PubMed İndeksli Yayınlar Koleksiyonu
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Article Citation Count: 30Effect of low-dose methyl prednisolone on serum cytokine levels following extracorporeal circulation(Arnold Hodder Headline Plc., 1999) Yılmaz, Mert; Ener, Serdar; Akalın, Halis; Sağdıç, Kadir; Serdar, O. Akin; Cengiz, MeteThe systemic inflammatory response to cardiopulmonary bypass (CPB) is associated with increased production of cytokines. This systemic inflammatory response characterized by the activation of interleukin-6 (IL-6) and interleukin-8 (IL-8) during and after CPB is well documented. A prospective randomized double-blind study was performed so as to understand the effects of low-dose methyl prednisolone sodium succinate (MPSS) on the circulating levels of serum cytokines and clinical outcome. Twenty patients were randomly divided into two groups on the basis of the administration of low-dose(1 mg/kg) MPSS in = 10) and placebo in = 10) into the pump prime solution. All patients were scheduled to undergo a primaryArticle Citation Count: 23The use of the 5-HT3-receptor antagonist ondansetron for the treatment of postcardiotomy delirium(W.B. Saunders Co Ltd, 2000) Bayındır, Osman; Akpınar, Belhhan; Can, Erol; Güden, Mustafa; Sönmez, Bingür; Demiroğlu, CemşidObjective:To evaluate the effect of the 5-HT3-receptor antagonist ondansetron in patients with postcardiotomy delirium. Design: Prospective study. Setting: University hospital. Participants: Thirty-five patients who had undergone coronary artery bypass graft surgery. Interventions: Thirty-five patients 23 men and 12 women who developed delirium in the intensive care unit after coronary artery bypass graft surgery were included. Mean patient age was 51.3 years (range 36 to 79 years). A mental status scoring scale was developed and patients were scored 0 to 4 according to their delirium status after confirming that there were no correctable metabolic abnormalities as an underlying cause for delirium. Normal behavior was scored as 0 and severe verbal and physical agitation was scored as 4. Patients received a single dose of ondansetron 8 mg intravenously and were reevaluated 10 minutes later. Measurements and Main Results: Before the treatment 7 patients had a score of 2 (20)Article Citation Count: 33Primary epiploic appendagitis CT manifestations(Elsevier Science Inc, 2000) Şırvancı, Mustafa; Tekelioğlu, Mehmet H.; Duran, Cihan; Yardımcı, Hakan; Onat, Levent; Özer, KadirInflammation of an epiploic appendage is considered to be a rare cause of acute abdomen. Recently it has been reported that typical computed tomography (CT) findings of primary epiploic appendagitis (PEA) provide a definitive diagnosis in most of the cases. However since these papers are only few they are easily overlooked by the practicing radiologists. Our purpose is to add four new cases to the existing literature and to perform a review of the literature. (C) 2001 Elsevier Science Inc. All rights reserved.Article Citation Count: 4Association of lipoprotein(a) concentration and apo(a) isoform size with restenosis after percutaneous transluminal coronary angioplasty(Springer Verlag, 2000) Sırıkcı, Onder; Aytekin, Vedat; Demiroglu, I. C. C.; Demiroğlu, Cemşid; Marcovina, S.M.Lp(a) is a unique class of lipoprotein particles that exhibits a considerable size heterogeneity resulting from the size polymorphism of apo(a) its unique protein component. An elevated level of Lp(a) in plasma has been proposed to be a risk factor for premature development of coronary artery disease. To evaluate the relationship between Lp(a) concentration and apo(a) isoform size with restenosis after percutaneous transluminal coronary angioplasty Lp(a) levels and apo(a) phenotypes were determined in 204 patients who underwent a successful coronary angioplasty procedure and stent implantation. The patients were followed with clinical examinations and exercise tests at 1 3 and 6 months and a control coronary angiography was performed after 6 months to evaluate restenosis. Lp(a) levels were determined with an ELISA that is insensitive to the size heterogeneity of Lp(a) and the apo(a) isoforms were determined by a high-resolution agarose gel electrophoresis method followed by immunoblotting with a specific monoclonal antibody. Of the 146 patients who underwent angiographic evaluation 57 (39%) had restenosis whereas 89 (61%) did not. Lp(a) levels and the distribution of the expressed apo(a) phenotypes were compared in these two groups of patients. Although the mean and median Lp(a) levels were higher in the restenosed group the difference was not statistically significant. However a significant difference in Lp(a) values was found in women (P=0.043) even though because of the small number of women in the study (n=35) no