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Dalkilinc Hokenek U, Arslan G, Ozcan T, Sayin Kart J, Dogu Geyik F, Eryildirim B, Tolga Saracoglu K. Comparison of hemodynamic and respiratory outcomes between two surgical positions for percutaneous nephrolithotomy: a prospective, randomized clinical trial. Actas Urol Esp 2023; 47:509-516. [PMID: 37084806 DOI: 10.1016/j.acuroe.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 04/23/2023]
Abstract
INTRODUCTION Percutaneous nephrolithotomy (PCNL) has become the gold standard for the treatment of large and complex kidney stones. OBJECTIVES The objective of this study is to evaluate the efficacy and safety of percutaneous nephrolithotomy (PCNL) for patients in the flank position versus prone position. METHODS In our prospective randomized trial, 60 patients who would undergo fluoroscopy and ultrasound-guided PCNL in prone or flank position were divided into two groups. Demographic features, hemodynamics, respiratory and metabolic parameters, postoperative pain scores, analgesic requirements, amount of fluid given, blood loss and transfusion, duration of operation and hospital stay, and perioperative complications were compared. RESULTS PaO2, SaO2, SpO2 and Oxygen Reserve İndex (ORi) at the 60th minute of the operation and in the postoperative period, Pleth Variability index (PVi) at the 60th minute of the operation, driving pressure in all time periods and the amount of bleeding during the operation were determined to be statistically significantly higher in the prone group. There was no difference between the groups in terms of other parameters. Was found to be statistically significantly higher in the prone group. CONCLUSIONS Due to our results the flank position can be preferred in PCNL operations, considering that the position should be chosen according to the surgeon's experience, the patient's anatomical and physiological data, positive effects on respiratory parameters and bleeding, and the operation time can be shortened as the experience increases.
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Affiliation(s)
- U Dalkilinc Hokenek
- Servicio de Anestesiología y Reanimación, Universidad de Ciencias de la Salud, Hospital Kartal Dr. Lutfi Kirdar, Estambul, Turkey.
| | - G Arslan
- Servicio de Anestesiología y Reanimación, Universidad de Ciencias de la Salud, Hospital Kartal Dr. Lutfi Kirdar, Estambul, Turkey
| | - T Ozcan
- Servicio de Urología, Universidad de Ciencias de la Salud, Hospital Kartal Dr. Lutfi Kirdar, Estambul, Turkey
| | - J Sayin Kart
- Servicio de Anestesiología y Reanimación, Universidad de Ciencias de la Salud, Hospital Kartal Dr. Lutfi Kirdar, Estambul, Turkey
| | - F Dogu Geyik
- Servicio de Anestesiología y Reanimación, Universidad de Ciencias de la Salud, Hospital Kartal Dr. Lutfi Kirdar, Estambul, Turkey
| | - B Eryildirim
- Servicio de Urología, Universidad de Ciencias de la Salud, Hospital Kartal Dr. Lutfi Kirdar, Estambul, Turkey
| | - K Tolga Saracoglu
- Servicio de Anestesiología y Reanimación, Universidad de Ciencias de la Salud, Hospital Kartal Dr. Lutfi Kirdar, Estambul, Turkey
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Dalkilinc Hokenek U, Arslan G, Ozcan T, Sayin Kart J, Dogu Geyik F, Eryildirim B, Tolga Saracoglu K. Comparación de los resultados hemodinámicos y respiratorios entre dos posiciones quirúrgicas para la nefrolitotomía percutánea: ensayo clínico prospectivo y aleatorizado. Actas Urol Esp 2023. [DOI: 10.1016/j.acuro.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
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Gündoğdu E, Mat E, Aboalhasan Y, Yıldız G, Başol G, Tolga Saraçoğlu K, Arslan G, Kale A. V-NOTES hysterectomy under spinal anaesthesia: A pilot study. Facts Views Vis Obgyn 2022; 14:275-282. [DOI: 10.52054/fvvo.14.3.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Spinal anaesthesia has not been widely adopted for laparoscopic surgeries until now. There are a few studies that have shown that spinal anaesthesia is at least as safe as general anaesthesia. The need for additional analgesics can be reduced by utilising early postoperative analgesic effects of spinal anaesthesia, and maximum benefit can be obtained from minimally invasive approaches when V-NOTES surgery is performed under spinal anaesthesia.
Objective: Combining V-NOTES with spinal anaesthesia to improve minimally invasive surgical techniques and provide maximum benefit to patients.
Materials and methods: Patients who were found to have benign pelvic organ pathologies, required a hysterectomy and were considered suitable for V-NOTES hysterectomy under spinal anaesthesia were included in this study. Spinal anaesthesia was achieved with 12.5 mg 0.5% hyperbaric bupivacaine in the sitting position. Perioperative events and complications related to spinal anaesthesia were noted. Postoperatively, the pain was evaluated using a visual analogue scale at the 6th, 12th, and 24th hours.
Main outcome measures: To evaluate the feasibility and safety of spinal anaesthesia in VNOTES hysterectomy and to increase the advantages of minimally invasive surgical procedures. Results: No conversion to conventional laparoscopy or laparotomy was required in all six operated patients. Conversion from spinal anaesthesia to general anaesthesia was unnecessary, and no major perioperative incident occurred in any of the cases.
Conclusion: In the current study by our team, we demonstrated that V-NOTES hysterectomy could be performed safely under spinal anaesthesia in well-selected patients. The need for additional analgesics can be reduced by utilising early postoperative analgesic effects of spinal anaesthesia, and maximum benefit can be obtained from minimally invasive approaches when VNOTES surgery is performed under spinal anaesthesia.
What is new? V-NOTES hysterectomy could be performed safely under spinal anaesthesia in well-selected patients.
