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Aksoy RA, Aksu MG, Korcum AF, Genc M. Radiotherapy for vertebral hemangioma: the single-center experience of 80 patients. Strahlenther Onkol 2022; 198:648-653. [PMID: 35278096 DOI: 10.1007/s00066-022-01915-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/20/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE This study aimed to evaluate the therapeutic effect of radiotherapy and to determine possible prognostic factors in patients with painful vertebral hemangioma. METHODS In the last two decades, 80 patients with vertebral hemangioma who received radiotherapy in our institute were evaluated in terms of pain response, treatment-related side effects, and prognostic factors. All patients were questioned 3 months after radiotherapy for the evaluation of pain response and were divided into three groups (complete response, partial response, and no change). Moreover, the visual analog scale (VAS) was used for pain response assessment in 46 patients. Pain status was assessed to detect recurrence at each clinical examination during the follow-up period. Possible prognostic factors such as gender, size of the hemangioma, location, multilevel involvement and additional musculoskeletal disease on pain response were analyzed. RESULTS In this study, 45 individuals had lesions in the lumbar spine, 28 in the thoracic, and 7 in the cervical region. Furthermore, 51 patients had additional musculoskeletal conditions such as disc herniation, degenerative diseases, spondylolisthesis, and compression fracture. Radiotherapy was performed with a median daily dose of 2 Gy and a median total dose of 40 Gy. Complete pain response occurred in 58.8% of patients, 26.2% of patients had partial pain response, and 15% of patients had no pain response. The overall response rate was 85%, and 7 patients showed recurrent pain symptoms in the overall response group at routine follow-up. Additional musculoskeletal disorders were found to be the only prognostic factor associated with pain response. The median follow-up time was 60 months. Secondary malignancy was not found in any of the patients in this short follow-up time. No acute or late radiation-associated side effects greater than grade II were observed. CONCLUSION To our best knowledge, this study is one of the largest single-institution radiotherapy series on vertebral hemangiomas reported to date. The obtained data support the efficacy and safety of radiotherapy in the treatment of painful vertebral hemangioma. Our study showed that additional musculoskeletal disease plays an important role in pain response. Other prognostic factors and treatment of vertebral hemangioma with stereotactic radiosurgery should be investigated in future studies.
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Affiliation(s)
- Rahmi Atil Aksoy
- Department of Radiation Oncology, Akdeniz University School of Medicine, Antalya, Turkey.
| | - Melek Gamze Aksu
- Department of Radiation Oncology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Aylin Fidan Korcum
- Department of Radiation Oncology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Mine Genc
- Department of Radiation Oncology, Akdeniz University School of Medicine, Antalya, Turkey
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Genc M, Kandemir FM, Coban O. Effects of In-Ovo Rutin Injection to Fertile Japanese Quail (Coturnix Coturnix Japonica) Egg on Hatchability, Embryonic Death, Hatchling Weight, and Hatchling Liver Oxidative and Nitrosative Stress. Braz J Poult Sci 2019. [DOI: 10.1590/1806-9061-2018-0786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- M Genc
- Ataturk University, Turkey
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Gur EB, Gur MS, Ince O, Kasap E, Genc M, Tatar S, Bugday S, Turan GA, Guclu S. Vitamin D deficiency in pregnancy may affect fetal thymus development. Ginekol Pol 2018; 87:378-83. [PMID: 27304655 DOI: 10.5603/gp.2016.0008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 06/02/2016] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The aim of our study was to evaluate the association of vitamin D deficiency (VDD) during pregnancy with thymus size in full-term fetuses. MATERIAL AND METHODS In this prospective study, we evaluated mid-pregnancy serum 25-hydroxyvitamin D3 (25(OH)D3) concentrations. The fetal thymus size was measured by ultrasound in the third trimester. Neonatal 25(OH)D3 levels were evaluated by umbilical cord blood sampling. Correlation of maternal and neonatal vitamin D levels and association between thymus size and both, maternal and neonatal vitamin D concentrations were investigated. RESULTS Serum 25(OH) D3 concentrations were within the normal range in 48 (29.8%) mothers and 10 (13.1%) new-borns. A strong correlation between mid-pregnancy maternal and neonatal 25(OH)D3 concentration (r = 0.8, p < 0.001) was found. A significant linear correlation was observed between both, maternal and neonatal 25(OH)D3 concentrations and thymus perimeter length (r = 0.45, p = 0.04 and r = 0.43, p < 0.01, respectively). Both, maternal and fetal VDDs were associated with decreased thymus perimeter (p = 0.04, p = 0.03). CONCLUSIONS Vitamin D deficiency during pregnancy may be associated with smaller fetal thymus. Our data suggest that VDD in pregnancy may lead to systemic inflammatory response in the fetus.
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Affiliation(s)
- Esra Bahar Gur
- Department of Obstetrics and Gynecology, Faculty of Medicine, Katip Celebi University, İzmir, Turkey.
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Şahin N, Genc M, Turan GA, Kasap E, Güçlü S. A comparison of 2 cesarean section methods, modified Misgav-Ladach and Pfannenstiel-Kerr: A randomized controlled study. ADV CLIN EXP MED 2018. [PMID: 29533540 DOI: 10.17219/acem/66215] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND The modified Misgav-Ladach method (MML) is a minimally invasive cesarean section procedure compared with the classic Pfannenstiel-Kerr (PK) method. OBJECTIVES The aim of the study was to compare the MML method and the PK method in terms of intraoperative and short-term postoperative outcomes. MATERIAL AND METHODS This prospective, randomized controlled trial involved 252 pregnant women scheduled for primary emergency or elective cesarean section between October, 2014 and July, 2015. The primary outcome measures were the duration of surgery, extraction time, Apgar score, blood loss, wound complications, and number of sutures used. Secondary outcome measures were the wound infection, time of bowel restitution, visual analogue scale (VAS) scores at 6 h and 24 h after the operation, limitations in movement, and analgesic requirements. At 6 weeks after surgery, the patients were evaluated regarding late complications. RESULTS There was a significant reduction in total operating and extraction time in the MML group (p < 0.001). Limitations in movement were lower at 24 h after the MML operation, and less analgesic was required in the MML group. There was no difference between the 2 groups in terms of febrile morbidity or the duration of hospitalization. At 6 weeks after the operation, no complaints and no additional complications from the surgery were noted. CONCLUSIONS The MML method is a minimally invasive cesarean section. In the future, as surgeons' experience increases, MML will likely be chosen more often than the classic PK method.
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Affiliation(s)
- Nur Şahin
- Department of Obstetrics and Gynecology, Sifa University, Izmir, Turkey
| | - Mine Genc
- Department of Obstetrics and Gynecology, Sifa University, Izmir, Turkey
| | | | - Esin Kasap
- Department of Obstetrics and Gynecology, Karatas Hospital, Izmir, Turkey
| | - Serkan Güçlü
- Department of Obstetrics and Gynecology, Kent Hospital, Izmir, Turkey
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Uyumlu A, Satilmis B, Batcioglu K, Karadag N, Genc M. Effects of Calcium Channel Blockers on Trypsinogen Activation and Severity of Cerulein-induced Acute Pancreatitis in Rats. Indian J Pharm Sci 2018. [DOI: 10.4172/pharmaceutical-sciences.1000383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Kasap E, Genc M, Turan GA, Eskicioğlu FE, Saklamaz A, Sahin N, Güclü SG. The association of impaired gestational glucose tolerance with maternal and fetal outcomes. CLIN EXP OBSTET GYN 2016. [DOI: 10.12891/ceog3141.2016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Genc M, Celik E, Eskicioglu F, Gur EB, Kurtulmus S, Gulec E, Guclu S. The relationship between uterine prolapse and premalignant endometrial pathology. CLIN EXP OBSTET GYN 2016. [DOI: 10.12891/ceog2095.2016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Kasap E, Turan GA, Eskicioğlu F, Cengiz H, Gur EB, Sivrikoz ON, Genc M, Yılmaz O. Comparison between resveratrol and cabergoline in preventing ovarian hyperstimulation syndrome in a rat model. Gynecol Endocrinol 2016; 32:634-640. [PMID: 26939766 DOI: 10.3109/09513590.2016.1152575] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE The aim of this study is to investigate the effects of resveratrol in a rat model of ovarian hyperstimulation syndrome (OHSS) and compare with cabergoline. DESIGN Randomized controlled, animal study. ANIMAL(S) Female Wistar rats. MATERIAL AND METHODS A rat OHSS model was used to investigate the effects of resveratrol compare with cabergoline administration for preventing OHSS. Body weight, ovary weight, diameter, vascular permeability (VP), vascular endothelial growth factor (VEGF), cyclooxygenase-2 (COX-2) expression (immunohistochemistry), and serum estradiol (E2) levels were then compared. RESULTS The ovarian VEGF concentration was significantly increased in the OHSS Groups (Groups 3-5) compared with the control groups (1 and 2). But vascular permeability, VEGF, and COX-2 expressions were reduced in animals treated with the resveratrol group compared with the cabergoline group (group 5) and the severe OHSS (group 3) group. Blood E2 levels were decreased in group treated with the resveratrol group compared with the cabergoline group (group 5) and severe the OHSS (group 3) group. CONCLUSION(S) Our results in a rat model suggest that resveratrol has a beneficial effect on OHSS by reducing the increases in ovarian daimeter, VP, and VEGF expression associated with OHSS. These effects may be mediated by the COX-2 inhibitory capacity of resveratrol.
