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Öğe Amniotic Membrane-Coated Polypropylene Mesh for the Repair of Incisional Hernia: An Experimental Study In a Rat Model of Abdominal Wall Defect(KOWSAR PUBL, 2018) Soylu, Sinan; Yildiz, Caglar; Bozkurt, Birkan; Karakus, Savas; Kurt, Begum; Kurt, AtillaBackground: Incisional hernia repairs are among common abdominal wall surgeries, can be primarily required or being reconstructed using a synthetic or biological material. Objectives: This study aimed at evaluating intra-abdominal adhesions and incisional site healing after the repair of abdominal wall by fresh amniotic membrane-coated polypropylene mesh in comparison to only polypropylene mesh in an experimental rat study. Methods: The study protocol was approved by Cumhuriyet University Institutional Ethics Committee for Animal Experiments (Sivas-Turkiye, date 24/06/2015). Sixteen pregnant female Wistar-Albino rats (mean weight, 275 g) were anesthetized on the 21st day of pregnancy and a 1-cm area of the abdominal wall was excised. The pregnancy was terminated, emerging amniotic membranes were dissected, and eight pieces of the 1-cm(2) polypropylene mesh were coated with these amniotic membranes without using any suture or adhesive. The polypropylene meshes were sutured on the abdominal wall of eight rats (control group), selected by simple random sampling. For the remaining eight rats, the same procedure was applied with the amniotic membrane-coated polypropylene meshes (experimental group). On the 28th postoperative day, the anterior abdominal wall was opened, and intra-abdominal adhesions were assessed macroscopically by Nair's adhesion scoring system. Strip-shaped biopsy samples were taken from incision lines for histopathological examination. Results: The experimental group had significantly less intra-abdominal adhesions (i.e. Nair's score of 2 to 4) compared to the control group (two and six rats, respectively; P= 0.046), and had significantly lower mean score for polymorphonuclear leukocyte infiltration (P = 0.039), hyperemia (P= 0.039), and epithelialization (P= 0.039). The score for increase in connective tissue (P = 0.018) was significantly higher in the experimental group, and the scores for edema (P= 0.590) and macrophage infiltration (P= 0.590) were similar between the two groups. Conclusions: The use of polypropylene mesh coated with fresh amniotic membrane provides advantage of decreasing postoperative intra-abdominal adhesions along with less inflammation and higher epithelialization after abdominal wall repair surgery.Öğe The Association of Plasminogen Activator Inhibitor Type 1 (PAI-1) Level and PAI-1 4G/5G Gene Polymorphism with the Formation and the Grade of Endometrial Cancer(SPRINGER/PLENUM PUBLISHERS, 2017) Yildirim, Malik Ejder; Karakus, Savas; Kurtulgan, Hande Kucuk; Kilicgun, Hasan; Ersan, Serpil; Bakir, SevtapPlasminogen activator inhibitor type 1 (PAI-1) is a serine protease inhibitor (Serpine 1), and it inhibits both tissue plasminogen activator and urokinase plasminogen activator which are important in fibrinolysis. We aimed to find whether there is a possible association between PAI-1 level, PAI-1 4G/5G polymorphism, and endometrial cancer. PAI-1 levels in peripheral blood were determined in 82 patients with endometrial carcinoma and 76 female healthy controls using an enzyme-linked immunoassay (ELISA). Then, the genomic DNA was extracted and screened by reverse hybridization procedure (Strip assay) to detect PAI 1 4G/5G polymorphism. The levels of PAI-1 in the patients were higher statistically in comparison to controls (P < 0.001). The distribution of PAI-1 4G/5G polymorphism was quite different between patients and controls (P = 0.008), and 4G allelic frequency was significantly higher in the patients of endometrial cancer than in controls (P = 0.026). We found significant difference between Grade 1 and Grade 2+3 patients in terms of the PAI-1 levels (P = 0.047). There was no association between PAI-1 4G/5G polymorphism and the grades of endometrial cancer (P = 0.993). Our data suggest that the level of PAI-1 and PAI-1 4G/5G gene polymorphism are effective in the formation of endometrial cancer. PAI-1 levels are also associated with the grades of endometrial cancer.