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Öğe Astım Hastalığı Tanısı İle Takip Edilen Tüm Ayçekirdeği Aspirasyonu(2016) Öncel, Murat; Arun, Oğuzhan; Yıldıran, Hüseyin; Sunam, Güven SadiYabancı cisim aspirasyonları, çocuklarda morbidite vemortaliteyi arttıran önemli bir klinik durumdur. Yabancıcisim aspirasyonu tanısı, anamnez, fizik muayene veradyolojik bulgularla konulmaktadır. Teşhis sırasındabazı hastalıklarla benzer klinik bulguların olması tanıyıgeciktirebilmektedir. Tanı ve tedavide altın standart olanbronkoskopi ile karşılaşılabilecek komplikasyonlarönlenebilmektedir. 3 yaş altında uzun süreli öksürükkliniği olan hastalarda yabancı cisim aspirasyonu akıldatutulmalıdırÖğe Effect of laparoscopic cholecystectomy techniques on postoperative pain: a prospective randomized study(KOREAN SURGICAL SOCIETY, 2013) Yılmaz, Hüseyin; Arun, Oğuzhan; Apilioğullari, Seza; Acar, Fahrettin; Alptekin, Hüsnü; Çalışır, Akın; Şahin, MustafaPurpose: Minimally invasive surgical technics have benefits such as decreased pain, reduced surgical trauma, and increased potential to perform as day case surgery, and cost benefit. The primary aim of this prospective, randomized, controlled study was to compare the effects of single incision laparoscopic cholecystectomy (SILC) and conventional laparoscopic cholecystectomy (CLC) procedures regarding postoperative pain. Methods: Ninety adult patients undergoing elective laparoscopic cholecystectomy were included in the study. Patients were randomized to either SILC or CLC. Patient characteristics, postoperative abdominal and shoulder pain scores, rescue analgesic use, and intraoperative and early postoperative complications were recorded. Results: A total of 83 patients completed the study. Patient characteristics, postoperative abdominal and shoulder pain scores and rescue analgesic requirement were similar between each group except with the lower abdominal pain score in CLC group at 30th minute (P = 0.04). Wound infection was seen in 1 patient in each group. Nausea occurred in 13 of 43 patients (30%) in the SILC group and 8 of 40 patients (20%) in the CLC group (P > 0.05). Despite ondansetron treatment, 6 patients in SILC group and 7 patients in CLC group vomited (P > 0.05). Conclusion: In conclusion, in patients undergoing laparoscopic surgery, SILC or CLC techniques does not influence the postoperative pain and analgesic medication requirements. Our results also suggest that all laparoscopy patients suffer moderate and/or severe abdominal pain and nearly half of these patients also suffer from some form of shoulder pain.Öğe Iliac artery ınjury during lumbar disc hernia surgery(ELSEVIER SCIENCE INC, 2019) Şahinoğlu, Mert; Arun, Oğuzhan; Orhan, Atilla; Nayman, Alaaddin; Çalışır, Akın; Bocu, Yasin; Cebeci, Yasemin; Duman, Ateş; Yılmaz, Hüseyin; Köktekir, Ender; Karabağlı, HakanBACKGROUND: Vascular injury complications during lumbar discectomy are rare but potentially life-threatening. Therefore, an early diagnosis and effective treatment management is required for these complications. CASE DESCRIPTION: A 50-year-old female patient was admitted to our outpatient clinic with severe back and right leg pain. She underwent surgery for right L4-5 extruded disc herniation with general anesthesia. Sudden arterial hemorrhage occurred during discectomy performed with straight disc forceps and was controlled using hemostatic materials, with no significant decrease in blood pressure. However, the patient became hypotensive near the end of the operation. The incision was quickly closed, and she was turned to supine position. Emergency abdominal ultrasound, computed tomography, and computed tomography angiography revealed an injury of the left main iliac artery, which was repaired by endovascular stenting. Laparotomy and Bogota bag were applied because of increased intrabdominal pressure at 3 hours postoperative. In addition, a retroperitoneal catheter was placed into the area of the right retroperitoneal hematoma on the first postoperative day. Tissue plasminogen activator was administered through the catheter. On postoperative day 3, the Bogota bag was removed, and the abdomen was closed. The patient was discharged without neurodeficit on day 27. Her abdominal fascial defect was closed with a synthetic graft after 5 months. CONCLUSIONS: Although lumbar discectomy is one of the most commonly performed neurosurgical procedures, the routine rules of discectomy should not be neglected. Early detection and a multidisciplinary approach can help prevent mortality in the event of vascular injury.