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Öğe Adneksiyal kitleyi taklit eden simplastik leiomyom ve MRI: Bir olgu sunumu(2003) Bayram, Merih; Özer, GülerAmaç: Simplastik leiomyom terimi, orta dereceden ciddi dereceye kadar sitolojik atipi kriterlerini karşılayan hücreleri içeren leiomyomları ifade etmektedir. Simplastik leiomyomlar sarkomla karıştırılabileceğinden tanınması önemlidir. Klinik davranışları sıradan leiomyomlarla benzerdir. Şüphede kalınan pelvik kitlelerin ayırıcı tanısında MRI kullanımı yararlı olabilir. Adneksiyal kitleyi taklit eden simplastik leiomyom olgusu sunuldu ve literatür eşliğinde tartışıldı.Öğe Apoptosis-related proteins and steroid hormone receptors in normal, hyperplastic, and neoplastic endometrium(Lippincott Williams & Wilkins, 2002) Bozdoğan, Önder; Atasoy, Pınar; Erekul, Selim; Bozdoğan, Nazan; Bayram, MerihThe purpose of this study was to evaluate the distribution and frequency of apoptosis-related proteins and their correlation with estrogen, progesterone, and androgen receptors in endometrial tissues. Immunohistochemical analyses of bcl-2, bax, bcl-x, and steroid receptors were performed in 22 endometrial carcinomas, 26 endometrial hyperplasias, and 19 cases of normal cyclical endometrium. Bcl-2 was expressed in 45.4% of carcinomas and 92.3% of hyperplasias. Bax immunostaining was found in 90.9% of carcinomas and 76.9% of hyperplasias. Bcl-x positivity was similar in carcinomas (68.1%) and endometrial hyperplasias (76.9%). In nor-Mal cyclical endometria, bcl-2 staining was intense and diffuse in the proliferative phase, but decreased dramatically in the early and mid-secretory phase to reappear in the late secretory phase. Bax was expressed throughout the menstrual cycle but more strongly in the secretory phase. Bcl-x displayed a similar degree of expression in proliferative and secretory endometria. Nineteen carcinomas (86.3%), 25 hyperplasias (96.1%), and 18 normal cyclical endometria (94.7%) were positive for estrogen receptor (ER). Progesterone receptor (PR) was observed in 20 carcinomas (90.9%), all hyperplasias (100%), and 18 normal cyclical endometria (94.7%). Androgen receptor (AR) positivity was seen in 7 carcinomas (31.8%), 6 hyperplasias (23.0%), and 3 normal cyclical endometria (15.7%). There was a statistically positive correlation between bcl-x and ER and a tendency toward significant correlation between bcl-x and PR and between ER and PR in carcinomas. In hyperplasias, there was a significant positive correlation between bcl-2 and PR and between bcl-2 and bax and a negative correlation between ER and bax. There was a statistically significant difference for bcl-2 (p = 0.001) and bax (p = 0.001) between the hyperplasia and carcinoma groups. There was increased expression of bax. decreased expression of bcl-2, and persistence of bcl-x protein in advanced endometrial carcinomas. Our findings show that ovarian hormones have a regulatory role on bcl-2 protein and that there is a correlation between other members of the bcl-2 family (bcl-x and bax) and steroid hormone receptors. Bax/bcl-x may be the major control mechanisms of apoptosis in advanced carcinomas; other members of the bcl-2 family may also be under hormonal control.Öğe Assessment of DNA damage in postmenopausal women under osteoporosis therapy(Elsevier Science Bv, 2006) Bayram, Merih; Soyer, Canan; Kadioglu, Ela; Sardas, SemraObjective: The following study was designed to examine possible DNA damage levels in peripheral blood leukocytes, using the alkaline Comet assay, isolated from postmenopausal women undergoing osteoporosis treatment. Study Design: Thirty-two postmenopausal women were randomized into two groups of 16. A dosage of 2.5 mg/day of tibolone (Livial) and 10 mg/day of alendronate sodium (Fosamax) were administered to Group 1 over a 12-month period while Group 2 took 10 mg/day of alendronate alone over the same period. The control group consisted of 16 postmenopausal women who did not receive any treatment. Genotoxicity was assessed by the standard method of alkaline Comet assay. Results: When the results of the study groups were compared with