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Öğe Anesthetic management and endovascular stent grafting of abdominal aortic aneurysm in a patient with Behcet's disease(W B Saunders Co-Elsevier Inc, 2002) Türköz, A; Toprak, IH; Köroglu, A; Durmus, M; But, AK; Ersoy, MÖ[Abstract Not Available]Öğe The effects of aprotinin and steroids on generation of cytokines during coronary artery surgery(W B Saunders Co-Elsevier Inc, 2001) Türköz, A; Çigli, A; But, K; Sezgin, N; Türköz, R; Gülcan, Ö; Ersoy, MÖObjectives: To compare the efficacy of aprotinin and methylprednisolone in reducing cardiopulmonary bypass (CPB)-induced cytokine release, to evaluate the effect of myocardial cytokine release on systemic cytokine levels, and to determine the influence of cytokine release on perioperative and postoperative hemodynamics. Design: Prospective, randomized clinical trial. Setting: University teaching hospital and clinics. Participants: Thirty patients undergoing elective coronary artery bypass graft surgery. Interventions: Patients were randomly allocated into groups treated with aprotinin (n = 10) or methylprednisolone (n = 10) or into an untreated control group (n = 10). Aprotinin-treated patients received aprotinin as a high-dose regimen (6 x 10(6) KIU), and methylprednisolone-treated patients received methylprednisolone (30 mg/kg intravenously) before CPB. Measurements and Main Results: Patients were analyzed for hemodynamic changes and alveolar-arterial PO2 difference (AaDO(2)) until the first postoperative day. Plasma levels of proinflammatory cytokines (tumor necrosis factor [TNF]a, interleukin [IL]-1 beta, IL-6, and IL-8) were measured in peripheral arterial blood immediately before the induction of anesthesia, 5 minutes before CPB, 3 minutes after the start of CPB, 2 minutes after the release of the aortic cross-clamp, 1 hour after CPB, 6 hours after CPB, and 24 hours after CPB; and in coronary sinus blood immediately before CPB and 2 minutes after the release of the aortic cross-clamp. The hemodynamic parameters did not differ among the groups throughout the study. After CPB, AaDO(2) significantly increased (p < 0.05) in all groups. A significant decrease in AaDO(2) was observed in aprotinin-treated patients at 24 hours after CPB compared with the other groups (p < 0.05). TNF-a level from peripheral arterial blood significantly increased in control patients 1 hour after CPB (p < 0.01) and did not significantly increase in methylprednisolone-treated patients throughout the study. In all groups, IL-6 levels increased after the release of the aortic cross-clamp and reached peak values 6 hours after CPB. At 6 hours after CPB, the increase in IL-6 levels in methyl prednisolone-treated patients was significantly less compared with levels measured in control patients and aprotinin-treated patients (p < 0.001). In control patients, IL-8 levels significantly increased 2 minutes after the release of the aortic cross-clamp (p < 0.05), and peak values were observed 1 hour after CPB (p < 0.01). IL-8 levels in control patients were significantly higher compared with patients treated with aprotinin and patients treated with methylprednisolone 1 hour after CPB (p < 0.05). Conclusion: This study showed that methylprednisolone suppresses TNF-, IL-6, and IL-8 release; however, aprotinin attenuates IL-8 release alone. Methylprednisolone does not produce any additional positive hemodynamic and pulmonary effects. An improved postoperative AaDO(2) was observed with the use of aprotinin. Copyright (C) 2001 by W.B. Saunders Company.Öğe Effects of halotane, sevoflurane and isoflurane anesthesia on neuromusculer blocking effect of rocuromum(Prof Sci Publ, 1999) Togal, T; Türköz, A; Sahin, S; Toprak, HI; Ersoy, MÖ[Abstract Not Available]Öğe Effects of polyenylphosphatidylcholine on cytokines, nitrite/nitrate levels, antioxidant activity and lipid peroxidation in rats with sepsis(Springer, 2004) Demirbilek, S; Ersoy, MÖ; Demirbilek, S; Karaman, A; Bayraktar, M; Bayraktar, NObjectives: To determine the effect of pretreatment with polyenylphosphatidylcholine ( lecithin, PPC) on plasma levels of tumor necrosis factor ( TNF)-alpha, interleukin (IL)-6, IL-10, total nitrite/nitrate (NOx), and tissue levels of superoxide dismutase ( SOD) and malondialdehyde (MDA) in septic rats. Design: Prospective, randomized, controlled animal study. Setting: University laboratory. Subjects: Forty-five Spraque-Dawley rats were divided into three groups: group C, sham-operated; group S, sepsis; and group P, sepsis pretreated with PPC. Interventions: Rats were made septic by cecal ligation and puncture (CLP). Group P rats