Feza Burak - Academia.edu (original) (raw)

Papers by Feza Burak

Research paper thumbnail of Karın Duvarında Endometriozis Eksterna : Olgu Sunumu

An external endometriosis case Is presented which has developed on the abdominal wall out of old ... more An external endometriosis case Is presented which has developed on the abdominal wall out of old incision scars and has been treated with total excision, in a 30 years old woman patient who underwent cesarean section. [Journal of Turgut Ozal Medical Center 1997;4(2):200-202] Key words: Endometriosis externa, abdominal wall, ceseraen section

Research paper thumbnail of A cystic hygroma case associated with Turner?s syndrome

Cystic hygroma is a congenital anomaly and its incidence is 1.7-5%. It is seen together with chro... more Cystic hygroma is a congenital anomaly and its incidence is 1.7-5%. It is seen together with chromosomal abnormalities and usually associated with Turner syndrome. Prenatal diagnosis is possible earlier in pregnancy with ultrasonography. We have discussed a case with cystic hygroma diagnosed prenatally. [Journal of Turgut Ozal Medical Center 1997;4(2): 206-208] Key Words: Cystic hygroma, prenatal diagnosis, Turner’s syndrome

Research paper thumbnail of Turner Sendromunun Eşlik Ettiği bir Kistik Higroma Olgusu

Cystic hygroma is a congenital anomaly and its incidence is 1.7-5%. It is seen together with chro... more Cystic hygroma is a congenital anomaly and its incidence is 1.7-5%. It is seen together with chromosomal abnormalities and usually associated with Turner syndrome. Prenatal diagnosis is possible earlier in pregnancy with ultrasonography. We have discussed a case with cystic hygroma diagnosed prenatally. [Journal of Turgut Ozal Medical Center 1997;4(2): 206-208] Key words: Cystic hygroma, prenatal diagnosis, Turner's syndrome

Research paper thumbnail of Abnormalni Test Opterećenja Glukozom I Blagi Gestacijski Dijabetes

Objective. The status of carbohydrate metabolism of pregnant women with positive glucose challeng... more Objective. The status of carbohydrate metabolism of pregnant women with positive glucose challenge test (GCT), but normal oral glucose tolerance test (OGTT) and their neonates are not defined clearly. Study Design. Pregnant women with normal GCT (n: 120), with abnormal glucose challenge test (AGCT) but normal OGTT (n: 67) and with gestational diabetes (GDM, n: 67) were included into the study. Insulin sensitivity was evaluated by fasting insulin level, homeostasis model assessment of insulin resistance index (HOMA-IR); quantitative insulin check index (QUICKI) and ISOGTT. Serum insulin and glucose values during OGTT were documented. Perinatal outcome and delivery modalities were compared. Results. Both GDM (31.6±5.9 yrs) and AGCT groups (29.0±4.0 yrs) were older than controls (28.1±4.9 yrs). Body mass index (BMI) was the predominant factor affecting both AGCT and GDM groups (OR: 3.78 and 5.97 respectively). Despite there was no significance between insulin indices; serum glucose and...

Research paper thumbnail of Endometriosis externa on the abdominal wall: a case report

Research paper thumbnail of O-020 Comparison of the effects of tibolone and hormone replacement therapy on echocardiographic basic cardiac functions in postmenopausal women: A randomized placebo controlled study

Fertility and Sterility, 1997

Objectives: This study is designed to investigate and compare the effects of synthetic steroid ti... more Objectives: This study is designed to investigate and compare the effects of synthetic steroid tibolone and HRT on systolic and diastolic heart functions in post-menopausal women. Methods: This prospective, randomized placebo controlled double blind study was conducted in a university clinic. Fifty-eight non-smoking, otherwise healthy post-menopausal women who did not receive any kind of HRT at least for 3 years within the onset of menopause were included in the study. The patients were randomly allocated to either 2.5 mg per day tibolone (OD, n = 18), daily combined 0.625 mg of conjugated estrogens 2.5 mg −1 of medroxy progesterone acetate pill (EP, n = 20) or a vitamin pill (n = 20) in a double blinded fashion. Their basic systolic and diastolic functions were investigated with HP Sonos-1000 echocardiography using standard positions and windows before and 6 months after the initiation of HRT. Results: Mean age, weight, length of post-menopausal period, heart rate, systolic and diastolic pressures were similar between the groups. At the initiation of the study all groups had similar echocardiographic measurements. However, at the end of 6 months, left ventricular end-systolic and -diastolic volumes were decreased significantly compared to pretreatment and placebo in both EP and OD treated groups. (55 .5 ± 18.4 and 53.7 ± 19.1.8 ml; 109.9 ± 19.9 and 110.7 ± 20.8 ml versus 74.5 ± 14.9 and 142.7 ± 19.1 ml, respectively; P< 0.05). Improvement in diastolic functions was significant in EP/OD groups compared to pre-treatment period and the placebo groups (E/A 1.34 ± 0.1 and 1.38 ± 0.1 versus 1.18 ± 0.09, deceleration time 204 ± 11.1 and 202.8 ± 27.1 ms versus 237.6 ± 26.9 ms, respectively). Besides increase in left ventricular mass adjusted for height, decrease in left ventricular relative wall thickness, and systemic vascular resistance were significant in EP and OD treated groups than placebo and the pre-treatment measurements. Although improved in both OD and EP groups, the changes in systolic and diastolic functions were significantly higher in the OD treated group. Based on our preliminary results, we may conclude that both EP and OD regimens may improve cardiac performance and age related dysfunctions. Conclusion: The present results may further support that both OD and EP exert

