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Öğe Alterations in placental pendrin expression in pre-eclampsia(Taylor & Francis Ltd, 2014) Karataş, Ahmet; Erdem, Havva; Albayrak, Mustafa; Oktay, Murat; Özlü, Tülay; Dönmez, Melahat EmineIntroduction: Pendrin is an integral membrane protein and plays a key role in extracellular fluid volume and blood pressure control. We aimed to investigate the relationship between pendrin immunostaining intensity in normal and pre-eclamptic placental tissue. Methods: Fifty-six placental tissues, of which 26 were in pre-eclamptic, and 30 were in control group were evaluated by immunohistochemical staining. Positive immunostaining was evaluated using a semiquantitative score: 0, negative; +, mild; ++, moderate; and +++, intense. Results: There was more positive immunstaining in the pre-eclamptic placenta compared to the controls (p<0.001). A significant positive correlation was observed between immunostaining level and diastolic blood pressure (r = 0.533, p = 0.005) in the pre-eclamptic group. However, no significant correlation was observed between any condition and immunostaining level in the control group. Conclusions: Placentas in the pre-eclamptic group were significantly more immunostained with pendrin than were those in the control group. In addition, a positive correlation between immunostaining intensity with pendrin and both systolic and diastolic blood pressure were observed. Pendrin may play a role in the mechanism of severe hypertension in women with pre-eclampsia.Öğe Are insulin resistance and serum resistin levels increased in women with idiopathic hirsutism?(Verduci Publisher, 2014) Erkan, Müşerref; Albayrak, Mustafa; Karataş, Ahmet; Keskin, Fatih; Aydın, YusufOBJECTIVE: To investigate the insulin resistance and serum resistin levels in women with idiopathic hirsutism compared to controls and women with polycystic ovary syndrome (PCOS). PATIENTS AND METHODS: Three groups of women including 23 women with idiopathic hirsutism, 28 women with PCOS and 28 non-hirsute women serving as controls were included into the study. The Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), serum fasting insulin and resistin levels were compared between the groups. RESULTS: There were no statistically significant differences regarding the age, BMI and waist circumferences between the groups. Mean and median fasting blood glucose, fasting insulin, HOMA-IR, serum resistin levels were statistically similar between the groups (p = 0.966, p = 0.378, p = 0.409 and p = 0.784, respectively). There were no correlations between the resistin, HOMA-IR, fasting insulin levels and BMI in any of the three groups. CONCLUSIONS: Insulin resistance and serum resistin levels do not appear to be increased in women with idiopathic hirsutism compared to controls at similar BMI's and waist circumferences.Öğe Bicuspid aortic valve and severe aortic stenosis in a newborn exposed to carbamazapine during pregnancy(2014) Karataş, Zehra; Karataş, Ahmet; Özlü, Tülay; Göksügür, Sevil Bilir; Varan, BirgülThe use of antiepileptic drugs increases the risk of major congenital malformations during pregnancy. Here, we report an infant who had a history of in-utero carbamazepine exposure and who was born with a cardiac malformation. The infant was born at 39 weeks of gestation vagi- nally to an epileptic mother who had been treated with carbamazepine throughout her pregnancy. He was referred due to cardiac murmur in the second week of his life. The mother had not received folic acid supplementation. Transthoracic echocardiography revealed bicuspid aortic valve, mild aortic stenosis, patent ductus arteriosus, patent foramen ovale and the renal ultrasound revealed mild left hydronephrosis. Follow-up echocardiography performed 14 weeks later showed increased severity of aortic stenosis and percutaneous balloon aortic valvuloplasty was performed. To our knowledge, there is only one case report in the literature mentioning the association of a bicuspid aortic valve and aortic stenosis with oxcarbazepine exposure, which is a structural derivative of carbamazepine. However, there are no reports for association with carbamazepine itself. Bicuspid aorta and aortic stenosis may be among the cardiac malformations that result from the teratogenic effect of carbamazepine.