Browsing by Author "Pala H.G."
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Item The comparison of insülin resistance, laboratory results and clinical factors in gestational diabetes mellitus patients with normal pregnant women without glucose intolerance; [Gestasyonel Diabetes Mellitus ve Normal Glukoz Toleransna Sahip Gebelerde nsülin Direnci, Laboratuvar Bulgular ve Klinik Faktörlerin Karşilaştirilmasi](2013) Pala H.G.; Özalp Y.; Saatli Gerçeklioglu G.; Yener A.S.; Uysal S.; Önvural A.Objective: To compare insulin resistance, laboratory results and clinical factors in gestational diabetes mellitus (GDM) patients with normal pregnant women without glucose intolerance. Material and Methods: 55 GDM patients and 50 normal pregnant women who were between 24th and 28th week of gestation included in this study. 25 patients who had not completed antenatal visits or had developed complications during pregnancy period were excluded from study. Statistical analysis was performed for the rest of 40 GDM and 40 normal pregnant women without glucose intolerance. Total cholesterol, triglyceride, high density lipoprotein (HDL), low density lipoprotein (LDL), HbAlc, glucose, insulin and c-peptide levels were measured between 24th-28th week of gestation after starvation in maternal blood sample which included into study. The relationship between these groups' measurements and the other established clinical-laboratory factors were investigated. Results: HbAlc, c-peptide, insulin, glucose, triglyceride and LDL levels were significantly higher in GDM patients compared with the group of patients with normal glucose tolerance. There was not significant difference in terms of total cholesterol and HDL levels. Calculated HOMA-IR score was significantly higher and c-peptide/insulin and c-peptide/glucose ratio were lower in GDM patients compared with the group of patients with normal glucose tolerance. Conclusion: It is accepted that increased maternal adipocyte and plasental hormones' effect aganist insulin combination had an important role in GDM pathogenesis. In this study; we ascertained that HOMA-IR was raised GDM probability 8 fold and showed that insulin resistance was one of the basic factor in GDM pathogenesis. Copyright © 2013 by Türkiye Klinikleri.Item Prenatal diagnosis of placenta percreta with ultrasound(Aras Part Medical International Press, 2014) Ulkumen B.A.; Pala H.G.; Baytur Y.The incidence of the placental invasion anomalies are increasing, mainly due to repeat cesarean deliveries. Placenta percreta occurs if these villi perforate the serosa and also sometimes into adjacent organs such as the bladder. The prenatal diagnosis is very important because of the high maternal morbidity and mortality rates without the appropriate surgical planning. The adherent placentas will result in severe early postpartum bleeding, just after the delivery of the fetus. Severe hemorrhage usually results rapidly in disseminated intravascular coagulation (DIC), shock, multiorgan failure or death.The surgery is also challenging due to the risk of the adjacent tissue damage, such as bladder or ureteral injury. Approximately 1 in every 3 cases need intensive care. We present here a prenatally diagnosed, 31-year-old gravida 7 para 2 abortus 4 pregnant case with placenta percreta and rewiev the relevant literature about the key aspects in the ultrasonograhic diagnosis and underlie the key points in the diagnosis. © 2014 The Author(s).Item Acute abdomen and massive hemorrhage due to placenta percreta leading to spontaneous uterine rupture in the second trimester(Saudi Arabian Armed Forces Hospital, 2014) Ulkumen B.A.; Pala H.G.; Baytur Y.Placental invasion anomalies are rare obstetrical complications. They cause severe third trimester hemorrhage, severe postpartum bleeding, and maternal morbidity and mortality unless they are diagnosed antenatally. We present a rare case with placenta percreta leading to spontaneous uterine rupture during the second trimester with an acute abdomen and hypovolemia. © 2014, Saudi Arabian Armed Forces Hospital. All rights reserved.Item Can mean platelet volume and platelet distrubition width be possible markers for ectopic pregnancy and tubal rupture? (MPV and PDW in ectopic pregnancy)(2014) Ulkumen B.A.; Pala H.G.; Calik E.; Koltan S.O.