Research paper thumbnail of Combined Cervical and Vaginal Reconstruction With Prefabricated Pudendal Thigh Flap in a Case With Cervical and Vaginal Agenesis (MURCS Syndrome): A New and Original Technique

Annals of Plastic Surgery, 2008

In the presence of functional endometrium, in addition to the construction of anatomically, funct... more In the presence of functional endometrium, in addition to the construction of anatomically, functionally normal and sensitive neovagina and cervix, the preservation of the uterus for future possible pregnancies must also be considered as the main goal in this process. So far, hysterectomy was the general treatment modality in such cases. For maintaining cervical patency, there were no reports in the literature related to cervical prefabrication using flaps. In this report we present a case with cervical and vaginal agenesis (MURCS syndrome). In this case combined cervical and vaginal reconstructions were successfully performed by using bilateral pudendal thigh flaps; a real-like cervix and cervical canal had been previously prefabricated on the distal part of one of the pudendal thigh flaps. Sensitivity and function were both preserved and maintained at the end of this operation.

Research paper thumbnail of Placebo-controlled cross-over study of effects of tibolone on premenstrual symptoms and peripheral beta-endorphin concentrations in premenstrual syndrome

Human Reproduction, 1998

Central nervous system hormones have been linked to premenstrual syndrome (PMS) and β-endorphin (... more Central nervous system hormones have been linked to premenstrual syndrome (PMS) and β-endorphin (β-EP) is thought to be involved in the pathophysiology. We have tested the efficacy of the synthetic steroid Org OD 14 (tibolone) in the treatment of PMS. This prospective, randomized, placebo-controlled, double-blind cross-over study included 18 ovulatory women with PMS as ascertained by a visual linear analogue scale (VLAS). The women in each group received either 2.5 mg per day Org OD 14 (n ⍧ 9) or a multi-vitamin pill as placebo (n ⍧ 9) for 3 months. Treatments were then crossed over to a placebo for a further 3 months. VLAS ratings were evaluated at the end of each menstrual cycle throughout the study. Peripheral β-EP concentrations were determined by radioimmunoassay on days 7 and 25 of each menstrual cycle. Changes in VLAS score and β-EP concentrations from baseline were calculated and analysed by Student's paired t-test. Improvements in VLAS scores and β-EP concentrations were evident during the second and third months of tibolone treatment. At the end of the third month, there was a significant improvement in VLAS scores of all symptom categories compared with pretreatment and placebo during treatment with tibolone (P < 0.05). Similar results were obtained in the first placebo group when switched to tibolone. β-EP concentrations were not significantly different between the study groups at the initial cycle (15.9 ⍨ 3.6 versus 17.2 ⍨ 2.3 pg/ml). The increase in β-EP concentration was significantly greater on day 25 of the menstrual cycle in women treated with tibolone compared with baseline and placebo group (22.5 ⍨ 4.4 versus 15.9 ⍨ 3.6 and 17.2 ⍨ 2.3 pg/ml respectively, P < 0.05). Our data confirm the clinical efficacy of tibolone in PMS-related symptoms, as well as its effects on serum β-EP concentrations in patients with PMS.

Research paper thumbnail of Acute Abdomen in a Case With Noncommunicating Rudimentary Horn and Unicornuate Uterus

JSLS : Journal of the Society of Laparoendoscopic Surgeons, 2005

Unicornuate uterus with a rudimentary horn is the rarest congenital anatomic anomaly of the femal... more Unicornuate uterus with a rudimentary horn is the rarest congenital anatomic anomaly of the female genital system, causing many obstetrical and gynecologic complications. The frequency of this pathology is approximately 1/100 000. A rudimentary horn usually develops following insufficient development of mullerian ducts. These patients present with dysmenorrhea, dyspareunia, and chronic pelvic pain because of endometriosis and rarely with acute abdominal symptoms following distention and torsion of the noncommunicating rudimentary horn. The case of a patient referred for acute abdomen after distention of a noncommunicating rudimentary horn is presented herein.

