Haldun Guner | Gazi University (original) (raw)

Papers by Haldun Guner

Research paper thumbnail of Human Reproduction vol.12 no.ll pp.2399-2401, 1997 Small diameter versus conventional laparoscopy: a prospective, self-controlled study

The objective of this study was to determine visual quality, diagnostic accuracy, and surgical me... more The objective of this study was to determine visual quality, diagnostic accuracy, and surgical merits of small diameter laparoscopy (SDL). Thirty-seven patients were randomly selected. The indications for laparoscopy were infertility, desire for tubal sterilization or chronic pelvic pain. Patients underwent SDL, followed by conventional laparoscopy (CL) as a control under general anaesthesia. Findings at operation were compared. The mean time for diagnostic work-up was longer with SDL than CL, 11.7 ± 5.6 versus 7.6 ± 3.2 min respectively (P < 0.04). Visual quality was scored from 4 to 1 by the operator; mean visual quality, mean endometriosis score and mean adnexal adhesions score were slightly lower with SDL than CL. Sensitivity of SDL in diagnosing endometriosis, adhesions, ovarian, uterine and pouch of Douglas lesions were 71, 58, 81, 89 and 73% respectively; specificity was 100, 96, 100, 100, 100% in the same order. Suction irrigation, cyst aspiration, tissue biopsies, simple adhesiolysis, tubal ligation and cauterization were easily performed with SDL. We conclude that SDL seems a good alternative to CL in diagnosing macro-pelvic anatomy and coarse pelvic pathologies and may also be good in performing surgical procedures such as: tubal ligation, biopsies and differential diagnosis of pelvic fluids. But SDL must be used cautiously in microoriented, functional conditions such as infertility, pelvic pain, endometriosis and adhesion scoring or treatment. SDL may be regarded as a less invasive but less sensitive tool with limited surgical merits.

Research paper thumbnail of Aylık GnRH-a (Goserelin) Enjeksiyonları ile Endometrial Hiperplazi Tedavisi: Prospektif, Kontrollü Çalışma

Turkiye Klinikleri Journal of Gynecology and Obstetrics, 1997

Amaç: Endometrial hiperplazili hastalarda GnRH-a tedavisinin etkinliğini ve endometrial hiperplaz... more Amaç: Endometrial hiperplazili hastalarda GnRH-a tedavisinin etkinliğini ve endometrial hiperplazi gelişiminde insülin rezistansının rolünü araştırmak.

Research paper thumbnail of Preperitoneal Balon Diseksiyon Tekniği (PBDT) ile Laparoskopik Burch Operasyonu: Olgu Sunumu

Turkiye Klinikleri Journal of Gynecology and Obstetrics, 1995

Gazi Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum ABD ÖZET Amaç: Kliniğimizde stres ink... more Gazi Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum ABD ÖZET Amaç: Kliniğimizde stres inkontinens tedavisi için laparosko pik preperitoneal disseksiyon tekniği ile yapılan Burch operasyonunu sunmak ve tekniği tanıtmaktır. Çalışmanın Yapıldığı Yar: Gazi Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum ABD, ANKARA Materyal ve Matod: Sistoseli olmayan bir stress inkontinensli hasta laparoskopik preperitoneal Burch operas yonu ile öpere edildi. Bulgular: Teknik postoperatif 6. aydaki kontrolde etkili ola rak bulundu, erken veya geç komplikasyon gelişmedi. Sonuç: Vaginal cerrahi için uygun bir aday olmayan, ek jine kolojik patolojisi bulunmayan ve peritoneal girişimden sakınılmasının uygun olacağı olgularda laparoskopik pre peritoneal balon diseksiyonlu Burch operasyonu uygun bir seçimdir.

Research paper thumbnail of Postmenapozal Kanamalı Hastalarda, Vajinal Ultrasonografi ile Endometrial Değerlendirme Diagnostik Kürtajları Azaltabilir mi?

Turkiye Klinikleri Journal of Gynecology and Obstetrics, 1995

Postmenapozal hastalarda transvajinai ultraso nogram endometrial değerlendirme ile, endometrial k... more Postmenapozal hastalarda transvajinai ultraso nogram endometrial değerlendirme ile, endometrial kûretajda elde edilen doku histolojisini karşılaştırmak ve postmenapozal kanamalı olgularda gereksiz tanısal küretaj sayısını azaltmak için endometrial kalınlık yönünden bir sınır değer saptamak.

Research paper thumbnail of Mikrolaparoskopi ve Konvansiyonel Laparoskopinin Karşılaştırılması

Turkiye Klinikleri Journal of Gynecology and Obstetrics, 1996

Sonuç: ML nin karına girerken daha az travmatik, karına girilen bölgede kanama ve herni riskinin ... more Sonuç: ML nin karına girerken daha az travmatik, karına girilen bölgede kanama ve herni riskinin daha az, karın içi organların zedelenme riskinin daha düşük olması ve genel anestezi gerektirmemesi gibi belirgin avantajları vardır. MLtuballigasyon, kist biyopsileri, fenestrasyonlar ve pelvik ağrı gibi durumlarda KL ye iyi bir alternatiftir. Fakat infertilité, endometriozis ve adezyonların skorlanmaları ve tedavileri gibi durumlarda etkinliği düşmektedir. ML kolay uygulanabilir, daha az invaziv fakat sensitivite si daha düşük bir yöntem olarak değerlendirilmiştir.

