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Biomedical subjects

O Gokmen

Publications and source records attributed to O Gokmen.

At least 19 recordsLinked to original sources
PubMed2001

Intravenous albumin versus hydroxyethyl starch for the prevention of ovarian hyperstimulation in an in-vitro fertilization programme: a prospective randomized placebo controlled study.

A prospective randomized placebo controlled clinical trial was carried out on 250 patients (cycles) considered at risk of developing OHSS in an IVF programme. Criteria for inclusion were: estradiol value of more than 3000 pg/ml or the presence of more than 20 follicles on the day of hCG administration. Patients were randomized by using a random table to receive either 20% human albumin 50 ml (n: 82); 6% hydroxyethyl starch (200/0.5) 500 ml (n: 85) or a placebo of 500 ml 0.9% NaCl solution (n: 83) over 30 min during oocyte collection. Groups were similar with respect to patients' age, estradiol levels on hCG day, body mass index, number of oocytes retrieved, number of embryos transferred and pregnancies (P>0.05). There was no severe OHSS in patients who received albumin and HES while four patients who received placebo developed severe OHSS. On the other hand moderate OHSS was encountered in four patients in the albumin group; five patients receiving HES; and 12 patients receiving placebo. There was a statistically significant difference in the incidence of moderate, severe and overall OHSS among groups (P values of <0.05, <0.05, and <0.01, respectively). Both HES and albumin significantly reduced the incidence of moderate, severe and overall incidence of OHSS. It is concluded that hydroxyethyl starch is a cheaper and safer alternative to Human Albumin in OHSS prevention.

Adult↗
PubMed2000

In vitro differentiation of human endometrial stromal cells: effect of transforming growth factor beta 1 on prolactin secretion.

OBJECTIVE: To investigate the role of Transforming Growth Factor beta 1 on differentiation of human endometrial stromal cells. STUDY DESIGN: A prospective study. MATERIAL AND METHODS: Human endometrial cells obtained from 9 women were cultured in DMEM-HAMs F12 media to adequate cell confluence and then the flasks were cultured in the presence and absence of TGF b 1. The influence of TGF beta 1 were measured by prolactin production expressed as nanograms of prolactin/mg of total DNA in cells measured by diphenylamine reaction. RESULTS: The levels of prolactin in the culture medium with and without TGF beta 1 were 0.16 +/- 0.27 ng/microgram DNA/day and 0.24 +/- 0.41 ng/microgram DNA/day respectively. There was no significant difference between groups. CONCLUSION: There is no direct effect of TGF beta 1 on differentiation of human endometrial stromal cells. However it may involve in more complex relationship in this process.

Adult↗
PubMed1998

Color Doppler ultrasonography in the earlier differentiation of benign molehydatidiforms from malignant gestational trophoblastic disease.

BACKGROUND: To find out the effectiveness of color Doppler ultrasonography of the uterine arteries in the differentiation of benign molehydatidiforms from malignant gestational trophoblastic disease. METHODS: Prospective study was performed in 32 women who were referred to the Oncology Department with the diagnosis of gestational trophoblastic disease. Uterine artery Doppler studies were made and resistance index for both uterine arteries were calculated. In the follow-up, twelve of these patients required chemotherapy (first group) and 20 of them were treated with only suction curettage (second group). Non parametric Mann Whitney U test was used for the statistical analysis. RESULTS: Median of the lowest uterine artery resistance index were 0.29 for the first group and 0.46 for the second group. Resistance index were significantly lower in the first group (alpha<0.001). Color Doppler study of the uterine arteries is helpful in the differentiation of benign molehydatiforms from malignant gestational trophoblastic disease.

Adult↗
PubMed1997

Influence of anterior colporrhaphy with colpoperineoplasty operations for stress incontinence and/or genital descent on sexual life.

The effect of anterior colporrhaphy and colpoperineoplasty operation for stress incontinence and/or genital descent on sexual life was studied in 44 women. All sexually active cases prior to the operation for stress incontinence and/or genital descent were evaluated by interview and gynaecological examination immediately before and six months after the operation. Prior to the operation, 30 out of 44 patients (68.2%), found their sexual life unsatisfactory because of various reasons like urinary incontinence, genital descent, vaginal relaxation and urinary incontinence during intercourse. Postoperatively, 20 (66%) of these 30 patients improved, 4 (14%) showed no change and 6 (20%) deteriorated. Twelve of 14 (86%) patients who found their sexual life satisfactory before the operation described no change and 2 (14%) experienced deterioration postoperatively. Overall, 8 patients described deterioration postoperatively and all complained of dyspareunia. Colpoperineoplasty in combination with anterior colporrhaphy might cause dyspareunia in some patients. Colpoperineoplasty may increase the disturbances due to the atrophic changes related to menopause and should therefore be done selectively.

