Browsing by Author "Kuscu N.K."
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Item Laser therapy in chronic cervicitis(2001) Dalgic H.; Kuscu N.K.Chronic cervicitis is one of the common disorders encountered in daily practice. To overcome this problem first step should be antibiotic therapy in acute phase. If this fails, the infection becomes chronic and may spread to internal genital organs leading to pelvic inflammatory disease and eventually to infertility. Chronic form of infection may necessitate tissue destruction to prevent the development of dysplasia and neoplasm. Various methods such as electrocautery, loop diathermy, cryotherapy or laser are used to destroy the inflamed area. In this study we present 26 cases of chronic cervicitis managed with Nd-YAG laser with a success rate of 93%. We advice this method to block the development of cervical intraepithelial neoplasm.Item Clomiphene citrate does not affect the secretion of α3, αv and β1 integrin molecules during the implantation window in patients with unexplained infertility(Oxford University Press, 2001) Lacin S.; Vatansever S.; Kuscu N.K.; Koyuncu F.; Ozbilgin K.; Ceylan E.Background: The expression of integrin molecules on the endometrium suggest that certain integrins may participate in the cascade of molecular events leading to successful implantation. A prospective, controlled study was carried out to investigate the effect of clomiphene citrate (CC) on secretions of β1, α3 and αv integrin molecules in the endometrium of patients with unexplained infertility during the implantation window. Methods: A total of 40 endometrial samples was evaluated in both spontaneous (n = 13) and ensuing clomiphene-treated cycles (100 mg on days 5-9) and also from fertile women serving as controls (n = 14) during postovulatory 7th or 8th day of menstrual cycle. A semiquantitative grading system (H-score) was used to compare the immunohistochemical staining intensities. Endometrial thickness and serum oestradiol and progesterone concentrations were also measured on the day of sampling. Results: Staining of αv but not β1 and α3 integrins was significantly less intense in infertile cases than fertile control cases (1.42 ± 0.12 versus 2.21 ± 0.13 respectively, P = 0.012) and this was not restored to normal concentrations with treatment. Conclusions: Our study indicated that cc treatment significantly decreased the endometrial thickness and increased oestradiol and progesterone concentrations. However, secretion of αv, β1 and α3 integrin molecules, which might play a role in implantation, was not affected.Item Insulin and oral antidiabetic agents for treatment of polycystic ovary syndrome.(2002) Kuscu N.K.; Koyuncu F.M.Insulin plays a major role in polycystic ovary syndrome (PCOS). Insulin resistance and resultant hyperinsulinemia stimulate both the ovary and adrenal to produce androgens. Oral antidiabetic agents have been used to alleviate the symptoms and to induce ovulation in women with PCOS. This review focuses on the relation between insulin and PCOS and discusses the use of oral antidiabetic agents.Item Immunohistochemical staining of IGF-I, IGF-binding proteins-1 and -3, and transforming growth factor beta-3 in the umbilical cords of preeclamptic patients(2002) Inan S.; Vatansever S.; Kuscu N.K.; Laçin S.; Ozbilgin K.; Koyuncu F.Background. To detect the immunoreactivity of insulin-like growth factor-I, insulin-like growth factor-binding proteins-1 and -3 and transforming growth factor beta-3 in the umbilical cords of normal and preeclamptic patients. Methods. Umbilical cords were obtained from 15 normal and 15 preeclamptic patients. Immunoreactivities were determined using either indirect immunofluorescence or immunoperoxidase techniques on formalin-fixed, paraffin-embedded sections. Staining intensity was graded by a semiquantitative scoring method. The results were compared by Mann-Whitney U-test. Results. The umbilical cords were thinner and the vessels were hypoplastic in the preeclamptic group. Moderate staining intensity for insulin-like growth factor-I, insulin-like growth factor binding protein-1 and -3 and transforming growth factor-beta 3 was observed in normal patients. The preeclamptic group had mild and strong intensities for insulin-like growth factor-I and insulin-like growth factor binding protein-1, respectively, and intensity for insulin-like growth factor binding protein-3 did not change, but diffuse and increased intensity