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    Iloprost reduces myocardial edema in a rat model of myocardial ischemia reperfusion
    (Sage Publications Ltd, 2014) Caliskan, A.; Yavuz, C.; Karahan, O.; Yazici, S.; Guclu, O.; Demirtas, S.; Mavitas, B.
    Objective: Myocardial ischemia severely reduces myocyte longevity and function. Extensive interstitial edema and cell damage occur as a result of myocardial reperfusion injury. Current therapies are directed at prevention of ischemia-induced damage to cardiac tissue. Iloprost is a novel pharmaceutical agent for the treatment of ischemia. Methods: Twenty rats were segregated into four experimental groups. The procedure control group consisted of four rats undergoing a sham operation. The remaining 16 rats were divided into two equal groups. The first group (control group) received a continuous intravenous infusion of physiological serum immediately prior to the procedure. Iloprost was administered by a continuous intravenous infusion into the right jugular vein at an infusion rate of 100 ng/kg/min for 30 minutes prior to reperfusion in the experimental group (study group). Following the infusion treatments, ligation of the left coronary artery was conducted for 30 minutes to induce myocardial ischemia. The rats were euthanized 24 hours after reperfusion and cardiac tissue was harvested from all specimens for analysis. Results: Histological examination revealed three myocardial tissue specimens with grade II damage and five myocardial tissue specimens with grade III reperfusion injury in the control group. However, the study group consisted of two grade III myocardial tissue specimens, five grade 11 myocardial tissue specimens and one grade 1 myocardial tissue specimen. Moreover, a statistically significant reduction in myocardial edema was observed in the study group (p=0.022). Conclusion: Our results support the hypothesis that iloprost enhances protection against cardiac ischemia reperfusion injury. This protective effect may be associated with vasodilation, antioxidant or anti-edema mechanisms.
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    The predictors of poor outcomes in patients with femoral artery injuries
    (Verduci Publisher, 2013) Yavuz, C.; Demirtas, S.; Caliskan, A.; Ertas, F.; Kaya, H.; Aydin, M.; Benli, E. D.
    PURPOSE: This study investigated the predictors of poor outcomes, including limb loss and death, in patients with femoral artery injuries. PATIENTS AND METHODS: The study included 158 patients aged 2-82 (mean age 28.4 +/- 16.5) with femoral arterial injury (common, deep, and superficial femoral artery) that were treated surgically between 2000 and 2010. Isolated venous injuries were excluded. Demographic and clinical data of the patients, including age, gender, admission time, pulse rate and blood pressure, hematocrit value, reason of injury, associated injury, and Mangled Extremity Severity Score (MESS) were recorded. RESULTS: Of the 158 patients, the death and amputation rates were 5.7% (9) and 5.1% (8), respectively. In logistic regression analysis, four variables (pulse rate, MESS, hematocrit, and bone trauma) were found to be independent predictors for poor outcomes. The Odd's ratios and confidence interval values of these variables were as follows: 7.24 (1.94-26.92), 21.75 (5.4187.48), 5.93 (3.04-11.54) and 7.46 (2.09-9.56), respectively. CONCLUSIONS: The MESS value, presence of bone fracture, hematocrit, and pulse rate on admission are predictive risk factors for poor outcomes in patients with femoral artery injury. Therefore, in these patients, prompt intervention by experienced surgeons is crucial for limb salvage and decreased mortality.
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    Serum ischaemia-modified albumin level is an irrelevant predictive factor for ischaemic duration in mesenteric ischaemia
    (Sage Publications Ltd, 2014) Caliskan, A.; Yavuz, C.; Karahan, O.; Demirtas, Sinan; Yazici, S.; Guclu, O.; Mavitas, B.
    Background: Acute mesenteric ischaemia is an emergency condition that requires urgent and expeditious diagnosis and immediate surgical or medical intervention. The initial hours are critical for the recovery of the affected bowel segment. Thus, its clinic diagnostic biomarkers are important when it comes to reducing mortality and morbidity rates. Methods: Twenty-four male Sprague-Dawley rats were included in the study. The rats were divided into three equal groups.Those in Group I were sacrificed to determine the basal serum values of ischaemia-modified albumin (IMA) after a simple laparotomy.The superior mesenteric artery (SMA) was clamped in a simple laparotomy in Groups II and III; blood samples were taken at 120 minutes in Group II and 360 minutes in Group III.The serum IMA levels were identified from the blood samples and the results obtained were compared statistically. Results:The serum IMA levels were determined to be 22 +/- 6 (22) mu/L, 34 +/- 7 (34) mu/L and 36 +/- 4 (37) mu/L in Groups I, II and III, respectively.The differences between the groups were not statistically significant. Conclusion: Our results showed that the serum IMA level is not an appropriate biomarker for acute mesenteric ischaemia. Additionally, the IMA level is not an appropriate biomarker for the detection of ischaemia duration. However, future studies should be conducted to clarify the efficacy of serum IMA levels under different ischaemic conditions.
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    Using oxidant and antioxidant levels to predict the duration of both acute peripheral and mesenteric ischemia
    (Sage Publications Ltd, 2014) Yazici, S.; Demirtas, S.; Guclu, O.; Karahan, O.; Yavuz, C.; Caliskan, A.; Mavitas, B.
    Objective: The aim of this study was to determine the relationship between oxidative stress markers and the duration of ischemia in rat mesenteric and peripheral ischemia models. Methods: Forty rats were divided into five equal groups, as follows: rats in Group I (control group) were sacrificed to determine the baseline characteristics of the serum markers; the superior mesenteric artery was clamped via a simple laparotomy to induce mesenteric ischemia in Groups II and III; the right common femoral artery was clamped to induce peripheral ischemia in Groups IV and V. Blood samples were taken at 2 (Groups II and IV) and 6 (Groups III and V) hours after these procedures. The serum total oxidative status (TOS), total antioxidant capacity (TAC), oxidative stress index (OSI) and paraoxonase-I (PON-I) enzyme activities were evaluated in the samples obtained from each group. Results: The OSI level of the control group was 91.00+/-5.46 (mean +/- SD). The OSI levels taken 2 hours after the induction of mesenteric ischemia and peripheral ischemia were significantly higher (194.50+/-11.16 and 301.75+/-19.98, respectively (p<0.05)). However, these levels decreased to 151.88+/-17.02 (mesenteric ischemia) and 108.88+/-9.46 (peripheral ischennia) after 6 hours. The PON-I levels of Group III (mesenteric ischemia at 6 hours) (99.75+/-7.26), Group IV (peripheral ischemia at 2 hours) (96.88+/-4.09), and Group V (peripheral ischemia at 6 hours) (111.25+/-10.33) were slightly elevated over that of the control group (87.38+/-5.31). However, the PON-I level of Group 11 (mesenteric ischemia at 2 hours) (42.88+/-3.14) was lower than that of the other groups (p<0.05). Conclusion: Despite the increment of oxidative markers in early periods of ischemia (2nd hour), which was a hypoxic response of ischemic cells, they have decreased markedly in prolonged ischemia. This might have been caused by the opening of some collateral circulation or the destruction of the ischemic cells.