Yazar "Kiraz, Hasan Ali" seçeneğine göre listele

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    A practical approach in difficult intubation: use of gum elastic bougie on 10 cases
    (Yerkure Tanitim & Yayincilik Hizmetleri A S, 2016) Altinisik, Ugur; Erbas, Mesut; Kiraz, Hasan Ali; Simsek, Tuncer; Altinisik, Hatice Betul; Turk, Fatos Ipek; Toman, Huseyin
    Objective: When faced with unexpected difficult intubation, despite all the technological advances, there is still a need of equipments that are easy to use and very reachable. In this study, we offer our experiences in use of gum elastic bougie in 10 cases with unexpected difficult intubation in our operation rooms. Material and Methods: In Canakkale 18 March University Medical Faculty's Operating Rooms and between the years 2013-2014, all the encountered unexpected difficult intubation cases are classified and the patients who has Mallampati score I-II and having any airway pathology evaluated for the use of Gum elastic bougie (GEB). Auxiliary equipments used in intubation, number of intubation attempts, number of anesthesiologists who tried for intubation, the number of trials with GEB and the complications due to the use of GEB were recorded. Results: A total of 10 cases with unexpected difficult intubation were included in the study. All of the cases were male and intubation was attempted with size 4 blades. Stylet in 6 cases, fast trach laryngeal mask in 1 case were used after unsuccessful intubation attempts. However the use of this equipments patients couldn't be intubated and after at least 3 three attempts GEB used this time for intubation. An experienced anesthesiologist with the help of GEB intubated all the patients at once. There were no complications related to the use of GEB. Conclusion: GEB is widely used in European countries for unexpected difficult intubation. In our patients, despite the absence of any complications, due to the blind insertion of bougie trauma cases have been reported. GEB when performed by an experienced anesthesiologist is a good alternative airway equipment in unexpected difficult airway management, because it's inexpensive, easy to use and portable.
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    A rare reason/cause of esophageal obstruction: Steakhouse syndrome
    (Yuzuncu Yil Universitesi Tip Fakultesi, 2016) Çıkman, Öztekin; Taş, Şükrü; Kiraz, Hasan Ali; Özkan, Ömer Faruk; Adam, Gürhan; Karaayvaz, Muammer
    Steakhouse syndrome is an esophageal acute obstruction, due to improperly chewed meat. In most cases the etiology cannot be exactly shown, it is seen more frequently in patients with motility disorders in the lower esophageal sphincter and in alcoholics. Medical history and endoscopic examination are the first to be done for diagnosis. The endoscopic removal of foreign body after the diagnosis of obstruction is the most effective treatment method. © 2016, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
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    Akciğer tüberkülozlu olguda stafilokok aureus’un etken olduğu lomber spinal spondilodiskitis
    (2013) Akman, Tarık; Alkan, Bahadır; Aras, Adem Bozkurt; Güven, Mustafa; Koşar, Şule; Kiraz, Hasan Ali; Coşar, Murat
    Lomber spinal spondilodiskitis ender görülen fakat sıklıklahızlı seyirli genellikle başta konulan yanlış tanılarla tanısıgeciken, bu nedenle de sonuçları ciddi olabilen infeksiyon- lardır. Günümüzde tanı yöntemlerinin gelişmesi ile özel- likle manyetik rezonans görüntüleme ile spinal infeksiyontanısını koyabilmek ve tedaviyi buna göre yönlendirebilmek mümkün olmaktadır.Erken teşhiste morbidite ve mortalite oranlarının belirgin bir şekilde azaldığı bildirilmektedir. Olgumuzda olduğu gibi lomber spinal spondilodiskitis düşünülen hastalarda yapılacak cerrahi müdahale oluşabilecek kalıcı nörolojik sekelleri önleyebilmek için önemlidir. Ayrıca multidisipli- ner bir yaklaşım gerektirir. Bu makalede, primer akciğer tüberkülozlu olguda cerrahi olarak tedavi edilen bir stafilokok aureus’un etken olduğu lomber spinal spondilodiskitisli olgu sunulmuştur.
