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Öğe A current method in gynecological cancer prediction: "Micronucleus": Review(OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S. aysea@turkiyeklinikleri.com Turkocagi Caddesi No. 30 Balgat 06520, 2016) Eser, Ayla Açar; Gürbüz, Neslihan; Kaygusuz, İkbal Cekmen; Canbal, Metin; Koş???us, Aydin; Köşüş, NerminPrediction and early diagnosis of cancer are vital in gynecology. Studies have shown that both micronucleus (MN) and micronucleus tests (MNT)s can be used to predict cancers. Approximately 92% of all of the human malignancies occur in epithelial tissues. The MN assay in exfoliated cells is an innovative genotoxicity technique which holds promise for the study of epithelial carcinogens. Micronuclei are usually produced during the metaphase/anaphase transition of mitosis. If the process of cell division is disturbed, the sharing of the genetic material to the two daughter nuclei may be affected. The same situation will also occur if the chromosomes are broken or damaged by radiation, drugs and chemicals. Under these conditions, the genetic materials that are not included in the nuclei of the daughter cells will then form its own "micronucleus". A MNT is a special toxicological test that is usually employed in screening chemical compounds that are potentially genotoxic. The main objective of the test is to identify those genotoxic agents, which are capable of modifying the structure and segregation of chromosomes, in a specific way that enables the induction of micronuclei in interphase cells. MNT is used to determine carcinogenic agents that are capable of triggering off a specific type of cytogenetic damage, which lead to the formation of micronuclei containing lagging chromosome fragments or whole chromosomes. Recently MNT began to be used in gynecology and will be one of the most important parameter in prediction, prognoses and response to treatment of cancer in the near future. © 2018 Elsevier B.V., All rights reserved.Öğe Amylase in obstetrics and gynecology: Review(OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S. aysea@turkiyeklinikleri.com Turkocagi Caddesi No. 30 Balgat 06520, 2016) Eser, Ayla Açar; Kaygusuz, İkbal Cekmen; Köşüş, Nermin; Koş???us, Aydin; İnegöl Gümüş, İlknurAmylase is one of the main enzymes of the digestive system. It is principally produced by the pancreas and the salivary glands. In the digestive system, its main function is digestion of carbohydrates to break down starch into maltose. Now, amylase has been widely recognized as a very important tool in the medical field. Too little or too much of amylase in the blood is an indication of a variety of problems, particularly with the pancreas. Now, salivary/serum/uterine amylase tests are being used extensively in the obstetrics and gynecology. These simple but wonderful tests have been found to be very effective and reliable, in the identification of certain gynecological diseases and disorders. For instance, the high level of amylase could be an early sign of ovarian cancer, ruptured ectopic pregnancy when the low levels of blood amylase can be a predictor of preeclampsia. Human uterine amylase may be related to infertility. The other related conditions may be hyperamylasemia in response to ritodrine or ephedrine and macroamylasemia in pregnant patients, etc. At the same time, amylase has now been identified as a stress marker and is consequently being used for identification of several stress-related complications that greatly affect women. Especially salivary amylase used to as a stress biomarker in pregnant patients. © 2018 Elsevier B.V., All rights reserved.Öğe Application of sentinel lymph node dissection in gynecologic cancers: Review(OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2015) Balci, Hatice; Koş???us, Aydin; Kaygusuz, İkbal Cekmen; Köşüş, Nermin; Eser, Ayla Açar; Altindiş, AyşeSentinel lymph node (SLN), where the primary tumoral lymphatic flow firstly ends is the place with the highest possibility of tumoral involvement in case of metastasis from the primary tumor. Therefore; according to the lymphatic mapping hypothesis, if the sentinel node is negative in terms of metastasis, non-sentinel nodes are also expected to be negative. Several techniques have been reported to identify the sentinel nodes. These are blue dye labeling, radio labeling and combined labeling that comprise sequential application of blue dye and technetium (tc) labeling. Blue dye is the general procedure when injected into damaged tissue intraoperativly to distinguish the tumor tissue. SLN dissection application is used in vulva and cervix cancers more commonly in gynecologic cancers. For this purpose, in cases where tc-labeled nanocolloid is used, SLN detection rate has been found 100%. It has been reported that SLN detection rate was 80-86% in cervical cancer, 50-80% in endometrial cancer and a little lower than those in vulva cancer. The method of SLN is consolidating its role in the diagnosis of vulvar and cervical cancer day by day. However, the most frequently encountered problems in the application of the SLN are the cases which found negative for metastasis in histopathological examination but understood to have micro level metastases at ultra-staging. The main prognostic factors in vulvar cancer is the nodal metastasis that independent from the primary tumor size. The conformity of routine use of SLN dissection without complementary lymphadenectomy is still controversial because inguinal region metastases is fatal in patients with vulvar carcinoma. However, most modern and promising future method is considering to be SLN biopsy. More studies are required for vulvar melanoma, vaginal, ovarial and endometrial cancers. © 2021 Elsevier B.V., All rights reserved.