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Öğe Ektopik Gebelik Olgularında Tedavi Seçenekleri ve Başarı Oranlarımız(2014) Kerimoğlu, Özlem Seçilmiş; Kebapçılar, Ayşe Gül; Pekin, Aybike; Yılmaz, Setenay Arzu; Beyhekim, Fatma; Çelik, ÇetinGiriş: Bu çalışmanın amacı kliniğimizde son üç yılda ektopik gebelik tanısı ile tedavi edilen hastaların tanı ve tedavi yaklaşımlarının irdelenerek tedavi başarı oranlarımızın belirlenmesidir. Gereç ve yöntem: 2010 ve 2013 tarihleri arasinda ektopik gebelik tanısı alan ve tedavi edilen toplam 77 olgu retrospektif olarak incelendi. Bulgular: Vakalarımızın yaş aralığı 20-44 yaş olup, ortalaması 29.27 4.99 olarak saptandı. Olgularımızın ektopik gebelik yerleşim yeri 74 (% 97) tubal, 1(% 1) servikal, 1(% 1) ovaryal ve 1(% 1) ise sezeryan skar hattı idi. Metotreksat tedavisine yanıt % 68.5 olarak hesaplandı. Maternal mortalite görülmedi. Sonuç: Ektopik gebelik fertiliteyi etkilemesi, mortalite ve morbiditesinin yüksek olması bakımından günümüzde hala önemini koruyan bir hastalıktır.Öğe Gastrointestinal Stromal Tumor Mimicking Ovarian Tumor(2012) Kerimoğlu, Özlem Seçilmiş; Baba, Füsun; Tazegül, Aybike; Alptekin, Hüsnü; Acar, Hasan; Çelik, ÇetinMalignant gastrointestinal stromal tumors are rare mesenchymal tumors originating from the gastroin- testinal tract. Making a differential diagnosis with gynecologic masses may be difficult in the preopera- tive period. The patient was a 45- year-old woman who presented to our clinic with a palpable mass fill- ing the pelvis. The CA 125 value was 42.7 U/ml. She underwent right hemicolectomy, total omentectomy, total abdominal hysterectomy, bilateral salpingo-oophorectomy and bilateral pelvic and para-aortic lymph node dissection since the frozen section assessment of the biopsy from the right colon was re- ported as a tumoral mass probably originating from the ovary. Tumoral tissue showed diffuse cytoplas- mic membraneous staining immunohistochemically with CD117, showed strong focal strong cytoplasmic staining with SMA. It was stained negative with desmin, S-100 and CD34. Molecular analysis of KIT gene was performed, we didn't detect mutations of exon 9 or 11. Surgical exploration of pelvic masses with undetermined origins should be performed in multidiciplinary hospitals including gynecological on- cology and surgical oncology teams. Histopathological examinations should be performed by experi- enced pathologistsÖğe Pyometranın nadir nedeni: Apendiksin Karsinoid Tümörü(2016) Yılmaz, Setenay Arzu; Acar, Fahrettin; Kerimoğlu, Özlem Seçilmiş; Pekin, Aybike Tazegül; İncesu, Feyza; Çelik, ÇetinPiyometra uterin kavite içerisinde enfekte pürülan materyalin birikmesidir ve uterusun doğal drenajının bozulduğu durumlarda görülmektedir. En yaygın nedeni jinekolojik kanserlerdir. Apendiksin karsinoid tümörlerinde teşhis genellikle genç hastalarda akut apandisit tanısı ile yapılan apendektomilerde konulur. Biz bu olguda tuba uterinaya fistülize apendiksin karsinoid tümörü sonucu gelişen piyometra olgusunu sunmayı amaçladıkÖğe THE RELATION OF SERUM VISFATIN AND RESISTIN LEVEL WITH ENDOMETRIAL CANCER AND ITS PROGNOSTIC FACTORS(LIPPINCOTT WILLIAMS & WILKINS, 2015) İlhan, Tolgay Tuyan; Kebapçılar, Ayşe Gül; Yılmaz, Setanay Arzu; İlhan, Türkan; Kerimoğlu, Özlem Seçilmiş; Tazegül, Aybüke; Akyürek, Fikret; Ünlü, Ali; Çelik, Çetin[Abstract not Available]Öğe Relations of serum visfatin and resistin levels with endometrial cancer and factors associated with its prognosis(Asian Pacific Organization for Cancer Prevention, 2015) İlhan, Tolgay Tuyan; Kebapcılar, Ayşe Gül; Yılmaz, Setenay Arzu; İlhan, Türkan; Kerimoğlu, Özlem Seçilmiş; Pekin, Aybike Tazegül; Akyürek, Fikret; Ünlü, Ali; Çelik, ÇetinBackground: The aims of this study were compare the serum visfatin and resistin levels between endometrial cancer (EC) patients and controls and evaluate their power to predict prognosis. Materials and Methods: This prospective study was conducted between March 2013 to June 2014 on the Gynecologic Oncology Department of the University of Selcuk, Konya, Turkey. A total of 42 EC patients and 42 controls were included and assessed for differences in serum visfatin and resistin levels, along with prognostic factors. Results: Endometrial cancer patients had significantly higher visfatin levels than control s (p: 0.011), associated with deep myometrial invasion (p: 0.019). In contrast the serum level of resistin did not significantly differ between EC patients and controls (p: 0.362). However, high resistin level in EC patients was associated with increase lymph node metastasis (p: 0.009). On logistic regression analysis, we found that serum visfatin elevation was associated with risk of myometrial invasion (OR: 1,091; 95%CI: 1.021- 1.166; p: 0.010) and serum resistin with risk of lymph node metastasis (OR: 1.018; 95%CI: 1.000- 1.035; p: 0.046). For myometrial invasion prediction, a serum visfatin level greater than 26.8 ng/mL demonstrated a sensitivity and specificity of 66.6 % and 96.4%, respectively. For lymph node metastasis prediction, the best cut-off for serum resistin level was 599ng/mL. A serum resistin level greater than this demonstrated a sensitivity and specificity of 87.5% and 77.1%, respectively. Conclusions: Our data suggest that serum visfatin is elevated in patients with EC and serum visfatin and resistin levels could be used to predict the risk of advance stage lesions.