Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item A New Technique for the Removal of A Transmigrated Intrauterine Device with Rectum Penetration(2015) Toprak, Erzat; Gokturk, Huseyin Savas; Tolu, Ahmet; 0000-0002-2877-1232; 0000-0002-2877-1232; 25698284; GRR-9885-2022; ABI-5902-2020Item Impaired Coronary Microvascular Function and Increased Intima-Media Thickness in Preeclampsia(2014) Ciftci, Faika C.; Caliskan, Mustafa; Ciftci, Ozgur; Gullu, Hakan; Uckuyu, Ayla; Toprak, Erzat; Yanik, Filiz; https://orcid.org/0000-0002-6463-6070; https://orcid.org/0000-0003-2579-9755; https://orcid.org/0000-0002-2877-1232; 25455007; A-7318-2017; IXD-5147-2023; GRR-9885-2022There is an association between preeclampsia (PE) and excessive morbidity and mortality. Some recent studies have revealed the presence of endothelial dysfunction in PE patients with inflammatory activity. Moreover, it has been argued that the chronic inflammatory state involved in PE leads to an acceleration in atherosclerosis. Accordingly, our goal in this study is to determine whether there is any coronary microvascular dysfunction and increase in the intima-media thickness in patients who had mild PE 5 years before, without the presence of any traditional cardiovascular risk factors. The study included 33 mild PE patients (mild preeclampsia is classified as a blood pressure (BP) of 140/90 mm Hg or higher with proteinuria of 0.3 to 3 g/d) whose mean age was 33.7 years old, and 29 healthy women volunteers whose mean age was 36.1 years old. Each subject was examined using transthoracic echocardiography 5 years after their deliveries. During the echocardiographic examination, coronary flow reserve (CFR) and carotid intima-media thickness (IMT) were measured. There was a statistically. lower CFR value in PE patients as compared with controls (2.39 +/- 0.48 vs. 2.90 +/- 0.49; P < .001). On the other hand, there was a significant increase in their IMT and high-sensitivity C-reactive protein (hs-CRP) values (respectively, 0.59 +/- 0.15 vs. 0.46 +/- 0.10; P < .001 and 3.80 +/- 2.10 vs. 2.33 +/- 1.79; P = .004). There was a negative correlation between the CFR values of the PE patients and hs-CRP (r = -0.568; P = .001) and IMT (r = -0.683, P < .001) results. We deteinfined in the study that there was impaired CFR and increased carotid IMT in patients with PE, and, moreover, that these adverse effects were significantly correlated with hs-CRP. (C) 2014 American Society of Hypertension. All rights reserved.Item Does the Presence of Endometrial Polyp Predict Colorectal Polyp ?(2016) Unler, Gulhan Kanat; Gokturk, Huseyin Savas; Toprak, Erzat; Erinanc, Ozgur Hilal; Korkmaz, Huseyin; https://orcid.org/0000-0003-0182-002X; https://orcid.org/0000-0002-2877-1232; https://orcid.org/0000-0003-1401-6356; 26897266; ABI-5902-2020; AAL-1268-2021Introduction: Endometrial polyps (EPs) and colorectal polyps (CPs) are common disorders and the incidence of both increase rapidly with aging. CPs are focal lesions and incidence increases with age. Aim: In this study, we aimed to analyze retrospectively the relationship between the EPs and CPs sharing similar clinical and genetic factors in their etiopathogenesis. Materials and Methods: This study was retrospectively performed between 2010 and 2013 and it included patients diagnosed to have eEPs. The study group and the control group consisted of patients who were diagnosed with or without EPs and who underwent colonoscopy at the same period. Results: The study group was formed by 57 patients with diagnosis of EP who underwent colonoscopy during the same period. The control group consisted of 71 patients without EP examined with colonoscopy. Among 128 patients assessed in this study, 24 were diagnosed with CPs, all of which were adenomatous polyps smaller than 1 cm. No hyperplastic or inflammatory polyps were diagnosed. While 18 of 57 patients with EPs had CPs, 6 of 71 control subjects had CPs. Hence, the risk of having CP was 5 times greater in patients with EP compared to those without (P < 0.05). Conclusion: