Biomedical subjects

Mehmet Erdem

Publications and source records attributed to Mehmet Erdem.

25 records · Page 2Linked to original sources

PubMed2003

Single-dose methotrexate for the treatment of unruptured ectopic pregnancy.

OBJECTIVE: The objective of this study was to review our experience with single dose intramuscular methotrexate (MTX) for the treatment of ectopic pregnancy and to evaluate major confounding factors that relate to the success of therapy. PATIENTS AND METHODS: The selection criteria were patients who had a stable hemodynamic status and an ectopic gestational mass of <4 cm. on ultrasound. Patients were not excluded from MTX therapy either by a baseline serum beta-hCG titer or by the presence of fetal cardiac activity demonstrated on ultrasonography. Thirty- four of 86 patients diagnosed with ectopic pregnancy and treated with single-dose MTX between July 1999 and November 2001 were reviewed retrospectively. RESULTS: The mean pre-treatment beta-hCG level was 2,490+/-2,912 mIU/ml. Twenty-two patients (73.3%) were successfully treated with a single-dose of MTX. Eight patients (26.6%) required a second dose 1 week after the first injection and 2 patients received three doses. Thirty of the 34 patients (88%) were successfully treated with MTX. The mean pre-treatment beta-hCG level was significantly lower in patients who were successfully treated with MTX than in patients who failed MTX therapy (1,932+/-2,361 mIU/ml vs. 6,955+/-2,690 mIU/ml respectively, p<0.05). The mean pre-treatment serum beta-hCG level was higher in patients who had a second MTX injection as compared to patients who were successfully treated with a single injection of MTX (3,272+/-3,551 mIU/ml vs. 1,280+/-2,273 mIU/ml respectively, p>0.05). The mean time to resolution of beta-hCG was 26.5 days (10 to 37 days) with MTX. All 3 patients who failed medical therapy had beta-hCG level >4,000 mIU/ml and 2 of them had positive fetal cardiac activity. CONCLUSION: In conclusion, this study showed that medical treatment of ectopic pregnancy with systemic single-dose methotrexate seems to be an option for some patients with unruptured tubal pregnancy.

Abortifacient Agents, Nonsteroidal↗

PubMed2003

Angiogenesis, p53, and bcl-2 expression as prognostic indicators in endometrial cancer: comparison with traditional clinicopathologic variables.

We investigated the relation of expression of tumor-suppressor gene product p53, apoptosis-regulator gene product bcl-2, and CD34 (as a measure of microvessel density [MVD]) with traditional clinicopathologic prognostic variables in endometrial carcinoma (histologic type, grade, depth of myometrial invasion, angiolymphatic invasion, lymph node involvement). In specimens from 63 patients with endometrial carcinoma, the mean MVD (64.38+/-28.71 microvessels per 200x field) was not related to any clinicopathologic variables. Nuclear p53 expression was detected in 15 (23.8%) patients and was higher in nonendometrioid carcinomas (p<0.05) and in tumors with increasing histologic grade (p<0.001). Cytoplasmic bcl-2 staining was seen in 79.3% of the tumors. There was a negative correlation between bcl-2 expression and histologic type and tumor grade (p<0.05). In survival analysis, patient age, FIGO stage, high expression of p53, low expression of bcl-2, and high and intermediate MVD values were found to be the most significant prognostic indicators of survival (p<0.05). In multivariate regression analysis, FIGO stage and low bcl-2 expression were found to be the only independent indicators of prognosis (p<0.05).

Adenocarcinoma↗

PubMed2003

Maternal and fetal plasma endothelin levels in intrauterine growth restriction: relation to umbilical artery Doppler flow velocimetry.