those of the control group, significant differences in terms of DNA damage levels were found (p < 0.05). However, no difference was detected between Groups 1 and 2 (p > 0.05). Conclusion: Although, no statistical difference in terms of DNA damage levels between tibolone plus alendronate as opposed to alendronate alone was found, an increase in DNA damage levels was observed in Groups 1 and 2 compared with the control group. Consequently, it can be asserted that the frequency of DNA damage in postmenopausal women with osteoporosis increases under alendronate treatment with or without tibolone. (C) 2006 Elsevier Ireland Ltd. All rights reserved.Öğe The detection of urinal neopterin concentration increases the efficiency of cervical smear in the diagnosis of cervical cancer(2004) Bayram, Merih; Boyunaga, Hakan; Diribaş, Kemal; Özer, Güler; Akgül, Emin O.; Erbil, M.KemalOBJECTIVE: To investigate the importance of urinal neopterin detection carried out together with cervical smear test, in the diagnosis of cervical cancer. METHODS: In this study, urine samples were collected from randomly selected vulvovaginitis' women who attended hospital and an independent control group. The participants were classified into two representative sample groups and a control group; 1st Group: 35 women with vulvovaginitis, whose ages varied from 21 to 42 and who had no viral infections, and chronic inflammatory diseases and no smoking habit, but had complaints of vaginal discharge. 2nd Group: 25 women aged between 38-52 with no smoking habit, who applied to hospital with complaints of vaginal discharge, and cervical cancer was diagnosed for them as the result of biopsy, but no associated treatment of cancer had been carried out yet. 3rd Group: A control group with 30 women who aged between 20 and 28, with no smoking habit, and who had not taken part in sexual activities yet. They had no complaints from any type of tumors, and viral infections or chronic inflammatory diseases. Urinalysis was carried out for each group member's urine sample in order to measure the level of neopterin. Neopterin was estimated by HPLC. Some statistical analyses were done by SPSS Windows 10.0 and were analyzed by Oneway Annova test. (p=0.000) Meaningful differences between the groups were determined by Post Hoc Tukey Test. RESULTS: The mathematical results of neopterin levels for the groups revealed that the level of Group 1 was significantly higher than the level of Group 3 (p= 0.0001). When the levels of Group 1 and 2 were compared with each other, a significant difference was determined (p=0.004). Also, the difference in the levels of Group 2 and 3 was found to be significant (p=0.0001). CONCLUSIONS: If the results of this study were not confounded by another factor, then we can deduce that an increment in the level of neopterin may be considered as a risk factor that should warrant further investigation of cervical cancer. Then, the detection of urinal neopterin level as a noninvasive test done together with cervical smear can increase the sensitivity of smear test.Öğe Doppler sonography of the normal lacrimal gland(Wiley, 2005) Bilgili, Yasemin; Taner, Pelin; Ünal, Birsen; Simsir, İlknur; Kara, Simay Altan; Bayram, Merih; Alıcıoğlu, BanuPurpose. We used Doppler sonography to determine the resistance index (RI) and pulsatility index (PI) of the normal lacrimal artery (LA) in both females and males. We also compared the values obtained at various periods of reproductive life. Methods. The study was performed in 25 prepubertal girls, 28 females of reproductive age, and 27 postmenopausal women, 23 pregnant women, and 104 healthy males. Doppler sonography was used to determine the RI and PI of the LA. Results. The mean PI for the entire patient population was 1.48 +/- 0.60 and the RI was 0.72 +/- 0.09. The RI and PI values of the LA did not differ between males and females. Similarly, the mean RI and PI values of the LA did not change significantly between the various reproductive phases. Conclusion. The PI and Rl of the lacrimal gland are similar in both sexes. Moreover, they are not altered by changes in levels of sex steroids. (c) 2005 Wiley Periodicals, Inc. J Clin Ultrasound 33:123-126, 2005; Published online in Wiley InterScience (www.interscience.wiley.com).