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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/3
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Publication Metadata only The effect of earthquake experience on pregnancy outcomes: a systematic review and meta-analysis(Elsevier, 2023) Aktoz, Fatih; Gunes, Ali Can; Yakın, Kayhan; School of MedicineObjectives: Pregnant women are vulnerable to the health consequences of earthquakes, experiencing stress and limited access to healthcare. Despite the widespread impact of these events, knowledge about their effects on pregnancy outcomes is scarce and inconsistent. This systematic review and meta-analysis aimed to evaluate the available evidence, estimate the overall effect, and identify key research gaps about earthquake on pregnant women. Study Design: A comprehensive search of English-language peer-reviewed articles was conducted using PubMed and Web of Science Core Collection. Various combinations of keywords related to earthquakes and pregnancy outcomes were used. Studies comparing quantitative data on pregnancy outcomes between earthquake-affected and unaffected pregnant women were included. Random and fixed-effects models were used to estimate the pooled effect size. Results: The meta-analysis revealed no significant difference in preterm delivery rates (OR: 1.18; 95 % CI: 0.94-1.47; I2 = 75 %; five studies, 26,365 women) and low birth weight (LBW) infant delivery rates (OR: 1.19; 95 % CI: 0.83-1.71; I2 = 72 %; three studies, 16,127 women) between the earthquake-affected and control groups. However, a statistically significant increase in small-for-gestational-age (SGA) infants was observed in the earthquake-affected group (OR: 1.25; 95 % CI: 1.08-1.43; I2 = 0 %; two studies, 10,238 women). Data on miscarriage and stillbirth rates were not suitable for meta-analysis. Conclusions: Limited evidence suggests that exposure to earthquakes may be associated with adverse pregnancy outcomes. Further studies are needed to confirm the increased risk of SGA in the affected population and to inform disaster management plans by enhancing our understanding of the adversities associated with earthquake exposure through more comprehensive epidemiologic research.Publication Metadata only A systematic review of uterine cervical elongation and meta-analysis of Manchester repair(ELSEVIER, 2024) Aktoz, Fatih; Çekiç, Sebile Güler; Urman, Cumhur Bülent; Aydın, Serdar; School of Medicine; Koç University HospitalObjective: This review aims to consolidate current research on cervical elongation, a common but often overlooked complication in pelvic organ prolapse and hysteropexy procedures. It seeks to define, diagnose, and manage cervical elongation, aiming to establish standardized criteria and strategies to enhance clinical outcomes for this condition. Data Sources: A comprehensive search of the PubMed/MEDLINE, Cochrane Library, and Web of Science databases was executed utilizing the keywords: "cervical elongation," "long cervix uteri," "Manchester," and "cervical amputation". Data were gathered and organized in an Excel spreadsheet, with the analysis conducted according to each category, methodology, or reference range. Study Eligibility Criteria: All types of study designs with full-text availability, including randomized controlled trials, cohort studies, case-control studies, case reports, and systematic reviews, were considered for inclusion. Included studies were fully accessible in English and focused on the topic of interest. Exclusions were made for studies addressing cervical elongation not pertinent to pelvic organ prolapse, and publications such as secondary analyses, case reports, literature reviews, and opinion papers. Results: Out of 108 relevant studies, only 63 defined their inclusion criteria; of these, 57 were utilized for the narrative review and 8 were used in a meta-analysis comparing the Manchester operation with vaginal hysterectomy. Magnetic Resonance Imaging offers the highest sensitivity in measuring cervical elongation, its practical limitations and high cost necessitate the use of the more feasible Pelvic Organ Prolapse Quantification System (POP-Q), particularly effective for stage 2 and 3 prolapse cases. The POP-Q point C emerges as a pivotal marker for identifying cervical elongation, with specific measurements indicating the condition's presence. The Manchester-Fothergill procedure presents a viable management option for isolated cervical elongation, showing fewer complications and comparable recurrence rates to vaginal hysterectomy. Conclusion: This review highlights the diagnostic and definitional diversity of cervical elongation within populations experiencing pelvic organ prolapse. It emphasizes the critical role of preoperative cervical evaluation, particularly in patients with uterine descensus for selecting the most appropriate surgical intervention.Publication Metadata only The impact of endometriosis and its treatment on ovarian reserve(Georg Thieme Verlag KG, 2015) Seyhan, Ayşe; Uncu, Gürkan; N/A; Ata, Mustafa Barış; Faculty Member; School of Medicine; 232576Endometriosis is a chronic disease mostly affecting women at reproductive age. There is a clear association between endometriosis and infertility; however, exact mechanisms are unknown. Some