  • Küçük Resim
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    Akciğerin Primer Skuamöz Hücreli Kanserlerinin Kranial Metastazları
    (Çanakkale Onsekiz Mart Üniversitesi, 2014) Akman, Tarık; Aras, Adem Bozkurt; Güven, Mustafa; Alkan, Bahadır; Kiraz, Hasan Ali; Koşar, Şule; Şen, Halil Murat; Coşar, Murat
    Dünya sağlık örgütü (WHO) kaynaklarına göre kanser, kardiyovasküler hastalıklar sonrası en sık görülen ölüm sebebidir. Tüm kanser olguları açısından karşılaştırıldığında akciğer kanseri görülme sıklığı açısından kadın cinsiyette ikinci sırada, erkek cinsiyette ise birinci sıradadır. Akciğer kanseri olgularının en sık görülen tipi ise küçük (yulaf) hücreli tipi olup, primeri açısından kıyaslandığında ise skuamöz hücreli varyantıdır. Akciğer kanserli olguların ilk konulan tanısında % 10-14’ unda kranial metastaz görülmektedir. Metastatik lezyon açısından mukayese edildiğinde ise kranial metastazlar küçük hücreli akciğer kanserinde görülmektedir. İntrakranial olgularda % 80-85’ inde supratentoriyel yerleşim görülür. Skuamöz hücreli akciğer kanserinin davranış şekli olarak sıklıkla geç metastaz yapmakta, kranial metastazı ise nadir olarak görülmektedir.İntrakranial metastaza bağlı görülebilecek semptomlar zamam zaman bulantı, kusmanın eşlik edebildiği başağrısı, fokal nörolojik bulgular, epileptik nöbetler, serebellar fonksiyonlarda bozulmadır. Beyin metastazlarının geliştiği akciğer tümörleri radyolojik olarak genellikle apikal ve periferik yerleşimlidir.Akciğer kanserinin kranial metastazı sıklıkla semptomatik hastalarda, daha nadir olarak da tarama amaçlı çekilen diagnostik kranial BT, beyin MRG, PET- CT sırasında saptanmaktadır.Bu çalışmamızda akciğer skuamöz hücreli kanser tanısıyla takip edilen hastada, intrakranial frontal ve temporal bölgede multipl metastazları saptanan olgunun literatür eşliğinde tartışılması amaçlanmıştır.
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    AKUT PANKREATİTTE ERKEN LAPARASKOPİK KOLESİSTEKTOMİ; SONUÇLARIMIZ
    (2016) Çıkman, Öztekin; Taş, Şükrü; Kiraz, Hasan Ali; Şekerci, Berkin; Karaayvaz, Muammer; Akgün, Yılmaz
    Amaç: Bu çalışmada, akut bilier pankreatit nedeniyle tedavi edilen hastaların, erken dönemde laparoskopik kolesistektomi sonuçlarının değerlendirilmesi amaçlanmıştır.Materyal ve Metod: Ocak 2012 - Temmuz 2015 tarihleri arasında akut biliyer pankreatit nedeniyle yatırılan, klinik ve laboratuar bulguları düzeldikten sonra taburcu edilmeden laparoskopik kolesistektomi yapılan 37 hastanın kayıtları retrospektif olarak değerlendirildi. Hastaların yaş, cinsiyet, laboratuar bulguları, ultrasonografi, MRCP ve ERCP sonuçları ameliyat süresi, açığa geçme, morbidite, mortalite ve postoperatif hastanede yatış süreleri kaydedildi.Bulgular: Akut biliyer pankreatit nedeniyle yatan 37 hastadan 16'sı erkek, 21'i kadın olup hastaların yaş ortalaması 58,1'di. Ranson skor ortalaması 1.38 olarak hesaplandı. Ultrasonografik açıdan değerlendirildiğinde 26 (%70,27) hastada multipl kalkül, 5 (% 13,51) hastada safra çamuru, 6 (16,22) hastada ise tek kalkül saptandı. Laboratuar ve klinik olarak safra yollarında patoloji olduğu düşünülen 19 hastaya MRCP çekildi. MRCP'de koledokta kalkül saptanan 6 hasta ERCP sonrası opere edildi. Tüm hastalarda standard laparoskopik kolesistektomi işlemi 4 portla başlandı. 1(%) hastada preop saptanamayan kolesistoduodenal fistül nedeniyle operasyonda açığa geçilerek bitirildi. Pos-toperatif hastaların ortalama yatış süresi iki bulundu.Sonuç: Erken dönem laparoskopik kolesi-tektomilerde operasyon süresi ve anatomik yapılarınortayakonmasındakizorluklararağmen, akut biliyer pankreatit sonrası erken dönemde kolesistektominin rekürren pankre-atit ataklarını önleyen, daha etkin bir tedavi seçeneği olduğunu düşünmekteyiz.
