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Öğe Association of maternal serum high sensitive C-reactive protein level with body mass index and severity of pre-eclampsia at third trimester(Wiley, 2010) Ertas, Ibrahim E.; Kahyaoglu, Serkan; Yilmaz, Bulent; Ozel, Murat; Sut, Necdet; Guven, Melih A.; Danisman, NuriAim: To assess a maternal serum level of high sensitive C-reactive protein (hs-CRP) as a useful clinical parameter in prediction of pre-eclampsia severity and, to evaluate the correlation between hs-CRP and body mass index (BMI). Material & Methods: Using cross-sectional study design, CRP was measured by a high sensitive immunoturbidimetric method between 24 and 40 weeks of gestation in normotensive controls (n = 115), in mild (n = 63) and severe (n = 34) pre-eclamptic patients. The receiver operating characteristic analysis was used to estimate the optimal threshold score of hs-CRP. Results: For disease severity evaluation, a hs-CRP concentration of 9.66 mg/L was determined as cut-off point with 88% sensitivity, 81% specificity, 71% positive predictive value and 92% negative predictive value. When all three groups of patients were adjusted for gestational age [24 degrees/7-27,6/7 28 degrees/7-33,6/7 34 degrees/7-406/7] and BMI, hs-CRP levels of severe pre-eclamptic patients were significantly higher than mild ones and controls in the study group with BMI < 25 kg/m2 (P < 0.001). In the study group with BMI >= 25 kg/m2, only severe pre-eclamptic patients between 28 degrees/7 and 336/7 weeks of gestation had significantly higher hs-CRP levels when compared with control and mild pre-eclamptic group (P < 0.001). When the patients were subgrouped as high (>= 9.66 mg/L) and low hs-CRP group (< 9.66 mg/L), adverse outcomes for hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome and intrauterine growth-restricted baby were statistically significant higher in high hs-CRP group (P = 0.004 and P < 0.001, respectively). Conclusion: Elevated level of hs-CRP is a useful parameter in the severity of clinical risk of pre-eclampsia in patients with BMI < 25 kg/m2 at third trimester.Öğe Atorvastatin causes regression of endometriotic implants in a rat model(Elsevier Sci Ltd, 2010) Yilmaz, Bulent; Ozat, Mustafa; Kilic, Sevtap; Gungor, Tayfun; Aksoy, Yasemin; Lordlar, Nese; Sut, NecdetEndometriotic implants were induced surgically in female Wistar albino rats, which were randomly divided into three groups. The rats in group I (n = 10) and group II (n = 9) were given 2.5 mg/kg/day intraperitoneal and oral atorvastatin, respectively, for 28 days. Group III (n = 9) was given no medication (control). The mean volume and weight of explants in group I were significantly lower (both P < 0.05) compared with group III. Histopathological score of the implants was significantly tower in groups I and II, when compared with group III (P < 0.01 and P < 0.05, respectively). There were significant reductions in explant concentrations of vascular endothelial growth factor and matrix metalloproteinase 9 in group I (P < 0.01 and P < 0.001, respectively) and group II (both P < 0.01) compared with group III while staining due to tissue inhibitor of metalloproteinase 2 was significantly higher in group I (P < 0.01) and group II (P < 0.01) compared with group III. Moreover, explant concentration of superoxide dismutase was significantly increased in groups I and II compared with group III (both P < 0.05). In conclusion, atorvastatin causes significant regression of endometriotic implants in rats. Moreover, intraperitoneal atorvastatin seems to be more effective than oral atorvastatin. (C) 2009, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.Öğe The efficacy of tyrosine kinase inhibitor dasatinib on colonic mucosal damage in murine model of colitis(Elsevier Masson, Corporation Office, 2016) Can, Guray; Ayvaz, Suleyrnan; Can, Hatice; Karaboga, Ihsan; Demirtas, Selim; Aksit, Hasan; Yilmaz, BulentBackground and objective: Ulcerative colitis is an inflammatory condition of the colon in the gastrointestinal system. Currently, the most potent medications used for ulcerative colitis produce no response in 20-30% of cases. There is a need for more efficient and reliable medications. Tyrosine kinase inhibitors have shown efficacy in some inflammatory diseases. Although dasatinib, a tyrosine kinase inhibitor, suppresses proinflammatory cytokines in colonic tissue, there are a few cases of hemorrhagic colitis with dasatinib. There is no study investigating the effect of dasatinib