Kanuni Sultan Suleyman Research and Teaching Hospital

İstanbul, Turkey

Kanuni Sultan Suleyman Research and Teaching Hospital

İstanbul, Turkey
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Corbacioglu Esmer A.,Istanbul University | Goksedef B.P.C.,Haseki Research and Teaching Hospital | Gunduz N.,Kanuni Sultan Suleyman Research and Teaching Hospital
Gynecologic and Obstetric Investigation | Year: 2014

Aim: To determine a cutoff age for endometrial evaluation in premenopausal abnormal uterine bleeding (AUB). Methods: Histopathology reports of endometrial sampling performed due to AUB in women aged 50 years or less were reviewed retrospectively. Histopathological findings were categorized into three groups as follows: group 1: hyperplasia without atypia + hyperplasia with atypia + malignancy, group 2: hyperplasia with atypia + malignancy, and group 3: malignancy. Results: Data from 2,516 patients were analyzed for this study. Overall, 13.5% of patients had endometrial hyperplasia without atypia, 1% of patients had hyperplasia with atypia and 0.6% of patients had malignant disease. Logistic regression revealed a significant difference in the odds ratios of group 1 in the age ranges of 40-45 and 45-50 years compared with <40 years (p = 0.001 and p = 0.01, respectively). There were no significant differences between the age groups for the odds ratio of group 2 and group 3. Conclusion: There is no cutoff age for sampling the endometrium in order to detect hyperplasia with atypia and cancer in premenopausal women with AUB. Therefore, the management of AUB should be tailored to each patient regardless of age, incorporating all risk factors for malignant disease. Copyright © 2013 S. Karger AG, Basel.

Alkis I.,Yuzuncu Yil University | Karaman E.,Ercis State Hospital | Han A.,Kanuni Sultan Suleyman Research and Teaching Hospital | Gulac B.,Kanuni Sultan Suleyman Research and Teaching Hospital | Ark H.C.,Kanuni Sultan Suleyman Research and Teaching Hospital
Archives of Gynecology and Obstetrics | Year: 2014

Purpose: The aim of this study was to evaluate the clinical characteristics, peri- and post-operative outcomes, and clinical effectiveness of the Manchester-Fothergill (MF) procedure for uterine descensus as a uterine-sparing surgery. Methods: In this study, 49 patients underwent the MF procedure as a uterine-sparing surgery for uterine descensus during 2008-2012 in the Department of Urogynecology at Kanuni Sultan Süleyman Research and Teaching Hospital, Istanbul, Turkey. Results: Medical records and follow-up data were collected from 24 of the 49 patients (48.9 %). The mean age was 49.3 ± 9.1 years, and parity 3.6 ± 1.5; 41.6 % were post-menopausal; 6 patients (25 %) had grade II, and 18 (75 %) had grade III uterine prolapse; 95.8 % had associated cystoceles, and 79.1 % had associated rectoceles; 66.6 % complained of urinary incontinence. On follow-up examination, the cervical stumps were satisfactorily situated in 23 of 24 patients, and recurrent prolapse was seen in 1 patient (4.1 %). Bladder perforation was repaired at the time of the operation in 1 patient, and one complained of post-operative urinary retention. Conclusion: The MF procedure is a viable option to surgically correct uterine descent while preserving the uterus to treat recurrent prolapse with a low complication rate and low morbidity. © 2014 Springer-Verlag.

PubMed | Umraniye Research and Teaching Hospital, Ardahan State Hospital, Kafkas University, Medical Park Hospital and 2 more.
Type: Journal Article | Journal: Brazilian journal of otorhinolaryngology | Year: 2016

Otoacariasis, the attachment of ticks and mites within the ear canal is a common phenomenon especially in rural areas.To determine the clinical and demographic features of cases with detected ticks in the ear canal, which is a common health problem, and identify tick species.Data of patients who had otoacariasis were collected. We also investigated all ticks at the Veterinary Department of Kafkas University.We present the data of patients with otoacariasis. All ticks were identified as otobius. Otobius ticks were found not related with any complications.It is very important to detect ticks in the ear canal as they act as vector of some diseases. Identifying species of ticks may help clinicians to prevent further complications associated with vector-borne diseases.

