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Antenatal Findings of Keratitis-Ichthyosis-Deafness Syndrome
(Elsevier Inc, 2020) Okmen, Firat; Hortu, Ismet; Jafarova, Ulduz; Imamoglu, Metehan; Ekici, Huseyin; Ergenoglu, Ahmet Mete
Background: Keratitis-ichthyosis-deafness (KID) syndrome is a congenital ectodermal disorder characterized by keratitis, ichthyosis, and deafness. This syndrome affects multiple systems and can be fatal. Case: A 34-year-old G2, P1 woman was admitted to the Ege University School of Medicine in Izmir, Turkey because of a rapid increase in abdominal circumference at 32 weeks gestation. Fetal anatomic screening revealed complete chorioamniotic separation, hypoplasia of the cerebellar vermis, and dysmorphic facial findings such as frontal bulging. After the delivery, the baby's whole body had granular thickened skin. Bilateral dry eye, corneal edema, and bilateral retinopathy of prematurity were diagnosed. Conclusion: This case report highlights the importance of prenatal diagnosis through ultrasonography and magnetic resonance imaging. This is the first case report that has antenatal ultrasonographic features in the literature. (c) 2019 the Society of Obstetricians and Gynaecologists of Canada/La Societe des obstetriciens et gynecologues du Canada. Published by Elsevier Inc. All rights reserved.
Can We Predict the Presence and Severity of Intra-Abdominal Adhesions before Cesarean Delivery?
(Karger, 2017) Taylan, Enes; Akdemir, Ali; Ergenoglu, Ahmet Mete; Yeniel, Ahmet Ozgur; Tekindal, Mustafa Agah
Aims: The study aimed to investigate whether we can predict the presence and severity of intra-abdominal adhesions before cesarean delivery using patient history, symptoms, and abdominal skin scar characteristics. Methods: In this prospective study, 143 pregnant women with history of previous abdominal surgery were included and they delivered by cesarean. Preoperative abdominal scar characteristics and symptoms as well as intraoperative abdominal adhesions were evaluated using the Manchester Scar Scale, a symptomatology questionnaire and the More Comprehensive Adhesion Scoring Method, respectively. Results: Patients with adhesions (n = 98) and without adhesions (n = 45) had similar baseline characteristics. In the adhesion group, abdominal scar scoring parameters were significantly increased. However, there was no significant correlation among total scar score, adhesion score, and symptom score. Conclusion: Despite the availability of many proposed methods, accurate prediction of the severity of surgery-related adhesions is beyond our current abilities. Therefore, as healthcare providers, obstetricians should avoid unnecessary use of the cesarean approach. This approach is more effective, beneficial, realizable, and reasonable than the prediction of surgery-related adhesions. (C) 2016 S. Karger AG, Basel
Can we rely on blind endometrial curettage for complete removal of focal intrauterine lesion? A prospective clinical study
(Elsevier Masson, Corp Off, 2020) Ergenoglu, Ahmet Mete; Hortu, Ismet; Taylan, Enes; Yeniel, Ahmet Ozgur; Akdemir, Ali; Sahin, Cagdas; Karadadas, Nedim
Objective: To investigate the diagnostic and therapeutic efficiency of dilatation-curettage (D&C) combined with aspiration curettage for endometrial pathology compared to hysteroscopy alone in this study. Material and methods: A total of 143 patients who have suspicion of endometrial mass like lesion, increased endometrial thickness (>5-mm at menopause and/or endometrial thickness upper than 5-mm in patients under tamoxifen treatment due to breast cancer during 2-D transvaginal ultrasonography examination) were enrolled. All patients underwent procedures in order of hysteroscopy, D&C plus aspiration and second look hysteroscopy. Data for age, menopausal status, tamoxifen treatment, endometrial histology, hysteroscopy and D&C findings were recorded and statistically analyzed. Results: Initial hysteroscopy revealed focally growing endometrial lesion in 96 patients. Second look hysteroscopy showed persistent focal lesion in 77 patients (80 %) after D&C plus aspiration. Endometrial blind curettage failed to diagnose 42 % (25/60) of endometrial polyps, none of submucous myomas as well as 27 %(3/11) of premalignant and malignant endometrial lesions. the sensitivity, specificity, overall accuracy, positive predictive value and negative predictive value of hysteroscopy were found as 84.1 %, 83.3 %, 83.9 %, 93.8 %, and 63.8 %, respectively. Conclusions: Hysteroscopy showed significant superiority in the diagnosis and definitive treatment of endometrial pathologies specifically in focally growing endometrial lesions compared to D&C plus aspiration. (C) 2020 Elsevier Masson SAS. All rights reserved.
