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Mumusoglu S, Erden M, Ozbek IY, Ince O, Esteves SC, Humaidan P, Yarali H. The true natural cycle frozen embryo transfer - impact of patient and follicular phase characteristics on serum progesterone levels one day prior to warmed blastocyst transfer. Reprod Biol Endocrinol 2023; 21:86. [PMID: 37723581 PMCID: PMC10506193 DOI: 10.1186/s12958-023-01136-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 09/10/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND In a true-natural cycle (t-NC), optimal progesterone (P4) output from the corpus luteum is crucial for establishing and maintaining an intrauterine pregnancy. In a previous retrospective study, low P4 levels (< 10 ng/mL) measured one day before warmed blastocyst transfer in t-NC were associated with significantly lower live-birth rates. In the current study, we aim to examine the relationship between patient, follicular-phase endocrine and ultrasonographic characteristics, and serum P4 levels one day prior to warmed blastocyst transfer in t-NC. METHOD 178 consecutive women undergoing their first t-NC frozen embryo transfer (FET) between July 2017-August 2022 were included. Following serial ultrasonographic and endocrine monitoring, ovulation was documented by follicular collapse. Luteinized unruptured follicle (LUF) was diagnosed when there was no follicular collapse despite luteinizing-hormone surge (> 17 IU/L) and increased serum P4 (> 1.5 ng/mL). FET was scheduled on follicular collapse + 5 or LH surge + 6 in LUF cycles. Primary outcome was serum P4 on FET - 1. RESULTS Among the 178 patients, 86% (n = 153) experienced follicular collapse, while 14% (n = 25) had LUF. On FET-1, the median serum luteal P4 level was 12.9 ng/mL (IQR: 9.3-17.2), ranging from 1.8 to 34.4 ng/mL. Linear stepwise regression revealed a negative correlation between body mass index (BMI) and LUF, and a positive correlation between follicular phase peak-E2 and peak-P4 levels with P4 levels on FET-1. The ROC curve analyses to predict < 9.3 ng/mL (< 25th percentile) P4 levels on FET-1 day showed AUC of 0.70 (95%CI 0.61-0.79) for BMI (cut-off: 23.85 kg/m2), 0.71 (95%CI 0.61-0.80) for follicular phase peak-P4 levels (cut-off: 0.87 ng/mL), and 0.68 (95%CI 0.59-0.77) for follicular phase peak-E2 levels (cut-off: 290.5 pg/mL). Combining all four independent parameters yielded an AUC of 0.80 (95%CI 0.72-0.88). The adjusted-odds ratio for having < 9.3 ng/mL P4 levels on FET-1 day for patients with LUF compared to those with follicle collapse was 4.97 (95%CI 1.66-14.94). CONCLUSION The BMI, LUF, peak-E2, and peak-P4 levels are independent predictors of low serum P4 levels on FET-1 (< 25th percentile; <9.3 ng/ml) in t-NC FET cycles. Recognition of risk factors for low serum P4 on FET-1 may permit a personalized approach for LPS in t-NC FET to maximize reproductive outcomes.
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Affiliation(s)
- Sezcan Mumusoglu
- Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Murat Erden
- Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey
| | | | - Onur Ince
- Department of Obstetrics and Gynecology, Kutahya Health Sciences University, Kutahya, Turkey
- Faculty of Arts and Science, Department of Statistics, Middle East Technical University, Ankara, Turkey
| | - Sandro C Esteves
- Androfert, Andrology, and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Peter Humaidan
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- The Fertility Clinic, Skive Regional Hospital, Resenvej 25, Skive, Denmark
| | - Hakan Yarali
- Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey.
- Anatolia IVF and Women Health Centre, Ankara, Turkey.
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Biyik I, Metineren H, Ozturk E, Simsek S, Oztas E, Guldur ME, Ince O. Placental T-Cadherin Correlates With Trophoblastic Invasion Anomalies: Placenta Percreta and Fetal Growth Restriction. Int J Gynecol Pathol 2023; 42:293-300. [PMID: 36731049 DOI: 10.1097/pgp.0000000000000884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In this study, we compared the placental T-cadherin staining intensity of pregnant women with placenta percreta (PP) and asymmetrical fetal growth restriction (FGR) compared with healthy control pregnancies. Placental T-cadherin levels of the placenta of 86 pregnant women in total, 25 with FGR, 30 with healthy pregnant subjects, and 31 with PP, were examined using monoclonal anti-T-cadherin (CDH13) antibody for immunohistochemical examination. In immunohistochemistry, H -scores were used for each group to compare the expression of T-cadherin in extravillous trophoblast (EVT) cells. T-cadherin H -score of EVTs was highest in the FGR group and the lowest in the PP group. The difference in H -score between the FGR group and the control group was not statistically significant ( P =0.344). The difference between the PP group and the other 2 groups was significant ( P <0.0001). Multivariable linear regression analysis with a stepwise elimination method was performed in order to identify demographic and clinical parameters with significant effects on the T-cadherin H -score of EVTs. The estimation results identified only the disease group as a significant predictor of the H -score of EVTs ( R2 =0.340, P <0.0001). The highest T-cadherin H -score of EVTs was found in the FGR group and the lowest in the PP group. The low T-cadherin H-score values in the PP group suggest that low T-cadherin EVTs may be associated with increased placental invasion. Likewise, despite the statistical insignificance, a higher T-cadherin H -score of EVTs in FGR compared with controls implies a decreased invasiveness of the placenta in FGR.
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Yildirim Karaca S, Adiyeke M, Ince O, Ileri A, Vural T, Şahingöz Yildirim AG, Şenkaya AR, Bulut S, Kantarci S, Sanci M. Prediction model for residual high-grade cervical intraepithelial lesions. Minerva Obstet Gynecol 2023; 75:158-164. [PMID: 35107237 DOI: 10.23736/s2724-606x.22.04991-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
BACKGROUND The aim of the study was to evaluate risk factors associated with high-grade cervical intraepithelial lesions (HSIL) in patients undergoing a second cervical excision procedure due to positive surgical margins and to create a prediction model for residual disease. METHODS This study included patients with HSIL positive surgical margins following loop electrosurgical excision procedures (LEEP) between March 2015 and August 2019. HSIL in the second cervical excision pathology in these patients was accepted as residual disease. For residual disease prediction, a multivariate logistic regression and stepwise elimination analysis of 14 variables including demographic characteristics, clinical characteristics, pathology results and HPV genotypes of the patients was performed. RESULTS Second cervical excision procedures were performed in 290 patients 85(29.4%) of these patients had CIN 2 (cervical intraepithelial neoplasia) and 205 (70.6%) had CIN 3. In the second excision procedure, 166 patients (57.2%) had ≤CIN 1, 124 patients (42.8%) had ≥CIN2. The prediction model of residual disease includes only 3 variables out of the 14 different clinical characteristics (AUC=0.605 [0.539-0.671]). These variables are gravida (adjusted OR: 1.15 [0.97-1.38], P=0.107), CIN2-3 presence in the endocervical canal in the first LEEP specimen (adjusted OR: 1.52 [0.94-2.47], P=0.091) and the presence of HR-HPV except 16/18 lesions (adjusted OR: 0.64 [0.38-1.06], P=0.083). CONCLUSIONS A prediction model was designed with our data, from variables reported to be risk factors for residual disease in previous studies. While this model was statistically significant, it was poor at distinguishing residual disease. A prediction model can be designed to guide clinicians with future studies.
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Affiliation(s)
- Suna Yildirim Karaca
- Department of Obstetrics and Gynecology, Health Sciences University, Tepecik Education and Research Hospital, Izmir, Turkey -
| | - Mehmet Adiyeke
- Department of Obstetrics and Gynecology, Health Sciences University, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Onur Ince
- Department of Obstetrics and Gynecology, Kutahya Health Sciences University, Kutahya, Turkey
| | - Alper Ileri
- Department of Obstetrics and Gynecology, Buca Seyfi Demirsoy State Hospital, Izmir, Turkey
| | - Tayfun Vural
- Department of Obstetrics and Gynecology, Health Sciences University, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Alkim G Şahingöz Yildirim
- Department of Obstetrics and Gynecology, Health Sciences University, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Ayşe R Şenkaya
- Department of Obstetrics and Gynecology, Health Sciences University, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Sertaç Bulut
- Department of Obstetrics and Gynecology, Health Sciences University, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Sercan Kantarci
- Department of Obstetrics and Gynecology, Health Sciences University, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Muzaffer Sanci
- Department of Obstetrics and Gynecology, Health Sciences University, Tepecik Education and Research Hospital, Izmir, Turkey
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Kirankaya A, Tugrul S, Ozcan S, Ince O, Donmez E, Atici A, Hancioglu E, Okuyan E, Sahin I. Correlation between the serum lumican level and the severity of coronary artery disease. Eur Rev Med Pharmacol Sci 2023; 27:2350-2357. [PMID: 37013754 DOI: 10.26355/eurrev_202303_31770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
OBJECTIVE Several studies have previously shown that some small leucine-rich proteoglycans (SLRPs) are associated with atherosclerotic plaque. We aim to investigate the relationship between circulating lumican levels and the severity of coronary artery disease (CAD). PATIENTS AND METHODS This study included 255 consecutive patients who underwent coronary angiography for stable angina pectoris. All demographic and clinical data were collected prospectively. The severity of CAD was assessed based on the Gensini score and a value >40 was defined as advanced CAD. RESULTS Eighty-eight patients were in the advanced CAD group; these are older and the frequency of diabetes mellitus, cerebrovascular accidents, reduced ejection fraction (EF), left atrium diameter was higher. Serum lumican levels were found as higher in advanced CAD group (0.4 ng/ml vs. 0.6 ng/ml, respectively, p<0.001). When the Gensini score increased, a statistically significant increase was observed in lumican levels with a good correlation (r=0.556 and p<0.001). In multivariate analysis, diabetes mellitus, EF and lumican were predictive for advanced CAD. Lumican level predicts CAD seriousness with a sensitivity rate of 64%, specificity rate of 65%. CONCLUSIONS In this study, we reveal a relationship between serum lumican levels and CAD severity. More research is warranted to determine the mechanism and prognostic values of lumican in the atherosclerosis.
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Affiliation(s)
- A Kirankaya
- Department of Biochemistry, Bagcilar Research and Education Hospital, Istanbul, Turkey.