Öğe Bakri balloon application in postpartum haemorrhage(OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2015) Eser, Ayla Açar; Koş???us, Aydin; Aslaner, Sevgi Yildirim; İnegöl Gümüş, İlknur; Kaygusuz, İkbal Cekmen; Köşüş, Nermin; Hizli, DenizObjective: To evaluate effectiveness of Bakri Balloon in post-partum haemorrhage treatment. Post-partum haemorrhage is the most common cause of maternal death in the world. It is potentially fatal complication of both vaginal and caesarean deliveries. In situations where medical interventions are unsuccessful in achieving haemostasis in cases of post-partum haemorrhage, either conservative or invasive surgical therapies are needed. Ultimately hysterectomy may be required. Invasive surgical interventions are associated with co-morbidities and potential implications for future fertility. Among the more conservative interventions are intrauterine balloon tamponade such as the Bakri balloon. Material and Methods: In this retrospective, observational study, records of 25 patients who were treated for post-partum haemorrhage in the Obstetrics and Gynecology Clinic of Turgut Ozal University Hospital, between January 2009 and August 2014 were examined. Frequency and efficacy of interventions were investigated in terms of haemostasis achievement without recourse to hysterectomy. Results: In 12 women who underwent Bakri balloon placement, haemostasis was achieved in all patients without subsequent hysterectomy. By contrast, of 9 women who underwent arterial ligation, 77.8% required hysterectomy as opposed to 31.3% of the 16 women who did not undergo arterial ligation. Use of combinations of surgical techniques was also significantly associated with higher risk of hysterectomy when compared to single techniques. Conclusion: Use of Bakri balloon is a highly effective method in achieving haemostasis in post-partum haemorrhage without necessity of hysterectomy. © 2021 Elsevier B.V., All rights reserved.Öğe Intrapartum ultrasonography for prediction of vaginal delivery: Review(OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S. aysea@turkiyeklinikleri.com Turkocagi Caddesi No. 30 Balgat 06520, 2016) Eser, Ayla Açar; Koş???us, Aydin; Köşüş, NerminIntrapartum ultrasound imaging is gaining popularity, with increased application due to its relative ease of use and direct on-site accessibility. Though its use was initially restricted to esoteric indications and routinely applied antepartum, sonography is now increasingly being used for more mundane intrapartum indications, for example illustration of the precise fetal head position, assessment of fetal head engagement and estimation of the fetal weight. Advance evaluation of the complex physiology of childbirth is now possible with intrapartum ultrasonography, including Doppler flow velocimetry. It is not, however, in current use for the purposes of pure clinical management, i.e. development of labor or the lack thereof. The increased rate of cesarean delivery is a worldwide problem. Medico-legal problems, however, can arise from difficult vaginal deliveries. Internationally, finding ways to reduce cesarean delivery rates is a clinical priority. This includes development of new techniques for encouraging normal vaginal delivery. Appropriate use of intrapartum sonography could contribute to reduction of cesarean delivery rates and help to protect patients and doctors from possible complications of difficult vaginal delivery. Detection of advancing cervical dilatation and descent of the fetal head, however, are two important aspects currently beyond the clinical scope of intrapartum ultrasound imaging. Determination of the descent of the fetal head will be the ultimate challenge of clinical applicability of intrapartum ultrasound imaging. The hope is that imaging ultrasound will ultimately permit us to assess these two vital clinical parameters, which have up until now proven indefinable. © 2018 Elsevier B.V., All rights reserved.Öğe Ontraceptive vaccines: Review(OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S. aysea@turkiyeklinikleri.com Turkocagi Caddesi No. 30 Balgat 06520, 2016) Namlı Kalem, Muberra; Koş???us, Aydin; Köşüş, Nermin; Kalem, Ziya; Eser, Ayla AçarThe population growth and unintended pregnancies are major public health issues worldwide. The world population has exceeded 6.8 billion and is increasing by 1 billion every 12 years. An estimated 80 million women have unintended or unwanted pregnancies worldwide annually and 45 million of these end in abortion. Most of these women use some type of contraceptive. All of these means there is an absolute need for an alternative form of contraceptive. Basic principle of immunocontraception is using the immune system to provide protection against an unwanted pregnancy. Since the 1900s, several antigens have been used as target for developing contraceptive vaccines. According to the targets, contraceptive vaccines can be categorized into three groups. First group GnRH, FSH,LH based vaccines inhibits production of gametes; the second group antisperm and zona pellucida based vaccines, impairs gamete outcome and the third group blocks the human chorionic gonadotropin (hCG) after fertilization. Although the vaccines targeted hCG that has undergone phase 1 and phase 2 clinical trials in women as a contraceptive vaccines with the encouraging results; nevertheless immunocontraception for the human use will not be available in the near future. One of the major challenges for the contraceptive vaccines is inter-individual wide variation of the immune response. In the future, in relation to progress in the field of genomics, proteomics and immunology; more specific targets and more potent vaccines will be developed. The aim of this article is to review and summarise past and present knowledge about contraceptive vaccines researchs. Cop yright & 2016 by Tür ki ye Kli nik le ri. © 2018 Elsevier B.V., All rights reserved.