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Biomedical subjects

C Fiçicioğlu

Publications and source records attributed to C Fiçicioğlu.

At least 19 recordsLinked to original sources
PubMed2003

The role of androgens in the aetiology and pathology of pre-eclampsia.

Pre-eclampsia and eclampsia, along with its complications such as prematurity, intrauterine growth retardation, perinatal asphyxia and abruptio placenta, continues to be one of the major causes of maternal and fetal morbidity and mortality. Due to its morbid course, it is necessary to identify those at risk for the illness and take precautions. However, the lack of knowledge about the aetiology makes it difficult to assess risk factors. We studied the role of the serum androgens in the pathogenesis of pre-eclampsia. Ninety severe pre-eclamptic, 10 mild pre-eclamptic and 50 normotensive pregnant women were studied. The patient and control groups' blood total testosterone, free oestriol (FE3), FAI (free androgene index), sex hormone binding globulin (SHBG) and dehydroepiandrostenedione sulphate (DHEA-S) values were compared. The sex, weight, APGAR scores and hospitalisation in the neonatal intensive care unit of the babies were also evaluated. No statistically significant difference in the total testosterone and free oestriol values was found between the groups. SHBG was found to be higher in the pre-eclamptic group, whereas free testosterone and DHEA-S were higher in the normotensive group. Compared to the severe pre-eclamptic group, no difference was found in the total testosterone levels, whereas free testosterone levels were significantly higher in the mild pre-eclamptic group. We reached the opinion that androgens do not play a clinically significant role in the pathogenesis of pre-eclampsia.

Adult↗
PubMed2003

Relationship between semen quality and seminal plasma total carnitine in infertile men.

This study was designed to determine any correlation between infertility and semen quality with concentrations of total carnitine in human seminal plasma. Seminal plasma total carnitine concentrations were determined in 79 men. The seminal plasma of 65 infertile men and 14 men as a control group with proved fertility were investigated. The concentrations of total carnitine were reduced significantly in the infertile group compared to the control group (31.52 +/- 20.77 vs. 45.52 +/- 10.73 mg/l, P<0.05). The 65 infertile men were divided into five groups according to their sperm analysis: normospermia (n=42), oligospermia (n=23), asthenospermia (n=40), teratospermia (n=44) and oligoasthenospermia (n=10). Total seminal plasma carnitine concentration differed significantly between controls and the patient groups (P<0.05). There was a statistically significant positive correlation between seminal plasma total carnitine concentration with total sperm count and the percentage of normal forms (P<0.05 and P<0.01, respectively). Total carnitine concentration was found to be low in the asthenospermia group when compared with the group of patients, whose total motile sperm percentage was 51 (P<0.05). These findings suggest that the determination of seminal carnitine levels may be a useful test in evaluation of male infertility.

Biomarkers↗
PubMed2003

The role of inhibin B as a basal determinant of ovarian reserve.

Our objective was to compare inhibin B and conventional basal determinants in designating the ovarian reserve in patients receiving assisted reproductive treatment. A total of 58 women, aged 19-47 years, who were accepted for assisted reproductive treatment at the Zeynep Kamil Women and Children's Hospital, Department of Assisted Reproductive Technologies, were included in the study. The age, body mass index, basal levels of follicle stimulating hormone, estradiol and inhibin B, volume of the ovary and number of antral follicles were compared prospectively. When the number of oocytes collected was > or = 5, this was accepted as a sufficient ovarian response. Serum inhibin B (cut-off level 56 pg/ml), as a basal determinant of ovarian reserve, had the highest sensitivity (81%) and specificity (81%). The usefulness of serum inhibin B measurement as a basal determinant of ovarian reserve is supported.

Adult↗
PubMed2003

Basal hormone levels in women with recurrent pregnancy loss.