sound conclusions can be reached on the predictive role of Lp(a) in restenosis. There also was no difference in the distribution of apo(a) phenotypes between the two groups. Because of their wide distribution Lp(a) values and apo(a) isoforms do not seem to be a useful indicator of risk of restenosis after percutaneous transluminal coronary angioplasty in our study cohort.Article Citation Count: 5Presence and localization of connexins 43 and 26 in cell cultures derived from myometrial tissues from nonpregnant and pregnant women and from leiomyomas(Mosby-Elsevier, 2000) Ciray, Haydar Nadir; Fu, Xin; Olovsson, Matts; Ahlsen, Goran; Shuman, Cheryl; Lindblom, Bo; Ulmsten, UlfOBJECTIVE: Our objective was to study the appearance and distribution of connexins 43 and 26 in various human myometrial cell cultures. STUDY DESIGN: Scrape loading Western blotting and immunohistochemical techniques were applied to cultured cells derived from myometrial tissues obtained from nonpregnant and pregnant women (upper and tower uterine segments) and from leiomyomas (tumor and analogous myometrial tissues). RESULTS: Scrape loading revealed the presence or metabolic coupling in all tissues. indirect immunohistochemical studies showed membrane localization of connexin 43 in all myometrial cultures. Western blots and indirect immunohistochemical studies showed the presence and localization of the connexin 26 protein and associated gap junctions in tissues from myomas and from nonpregnant and pregnant women except for those derived from the upper segment of the pregnant uterus. CONCLUSION: These results show that human myometrial cultures express various gap junction proteins and that there are regional differences in expression of connexins in tissues from pregnant women.Editorial Citation Count: 20In situ split costal cartilage graft harvesting through a small incision using a gouge(Lippincott Williams & Wilkins, 2000) Ağaoğlu, Galip; Erol, O. OnurA costal cartilage graft is one of the most useful materials in reconstructive plastic surgery. In this article a technique of in situ split costal cartilage graft harvesting through a small incision (2 to 3 cm) using a gouge is described. The technique used has many advantages: it is a simple technique is easy to learn and can be performed quickly through a small incision. By avoiding complete costal cartilage graft harvesting the associated potential complications such as pleural perforation chest wall deformities long-lasting postoperative pain and incisional scar length are reduced. This technique will be useful in selected cases for which a complete block of costal cartilage graft is not needed.Article Citation Count: 1Facial autologous soft-tissue contouring by adjunction of tissue cocktail injection (micrograft and minigraft mixture of dermis, fascia, and fat)(2000) Erol, O. OnurFacial aging is both a physiologic and anatomic process characterized by changes in the skin and supporting tissues. The aging process produces an outer envelope that gradually expands while its contents gradually involute and the underlying structure weakens. This process results in an excess of skin that tends to create folds, grooves, and deepening furrows. Contour augmentation and filling depressions with autologous tissue or heterogeneous materials are widely used in face rejuvenation as an adjunctive procedure. There is unanimous agreement on the advantages of autogenous tissue grafts over alloplastic materials and heterogeneous transplants. It is also well known that the revascularization of a small graft (fat, dermis, and/or composite graft) is better than a large graft. For this reason, fat injections consisting of small particles have recently become popular. According to different authors, a graft take may vary from 30 to 50 percent. Nevertheless, it has been thoroughly documented that a graft consisting of dermis or fascia is superior to a fat graft in both the graft take rate and quality of the tissue. Strips of dermal graft have been used successfully for several years to fill lip contour and nasolabial folds. However, the main disadvantage of this technique is that utilization is restricted only to certain areas where there is a need for a small incision. To overcome this obstacle, the author developed a simple technique to obtain an injectable mass from a mixture of dermis, muscle strips, fat tissue, and fascia to use in body contouring (especially in the facial region) in large areas. The author describes the use of the technique in 450 patients. Follow-up in these patients from 6 months to 10 years showed that the application of the "tissue cocktail" procedure in select patients improved the author's results and created a marked increase in the number of satisfied patients with no complaints. The take and