1
|
Sørensen DM, Bostock H, Abrahao A, Alaamel A, Alaydin HC, Ballegaard M, Boran E, Cengiz B, de Carvalho M, Dunker Ø, Fuglsang-Frederiksen A, Graffe CC, Jones KE, Kallio M, Kalra S, Krarup C, Krøigård T, Liguori R, Lupescu T, Maitland S, Matamala JM, Moldovan M, Moreno-Roco J, Nilsen KB, Phung L, Santos MO, Themistocleous AC, Uysal H, Vacchiano V, Whittaker RG, Zinman L, Tankisi H. Estimating motor unit numbers from a CMAP scan: Repeatability study on three muscles at 15 centres. Clin Neurophysiol 2023; 151:92-99. [PMID: 37236129 DOI: 10.1016/j.clinph.2023.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 01/04/2023] [Revised: 03/16/2023] [Accepted: 04/15/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To assess the repeatability and suitability for multicentre studies of MScanFit motor unit number estimation (MUNE), which involves modelling compound muscle action potential (CMAP) scans. METHODS Fifteen groups in 9 countries recorded CMAP scans twice, 1-2 weeks apart in healthy subjects from abductor pollicis brevis (APB), abductor digiti minimi (ADM) and tibialis anterior (TA) muscles. The original MScanFit program (MScanFit-1) was compared with a revised version (MScanFit-2), designed to accommodate different muscles and recording conditions by setting the minimal motor unit size as a function of maximum CMAP. RESULTS Complete sets of 6 recordings were obtained from 148 subjects. CMAP amplitudes differed significantly between centres for all muscles, and the same was true for MScanFit-1 MUNE. With MScanFit-2, MUNE differed less between centres but remained significantly different for APB. Coefficients of variation between repeats were 18.0% for ADM, 16.8% for APB, and 12.1% for TA. CONCLUSIONS It is recommended for multicentre studies to use MScanFit-2 for analysis. TA provided the least variable MUNE values between subjects and the most repeatable within subjects. SIGNIFICANCE MScanFit was primarily devised to model the discontinuities in CMAP scans in patients and is less suitable for healthy subjects with smooth scans.
Collapse
Affiliation(s)
- D M Sørensen
- Department of Clinical Neurophysiology, Aarhus University Hospital, Denmark
| | - H Bostock
- UCL Queen Square Institute of Neurology, Queen Square, London, United Kingdom
| | - A Abrahao
- Department of Medicine, University of Toronto, Toronto, Canada
| | - A Alaamel
- Department of Neurology, Akdeniz University Hospital, Antalya, Turkey
| | - H C Alaydin
- Department of Neurology, Gazi University, Ankara, Turkey
| | - M Ballegaard
- Department of Clinical Neurology, Zealand University Hospital, Roskilde, Denmark
| | - E Boran
- Department of Neurology, Gazi University, Ankara, Turkey
| | - B Cengiz
- Department of Neurology, Gazi University, Ankara, Turkey
| | - M de Carvalho
- Faculty of Medicine, iMM, Centro de Estudos Egas Moniz, Universidade de Lisboa, Department of Neurosciences and Mental Health, CHULN, Lisbon, Portugal
| | - Ø Dunker
- Department of Neurology and Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Norway
| | - A Fuglsang-Frederiksen
- Department of Clinical Neurophysiology, Aarhus University Hospital, Denmark; Department of Clinical Institute, Aarhus University, Aarhus, Denmark
| | - C C Graffe
- Department of Clinical Neurophysiology, Rigshospitalet, Copenhagen, Denmark
| | - K E Jones
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada
| | - M Kallio
- Department of Clinical Neurophysiology, Oulu University Hospital, Oulu, Finland
| | - S Kalra
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada
| | - C Krarup
- Department of Clinical Neurophysiology, Rigshospitalet, Copenhagen, Denmark
| | - T Krøigård
- Department of Neurology, Odense University Hospital, Denmark
| | - R Liguori
- Dipertimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - T Lupescu
- Department of Neurology, Agrippa Ionescu Hospital, Bucharest, Romania
| | - S Maitland
- Translational and Clinical Research Institute, Newcastle University, United Kingdom
| | - J M Matamala
- Translational Neurology and Neurophysiology Lab, Department of Neurological Sciences and Biomedical Neuroscience Institute, University of Chile, Santiago, Chile
| | - M Moldovan
- Department of Clinical Neurophysiology, Rigshospitalet, Copenhagen, Denmark
| | - J Moreno-Roco
- Translational Neurology and Neurophysiology Lab, Department of Neurological Sciences and Biomedical Neuroscience Institute, University of Chile, Santiago, Chile
| | - K B Nilsen
- Department of Neurology and Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Norway
| | - L Phung
- Department of Medicine, University of Toronto, Toronto, Canada
| | - M O Santos
- Faculty of Medicine, iMM, Centro de Estudos Egas Moniz, Universidade de Lisboa, Department of Neurosciences and Mental Health, CHULN, Lisbon, Portugal
| | - A C Themistocleous
- Nuffield Department of Clinical Neurosciences University of Oxford, Oxford, United Kingdom
| | - H Uysal
- Department of Medicine, University of Toronto, Toronto, Canada
| | - V Vacchiano
- Dipertimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - R G Whittaker
- Translational and Clinical Research Institute, Newcastle University, United Kingdom
| | - L Zinman
- UCL Queen Square Institute of Neurology, Queen Square, London, United Kingdom
| | - H Tankisi
- Department of Clinical Neurophysiology, Aarhus University Hospital, Denmark; Department of Clinical Institute, Aarhus University, Aarhus, Denmark.
| |
Collapse
|
2
|
Calim M, Uysal H, Kahraman Ay N, Karaaslan K, Daskaya H. Utility of the gastro-laryngeal tube during transesophageal echocardiography: A prospective randomized clinical trial. Medicine (Baltimore) 2022; 101:e32269. [PMID: 36550887 PMCID: PMC9771168 DOI: 10.1097/md.0000000000032269] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND To validate the utility and performance of the gastro-laryngeal tube (GLT) in terms of cardiologist and patient satisfaction levels, incidence of and attempts at successful transesophageal echocardiography (TEE) probe placement, perioperative and postoperative hemodynamics, and adverse events related to the TEE procedure. METHODS In this randomized prospective clinical study, forty-four patients undergoing TEE and aged 20 to 80 years old scheduled for TEE were randomly allocated to two study groups: Group SA (sedation and analgesia) and Group GLT. Cardiologist and patient satisfaction levels, TEE probe placement performance, hemodynamics, adverse events related to the TEE procedure, demographic characteristics, and TEE procedure data were recorded. RESULTS The cardiologist satisfaction level was significantly higher in Group GLT (P = .011). The TEE probe was successfully placed at the first attempt in all the patients in Group GLT and at the first attempt in 11 patients, at the second attempt in 8 patients, and at the third attempt in 3 patients in Group SA. The TEE probe placement success was significantly higher in Group GLT (P < .001), and TEE probe placement was significantly easier in Group GLT (P < .001). There were no significant differences in patient satisfaction, heart rate, mean arterial pressure, oxygen saturation, adverse events related to the TEE procedure between the groups. CONCLUSION The present study revealed that GLT use elicited a higher cardiologist satisfaction level and resulted in more successful and easier TEE probe placement. We thus conclude that the use of the recently developed GLT may ensure airway management safety and a comfortable TEE experience.
Collapse
Affiliation(s)
- Muhittin Calim
- Department of Anesthesiology and Reanimation, Bezmialem Vakif University School of Medicine, Istanbul, Turkey
- * Correspondence: Muhittin Calim, Department of Anesthesiology and Reanimation, Bezmialem Vakif University School of Medicine, Istanbul 34093, Turkey (e-mail: )
| | - Harun Uysal
- Department of Anesthesiology and Reanimation, Bezmialem Vakif University School of Medicine, Istanbul, Turkey
| | - Nuray Kahraman Ay
- Department of Cardiology, Bezmialem Vakif University School of Medicine, Istanbul, Turkey
| | - Kazim Karaaslan
- Department of Anesthesiology and Reanimation, Bezmialem Vakif University School of Medicine, Istanbul, Turkey
| | - Hayrettin Daskaya
- Department of Anesthesiology and Reanimation, Bezmialem Vakif University School of Medicine, Istanbul, Turkey
| |
Collapse
|
3
|
Koc S, Hanikoglu F, Dokur M, Polat Y, Celebi S, Koc SG, Kupeli I, Uysal H. Comparison of Cytokine Hemadsorption as an Immunomodulator Therapy in COVID-19 Patients with and without Bacterial Sepsis. Clin Lab 2022; 68. [PMID: 36250840 DOI: 10.7754/clin.lab.2022.211249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND In this retrospective study, we aimed to compare the laboratory and clinical results of cytokine hem-adsorption as an immunomodulation therapy in COVID-19 ICU patients with or without sepsis. METHODS The levels of PCT, CRP, and ferritin were determined as indicators of infection/sepsis; the levels of in-terleukins (IL-6, IL-8 and IL-10, and TNF-α) were determined as indicators of cytokine storm were compared. APACHE score, SOFA score, and mortality rates were compared for the progression of the disease in 23 COVID-19 patients. RESULTS The therapy was generally successful in reducing the levels of IL-6, IL-8, IL-10, and TNF-α but the levels measured after the procedure did not differ among the patients with or without sepsis, suggesting that the presence of sepsis did not affect the efficacy and function of the cytokine hemadsorption procedure in COVID-19 patients. All parameters were reduced after the procedure except the levels of PCT and ferritin and mortality rates of patients diagnosed with sepsis. The level of PCT was significantly higher in these patients compared with the patients without sepsis while the ferritin and mortality did not show any significant difference between the two groups, suggesting that the cytokine hemadsorption may be safe in the treatment of critical COVID-19 patients. CONCLUSIONS As a result, the progression of sepsis in COVID-19 may be avoided with cytokine hemadsorption applied as an immunomodulator therapy. However, this therapy should be further explored and validated prior to its introduction to everyday clinical practice when the epidemic conditions end.