Aslcloglu O.,Sisli Etfal Training and Research Hospital | Gungorduk K.,Klzlltepe State Hospital | Aslcloglu B.B.,Kanuni Sultan Suleyman Research and Teaching Hospital | Ylldlrlm G.,Kanuni Sultan Suleyman Research and Teaching Hospital | And 2 more authors.
American Journal of Perinatology | Year: 2013

Objective This study compared two methods of expanding the uterine incision at the time of cesarean delivery, which is associated with the risk of unintended extension. Study Design This randomized trial included 1,076 women who underwent elective cesarean delivery. The primary outcome measure was the incidence of unintended extension related to the method used for expanding the uterine incision. Results Participants in both groups (blunt vs. sharp) had similar demographic and clinical characteristics. The incidence of unintended extension (8.8% vs. 4.8%; p = 0.009), mean estimated blood loss (853.67 ± 42 mL vs. 664.80 ± 38 mL; p = 0.001), and blood loss >1000 mL (11.4% vs. 6.8%; p = 0.009) was significantly higher in the sharp group compared with the blunt group. No difference in transfusions (7.5% vs. 6.3%; p = 0.440) or the need for additional supertonic agents (16% vs. 12.9%; p = 0.144) was noted. Conclusion Sharp expansion of the uterine incision was related to a higher risk of unintended extension and maternal blood loss. Because blunt expansion is associated with a lower risk for unintended extension and maternal blood loss, it should be the first option during elective cesarean delivery.

Corbacioglu Esmer A.,Istanbul University | Gul A.,Kanuni Sultan Suleyman Research and Teaching Hospital | Nehir A.,Istanbul University | Yuksel A.,Istanbul University | And 4 more authors.
Fetal Diagnosis and Therapy | Year: 2013

Objective: The purpose of this study was to determine the frequency of chromosomal anomalies among the fetuses with isolated and non-isolated aberrant right subclavian artery (ARSA), and to evaluate the sonographic findings associated with ARSA. Methods: This is a retrospective study conducted during the period between January 2008 and December 2012 at the maternal fetal medicine units of three different referral centers. Results: Among the 148 cases of ARSA, 98 were isolated and 50 were associated with cardiac anomalies, extracardiac malformations or soft markers. Trisomy 21 was the only chromosomal anomaly with a prevalence of 6.8% (10/148). The corresponding rate was 6.1% (6/98) and 8% (4/50) for isolated and non-isolated ARSA, respectively. Cardiac anomalies, extracardiac findings and soft markers were detected in 5.4% (8), 10.8% (16) and 24.3% (36) of cases, respectively. Among the 10 fetuses with trisomy 21, 6 were isolated, 4 were associated with soft markers, 2 were associated with fetal growth restriction and 1 was associated with hydrops fetalis. Cardiac anomalies were not observed in any of these fetuses. Conclusion: The prenatal diagnosis of ARSA should prompt meticulous anatomic survey, and karyotype analysis might be offered even in the absence of associated findings. © 2013 S. Karger AG, Basel.

Han A.,Kanuni Sultan Suleyman Research and Teaching Hospital
Gynecologic and Obstetric Investigation | Year: 2015

Aims: To determine and compare the effectiveness, peri- and postoperative outcomes of mid-urethral sling (MUS) operations for urinary incontinence, using 2 different patient positions during surgery. Methods: In this study, 146 patients underwent MUS surgery in a urogynecology clinic. Of them, 72 patients underwent the intraoperative surgical procedure of reverse trendelenburg patient positioning for tape adjustment (group 1) and the remaining 74 patients had the routine surgical procedure of MUS surgery (group 2). The primary outcome was the evaluation of postoperative urine leaks, using the stress test, and secondary outcomes were quality of life, using the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF, Turkish version) and complication rates. Results: There were no significant differences in demographic variables between the 2 groups. The overall cure rates for incontinence in the lithotomy position was 97.22 and 85.13% for groups 1 and 2, respectively, in which group 1 had a statistically significant decrease in urine leak postoperatively (p < 0.05; OR 3.08, 95% CI 2.78-22.14). The postoperative ICQ-SF scores showed no significant difference between the 2 groups (p = 0.19). Conclusion: Applying a 45-degree reverse trendelenburg position for tape adjusting during MUS operation results in a greater objective cure rate compared with the typical dorsolithotomy position; however, there was no difference in the subjective outcome. © 2015 S. Karger AG, Basel Copyright © 2015, S. Karger AG. All rights reserved.