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    AN EXTREMELY RARE COMPLICATION OF MECKEL'S DIVERTICULUM: ENTEROCUTANEOUS FISTULIZATION OF UMBILICAL HERNIA
    (Colegio Brasileiro Cirurgia Digestiva-Cbcd, 2015) Cikman, Oztekin; Kiraz, Hasan Ali; Ozkan, Omer Faruk; Adam, Gurhan; Celik, Ahmet; Karaayvaz, Muammer
    [Anstract Not Available]
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    Anesthesia management of a patient with Wilson's disease
    (Anestezi Dergisi, 2015) Do?u, Tu?ba; Şahin, Hasan; Erbaş, Mesut; Şimşek, Tuncer; Toman, Hüseyin; Altinişik, Hatice Betül; Kiraz, Hasan Ali
    Wilson's disease (WD) is an autosomal recessive disorder characterized by mutations in the ATP7B gene, which causes the disorder of copper excretion into bile. In this study we aimed to discuss our anesthesia experience in a Wilson's disease patient who underwent emergency surgical procedures for appendicitis. A 42-year-old male WD patient suffering the disease for 6 years with a diagnosis of cardiomyopathy and asthma, was planned an emergency surgery for appendicitis. The patient's neurological examination was normal. General anesthesia was preffered and for induction 2 mg kg-1 propofol, 1 ?g kg-1 fentanyl, and 0.5 mg kg-1 rocuronium was intravenously administered. Anesthesia was maintained with 50% oxygen and 50% air and 2% sevoflurane. The patient was extubated uneventfully, subsequently postoperative choreiform movements occurred. During the postoperative follow-up, the patient's choreiform movements were observed to disappear and declined by between 3-6 hours. We did not observe a delay in the patient's anesthesia recovery. Consequently, we think general anesthesia can be uneventually applied in Wilson's disease patients by using least toxic agents to the liver, protective measures and with an attentive follow-up in the perioperative and postoperative periods.
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    Anesthetic management for super-super morbidly obese patient
    (Anaesthesia Pain & Intensive Care, 2014) Erbas, Mesut; Toman, Huseyin; Kiraz, Hasan Ali; Simsek, Tuncer; Arik, M. Kasim; Uyan, Berna; Sahin, Hasan
    Obesity leads to several changes in both airway and drug metabolism. The problems are compounded in cases of super super morbid obesity. Gastric banding surgery for weight loss was planned for a 47 year old, super-super morbidly obese female patient (164 kg and 151 cm, BMI: 72 kg/m(2)). On pre-operative examination, patient had a short thick neck and grade 4 Mallampatti class. Induction of anesthesia was done in the sitting / semi-sitting position Maintenance was provided with 6% desflurane and O-2/air mixture. Remifentanil infusion of 0.05 mu g/kg was administered during surgery. Patient had an uneventful recovery. The use of short acting drugs and appropriate monitoring provided hemodynamic stability and a fast and smooth recovery
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    Antioxidant Activity of Syringic Acid Prevents Oxidative Stress in L-arginine-Induced Acute Pancreatitis: An Experimental Study on Rats
    (Int College Of Surgeons, 2015) Cikman, Oztekin; Soylemez, Omer; Ozkan, Omer Faruk; Kiraz, Hasan Ali; Sayar, Ilyas; Ademoglu, Serkan; Taysi, Seyithan
    The aim of this study was to investigate the possible protective role of antioxidant treatment with syringic acid (SA) on L-arginine-induced acute pancreatitis (AP) using biochemical and histopathologic approaches. A total of 30 rats were divided into 3 groups. The control group received normal saline intraperitoneally. The AP group was induced by 3.2 g/kg body weight L-arginine intraperitoneally, administered twice with an interval of 1 hour between administrations. The AP plus SA group, after having AP induced by 3.2 g/kg body weight L-arginine, was given SA (50 mg kg(-1)) in 2 parts within 24 hours. The rats were killed, and pancreatic tissue was removed and used in biochemical and histopathologic examinations. Compared with the control group, the mean pancreatic tissue total oxidant status level, oxidative stress index, and lipid hydroperoxide levels were significantly increased in the AP group, being 30.97 +/- 7.13 (P < 0.05), 1.76 +/- 0.34 (P < 0.0001), and 19.18 +/- 4.91 (P < 0.01), respectively. However, mean total antioxidant status and sulfhydryl group levels were significantly decreased in the AP group compared with the control group, being 1.765 +/- 0.21 (P < 0.0001) and 0.21 +/- 0.04 (P < 0.0001), respectively. SA reduces oxidative stress markers and has antioxidant effects. It also augments antioxidant capacity in L-arginine-induced acute toxicity of pancreas in rats.