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Ince O, Önder H, Gencturk M, Cebeci H, Golzarian J, Young S. Abstract No. 27 Radiomics with machine learning in selective internal radiation therapy: prediction of radiologic response. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Ince O, Önder H, Gencturk M, Golzarian J, Young S. Abstract No. 220 Machine learning and refractory ascites: ability to predict those who will respond to TIPS placement. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Erten Ö, Biyik İ, Soysal C, Ince O, Keskin N, Tascı Y. Effect of the Covid 19 pandemic on depression and mother-infant bonding in uninfected postpartum women in a rural region. BMC Pregnancy Childbirth 2022; 22:227. [PMID: 35305584 PMCID: PMC8934050 DOI: 10.1186/s12884-022-04580-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/14/2022] [Indexed: 11/30/2022] Open
Abstract
Background Postpartum depression and maternal-infant attachment scores were examined in uninfected women during the COVID 19 pandemic in Kutahya, a rural province in Turkey's North Aegean region. Methods This cohort study was conducted in the Kutahya Health Sciences University Hospital obstetrics unit between April 2021 and August 2021. 178 low-risk term pregnant women who gave birth were given the surveys Edinburgh Postpartum Depression Scale and Mother-to-Infant Bonding Scale (MIBQ) 6 weeks after birth. The Edinburgh Postpartum Depression Scale was used to determine postpartum depression and the Mother-to-Infant Bonding Scale was used to determine maternal attachment. Results In this study, the postpartum depression rate was calculated as 17.4%. When depressed and non-depressed patients were compared, education level, maternal age, BMI, MIBQ score, history of previous pregnancies, route of delivery, previous operation history, economic status, employment status and pregnancy follow-up information were found to be similar (p > 0.05). The ratings on the Mother-to-Infant Bonding Scale were found to be similar in depressed and non-depressed patients (p > 0.05). The odds of maternal depression for patients who received guests at home was 3.068 (95%CI [1.149–8.191]) times the odds of patients who did not receive guests at home. Conclusions Although a relationship has been found between accepting guests in the postpartum period and postpartum depression, it is necessary to investigate in further studies whether there is a causal relationship.
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Ince O. The Strong Relationship Between PTEN Expression in Human Granulosa Cells and the Ovarian Response. Reprod Sci 2021; 29:524-525. [PMID: 34618344 DOI: 10.1007/s43032-021-00744-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/10/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Onur Ince
- Department of Obstetrics and Gynaecology, Kutahya Health Sciences University, 43000, Kutahya, Turkey. .,Department of Statistics, Faculty of Arts and Science, Middle East Technical University, 06800, Ankara, Turkey.
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Keskin N, Biyik I, Ince O, Gokten H, Simsek S, Soysal C, Erten O. Evaluation of the consistency ratios of cervical smear, cervical biopsy and conization results. Ginekol Pol 2021; 92:778-783. [PMID: 33914320 DOI: 10.5603/gp.a2021.0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/15/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Possible discrepancies between the cervical smear, biopsy histology and loop electrosurgical excision procedure (LEEP) results of the same patient is a matter of debate in the literature. In this study, we investigate the degree to which these results differ, and the clinical reasons for these differences. MATERIAL AND METHODS With a retrospective design, cervical smear, cervical biopsy and LEEP results of patients were compared in terms of consistency. One hundred sixty-four patients who underwent till LEEP procedure due to pathologic initial smear and biopsy results between January 2015 and March 2020 were included in the study. RESULTS Exact diagnosis discrepancy and high grade squamous intraepithelial lesion (HSIL) discrepancy were 78.9% and 50.0% between smear and cervical biopsy, 64.6% and 31.7% between cervical smear and LEEP and 43.8% and 28.1% between cervical biopsy and LEEP results, respectively. Age did not affect the consistency rates of pathologic results between smear-biopsy (p = 0.408) and biopsy-LEEP (p = 0.590). However, the probability of the consistency of smear and LEEP results exhibited a statistically significant linear relation with age (OR = 1.043, p = 0.015). HPV infections did not affect the discrepancy between smear-biopsy (p = 0.533), smear-LEEP (p = 1.000) and biopsy-LEEP (p = 0.529) CONCLUSIONS: Smear technique has a serious discrepancy and under-diagnosis problem when its results are compared with biopsy and LEEP. The consistency between smear and LEEP results appears to improve with age. When HSIL is evaluated in terms of detection, this discrepancy decreases. A smear test can detect HSIL and carcinoma with a higher accuracy than low-grade lesions.
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Affiliation(s)
- Nadi Keskin
- Kütahya Sağlık Bilimleri Üniversitesi, Evliya Çelebi Yerleşkesi Tavşanlı Yolu 10. Km Kütahya, Turkey.
| | - Ismail Biyik
- Kütahya Sağlık Bilimleri Üniversitesi, Evliya Çelebi Yerleşkesi Tavşanlı Yolu 10. Km Kütahya, Turkey
| | - Onur Ince
- Kütahya Sağlık Bilimleri Üniversitesi, Evliya Çelebi Yerleşkesi Tavşanlı Yolu 10. Km Kütahya, Turkey
| | - Hazal Gokten
- Kütahya Sağlık Bilimleri Üniversitesi, Evliya Çelebi Yerleşkesi Tavşanlı Yolu 10. Km Kütahya, Turkey
| | - Sercan Simsek
- Kutahya Evliya Celebi Education and Research Hospital, Turkey
| | - Cenk Soysal
- Kütahya Sağlık Bilimleri Üniversitesi, Evliya Çelebi Yerleşkesi Tavşanlı Yolu 10. Km Kütahya, Turkey
| | - Ozlem Erten
- Kütahya Sağlık Bilimleri Üniversitesi, Evliya Çelebi Yerleşkesi Tavşanlı Yolu 10. Km Kütahya, Turkey
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Ince O, Karaca SY, Karaca I. M-mode Ultrasound Scan as a Potential Alternative Technique for Monitoring Uterine Contractions in Obese Patients. Reprod Sci 2021; 28:1989-1995. [PMID: 33442847 DOI: 10.1007/s43032-020-00435-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/13/2020] [Indexed: 11/29/2022]
Abstract
We investigate motion mode (M-mode) ultrasound scan as a potential non-invasive uterine monitoring technique and compare its contraction characteristics with external tocodynamometry (TOCO). This prospective diagnostic accuracy study included 39 term pregnant woman in active spontaneous labor. M-mode and TOCO were simultaneously performed and uterine contraction characteristics and consistency were compared quantitatively and visually. The results identified a 71.5% ± 35.3% uterine wall thickening during uterine contractions on M-mode. Uterine monitoring with M-mode had a consistency rate of 88.7% ± 6.9% with conventional TOCO method. During 20-min monitoring, the number of detected contractions was significantly higher (p < 0.001) in M-mode (8.2 ± 1.2) than TOCO (7.4 ± 1.5). As for the mean value of the duration of a contraction (seconds), it was significantly shorter (p < 0.001) in M-mode (38.5 ± 3.5) than TOCO (49.2 ± 4.1). For M-mode, the number of detected contractions had a negative but insignificant correlation with the body mass index (BMI) (r = - 0.25 [- 0.52, 0.07], p = 0.127) and the subcutaneous tissue thickness (STT) (r = - 0.21 [- 0.49, 0.11], p = 0.200). As for TOCO, the contractions had a negative and significant correlation with BMI (r = - 0.41 [- 0.64, - 0.11], p = 0.009) and negative and insignificant correlation with STT (r = - 0.26 [- 0.54, 0.06], p = 0.104). The evidence suggests that contraction detection with M-mode is a promising non-invasive technique for uterine monitoring. The preliminary analysis finds that contraction detection is not affected by BMI or STT. With future sensitivity studies, and improvements in image-processing and software technologies, the proposed technique promises to be a viable alternative to existing techniques, especially for obese patients.
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Affiliation(s)
- Onur Ince
- Department of Obstetrics and Gynaecology, Kutahya Health Sciences University, 43000, Kutahya, Turkey.,Department of Statistics, Faculty of Arts and Science, Middle East Technical University, 06800, Ankara, Turkey
| | - Suna Yildirim Karaca
- Department of Obstetrics and Gynaecology, Health Sciences University Tepecik Education and Research Hospital, 35020, Izmir, Turkey
| | - Ibrahim Karaca
- Department of Obstetrics and Gynaecology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, 34147, Istanbul, Turkey.
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Kalyoncu Ş, Yilmaz B, Demir M, Tuncer M, Bozdağ Z, Ince O, Bozdayi MA, Ulusal H, Taysi S. Melatonin attenuates ovarian ischemia reperfusion injury in rats by decreasing oxidative stress index and peroxynitrite. Turk J Med Sci 2020; 50:1513-1522. [PMID: 32927928 PMCID: PMC7605088 DOI: 10.3906/sag-2004-135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 09/08/2020] [Indexed: 12/17/2022] Open
Abstract
Background/aim To evaluate the protective effect of melatonin on ovarian ischemia reperfusion injury in a rat model. Materials and methods Forty-eight rats were separated equally into 6 groups. Group 1: sham; Group 2: surgical control with 3-h bilateral ovarian torsion and detorsion; Group 3: intraperitoneal 5% ethanol (1 mL) just after detorsion (as melatonin was dissolved in ethanol); Group 4: 10 mg/kg intraperitoneal melatonin 30 min before 3-h torsion; Group 5:10 mg/kg intraperitoneal melatonin just after detorsion; Group 6:10 mg/kg intraperitoneal melatonin 30 min before torsion and just after detorsion. Both ovaries and blood samples were obtained 7 days after detorsion for histopathological and biochemical analysis. Results In Group 1, serum levels of total oxidant status (TOS) (μmol H2O2 equivalent/g wet tissue)were significantly lower than in Group2 (P = 0.0023), while tissue TOS levels were lower than in Group 3 (P = 0.0030). Similarly, serum and tissue levels of peroxynitrite in Group 6were significantly lower than those ofGroup 2 (P = 0.0023 and P = 0.040, respectively). Moreover, serum oxidative stress index (OSI) (arbitrary unit) levels were significantly increased in Group 2 when compared to groups 1 and 6 (P = 0.0023 and P= 0.0016, respectively) and in Group 3 with respect to groups 1, 4, 5, and 6 (P = 0.0023, P = 0.0026, P = 0.0008, and P = 0.0011, respectively). Furthermore, there was a significant decrease in histopathological scores including follicular degeneration, vascular congestion, hemorrhage, and inflammation in the melatonin and sham groups in comparison with control groups. Additionally, primordial follicle count was significantly higher in Group 6 than in Group 2 (P = 0.0002). Conclusion Melatonin attenuates ischemia reperfusion damage in a rat torsion/detorsion model by improving histopathological and biochemical findings including OSI and peroxynitrite.
