Biomedical subjects

H Yarali

Publications and source records attributed to H Yarali.

17 recordsLinked to original sources

PubMed1992

The effect of short-interval laparoscopic lysis of adhesions on pregnancy rates following Nd-YAG laser photocoagulation of polycystic ovaries.

Laparoscopic Nd-YAG laser photocoagulation of the ovaries was performed in 40 anovulatory women with clomiphene citrate-resistant polycystic ovary disease. Following this procedure, the subjects were randomly assigned to have either a second-look laparoscopy with lysis of adhesions within 3-4 weeks of the initial laparoscopy (N = 19) or expectant management (N = 20). One patient assigned to the laparoscopy group refused the procedure. Minimal and mild adhesions that did not distort the normal tubo-ovarian relationship were encountered in 13 patients (68%) in the second-look laparoscopy group; these adhesions were easily lysed using sharp or blunt dissection. The pregnancy rates over 6 months were similar in the two groups (47% in the second-look group and 55% in the expectant-management group; P greater than .05). These data suggest that early laparoscopic lysis of adhesions does not improve short-term conception rates following laparoscopic Nd-YAG laser photocoagulation of polycystic ovaries.

Adult↗

PubMed1992

Infertility surgery: microsurgery.

Tubal and peritoneal factors continue to be a leading cause of infertility. In vitro fertilization, operative laparoscopy, and microsurgery are alternatives, but they are frequently complimentary therapeutic approaches. Proper investigation is the key to select the primary treatment modality. A well-performed hysterosalpingography is most valuable in the initial assessment of the tubes and uterus. Hysterosalpingosonography, radionuclide hysterosalpingography, and falloposcopy are experimental investigative tools that may be useful in selected circumstances. Effective adjuvants to reduce postoperative adhesions continue to elude the surgeon and new substances are being experimented with. In proximal tubal obstruction, selective salpingography and tubal catheterization may differentiate cornual spasm from pathologic tubal occlusion and may be therapeutic when viscous material or endotubal synechia are the cause of obstruction. Microsurgery remains the effective approach for significant lesions such as salpingitis isthmica nodosa, endometriosis, obliterative fibrosis, and chronic follicular salpingitis. Distal tubal occlusion is amenable to treatment via either laparoscopy or microsurgery. The functional status of the oviduct appears to be the most important prognostic factor in subsequent pregnancy outcome.

Fallopian Tube Diseases↗

PubMed1991

Endometrial carcinoma: a pathologic evaluation of 142 cases with and without associated endometrial hyperplasia.

The association of some cases of endometrial carcinoma (EC) with hyperestrogenism is well known. The prognostic significance of concomitant endometrial hyperplasia (EH) in EC were evaluated in 142 patients with clinical stage I EC in whom lymph node assessment was carried out in 121 patients. The presence of EH was significantly associated with better differentiated tumor having lesser degrees of myometrial invasion, low segment-adnexal-lymphovascular space and pelvic/para-aortic lymph node involvement. However, the presence of EH was not significantly associated with the less virulent histologic subtypes. The possible existence of two types of EC--a hormonal-dependent EC associated with EH, and an independent EC not associated with EH--is discussed and the prognostic significance of concomitant EH stressed.

Adenocarcinoma↗

PubMed1991

Prognosticators of second-look laparotomy findings in patients with epithelial ovarian cancer.

Prognosticators of outcome at second-look laparotomy (SLL) were evaluated in 49 patients with epithelial ovarian carcinoma undergoing SLL. Residual tumor volume was found to be the most significant prognosticator of outcome, with initial tumor stage being of secondary importance. Grade of tumor played no role in outcome at SLL. The results of the study led us to the conclusion that the second-look procedure may be safely omitted in stage I patients. The importance of optimal cytoreduction during primary surgery was stressed.

Carcinoma↗

PubMed1991

The value of human menopausal gonadotropin treatment in patients with unexplained infertility.

The role of multiple ovulation with human menopausal gonadotropin (HMG) in the treatment of unexplained infertility is evaluated. Of a total 73 patients with unexplained infertility, 39 received four cycles of HMG, whereas, 34 were left untreated. Eight (20.5%) women conceived during HMG treatment, in comparison to only 1 (2.9%) in the control group (P less than 0.05). This study gives further credit to the value of HMG treatment for unexplained infertility.

