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Citation Count: 0
Diltiazemin internal torasik arter kan akımı üzerine etkisi
(1996) Akpinar, Belhhan; Çetin, Gürkan; Bayındır, Osman; Cakali, Emine; Pekcan, Ülkü; Sönmez, Bingür
Bir kalsiyum antagonist! olan diltiazemin koroner arter cerrahisinde internal torasik arter (İTA) akımı üzerindeki etkisini incelemek üzere 60 olgu üzerinde yapılan çalışmada, 30 olguya peroperatif 0.1 mg/kg/saat - 0.3 mg /kg / saat arasında değişen dozlarda diltiazem perfüzyonu başlandı ve 24 saat devam edildi (Grup 1). Diğer 30 olguya (Grup 2) diltiazem verilmedi. Yapılan ölçümlerde İTA kan akımı Grup Vde 110 ± 5 ml/dk, Grup 2'de 70 ± 7 mi/ dk bulundu (p < 0.05). Grup 2'deki olgulara İTA içine papaverin enjekte edildikten sonra yapılan ölçümlerde İTA kan akımı 120 ± 5 mi olarak ölçüldü. Elde edilen gözlem, peroperatif başlanan diltiazem perfüzyonunun İTA kan akımını önemli ölçüde artırdığı şeklindedir.
Citation Count: 0
Ekmek mayası (saccharomyces cerevisiae) yardımı ile L-3,4- dihitroksifenil alanin (L-dopa) için yeni bir sentez yöntemi
(TUBITAK Scientific & Technical Research Council Turkey, 1997) Yelekçi, Kemal; Hamamcı, Haluk; Kahraman, M. Vezir; Karataş, Sevim
Ekmek mayası (saccharomyces cerevisiae) kolay ve ucuz bulunan bir reaktif olmasına karşın, organik kimyada yaptığı tepkimeler hem ilginç hem de diğer sentez yöntemleri ile yapılması ya imkansız ya da çok zordur. Bu amaçla klasik organik sentez yöntemleri ve maya kullanılarak daha önce sentezi bu yolla denenmeyen, anti parkinson ilacı L-3,4-Dihidroksifenilalanin'in sentezine yönelik ikisi orjinal dört önemli substurat hazırlanacak ve bu substratlar üzerinde bulunan karbon karbon çift bağı ekmek mayası ile stereospesifık olarak indirgenmeye çalışılacaktır.
Citation Count: 1
Sağlıklı gönüllülerde geri dönüşlü MAO inhibitörü moklobemidin dikkat öncesi süreçler ve işitsel duysal belleğe etkileri
(1999) Ermutlu, Numan; Demiralp, Tamer; Üresin, Yağız
Sekiz sağlıklı gönüllü üzerinde geri dönüşlü monoamin oksidaz inhibitörü moklobemidin, dikkat öncesi beyin süreçleri ve işitsel belleği yansıtan olaya ilişkin potansiyel bileşeni olan mismatch negatifliği (mismatch negativity, MMN) üzerine akut etkileri araştırıldı. Yöntem: İki ayrı edilgen oddbal düzeneğinde, bir saniye uyaranlar arası sürelerde (UAS), kısa (50 ms) ve uzun (500 ms) süreli işitsel uyaranlara karşı olaya ilişkin potansiyeller kaydedildi. Deneklerden kendi seçtikleri bir kitabı okumaları ve seslere dikkat etmemeleri istendi. Mismatch negatifliği, aykırı (deviyant) uyaranlara karşı ortaya çıkan yanıtlardan standart uyaranlara karşı gelişen yanıtlar çıkartılarak elde edildi. Uzun ve kısa işitsel uyaranların her ikisine karşı uyarılmış potansiyel kayıtları biri kontrol koşulu diğeri tek doz (150 mg) moklobemid alımından iki saat sonra olmak üzere iki ayrı oturumda alındı. Bulgular: Kontrol koşulunda kısa süreli uyaranlara karşı oluşan mismatch negatifliği ortalama genlikleri uzun uyaranlarla elde edilen mismatch negatifliği genliklerinden anlamlı olarak yüksekti. Moklobemid alımından sonra uzun süreli işitsel uyaranlara karşı oluşan mismatch negatifliği ortalama genlikleri anlamlı olarak artarken, kısa süreli uyaranlara karşı oluşan mismatch negatifliği ortalama genlikleri arasında fark bulunamadı. Sonuç: Yüksek uyaran yoğunluklu koşulda moklobemid dikkat öncesi süreçlerin ve işitsel belleğin etkinliğini artırmaktadır. Artmış noradrenalin etkinlik, muhtemelen sinyal/gürültü oranını ve işitsel sinirlerin toparlanma süresini hızlandırarak bu etkiden sorumlu olabilir.
