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Öğe Characteristics of venous insufficiency in western Turkey: VEYT-I study(SAGE PUBLICATIONS INC, 2012) Akbulut, Birkan; Uçar, Halil İbrahim; Oc, Mehmet; İkizler, M.; Yorgancıoğlu, Cem; Dernek, Sadettin; Böke, E.Objectives: Syndromes of venous hypertension and reduced venous clearance are important causes of morbidity and disability in patients with varicose venous disease. Published estimates of the prevalence of varicosities range from 7% to 55% in the adult population, with most studies demonstrating clinical varicose reflux in about 40% of the population where the frequency of venous insufficiency is believed to be higher in Westernized and industrialized nations, most likely due to differences in lifestyle and activity. Unfortunately, the prevalence in a Turkish population is not known. The goal of the VEYT-I study was to determine the characteristics of venous insufficiency in a Turkish population. Method: Randomized patients who applied to a health-care centre were included in this study. The Tubingen questionnaire was used to evaluate the signs and symptoms of venous insufficiency and their seriousness in a Turkish population. Patients were additionally questioned on demographic data, education, working, living habits, quality of life and actual health status. Results: A total of 2167 patients were involved in this study. Four patients with chronic renal failure and 40 patients with congestive heart failure were excluded. In patients with venous insufficiency, 90.1% did not receive any therapy. In all, 51.53% of patients with venous insufficiency were men, and mean age was 56.9 +/- 9.4. Conclusion: The prevalence of venous insufficiency seems to be somewhat higher when compared with Western populations. One of the most prominent facts is that about 90% of patients with venous insufficiency did not receive any therapy. Therefore, disease-related complications or discomfort might emerge soon, and so more importance should be given to venous insufficiency. The VEYT-I study is a continuing database study and the target is to enlarge the study population.Öğe Doble Outlet Right Ventricle with Discordant Atrioventricular Connections in a Newborn: Case Report and Brief Overview of the Literature(DERMAN MEDICAL PUBL, 2016) Sert, Ahmet; Aypar, Ebru; Gokmen, Zeynel; Oc, Mehmet; Odabas, DursunDouble outlet right ventricle is a rare cardiac malformation of all congenital cardiac defects. It is a heterogeneous group of abnormal ventriculoarterial connections. Both great arteries (pulmonary artery and aorta) arise primarily from the morphological right ventricle. Double outlet right ventricle with discordant atrioventricular connections have been reported rarely in the literature. We report a newborn with double outlet right ventricle with discordant atrioventricular connections arid hypoplastic pulmonary arteries. We reported a rare complex cardiac malformation diagnosed by echocardiography. Segmental approach and sequential analysis of cardiac segments by echocardiography are the clue for diagnosis of complex cardiac ma formationsÖğe Endovenous Laser Ablation under General Anesthesia for Day Surgery: Feasibility and Outcomes of the 300 Patients(MEDICAL TRIBUNE INC, 2014) Arun, Oguzhan; Oc, Bahar; Duman, Ates; Yildirim, Serkan; Simsek, Murat; Farsak, Bora; Oc, MehmetPurpose: Endovenous laser ablation (EVLA) for superficial venous insufficiency is traditionally performed under tumescent local anesthesia as day case surgery. The aim of this study is to evaluate the feasibility of general anesthesia in addition to tumescent anesthesia in patients undergoing EVLA. Methods: The anesthesia and clinical registration records of 341 extremities of 300 adult patients were reviewed and analyzed retrospectively. Demographic and clinical data, preoperative anesthetic evaluation data (ASA physical status, preoperative airway assessment, Mallampati score), type of supraglottic device, duration of anesthesia and surgery, any surgical and/or anesthetic complication, timing of mobilization and discharge, and postoperative course were evaluated. Results: Mean duration of operation and anesthesia was 28 (12-55) and 40 (20-65) minutes, respectively. Mobilization and discharge timing was 25 (11-45) and 139 (110-200) minutes, respectively. All patients were discharged the same day of surgery. Conclusion: The combination technique of administering general anesthesia with supraglottic device and tumescent anesthesia is a safe and effective method to reduce the patients' pain and discomfort during the EVLT procedure within the scope of day case surgery.