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    Bilateral alt ekstremite uzuv kaybı olan geriatrik hastada spinal anestezi: 2 olgu sunumu
    (2013) Erbaş, Mesut; Öztürk, Ömür; Kiraz, Hasan Ali; Toman, Hüseyin; Şahin, Hasan; Demiraran, Yavuz
    Yaşam kalitesinin yükselmesi, yeni teşhis ve tedaviolanaklarının geliştirilmesi ile yaşlı popülasyon tüm dünyadahızla artmaktadır. Yaşlı hasta grubundaki yandaş hastalıklarve gelişebilecek komplikasyonlar nedeniyle rejyonel anesteziteknikleri genel anesteziye tercih edilmektedir. Spinalanestezinin operasyon sırasında kognitif fonksiyonların vehava yolu reflekslerinin korunması, postoperatif dönemdeetkin analjezinin sağlanması ile birlikte erken mobilizasyongibi avantajları vardır. Spinal anestezide lokal anesteziğinsefale doğru yayılması ile birlikte preganglionik sempatikliflerde blokaj olması, kardiovasküler yan etkilere yol açabilir.Özellikle geriatrik hastalarda bu hemodinamik instabilitedenkaçınmak için lokal anesteziğin mümkün olan en düşükdozda kullanılması tercih edilmelidir. Biz bu yazıda geriatrik,bilateral alt ekstermite uzuv kaybı olan ve ürolojik girişimgeçirecek olan yüksek riskli iki olgumuzda spinal anesteziuygulamamızı ve bilateral uzuv kaybının uyguladığımız lokalanestezik d ozuna etkisini literatür eşliğinde tartışmayıamaçladık.
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    Büyük Hücreli Nöroendokrin Karsinomu'nun İntrakranial Metastazı-Olgu Sunumu
    (2015) Bozkurt, Adem Aras; Alkan, Bahadır; Şafak, Özbey; Kiraz, Hasan Ali; Koşar, Şule; Akman, Tarık; Güven, Mustafa
    Beyin metastazları, sistemik kanserlerin iyi bilinen bir komplikasyonudur. Yetişkinlerde beyin metastazlarının en çok kaynağı akciğerlerdir. Hemisferler, beyincik, beyinsapı, hipofiz (sellar bölge), serebellopontin/internal akustik kanal ve leptomeningeal bölgeler potansiyel yayılım lokalizasyonlarıdır. Dünya Sağlık Örgütü, 2004 yılında malign akciğer tümörlerinin yeni histolojik sınıflamasını oluşturmuştur. Bu sınıflamada yer alan büyük hücreli nöroendokrin karsinom kötü prognoza sahip nadir ve agresif bir tümördür. Büyük hücreli nöroendokrin karsinom tanısında farklı immünohistokimyasal belirteçler kullanılabilir. Bu olguda; 61 yaşındaki bir erkek hastada yürürken dengesizlik ve hafif baş ağrısı şikayete neden olan, kranyal MRG' sinde sağ parietal ve sol serebellar yerleşimli metastazları olan olgu sunulmuştur. Sağ pariyetal yerleşimli tümör kranyektomi yapılarak çıkartıldı. Histopatolojik ve immünohistokimyasal bulgular büyük hücreli nöroendokrin karsinom ile uyumlu olarak değerlendirildi. Bu makalede; nadir görülen ve kötü prognoza sahip olan bu tümörlerin tanısı, yapmış olduğu metastazlar, radyolojik özellikleri, patogenezi, ve cerrahi yaklaşımları tartışılmıştır
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    Changes in retinal nerve fiber layer thickness after spinal surgery in the prone position: a prospective study
    (Elsevier Science Inc, 2015) Gencer, Baran; Cosar, Murat; Tufan, Hasan Ali; Kara, Selcuk; Arikan, Sedat; Akman, Tarik; Kiraz, Hasan Ali
