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Biomedical subjects

O Aslan

Publications and source records attributed to O Aslan.

14 recordsLinked to original sources

Seeing the invisible: painless aortic dissection in the emergency setting.

Acute dissection of the aorta can be one of the most dramatic cardiovascular emergencies. Classically, aortic dissection presents as sudden, severe chest, back, or abdominal pain that is characterised as ripping or tearing in nature. However, a timely diagnosis can be elusive in the event of an atypical presentation. In this report, the authors present two patients with painless aortic dissection who were misdiagnosed during their initial evaluation in the emergency department.

Adult↗

Time-level relationship for nitric oxide and the protective effects of aminoguanidine in experimental spinal cord injury.

BACKGROUND: The secondary injury process following spinal cord trauma has been shown to involve different mechanisms such as excessive release of excitatory amino-acids, and induction of free radical induced lipid peroxidation. In this experimental study, the time-level relationship of the nitric oxide and the neuroprotective effects of aminoguanidine were investigated in a rat spinal cord trauma model. METHODS: The experiments were performed on 63 Wistar albino rats divided into three groups; sham-operated control (Group 1), trauma created control (Group 2) and aminoguanidine group (Group 3). In groups 2 and 3, spinal cord trauma was produced at thoracic level by using weight the drop technique (at a severity of 50 gr-cm). After the trauma, the rats in Group 3, received an intraperitoneal injection of 100 mg/kg aminoquanidine twice a day for 3 days. The effects of the injury and the efficacy of aminoguanidine were determined based on biochemical parameters (lipid peroxidation and nitric oxide levels in tissue), and on light microscopy findings in cord tissue collected at different times post-injury. Biochemical parameters were performed one hour, three and five days after injury. Functional recovery was assessed at 3, and 5 days after cord trauma with the inclined-plane technique and Tarlov's motor grading scale. FINDINGS: Although there was no statistically significant difference at the 1(st) hour, the values of the tissue nitric oxide in trauma created controls were 42% higher on the 3(rd) day and 40% higher on the 5(th) day when compared with those in sham controls. The levels of the tissue lipid peroxidation in trauma created controls were 88% higher at the 1(st) hour and 52.8% higher on the 5(th) day when compared with shame controls, but there was no meaningful difference on the 3(rd) day. In the trauma created control group, the mean motor function scores decreased to 1.16 +/- 0.40 and to 1 +/- 0 on the 3(rd) and 5(th) day, respectively. In this group the mean values of the inclined plane were 39.16 +/- 2.04 on the 3(rd) day and 37.91 +/- 1.02 on the 5(th) day. No statistically significant difference was observed in both tissue lipid peroxidation and nitric oxide levels for all time points between the aminoguanidine group and the sham-operated controls (p>0.01). The motor function scores were observed as 2.16 +/- 0.40 on the 3(rd) day and as 3 +/- 0 on the 5(th) day in aminoguanidine group. These values were significantly higher than the trauma created controls (p<0.01). Aminoguanidin treatment also improved the inclined plane performance of the rats; In this group, the mean values of the inclined plane scores were 44.58 +/- 2.92 and 52.91 +/- 1.88 on the 3(rd) and 5(th) days, respectively. These values were significantly higher than the trauma created controls (p<0.01). INTERPRETATION: This study shows that the nitric oxide level does not increase in the spinal cord tissue during the first hour after the spinal cord trauma. It increases significantly in the spinal cord tissue not only three days but also five days following the trauma. Aminoguanidine treatment, which is started just after the trauma, can prevent both the nitric oxide production and lipid peroxidation in spinal cord tissue and it can improve the functional status of the animals. In this respect, aminoguanidine may have a potential role in the treatment of acute spinal cord injury.

Animals↗

Nitroderm TTS band application for pain after hemorrhoidectomy.