The present study demonstrated that the prevalence of CPs increased significantly in postmenopausal patients with EPs. Recommending colonoscopy to these patients irrespective of age may be beneficial for detecting more CPs and preventing colorectal cancer.Item Increased Expression of Nestin and VEGF in Endometrial Polyps: An Immunhistochemical Study(2016) Erinanc, Hilal; Toprak, Erzat; 0000-0003-1401-6356; 0000-0002-2877-1232; AAL-1268-2021; ABI-5902-2020; GRR-9885-2022Background: Pathogenesis of endometrial polyps have not been fully understood however the increased proliferation of blood vessells and fibrosis may play an important role in the pathogenesis of endometrial polyps. Vascular endothelial growth factor (VEGF) is a a key regulator of angiogenesis and vascular function. Nestin is another molecule which has been reported to be associated with the process of angiogenesis. The aim of this study was to evaluate the expression of Nestin protein and VEGF in pathogenesis of endometrial polyps. Methods: A total of 20 women who had hysteroscopic and histologic confirmation of benign endometrial polyps and their normal endometrial tissue were recruited into the study. Immunohistochemical analysis for VEGF, Nestin and CD34 were performed on formalin fixed, paraffin-embedded tissue using the streptavidin-biotin-peroxidase technique. Angiogenesis was assessed by immunohistochemistry using monoclonal antibody against CD34. Results: Immunostaining of VEGF in glandular epithelial cells and stromal fibroblasts, and immunostaining of Nestin in newly formed vessels were determined. Immunopositivity staining of VEGF in endometrial polyps were significantly stronger than normal endometrium (P<0.05). Nestin expression was observed in vessels which were smaller than that of CD34-positive preexisting large blood vessels. Endometrial polyps demonstrated significantly greater expression of Nestin in proliferating endothelial cells, compared with control endometrium (P<0.05). Conclusion: This study suggests that the increased expression of VEGF and Nestin protein which are may have a role in the pathogenesis of endometrial polyps.Item The Relationship Between Placental Transfusion, and Thymic Size and Neonatal Morbidities in Premature Infants - A Randomized Control Tiral(2018) Silahli, Musa; Duman, Enes; Gokmen, Zeynel; Toprak, Erzat; Gokdemir, Mahmut; Ecevit, Ayse; 0000-0002-2746-0547; 0000-0002-2877-1232; 0000-0002-5676-2747; 0000-0002-2232-8117; 30410129; AAX-9343-2021; AAJ-8069-2021; ABI-5902-2020; N-4174-2014; AAJ-4616-2021Objectives: To compare the effect of umbilical cord milking and early cord clamping on thymic size, and neonatal mortality and morbidity in preterm infants. Methods: This single-center, prospective, double-blind, randomised controlled study was conducted at Baskent University, Konya Education and Research Centre, Konya, Turkey, between October 2015 and April 2016. Pregnant women who delivered before 32 weeks of gestation were randomised to receive umbilical cord milking (group 1) or early cord clamping (group 2). Ultrasonographic evaluation was performed in each newborn by an experienced radiologist within the first 24 hours of life. Thymic size was estimated in line with literature. SPSS 15 was used for all data analyses. Results: There were 38 subjects in group 1 and 37 in group 2. There were as many infants in the two groups (p>0.05) The haemoglobin levels was higher in group 1, but not significantly (p=0.213). The absolute neutrophil count in group 1 was significantly lower (p=0.017) than group 2. In terms of neonatal mortaility and morbidity, there were no significant differences between the groups (p>0.05). Conclusion: Umbilical cord milking was not associated with thymic size during the the first 24h of life.Item Vesicouterina fistula: Youssef's syndrome(2015) Cicek, Tufan; Duman, Enes; Toprak, Erzat; Kosan, MuratVesico-uterin fistula is a rare type of fistulas and can be diagnosed frequently after surgery. First described by Youssef in 1957. Clasically findings are; cyclic