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Öğe The acute effect of humic acid on iron accumulation in rats(Biological Trace Element Research, 2016) Çağın, Yasir Furkan; Şahin, Nurhan; Polat, Alaadin; Erdoğan, Mehmet Ali; Atayan, Yahya; Eyol, Ergül; Bilgiç, Yılmaz; Seçkin, Yüksel; Çolak, CemilAbstract Free iron leads to the formation of pro-oxidant reactive oxygen species (ROS). Humic acids (HAs) enhance permeability of cellular wall and act as a chelator through electron transferring. This study was designed to test chelator effect of HA on iron as well as its anti-oxidant effect against the iron-induced hepatotoxicity and cardiotoxicity. The rats used were randomly divided into four groups (n = 8/group): group I (the control group); group II (the HA group), humic acid (562 mg/kg) was given over 10 days by oral gavage; group III (the iron group), iron III hydroxide polymaltose (250 mg/kg) was given over 10 days by intraperitoneal route; and group IV (the HA plus iron group), received the iron (similar to group II) plus humic acid (similar to those in groups II and III) group. Blood and two tissue samples both from liver and heart were obtained for biochemical and histopathological evaluations. Iron deposition, the iron-induced hepatotoxicity, and cardiotoxicity were demonstrated by histopathological and biochemical manner. However, no significant differences were observed in the serum biochemical values and thehistopathological results among the iron and the HA plus iron groups in the liver tissue but not in the heart tissue. The protective effects of humic acid against iron-induced cardiotoxicity were shown but not against hepatotoxicity in our study.Öğe The acute effect of humic acid on ıron accumulation in rats(Biological Trace Element Research, 2016) Çağın, Yasir Furkan; Şahin, Nurhan; Polat, Alaadin; Erdoğan, Mehmet Ali; Atayan, Yahya; Eyol, Ergül; Bilgiç, Yılmaz; Seçkin, Yüksel; Çolak, CemilFree iron leads to the formation of pro-oxidant reactive oxygen species (ROS). Humic acids (HAs) enhance permeability of cellular wall and act as a chelator through electron transferring. This study was designed to test chelator effect of HA on iron as well as its anti-oxidant effect against the iron-induced hepatotoxicity and cardiotoxicity. The rats used were randomly divided into four groups (n = 8/group): group I (the control group); group II (the HA group), humic acid (562 mg/kg) was given over 10 days by oral gavage; group III (the iron group), iron III hydroxide polymaltose (250 mg/kg) was given over 10 days by intraperitoneal route; and group IV (the HA plus iron group), received the iron (similar to group II) plus humic acid (similar to those in groups II and III) group. Blood and two tissue samples both from liver and heart were obtained for biochemical and histopathological evaluations. Iron deposition, the iron-induced hepatotoxicity, and cardiotoxicity were demonstrated by histopathological and biochemical manner. However, no significant differences were observed in the serum biochemical values and the histopathological results among the iron and the HA plus iron groups in the liver tissue but not in the heart tissue. The protective effects of humic acid against iron-induced cardiotoxicity were shown but not against hepatotoxicity in our study.Öğe Acute Fatty Liver of Pregnancy Developing in Early Stages(Turgut Özal Tıp Merkezi Dergisi, 2014) Atayan, Yahya; Çağın, Yasir Furkan; Erdoğan, Mehmet Ali; Aladağ, Murat; Karıncaoğlu, Melih; Harputoğlu, Murat; Seçkin, YükselÖz: Gebeliğin akut yağlı karaciğeri (GAYK) erken tanı konulmadığında ve tedavi edilmediğinde ölümcül seyredebilen gebeliğin nadir ama önemli bir üçüncü trimester komplikasyonudur. GAYK ciddi karaciğer hasarı ile birlikte karaciğer yetmezliği, yaygın damar içi pıhtılaşma (DİK), hepatik ensefalopati, postpartum kanama, çoklu organ yetmezliği ve ölüme yol açabilir. GAYK’de erken tanı ve tedavi ile maternal ve neonatal mortalitenin azalması sağlanabileceğinden her kadın hastalıkları ve doğum hekiminin bu konuda bilgili ve dikkatli olması gerekir. Olguların postpartum dönemde kanama gibi risklerle karşı karşıya olduğu akılda bulunmalıdır. Bu yazıda GAYK hastalığı düşünülen sonrasında DİK ve postpartum ikinci günde karın içi masif kanama gelişen, 36 hafta ikiz gebeliği olan bir olgu sunulması ve literatür eşliğinde olgunun tartışılması amaçlandı.