Öğe Drug use and/or exposure in pregnancy : presence of risk versus quantity of risk response(Turgut Yayıncılık & Ticaret AŞ., 2015) Karataş, AhmetÖğe Early neonatal outcomes in patients with late preterm birth(2013) Karataş, Ahmet; Albayrak, Mustafa; Keskin, Fatih; Biyik, Ismail; Okur, Mesut; Güneş, Cemalettin; Köse, Seyit AliObjective: Preterm deliveries increased in many countries in recent years. However, despite fetal lung maturity, substantial neonatal morbidity may occur even after 34 weeks of gestation. The aim of this study was to evaluate neonatal morbidity and mortality in women with late preterm births. Design: Retrospective. Setting: Duzce University School of Medicine, Departments of Obstetrics and Gynecology and Pediatrics. Patients: Medical records of 291 pregnant women and newborns born between the 340/7-366/7 weeks of gestation were reviewed. Interventions: The whole population is first divided into two groups as depending on the presence of PPROM or not; and then also divided into-three groups based on the gestational age at delivery as 340/7-346/7 week (Group 1), 350/7-356/7 week (Group 2), and 360/7-366/7 week (Group 3). Main outcome measures: Groups were compared with respect to neonatal complications related to prematurity and early membrane rupture. Results: Of the 291 neonates included in the study, 85 were delivered preterm due to PPROM, 206 were non-PPROM group, and 76 were in group 1, 108 were in group 2, and 107 were in group 3. Sepsis rate was higher in group 1 and 2 compared to group 3 (p=0.016, p=0.029). NICU stay period was longer in group 1 and group 2 than group 3 (p=0.028, p=0.015 respectively). Newborns in group 1 had significantly longer hospital stay than group 3 (p=0.010), and total hospital stay period were significantly higher in newborns with sepsis. Conclusions: The late-preterm infants especially in earlier weeks represent a significantly higher risk category for neonatal complications, and they have a significantly longer NICU and hospital stay period.Öğe The effect of smoking on placental pendrin expression(Taylor & Francis Inc, 2017) Karataş, Ahmet; Erdem, Havva; Karataş, Zehra; Özlü, Tülay; Çakmak, BülentPendrin is important for transport of iodine across the placenta. Thiocyanate coming from cigarette is a competitive inhibitor of iodine transport. We aimed to evaluate the pendrin immunostaining intensity in placentas of smoker and non-smoker women. Placental tissues from 61 women, of which 28 were in smoking, and 33 were in non-smoking group were evaluated by immunohistochemical staining. Positive immunostaining was evaluated using a semiquantitative score: 0, negative; +, mild; ++, moderate; and +++, intense. Birth weight was significantly lower in the smoker group (p=0.024). There was a negative correlation between birth weight and intensity of placental pendrin immunostaining in the smoker group (r=-0.44, p=0.02). Placentas of the smoking women showed significantly higher immunostaining with pendrin than the control group (p=0.006). Thiocyonate coming from cigarettes may competitively inhibit pendrin mediated iodine transport in the placenta and adversely affect foetal development by this mechanism.Öğe The effects of smoking on the placentas of smoker mothers in terms of MPO, MMP-9 and FGF(Bayrakol Medical Publisher, 2020) Aslan, Ali; Karataş, Ahmet; Erdem, Havva; Kadıoğlu, Nilüfer; Ankaralı, Handan; Admış ÖzlemAim: Smoking during pregnancy remains a common habit. Pregnant smokers harm both themselves and their fetus. Therefore, in this study, we aimed to investigate oxidative stress and angiogenic effects of smoking on pregnant smokers by analyzing FGF, MMP-9, and MPO levels. Material and Methods: The placentas of 68 pregnant women which referred to the pathology laboratory between the years 2010 and 2011 were included in the study. Of the total, 28 women were smokers (S) and 40 women were non-smokers (NS). The FGF, MMP-9, and MPO immunostaining of placental tissues were examined by manual microarray study. The number of cigarettes smoked, age, systemic disease rate, mean abortus number, blood pressure, hemoglobin and hematocrit, Apgar, and pathological parameters were also evaluated. Results: Statistically significant positive relationships were found between S and NS groups in terms of MMP-9 staining (grade 1) (p=0.039). There was no MMP-9 staining in S group. Systemic diseases were more frequent in S than NS group (p=0.049). There was no statistically significant relationship between other parameters. Discussion: The effects of smoking on the fetus have been demonstrated with MMP-9. More comprehensive studies are needed to reveal the relationship between fetus and smoking.