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Affiliation(s)
- Şenol Kalyoncu
- Department of Obstetrics and Gynecology, TOBB ETU University Hospital, Ankara, Turkey
| | - Bülent Yilmaz
- Department of Obstetrics and Gynecology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Mustafa Demir
- Department of Obstetrics and Gynecology, ANKA Hospital, Gaziantep, Turkey
| | - Meltem Tuncer
- Department of Physiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Zehra Bozdağ
- Department of Pathology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Onur Ince
- Department of Obstetrics and Gynecology, Faculty of Medicine, Health Science University, Kütahya, Turkey
| | - Mehmet Akif Bozdayi
- Department of Biochemistry, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Hasan Ulusal
- Department of Biochemistry, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Seyithan Taysi
- Department of Biochemistry, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
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Kalyoncu S, Yilmaz B, Demir M, Tuncer M, Bozdag Z, Ince O, Akif Bozdayi M, Ulusal H, Taysi S. Octreotide and lanreotide decrease ovarian ischemia-reperfusion injury in rats by improving oxidative and nitrosative stress. J Obstet Gynaecol Res 2020; 46:2050-2058. [PMID: 32748523 DOI: 10.1111/jog.14379] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/29/2020] [Accepted: 06/12/2020] [Indexed: 12/31/2022]
Abstract
AIM To investigate the protective effect of octreotide and lanreotide on ovarian damage in experimental ovarian ischemia-reperfusion injury. METHODS Fifty-six rats were separated into seven groups; group 1: sham group, group 2: surgical control group with 3-h torsion and detorsion, group 3: 0.02 mg/kg s.c. octreotide 30 min before 3-h torsion, group 4; octreotide just after detorsion for 7 days, group 5: octreotide 30 min before torsion and just after detorsion for 7 days, group 6: single time 20 mg/kg s.c. lanreotide before torsion, group 7: single time lanreotide just after detorsion. RESULTS All histopathological scores except congestion were significantly lower in group 1 than other groups. In addition, hemorrhage (group 2 vs 4: P < 0.05), degeneration (group 2 vs 4: P < 0.05, group 2 vs 5: P < 0.01 and group 2 vs 6: P < 0.05) and total damage score (group 2 vs 4: P < 0.05, group 2 vs 5: P < 0.05, group 2 vs 6: P < 0.05 and group 2 vs 7: P < 0.05) were significantly lower than other groups. Moreover, ovarian tissue total oxidant status and oxidative stress index levels were significantly decreased in groups 5 (both P < 0.05) and 7 (both P < 0.05) when compared to group 2. Furthermore, tissue levels of peroxynitrite were significantly higher in group 2 than groups 1, 3 and 5 (all P < 0.05). CONCLUSIONS Octreotide and lanreotide have a protective role against ischemia-reperfusion damage in rat torsion detorsion model by improving histopathological and biochemical findings including tissue levels of total oxidant status, oxidative stress index and peroxynitrite.
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Affiliation(s)
- Senol Kalyoncu
- Obstetrics and Gynecology Clinic, TOBB ETU University Hospital, Ankara, Turkey
| | - Bulent Yilmaz
- Department of Obstetrics and Gynecology, Recep Tayyip Erdogan University, Faculty of Medicine, Rize, Turkey
| | - Mustafa Demir
- Obstetrics and Gynecology Clinic, ANKA Hospital, Gaziantep, Turkey
| | - Meltem Tuncer
- Department of Physiology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Zehra Bozdag
- Department of Pathology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Onur Ince
- Department of Obstetrics and Gynecology, Kutahya Health Sciences University, Faculty of Medicine, Kutahya, Turkey
| | - Mehmet Akif Bozdayi
- Department of Biochemistry, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Hasan Ulusal
- Department of Biochemistry, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Seyithan Taysi
- Department of Biochemistry, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
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Demir M, Ince O, Yilmaz B, Decleer W, Osmanagaoglu K. The effect of human papilloma virus vaccination on embryo yield and clinical in vitro fertilisation outcomes: a matched retrospective cohort study. J OBSTET GYNAECOL 2020; 41:421-427. [PMID: 32662316 DOI: 10.1080/01443615.2020.1739008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The effects of HPV vaccination on embryo yield and pregnancy outcomes in IVF cycles with fresh embryo transfer (ET) were investigated. First, embryo yielding rates (EYR) in 2795 cycles with and without HPV vaccination were compared by retrospective cohort study design. EYR of HPV vaccinated and non-vaccinated patients were not significantly different (OR, 1.66; 95% CI, 0.76-3.63). Second, ET outcomes were compared for 155 HPV vaccine + cycles and 465 HPV vaccine - cycles after matching for ages and cycle attempt number. The differences in the number of retrieved oocytes (10.2 ± 6.1, 11.2 ± 6.7; p = .161), mature (MII) oocytes (8.7 ± 5.7, 9.8 ± 6.3; p = .088), two pronuclear zygotes (2PN) (5.4 ± 4.1, 6.1 ± 4.6; p = .110) and fertilisation rates (0.62 ± 0.23, 0.62 ± 0.23; p = .539) were insignificant between the two groups. Moreover, positive (OR, 0.74; 95% CI, 0.47-1.16), clinical (0.60; 0.36-1.01) and the ongoing pregnancy (0.55; 0.30-1.01) rates were lower in the HPV vaccinated group but the difference was not statistically significant.IMPACT STATEMENTWhat is already known on this subject? There are recent case studies that report premature ovarian insufficiency (POI) following a post-vaccination autoimmune response against the HPV vaccine. These studies suggest that the possible trigger for the immune reaction might be the immunogen content of the vaccine. However, the number of clinical studies investigating the effects of the HPV vaccine on reproductive function and in vitro fertilisation outcomes is limited.What do the results of this study add? In contrast to the case reports suggesting impaired reproductive and ovarian functions in HPV vaccinated patients, this study finds that in IVF patients HPV vaccinated and non-vaccinated women have similar EYR, MII, 2PN, oocyte counts, fertilisation rates, positive, clinical and ongoing pregnancy rates.What are the implications of these findings for clinical practice and/or further research? The results suggest the HPV vaccine does not have a negative impact on embryo yielding rates oocyte counts and fertilisation rates, positive, clinical and ongoing pregnancy rates in IVF treatments. Hence, they can be safely used for primary prevention against cervical cancer.
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Affiliation(s)
- Mustafa Demir
- Department of Obstetrics and Gynecology, Anka Hospital, Gaziantep, Turkey.,IVF Centrum, AZ Jan Palfijn Hospital, Gent, Belgium
| | - Onur Ince
- Department of Obstetrics and Gynecology, Kutahya Health Sciences University, Kutahya, Turkey
| | - Bulent Yilmaz
- Faculty of Medicine, Department of Obstetrics and Gynecology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Wim Decleer
- IVF Centrum, AZ Jan Palfijn Hospital, Gent, Belgium
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Karaca I, Erdoğan ŞV, Doğan K, Alay I, Ince O, Yıldırım Karaca S, Comba C, Bahceci E, Erdoğan A, Ozturk E, Ekin M. The effects of exogenous oral micronized progesterone on first trimester aneuploidy screening markers in women with threatened miscarriage: a matched case control study. J Matern Fetal Neonatal Med 2020; 35:1224-1229. [PMID: 32456488 DOI: 10.1080/14767058.2020.1745175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives: To evaluate the effect of using progesterone due to early vaginal bleeding on aneuploidy screening markers in the first trimester.Material and methods: This case control study includes the pregnant women who applied to our clinic in order to have a screening test for Down syndrome in the weeks of 11°/7-136/7. The patients were divided into three groups. Self reported vaginal bleeding with progesterone therapy (Bl+, Prg+, n:70), Self reported vaginal bleeding without progesterone therapy (Bl+, Prg-, n:70) and as a control group pregnant women who had no vaginal bleeding. (NoBl, NoPrg, n:70). In all patients, free beta-human chorionic gonadotrophin (β-hCG), pregnancy associated plasma protein-A (PAPP-A) levels and nuchal translucency (NT) thickness were analyzed. Mean MoMs of the markers were compared between three groups.Results: In the two groups with vaginal bleeding (Bl+, Prg + and Bl+, Prg-) the free β-Hcg MoM values were statistically higher (1.22 ± 0.72, 0.98 ± 0.45, respectively) compared to the No Bleeding/No Progesterone group (0.81 ± 0.52) (p ≤ 0.001, p ≤ .01, respectively). However, no significant difference was found between the free β-hCG MoM value of women with Bl+, Prg + group (1.22 ± 0.72) and Bl+, Prg - group (0.98 ± 0.45). (p: .053, significance level limitation with Bonferroni correction p: .017). PAPP-A and NT thickness did not differ significantly between the groups.Conclusion: Our data did not find an association between the use of oral progesterone and any alternations in first trimester screening parameters. Regardless of the progesterone usage, vaginal bleeding in the first trimester pregnancies increased the free β-hCG MoM values compared to pregnancies without vaginal bleeding during pregnancy.
