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Öğe Effect of paclitaxel on primordial follicular reserve in mice(Elsevier Science Inc, 2001) Gücer, F; Balkanli-Kaplan, P; Doganay, L; Yüce, MA; Sayin, NC; Yardim, T[Abstract Not Available]Öğe Effects of oral, continuous and transdermal cyclic 17-? estradiol and norethindrone acetate replacement therapy on platelet aggregation in postmenopausal women(Sci Printers & Publ Inc, 2002) Kaplan, PB; Gücer, F; Sayin, NC; Yüce, MA; Yardim, TOBJECTIVE: To evaluate the affects of an oral continuous and transdermal cyclic 17-beta estradiol and norethindrone acetate combination on platelet aggregation in postmenopausal women. STUDY DESIGN: Fifty postmenopausal women were randomly assigned to receive 17-beta estradiol and norethindrone acetate either orally continuously or transdermally cyclically and sequentially. Platelet counts and maximum platelet aggregation rates were measured before and after three months treatment. RESULTS: At three months there were no significant changes in platelet counts or in adenosine diphosphate-induced or epinephrine-induced platelet aggregation rates in either treatment group. CONCLUSION: Hormone replacement treatment with a 17-beta estradiol and norethindrone. acetate combination either orally continuously or transdermally cyclically and sequentially does not affect platelet aggregation in postmenopausal women.Öğe Elevated serum TNF-? levels in normal-weight women with polycystic ovaries or the polycystic ovary syndrome(Sci Printers & Publ Inc, 2003) Sayin, NC; Gücer, F; Balkanli-Kaplan, P; Yüce, MA; Ciftci, S; Kücük, M; Yardim, TOBJECTIVE: To compare the serum tumor necrosis factor-alpha (TNF-alpha) levels in nonobese women with those in women with polycystic ovaries (PCO) and polycystic ovary syndrome (PCOS) and healthy controls. STUDY DESIGN: Twenty-one sonographically and biochemically diagnosed women with PCOS, 19 with PCO and 14 healthy women were recruited for the study. Serum TNF-alpha levels were measured in all three groups. Insulin and glucose serum concentrations were analyzed before and after a 75-g oral glucose tolerance test in all samples. The serum TNF-alpha, glucose and insulin levels were compared in PCOS, PCO and controls. RESULTS: Serum TNF-alpha levels were similar in the PCOS and PCO groups (23.67 +/- 5.58 and 13.58 +/- 1.34 pg/mL, respectively) and significantly higher than in the control group. Serum TNF-alpha levels did not significantly correlated with body mass index, serum total testosterone, LH, DHEAS, fasting glucose and fasting insulin levels or glucose and insulin area under the curve values in the three groups. CONCLUSION: We found similar TNF-alpha levels in patients with PCOS and with PCO; however, there was no correlation between the TNF-alpha and insulin, glucose and androgen levels in the study.Öğe Evaluation of gestational age based on ultrasound petal growth measurements(Yonsei Univ College Medicine, 2001) Varol, F; Saltik, A; Kaplan, PB; Kilic, T; Yardim, TMonitoring fetal growth and assessing its predictors have important place in antenatal care management. Accurate prediction of gestational age (GA) and birth weight (BW) is clinically important. Standard growth curve chosen should be evaluated to see if it satisfies the criteria for a valid assesment. In this paper, for the purpose of contributing to develop national standards and to evaluate Hadlock's standard data pertaining to 1411 fetuses were examined. Of 1411 normally growing fetuses, one measurement for AC, BPD and FL was taken by ultrasound. GA was assessed via menstrual history which is also confirmed by ultrasonography. Several variables, AC, BPD, FL, FL/AC, BPD/FL and dependent variables (GA & BW) were modelled mathematically. Percentile values, correlation coefficients were calculated and well functioning regression equations were produced for the fetal growth evaluation. Simple correlation model re-confirmed that AC, BPD and FL were well predictors of GA. Via modelling by multivariate regression analysis (adj. R-2 = 937), GA=4.945 (95% CI: 4.661-5.654) +.606 AC + .105 BPD +.286 FL can be estimated. It couldn't be possible establishing an appropriate equation for prediction of BW vith current data. Our study is intended to draw an attention on requirement of national standards although Hadlock's standard growth curve may evaluate fetal development accurately. Forming comprehensive cohort group is under our consideration. The equation we developped (shown in the results), might be a working contribution.