Öğe Endothelial nitric oxide synthase gene polymorphisms (Promoter-786T/C, Exon 894 G/T and intron G10T) in unexplained female infertility(Karger, 2014) Karataş, Ahmet; Eröz, Recep; Bahadır, Anzel; Keskin, Fatih; Özlü, TülayBackground/Aims: Recent investigations in both males and females show that there may also be some genetic risk factors associated with infertility, and endothelial nitric oxide synthase (eNOS) has important functions in implantation. We aimed to investigate the association of three different polymorphisms of eNOS (promoter -786T/C, exon 894 G/T and intron G10T) with unexplained female infertility. Materials and Methods: Two groups of patients were included in the study: (1) women with unexplained infertility and (2) healthy, fertile women with normal menstrual cycles. eNOS polymorphisms were studied in genomic DNA of each patient by polynnerase chain reaction-restriction fragment length polymorphism method. Results: Forty-one women with unexplained infertility and 40 fertile women were included. Baseline physical characteristics and hormonal parameters of the two groups were similar. For eNOS exon 894 G/T polymorphism, the GG honnozygotes were significantly lower and the heterozygotes GT were significantly higher in the infertile group than in the control group (p < 0.05). eNOS gene polymorphism both for promoter and intron were similar in the two groups (p > 0.05). Conclusion: Altered eNOS protein caused by eNOS exon 894 G/T polymorphism might cause implantation failure, which may be a possible cause of unexplained female infertility. (C) 2014 S. Karger AG, BaselÖğe Evaluation of chromosomal abnormalities and common trombophilic mutations in cases with recurrent miscarriage(Makerere Univ, Fac Med, 2014) Karataş, Ahmet; Eröz, Recep; Albayrak, Mustafa; Özlü, Tülay; Çakmak, BülentBackground: Recurrent miscarriage (RM) is a frequent obstetric problem. Its' pathophysiology is poorly understood. Infections, genetic, endocrine, anatomic and immunologic problems have been suggested as causes for RM. Objective: To evaluate the frequency of chromosomal abnormalities and 3 common thrombophilic mutations in couples with RM. Methods: A retrospective data collection was performed for the results of the cytogenetic analysis of the couples and Methylenetetrahydrofolate Reductase (MTHFR) C677T, Factor V Leiden (FVL) G1691A and Prothrombin (PTm) G20210A mutations of the mother in 142 couples suffering from RM. Results: Prevalence of FVL, MTHFR, and PTm gene mutations were similar between cases shaving 2 or >= 3 abortions (P=0.528; P=0.233; P=0.375). In patients with FVL, MTHFR and PTm gene mutations, the OR's of having >= 3 abortions when compared to having 2 abortions were 1.515 (95% CI: 0.414-5.552), 0.573 (95% CI: 0.228-1.441), and 2.848 (95% CI: 0.355-22.871). All cases with PTm mutation had >= 3 abortions and all abortions occurred between 6-8 gestational weeks. Conclusion: Chromosomal abnormalities and thrombophilic mutations (especially PTm) seem to have an important role in RM. Additional larger studies involving investigation of more genes that may have a role in pregnancy are needed to assess this association.Öğe Evaluation of treatment success in patients undergoing transobturator tape surgery(Turkish Society of Obstetrics and Gynecology, 2014) Karataş, Ahmet; Duran, Bülent; Özlü, Tülay; Koç, Önder; Dönmez, Melahat Emine; Güler, ArzuObjective: Transobturator tape (TOT), a minimal invasive surgical technique in the treatment of urinary incontinence, is also frequently applied in addition to other gynecologic surgeries. Previous studies report a cure rate of 80%-92% with TOT. In this study, we aimed to evaluate treatment success in patients in whom TOT was performed in our clinics. Material and Methods: Patients in whom TOT was performed in our clinics between January 2009 and April 2013 were retrospectively evaluated. Follow up records were investigated to evaluate the TOT success rate and other urogynecologic problems that developed during follow up. Presence of ongoing urinary incontinence was accepted as TOT failure. Results: One hundred seven cases in whom TOT was performed and had available data were included. Median age of the cases was 59 (26-84) years. 