Expression of p53 in epithelial ovarian cancer.
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Biomedical subjects
Publications and source records attributed to S Ozalp.
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OBJECTIVES: To evaluate the factors that may affect the selection of a reversible or an irreversible contraceptive method. METHODS: In an urban area of a developing country, demographic characteristics, educational and income levels, and previously used contraceptive methods were retrospectively reviewed for 3 years from the files of women who had chosen reversible or irreversible contraceptive methods. Student's t test and the chi2 test were used to analyze the data obtained from the two groups of women. RESULTS: Out of a total of 8078 women, 595 (7.4%) selected surgical sterilization, while 7483 (92.6%) preferred reversible methods such as intrauterine devices (38.1%), combined oral contraceptives (13.9%), condoms (40%) and Norplant (0.6%). Compared to those who preferred reversible methods, the women with surgical sterilization had a higher mean age (33.9 +/- 4.2 years versus 29.6 +/- 3.9 years), mean gravidity (3.8 +/- 0.9 versus 2.3 +/- 1.2) and mean number of living children (2.6 +/- 0.8 versus 2.1 +/- 1.1) (p < 0.01). These women had also higher rates of high-school education (37.3% versus 30.1%) and previous modern contraceptive use (78.1% versus 71.2%) (p < 0.01). None of the women with surgical sterilization, but 1770 (33.0%) of those who chose reversible methods, had fewer than two living children. CONCLUSIONS: These data suggest that irreversible contraceptive methods tend to be chosen by older women with higher educational levels, who have decided that their family is complete and who have at least two children.
BACKGROUND: To assess the correlation between the severity of incontinence and some ultrasonographic parameters used to document the mobility of bladder neck. METHODS: The severity of the incontinence and mobility the bladder neck were evaluated by pad test and perineal ultrasonography respectively in 74 patients with pure anatomic stress incontinence. During perineal ultrasonography, distances from the bladder neck to the lower tip (A) and to the posterior midpoint of symphysis pubis (B) were measured at rest and during stress. The first bladder neck mobility was obtained by two caliper method (Mu). After superimposing the symphysis pubis of the frozen images, the bladder neck positions at rest and during stress were plotted on an x-y coordinate system by using computer programs and the corresponding X and Y values were calculated. The second bladder neck mobility was measured on this x-y coordinate system (Mc). Paired t-test and correlation analysis were used for statistical analysis of the data. RESULTS: The mean Mc was significantly higher than the mean Mu (p<0.01). Compared to the values at rest, the mean distance A did not change significantly; however, the mean distance B increased, and X and Y values decreased significantly during stress (p<0.01). The amount of urine leaked per hour had significant positive correlation with distance B-stress and Mc and significant negative correlation with Y-rest, X-stress and Y-stress (p<0.05-0.001). CONCLUSION: These data suggested that the bladder neck mobility was underestimated when it was measured by two caliper method and the absolute positions or mobility of the bladder neck measured by computer on an x-y coordinate system could effectively document the severity of the decreased support of bladder neck.
OBJECTIVE: The aim of this study was to evaluate the value of transvaginal ultrasonography (TVUS) and uterine artery flow velocimetry indices in the preoperative detection of deep myometrial invasion in endometrial carcinoma (EC). METHODS: Thirty-nine patients with EC underwent TVUS and Doppler flow velocimetry studies, during which endometrial, myometrial, and uterine measurements, presence and depth of myometrial invasion, and pulsatility and resistance indices (PI and RI, respectively) of uterine arteries were noted. TVUS and Doppler findings were correlated with pathological findings obtained by surgical staging. The respective diagnostic accuracies of these variables, and of age and grade, in detecting deep myometrial invasion were assessed with the use of histological findings as the standard. RESULTS: All patients with Grade 3 tumors had deep myometrial invasion, compared to 19% of patients with Grade 1 tumors. The mean age of patients with deep invasion was significantly higher, and their mean PI and RI were significantly lower, than patients with lesser degrees of invasion. While the sensitivity and specificity of TVUS in detecting deep invasion were 37 and 90%, respectively, the corresponding figures for age, grade, and uterine artery RI, found to be independent discriminators of deep invasion, were in the range of 58-84% and 60-70%. The combined use of the latter three parameters resulted in a sensitivity of 100% and specificity of 95%. CONCLUSIONS: Our findings indicate that TVUS is unreliable in diagnosing deep myometrial invasion. Detection rates of this pathological feature can be greatly improved, however, with the concomitant use of age, tumor grade, and uterine artery RI.