haematuria without urinary incontinence and secondary amenorrhea. The patient was referred to our clinic for cyclic hematuria and she was diagnosed with vesicouterine fistula by radiological imaging methods and a cystoscopy procedure. Being a rare occurrence, this case was reported with a discussion of the relevant literature.Item Polycystic Ovary Syndrome: The Correlation Between Renal Doppler Ultrasound and Laboratory Parameters(2016) Karadeli, Elif; Uckuyu, Ayla; Ciftci, Faika Ceylan; Toprak, Erzat; Turhan, Erdem; Ozcimen, Emel; Niron, Emin AlpAim: To investigate whether there is alteration both right and left kidney lenght, parenchymal thickness, renal arterial, venous blood flow measurements in normotensive reproductive age women with polycystic ovary syndrome (PCOS). Material and Method: Forty women with PCOS according to Rotterdam criteria and thirty-six healthy volunteers women were included in our study. Hormonal, biochemical analysis, renal Doppler ultrasonography were performed and were investigated in terms of both left and right renal lenght, parenchymal thickness, peak systolic velocity (PSV), resistive index (RI), venous impedance index (VI), metabolic characteristics having insulin resistance, impaired glucose tolerance, serum lipid concentration. The student t test and pearson corelation test were used for statistical analysis. Results: The measurements for kidneys were not different between women with PCOS and healthy women. The peak systolic velocity of mean renal artery was lower in PCOS group. The mean renal venous impedance also was higher in PCOS group than control group. The mean renal resistive index was slightly higher in PCOS but not statistical significant. In bivariate corelation analyse including all patients, it was seen that BMI, WHR, level of serum fasting glucose, insulin, LDL, trigliserides were positively related with mean renal length and mean parenchymal thickness measurements. Discussion: We found that there was alterations kidney blood flow in normotensive reproductive age women with PCOS. This findings may indicate results of long term renal and cardiovascular complications of PCOS.Item Platelet-to-lymphocyte ratio: A new inflammatory marker for the diagnosis of preterm premature rupture of membranes(2017) Ozcimen, Emel Ebru; Toprak, Erzat; Bozkurt, Murat; Cakmak, Burcu Dincgez; Silahli, Musa; Yumru, Ayse Ender; Caliskan, Eray; 0000-0002-2877-1232; 28890425; ABI-5902-2020Objective: Preterm premature rupture of membranes (PPROM) is closely related with maternal and fetal complications. Therefore, early diagnosis is extremely important to provide maternal and fetal well-being. Many inflammatory markers have been evaluated for their ability to diagnose membrane rupture at early stages. We aimed to investigate the relationship between the platelet-to-lymphocyte ratio (PLR) and preterm premature membrane rupture. Material and Methods: In this study, 121 pregnant women with PPROM and 96 age-matched pregnant women with spontaneous preterm labor who were admitted to our hospital between January 2014 and December 2015 were enrolled. Demographic data, complete blood cell count results, and neonatal outcomes were recorded. Results: The neutrophil and platelet counts were higher in the PPROM group (9948.4 +/- 3393.2 vs. 7466.1 +/- 1698.5/mm(3) and 244.5 +/- 60 vs. 210.6 +/- 64.8/mm(3), respectively, p<0.001). The PLR and neutrophil-to-lymphocyte ratios (NLR) were both significantly higher in the PPROM group (p<0.001). Correlation analysis revealed that the PLR was positively correlated with the NLR (r=0.10, p=0.031). The ability of the PLR to diagnose preterm premature rupture of membranes was evaluated using an ROC curve. The sensitivity and specificity of the PLR was 57.8% and 73.7%, respectively, at a threshold >117.14 (p<0.001). Conclusion: The PLR might be a cost effective, easy to use, and practical marker for the early diagnosis of PPROM, which can help to determine the appropriate waiting time for delivery and provide maternal and fetal well-being.