Nejat Ceyhan

Short-term outcome of newborn infants: spinal versus general anesthesia for elective cesarean section: A prospective randomized study

OBJECTIVE To compare general and spinal anesthesia with respect to the short-term outcome of newborns born by elective cesarean deliveries. METHODS Pregnant women admitted to our hospital from January 1999 to July 2000, for whom elective repeat cesareans were planned after 37 weeks gestation, were allocated randomly after their informed consent to spinal anesthesia or general anesthesia. Maternal age, gestational age, birth weight, Apgars score, hospital stay duration, and duration of cesarean section time were all noted. The rate of the neonatal respiratory depression, perinatal asphyxia, and admittance to the neonatal intensive care unit of the infants were documented. We also studied arterial samples withdrawn from the cord for the pH, bicarbonate, PaO(2) (oxygen pressure, arterial), and PaCO(2) (carbon dioxide pressure, arterial). The serum levels of creatine kinase with myocardial-specific isoform, aspartate aminotransferase, alanine aminotransferase, and total cortisol levels of the newborns were measured and served in ruling out perinatal stress and in confirming the diagnosis of perinatal asphyxia (and of myocardial damage). Statistical analyses was performed with the use of an unpaired Students t-test, Chi-square test, and a power calculation was done. RESULTS From the randomly selected patients, we had 38 (45.2%) infants for general anesthesia and 46 (54.8%) for spinal anesthesia. None of our primary endpoints favored any of the study groups, and the clinical short-term outcome of the infants was similar in the neonates born both by spinal and general anesthesia (P>0.05). The biochemical assays did not rule out or confirm any differences in the occurrence of perinatal stress (P>0.05). CONCLUSION Anesthesia type does not seem to influence the short-term outcome of the newborn infants for the elective cesarean deliveries. We believe that both spinal and general anesthesia could be performed in elective term cesarean deliveries without any risk to the newborn infants.

Combination of Vaginal Ultrasonography and Pipelle Sampling in the Diagnosis of Endometrial Disease

In this article, we aimed to investigate the value of Pipelle endometrial sampling with and without sonographic measurement of endometrial thickness in the diagnosis of endometrial disease. We studied prospectively 78 patients scheduled for dilatation and curettage in order to evaluate abnormal uterine bleeding. Sonographic measurement of the endometrial thickness and endometrial sampling with the Pipelle were performed before the curettage. The accuracy of ultrasonography and the Pipelle sampling was measured against the final diagnosis. In 68 cases (87.1%), the endometrial histological results of curettage agreed with those of the Pipelle sampling. Pipelle endometrial sampling had a sensitivity of 73% and a specificity of 100% for endometrial disease. The use of ultrasonography increased the sensitivity of the Pipelle aspiration from 73% to 90%.

The effect of tamoxifen on the endometrium, serum lipids and hypothalamus pituitary axis in the postmenopausal breast cancer patients

Background. There is still no cost‐effective endometrial screening method for asymptomatic postmenopausal breast cancer patients using tamoxifen. We investigated the effectivity of transvaginal ultrasonography and endometrial sampling as a screening method for asymptomatic patients. Additionally the effect of tamoxifen on hypothalamus‐pituitary axis and serum lipid profiles were investigated.

Angiomyofibroblastoma of the vulva: a rare but distinct entity.

Angiomyofibroblastoma of the genital region is a relatively recently described tumor of the superficial soft tissues with a marked preference for female patients (1). Since symptoms of benign and malignant conditions in the vulval area are frequently similar, early diagnosis and treatment are mandatory. The following case report presents several interesting features of a ‘vulval angiomyofibroblastoma’ with respect to the origin of the tumor and the histologic, immunohistochemical findings.

Combination of Endometrial Thickness and Pipelle Sampling in the Diagnosis of Endometrial Disease in Postmenopausal Women

In this article, we evaluate the value of the combined use of vaginal sonography and endometrial sampling for the diagnosis of endometrial disease in postmenopausal women. Fifty-three postmenopausal w