evidence suggests an adverse effect on oocytes. Endometriosis and its surgical treatment can affect quantitative ovarian reserve as well. In the presence of endometriomas, serum level of anti-Müllerian hormone (AMH) seems a more reliable marker of ovarian reserve than antral follicle count. Women with endometrioma have decreased serum AMH levels as compared with healthy controls. This is further declined after surgical excision, and the decline seems permanent. Bipolar cauterization of the ovary seems to be playing a role on ovarian damage. Extraovarian endometriosis and its surgical treatment can also be associated with decreased ovarian reserve, but there is limited information. Patients with endometriosis should be informed about fertility preservation options, especially in the presence of bilateral endometriomas or prior to surgery.Publication Metadata only Recombinant anti-Mullerian hormone treatment attenuates primordial follicle loss after ovarian cryopreservation and transplantation(Springer, 2023) Celik, Soner; Ozkavukcu, Sinan; N/A; Özenci, Çiler Çelik; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; 127168Purpose The foremost drawback of ovarian tissue cryopreservation and re-transplantation (OTCT) technique is the rapid loss of the primordial follicle (PF) pool. In recent studies, we have demonstrated that post-transplantation burnout of the PFs occurs due to the altered expression of the activatory and inhibitory proteins that control PF reserve, and rapamycin prevented it. Methods Here, we investigated whether anti-Mullerian hormone administration in the bilateral oophorectomy and transplantation group and internal AMH in the unilateral oophorectomy and transplantation group protect follicle reserve by regulating the expression of the molecules that control follicle growth after OTCT in mice. Results After 14 days of OTCT, PF reserve is significantly reduced in both unilateral oophorectomy and transplantation and bilateral oophorectomy and transplantation groups, while anti-Mullerian hormone treatment attenuates PF loss after bilateral oophorectomy and transplantation. The expression of KitL, Bmp-15, and p27 decreased after unilateral oophorectomy and transplantation and bilateral oophorectomy and transplantation, yet recombinant anti-Mullerian hormone treatment did not restore the expression of these proteins in the BLO-T group. Conclusion Exogenous recombinant anti-Mullerian hormone administration in the BLO-T group preserved the expressions of Tsc1 and Gdf-9 in PF and p-s6k and Gdf-9 in growing follicles after OTCT. Nonetheless, recombinant anti-Mullerian hormone administration did not affect granulosa cell proliferation and death rates in the growing follicles. These findings suggest a novel hormonal replacement strategy for fertility preservation by restoring anti-Mullerian hormone to regulate Tsc1 and p-s6k, thereby linking this hormone with the mTOR pathway and Gdf-9 signaling.Publication Metadata only hCG ımproves luteal function and promotes progesterone output through the activation of JNK pathway in the luteal granulosa cells of the stimulated IVF cycles(Oxford Univ Press Inc, 2020) N/A; Bildik, Gamze; Akın, Nazlı; Esmaeilian, Yashar; Hela, Francesko; Yakın, Kayhan; Önder, Tamer Tevfik; Urman, Cumhur Bülent; Öktem, Özgür; Teaching Faculty; Master Student; Researcher; PhD Student; Faculty Member; Faculty Member; Faculty Member; Faculty Member; School of Medicine; Graduate School of Health Sciences; N/A; Graduate School of Health Sciences; School of Medicine; School of Medicine; School of Medicine; School of Medicine; N/A; N/A; N/A; N/A; 106822; 42946; 12147; 102627Human chorionic gonadotropin (hCG) is a luteotropic hormone that promotes the survival and steroidogenic activity of corpus luteum (CL) by acting through luteinizing hormone receptors (LHRs) expressed on luteinized theca and granulosa cells (GCs). Therefore, it is used to support luteal phase in in vitro fertilization (IVF) cycles to improve clinical pregnancy rates and prevent miscarriage. However, the molecular mechanism underlying this action of hCG is not well characterized. To address this question, we designed an in vitro translational research study on the luteal GCs obtained from 58 IVF patients. hCG treatment at different concentrations and time points activated c-Jun N-terminal kinase (JNK) pathway and significantly increased its endogenous kinase activity along with upregulated expression of steroidogenic enzymes (steroidogenic acute regulatory protein (stAR), 3β-Hydroxysteroid dehydrogenase (3β-HSD)) in a dose-dependent manner in the luteal GCs. As a result, in vitro P production of the cells was significantly enhanced after hCG. When JNK pathway was inhibited pharmacologically or knocked-down with small interfering RNA luteal function was compromised, P4 production was declined along with the expression of stAR and 3β-HSD in the cells. Further, hCG treatment after JNK inhibition failed to correct the luteal defect and promote P4 output. Similar to hCG, luteinizing hormone (LH) treatment improved luteal function as well and this action of LH was associated with JNK activation in the luteal GCs. These findings could be important from the perspective of CL biology and luteal phase in human because we for the first time identify