PURPOSE: Anal sphincter spasm is believed to play an important role in pain after hemorrhoidectomy. We tested a different form of nitroglycerin: the Nitroderm TTS band. We investigated its efficacy on posthemorrhoidectomy pain and the relation between pain and anal resting pressure measured preoperatively and postoperatively. METHODS: Thirty-eight hemorrhoid patients were divided into two groups: those with high anal resting pressure were classified as group A (n = 24) and those with low anal resting pressure were classified as group B (n = 14). After hemorrhoidectomy, Nitroderm TTS bands were placed into the anal canal in half of the patients in groups A and B (groups A-1 and B-1) and not in the remaining half (groups A-2 and B-2). Anal resting pressure measurement was repeated at the first day and third month postoperatively. Postoperative pain was assessed by linear analog scale, and analgesic consumption was recorded. RESULTS: Preoperative anal resting pressure was 112.0 (range, 95-140) cm H2O in group A-1 and 110.6 (range, 96-138) cm H2O in group A-2. The difference was insignificant. However, on the first postoperative day, anal resting pressures were 88.7 (range, 75-115) and 110.9 (range, 92-135) cm H2O (P = 0.0001), and at the third month, they were 76.5 (range, 70-100) and 78.0 (range, 70-105) cm H2O, respectively (P = 0.690). Postoperative pain scores were significantly lower in group A-1 than group A-2 (P = 0.0001). In the low-pressure groups (B-1 and B-2), anal resting pressures before surgery, on the first postoperative day, and at the third month postoperatively were 70.4 (range, 56-76), 67.4 (range, 50-75), and 67.2 (range, 55-74) cm H2O in group B-1 and 69.8 (range, 58-76), 70.2 (range, 60-76), and 68.4 (range, 60-74) cm H2O in group B-2. The differences were insignificant (P > or = 0.660). The differences between pain scores in these groups were also insignificant (P > or = 0.160). CONCLUSION: Nitroderm TTS bands effectively reduced anal resting pressure and relieved pain in patients with high preoperative anal resting pressure.

Administration, Cutaneous↗

Effects of antiadhesive agents on the healing of intestinal anastomosis.

PURPOSE: The effects of antiadhesive agents on the healing of intestinal anastomosis were investigated. METHODS: Eighty rats were divided into eight groups. Colotomy and anastomosis were performed to all rats. Saline solution (control), carboxymethylcellulose, aprotinin, verapamil, tenoxicam, cyclosporine, and dextran 70 were administered intraperitoneally. Vitamin E was administered intramuscularly. The rats were killed 15 days later. Anastomotic healing was assessed by bursting pressure and the hydroxyproline content of the anastomotic tissues. The results were evaluated by Mann-Whitney U test. RESULTS: The mean (+/- standard deviation) bursting pressures of carboxymethylcellulose, cyclosporine, and aprotinin groups (108 +/- 6.73, 122.5 +/-14.39, and 127 +/- 20.23, respectively) were significantly lower than those of the control group (234 +/- 6.19). The mean level of hydroxyproline in the anastomotic tissues was significantly lower in the carboxymethylcellulose and cyclosporine groups (8.92 +/- 0.6 and 8.32 +/- 0.63) than that in the control group (16.33 +/- 0.68). CONCLUSION: These findings indicate that carboxymethylcellulose and cyclosporine had adverse effects on intestinal anastomosis in rats.

Anastomosis, Surgical↗

Heart rate variability, late potentials and QT dispersion as markers of myocardial involvement in patients with Behçet's disease.

BACKGROUND: Myocardial involvement in Behçet's disease has been reported to be relatively rare. OBJECTIVE: To evaluate myocardial involvement noninvasively in patients with Behçet's disease by measuring signal-averaged electrocardiography (SAECG), QT dispersion and heart rate variability (HRV). PATIENTS AND METHODS: The study group comprised 28 eligible patients (16 male, mean age 37+/-13 years) of 33 patients with Behçet's disease, and 25 age- and sex-matched control subjects. RESULTS: The echocardiographic left ventricular measurements were within normal limits and similar in both groups except the E/A ratio, which was significantly lower in patients with the disease than in control patients. Minimal pericardial effusion was detected in four patients. Considering the SAECG recordings, values of root mean square voltage in the last 40 ms were 30+/-18 microV and 38+/-18 microV in patients with Behçet's disease and in the control group, respectively. The number of cases with a value less than 20 microV was seven (25%) and one (4%) in the same groups, respectively. Both QT dispersion and the corrected QT interval dispersion were significantly increased in patients with Behçet's disease compared with the control patients (50.2+/-16.6 versus 20.4+/-18.8, P<0.01). Although all HRV measures appeared to be decreased in the Behçet's group, only the standard deviation of all filtered RR intervals in the entire 24 h ECG recordings and the percentage of differences between adjacent filtered RR intervals that are greater than 50 ms for the whole analysis values differed significantly between the groups (P<0.05). No significant difference was observed in frequency domain parameters. In the Holter ECG recording, grade 2 or greater premature ventricular complexes were observed in seven patients from the Behçet's group (25%) but in only one subject from the control group (4%) (P<0.05). CONCLUSIONS: Patients with Behçet's disease appeared to have significantly increased QT dispersion, a left ventricular diastolic dysfunction pattern in echocardiography, a high incidence of positive late potentials and more complex ventricular arrhythmias, suggesting myocardial involvement and the existence of an arrhythmogenic substrate, whereas the HRV measures do not suggest a clear autonomic abnormality in Behçet's disease.