Öğe Endometrial doku içindeki ağır metallerin elektron mikroskop aracılığı ile tesbiti(2006) Soyer, Canan; Bayram, MerihÖZET Amaç: Endometrium dokusunda çevre kirliliğine yol açan ağır metallerin tesbiti. Materyal ve Metod: 20 adet albino Wistar rat randomize olarak 2 gruba ayrıldı. Grup l'deki ratlar Ankara'da, Grup 2'deki ratlar Kırıkkale'de 1 ay süresince tutuldular. Genel anestezi altında çıkarılan uteruslar scanning electron mikroskopta incelenerek metal tayinleri yapıldı. Bulgular: Her iki grup karşılaştırıldığında Grup 2'deNikel anlamlı olarak yüksek tesbit edildi (p0.05). Sonuçlar: endometrium dokusundaki yüksek nikel düzeyi endometrial kompozisyonu etkileyerek düşük sebebi olabilir.Öğe Endosalpingiosis in association with uterine anomaly: A case report(2003) Sağsöz, Nevin; Atasoy, Pınar; Bayram, MerihEndosalpinjiosis fallop tüpüne ait glandüler epitelin ektopik lokalizasyonda bulunmasıdır. Endosalpingiosisin semptom, bulgu ve tedavisi net olarak belirlenmemiştir. Bikornuat uterusla birlikte tespit edilen endosalpinjiosis olgusu sunuldu ve literatür eşliğinde tartışıldı.Öğe Evaluation of adrenomedullin and endothelin-1: Are they factors in the adaptation of maternal vascular system in normotensive pregnancy(Springer, 2008) Bayram, Merih; Bostanci, Suhha; Caglayan, Osman; Ilhan, Mustafa N.Introduction: The aim of our study was to analyse the role of adrenomedullin (AM) and endothelin-1 (ET-1) in the adaptation of the maternal vascular system in normotensive pregnancy. Methods: Twenty-eight pregnant women, who were normotensive throughout the duration of their pregnancy, were recruited into the study. Plasma levels of AM and ET-1 at each trimester were measured and the AM/ET-1 ratio was calculated. Results: Our experiment showed a significant decrease in plasma concentrations of AM in the first trimester for the study group (n=28) compared with the non-pregnant control group (n=16). There was also a significant decrease in plasma concentrations of ET-1 in all three trimesters (P < 0.05) and a significant increase in the AM/ET-1 ratio in all three trimesters (P < 0.05) for the study group compared with the control group. Conclusion: An alteration in vascular equilibrium between AM and ET-1, favouring AM, may be a reason why the physiological adaptation of the maternal vascular system to pregnancy occurs during normotensive pregnancy.Öğe Evaluation of endometrial thickness and body mass index in postmenopausal women(2000) Sağsöz, Nevin; Bayram, Merih; Kamacı, MansurBu çalışmanın amacı endometrium kalınlığının ölçümü ile menopozda vücût kitle indeksi arasında ilişki olup olmadığını incelemektir. Kırıkkale Üniversitesi Tıp Fakültesi Kadın-Doğum polikliniğimize başvuran en az bir yıllık amenore döneminden sonra gelen klinik ve hormonal olarak menopoz tanısı konan ve hormon replasmanı almayan 50 hasta çalışma kapsamına alındı. Endometrium kalınlığı çift tabaka kalınlık olarak ölçüldü. Hastalar endometrium kalınlığı, 5 mm. ve 5 mm olanlar olarak iki gruba ayrıldı, istatistiki testlerden, ortalama ve lineer regrasyon analizleri kullanıldı, p 0,05 istatistiki olarak anlamlı kabul edildi. Hastalarımızın yaş ortalaması 50,0 4,4 yıl olup ortalama menopoz süresi 3,1 2,3 yıl idi. Asemptomatik hastalarda endometrium kalınlığı ile vücut kitle indeksi arasında istatistiki olarak anlamlı ilişki tesbit ettik (r 0,124, p 0,01). Bu da vücut kitle indeksinin önemini vurgulamaktadır.