Biomedical subjects

A Sarioglu

Publications and source records attributed to A Sarioglu.

11 recordsLinked to original sources

PubMed2006

Current management of late failure after classic Fontan modifications: Fontan conversion.

BACKGROUND: Re-establishment of Fontan circulation by eliminating the drawbacks of classic Fontan modifications has been proposed recently to improve the functional class and quality of life of patients with failed Fontan circulation. METHODS: Five patients underwent extracardiac and lateral tunnel Fontan conversion due to failure of the Fontan circulation, after classic Fontan modifications. All of the patients were female and mean age was 10.2 +/- 2.2 years (range: 8-14 years). Previous Fontan modifications were atrio-pulmonary anastomosis in 3 and Kawashima operation in 2 patients. Time to re-operation for Fontan conversion was 6 +/- 1.5 years (range: 4-8 years). Indications for re-operation were right heart failure, right atrial dilatation, and intractable atrial arrhythmias in patients with previous atrio-pulmonary anastomosis, progressive hypoxia and exercise intolerance in patients with previous Kawashima operation due to pulmonary arteriovenous fistulas. Previous atrio-pulmonary anastomoses were converted to intra-atrial or lateral tunnel Fontan operation with modified right atrial Maze procedure. Extracardiac Fontan completion was carried out after previous Kawashima operations by redirection of hepatic veins to the lungs. RESULTS: There was no mortality and no major morbidity. All patients were discharged from the hospital in good condition and in sinus rhythm. No prolonged or recurrent effusions were observed. On follow-up, all patients were in sinus rhythm and had NYHA class I functional capacity. In two Kawashima patients, SpO(2) gradually increased from 60 % to 90 % six months after the operation. DISCUSSION: We suggest that Fontan conversion should be considered in patients with previous atrio-pulmonary anastomosis, when right atrial dilatation or intractable atrial arrhythmias with deteriorating functional status develops. Redirection of hepatic venous flow to lungs induces regression of pulmonary arteriovenous fistulas and improves arterial saturation in patients with previous Kawashima operation.

Adolescent↗

PubMed2005

Early results of extracardiac fontan procedure with autologous pericardial tube conduit.

BACKGROUND: Different types of conduits are used for extracardiac Fontan procedure. The use of autologous pericardial tube as an alternative conduit for connecting the inferior vena cava to the pulmonary artery is investigated. METHODS: We performed 25 extracardiac Fontan procedures by using pericardial tube between June 2000 and October 2003. Fifteen patients were male. Mean age and weight were 7.6 +/- 4.9 years (range 3 to 24 years) and 22.8 +/- 10.4 kg (range 12 - 50 kg), respectively. RESULTS: All patients survived after extracardiac Fontan procedure. Prolonged chest tube drainage (> 7 days) was required in 9 (36 %) patients. Follow-up was complete and mean follow-up was 24.6 +/- 11.5 months (1 - 39 months). One patient died 3 months postoperatively. Routine serial postoperative echocardiographic examinations in all patients and magnetic resonance angiography in 6 patients with suspect flow patterns in echocardiography did not reveal any problems with the Fontan circuit. CONCLUSIONS: Fresh autologous pericardial tube conduit is a suitable and safe alternative for extracardiac Fontan procedures. Major advantages are availability, no cost, easy handling and hemostasis, low risk of thrombosis and emboli, and growth potential.

Adolescent↗

PubMed2003

Pericardial collar modification for Ross procedure.

Although the surgical technique of the Ross operation has been improved over the years, there are still some technical difficulties: (1) The possibility of damage to first septal artery during harvesting and reconstruction of right ventricular outflow tract (RVOT). (2) Weak posterior anastomotic area during RVOT reconstruction. (3) Persistent bleeding from septal dissection site of pulmonary autograft. To deal with these difficulties, we used a 1-cm wide pericardial strip (pericardial collar) which was sutured to epicardium at the posterior and septal edge of the RVOT. The conduit used for the reconstruction of pulmonary outflow was then sutured to this pericardial strip at the posterior part of the anastomosis. We found this technique very useful to create a safe and strong margin for the posterior suture line. Persistent bleeding from septal dissection site can be also avoided using this modification by diverting the bleeding site into the right ventricular cavity.

Cardiopulmonary Bypass↗

PubMed2001

Capsaicin in albino rats prevents contralateral testis from the damaging effects posed by ipsilateral testis that underwent torsion.

