E-ISSN 2757-8062
Volume : 47 Issue : 4 Year : 2022

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ZEYNEP KAMIL MEDICAL JOURNAL - Zeynep Kamil Med J: 47 (4)
Volume: 47  Issue: 4 - 2016
1.Determination of Recurrent/Residual CIN-II and CIN-III After Leep, Cytology or HPV-DNA?
Özgür Çoban, Hüseyin Durukan, Talat Umut Kutlu Dilek, Arzu Doruk, Saffet Dilek
doi: 10.16948/zktb.09286  Pages 101 - 105
GİRİŞ ve AMAÇ: Bazı avantajlara sahip olan LEEP uygulaması CIN-II ve III lezyonlarının standart tedavisi haline gelmiştir. Ne yazık ki,diğer tedavi yöntemlerinde olduğu gibi tedavi başarısızlıkları LEEP uygulaması sonrasında da görülebilmektedir. Bu çalışma CIN II veya III nedeniyle LEEP yapılan olgularda rekürren/ rezidüel hastalık belirlenmesinde servikal sitoloji, cerrahi sınır pozitifliği ve HPV DNA testinin değerini ortaya koymayı amaçlamaktadır.
YÖNTEM ve GEREÇLER: LEEP tedavisi uygulanmış ve altı ay sonrasında kolposkopi yönlendirilmiş biyopsi ve endoservikal küretaj yapılmış 77 olgu retrospektif olarak incelendi. Rekürren / rezidüel hastalık tespiti için histolojik inceleme uygulanmıştı. LEEP esnasındaki cerrahi sınır pozitifliği, altı ay sonrasında alınan sitoloji ve HPV DNA PCR test sonuçları karşılaştırmaya dahil edildi.
BULGULAR: Rekürren / rezidüel hastalık 77 olgunun 14’ünde (%18,1) belirlenmiştir. HR-HPV 13 (%17) olguda pozitif ve 64 (%83) olguda negatifti. Rekürren / rezidüel hastalık oranı HR-HPV pozitif olgularda 12/13 (%92), ve HR-HPV negatif olgularda 2/64 (%3) olarak saptandı. Cerrahi sınır pozitifliği olan 25 olgunun ise 7’sinde (%28) rekürren / rezidüel hastalık saptandı. Sitoloji 26 (%33,8) olguda pozitifti.. Rekürren / rezidüel hastalık sitolojis negatif olan 2 olguda ve sitolojisi pozitif olan 12 olguda saptandı.
Rekürren / rezidüel hastalık öngörmede HPV testinin cerrahi marjin pozitifliğinden veya konvansiyonel sitolojiden daha üstün olduğu görüldü.
TARTIŞMA ve SONUÇ: HPV testi LEEP sonrası tedavi başarısızlığını belirlemede ilk planda kullanılabilir.
INTRODUCTION: Having some advantages, LEEP becomes the standard treatment of CIN-II and III lesions. However, failure to treatment after LEEP is also seen as in other treatment methods. This study aims to determine the value of cervical cytology, surgical margin positivity and HPV-DNA testing for determination of residual or recurrent disease in patients undergone LEEP with the diagnosis of CIN II or III.
METHODS: Colposcopy directed biopsy and endocervical curettage applied 77 cases six months after initial LEEP treatments were retrospectively analyzed. Histological examination is used in order to determine residual/recurrent disease. Cytology and HPV-DNA PCR tests after six months and initial surgical margin positivity at the time of LEEP were all compared.
RESULTS: In 14 (18.1%) of the 77 cases, residual/recurrent disease was determined. HR-HPV was positive in 13 (17%) and negative in 64 (83%). Recurrent/residual disease rate was found to be 12/13 (92%) in HR-HPV positive cases and 2/64 (3%) in HR-HPV negative cases. Out of 25 patients who were surgical margin positive, recurrent/residual disease was determined in 7 (28%). Cytology was positive in 26 (33.8%) cases. Recurrent/residual disease was determined in 2 of the cytology negative and in 12 of the cytology positive cases.
In prediction of residual/recurrent disease, HPV testing was found to be superior to surgical margin positivity or conventional cytology
DISCUSSION AND CONCLUSION: HPV test may be considered primarily for determination of treatment failures after LEEP.

ORIGINAL RESEARCH
2.Relationship Between Maintaining Diet Containing High Fructose and Development of Polycystic Ovary Via Perilipin Expression
Nejda Bedri, Ilknur Keskin
doi: 10.16948/zktipb.257211  Pages 106 - 110
INTRODUCTION: Studies showing diet consisting of PCOS combined with high fructose are in a limited level. In this study, it is aimed to investigate PLIN2 and PLIN3 expressions by showing diet consisting of combination of high fructose and PCOS.
METHODS: A total of 26 Balb/C type female mice have been used and 3 groups are created: Control (no treatment), HF (tap water containing 20% fructose is given by oral gavege) and Hormone (The injection of DHEA is injected s.c.). In order to show the morphological differences between the groups haematoxylin and eosin staining method has been used. For PLIN2 and PLIN3 antibodies western blot method has been used. ELISA technic has been used to compare progesterone and LH levels between the groups.
RESULTS: It is seen that antral and preantral follicle numbers of HF and Hormone groups have increased. It is also seen that PLIN2 and PLIN3 expressions are high in HF and Hormone groups.
DISCUSSION AND CONCLUSION: As a result diet with high fructose could contribute to PCOS development and in this mechanism PLIN2 and PLIN3 proteins could also be effective.

