Browsing by Author "Atalay, Mehmet Aral"

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An unusual presentation of a submucous leiomyoma accounting to a non-puerperal uterine inversion: A case report
(Galenos Yayıncılık, 2013-06-01) Atalay, Mehmet Aral; Demir, Bilge Çetinkaya; Solak, Neşe; Atalay, Fatma Öz; Kuçükkömürcü, Şakir; Atalay, Mehmet Aral; ÇETİNKAYA DEMİR, BİLGE; Solak, Neşe; ÖZ ATALAY, FATMA; Kuçükkömürcü, Şakir; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Cerrahi Patoloji Anabilim Dalı.; 0000-0002-9685-956X; 0000-0001-6845-9991; AAH-9834-2021; GBG-9889-2022; DSL-0496-2022; JHC-4482-2023; JIU-6695-2023
Non-puerperal uterine inversion is an extremely rare gynaecological event that is usually associated with uterine tumours such as submucous or cervical leiomyomas. In this report, we describe a case of uterine inversion due to a large submucous leiomyoma in a 42-yearold multiparous and obese Caucasian woman.
Anatomic and functional outcomes of paramesonephric remnant-supported laparoscopic double-layer peritoneal pull-down vaginoplasty technique in patients with mayer-rokitansky-kuster-hauser syndrome: Uncu modification
(Elsevier, 2018) Ata, Barış; Uncu, Gürkan; Özerkan, Kemal; Kasapoğlu, Işıl; Atalay, Mehmet Aral; Orhan, Adnan; Aslan, Kiper; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-7558-8166; 0000-0002-9277-7735; AAT-3479-2021; V-5292-2019; AAH-9694-2021; AAH-9791-2021; AER-7173-2022; 6603716169; 6603345841; 55800494800; 53863297800; 56671094200; 56740498500
Objective: To describe modifications to the double-layer peritoneal pull-down laparoscopic vaginoplasty technique (Davydov operation) and evaluate anatomic and functional outcomes of the new technique, known as the Uncu modification. Design: Case series (Canadian Task Force classification III). Setting: Tertiary care university hospital. Patients: Women with Mayer-Rokitansky-Kuster-Hauser syndrome (MRKHS) who underwent surgery between 2010 and 2016. Interventions: Laparoscopic double-layer peritoneal pull-down vaginoplasty with paramesonephric remnant support to the neovagina. Measurements and Main Results: Long-term anatomic and functional satisfaction results. Twenty-seven women with MRKHS underwent surgery with the Uncu-modified Davydov procedure. At 1 year after surgery, the mean vaginal length in these patients was 7.91 +/- 1.4 cm. Among the 23 patients who had regular vaginal intercourse, the mean functional satisfaction score was 8.65 +/- 1.2. One patient had a perioperative bladder injury, and another patient had a rectovaginal fistula at 3 months after the operation. One woman who did not comply with the prescribed postoperative mold exercises had complete closure of the introitus. Conclusion: The Uncu modified laparoscopic double-layer peritoneal pull-down technique appears to be an effective and safe surgical management option that is easy to learn and perform by gynecologic surgeons.
Change in the ovarian environment after hysterectomy with bilateral salpingectomy: Is it the technique or surgery itself?