was observed for transforming growth factor-beta 3. Conclusion. Changes in the intensity of insulin-like growth factor-I and its major binding protein and the transformation of growth factor-beta 3 may play a role in the pathogenesis of preeclampsia by altering the structure and responsiveness of the umbilical cord.Item Increased vascular surface density in ovarian endometriosis(Parthenon Publishing Group Ltd, 2003) Inan S.; Kuscu N.K.; Vatansever S.; Ozbilgin K.; Koyuncu F.; Sayhan S.Our goal in this study was to investigate the presence of angiogenesis-related factors in endometriomas by evaluating their vascular surface densities. Thirty ovarian samples were included in the study. Of these, ten were histologically confirmed endometriomas, ten were ovarian specimens in the follicular phase and ten were ovarian specimens in the luteal phase, serving as controls. Histological specimens were immunostained for von Willebrand factor (vWF: factor VIII-related antigen) and CD34. The area with the highest microvessel density in endometriosis and in the normal ovary was evaluated by using an intercept grid. All microvessels in a specific field (x 100 magnification) were counted and vascular surface density was measured, as 164.01 ± 21.26 vs. 125.15 ± 11.28 and 117.44 ± 9.27 by using vWF, and as 172.97 ± 25.64 vs. 138.65 ± 32.21 and 120.34 ± 18.40 by using CD34 in endometriotic, follicular and luteal ovarian samples, respectively (p < 0.001). The mean vascular surface density was significantly higher in endometriosis than in the ovarian samples of the follicular phase or the luteal phase. No significant difference was seen between normal ovarian samples. Endometriosis was associated with angiogenic properties. Having demonstrated elevated angiogenic factors in endometriotic samples, we concluded that activation of angiogenesis might be a key factor in the pathogenesis of endometriosis.Item Detection of endothelial dysfunction in preeclamptic patients by using color Doppler sonography(Springer Verlag, 2003) Kuscu N.K.; Kurhan Z.; Yildirim Y.; Tavli T.; Koyuncu F.Our goal in this study was to detect endothelial function in normal and preeclamptic patients by using color Doppler sonography and plasma fibronectin levels. The increased ratio of the brachial artery diameter during shear stress, and plasma fibronectin levels were measured in 15 preeclamptic and 11 normal, gestational-age matched pregnant patients. The test was repeated at the postpartum second and sixth weeks in the preeclamptic group. In addition, the plasma fibronectin levels of all patients were measured. The increased ratios were 4.26±0.69% vs 12.18±1.97% in the preeclamptic and normal patients, respectively (P=0.003). At the second and sixth postpartum weeks, the ratios were 6.67±0.89% and 9.27±1.16% in the preeclamptic group, revealing a significant improvement in the sixth week (P=0.001). Fibronectin levels were 0.80±0.11 g/L vs 0.45±0.06 g/L in preeclamptic and normal patients (P=0.01). The correlation coefficient between the fibronectin levels and increase rate was r=-0.38 and P=0.05. We conclude that endothelial dysfunction, which is fundamental to preeclampsia, can be detected by using color Doppler sonography.Item Tear function changes of postmenopausal women in response to hormone replacement therapy(2003) Kuscu N.K.; Toprak A.B.; Vatansever S.; Koyuncu F.M.; Guler C.Objective: The goal of this study was to search the effect of hormone replacement therapy (HRT) on tear function changes in postmenopausal women. Methods: Following initial ophtalmic evaluation and tear sample collection, the subjects were given daily 0.625 mg conjugated estrogen, and either continuous combined or cyclic 5 mg medroxyprogesterone acetate was added. Eye examination included visual acuity, slit-lamp examination, fundus examination, tonometry, Schirmer's test, and break up time (BUT) evaluation. Six months later, control examination was done and repeat tear samples were obtained. Tear immune globulin A (IgA) and lysozyme levels were measured by gel electrophoresis. The pictures of the bands were evaluated by digital image analysis with Scion Image program. Results: Conjunctival vascular congestion, laxity and corneal desquamation did not change before and after HRT (P>0.05). A significant improvement was noted in meibomian gland inflammation (P=0.034). We have not observed any significant difference in burning, foreign body sensation, and tearing (P>0.05). In