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Biomedical subjects

H Guner

Publications and source records attributed to H Guner.

11 recordsLinked to original sources
PubMed2005

Assessment of human papilloma viral load of archival cervical intraepithelial neoplasia by real-time polymerase chain reaction in a Turkish population.

The purpose of this study was to determine the existence, and viral load of human papilloma virus (HPV) subtypes 16 and 18 in paraffinized cervical intraepithelial neoplasia (CIN) samples by real-time polymerase chain reaction (RT-PCR). Overall 94 women were included. Of these patients 47 (50%) had CIN I, 27 (28.8%) had CIN II, and 20 (21.2%) had CIN III. HPV positivity for these three groups were 4.2%, 14.8% and 45%, respectively. HPV positivity in CIN III patients was significantly higher than CIN I (OR = 18.41, 95% CI 3.00-145.73; p < 0.001), and CIN II patients (OR = 4.70, 95% CI 1.00-23.76; p = 0.05). The difference between CIN I and II was not significant (p = 0.18). Viral loads were 10(2), and 10(4) copy/ml for two CIN I patients; 10(2), 10(3), and 10(5) for three CIN II patients; and 10(2), 10(3), 10(4), 10(4), 10(5), 10(5), and 10(6) copy/ml for eight patients with CIN III. Viral load of the remaining one patient could not be assessed. No significant variance was noted among the groups with respect to viral load (p = 0.73). RT-PCR had important advantages of detecting, typing, and quantifying at the same time. Although HPV positivity was increased significantly by the degree of lesions, this relation was not observed for viral load.

Adult↗
PubMed2004

The effect of recombinant GM-CSF on IL-6 and TNF-alpha levels in epithelial ovarian cancer patients who received paclitaxel and cisplatinum: preliminary results.

OBJECTIVE: We investigated the effects of GM-CSF factor on IL-6 and TNF-alpha levels prior to paclitaxel-cisplatinum combination chemotherapy for advanced epithelial ovarian cancer. MATERIALS AND METHODS: Twenty-three consecutive patients with FIGO (International Federation of Gynecology and Obstetrics) Stage III-IV epithelial ovarian cancer were enrolled in the study. Following cytoreductive surgery patients received 175 mg/m2 paclitaxel and 75 mg/m2 cisplatinum on the same day. These 23 patients also received RhuGM-CSF five days before at a dose of 5 microg/kg/day by subcutaneous injection for three days. IL-6 and TNF-alpha levels were measured before and 24 hours later following the last dose of RhuGM-CSF. RESULTS: White blood cell counts on the 10th day of the cycle were lower than preGM-CSF white blood cell counts and the difference was statistically significant (p = 0.003). Platelet levels on the 10th day of the chemotherapy cycle were lower than pre GM-CSF levels, however were not statistically significant (p = 0.097). Post GM-CSF TNF-alpha and IL-6 levels were higher than pre GM-CSF levels. This difference was statistically significant for TNF-alpha (p = 0.002) however for IL-6 a statistically significant difference was not detected (p = 0.55). GM-CSF does not significantly effect IL-6 levels in contrast to TNF-alpha. CONCLUSION: Clinical implications of increased levels of TNF-alpha are unclear and for a precise determination further studies are needed.

Adult↗
PubMed2001

The changes in ovarian hormone levels and ovarian artery blood flow rate after laparoscopic tubal sterilization.

OBJECTIVE: To investigate the changes in serum ovarian hormone levels and ovarian artery blood flow rate by Doppler ultrasonography following laparoscopic tubal sterilization. METHODS: Laparoscopic tubal sterilization have been performed on 13 voluntary subjects between the sixth and eighth days of the menstrual cycle. Serum ovarian hormone levels and ovarian artery blood flow rate, by Doppler ultrasonography, were determined 3 days before the operation, on the post-operative third day and on the post-operative third month. The results of 10 participants who finished the follow-up period were analyzed. RESULTS: There were no statistically significant changes in serum levels of ovarian hormones after laparoscopic tubal ligation. The end-diastolic blood flow in ovarian artery was found to be decreased following tubal sterilization (8.7+/-2.8 and 7.4+/-1.8m/sec, respectively, P>0.05), while resistivity index (RI) increased after the operation (0.7+/-0.1 and 0.8+/-0.03, respectively, P>0.05). CONCLUSION: There was no change in ovarian hormone levels after laparoscopic tubal sterilization. There is slight but statistically non-significant decrease in ovarian artery blood flow rate following tubal sterilization, signifying a local increase in vascular resistance.