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Affiliation(s)
- Esin Kasap
- a Department of Obstetrics and Gynecology , Sifa University School of Medicine , İzmir , Turkey
| | - Gülizar Arzu Turan
- a Department of Obstetrics and Gynecology , Sifa University School of Medicine , İzmir , Turkey
| | - Fatma Eskicioğlu
- b Department of Obstetrics and Gynecology , Merkez Efendi State Hospital , Manisa , Turkey
| | - Hakan Cengiz
- c Department of Biostatistics and Medical Informatics , Medical School, Sifa University, Izmir, Turkey Molecular Medicine, Institute of Health Science, Dokuz Eylül University , Inciralti , Izmir , Turkey
| | - Esra Bahar Gur
- a Department of Obstetrics and Gynecology , Sifa University School of Medicine , İzmir , Turkey
| | - Oya Nermin Sivrikoz
- d Department of Pathology , Sifa University School of Medicine , İzmir , Turkey , and
| | - Mine Genc
- a Department of Obstetrics and Gynecology , Sifa University School of Medicine , İzmir , Turkey
| | - Osman Yılmaz
- e Department of Laboratory Animal Science , Dokuz Eylul University School of Medicine , İzmir , Turkey
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Kasap E, Karaarslan S, Gur EB, Genc M, Sahin N, Güclü S. Investigation of the Roles of Cyclooxygenase-2 and Galectin-3 Expression in the Pathogenesis of Premenopausal Endometrial Polyps. J Pathol Transl Med 2016; 50:225-30. [PMID: 27086598 PMCID: PMC4876085 DOI: 10.4132/jptm.2016.03.08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 03/06/2016] [Accepted: 03/08/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The pathogenesis and etiology of endometrial polyps has not been elucidated. In this study, we aimed to examine the pathogenic mechanisms of endometrial polyp development using immunohistochemistry. We evaluated the expression of galectin-3 and cyclooxgenase-2 (COX-2) during the menstrual cycle in premenopausal women with endometrial polyps or normal endometrium. METHODS Thirty-one patients with endometrial polyps and 50 healthy control patients were included in this study. The levels of expression of COX-2 and galectin-3 were studied by immunohistochemistry. RESULTS The percentage of COX-2-positive cells and the intensity of COX-2 staining in the endometrium did not vary during the menstrual cycle either in the control group or in patients with endometrial polyps. However, expression of galectin-3 was significantly lower in endometrial polyps and during the proliferative phase of the endometrium compared with the secretory phase. CONCLUSIONS Our data suggests that the pathogenesis of endometrial polyps does not involve expression of COX-2 or galectin-3.
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Affiliation(s)
- Esin Kasap
- Department of Obstetrics and Gynecology, Sifa University School of Medicine, Izmir, Turkey
| | - Serap Karaarslan
- Department of Patology, Sifa University School of Medicine, Izmir, Turkey
| | - Esra Bahar Gur
- Department of Obstetrics and Gynecology, Sifa University School of Medicine, Izmir, Turkey
| | - Mine Genc
- Department of Obstetrics and Gynecology, Sifa University School of Medicine, Izmir, Turkey
| | - Nur Sahin
- Department of Obstetrics and Gynecology, Sifa University School of Medicine, Izmir, Turkey
| | - Serkan Güclü
- Department of Obstetrics and Gynecology, Sifa University School of Medicine, Izmir, Turkey
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Saklamaz A, Calan M, Yilmaz O, Kume T, Temur M, Yildiz N, Kasap E, Genc M, Sarer Yurekli B, Unal Kocabas G. Polycystic ovary syndrome is associated with increased osteopontin levels. Eur J Endocrinol 2016; 174:415-23. [PMID: 26701868 DOI: 10.1530/eje-15-1074] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Accepted: 12/23/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Osteopontin (OPN) is a multi-functional secreted glycoprotein that plays a crucial role in glucose metabolism and inflammatory process. Growing evidence suggests that there is a link between OPN and ovarian function. However, no such link has yet been found for OPN in polycystic ovary syndrome (PCOS). Our aim was to ascertain whether circulating OPN levels are altered in women with PCOS and to determine whether OPN levels differ between the follicular phase and mid-cycle of the menstrual cycle in eumenorrheic women. DESIGN AND METHODS In total, 150 women with PCOS and 150 age- and BMI-matched controls without PCOS were recruited for this prospective observational study. OPN levels were measured using ELISA. Metabolic parameters were also determined. RESULTS Circulating OPN levels were significantly elevated in PCOS women compared with controls (69.12±31.59 ng/ml vs 42.66±21.28 ng/ml; P<0.001). OPN levels were significantly higher at mid-cycle than in the follicular phase in eumenorrheic women. OPN was positively correlated with BMI, homeostasis model assessment of insulin resistance (HOMA-IR), free testosterone, and high sensitivity C-reactive protein (hs-CRP). Multivariate logistic regression analyses revealed that the odds ratio (OR) for PCOS was 3.64 for patients in the highest quartile of OPN compared with those in the lowest quartile (OR=3.64; 95% CI=2.42-5.57; P=0.011). Our findings indicate that BMI, HOMA-IR, hs-CRP, and free testosterone are independent factors influencing serum OPN levels and that OPN is an independent predictor for HOMA-IR. CONCLUSION PCOS is associated with increased OPN levels.