Öğe Evaluation of hormone replacement therapy which may have an adrenomedullin-mediated protective effect on cardiovascular disorders(Springer, 2007) Bayram, Merih; Bayram, Orhan; Bilgili, M. Yasemin Karadeniz; Çaglayan, Osman; Ilhan, Mustafa N.Background and aims: This study aimed to determine whether there is an adrenomedullin (AM)-mediated protective effect of postmenopausal estroger/progestin therapy (HRT) against cardiovascular disorders. Methods: A total of 22 post-menopausal women without hysterectomy undergoing postmenopausal symptoms (aged 43-52) were treated with conjugated equine estrogen (0.625 mg/die) plus medroxyprogesterone acetate (2.5 mg/die) for six months. The flow velocity of the right middle cerebral artery [measured as resistance index (RI) and pulsatility index (PI)], plasma levels of adrenomedullin and endothelin-1 (ET-1), mean baseline ratio of AM to ET-1, and lipid profiles were assessed before and after HRT. Results: A statistically significant difference was found for triglycerides, total cholesterol, AM/ET-1 ratio and right middle cerebral artery PI (p < 0.05), without any significant differences in HDL, LDL, AM, ET-1, systolic blood pressure, diastolic blood pressure, a right middle cerebral artery RI (p > 0.05) between pre- and post-HRT. Conclusions: Adrenomedullin may be added to other vasoactive peptides as a new potential candidate for HRT-mediated vascular protection. The ratio of AM/ET-1 vs AM or ET-1 alone may be a useful biological marker of this protection.Öğe Expression of steroid receptors in intact rat uterus, mammary gland, and liver treated with selective estrogen receptor modulators and conjugated equine estrogens(Springer, 2005) Bayram, Merih; Bayram, Orhan; Dursun, Ayşe; Işık, İpek; Dileköz, Ergin; Özkan, SeçilThe aim of the present Study was to determine the effects of conjugated equine estrogens (CEE) and selective estrogen receptor modulators (SERM) (tamoxifen [TAM] and raloxifene [RALI) on the expression of steroid receptors-estrogen receptor (ER) and progesterone receptor (PR)-in intact rat uterus, mammary gland, and liver. A total of 24 female rats weighing 250 to 300 g were randomized into 4 groups. Groups 1, 2, 3, and 4 were respectively given conjugated equine estrogen, tamoxifen, raloxifene, and vehicle for a 28-day period. ER and PR expression was detected in tissues of the uterus, mammary gland, and liver. Uterine wet weight and serum estradiol levels were established for all groups. No statistical difference was observed between groups in the ER expression of mammary gland and liver and in the PR expression of uterus, mammary gland, and liver, but differences were noted in serum estradiol levels and uterine ER expression. Serum estradiol levels were lower in the TAM-treated group; differences between the TAM-treated group and the other groups were statistically important (P<.05). Uterine ER expression was greater in the CEE-treated group; differences between the CEE-treated group and the TAM- and RAL-treated groups were statistically important (P<.05). CEE or SERM versus vehicle treatment in controls did not seem to result in statistically important differences in ER and PR expression in intact rat uterus, mammary gland, and liver. Only ER expression in the uterus was found to be greater in the CEE-treated group than in SERM-treated groups.Öğe Gestasyonel diabetes mellitus: Herkesi tarayalım mı?(2004) Bayram, Merih; Soyer, Canan; Özer, Güler; Sevinç, F. CeylanAmaç: Gestasyonel diabetes mellitus taramasında 50 g oral glukoz testinin gerekliliğinin araştırılması. Çalışmanın Yapıldığı Yer: Kırıkkale Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı. Materyal ve Method: Çalışmaya 425 gebe dahil edildi. Bunların 274'Une 50 g oral glukoz tarama testi (OGL), riskli olan 149'una ise 100 g oral glukoz tolerans testi (OGTT) uygulandı. Bulgular: Taranan 274 gebenin 30'unda ( % 10,9) OGL sonucu 140 mg/dl ve üzerinde bulundu. Bunlardan hiç birine uygulanan OGTT'ler ile GDM tanısı konmadı. Risk taşıyan 149 gebeye, OGTT uygulandı. Bu gebelerin 9 (%6) tanesine GDM tanısı kondu. Bizim popülasyonumuzdaGDMinsidansı% 2 olarak tespit edildi. Sonuçlar: Bu çalışma GDM için tüm gebelerin taranmasının gerekli olmadığını göstermektedir. Biz tam saha taraması yerine seçilmiş vakaların taranmasını öneriyoruz.