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    Analysis of the learning curve for robotic hysterectomy for benign gynaecological disease
    (Wiley, 2014) Sendag, Fatih; Zeybek, Burak; Akdemir, Ali; Ozgurel, Banu; Oztekin, Kemal
    BackgroundThe objective was to evaluate the learning curve for performing a robotic hysterectomy to treat benign gynaecological disease. MethodsThirty-six patients underwent robotic hysterectomy for benign indications. A systematic chart review of consecutive cases was conducted. The collected data included age, BMI, operating time, set-up time, docking time, uterine weight, blood loss, intraoperative complications, postoperative complications, conversions to laparotomy and length of hospital stay. ResultsThe mean operating, set-up and docking times were 16954.5, 52.9 +/- 12.4 and 7.8 +/- 7.6min, respectively. The learning curve analysis revealed a decrease in both docking and operating times, with both curves plateauing after case 9. ConclusionsThe learning curve analysis revealed a decrease in docking time and operating time after case 9, suggesting that there might be a fast, learning curve for experienced laparoscopic surgeons to master robotic hysterectomy, and that the docking process does not have a significant negative influence on the overall operating time. Copyright (c) 2013 John Wiley & Sons, Ltd.
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    The association of RANK gene C421T and C575T polymorphisms with bone mineral density in postmenopausal Turkish women
    (Springer Heidelberg, 2013) Isleten, Banu; Durmaz, Burak; Durmaz, Berrin; Onay, Huseyin; Özkınay, Ferda; Durmaz, Asude; Turan, Volkan; Oztekin, Kemal
    To investigate the association between C421T polymorphism within exon 4, C575T polymorphism within exon 6 of the RANK gene and bone mineral density (BMD) variations in postmenopausal Turkish women. One hundred seventy-eight postmenopausal women (patients = 100 and controls = 78) who applied to Ege University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, for osteoporosis examination were analyzed. BMDs of the lumbar spine and femoral sites were measured. Patient and control groups were established based on their T-score values being above and/or below -1. After venous blood sampling, C421T and C575T polymorphisms of the RANK gene were assessed through PCR process following DNA extraction. Genotype frequencies for the C421T and C575T polymorphisms were compared between the control group and the patient group. No significant difference was detected between the two groups for both polymorphisms. There was also no significant difference between the control and patient groups in terms of the combined genotype (p = 0.752) and the combined haplotype analysis of the C421T and C575T polymorphisms (p = 0.723). In the control and patient groups separately, no significant differences in BMD values either at the femoral sites or at the lumbar spine were detected between the combined genotypes of the two polymorphisms. The genotypes, combined genotypes and allele frequencies of C421T and C575T polymorphisms of the RANK gene have not been found to be associated with BMD in Turkish women. Further studies including both sexes and more cases are required.
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    Early menopause association with employment, smoking, divorced marital status and low leptin levels
    (Informa Healthcare, 2011) Sarac, Fulden; Oztekin, Kemal; Celebi, Gurbuz
    Aims. The aims of this study were (1) to investigate the determining risk factors related to early menopause and (2) to compare the relationships between demographic characteristics and hormonal status and leptin levels in subjects with early (no surgical) and natural menopause. Study design. The prospective study was conducted on 500 women with early and 2700 women with natural menopause. Detailed information was collected about their employment status, past and present smoking habits, coffee and alcohol use, educational level and other factors relevant to health. Thirty participants with early menopause and 30 participants with natural menopause were evaluated for hormone and leptin levels. Results. Employment status (OR: 1.94), current smoking (OR: 1.80) and divorced marital status (OR: 1.79) were found to be significant risk factors for early menopause. Mean levels of leptin in natural and early menopause were measured 11.40 +/- 4.1 rig/ml and 8.01 +/- 3.9 ng/ml, respectively (p = 0001). Leptin levels in the early (r = 0.765, p = 0.001) and natural (r = 0.750, p = 0.001) menopause subjects correlated positively with oestradiol (E2) levels. Conclusion. This study shows that early onset of menopause is correlated with smoking, employment status, divorced marital status and lower leptin levels.
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    Effect of ovarian stimulation with human menopausal gonadotropin and recombinant follicle stimulating hormone on the expression of integrins alpha(3), beta(1) in the rat endometrium during the implantation period
    (Elsevier Science Bv, 2010) Sendag, Fatih; Akdogan, Aysin; Ozbilgin, Kemal; Giray, Guelsen; Oztekin, Kemal
    Objective: To investigate the effect of exogenous ovarian stimulation with human menopausal gonadotropin (hMG) and recombinant follicle stimulating hormone (rFSH) on the expression of integrins alpha(3), beta(1) in the rat endometrium during implantation. Study design: Following three successive normal estrous cycles the animals were divided into five groups: Group I (n = 10, control group) received no medication; Group II (n = 10) received 10 units of hMG; Group III (n = 10) received 20 units of hMG; Group IV (n = 10) received 10 units of rFSH; Group V (n = 10) received 20 units of rFSH at midday of middiestrous. The rats were then mated with fertile males. The animals were sacrificed on the day of implantation. The uterine horns were placed in fixative and paraffin blocks of the tissue were cut in 5 mu m sections. The tissues were stained with primary antibodies; monoclonal anti-integrin alpha(3) and monoclonal anti-integrin beta(1) using immunohistochemical methods. The staining intensities of alpha(3) and beta(1) integrins were calculated separately for epithelium and stroma in each group. Results: Staining intensities of alpha(3) and beta(1) integrins in both the epithelium and the stroma were significantly lower in the treatment groups than the control group (p < 0.05). Conclusion: Ovarian stimulation by low and high doses of HMG and rFSH may have an effect on endometrial receptivity, possibly via a decrease in expression of integrins in the endometrium during the implantation period. (C) 2010 Elsevier Ireland Ltd. All rights reserved.
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    Effects of Hormone Replacement Therapy on Insulin Resistance and Platelet Function Tests
    (Karger, 2009) Sarac, Fulden; Saydam, Güray; Sahin, Fahri; Oztekin, Kemal; Saygili, Fusun; Tuzun, Mehmet; Yilmaz, Candeger
    Objectives: The aim of this study was to evaluate measures of insulin resistance and platelet function in postmenopausal women with oral or transdermal hormone replacement therapy (HRT). Subjects and Methods: Eighty women divided into four groups of 20 each were enrolled in the study. Group 1: postmenopausal hysterectomized women who received only transdermal estradiol (13.9 mg/12.5 cm(2)); group 2: women with intact uterus who were treated with estrogen-progestin combination ( HRT); group 3: postmenopausal women who were treated with the selective estrogen receptor modulator tibolone, and group 4: women who were not taking any drugs for HRT were chosen as a control group ( group 4). Results: In group 2, homeostasis model assessment of insulin resistance and fasting insulin levels were 2.90 +/- 0.37 and 9.3 +/- 3.0 mu U/ml, respectively, prior to administration of HRT. These levels were reduced to 1.91 +/- 0.41 (p = 0.001) and 7.1 +/- 2.7 mu U/ml (p = 0.002), respectively, after drug therapy. Mean levels of high-sensitivity C-reactive protein (hsCRP) were decreased with HRT only in group 2 (p = 0.002). No changes for biochemical and hematological parameters were observed in the other groups. Platelet function tests showed no differences after HRT in any group. Conclusions: Estrogen-progestin combination HRT decreased measures of insulin resistance and hsCRP levels, but had no effect on platelet function tests in postmenopausal women. Copyright (C) 2008 S. Karger AG, Basel