Browsing by Author "Kolusari, Ali"

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Acoustic Radiation Force Impulse Elastosonography of Placenta in Maternal Red Blood Cell Alloimmunization: a Preliminary and Descriptive Study
(Soc Romana Ultrasonografe Medicina Biologie-srumb, 2017) Cetin, Orkun; Karaman, Erbil; Arslan, Harun; Akbudak, Ibrahim; Yildizhan, Recep; Kolusari, Ali
Aims: Maternal red blood cell alloimmunization is an important cause of fetal morbidity and mortality in the perinatal period, despite well-organized prophylaxis programs. The objective of the study was to evaluate placental elasticity by using Acoustic Radiation Force Impulse (ARFI) in Rhesus (Rh) alloimmunized pregnant women with hydropic and nonhydropic fetuses and to compare those with healthy pregnant women. Material and methods: This case-control and descriptive study comprised twenty-eight healthy pregnant women, 14 Rh alloimmunized pregnant women with nonhydropic fetuses, and 16 Rh alloimmunized pregnant women with hydropic fetuses in the third trimester of pregnancy. Placental elasticity measurements were performed by ARFI elastosonography at the day of delivery. The maternal characteristics and neonatal outcomes of the patients were also noted. Results: The highest mean placental ARFI scores were observed in Rh alloimmunized pregnant women with hydropic fetuses (1.13 m/s) (p= 0.001). Healthy controls and Rh alloimmunized pregnant women with nonhydropic fetuses had similar mean placenta ARFI scores (0.84 m/s, 0.88 m/s, respectively) (p< 0.05). Conclusions: Based on the present findings, the placenta becomes stiffer in Rh alloimmunized pregnancies complicated with hydrops fetalis. The increased placental ARFI scores may be a supplemental marker for adverse pregnancy outcomes, additional to Doppler evaluation of middle cerebral artery. This data should be confirmed with a large sample size and prospective studies by using serial measurements of ARFI elastosonography in maternal red blood cell alloimmunization.
Association of Cord Blood Ischemia-Modified Albumin Level With Abnormal Foetal Doppler Parameters in Intrauterine Growth-Restricted Foetuses
(Taylor & Francis Ltd, 2021) Andic, Esra; Karaman, Erbil; Kolusari, Ali; Cokluk, Erdem
Objective: To investigate cord blood ischemia-modified albumin (IMA) levels in pregnancies with intrauterine growth restriction (IUGR) and to determine its association with abnormal fetal Doppler findings.Methods: Umbilical cord IMA levels were assessed in 34 pregnant women with IUGR and 32 pregnancies with normal fetal development. Associations of IMA with abnormal umbilical artery Doppler findings, preeclampsia, and oligohydramnios were investigated. IMA was measured using a colorimetric test based on a decrease in cobalt binding.Results: No significant between group differences in maternal age, body mass index, gravida, and parity were identified. The mean gestational age at delivery was earlier in the IUGR group than in the control group (35.73.2 versus 38.4 +/- 1.2, respectively). The mean cord blood IMA values for the IUGR group were significantly increased compared to those in the control group (0.565 +/- 0.22 versus 0.250 +/- 0.12, respectively, p=.001). There was a significant positive correlation between umbilical artery pulsatility index and IMA levels in the IUGR group. Patients with preeclampsia, oligohydramnios, and abnormal nonstress test results in the IUGR group had significantly higher IMA levels. Patients with systolic to diastolic ratios >3 and pulsatility index (PI) above the 95th percentile in the IUGR group had significantly higher cord blood IMA levels (p=.001 and p=.007, respectively).Conclusions: Cord blood IMA values may be a useful marker for perinatal asphyxia. Abnormal Doppler findings are associated with increased IMA levels in complicated pregnancies with IUGR.