The potential role of endocrine abnormalities during the follicular phase in women with unexplained recurrent pregnancy loss was investigated in a retrospective study. Eighty women with recurrent pregnancy loss underwent routine work-up to exclude known associations with the condition. Following investigation, 58 women failed to reveal an identifiable cause, and were therefore classified as having unexplained recurrent pregnancy loss. The control group consisted of women with known causes of abortions, such as uterine septum and parental chromosomal abnormalities. Mean age, gravidity, parity, presence of infertility, previous number of miscarriages and duration of marriage were similar in both groups. Day-3 serum levels of follicle stimulating hormone (FSH), estradiol, luteinizing hormone (LH) prolactin, total testosterone, dehydroepiandrosterone sulfate (DHEAS) and thyroid stimulating hormone (TSH) were compared in the two groups. FSH, estradiol, LH, prolactin and DHEAS concentrations were significantly higher in the unexplained recurrent pregnancy loss group than in the explained recurrent pregnancy loss group, although serum concentrations of all hormones were within the normal range (p < 0.01). TSH and total testosterone levels were similar in the two groups (p > 0.05). There were no differences in the frequency of abnormal levels of hormones between the two groups (p > 0.05). We conclude that endocrine abnormalities in the follicular phase are not associated with recurrent pregnancy loss.

Abortion, Habitual↗
PubMed1999

MRI and MRS in HMG-CoA lyase deficiency.

3-Hydroxy-3-Methylglutaryl coenzyme A lyase (HMG-CoA) deficiency is a rare inborn error of leucine catabolism. The disease is characterized by recurrent episodes of metabolic acidosis, hyperammonemia without ketosis, hypoglycemia, lethargy, hepatomegaly, and seizures. This study has evaluated the magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) findings of three patients with HMG-CoA deficiency. The common findings on all of the MRI scans were multiple, coalescent, marked lesions in periventricular white matter and arcuate fibers, most prominently in frontal or periatrial regions that were superimposed on diffuse, slightly hyperintense subcortical white matter signal. Involvement of the caudate nucleus and the dentate nucleus were observed in the reported patients. MRS studies by both STEAM and PRESS spectra of all patients revealed a decrease in N-acetylaspartate and elevation in both myoinositol and choline. A pathologic peak at 1.33 ppm, which is compatible with lactate, and a particular peak at 2.42 ppm in all patients were also found. The combination of both MRI and MRS findings could be considered as being specific in patients with HMG-CoA lyase deficiency.

Amino Acid Metabolism, Inborn Errors↗
PubMed1996

Effect of vaginal misoprostol application for cervical softening in pregnancy interruption before ten weeks of gestation.

OBJECTIVE: To determine the effect of vaginal misoprostol application for cervical dilatation and to determine the time taken for pregnancy interruption. METHODS: 200 micrograms misoprostol and gyno-flor vaginal tablet, employed to create acidic milieu, were applied into the posterior fornix of 40 women with gestational age of 5 to 10 weeks. Placebo was applied vaginally to 20 women who made up the control group. All cases were examined 5 hours later. The cervical dilatation, presence of fetoplacental material in the vagina, extrauterine cervical bleeding and the time necessary for dilatation and suction curettage were investigated. RESULTS: In 33 (82.5%) of the cases cervical bleeding, in 21 (52.5%) of the cases fetoplacental material on the cervix and/or in the vagina were detected in women of misoprostol group, while neither cervical bleeding nor fetoplacental material on the cervix and/or in the vagina was detected in the placebo group. In the misoprostol group the time taken for the operation was significantly (p < 0.005) shorter than that of the control group. CONCLUSION: Vaginal application of misoprostol shortens the time needed for the termination of the gestation by its facilitating effect on cervical dilatation.

Abortion, Induced↗
PubMed1996

The number of follicles and ovarian volume in the assessment of response to clomiphene citrate treatment in polycystic ovarian syndrome.

