Browsing by Author "Aydin, Cemalettin"
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Article Analysis of the Influences of Short-Term Levosimendan Exposure on Oxidant/Antioxidant Status and Trace-Element Levels in the Physiological Status of the Thoracic Aorta of Rats(Springer, 2012) Aydin, Cemalettin; Ay, Yasin; Basel, Halil; Kavak, Servet; Inan, Bekir; Bektas, Hava; Demir, HalitThe objective of this study was to evaluate the effect of levosimendan (chemical formula C14H12N6O) exposure on oxidant/antioxidant status and trace-element levels in the thoracic aorta of rats. Eighteen male Wistar albino rats were randomly divided into two groups of eight animals each. Group 1 was not exposed to levosimendan and served as a control. Levosimendan (12 mu g/kg) diluted in 10 ml 0.5 % dextrose was administered intraperitoneally to group 2. Animals of both groups were killed after 3 days, and their thoracic aortae were harvested for determination of changes in tissue oxidant/antioxidant status and trace-element levels. The animals in both groups were killed 72 h after levosimendan exposure, and thoracic aortae were harvested for determination of the lipid peroxidation product MDA and antioxidant GSH levels and the activities of antioxidant enzymes such as SOD, GSH-Px and CAT. It was found that MDA, GSH and CAT enzyme levels increased in thoracic aortae of rats after levosimendan administration. SOD and CA enzyme activities and the level of antioxidant GSH decreased in thoracic aortae of rats after levosimendan treatment. Pb, Cd and Fe levels of thoracic aortae were significantly higher (P < 0.001) and Mg, Mn, Zn and Cu were significantly lower (P < 0.001) in the levosimendan group compared to the control group. These results suggest that short-term levosimendan treatment caused an increase in free radical production and a decrease in antioxidant enzyme activity in thoracic aortae of levosimendan-treated rats. It also causes a decrease or increase in many mineral levels of the thoracic aorta, which is an undesirable condition for normal pharmacological function.Article Basilic Vein Transposition Fistulas Versus Prosthetic Bridge Grafts in Patients With End-Stage Renal Failure(Elsevier Science inc, 2011) Basel, Halil; Ekim, Hasan; Odabasi, Dolunay; Kiymaz, Adem; Aydin, Cemalettin; Dostbil, AysenurBackground: Basilic vein transposition fistulas (BVTFs) and prosthetic bridge grafts (PBGs) provide good vascular access for hemodialysis. To evaluate the patency and complication rates after arteriovenous fistula formation, a concurrent series of patients was reviewed. Methods: Between September 2003 and September 2009, 147 hemodialysis access procedures were performed in 147 consecutive patients at Van Research and Training Hospital and Yuzuncu Yil University Hospital, Van, Turkey. All access procedures were planned on the basis of preoperative duplex scans of arm and forearm veins. Functional patency was defined as the ability to cannulate hemodialysis patients successfully. Primary and secondary cumulative functional patency rates of BVTFs and PBGs were determined with life-table analysis and differences were analyzed with retrospective study. Differences in revision rates, including thrombolysis thrombectomies and operative revisions, were analyzed with the Fisher exact t-test. Results: Mean follow-up was 15 months (range, 3-24 months). Risk factors were similar between the two groups. BVTFs had better patency at 15 months. The dialysis access complications were higher in the PBG group versus BVTF group, and the PBG group had a higher infection rate than the BVTF group. Conclusion: The primary and secondary patency rates were superior in the BVTF group. Our data strongly support the contention that as long as the patient is a candidate for an upper arm BVTF based on anatomical criteria, BVTF always be considered before a PBG.Article The Effects of Levosimendan Exposure on Oxidant/Antioxidant Status and Trace Element Levels in the Pulmonary Artery of Rats(Springer, 2013) Ay, Yasin; Aydin, Cemalettin; Basel, Halil; Bektas, Hava; Bulut, Gulay; Inan, Bekir; Demir, IsmailWe investigated both the effect of levosimendan and the role of oxidant/antioxidant status and trace element levels in the pulmonary artery of rats. Fourteen male Wistar albino rats were randomly divided into two groups of seven animals each. Group 1 was not exposed to levosimendan and served as a control. Levosimendan (12 mu g/kg) diluted in 10 ml 0.9 % NaCl was administered intraperitoneally to group 2. Animals of both groups were killed after 3 days, and their pulmonary arteries were harvested to determine changes in tissue oxidant/antioxidant status and trace element levels. The animals in both groups were killed 72 h after the levosimendan exposure treatment, and pulmonary arteries were harvested to determine levels of the lipid peroxidation product MDA and the antioxidant GSH as well as the decreased activity of antioxidant enzymes such as SOD, GSH-Px and CAT. It was found that MDA levels increased in pulmonary artery tissues of rats after levosimendan administration. The GSH level decreased in the pulmonary artery of rats after levosimendan treatment. Co, Mn, Fe, Cd and Pb levels were significantly higher (P < 0.001) and Mg, Zn and Cu levels significantly lower (P < 0.001) in