Collapse
|
4
|
Koc S, Dokur M, Uysal H. Analysis of the effects of ha-330 hemo adsorption column application on mortality and morbidity of adult patients with sepsis in general intensive care unit. Med-Science 2022. [DOI: 10.5455/medscience.2021.09.320] [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
|
5
|
|
6
|
Bakan M, Umutoglu T, Topuz U, Guler EY, Uysal H, Ozturk E. Prospective evaluation of remifentanil-propofol mixture for total intravenous anesthesia: A randomized controlled study. Exp Ther Med 2021; 22:1198. [PMID: 34584543 PMCID: PMC8422392 DOI: 10.3892/etm.2021.10632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 01/18/2021] [Indexed: 01/02/2023] Open
Abstract
Application of total intravenous anesthesia (TIVA) may be considered as unpractical when compared with inhalational anesthesia. Although it is mostly not recommended, mixing intravenous agents is popular in clinical practice. The aim of the present study was to investigate the suitability of using remifentanil-propofol mixture (MIXTIVA) for TIVA. Adult patients with an American Society of Anesthesiologists grade of I-II scheduled for elective thyroidectomy were randomly allocated to 3 groups (n=32 for each) to receive TIVA with remifentanil and propofol infusions separately (control group, Group I) or with MIXTIVA infusion that contained remifentanil/propofol at a proportion of 2/1,000 or 3/1,000 (remifentanil concentration, 20 or 30 µg/ml in 1% propofol in Group II or Group III, respectively). The extubation time (the primary outcome of the study), the orientation time and number of patients in whom intraoperative hypotension, hypertension or bradycardia episodes were encountered during anesthesia were comparable among the groups. The mean remifentanil infusion rate in Group III was significantly higher than that in the other groups. The mean propofol infusion rates and mean bispectral index (BIS) scores during anesthesia were comparable among groups. Hypotension accompanied with a high BIS was encountered in one patient in Group III. In conclusion, compared to the standard TIVA technique using separate drug infusions, MIXTIVA infusion used for thyroidectomies did not result in any statistically significant difference in recovery and clinical outcomes. This technique may be considered as a practical implementation for busy ambulatory centers performing general anesthesia. The present study was retrospectively registered at clinicaltrials.gov (trial registration no. NCT04394897).
Collapse
Affiliation(s)
- Mefkur Bakan
- Department of Anesthesiology, Vocational School of Health Services, Istanbul Rumeli University, Silivri, Istanbul 34570, Turkey
| | - Tarik Umutoglu
- Deparment of Anesthesiology, Istanbul Health and Technology University, Zeytinburnu, Istanbul 34015, Turkey
| | - Ufuk Topuz
- Department of Anesthesiology, Vocational School of Health Services, Istanbul Rumeli University, Silivri, Istanbul 34570, Turkey
| | - Emine Yilmaz Guler
- Department of Anesthesiology, Ministry of Health Haseki Training and Research Hospital, Fatih, Istanbul 34130, Turkey
| | - Harun Uysal
- Department of Anesthesiology, Bezmialem Vakif University, Fatih, Istanbul 34093, Turkey
| | - Erdogan Ozturk
- Department of Anesthesiology, Türk Böbrek Vakfı Memorial Hizmet Hospital, Bahçelievler, Istanbul 34180, Turkey
| |
Collapse
|
7
|
Sümer I, Uysal H, Yeşiltaş S, Türkay M. The Effect of Intraoperative Body Temperature on Postoperative Nausea and Vomiting in Pediatric Patients. J Perianesth Nurs 2021; 36:706-710. [PMID: 34362639 DOI: 10.1016/j.jopan.2021.04.012] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/25/2021] [Accepted: 04/06/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE Pediatric patients are at greater risk for both perioperative hypothermia and postoperative nausea and vomiting (PONV). The primary aim of this study was to investigate whether there is a relationship between intraoperative body temperature and PONV in children undergoing anesthesia. The secondary aim was to investigate the relationship between PONV and intraoperative fentanyl use, age and duration of operation. DESIGN A prospective cohort study METHODS: The study included 80 children who were undergoing lower abdominal surgery. Body temperature was monitored after routine preoperative preparation and standard induction. Analgesic and antiemetic requirements and the presence of nausea and vomiting were assessed postoperatively on the 30th minute and the 6th, 12th and 24th hour. FINDINGS The children with or without PONV were compared. At the postoperative 6th hour, the incidence of nausea was statistically significant in the children with a mean body temperature below 36°C (P = 0.044; P < 0.05). The mean duration of the surgery was statistically significant longer in the children with PONV (P = 0.001; P = 0.004; P <0.05). Mean body temperature was not statistically significant when comparing children with and without vomiting(P > 0.05). CONCLUSION While a body temperature below 36°C increases the incidence of postoperative nausea, it does not cause an increase in the incidence of vomiting. A long operation time in pediatric patients causes an increase in the incidence of PONV. Although not statistically significant, PONV is encountered more than twice as much in patients receiving intraoperative fentanyl administration.
Collapse
Affiliation(s)
- Ismail Sümer
- Department of Anesthesiology, Bezmialem Vakıf University, Istanbul, Turkey.
| | - Harun Uysal
- Department of Anesthesiology, Bezmialem Vakıf University, Istanbul, Turkey
| | - Serdar Yeşiltaş
- Department of Anesthesiology, Bezmialem Vakıf University, Istanbul, Turkey
| | - Meltem Türkay
- Department of Anesthesiology, Bezmialem Vakıf University, Istanbul, Turkey
| |
Collapse
|
8
|
Daskaya H, Yilmaz S, Uysal H, Calim M, Sümbül B, Yurtsever I, Karaaslan K. Usefulness of oxidative stress marker evaluation at admission to the intensive care unit in patients with COVID-19. J Int Med Res 2021; 49:3000605211027733. [PMID: 34310245 PMCID: PMC8320569 DOI: 10.1177/03000605211027733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Two critical processes in the coronavirus disease 2019 (COVID-19) pandemic involve assessing patients' intensive care needs and predicting disease progression during patients' intensive care unit (ICU) stay. We aimed to evaluate oxidative stress marker status at ICU admission and ICU discharge status in patients with COVID-19. METHODS We included patients in a tertiary referral center ICU during June-December 2020. Scores of Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), and clinical severity, radiologic scores, and healthy discharge status were noted. We collected peripheral blood samples at ICU admission to evaluate total antioxidants, total oxidants, catalase, and myeloperoxidase levels. RESULTS Thirty-one (24 male, 7 female) patients were included. At ICU admission, patients' mean APACHE II score at ICU admission was 17.61 ± 8.9; the mean SOFA score was 6.29 ± 3.16. There was no significant relationship between clinical severity and oxidative stress (OS) markers nor between radiological imaging and COVID-19 data classification and OS levels. Differences in OS levels between patients with healthy and exitus discharge status were not significant. CONCLUSIONS We found no significant relationship between oxidative stress marker status in patients with COVID-19 at ICU admission and patients' ICU discharge status.