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Acar S, Gürsoy S, Arslan G, Nalbantoğlu Ö, Hazan F, Köprülü Ö, Özkaya B, Özkan B. Screening of 23 candidate genes by next-generation sequencing of patients with permanent congenital hypothyroidism: novel variants in TG, TSHR, DUOX2, FOXE1, and SLC26A7. J Endocrinol Invest 2022; 45:773-786. [PMID: 34780050 DOI: 10.1007/s40618-021-01706-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 11/07/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE To date, many genes have been associated with congenital hypothyroidism (CH). Our aim was to identify the mutational spectrum of 23 causative genes in Turkish patients with permanent CH, including thyroid dysgenesis (TD) and dyshormonogenesis (TDH) cases. METHODS A total of 134 patients with permanent CH (130 primary, 4 central) were included. To identify the genetic etiology, we screened 23 candidate genes associated with CH by next-generation sequencing. For confirmation and to detect the status of the specific familial variant in relatives, Sanger sequencing was also performed. RESULTS Possible pathogenic variants were found in 5.2% of patients with TD and in 64.0% of the patients with normal-sized thyroid or goiter. In all patients, variants were most frequently found in TSHR, followed by TPO and TG. The same homozygous TSHB variant (c.162 + 5G > A) was identified in four patients with central CH. In addition, we detected novel variants in the TSHR, TG, SLC26A7, FOXE1, and DUOX2. CONCLUSION Genetic causes were determined in the majority of CH patients with TDH, however, despite advances in genetics, we were unable to identify the genetic etiology of most CH patients with TD, suggesting the effect of unknown genes or environmental factors. The previous studies and our findings suggest that TSHR and TPO mutations is the main genetic defect of CH in the Turkish population.
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Affiliation(s)
- S Acar
- Division of Pediatric Endocrinology, Dr. Behçet Uz Children's Education and Research Hospital, İsmet Kaptan Mh, Sezer Doğan Sokağı No:11, 35210, Konak/Izmir, Turkey.
| | - S Gürsoy
- Division of Pediatric Genetics, Dr. Behçet Uz Children's Education and Research Hospital, Izmir, Turkey
| | - G Arslan
- Division of Pediatric Endocrinology, Dr. Behçet Uz Children's Education and Research Hospital, İsmet Kaptan Mh, Sezer Doğan Sokağı No:11, 35210, Konak/Izmir, Turkey
| | - Ö Nalbantoğlu
- Division of Pediatric Endocrinology, Dr. Behçet Uz Children's Education and Research Hospital, İsmet Kaptan Mh, Sezer Doğan Sokağı No:11, 35210, Konak/Izmir, Turkey
| | - F Hazan
- Department of Medical Genetics, Dr. Behçet Uz Children's Education and Research Hospital, Izmir, Turkey
| | - Ö Köprülü
- Division of Pediatric Endocrinology, Dr. Behçet Uz Children's Education and Research Hospital, İsmet Kaptan Mh, Sezer Doğan Sokağı No:11, 35210, Konak/Izmir, Turkey
| | - B Özkaya
- Division of Pediatric Endocrinology, Dr. Behçet Uz Children's Education and Research Hospital, İsmet Kaptan Mh, Sezer Doğan Sokağı No:11, 35210, Konak/Izmir, Turkey
| | - B Özkan
- Division of Pediatric Endocrinology, Dr. Behçet Uz Children's Education and Research Hospital, İsmet Kaptan Mh, Sezer Doğan Sokağı No:11, 35210, Konak/Izmir, Turkey
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Yavas G, Yavas C, Arslan G, Efe E, Onal C. PO-1219 Utility of MRI-guided adaptive radiotherapy for pancreatic cancer: Baskent University experience. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07670-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Arslan G, Tokem Y. Factors influencing adherence to medication in patients using anticoagulant drug. Eur J Cardiovasc Nurs 2021. [DOI: 10.1093/eurjcn/zvab060.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None. Main funding source(s): Researcher
Introduction
Anticoagulant drugs are quite narrow in their therapeutic range, which should be closely monitored throughout the treatment. In addition to monitoring the responses to the drug in patients who are taking anticoagulant medication, informing the patient and his family is one of the important responsibilities of the nurse within the scope of the counseling and training roles.
Aim
The aim of this comparative study is to investigate the factors affecting drug compliance in young adult (18-65 years) and elderly (over 65 years) patients who using anticoagulant drugs.
Method
This research was carried out descriptively and cross-sectionally in a public hospital between October 1 and December 31, 2018, and was conducted with 100 patients in Cardiovascular Surgery and Cardiology outpatient clinics and clinics. Research data was obtained by; Patient Information Form (55 questions) and Morisky Medication Adherence Scale (9 questions).
Results
56% of the patients were female and 44% were male, the mean age of the patients was 63.3 ± 14.67 years. The mean scale score of young adult patients was 5.41 ± 2.44 (compatible) and the mean scale score of elderly patients was found to be 8.95 ± 2.21 (incompatible). 48.2% of the female patients and 54.5% of the male patients were found to be compatible with the treatment. When the relationship between the knowledge level of anticoagulant drugs and their compliance with the treatment according to age group is evaluated; patients in all age groups who expressed their own level of knowledge inadequately, were found to be incompatible with treatment. 46.2% of young adult patients who stated that they had hospitalization due to the drug and 64.3% of young adult patients who stated that they applied to the emergency department, were highly compatible; 93.8% of elderly patients who stated that they had hospitalized and 88.6% of the elderly patients who stated that they applied to the emergency department, had a low compliance. (p ˂0,05)
Conclusions and Recommendations: Many factors such as age, education, other people who they live together, level of knowledge about anticoagulant medication, forgetting to use the drug, thinking the treatment damages themselves or not wanting the treatment, carrying information about medication beside themselves and using other medications without asking a doctor were found as many cases which affect the compliance with the treatment. It was found that compliance with treatment in older patients was found to be more incompatible with treatment compared to young adult patients. It is recommended that healthcare professionals in healthcare environments in our country specialize in anticoagulant therapy management and establish certification programs. It is suggested to provide effective continuity of these programs by planning trainings for patients receiving anticoagulant therapy by specialized healthcare professionals.