    Background and objectives: Changes in ocular perfusion play an important role in the pathogenesis of ischemic optic neuropathy. Ocular perfusion pressure is equal to mean arterial pressure minus intraocular pressure. The aim of this study was to evaluate the changes in the intraocular pressure and the retinal nerve fiber layer thickness in patients undergoing spinal surgery in the prone position. Methods: This prospective study included 30 patients undergoing spinal surgery. Retinal nerve fiber layer thickness were measured one day before and after the surgery by using optical coherence tomography. Intraocular pressure was measured by tonopen six times at different position and time-duration: supine position (baseline); 10 min after intubation (Supine 1); 10 (Prone 1), 60 (Prone 2), 120 (Prone 3) min after prone position; and just after postoperative supine position (Supine 2). Results: Our study involved 10 male and 20 female patients with the median age of 57 years. When postoperative retinal nerve fiber layer thickness measurements were compared with preoperative values, a statistically significant thinning was observed in inferior and nasal quadrants (p=0.009 and p=0.003, respectively). We observed a statistically significant intraocular pressure decrease in Supine 1 and an increase in both Prone 2 and Prone 3 when compared to the baseline. Mean arterial pressure and ocular perfusion pressure were found to be significantly lower in Prone 1, Prone 2 and Prone 3, when compared with the baseline. Conclusions: Our study has shown increase in intraocular pressure during spinal surgery in prone position. A statistically significant retinal nerve fiber layer thickness thinning was seen in inferior and nasal quadrants one day after the spinal surgery. (C) 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.
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    Comparison of effects of sugammadex and neostigmine on QTc prolongation in rabbits under general anesthesia
    (Acta Cirurgica Brasileira, 2014) Erbas, Mesut; Toman, Huseyin; Sahin, Hasan; Kiraz, Hasan Ali; Barutcu, Ahmet; Simsek, Tuncer; Yener, Ali Umit
    PURPOSE: To compare the effects of sugammadex and neostigmine, used to antagonize the effects of rocuronium, on the QT(c) interval. METHODS: This study used 10 adult New Zealand white rabbits of 2.5-3.5 kg randomly divided into two groups: sugammadex group (Group S, n: 5) and neostigmine group (Group N, n: 5). For general anesthesia administering 2 mg/kg iv propofol and 1 mcg/kg iv fentanyl, 0.6 mg/kg iv rocuronium was given. Later to provide reliable airway for all experimental animals V-Gel Rabbit was inserted. The rabbits were manually ventilated by the same anesthetist. After the V-Gel Rabbit was inserted at 2, 5, 10, 20, 25, 27, 30 and 40 minutes measurements were repeated and recorded. At 25 minutes after induction Group N rabbits were given 0.05 mg/kg iv neostigmine + 0.01 mg/kg iv atropine. Group S were administered 2 mg/kg iv sugammadex. RESULTS: Comparing the QT(c) interval in the rabbits in Group S and Group N, in the 25th, 27th and 30th minute after muscle relaxant antagonist was administered the QT(c) interval in the neostigmine group rabbits was significantly increased (p < 0.05). CONCLUSION: While sugammadex, administered to antagonize the effect of rocuronium, did not significantly affect the QTc interval, neostigmine+atropine proloned the QT(c) interval.
