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Öğe Analysis of peripheral vascular injuries: A social catastrophe(Dicle Üniversitesi Tıp Fakültesi, 2014) Yazıcı, Süleyman; Karahan, Oğuz; Güçlü, Orkut; Yavuz, Celal; Demirtaş, Sinan; Çalışkan, Ahmet; Tezcan, Orhan; Mavitaş, BinaliObjective: In the current study, peripheral vascular injuries caused from weapons and the associated clinical outcomes were retrospectively investigated. Methods: Two hundred patients who received a surgical procedure for a vascular injury between January 2009 and December 2011 were included in the study. The patients were evaluated retrospectively; type of injury, localization, characteristics, and type of surgical application were classified. Results: Weapon-related penetrating injuries were classified as gunshot injuries (n=55, 28%), stab wounds (n = 143, 71%), and mine injuries (n= 2, 1%). There were 77 interposition applications (71 arterial and 6 venous) with saphene vein grafts, 16 arterial interposition applications with polytetrafluoroethylene grafts, and 11 venous ligations. A total of 170 direct repairs (134 arterial and 36 venous) were performed. Postoperative amputation was required in none of the cases, advanced intensive care unit follow-up was required for four patients (2%; two cases were referred with hypovolemic shock and two case were referred with asystole), and a postoperative follow-up period for any mortality was not observed. Conclusion: Some regions contain higher levels of war injuries. Therefore, these regions require specialized intervention centres. A large amount of these injuries are vascular, and surgery and rapid interventions are essential for reducing mortality and morbidity rates. Successful results can be obtained in these cases through the collaboration of various medical disciplines.Öğe Application of thoracic endovascular dissecting aneurysm repair for secondary type B aortic dissection(Clinics Cardive Publ Pty Ltd, 2015) Karahan, Oguz; Tezcan, Orhan; Demirtas, Sinan; Caliskan, Ahmet; Yavuz, CelalType A aortic dissection is an emergency condition that requires immediate surgery. Graft replacement of the ascending aorta is the main treatment for this disorder. However, after ascending aortic replacement, the dissection flap may progress to the distal side (to the descending aorta) and a new intimal tear may develop. In this study, we report on a 66-year-old woman who had a history of ascending aortic replacement six months earlier. She was admitted to hospital with a new onset of back pain. Computed tomography revealed a new dissection tear originating from the distal side of the subclavian artery orifice. Thoracic endovascular dissecting aneurysm repair (TEVDAR) was carried out on the patient. Additional complications were not observed in the postoperative period. Complete cure was provided and the patient was discharged on the fourth day after the operation. TEVDAR may be safe and effective in preventing progression of the aortic flap and the formation of a new intimal tear in type A aortic dissections. Optional hybrid interventions could ameliorate the outcomes in aortic dissection cases.Öğe Derin ven trombozunda tam kan sayımı parametrelerinin araştırılması(Dicle Üniversitesi Tıp Fakültesi, 2014) Çalışkan, Ahmet; Yazıcı, Süleyman; Karahan, Oğuz; Demirtaş, Sinan; Yavuz, Celal; Güçlü, Orkut; Tezcan, Orhan; Mavitaş, BinaliAmaç: Derin ven trombozunun (DVT) seyrinde inflamasyonun rolü çeşitli çalışmalarda açıklanmıştır. Bu nedenle literatürde inflamatuar belirteçlerin bu hastalıkta rolü araştırılmıştır. Son dönemde, tam kan sayımı parametreleri (Hemogram) arasında inflamatuar belirteçlerin kısa ifadesi olarak nötrofil lenfosit oranı (NLR), platelet lenfosit oranı (PLR) gibi belirteçler sıkça kullanılmaya başlanmıştır. Bu çalışma da hemogram parametrelerinin DVT ile ilişkisi incelenmiştir. Yöntemler: Kliniğimize akut DVT tanısı ile başvuran 50 hasta (28 kadın, 22 erkek) çalışmaya