Adult↗
PubMed2001

Effects of a monthly injectable steroidal contraceptive, Mesigyna, on menstrual pattern, lipoproteins, and coagulation parameters.

The objective of this study was to determine the effects of a once-monthly injectable contraceptive (Mesigyna) on menstrual pattern, lipoproteins, and coagulation parameters. Thirty-six women aged 18-35 years requesting monthly injectable contraception were included. Before injecting estradiol valerate 5 mg and norethisterone enanthate 50 mg, coagulation, lipoprotein, and liver function parameters were determined. After the 3- and 6-month injections, the same coagulation and serum lipid measurements and liver function tests were repeated, and women were questioned about their menstrual patterns and side effects. Thirty women who completed 6 months were evaluated. At the end of 3 months, two-thirds of the 30 women had normal menstrual patterns; at the end of 6 months, 80% of the women had normal menses. Serum LDL, total cholesterol, and triglyceride levels did not change significantly, while HDL and VLDL decreased significantly (p = 0.032 and p = 0.039, respectively) at 6 months. PT and aPTT measures did not change at the end of 6 months, while fibrinogen levels were significantly lower (p = 0.013). Serum total bilirubin levels increased (p = 0.022) and albumin levels decreased (p = 0.022) at the end of 6 months. Mesigyna was well tolerated and side effects and menstrual abnormalities were acceptable. There were no clinically significant changes in lipoprotein, coagulation, or hepatic parameters.

Adolescent↗
PubMed2001

Transvaginal sacrospinous colpopexy for marked uterovaginal and vault prolapse.

OBJECTIVE: The transvaginal sacrospinous ligament fixation technique was used as part of the vaginal repair procedure for marked uterovaginal prolapse, and in the treatment of vault prolapse. METHOD: Out of the 26 women treated with sacrospinous ligament suspension of the vaginal vault, 23 had marked uterovaginal prolapse and three had vault prolapse following hysterectomy. Patients with vault prolapse underwent posterior vaginal repair, obliteration of the enterocele sac and sacrospinous colpopexy. Patients with marked uterovaginal prolapse underwent vaginal hysterectomy with high ligation of the enterocele sac, anterior and posterior vaginal repair, and sacrospinous colpopexy. Bilateral salpingoopherectomy was added to the procedure in five patients. All patients were examined 6 weeks after the operation and, subsequently, on an annual basis. The mean follow-up period was 2.6 years (1-5 years). RESULTS: Out of the three patients with previous vault prolapse, none had recurrences. Out of the 23 patients with previous marked uterovaginal prolapse, only two had small cystocele, and one had small enterocele at 36 months following the operation. These patients were asymptomatic and did not need an operation. Vaginal vault prolapse was not observed in any of these patients. Two women had post-operative urinary tract infection and five had buttock discomfort, which subsided after 2 months. No other intra- or post-operative complications occurred. CONCLUSION: Transvaginal sacrospinous colpopexy can be performed together with vaginal hysterectomy, and anterior and posterior vaginal wall repair in patients with marked uterovaginal prolapse because of its high success in avoiding possible vault prolapse, and low intra- and post-operative complication rates.

Female↗
PubMed2001

Comparison of microlaparoscopy and conventional laparoscopy for tubal sterilization under local anesthesia with mild sedation.

STUDY OBJECTIVE: To compare tubal sterilization performed by microlaparoscopy and conventional laparoscopy. DESIGN: Prospective, randomized trial (Canadian Task Force classification I). SETTING: Gazi University School of Medicine. PATIENTS: Twenty women undergoing surgical sterilization. INTERVENTION: Ten sterilizations by conventional laparoscopy and 10 by microlaparoscopy. MEASUREMENTS AND MAIN RESULTS: The techniques were comparable in quality of visualization, operating time, amount of drugs used for sedation and local anesthesia, and intraoperative pain scores. However, the postoperative analgesic requirement was significantly less in women treated by by microlaparoscopy. CONCLUSION: Tubal sterilization by microlaparoscopy does not differ greatly from conventional laparoscopic sterilization.