Collapse
Affiliation(s)
- Hayrettin Daskaya
- Department of Anesthesiology and Reanimation, Bezmialem Vakif University, Medical Faculty, Istanbul, Turkey
| | - Sinan Yilmaz
- Department of Anesthesiology and Reanimation, Bezmialem Vakif University, Medical Faculty, Istanbul, Turkey
| | - Harun Uysal
- Department of Anesthesiology and Reanimation, Bezmialem Vakif University, Medical Faculty, Istanbul, Turkey
| | - Muhittin Calim
- Department of Anesthesiology and Reanimation, Bezmialem Vakif University, Medical Faculty, Istanbul, Turkey
| | - Bilge Sümbül
- Department of Medical Microbiology, Bezmialem Vakif University, Medical Faculty, Istanbul, Turkey
| | - Ismail Yurtsever
- Department of Radiology, Bezmialem Vakif University, Medical Faculty, Istanbul, Turkey
| | - Kazım Karaaslan
- Department of Anesthesiology and Reanimation, Bezmialem Vakif University, Medical Faculty, Istanbul, Turkey
| |
Collapse
|
9
|
Uysal H, Senturk H, Calim M, Daskaya H, Guney IA, Karaaslan K. Comparison of LMA® gastro airway and gastro-laryngeal tube in endoscopic retrograde cholangiopancreatography: a prospective randomized observational trial. Minerva Anestesiol 2021; 87:987-996. [PMID: 33982986 DOI: 10.23736/s0375-9393.21.15371-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND New generation airway devices with different designs have been developed as an alternative to endotracheal intubation in order to avoid adverse events associated with sedation in endoscopic procedures and to provide patent airway. We aimed to compare two supraglottic airway devices (SGADs), the LMA®GastroTM Airway and Gastro Laryngeal Tube (GLT), in terms of airway efficiency, performance during procedure and adverse events in Endoscopic Retrograde Cholangiopancreatography (ERCP). METHODS A hundred-three ERCP patients without high risk of aspiration were included. Patients were randomly allocated to the LMA Gastro and GLT groups. The primary study outcomes were the comparison of the two SGADs in terms of oropharyngeal leak pressure (OLP). Secondary study outcome was SGADs-related adverse events. RESULTS Procedures were completed with SGADs in fifty patients in each group. The rate of successful insertion at first attempt was 72% in GLT and 96% in LMA Gastro (p=0.004). The mean OLP of LMA Gastro Group (31.8cm H2O) was significantly higher than that of the GLT Group (26.5cm H2O), (p=0.0001). However endoscopists' satisfaction was higher in GLT (p=0.0001). Mucosal damage and sore throat were lower in LMA Gastro Group. CONCLUSIONS LMA® Gastro™ had a higher OLP than GLT. However, GLT was better for endoscopist satisfaction, as it provides more satisfying maneuverability. As to secondary outcome advers events were lower in LMA® Gastro™. The lower complication rates associated with the device and providing a more patent airway also highlighted the apparent clinical efficacy of LMA® Gastro™ than GLT, in ERCP.
Collapse
Affiliation(s)
- Harun Uysal
- Department of Anesthesiology and Reanimation, Bezmialem Vakif University Medical Faculty, Istanbul, Turkey -
| | - Hakan Senturk
- Department of Gastroenterology and Hepatology, Bezmialem Vakif University Medical Faculty, Istanbul, Turkey
| | - Muhittin Calim
- Department of Anesthesiology and Reanimation, Bezmialem Vakif University Medical Faculty, Istanbul, Turkey
| | - Hayrettin Daskaya
- Department of Anesthesiology and Reanimation, Bezmialem Vakif University Medical Faculty, Istanbul, Turkey
| | - Ibrahim A Guney
- Department of Anesthesiology and Reanimation, Bezmialem Vakif University Medical Faculty, Istanbul, Turkey
| | - Kazim Karaaslan
- Department of Anesthesiology and Reanimation, Bezmialem Vakif University Medical Faculty, Istanbul, Turkey
| |
Collapse
|
10
|
Ikitimur H, Borku Uysal B, Cengiz M, Ikitimur B, Uysal H, Ozcan E, Islamoglu MS, Seyhan S, Yavuzer H, Yavuzer S. Determining host factors contributing to disease severity in a family cluster of 29 hospitalized SARS-CoV-2 patients: Could genetic factors be relevant in the clinical course of COVID-19? J Med Virol 2020; 93:357-365. [PMID: 32492209 PMCID: PMC7300487 DOI: 10.1002/jmv.26106] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 05/05/2020] [Accepted: 05/31/2020] [Indexed: 02/02/2023]
Abstract
In this study, we report a large family cluster consisting of 29 genetically related patients hospitalized with coronavirus disease‐2019 (COVID‐19). We sought to determine the clinical characteristics relevant to the clinical course of COVID‐19 by comparing the family cluster to unrelated patients with SARS‐CoV‐2 infection so that the presence of potential determinants of disease severity, other than traditional risk factors previously reported, could be investigated. Twenty‐nine patient files were investigated in group 1 and group 2 was created with 52 consecutive patients with COVID‐19 having age and gender compatibility. The virus was detected for diagnosis. The clinical, laboratory and imaging features of all patients were retrospectively screened. Disease course was assessed using records regarding outcome from patient files retrospectively. Groups were compared with respect to baseline characteristics, disease severity on presentation, and disease course. There was no difference between the two groups in terms of comorbidity and smoking history. In terms of inhospital treatment, use differed not significantly between two groups. We found that all 29 patients in the group 1 had severe pneumonia, 18 patients had severe pneumonia. Hospitalization rates, length of hospital stay, and transferred to intensive care unit were found to be statistically significantly higher in the group 1. In the present study, COVID‐19 cases in the large family cluster were shown to have more severe disease and worse clinical course compared with consecutive patients with COVID‐19 presenting to the same time. We believe further studies into potential genetic mechanisms of host susceptibility to COVID‐19 should include such family clusters.
Collapse
Affiliation(s)
- Hande Ikitimur
- Department of Pulmonary Diseases, Biruni University, Istanbul, Turkey
| | - Betul Borku Uysal
- Department of Internal Medicine, Medical Faculty, Biruni University, Istanbul, Turkey
| | - Mahir Cengiz
- Department of Internal Medicine, Medical Faculty, Biruni University, Istanbul, Turkey
| | - Barış Ikitimur
- Department of Cardiology, Cerrahpaşa School of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Harun Uysal
- Department of Anesthesiology and Reanimation, Bezmialem Vakif University, Istanbul, Turkey
| | - Erkan Ozcan
- Department of Internal Medicine, Medical Faculty, Biruni University, Istanbul, Turkey
| | - Mehmet Sami Islamoglu
- Department of Internal Medicine, Medical Faculty, Biruni University, Istanbul, Turkey
| | - Serhat Seyhan
- Department of Medical Genetics, Medical Faculty, Biruni University, Istanbul, Turkey
| | - Hakan Yavuzer
- Division of Geriatrics, Department of Internal Medicine, Cerrahpaşa School of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Serap Yavuzer
- Department of Internal Medicine, Medical Faculty, Biruni University, Istanbul, Turkey
| |
Collapse
|
11
|
Borku Uysal B, Ikitimur H, Yavuzer S, Ikitimur B, Uysal H, Islamoglu MS, Ozcan E, Aktepe E, Yavuzer H, Cengiz M. Tocilizumab challenge: A series of cytokine storm therapy experiences in hospitalized COVID-19 pneumonia patients. J Med Virol 2020; 92:2648-2656. [PMID: 32484930 PMCID: PMC7300754 DOI: 10.1002/jmv.26111] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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: 05/21/2020] [Accepted: 05/29/2020] [Indexed: 12/19/2022]
Abstract
To recognize the period of exaggerated cytokine response in patients with coronavirus disease 2019 (COVID‐19) pneumonia, and to describe the clinical outcomes of using tocilizumab as a treatment option. The data of 12 adult COVID‐19 pneumonia patients who were followed in the inpatient clinics of Biruni University Medical Faculty Hospital (Istanbul, Turkey) were retrospectively analyzed. Diagnostic tests, laboratory examinations, clinical findings, and computed tomography of the thorax imaging results were evaluated. A dramatic laboratory and clinical improvement was observed in 83% (10 out of 12) of patients after tocilizumab. In 17% (2 out of 12) of our patients, short‐term ventilator support was required in the intensive care unit. The longest hospital stay was 18 days. However, in the end, all of our patients were discharged home with good health. Although arterial oxygen saturations (87.58 ± 3.12%) dropped in room air in the pre‐tocilizumab period, post‐tocilizumab they normalized in all patients (94.42 ± 1%). None of them had fever after tocilizumab treatment and the levels of C‐reactive protein (13.08 ± 12.89) were almost within normal limits. Eosinophil values were quite low at the time of diagnosis (10 ± 17.06), but increased significantly post‐tocilizumab (155.33 ± 192.69). There is currently no proven treatment for COVID‐19 induced by novel coronavirus SARS‐CoV‐2. Based on our experience with twelve adult COVID‐19 pneumonia patients, we can say that tocilizumab, an IL‐6 inhibitor, is more beneficial in preventing the damage caused by excessive cytokine response in the body if administered at the right time and provides clinical and radiological recovery.
