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    Effects of induced pressure and clamping force by vascular clamps on the vascular endothelium of rat aorta
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2016) Tezcan, Orhan; Basyigit, Ismail; Caliskan, Ahmet; Ekinci, Cenap; Demirtas, Sinan; Yavuz, Celal; Deveci, Engin
    Background: This study aims to investigate the effects of vascular clamps on the vascular endothelium of rat aorta. Methods: The study included 32 male Sprague-Dawley rats (weight 242 +/- 26 g; age 9 to 11 weeks). Rats were divided into four equal groups: control group: no clamp was applied on abdominal aorta; group 1: plastic bulldog clamp was applied on abdominal aorta for 10 minutes; group 2: metal bulldog clamp was applied on abdominal aorta for 10 minutes; group 3: microvascular clamp was applied on abdominal aorta for 10 minutes. At the end of 10 minutes, segments occluded with vascular clamp were excised in all groups and endothelial structures were evaluated histopathologically. Results: Normal cellular sequencing and structure were determined in control group. Most severe injury of the endothelial surface was observed in group 3, moderate level endothelial injury was observed in group 2, while mildest endothelial injury was observed in group 1. Increased vascular endothelial growth factor expression levels were detected histopathologically in groups 1 and 2 (2.8 +/- 0.5 and 3.3 +/- 0.5, respectively) when compared with the control subjects (2.0 +/- 0.5). Conclusion: Due to their induced pressure and clamping force, vascular clamps may cause endothelial injury.
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    Öğe
    Factors affecting mortality in penetrating cardiac injuries: our 10-year results
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2011) Yavuz, Celal; Cil, Habib; Basyigit, Ismail; Demirtas, Sinan; Islamoglu, Yahya; Tekbas, Guven; Elbey, Mehmet Ali
    Background: In this study, we investigated the factors affecting survival in patients who were admitted to our center because of a penetrating heart injury and given treatment. Methods: Ninety-four patients with penetrating heart injuries (82 males, 12 females, mean age 25.9 +/- 12.7 years; range 3 to 67 years) admitted to our clinic between November 2000 and June 2010 were retrospectively evaluated. We recorded the demographic features, transfer time to hospital, way of transfer, clinical condition at admission, and reasons for the patient injuries. Additionally, the presence of hemothorax, pericardial hematoma, tamponade, coronary artery injury, the method of decision for surgery (operation following resuscitation thoracotomy, clinical follow-up or some diagnostic methods), the injured chamber of the heart, presence of accompanying injury in another organ, heart rhythm at the beginning of the surgery, and the surgical approach used were recorded. Results: The mortality rate was 13.8% in our study. Survival was not found to be related to age, gender, reason of injury (gunshot, stabbing, iatrogenic injuries), and presence of tamponade, and coronary artery injury. However, a significant relationship was found between survival and the way of transfer (ambulance or other vehicles), transfer time to hospital, clinical condition at admission, the method of decision for surgery, heart rhythm before the surgery, presence of pericardial hematoma or hemothorax, injured heart chamber, and presence of accompanying injury in another organ. Conclusion: The transfer time to hospital is the most important modifiable factor that may affect the outcomes in penetrating heart injuries. Shortening this time will dramatically improve the survival in these patients who have a very high mortality.