were treated with PPC ( 100 mg/day orally) for 10 days before sepsis. Twenty-four hours later CLP, plasma concentrations of TNFalpha, IL-6 and IL-10 and plasma levels of NOx were measured. SOD and MDA were determined in liver, lung and heart homogenates. Measurements and main results: All rats in group P survived during the 24-h observation time after CLP, whereas survival rate in group S was 66.7% (10/15; P< 0.05). PPC significantly reduced plasma levels of TNF-alpha (P= 0.006), IL-6 ( P= 0.007), IL-10 ( P= 0.016), NOx ( P< 0.001), and tissue levels of MDA ( P< 0.001) in group P with respect to in group S. Tissue levels of SOD significantly increased in group P when compared with group S ( P< 0.001). Conclusions: These results show that PPC pretreatment exerts cumulative effects in decreasing the levels of cytokines, NOx, and tissue MDA concentrations, with a concomitant increase in survival in septic rats. Lecithin therapy may be a useful adjuvant therapy in controlling of the excessive production of the inflammatory cytokines in patients with severe sepsis. Descriptor: SIRS/sepsis, experimental studies.Öğe Sevoflurane as an alternative anaesthetic for electroconvulsive therapy(Lippincott Williams & Wilkins, 2005) Toprak, HI; Gedik, E; Begeç, Z; Öztürk, E; Kaya, B; Ersoy, MÖObjectives: The aim of this study was to investigate the effects of sevoflurane and propofol used in electroconvulsive therapy (ECT) on hemodynamic variables and duration of seizure activity and recovery profiles. Methods: Sixteen patients who were not premedicated, with a mean age 27.1 years, were enrolled in this prospective open trial, receiving a total of 64 ECT treatments. Each patient was given the following 2 anesthetic regimens in random order: In group S, anesthesia was induced with 7% sevoflurame in 100% oxygen at 6 L min (1) fresh gas flow until the loss of consciousness and 1.5 mg kg(-1) propofol in group P. Adequate muscle relaxation was achieved with suxamethonium, 1.0 - 1.2 mg kg(-1). Noninvasive mean arterial pressure (MAP) and heart rate (HR) values, duration of motor seizure activity, and recovery times were recorded. Results: The mean motor seizure duration was significantly longer with sevoflurane (mean [SD]: 43.09 [16.6] s) than with propofol (28.91 [7.9] s; P < 0.05). The MAP 1 minute and 10 minutes after ECT (10 1.25 [7.5] mm Hg and 100.16 [11.0] min mu g, respectively) was significantly increased compared with before ECT (94,56 [6.91 mm fig) in sevoflurane group (P < 0.05). Time to spontaneous breathing, eye opening and obeying commands, and changes in MAP and HR during and after ECT were similar in both regimens. Conclusion: Induction with 7% sevoflurane allows prolonged duration of motor seizures in ECT. We concluded that induction of anesthesia with sevoflurane inhalation is a reasonable alternative for patients undergoing ECT.Öğe Spinal anaesthesia in full-term infants of 0-6 months(Cambridge Univ Press, 2005) Köroglu, A; Durmus, M; Togal, T; Özpolat, Z; Ersoy, MÖBackground and objective: The aim of the study was to report our experience concerning the effectiveness, complications and safety of spinal anaesthesia, and to determine whether spinal anaesthesia was effective in full-term infants undergoing elective inguinal hernia repair. Methods: Sixty-eight full-term infants aged <6 months were included in the study. Infants were divided into three groups; Group I (<1 month, n = 20), Group II (>1 and <3 months, n = 26), and Group III (3-6 months, n = 22). All spinal blocks were performed under mask inhalation anaesthesia. A dose of bupivacaine 0.596 0.5 mg kg(-1) was used for infants under 5 kg and 0.4 mg kg(-1) for those over 5 kg. Heart rate, mean arterial pressure, respiratory rate and SpO2 were recorded before and after spinal anaesthesia at 5 min intervals. Time to onset of analgesia, time to start of operation, duration of operation, anaesthesia and hospitalization, postoperative analgesic requirement and complications were recorded. Results: Adequate spinal anaesthesia without sedation was better, time to obtain maximum cutaneous analgesia was shorter and need for sedation and postoperative analgesic requirement were significantly lower in Group I. Although heart rate, mean arterial pressure and respiratory rate decreased <20% in all groups following spinal analgesia, the decrease in Group I was lower than the others. Conclusions: Spinal anaesthesia is an effective choice in inguinal hernia repair for full-term infants aged <1 month, providing excellent and reliable surgical conditions. However, this technique is not as useful for infants aged between 1 and 6 months.
