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Acute ventricular rupture due to myocardial infarction during postpartum period
(2009) Topal, Aşkın Ender; Eren, Mehmet Nesimi
Ventricular rupture is the third most common cause of deaths due to myocardial infarction. However, myocardial infarction is uncommon during pregnancy and postpartum period. We review a case with left ventricular rupture as a complication of myocardial infarction during postpartum period.
Adropin as a potential marker of enzyme-positive acute coronary syndrome
(Clinics Cardive Publ Pty Ltd, 2017) Aydin, Suna; Eren, Mehmet Nesimi; Yilmaz, Musa; Kalayci, Mehmet; Yardim, Meltem; Alatas, Omer Dogan; Kuloglu, Tuncay
Aim: Enzyme-positive acute coronary syndrome (EPACS) can cause injury to or death of the heart muscle owing to prolonged ischaemia. Recent research has indicated that in addition to liver and brain cells, cardiomyocytes also produce adropin. We hypothesised that adropin is released into the bloodstream during myocardial injury caused by acute coronary syndrome (ACS), so serum and saliva levels rise as the myocytes die. Therefore, it could be useful to investigate how ACS affects the timing and significance of adropin release in human subjects. Methods: Samples were taken over three days after admission, from 22 EPACS patients and 24 age-and gendermatched controls. The three major salivary glands (submandibular, sublingual and parotid) were immunohistochemically screened for adropin production, and serum and saliva adropin levels were measured by an enzyme-linked immuno-sorbent wassay (ELISA). Salivary gland cells produce and secrete adropin locally. Results: Serum adropin, troponin I, CK and CK-MB concentrations in the EPACS group became gradually higher than those in the control group up to six hours (p < 0.05), and troponin I continued to rise up to 12 hours after EPACS. The same relative increase in adropin level was observed in the saliva. Troponin I, CK and CK-MB levels started to decrease after 12 hours, while saliva and serum adropin levels started to decrease at six hours after EPACS. In samples taken four hours after EPACS, when the serum adropin value averaged 4.43 ng/ml, the receiver operating characteristic curve showed that the serum adropin concentration indicated EPACS with 91.7% sensitivity and 50% specificity, while when the cut-off adropin value in saliva was 4.12 ng/ml, the saliva adropin concentration indicated EPACS with 91.7% sensitivity and 57% specificity. Conclusion: In addition to cardiac troponin and CK-MB assays, measurement of adropin level in saliva and serum samples is a potential marker for diagnosing EPACS.
The bioactive peptides salusins and apelin-36 are produced in human arterial and venous tissues and the changes of their levels during cardiopulmonary bypass
(Elsevier Science Inc, 2012) Aydin, Suna; Eren, Mehmet Nesimi; Aydin, Suleyman; Ozercan, Ibrahim Hanefi; Dagli, Adile Ferda
This study aimed to examine the effects of CPB on salusin-alpha, salusin-beta and apelin-36 bioactive peptides in people who are planned to undergo coronary artery bypass graft (CABG) operation due to coronary artery disease and to explore whether these peptides are produced in human aortic, saphenous and arterial tissues. The study included age and BMI matched 15 patients who underwent CABG operation by CPB. In order to determine salusin-alpha, salusin-beta and apelin-36 levels, venous blood samples were collected before induction of anesthesia (T1), before CPB (T2), 5 min before the removal of cross-clamp (T3), 5 min after the removal of cross-clamp (14), upon arrival in the intensive care (15), at postoperative 24th hour (16) and 72nd hour (T7). Salusin and apelin expressions of the tissues were shown by immunohistochemical method. Peptide amounts of sera and tissues were measured using ELISA. Salusins production by vessels occurs in fibroblast cells of the media in the aorta and smooth muscle cells of the media in the LIMA and saphena. Apelin is produced by endothelial cells of the intima and fibroblast cells of the media in the aorta and by smooth muscle cells of the media in the LIMA and saphena. Changes in the levels of salusin-beta and apelin-36 were significant during CPB. Salusin-alpha, salusin-beta and apelin-36 are locally synthesized in the arteries and veins. Salusins and apelin-36 might be important markers in the CPB, and also that salusin-beta was more specific in comparison to salusin-alpha. (C) 2012 Elsevier Inc. All rights reserved.
