Browsing by Author "Kucukaydin, Zehra"

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Comparison of the Efficacy of Intrauterine Lidocaine, Paracervical Block and Oral Etodolac for Decreasing Pain in Endometrial Biopsy
(Galenos Yayincilik, 2010) Guler, Ayse; Sahin, H. Guler; Kucukaydin, Zehra; Erdemoglu, Evrim
Objective: To compare the effectiveness of paracervical block, intrauterine lidocaine and oral etodolac in decreasing the pain caused by pipelle endometrial sampling. A secondary goal of this study was to determine the adverse effects and compare possible effects of these methods on pulse and blood pressure. Material and Methods: The study was performed between April 2006 and October 2006 in the Obstetrics and Gynecology Department of Van Yriziincji Yil University Research Hospital. One-hundred twenty patients were randomized into four groups: 1. Group: Paracervical block was performed with 3 ml 2% prilocaine solution. 2. Group: Five ml of 2% lidocaine solution was instilled through the endocervix into the uterine cavity. 3. Group: Subjects received 400 mg oral etodolac tablet 1-1.5 hour before the procedure. 4. Group: No method of anesthesia was used in the control group. Endometrial sampling was performed with pipelle. Severity of pain during the procedure was scored by the subjects according to the "6-point Verbal Rating Scale (VRS)". Blood pressure and pulse rate were measured before, during and 30 minutes after the procedure. Results: Pain scores in intrauterine lidocaine group (2"d group) were found statistically significantly lower than the other three groups (p<0.05). Conclusion: Intrauterine lidocaine anesthesia technique decreases pain in endometrial sampling with pipelle more efficiently than paracervical block or oral etodolac. While indication of menorrhagia and endometrial thickness more than 5 mm increased pain scores, intrauterine lidocaine application or paracervical block decreased tyre scores significantly (p<0.05).
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.
Expression of Laminin Receptor 1 in Human Placentas From Normal and Preeclamptic Pregnancies and Its Relationship With the Severity of Preeclampsia
(Walter de Gruyter Gmbh, 2011) Kurdoglu, Mertihan; Kurdoglu, Zehra; Ozen, Suleyman; Kucukaydin, Zehra; Bulut, Gulay; Erten, Remzi; Kamaci, Mansur
Objectives: To investigate the expression of laminin receptor 1 (LR1), a non-integrin-type laminin receptor, in preeclamptic and normal third-trimester placentas, as well as to investigate whether its expression differs with disease severity. Study design: Third trimester placental samples obtained from deliveries of preeclamptic (n = 34) and normotensive healthy pregnant women (n = 35) were immunohistochemically studied for the expression of LR1. The placentas from both mild (n = 14) and severe (n = 20) preeclamptic pregnancies were further assessed for strength of LR1 expression according to disease severity. Results: When compared with normal placentas, the staining with LR1 protein in cytotrophoblasts and syncytiotrophoblasts was lower in preeclamptic placentas (P<0.05 and P<0.01, respectively). The intensity of staining with LR1 in decidual cells, cytotrophoblasts, syncytiotrophoblasts, and extracellular matrix cells of preeclamptic placentas did not vary with disease severity (P>0.05). Conclusions: Decreased LR1 expression in cytotrophoblasts and syncytiotrophoblasts of preeclamptic placentas, which may be independent of disease severity, might have a role in shallow trophoblastic invasion in preeclampsia.