The objective of this study was to examine maternal and fetal endothelin-1 (ET-1) in pregnancies complicated with intrauterine growth restriction (IUGR) and to correlate these data with umbilical artery Doppler flow velocity waveforms (FVW). Higher mean maternal (13.8 +/- 6.4 vs 9.2 +/- 3.4 pmol/L, p < 0.05) and fetal (18.5 +/- 9.6 vs 11.7 +/- 6.9 pmol/L, p < 0.05) ET-1 levels were found in pregnancies complicated with IUGR than in controls. Fetal ET-1 level was related to birth weight percentile for gestational week. Maternal and fetal ET-1 concentrations were not related to umbilical artery Doppler flow S/D ratio, PI and RI. Maternal or fetal ET-1 concentrations were also not related to umbilical artery pH, PO2 and PCO2. Pregnancy-induced hypertension was significantly associated with an elevated fetal and maternal ET-1 concentration. In conclusion, increased production and secretion of ET-1 may play a role in the pathophysiology of idiopathic IUGR. Over-production of ET-1 in IUGR is not associated with increased placental resistance as reflected in abnormal umbilical artery Doppler FVW.

Birth Weight↗

PubMed2002

Detection of Helicobacter pylori seropositivity in hyperemesis gravidarum and correlation with symptoms.

The aim of this study was to investigate whether there was a relationship between H. pylori (Helicobacter pylori) infection positivity and characteristics (time and duration) of hyperemesis gravidarum (HG) symptoms. Forty-seven pregnant women with HG and 39 pregnant controls at the same gestational weeks without any gastrointestinal symptoms were included in this prospective study. H. pylori serum Immunoglobulin (Ig) G concentrations were determined by enzyme-linked immunoadsorbent assay (ELISA) in patients with HG and controls. Positive serology for H. pylori was correlated with the duration of symptoms in patients with HG. The prevalence of H. pylori infection was 85.1% (40 of 47) and 64.1% (25 of 39) in patients with HG and controls, respectively (p <0.05, chi (2) test). Mean values of H. pylori IgG (+/- standard deviation) were significantly higher in patients with HG than in controls (22.66 aIU/mL +/- 22.34 vs. 11.54 aIU/mL +/- 13.89, p <0.01, Student's t-test). In HG group, time (gestational weeks) and the duration (weeks) of HG symptoms for patients serologically positive and negative for H. pylori were 6.95 +/- 1.55 versus 6.58 +/- 1.78 weeks, (p >0.05, Student's t-test) and 8.35 +/- 5.28 versus 11.40 +/- 7.17 weeks (p >0.05, Mann-Whitney U-test), respectively. There was no correlation between duration of HG symptoms and serum H. pylori IgG concentrations. Although a majority of pregnant women with HG were serologically positive for H. pylori infection, there was no correlation between positive serology and duration of symptoms, which is not suggestive of a direct causal relationship between H. pylori infection and HG.

Adult↗

PubMed2002

Age-related changes in ovarian volume, antral follicle counts and basal FSH in women with normal reproductive health.

OBJECTIVE: To investigate the relation between ultrasound-based ovarian volume and antral follicle counts and hormonal parameters of ovarian reserve in a group of women with normal reproductive health. STUDY DESIGN: Prospective study. One hundred eight women with at least one previous pregnancy reaching term were divided into three age groups (group 1 = 35-39 years, group 2 = 40-44 years, and group 3 = 45-50 years). Basal hormone measurements and transvaginal ultrasonography estimation of ovarian volume and follicle counts were performed in the early follicular phase (day 3) of the menstrual cycle. RESULTS: There were significant differences in FSH (P < .0001) and E2 (P < .002) levels when group I was compared to groups II and III. There was a significant decrease in mean follicle counts (MFC) between groups I and III (P < .05). The decrease in mean ovarian volume (MOV) with age was not statistically significant. Age strongly correlated with MFC (r = -.38, P < .001) and weakly with MOV (r = -.29, P < .05). However, basal FSH correlated positively with age (r = .50, P < .001) and negatively with MOV (r = -.590, P < .001) and MFC (r = -.658, P < .001). Basal E2 correlated with MOV (r = .50, P < .001) and MFC (r = .50, P < .001). There was also a strong positive correlation between MFC and MOV (r = .777, P < .001). CONCLUSION: There was a decrease in MOV and MFC with aging coincident with increasing basal FSH levels after age 35 in women with normal reproductive health.

