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Öğe Asymptomatic and isolated accessory mitral valve tissue in adult population: three case reports and review of the literature.(2012) Cil H.; Atilgan Z.A.; Islamoglu Y.; Yavuz C.; Tekbas E.O.Accessory mitral valve tissue is a rare congenital cardiac anomaly and commonly it may cause left ventricular outflow tract obstruction (LVOTO). This anomaly occurs as a part of other congenital cardiac anomalies. However, it may be seen isolated. Structures in LVOT such as tumor, vegetation, cysts may have attention for differential diagnosis. The number of cases is increasing with the routinely using of two-dimensional echocardiography. Accessory mitral valve tissue is detected first early in children with symptoms of LVOT and is very rarely diagnosed in adults. One third of cases may asymptomatic, but commonly significant left ventricular outflow tract gradient can be detected in these cases, especially adult period. Optimal treatment of this anomaly is surgery if there is a significant LVOTO. In this report, we presented the three asymptomatic adult cases with accessory mitral valve tissue, without increased gradient in LVOT. Surgical excision was recommended to the first case in another hospital with diagnosis of cardiac cyst. Two cases are presented.Öğe Cardiac thrombus developing after an accidental high-voltage electric shock in a child(Turkish Journal of Pediatrics, 2015) Akın A.; Bilici M.; Demir F.; Gözü-Pirinççioğlu A.; Yavuz C.Electric shock is a condition that may affect various organ systems and potentially cause death. Cardiac findings vary from asymptomatic mild injury to fatal myocardial involvement. Herein we present a five-year-old boy with a cardiac thrombus developing after an accidental electrical shock. Cardiac arrhythmias and evidence of ischemia have been reported after electric shock; we were, however, unable to identify an earlier case report of intracardiac thrombosis related to electric shock. Findings such as elevated cardiac enzymes and systolic dysfunction, which indicate myocardial damage following electric shock, were present in our patient. We think that the cardiac thrombus might have resulted from the myocardial damage and the slowed intracardiac blood flow related to systolic dysfunction. As the thrombus was thought to have been formed through known mechanisms, it was treated traditionally. However, further data regarding the etiology and management of such thrombi is needed. © 2015, Turkish Journal of Pediatrics. All rights reserved.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 Dietary addition of caffeic acid phenethyl ester protects myocardial tissue against ethambutol induced oxidative stress(2013) Yavuz C.; Demirta S.; Yazici S.; Çalikan A.; Güçlü O.; Karahan O.; Mavitaş B.Objective: The myocardial effect of ethambutol (ETM) has not yet been clarified. The main purpose of this study was to determine both the oxidative status in myocardial tissue after administration of ETM and the adjuvant benefits of caffeic acid phenethyl ester (CAPE). Material and Method: Twenty four male rats were divided into three experimental groups as follows: a control group (without any drug administration) was created for obtaining normal myocardial tissue; an ETM group (rats received only ETM for thirty days) was created for ethambutol administration; and an ETM+CAPE group was created for administration of the full regimen (rats received ETM+CAPE for thirty days). Rats were sacrified at the end of day 30 and heart tissues were obtained for histopathological and biochemical examination. Oxidant and antioxidant parameters were biochemically investigated in all tissue samples. Results: In the ETM group, myocardial malondialdehyde (MDA) levels and total oxidant status (TOS) were significantly higher than in the control group (p<0.001). Conversely, total antioxidant capacity (TAC), the activity of superoxide dismutase (SOD) and of serum paraoxonase (PON1) were reduced in the ETM group (p<0.05). Furthermore, MDA and TOS activity was significantly reduced in the ETM+CAPE group (p<0.05); TAC, SOD, and PON1 activities were increased with adjuvant CAPE therapy (in the ETM+CAPE group) rather than in the ETM group. Conclusion: ETM may lead to increased myocardial oxidative stress due to lipid peroxidation. Nevertheless, adjuvant CAPE administration seems to provide a partial enhancement of myocardial damage.Öğe Effects of sodium nitroprusside on ischemia-reperfusion injury(TIP ARASTIRMALARI DERNEGI, 2010) Yavuz C.; Çakir O.; Göz M.; Kale E.; Uzunlar A.K.Aim: The aim of this study was to investigate the effects of sodium nitroprussid (SNP) on ischemia-reperfusion injury in rats. Method: Twenty-four Sprague-Dawney rats were divided into four equal groups: group I without ischemia-reperfusion (I-R); group II with ischemia; group III with I-R; group IV with I-R and SNP. Complete bilateral hindlimb ischemia was produced by means of tourniquet occlusion of the upper thigh. Result: Blood creatine phosphokinase, lactate dehydrogenase, aspartate transaminase, urea, creatinine levels were not significantly different between groups 3 and 4. Malondialdehyde (MDA) levels were not significantly different between groups 3 and 4 in liver, soleus muscles and lung tissue. However, MDA levels were significantly lower in group 4 when compared with group 3 in renal tissue. Histological examination of the soleus muscles revealed that neutrophil leukocyte infiltration in group 3 was significantly less prominent than in group 4. Conclusion: These results have shown that SNP was not able to improve muscle ischemia-reperfusion injury in our study.