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Öğe Basilic vein superficialization for hemodialysis vascular access(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2013) Yuksel, Volkan; Halici, Umit; Huseyin, Serhat; Guclu, Orkut; Canbaz, Suat; Ege, Turan; Sunar, HasanBackground: This study aims to discuss the outcomes of superficialization of basilic vein technique in brachiobasilic arteriovenous fistula formation and to present our experience. Methods: Between January 2006 and January 2012, 170 patients (74 males, 96 females; mean age 60.7 +/- 9.1 years; range 31 to 83 years) who underwent basilic vein superficialization surgery in our clinic were included. All patients were examined under Doppler ultrasonography preoperatively. Demographic data of the patients, maturation time and complications were recorded. The mean follow-up was 12 months. Results: Non-dominant upper limb was preferred for surgery. Of the 170 patients who were operated, 166(97.6%) underwent hemodialysis. The mean maturation time was 61 days. Massive bleeding in the postoperative period occurred in two patients (1.2%). Wound infection was observed in eight patients (4.7%) in the early postoperative period. The most common reason for primary failure was thrombosis, which was observed in 48 patients (28.2%). The primary and secondary patency rates of the fistulas were 77% and 82%, respectively at one-year. Conclusion: Arteriovenous fistula formation through superficialization of the basilic vein offers satisfactory results in chronic hemodialysis patients with reasonable postoperative complication rate.Öğe Clinical correlation of biopsy results in patients with temporal arteritis(Assoc Medica Brasileira, 2017) Yuksel, Olkan; Guclu, Orkut; Tastekin, Ebru; Halici, Umit; Huseyin, Serhat; Inal, Volkan; Canbaz, SuatObjective: Temporal arteritis is systemic vasculitis of medium and large sized vessels. The lowest incidence rates were reported in Turkey, Japan and Israel. We aimed to investigate the results of patients with biopsy-proven temporal arteritis and those classified according to the American College of Rheumatology criteria from a low-incidence region for temporal arteritis. The results of our study are noteworthy, since there is limited data on pathologic diagnosis of temporal arteritis in Turkey. Method: We studied the medical records, laboratory findings such as erythrocyte sedimentation rate and C-reactive protein levels, biopsy results, and postoperative complications of all the patients operated for temporal artery biopsy at our clinic. We used the computerized laboratory registry that keeps all records of 42 consecutive temporal artery biopsy results from January 2011 to December 2016. Results: The mean age was 66 +/- 12.5 years. The most common manifestations on admission were temporal headache, optic neuritis and jaw claudication, respectively. Temporal artery biopsy results confirmed tempoal arteritis in eight out of 42 (19%) patients. There was no statistically significant difference between biopsy-positive and biopsy-negative groups in terms of sex, age, erythrocyte sedimentation rate, C-reactive protein and biopsy length. Conclusion: We were not able to find a correlation between the analysis of biopsy results and clinical evaluation of patients with temporal arteritis. We suggest that diagnosis of temporal arteritis depends on clinical suspicion. Laboratory examination results may not be helpful in accurate diagnosis of tempoal arteritis.Öğe A comparison of the vasodilatory effects of verapamil, papaverine and nitroglycerin on isolated rat aorta(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2013) Ege, Turan; Halici, Umit; Gur, Ozcan; Gurkan, Selami; Gur, Demet Ozkaramanli; Duran, EnverBackground: This study aims to compare the vasodilatory effects of verapamil, papaverine and nitroglycerin on rat aortic preparations in in vitro isolated tissue bath system and to evaluate the role of vascular endothelium on vasodilatory responses of the isolated rat aorta samples. Methods: The thoracic aorta segments collected from 30 male Wistar rats (20 endothelialized and 20 de-endothelialized vascular rings for each drug in 2 mm wide strips, total number of 120 vascular rings) were suspended into the Krebs solution of the isolated tissue bath system. Phenylephrine was used to induce isometric contraction and tissue samples were treated with verapamil, papaverine and nitroglycerin separately to draw concentration-response curves of isometric vasodilatory responses. This procedure was repeated for de-endothelialized aorta samples. Results: Papaverine and verapamil induced vasodilatatory responses starting from the concentration of 10(-8) M and reached its maximum at concentration of 10(-3) M, while nitroglycerin induced vasodilation at lower concentrations starting from a concentration of 10(-12) M, reaching its maximum at 10(-6) M. Nitroglycerin was the most potent agent, followed by verapamil and papaverine. Efficacy analysis revealed that the most efficient agents were papaverine (140 +/- 6.7%), nitroglycerin (110.8 +/- 1.35%) and verapamil (99 +/- 4.14%), respectively. The results were similar in aorta samples without endothelium (p >= 0.05, F test). Conclusion: In this study examining isolated rat aorta, nitroglycerin was the most potent agent, while papaverine was the most efficient agent. Our study results showed that endothelium played no role in vasodilatation responses of these drugs.