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Affiliation(s)
- G Arslan
- Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
| | - Y Tokem
- Izmir Katip Celebi University, Internal Medicine Nursing, Izmir, Turkey
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Onal C, Bozca R, Dolek Y, Guler O, Arslan G. PO-1382: Incidental testicular doses during volumetricmodulated ARC radiotherapy in prostate cancer patients. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01400-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
OBJECTIVE Hemopressin (Hp) is the first peptide ligand described for the CB1 cannabinoid receptor. Therefore, we aimed to investigate the effect of hemopressin on pencillin-induced epileptiform activity by using electrophysiological recording (ECoG) technique. METHODS Male Wistar rats were anesthetized with urethane (1.25 g/kg), and epileptiform activity was induced by intracortical injection of penicillin (500 IU). Animals were randomly divided into eight groups. Subsequently, the rats were administered with saline or hemopressin as follows: saline control group (Group I: 2 μl/i.c.v/saline), hemopressin groups (Group II: 0.025 μg/i.c.v; Group III: 0.075 μg/i.c.v; Group IV: 0.15 μg/i.c.v; Group V: 0.3 μg/i.c.v; Group VI: 0.6 μg/i.c.v; Group VII: 1.2 μg/i.c.v; Group VIII: 2.4 μg/i.c.v). The various doses of hemopressin were injected intracerebroventricularly (i.c.v) 30 minutes after penicillin (2.5μl) injection. After hemopressin injection, ECoGs were recorded for three hours. RESULTS Hp at doses of 0.075, 0.15, 0.3, 0.6, 1.2 and 2.4 μg/kg significantly increased the frequency of epileptiform ECoG activity compared to penicillin-injected group without changing the amplitude. The 0.6 µg hemopressin was the most effective dose to increase the epileptiform activity (p 0.05). CONCLUSIONS The results of this study provided electrophysiological evidence for hemopressin to be modulating penicillin-induced epileptiform activity by acting as CB1 receptor antagonist. Further studies are required to elucidate the involved mechanism underlying this effect (Fig. 3, Ref. 40).
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Kocum A, Turkoz A, Ulger H, Sener M, Arslan G. Ropivacaine 0.25% is as Effective as Bupivacaine 0.25% in Providing Surgical Anaesthesia for Lumbar Plexus and Sciatic Nerve Block in High-Risk Patients: Preliminary Report. Anaesth Intensive Care 2019; 35:510-4. [DOI: 10.1177/0310057x0703500408] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Ropivacaine is potentially less cardiotoxic and neurotoxic than bupivacaine. The aim of this study was to compare the effectiveness of ropivacaine 0.25% and bupivacaine 0.25% for surgical anaesthesia and postoperative analgesia during lumbar plexus and sciatic nerve block in high-risk patients. We performed combined lumbar plexus and sciatic nerve blockade on 62 consecutive ASA III or IV patients undergoing unilateral hip or femur surgery. The first 30 patients received bupivacaine (Group 1) and the remaining 32 patients received ropivacaine (Group 2). Perioperative management was otherwise similar. The groups were compared for the time of onset of the block, additional analgesics and sedatives required, time from end of surgery to the first analgesic requirement and the need for rescue analgesia. Ninety percent (29/32) of the patients in the ropivacaine group and 86% (26/30) of the patients in the bupivacaine group reached surgical anaesthesia. The time from the end of the surgery to the first analgesic requirement was similar between the two groups (10.3±5.2 hours for ropivacaine, 11.2±4.6 hours for bupivacaine). There was no statistically significant difference between the two groups in any of the measured variables (P>0.05). The results of this preliminary study suggest that ropivacaine 0.25% is as effective as bupivacaine 0.25% when used for blocking lumbar plexus and sciatic nerve in high-risk patients undergoing hip or femur surgery.
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Affiliation(s)
- A. Kocum
- Department of Anesthesiology and Reanimation, Baskent University Faculty of Medicine, Ankara, Turkey
| | - A. Turkoz
- Department of Anesthesiology and Reanimation, Baskent University Faculty of Medicine, Ankara, Turkey
| | - H. Ulger
- Department of Anesthesiology and Reanimation, Baskent University Faculty of Medicine, Ankara, Turkey
| | - M. Sener
- Department of Anesthesiology and Reanimation, Baskent University Faculty of Medicine, Ankara, Turkey
| | - G. Arslan
- Department of Anesthesiology and Reanimation, Baskent University Faculty of Medicine, Ankara, Turkey
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Abstract
Objective: To review the prevalence and location of vertebral pneumatocysts and evaluate the CT findings of these benign lesions.Material and Methods: Retrospectively we reviewed CT images of 89 patients with suspected disc disease during a 6-month period.Results: Distinctive CT pattern of intraosseous pneumatocysts involving the cervical, thoracic and lumbar spine was found. In 8 patients (9%), 10 vertebral pneumatocysts were detected. Five were located in the vertebral body and 4 of these were associated with vacuum phenomenon in adjacent intervertebral discs. Five were located near the facet joint and all were associated with vacuum phenomenon in adjacent facet joint.Conclusion: Intraosseous pneumatocyst is a benign lesion, therefore biopsy and follow-up are unnecessary. Although vertebral pneumatocysts seem to be uncommon with a few reported cases, this study shows them to be more frequent than previously thought.
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Affiliation(s)
- G Arslan
- Department of Radiology, Akdeniz University Medical Faculty, Arapsuyu, Antalya, Turkey
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Yazisiz V, Oygen S, Erbasan F, Arslan G, Gökalp E, Tazegül G, Avci A, Terzioğlu E. FRI0279 Current Immunosuppressive Drugs Are Not Enough To Treat The Pulmonary Involvement of Connective Tissue Diseases. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Onal C, Arslan G, Dolek Y, Efe E. EP-1692: Dosimetric analysis of testicular doses in prostate radiotherapy at different energy levels. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32943-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kaval E, Zeyneloglu P, Camkiran A, Sezgin A, Pirat A, Arslan G. Bispectral index-guided anesthesia on time to tracheal extubation after onpump cardiac surgery. Crit Care 2015. [PMCID: PMC4472730 DOI: 10.1186/cc14573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Türker M, Pirat A, Firat A, Pirat B, Sezgin A, Arslan G. Speckle tracking imaging for evaluation of effects of positive end-expiratory pressure level on right ventricular function. Crit Care 2015. [PMCID: PMC4471497 DOI: 10.1186/cc14218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abstract
OBJECTIVE The calcaneus is the most frequently broken tarsal bone in the setting of trauma. The diagnosis, treatment and prognosis of calcaneal fractures depend on the location and type determined by the Sanders classification. With the help of measurements on lateral view radiographs like the Böhler's angle, the angle of Gissane, the calcaneal inclination angle and the calcaneal facet height, we can predict the severity of the trauma and prognosis by assessing the collapse of the calcaneus. On computed tomography (CT), calcaneal fractures which reach into the joint space can be classified by the Sanders classification system according to the number of fragments. In this study, we tried to determine whether calcaneal fracture severity determined by angle and facet height measurements on lateral X-ray radiographs correlate with the Sanders classification. MATERIALS AND METHODS Among 69 patients diagnosed with calcaneal fractures, we performed a retrospective study by analysing the Böhler's angle, the angle of Gissane, the calcaneal inclination angle and the calcaneal facet height on digital lateral X-rays and by classifying the fractures according to the Sanders classification by CT. We compared the results of the two different imaging modalities. RESULTS We found that, as the Sanders classification type became more severe from type 1 to type 4, a general decrease was observed in the Böhler's angle, the inclination angle and the facet length, whereas a general increase was observed for the mean values of the angle of Gissane. CONCLUSION These findings suggest that measurements obtained from lateral X-rays coincide with the Sanders classification and, therefore, might indicate the prognosis.