(Elsevier, 2016-07-20) Atalay, Mehmet Aral; Demir, Bilge Çetinkaya; Özerkan, Kemal; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0001-6897-3392; AAH-9834-2021; AAH-9791-2021; 53863297800; 36923039100; 6603345841
Objective: To compare the effects of total laparoscopic hysterectomy with bilateral salpingectomy (TLH-BS) and total abdominal hysterectomy with bilateral salpingectomy (TAH-BS) on ovarian function among women of reproductive age. Study design: One hundred and three patients with a diagnosis of benign uterine disorder were divided into two groups in this prospective longitudinal study. Patients who had never had sexual intercourse and patients with uterovaginal disproportion underwent TAH-BS (n = 57), and the remaining patients (n = 46) underwent TLH-BS. Ovarian function was assessed before and 6 months after surgery; ovarian volume was assessed by gray-scale ultrasonography, and levels of serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), oestradiol (E2), anti-Mullerian hormone (AMH) and inhibin B were measured. Results: Postoperative serum FSH, LH and inhibin B decreased significantly in both groups. Postoperative serum E2 did not change significantly. Postoperative serum AMH and ovarian volume decreased significantly in the TAH-BS group (p = 0.016 and p < 0.001, respectively), but not in the TLH-BS group. Significant differences were observed between the TLH-BS and TAH-BS groups with respect to change in FSH (p = 0.012) and ovarian volume (p = 0.001); between-group differences were not significant for changes in AMH and inhibin B. Conclusions: Although serum AMH did not change significantly in patients who underwent TLH-BS, ovarian aging commenced following both surgical procedures.
Clinical significance of maternal serum vascular endothelial growth factor (VEGF) level in idiopathic recurrent pregnancy loss
(Verduci Publisher, 2016-07) Uǧurlu, Nil; Zülfikaroǧlu, Ebru; Danışman, Nuri; Atalay, Mehmet Aral; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 53863297800
OBJECTIVE: The aim of this study was to determine whether maternal serum vascular endothelial growth factor (VEGF) levels are associated with unexplained recurrent pregnancy losses (RPLs). PATIENTS AND METHODS: Twenty-one pregnant women with idiopathic RPLs who were selected from 47 cases with RPLs were compared with age-matched 24 control participants. Transvaginal obstetric ultrasonographies were performed and maternal serum samples were collected between 5th and 10th gestational weeks to evaluate serum VEGF and progesterone (P4) concentrations. Enzyme-linked immunosorbent assay technique was used in measurements of VEGF and P4. RESULTS: Prevalence of idiopathic cases among all RPLs was 44.7%. Median serum VEGF value was found statistically higher in RPL group when compared to control group (210.33 +/- 108.23 pg/ml vs. 123.91 +/- 18.8 pg/ml, respectively). There was no statistical difference between the median values of serum P4 levels in idiopathic RPL group and the control group (19.53 +/- 5.79 ng/ml and 20.08 +/- 7.85 ng/ml, respectively). Serum VEGF levels did not differ significantly with regard to gestational age within the RPL and control groups (p = 0.72 and p = 0.89, respectively). A positive correlation was found between VEGF levels and the patients' age within RPL group (r = 0.515). CONCLUSIONS: Serum VEGF levels are independent by the gestational age. Serum VEGF concentrations correlate positively to maternal age. Increased maternal age, especially maternal age over 35 years, is related to elevated serum VEGF concentration. Increased maternal serum VEGF concentration is related with recurrent pregnancy loss.
Cutaneous fistulization of an ovarian mature cystic teratoma: An unusual occurrence
(Karger, 2015-01-01) Atalay, Mehmet Aral; Orhan, Adnan; Atalay, Fatma Öz; Saydam, İlkay; Demir, Bilge Çetinkaya; Atalay, Mehmet Aral; ORHAN, ADNAN; ÖZ ATALAY, FATMA; Saydam, İlkay; ÇETİNKAYA DEMİR, BİLGE; Uludağ Üniversitesi/Tıp Fakültesi/Cerrahi Patoloji Bölümü; Uludağ Üniversitesi/Tıp Fakültesi/Doğum ve Jinekoloji Bölümü; 0000-0002-9685-956X; 0000-0002-7558-8166; 0000-0001-6845-9991; AAH-9834-2021; V-5292-2019; GBG-9889-2022; JHC-4482-2023; DRD-3800-2022
A bilobulated mature cystic teratoma (MCT) at the left ovary measuring 6 cm in diameter fistulized to the left lower quadrant of the anterior abdominal wall, contralateral to McBurney's point. This is the first reported case of a MCT fistulized to the skin. Symptoms, if present, usually depend on the size of the teratoma. However, most patients with a MCT are asymptomatic. Complications such as rupture of the cyst capsule are quite rare. Moreover, complication of fistulization is highly infrequent.