Adult↗
PubMed1996

Intravenous albumin prevents moderate-severe ovarian hyperstimulation in in-vitro fertilization patients: a prospective, randomized and controlled study.

OBJECTIVE: To assess the effectiveness of intravenous administration of albumin in prevention of ovarian hyperstimulation syndrome (OHSS) in patients of an in-vitro fertilization program. STUDY DESIGN: Prospective randomized study. Patients with hCG day E2 levels are 11010 pmol/l (3000 pg/ml) or more were recruited into two groups. Group A (n = 27) received 10 g 20%, 50 ml human albumin infusion before oocyte pick-up and no medication was administered in Group B (n = 28). RESULTS: Patients were similar in terms of cycle characteristics. No moderate-severe OHSS developed in Group A whereas one severe OHSS case and four moderate OHSS cases developed in Group B. Statistical analysis revealed a significant (P < 0.05) protection in albumin treated group. CONCLUSION: Human albumin proves effectiveness in prevention of moderate-severe OHSS.

Adult↗
PubMed1996

Transvaginal sonographic diagnosis of ovarian endometrioma.

OBJECTIVE: To assess the efficacy of transvaginal sonography (TVS) in differentiating endometriomas from other adnexal masses. METHODS: One thousand thirty-five adnexal masses undergoing laparoscopy or laparotomy were evaluated prospectively using TVS. Masses diagnosed as endometrioma according to their sonographic appearance were divided into two groups: those with a round shape, regular margins, thick walls and homogeneous, low-level echoes (group A); or those with irregular margins, internal septations and an anechoic appearance (group B). RESULTS: The sensitivity of TVS in diagnosing endometriomas was 86.50% and the specificity 99.11%. The positive predictive value (PPV) and the negative predictive value of the test were calculated to be 91.45% and 98.14%, respectively. By using the criteria determining group A, the PPV of the test increased to 97%, whereas group B had a lower PPV (70.85%). CONCLUSION: We propose that the accuracy of TVS in diagnosing endometriomas may be beneficial in various clinical conditions.

Adnexal Diseases↗
PubMed1996

Demographic and epidemiologic features of female adolescents in Turkey.

OBJECTIVES: To determine the average menarcheal age and menstrual cycle pattern, prevalence of dysmenorrhea, frequency of smoking, alcohol and drug use, sexual education level, and the gynecologic problems in female adolescents in Turkey. METHODS: A questionnaire consisting of 43 questions were given to 13,665 high school girls between the ages 13-18 years. RESULTS: The results showed that average menarcheal age was 13.28 +/- 1.09 years and 77.8% of the girls had menstrual cycles between 20-35 days; 10,688 (78.1%) of the girls complained about pain during their menstruation and 25.6% frequently missed school for this reason. That notwithstanding, only 0.4% of the adolescents with dysmenorrhea had sought medical consultation. Out of 13,665 girls, 19.7% smoked cigarettes, 14.9% used alcohol, and 0.63% used other drugs. Although 50.8% of the students believed that their knowledge about sexuality was adequate, on evaluating the results, this was not confirmed. Girlfriends were found to be the most important source of sexual knowledge. The study indicated that 88.8% of the girls wanted to have sexual education at schools and 60.5% of those preferred to take such a lecture together with boys. The study also revealed that 10.5% of the girls previously consulted a gynecologist and menstrual disorders (26.1%) and dysmenorrhea (23.4%) were the most common complaints. The results showed that 68.7% of the girls preferred a woman gynecologist and 66.3% wanted to be alone with the doctor during examination. CONCLUSION: We provided data about demographic and epidemiologic features of Turkish female adolescents.

Adolescent↗
PubMed1996

Prophylactic vasopressin during laparoscopic salpingotomy for ectopic pregnancy.