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Affiliation(s)
- G Arslan
- Radiology Department, Erzincan Gazi Mengücek Training- Research Hospital, Erzincan, Turkey.
| | - I K Yirgin
- Radiology Department, Bakirkoy Dr. Sadi Konuk Training- Research Hospital, Istanbul, Turkey.
| | - A Tasguzen
- Radiology Department, Bakirkoy Dr. Sadi Konuk Training- Research Hospital, Istanbul, Turkey.
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Güler O, Onal C, Arslan G, Sonmez S. EP-1566: Comparison of IMRT and VMAT plans with different energy levels using monte carlo algorithm for prostate cancer. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31684-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kuslu S, Zeyneloglu P, Pirat A, Camkiran A, Ozkan M, Arslan G. Comparison of the effects of histidine-triptophan-ketoglutarate solution and crystalloid cardioplegia on myocardial protection during pediatric cardiac surgery. Crit Care 2014. [PMCID: PMC4068765 DOI: 10.1186/cc13368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Onal C, Sonmez S, Erbay G, Guler OC, Arslan G. Simultaneous integrated boost to intraprostatic lesions using different energy levels of intensity-modulated radiotherapy and volumetric-arc therapy. Br J Radiol 2013; 87:20130617. [PMID: 24319009 DOI: 10.1259/bjr.20130617] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE This study compared the dosimetry of volumetric-arc therapy (VMAT) and intensity-modulated radiotherapy (IMRT) with a dynamic multileaf collimator using the Monte Carlo algorithm in the treatment of prostate cancer with and without simultaneous integrated boost (SIB) at different energy levels. METHODS The data of 15 biopsy-proven prostate cancer patients were evaluated. The prescribed dose was 78 Gy to the planning target volume (PTV78) including the prostate and seminal vesicles and 86 Gy (PTV86) in 39 fractions to the intraprostatic lesion, which was delineated by MRI or MR-spectroscopy. RESULTS PTV dose homogeneity was better for IMRT than VMAT at all energy levels for both PTV78 and PTV86. Lower rectum doses (V30-V50) were significantly higher with SIB compared with PTV78 plans in both IMRT and VMAT plans at all energy levels. The bladder doses at high dose level (V60-V80) were significantly higher in IMRT plans with SIB at all energy levels compared with PTV78 plans, but no significant difference was observed in VMAT plans. VMAT plans resulted in a significant decrease in the mean monitor units (MUs) for 6, 10, and 15 MV energy levels both in plans with and those without SIB. CONCLUSION Dose escalation to intraprostatic lesions with 86 Gy is safe without causing serious increase in organs at risk (OARs) doses. VMAT is advantageous in sparing OARs and requiring less MU than IMRT. ADVANCES IN KNOWLEDGE VMAT with SIB to intraprostatic lesion is a feasible method in treating prostate cancer. Additionally, no dosimetric advantage of higher energy is observed.
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Affiliation(s)
- C Onal
- Department of Radiation Oncology, Baskent University Faculty of Medicine, Adana, Turkey
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Araz C, Camkiran A, Zeyneloglu P, Sezgin A, Moray G, Pirat A, Arslan G. Early-Onset Posterior Reversible Encephalopathy Syndrome After Solid Organ Transplantation in Pediatric Patients: A Report of 2 Cases. Transplant Proc 2013; 45:3555-7. [DOI: 10.1016/j.transproceed.2013.08.101] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Arslan G, Ozmen D, Haydar Sever A, Koyuncu Arslan M, Ellidokuz H, Soylu A, Lofaro D, Abu-Hanna A, Jager K, Schaefer F, Verrina E, van Stralen K, Kemper M, Oh J, Lehnhardt A, van Husen M. Paediatric nephrology - A. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kaya E, Dogancı S, Arslan G, Karabacak K, Bolcal C. OP-043 CILOSTAZOL TREATMENT IN PATIENTS SUFFERING FROM INTERMITTENT CLAUDICATION ASSOCIATED WITH BUERGER'S DISEASE. Int J Cardiol 2013. [DOI: 10.1016/s0167-5273(13)70044-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kaya E, Dogancı S, Arslan G, Karabacak K, Kadan M, Bolcal C. OP-044 EFFICIENCY OF CILOSTAZOL IN THE TREATMENT OF UPPER EXTREMITY ARTERIAL OCCLUSIVE DISEASE: GATA EXPERIENCE. Int J Cardiol 2013. [DOI: 10.1016/s0167-5273(13)70045-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Turker M, Zeyneloglu P, Pirat A, Sezgin A, Arslan G. Predictors of prolonged mechanical ventilation after heart transplantation. Crit Care 2012. [PMCID: PMC3363890 DOI: 10.1186/cc11079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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25
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Turkmen F, Isitmangil G, Berber I, Arslan G, Sevinc C, Ozdemir A. Comparison of serum creatinine and spot urine interleukin-18 levels following radiocontrast administration. Indian J Nephrol 2012; 22:196-9. [PMID: 23087555 PMCID: PMC3459524 DOI: 10.4103/0971-4065.98756] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Radiocontrast administration is an important cause of acute renal failure. In this study, compared the plasma creatinine levels with spot urine IL-18 levels following radiocontrast administration. Twenty patients (11 males, 9 females) underwent radiocontrast diagnostic and therapeutic-enhanced examinations. The RIN Mehran risk score was low (≤5). The radiocontrast agents used were 623 mg/mL Iopromid (1.5 mL/kg), and 100 mL of 650 mg/mL meglumine diatrizoate as three-way oral and rectal contrast material for abdominal computed tomography (CT) scans. Serum blood urea nitrogen, creatinine, Na, K, Cl, Ca, P, creatinine clearance, and spot urine IL-18 levels were analyzed before and repeated at 24, 48, and 72 h after radiocontrast administration. Six and 24-h urinary IL-18 levels were measured with a human IL-18 ELISA kit following radiocontrast administration. An increase in plasma creatinine 24 and 48 h following radiocontrast administration was observed compared with precontrast values, but it was not statistically significant (P=0.052 and P=0.285, respectively). A statistically significant increase in IL-18 levels was observed at 6 and 24 h, compared with precontrast values (P=0.048 and P=0.028, respectively). A tendency for postcontrast 24-h urinary IL-18 levels to increase was observed compared with 6 h, but the increase was not statistically significant (P=0.808). Our results show that plasma creatinine starts to increase at 24th hour; however, spot urine IL-18 levels go up at 6th hour following radiocontrast administration implying urine IL-18 to be an earlier parameter for kidney injury.
