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Biomedical subjects

E Ekici

Publications and source records attributed to E Ekici.

At least 19 recordsLinked to original sources
PubMed2003

Effects of bupivacaine used with sevoflurane on the rhythm and contractility in the isolated rat heart.

BACKGROUND AND OBJECTIVE: The effects of sevoflurane on bupivacaine cardiotoxicity are mainly attributed to systemic effects. The purpose of this study was to investigate the direct myocardial effects of sevoflurane on bupivacaine toxicity. METHODS: Hearts of 30 Wistar albino rats were isolated and mounted on a Langendorff apparatus perfused by modified Tyrode solution. Experimental groups were: a sevoflurane group (Group S, n = 10)--following baseline and 20 min (Stage 1) recordings, sevoflurane was added in doses of 1.4% (1 MAC) and 2.8% (2 MAC). In the two bupivacaine groups, bupivacaine 5 micromol (Group B5, n = 10) and bupivacaine 10 micromol (Group B10, n = 10) was added to the solution at Stage 1, and sevoflurane was added to the system as in Group S. Haemodynamic variables, i.e. heart rate, PR interval, QRS duration, left ventricular systolic pressure, contractility (+dp/dtmax), relaxation, time to reach peak systolic pressure, change in left ventricular diastolic pressure from baseline, and rate-pressure product were recorded. RESULTS: In Group S, there was no change in cardiac rhythm. In bupivacaine groups, severe rhythm disturbances occurred and both the PR intervals and QRS complexes were prolonged significantly. All contractility variables deteriorated and the rate-pressure product decreased by 67-90% with the addition of bupivacaine. In all groups, 2 MAC sevoflurane lowered +dp/dtmax further. CONCLUSIONS: Sevoflurane does not have any untoward effect on bupivacaine-induced cardiotoxicity in clinically relevant doses in the isolated rat heart.

Anesthetics, Inhalation↗
PubMed2000

Partial hydatidiform mole with diploid karyotype in a live fetus.

Even though most instances of partial mole are triploid, only a few cases of diploid partial moles have been reported. Prognosis of partial mole is usually better than the complete mole as few cases of partial moles progress to persistent trophoblastic disease. However, the nature and the risks of diploid partial moles are not well established and they seem to be a distinct clinical entity. Here we report a case of partial mole presenting with a 22 weeks live fetus and preeclampsia. Fetal blood sampling was performed for cytogenetic analysis which revealed a diploid (46XY) karyotype. No progression to malignant gestational trophoblastic disease occurred.

Adult↗
PubMed1998

Effect of hysterectomy on ovarian blood supply and function.

Ovarian blood supply and function were assessed before and after hysterectomy in 43 patients and 30 healthy subjects (control group). Before the hysterectomy, transvaginal colour Doppler resistance index values of ovarian artery and hormonal levels were measured. Five days and 6 months after operation, all these measurements were repeated and compared with those of a control group. The sole hormone whose serum level decreased on the 5th postoperative day was oestradiol. Serum levels of all the other hormones remained unchanged 5 days and 6 months after the surgical operations. We also did not find any statistically significant difference between the preoperative, the postoperative and the control group resistance index of the ovarian arteries. We propose that the decision whether to preserve or remove the ovaries must be based on assessment of their functional status. Advantages and disadvantages of leaving ovaries intact should be carefully evaluated and the most useful approach applied to each patient on an individual basis.

Journal Article↗
PubMed1998

Anatomic correction in transposition of the great arteries with unusual coronary pattern and side-by-side location.

Switch operation is the treatment of choice in infants with transposition of the great arteries. The anatomic correction restores the left ventricle to its normal systemic function. In complete transposition, however, the diverse spectrum of coronary pattern influences the surgical outcome. We describe a successful arterial switch operation without LeCompte manoeuvre in a neonate with unusual coronary artery anatomy and side-by-side great arteries.

