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Öğe ERKEN EVRE UTERİN SERVİKS KANSERLİ HASTALARDA PELVİK VE PARAAORTİK LENF NODU METASTAZLARININ SAPTANMASINDA 18F-FDG PET / BT'NİN TANISAL DEĞERİNİN BELİRLENMESİ(2019) Tas, Mustafa; Yavuz, Adem; Kaya, Eser; Özçelik, BülentAmaç: Bu çalışmanın amacı, erken evre uterin serviks kanserli hastalarda pelvik ve paraaortik lenf nodumetastazlarının saptanmasında 18F-florodeoksiglukoz Pozitron Emisyon tomografisi / Bilgisayarlı Tomografi(PET/BT) 'nin tanısal değerini belirlemekti.Gereç ve Yöntem: Radikal histerektomi ve sistemik pelvik ve paraaortik lenf nodu diseksiyonu öncesi PET/BT görüntülemesi yapılan erken evre uterin serviks kanserli 18 hasta çalışmaya dahil edildi. Lenf nodlarınınhistopatolojik değerlendirmesi tanısal standart olarak kabul edildi ve PET/BT bulguları histopatolojik bulgularlakarşılaştırıldı.Bulgular: 18 hastadan toplam 807 (577 pelvik - 230 paraaortik) lenf nodu örneklendi ve histopatolojikincelemede 5 (% 28) hastada 10 (%1,2) nod (8 pelvik - 2 paraaortik) pozitif bulundu. Genel nod bazlı PET/BT'nin duyarlılık, özgüllük, pozitif prediktif değer (PPV), negatif prediktif değer (NPV) ve doğruluğu sırasıyla %10 (1/10), % 100 (797/797), %100 (1/1) % 99 (797/806) ve % 99 (798/807) idi.Genel hasta bazlı PET/BT'nin duyarlılık, özgüllük, PPV, NPV ve doğruluğu sırasıyla %20 (1/5), %100 (13/13), %100 (1/1), % 76 (13/17), %78 (14/18) idi.Sonuç: Erken evre uterin serviks kanserli hastaların yönetiminde, mikrometastatik lenf nodu olan hastalarınPET / BT'de yanlış negatif olarak rapor edilebileceği akılda tutulmalıdır.Öğe Evaluation of protective effects of GnRH agonist or antagonist on ovarian reserve with anti-M?llerian hormone and histological analysis in a rat model using cisplatin(Termedia Publishing House Ltd, 2023) Tas, Mustafa; Oner, Gokalp; Ulug, Pasa; Yavuz, Adem; Ozcelik, BulentIntroduction: The aim of this prospective trial was to evaluate the ovarian reserve with anti-Mullerian hormone (AMH), which is the best predictor of ovarian reserve, and perform histological analysis after exposure to cisplatin with a GnRH agonist or antagonist.Material and methods: Twenty-four Wistar albino rats were randomly divided into three groups, each consisting of eight rats. In the GnRH agonist group (group 1), rats received a single dose of 50 mg/m2 cisplatin with 1 mg/kg triptorelin. In the GnRH antagonist group (group 2), rats received a single dose of 50 mg/m2 cisplatin with 1 mg/kg cetrorelix. In the control group (group 3), rats received 50 mg/m2 cisplatin. Ovarian reserve was assessed by AMH and histology.Results: Primary follicle counts were higher in group 2 (4.50 +/- 1.47 vs. 3.50 +/- 1.70 vs. 3.00 +/- 3.54) and secondary follicle counts were higher in group 1 (2.96 +/- 1.11 vs. 1.74 +/- 1.03 vs. 1.37 +/- 3.11). Numbers of tertiary follicles were higher both in groups 1 and 2 than the control group (1.36 +/- 0.83 vs. 0.84 +/- 0.99 vs. 0.50 +/- 0.75). The total follicle count of the study groups were signifi-cantly higher compared with the control group (14.32 +/- 5.96 vs. 12.48 +/- 4.12 vs. 10.63 +/- 6.80). AMH was significantly higher in groups 1 and 2 compared with the control group (18.56 +/- 25.33 vs. 16.48 +/- 24.66 vs. 9.37 +/- 26.54).Conclusions: This is the first prospective randomized controlled study show-ing the protective effects of GnRH agonist and antagonist on ovarian reserve after cisplatin exposure in an animal model.Öğe Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Discriminating Precancerous Pathologies from Cervical Cancer(Hindawi Ltd, 2019) Tas, Mustafa; Yavuz, Adem; Ak, Mehmet; Ozcelik, BulentPurpose. We aimed to determine the predictive value of several hematological markers of inflammation on the presence/absence of cervical cancer and also to determine their ability in discriminating precancerous cervical pathologies from cervical cancer. Materials and Methods. In this study, patients who presented to Acibadem Kayseri Hospital between May 2010 and June 2018 were evaluated. Forty patients with low-grade squamous intraepithelial lesions (LSIL), 40 patients with high-grade squamous intraepithelial lesions (HSIL), and 30 patients with cervical cancer (CC) were retrospectively included in this study. A control group of 70 healthy volunteers with normal cervical cytology was also included in the study. Results. The neutrophil-to-lymphocyte ratio (NLR) was significantly higher in patients with CC than in controls. The platelet-to-lymphocyte ratio (PLR) was significantly higher in patients with CC compared to those with LSIL and HSIL diagnoses and also controls (p<0.001). Logistic regression analysis revealed that age (OR: 1.075, 95% CI: 1.020-1.132, p=0.007), NLR (OR: 1.643, 95% CI: 1.009-3.142, p=0.047), and PLR (OR: 1.032, 95% CI: 1.003-1.062, p=0.029) were predictors for the presence of CC. ROC curve analysis revealed that both NLR and PLR were predictive of CC with a cutoff value of 2.02 for NLR (71% sensitivity and 60% specificity, AUC: 0.682, p=0.004) and 126.7 for PLR (83% sensitivity and 69% specificity, AUC: 0.752, p<0.001). Conclusion. In addition to patients' age, determination of NLR and PLR values, which are simple, inexpensive, and readily available markers of systemic inflammation, may help in decision making precancerous pathologies of the cervix.