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Affiliation(s)
- F Turkmen
- Department of Internal Medicine, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
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26
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Arslan G. Management of restricted antibiotics. Eur J Hosp Pharm 2012. [DOI: 10.1136/ejhpharm-2012-000074.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Pirat A, Camkiran A, Zeyneloglu P, Ozkan M, Akpek E, Arslan G. Comparison of internal jugular and subclavian access for central venous catheterization in pediatric cardiac surgery. Crit Care 2012. [PMCID: PMC3363628 DOI: 10.1186/cc10817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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28
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Zeyneloglu P, Ozdemir H, Komurcu O, Bayraktar N, Sezgin A, Pirat A, Arslan G. Effects of renal-dose dopamine on renal tubular functions following coronary artery bypass grafting surgery. Crit Care 2012. [PMCID: PMC3363766 DOI: 10.1186/cc10955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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29
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Camkiran A, Kundakci A, Araz C, Pirat A, Zeyneloglu P, Arslan H, Arslan G. Predictors of multidrug-resistant Acinetobacter baumannii infections: a retrospective analysis in surgical ICU patients. Crit Care 2012. [PMCID: PMC3363462 DOI: 10.1186/cc10651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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30
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Ozdoğan O, Değirmenci B, Senocak O, Gülbahar S, Arslan G, Taşçı C, Akalın E, Durak H. Tc-99m HIG Scintigraphy in Detection of Active Inflammation in Ankylosing Spondylitis. Mol Imaging Radionucl Ther 2011; 20:52-8. [PMID: 23486228 PMCID: PMC3590946 DOI: 10.4274/mirt.21] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Accepted: 09/19/2011] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The diagnosis of active inflammation in ankylosing spondylitis (AS) is crucial for treatment to delay possible persistent deformities. There are no specific laboratory tests and imaging methods to clarify the active disease. We evaluated the value of Tc-99m human immunoglobulin (HIG) scintigraphy in detection of active inflammation. MATERIAL AND METHODS Twenty-nine patients were included. Tc-99m methylenediphosphonate bone (MDP) and HIG scintigraphies were performed within 2-5 day intervals. Two control groups were constituted both for MDP and HIG scintigraphies. Active inflammation was determined clinically and by serologic tests. Both scintigraphies were evaluated visually. Sacroiliac joint index values (SII) were calculated. RESULTS Active inflammation was considered in five (sacroiliitis in 2, sacroiliitis-spinal inflammation in 1, achilles tendinitis in 1, arthritis of coxafemoral joints in 1) patients. HIG scintigraphy demonstrated active disease in all 3 patients with active sacroiliitis. But, it was negative in the rest. The other 2 active cases were HIG negative. Right and left SII obtained from HIG scintigraphy was higher (p<0.05) in clinically active patients than inactive patients. There was not any significant difference between patients with inactive sacroiliitis and normal controls. Right and left SII obtained from bone scintigraphy was higher (p<0.05) in patient group than in control group. CONCLUSION Clinically inactive AS patients, behave no differently than normal controls with quantitative sacroiliac joint evaluation on HIG scintigraphy. HIG scintigraphy may be valuable for evaluation of sacroiliac joints in patients with unc RESULTS ertain laboratory and clinical findings. CONFLICT OF INTEREST None declared.
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Affiliation(s)
- Ozhan Ozdoğan
- Dokuz Eylül University, School of Medicine, Department of Nuclear Medicine, İzmir, Turkey
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Karakayali H, Sevmis S, Boyvat F, Aktas S, Ozcay F, Moray G, Arslan G, Haberal M. Diagnosis and treatment of late-onset portal vein stenosis after pediatric living-donor liver transplantation. Transplant Proc 2011; 43:601-4. [PMID: 21440774 DOI: 10.1016/j.transproceed.2011.01.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Portal vein stenosis is a relatively rare complication after living-donor liver transplantation, which sometimes leads to a life-threatening event owing to gastrointestinal bleeding or graft failure. This study sought to evaluate the diagnoses and management of late-onset portal vein stenosis in pediatric living-donor liver transplants. MATERIALS AND METHODS Since September 2001, we performed 123 living-donor liver transplant procedures in 120 children, among which 109 children with a functioning graft at 6 months after living-donor liver transplant are included in this analysis. Seven instances of portal vein stenosis were diagnosed and were analyzed retrospectively. RESULTS The median age of the children was 5.3 years, and the median body weight was 19.2 kg. Portal vein stenosis was diagnosed at 11.2±3.1 months after living-donor liver transplantation. Whereas 3 children were asymptomatic, splenomegaly and/or massive ascites were observed in the remaining 4. Additionally, platelet counts were below the normal limit in 4 children. All children were treated with transhepatic balloon dilatation except 1. Intraluminal stent placement was needed in 1 child owing to resistance of balloon dilatation. The mean pressure gradient decreased from 12.4 to 3.2 mmHg after successful treatment. We did not observe any treatment-related complications. Portal venous patency was maintained in all children during posttreatment follow-up of 43.2±20.4 months. There were no recurrences of portal vein stenosis. One child died; the remaining 6 children are alive with good graft function at 49.8±23.9 months of follow-up. CONCLUSION Although most portal vein stenosis is asymptomatic, splenomegaly and platelet counts are 2 important markers for portal vein stenosis. Early detection of portal vein stenosis with these 2 markers can lead to successful interventional percutaneous approaches and avoid graft loss.
