Browsing by Author "Saribülbül O."
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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 The clinical significance of atrial and brain natriuretic peptides; [Atrial ve beyin natriüretik peptid'in klinik önemi](2002) Saribülbül O.; Coşkun Ş.Heart is not only a pump functionally, but also secrets two different significant peptides like an endocrine organ: ANP (Atrial Natruretic Peptide) and BNP (Brain Natriuretic Peptide). Many different effects of these peptides which have structural homology, on heart, kidneys, electrolytes and blood volume were proven. A different peptide, C-type natriuretic peptide, originates from vascular endothelial wall and since it doesn't originate from myocard, it is not mentioned together with others. ANP is secreted from atrium. Although BNP originates from cardiac ventricules, since it was first isolated from brain, it is called brain natriuretic peptide. The changing concentrations of ANP and BNP according to some physiological conditions like posture or effort were measured both in renal failure and after myocardial infarction and also particularly in heart failure. Besides, these findings revealed that the levels of ANP and BNP can be used to follow the clinical status of patients. According to recent studies, BNP can be used as an indicator to predict the prognosis of the patients with both asymptomatic and severe ischemic heart failure.Item Diagnosis of asymptomatic atrial septal aneurysms using two-dimensional color Doppler and contrast transthoracic echocardiography(2003) Coşkun S.; Sekuri C.; Bayturan Ö.; Yüksel H.; Saribülbül O.; Bilge A.Objective. To evaluate the dimensions of atrial septal aneurysm (ASA), the presence and characteristics of interatrial shunt, the movement of the wall of the aneurysm, and correlation between these findings and sign and/or symptoms suggesting embolism in Manisa, a district of a western Anatolian city of Turkey. Methods. Two thousand five hundred cases were examined by routine transthoracic echocardiography (TTE) in both pediatric and adult cardiology outpatient clinics. ASA was detected in 20 cases and evaluated by two-dimensional color Doppler echocardiography (CDE). The length of the base, the maximum radius and the maximum displacement of ASA were measured. The shunt between the atria was examined by CDE. In cases where a shunt could not be found, galactose and palmitic acid was injected. Standard 12-lead electrocardiogram (ECG) and exercise stress test were also performed. Results. No clinical signs or symptoms were found, suggesting a systemic or cerebral embolism. The maximum displacement of ASA was between 2 and 5 mm. All of the aneurysms were localized in the right atrium, and the walls of the aneurysm did not move beyond the base of the left atrium during the maximum displacement. Interatrial shunt was detected in 14 of 20 patients (70%) by CDE and in the remaining six cases by contrast TTE. Frequent ventricular ectopic beats were observed in one patient. Conclusion. During routine TTE we observed 0.8% asymptomatic ASA in our population. The use of a contrast agent was found to be a valuable additional method in patients with ASA when the shunt could not be detected by CDE. The risk for embolism is not high when the maximum displacement of the wall of ASA was 5 mm or less and no bulge into the left atrium was observed. Based on our experience with this method, TTE is easy to perform, well-tolerated and acceptable.Item Hemangioma of the rib(2006) Yilmaz Ovali G.; Göktan C.; Tarhan S.; Örgüç Ş.; Ayhan S.; Saribülbül O.; Zeybek R.[No abstract available]Item The effect of cardiopulmonary bypass on the expression of inducible nitric oxide synthase, endothelial nitric oxide synthase, and vascular endothelial growth factor in the internal mammary artery(2006) Toprak V.; Şirin B.H.; Tok D.; Özbilgin K.; Saribülbül O.Objective: Endothelial function of a vessel may be impaired by local or systemic inflammation initiated by cardiopulmonary bypass (CPB) during coronary artery bypass graft (CABG) surgery. The present study was designed to investigate the early effects of CPB on nitric oxide production and vascular endothelial growth factor (VEGF) expression in internal mammary artery (IMA). Design: Prospective study. Setting: University hospital. Participants: Twenty patients who were scheduled for elective CABG with CPB. Interventions: IMA sections were studied immunohistochemically from these patients. The samples were taken from the distal end of the IMA before the institution of CPB and just before the construction of the IMA-left anterior descending artery anastomosis. Measurement and Main Results: After CPB, VEGF and endothelial nitric oxide synthase immunoreactivity increased significantly when compared with baseline values in the endothelium (p = 0.0156, p = 0.0313) and adventitia (p = 0.0313, p = 0.0001), respectively. No significant change was observed in inducible nitric oxide synthase immunoreactivity. Conclusions: The increase in eNOS expression may have been induced by the inflammation caused by CPB. © 2006 Elsevier Inc. All rights reserved.