Research paper thumbnail of Laparoskopik Sakroservikopeksi veİntraperitoneal Burch Operasyonu: İki Olgu Sunumu

Turkiye Klinikleri Journal of Gynecology and Obstetrics, 2002

Pelvik organ prolapsusu jinekologların sık karşılaştıkları problemlerden birini oluşturmaktadır. ... more Pelvik organ prolapsusu jinekologların sık karşılaştıkları problemlerden birini oluşturmaktadır. Uterovajinal prolapsus kimi zaman rutin jinekoloji muayenesinde saptanan bir bulgu olup bu hastalar sıklıkla asemptomatik olmakla birlikte ağrı, basınç hissi, konstipasyon, sık idrara çıkma, idrar inkontinansı gibi şikayetler ile de doktora başvurabilirler. Pelvik organ prolapsusu özellikle kırklı yaşlardan sonra ortaya çıkar ve

Research paper thumbnail of Stage 1 Endometrium Kanseri Tedavisinde Laparoskopik Histerektomi ve Laparoskopik Lenf Nodu Örneklemesi: İki Olgu Sunumu

Turkiye Klinikleri Journal of Gynecology and Obstetrics, 2001

Endometrium kanseri kadýnlarda erken taný ve tedavi ile yüz güldürücü sonuçlarýn alýndýðý bir neo... more Endometrium kanseri kadýnlarda erken taný ve tedavi ile yüz güldürücü sonuçlarýn alýndýðý bir neoplastik hastalýktýr. Bundan 20 yýl öncesine kadar diðer jinekolojik tümörler gibi cerrahi tedavisi laparotomi sonrasýnda

Research paper thumbnail of Myoma Uteri'li Hastalarda İnsülin Rezistansı

Turkiye Klinikleri Journal of Gynecology and Obstetrics, 2001

Uterus myomlarý jinekolojik kaynaklý, en sýk rastlanan tümörler olmakla birlikte etiyoloji ve gel... more Uterus myomlarý jinekolojik kaynaklý, en sýk rastlanan tümörler olmakla birlikte etiyoloji ve geliþimleri hakkýnda fazla bilgi yoktur. Insulin-like growth faktörler (IGF, insulin benzeri büyüme faktörü) yapýsal olarak pro-insuline benzeyen, sentezleri baþlýca karaciðer olmak üzere vücutta pek çok dokuda gerçekleþtirilen, düþük moleküler aðýrlýkta polipeptid-lerdir (1). Bu faktörler hücre mitozu ve diferansiasyonunu uyarýrlar. Esas moleküllerin yanýsýra reseptörlerin de ben-zerliðinden dolayý (2), IGF-I ve insulin, benzer etki göstermektedirler (3,4). Yüksek düzeylerde insulin, IGF-I reseptörlerini uyarmak suretiyle, IGF-I gibi davran

Research paper thumbnail of Adneksiyel Kitlelerin Laparoskopik Cerrahi ile Tedavisi

Turkiye Klinikleri Journal of Gynecology and Obstetrics, 1997

Adneksiyel kitlelerin tanı ve tedavisinde laparoskopi son yıllarda çok önemli bir yer almıştır. O... more Adneksiyel kitlelerin tanı ve tedavisinde laparoskopi son yıllarda çok önemli bir yer almıştır. Operatif laparoskopinin konvansiyonel laparatomiye oranla çeşitli avantajları vardır. Bazı olgularda operasyon daha kısa sürmekte, hastanın postoperatif iyileşmesi daha çabuk olmakta, hastanede kalış süreleri kısalarak birçok hastanın yatırılmasına dahi gerek duyulmamaktadır. Yine birçok yayında laparoskopi ile cerrahi olarak laparotomiye kıyasla benzer oranlarda başarı sağlandığı bildirilmiştir. Adneksiyel kitlelerin çoğunluğu benign olup, çeşitli çalışmalarda malignite oranı premenapozal hastalarda %7-13, postmenapozal hastalarda ise %8-45 arasında bulunmuştur (1). Hastanın pelvik muayenesi, ultrasono

Research paper thumbnail of Serviksin Glandüler Hücreli Lezyonları

Turkiye Klinikleri Jinekoloji Obstetrik Dergisi, 2001

Research paper thumbnail of Stress İnkontinensinin Nonabsorbabl Sentetik Greft Kullanılarak Sling Metodu ile Cerrahi Tedavisi

Turkiye Klinikleri Journal of Gynecology and Obstetrics, 1991

Stress inkonlinensi olan 26-52 yaşları arasındaki 19 hastaya sling operasyonu uygulandı. Bunlarda... more Stress inkonlinensi olan 26-52 yaşları arasındaki 19 hastaya sling operasyonu uygulandı. Bunlardan 6 ededi daha önce ameliyat geçirmiş nüks vakalardı. Hastalanınız postoperatif ortalama 12 ay boyunca takip edildi. 18 vakada başanlı sonuç alındı (%94.7). Bir vakada yeniden nüks teşekkül elti. Sling operasyonu Gerçek Stress İnkonlinensi olan hastalarda isler priıner, isler nüks vakalar olsun tecrübeli ellerde uygulandığında çok iyi netice alınan bir operasyon şeklidir.