Adolescent↗

A fistula connecting the right coronary artery to the right atrium: a hitherto undescribed association.

A case of double right coronary artery accompanying a fistulous connection is presented. An additional right coronary artery is an extremely rare congenital abnormality. In this case, the second right coronary artery was draining into a cardiac chamber via a fistulous connection. This is the first case in the literature to present these abnormalities coexisting in the same patient.

Arterio-Arterial Fistula↗

Value of QT dispersion in diagnosis of restenosis after intracoronary stent implantation.

We studied the ECGs of patients with single vessel disease before and after (long term) coronary stent implantation. The interlead variability of the QT interval, known as QT dispersion (QTd), is believed to reflect the regional variations in ventricular repolarization and, thus, may provide an indirect marker of arrhythmogenicity. There are no reliable noninvasive markers of significant restenosis after stent implantation. The effect of coronary revascularization on QTd in patients who underwent coronary stenting has not been investigated extensively. The aim of this study was to evaluate the value of QTd in predicting restenosis after intracoronary stent implantation. QTd with 12 lead surface ECG was measured in 48 patients (21 with restenosis and 27 without restenosis; 33 male; mean age, 58+/-10.8 years) before the procedure and after long-term follow-up (mean, 6.8+/-3.2 months). All patients had coronary angiographic control at the end of the follow-up period. QTd (as the difference between the maximum and minimum QT interval measured from 12 lead ECG) and rate-corrected QT (QTcd) were evaluated at rest. In 27 patients without restenosis, QTd and QTcd decreased from 58+/-14.4 and 62.8+/-20.4 ms to 26.3+/-9.2 and 29.6+/-10.6 ms in the long term follow-up, respectively (P<0.001). However, in 21 patients with restenosis, there was no significant change in QTd and QTcd intervals and they were still increased at the end of the long-term follow-up (P>0.05). In conclusion, increased QT interval dispersion may be an inexpensive and simple marker of restenosis after intracoronary stent implantation.

Aged↗

Management of traumatic retinal detachment with vitreon in children.

PURPOSE: To report the use of perfluoroperhydrophenanthrene (vitreon) for traumatic retinal detachment in children. METHODS: Vitreon was used as an intraoperative adjunct in 34 children with complicated retinal detachment secondary to penetrating and perforating trauma. The characteristics of the injuries, the final visual acuities, the postoperative complications and the rate of anatomic success were evaluated in a retrospective study. RESULTS: Patients were followed-up an average of 20 months. Eighteen retinas (53%) were reattached, and the postoperative visual acuity was counting fingers or better in 9 cases (26%), and only 4 eyes saw better than 10/200 at last follow-up. Hypotony developed in 7 (21%) of 34 eyes. CONCLUSION: Management of traumatic retinal detachment in children is difficult. Vitreon, as other perfluorocarbons, may be an effective intraoperative tool for vitreoretinal surgery in pediatric eyes that suffer trauma.

Adolescent↗

Cardioversion with sotalol in selected patients with vagally and adrenergically mediated paroxysmal atrial fibrillation.

This study was designed to evaluate and compare the effects of oral sotalol for the treatment of vagal and adrenergic paroxysmal atrial fibrillation (PAF). Thirty-five eligible patients with atrial fibrillation of > 12 hours and < 7 days were enrolled in the study. Patients were classified as vagally mediated (group I, n: 14) and adrenergically mediated (group II, n: 21) PAF groups. All patients were given racemic sotalol at a dose up to 120 mg bid for 2 days. At the end of the observation period of 48 hours, 36% of patients (n: five) in group I returned to sinus rhythm. Conversion rate in group II was 71% (n: 15), and this figure was significantly higher than the success rate in group I. Mean times to cardioversion were 22 +/- 15 hours in group I and 16 +/- 14 hours in group II (p < 0.05). The result of this study suggests that oral sotalol is more effective for adrenergic PAF. This beneficial effect of sotalol is not apparent in vagal PAF patients.

