Browsing by Author "Uyar, Y"
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Item The Effect of Steroid Hormones on Cognitive Functions and Psychological Status in Healthy WomenKutlu, N; Mentese, B; Ulman, C; Demet, MM; Uyar, YItem De novo Reciprocal Translocation t(5;11)(q22;p15) Associated with Hydrops Fetalis (Reciprocal Translocation and Hydrops Fetalis)Pala, HG; Artunc-Ulkumen, B; Uyar, Y; Bal, F; Baytur, YB; Koyuncu, FMObjective: 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.Item Comparison of the Bishop score, body mass index and transvaginal cervical length in predicting the success of labor inductionUyar, Y; Erbay, G; Demir, BC; Baytur, YTo evaluate the role of ultrasonographic and various maternal and fetal parameters in predicting successful labor induction. Body mass index, cervical length, dilatation, effacement, Bishop score, parity, maternal age and birth weight were evaluated in 189 singleton pregnant women at 37-42 weeks of gestation and having induction of labor. All underwent induction of labor with oxytocin. Body mass index was calculated using the formula weight (kg)/height(2) (m), cervical measurement was performed by transvaginal ultrasonography and Bishop score was determined by digital examination of cervix. Logistic regression analysis indicated that the cervical length and body mass index were independent variables in determining the risk of cesarean section (OR = 1.206, P = 0.000, CI 95% = 1.117-1.303; OR = 1.223, P = 0.007, CI 95% = 1.058-1.414 respectively). In multiple linear regression analysis, the effect of cervical length and body mass index on induction delivery interval was found to be statistically significant (t = 5.738, P = 0.000; t = 2.680, P = 0.009, respectively). ROC curve showed that the best parameter in predicting the risk of cesarean section was cervical length and that cervical length and body mass index were better parameters compared to the Bishop score (the areas under the curve are 0.819, 0.701 and 0.416, respectively). Body mass index and transvaginal cervical length were better predictors compared to the Bishop score in determining the success of labor induction.Item Three-dimensional placental volume and mean grey value: Normal ranges in a Turkish population and correlation with maternal serum biochemistry and Doppler parametersPala, HG; Ulkumen, BA; Uyar, Y; Koyuncu, FM; Baytur, YBThe aim of this study is to evaluate the relationship between three-dimensional (3D) ultrasound measurements of placenta at 11-13(6) weeks' gestation and maternal serum levels of pregnancy associated plasma protein-A (PAPP-A), free beta human chorionic gonadotrophin (f beta hCG), Doppler parameters in early pregnancy. This prospective study consisted of 334 singleton pregnancies at 11-13(6) weeks' gestation. Placental volume and placental volumetric mean grey values were evaluated. The placental volume (cm(3)) 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 cm(3). 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 f beta hCG (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.Item Normal ranges of biorbital and interorbital distances in healthy Turkish pregnancies at 19-23 weeks of gestation and correlation with craniofacial structuresPala, HG; Artunç-Ülkümen, B; Koyuncu, FM; Uyar, Y; Bülbül-Baytur, YObjective: We aimed to determine the normal ranges for biorbital (BOD) and interorbital distances (IOD) during the second trimester in Turkish women with normal pregnancies and to assess the correlation between BOD, IOD, and other fetal craniofacial structures and biometric parameters. Material and Methods: Our retrospective study comprised 1328 women with singleton normal pregnancies who had undergone ultrasonography (USG) examinations at 19-23 weeks of gestation in the second trimester screening. The measurements of BOD and IOD were obtained with the coronal section of the fetal face at the plane of orbits. Results: Mean BOD was 3.4 +/- 0.33 cm, whereas mean IOD was 1.28 +/- 0.24 cm. Correlation analysis revealed that BOD was significantly correlated with IOD, transcerebellar diameter (TCD), cisterna manga (CM), nuchal fold (NF), nasal bone (NB), biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL), and gestational week. There was a significant relation between IOD and the lateral ventricle posterior horn, TCD, CM, NF, NB, BPD, HC, AC, and FL. Conclusion: The reference ranges obtained in our study enabled accurate evaluation of BOD and IOD in the second trimester of normal pregnancies. USG detection of fetal orbital biometric anomalies may alert the clinician for different anomalies associated with abnormal development of eye.Item Pelvic floor function and anatomy after