Öğe Comparison of Effectiveness of Laminaria versus Vaginal Misoprostol for Cervical Preparation Before Operative Hysteroscopy in Women of Reproductive Age: A Prospective Randomized Trial(ELSEVIER SCIENCE INC, 2016) Karakus, Savas; Akkar, Ozlem Bozoklu; Yildiz, Caglar; Yenicesu, Gonca Imir; Cetin, Meral; Cetin, AliStudy Objective: To compare the effectiveness and safety of intracervical laminaria dilator versus intravaginal misoprostol administered before surgery to facilitate cervical dilation before operative hysteroscopy. Design: A prospective randomized study (Canadian Task Force classification 1). Setting: A university hospital. Patients: A total of 150 women were assigned at random to the following groups: laminaria dilation (n = 50), misoprostol dilation (n = 50), and mechanical dilation (n = 50). Interventions: Hysteroscopic surgery of intrauterine lesions. Measurements and Main Results: In this study, 150 women were assigned at random to receive cervical priming with an intracervical laminaria dilator, 200 mu g of intravaginal misoprostol, or a mechanical dilator before operative hysteroscopy. Cervical response, surgical outcome, and complications of operative hysteroscopy were assessed. Visual analog scale (VAS) pain scores were recorded in the misoprostol and laminaria dilation groups. Demographic variables of the study groups were comparable (p = .278.988). The duration of cervical pretreatment was similar with the intracervical larminaria dilator and intravaginal misoprostol (p = .803); however, intravaginal misoprostol was associated with more adverse effects (p = .031). Compared with the misoprostol dilation group, in which all patients required additional cervical dilation, notably fewer patients in the laminaria dilation group required additional cervical dilation after cervical preparation (p = .001). VAS pain scores were significantly higher in the laminaria dilation group, however (p = .001). Conclusion: Cervical priming with an intracervical laminaria dilator before operative hysteroscopy reduces the need for cervical dilation and better facilitates hysteroscopic surgery compared with intravaginal misoprostol. Oral analgesic use may be required before the use of this device. Journal of Minimally Invasive Gynecology (C) 2016 AAGL. All rights reserved.Öğe Comparison of maternal serum vitamin D and paraoxonase 1 levels and neutrophil to lymphocyte ratios of preeclamptic and severe preeclamptic, and normal pregnant women(E-CENTURY PUBLISHING CORP, 2016) Akkar, Ozlem Bozoklu; Sancakdar, Enver; Karakus, Savas; Yildiz, Caglar; Arslan, Murat; Yucel, Hasan; Ozcelik, Fatma; Yenicesu, Ayse Gonca Imir; Cetin, Meral; Cetin, AliPreeclampsia is one of the most common causes of maternal and neonatal morbidity and mortality worldwide. We aimed to evaluate the diagnostic values of maternal serum levels of 25-hydroxyvitamin D and paraoxonase 1 (PON1) and neutrophil to lymphocyte ratio (NLR) in the preeclamptic patients and to assess whether they can be used to distinguish the severity of preeclampsia. This prospective study was conducted in women with preeclampsia (n=34) or severe preeclampsia (n=10) and normal pregnancies (n=36), with at least gestational age of 24 weeks. Maternal serum 25-hydroxyvitamin D and PON1 were measured and NLR was calculated. The 25-hydroxyvitamin D levels of the study groups were found comparable (P > 0.05). The normal pregnancy and preeclampsia groups were comparable (P > 0.05) with regard to the PON1 level; however, their PON1 levels were significantly higher compared to the severe preeclampsia group (P < 0.05). The NLRs of the normal pregnancy and preeclampsia groups were found similar (P > 0.05), but the NLR of severe preeclampsia group was significantly higher compared to the normal pregnancy and preeclampsia groups (P < 0.05). The maternal serum 25-hydroxyvitamin D level is not useful as a marker in the diagnosis of preeclampsia; however, the maternal serum PON1 level and NLR may distinguish the patients with preeclampsia with severe features, but not the patients with preeclampsia without severe features.