Brucellosis in Pregnancy: a 6-Year Clinical Analysis
(Springer Heidelberg, 2010) Kurdoglu, Mertihan; Adali, Ertan; Kurdoglu, Zehra; Karahocagil, Mustafa Kasim; Kolusari, Ali; Yildizhan, Recep; Akdeniz, Hayrettin
To review our experience with brucellosis in pregnancy and to characterize the risk factors, clinical presentations, the rates of possible perinatal complications, and the effect of hospitalization on pregnancy outcomes. We reviewed the medical records of 21 pregnant women at a tertiary care hospital and 12 at a maternity hospital, who presented with acute, subacute, chronic, or relapsing brucellosis. Their risk factors and clinical presentations were defined. The reproductive outcomes of 29 cases were compared within themselves according to the hospitals they were managed and with the outcomes for all women followed in the maternity hospital for the period from January 2008 through December 2008. Consumption of unpasteurized dairy products had occurred in 92.3% of the cases. Spontaneous abortion, intrauterine fetal death, and preterm delivery rates were 24.14, 3.45, and 6.9%, respectively. Only spontaneous abortion rate substantially exceeded that among the general population of pregnant women in our maternity hospital (P < 0.05). Hospitalization did not affect pregnancy outcomes significantly (P > 0.05). Brucellosis in pregnancy is associated with increased incidence of spontaneous abortion without an association with the magnitude of serum agglutination titer, the clinical type of brucellosis and hospitalization. In endemic areas with habitants of low socioeconomic class and low educational level, educating women of childbearing age about brucellosis may help to prevent the disease and its complications in pregnancy.
Clinical and Perinatal Outcomes in Eclamptic Women With Posterior Reversible Encephalopathy Syndrome
(Springer Heidelberg, 2015) Kurdoglu, Zehra; Cetin, Orkun; Sayin, Refah; Dirik, Deniz; Kurdoglu, Mertihan; Kolusari, Ali; Sahin, H. Guler
Purpose To compare the clinical and perinatal outcomes in eclamptic women with and without posterior reversible encephalopathy syndrome (PRES). Methods This single-center, retrospective, cohort study was conducted between 2008 and 2013. The clinical and perinatal outcomes of eclamptic patients were obtained from hospital records. Magnetic resonance imaging was used for the diagnosis of PRES. Eighty-one eclamptic women were divided into two groups: 45 and 36 patients were included in the PRES and non-PRES groups, respectively. Results In the PRES group, headache and visual impairment together (60.0 %) were the most common presenting symptoms. In the non-PRES group, only headache was the most common (50 %) presenting symptom. Occipital and parietal lobes were the most frequently affected areas in the PRES group. Women in the PRES group had a higher body mass index value (p = 0.005), longer hospitalization time (p = 0.001), and higher level of proteinuria (p = 0.012) than those in the non-PRES group. Women in the non-PRES group had higher Apgar scores (p = 0.002) than those in the PRES group. Conclusions This study indicates that PRES manifests predominantly with headache and visual impairment together. Adverse neonatal outcomes are also common in these patients.
Comparison of Topical Lidocaine Spray With Forced Coughing in Pain Relief During Colposcopic Biopsy Procedure: a Randomised Trial
(Taylor & Francis inc, 2019) Karaman, Erbil; Kolusari, Ali; Alkis, Ismet; Cetin, Orkun
Our objective was to compare the effectiveness of local lidocaine spray (LS) compared to forced coughing (FC) for relieving the pain during colposcopically guided cervical biopsies (CGBs). The study was a randomised study, which included patients with abnormal cervical cytologic results requiring a colposcopic biopsy procedure. The patients were randomly assigned to either the 10% LS or the FC groups before the biopsy procedure. As a primary outcome, the pain was assessed by using a 10cm visual analogue scale at the different steps during the procedure. Forty-four and 42 patients had CGBs using LS and FC, respectively. The age, parity, body mass index, history of previous curettage and vaginal delivery, smoking status and the number of biopsies were similar in both groups. The meanSD pain scores after the cervical biopsy were 3.251.4 and 4.41.3 in the LS and FC groups, respectively (p<.05). The operative time was longer in the LS than in the FC group (7.6 +/- 1.4 vs. 5.2 +/- 0.8, p: .004). No complication or adverse effect was observed in both groups. The present study showed that LS use can be recommended for pain relief during colposcopically directed cervical biopsy procedure with a superiority to the FC in the terms of pain and absence of any adverse reactions.Impact StatementWhat is already known on this subject? A colposcopic-guided cervical biopsy is a painful procedure and different techniques have been proposed to relieve this pain with conflicting results. Studies have demonstrated that a forced coughing is a good and easy method for relieving pain with some disadvantages. Local lidocaine spray (LS) is another option for pain relief during the biopsy procedure. However, no randomised study has compared these two methods yet.What the results of this study add? The results from this randomised study suggest that LS has superiority in terms of pain relief during the colposcopic biopsy procedure and has no adverse reactions.What the implications are of these findings for clinical practice and/or further research? The evidence from different studies showed some conflicting results regarding the pain relief methods during the colposcopic biopsy procedure. The local LS can be used in this procedure in routine clinical practice. However, further studies with larger samples and comparison of different methods are needed.