durability of this kind of graft were superior to the author's results using fat grafts. The tissue cocktail graft remained stable for several years, as effectively seen in the chin region. The sole complication from the procedure was some bruising, which was resolved in several days. No single infection or inclusion cyst was observed in this series.Article Citation Count: 17Off-pump coronary artery bypass grafting with use of the octopus 2 stabilization system(2000) Akpınar, Belhhan; Güden, Mustafa; Sağbaş, Ertan; Sanisoğlu, İlhan; Aytekin, Vedat; Bayındır, OsmanBackground: The treatment of coronary artery disease has evolved rapidly over the last two decades. The gold standard of surgical revascularization, the on-pump coronary artery bypass graft, has been challenged by the development of percutaneous transluminal coronary angioplasty. Our experience with the alternative of the off-pump ("beating heart") coronary artery bypass (OPCAB) technique during a period of 18 months suggests that OPCAB avoids the complications of cardiopulmonary bypass and offers patients the benefit of long-term graft patency that greatly exceeds that of current endovascular technologies. Methods: The early results of 126 OPCAB procedures performed through a medial sternotomy incision during a period of 18 months were evaluated. There were 80 male and 46 female patients, with a mean age of 69 +/- 4.3 years. Emergency cases and reoperations were not included. A total of 268 anastomoses were performed, with a mean number of 2.12 anastomoses per patient. Conduits used, with their percentage of use, were: left internal thoracic artery (LITA) (100%), right internal thoracic artery (11.1%), greater saphenous vein (84%), and radial artery (31%). In 72% of the cases, off-pump surgery was chosen because of patient risk factors such as atherosclerotic aortic disease, previous cerebrovascular accident or carotid artery disease, renal dysfunction, malignancy or poor left ventricular function. Results: There was no operative mortality. One-month postoperative mortality was three patients (2.3%). Two died because of mesenteric ischemia, and the other death was due to cardiac failure. Seventy-one patients had a control angiogram before discharge. The patency of LITA anastomosis was 100% while overall patency rate was 95%. In 43 patients for whom an angiogram could not be performed, a Thallum 201 stress test was performed three months postoperatively. Thirty-eight patients had a normal test while five patients showed signs of ischemia. These patients had a control angiogram: in four patients anastomoses were patent, but in one patient there was a severe narrowing of a venous anastomosis to the distal right coronary artery (RCA) which was corrected with angioplasty. In the whole series eight patients (6.3%) refused to have any control examination. Conclusions: Our early results suggest that off-pump CABG with Octopus 2 (Medtronic, Inc., Minneapolis, MN) can be a good alternative in high risk patients who need multiple vessel revascularization.Article Citation Count: 18Off-pump coronary artery bypass grafting with use of the octopus 2 stabilization system.(2000) Akpinar,B.; Güden,M.; Sagbas,E.; Sanisoglu,I.; Aytekin,V.; Bayindir,O.BACKGROUND: The treatment of coronary artery disease has evolved rapidly over the last two decades. The gold standard of surgical revascularization, the on-pump coronary artery bypass graft, has been challenged by the development of percutaneous transluminal coronary angioplasty. Our experience with the alternative of the off-pump ("beating heart") coronary artery bypass (OPCAB) technique during a period of 18 months suggests that OPCAB avoids the complications of cardiopulmonary bypass and offers patients the benefit of long-term graft patency that greatly exceeds that of current endovascular technologies. METHODS: The early results of 126 OPCAB procedures performed through a medial sternotomy incision during a period of 18 months were evaluated. There were 80 male and 46 female patients, with a mean age of 69 +/- 4.3 years. Emergency cases and reoperations were not included. A total of 268 anastomoses were performed, with a mean number of 2.12 anastomoses per patient. Conduits used, with their percentage of use, were: left internal thoracic artery (LITA) (100%), right internal thoracic artery (11.1%), greater saphenous vein (84%), and radial artery (31%). In 72% of the cases, off-pump surgery was chosen because of patient risk factors such as atherosclerotic aortic disease, previous cerebrovascular accident or carotid artery disease, renal dysfunction, malignancy or poor left ventricular function. RESULTS: There was no operative mortality. One-month postoperative mortality was three patients (2.3%). Two died because of mesenteric