. Therefore D&C can not be assessed as a therapeutic tool. Therefore D&C is suggested to be replaced by alternative and more accurate methods of diagnosis of endometrial abnormalities.Öğe Emergency Peripartum Hysterectomy: 16-year Experience of a Medical Hospital(Lippincott Williams & Wilkins, 2010) Yalinkaya, Ahmet; Guzel, Ali Irfan; Kangal, KadirBackground: We conducted this retrospective study to evaluate the outcomes and indications of emergency peripartum hysterectomy (EPH) as a life-saving procedure. Methods: We analyzed a series of 140 cases of EPH, between January 1993 and December 2008 in our clinic, retrospectively. The data were collected from the patients' files. The incidence, demographic characteristics, risk factors, indications and outcomes of hysterectomy, peripartum complications, the operation types, maternal morbidity and mortality and fetal mortality were evaluated. Results: A total of 26,015 of women were delivered. The incidence of EPH was 5.38 per 1,000 deliveries. The mean age was 34.19 +/- 6.04 years (range, 21-49 years), gravidity was 6.84 +/- 3.38 (1-17) and parity was 5.58 +/- 3.04 (0-15). Of the 140 cases, 90 were delivered by cesarean section [29 (20.71%) of these had had a previous cesarean section] and 50 were vaginally delivered. One hundred and five cases had subtotal hysterectomy and 35 had total abdominal hysterectomy. The most common indications for EPH were uterine atony followed by uterine rupture and abnormal placentation. Mean operation time was 142.23 +/- 43.70 minutes. The average blood transfusion was 4.79 +/- 3.36 (1-14) units. Relaparotomy was performed in 23 cases. Maternal mortality was seen in 13 cases. Seventy-nine of the cases delivered at an outside center and were referred to our clinic for the intensive care unit. Sixty-one of the cases delivered at our clinic and 31 had stillbirths. Conclusion: This study suggests that the most common indications for EPH are uterine atony, uterine rupture and abnormal placentation. This is probably due to the advanced age of pregnancies and multiparity in our region. Therefore, we believe that the risk of EPH may be decreased with appropriate and closer prenatal care as well as education of the pregnant women. [J Chin Med Assoc 2010;73(7):360-363]Öğe GENETIC ANALYSIS IN PREGNANCY WITH FETAL PATHOLOGIC ULTRASOUND FINDINGS(Diagnosis Press Ltd, 2013) Simsek, Selda; Turkyilmaz, Aysegul; Oral, Diclehan; Yalinkaya, Ahmet; Tekes, Selahaddin; Akbas, Halit; Budak, TurgayThe aim of this study was to investigate the relationship between fetal abnormal karyotype and fetal abnormal ultrasound examination in pregnancy A total of 191 women were analyzed for karyotyping after detection of a soft marker or of major malformations at the routine antenatal USG, for the period 2007-2011. A total of 191 amniotic fluid samples were analyzed for chromosome aberrations and the fetal karyotype was abnormal in 24.6 % (47/191) of all cases. Among them, 13 cases were with trisomy 21; 5 cases with trisomy 18; 1 case with trisomy 13; 2 cases with triploidy; 7 cases with karyotype of 45,X; 1 case with karyotype 47,XXY; and 18 cases with other abnormal chromosome structures. One hundred and fifty-two karyotyping procedures were done due to the finding of a single sonographic marker Within this group, 17.1 % of the karyotypes were abnormal. Thirty-nine karyotyping procedures were done due to the finding of a multiple sonographic marker In this group, 53.8 % of the karyotypes were abnormal. The overall termination rate was 61.7 % (29/47) in cases with a fetus affected by chromosomal abnormalities. Ultrasound examination is important in prenatal diagnosis. We suggest that karyotype analysis should be advised to pregnant women with an abnormal fetus in the ultrasound examination.Öğe Imperforate Hymen with Elevated Serum CA 125 and CA 19-9 Levels(Sci Printers & Publ Inc, 2013) Sak, Muhammet Erdal; Evsen, Mehmet Siddik; Soydinc, Hatice Ender; Sak, Sibel; Yalinkaya, AhmetOBJECTIVE: To report the clinical characteristics of 14 patients with imperforate hymen and their levels of tumor markers (CA 19-9 and CA 125). STUDY DESIGN: Fourteen patients with imperforate hymen who followed-up between September 2006 and September 2010 in the Department of Obstetrics and Gynecology, Dicle University School of Medicine, Diyarbakir, Turkey, were evaluated retrospectively. The clinical features and the management of the patients are discussed. RESULTS: The mean age of the patients was 13.8 years. All patients had primary amenorrhea and pelvic pain. The most common clinical symptoms were cryptomenorrhea in 14 patients, pelvic pain in 11, palpable