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 EP. Our preliminary results show that MPV levels may decrease in the ruptured EP cases. At the same time, PDW levels may increase.Item Retrospective analysis of fetal anterior abdominal wall defects(Saudi Arabian Armed Forces Hospital, 2014) Ulkumen B.A.; Pala H.G.; Baytur Y.; Koyuncu F.M.Objective: To analyze fetal abdominal defects diagnosed during the prenatal period in the perinatology department in a tertiary center in Turkey.; Methods: This retrospective study consisted of 27 cases diagnosed with fetal abdominal wall defects between January 2011 and February 2014 in the perinatology outpatient clinic of Celal Bayar University, Manisa, Turkey.; Conclusion: The prenatal diagnosis of fetal abdominal wall defects is important, because they differ greatly in terms of perinatal and neonatal morbidity and mortality due to underlying chromosomal abnormalities and associated structural anomalies.; Results: Eighteen (66.7%) cases were diagnosed with omphalocele, 6 (22.2%) had gastroschisis, and 3 (11.1%) had limb body wall defects. Twenty-one (77.7%) patients diagnosed either as omphalocele or limb body wall defect were offered karyotype analysis; 11 (52.4%) of them accepted the intervention, and 2 of the 11 patients (18.2%) had abnormal karyotype. Regarding the omphalocele cases; 12 (66.6%) cases had isolated omphalocele, whereas 6 of the 18 cases (33.3%) had associated anomalies. Expectant management was performed in 8 (66.7%) of 12 isolated omphalocele cases. Two of the isolated omphalocele group (16.7%) had missed abortion, the other 2 (16.7%) had termination of the pregnancy because of the associated chromosomal anomaly (47,XXY and 45,X0). Three of the gastroschisis group (50%) had missed abortion, and the other 3 (50%) had expectant management with cesarean delivery between 38-39 gestational weeks. Cases with limb body wall defect were terminated due to the lethal condition. © 2014, Saudi Arabian Armed Forces Hospital. All rights reserved.Item Familial tetra-amelia syndrome(Aras Part Medical International Press, 2014) Eskicioglu F.; Ülkümen B.A.; Pala H.G.; Koyuncu F.M.Tetra-amelia is known as an anomaly characterized by the absence of all four limbs. It is a rare congenital anomaly, with an incidence of 1.5-4 per 100,000 births. It occurs as a result of developmental interruption between 24th and 36th days after fertilization. Its etiology is not well known. It may be observed isolated or associated with other anomalies. In this paper, we present an interesting case of an intra-uterine diagnosed tetra-amelia male fetus with the recurrence in the previous two more male fetuses in the same family. Tetra- amelia syndrome observed in all three male fetuses of a couple with blood relationship is presented. The first two male newborn died just after birth due to prematurity in 28th and 32nd weeks. The third male fetus was in 23nd weeks of the intrauterine life. There was no exposure to teratogenic agents in this pregnancy. It detected that the third male baby had subcutaneous edema, intra-abdominal ascites and lateral ventricle enlargement in cranium. Since tetra-amelia due to genetic inheritance based on X chromosome was suspected, the family was offered the options of termination of pregnancy, karyotype analysis and genetic consultation. © 2014 The Author(s).Item Ovarian failure in diabetic rat model: Nuclear factor-kappaB, oxidative stress, and pentraxin-3(Elsevier Ltd, 2014) Erbas O.; Pala H.G.; Pala E.E.; Oltulu F.; Aktug H.; Yavasoglu A.; Taskiran D.Objective: The aim of the present study was to investigate the effects of diabetes mellitus (DM) on ovarian reserve and injury by considering laboratory and histopathological parameters in rat models. Materials and methods: An experimental DM model was created in 16 rats. Eight rats with normal blood glucose levels were included in the control group. Diabetic rats were divided randomly into two groups: nontreated and resveratrol-treated groups. Histopathological examination and nuclear factor (NF)-κB immunoexpression level determination were performed. Plasma malondialdehyde, glutathione, pentraxin-3, and anti-Müllerian hormone levels were measured. Relations between the variables were compared by Student t test, analysis of variance, and Mann-Whitney U and χ2 tests. Results: We found statistically significantly lower glutathione and