Öğe Airway management in an osteogenesis imperfecta case in the lateral decubitus position(Medicine Science, 2016) Uçar, Muharrem; Özkan, Ahmet Selim; Demiröz, Duygu; Erdoğan, Mehmet Ali; Özgul, Ülkü; Durmuş, MahmutAbstract Osteogenesis imperfecta that is a connective tissue disorder is a rare autosomal disease. Osteogenesis imperfecta in the presence spinal deformity, respiratory disorders, cardiac anomalies and bone deformities may create several problems in the management of anesthesia. The risks of teeth, mandible and cervical trauma and difficulty making positions due to bone deformity challenge difficult airway management. We aim to provide airway management with ProSeal Laryngeal Mask Airway in left lateral decubitus position in a child patient who has severe thoracic spine deformity and can not be given supine position. Keywords: Osteogenesis imperfecta, PLMA, airway managementÖğe Akut demir zehirlenmesi olgularına klinik yaklaşım: olgu serisi(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2013) Erdoğan, Mehmet Ali; Özgül, Ülkü; Aydoğan, Mustafa Said; Kaçmaz, Osman; Gedik, Ender; Toğal, TürkanAmaç: Akut demir zehirlenmesi çocukluk yaş grubunda daha sık görülse de; her yaşta rastlanabilen önemli bir klinik durumdur. Akut demir zehirlenmesi; gastrointestinal kanama, kardiyovaskuler kollaps, mental durum bozukluğu, karaciğer ve böbrek yetmezliğine neden olabilir. Bu çalışmada, yoğun bakım ünitemizde akut demir zehirlenmesi nedeniyle yatırılan hastaların demografik özellikleri değerlendirildi, tanı ve tedavi yaklaşımlarını tartışıldı. Gereç ve Yöntem: Ocak 2010- Aralık 2011 arasında yoğun bakım ünitemize akut demir zehirlenmesi nedeniyle kabul edilen 8 hasta incelendi. Hastaların yaş, cinsiyet, zehirlenmenin nedeni, alınan ilaç veya ilaçlar, alınma yolu, daha önce zehirlenme öyküsünün varlığı, ilacın alınmasından yoğun bakım yatışına kadar geçen süre, bilinç durumu, Glaskow Koma Skoru, yoğun bakımda kalış süresi, laboratuvar tetkik sonuçları ile uygulanan tedavi yöntemleri değerlendirildi. Bulgular: Akut demir zehirlenmesi nedeniyle yoğun bakımda takip edilen 8 hastanın tamamı kadındı ve yaş ortalaması 22±5,4 yıl idi. Hastaların zehirlenme nedenleri intihar amacıyla yüksek doz ilaç alımıydı. Hastalarda görülen en sık semptom karın ağrısı (n=7), kusma (n=5), diyare (n=4) idi. Alınan elementer demir miktarı ortalama 30,25±11,4mg/kg’dır. Hastaların hiçbirinde biyokimya ve koagülasyon parametrelerinde klinik olarak önemli bir değişiklik olmadı. Tüm hastaların nazogastrik sondaları acil serviste takılmış ve mide lavajları yapılmıştı. Serum demir düzeyi 500 ?g/dL’den yüksek olmadığından desferroksamin tedavisi uygulanmadı. Hastaların gastrointestinal şikayetleri ortalama 4-5 saat sürdü, 2 gün takipleri yapılan hastalardan biri psikiyatri kliniğine devir edilirken 7 hasta taburcu oldu. Sonuç: Ölümcül seyredebilen akut demir zehirlenmesinde erken laboratuar ve klinik takiple ciddi komplikasyonların önüne geçilebilir. Temel destek tedavisi ile barsak irrigasyonu ve desferroksamin tedavisi zamanında yapılmalıdır.Öğe Akut Demir Zehirlenmesi Olgularına Klinik Yaklaşım: Olgu Serisi(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2014) Erdoğan, Mehmet Ali; Özgül, Ülkü; Aydoğan, Mustafa Said; Kaçmaz, Osman; Gedik, Ender; Toğal, TürkanAim: Although acute iron poisoning is more common in the pediatric age, it may be seen at any age and is an important clinical condition. In this study, we aimed to evaluate the etiological factors and diagnosis and discuss treatment approaches in the acute iron poisoning. Material and Methods: Eight patients who were admitted to the intensive care unit due to acute iron poisoning were analyzed. Data