Collapse
Affiliation(s)
- Betul Borku Uysal
- Department of Internal Medicine, Faculty of Medicine, Biruni University, Istanbul, Turkey
| | - Hande Ikitimur
- Department of Pulmonary Diseases, Faculty of Medicine, Biruni University, Istanbul, Turkey
| | - Serap Yavuzer
- Department of Internal Medicine, Faculty of Medicine, Biruni University, Istanbul, Turkey
| | - Baris Ikitimur
- Department of Cardiology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Harun Uysal
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Mehmet Sami Islamoglu
- Department of Internal Medicine, Faculty of Medicine, Biruni University, Istanbul, Turkey
| | - Erkan Ozcan
- Department of Internal Medicine, Faculty of Medicine, Biruni University, Istanbul, Turkey
| | - Emre Aktepe
- Department of Infectious Disease, Faculty of Medicine, Biruni University, Istanbul, Turkey
| | - Hakan Yavuzer
- Department of Internal Medicine, Division of Geriatrics, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Mahir Cengiz
- Department of Internal Medicine, Faculty of Medicine, Biruni University, Istanbul, Turkey
| |
Collapse
|
12
|
Kuraszkiewicz B, Goszczyńska H, Podsiadły-Marczykowska T, Piotrkiewicz M, Andersen P, Gromicho M, Grosskreutz J, Kuźma-Kozakiewicz M, Petri S, Stubbendorf B, Szacka K, Uysal H, de Carvalho M. Potential Preventive Strategies for Amyotrophic Lateral Sclerosis. Front Neurosci 2020; 14:428. [PMID: 32528241 PMCID: PMC7264408 DOI: 10.3389/fnins.2020.00428] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 04/07/2020] [Indexed: 12/11/2022] Open
Abstract
It may seem useless to propose preventive measures for a disease without established pathogenesis and successful therapy, such as amyotrophic lateral sclerosis (ALS). However, we will show that ALS shares essential molecular mechanisms with aging and that established anti-aging strategies, such as healthy diet or individually adjusted exercise, may be successfully applied to ameliorate the condition of ALS patients. These strategies might be applied for prevention if persons at ALS risk could be identified early enough. Recent research advances indicate that this may happen soon.
Collapse
Affiliation(s)
- B Kuraszkiewicz
- Department of Methods of Brain Imaging and Functional Research of Nervous System, Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - H Goszczyńska
- Department of Methods of Brain Imaging and Functional Research of Nervous System, Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - T Podsiadły-Marczykowska
- Department of Methods of Brain Imaging and Functional Research of Nervous System, Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - M Piotrkiewicz
- Department of Methods of Brain Imaging and Functional Research of Nervous System, Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - P Andersen
- Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - M Gromicho
- Institute of Physiology, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - J Grosskreutz
- Department of Neurology, University Hospital Jena, Jena, Germany.,Jena Centre for Healthy Aging, University Hospital Jena, Jena, Germany
| | | | - S Petri
- Clinic for Neurology, Hannover Medical School, Hanover, Germany
| | - B Stubbendorf
- Department of Neurology, University Hospital Jena, Jena, Germany
| | - K Szacka
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
| | - H Uysal
- Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - M de Carvalho
- Institute of Physiology, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| |
Collapse
|
13
|
Degirmenci N, Ozdem A, Uysal H, Sen P, Senturk E, Ozturan O, Turkoz A. The Effect of Sphenopalatine Ganglion Block on the Postoperative Pain in Patients Undergoing Septorhinoplasty. Ann Otol Rhinol Laryngol 2020; 129:722-726. [PMID: 32090594 DOI: 10.1177/0003489420909417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study aimed to evaluate the effect of preoperative sphenopalatine ganglion block (SPBG) on the postoperative pain (POP) in patients undergoing septorhinoplasty (SRP). METHODS A retrospective cohort study was performed. A total of 42 patients that had received septorhinoplasty included in the study. The patients that had received SPBG before the surgery included in the Block group (n:20) and the patients that had not received SPBG before the surgery included in the Control group (n:22). POP was questioned with a numeric rating scale (NRS) at the 30th minute (t1), 1st hour (t2), 4th hour (t3), 12th hour (t4), and 24th hour (t5) and noted. The intraoperative details and the dose of the postoperative rescue analgesics were also noted. RESULTS The average dose of Paracetamol that was used in the postoperative first 24 hours was 500 mg in the Block group and 1363 mg in the Control group, and the difference was statistically significant (P = .001). The average dose of Tramadol was 0 mg in the Block group and 45 mg in the Control group, and the difference was statistically significant (P = .001). There was a statistically significant difference among the groups with respect to NRS in the first 24 hours postoperatively (P < .05). The number of the patients requiring rescue analgesics was lower in the Block group than the Control group. The difference was statistically significant at the t1, t2, and t5 time intervals (P > .05). CONCLUSIONS Preoperative SPGB is an effective option to reduce POP and the need for rescue analgesics for patients undergoing SRP. CLINICAL TRIAL NUMBER NCT04020393.
Collapse
Affiliation(s)
- Nazan Degirmenci
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical Faculty, Bezmialem Vakif University, Istanbul, Turkey
| | - Abdullah Ozdem
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical Faculty, Bezmialem Vakif University, Istanbul, Turkey
| | - Harun Uysal
- Department of Anesthesiology and Reanimation, Medical Faculty, Bezmialem Vakif University, Istanbul, Turkey
| | - Pelin Sen
- Department of Anesthesiology and Reanimation, Medical Faculty, Bezmialem Vakif University, Istanbul, Turkey
| | - Erol Senturk
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical Faculty, Bezmialem Vakif University, Istanbul, Turkey
| | - Orhan Ozturan
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical Faculty, Bezmialem Vakif University, Istanbul, Turkey
| | - Ayda Turkoz
- Department of Anesthesiology and Reanimation, Medical Faculty, Bezmialem Vakif University, Istanbul, Turkey
| |
Collapse
|
14
|
Erbin A, Ucpinar B, Cubuk A, Yazici O, Uysal H, Savun M, Basal S, Akbulut MF. The Impact of Sheath Size in Miniaturized Percutaneous Nephrolithotomy in Adult Patients; A Matched-pair Analysis. Urol J 2019; 16:536-540. [PMID: 30882171 DOI: 10.22037/uj.v0i0.4676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE The miniaturized percutaneous nephrolithotomy (mPNL) can be performed by using a very wide range of different access sheaths (14-22 Fr).It has been well known that tract size is one of the main parameters affecting the complication rates in PNL. We aimed to compare 21 Fr with 16.5 Fr mPNL tract sizes in adult patients. MATERIAL AND METHODS From May 2013 to April 2018, 604 patients with kidney stone underwent mPNL in our department. The study was designed as retrospective and match-pair analysis was the preferred method for the formation of groups. The 21 Fr mPNL cases were matched with 16.5 Fr mPNL cases at a 1:1 ratio, according to the patients' age, gender, body mass index, American Society of Anesthesiologists (ASA) score, stone characteristics (stone size, opacity and localization) and hydronephrosis. Patients with solitary kidney, renal anomalies, musculoskeletal abnormalities, and pediatric patients (< 18 years old) were excluded from the study. Both groups (21 Fr and 16.5 Fr) were compared in terms of demographics, stone characteristics, operative data and post-operative outcomes. RESULTS A total of 260 patients were included in the study (130; 21 Fr mPNL group and 130; 16.5 Fr mPNL group). The operation time was significantly shorter in 21 Fr group (21 Fr; 85.2±37.5, 16.5 Fr; 101.7±37.7 minutes, p: 0.001). Complete stone clearance rates were 76.9% and 62.3% in 21 Fr and 16.5 Fr mPNL, respectively (p: 0.01). There was no significant difference between the groups in terms of overall operative and post-operative complications. However, in subgroups analysis, post-operative fever was higher in 16,5 Fr mPNL (4 patients in 16.5 Fr, no patients in 21 Fr group, p: 0.044); steinstrasse, renal colic and post-operative JJ stent requirement rates were higher in 21 Fr mPNL procedure (p: 0.018, p: 0.031 and p: 0.046, respectively). The hospitalization time was significantly higher in 21 Fr (p: 0.01). CONCLUSIONS Although 21 Fr mPNL procedure has advantages such as better success rates and shorter operation time, some post-operative complications (steinstrasse, renal colic, post-operative JJ stent requirement) are against of 21 Fr mPNL when compared with 16.5 Fr mPNL procedure. Further randomized prospective studies with larger patient volume are needed to confirm these results.