dahil edildi. Hastaların tanıları klinik semptomlar ve Doppler ultrasonografi ile konuldu. Hastalardan ek inflamatuar cevap oluşturacak hastalığı olanlar değerlendirme dışı bırakıldı. Kontrol grubu olarak da 30 sağlıklı gönüllü seçildi. Bu hastaların retrospektif olarak rutin hemogram sonuçları değerlendirildi. Rutin hemogram parametreleri ve nonselektif inflamatuar belirteçler olan kırmızı hücre dağılım hacmi (RDW), beyaz küre (WBC), NLR, PLR nin ölçümleri istatistiksel olarak incelendi. Bulgular: Çalışmaya alınan hastaların yaş ortalaması 46.2±14.2 yıl olup %53’ü kadın cinsiyette idi. Gruplar hematolojik parametreler açısından incelendiğinde DVT grubunda lenfosit (2.6±0.8 ve 2.1±0.7, p=0.003) ve platelet miktarları (322±144 ve 264±66, p=0.042) daha yüksek, hemoglobin (13.2±2.0 ve 14.6±1.5, p=0.002) ve hematokrit değerleri (38.7±5.1 ve 42.8±6.9, p<0.001) daha düşük saptanırken, WBC, nötrofil, NLR, RDW ve PLR istatistiksel olarak benzer saptandı. DVT grubu antikoagülan alan ve almayan olarak iki gruba ayrıldığında yaş, cinsiyet ve hematolojik parametreler açısından gruplar arasında anlamlı farklılık izlenmedi Sonuç: Bu çalışmada değerlendirmeye alınan pür DVT’li olgular ile sağlıklı gönüllülerin hemogram belirteçleri arasında anlamlı değişiklik göstermemiştir.Öğe Diagnostic value of plasma C-type natriuretic peptide levels in determination of the duration of mesenteric ischaemia(Clinics Cardive Publ Pty Ltd, 2014) Demirtas, Sinan; Karahan, Oguz; Yazici, Suleyman; Guclu, Orkut; Caliskan, Ahmet; Tezcan, Orhan; Yavuz, CelalObjective: Mesenteric arteries release C-type natriuretic peptide (CNP), which hyperpolarises vascular smooth muscle. We measured the levels of this peptide after inducing mesenteric ischaemia over a series of time intervals, so as to determine its predictive value in demonstrating the severity of ischaemia in a rat model. Methods: A total of 32 rats were allocated to four groups containing eight rats each. Basal CNP reference levels were measured in the control group, which was not exposed to any intervention. In groups I, II and III, mesenteric ischaemia was induced over three, six and nine hours, respectively, and plasma CNP levels were measured afterwards. Mesenteric ischaemia was induced by clamping the superior mesenteric artery. Results: In comparison with the controls (2.38 +/- 0.18 pg/ml), CNP levels were relatively lower in group I (2.54 +/- 0.42 pg/ml). However, significant increases in plasma CNP levels were observed over longer periods of ischaemia in group II, at 5.23 +/- 0.22 pg/ml, and in group III, at 6.19 +/- 0.67 pg/ml (p < 0.05). A significant direct relationship was determined between plasma CNP levels and prolonged intervals of mesenteric ischaemia (R = 0.56, p < 0.001). Conclusion: Measuring plasma CNP levels in patients with acute mesenteric ischaemia may be beneficial in estimating the time period over which the ischaemic injury has occurred.Öğe Does the direction of tumescent solution delivery matter in endovenous laser ablation of the great saphenous vein?(2015) Kutaş, Barış; Özdemir, Ferit; Güneş, Tevfik; Erkoç, Kamuran; Tezcan, Orhan; Altın, Fırat; Karahan, OğuzBackground: The aim of this study was to compare the two different directions of tumescent solution delivery (from distal to proximal knee to the saphenofemoral junction [SFJ] or proximal to distal SFJ to the knee) in terms of differences in tumescent volume, number of punctures, and pain and comfort scores of patients. Methods: A total of 100 patients were treated with endovenous laser ablation (EVLA) under local anesthesia between August 2013 and October 2013. These 100 patients were divided into two groups. In group 1, tumescent solution was delivered in a proximal to distal direction. In group 2, the tumescent solution was delivered in a distal to proximal direction. In each group, the great saphenous vein (GSV) diameter, delivered total energy, treated GSV length, delivered tumescent