regarding demographic features, cause of poisoning, toxic agents, the route of exposure, a history of previous toxicity, the time between exposure and intensive care unit admission, the owner of the poisoning agent (the patient or someone else), consciousness status on arrival, Glasgow coma score, the length of the intensive care unit stay, the result of laboratory tests, methods of treatment, and outcome were evaluated. Results: All 8 patients were female and the mean age was 22±5,4 years. The most common symptoms were abdominal pain, vomiting and diarrhea. The amount of received elemental iron was 30,25±11,4mg/kg. Nasogastric catheters were inserted and gastric lavages were performed to all the patients in the emergency department. Deferoxamine treatment was not implemented because of serum iron levels were not higher than 500 mg / dL. After observing all patients for two days, one patient was transferred to psychiatric clinic, 7 patients were discharged with full recovery. Conclusions: In potentially fatal acute iron poisoning, serious complications can be avoided with early laboratory and clinical follow-up. The basic supportive therapy with gastric lavage and desferroksamine therapy should be managed on time.Öğe Akut Kardiyojenik Pulmoner Ödem Gelişen Ağır Astımlı Hastada Non- invaziv Ventilasyon Tedavisi: Olgu Sunumu(Turgut Özal Tıp Merkezi, 2012) Aydoğan, Mustafa Said; Erdoğan, Mehmet Ali; Şanlı, Mukadder; Togal, Türkan; Ersoy, M. ÖzcanSpinal anestezi altında transüretral rezeksiyon planlanan ağır astımlı bir hastada gelişen akut kardiyojenik pulmoner ödemin non invaziv ventilasyon ile tedavisi anlatılmaktadır. Literatürde ciddi astım sonrası non invaziv ventilasyon ile ilgili bilgi bulunmamaktadır. Biz bu nadir uygulanan tedaviye dikkat çekilmesinin önemli olduğuna inanıyoruz.Öğe Anesthetic Management of a Patient with Motor-sensory polyneuropathy(2016) Erdoğan, Mehmet Ali; Uçar, Muharrem; Özgül, Ülkü; Demiröz Aslan, Duygu; Durmuş, MahmutAbstract: Polinöropati, yaygın aksonal dejenerasyon veya multifokal segmental demiyelinizasyonla seyreden ve genellikle periferik sinirleri tutan nöropatidir. Kas kuvvetsizliği, atrofi, fasikülasyon, solunum kaslarının tutulumuyla solunum yetmezliğine neden olabilir. Polinöropatili hastaların; artmış malign hipertermi riski, solunum kaslarının tutulmasıyla ekstübasyon sonunda gelişebilecek potansiyel hava yolu sorunları, nondepolarizan kas gevşeticilerin uzamış etki süresi ve nöroaksiyel blokların kullanılmasının tartışmalı olması anestezi yönetimini önemli kılmaktadır. Bu sunuda skolyoz nedeniyle posteriyor enstrümantasyon planlanan demiyelinizan ağırlıklı motor-duyu polinöropatili olguya nöromuskuler bloker kullanmadan uyguladığımız genel anestezi yönetimini aktarmayı amaçladıkÖğe Ascites and hepatic involvement: a rare and atypical presentation of Burkitt Lymphoma(Turgut Özal Tıp Merkezi Dergisi, 2016) Seçkin, Yüksel; Cagin, Yasir Furkan; Özkan, Ahmet Selim; Bilgiç, Yılmaz; Yıldırım, Oğuzhan; Erdoğan, Mehmet Ali; Atayan, Yahya; Kırımlıoğlu, Hale; Aydoğdu, İsmetAbstract Burkitt lymphoma (BL) is an uncommon form of lymphoma in adults. In this disease, extensive involvement of the omentum and the peritoneum is rare. We present this case with ascites because it is such a rare and overlooked clinical presentation of BL. A previously healthy 20-year-old man was admitted to our hospital with abdominal pain, distension, and night sweats. Physical examination revealed massive ascites. Computerized tomography showed liver metastasis and ascites, but no pathologic thoracal or abdominal lympadenopathy was reported. Atypical lymphocytic cells with cytoplasmic vacuoles were determined on cytologic examination of ascites. We detected starry sky view on the bone marrow examination. On immunophenotyping, cells were CD20 positive, but negative for CD30, CD79a/Tdt. Patient was diagnosed as BL. Burkitt lymphoma should be considered in young patients presenting with ascites and hepatic mass even without lymphadenopathy or focal gastrointestinal masses. Keywords: Ascite; Hepatic İnvolvement; Burkitt Lymphoma.