OBJECTIVE: To evaluate the effect of capsaicin, a powerful neurotoxin selective to afferent nerves, on contralateral testicular damage in ipsilateral testicular torsion. METHODS: Forty male albino rats were randomly allocated into five groups. No operation was performed in group one. After intraperitoneal administration of 0.9% NaCl, rats underwent a sham operation in group 2 and testicular torsion in group 3. In groups 4 and 5 rats underwent sham operation and testicular torsion, respectively after intraoperitoneal capsaicin injection. Contralateral testes were harvested on the fifteenth day of the experiment and mean seminiferous tubular diameters and mean testicular biopsy scores were recorded for each testis. The values were compared through analysis of variance (ANOVA) with Turkey-Kramer multiple comparisons test and p values less than 0.05 were considered to be significant. RESULTS: Mean testicular biopsy scores and mean seminiferous tubular diameters of group 5 was significantly higher than the group 3. There was no difference between the groups 1, 2, 4, and 5 when these two parameters are concerned. CONCLUSION: Capsaicin effectively prevents contralateral testicular damage encountered following ipsilateral testicular torsion. The inhibition of afferent impulses from the ipsilateral testis under distress prevents contralateral testicular injury, and provides additional data to support the role of an autonomic reflex arc in contralateral testicular injury.

Afferent Pathways↗

PubMed2001

Antithrombin III reduces renal ischemia-reperfusion injury in rats.

Few studies have pointed out the relationship between ischemia-reperfusion (IR) injury and the coagulation system. Antithrombin III (AT) has anti-inflammatory effects in IR injury. We investigated the effect of AT supplementation on renal IR injury in rats achieved by clamping of the left renal pedicle for 60 min and subsequent 24-h reperfusion after right nephrectomy. Sprague-Dawley rats were divided into three groups: sham-operated (no IR injury), ischemic controls, and an AT-treated group (250 U/kg before reperfusion). Creatinine values, tissue malondialdehyde (MDA) levels, myeloperoxidase (MPO) activity, and histopathological damage were investigated after 24 h of reperfusion. In addition, the 7-day survival rates in each group were evaluated. Creatinine and MDA levels and MPO activity were significantly elevated and histopathological damage was more severe in controls than in the sham group (P<0.05). Creatinine and MDA levels and MPO activity were significantly lower and there was less histopathological damage in the AT group than in controls. Accumulation of lipid peroxidation products and neutrophils were significantly inhibited by AT treatment. We conclude that AT may attenuate renal IR injury in rats.

Acute Kidney Injury↗

PubMed2000

Effects of carotid artery repair following neonatal extracorporeal membrane oxygenation.

Between 1 June 1991 and 30 June 1996, 62 neonates were placed on extracorporeal membrane oxygenation (ECMO). In 61 the right carotid artery was cannulated. At the time of decannulation, a decision was made regarding carotid artery repair (CAR) based on the condition of the vessel. Thirty-two patients underwent end-to-end CAR and 29 had artery ligation. There was no difference between groups in gestational age or birth weight, but the ligation group contained 11 patients with congenital diaphragmatic hernia, compared to 2 in the repair group. The time on ECMO was 148 h for the repair group and 297 h in the ligation group. Follow-up contrast-enhanced magnetic resonance imaging (MRI) studies and ultrasound (US) demonstrated 2 occluded vessels in the repair group (7%); 3 vessels appeared stenotic on MRI. Follow-up neurologic examination was normal or near-normal in 17 of 19 repair infants and 9 of 16 ligation patients. Two repair infants had slight delays in development, while 3 ligation patients had significant delays. Follow-up US showed 3 grade I changes in the repair group with 1 hydrocephalus. There was 1 grade I and 1 grade III change in the ligation group. Follow-up MRI showed 6 minimal changes in the repair group and 9 in the ligation group. CAR does not adversely affect neurologic outcome after neonatal ECMO. The early patency rate was 93%, although 12% of the vessels appeared stenotic. Long-term follow-up confirmed persistent patency. CAR, if technically feasible, should be encouraged following neonatal ECMO therapy.

Carotid Artery, Common↗

PubMed1999

Effect of nitric oxide on postoperative adhesion formation.

Peritoneal adhesions continue to be a significant cause of postoperative complications. The purpose of the present study was to investigate the effect of nitric oxide in preventing postoperative adhesion formation in rats. Three randomized groups of Sprague-Dawley rats were subjected to a standardized lesion by cecal abrasion and parietal peritoneal defect. 0.9% NaCl (control, group 1), L-arginine (300 mg/kg, group 2) and Nomega-nitro arginine methyl ester (L-NAME; 25 mg/kg, group 3) were administered intraperitoneally before abdominal closure and during 3 consecutive days after surgery. Two weeks after surgery, a relaparotomy was performed and the extent of adhesion formation was determined. In groups 1 and 3 heavy adhesions were detected. In the L-arginine group, adhesion formation was significantly less than in the other groups (p < 0.05). This study showed that L-arginine reduced adhesion formation.

