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Biomedical subjects

Ahmet Ekin

Publications and source records attributed to Ahmet Ekin.

8 recordsLinked to original sources
PubMed2006

A new method for estimating arterial occlusion pressure in optimizing pneumatic tourniquet inflation pressure.

To reduce pressure-related injuries resulting from pneumatic tourniquet use, the lowest possible inflation pressure is recommended. Arterial occlusion pressure (AOP) is a measure of the cuff pressure required to maintain a bloodless surgical field. However, its determination method is time consuming, requires operator skill, and is therefore seldom used in current practice. An AOP estimation can be made by knowing the pressure transmitted to the underlying soft tissues. We measured upper and lower extremity tissue pressures under the tourniquet cuff at 100, 200, and 300 mm Hg of tourniquet inflation pressures in 30 anesthetized living adult patients. All patients received general anesthesia with neuromuscular relaxation. A Stryker intra-compartmental pressure monitor was used to measure tissue pressures under the tourniquet cuff. In all patients, the soft tissue pressures were consistently lower than the applied tourniquet inflation pressures. Our results revealed tissue padding coefficients for extremities 20 to 75 cm in circumferences. An estimation method of AOP was developed [AOP = (systolic blood pressure + 10)/Tissue padding coefficient]. The new AOP estimation method may be a simple, rapid, and clinically practical alternative to the AOP determination method.

Adolescent↗
PubMed2005

[Anatomy, biomechanics, and pathophysiology of instability of the glenohumeral joint].

The stability of the shoulder is dependent on both static and dynamic anatomic restraints. In most cases, there must be insufficiency of more than one restraint for the shoulder joint to become instable. Although the role of these restraints is largely known in maintaining shoulder stability, our information on their interactions is insufficient. This article reviews the anatomy and biomechanics of the shoulder and conditions causing instability of the glenohumeral joint.

Biomechanical Phenomena↗
PubMed2005

[Shoulder instability: classification and methods of clinical examination].

The shoulder is a complex joint whose stability relies on both dynamic and static factors. Dysfunction of one of these components gives rise to shoulder problems. Diagnosis of shoulder instability depends on a detailed history and appropriate physical examination. Despite the presence of many tests, none has proved to be purely diagnostic for shoulder instability. Therefore, these tests should be regarded as a part of the diagnostic procedure rather than a referral to diagnosis itself. Tests performed to assess laxity and instability are different in nature; thus, positive laxity tests do not necessarily show instability unless supported by further evidence. The reliability of the tests for superior labrum anterior-posterior lesions has not been adequately validated by clinical studies and few anatomical studies have examined the effect of these tests on the superior labral complex.

Humans↗
PubMed2005

[Open surgical treatment of recurrent anterior instability of the shoulder].

Recurrent anterior gleonohumeral instability is the most frequent joint instability of the body. Because of the complex stability mechanisms and diverse instability patterns of the glenohumeral joint, most cases present with more than one anatomic cause. Thus, the treatment of recurrent anterior instability of the shoulder should be designed to treat these pathologies. Although arthroscopic repair has outweighed the use of open surgical methods especially for the first dislocations, recurrent dislocations still require open repair techniques to overcome capsular laxity accompanying a Bankart lesion.

Humans↗
PubMed2005

[Multidirectional shoulder instability and open surgical procedures].

The principles and procedures for multidirectional instability do not substantially differ from those for anterior instability. Correct diagnosis is difficult, but it is important for a successful treatment. Conservative treatment should be attempted before surgery. Open surgical treatment using the inferior capsular shift procedure is the gold standard. It can be carried out either anteriorly or posteriorly. We prefer a laterally-based capsular shift because it facilitates capsular plication.

Humans↗
PubMed2003

Controlled hypotension and minimal inflation pressure: a new approach for pneumatic tourniquet application in upper limb surgery.

UNLABELLED: Minimal inflation pressures are recommended for limb surgery to eliminate complications attributable to high inflation pressures with the pneumatic tourniquets. We applied controlled hypotension and a minimal inflation pressure (CHAMIP) technique to provide a bloodless surgical field. Thirty-six patients scheduled for upper extremity surgery were randomized equally to receive either normotensive anesthesia and conventional inflation pressures or controlled hypotension (systolic arterial blood pressure of 80-100 mm Hg and mean arterial blood pressure >60 mm Hg) and minimum inflation pressures. Anesthesia was induced with propofol IV bolus and remifentanil IV continuous infusion and maintained with propofol and remifentanil IV continuous infusion. To determine the minimal inflation pressure, the digital plethysmograph was applied to the second finger at the side of the operation and the tourniquet was inflated slowly until the arterial pulsations disappeared on the oscilloscope. A bloodless surgical field was obtained in almost all patients, even though systolic arterial blood pressures (100-138 mm Hg versus 80-100 mm Hg) and applied tourniquet inflation pressures (270 mm Hg versus 110-140 mm Hg) were significantly lower in the hypotensive group. No complications associated with controlled hypotension were encountered. In conclusion, CHAMIP may be a safe and reliable method for upper extremity surgery performed with pneumatic tourniquets. IMPLICATIONS: Pneumatic tourniquets are associated with adverse effects resulting from high inflation pressures. Therefore, minimal inflation pressures are recommended in extremity surgery. To reach real minimal inflation pressure the patient's blood pressure must be reduced. We used controlled hypotension with remifentanil and propofol to reach minimal inflation pressures.

Adult↗
PubMed2003

[Massive rotator cuff tears: diagnosis and treatment techniques].

The treatment of massive rotator cuff tears presents challenging difficulties. Re-rupture after treatment may be frequently seen, along with it muscular degeneration, leading to insufficient clinical results. There is still controversy as to whether conservative or surgical treatment methods will be more appropriate for massive and partial tears. This article aimed to provide an update on the diagnosis and treatment of massive rotator cuff tears.

Injury Severity Score↗