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    Evolution of microbial ecology: A rare multidrug-resistant (Enterobacter Cloacae) surgical wound infection after cesarean delivery: Our experience of 5946 cesarean deliveries
    (2020) Bayramoglu, Zeynep; Okuyan, Erhan; Yoldas, Adem; Tay, Hayrettin
    To demonstrate the rapidly changing multidrug-resistant microbial environment and its challenges from the viewpoint of microbiologists, pathologists, and obstetricians.In our research; upon our encounter with a rare multidrug resistance wound infection following a cesarean section; we retrospectively analyzed 5946 cesarean sections performed in our clinic between 2017- 2019. Of the 5946 patients, 978 (16.44%) were literate and 4968 (%83.56) were illiterate. The average age of our patients is 23.44 and their average weight is 78.35 kg. The number of patients taken to emergency cesarean was 954, and 4992 of our patients were operated due to recurrent cesarean section. The number of patients operated under general anesthesia was 347, and 5599 patients received spinal anesthesia. In 2 years, 5946 patients had surgical site infection in 23 (0.39%) patients. Only one of our patients had multidrug-resistant Enterobacter Cloacae. None of our patients with surgical site infection had maternal mortality. Drug-resistant bacterial infection increases hospital stay, healthcare costs, and mortality, and for all nations, this problem is growing exponentially. Nowadays, understanding the multifactorial genetic basis of multidrug resistance should investigate genetic signatures in invasive infection.
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    Our sentinel lymph node experience in patients diagnosed with DCIS and microinvasive breast carcinoma
    (2021) Bayramoglu, Zeynep; Omeroglu, Ethem; Koksal, Hande; Eryilmaz, Mehmet Ali; Unlu, Yasar
    Aim: Along with the increased availability of radiologic imaging methods, early identification of tumor tissue, and patient surveillance programs; ductal carcinoma in situ (DCIS) and microinvasive DCIS became more commonly identified in the tru-cut biopsy specimens and resected samples of patients. Pathological examinations of the excision materials from these patients reveal invasive tumors, microinvasions or DCIS alone. Recently, it has become debatable whether to perform a sentinel lymph node biopsy (SLNB) in patients diagnosed with DCIS or microinvasive DCIS. In this present study, we evaluated the diagnosis made by examining the excision material, any presence of lymph node metastases, and the relationship of hormone profile to the presence of metastases in the patients diagnosed with DCIS or microinvasive DCIS by the examination of tru-cut biopsy specimens. Based on our study results, we discussed the requirement for SLNB in patients with a tru-cut diagnosis of DCIS or microinvasive DCIS. Materials and Methods: The study included 172 patients, who underwent surgical excision and SLNB after receiving a tru-cut biopsy diagnosis of DCIS and microinvasive DCIS in our hospital from the year 2010 to 2018. Results: Tru-cut biopsy diagnoses were DCIS and microinvasive DCIS in 69.8% (120 patients) and 30.2% (52 patients) respectively. SLNB metastases were identified in 35.8% (n=43) of the DCIS positive patients and 44.2% (n=23) in the microinvasive DCIS positive patients. The diagnosis of invasive ductal carcinoma after mastectomy was made at a rate of 90.0% (n=108) among the DCIS positive patients and 92.3% (n=48) among the microinvasive DCIS positive patients. Conclusion: SLNB metastases were found in 35.8% (n=43) and 44.2% (n=23) of the DCIS positive patients and microinvasive DCIS positive patients, respectively. We conclude that SLNB should be favorably proper to perform in the patients with tru-cut diagnoses of DCIS and microinvasive DCIS because a high rate of SLNB metastases was detected in our DCIS and microinvasive DCIS patients and a high rate of invasive ductal carcinoma diagnosis was made after examining the excision material of these patients.
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    Safe, easily applicable mini-laparotomic surgical steps in cornual ectopic pregnancy: Case report and demonstration of surgical technique
    (2020) Okuyan, Erhan; Altundal, Caglar; Bayramoglu, Zeynep
    In the management of rare cornual ectopic pregnancy, there is no consensus on surgical treatment modalities in obstetric practice. In this article, we aimed to describe the safe and easily applicable minilaparotomic surgical steps with black pencil drawings. A 5-centimeter-size of Pfannenstiel incision was made to enter the abdomen with sterile covering under operating room conditions. After evaluating the topographic anatomy of the uterus and adnexa, a window was opened just below the ligamentum ovarii proprium and skeletonization of the cornual ectopic pregnancy was achieved. Then, ligamentum ovarii proprium was ligated and cut by using 1.0 vicryl and U sutures were placed in 3 planes after skeletalization of cornual ectopic pregnancy mass. After cornuotomy was performed and the pregnancy material was removed the uterine myometrium layer and serosa were closed separately with baseball stitches. Total operation time was 20 minutes, perioperative blood loss was recorded as 50 ccs/dl and the patient was discharged at 24th hour without any complications. With this surgical technique applied with minilaparotomic incision, fertility-preserving surgery can be performed in a short time without causing excessive blood loss or hysterectomy. Studies involving many cases are needed to prove perioperative and postoperative results of this surgical technique.
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    What GATA-3 told us in breast carcinoma? 2 Years of single tertiary center experience
    (2021) Ugur Kilinc, Ayse Nur; Omeroglu, Ethem; Bayramoglu, Zeynep; Unlu, Yasar
    Aim: Our study aims to find the relationship between the degree of GATA-3 expression in breast cancer and other prognostic factors such as ER, PR, HER-2, Ki67, and axillary metastasis. Materials and Methods: The cases in which GATA-3 immunohistochemical staining was applied to breast cancer tissues between 2018 and 2020 were detected. Immunohistochemically stained preparations of ER, PRG, GATA-3, Ki-67, and HER-2 of these cases were obtained from the hospital archive and evaluated by two pathologists. Results: As a result, GATA-3 was directly proportional to PR and ER and inversely proportional to Ki 67. GATA-3 expression was associated with a higher Ki-67 mitotic index compared to the percentage of ER and PR expression. Conclusion: According to the results of our study, indicating GATA-3 positivity and negativity as well as the degree of expression in the pathology reports of breast tumors will help the clinician in terms of differentiation and prognosis of the tumor. Finally, breast tumors with high GATA-3 loss should be evaluated as more primitive tumors and the patients with these tumors should be followed up more closely.