Öğe Effect of imatinib on growth of experimental endometriosis in rats(ELSEVIER SCIENCE BV, 2016) Yildiz, Caglar; Kacan, Turgut; Akkar, Ozlem Bozoklu; Karakus, Savas; Seker, Metin; Kacan, Selen Baloglu; Ozer, Hatice; Cetin, AliObjective: Currently, medical and surgical treatment options for endometriosis are limited due to suboptimal efficacy, and also safety and tolerance issues. Long-term use of gonadotrophin-releasing hormone analogs, androgenes, and the danazol, which are widely used drugs for endometriosis, is usually not possible due to their suboptimal safety and tolerance profile. The lack of an effective, tolerable and safe treatment option for endometriosis makes animal models of experimental endometriosis necessary to study candidate drugs. The aim of this study was to investigate the efficacy of imatinib on the experimental endometriosis in a rat model. Study design: Endometriosis was induced by autotransplantation of uterine tissue into the peritoneal cavity. Twenty-four rats, which had visually confirmed endometriotic implants on subsequent laparotomy, were randomized into three groups to receive imatinib (25 mg/kg/day, p.o.), anastrozole (0.004 mg/day, p.o.), or normal saline (0.1 mL, i.p.) for 14 days. After removal of endometriotic tissue and H & E staining, endometriosis score was determined according to a semiquantitative histological classification. Also, immunostaining with primary antibodies including VEGF, CD117, and Bax were used for immunohistochemical (IHC) examination. Results: Both anastrozole and imatinib suppressed the growth of endometriotic tissue and reduced the number of ovarian follicles. Although the difference was not statistically significant, imatinib was less effective than anastrozole for treatment of endometriosis. Conclusion: Imatinib effectively treats experimental endometriosis by its inhibitor effects on angiogenesis and cell proliferation. (C) 2015 Elsevier Ireland Ltd. All rights reserved.Öğe The Effects of Erzincan Grape (Vitis vinifera spp., Cimin) and Benzothiazol on a Coenorhabditis elegans Organism Model(MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2017) Ozpinar, Hulya; Ozpinar, Necati; Karakus, SavasBackground: Grapes and their products are known to have been used for the treatment of diseases throughout history. Objective: It was aimed to investigate the effects of Erzincan Cimin grapes on an organism model of Caenorhabditis elegans N2 wild type and C. elegans BS913 strains with gonad cancer. Materials and Methods: The effects of methanol extracts of the skin and seeds of Erzincan Cimin grapes were examined separately on C. elegans N2 wild type and an effect was determined on lifespan. By applying GS-MS analysis, a potential agent substance was determined in the skin and seed methanol extracts. This substance was purchased and the effects of this substance were investigated on lifespan and fertility in C. elegans BS913 strains with gonad cancer. In addition, the effects on young subjects exposed to this agent substance in L1 form were investigated. Results: Grape seed and skin methanol extract was observed to prolong the lifespan most at a dose of 10 mg/100 mL. Lifespan was determined to be at a maximum in a gonad cancer organism model with benzothiazol at a dose of 50 ppm. At the same dose, positive effects were determined on the fertility of strains with cancer. When the effects of benzothiazol were examined on young Li forms, an evident retardation of growth was determined at doses of 10, 50, and 100 ppm. Conclusion: Owing to anti-carcinogenic effects of benzothiazol and benzothiazol-derived substances, they can be considered as agent substances in academic studies related to cancer.Öğe Effects of lavender scent on patients' anxiety and pain levels during gynecological examination(ELSEVIER SCI LTD, 2017) Tugut, Nilufer; Demirel, Gulbahtiyar; Baser, Muruvvet; Ata, Elvan E.; Karakus, Savas…Öğe Effects of Pazopanib, Sunitinib, and Sorafenib, Anti-VEGF Agents, on the Growth of Experimental Endometriosis in Rats(SAGE PUBLICATIONS INC, 2015) Yildiz, Caglar; Kacan, Turgut; Akkar, Ozlem Bozoklu; Karakus, Savas; Kacan, Selen Baloglu; Ozer, Hatice; Cetin, AliWe aimed to compare the effects of pazopanib, sunitinib, and sorafenib on endometriotic tissue morphology and histological characteristics as well as ovarian reserve in a rat model. Experimental endometriosis was established in 32 rats. They were randomly divided into 4 groups (8 rats for each group) to administer study drugs: pazopanib, sunitinib, sorafenib, and normal saline. Histological examination with hematoxylin and eosin staining to determine endometriosis score and immunostaining with primary vascular endothelial growth factor (VEGF), CD117, and Bax antibodies were performed. Bilateral ovaries excised to determine