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Affiliation(s)
- Ibrahim Karaca
- Department of Obstetrics and Gynecology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Şakir Volkan Erdoğan
- Department of Obstetrics and Gynecology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Keziban Doğan
- Department of Obstetrics and Gynecology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ismail Alay
- Department of Obstetrics and Gynecology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Onur Ince
- Department of ObstetricsandGynecology, Kutahya Health Sciences University, Kutahya, Turkey
| | - Suna Yıldırım Karaca
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Teaching and Research Hospital, İstanbul, Turkey
| | - Cihan Comba
- Department of Obstetrics and Gynecology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ece Bahceci
- Department of Obstetrics and Gynecology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Aliye Erdoğan
- Department of Obstetrics and Gynecology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Emine Ozturk
- Department of Obstetrics and Gynecology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Murat Ekin
- Department of Obstetrics and Gynecology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
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Ozturk E, Ince O, Karaca İ, Demirayak G, Comba C, Alay I, Erdogan VS, Yıldırım Karaca S, Ozdemir IA. The impact of concurrent HPV infections on the presentation of high grade cervical intraepithelial lesions. Ginekol Pol 2020; 91:324-330. [PMID: 32374017 DOI: 10.5603/gp.a2020.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/25/2019] [Accepted: 11/27/2019] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES We investigate how concurrent high-risk (hr) HPV (human papillomavirus) genotypes affect CIN2-3 risk and evaluate the relationship of different genotype combinations with cervical epithelial lesions. MATERIAL AND METHODS This study included HPV positive patients between the ages of 30 and 60 who underwent liquid-based cervical smears and HPV screening through community-based, cervical cancer screening programs between June 2015 and June 2017. The impact of the increase in hrHPV types was calculated by estimating how it changed the odds ratio of CIN2-3 risk. RESULTS The rate of multiple concurrent HPV infections was 48.7% in the CIN2-3 group and 58.4% in the CIN1 group. Among patients in the CIN2-3 and CIN1 groups, the most common HPV coinfection was respectively HPV 16+31 and HPV 16+51. The HPV 51 ratio in CIN1 patients was 28.9% and the HPV 51 ratio in the CIN2-3 patient was 6.6%. With every increase in the number of hrHPV infection types, the frequency of CIN2-3 decreased [OR: 0.72, 95% CI: 0.54-0.95]. For all hrHPV combinations, the addition of HPV 16 was associated with a higher risk of CIN2-3. CONCLUSIONS An increase in number of hrHPV types is associated with lower CIN2-3 risk. Further cohort studies with larger samples are needed to clarify this relationship. The available evidence suggests that HPV 16 genotype plays an important role in patients with high-grade cervical lesions and has a negative impact on the cervix in concurrent multiple HPV infections.
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Affiliation(s)
- Emine Ozturk
- Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Obstetrics and Gynecology, İstanbul, Turkey
| | - Onur Ince
- Kutahya Health Sciences University, Department of Obstetrics and Gynecology, Kutahya, Turkey
| | - İbrahim Karaca
- Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Obstetrics and Gynecology, İstanbul, Turkey.
| | - Gokhan Demirayak
- Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Obstetrics and Gynecology, İstanbul, Turkey
| | - Cihan Comba
- Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Obstetrics and Gynecology, İstanbul, Turkey
| | - Ismail Alay
- Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Obstetrics and Gynecology, İstanbul, Turkey
| | - Volkan Sakir Erdogan
- Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Obstetrics and Gynecology, İstanbul, Turkey
| | - Suna Yıldırım Karaca
- Kanuni Sultan Süleyman Training and Research Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey
| | - Isa Aykut Ozdemir
- Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Obstetrics and Gynecology, İstanbul, Turkey
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Karaca I, Ozturk M, Alay I, Ince O, Karaca SY, Erdogan VS, Ekin M. Influence of Abdominal Binder Usage after Cesarean Delivery on Postoperative Mobilization, Pain and Distress: A Randomized Controlled Trial. Eurasian J Med 2019; 51:214-218. [PMID: 31692751 DOI: 10.5152/eurasianjmed.2019.18457] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective The purpose of the present study was to determine the effect of abdominal binder usage on mobilization, postoperative pain, and distress after cesarean delivery. Materials and Methods This prospective randomized controlled study was conducted between September 1, 2017 and January 31, 2018 at Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey. A total of 89 women undergoing elective cesarean were randomized to the study (binder, n=45) or control (no binder, n=44) groups. Patients in the study group were fitted with a binder before leaving the operating room. Mobilization (6-minute walk test), postoperative pain (measured by Short-Form McGill Pain Questionnaire and Visual Analog Scale), and perceived distress status of both groups were evaluated within 8th (first mobilization time), 24th, and 48th h of surgery. Results We found that the binder group (BG) walked longer than the control group during the 6-minute walking distance test. At the first mobilization time (postoperative 8th h), the BG (99.4±27.3 m) covered significantly more distance than the control group (81.0±22.2 m) (p=0.001) in the walking distance test. At postoperative 24th h, the McGill pain score in the BG was significantly lower than that in the control group (p=0.004). For all three test times, the Symptom Distress Scale of the BG was lower than that of the control group (postoperative 8th h p=0.024, 24th h p<0.001, and 48th h p<0.001). Conclusion The evidence is consistent with abdominal binder usage after cesarean section decreasing the feeling of distress and increasing mobility.
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Affiliation(s)
- Ibrahim Karaca
- Department of Gynecology and Obstetrics, Health Sciences University, Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Mustafa Ozturk
- Department of Gynecology and Obstetrics, Health Sciences University, Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Ismail Alay
- Department of Gynecology and Obstetrics, Health Sciences University, Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Onur Ince
- Department of Gynecology and Obstetrics, Kutahya Health Sciences University, School of Medicine, Kutahya, Turkey
| | - Suna Yildirim Karaca
- Department of Gynecology and Obstetrics, Health Sciences University, İstanbul Kanuni Sultan Suleyman Training and Research Hospital, İstanbul, Turkey
| | - Volkan Sakir Erdogan
- Department of Gynecology and Obstetrics, Health Sciences University, Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Murat Ekin
- Department of Gynecology and Obstetrics, Health Sciences University, Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
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Coskun B, Ince O, Erkilinc S, Elmas B, Saridogan E, Coskun B, Doganay M. The feasibility of the platelet count and mean platelet volume as markers of endometriosis and adenomyosis: A case control study. J Gynecol Obstet Hum Reprod 2019; 49:101626. [PMID: 31499283 DOI: 10.1016/j.jogoh.2019.101626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 06/29/2019] [Accepted: 09/05/2019] [Indexed: 01/24/2023]
Abstract
INTRODUCTION The aim of the study is to investigate the role of platelet count (PC) and mean platelet volume (MPV) in determining adenomyosis and endometriosis. MATERIAL AND METHODS This was a retrospective case control study that included adenomyosis, endometriosis and control groups. The adenomyosis group included 84 women diagnosed between January 2013 and January 2015 based on hysterectomy specimen. The endometriosis group included 102 patients underwent diagnostic laparoscopy and confirmed by histopathologic examination. Lastly, the control group included 88 women had no medical problem and underwent tubal ligation. RESULTS MPV (fl) was significantly lower in adenomyosis group (8.5) compared to endometriosis (9, p<0.05) and control groups (9, p<0.01). Modified platelet activity (MPV/PC) was significantly lower in adenomyosis group compared to control group (p<0.01). Bivariate logistic regression model was used to assess the odds ratio of risk factors and serum markers related to endometriosis and adenomyosis. Variables showing significant differences based on post-hoc Bonferroni test were included in the logistic regression model for comparison of each disease with the control group. MPV was not found to be a risk factor both for presence of endometriosis and adenomyosis after adjusting for demographic and clinical characteristics. DISCUSSION Our study suggested that PC and MPV were not useful diagnostic markers for endometriosis or adenomyosis. Further research on how platelet indices and other inflammatory markers are related to inflammation might help better understand their potential as markers for these diseases.
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Affiliation(s)
- Bugra Coskun
- University of Health Sciences Gülhane Education and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey.
| | - Onur Ince
- Kutahya Health Sciences University, Faculty of Medicine, Department of Obstetrics and Gynecology, 43000, Kutahya, Turkey.
| | - Selcuk Erkilinc
- University of Health Sciences Tepecik Education and Research Hospital, Department of Gynecologic Oncology, İzmir, Turkey.
| | - Burak Elmas
- University of Health Sciences Zekai Tahir Burak Women's Health Education and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey.
| | - Erdinc Saridogan
- University of Health Sciences Zekai Tahir Burak Women's Health Education and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey.
| | - Bora Coskun
- University of Health Sciences Gülhane Education and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey.
| | - Melike Doganay
- University of Health Sciences Zekai Tahir Burak Women's Health Education and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey.
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Ertas IE, Ince O, Emirdar V, Gultekin E, Biler A, Kurt S. Influence of preoperative enema application on the return of gastrointestinal function in elective Cesarean sections: a randomized controlled trial. J Matern Fetal Neonatal Med 2019; 34:1822-1826. [PMID: 31397204 DOI: 10.1080/14767058.2019.1651264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIM There is an extensive literature on the mechanical bowel preparation by an enema in colorectal, abdominal, and gynecologic surgeries that provide evidence against the use of enema. There are, however, few studies investigating the effect of enema prior to elective Cesarean sections. The aim of this study is to investigate whether preoperative enema facilitates the return of gastrointestinal activity in pregnant women undergoing elective Cesarean section. MATERIALS AND METHODS The surgeon-blinded prospective randomized controlled study included 225 elective Cesarean patients between the ages of 18 and 44. The patients were randomized into two groups: those who had enema preoperatively (n = 114) and those who did not (n = 111). The outcome measures were first bowel sound time and first flatus time, the length of hospital stay, the rate of mid ileus symptoms, and additional analgesic and antiemetic need. RESULTS In the non-enema group, the time of the first bowel sound, flatus time, length of hospital stay, the rates of additional analgesic need, additional antiemetic need, and mild ileus symptoms were respectively 10.5 ± 5.8 hours, 16.0 ± 7.6 hours, 1.9 ± 0.3 days, 8.1%, 7.2%, and 2.7%. For the enema group, the same parameters were respectively 11.6 ± 4.7 hours, 17.5 ± 6.5 hours, 1.8 ± 0.3 days, 7%, 6.1% ,and 1.8%. For all parameters, the difference between the groups was not statistically significant (p values were respectively .09, .12, .8, .79, .68, and .26). CONCLUSIONS The study suggests that preoperative enema in elective cesarean sections does not prevent postoperative gastrointestinal complications and does not shorten the recovery of bowel movements or length of hospital stay.
