G Gundem

Ege University, İzmir, Izmir, Turkey

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Publications (6)3.84 Total impact

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    ABSTRACT: The purpose of this study was to compare the clinical symptoms and histopathological findings in subjects with adenomyosis uteri. Infiltration depth and spread of adenomyotic foci together with clinical symptoms and findings were compared in a total of 103 subjects who had undergone hysterectomy and were diagnosed with adenomyosis uteri through histopathological examinations. The spread of adenomyotic foci in myometrial tissues was observed to significantly increase as the depth of myometrial infiltration increased in subjects with adenomyosis (p < 0.05). It was observed that there was significantly higher myometrial infiltration depth in subjects with dysmenorrhea and severe anemia, and diffuse adenomyotic foci in subjects with menometrorrhagia (p < 0.05). Increased infiltration depth and spread of adenomyotic foci in myometrial tissues in subjects with adenomyosis uteri were studied. When clinical symptoms and findings in subjects with adenomyosis, such as dysmenorrhea, anemia and menometrorrhagia are compared with these histopathological findings, infiltration depth and spread of adenomyotic foci appear to determine the clinical severity of adenomyosis.
    Clinical and experimental obstetrics & gynecology 01/2008; 35(1):48-53. · 0.38 Impact Factor
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    ABSTRACT: This prospective study investigated the prevalence of adenomyosis in histopathological examinations of patients who had undergone hysterectomy due to various indications in our clinic. Epidemiological characteristics, predisposing risk factors, symptoms and clinical findings of adenomyosis were evaluated. A total of 298 subjects who had undergone abdominal, vaginal or laparoscopic hysterectomy with/without salpingooophorectomy between October 2003 and April 2004 in our clinic were included. Uterine specimens obtained through hysterectomy were weighed and histopathologically examined in the Pathology Department of Ege University. The study group (n = 103), cases with adenomyosis, was compared with the control group (n=195), cases without adenomyosis, with respect to the epidemiological, clinical and histopathological characteristics. The prevalence of adenomyosis in 298 subjects was 36.2% (103). Duration of the reproductive period in patients with adenomyosis was found to be significantly longer than for those in the control group (p < 0.05). Prevalence of pelvic pain, dysmenorrhea and dyspareunia was also significantly higher in the study group (p < 0.05). Moreover, the number of cases requiring blood transfusion before the operation was significantly higher in the study group (p < 0.05) as were the rates of smoking, previous uterine surgery and nulliparity (p < 0.05). The most common gynecological condition accompanying adenomyosis was found to be uterine myoma in both groups, but the difference was not significant. Adenomyosis is not a rare histopathological finding. Due to diagnostic and therapeutic methods which are being developed as an alternative to hysterectomy, the clinical effects of adenomyosis and its association with other gynecological conditions, adenomyosis appears to be an issue which will be more intensively investigated in the future.
    Clinical and experimental obstetrics & gynecology 01/2007; 34(3):163-7. · 0.38 Impact Factor
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    ABSTRACT: The aim of the study was to determine mammographic breast density changes during raloxifene therapy in postmenopausal patients Fifty-five cases who were using raloxifen therapy were included in this retrospective analysis. Raloxifene was given for osteopenia and osteoporosis according to low bone mineral density measured by dual-energy X-ray absorptiometry (DEXA). None of the patients were using hormone replacement therapy 12 months before the initiation of raloxifene treatment or during the study. Mammographic breast density was determined by mammography before the initiation of raloxifene treatment (baseline) and after 12 to 16 months of therapy. The Breast Imaging Reporting and Data System (BI-RADS) breast density score was used for the evaluation of mammographic density. There was no change in mammographic breast density when the baseline and the first mammography taken after the initiation of therapy were compared (p = 0.32). There was no significant correlation between the duration of raloxifene treatment and mammographic density measured after raloxifene treatment (r = -0.158, p = 0.25). Only in one patient did the BI-RADS classification of 2 change to 3 after 12 months of therapy. In conclusion, raloxifene therapy for 12 to 16 months does not increase mammographic breast density in postmenopausal women with low bone mass.
    European journal of gynaecological oncology 02/2006; 27(2):177-8. · 0.58 Impact Factor