anti-Müllerian hormone levels, and higher malondialdehyde and pentraxin-3 levels in nontreated diabetic group when compared with the control and resveratrol-treated diabetic groups. Stromal degeneration, follicle degeneration, stromal fibrosis scores, and NF-κB immunoexpression levels were significantly higher in nontreated diabetic rats. Primordial and primary follicle counts were significantly lower in the nontreated diabetic group when compared with the control and resveratrol-treated groups. There was no statistically significant difference in secondary and tertiary follicles between these groups. Conclusion: These findings provide strong evidence that the ovarian follicle pool in nontreated diabetic rats is affected in the early stages of the follicle development process. We precluded negative effects of DM on ovaries by inhibiting the NF-κB pathway with resveratrol. We thought that the NF-κB pathway plays a role in the pathophysiology of ovarian failure in diabetic rats. Further studies should evaluate this precise mechanism that leads to a decline in the anti-Müllerian hormone levels. In addition, the relationship between this abnormality and reproductive function in diabetic patients should be analyzed further. © 2014.Item The effect of parity on first trimester uterine artery doppler waveforms in low-risk singleton pregnancies(Studio K Krzysztof Molenda, 2014) Ulkumen B.A.; Pala H.G.; Uyar Y.; Baytur Y.B.; Koyuncu F.M.Objectives: The aim of the study was to evaluate the effect of parity on uteroplacental blood flow during the first trimester in low-risk singleton pregnancies. Materials and methods: Uterine artery Doppler examinations were performed in 190 singleton pregnancies between 11-14 gestational weeks. Twenty-five pregnancies were excluded from the study due to history of preeclampsia, diabetes mellitus or inherited thrombophilia. A total of 165 low-risk singleton pregnancies were included in the study. Mean uterine artery pulsatility index (PI) was recorded and compared between nulliparous and multiparous women. The relation between maternal age, gestational week, maternal weight, parity, biochemical markers and abnormal uterine artery Doppler flows was evaluated. T-test and logistic regression analyses were used for the statistical analysis. Results: A total of 165 singleton pregnancies without any risk factors for uteroplacental insufficiency were included in the study. Of them, 58 (36.7%) were nulliparous and 107 (63.3%) were parous. Correlation analysis revealed that the uterine artery pulsatility indices during the first trimester were not affected by maternal age and parity. Conclusions: Mean uterine artery pulsatility indices are not different in nulliparous and multiparous low risk pregnancies at 11-14 weeks of gestation. © Polskie Towarzystwo Ginekologiczne.Item Normal range of intracranial translucency in healthy Turkish pregnancies and its association with first trimester maternal serum biochemistry and ductus venosus pulsatility index(Via Medica, 2014) Artunc-Ulkumen B.; Pala H.G.; Uyar Y.; Bulbul-Baytur Y.; Koyuncu F.M.Objective: To measure the intracranial translucency (IT) by establishing reference ranges in uncomplicated singleton Turkish pregnancies and to evaluate the association of IT with maternal serum biochemistry, gestational week, crown-rump length (CRL) measurement, nuchal translucency (NT) and ductus venosus Doppler velocimetry. Materials and methods: 190 uncomplicated singleton pregnancies were included in the study. IT, NT and CRL measurements between 11-14 gestational weeks were obtained with mid-sagittal plane. Two independent measurements were taken and averaged to obtain the final measurement used in the calculations. Statistical analysis was performed with SPSS for Windows 20.0 software package. Correlation analysis was used to determine the association between IT and NT, pregnancy-associated plasma protein-A (PAPP-A), free β-human chorionic gonadotropin (fβ-hCG) and CRL length. A p-value of <0.05 was considered statistically significant. Results: The assessment rate of IT was 167/190 (87.89%). The mean CRL length, gestational week, NT and IT measurements were 63.63±10.05 mm, 12.28±0.75 weeks, 1.23±0.43 mm (range: 0.20-2.68) and 2,29±0,49 mm (range: 0.18-3.80), respectively. There was no significant correlation between IT and maternal serum