Detecting coagulability status by thromboelastography in women with the history of preeclampsia and inherited thrombophilia
(Canada Inc, 2015-01-01) Bülbül, Mehmet; Atalay, Mehmet Aral; Demir, Bilge Çetinkaya; Türker, Gürkan; Esmer, A.; Atalay, Mehmet Aral; ÇETİNKAYA DEMİR, BİLGE; TÜRKER, YUNUS GÜRKAN; Esmer, A.; Uludağ Üniversitesi/Tıp Fakültesi/Jinekoloji Bölümü; Uludağ Üniversitesi/Tıp Fakültesi/Anestezi ve Reanimat Bölümü; 0000-0002-9685-956X; 0000-0001-6845-9991; 0000-0002-3019-581X; AAI-6642-2021; AAH-9834-2021
Objective: To assign tendency to thrombosis in patients with preeclampsia and inherited thrombophilia using thromboelastography (TEG), and therefore to evaluate possible relationship between thrombophilia and preeclampsia. Materials and Methods: Kinetics of clot formation was assessed with TEG analyzer in 49 patients with severe preeclampsia, 54 cases with previous diagnosis of inherited thrombophilia, and 31 controls. Results: 'r', 'k', TMA, coagulation index (CI) parameters were found statistically discrete between patients with inherited thrombophilia and controls. The difference between preeclampsia and control groups was not statistically significant. The difference in a angle was statistically significant between thrombophilics and preeclamptics (p = 0.01), and between thrombophilics and controls (p = 0.004). CI was found statistically lower in thrombophilia group than control group (p = 0.006). Particularly, clot lysis time (CLT) was measured to shorten in preeclampsia when compared with controls and patients with thrombophilia (p = 0.032, p = 0.028, respectively). Conclusions: Not only the inherited thrombophilia group but also preeclampsia group demonstrated elongated clot initiation patterns when compared to the controls. Moreover, apart from the patients with inherited thrombophilia, preeclamptics exposed shorter CLT values indicating a possible increment in clot turn over, which eventually results in increased depletion of coagulation substrates, and thus, increased frequencies of oxidative cycle injury.
Ekstramedüller hematopoez odakları içeren uterin leiomyoma: olgu sunumu
(Bursa Uludağ Üniversitesi, 2020-03-10) Atalay, Mehmet Aral; Akyol, Sevda; Atalay, Fatma Öz; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Patoloji Anabilim Dalı.
Ekstramedüller hematopoez, hematopoetik dokunun kemik iliği ve periferik kan dışındaki neoplastik olmayan proliferasyonudur. Ekstramedüller hematopoeze pek çok organ ve tümör içerisinde rastlanılabilmektedir. Dismenore ve metroraji şikayetleri ile hastanemize başvuran 37 yaşındaki hastaya radyolojik görüntülemelerde izlenen submukozal myom nedeniyle myomektomi uygulanmıştır. Materyalin mikroskobik incelemesinde, tümör hücrelerinin birbirini çaprazlayan demetler şeklinde düzenlenmiş iğsi hücrelerden oluştuğu görülmüştür. Morfolojik olarak leiomyoma benzeyen bu tümör, büyük büyütmede incelendiğinde, stromasında küçük odaklar halinde yerleşim gösteren, hiperkromatik nükleuslu, nükleus /sitoplazma oranları yüksek, değişik büyüklüklerde birkaç farklı hücre grubundan oluşan hücre topluluklarına rastlanmıştır. Uygulanan immünohistokimyasal çalışmalar sonucunda odaklardaki hücrelerden bazılarının glikoforin A, bazılarının ise myeloperoksidaz ile immünreaktivite gösterdiği görülmüştür. Morfolojik ve immünohistokimyasal boyamalar sonucunda bu hücre gruplarının eritroid ve myeloid seri öncülleri içeren ekstramedüller hematopoez alanları olduğu ortaya konmuş, olgu ekstramedüller hematopoez alanları içeren leiomyoma olarak raporlanmıştır. Leiomyoma, üreme çağındaki kadınlarda sık rastlanılan benign düz kas tümörü olmakla birlikte, literatür incelendiğinde, ekstramedüller hematopoez alanları içeren leiomyom olgusunun az sayıda olduğu görülmüştür.