Collapse
Affiliation(s)
- Akif Erbin
- Department of Urology, Haseki Traning and Research Hospital, Istanbul, Turkey
| | - Burak Ucpinar
- Department of Urology, Haseki Traning and Research Hospital, Istanbul, Turkey
| | - Alkan Cubuk
- Department of Urology, Haseki Traning and Research Hospital, Istanbul, Turkey
| | - Ozgur Yazici
- Department of Urology, Haseki Traning and Research Hospital, Istanbul, Turkey
| | - Harun Uysal
- Department of Anesthesiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Metin Savun
- Department of Urology, Haseki Traning and Research Hospital, Istanbul, Turkey
| | - Seref Basal
- Department of Urology, Haseki Traning and Research Hospital, Istanbul, Turkey
| | | |
Collapse
|
15
|
Yılmaz İnal F, Yılmaz Y, Daşkaya H, Toptaş M, Koçoğlu H, Uysal H, Akkoç İ. Evaluation of the attitudes of surgeons about regional anesthesia: a survey study. Local Reg Anesth 2019; 12:89-95. [PMID: 31571980 PMCID: PMC6756757 DOI: 10.2147/lra.s211469] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 07/29/2019] [Indexed: 11/23/2022] Open
Abstract
Background The intraoperative attending anaesthesiologist ultimately makes decisions about the anaesthesiology technique to be performed, but the attitudes of surgeons and preferences of patients on this subject may affect their choice. In this questionnaire-based study, we aimed to evaluate the attitudes and behaviors of surgeons about the use of regional anaesthesia (RA) in surgical operations. Methods Surgeons from different surgical branches with residencies at 4 different hospitals were asked to complete questionnaires that included reasons for preferring (12 reasons) and not preferring (13 reasons) the use of RA techniques for surgeries, using a 5-point Likert scale. Results A total of 156 surgeons from 4 hospitals, out of 167 surgeons who were approached to participate in the study, completed the questionnaire. The most commonly observed reason for a preference towards regional anaesthesia among the surgeons was the risk of general anaesthesia for patients with an American Society of Anesthesiologists (ASA) risk class of III and above. The second most commonly observed reason was for protection from the complications of general anaesthesia, and the third most commonly observed reason was the lower risk of thromboembolisms with regional anaesthesia. The most commonly observed reasons for not choosing regional anaesthesia were found to be incompatibility of the patients and patients’ fears of feeling pain during surgery. Conclusion We conclude that programmes for informing surgeons and educating patients about the advantages of RA may increase the preference ratio among surgeons and decrease patients’ refusals to choose this procedure.
Collapse
Affiliation(s)
- Ferda Yılmaz İnal
- Faculty of Medicine, Department of Anesthesiology and Reanimation, Istanbul Medeniyet University, Istanbul, Turkey
| | - Yadigar Yılmaz
- Department of Anesthesiology and Reanimation, Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey
| | - Hayrettin Daşkaya
- Faculty of Medicine, Department of Anesthesiology and Reanimation, Bezmialem Vakıf University, Istanbul, Turkey
| | - Mehmet Toptaş
- Department of Anesthesiology and Reanimation, Haseki Education and Research Hospital, Istanbul, Turkey
| | - Hasan Koçoğlu
- Faculty of Medicine, Department of Anesthesiology and Reanimation, Istanbul Medeniyet University, Istanbul, Turkey
| | - Harun Uysal
- Department of Anesthesiology and Reanimation, Haseki Education and Research Hospital, Istanbul, Turkey
| | - İbrahim Akkoç
- Department of Anesthesiology and Reanimation, Haseki Education and Research Hospital, Istanbul, Turkey
| |
Collapse
|
16
|
Güzel C, Yeşiltaş S, Daşkaya H, Uysal H, Sümer I, Türkay M. The effect of gender on acute kidney injury developing in the intensive care unit. Hippokratia 2019; 23:126-130. [PMID: 32581498 PMCID: PMC7307507] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND There are distinct differences specific to gender in the susceptibility, prevalence, and progression of kidney injuries. We aimed to investigate whether there is a correlation between acute kidney injury (AKI) developing in patients monitored in the intensive care unit (ICU) with regards to gender. METHODS The current study retrospectively screened the electronic records of patients monitored in the adult ICU between 2015 and 2018. The patients' age, gender, duration of their stay in the ICU, mortality rate, and need for hemodialysis were recorded and analyzed. The diagnosis of AKI was defined according to the Acute Kidney Injury Network (AKIN) criteria. Patients with AKIN stage 2 and stage 3 were accepted as having an AKI. Patients were separated into two groups: those who developed an AKI and those who did not. The patients were classified into age groups: those aged 18-65 years and those older than 65 years. The demographic data and gender distribution of the groups were then compared. RESULTS Of the patients who developed AKI, the mean age (p =0.0001), the number of days they stayed at the ICU (p =0.006), the mortality rate (p =0.0001), and the need for hemodialysis were significantly higher than the non-AKI group. There was no statistically significant difference between the groups with regards to gender distribution (p =0.612). Acute kidney injury was found to be statistically significantly higher in both the male and female groups over 65 years when compared to the group aged 18-65-years (male p =0.004, female p =0.002, respectively). CONCLUSIONS When surveying the complete patient sample, AKI in the ICU was more prevalent in adult males under 65 than their female counterparts. However, there were more incidences of AKI in women over 65 than in men over 65 years. This may be due to structural changes and comorbidities in the kidney due to advanced age, as well as a decrease in estrogen levels. HIPPOKRATIA 2019, 23(3): 126-130.
Collapse
Affiliation(s)
- C Güzel
- Department of Anesthesiology,BezmialemVakıf University, Istanbul, Turkey
| | - S Yeşiltaş
- Department of Anesthesiology,BezmialemVakıf University, Istanbul, Turkey
| | - H Daşkaya
- Department of Anesthesiology,BezmialemVakıf University, Istanbul, Turkey
| | - H Uysal
- Department of Anesthesiology,BezmialemVakıf University, Istanbul, Turkey
| | - I Sümer
- Department of Anesthesiology,BezmialemVakıf University, Istanbul, Turkey
| | - M Türkay
- Department of Anesthesiology,BezmialemVakıf University, Istanbul, Turkey
| |
Collapse
|
17
|
Demir E, Uysal H, Sümer İ, Çalışkan B, Toptaş M, Özenç E. Anesthetic Management in Bariatric Surgery: A Case Report. Haseki 2019. [DOI: 10.4274/haseki.galenos.2018.4197] [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: 12/01/2022] Open
|
18
|
Uysal H, Daşkaya H. Analysis of Anesthesia Administration in the Endoscopy Unit in Terms of Patient Profile and Complications: Retrospective Study. Medeni Med J 2019; 34:278-283. [PMID: 32821449 PMCID: PMC7433739 DOI: 10.5222/mmj.2019.52280] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 09/04/2019] [Indexed: 11/29/2022] Open
Abstract
Objective: This study aimed to analyze patients undergoing endoscopic interventions in terms of comorbid diseases, preoperative anesthesia management predictions, intraoperative-postoperative complications and requirements for intensive care. Method: Records of patients who underwent procedures under anesthesia in the endoscopy unit were retrospectively screened. The patients’ preoperative anesthesia evaluation, intraoperative anesthesia, and postoperative recovery data and intensive care monitoring requirements were recorded. The data obtained were analyzed statistically. Results: It was identified that the preoperative risk prediction of patients was statistically significant for intraoperative and postoperative monitoring. Comorbid disease and high age were determined to increase the requirements for intensive care after the procedure. Increased need for qualified admission was determined in patients with desaturation and hypotension. Conclusion: A prerequisite for reliable administration of anesthesia is having detailed information about the patient and being prepared for possible complications. When examined from this aspect, analysis of the patient profile undergoing procedures in the endoscopy unit is important. In our study, we revealed the presence of elderly patients and comorbid disease(s) in the patient group who underwent procedures in this unit. The need for detailed preliminary evaluation of the patients undergoing these types of procedure and requirements for intensive care after the procedure, if necessary, should definitely be considered.