PubMed | Istanbul University and Kanuni Sultan Suleyman Research and Teaching Hospital
Type: Case Reports | Journal: Journal of clinical ultrasound : JCU | Year: 2016

Tethered spinal cord is mostly caused by myelomeningocele and lipomyelomeningocele, while dermal sinus tract, diastematomyelia, lipoma, tumor, thickened/tight filum terminale, spinal trauma, and spinal surgery are among the other causes. Prenatal diagnosis of tethered cord has been reported, and it is usually associated with neural tube defects. We present an atypical presentation of a tethered spinal cord, which was associated with a sacrococcygeal teratoma and was diagnosed in the 23rd week of pregnancy by ultrasonography. 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:506-509, 2016.

PubMed | Istanbul University and Kanuni Sultan Suleyman Research and Teaching Hospital
Type: Journal Article | Journal: Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine | Year: 2016

Persistent hyperplastic primary vitreous is a spectrum of congenital ocular abnormalities characterized by leukocoria, microphthalmia, cataracts, extensive intravitreal hemorrhage, persistence of the hyaloid artery, glaucoma, and retinal detachment. It might be isolated or associated with congenital syndromes such as trisomy 13, Walker-Warburg syndrome, and Norrie disease. We present 2 cases of persistent hyperplastic primary vitreous diagnosed by prenatal sonography in the early third trimester. Bilateral hyperechoic lenses and retinal nonattachment were detected in the sonographic examination of the first case, whereas irregular echogenic bands between the lenses and posterior walls of the eyes were prominent in the second case. In both of the cases, ocular findings were accompanied by intracranial findings, including severe hydrocephalus, an abnormal gyral pattern, and cerebellar hypoplasia, suggesting the diagnosis of Walker-Warburg syndrome. We also present a review of the literature regarding the prenatal diagnosis of this malformation.

PubMed | Istanbul University and Kanuni Sultan Suleyman Research and Teaching Hospital
Type: Journal Article | Journal: SpringerPlus | Year: 2016

To determine the feasibility of evaluating the subarachnoid space by measuring two novel sonographic parameters in axial section using transabdominal ultrasound, in addition to the parameters previously defined in coronal section, and to construct a normal range for the subarachnoid space width in singleton healthy fetuses.Healthy pregnant women between 20 and 29weeks were scanned using transabdominal ultrasound. Four variables were measured for the evaluation of subarachnoid space width; sinocortical width and anterior craniocortical width in coronal plane, and lateral and posterior craniocortical width in axial plane.The data of 154 patients were recorded. SCW could be measured in 87.6% (135) of fetuses, while the same figure was 77.9% (120), 96.1% (151) and 98.1% (148) for anterior, lateral and posterolateral CCW, respectively. The SCW and anterior CCW did not display a significant correlation with gestational age and head circumference. The mean of SCW was 1.550.41mm with a range of 0.85-3.87mm. The mean anterior CCW was 1.630.39mm with a range of 0.85-2.82mm. A linear regression line was plotted between gestational age and lateral CCW (r=0.707; p<0.0001) and posterolateral CCW (r=0.437; p<0.0001), and nomograms for these parameters are constructed.This study presents a novel approach for the in utero evaluation of the subarachnoid space with two measurements in axial plane using transabdominal ultrasound. The nomograms will be helpful when there is a suspicion of subarachnoid space dilatation during routine cranial scan.

PubMed | Kanuni Sultan Suleyman Research and Teaching Hospital
Type: Journal Article | Journal: Pregnancy hypertension | Year: 2015

The aim of this study was to determine the relationship between serum concentrations of cancer antigen-125 (CA-125) and pre-eclampsia severity.We evaluated 91 females with a singleton pregnancy. Serum CA-125 levels were measured in subjects with severe pre-eclampsia (n=34) and those with mild pre-eclampsia (n=24). Females with healthy pregnancies (n=31) served as the control group. The three study groups were statistically similar in terms of maternal age, gestational age, and body mass index.The CA-125 level was significantly higher in the severe pre-eclampsia group than that in the mild pre-eclampsia and control groups (p<0.05). No significant difference in CA-125 levels between the mild pre-eclampsia and control groups was observed. CA-125 level was positively correlated with proteinuria (r=0.489, p=0.000), systolic blood pressure (r=0.503, p=0.018), and diastolic blood pressure (r=0.532, p=0.000). In contrast, CA-125 was negatively correlated with birth weight (r=0.266, p=0.012) and gestational age at birth (r=0.250, p=0.018).CA-125 level increased in severe pre-eclampsia, which reflected abnormal trophoblastic invasion and chronic inflammation. Elevated levels of CA-125 in pre-eclamptic patients may be a marker of the disease severity.

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