Bronşektazide operasyonun rolü: Cerrahi ve medikal tedavinin karşılaştırması
(2002) Balcı, Akın Eraslan; Balcı, Ansal Tansel; Eren, Mehmet Nesimi; Nazaroğlu, Hasan
Amaç: Modern antibiyoterapi çağında, bronşektazi tedavisinde operasyonun rolünü araştırmak için, 162 bronşektazi hastası değerlendirildi. Materyal ve Metod: Hastaların 118'i cerrahi (A grubu), 28'i medikal olarak (B grubu) tedavi edildi. Her iki grup yaş, hastalıklı segment sayısı ve izlem süresi bakımından benzerdi. Bulgular: Operasyon endikasyonları %51.7 medikal tedavinin yetmezliği, %20.3 hemoptizi ve %14.4 gelişme geriliğiydi. Bilateral hastalık A grubunda %17.8, B grubunda %21.4'ü. En sık (%39'a karşın 32.1) alt lob bazal segmentler tutulmuştu. Hastalıklı segment sayısı ortalama 4.8'e karşın 4.7 idi. Lobektomi %73.7, pnömonektomi %9.3, wedge-segmentektomi %8.4 oranında yapıldı. Tam rezeksiyon tek taraflı hastalıkta %95, iki taraflı hastalıkta %28.5 başarıldı. Morbidite %21.2, mortalite %3.4'dü. A grubu hastalarda ortalama postoperatif hastane süresi B grubundan daha kısaydı (8.6'ya karşılık 13.2 gün). İki yıllık izlemde tam rezeksiyonun başarıldığı hastaların %94.4'ü, B grubu hastaların ise %60'ı asemptomatik kaldı (p < 0.05). Sonuç: Rezeksiyon, iyi seçilen hastalarda düşük morbidite ve mortaliteyle yapılabilir ve uzun dönemde medikal tedaviye üstünlük taşır.
Cardiac, skeletal muscle and serum irisin responses to with or without water exercise in young and old male rats: Cardiac muscle produces more irisin than skeletal muscle
(Elsevier Science Inc, 2014) Aydin, Suna; Kuloglu, Tuncay; Aydin, Suleyman; Eren, Mehmet Nesimi; Celik, Ahmet; Yilmaz, Musa; Kalayci, Mehmet
Irisin converts white adipose tissue (WAT) into brown adipose tissue (BAT), as regulated by energy expenditure. The relationship between irisin concentrations after exercise in rats compared humans after exercise remains controversial. We therefore: (1) measured irisin expression in cardiac and skeletal muscle, liver, kidney, peripheral nerve sheath and skin tissues, as also serum irisin level in 10 week-old rats without exercise, and (2) measured tissue supernatant irisin levels in cardiac and skeletal muscle, and in response to exercise in young and old rats to establishing which tissues produced most irisin. Young (12 months) and old rats (24 months) with or without 10min exercise (water floating) and healthy 10 week-old Sprague-Dawley rats without exercise were used. Irisin was absent from sections of skeletal muscle of unexercised rats, the only part being stained being the perimysium. In contrast, cardiac muscle tissue, peripheral myelin sheath, liver, kidneys, and skin dermis and hypodermis were strongly immunoreactivity. No irisin was seen in skeletal muscle of unexercised young and old rats, but a slight amount was detected after exercise. Strong immunoreactivity occurred in cardiac muscle of young and old rats with or without exercise, notably in pericardial connective tissue. Serum irisin increased after exercise, being higher in younger than older rats. Irisin in tissue supernatants (cardiac and skeletal muscle) was high with or without exercise. High supernatant irisin could come from connective tissues around skeletal muscle, especially nerve sheaths located within it. Skeletal muscle is probably not a main irisin source. Copyright (C) 2013 Elsevier Inc. All rights reserved.