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    Comparison of Hydroxyethyl starch 130/0.4 (6%) with commonly used agents in an experimental Pleurodesis model
    (BMC, 2020) Kapicibasi, Hasan Oguz; Kiraz, Hasan Ali; Gok, Nazli Demir
    Background: Hydroxyethyl Starch (HES) 130/0.4 (6%) is a commonly used intravascular volume expander with anti-inflammatory and antioxidant properties. In this study, we aimed to compare the histopathologic activity of HES 130/0.4 (6%) with various widely-used agents in pleurodesis. Methods: Forty male Wistar-Albino rats were divided into five groups: controls, povidone-iodine recipients (PI group), sterile talcum recipients (Talcum group), autologous blood recipients (AB group) and HES 130/0.4 (6%) recipients (HES group). Thirty days after application of agents, pleural and lung tissues were resected. Evaluation was performed via macroscopic scoring (adhesion) and specimens were stained with H&E for microscopic examination (inflammation and fibrosis). Results: HES recipients had significantly higher adhesion compared to controls (lower grade 0, higher grade 1 frequency vs. controls), they were found to have significantly lower frequency of grade 2 adhesion (vs. PI, Talc and AB) and grade 3 adhesion (vs. AB), indicating that the adhesion-generating properties of HES were only superior to the control group. HES recipients had significantly higher inflammatory grades compared to controls (lower grade 0, higher grade 1 frequency), while they had lower grades compared to the PI, Talc and AB groups. Although the PI, Talc and AB groups were statistically similar in most comparisons, we observed a trend towards higher success with the use of Talc and especially AB. Conclusion:Our results do not support a role for HES in pleurodesis. We believe that the autologous blood method remains as an effective and successful procedure without side effects.
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    Comparison of the effectivity of oral and intra-articular administration of tenoxicam in patients with knee osteoarthritis
    (Elsevier Science Inc, 2015) Erbas, Mesut; Simsek, Tuncer; Kiraz, Hasan Ali; Sahin, Hasan; Toman, Huseyin
    Background and objectives: Tenoxicam is widely used in osteoarthritis treatment and we aimed to compare the effectivity of oral and intra-articular administration of tenoxicam in osteoarthritis treatment. Methods: This study was performed between 2011 and 2012 by retrospectively analyzing and comparing the findings of 60 patients who were clinically and radiologically diagnosed with knee degenerative osteoarthritis in Bunyan state hospital pain policlinic. 60 patients included in the study were divided into two groups. The first group (tenoxicam IA, n=30) included patient findings of those subjected to intra-articular injection of 20 mg tenoxicam to the knee once a week for three weeks and the second group (oral tenoxicam, n=30) included patients who were administered 20 mg oral tenoxicam once a day for three weeks. All patients were clinically evaluated pre-treatment and in the 1st week, 1st month and 3rd month post-treatment according to specified criteria. Results and conclusions: Twenty two of 60 patients included in the study were male and 38 were female. In both groups significant improvements were detected in all of the observed parameters: visual analog scale, Western Ontario McMaster Osteoarthritis Index (pain, physical activity, knee stiffness) and Lequesne index scores and in the evaluations performed in 1st week, 1st month and 3rd month with respect to pre-treatment values. Besides, a better compliance to treatment and gastrointestinal system tolerability in tenoxicam IA group was also observed. Intra-articular tenoxicam administration could be thought as an alternative treatment method in patients with knee osteoarthritis who cannot use oral tenoxicam especially due to systemic gastrointestinal system side effects and those who have difficulties in adapting to treatment. (c) 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.
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    Comparison of the effects of various airway devices on hemodynamic response and QTc interval in rabbits under general anesthesia
    (Springer Heidelberg, 2015) Toman, Huseyin; Erbas, Mesut; Sahin, Hasan; Kiraz, Hasan Ali; Uzun, Metehan; Ovali, Mehmet Akif
    In this study, we aimed to compare the effects of various airway devices on QTc interval in rabbits under general anesthesia. The subjects were randomly separated into four groups: Group ETT, Group LMA, Group PLA, Group V-gel. Baseline values and hearth rate, mean arterial pressure and ECG was obtained at the 1st, 5th and 30th minutes after administration of anesthesia and placement of airway device and, QTc interval was evaluated. Difference was observed between ET group and V-gel group in the 5th minute mean arterial pressure values (p < 0.05). It was observed that QTc intervals at the 1st and 5th minute in the ET group significantly increased when compared with the other groups (p < 0.05). Again, it was observed that QTc interval of ET group at the 15th and 30th minute was longer when compared with PLA and V-gel groups (p < 0.05). It was also observed that QTc interval of LMA Group at the 5th minute after intubation significantly increased when compared with V-gel group (p < 0.05). It was observed that HR values of ETT group at the 1st, 5th and 15th minutes after intubation increased with regards to PLA and V-gel groups (p < 0.05). It was determined that the 30th minute hearth rate of ETT group was higher when compared to V-gel group (p < 0.05). Conclusion: In our study we observed that V-gel Rabbit affected both hemodynamic response and QT interval less than other airway devices.
