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Öğe Anne serumundaki çözünebilir HLA-G düzeylerinin missed abortuslar ile ilişkisi(Düzce Üniversitesi, 2012) Keskin, Fatih; Karataş, AhmetGiriş ve Amaç: Fetal genlerin yarısı baba kaynaklıdır ve gebelikte annede fetüse karşı immun toleransın nasıl geliştiği açık değildir. Fetal dokuların reddini önleyen moleküllerden biri de, aynı zamanda anne serumunda da saptanabilen çözünebilir HLA-G (sHLA-G)'dir. Bu molekül başlıca ekstravillöz trofoblastlar, plasental makrofajlar ve mezenkimal koryonik villuslardaki endotelyal hücreler tarafından üretilir. sHLA-G, gebe olmayan kadınların serumunda da saptanmasına rağmen gebelerde daha yüksek düzeylerde saptanır. Gebelik kayıplarının patogenezinde maternal immün tolerans ile ilgili sorunlar olduğu düşünülmektedir. Çalışmamızın amacı, anne serum sHLA-G düzeylerinin, missed abortus ile olan ilişkisini araştırmaktır. Gereç ve Yöntemler: Çalışmaya 40 normal ve 40 missed abortus olmak üzere toplam 80 gebe dahil edildi. Rutin gebelik takibi için başvuran olgulara transvajinal ultrasonografi ve laboratuar parametrelerine ek olarak anne serumundaki sHLA-G düzeyine bakıldı. Bulgular: Gruplar arasında demografik parametreler açısından fark saptanmadı. Çalışma grubu hastalarının ortanca serum sHLA-G düzeyleri kontrol grubundaki gebelerin ortanca serum sHLA-G düzeylerinden anlamlı olarak daha düşük bulundu (P< 0,001). Sonuç: Missed abortus riski artmış kadınların öngörülmesinde, anne serum sHLA-G ölçümü prenatal tanıda önemli ve yeni bir tanısal araç olabilir.Öğe Are insulin resistance and serum resistin levels increased in women with idiopathic hirsutism?(Verduci Publisher, 2014) Erkan, Müşerref; Albayrak, Mustafa; Karataş, Ahmet; Keskin, Fatih; Aydın, Yusuf; Ak, H.Y.; Bıyık, İsmailOBJECTIVE: To investigate the insulin resistance and serum resistin levels in women with idiopathic hirsutism compared to controls and women with polycystic ovary syndrome (PCOS). PATIENTS AND METHODS: Three groups of women including 23 women with idiopathic hirsutism, 28 women with PCOS and 28 non-hirsute women serving as controls were included into the study. The Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), serum fasting insulin and resistin levels were compared between the groups. RESULTS: There were no statistically significant differences regarding the age, BMI and waist circumferences between the groups. Mean and median fasting blood glucose, fasting insulin, HOMA-IR, serum resistin levels were statistically similar between the groups (p = 0.966, p = 0.378, p = 0.409 and p = 0.784, respectively). There were no correlations between the resistin, HOMA-IR, fasting insulin levels and BMI in any of the three groups. CONCLUSIONS: Insulin resistance and serum resistin levels do not appear to be increased in women with idiopathic hirsutism compared to controls at similar BMI's and waist circumferences.Öğe Comparison of Ectopic Pregnancy Treatment Modalities: Experience from a Tertiary Center(Kuwait Medical Assoc, 2013) Albayrak, Mustafa; Karataş, Ahmet; Bıyık, İsmail; Keskin, FatihObjectives: To review and analyze the outcomes of various treatment modalities in women with ectopic pregnancy (EP) in a tertiary center between January 2006 and February 2011 Design: Retrospective study Setting: Duzce University Hospital, Turkey Subjects and Methods: The medical records of 116 women diagnosed with EP were reviewed retrospectively. Women were grouped based on the treatment modality: Expectant (Group I), Medical treatment with methotrexate (Group II) and Surgical (salpingostomy and salpingectomy) (Group III). Demographic characteristics were analyzed and the success rates between the groups were compared. Intervention: None Main Outcome Measures: Success rates between groups based on treatment modality Results: Success rates for expectant, medical management with single dose of methotrexate, salpingostomy and salpingectomy were 66.7%, 79%, 92.7% and 100%, respectively. There was no difference between the success rates of laparoscopic salpingostomy and single dose methotrexate (p = 0.246). Salpingectomy was more successful compared to expectant and medical managements (p = 0.003 and p = 0.040, respectively). Conclusion: The highest success rate in EP was achieved by surgical treatment. However, expectant and medical treatment may eliminate the need for surgery in selected cases with low and / or decreasing initial beta-hCG levels.