Citation Count: 30
Effect 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, Mete
The 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 primary
Citation Count: 0
Aortanın ileri derecede aterosklerozunda koroner arter cerrahisi
(1999) Akpınar, Belhhan; Güden, Mustafa; Polat, Bülent; Sağbaş, Ertan; Sanisoğlu, İlhan; Sönmez, Bingür; Demiroğlu, Cemşid
Açık kalp cerrahisinde tekniklerin ilerlemesine rağmen nörolojik komplikasyonların görülme sıklığı azalmamıştır ve inme (stroke) morbidite ve mortaliteyi önemli ölçüde artırmaktadır. Bu yazıda çıkan aortada ileri derecede kalsifikasyon bulunan vakalarda hipotermik fibrilasyon tekniği kullanılarak aortaya dokunulmadan ve kross klemp konulmadan yapılan koroner by-pass ameliyatları anlatıldı. 2 yıl içinde aortada ileri derecede kalsifikasyon bulunan 23 olguda bu teknik kullanıldı. Yaş ortalaması 65 + 3 yıl idi. Kardiopulmoner bypass için femoral arter ve sağ atrium kullanıldı. Tüm hastalar 26-28 ºC'de ventriküler fibrilasyon ile ameliyat edildi ve internal torasik arterler ve gastroepiploik arter ve bu greftlerin kombinasyonu kullanıldı. Aortaya klemp uygulanmadı ve proksimal anastomoz yapılmadı. 30 günlük ölüm oranı 0 idi. Hiçbir olguda nörolojik komplikasyon, alt ekstremite iskemisi ve hemodinamik problem gözlenmedi. Sadece 1 olgu kanama nedeniyle tekrar ameliyata alındı ve eksik revaskülarizasyon yapılan 1 vakada peroperatif miyokard enfarktüsü görüldü, fakat hemodinamik olarak bir problem olmadı. Bu teknik iyi miyokard korunması sağladığı, uygun revaskülarizasyonu engellemediği ve emboliye bağlı nörolojik komplikasyonları önemli ölçüde engellediği için tercih edilebilir.
Citation Count: 0
Does different orientation of the Medtronic Hall tilting disc valve in the aortic position effect transvalvuler pressure gradients?
(Medimond Srl, 2000) Güden, Metin; Akpınar, Belhhan; Sağbaş, Ertan; Sanisoğlu, İlhan; Arpaz, M.; Bayındır, Osman
The effect of valve orientation during aortic valve replacement (AVR) with the Medtronic Hall (MH) tilting disc valve on transvalvuler pressure gradients was evaluated. 30 patients (pts) undergoing isolated AVR received a MH which was oriented so that the greater opening of the valve faced the non coronary aortic sinus. There were 12 male and 8 female pts in this group with a mean age of 59 +/- 5.2 years. An echocardiographic examination was performed 6 days after the operation and resting transvalvuler gradients were measured (Group 1). The gradients were compared with the results of 30 pts. who had undergone AVR with the same valve previously but with the orientation of the greater opening towards the left or the right coronary sinus (Group 2). In Group 1 the mean valve size was 22 mm. and the measured mean valvuler gradient was 24/13 mmHg (peak/mean). In Group 2 the mean valve size was 22.1 mm. and the measured mean valvuler gradient was 31/20 mmHg (peak/mean). Student's t test was used for statistical analysis and transvalvular gradients in Group 1 were found to be significantly lower than Group 2 (p>005). Implantation with greater opening of the tilting mechanical valve facing the non-coronary sinus seems to result in lower transvalvuler gradients than other orientations.
Citation Count: 21
Going against the national cultural grain: a longitudinal case study of organizational culture change in Turkish higher education
(Carfax Publishing, 2000) Herguner, Gülten; Reeves, Nigel B.R.
This paper presents results of a longitudinal case study inquiry into the measurement of organizational culture change through the implementation of total quality management (TQM) concepts in a higher education context. The inquiry deals with the relationship between national culture and the company corporate culture the consequences of manager style change for TQM implementation and how culture change can be measured adequately. The results are achieved by the utilization of external (quantitative) and internal (qualitative) measurement devices. Limitations consequent upon the number of participants and the dual role of the researcher indicate the potential value of further investigations into the topic using these devices. The main conclusion is that the maintenance of TQM systems without continued senior managerial commitment may not suffice to secure change and prevent a reversion to earlier cultural patterns. Certainly since the findings of this inquiry are limited to one case study it would be unwise to assume that similar results would necessarily pertain in other higher education contexts. Nevertheless we are of the view that the findings are suggestive of the pressures imposed on organizational change by national cultural patterns. The devices implemented for measuring organizational cultural change while not designed for that purpose have however yielded sufficiently well-defined results to suggest the value of similar implementations to gain insight into the topic in further higher education and other organizational contexts.
