Osman Zekioglu

Ege University, Ismir, İzmir, Turkey

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Publications (73)88.16 Total impact

  • The Kaohsiung journal of medical sciences 03/2014; 30(3):159-60. · 0.50 Impact Factor
  • The Kaohsiung Journal of Medical Sciences. 01/2014;
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    ABSTRACT: BACKGROUND: Chorioamnionitis is closely related to premature birth and has negative effects on neonatal morbidity and mortality. METHODS: In this prospective study, 43 mothers who delivered earlier than 35 gestational weeks and their 57 infants were evaluated clinically and with laboratory findings. Placentas and umbilical cords were investigated histopathologically for chorioamnionitis and funisitis. RESULTS: The overall frequency of clinical and histological chorioamnionitis (HCA) was 8.3% and 23.2%, respectively. The frequency of HCA was 47.3% and 83.3% in mothers delivered <32 weeks and <30 weeks, respectively. Maternal demographic and clinical findings and also leukocyte and C-reactive protein values were not indicative of HCA. Infants of mothers with HCA had significantly lower Apgar scores together with higher SNAP-PE-II and CRIB scores. These infants had increased mechanical ventilator and surfactant requirements, higher incidences of patent ductus arteriosus, early sepsis, and bronchopulmonary dysplasia, and higher mortality rates. The effect of HCA on neonatal morbidity and mortality was more prominent than the effect of low birthweight and lower gestational age. CONCLUSION: Chorioamnionitis not only causes premature deliveries, but is also associated with neonatal complications and increased mortality. Clinical findings and infectious markers in mother or infant do not predict the diagnosis of histological chorioamnionitis. Therefore, placental histopathology may have a role in predicting neonatal outcome in premature deliveries, especially those below 30 weeks.
    Pediatrics & Neonatology 04/2013; · 0.93 Impact Factor
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    ABSTRACT: To evaluate the importance of ultrasonography (US) and magnetic resonance imaging (MRI) in detecting placental adherence defects. Patients diagnozed with total placenta previa (n = 40) in whom hysterectomy was performed due to placental adherence defects (n = 20) or in whom the placenta detached spontaneously after a Cesarean delivery (n = 20) were included into the study between June 2008 and January 2011, at the Department of Obstetrics and Gynecology Ege University (lzmir Turkey). Gray-scale US was used to check for any placental lacunae, sub-placental sonolucent spaces or a placental mass invading the vesicouterine plane and bladder Intra-placental lacunar turbulent blood flow and an increase in vascularization in the vesicouterine plane were evaluated with color Doppler mode. Subsequently all patients had MRI and the results were compared with the histopathologic examinations. The sensitivity of MRI for diagnosis of placental adherence defects before the operation was 95%, with a specificity of 95%. In the presence of at least one diagnostic criterion, the sensitivity and specificity of US were 87.5% and 100% respectively, while the sensitivity of color Doppler US was 62.5% with a specificity of 100%. Currently MRI appears to be the gold standard for the diagnosis of placenta accreta. None of the ultrasonographic criteria is solely sufficient to diagnose placental adherence defects, however they assist in the diagnostic process.
    Ginekologia polska 03/2013; 84(3):186-92. · 0.79 Impact Factor
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    ABSTRACT: The aim of this study is to compare collection of sufficient material and diagnostic accuracy of Pipelle biopsy with curettage and hysterectomy. A total of 82 cases with indications for endometrial biopsy for any reason and in which endometrial biopsy was performed with dilatation and curettage (D&C) and Pipelle aspiration biopsy, and 66 cases in which an indication for hysterectomy was established for any reason were included in the study. Histopathological findings were examined in the following six groups: normal; endometrial polyps; hyperplasia without atypia; hyperplasia with atypia; atrophy; and insufficient material. Descriptive statistical methods and McNemar's test were used. When the histopathological compatibility between Pipelle and D&C was considered (n = 82), a diagnosis that was different from that obtained by D&C was obtained in 22 of the 63 cases (34%), in whom normal endometrial histology was found with a Pipelle biopsy specimen. It was observed that only 1 of 13 cases of endometrial polyps was diagnosed with Pipelle biopsy. Insufficient material was obtained in six cases (7%) with Pipelle biopsies and three cases (4%) with D&C. While Pipelle biopsies and D&C have a nearly equal level of success in widespread endometrial lesions, Pipelle biopsies provide limited diagnostic accuracy in cases with focal pathologies.