The expression of Fas protein is downregulated in the endometrium of patients with endometriosis
(SCI Printers & Publ Inc, 2018) Atalay, Mehmet Aral; Kayaoğlu, Murat; Atalay, Fatma Öz; Küçükkömürcü, Şakir; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 53863297800; 57204432211; 15623010600; 6507291599
OBJECTIVE: To introduce a possible role of Fas protein in the pathophysiology of endometriosis. STUDY DESIGN: This prospective case-control study was conducted between March 2012 and February 2015. Endometrial biopsies from 30 patients diagnosed with endometriosis after laparoscopic or open surgery were compared with biopsies from 30 patients who were operated on for benign ovarian cysts. Endometrial samplings from the participants were performed with Pipelle biopsies in the luteal phase of the menstrual cycle. Immunostaining for Fas protein was performed. A histochemical score (H-score) calculation was performed with the formula Pix(i + 1), in which i illustrated the staining intensity and Pi illustrated the percentage of stained epithelial cells. RESULTS: The differences in staining percentage and staining intensity of endometrial epithelial cells as well as total H-score of Fas immunoexpression between patients with endometriosis and the control group were found to be statistically significant (p<0.001). There were statistically significant differences between gravidity and H-score, and age and H-score, within the endometriosis group (p=0.031 and p=0.018, respectively). Gravidity and H-score, and age and H-score, were found to correlate in negative linear character in patients with endometriosis (r=-0.509 and r=-0.429, respectively). CONCLUSION: Immunoexpression of Fas protein in endometrial cells was downregulated in patients with endometriosis as compared to that in healthy women. Endometrial Fas immunoexpression in patients with endometriosis is inversely correlated with age.
Familial ectrodactyly-ectodermal dysplasia-clefting syndrome
(Wiley, 2012-10) Gün, İsmet; Kızılaslan, Cem; Atalay, Mehmet Aral; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 53863297800
Fetal intrakraniyal teratomun erken prenatal tanısı ve fetal intrakraniyal kitlelere yaklaşım
(Ortadoğu Yayınları, 2011) Akpınar, Funda; Kimya, Yalçın; Atalay, Mehmet Aral; Cengiz, Candan; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Perinatoloji Anabilim Dalı.; 55663298700; 53863297800; 6701513182
Konjenital intrakraniyal tümörler, oldukça nadir görülen çocukluk çağı santral sinir sistemi tümörleridir. Bu tümörlerin önemli bir kısmını teratomlar oluşturmaktadır. İntrakraniyal teratomların prognozları kötüdür. Prenatal tanı konulabilen olguların sağ kalım ve canlı doğum oranları oldukça düşüktür. Obstetrik ultrasonografi öncelikli tanı yöntemidir; bununla birlikte seçilmiş vakalarda, manyetik rezonans görüntüleme (MRG) tanıya yardımcı olabilir. MRG, tümörün fetal beyinde yol açtığı hasarın ortaya konmasında ve gebeliğin prognozunun belirlenmesinde faydalı olabilir. Bu yazıda, 22. gebelik haftasında tanısı konulan fetal beyin teratomu vakası sunulmuştur. Bilgimize göre, bu olgu, literatürde yayınlanan 14. gebelik haftasında tanı almış olan intrakraniyal teratom olgusundan sonra en erken tanı alan ikinci intrakraniyal teratom olgusudur. Ultrasonografi ile fetal kraniyum içerisinde, heterojen eko sergileyen, düzgün sınırlı, yer kaplayan kitle ile birlikte sekonder obstrüktif hidrosefali saptanmıştır. Olgunun MRG ile elde edilen bulguları bu açıdan ultrasonografik bulgular ile benzerlik göstermiştir. Gebelik ailenin de onayı alınarak termine edilmiştir. Sunulan olguda MRG tanıya ve olgunun yönetimine ek katkı sağlayamamıştır. Bu sunumda, olgunun sonografi ve MRG bulguları ile birlikte bu vakalara obstetrik yaklaşım tartışılmaktadır.
