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Öğe Association of folic acid receptor ? in maternal serum with neural tube defects(Informa Healthcare, 2014) Celik, Ebru; Karaer, Abdullah; Turkcuoglu, Ilgin; Turhan, Ugur; Gungoren, Arif; Taskapan, Cagatay; Ozyalin, FatmaObjective: To evaluate whether serum folic receptor alpha levels are changed in women whose previous pregnancies were complicated with neural tube defects (NTDs). Methods: This was a case-control study that included 41 women as the control group who had previously had at least one healthy pregnancy and 37 women as the study group who had a previous pregnancy complicated with NTDs. Blood samples were obtained from all of the participants six weeks after the termination of pregnancy or delivery of a baby. Serum folate receptor alpha concentrations were analyzed using a commercially available enzyme-linked immunosorbent assay (ELISA) kit. Results: The mean concentrations of serum folate receptor alpha were significantly lower in the NTD cases compared to those in the control group (p = 0.02). There was no significant difference in mean serum folate titers between the NTD cases and the control group (p = 0.07). Conclusion: Low serum folic acid receptor alpha levels in the current study did not appear to be a regulatory marker of maternal folate homeostasis per se but rather a factor that contributed to the development of NTDs.Öğe Association of Helicobacter pylori positivity with the symptoms in patients with hyperemesis gravidarum(Springer Heidelberg, 2013) Gungoren, Arif; Bayramoglu, Neslihan; Duran, Nizami; Kurul, MehmetTo investigate the relationship between Helicobacter pylori (Hp) positivity and the severity of symptoms of nausea and vomiting in patients diagnosed with hyperemesis gravidarum (HG). Prospective controlled. Ninety patients with the diagnosis of HG below the 20th week gestation, who had no additional disease and 50 pregnant women with no complaints were enrolled in the study. According to the severity of symptoms, the patients were divided into three groups as group I, II and III (mild, moderate and severe, respectively). The Rhode's scoring system was used to determine the severity of HG symptoms. HpIgG and IgM levels were determined in the blood samples and Hp DNA positivity with PCR was investigated in the saliva. In accordance with the Rhode's scoring system, 15.5 % of the pregnant women had mild, 58.9 % had moderate, and 25.6 % had severe symptoms (group I, II and III, respectively). HpIgG was determined as positive in 78.6, 84.9 and 82.6 % in groups I, II and III, respectively. HpIgM positivity was determined as 26.1 % only in group III (p = 0.847). HpDNA was determined as 7.2, 3.8, and 91.3 % in group I, II, and III, respectively (p < 0.01). While HpIgG was positive in 60 %, HpDNA was found to be positive in 2 % and HpIgM was found to be negative in all the pregnant women in the control group. A positive relationship between the symptoms of HG and Hp positivity was determined using PCR.Öğe Can the ductus venosus doppler predict the hemoglobinopathies?(E-Century Publishing Corp, 2015) Karateke, Atilla; Silfeler, Dilek Benk; Gungoren, Arif; Kurt, Raziye Keskin; Okyay, Ayse Guler; Dokuyucu, Recep; Ulutas, TurkerObjective: The aim of our study was to investigate the ductus venosus doppler between 11-13+6 (weekday) in pregnant women with hemoglobinopaties and its relation with fetal outcomes. Material and methods: A total of 100 pregnant women with hemoglobinopathies and 100 healthy pregnant women were included in our study. Ultrasonography (USG) was performed to all pregnant women and the ductus venosus doppler (DVD) flows were evaluated. The results were statistically analyzed. Results: The mean hemoglobin level was significantly lower in hemoglobinopathy group (9.7 +/- 0.7) than control group (10.67 +/- 0.82) (P<0.001). There was a significant relationship between Vmax, Vmin, S/D and reverse 'a' wave in fetuses with hemoglobinopathies. Vmax, Vmin and S/D parameters were higher in the group of hemoglobinopathies (respectively mean value, 31.3 +/- 1.66, 8.90 +/- 0.81, 2.97 +/- 0.49). Reverse 'a' wave was detected especially in all fetuses with sickle cell anemia. There was no significantly relationship between the groups in terms of PI, RI and HR. In a logistic regression analyses, fetal hemoglobinopathy was independently associated with Vmin (beta = 1.07, P = 0.001), S/D (beta = 2.61, P = 0.001) and reverse 'a' wave (beta = 2.46, P = 0.004). Conclusion: Pregnant women with hemoglobinopathies had changed ductus venosus doppler values in compared to normal pregnant women. Maternal anemia may cause this doppler changes. Furthermore all fetuses with sickle cell anemia (n = 5) had abnormal ductus venosus doppler findings. Further studies are needed to investigate the relationship between abnormal ductus venosus doppler findings and fetuses diagnosed with sickle cell anemia.