ischemia, and the other death was due to cardiac failure. Seventy-one patients had a control angiogram before discharge. The patency of LITA anastomosis was 100% while overall patency rate was 95%. In 43 patients for whom an angiogram could not be performed, a Thallum 201 stress test was performed three months postoperatively. Thirty-eight patients had a normal test while five patients showed signs of ischemia. These patients had a control angiogram: in four patients anastomoses were patent, but in one patient there was a severe narrowing of a venous anastomosis to the distal right coronary artery (RCA) which was corrected with angioplasty. In the whole series eight patients (6.3%) refused to have any control examination. CONCLUSIONS: Our early results suggest that off-pump CABG with Octopus 2 (Medtronic, Inc., Minneapolis, MN) can be a good alternative in high risk patients who need multiple vessel revascularization.Letter Citation Count: 1Long-standing seroma after ultrasound-assisted liposuction(Lippincott Williams & Wilkins, 2001) Ağaoğlu, Galip; Erol, O. Onur[Abstract Not Available]Article Citation Count: 8Does off-pump coronary artery bypass surgery reduce mortality in high risk patients?(Forum Multimedia Publishing LLC., 2001) Akpınar, Belhhan; Güden, Mustafa; Sanisoğlu, İlhan; Sağbaş, Ertan; Caynak, Barış; Bayramoğlu, Zehra; Bayındır, OsmanBackground: The aim of this retrospective study was to compare outcome in two groups of patients who were classified according to their risk groups and underwent coronary revascularization with or without cardiopulmonary bypass. Material and Methods: Between January 1996 and July 2000 480 cases that underwent coronary artery bypass surgery (CABG) were included in a retrospective nonrandomized manner for study. Group I included 210 patients who were revascularized using off-pump techniques. Octopus 2 and 3 (Medtronic Inc. Minneapolis MN) were used for tissue stabilization. Group 2 included 270 cases who underwent CABG using CPB. Emergency cases combined operations reoperations and patients in cardiogenic shock were excluded. Demographic variables were comparable between two the groups. Using the Allegheny Clinic Risk Scoring Scale [Magovern 1996] patients in both groups were scored as low moderate and high risk. In Group 1 37% of patients consisted of high risk patients while Group 2 had 14% (p < 0.05) Student's t-test and chi-square test were used for statistical analysis and alfa < 0.05 was considered significant. Results: Mortality was 1.4% in Group 1 and 1.5% in Group 2 (p = ns). Mean anastomosis per patient was 2.6 +/- 0.6 in Group 1 and 3.2 +/- 0.5 in Group 2 (p < 0.05). Patients in Group I needed less blood transfusions and less inotropic support postoperatively (p < 0.05). There were also fewer minor neurological events (p < 0.05) and pulmonary complications (Type 2) in Group 1. Atrial fibrillation rate infection and major neurological deficit (Type 1) were similar in both groups. Mortality was less among Group 1 high risk patients (3.9%) in comparison to Group 2 high risk patients (7.9%) but this did not reach statistical significance. Conclusions: In low or moderate risk patients CABG can be performed safely with or without CPB. In high risk patients with several comorbidities off-pump CABG seems to be a safe and efficient method that can improve outcome.Article Citation Count: 11Electrical activity regulates AChR gene expression via JNK PKC zeta and Sp1 in skeletal chick muscle(Elsevier Science Bv, 2001) Altiok, Nedret; Changeux, Jean-PierreElectrical activity of myotubes represses nicotinic acetylcholine receptor (AChR) gene expression. This effect is mimicked by okadaic acid and blocked by tetrodotoxin (TTX) or staurosporine in cultured myocytes [Altiok et al. EMBO J. 16 (1997) 717-725]. In this study we investigated the mechanism of this repression. We show that addition of exogenous phospholipase D (PLD) and C inhibits AChR expression in a manner which parallels that of okadaic acid. Furthermore okadaic acid caused an increase of the threonine phosphorylation of protein kinase C zeta (PKC zeta) and activator of transcription factor (ATF2) and a decrease of the phosphorylation of Sp1. All these effects were reversed by staurosporine and TTX also abolished ATF2 phosphorylation. These data reveal a possible involvement of PLD c-jun N-terminal kinase PKC zeta and Sp1 in the repression of AChR genes by electrical activity. (C) 2001 Federation of European Biochemical Societies. Published by Elsevier Science B.V. All rights reserved.Article Citation Count: 20Ondansetron hydrochloride for the treatment of delirium after coronary artery surgery(Mosby Inc, 2001) Bayındır, Osman; Güden, Mustafa; Akpınar, Belhhan; Sanisoğlu, İlhan; Sağbaş, Ertan[Abstract Not Available]Article Citation