Glutathione S-transferase M1 and T1 gene polymorphisms are not associated with increased risk of gestational diabetes mellitus development
(Univ West Indies Faculty Medical Sciences, 2014-08) Orhan, O.; Atalay, Mehmet Aral; Orhan, Fulya; Karkucak, Mutlu; Centinkaya Demir, B.; Yakut, Tahsin; Cengiz, Candan; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Eczacılık Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Genetik Anabilim Dalı.; AAH-9834-2021; ABI-5648-2022; 53863297800; 55866311800; 35388323500; 57196943280; 6602802424; 6701513182
Aim: The aim of this study was to investigate whether the glutathione S-transferase M1 (GSTM1) and T1 (GSTT1) gene polymorphisms contributed to development of gestational diabetes mellitus (GDM). Subjects and Methods: Fifty women with diagnosis of GDM and 50 control individuals without GDM or altered glucose intolerance during their pregnancy were enrolled in the study. Multiplex polymerase chain reaction-restriction fragment length polymorphism method was applied to determine the GSTM1 and GSTT1 gene polymorphisms. Genotypes were determined according to bands detected with the agarose gel electrophoresis. Results: The difference in the frequencies of GSTM1 null genotypes between GDM and control groups was not statistically significant (60% and 54%, respectively). There was no statistically significant difference between GDM and control groups with respect to GSTT1 null genotype rates (22% and 20%, respectively). Conclusion: This study shows no association between GST gene polymorphisms and GDM.
Impact of extended torsion on ovarian reserve: Experimental torsion-detorsion model in rabbit
(Sci Printers & Publication, 2017-04) Demir, Bilge Çetinkaya; Atalay, Mehmet Aral; Atalay, Fatma Öz; Durusoy, Emine Emsal; Özkaya, Güven; Oral, Arzu Yılmaztepe; Özerkan, Kemal; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji, Biyoistatistik ve Biyokimya Anabilim Dalları.; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0003-0297-846X; 0000-0003-0463-6818; A-4421-2016; AAH-9791-2021; A-5841-2017; AAH-9834-2021; 36923039100; 53863297800; 15623010600; 55836312500; 16316866500; 23091316500; 6603345841
OBJECTIVE: To evaluate the effect of duration of torsion on ovarian reserve. STUDY DESIGN: Twenty-two female New Zealand rabbits were divided into a sham and 2 study groups. The torsion/detorsion (T/DT) groups had left adnexal torsion for either 3 or 6 hours followed by detorsion. Ovaries were evaluated histologically for follicular damage, and preoperative, predetorsion, and postdetorsion blood samples were drawn from each rabbit to measure antiMiillerian hormone (AMH) levels. RESULTS: Mean primary, small antral, and antral follicle counts were lower in the T/DT groups as compared to the sham group. Primordial, small antral, and antral follicle counts were not different between the 3-hour T/DT and 6-hour T/DT groups. When compared with contralateral ovary, the 6-hour T/DT group had significantly lower follicle count. The 6-hour T/DT group had higher percent change in both predetorsion and postdetorsion AMH levels as compared to the 3-hour T/DT group. CONCLUSION: Although extended time of torsion has negative impact on ovarian reserve, the ovary keeps its viability with functioning follicles after detorsion.