  • Australian and New Zealand Journal of Obstetrics and Gynaecology 09/2004; 44(4):351-3. · 1.30 Impact Factor
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    ABSTRACT: Although the only objective finding of intrapartum fetal distress is obtained through the measurement the fetal scalp pH, this invasive procedure is not available in every institution. The careful examination of fetal heart rate tracings for abnormalities, especially of the most commonly seen one, variable decelerations gains great importance under these circumstances. The aim of the present study is to determine the prognostic significance of variable decelerations in intrapartum fetal heart rate monitoring. A total of 96 fetal heart rate tracings were analysed to assess the prognostic significance of variable decelerations. Sixty-six percent (64/96) of cases exhibited atypia characterised with (1) slow return of the fetal heart rate to the baseline; (2) loss of variability during the decelerations; (3) loss of initial and/or secondary accelerations; (4) persistence of secondary acceleration (overshoot); and (5) continuation of the baseline fetal heart rate at a lower level; (6) biphasic deceleration. One and five-minute Apgar scores and umbilical artery pH were used to assess the final fetal condition. Adverse fetal outcome characterised by fetal acidosis and Apgar score lower than 7 at one and five minutes were uncommon with pure variable decelerations. Typical and atypical variable decelerations were associated with low Apgar scores (< 7) at one minute in 9.3% and 54.6% of cases (p < 0.001) and at five minutes in 6.25% and 25% of cases (p < 0.05), respectively. In addition umbilical artery pH found to be lower than 7.2 in these cases ( 18.75% - p < 0.05). There was no danger for the fetal haemodynamic conditions when typical uterus contraction/variable deceleration ratios were two or more than two. However, risk of fetal hypoxia damage was quite high when this ratio was lower than two in atypical variable 5th minute low Apgar scores and pH (81.8% and 36.6% respectively). Atypical features are helpful in the identification of distress characterised by low Apgar scores in fetuses with variable decelerations. Admission to the neonatal intensive care unit was more common in patients with atypical variable decelerations in comparison with typical variable decelerations (34.3% versus 3.1%). While typical variable decelerations are frequently harmless, atypical variations pose a significant risk of fetal hypoxia.
    Singapore medical journal 06/2003; 44(5):243-7. · 0.63 Impact Factor
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    ABSTRACT: To determine the preoperative and postoperative correlation of histopathological findings in cases of endometrial hyperplasia. One hundred and three patients with endometrial hyperplasia detected by surgical curettage performed due to various gynecologic pathologies were treated by hysterectomy. We compared retrospectively the histopathological diagnoses found on curettage with those found on hysterectomy specimens. The classification scheme endorsed by the International Society of Gynecological Pathologists was used to classify the endometrial hyperplasia. The histologic findings found on the endometrial tissue of curettage specimens were correlated with those from hysterectomy specimens. Histopathologic evaluation was performed by a single skilled gynecologic pathologist. A total number of 103 women--76 (73.8%) premenopausal and 27 (26.2%) postmenopausal--were determined to have endometrial hyperplasia on histopathological evaluation of endometrial tissues obtained by endometrial curettage performed for evaluation of various bleeding abnormalities. These included 94 patients with simple hyperplasia without atypia (91.3%), two patients with simple hyperplasia with atypia (1.9%), five patients with complex hyperplasia without atypia (4.9%), and two patients with complex hyperplasia with atypia (1.9%). Histopathological evaluation of endometrial tissue obtained from hysterectomy specimens (of patients diagnosed with hyperplasia on curettage) revealed a total number of 65 cases (63.1%) with endometrial hyperplasia, and 38 cases (36.9%) with various histopathological findings. The correlation between preoperative and postoperative endometrial histologic findings was found to be statistically insignificant (r = 0.105, p = 0.29). Among 94 patients who were found to have simple hyperplasia without atypia on curettage specimens, 55.3%, were found to have simple hyperplasia without atypia, 1.1% simple hyperplasia with atypia, 5.3% complex hyperplasia without atypia, 9.6% secretory endometrium, 4.3% proliferative endometrium, 21.3% disorganized proliferative endometrium, 1.1% corpus luteum persistency, 1.1% basal endometrium, and 1.1% endometrium cancer on final hysterectomy specimens. Postoperative diagnosis of endometrial pathology might be different from that of preoperative especially in cases with simple endometrial hyperplasia without atypia.
    European journal of gynaecological oncology 02/2003; 24(3-4):330-3. · 0.58 Impact Factor