    Journal of Obstetrics and Gynaecology 11/2012; 32(8):790-4. · 0.55 Impact Factor
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    ABSTRACT: Nomogram accuracies for predicting non-sentinel lymph node (SLN) involvement vary between different patient populations. Our aim is to put these nomograms to test on our patient population and determine our individual predictive parameters affecting SLN and non-SLN involvement. Data from 932 patients was analyzed. Nomogram values were calculated for each patient utilizing MSKCC, Tenon, and MHDF models. Moreover, using our own patient- and tumor-depended parameters, we established a unique predictivity formula for SLN and non-SLN involvement. The calculated area under the curve (AUC) values for MSKCC, Tenon, and MHDF models were 0.727 (95% confidence interval (CI) 0.64-0.8), 0.665 (95% CI 0.59-0.73), and 0.696 (95% CI 0.59-0.79), respectively. Cerb-2 positivity (p = 0.004) and size of the metastasis in the lymph node (p = 0.006) were found to correlate with non-SLN involvement in our study group. The AUC value of the predictivity formula established using these parameters was 0.722 (95% CI 0.63-0.81). The most accurate nomogram for our patient group was the MSKCC nomogram. Our unique predictivity formula proved to be as equally effective and competent as the MSKCC nomogram. However, similar to other nomograms, our predictivity formula requires future validation studies.
    Breast Care 10/2012; 7(5):397-402. · 0.68 Impact Factor
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    ABSTRACT: PURPOSE: To determine the frequency by which breast magnetic resonance imaging (MRI) provides information that influences the surgical management of patients with breast cancer. MATERIALS AND METHODS: From August 2006 to December 2008, contrast-enhanced bilateral breast MRI was performed on 68 patients, all of whom exhibited highly suspicious imaging findings (BI-RADS category 4 or 5). Patients were grouped according to their histopathological diagnosis and type of breast parenchyma. All of the enrolled patients were believed to be candidates for breast conservation on the basis of physical examination, mammography, and ultrasonography. The patients were reevaluated with the MRI examination as to whether they were still candidates for breast conservation therapy. RESULTS: The MRI findings changed the previous management plans in 19.1% of the 68 patients. With respect to the surgical approach, no statistically significant difference was observed between the histopathology groups (P = 0.403). In terms of the breast parenchymal pattern, however, surgical planning was changed in 53.8% of the patients who exhibited a dense pattern, which was significantly different from the rates of the other groups (P = 0.006). The sensitivity, specificity, positive predictive value, and negative predictive value of the MRI for additional malignant lesion detection and identification were 85%, 98%, 92%, and 96%, respectively. The agreement test revealed 86% agreement (very good) between the additional findings observed on the MRI and the histopathological results. CONCLUSION: If breast-conserving surgery is planned, an MRI should be performed in all women with suspected breast cancer, especially those exhibiting dense or heterogeneously dense breast parenchyma, for which the sensitivity of both ultrasonography and mammography is low.
    Diagnostic and interventional radiology (Ankara, Turkey) 05/2012; · 1.03 Impact Factor
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    ABSTRACT: To investigate the decisive role of preoperative serum thrombopoietin levels in the discrimination of benign and malignant ovarian pathologies and its value in the evaluation of treatment response. Fifty patients with diagnoses of adnexal masses (25 benign, 25 malignant) were included in the study. Blood samples were collected from all cases preoperatively. Age, menopausal status, adnexal mass size, preoperative CA-125 level, platelet count, the stage of the disease (FIGO stage), tumor grade, histologic subgroup, the residual tumor mass, ascites cytology, surgical procedures, and postoperative treatments were recorded for the malignant group. Response to treatment was evaluated based on the revised RECIST guideline. The preoperative serum thrombopoietin levels of the malignant cases (median, 98; range, 7 to 768) were significantly higher when compared with those of benign cases (median, 27; range, 13 to 131; p=0.004). The positive predictive value of CA-125 was found to be 79%, when it was used as a single marker; however it had risen to 85% when both CA-125 and thrombopoietin levels were used. There was no significant relationship between preoperative serum thrombopoietin levels and tumor grade, ascites cytology, presence of residual mass, and response to treatment. The preoperative serum thrombopoietin levels were significantly higher in stage III-IV cases and cases with serous histology. The post-treatment serum thrombopoietin levels in the malignant group were significantly lower as compared with the preoperative thrombopoietin levels. Thrombopoietin can play an additive role for prediction of ovarian cancer.