Intrahepatic cholestasis of pregnancy: Relationship between bile acid levels and maternal and fetal complications
(Galenos Yayıncılık, 2014-09-01) Demir, Bilge Çetinkaya; Güneş, Esra Şahin; Atalay, Mehmet Aral; ÇETİNKAYA DEMİR, BİLGE; Güneş, Esra Şahin; Atalay, Mehmet Aral; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0001-6845-9991; 0000-0002-9685-956X; AAH-9834-2021; IDE-0603-2023; GBG-9889-2022
Objective: Intrahepatic cholestasis of pregnancy (ICP) complicates pregnancies which is characterized by elevated serum bile acid levels. ICP increases maternal and fetal morbidities. This study was designed to determine the association of maternal and fetal complications and serum bile acid levels.Material and method: Maternal and fetal characteristics were analyzed from the medical records of 61 patients who gave birth following a pregnancy complicated with ICP between 2009 and 2013.Results: Eighty seven percent of 61 cases were singletons, and 13% of them were twins. Mean SBA level was 36 mu mol/L. Preterm birth rate among singletons and twin pregnancies were 24.5% and 62.5%, respectively. Mean SBA level in preterm birth group was statistically higher with respect to the term birth group (100.8 mu mol/L and 25.61 mu mol/L, respectively; p=0.001). No perinatal mortality associated with ICP was detected in the study group.Conclusion: Pregnant women with the ICP compose high-risk group in regard to fetal and maternal risks. Close follow-up of these patients is required due to increased risks such as preterm delivery, meconium staining and fetal death.
Investigating maternal serum thyroid hormone, beta-human chorionic gonadotropin (Beta-HCG) and free beta-HCG levels in hyperemesis gravidarum
(Erciyes Üniversitesi Tıp Fakültesi, 2015-12-01) Atmaca, Uğur; Atalay, Mehmet Aral; Özçimen, Necati; Sidal, Bilhan; Ates, Ugur; Atalay, Mehmet Aral; Uludağ Üniversite/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; GBG-9889-2022
Objective: To investigate the influence of thyroid hormones, beta human chorionic gonadotropin (beta-HCG), and free beta-HCG (f beta-HCG) in the etiology of hyperemesis gravidarum (HG) and to determine the main hormone that is responsible for the exacerbation of symptoms.Materials and Methods: Serum thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), beta-HCG, and f beta-HCG levels were measured twice (before and after hospitalization) in 55 patients with HG and measured once in 64 healthy controls. Serum hormone levels were determined using enzyme-linked immunosorbent assay.Results: Decreased mean TSH and increased mean fT4 levels were found in the pre-treatment serum samples of the HG group compared with the control group. Both differences were statistically significant (p=0.020 and p=0.007, respectively). However, there was no statistically significant difference in mean fT3, beta-HCG, and f beta-HCG levels between the pre-treatment serum samples of the HG group and control group. We could not demonstrate any correlation between the levels of beta-HCG and thyroid hormones in the HG group; however, f beta-HCG moderately correlated with fT4 levels (r=0.494).Conclusion: The presence of hyperthyroidism was observed as the leading alteration in HG. In this study, f beta-HCG was demonstrated to have no direct effect on the etiology of HG; however, a possible indirect effect of f beta-HCG in relation with thyroid hormones was indicated. Hyperthyroidism was assessed to be primarily responsible for the symptoms in HG.