addition, no significant difference was noted in BUT (P=0.370) and Schirmer's test values (P=0.271). Though both lysozyme and IgA levels were elevated following the therapy, only IgA levels increased significantly (P=0.04). Conclusion: HRT decreased meibomian gland inflammation and increased tear lysozyme and IgA levels in postmenopausal women. © 2002 Elsevier Science Ireland Ltd. All rights reserved.Item Interleukin-6 levels in hyperemesis gravidarum(2003) Kuscu N.K.; Yildirim Y.; Koyuncu F.; Var A.; Uyanik B.S.Introduction: Hyperemesis gravidarum (HG) is associated with higher levels of serum β-hCG levels and hyperthyroidism. Interleukin-6 (IL-6), a pro-inflammatory cytokine, is reported to enhance secretion of β-hCG from trophoblastic cell line. Methods: We measured serum levels of IL-6, thyroid hormones and β-hCG of hyperemetic patients and gestational age-matched controls to search for a difference between the two groups. Results: There was a significant difference in β-hCG (p=0.028), though IL-6 levels were higher in the hyperemetic group, it did not reach a significant level. Interleukin-6 positively correlated with β-hCG (r=0.38 and p=0.13).Item Endothelial dysfunction in preeclampsia: Increased homocysteine and decreased nitric oxide levels(2003) Var A.; Yildirim Y.; Onur E.; Kuscu N.K.; Uyanik B.S.; Goktalay K.; Guvenc Y.Endothelial dysfunction underlies the pathogenesis of preeclampsia, but its mechanism has not yet been completely understood. Elevated oxygen free radicals may partially explain the endothelial cell damage. In this study, we have aimed to measure homocysteine (Hcy) and nitric oxide (NO) levels as endothelial dysfunction markers in preeclamptic women. Nineteen preeclamptic (33.9 ± 1.4 weeks) and 15 gestational-age-matched normal pregnant women (35.5 ± 0.7 weeks) were included in the study. Mean NO level was significantly lower (p < 0.001) and mean Hcy level was significantly higher (p < 0.001) in the preeclamptic group. Elevated Hcy and oxygen free radical levels could decrease NO levels due to the reaction with each other and reduced NO may increase blood pressure and ischemia in preeclamptic patients. We have concluded that increased Hcy and oxygen free radical levels, and decreased NO levels are closely associated with preeclampsia-related endothelial dysfunction. Copyright © 2003 S. Karger AG, Basel.Item Effect of insulin on rat ovarian leptin expression by immunohistochemical staining(2003) Kuscu N.K.; Ozbilgin K.; Inan S.; Giray G.; Ceylan E.; Koyuncu F.Aim: Leptin and insulin may interact in regulating ovarian steroid synthesis. The objective of this study was to investigate immunohistochemical staining of leptin in normal rat ovarian tissues and in rats treated with insulin and insulin plus human chorinoic gonadotropin (hCG). Methods: Paraffin blocks of rat ovarian tissues from a previous study, in which 18 adult, female Wistar rats with an average weight of 250 g were divided into three groups to receive either saline solution, human insulin (2 U/day) or human insulin (2 U/day) plus hCG (4 U/day) for 4 weeks, were used in this study to compare the effects on leptin staining. The results were analysed using a semiquantitative scoring system, such as mild, moderate and strong. Results: No staining was observed in granulosa cells and theca interna cells of normal ovarian tissues. Theca externa cells had mild staining intensity (+), corpus luteum had moderate (+ +) and stroma had mild (+) staining intensity. Histological structure was impaired in the insulin group, luteinized cells had-mild staining, there was no difference in other cell groups. Only theca externa cells of the developing follicles were stained in insulin plus hCG group, luteinized cells again had mild staining. Conclusions: Besides damaging the rat ovarian structure, insulin reduced staining intensity of leptin in luteinized cells. Insulin may stimulate ovarian steroid synthesis not only through its own receptors, but also by acting on the leptin expression of these cells.Item Leptin levels in patients with polycystic ovary syndrome in response to two different oral contraceptive treatments(2003) Koyuncu F.M.; Kuscu N.K.; Var A.; Onur E.