Differences Fin Geographical Distribution and Risk Factors for Urinary Incontinence in Turkey: Analysis of 6,473 Women
(Karger, 2014) Dursun, Polat; Dogan, Nasuh Utku; Kolusari, Ali; Dogan, Selen; Ugur, Mete Gurol; Komurcu, Ozge; Yigit, Filiz Altinok
Objective: To assess the prevalence, types and risk factors for urinary incontinence (UI) and to evaluate the impact of incontinence on quality of life by using validated and objective questionnaires in the western and eastern parts of Turkey. Methods: In this multicenter observational study, 6,473 women from 38 cities in the western and eastern parts of Turkey were included. UI was assessed by ICIQ-SF (International Consultation on Incontinence Questionnaire Short Form) and IIQ-7 (Incontinence Impact Questionnaire). Results: The UI rate was 20.9% (10% for stress, 8.3% overactive bladder and 2.6% for mixed type). In all, stress incontinence was the most common type. The rate of UI in women residing in the west was higher than in women living in the east (p < 0.001). ICIQ scores were comparable in the two groups but women in the west scored higher in each item of the IIQ. Age >40 years (p < 0.001), number of siblings >5 (p < 0.001) and low educational status (p < 0.001) increased the rate of incontinence. In binary logistic regression analysis menopausal status, age >40 years, number of siblings >5, being overweight, region of residence, and educational status were associated with UI. Conclusion: The rate of UI in women residing in the western part of Turkey was higher than women living in the east. Residing in a different geographical region (in our case living either in the western or eastern part of Turkey) seemed to be an independent risk factor for UI. Moreover, UI deteriorates quality of life and more attention should be paid to this vulnerable population. (C) 2013 S.Karger AG, Basel
Does Residual Amniotic Fluid After Preterm Premature Rupture of Membranes Have an Effect on Perinatal Outcomes? 12 Years Experience of a Tertiary Care Center
(Springer Heidelberg, 2010) Kurdoglu, Mertihan; Kolusari, Ali; Adali, Ertan; Yildizhan, Recep; Kurdoglu, Zehra; Kucukaydin, Zehra; Kamaci, Mansur
To review our experience with preterm premature rupture of membranes at a tertiary-care hospital in Turkey to determine whether the amount of residual amniotic fluid after rupture has prognostic value for adverse maternal and fetal outcomes. We reviewed the medical records of 191 pregnant women with gestational ages between 24 and 34 weeks at the time of rupture of the amniotic membrane and of their babies delivered in our hospital between January 1996 and September 2008. On the basis of amniotic fluid index (AFI) values recorded at the time of admission, patients were categorized into two groups: those with an AFI < 50 mm (n = 119) and those with an AFI > 50 mm (n = 72). The patients with high gravidity (4-8) were more prevalent in the group with an AFI < 50 mm (37 vs. 23.6%), while nulliparous women were more common in the group with an AFI > 50 mm (44.4 vs. 30.2%) (P < 0.05). Seventy-two percent of the cesarean sections performed due to nonreassuring fetal status were in the group with an AFI < 50 mm (P < 0.01). In 71.4% of the cases with a 5 min Apgar score a parts per thousand currency sign 7, AFI was less than 50 mm (P < 0.01). AFI < 50 mm was present in 65, 70.8, 76.7, and 73.1% of the pregnancies complicated by chorioamnionitis, respiratory distress syndrome, composite neonatal morbidity, and neonatal death, respectively (P < 0.05). A residual AFI < 50 mm after preterm PROM between 24 and 34 weeks of gestation, which is mostly seen in grand multiparous women in Eastern Turkey, may be a valuable prognostic variable for anticipating adverse maternal and neonatal outcomes.