72% (n=77) of them were in menopause, 91.6% (n=98) were multiparous and 59.8% (n=64) had other simultaneous gynecologic surgeries. Most frequent simultaneous operation was vaginal hysterectomy (n=42, 39.3%). Median postoperative follow up duration was 2.4 years (0.5-4 years). 12.1% (n=14) of the cases had ongoing urinary incontinence during follow up. Our TOT success rate was 87.9%. This rate was 87.5% in cases with simultaneous surgery and 88.4% in cases without a simultaneous surgery (p>0.05); 85.7% in postmenopausal and 93.3% in premenopausal cases (p>0.05). During follow up, cystocele developed in 8.4% and cuff prolapsus developed in 11.2% of the cases. Conclusion: Cure rate of TOT cases in our clinics were in accordance with the numbers in the literature. TOT success rate is not affected by the menopausal status or the application of any other simultaneous gynecologic surgery.Öğe Evaluation of treatment success in patients who underwent Transobturator Tape surgery(2014) Karataş, Ahmet; Duran, Bülent; Özlü, Tülay; Koç, Önder; Dönmez, Melahat EmineObjective: Transobturator tape (TOT), a minimal invasive surgical technique in the treatment of urinary incontinence, is also frequently applied in addition to other gynecologic surgeries. Previous studies report a cure rate of 80%-92% with TOT. In this study, we aimed to evaluate treatment success in patients in whom TOT was performed in our clinics. Material and Methods: Patients in whom TOT was performed in our clinics between January 2009 and April 2013 were retrospectively evaluated. Follow up records were investigated to evaluate the TOT success rate and other urogynecologic problems that developed during follow up. Presence of ongoing urinary incontinence was accepted as TOT failure. Results: One hundred seven cases in whom TOT was performed and had available data were included. Median age of the cases was 59 (26-84) years. 72% (n=77) of them were in menopause, 91.6% (n=98) were multiparous and 59.8% (n=64) had other simultaneous gynecologic surgeries. Most frequent simultaneous operation was vaginal hysterectomy (n=42, 39.3%). Median postoperative follow up duration was 2.4 years (0.5-4 years). 12.1% (n=14) of the cases had ongoing urinary incontinence during follow up. Our TOT success rate was 87.9%. This rate was 87.5% in cases with simultaneous surgery and 88.4% in cases without a simultaneous surgery (p>0.05); 85.7% in postmenopausal and 93.3% in premenopausal cases (p>0.05). During follow up, cystocele developed in 8.4% and cuff prolapsus developed in 11.2% of the cases. Conclusion: Cure rate of TOT cases in our clinics were in accordance with the numbers in the literature. TOT success rate is not affected by the menopausal status or the application of any other simultaneous gynecologic surgery.Öğe The frequency of plasminogen activator inhibitor (pai) polymorphism and its effects on recurrent ivf failure.(Elsevier Science Inc, 2016) Ersoy, Ebru; Yılmaz, Nafiye; Ersoy, Ali; Karataş, Ahmet; Engin Üstün, YaprakOBJECTIVE: Recurrent IVF failure is still a challenging clinical situation. Plasminogen Activator Inhibitor (PAI) enzyme polymorphisms have been recently cited to be associated with endometrial receptivity which is about the differential effect of PAI-1 enzyme activity on extracellular matrix degradation (1). Here we aimed to investigate the frequency of different PAI polymorphism groups and their effects on IVF outcomes. DESIGN: Retrospective cross-sectional study. MATERIALS AND METHODS: One hundred seventy-nine nulliparous patients who had a history of two IVF failure at least and attended to the Assisted Reproduction Clinics of our tertiary care institution between January 2013 and January 2015 were included in this study. PAI-1 gene polymorphisms were detected using PCR prior to any controlled ovarian hyperstimulation protocols. The patients were merged into three groups as followings: 5G/5G (Normal), 4G/5G (Heterozygote), 4G/4G (Homozygote). Individual characteristics and IVF outcomes were compared among groups. RESULTS: The ages, FSH levels (Day 3), mean number of oocytes retrieved, fertilisation rate and the number of transferred good quality embryos were comparable among groups. Clinical pregnancy rates were 25%, 34.1%, 34.9%, respectively, and there was no significant difference among them. Also, live birth rates were comparable among groups. CONCLUSIONS: The present study indicated that different PAI polymorphism states had no effect on IVF outcomes of patients who had recurrent VF failure.Footnote of the table: CI: Confidence interval, PAI: Plasminogen Activator Inhibitor. Values were given as meanstandard deviation, median (range), or number (percentage).