Research paper thumbnail of Labor induction post-term with 25 micrograms vs. 50 micrograms of intravaginal misoprostol

International Journal of Gynaecology and Obstetrics, Jun 1, 2003

Objectives: To compare the effectiveness of 25 mg vs. 50 mg of intravaginal misoprostol for cervi... more Objectives: To compare the effectiveness of 25 mg vs. 50 mg of intravaginal misoprostol for cervical ripening and labor induction beyond 41 weeks' gestation. Methods: The study population consisted of 120 women not in active labor with a gestational age )41 weeks, singleton pregnancy with vertex presentation, reactive fetal heart rate tracing, amniotic fluid index G5, and Bishop score -5. Women were randomized to receive either 25 mg (ns60) or 50 mg (ns60) of intravaginal misoprostol. The dose was repeated every 4 h (maximum number of doses limited to six) until the patient exhibited three contractions in 10 min. The main outcome measure was the induction-vaginal delivery interval. Results: There was no significant difference between the two groups with regard to the inductionvaginal delivery interval (685"201 min in the 25 mg group vs. 627"177 min in the 50 mg group, Ps0.09). The proportion of women delivering vaginally with one dose of vaginal misoprostol was significantly greater in the 50 mg group (0y49 vs. 41y47, P-0.001). There were no differences in the rates of cesarean and operative vaginal delivery rates, or in the incidences of tachysystole and hyperstimulation syndrome in the two treatment groups. Neonatal outcomes were also similar. Conclusions: Intravaginal administration of 25 mg of misoprostol appears to be as effective as 50 mg for cervical ripening and labor induction beyond 41 weeks' gestation.

Research paper thumbnail of Abnormal glucose challenge test reflects mild gestational diabetes

Research paper thumbnail of Laparoscopic management of adnexal masses

J Amer Assoc Gynecol Laparosc, 1998

Research paper thumbnail of Uterin Fibromyomalı KadınlardaHisterektomi Öncesi Endometrial Küretaj Gerekli mi?

Turkiye Klinikleri Jinekoloji Obstetrik Dergisi, 2001

Research paper thumbnail of Abnormal Glucose Challenge Test and Mild Gestational Diabetes

Gynaecologia Et Perinatologia, Mar 1, 2008

Objective. The status of carbohydrate metabolism of pregnant women with positive glucose challeng... more Objective. The status of carbohydrate metabolism of pregnant women with positive glucose challenge test (GCT), but normal oral glucose tolerance test (OGTT) and their neonates are not defined clearly. Study Design. Pregnant women with normal GCT (n: 120), with abnormal glucose challenge test (AGCT) but normal OGTT (n: 67) and with gestational diabetes (GDM, n: 67) were included into the study. Insulin sensitivity was evaluated by fasting insulin level, homeostasis model assessment of insulin resistance index (HOMA-IR); quantitative insulin check index (QUICKI) and IS OGTT . Serum insulin and glucose values during OGTT were documented. Perinatal outcome and delivery modalities were compared. Results. Both GDM (31.6±5.9 yrs) and AGCT groups (29.0±4.0 yrs) were older than controls (28.1±4.9 yrs). Body mass index (BMI) was the predominant factor affecting both AGCT and GDM groups (OR: 3.78 and 5.97 respectively). Despite there was no significance between insulin indices; serum glucose and insulin values were similarly different; macrosomic infant and caesarean section rates were higher than controls in both GDM and AGCT groups in favor of gestational diabetics (6.6% vs. 18.9%; p=0.0001 and 20% vs. 27.7% p=0.0001 respectively). Conclusion. Pregnant woman with abnormal glucose challenge test have impaired carbohydrate metabolism as in gestational diabetics with a lesser severe degree.