Öğe Guideline on Pregnancy and Diabetes by the Society of Specialists in Perinatology (PUDER), Turkey(2020) Bayram, Merih; Biri, Aydan Asyalı; Büyükbayrak, Esra Esim; Dağlar, Halil Korkut; Ercan, Fedi; Erzincan, Selen Gürsoy; Esmer, Aytül ÇorbacıoğluABS TRACT Diabetes mellitus (DM) is the most common endocrinologic problem in pregnancy. In Turkey, the reported prevalance is between 1.9-27.9%, with an average of 7.7%. While some of these cases are pregestational diabetes (PGDM), about 90% are detected during the pregnancy for the first time and diagnosed as gestational diabetes (GDM). Diabetes in pregnancy confers serious risks regarding the fetus, newborn and the mother. Therefore, we offer GDM screening for all pregnant women preferantially between 24-28 weeks of gestation. Either one-step 75-g oral glucose tolerance test (OGTT) or two-step 50-g glucose challenge test and 100-g OGTT may be used for the screening and diagnosis. In pregnancies with high-risk for DM, screening should be performed earlier, if possible, in the first antenatal visit. When GDM is diagnosed, maternal glycemic control is tried to be achieved by diet and exercise program, and if necessary, by using insulin. The use of metformin or glyburide in pregnancy is also possible. In women with the diagnosis of DM before pregnancy, preconceptional control of plasma glucose levels is of utmost importance in order to prevent adverse pregnancy outcomes. In pregnancies with GDM regulated by diet and exercise, pregnancy follow-up may be performed as in the low risk group without any pregnancy complications. If maternal or fetal distress is not observed, delivery is planned between 39+0 -40+6 weeks. Although caesarean section is recommended when estimated fetal weight is 4500 g or more, the mode of delivery may be decided more appropriately on a case-by-case basis.Öğe Kırıkkale bölgesinde smear testinde saptanan serviks patolojilerinin prevalansı(2004) Bayram, Merih; Soyer, Canan; Sevinç, F. Ceylan; Uçar, Banu; Bakırçetin, BaharAmaç: Bu çalışmanın amacı Kırıkkale bölgesinde Papanicolaou (Pap) servikal smear taraması ile servikal patolojilerin prevelansının belirlenmesidir. Materyal ve Metod: Kırıkkale Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Polikliniğine Şubat 2000-Ocak 2004 yılları arasında başvuran 5330 kadın retroprospektif olarak değerlendirildi. Tüm kadınların servikal smear sonuçları belirlendi. Servikal intraepitelyal lezyonların yaş gruplarına göre dağılım oranları araştırıldı. Bulgular: 5330 kadından 5294'ü (%99.32) intraepitelyal lezyon (SIL) veya malignite açısından negatif, 36'sı (%0.68) epitelyal hücre anomalisi gösteren smear sonucuna sahipti. Önemi belirlenemeyen atipik glandüler hücreler (AGUS), adenokarsinom, squamöz hücreli karsinom gösteren smear sonucu bulunmamakta idi. Sonuç: Serviks kanseri ve prekanseröz lezyonları bölgemizde nadir görülen bir patolojidir. Pap smear testi serviksin prekanseröz lezyonlarının belirlenebildiği uygulanabilir bir testtir ve serviks neoplazilerinin taramasında kullanılmaktadır. Serviks kanseri ve prekanseröz lezyonlarının sitolojik inceleme ile taranması ve erken dönemde tedavisi mümkündür. Serviks kanseri açısından riskli popülasyonun ortaya kanması açısından serviksin prekanseröz lezyonlarının sitolojik inceleme ile taranması gerekmektedir.Öğe Kırıkkale il merkezinde yaşayan kadınların menopoz konusundaki bilgileri ve yaklaşımları nedir? Bu konuda eğitimin yararı nasıldır?(2002) Bayram, Merih; Saygun, Meral; Çakmak, Z. Aytül; Sevinç, F. CeyhunAmaç: Bu çalışmada amaç, premenopoz, menopoz ve postmenopozlu kadınların menopoz hakkında bilgi edinme yollarını analiz etmekti. Çalışmanın yapıldığı yer: Kırıkkale Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı MateryalMetod: Yaşlan 40-79 arasında olan 120 kadın çalışmada yer aldı. Bu kişilere özel hazırlanmış anket uygulandı. Bulgular: Çalışmaya katılan kadınların menopoz hakkındaki bilgileri; %39,6'sı doktorundan, %35,8'i medyadan, %17,0'ı üniversite eğitim seminerlerinden, %5,7'si aile büyüklerinden edindikleri öğrenildi. Sonuçlar: Kadınların menopoz hakkında edinmesi ile menopoza bakış açıları olumlu yönde etkilenmektedir.