Domestic Violence Against Infertile Women in a Turkish Setting
(Elsevier Ireland Ltd, 2009) Yildizhan, Recep; Adali, Ertan; Kolusari, Ali; Kurdoglu, Mertihan; Yildizhan, Begum; Sahin, Guler
Objective: To investigate the prevalence of domestic violence against infertile women in a Turkish setting. Methods: A total of 122 women with primary infertility attending an obstetrics and gynecology outpatient clinic were interviewed using the Abuse Assessment Screen questionnaire to investigate their experiences of domestic violence. Results: In total, 41 (33.6%) women had experienced domestic violence because of their infertility. Of these women, 32 (78%) had experienced domestic violence for the first time in the relationship with the current partner following diagnosis of female factor infertility. The percentage of nonabused and abused infertile women who were mostly satisfied with their sexual lives was 56.87% and 29.2%, respectively (P<0.05). Conclusion: Routine screening for domestic violence in infertility clinics is necessary to give affected women an opportunity to access appropriate health care and support services. (C) 2008 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Doppler Analysis of Uterine Perfusion and Ovarian Stromal Blood Flow in Polycystic Ovary Syndrome
(Wiley, 2009) Adali, Ertan; Kolusari, Ali; Adali, Fulya; Yildizhan, Recep; Kurdoglu, Mertihan; Sahin, Hanim Guler
Objective: To investigate blood flow velocity in the ovarian stromal artery and uterine artery in women with polycystic ovary syndrome (PCOS) and to correlate these velocities with clinical and biochemical parameters. Methods: A prospective study was carried out in 55 patients with PCOS and 42 age-matched women who did not have PCOS. Clinical, biochemical, and hormonal characteristics, and utero-ovarian Doppler ultrasound blood flow parameters were determined, and correlations between the parameters were evaluated. Results: Ovarian stromal blood flow was higher (P<0.01) and uterine perfusion was lower (P<0.01) in women with PCOS compared with women who did not have PCOS. Ovarian stromal artery pulsatility index (PI) was inversely correlated with levels of dehydroepiandrosterone sulfate (DHEAS) and insulin-like growth factor-1, and with the luteinizing hormone/follicle-stimulating hormone ratio. There was a positive correlation between uterine artery PI and DHEAS level. Conclusion: Doppler analysis of the uterine and intraovarian arteries may provide additional information about the etiopathogenesis of PCOS and partly explain the clinical implications of the condition. (C) 2009 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
The Effect of Erythropoietin in Preventing Ischemia-Reperfusion Injury in Ovarian Tissue Transplantation
(Sage Publications inc, 2018) Kolusari, Ali; Okyay, Ayse Guler; Kockaya, Evrim Arzu
Condensation Erythropoietin improved the survival of follicles in ovarian grafts most likely by reducing ischemic injury, by improving neoangiogenesis, and by its antioxidant effects. Objective: Ovarian tissue cryopreservation and transplantation are the only options accepted for prepubertal girls and women requiring immediate chemotherapy. Ischemia-reperfusion injury is the main obstacle for ovarian tissue transplantation. In the present study, we aimed to evaluate the effects of recombinant human erythropoietin (EPO) on tissue viability in autotransplanted rat ovaries. Study Design: Seventeen female rats were randomized into 3 groups as sham control group (n = 5), EPO-treated group (n = 6), and EPO-untreated group (n = 6). Both ovaries were excised and transplanted into a subcutaneous pouch formed at the anterior abdominal wall in the EPO-treated and untreated groups. In the EPO group, 5000 U/kg EPO was applied as local injection to the site that ovarian tissue was placed and the dose was repeated with the same route at the end of the fourth week. After 2 months, ovaries were removed and blood samples were obtained. Levels of estradiol (E-2), vascular endothelial growth factor (VEGF), VEGF-C, and lipid hydroperoxidase (LPO) and the activity of glutathione peroxidase (GPX), superoxide dismutase (SOD), and catalase (CAT) were measured both in blood and tissue samples. Histopathological and morphometric analyses were also performed on tissue samples. Results: Considering serum levels, mean CAT was significantly higher (P = .003) and mean SOD (P = .033), LPO (P = .050), VEGF (P = .001), and VEGF-C (P = .024) were significantly lower in the EPO-treated group than in the untreated group. Mean serum GPX levels were similar. Significantly higher levels of E-2 were determined in the EPO group than in the untreated group. Highest serum E-2 levels were found in the sham group (P = .001). Tissue levels of GPX (1.23) and CAT (53.17) were significantly higher in the EPO group (P = .002 and P = .001, respectively). However, tissue levels of SOD and LPO, VEGF, and VEGF-C levels were significantly lower in the EPO group than those in the untreated group (P = .033, P = .050, P = .002, and P = .003, respectively). In tissue examination, the highest values of x, y axis and epithelial height were in the sham group. Mean value of the EPO group was found statistically significantly higher than that of the untreated group (P .05). In terms of antral follicle count, ordering was found as sham > EPO-treated > EPO-untreated group. Follicle counts in the EPO group were significantly higher than those in the untreated group (P 0.05). Conclusion: Erythropoietin improved the survival of follicles in ovarian grafts most likely by reducing ischemic injury, by improving neoangiogenesis, and by its antioxidant effects.