[No abstract available]Item Immunolocalization of integrins and fibronectin in tubal pregnancy(Elsevier GmbH, 2004) Inan S.; Giray G.; Vatansever H.S.; Ozbilgin K.; Kuscu N.K.; Sayhan S.Integrins are a large family of cell adhesion molecules that serve as receptors involved in cell-to-cell and cell-to-matrix interactions during implantation. We studied immunohistochemical staining of integrins (α3, αV, β1, and α2β1) and fibronectin in ectopic tubal pregnancy. Thirty fallopian tube samples with ectopic pregnancies and five normal tubal segments were obtained during ligation operations; the latter specimens served as controls in the study. Formalin-fixed paraffin-embedded tissue sections were stained with hematoxylin-eosin or primary antibodies against α3, β1, αV, and α2β1 integrins and fibronectin, using the avidin-biotin-peroxidase method. A semi-quantitative grading system was used to compare staining intensities. In the control samples, immunostaining of all integrins was found in a single layer of tall columnar epithelial cells, the lamina propria (Lp) and the muscular layer. Fibronectin staining was detected in the Lp and the muscular layer. Staining intensities of α3 and β1 integrins and fibronectin were increased in the normal part of fallopian tubes with ectopic pregnancies. Staining of β1 integrin was more intense than staining of α3 and fibronectin, whereas there was no difference in αV and α2β1 integrin expression between normal tubal tissue in the ectopic pregnancy group and control tubal tissue. In the tubal pregnancy group at the site of implantation, staining intensity of α3 and β1 integrins and fibronectin was strong in decidual cells, supporting tissue and placental villi, whereas αV and α2β1 staining was mild. We concluded that integrins, especially β1 and α3, and fibronectin may play a role in progression of tubal implantation. Although the role of integrins has not yet been clearly defined, these molecules may function as markers of normal and abnormal states of receptivity. We like to suggest that integrins and fibronectin, which are needed in utero implantation, are expressed in tubal tissues during ectopic pregnancy and are involved in ectopic implantation. © 2004 Elsevier GmbH. All rights reserved.Item Sexual life following total abdominal hysterectomy(2005) Kuscu N.K.; Oruc S.; Ceylan E.; Eskicioglu F.; Goker A.; Caglar H.Aim: The goal of this study was to evaluate the effect of total abdominal hysterectomy (TAH) on sexual lives of patients in the postoperative period. Materials and methods: Eighty-six patients who accepted to participate a phone-questionnaire were recruited in the study after TAH or TAH + BSO. They were asked about sexual desire, pain during sexual intercourse, frequency and satisfaction of sexual intercourse at pre- and postoperative periods, and loss of "feeling a woman" in the postoperative period. Sexual desire, pain during sexual intercourse, loss of "feeling a woman" questions were answered as "yes" or " no", number of weekly sexual intercourse was recorded, and satisfaction was graded as no = 0, mild = 1 and complete = 2 points. Results: While sexual desire and frequency were found to be significantly lower (p=0.026 and p=0.01 respectively), no difference was noted in dyspareunia and satisfaction. When the patients were divided into two groups according to the presence of endogenous or exogenous estrogen, no difference was seen between the two groups in the postoperative period. Conclusion: We concluded that the effect of TAH or TAH+BSO operations were mainly on sexual desire and the number of weekly intercourse, and estrogen in the postoperative period did not make any difference between the two groups. © Springer-Verlag 2004.Item Two oestrous cycles. Ten days insulin treatment reduced ovarian leptin expression of rat(2005) Ozbilgin K.; Kuscu N.K.Objective: Previous studies have reported a role for insulin in leptin secretion from rat ovarian cells although the time dependent effect of insulin has yet to be obtained. The study aim is to determine the time dependent effect of insulin on leptin staining intensity in the rat ovary. Methods: Normally cycling rats were investigated in a spontaneous cycle (control, n=6), one cycle with insulin treatment 2U/day for 5 days (D5) (n=6), and 2 cycles with insulin treatment 2 U/day for 10 days (D10) (n=6) in the Department of Histology and Embryology, Celal Bayar University, Manisa, Turkey, from May 2004 to August 2004. Histological structures and leptin staining of the ovarian cells were investigated with immunohistochemical technique and evaluated by a semi-quantitative scoring system. Results: Number of follicles and stromal cells decreased with longer insulin treatment. No leptin