The cardiovascular system and the biochemistry of grafts used in heart surgery
(Springer International Publishing Ag, 2013) Aydin, Suna; Aydin, Suleyman; Eren, Mehmet Nesimi; Sahin, Ibrahim; Yilmaz, Musa; Kalayci, Mehmet; Gungor, Orhan
Blood is pumped into the cardiac muscle through arteries called the coronary arteries. Over time, the accumulation of cholesterol, coagulation factors, and cells on the walls of these arteries causes the walls to thicken and lose their elasticity, resulting in the development of atherosclerosis. When the blood supply of the heart is diminished by atherosclerosis, it can be restored by bypass surgery, in which atherosclerosis-free vein and/ or artery grafts taken from another area of the body are used to replace the atherosclerotic vessels. These biological grafts used in surgery differ in biochemical composition and long-term patency. Although the great saphenous vein (GSV) has been the most popular graft material in revascularization for years, it has recently been superseded by the internal mammarian artery (IMA), which has a lower incidence of recurrence of atherosclerosis. The aim of the present review is briefly to address the structure of the cardiovascular system and blood vessels, and then, in the light recent data, to present the biochemical compositions and individual advantages of the graft materials used to restore an impaired blood supply to the heart.
Comparison of effects of iloprost and pentoxiphylline on walking capacity and skin oxygenation in diabetic patients with peripheral artery disease
(Academic Journals, 2012) Topal, Askin Ender; Eren, Mehmet Nesimi
Diabetes is in close relation with peripheral artery disease (PAD) and there are conflicting results regarding efficacy of iloprost in PAD. The aim of this study was to investigate the efficacy of iloprost in improving walking capacity and increasing oxygenation to diseased tissues in PAD patients with diabetes, compared to pentoxiphylline. Data of 80 patients were recorded contemporaneously. Patients were divided into two groups (Group 1: Users of iloprost and pentoxiphylline; Group 2: Users of only pentoxiphylline). O-2 saturations in diseased limbs were significantly improved at three-months follow-up in both groups (both p<0.001). The difference between groups was in favor of Group 1 (p = 0.012). Maximum walking capacity was also increased significantly in both groups (both p<0.001). However, the improvements in walking distance were at similar extent (p = 0.226). In comparison with pentoxiphylline, iloprost has no superior effect on walking capacity of diabetic patients with intermittent claudication. However, iloprost improves oxygenation of tissues better than pentoxiphylline, therefore iloprost may be preferred especially in diabetic patients with critical limb ischemia as an adjunctive therapy followed by pentoxiphylline or cilostazol. Usage of iloprost may contribute to the recovery of diabetic ulcers and also, it may postpone occurrence of diabetic ulcers.
Decreased saliva/serum irisin concentrations in the acute myocardial infarction promising for being a new candidate biomarker for diagnosis of this pathology
(Elsevier Science Inc, 2014) Aydin, Suna; Aydin, Suleyman; Kobat, Mehmet Ali; Kalayci, Mehmet; Eren, Mehmet Nesimi; Yilmaz, Musa; Kuloglu, Tuncay
Irisin is a muscle-secreted protein. Cardiac muscle produces more irisin than skeletal muscle in response to acute exercise, and is associated with myocardial infarction (MI) in an experimental model induced by isoproterenol in rats. The timing and significance of its release in patients with acute myocardial infarction (AMI) needs further investigation. We have studied the relationship between serum/saliva irisin concentration and AMI in humans. Serum and saliva samples were taken within 3 days of admission in 11 patients with AMI and in 14 matched controls. Salivary gland irisin was detected immunohistochemically, and serum and saliva levels were measured by ELISA. The three major paired salivary glands (submandibular, sublingual and parotid) produce and release irisin into saliva. Troponin-I, CK, CK-MB concentrations in the AMI group gradually increased from up to 12 h, while saliva and serum irisin gradually decreased from up to 48 h, compared with the control group (P < 0.05). After 12 h, troponin-I, CK, CK-MB started to decrease, while saliva and serum irisin started to increase at 72 h. Serum irisin levels correlated with age, while troponin I, CK-MB, and CK were correlated and with saliva irisin in AMI patients. Besides cardiac troponin and CK-MB, irisin adds new diagnostic information in AMI patients, and the gradual decrease of saliva/serum irisin over 48 h could be a useful biomarker. (c) 2014 Elsevier Inc. All rights reserved.