OBJECTIVES: To evaluate the factors affecting the contraceptive choice of women in a developing country. METHODS: Demographic characteristics, education and income level, previous and current contraceptive choices of the women from a maternity and a university hospital were retrospectively reviewed for 2 years. The data obtained from the two hospitals were analyzed by Student's t- and chi2-tests. RESULTS: Family planning services were offered to 651 and 7427 women in the university and the maternity hospital, respectively. Although the mean ages and income levels of the women in two centers were similar, the women in the university hospital had lower mean gravidity and mean number of living child, while they had higher education level and previous modern contraceptive use (P < 0.05-0.001). The women in the university hospital more frequently preferred combined oral contraceptive and surgical sterilization, while those in the maternity hospital chose condom and intrauterine device (P < 0.01-0.001). CONCLUSIONS: Women with higher education level had a lower number of pregnancies and living children due to more frequent use of previous effective contraception and they chose combined oral contraceptives and irreversible methods more frequently.
PURPOSE: To report the use of perfluoroperhydrophenanthrene (vitreon) for traumatic retinal detachment in children. METHODS: Vitreon was used as an intraoperative adjunct in 34 children with complicated retinal detachment secondary to penetrating and perforating trauma. The characteristics of the injuries, the final visual acuities, the postoperative complications and the rate of anatomic success were evaluated in a retrospective study. RESULTS: Patients were followed-up an average of 20 months. Eighteen retinas (53%) were reattached, and the postoperative visual acuity was counting fingers or better in 9 cases (26%), and only 4 eyes saw better than 10/200 at last follow-up. Hypotony developed in 7 (21%) of 34 eyes. CONCLUSION: Management of traumatic retinal detachment in children is difficult. Vitreon, as other perfluorocarbons, may be an effective intraoperative tool for vitreoretinal surgery in pediatric eyes that suffer trauma.
BACKGROUND: To investigate the diagnostic efficacy of preoperative lymphoscintigraphy (LS), Ga-67 scintigraphy (GS) and computed tomography (CT) for detection of lymph node metastasis in patients with endometrial or ovarian carcinoma. METHODS: The results of preoperative LS, GS and CT used to detect lymph node metastasis were compared to the postoperative histopathological results of lymph node dissection materials of a total of 37 patients, including 16 patients with endometrial and 21 patients with ovarian carcinomas. The diagnostic efficacy of these methods for detecting lymph node metastasis were calculated. RESULTS: When the results of all of the patients were taken into account, the preoperative LS, GS and CT were found to have sensitivities of 50%, 20% and 40% and specificities of 51.8%, 96.3%, and 92.6%, respectively, for detection of pelvic lymph node metastasis. The same methods had sensitivities of 27.3%, 27.3% and 72.7% and specificities of 88.5%, 88.5%, 84.6%, respectively, for detecting para-aortic lymph node metastasis in all patients. CONCLUSION: These data suggested that although LS, GS and CT had relatively high specificity, low sensitivity of these imaging methods precluded their routine preoperative use for diagnosis of lymph node metastasis of ovarian or endometrial carcinoma.
OBJECTIVE: To define the factors which might effect the results of second-look laparotomy (SLL) and the prognosis of patients with negative SLL. METHODS: Fourteen (42.4%) of the 33 patients who underwent SLL for primary epithelial ovarian cancer had residual disease (positive SLL), while 19 (57.6%) of them had no evidence of disease (negative SLL); 13 (68.4%) of the 19 patients who were followed without any intervention, still had no evidence of disease, while 6 (31.6%) of them had clinical recurrences. The age of the patients, histopathological type, stage and grade of the cancers, type of chemotherapy and the effectiveness of the cytoreductive surgery were presumed as prognosticators and were compared in each group of patients. RESULTS: The age of the patients, histopathological type of the carcinomas and the type of combined chemotherapy were similar in patients with negative or positive SLL and those with recurrences or no evidence of disease during the follow-up after negative SLL (p>0.05). However, the groups of patients with negative SLL and those with no evidence of disease during the follow-up period had lower grade or stage of cancers and less frequent sub-optimal cytoreduction than the groups of patients with positive SLL and those with recurrences during the follow-up, respectively (p<0.05). CONCLUSION: SLL could be selectively performed in patients with high grade or high stage ovarian carcinoma or in those patients treated by sub-optimal cytoreduction.