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Affiliation(s)
- H Karakayali
- Department of General Surgery, Başkent University Faculty of Medicine, Ankara, Turkey
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32
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Zeyneloglu P, Pirat A, Baskin E, Camkiran A, Araz C, Ozkan M, Bayraktar N, Arslan G. Evaluation of acute kidney injury with pediatric-modified RIFLE criteria after pediatric cardiac surgery. Crit Care 2011. [PMCID: PMC3061730 DOI: 10.1186/cc9520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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33
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Zeyneloglu P, Pirat A, Veziroglu N, Sezgin A, Arslan G. Acute kidney injury after coronary artery bypass grafting surgery. Crit Care 2011. [PMCID: PMC3061731 DOI: 10.1186/cc9521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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34
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Moray G, Shahbazov R, Sevmis S, Karakayali H, Torgay A, Arslan G, Savas N, Yilmaz U, Haberal M. Liver transplantation in management of alveolar echinococcosis: two case reports. Transplant Proc 2010; 41:2936-8. [PMID: 19765480 DOI: 10.1016/j.transproceed.2009.07.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Hepatic alveolar echinococcosis is an infectious disease caused by the larval stage of Echinococcus multilocularis, which grows primarily in the liver of an infected person and develops as a tumorlike lesion. In advanced cases, the organisms infiltrate every organ neighboring the liver and spread hematogenously to distant organs such as lungs and brain. Surgical resection and liver transplantation are accepted treatment options for early and advanced disease, respectively. Herein, we present case reports of 2 patients with advanced alveolar echinococcal disease that invaded both lobes of the liver and neighboring vital structures including the inferior vena cava. Despite the technical difficulty of the surgery, both patients were successfully treated with living donor liver transplantation. Liver transplantation should be accepted as a life-saving treatment of choice in patients with alveolar echinococcosis for whom there is no other medical or surgical treatment options.
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Affiliation(s)
- G Moray
- Department of General Surgery, Faculty of Medicine, Başkent University, Ankara, Turkey
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35
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Cubuk R, Tasali N, Arslan G, Midi A, Manukyan MN, Guney S. A giant villous adenoma: case mimicking rectosigmoid malignancy; radiological survey to diagnosis. Prague Med Rep 2010; 111:76-81. [PMID: 20359441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
Villous adenomas are benign lesions, which are difficult to interpret because of their malignancy potential. They have similar radiological findings to malignant lesions. Usually, villous adenomas are asymptomatic although they may cause rectal bleeding like malignant tumours. We present a case of giant villous adenoma to evaluate the contribution of its radiological features including double contrast barium enema, computed tomography and magnetic resonance imaging examinations for the differential diagnosis.
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Affiliation(s)
- R Cubuk
- Department of Radiology, Maltepe University, Maltepe, Istanbul, Turkey.
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Pirat A, Zeyneloglu P, Kundakci A, Aydogan C, Arslan G, Haberal M. Predictors of mechanical ventilation after burn injury. Crit Care 2010. [PMCID: PMC2934568 DOI: 10.1186/cc8519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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38
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Kundakci A, Pirat A, Komurcu O, Torgay A, Karakayalı H, Arslan G, Haberal M. RIFLE criteria for acute kidney dysfunction following liver transplantation: incidence and risk factors. Crit Care 2010. [PMCID: PMC2934231 DOI: 10.1186/cc8765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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39
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Eker H, Turkoz A, Kocum AI, Cok OY, Akpinar S, Arslan G. 634 COMPARISON OF INTERSCALENE BLOCK WITH 0.25% BUPIVACAINE AND 0.25% LEVOBUPIVACAINE FOR SHOULDER SURGERY: A RANDOMIZED, DOUBLE‐BLIND STUDY. Eur J Pain 2009. [DOI: 10.1016/s1090-3801(09)60637-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- H.E. Eker
- Baskent University Teaching and Research Hospital Department of Anesthesiology, Adana, Turkey
| | - A. Turkoz
- Baskent University Teaching and Research Hospital Department of Anesthesiology, Istanbul, Turkey
| | - A. Inan Kocum
- Baskent University Teaching and Research Hospital Department of Anesthesiology, Adana, Turkey
| | - O. Yalcin Cok
- Baskent University Teaching and Research Hospital Department of Anesthesiology, Adana, Turkey
| | - S. Akpinar
- Baskent University Teaching and Research Hospital Department of Orthopaedics and Traumatology, Adana, Turkey
| | - G. Arslan
- Baskent University Ankara Teaching and Research Hospital Department of Anesthesiology, Ankara, Turkey
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40
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Onal C, Arslan G, Topkan E, Yavuz M, Oymak E, Yavuz A. 8044 Comparison of conventional and CT-based planning for intracavitary brachytherapy for cervical cancer for target volume coverage and organs at risk doses. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71566-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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41
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Haberal M, Karakayali H, Sevmis S, Akbulut S, Colak T, Baskin E, Moray G, Torgay A, Arslan G. Preemptive living donor renal transplantation: a single-center experience. Transplant Proc 2009; 41:2764-7. [PMID: 19765429 DOI: 10.1016/j.transproceed.2009.07.047] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Renal transplantation is considered preemptive if it occurs before initiation of dialysis. In our experience and in the literature, preemptive transplantation has been shown not only to reduce the costs of renal replacement therapy but also to avoid the long-term adverse effects of dialysis. Preemptive renal transplantation therefore is associated with better survival of both the allograft and the recipient. Our aim was to evaluate the outcomes of preemptive renal transplantation experience at our center. Since 1985, 1385 renal transplantations have been performed at our center. We retrospectively analyzed the 16/1385 recipients (11 male, 5 female) of overall mean age of 28.5 +/- 15 years who underwent preemptive procedures. The causes of end-stage renal failure were focal segmental glomerulosclerosis (n = 5), vesicular ureteral reflux (n = 4), Berger disease (n = 2), polycystic renal disease (n = 2), and others (n = 3). Ten patients were adults, the remaining six, children. The mean creatinine clearance and plasma creatinine levels of the recipients before renal transplantation were 13.5 +/- 8.5 mL/min and 6.7 +/- 2.4 mg/dL, respectively. All renal transplantations were performed from living related donors. The mean preoperative serum creatinine levels, mean glomerular filtration rate, and creatinine clearance rates of the donors were 0.8 +/- 0.1 mg/dL, 61.6 +/- 6.5 mL/min, and 112.5 12 mL/min, respectively. Two episodes of acute cellular rejection and one of humoral rejection occurred during a mean follow-up of 48.7 +/- 14 months (range = 25-76 months). The two patients who experienced graft losses due to humoral rejection or chronic rejection were retransplanted 2 and 48 months thereafter, respectively. At this time all patients are alive with good renal function. In conclusion, our single-center results are promising for preemptive renal transplantation as the optimal, least-expensive mode of treatment for end-stage renal disease.