volume, number of punctures, and pain and comfort scores were recorded for each patient. Results: All patients were treated unilaterally. EVLA was performed with 100% technical success in all patients. There was no difference statistically between group 1 and group 2 according to GSV diameter, delivered total energy, and treated GSV length. Average tumescent volume, number of punctures, and pain scores in group 2 were lower than in group 1 (p = 0.0001; p < 0.05). Also, the average comfort score was higher in group 2 than in group 1 (p = 0.0001; p < 0.05). We believe that delivering the tumescent solution in a distal to proximal direction increases the comfort of both patient and surgeon with lower tumescent volume during the EVLA of the GSV.Öğe Effects of Hyperbaric Oxygen Treatment on Renal System(Iranian Soc Nephrolgy, 2017) Tezcan, Orhan; Caliskan, Ahmet; Demirtas, Sinan; Yavuz, Celal; Kuyumcu, Mahir; Nergiz, Yusuf; Guzel, AbdulmenapIntroduction. Hyperbaric oxygen (HBO) treatment is steadily increasing as a therapeutic modality for various types of diseases. Although good clinical outcomes were reported with HBO treatment for various diseases, the multisystemic effects of this modality are still unclear. This study aimed to investigate the renal effects of HBO experimentally. Materials and Methods. Fourteen New Zealand White rabbits were divided into 2 groups randomly as the control group and the study group. The study group received HBO treatment for 28 days (100% oxygen at 2.5 atmospheres for 90 minutes daily) and the control group was used to obtain normal renal tissue of the animal genus. After the intervention period, venous blood samples were obtained, and renal tissue samples were harvested for comparisons. Results. Normal histological morphology was determined with Masson trichrome staining and periodic acid-Schiff staining in the control group. Atrophic glomerular structures, vacuolated tubule cells, and degeneration were detected in the renal samples of the study group with Masson trichrome staining. Additionally, flattening was observed on the brush borders of the proximal tubules, and tubular dilatation was visualized with periodic acid-Schiff staining. The histopathologic disruption of renal morphology was verified with detection of significantly elevated kidney function laboratory biomarkers in the study group. Conclusions. Our findings suggests that HBO has adverse effects on renal glomerulus and proximal tubules. However, the functional effects of this alteration should be investigated with further studies.Öğe 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, EnginBackground: 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.Öğe Endovasküler aortik onarımda tek merkez deneyimi: Teknik ve klinik yönlerin incelenmesi(Dicle Üniversitesi Tıp Fakültesi, 2014) Demirtaş, Sinan; Tiryakioğlu, Osman; Çalışkan, Ahmet; Güçlü, Orkut; Yümün, Gündüz; Yavuz, Celal; Tezcan, Orhan; Karahan, OğuzAmaç: Bu çalışmanın amacı; cerrahisi yüksek riskli aortik patolojiye sahip hastalarda uyguladığımız Endovasküler Aortik Onarım tecrübelerimizin paylaşılması ve önceki raporlarla; gelişen mortalite, komplikasyonlar, ek girişimler açısından kıyaslanarak literatüre katkı sağlanmasıdır. Yöntemler: Retrospektif olarak endovasküler aortik onarım uygulanan hastalar değerlendirildi. Perioperatif 1 aylık mortalite, prosedür esnasındaki ek girişimler, gelişen komplikasyonlar, endoleak tipleri, uygulanan anestezi yöntemi, hastalığın tanısı, komorbid faktörleri ve demografik veriler kaydedildi. Sonuçlar literatürdeki veriler ile karşılaştırıldı. Bulgular: Abdominal endovasküler aortik onarım (EVAR) 19 hastaya uygulandı. Torasik endovasküler aortik onarım (TEVAR) 11 hastaya uygulandı. EVAR hastaları abdominal aort anevrizma tanısı ile işleme alındı. Bu hastaların 9 ‘u rüptür nedeniyle acil olarak opere edildi. TEVAR uygulanan 8 hasta Tip 3 aort diseksiyonu, 1 hasta ise transeksiyon nedeniyle işleme alındı. Tüm