Letter to the editor regarding the article "magnetic resonance imaging features of uterine sarcoma and mimickers"
(Springer, 2019-02-01) Öztürk, Kerem; Atalay, Mehmet Aral; Savcı, Gürsel; SAVCI, GÜRSEL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0001-9664-2347; 0000-0002-9685-956X; E-1228-2018; AAH-5481-2021
Maternal adiponectin and visfatin concentrations in normal and complicated pregnancies
(IMR Press, 2013) Demir, Bilge Çetinkaya; Atalay, Mehmet Aral; Özerkan, Kemal; Doster, Y.; Ocakoğlu, Gökhan; Küçükkömürcü, Şakir; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; AAH-9834-2021; AAH-5180-2021; AAH-9791-2021; 36923039100; 53863297800; 6603345841; 55623210600; 15832295800; 6507291599
Objective: To evaluate the role of adiponectin and visfatin in the pathophysiology of pre-eclampsia (PE) and how their concentrations correlate with the severity of the disease and neonatal outcomes. Study Design: A prospective case-control study was carried out in 52 preeclamptic and 28 healthy pregnant women during the third trimester. The maternal plasma concentrations of adiponectin and visfatin were determined. Neonatal outcomes were also recorded. Results: Mean maternal plasma adiponectin concentrations in healthy pregnant women did not differ significantly from those of mild PE and severe PE groups. The plasma adiponectin levels of PE patients with small for gestational age (SGA) and those without SGA did not differ significantly, but the median plasma visfatin concentration of patients with SGA fetus was significantly higher if the patient was preeclamptic (p = 0.036). Conclusion: The severity of preeclampsia did not change the plasma levels of adiponectin and visfatin, but the median plasma visfatin concentration of patients with SGA fetuses were significantly higher if the patient was preeclamptic. Altered levels of adipocytokines strongly imply that the regulation of adipocytokines in PE is different and more complex compared to that in healthy pregnancy.
Meckel gruber syndrome, a case report
(Taylor, 2015-01-01) Aslan, Kiper; Aslan, Elif Kulahçı; Orhan, Adnan; Atalay, Mehmet Aral; ASLAN, MÜNİR KİPER; ASLAN, ELİF; ORHAN, ADNAN; Atalay, Mehmet Aral; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı; 0000-0002-9277-7735; 0000-0002-6553-1350; 0000-0002-7558-8166; 0000-0002-9685-956X; AER-7173-2022; AAH-9694-2021; V-5292-2019; JRN-8064-2023; GBG-9889-2022
Introduction: Meckel-Gruber Syndrome was first described by J R Meckel in 1822. It is an autosomal recessive disorder, and is caused by the failure of mesodermal induction. The typical triad of Meckel-Gruber Syndrome (MGS) involves meningo-encephalocele, polycystic kidneys and postaxial polydactyly. The worldwide incidence varies from 1 in 1.300 to 1 in 140.000 live births.Case: In this report, we present a case of MGS in which the diagnosis was made at 19 weeks of gestation based on ultrasonographic findings of the typical triad of the disease (encephalocele, polycystic kidneys, and polydactyly) These features were suggestive of the diagnosis of Meckel Gruber Syndrome (MGS). She had also placenta previa totalis. The patient was counselled regarding the lethal outcome of MGS. Unfortunately, the family did not approve the termination of pregnancy. At the 32nd week, she referred to hospital with complaints of vaginal bleeding and uterine contractions. An emergency cesarean section was perfomed due to plasental malposition. A 1380 gr, female fetus was delivered. First and 5th minute Apgar scores were 1 and 0, respectively. Consequently, the baby died after 45 minutes of neonatal resuscitation.Conclusion: MGS is a lethal disorder. One cannot speak about survival of the fetus because of the pulmonary hypoplasia. The parents should be counseled about prognosis of the fetus and the outcome. Counselers should strictly give information about the recurrence risk for the next pregnancies.
