İsmail Temur

Effects of the Maternal Position and Rest on the Fetal Urine Production Rate A Prospective Study Conducted by 3-Dimensional Sonography Using the Rotational Technique (Virtual Organ Computer-Aided Analysis)

The purpose of this study was to determine the effect of the maternal left lateral decubitus position and rest on the fetal urine production rate.

First trimester diagnosis of parapagus diprosopus dibrachius dipus twins with cranirachischisis totalis by three-dimensional ultrasound

Parapagus (laterally fused), diprosopus (two faces), dibrachius (two upper extremities), dipus (two lower extremities) conjoined twinning is extremely rare. The coexistence of anencephaly with a contiguous spinal defect (craniorachischisis totalis) makes the present case one of the rarest of the published cases. In our case, it was difficult to make the final diagnosis by two‐dimensional abdominal and vaginal ultrasound. Three‐dimensional ultrasound was helpful for final diagnosis and post‐abortal examination confirmed the prenatal ultrasound diagnosis. The heart, diaphragm, liver and perineum were all united. Fine dissection of the heart showed four vessels arising from the ventricles and a membranous type ventricular septal defect.

Effects of modernisation and new population policies on reproductive health in Kars, Turkey

ABSTRACT Background The 1983 Turkish Population Planning Act aimed at improving reproductive health outcomes. We examined the effects of the Act and of modernisation in a small, underdeveloped city and province, Kars. Methods Between June 2009 and January 2010, 576 parous women at a hospital in Kars participated in a study of reproductive histories and living standards. Results were compared by decade during which the birth took place of the first child who survived its first year, and urban/rural residence. Correlation and multi-way analyses of variance (ANOVA), χ2 and t tests were used as appropriate. We also examined womens education and living standards and use of hospital and family planning (FP) facilities. Result From 1970 through 2009 maternal age at first live birth increased by 4.9 years (p < 0.05) from a baseline of 18.9 years. The number of pregnancies fell from a mean of 8.1 per woman in the 1970s to 5.6 in the 1980s (p < 0.05), with strong indications of continued decreases through the 2000–2009 decade. FP sites in Kars province increased in number and services, as did antenatal hospital visits and the proportions of women giving birth in a hospital. Concomitantly, delivery by caesarean section augmented markedly over the decades. Education levels of both urban and rural women rose from two years of schooling in the 1970s to ten years in the last decade. Conclusion Modernisation, including increasing urbanisation, education, and new governmental policies that translated into maternal-child health and FP services were likely the backbone for improved reproductive health and lower fertility rates of women in Kars over the 40 year-period we studied.

The first case of Horn Kolb Syndrome in Turkey, diagnosed prenatally at the 23rd week of a pregnancy: A very rare and unusual case far from the original geography

Summary Background: The aim of this report was to evaluate and announce the first documented appearance of Horn Kolb syndrome in Turkey. Case Report: Acheiropodia (Horn Kolb Syndrome) is the bilateral congenital amputation of the distal parts of the 4 extremities. It is an autosomal recessive developmental disorder. The characteristic features are amputation of the upper and lower extremities with aplasia of the hands and feet. The disorder affects only the extremities without other systemic manifestations. In this report, we present the first known case of Horn Kolb syndrome in Turkey, along with the diagnostic features. Conclusions: Severe dysmorphic skeletal anomalies should be excluded as soon as the earlier gestational weeks in every pregnancy by visualizing all 4 limbs of the fetus in routine prenatal ultrasound screening.

Severe ovarian hyperstimulation syndrome in spontaneous pregnancy treated successfully with cabergoline

Ovarian hyperstimulation syndrome (OHSS) is a relatively common complication in infertile patients treated with exogenous gonadotropins. Ovarian hyperstimulation in spontaneous pregnancies is a rare but possible. The pathogenesis of spontaneous OHSS is not well known. Risk factors for OHSS are young age, polycystic ovaries, low body mass index, high gonadotropin dose, increased estradiol and human chorionic gonadotropin levels, multiple pregnancy, OHSS history, molar pregnancy and hypothyroidism. In this report we present a case of severe spontaneous OHSS with a brief summary of the literature. She was hospitalized and treated in the clinic with the diagnosis of severe OHSS accompanying spontaneous pregnancy.

CO2 Flow Dynamics of Bladder Injury During Laparoscopy and the Effect of the Content of the Abdominal Viscera During Injury--Experimental Study.

BACKGROUND Despite the well-known and easily recognizable signs of bladder injury during laparoscopy, some injuries remain unnoticed. Intra-operative diagnosis of a urinary bladder injury provides the opportunity to repair and prevent later complications involving the formation of fistula, infection, ascites and impairment of renal function. Small and unrecognized bladder injuries increase the chance of morbidity and permanent organ dysfunctions. OBJECTIVES The aim of the study was to evaluate the CO2 flow dynamics of bladder injury occurring during laparoscopy and the effect of the content of the abdominal viscera during injury. MATERIAL AND METHODS The study involved eight male New Zealand rabbits. Following urinary catheterization of the rabbits with an 8-gauge urinary catheter connected securely to a urinary drainage bag, pneumoperitoneum was created at a pressure level of 12 mm Hg. The experiment consisted of three phases. After the observational phase (Phase 1), the anterior wall of the urinary bladder was perforated with the tip of a 21 G needle (Phase 2) and methylene blue was administrated to evaluate the CO2 flow dynamics (Phase 3). RESULTS The amount of CO2 consumption and accumulation in the urinary drainage bags differed significantly among the three phases of the experiment (p<0.05). There was no CO2 consumption or accumulation in the urinary drainage bags during Phase 1. The amount of CO2 consumption and accumulation in the urinary drainage bags during Phase 2 was significantly higher than during Phase 3. CONCLUSIONS Urinary catheterization helps in the diagnosis of small or unnoticed urinary bladder injuries occurring during laparoscopy. CO2 flow and consumption is lower if the viscosity of the content overlying the injury site is higher.