the levosimendan group compared to the control group. These results suggest that levosimendan treatment caused an increase in free radical production and a decrease in antioxidant enzyme activity in the pulmonary artery of levosimendan-treated rats. It also caused a decrease or increase in the levels of many minerals in the pulmonary artery, which is an undesirable condition for normal pharmacological function.Article Jejunal Diverticulum Perforation Resulting From Distal Mechanic Obstruction: a Case Report(Aves, 2011) Olmez, Aydemir; Sumer, Aziz; Piskin, Turgut; Aydin, CemalettinExcluding Meckel's diverticulum, jejunum and ileum diverticula are acquired diverticula which are rarely observed and have an asymptomatic course. They are mostly observed in elderly patients. Men are twice as likely as women to have diverticula. The complications like inflammation, bleeding, obstruction and perforation may develop in less than 10% of patients with jejunal diverticula. Perforation, as an uncommon complication, may occur following diverticulitis in 82%, blunt trauma in 12%, and impact of foreign body in 6% of cases. Herein we present a 62 year old man operated emergently due to development of acute abdomen that resulted from perforation caused by an increased jejunal and diverticular pressure secondary to rectal obstruction without any common factors mentioned for diverticular perforation. We performed resection and anastomosis at operation.Article Management of Giant Venous Aneurysms Secondary To Arteriovenous Fistula in Hemodialysis Patients(Professional Medical Publications, 2011) Ekim, Hasan; Odabasi, Dolunay; Basel, Halil; Aydin, CemalettinObjective: An aneurysmal fistula can continue to provide hemodialysis access for along time, but giant aneurysms should be operated on to prevent complication. The purpose of this study was to describe our experience of the surgical management of giant venous aneurysms that have developed as a complication of dialysis access. Methodology: Twenty patients with giant venous aneurysms of the AVF underwent surgical procedures at our hospital from December 2003 to December 2010. The diagnoses were made by physical examination and Color Doppler Ultrasonography. Results: There were 12 male and 8 female patients ranging in age from 29 to 68 years with a mean age of 44.6 +/- 12.3 years. Plication of the aneurysmal dilatations was performed in 17 patients. In two patients, aneurysmal dilatations were excised with restoration of the artery. The remaining one patient who received a successful renal transplantation was also associated with brachial artery aneurysm. Venous aneurysmal dilatations were excised and arterial aneurysms were repaired. All patients experienced a marked decrease in the size of venous dilatations. There were no vascular complications during the follow-up period. Conclusion: We suggest that plication is safe and effective in controlling venous dilatation and achieving patency. Reinforcing the suture line using an external mesh may not be required. However, prospective randomized studies will be required to assess the long-term outcomes.Article Orifice Location Guided Excision and Flap Procedures for Treatment of Sacrococcygeal Pilonidal Disease(Wroclaw Medical Univ, 2011) Piskin, Turgut; Olmez, Aydemir; Mecit, Eren A.; Unal, Bulent; Aydin, Cemalettin; Kayaalp, CuneytBackground. Although various surgical techniques have been described, there is no consensus on the optimal treatment for sacrococcygeal pilonidal disease (SPD). Objectives. The aim of this study is to report the medium-term results of three different surgical methods used to treat SPD that were chosen according to the localization of the sinus orifices. Material and Methods. Between November 2005 and April 2007, 43 patients with symptomatic SPD were treated by three different surgical methods. A classic approach, a modified flap technique and a new excision and flap technique were evaluated for treating SPD cases with different localizations of the sinus orifices. The study was carried out on the basis of retrospective reviews of patient charts and telephone interviews for prospective evaluation. Outcome measures included wound complications, time off work, complete healing time, paresthesia, recurrence rates and satisfaction with the procedures and outcomes. Results. There were no early postoperative complication among the 43 patients. The median hospitalization time was 6.76 days (2-12 days). The authors reached 31 patients (72.09%) by phone for the interview; the median follow-up time was 48.41 months (range 42-59 months). No recurrences were reported. The median time off work and complete healing time were 20.54 and 18.61 days, respectively. All but three of the patients reported satisfaction with the esthetic outcome. All the patients reported satisfaction with the effectiveness of the surgical approaches used. One patient reported dissatisfaction with the anesthesia technique. There were complaints of paresthesia from eight patients (one severe, seven moderate). All the patients said that they would recommend these operations and anesthesia techniques to relatives or other patients with sacrococcygeal pilonidal disease. Conclusions. Different excision and flap methods should be used to treat cases of sacrococcygeal pilonidal