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Öğe APPENDICEAL MUCOCELE MIMICKING A CYSTIC RIGHT ADNEXAL MASS(ELSEVIER TAIWAN, 2009) Balci, Osman; Ozdemir, Suna; Mahmoud, Alaa S.Objective: Appendiceal mucocele is formed by cystic dilatation, abnormal mucinous secretion and epithelial proliferation of the appendiceal lumen. Mucocele may be a finding in cases of benign or malignant neoplasms, and can lead to the development of pseudomyxoma peritonei. Case Report: A 71-year-old woman presented with a 3-day history of right lower abdominal pain radiating to her right thigh. A simple 5 x 7 cm cyst with smooth borders and a thick capsule was detected in the right adnexal area by transvaginal ultrasonography. Magnetic resonance imaging identified a 4 x 8 cm cystic lesion in the area of the right ovary. The patient was admitted to our clinic with an initial diagnosis of adnexal cyst, later found to be appendiceal mucocele. Conclusion: The signs and symptoms of appendiceal mucocele are not specific. Because of its anatomic position, it should be considered in the differential diagnosis of adnexal masses. [Taiwan J Obstet Gynecol 2009; 48(4):412-414]Öğe Assessment of ischemia-modified albumin level in patients with recurrent pregnancy loss during the first trimester(ELSEVIER, 2011) Ozdemir, Suna; Kiyici, Aysel; Balci, Osman; Goktepe, Halime; Cicekler, Humeyra; Celik, CetinObjective: The finding that ischemia-modified albumin (IMA) is increased in pre-eclamptic pregnancy suggests a role for IMA as a potential biomarker for abnormal placental development related to miscarriage. This study was undertaken to evaluate IMA levels in women with recurrent pregnancy loss (RPL). Study design: This case-control study was performed between March 2008 and September 2009, at the Department of Obstetrics and Gynecology of Meram School of Medicine. Serum IMA and albumin concentrations were assessed in 43 women with a history of two or more unexplained first trimester miscarriages (group 1), and 42 healthy pregnant women (group 2) in the first trimester. IMA, adjusted IMA and albumin concentrations were compared between the groups. Statistical analysis was performed using Student's t-test and Mann-Whitney U test. Results: IMA and adjusted IMA levels were significantly higher in women with RPL (1.11 + 0.08 and 1.09 + 0.09, respectively) compared to women in group 2 (0.88 + 0.10 and 0.88 + 0.11, respectively). Albumin levels in group 1 were significantly lower compared with group 2. There was a negative correlation between IMAand albumin levels in each group. Conclusion: Maternal IMA levels appear to be elevated in women with early RPL This finding may suggest that an abnormally high hypoxic intrauterine environment may be associated with abnormal placental development that contributes to early miscarriage. (C) 2010 Elsevier Ireland Ltd. All rights reserved.Öğe Assessment of Myometrial Invasion in Endometrial Cancer by Transvaginal Sonography, Doppler Ultrasonography, Magnetic Resonance Imaging and Frozen Section(BMJ PUBLISHING GROUP, 2009) Ozdemir, Suna; Celik, Cetin; Emlik, Dilek; Kiresi, Demet; Esen, HasanObjective: We aimed to compare the diagnostic performance of transvaginal sonography (TVS), magnetic resonance imaging (MRI). and intraoperative frozen section in the assessment of myometrial invasion and to evaluate intratumoral blood flow in any myometrial invasion with transvaginal Color Doppler Ultrasonography (TV-CDU). Methods: This prospective Study included 64 women consecutively diagnosed with endometrial carcinoma. The Subjects were evaluated by TVS, MRI, and TV-CDU by 2 radiologists with a special training in gynecology. Intraoperatively, a frozen section was obtained and processed for interpretation by a blinded pathologist. Sensitivity, specificity, negative, and positive predictive values were calculated for each imaging modality and frozen section with regard to assessment of myometrial invasion. The intratumoral blood flow was evaluated by TV-CDU. Results: Transvaginal sonography, MRI, and frozen section showed no statistical significant differences in overall diagnostic performance for the preoperative and intraoperative assessment of any myometrial invasion, although frozen section seemed to be slightly superior to the imaging techniques. The positive rate of intratumoral blood flow was higher in deep myometrial invasion, but statistical significance was not obtained. The mean value of resistance index was significantly lower in the cases with deep myometrial invasion. Conclusions: Transvaginal sonography with concomitant TV-UCD is low-cost, easily performed, and repeated technique for particularly deep myometrial invasion. Because of its high costs and time-consuming, MRI may be recommended in the cases with poor quality of TVS. Because depending solely oil imaging methods Could lead to insufficient treatment Schedules, intraoperative frozen section should also be performed for myometrial assessment.