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Affiliation(s)
| | - Mehmet Calan
- Division of Endocrinology and MetabolismDepartment of Internal Medicine, Sifa University School of Medicine, 35410 Izmir, TurkeyPCOS Research GroupDivision of Endocrinology and Metabolism, Department of Internal Medicine, Izmir Bozyaka Training and Research Hospital, 35170 Bozyaka, Izmir, TurkeyPCOS Research GroupDepartment of Obstetrics and Gynecology, Manisa Merkezefendi State Hospital, 45020 Merkezefendi, Manisa, TurkeyDepartment of Biochemistry and Clinical BiochemistryDokuz Eylul University Faculty of Medicine, 35340 Inciralti, Izmir, TurkeyDepartment of Obstetrics and GynecologySifa University School of Medicine, 35410 Izmir, TurkeyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Ege University Medical School, 35100 Bornova, Izmir, Turkey
| | - Ozgur Yilmaz
- Division of Endocrinology and MetabolismDepartment of Internal Medicine, Sifa University School of Medicine, 35410 Izmir, TurkeyPCOS Research GroupDivision of Endocrinology and Metabolism, Department of Internal Medicine, Izmir Bozyaka Training and Research Hospital, 35170 Bozyaka, Izmir, TurkeyPCOS Research GroupDepartment of Obstetrics and Gynecology, Manisa Merkezefendi State Hospital, 45020 Merkezefendi, Manisa, TurkeyDepartment of Biochemistry and Clinical BiochemistryDokuz Eylul University Faculty of Medicine, 35340 Inciralti, Izmir, TurkeyDepartment of Obstetrics and GynecologySifa University School of Medicine, 35410 Izmir, TurkeyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Ege University Medical School, 35100 Bornova, Izmir, Turkey
| | - Tuncay Kume
- Division of Endocrinology and MetabolismDepartment of Internal Medicine, Sifa University School of Medicine, 35410 Izmir, TurkeyPCOS Research GroupDivision of Endocrinology and Metabolism, Department of Internal Medicine, Izmir Bozyaka Training and Research Hospital, 35170 Bozyaka, Izmir, TurkeyPCOS Research GroupDepartment of Obstetrics and Gynecology, Manisa Merkezefendi State Hospital, 45020 Merkezefendi, Manisa, TurkeyDepartment of Biochemistry and Clinical BiochemistryDokuz Eylul University Faculty of Medicine, 35340 Inciralti, Izmir, TurkeyDepartment of Obstetrics and GynecologySifa University School of Medicine, 35410 Izmir, TurkeyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Ege University Medical School, 35100 Bornova, Izmir, Turkey
| | - Muzaffer Temur
- Division of Endocrinology and MetabolismDepartment of Internal Medicine, Sifa University School of Medicine, 35410 Izmir, TurkeyPCOS Research GroupDivision of Endocrinology and Metabolism, Department of Internal Medicine, Izmir Bozyaka Training and Research Hospital, 35170 Bozyaka, Izmir, TurkeyPCOS Research GroupDepartment of Obstetrics and Gynecology, Manisa Merkezefendi State Hospital, 45020 Merkezefendi, Manisa, TurkeyDepartment of Biochemistry and Clinical BiochemistryDokuz Eylul University Faculty of Medicine, 35340 Inciralti, Izmir, TurkeyDepartment of Obstetrics and GynecologySifa University School of Medicine, 35410 Izmir, TurkeyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Ege University Medical School, 35100 Bornova, Izmir, Turkey
| | - Nurdan Yildiz
- Division of Endocrinology and MetabolismDepartment of Internal Medicine, Sifa University School of Medicine, 35410 Izmir, TurkeyPCOS Research GroupDivision of Endocrinology and Metabolism, Department of Internal Medicine, Izmir Bozyaka Training and Research Hospital, 35170 Bozyaka, Izmir, TurkeyPCOS Research GroupDepartment of Obstetrics and Gynecology, Manisa Merkezefendi State Hospital, 45020 Merkezefendi, Manisa, TurkeyDepartment of Biochemistry and Clinical BiochemistryDokuz Eylul University Faculty of Medicine, 35340 Inciralti, Izmir, TurkeyDepartment of Obstetrics and GynecologySifa University School of Medicine, 35410 Izmir, TurkeyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Ege University Medical School, 35100 Bornova, Izmir, Turkey
| | - Esin Kasap
- Division of Endocrinology and MetabolismDepartment of Internal Medicine, Sifa University School of Medicine, 35410 Izmir, TurkeyPCOS Research GroupDivision of Endocrinology and Metabolism, Department of Internal Medicine, Izmir Bozyaka Training and Research Hospital, 35170 Bozyaka, Izmir, TurkeyPCOS Research GroupDepartment of Obstetrics and Gynecology, Manisa Merkezefendi State Hospital, 45020 Merkezefendi, Manisa, TurkeyDepartment of Biochemistry and Clinical BiochemistryDokuz Eylul University Faculty of Medicine, 35340 Inciralti, Izmir, TurkeyDepartment of Obstetrics and GynecologySifa University School of Medicine, 35410 Izmir, TurkeyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Ege University Medical School, 35100 Bornova, Izmir, Turkey
| | - Mine Genc
- Division of Endocrinology and MetabolismDepartment of Internal Medicine, Sifa University School of Medicine, 35410 Izmir, TurkeyPCOS Research GroupDivision of Endocrinology and Metabolism, Department of Internal Medicine, Izmir Bozyaka Training and Research Hospital, 35170 Bozyaka, Izmir, TurkeyPCOS Research GroupDepartment of Obstetrics and Gynecology, Manisa Merkezefendi State Hospital, 45020 Merkezefendi, Manisa, TurkeyDepartment of Biochemistry and Clinical BiochemistryDokuz Eylul University Faculty of Medicine, 35340 Inciralti, Izmir, TurkeyDepartment of Obstetrics and GynecologySifa University School of Medicine, 35410 Izmir, TurkeyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Ege University Medical School, 35100 Bornova, Izmir, Turkey
| | - Banu Sarer Yurekli
- Division of Endocrinology and MetabolismDepartment of Internal Medicine, Sifa University School of Medicine, 35410 Izmir, TurkeyPCOS Research GroupDivision of Endocrinology and Metabolism, Department of Internal Medicine, Izmir Bozyaka Training and Research Hospital, 35170 Bozyaka, Izmir, TurkeyPCOS Research GroupDepartment of Obstetrics and Gynecology, Manisa Merkezefendi State Hospital, 45020 Merkezefendi, Manisa, TurkeyDepartment of Biochemistry and Clinical BiochemistryDokuz Eylul University Faculty of Medicine, 35340 Inciralti, Izmir, TurkeyDepartment of Obstetrics and GynecologySifa University School of Medicine, 35410 Izmir, TurkeyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Ege University Medical School, 35100 Bornova, Izmir, Turkey
| | - Gokcen Unal Kocabas
- Division of Endocrinology and MetabolismDepartment of Internal Medicine, Sifa University School of Medicine, 35410 Izmir, TurkeyPCOS Research GroupDivision of Endocrinology and Metabolism, Department of Internal Medicine, Izmir Bozyaka Training and Research Hospital, 35170 Bozyaka, Izmir, TurkeyPCOS Research GroupDepartment of Obstetrics and Gynecology, Manisa Merkezefendi State Hospital, 45020 Merkezefendi, Manisa, TurkeyDepartment of Biochemistry and Clinical BiochemistryDokuz Eylul University Faculty of Medicine, 35340 Inciralti, Izmir, TurkeyDepartment of Obstetrics and GynecologySifa University School of Medicine, 35410 Izmir, TurkeyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Ege University Medical School, 35100 Bornova, Izmir, Turkey
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Kasap E, Aksu EE, Gur EB, Genc M, Eskicioğlu F, Gökduman A, Güçlü S. Investigation of the relationship between salivary cortisol, dehydroepiandrosterone sulfate, anxiety, and depression in patients with hyperemesis gravidarum. J Matern Fetal Neonatal Med 2016; 29:3686-9. [PMID: 26752270 DOI: 10.3109/14767058.2016.1140741] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of this study was to determine the relationship of the salivary levels of dehydroepiandrosterone sulfate (DHEA-S) and cortisol with factors related to depression and anxiety in patients with hyperemesis gravidarum (HG). METHODS Forty patients with a diagnosis of HG were selected for the study and matched with 40 control patients according to body mass index, parity, and age. Symptoms of depression and anxiety were investigated using the Beck Depression Inventory and Beck Anxiety Inventory for Adults, respectively. Saliva samples were collected in the morning and at night and subjected to enzyme-linked immunosorbent assay for the determination of DHEA-S and cortisol levels. RESULTS We observed a positive correlation between increased levels of depression and anxiety and increased salivary levels of cortisol and DHEA-S in patients with HG. CONCLUSIONS Salivary cortisol and DHEA-S levels, as well as mood disorders, should be monitored in patients with HG, although further large, prospective studies are needed to confirm our results.