a critical role for JNK signaling pathway downstream LHR activation by hCG/LH in luteal GCs.Publication Metadata only Altered expression of Notch signaling, Tlr receptors, and surfactant protein expression after prostaglandin inhibition may be associated with the delayed labor in LPS-induced mice(Springer/Plenum Publishers, 2022) Avcı, Sema; Kuşçu, Nilay; Durkut, Begüm; Kılınç, Leyla; Üstünel, İsmail; N/A; Özenci, Çiler Çelik; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; 127168Purpose This study aims to investigate whether indomethacin (IND) delays preterm birth by regulating the Notch pathway, Tlr receptors, and Sp-A in the placenta in lipopolysaccharide (LPS)-induced preterm labor (PTL) model. Methods CD-1 mice were distributed to the pregnant control (PC), Sham, PBS, IND (2 mg/kg; i.p.), LPS (25 mu g/100 mu l; intrauterine), and LPS + IND groups. The injections were performed on day 14.5 of pregnancy. Placentae were collected on day 15.5 of pregnancy, and immunohistochemical analyzes were performed. Differences in staining intensities between the Cox-1, Notch-1 (N1), Dll-1, Jagged-2 (Jag-2), Tlr-2, and Tlr-4 proteins were compared. Results Preterm labor rates were 100% and 66% (preterm delivery delayed 5 h) in the LPS and LPS + IND groups, respectively. In LPS-treated mice, a general morphological deterioration was observed in the placenta. Total placental mid-sagittal measurement was significantly reduced in the LPS-treated group, while it was similar to the PC group in the LPS + IND group. Cox-1 expression in the LZ increased, and Sp-A expression decreased after LPS injection, and IND administration diminished this increase. N1 expression increased in the labyrinth zone (LZ) and the junctional zone (JZ). Dll-1 and Jag-2 expression increased in the JZ after LPS injection (p < 0.0001). IND administration diminished Tlr-2 expression in the LZ and Tlr-4 expression in the JZ after LPS injection. Conclusion In conclusion, PG (prostaglandin) inhibition may alter Notch signaling, Tlr, and Sp-A protein expression and may be associated with delayed labor in LPS-induced mice.Publication Metadata only Cytotoxicity and mitogenicity assays with real-time and label-free monitoring of human granulosa cells with an impedance-based signal processing technology intergrating micro-electronics and cell biology(Pergamon-Elsevier Science Ltd, 2016) Yakar, Feridun; Güzel, Yılmaz; Balaban, Başak; Iwase, Akira; N/A; Öktem, Özgür; Bildik, Gamze; Şenbabaoğlu, Filiz; Lack, Nathan Alan; Akın, Nazlı; Urman, Defne; Urman, Cumhur Bülent; Faculty Member; Teaching Faculty; PhD Student; Faculty Member; Master Student; Master Student; Faculty Member; School of Medicine; School of Medicine; Graduate School of Health Sciences; School of Medicine; Graduate School of Health Sciences; Graduate School of Health Sciences; School of Medicine; 102627; N/A; N/A; 120842; N/A; N/A; 12147A recently developed technology (xCelligence) integrating micro-electronics and cell biology allows real-time, uninterrupted and quantitative analysis of cell proliferation, viability and cytotoxicity by measuring the electrical impedance of the cell population in the wells without using any labeling agent. In this study we investigated if this system is a suitable model to analyze the effects of mitogenic (FSH) and cytotoxic (chemotherapy) agents with different toxicity profiles on human granulosa cells in comparison to conventional methods of assessing cell viability, DNA damage, apoptosis and steroidogenesis. The system generated the real-time growth curves of the cells, and determined their doubling times, mean cell indices and generated dose-response curves after exposure to cytotoxic and mitogenic stimuli. It accurately predicted the gonadotoxicity of the drugs and distinguished less toxic agents (5-FU and paclitaxel) from more toxic ones (cisplatin and cyclophosphamide). This platform can be a useful tool for specific end-point assays in reproductive toxicology.Publication Metadata only Reproductive aspects of systemic lupus erythematosus(Elsevier, 2016) N/A; N/A; Öktem, Özgür; Yağmur, Hande; Bengisu, Hale; Urman, Cumhur Bülent; Faculty Member; Doctor; Doctor; Faculty Member; School of Medicine; N/A; N/A; School of Medicine; N/A; Koç University Hospital; Koç University Hospital; N/A; 102627; N/A; N/A; 12147Systemic lupus erythematosus (SLE) is an auto-immune systemic disease showing a strong predilection for women of reproductive age. Higher prevalance of SLE among young women are in part accounted for by the effects of estrogen hormone on immune system. The key pathophysiological features of this disease are the generation of autoantibodies and the deposition of antibody-antigen complexes in the basal membranes of the organs where they evoke inflammatory responses and injury. Young females diagnosed with SLE are more prone to developing a multitude of adverse reproductive and obstetric outcomes, especially in the presence of active disease. Our motivation in writing this review article is to outline the recent interesting findings of molecular and clinical studies showing multi-faceted roles of estrogen hormone in both normal immune function and auto-immunity and to provide an update on the ovarian function and other poor reproductive outcomes in young females with SLE.