the ovarian follicle number. The endometriosis score was significantly reduced by pazopanib compared to other study drugs and by sunitinib compared to sorafenib and normal saline (P < .05). Sorafenib did not affect endometriosis score (P > .05). The VEGF score was significantly decreased similarly by pazopanib, sunitinib, and sorafenib compared to normal saline (P < .05). The CD117 score was reduced by pazopanib and sunitinib similarly compared to both sorafenib and normal saline that provided similar effect on the score (P < .05). The Bax scores of all the groups were found similar (P > .05). No study drugs caused meaningful change in the ovarian follicle number (P > .05). Pazopanib reduces the growth of endometriotic implants. This effect may be related to the suppressive effect of pazopanib on the endometriotic tissue expressions of VEGF and CD117 but not Bax. The study drugs do not affect ovarian reserve. The inconsistent effects of study drugs regarding study parameters require further studies to elucidate the molecular bases of their effects on the growth of endometriotic implants.Öğe Elevated Serum CD95/FAS and HIF-1 alpha Levels, but Not Tie-2 Levels, May Be Biomarkers in Patients With Severe Endometriosis: A Preliminary Report(ELSEVIER SCIENCE INC, 2016) Karakus, Savas; Sancakdar, Enver; Akkar, Ozlem; Yildiz, Caglar; Demirpence, Ozlem; Cetin, AliStudy Objective: To evaluate serum values of cluster of differentiation 95 (CD95/FAS), hypoxia-inducible factor 1-alpha (HIF-1 alpha), and tyrosine kinase receptor 2 (Tie-2) as possible biomarkers of disease presence and severity in women with endometriosis, and to characterize the changes in these values in women with stage I/II and stage III/IV endometriosis. Design: Prospective study (Canadian Task Force classification I). Setting: University hospital. Patients: Thirty women with endometriosis and 30 healthy women without endometriosis. Intervention: For the diagnosis of endometriosis and prediction of its severity, we measured the serum levels of CD95/FAS, which assess apoptotic conditions, and of HIF-1 alpha and Tie-2, which assess angiogenesis. Endometriosis was diagnosed and staged through surgical laparoscopy and later confirmed histologically. During the surgery, the patients with endometriosis were divided into 2 groups based on disease stage. Eleven patients had stage I/II endometriosis, and 19 had stage III/IV endometriosis. Measurements and Main Results: Endometriosis was associated with increased serum CD95/FAS and HIF-1 alpha levels, but not Tie-2 levels. We also determined that stage III/IV endometriosis was associated with higher serum CD95/FAS and HIF-1 alpha levels, but not Tie-2 levels, compared with stage I/II endometriosis. Conclusion: Endometriosis, in accordance with its severity, increases serum CD95/FAS and HIF-1 alpha levels, but not Tie-2 levels. These biomarkers may be useful for reproductive surgeons to improve the quality of counseling women about the presence and severity of endometriosis. (C) 2016 AAGL. All rights reserved.Öğe Evaluation of Maternal Serum 25-Hydroxyvitamin D, Paraoxonase 1 Levels, and Neutrophil-to-Lymphocyte Ratio in Spontaneous Preterm Birth(INT SCIENTIFIC LITERATURE, INC, 2016) Akkar, Ozlem Bozoklu; Sancakdar, Enver; Karakus, Savas; Yildiz, Caglar; Akkar, Ismail; Arslan, Murat; Sahin, Irfan Oguz; Yenicesu, Ayse Gonca Imir; Cetin, AliBackground: The aim of this study was to evaluate the association of maternal serum 25-hydroxyvitamin D, paraoxonase 1, and neutrophil-to-lymphocyte ratio in women having early spontaneous preterm birth without clinical chorioamnionitis. Material/Methods: This study was prospectively administered in women referred to our obstetrics service with preterm labor that resulted in preterm birth (n=35) and term labor that ended in term birth (n=44). The maternal serum levels of 25-hydroxyvitamin D and paraoxonase 1 were measured and neutrophil-to-lymphocyte ratio was calculated. Results: The 25-hydroxyvitamin D and paraoxonase 1 levels of the preterm group were significantly lower than those of the term group (p<0.05). The neutrophil-to-lymphocyte ratio value of the preterm group was significantly higher than that of the term group (p<0.05). There was a significant but small positive correlation between the serum levels of 25-hydroxyvitamin D and paraoxonase 1 in the preterm group (r=0.35; p=0.021). Conclusions: Decreased maternal serum 25-hydroxyvitamin D and paraoxonase 1 levels and increased neutrophil-to-lymphocyte ratio may have a role in the etiology of spontaneous preterm birth.