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Öğe Continuous renal replacement therapy after cardiac surgery in patients with acute renal failure(2013) Guclu O.; Yavuz C.; Gurkan S.C.; Yuksel V.; Demirtas S.; Caliskan A.; Gur O.Aim Acute renal failure is an important adverse effect of cardiopulmonary bypass that can result in high mortality or morbidity rates. It can be treated with continuous renal replacement therapy after cardiac surgery. The purpose of this study was to determine the factors associated with the mortality and incidence of acute renal failure in patients of post cardiac surgery. Methods Patients (1564) who underwent cardiac surgery between January 2007 and January 2012 and treated with continuous renal replacement therapy were included (N=40). Patients with previous renal disorders were excluded. A retrospective analysis was carried out. Results Overall, continuous renal replacement therapy was used in 40 (2.6%) patients. The mean age was 62.7±11 years. Mean duration of cardiopulmonary bypass was 166±80 min, and aorta cross-clamping time was 97±35 min. The patients' mean pretherapy creatinine level and mean creatinine level before hospital discharge were 3.3±1.1 mg/dL and 1.1±0.4 mg/dl, respectively. Thirty-day mortality was 35%. Only 6 patients required long-term renal replacement therapy. Conclusion Acute renal failure requiring hemodialysis after cardiac surgery is associated with higher mortality and morbidity and prolonged hospital stay. Early renal recovery with continuous renal replacement therapy seems to offer an evident survival benefit. Continuous renal replacement therapy may represent an important therapy and reduce mortality rates. We believe that these rates might decrease even more with detailed preoperative evaluation and meticulous postoperative care with collaborative management.Öğe Evaluating the anti-angiogenic properties of iloprost and dipyridamole in the chick embryo chorioallantoic membrane model(Scientific Publishers of India, 2014) Guclu O.; Karahan O.; Yazici S.; Caliskan A.; Demirtas S.; Yavuz C.; Muratoglu A.Dipyridamole is an antithrombotic agent that is widely used in the treatment of many vascular disorders. Also, the prostacyclin analogue iloprost has been utilized to salvage limbs in patients with severe limb ischemia. In this study we investigated whether dipyridamole and iloprost have anti-angiogenic properties and their anti-angiogenic properties were compared to bevacizumab, a known inhibitor of angiogenesis, using the in vivo chick chorioallantoic membrane animal model. Agar pellets were prepared with three different drug concentrations at 10-6 M, 10-5 M, and 10-4 M. For each drug concentration twenty fertilized eggs were used. The entire experiment was performed in duplicate. Blood vessel density and loss were examined and scored under a stereoscopic microscope. For the 10-4 M, 10-5 M and 10-6 M concentrations, the anti-angiogenic scores of iloprost were 0.2, 0.1 and 0.05, respectively. In the same order, the anti-angiogenic scores for dipyridamole were 0.2, 0.3 and 0.8. The anti-angiogenic scores for bevacizumab were significantly higher than dipyridamole and iloprost over all concentrations (p<0.05). There were no significant differences found between the anti-angiogenic scores for iloprost and dipyridamole for all concentrations (p>0.05). Iloprost demonstrated no anti-angiogenic properties in the chorioallantoic membrane animal model, while dipyridamole did exhibit very weak anti-angiogenic activity only at very high doses of 10-4 M. These results reveal that both agents can be prescribed safely for the treatment of medical conditions that require angiogenesis to facilitate healing.Öğe The investigation of the antiangiogenic potential of amiodarone HCl in the chick embryo chorioallantoic membrane model(2013) Karahan O.; Yavuz C.; Demirtas S.; Caliskan A.; Atahan E.Angiogenesis, which plays a significant role in a variety of physiological processes, such as embryonic growth and wound healing, is strictly delimited and finely tuned by a balance of proangiogenic and antiangiogenic factors. Cardiac rhythm disorders are diseases that are often accompanied by vascular pathologies. As such, the purpose of this study was to investigate the antiangiogenic effects of Amiodarone HCl in the chorioallantoic membrane model. In this study, the antiangiogenic effect of Amiodarone HCl was compared with a positive control group that was given pure paraffin and the vascular endothelial growth factor inhibitor Bevacizumab, as well as a negative control group in which clearly antiangiogenic activity was shown in this model previously. Concentrations of 10-4, 10-5, and 10-6M of each drug were administered. For the purpose of determining the antiangiogenic effects of the drugs, blood vessels of the chorioallantoic membranes were evaluated using a stereoscopic microscope. The antiangiogenic effect scores of Amiodarone HCl at the dose of 10-4 molar (M) were higher than those of 10-5M and 10-6M, but that result was statistically insignificant. The antiangiogenic effect scores of Bevacizumab at the concentrations of 10-4M and 10-5M were significantly higher than that of 10-6M. This effect of Amiodarone may be important for determining routine antiarrhythmic doses.Öğe Relation of interatrial duration and p wave terminal force as a novel indicator of severe mitral regurgitation.(2012) Elbey M.A.; Oylumlu M.; Akil A.; Demirtas S.; Ertas F.; Erdogan E.; Tasal A.Interatrial duration is defined as prolonged p wave on electrocardiogram. p waves with a negative terminal phase recorded in V1 enclosing an area of one small square on the electrocardiogram is significantly and strongly correlated with interatrial duration. The aim of study was to investigate whether interatrial duration with p terminal force can be used as reflection of echocardiographic severity of mitral regurgitation. Sixty two consecutive patients with mitral regurgitation. were prospectively studied. Age/gender matched 57 subjects who had normal mitral structure and did not have mitral regurgitation. Patients with mitral regurgitation referred to a single cardiac center for echocardiography and who met the entry criteria documented moderate or severe mitral regurgitation with sinus were included. The interatrial duration was defined on the routine 12-lead electrocardiogram (50 mm/s, 10 mm/mV) using the greatest duration of p waves from D2, D3, AVF and V1. There was a positive correlation between interatrial duration (>/= 110 ms) and effective regurgitant orifice (r = 0.3, p < 0.001). However, left atrial diameter and brain natriuretic peptide were significantly higher in cases with mitral regurgitation. There was also strong correlation between interatrial duration (>/= 110 ms) and p terminal force and left atrial diameter. ROC analysis revealed that interatrial duration of > 110 msec. could predict of severe mitral regurgitation with 88% sensitivity and 100% specificity. Severe mitral regurgitation, left atrial diameter was correlated with p terminal force and interatrial duration. Significant interatrial duration (>/= 110 ms) and p terminal force might be considered as novel indicators of severe mitral regurgitation.