Öğe Evaluation of hepatic venous pulsatility and portal venous velocity with doppler ultrasonography during the puerperium(Elsevier Sci Ireland Ltd, 1999) Pekindil, G; Varol, FG; Yüce, MA; Yardim, TObjective: The aim of this study is to evaluate pregnancy-induced changes of hepatic venous pulsatility and portal venous velocity in the puerperium and to determine if these changes disappeared by the end of the puerperium. Methods and material: Healthy normal volunteers (90) were examined on the 2nd and 7th days of puerperium and between the Gth and 8th weeks postpartum Doppler waveform patterns were obtained in the middle hepatic vein and main portal vein. The hepatic venous pulsatility was named as normal, damped or flat. Results: On the 2nd day postpartum, the hepatic vein pulsatility was shown as normal in 8 (26%), damped in 11 (37%) and flat in 11 (37%) cases. On the 7th day postpartum, 15 (50%) cases had normal, 9 (30%) cases had dampened, and 6 (20%) cases had still flat pattern. The majority of the cases (60%) displayed normal hepatic venous pulsatility in the 6th and 8th weeks of puerperium, whereas 23% had still dampened and 17%, had flat patterns. There was a trend toward normal pulsatility with increasing puerperal age. The mean portal venous velocity was still higher than the non-pregnant levels and did not showed significant alterations during puerperium. Conclusion: This study emphasised that, since pregnancy-induced alterations in hepatic venous pulsatility and portal venous velocity had not completely returned to normal in most cases until the end of the puerperium. these physiological changes should be considered whenever hepatic and portal systems are interpreted with Doppler sonography during the puerperal period. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.Öğe The fetal stomach circumference abdominal circumference ratio: A possible parameter in assessing fetal stomach size(Yonsei Univ College Medicine, 1998) Pekindil, G; Varol, F; Yuce, MA; Yardim, TNonvisualized, dilated or even a small fetal stomach can be associated with a variety of anomalies and poor fetal outcome. Therefore, we attempted to evaluate the stomach circumference (SC) / abdominal circumference (AC) ratio to assess normal limits of fetal stomach size. A total of 363 fetuses ranging from 15 to 39 weeks' gestation were prospectively evaluated with ultrasonography. The SC was measured from a plane that is perpendicular to the fetal longitudinal axis at the level where the largest axial circumference of the stomach was obtained using a digitizer. The AC was also measured at the same section and the ratio was calculated by dividing the SC by the AC and multiplying by 100. The SC increased linearly from 15 to 24 weeks and showed fluctuations in size thereafter to 39 weeks. A strong correlation was noted between gestational age and both SC (r: 0.842, P < 0.0001) and AC (r: 0.975, P < 0.0001). The SC/AC ratio was normally distributed with a mean of 20.4 +/- 3.9% and ranged between 14.8% and 27.03% throughout pregnancy (r: 0.021, P > 0.05). Although the fetal stomach is a dynamically changing organ, the SC/AC ratio can be considered as a potentially useful parameter in assessing fetal stomach size.Öğe Insulin resistance and lipid profile in women with polycystic appearing ovaries(Parthenon Publishing Group, 2003) Sayin, NC; Gücer, F; Balkanli-Kaplan, P; Yüce, MA; Yardim, TThe aim of this study was to investigate carbohydrate and lipid profiles in women with polycystic appearing ovaries (PCO) on ultrasound examination who did not fulfill the criteria for polycystic ovary syndrome (PCOS). We sonographically evaluated and biochemically diagnosed 35 patients with PCO, 31 women with PCOS and 23 healthy controls. We performed oral glucose tolerance tests (OGTT) and calculated the quantitative insulin sensitivity check index (QUICKI) and the homeostatic model assessment (HOMAIR) scores. Serum fasting insulin levels, 1-h insulin response, HOMAIR and QUICKI scores were significantly higher in the PCO and PCOS groups than in the controls. However, serum fasting glucose levels, fasting insulin levels, HOMAIR and QUICKI scores were similar in women with PCO and PCOS. In women with PCO, high-density lipoprotein (HDL) levels were higher, and very-low-density lipoprotein (VLDL) and triglyceride levels were lower compared with women with PCOS. Furthermore, insulin responses to OGTT, HOMAIR and QUICKI scores and lipid values correlated with serum androgen levels and body mass index (BMI) in PCO patients. In conclusion, women with PCO who do not fulfill the criteria for PCOS have abnormal insulin sensitivity and insulin resistance. The finding of similar insulin abnormalities in women with PCO to those in women with PCOS confirms that women with PCO have similar metabolic characteristics to those with PCOS.