Abnormalities, Multiple↗
PubMed1997

Successful treatment of cornual pregnancy by local injection of methotrexate under laparoscopic and transvaginal ultrasonographic guidance.

This report describes a woman with cornual pregnancy, documented by ultrasonography and laparoscopy, who was successfully treated with two doses of methotrexate under laparoscopic and ultrasonographic guidance. The serum beta human chorionic gonadotropin level was 20,000 mIU/ml and increased to 43,800 mIU/ml after the first methotrexate injection and to 44,400 mIU/ml after second injection and fell precipitously to nonpregnant levels within 27 days. No side effects were experienced by the patient.

Adult↗
PubMed1996

Diagnostic problems in a case with mucometrocolpos, polydactyly, congenital heart disease, and skeletal dysplasia.

Mucometrocolpos is the distention of the uterus and vagina caused by obstruction to the drainage of genital secretions. Although most cases of mucometrocolpos are sporadic, it may be part of an autosomal recessive condition, known as McKusick-Kaufman syndrome (MKS), including postaxial polydactyly and congenital heart disease as main findings. The diagnosis may be difficult when the presence of additional findings creates an overlap with other syndromes. We report on a female infant with mucometrocolpos, postaxial polydactyly, congenital heart disease, short limbs, short ribs, and chest constriction. The clinicopathological findings are described and discussed in the context of the phenotypic spectrums of MKS and mucometrocolpos concomitant with Ellis van Creveld syndrome.

Abnormalities, Multiple↗
PubMed1996

Causative factors in first trimester abortion failure.

OBJECTIVE: To evaluate the main contributors to failed first trimester abortions. PATIENTS AND DESIGN: Forty-two cases of unintentional continued pregnancy were detected among 23,000 termination procedures performed between 1989 and 1995. The patients were diagnosed either at follow-up visits or at the time of operation due to abnormal pelvic findings or discrepancy between the expected and obtained tissue. RESULTS: The failure rate was found to be 0.18%. Among the patients with failed abortion 8 patients had unsuspected anomalies; two of these patients conceived with an intrauterine device in position; 7 patients had uterine malposition (2 markedly anteverted and 5 markedly retroverted), and 2 patients had leiomyomas. No genital disorder was identified in the remaining 25 women. Among these 25 women, 10 had gestations beyond 8 weeks, for which suction curettage followed by sharp curettage was performed. Among the remaining 15 in whom only suction curettage was used for termination, 13 had less than 6 weeks of gestation at the time of pregnancy termination. CONCLUSION: When a termination fails, when scanty tissue is obtained, or when doubt exists about the termination, an extrauterine pregnancy must be ruled out and other causes of termination failure should be considered such as technical failure, uterine anomaly, or malposition.

Abortion, Induced↗
PubMed1996

Transvaginal sonographic diagnosis of ovarian endometrioma.

OBJECTIVE: To assess the efficacy of transvaginal sonography (TVS) in differentiating endometriomas from other adnexal masses. METHODS: One thousand thirty-five adnexal masses undergoing laparoscopy or laparotomy were evaluated prospectively using TVS. Masses diagnosed as endometrioma according to their sonographic appearance were divided into two groups: those with a round shape, regular margins, thick walls and homogeneous, low-level echoes (group A); or those with irregular margins, internal septations and an anechoic appearance (group B). RESULTS: The sensitivity of TVS in diagnosing endometriomas was 86.50% and the specificity 99.11%. The positive predictive value (PPV) and the negative predictive value of the test were calculated to be 91.45% and 98.14%, respectively. By using the criteria determining group A, the PPV of the test increased to 97%, whereas group B had a lower PPV (70.85%). CONCLUSION: We propose that the accuracy of TVS in diagnosing endometriomas may be beneficial in various clinical conditions.

Adnexal Diseases↗
PubMed1996

Hyperreactio luteinalis masquerading as an ovarian neoplasm in a triplet pregnancy.

