Browsing by Author "Koltan, SO"

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    Can mean platelet volume and platelet distrubition width be possible markers for ectopic pregnancy and tubal rupture?
    Ulkumen, BA; Pala, HG; Calik, E; Koltan, SO
    Objective: We aimed to evaluate the alterations in serum levels of platelet indices such as mean platelet volume (MPV) and platelet distribution width (PDW) in ectopic pregnancy (EP) and discuss the mechanism of the alterations in MPV and PDW. Methods: This retrospective evaluation of 153 tubal EP patients (39 ruptured and 114 non-ruptured) admitted to our clinic between 2009 and 2013 and 67 healthy pregnancies was conducted. The data regarding the maternal age, hemoglobin level, platelet level, MPV, PDW was analyzed. Results: MPV was lower in the EP, especially in ruptured EP, compared to control group. However, no significant difference could be found between the groups (p=0.616). PDW was higher in the EP, especially in ruptured EP, compared to control group, however there was no statistical difference between the three groups (p=0.451). Platelet counts were significantly lower in ruptured EP compared to non-ruptured ectopic pregnancies and control groups (p=0.005). Conclusions: MPV seems to be lower in ruptured EP suggesting the possible high grade inflammation in pathology. Platelet counts tend to be lower in ruptured EP suggesting the consumption of the platelets at the inflammation site. However, further studies are needed to describe the usefulness of the platelet indices in the diagnosis and clinical follow-up of ER Our preliminary results show that MPV levels may decrease in the ruptured EP cases. At the same time, PDW levels may increase.
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    Effect of Pirfenidone on Vascular Proliferation, Inflammation and Fibrosis in an Abdominal Adhesion Rat Model
    Hasdemir, PS; Ozkut, M; Guvenal, T; Uner, MA; Calik, E; Koltan, SO; Koyuncu, FM; Ozbilgin, K
    Aim: To study the efficacy of pirfenidone for prevention of postoperative adhesion formation in an adhesion rat model. Materials and Methods: Eighteen female Wistar rats were subjected to right-sided parietal peritoneum and right uterine horn adhesion model. Rats were randomized into three groups: group 1 (control) (closure of midline abdominal incision without any agent administration), group 2 (closure of incision after intraperitoneal administration of pirfenidone), and group 3 (closure of incision and only oral administration of pirfenidone for 14 days). Relaparotomy was performed 14 days after the first surgery. Effect of pirfenidone on adhesion formation was assessed on light microscopy by scoring vascular proliferation, inflammation, fibrosis, and collagen formation in the scarred tissue. Effect of pirfenidone on inflammation was assessed by measurement of transforming growth factor-beta and interleukin-17 levels in scarred tissue. Results: The degree of vascular proliferation (1.32 +/- 0.39 versus 2.34 +/- 0.46, p < 0.001), inflammation (1.60 +/- 0.70 versus 2.60 +/- 0.52, p < 0.01), and fibrosis (1.50 +/- 0.53 versus 2.40 +/- 0.52, p < 0.01) were less prominent in group 2 compared to group 1, respectively. Only vascular proliferation was found to be less prominent in group 3 compared to group 1 (1.60 +/- 0.42 versus 2.34 +/- 0.46, p < 0.01). Intraperitoneal and oral administration of pirfenidone reduced tissue levels of inflammatory markers (TGF-beta and IL-17) in parietal and visceral peritoneum compared to control group. Intraperitoneal administration of pirfenidone compared to oral administration was more effective in reducing tissue levels of inflammatory markers. Conclusion: Pirfenidone is an effective agent on the prevention of postoperative vascular proliferation, inflammation and fibrosis in scarred tissue particularly with intraperitoneal administration.
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    Chronic Cervical Perforation by an Intrauterine Device
    Koltan, SO; Tamay, AG; Yildirim, Y
    The intrauterine device (IUD) is a widely used, highly effective method of birth control. Uterine perforation is a rare yet serious complication and is usually seen during insertion of the IUD. A regular examination is necessary for follow-up. We present a patient with an IUD that had perforated the cervix. The diagnosis was made during routine gynecological examination, and the patient was treated in a timely manner before any complications such as ectopic pregnancy, intrauterine pregnancy, infection or irreversible harm to the cervix arose. This case stresses the importance of regular visits to maintain health and diagnose possible adverse effects of intrauterine contraceptive methods. [J Chin Med Assoc 2010;73(6):325-326]
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    Platelet distribution width (PDW): A putative marker for threatened preterm labour
    Ulkumen, BA; Pala, HG; Calik, E; Koltan, SO
    Objective: To determine the alterations of mean platelet volume (MPV), platelet distribution width (PDW), platelet level and hemoglobin level in pregnancies with threatened preterm labor (TPL). Methods: The retrospective analysis of 201 pregnant women with threatened preterm labour admitted to our clinic between 2009 and 2013 and 192 healthy pregnancies was conducted. The data regarding the maternal age, hemoglobin level, platelet count, mean platelet volume (MPV), platelet distribution width (PDW) was evaluated. Results: The mean MPV and hemoglobin levels were significantly lower in TPL group (p=0.001 and p=0.01, respectively). PDW levels were significantly higher in TPL group (p=0.05). (p=0.01). Regarding the platelet count, there was no statistically significant difference between the TPL and control groups. ROC curve analysis for PDW revealed an area under curve (AUC) 66.8%. By using a cut-off value 16.15 for PDW, sensitivity was 76.1% and specificity was 43.5% for TPL. Conclusion: MPV seems to be lower in threatened preterm deliveries, whereas PDW levels were increased suggesting the possible high grade inflammation and platelet activation in the pathology. Anemia occurs more frequently in threatened preterm delivery. Increased PDW levels especially > 16.15 may alert the obstetrician for the risk of the preterm delivery. However, further studies are needed to state the usefulness of the platelet indices in the diagnosis and clinical follow-up of preterm labor.