Elevated adropin: A candidate diagnostic marker for myocardial infarction in conjunction with troponin-I
(Elsevier Science Inc, 2014) Aydin, Suna; Kuloglu, Tuncay; Aydin, Suleyman; Kalayci, Mehmet; Yilmaz, Musa; Cakmak, Tolga; Eren, Mehmet Nesimi
Myocardial infarction (MI; heart attack) can cause injury to or death of heart muscle tissue (myocardium) owing to prolonged ischemia and hypoxia. Troponins and CK-MB are released from heart muscle cells during MI. It has been demonstrated that energy expenditure is regulated by adropin expressed in the endocardium, myocardium, and epicardium. We hypothesized that adropin is released into the bloodstream during myocardial muscle injury caused by MI, so the serum level rises as myocytes die. Therefore, we examined the association between adropin expression and myocardial infarction in isoproterenol-induced myocardial infarction. Rats were randomly allocated to six groups. After treatment they were decapitated and their blood and tissues were collected for adropin measurement. Changes in adropin synthesis in rat heart, kidney and liver tissues in isoproterenol (ISO)-induced MI were demonstrated immunohistochemically. Serum adropin concentrations were measured by ELISA, and troponin-I, CK and CK-MB concentrations by autoanalysis. The results demonstrated that cardiac muscle cells, glomerular, peritubular and renal cortical interstitial cells, hepatocytes and liver sinusoidal cells all synthesize adropin, and synthesis increased 1-24 h after MI except in the liver cells. The findings elucidate the pathogenesis of MI, and the gradual increase in serum adropin could be a novel diagnostic marker and serve as an alternative to troponin-I measurement for diagnosing MI. (C) 2014 Elsevier Inc. All rights reserved.
Esophageal foreign bodies under cricopharyngeal level in children: An analysis of 1116 cases
(2004) Balcı, Akın Eraslan; Eren, Şevval; Eren, Mehmet Nesimi; 0000-0002-5570-705X
Esophageal foreign bodies (FBs) in children are a commonly seen complaint that can cause severe morbidity. Different methods are used for their extraction. We reviewed our cases and described direct extraction technique. The specifications of 1116 children with esophageal FBs between 1990 and 2000 were evaluated. All FB cases were considered emergencies and intervention was performed in the operating theater. Patients with coins were only sedated and relaxed while the FB was removed under direct vision by McGill forceps. Other FBs were removed under general anesthesia by rigid esophagoscope. There were 1035 coins in 1007 patients and 112 other FBs in 109 children. Mean age was 4.2 years, ranging from 1 month to 15 years. Immediate interventions were performed in 16 (1.4%) patients. Reasons included respiratory distress from pressure in eight (five coins, three toy pieces), increased rupture risk after 4 days in three (all coins) and esophageal rupture in five patients. Four (0.3%) perforations occurred during intervention; two (0.02%, 2/1116) arose from coin extraction, and another two (1.8%, 2/109) were caused by esophagoscopic removal. The success rate for esophagoscopic removal was 95.4% (105/109). Three (0.2%) of 1116 patients underwent surgery to remove FBs. All were esophagoscopy patients, thus the surgery ratio for esophagoscopic removal was 2.7% (3/109). If an FB is diagnosed quickly and removed few problems arise. Esophageal coins can be successfully extracted under direct vision. © 2003 Elsevier B.V. All rights reserved.