Öğe Karotid endarterektomi geçiren hastalarda kontrolsüz diyabetin statin kullanan ve kullanmayan hastalarda LDL seviyelerine etkisi(2016) Öç, Mehmet; Duman, İpek; Vatansev, Hüsamettin; Şimşek, Murat; Arun, Oğuzhan; Öç, Bahar; Duman, AteşAmaç: Çalışmanın amacı Karotid endarterektomi geçiren hastalarda kontrolsüz diyabetes mellitusun (DM) uzun süreli statin kullanan ve kullanmayan hastalarda Düşük Yoğunluklu Lipoprotein (LDL) seviyelerine etkisini araştırmaktı.Gereç ve yöntem: Ateroskleroz nedeniyle karotid endarterektomi geçiren 40 hastanın ameliyat öncesi LDL seviyeleri retrospektif olarak analiz edildi. Tüm hastalar en az 1 yıldır statin kullanıyordu. HbA1C seviyelerinin % 6,4'den fazla olması kontrolsüz DM kriteri kabul edildi (D). Diğer hastalar diyabet olmayan gruplara alındı (D-). Grup 1: D statin kullanan (n9), grup 2: D- statin kullanan (n10), grup 3: D statin kullanmayan (n8), grup 4: D- statin kullanmayan (n13) hastalardan oluştu. İstatistiksel değerlendirme için Kruskal-Wallis ve Mann-Whitney testleri kullanıldı. p0,05 anlamlı kabul edildi.Bulgular: Demografik veriler benzerdi. Grup 1, 2, 3 ve 4 için LDL seviyeleri sırasıyla 125,08,7 mg/dl, 95,07,0 mg/dl, 133,510,0 mg/dl, 114,010,2 mg/dl olarak bulundu. ). Statin kullanan ve kullanmayan kontrolsüz diyabet hastalarının LDL seviyeleri diğer gruplardan anlamlı derecede yüksekti (p0,05). Statin kullanan diyabetik hastaların LDL seviyeleri de statin kullanan normal hastalardan daha yüksekti (p0,05). Kontrolsüz diyabet olan hastaların LDL seviyeleri statin kullanan ve kullanmayan gruplarda benzerdi (p0,05). Diyabet olmayan hastaların LDL seviyeleri benzer bulundu (p0,05).Sonuç: Bu çalışma, kontrolsüz diyabeti olan ateroskleroz hastalarının LDL seviyelerinin, statin kullansınlar ya da kullanmasınlar diyabet olmayan ateroskleroz hastalarından daha yüksek olduğunu göstermiştir. İleri çalışmaların kanıtlanmış aterosklerozu olan hasta gruplarında çok merkezli ve yüksek vaka sayılı olarak yapılmasının uygun olacağı görüşündeyiz.Öğe Management of Postdural Puncture Headache with Epidural Saline Patch in a 10-Year-Old Child After Inguinal Hernia Repair: A Case Report(W B SAUNDERS CO-ELSEVIER INC, 2012) Kara, İnci; Çiftçi, İlhan; Apilioğulları, Seza; Arun, Oğuzhan; Duman, Ateş; Çelik, Jale BengiSpinal anesthesia (SA) is becoming increasingly popular among pediatric anesthetists. Postdural puncture headache (PDPH) has been reported in children. PDPH generally spontaneously resolves within a few days with bed rest and nonopioid analgesics, but it may last for several days. If the symptoms persist, an epidural blood patch is considered as an effective treatment. We describe the successful use of an epidural saline patch in a 10year-old child with PDPH who did not respond to conservative treatment.Öğe Nötrofil jelatinaz ilişkili lipokalin akut böbrek hasarı tanısında yeterince değerli mi?(2014) Arun, Oğuzhan; Öç, Bahar; Duman, Ateş; Öç, Mehmet[Abstract not Available]Öğe Sugammadeksin Kalp Kası Aksiyon Potansiyeli Üzerine Doz Bağımlı İn Vitro Etkileri(Selçuk Üniversitesi Sağlık Bilimleri Enstitüsü, 2023) Arun, Oğuzhan; Ayaz, MuratSugammadex, a modified gamma-cyclodextrin, is a pharmacological agent that rapidly and completely reverses the effects of steroidal neuromuscular blocking agents such as rocuronium and vecuronium by encapsulation. Prolongation of the QTc interval on ECG, hypotension, bradycardia, atrioventricular block, atrial fibrillation, and even asystole are among the cardiovascular side effects reported due to sugammadex. In this study, it was aimed to investigate the effects of sugammadex, rocuronium and rocuronium-sugammadex complex, which have been shown to accumulate in cardiac muscle tissue by clinical trials, on various electrophysiological parameters such as action potential and contraction in heart tissue, and to examine whether sugammadex has possible clinical effects on heart tissue. After the approval of the Local Ethics Committee of Animal Experiments, sugammadex, rocuronium and combinations of these two drugs were applied on myocytes obtained from 12 Wistar species male rats (3 rats in each group for 4 groups) in vitro and in a cumulative dose order. Myocyte contraction and relaxation responses were recorded after measuring action potential, L-type calcium (Ca+2) and potassium (K+) channel currents. Statistical analyzes and comparisons of data were made with Student's paired t-test where appropriate. However, repeated measures of ANOVA were performed with Tukey's multiple comparison test for more than two data sets. The statistical significance level was accepted as 95%. Sugammadex, rocuronium, and the combination of these two drugs caused a dose-dependent decrease in myocyte contraction and relaxation responses. Sugammadex caused a prolongation in the repolarization phase of the action potential (AP) in myocyte, while rocuronium caused a prolongation in all AP phases, while the combination of both drugs did not cause any effect on AP. Sugammadex caused a suppression of the peak value of Ca+2 channel currents, and in addition to this effect, an additional significant decrease was found in the I-V characteristics of L-type Ca+2 currents in response to the rocuronium and to the combination of both drugs. No significant difference was observed in It0, Iss and IK1 currents in any of the drugs administered in the study. Further in vivo and in vitro experimental studies as well as clinical studies are needed in order to reveal the clinical consequences of the suppressive effects on AP and Ca+2 channel currents on cardiac functions due to sugammadex, rocuronium, and the combination of these two drugs.