Öğe Chromosome Imbalances and Alterations in the p53 Gene in Uterine Myomas from the Same Family Members: Familial Leiomyomatosis in Turkey(Asian Pacific Organization Cancer Prevention, 2013) Hakverdi, Sibel; Demirhan, Osman; Tunc, Erdal; Inandiklioglu, Nihal; Uslu, Inayet Nur; Gungoren, Arif; Erdem, DuyguUterine leiomyomas (UL) are extremely common neoplasms in women of reproductive age, and are associated with a variety of characteristic choromosomal aberrations (CAs). The p53 gene has been reported to play a crucial role in suppressing the growth of a variety of cancer cells. Therefore, the present study investigated the effects of CAs and the p53 gene on ULs. We performed cytogenetic analysis by G-banding in 10 cases undergoing myomectomy or hysterectomy. Fluorescence in situ hybridization (FISH) with a p53 gene probe was also used on interphase nuclei to screen for deletions. In patients, CAs were found in 23.4% of 500 cells analysed, significantly more frequent than in the control group (p<0.001). In the patients, 76% of the abnormalities were structural aberrations (deletions, translocations and breaks), and only 24% were numerical. Deletions were the most common structural aberration observed in CAs. Among these CAs, specific changes in five loci 1q11, 1q42, 2p23, 5q31 and Xp22 have been found in our patients and these changes were not reported previously in UL. The chromosome breaks were more frequent in cases, from high to low, 1, 2, 6, 9, 3, 5, 10 and 12. Chromosome 22, X, 3, 17 and 18 aneuploidy was observed to be the most frequent among all numerical aberrations. We observed a low frequency of p53 losses (2-11%) in our cases. The increased incidence of autosomal deletions, translocations, chromatid breaks and aneuploidy, could contribute to the progression of the disease along with other chromosomal alterations.Öğe Comparison of the efficacy and adverse effects of trospium chloride and tolterodine tartrate in the treatment of overactive bladder symptoms(Galenos Yayincilik, 2008) Guven, Melih Atahan; Coskun, Ayhan; Gungoren, Arif; Ozdemir, Ozgur; Ercan, Onder; Karakus, SavasObjective: To compare the efficacy and adverse effects of two antimuscarinic agents (trospium chloride (TCl), tolterodine Ltartrate) in patients having overactive bladder symptoms. Material and Method: During 2005, patients admitted with urge incontinence to Faculty of Medicine, Gynaecology Clinic and answered overactive bladder evaluation questionnaire form, and given Tolterodine-L-Tartrate (Detrusitol (R)) 2 mg, 2x1 (n: 38), Trospium chloride (Spazmex (R)) 30 mg tb 2x1 (n: 41), were retrospectively evaluated. Patients taken both drugs were determined by giving points regarding efficacy and adverse effects as questioned in the questionnaire form at the 1st and 3rd months following the initiation of treatment. Results: Demografic data were similar in both groups (p> 0.05). Points given after treatment were found significantly lower than the points given before treatment in both groups (p<0.001). The efficacy and adverse effects of both drugs were found statisticaly similar (p>0.05). Conclusion: In the highligths of retrospevtive data, we concluded that Trospium chloride and Tolterodine may be used alternatively to each other in treatment of overactive bladder.Öğe Deep vein thrombosis in pregnant women with heterozygous factor-V Leiden mutation: a case report(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2009) Fansa, Iyad; Gungoren, Arif; Hakverdi, Ali Ulvi; Zeteroglu, Sahin; Yetim, CagcilDeep vein thrombosis during pregnancy is an important risk factor increasing maternal morbidity and mortality. Factor V Leiden mutation is the most frequent one among many hereditary and acquired thrombophilic risk factors during pregnancy. In a 23-year-old woman who had been pregnant for 11 weeks and applied to hospital with sudden onset pain, swelling, and erythema in her left lower extremity, a thrombus from left main iliac to superficial femoral veins was detected via Doppler ultrasonography. She was hospitalized and low molecular-weight heparin (enoxaprine sodium) was initiated with a dosage of 12000 IU/day. She showed a rapid healing clinically and was followed up with enoxaprine and varsity sock until delivery. After labor, the dosage of enoxaprine was halved and withdrawn after six weeks, and oral warfarin sodium was started. The patient is still continued to be followed up without any problems.