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    Decreased maternal serum cortistatin levels in pregnancies with gestational diabetes mellitus
    Akbas, M; Koltan, SO; Koyuncu, FM; Ulkumen, BA; Taneli, F; Ozdemir, H
    Objective: To investigate serum cortistatin levels in women with gestational diabetes mellitus (GDM) and women with uncomplicated pregnancies. Material and methods: This case-control study consisted of 40 pregnancies with GDM and 41 healthy singleton pregnancies matched for maternal and gestational age. The maternal serum levels of cortistatin were measured with enzyme-linked immunosorbent assay and compared between groups. Results: Cortistatin levels were significantly lower in GDM group (48.85 +/- 20.18 versus 65.84 +/- 33.98 ng/ml, p = .008). There was a statistically significant difference in cortistatin levels between different treatment modalities and control group (chi(2)(2) = 8.828, p = .012). Pairwise comparisons showed that diet group had significantly lower CST levels than control group (p = .012). Serum cortistatin levels were negatively correlated with serum insulin and glucose levels and HOMA-IR (r = -0.358, p = .001; r = -0.303, p = .006; r = -0.444, p < .001, respectively). Conclusion: Cortistatin levels were significantly lower in GDM pregnancies and related to serum insulin and glucose levels and HOMA-IR in pregnancy. This may help to better clarify the mechanism of GDM pathogenesis.
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    MANAGEMENT OF ECTOPIC PREGNANCY: A RETROSPECTIVE ANALYSIS OF 74 CASES
    Tamay, AG; Yildirim, Y; Koltan, SO; Adiyeke, M; Koyuncu, FM
    Objective: To analyse different management strategies of ectopic pregnancy and their effectiveness retrospectively. Materials and methods: Seventy four patients with a diagnosis of ectopic pregnancy who applied to Celal Bayar University Obstetrics and Gynecology Department between November 2006 - July 2009 have been evaluated. Results: Forty four patients with a diagnosis of ectopic pregnancy have received methotrexate therapy, 23 patients were surgically treated and 7 patients were managed expectantly. The success rate of methotrexate was found to be 90.9% and indications for surgery were rupture and cornual pregnancy. Conclusion: Early diagnosis of ectopic pregnancy is important for the prevention of morbidity and mortality. Methotrexate treatment, surgical intervention or expectant management prove successful in correctly chosen patients with low complication rates.
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    DETECTION OF HPV E6/E7 MRNA USING NUCLISENS EASYQ HPV™ IN ABNORMAL CYTOLOGY SPECIMENS
    Guvenal, T; Birge, O; Ulkumen, BA; Akcali, S; Sanlidag, T; Koltan, SO; Koyuncu, FM; Kandiloglu, AR
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    Relationship between women's attitude towards menopause and quality of life
    Yanikkerem, E; Koltan, SO; Tamay, AG; Dikayak, S
    Objectives The aim of the study was to assess the symptoms of women and to describe the relationship between women's attitude towards menopause and quality of life. Methods This study was conducted from November 2010 to April 2011 at Celal Bayar University Faculty of Medicine and 494 women agreed to participate in the study. Women's attitudes towards menopause and quality of life were evaluated by Menopause-specific Quality of Life (MENQOL) questionnaires. Results Women with no education had the highest scores for vasomotor, psychosocial and physical cluster symptoms (4.1 +/- 2.0, 3.1 +/- 1.6, 3.2 +/- 1.4, respectively). Vasomotor (4.0 +/- 1.9) and physical quality-of-life scores (3.2 +/- 1.40) were significantly higher among housewives. Psychosocial (3.6 +/- 1.8) and physical scores (3.5 +/- 1.5) of women who had no health insurance were found to be higher. The highest scores reported by the women were as follows: vasomotor, physical, psychosocial and sexual cluster (3.8 +/- 1.9, 3.1 +/- 1.4, 2.9 +/- 1.6, 2.7 +/- 1.8, respectively). Women with a negative attitude towards menopause were associated with more frequently reported symptoms compared to women with a positive attitude. The women whose relationships with their husband were negatively affected had higher vasomotor, psychosocial, physical, and sexual symptom scores (4.2 +/- 1.7, 3.7 +/- 1.7, 3.5 +/- 1.5, 3.5 +/- 1.8). Similarly, the vasomotor, psychosocial, physical, and sexual symptom scores were high in women who declared an unfavorable relationship with their children (4.5 +/- 1.8, 3.8 +/- 1.6, 3.7 +/- 1.4, 3.2 +/- 1.9). Conclusion Health-care professionals should understand women's attitudes towards menopause, in order to give optimal information and help the women create positive attitudes and healthy perceptions of this period of life.