Öğe Evaluation of ovarian reserve using anti-mullerian hormone and antral follicle count in Sjogren's syndrome: Preliminary study(WILEY, 2017) Karakus, Savas; Sahin, Ali; Durmaz, Yunus; Aydin, Huseyin; Yildiz, Caglar; Akkar, Ozlem; Dogan, Mansur; Cengiz, Ahmet; Cetin, Meral; Cetin, AliAimThe aim of this study was to determine ovarian reserve status using anti-mullerian hormone (AMH) level and antral follicle count (AFC) in patients with Sjogren's syndrome (SS). MethodsTwenty-four women with SS diagnosed according to the classification criteria proposed by the American-European Consensus Group and 25 healthy women as controls were enrolled in this study. Ovarian reserve was assessed on clinical findings, AFC, and serum AMH and reproductive hormone levels. ResultsCompared with the healthy controls, in the SS patients, the duration of menstrual cycle was significantly shorter (P = 0.043); serum AMH (P = 0.001) and AFC (P = 0.001) were significantly lower, and serum luteinizing hormone (LH) was significantly higher (P = 0.019). The right (P = 0.555) and left ovarian (P = 0.386) volumes were also lower but this did not reach statistical significance. Serum follicle-stimulating hormone (P = 0.327), estradiol (P = 0.241), and prolactin (P = 0.55) were similar between the two groups. ConclusionsOvarian reserve may be reduced in SS patients. For the assessment of ovarian reserve, serum AMH and ovarian AFC with serum LH may be useful. Further studies with long-term follow-up are required to determine the course of ovarian reserve abnormalities and best possible biomarkers of reduced ovarian reserve in SS patients.Öğe Exploring altered free amino acids and metabolites: Insights into the metabolic landscape of preeclampsia(W B Saunders Co Ltd, 2024) Karakus, Savas; Dogan, Halef OkanIntroduction: Preeclampsia (PE) is a complex disease that poses a risk for maternal and perinatal morbidity and mortality. This study aimed to investigate the role of maternal serum amino acids (AAs) levels in PE. Materials and methods: A total of 56 pregnant women (26 with PE and 30 controls) were included in the study. The participants had a confirmed gestational age between 24 and 37 weeks. The mean body mass index (BMI) for the PE group was 33.1 kg/m2, while the control group had a mean BMI of 29.6 kg/m2. AAs levels were quantified, and statistical analyses were performed to identify significant differences between the two groups. Receiver Operating Characteristic (ROC) curve analysis was employed the diagnostic potential of specific AAs. Results: We observed significantly elevated levels of multiple AAs in the PE group, including citrulline, lysine, ethanolamine, ornithine and histidine. Citrulline exhibited exceptional predictive power for PE with 100.0% sensitivity and specificity at a cutoff of 7.79 mu mol/L, reflected in an area under the curve (AUC) of 1.000. Discussion: Our study highlights the crucial involvement of altered amino acid levels, specifically in the urea cycle, disruptions in lysine and ethanolamine metabolism in PE development. Exploring these changes may reveal new therapeutic targets, providing insights into the disease's molecular mechanisms. Understanding amino acid metabolism in PE not only informs therapeutic strategies but also holds the potential to revolutionize early diagnosis and intervention.Öğe Genetic variants in the microRNA machinery gene (Dicer) have a prognostic value in the management of endometrial cancer(WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2018) Oz, Muhammed; Karakus, Savas; Yildirim, Malik; Bagci, Binnur; Sari, Ismail; Bagci, Gokhan; Yildiz, Caglar; Akkar, Ozlem; Cetin, Ali; Yanik, AliAim: Although several associations were found between Dicer rs3742330 single nucleotide polymorphism (SNP) and development and prognosis of some epithelial cancers, relationship between the SNP rs3742330 and endometrial cancer (EC) has not yet been studied. We aimed to investigate the prognostic role of rs3742330 SNP of Dicer gene in EC patients. Subjects and Methods: A total of 80 EC patients and 80 control subjects included in the study. Real-time polymerase chain reaction and the allele discrimination technique was used for