vakaların 1 aylık mortalitesi % 10 ( 3 hasta) olarak bulundu. Endoleak gelişen 6 hastadan, 3 tanesi Tip1a, 2 tanesi Tip1 b ve 1 tanesi de Tip 2 idi. İki hastaya Tip1a ve 1 hastaya daTip1b endoleak nedeniyle balon anjioplasti yapıldı. Bir hastada postoperatif kontrast nefropatisine bağlı kronik böbrek yetmezliği(% 3,3) gelişti. Postoperatif dönemde hematom nedeniyle 2 (%6,7) hastada reeksplorasyon uygulandı. Sonuç: Endovasküler yöntemler aort patolojilerinde teknolojinin de ilerlemesiyle sıkça tercih edilen bir tedavi yöntemi haline gelmiştir. Bizim serimizde olduğu gibi cerrahi açıdan ciddi risk taşıyan hasta grubunda endovasküler yöntemlerin güvenle tercih edilebilecek bir alternatif olduğu kanaatindeyiz.Öğe An evaluation of factors affecting clinical outcomes in penetrating cardiac injuries: A single center experience(Ulusal Travma ve Acil Cerrahi Derneği, 2017) Tezcan, Orhan; Karahan, Oğuz; Yavuz, Celal; Demirtaş, Sinan; Çalışkan, Ahmet; Mavitaş, BinaliBACKGROUND: Penetrating cardiac injury (PCI) has highly mortal outcome. Therefore, management of this emergency situation is extremely important. The present study is an investigation of main factors that can affect mortality and morbidity in PCI. METHODS: Records of 112 patients who were admitted to emergency department with PCI in the last decade were evaluated retrospectively. Demographic data, initial approach, transfer duration and conditions, vital status and findings, type of injury, localization, characteristics, and type of surgical application were recorded. RESULTS: Demographic findings (age, sex, cause of injury) were not found to be significant factors affecting mortality. Early mortality (1-week observation period) occurred in 14 (12.5%) patients. Method of transfer to hospital (under medical team supervision by ambulance, or without supervision), transfer duration, initial vital findings upon arrival (blood pressure, rhythm, breathing, consciousness), operation timing (elective or emergency), and injuries to additional organs were determined to be important predictors of survival. CONCLUSION: Cardiac injury is highly mortal emergency situation. Expert medical management is important for survival. However, basic first aid measures and immediate hospital transfer are as important as expert clinical management.Öğe Hyperbaric Oxygen Preconditioning Provides Preliminary Protection Against Doxorubicin Cardiotoxicity(Taiwan Soc Cardiology, 2017) Tezcan, Orhan; Karahan, Oguz; Alan, Mustafa; Ekinci, Cenap; Yavuz, Celal; Demirtas, Sinan; Ekinci, AysunBackground: Doxorubicin (DOX) is generally recognized to have important cardiotoxic side effects. Studies are contradictory about the interaction between hyperbaric oxygen (HBO2) therapy and doxorubicin-induced cardiomyotoxicity. Recent data suggests that HBO2 therapy can lead to preconditioning of myocardium while generating oxidative stress. Herein we have investigated the effect of HBO2 therapy in a DOX-induced cardiomyocyte injury animal model. Methods: Twenty-one rats were divided into three equal groups as follows: 1) Group 1 is a control group (without any intervention), used for evaluating the basal cardiac structures and determining the normal value of cardiacs and serum oxidative markers; 2) Group 2 is the doxorubicin group (single dose i.p. 20 mg/kg doxorubicin) for detecting the cardiotoxic and systemic effects of doxorubicin; 3) Group 3 is the doxorubicin and HBO2 group (100% oxygen at 2.5 atmospheric for 90 minutes, daily), for evaluating the effect of HBO2 in doxorubicin induced cardiotoxicity. At the end of the protocols, the hearts were harvested and blood samples (2 ml) were obtained. Results: The doxorubicin treated animals (Group 2) had increased oxidative stress markers (both cardiac and serum) and severe cardiac injury as compared to the basal findings in the control group. Nevertheless, the highest cardiac oxidative stress index was detected in Group 3 (control vs. Group 3, p = 0.01). However, histological examination revealed that cardiac structures were well preserved in Group 3 when compared with Group 2. Conclusions: Our results suggest that HBO2 preconditioning appears to be protective in the doxorubicin-induced cardiotoxicity model. Future studies are required to better elucidate the basis of this preconditioning effect of HBO2.