childbirthBaytur, YB; Serter, S; Tarhan, S; Uyar, Y; Inceboz, U; Pabuscu, YOBJECTIVE: To investigate pelvic floor musclefunction and anatomy after childbirth in continent women differing in obstetric history. STUDY DESIGN: Young, continent women, age range 20-40 years, were recruited into 3 groups: I elective prelabor cesarean delivery (n = 12); 2. vaginal delivery (n = 15); and 3. age-matched nulliparas as controls (n = 13). Pelvic floor muscle strength was measured by a perineometer and also assessed by vaginal palpation. Magnetic resonance imaging of the pelvic floor at rest and on maximal strain was performed. Statistical analysis was carried out using SPSS 10.0 (Chicago, Illinois) for Windows (Microsoft, Redmond, Washington); p < 0.05 was considered significant. RESULTS: Pelvic floor muscle strength was not different between the vaginal delivery and cesarean groups. The descent of the bladder and cervix on straining was greater in the subjects who delivered vaginally than in the cesarean delivery and nulliparous groups. There was a positive and significant correlation between the duration of labor and the area of the levator sling and also between birth weight and the descent of the cervix on straining. CONCLUSION: The results of this study show that delivery method does not affect pelvic muscle strength.Item Assessment of fetal cerebral arterial and venous blood flow before and after vaginal delivery or Cesarean sectionBaytur, YB; Tarhan, S; Uyar, Y; Ozcakir, HT; Lacin, S; Coban, B; Inceboz, U; Caglar, HObjectives To compare perinatal intracranial arterial and venous blood velocity changes between healthy term neonates delivered vaginally or by Cesarean section and to correlate these changes with cord blood gases and pH values at birth. Methods The study involved 43 healthy term neonates who were delivered vaginally (n = 20) or by Cesarean section (n = 23). All fetuses/neonates were examined by Doppler ultrasound to obtain middle cerebral artery (MCA) and cerebral transverse sinus (Tsin) Doppler waveforms on three occasions (before delivery, and 1 h and 24 h after birth). Pulsatility index (PI) and peak systolic velocity (PSV) for MCA and Tsin were measured and compared between neonates who were delivered vaginally or by Cesarean section. Umbilical cord blood samples were analyzed for umbilical artery and vein pH, pO(2) and pCO(2) and values were correlated with MCA and Tsin Doppler indices. Results MCA-PI increased and MCA-PSV decreased at 1 h after birth, and Doppler measurements returned to predelivery values at 24 h after birth. Tsin Doppler measurements remained unchanged at 1 h and 24 h when compared to predelivery values in both the Cesarean and vaginal delivery groups. There was a negative correlation between Tsin-PI before birth and umbilical venous pH. There was a positive correlation between Tsin-PSV at 1 h after birth and umbilical vein PCO2. Conclusions Cerebral arterial blood velocity decreases immediately after birth and increases within 24 h, probably as part of neonatal adaptation. Cerebral venous blood velocity remains constant during the perinatal period and is likely to be regulated in a different and more complex manner than that of arterial blood velocity. Mode of delivery does not affect cerebral blood velocity. Copyright (C) 2004 ISUOG. Published by John Wiley Sons, Ltd.Item Evaluation of retinochoroidal tissues in third trimester pregnants: An optical coherence tomography angiography studyYildirim, A; Kurt, E; Altinisik, M; Uyar, YIntroduction: The structural and vascular changes in the retina and choroid in women in the third trimester of pregnancy were analyzed using optical coherence tomography angiography (OCTA). Methods: Forty women in the third trimester of uncomplicated pregnancy and 40 age-matched healthy women were included. Vascular density (VD) in the superficial and deep capillary plexuses (SCP/DCP), foveal density (FD), and foveal avascular zone (FAZ) area and perimetry measured with OCTA, as well as OCT measurements of central macular thickness (CMT) and choroidal thickness (CT) were compared between the groups. Correlations between structural OCT parameters and vascular OCTA metrics were analyzed. Results: The mean gestational age was 34 (28-41) weeks. Mean age was comparable in the groups (p = 0.732). The pregnant women had significantly higher parafoveal DCP-VD (p = 0.015), FAZ area (p = 0.044), and FD (p = 0.002). Mean subfoveal CT was 21 mu m higher in pregnant women but was not significant (p = 0.472). There was no difference in CMT (p = 0.448). FAZ metrics were positively correlated with CT in pregnants and with CMT in the control group (p < 0.05). Parafoveal VD was negatively correlated with CT in the control group (p < 0.05). After