Öğe Live birth of healthy twins after a heterotopic tubal and intrauterine twin pregnancy in a woman who was stimulated with clomiphene citrate(Elsevier Science Inc, 2003) Sayin, NC; Yardim, TObjective: To report a heterotopic pregnancy with successful delivery of monochorionic-diamniotic twins after rupture of the tubal ectopic gestation. Design: Case report. Setting: University teaching hospital. Patient(s): A patient with heterotopic twin monochorionic-diamniotic pregnancy. Intervention(s): Surgical removal of the ectopic pregnancy. Main Outcome Measure(s): Pregnancy course and outcome. Result(s): The patient successfully delivered twins. Conclusion(s): Heterotopic pregnancy after clomiphene citrate administration may have a complicated course, but could end in successful live birth of twins. (Fertil Steril(R) 2003;80:1265-7. (C) 2003 by American Society for Reproductive Medicine.).Öğe Maternal serum cytokine levels in women with hyperemesis gravidarum in the first trimester of pregnancy(Elsevier Science Inc, 2003) Kaplan, PB; Gücer, F; Sayin, NC; Yüksel, M; Yüce, MA; Yardim, TObjective: To compare serum cytokine levels in patients with hyperemesis gravidarum with levels in healthy pregnant and nonpregnant women. Design: Case-control study. Setting: Clinical and academic research center. Patient(s): Thirty women with hyperemesis gravidarum, 30 healthy women in the first trimester of pregnancy, and 30 healthy nonpregnant women. Main Outcome Measure(s): Serum levels of interleukin-1beta, interleukin-2 receptor, interleukin-6, interleukin-8, and tumor necrosis factor (TNF)-alpha. Result(s): Median serum levels of interleukin-2 receptor and interleukin-8 did not differ significantly among the three groups. Serum levels of interleukin-1beta and interleukin-6 were significantly higher in healthy pregnant women than in healthy nonpregnant women. Median TNF-alpha levels were significantly higher in women with hyperemesis (25.8 pg/mL [range, 4.9-140 pg/mL]) than in healthy pregnant and nonpregnant women (10.85 pg/mL [range, 4.1-35.8 pg/mL] and 12 pg/mL [4.3-68.2 pg/mL], respectively). Conclusion(s): Levels of TNF-alpha were significantly higher in patients with hyperemesis gravidarum than in healthy pregnant and nonpregnant women. Thus, TNF-alpha may be involved in the etiology of hyperemesis gravidarum.Öğe Maternal serum levels of tumor necrosis factor-? and interleukin-2 receptor in threatened abortion(Elsevier Science Inc, 2001) Gücer, F; Balkanli-Kaplan, P; Yüksel, M; Sayin, NC; Yüce, MA; Yardim, TObjective: We evaluated tumor necrosis factor-alpha (TNF-alpha) and interleukin-2 (IL-2) receptor levels in patients with threatened abortion and compared the levels with normal and pathologic pregnancies. Design: A prospective, nonrandomized, case-control study. Setting: Academic research setting. Patient(s): Twenty-two patients with threatened abortion, 18 patients with pathologic pregnancies, 20 healthy pregnant women, and 20 nonpregnant women. Intervention (s): Maternal serum TNF-alpha and IL-2 receptor levels were measured with a solid-phase, two-site chemiluminescent enzyme immunometric assay method. Main Outcome Measure(s): TNF-alpha and IL-2 receptor levels. Result(s): The mean SEM maternal serum IL-2 receptor level for patients with threatened abortion was 481.3 +/- 35.7 U/mL, compared with 426.5 +/- 22.4 U/mL in the normal pregnant group. There was no statistically significant difference in the mean SEM serum TNF-alpha level between the patients with threatened abortion and those with normal pregnancies (16.1 +/- 2.7 pg/mL vs. 10.9 +/- 0.8 pg/mL). The mean SEM maternal serum IL-2 receptor level was significantly higher in patients with pathologic pregnancies than in those with normal pregnancies (506.2 +/- 27.6 U/mL vs. 426.5 22.4 U/mL). The mean SEM maternal serum TNF-alpha level was significantly higher in patients with pathologic pregnancies than in those with threatened abortion (39.2 +/- 9.5 pg/mL vs. 16.1 +/- 2.7 pg/mL) and normal pregnancies (39.2 +/- 9.5 pg/mL vs. 10.9 +/- 0.8 pg/mL). Conclusion(s): In comparison with normal pregnancies, maternal serum IL-2 receptor and TNF-alpha levels were not significantly increased in patients with threatened abortion with good outcome. (Fertil Steril(R) 2001;76: 707-11. (C) 2001 by American Society for Reproductive Medicine.).