Research paper thumbnail of Karın Duvarında Endometriozis Eksterna : Olgu Sunumu

Turgut Ozal Tıp Merkezi Dergisi, 1997

Research paper thumbnail of Adhesion formation after microlaparoscopic and laparoscopic ovarian coagulation for polycystic ovary disease

The Journal of the American Association of Gynecologic Laparoscopists, May 31, 1999

To compare the effects of microlaparoscopy and decreased C02 exposure on peritoneal microcirculat... more To compare the effects of microlaparoscopy and decreased C02 exposure on peritoneal microcirculation and potential adhesion formation after ovarian surgery with those of conventional operative laparoscopy. Design. Prospective, randomized study (Canadian Task Force classification I). Setting. Teaching hospital. Patients. Eighteen women with polycystic ovary disease. Interventions. Microlaparoscopic or laparoscopic ovarian coagulation of the ovaries. Measurements and Main Results. Approximately 10 to 12 coagulation points were applied to each ovary. Two to 3 weeks after the initial surgery second-look microlaparoscopy was performed to determine the extent of adhesions in both groups. The frequency of adhesion formation and changes in glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), catalase (CAT), and gtutathione (GSH) levels were studied in homogenized peritoneal tissues obtained during surgery in each group. Results. Clinical profiles were similar between groups. Mean exposure, amount, and pressure of CO 2 were significantly less in the microlaparoscopy group (p <0.05). The laparoscopy group had significantly more adhesions than the microlaproscopy group (24% vs 48%, p <0.05). The GSH-Px, SOD, CAT, and GSH levels were significantly lower in the laparoscopy group (0.425 pmol, 1.2 ng, 37.55 pmol, and 0.9 nmol vs 0.755 I_tmol, 2.1 ng, 625 I~mol, and 2.6 nmol, respectively). Conclusion. Reduced exposure to and amount of C02 during microlaparoscopy may result in decreased adhesion formation compared with conventional laparoscopy. This effect may possibly be due to lack of or minimal adverse effects on peritoneal microcirculation and cell-protective systems, which are proposed mechanisms for adhesion formation and closely related to peritoneal injury. In addition, microlaparoscopy may be a cost-effective alternative to conventional laparoscopy.

Research paper thumbnail of Acute abdomen in a case with noncommunicating rudimentary horn and unicornuate uterus

Jsls Journal of the Society of Laparoendoscopic Surgeons Society of Laparoendoscopic Surgeons, 2005

Unicornuate uterus with a rudimentary horn is the rarest congenital anatomic anomaly of the femal... more Unicornuate uterus with a rudimentary horn is the rarest congenital anatomic anomaly of the female genital system, causing many obstetrical and gynecologic complications. The frequency of this pathology is approximately 1/100 000. A rudimentary horn usually develops following insufficient development of mullerian ducts. These patients present with dysmenorrhea, dyspareunia, and chronic pelvic pain because of endometriosis and rarely with acute abdominal symptoms following distention and torsion of the noncommunicating rudimentary horn. The case of a patient referred for acute abdomen after distention of a noncommunicating rudimentary horn is presented herein.

Research paper thumbnail of Chronic pelvic pain associated with pelvic congestion syndrome and the benefit of Daflon 500 mg: a review

Research paper thumbnail of Acute abdomen in a case with noncommunicating rudimentary horn and unicornuate uterus

JSLS : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons

Unicornuate uterus with a rudimentary horn is the rarest congenital anatomic anomaly of the femal... more Unicornuate uterus with a rudimentary horn is the rarest congenital anatomic anomaly of the female genital system, causing many obstetrical and gynecologic complications. The frequency of this pathology is approximately 1/100 000. A rudimentary horn usually develops following insufficient development of mullerian ducts. These patients present with dysmenorrhea, dyspareunia, and chronic pelvic pain because of endometriosis and rarely with acute abdominal symptoms following distention and torsion of the noncommunicating rudimentary horn. The case of a patient referred for acute abdomen after distention of a noncommunicating rudimentary horn is presented herein.

Research paper thumbnail of Comparison of the effects of ovarian cauterization and gonadotropin-releasing hormone agonist and oral contraceptive therapy combination on endocrine changes in women with polycystic ovary disease

Fertility and sterility, 1996

To study the effects of laparoscopic ovarian cauterization and combination of long-acting GnRH ag... more To study the effects of laparoscopic ovarian cauterization and combination of long-acting GnRH agonist (GnRH-a) and oral contraceptive (OC) therapy on endocrine changes in women with clomiphene citrate (CC)- resistant polycystic ovary disease (PCOD). Prospective, randomized. University-based infertility clinic. Seventeen women with CC-resistant PCOD were included randomly in the study to either laparoscopic ovarian cautery or GnRH-a and OC therapy for 3 months. Serum concentrations of LH, FSH, androstenedione (A), T, and sex hormone-binding globulin (SHBG) were determined before each therapeutic approach and during the follicular phase of first menstrual cycle after the cessation of each treatment. The mean serum concentrations and the clinical profiles were similar in both groups. Both groups showed significant changes in LH, FSH, A, T, and SHBG compared with pretreatment levels. There were no significant differences in the final concentrations of LH, FSH, and A between the two stu...