Hyperreactio luteinalis is a non-neoplastic tumor-like ovarian lesion associated with pregnancy. Most patients are asymptomatic, with the ovarian enlargement being incidentally discovered at the time of cesarean section. It can simulate a neoplasm on clinical, gross and sometimes microscopic examination. We report a case of hyperreactio luteinalis in a patient, who was diagnosed as having polycystic ovary disease before conceiving a triplet pregnancy after three treatment cycles of human menopausal gonadotropin-human chorionic gonadotropin therapy, and discuss its pathogenesis.

Adult↗
PubMed1996

Reverse end-diastolic uterine artery velocity in a pregnant woman complicated by mild preeclampsia and severe growth retardation.

In a pregnant woman with mild preeclampsia and severe intrauterine growth retardation, a reverse end-diastolic flow velocity was detected in both uterine arteries by colour Doppler ultrasound at 30 weeks 4 days of pregnancy. During follow up, both umbilical and internal iliac arteries also showed reverse end-diastolic velocity waveforms and the fetus died in utero at 33 weeks gestation.

Adult↗
PubMed1996

Transvaginal sonographic findings of chronic ectopic pregnancy.

Chronic ectopic pregnancy is not precisely defined in gynecologic and sonographic texts. The diagnosis of this enigmatic clinical condition is frequently not made until laparotomy. In the present retrospective study, we evaluated the transvaginal sonographic findings of cases who were diagnosed as chronic ectopic pregnancy intraoperatively and/or postoperatively. The incidence of chronic ectopic pregnancy was found to be 20.3% (62/305) of all ectopic pregnancies. Of these 62 cases, 55 had transvaginal sonographic examination. On transvaginal sonographic examination, all 55 cases of chronic ectopic pregnancy had a complex adnexal mass with an empty uterus and only 18 (32.7%) had simple fluid in the pelvis/cul-de-sac. In the majority of cases (82.7%, n = 48), there was a non-homogeneous echo pattern within the adnexal mass. Of 55 cases, 30 had color Doppler flow examination, of whom none had color Doppler flow imaging on the wall of the mass or within the mass. There was a negative quantitative beta human chorionic gonadotropin (beta-hCG) assay (i.e. 0 mIU/ml) in only 4 cases. Based on this study, we concluded that chronic ectopic pregnancy is not a rare clinical entity and should be considered in differential diagnosis among patients presenting with an adnexal mass and an overt clinical picture. Transvaginal sonography is sensitive in diagnosing chronic ectopic pregnancy, but not specific. The combined use of transvaginal ultrasonography and beta-hCG assay increases diagnostic accuracy. However, it should be kept in mind that a negative beta-hCG value does not rule out chronic ectopic pregnancy.

Adnexa Uteri↗
PubMed1996

The effects of hormone replacement therapy on uterine fibroids in postmenopausal women.

OBJECTIVE: To evaluate and compare the effects of two different modalities of hormone replacement therapy (HRT) on the size of uterine fibroids. DESIGN: Randomized clinical study. SETTING: The Menopause Center of a public hospital. PATIENTS: Postmenopausal women with small asymptomatic uterine fibroids were selected. INTERVENTIONS: One group was treated with 50 micrograms transdermal E2 plus 5 mg medroxyprogesterone acetate (MPA) continuously, whereas the second group was given 0.625 mg conjugated equine estrogen plus 2.5 mg MPA continuously. MAIN OUTCOME MEASURE: The size of the uterine fibroids was measured before and after the first year of HRT. RESULTS: At the end of the first year on HRT, the size of the uterine fibroids was re-evaluated sonographically and no significant difference was found with the oral group, whereas there was a significant increase in the transdermal group. CONCLUSION: Hormone replacement therapy with 50 micrograms transdermal E2 plus 5 mg MPA increases the size of the uterine fibroids.

Antineoplastic Agents, Hormonal↗
PubMed1996

Chronic ectopic pregnancy: a clinical analysis of 62 cases.