Research paper thumbnail of Prostaglandin E2 Jel'in Servikal Olgunlaşma ve Doğum İndüksiyonunda Kullanımı

Turkiye Klinikleri Journal of Gynecology and Obstetrics, 1995

Hastalıkları ve Doğum ABD ANKARA ÖZET Amaç; Prostaglandin £2 (PGE2) jetinin servikal olgunlaşma v... more Hastalıkları ve Doğum ABD ANKARA ÖZET Amaç; Prostaglandin £2 (PGE2) jetinin servikal olgunlaşma ve doğum indüksiyonundaki etkisinin araştırılması.

Research paper thumbnail of Histerektomi Sonrası Vajinal Eversiyon Gelişen İki Vakada Transvajinal Sakrospinöz Kolpopeksi

Turkiye Klinikleri Jinekoloji Obstetrik Dergisi, 1995

Histerektomi sonrası vajinal eversiyon gelişen iki va ka dolayısıyla transvajinal sakrospinöz kol... more Histerektomi sonrası vajinal eversiyon gelişen iki va ka dolayısıyla transvajinal sakrospinöz kolpopeksi tek niğinin gözden geçirilmesi.

Research paper thumbnail of The effect of captopril on endometriotic implants in a rat model

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2014

To determine the effects of captopril on experimentally induced endometriosis in a rat model. Twe... more To determine the effects of captopril on experimentally induced endometriosis in a rat model. Twenty-four adult, mature female Wistar-Albino rats in which endometriotic implants were induced by transplanting autologous uterine tissue to ectopic sites on the peritoneum. After the endometriotic implants were formed surgically, the 24 rats were randomly divided into three groups. Group 1 (captopril group, eight rats) were given 50 mg kg(-1)d(-1) of oral captopril for 21 d. Group 2 (leuprolide acetate group, eight rats) were given a single 1 mg kg(-1) subcutaneous injection of leuprolide acetate. Group 3 (control) were given no medication and served as controls (eight rats). The surface area of the endometriotic implants and the score of histologic analysis. Also, VEGF and MCP-1 levels in peritoneal fluids and bloods were analyzed. At the beginning of the medical treatment, the mean surface areas of the endometriotic implants were comparable in all three groups. At the end of the treatment the mean implant surface area in the captopril group and leuprolide acetate group was less than that in the control group. Mean histopathological examination score for the implants post treatment was lower in the captopril and leuprolide acetate groups. Peritoneal fluids VEGF level in the captopril and leuprolide acetate groups was lower than that in the control group. The post-treatment MCP-1 level was also lower in the captopril and leuprolide acetate groups than in the control group. The serum VEGF and MCP-1 levels post treatment were significantly lower in the captopril and leuprolide acetate groups than in the control group. Administration of captopril reduced the size and progression of endometriotic lesions in a rat model.

Research paper thumbnail of A potential novel treatment strategy: inhibition of angiogenesis and inflammation by resveratrol for regression of endometriosis in an experimental rat model

Gynecological Endocrinology, 2014

Abstract The aim of our study was to evaluate the effectiveness of resveratrol in experimentally ... more Abstract The aim of our study was to evaluate the effectiveness of resveratrol in experimentally induced endometrial implants in rats through inhibiting angiogenesis and inflammation. Endometrial implants were surgically induced in 24 female Wistar-Albino rats in the first surgery. After confirmation of endometriotic foci in the second surgery, the rats were divided into resveratrol (seven rats), leuprolide acetate (eight rats), and control (seven rats) groups and medicated for 21 d. In the third surgery, the measurements of mean areas and histopathological analysis of endometriotic lesions, VEGF, and MCP-1 measurements in blood and peritoneal fluid samples, and immunohistochemical staining were evaluated. After treatment, significant reductions in mean areas of implants (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01) and decreased mean histopathological scores of the implants (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05), mean VEGF-staining scores of endometriotic implants (p = 0.01), and peritoneal fluid levels of VEGF and MCP-1 (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01, for VEGF and p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01, for MCP-1) were found in the resveratrol and leuprolide acetate groups. Serum VEGF (p = 0.05) and MCP-1 (p = 0.01) levels after treatment were also significantly lower in the resveratrol and leuprolide acetate groups. Resveratrol appears to be a potential novel therapeutic agent in the treatment of endometriosis through inhibiting angiogenesis and inflammation. Further studies are needed to determine the optimum effective dose in humans and to evaluate other effects on reproductive physiology.

Research paper thumbnail of Zinc and Homocysteine Levels in Polycystic Ovarian Syndrome Patients with Insulin Resistance

Biological Trace Element Research, 2014

In this study, our objective was to evaluating the value of serum zinc levels as an etiologic and... more In this study, our objective was to evaluating the value of serum zinc levels as an etiologic and prognostic marker in patients with polycystic ovarian syndrome. We conducted a prospective study, including 53 women with polycystic ovarian syndrome and 33 healthy controls. We compared serum zinc levels, as well as clinical and metabolic features, of the cases. We also compared serum zinc levels between patients with polycystic ovarian syndrome with insulin resistance. Mean zinc levels were found to be significantly lower in patients with polycystic ovarian syndrome than healthy controls. Multiple logistic regression analysis of significant metabolic variables between polycystic ovarian syndrome and control groups (serum zinc level, body mass index, the ratio of triglyceride/high-density lipoprotein cholesterol, and homocysteine) revealed that zinc level was the most significant variable to predict polycystic ovarian syndrome. Mean serum zinc levels tended to be lower in patients with polycystic ovarian syndrome with impaired glucose tolerance than patients with normal glucose tolerance, but the difference was not statistically significant. In conclusion, zinc deficiency may play a role in the pathogenesis of polycystic ovarian syndrome and may be related with its long-term metabolic complications.