Öğe DIAGNOSTIC VALUE OF DILATATION AND CURETTAGE TO DETECT INTRAUTERINE LESIONS IN WOMEN WITH ABNORMAL UTERINE BLEEDING(Galenos Yayincilik, 2008) Hakverdi, Sibel; Gungoren, Arif; Hakverdi, Ali Ulvi; Dolapcioglu, Kenan; Ciftci, Sinasi; Kaya, Zozan; Yalinkaya, AhmetObjective: To evaluate the diagnostic inadequacy of dilatation and curettage (D&C) by comparing histologic findings derived from D&C with histologic findings obtained after hysterectomy procedure retrospectively. Material and methods: Files of 259 patients with abnormal uterine bleeding who underwent hysterectomy within two months of a diagnostic D&C were analyzed. All patients had gynecologic and ultrasonographic examination, then they underwent D&C procedure under anesthesia. Hysterectomy was performed accordingly due to the histologic findings or persistence of the symptoms. Histologic diagnosis in D&C and after hysterectomy for each patient were compared. Results: 54.5% of the women had no pathology in D&C techniques. 59.5% of remaining patients had the same the pathologic findings in the hysterectomy specimens. In 105 of 259 patients, D&C failed to detect intrauterine disorders subsequently found at hysterectomy. After hysterectomy, in 227 of 259 patients were found additional pathologic abnormalities besides the histologic diagnosis in D&C specimens. Conclusions: D&C involves additional hospital costs and risk of complications; uterine perforation, infection and laceration of the cervix. If there are lesions in the uterus, dilatation and curettage is an inadequate diagnostic tool. D&C missed 40.5% of major intrauterine disorders and endometrial lesions were still present in the removed uterus. Therefore D&C can not be assessed as a therapeutic tool. Therefore D&C is suggested to be replaced by alternative and more accurate methods of diagnosis of endometrial abnormalities.Öğe Distribution of Candida species in women with vulvovaginal symptoms and their association with different ages and contraceptive methods(Informa Healthcare, 2007) Cetin, Meryem; Ocak, Sabahattin; Gungoren, Arif; Hakverd, Ali UlviThe aim of this study was to determine the frequency and distribution of Candida spp. within different age groups and different contraceptive methods users in women with vulvovaginal symptoms. The study included 569 female outpatients who had visited the Education and Research Hospital of Mustafa Kemal University, Turkey, between Jaunary 2004 and June 2005. Among 569 women with symptoms of vulvovaginitis, 240 (42.2%) were positive for Candida spp., of which 106 (44.2%) were C. albicans and 134 (55.8%) were non-albicans spp. The age group 26-30 y had the highest frequency of Candida spp. (23.7%). Candida spp. were isolated from 44.2% of contraceptive method users, and 37.9% of noncontraceptive users (p > 0.05). The isolation rate of C. albicans was higher among oral-contraceptive users (57.5%) than IUCD users (38.5%), coitus interruptus (48.5%) and condom users (42.8%). These results indicate that factors associated with age and contraceptive method used may influence the occurrence and distribution of Candida spp. in women with vulvovaginal symptoms.Öğe Does the presence of anhydramnios affect the duration of medical abortion?(Via Medica, 2016) Karapinar, Oya Soylu; Gungoren, Arif; Dolapcioglu, Kenan; Silfeler, Dilek Benk; Kurt, Raziye Keskin; Sahin, Hanifi; Hakverdi, Ali UlviObjectives: The aim of the study was to determine whether anhydramnios affected the duration of medical abortion in cases with various indications as compared to cases with normal amniotic fluid volume. Material and methods: Patients who were admitted to our clinic because of medical abortion between January 2010-December 2013 were included in this retrospective study. A total of 32 pregnant women with anhydramnios (study group) and 67 pregnant women with normal amniotic fluid volume but with fetal abnormality (control group) were included in the study. Patient age, gravidity, parity, gestational age, previous delivery route, and duration of the abortion were recorded. Results: Mean duration of the abortion in the study group was 71.93 +/- 47.51 h as compared to 79.08 +/- 52.62 h in the control group. There were no statistically significant differences between the two groups in terms of duration of the abortion (p = 0.516). Also, we found no statistically significant differences in duration of the abortion with regard to previous delivery route (p = 0.220). Conclusions: There were no statistically significant differences between the study group and controls in terms of duration of the abortion. In addition, neither parity nor previous delivery route affected the duration of the abortion.