OBJECTIVE: To evaluate the effect of corticosteroid treatment on the postpartum recovery of parturients with HELLP syndrome. METHOD: Thirty cases with HELLP syndrome were randomly assigned to a study or a control group, each including 15 patients. A total dose of 30 mg intravenous dexamethasone was given to the study group during the 36 h following the childbirth, while the control group did not receive any steroid medication. Arterial blood pressure, urine output, hematocrit ratio, platelet count, serum alanine and aspartate aminotransferases and uric acid levels were monitored during the first 48 h postpartum. The data were analyzed by unpaired t-test, chi2 or Fisher's exact tests. RESULT: Before the treatment, no significant difference was observed between the two groups. The study group showed statistically significant improvement in mean arterial blood pressure, mean serum aspartate aminotransferase level, mean urine volume per hour and mean platelet count (P < 0.05). Length of hospitalization was also shorter in the study group (P < 0.01). CONCLUSION: Early postpartum high-dose corticosteroid treatment accelerates the recovery and shortens the hospitalization of the parturients with HELLP syndrome.
BACKGROUND: To evaluate the results of anti-incontinence operations and Kegel exercises in patients with pure type II anatomic stress incontinence. METHODS: After evaluation by physical, genitourinary and urologically oriented neurological examinations, urogynecologic tests, perineal ultrasonography and cystometry, pure type II anatomic stress incontinence was diagnosed in 98 patients. Modified Pereyra and Burch operations were performed in 27 and 24 of the 51 (52.0%) patients, who had surgical treatments, respectively, while the remaining 47 (48.0%) patients were advised to perform Kegel exercise. The results of the treatment methods were evaluated subjectively by patient questionnaire and 24-hour urinary diary and objectively by one-hour pad test and stress test. RESULTS: Fifty-one patients treated by anti-incontinence operations had 90.2% objective and 94.1% subjective complete successes (cure) with a mean follow-up of 13.7 months. These data were 8.5% and 14.9% respectively, for 47 patients treated by Kegel exercises with a mean follow-up of 12.8 months. Both the subjective and objective cure rates of surgical treatments were found to be significantly higher than those of Kegel exercises in patients with type II anatomic stress incontinence (p<0.01). Patients with good compliance to Kegel exercises had 20.7% subjective and 13.8% objective cures, however those with low compliance had only 5.6% subjective and no objective cures. CONCLUSIONS: These data suggested that anti-incontinence operations were more effective than Kegel exercises for the treatment of patients with type II anatomic stress incontinence.
BACKGROUND AND OBJECTIVE: To evaluate the effect of perfluorodecalin on the repair of retinal detachments with retinoschisis. PATIENTS AND METHODS: Twenty-two eyes of 20 patients with degenerative and X-linked retinoschisis underwent pars plana vitrectomy, perfluorodecalin injection, internal fluid drainage, and fluid-air exchange. RESULTS: The retina was reattached intraoperatively in 21 (95.4%) of the 22 eyes. In 4 eyes, retinal detachment recurred within 2 months postoperatively. All of the recurrent cases underwent reoperation with perfluoropropane gas and the retina was reattached at the end of 2 operations. As a result, visual acuity increased in 18 (81.8%) of the 22 eyes. CONCLUSION: Perfluorodecalin makes flattening of the retina and evacuation of subretinal fluid easier in the management of rhegmatogenous retinal detachments associated with degenerative and X-linked retinoschisis.