Öğe İndüklenebilir periferik iskeminin saptanmasında C-tip natriüretik peptidin gösterge olarak kullanımı(2014) Yavuz, Celal; Demirtaş, Sinan; Tezcan, Orhan; Karahan, Oğuz; Güçlü, Orkut; Yıldız, Bekir; Çalışkan, AhmetAmaç: Bu deneysel çalışmada, periferik iskeminin başında kritik saatlerdeki plazma C-tip natriüretik peptid (CNP) düzeylerindeki değişiklikler değerlendirildi.Çalışma planı: Çalışmaya 40 adet Sprague-Dawley cinsi erkek sıçan (8-12 haftalık ve ortalama ağırlıkları 230±30 g) alındı. Her grupta 10 sıçan olacak şekilde dört grup oluşturuldu: kontrol grubu, grup 1, grup 2 ve grup 3. Kontrol grubunda herhangi bir işlem yapılmadan başlangıç plazma CNP değeri tespit edilirken, grup 1'de periferik iskeminin ikinci saatinde plazma CNP düzeyine bakıldı. Grup 2'de periferik iskeminin beşinci saatindeki plazma CNP düzeyi tespit edilirken, plazma CNP düzeyleri grup 3'te periferik iskeminin sekizinci saatinde belirlendi.Bul gu lar: Başlangıç plazma CNP düzeyi kontrol grubunda 0.285±0.011 pmol/L olarak tespit edildi. Periferik iskemi oluşturulan sıçanlarda, plazma CNP düzeyinin zamana bağlı olarak anlamlı olarak arttığı tespit edildi (p<0.05). Plazma CNP düzeyleri grup 1, 2 ve 3'de sırasıyla 0.350±0.015, 0.486±0.084 ve 0.534±0.048 pmol/L olarak tespit edildi. So nuç: Endotel kaynaklı vazodilatatör olan plazma CNP zamana bağlı olarak iskemik dokularda hücresel yanıt ile ilişkilidir.Öğe Investigation of possible prophylactic, renoprotective, and cardioprotective effects of thromboprophylactic drugs against ischemia-reperfusion injury(Elsevier Taiwan, 2015) Demirtas, Sinan; Karahan, Oguz; Yazici, Suleyman; Guclu, Orkut; Caliskan, Ahmet; Tezcan, Orhan; Kaplan, IbrahimThe aim of this study was to investigate whether anticoagulant and antiaggregant agents have protective effects against oxidative damage induced by peripheral ischemia ereperfusion (I/R). Groups were created as follows: control group, I/R group (sham group), I/R plus acetylsalicylic acid (Group I), I/R+clopidogrel (Group II), I/R+rivaroxaban (Group III), I/R+bemiparin sodium (Group IV), and I/R+enoxaparin sodium (Group V). In Groups I, II, III, IV, and V, drugs were administered daily for 1 week before I/R creation. Peripheral I/R was induced in the I/R groups by clamping the right femoral artery. The rats were sacrificed 1 hour after reperfusion. Nitrogen oxide levels, malondialdehyde (MDA) levels, paraoxonase-1 (PON1) activity, and prolidase activity were evaluated in both cardiac and renal tissues. There was no significant difference in nitrogen oxide levels between the groups. However, cardiac and renal MDA were significantly higher and PON1 activity was markedly lower in the I/R groups compared with the control group (p < 0.05). Although elevated prolidase activity was detected in both the cardiac and renal tissue of the I/R groups, only the sham group and Group V had significantly higher renal prolidase activity (p < 0.05). Group V had significantly higher cardiac MDA, PON1, prolidase levels, and renal prolidase activity compared with the sham group (p < 0.05). Significant improvement in renal MDA levels was only observed in Group III, and marked improvement was observed in the cardiac MDA levels of Group II when compared with the sham group (p < 0.05). Thromboprophylactic agents appear to provide partial or prominent protection against I/R injury. Copyright (C) 2015, Kaohsiung Medical University. Published by Elsevier Taiwan LLC. All rights reserved.