Öğe Geç preterm doğum olgularında erken neonatal sonuçlar(2013) Karataş, Ahmet; Albayrak, Mustafa; Keskin, Fatih; Bıyık, İsmail; Okur, MesutAmaç: Preterm doğumlar son zamanlarda birçok ülkede artış göstermiştir. Fetal akciğerin gelişmiş olmasına rağmen, 34. gebelik haftasından sonra bile ciddi yenidoğan morbiditesi meydana gelebilir. Bu çalışmanın amacı, geç preterm doğum olgularında neonatal morbidite ve mortaliteyi araştırmaktır. Planlama: Retrospektif Ortam: Düzce Üniversitesi Tıp Fakültesi, Kadın Hastalıkları-Doğum ve Pediatri Kliniği Hastalar: 340/7-366/7 gebelik haftasında doğum yapan 291 gebe kadın ve yenidoğanlar incelendi. Girişim: Çalışmaya dahil edilen olgular PPROM varlığı ya da yokluğuna göre öncelikle iki gruba ayrıldı. Daha sonra gruplar, tekrar gebelik haftasına göre kendi içlerinde, 340/7-346/7 hafta olanlar(grup 1),350/7-356/7 hafta olanlar (grup 2), 360/7-366/7 hafta olanlar(grup 3) şeklinde üçe ayrıldı. Değerlendirme parametreleri: Gruplar prematürite ve erken membran rüptürü ile ilişkili yenidoğan komplikasyonları açısından karşılaştırıldı. Sonuç: Çalışmaya dahil edilen ikiyüz doksanbir olgunun 85'i PPROM nedeniyle erken doğum yapmıştı. 206'sı PPROM olmayan gruptaydı ve 76'sı 1. grup, 108'i 2. grup, 107'si de 3. grupta yer aldı. Sepsis oranı, birinci ve ikinci grupta üçüncü gruba göre daha yüksekti (p:0.016, p:0.029). Yenidoğan yoğunbakım ünitesinde (YDYB) kalış süresi 3. gruba oranla, 1. ve 2. grupta daha yüksekti (sırasıyla p:0.028, p:0.015). Birinci gruptaki yenidoğanlar, üçüncü gruptakilere göre anlamlı olarak daha uzun hastanede kalış süresine sahipti (p=0.010), ve toplam hastanede kalış süresi sepsisli yenidoğanlarda anlamlı olarak daha yüksekti. Yorum: Özellikle daha erken gebelik haftalarında olan geç preterm yenidoğanlar, yenidoğan komplikasyonları için anlamlı olarak daha fazla risklidirler, aynı zamanda anlamlı olarak yenidoğan yoğun bakım ve hastanede daha uzun kalış süresine sahiptir.Öğe Intraperitoneal nigella sativa for prevention of postoperative intra-abdominal adhesions in rats(Informa Healthcare, 2014) Karataş, Ahmet; Özlü, Tülay; Özyalvaçlı, Gülzade; Tosun, Mehmet; Çetinkaya, Ayhan; Dönmez, Melahat Emine; Türker, ArzuObjective: To evaluate intraperitoneal administration of Nigella sativa (NS) to prevent postoperative intraperitoneal adhesion (PPA) after surgical manipulation of rat uterine horn. Materials and Methods: Two forms of NS were used in the study (Volatile oil (NSVO) and the ethanolic extract (NSEE)). A total of 50 rats were randomly assigned to the sham group (n = 10), control group (n = 10), NSVO group (n = 10), NSEE group (n = 10), and the Seprafilm group(n = 10). After 14 days, rats were sacrificed. Adhesions were examined macroscopically, and degree of adhesions was scored. A part of horn was excised, and superoxide dismutase (SOD) and glutathione peroxidase activities as well as malondialdehyde levels were evaluated, and histological score was calculated. Results: Total microscopic score of the NSEE groupwas significantly lower than the control group (p = .001) and was marginally significantly lower than the seprafilm group (p = .005). Collagen formation score was higher in the seprafilm group compared to the sham and NSEE groups (p < 0.001, p = .003, respectively). Apoptotic cells were lower in the NSEE group compared to the control group (p=. 003) and also lower in the NSEE and NSVO groups compared to the seprafilm group (p = .001, p < .001, respectively). Only SOD activity was higher in the NSVO and seprafilm groups compared to the control group (p < .001). Conclusion: NSEE form seems to have a possible effect in the prevention of PPAs. This may occur by its effect in decreasing collagen formation and by decreasing apoptosis in the injured tissues. NSVO form seems to induce SOD. Therefore, combined use of NSVO with seprafilm may increase the adhesion preventive effect of seprafilm.