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    Effectiveness of segmental resection technique in the treatment of placenta accreta spectrum
    (Taylor & Francis Ltd, 2019) Cirpan, Teksin; Akdemir, Ali; Okmen, Firat; Hortu, Ismet; Ekici, Huseyin; Imamoglu, Metehan
    Background: Placental accreta is a serious obstetrical entity and its management is challenging. the aim of this study was to evaluate and define our uterus sparing surgical technique in patients with placenta accreta spectrum. Methods: the data of 21 patients who underwent uterine segmental resection during cesarean section with a preliminary diagnosis of placenta accreta spectrum at Ege University between January 2017 and December 2018 were evaluated retrospectively. Results: Twenty-one patients were successfully treated with the segmental resection technique. in all cases, resected tissues were evaluated by histopathologically and the diagnosis of placenta accreta spectrum was confirmed. Hysterectomy was performed in two cases due to peri-partum hemorrhage that disrupted hemodynamics. None of the patients had complications such as visceral organ injury and wound infection. Conclusion: Our technique of uterine sparing surgery seems to be safe and effective in the management of placenta accreta spectrum without increasing complication rates.
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    Effectiveness of segmental resection technique in the treatment of placenta accreta spectrum
    (Taylor & Francis Ltd, 2021) Cirpan, Teksin; Akdemir, Ali; Okmen, Firat; Hortu, Ismet; Ekici, Huseyin; Imamoglu, Metehan
    Background: Placental accreta is a serious obstetrical entity and its management is challenging. The aim of this study was to evaluate and define our uterus sparing surgical technique in patients with placenta accreta spectrum. Methods: The data of 21 patients who underwent uterine segmental resection during cesarean section with a preliminary diagnosis of placenta accreta spectrum at Ege University between January 2017 and December 2018 were evaluated retrospectively. Results: Twenty-one patients were successfully treated with the segmental resection technique. In all cases, resected tissues were evaluated by histopathologically and the diagnosis of placenta accreta spectrum was confirmed. Hysterectomy was performed in two cases due to peri-partum hemorrhage that disrupted hemodynamics. None of the patients had complications such as visceral organ injury and wound infection. Conclusion: Our technique of uterine sparing surgery seems to be safe and effective in the management of placenta accreta spectrum without increasing complication rates.
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    The effects of raloxifen on depression and cognition in ovariectomized rats
    (Elsevier Science Inc, 2008) Karahancer, Mehmet; Cirpan, Teksin; Kanit, Lutfiye; Terek, Mustafa Cosan; Dikmen, Yilmaz; Ozsener, Serdar
    This study investigates the effects of raloxifen on cognition and depression in an animal model.
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    Exenatide preserves trabecular bone microarchitecture in experimental ovariectomized rat model
    (Springer Heidelberg, 2018) Eminov, Elmin; Hortu, Ismet; Akman, Levent; Erbas, Oytun; Yavasoglu, Altug; Cirpan, Teksin
    Purpose The aim of this study is to investigate effects of exenatide (Glucagon-Like Peptide Agonist) replacement on bone mineral density (BMD) and microarchitecture in a surgical menopause-induced osteoporosis model in rats. Methods In this study, 24 female Sprague-Dawley albino mature rats were used. Rats were assigned either to the group ovariectomized administered exenatide or to the control group. Bone Mineral Density (BMD), plasma cytokine levels and histomorphometric analysis were measured. Results Ovariectomized rats showed significant decrease BMD values, trabecular counts, trabecular thickness and trabecular area. Also, significant increase trabecular separation and plasma TNE-oc (Tumor Necrosis Factor) and IL-6 (Interleukin) levels. Exenatide treatment reversed these changes and it showed a considerable protective effect on trabecular bone microarchitecture. Conclusions Exenatide may be a candidate for use in the treatment of postmenopausal osteoporosis and anti-inflammatory properties can be attributed this effects.
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    How quickly can acute symptomatic hyponatremia be corrected?