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    CONN SENDROMUNDA VENÖZ ÖRNEKLEME SONRASI LAPAROSKOPİK SOL SÜRRENALEKTOMİ
    (2014) Çıkman, Öztekin; Özkan, Ömer Faruk; Kiraz, Hasan Ali; Şen, Hacer; Adam, Gürhan Adam; Özkul, Faruk; Taş, Şükrü
    Primer Hiperaldosteronizm; Aldosteron hormonunun adrenal kortexten genellikle soliter adenom veya bilateral adrenal hiperplaziye bağlı otonom aşırı salgılanması, plazma renin aktivitesinin (PRA) baskılanması ve bunun sonucunda da hipertansiyon ve hipopotasemi ortaya çıkmasıdır. 30-50 yaş kadınlarda daha sık olduğu bildirilmektedir. Cerrahi tedavi planlanan hastalara, adrenal venöz örnekleme (AVÖ) önerilmektedir. AVÖ unilateral hastalığı bilateral hastalıktan ayırmada altın standart olarak görülmektedir. Çalışmamızda, kliniğimizde ilk kez yapılan venöz örnekleme sonrası tanısı konulan sürrenal adenomu olgusunun sunulması amaçlanmıştır
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    Cost-conscious of anesthesia physicians: An awareness survey
    (Professional Medical Publications, 2015) Hakimoglu, Sedat; Hancı, Volkan; Karcıoglu, Murat; Tuzcu, Kasım; Davarcı, Isıl; Kiraz, Hasan Ali; Turhanoglu, Selim
    Objective: Increasing competitive pressure and health performance system in the hospitals result in pressure to reduce the resources allocated. The aim of this study was to evaluate the anesthesiology and intensive care physicians awareness of the cost of the materials used and to determine the factors that influence it. Methods: This survey was conducted between September 2012 and September 2013 after the approval of the local ethics committee. Overall 149 anesthetists were included in the study. Participants were asked to estimate the cost of 30 products used by anesthesiology and intensive care units. Results: One hundred forty nine doctors, 45% female and 55% male, participated in this study. Of the total 30 questions the averages of cost estimations were 5.8% accurate estimation, 35.13% underestimation and 59.16% overestimation. When the participants were divided into the different groups of institution, duration of working in this profession and sex, there were no statistically significant differences regarding accurate estimation. However, there was statistically significant difference in underestimation. In underestimation, there was no significant difference between 16-20 year group and >20 year group but these two groups have more price overestimation than the other groups (p=0.031). Furthermore, when all the participants were evaluated there were no significant difference between age-accurate cost estimation and profession time-accurate cost estimation. Conclusion:Anesthesiology and intensive care physicians in this survey have an insufficient awareness of the cost of the drugs and materials that they use. The institution and experience are not effective factors for accurate estimate. Programs for improving the health workers knowledge creating awareness of cost should be planned in order to use the resources more efficiently and cost effectively. © 2015, Professional Medical Publications. All rights reserved.