Öğe Kırıkkale Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Polikliniği'ne başvuran adölesan gebelerin eğitim durumları ve adölesan gebeliğin prevalansı(2005) Bayram, Merih; Özer, Güler; Soyer, Canan; Uçar, Banu; Yücer, GökçenAmaç: Bu retrospektif çalışmada, Kırıkkale Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Polikliniği'ne başvuran adölesan gebelerin eğitim durumlarını ve adölesan gebeliğin prevalansını inceledik. Materyal ve Metot: Şubat 2001 ile Eylül 2003 tarihleri arasında antenatal takibi yapılan 954 gebe kadına ait kayıtlar incelendi. Sonuçlar: Takip edilen 954 gebe kadının %7.9'unun adofesan yaş grubunda olduğu bulundu. Adölesanların eğitim durumuna geldiğimizde %69.3'ünün ilköğretim mezunu, %26.6'sının lise mezunu olduğu ve %1.3'ünün halen bir yükseköğretim kurumunda eğitim görmekte olduğu tespit edildi. Tartışma: Kırıkkale Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Polikliniği'ne başvuran gebelerde, adölesan gebelik oranı (%7.9) Türkiye genelinden düşük bulunurken, eğitim düzeyi daha yüksek olarak tespit edilmiştir.Öğe Light and electron microscope examination of the effects of methotrexate on the endosalpinx(Elsevier Science Bv, 2005) Bayram, Merih; Özoğul, Candan; Dursun, Ayşe; Ercan, Z. Sevim; Işık, İpek; Dileköz, ErginObjective: To examine the effects of increasing doses of methotrexate (Mtx) on the fallopian tubes. Study design: The study was carried out on 24 female rats (Albino Wistar type, 250-300 g). The rats were randomly divided into four groups of six. Different doses of Mtx were given to the rats by i.p. injection: 1 mg/kg to those in group 1, 5 mg/kg in group 2 and 10 mg/kg in group 3. Rats in group 4 received injections of physiological serum only and were treated as the control group. Ten days after the injection, the fallopian tubes of the rats were removed for examination separately by light and electron microscopy (EM) for comparison. Results: Light microscopy showed that in group I the surface epithelial cells were normal and the lamina propria was infiltrated by numerous inflammatory cells with a prevalence of polymorphonuclear leucocytes. Findings in groups 2 and 3 were similar: the lamina propria was infiltrated with granulocytes in one specimen from each of the two groups, and granulocytes were also observed among epithelial cells. In the control group all surface structures were found to be in a normal condition. Electron microscopy showed cilial loss in the epithelial cells and central crystolysis in mitochondria in all group I specimens. Findings in groups 2 and 3 were similar. The cytoplasm of the epithelial cells seemed to be dense, there was prominent crystolysis (crystalloid formation) in the mitochondria, and vacuolisation (vacuole formation) in the cytoplasm seemed to be augmented. Cilial loss was prominent, and the basal membrane was irregular. Epithelial cell nuclei were in disorder. Lipid granules were observed extensively in epithelial cells. Eosinophils seemed to be dominant in connective tissues below the epithelium. In all control group specimens the epithelium seemed to be normal with all organelles in place; the condition of intercellular junctions, ciliated epithelium and all mitochondria also seemed to be normal, and the basal membrane was observed to be in order. Conclusion: In view of these findings, we conclude that the ultrastructural derangements resulting from administration of Mtx in doses in excess of I mg/kg can cause a reduction in the surface epithelium's ability to make rhythmic lashing movements and can impair the patency of the fallopian tubes. All these disturbances could be involved to some degree in the causation of infertility and recurrent ectopic pregnancy. Therefore, the dosage of Mtx should be limited to use of the lowest effective dose to avoid these adverse effects. (c) 2004 Elsevier Ireland Ltd. All rights reserved.Öğe Plasma leptin concentrations in postmenopausal women with osteoporosis(Taylor & Francis Inc, 2005) Yılmazı, Murat; Keleş, Işık; Aydın, Gülümser; Orkun, Sevim; Bayram, Merih; Sevinç, F. Ceylan; Yetkin, İlhan; Üçler, KısaOsteoporosis is less common in obese individuals with increased bone mineral density (BMD) and plasma leptin concentrations. The aim of this study was to determine the correlation between leptin levels and BMD in postmenopausal women. The study consisted of 90 postmenopausal women with a mean age of 53.45 +/- 0.87 years who visited our outpatient clinic for the evaluation of BMD. Thirty-six postmenopausal