Cervical cerclage in twin pregnancies: obstetric and neonatal outcomes
(Springer London Ltd, 2022) Ekici, Huseyin; Okmen, Firat; Saritas, Didem Gul; Khaligli, Gultap; Ergenoglu, Ahmet Mete
Background Although there have been significant improvements in prenatal and neonatal care in recent years, twin pregnancies account for 17-20% of all preterm births and are associated with an increased risk of perinatal mortality and morbidity. Aims To evaluate the contribution of cerclage to the continuation of pregnancy in twin pregnancy cases required cervical cerclage. Methods Cases of twin pregnancies who performed cervical cerclage with follow-up and deliveries between January 2010 and January 2022 in the Department of Obstetrics and Gynecology, Ege University Faculty of Medicine Hospital, were retrospectively analyzed. Obstetric and neonatal outcomes were evaluated. Results A total of 23 women who performed cervical cerclage due to cervical insufficiency in twin pregnancies were evaluated retrospectively. The mean time between cerclage placement and delivery was 12.1 +/- 7 weeks, maximum prolongation was in the obstetric history-indicated cerclage group. The gestational age at delivery was 20-38 (median 30) weeks. The rate of spontaneous preterm birth at < 34, < 32, < 28, and < 24 weeks was higher in the physical examination-indicated cerclage group. Overall neonatal survival was 82.5% (n = 33/40). Conclusion The time between cerclage placement and birth were considered as an important gain for twin pregnancies at the limit of viability. Further studies are needed to better understand the role of cervical cerclage in preventing premature birth and to determine the indications for cerclage.
Comparison of melatonin and oxytocin in the prevention of critical illness polyneuropathy in rats with experimentally induced sepsis
(Academic Press Inc Elsevier Science, 2013) Erbas, Oytun; Ergenoglu, Ahmet Mete; Akdemir, Ali; Yeniel, Ahmet Ozgur; Taskiran, Dilek
Background: Critical illness polyneuropathy is an acute neuromuscular disorder of critically ill patients and is characterized by limb and respiratory muscle weakness. The purpose of the study was to evaluate the neuroprotective effects of melatonin (MEL) and oxytocin (OT) on the early stage of sepsis by recording compound muscle action potentials and measuring plasma tumor necrosis factor (TNF)-alpha levels, lipid peroxidation (malondialdehyde; MDA), and total antioxidant capacity. Materials and methods: One hundred adult male Sprague-Dawley rats were included in the study. The cecal ligation and puncture (CLP) procedure was performed to induce the sepsis model. MEL (10, 20, and 40 mg/kg), OT (0.4, 0.8, and 1.6 mg/kg), and a combination of MEL (20 mg/kg) and OT (0.8 mg/kg) were administered intraperitoneally in the first hour of surgery. Electromyography (EMG) studies were achieved 24 h after CLP surgery and then blood samples were collected for biochemical measurements. Results: EMG findings revealed that compound muscle action potential amplitude was significantly decreased and distal latency was prolonged in the CLP group compared with the sham group (P < 0.05 and P < 0.0005). Moreover, the animals that received CLP surgery showed significantly higher TNF-alpha and MDA levels and lower total antioxidant capacity values than the sham group. The administration of MEL and OT to rats significantly abolished the EMG alterations and suppressed oxidative stress and TNF-alpha release in CLP-induced rats. Conclusions: The inflammatory processes and imbalance in oxidative/antioxidative status play important roles in the pathogenesis of critical illness polyneuropathy. We suggest that both oxytocin and melatonin may have beneficial effects against sepsis-induced polyneuropathy in critical illness. (C) 2013 Elsevier Inc. All rights reserved.