Research paper thumbnail of Karın Duvarında Endometriozis Eksterna : Olgu Sunumu

An external endometriosis case Is presented which has developed on the abdominal wall out of old ... more An external endometriosis case Is presented which has developed on the abdominal wall out of old incision scars and has been treated with total excision, in a 30 years old woman patient who underwent cesarean section. [Journal of Turgut Ozal Medical Center 1997;4(2):200-202] Key words: Endometriosis externa, abdominal wall, ceseraen section

Research paper thumbnail of A cystic hygroma case associated with Turner?s syndrome

Cystic hygroma is a congenital anomaly and its incidence is 1.7-5%. It is seen together with chro... more Cystic hygroma is a congenital anomaly and its incidence is 1.7-5%. It is seen together with chromosomal abnormalities and usually associated with Turner syndrome. Prenatal diagnosis is possible earlier in pregnancy with ultrasonography. We have discussed a case with cystic hygroma diagnosed prenatally. [Journal of Turgut Ozal Medical Center 1997;4(2): 206-208] Key Words: Cystic hygroma, prenatal diagnosis, Turner’s syndrome

Research paper thumbnail of Turner Sendromunun Eşlik Ettiği bir Kistik Higroma Olgusu

Cystic hygroma is a congenital anomaly and its incidence is 1.7-5%. It is seen together with chro... more Cystic hygroma is a congenital anomaly and its incidence is 1.7-5%. It is seen together with chromosomal abnormalities and usually associated with Turner syndrome. Prenatal diagnosis is possible earlier in pregnancy with ultrasonography. We have discussed a case with cystic hygroma diagnosed prenatally. [Journal of Turgut Ozal Medical Center 1997;4(2): 206-208] Key words: Cystic hygroma, prenatal diagnosis, Turner's syndrome

Research paper thumbnail of Abnormalni Test Opterećenja Glukozom I Blagi Gestacijski Dijabetes

Objective. The status of carbohydrate metabolism of pregnant women with positive glucose challeng... more Objective. The status of carbohydrate metabolism of pregnant women with positive glucose challenge test (GCT), but normal oral glucose tolerance test (OGTT) and their neonates are not defined clearly. Study Design. Pregnant women with normal GCT (n: 120), with abnormal glucose challenge test (AGCT) but normal OGTT (n: 67) and with gestational diabetes (GDM, n: 67) were included into the study. Insulin sensitivity was evaluated by fasting insulin level, homeostasis model assessment of insulin resistance index (HOMA-IR); quantitative insulin check index (QUICKI) and ISOGTT. Serum insulin and glucose values during OGTT were documented. Perinatal outcome and delivery modalities were compared. Results. Both GDM (31.6±5.9 yrs) and AGCT groups (29.0±4.0 yrs) were older than controls (28.1±4.9 yrs). Body mass index (BMI) was the predominant factor affecting both AGCT and GDM groups (OR: 3.78 and 5.97 respectively). Despite there was no significance between insulin indices; serum glucose and...

Research paper thumbnail of Endometriosis externa on the abdominal wall: a case report

Research paper thumbnail of O-020 Comparison of the effects of tibolone and hormone replacement therapy on echocardiographic basic cardiac functions in postmenopausal women: A randomized placebo controlled study

Fertility and Sterility, 1997

Objectives: This study is designed to investigate and compare the effects of synthetic steroid ti... more Objectives: This study is designed to investigate and compare the effects of synthetic steroid tibolone and HRT on systolic and diastolic heart functions in post-menopausal women. Methods: This prospective, randomized placebo controlled double blind study was conducted in a university clinic. Fifty-eight non-smoking, otherwise healthy post-menopausal women who did not receive any kind of HRT at least for 3 years within the onset of menopause were included in the study. The patients were randomly allocated to either 2.5 mg per day tibolone (OD, n = 18), daily combined 0.625 mg of conjugated estrogens 2.5 mg −1 of medroxy progesterone acetate pill (EP, n = 20) or a vitamin pill (n = 20) in a double blinded fashion. Their basic systolic and diastolic functions were investigated with HP Sonos-1000 echocardiography using standard positions and windows before and 6 months after the initiation of HRT. Results: Mean age, weight, length of post-menopausal period, heart rate, systolic and diastolic pressures were similar between the groups. At the initiation of the study all groups had similar echocardiographic measurements. However, at the end of 6 months, left ventricular end-systolic and -diastolic volumes were decreased significantly compared to pretreatment and placebo in both EP and OD treated groups. (55 .5 ± 18.4 and 53.7 ± 19.1.8 ml; 109.9 ± 19.9 and 110.7 ± 20.8 ml versus 74.5 ± 14.9 and 142.7 ± 19.1 ml, respectively; P< 0.05). Improvement in diastolic functions was significant in EP/OD groups compared to pre-treatment period and the placebo groups (E/A 1.34 ± 0.1 and 1.38 ± 0.1 versus 1.18 ± 0.09, deceleration time 204 ± 11.1 and 202.8 ± 27.1 ms versus 237.6 ± 26.9 ms, respectively). Besides increase in left ventricular mass adjusted for height, decrease in left ventricular relative wall thickness, and systemic vascular resistance were significant in EP and OD treated groups than placebo and the pre-treatment measurements. Although improved in both OD and EP groups, the changes in systolic and diastolic functions were significantly higher in the OD treated group. Based on our preliminary results, we may conclude that both EP and OD regimens may improve cardiac performance and age related dysfunctions. Conclusion: The present results may further support that both OD and EP exert