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Affiliation(s)
- M Haberal
- Department of General Surgery, Başkent University Faculty of Medicine, Ankara, Turkey.
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42
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Eker H, Cok OY, Aribogan A, Arslan G. 553 THE EVALUATION OF PERIPHERAL NERVE BLOCKS WITH STEROIDS IN THE MANAGEMENT OF ACUTE AND CHRONIC NEUROPATHIC PAIN DUE TO TRAUMA. Eur J Pain 2009. [DOI: 10.1016/s1090-3801(09)60556-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- H.E. Eker
- Baskent University Teaching and Research Hospital Department of Anesthesiology, Adana, Turkey
| | - O. Yalcin Cok
- Baskent University Teaching and Research Hospital Department of Anesthesiology, Adana, Turkey
| | - A. Aribogan
- Baskent University Teaching and Research Hospital Department of Anesthesiology, Adana, Turkey
| | - G. Arslan
- Baskent University Ankara Teaching and Research Hospital Department of Anesthesiology, Ankara, Turkey
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43
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Onal C, Topkan E, Efe E, Yavuz M, Arslan G, Yavuz A. The effect of concurrent androgen deprivation and 3D conformal radiotherapy on prostate volume and clinical organ doses during treatment for prostate cancer. Br J Radiol 2009; 82:1019-26. [PMID: 19581310 DOI: 10.1259/bjr/65939531] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
In this study, we investigated the shrinking effect of concurrent three-dimensional conformal radiotherapy (3D-CRT) and androgen deprivation (AD) on prostate volume, and its possible impact on the dose received by the rectum and bladder during the course of 3D-CRT. The difference between the prostatic volumes determined on pre-treatment planning CT (PL-CT) and post-treatment CT (PT-CT) following a 3D-CRT course was assessed in 52 patients with localised prostate carcinoma. The changes in mean prostate volume when compared with PL-CT and PT-CT-based measurements were assessed. The pre- and post-treatment mean prostate volumes for the whole study population were 49.7 cm(3) and 41.0 cm(3) (p _ 0.02), respectively. The study cohort was divided into two groups depending on the duration of neoadjuvant androgen deprivation (NAD): 23 patients (44.7%) were designated as "short NAD" (< or =3 months; SNAD) and the remaining 29 (55.3%) as "long NAD" (>3 months; LNAD). Patients on SNAD experienced a significantly greater reduction in prostate volume compared with those on LNAD (14.1% vs 5.1%; p _ 0.03). A significant increase in rectum V(40-60) values in PT-CT compared with PL-CT was demonstrated. LNAD patients had significantly higher rectal V(50-70) values at PT-CT compared with the SNAD group. There was a significant decline in V(30)-V(75) bladder values in PT-CT compared with PL-CT in the SNAD group. In conclusion, a higher prostate volume reduction during 3D-CRT was demonstrated when RT planning was performed within 3 months of NAD. However, this reduction and daily organ motion may lead to an unpredictable increase in rectal doses.
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Affiliation(s)
- C Onal
- Department of Radiation Oncology, Baskent University, Adana, Turkey.
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44
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Arslan G, Pehlivan E. Uptake of Cr3+ from aqueous solution by lignite-based humic acids. Bioresour Technol 2008; 99:7597-7605. [PMID: 18358715 DOI: 10.1016/j.biortech.2008.02.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2006] [Revised: 02/01/2008] [Accepted: 02/10/2008] [Indexed: 05/26/2023]
Abstract
Humic acid (HA) produced from brown coal, a relatively abundant and inexpensive material is currently being investigated as an adsorbent to remove toxic metals from aqueous solution. The influence of five parameters (contact time, solution pH, initial metal concentration, temperature and amount of adsorbent) on the removal at 20+/-1 degrees C was studied. HAs were prepared from lignites by using alkaline extraction, sedimentation and acidic precipitation. Adsorption equilibrium was achieved in about 60 min for Cr3+ ion. The Langmuir adsorption isotherm was used to describe observed sorption phenomena. The maximum adsorption capacity of 0.17 mmol for Ilgin (HA1), 0.29 mmol for Beysehir (HA2) and 0.18 mmol Ermenek (HA3) and 0.17 mmol of Cr3+/g for activated carbon (AC) was achieved, respectively at pH of 4.1. More than 84% of Cr3+ was removed by HA2, 54% by HA3 and 51% by HA1 and 50% by AC from aqueous solution. The adsorption was strongly dependent on pH but independent of ionic strength and metal ions. The adsorption of Cr3+ was higher between pH 4.1 and 5.1 for all HAs and maximum sorption was observed at pH 4.1. The rise in temperature caused a slight decrease in the value of the equilibrium constant (Kc) for the sorption of Cr3+ ion. Complex mechanisms including ion exchange, complexation and adsorption and size exclusion are possible for sorption of Cr3+ ion on HAs.