abdominal mass in 6, voiding difficulties in 7, and defecation problems in 2. In 6 patients with palpable pelvic mass, the mean +/- standard deviation values of tumor markers were as follows: CA 125, 84.0 +/- 23.7 and CA 19-9, 162 +/- 189. One week after surgery we measured CA 125 and CA 19-9 levels once again. The postoperative mean CA 125 level was 13.8 +/- 3.6, and the mean postoperative CA 19-9 level was 17.5 +/- 3.5. Preoperative leziels of CA 125 and CA 19-9 were significantly higher than those of the postoperative period (p < 0.001 for both comparisons). Six patients were treated by T-shaped incision and 8 patients by a central surgical incision through the hymenal membrane. CONCLUSION: Diagnosis of imperforate hymen is very important before undergoing surgery in a different clinic. Many patients have seen several doctors before receiving a clear diagnosis and have had tumor markers evaluated because the presence of pelvic mass in patients suggests the possibility of a gynecologic malignancy. Imperforate hymen is one of the benign conditions that increase serum CA 125 and CA 19-9 levels and which is not listed in the classical medical textbooks. These markers are not needed for the diagnosis. (J Reprod Med 2013;58:47-50)Öğe Intrauterine blood transfusion in immune hydrops fetalis, corrects middle cerebral artery Doppler velocimetry very quickly(Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2012) Yalinkaya, Ahmet; Evsen, Mehmet Siddik; Celik, Yusuf; Sak, Muhammet Erdal; Soydinc, Hatice Ender; Taner, Mehmet ZekiThe aim of our study was to evaluate the middle cerebral artery velocimetry before and after intrauterine blood transfusion in immune hydrops fetalis. The current study was conducted in a tertiary research hospital, from February 2009 to January 2011. Nineteen intrauterine blood transfusions performed during the study period. The factors recorded were age of the mothers, gestational weeks, pre-transfusion fetal hematocrit and post-transfusion fetal hematocrit, and also middle cerebral artery peak systolic velocimetry (MCA-PSV) was detected and recorded before and after intrauterine transfusion. A control group of twenty two cases for normal MCA doppler velocimetry was also included to the study. During the study, a total of eleven rhesus isoimmunized pregnancies underwent intrauterine blood transfusions at our perinatal diagnose unit. Before transfusion seventeen severe and two moderate anemias were detected and mean MoM of MCA-PSV was 1.76 +/- 0.38 MoM. Post transfusion mean MoM of MCA-PSV in the patient group and control group were 1.08 +/- 0.22 MoM and 0.96 +/- 0.21 MoM, respectively. The mean MCA-PSV values were higher in RI fetuses than post transfusion and control group. In current study, we found that MCA-PSV is a valuable parameter in detecting fetal anemia requiring intrauterine transfusion and mean MCA-PSV values is higher than 1.5 MoM in fetuses with anemia. And also decrease in MCA-PSV just after transfusion in anemic fetuses showed the quick response of the fetus to correction of anemia. (C) 2012 Association of Basic Medical Sciences of FBIH. All rights reservedÖğe Misoprostol-induced termination of second-trimester pregnancy in women with a history of cesarean section: A retrospective analysis of 56 cases(Studio K, 2013) Turgut, Abdulkadir; Ozler, Ali; Goruk, Neval Yaman; Karacor, Talip; Yalinkaya, AhmetObjective: 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 Parental Decisions Regarding a Prenatally Detected Fetal Chromosomal Abnormality and the Impact of Genetic Counseling: An Analysis of 38 Cases with Aneuploidy in Southeast Turkey(Springer, 2010) Balkan, Mahmut; Kalkanli, Sevgi; Akbas, Halit; Yalinkaya, Ahmet; Alp, M. Nail; Budak, TurgayThis study investigated parental decision-making to terminate or continue a pregnancy after prenatal diagnosis of a chromosomal abnormality among a sample of patients in Southeast Turkey. Between 2004 and 2007, 1068 amniocentesis tests were performed in the Medical Biology and Genetic Department Laboratory at Dicle University. Aneuploidy was found in 38 cases (3.56%). Genetic counseling was provided for the couples that received abnormal results, and they were later interviewed and asked if they had continued or interrupted the pregnancy after the diagnosis. When confronted with autosomal aneuploidy in which a severe prognosis was expected, 85% of cases decided to terminate the pregnancy. When confronted with sex chromosome aneuploidy with a low risk of an abnormal clinical phenotype 60% of cases decided to continue the pregnancy. Among the diagnoses with aneuploidy, pregnancy was continued in 21.1% of cases due to religious beliefs regardless of whether there was a low or severe risk of an abnormal clinical phenotype. These findings indicate that both severity of abnormality and religiosity play an important role in genetic counseling patients' decision-making processes and outcomes in Turkey. In addition, the findings suggest the need for legislation that reduces the differences in approaches between the physicians and institutions regarding parental decision-making to terminate or continue a pregnancy in our country.