Chronic ectopic pregnancy is a form of tubal pregnancy in which salient minor ruptures or abortions of an ectopic pregnancy instead of a single episode of bleeding, incites an inflammatory response often leading to the formation of a pelvic mass. Its clinical features are often confusing, and laboratory evaluations are often misleading. Surgery for chronic ectopic pregnancy is frequently difficult since chronic inflammatory changes and adhesions distort the normal anatomy. In the present retrospective study, its incidence was found to be 20.3% (n = 62) in a series of 305 ectopic pregnancies. A pelvic mass of varying sonographic appearance, mostly with a nonhomogenous echo pattern, was demonstrated in all 55 patients in whom transvaginal sonographic evaluation was performed preoperatively. Although most of the patients [91.9% (n = 57)] had a positive serum beta HCG value, 5 patients had a negative test value. Laparotomy resulted in 40 salpingectomies, 19 salpingo-oophorectomies, and 3 total abdominal hysterectomies with salpingo-oophorectomies. One patient had a incidental cystotomy and 2 an incidental colotomy. We conclude that chronic ectopic pregnancy is not rare although little is mentioned about it as a clinical entity in the gynaecological literature. With increased awareness of its mildly symptomatic and protracted clinical course, and with proper interpretation of laboratory evaluations, a preoperative diagnosis can be made in the majority of the cases.

Adolescent↗
PubMed1996

Ultrasonographic appearance of non-Hodgkin's lymphoma in a pregnant woman.

Non-Hodgkin's lymphoma during pregnancy is rare. We report a case of non-Hodgkin's lymphoma detected in a pregnant women. She was initially diagnosed as having an ovarian tumor by ultrasonography, but definitive diagnosis was made at the time of cesarean section. After delivery she took combined chemotherapy for 7 cycles and is in complete remission over 1 year.

Adult↗
PubMed1996

Iniencephaly: sonographic-pathologic correlation of 19 cases.

During a four year period (1991-1994), 19 cases of iniencephaly were evaluated at our institution. Associated cranial malformations include anencephaly in 15 (79%), and posterior encephalocele in 5 (26.3%) of the cases. Other associated malformations include diaphragmatic defects with a accompanying hernia, omphalocele, gastrointestinal malformations, cardiovascular and genitourinary malformations, single nostril, facial cleft, spina bifida, hypoplastic lungs, club foot and single umbilical artery. No single causative agent for this group was identified. A brief review of the literature is included regarding categorization of these malformations and also a discussion of the embryological basis for these lesions and possible etiological factors.

Abnormalities, Multiple↗
PubMed1996

The effect of intravascular transfusion for severely anemic fetuses on umbilical artery Doppler flow velocity waveforms.

BACKGROUND: To evaluate whether the doppler flow velocity waveforms reflect the fetal hematocrit and to assess the changes of the umbilical artery doppler indices before and after the puncture of the umbilical cord. MATERIAL AND METHODS: In this prospective-study, Pulsed-Doppler examinations of blood flow velocities in the umbilical artery were carried out before and after 22 diagnostic cordocentesis and 14 fetal blood transfusions into the umbilical vein. RESULTS: There were decreases in the systolic/diastolic ratio (p < 0.001), the pulsatility index (PI)(p < 0.001), and the resistance index (RI)(p < 0.003) after cordocentesis but not after fetal blood transfusion. There were no correlations between the initial hematocrit and the umbilical artery doppler indices in both fetal blood transfusion group and fetal blood sampling group. There was no correlation between the increase in hematocrit and changes in umbilical artery blood-velocity waveform indices following fetal blood transfusion. The umbilical artery doppler flow-velocity indices did not predict the fetal hematocrit. CONCLUSION: These findings suggest that acute changes in blood viscosity following intravascular transfusion are not associated with an increase in resistance to flow as assessed by doppler velocimetry. Umbilical blood sampling per se may be associated with a humorally mediated reduction in placental vascular resistance to flow.

Blood Transfusion, Intrauterine↗