on experimental colitis. We aimed to investigate the effect of dasatinib in a colitis model induced with acetic acid in our study. Methods: In the study, 24 male Sprague-Dawley rats randomly distributed into 4 groups of 6 rats each as control, dasatinib, colitis and dasatinib + colitis groups. For colitis induction, 4% acetic acid was used. Sacrificing of the rats was performed on the seventh day. Disease activity, morphologic and histological injury, superoxide dismutase, myeloperoxidase and malondialdehyde activity, TNF alpha and CD3 expression were assessed in colonic tissue. Results: Apart from malondialdehyde, significant difference in all parameters between the control and colitis groups was determined. Difference between the colitis and colitis + dasatinib groups was not significant in only weight loss and biochemical parameters. Though dasatinib does not fully resolve the changes in colitis, there was significant regression. Conclusions: Dasatinib decreased the inflammation in a rodent model of colitis. It may be provide this effect by the suppression of TNF alpha. Dasatinib may be one of the treatment options for ulcerative colitis. (C) 2016 Elsevier Masson SAS. All rights reserved.Öğe Meperidine versus valethamate bromide in shortening the duration of active labor(Elsevier Ireland Ltd, 2009) Yilmaz, Bulent; Kart, Cavit; Kelekci, Sefa; Gokturk, Umut; Sut, Necdet; Tarlan, Nurten; Mollamahmutoglu, LeylaObjective: To compare the efficacy and safety of meperidine hydrochloride and valethamate bromide against placebo in shortening the duration of active labor. Method: We randomly assigned 160 nulliparous women with a singleton pregnancy at term who needed induction of labor to one of 3 treatments: 50 mg of meperidine (n = 53), 16 mg of valethamate bromide (n = 53), or a normal saline solution as placebo (n = 54). All medications were given by slow intravenous infusion. Labor duration was the main outcome measure. Results: The intervals between infusion and complete cervical dilation and between infusion and delivery were significantly reduced (P<0.001 and P<0.01) in the meperidine group (103.0 +/- 64.5 minutes and 119.8 +/- 70.2 minutes), in contrast to the placebo group (173.9 +/- 74.8 minutes and 192.2 +/- 82.8 minutes). However, differences were not significant between the 2 treatment groups (139.6 +/- 63.1 minutes and 160.6 +/- 71.9 minutes), or between the valethamate bromide and the placebo group. Conclusion: Meperidine, but not valethamate bromide, significantly shortened the duration of active labor in nulliparous women with a singleton pregnancy at term. (C) 2009 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.Öğe Metformin and atorvastatin reduce adhesion formation in a rat uterine horn model(Reproductive Healthcare Ltd, 2009) Yilmaz, Bulent; Aksakal, Orhan; Gungor, Tayfun; Sirvan, Levent; Sut, Necdet; Kelekci, Sefa; Soysal, SunullahThe aim of the present study was to determine whether atorvastatin and metformin are effective in preventing adhesions in a rat uterine horn model. A total of 40 non-pregnant, female Wistar albino rats, weighing 180-210 g, were used as a model for post-operative adhesion formation. The rats were randomized into four groups after seven standard lesions were inflicted in each uterine horn and lower abdominal sidewall using bipolar cauterization. The rats were given atorvastatin 2.5 mg/kg/day, p.o. (10 rats), atorvastatin 30 mg/kg/day, p.o. (10 rats), metformin 50 mg/kg/day, p.o. (10 rats) and no treatment was applied in the control group (10 rats). The animals were killed 2 weeks later and adhesions were scored both clinically and pathologically by authors blinded to groups. One rat in the control group died before the end of the 2 week period. Total clinical adhesion scores regarding extent, severity and degree of adhesions and histopathological findings including inflammation and fibrosis were significantly lower in the metformin (P < 0.001 and P < 0.01, respectively) and atorvastatin 30 mg/kg/day (P < 0.001 and P < 0.01, respectively) groups when compared with control group. Metformin and atorvastatin are both effective for prevention of adhesion formation in a rat uterine horn model.