Adult↗
PubMed1997

Small diameter versus conventional laparoscopy: a prospective, self-controlled study.

The objective of this study was to determine visual quality, diagnostic accuracy, and surgical merits of small diameter laparoscopy (SDL). Thirty-seven patients were randomly selected. The indications for laparoscopy were infertility, desire for tubal sterilization or chronic pelvic pain. Patients underwent SDL, followed by conventional laparoscopy (CL) as a control under general anaesthesia. Findings at operation were compared. The mean time for diagnostic work-up was longer with SDL than CL, 11.7 +/- 5.6 versus 7.6 +/- 3.2 min respectively (P < 0.04). Visual quality was scored from 4 to 1 by the operator; mean visual quality, mean endometriosis score and mean adnexal adhesions score were slightly lower with SDL than CL. Sensitivity of SDL in diagnosing endometriosis, adhesions, ovarian, uterine and pouch of Douglas lesions were 71, 58, 81, 89 and 73% respectively; specificity was 100, 96, 100, 100, 100% in the same order. Suction irrigation, cyst aspiration, tissue biopsies, simple adhesiolysis, tubal ligation and cauterization were easily performed with SDL. We conclude that SDL seems a good alternative to CL in diagnosing macro-pelvic anatomy and coarse pelvic pathologies and may also be good in performing surgical procedures such as: tubal ligation, biopsies and differential diagnosis of pelvic fluids. But SDL must be used cautiously in micro-oriented, functional conditions such as infertility, pelvic pain, endometriosis and adhesion scoring or treatment. SDL may be regarded as a less invasive but less sensitive tool with limited surgical merits.

Adult↗
PubMed1996

An extraperitoneal burch procedure: a case report.

A new laparoscopic Burch procedure with preperitoneal balloon dissection is introduced. A stress incontinence case without cystocele was operated by laparoscopic extraperitoneal colposuspension. The procedure was found to be effective a year after and no complications were seen. The extraperitoneal Burch procedure has the advantages of easy dissection, less bleeding, pain, and adhesion formation, a lower chance of injury to intraperitoneal organs, and short hospital stay and operation time; but the procedure has the disadvantages of a new anatomy orientation and the additional cost of a disposable balloon dissection set.

Catheterization↗
PubMed1994

Surgical treatment of urinary stress incontinence by a suburethral sling procedure using a Mersilene mesh graft.

A suburethral sling procedure using a Mersilene mesh has been performed in 24 patients. Six patients had recurrent incontinence after an unsuccessful past operation. A postoperative follow-up was done for an average of 24 months. Twenty-three patients were free of symptoms, while only 1 patient had recurrent incontinence. The suburethral sling procedure can be applied to all patients, particularly for recurrent stress urinary incontinence, with reasonable cure rates when performed with a proper technique.

Adult↗
PubMedDate not supplied

The prognostic value of endoglin (CD105) expression in ovarian carcinoma.

Intratumoral angiogenesis has become an important issue after the identification of antiangiogenic therapeutics. The purpose of this study was to investigate the prognostic value of CD105 in patients with ovarian cancer and also to compare with CD31. Fifty-eight patients were included to this study. All the paraffin blocks were reviewed, and angiogenesis was determined by immunohistochemical staining, using anti-CD105 and anti-CD31 monoclonal antibodies. The mean microvessel density (MVD) with CD105 and CD31 were 28.78 +/- 22.20 and 28.69 +/- 18.57, respectively (P = 0.97). With respect to prognostic factors, CD31 was only significant for suboptimal cytoreduction (P = 0.02), and CD105 was significant for both advanced stage and suboptimal cytoreduction (P = 0.02 and P = 0.05, respectively). For survival analysis, patients were divided into three groups by quartiles for each marker (group 1, <25%; group 2, 25-75%; and group 3, >75%). By CD31, only significant difference was noted between group 1 and group 2 (P = 0.03). In analysis with CD105, the survival rate of patients with group 3 was significantly worse than group 1 and group 2 (P = 0.01 for both). In multivariate analysis, cytoreduction and MVD determined by CD105 remained significant. In this study, endoglin was found to be an independent predictor of poor survival. Therefore, it could be used for antiangiogenic therapies.

Adult↗