PAPP-A MoM (r=-0.34, p=0.698) or maternal serum free β-hCG MoM (r=-0.79, p=0.363), respectively. There was weak- but statistically significant correlation between IT with with maternal weight (r=0.172, p=0.047), CRL length (r =0.301, p < 0.001), gestational week (r=0.286, p=0.001) and NT measurement (r=0.224, p=0.007), respectively. There was no significant association between IT with ductus venosus doppler pulsatility index (r=0.108, p=0.213). Conclusion: IT can be easily measured while scanning for NT. This study shows normal range values in healthy Turkish pregnancies. Consistent with recent data, our results show positive correlation with gestational week and CRL length. Maternal serum biochemistry does not have any effect on IT. Besides, our study highlights that IT is correlated with NT and adds newly to the literature that there is no correlation of IT with ductus venosus pulsatility index. © Polskie Towarzystwo Ginekologiczne.Item Platelet distribution width (PDW): A putative marker for threatened preterm labour(Professional Medical Publications, 2014) Artunc Ulkumen B.; Pala H.G.; Calik E.; Oruc Koltan S.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.Item Ductus venosus doppler flow velocity after transplacental and non-transplacental amniocentesis during midtrimester(Professional Medical Publications, 2014) Artunc Ulkumen B.; Pala H.G.; Bulbul Baytur Y.; Koyuncu F.M.Objective: We aimed to evaluate ductus venosus Doppler waveforms before and after amniocentesis in order to investigate any effect of amniocentesis on fetal myocardial hemodynamics. We also evaluated the umbilical artery, uterine artery and fetal mid-cerebral artery Doppler waveforms in order to investigate any relationship with ductus venosus Doppler changes. Methods: The study population consisted of 56 singleton pregnancies having genetic amniocentesis. Twenty seven of them had transplacental needle insertion; whereas 29 of them had non-transplacental amniocentesis. Uterine artery, umbilical artery, mid-cerebral artery and ductus venosus pulsatiliy index and resistance index were measured just before and after amniocentesis. Results: Amniocentesis does not cause any significant changes in fetal ductus venosus Doppler waveforms. There is also no significant changes in uterine artery, umbilical artery, mid-cerebral artery pulsatility and resistance index. Conclusion: Amniocentesis-whether transplacental or not- does not cause any significant effect on fetal myocardial hemodynamics.Item Sexual dysfunction in Turkish women with dispareunia and its impact on the quality of life(S.O.G. CANADA Inc., 2014) Ulkumen B.A.; Erkan M.M.; Pala H.G.; Baytur Y.B.Purpose of Investigation: The authors aimed to determine the prevalence of female sexual dysfunction (FSD) among Turkish dyspareunic women and to establish the associated factors with FSD. Furthermore, they aimed to investigate if dyspareunia and possible ssociated sexual complaints were related to impaired quality of life (QoL). Materials and Methods: The study included 154 women admitted to the present gynecology department at a tertiary center in the west region of Turkey, 67 of which suffered from dyspareunia. The remaining 87 sexually healthy women were included in the control group. FSD was assessed with 19-item validated female sexual function index (FSFI). QoL was assessed using short form 36 (SF-36). The chi-squared test and t-test were used for analysing the group differences. Pearson's correlation test was used to determine the effect of the variables of FSFI on the SF-36. Multivariate analysis and logistic regression was used to determine independent risk factors for FSD and to estimate odds ratio (OR) with 95% confidence interval (CI). Results: The incidence of FSD in dyspareunic group and control group was 86.57% and 36.8%, respectively (p < 0.001). Dyspareunic women had lower scores with regards to sexual desire, arousal, lubrication, orgasm, satisfaction, and pain domains at significant level (p < 0.001). Education level, time period after the last delivery, duration of marriage, parity, and dyspareunia were significantly related to FSD. However, dyspareunia was an independent risk factor for FSD (OR 11.49; 95% CI 4.95-26.67). Regarding the impact on the QoL, dyspareunic women had lower scores with regards to the physical role, social function, bodily