Öğe Metformin regresses endometriotic implants in rats by improving implant levels of superoxide dismutase, vascular endothelial growth factor, tissue inhibitor of metalloproteinase-2, and matrix metalloproteinase-9(Mosby-Elsevier, 2010) Yilmaz, Bulent; Sucak, Ayhan; Kilic, Sevtap; Aksakal, Orhan; Aksoy, Yasemin; Lortlar, Nese; Sut, NecdetOBJECTIVE: We sought to test if metformin could regress endometriotic explants in rats. STUDY DESIGN: After inducing endometriotic implants and randomization of female Wistar albino rats, they were given 25 and 50 mg/kg/day of oral metformin in group A (n = 9) and B (n = 8), respectively, for 28 days. Group C (n = 9) was given saline as placebo. RESULTS: Mean volume, weight, and histologic score of implants in groups A (P < .01, P < .05, and P < .05, respectively) and B (P < .01, P < .05, and P < .05, respectively) were significantly lower than in group C. The activity of superoxide dismutase and tissue inhibitor of metalloproteinase-2 staining in groups A (P < .05 and P < .01, respectively) and B (P < .01 and P < .01, respectively) was significantly higher than in the control group. Moreover, there were more significant reductions in implant levels of vascular endothelial growth factor and matrix metalloproteinase-9 in groups A (both P < .001) and B (both P < .001) than in group C. CONCLUSION: Metformin causes regression of endometriotic implants in rats.Öğe Moistening of misoprostol tablets with acetic acid prior to vaginal administration for mid-trimester termination of anomalous pregnancy: A randomised comparison of three regimens(Taylor & Francis Ltd, 2010) Yilmaz, Bulent; Ertas, Ibrahim Egemen; Kelekci, Sefa; Sut, Necdet; Mollamahmutoglu, Leyla; Danisman, NuriMethods A total of 118 women requiring second-trimester pregnancy termination were randomly assigned to one of three treatment groups: 400 mu g 3-hourly in group A (n = 39), 600 mu g 6-hourly in group B (n = 39), and 800 mu g 12-hourly in group C (n = 40). Misoprostol tablets moistened with 3 ml of 5% acetic acid were placed into the posterior vaginal fornix. Results The median induction-abortion times in groups A (8 h [range: 3-64]) and B (9 h [4-81]) were significantly shorter (p < 0.01 and p < 0.05, respectively) than in group C (12.5 [3-72]). Moreover, expulsion rates within 24 hours in groups A (92.3%) and B (92.3%) were significantly higher (p < 0.05 in both cases) than that of group C (75%). Expulsion rate within 48 hours, number of tablets used, number of patients with retained placenta and side effects did not differ between groups. Conclusions Misoprostol moistened with acetic acid is effective for second-trimester pregnancy termination when given vaginally 3-hourly, 6-hourly or 12-hourly. The former two regimens are significantly more effective than the latter.Öğe Pimecrolimus 1% cream for pruritus in postmenopausal diabetic women with vulvar lichen simplex chronicus: A prospective non-controlled case series(Taylor & Francis Ltd, 2008) Kelekci, Handan Kiymet; Uncu, Hikmet Gulsen; Yilmaz, Bulent; Ozdemir, Orcun; Sut, Necdet; Kelekci, SefaBackground: Pruritus vulvae may have a variety of causes, such as infections, dermatologic disorders or non-neoplastic/neoplastic vulvar diseases. Objectives: To investigate the efficacy and side effects of topical pimecrolimus 1% cream for pruritus vulvae. Methods: Twelve postmenopausal diabetic women with vulvar lichen simplex chronicus were enrolled in this trial. Each patient was treated with pimecrolimus 1% cream which was applied twice daily in a thin layer to the vulvae for 3 months. Clinical examination and recording of patients' symptoms using a scoring system was performed by the same physician before, after 4 weeks and after 3 months of therapy. Results: All of the patients completed the study. A substantial decrease in pruritus after treatment was reported by the patients at the 4th week (2.17 +/- 0.72, p < 0.01) and 3rd month of treatment (0.42 +/- 0.92, p < 0.001) when compared with the baseline score (3.75 +/- 0.45). Follow-up of the patients after 3 months of treatment showed that complete cure occurred in 10 patients (83.3%) and the pruritus was improved in two (16.7%) patients. Conclusions: Pimecrolimus 1% cream seems to be an effective and safe treatment modality for pruritus in postmenopausal women with vulvar lichen simplex chronicus.Öğe Prematurity: is it a risk factor for striae distensae?