    Journal of Gynecologic Oncology 04/2012; 23(2):86-90. · 1.73 Impact Factor
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    ABSTRACT: Endometrial intraepithelial neoplasia (EIN) applies specific diagnostic criteria to designate a monoclonal endometrial preinvasive glandular proliferation known from previous studies to confer a 45-fold increased risk for endometrial cancer. In this international study we estimate accuracy and precision of EIN diagnosis among 20 reviewing pathologists in different practice environments, and with differing levels of experience and training. Sixty-two endometrial biopsies diagnosed as benign, EIN, or adenocarcinoma by consensus of two expert subspecialty pathologists were used as a reference comparison to assess diagnostic accuracy of 20 reviewing pathologists. Interobserver reproducibility among the 20 reviewers provided a measure of diagnostic precision. Before evaluating cases, observers were self-trained by reviewing published textbook and/or online EIN diagnostic guidelines. Demographics of the reviewing pathologists, and their impressions regarding implementation of EIN terminology were recorded. Seventy-nine percent of the 20 reviewing pathologists' diagnoses were exactly concordant with the expert consensus (accuracy). The interobserver weighted κ values of 3-class EIN scheme (benign, EIN, carcinoma) diagnoses between expert consensus and each of reviewing pathologists averaged 0.72 (reproducibility, or precision). Reviewing pathologists demonstrated one of three diagnostic styles, which varied in the repertoire of diagnoses commonly used, and their nonrandom response to potentially confounding diagnostic features such as endometrial polyp, altered differentiation, background hormonal effects, and technically poor preparations. EIN diagnostic strategies can be learned and implemented from standard teaching materials with a high degree of reproducibility, but is impacted by the personal diagnostic style of each pathologist in responding to potential diagnostic confounders.
    Modern Pathology 02/2012; 25(6):877-84. · 5.25 Impact Factor
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    ABSTRACT: Aberrant breast tissue is an anomaly in the embryogenesis of the breast that is found along the mammary ridge or out of that line. We report a case of a 71-year-old female patient with an abdominal aberrant breast tissue found incidentally in a piece of mesenteric biopsy. The histological features were consistent with breast tissue.
    Case Reports in Medicine 01/2012; 2012:943102.
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    ABSTRACT: SUMMARY. This study focused on developing in situ gel formulations of miconazole nitrate with poloxamer 188 and 407 for treatment of mucosal candidiasis. In situ gel formulations were prepared and gelation temperature, rheological, mechanical and mucoadhesive properties, syringeability and release profiles were evaluated. Based on their suitable gelation temperature properties, formulations containing the poloxamer (Plx) 407 and 188 in ratios of 15:15 (F1), 15:20 (F2) and 20:10 (F3) were chosen for further studies. F3 exhibited typical gel-type mechanical spectra at 37 °C whereas F1 and F2 behaved like weakly cross-linked gels. Texture profile analysis demonstrated that F3 showed the highest cohesiveness, adhesiveness, hardness and compressibility. According to the these results, F3 was chosen for in vivo studies and it was shown that it is effective for the treatment of the vaginal candidiasis. Histopathologic evaluation also supported the effectiveness of the formulation. As a result, in situ gel formulations prepared with Plx 407 and 188 mixture of miconazole nitrate proved to be a promising alternative dosage form for treatment of mucosal candidiasis.
    LATIN AMERICAN JOURNAL OF PHARMACY 01/2012; 31(6):821-9. · 0.24 Impact Factor
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    ABSTRACT: This study describes the in-situ gelling of econazole nitrate containing thermosensitive polymers composed of poloxamer 407 and 188 as a novel treatment platform for vaginal candidiasis. Aqueous thermosensitive formulations containing 1% of econazole nitrate and poloxamer 407 and/or 188 were prepared and their rheological, mechanical and drug-release properties determined at 20 ± 0.1°C and/or 37 ± 0.1°C. Based on their biologically suitable thermorheological properties, formulations containing the mixtures of poloxamer 407 and 188 in ratios of 15:15 (F1), 15:20 (F2) and 20:10 (F3) were chosen for comprehensive analysis. Formulations based on F3 exhibited typical gel-type mechanical spectra (G' > G″) at 37°C whereas formulations based on F1 and F2 exhibited properties akin to weakly cross-linked gels. Texture profile analysis demonstrated that F3 showed the highest cohesiveness, adhesiveness, hardness and compressibility. No statistically significant differences (P > 0.5) were observed in the release of econazole nitrate from the formulations at pH 4.5, which in all cases followed anomalous diffusion kinetics. Formulations based on 20% poloxamer 407:10% poloxamer 188 were chosen for in-vivo studies and were shown to be effective for the treatment of the vaginal candidiasis. Histopathologic evaluation also supported the effectiveness of the thermosensitive formulation administered intravaginally. By careful engineering of the rheological properties, in-situ thermosensitive gel formulations of econazole nitrate were prepared and were shown to be efficacious in the treatment of vaginal candidiasis.
