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Biomedical subjects

H Posacioglu

Publications and source records attributed to H Posacioglu.

9 recordsLinked to original sources

The histological effect of harmonic scalpel and electrocautery in lung resections. An experimental study in a rat model.

AIM: In the last decade, ultrasonically activated scalpels (the Harmonic Scalpel, HS) have been developed and used for both open and endoscopic surgical procedures. The present study compares the deepness of lung tissue damage caused by HS and unipolar electrocautery (EC) in rats. METHODS: Ten rats were used for the study. Morphological damage on lung parenchyma of the rats was measured with the ocular micrometer in light microscopy. RESULTS: The mean depth of the tissue damage was 0.23+/-0.08 mm in the HS group, and 0.33+/-0.10 mm in the EC group. The difference was statistically significant between the 2 groups (p=0.028). CONCLUSION: HS induces significantly less tissue damage than EC in rat lungs.

Animals↗

The effects of L-carnitine on spinal cord ischemia/reperfusion injury in rabbits.

BACKGROUND: Paraplegia after distal aortic aneurysm repair remains a persistent clinical problem. We hypothesized that the tolerance of the spinal cord to an ischemic period could be improved with hypothermic Ringer's Lactate containing L-Carnitine. MATERIALS AND METHODS: Twenty-eight New Zealand white rabbits were used as spinal cord ischemia models. We separated rabbits into four equal groups and clamped each animal's abdominal aorta distal to the left renal artery. We occluded the aortas above the iliac bifurcation for 30 minutes. In group I, the infrarenal aorta was clamped without infusing any solution. In group II, Ringer's Lactate solution was infused at + 25degrees C for 3 minutes at a rate of 5 ml/min into the isolated aortic segments immediately after cross-clamping and the last 3 minutes of ischemia. In group III, Ringer's Lactate solution at +3 degrees C was given in the same method as that of group II. In group IV, Ringer's Lactate solution at +3 degrees C plus 100 mg/kg of L-carnitine was infused using the same technique. We assessed the neurological status of the hind limbs 24 and 48 hours after operation according to Tarlov's criteria. All animals were sacrificed and spinal cords were harvested for histological analyses. RESULTS: The neurological status in groups III and IV was significantly superior to that of groups I and II. All the animals in group I had complete hind-limb paraplegia. Complete hind-limb paraplegia occurred in 5 rabbits in group II. Two of the 7 animals in group III had spastic paraplegia, and none at all in group IV. Histological analysis of the cross-clamped segments of the rabbits with paraplegia in group I, II and III revealed changes consistent with ischemic injury, while findings were normal for the normal animals in group III and IV. CONCLUSIONS: In this model, the infusion of hypothermic Ringer's Lactate contained L-carnitine provided sufficient spinal cord protection against ischemia. Clinically, this may be a useful adjunct for prevention of paraplegia during surgery of the descending aorta.

Animals↗

Circulatory arrest to protect transplant kidney in a patient with chronic type III dissection.

With broader indications for renal transplantation and improved allograft survival, it is anticipated that the problem of aortic disease in the post-transplant patient will be encountered with increasing frequency. We report a technique of protecting the transplant kidney from ischemic damage during distal aortic surgery. A 30-year-old renal transplant patient who had undergone an operation for ruptured chronic type III dissection 3 years previously underwent abdominal aortic aneurysm repair under hypothermic circulatory arrest. The patient recovered uneventfully and is presently doing well 1 year after the operation. Hypothermic circulatory arrest could be used in selected cases as a useful alternative for transplant kidney protection.

Adult↗

Ectopic mediastinal pancreas.

Ectopic localisation of the pancreas is not an uncommon entity, but it is mostly seen in the gastrointestinal tract. Herein we report a 45-year-old woman with a cyst containing pancreatic tissue in the mediastinum. The English literature reveals only three previous cases of this extremely rare localisation of the pancreas.

Adult↗

Left ventricular diverticulum associated with Cantrell's syndrome and tetralogy of Fallot in an adult.

In this report we describe the surgical treatment of a 27-year-old patient with complete Cantrell's syndrome, i.e. multiple ventricular septal defect, left ventricular diverticulum, dextrorotation of the heart, an anterior diaphragmatic defect, and a midline supraumbilical abdominal wall defect with tetralogy of Fallot. Resection of the diverticulum was combined with correction of the tetralogy of Fallot and thoracoabdominal defects. The postoperative period was uncomplicated. We have have found only one previous report describing resection of the diverticulum combined with correction of Fallot's tetralogy and thoracoabdominal defects in an adult. One-stage repair of these complex anomalies is technically feasible and should be the treatment of choice.

Adult↗

Multiple coronary artery aneurysms combined with abdominal aortic aneurysm.

Coronary artery aneurysm (CAA) is defined as coronary dilatation which exceeds the diameter of a normal adjacent segment or the diameter of the patients's largest coronary vessel by as much as 1.5 times. It is an uncommon pathology with a frequency of 1-4% in routine autopsies or coronary angiographies. Atherosclerosis plays an important role in the development of CAA, and it may be a predominant cause in the majority of patients. However, the timing of surgical intervention and the treatment options for CAA are still controversial. In this report, we present a patient who had multiple CAAs of all main coronary arteries and abdominal aortic aneurysm. Different treatment modalities and indications are also discussed.

Aortic Aneurysm, Abdominal↗

Cerebral perfusion through separate grafts for repair of acute aortic dissection with torn arch.

We have modified the technique of cerebral perfusion through anastomosed grafts for repair of acute arch dissections that require total arch replacement. We have performed this operation on a 71-year-old man with an acute type-A dissection and an arch tear between the orifices of the brachiocephalic arteries. We used 2 separate grafts for the brachiocephalic arteries and minimized brain ischemia by initiating antegrade selective cerebral perfusion after the 1st anastomosis. The patient had an excellent outcome. This method is simple and provides effective protection. Cerebral ischemic time can be kept under 30 minutes without need of a sophisticated pump setup or a multibranched graft. This affords extra time in case the surgeon encounters an unexpected lesion in the arch.

Aged↗

Intramural hydatid cyst of descending aorta complicated by false aneurysm.

Hydatid disease is caused by the larval stage of Echinococcus granulosus, and the resultant fluid-filled cysts almost invariably affect the liver. Primary involvement of the aortic wall is very rare. We report a case of hydatid disease presenting as a huge cyst invading the wall of the descending aorta and complicated by a false aneurysm. Diagnostic problems and operative management are reviewed.

Aneurysm, False↗