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Öğe Association of FSH receptor gene polymorphism with menarche age(TAYLOR & FRANCIS LTD, 2016) Kerimoglu, Ozlem Secilmis; Pekin, Aybike; Yilmaz, Setenay; Incesu, Feyza; Nergiz, Suleyman; Dogan, Nasuh; Acar, Hasan[Abstract not Available]Öğe Effect of the percentage of body fat on surgical, clinical and pathological outcomes in women with endometrial cancer(WILEY, 2015) Kerimoglu, Ozlem Secilmis; Pekin, Aybike; Yilmaz, Setenay Arzu; Yavas, Guler; Beyhekim, Fatma; Demirtas, Ayse Ayda; Dogan, Nasuh UtkuAimThis study used the measure of percentage of body fat (%BF) to define obesity and evaluated the effect of percentage of %BF on clinical, surgical and pathological features in women with endometrial cancer. MethodsBetween 2011 and 2013, bioelectrical impedance analysis and body size measurements of 94 patients whose endometrial biopsy revealed endometrial cancer were obtained. Patients were divided into two groups according to body mass index (BMI) (normal, <30kg/m(2); elevated, 30kg/m(2)), and also classified by %BF (normal, <32%; elevated, 32%). ResultsThe patients' mean age was 55.010.9 years. Mean %BF and BMI were 40.8%+/- 9.8% and 32.9 +/- 7.5, respectively. Eighty-three (88%) patients were obese according to %BF; 54 (57%) were obese according to BMI. Patients with elevated %BF were more likely to have less than 50% myometrial invasion (P=0.004). Significantly more para-aortic lymph nodes were retrieved in patients with normal %BF or BMI (P<0.001, P<0.001). Patients with elevated %BF had longer operating times (P=0.043) and were more likely to have stage I disease than patients with normal %BF (P<0.001). ConclusionEndometrial cancer patients with an elevated %BF are more likely to have stage I disease and less than 50% myometrial invasion than patients with normal %BF. Defining obesity by BF may provide better estimation of obesity prevalence in patients with endometrial cancer and further understanding the relationship between BF with endometrial cancer may give more information about the effects of obesity on endometrial cancer.Öğe Ektopik Gebelik Olgularında Tedavi Seçenekleri ve Başarı Oranlarımız(2014) Kerimoğlu, Özlem Seçilmiş; Kebapçılar, Ayşe Gül; Pekin, Aybike; Yılmaz, Setenay Arzu; Beyhekim, Fatma; Çelik, ÇetinGiriş: Bu çalışmanın amacı kliniğimizde son üç yılda ektopik gebelik tanısı ile tedavi edilen hastaların tanı ve tedavi yaklaşımlarının irdelenerek tedavi başarı oranlarımızın belirlenmesidir. Gereç ve yöntem: 2010 ve 2013 tarihleri arasinda ektopik gebelik tanısı alan ve tedavi edilen toplam 77 olgu retrospektif olarak incelendi. Bulgular: Vakalarımızın yaş aralığı 20-44 yaş olup, ortalaması 29.27 4.99 olarak saptandı. Olgularımızın ektopik gebelik yerleşim yeri 74 (% 97) tubal, 1(% 1) servikal, 1(% 1) ovaryal ve 1(% 1) ise sezeryan skar hattı idi. Metotreksat tedavisine yanıt % 68.5 olarak hesaplandı. Maternal mortalite görülmedi. Sonuç: Ektopik gebelik fertiliteyi etkilemesi, mortalite ve morbiditesinin yüksek olması bakımından günümüzde hala önemini koruyan bir hastalıktır.Öğe Endometrium Kanserli ve Endometrial Hiperplazili Hastaların Preoperatif ve Postoperatif Trombosit ve Lökosit Sayılarının Değerlendirilmesi(2012) Doğan, Nasuh Utku; Çelik, Çetin; Seçilmiş Kerimoğlu, Özlem; Pekin, Aybike; Talaş, HasanAim: To investigate association between preoperative and postoperative complete blood counts and malignant process in patients with endomatrial cancer and endometrial hyperplasia. Materials and Methods: 51 endometrial cancer and 23 endometrial hyperplasia patients were included. Preoperative and postoperative blood count values were retrospectiveley evaluated in two groups. Results: 43 out of 51 cancer patinets had early stage disease, 8 had advanced disease. 15 out 23 hyperplasia patients had complex atypia while 15 had simple hyperplasia without atypia. There were no association between preoperative and postoperative thrombocyte and leukocyte count in patients with endometrial cancer or atypical hyperplasia. But endometrial cancer patients with advanced disesase had higher preoperative leukocye count than patients with simple hyperplasia. Moreover there were no difference with regard to preoperative and postoperative blood counts between advanced stage disease and early disase. Although not significant endometrial cancer patients with advanced disease had higher preoperative leukocyte count than patinets with early stage disease. Also rate of preoperative leukocytosis for malignant patients was higher than patients with hyperplasia. Conclusion: The value of pre or postoperative complete blood count to differentiate hyperplasia from malignant endometrial disease is limited. But leukocytosis to differentiate advanced malignant disease from early stage disease could be useful.