Browsing by Author "Ozbakkaloglu A."
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Item Native valve endocarditis caused by streptococcus bovis following colonoscopy; [Kolonoskopi̇ sonrasi görülen streptococcus bovise baǧli doǧal kapak endokardi̇ti̇](2010) Kahraman N.; Iskesen I.; Kurdal A.T.; Ozbakkaloglu A.; Hayrettin B.The strongest relationship focuses on Streptococcus bovis. All types of Streptococcus bovis infection have been related to the presence of a gastrointestinal neoplasia, which in most cases is colonic adenoma or carcinoma. We report the case of a patient who was diagnosed with villous adenoma of the colon and underwent aortic valve replacement because of a large vegetation on the aortic valve caused by Streptococcus Bovis endocarditis.48 years old male patient with a history of abdominal pain and weight loss for the last 1.5 months was diagnosed with villous adenoma. 1 week after his colonoscopy the patient presented to our clinic with tachycardia, fever, fatique, and swelling of the feet. In echocardiographic evaluation a 4.5x1.1 cm mobile mass filling the aortic lumen almost totally and reaching the mitral valve region and 3rd degree aortic regurgitation was found. The postoperative course was uneventful. After the first postoperative month the patient was transferred to general surgery clinic. Streptococcus Bovis endocarditis is normaly very uncommon. Since Streptococcus Bovis endocarditis is strongly associated with emboli, urgent operation should be planned and the vegetation should be removed.Item Effect of surgical staging on 539 patients with borderline ovarian tumors: A Turkish Gynecologic Oncology Group study(2013) Guvenal T.; Dursun P.; Hasdemir P.S.; Hanhan M.; Guven S.; Yetimalar H.; Goksedef B.P.; Sakarya D.K.; Doruk A.; Terek M.C.; Saatli B.; Guzin K.; Corakci A.; Deger E.; Celik H.; Cetin A.; Ozsaran A.; Ozbakkaloglu A.; Kolusari A.; Celik C.; Keles R.; Sagir F.G.; Dilek S.; Uslu T.; Dikmen Y.; Altundag O.; Ayhan A.Objective The objectives of this study were to examine demographic and clinicopathologic characteristics and to determine the effects of primary surgery, surgical staging and the extensiveness of staging. Methods In a retrospective Turkish multicenter study, 539 patients, from 14 institutions, with borderline ovarian tumors were investigated. Some of the demographic, clinical and surgical characteristics of the cases were evaluated. The effects of type of surgery, surgical staging; complete or incomplete staging on survival rates were calculated by using Kaplan-Meier method. Results The median age at diagnosis was 40 years (range 15-84) and 71.1% of patients were premenopausal. The most common histologic types were serous and mucinous. Majority of the staged cases were in Stage IA (73.5%). 242 patients underwent conservative surgery. Recurrence rates were significantly higher in conservative surgery group (8.3% vs. 3%). Of all patients in this study, 294 (54.5%) have undergone surgical staging procedures. Of the patients who underwent surgical staging, 228 (77.6%) had comprehensive staging including lymphadenectomy. Appendectomy was performed on 204 (37.8%) of the patients. The median follow-up time was 36 months (range 1-120 months). Five-year survival rate was 100% and median survival time was 120 months. Surgical staging, lymph node sampling or dissection and appendectomy didn't cause any difference on survival. Conclusion Comprehensive surgical staging, lymph node sampling or dissection and appendectomy are not beneficial in borderline ovarian tumors surgical management. © 2013 Elsevier Inc.Item Ultrasound-guided catheter-directed foam sclerotherapy for great saphenous vein(Edizioni Minerva Medica, 2015) Kurdal A.T.; Yildirim F.; Ozbakkaloglu A.; Iskesen I.; Tetik O.Aim: The problem of varicose veins in the lower leg is a common disease and associated with long-term morbidity. It has usually been treated using high ligation with stripping and endovenous ablation surgery of the great saphenous vein. The aim of this paper is to report our own series of patients treated by ultrasound guided catheter directed foam sclerotherapy for the chemical ablation of great saphenous vein. Methods. The study involved 108 legs with symptomatic varicose veins (C2-4) secondary to great saphenous vein insufficiency. The great saphenous vein was accessed at knee level. With the method of Tessari sclerosant foam was made (2 mL 3% polidocanol and 8 mL air) and delivered along the great saphenous vein while the catheter was withdrawn. At two and fifty two weeks after treatment the patients were evaluated. Results. Catheter-directed foam sclerotheraphy was successfully performed in all of the patients. Venous Clinic Severity Score was reduced significantly (P<0.05). Eighty nine percent of the GSV were completely occluded, 4% were partly occluded and 7% were recanalized. No serious side-effects occurred. Conclusion. Catheter-directed foam sclerotheraphy is a safe, simple and minimally invasive procedure. Patient satisfaction was good and the occlusion rate is promising after a single treatment.Item Is "attenuation of Oxidative Stress" Helpful to Understand the Mechanism of Remote Ischemic Preconditioning in Cardiac Surgery?