Research paper thumbnail of HPV types in Turkey: multicenter hospital based evaluation of 6388 patients in turkish gynecologic oncology group centers

Turkish Journal of Pathology, 2013

Objective: To evaluate the prevalence of HPV DNA and cervical cytological abnormalities, to compa... more Objective: To evaluate the prevalence of HPV DNA and cervical cytological abnormalities, to compare cervical cytology results and HPV DNA and to define HPV types distribution in a large series of Turkish women who have undergone HPV analysis in hospitals that are members of the Turkish Gynecological Oncology Group. Material and Method: Between 2006 and 2010, a total of 6388 patients' data was retrospectively evaluated at 12 healthcare centers in Turkey. Demographic characteristics, cervical cytology results, HPV status and types were compared. Results: Th e mean age of the patients was 38.9±10.2. Overall, 25% of the women were found to be HPV positive. Presence of HPV-DNA among patients with abnormal and normal cytology was 52% and 27%, respectively. Th ere was significant diff erence with respect to decades of life and HPV positivity (p < 0.05). HPV was positive in (within the HPV (+) patients) 37%, 9%, 27%, 20%, 22%, and 41% of the ASCUS, ASC-H, LSIL HSIL, glandular cell abnormalities, and SCC cases respectively Th e most common HPV types in our study were as follows; HPV 16 (32%), HPV 6 (17%), HPV 11 (9%), HPV 18 (8%), HPV 31 (6%), HPV 51 (5%), HPV 33 (3%). Conclusion: In this hospital based retrospective analysis, HPV genotypes in Turkish women with normal and abnormal cytology are similar to those reported from western countries. Further population based prospective multicenter studies are necessary to determine non-hospital based HPV prevalence in Turkish women.

Research paper thumbnail of An Extraperitoneal Burch Procedure: A Case Report

Journal of Laparoendoscopic Surgery, 1996

A new laparoscopic Burch procedure with preperitoneal balloon dissection is introduced. A stress ... more A new laparoscopic Burch procedure with preperitoneal balloon dissection is introduced. A stress incontinence case without cystocele was operated by laparoscopic extraperitoneal colposuspension. The procedure was found to be effective a year after and no complications were seen. The extraperitoneal Burch procedure has the advantages of easy dissection, less bleeding, pain, and adhesion formation, a lower chance of injury to intraperitoneal organs, and short hospital stay and operation time; but the procedure has the disadvantages of a new anatomy orientation and the additional cost of a disposable balloon dissection set.

Research paper thumbnail of HIV antibody screening in a gynecology and obstetrics clinic Ankara, Turkey

International Journal of Gynecology & Obstetrics, 1989

In 416 pregnant women, admitted to our outpatient obstetric clinic for antenatal care between Dec... more In 416 pregnant women, admitted to our outpatient obstetric clinic for antenatal care between December 1987 and August 1988, HIV antibody assessments were performed by ELISA technique. No seropositive case was reported.

Research paper thumbnail of Small diameter versus conventional laparoscopy: a prospective, self-controlled study

Human Reproduction, 1997

The objective of this study was to determine visual quality, diagnostic accuracy, and surgical me... more The objective of this study was to determine visual quality, diagnostic accuracy, and surgical merits of small diameter laparoscopy (SDL). Thirty-seven patients were randomly selected. The indications for laparoscopy were infertility, desire for tubal sterilization or chronic pelvic pain. Patients underwent SDL, followed by conventional laparoscopy (CL) as a control under general anaesthesia. Findings at operation were compared. The mean time for diagnostic work-up was longer with SDL than CL, 11.7 ± 5.6 versus 7.6 ± 3.2 min respectively (P < 0.04). Visual quality was scored from 4 to 1 by the operator; mean visual quality, mean endometriosis score and mean adnexal adhesions score were slightly lower with SDL than CL. Sensitivity of SDL in diagnosing endometriosis, adhesions, ovarian, uterine and pouch of Douglas lesions were 71, 58, 81, 89 and 73% respectively; specificity was 100, 96, 100, 100, 100% in the same order. Suction irrigation, cyst aspiration, tissue biopsies, simple adhesiolysis, tubal ligation and cauterization were easily performed with SDL. We conclude that SDL seems a good alternative to CL in diagnosing macro-pelvic anatomy and coarse pelvic pathologies and may also be good in performing surgical procedures such as: tubal ligation, biopsies and differential diagnosis of pelvic fluids. But SDL must be used cautiously in microoriented, functional conditions such as infertility, pelvic pain, endometriosis and adhesion scoring or treatment. SDL may be regarded as a less invasive but less sensitive tool with limited surgical merits.