Expression of Laminin Receptor 1 in Normal, Hyperplastic, and Malignant Endometrium
(Lippincott Williams & Wilkins, 2019) Kurdoglu, Mertihan; Kucukaydin, Zehra; Kurdoglu, Zehra; Bulut, Gulay; Unlu, Yasar; Ozen, Suleyman
Laminin receptor 1 may have a role in the progression from endometrial hyperplasia with or without atypia to endometrial cancer. Therefore, we aimed to investigate the pattern, percentage, and intensity of laminin receptor 1 expression in normal, hyperplastic, and neoplastic endometrium. Paraffin blocks of 131 specimens with the diagnoses of normal endometrium (n=25), endometrial hyperplasia with atypia (n=21) or without atypia (n=55), and endometrial cancer (n=30) were immunostained with laminin receptor 1 antibody, and its expression percentage, pattern, and intensity in the epithelial cytoplasm, basement membrane, and endometrial stroma of these tissues were assessed. When compared with hyperplasia with or without atypia and endometrial cancer, the percentage of nonstaining with laminin receptor 1 in the epithelial basement membrane was higher (96%), and the percentage of <50% staining with laminin receptor 1 was lower (4%) in the normal endometrium (P=0.001). While a progressive increment in staining percentage and density of epithelial cytoplasm and basement membrane was noted through an orderly progression from normal endometrium to endometrial hyperplasia without atypia, endometrial hyperplasia with atypia, and cancer of endometrium (P<0.001), such a relationship was not found for the staining percentage and density of endometrial stroma (P>0.05). Disease progression-related gradual increment in laminin receptor 1 expression in the epithelial basement membranes of hyperplastic endometrium with or without atypia and cancer of endometrium reveals that it may play a substantial role in the transition from premalignant to the malignant state of endometrial lesions.
Gestational Trophoblastic Diseases: Fourteen Year Experience of Our Clinic
(Galenos Yayincilik, 2011) Kurdoglu, Mertihan; Kurdoglu, Zehra; Kucukaydin, Zehra; Sahin, Hanim Guler; Kamaci, Mansur
Objective: To evaluate the patients followed and treated with a diagnosis of gestational trophoblastic disease in our clinic retrospectively. Design: The files of the patients followed and treated in our clinic between 1996 and 2010 with a diagnosis of gestational trophoblastic disease were examined. Setting: Yuzuncu YIl University, Faculty of Medicine, Department of Obstetrics and Gynecology, Van. Patients: The 147 patients with satisfactory information in their files within 173 patients treated and followed in our clinic between 1996 and 2010 with a diagnosis of gestational trophoblastic disease. Interventions: No intervention to the patients. Main outcome measures: Demographic and obstetric parameters, blood group, obstetric history in the previous pregnancy, contraceptive method, gestational week and complaints on admission, hystological type, stage, treatment and complications of gestational trophoblastic disease and presence of associated clinical problems. Results: In our clinic, 18.324 deliveries occured and 173 cases had a diagnosis of gestational trophoblastic disease between 1996 and 2010. Out of 147 patients, 72 (49%), 61 (41.5%), 3 (2%), 7 (4.8%) and 1 (0.7%) had diagnoses of complete mole, partial mole, invasive mole, choriocarcinoma and placental site trophoblastic tumor, respectively. In 3 patients ( 2%), subtype could not be determined. Mean age was 31.45 +/- 10.29 years and the most common complaint was vaginal bleeding (77.6%). As the primary therapy, suction curettage with oxytocin infusion or hysterectomy was appplied to 140 and 7 patients, respectively. A single agent chemotherapy was performed to 26 patients while a multiagent chemotherapy was given to 6 patients. All patients were followed up by serial serum beta-hCG measurements. Conclusions: The incidence of gestational trophoblastic disease in our clinic was calculated as 8.1 per 1000 deliveries and socio-economic and educational status of majority of the patients were low. Lowering the high birth rate in our region may contribute to decrease of disease incidence.
Isolated Impairment of Posterior Pituitary Function Secondary To Severe Postpartum Haemorrhage Due To Uterine Rupture
(informa Healthcare, 2011) Adali, Ertan; Kucukaydin, Zehra; Adali, Fulya; Yildizhan, Recep
Cranial diabetes insipidus (DI) due to postpartum haemorrhage is an extremely rare clinical event. We describe herein isolated posterior pituitary insufficiency in a 26-year-old woman who had undergone subtotal hysterectomy for severe postpartum haemorrhage because of uterine rupture. The patient experienced polyuria within 6 h postoperatively. DI was suggested by the elevated urine volumes and low urine specific gravity. The diagnosis of DI was confirmed by water deprivation test and vasopressin stimulation test. The anterior pituitary function was within normal limits. A high clinical suspicion is certainly required for the diagnosis of DI in the immediate postpartum period. To rapidly initiate appropriate therapy, the possibility of DI should always be kept in mind while evaluating patients who have polyuria and polydipsia after severe postpartum bleeding. Delay or failure to treat this condition might result in hypovolemic shock.