Citation Count: 9
VLSI implementation of GRBF (Gaussian Radial Basis Function) networks
(IEEE, 2000) Çevikbaş, I. Can; Öğrenci, Arif Selçuk; Dündar, Günhan; Balkır, Sina
A GRBF network is designed for VLSI implementation. Building blocks of the network consist mainly of analog circuits: op-amp multiplier multiplying DAC (digital to analog converter) floating resistor summer and exponentiator. Parameters of the network (center width of the Gaussian function and output layer weights) are represented digitally for convenient interfacing. It is shown that individual GRBF units allow independent tuning of center width and amplitude. Several network structures are simulated as function approximation examples and the performance is verified to be satisfactory.
Citation Count: 23
The 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, Cemşid
Objective: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)
Citation Count: 1
Malign plevral sıvıların tanısında CYFRA 21-1, CA 19-9, CA-125 ve mutant p53 düzeylerinin değeri
(2000) Sevinç, Can; İşlekel, Hüray; Akkoçlu, Atila; Yenice, Sedef; Kılınç, Oğuz; İtil, Oya; Uçan, Eyüp Sabri; Çırmın, Arif; Altın, Remzi
Plevral sıvıların ayırıcı tanısında tümör belirleyicilerinin rolü henüz tam olarak tanımlanamamıştır. Bu çalışmada malign plevral sıvı tanısına katkılarını araştırmak amacıyla sitokeratin 19 fragmanı olan CYFRA 21-1, CA 19-9, CA-125 ve tümör baskılayıcı genlerden p53'ün mutant form ürünü düzeyleri malign plevral sıvılarda (n=20) kantitatif olarak ölçüldü. Bu değerler benign plevral sıvılardaki düzeyler (n=10) ile karşılaştırıldı. CYFRA 21-1 konsantrasyonları katı-faz sandviç immunoradyometrik ölçüm yöntemi ile ölçülürken, diğer parametreler ELISA yöntemi ile belirlendi. CYFRA 21-1, CA-125 ve CA 19-9'un plevral sıvı düzeyleri malign sıvılarda benign sıvılara göre istatistiksel olarak anlamlı biçimde yüksek bulundu. Mutant p53'ün ortalama düzeyi açısından iki grup arasında istatistiksel farklılık saptanamazken, plevral sıvılarda ölçülebilecek düzeyde mutant p53 düzeyi esas alındığında, malign sıvıların %65'inde, benign sıvıların ise %30'unda mutant p53 varlığı belirlendi. En yüksek tanısal duyarlılığa CYFRA 21-1 ve CA 19-9 (%100), özgüllüğe CA 19-9 (% 80), pozitif öngörü değerine CA 19-9 (%90), negatif öngörü değerine CYFRA 21-1 ve CA 19-9 (%100), toplam tanısal doğruluğa ise CA 19-9 (%93) ile ulaşıldığı saptandı. Sonuç olarak, malign ve benign plevral sıvıların ayırt edilmesinde CYFRA 21-1 ve CA 19-9 düzeylerinin ölçülmesinin geleneksel tanı yöntemleri ile birlikte kullanıldığında yararlı olabileceğini düşünmekteyiz.
Citation Count: 33
Primary epiploic appendagitis CT manifestations
(Elsevier Science Inc, 2000) Şırvancı, Mustafa; Tekelioğlu, Mehmet H.; Duran, Cihan; Yardımcı, Hakan; Onat, Levent; Özer, Kadir
Inflammation 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.
Citation Count: 4
Association 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.
Citation Count: 5
Presence 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, Ulf
OBJECTIVE: 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.
Citation Count: 20
In situ split costal cartilage graft harvesting through a small incision using a gouge
(Lippincott Williams & Wilkins, 2000) Ağaoğlu, Galip; Erol, O. Onur
A 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.