The Effect of Oxytocin Infusion and Misoprostol on Neonatal Bilirubin Levels
(Springer Heidelberg, 2010) Sahin, H. Guler; Kolusari, Ali; Kamaci, Mansur; Kaynak, Canev; Tuncel, Hatice
To investigate the association of neonatal bilirubin levels with oxytocin and misoprostol use for labour induction. A total of 100 neonates were included in the study. The first group consisted of 50 healthy babies of women who had received oxytocin infusion and the second group consisted of 50 healthy babies of women who had received 25 mu g misoprostol every 4 h placed in the posterior fornix for labour induction. Bilirubin and haematocrit levels were measured in all on days 1 and 4 of the neonatal period. The levels of bilirubin in the oxytocin group were significantly higher than those in the misoprostol group on day 1 [4.42 +/- A 0.27 mg/dl versus 3.55 +/- A 0.28 mg/dl (P = 0.035)] while they were higher also on day 4 but was not significantly so [7.47 +/- A 0.63 mg/dl versus 6.86 +/- A 0.65 mg/dl (P = 0.525)]. The mean haematocrit levels on day 1 were 50.62 +/- A 1.23 and 58.04 +/- A 1.30 in groups 1 and 2, respectively, with a significant difference between them. The levels were 52.31 +/- A 1.27 and 58.96 +/- A 1.14 on day 4 and the difference was again significant. P < 0.05 indicated statistical significance. Labour induction with misoprostol and oxytocin does not seem to have harmful effects on bilirubin levels in the neonate.
Evaluation of Maternal Liver Elasticity by Acoustic Radiation Force Impulse Elastosonography in Hypertensive Disorders of Pregnancy: a Preliminary Descriptive Study
(Taylor & Francis Ltd, 2017) Cetin, Orkun; Karaman, Erbil; Arslan, Harun; Kolusari, Ali; Yildizhan, Recep; Ozgokce, Mesut; Akbudak, Ibrahim
Purpose: To compare maternal liver elasticity scores by Acoustic Radiation Force Impulse (ARFI) elastosonography in healthy and preeclamptic pregnancies and its association with the severity of the disease.Materials and methods: Forty-two healthy, 33 mild, 33 severe preeclamptic and 28 pregnant women with Hemolysis, Elevated Liver enzymes and Low Platelets (HELLP) syndrome were included into the study. Maternal liver elasticity was measured by ARFI elastosonography at the first day of puerperium. The maternal and neonatal outcomes of the patients were retrieved from the medical records.Results: The ARFI-Mean liver elastosonography scores of controls and mild preeclamptic women were lower than severe preeclamptic and HELLP syndrome women (p: 0.001). The mean ARFI elastosonography score >1.22 m/s indicated the effect of severe preeclampsia on maternal liver elasticity with 72.7% sensitivity and 74.7% specificity (Area under curve [AUC], 0.835, 95% confidence interval [CI], 0.757-0.913). The mean ARFI elastosonography score >1.31 m/s indicated the effect of HELLP syndrome on maternal liver elasticity with 78.6% sensitivity and 75.9% specificity (AUC, 0.794, 95% CI, 0.695-0.892).Conclusions: The maternal liver becomes stiffer in severe preeclampsia and HELLP syndrome measured by ARFI elastosonography. The increased maternal liver ARFI scores may alert the obstetrician about the possible maternal puerperal morbidity.