genotyping of rs3742330 SNP. Results: There was no significant difference between EC patients and control subjects with regard to the genotype and allele frequencies for Dicer rs3742330 SNP (P > 0.05). Despite Dicer rs3742330 SNP had no prognostic value in terms of stage, grade, lymphovascular invasion, myometrial invasion, tumor size, and histopathology; malignant peritoneal cytology has been detected higher in the patients bearing AA genotype compare with AG genotype (P = 0.023). Higher recurrence rate and shorter time to recurrence were found in patients bearing AG and GG genotype compare with AA genotype (P = 0.009). Conclusion: Dicer rs3742330 AG and GG genotypes may have the potential to be used as a predictor of poor prognosis in the management of EC case.Öğe Investigating the protective potential of dinoprost in a rat model of ischemia-reperfusion(2023) Karakus, Savas; Ozkaraca, MustafaAim: This study investigates the protective effects of Dinoprost against Ischemia/ Reperfusion (I/R) damage in the rat ovary, focusing on the expression of cyclooxygenase-2 (COX-2), Interleukin-1? (IL1?), and Tumor Necrosis Factor-? (TNF-?). Additionally, the impact of Dinoprost on reducing hemorrhage in the ovarian tissue is evaluated. Materials and Methods: A total of 24 rats were randomly divided into four groups: Control, Ischemia (Isch), I/R, and Dino+I/R. Ischemia was induced by clamping the ovarian blood supply, followed by reperfusion. Dinoprost was administered before reperfusion in the Dino+I/R group. COX-2, IL1?, and TNF-? expression levels were assessed through histochemical and immunochemical analyses. Hemorrhage in the ovarian tissue was also examined. Results: The Dino+I/R group exhibited a significant decrease in COX-2 expression compared to the Isch and I/R groups (p<0.05). However, there were no significant changes in the expression levels of IL1? and TNF-? among the groups. Notably, the Dino+I/R group showed significantly reduced hemorrhage compared to the Isch and I/R groups (p<0.05). Conclusion: Dinoprost demonstrated a protective effect against I/R damage in the rat ovary, primarily by attenuating COX-2 expression and reducing hemorrhage. These findings suggest the potential therapeutic utility of Dinoprost in mitigating ovarian I/R injury, emphasizing its role in preserving ovarian function and fertility.Öğe Maternal serum amino acid levels as predictors of premature rupture of membranes: A comprehensive analysis(W B Saunders Co Ltd, 2024) Karakus, Savas; Dogan, Halef OkanIntroduction: The aim of this study is to investigate the association between altered maternal serum amino acids (AAs) levels and premature rupture of membranes (pPROM) in pregnant women.Methods: We conducted a case-control study involving 60 pregnant women diagnosed with pPROM and 60 healthy pregnant women as controls. Amino acid levels were quantified using high-performance liquid chromatography. Receiver operating characteristic (ROC) curve analysis was performed to determine the predictive capability of specific AAs for pPROM.Results: Our findings revealed that lysine, glycine, and glutamic acid levels were significantly elevated in the pPROM group compared with the control group. Lysine, with a threshold value exceeding 137.90 mu mol/L, exhibited the highest predictive accuracy, with an area under the curve (AUC) of 0.796 (p < 0.001), sensitivity of 66.7 %, and specificity of 80.0 %. Glycine, with a cut-off value of >242.48 mu mol/L, had an AUC of 0.789 (p < 0.001), sensitivity of 83.3 %, and specificity of 65.0 %. Glutamic acid, at a threshold of 111.40 mu mol/L, demonstrated an AUC of 0.787 (p < 0.001), sensitivity of 88.3 %, and specificity of 65.0 %. These AAs could effectively predict the occurrence of pPROM.Conclusion: Elevated blood levels of lysine, glycine, and glutamic acid were found to be associated with pPROM. These AAs serve as potential predictive biomarkers for pPROM, with lysine showing the highest AUC and sensitivity. Identifying such biomarkers may contribute to the development of non-invasive diagnostic tools for pPROM risk assessment, enabling timely interventions and improved maternal and fetal outcomes.