Collapse
Affiliation(s)
- Harun Uysal
- Bezmialem Vakif University Faculty of Medicine, Department of Anesthesiology and Reanimation, Istanbul, Turkey
| | - Hayrettin Daşkaya
- Bezmialem Vakif University Faculty of Medicine, Department of Anesthesiology and Reanimation, Istanbul, Turkey
| |
Collapse
|
19
|
Uysal H, Özkan Ö, Özkan Ö, Şenol U, Barçın E, Çolak Ö. The complementary phenomena; phantom hand and phantom face. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.324] [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: 11/25/2022]
|
20
|
Uysal H, Karaaslan K, Calim M, Nasifov M, Aydin C. Abstract PR412. Anesth Analg 2016. [DOI: 10.1213/01.ane.0000492800.14168.d7] [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: 11/05/2022]
|
21
|
Daşkaya H, Uysal H, Çiftçi T, Baysal B, İdin K, Karaaslan K. Use of the gastro-laryngeal tube in endoscopic retrograde cholangiopancreatography cases under sedation/analgesia. Turk J Gastroenterol 2016; 27:246-51. [PMID: 27210780 DOI: 10.5152/tjg.2016.16121] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND/AIMS In this study, we aimed to analyze the effects of Gastro-Laryngeal Tube (GLT) use on intraoperative and postoperative hemodynamic parameters, comfort of the procedure, and patients' satisfaction in endoscopic retrograde cholangiopancreatography (ERCP). MATERIALS AND METHODS A total of 80 patients between the ages of 20 and 75 years who were scheduled for elective ERCP were enrolled. The patients were randomly assigned to two groups: groups N and G. Those in group N underwent the procedure with sedation without any airway instruments and those in group G underwent procedure after sedation and airway management with GLT. Intraoperative and postoperative vital signs as well as the satisfaction of the patients were recorded. RESULTS The duration to esophageal visualization was found to be significantly higher in group N (16 s) than in group G (7 s) (p=0.001). The mean Visual Analogue Scale for Pain (VAS) was significantly higher in group G (1.85) than in group N (0.45) (p=0.016). Group G had higher endoscopist satisfaction scores than group N. The incidence of desaturation during ERCP was significantly higher in group N (60%) than in group G (0%) (p=0.000). CONCLUSION In conclusion, ERCP should be performed under optimal conditions to avoid the occurrence of unwanted complications, such as aspiration-related disorders. Therefore, according to the structural properties of GLT, sedation anesthesia application with GLT in ERCP will be safer, more comfortable, and more effective.
Collapse
Affiliation(s)
- Hayrettin Daşkaya
- Department of Anaesthesiology and Intensive Care, Bezmialem Vakıf University, İstanbul, Turkey.
| | | | | | | | | | | |
Collapse
|
22
|
Idin K, Ulgen Zengin S, Uysal H, Alver S, Salihoglu Z. Ritter Syndrome Mimicking Drug Eruption. Bezmialem Science 2015. [DOI: 10.14235/bs.2015.491] [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: 11/14/2022]
|
23
|
Başaranoğlu G, İdin K, Umutoğlu T, Topuz U, Esen A, Uysal H. Temporary Vision Loss After Spinal Anesthesia. Haseki 2015. [DOI: 10.4274/haseki.1891] [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: 12/01/2022] Open
|
24
|
Basaranoglu G, Idin K, Batmaz G, Topuz U, Uysal H, Salihoglu Z. The Attitudes and Behaviors of Pregnant Women about Labor Anesthesia. Bezmialem Science 2015. [DOI: 10.14235/bs.2014.122] [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: 11/14/2022]
|
25
|
Bakan M, Umutoglu T, Topuz U, Uysal H, Bayram M, Kadioglu H, Salihoglu Z. Opioid-free total intravenous anesthesia with propofol, dexmedetomidine and lidocaine infusions for laparoscopic cholecystectomy: a prospective, randomized, double-blinded study. Braz J Anesthesiol 2014; 65:191-9. [PMID: 25925031 DOI: 10.1016/j.bjane.2014.05.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Accepted: 05/05/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Intraoperative use of opioids may be associated with postoperative hyperalgesia and increased analgesic consumption. Side effects due to perioperative use of opioids, such as postoperative nausea and vomiting may delay discharge. We hypothesized that total intravenous anesthesia consisting of lidocaine and dexmedetomidine as an opioid substitute may be an alternative technique for laparoscopic cholecystectomy and would be associated with lower fentanyl requirements in the postoperative period and less incidence of postoperative nausea and vomiting. METHODS 80 Anesthesiologists I-II adults were scheduled for elective laparoscopic cholecystectomy. Patients were randomly allocated into two groups to have either opioid-free anesthesia with dexmedetomidine, lidocaine, and propofol infusions (Group DL) or opioid-based anesthesia with remifentanil, and propofol infusions (Group RF). All patients received a standard multimodal analgesia regimen. A patient controlled analgesia device was set to deliver IV fentanyl for 6h after surgery. The primary outcome variable was postoperative fentanyl consumption. RESULTS Fentanyl consumption at postoperative 2nd hour was statistically significantly less in Group DL, compared with Group RF, which were 75 ± 59 μg and 120 ± 94 μg respectively, while it was comparable at postoperative 6th hour. During anesthesia, there were more hypotensive events in Group RF, while there were more hypertensive events in Group DL, which were both statistically significant. Despite higher recovery times, Group DL had significantly lower pain scores, rescue analgesic and ondansetron need. CONCLUSION Opioid-free anesthesia with dexmedetomidine, lidocaine and propofol infusions may be an alternative technique for laparoscopic cholecystectomy especially in patients with high risk for postoperative nausea and vomiting.
Collapse
Affiliation(s)
- Mefkur Bakan
- Department of Anesthesiology and Reanimation, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey.
| | - Tarik Umutoglu
- Department of Anesthesiology and Reanimation, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey
| | - Ufuk Topuz
- Department of Anesthesiology and Reanimation, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey
| | - Harun Uysal
- Department of Anesthesiology and Reanimation, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey
| | - Mehmet Bayram
- Department of Pulmonary Medicine, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey
| | - Huseyin Kadioglu
- Department of General Surgery, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey
| | - Ziya Salihoglu
- Department of Anesthesiology and Reanimation, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey
| |
Collapse
|
26
|
Coskun M, Altinisik Inan G, Guler Avci G, Altundag M, Uysal H, Guney Y. EP-1393: CyberKnifeÆ Re-irradiation For Recurrent Low-Grade Glioma. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31511-5] [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] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
27
|
Delikgoz Soykut E, Dizman A, Yukselen Guney Y, Olcay G, Cetindag M, Duman R, Balci M, Ozdogan S, Ordu Altundag I, Uysal H. EP-1395: The retrospective evaluation of uveal melanoma cases treated with fractionated stereotactic radiotherapy. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31513-9] [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: 10/23/2022]
|
28
|
Altun D, Uysal H, Ayar A, Askin H. Removal of the toxic effects of chlormadinon acetate on the development of Drosophila melanogaster via the use of nordihydroguaiaretic acid. Toxicol Ind Health 2010; 27:29-33. [PMID: 20713429 DOI: 10.1177/0748233710380216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this study, the effects of chlormadinon acetate (CMA) and CMA + nordihydroguaiaretic acid (NDGA) on various developmental stages of Drosophila melanogaster were investigated. Different concentrations of CMA (1.0; 3.0; 5.0 and 10.0 μM/100 mL medium) and CMA + NDGA as the concentrations of CMA (1.0 + 1.0; 3.0 + 3.0; 5.0 + 5.0 and 10.0 + 10.0 μM/100 mL medium) were carried out during the developmental periods of the flies. When F(1) progeny of control and application groups were compared, CMA was found to extend the process of metamorphosis and decrease the total offspring numbers. However, these negative effects were inhibited by NDGA treatment at different concentrations. These results suggest that NDGA could effectively inhibit CMA-induced abnormalities in developmental stages of D. melanogaster. It was found that the difference between the groups was significantly important (p < 0.05).
Collapse
Affiliation(s)
- D Altun
- Department of Biology, Faculty of Art and Science, Erzincan University, Erzincan, Turkey
| | | | | | | |
Collapse
|
29
|
Aralasmak A, Karaali K, Cevikol C, Uysal H, Senol U. MR imaging findings in brachial plexopathy with thoracic outlet syndrome. AJNR Am J Neuroradiol 2009; 31:410-7. [PMID: 19815618 DOI: 10.3174/ajnr.a1700] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The BPL is a part of the peripheral nervous system. Many disease processes affect the BPL. In this article, on the basis of 60 patients, we reviewed MR imaging findings of subjects with brachial plexopathy. Different varieties of BPL lesions are discussed.
Collapse
Affiliation(s)
- A Aralasmak
- Department of Radiology, Akdeniz University, Antalya, Turkey.
| | | | | | | | | |
Collapse
|
30
|
Abstract
Phenol (PN), obtained from coal tar, is used commonly in medical treatments, industrial areas, petroleum refineries, production of glue, fiber, and nylon. PN is used in the production of benzene and it is emitted in the atmosphere by motor vehicles. Folic acid (FA) is an essential nutrient among the B complex group of vitamins. The main aim of this study was to investigate the effects of PN and PN + FA on various developmental stages of Drosophila melanogaster. Different concentrations of PN and PN + FA were administered during the developmental periods of the fly (egg, larva and pupa). When F1 progeny of control and experimental groups were compared, PN was found to extend the process of metamorphosis and decrease the total offspring numbers. However, these negative effects were inhibited by FA treatment at different concentrations (0.25-2.50 mg/kg). These results suggest that FA could effectively inhibit PN-induced abnormalities in developmental stages of Drosophila melanogaster.