The Evaluation of Maternal Systemic Thiol/Disulphide Homeostasis for the Short-Term Prediction of Preterm Birth in Women With Threatened Preterm Labour: a Pilot Study
(Taylor & Francis inc, 2022) Cetin, Orkun; Karaman, Erbil; Alisik, Murat; Erel, Ozcan; Kolusari, Ali; Sahin, Hanim Guler
The aim of this study was to investigate maternal systemic thiol/disulphide homeostasis (TDH) for the short-term prediction of preterm birth in women with threatened preterm labour (TPL). This prospective study included 75 pregnant women whose pregnancies were complicated by TPL. Thirty-seven of them delivered within 7 days and 38 of them delivered beyond 7 days. Maternal serum samples were collected at the day of diagnosis and the TDH was measured. The maternal disulphide level was significantly higher in pregnant women who delivered within 7 days (25.0 +/- 9.8 mu mol/L vs 19.4 +/- 9.8 mu mol/L, p: .015). The threshold value of 22.1 mu mol/L for maternal disulphide level predicted delivery within 7 days with 62.2% sensitivity and 60.5% specificity (area under curve 0.651, confidence interval 0.53-0.78). The likelihood ratios for short cervix (<= 25 mm) and maternal disulphide level (>= 22 mu mol/L) to predict delivery within 7 days was found to be 8.7 and 7.3, respectively. The likelihood ratio of combining two tests to predict delivery within 7 days was found to be 11.4. The maternal TDH, which is an indicator of oxidative stress status in maternal compartment, is disturbed in TPL cases who delivered within 7 days. Elevated maternal disulphide level along with cervical length screening predicts a short latency period in pregnancies with TPL. IMPACT STATEMENT What is already known on this subject? Spontaneous preterm delivery is one of the major complication of pregnancy and the common cause of neonatal morbidity and mortality. Threatened preterm labour (TPL) is also a frequent complaint in obstetric emergency care units in all around the world. Triaging women with TPL is mandatory for planning further management therapies, since the most of them will eventually deliver at term. Only the measurement of cervical length in symptomatic women has moderate accuracy in predicting preterm delivery. Short cervix is described as an independent predictor of preterm delivery in women with TPL, its predictive accuracy as a single measurement is relatively limited. On this account, several potential markers like foetal fibronectin in the cervicovaginal fluid, salivary oestriol, prolactin in vaginal discharge, maternal serum calponin and interleukin-6 in the amniotic fluid were examined to predict preterm delivery in previous studies. However, none of them represented an excessive predictive accuracy like high sensitivity, PPV or NPV. What do the results of this study add? We report a method which has higher diagnostic and predictive performance to identifying TPL women with high risk of preterm delivery. According to the current literature, there are accumulated data about the correlation between oxidative stress (OS) and preterm delivery regardless of the amniotic membrane status. However, it is still debated whether OS is a trigger or a consequence of preterm delivery. Our study provides evidence for the first time that maternal serum thiol/disulphide homeostasis, which is an indicator of OS in maternal compartment, is disturbed in TPL cases who delivered within 7 days. The high disulphide level in maternal serum, along with cervical length measurement (short cervix) accurately predicts a short latency period in TPL cases. What are the implications of these findings for clinical practice and/or further research? This novel test combination (maternal serum disulphide level and cervical length measurement) could be used clinically to triage pregnant women presenting with TPL, avoiding overtreatment, unnecessary hospitalisations and increased medical costs. The future research would be addressed on reducing maternal OS by using new antioxidant treatment strategies to improve perinatal and long-term childhood outcomes.
Expression of Laminin Receptor 1 in Gestational Trophoblastic Diseases and Normal Placenta and Its Relationship With the Development of Postmolar Tumors
(Academic Press inc Elsevier Science, 2009) Kurdoglu, Mertihan; Bayram, Irfan; Kolusari, Ali; Erten, Remzi; Adali, Ertan; Bulut, Gulay; Sahin, H. Guler
Objectives. To investigate the expression of laminin receptor 1 (LR1), a non-integrin-type laminin receptor, in gestational trophoblastic diseases and normal first-trimester placenta, since it may play a role in controlling trophoblast invasion in normal and molar pregnancies. Methods. Paraffin sections from 24 gestational age controlled normal first-trimester placentas, 47 partial moles, 56 complete moles, 3 invasive moles, 4 gestational choriocarcinomas, and 1 placental-site trophoblastic tumor were studied immunohistochemically for expression of LR1. Results. In complete and partial moles, decidual cells showed significantly stronger LR1 protein staining compared to the normal placenta (p<0.01). When compared to the partial moles, weak staining in less than 33% of decidual cells was also more prominent in the normal placenta (p<0.05). Complete and partial moles, invasive moles, choriocarcinomas, and placental-site tumors did not differ from each other with respect to staining intensity. Strong immunostaining for LR1 in decidual cells, cytotrophoblasts, syncytiotrophoblasts, and extracellular matrix cells of partial and complete moles was not significantly correlated with the development of persistent postmolar gestational trophoblastic tumors. Conclusions. LR1 may be important in the pathogenesis of gestational trophoblastic diseases. The increased expression of LR1 in decidual cells of partial and complete moles may not influence the development of persistent gestational trophoblastic tumor. Since they are seen rarely, multicentric studies should be planned to study LR1 expression in invasive moles and gestational trophoblastic neoplasms. (C) 2009 Elsevier Inc. All rights reserved.