Öğe The Effects of an Absorbable Hemostat Produced From Oxidized Regenerated Cellulose on Adhesion Formation in a Rat Mode(Galenos Yayincilik, 2021) Yavuz, Adem; Oner, Gokalp; Tas, Mustafa; Cinaroglu, SelimObjective: This study aimed to analyze the effect of an absorbable hemostat produced from oxidized regenerated cellulose (ORC) on pelvic adhesion formation in a rat model using an adhesion scoring system and immunohistochemical staining. Methods: This randomized, controlled experimental study included 20 female Wistar-Albino rats that were equally divided into the following groups: control and absorbable hemostat groups. The uterine horns of all the rats were exposed by laparotomy and using 10 W bipolar cautery. Five standard lesions were applied to the antimesenteric areas of each uterine horn. The experimental group received an absorbable hemostat to the traumatized uterine surfaces, whereas the control group did not. After a 28-day follow-up period, a relaparotomy was performed, and adhesions were evaluated based on an adhesion scoring system, and histological sections from areas with adhesion were obtained for immunohistochemical staining. Immunohistochemical staining included analysis of Ki-67 (proliferation index), CD-31 (neovascularization index), and Masson Trichrome [(MTC) fibrosis and collagen formation index]. Additionally, acute and chronic inflammation indices were determined via polymorphonuclear leukocytes (PMNL) and mononuclear leukocytes (MNL), respectively. Results: The intensity and scope of adhesion and overall adhesion ratings were substantially higher in the absorbable hemostat group than the control group (2.8 +/- 0.85 vs. 2.2 +/- 0.53, 0.92 +/- 0.26 vs. 0.61 +/- 0.25, and 3.72 +/- 0.96 vs. 2.81 +/- 0.75, respectively). Staining results for Ki-67, CD-31, MTC, PMNL, and MNL were also significantly higher in the absorbable hemostat group than in the control group (p<0.05 for all). Conclusion: The obtained results suggest that the use of ORC-based absorbable hemostats in pelvic surgery may increase adhesion formation on peritoneal surfaces by increasing inflammation, vascularity, and collagen formation.Öğe The impact of indomethacin on the number of oocytes retrieved and IVF outcomes in patients with poor ovarian response(Elsevier, 2021) Yavuz, Adem; Oner, Gokalp; Tas, Mustafa; Sonmezer, MuratObjective: The aim of this retrospective case-control study was to analyze the effect of administering indomethacin after triggering final oocyte maturation in patients with poor ovarian response (POR) on the cycle cancellation rate due to premature ovulation (PO), the number of oocytes retrieved and the clinical outcomes of IVF cycles. Study Design: A total of 214 patients with POR, diagnosed according to the Bologna criteria, who underwent fresh IVF cycle via flexible gonadotrophin-releasing hormone antagonist (GnRH-ant) protocol were enrolled in the study. The control group consisted of 100 patients, whereas the indomethacin group included 114 patients who received 100 mg rectal indomethacin administered twice within the same day (twelve hours apart)-starting at twelve hours after triggering. Cycle cancelation rates (CCR), number of oocytes retrieved (nOR), implantation rates (IR), biochemical pregnancy (BP) and clinical pregnancy loss rates (CPL), ongoing pregnancy rates (OPR) and live birth rates (LBR) were compared between the indomethacin and control groups. Results: The CCR rate was significantly lower in the indomethacin group (1.8%) compared to the control group (1.8% vs %12%, p = 0.01). In the control group, those with cycle cancellation were older than those without cycle cancellation (mean age 42.2 +/- 2.3 years vs. 39.36 +/- 4.3 years, p = 0.001) and had lower anti-Mullerian hormone levels and lower antral follicle count (0.59 +/- 0.2 ng/mL vs 0.79 +/- 0.2 ng/mL, p = 0.001 and 4 +/- 0.6 vs 5.7 +/- 1.7, p = 0.001, respectively). In multivariable analysis, when the dependent variable in the logistic regression model was coded as the absence of cycle cancellation, it was observed that only indomethacin had a statistically significant effect on cycle cancellation (beta = -1.931, standard error = 0.832, Exp(B) = 0.145, p = 0.020). nOR was higher in the indomethacin group than control group but the difference did not reach significance (p = 0.07). Moreover, the IR, OPR and LBR, BP and CPL values were similar in the indomethacin and control groups (p > 0.05). Conclusions: Based on data from this study, it can be concluded that indomethacin reduces cycle cancelation due to PO in patients with POR -without compromising implantation and pregnancy rates. However, further randomized controlled trials with larger sample sizes are required to clarify the definitive effect of indomethacin in the treatment of patients with POR. (C) 2021 Elsevier B.V. All rights reserved.