Adult↗

PubMed1991

Evaluation of adhesion formation after laparoscopic treatment of polycystic ovarian disease.

The incidence and fertility effects of postoperative adhesion formation after laparoscopic ovarian electrocautery or laser photocoagulation of polycystic ovaries has not been adequately analyzed. Short-interval second-look laparoscopy appears to be a useful method for addressing this issue. Employing short-interval second-look laparoscopy 3 to 4 weeks after the initial laparoscopic intervention, we were able to demonstrate adhesions in 6 of 7 patients (85%) treated with ovarian electrocautery and 8 of 10 patients (80%) submitted to laser therapy. The adhesions were amenable to laparoscopic lysis in 12 of 14 patients (85%). The subsequent conception rates within 6 months of second-look laparoscopy that were 57% and 40% in the electrocautery and the Nd:YAG laser groups, respectively, may in part be attributed to the restoration of normal pelvic anatomy during this procedure.

Adult↗

PubMed1991

Borderline epithelial ovarian tumours.

Twenty-four patients with borderline epithelial ovarian tumours treated in the Department of Obstetrics and Gynaecology of Hacettepe University during the last 12 years were evaluated with regard to histopathology, therapeutic modalities employed and outcome. No mortality was encountered among the 23 patients with Stage 1 disease, regardless of the surgical mode of treatment or adjuvant therapy. The related literature was reviewed briefly to help enlighten the controversial issue of borderline ovarian tumours.

Adult↗

PubMed1991

Evaluation of the functional status of the fallopian tubes in unexplained infertility with radionuclide hysterosalpingography.

The functional status of the Fallopian tubes in patients with unexplained infertility (UI) was evaluated with radionuclide hysterosalpinography (RN-HSG). The rate of bilateral tubal occlusion with RN-HSG in women with UI (3/18 = 16.7%) was considerably higher than in a group of fertile and male-infertile women (0/28 = 0%), implying that a number of cases with UI might be associated with functional rather than anatomical tubal defects. RN-HSG is a simple, innocuous and potentially useful method for assessing functional tubal occlusion, and it might give a better understanding of the functional status of the tubes in UI.

Fallopian Tube Patency Tests↗

PubMed1991

Radionuclide hysterosalpingography. A simple and potentially useful method of evaluating tubal patency.

A prospective study was undertaken to evaluate the efficacy of radionuclide hysterosalpingography (RN-HSG) using 99mTc-labeled human albumin microspheres to assess the patency of the fallopian tubes in 36 women (72 tubes). The study group consisted of 20 women with proven fertility undergoing laparoscopic tubal ligation, 8 with male factor infertility and 8 with bilateral isthmic tubal occlusion. All RN-HSG scan results were correlated with the findings at laparoscopy when tubal patency was ultimately assessed with chromopertubation. The sensitivity and specificity of RN-HSG were 100% and 94.6%, respectively. The positive predictive value (probability of occlusion when RN-HSG was positive) was 84%, whereas the negative predictive value (probability of no occlusion when RN-HSG was negative) was 100%. RN-HSG is a simple and potentially useful method of assessing the patency of the fallopian tubes.

Albumins↗

PubMed1991

Complications of radical hysterectomy in women with early stage cervical cancer: clinical analysis of 270 cases.

During a 25 year period, 270 cases of stage IB and IIA cervical cancer were subjected to radical hysterectomy and lymphadenectomy. The morbidity rate was 27.6% and mortality rate was 0.3%. While injuries to the great vessels were the most common intra-operative complications, the most frequent postoperative complications were in the urinary system. The leading causes of morbidity were bladder dysfunction (16.2%), urinary infection (5.9%), lymphocyst (6.4%) and wound infections (3.5%). While the overall complications seem high, the frequency of serious morbidity has diminished and radical hysterectomy now represents one of the accepted methods of treatment of cervical carcinoma, with good 5-year survival rates.

Adult↗

PubMed1990

Comparison of clinical and surgical-pathologic staging in patients with endometrial carcinoma.