Öğe Kalp damar kliniğimizdeki 14 yıllık konjenital kalp hastalığı deneyimlerimiz(Dicle Üniversitesi Tıp Fakültesi, 2014) Tezcan, Orhan; Güçlü, Orkut; Yazıcı, Süleyman; Benli, Emre Demir; Demirtaş, Sinan; Yavuz, Celal; Çalışkan, Ahmet; Karahan, Oğuz; Mavitaş, BinaliAmaç: Kliniğimizde konjenital kalp hastalığı tanısı ile tedavi edilen hastaların tanı ve tedavi sonuçlarını tartışmayı amaçladık. Yöntemler: Dicle Üniversitesi Kalp Damar Cerrahisi Anabilim Dalında, 2000-2014 tarihleri arasında konjenital kalp hastalığı tanıları ile tedavi edilen 78 hastaya ait kayıtlar retrospektif olarak incelendi. Hastalar 16 yaş ve altı (Grup I) ve 16 yaş üstü (Grup II) olmak üzere gruplandırıldı. Her iki grubun demografik özellikleri, sıklık sırasına göre görülen patalojileri ve tedavi sonuçları karşılaştırıldı. Bulgular: Grup I’de 35 hasta, grup II’de 43 hasta vardı. Grup I’deki olguların 17’si (%49) erkek, 18’i (%51) kadın, yaş ortalaması 6,2 idi. Grup I’deki hastaların 17’si atrial septal defekt (ASD) mevcuttu. Bu ASD’ lerin birine pulmoner darlık (PD), birine kleft mitrale, birine patent duktus arteriozus (PDA), birine de total pulmoner venöz dönüş anomalisi (TPVDA) eşlik ediyordu. Grup I’deki diğer hastaların 11’i de PDA 7’si ventriküler septal defekt (VSD) , 1’i fallot tetralojisi (TOF), idi. Grup II’deki olguların 9’u (%21) erkek, 34’ü (%79) kadın, yaş ortalaması 22,5 idi. Grup II’deki hastaların ise 36’inde ASD mevcuttu.Bu ASD’lerin 2’sinde PD, birinde kleft mitrale, birinde de PDA eşlik ediyordu. Grup II’deki diğer hastaların 3’ünde VSD, 2’sinde TOF, 2’sinde de PDA saptandı. Postoperatif erken dönemde 1 hasta kaybedildi. Sonuç: Birinci grupta en sık görülen patoloji ASD, ikinci grupta ise PDA idi. Birinci grupta çeşitli kompleks anomaliler görülürken ikinci grupta daha çok izole ASD gibi basit patolojiler tespit edildi.Öğe Pharmacomechanical thrombolysis with a rotator thrombolysis device in iliofemoral deep venous thrombosis(Sage Publications Ltd, 2016) Karahan, Oguz; Kutas, H. Baris; Gurbuz, Orcun; Tezcan, Orhan; Caliskan, Ahmet; Yavuz, Celal; Demirtas, SinanObjective Deep venous thrombosis (DVT) is a life-threatening and morbid pathology. This study aimed to investigate the efficacy of an early thrombolysis procedure using a rotator thrombolysis device. Methods Sixty-seven patients with acute proximal DVT were enrolled in the study. Patients' data were recorded retrospectively. Initially, an infrarenal retrievable vena cava filter was placed through the femoral vein. Then, a rotator thrombolysis device and a thrombolytic agent injection were applied to the occluded segments of the deep veins by puncturing the popliteal vein. Results The identified reasons were trauma (43.3%), pregnancy (20.9%), undiagnosed (11.9%), major surgical operation (10.5%), immobilization (7.5%), and malignancy (5.9%). Immediate total recanalization was conducted in all patients, and the leg diameters returned to normal ranges in the early postoperative period. Hospital mortality or severe complications were not detected. Conclusion New thrombolytic devices seem to reduce in-hospital mortality risks and may potentially decrease post-thrombotic morbidity.Öğe Protective effects of ginseng extracts and common anti-aggregant drugs on ischaemia-reperfusion injury(Clinics Cardive Publ Pty Ltd, 2015) Caliskan, Ahmet; Karahan, Oguz; Yazici, Suleyman; Demirtas, Sinan; Guclu, Orkut; Tezcan, Orhan; Yavuz, CelalObjective: Ginseng is a traditional herbal medicinal product widely used for various types of diseases because of its cellular protective effects. Possible protective effects of ginseng were investigated in blood, cardiac and renal tissue samples and compared with common anti-aggregant agents in an animal ischaemia-reperfusion (I/R) model. Methods: Twenty rats were equally divided into four different groups as follows: control group (I/R-induced group without drug use), group I (acetylsalicylic acid-administered group), group II (clopidogrel bisulfate-administered group), group III (ginsenoside Rb-1-administered group). For the groups assigned