Öğe Maternal serum tumor necrosis factor-? in patients with preterm labor(Sci Printers & Publ Inc, 2001) Gücer, F; Balkanli-Kaplan, P; Yüksel, M; Yüce, MA; Türe, M; Yardim, TOBJECTIVE: To evaluate maternal serum tumor necrosis factor-alpha (TNF alpha) levels in patients with preterm labor without clinical signs of chorioamnionitis and to compare these with levels in nonlaboring controls. STUDY DESIGN: The study group consisted of 44 patients with a singleton pregnancy admitted to our department with the diagnosis of preterm labor between 26 and 36 weeks' gestation. The control group consisted of 25 healthy consecutive patients with a singleton pregnancy without preterm contractions who were seen for routine antenatal visits. Maternal serum TNF alpha was measured using a solid-phase, two-site chemiluminescent enzyme immunometric assay method, and levels were compared in patients with preterm labor and nonlaboring controls. RESULTS: The median maternal serum TNF alpha level for patients with preterm labor was 29.4 pg/mL (range, 12.3-173) as compared with 23 pg/mL (range, 11.9-62.7) in the control group (P = .031). Among 44 patients with preterm labor, 14 (32%) delivered within one week of admission. The median maternal serum TNF alpha level was significantly higher in patients who delivered within one week than in those who delivered after one week and controls (71.3 pg/mL [range, 28-173]) versus 22 pg/mL (range, 12.3-86) versus 23 pg/mL (range, 11.9-62.7) (P < .0001). CONCLUSION: TNF was elevated in patients with preterm labor, suggesting a role for maternal serum TNF alpha in its initiation.Öğe Persistent large choroid plexus cyst -: A case report(Sci Printers & Publ Inc, 2001) Gücer, F; Yüce, MA; Karasalihoglu, S; Cakir, B; Yardim, TBACKGROUND: Prenatally diagnosed choroid plexus cysts regress or resolve spontaneously during pregnancy. A persistent large choroid plexus cyst with a prenatal diagnosis has not been reported previously CASE: A 28-year-old, healthy primigravida was referred to our department at 32 weeks' gestation for a suspected fetal intracranial anomaly. Ultrasonography revealed a lateral ventricle 13 mm in width. The ventricle was dilated only in the atrium region. The choroid plexus was not distinct from the inner wall of the ventricle and did not fill the atrium of the lateral ventricle. The patient was followed with biweekly ultrasonography until delivery, and the left ventricular width increased from 13 to 17 mm. At 38 weeks' gestation the patient delivered a 3,350-g girl. Magnetic resonance imaging showed a 1.7x2.5x3.0-cm cyst in the left lateral ventricle. Follow-up magnetic resonance imaging scans at 6 and 11 months showed unchanged findings. Clinical and neurologic examinations at 11 months of age showed normal development. CONCLUSION: Although small (<1 cm), postnatally persistent choroid plexus cysts are clinically insignificant variants of normal; the prognosis of large, persistent cysts (1 cm) is less clear. Long-term neurologic follow-up is mandatory for these neonates.Öğe Prenatally closed gastroschisis with midgut atresia(Springer-Verlag, 2002) Basaran, UN; Inan, M; Gücer, F; Yardim, T; Pul, MSpontaneous prenatal closure of gastroschisis (GS) is rare and usually associated with atresia of the midgut. We describe a case of GS diagnosed at 20 weeks' gestation that resolved spontaneously in utero. At delivery the infant had an ileus. A laparotomy with a jejunocolostomy was performed, but she died at 2 months of age due to complications of total parenteral nutrition.Öğe Prevention of cyclophosphamide-induced ovarian damage by concomitant administration of GnRHa in mice(I R O G Canada, Inc, 2004) Yüce, MA; Kaplan, PB; Gücer, F; Doganay, L; Altaner, S; Canda, T; Yardim, TObjective (s): This experimental study investigates the dose-related effects of cyclophosphamide (Cy) on primordial follicular reserve in young mice, and examines whether the concomitant administration of a gonadotropin-releasing hormone agonist (GnRHa) may protect gonadal reserve, even at different doses of Cy. Methods: Forty sexually mature virginal Balb/c mice aged five to six weeks were administered different doses (0, 50, 75,100 mg/kg) of Cy. Another 40 animals were treated with increasing doses (10, 50, 75, 100 mg/kg) of Cy in combination with GnRHa. GnRHa treatment was initiated one week prior to chemotherapy and also continued after chemotherapy for one week. The ovaries were removed seven days after Cy administration and the total number of primordial follicles in both ovaries was counted. Results: Primordial follicular destruction occurred at all levels of Cy exposure. There was a positive correlation between increasing doses of Cy and higher proportion of follicular loss (p < 0.0001). GnRHa was not able to protect against the chemotherapy-induced negative effect on primordial follicular count at low doses (50 mg/kg and 75 mg/kg). Mean +/-SD primordial follicle count in the 100 mg/kg Cy-treated group was significantly lower than in the 100 mg/kg Cy + GnRHa treatment group (73.9 +/- 33.1 vs 89 +/- 17.9, p = 0.047). Conclusion: Our data suggest a possible ovarian protective effect of GnRHa cotreatment only at high doses of Cy treatment. However, in spite of co-administration of GnRHa, loss of primordial follicular reserve occurred at all doses of Cy in mice.