women with osteoporosis (mean age: 54.52 +/- 1.41 years and mean body mass index (BMI, kg/m 2 ) 29.33 +/- 0.66), 30 age- and BMI-matched postmenopausal women with normal BMD, and 24 postmenopausal women (mean age: 52.79 +/- 1.48 years and mean BMI: 29.45 +/- 0.89) with osteopenic BMD were included in the study. Plasma concentrations of leptin after an overnight fast were measured by radioimmunoassay. BMD values were measured by dual-energy X-ray absorptiometry (DEXA) at the L 2 -L 4 lumbar spine and femoral neck. The median spine BMD value in the patient group (0.67 +/- 0.08 g/cm(2) , mean +/- SEM) was significantly lower than that in the control group (1.02 +/- 0.25 g/cm 2 , mean + SEM) and osteopenic group (0.87 +/- 0.05 g/cm 2 , mean + SEM) (p < 0.150). Plasma leptin concentrations were correlated with BMI in three groups (r(s) = 0.450, p = 0.025 in normal BMD group and r(s) = 0.4254, P = 0.009 in the osteoporotic group, and r(s) = 395, p = 0.015 in the osteopenia group. There was no correlation between plasma leptin concentrations and BMD values in three groups (r(s) = -0.89 in normal BMD group, r(s) = -0.124 in osteopenia group, and r(s) = -0.195 in osteoporosis group). From this study we conclude that circulating plasma leptin does not have a significant direct influence on bone mass in postmenopausal women.Öğe Polikistik over sendromu gelişiminde rolü olan etyopatogenetik faktörler(2005) Sevinç, F. Ceyhan; Bayram, Merih; Soyer, CananAmaç: Polikistik Over Sendromunun farklı kriterlere göre tanımlanması ve bu sendromun gelişiminde rol alan etyopatogenetik faktörlerdeki çeşitliliğin araştırılmasıdır. Method: Polikistik Over Sendromu ilk olarak 1935'de Stein ve Leventhal tarafından tanımlanmıştır. Geçmiş yıllarda klinik tanı amenore, hirsutizm, obesite triadından oluşmaktaydı. Ancak son zamanlarda yapılan çalışmalar ise PKOS'nun geniş, heterojen bir klinik tabloya ve multifaktöriyel bir etyolojiye sahip olduğunu göstermiştir. PKOS'da görülen hiperandrojenizm ve anovulasyon endokrinolojik olarak 4 kompartmanda görülen anormallikler sonucu ortaya çıkar; over, adrenal bez, cilt ve yağ dokusu, hipotalamo-hipofizer aks. PKOS'nda etyopatogenez.de hipotalamo-ptuiter-overyen akstaki değişiklikler, intrinsik over patolojisi, peripubertal ekzajere adrenarş ve fizyolojik insülin rezistansının birlikteliği, obezite, patolojik insülin rezistansı ve pankreasla beta hücre disfonksiyonu ve genetik etyolojiye işaret eden ailesel birikimin rolü kesin olarak gösterilmekle beraber bu konuda halen çalışmalar devam etmektedir. Bu derlemede 'PKOS'nun farklı kriterlere göre tanımlanması ve sendromun gelişiminde rol alan çeşitli etyopatogenetik faktörler anlatılmaktadır. Sonuç: PKOS'da etyopatogenetik faktörlerin tam olarak bilinmesi; hastalığın tanısı, izlemi, tedavisi ve uzun dönem komplikasyonların gelişiminin engellenmesi açısından çok büyük bir önem kazanmaktadır.Öğe Prevalence of Adolescent Pregnancies and Educational Status of Pregnant Adolescents Admitted to the Kirikkale University Faculty of Medicine, Department of Gynecology and Obstetrics(Galenos Yayincilik, 2005) Bayram, Merih; Ozer, Guler; Soyer, Canan; Ucar, Banu; Yucer, GokcenObjective: In this retrospective study, we wanted to determine the prevalence of adolescent pregnancies and educational status of the adolescent pregnant women admitted to the outpatient clinic of Kirikkale University, Faculty of Medicine, Department of Obstetrics and Gynecology. Materials and Methods: Records of antenatal follow up of 954 pregnant women between February 2001 and September 2003 were analyzed. Results: Out of 954 pregnant women who were followed up antenatally, 7.9% were in adolescent age group. As for the educational status of these adolescents, 69.3% were primary school graduate, 26.6% were high school graduate and 1.3% were attendant to a university programme. Conclusion: Although the rate of adolescent pregnancies admitted to the outpatient clinic of Kirikkale University, Faculty of Medicine, Department of Obstetrics and Gynecology (7.9%) was not as high as in the general population of Turkey, their educational status were higher.