Research paper thumbnail of Human Reproduction vol.12 no.ll pp.2399-2401, 1997 Small diameter versus conventional laparoscopy: a prospective, self-controlled study

The objective of this study was to determine visual quality, diagnostic accuracy, and surgical me... more The objective of this study was to determine visual quality, diagnostic accuracy, and surgical merits of small diameter laparoscopy (SDL). Thirty-seven patients were randomly selected. The indications for laparoscopy were infertility, desire for tubal sterilization or chronic pelvic pain. Patients underwent SDL, followed by conventional laparoscopy (CL) as a control under general anaesthesia. Findings at operation were compared. The mean time for diagnostic work-up was longer with SDL than CL, 11.7 ± 5.6 versus 7.6 ± 3.2 min respectively (P < 0.04). Visual quality was scored from 4 to 1 by the operator; mean visual quality, mean endometriosis score and mean adnexal adhesions score were slightly lower with SDL than CL. Sensitivity of SDL in diagnosing endometriosis, adhesions, ovarian, uterine and pouch of Douglas lesions were 71, 58, 81, 89 and 73% respectively; specificity was 100, 96, 100, 100, 100% in the same order. Suction irrigation, cyst aspiration, tissue biopsies, simple adhesiolysis, tubal ligation and cauterization were easily performed with SDL. We conclude that SDL seems a good alternative to CL in diagnosing macro-pelvic anatomy and coarse pelvic pathologies and may also be good in performing surgical procedures such as: tubal ligation, biopsies and differential diagnosis of pelvic fluids. But SDL must be used cautiously in microoriented, functional conditions such as infertility, pelvic pain, endometriosis and adhesion scoring or treatment. SDL may be regarded as a less invasive but less sensitive tool with limited surgical merits.

Research paper thumbnail of Aylık GnRH-a (Goserelin) Enjeksiyonları ile Endometrial Hiperplazi Tedavisi: Prospektif, Kontrollü Çalışma

Turkiye Klinikleri Journal of Gynecology and Obstetrics, 1997

Amaç: Endometrial hiperplazili hastalarda GnRH-a tedavisinin etkinliğini ve endometrial hiperplaz... more Amaç: Endometrial hiperplazili hastalarda GnRH-a tedavisinin etkinliğini ve endometrial hiperplazi gelişiminde insülin rezistansının rolünü araştırmak.

Research paper thumbnail of Preperitoneal Balon Diseksiyon Tekniği (PBDT) ile Laparoskopik Burch Operasyonu: Olgu Sunumu

Turkiye Klinikleri Journal of Gynecology and Obstetrics, 1995

Gazi Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum ABD ÖZET Amaç: Kliniğimizde stres ink... more Gazi Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum ABD ÖZET Amaç: Kliniğimizde stres inkontinens tedavisi için laparosko pik preperitoneal disseksiyon tekniği ile yapılan Burch operasyonunu sunmak ve tekniği tanıtmaktır. Çalışmanın Yapıldığı Yar: Gazi Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum ABD, ANKARA Materyal ve Matod: Sistoseli olmayan bir stress inkontinensli hasta laparoskopik preperitoneal Burch operas yonu ile öpere edildi. Bulgular: Teknik postoperatif 6. aydaki kontrolde etkili ola rak bulundu, erken veya geç komplikasyon gelişmedi. Sonuç: Vaginal cerrahi için uygun bir aday olmayan, ek jine kolojik patolojisi bulunmayan ve peritoneal girişimden sakınılmasının uygun olacağı olgularda laparoskopik pre peritoneal balon diseksiyonlu Burch operasyonu uygun bir seçimdir.

Research paper thumbnail of Postmenapozal Kanamalı Hastalarda, Vajinal Ultrasonografi ile Endometrial Değerlendirme Diagnostik Kürtajları Azaltabilir mi?

Turkiye Klinikleri Journal of Gynecology and Obstetrics, 1995

Postmenapozal hastalarda transvajinai ultraso nogram endometrial değerlendirme ile, endometrial k... more Postmenapozal hastalarda transvajinai ultraso nogram endometrial değerlendirme ile, endometrial kûretajda elde edilen doku histolojisini karşılaştırmak ve postmenapozal kanamalı olgularda gereksiz tanısal küretaj sayısını azaltmak için endometrial kalınlık yönünden bir sınır değer saptamak.

Research paper thumbnail of Mikrolaparoskopi ve Konvansiyonel Laparoskopinin Karşılaştırılması

Turkiye Klinikleri Journal of Gynecology and Obstetrics, 1996

Sonuç: ML nin karına girerken daha az travmatik, karına girilen bölgede kanama ve herni riskinin ... more Sonuç: ML nin karına girerken daha az travmatik, karına girilen bölgede kanama ve herni riskinin daha az, karın içi organların zedelenme riskinin daha düşük olması ve genel anestezi gerektirmemesi gibi belirgin avantajları vardır. MLtuballigasyon, kist biyopsileri, fenestrasyonlar ve pelvik ağrı gibi durumlarda KL ye iyi bir alternatiftir. Fakat infertilité, endometriozis ve adezyonların skorlanmaları ve tedavileri gibi durumlarda etkinliği düşmektedir. ML kolay uygulanabilir, daha az invaziv fakat sensitivite si daha düşük bir yöntem olarak değerlendirilmiştir.