Öğe The effect of obesity on inflammatory markers in patients with PCOS: a BMI-matched case-control study(Springer Heidelberg, 2014) Kurt, Raziye Keskin; Okyay, Ayse Guler; Hakverdi, Ali Ulvi; Gungoren, Arif; Dolapcioglu, Kenan Serdar; Karateke, Atilla; Dogan, Mustafa OzcilPrevious studies have shown increased inflammatory activity in patients with polycystic ovary syndrome (PCOS); however, it remains uncertain whether this increased inflammatory activity is a consequence of the disorder itself or of the accompanying obesity. We therefore aimed to test the inflammatory marker levels in obese and lean patients with PCOS by using two separate control groups with matching body mass index (BMI). A total of 120 women in reproductive age with (n = 62) and without (n = 60) PCOS were recruited for the study. Patients with PCOS were divided into two groups as obese (n = 32) and lean (n = 30) PCOS groups according to BMI. Two BMI-matched control groups were created. Furthermore, high sensitive CRP protein (hsCRP), neutrophils, lymphocytes, white blood cell count (WBC) and neutrophil to lymphocyte ratio (NLR) were evaluated with complete blood count. The hsCRP (5.5 +/- A 0.8 vs. 3.1 +/- A 0.7, p < 0.001), neutrophil count (3.8 +/- A 0.4 vs. 2.9 +/- A 0.7, p < 0.001), leukocyte count (7.2 +/- A 1.8 vs. 5.6 +/- A 1.6, p < 0.001), and NLR (2.6 +/- A 1.4 vs. 1.5 +/- A 0.4, p < 0.001) were higher in patients with PCOS compared to the control group while lymphocyte count was lower (1.71 +/- A 0.65 vs. 1.98 +/- A 0.39, p = 0.008). Similarly, both obese and lean patients with PCOS had higher levels of hsCRP, neutrophils, leukocytes and NLR ratios compared to BMI-matched controls. The correlation analysis revealed a moderate correlation between NLR and hsCRP (r 0.459, p < 0.001), and between HOMA-IR (r 0.476 p < 0.001) and BMI (r 0.310, p 0.001). Our study results demonstrated that both lean and obese patients with PCOS have increased inflammatory markers compared to BMI-matched control groups indicating that the inflammation seen in PCOS might be related with the presence of the disorder rather than with obesity.Öğe Effectiveness of Periurethral Injection on Stress Urinary Incontinence(Ortadogu Ad Pres & Publ Co, 2011) Gungoren, Arif; Dolapcioglu, Kenan; Hakverdi, Ali Ulvi; Yetim, CagcilObjective: To determine one-year subjective and objective evaluation results of penurethral injection (PUT) applied to women suffering from stress urinary incontinence (SUI). Material and Methods: Twenty five patients with complaints of SUI have participated in our study. Preoperative and postoperative results of urinalysis, stress and Q-tip tests, post voiding residual volumes (RV) and survey of incontinence quality of life (I-QOL) criteria were recorded. Later on, Urodex (R) (Cross- linked hyaluronic acid, detxranomere) was injected to them. The cases were monitored at regular intervals for a mean of 14 +/- 5.84 months. Results: Eighteen (72%) out of all cases were encountered during menopausal period. Eight of the patients had previous gynecologic operations. Mean age was 53.97 +/- 13.01 years. Mean application period of PUT was 6.95 +/- 1.46 minutes. Differences between the preoperative and postoperative results of RV and I-QOL were not statistically significant. From subjective success point of view; 17 (68%) of the patients claimed no change on their incontinence problem, two (8%) of the patients claimed that their conditions were slightly improved, and six (24%) of the patients claimed that their conditions significantly improved. When objective success is considered, there was success in seven (28%) patients, and failure in 18 (72%) patients. Conclusion: PUT is a minimally invasive treatment method used in all types of SUI. PUI treatment might be preferred for the old, obese patients with additional health problems, having incontinence dependent on hypermobility at which the open surgery incurs a great risk. However, as the new techniques are not readily available, a periurethral injection technique may still be a valid choice in patients who have poor surgical risks, and to whom the low success rate has been adequately explained.