Öğe Ascites and hepatic involvement: a rare and atypical presentation of Burkitt Lymphoma(Turgut Özal Tıp Merkezi Dergisi, 2016) Seçkin, Yüksel; Cagin, Yasir Furkan; Özkan, Melda Çömert; Bilgiç, Yılmaz; Yıldırım, Oğuzhan; Erdoğan, Mehmet Ali; Atayan, Yahya; Kırımlıoğlu, Hale; Aydoğdu, İsmetAbstract Burkitt lymphoma (BL) is an uncommon form of lymphoma in adults. In this disease, extensive involvement of the omentum and the peritoneum is rare. We present this case with ascites because it is such a rare and overlooked clinical presentation of BL. A previously healthy 20-year-old man was admitted to our hospital with abdominal pain, distension, and night sweats. Physical examination revealed massive ascites. Computerized tomography showed liver metastasis and ascites, but no pathologic thoracal or abdominal lympadenopathy was reported. Atypical lymphocytic cells with cytoplasmic vacuoles were determined on cytologic examination of ascites. We detected starry sky view on the bone marrow examination. On immunophenotyping, cells were CD20 positive, but negative for CD30, CD79a/Tdt. Patient was diagnosed as BL. Burkitt lymphoma should be considered in young patients presenting with ascites and hepatic mass even without lymphadenopathy or focal gastrointestinal masses. Keywords: Ascite; Hepatic İnvolvement; Burkitt Lymphoma.Öğe Assessment of aortic stiffness, myocardial performance index and cardiac functions in patients with end-stage renal disease(2018) Erdoğan, Mehmet Ali; Çiftçi, HilmiAim: Chronic renal failure is a prevalent health disorder in which risk for cardiovascular disease is increased. Cardiovascular diseases (CVDs) are one of the leading causes of mortality in this patient population. Aortic stiffness is an early and independent marker for CVDs. We aimed to investigate aortic stiffness in patients with end-stage renal disease (ESRD).Material and Methods: This study was conducted on patients who underwent hemodialysis with ESRD in Hemodialysis Unit ofNephrology Department of Goztepe Teaching Hospital between July, 2009 and November, 2009. The study included 65 patients with ESRD and 20 healthy controls. Systolic and diastolic functions of left ventricle, aortic stiffness and TEI index were evaluated in all subjects by using echocardiography.Results: Systolic and diastolic blood pressures were higher in the patient group compared to the control group (p<0.05). Having compared the patient and control groups, it was found that diastolic ventricular functions and TEI index were significantly impaired in the patient group. The aortic strain and distensibility were decreased while aortic stiffness index was increased in the patient group compared to the control group (p<0.05).Conclusion: We observed impaired cardiac functions , increased aortic stiffness and myocardial performance index (MPI) in patients with ESRD. However, we believe that this area needs more study.Öğe Characteristics and outcomes of adult patients receiving mechanical ventilation due to acute poisoning(Türk Yoğun Bakım Dergisi, 2013) Erdoğan, Mehmet Ali; Aydoğan, Mustafa Said; Özgül, Ülkü; Gedik, Ender; Togal, Türkan; Durmuş, Mehmet; Çolak, Cemil; Uçar, MuharremÖz: ÖZET Amaç: Zehirlenme, yoğun bakım ünitelerine (YBÜ) kabulün önemli bir nedenidir ve yoğun bakımda kalış süresini uzatır. Zehirlenme nedeniyle YBÜ ye kabul edilen hastalar mekanik ventilasyona (MV) ihtiyaç duyabilirler. Uzamış MV gereksinimi YBÜ de kalış süresini ve mortaliteyi artırır. Zehirlenme nedeniyle MV uygulanan hastaların özellikleri ve sonuçlarının değerlendirilmesi, klinik yönetimde yararlı olabilir ve hastalar ile ailelerine daha iyi danışmanlık sağlayabilir. Bu geriye dönük çalışmanın amacı zehirlenme nedeniyle YBÜ ye yatırılan hastaların demografik ve etiyolojik özellikleri ile MV ihtiyacı arasındaki ilişkiyi incelemektir. Gereç ve Yöntem: Ocak 2010 - Aralık 2011 tarihleri arasında YBÜ ye kabul edilen 211 değerlendirildi. Yaş, cinsiyet, zehirlenme oluşumu ile