Research paper thumbnail of Laparoskopik Sakroservikopeksi veİntraperitoneal Burch Operasyonu: İki Olgu Sunumu

Turkiye Klinikleri Journal of Gynecology and Obstetrics, 2002

Pelvik organ prolapsusu jinekologların sık karşılaştıkları problemlerden birini oluşturmaktadır. ... more Pelvik organ prolapsusu jinekologların sık karşılaştıkları problemlerden birini oluşturmaktadır. Uterovajinal prolapsus kimi zaman rutin jinekoloji muayenesinde saptanan bir bulgu olup bu hastalar sıklıkla asemptomatik olmakla birlikte ağrı, basınç hissi, konstipasyon, sık idrara çıkma, idrar inkontinansı gibi şikayetler ile de doktora başvurabilirler. Pelvik organ prolapsusu özellikle kırklı yaşlardan sonra ortaya çıkar ve

Research paper thumbnail of Stage 1 Endometrium Kanseri Tedavisinde Laparoskopik Histerektomi ve Laparoskopik Lenf Nodu Örneklemesi: İki Olgu Sunumu

Turkiye Klinikleri Journal of Gynecology and Obstetrics, 2001

Endometrium kanseri kadýnlarda erken taný ve tedavi ile yüz güldürücü sonuçlarýn alýndýðý bir neo... more Endometrium kanseri kadýnlarda erken taný ve tedavi ile yüz güldürücü sonuçlarýn alýndýðý bir neoplastik hastalýktýr. Bundan 20 yýl öncesine kadar diðer jinekolojik tümörler gibi cerrahi tedavisi laparotomi sonrasýnda

Research paper thumbnail of Myoma Uteri'li Hastalarda İnsülin Rezistansı

Turkiye Klinikleri Journal of Gynecology and Obstetrics, 2001

Uterus myomlarý jinekolojik kaynaklý, en sýk rastlanan tümörler olmakla birlikte etiyoloji ve gel... more Uterus myomlarý jinekolojik kaynaklý, en sýk rastlanan tümörler olmakla birlikte etiyoloji ve geliþimleri hakkýnda fazla bilgi yoktur. Insulin-like growth faktörler (IGF, insulin benzeri büyüme faktörü) yapýsal olarak pro-insuline benzeyen, sentezleri baþlýca karaciðer olmak üzere vücutta pek çok dokuda gerçekleþtirilen, düþük moleküler aðýrlýkta polipeptid-lerdir (1). Bu faktörler hücre mitozu ve diferansiasyonunu uyarýrlar. Esas moleküllerin yanýsýra reseptörlerin de ben-zerliðinden dolayý (2), IGF-I ve insulin, benzer etki göstermektedirler (3,4). Yüksek düzeylerde insulin, IGF-I reseptörlerini uyarmak suretiyle, IGF-I gibi davran

Research paper thumbnail of Adneksiyel Kitlelerin Laparoskopik Cerrahi ile Tedavisi

Turkiye Klinikleri Journal of Gynecology and Obstetrics, 1997

Adneksiyel kitlelerin tanı ve tedavisinde laparoskopi son yıllarda çok önemli bir yer almıştır. O... more Adneksiyel kitlelerin tanı ve tedavisinde laparoskopi son yıllarda çok önemli bir yer almıştır. Operatif laparoskopinin konvansiyonel laparatomiye oranla çeşitli avantajları vardır. Bazı olgularda operasyon daha kısa sürmekte, hastanın postoperatif iyileşmesi daha çabuk olmakta, hastanede kalış süreleri kısalarak birçok hastanın yatırılmasına dahi gerek duyulmamaktadır. Yine birçok yayında laparoskopi ile cerrahi olarak laparotomiye kıyasla benzer oranlarda başarı sağlandığı bildirilmiştir. Adneksiyel kitlelerin çoğunluğu benign olup, çeşitli çalışmalarda malignite oranı premenapozal hastalarda %7-13, postmenapozal hastalarda ise %8-45 arasında bulunmuştur (1). Hastanın pelvik muayenesi, ultrasono

Research paper thumbnail of Serviksin Glandüler Hücreli Lezyonları

Turkiye Klinikleri Jinekoloji Obstetrik Dergisi, 2001

Research paper thumbnail of Stress İnkontinensinin Nonabsorbabl Sentetik Greft Kullanılarak Sling Metodu ile Cerrahi Tedavisi

Turkiye Klinikleri Journal of Gynecology and Obstetrics, 1991

Stress inkonlinensi olan 26-52 yaşları arasındaki 19 hastaya sling operasyonu uygulandı. Bunlarda... more Stress inkonlinensi olan 26-52 yaşları arasındaki 19 hastaya sling operasyonu uygulandı. Bunlardan 6 ededi daha önce ameliyat geçirmiş nüks vakalardı. Hastalanınız postoperatif ortalama 12 ay boyunca takip edildi. 18 vakada başanlı sonuç alındı (%94.7). Bir vakada yeniden nüks teşekkül elti. Sling operasyonu Gerçek Stress İnkonlinensi olan hastalarda isler priıner, isler nüks vakalar olsun tecrübeli ellerde uygulandığında çok iyi netice alınan bir operasyon şeklidir.