Öğe Effects of intrauterine device and oral contraceptive on vaginal flora and epithelium(Saudi Med J, 2007) Ocak, Sabahattin; Cetin, Meryem; Hakverdi, Sibel; Dolapcioglu, Kenan; Gungoren, Arif; Hakverdi, Ali U.Objectives: To investigate the microbial and cytopathological changes and genital symptoms in oral contraceptive pill (OCP) and intrauterine contraceptive device (IUCD) users. Methods: Included in the study were 34 women using OCP and 34 women using IUCD for 24 to 36 months period and 34 women as control group. We conducted the study between March to September 2005 in Antakya Maternity Hospital, Turkey. Vaginal discharge was subjected to wet mount examination, gram staining, and culture. Cervical smears were examined and reported using the Bethesda system as reference. Results: In the IUCD group, women with intermediate score was 20.6%, while those with bacterial vaginosis was 11.7%. In the OCP group however, women with intermediate score was 8.8%, while those with bacterial vaginosis was 5.9%. Compared to the control group, these rates were 2.9% for those with intermediate score and 2.9% for those with bacterial vaginosis. Escherichia coli vaginal colonization increased by 5-fold in the IUCD users (P<0.05). Cervical erosion was found in 14.7% of the women using IUCD as compared to the other groups (p<0.05). Actinomyces like organisms was detected in 11.7% of the IUCD users (P<0.05). Conclusion: The use of IUCD clearly alter the normal vaginal flora, although OCP appears to have minimal effects on the vaginal microbial flora. The data support the hypothesis that IUCD might change cervico vaginal environment, and suggests that women with IUCD may be at a higher risk for vulvovaginal infection.Öğe Evaluation of Fetal Autopsy Findings in the Hatay Region: 274 Cases(De Gruyter Open Ltd, 2012) Hakverdi, Sibel; Guzelmansur, Ismail; Gungoren, Arif; Toprak, Serhat; Yaldiz, Mehmet; Hakverdi, Ali UlviObjective: The aim of this study was to present the incidence of fetal anomalies in our region of Hatay, Turkey in order to determine the efficiency of prenatal diagnosis through fetal autopsy, and to compare our statistical data with other national and international studies. Material and Method: This study was conducted on 274 fetuses from terminated pregnancies due to abnormal prenatal findings and intrauterine deaths from 2005 to September 2010. Fetuses were evaluated through postmortem examination, external measurements, X-rays, Magnetic Resonance Images, Multislice Computerized Tomography and photographs. The autopsy was completed by the histological examination of each organ. Results: Autopsy was conducted on 274 fetuses. A fetal anomaly was detected in 160 (58.39%) cases. The central nervous system contained the most frequent structural defects (79 cases, 49.38%), followed by malformations in the musculoskeletal system in 36 cases (22.5%). The most frequent multiple system anomalies were central nervous system defect and bilateral adrenal agenesis, musculoskeletal system malformations and urinary system defects. Fetal autopsy provided additional findings in 43 cases (26.88%). Conclusion: Fetal autopsy is a very important procedure and an integral part of the general prenatal management. New findings through this method may suggest invaluable data for parents about potential risks in future pregnancies.Öğe A giant serous cystadenoma developing in an accessory ovary(Springer Heidelberg, 2008) Temiz, Muhyittin; Aslan, Ahmet; Gungoren, Arif; Diner, Guevenc; Karazincir, SinemBackground Accessory ovaries are rare anomalies and cysts arising from accessory ovaries are extremely rare. Their reported incidence is 1/29,000-1/700,000. Establishing the diagnosis preoperatively is difficult. Radiologic methods are usually inadequate in recognizing the origin of these tumors. Thus, they are usually confused with other intraabdominal tumors. Case A 22-year-old nulliparous girl presented with abdominal pain and tumoral growth for 1.5 years. Abdominal ultrasound and computed tomography revealed a 33 x 26 x 15 cm cystic mass filling the abdominal cavity. The preoperative diagnosis was a mesenteric cyst. Diagnostic laparotomy revealed a giant cystic mass arising in an accessory ovary. The left tuba and fimbrias were adhered to the cyst. The tumor was totally removed and fimbrioplasty performed. Conclusion In spite of being rare entities, paraovarian anomalies should be considered in the differential