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Affiliation(s)
- Ibrahim Egemen Ertas
- Department of Gynecology and Obstetrics, University of Health Sciences, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Onur Ince
- Department of Gynecology and Obstetrics, University of Health Sciences, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Volkan Emirdar
- Department of Gynecology and Obstetrics, University of Health Sciences, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Emre Gultekin
- Department of Gynecology and Obstetrics, University of Health Sciences, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Alper Biler
- Department of Gynecology and Obstetrics, University of Health Sciences, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Sefa Kurt
- Department of Gynecology and Obstetrics, University of Health Sciences, Tepecik Education and Research Hospital, Izmir, Turkey
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Demir M, Kalyoncu S, Ince O, Ozkan B, Kelekci S, Saglam G, Sutcu R, Yilmaz B. Endometrial Flushing Tumor Necrosis Factor Alpha and Interleukin 2 Levels in Women with Polycystic Ovary Syndrome, Leiomyoma and Endometrioma: Comparison with Healthy Controls. Geburtshilfe Frauenheilkd 2019; 79:517-523. [PMID: 31148852 PMCID: PMC6529228 DOI: 10.1055/a-0829-3873] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 01/02/2019] [Accepted: 01/07/2019] [Indexed: 12/12/2022] Open
Abstract
Introduction An important open question in the literature is whether endometrial receptivity marker levels are different in infertility related diseases than healthy women. The aim of the study is to compare the levels of interleukin two (IL-2) and tumor necrosis factor alpha (TNF-α) during the implantation window in the endometrial flushing fluid of polycystic ovary syndrome (PCOS), endometrioma, leiomyoma patients with healthy controls. Material and Methods In this case control study, after obtaining endometrial flushing fluids at mid-luteal phase of ovulatory women with PCOS (n = 20), endometrioma (n = 19), leiomyoma (n = 20) and healthy controls (n = 20), IL-2 and TNF-α levels were measured using ELISA kits in BioTek ELISA devices. Results Mean TNF-α levels (ng/mL) were similar for the PCOS (305.6, p = 0.220) and the leiomyoma group (246.3, p = 0.502) compared to healthy patients (261.1). However, the levels were higher in the endometrioma group (338.2, p = 0,004) than the control group (261.1) in a statistically significant way. Mean IL-2 levels (ng/mL) were significantly lower in the PCOS (290.9, p = 0.0005), the leiomyoma (282.9, p = 0.0002) and the endometrioma patients (229.5, p = 0.0009) than the control group (416.0). Conclusion Relative to the control group, endometrial flushing fluid TNF-α levels were significantly higher in endometrioma patients and IL-2 levels were significantly lower in PCOS, leiomyoma and endometrioma patients. In benign gynecological diseases, endometrial markers related to infertility seem to show differences in endometrial flushing fluid. Future studies might identify the reference values for these markers, and endometrial markers can be used to diagnose gynecologic disorders causing infertility.
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Affiliation(s)
- Mustafa Demir
- Department of Obstetrics and Gynecology, Harran University Faculty of Medicine, Sanliurfa, Turkey.,Department of Obstetrics and Gynecology, Izmir Katip Celebi University Faculty of Medicine, Izmir, Turkey
| | - Senol Kalyoncu
- Department of Obstetrics and Gynecology, TOBB University of Economics and Technology, ETU Hospital, Ankara, Turkey
| | - Onur Ince
- Department of Obstetrics and Gynecology, IVF Unit, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Bulent Ozkan
- Department of Biostatistics, Izmir Katip Celebi University Faculty of Medicine, Izmir, Turkey
| | - Sefa Kelekci
- Department of Obstetrics and Gynecology, Izmir Katip Celebi University Faculty of Medicine, Izmir, Turkey
| | - Gulcan Saglam
- Department of Biochemistry, Izmir Katip Celebi University Faculty of Medicine, Izmir, Turkey
| | - Recep Sutcu
- Department of Biochemistry, Izmir Katip Celebi University Faculty of Medicine, Izmir, Turkey
| | - Bulent Yilmaz
- Department of Obstetrics and Gynecology, Izmir Katip Celebi University Faculty of Medicine, Izmir, Turkey.,Department of Obstetrics and Gynecology, IVF Unit, Tepecik Education and Research Hospital, Izmir, Turkey
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Golbasi H, Ince O, Golbasi C, Ozer M, Demir M, Yilmaz B. Effect of progesterone/estradiol ratio on pregnancy outcome of patients with high trigger-day progesterone levels undergoing gonadotropin-releasing hormone antagonist intracytoplasmic sperm injection cycles: a retrospective cohort study. J OBSTET GYNAECOL 2018; 39:157-163. [PMID: 30280612 DOI: 10.1080/01443615.2018.1504204] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This study investigates the predictive power of serum progesterone/estradiol (P/E2) level for estimating the live birth rate in patients who had a serum progesterone (P) rate ≥ 1.5 ng/mL on the human chorionic gonadotropin (hCG) administration day and who received the gonadotropin-releasing hormone (GnRH) antagonist protocol and intracytoplasmic sperm injection (ICSI). This retrospective cohort study included 176 cycles. The P/E2 ratio was lower in patients with a live birth (0.73 ± 0.54) than those without a live birth (1.05 ± 1.38), but the difference was not statistically significant (p = .158). According to the receiver operating characteristic curve analysis of the hCG day P/E2 ratio, the area under the curve was 0.579 (95% confidence interval: 0.478 - 0.680, p = .158) for predicting live birth. In conclusion, this study suggests that a P/E2 ratio is not a significant predictor of a live birth rate in the patients with an hCG-day serum progesterone level of ≥1.5 ng/mL undergoing GnRH antagonist ICSI cycles with a fresh embryo transfer. Impact statement What is already known on this subject? As the progesterone (P) levels in the late follicular phase correlate with the estradiol (E2) levels and the increase in mature follicles, earlier studies have proposed the trigger-day progesterone/estradiol (P/E2) ratio as a potential new marker for a premature luteinisation and live birth success. Most of these studies were conducted on long agonist cycles, and found that arbitrarily defined P/E2 ratio of >1 to be associated with poor pregnancy outcomes. What do the results of this study add? This study retrospectively examines the gonadotropin-releasing hormone (GnRH) antagonist cycles with a trigger-day serum P value of ≥1.5 ng/mL undergoing the intracytoplasmic sperm injection (ICSI) treatment. The receiver operating characteristic (ROC) curve analysis did not identify a statistically significant threshold value for the trigger-day P/E2 ratio that was beneficial in predicting a live birth. The P/E2 ratio was also lower in the cycles with a live birth than those without a live birth, although the difference was not statistically significant. What are the implications of these findings for clinical practice and/or further research? The trigger-day P/E2 ratio does not seem to be an efficient prognostic factor for a live birth in the GnRH antagonist ICSI cycles with a trigger-day serum progesterone level of ≥1.5 ng/mL. Further studies are needed to clarify the association of the trigger-day P/E2 ratio and the pregnancy outcomes in GnRH antagonist ICSI cycles.
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Affiliation(s)
- Hakan Golbasi
- a Department of Obstetrics and Gynecology , Sakarya Akyazı State Hospital , Sakarya , Turkey
| | - Onur Ince
- b Department of Obstetrics and Gynecology , Bingöl Maternity and Pediatric Hospital , Bingöl , Turkey
| | - Ceren Golbasi
- c Department of Obstetrics and Gynecology , Sakarya Training and Research Hospital , Sakarya , Turkey
| | - Mehmet Ozer
- d Department of Obstetrics and Gynecology , İzmir Tepecik Training and Research Hospital , İzmir , Turkey
| | - Mustafa Demir
- e Department of Obstetrics and Gynecology , Harran University School of Medicine , Şanlıurfa , Turkey
| | - Bulent Yilmaz
- f Department of Obstetrics and Gynecology , Izmir Katip Celebi University School of Medicine , İzmir , Turkey
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Ozbayram E, Akyol Ç, Ince B, Karakoç C, Ince O. Rumen bacteria at work: bioaugmentation strategies to enhance biogas production from cow manure. J Appl Microbiol 2018; 124:491-502. [DOI: 10.1111/jam.13668] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 12/05/2017] [Accepted: 12/07/2017] [Indexed: 11/29/2022]
Affiliation(s)
- E.G. Ozbayram
- Institute of Environmental Sciences; Bogazici University; Istanbul Turkey
| | - Ç. Akyol
- Department of Environmental Engineering; Faculty of Civil Engineering; Istanbul Technical University; Istanbul Turkey
| | - B. Ince
- Department of Environmental Engineering; Faculty of Civil Engineering; Istanbul Technical University; Istanbul Turkey
| | - C. Karakoç
- Department of Environmental Microbiology; Helmholtz Centre for Environmental Research - UFZ; Leipzig Germany
| | - O. Ince
- Institute of Environmental Sciences; Bogazici University; Istanbul Turkey
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Demir M, Ince O, Ozkan B, Kelekci S, Sutcu R, Yilmaz B. Endometrial flushing α Vβ 3 integrin, glycodelin and PGF2α levels for evaluating endometrial receptivity in women with polycystic ovary syndrome, myoma uteri and endometrioma. Gynecol Endocrinol 2017; 33:716-720. [PMID: 28454508 DOI: 10.1080/09513590.2017.1318276] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
The aim of this cross-sectional study is to compare endometrial flushing fluid levels of αVβ3 integrin, glycodelin and PGF2α during the midluteal phase of the menstrual cycle of women with polycystic ovary syndrome (PCOS, n = 20), myoma uteri (n = 20) and endometrioma (n = 19) with the healthy controls (n = 20). After collecting samples at the midluteal phase of ovulatory volunteers and storing them at -80 °C, αVβ3 integrin, glycodelin and PGF2α levels were analyzed using ELISA. The mean ages of the groups were 28.90 ± 5.45, 37.25 ± 2.73, 32.84 ± 6.62 and 32.15 ± 5.18 in PCOS, myoma uteri, endometrioma and control groups, respectively. The αVβ3 integrin level (ng/ml) was statistically significantly higher in endometrioma group (9.70 ± 1.72, p < 0.05) as compared to myoma uteri and control groups. Similarly, glycodelin level (ng/ml) was significantly higher in endometrioma group (341.04 ± 93.32) than PCOS (p < 0.01), myoma uteri (p < 0.001) and healthy subjects (p < 0.001). Moreover, PGF2α level (350.04 ± 464.50 ng/ml) was significantly higher in PCOS group relative to myoma uteri (p < 0.001), endometrioma (p < 0.05) and control (p < 0.05) groups. In conclusion, αVβ3 integrin level was significantly higher in endometrioma subjects than those with myoma uteri and control groups; glycodelin level was significantly higher in endometrioma group than other three groups, and lastly, PCOS patients had significantly higher PGF2α levels than those patients with myoma uteri, endometrioma and controls.
