Gulhane Military Medical Academy and Medical School

Ankara, Turkey

Gulhane Military Medical Academy and Medical School

Ankara, Turkey

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Sobaci G.,Gulhane Military Medical Academy and Medical School | Ozge G.,Gulhane Military Medical Academy and Medical School | Gundogan F.C.,Gulhane Military Medical Academy and Medical School
Clinical Ophthalmology | Year: 2012

Purpose: To investigate whether or not thicker retinal nerve fiber layer (RNFL) in retinitis pigmentosa (RP) patients relates to functional abnormalities of the photoreceptors. Methods: Optical coherence tomography-based RNFL thickness was measured by Stratus-3™ (Zeiss, Basel, Switzerland) optical coherence tomography and electroretinogram (ERG) recordings made using the RETI-port® system (Roland, Wiesbaden, Germany) in 27 patients with retinitis pigmentosa and in 30 healthy subjects. Results: Photopic ERG b-wave amplitude, cone ERG b-wave latency, 30 Hz flicker amplitude, and 30 Hz flicker latency had significant correlations to the RNFL-temporal (r = -0.55, P = 0.004, r = 0.68, P = 0.001, r = -0.65, P = 0.001, and r = -0.52, P = 0.007, respectively). Eyes with thicker RNFL (ten eyes) differed significantly from those with thinner RNFL (eight eyes) regarding cone ERG b-wave latency values only (P = 0.001). Conclusion: Thicker RNFL in patients with retinitis pigmentosa may be associated with functional abnormality of the cone system. © 2012 Sobaci{dotless} et al, publisher and licensee Dove Medical Press Ltd.


Keskin U.,Gulhane Military Medical Academy and Medical School | Ulubay M.,Gulhane Military Medical Academy and Medical School | Dede M.,Gulhane Military Medical Academy and Medical School | Ozgurtas T.,Gulhane Military Medical Academy and Medical School | And 3 more authors.
Archives of Gynecology and Obstetrics | Year: 2015

Purpose: The aim of this study was to evaluate the levels of vascular endothelial growth factor (VEGF), soluble VEGF receptor-1 (sVEGFR-1) and placenta growth factor (PlGF) and VEGF/SVEGFR-1 ratio in pregnant women with threatened abortion (TA) compared to uncomplicated pregnancies at the same gestational week.Methods: Thirty-three pregnant women with TA and thirty-three pregnant women with uncomplicated pregnancies were included in this case–control study. The level of VEGF, sVEGFR-1, and PIGF was analyzed by enzyme-linked immunosorbent assay (ELISA). The primary purpose of this study was to compare the VEGF, sVEGFR- 1, and PlGF levels and VEGF/sVEGFR-1 ratios in pregnant women with TA and pregnant women with uncomplicated pregnancies. The secondary purpose of this study was to evaluate the correlation between serum levels of these markers and gestational age.Results: The serum levels of the sVEGFR-1 [0.60 (0.21–1.68) vs. 0.24 (0.09–0.57) ng/ml], VEGF [39.10 (6.57–163.56) vs. 5.24 (0.84–15.08) ng/ml] and VEGF/SVEGFR-1 ratio [68.64 (6.45–550.48) vs 24.12 (2.63–72.63)] were significantly elevated in women with TA (respectively, p: 0.001, p: 0.001, p: 0.001). However, PlGF did not elevate in women with TA [20.80 (3.13–93.11) vs 20.16 (1.22–49.91) ng/ml] (p: 0.473).Conclusion: These findings support the hypothesis that increased levels of the VEGF and sVEGFR-1 and VEGF/SVEGFR-1 ratio may be associated with the pathogenesis of TA. © 2014, Springer-Verlag Berlin Heidelberg.


Sobaci G.,Gulhane Military Medical Academy and Medical School | Erdem U.,Gulhane Military Medical Academy and Medical School | Gundogan F.C.,Gulhane Military Medical Academy and Medical School | Musayev S.,Gulhane Military Medical Academy and Medical School
Ophthalmic Research | Year: 2013

Purpose: To determine the effect of chronic smoking on the pupil and photostress recovery time. Methods: Macular adaptation to photostress condition, and mesopic and photopic pupillary responses were measured using automated perimetry (Humprey®), and an OPD device (Nidek), respectively. Forty heavy smokers (smoking ≥1 box/day for the past 5 years at least), and 40 age- and sex-matched nonsmokers were enrolled. All the subjects had full vision and no ocular problems. Results: The baseline foveal threshold value (FTV) before photostress was similar in both groups (p = 0.75). Although photostress recovery times (7.1 ± 1.1 and 7.4 ± 1.3 min) were similar in smokers and nonsmokers (p = 0.30), FTV measured at the first minute after photostress was statistically higher in smokers (36.05 ± 0.98 dB) than nonsmokers (34.7 ± 1.03 dB; p = 0.018). Scotopic pupil sizes in smokers (6.73 ± 0.82 mm) and nonsmokers (6.55 ± 0.62 mm) were similar (p = 0.28); however, photopic pupil size in smokers (5.36 ± 0.73 mm) was different from nonsmokers (4.73 ± 0.58 mm; p = 0.001). Conclusions: Chronic smoking may dilate the pupil, and increases macular FTV immediately after photostress. Copyright © 2012 S. Karger AG, Basel.