Öğe Septic pelvic thrombophlebitis in differential diagnosis of postpartum acute abdomen: Case report(OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2015) Eser, Ayla Açar; Gök, Gülden Aday; İnegöl Gümüş, İlknur; Sürgit, Önder; KARATAş, Gülhiz; Gonca, Mehmet OğuzAcute abdomen is general definition of pathologies with foreground abdominal pain which are acute initiated without trauma and requires immediate treatment. Septic pelvic thrombophlebitis is a serious but rare complication of pelvic infection. It appears more often on obstetric patients than gynecological patients. There is no specific symptom and often presented as acute abdomen. If the diagnosis and treatment are delaed it may cause serious and mortal complications. Diagnosis is mostly possible retrospectively with pyrexia and abdominal pain response to combination of antibiotic and anticoagulant treatment but with no response to antibiotics alone. Computed tomography and magnetic resonance imaging are helpful in diagnosis. In treatment, anticoagulant treatment is suggested in addition to broad-spectrum antibiotics. In our paper, we presented a case with septic pelvic thrombophlebitis which mimics acute abdomen in postpartum period. © 2021 Elsevier B.V., All rights reserved.Öğe Sleep abnormalities in pregnancy: Review(OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2015) Eser, Ayla Açar; Kaygusuz, İkbal Cekmen; İnegöl Gümüş, İlknur; Koş???us, Aydin; Köşüş, NerminPregnancy and sleep disorders are strongly correlated. Sleep disorders commonly experienced in pregnancy include insomnia, restless legs syndrome, excessive daytime sleepiness and sleep disordered breathing, for example sleep apnea. Causes can be physical discomfort, hormonal changes, alterations in respiratory physiology and psychological and emotional upheaval. Incidence of the different types of sleep disorders varies depending on pregnancy trimester. The first trimester is associated with excessive daytime sleepiness, although this can continue throughout pregnancy. Physical factors such as nausea and vomiting and hormonal changes are important causes. By the second trimester, hormonal changes are stabilising but women may still suffer sleep problems due to enlarged abdomen causing low back pain, abrupt fetal movements, heartburn and nocturia. In the third trimester, the majority of women suffer from sleep problems. Incidence of insomnia and restless legs syndrome reach their maximum. Sleep disordered breathing issues including sleep apnea, snoring and hypoventilation are also more common, influenced by rising progesterone levels, disordered and periodic breathing, excessive weight gain and altered neck circumference. Sleep disorders in pregnancy have been associated with adverse maternal and fetal outcomes. Treatment options include improving sleep hygiene, exercise, positional therapy, continuous positive airway pressure, behavioural therapies and, where the sleep disorders are refractory to these types of interventions, short-term pharmacological treatment with suitable hypnotics. Postpartum, many of the pregnancy-associated sleep disorders resolve, however many women continue to experience excessive daytime sleepiness and both pre-and post-partum sleep disorders have been linked to incidence of post-natal depression. © 2021 Elsevier B.V., All rights reserved.Öğe The management of gynecological laparoscopy complications: Review(OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S. aysea@turkiyeklinikleri.com Turkocagi Caddesi No. 30 Balgat 06520, 2017) Eser, Ayla Açar; İnegöl Gümüş, İlknur; Akgün, Nilüfer; Yüce, Ebru; Namlı Kalem, MuberraLaparoscopy has a good safety profile, with advantages over more invasive surgeries such as reduced operative procedure time, reduced complications, decreased hospital stay and improved recovery time. However, complications can arise, including vessel injuries, gastrointestinal and genitourinary injury, gas embolism, incisional hernia, port site metastases, subcutaneous emphysema, wound site infection, intraperitoneal adhesions and anaesthesia related complications. Training and supervision of new surgeons, familiarity with equipment and instruments, development of excellent surgical skills and awareness of potential complications are key to management of complications in gynaecological endoscopic procedures. Importantly, there are many ways in which the risk of complications can be minimised. Laparoscopic camera control systems and robotically assisted endoscopic surgeries are some recently developed technological innovations. The use of laparo-endoscopic single-site surgery for procedures including balloon vaginoplasty should theoretically also help reduce complications. There is also a trend towards natural orifice transluminal endoscopic surgery, for example, transvaginal natural orifice transluminal endoscopic hysterectomy, which has the advantages of not being limited by uterine volume or the need for abdominal incision. Thus, surgeons can incorporate innovative techniques and technologies into management and minimisation of complications in gynaecological endoscopic procedures. This article reviews measures can be taken to minimize and management of gynecological laparoscopic complications. © 2018 Elsevier B.V., All rights reserved.