Laminin Receptor 1 Expression in Premalignant and Malignant Squamous Lesions of the Cervix
(Taylor & Francis Ltd, 2024) Kurdoglu, Mertihan; Kurdoglu, Zehra; Kucukaydin, Zehra; Erten, Remzi; Bulut, Guelay; Ozen, Suleyman
Laminin receptor 1 (LAMR) may have a role in the progression of premalignant squamous epithelial lesions to cervical cancer. Therefore, we aimed to investigate the expression of laminin receptor 1 (LAMR) in normal, premalignant, and malignant tissues of the uterine cervix. Paraffin blocks of 129 specimens with the diagnoses of normal cervical tissue (n = 33), cervical intraepithelial neoplasia (CIN) 1 (n = 30), CIN 2 (n = 14), CIN 3 (n = 28), and squamous cell carcinoma (n = 24) were immunohistochemically stained with LAMR antibody and its expression percentage, pattern, and intensity in these tissues were assessed. Compared to the other groups, the nonstaining with LAMR was highest in low grade squamous intraepithelial lesion (LSIL) (p < 0.0001). LAMR expression, which was positive in less than 50% of cells with weak staining, increased significantly between normal cervical epithelium and high-grade squamous intraepithelial lesion (HSIL) or invasive carcinoma, as well as between LSIL and HSIL (p < 0.0001). Between LSIL and invasive carcinoma, a significant increment was also observed for weak staining in less than 50% of cells (p < 0.001). LAMR expression, which was positive in more than 50% of cells with strong staining, was significantly higher in normal cervical tissue compared to the other groups (p < 0.0001). Disease progression related gradual increment of LAMR expression from normal cervical epithelium or LSIL towards HSIL or cervical cancer reveals that LAMR may play an important role in the transition from premalignant to malignant state in cervical lesions.
Selected Maternal, Fetal and Placental Trace Element and Heavy Metal and Maternal Vitamin Levels in Preterm Deliveries With or Without Preterm Premature Rupture of Membranes
(Wiley, 2018) Kucukaydin, Zehra; Kurdoglu, Mertihan; Kurdoglu, Zehra; Demir, Halit; Yoruk, Ibrahim H.
Aim: To compare maternal, fetal and placental trace element (magnesium, zinc and copper) and heavy metal (cadmium and lead) and maternal vitamin (retinol, alpha [alpha]-tocopherol, vitamin D-3, 25-hydroxyvitamin D-3 and 1,25-dihydroxyvitamin D-3) levels in preterm deliveries with and without preterm premature rupture of membranes (PPROM). Methods: Sixty-eight patients giving birth preterm were grouped into preterm deliveries with PPROM (n = 35) and without PPROM (n = 33). Following delivery, maternal and umbilical cord blood sera and placental tissue samples were obtained. While magnesium, zinc, copper, cadmium and lead levels were measured in all samples, the levels of retinol, -tocopherol, vitamin D-3, 25-hydroxyvitamin D-3 and 1,25-dihydroxyvitamin D-3 were measured only in maternal serum. Results: While magnesium level in maternal serum and zinc levels in both maternal and umbilical cord sera were lower, placental magnesium level was higher in preterm deliveries with PPROM (P < 0.01). Umbilical cord serum magnesium, placental tissue zinc and maternal and umbilical cord sera and placental tissue copper, cadmium, and lead levels did not differ between the groups (P > 0.05). In preterm deliveries with PPROM, 25-hydroxyvitamin D-3 and retinol levels were higher, while vitamin D-3 and 1,25-dihydroxyvitamin D-3 levels were lower in maternal serum (P < 0.05). Maternal serum -tocopherol levels were similar between the groups. Conclusion: Compared to spontaneous preterm births, PPROM is associated with low maternal serum together with high placental tissue magnesium and low maternal and umbilical cord sera zinc levels. Higher retinol and 25-hydroxyvitamin D-3 and lower vitamin D-3 and 1,25-dihydroxyvitamin D-3 maternal serum levels are also evident in these patients.