Research paper thumbnail of Prostaglandin E2 Jel'in Servikal Olgunlaşma ve Doğum İndüksiyonunda Kullanımı

Turkiye Klinikleri Journal of Gynecology and Obstetrics, 1995

Hastalıkları ve Doğum ABD ANKARA ÖZET Amaç; Prostaglandin £2 (PGE2) jetinin servikal olgunlaşma v... more Hastalıkları ve Doğum ABD ANKARA ÖZET Amaç; Prostaglandin £2 (PGE2) jetinin servikal olgunlaşma ve doğum indüksiyonundaki etkisinin araştırılması.

Research paper thumbnail of Histerektomi Sonrası Vajinal Eversiyon Gelişen İki Vakada Transvajinal Sakrospinöz Kolpopeksi

Turkiye Klinikleri Jinekoloji Obstetrik Dergisi, 1995

Histerektomi sonrası vajinal eversiyon gelişen iki va ka dolayısıyla transvajinal sakrospinöz kol... more Histerektomi sonrası vajinal eversiyon gelişen iki va ka dolayısıyla transvajinal sakrospinöz kolpopeksi tek niğinin gözden geçirilmesi.

Research paper thumbnail of The effect of captopril on endometriotic implants in a rat model

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2014

To determine the effects of captopril on experimentally induced endometriosis in a rat model. Twe... more To determine the effects of captopril on experimentally induced endometriosis in a rat model. Twenty-four adult, mature female Wistar-Albino rats in which endometriotic implants were induced by transplanting autologous uterine tissue to ectopic sites on the peritoneum. After the endometriotic implants were formed surgically, the 24 rats were randomly divided into three groups. Group 1 (captopril group, eight rats) were given 50 mg kg(-1)d(-1) of oral captopril for 21 d. Group 2 (leuprolide acetate group, eight rats) were given a single 1 mg kg(-1) subcutaneous injection of leuprolide acetate. Group 3 (control) were given no medication and served as controls (eight rats). The surface area of the endometriotic implants and the score of histologic analysis. Also, VEGF and MCP-1 levels in peritoneal fluids and bloods were analyzed. At the beginning of the medical treatment, the mean surface areas of the endometriotic implants were comparable in all three groups. At the end of the treatment the mean implant surface area in the captopril group and leuprolide acetate group was less than that in the control group. Mean histopathological examination score for the implants post treatment was lower in the captopril and leuprolide acetate groups. Peritoneal fluids VEGF level in the captopril and leuprolide acetate groups was lower than that in the control group. The post-treatment MCP-1 level was also lower in the captopril and leuprolide acetate groups than in the control group. The serum VEGF and MCP-1 levels post treatment were significantly lower in the captopril and leuprolide acetate groups than in the control group. Administration of captopril reduced the size and progression of endometriotic lesions in a rat model.

Research paper thumbnail of A potential novel treatment strategy: inhibition of angiogenesis and inflammation by resveratrol for regression of endometriosis in an experimental rat model

Gynecological Endocrinology, 2014

Abstract The aim of our study was to evaluate the effectiveness of resveratrol in experimentally ... more Abstract The aim of our study was to evaluate the effectiveness of resveratrol in experimentally induced endometrial implants in rats through inhibiting angiogenesis and inflammation. Endometrial implants were surgically induced in 24 female Wistar-Albino rats in the first surgery. After confirmation of endometriotic foci in the second surgery, the rats were divided into resveratrol (seven rats), leuprolide acetate (eight rats), and control (seven rats) groups and medicated for 21 d. In the third surgery, the measurements of mean areas and histopathological analysis of endometriotic lesions, VEGF, and MCP-1 measurements in blood and peritoneal fluid samples, and immunohistochemical staining were evaluated. After treatment, significant reductions in mean areas of implants (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01) and decreased mean histopathological scores of the implants (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05), mean VEGF-staining scores of endometriotic implants (p = 0.01), and peritoneal fluid levels of VEGF and MCP-1 (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01, for VEGF and p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01, for MCP-1) were found in the resveratrol and leuprolide acetate groups. Serum VEGF (p = 0.05) and MCP-1 (p = 0.01) levels after treatment were also significantly lower in the resveratrol and leuprolide acetate groups. Resveratrol appears to be a potential novel therapeutic agent in the treatment of endometriosis through inhibiting angiogenesis and inflammation. Further studies are needed to determine the optimum effective dose in humans and to evaluate other effects on reproductive physiology.

Research paper thumbnail of Zinc and Homocysteine Levels in Polycystic Ovarian Syndrome Patients with Insulin Resistance

Biological Trace Element Research, 2014

In this study, our objective was to evaluating the value of serum zinc levels as an etiologic and... more In this study, our objective was to evaluating the value of serum zinc levels as an etiologic and prognostic marker in patients with polycystic ovarian syndrome. We conducted a prospective study, including 53 women with polycystic ovarian syndrome and 33 healthy controls. We compared serum zinc levels, as well as clinical and metabolic features, of the cases. We also compared serum zinc levels between patients with polycystic ovarian syndrome with insulin resistance. Mean zinc levels were found to be significantly lower in patients with polycystic ovarian syndrome than healthy controls. Multiple logistic regression analysis of significant metabolic variables between polycystic ovarian syndrome and control groups (serum zinc level, body mass index, the ratio of triglyceride/high-density lipoprotein cholesterol, and homocysteine) revealed that zinc level was the most significant variable to predict polycystic ovarian syndrome. Mean serum zinc levels tended to be lower in patients with polycystic ovarian syndrome with impaired glucose tolerance than patients with normal glucose tolerance, but the difference was not statistically significant. In conclusion, zinc deficiency may play a role in the pathogenesis of polycystic ovarian syndrome and may be related with its long-term metabolic complications.