STUDY OBJECTIVE: To evaluate the safety and efficacy of prophylactic mesosalpingeal vasopressin injection for hemostasis during laparoscopic salpingotomy for ectopic pregnancy. DESIGN: Prospective, randomized clinical study. SETTING: Reproductive endocrinology and endoscopic surgery clinic of a tertiary care hospital. PATIENTS: Forty women with ectopic pregnancy. INTERVENTIONS: Laparoscopic linear salpingotomy was attempted, with prophylactic mesosalpingeal dilute vasopressin injection in 20 patients (study group), and without vasopressin in 20 patients (control group). The two groups were similar with regard to age, size of ectopic pregnancy, gestational age, and initial beta-hCG values. A multipuncture operative laparoscopy technique was used in all cases and bipolar electrocoagulation was used for hemostasis. MEASUREMENTS AND MAIN RESULTS: The operating time was significantly shorter and the need for electrocoagulation was significantly less in the study than in the control group (p <0.05). Laparoscopic salpingotomy was performed successfully in 85% of study group patients compared with 70% of controls (p >0.05). Postoperative hysterogram revealed patency of the affected tube in 76.5% of women in the study group compared with 57.1% of controls (p >0.05). Possible complications of vasopressin, such as hypertension, bradycardia, and delayed bleeding, did not occur in any patient. CONCLUSIONS: Vasopressin use reduces both operating time and the need for electrocoagulation for hemostasis, which can have undesirable effects on the tube. Vasopressin was not associated with side effects in this relatively small sample.

Adult↗
PubMed1996

The effect of intravascular transfusion for severely anemic fetuses on umbilical artery Doppler flow velocity waveforms.

BACKGROUND: To evaluate whether the doppler flow velocity waveforms reflect the fetal hematocrit and to assess the changes of the umbilical artery doppler indices before and after the puncture of the umbilical cord. MATERIAL AND METHODS: In this prospective-study, Pulsed-Doppler examinations of blood flow velocities in the umbilical artery were carried out before and after 22 diagnostic cordocentesis and 14 fetal blood transfusions into the umbilical vein. RESULTS: There were decreases in the systolic/diastolic ratio (p < 0.001), the pulsatility index (PI)(p < 0.001), and the resistance index (RI)(p < 0.003) after cordocentesis but not after fetal blood transfusion. There were no correlations between the initial hematocrit and the umbilical artery doppler indices in both fetal blood transfusion group and fetal blood sampling group. There was no correlation between the increase in hematocrit and changes in umbilical artery blood-velocity waveform indices following fetal blood transfusion. The umbilical artery doppler flow-velocity indices did not predict the fetal hematocrit. CONCLUSION: These findings suggest that acute changes in blood viscosity following intravascular transfusion are not associated with an increase in resistance to flow as assessed by doppler velocimetry. Umbilical blood sampling per se may be associated with a humorally mediated reduction in placental vascular resistance to flow.

Blood Transfusion, Intrauterine↗
PubMed1996

The efficiency of ultrasonography in the diagnosis of dermoid cysts.

The aim of the study was to assess the efficiency of sonography in differentiating dermoid cysts of the ovary (mature cystic teratoma) from other adnexal masses. It was carried out prospectively at Dr. Zekai Tahir Burak Women's Hospital of Ankara, Turkey. 943 women with 1035 adnexal masses who had undergone laparotomy and/or laparoscopy between January 1989 and March 1995 were included into the study group. All of these patients had a sonographic preoperatively examination within one week of surgery and the sonographic diagnosis was compared to histopathological findings. The visualization of: 1. echogenic mass with or without acoustic shadowing or enhancement (assumed to represent sebum with lipophilic contaminants or with hair) 2. Dermoid plug; layered lines and dots; fat-fluid level; isolated brigth echogenic foci with acoustic shadowing within the complex mass (assumed to represent Rokitansky protuberance; hair in low viscosity fluid; sebum as a supernatant of serous fluid; teeth or bone fragments respectively) 3. intraovarian echogenic mass with or without acoustic shadowing or enhancement (assumed to represent intraovarian dermoid cyst) were chosen as characteristical sonographic findings of dermoid cysts. Combining these with the subjective visual assessment of the operator, the sensitivity and the specificity were calculated for each visualized adnexal mass to assess the efficiency of sonography in differentiating dermoid cysts from other ovarian masses. All in all 1035 adnexal masses were visualized, 155 were suspected to be dermoid cysts and the diagnosis was confirmed by histopathology in only 147 cases. The sensitivity and specificity of sonography were 94% and 99% respectively. As a conclusion this study demonstrates that ultrasonography has an accuracy of 98% in differentiating dermoid cysts from other adnexal masses with a specificity of 99%.

Adolescent↗
PubMed1995

Twin sisters with impetigo herpetiformis.

Impetigo herpetiformis is a rare and serious pustular eruption resembling pustular psoriasis that mostly occurs in pregnant women. The etiology of the disease is unclear and it is not known if genetic factors play a role. We present two sisters (twins) with impetigo herpetiformis supporting an inheritance pattern.

Adult↗
PubMed1995

Vaginal thrush and its management in pregnancy.