Comparison of three-dimensional ultrasound and magnetic resonance imaging diagnosis in surgically proven Mullerian duct anomaly cases
(Elsevier Science Bv, 2016) Ergenoglu, Ahmet Mete; Sahin, Cagdas; Simsek, Deniz; Akdemir, Ali; Yeniel, Ahmet Ozgur; Yerli, Hasan; Sendag, Fatih
Objective: To determine and compare the diagnostic accuracy of 3-dimensional ultrasound (3D US) and magnetic resonance imagining (MRI) in patients with surgically diagnosed Mullerian duct anomaly (MDA). Study design: Charts of patients with MDA were retrospectively evaluated. Patients who underwent both laparoscopic and hysteroscopic surgery and had 3D US and MRI examinations were included in the study. The diagnoses achieved via 3D US and MRI were compared with the surgical diagnoses to determine the diagnostic accuracy of these imagining techniques. Results: Twenty-nine patients were included in the study. Three-dimensional ultrasound detected 28 out of 29 (96%) patients correctly. Only one patient was diagnosed with a uterine septum instead of uterine arcuatus. Magnetic resonance imaging detected 23 out of 29 patients correctly (79%). The Kappa indexes of the 3D US and MRI were 0.896 and 0.592, respectively. Conclusion: Our results indicate that 3D US has a higher diagnostic accuracy level than MRI in evaluating MDA, especially when used in experienced hands. However, additional, well-designed studies are needed to better compare the diagnostic accuracy of the 3D US and MRI. Crown Copyright (C) 2015 Published by Elsevier Ireland Ltd. All rights reserved.
Coring-type laparoscopic resection of a cavitated non-communicating rudimentary horn under hysteroscopic assistance
(Wiley-Blackwell, 2014) Akdemir, Ali; Ergenoglu, Ahmet Mete; Yeniel, Ahmet Ozgur; Sendag, Fatih; Karadadas, Nedim
Non-communicating accessory uterine horns with an endometrial cavity are the most common and clinically significant unicornuate subtype of M llerian duct abnormality. They are generally associated with symptoms of dysmenorrhea, dyspareunia, infertility, endometriosis, adhesions, and life-threatening cornual pregnancy. Treatment options include surgical resection of the rudimentary horn, hysteroscopic recanalization, and endometrial ablation. Currently, laparoscopic resection is the recommended treatment choice. Dissection of the rudimentary horn from the unicornuate uterus is the most challenging part of this procedure and may compromise the remaining unicornuate uterus wall. Here we describe a case of laparoscopic coring-type resection of a non-communicating functional rudimentary horn firmly attached to the unicornuate uterus, by using hysteroscopic assistance. The use of hysteroscopy, adjunct to laparoscopy, facilitates the coring-type resection and may strengthen the remaining myometrial scar.
Dexmedetomidine infusion prevents postoperative shivering in patients undergoing gynecologic laparoscopic surgery
(Tubitak Scientific & Technical Research Council Turkey, 2013) Karaman, Semra; Gunusen, Ilkben; Ceylan, Mustafa Arda; Karaman, Yucel; Cetin, Esra Nur; Derbent, Abdurrahim; Ergenoglu, Ahmet Mete
Aim: This placebo-controlled, randomized study was performed to evaluate the efficacy of dexmedetomidine in preventing postoperative shivering. Materials and methods: Sixty patients undergoing gynecologic laparoscopic surgery were assigned randomly to 2 groups to be administered either dexmedetomidine as a loading of 1 mu g kg(-1) for 10 min followed by a maintenance infusion of 0.5 mu g kg(-1) h(-1) (Group D, n = 30), or a normal saline infusion (Group S, n = 30). Results: Postoperative shivering was observed in 14 patients in Group S and in 3 patients in Group D (P = 0.001). The sedation scores were higher in the dexmedetomidine group than in the saline group (P < 0.05). Postoperative pain scores were higher in the saline group for the first 40 min (P < 0.05). Perioperative tympanic temperatures were not different between the groups. Conclusion: Intraoperative dexmedetomidine infusion reduces postoperative shivering in patients undergoing gynecologic laparoscopy.