Nadir görülen bir over tümörü: sklerozan stromal tümör
(Bursa Uludağ Üniversitesi, 2020-12-09) Hasdemir, Seçil; Atalay, Mehmet Aral; Atalay, Fatma Öz; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Patoloji Anabilim Dalı.; 0000-0002-7188-6115
Sklerozan stromal tümör (SST) over seks kord stromal tümörleri arasında yer alan oldukça nadir görülen benign bir stromal tümördür. Bu olgu sunumunda sağ overde SST saptanan hastanın, radyolojik bulguları ve histopatolojik özellikleri literatür eşliğinde kısaca tartışılmıştır. 23 yaşında kadın hasta, pelvik ağrı şikayeti ile başvurduğu dış merkezde yapılan abdominal ultrasonografisinde sağ adnekste kistik ve solid komponenti olan kitle lezyon saptanması üzerine ileri tanı ve tedavi için hastanemiz kadın doğum polikliniğine yönlendirildi. Cinsiyet değiştirme istemi de olan hastaya yapılan laboratuvar incelemelerinde herhangi bir hormonal anormallik saptanmadı. Kitlenin frozen incelemesi sonrasında total abdominal histerektomi ve bilateral salpingoooferektomi (TAH+BSO) yapılması kararlaştırıldı. Frozen kesitlerin incelenmesi sonucu “seks kord stromal tümör” olarak değerlendirilen tümörün mikroskopik incelemesinde, kollajenöz ve ödemli hiposellüler alanlar ile hipersellüler alanların oluşturduğu psödolobüler patern, belirgin vasküler proliferasyon izlendi. Morfolojik ve immunhistokimyasal bulgular ışığında sağ overde izlenen tümör “SST” olarak tanı almıştır. Sklerozan stromal tümör olgularının büyük bir kısmı vasküler açıdan zengin solid kitle olduğundan radyolojik olarak öncelikle malign tümör olasılığı akla gelmektedir. SST’nin benign biyolojik davranışa sahip olması ve konservatif cerrahinin gerekli olduğu genç hastalarda görülmesi nedeniyle intraoperatif patolojik tanısı oldukça önemlidir.
Outcomes of laparoscopic peritoneal vaginoplasty operation in patients with mullerian agenesis
(Oxford University, 2017-07) Ata, Barış; Uncu, Gürkan; Orhan, Adnan; Aslan, Kiper; Kasapoğlu, Işıl; Atalay, Mehmet Aral; Özerkan, Kemal; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-7558-8166; 0000-0002-9277-7735; AAT-3479-2021; V-5292-2019; AAH-9694-2021; AER-7173-2022; AAH-9791-2021
Overin granüloza hücreli tümörleri: 10 vakanın retrospektif klinik analizi
(Uludağ Üniversitesi, 2011-08-23) Kayaoğlu, Murat; Özsoy, Sibel; Ozan, Hakan; Atalay, Mehmet Aral; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.
Granuloza hücreli tümörler overin nispeten nadir görülen, fonksiyonel ve düşük gradeli tümörleridir. Tüm over kanserlerinin %2-3’ünü oluştururlar. Bu çalışmanın amacı, olguların klinik seyri, tedavisi ve tedavi sonuçlarını incelemek ve overin granuloza hücreli tümörleri ile ilişkili prognostik faktörleri ortaya koymaktır. 1992 ile 2007 yılları arasında Uludağ Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum ABD’nda overin granuloza hücreli tümörü tanısı ile cerrahi evrelemesi ve tedavisi yapılan 10 olgunun klinik bulguları, uygulanan tedaviler ve hastalık takip sonuçları araştırılmıştır. Hastaların klinik evrelemesinde FIGO evrelemesi kullanılmıştır. Primer cerrahiden sonra ortalama takip süresi 79.9±60.2 aydır. Hastaların ortalama yaşı 41.80±11.23 olarak saptandı. Hastaların %50’si premenopozal durumda idi. En sık premenepozal başvuru şikayeti irregüler ve şiddetli vaginal kanama (%35.7), en sık postmenopozal başvuru şikayeti ise karın ve kasık ağrısı olarak saptandı (%28.6). Ca 125 seviyeleri 1 hasta dışında normal değerlerde saptandı. Beş olguya primer optimal cerrahi prosedür uygulanırken, 1 olguya fertilite koruyucu cerrahi uygulanmıştı. Diğer olgulara ise primer optimal cerrahi prosedür uygulanmamıştı. Bu çalışmada, hastalığın evresi tek başına hastalık için en önemli bağımsız prognostik faktör olarak saptanmıştır. Diğer prognostik faktörlerin öneminin belirlenebilmesi için daha geniş kapsamlı çalışmalara ihtiyaç vardır.