YBÜ ye kabulüne kadar geçen süre, zehirlenmenin tipi, maruz kalınan toksik ajanlar, alınma yolu, daha önceki zehirlenme öyküsü, başvurudaki bilinç durumu, YBÜ de kalış süresi, MV ihtiyacı. MV ile ilişkili komplikasyonlar, Glasgow koma skoru ve sonuçları incelendi. Bulgular: Değerlendirilen 211 hastanın 143 ü (%67,8) kadındı. Zehirlenmenin en sık nedeni intihar (%87,7) idi ve oral yol ile (%93,4) gerçekleşmişti. Hastaların en çok maruz kaldığı ajanlar ilaçlardı (%74,4). İlaçlarla oluşan zehirlenmenin en sık nedeni antidepresanlar (trisiklik antidepresanlar dahil) (%38,3) idi. MV ihtiyacı hem cinsiyet (p=0,04), hem de alınma yolu ile anlamlı şekilde ilişkiliydi. MV ihtiyacı zehirlenmenin tipi (p=0,01) ve toksik ajanlar (p<0,001) ile de anlamlı şekilde ilişkiliydi. İlaçlarla zehirlenme ile cinsiyet (p=0,002) ve zehirlenme tipi ile cinsiyet (p=0,006) arasında oldukça güçlü bir ilişki vardı. Sonuç: Bu çalışmada MV ihtiyacı ile cinsiyet, zehirlenmenin tipi, toksik ajanlar, alınma yolu ve YBÜ de kalış süresi arasında anlamlı bir ilişki olduğu gösterildi. MV ihtiyacı ventilatöre bağlı komplikasyonların sıklığı ve daha uzun süre YBÜ de yatışı ile ilişkili olarak kötü prognoza öncülük edebilir.Öğe Comparison of propofol and ketamine propofol mixture ketofol on laryngeal tube suction II conditions and hemodynamics a randomized prospective double blind trial(Current Therapeutic Research, 2013) Özgül, Ülkü; Begeç, Zekine; Karahan, Kalender; Erdoğan, Mehmet Ali; Aydoğan, Mustafa Said; Çolak, Cemil; Durmuş, Mahmut; Ersoy, ÖzcanObjective: The aim of our study is to compare the effect of ketamine–propofol mixture (ketofol) and propofol on the laryngeal tube-Suction II (LTS II) insertion conditions and hemodynamics. Methods: Eighty American Society of Anesthesiologists class 1 and 2 patients were divided into 2 random groups to receive either 1 mg/kg remifentanil and propofol 2 mg/kg in Group P (n ¼ 40), or 1 mg/kg remifentanil and ketofol (using a 1:1 single syringe mixture of 5 mg/mL ketamine and 5 mg/mL propofol) in Group K (n ¼ 40) before induction of anesthesia. After induction, LTS II was inserted. Heart rate and noninvasive blood pressure were recorded before induction of anesthesia (t0); immediately following induction (t1); immediately after LTS II insertion (t2); and 3 minutes (t3), 5 minutes (t4), and 10 (t5) minutes after LTS II insertion. Conditions of insertion of LTS II were assessed and scored 1 to 3 using 6 variables as follows: mouth opening, swallowing, coughing, head and body movements, laryngospasm, and ease of LTS II insertion by the same experienced anesthesiologist who did not know the agents. LTS II insertion summed score was prepared depending upon these variables. Results: In regard to LTS II insertion summed score, Group K was more favorable than Group P (P o 0.05). Apnea duration was longer in Group P (385.0 seconds [range ¼ 195.0–840.0 seconds]) compared with Group K (325.50 seconds [range ¼ 60.0–840.0 seconds]) but this was not statically significant. The heart rate values were significantly lower at all measurement intervals in both groups compared with the baseline values (P o 0.05). There was no difference in heart rate between Group P and Group K. The mean arterial pressure values were significantly lower at all measurement intervals in Group P compared with baseline values (P o 0.05). In Group K, the mean arterial pressure values were significantly lower at all measurement intervals compared with the baseline values, except t2 (P o 0.05). There was a significant difference between Group P and Group K in terms of mean arterial pressure at t3 (P o 0.05). Conclusions: We found that ketofol provided better insertion summed score for LTS II than propofol, with minimal hemodynamic changes.