adjusting for CT and CMT, the significant difference in VD and FD persisted (p < 0.05), while the difference in FAZ area lost significance (p > 0.05). Conclusions: Considering the effects of the probable covariant factors CMT and CT, systemic changes in pregnant women in their third trimester may cause an increase in VD in the macula and parafoveal DCP.Item The assessment of placental volume and mean gray value in preeclamptic placentas by using three-dimensional ultrasonographyUlkumen, BA; Pala, HG; Uyar, Y; Koyuncu, FM; Baytur, YBObjectives: 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(3)) 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 +/- 167.82 cm(3); 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.Item The effect of parity on first trimester uterine artery Doppler waveforms in low-risk singleton pregnanciesUlkumen, BA; Pala, HG; Uyar, Y; Baytur, YB; Koyuncu, FMObjectives: 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.Item The alteration in placental volume and placental mean grey value in growth-restricted pregnancies assessed by 3D ultrasoundUlkumen, BA; Pala, HG; Uyar, Y; Koyuncu, FM; Baytur, YBWe aimed to evaluate the volumetric and echogenic alterations in placentas between the intrauterine growth restriction (IUGR) and normal pregnancies using three-dimensional ultrasound and virtual organ computer-aided analysis (VOCAL) software. This case-control prospective study consisted of 48 singleton pregnancies complicated by IUGR and 60 healthy singleton pregnancies matched for maternal age, gestational age and parity. Placental volume (PV) and placental volumetric mean grey values (MGV) were evaluated. PV (cm(3)) was analysed using the VOCAL imaging analysis program, and 3D histogram was used to calculate the volumetric MGV (%). PV was 278.50 +/- 63.68 and 370.98 +/- 97.82 cm(3) in IUGR and control groups, respectively (p = 0.004). MGV of the placenta was 38.24 +/- 8.41 and 38.24 +/- 8.41 in IUGR and control groups, respectively (p = 0.30). receiver operator curve (ROC) curve analysis revealed that area under curve was 0.731 for PV. Correlation analysis revealed that PV was significantly associated with estimated fetal weight (r = 0.319, p = 0.003), biparietal diameter (r = 0.346, p = 0.002), head circumference (r = 0.269, p = 0.019), abdominal circumference (r = 0.344, p = 0.002) and femur length (r = 0.328, p = 0.004). PV was inversely related to the umbilical artery pulsatility index (r = - 0.244, p = 0.017). To the best of our knowledge, this is the first study evaluating volumetric MGV in IUGR placentas by comparing them with healthy pregnancies. Our study showed that PV diminishes significantly in IUGR pregnancies, whereas volumetric MGV does not alter significantly.Item The effect of tibolone on endometrial IGF-1 and IGFBP-1 levels in ovariectomized ratsKuscu, NK; Koyuncu, FM; Inan, S; Tuglu, I; Uyar, Y; Ozbilgin, KObjective: The goal of this study was to search the effects of two different doses of tibolone on endometrial IGF-1 and IGFBP-1 levels in ovariectomized rats. Methods: Eighteen adult, female, 80-90-days-old, Wistar rats with an average weight of 250 g underwent bilateral ovariectomy under general anesthesia. After waiting for 4 weeks, they were randomized into three groups to receive either oral tibolone in two different doses or placebo. The treatment was continued for 5 weeks, and then the rats were sacrificed and the endometria were analyzed. Results: Low columnar epithelium of the endometrial surface, longer epithelium and stratified squamous epithelium were seen in the control low-dose and high-dose groups, respectively. The staining intensity of IGF-1 was mild in control, and moderate in both treatment groups, the difference between control the treatment groups was significant (P=0.015 for group L, and P=0.03 for group H). The staining intensity of IGFBP-1 was moderate in control, and strong in groups L and H. Again the difference was significant between control and both treatment groups (P=0.039 for grup L, and P=0.03 for group H). No significant difference was noted between each treatment group for both IGF-1 and IGFBP-1. Conclusion: Tibolone caused histological changes in endometrium and stimulated IGF-I and IGFBP-1 staining. Both low and high dose treatments led to moderate and strong staining intensities for IGF-1 and IGFBP-1, respectively. The strong staining intensity of IGFBP-1 is likely due to the progestagenic effect of tibolone. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.Item Sexual behaviour during pregnancyOruc, S; Esen, A; Lacin, S; Adigüzel, H; Uyar, Y; Koyuncu, FThe effects of pregnancy on sexuality were studied in 158 pregnant women. They were surveyed by questionnaire about sociodemographic variables and sexual behaviour. Dyspareunia was common in our study group during pregnancy. Pregnancy had a negative effect on orgasmic quality. Dyspareunia and orgasmic quality influenced coital frequency. Coital frequency declined as the month of the pregnancy increased. Pregnancy is a potent influence on sexuality irrespective of an individual's conditioning.Item Perineometer and digital examination for assessment of pelvic floor strengthUyar, Y; Baytur, YB; Inceboz, UItem Primary vaginal squamous cell carcinoma-the coeffect of vaginal leiomyoma and Human papillomavirus (HPV); A case reportMavili, HS; Kandiloglu, AR; Atmis,Ö; Uyar, YPrimary vaginal squamous cell carcinoma (SCC) is extremely rare. Primer vaginal SSC developed by the coeffect of leiomyoma and Human papillomavirus (HPV) is presented. We report a case of primary vaginal SCC in a 62-year-old woman presenting dyspareunia. On macroscopic examination, the surface of the operation material was partly ulcerated. On the cut surface, the material was solid, firm, white, and whorled. Microscopic examination revealed leiomyoma ulcerating the mucosa and SCC at the base of the ulcer. The case, in which vaginal SCC developed in the vagina due to the irritation of the leiomyoma, as well as its relationship with HPV, is important to be the first to our knowledge.Item Comparative effects of risedronate, atorvastatin, estrogen and SERMs on bone mass and strength in ovariectomized ratsUyar, Y; Baytur, Y; Inceboz, U; Demir, BC; Gumuser, G; Ozbilgin, KObjective: The aim of this study was to investigate bone protective effects of risedronate, atorvastatin, raloxifene and clomiphene citrate in ovariectomized rats. Methods: Our study was conducted on 63 rats at Experimental Research Center of Celal Bayar University. Six-month-old rats were divided into seven groups. There were five drug administered ovariectomized groups, one ovariectomized control group without drug administration and one non-ovariectomized control group without drug administration. Eight weeks postovariectomy, rats were treated with the bisphosphonate risedronate sodium, the statin atorvastatin, the estrogen 17 beta-estradiol and the selective estrogen receptor modulators (SERMs) raloxifene hydrochloride and clomiphene citrate by gavage daily for 8 weeks. At the end of the Study, rats were killed under anesthesia. For densitometric evaluation, left femurs and tibiae were removed. Left femurs were also used to measure bone volume. Right femurs were used for three-point bending test. Results: Compared to ovariectomized group, femur cortex volume increased significantly in nonovariectomized group (p=0.016). Compared to non-ovariectomized group, distal femoral metaphyseal and femur midshaft bone mineral density values were significantly lower in ovariectomized group (p = 0.047). In ovariectomy + atorvastatin group, whole femur and femur midshaft bone mineral density and three-point bending test maximal load values were significantly higher than ovariectomized group (p = 0.049, 0.05, and 0.018). When compared to the ovariectomized group, no significant difference was found with respect to femoral maximum load values in groups treated with risedronate, estrogen, raloxifene and clomiphene (p = 0.602, 0.602, 0.75, and 0.927). In ovariectomy + risedronate group, femur midshaft bone mineral density values were significantly higher than the values in ovariectomized group (p = 0.023). When compared to ovariectomized group, no significant difference was found with respect to femur midshaft bone mineral density values in groups treated with estrogen, raloxifene and clomiphene (p = 0.306, 0.808, and 0.095). Conclusions: While risedronate sodium prevented the decrease in bone mineral density in ovariectomized rats, atorvastatin maintained mechanical characteristics of bone and also prevented the decrease in bone mineral density as risedronate sodium. (C) 2009 Elsevier Ireland Ltd. All rights reserved.Item The effect of infertility-related distress and marital adjustment on sexual dysfunction in women: a mixed methods studyYanikkerem, E; Topsakal,Ö; Kusçu, NK; Göker, A; Uyar, YTo investigate the effects of infertility-related distress and marital adjustment on sexual dysfunction. The research was carried out in two stages using a mixed method, both quantitatively with 242 and qualitatively with 12 infertile women. Characteristics of women questionnaire, the Infertility Distress Scale, Marital Adjustment Test, Female Sexual Function Index, and semi-structured interview form were used for data collection. The study found that smoking, husband's unemployment, and duration of wanting children led to an increase in infertility stress and decrease in marital