3.Analysis of Maternal and Fetal Outcomes of Patients Diagnosed with HELLP Syndrome
Ümmügülsüm Esenkaya, Metin Ingeç, Emsal Pınar Topdağı Yılmaz, Şengül Talar Arslan
doi: 10.16948/zktipb.237221  Pages 111 - 116
INTRODUCTION: HELLP syndrome is a multisystem disorder which causes rapid deterioration of maternal and fetal well-being. In this study, we aimed to investigate clinical and labaratory parameters that influencing maternal and perinatal outcomes in addition to relatonship between maternal and perinatal morbidity and mortalitiy in patients which had been diagnosed as HELLP syndrome.
METHODS: In this study, the hospital’s computer system records of 155 patients diagnosed with HELLP syndrome in our clinic between January 2005 and December 2010 were reviewed retrospectively.The demographic characteristics of the patients, maternal and perinatal outcomes and laboratory parameters were analyzed.
RESULTS: The average age of the patients was 29.8 ± 6.9 year, the mean gestational age was 31.4 ± 4.2 week, the mean fetal birth weight was 1672.72±726 gr. Sixty-one percent of patients were multigravida while 39%of patients were primipar. The most common maternal complications were the transfusion requirement in 58 patients (37.4%). We found significant differences between patients who developed at least one complications and no maternal complication with regard to AST, LDH, creatinine, thrombocyte, and total bilirubine levels. Prematurity rate was detected as 83.4%. Maternal mortality was occurred in 12 patients (7.7%).Perinatal mortality was occurred in 9 patients (12%).
DISCUSSION AND CONCLUSION: HELLP syndrome increases maternal-fetal morbidity and mortality. Early diagnosis and appropriate treatment are important in determining the prognosis of HELLP syndrome.

CASE REPORT
4.Expulsion of a Uterine Myoma After Uterine Artery Embolization: Case Report
Ali Cenk Özay, Özlen Ekmekçi, Berrin Acar, Aygün Akberova, Aslı Akdöner
doi: 10.16948/zktipb.237119  Pages 117 - 119
A 42 years old woman was admitted with abnormal vaginal bleeding. In her vaginal examination 6 cm myoma was detected. She refused operation and therefore uterine artery was embolization was done. 8 days after the embolization she was admitted to emergency unit with prolapse of the myoma and vaginal bleeding and she had total abdominal hysterectomy.

5.Rare Cutaneous Ulcers Related to Methotrexate Use in Persistant Gestational Trophoblastic Neoplasia: A Case Report
Alper Seyhan, Baki Erdem, Emel Canaz, Hakan Güraslan, Ayşegül Bestel, Özgür Akbayır
doi: 10.16948/zktb.72592  Pages 120 - 123
Methotrexate is a chemotherapeutic agent which inhibits the folate metabolism is a frequently used in different disease spectrum; malignancies (hematologic malignancies, solid tumors, gestational neoplastic diseases…) or non-malignant such as chronic inflammatory diseases or dermatologic diseases. While it’s using, different toxic side effects can be seen which are dose-dependent or not. Different types of medications are used to prevent toxic side effects. Despite all preventive approaches, personal and genetic differences effect treatment results.

REVIEW ARTICLE
6.Oral Nutrition During Birth
Emine Koç, Nevin Şahin
doi: 10.16948/zktipb.237170  Pages 124 - 127
Giving birth is a natural process. Some faulty or unnecessary practices during this process may spoil the naturalness of birth and cause ketosen, ketosen associated with prolonged labor, dehydration, assisted delivery and postpartum hemorrhage to develop in the mother and hipogilise, hpyponetremia and some complications in the fetus. To ensure a natural birth and to let it proceed in a healthy process, it is necessary that health services are standardized in line with results from evidence based practices. Many countries follow different policies in the meeting of the energy needed by women while giving birth. While oral nutrition is not limited during birth in America, Canada, England and various centers in several European countries, Ours country restrict oral nutrition and women’s energy need is met via parenteral nutrition. This paper evaluates the prevalent restriction in the oral administration of liquids and food in our country in terms of the mother and the baby and inspect evidence based practices in this issue as well as the nourishment requirements of women during child birth. In addition, it aims to raise awareness in support and care providers to women and guide the practices.

CASE REPORT
7.Bilateral Renal Agenesis and Aortic Stenosis in an Antenatally Diagnosed Turner Syndrome
Handan Hakyemez Toptan, Nilgün Karadağ, Abdülhamit Tüten, Tülin Gökmen Yıldırım, Gülsen Akay, Mehmet Burak Kutlu, Güner Karatekin
doi: 10.16948/zktipb.237205  Pages 128 - 131
Turner syndrome is a genetic disorder caused by loss or structural disorders of X chromosome. A significant number of cases result with abortion. Clinical symptoms are not always apparent in the newborn period. Therefore it could be diagnosed in later years of life. Turner syndrome should be considered in patients with lymphedema on hands and feets, low hairline, short and webbed neck. Cardiovascular, genitourinary, endocrine system disorders could be accompanied. Here we present an antenatally diagnosed Turner syndrome with bilateral renal agenesis, pulmonary hypoplasia and aortic stenosis.

REVIEW ARTICLE
8.Meconium Aspiration Syndrome and Innovationin the Approach
Handan Hakyemez Toptan, Nilgün Karadağ, Güner Karatekin
doi: 10.16948/zktipb.237216  Pages 132 - 138
ABSTRACTMeconium aspiration syndrome is as definition a respiratory distress syndrome in newborns born to meconium stained amniotic fluid which cannot be explained with any other reasons. It is mostly a problem of terms and postterms which passing oxidative process and increased the requirement for neonatal intensive care unit (NICU). The mechanism of lung injury at meconium aspiration syndrome (MAS) is quite complex. Blocking of the airway with meconium, ventilation and gas exchange defects, surfactant inactivation, chemical pneumonitis and pulmonary hypertension are associated with this complex mechanism. In this article is the approach of babies born with meconium aspiration syndrome in the light of current knowledge revised.

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