Öğe The correlation between cytological examination of ascitic fluid and serum ascites albumin gradient in the differential diagnosis of ascites(2019) Atayan, Yahya; Erdoğan, Mehmet Ali; Çalışkan, Ali Rıza; Deviren, Mehmet Veysi; Apak, Ayetullah; Yaslıkaya, SendagAbstract: Aim: The accumulation of fluid in pathological quantities in the peritoneal cavity is called ascites. In every newly diagnosed ascites, necessary investigations should be conducted by puncturing ascitic fluid. In this study, we aimed to investigate whether there is any correlation between cytological examination of ascitic fluid and serum ascites albumin gradient (SAAG) in the determination of etiologic causes of ascites. Material and Method: The files of the patients who were admitted to our clinic for the investigation of their ascites etiology between May 2014 and May 2018, were analyzed retrospectively. Pathology reports of the patients whose SAAG was calculated by taking the difference between serum albumin values and simultaneously taken ascitic fluid albumin and whose ascitic fluid cytology examination was performed, were recorded. The data of 248 patients with clinical diagnosis were included in the study. Patients with SAAG <1.1 g / dl and SAAG ?1.1 g / dl, were divided into two groups. Results: Of the 248 patients included in the study, 114 were female (45.90%) and 134 were male (54.10%) patients. The patients were divided into 2 groups according to SAAG value. In group 1, there were 107 (43.14%) patients with SAAG <1.1 g / dl and in group 2, there were 141 (56.85%) patients with SAAG ?1.1 g /dl. Group 1: In 70 (28.22%) of 107 patients, positive malignant cytology was consistent with ascites (p<0.0001). In 37 (14.91%) patients, benign cytology ascites was present. Group 2: 133 (53.62%) of 141 patients had benign cytology and 8 (3.23%) had malignant cytology. Conclusion: There was a correlation between malignant cytology of ascites with SAAG <1.1.Öğe Dilation of benign esophageal strictures with balloon/bougie; a single center experience(2024) Erdoğan, Mehmet Ali; Çalışkan, Ali RizaAim: Narrowing in the esophagus caused by benign conditions such as peptic injury, surgical anastomosis, radiation therapy, Schatzki rings, esophageal webs, erosive injury and eosinophilic esophagitis are called benign esophageal strictures. In the treatment of benign esophageal stricture, endoscopic dilation with balloon or bougie is the first priority. Materials and Methods: The study included a total of 96 patients who were diagnosed with a benign stricture at the gastroenterology clinic of our university from May 2009 to October 2023. All patients were symptomatic, and their main complaint was dysphagia. The benign stricture was diagnosed through clinical examination, radiological imaging and endoscopy. Patient data were scanned retrospectively. The dilation method (bougie, balloon), the number of times the procedure was permormed and any potential complications were recorded. Stents were applied to patients who did not provide adequate dilatation. Results: A total of 96 patients were included in the study. Forty-seven (49%) of them were women and 49 (51%) were men. The average age was 48±17 years (the youngest was 18, the oldest was 81). A total of 198 dilation procedures were performed on 96 patients. The average follow-up period was 79±54 (1-179) months. Srictures were divided into 4 groups according to etiology as anastomotic stricture, peptic stricture, caustic stricture and post-radiotherapy stricture. Of the cases with stricture, 76 (79.2%) underwent bougie dilation, 26 (27.1%) underwent balloon dilation, 5 (5.2%) underwent bougie and then balloon dilation, and in 5 (5.2%) cases, metallic stent was placed due to failed dilations. Conclusion: This study shows the effectiveness of bougie and/or balloon dilation in treating most of the patients with benign esophageal strictures, with a low complication rate. It is less invasive, comfortable and cost-effective than the alternative surgical approach.