OBJECTIVE: To evaluate whether the number of follicles and ovarian volume have any significance in evaluating the response to clomiphene citrate treatment in polycystic ovarian syndrome (PCOS). DESIGN: A prospective study of 70 infertile women, 44 of which were diagnosed with polycystic ovarian syndrome. MAIN OUTCOME MEASURES: Follicle numbers and volumes in both ovaries, hormonal profile, response to Clomiphene Citrate(CC). RESULTS: Ovarian volume was significantly greater in cases with polycystic ovarian syndrome than controls. However, ovarian volume in the Clomiphene Citrate nonresponders was significantly greater than in Clomiphene Citrate responders in the polycystic ovarian syndrome group. The number of small follicles was significantly higher in cases with polycystic ovarian syndrome than controls, and in the Clomiphene Citrate nonresponder group this number was also significantly higher than in Clomiphene Citrate responders. Endocrine features of patients with polycystic ovarian syndrome revealed that Dehydroepiandrostenedione sulfate, Androstenedione, follicle stimulating and luteinizing hormone do not discriminate between patients who respond to Clomiphene Citrate and those who do not respond. However, Testosterone and luteinizing hormone levels differ significantly in responders and nonresponders. CONCLUSIONS: Small multiple follicles (> 9) and enlarged ovarian volume (> 6.8 ml) were the most prominent transvaginal ultrasonographic features of ovaries in Clomiphene Citrate nonresponsive patients with polycystic ovarian syndrome. Higher levels of Testosterone, luteinizing hormone and significantly higher number of small follicles were associated with lack of Clomiphene Citrate response. These ultrasonographic features and laboratory assays could be clinically useful for distinguishing better the Clomiphene Citrate nonresponders from responders.

Adult↗
PubMed1995

Reduced immune response to hepatitis B vaccine in children with insulin dependent diabetes.

Twenty-four patients with moderately controlled insulin dependent diabetes with a duration of diabetes ranging from 2 to 10 years as well as 17 control subjects were vaccinated against hepatitis B virus using Gen Hevac B vaccine. The vaccine was injected 0.5 mL intramuscularly into the deltoid region on three separate occasions at intervals of 1 month. If subjects were still negative for anti-hepatitis B surface antigen (HBs) or had inadequate antibody after the third injection, a fourth administration of vaccine was given 3 months later. The mean anti-HBs titer was 243.3 +/- 97.2 mi.u./mL in control subjects and 39.8 +/- 53.2 in diabetic patients (P < 0.001). In the control group optimal protection was obtained in 100% of subjects, whereas 11 diabetic patients (45.8%) had low anti-HBs titer (< 10 mi.u./mL). All of 11 diabetic patients showed adequate (> 10 mi.u./mL) anti-HBs titer after the fourth dose of vaccine. In diabetic patients the most striking feature was the reduced CD4/CD8 ratio which was significantly lower (P < 0.001) than that of the control group. We conclude that diabetic children have an impaired immune response to hepatitis B vaccine. It is suggested that diabetic children should be vaccinated against hepatitis B virus with four injections instead of three.

Adolescent↗
PubMedDate not supplied

Peripheral neuropathy in children with insulin-dependent diabetes mellitus.

Peripheral somatic nerve function was studied in 38 unselected diabetic children and 31 age and sex-matched healthy controls. Thirteen of the 38 diabetics had abnormal peripheral somatic nerve function tests (more than 3 SD below the mean for normals). Five of the 13 diabetic children had only abnormal peripheral nerve function (early asymptomatic neuropathy); seven of these 13 were abnormal both in neurologic examination and peripheral nerve function (asymptomatic neuropathy). Only one of the 13 patients showed neuropathic symptoms as well as an abnormal neurologic examination and impaired peripheral nerve function tests (symptomatic neuropathy). Both motor and sensory peripheral somatic nerve abnormalities were related to poor glycemic control (HbA1c) and duration of diabetes. Individual peripheral nerve tests correlated with HbA1c (fibular motor, p < 0.001; sural sensory, p < 0.05) or duration of diabetes (fibular motor, p < 0.01; median motor, p < 0.01). These results emphasize the importance of metabolic control and duration of diabetes in the pathogenesis of diabetic neuropathy. The findings suggest that peripheral neuropathy is common in young, insulin-dependent diabetics. Being easy to conduct and sensitive, regular follow-up of nervous function test results may help to achieve good metabolic control and prevent diabetic complications.

Adolescent↗
PubMedDate not supplied

Pentoxifylline in male-factor infertility: its therapeutic efficacy after oral administration.