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Affiliation(s)
- Esin Kasap
- a Department of Obstetrics and Gynecology
| | - Ebru Emine Aksu
- b Department of Psychiatry , Sifa University School of Medicine , İzmir , Turkey
| | | | - Mine Genc
- a Department of Obstetrics and Gynecology
| | - Fatma Eskicioğlu
- c Department of Obstetrics and Gynecology , Merkez Efendi State Hospital , Manisa , Turkey , and
| | - Ayşe Gökduman
- d Department of Biochemistry , Sifa University School of Medicine , İzmir , Turkey
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Kasap E, Genc M, Turan GA, Eskicioglu F, Saklamaz A, Sahin N, Guclu S. The association of impaired gestational glucose tolerance with maternal and fetal outcomes. CLIN EXP OBSTET GYN 2016; 43:755-758. [PMID: 30074333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The aim of the present study was to examine the associations of gestational diabetes mellitus (GDM) and impaired glucose tolerance (IGT) with maternal and fetal outcomes.A total of 200 pregnant women were included in this cross-sectional study. A 50-gram oral glucose challenge test (GCT) was performed between 24 and 28 weeks of gestation, followed by glucose tolerance test (OGTT) with 100 grams of oral glucose in those with an abnormal one-hour test result. The following were not significantly different between groups. Preterm labour (PL), pregnancy induced hypertension(PIH), pre-eclampsia, polyhydramnios, and macrosomia. However, a significant increase was noted in the fetal birth weight as well as in number of cesarean deliveries among GDM subjects. Neonatal outcomes were also similar between the two groups. In conclusion, the present results suggest that single high glucose readings in OGTT may be as important as a diagnosis of GDM in terms of fetomaternal complication risk.
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Genc M, Celik E, Eskicioglu F, Bahar Gur E, Kurtulmus S, Gulec E, Guclu S. The relationship between uterine prolapse and premalignant endometrial pathology. CLIN EXP OBSTET GYN 2016; 43:500-503. [PMID: 29734535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The aim of this study was to stress the importance of performing a thorough uterine assessment before selecting an organ- sparing surgery in patients presenting with uterine prolapse and no other complaints. MATERIALS AND METHODS This study included a total of 111 participants who presented with pelvic organ prolapse and underwent hysterectomy for grades 3-4 uterine prolapse. The posthysterectomy histopathology results were classified as benign (atrophic endometrium, proliferative or secretory endometrium) or pathologic (endometrial hyperplasia, endometrial polyp, adenomyosis, myoma uteri, and endometrium carcinoma). RESULTS Of the 111 patients enrolled in this study, 23 (20.2%) had endometrial hyperplasia, eight (7.2%) had endometrial polyps, 30 (27%) had uterine fibroids, and 20 (18%) had adenomyosis. CONCLUSION There may be premalignant lesions of the endometrium in both premenopausal and postmenopausal women presenting with uterine prolapse and no other symptoms. A chronic inflammatory process resulting from the extra-vaginal location of the uterus may play a role in the development of these lesions. Further studies are needed on this subject.
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Gur EB, Karadeniz M, Inceefe H, Tatar S, Turan GA, Genc M, Guclu S. Thyroid antibodies in euthyroid and subclinical hypothyroidic pregnant women with autoimmune hypothyroidism: effects on hematological parameters and postpartum hemorrhage. Ginekol Pol 2015; 86:666-71. [PMID: 26665567 DOI: 10.17772/gp/57810] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The aim of the study was to investigate the relationship between thyroid antibodies and hematological parameters in euthyroid or subclinical hypothyroidic (S H) pregnant women with autoimmune hypothyroidism and to verity whether these pregnant women are affected by a higher rate of postpartum hemorrhage. MATERIAL AND METHODS Thirty-six out hyroid and 21 S H pregnant women with autoimmune thyroid disease and 52 healthy pregnant women were evaluated. The relationship between thyroid hormones, thyroid antibodies level, the dosage of Levotroxin (LT4) and hematological parameters and the amount of postpartum bleeding was investigated. RESULTS The mean platelet volume (MPV), was significantly higher in the SH group than in the euthyroid group and in the euthyroid group than healthy group (p<0.001). Hemoglobin (Hb) was significantly lower in both the SH group and the euthyroid group than control group (p<0.001). Other hematological parameters and the amount of postpartum bleeding did not differ between the groups. The correlation between Hb and fT3, FT4 was significant and positive, whereas between Hb and T SH was significant and negative (r=0.3 p<0.01, r=0.2 p=0.01, and r = -0.18 p=0.04, respectively). There was a significant and negative correlation between the PLT count and FT4, PT and FT3 (r = -0.2 p=0.01, r = -0.3 p<0.01, and r = -0.3 p<0.01, respectively). CONCLUSION It has been described that being thyroid antibody-positive (TAb+) may be a risk factor for anemia and high MPV. However euthyroid and SH pregnant women with thyroid antibodies do not differ in terms of other coagulation parameters and postpartum hemorrhage from healthy controls.
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Biberoglu EH, Kirbas A, Dirican AÖ, Genc M, Avci A, Doganay B, Uygur D, Biberoglu K. Alterations in lipid peroxidation and T-cell function in women with hyperemesis gravidarum. J OBSTET GYNAECOL 2015; 36:93-6. [PMID: 26368575 DOI: 10.3109/01443615.2015.1030604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The objective of this study was to investigate serum adenosine deaminase (ADA) activity as a marker of T lymphocyte activation and parameters of oxidative stress and antioxidant defence in hyperemesis gravidarum (HG). Serum ADA activity, malondialdehyde (MDA), catalase (CAT) and glutathione peroxidase (GPx) levels were investigated in 40 pregnant women with the HG and 40 with healthy pregnancies, in a descriptive study. Although serum ADA and CAT were measured to be higher in HG group, the difference was not significant. Serum MDA and GPx levels were significantly elevated in women with HG when compared with those without HG. The significance of changes in lipid peroxidation and T-cell activation in the pathogenesis of HG and whether this is a cause or a compensatory reaction to HG requires further investigations with larger multicentre trials.
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Affiliation(s)
- E H Biberoglu
- a Dr. Zekai Tahir Burak Women Health Care, Education and Research Hospital, Department of Perinatology , Ankara , Turkey
| | - A Kirbas
- a Dr. Zekai Tahir Burak Women Health Care, Education and Research Hospital, Department of Perinatology , Ankara , Turkey
| | - A Ö Dirican
- a Dr. Zekai Tahir Burak Women Health Care, Education and Research Hospital, Department of Perinatology , Ankara , Turkey
| | - M Genc
- b Ankara University Faculty of Medicine, Department of Biochemistry , Ankara , Turkey
| | - A Avci
- b Ankara University Faculty of Medicine, Department of Biochemistry , Ankara , Turkey
| | - B Doganay
- c Ankara University Faculty of Medicine, Department of Biostatistics , Ankara , Turkey
| | - D Uygur
- a Dr. Zekai Tahir Burak Women Health Care, Education and Research Hospital, Department of Perinatology , Ankara , Turkey
| | - K Biberoglu
- d Gazi University Faculty of Medicine, Department of Obstetrics and Gynecology , Ankara , Turkey
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Gur EB, Karadeniz M, Genc M, Eskicioglu F, Yalcin M, Hepyilmaz I, Guclu S. Relationship between mean platelet volume and vitamin D deficiency in gestational diabetes mellitus. Arch Endocrinol Metab 2015. [PMID: 26201009 DOI: 10.1590/2359-3997000000063] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate whether vitamin D deficiency is associated with high mean platelet volume (MPV) in pregnancies diagnosed with gestational diabetes mellitus (GDM) compared to healthy pregnancies. SUBJECTS AND METHODS This study included 200 pregnant women. 25-hydroxyvitamin D3(25(OH)D3) and MPV values were monitored between pregnant women with GDM and normal glucose metabolism. Correlation between 25(OH)D3 and MPV was calculated both in GDM and healthy pregnancies. Both 25(OH)D3 level in different MPV percentile (≤ 50, 50-75, 75-90, ≥ 90 percentile) and MPV value in different 25(OH)D3 level (≤ 10, 10-20, ≥ 20 ng/mL) were calculated. RESULTS Low 25(OH)D3 level and high MPV were observed both in GDM group (p = 0.007, p = 0.06, respectively) and in glucose metabolism disorders (GMD) group (p = 0.03, p = 0.04, respectively). There was no significant relationship between 25(OH)D3 and MPV in healthy pregnancies. Whereas, it is observed that there is a negative, but statistically insignificant correlation between MPV and 25(OH)D3 pregnant women with GMD (r = 0.1, r = -0.7, respectively). MPV values had significantly higher in vitamin D deficient group than pregnant women with normal 25(OH)D3 level in GMD group (p = 0.04). The optimal 25(OH)D3 cut off point for predicting future cardiovascular risk was 10.4 ng/ mL (area under curve (AUC) = 0.58). CONCLUSIONS Vitamin D deficiency may contribute to an increased risk for future cardiovascular diseases and a risk of thrombotic complications in pregnant women with GDM.