Öğe Ovarian Reserve Assessment in Celiac Patients of Reproductive Age(INT SCIENTIFIC LITERATURE, INC, 2018) Cakmak, Erol; Karakus, Savas; Demirpence, Ozlem; Coskun, Banu DemetBackground: This study aimed to investigate ovarian reserve in patients of reproductive age with Celiac disease (CD) using anti-Mullerian hormone (AMH) levels, antral follicle counts (AFCs), and ovarian volume. Material/Methods: We included into this study 46 CD female patients and 40 healthy female subjects of reproductive age, ages 18-45 years. Venous blood samples were taken from both groups on days 2-4 of the menstrual cycle, and follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E-2), prolactin (PRL), and AMH levels were measured. On the same day, AFCs and ovarian volumes were determined. Data on body mass index (BMI), gravidity/parity/abortions/alive counts, disease duration, and Marsh histological classification were recorded. Results: There were no statistically significant differences between CD and control groups in terms of mean age, BMI, or median gravidity/parity/abortions/alive counts (p>0.05). Also, there were no statistically significant differences between the 2 groups in terms of mean FSH, LH, E-2, PRL levels, right and left ovarian volumes, and median right and left ovarian AFCs (p>0.05). However, AMH level was significantly lower in the CD group (p=0.032). No statistically significant correlation was found between AMH levels and age, BMI, FSH, LH, E-2, PRL levels, right and left ovarian volumes, right and left ovarian AFCs, or Marsh histological classification using the Spearman correlation test (p>0.05). However, an inverse correlation was detected showing that AMH levels decrease with increasing CD duration (r=-0.054, p=0.001). Conclusions: We found that AMH level and ovarian reserve was decreased in CD patients of reproductive age compared to healthy controls, and that AMH level and ovarian reserve decreased with increasing disease duration in CD patients.Öğe Ovarian reserve is preserved in Behcet's disease(WILEY, 2017) Sahin, Ali; Karakus, Savas; Durmaz, Yunus; Yildiz, Caglar; Aydin, Huseyin; Cengiz, Ahmet KivancAimTo compare ovarian reserve with anti-mullerian hormone (AMH) levels, antral follicle counts (AFCs) and ovarian volume in patients with Behcet's disease (BD) and healthy subjects. MethodThis study included 35 women with BD (mean age: 34.45.3years) and 35 healthy controls (mean age: 34.16.0years). Venous blood samples collected from groups on menstrual cycle Days 2-4 were analyzed using the enzyme-linked immunosorbent assay to measure follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E-2), prolactin (PRL) and AMH levels. The AFCs and ovarian volumes were estimated by ultrasonography on the same day. The body mass index (BMI), duration and severity of the disease, medications, and number of children were recorded. ResultsThere was no statistically significant difference in the mean age, median gravida/para/abortus and the number of live births and mean BMI between the patient and control groups (P>0.05). No statistically significant difference in the median FSH, LH, E2, PRL levels, right and left ovarian volumes, and right and left ovarian AFCs was observed among the patients and the controls (P>0.05). There was no statistically significant difference in the mean AMH levels (P=0.468). Bonferroni correction showed no statistically significant correlation between AMH levels and age, BMI, FSH, LH, E2, PRL levels, right and left ovarian AFCs, right and left ovarian volume (P>0.025) among the controls and the patients. ConclusionOur study results suggest that ovarian reserve is preserved in patients with BD. In addition, AMH levels of the BD patients were similar to levels of healthy subjects.Öğe Primary Sjogren's Syndrome Adversely Affects the Female Sexual Function Assessed by the Female Sexual Function Index: A Case-Control Study(TURKISH LEAGUE AGAINST RHEUMATISM, 2017) Yildiz, Caglar; Karakus, Savas; Bozoklu Akkar, Ozlem; Sahin, Ali; Bozkurt, Birkan; Yanik, AliObjectives: This study aims to evaluate the sexual function of females with primary Sjgren's syndrome (pSS) in comparison to healthy females by using the Female Sexual Function Index (FSFI). Patients and methods: This case-control study included 31 female patients (mean age 46.0 +/- 10.2 years; range 30 to 68 years) with pSS and 27 healthy females (mean age 44.2 +/- 8.5 years; range 30 to 55 years) as control group. The sexual function of the participants was assessed by 19-item FSFI. Results: Mean duration of pSS in the patient group was 35.9 months (range 3 to 264 