Dexmedetomidine infusion prevents postoperative shivering in patients undergoing gynecologic laparoscopic surgery
(Tubitak Scientific & Technical Research Council Turkey, 2013) Karaman, Semra; Gunusen, Ilkben; Ceylan, Mustafa Arda; Karaman, Yucel; Cetin, Esra Nur; Derbent, Abdurrahim; Ergenoglu, Ahmet Mete
Aim: This placebo-controlled, randomized study was performed to evaluate the efficacy of dexmedetomidine in preventing postoperative shivering. Materials and methods: Sixty patients undergoing gynecologic laparoscopic surgery were assigned randomly to 2 groups to be administered either dexmedetomidine as a loading of 1 mu g kg(-1) for 10 min followed by a maintenance infusion of 0.5 mu g kg(-1) h(-1) (Group D, n = 30), or a normal saline infusion (Group S, n = 30). Results: Postoperative shivering was observed in 14 patients in Group S and in 3 patients in Group D (P = 0.001). The sedation scores were higher in the dexmedetomidine group than in the saline group (P < 0.05). Postoperative pain scores were higher in the saline group for the first 40 min (P < 0.05). Perioperative tympanic temperatures were not different between the groups. Conclusion: Intraoperative dexmedetomidine infusion reduces postoperative shivering in patients undergoing gynecologic laparoscopy.
Do stages of menopause affect the outcomes of pelvic floor muscle training?
(Lippincott Williams & Wilkins, 2015) Tosun, Ozge Celiker; Mutlu, Ebru Kaya; Tosun, Gokhan; Ergenoglu, Ahmet Mete; Yeniel, Ahmet Ozgur; Malkoc, Mehtap; Askar, Niyazi; Itil, Ismail Mete
Objective: The purpose of our study is to determine whether there is a difference in pelvic floor muscle strength attributable to pelvic floor muscle training conducted during different stages of menopause. Methods: One hundred twenty-two women with stress urinary incontinence and mixed urinary incontinence were included in this prospective controlled study. The participants included in this study were separated into three groups according to the Stages of Reproductive Aging Workshop staging system as follows: group 1 (n = 41): stages -3 and -2; group 2 (n = 32): stages +1 and -1; and group 3 (n = 30): stage +2. All three groups were provided an individual home exercise program throughout the 12-week study. Pelvic floor muscle strength before and after the 12-week treatment was measured in all participants (using the PERFECT [power, endurance, number of repetitions, and number of fast (1-s) contractions; every contraction is timed] scheme, perineometry, transabdominal ultrasound, Brink scale, pad test, and stop test). Data were analyzed using analysis of variance. Results: There were no statistically significant differences in pre-exercise training pelvic floor muscle strength parameters among the three groups. After 12 weeks, there were statistically significant increases in PERFECT scheme, Brink scale, perineometry, and ultrasound values. In contrast, there were significant decreases in stop test and 1-hour pad test values observed in the three groups (P = 0.001, dependent t test). In comparison with the other groups, group 1 demonstrated statistically significant improvements in the following postexercise training parameters: power, repetition, speed, Brink vertical displacement, and stop test. The lowest increase was observed in group 2 (P < 0.05). Conclusions: Strength increase can be achieved at all stages of menopause with pelvic floor muscle training, but the rates of increase vary according to the menopausal stage of the participants. Women in the late menopausal transition and early menopause are least responsive to pelvic floor muscle strength training. Further studies in this field are needed.