Expression of adropin in rat brain, cerebellum, kidneys, heart, liver, and pancreas in streptozotocin-induced diabetes
(Springer, 2013) Aydin, Suleyman; Kuloglu, Tuncay; Aydin, Suna; Eren, Mehmet Nesimi; Yilmaz, Musa; Kalayci, Mehmet; Sahin, Ibrahim
We have investigated how diabetes affects the expression of adropin (ADR) in rat brain, cerebellum, kidneys, heart, liver, and pancreas tissues. The rats in the diabetic group were administered an intraperitoneal (i.p.) injection of a single dose of 60 mg/kg streptozotocin (STZ) dissolved in a 0.1 M phosphate-citrate buffer (pH 4.5). The rats were maintained in standard laboratory conditions in a temperature between 21 and 23 A degrees C and a relative humidity of 70 %, under a 12-h light/dark cycle. The animals were fed a standard commercial pellet diet. After 10 weeks, the animals were sacrified. ADR concentrations in the serum and tissue supernatants were measured by ELISA, and immunohistochemical staining was used to follow the expression of the hormones in the brain, cerebellum, kidneys, heart, liver, and pancreas tissues. The quantities were then compared. Increased ADR immunoreaction was seen in the brain, cerebellum, kidneys, heart, liver, and pancreas in the diabetes-induced rats compared to control subjects. ADR was detected in the brain (vascular area, pia mater, neuroglial cell, and neurons), cerebellum (neuroglial cells, Purkinje cells, vascular areas, and granular layer), kidneys (glomerulus, peritubular interstitial cells, and peritubular capillary endothelial cells), heart (endocardium, myocardium, and epicardium), liver (sinusoidal cells), and pancreas (serous acini). Its concentrations (based on mg/wet weight tissues) in these tissues were measured by using ELISA showed that the levels of ADR were higher in the diabetic rats compared to the control rats. Tissue ADR levels based on mg/wet weight tissues were as follows: Pancreas > liver > kidney > heart > brain > cerebellar tissues. Evidence is presented that shows ADR is expressed in various tissues in the rats and its levels increased in STZ-induced diabetes; however, this effect on the pathophysiology of the disorder remains to be understood.
Gradually increasing predominance of self-mutilation in upper extremity arterial injuries: Iess morbidity but with high threat to society
(2010) Eren, Mehmet Nesimi; Topal, Aşkın Ender
AMAÇ Üst ekstremite vasküler yaralanma sıklığı giderek artmakla beraber, mortalite ve morbidite oranları %0-%8 arasında kalmaktadır. Son yıllarda self-mutilasyon olguları belirgin olarak karşımıza çıkmaktadır. Üst ekstremite vasküler yaralanmalarında self-mutilasyon ve diğer penetran travma sonuçlarını karşılaştırmak ve self-mutilasyonun toplum için oluşturduğu tehditi ortaya koymak amacıyla bu çalışmayı planladık. GEREÇ VE YÖNTEM Üst ekstremite penetran vasküler yaralanması tanısıyla ameliyat edilen 249 hastanın verileri retrospektif olarak değerlendirildi. Hastaların 214?ü (%86) erkek, 35?i kadındı (%14). Ortalama yaş 24,76±11,28 idi (dağılım, 2-69 yaş). Hastaların 129?u (%52) self-mutilatördü.BULGULAR En sık yaralanan arter ulnar arterdi (n=140, %56). Ölüm ve uzuv kaybı yaşanmadı. Ancak, penetran travmalı 8 hastada parmak hareket kısıtlılığı ortaya çıktı. Erkek baskınlığı, madde bağımlılığı ve eşlik eden sinir yaralanması varlığı self-mutilatör grupta anlamlı olarak daha yaygındı (sırasıyla p değerleri <0,001, <0,001 ve 0,005). Buna karşılık brakiyal arter yaralanma sıklığı, ven greft interpozisyon kullanımı ve fasyotomi oranları penetran travma grubunda daha yüksekti (p değerleri <0,001). SONUÇ Üst ekstremite penetran travmalarında, yaralanma şekli ve sebebi dikkatlice sorgulanmalı, self-mutilasyon varlığında madde bağımlılığı araştırılmalı ve self-mutilatör hastalara hemen psikiyatrik destek başlanması sağlanmalıdır.