pain, and vitality domains. Conclusion: The present results show that dyspareunia has a major impact on women's sexual ftinction and QoL. Clinicians have an important role for encouraging women to report their sexual complaints. Identifying dyspareunia and treating FSD may positively affect women's sexual function and overall QoL.Item The protective effect of granulocyte colony-stimulating factor on endometrium and ovary in a rat model of diabetes mellitus(S. Karger AG, 2014) Pala H.G.; Pala E.E.; Artunc Ulkumen B.; Aktug H.; Yavasoglu A.; Korkmaz H.A.; Erbas O.Aims: To evaluate the effect of granulocyte colony-stimulating factor (G-CSF) on the endometrium and ovaries in an experimental diabetes mellitus (DM) rat model. Methods: A total of 18 female Sprague-Dawley albino mature rats (8 weeks, 200-220 g) were used in this study. Diabetes was induced by intraperitoneal (i.p.) injection of streptozocin randomly in 12 rats. No drug was administered to the remainder of the rats (control group, group 1, n = 6). The other 12 rats were randomly divided into 2 groups; 1 ml/kg i.p. saline was given as vehicle to group 2 (diabetic nontreated control group, n = 6) and 100 μg/kg/day of i.p. G-CSF was given to group 3 (G-CSF-treated group, n = 6) for 4 weeks. After 4 weeks, blood samples were collected and hysterectomy with bilateral oophorectomy was performed for histopathological examination. Results: The mean endometrial gland degeneration and stromal fibrosis scores were significantly higher in group 2 compared with groups 1 and 3. Ovarian follicle degeneration, stromal degeneration and stromal fibrosis scores were significantly higher in group 2 compared with groups 1 and 3. Plasma TGF-β and malondialdehyde levels were significantly lower in groups 1 and 3 compared with group 2. Antimüllerian hormone levels were significantly lower in group 2 compared with groups 1 and 3. Conclusion: Glucose toxicity occurred severely in the ovaries and endometrium of the DM rats. After G-CSF treatment, ovarian and endometrial injury and fibrosis scores decreased significantly. The effects of G-CSF in rat models give hope to improved treatment of human DM complications such as premature ovarian failure and endometrial dysfunction. © 2014 S. Karger AG, Basel.Item Therapeutic effect of sunitinib on diabetes mellitus related ovarian injury: An experimental rat model study(Informa Healthcare, 2015) Erbas O.; Pala H.G.; Pala E.E.; Artunc Ulkumen B.; Akman L.; Akman T.; Oltulu F.; Aktug H.; Yavasoglu A.The aim of our study is to investigate the effect of sunitinib on diabetes mellitus related-ovarian injury and fibrosis in rat models. An experimental diabetes mellitus model was created in 16 rats, and eight rats with normal blood glucose levels were included in control group (Group-1). The diabetic rats were divided into two groups:diabetic control group (water given)-Group-2 and sunitinib treatment group-Group-3. After four weeks, bilateral oophorectomy was performed and ovaries were examined histologically. The groups were compared by Student's t-test, analysis of variance (ANOVA) and Mann-Whitney's U-test. There was a significant increase in no-medication (water given) diabetic rat's ovary (Group-2) in terms of follicular degeneration, stromal degeneration, stromal fibrosis and NF-kappaB immune-expression compared with control group normal rats' ovary (Group-1) (p < 0.0001). Stromal degeneration (p = 0.04), stromal fibrosis (p = 0.01), follicular degeneration (p = 0.02), NF-kappaB immune-expression (p = 0.001) significantly decreased in sunitinib-treated diabetic rat's ovary (Group-3) when compared with no-medication (water given) diabetic rat's ovary (Group-2) (p < 0.05). When we used sunitinib in the treatment of diabetic rats, ovarian injury, fibrosis and NF-kappaB immunoexpression decreased significantly. The effects of sunitinib in rat models give hope to the improved treatment of premature ovarian failure due to diabetes mellitus in humans. © 2015 Informa UK Ltd. All rights reserved: reproduction in whole or part not permitted.Item Posterior reversible encephalopathy syndrome: An atypical complication of postpartum wound infection(Informa Healthcare, 2015) Pala H.G.; Baris M.M.; Artunc Ulkumen B.; Gurkan M.A.; Pala E.E.