Öğe Extremely Low Birth Weight Infants with Patent Ductus Arteriosus: Searching for the Least Invasiveness(FORUM MULTIMEDIA PUBLISHING, LLC, 2012) Oc, Mehmet; Farsak, Bora; Oc, Bahar; Yildirim, Serkan; Simsek, MuratPatent ductus arteriosus (PDA) is an important problem in premature infants. Extremely low birth weight infants (ELBWI) are so fragile with respect to surgical stress that minimally invasive procedures are required. We report 26 ELBWI cases with PDA who underwent surgical closure. All had failed indomethacin treatment, or it had been contraindicated. The mean gestational age at birth was 27 weeks (range, 24-38 weeks), and the mean birth weight was 960.96 g (range, 710-1440 g). The mean age at operation was 18.06 days (range, 7-34 days), and the mean body weight at operation was 989.42 g (range, 680-1460 g). There was no surgery-related mortality or morbidity. Our surgical procedures consisted of posterior muscle-sparing thoracotomy, clipping the PDA and no ligation, and closing the thorax without a tube thoracostomy. Muscle-sparing thoracotomy reduces the likelihood of long-term physical impairment and deformity, the clipping technique minimizes the dissection of surrounding PDA tissue, and the thorax is closed without a tube. Nursing care is simplified, costs are reduced, and the number of chest x-rays needed postoperatively is reduced. We believe that surgical closure of PDA without chest tube drainage can be accomplished safely in premature infants.Öğe Is neutrophil gelatinase associated lipocalin enough valuable in the diagnosis of acute kidney injury?(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2014) Arun, Oguzhan; Oc, Bahar; Duman, Ates; Oc, Mehmet[Abstract not Available]Öğe Peroperative effects of fresh frozen plasma and antithrombin III on heparin sensitivity and coagulation during nitroglycerine infusion in coronary artery bypass surgery(LIPPINCOTT WILLIAMS & WILKINS, 2011) Kanbak, Meral; Oc, Bahar; Salman, Mehmet A.; Ocal, Turgay; Oc, MehmetNitroglycerin (NTG) reduces the anticoagulant effects of heparin and may lead to heparin resistance. Fresh frozen plasma (FFP) and antithrombin III (ATIII) may be used for the treatment of heparin resistance. We aimed to compare the effects of FFP and ATIII on heparin requirement, coagulation parameters, and bleeding in patients undergoing coronary artery bypass graft surgery (CABGS) with moderate dose of intraoperative NTG infusion. Forty-eight patients undergoing CABGS with NTG infusion were randomly allocated to three groups. Group C served as control, whereas the patients in group P received FFP and those in group A received ATIII after anesthesia induction. ATIII activity and coagulation parameters were measured at five different times intraoperatively. Total heparin requirement, heparin consumption, and heparin sensitivity were calculated. ATIII activity and ACT were significantly higher and activated partial thromboplastin time and fibrinogen level were significantly lower during cardiopulmonary bypass in group A than in groups P and C. Heparin sensitivity was significantly higher and total heparin requirement and consumption were significantly lower in ATIII group than in other groups. ATIII administration increases heparin sensitivity and decreases heparin requirements compared with FFP in patients undergoing CABGS with peroperative NTG infusion. ATIII may be preferred to FFP in patients with heparin resistance due to NTG infusion undergoing CABGS. Blood Coagul Fibrinolysis 22:593-599 (C) 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.Öğe Plasma leptin levels increase to a greater extent following on-pump coronary artery surgery in type 2 diabetic patients than in nondiabetic patients(ELSEVIER IRELAND LTD, 2012) Guvener, Murat; Ucar, Halil Ibrahim; Oc, Mehmet; Pinar, AsliAims: We aimed to evaluate whether leptin and ghrelin responses to cardiopulmonary bypass (CPB) are dependent on type 2 diabetes and whether these responses are associated with interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP), cortisol and insulin. Methods: We examined stress-response patterns in plasma leptin, ghrelin, hsCRP, IL-6, cortisol and insulin levels before and up to 5 days after cardiopulmonary bypass in 20 patients