Öğe Bilateral adnexal torsion due to postmenopausal hydatidiform mole(WILEY-BLACKWELL, 2011) Ozdemir, Suna; Balci, Osman; Gorkemli, Huseyin; Koyuncu, Tuba; Turan, GulayOccurrence of gestational trophoblastic neoplasia (GTN) and adnexal torsion is rare in postmenopause. We report a 58-year-old postmenopausal woman with adnexal torsion caused by hydatidiform mole. The patient was admitted to our clinic complaining of acute abdominal pain, nausea and vomiting lasting one day. Ultrasonography showed an enlarged uterus including hypo/hyperechogenous cystic areas in the endometrial cavity and bilateral adnexal masses. beta-HCG level was investigated and determined as 157.000 IU/l, because of the suspicion of GTN in ultrasonography. Doppler sonography revealed enlarged left adnexa with absence of vascular flow. The patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. beta-HCG decreased to normal ranges in the fourth postoperative week. The resected uterus contained an endometrial, cystic, grapelike tumor. The ovaries were enlarged bilaterally with necrotic appearance. Histopathology revealed complete hydatidiform mole and theca lutein cysts. To our knowledge, the present case is the first hydatidiform mole associated with bilateral adnexal torsion caused by theca lutein cysts in postmenopausal period.Öğe Clinical and metabolic effects of medroxyprogesterone acetate and ethinyl estradiol plus drospirenone in women with polycystic ovary syndrome(WILEY, 2008) Ozdemir, Suna; Gorkemli, Huseyin; Gezginc, Kazim; Ozdemir, Mustafa; Kiyici, AyselObjectives: To investigate the effects of treatment with medroxyprogesterone acetate (MPA), 10 days per month for 6 months, on lipid and carbohydrate metabolism in women with polycystic ovary syndrome (PCOS). Methods: Sixty-three women with PCOS were randomized to receive MPA or ethinyl estradiol plus drospirenone. Results: There were no changes in lipid or carbohydrate metabolism in the MPA group, but serum levels of luteinizing hormone (P < 0.001) and total testosterone (P < 0.003) significantly decreased, as did the free androgen index (P < 0.02) and acne (P < 0.03) and seborrhea (P < 0.04) scores. In the ethinyl estradiol plus drospirenone group lipid and hormone values significantly increased whereas acne, seborrhea, hair Loss, and Ferriman-Gallwey scores decreased. There was no statistically significant change in the total cholesterol to high-density cholesterol ratio in either group. Conclusion: Treatment of PCOS patients with MPA provided good menstrual cycle control, beneficial changes in hormonal values associated with hyperandrogenism, and no significant changes in lipid or carbohydrate metabolism. (c) 2008 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All, rights reserved.Öğe Compared effects of surgical and natural menopause on climacteric symptoms, osteoporosis, and metabolic syndrome(WILEY, 2009) Ozdemir, Suna; Celik, Cetin; Gorkemli, Huseyin; Kiyici, Aysel; Kaya, BugraObjective: To compare the effects of surgical (ie, earlier) and natural (ie, later) menopause oil climacteric symptoms, osteoporosis. and metabolic syndrome. Method: The study was conducted with 94 women who underwent hysterectomy and bilateral oophorectomy and 95 women who were older than 40 years and in natural menopause. None had received hormone theraphy or osteoporosis treatment. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III. Results: The rates of hot flushes (P=0.001), sweating (P=0.001), poor memory (P=0.04), change in sexual desire (P=0.04), and osteoprosis (diagnosed in the hip bone, P=0.005) were significantly higher among the women in Surgical menopause, but the rate of metabolic syndrome was similar in the 2 groups (47.8% and 40%; P=0.28). Conclusion: Compared with natural menopause, surgical menopause was found to be associated with highter rates of climacteric symptoms and osteoporosis but not of of metabolic syndrome. Crown Copyright (C) 2009 Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics. All rights reserved.Öğe The efficacy of multiple-dose methotrexate treatment for unruptured tubal ectopic pregnancy and conversion rate to surgery: a study on 294 cases(ELSEVIER SCIENCE INC, 2010) Balci, Osman; Ozdemir, Suna; Mahmoud, Alaa S.; Acar, Ali; Colakoglu, Mehmet C.In this prospective study 294 patients diagnosed with ectopic pregnancy (EP) were treated with multiple-dose methotrexate (MTX) to determine the conversion rate to surgery. We concluded that multiple-dose MTX treatment had a low success rate, and the success rate was not related to initial b-hCG value; it was more related to the size of gestational mass before treatment. (Fertil Steril (R) 2010;93:2415-7. (C) 2010 by American Society for Reproductive Medicine.)