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Affiliation(s)
- G Arslan
- Department of Chemistry, Selcuk University, Campus, 42079 Konya, Turkey
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45
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Eker HE, Yalcın Cok O, Aribogan A, Arslan G. 461. Intra-Articular Lidocaine Injection in Chronic Knee Pain Due to Osteoarthritis: Preliminary Clinical Experience in 18 Patients. Reg Anesth Pain Med 2008. [DOI: 10.1136/rapm-00115550-200809001-00420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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46
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Cok YO, Eker HE, Turkoz A, Findikcioglu A, Akin S, Aribogan A, Arslan G. 511. Effects of Thoracic Epidural Anaesthesia on Intraoperative Haemodynamics and Postoperative Analgesia for Thoracic Surgery: Levobupivacaine Versus Bupivacaine. Reg Anesth Pain Med 2008. [DOI: 10.1136/rapm-00115550-200809001-00069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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47
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Inan K, Goksel O, Uçak A, Temizkan V, Karaca K, Ugur M, Arslan G, Us M, Yılmaz A. Thoracic Endoscopic Surgery for Hyperhidrosis: Comparison of Different Techniques. Thorac Cardiovasc Surg 2008; 56:210-3. [DOI: 10.1055/s-2007-989327] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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48
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Haberal M, Telatar H, Bilgin N, Buyukpamukcu N, Kayhan B, Bayraktar Y, Arslan G, Karamehmetoglu M, Gulay H, Sert S, Uzunalimoglu B, Turan M, Koc M, Hamaloglu E. Living-related liver transplantation in an adult and a child. EXP CLIN TRANSPLANT 2008; 6:95-100. [PMID: 18816234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- M Haberal
- Turkish Transplantation and Burn Foundation Hospital Fevzi Cakmak Cad., 10. Sk., No: 45, 06490 Bahcelievler, Ankara, Turkey.
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Balci ST, Pirat A, Torgay A, Cinar O, Sevmis S, Arslan G. Effect of restrictive fluid management and acute normovolemic intraoperative hemodilution on transfusion requirements during living donor hepatectomy. Transplant Proc 2008; 40:224-7. [PMID: 18261592 DOI: 10.1016/j.transproceed.2007.12.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The aim of this study was to evaluate the safety and effectiveness of a restrictive fluid management strategy and acute normovolemic intraoperative hemodilution (ANIH) to decrease transfusion requirements among living-donors for liver transplantation (LDLT). We retrospectively reviewed the data of 114 consecutive LDLT donors. The patients were divided into 2 groups based on whether (Group I; n = 73) or not (Group II; n = 41) a restrictive fluid management strategy with ANIH was used during the procedure. For each group we recorded demographic features, intraoperative and postoperative transfusions, amount of administered intraoperative crystalloid and colloids, intraoperative hemodynamics, preoperative and postoperative laboratory values (renal and liver functions), intraoperative and postoperative urine output, and length of hospital stay. Demographic features and preoperative laboratory values were similar for the 2 groups, except for age (Group I, 36 +/- 9 vs Group II, 33 +/- 8; P = .04). Intraoperatively, 7 patients (10%) in Group 1 and 9 (22%) in Group II required blood transfusions (P = .06). The respective amount of heterologous blood transfusion for Groups I and II was 96 +/- 321 mL vs 295 +/- 678 mL (P = .06). Postoperative renal and liver functions were not different between the 2 groups (P > .05). Patients in Group I had a shorter hospital stay than those in Group II (8.2 +/- 4.6 days vs 10.1 +/- 4.9 days; P = .03). In conclusion, a restrictive fluid management strategy with ANIH was a safe blood-salvage technique for LDLT. This approach was also associated with decreased length of hospital stay and a trend toward decreased transfusion requirements.
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Affiliation(s)
- S T Balci
- Department of Anesthesiology, Baskent University Faculty of Medicine, Ankara, Turkey.
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Zeyneloglu P, Pirat A, Balci ST, Torgay A, Cinar O, Sevmis S, Arslan G. A comparison of right and left lobectomies for living donor liver transplantation: an anesthesiologist's point of view. Transplant Proc 2008; 40:53-6. [PMID: 18261546 DOI: 10.1016/j.transproceed.2007.11.057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Because of the shortage of cadaveric donor organs, living donor liver transplantation (LDLT) has become an established therapy modality for end-stage liver disease. Based on recipient size, both right and left liver lobe grafts have been used successfully in LDLT. The aim of this study was to compare the risk of intraoperative complications and transfusion requirements between right and left lobe donors. We reviewed the charts of 54 right lobe (Group RL), 29 left lobe (Group LL), and 31 left lateral segment (Group LLS) donors who underwent lobectomy from January 2003 through January 2007. We recorded patient demographics, perioperative laboratory values, intraoperative fluid and transfusion requirements, intraoperative hemodynamic parameters, and complications. Demographic features and preoperative laboratory values were similar for the 3 groups, except for age (Group RL, 37.3 +/- 8.7; Group LL, 36.0 +/- 9.3; Group LLS, 31.7 +/- 9.4; P = .02). There were no significant differences in mean liver volumes among the groups (P > .05). Respective graft volumes were 803.1 +/- 139.2 mL, 438.0 +/- 122.7 mL, and 308.2 +/- 76.6 mL for Groups RL, LL, and LLS, respectively (P < .001). More patients in Group LLS required heterologous blood transfusion than did those in the other groups (P = .01). The incidence of intraoperative hypotension was similar for all groups (P > .05). Group RL had a significantly higher rate of intraoperative hypothermia than the other groups (P = .01). There were no intraoperative respiratory complications or cardiac events. These results indicated that both right and left donor lobectomies for LDLT were safe procedures with acceptable rates of minor intraoperative complications.
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Affiliation(s)
- P Zeyneloglu
- Department of Anesthesiology, Baskent University Faculty of Medicine, Ankara, Turkey.
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