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Affiliation(s)
- Esra Bahar Gur
- Department of Obstetrics and Gynecology, Faculty of Medicine, Sifa University, Izmir, Turkey
| | - Muammer Karadeniz
- Department of Endocrinology, Faculty of Medicine, Sifa University, Izmir, Turkey
| | - Mine Genc
- Department of Obstetrics and Gynecology, Faculty of Medicine, Sifa University, Izmir, Turkey
| | - Fatma Eskicioglu
- Obstetrics and Gynecology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Murat Yalcin
- Department of Internal Medicine, Faculty of Medicine, Sifa University, Izmir, Turkey
| | - Irem Hepyilmaz
- Department of Obstetrics and Gynecology, Faculty of Medicine, Sifa University, Izmir, Turkey
| | - Serkan Guclu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Sifa University, Izmir, Turkey
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17
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Genc M, Genc B. Ovarian fibrothecoma: a rare cause of ovarian torsion in postmenopausal woman. MKÜ Tıp Derg 2015. [DOI: 10.17944/mkutfd.72714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Sahin N, Genc M, Solak A, Kasap E, Yalaz S, Solak I, Genc B, Karaarslan S. Typical and Atypical Imaging Findings of Abdominal Teratomas. Curr Med Imaging 2015. [DOI: 10.2174/1573405611666150420234942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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19
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Genc M, Genc B, Karaarslan S, Kurtulmus S, Yalaz S, Karapolat İ. Concurrent Endometrial Carcinosarcoma and Thyroid Papillary Carcinoma: PET CT Imaging Findings. Mol Imaging Radionucl Ther 2015. [DOI: 10.4274/mirt.96268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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20
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Sahin N, Genc M, Kasap E, Solak A, Korkut B, Yilmaz E. Anterior Sacral Meningocele Masquerading as an Ovarian Cyst: A Rare Clinical Presentation Associated with Marfan Syndrome. Clin Pract 2015; 5:752. [PMID: 26236457 PMCID: PMC4500879 DOI: 10.4081/cp.2015.752] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 03/15/2015] [Accepted: 04/16/2015] [Indexed: 11/23/2022] Open
Abstract
Anterior sacral meningocele is a very rare clinical entity characterized by herniation of a meningeal sac through a sacrococcygeal defect. We report a case of a 20-year old female with Marfan syndrome who presented with abdominal distention that was misdiagnosed as an ovarian cyst on pelvic ultrasound. Pelvic magnetic resonance (MR) imaging showed large, well-defined multiloculated intrasacral and presacral cysts communicating via two separate broad necks and extending through defects in anterior aspect of sacral vertebrae. This case emphasizes that anterior sacral meningocele should be considered in the differential diagnosis of cases with pelvic cysts particularly in patients with underlying connective tissue disorders. Because severe neurologic complications or even death may occur without proper preoperative planning in such cases, MR imaging should always be performed for evaluation and characterization of pelvis cystic lesions.
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Affiliation(s)
| | - Mine Genc
- Department of Obstetrics and Gynecology, Sifa University School of Medicine , İzmir, Turkey
| | - Esin Kasap
- Department of Obstetrics and Gynecology, Sifa University School of Medicine , İzmir, Turkey
| | | | - Berrin Korkut
- Department of Obstetrics and Gynecology, Sifa University School of Medicine , İzmir, Turkey
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21
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Gur EB, Genc M, Eskicioglu F, Kurtulmus S, Guclu S. The effect of vitamin D level in pregnancy on postpartum depression. Arch Womens Ment Health 2015; 18:263-264. [PMID: 25640762 DOI: 10.1007/s00737-015-0509-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 12/19/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Esra Bahar Gur
- Faculty of Medicine, Department of Obstetrics and Gynecology, Sifa University, Bornova, 35100, Izmir, Turkey.
| | - Mine Genc
- Faculty of Medicine, Department of Obstetrics and Gynecology, Sifa University, Bornova, 35100, Izmir, Turkey
| | - Fatma Eskicioglu
- Faculty of Medicine, Department of Obstetrics and Gynecology, Celal Bayar University, Manisa, Turkey
| | - Secil Kurtulmus
- Faculty of Medicine, Department of Obstetrics and Gynecology, Katip Celebi University, Izmir, Turkey
| | - Serkan Guclu
- Faculty of Medicine, Department of Obstetrics and Gynecology, Sifa University, Bornova, 35100, Izmir, Turkey
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22
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Genc M, Sivrikoz ON, Sahin N, Celik E, Turan GA, Guclu S. Does uterine prolapse alter endometrial cyclooxygenase 2 expression and promote the development of premalignant lesions? Gynecol Obstet Invest 2015; 80:119-23. [PMID: 25662613 DOI: 10.1159/000371348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 12/03/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the expression of cyclooxygenase 2 (COX-2) and its association with the development of premalignant lesions in gland structures of the endometrium in patients with uterine prolapse, a condition which exposes the uterus to mechanical and infectious stress. METHODS The study included 102 patients who underwent hysterectomy to correct grade 3-4 uterine prolapse and 105 patients who underwent hysterectomy for other causes. Endometrial gland structures underwent immunohistochemical staining and COX-2 expression was graded. Grades 0 and 1 represent low expression; grades 2 and 3 correspond to high levels of COX-2 expression. RESULTS The prevalence of grade 2-3 COX-2 expression was significantly higher in the endometrial gland structures of patients with prolapse and hyperplasia compared to the remaining patients (p = 0.014). Grade 0-1 COX-2 expression was significantly more common in the endometrial gland structures of patients without uterine prolapse or hyperplasia (p = 0.004). Among the patients without endometrial hyperplasia, COX-2 expression was elevated in the endometrial gland structures of those with uterine prolapse compared to those without prolapse. CONCLUSION Elevated COX-2 expression may explain the presence of unexpected premalignant lesions of the endometrium in patients with uterine prolapse.
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Affiliation(s)
- Mine Genc
- Department of Obstetrics and Gynecology, Sifa University School of Medicine, Izmir, Turkey
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23
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Genc M, Sahin N, Maral J, Celik E, Kar AA, Usar P, Korkut B, Guclu S. Does bupivacaine and fentanyl combination for epidural analgesia shorten the duration of labour? J OBSTET GYNAECOL 2014; 35:672-5. [PMID: 25546524 DOI: 10.3109/01443615.2014.991299] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In this study we aimed to explore the effects of epidural analgesia achieved by a combination of low-dose bupivacaine and fentanyl infused through an epidural catheter on mother, foetus and labour process in nulliparous at-term pregnant women during vaginal delivery. This study was designed in a prospective, randomised controlled manner. Epidural analgesia was achieved in 50 nulliparous women. Fifty nulliparous women did not undergo epidural analgesia procedure. The duration of the first stage of labour was significantly shortened, while the second stage was significantly lengthened in pregnant women who underwent epidural analgesia (p < 0.05). In conclusion, starting epidural analgesia application during the active phase of the first stage of labour may shorten the duration of the first stage compared with the group of nulliparous women not undergoing epidural analgesia. The factor that has an impact on this may be the addition of fentanyl to bupivacaine used for epidural analgesia.