Öğe Evaluation of Toll-Like Receptor Expression with Clinicopathologic Variables in Endometrium Cancer(YERKURE TANITIM YAYINCILIK HIZMETLERI AS, 2018) Bakbak, Berat Berrin Gencoglu; Ilhan, Tolgay Tuyan; Pekin, Aybike; Kerimoglu, Ozlem Secilmis; Yilmaz, Setenay Arzu; Kebapcilar, Aysegul; Dogan, Nasuh UtkuObjectives: Clinical evidence supports the association of toll-like receptor (TLR) with abnormal cell proliferation and cancer. In this study, we investigated the expression of TLRs 2, 4, 5, and 6 in healthy endometrium and endometrium cancer to study the relationship of these receptors' expression with carcinogenesis. Methods: Patients who had undergone a hysterectomy owing to endometrium cancer (group 1, 66 patients), endometrial hyperplasia (group 2, 14 patients), and other reasons besides endometrium cancer (group 3, 20 patients as controls) were included. The cases in the first group were classified by histological type of the cancer, stage, grade, and size of the tumor. In all the cases, expressions of TLRs 2, 4, 5, and 6 were assessed, and the relationship of these receptors with clinicopathologic signs was analyzed. For immunohistochemical staining, nuclear and cytoplasmic stainings were considered positive. A Chi-squared test was used to assess the correlation of the groups. A p<0.05 was considered significant. Results: The mean ages of patients in groups 1, 2, and 3 were 59.8 (range 33-83), 48.3 (range 40-59), and 53.4 (range 38-84) years, respectively. All types of TLRs were highly expressed in both types of endometrium cancer (groups 1 and 2). TLR expression was observed with a ratio of 87.9% in group 1, 100% in group 2, and 35% in group 3. There was a statistically significant association of TLR 2 among the three groups (p=0.000). TLR 6 expression in both group 1 and group 2 was significantly higher than that in the control group (p=0.000, p=0.000, respectively). In addition, TLR 6 was higher in cases with late-stage cancer (p=0.033). Regarding tumor grade and the size of the tumor, no association was found between TLR 2 and TLR 6. Conclusion: TLR 2 and TLR 6 were significantly more expressed in cases with endometrium cancer and endometrial hyperplasia. In addition, the presence of TLR 6 may indicate the presence of late-stage endometrial cancer.Öğe Follicle-stimulating hormone receptor gene polymorphisms in women with endometriosis(SPRINGER HEIDELBERG, 2015) Kerimoglu, Ozlem Secilmis; Yilmaz, Setenay Arzu; Pekin, Aybike; Nergiz, Suleyman; Incesu, Feyzanur; Dogan, Nasuh Utku; Acar, HasanThe purpose of this study was to evaluate the influence of the follicle-stimulating hormone (FSH) receptor poymorphisms Asn680Ser and Thr307Ala on endometriosis in Turkish women. Polymorphic analysis of the FSH receptor gene was performed in 100 patients with endometriosis and 100 controls. Genomic DNA was obtained from peripheral blood leukocytes and polymorphisms were investigated using restriction fragment length polymorphism analysis. There were no significant differences in genotype frequencies of FSH receptor gene between endometriosis patients and controls. When the patients were divided into two groups according to disease severity, we found that the patients with the SS (680 Ser/Ser) or AA (307 Ala/Ala) genotype were less likely to develop stage 3-4 endometriosis compared to the stage 1-2 endometriosis group (P = 0.004; OR: 0.177, 95 % CI 0.055-0.568 and P = 0.040; OR: 0.240, 95 % CI 0.061-0.938; respectively). The distributions of FSHR polymorphisms may not have an effect on endometriosis development but they are associated with the severity of the disease. The polymorphisms encoding SS at the position 680 and AA at the position 307 and the patients with the genotype that included alanine or serine were less likely to develop stage 3-4 endometriosis compared to the stage 1-2 endometriosis group.