staining was observed in granulosa cells of all groups. Staining intensity and H-score of the controls, D5 and D1O groups were (+++)/204, (++)/80 and (+)/9.5 for theca externa cells; (+++)/289.5, (++)/126 and (+)/65 for stroma; (++)/140, (++)/70 and (+)/21 for corpus luteum. The difference between H-scores of control and D1O groups was statistically significant in all tissue types (P<0.0 1). Conclusion: Insulin treatment for 10 days (2 estrous cycles) reduced leptin-staining intensity in various tissues of the rat ovary and decreased follicle development in a time dependent manner.Item The effect of oestradiol and neta on immunohistochemical staining of iNOS and eNOS in coronary arteries of ovariectomized rats(2006) Koyuncu F.M.; Ozbilgin K.; Kuscu N.K.; Inan S.; Vatansever S.; Ceylan E.Aim: The postmenopausal period is associated with increased risk for coronary atherosclerosis, and the effect of hormone replacement therapy in reducing this risk is controversial. Previous studies reported that nitric oxide synthetase (NOS) level might be important for the development of atherosclerosis, but no study has shown the interaction between hormone replacement therapy and endothelial NOS and inducible NOS intensity on coronary arteries yet. Our goal was to find out the immunostaining intensity of endothelial NOS and inducible NOS in ovariectomized rats which received oestradiol and norethisterone treatment. Methods: We performed bilateral ovariectomy in 15, female, 90-day-old Wistar rats with an average weight of 250 grams. After waiting for 4 weeks for the menopausal state, they were divided into 3 groups to receive either placebo, 0.1 mg/day 17-β-oestradiol (group E2), or 0.1 mg/day 17-β-oestradiol + 0.1 mg/day norethisterone acetate (group E2-NETA) for 5 weeks. Another group included 5, normal, adult, female intact rats and served as controls. At the end of the treatment, all rats were sacrificed and coronary arteries were stained with inducible NOS and endothelial NOS polyclonal antibodies using streptavidin-biotin technique. Results: The immunostaining of inducible NOS was prominent in perivascular connective tissue of the ovariectomized group but not in the control group. The inducible NOS immunostaining immunoreactivity was not detected in either treated groups. Immunostaining intensity of endothelial NOS did not differ in any 4 groups with similar staining. Conclusion: The present findings indicate that hormone replacement therapy down-regulates iNOS expression in coronary arteries of ovariectomized rats, and reduced iNOS may likely be involved in estrogen's beneficial effects.Item Leiomyoma as a cause of urinary retention(Page Press Publications, 2013) Sarsmaz K.; Goker A.; Kuscu N.K.Urinary retention is uncommon in reproductive age women. The frequent causes for obstructive retention are pelvic masses and a history of surgery. We report a case of intermittent urinary retention caused by a leiomyoma. A 47-year old patient with voiding difficulties for the past four months was referred to the gyne-cology outpatient clinic. She had urinary retention and had been catheterized several times for bladder emptying. She had been evaluated by the urology clinic and a cystoscopy was performed with normal findings. Magnetic resonance imaging (MRI) revealed a pelvic mass at the anterior uterine wall with a diameter of 10 cm. Her physical examination confirmed the MRI findings. Total abdominal hysterectomy was performed with a complete resolution of the patient's complaints. Women with urinary retention should be consultated with a gynecologist in order to rule out pelvic masses. © Copyright K. Sarsmaz et al., 2013.Item Rectus abdominis muscle endometriosis(College of Physicians and Surgeons Pakistan, 2014) Goker A.; Sarsmaz K.; Pekindil G.; Kandiloglu A.R.; Kuscu N.K.Endometriosis is characterized by an abnormal existence of functional endometrial tissue outside the uterine cavity, typically occuring within the pelvis of women in reproductive age. We report two cases with endometriosis of the abdominal wall; the first one in the rectus abdominis muscle and the second one in the surgical scar of previous caesarean incision along with the rectus abdominis muscle. Pre-operative evaluation included magnetic resonance imaging. The masses were dissected free from the surrounding tissue and excised with clear margins. Diagnosis of the excised lesions were verified by histopathology.Item Assessment of serum chemerin, vaspin