Papers by H. Levent Keskin
Gynecology Obstetrics and Reproductive Medicine, Aug 10, 2010
OBJECTIVE: Understanding the relation between the numbers of removed lymph node and getting posit... more OBJECTIVE: Understanding the relation between the numbers of removed lymph node and getting positive lymph node. STUDY DESIGN: Medical records of 250 patients diagnosed as stage IB-IIA cervical cancer and treated with type III radical hysterectomy plus systematic pelvic and para-aortic lymphadenectomy in between January 1993 and December 2007 were evaluated. Clinical stage IB1 tumor was present in 171 patients, IB2 in 30 patients and IIA in 49 patients. RESULTS: The mean age of patients was 53.9 years. The metastatic node was determined in 34% of patients. The median number of removed nodes was 52 (13-160). It was removed 20 or less lymph nodes in 3.6% of patients, 21-30 lymph nodes removed in 11.6% of patients, 31-40 lymph nodes in 18.4% of patients, 41-50 lymph nodes in 14.4% of patients, 51-60 lymph nodes in 15.6% of patients, 61-70 lymph nodes in 15.6% of patients, 71-80 lymph nodes in 10% of patients and more than 80 in 10.8% of patients. The positive lymph node incidence was at minimum (11.1 %) in the ≤20 lymph nodes removed group and incidence was at maximum (60.4%) was observed in 31-40 lymph nodes removed group. However, there was no significant relationship between the number of removed nodes and getting positive lymph nodes. CONCLUSION: There was no relationship between number of lymph nodes removed and the chance of finding metastasis. However, the percentage of positive lymph nodes was lowest in the group where lowest number of nodes was removed.
Gorm, 2012
Tuberculosis incidence increases worldwide and it is still a public health problem particularly i... more Tuberculosis incidence increases worldwide and it is still a public health problem particularly in developing countries like Turkey. We aimed to present in this report 3 peritoneal/pelvic tuberculosis cases required diagnostic laparatomy due to malignity or abscess pre-diagnosis based on the presence clinical manifestations, such as pelvic pain, mass, ascites and increased CA-125 level, mimicking pelvic pathology. Peritoneal/pelvic tuberculosis should be absolutely considered in the differential diagnosis in cases with a presumptive diagnosis of pelvic malignancy or abscess with ascites, particularly in developing countries.
Turkish Journal of Medical Sciences
The study included postmenopausal 46 patients with ovarian cysts that were assessed pre-and posto... more The study included postmenopausal 46 patients with ovarian cysts that were assessed pre-and postoperatively using CA125 levels, ultrasonographic findings, and histopathological examination at the Obstetrics and Gynecology Clinic, Ankara Atatürk Training and Research Hospital. Results: Mean age of menopause onset was 46 years and mean duration of menopause was 11 years. Histopathological examination revealed that 28.3% of the ovarian cysts were malignant and 71.7% were benign. Of the malignant cysts, 84% were unilateral, with a mean diameter of 74.61 mm; mean diameter of the benign cysts was 58 mm. While 80% of cysts with a high CA125 value were malignant, 20% were benign. Pathological examination revealed that 96.8% of cysts with a normal CA125 value were benign and 3.2% were malignant. Mean CA125 values were 264 U/ml for malignant cysts and 14.2 U/ml for benign cysts. When pathological assessment was based only on ultrasonographic findings, 73.9% of the ovarian cysts were malignant and 26.1% were benign. While unilateral or bilateral localization in the ultrasonography was insignificant, the presence of a solid component was a good predictor of malignancy (P = 0.0001). Conclusions: In the differentiation of benign and malignant cysts in postmenopausal women, the presence of a solid component based on ultrasonography, cysts larger than 5-6 cm, and high CA125 values may be used as discriminative criteria. For those patients with cysts that are assumed to be benign follow-up may be an option for reducing the mortality and morbidity associated with surgery.