Effect of oxytocin treatment on explant size, plasma and peritoneal levels of MCP-1, VEGF, TNF-alpha and histopathological parameters in a rat endometriosis model
(Elsevier, 2014) Yeniel, Ahmet Ozgur; Erbas, Oytun; Ergenoglu, Ahmet Mete; Aktug, Huseyin; Taskiran, Dilek; Yildirim, Nuri; Ulukus, Murat
Objective: To determine the effects of oxytocin (OT) on surgically induced endometriosis in a rat model. Study design: Twelve female Sprague-Dawley rats were included. After the implantation and establishment of autologous endometrium onto the abdominal wall peritoneum, the rats were randomly divided into two groups, treated with intramuscular oxytocin (OT group, 160 mu g kg/day, n = 6) or isotonic NaCl solution (control group, 1 mL kg/day, n = 6) for 28 days. To evaluate the therapeutic effects of OT, the explant volumes were calculated and the levels of vascular endothelial growth factor (VEGF), monocyte chemotactic protein-1, and TNF-alpha were measured in plasma and peritoneal fluid. Endometriotic explants were examined histologically by semiquantitative analysis. Results: After treatment, the mean endometriotic explant volume was decreased in the OT group (p = 0.016). The histopathological score and VEGF immunoexpression of endometriotic explants were significantly lower in the OT group (p = 0.007) than in controls (p = 0.000). Inflammatory cytokine levels in plasma and peritoneal fluid were considerably decreased in the OT group. Moreover, TUNEL immunohistochemistry clearly demonstrated more apoptotic changes in the mononuclear cells of the OT group compared with controls. Conclusion: We suggest that oxytocin might be considered as a potential candidate therapeutic agent for endometriosis. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
The effect of surgical menopause after bilateral oophorectomy on hormonal changes, mucociliary clearance, and quality of life
(Springer, 2020) Gumussoy, Sureyya; Gumussoy, Murat; Hortu, Ismet; Ergenoglu, Ahmet Mete
Purpose the removal of the ovaries for any reason causes surgical menopause. Hormonal changes that occur progressively over 5-10 years in natural menopause occur acutely in surgical menopause. Signs of estrogen deficiency appear suddenly and are permanent after this surgery. This study investigated the short- and long-term effects of estrogen deficiency occurring after surgical menopause on both nasal mucociliary activity and sinonasal symptoms. Methods This prospective study included women aged 20-45 years who were not in the menopause, who had a planned bilateral oophorectomy and who attended the Gynecology Clinic at the Faculty of Medicine at a university hospital between January 2018 and December 2019. the nasal mucociliary clearance time, and blood Estradiol (E2) and FSH levels were measured once in the preoperative period, and at the postoperative 3rd, 6th, 9(th), and 12th months. At the same times, the Sinonasal Outcome Test 22 (SNOT-22) was also applied. Results the average age of the 47 patients was 41.2 +/- 2.7. the mean serum estradiol levels of the women were 164.7 +/- 63.4 pg/ml in the preoperative period, 14.8 +/- 3.7 pg/ml at the postoperative 3rd month, 12.5 +/- 3.5 pg/ml at the postoperative 6th month, 11.6 +/- 3.0 pg/ml at the postoperative 9th month, and 11.1 +/- 2.7 pg/ml at the postoperative 12th month. the mean FSH levels of the women were 9.4 +/- 2.4 mIU/ml in the preoperative period, 60.5 +/- 9.6 mIU/ml at the postoperative 3rd month, 61.9 +/- 9.4 mIU/ml at the postoperative 6th month, 63.0 +/- 9.3 mIU/ml at the postoperative 9th month, and 64.6 +/- 8.7 mIU/ml at the postoperative 12th month. the changes in postoperative mean estradiol and FSH levels over a year were significant and consistent with menopausal symptoms (p < 0.001). the mean mucociliary clearance times were 12.6 +/- 1.2 before menopause, 13.2 +/- 1.7 at the postoperative 3rd month, 14.5 +/- 1.7 at the postoperative 6th month, 17.5 +/- 1.6 at the postoperative 9th month, and 19.4 +/- 1.9 at the postoperative 12th month. the extension of the mean mucociliary clearance time over 1 year was significant (p < 0.001). the mean scores for the SNOT-22 were 17.3 +/- 6.9 before the operation, 17.8 +/- 6.0 at the postoperative 3rd month, 19.6 +/- 6.9 at the postoperative 6th month, 23.4 +/- 10.4 at the postoperative 9th month, and 36.1 +/- 10.0 at the postoperative 12th month. the mean scores for rhinologic symptoms were 5.2 +/- 1.9 (3-11) in the preoperative period, 5.7 +/- 2.0 (3-12) at the postoperative 3rd month, 7.1 +/- 2.3 (4-14) at the postoperative 6th month, 9.3 +/- 3.3 (4-16) at the postoperative 9th month, and 11.9 +/- 3.3 (6-18) at the postoperative 12th month. the 1-year change in the SNOT-22 scores was found to be significant (p < 0.001). Conclusion After bilateral oophorectomy, menopausal hormonal values were acutely high in women. At the 1-year postmenopausal follow-up, the mean scores for the SNOT-22 had increased significantly. in other words, quality of life decreased in parallel with prolonged nasal mucociliary clearance time.