Adult↗

PubMed2002

[Treatment of residual obstetrical brachial plexus palsy with tendon transfer].

OBJECTIVES: We evaluated the results of the correction of adduction and internal rotation deformities of the shoulder associated with residual obstetrical brachial plexus palsy (OBPP) by the transfer of latissimus dorsi and teres major muscles to the rotator cuff. METHODS: In order to correct adduction and internal rotation deformities associated with residual OBPP, 10 patients (7 males, 3 females; mean age 8.1 years; range 4 to 19 years) underwent transfer of the latissimus dorsi and teres major muscles to the rotator cuff and lengthening of the pectoralis major tendon with Z-plasty. The right and left extremities were affected in seven and three patients, respectively. Involvement of the C5-C6 nerve roots was detected in four, and C5-C6-C7 nerve roots in six patients. In two patients with a positive Putti sign, axillary roentgenograms showed posterior subluxation of the humeral head, and magnetic resonance and computed tomography scans revealed type III glenohumeral deformity. Functional evaluations were made using a 5-point scoring system proposed by Mallet. The mean follow-up was 23.6 months (range 5 to 42 months). RESULTS: Postoperatively, the mean abduction and external rotation were 134.5 degrees (range 95 degrees to 170 degrees ) and 70 degrees (range 45 degrees to 90 degrees ), respectively. The mean global abduction score was 4, external rotation score was 4.2, and the scores assigned to the ability to move hand to the neck and mouth were 3.5. Of two patients with type III glenohumeral deformity, whose ages were four and 19 years, abduction and external rotation were 150 degrees and 45 degrees in the former, 135 degrees and 70 degrees in the latter, respectively. CONCLUSION: The transfer of the latissimus dorsi and teres major tendons is a necessary procedure to restore external rotation and abduction functions of paralysed shoulders. Compared to other techniques employed, it offers obvious advantages in terms of ease and cost, as well.

Adolescent↗

PubMedDate not supplied

Immunohistochemical localization of endothelin-1 in human placenta from normal and growth-restricted pregnancies.

The purpose of this study was to investigate whether the localization of endothelin-1 (ET-1) immunoreactivity differs in human placental tissues from third-trimester normal and intrauterine growth restricted (IUGR) pregnancies. Immunohistochemistry for ET-1 was performed on human placentas from 30 IUGR and 30 uncomplicated pregnancies matched for gestational age. The distribution and intensity of ET-1 immunoreactivity was assessed by a semiquantitative scoring system. Doppler flow velocity waveform analysis of the umbilical artery was performed in each patient before delivery. ET-1 was localized diffusely in placental specimens from normal and IUGR pregnancies. The localization of ET-1 immunoreactivity was significantly higher in the capillary endothelial cells of villi as well as in the endothelial, decidual, and trophoblastic cells of the basal plate in placentas from normal pregnancies than from IUGR pregnancies. There was no significant difference in placental ET-1 immunoreactivity between IUGR pregnancies with normal and abnormal umbilical artery Doppler flow velocity waveforms. Placental ET-1 immunoreactivity was significantly higher in the decidual and trophoblastic cells of the basal plate and the capillary endothelial cells of villi in normal pregnancies than in IUGR pregnancies with normal umbilical artery Doppler flow velocity waveforms. However, only the decidual and trophoblastic cells of the basal plate demonstrated significantly higher abundant localization of ET-1 immunoreactivity in normal pregnancies than in IUGR pregnancies with abnormal umbilical artery Doppler flow velocity waveforms. In conclusion, our findings suggest that the lower expression of ET-1 in placental tissues from IUGR pregnancies might be secondary to an adaptive mechanism to reduce the vasoconstrictor effect of ET-1.

Adult↗