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    Dexmedetomidine protects from post-myocardial ischaemia reperfusion lung damage in diabetic rats
    (Co-Action Publishing, 2015) Kip, Gulay; Celik, Ali; Bilge, Mustafa; Alkan, Metin; Kiraz, Hasan Ali; Ozer, Abdullah; Sivgin, Volkan
    Objective: Diabetic complications and lipid peroxidation are known to have a close association. Lipid peroxidation commonly occurs at sites exposed to ischaemia, but distant organs and tissues also get damaged during ischaemia/reperfusion (I/R). Some of these targets are vital organs, such as the lung, liver, and kidney; the lung is the most frequently affected. The aim of our study was to investigate the effects of dexmedetomidine on I/R damage in lung tissue and on the oxidant/anti-oxidant system in diabetic rats. Material and methods: Diabetes was induced with streptozotocin (55 mg/kg) in 18 Wistar Albino rats, which were then randomly divided into three groups (diabetes control (DC), diabetes plus ischaemia-reperfusion (DIR), and diabetes plus dexmedetomidine-ischaemia/reperfusion (DIRD)) after the effects of diabetes were clearly evident. The rats underwent a left thoracotomy and then ischaemia was produced in the myocardium muscle by a left anterior descending artery ligation for 30 min in the DIRand DIRD groups. I/Rwas performed for 120 min. The DIRD group received a single intraperitoneal dose of dexmedetomidine (100 mu g/kg); the DIR group received no dexmedetomidine. Group DC was evaluated as the diabetic control group and also included six rats (C group) in which diabetes was not induced. These mice underwent only left thoracotomy and were closed without undergoing myocardial ischaemia. Histopathological changes, activities of catalase (CAT) and glutathione-S-transferase anti-oxidant enzymes, and malondialdehyde (MDA) levels were evaluated in the lung tissues of all rats. Results: Neutrophil infiltration/aggregation was higher in the DIR group than in the C, DC, and DIRD groups (p = 0.001, p = 0.013, and p = 0.042, respectively). The lung injury score was significantly higher in the DIR group than in the C and DC groups (p < 0.0001 and p = 0.024, respectively). The levels of MDA were significantly higher in the DIR group than in the C and DIRD groups. CATactivity was significantly higher in the DIR group than in the DIRD and C groups. Conclusion: Our results confirm that dexmedetomidine has protective effects against the lung damage resulting from I/R in diabetic rats. Future studies conducted to evaluate the effects of the use of dexmedetomidine on damage to various organs following different I/R durations may help understanding possible protective effects of dexmedetomidine and underlying mechanisms in tissue damage related to I/R injury.
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    Effect of Low and High Dose Sugammadex on Erythrocyte Deformability in Streptozotocin- Induced Diabetic Rats
    (2015) Kiraz, Hasan Ali; Turgut, Hüseyin Cihad; Kartal, Seyfi; Çomu, Faruk Metin; Kip, Gülay; Alkan, Metin; Aydın, Muhammed Enes
    Amaç: Eritrosit deformabilitesi eritrosit membranının özel yapısı ile ilgili bir fonksiyon olup, hücrenin dağılmadan oksijen taşımasına olanak sağlar. Diyabette görülen bozulmuş eritrosit deformabilitesi eritrosit agregasyonu ve mikrovasküler düzeydeki dolaşım bozukluğunun etkenlerinden biridir. Bu çalışmada sıçanlarda streptozosinle indüklenen diyabette yüksek ve düşük doz sugammadeksin eritrosit deformabilitesi üzerindeki etkisini araştırmayı amaçladık. Yöntemler: Ağırlıkları 225-300 gram arasında değişen 24 erkek Wistar albino sıçan rasgele 4 gruba ayrıldı. Grup K (kontrol; n=6), Grup DK (diyabet kontrol; n=6), Grup DR-16S (diyabet-rokuronyum-16mg sugamadeks; n=6) ve Grup DR96S (diyabet- rokuronyum-96mg sugammadeks; n=6). Kontrol ve diyabet gruplarındaki sıçanlara aynı hacimde %0.9 NaCl verildi. Diyabet oluşturmak için tek intraperitoneal enjeksiyonla 55 mg.kg-1 streptozosin (Sigma Chemical, St. Louis, MO, USA) uygulandı. Hayvanlar 30 gün süre ile izlendi ve takip süresinin sonunda kan örneklerinden eritrosit deformabilitesi ölçümü yapıldı. Bulgular: Kontrol grubundaki serum glukoz düzeyi DK, DR-16S ve DR-96S gruplarındakilerden anlamlı olarak düşük bulundu (p<0.0001). Diyabet oluşturulan sıçanlarda deformabilite indeksi anlamlı düzeyde yüksek bulundu (p<0.0001). Eritrosit deformabilitesi DR-96S grubunda Kontrol ve DK gruplarındakinden anlamlı olarak yüksek bulundu (p<0.0001 ve p=0.028). Sonuç: Bu çalışmada diyabetik sıçanlarda düşük doz sugammadeksin güvenli olduğunu gösterdik. Çalışmamazın sonuçları sugammadeksin eritrosit deformabilitesi ve mikro/makrosirkülasyon üzerindeki etkilerini araştıracak insan ve hayvan çalışmaları için yol gösterici olabilir