Öğe Two cases of placental site trophoblastic tumor(Elsevier Taiwan, 2011) Yalinkaya, Ahmet; Guzel, Ali Irfan; Kangal, Kadir; Buyukbayram, Huseyin; Firat, Ugur[Abstract Not Available]Öğe Ultrasound findings in aneuploidy fetusus: Evaluation of 332 cases(Galenos Yayincilik, 2010) Yalinkaya, Ahmet; Guzel, Ali Irfan; Kangal, Kadir; Turkyilmaz, Aysegul; Savas, ZelalObjective: To evaluate the ultrasound findings found on ultrasound examination among cases that had aneuploidy at amniocentesis. Material and Methods: This prospective study was performed at Dicle University, School of Medicine, Department of Obstetrics and Gynecology. 332 cases applied to our department for prenatal diagnosis and amniocentesis (AC) was performed. Of these cases, twenty were found to have aneuploidy evaluated. The factors recorded were; mean age, gestational weeks, AC indications, ultrasound findings (by Toshiba 140A and GE Voluson 730 Pro 4D ultrasound device) and fetal anomalies. Results: 332 cases have had AC by an experienced specialist, in a two year period. The mean age of the cases was 32.20 +/- 6.03 years (22-44), and gestational weeks 16.45 +/- 1.46 (13-19). AC indications were; high double and/or triple test with ultrasound findings and abnormal ultrasound findings. In 8 (2.40%) cases there was no reproduction on cell culture. In 14 (4.21%) cases, different types of chromosomal anomalies were detected. In these cases, peripheral blood was taken from the parents and if, at least in one of them this situation was present, this would be accepted as normal. In 20 (6.02%) cases aneuploidy (numerical chromosomal anomalies) were detected and 11 of them (55.00%) were trisomy 21. In all of these aneuploidy cases, different types of ultrasound findings were detected; most of them had multiple ultrasound findings, and some of them had one anomaly. Of all 20 aneuploidy cases; termination of pregnancy was decided in 17 (85%) of them. 3 (15%) of these cases decided to carry on their pregnancy. Of the 3 cases; one baby was delivered spontaneously and live, one had died in utero and labor was induced and the third pregnancy is ongoing. Conclusion: The importance of ultrasound in fetal anomaly screening is incontrovertible and positive ultrasound findings are the most important indications of amniocentesis. For this reason, before amniocentesis, we advise a detailed ultrasound examination by an experienced specialist.Öğe Which parameters may influence the duration of hospitalization after vaginal hysterectomy?(Galenos Yayincilik, 2013) Turgut, Abdulkadir; Soydinc, Hatice Ender; Evsen, Mehmet Siddik; Basaranoglu, Serdar; Yalinkaya, AhmetObjective: To estimate the variables that may affect the duration of hospitalization after vaginal hysterectomy. Material and Methods: An 11-year retrospective analysis was performed on data derived from 197 patients who underwent vaginal hysterectomy due to non-malignant pathology at a tertiary care center between January 2000 to November 2011. Results: The average age of the patients in our series was 60.9 +/- 11.1 with a duration of hospitalization of 11.6 +/- 6.1 days after vaginal hysterectomy. The grouping variables consisted of age, number of pregnancies, abortions, parities and the presence of intra or postoperative complications. Advanced age (>60), increased number of pregnancies (>5) and parities (>5) and occurrence of intra or postoperative complications were found to be correlated with the duration of hospitalization after vaginal hysterectomy. Categorical variables were analyzed by Pearson's chi square or the Fisher exact test. The Mann Whitney U test was used to compare groups, while the correlation of variables was assessed with the Spearman Correlation Analysis. Conclusion: Vaginal hysterectomy is a safe and effective procedure. Advanced age, increased number of pregnancies and parities and occurrence of intra or postoperative complications may prolong the duration of hospitalization after surgery. Increased experience, careful surgical technique and adherence to aseptic principles may improve the cost-effectivity and decrease the duration of hospitalization.