Zeitschrift für Geburtshilfe und Neonatologie
Background To estimate a possible association between the effects of daily meteorological variati... more Background To estimate a possible association between the effects of daily meteorological variation and climatological changes (temperature, air pressure, humidity, sunniness level) on pregnant women with hyperemesis gravidarum (HG) according to symptoms grade and hospitalization state. Methods A retrospective study was conducted with 118 patients diagnosed and hospitalized with HG. HG patients were graded as mild, moderate, or severe according to the Pregnancy Unique Quantification of Emesis (PUQE-24) scale. Data regarding demographic characteristics, PUQE scale value, gestational week on hospitalization, hospital admission and discharge dates, weather conditions, daily meteorological values during hospitalization ( temperature, air pressure, humidity, sunniness level), seasonal averages, and daily changes were recorded. Weather records were obtained from the Ankara Meteorology General Directorate (Ankara, Turkey). Differences between groups were compared according to HG grade. Res...
Study design, materials and methods This prospective study study has been carried out in the urog... more Study design, materials and methods This prospective study study has been carried out in the urogynecology division of Ataturk Research and Training Hospital between November 2009 February 2011. We assessed 28 consecutive patients who had undergone mesh implantation for the correction of symptomatic posterior vaginal wall prolapse. During the surgery, the actual surface area was measured by multiplying the long edge with the short edge (initial area). 0n 3 rd , 6 th and 12 th postoperative months, we performed translabial ultrasound examination to measure the surface area. The cases that we could not perform a uniform measurements were not included in the study. The general lineer model repeated measures test has been used in the analysis of data. The test value for the comparison between the measurements was p<0.001. Adjustment for multiple comparisons was made by using Bonferroni test.
… Klinikleri Jinekoloji ve …, 2009
Hippokratia, 2013
BACKGROUND The placenta is the major source of oxidative stress in normal human pregnancy. The pl... more BACKGROUND The placenta is the major source of oxidative stress in normal human pregnancy. The placental tissue is typically functional in postterm pregnancies. We hypothesized that such pregnancies experience deteriorating oxidative balance and increasing oxidative stress. In this case-control study, our aim was to investigate the oxidative status in postterm pregnancies comparing with term by using total antioxidant status (TAS) measurement. METHODS Fifty pregnant women who were in their 41st gestational week (GW) and whose labor had not yet started were selected for the study group. Fifty subjects whose spontaneous labor onset and who delivered before their 41st GW were included for control group. Venous blood samples were obtained from each participant before the onset of labor. A premixed reagent was used to obtain serum TAS measurements from the blood samples. The Mann-Whitney test was used to compare the groups. RESULTS Age, gravity, and parity of the subjects were similar be...
Turkiye Klinikleri Journal of Gynecology and Obstetrics, 2009
Turkiye Klinikleri Journal of Gynecology and Obstetrics, 2011
ABS TRACT Pel vic ac ti nomy co sis is a ra re di se a se which is ca u sed by ac ti nomy ces spe... more ABS TRACT Pel vic ac ti nomy co sis is a ra re di se a se which is ca u sed by ac ti nomy ces spe ci es and of ten pre sents as a comp li ca ti on of intrauterine device (IUD) use. Pel vic ac ti nomy co sis can ca u se dif fe rent cli ni cal fe a tu res and this in fec ti on is di ag no sed by his to pat ho lo gi cally. We re port a ca se of pel vic ac ti nomy co sis in a 53-ye ar-old wo man wit ho ut IUD who had a his tory of long du ra ti on of IUD use. Pel vic ul tra so und exa mi na ti on re ve a led ir re gu lar he te ro ge ne o us en do met ri um. The re fo re an en do met ri al bi opsy was per for med and the en do met ri tis that ca u sed by ac ti nomy ces was de tec ted. The pa ti ent was tre a ted me di cally and then a la pa ro tomy was per for med. Pat ho lo gic exa mi na ti on re ve a led cha rac te ris tic sul fur gra nu les in the ute ri ne ca vity and ot her in fec ted tis su es. Be ca u se of the dif fe rent cli ni cal fe a tu res of this di se a se it is dif fi cul...