disease with different localizations of the sinus orifices (Adv Clin Exp Med 2011, 2011, 4, 481-488).Article Our Experience of Infrapopliteal Revascularization of Lower Extremity in Ten Years(Professional Medical Publications, 2011) Basel, Halil; Ekim, Hasan; Aydin, Cemalettin; Goya, CemilObjective: In this study the long term results of infrapopliteal arterial revascularization procedure was evaluated. The efficiency of distal revascularization was also searched for the treatment of critical limb ischemia. Methodology: From 1999 to 2009 32 patients underwent infrapopliteal revascularization procedure in our hospital for the treatment of critical limb ischemia. Demographic data of patients are: 23 male, 9 female and mean age was 60.5. Hypertension (n:15, 46.3%), diabetes mellitus (n:16, 50%), smoking (n:29, 90.6%) were the risk factors. The patients were classified in Fontaine III (n:25) and Fontaine IV (n:7). Extremity viability and long term patency was detected with limb examination, Doppler Ultrasonography and angiography. The cases were evaluated for post operative mortality, morbidity and primary graft patency for one year. Results: Mean follow up period was 21.3-/+15.9 monthes (12-60 monthes). Two patients died in early post operative period. Eight patients underwent re-operation. Re-operations were performed on six patients for the treatment of acute graft thrombosis and two patients for the control of surgical bleeding. The long term graft patency was 38% and extremity recovery rate was 46%. In post operative early period two minor and one major amputation was performed. Conclusion: Infrapopliteal arterial revascularization procedure is an efficient method for the treatment of critical limb ischemia and high rate of long term patency is the main advantage of this procedure.Article Outcomes of De Vega Versus Biodegradable Ring Annuloplasty in the Surgical Treatment of Tricuspid Regurgitation (mid-Term Results)(Forum Multimedia Publishing, Llc, 2010) Basel, Halil; Aydin, Unal; Kutlu, Hakan; Dostbil, Aysenur; Karadag, Melike; Odabasi, Dolunay; Aydin, CemalettinPurpose: The aim of this study was to compare De Vega semicircular annuloplasty and a new biodegradable ring annuloplasty technique in patients requiring surgical intervention for tricuspid valve disease with concomitant disease of the mitral valve. Methods: Between January 2004 and May 2008, 129 consecutive patients underwent annuloplasty procedures to correct tricuspid valve regurgitation during a concomitant mitral valve operation requiring replacement. Additionally, 24 patients underwent aortic valve replacement (AVR), 11 underwent coronary artery bypass grafting (CABG), 5 underwent AVR plus CABG, 3 underwent mitral valve replacement plus atrial septal defect (ASD) closure, and 2 underwent ASD closure. The patients in this study were assigned to 2 groups: Kalangos ring annuloplasty was performed in 67 patients (group 1), and De Vega semicircular annuloplasty was performed in the remaining 62 patients (group 2). Results: Both tricuspid valve repair techniques produced a low rate of complications; however, the number of patients who developed residual tricuspid regurgitation was significantly lower in group 1. Conclusion: The biodegradable ring annuloplasty technique may be used easily and safely in moderate and severe cases of tricuspid regurgitation; however, larger clinical series are necessary to confirm our promising results.Article Surgical Management of Atrial Septal Defect in Patients Over 40 Years of Age(Professional Medical Publications, 2011) Ekim, Hasan; Odabasi, Dolunay; Gumrukcuoglu, Hasan Ali; Basel, Halil; Aydin, CemalettinObjective: Atrial septal defect (ASD) makes up about 10% of all congenital heart diseases diagnosed after delivery and up to 30-40% of heart defects diagnosed in patients aged over 40 years. The objective of this study was to evaluate the effects of surgical ASD repair on functional status, right ventricular size, cardiothoracic ratio and pulmonary hypertension in patients over 40 years of age. Methodology: Between the period of August 2001 and August 2010, 20 of the patients who had undergone surgical repair of a secundum ASD when they were aged >40 years at our institution were included in this study. To evaluate the effects of surgery on clinical outcome, we compared functional status, echocardiographic and radiographic findings of the patients before and after surgery. The defect was closed with either a running nonabsorbable suture or an autologous pericardial patch. Results: Postoperatively, clinical status of the patients improved significantly. The mean NYHA functional class decreased from 2.8 +/- 0.4 to 1.5 +/- 1.1 (P < 0.001). Postoperatively, mean right ventricle diameter was found regressed from 38.2 +/- 9.3 mm to 34.8 +/- 6.2 mm (P < 0.002) at a median interval of four months. The pulmonary artery pressures were also significantly decreased (p < 0.002). Conclusion: The data provided by this study suggest that surgical repair of ASD improves functional status and relieves symptoms. Therefore, we suggest that ASDs that are unsuitable for transcatheter closure or requiring additional surgical intervention should undergo surgical repair to reduce subsequent morbidity and mortality, in patients including over 40 years of age.