Öğe Effect of preoperative iron deficiency in liver transplant recipients on length of intensive care ünit stay(Transplantation Proceedings, 2013) Aydoğan, Mustafa Said; Özgül, Ülkü; Erdoğan, Mehmet Ali; Yücel, Aytaç; Toprak, Hüseyin İlksen; Durmuş, Mahmut; Çolak, CemilLiver transplant (LT) recipients often display iron deficiency preoperatively, which significantly increases the quantity of blood that needs to be transfused intraoperatively, A risk factor for a prolonged intensive care unit (ICU) stay. The aim of this retrospective study was to determine whether there was a clinically significant association between iron deficiency and the length of ICU stay, among 153 patients scheduled for OLT from September 2011 to June 2012. Patients were divided into 2 groups according to their baseline iron status: iron- deficient (ID) and non-ID (normal iron profile) cohorts. Iron deficiency was assessed on the basis of several parameters; transferrin saturation as well as serum iron, ferritin, soluble transferrin receptor, and C-reactive protein levels. We retrospectively analyzed the data regarding demographic and clinical features, preoperative laboratory values, intraoperative transfusions, and length of ICU stay. Patient demographic features and preoperative values were similar between the groups. Preoperative iron deficiency, which was diagnosed in 72 patients (58.6%), was associated with a greater intraoperative use of fresh frozen plasma and red blood cell transfusions (P .0001). The median length of ICU stay after LT was longer among the ID versus the non-ID group (5 and 3 days per patient, respectively; P .0001). Therefore, we have suggested that preoperative iron deficiency may be a prognostic factor for the length of ICU stay after LT.Öğe Effects of dexmedetomidine and midazolam on motor coordination and analgesia a comparative analysis(Current Therapeutic Research, 2013) Aydoğan, Mustafa Said; Parlakpınar, Hakan; Erdoğan, Mehmet Ali; Yücel, Aytaç; Uçar, Muharrem; Sağır, Mustafa; Çolak, CemilObjective: We compared the effects of 2 sedative drugs, dexmedetomidine and midazolam, on motor performance and analgesic efficacy in a rat model. Materials and methods: Rats were randomly divided into the following 4 groups on the basis of the treatment received. The first group received 83 mg/kg/min midazolam; the second, 1 mg/kg/min dexmedetomidine; the third, 83 mg/kg/min morphine; and the fourth was a control group. The rats were measured motor coordination and pain reflexes by using rotarod, accelerod, hot plate, and tail flick tests. Results: At all the tested speeds, the midazolam-injected rats remained on the rotarod longer than did the dexmedetomidine-injected rats. Furthermore, in the 10-minute accelerod test, the midazolaminjected rats remained for a longer duration than did the dexmedetomidine-injected rats. The latency time for the hot plate test was significantly higher at 10 minutes and 20 minutes in the dexmedetomidine group than in the midazolam group. Further, the latency time at 10 minutes for the tail flick test was greater in the dexmedetomidine group than in the midazolam group. Conclusions: In this rat model, midazolam results in faster recovery of motor coordination performance when compared with dexmedetomidine.Öğe Effects of dexmedetomidine and midazolam on motor coordination and analgesia a comparative analysis(Current Therapeutic Research, 2013) Aydoğan, Mustafa Said; Parlakpınar, Hakan; Erdoğan, Mehmet Ali; Yücel, Aytaç; Uçar, Muharrem; Sağır, Mustafa; Çolak, CemilObjective: We compared the effects of 2 sedative drugs, dexmedetomidine and midazolam, on motor performance and analgesic efficacy in a rat model. Materials and methods: Rats were randomly divided into the following 4 groups on the basis of the treatment received. The first group received 83 mg/kg/min midazolam; the second, 1 mg/kg/min dexmedetomidine; the third, 83 mg/kg/min morphine; and the fourth was a control group. The rats were measured motor coordination and pain reflexes by using rotarod, accelerod, hot plate, and tail flick tests. Results: At all the tested speeds, the midazolam-injected rats remained on the rotarod longer than did the dexmedetomidine-injected rats. Furthermore, in the 10-minute accelerod test, the midazolaminjected rats remained for a longer duration than did the dexmedetomidine-injected rats. The latency time for the hot plate test was significantly higher at 10 minutes and 20 minutes in the dexmedetomidine group than in the midazolam group. Further, the latency time at 10 minutes for the tail flick test was greater in the dexmedetomidine group than in the midazolam group. Conclusions: In this rat model, midazolam results in faster recovery of motor coordination performance when compared with dexmedetomidine.