    The Journal of pharmacy and pharmacology. 10/2011; 63(10):1274-82.
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    ABSTRACT: Borderline paratubal cysts are rare entities. These tumors are identified as epithelial proliferation without stromal invasion. A 19-year-old virgin patient was admitted to our clinic with abdominal pain and nausea. The sonographic evaluation showed a left adnexal mass 89 × 80 mm in diameter with solid tissue projections. Doppler examination revealed no significant blood supply. At surgery, a torsed left paratubal cyst 10 cm in diameter and normal bilateral ovaries were encountered. Cystectomy was performed and of frozen section revealed a borderline Fallopian tube neoplasm. Final pathology review was reported as a serous borderline paratubal tumor. The evaluation of the structure of cyst by ultrasound and the performance of intraoperative frozen section analysis are two important issues to diagnose the nature of a cyst. Fertility-sparing surgery is the main point of management.
    Journal of pediatric and adolescent gynecology 07/2011; 24(5):e115-6. · 0.90 Impact Factor
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    ABSTRACT: The aim of this study was to determine the markers of prognosis in metastatic inflammatory breast cancer (IBC). The prognostic value of patients' clinical characteristics and expression of c-erbB-2, p53, Ki-67, ER and PgR were assessed in the 45 patients with IBC who had developed distant metastasis. Immunohistochemical methods were used to detect the expression of c-erbB-2, p53, Ki-67, ER and PgR in surgical resection specimens of the patients' primary tumor. The median overall survival (OS) measured from the diagnosis of metastatic disease was 23 months. In the univariate analysis, p53 protein accumulation and the presence of visceral metastasis were predictive of poor survival (p = 0.01 and 0.003, respectively). In the multivariate analysis, accumulation of p53 protein and the presence of visceral metastasis correlated with OS (p = 0.02 and 0.008, respectively). In metastatic IBC, accumulation of p53 protein and presence of visceral metastasis are independent prognostic factors for OS. Established prognostic factors in non-IBC patients such as patient age, histologic grade, hormone receptor status and c-erbB-2 status did not have independent significance in IBC in this study.
    Medical Principles and Practice 01/2011; 20(2):159-64. · 0.96 Impact Factor
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    ABSTRACT: Inhibitors of tumor angiogenesis and metastasis are emerging as important new drug candidates for cancer therapy. Galectin-3 and heparanase have been shown to function in tumor progression and metastatic spread. Both of them exert pleiotropic effects; proliferation, cell migration, differentiation and tissue remodeling. The aim of this study was to investigate heparanase and galectin-3 expression in endometrioid and serous carcinomas of the endometrium and their relation with well-known prognostic factors, in addition to estrogen, progesterone, C-erbB-2, Ki-67 and p53. Sixty-four endometrial cancers, which include 24 serous types, were obtained from previously untreated patients. Immunohistochemical analysis of 64 carcinomas, 20 endometrial hyperplasia (ten of simple hyperplasia and ten of complex atypic hyperplasia) and 20 normal endometrium (ten of proliferative and ten of secretory) was performed. This investigation suggests that the decreased expression of galectin-3 may be involved in the pathogenesis of endometrial carcinomas from normal endometrium to carcinoma. Also down-regulated stromal expression of galectin-3 in endometrial carcinoma may be involved in lymph node metastasis. Further studies on a larger advanced stage (FIGO stage 3-4) endometrial carcinoma group may determine the value of heparanase in the endometrial carcinoma.