Adrenergic Fibers↗

The use of perfluorodecalin in retinal detachments with retinoschisis.

BACKGROUND AND OBJECTIVE: To evaluate the effect of perfluorodecalin on the repair of retinal detachments with retinoschisis. PATIENTS AND METHODS: Twenty-two eyes of 20 patients with degenerative and X-linked retinoschisis underwent pars plana vitrectomy, perfluorodecalin injection, internal fluid drainage, and fluid-air exchange. RESULTS: The retina was reattached intraoperatively in 21 (95.4%) of the 22 eyes. In 4 eyes, retinal detachment recurred within 2 months postoperatively. All of the recurrent cases underwent reoperation with perfluoropropane gas and the retina was reattached at the end of 2 operations. As a result, visual acuity increased in 18 (81.8%) of the 22 eyes. CONCLUSION: Perfluorodecalin makes flattening of the retina and evacuation of subretinal fluid easier in the management of rhegmatogenous retinal detachments associated with degenerative and X-linked retinoschisis.

Adolescent↗

Hepatic adenomatosis: gadolinium-enhanced dynamic MR findings.

Hepatic adenomatosis is a rarely encountered liver disease. It is an entity distinct from hepatocellular adenoma and is characterized by the presence of more than 10 hepatic adenomas. We present the multiplanar and multiphasic dynamic magnetic resonance findings of hepatic adenomatosis in a 15-year-old adolescent who developed transfusional hemosiderosis and had received anabolic steroids for the treatment of aplastic anemia.

Adenoma, Liver Cell↗

Needs of lay caregivers of bone marrow transplant patients in Turkey: a multicenter study.

The purpose of this research was to identify the needs of lay caregivers of bone marrow transplant (BMT) patients throughout the BMT trajectory. The sample consisted of 58 lay caregivers of BMT patients (5 of which were inpatients) from the 4 BMT units in Ankara, Turkey. Data were collected through a demographic data form and the Psychological and Social Needs Scale. Data analysis was performed using SPSS 10.0 for Windows. Among the descriptive statistics, frequencies and percentages were used to define the characteristics of lay caregivers and responses related to information. Mean values, standard deviations, and the Pearson correlation coefficients were also calculated for the results of the subscales. Most of the lay caregivers were spouses. The rest were other family members: brother/sister, mother, son/daughter, or father. Only one lay caregiver was a friend. The most common type of BMT was autologous. Most of the surveys were completed by the lay caregivers whose patients had been out of the hospital for 100+ days after BMT. The lay caregivers were educated on the BMT process by various sources, and 67.24% of them expressed satisfaction with the information that they were given. A majority of them preferred face-to-face communication with a healthcare professional. The categories of the information provided were diagnosis and treatment, homecare after discharge, follow-ups and laboratory tests, and nutrition. They indicated a need for more information, particularly regarding homecare after discharge and diagnosis. Fear was the highest scoring psychological needs/problems of lay caregivers, whereas leisure activity deficit was highest among the social needs/problems. The information gathered from this study led us to reevaluate our healthcare services for both patients and lay caregivers to improve physical, psychological, and social aspects of the nursing care as a whole.

Adult↗

Intraocular pressure changes in the vitreon study.

BACKGROUND AND OBJECTIVE: To detect the effect of Perfluoroperhydrophenanthrene (vitreon) on intraocular pressure (IOP) changes. PATIENTS AND METHODS: One hundred-five eyes with proliferative vitreoretinopathy undergoing vitrectomy using vitreon as an intraoperative surgical adjunct were randomized to 2 groups. Vitreon was completely removed in 43 eyes (Group A) at the end of operation while it was left intravitreally in 62 eyes (Group B) for 4 weeks. Patients were followed for at least 18 months. RESULTS: During the first postoperative week, 6 eyes (14%) in Group A and 14 eyes (22%) in Group B had IOP of 23 mm Hg or more (P = .393) while no eyes in either group had hypotony. At the last follow-up 2 eyes (5%) in Group A and 6 eyes (10%) in Group B showed chronic hypotony (P = .561). CONCLUSION: Although postoperative chronic hypotony risk increased twofold by vitreon when it was left intravitreally for 4 weeks, this difference was statistically insignificant. Vitreon can be used as a vitreous substitute for 4 weeks in this regard.

Adult↗