Research paper thumbnail of Combined Cervical and Vaginal Reconstruction With Prefabricated Pudendal Thigh Flap in a Case With Cervical and Vaginal Agenesis (MURCS Syndrome): A New and Original Technique

Annals of Plastic Surgery, 2008

In the presence of functional endometrium, in addition to the construction of anatomically, funct... more In the presence of functional endometrium, in addition to the construction of anatomically, functionally normal and sensitive neovagina and cervix, the preservation of the uterus for future possible pregnancies must also be considered as the main goal in this process. So far, hysterectomy was the general treatment modality in such cases. For maintaining cervical patency, there were no reports in the literature related to cervical prefabrication using flaps. In this report we present a case with cervical and vaginal agenesis (MURCS syndrome). In this case combined cervical and vaginal reconstructions were successfully performed by using bilateral pudendal thigh flaps; a real-like cervix and cervical canal had been previously prefabricated on the distal part of one of the pudendal thigh flaps. Sensitivity and function were both preserved and maintained at the end of this operation.

Research paper thumbnail of Placebo-controlled cross-over study of effects of tibolone on premenstrual symptoms and peripheral beta-endorphin concentrations in premenstrual syndrome

Human Reproduction, 1998

Central nervous system hormones have been linked to premenstrual syndrome (PMS) and β-endorphin (... more Central nervous system hormones have been linked to premenstrual syndrome (PMS) and β-endorphin (β-EP) is thought to be involved in the pathophysiology. We have tested the efficacy of the synthetic steroid Org OD 14 (tibolone) in the treatment of PMS. This prospective, randomized, placebo-controlled, double-blind cross-over study included 18 ovulatory women with PMS as ascertained by a visual linear analogue scale (VLAS). The women in each group received either 2.5 mg per day Org OD 14 (n ⍧ 9) or a multi-vitamin pill as placebo (n ⍧ 9) for 3 months. Treatments were then crossed over to a placebo for a further 3 months. VLAS ratings were evaluated at the end of each menstrual cycle throughout the study. Peripheral β-EP concentrations were determined by radioimmunoassay on days 7 and 25 of each menstrual cycle. Changes in VLAS score and β-EP concentrations from baseline were calculated and analysed by Student's paired t-test. Improvements in VLAS scores and β-EP concentrations were evident during the second and third months of tibolone treatment. At the end of the third month, there was a significant improvement in VLAS scores of all symptom categories compared with pretreatment and placebo during treatment with tibolone (P < 0.05). Similar results were obtained in the first placebo group when switched to tibolone. β-EP concentrations were not significantly different between the study groups at the initial cycle (15.9 ⍨ 3.6 versus 17.2 ⍨ 2.3 pg/ml). The increase in β-EP concentration was significantly greater on day 25 of the menstrual cycle in women treated with tibolone compared with baseline and placebo group (22.5 ⍨ 4.4 versus 15.9 ⍨ 3.6 and 17.2 ⍨ 2.3 pg/ml respectively, P < 0.05). Our data confirm the clinical efficacy of tibolone in PMS-related symptoms, as well as its effects on serum β-EP concentrations in patients with PMS.

Research paper thumbnail of Acute Abdomen in a Case With Noncommunicating Rudimentary Horn and Unicornuate Uterus

JSLS : Journal of the Society of Laparoendoscopic Surgeons, 2005

Unicornuate uterus with a rudimentary horn is the rarest congenital anatomic anomaly of the femal... more Unicornuate uterus with a rudimentary horn is the rarest congenital anatomic anomaly of the female genital system, causing many obstetrical and gynecologic complications. The frequency of this pathology is approximately 1/100 000. A rudimentary horn usually develops following insufficient development of mullerian ducts. These patients present with dysmenorrhea, dyspareunia, and chronic pelvic pain because of endometriosis and rarely with acute abdominal symptoms following distention and torsion of the noncommunicating rudimentary horn. The case of a patient referred for acute abdomen after distention of a noncommunicating rudimentary horn is presented herein.