The effects of uterine size with or without abdominal obesity on spinal block level and vasopressor requirement in elective cesarean section: a prospective observational study
(Tubitak Scientific & Technical Research Council Turkey, 2019) Gunusen, Ilkben; Sargin, Asuman; Akdemir, Ali; Ergenoglu, Ahmet Mete
Background/aim: Hypotension is a serious complication caused by spinal anesthesia that places both the mother and fetus at increased risk. We aimed to investigate the effects of uterine size with or without abdominal obesity on sensory block level of pregnant women receiving spinal anesthesia. Materials and methods: This study included 125 term parturients who underwent cesarean section. Motor and sensory block characteristics, the distance between the symphysis pubis and the fundus (SIT), the distance between the symphysis pubis and the xiphoid (SPX), newborn and placental weights, adverse effects, and doses of ephedrine were recorded. Results: Sensory block level and ephedrine dose were significantly correlated with the SPX and the combined newborn and placenta weights (P < 0.05). The incidence of hypotension was related to the SPX and the combined newborn and placenta weight (P < 0.05). There was no correlation between the SPF and sensory block level or ephedrine dose. The sensory block level was higher for patients who had greater SPX values and higher combined newborn and placenta weights. The incidence of hypotension and the ephedrine dose were also higher in these subjects. Conclusion: SPX values and combined newborn and placenta weights are more predictive of sensory block level than SPF values in parturients receiving spinal anesthesia.
Evaluation of complement system proteins C3a, C5a and C6 in patients of endometriosis
(Pergamon-Elsevier Science Ltd, 2020) Karadadas, Elif; Hortu, Ismet; Ak, Handan; Ergenoglu, Ahmet Mete; Karadadas, Nedim; Aydin, Hikmet Hakan
[No abstract available]
Evaluation of glycemic and oxidative/antioxidative status in the estradiol valerate-induced PCOS model of rats
(Elsevier Science Bv, 2012) Dikmen, Aysegul; Ergenoglu, Ahmet Mete; Yeniel, Ahmet Ozgur; Dilsiz, Ozlem Yilmaz; Ercan, Gulinnaz; Yilmaz, Huseyin
Objective: The aim of this study was to show glycemic and oxidative/antioxidative status (GOAS) in rats with estradiol valerate (EV)-induced polycystic ovarian syndrome. Study design: Thirty mature female rats were randomly allocated to EV-induced PCOS, sham and control groups. Malondialdehyde, catalase and fasting blood glucose levels were determined in order to evaluate GOAS. Results: There was a statistically significant difference between PCOS and control groups (p < 0.001) for hemolysate MDA while no difference was determined for either catalase or fasting blood glucose levels. On histopathological examination, the EV-induced PCOS group revealed disease-characteristic ovarian morphology. Conclusion: There was an increased compensation for oxidative stress by antioxidative biologic mechanisms in EV-induced PCOS rats. Interestingly, the sole result derived from this limited study is that the sesame oil + EV combination is not appropriate for the evaluation of oxidant-antioxidant status and also glycemic condition in PCOS. This study demonstrates the need for better designed experimental studies to elucidate the aetiopathogenesis of PCOS via novel techniques. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
Fetal aortic isthmus Doppler measurements for prediction of perinatal morbidity and mortality associated with fetal growth restriction