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 Factors having effect on complication and success rate in central venous catheterization(2010) Yavuz C.; Çil H.; Başyi?it I.; Demlrtaş S.; Islamo?lu Y.; Elbey M.A.; Tekbaş G.We aimed to investigate impact of insertion site, indication of catheterization and other clinical feature on complications and success rate in our study. 699 patients who underwent central venous catheterization in Cardiology and Cardiovascular Surgery Units between March 2008 To May 2010 were included in our study. Age, sex, insertion site, indication of catheterization, units, complications and level of prosperity-success. 699 patients were included the study which mean age 56.6±19.5. Most commonly used sites were internal juguler vein, the subclavian vein, and the femoral vein (71.5%, 25.7%, 2.8%; respectively). According to indications of catheterization, primary success rates were 93.2%in central venous pressure measurement group, 89.1%in dialysis group, %87.1 in liquid-drug infusion group and 69%in total parenteral nutrition group. The total complication rate, in all patients who underwent catheterization was found 6.15%. The most frequent complication was catheter dysfunction in all patient %2.15, (n=15). In terms of catheterisation endication, the highest complication risk group was detected in total parenteral nutrition group (10.3%), and the lowest risk group was liquid-drug infusion group (4.6%). There was higher complication rate in suclavian vein group than internal juguler vein group. (8.8%and 4.6%, p=0.001). Our study showed that most confidence way in terms of complications and primary success is internal juguler vein. Indications of catheterization also affect the success and complication rates.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 Protective effect of caffeic acid phenethyl ester in rat cerebral ischemia/reperfusion damage(Turkish Neurosurgical Society, 2011) Uzar E.; Acar A.; Firat U.; Evliyaoğlu O.; Alp H.; Tüfek A.; Yavuz C.Objective: Because oxidative stress is related to cerebral ischemia/reperfusion (I/R) injury, modulation of oxygen free radical production may represent a new approach to the management of cerebral I/R. Caffeic acid phenethyl ester (CAPE) has been determined to have neuroprotective, antioxidant, anti-inflammatory, and anti-apoptotic activities. The aim of this study was to investigate whether CAPE has a protective effect on cerebral I/R damage, and to determine the possible effects of CAPE on total antioxidant/oxidant status. Methods: A total of 30 rats were randomly divided into three groups as control group, I/R group, and I/R + CAPE. Total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI) levels and histopathological cellular structures were evaluated in cerebral tissues obtained after the experiment procedure in all groups. Results: In the brain tissue, TOS and OSI levels were found to be significantly increased in the I/R group compared to the controls (p= 0.023, p= 0.001, respectively). Significantly decreased TAS levels were found in the I/R group compared to the controls (p= 0.001). CAPE treatment prevented the increase in TOS and OSI that is produced by cerebral I/R (p= 0.041, p= 0.001, respectively). TAS was found to be increased in the CAPE + I/R group compared with the I/R group (p= 0.002). In the I/R group, the brain sections showed findings of cerebral I/R damage including inflammation, vascular congestion and necrosis (for both variables, p= 0.001). These histopathological cerebral damage findings were found to be significantly reduced in the CAPE + I/R group compared to the I/R group (for both parameters, p< 0.05). Conclusion: In this study, it was found that oxidative stress had an important role in the pathogenesis of cerebral I/R damage, and histopathological and biochemical evaluations showed significantly decreased I/R damage following CAPE treatment in rats.Öğe Tracheobronchial injuries(2003) Ulkü R.; Eren M.N.; Eren S.; Onat S.; Yavuz C.BACKGROUND: Tracheobronchial injuries are among the least common sort of thoracic traumas. This injury can be life threatening. However, successful diagnosis and treatment can prevent devastating acute or delayed complications. The aim of this study was to review the authors' surgical experience in tracheobronchial injuries. METHODS: We reviewed our records of 29 patients with tracheobronchial injuries from January 1979 to December 2000. The median age was 22.7. Twenty-seven patients were male and two were females. RESULTS: The causes of traumas were penetrating injury in seventeen, blunt injury in eleven patients and animal bite in one. In sixteen patients cervical trachea, in nine main stem bronchus, in 3 lobar bronchus and in one patient mediastinal trachea were found to be injured. In seven of twenty-nine patients there were combined tracheal and esophageal injuries. Surgical approach was made by oblique incision, collar incisions and thoracotomy. In general we preferred primary repair. The overall mortality rate was 24%. CONCLUSION: In our opinion, the number of complications and mortality can be diminished by early recognition of the injuries and treatment.