Öğe Evaluation of patients with Beh double dagger et's disease by cervical cytology and colposcopic examination(SPRINGER HEIDELBERG, 2012) Ozdemir, Suna; Ozdemir, Mustafa; Celik, Cetin; Balevi, Ali; Toy, Hatice; Kamis, UmitWe evaluated the genital involvement in women with Beh double dagger et's disease (BD) by cervical cytology and colposcopy, and compared these findings with healthy controls. A total of 152 women were referred to the Gynecology Clinic of Meram School of Medicine between March 2008 and December 2009. The study group was composed of 78 women with BD, and the control group included 74 healthy women admitted for routine gynecologic examination. These patients were subjected to cervical cytology and colposcopic examination. Cervical biopsy was performed in cases with abnormal cytology. These findings and some gynecologic complaints were compared. The demographic features were similar between each group. Genital involvement (scar + ulcer) was detected in 58 (74.3%) patients. The most common sites of ulcers (55.1%) and scars (7.6%) were the labia majora. Abnormal cytology in study and control groups was detected in nine (11.5%) and three (4%) of the patients, respectively, and a slight statistical significance was obtained (p = 0.048). Acetowhite and iodine-negative epithelium were higher in the study group than in controls (p = 0.015 and p = 0.042). Dyspareunia was higher in BD patients (p = 0.001). Patients with BD are more prone to having an abnormal cervical cytology and acetowhite and iodine-negative epithelium on colposcopic examination. However, these findings are mostly benign conditions. The complaint of dyspareunia should be considered during treatment of female patients with BD.Öğe Long-Term Effects of Valproic Acid on Reproductive Endocrine Functions in Turkish Women with Epilepsy(KARGER, 2009) Gorkemli, Huseyin; Genc, Bulent Oguz; Dogan, Ebru Apaydin; Genc, Emine; Ozdemir, SunaThe long-term effects of valproic acid (VPA) on reproductive endocrine functions in women with epilepsy (WWE) were studied. Serum reproductive hormone concentrations, clinical findings and ovarian morphology were analyzed in 71 WWE who had been receiving antiepileptic drugs (AED) for a minimum of 2 years. Of the 71 WWE, polycystic ovarian syndrome (PCOS) (p = 0.011) and menstrual irregularities (p = 0.009) were found to be more prevalent in women receiving VPA treatment when compared to women on non-VPA treatment. There was no statistically significant dose or duration-related rise of risk for patients who developed PCOS and menstrual irregularities and those who were not on long-term VPA therapy. The lack of a duration-related reproductive dysfunction in this patient population may support the hypothesis of early occurring VPA-associated metabolic and endocrine changes. Copyright (C) 2009 S. Karger AG, BaselÖğe Relation of metabolic syndrome with endometrial pathologies in patients with abnormal uterine bleeding(TAYLOR & FRANCIS LTD, 2015) Ozdemir, Suna; Batmaz, Gonca; Ates, Seda; Celik, Cetin; Incesu, Feyzanur; Peru, CelalettinPurpose: We aimed to investigate the association of metabolic syndrome and metabolic risk factors with endometrial hyperplasia and carcinoma among women with abnormal uterine bleeding (AUB). Methods: This study included 199 patients who had undergone endometrial curettage due to abnormal uterine bleeding. We divided the patients into two groups according to whether they had an abnormal (n = 53) or normal endometrium (n = 146). Waist circumference, blood pressure, fasting glucose and serum lipid levels were measured and statistically analyzed. The women in each group were matched with regard to mean age, gravidity, parity and menopausal status. Results: We found increased prevalence of metabolic syndrome, diabetes, general and abdominal obesity, hypertension, elevated levels of glucose, total cholesterol and LDL-cholesterol and reduced levels of HDL-cholesterol among women with endometrial carcinoma and hyperplasia. These results were detected particularly in postmenopausal (450 years) women compared to pre-menopausal cases (550 years). All metabolic parameters were similar between hyperplasia and cancer groups. Conclusion: Metabolic syndrome and its components have been shown to have profound impacts on initiation and progession of endometrial pathology, particularly during postmenopausal period.
