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Biomedical subjects

K Vicdan

Publications and source records attributed to K Vicdan.

36 records · Page 2Linked to original sources
PubMed1996

Transvaginal sonographic findings of chronic ectopic pregnancy.

Chronic ectopic pregnancy is not precisely defined in gynecologic and sonographic texts. The diagnosis of this enigmatic clinical condition is frequently not made until laparotomy. In the present retrospective study, we evaluated the transvaginal sonographic findings of cases who were diagnosed as chronic ectopic pregnancy intraoperatively and/or postoperatively. The incidence of chronic ectopic pregnancy was found to be 20.3% (62/305) of all ectopic pregnancies. Of these 62 cases, 55 had transvaginal sonographic examination. On transvaginal sonographic examination, all 55 cases of chronic ectopic pregnancy had a complex adnexal mass with an empty uterus and only 18 (32.7%) had simple fluid in the pelvis/cul-de-sac. In the majority of cases (82.7%, n = 48), there was a non-homogeneous echo pattern within the adnexal mass. Of 55 cases, 30 had color Doppler flow examination, of whom none had color Doppler flow imaging on the wall of the mass or within the mass. There was a negative quantitative beta human chorionic gonadotropin (beta-hCG) assay (i.e. 0 mIU/ml) in only 4 cases. Based on this study, we concluded that chronic ectopic pregnancy is not a rare clinical entity and should be considered in differential diagnosis among patients presenting with an adnexal mass and an overt clinical picture. Transvaginal sonography is sensitive in diagnosing chronic ectopic pregnancy, but not specific. The combined use of transvaginal ultrasonography and beta-hCG assay increases diagnostic accuracy. However, it should be kept in mind that a negative beta-hCG value does not rule out chronic ectopic pregnancy.

Adnexa Uteri↗
PubMed1996

Demographic and epidemiologic features of female adolescents in Turkey.

OBJECTIVES: To determine the average menarcheal age and menstrual cycle pattern, prevalence of dysmenorrhea, frequency of smoking, alcohol and drug use, sexual education level, and the gynecologic problems in female adolescents in Turkey. METHODS: A questionnaire consisting of 43 questions were given to 13,665 high school girls between the ages 13-18 years. RESULTS: The results showed that average menarcheal age was 13.28 +/- 1.09 years and 77.8% of the girls had menstrual cycles between 20-35 days; 10,688 (78.1%) of the girls complained about pain during their menstruation and 25.6% frequently missed school for this reason. That notwithstanding, only 0.4% of the adolescents with dysmenorrhea had sought medical consultation. Out of 13,665 girls, 19.7% smoked cigarettes, 14.9% used alcohol, and 0.63% used other drugs. Although 50.8% of the students believed that their knowledge about sexuality was adequate, on evaluating the results, this was not confirmed. Girlfriends were found to be the most important source of sexual knowledge. The study indicated that 88.8% of the girls wanted to have sexual education at schools and 60.5% of those preferred to take such a lecture together with boys. The study also revealed that 10.5% of the girls previously consulted a gynecologist and menstrual disorders (26.1%) and dysmenorrhea (23.4%) were the most common complaints. The results showed that 68.7% of the girls preferred a woman gynecologist and 66.3% wanted to be alone with the doctor during examination. CONCLUSION: We provided data about demographic and epidemiologic features of Turkish female adolescents.

Adolescent↗
PubMed1996

Pregnancies achieved with testicular and ejaculated spermatozoa in combination with intracytoplasmic sperm injection in men with totally or initially immotile spermatozoa in the ejaculate.

The efficacy of intracytoplasmic sperm injection (ICSI) employing testicular and ejaculated spermatozoa was assessed in 24 couples with totally or initially immotile spermatozoa. No criteria were employed in selecting which patients would be treated with testicular or ejaculated spermatozoa. The men were chosen at random. Testicular spermatozoa obtained by testicular sperm extraction were used in 14 and ejaculated spermatozoa were used in 10 of these couples. In all cases. asthenozoospermia was total in their basal semen sample. In 12 male partners, spermatozoa were totally immotile before and after Percoll gradient fractionation (totally immotile). In the remaining 12 men, spermatozoa initially showed a total absence of motility; however, some of the spermatozoa had showed very poor motility (0. 1%) after Percoll gradient fractionation and a 1.5-2.0 h incubation period (initially immotile). Of these 24 total asthenozoospermic males, 14 also had total teratozoospermia. The fertilization and cleavage rates in the testicular and ejaculated sperm groups were 53. 5 and 96.3 and 54.5 and 94.4% respectively. One cycle resulted in complete fertilization failure, and in 23 embryo transfer cycles a total of 10 pregnancies were obtained (41.6%). Eight pregnancies were achieved in the testicular sperm group, while only two pregnancies were obtained in the ejaculated sperm group. Four pregnancies, two from the ejaculated sperm group and two from the testicular sperm group, resulted in clinical abortions in the first trimester. Of the remaining six pregnancies, two have already resulted in healthy births and four pregnancies are now in the second or third trimester in the testicular sperm group. Using testicular spermatozoa in combination with ICSI can be an alternative mode of treatment in cases with totally or initially immotile spermatozoa in the ejaculate. Very low pregnancy rates have been obtained and no ongoing pregnancy has been achieved using ejaculated spermatozoa in these cases.