Count: 3Hip fracture-dislocation (Pipkin type IV) associated with an apparent traumatic aortic valve rupture. Case history(2001) Gögüş, A.; Akpinar, S.; Unal, M.; Sönmez, B.; Hamzaoglu, A.Traumatic aortic valve rupture with resultant aortic insufficiency is a rare complication of blunt trauma. Here reported is a case with a posterior fracture-dislocation of the hip (Pipkin type-IV) and an undisplaced sternum fracture who developed hemodynamic instability in the clinical follow-up and was diagnosed having a traumatic aortic valve rupture using echocardiography. He first was treated with a biological valve replacement. Two weeks later a total hip arthroplasty combined with the osteosynthesis of the posterior wall of the acetabulum was performed. Sternum fracture healed conservatively. In multiply injured patients especially with a blunt thorax trauma hemodynamic instability despite appropriate fluid replacement should rise the suspicion of cardiac injuries, especially traumatic aortic valve rupture. Echocardiography is a simple but reliable method for the diagnosis.Article Citation Count: 1Screening of a stentless valve with electron beamed tomograpy 5 years after operation(2001) Akpınar, Belhhan; Güden, Mustafa; Memişoğlu, Esat I.[Abstract Not Available]Article Citation Count: 1One-stage surgical correction of congenital thoracic lordosis - report of 2 cases(Taylor & Francis, 2001) Göğüş, Abdullah; Talu, Ufuk; Hamzaoğlu, Azmi[Abstract Not Available]Article Citation Count: 8Removal of UroLume endoprosthesis using holmium : YAG laser(Mary Ann Liebert Inc Publ, 2001) Kural, Ali Riza; Tüfek, İlter; Akpınar, Haluk; Gürtuğ, AdilA potential complication of UroLume endoprosthesis is migration which may necessitate removal of the stent. Stent removal may be associated with complications such as urethral injury bleeding and external sphincter trauma. We report a patient in whom a holmium:yttrium-aluminium-garnet (Ho:YAG) laser was used to cut the UroLume endoprosthesis into fragments which led to easy and uneventful stent removal.Article Citation Count: 2The evaluation of microbial contamination in platelet concentrates prepared by two different methods(Pergamon-Elsevier Science Ltd, 2001) Kocazeybek, Bekir Sami; Arabaci, Ümit; Akdur, Hülya; Sezgic, Metin; Erentürk, SelimThe microbial contamination of platelet concentrates (PCs) prepared by two different methods both with a high risk of bacterial contamination during preparation and storage were evaluated. For apheresis platelets the concentrates were obtained using the Haemonetics MCS 3P device. For the random method platelets were obtained by two phase centrifugation in the Heraeus Cryofuge 8500 I device using the Kansuk 3-way bags which permit storage for five days. 1620 platelet pheresis units prepared by apheresis and 9838 units prepared by the random method were included in the study. Of the 11458 PCs studied 32 (0.27%) were false positives and 24 (0.2%) were real positives. All of the positive results occurred in platelets prepared by the random method. C. xerosis and S. epidermidis S. hominis Alpha-hemolytic streptococci all flora of the skin were isolated in the contaminated concentrates. The risk of microbial contamination of PCs prepared both by apheresis and from whole blood continues at a low rate although the products were collected into specific bags following rules including appropriate disinfection of the skin correct centrifugation collection time and optimal storage conditions including temperature and agitation. These results again emphasize the importance of. obeying phlebotomy rules and hand disinfection of the person who collects the blood as well as the need for careful skin decontamination of the donor during donation. (C) 2001 Elsevier Science Ltd. All rights reserved.Article Citation Count: 12Acute aortic valve regurgitation secondary to blunt chest trauma(Texas Heart Inst., 2001) Ünal, Mehmet; Demirsoy, Ergun; Göğüş, Abdullah; Arbatlı, Harun; Hamzaoğlu, Azmi; Sönmez, BingürBlunt injury to the cardiac valves leads to progressive acute ventricular failure which often requires urgent surgical management In this case report we describe an acute aortic valve rupture caused by air-bag inflation during an automobile accident. Laceration of an aortic valve cusp was treated successfully with urgent aortic valve replacement. A concomitant orthopedic injury was treated electively 15 days after cardiac surgery. Acute aortic valve rupture is a very rare complication of blunt chest trauma. We discuss how to diagnose and manage this potentially catastrophic event.Letter Citation Count: 4The use of composite stentless valves with graft extension for the treatment of ascending aortic aneurysms(Elsevier Science Bv, 2001) Akpınar, Belhhan; Güden, Mustafa[Abstract Not Available]