Familial Imperforate Hymen
(Galenos Yayincilik, 2007) Erdemoglu, Evrim; Kolusari, Ali; Sahin, Guler; Kamaci, Mansur
Imperforate hymen, a rare obstructive anomaly of female genital tract, is accepted to be sporadic and isolated. We report an unusual case of familial imperforate hymen and discuss the possible inheritance mode. This is the fifth case to be reported. In our case, there were two affected sisters in a consanguineous marriage suggesting recessive mode of transmission. Imperforate hymen could be a familial condition and examination of family members is important to avoid late diagnosis and associated complications.
A Five-Year Audit of Cases With Ectopic Pregnancy in Our Clinic
(Galenos Yayincilik, 2010) Adali, Ertan; Kurdoglu, Mertihan; Kolusari, Ali; Yildizhan, Recep; Cim, Numan; Sahin, Hanim Guler; Kamaci, Mansur
Objective: The aim of this study was to review the ectopic pregnancy cases that were administered to our clinic in the last five years. Materials and methods: According to the dermographic features, risk factors, clinical signs and treatment approaches, ninetyone cases with ectopic pregnancies were evaluated retrospectively between 2004-2009. For statistical analysis, SPSS was used. Results: The average age of the patients were 28,38 +/- 6,47 years and ectopic pregnancies were mostly seen between the ages of 26-35. The mean gravida and parity were 3,86 +/- 2,55 and 2,34 +/- 2,16, respectively. The mean serum beta-hCG level of the patients on admission to our clinic was 3085,41 +/- 6346,84 mIU/L. The risk factors in the order of frequencies were previous abdomino-pelvic surgery (16 %), the use of intrauterine device (12 %), previous ectopic pregnancies (7 %) and previous pelvic inflammatory disease (2 %). The most common complaint on admission were abdominal pain (40 %) and following that in the order of frequencies were vaginal bleeding with pain (38 %) and only vaginal bleeding (15 %). As a treatment option, surgery, methotrexate and expectant management were applied to 66 %, 20% and 10% of the patients respectively. Conclusion: Ectopic pregnancies are important health problems since they may interfere with fertility capability of the patient in her future life and may even cause maternal mortality. Especially, women who had abdomino-pelvic surgery before are at risk. Early diagnosis enables conservative management approaches.
Ghrelin Does Not Change in Hyperemesis Gravidarum
(Via Medica, 2019) Ege, Serhat; Kolusari, Ali; Bugdayci, Guler; Cim, Numan; Bademkiran, Muhammet Hanifi; Peker, Nurullah; Yildizhan, Recep
Objectives: Ghrelin levels can play an important role in maintaining the energy balance of pregnant women. Therefore, we investigated the relationship between HG and Ghrelin. Material and methods: 50 female patients admitted to the VAN Yuzuncu Yil University, Gynecology and Obstetrics Department were evaluated. The patients were divided into two groups: Group 1 included 25 pregnant women with HG, Group 2 included 25 healthy pregnant women. Results:The two groups showed similarities in terms of age, gravidity, B-HCG and gestational age.There was no statistically significant difference between the two groups in terms of the Ghrelin levels (p = 0.867). Conclusions: This study shows that there is no difference between Ghrelin levels and HG during pregnancy. Increased Ghrelin in previous studies was attributed to low oral intake. Another study reported lower Ghrelin levels are not the result of, but are rather the cause of, reduced oral intake during. The balancing of these two conditions does not lead to a change in the level of Ghrelin.