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Affiliation(s)
- M Genc
- a Department of Obstetrics and Gynecology , Faculty of Medicine, Sifa University , İzmir , Turkey
| | - N Sahin
- a Department of Obstetrics and Gynecology , Faculty of Medicine, Sifa University , İzmir , Turkey
| | - J Maral
- b Department of Anaesthesia and Intensive Care , Faculty of Medicine, Sifa University , İzmir , Turkey
| | - E Celik
- a Department of Obstetrics and Gynecology , Faculty of Medicine, Sifa University , İzmir , Turkey
| | - A A Kar
- b Department of Anaesthesia and Intensive Care , Faculty of Medicine, Sifa University , İzmir , Turkey
| | - P Usar
- b Department of Anaesthesia and Intensive Care , Faculty of Medicine, Sifa University , İzmir , Turkey
| | - B Korkut
- a Department of Obstetrics and Gynecology , Faculty of Medicine, Sifa University , İzmir , Turkey
| | - S Guclu
- a Department of Obstetrics and Gynecology , Faculty of Medicine, Sifa University , İzmir , Turkey
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Abstract
OBJECTIVE The aim of this study was to determine the rate of unexpected uterine pathology in postmenopausal women admitted to a gynecology clinic with symptoms other than vaginal bleeding and who were scheduled to undergo hysterectomy. MATERIALS AND METHODS We reviewed retrospectively the medical records of 283 postmenopausal patients who had gynecological surgery between September 2007 and January 2014. We reviewed their presenting symptoms on admission, the indications for surgery, and their transvaginal ultrasonographic findings. Postoperative histopathological results based on uterine specimens were also recorded. The results were analyzed statistically. RESULTS Of 283 patients who had surgery, 209 had no vaginal bleeding at the time of admission. From this group, 75.6% were found to have unsuspected pathology, including endometrial hyperplasia, endometrial polyps, uterine fibroids, adenomyosis, and one case of endometrial carcinoma (0.5%). The remaining 74 patients had experienced postmenopausal bleeding and in 87.8% there were pathological findings including 13 cases (17.6%) of endometrial cancer (p = 0.0001). CONCLUSION Vaginal bleeding in postmenopausal women is indicative of a wide array of gynecological pathologies, including endometrial carcinoma. However, uterine fibroids, pelvic masses, or even endometrial cancer may develop without co-morbid vaginal bleeding. Therefore we advocate that postmenopausal women should undergo yearly screening and consultation, without waiting for an episode of vaginal bleeding.
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Affiliation(s)
- M Genc
- Departments of Obstetrics and Gynecology, Sifa University , İzmir , Turkey
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Gur EB, Genc M, Eskicioglu F, Kurtulmus S, Guclu S. Ultrasonographic visceral fat thickness measurement may be a good scan test for prediction of gestational diabetes mellitus. J Matern Fetal Neonatal Med 2014; 28:893-4. [PMID: 24949931 DOI: 10.3109/14767058.2014.936003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Esra Bahar Gur
- Department of Obstetrics and Gynecology, Faculty of Medicine, Sifa University , Izmir , Turkey
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Genc M, Aksu GM, Korcum AF, Yavuz MN. Commentary on "late bone and soft tissue sequelae of childhood radiotherapy". Strahlenther Onkol 2014; 190:962. [PMID: 24888512 DOI: 10.1007/s00066-014-0691-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Accepted: 05/14/2014] [Indexed: 11/24/2022]
Affiliation(s)
- Mine Genc
- Medical Faculty, Akdeniz University, Antalya, Turkey,
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Genc M, Genc B, Solak A, Sivrikoz ON. Placenta percreta resulting in incomplete spontaneous abortion in first trimester. Int J Fertil Steril 2014; 8:347-50. [PMID: 25379165 PMCID: PMC4221523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Accepted: 09/22/2013] [Indexed: 10/26/2022]
Abstract
Placenta percreta is a rare complication potentially fatal to fetus and the mother. We present here a 41-year-old female patient who underwent curettage for incomplete abortion at 6(th) week of pregnancy. She had persistent vaginal bleeding for 2 months after the curettage, for which she was treated with hysterectomy. Preoperative ultrasonography and magnetic resonance imaging (MRI) made the diagnosis of placenta percreta. Postoperative pathological examination confirmed this diagnosis.
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Affiliation(s)
- Mine Genc
- Department of Obstetrics and Gynecology, Sifa University School of Medicine, Izmir, Turkey,Department of Obstetrics and GynecologySifa University School of MedicineİzmirTurkey
| | - Berhan Genc
- Department of Radiology, Sifa University School of Medicine, Izmir, Turkey
| | - Aynur Solak
- Department of Radiology, Sifa University School of Medicine, Izmir, Turkey
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Cetin A, Genc M, Sevil S, Coban YK. Prevalence of the palmaris longus muscle and its relationship with grip and pinch strength: a study in a Turkish pediatric population. Hand (N Y) 2013; 8:215-20. [PMID: 24426922 PMCID: PMC3652998 DOI: 10.1007/s11552-013-9509-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Clinical studies generally reveal a trend of variation in the reported prevalence of the palmaris longus (PL) muscle absence. The aim of this study was to find an answer to the question of whether the congenital absence of tendon would affect hand functions or not. A total of 585 subjects, comprised of 305 males and 280 females, were included in our study. Mean age was 8.9 ± 1.4 standard deviation within a range of 6-11. For both sexes, the groups were divided further into three subgroups including 6-7, 8-9, and 10-11 years of age ranges. The grip strength of each hand and pinch strength of all fingers of each subject were measured separately. The absence of PL tendon in the right hand was 35.4 % in females, 25.9 % in males, and 30.4 % in overall average. The distribution of absence of the palmaris longus muscle between both genders was statistically significant. The p value for the right hand was 0.013. The absence of PL tendon in the left hand was 37.5 % in females, 27.9 % in males, and an overall average of 32.5 %. The p value for the left hand was 0.017. In terms of grip strength, a comparison between females and males did not reveal a significant difference. The pinch strength of the second fingers of both hands did not show any difference in both sexes. Pinch strength of the third finger of the right hand was different only in girls of subgroup 6-7 ages (p = 0.024). In girls, the pinch strength of the fourth finger of the right hand of subgroups 6-7 and 10-11 ages showed difference (p = 0.009 and p = 0.026, respectively). In boys, the fourth finger in subgroup of 8-9 ages showed significant difference in both hands (p = 0.011). The fifth fingers of both hands were found different in males for only subgroup of 8-9 ages (p = 0.001). Pinch strength of the fifth finger of the right hand was different in females for only subgroups of 6-7 and 10-11 ages (p = 0.023 and p = 0.047, respectively). While grip strength of the hand was not affected in the case of absence of the palmaris longus, in both sexes, pinch strength of the fourth and fifth fingers of both hands decreased.
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Affiliation(s)
- A. Cetin
- />Department of Anatomy, Inonu University Medical Faculty, Malatya, Turkey 44280
| | - M. Genc
- />Department of Community Health, Inonu University Medical Faculty, Malatya, Turkey
| | - S. Sevil
- />Menemen 3rd, Family Practice Center Asarlik-Menemen, Izmir, Turkey
| | - Y. K. Coban
- />Department of Plastic Surgery, Inonu University Medical Faculty, Malatya, Turkey
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Rosenbluth EM, Wells LM, Sparks AE, Van Voorhis BJ, Reyes-Palomares A, Palomares AR, Medina MA, Ruiz Galdon M, Reyes Engel A, Stanghellini I, Luiselli D, Magli MC, Lang M, Romeo G, Ferraretti AP, Gianaroli L, Gun Eryilmaz O, Sarikaya E, Yilmaz S, Avci A, Ozogul C, Barun S, Genc M, Kitsou C, Kosmas I, Peschos D, Euaggelou A, Lazaros L, Stefos T, Tournaye H, Prapa S, Prapas N, Prapas Y, Zikopoulos K, Georgiou I, Loewke K, Moussavi F, Maddah M, Conaghan J, Ivani K, Suraj V, Chen A, Shen S, Dittrich R, Hoffmann I, Kunzel J, Lotz L, Mueller A, Reissmann C, Hildebrandt T, Hakl J, Unluhan N, Oppelt PG, Beckmann MW, Huszar G, Geerts N, McGrath J, Vanderlick K, Pohl O, Gotteland JP, Bestel E, Sinai Talaulikar V, Manyonda I. TRANSLATIONAL RESEARCH. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.92] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Toy H, Yavas O, Eren O, Genc M, Yavas C. Correlation between osteopontin protein expression and histological grade of astrocytomas. Pathol Oncol Res 2008; 15:203-7. [PMID: 19048398 DOI: 10.1007/s12253-008-9130-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2008] [Accepted: 11/11/2008] [Indexed: 12/26/2022]
Abstract
Osteopontin is a ligand for the integrin proteins, which are cell surface receptors that mediate the physical and functional interactions between a cell and the extracellular matrix. The expression of osteopontin is reportedly increased in a number of transformed cell lines and tumor tissues. Furthermore, increased expression of osteopontin results in some infiltrative features of tumors. The aim of the study is to demonstrate that expression of osteopontin in human astrocytomas correlates with histological tumor grade. The expression of osteopontin in human astrocytomas was determined with immunohistochemistry. Median osteopontin expression levels were 1%, 7.5%, 60%, and 50% in grade I, II, III, and IV tumors, respectively. Osteopontin staining was significantly higher in high grade (grade III-IV) than low grade (grade I-II) tumors. These findings indicate that osteopontin immunoreactivity in human astrocytomas may correlate with the grade of a tumor.
