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    The effects of hormone replacement therapy on myocardial performance in early postmenopausal women
    (TAYLOR & FRANCIS LTD, 2010) Düzenli, Mehmet Akif; Özdemir, Kurtuluş; Sökmen, A.; Gezginç, K.; Soylu, A.; Çelik, C.; Altunkeser, Bülent Behlül
    Method In a prospective, controlled study, 60 healthy postmenopausal women were assigned to two groups (32 in the HRT group and 28 in the control group). After conventional echocardiographic parameters were measured, tissue Doppler echocardiography recordings were obtained from the mitral and tricuspid annulus. Systolic myocardial velocity (Sm), early and late diastolic myocardial velocities (Em and Am) and time intervals were measured and MPI was calculated. Then the symptom-limited exercise stress test using the Bruce protocol was performed. After 3 and 6 months of HRT (oral 0.625 mg conjugated estrogen + 2.5 mg medroxyprogesterone acetate/day), the same examinations were repeated. The effects of HRT on myocardial velocities, MPI and exercise time were evaluated at the 3rd and 6th months. Results The parameters of the control group remained statistically unchanged during the study. HRT did not have any effect on segmental and mean left ventricular (LV) Sm or right ventricular (RV) Sm. However, LV Em/Am and RV Em/Am ratios significantly increased at the 6th month of HRT, and LV and RV MPI values were observed to decrease significantly as compared to basal values. Additionally, a significant increase was observed in exercise duration and metabolic equivalent values after 3 months of HRT, and this increase continued at the 6th month as well. The favorable changes in all parameters in the HRT group were significantly different from those of the control group. Conclusion Data obtained in this study suggest that HRT is not only effective for treating menopausal complaints but also increases cardiovascular performance by improving especially diastolic functions in early postmenopausal women.
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    Fentanyl Added to Bupivacaine 0.05% or Ropivacaine 0.05% in Patient-Controlled Epidural Analgesia in Labour
    (Greenwich Medical Media Ltd, 2002) Pirbudak, Lütfiye; Tuncer, Sema; Koçoğlu, Hasan; Göksu, S.; Çelik, C.
    Background and objective: Epidural analgesia is the most effective method for pain relief during labour. The aim was to elucidate the efficacy of ropivacaine 0.05% and bupivacaine 0.05%, which were both combined with fentanyl 0.00015% to provide analgesia in labour. Methods: Forty nulliparous females were enrolled into the study. After insertion of an epidural catheter, patients were randomly assigned into two groups. Once the os uteri had dilated to 4-5 cm, a bolus of bupivacaine 0.125% 10 mL + fentanyl 50 mug (1 mL) in Group 1 patients, and ropivacaine 0.125% 10 mL + fentanyl 50 mug (1 mL) in Group 2 patients was administered via the epidural catheter. Then, patient-controlled epidural analgesia was started with a basal infusion of bupivacaine 0.05% 10 mL h(-1) + fentanyl 0.00015% 1.5 mug mL(-1) in Group 1, and ropivacaine 0.05% + fentanyt 1.5 mug mL(-1) in Group 2. When needed, a 10 mL bolus infusion could be given and the lockout time was 20 min. Maternal and fetal haemodynamic variables were monitored before induction and subsequently at 5 min intervals. Using a visual analogue scale assessed the degree of pain. Results: Maternal haemodynamic variables and Apgar scores were not different between the two groups. The second stage of the tabour was shorter in Group 2 (P < 0.01). There were no significant differences in patients' assessment of motor block or mode of delivery between groups. Conclusions: An epidural infusion (10 mL h(-1)) of bupivacaine 0.05% or ropivacaine 0.05% together with fentanyl 1.5 μg mL(-1) provided good and safe analgesia during tabour.
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    The Role of FDG-PET/CT in Ovarian Cancer Patients with High Tumor Markers or Suspicious Lesion on Contrast-Enhanced Ct in Evaluation of Recurrence and/or in Determination of Intraabdominal Metastases
    (ELSEVIER SCIENCE INC, 2012) Sarı, O.; Kaya, B.; Özcan Kara, P.; Kara Gedik, G.; Çelik, C.; Özbek, O.; Serdengeçti, M.
    Objectives: This retrospective study was designed to investigate the role of fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in determination of recurrence and/or intraabdominal metastasis in patients with ovarian cancer having increased tumor markers or suspicious lesion detected by a contrast-enhanced abdominal CT (ceCT). Materials and methods: A total of 34 female patients who were treated for histopathologically proven ovarian cancer, underwent PET/CT examination for restaging and suspected recurrence. Patients with pathology report, tumor marker levels, ceCT and PET/CT performed within one month were included in the study. Results: A total of 34 patients were included in the study. 25 of 34 patients had high tumor marker (CA 125) level. The remaining 9 patients had suspected recurrence on ceCT imaging with normal tumor marker levels. Recurrence was confirmed by re-operation and biopsy (n = 4), clinical and imaging follow-up (n = 21) in 25 patients with elevated tumor markers. Recurrent disease was not shown in 5 of 25 patients on ceCT imaging and 1 of 25 patients on PET/CT imaging with high CA125 values. Both ceCT and PET/CT revealed recurrent disease in 19 of 25 patients. PET/CT showed more lesions in 11 of 19 patients. Sensitivity, specificity and accuracy of the PET/CT were 96.1%, 100% and 97%, respectively. Conclusion: PET/CT is found as a beneficial method for detection of the recurrence, in patients with increased serum CA 125 level and negative CT findings or with normal CA 125 level and recurrence detected by CT which was performed due to clinical symptoms.