with type 2 diabetes and 20 patients without diabetes. Results: Plasma leptin levels increased significantly in both groups (p < 0.05) and rose significantly higher in diabetics when compared with nondiabetic patients (p = 0.004). Plasma ghrelin levels increased significantly only in diabetics (p = 0.033). Patients with and without diabetes showed significantly elevated serum concentrations of IL-6, hsCRP, cortisol and insulin (p < 0.005 for IL-6, hsCRP; p < 0.05 for cortisol, insulin) but the difference between the two groups was nonsignificant. Leptin was independently predicted by hsCRP (p < 0.05, F = 2.9), gender (women p < 0.001, F = 4.7), body mass index (BMI p < 0.0001, F = 6.1) whereas ghrelin levels were not associated with any variables in the total patient population. (critical F = 2.26, p <= 0.05). Conclusions: Acute phase response in diabetics differs by higher leptin levels independent of BMI, gender and IL-6, hsCRP, insulin and cortisol levels. (C) 2012 Elsevier Ireland Ltd. All rights reserved.Öğe A rare giant pericardial cyst mimicking a paracardiac mass(CLINICS CARDIVE PUBL PTY LTD, 2016) Akbayrak, Hakan; Yildirim, Serkan; Simsek, Murat; Oc, MehmetPericardial cysts are rare benign lesions of the thoracic cavity and are mostly congenital anomalies. They are induced by an incomplete coalescence of foetal lacunae during the development of the pericardium. Pericardial cysts are usually unilocular, well marginated spherical or teardrop shaped and may be attached to the pericardium directly or by a pedicle. Of all pericardial cysts, 70 to 75% are located at the right cardiophrenic angle. We report a case that was incidentally diagnosed with only chest magnetic resonance imaging because of a paracardiac mass. In order to prevent complications, the giant pericardial cyst was excised outside of the pericardium with median sternotomy.Öğe Renal Effects of Coronary Artery Bypass Graft Surgery in Diabetic and Non-Diabetic Patients: A Study with Urinary Neutrophil Gelatinase-Associated Lipocalin and Serum Cystatin C(KARGER, 2015) Arun, Oguzhan; Celik, Gulperi; Oc, Bahar; Unlu, Ali; Celik, Jale Bengi; Oc, Mehmet; Duman, AtesBackground/Aims: Cardiac surgery and diabetes are major causes of acute kidney injury (AKI). We aimed to investigate the value of urinary neutrophil gelatinase-associated lipocalin (NGAL) and serum cystatin C, as early biomarkers for prediction of AKI in diabetic and nondiabetic adult patients undergoing cardiac surgery. Methods: 15 non-diabetic and 15 diabetic adult patients undergoing cardiac surgery were enrolled. Peri-operative clinical and laboratory variables were recorded. Urinary NGAL, serum cystatin C, serum creatinine (Cre) and blood urea nitrogen (BUN) were evaluated. Results: AKI was detected in 4 patients in non-diabetic group and 12 patients in diabetic group. Urinary NGAL levels of diabetic and non-diabetic patients and serum cystatin C levels of diabetic patients exceed upper normal limits or cut off values much earlier than BUN and Cre. cystatin C levels of non-diabetic patients remain unchanged. Cystatin C and NGAL levels of patients meeting AKI criteria and NGAL levels of patients not meeting AKI criteria exceeded upper normal limits or cut off values much earlier in than BUN and Cre. Conclusions: Measurement of cystatin C level in both diabetic and nondiabetic patients may reveal AKI earlier than NGAL and BUN. In diabetic patients, measurement of urinary NGAL and serum cystatin C levels may indicate AKI signs earlier than BUN and Cre. Copyright (C) 2015 S. Karger AG, BaselÖğe Surgical Treatment of Right Ventricular Hydatid Cyst(FORUM MULTIMEDIA PUBLISHING, LLC, 2012) Oc, Mehmet; Ulular, Omer; Oc, BaharHydatid cyst is a serious endemic parasitic disease found in cattle-raising areas of the world. Cardiac hydatid cysts arc rare and appear in 0.5% to 2% of hydatid cyst cases. A 24-year-old male patient was admitted to the hospital because of chest pain. A cystic mass (4 4 3 cm) was demonstrated with transthoracic echocardiography, computed tomography, and magnetic resonance imaging. A hydatid cyst was located in the right ventricular wall near the inferior branch of the acute marginal branch of the right coronary artery and was located such that it pushed the tricuspid valve inward. The cystic materials were removed with the patient on cardiopulmonary bypass. The surgery for cardiac hydatid disease is safe, and the results are satisfactory.