Persistent amniorrhea and extraamniotic fluid collection was observed after amniocentesis. After the drainage of extraamniotic fluid, maternal blood was given under ultrasonographic guidance to produce a clot patch. Amniorrhea was controlled within 12 hours and a healthy baby was delivered at term.
OBJECTIVE: To detect associated anomalies, karyotypes and perinatal prognosis of fetuses with single umbilical artery. METHOD: Fifteen fetuses who have single umbilical artery were evaluated in the obstetrical ultrasonography and medical genetics departments of Osmangazi University. RESULTS: Fifteen fetuses with single umbilical artery were detected during antenatal ultrasonographic examinations. Associated sonographic abnormalities include oligohydramnios (two), intrauterine growth retardation (one), renal agenesis (one), fetal ascites (one), diaphragmatic hernia (one), hydrocephalus (two), and meningomyelocele (one). Complications related to the pregnancy were pre-eclampsia in one case and abruptio placenta in another. Karyotype analysis was available in 11 cases and the only cytogenetic abnormality detected was trisomy 18 in one case. Two cases with hydrocephalus and single umbilical artery were delivered by cesarean section at 34 and 38 weeks, but both died (on the first and fifth days after birth). Five pregnancies were terminated because of intrauterine death (one), severe pre-eclampsia (one), cytogenetic abnormality (one), and multiple congenital anomalies associated with single umbilical artery (two) at 36, 27, 22, 26 and 29 weeks, respectively. Eight of the neonates who had no additional congenital or cytogenetic abnormality were completely normal at birth and during the neonatal period. Diagnoses were confirmed pathologically in all cases. CONCLUSION: Scanning the umbilical cord should be one of the essential parts of ultrasonographic examination. When single umbilical artery is detected, a detailed ultrasonographic examination is necessary to rule out associated abnormalities. We advise fetal karyotyping even when no additional pathology can be detected on ultrasonographic examination.
OBJECTIVE: Biophysical profile scoring (BPS) is a valuable antepartum test for establishing fetal well-being, although the time constraint in some clinics limits its extensive use. In this study we attempted to shorten the total test time without excluding any of the test components. METHOD: The non-stress test (NST) part of the BPS was performed using simultaneous pulsed wave Doppler and B-mode ultrasonography (duplex NST). It was possible to observe all the components of the BPS during the same period (duplex BPS). RESULTS: Fifty-four tests were performed on 40 pregnant patients. The mean test time was 14.3 min. A discrepancy was shown between the ultrasonographic observation and the women's perception of the fetal movements in 46% of the tests. CONCLUSION: Duplex NST is considered a more reliable test than the classical cardiotocographic NST. Duplex BPS is proposed as an easy-to-perform, compact and time-saving modification to the classical BPS.
To clarify the osteocalcin metabolism in the fetus, we determined venous osteocalcin levels of 13 women and umbilical arterial and venous osteocalcin levels of their newborns at delivery. Calcium, phosphorus and alkaline phosphatase levels were also established. Umbilical arterial and venous blood calcium and phosphorus levels were significantly higher than maternal venous blood values (P < 0.001 for all). Umbilical arterial calcium was 2.46 +/- 0.02 mmol/l, phosphorus 1.48 +/- 0.04 mmol/l, umbilical venous calcium 2.50 +/- 0.03 mmol/l, phosphorus 1.45 +/- 0.04 mmol/l, maternal calcium 2.16 +/- 0.03 mmol/l, phosphorus 0.98 +/- 0.04 mmol/l. Both umbilical venous (5.85 +/- 0.66 nmol/l) and arterial (3.49 +/- 0.51 nmol/l) osteocalcin levels were significantly higher than maternal values (1.42 +/- 0.15 nmol/l). The high umbilical venous osteocalcin levels may be due to increased osteocalcin degradation in fetus or placental osteocalcin synthesis.
In order to determine the incidence of confined placental mosaicism (CPM) in term placentae and to show the presence of specific sites and the effect on fetal development, 125 placentae from uneventful pregnancies were analysed by cytogenetic methods. The incidence was at least 4.8 per cent and there were no specific sites on the placenta. Although the number of cases is still too small, we found CPM to be associated with intrauterine growth retardation in six cases.
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