harmony. Likewise, infertility treatment history, spouse's unemployment, paying all treatment expenses personally, and concerns about adoption were found to affect sexual functions. In this study, women's sexual functions were positively related to marital adjustment and negatively related to infertility stress. Qualitative data analysis identified four main themes: the implications of infertility, infertility on treatment, infertility on marriage, and infertility on sexuality. Women reported that their sex life suffered during diagnosis and treatment, with intercourse becoming a duty solely for conception, making them feel like robots. Health care providers should recognize the factors affecting women's sexual lives in infertility clinics.Item Normal range of intracranial translucency in healthy turkish pregnancies and its association with first trimester maternal serum biochemistry and ductus venosus Pulsatility IndexArtunc-Ulkumen, B; Pala, HG; Uyar, Y; Bulbul-Baytur, Y; Koyuncu, FMObjective: To measure the intracranial translucency (IT) by establishing reference ranges in uncomplicated single ton 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 beta-human chorionic gonadotropin (f beta-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 beta-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.Item Use of DNA hybridization test for diagnosing bacterial vaginosis in women with symptoms suggestive of infectionGazi, H; Degerli, K; Kurt, O; Teker, A; Uyar, Y; Caglar, H; Kurutepe, S; Surucuoglu, SThe purpose of this study was to evaluate a DNA hybridization test (Affirm VPIII) as an alternative to Gram stain for the rapid diagnosis of bacterial vaginosis in women with clinical signs of vaginal infection. Vaginal specimens were collected from 321 symptomatic women, and analyzed for bacterial vaginosis by both Gram stain using Nugent criteria and DNA hybridization test. Sensitivity, specificity, positive predictive value, and negative predictive value of the DNA hybridization test were determined using the Gram staining as the standard for diagnosis of bacterial vaginosis. Of the 321 patients, 115 (35.8%) were Gram positive for bacterial vaginosis and 126 (39.2%) were negative. 80 patients (25.0%) demonstrated intermediate Gram staining that was also considered negative. The Affirm system detected G. vaginalis in 107 (93.0%) of 115 vaginal specimens positive for bacterial vaginosis diagnosed by Gram stain. Compared to the Gram stain, DNA hybridization test had a sensitivity of 87.7% and a specificity of 96.0%. Positive and negative predictive values of the DNA hybridization test were 93.0% and 92.7%, respectively. In conclusion, Affirm VPIII hybridization test correlated well with Gram stain and may be used as a rapid diagnostic tool to exclude bacterial vaginosis in women with genital complaints.Item The correlation between unexplained infertility and exosomesUyar, Y; Özgül, M; Gökalp, S; Ok, G; Tan, A; Vatansever, HSObjectives: Endometrial receptivity plays the most important role for successful implantation. Increasing endometrial receptivity may improve infertility and increase Assisted Reproductive Technologies success. The aim of this study was to investigate the effect of exosome specific markers CD63 and CD9 which are promising molecules in the pathogenesis and treatment of many diseases on endometrial receptivity in women with unexplained infertility. Material and methods: This prospective study was conducted between November 2015 and March 2017. Proliferation and secretion periods of endometrial samples from fertile and infertile cases were collected. The paraffin-embedded tissue sections were stained with hematoxylin-eosin for the immunohistochemical analysis distributions of CD63 and CD9. Results: The results of this study demonstrated that the CD63 immunoreactivity was higher in both luminal and glandular epithelium of infertile patients when compared with fertile patients during the proliferative phase (p = 0.009, p = 0.008). In the infertile proliferation phase, endometrium CD9 immunoreactivity was rarely detected in both the luminal and glandular epithelium. In the secretion phase of endometrium, CD9 immunoreactivity was mild in fertile patients, the increased immunoreactivity of CD9 was observed in both luminal and glandular epithelium of infertile patients (p = 0.037, p = 0.037). Conclusions: Increased levels of CD63 in infertile proliferation phase endometrium should represent an unfavorable signaling. Moreover, the increased levels of CD9 in infertile secretion phase endometrium could be used as a biomarker to evaluate endometrial receptivity. These exosome-specific markers can be considered as potential molecular markers of infertility.