(Wiley, 2011) Kelekci, Kiymet Handan; Kelekci, Sefa; Destegul, Emre; Aksoy, Ayhan; Sut, Necdet; Yilmaz, BulentBackground Although the causes of striae distensae (SD) remain to be elucidated, the condition is known to relate to changes in the structures that provide the skin with its tensile strength and elasticity. Objective This study was conducted to evaluate whether premature birth is a risk factor for SD. Methods A total of 15,475 parous women ranging in age from 18-45 years were interviewed between January 2007 and June 2009. After exclusion criteria were applied, a total of 1336 women were included in the study. Group 1 consisted of 1231 women of reproductive age who had been born at term. Group 2 included 105 women of reproductive age who had been born prematurely. The main outcome measure was the prevalence of SD. Results The overall prevalence of SD was 34.6% (462/1336). Mild SD was significantly more common (P < 0.01) in women who had been born prematurely (49.5%) than in women who had been born at term (31.8%). A multivariate analysis using backward stepwise logistic regression analysis identified that height, weight, gravidity, parity and abortion were found to be significantly associated with SD. Conclusions Striae distensae was significantly more common in women who had been born prematurely than in women who had been born at term.Öğe A randomised controlled trial on melatonin and rosiglitazone for prevention of adhesion formation in a rat uterine horn model(Springer Heidelberg, 2010) Aksakal, Orhan; Yilmaz, Bulent; Gungor, Tayfun; Sirvan, Levent; Sut, Necdet; Inan, Ismet; Kalyoncu, SenolTo investigate the effectiveness of melatonin and rosiglitazone in reducing postoperative adhesion formation in a rat uterine horn model. Thirty non-pregnant female Wistar albino rats, weighing 180-220 g, were used as a model for postoperative adhesion formation. The rats were randomised into three groups after seven standard lesions were inflicted in a 2-cm segment of each uterine horn and lower abdominal sidewall using bipolar cauterisation. The rats were treated with 10 mg/kg, intraperitoneal melatonin, and 1 mg/kg per day peroral rosiglitazone. No medication was given to the control group. As much as 20 uterine horns of 10 rats were evaluated in each group. Extent, severity, and degree of the adhesions to the uterine horns and, inflammation and fibrosis scores (histopathologically) were evaluated after 2 weeks of the treatment. There was no mortality in the groups and all of the rats recovered without incident after operation. Rosiglitazone group had lower adhesion scores [median (min-max ranges)] regarding extent, severity, and degree of the adhesions [0 (0-3), 0 (0-3) and 0 (0-3), respectively], which were significantly different (P < 0.001, P < 0.05 and P < 0.01, respectively) from those of the controls [1 (0-3), 2 (0-2) and 2 (0-3), respectively]; however, there were no statistically significant differences between rosiglitazone versus melatonin groups [1 (0-4), 2 (0-3) and 1 (0-3), respectively] and melatonin versus control groups. Moreover, no significant differences were determined between groups regarding histopathologic findings. Rosiglitazone, but not melatonin, is effective in prevention of adhesion formation in a rat uterine horn model.Öğe The Role of Vaginal pH on Efficacy of Controlled-Release Dinoprostone Vaginal Insert for Cervical Ripening/Labor Induction: A Prospective Double-Blind Study(Galenos Yayincilik, 2008) Onen, Fiahin; Ozaksit, Gulnur; Yilmaz, Bulent; Gungor, Tayfun; Bilge, Umit; Sut, Necdet; Mollamahmutoglu, LeylaObjective: To evaluate if vaginal pH has any effect on the efficacy of controlled-release PGE 2 vaginal insert for cervical ripening/labor induction in post-term patients. Materials and Methods: Sixty-three post-term women with unfavorable cervix (Bishop's score +/- 6) undergoing labor induction were enrolled in this prospective, double-blinded trial. All patients received sustained-release dinoprostone vaginal insert for cervical ripening/labor induction during 12 hours, repeated dosing one time 24 hours later. Results: Women with a low vaginal pH (>4.5, n= 38) and women with a high vaginal pH (> 4.5, n= 25) were similar in maternal age, parity, body mass index, gestational age or initial Bishop's score. Bishop's score change over the initial 12 hours significantly (p<0.05) differed between the low vaginal pH (3.9 +/- 3.3) and the high vaginal pH group (5.5 +/- 3.4). Time to active labor (14.7 +/- 17.3 hrs vs 13.1 +/- 9.8 hrs), complete dilation (19.6 +/- 20.1 hrs vs 17.1 +/- 11.8 hrs) and delivery (20.0 +/- 21.4 hrs vs 17.6 +/- 12.0 hrs) were comparable between the low and high vaginal pH groups, respectively. Linear regression analysis revealed no significant association between vaginal pH and Bishop's score change over 12 hours, time to active labor, time to complete dilation, or time to delivery. Discussion: Vaginal pH has significant effect on cervical ripening but has no effect on delivery outcomes in post-term patients with unfavorable cervices, who undergo cervical priming/labor induction using sustained-release dinoprostone vaginal insert.