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Affiliation(s)
- H Toy
- Department of Pathology, Meram Medical School, Selcuk University, 42080 Meram, Konya, Turkey.
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Atahan IL, Ozyar E, Yildiz F, Ozyigit G, Genc M, Ulger S, Usubutun A, KÖSE F, Yuce K, Ayhan A. Vaginal high dose rate brachytherapy alone in patients with intermediate- to high-risk stage I endometrial carcinoma after radical surgery. Int J Gynecol Cancer 2008; 18:1294-9. [DOI: 10.1111/j.1525-1438.2008.01198.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The objective of this study was to analyze the efficacy and morbidity of vaginal cuff brachytherapy alone in intermediate- to high-risk stage I endometrial cancer patients after complete surgical staging. Between October 1994 and November 2005, 128 patients with intermediate- to high-risk stage I endometrial adenocarcinoma were treated with high dose rate (HDR) brachytherapy alone after complete surgical staging. The intermediate- to high-risk group was defined as any stage I with grade 3 histology or stage IB grade 2 or any stage IC disease. The comprehensive surgery was in the form of total abdominal hysterectomy, bilateral salpingo-oophorectomy in addition to infracolic omentectomy, and routine pelvic and para-aortic lymphadenectomy. The median number of the lymph nodes dissected was 33. The median age at the time of diagnosis was 60 years. Forty patients were staged as IB (grade 2: 25 and grade 3: 15), and 88 patients were staged as IC (grade 1: 31, grade 2: 41, and grade 3: 16). A total dose of 27.5 Gy with HDR brachytherapy, prescribed at 0.5 cm, was delivered in five fractions in 5 consecutive days. Median follow-up was 48 months. Six (4.7%) patients developed either local recurrence (n= 2) or distant metastases (n= 4). Five-year overall survival and disease-free survival (DFS) rates are 96% and 93%, respectively. Only age was found to be significant prognostic factor for DFS. Patients younger than 60 years have significantly higher DFS (P= 0.006). None of the patients experienced grade 3/4 complications due to the vaginal HDR brachytherapy. Vaginal cuff brachytherapy alone is an adequate treatment modality in stage I endometrial adenocarcinoma patients with intermediate- to high-risk features after complete surgical staging with low complication rates.
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Yavas O, Yazici M, Eren O, Boruban C, Artac M, Genc M. The acute effect of tropisetron on ECG parameters in cancer patients. Support Care Cancer 2008; 16:1011-5. [DOI: 10.1007/s00520-007-0400-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2007] [Accepted: 12/19/2007] [Indexed: 12/01/2022]
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Atahan IL, Yildiz F, Ozyar E, Pehlivan B, Genc M, Kose MF, Tulunay G, Ayhan A, Yuce K, Guler N, Kucukali T. Radiotherapy in the adjuvant setting of cervical carcinoma: treatment, results, and prognostic factors. Int J Gynecol Cancer 2007; 17:813-20. [PMID: 17359296 DOI: 10.1111/j.1525-1438.2007.00887.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
To evaluate the efficacy of postoperative radiotherapy and to investigate prognostic factors for early-stage cervical cancer patients. From December 1993 to December 2001, 141 patients with stage I-II cervical cancer without para-aortic lymph node (LN) metastases and treated by surgery and postoperative radiotherapy (RT) were included in this study. Indications for postoperative external RT were based on pathologic findings, including LN metastasis, positive surgical margins, parametrial involvement, pT2 tumor, and presence of any two minor risk factors like lymphvascular space involvement, deep stromal invasion, and tumor diameter between 2-4 cm. Sixty-six (47%) patients received RT alone, whereas 59 (42%) were treated with RT and concomitant chemotherapy (CT), and 16 received neoadjuvant CT. Patients with positive vaginal margins also received 27.5 Gy high-dose rate vaginal cuff brachytherapy in five fractions. Median follow-up time was 55 months. The actuarial 5-year overall (OS), disease-free (DFS), locoregional recurrence-free (LRFS), and distant metastases-free (DMFS) survival rates are 70%, 68%, 77%, and 88%, respectively. Univariate and multivariate analyses revealed that level and number of metastatic LNs and concomitant CT were unique significant prognostic factors for OS, DFS, and LRFS. Endometrial involvement, on the other hand, was proven to be significant for DFS and DMFS. Patients with less than three LN metastases or having only obturator LN involvement showed similar prognosis with their counterparts having no LN metastases. On the other hand, patients with either common iliac LN or more than three LN metastases had significantly worse outcome. Our results indicate that level and number of metastatic LNs are the most important prognostic factors determining the survival rates, and patients with upper lymphatic involvement or more than three metastatic LNs seem to need more effective treatment approaches.
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Affiliation(s)
- I L Atahan
- Department of Radiation Oncology, Hacettepe University, Ankara, Turkey
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Abstract
Treatment of radiation myelopathy remains a challenge. Supportive and rehabilitative therapy is the mainstay of treatment. This article describes a case of central nervous system (CNS) toxicity of radiation with a progressive improvement in the clinicoradiological picture following high dose steroid treatment. A female patient was admitted to the neurology department of our hospital 7 months after a course of radiotherapy in another centre for lingual epidermoid cancer. Neurological examination revealed a heavy spastic quadriplegia syndrome. On MRI examination, T2 weighted hyperintensities were observed in cerebral and cerebellar peduncles, periventricular regions and medulla spinalis at Th1-Th2 levels. The patient was treated with high dose methylprednisolone, 1 g day(-1) for 5 days (pulse therapy) followed by oral methylprednisolone 80 mg day(-1) for a week, tapered over 3 weeks. Within the first week of pulse therapy, she regained muscle strength of upper limbs against gravity. At the 2 year follow-up, MRI demonstrated obvious regression of the lesions in the medulla and cerebellum with disappearance of contrast enhancement. This case report is notable with the complete disappearance of MRI lesions at the 2 year follow-up after the treatment with high dose steroid.
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Affiliation(s)
- M Genc
- Department of Radiation Oncology, Meram Medical Faculty, Selcuk University,Akyokus, Konya, Turkey.
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Atahan L, Ozyar E, Genc M, Kose F, Ayhan A, Kucukali T. 2353. Int J Radiat Oncol Biol Phys 2006. [DOI: 10.1016/j.ijrobp.2006.07.762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ozyar E, Genc M. Relapse pattern of GOG 122 trial should be more informative. J Clin Oncol 2006; 24:3709-10; author reply 3710. [PMID: 16877741 DOI: 10.1200/jco.2006.06.8833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Cengiz M, Ozyar E, Genc M. In regards to: Adjuvant radiotherapy after transoral laser microsurgery for advanced squamous cell carcinoma of the head and neck by Pradier et al. (Int J Radiat Oncol Biol Phys 2005;63:1368-1377). Int J Radiat Oncol Biol Phys 2006; 65:955; author reply 955-6. [PMID: 16751078 DOI: 10.1016/j.ijrobp.2006.02.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2006] [Accepted: 02/24/2006] [Indexed: 11/18/2022]
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Genc M, Yavuz M, Cimsit G, Cobanoglu O, Yavuz A. Radiation port wart: a distinct cutaneous lesion after radiotherapy. J Natl Med Assoc 2006; 98:1193-6. [PMID: 16895295 PMCID: PMC2569464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
UNLABELLED LABELED BACKGROUND: Radiotherapy may cause common cutaneous side effects such as acute and chronic radiodermatitis and also rare skin conditions. CASE REPORT A 42-year-old woman who received radiotherapy for invasive breast carcinoma developed multiple, scaly, rough papules and nodules restricted to treatment fields six months after completion of the treatment. A relapse of the breast cancer and/or seborrheic keratosis was ruled out by histological confirmation of verruca vulgaris. CONCLUSION We report the first case of verruca vulgaris associated with radiation treatment. Radiotherapists and dermatologists should be aware of this possibility and be able to differentiate it from other skin lesions associated with irradiation.
