Browsing by Author "Işkesen I."
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Item Pleural amebiasis: Isolated organ involvement(Asia Publishing Exchange Pte Ltd, 2000) Zeybek R.; Tüzün E.; Işkesen I.; Aksoy Ö.A rare case of pleural amebic abscess without invasion of another organ was encountered in a 23-year-old man. He was successfully treated surgically when conservative measures failed.Item The hemodynamic responses to hypothermic and normothermic cardiopulmonary bypass(2001) Zeybek R.; Adanir T.; Işkesen I.; Tüzün E.This prospective randomized clinical study was designed to assess and compare the effects of normothermic and hypothermic nonpulsative cardiopulmonary bypass in patients with mitral valve replacement. Forty patients undergoing elective mitral valve replacement were randomly divided into two groups according to the temperature of perfusion. Group N (15 patients) underwent normothermic cardiopulmonary perfusion and Group H (25 patients) underwent hypothermic cardiopulmonary perfusion. These groups were compared using clinical and electrocardiographic criteria and cardiovascular evaluation parameters. Quantitative data were analyzed using the paired Student t test. While there was a significant increment in heart rate in Group N in relation to preoperative values, there was no change in heart rate in Group H. Increasing values in systemic vascular resistance (SVR) parameters were detected in both groups. Oxygen consumption (VO2) values decreased in Group N in relation to Group H. There was no significant change in alveolar-arterial O2 difference (DO2) values between these two groups. These results indicate that the temperature of cardiopulmonary perfusion had no effect on the immediate postoperative values but did cause an increase in heart rate in the normothermic group.Item Ischaemic preconditioning reduces spinal cord injury in transient ischaemia(Acta Cardiologica, 2002) Şirin B.H.; Ortaç R.; Cerrahoǧlu M.; Saribülbül O.; Baltalarli A.; Çelebisoy N.; Işkesen I.; Rendeci O.Objective - Paraplegia remains a devastating complication after thoracic and thoracoabdominal aortic surgery for coarctations, dissections or aneurysms. Since the advent of ischaemic preconditioning of the myocardium, attention has been directed to the nervous system. This study was designed to evaluate the acute protective effect of ischaemic preconditioning on the spinal cord. Medhods and results - Thirty-six New Zealand white rabbits were randomly assigned to one of three groups. The preconditioning group had 5 minutes of aortic occlusion, 25 minutes reperfusion and 20 minutes of ischaemia, whereas the controls had only 20 minutes of ischaemia. The sham group was anaesthetized and subjected to laparotomy without aortic occlusion. Physiological parameters and somatosensory evoked potentials were monitored during the experiment. Neurological outcome was clinically evaluated up to 48 hour after ischaemia and motor function was scored. Then the animals were sacrificed. Their spinal cord, abdominal aorta and its branches were removed and processed for histopathological examination. Histhopathological changes of the gray matter in the lumbosacral segments were scored from 0 to 6 according to a semi-quantitative scala. The changes in amplitudes of evoked potentials during ischaemia and recovery periods were similar in preconditioning and control groups. The average motor function score was significantly higher in the preconditioning group than the control group at 24 and 48 hours after the ischaemic event (p < 0.05). Histological observations were consistent with the neurological findings. The histopathological scores in the control group and the preconditioning group were 3.2 (1.4-5.2) and 2.4 (0.8-4.4), respectively (p < 0.05). Conclusions - The results suggest that ischaemic preconditioning reduces the spinal cord injury and improves neurological outcome in transient ischaemia in rabbits. This protective mechanism is rapidly invoked within only 25 minutes interval between the preconditioning stimulus and the ischaemic insult.Item A rare cardiac tumor in childhood: Right atrial myxoma; [Çocuk yaş grubunda nadir bir kardiyak tümör: Saǧ atriyal miksoma](2011) Kurdal A.T.; Eserdaǧ M.; Işkesen I.; Şirin B.H.Myxoma is a rare tumor in childhood and unlike left atrial localization is quite rare in right atrium. A 14-year-old male child presented with complains of exertional dys-pnea and tachycardia. Transthoracic echocardiography revealed a huge myxoma in the right atrium, closing the inferior vena cava orifice and causing tricuspid stenosis. Cardiopulmonary bypass was started only with superior vena cava cannulation. Inferior vena cava cannulation was performed after cardiac arrest due to the embolic risk. The total resection was performed by right atriotomy.Item Coagulation effects of hydroxyethylstarch versus modified fluid gelatin when used as normovolemic hemodilution solutions during cardiac surgery(Turkish Anaesthesiology and Intensive Care Society, 2014) Öztürk T.; Topçu I.; Tuncer B.; Açikgöz B.; Yildirim F.; Işkesen I.Objective: The aim of this study to examine the effects of hydroxyethyl starch and gelatin solutions used for acute normovolemic hemodilution on coagulation during coronary artery bypass surgery. Material and Method: Seventy-two patients undergoing elective coronary artery bypass graft surgery randomly received no hemodilution (control), or 6% HES 200/0.5 (n=24) or 4% gelatin solution (n=24) for acute normovolemic hemodilution before cardiopulmonary bypass. Thromboelastography parameters were measured before (T0) and after (T1) acute nor-movolemic hemodilution, and one (T2) and four (T3) hours after separation from CPB. Results: The R (reaction) time in HES was significantly longer than in controls at T(2) (p=0.03). The K (coagulation) values in group HES and GEL were significantly longer than in controls at T(2) and T(3) (p=0.02 and 0.03, respectively). Rapidity of clot formation (alpha angle) was significantly smaller in HES and GEL compared to controls (p=0.01 and p=0.02, respectively). Maximum amplitudes in HES and GEL were not significantly different than controls at T(2) (p=0.3 and 0.9, respectively). At T2, three patients in GEL (but none in HES) showed clotlysis at 30 min (p=0.1). GEL and HES received fewer units of erythrocyts compared to controls(p<0.001); however, use of fresh frozen plasma was not significantly different than in controls. Mediastinal blood loss was greater in group HES than in controls (p<0.05). Conclusion: Performing acute normovolemic hemodilution with HES and GEL solutions caused significant change in coagulation state by thromboelastography, reduced the need for errytrocyt. Regarding the increase in mediastinal chest drainage, we concluded that HES may not be safety in patients undergoing coronary surgery.Item Anaesthetic management of the patient undergoing cardiopulmonary bypass graft surgery after pneumonectomy(Turkish Anaesthesiology and Intensive Care Society, 2014) Öztürk T.; Bambal H.; Işkesen I.; Şirin H.The aim of this case report is to discuss the recommendations for preoperative evaluation, the technical difficulties experienced in the perioperative period and the ventilation methods used to minimize pulmonary injury in a post-pneumonectomy patient undergoing coronary artery bypass grafting surgery.