Öğe The relationship between Polycystic ovary syndrome and vitamin D levels(GALENOS YAYINCILIK, 2015) Yılmaz, Setenay Arzu; Altınkaya, Sündüz Özlem; Kebabcılar, Ayşe Gül; Kerimoğlu, Özlem Seçilmiş; Pekin, Aybike Tazegül; Abuşoğlu, Sedat; Çelik, ÇetinObjective: The main aim of this study was to determine the association of serum 25-hydroxyvitamin D (25-OH D) levels with hormonal, clinical and metabolic profile in patients with and without Polycystic ovary syndrome (PCOS). Materials and Methods: Forty-eight normal-weight (body mass index (BMI) of 19-24.99 kg/m(2)) women with PCOS, 36 overweight (BMI of 25-29.9 kg/m(2)) women with PCOS and 56 normal-weight controls participated in the study. Blood samples were collected in the early follicular phase (between day 2 and day 5 of the menstrual cycle) at 9: 00 am after an overnight fast. Circulating concentrations of 25-OH D, luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin, TSH, free testosterone, dehydroepiandrosterone sulphate (DHEA-SO4), 17-hydroxyprogesterone, sex hormone-binding globulin (SHBG), fasting insulin, fasting glucose, and lipid profile were assessed. Results: Normal weight (BMI 19-24.99 kg/m(2)) and overweight (BMI 25-29.99 kg/m(2)) women with PCOS were compared with normal-weight controls and lower 25-OH D levels were found in both PCOS groups (p<0.05 and p<0.01, respectively 25-OH D significantly negatively correlated with waist circumference (WC), waist-to-hip ratio (WHR), free testosterone and modified Ferriman-Gallwey scores, however, there was a positive correlation between 25-OH D and SHBG levels (p<0.05). Conclusion: Our findings suggest that PCOS is associated with hypovitaminosisÖğe The role of human epididymis secretory protein E4 in patients with endometrial cancer and premalignant endometrial lesions(TAYLOR & FRANCIS INC, 2017) Yılmaz, Setenay Arzu; Altınkaya, Sündüz Özlem; Kerimoğlu, Özlem Seçilmiş; Pekin, Aybike Tazegül; Akyürek, Fikret; İlhan, Tolgay Tuyan; Benzer, NilgünWe evaluated the concentrations of human epididymis secretory protein E4 (HE4) and Ca-125 in relation to clinicopathologic features in patients with endometrial cancer and premalignant endometrial lesions. Women with abnormal uterine bleeding (n=167) who underwent endometrial sampling were divided into four groups. Group 1: endometrial cancer (n=68), group 2: atypical endometrial hyperplasia (n=12), group 3: endometrial hyperplasia without atypia (n=39) and group 4: controls (n=48). Women with endometrial cancer exhibited higher concentrations of HE4 levels than controls (91.4pmol/L vs. 46.2pmol/L, p<0.001). HE4 levels were significantly higher in patients with lymphatic involvement, deep myometrial invasion, lymphovascular space involvement and non-endometrioid histology (p<0.001). The sensitivity, specificity, positive and negative predictive values for HE4 in detecting endometrial cancer were 72.7%, 84.4%, 80% and 78.4%, respectively. Preoperative HE4 levels are more elevated in women with endometrial cancer than those with benign endometrium as well as in women with prognostic high-risk factors with endometrial cancer. HE4 may be used as an additional marker in combination with other clinicopathologic features for planning the treatment.Öğe Uterine Prolapse Complicating the 3rdTrimester of the Pregnancy: A Case Report(2012) Kerimoğlu, Özlem Seçilmiş; İncesu, Feyza Nur; Tazegül, Aybike; Doğan, Nasuh Utku; Yılmaz, Setenay Arzu; Çelik, ÇetinUterin prolapsus gebelikte son derece nadir görülen bir durumdur. Prolapsus etyolojisi ileri yaş, multipartite, zor vajinal doğum ve artmış vücut kitle indeksi gibi çok çeşitli faktörlere bağlanmaktadır. Bu durumun servikste kuruma ve ülserasyona, erken veya zor doğuma ve hatta maternal ölüme sebep olabileceği bildirilmiştir. Bu vaka sunumunda gebelikte oluşan bir uterin prolapsus vakasını sunmayı hedefledik. 40 yaşında, 5 gebeliği, 4 doğumu ve uterin prolapsusu olan hasta, gebeli- ğinin 35. haftasında pelvik ağrı ve üriner sistem enfeksiyonu nedeniyle hastaneye başvurdu. Gebeliğin 38. haftasında do- ğum eylemi sırasında; ödemli, ülsere ve kuru serviks nedeniyle gelişen aşırı servikal kanama nedeniyle sezaryen ile doğum yaptı. Doğum sonrası uterin prolapsusu spontan olarak düzeldi. Gebelikte oluşan uterin prolapsus konservatif yaklaşımla takip edilebilir. Kuruyan ve ülsere olan serviks dilatasyon sırasında şiddetli kanamaya sebep olarak doğum yöntemi olarak sezaryenin tercih edilmesine neden olabilir.