diagnosis of intraabdominal tumors, especially when the origin is not identified by radiologic means. Case A 22-year-old single, nulliparious female was admitted to our hospital with abdominal pain, nausea and a growing abdominal swelling since 1.5 years. A tumoral mass was palpated on physical examination. Abdominal ultrasound and computed tomography revealed a 33 x 26 x 15 cm cystic mass filling the abdominal cavity. The origin of the tumor could not be detected. Operation revealed a giant cystic mass arising from an accessory ovary. Histopathologic diagnosis was serous cystadenoma. Conclusion Ovarian or accessory ovarian pathologies must be considered in the differential diagnosis of intraabdominal tumors, especially in young female population.Öğe Intravenous leiomyomatosis of uterus: A case report(De Gruyter Open Ltd, 2006) Atik, Esin; Altintas, Suleyman; Akansu, Bulent; Zeteroglu, Sahin; Gungoren, ArifIntravenous leiomyomatosis is an uncommon variant of uterine leiomyomas. These tumors originate from smooth muscle cells of veins or lymphatics. Generally, they can't be diagnosed before surgery. Both gross and histopathological findings are important for diagnosis. Growing into the right ventricle through inferior vena cava may be seen in some of the cases. Benign cystic lung metastases have been also reported. In this article, a 42 year-old woman who had 3 children applied to our outpatient clinic of gynecology with pelvic pain and abnormal menstrual bleeding which had started 7 years ago, is presented. In physical examination uterus was palpated as hard, painful, and abnormally large. Total abdominal hysterectomy and unilateral salphingo-oophorectomy was performed with myomatosis uteri prediagnosis. During operation, frozen section specimen was diagnosed as intravenous leiomyomatosis. By presenting this case, we aim both to emphasize the importance of post-diagnosis follow-up of patients, and also evaluate intravenous leiomyomatosis in the light of literature.Öğe The Investigation of the Association Between the Frequency of Trichomonas Vaginalis and Using Intrauterine Contraceptive Device(Aves Yayincilik, Ibrahim Kara, 2009) Duran, Nizami; Culha, Guelnaz; Hakverdi, Ali Ulvi; Gungoren, ArifObjectives: We investigated the association between the frequency of Trichomonas vaginalis and using intrauterine contraceptive device (IUD). Patients and Methods: A total of 1058 vaginal swab samples were collected. The study population included 402 symptomatic and 656 asymptomatic women, between 18-45 years of age. Specimens were taken with a speculum and sterile cotton swabs from the posterior fornix of the vagina. Wet mount preparations were examined first, and then inoculated into Trypticase-yeast extract-maltose medium. Results: T vaginalis was determined in 35 (3.31%) samples out of 1058 specimens using both diagnostic methods (direct examination and/or culture). While a total of 402 women were symptomatic, 656 women were asymptomatic. Among 190 IUD users, the frequency of T vaginalis was determined as 6.84%, and among 868 non-users, this ratio was determined as 2.53%. Moreover, while among 100 symptomatic women with IUD, 11 women were positive for T vaginalis (11%), of the 302 symptomatic women without IUD, 17 were positive (5.63%) for T vaginalis. Significant correlation was determined between the use of IUD and the presence of T vaginalis (p<0.05). Conclusion: These results showed that IUD use may increase the growth of T vaginalis in the vaginal mucosa. To reduce the incidence of this pathogen in IUD users, they should be followed up closely.Öğe Massive Edema of the Ovary: Case Report(De Gruyter Open Ltd, 2010) Akansu, Bulent; Atik, Esin; Altintas, Suleyman; Gungoren, Arif; Canda, M. SerefettinMassive ovarian edema is a rare condition characterized by marked enlargement of one or both ovaries as a result of accumulation of edema fluid in stroma. It is a benign lesion and is generally seen in young females between 6-33 years of age. Our aim is to remind that massive ovarian edema should be considered in the differential diagnosis especially in young patients to avoid aggressive treatment. Our patient was a 17-year-old female who was admitted to our hospital with complaints of irregular menstruation and right groin pain for the last 3 months. There was no remarkable finding in the physical examination. 