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Öğe Effect of off-pump and on-pump coronary artery bypass grafting on renal function(TAYLOR & FRANCIS LTD, 2005) Celik, JB; Gormus, N; Topal, A; Okesli, S; Solak, HBackground. Coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) has the risk of renal dysfunction. The cause of renal dysfunction after CPB is multifactorial, such as nonpulsatile flow, renal hypoperfusion, hypothermia, and duration of CPB. This study compared off-pump technique with on-pump technique on renal function in patients who underwent CABG. Methods. Sixty patients with normal preoperative renal functions undergoing CABG were randomly assigned to conventional revascularization with CPB (on-pump) or beating heart revascularization (off-pump). Renal functions were assessed up to 10 days postoperatively. Results. Creatinine clearance was found to be significantly higher in the off-pump group than in the on-pump group (p <.05). The off-pump group had significantly less increase in creatinine levels when compared with the on-pump group (p <.05). The free water clearance values decreased similarly in both groups; however, the recovery was more prompt in the off-pump group (p <.05). No significant differences were found in the prevalence of postoperative hemodialysis. Conclusion. The off-pump technique may provide a positive contribution and sufficient protection on postoperative renal functions in patients undergoing CABG.Öğe Effects of gamma-hydroxybutyrate on cerebrospinal fluid lactate and glucose levels after spinal cord trauma(ELSEVIER SCI LTD, 2004) Guney, O; Celik, JB; Arazi, M; Ustun, METhis study aims to evaluate the effects of gamma-hydroxybutyrate (GHB) after spinal cord trauma (SCT). Twenty rabbits were divided equally into four groups: group I was the sham-operated group, group 11 suffered from SCT but received no treatment, group III was given a dose of 400 mg/kg of GHB intravenously before SCT and group IV received the same dose after SCT. Cerebrospinal fluid (CSF) samples were obtained 30 min before SCT (T-0), at 60 (T-1) and 120 min (T-2) after SCT. There was a threefold increase in lactate levels from baseline value at T-2 in group 11, while statistically significant elevation of the lactate levels were not observed in groups III and IV. Glucose levels at T, and T2 were significantly lower in groups III and IV compared with the control group. The findings of this study demonstrate that GHB can control the increase of CSF lactate and glucose levels following SCT and that this metabolic effect may be associated with neuroprotective physiological changes. (C) 2004 Elsevier Ltd. All rights reserved.Öğe An investigation of non-depolarizing muscle relaxants on embryonic development in cultured rat embryos(LIPPINCOTT WILLIAMS & WILKINS, 2004) Karabulut, AK; Reisli, R; Uysal, II; Celik, JB; Ziylan, TBackground and objective: We have investigated the toxic and teratogenic effects of certain non-depolarizing muscle relaxants on embryonic development in cultured rat embryos. Methods: Rat embryos of 9.5 days were explanted and cultured in vitro for 48 h in rat serum. Whole rat serum was used as a culture medium for the control group while different concentrations of atracurium, cis-atracurium, rocuronium and mivacurium were added to rat serum for the experimental groups. Dose-dependent effects of these agents on embryonic developmental parameters were compared using morphological and biochemical methods. Each embryo was evaluated for the presence of any malformations. Results: When compared to the control embryos, the muscle relaxants significantly decreased all growth and developmental parameters dose dependently with an increase in overall dismorphology. Among these malformations, maxillary deformity was most frequently observed. These effects were observed in much lower doses with atracurium and cis-atracurium compared to those with rocuronium and mivacutium. Conclusions: Our results suggest that non-depolarizing muscle relaxants cause dose-dependent toxicity on rat embryos at concentrations much greater than those in clinical practice. Although, these agents seems to have a low potential for causing developmental toxicity during organogenesis, because of the lower toxic effects observed with rocuronium and mivacurium, these agents may be preferred when recurrent administrations are necessary for parturients.Öğe Methylprednisolone prevents inflammatory reaction occurring during cardiopulmonary bypass: effects on TNF-alpha, IL-6, IL-8, IL-10(SAGE PUBLICATIONS LTD, 2004) Celik, JB; Gormus, N; Okesli, S; Gormus, ZI; Solak, HObjective: This study examined the correlation between tumour necrosis factor-alfa (TNF-alpha), interleukin (IL)-6 and IL-8, IL-10 and methylprednisolone pretreatment. Methods: This is a prospective, randomized and double-blinded study. Sixty patients undergoing coronary artery bypass grafting (CABG) were randomized to receive either intravenous methylprednisolone (n = 30, Group M) or intravenous placebo (n = 30, Group S). The patients received intravenously either 30 mg/kg methylprednisolone ( Group M) or placebo (Group S) 10 min before and after cardiopulmonary bypass (CPB). In an intensive care unit (ICU), four additional doses were given at 6-hourly intervals. Blood samples for the measurements of TNF-alpha, IL-6, IL-8 and IL-10 were obtained before induction of anaesthesia (T0 = control value), after induction (T1), before starting CPB (T2), after aortic declamping (T3), at the end of CPB (T4) and 6 hours (T5), 12 hours (T6) and 24 hours (T7) after skin closure. Creatine kinase (CK) and creatine kinase isoenzyme MB (CK-MB) were evaluated at the following intervals: T0, T5, T6 and T7. Results: When compared with the control value, TNF-alpha, IL-6 and IL-8 significantly increased in Group S and Group M (p < 0.05), but these values were significantly greater in Group S than in Group M (p < 0.05). In comparison with the control value, IL-10 increased in both groups (p < 0.05), but was significantly greater in Group M than in Group S (p < 0.05). CK and CK-MB were increased in both groups in postoperative values compared to control values. In Group S, CK and CK-MB levels were significantly lower than in Group M (p < 0.05). Conclusion: In this study, we have found that pre-operative administration of methylprednisolone has decreased TNF-alpha, IL-6 and IL-8 release, and increased the perfusing IL-10 levels after CPB. Thus, methylprednisolone may decrease the inflammatory response during the CPB procedure.Öğe Preoperative analgesia management with rofecoxib in thoracotomy patients(W B SAUNDERS CO, 2005) Celik, JB; Gormus, N; Gormus, ZI; Okesli, S; Solak, HObjective: Pain management after thoracotomy is significant because pain reduces the postoperative respiratory performance. In this study, the analgesic efficacy and safety of rofecoxib in thoracotomy patients were evaluated. Design: A prospective, randomized, double-blind, and placebo-controlled study. Setting: This study was performed in the Meram Medical School of Selcuk University Departments of Cardiovascular Surgery and Anesthesiology. Participants: Sixty patients undergoing elective thoracic surgery via thoracotomy were randomized to receive either oral placebo or rofecoxib, 50 mg, 1 hour before surgery. Interventions: All patients received a standard anesthetic. Pain scores, sedation scores, heart rate, mean arterial pressure, respiratory rate, analgesic requirements, and side effects were noted 2, 4, 8,12, 18, 24, 32, 40, and 48 hours after operation. Measurements and Main Results:There were no significant differences between the 2 study groups with respect to demographics, sedation score, intraoperative blood loss, and postoperative drainage. Compared with placebo, morphine consumption and pain scores at rest and during coughing were significantly lower with rofecoxib. Conclusions: The preoperative administration of rofecoxib, 50 mg, provides significant analgesia for postoperative pain relief and decreases additional opioid requirements after thoracotomy. (C) 2005 Elsevier Inc. All rights reserved.Öğe Respiratory arrest after intrathecal injection of sufentanil and bupivacaine(WILEY, 2004) Celik, JB; Reisli, R; Sarkilar, G; Okesli, S[Abstract not Available]