(Wiley-Blackwell, 2013) Abdelrazzaq, Khalil; Yeniel, Ahmet Ozgur; Ergenoglu, Ahmet Mete; Yildirim, Nuri; Akercan, Fuat; Karadadas, Nedim
Objective To identify the role of longitudinal measurements of fetal aortic isthmus blood flow using Doppler ultrasonography in the prediction of perinatal morbidity and mortality. Setting Obstetrics department of a university hospital. Population and design This prospective study includes women with fetal growth restriction and abnormal umbilical artery Doppler results, seen between November 2009 and January 2011. Methods 31 women were divided into two groups according to the aortic isthmus blood flow pattern just before birth: anterograde (n=12) or retrograde (n=19). Main outcome measure Longitudinal measurements of fetal aortic isthmus in relation to perinatal outcome. Results Total morbidity and mortality rates were significantly higher in the retrograde flow group. There was no statistically significant difference for respiratory distress syndrome, intraventricular hemorrhage, bronchopulmonary dysplasia or necrotizing enterocolitis, but the neonatal sepsis rate was significantly higher in the retrograde flow group. An abnormal aortic isthmus flow pattern was detected approximately 1520days after umbilical artery and middle cerebral artery Doppler flow abnormalities and 37days before deterioration in ductus venosus blood flow. Conclusion We suggest that aortic isthmus Doppler measurements are useful for identifying fetal growth restriction before deterioration in ductus venosus blood flow and fetal acidosis.
Fetal arrhythmias: Ten years' experience and review of the literature
(Galenos Publ House, 2022) Ekici, Huseyin; Okmen, Firat; Imamoglu, Metehan; Imamoglu, Aysegul Gizem; Ergenoglu, Ahmet Mete
Objective: Fetal arrhythmias complicate 1-2% of all pregnancies. Ultrasound evaluation and Doppler technology are indispensable in both diagnosis and management. Digoxin, sotalol, flecainide and amiodarone are widely accepted antiarrhythmic agents that are frequently. We reviewed the maternal and fetal outcomes in cases with fetal arrhythmia in a tertiary care center in the last decade. Materials and Methods: Fetal arrhythmias were classified under three main groups: Irregular rhythms, tachyarrhythmia and bradyarrhythmia. Detailed anatomical evaluation and fetal echocardiography were performed in all cases to determine whether a structural cardiac and extracardiac anomaly accompanied fetal arrhythmia and the type of fetal arrhythmia. Digoxin was started primarily as first-line therapy in patients with persistent fetal tachyarrhythmia. In cases, not responding to digoxin, other antiarrhythmic agents (sotalol, flecainide) were combined with treatment without discontinuing digoxin. Results: Fetal arrhythmia was detected in 36 cases during the study period. 50% (n=18/36) of the cases had supraventricular tachycardia, whereas 28% (n=10/36) of them were fetal bradyarrhythmia and 22% (n=8/36) of them were with various irregular rhythms. Transplacental therapy was initiated in 13 patients with persistent supraventricular tachycardia and atrial flutter regardless of the presence of hydrops. The success rate in transplacental therapy was 77% (n=10/13). Conclusion: Successful transplacental therapy was achieved in approximately 80% of cases and delivery could be postponed to advanced gestational weeks, confirming the crucial role of this treatment for the management of tachyarrhythmia.