'Sex-cord stromal tumor (luteinized thecoma)' could not be excluded in the intraoperative frozen section. The diagnosis was reported as 'massive ovarian edema' with routine examination. Pathological evaluation is required because of the difficulty of differentiating these lesions from malignant lesions with radiological methods in the pre-operative period. Although it is a rare lesion, clinicians and pathologists should consider it in the differential diagnosis to avoid aggressive treatment.Öğe MUCINOUS CYSTADENOMATOGETHER WITH ENDOMETRIOMA: CASE REPORT(Galenos Yayincilik, 2008) Gungoren, Arif; Kakverdi, Sibel; Hakverdi, Ali Ulvi; Karazincir, Sinem; Karapinar, SoyluEndometriosis effects 2-5 % of women at reproductive age. Malignant transformation of endometrioma is around 2.5 %. Ovarian mucinous tumors constitute approximately 10 % of all ovarian neoplasms. 35-year-old woman with gravida 0 parite 0, admitted with pelvic pain for two days, to our hospital. She had laparoscopic surgery for right ovarian cyst nine years ago, the pathological examination of which was endometrioma. Gynecological examination of patient revealed semisolid masses about 6 cm in diameter in bilateral ovaries. CA-125 and CA-19,9 were found 121.5mIU/L, 127.3mIU/L, respectively other tumor markers were within normal levels. After her approval bilateral ovarian cyst excision with laparotomy was carried out. Pathological examination demonstrated mucinous cystadenoma in the right ovary and endometrioma in the left ovary. Ovarian ephitelial malign tumors can be found together with endometrioma. Epithelial metaplastic transformation, especially ciliated cell and eosinophilic transformation were often reported, whereas hobnail and mucinous transformation were reported rarely in ovarian endometriosis. Mucinous metaplasia and hyperplasia in ovarian endometriosis might be closely associated with the development of mucinous borderline tumors. We didn't find mucinous cystadenoma reported together with endometrioma in literature.Öğe Seroprevalence of Toxoplasma gondii, rubella and cytomegalovirus among pregnant women in southern Turkey(Informa Healthcare, 2007) Ocak, Sabahattin; Zeteroglu, Sahin; Ozer, Cahit; Dolapcioglu, Kenan; Gungoren, ArifPrimary infections caused by Toxoplasma gondii, rubella and cytomegalovirus (CMV) can lead to serious complications in pregnant women. The aim of this study was to determine the seroprevalence of Toxoplasma, rubella and CMV infections through antenatal screening. In this study, the consecutive records of 1652 pregnant women examined between the period March 2004 to January 2006 were included. The results of the antenatal screening for Toxoplasma, rubella and CMV during the first trimester of pregnancy were evaluated. Anti-Toxoplasma, anti-rubella and anti-CMV IgG and IgM antibodies were assayed using an enzyme linked immunosorbent assay method. Of the 1652 pregnant women tested, anti-Toxoplasma IgG antibody was found in 860 (52.1%) of the cases, while 9 (0.54%) of the subjects tested positive for anti-Toxoplasma IgM. Anti-rubella IgG and IgM antibodies were reactive in 1570 (95.0%), and in 9 ( 0.54%) of the tested women, respectively. Moreover, 1568 (94.9%) of them were found to be positive for anti-CMV IgG, while 7 (0.4%) tested positive for anti-CMV IgM. Consequently, because of the high seropositivity of T. gondii, rubella and CMV in the pregnant women, the country's health authorities should be alerted, and preventive measures should be taken.Öğe Sigmoid colon cancer presenting with ileus in pregnancy: Two case reports(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2008) Temiz, Muhyittin; Aslan, Ahmet; Hakverdi, Sibel; Gungoren, Arif; Canbolant, ElifColorectal cancer during pregnancy is very rare with the reported incidence of between 0.001-0.1%. The prognosis is poor due to delayed diagnosis and secondary advanced disease. Acute abdomen due to sigmoid colon tumor is extremely rare. We report two cases presenting with ileus due to sigmoid colon cancer during pregnancy. Two women 35 and 32 years old with 32nd and 27th week of pregnancy respectively, presented with abdominal pain, obstructive symptoms and ileus. Exploratory laparotomy revealed obstructive sigmoid colon cancer in both. Extended mesocolon dissection was not possible in one of the cases due to enlarged size of the uterus. In the same case lumen of the colon was filled with polipoid lesions. Acute abdomen due to sigmoid colon tumor in pregnancy is extremely rare and the tumor can be easily missed if a complete routine exploration of the abdomen is not performed during surgery. Currently a high index of clinical suspicion is the only way to make the diagnosis.