Research paper thumbnail of Labor induction post-term with 25 micrograms vs. 50 micrograms of intravaginal misoprostol

International Journal of Gynaecology and Obstetrics, Jun 1, 2003

Objectives: To compare the effectiveness of 25 mg vs. 50 mg of intravaginal misoprostol for cervi... more Objectives: To compare the effectiveness of 25 mg vs. 50 mg of intravaginal misoprostol for cervical ripening and labor induction beyond 41 weeks' gestation. Methods: The study population consisted of 120 women not in active labor with a gestational age )41 weeks, singleton pregnancy with vertex presentation, reactive fetal heart rate tracing, amniotic fluid index G5, and Bishop score -5. Women were randomized to receive either 25 mg (ns60) or 50 mg (ns60) of intravaginal misoprostol. The dose was repeated every 4 h (maximum number of doses limited to six) until the patient exhibited three contractions in 10 min. The main outcome measure was the induction-vaginal delivery interval. Results: There was no significant difference between the two groups with regard to the inductionvaginal delivery interval (685"201 min in the 25 mg group vs. 627"177 min in the 50 mg group, Ps0.09). The proportion of women delivering vaginally with one dose of vaginal misoprostol was significantly greater in the 50 mg group (0y49 vs. 41y47, P-0.001). There were no differences in the rates of cesarean and operative vaginal delivery rates, or in the incidences of tachysystole and hyperstimulation syndrome in the two treatment groups. Neonatal outcomes were also similar. Conclusions: Intravaginal administration of 25 mg of misoprostol appears to be as effective as 50 mg for cervical ripening and labor induction beyond 41 weeks' gestation.

Research paper thumbnail of Abnormal glucose challenge test reflects mild gestational diabetes

Research paper thumbnail of Laparoscopic management of adnexal masses

J Amer Assoc Gynecol Laparosc, 1998

Research paper thumbnail of Uterin Fibromyomalı KadınlardaHisterektomi Öncesi Endometrial Küretaj Gerekli mi?

Turkiye Klinikleri Jinekoloji Obstetrik Dergisi, 2001

Research paper thumbnail of Abnormal Glucose Challenge Test and Mild Gestational Diabetes

Gynaecologia Et Perinatologia, Mar 1, 2008

Objective. The status of carbohydrate metabolism of pregnant women with positive glucose challeng... more Objective. The status of carbohydrate metabolism of pregnant women with positive glucose challenge test (GCT), but normal oral glucose tolerance test (OGTT) and their neonates are not defined clearly. Study Design. Pregnant women with normal GCT (n: 120), with abnormal glucose challenge test (AGCT) but normal OGTT (n: 67) and with gestational diabetes (GDM, n: 67) were included into the study. Insulin sensitivity was evaluated by fasting insulin level, homeostasis model assessment of insulin resistance index (HOMA-IR); quantitative insulin check index (QUICKI) and IS OGTT . Serum insulin and glucose values during OGTT were documented. Perinatal outcome and delivery modalities were compared. Results. Both GDM (31.6±5.9 yrs) and AGCT groups (29.0±4.0 yrs) were older than controls (28.1±4.9 yrs). Body mass index (BMI) was the predominant factor affecting both AGCT and GDM groups (OR: 3.78 and 5.97 respectively). Despite there was no significance between insulin indices; serum glucose and insulin values were similarly different; macrosomic infant and caesarean section rates were higher than controls in both GDM and AGCT groups in favor of gestational diabetics (6.6% vs. 18.9%; p=0.0001 and 20% vs. 27.7% p=0.0001 respectively). Conclusion. Pregnant woman with abnormal glucose challenge test have impaired carbohydrate metabolism as in gestational diabetics with a lesser severe degree.