to a medication, peripheral I/R was induced by clamping the femoral artery one week after initiation of the specified medication. After reperfusion was initiated, cardiac and renal tissues and blood samples were obtained from each rat with subsequent analysis of nitrogen oxide (NOx), malondialdehyde (MDA), paraoxonase 1 (PON1) and prolidase. Results: NOx levels were similar in each group. Significant decrements were observed in serum PON1 levels in each group when compared with the control (p < 0.05). Serum MDA levels were significantly lower in groups II and III (p < 0.05). Ameliorated renal prolidase levels were detected in study groups (p < 0.05) and recovered cardiac prolidase levels were obtained in groups II and III (p < 0.05). Conclusion: These findings indicate that ginseng extracts may have a potential beneficial effect in I/R injury. However, more comprehensive studies are required to clarify the hypothetical cardiac, renal and systemic protective effects in reperfusion-induced oxidative damage.Öğe The relationship between fibrinogen to albumin ratio and severity of coronary artery disease in patients with STEMI(W B Saunders Co-Elsevier Inc, 2016) Karahan, Oguz; Acet, Halit; Ertas, Faruk; Tezcan, Orhan; Caliskan, Ahmet; Demir, Muhammed; Kaya, Ahmet FerhatObjective: Previous studies show that serum fibrinogen levels are established risk factors for coronary artery disease (CAD) and that serum albumin levels are of a higher specificity and sensitivity in ST-elevation myocardial infarction (STEMI). In this study, we sought to evaluate the association between fibrinogen to albumin ratio (FAR) and the extent and severity of CAD evaluated by TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed Arteries (SYNTAX) Score (SS) in patients with STEMI. Methods: A total of 278 patients with STEMI were included in the study. FAR was calculated using specified variables. The extent and severity of CAD were evaluated using the SS. The patients were divided into low( SS < 22) and high- (SS >= 22) risk groups. A Spearman rank correlation coefficient analysis was used for the relationship between FAR and SS. The cutoff points for sensitivity and specificity of FAR in predicting SS were estimated by performing a receiver operator characteristic curve analysis. Results: There were significant differences in the mean age (P = .016), admission serum albumin (P = .041), serum fibrinogen (P < .001), FAR (P < .001), and SS risk groups. Positive correlation was detected between FAR and SS (r = 0.458, P < .001). A cutoff level of >87 FAR predicted SS (sensitivity, 70%; specificity, 70%), and an area under the curve of 0.758 serum fibrinogen and albumin level was an independent predictor for SS in patients with STEMI (b = 0.039; 95% confidence interval, 0.016-0.062; P = .001 and b = -6.906; 95% confidence interval,-12.284 to -1.527; P = .013, respectively). Conclusion: In the present study, we showed that FAR is significantly related to SS in predicting the severity of CAD in patients with STEMI. (C) 2016 Elsevier Inc. All rights reserved.Öğe Simple blood tests as predictive markers of disease severity and clinical condition in patients with venous insufficiency(Lippincott Williams & Wilkins, 2016) Karahan, Oguz; Yavuz, Celal; Kankilic, Nazim; Demirtas, Sinan; Tezcan, Orhan; Caliskan, Ahmet; Mavitas, BinaliChronic venous insufficiency (CVI) is a progressive inflammatory disease. Because of its inflammatory nature, several circulating markers were investigated for predicting disease progression. We aimed to investigate simple inflammatory blood markers as predictors of clinical class and disease severity in patients with CVI. Eighty patients with CVI were divided into three groups according to clinical class (grade 1, 2 and 3) and score of disease severity (mild, moderate and severe). The basic inflammatory blood markers [ neutrophil, lymphocyte, mean platelet volume (MPV), white blood cell (WBC), platelet, albumin, D-dimer, fibrinogen, fibrinogen to albumin ratio, and neutrophil to lymphocyte ratio] were investigated in each group. Serum neutrophil, lymphocyte, MPV, platelet count, D-dimer and neutrophil to lymphocyte ratio levels were similar among the groups (P>0.05). Although the serum WBC levels were significant in the clinical severity groups (P<0.05), it was useless to separate each severity class. However, albumin, fibrinogen and the fibrinogen to albumin ratio were significant predictors of clinical class and disease severity. Especially, the fibrinogen to albumin ratio was detected as an independent indicator for a clinical class and disease severity with high sensitivity and specificity (75% sensitivity and 87.5% specificity for clinical class and 90% sensitivity and 88.3% specificity for disease severity). Serum fibrinogen and albumin levels can be useful parameters to determine clinical class and disease severity in patients with CVI. Moreover, the fibrinogen to albumin ratio is a more sensitive and specific predictor of the progression of CVI. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.Öğe Unexpected complication of oesophagoscopy: iatrogenic aortic injury in a child(Clinics Cardive Publ Pty Ltd, 2016) Tezcan, Orhan; Oruc, Menduh; Kuyumcu, Mahir; Demirtas, Sinan; Yavuz, Celal; Karahan, OguzIntroduction: Oesophagoscopy is usually a safe procedure to localise and remove ingested foreign bodies, however, unexpected complications may develop during this procedure. In this case report we discuss iatrogenic aortic injury, which developed during oesophagoscopy, and its immediate treatment. Case report: A six-year-old male patient was admitted to hospital with symptoms of having ingested a foreign body. Oesophagoscopy was carried out and the foreign body was visualised at the second constriction of the oesophagus. During this procedure, profuse bleeding occurred. Subsequently, a balloon dilator was placed to control bleeding in the oesophagus. Thoracic contrast tomography revealed thoracic aortic injury. Open surgical aortic repair was immediately carried out on the patient and the oesophageal hole was primarily repaired. The patient was discharged on postoperative day 15 with a total cure. Conclusion: Although oesophagoscopy is a safe, easily applied method, it should be kept in mind that fatal complications may occur during the procedure. This procedure should be done in high-level medical centres, which have extra facilities for managing complications.Öğe Use of C-type natriuretic peptide as an indicator in detection of inducible peripheral ischemia(Turkish Society of Cardivascular Surgery, 2014) Çalışkan, Ahmet; Yazıcı, Süleyman; Karahan, Oğuz; Güçlü, Orkut; Tezcan, Orhan; Demirtaş, Sinan; Yıldız, Bekir; Yavuz, CelalAmaç: Bu deneysel çalışmada, periferik iskeminin başında kritik saatlerdeki plazma C-tip natriüretik peptid (CNP) düzeylerindeki değişiklikler değerlendirildi.Çalışma planı: Çalışmaya 40 adet Sprague-Dawley cinsi erkek sıçan (8-12 haftalık ve ortalama ağırlıkları 230±30 g) alındı. Her grupta 10 sıçan olacak şekilde dört grup oluşturuldu: kontrol grubu, grup 1, grup 2 ve grup 3. Kontrol grubunda herhangi bir işlem yapılmadan başlangıç plazma CNP değeri tespit edilirken, grup 1'de periferik iskeminin ikinci saatinde plazma CNP düzeyine bakıldı. Grup 2'de periferik iskeminin beşinci saatindeki plazma CNP düzeyi tespit edilirken, plazma CNP düzeyleri grup 3'te periferik iskeminin sekizinci saatinde belirlendi.Bul gu lar: Başlangıç plazma CNP düzeyi kontrol grubunda 0.285±0.011 pmol/L olarak tespit edildi. Periferik iskemi oluşturulan sıçanlarda, plazma CNP düzeyinin zamana bağlı olarak anlamlı olarak arttığı tespit edildi (p<0.05). Plazma CNP düzeyleri grup 1, 2 ve 3'de sırasıyla 0.350±0.015, 0.486±0.084 ve 0.534±0.048 pmol/L olarak tespit edildi. So nuç: Endotel kaynaklı vazodilatatör olan plazma CNP zamana bağlı olarak iskemik dokularda hücresel yanıt ile ilişkilidir.