Öğe Effect of combined oral contraceptive use on platelet volume in women at reproductive age(I R O G Canada, Inc, 2012) Bulur, Serkan; Albayrak, Mustafa; Bulur, S.; Keskin, Fatih; Köse, Seyit Ali; Aslantaş, Yusuf; Özhan, HakanInvestigation: Combined oral contraceptives use is associated with an increased risk of developing venous and arterial thromboembolic events. Platelet size, measured as mean platelet volume (MPV), is associated with platelet reactivity. Methods: Ninety-five women using oral contraceptives for contraception were investigated retrospectively. The patients' blood pressure, pulse and hematological values at application and at the sixth month were evaluated retrospectively. Results: There was no difference between the values of blood pressure (systolic and diastolic), pulse, hematological values (which contain leukocytes, platelets and mean platelet volume) at application and at the sixth month. Conclusion: We determined that using oral contraceptives for contraception did not change MPV values in young women.Öğe Endothelial Nitric Oxide Synthase Gene Polymorphisms (Promoter-786T/C, Exon 894 G/T and Intron G10T) in Unexplained Female Infertility(Karger, 2014) Karataş, Ahmet; Eröz, Recep; Bahadır, Anzel; Keskin, Fatih; Özlü, Tülay; Özyalvaçlı, Mehmet EminBackground/Aims: Recent investigations in both males and females show that there may also be some genetic risk factors associated with infertility, and endothelial nitric oxide synthase (eNOS) has important functions in implantation. We aimed to investigate the association of three different polymorphisms of eNOS (promoter -786T/C, exon 894 G/T and intron G10T) with unexplained female infertility. Materials and Methods: Two groups of patients were included in the study: (1) women with unexplained infertility and (2) healthy, fertile women with normal menstrual cycles. eNOS polymorphisms were studied in genomic DNA of each patient by polynnerase chain reaction-restriction fragment length polymorphism method. Results: Forty-one women with unexplained infertility and 40 fertile women were included. Baseline physical characteristics and hormonal parameters of the two groups were similar. For eNOS exon 894 G/T polymorphism, the GG honnozygotes were significantly lower and the heterozygotes GT were significantly higher in the infertile group than in the control group (p < 0.05). eNOS gene polymorphism both for promoter and intron were similar in the two groups (p > 0.05). Conclusion: Altered eNOS protein caused by eNOS exon 894 G/T polymorphism might cause implantation failure, which may be a possible cause of unexplained female infertility. (C) 2014 S. Karger AG, BaselÖğe Evaluation of chromosomal abnormalities and common trombophilic mutations in cases with recurrent miscarriage(Makerere Univ, Fac Med, 2014) Karataş, Ahmet; Eröz, Recep; Albayrak, Mustafa; Özlü, Tülay; Çakmak, Bülent; Keskin, FatihBackground: Recurrent miscarriage (RM) is a frequent obstetric problem. Its' pathophysiology is poorly understood. Infections, genetic, endocrine, anatomic and immunologic problems have been suggested as causes for RM. Objective: To evaluate the frequency of chromosomal abnormalities and 3 common thrombophilic mutations in couples with RM. Methods: A retrospective data collection was performed for the results of the cytogenetic analysis of the couples and Methylenetetrahydrofolate Reductase (MTHFR) C677T, Factor V Leiden (FVL) G1691A and Prothrombin (PTm) G20210A mutations of the mother in 142 couples suffering from RM. Results: Prevalence of FVL, MTHFR, and PTm gene mutations were similar between cases shaving 2 or >= 3 abortions (P=0.528; P=0.233; P=0.375). In patients with FVL, MTHFR and PTm gene mutations, the OR's of having >= 3 abortions when compared to having 2 abortions were 1.515 (95% CI: 0.414-5.552), 0.573 (95% CI: 0.228-1.441), and 2.848 (95% CI: 0.355-22.871). All cases with PTm mutation had >= 3 abortions and all abortions occurred between 6-8 gestational weeks. Conclusion: Chromosomal abnormalities and thrombophilic mutations (especially PTm) seem to have an important role in RM. Additional larger studies involving investigation of more genes that may have a role in pregnancy are needed to assess this association.