OBJECTIVE: To determine whether the oral use of pentoxifylline improves the fertilization ability, concentration and motility of spermatozoa of poor fertilizer male subject. DESIGN: Analysis of the spermiogram parameters before and after oral pentoxifylline administration. SETTING: Zeynep Kamil Women and Children's Hospital, Department of Infertility. PATIENTS: Fourteen healthy, untreated male partners of couples who applied to our infertility department and were found to have poor semen parameters. MAIN OUTCOME MEASURES: Data of the semen analyses and fertilization rates are compared before and after treatment. RESULTS: Before the treatment, the average percentage sperm motility and density were 30.1 +/- 8 (%) and 14.8 +/- 3.2 (10(6)/ml), respectively. The same parameters were found to be 37.8 +/- 13 (%) and 19.5 +/- 10 (10(6)/ml), respectively, following the treatment. Not significant, p = 0.08 and p = 0.116, respectively). CONCLUSION: None of the semen parameters evaluated were improved by oral administration of pentoxifylline. Therefore pentoxifylline does not increase percentage motility and density of spermatozoa or the fertilization rates.

Adult↗
PubMedDate not supplied

The use of transvaginal ultrasonography in the evaluation of luteal phase endometrium.

OBJECTIVE: To investigate the use of transvaginal ultrasonography, a non invasive method, for the evaluation of endometrium, to diagnose luteal phase insufficiency. DESIGN: Prospective, randomized, clinical study. SETTING: Human volunteers in an infertility clinic. PATIENTS: Patients who applied to the infertility clinic undergoing diagnostic procedures for their complaints. INTERVENTIONS: Follicle maturation, ovulation and endometrial grades were studied with transvaginal ultrasonography. Endometrial sampling was performed during midluteal and late luteal phase. Progesterone and estradiol levels were measured in the blood drawn on the sampling day. MAIN OUTCOME MEASURES: Endometrial grade, histopathology, estradiol and progesterone levels. RESULTS: In both groups, as the endometrial grades increased, the rate of normal histopathological results increased significantly. There was no statistically significant correlation between endometrial thickness and progesterone and estradiol levels. CONCLUSIONS: Evaluation of stromal maturation with ultrasonography is successful, but cannot replace endometrial sampling in evaluating luteal phase endometrium.

Endometrium↗
PubMedDate not supplied

Effects of methylprednisolone pulse therapy on insulin injections in patients with insulin-dependent diabetes mellitus.

In this study we evaluated 31 insulin-dependent diabetes mellitus (IDDM) patients (ages 12.1 +/- 3.4 years, 18 males/13 females) who started on multiple subcutaneous insulin injections (MSII) within six weeks of diagnosis and achieved either complete (CR: no insulin requirement and near-normoglycemia for at least two weeks) or incomplete (ICR: minimum 50% decline in insulin requirement while maintaining near-normoglycemia for two weeks or more) remissions within the first 12 weeks of the MSII trial. Methylprednisolone pulse therapy (MP) was administered four times per day by i.v. bolus at a dose of 30 mg/kg (max. 1000 mg) on alternative days. Eleven patients did not accept "MP-pulse" therapy; therefore, we followed these cases (7 males/4 females) as the control group. During the first year of follow-up, 13 patients from the "MP pulse" group achieved CR (3 males/1 female) or ICR (5 males/4 females) in 3.5 to 14 months. Remission occurred in only two of the control group cases (1 male CR for 17 days and 1 female CR for 7 months). Of those with CR in the "MP-pulse" and control groups, all were greater than 12 years of age, and all but one in the "MP-pulse" group were males. The stimulation capacity of beta cells (as defined by percentage increase in serum C-peptide levels after glucagon injection) among CR cases was found to be higher than that of non-remitted (NR) cases (p < 0.05 at onset, p < 0.001 during MSII-induced remission and p < 0.05 at the end of the first year of follow-up). Although patients with CR or ICR had higher beta cell reserves than NR cases at onset, only CR cases could sustain this capacity during the MSII-induced remission phase and one year after "MP-pulse" therapy. From this preliminary study, we conclude that "MP-pulse" therapy, may lead to prolonged near-normal beta cell function or partly preserved residual beta cell reserve during the MSII-induced remission phase of IDDM, The beneficial effects of MP could be seen clearly in patients diagnosed during the late childhood years.

Adolescent↗
PubMedDate not supplied

Relation between limited joint mobility and peripheral nerve function in diabetic children.