Gradually increasing predominance of self-mutilation in upper extremity arterial injuries: less morbidity but with high threat to society
(Turkish Assoc Trauma Emergency Surgery, 2010) Topal, Askin Ender; Eren, Mehmet Nesimi
BACKGROUND Although vascular trauma of the upper extremity is increasingly more common, mortality and morbidity rates remain low, at between 0-8%. Self-mutilation has become evident in recent years. We planned this study to compare the results of self-mutilation with other penetrating trauma in upper extremity vascular injuries and also to emphasize the dangers of self-mutilation for society. METHODS Data of 249 patients with penetrating vascular injury of the upper extremity were retrospectively analyzed. There were 214 male (86%) and 35 female (14%) patients, with a mean age of 24.76 +/- 11.28 years (range: 2-69 years). Of these, 129 (52%) were self-mutilators. RESULTS The ulnar artery was the most frequently affected (n=140, 56%). There was no mortality or limb loss. However, eight (3.21%) patients, who had penetrating trauma, had restriction in finger motions. Male predominance, substance abuse and associated nerve injury were significantly more common among self-mutilators (p values <0.001, <0.001 and 0.005, respectively), whereas brachial artery injury, vein graft interposition and fasciotomy rates were higher among the penetrating trauma group (p<0.001 for all). CONCLUSION The form of and reason for injuries and presence of substance abuse in case of self-mutilation must be investigated cautiously, and the immediate commencement of psychiatric treatment must be provided to the self-mutilators.
Holt-Oram sendromu. Olgu sunumu
(2002) Çakır, Ömer; Kesemenli, Cumhur; Eren, Mehmet Nesimi
Holt-Oram sendromu üst ekstremite iskelet displazisi ve konjenital kardiyak defektlerle karakterize otozomal dominant geçişli herediter bir hastalıktır. Olgumuz her iki elde birinci parmak yokluğu, ikinci ve üçüncü parmaklarda basit inkomplet sindaktili ve torakal bölgede konjenital kifoskolyozu olan on yaşında erkek çocuktu. Hastanın her iki önkol ve el grafilerinde tip C radius aplazisi ve birinci ray yokluğu, torakal grafide ise kifoskolyoz saptandı. Ekokardiyografide geniş atriyal septal defekt vardı. Atriyal septal defekt kardiyopulmoner bypass kullanılarak perikard yama ile kapatıldı. Literatürde Holt-Oram sendromu ile birlikte şiddetli kifoskolyoza rastlamadığımız için bu olguyu yayınlamayı uygun bulduk.
Irisin in coronary bypass surgery
(Bentham Science Publishers B.V., 2018) Aydın, Suna; Çatak, Zekiye; Eren, Mehmet Nesimi; Topal, Aşkın Ender; Aydın, Süleyman
Introduction: In coronary bypass surgery, after cardiopulmonary bypass is initiated by arterial cannulation in the ascending aorta and venous cannulation through a single vein generally in the right atrium, the process of cooling the patient is started. Objective: There is a relation between cooling the patient and irisin, which is responsible for releasing heat. Therefore, the main objective of the present study is to explore how irisin concentrations and some other panel of myocardium injury in patients undergoing coronary artery bypass surgery. Methods: The blood samples collected before induction (T1), before bypass (T2), before (T3) and after (T4) removing the cross-clamp, upon admission to intensive care (T5), and at the postoperative 24 (T6) and 72 (T7) hours, and whether these concentrations are correlated with lactate levels classically used in monitoring this surgery. A total of biological samples, 23 from control individuals and 105 from bypass patients (14-16 samples for each timeframe) were analyzed to determine irisin, CK-MB, TnT and BNP levels by ELISA and lactate levels by lactate assay kit. Both lactate and irisin were seen to increase gradually from the time of induction to the removal of the cross-clamp. After the cross-clamp was removed and the patient was started to be warmed, both parameters began to decrease gradually and were restored to normal levels on the second and third post-operative days. The increase and decrease in irisin were found correlated with lactate levels. CK-MB, TnT and BNP alteration were similar to each other. Results: Based on these results, it is estimated that measurement of irisin along with lactate may prove to be a useful parameter in monitoring the coronary bypass surgery and irisin may be a significant marker of hypothermia. Beside CK-MB, TnT and BNP, measurements of irisin concentration in open heart surgery may also be useful parameters for the panel of myocardium injury. © 2018 Bentham Science Publishers.