Adult↗
PubMed1996

Chronic ectopic pregnancy: a clinical analysis of 62 cases.

Chronic ectopic pregnancy is a form of tubal pregnancy in which salient minor ruptures or abortions of an ectopic pregnancy instead of a single episode of bleeding, incites an inflammatory response often leading to the formation of a pelvic mass. Its clinical features are often confusing, and laboratory evaluations are often misleading. Surgery for chronic ectopic pregnancy is frequently difficult since chronic inflammatory changes and adhesions distort the normal anatomy. In the present retrospective study, its incidence was found to be 20.3% (n = 62) in a series of 305 ectopic pregnancies. A pelvic mass of varying sonographic appearance, mostly with a nonhomogenous echo pattern, was demonstrated in all 55 patients in whom transvaginal sonographic evaluation was performed preoperatively. Although most of the patients [91.9% (n = 57)] had a positive serum beta HCG value, 5 patients had a negative test value. Laparotomy resulted in 40 salpingectomies, 19 salpingo-oophorectomies, and 3 total abdominal hysterectomies with salpingo-oophorectomies. One patient had a incidental cystotomy and 2 an incidental colotomy. We conclude that chronic ectopic pregnancy is not rare although little is mentioned about it as a clinical entity in the gynaecological literature. With increased awareness of its mildly symptomatic and protracted clinical course, and with proper interpretation of laboratory evaluations, a preoperative diagnosis can be made in the majority of the cases.

Adolescent↗
PubMed1996

Ultrasonographic appearance of non-Hodgkin's lymphoma in a pregnant woman.

Non-Hodgkin's lymphoma during pregnancy is rare. We report a case of non-Hodgkin's lymphoma detected in a pregnant women. She was initially diagnosed as having an ovarian tumor by ultrasonography, but definitive diagnosis was made at the time of cesarean section. After delivery she took combined chemotherapy for 7 cycles and is in complete remission over 1 year.

Adult↗
PubMed1995

Rupture of the uterus.

OBJECTIVES: To investigate the frequency of ruptured uterus, possible etiologic factors and fetomaternal outcomes. METHODS: The birth records of 58262 deliveries at Dr Zekai Tahir Burak Women's Hospital from 1 January 1990 to 31 December 1992 were reviewed and the results compared with those of two previous studies reported from this hospital on the same subject. RESULTS: Forty uterine ruptures occurred between 1990 and 1992, with a frequency of 0.068% (1/1457). All occurred spontaneously but 10 (25%) had no previous surgery, whereas 30 followed previous cesarean section. There was no traumatic uterine rupture during this period. Fetal mortality was 32.5% and no maternal deaths were recorded. CONCLUSION: The rate of ruptured uterus has declined among our hospital population as etiologic factors responsible for the complication have been reduced.

Cesarean Section↗
PubMed1995

Ultrasonographic appearance of fallopian tube carcinoma.

Preoperative diagnosis of tubal carcinoma is difficult and a diagnosis cannot usually be established until the time of operation. However, since prognosis is strictly related to the stage of the neoplasm, it is very important to be familiar with the clinical and imaging characteristics of primary fallopian tube carcinoma in order to make an early and accurate diagnosis. This report presents the ultrasonographic features of three cases of fallopian tube carcinoma and reviews the literature on the subject.

Adenocarcinoma↗
PubMed1995

Twin sisters with impetigo herpetiformis.

Impetigo herpetiformis is a rare and serious pustular eruption resembling pustular psoriasis that mostly occurs in pregnant women. The etiology of the disease is unclear and it is not known if genetic factors play a role. We present two sisters (twins) with impetigo herpetiformis supporting an inheritance pattern.

Adult↗
PubMed1994

Tubal histopathology in ectopic pregnancies.

A histopathologic study in eighty six patients with ectopic pregnancy and in eighty six control patients was undertaken to evaluate the association between ectopic pregnancy and tubal pathology in our population. Fifty six (65%) and nine (10.4%) cases with chronic salpingitis (CS) were diagnosed in the study group and in the control group, respectively. This difference was statistically significant (p < 0.001). Twelve of 56 cases with chronic salpingitis were salpingitis isthmica nodosa (SIN) and no patient with SIN was observed in the control group. SIN was always concomittant with chronic salpingitis in our study. Based on these findings, we concluded that chronic salpingitis and SIN have an important role in the etiology of ectopic pregnancy in our population and SIN is significantly associated with chronic salpingitis.