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Affiliation(s)
- Mustafa Demir
- a Department of Obstetrics and Gynecology , Faculty of Medicine, Izmir Katip Celebi University , İzmir , Turkey
- b Department of Obstetrics and Gynecology , Faculty of Medicine, Harran University , Sanliurfa , Turkey
| | - Onur Ince
- c Department of Obstetrics and Gynecology , IVF Unit, Tepecik Education and Research Hospital , Izmir , Turkey
| | | | - Sefa Kelekci
- a Department of Obstetrics and Gynecology , Faculty of Medicine, Izmir Katip Celebi University , İzmir , Turkey
| | - Recep Sutcu
- e Department of Biochemistry , Faculty of Medicine, Izmir Katip Celebi University , Izmir , Turkey
| | - Bulent Yilmaz
- a Department of Obstetrics and Gynecology , Faculty of Medicine, Izmir Katip Celebi University , İzmir , Turkey
- c Department of Obstetrics and Gynecology , IVF Unit, Tepecik Education and Research Hospital , Izmir , Turkey
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Sanci M, Töz E, Ince O, Özcan A, Polater K, Inan AH, Beyan E, Akkaya E. Reference values for maternal total and differential leukocyte counts in different trimesters of pregnancy and the initial postpartum period in western Turkey. J OBSTET GYNAECOL 2017; 37:571-575. [PMID: 28604181 DOI: 10.1080/01443615.2016.1268575] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The aim of this study was to investigate alterations in the leukocyte and differential leukocyte counts in different trimesters of pregnancy and the initial postpartum period. The study population consisted of 40,325 pregnant women. A full blood count and automated differential leukocyte count were performed and all the haemogram results in the different trimesters of pregnancy were recorded. Percentiles were calculated using statistical software. A total of 82,786 complete blood count evaluations were performed in 40,325 subjects from the 6th to 41st week of pregnancy and in the initial postpartum period. The leukocyte counts increased from the 1st to the 3rd trimester and peaked in the initial postpartum period. Our reference values for the total and differential leukocyte counts may assist clinicians in distinguishing between leukocytosis and pathological elevation of the white blood cell count during pregnancy and the initial postpartum period. Impact statement Pregnancy requires profound adaptation by multiple systems to accommodate the demands of the developing foetus. Similar to all other systems, many haematological changes occur during pregnancy. Studies of normal variation in leukocyte counts were insufficient to distinguish normal from abnormal leukocyte counts during pregnancy and in the initial postpartum period, due to small numbers of patients and a lack of differential leukocyte counts. Without reference leukocyte levels, infections may be more difficult to assess during pregnancy and in the postpartum period. In this study, we report the 3rd, 5th, 10th, 50th, 95th and 99th percentile values for the total and differential leukocyte counts according to trimester in normal pregnancy and the initial postpartum period. Our reference values for the total and differential leukocyte counts in each trimester and the initial postpartum period may assist clinicians in distinguishing between normal leukocytosis and pathological elevation of the white blood cell count during pregnancy and the initial postpartum period. Our results may prevent misdiagnosis of physiological elevated leukocytes as bacterial infection that leads to unnecessary medication use that may compromise the foetus.
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Affiliation(s)
- Muzaffer Sanci
- a Department of Gynecology and Obstetrics , Tepecik Education and Research Hospital , İzmir , Turkey
| | - Emrah Töz
- a Department of Gynecology and Obstetrics , Tepecik Education and Research Hospital , İzmir , Turkey
| | - Onur Ince
- a Department of Gynecology and Obstetrics , Tepecik Education and Research Hospital , İzmir , Turkey
| | - Aykut Özcan
- a Department of Gynecology and Obstetrics , Tepecik Education and Research Hospital , İzmir , Turkey
| | - Kevser Polater
- a Department of Gynecology and Obstetrics , Tepecik Education and Research Hospital , İzmir , Turkey
| | - Abdurrahman Hamdi Inan
- a Department of Gynecology and Obstetrics , Tepecik Education and Research Hospital , İzmir , Turkey
| | - Emrah Beyan
- a Department of Gynecology and Obstetrics , Tepecik Education and Research Hospital , İzmir , Turkey
| | - Emrah Akkaya
- b Department of Gynecology and Obstetrics , Manisa Maternity and Child Hospital , Manisa , Turkey
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Cetecioglu Z, Ince B, Orhon D, Ince O. Anaerobic sulfamethoxazole degradation is driven by homoacetogenesis coupled with hydrogenotrophic methanogenesis. Water Res 2016; 90:79-89. [PMID: 26724442 DOI: 10.1016/j.watres.2015.12.013] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Revised: 12/01/2015] [Accepted: 12/11/2015] [Indexed: 06/05/2023]
Abstract
In this study, microbial community dynamics were assessed in two lab-scale anaerobic sequencing batch reactors (ASBRs). One of the reactors was fed by synthetic pharmaceutical industry wastewater with sulfamethoxazole (SMX) as the test reactor and the other without sulfamethoxazole as the control reactor. DNA based DGGE results indicated that Clostiridum sp. became dominant in the SMX reactor while the inoculum was dominated with Firmicutes (61%) and Methanomicrobiales (28%). However their abundances in active community decreased through the last phase. Also the abundance of hydrogenotrophs was high in each phase, while acetoclastic methanogens disappeared in the last phase. Q-PCR analysis revealed that there is a significant reduction in the bacterial community approximately 84%, while methanogens increased to 97% through the operation. Additionally an increase in the expression level of bacterial and methanogenic 16S rRNA (60% and 20%, respectively) was detected. Significant correlation between microbial community and the reactor operation data was found. The study demonstrated that the microbial community maintains the system stability under high antibiotic concentration and long-term operation by homoacetogenesis coupled with hydrogenotrophic methanogenesis.
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Affiliation(s)
- Z Cetecioglu
- Environmental Engineering Department, Istanbul Technical University, 34469, Maslak, Istanbul, Turkey.
| | - B Ince
- Bogazici University, Institute of Environmental Sciences, Rumelihisarustu - Bebek, 34342, Istanbul, Turkey
| | - D Orhon
- Environmental Engineering Department, Istanbul Technical University, 34469, Maslak, Istanbul, Turkey
| | - O Ince
- Environmental Engineering Department, Istanbul Technical University, 34469, Maslak, Istanbul, Turkey
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Gur EB, Turan GA, Ince O, Karadeniz M, Tatar S, Kasap E, Sahin N, Guclu S. Effect of Ramadan fasting on metabolic markers, dietary intake and abdominal fat distribution in pregnancy. Hippokratia 2015; 19:298-303. [PMID: 27688692 PMCID: PMC5033138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND The aim of this study is to evaluate the effect of Ramadan intermittent fasting on metabolic markers, dietary intake, anthropometric measurements, and abdominal visceral fat thickness (VFT) in pregnancy. METHODS Seventy-eight healthy pregnant subjects who had fasted for at least 15 days during the month of Ramadan in 2012 and 2013 and 78 controls were included in this study. Metabolic markers, dietary intake, anthropometric measurements, and ultrasonographic VFT were calculated for each subject before and after Ramadan fasting. RESULTS When before and after Ramadan values in the fasting group were compared, we found that daily protein intake was increased (p <0.001), but fat and carbohydrate intake remained unchanged. A significant reduction was observed in liquid consumption while the frequency of asymptomatic bacteriuria was increased. High-density lipoprotein significantly increased, and glycated hemoglobin, insulin, and homeostasis model index significantly decreased (p =0.005, p =0.01, p <0.001, and p =0.03, respectively). A significant increase in ferritin was found (p =0.02). No change was observed in subcutaneous fat thickness, while VFT significantly decreased (p =0.08, p =0.005). However, in the control group, only ferritin level increased. CONCLUSION A combined change in the number and timing of meals and the portioning of the entire daily intake into only two meals per day may have beneficial metabolic effects and reduction in VFT during pregnancy. Hippokratia 2015; 19 (4): 298-303.
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Affiliation(s)
- E B Gur
- Department of Obstetrics and Gynecology, Faculty of Medicine, Katip Celebi University, Izmir, Turkey
| | - G A Turan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Sifa University, Izmir, Turkey
| | - O Ince
- Department of Radiology, Faculty of Medicine, Sifa University, Izmir, Turkey
| | - M Karadeniz
- Department of Endocrinology, Faculty of Medicine, Sifa University, Izmir, Turkey
| | - S Tatar
- Department of Obstetrics and Gynecology, Faculty of Medicine, Sifa University, Izmir, Turkey
| | - E Kasap
- Department of Obstetrics and Gynecology, Faculty of Medicine, Sifa University, Izmir, Turkey
| | - N Sahin
- Department of Obstetrics and Gynecology, Faculty of Medicine, Sifa University, Izmir, Turkey
| | - S Guclu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Sifa University, Izmir, Turkey
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Kobak S, Saydam G, Ince O, Sever F. SAT0551 Sensitivity of Chest Radiography in the Early Diagnosis of Sarcoidosis: is it Really Should be Done? Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Töz E, Ince O, Apaydın N, Gürbüz T, Dayanıklı N, Ayaz D. A case of bladder endometriosis that became symptomatic during the third trimester. Case Rep Womens Health 2015; 6:1-3. [PMID: 29629304 PMCID: PMC5885998 DOI: 10.1016/j.crwh.2015.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 02/26/2015] [Indexed: 11/05/2022] Open
Abstract
Background The urinary tract endometriosis is observed in 1–2% of the patients and in 90% of these cases, there are endometriotic nodules in the bladder. With respect to knowledge, it is generally believed that pregnancy cures endometriosis. However in this case, symptoms developed during the third trimester of pregnancy. Case report We report a case of 31 year old, 30 week pregnant woman with a vegetative mass with 33 × 33 × 21 mm dimensions and irregular borders on the posterior wall of the bladder. After the cesarean section, the vegetative and superiorly localized mass on the internal wall of the bladder was excised with partial bladder excision. The patient had no other apparent findings of pelvic endometriosis at operation but the pathology result indicated endometriosis. Conclusion Although this case shows that endometriosis may become symptomatic during pregnancy, it has to be underlined that it cannot be discerned whether it is consequent to progress of the disease or to pregnancy-mediated modifications of a pre-existing lesion. Endometriosis may become symptomatic during pregnancy. When a mass detected in the bladder, the most appropriate tool for diagnosis is cystoscopic biopsy. Cystoscopy during pregnancy may fail to detect bladder nodules. With decidual changes endometriotic nodules in the bladder can mimic malignancy during pregnancy.