Irisin: A potentially candidate marker for myocardial infarction
(Elsevier Science Inc, 2014) Kuloglu, Tuncay; Aydin, Suna; Eren, Mehmet Nesimi; Yilmaz, Musa; Sahin, Ibrahim; Kalayci, Mehmet; Sarman, Emine
Myocardial infarction (MI) causes energy depletion through imbalance between coronary blood supply and myocardial demand. Irisin produced by the heart reduces ATP production by increasing heat generation. Energy depletion affects irisin concentration in circulation and cardiac tissues, suggesting an association with MI. We examined: (1) irisin expression immunohistochemically in rat heart, skeletal muscle, kidney and liver in isoproterenol (ISO)-induced MI, and (2) serum irisin concentration by ELISA. Rats were randomly allocated into 6 groups (n=6), (i) control, (ii) ISO (1 h), (iii) ISO (2 h), (iv) ISO (4 h), (v) ISO (6 h), and (vi) ISO (24 h), 200 mg ISO in each case. Rats were decapitated and the blood and tissues collected for irisin analysis. Blood was centrifuged at 1792 g for 5 min. Tissues were washed with saline and fixed in 10% formalin for histology. Serum irisin levels gradually decreased from 1 h to 24h in MI rats compared with controls, the minimum being at 2 h, increasing again after 6 h. Cardiac muscle cells, glomerular, peritubular renal cortical interstitial cells, hepatocytes and liver sinusoidal cells and perimysium, endomysium and nucleoi of skeletal muscle were irisin positive, but its synthesis decreased 1-4 h after MI. At all time-points, irisin increased near myocardial connective tissue, with production in skeletal muscle, liver and kidney recovering after 6 h, although slower than controls. Unique insight into the pathogenesis of MI is shown, and the gradually decrease of serum irisin might be a diagnostic marker for MI. (C) 2014 Elsevier Inc. All rights reserved.
Konjenital lobar amfizem
(2002) Eren, Tahir Şevval; Balcı, Akın Eraslan; Eren, Mehmet Nesimi; Ülkü, Refik; Kılınç, Nihal
1993-2001 yılları arasında cerrahi olarak tedavi edilen 4 konjenital lobar amfizemli olgu gözden geçirildi. Olguların 3'ü erkek, 1'i kızdı ve yaşları 28 gün, 2, 3 ve 10 aydı. Tekrarlayan akciğer enfeksiyonları, dispne, siyanoz ve sıkıntılı solunum ana bulgulardı. Olguların 3'ünde sol üst lob tutulmuştu. Göğüs x-ray ve bilgisayarlı tomografi tutulmuş lobların hiperaerasyonunu gösteriyordu. Bütün olgularda lobektomi yapıldı ve postoperatif dönem sorunsuz geçti. Solunum sıkıntısı ile gelen her infantta konjenital lobar amfizemden şüphelenilmelidir. Başarılı medikal tedaviler bildirilmesine rağmen, tutulan lobun cerrahi rezeksiyonu kabul edilen tedavi yöntemidir.
Left Ventricle and Left Atrium Remodeling after Mitral Valve Replacement in Case of Mixed Mitral Valve Disease of Rheumatic Origin
(Wiley, 2010) Topal, Askin Ender; Eren, Mehmet Nesimi; Celik, Yusuf
P>Background: The objective of this study was to evaluate the recovery of the left ventricle (LV) function, and to analyze postoperative size reduction of LV and left atrium (LA), after mitral valve replacement (MVR) in patients with chronic rheumatic mitral disease. Methods: Thirty consecutive elective patients with MVR for mixed mitral disease of rheumatic origin formed the study group. Of these, 21 (70%) were women and the mean age was 37 years. Transthoracic echocardiography was performed prior to surgery, at three-month follow-up, and at three-year follow-up except for the latest nine patients. Results: The mean duration of follow-up was 3.6 +/- 1.8 years. MVR surgery improved the functional class (mean New York Heart Association [NYHA] class) at three-year follow-up (p = 0.008). LV end-diastolic diameter and LA sizes decreased after MVR. Total chordal preservation causes better outcome, regarding to LV ejection fraction (LVEF) and NYHA functional class of patients. Preoperative high NYHA class, low LVEF, and high LV end-systolic diameter (LVESd) resulted with postoperative LV dysfunction (p were < 0.001, < 0.001, and 0.006, respectively). Conclusion: In patients with mixed mitral valve disease, MVR enhanced LV and LA remodeling resulting in better NYHA function. Preoperative NYHA, LVEF, and LVESd were significant predictors of postoperative LV function. (J Card Surg 2010;25:367-372).