(W.B. Saunders, 2016) Yildirim F.; Iskesen I.; Kurdal A.T.; Ozturk T.; Taneli F.; Gozukara C.; Ozbakkaloglu A.Objectives The aim of this study was to determine the effect of remote ischemic preconditioning (RIPC) on markers of cardiac ischemia and response to oxidative stress in patients undergoing coronary artery bypass grafting (CABG) surgery. Design A prospective, randomized, and blinded study. Setting A single-center university hospital. Participants This study included patients who underwent isolated CABG surgery with cardiopulmonary bypass who were selected carefully to prevent confounding with factors known to affect markers of ischemia-reperfusion and response to oxidative stress. Interventions The authors randomly assigned patients to RIPC to the left lower extremity using a blood pressure cuff (study group) or a cuff that was applied but not inflated or deflated (control group). Measurements and Main Results At 6 hours after CABG surgery, high-sensitivity cardiac troponin T levels were significantly lower in the study group than in the control group. Levels of superoxide dismutase, an antioxidant enzyme, were significantly greater 15 minutes after release of the cross-clamp in the study group, whereas malondialdehyde levels were lower (not significantly) at 1 and 15 minutes after release of the cross-clamp. Hemodynamic parameters were not significantly different at any time point during the study. Conclusions The authors' method of RIPC before CABG surgery resulted in less myocardial ischemia, as indicated by lower troponin levels. Changes in levels of endogenous antioxidant enzymes supported the hypothesis that this protection from ischemia-reperfusion injury was related to scavenging of free oxygen radicals. Future studies might include a more heterogeneous population and medications that lower the body's response to oxidative stress. © 2016 Elsevier Inc.Item Thromboelastogram reduces blood use by inspecting coagulation in heart surgery(SAGE Publications Inc., 2016) Yildirim F.; Tuncer B.; Ozbakkaloglu A.; Kurdal A.T.; Ozturk T.; Iskesen I.Objective Blood transfusion after coronary artery bypass surgery is carried out according to general coagulation tests and blood counts. Our aim was to determine the effects of rotational thromboelastography results on the amount of blood products used in the intraoperative and postoperative periods in coronary artery bypass patients. Methods Our study included 164 patients who underwent coronary artery bypass. A control group was formed from 82 patients picked from hospital records, who had elective coronary artery bypass before the introduction of rotational thromboelastography in our clinic. Blood transfusion was performed in this group according to conventional laboratory data. The study group comprised 82 patients who had elective coronary artery bypass after the introduction of rotational thromboelastography. Blood transfusion was performed in the study group according to rotational thromboelastogram results. The amounts of blood products used in the 2 groups were compared. Results There were statistically significant decreases in the intraoperative and postoperative amounts of packed red blood cells (p = 0.012 and p = 0.006) and postoperative whole blood (p = 0.013) used in the study group compared to the control group. Postoperative bleeding was also significantly reduced (p = 0.001) in the study group. Conclusion Blood transfusion is an important issue after coronary artery bypass, and because of the decreased amount of blood products used, a rotational thromboelastography-based blood transfusion algorithm should be applied in patients undergoing coronary artery bypass. © 2014 SAGE Publications.Item Ultrasound-guided catheter-directed foam sclerotherapy for great saphenous vein; [Uitrascha11geführte, kathetergestutzte schaumsklerotherapie der vena saphena magna](Viavital Verlag, 2016) Kurdal A.T.; Yildirim F.; Ozbakkaloglu A.; Iskesen I.; Tetik O.[No abstract available]Item Bentall Operation in a Patient with Severe Hemophilia A and Marfan Syndrome by Use of a Biologic Composite Graft(Elsevier USA, 2016) Yildirim F.; Ozbakkaloglu A.; Ozturk T.; Tetik O.We describe a patient with severe hemophilia A and Marfan syndrome who underwent an elective Bentall operation. Because of the severe hemophilia, anticoagulation could not be given postoperatively; thus, a biologic Valsalva conduit graft was used. During the procedure, factor VIII was given as a bolus dose just before incision, then by continous infusion intraoperatively to maintain the factor VIII activity level between 200% and 300%. Minimal postoperative bleeding occurred. The infusion was continued postoperatively at a lower dose until all chest tubes, pacing wires, and invasive catheters were removed. The patient was discharged on postoperative day 7 without adverse events. © 2016 The Society of Thoracic Surgeons.