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Affiliation(s)
- Emrah Töz
- Department of Gynecology and Obstetrics, İzmir Tepecik Education and Research Hospital, İzmir, Turkey
| | - Onur Ince
- Department of Gynecology and Obstetrics, İzmir Tepecik Education and Research Hospital, İzmir, Turkey
| | - Nesin Apaydın
- Department of Gynecology and Obstetrics, İzmir Tepecik Education and Research Hospital, İzmir, Turkey
| | - Tutku Gürbüz
- Department of Gynecology and Obstetrics, İzmir Tepecik Education and Research Hospital, İzmir, Turkey
| | - Nihat Dayanıklı
- Department of Urology, İzmir Tepecik Education and Research Hospital, İzmir, Turkey
| | - Duygu Ayaz
- Department of Pathology, İzmir Tepecik Education and Research Hospital, İzmir, Turkey
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Cetecioglu Z, Ince B, Ince O, Orhon D. Acute effect of erythromycin on metabolic transformations of volatile fatty acid mixture under anaerobic conditions. Chemosphere 2015; 124:129-135. [PMID: 25542637 DOI: 10.1016/j.chemosphere.2014.12.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Revised: 11/30/2014] [Accepted: 12/03/2014] [Indexed: 06/04/2023]
Abstract
The study explored the acute inhibitory impact of erythromycin on the methanogenic activity of acclimated biomass fed with a volatile fatty acid mixture and acetate alone. Parallel batch reactors were operated for six days, with increasing erythromycin dosing in the range of 1-1000 mg L(-1). Substrate removal was monitored by means of soluble COD and volatile fatty acid (VFA) measurements together with parallel observations on biogas and methane generation. The inhibitory impact was variable with the initial erythromycin dose: At lower doses, the VFA mixture was completely removed but partially utilized, leading to reduced biogas and methane generation, suggesting the analogy of uncompetitive inhibition. At higher doses, propionate utilization was totally impaired and butyrate removal was reduced, but acetate was still fully removed. Remaining VFAs were partly converted to new VFA compound through isomerization and polymerization reactions. High erythromycin doses induced total inactivation of microbial metabolism with negligible methane generation.
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Affiliation(s)
- Z Cetecioglu
- Istanbul Technical University, Civil Engineering Faculty, Department of Environmental Engineering, 34469 Maslak, Istanbul, Turkey.
| | - B Ince
- Bogazici University, Institute of Environmental Sciences, Rumelihisarustu-Bebek 34342, Istanbul, Turkey
| | - O Ince
- Istanbul Technical University, Civil Engineering Faculty, Department of Environmental Engineering, 34469 Maslak, Istanbul, Turkey
| | - D Orhon
- Istanbul Technical University, Civil Engineering Faculty, Department of Environmental Engineering, 34469 Maslak, Istanbul, Turkey; The Science Academy, Besiktas 34453, Istanbul, Turkey
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29
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Eyice Ö, Ince O, Ince BK. Monitoring the abundance and the activity of ammonia-oxidizing bacteria in a full-scale nitrifying activated sludge reactor. Environ Sci Pollut Res Int 2015; 22:2328-2334. [PMID: 25185496 DOI: 10.1007/s11356-014-3519-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 08/24/2014] [Indexed: 06/03/2023]
Abstract
Cell-specific ammonia oxidation rate (AOR) has been suggested to be an indicator of the performance of nitrification reactors and to be used as an operational parameter previously. However, published AOR values change by orders of magnitude and studies investigating full-scale nitrification reactors are limited. Therefore, this study aimed at quantifying ammonia-oxidizing bacteria (AOB) and estimating their in situ cell-specific AOR in a full-scale activated sludge reactor treating combined domestic and industrial wastewaters. Results showed that cell-specific AOR changed between 5.30 and 9.89 fmol cell(-1) h(-1), although no significant variation in AOB cell numbers were obtained (1.54E + 08 ± 0.22 cell/ml). However, ammonia-removal efficiency varied largely (52-79 %) and was proportional to the cell-specific AOR in the reactor. This suggested that the cell-specific AOR might be the factor affecting the biological ammonia-removal efficiency of nitrification reactors independent of the AOB number. Further investigation is needed to establish an empirical relationship to use cell-specific AOR as a parameter to operate full-scale nitrification systems more effectively.
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Affiliation(s)
- Ö Eyice
- School of Life Sciences, University of Warwick, Coventry, UK, CV4 7AL,
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30
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Ince O, Altintas N, Findik S, Sariaydin M. Risk stratification in submassive pulmonary embolism via alveolar-arterial oxygen gradient. Hippokratia 2014; 18:333-339. [PMID: 26052200 PMCID: PMC4453807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM This study investigated the utility of the alveolar-arterial (AaDO2) gradient in predicting the short-term prognosis of submassive pulmonary embolism (PE). MATERIAL AND METHODS This study retrospectively enrolled 124 patients with acute submassive PE. During the first 24 h of admission, all patients had initial artery blood gas collected under room air. Cardiac troponin T (cTn-T) was measured and on spiral computed tomography pulmonary angiography (CTPA) and echocardiography both right ventricle diameter and left ventricle diameter was calculated (RV/LV ratio). Patients who did not have objectively confirmed submassive PE and who had curative anticoagulant treatment for more than 24 hours and had a life expectancy less than 3 months were excluded from the study. RESULTS The best cut-off value for AaDO2 was 42.38 mmHg and using this, fourteen of 15 patients who died had AaO2 ≥ 42.38 and 71 of 109 patients who survived had a AaO2 lower than 42.38 with a sensitivity, specificity and negative predictive value (NPV) for overall deaths were 93.3%, 65.1% and 98.6% respectively. In addition, AaDO2 < 42.38 showed significant survival benefit for overall mortality rates. In this study, having high cTn-T and PaO2/ PaCO2 < 1.83 and pulmonary artery pressure > 47.5 were also an indicator of poor prognosis for patients with submasssive PE. CONCLUSION The AaDO2 measurement is a highly useful and simple measurement for predicting short-term prognosis in patients with submassive PE. It may be used in risk stratification of patients with submassive PE. Aggressive thrombolytic treatment strategies may be considered for patients who have AaO2 < 42.38. Hippokratia 2014; 18 (4): 333-339.
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Affiliation(s)
- O Ince
- Department of Pulmonary Medicine, Faculty of Medicine, 19 Mayis University, Samsun, Turkey
| | - N Altintas
- Department of Pulmonary, Allergy, and Critical Care Medicine, Faculty of medicine, University of Pittsburgh, PA/USA
| | - S Findik
- Department of Pulmonary Medicine, Faculty of Medicine, 19 Mayis University, Samsun, Turkey
| | - M Sariaydin
- Department of Pulmonary Medicine, Faculty of Medicine, 19 Mayis University, Samsun, Turkey
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31
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Kobak S, Sever F, Ince O, Orman M. THU0401 The Frequency of Sacroiliitis and Spondylarthritis in Patients with Sarcoidosis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Aydin S, Ince B, Cetecioglu Z, Ozbayram EG, Shahi A, Okay O, Arikan O, Ince O. Performance of anaerobic sequencing batch reactor in the treatment of pharmaceutical wastewater containing erythromycin and sulfamethoxazole mixture. Water Sci Technol 2014; 70:1625-1632. [PMID: 25429450 DOI: 10.2166/wst.2014.418] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study evaluates the joint effects of erythromycin-sulfamethoxazole (ES) combinations on anaerobic treatment efficiency and the potential for antibiotic degradation during anaerobic sequencing batch reactor operation. The experiments involved two identical anaerobic sequencing batch reactors. One reactor, as control unit, was fed with synthetic wastewater while the other reactor (ES) was fed with a synthetic substrate mixture including ES antibiotic combinations. The influence of ES antibiotic mixtures on chemical oxygen demand (COD) removal, volatile fatty acid production, antibiotic degradation, biogas production, and composition were investigated. The influent antibiotic concentration was gradually increased over 10 stages, until the metabolic collapse of the reactors, which occurred at 360 days for the ES reactor. The results suggest that substrate/COD utilization and biogas/methane generation affect performance of the anaerobic reactors at higher concentration. In addition, an average of 40% erythromycin and 37% sulfamethoxazole reduction was achieved in the ES reactor. These results indicated that these antibiotics were partly biodegradable in the anaerobic reactor system.
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Affiliation(s)
- S Aydin
- Environmental Engineering Department, Istanbul Technical University, Maslak, Istanbul, Turkey E-mail:
| | - B Ince
- Institutes of Environmental Sciences, Bogazici University, Bebek, Istanbul, Turkey
| | - Z Cetecioglu
- Environmental Engineering Department, Istanbul Technical University, Maslak, Istanbul, Turkey E-mail:
| | - E G Ozbayram
- Environmental Engineering Department, Istanbul Technical University, Maslak, Istanbul, Turkey E-mail:
| | - A Shahi
- Environmental Engineering Department, Istanbul Technical University, Maslak, Istanbul, Turkey E-mail:
| | - O Okay
- Naval Architecture and Ocean Engineering Department, Istanbul Technical University, Maslak, Istanbul, Turkey
| | - O Arikan
- Environmental Engineering Department, Istanbul Technical University, Maslak, Istanbul, Turkey E-mail:
| | - O Ince
- Environmental Engineering Department, Istanbul Technical University, Maslak, Istanbul, Turkey E-mail:
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Cetecioglu Z, Ince B, Gros M, Rodriguez-Mozaz S, Barceló D, Orhon D, Ince O. Chronic impact of tetracycline on the biodegradation of an organic substrate mixture under anaerobic conditions. Water Res 2013; 47:2959-69. [PMID: 23561494 DOI: 10.1016/j.watres.2013.02.053] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 02/08/2013] [Accepted: 02/26/2013] [Indexed: 05/23/2023]
Abstract
The study evaluates the chronic impact of the antibiotic tetracycline on the biodegradation of organic substrate under anaerobic conditions. The experiments involved an anaerobic sequencing batch reactor fed with a synthetic substrate mixture including glucose, starch and volatile fatty acids, and operated in a sequence of different phases with gradually increasing tetracycline doses of 1.65-8.5 mg/L, for more than five months. Tetracycline exerted a terminal/lethal effect at 8.5 mg/L on the microbial community under anaerobic conditions, which caused the inhibition of substrate/COD utilization and biogas generation and leading to a total collapse of the reactor. The microbial activity could not be recovered and re-started within a period of more than 10 days, even after stopping tetracycline dosing. At lower doses, substrate utilization was not affected but a reduction of 10-20% was observed in the biogas/methane generation, suggesting that substrate utilization of tetracycline to the biomass was limiting their bioavailability. During the experiments, tetracycline was partially removed either through biodegradation or conversion into its by-products. The adverse long-term impact was quite variable for fermenting heterotrophic and methanogenic fractions of the microbial community based on changes inflicted on the composition of remaining/residual organic substrate.