Collapse
Affiliation(s)
- H Aşkin
- Science and Art Faculty, Biology Department, Atatürk University, Erzurum, Turkey.
| | | | | |
Collapse
|
31
|
|
32
|
Abstract
Cervical root fracture is a major clinical problem in flared root canals treated with different post and core applications. This in vitro study evaluated the stress transfer of different post and core systems to the cervical part of the artificially created flared root canals, by using strain gauges. The post-core systems investigated were: (a) cast post-core system without resin reinforcement, (b) cast post-core system with resin reinforcement, (c) pre-fabricated post and resin core with resin reinforcement. The post-core systems which were cemented on simulated roots were subjected to a load applied at an angle of 45 degrees to the long axis of the simulated roots. The strain gauges which were cemented to the cervical part of simulated roots were connected to the data acquisition module to measure and record the changes in strain data. Specimens restored with resin reinforcement either with cast post-core or pre-fabricated post and resin core transferred the stress to the cervical part of the artificial roots at a rate lower than conventional cast post-core system (P = 0.001; anova and Tukey's post hoc test). It was concluded that the resin reinforcement of root canals before post-core applications reduces the stresses at the cervical part of the root surfaces.
Collapse
Affiliation(s)
- O Yoldas
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Cukurova University, Adani, Turkey.
| | | | | |
Collapse
|
33
|
Kavas G, Uysal H, Kilic S, Akbulut N, Kesenkas H. Production and Selected Properties of Bioghurt Made from Goat Milk and Cow–Goat Milk Mixtures by Ultrafiltration and Addition of Skim Milk Powder. International Journal of Food Properties 2004. [DOI: 10.1081/jfp-200032939] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
34
|
Kavas G, Oysun G, Kinik O, Uysal H. Effect of some fat replacers on chemical, physical and sensory attributes of low-fat white pickled cheese. Food Chem 2004. [DOI: 10.1016/j.foodchem.2004.01.054] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
35
|
Abstract
The purpose of this study was to compare the pulmonary functions in female Behcet's patients with or without pathological pulmonary lesions using high resolution computerized tomography (HRCT). Twenty-nine female patients aged 19-54 yrs and 20 healthy females aged 19-50 yrs (control group) were accepted into the study. HRCT images were taken and according to HRCT patients were divided into HRCT (+) and HRCT (-) groups (18 patients in each). Pulmonary function tests (PFT) through a spirometer were performed and FVC, FEV(1), FEF(25-75%), PEF, VC, RV, FRC, DLCO and DLCO/VA were determined. No statistically significant difference was observed when the PFT values were compared between HRCT (+) and HRCT (-) patients for the obtained results and the percentage of the expected values. When the PFT values were compared for both HRCT (+) and HRCT (-) patients with the control group separately there was no statistical difference between the best values. A statistically low DLCO/VA value was observed between the percentage of the expected values. It is concluded that though there is a pulmonary restriction in Behcet's disease, this restriction has no relation to pulmonary functions. It would be useful to perform pulmonary function tests in the patients with Behcet's disease both with or without any pathological findings in HRCT for obtaining information about pulmonary functions. We suggest that even when the results of the pulmonary function tests are normal, considering some pathological changes in HRCT, HRCT investigations may be useful for following up the disease.
Collapse
Affiliation(s)
- H Uysal
- Department of Physiology, Selçuk University, Meram Faculty of Medicine, 42080 Konya, Turkey
| | | | | | | |
Collapse
|
36
|
Uysal H, Kaya Y. Toxicity of Euphorbia canariensis latex to some developmental stages of Drosophila melanogaster (Diptera: Drosophilidae). Bull Environ Contam Toxicol 2004; 72:45-53. [PMID: 15058653 DOI: 10.1007/s00128-003-0239-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- H Uysal
- Atatürk Universitesi, Fen-Edebiyat Fakültesi, Biyoloji Bölümü, Erzurum, Turkey
| | | |
Collapse
|
37
|
Uysal H, Kilic S, Kavas G, Akbulut N, Kesenkas H. Some properties of set yoghurt made from caprine milk and bovine-caprine milk mixtures fortified by ultrafiltration or the addition of skim milk powder. INT J DAIRY TECHNOL 2003. [DOI: 10.1046/j.1471-0307.2003.00101.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
38
|
Kilinç M, Ertürk IO, Uysal H, Birler K, Evrenkaya T, Akkalyoncu BB. Multiple plasma cell granuloma of the central nervous system: a unique case with brain and spinal cord involvement. Case report and review of literature. Spinal Cord 2002; 40:203-6. [PMID: 11965561 DOI: 10.1038/sj.sc.3101271] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [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: 12/12/2022]
Abstract
STUDY DESIGN Single subject (male, 34 years-of-age) case report. OBJECTIVES To describe a unique case of plasma cell granuloma (PCG) with simultaneous brain and spinal cord involvement. SETTING Private hospital, capital city, Turkey. METHODS The patient presented with headache and paraplega. T2 weighted MR images showed multiple hyperintense cerebral, cerebellar, brainstem and spinal cord lesions that enhanced homogeneously with contrast medium. The patient was operated on, and the two intramedullary spinal cord lesions at T11 and T12 were totally excised. RESULTS After 3 months of an intense physiotherapy programme the patient was able to walk with help. CONCLUSION We report for the first time, the occurrence of multiple, simultaneous brain and intramedullary spinal cord plasma cell granulomas.
Collapse
Affiliation(s)
- M Kilinç
- Baskent University Hospital, Neurology Department, Bahçelievler-Ankara, Turkey 06490
| | | | | | | | | | | |
Collapse
|
39
|
Abstract
Blind nasoenteric intubation was attempted in a patient with chronic parkinsonism. The tube was inadvertently misplaced and penetrated the left pleural cavity. The next day, the patient developed cardiopulmonary arrest during dietary supplement infusion. This complication ultimately led to the patient's death. We have reviewed the known complications of nasoenteric tube placement and conclude that difficult insertion in patients at risk from tube misplacement should be followed by chest radiography to confirm the correct placement of the tube before nutritional support is started.
Collapse
Affiliation(s)
- B Yavaşcaoğlu
- Department of Anaesthesiology, Uludağ University Medical School, Bursa, Turkey
| | | | | | | | | | | |
Collapse
|
40
|
Duydu Y, Süzen HS, Aydin A, Cander O, Uysal H, Işimer A, Vural N. Correlation between lead exposure indicators and sister chromatid exchange (SCE) frequencies in lymphocytes from inorganic lead exposed workers. Arch Environ Contam Toxicol 2001; 41:241-246. [PMID: 11462150 DOI: 10.1007/s002440010244] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2000] [Accepted: 02/25/2001] [Indexed: 05/23/2023]
Abstract
Inorganic lead exposure was studied in 31 volunteers employed in storage battery plant. The genotoxicity of lead was measured in terms of sister chromatid exchange (SCE). Erythrocyte delta-aminolevulinic acid dehydrogenase (ALAD) activity, urinary delta-aminolevulinic acid (U-ALA), and blood lead levels (PbBs) were also determined to evaluate some possible relations between these lead exposure indicators and the observed SCE frequencies. Blood lead concentration of 36.31 microg/dl was determined as an average level in the workers. Consequently decreased ALAD activity in erythrocytes and increased U-ALA excretion was observed in statistically higher PbBs when compared with the control group. A statistically significant correlation was observed between the PbBs and SCE frequencies (p < 0.05). Moreover, the correlation between U-ALA excretion and SCE frequencies (p < 0.01) was relatively higher than the correlation between PbBs and SCE frequencies. These results might indicate a possible mechanism of ALA mediation in the genotoxic effects of lead.
Collapse
Affiliation(s)
- Y Duydu
- University of Ankara, Faculty of Pharmacy, Department of Toxicology, 06100, Tandogan, Ankara, Turkey.
| | | | | | | | | | | | | |
Collapse
|
41
|
Abstract
A 54-year-old woman was admitted to our clinic with frequent convulsions. Subsequently she developed a toxic look, rigidity, confusion and severe encephalopathy. Salmonella typhii was isolated from the blood cultures and she was diagnosed with Salmonella encephalopathy. The prominent electrophysiological finding was the frontal intermittent rhythmic delta activity (FIRDA) in electroencephalograph (EEG). After treatment EEG revealed normal activity. The presence of FIRDA is not a specific finding but this kind of EEG change has not been reported before. Diffuse encephalopathy due to endotoxins might be the reason. We propose that S. typhii encephalopathy was the cause of FIRDA which is a sign of diffuse encephalopathy.
Collapse
Affiliation(s)
- H Uysal
- Dept of Neurology, Sevgi Hospital, Ankara, Turkey.
| | | | | | | |
Collapse
|
42
|
Abstract
The role of nitric oxide (NO) in childhood bacterial meningitis was investigated by determining the levels of nitrate/nitrite, stable end products of NO metabolism, in cerebrospinal fluid (CSF). Eighteen children with bacterial meningitis and 18 as a control group were included in the study. Mean (+/- SD) CSF nitrate/nitrite levels were 27.6 +/- 26 micromol/l in the bacterial meningitis group and 3.2 +/- 1.8 micromol/l in the control group (p = 0.0005). We found no correlation between CSF nitrate/nitrite levels and CSF white blood cell count (r = 0.22), protein (r = 0.26) or tumour necrosis factor alpha (TNF-alpha) levels (r = 0.046), but a moderate negative correlation between CSF nitrate/nitrite and glucose levels (r = -0.46).