Öğe Geç Preterm Doğum Olgularında Erken Neonatal Sonuçlar(2013) Karataş, Ahmet; Albayrak, Mustafa; Keskin, Fatih; Bıyık, İsmail; Okur, Mesut; Güneş, Cemalettin; Köse, Seyit AliAmaç: Preterm doğumlar son zamanlarda birçok ülkede artış göstermiştir. Fetal akciğerin gelişmiş olmasına rağmen, 34. gebelik haftasından sonra bile ciddi yenidoğan morbiditesi meydana gelebilir. Bu çalışmanın amacı, geç preterm doğum olgularında neonatal morbidite ve mortaliteyi araştırmaktır. Planlama: Retrospektif Ortam: Düzce Üniversitesi Tıp Fakültesi, Kadın Hastalıkları-Doğum ve Pediatri Kliniği Hastalar: 340/7-366/7 gebelik haftasında doğum yapan 291 gebe kadın ve yenidoğanlar incelendi. Girişim: Çalışmaya dahil edilen olgular PPROM varlığı ya da yokluğuna göre öncelikle iki gruba ayrıldı. Daha sonra gruplar, tekrar gebelik haftasına göre kendi içlerinde, 340/7-346/7 hafta olanlar(grup 1),350/7-356/7 hafta olanlar (grup 2), 360/7-366/7 hafta olanlar(grup 3) şeklinde üçe ayrıldı. Değerlendirme parametreleri: Gruplar prematürite ve erken membran rüptürü ile ilişkili yenidoğan komplikasyonları açısından karşılaştırıldı. Sonuç: Çalışmaya dahil edilen ikiyüz doksanbir olgunun 85'i PPROM nedeniyle erken doğum yapmıştı. 206'sı PPROM olmayan gruptaydı ve 76'sı 1. grup, 108'i 2. grup, 107'si de 3. grupta yer aldı. Sepsis oranı, birinci ve ikinci grupta üçüncü gruba göre daha yüksekti (p:0.016, p:0.029). Yenidoğan yoğunbakım ünitesinde (YDYB) kalış süresi 3. gruba oranla, 1. ve 2. grupta daha yüksekti (sırasıyla p:0.028, p:0.015). Birinci gruptaki yenidoğanlar, üçüncü gruptakilere göre anlamlı olarak daha uzun hastanede kalış süresine sahipti (p0.010), ve toplam hastanede kalış süresi sepsisli yenidoğanlarda anlamlı olarak daha yüksekti. Yorum: Özellikle daha erken gebelik haftalarında olan geç preterm yenidoğanlar, yenidoğan komplikasyonları için anlamlı olarak daha fazla risklidirler, aynı zamanda anlamlı olarak yenidoğan yoğun bakım ve hastanede daha uzun kalış süresine sahiptir.Öğe Maternal Serum Soluble HLA-G Levels in Missed Abortions(Mdpi, 2013) Keskin, Fatih; Karataş, Ahmet; Albayrak, Mustafa; Bıyık, İsmail; Erkan, Müşerref; Demirin, Hilmi; Dilbaz, SerdarBackground and Objective. It is unclear how immune tolerance develops to a semiallograft fetus in pregnancy. Human leukocyte antigen G (HLA-G) expressed by extravascular trophoblasts plays an important role in the recognition of the gestational tissues as self and the development of immune tolerance against the gestational tissues by the maternal immune system. The soluble form of the HLA-G (sHLA-G) molecule in the maternal serum is also reported to contribute to the prevention of rejection during pregnancy. The aim of the study was to compare the maternal serum sHLA-G levels of the women with missed abortions and control subjects with uncomplicated pregnancies. Material and Methods. The prospective cross-sectional study involving 40 with missed abortions and 40 control women, matched by age, gestational age, and body mass index, was carried out. The study group consisted of the women with singleton pregnancies, who were diagnosed with a missed abortion. Only the patients who were confirmed to have an uncomplicated term delivery during follow-up were included in the control group. The serum sHLA-G level was compared between the groups. Results. There was no significant difference in the mean serum sHLA-G levels in terms of gravidity (P=0.761) and a history of abortion (P=0.379) in the control group. The median serum sHLA-G level in the missed abortion group was significantly lower compared with the control group (16.8 [8.5-35.8] vs. 26 [11-135] U/mL, P<0.001). All the women in the control group had uncomplicated term deliveries. Conclusion. Our results showed that the women with missed abortions had significantly lower serum sHLA-G levels compared with the healthy pregnant controls, which may have potentially played a role in the impairment of physiological immunological tolerance during pregnancy. However, the determination of the exact role and the potential clinical utility of maternal serum sHLA-G for the detection/ prediction of a missed abortion risk requires further detailed studies.