Öğe Is the Mean Platelet Volume a Predictive Marker of a Low Apgar Score and Insulin Resistance in Gestational Diabetes Mellitus? A Retrospective Case-Control Study(PREMCHAND SHANTIDEVI RESEARCH FOUNDATION, 2016) Kebapcilar, Levent; Kebapcilar, Ayse Gul; Ilhan, Tolgay Tuyan; Ipekci, Suleyman Hilmi; Baldane, Suleyman; Pekin, Aybike; Kulaksizoglu, MustafaIntroduction: Gestational diabetes is defined as various degrees of glucose intolerance diagnosed or detected for the first time during pregnancy and is the most common metabolic complication of pregnancy. Early diagnosis and adequate treatment are important to prevent complications. Preeclampsia, polyhydramnios, fetalmacrosomia, and operative delivery are some of the complications seen in pregnant women diagnosed with Gestational Diabetes Mellitus (GDM). Aim: The present study was designed to determine whether there was an association between Mean Platelet Volume (MPV) in predicting poor fetal outcome, insulin resistance, neonatal Apgar scores and gestational age for women with GDM. Materials and Methods: In this retrospective study, we enrolled 101 pregnant women with GDM together with a group of 138 healthy controls. MPV, insulin and homeostatic model assessment (HOMA-IR) values were measured at 24-28 weeks of the pregnancy. An independent samples t-test was used to compare MPV values. Multivariate linear regression models were used to establish relations between MPV values, HOMAIR, insulin levels and Apgar score. Results: There was a significant positive correlation between MPV values, HOMA-IR and Insulin levels and a negative correlation with Apgar score at 1 min and 5 min in the GDM group (r=0.227, p=0.02; r=0.206, p=0.03; r=-0.485, p<0.001; and r=-0.399, p<0.001, respectively). In the multivariate logistic regression analysis, a high MPV value was most consistently associated with a low Apgar 1 min score (beta=-0.387, p=0.003) in the GDM group. An MPV of >8.0 fL had a sensitivity of 82% and a specificity of 75% for the prediction of GDM. Conclusion: We investigated the potential of MPV values in predicting low Apgar scores and insulin resistance in women with GDM.Öğe Sezaryen Skar Gebeliği: Dilatasyon Ve Küretaj İle Tedavi Edilen Beş Olgunun Literatür Eşliğinde Değerlendirilmesi(2016) Kebapçılar, Ayşe Gül; İlhan, Tolgay Tuyan; Avşar, Nilgün; Yılmaz, Setenay Arzu; Pekin, Aybike; Çelik, ÇetinSezeryan skarında implantasyon gösteren gebelik, dış gebeliğin en nadir formu olup hayati tehlike içerebilen klinik bir durumdur.Sezeryan skar gebeliğinin 2226 gebelikten birinde görüldüğü bildirilmiştir. Bununla beraber sezaryen skar gebeliklerinin (SSG) insidansı son yıllarda giderek artmaktadır. Bunun nedeni ise tüm dünyada artan sezaryen oranları ve gebeliğin erken dönemlerinde transvajinal ultrasonografinin (USG) daha sık kullanımıdır.(1,2) Bunun yanında eski sezaryanlı olgularda ise skar gebeliği için artmış risk faktörleri; dilatasyon ve küretaj öyküsü, plasental patoloji, dış gebelik öyküsü ve yardımcı üreme tekniklerinin kullanımıdır (3,4). SSG uterin rüptür, hemoraji gibi hayatı tehdit eden komplikasyonları olabilen bir durumdur(5) Olabildiğince erken tanı ve tedavinin yapılması gereklidir.(6) Patofizyolojisinde, embriyonun skardaki mikroskopik ayrılma noktasına olan penetrasyonu sorumlu tutulmaktadır.(7) Bu durum önceden geçirilen sezeryan, miyomektomi, metroplasti operasyonları, küretaj, histeroskopi ve plesentanın elle alınması gibi müdahaleler sonrası meydana gelebilir. Diğer bir mekanizma ise IVF veya embriyo transferi sırasındaki intramural implantasyondur.(8) Literatür incelemeleri bu hastaların %54'ünün birden fazla sezaryen operasyonu geçirdiğini ortaya koymaktadır.(3) Tanı için transvajinal ultrasonografi ve Doppler ultrasonografi önerilmektedir.(9) Geçmişte erken tanı koyulamadığı için; tek tedavi maternal morbidite, masif hemoraji ve uterin rüptür nedeniyle ölümü önlemek için acil laparotomi ve gerektiğinde histerektomi yapmaktı. Ancak bugün için tedavide koruyucu seçeneklerde mevcuttur. Uterusu koruyucu seçenekler cerrahi (laparoskopik ya da laparotomik alt segment eksizyonu, histeroskopi, küretaj), medikal (sistemik ya da lokal metotreksat enjeksiyonu, lokal potasyum klorür (KCl) enjeksiyonu) ve minimal invaziv girişimler (selektif arter embolizasyonu) olarak sıralanabilir. Nadir görülmesi nedeniyle sezaryen skar gebeliğine dair veriler çoğunlukla olgu sunumlarına dayanır. Bu nedenle tanı ve tedavisi üzerinde fikir birliğine varılmış bir klinik yönetimi bulunmamaktadır(10). Bu yazıda dilatasyon-küretaj ile başarılı bir şekilde tedavi edilmiş sezaryen skar gebeliğine sahip beş olgumuzu literatür eşliğinde sunmayı amaçladık.