    Archives of Gynecology 12/2010; 284(5):1231-9. · 0.91 Impact Factor
  • Osman Zekioglu, N Ozdemir, C Terek, A Ozsaran, Y Dikmen
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    ABSTRACT: Sclerosing stromal tumours (SST) of the ovary are rare, benign tumours. SSTs are usually hormone inactive and tend to occur in the second and third decades of life. The most common clinical symptom is menstrual irregularity. Fourteen women diagnosed with SST of the ovary were included in this study. Tumour samples were collected, embedded in paraffin and stained with haematoxylin and eosin, periodic acid-Schiff (PAS), and PAS with digestion, as well as immunohistochemically for vimentin, smooth muscle actin, desmin, CD 99, inhibin-α and the oestrogen and progesterone receptor. The age of the patients ranged from 16 to 54 years (mean age 25.2 years). The tumours ranged in size from 6 to 21 cm (mean 10.5 cm). Macroscopically, eight tumours were solid and six were solid and cystic. All SSTs were well circumscribed with pseudolobule formation. Spindle-shaped fibroblast-like cells and vacuolated theca-like cells were prominent. Blood vessels exhibited a hemangiopericytomatous pattern and boomerang-like features. Immunohistochemical results were as follows: vimentin, 14/14 cases positive; smooth muscle actin, 14/14 cases positive; desmin, 14/14 cases positive; CD 99, 4/14 cases positive; inhibin-α, 14/14 cases positive; oestrogen receptor, 0/14 cases positive; progesterone receptor, 2/14 cases positive. The characteristic histopathological features we observed in our study are usually adequate for the diagnosis of SSTs. Although inhibin-α, CD 99 and desmin staining may be a useful and reliable tool for SST diagnosis in problematic cases, an immunohistochemical panel will not discriminate from other tumours in the sex cord-stromal group.
    Archives of Gynecology 02/2010; 282(6):671-6. · 0.91 Impact Factor
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    ABSTRACT: To evaluate the loop electrosurgical excisional procedure (LEEP) which is performed to treat high-grade cervical intraepithelial lesions (HGSIL). Twenty-one cases diagnosed as LGSIL and HGSIL after histopathological examination were included in the study among patients who had cervical colposcopy-directed biopsies after an abnormal cytology report at Ege University School of Medicine, Obstetrics and Gynecology Department between the years of 2007 and 2009. The patients underwent LEEP or LEEP-cone procedures. The patients with cervical smear results of ten ASCUS, eight LGSIL, and three HGSIL underwent colposcopy-guided punch biopsies. Those with the result of CIN 1 and CIN 2 underwent LEEP or LEEP-cone procedures. Pathologic examination correlated with biopsy results and surgical margins were all negative. All patients were followed-up with cervical cytology. LEEP and LEEP-cone procedures are therapeutic procedures in cervical intraepithelial lesions.
    European journal of gynaecological oncology 01/2010; 31(5):562-3. · 0.58 Impact Factor
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    ABSTRACT: Adenomyosis is defined by the presence of endometrial tissue (glands and stroma) within the myometrium and malignant transformation of adenomyosis in premenopausal women with normal endometrium is extremely rare. Adenocarcinomas arising within adenomyosis need to be distinguished from endometrial carcinomas which arise from the eutopic endometrium, then extend into preexisting adenomyosis of the uterine wall. We report a case of grade 2 endometrioid adenocarcinoma arising from an adenomyotic focus in the uterus.
    European journal of gynaecological oncology 01/2010; 31(6):719-21. · 0.58 Impact Factor
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    ABSTRACT: Ovarian cancer which is the most common cause of death among all gynecological malignancies tends to metastasize through peritoneal cavity. Skin metastasis, however, is a very rare clinical entity and related with poor prognosis. We report a 43-year-old patient with recurrent ovarian cancer presented with extensive abdominal skin metastasis approximately 6 years after the initial diagnosis. Patient was treated with radiotherapy with electrons to a total dose of 37.5 Gy given in 2.5 Gy per fraction per day. Skin metastasis showed good response to radiotherapy, and the patient has been alive for 7 months after radiotherapy with no recurrences on abdominal skin. Radiotherapy might be considered as an efficient palliative treatment option for the skin metastasis of ovarian cancer.
    Medical Oncology 07/2009; 27(3):628-31. · 2.14 Impact Factor

Publication Stats

430 Citations
88.16 Total Impact Points

Institutions

  • 2001–2014
    • Ege University
      • • Department of Obstetrics and Gynecology
      • • Department of Pathology
      • • Faculty of Medicine
      • • Family Planning Infertility Research and Treatment Center
      Ismir, İzmir, Turkey
  • 2012
    • Kocaeli Derince Eğitim ve Araştırma Hastanesi
      Yaremdji, Kocaeli, Turkey
    • Hacettepe University
      • Department of Pathology
      Ankara, Ankara, Turkey
  • 2008–2009
    • Pamukkale University
      • Department of Pathology
      Denisli, Denizli, Turkey
  • 2005–2009
    • Celal Bayar Üniversitesi
      • Department of Surgery
      Saruhan, Manisa, Turkey
  • 2004
    • Dr. Zekai Tahir Burak Women's Health Research and Education Hospital
      Engüri, Ankara, Turkey