Gaseous distension of the urinary bag during CO2 laparoscopy in the usual operative settings: Does the CO2 diffuse into the urinary bladder or is it a sign of urinary tract injury?

Abstract Objective To compare the amounts of any clinically detectable gas passage into the urinary bag in laparoscopic and open surgeries. Methods Seventy-nine women were allocated into two surgical groups; Group 1: carbon dioxide (CO 2 ) laparoscopy ( n =37) and Group 2: gasless laparoscopy or laparotomy ( n =42). All patients had urinary catheter during the surgeries. After checking the tightness of the connection of the urinary catheter and bag operations were performed. At the end of each surgery the urine volumes were recorded. The bags were immersed into a water containing container with a volume scale. The volume rise of the container was recorded. The valve of the outlet of the bag was turned on under the water and any leakage of air bubbles was observed. The final volume of the container was recorded once again while the bag was still in the water. The two groups were compared by using the Students t or Mann Whitney U tests. Results We did not observe and hence measure any gas accumulation in the urine bags of both groups. The womens ages, total intraoperative urine volume, urine production rate and total operative times of the groups were not significantly different. The mean operative time was (82.98±62.14) min in open surgeries and (73.46±52.74) minutes in CO 2 laparoscopic surgeries. The difference between the groups was not significant ( P =0.468). Conclusions Any gas accumulation in the urine bag during CO 2 laparoscopic surgery should raise the suspicion of urinary tract injury. Urinary catheterization helps to diagnose the unnoticed bladder injuries.

Omfalosel ve gastroşizis ayırıcı tanısında üç boyutlu ultrasonografinin rolü

Gastroschisis and omphalocele are the two of the most common malformations of the anterior abdominal wall that both of them associated with high morbidity and mortality. Sometimes the diagnosis and the realization of the situations by physicians and the parents are difficult. Herein, one omphalocele and one gastroschisis cases were presented with the two-dimensional and threedimensional ultrasonographic diagnostic features. The two entities and the role of three-dimensional ultrasound in diagnosis and the clinical management of the situations are discussed in the view of medical literature. The three-dimensional ultrasound helps in the diagnosis and detection of the severity of the omphalocele and the gastroschisis. J Clin Exp Invest 2011; 2(1): 106-109Gastroschisis and omphalocele are the two of the most common malformations of the anterior abdominal wall that both of them associated with high morbidity and mortality. Sometimes the diagnosis and the realization of the situations by physicians and the parents are difficult. Herein, one omphalocele and one gastroschisis cases were presented with the two-dimensional and three-dimensional ultrasonographic diagnostic features. The two entities and the role of three-dimensional ultrasound in diagnosis and the clinical management of the situations are discussed in the view of medical literature. The three-dimensional ultrasound helps in the diagnosis and detection of the severity of the omphalocele and the gastroschisis.

Laparoscopy-assisted mini-laparotomy: management of a giant (32 cm) ovarian cyst

Ovarian cysts over 5 and 15 cm are described as large and giant, respectively. Ovarian cysts over 5 cm without regression in 6-8 weeks are indicated for surgery. Although there are published data about the laparoscopic or laparoscopy assisted management of the large and giant cysts, especially in cases of giant cysts midline laparotomy is preferred by many surgeons. In this paper, we present the management of a 32 cm mucinous ovarian cyst by laparoscopy-assisted mini-laparotomy.

P14.19: Diagnosis of primary megaureter with the aid of 3D ultrasonography: a case report

the current PP13 ELISA test and their existence can explain low levels of serum PP13 in women who subsequently develop preeclampsia. In this study we investigated the presence of circulating PP13 mRNA in pregnancies with physiological course of gestation. Methods: For the testing, we developed three various real-time RT-PCR systems (exon 1–2, exon 4, exon 4-UTR) for the detection of normal PP13 mRNA and for its shorter isoforms. The presence of PP13 mRNA was analysed in plasma samples of 16 women during the first and the third trimesters of gestation. Results: The systems were optimised to detect reliably 500, 50 and even 5 copies of placental-derived PP13 in a mixture with redundant PP13 negative RNA plasma sample derived from non-pregnant healthy individuals. However, the detection rate of PP13 mRNA in maternal plasma samples was substantially inconsistent (at the most one or two positive replicates out of 6 tested ones). Conclusions: The early detection of PP13 mRNA in maternal plasma does not represent a suitable method to predict later development of preeclampsia. This work was supported by grant project MSM 0021620806.