Increased Expression of Electron Transport Chain Genes in Uterine Leiomyoma
(Assoc Clinical Scientists, 2014) Tuncal, Akile; Aydin, Hikmet Hakan; Askar, Niyazi; Ozkaya, Ali Burak; Ergenoglu, Ahmet Mete; Yeniel, Ahmet Ozgur; Akdemir, Ali; Ak, Handan
The etiology and pathophysiology of uterine leiomyomas, benign smooth muscle tumors of the uterus, are not well understood. To evaluate the role of mitochondria in uterine leiomyoma, we compared electron transport gene expressions of uterine leiomyoma tissue with myometrium tissue in six uterine leiomyoma patients by RT-PCR array. Our results showed an average of 1.562 (+/- 0.445) fold increase in nuclear-encoded electron transport genes. These results might suggest an increase in size, number, or activity of mitochondria in uterine leiomyoma that, to our knowledge, has not been previously reported.
Innovative Technique for Enclosed Morcellation Using a Surgical Glove
(Lippincott Williams & Wilkins, 2015) Akdemir, Ali; Taylan, Enes; Zeybek, Burak; Ergenoglu, Ahmet Mete; Sendag, Fatih
OBJECTIVE: To describe an innovative approach for enclosed morcellation using a surgical glove in multiport laparoscopic surgery. METHODS: Power morcellation was performed within an insufflated surgical glove in a completely enclosed manner between January and May 2014. The specimen was placed into the glove within the abdomen. The glove opening and thumb were exteriorized through the umbilical and left lower abdominal trocar incisions, respectively. The optical trocar and optic were inserted into the glove, which was then insufflated. The thumb tip was cut, and a power morcellator was inserted through this finger. The morcellation was accomplished within the completely enclosed glove. The thumb tip was closed, and the glove, containing residual specimens and bloody fluid, was removed from the abdomen through the umbilical incision. Thus, the risks of bag piercing and leakage during contained power morcellation were eliminated. Demographic and operative data were collected and analyzed for all cases. RESULTS: Thirty multiport laparoscopic myomectomy and morcellation procedures were performed during the study period. The median operative time was 85 minutes (range 60-140 minutes). The median morcellation preparation time, total morcellation time, and withdrawal time were 6 (range 4.5-14), 32 (range 15-55), and 1.2 (range 1-1.5) minutes, respectively. No intraoperative complications or bag ruptures were recorded. CONCLUSION: With our innovative technique, a disposable latex glove can be used for an enclosed morcellation that avoids piercing the enclosure container within the abdominal cavity, thereby offering decreased risks related to bag perforation and leakage compared with previous contained power morcellation techniques.
Innovative Technique for Enclosed Morcellation Using a Surgical Glove
(Lippincott Williams & Wilkins, 2015) Akdemir, Ali; Taylan, Enes; Zeybek, Burak; Ergenoglu, Ahmet Mete; Sendag, Fatih
OBJECTIVE: To describe an innovative approach for enclosed morcellation using a surgical glove in multiport laparoscopic surgery. METHODS: Power morcellation was performed within an insufflated surgical glove in a completely enclosed manner between January and May 2014. The specimen was placed into the glove within the abdomen. The glove opening and thumb were exteriorized through the umbilical and left lower abdominal trocar incisions, respectively. The optical trocar and optic were inserted into the glove, which was then insufflated. The thumb tip was cut, and a power morcellator was inserted through this finger. The morcellation was accomplished within the completely enclosed glove. The thumb tip was closed, and the glove, containing residual specimens and bloody fluid, was removed from the abdomen through the umbilical incision. Thus, the risks of bag piercing and leakage during contained power morcellation were eliminated. Demographic and operative data were collected and analyzed for all cases. RESULTS: Thirty multiport laparoscopic myomectomy and morcellation procedures were performed during the study period. The median operative time was 85 minutes (range 60-140 minutes). The median morcellation preparation time, total morcellation time, and withdrawal time were 6 (range 4.5-14), 32 (range 15-55), and 1.2 (range 1-1.5) minutes, respectively. No intraoperative complications or bag ruptures were recorded. CONCLUSION: With our innovative technique, a disposable latex glove can be used for an enclosed morcellation that avoids piercing the enclosure container within the abdominal cavity, thereby offering decreased risks related to bag perforation and leakage compared with previous contained power morcellation techniques.

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