Research paper thumbnail of HPV types in Turkey: multicenter hospital based evaluation of 6388 patients in turkish gynecologic oncology group centers

Turkish Journal of Pathology, 2013

Objective: To evaluate the prevalence of HPV DNA and cervical cytological abnormalities, to compa... more Objective: To evaluate the prevalence of HPV DNA and cervical cytological abnormalities, to compare cervical cytology results and HPV DNA and to define HPV types distribution in a large series of Turkish women who have undergone HPV analysis in hospitals that are members of the Turkish Gynecological Oncology Group. Material and Method: Between 2006 and 2010, a total of 6388 patients' data was retrospectively evaluated at 12 healthcare centers in Turkey. Demographic characteristics, cervical cytology results, HPV status and types were compared. Results: Th e mean age of the patients was 38.9±10.2. Overall, 25% of the women were found to be HPV positive. Presence of HPV-DNA among patients with abnormal and normal cytology was 52% and 27%, respectively. Th ere was significant diff erence with respect to decades of life and HPV positivity (p < 0.05). HPV was positive in (within the HPV (+) patients) 37%, 9%, 27%, 20%, 22%, and 41% of the ASCUS, ASC-H, LSIL HSIL, glandular cell abnormalities, and SCC cases respectively Th e most common HPV types in our study were as follows; HPV 16 (32%), HPV 6 (17%), HPV 11 (9%), HPV 18 (8%), HPV 31 (6%), HPV 51 (5%), HPV 33 (3%). Conclusion: In this hospital based retrospective analysis, HPV genotypes in Turkish women with normal and abnormal cytology are similar to those reported from western countries. Further population based prospective multicenter studies are necessary to determine non-hospital based HPV prevalence in Turkish women.

Research paper thumbnail of An Extraperitoneal Burch Procedure: A Case Report

Journal of Laparoendoscopic Surgery, 1996

A new laparoscopic Burch procedure with preperitoneal balloon dissection is introduced. A stress ... more A new laparoscopic Burch procedure with preperitoneal balloon dissection is introduced. A stress incontinence case without cystocele was operated by laparoscopic extraperitoneal colposuspension. The procedure was found to be effective a year after and no complications were seen. The extraperitoneal Burch procedure has the advantages of easy dissection, less bleeding, pain, and adhesion formation, a lower chance of injury to intraperitoneal organs, and short hospital stay and operation time; but the procedure has the disadvantages of a new anatomy orientation and the additional cost of a disposable balloon dissection set.

Research paper thumbnail of HIV antibody screening in a gynecology and obstetrics clinic Ankara, Turkey

International Journal of Gynecology & Obstetrics, 1989

In 416 pregnant women, admitted to our outpatient obstetric clinic for antenatal care between Dec... more In 416 pregnant women, admitted to our outpatient obstetric clinic for antenatal care between December 1987 and August 1988, HIV antibody assessments were performed by ELISA technique. No seropositive case was reported.

Research paper thumbnail of Small diameter versus conventional laparoscopy: a prospective, self-controlled study

Human Reproduction, 1997

The objective of this study was to determine visual quality, diagnostic accuracy, and surgical me... more The objective of this study was to determine visual quality, diagnostic accuracy, and surgical merits of small diameter laparoscopy (SDL). Thirty-seven patients were randomly selected. The indications for laparoscopy were infertility, desire for tubal sterilization or chronic pelvic pain. Patients underwent SDL, followed by conventional laparoscopy (CL) as a control under general anaesthesia. Findings at operation were compared. The mean time for diagnostic work-up was longer with SDL than CL, 11.7 ± 5.6 versus 7.6 ± 3.2 min respectively (P < 0.04). Visual quality was scored from 4 to 1 by the operator; mean visual quality, mean endometriosis score and mean adnexal adhesions score were slightly lower with SDL than CL. Sensitivity of SDL in diagnosing endometriosis, adhesions, ovarian, uterine and pouch of Douglas lesions were 71, 58, 81, 89 and 73% respectively; specificity was 100, 96, 100, 100, 100% in the same order. Suction irrigation, cyst aspiration, tissue biopsies, simple adhesiolysis, tubal ligation and cauterization were easily performed with SDL. We conclude that SDL seems a good alternative to CL in diagnosing macro-pelvic anatomy and coarse pelvic pathologies and may also be good in performing surgical procedures such as: tubal ligation, biopsies and differential diagnosis of pelvic fluids. But SDL must be used cautiously in microoriented, functional conditions such as infertility, pelvic pain, endometriosis and adhesion scoring or treatment. SDL may be regarded as a less invasive but less sensitive tool with limited surgical merits.