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Affiliation(s)
- Mine Genc
- Department of Radiation Oncology, Selcuk University, Meram Medical Faculty, Akyokus, Konya, Turkey.
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Yildiz F, Genc M, Akyurek S, Cengiz M, Ozyar E, Selek U, Atahan IL. Radiotherapy in the management of Kaposi's sarcoma: comparison of 8 Gy versus 6 Gy. J Natl Med Assoc 2006; 98:1136-9. [PMID: 16895284 PMCID: PMC2569458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To evaluate prospectively the efficacy of a single fraction of high-dose radiotherapy in patients with Kaposi's sarcoma. PATIENTS Between 1994 and 2004, 47 patients with Kaposi's sarcoma were treated at Hacettepe University, Department of Radiation Oncology. Thirteen (28%) patients received chemotherapy before radiotherapy and were referred due to recurrent or progressive disease or intolerance to chemotherapy. All lesions were treated locally with a 2-3-cm safety margin with 4-6-MeV electron beams. Radiotherapy consisted of a single fraction of 8 Gy in the first four years and 6 Gy thereafter. RESULTS The male:female ratio was 4:1. The median age was 61 years (range 18-87). Eight out of 47 patients (17%) had an underlying immunocompromised state, and one had a previous diagnosis of Hodgkin's disease. Of 203 fields treated, 51 and 152 fields were treated with 8 Gy and 6 Gy, respectively. Overall response rates (RR) at 12 months for 8- and 6 Gy were 93% and 86%, which were not statistically different. However, the difference between complete RRs at 12 months (93% and 60% for 8 Gy and 6 Gy respectively) was significant (p<0.0001). Progression-free survival and reirradiation rates were not significantly different. Side effects were tolerable in all but three patients with grade 2-3 fibrosis and edema. CONCLUSION Radiotherapy is an effective mode of treatment for Kaposi's sarcoma, and a single dose of 8 Gy is more effective in terms of complete RR compared to 6 Gy, though overall response and progression-free survival rates were similar.
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Affiliation(s)
- Ferah Yildiz
- Department of Radiation Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
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Cengiz M, Yildiz F, Genc M. Cetuximab plus radiotherapy for head and neck cancer. N Engl J Med 2006; 354:2187; author reply 2187. [PMID: 16710908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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Yavuz AA, Cobanoglu U, Genc M, Yavuz MN, Kosucu P, Aslan MK. Malignant fibrous histiocytoma of the thyroid gland: recurrence treated by radiotherapy. ACTA ACUST UNITED AC 2005; 34:216-20. [PMID: 16089231 DOI: 10.2310/7070.2005.04002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- A Aydin Yavuz
- Department of Radiation Oncology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
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Akyürek S, Yildiz F, Cengiz M, Onal C, Yildiz O, Genc M, Atahan IL. Importance of timing of antiaggregant treatment in the prevention of radiation induced enteropathy. Med Hypotheses 2005; 65:736-9. [PMID: 15953694 DOI: 10.1016/j.mehy.2005.04.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2005] [Accepted: 04/03/2005] [Indexed: 11/18/2022]
Abstract
Chronic radiation enteropathy (CRE) is an undesirable radiation-induced toxicity and a common health problem in patients with pelvic or abdominal malignancies. Damage to microvascular endothelial cells and connective tissue is blamed to cause this adverse effect. It is shown that platelets are the first cellular elements that initiate the homeostatic and inflammatory responses and release of several proinflammatory and fibrinogenic mediators. Antiplatelet agents such as ticlopidine and clopidogrel were shown to prevent CRE and this effect is believed to be directed by their activities against thrombocytes. However, recent studies have shown that these drugs also induce apoptosis in endothelial cells and may lead to decreased expression of endothelial prostacyclin and thrombomodulin (TM) and increased release of von Willebrand factor which are shown to be major contributors of coagulation process. Assuming that radiation induced apoptosis occur 6-10h after irradiation, we think that timing of these antiaggregant drugs with irradiation is important and a 6-10h interval between these may be beneficial to avoid this adverse interaction.
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Affiliation(s)
- S Akyürek
- Ankara University School of Medicine, Faculty of Medicine, Department of Radiation Oncology, Dikimevi, 06100 Ankara, Turkey.
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Karaoglu L, Pehlivan E, Gunes G, Genc M, Tekerekoglu SM, Ercan C, Egri M, Yologlu S. Evaluation of the immune response to hepatitis B vaccination in children aged 1-3 years in Malatya, Turkey. New Microbiol 2003; 26:311-9. [PMID: 14596341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
By the end of 1998, Turkey had launched the routine vaccination of infants against hepatitis B. The purpose of the study is to evaluate the immune response in a sample of vaccinated children aged 1-3 years in the city of Malatya. A total of 210 vaccinated children 12 to 48 months old were selected for the study with 30 cluster sampling in the city of Malatya, Turkey. The children were visited at their homes during January-April 2002. The information on demographic characteristics, family's and child's medical history was gathered, childrens' weight and height were measured and blood samples were taken. Anti-HBs, HbsAg and anti-HBc titers were assayed by micro-ELIZA from the sera. The mean age of the children was 26.3 months, 100 (47.6%) were male and 110 (52.4%) were female. Overall, 203 (96.7%) children had protective anti-HBs levels (> or = 10 IU/l), 0.5% showed evidence of natural infection (with positive anti-HBc and anti-HBs titers), 0.5% had acute or chronic infection (with positive HbsAg and anti-HBc titers) and 2.3% were seronegative. Geometric mean titer of anti-HBs among vaccinated children except those who had positive anti-HBc titers was 138.7 mIU/ml (95% CI:124.7-154.2) and seroconversion rates did not differ by age, sex, anthropometric measurements, time after third dose and place of vaccine administered (P > 0.05). The high seroprotection rate over 95% showed that routine infant vaccination program for hepatitis B was successfully carried out in the city Malatya.
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Affiliation(s)
- L Karaoglu
- Department of Public Health, Faculty of Medicine, Inonu University, Malatya, Turkey
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Abstract
PURPOSE To determine the safety and effectiveness of accelerated hyperfractionated radiotherapy in the treatment of supratentorial malignant astrocytomas. MATERIALS AND METHODS Between June 1995-July 1997, 75 patients were enrolled to a prospective phase II study. A total dose of 60 Gy was delivered in 2 Gy b.i.d. fractions with an interval of 6-8 h, 5 days per week, in an overall time of 3 weeks. The treatment protocol was planned to give 40 Gy to a treatment volume covering the contrast-enhancing lesion and oedema (+ 3-cm margin) and additional 20 Gy to the volume encompassing the contrast-enhancing lesion alone with a 1-cm margin based on preoperative magnetic resonance imaging and/or CT findings. The patients had a median age of 46 years and a median Karnofsky performance status score of 80. Histology consisted of anaplastic astrocytoma (AA) in 16 (21%) and glioblastoma multiforme (GBM) in 59 (79%) patients. RESULTS Median survival was 11 months for all patients; 10 months for GBM patients and 40 months for AA patients. Survival rates at 1 and 3 years were 41%, 11% for all patients; 62, 37% for AA patients and 35, 6% for GBM patients, respectively. Multivariate analysis revealed significant impact of age, histology and neurological functional class on survival. The incidence of grade 3 or worse late neurological toxicity was 5.3%. CONCLUSIONS Although accelerated hyperfractionated radiotherapy showed no significant advantage on survival, it shortened the treatment period from 6 to 3 weeks. Radiotherapy was well tolerated and the incidence of late toxicity is acceptable.
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Affiliation(s)
- M Genc
- Department of Radiation Oncology, University of Selcuk, Faculty of Medicine, Konya, Turkey
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