    (Springer, 2013) Yaprak, Mustafa; Turan, Mehmet Nuri; Tamer, Abdulkerim Furkan; Peker, Nuri; Demirci, Meltem Sezis; Cirpan, Teksin; Asci, Gulay
    The systemic absorption of the flush liquid, including sorbitol, glycine or mannitol, can lead to complications, such as hyponatremia, volume overload and pulmonary or cerebral edema. Acute hyponatremia is defined as a reduction in the plasma sodium level in less than 48 h. Acute symptomatic hyponatremia should be corrected aggressively because it may cause irreversible neurological damage and death. Rapid correction of hyponatremia causes severe neurologic deficits, such as central pontine myelinolysis; thus, the optimal therapeutic approach has been debated. This article examined acute symptomatic hyponatremia in a patient undergoing transcervical myomectomy for a submucosal myoma. A thirty-seven-year-old patient was evaluated in obstetrics and gynecology clinic because of altered mental status and agitation. There was no history of chronic illness or drug use. It was discovered that during the operation, 12 L of the flush fluid, which contained 5 % mannitol, had been infused, but only 7 L of the flush fluid had been collected. On physical examination, the patient's general condition was moderate, her cooperation was limited, she was agitated, and her blood pressure was 120/70 mmHg. The sodium level was 99 mEq/L. Furosemid and 3 % NaCl solution were given. Her serum sodium returned to normal by increasing 39 mEq/L within 14 h. Her recovery was uneventful, and she was discharged 24 h after her serum sodium returned to normal. In conclusion, if there is a difference between the infused and collected volumes of the mannitol irrigant, severe hyponatremia may develop due to the flush fluid used during transcervical hysteroscopy and myomectomy. In these patients, acute symptomatic hyponatremia may be corrected as rapidly as the sodium level dropped.
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    The immunohistochemical evaluation of VEGF in placenta biopsies of pregnancies complicated by preeclampsia
    (Springer Heidelberg, 2008) Akercan, Fuat; Cirpan, Teksin; Terek, M. Cosan; Ozcakir, H. Tayfun; Giray, Gulsen; Sagol, Sermet; Karadadas, Nedim
    Objective The study was designed to determine the protein levels of vascular endothelial growth factor (VEGF) in the placenta biopsies of patients with preeclampsia and compare with normal controls. Design Prospective cohort study. Methods The placental biopsies were obtained from ten patients with preeclampsia and ten patients of control group at the time of delivery. Avidin-biotin-peroxidase immunohistochemistry was then performed to identify levels of VEGF protein within the tissue and a semi-quantitative method was devised to score the amount of staining present in the sample. Two histopathologists who were blinded to the groups were asked to score each sample for the intensity of staining and the number of cells stained in a randomly selected per high-power fields of each sample. The resulting "H-score" was computed as a product of intensity and percent of cells stained. Results The VEGF expression was significantly higher in placenta biopsies of preeclamptic patients compared to that of controls (271.2 +/- 22.65 vs. 201.9 +/- 12.33, P = 0.000). Conclusion Immunostaining of VEGF is significantly higher in placenta biopsies of patients with preeclampsia.
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    Mullerian anomalies and value of diagnosis with 2D ultrasonography
    (Derman Medical Publ, 2019) Sahin, Cagdas; Hortu, Ismet; Cirpan, Teksin
    Aim: Mullerian anomalies may accompany some gynecologic, reproductive, or obstetrical problems. They should be kept in mind as a factor for infertility and poor obstetrical results. Conventionally, 2D ultrasonography has been used for diagnosing mullerian anomalies. We evaluated mullerian anomalies diagnosed in our clinic and investigated the prediction of them by 2D ultrasonography. Material and Method: In this study, 82 patients were included who had mullerian duct anomalies. We evaluated all the patients through their medical records and interventions such as 2D ultrasonography, laparoscopy, and hysteroscopy. Results: Out of 82 patients, 53 suffered from infertility. Of the infertile patients, 67.9% (36/53) had uterus septus. The mean duration of infertility of the cases was 2.76 years (+/- SD 3.27). When we compared ultrasonography against laparoscopy findings, the sensitivity of ultrasonography was 96% and specificity was 15%. Also, comparing ultrasonography against hysteroscopy in diagnosis, the sensitivity and positive predictive value of ultrasonography were both 90%. But specificity was 33%. Discussion: The results of this study suggest that, laparoscopy and hysteroscopy is the gold standard for the diagnosis of mullerian anomalies when compared to 2D ultrasonography, as specificity is low with ultrasonography.