Kartal O.,Gulhane Military Medical Academy and Medical School | Gulec M.,Gulhane Military Medical Academy and Medical School | Caliskaner Z.,University of Konya | Musabak U.,Gulhane Military Medical Academy and Medical School | Sener O.,Gulhane Military Medical Academy and Medical School
Immunopharmacology and Immunotoxicology | Year: 2015

Context: Although subcutaneous allergen immunotherapy (SCIT) is effective in allergic rhinitis (AR) and asthma, it carries a risk of local and systemic adverse reactions. Objective: The aim of this study was to evaluate the rates and clinical characteristics of local and systemic reactions (LR and SR), and to identify their relation of demographic features, allergen extracts and diagnosis. Materials and methods: This study analyzed the administration of SCIT from 1983 to 2013; involving 1816 patients affected by allergic asthma and/or AR. Results: The rates of SR from SCIT were 0.078% per injection and 9% per patient. According to the World Allergy Organization 2010 grading system, 91 grade 1 reactions (44%), 67 grade 2 reactions (32.3%), 33 grade 3 reactions (16%) and 16 grade 4 reactions (7.7%) were seen. There was no fatal outcome from any of the SRs. Risk factors for a SR included: aluminium-adsorbed extract, pollen-containing vaccines, large LR and recurrent (≥2) LRs. The total LR rates were 0.062% per injection and 5.2% per patient; the small LR rates were 0.027% per injection and 2.3% per patient, and the large LR rate were 0.035% per injection and 2.9% per patient. Female gender, depot extracts, calcium phosphate-adsorbed extract and pollen vaccines were identified as risk factors for LR. Conclusion: The analysis of our data over a 30-year period confirmed that SCIT with inhalant allergens conducted strictly according to the standard protocols and when administrated by experienced staff is a safe method of treatment with only a few side-effects. © 2015 Informa Healthcare USA, Inc.


Topal E.,Gazi University | Gucenmez O.A.,Gazi University | Harmanci K.,DIskapI Education and Research Hospital | Arga M.,Gulhane Military Medical Academy and Medical School | And 2 more authors.
Annals of Allergy, Asthma and Immunology | Year: 2014

Background Knowledge of factors that affect relapse will allow close monitoring of patients at risk, resulting in a decreased rate of readmission to the emergency department. Objective To determine risk factors associated with relapse within 7 days after treatment of asthma exacerbations in children. Methods This was a multicenter, prospective study of children with asthma attacks. Patients between the ages of 6 months and 17 years who met the criteria between June 2009 and September 2012 were considered. Results The study included 1177 patients (775 males [65.8%]) with a mean (SD) age of 70.72 (48.24) months. Of them, 199 (16.9%) had a relapse within 1 week after being discharged from the hospital. Factors independently associated with relapse identified by a logistic regression model for the 1,177 study visits were having taken a short-acting inhaled β2-agonist within 6 hours before admission (odds ratio [OR], 2.43; 95% confidence interval [CI], 1.728-3.426; P =.001), presence of retraction on physical examination (OR, 1.76; 95% CI, 1.123-2.774; P =.01), no prescription for high-dose inhaled steroids on release (OR, 2.02; 95% CI, 1.370-3.002; P <.001), and not being given a written instructional plan (OR, 1.55; 95% CI, 1.080-2.226; P =.02). Conclusion Whereas having taken short-acting β2-agonists within 6 hours before admission and the presence of retractions on physical examination increased the risk of relapse after treatment of the acute attack, being given high-dose inhaled steroids and a written instructional plan when being sent home reduced the risk. © 2014 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.


Mutlu F.M.,Gulhane Military Medical Academy and Medical School | Sarici S.U.,Gulhane Military Medical Academy and Medical School
International Journal of Ophthalmology | Year: 2013

Retinopathy of prematurity (ROP), a retinal vascular disease of premature infants, continues to be a major cause of preventable childhood blindness all over the world. The incidence of ROP varies among countries, being influenced by the quality of the level of neonatal intensive care. Here, we discuss the potential treatments that are now available or will soon or probably be available for ROP. Although ablation of the avascular retina with laser photocoagulation remains the current gold standard and well established therapy for ROP, some new therapeutic options including angiostatic therapies are being explored based on our knowledge of the pathophysiology of the ROP and complications and efficacy of laser treatm ent. Howev er, prev ention of the dev elopm ent of sev ere ROP and screening for ROP seem to be the best strategy in avoiding visual impairment caused by ROP in premature infants. New therapeutic interventions including vascular endothelial growth factor antibody administration, gene therapy and supplemental therapies should be supported with evidence-based data for the treatment of ROP. Copyright International Journal of Ophthalmology Press.