Öğe Is there any predictive capability of the first beta-HCG level in in vitro fertilization cycles(Elsevier Science Inc, 2016) Özkök, Beyza Ahlatçıoğlu; Yılmaz, Nurdane; Karataş, Ahmet; Tokmak, Aslı; Çavdar, SongülOBJECTIVE: Presence of a marker that can predict pregnancy results in in-vitro fertilization cycles and the course of these pregnancies will be a stress mitigating factor for both doctors and the couples receiving treatment. This study was performed to assess whether serum ß-hCG level on the 13th day after embryo transfer (D13 ß-hCG) has a predictive role for different pregnancy results or not. DESIGN: Retrospective cohort study in a single tertiary center. MATERIALS AND METHODS: Two thousand two hundred thirty-six ICSI cycles were investigated. A total of 616 fresh, non-donor ICSI cycles who met the inclusion criteria were classified into two groups according to D13 ß-hCG; those R10 mIU/mL (pregnant¼251 cases) and those <10 mIU/mL (non pregnant¼365 cases). D13 ß¼hCG after embryo transfer were compared between the two groups and its predictive value for pregnancy outcomes was investigated. Mann-Whitney U test, Kruskal Wallis test, Pearson chi-square and fisher exact test were used, Post Hoc test was performed. ROC analysis and Spearman correlation were performed. A p value of p<0.05 was considered significant. RESULTS: Demographic cahracteristics and the number of embryos transferred were similar among groups with and without pregnancy (p>0.05). Among the 251 cases diagnosed with a pregnancy, 67 had miscarriages (55 early, 12 late). In singleton pregnancies; D13 ß-hCG levels was significantly lower in miscarriage group than ongoing pregnancy group (p<0.05). D13 ß hCG >127mIU/mL was found to predict that pregnancy will continue >20 weeks with a sensitivity of 83% and a specificity of 66.7% (PPV¼86.3% and NPV¼60%) (95% CI: 68%-84%, p<0,001). D13 ß-hCG <126mIU/mL could predict early miscarriage with 72% sensitivity and 82% spesificity (95% CI: 74%-89%) (p<0,001). D13 ß hCG levels could not predict preterm delivery either in single or multiple pregnancies (p¼0.552 and p¼0.426, respectively), and had no correlation with birth weight or gestational week at delivery (p¼0.102 and p¼0.571, respectively). CONCLUSIONS: According to this study live births were more frequent in patients with ß hCG >127.5 whereas early pregnancy loss was more likely below a ß-hCG level of 126.85. Levels above 319.5 could predict multiple pregnancy. No prediction for low birth weight or preterm birth could be made according to the ß hCG level. This is a retrospective analysis. Further prospective studies with more participants are required to predict early pregnancy outcomes in COH cycles.Öğe Late postpartum HELLP syndrome 60 hours after delivery associated with mild pre-eclampsia(2013) Çakmak, Bülent; Toprak, Muhammet; Nacar, Mehmet Can; Karataş, AhmetThe purpose of this report is to present a case of mild Pre-eclampsia which was complicated with postpartum HELLP syndrome. A 25-years-old pregnant woman with mild Pre-eclampsia at 36 weeks of gestation was admitted to our clinic with uterine contractions. A caesarean section was performed, due to her previous caesarean section history. Postpartum period was uneventful until the 2nd day after the caesarean section. Epigastric pain, nausea and vomiting appeared two days after her delivery. In evaluation of the case, laboratory findings which were associated with HELLP syndrome were found to include haemolysis, elevated liver enzymes and low platelet counts. The general condition and laboratory findings of the case returned to normal with supportive and steroid treatment after 3 days. It should be noted that HELLP syndrome can develop in the postpartum period. Therefore, caution should be exercised in patients with pre-eclampsia, for the development of the postpartum HELLP syndrome.