In order to assess the relation between limited joint mobility (LJM) and peripheral nerve function in diabetic children, peroneal nerve amplitude and motor conduction velocity as well as sural nerve amplitude and distal latency were measured with a Medelec MSG electromyograph. LJM was examined by observing the hands in the prayer position of 60 unselected diabetic children (average age 11.2 +/- 3.1 years; mean duration of diabetes 4.1 +/- 3 years) and 31 healthy controls. Of 60 patients, 38.3 percent had limited joint mobility. no influence of sex on expression of LJM was found. Its appearance was influenced by age, duration of diabetes and metabolic control (HbA1c) (p < 0.001, p < 0.001, p < 0.001, respectively). The mean amplitude, nerve conduction velocity and distal latency values in diabetic children with LJM were slower than those in the normal control group (peroneal amplitude p < 0.01), peroneal MCV p < 0.001, sural amplitude p < 0.001, sural distal latency p < 0.001). Of four patients with stage IV LJM, three had symptomatic neuropathy diagnosed using the criteria suggested by Dyck. Consequently, LJM identifies a population at risk for development of diabetic neuropathy. Thus, being easy and sensitive, LJM determination may provide both the physician and the patient himself with an important motivation to improve diabetic control in an effort to prevent diabetic neuropathy.

Adolescent↗
PubMedDate not supplied

A murine model of adenomyosis: the effects of hyperprolactinemia induced by fluoxetine hydrochloride, a selective serotonin reuptake inhibitor, on adenomyosis induction in Wistar albino rats.

OBJECTIVE: The aim of this study was to investigate whether fluoxetine given to castrated and noncastrated rats caused hyperprolactinemia and its effects with respect to adenomyosis. DESIGN: Fluoxetine, a serotonin reuptake inhibitor, was given to Wistar Albino rats for 98 days to produce hyperprolactinemia. The drug was given to two groups consisting of castrated and noncastrated rats and compared to two groups of castrated and noncastrated controls. Prolactin levels were measured and the uteri of the rats were removed for histopathological analysis at the end of 98 days. SETTING: Marmara University School of Medicine, Department of Histology and Embryology, Zeynep Kamil Women and Children's Hospital. MAIN OUTCOME MEASURES: Serum prolactin levels, uterine histopathology. RESULTS: The prolactin levels of castrated and noncastrated groups treated with fluoxetine were statistically significantly higher when compared to their respective control groups. Histological studies revealed 11 cases of adenomyosis, all within the noncastrated group receiving fluoxetine. CONCLUSION: It was suggested that high serum prolactin levels cause degeneration of myometrial cells in the presence of ovarian steroids that results in a myometrial invasion by endometrial stroma. This invasion eventually progresses to adenomyosis.

Animals↗
PubMedDate not supplied

The number of follicles and ovarian volume in the assessment of the response to clomiphene citrate in polycystic ovarian syndrome.

OBJECTIVE: To evaluate whether the number of follicles and ovarian volume have any significance in evaluating the response to clomiphene citrate treatment in Polycystic ovarian syndrome (PCOS). DESIGN: A prospective study of 70 infertile women, 44 of which were diagnosed with PCOS. SETTING: Zeynep Kamil Women and Children's Hospital Infertility Polyclinic. MAIN OUTCOME MEASURES: Follicle numbers and volumes in both ovaries, hormonal profile, response to Clomiphene Citrate (CC). Ovarian volume was significantly greater in PCOS cases than controls. However ovarian volume in the CC nonresponders was significantly greater than in CC responders in the PCOS group. The number of small follicles was significantly higher in PCOS cases than controls, and in the CC nonresponder group this number was also significantly higher than in CC responders. Endocrine features of patients with PCOS revealed that FSH, LH/FSH, DHEAS and Androstenedion do not discriminate between patients who respond to CC and those who do not respond. However, Testosterone (T) and LH levels differ significantly in responders and nonresponders. Small multiple follicles (> 9) and enlarged ovarian volume (> 6.8 ml) were the most prominent transvaginal ultrasonographic features of ovaries in CC nonresponsive patients with PCOS. Higher levels of T, LH, and significantly higher number of small follicles were associated with lack of CC response. These ultrasonographic features and laboratory assays could be clinically useful for distinguishing better the CC nonresponders from responders.

Adult↗