Öğe The Syk Inhibitor Fostamatinib Decreases the Severity of Colonic Mucosal Damage in a Rodent Model of Colitis(Oxford Univ Press, 2015) Can, Guray; Ayvaz, Suleyman; Can, Hatice; Demirtas, Selim; Aksit, Hasan; Yilmaz, Bulent; Korkmaz, UgurBackground and aims: Inflammatory bowel disease is a chronic inflammatory disease of the gastrointestinal system. In some cases, current medications used for inflammatory bowel disease may not be enough for remission, creating a need for more potent and reliable medications. There is no study showing the efficacy of fostamatinib, with proven effects on some inflammatory diseases, on ulcerative colitis. In our study we planned to research the efficacy of fostamatinib, a spleen tyrosine kinase inhibitor, on acetic acid-induced colitis. Methods: The study included 28 male Sprague-Dawley rats, randomly divided into control group, fostamatinib group, colitis group and fostamatinib + colitis group, each containing seven rats. Colitis induction was performed with 4% acetic acid. Colonic inflammation was assessed with disease activity index, macroscopic and histological damage scores, colonic myeloperoxidase, malondialdehyde and superoxide dismutase activity, and tumour necrosis factor alpha [TNF alpha], CD3, Syk, and phospho-Syk expression. Results: There was a significant difference between the colitis and control groups in terms of all parameters. The disease activity index, macroscopic and microscopic damage scores, immunohistochemical TNF alpha, CD3, Syk, and phospho-Syk expression, and tissue myeloperoxidase activity were found to be significantly lower in the colitis + fostamatinib group compared with the colitis group. There was no significant difference between the two groups in terms of myeloperoxidase and malondialdehyde activity. Conclusions: Fostamatinib reduced the inflammatory damage in the experimental colitis. This effect may be due to suppression of TNF alpha, T-lymphocytes, and neutrophils in colonic mucosa via suppression of Syk. Fostamatinib may be an appropriate treatment alternative for ulcerative colitis. Further clinical studies are required to support this.Öğe Tyrosine kinase-2 gene polymorphisms are associated with ulcerative colitis and Crohn's disease in Turkish Population(Elsevier Masson, Corp Off, 2015) Can, Guray; Tezel, Ahmet; Gurkan, Hakan; Can, Hatice; Yilmaz, Bulent; Unsal, Gulbin; Soylu, Ali RizaBackground and objective: Inflammatory bowel disease is a group of chronic inflammatory conditions affecting gastrointestinal tract. Lots of genes have been identified resulting in susceptibility to inflammatory bowel disease. Any polymorphism leading to functional modifications in tyrosine kinase-2 may precipitate excessive immune response in the intestinal mucosa. The aim of our study is to investigate the involvement of tyrosine kinase-2 polymorphisms in the patients with inflammatory bowel disease in Turkish population. Methods: Four single nucleotide polymorphisms in tyrosine kinase-2 (rs280523, rs2304256, rs280519 and rs280496) were genotyped in 60 Crohn's disease, 151 ulcerative colitis patients and 89 unrelated healthy controls. These polymorphisms were detected by real-time polymerase chain reaction. Results: The presence of genotype (CC) in rs2304256 and (AA) in rs280519 were found to increase the susceptibility to ulcerative colitis (P = 0.024, 0.025, respectively). rs2304256 (CA) and rs280519 (AG) have provided protection against ulcerative colitis (P = 0.021, 0.012, respectively). rs280519 (AG) was protective against Crohn's disease (P = 0.045). rs2304256 (CC) increased the susceptibility to inflammatory Crohn's disease (P = 0.014). The presence of rs2304256 (A) increased the susceptibility to perianal Crohn's disease (P = 0.03). Both rs280519 and rs2304256 polymorphisms were associated with the requirement of corticosteroid and immunosuppressive therapy in ulcerative colitis. Conclusion: This study is the first demonstration of the single marker association of tyrosine kinase-2 polymorphisms with ulcerative colitis and Crohn's disease in Turkish population. They may be effective in the etiology of inflammatory bowel disease in our population. Disparity between our study and others may be related to ethnic differences. (C) 2015 Elsevier Masson SAS. All rights reserved.