and omentin-1 levels in patients with polycystic ovary syndrome(SAGE Publications Ltd, 2016) Guvenc Y.; Var A.; Goker A.; Kuscu N.K.Objective: To determine serum chemerin, vaspin and omentin-1 in overweight and normal weight patients with polycystic ovary syndrome (PCOS) and investigate the possible relationship between these adipokines and metabolic syndrome. Methods: This cross sectional study enrolled women with PCOS and healthy women. Serum chemerin, vaspin and omentin-1 were assessed by enzyme-linked immunosorbent assay methods. Results: Forty patients with PCOS and 30 healthy controls were included in the study. In the PCOS group, 18 women were overweight (body mass index [BMI] = 25.0–29.9 kg/m2) and 22 had normal weight (BMI = 18.5–24.9 kg/m2). Chemerin, total cholesterol, dehydroepiandrosterone sulphate and free androgen index (FAI) were significantly higher; and high-density lipoprotein cholesterol and sex hormone binding globulin were significantly lower in overweight PCOS patients compared with normal weight PCOS patients. A positive correlation was found between chemerin and BMI, triglyceride, insulin, homeostatic model assessment of insulin resistance and FAI in the PCOS group. There was no difference in serum chemerin, vaspin and omentin-1 between PCOS patients and healthy controls. Conclusion: Circulating chemerin was increased in overweight compared with normal weight PCOS patients. The most predictive variables for circulating chemerin in PCOS patients were BMI, FAI and age. © 2016, © The Author(s) 2016.Item Immunohistochemical and ultrastructural analysis of the effect of omega-3 on embryonic implantation in an experimental mouse model(Elsevier Ltd, 2016) Sarsmaz K.; Goker A.; Micili S.C.; Ergur B.U.; Kuscu N.K.Objective: Implantation is the first step to a healthy pregnancy. Omega-3 supplementation is common to use during pregnancy, for its antioxidant and membrane stabilising effect. In this study we have aimed to study the effect of Omega-3 supplementation on implantation in a mouse model by immunohistochemical methods and electron microscopic evaluation. Materials and methods: Mice were randomized into three groups to receive standard food, Omega-3 400 mg/kg and Omega-3 1000 mg/kg one menstrual cycle before mating. Mice were sacrificed on third day of estimated implantation and uterine horns were evaluated immunohistochemically for staining of Laminin and Leukemia Inhibitory Factor (LIF) and ultrastructural morphology. Results: Laminin and LIF immunoreactivity were increased signifcantly in the high dose group when compared to the control and low-dose groups in lumen epithelium basal membrane, gland epithelium basal membrane and endometrial stroma. Electron-microscopic evaluation showed a decrease in epithelial height and microvilli loss in the high dose groups. Conclusion: Omega-3 supplementation increased implantation markers Laminin and LIF and decreased epithelial height and microvilli thus seems to prepare the endometrium for a favorable environment of implantation. © 2016.Item Quality of life in Turkish infertile couples and related factors(Taylor and Francis Ltd, 2018) Goker A.; Yanikkerem E.; Birge O.; Kuscu N.K.Infertility is a major life crisis affecting couples’ psychosocial and physical health. We aimed to assess the quality of life in Turkish infertile couples. This cross-sectional survey was carried out in 127 infertile couples admitted to a University Hospital. The quality of life was measured using the fertility quality of life tool (FertiQoL) scale. Women had lower overall quality of life than men. Women and men who were married for fewer than 10 years had a significantly lower emotional score. Women who had a history of infertility treatment, men who have lived in the town or village men with primary infertility and men who have had primary education or lower, had lower scores for mind/body subscale. Social scores were found lower in women under the age of 30, women with middle or low income, men who were married for fewer than 10 years, men who did not have children for 5 years or more and men with primary infertility. The tolerability and environment scores were significantly higher in women who had been married more than once. We conclude that health care providers should be aware of the factors affecting the quality of life (QoL) and give counselling to improve couples’ quality of life at infertility clinics. © 2017, © 2017 The British Fertility Society.