Öğe Maternal metformin, obesity, and metabolic syndrome: the contribution of autonomic nervous system function(Mosby-Elsevier, 2014) Karataş, Ahmet; Özlü, Tülay; Erdem, AlimÖğe Maternal serum soluble HLA-G levels in missed abortions(Mdpi, 2013) Keskin, Fatih; Karataş, Ahmet; Albayrak, Mustafa; Bıyık, İsmail; Erkan, MüşerrefBackground and Objective. It is unclear how immune tolerance develops to a semiallograft fetus in pregnancy. Human leukocyte antigen G (HLA-G) expressed by extravascular trophoblasts plays an important role in the recognition of the gestational tissues as self and the development of immune tolerance against the gestational tissues by the maternal immune system. The soluble form of the HLA-G (sHLA-G) molecule in the maternal serum is also reported to contribute to the prevention of rejection during pregnancy. The aim of the study was to compare the maternal serum sHLA-G levels of the women with missed abortions and control subjects with uncomplicated pregnancies. Material and Methods. The prospective cross-sectional study involving 40 with missed abortions and 40 control women, matched by age, gestational age, and body mass index, was carried out. The study group consisted of the women with singleton pregnancies, who were diagnosed with a missed abortion. Only the patients who were confirmed to have an uncomplicated term delivery during follow-up were included in the control group. The serum sHLA-G level was compared between the groups. Results. There was no significant difference in the mean serum sHLA-G levels in terms of gravidity (P=0.761) and a history of abortion (P=0.379) in the control group. The median serum sHLA-G level in the missed abortion group was significantly lower compared with the control group (16.8 [8.5-35.8] vs. 26 [11-135] U/mL, P<0.001). All the women in the control group had uncomplicated term deliveries. Conclusion. Our results showed that the women with missed abortions had significantly lower serum sHLA-G levels compared with the healthy pregnant controls, which may have potentially played a role in the impairment of physiological immunological tolerance during pregnancy. However, the determination of the exact role and the potential clinical utility of maternal serum sHLA-G for the detection/ prediction of a missed abortion risk requires further detailed studies.Öğe Polymorphisms of toll-like receptors 2, 3 and 4 in patients that do and do not enter labour spontaneously at term(Taylor & Francis Inc, 2014) Özlü, Tülay; Ocak, Zeynep; Simavlı, Serap Aynur; Karataş, AhmetTo assess the association of polymorphisms of toll-like receptors (TLRs) 2, 3 and 4 with the delay in onset of labour at term pregnancies, patients delivering at >37 weeks and without pre-eclampsia, IUGR or a history of preterm delivery were prospectively evaluated. TLR2 Arg753Gln, TLR3 (c.1377C/T) and TLR4 Asp299Gly and Thr399Ile polymorphisms were genotyped by using PCR-RFLP. Patients labouring spontaneously before the 41st week were compared with those who did not labour spontaneously until this week in terms of baseline characteristics, TLR 2, 3 and 4 polymorphisms. The same comparisons were also performed by using a 40th week cut-off. Chi-square test, two-sample t-test or Mann-Whitney U tests were used for comparisons, as appropriate. In total, 79 patients delivering after 37 weeks were evaluated. All had CC genotype for TLR2 Arg753Gln and TLR4 Thr399Ile. There were no significant differences for TLR4 Asp299Gly GA and TLR3 (c.1377C/T) polymorphisms between patients spontaneously entering or not entering labour until the 41st week; the same was true when the 40th week cut-off was used. Delay in onset of labour at term pregnant women does not seem to be affected by the presence of TLR 2, 3 or 4 polymorphisms. Further studies are needed.Öğe Primary chondroblastic osteosarcoma of the uterus: Immunohistochemical examination and differential diagnosis with malignant mixed mullerian tumor(2015) Özyalvaçlı, Gülzade; Behzatoğlu, Kemal; Astarcı, Hesna Müzeyyen; Kilitci, Asuman; Çinpolat, Ertunç; Karataş, Ahmet; Özlü, Tülayİskelet sistemi dışında görülen osteosarkomlar nadir görülen tümörlerdir. Bununla birlikte uterusun primer osteosarkomları oldukça nadir olup literatürde yalnızca 21 olgu bildirimiştir. Genellikle postmenopozal dönemde görülen bu tümörler klinik olarak agresif seyrederler. Malign Mikst Müllerien Tümör (MMMT) ile ayırıcı tanısı önem taşır. 61 yaşında postmenopozal dönemde olan bir kadının uterusunda kitle tesbit edilmiş olup, kitlenin histopatolojik ve immünohistokimyasal analizi sonucunda tanısı primer kondroblastik osteosarkom olarak verilmiş ve çok nadir görüldüğü için sunulmuştur.