Citation Count: 0
Arteriovenöz fistüllerin erken dönem açıklığının venöz sistem basıncının ölçümü ile tayini (Arteriovenöz fistülün arteryel ve venöz sistem basınçlarının analizi)
(2000) Korkut, Ali Kubilay; Haberal, Cevahir; Özcan, Vural; Hökenek, Faruk; Alpagut, Ufuk; Tireli, Emin; Kargı, Aydın; Onursal, Ertan
Kronik böbrek yetersizliğindeki hastalara açılan arteriovenöz şantların erken dönem açıklık oranları birçok faktörden etkilenir. Bu faktörlerin biri de venöz sistemdeki darlık ve tıkanıklıklardır. Bu çalışmanın amacı venöz sistem darlıklarının arteriovenöz fistüllere olan etkisini venöz sistem basıncını ölçerek ortaya koymaktır. İ.Ü İstanbul Tıp Fakültesi Göğüs, Kalp ve Damar Cerrahisi ABD'nda 1997 yılında yapılan 410 arteriovenöz fistülden yaş, cinsiyet ve primer böbrek hastalığı farklılıklarını gözetmeksizin rastgele seçilmiş 15 hastada fistül yapıldıktan sonra peroperatuar venöz sistem basıncı ölçülmüştür. Bu fistüllerin 11 tanesi snuff-box, 3 tanesi brescio-simino, 1 tanesi de brakial konumda yapılmıştır. Tril alınan 10 hastada ortalama sistolik venöz basınç 35.8 mmHg olup, ortalama sistolo-diastolik basınç farkı 3.4 mmHg'dır. Tril olmayan 5 hastada ise ortalama venöz basınç 51.3 mmHg olup, sistolodiastolik basınç farkı 42 mmHg'ya yükselmiştir. Venöz sistemde tıkanıklık olan bir hastanın arteriovenöz fistül sonrası ölçülen venöz basınç değeri, venöz tıkanıklığı olmayan bir hastaya göre anlamlı olarak yüksektir. Arteriovenöz fistülün erken dönem patensini etkileyen venöz sistem patolojilerinden şüphe edildiğinde fistül açtıktan sonra venöz sistemde bakılacak sistolik basınç ve sistolodiastolik basınç farkı fistülün erken dönem açıklılığını gösteren bir kriterdir.
Citation Count: 10
Acute gastrointestinal complications after open heart surgery
(Asia Publishing Exchange Pte Ltd, 2000) Akpınar, Belhhan; Sağbaş, Ertan; Güden, Mustafa; Kemertas, Kubilay; Sönmez, Bingür; Bayındır, Osman; Demiroğlu, Cemşid
Retrospective analysis revealed that 24 of 4401 adult patients (0.5%) developed severe gastrointestinal complications after open heart surgery during a 3-year period from January 1995. There were 4 women (17%) and 20 men (83%). Mean age was 61.7 ± 2.02 years. Gastrointestinal bleeding (33.3%) mesenteric ischemia (20.8%) pancreatitis (20.8%) hepatic dysfunction (16.7%) and cholecystitis (16.7%) were the most common complications. Mortality was 41.7% (10 patients). During the same period mortality in the patients who did not develop gastrointestinal complications was 1.89% (p < 0.0001). Emergency basis reoperation combined operations peripheral vascular disease diabetes mellitus chronic lung disease and impaired left ventricle function were found to be risk factors for the development of postoperative gastrointestinal complications.
Citation Count: 0
Intraoperative thermal coronary angiography: quality control
(Medimond Srl, 2000) Sönmez, Barış; Tansal, Selim; Yagan, N.; Ünal, M.; Arbatlı, Harun; Korkut, K.; Demirsoy, Ergun; Bayındır, Osman
Per operative coronary angiography has always been desired by coronary surgeons. Direct coronary angiographic imaging is not practical since needs contrast injection requires radiation and excessive technology with experienced staff which adds more expenses. Thermal angiography device IVA-2000 (OPGAL) is started to be used in our coronary bypass operations as a routine procedure. Thermal imaging provides an effective and real time coronary angiograms which provides very clear coronary angiograms as well as graft flows. The temperature differences generated in between the myocardium and the coronary arteries by injecting cold cardioplegic solution into the proximal end of the vein graft or by warm blood running through an internal thoracic artery graft creates an angiographic image and provides graft flow with termodilution technique after cross clamp released. Thermal images provided with thermal camera easy to tax no need for extra staff no side effects of contrast media to the patients and no radiation effect to the theatre stuff also. We will demonstrate basic principal of thermal camera and thermal coronary angiograms of different patients with different aspects.
Citation Count: 0
A synthesis tool for the multiplierless realization of FIR-based multirate DSP systems
(IEEE, 2000) Yurdakul, Arda
In this study a synthesis tool using a novel multirate folding technique which handles each FIR filter in a multirate DSP system as a single node is developed. A new architecture is presented for the multiplierless realization of a fold of multirate FIR filters. This synthesizer fully exploits the redundancies (i.e. `idle' and `missing' cycles) and common terms in multirate systems without sacrificing from overall system quality to produce multiplierless multirate systems. It also enables the usage of a single clock for all parts of the circuit.
Citation Count: 1
Facial autologous soft-tissue contouring by adjunction of tissue cocktail injection (micrograft and minigraft mixture of dermis, fascia, and fat)
(2000) Erol, O. Onur
Facial 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.
Citation Count: 17
Off-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, Osman
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.

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