Increased Plasma Thrombin-Activatable Fibrinolysis Inhibitor Levels in Young Obese Women With Polycystic Ovary Syndrome
(Elsevier Science inc, 2010) Adali, Ertan; Yildizhan, Recep; Kurdoglu, Mertihan; Bugdayci, Guler; Kolusari, Ali; Sahin, H. Guler
Objective: To evaluate carotid intima-media thickness and thrombin-activatable fibrinolysis inhibitor levels in young women with polycystic ovary syndrome (PCOS) and age-matched healthy controls, and to investigate their relationship with each other and with clinical, metabolic, and hormonal parameters. Design: Clinical study. Setting: University hospital. Patient(s): Fifty young women with PCOS (overweight or obese [n = 24] and nonobese [n = 26]) and 25 age-matched healthy controls. Intervention(s): History and physical examination, peripheral venous blood sampling, carotid ultrasonography. Main Outcome Measure(s): Plasma thrombin-activatable fibrinolysis inhibitor, serum FSH, LH, DHEAS, total T, E-2, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride, insulin resistance defined by the homeostasis model assessment insulin resistance index, and carotid intima-media thickness. Result(s): Plasma thrombin-activatable fibrinolysis inhibitor levels in the overweight or obese PCOS group were significantly higher than those in the nonobese PCOS and control groups. Carotid intima-media thickness did not significantly differ between the groups. Obesity and insulin resistance were associated positively with plasma thrombin-activatable fibrinolysis inhibitor levels, but there was no association between carotid intima-media thickness and thrombin-activatable fibrinolysis inhibitor. Conclusion(s): Young overweight or obese women with PCOS have increased plasma thrombin-activatable fibrinolysis inhibitor levels. Impaired fibrinolysis may be responsible for the increased risk of cardiovascular diseases in women with PCOS. (Fertil Steril (R) 2010;94:666-72. (C) 2010 by American Society for Reproductive Medicine.)
Increased Visfatin and Leptin in Pregnancies Complicated by Pre-Eclampsia
(Taylor & Francis Ltd, 2009) Adali, Ertan; Yildizhan, Recep; Kolusari, Ali; Kurdoglu, Mertihan; Bugdayci, Guler; Sahin, Hanim Guler; Kamaci, Mansur
Objective. To evaluate the role of the adipokines, visfatin and leptin in the pathophysiology of pre-eclampsia and how their concentrations correlate with the severity of the disease and abnormal Doppler velocimetry. Methods. A cross-sectional study was carried out in 72 pregnant women (30 patients with mild pre-eclampsia, 20 patients with severe pre-eclampsia and 22 healthy normotensive pregnant women) during the third trimester of pregnancy. The maternal levels of plasma visfatin and serum leptin were determined in all cases by enzyme immunoassay and enzyme-linked immunosorbent assay, respectively. The uterine artery and umbilical artery RI were determined by Doppler analysis in all cases. Results. Plasma visfatin levels and serum leptin levels were higher in patients with pre-eclampsia than in the normotensive pregnant women. Six patients with mild pre-eclampsia and five patients with severe pre-eclampsia had abnormal Doppler velocimetry. Visfatin and leptin levels of pre-eclamptic patients with abnormal Doppler velocimetry were significantly higher than they were in those with normal Doppler velocimetry. Serum leptin levels were positively correlated with plasma visfatin level in cases of pre-eclampsia. Conclusions. These findings suggest that increased maternal levels of leptin and visfatin may be involved in the pathogenesis of pre-eclampsia, and measurement of these adipokines may be useful in assessment of the severity of disease.
Local Resection May Be a Strong Alternative To Cesarean Hysterectomy in Conservative Surgical Management of Placenta Percreta: Experiences From a Tertiary Hospital
(Taylor & Francis Ltd, 2017) Karaman, Erbil; Kolusari, Ali; Cetin, Orkun; Cim, Numan; Alkis, Ismet; Yildizhan, Recep; Gul, Abdulaziz
Objective: To evaluate and describe a surgical approach for uterine preservation and management of postpartum hemorrhage in placenta percreta. Methods: We analyzed the data of patients who were diagnosed with placenta percreta prenatally and subsequently underwent cesarean section in which local resection technique was used to manage postpartum hemorrhage and uterine preservation at our tertiary care center between 2013 and 2016. The technique includes local resection of placental invasion site and suturing the new uterine edges. Results: The technique of local resection described above was successful in preserving the uterus and stopping the bleeding in 8 of 12 cases. The diagnosis of placenta percreta in all cases was confirmed intraoperatively and postoperatively by histological examinations. Four cases were resorted to hysterectomy. The mean number of transfused erythrocyte suspension was 4.82.6. One complication of bladder injury was encountered in which treated conservatively. Conclusion: Local resection of percreta site is an effective, safe and fertility preserving approach that can be applied to manage the postpartum hemorrhage and preservation of uterus in patients with placenta percreta.