months). Significantly higher number of pSS patients reported positive history for vaginal infection compared to controls (n= 26, 83.9% vs n= 7, 25.9%, respectively; p< 0.001) without any difference in endocervical culture result. Cervical smear assessment revealed more inflammation and atrophy in patient group compared to control group (p= 0.001). Mean FSFI total score was significantly lower in patient group than control group (18.9 +/- 9.9 vs 25.1 +/- 5.1, respectively; p=0.004). Similarly, five out of six domains of FSFI-arousal, lubrication, orgasm, satisfaction, and pain-were significantly lower in patient group. FSFI total and subscale scores, except for pain, were found to be negatively correlated with duration of pSS. Conclusion: The pSS causes sexual dysfunction in female patients. Furthermore, as disease duration increases, female sexual function decreases. Clinical management of female patients with pSS should cover the assessment of their sexual functionality and taking the necessary precautions to maintain satisfactory quality of life and treatment outcome.Öğe Prophylactic hypogastric artery ligation in surgery for placental invasion disorders(E-CENTURY PUBLISHING CORP, 2016) Kostu, Bulent; Ozer, Alev; Ercan, Onder; Bakacak, Murat; Karakus, Savas; Keten, HamitObjective: To determine the effectiveness of prophylactic hypogastric artery ligation (HAL) on the bleeding control in surgeries of placental invasion anomalies. Study design: In this study, an evaluation was made of the effects on bleeding of prophylactic HAL applied before hysterectomy in cases of placental invasion anomalies. A total of 45 pregnant patients with placental invasion anomalies were examined retrospectively. In Group 1 (n=19) hysterectomy alone was applied in the surgical treatment and in Group 2 (n=26), prophylactic HAL was applied before hysterectomy. The results were compared with evaluation of morbidities, particularly bleeding. Results: Statistically significantly higher values were determined in Group 1 compared to Group 2 in respect of estimated blood loss (3183 vs 2204 ml, P<0.001), amount of fluid drainage (2346 vs 700 ml, P<0.001), and mean units of packed red cells and thrombocytes transfused (5.8 vs 3.3 units, P<0.001 and 3.9 vs 2.5 units, P<0.001 respectively). The hCO3 level was statistically significantly lower in Group 1 (16.3 meq/L in Group 1, 19.2 meq/L in Group 2) (P=0.003). Conclusions: Prophylactic HAL has a protective effect on bleeding in operations of placental invasion anomalies and may be used in cases in which balloon occlusion of the hypogastric artery can not be performed.Öğe Renalase gene polymorphism is associated with increased blood pressure in preeclampsia(ELSEVIER SCI LTD, 2016) Bagci, Binnur; Karakus, Savas; Bagci, Gokhan; Sancakdar, EnverBackground: Renalase is a novel enzyme that degrades circulating catecholamines. We aimed to investigate the role of rs2576178 and rs10887800 polymorphisms of the renalase gene in preeclampsia (PE) patients Methods: This case-control study consisted of 110 women with PE and 102 normotensive controls. PCR-RFLP method was used for determination of renalase gene polymorphisms. Results: Allele frequency and genotype distribution of rs10887800 polymorphism were found statistically significantly higher in women with PE (p < 0.05). Also G allele and GG genotype of rs10887800 polymorphism were found higher in women with severe PE than that of mild PE (p < 0.05). There was no significant difference for rs2576178 polymorphism in terms of allele frequency and genotype distribution (p > 0.05). In PE patients, systolic blood pressure (SBP) means according to rs10887800 genotypes were found statistically significantly higher (GG vs AA; p = 0.001) and (GG vs GA; p = 0.001). Similarly, diastolic blood pressure (DBP) means were found statistically significantly higher in PE patients (GG vs GA: p = 0.001); (GG vs AA: p = 0.004). For rs2576178 polymorphism, SBP means were found as (GG vs AA; p = 0.012, GG vs GA; p > 0.05) in PE patients. DBP means were not significant according to rs2576178 genotypes in PE patients (p > 0.05). Conclusions: The findings of the present study suggest that blood pressure may be increased by GG genotype and G allele of rs10887800 polymorphism and the polymorphism may increase the susceptibility to PE. (C) 2016 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.