Öğe Effects of ketamine propofol mixture on intraocular pressure and hemodynamic in elderly patients a randomized double blind trial(Turkish Journal of Anesthesia and Reanimation, 2014) Aydoğan, Mustafa Said; Demirel, Soner; Erdoğan, Mehmet Ali; Fırat, Penpegül; Çolak, Cemil; Durmuş, MahmutObjective: The aim of this study was to compare the effects of a ketamine-propofol mixture (ketofol) and propofol on intraocular pressure (IOP) and haemodynamics in elderly patients during anaesthetic management at each repeated measurement times. Methods: Forty elderly ASA I and II patients were divided into two random groups and received either propofol (1.5 mg kg-1; group P, n=20) or ketofol (1:1 single syringe mixture of 5 mg mL-1 ketamine and 5 mg mL-1 propofol; group KP, n=20). A proseal laryngeal mask airway (PLMA) was inserted 60 seconds after induction of anaesthesia. IOP, systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) values were recorded at preinduction (t0), immediately following induction (t1), and at 1 (t2), 3 (t3), and 5 (t4) minutes after induction. Haemodynamic complications and the need for ephedrine were also recorded. Results: Patient characteristics at the beginning of the procedure were similar between the groups. SBP and HR were significantly increased in group KP compared to group P at t1 and t4 (p=0.044). Induction of both anaesthetic agents significantly decreased the IOP values from the t0 (p=0.026). A significant decrease in IOP was found at t1 and t4 in group P compared to group KP (p=0.018). The total dose of ephedrine was statistically different in group P (p=0.034). Conclusion: Ketofol can be an alternative agent to provide haemodynamic stability with a moderate decrease in IOP during anaesthesia induction in elderly patients.Öğe Effects of ketamine propofol mixture on ıntraocular pressure and hemodynamic in elderly patients a randomized double blind trial(Turkish Journal of Anesthesia and Reanimation, 2014) Aydoğan, Mustafa Said; Demirel, Soner; Erdoğan, Mehmet Ali; Fırat, Penpegül; Çolak, Cemil; Durmuş, MahmutObjective: The aim of this study was to compare the effects of a ketamine-propofol mixture (ketofol) and propofol on intraocular pressure (IOP) and haemodynamics in elderly patients during anaesthetic management at each repeated measurement times. Methods: Forty elderly ASA I and II patients were divided into two random groups and received either propofol (1.5 mg kg-1; group P, n=20) or ketofol (1:1 single syringe mixture of 5 mg mL-1 ketamine and 5 mg mL-1 propofol; group KP, n=20). A proseal laryngeal mask airway (PLMA) was inserted 60 seconds after induction of anaesthesia. IOP, systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) values were recorded at preinduction (t0), immediately following induction (t1), and at 1 (t2), 3 (t3), and 5 (t4) minutes after induction. Hemodynamic complications and the need for ephedrine were also recorded. Results: Patient characteristics at the beginning of the procedure were similar between the groups. SBP and HR were significantly increased in group KP compared to group P at t1 and t4 (p=0.044). Induction of both anaesthetic agents significantly decreased the IOP values from the t0 (p=0.026). A significant decrease in IOP was found at t1 and t4 in group P compared to group KP (p=0.018). The total dose of ephedrine was statistically different in group P (p=0.034). Conclusion: Ketofol can be an alternative agent to provide haemodynamic stability with a moderate decrease in IOP during anaesthesia induction in elderly patients.