The frequency of vaginal thrush was determined in an unselected group of patients attending the antenatal clinic. Diagnosis was based on phase-contrast microscopy and culture. One hundred and two patients were initially included but only 98 completed this study. Thrush infection was detected in 25 (25%) patients. All 25 patients underwent treatment with one vaginal ovule containing 400 mg ketoconazole on each of three successive evenings. Thrush attack was eliminated in 23 (92%) cases. In view of the virtual absence of clinical symptoms, the recommendation to undertake general screening for thrush in pregnancy is discussed. The efficacy of treatment with ketoconazole ovules was studied and the results of treatment were reviewed after 4 and 8 weeks. Recurrence or re-infection has to be considered in pregnancy so that thrush treatment should sensibly be undertaken in the third trimester unless subjective symptoms indicate the need for earlier therapy.

Candidiasis, Vulvovaginal↗
PubMed1994

The hormonal profile in ectopic pregnancies.

We prospectively investigated the maternal serum level of beta- human chorionic gonadotropin (beta-hCG) progesterone (P), estradiol (E2), human placental lactogen (HPL), alfa-fetoprotein (AFP) and cancer antigen 125 (CA 125) during the first trimester of normal and abnormal pregnancies. Serum samples were obtained from 20 women with normal intra-uterine pregnancy (IUPs). Fifteen whose pregnancies were complicated with spontaneous abortion and 31 with surgically and pathologically confirmed ectopic pregnancies (EPs). The mean serum levels of beta-hCG, E2 and P in patients with Eps (9490.55 +/- 3071.2 mIU/ml, 100.1 +/- 22.09 pg/ml, 4.18 +/- 1.19 ng/ml, respectively) were significantly lower than those measured in normal IUPs (73796.8 +/- 15554.7 mIU/ml, 500.15 +/- 98.84 pg/ml, 19.2 +/- 2.8 ng/ml respectively (p < 0.001) and significantly lower than in patients with spontaneous abortion (22524 +/- 6213 mIU/ml, p < 0.05, 339.8 +/- 112.16 pg/ml, p < 0.01, 10.59 +/- 3.03 ng/ml, p < 0.05 respectively). No significant difference was recorded with respect to serum levels of HPL, AFP and CA 125 among the groups. We also investigated the diagnostic value of simple E2 and P in patients with EPs. We could not identify a discriminatory cutoff value because there was a considerable overlap in serum P ans E2 levels between the patients with IUPs and EPs. In conclusion, it is not possible to define a cutoff discriminatory value of P and E2 that completely separates ectopic from IUPs, but the addition of these assays to the workup of a patient with suspected EP may facilitate the earlier diagnosis of EP.

Abortion, Spontaneous↗
PubMed1993

IUD (TCu380A) insertion following induced first trimester abortion.

In this study, 110 women (study group) who received an IUD (TCu380A) immediately after induced legal first trimester abortion were compared with 90 women (group 1) who started another type of contraception following legal abortion. Additionally, 100 women (group 2) who had an interval IUD insertion, were compared with both. In the study group, 3 (2.7%) patients were found to have an infection which did not fulfill the diagnostic criteria described by WHO and were treated easily by relevant antibiotics. One of 90 patients (1.1%) in group 1 developed acute PID after induced abortion within 7 days. None of group 2 patients had either a suspicion of pelvic infection or infection within the follow-up period (3 months). Among the women in the study group, bleeding and pain were not found to be more frequent, intense or of longer duration when compared with the other groups. Spontaneous expulsion of an IUD occurred in 2 patients (1.8%) of the study group and in 1 patient (1%) of group 2. At the end of the follow-up period, the continuation rates of the study group, group 1 and group 2 were 96.3%, 86.6%, 99%, respectively.

Abortion, Induced↗
PubMed1993

Pelvic inflammatory disease and intrauterine devices: prophylactic antibiotics to reduce febrile complications.

In the present study, we tried to determine whether IUD insertion related PID and febrile complications could be prevented by prophylactic use of antibiotics. We studied 300 patients who were admitted to our family planning clinic for IUD contraception. Of these, 150 patients received prophylactic Doxycycline (group 1) and the second 150 received no therapy (group 2). Five cases experienced fever with or without leucocytosis and none required hospitalization. PID was observed in one woman in each group. Positive culture (gonorrhea) was obtained in one woman who was then treated by relevant antibiotics; the other woman required hospitalization for two days. The overall infection rates for group 1 and 2 were 2.1% and 2.9%, respectively and this difference was not significant. The incidence of PID infection and febrile complications was found to be very low for both groups when compared to other studies, suggesting that aseptic conditions with proper insertion reduce the risk of infection.

Adult↗