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    Evaluation of the effects of gonadotropin-relasing hormone antagonist (GnRH-ant) and agonist (GnRH-a) in the prevention of postoperative adhesion formation in a rat model with immunohistochemical analysis
    Tamay, AG; Guvenal, T; Micili, SC; Yildirim, Y; Ozogul, C; Koyuncu, FM; Koltan, SO
    Objective: To investigate the effects of GnRH antagonist (GnRH-ant) and agonist (GnRH-a) in the prevention of postoperative pelvic adhesions by a visual scoring system and immunohistochemical methods in a rat uterine horn model. Design: Controlled experimental animal study. Setting: Animal laboratory at an academic research environment. Animal(s): Twenty-one Wistar albino rats. Intervention(s): Rats were randomized into three groups. One week before the operation the rats received either GnRH-ant or GnRH-a or saline solution; they then underwent surgical laparotomy, and both uterine horns were traumatized by a scalpel. Three weeks later, all rats were sacrificed and extension and severity of the adhesions in each group were scored by a visual scoring system. Adhesion tissues were evaluated immunohistochemically for vitronectin and u-PAR. Main Outcome Measure(s): Scores of extend and severity of adhesions and staining of vitronectin and u-PAR. Result(s): The extent of adhesion scores were 1.85 +/- 0.86, 0.78 +/- 1.05, and 0.42 +/- 0.64, and the severity of adhesion scores were 1.71 +/- 0.91, 0.57 +/- 0.85, 0.50 +/- 0.75 for control, GnRH-ant, and GnRH-a groups, respectively. The extent and severity of adhesions were significantly lower in both GnRH-ant and GnRH-a groups when compared with the control group. Adhesion extent scores in the GnRH-a group were lower than in the GnRHant group, but this difference was not significant. vitronectin and u-PAR staining were significantly greater in both the GnRH-ant and GnRH-a groups than in the control group. Conclusion(s): GnRH-ant as well as GnRH-a reduced postoperative adhesion formation in a rat model. This finding was supported immunohistochemically by vitronectin and u-PAR staining. (Fertil Steril (R) 2011; 96: 1230-3. (C) 2011 by American Society for Reproductive Medicine.)
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    The effect of clomiphene citrate on osteoporosis in ovariectomized rats
    Uyar, Y; Koltan, SO; Pögün, S; Vatansever, S; Çaglar, H
    Objective The aim of this study was to investigate whether clomiphene citrate (CC) administration could be a new therapeutic agent in case of contraindication of estrogen therapy for hormone-dependent osteoporosis and to show the changes in bone structure by histomorphometric analysis in ovariectomized rats administered CC. Study design This study was carried out in the Experimental Surgery Laboratory of the Brain Research Centre of the Medical Faculty of Ege University. Four-month-old Sprague-Dawley rats were used for the experiment. The study was carried out on six groups of animals each consisted of eight rats. Four groups of rats were ovariectomized and 2 groups of rats were used as control group. For 6 weeks every day, rats were injected physiological saline solution (1 ml/kg), clomiphene citrate (1 or 10 mg/l ml/kg, Organon), 17 beta-estradiol (50 mu g/l ml/kg, within susame oil, Sigma) or susame oil (1 ml/kg, Sigma). Drug administrations were carried out according to the weekly weight measurements. Group 1(PSS), n = 8, non-ovariectomized, were injected with physiological saline solution. Group 2(CC-1), n = 7, non-ovariectomized, were injected with CC (1 mg/l ml/kg). Group 3(OVX + CC-1), n = 7, ovariectomized, were injected with CC (1 mg/l ml/kg). Group 4(OVX + CC-10), n = 6, ovariectomized, were injected with CC (10 mg/l ml/kg). Group 5(OVX + E), n = 8, ovariectomized, were injected with 17 beta-estradiol (50 mu g/l ml/kg). Group 6(OVX), n = 8, ovariectomized, were injected with susame oil (1 ml/kg) Bone-specific serum alkaline phosphatase (ALP) levels were measured and statistical analyses were made by Kruskal Wallis test. Left femur bone histomorphometric studies were done. The uteri were dissected out to measure their weight and ANOVA was used to show the intergroup differences. Results The level of ALP in group 3 was significantly higher than the other five groups. Bone histomorphometric examination showed that total bone volume in group 3, 4, and 5 was higher than group 6, and group 4 had the highest level of bone volume compared to the rest of the groups. Uterus weights in group 1 were significantly higher than group 3 and 6 (P = 0.02, P = 0.01) and uterus weights in group 5 were significantly higher than group 3 and 4 (P = 0.00, P = 0.01) Conclusions In ovariectomized rats, treatment with CC is seen as effective as estrogen treatment in preventing osteoporosis, without causing uterin hyperstimulation. Nevertheless, further investigations on more rats are needed to assess whether it is an alternative treatment method to estrogen.