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Biomedical subjects

Mehmet Ates

Publications and source records attributed to Mehmet Ates.

24 records · Page 2Linked to original sources

Acute pancreatitis: an obscure complication of organophosphate intoxication.

Acute pancreatitis secondary to organophosphate intoxication is a rare and generally well-course condition, but it is important to be aware of this complication for appropriate clinical management. There are a few reports about this subject in the literature, but it is believed that there are more cases than are reported for this condition. Because symptoms of toxicity can mask this severe complication, we report two cases of acute pancreatitis due to organophosphate intoxication for alerting this condition.

Acute Disease↗

Comparative assessment of chordal preservation versus chordal resection in mitral valve replacement for mitral stenosis (long-term follow-up: 8 years).

Carrying out a mitral valve replacement (MVR) while preserving all chordae tendineae in patients with mitral regurgitation has been proven beneficial to the left ventricular performance. To evaluate the effectiveness of this technique in patients with mitral stenosis, a comparison of the echocardiographic data between patients who were operated on using this technique (Group Preservation = GroupP, n = 15), and those operated on using the conventional method of MVR (Group Conventional = GroupC, n = 15) was made. All patients were examined before surgery, 6 months after surgery and 8 years after surgery. The study population was limited to patients who had no evidence of coronary artery disease, aortic stenosis and/or regurgitation and patients who had pure mitral stenosis. Echocardiographic measurements obtained both 6 months and 8 years postoperatively revealed a significant decrease in the left ventricular ejection fraction in GroupC (61.33+/-9.29% preoperatively, 53.2+/-10.3% postoperatively). The difference between the decrease in the left ventricular ejection fraction of the two groups was statistically significant (-0.71+/-6.28% in GroupP, -8.07+/-13.35% in GroupC). There was no evidence of prosthetic valve dysfunction and no operative deaths. Two patients died in GroupP, 3 patients died in GroupC within the 8 year period. The conclusion was reached, that if suitable, mitral valve replacement while preserving the chordae tendineae is expected to have a beneficial effect on postoperative left ventricular performance in patients with mitral stenosis.

Adult↗

A case of successfully treated inferior vena cava injury.

The inferior vena cava (IVC) is the most frequently injured retroperitoneal vascular structure. Despite the improvements in preoperative care and operation techniques, mortality rates for inferior vena cava injuries are still high due to delayed or inadequate volume recussitation, difficulty of diagnosis and technical problems in repair. A 1.5-cm sized wound at the IVC was primarly repaired by suturing. Because of appropriate and successful perioperative blood and fluid resuscitation, the patient was able to survive. We report a case of successfully treated IVC injury caused by a gunshot.

Abdominal Injuries↗

A role for endocannabinoids in indomethacin-induced spinal antinociception.

Inhibition of prostaglandins synthesis does not completely explain non-steroidal anti-inflammatory drug-induced spinal antinociception. Among other mediators, endocannabinoids are involved in pain modulation. Indomethacin-induced antinociception, in the formalin test performed in spinally microdialysed mice, was reversed by co-administration of the cannabinoid 1 (CB(1)) antagonist, N-(piperidin-1-yl)-5-(4-iodophenyl)-1-(2,4-dichlorophenyl)-4-methyl-1-H-pyrazole-3-carboxamide (AM-251), but not by co-infusion of prostaglandin E(2). Indomethacin was ineffective in CB(1) knockout mice. AM-251 also reversed the indomethacin-induced antinociception in a test of inflammatory hyperalgesia to heat. Furthermore, during the formalin test, indomethacin lowered the levels of spinal nitric oxide (NO), which activates cellular reuptake and thus breakdown of endocannabinoids. The pronociceptive effect of an NO donor, 3-methyl-N-nitroso-sydnone-5-imine (RE-2047), was abolished by co-administration of the endocannabinoid transporter blocker N-(4-hydroxyphenyl) arachidonoyl amide (AM-404). Moreover, the antinociceptive activity of the NO synthase inhibitor, N-nitro-L-arginine methyl ester (L-NAME), was reversed by AM-251. Thus we propose that at the spinal level, indomethacin induces a shift of arachidonic acid metabolism towards endocannabinoids synthesis secondary to cyclooxygenase inhibition. In addition, it lowers NO levels with subsequent higher levels of endocannabinoids.

Analgesics↗

The cannabinoids R(-)-7-hydroxy-delta-6-tetra-hydrocannabinol-dimethylheptyl (HU-210), 2-O-arachidonoylglycerylether (HU-310) and arachidonyl-2-chloroethylamide (ACEA) increase isoflurane provoked sleep duration by activation of cannabinoids 1 (CB1)-receptors in mice.

Cannabinoids produce antinociception via specific cannabinoid receptor activation, but there are also non-receptor mediated effects like for example the activation of the arachidonic acid cascade. Here we investigate the influence of cannabinoids (CB) on sleep duration after isoflurane anesthesia. We found that the CB receptor agonists R(-)-7-hydroxy-delta-6-tetra-hydrocannabinol-dimethylheptyl (HU-210) (0.1 mg/kg), 2-O-arachidonoylglycerylether (30 mg/kg) and arachidonyl-2-chloroethylamide (3 mg/kg) significantly prolong the duration of isoflurane induced sleep in mice (P<0.05). This effect was absent when co-injecting the selective CB(1) antagonist N-(piperidin-1-yl)-5-(4-iodophenyl)-1-(2,4-dichlorophenyl)-4-methyl-1H-pyrazole-3-carboxamide (1 mg/kg). Furthermore, HU-210 was ineffective in CB(1) receptor knockout mice (CB(1)-/-). Our behavioral tests (tail flick, rotarod) indicate that the sleep latency can be prolonged even at low drug dosages which do not influence thermal nociception. In the chosen dosages thimerosal (20 mg/kg), 2-AG (10 mg/kg), R(1)-methanandamide (R(1)-MAEA) (10 mg/kg) and flurbiprofen (27 mg/kg) were ineffective to increase sleep duration.

Anesthesia Recovery Period↗

Blood pressure changes after aortic coarctation surgery performed in adulthood.

OBJECTIVE: The aim of this study was to assess the effect of aortic coarctation surgery in adult patients on arterial blood pressure in the early postoperative period. METHODS: Ninety-three adult patients (61 male, 32 female) aged 15-43 years who had operation since 1962 for aortic coarctation in Siyami Ersek Cardiovascular Surgery Center were retrospectively evaluated. Tube graft interposition was done in 31 patients; resection and end-to-end anastomosis were performed in 32 patients; 24 patients had undergone pathchplasty; and 6 patients by-pass shunting performed. The effect of surgery on the blood pressure was investigated. RESULTS: The mean systolic and diastolic blood pressure significantly reduced after operation (systolic 193.6 +/- 33.7 mmHg vs 147.4 +/- 22.0 mmHg, diastolic 99.8 +/- 17.9 mmHg vs 82.0 +/- 10.8 mmHg). From 93 patients (all with hypertension) 54 (58%) became normotensive after operation according to VIth Joint National Committee classification. The number of normotensive patients after operation was 28 (of 37) for 15-19 years age group, 14 (of 23) for the 20-24 years age group, 4 (of 16) for 25-29 years age group, 6 (of 11) for 30-34 years age group, and 2 (of 6) for the over 35 years old age group. CONCLUSION: The diastolic and systolic blood pressures reduce significantly in the adult patients operated for aortic coarctation. On the other hand, persistent hypertension seemed to increase in the older age groups in spite of the surgery.

Adolescent↗