Animals↗

PubMed1999

Right ventricular diastolic function after repair of tetralogy of Fallot: its relationship to the insertion of a 'transannular' patch.

Examined was the effect of surgical technique, particularly the insertion of a transannular patch, on right ventricular diastolic function, and the relationship of forward flow in the pulmonary arteries during late diastole to right ventricular diastolic function in patients with tetralogy of Fallot. Transtricuspid, superior caval venous and pulmonary arterial Doppler spectrals were obtained and compared between 44 patients who had been repaired with a transannular patch; 14 patients who had been repaired with muscular resection and/or pulmonary valvotomy; six who had been repaired with an infundubular patch; and 32 normal children. The velocities of forward flow during late diastole in the pulmonary arteries of normal children ranged from 19.8 to 29.4 cm s(-1) (mean 24.9 +/- 2.8 cm s(-1)) throughout the respiratory cycle. Restrictive right ventricular physiology, defined on the basis of increased forward flow in the pulmonary arteries during late diastole (> 30 cm s(-1)) was present in 25 (57%) of 44 patients with tetralogy of Fallot repaired using a transannular patch. Right ventricular volume was 50.1 +/- 23.7 cm3 in patients with a restrictive right ventricle and 64.9 +/- 21.4 cm3 in patients in whom the ventricle was non-restrictive (p < 0.03). QRS duration was 140 +/- 18 and 156 +/- 24 ms in patients with restrictive and non-restrictive right ventricular physiology respectively (p < 0.003). Restrictive physiology was not encountered in patients with tetralogy in whom the pulmonary valve had been preserved. It is concluded that right ventricular restriction is present in many patients with tetralogy of Fallot at mid-term follow-up subsequent to repair using a 'transannular' patch. Restriction is associated with smaller right ventricular size and less prolongation of the QRS complex.

Blood Flow Velocity↗

PubMed1998

Report of eight cases of humeral fracture following the throwing of hand grenades.

A series of eight cases is presented in which similar fractures of the shaft of the humerus occurred during the throwing of hand grenades. Transient paresis of the radial nerve accompanied the fracture in one patient. In seven patients, the fracture healed without complication. In the remaining case, non-union developed, and surgical treatment was instituted. The mechanism of the fracture is discussed with reference to the literature.

Adult↗

PubMed1997

Hirschsprung-associated congenital anomalies.

Between 1976-1993, 302 patients were diagnosed to have Hirschsprung's disease (HD) in Hacettepe University Children's Hospital. All patients have been searched for the occurrence of associated anomalies and other parameters including 1) sex, 2) gestational age, 3) birth weight, 4) length of aganglionic segment, 5) familial occurrence, 6) consanguinity. Forty-nine of 302 patients were proved to have 83 associated congenital anomalies together with HD. Distribution of anomalies was as follows; central nervous system and special senses 28.92%, genitourinary system 26.51%, skeletal 24.09%, gastrointestinal 12.05%, cardiovascular 8.43%. In eleven patients more than one anomaly involving different systems were detected; only one of these patients was female and six of them have shown short segment disease. Down's syndrome was present in 5 patients. Female: male ratio was 1:4.2 for the whole series and 1:6 for the patients with Hirschsprung associated congenital anomalies (HACA). In the HACA group the percentage increased in favor of long-segment and extensive aganglionosis without statistical significance (p>0.05). The majority of patients were term babies and their birth weights were between 2500g < 3500g. Consanguinity was present in 36 families. No affected parents were detected but two sisters and four brothers were proved to have HD. Three pairs of twins, one of which was monozygotic, and all showing discordance were detected. There was no difference between HACA group and HD without HACA in terms of sex, birth weight, length of aganglionic segment and consanguinity. Although HD seemed to be genetically heterogeneous HACA did not have a genetically different origin from that of HD.

Abnormalities, Multiple↗

PubMed1989

[Neurofibromatosis 2 (bilateral acoustic neurofibromatosis)].

We report a personal series of 28 patients with neurofibromatosis 2 (NF-2), emphasizing the differences from classical NF-1. The hallmark of NF-2 is bilateral acoustic neuromas with initial symptoms usually occurring in the second or third decade. The natural history may lead to bilateral deafness, but hearing loss may also be a complication of surgery. NF-2 is frequently accompanied by additional intracranial tumors (particularly multiple meningiomas). Half of our patients had a spinal space-occupying lesion. NF-2 is inherited as an autosomal dominant trait, and many patients appear to represent new mutations.

Adolescent↗