Turkiye Klinikleri Journal of Gynecology and Obstetrics, 2008
Turkiye Klinikleri J Gynecol Obst 2008, 18 88 r ken ve spon tan ge be lik ka yıp la rı sık kar şı... more Turkiye Klinikleri J Gynecol Obst 2008, 18 88 r ken ve spon tan ge be lik ka yıp la rı sık kar şı la şı lan obs tet rik problem le rin ba şın da ge lir. Abor tus (Ab.) im mi nens, er ken ge be lik kaybı nın bir işa re ti ola rak or ta ya çık mak ta ve de vam eden ge be lik le rin %15-20’sin de gö rül mek te dir.1 Tür ki ye’ de yak la şık 1.5 mil yon yıl (TÜ İK Abortus İmminens, Erken Doğum Eylemini Öngördürebilir Bir Faktör mü?
Turkiye Klinikleri Tip Bilimleri Dergisi, 2009
Bu gelişmenin henüz gerçekleşmediği yerler de vardır: Üçüncü dünya ülkeleri, özellikle Afrika ülk... more Bu gelişmenin henüz gerçekleşmediği yerler de vardır: Üçüncü dünya ülkeleri, özellikle Afrika ülkeleri. Bu ülkelerden biri de, Türkiye ile tarihi bağları olan ve hâlâ soylarında Türk bağı olanların bunu söylemekten gurur duyduğu bir ülke olan Sudan, bu yüzyılın ortalarında bağımsızlığını kazandı. Ancak Afrika kıtasının en geniş topraklarına ve zengin yer altı kaynaklarına sahip ülke konumunda olmasına rağmen arzu edilen gelişmişlik düzeyine henüz ulaşamamış bir ülke. Yurt dışında eğitimini almış (Türkiye’de de çok sayıda Sudanlı tıp fakültesi ve uzmanlık öğrencisi bulunmakta hatta eğitim alıp ülkesine dönenler de mevcut). Çok sayıda iyi eğitimli hekim olmasına rağmen kaynaklar hâlâ kısıtlı. Ülkede patolog ve anestezi uzmanı parmakla sayılacak kadar az. Ameliyatta kullanılan tıbbi gereçler eski, onarıma muhtaç, yetersiz, anestezide kullanılan malzemelerin çoğu sterilize edilmek bir yana, yıkanmadan tekrar tekrar kullanılan malzemelerdi. Girdiğimiz iki ameliyatta (over kanseri ve yakl...
250 a pı şık ikiz lik na dir gö rü len, yük sek mor ta li te ora nı ve ağır mor bi di tey le sey ... more 250 a pı şık ikiz lik na dir gö rü len, yük sek mor ta li te ora nı ve ağır mor bi di tey le sey re den bir fe tal ano ma li dir. Do ğa nın bu ola ğan dı şı ka za sı;1 ta rih bo yun ca in san la rı kor kut muş ve ilk çağ lar da Tan rı ‘ la rın ga za bı ola rak ni te len di ril miş tir. Za man içe ri sin de sirk ler de pa ra kar şı lı ğı in san la ra se yir lik ola rak da hi su nul muş tur. Gü nü müz de bu ano ma li med ya nın ve in san la rın yo ğun il gi si ni çek mek te, di ni, ah la ki, etik ve hu kuk sal tar tış ma la ra ne den ol mak ta dır. Ta rih te ya pı şık ikiz lik le il gi li ilk ör nek ler den bi ri (M.Ö. 6800-5700) Ça tal hö yük ka zı la rın da bu lu nan ve Ana do lu Me de ni yet le ri Mü ze si’n de ser gi le nen pa ra pa gus lu ya pı şık ikiz (be re ket kül tü Ana Tanrı ça) mer mer hey ke li dir.
Results: Of the 40 patients’ results obtained with the 2 methods, 32 were similar. In 31 of these... more Results: Of the 40 patients’ results obtained with the 2 methods, 32 were similar. In 31 of these 32 cases, chromosome analysis interpreted as normal by QF-PCR was also established to be normal by standard karyotype analysis and 1 case evaluated as trisomy by QF-PCR was also determined to be trisomy 21 by standard karyotype analysis. In 6 cases, however, results were evaluated as chromosomal abnormality by QF-PCR, whereas standard analysis found them to be normal. The efficacy indices of QF-PCR were as follows: sensitivity 50%, specificity 83.7%, PPV 14.3%, and NPV 96.9%. Conclusion: Until the efficacy of QF-PCR increases, along with the sophistication of the technique, conventional karyotype analysis will remain the gold standard.
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Papers by H. Levent Keskin