In that accurate staging is essential to proper management of patients with endometrium cancer, preoperative clinical staging was compared with surgical-pathological staging in 160 patients with endometrium cancer. One hundred fifty-two patients had clinical stage I, and eight had clinical stage II disease. Overall, the clinical stage was changed in 26.9% of patients. The incidence of inaccurate staging was 25% for clinical stage I and 62.5% for clinical stage II disease. Endocervical curettage was found to have a 12.5% false-positive rate and an 8.6% false-negative rate. The extent of malignant disease for endometrium cancer (clinical stages I-II) cannot be adequately and accurately assessed with clinical staging because there is a high rate of discordance between clinical and surgical-pathologic staging.

Clinical Competence↗

PubMed1990

Predictors of recurrent disease after negative second-look laparotomy for epithelial ovarian cancer.

Twenty-four patients with epithelial ovarian cancer who had negative second-look laparotomy (SLL) were assessed in regard to recurrent disease. Four patients showed recurrence 11-36 months after negative SLL. All four patients had advanced stage and grade III tumors, with two having residual tumors greater than 1 cm in diameter after initial laparotomy. We believe that patients with advanced stage and high-grade tumors should receive some kind of treatment after negative SLL.

Adult↗

PubMed1990

An abdominal pregnancy 10 years after treatment for pelvic tuberculosis.

An abdominal pregnancy after treatment for female genital tuberculosis is presented. Early treatment after the diagnosis of female genital tuberculosis may restore fertility in the rare patient. Chemotherapy is the cornerstone of therapy. Ectopic pregnancies are common and should be ruled out to avoid catastrophic results.

Adult↗

PubMed1990

Beta-thromboglobulin and platelet factor 4 levels in pregnancy and preeclampsia.

The plasma levels of beta-thromboglobulin (BTG) and platelet factor 4 (PF-4) were measured in patients during the normal obstetric period and in preeclampsia. A significant increase was observed in the two proteins with respect to the nonpregnant control group. Both proteins increased significantly with preeclampsia and a further increment was observed with the severity of preeclampsia though no significant difference in PF-4 levels was encountered between pregnant and mildly preeclamptic women. There was no correlation between BTG, PF-4 and thrombocyte counts.

Adult↗

PubMed1990

Digoxin-like immunoreactive substance and preterm labor.

An endogenous digoxin-like substance (DLIS) that may be related to preterm labor has been studied. Using a commercially available radioimmunoassay kit. DLIS levels were determined in 110 women, of whom 33 were in preterm labor, 27 were in labor at term, 26 had normally ongoing pregnancies before term and were not in labor, and finally 24 were at term but not in labor. Mean DLIS levels of women in preterm labor was found to be significantly high (greater than 0.2 ng/ml, p less than 0.05). Whether this finding points to a causative role for DLIS in preterm labor remains to be further investigated.

Adult↗

PubMed1990

Serum and peritoneal fluid CA-125 levels in early stage endometriosis.

Serum and peritoneal fluid (PF) CA-125 levels were assayed using the immunoradiometric assay in 17 women with minimal endometriosis and 21 control women at the time of laparoscopy. Serum levels of CA-125 were not significantly higher in women with minimal endometriosis. Minimal endometriosis was diagnosed with a 70.6% rate of sensitivity and a 71.4% rate of specificity with 16 U/ml as the upper limit of normal. PF CA-125 levels were significantly higher than serum levels but showed no significant difference between control and endometriosis patients.

Adult↗

PubMed1989

Lymph node metastasis in early endometrium cancer.

The incidences of pelvic and paraaortic lymph node metastases in 106 patients with clinical Stage 1 endometrium cancer are presented. All patients were primarily surgically staged and treatment consisted of peritoneal cytology assessment, type II radical hysterectomy, bilateral salpingooophorectomy, pelvic and paraaortic total lymphadenectomy. Pelvic lymph node metastases were present in 15.1% and paraaortic lymph node metastases in 8.5% of the patients. Multiple prognostic factors were evaluated in respect to nodal status. This study adds credence to primary surgical staging with total pelvic and paraaortic lymphadenectomy regardless of presence or absence of the various risk factors.

Female↗