[No abstract available]Item The assessment of placental volume and mean gray value in preeclamptic placentas by using three-dimensional ultrasonography(Informa Healthcare, 2015) Artunc Ulkumen B.; Pala H.G.; Uyar Y.; Koyuncu F.M.; Bulbul Baytur Y.Objectives: We aimed to evaluate the placental volume and placental mean gray value in preeclampsia and healthy placentas by using three-dimensional (3D) ultrasonography and Virtual Organ Computer-aided AnaLysis (VOCAL). Methods: This case-control prospective study consisted of 27 singleton pregnancies complicated by preeclampsia and 54 healthy singleton pregnancies matched for gestational age, maternal age and parity. Placental volume and placental volumetric mean gray values were evaluated. The placental volume (cm) was analyzed using the VOCAL imaging program, and 3D histogram was used to calculate the volumetric mean gray value (%). Results: Preeclamptic and control group consisted of 27 (mean age: 28.90±5.95 years, mean gestation: 32.0±4.55 weeks) and 54 (mean age: 29.48±5.78 years, mean gestation: 32.61±4.23 weeks) singleton pregnancies, respectively. Placental volume was significantly smaller in preeclampsia (250.62±91.69 versus 370.98±167.82cm; p=0.001). Volumetric mean gray value of the placenta was significantly higher in preeclampsia (38.24±8.41 versus 33.50±8.90%; p=0.043). Placental volume was significantly correlated with the estimated fetal weight (r=0.319; p=0.003). There was negative significant relation between placental volume and umbilical artery pulsatility index, resistance index and systolic/diastolic ratio (r=-0.244, p=0.024; r=-0.283, p=0.005; r=-0.241, p=0.024, respectively). Conclusions: Placental volume diminishes significantly in preeclampsia, whereas volumetric mean gray values increases. This may reflect the early alterations in preeclamptic placentas, which may help to understand the pathophysiology better. © 2014 Informa UK Ltd. All rights reserved: reproduction in whole or part not permitted.Item Three-dimensional placental volume and mean grey value: Normal ranges in a Turkish population and correlation with maternal serum biochemistry and Doppler parameters(Informa Healthcare, 2015) Pala H.G.; Artunc Ulkumen B.; Uyar Y.; Koyuncu F.M.; Bulbul Baytur Y.The aim of this study is to evaluate the relationship between three-dimensional (3D) ultrasound measurements of placenta at 11136 weeks' gestation and maternal serum levels of pregnancy associated plasma protein-A (PAPP-A), free beta human chorionic gonadotrophin (fβhCG), Doppler parameters in early pregnancy. This prospective study consisted of 334 singleton pregnancies at 11136 weeks' gestation. Placental volume and placental volumetric mean grey values were evaluated. The placental volume (cm3) was analysed using the Virtual Organ Computer-aided AnaLysis (VOCAL) imaging program and 3D histogram was used to calculate the volumetric mean grey value (%). Mean maternal age was 28.35 ± 7.55. Mean gestational age was 12.29 ± 0.68 weeks. Placental volume was 77.04 ± 35.74 cm3. Mean grey value of the placenta was 34.38 ± 8.02%. Correlation analysis revealed that placental volume was significantly correlated with the crown-rump length (r = 0.173, p = 0.002), gestational week (r = 0.116, p = 0.036), ductus venosus pulsatility index (r = 0.101, p = 0.04) and maternal weight (r = 0.099, p = 0.037). There was a significant relation between the mean grey value of the placenta and maternal age (r = 0.131, p = 0.02), nuchal translucency (r = 0.109, p = 0.048), PAPP-A (r = 0.108, p = 0.04) and fβhCG (r = 0.104, p = 0.042). Volumetry of the placenta can be carried out with a high percentage of 1st trimester pregnancies. Volumetry during the 1st trimester could be helpful because of the less advanced state of placentation. This examination is easy to perform and the measurements can be acquired correctly and quickly. © 2015 Informa UK, Ltd.Item The effects of sunitinib on endometriosis(Informa Healthcare, 2015) Pala H.G.; Erbas O.; Pala E.E.; Ulkumen B.A.; Akman L.; Akman T.; Oltulu F.; Yavasoglu A.The aim of the present study was to evaluate the effect of sunitinib on endometriotic implants and adhesions in a rat endometriosis model. An experimental endometriosis model was created in 21 rats. These rats were randomly divided into three groups: Group 1 (control group, 7 rats) was given no medication; Group 2 (sunitinib group, 7 rats) was given 3 mg/ kg per day of oral sunitinib; and