Öğe Emergency surgical treatment of a ruptured abdominal aortic aneurysm: a 10-year experience in diagnosis and treatment(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2014) Halici, Umit; Yuksel, Volkan; Huseyin, Serhat; Okyay, Ahmet; Canbaz, Suat; Sunar, HasanBackground: This study aims to report the results of emergency operations of ruptured abdominal aortic aneurysm. Methods: Between February 2001 and February 2011, 20 patients (1 female, 19 males; mean age 64.9 +/- 9.4 years; range 50 to 77 years) who were admitted to the emergency department and underwent emergency operation for ruptured abdominal aort aneurysm were retrospectively analyzed. Combined left thoracotomy + median laparotomy was performed in one patient (5%), while median laparotomy alone was performed in others. Aaortic cross clamping was applied following heparinization. In patients in whom aortic cross clamping was not suitable (n=3), proximal bleeding control was performed through occlusion by endoclamping with a Foley catheter. Aneurysmectomy + aortobifemoral bypass was performed in six patients (30%), aneurysmectomy + aortobiiliac bypass in 10 (50%), aneursymectomy + abdominal aortic graft interposition in two (10%), explorative laparotomy in one (5%), and thoracic + abdominal exploration in one (5%). Polytetrafluoroethylene (PTFE) pant graft (80%) and Dacron tube graft (10%) were used as graft materials during surgery. Results: In the early postoperative period, ischemic colitis developed in one patient (5%), prolonged entubation (>72 hours) in four (20%), wound infection in one (5%), arrhythmia in two (10%), and disseminated intravascular coagulation in one (%5). The mean duration of intensive care unit and hospital stay were 3.8 +/- 2.1 days and 8.5 +/- 3.4 days, respectively. Total mortality was seen in four patients (20%). Conclusion: We believe that early diagnosis of a ruptured abdominal aort aneurysm and endoclamping with a Foley catheter or an intraaortic balloon occlusion in patients who are ineligible for aortic cross clamping may increase the success of an emergency operation.Öğe Emergency surgical treatment of ruptured abdominal aortic aneurysm: a 10-year experience in diagnosis and treatment Response(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2014) Halici, Umit; Yuksel, Volkan; Huseyin, Serhat; Okyay, Ahmet; Canbaz, Suet; Sunar, Hasan[Abstract Not Available]Öğe In Vitro Effects of Dopamine on Internal Thoracic Artery Graft Used in Coronary Artery Bypass Surger(Aves Yayincilik, Ibrahim Kara, 2010) Halici, Umit; Ege, Turan; Karadag, Cetin Hakan; Duran, EnverObjective: The aim of this study was to investigate in vitro effects of dopamine on internal thoracic artery (ITA) graft. Material and Methods: Between December 2003- June 2005, 32 patients (2 women and 30 men, mean age; 59.26+/-8.34, range 37-75 years old) who were subjected to coronary artery bypass grafting (CABG) operation in our clinic were enrolled in this study. ITA remnants were suspended in an isolated organ bath. Constrictor or relaxant responses to dopamine were recorded isometrically. Results: Dopamine in the concentration range of 10(-9) M-10(-7) M produced a mild relaxant effect on phenylephrine-precontracted ITA, and at higher concentrations than 10(-7) M it produced a constrictor response. Ther relaxant effect of dopamine was partially antagonized by L-NAME (nitric oxide synthase inhibitor, 10(-6) M), propranolol (10(-6) M), and cis-alpha-flupenthixol (dopaminergic receptor antagonist, 10(-6) M), but not by metoclopramide (D-2-dopaminergic receptor antagonist). The constrictor effect of dopamine was partially antagonized by phentolamine, prazosin and, yohimbine. Conclusion: It was concluded that, while dopamine produces a vasodilator response at the lower concentrations, it causes a constrictor effect on ITA at the higher concentrations. Both a beta-adrenergic and a nitric oxide mediated mechanism (via D-1-dopaminergic receptor) may play a role in the relaxant effect of dopamine on ITA at the lower concentrations. Constrictor response to dopamine at the higher concentrations on ITA may be produced by the activation of alpha(1)- and alpha(2)-adrenergic receptors.