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Affiliation(s)
- Z Cetecioglu
- Environmental Engineering Department, Istanbul Technical University, 34469 Maslak, Istanbul, Turkey.
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Cokgor EU, Tas DO, Zengin GE, Aydinli E, Ozdemir S, Insel G, Kolukirik M, Ince O, Ince BK. Erratum to “Effect of aerobic stabilization on biomass activity” [J. Biotechnol. 150S (2010) S35]. J Biotechnol 2012. [DOI: 10.1016/j.jbiotec.2012.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kolukirik M, Ince O, Cetecioglu Z, Celikkol S, Ince BK. Spatial and temporal changes in microbial diversity of the Marmara Sea sediments. Mar Pollut Bull 2011; 62:2384-2394. [PMID: 21962921 DOI: 10.1016/j.marpolbul.2011.08.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2009] [Revised: 08/19/2011] [Accepted: 08/25/2011] [Indexed: 05/31/2023]
Abstract
Spatial (10 different locations) and temporal (2 years) changes in characteristics of the Marmara Sea Sediments were monitored to determine interactions between the chemical and microbial diversity. The sediments were rich in terms of hydrocarbon, nitrate, Ni and microbial cell content. Denitrifying, sulfate reducing, fermentative and methanogenic organisms were co-abundant in 15 cm below the sea floor. The local variations in the sediments' characteristics were more distinctive than the temporal ones. The sulfate and nitrate contents were the main drivers of the changes in the microbial community compositions. N and P were limited for microbial growth in the sediments, and their levels determined the total cell abundance and activity. Seasonal shifts in temperatures of the shallow sediments were also reflected in the active cell abundances. It was concluded that the Marmara Sea is a promising ecosystem for the further investigation of the ecologically important microbial processes.
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Affiliation(s)
- M Kolukirik
- Department of Molecular Biology and Genetics, Istanbul Technical University, 34469 Istanbul, Turkey.
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36
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Oz NA, Ince O, Turker G, Ince BK. Effect of seed sludge microbial community and activity on the performance of anaerobic reactors during the start-up period. World J Microbiol Biotechnol 2011; 28:637-47. [DOI: 10.1007/s11274-011-0857-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Accepted: 08/02/2011] [Indexed: 11/30/2022]
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37
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Kolukirik M, Ince O, Ince BK. Methanogenic community change in a full-scale UASB reactor operated at a low F/M ratio. J Environ Sci Health A Tox Hazard Subst Environ Eng 2007; 42:903-10. [PMID: 17558771 DOI: 10.1080/10934520701366640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
A full-scale upflow anaerobic sludge blanket (UASB) reactor was investigated in terms of archaeal composition, acetoclastic methanogenic capacity and performance over a 2-year period. Performance of the reactor in terms of COD removal efficiency varied between 60% and 80% at organic loading rates (OLRs) in the range of 2.5-12 kg COD m-3 d-1. The reactor had been operated under a F/M (food to microorganisms) ratio of 0.02-0.03 gCOD gTVS-1 d-1, which is much lower than the typical values reported for similar reactors. According to specific methanogenic activity (SMA) tests the anaerobic sludge was operating at only 12-34% of its potential acetoclastic methanogenic capacity. These results demonstrated that the UASB reactor was under loaded compared to its maximum loading capacity. All other operational parameters had been maintained within their desired ranges. The SMA test and Fluorescence in situ hybridization (FISH) results revealed that a decrease in the acetoclastic methanogenic activity of the UASB sludge from 344 mL CH4 gTVS-1 d-1 to 109 mL CH4 gTVS-1 d-1 coincided with a decrease in the relative abundance of acetoclastic Methanosaeta from 90%+/-1.2 to 79%+/-1.4 of the archaeal population, and an increase in the relative abundance of hydrogenotrophic Methanobacteriales from non-detectable levels to 24%+/-0.7% of the archaeal population during the 2-year operation of the reactor. The relative abundance of archaeal cells within the UASB sludge was in the range of 15-17%.
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Affiliation(s)
- M Kolukirik
- Department of Molecular Biology and Genetics, Istanbul Technical University, Turkey.
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Ince O, Kolukirik M, Cetecioglu Z, Eyice O, Tamerler C, Kasapgil Ince B. Methanogenic and sulphate reducing bacterial population levels in a full-scale anaerobic reactor treating pulp and paper industry wastewater using fluorescence in situ hybridisation. Water Sci Technol 2007; 55:183-91. [PMID: 17564384 DOI: 10.2166/wst.2007.321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
In this study, specific methanogenic activity (SMA) test and fluorescence in situ hybridisation (FISH) were respectively used to determine acetoclastic methanogenic capacity, and composition and number of methanogenic and sulphate reducing bacterial (SRB) populations within a full scale anaerobic contact reactor treating a pulp and paper industry effluent. The sludge samples were collected from three different heights along the anaerobic reactor having a difficulty of completely stirring. Performance of the anaerobic reactor in terms of COD removal efficiency varied between 47 and 55% at organic loading rates in a range of 1.6-1.8 kg COD m(-3) d(-1) and methane yield varied between 0.18 and 0.20 m3CH4kg CODrem(-1). The anaerobic reactor was not operated for 2 weeks during the monitoring period. According to SMA test results, potential methane production rate was 276 mLCH4 gVSS(-1) d(-1) before the off period of the reactor, however it decreased to 159 mL CH4 gVSS(-1) d(-1) after this period. SMA test and FISH results along the reactor height showed that the acetoclastic methanogenic activity of the sludge samples, the relative abundance of acetoclastic methanogens, hydrogenotrophic methanogens and acetate oxidising SRB decreased as the reactor height increased, however the relative abundance of non-acetate oxidising SRB increased.
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Affiliation(s)
- O Ince
- Istanbul Technical University, Department of Environmental Engineering, 34469, Istanbul, Turkey.
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Ince O, C noz B, Yaz c oglu N, Celiker C. 29 Clinical importance of permanent pacemaker mode selection in patients with complete atrioventricular block. Europace 2005. [DOI: 10.1016/eupace/7.supplement_1.6-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- O. Ince
- Kardiyoloji Enstit s , Kardiyoloji, Istanbul, Turkey
| | - B. C noz
- Kardiyoloji Enstit s , Kardiyoloji, Istanbul, Turkey
| | - N. Yaz c oglu
- Kardiyoloji Enstit s , Kardiyoloji, Istanbul, Turkey
| | - C. Celiker
- Istanbul University, Kardiyoloji Enstitusu, Istanbul, Turkey
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Bedirli A, Gokahmetoglu S, Sakrak O, Soyuer I, Ince O, Sozuer E. Beneficial effects of recombinant platelet-activating factor acetylhydrolase and BN 52021 on bacterial translocation in cerulein-induced pancreatitis. Eur Surg Res 2004; 36:136-41. [PMID: 15178901 DOI: 10.1159/000077254] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2003] [Accepted: 11/13/2003] [Indexed: 02/06/2023]
Abstract
BACKGROUND Bacterial translocation (BT) has been suggested to be responsible for the high incidence of infections occurring after acute pancreatitis (AP). The aim of this study was to investigate the effects of the platelet-activating factor (PAF) inactivator, recombinant PAF-acetylhydrolase (rPAF-AH), and the PAF receptor antagonist, BN 52021, in AP. METHODS Forty-eight male Wistar rats were divided into 4 groups: the sham group received saline intraperitoneally every hour for 6 h; the control group received cerulein 50 g/kg i.p. every hour for 6 h; the rPAF-AH group received AP plus rPAF-AH (5 mg/kg i.v. bolus), and the BN52021 group received AP plus BN 52021 (5 mg/kg i.v. bolus). The animals were sacrificed 12 h after the first cerulein injection. RESULTS Supramaximal cerulein stimulation induced an increase in serum pancreatic enzymes, interleukin (IL)-6, pancreatic edema, and produced histologic evidence of AP. Compared with the control group, the addition of PAF receptor antagonists had a significant effect on serum pancreatic enzymes, pancreatic edema, and the histologic score of the pancreatitis. AP caused significant increases in BT in mesenteric lymph nodes (MLNs), pancreas, liver, spleen and blood. Compared with the control group, both rPAF-AH and BN 52021 decreased BT in the pancreas and blood. In addition, rPAF-AH decreased BT in the MLNs. We also found that PAF receptor antagonists suppressed the elevation in IL-6 levels. CONCLUSION PAF antagonists attenuated the severity of experimental AP and reduced pancreatitis-induced BT to distant sites.
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Affiliation(s)
- A Bedirli
- Department of Surgery, Gazi University, Faculty of Medicine, Ankara, Turkey.
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Sözüer EM, Ok E, Banli O, Ince O, Kekeç Z. [Traumatic splenic injuries]. Ulus Travma Derg 2001; 7:17-21. [PMID: 11705167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Splenectomy is the frequently used surgical method for the treatment of traumatic splenic injuries. In this study, the patients who had traumatic splenic injuries were investigated and the results of surgical treatments were evaluated. There were 225 patients with traumatic splenic injuries, which contains 55 (24%) female and 170 (76%) male. The mean age was 29 (range 16-71) years. Severity of splenic injury was classified according to Moore organ injury scaling and there were 23 (10%) patients in grade 1, 96 (43%) in grade II, 75 (33%) in grade III, 24 (11%) in grade IV and 7 (3%) in grade V. Splenectomy was performed in 203 (90%) patients, splenoraphy in 18 (8%) and partial splenectomy in 4 (2%) patients. The overall mortality was 12%. A positive correlation was estimated between the combined trauma and the mortality (Fisher's Chi-Square test; chi 2 = 9,538, p < 0.002). In conclusion, non-operative treatment methods may prevent unnecessary splenectomies, especially in grade I and II blunt or penetrating splenic injuries. Combined injuries are the major factor increasing the mortality.
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Affiliation(s)
- E M Sözüer
- Erciyes Universitesi Tip Fakültesi Genel Cerrahi Anabilim Dali 38039, Kayseri
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