Lower extremity arterial injuries over a six-year period: outcomes, risk factors, and management
(Dove Medical Press Ltd, 2010) Topal, Askin Ender; Eren, Mehmet Nesimi; Celik, Yusuf
Purpose: Limb loss following lower extremity arterial injury is not uncommon and has serious implications on the patient's life and functionality. This retrospective study was performed to analyze the results of lower extremity arterial injuries and to identify the risk factors associated with amputation. Methods: Between 2002 and 2009, retrospectively collected data on 140 patients with 173 lower extremity arterial injuries were analyzed. Results: There were 133 males (95%) and 7 females (5%). The mechanism of injuries was gunshot wounds in 56.4% of cases, stab wounds in 30%, and blunt trauma in 13.4%. Associated injuries included vein injury in 45% of cases, nerve injury in 16.4%, and bone fracture in 31.4%. The most frequently injured artery was superficial femoral artery (31.2%). More than 1 artery was injured in 18.6% of patients. Surgery was carried out, with a limb salvage rate of 90.4% and a survival of 97.1%. Amputation was performed in 75% of patients in whom only 1 artery was repaired, although all crural arteries were injured. Multivariate logistic regression analysis showed that significant risk factors of outcome were below-knee multiple arterial injuries (odds ratio [OR] 6.62, P < 0.001), associated 2-bone fractures (OR 2.71, P = 0.003), development of compartment syndrome (OR 1.94, P = 0.042), and great soft tissue disruption (OR 1.74, P = 0.010). Conclusions: Limb loss may be decreased by performing prophylactic fasciotomy more often and by repairing at least 2 crural arteries.
Penetran kalp yaralanmaları; mortalite belirleyicilerinin analizi
(2009) Eren, Mehmet Nesimi; Göz, Mustafa; Çakır, Ömer
AMAÇ Penetran kalp yaralanmaları, dramatik ve ölümcül travmalardır. Bu hastaların birçoğu, hastaneye ciddi şok veya ölü olarak ulaşırlar. Erken tanı ve ameliyat prognozu belirler. Bu çalışmada, kliniğimizde tedavi edilen penetran kalp yaralanmalı olgulardaki yaralanma biçimi, acil servise geliş tablosu, geliş süresi ile tedavi yaklaşımlarının morbidite ve mortalite üzerine olan etkileri değerlendirildi. GEREÇ VE YÖNTEM Penetran kalp yaralanmalı 52 hasta retrospektif olarak incelendi. Hastaların demografik karekterleri, yaralanmanın sebepleri, hastaneye geliş zamanı, acil servis inceleme bulguları, kullanılan tanı yöntemleri ve uygulanan cerrahi yöntemlerin sonuçlar üzerine etkisi incelendi. BULGULAR Erkek-kadın oranı 48: 4 olup yaş ortalaması 27,86±13,73 idi. Kırk altı hastada (%88,5) delici alet, dört hastada ateşli silah ve iki hastada iyatrojenik yaralanma etyolojide rol oynamaktaydı. Tüm hastalara acil cerrahi girişim uygulandı. Kardiyak yaralanmalar primer dikişle tamir edildi. Sekiz olgu ile hastane mortalitesi %15,4 olarak saptandı. SONUÇ Penetran kardiyak yaralanmalarda kanama ve/veya tamponad nedeniyle çok kısa sürede şok gelişebilir. Erken tanı ve acil torakotomi penetran kardiyak yaralanma sonrası hastaların yaşamasında temel faktörlerdir.

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