Research paper thumbnail of Karın Duvarında Endometriozis Eksterna : Olgu Sunumu

Turgut Ozal Tıp Merkezi Dergisi, 1997

Research paper thumbnail of Adhesion formation after microlaparoscopic and laparoscopic ovarian coagulation for polycystic ovary disease

The Journal of the American Association of Gynecologic Laparoscopists, May 31, 1999

To compare the effects of microlaparoscopy and decreased C02 exposure on peritoneal microcirculat... more To compare the effects of microlaparoscopy and decreased C02 exposure on peritoneal microcirculation and potential adhesion formation after ovarian surgery with those of conventional operative laparoscopy. Design. Prospective, randomized study (Canadian Task Force classification I). Setting. Teaching hospital. Patients. Eighteen women with polycystic ovary disease. Interventions. Microlaparoscopic or laparoscopic ovarian coagulation of the ovaries. Measurements and Main Results. Approximately 10 to 12 coagulation points were applied to each ovary. Two to 3 weeks after the initial surgery second-look microlaparoscopy was performed to determine the extent of adhesions in both groups. The frequency of adhesion formation and changes in glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), catalase (CAT), and gtutathione (GSH) levels were studied in homogenized peritoneal tissues obtained during surgery in each group. Results. Clinical profiles were similar between groups. Mean exposure, amount, and pressure of CO 2 were significantly less in the microlaparoscopy group (p <0.05). The laparoscopy group had significantly more adhesions than the microlaproscopy group (24% vs 48%, p <0.05). The GSH-Px, SOD, CAT, and GSH levels were significantly lower in the laparoscopy group (0.425 pmol, 1.2 ng, 37.55 pmol, and 0.9 nmol vs 0.755 I_tmol, 2.1 ng, 625 I~mol, and 2.6 nmol, respectively). Conclusion. Reduced exposure to and amount of C02 during microlaparoscopy may result in decreased adhesion formation compared with conventional laparoscopy. This effect may possibly be due to lack of or minimal adverse effects on peritoneal microcirculation and cell-protective systems, which are proposed mechanisms for adhesion formation and closely related to peritoneal injury. In addition, microlaparoscopy may be a cost-effective alternative to conventional laparoscopy.

Research paper thumbnail of Acute abdomen in a case with noncommunicating rudimentary horn and unicornuate uterus

Jsls Journal of the Society of Laparoendoscopic Surgeons Society of Laparoendoscopic Surgeons, 2005

Unicornuate uterus with a rudimentary horn is the rarest congenital anatomic anomaly of the femal... more Unicornuate uterus with a rudimentary horn is the rarest congenital anatomic anomaly of the female genital system, causing many obstetrical and gynecologic complications. The frequency of this pathology is approximately 1/100 000. A rudimentary horn usually develops following insufficient development of mullerian ducts. These patients present with dysmenorrhea, dyspareunia, and chronic pelvic pain because of endometriosis and rarely with acute abdominal symptoms following distention and torsion of the noncommunicating rudimentary horn. The case of a patient referred for acute abdomen after distention of a noncommunicating rudimentary horn is presented herein.

Research paper thumbnail of Chronic pelvic pain associated with pelvic congestion syndrome and the benefit of Daflon 500 mg: a review

Research paper thumbnail of Acute abdomen in a case with noncommunicating rudimentary horn and unicornuate uterus

JSLS : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons

Unicornuate uterus with a rudimentary horn is the rarest congenital anatomic anomaly of the femal... more Unicornuate uterus with a rudimentary horn is the rarest congenital anatomic anomaly of the female genital system, causing many obstetrical and gynecologic complications. The frequency of this pathology is approximately 1/100 000. A rudimentary horn usually develops following insufficient development of mullerian ducts. These patients present with dysmenorrhea, dyspareunia, and chronic pelvic pain because of endometriosis and rarely with acute abdominal symptoms following distention and torsion of the noncommunicating rudimentary horn. The case of a patient referred for acute abdomen after distention of a noncommunicating rudimentary horn is presented herein.

Research paper thumbnail of Comparison of the effects of ovarian cauterization and gonadotropin-releasing hormone agonist and oral contraceptive therapy combination on endocrine changes in women with polycystic ovary disease

Fertility and sterility, 1996

To study the effects of laparoscopic ovarian cauterization and combination of long-acting GnRH ag... more To study the effects of laparoscopic ovarian cauterization and combination of long-acting GnRH agonist (GnRH-a) and oral contraceptive (OC) therapy on endocrine changes in women with clomiphene citrate (CC)- resistant polycystic ovary disease (PCOD). Prospective, randomized. University-based infertility clinic. Seventeen women with CC-resistant PCOD were included randomly in the study to either laparoscopic ovarian cautery or GnRH-a and OC therapy for 3 months. Serum concentrations of LH, FSH, androstenedione (A), T, and sex hormone-binding globulin (SHBG) were determined before each therapeutic approach and during the follicular phase of first menstrual cycle after the cessation of each treatment. The mean serum concentrations and the clinical profiles were similar in both groups. Both groups showed significant changes in LH, FSH, A, T, and SHBG compared with pretreatment levels. There were no significant differences in the final concentrations of LH, FSH, and A between the two stu...