Collapse
Affiliation(s)
- G Uysal
- Department of Pediatric Infectious Disease, Childrens Hospital, Social Security Institution, Ankara, Turkey
| | | | | | | | | |
Collapse
|
43
|
Uysal H, Hemming FW. Changes in the expression and distribution of fibronectin, laminin and tenascin by cultured fibroblasts from skin lesions of patients with tuberous sclerosis. Br J Dermatol 1999; 141:658-66. [PMID: 10583113 DOI: 10.1046/j.1365-2133.1999.03104.x] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Fibronectin, laminin and tenascin play an important part in the assembly of the extracellular matrix and the interaction of cells with it. In this study, changes in their expression and distribution associated with tuberous sclerosis are reported. Fibroblasts from three different tuberous sclerosis skin lesions (forehead plaque, neck fibroma and ungual fibroma) secreted more fibronectin and tenascin into their culture medium than did normal skin fibroblasts. Immunohistochemistry and flow cytometry showed that cells from an ungual fibroma which secreted most of each of these glycoproteins also retained more of them, associated mainly with the cell surface and a perinuclear area. Laminin was also produced by all fibroblasts but only in those from the neck fibroma was more both secreted and retained. The proportions of fibronectin/laminin/tenascin secreted by the skin lesion fibroblasts were markedly different from normal. The results suggest that the characteristic tissue hardening of skin lesions in tuberous sclerosis may result, at least in part, from differences in the expression and distribution of these critical components of the extracellular matrix and its consequent abnormal assembly.
Collapse
Affiliation(s)
- H Uysal
- School of Biomedical Sciences, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, U.K
| | | |
Collapse
|
44
|
Uysal H, Bahşi YZ, Yurdakul M. Babinski reflex by sural stimulation and dysfunction of descending motor pathway. Electromyogr Clin Neurophysiol 1999; 39:361-6. [PMID: 10499207] [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] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
The aim of the study was to find out the relationship between the Babinski reflex and flexor polysynaptic reflexes which was evaluated by sural nerve stimulation, and to evaluate the descending motor pathway in involvement by cervical and transcortical cranial stimulation (TCCS) in a group of patients that were diagnosed as having the Babinski sign with either hemiparetic of hemiplegic, due to a cerebrovascular accident. In the normal population no significant responses were seen from the EHL by sural stimulation and these responses were recorded from the BF with a latency of 88 msec. In the patients who had Babinski reflex responses, signs could be easily recorded from EHL by sural stimulation with a latency of 166 msec. In this group, reflex responses from the BF were recorded with a latency of approximately 100 msec. Responses from the EHL were evaluated in 100% ratio by TCCS with a latency of 33.4 msec. in the normal group. The responses recorded from EHL by TCCS and latency was 47.5 msec. in 35.7% of the patients, who having Babinski sign. In 100% of the normal population, responses were evaluated with a latency of 28.8 msec. from EHL by cervical stimulation. In only 55% of the patients having the Babinski sign, responses were recorded in the same limb with a latency was 32.3 msec. These results support a different mechanism that control the EHL muscle in comparison to the BF muscle having dysfunction of descending motor tracts due to a pyramidal lesion.
Collapse
Affiliation(s)
- H Uysal
- Department of Neurology, Sevgi Hospital, Ankara, Turkey
| | | | | |
Collapse
|
45
|
Abstract
OBJECTIVES The present study explored whether testing tendon jerks during voluntary contraction of the test muscle would improve reproducibility by effectively 'clamping' the excitability of the motoneurone pool at firing threshold. METHODS Tendon jerk reflexes of soleus, tibialis anterior and vastus lateralis and the soleus H reflex were recorded in 12 healthy subjects at rest and during voluntary contractions of 10-20% of maximum. Recordings were repeated 8-10 times in 5 subjects, in whom reflex symmetry was also determined. RESULTS Not all tendon jerk reflexes could be recorded at rest, and the variability of latency and amplitude was high. All reflexes could be recorded in each subject during contractions. The latency of tendon jerk reflexes decreased by approximately 2 ms during contractions, but H-reflex latency decreased by only 0.2-0.3 ms. For the tendon jerks, an asymmetry of >3.0 ms at rest and >2.5 ms contracting would be outside 3 SD of the normal mean. In repeat studies, the coefficient of variation of reflex latency was <4% for the tendon jerk. CONCLUSIONS A voluntary contraction could potentiate the tendon jerk by a number of mechanisms, but the most important is probably enhancement of the excitability of the motoneurone pool. The present techniques should increase the value of tendon reflex testing when assessing possible peripheral nerve, plexus and root disturbances.
Collapse
Affiliation(s)
- H Uysal
- Department of Neurology, Prince of Wales Hospital, Prince of Wales Medical Research Institute, and University of New South Wales, Sydney, Australia
| | | | | |
Collapse
|
46
|
Affiliation(s)
- Y Duydu
- University of Ankara, Faculty of Pharmacy, Department of Toxicology, 06100, Tandoğan, Ankara, Turkey
| | | | | | | | | |
Collapse
|
47
|
Abstract
Four cushion adhesives (Fittydent I; Fittydent II, introduced as an advanced formula; Protefix; and Seabond) were compared clinically through patients subjective evaluations. Maxillary dentures of 32 patients were relined and the mandibular dentures were scored by Kapur index before the application of different treatments. The cushion adhesives were used only with the existing mandibular prosthesis. The four treatments were applied to the patients in groups of 8 by allocating each group randomly to one of the four sequences of treatments determined by latin square design. Each patient took each treatment only once. The adhesives were applied by the authors as recommended by the manufacturers. Patients used each material for 24 h and, through a questionnaire, they evaluated the seven following aspects of each different cushion material: retention, duration of retention, effects on ability to chew, effects on other oral functions, cleansing of dentures, cleansing of gums, and an overall evaluation of materials. Both Fittydent products significantly improved denture retention and the ability to chew. The patients who expressed 'much better' chewing with Fittydent products, had mandibular dentures rated poor or fair.
Collapse
Affiliation(s)
- H Uysal
- Department of Prosthodontics, Faculty of Dentistry, Cukurova University, Balcali, Adana, Turkey
| | | | | | | |
Collapse
|
48
|
Abstract
The effects of aluminum on the pulmonary function of aluminum workers were investigated in this study. Serum aluminum levels and spirometry were measured in 55 male workers and 30 male controls. The mean serum aluminum level of workers (72.7 +/- 9.9 ng/ml) was significantly high compared to that of controls, indicating aluminum toxicity. Spirometric parameters were significantly lower in workers than in controls and correlated negatively with both exposure time and serum aluminum levels. The impairment in pulmonary function may be due to exposure time and insufficient protection.
Collapse
Affiliation(s)
- L N San
- Department of Physiology, Faculty of Medicine, Selçuk University, Konya, Turkey
| | | | | | | | | |
Collapse
|
49
|
Mihoglu H, Inan LE, Uysal H, Uçler S, Tulunay FC. Brain stem reflexes in cervicogenic headaches. Funct Neurol 1998; 13:87. [PMID: 9584884] [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] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- H Mihoglu
- Ministry of Health, Ankara State Hospital, Neurology Clinic, Turkey
| | | | | | | | | |
Collapse
|
50
|
Uysal H, Saxton J, Hemming FW. Changes in the secretion and glycosylation of fibronectin by human skin fibroblasts associated with tuberous sclerosis. Glycoconj J 1997; 14:439-47. [PMID: 9249141 DOI: 10.1023/a:1018543316793] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [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: 02/05/2023]
Abstract
Fibroblasts from skin and skin lesions of patients with tuberous sclerosis (TS) and from skin of normal individuals were grown in culture. ELISA showed that the spent medium of those derived from TS skin lesions contained significantly more fibronectin (FN) than spent medium from the other cells. Amino acid compositional analysis of the FN from TS and normal sources revealed no substantial differences. However the FN of fibroblasts from TS-skin lesions was shown by HPAEC to contain a two- to three-fold increased content of carbohydrate. The changed monosaccharide composition was consistent with an increased content of N- and O-linked glycans and with the former containing polylactosamine chains. Fibroblasts from a normal individual were shown to proliferate more slowly and to produce larger cells when grown on FN from a TS skin lesion compared to growth on FN from normal skin.
Collapse
Affiliation(s)
- H Uysal
- Department of Biochemistry, The University of Nottingham, UK
| | | | | |
Collapse
|