Group 3 (danazol group, 7 rats) was given 7.2 mg/kg per day of oral danazol. The volume of endometriotic implants was calculated. The extent and severity of adhesions were evaluated. The groups were compared by the Student's t-test, analysis of variance (ANOVA) and the Mann-Whitney U test. There was no statistically significant difference in the mean volume of endometriotic implants before medication between three groups. The volume of implants and extent, severity, total score of adhesions were significantly decreased after medication in Group 2 and Group 3. We noted that the volume of the endometriotic implants and adhesion formation were decreased both after sunitinib and danazol treatment. As a result, sunitinib seems to be effective for endometriotic peritoneal lesions. The effects of sunitinib in rat models give hope for improving the treatment of human endometriosis and prevention of pain symptoms. © 2014 Informa UK, Ltd.Item De novo reciprocal translocation t(5;11)(q22;p15) associated with hydrops fetalis (reciprocal translocation and hydrops fetalis)(Informa Healthcare, 2015) Pala H.G.; Artunc-Ulkumen B.; Uyar Y.; Bal F.; Baytur Y.B.; Koyuncu F.M.Objective: This is a case of a prenatally diagnosed non-immune hydrops fetalis (NIHF) associated with translocation t(5;11)(q22;p15). An association between NIHF and this translocation has not been reported previously.; Case Report: The patient was referred to the perinatology clinic with hydrops fetalis diagnosis at 23 weeks' gestation. We noted that the fetus had bilateral pleural effusion, ascites, widespread subcutaneous edema, membranous ventricular septal defect, hypoplastic fifth finger middle phalanx, clinodactyly, single umbilical artery. We performed cordocentesis. Chromosomal analysis on blood showed a balanced translocation between the long arm of chromosome 5 and the short arm of chromosome 11 with karyotype of 46,XX,t(5;11)(q22;p15).; Conclusion: We present prenatal diagnosis of a de novo translocation (5;11) in a hydropic fetus with ultrason abnormalities. In our case, karyotype analysis of the fetus, mother and father provided evidence of a de novo translocation, that might explain the NIHF. © 2015 Informa Healthcare USA, Inc.Item Exenatide improves ovarian and endometrial injury and preserves ovarian reserve in streptozocin induced diabetic rats(Informa Healthcare, 2015) Artunc-Ulkumen B.; Pala H.G.; Pala E.E.; Yavasoglu A.; Yigitturk G.; Erbas O.We aimed to evaluate: (1) endometrial and ovarian tissue injury caused by the glucose toxicity in diabetic rat model and (2) the effect of GLP-1 analog (exenatide) on endometrial and ovarian diabetes induced injury with emphasizing the underlying mechanism. The study group composed of 24 female rats assigned randomly into 3 groups. Group 1 was the control group (n=8) and received no treatment. Diabetes was induced by intraperitoneal injection of streptozocin for 16 rats which are further assigned randomly into 2 groups: 1ml/kg intraperitoneal saline was given to Group-2 (diabetic non-treated control group, 8 rats) and 10μg/kg/day of intraperitoneal exenatide was given to Group 3 (exenatide treated group, 8 rats) for four weeks. After four weeks, blood samples were collected and hysterectomy with bilateral oophorectomy was performed for histopathological examination. Diabetes caused endometrial and ovarian tissue injury in rats (p<0.0001). Serum transforming growth factor beta (TGF-ß), malonylaldehyde (MDA), pentraxin-3 (PTX-3) levels were higher in diabetic rats (p<0.0001), whereas antimullerian hormone (AMH) was lower (p<0.001). Serum levels of these markers reflected that Diabetes induced injury in the reproductive tract occured via oxidative stress, fibrosis and severe inflammation. Diabetes diminished ovarian reserve. Exenatide treatment improved the histological degeneration and fibrosis in the endometrium and ovary with concomitant decrease in inflammatory and oxidative stress markers (p<0.05). Exenatide also improved ovarian reserve (p<0.05). Glucose toxicity occured severely in ovary and endometrium in DM. After exenatide treatment; ovarian and endometrial injury and fibrosis seems to decrease significantly. The effects of exenatide in rat models give hope to prevent the women with DM from premature ovarian failure and endometrial dysfunction. © 2014 Informa UK Ltd.