Keskin U.,Gulhane Military Medical Academy and Medical School | Coksuer H.,Dumlipinar University | Gungor S.,Gulhane Military Medical Academy and Medical School | Ercan C.M.,Gulhane Military Medical Academy and Medical School | And 2 more authors.
Fertility and Sterility | Year: 2011

Objective: To examine the impact of type of infertility on female sexual function. Design: Comparison of female sexual function index and prevalence in primary infertile women and secondary infertile women. Setting: Hospital. Patient(s): One hundred twenty-two primary infertile and 51 secondary infertile women. Intervention(s): Questionnaires (Female Sexual Function Index [FSFI] and Beck Depression Inventory). Main Outcome Measure(s): Prevalence of dysfunction in primary and secondary infertile women. Result(s): The prevalence of female sexual dysfunction was 64.8% (n = 79) and 76.5% (n = 39) in primary infertile and secondary infertile women, respectively. In analyses of mean overall and subgroup scores of FSFI, there were significant differences between primary and secondary infertile women in the mean scores of orgasm, satisfaction, and total FSFI. Backward logistic regression identified a model with four significant predictors of sexual dysfunction (group, age, income level, and educational level). Secondary infertile women had a 9.5-fold higher risk of sexual dysfunction than primary infertile women after adjustment for confounding factors. Conclusion(s): There was a higher prevalence of sexual dysfunction in secondary infertile women. Secondary infertile women have decreased sexual desire, orgasm, and satisfaction compared with primary infertile women. © 2011 American Society for Reproductive Medicine.


PubMed | Gulhane Military Medical Academy and Medical School and Etimesgut Military Hospital
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2016

Urinary incontinence negatively affects the quality of life. Various methods are used in the treatment of stress incontinence. Burch colposuspension (BC) is the classical treatment of urinary incontinence.To compare the long-term satisfaction in patients receiving BC with or without concomitant total abdominal hysterectomy.One hundred and twenty patients with stress incontinence underwent burch colposuspension with or without concomitant total abdominal hysterectomy. Ninety-three (77.5%) patients were interviewed by telephone. Of these, 91(75, 8%) patients agreed to participate in the study. The patients were divided into two groups according to the type of the surgical procedure. Group 1(N=48, 52.7%) had received burch colposuspension with concomitant total abdominal hysterectomy. Group 2 (N=43, 47.3%) had received burch colposuspension without concomitant total abdominal hysterectomy.In Group 1, 41 patients (85%) were satisfied with the surgery and did not complain of urinary incontinence (p<0.05). In Group 2, 37 (86%) patients were satisfied with the surgery (p<0.05).There were no difference in patient satisfaction between hysterectomy and BC and only BC to treat incontinence.


PubMed | Etimesgut Military Hospital and Gulhane Military Medical Academy and Medical School
Type: Journal Article | Journal: The journal of obstetrics and gynaecology research | Year: 2016

A preliminary study was designed to evaluate whether a narrow-band imaging (NBI) endoscopic light source could detect chronic endometritis that was not identifiable with a white light hysteroscope.A total of 86 patients with endometrial pathology (71 abnormal uterine bleeding and 15 postmenopausal bleeding) were examined by NBI endoscopy and white light hysteroscopy between February 2010 and February 2011. The surgeon initially observed the uterine cavity using white light hysteroscopy and made a diagnostic impression, which was recorded. Subsequently, after pressing a button on the telescope, NBI was used to reevaluate the endometrial mucosa.The median age of the patients was 40 years (range: 30-60 years). Endometritis was diagnosed histologically. Six cases of abnormal uterine bleeding (6/71, 8.4%, 95% confidence interval [CI] 0.03-0.17) and one case of postmenopausal bleeding (1/15, 6%, 95%CI 0.01-0.29) were only diagnosed with chronic endometritis by NBI (7/86, 8.1%, 95%CI 0.04-0.15).Capillary patterns of the endometrium can be observed by NBI and this method can be used to assess chronic endometritis.


PubMed | Ufuk University, Etimesgut Military Hospital and Gulhane Military Medical Academy and Medical School
Type: Journal Article | Journal: Diagnostic cytopathology | Year: 2016

Current cervical cancer screening guidelines recommend a 1-year follow-up period for patients with a postmenopausal low-grade squamous intraepithelial lesion (LSIL) who are test negative for high-risk human papillomavirus (HrHPV). The aim of this study was to assess whether such patients had an increased immediate risk of high-grade squamous intraepithelial lesion.We assessed 54 HrHPV-negative women with postmenopausal LSIL in the Department of Obstetrics and Gynecology of our hospital between 2012 and 2013. All patients underwent liquid-based cytology and reflex HrHPV testing (for human papillomavirus [HPV] types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68). Colposcopic examination and guided biopsy were performed by the same gynecologist (MO).The average age of the patients was 53.13.2 years. There were 33 patients (61%) with cervical intraepithelial neoplasia (CIN) grade 1 and 21 who were non-dysplastic. None of the patients was positive for CIN 2 or any other lesions.If the HPV test is negative, repeat cytology after 12 months is recommended by the American Society for Colposcopy and Cervical Pathology for cases of HrHPV-negative postmenopausal LSIL. We recommend reflex HPV testing as the best choice for patients who test positive for postmenopausal LSIL by Pap smear, in line with the literature. Diagn. Cytopathol. 2016;44:969-974. 2016 Wiley Periodicals, Inc.

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