Endometriosis↗
PubMed1994

The hormonal profile in ectopic pregnancies.

We prospectively investigated the maternal serum level of beta- human chorionic gonadotropin (beta-hCG) progesterone (P), estradiol (E2), human placental lactogen (HPL), alfa-fetoprotein (AFP) and cancer antigen 125 (CA 125) during the first trimester of normal and abnormal pregnancies. Serum samples were obtained from 20 women with normal intra-uterine pregnancy (IUPs). Fifteen whose pregnancies were complicated with spontaneous abortion and 31 with surgically and pathologically confirmed ectopic pregnancies (EPs). The mean serum levels of beta-hCG, E2 and P in patients with Eps (9490.55 +/- 3071.2 mIU/ml, 100.1 +/- 22.09 pg/ml, 4.18 +/- 1.19 ng/ml, respectively) were significantly lower than those measured in normal IUPs (73796.8 +/- 15554.7 mIU/ml, 500.15 +/- 98.84 pg/ml, 19.2 +/- 2.8 ng/ml respectively (p < 0.001) and significantly lower than in patients with spontaneous abortion (22524 +/- 6213 mIU/ml, p < 0.05, 339.8 +/- 112.16 pg/ml, p < 0.01, 10.59 +/- 3.03 ng/ml, p < 0.05 respectively). No significant difference was recorded with respect to serum levels of HPL, AFP and CA 125 among the groups. We also investigated the diagnostic value of simple E2 and P in patients with EPs. We could not identify a discriminatory cutoff value because there was a considerable overlap in serum P ans E2 levels between the patients with IUPs and EPs. In conclusion, it is not possible to define a cutoff discriminatory value of P and E2 that completely separates ectopic from IUPs, but the addition of these assays to the workup of a patient with suspected EP may facilitate the earlier diagnosis of EP.

Abortion, Spontaneous↗
PubMed1994

Thyroid function: fetal-maternal relationship at term.

The present study was undertaken to examine serum parameters of thyroid function at term in normal pregnant women and their normal fetuses. Paired sera from 56 mothers and their respective newborn infants' umbilical cord were obtained at parturition. Maternal and fetal TSH, FT4, T4, FT3 and T3 levels were measured and the differences between these two groups were analysed. The levels of fetal serum TSH (8.86 +/- 5.82 IU/ml) were significantly higher than maternal TSH levels (3.32 +/- 3.3 IU/ml) (P < 0.001), but there was no significant difference between the fetal and maternal T4, FT4 and T3. On the other hand, cord FT3 levels (1.7 +/- 1.2 pg/dl) were significantly lower than maternal levels (2.7 +/- 1.4 pg/dl) (P < 0.001).

Adult↗
PubMed1993

Uterine myolipoma: diagnosis by ultrasound.

Lipomatous lesions of the uterus are extremely rare and their diagnosis is made postoperatively in most instances. A case of uterine myolipoma identified preoperatively by ultrasound and confirmed by pathologic examination is presented.

Female↗
PubMedDate not supplied

The hormonal profile in ectopic pregnancies.

The hormonal profile in a patient with an ectopic pregnancy (EP) differs in many respects from that of a patient with a normal intrauterine pregnancy (IUP). Although there are several reports using different hormones for early diagnosis of ectopic pregnancy most of the results are contradictory. In this study, therefore, we prospectively investigated the maternal serum level of beta-human chorionic gonadotropin (beta-hCG), progesterone (P), estradiol (E2), human placental lactogen (HPL), alfafetoprotein (AFP) and cancer antigen 125 (CA 125) during the first trimester of normal and abnormal pregnancies. Serum samples were obtained from 20 women with normal IUPs, 15 women whose pregnancies complicated with spontaneous abortion and 31 women with surgically and pathologically confirmed EPs. The mean serum levels of beta-hCG, E2 and p in patients with EPs (9490.55 +/- 3071.2 mlU/ml, 100.1 +/- 22.09 pg/ml, 4.18 +/- 1.19 ng/ml, respectively) were significantly lower than those measured in normal IUPs (73796.8 +/- 15554.7 mlU/ml, 500.15 +/- 98.84 pg/ml, 19.2 +/- 2.8 ng/ml, respectively p < 0.001) and significantly lower than in patients with spontaneous abortion (22524 +/- 6213 mlU/ml, p < 0.05, 339.8 +/- 112.16 pg/ml, p < 0.01, 10.59 +/- 3.03 ng/ml, p < 0.05 respectively). No significant difference was recorded with respect to serum levels of HPL, AFP and CA 125 among the groups. We also investigated the diagnostic value of simple E2 and P in patients with EPs. We could not identify a discriminatory cutoff value because there was a considerable overlap in serum P and E2 levels between the patients with IUPs and EPs.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Spontaneous↗