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    Effect of Verapamil on Reduction of Peri-implant Capsular Thickness
    (Springer, 2009) Benlier, Erol; Unal, Yasin; Usta, Ufuk; Top, Husamettin; Aygit, Ahmet C.
    Silicone is a material commonly used in reconstructive and aesthetic surgery, but capsular formation is a very frequent complication of silicone implants. This study aimed to investigate whether verapamil, a calcium-channel blocker, can reduce the thickness of the peri-implant capsule in rats when it is instilled into the subcutaneous pockets. For this study, 60 female Wistar albino rats were used, and cubes of silicone blocks (10 x 10 x 5 mm) were crafted. The rats were divided into five groups of 12 each, and the groups were distinguished according to the use of silicone and artificially created hematoma relevant to administration of a single dose of 5 mg verapamil (Isoptin). The control group was left without silicone. In two of the four silicone groups, hematoma was artificially created around the silicone by a 1-ml injection of blood. The implants were removed 6 months later, and capsulectomy was performed. Under light microscopic examination, no severe inflammation was observed in any of the capsule tissues. Additionally, the thickness of the capsule was measured and found to be significantly reduced statistically in all the verapamil-treated groups, including the groups with the artificially created hematoma. In conclusion, based on the statistically significant data obtained in this study, subcutaneous verapamil administration may be a useful adjunct for preventing formation of capsular contracture after silicone implantations. This preliminary work in rats should be confirmed with larger mammals before carefully controlled clinical trials are considered.
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    Evaluation of prefabrication of high-density porous polyethylene implants (HDPPIs) by pathology, microangiography and bone scintigraphy
    (Soc Nuclear Medicine Inc, 2009) Top, Husamettin; Sarikaya, Ali; Benlier, Erol; Yalcin, Omer; Unal, Yasin; Aygit, Cemal
    [Abstract Not Available]
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    Fucoidin, a neutrophil rolling inhibitor, reduces damage in a rat electrical burn injury model
    (Elsevier Sci Ltd, 2011) Benlier, Erol; Eskiocak, Sevgi; Puyan, Fulya Oz; Kandulu, Huseyin; Unal, Yasin; Top, Husamettin; Aygit, Ahmet Cemal
    Background: Electrical injuries induce progressive tissue loss caused by free oxygen radicals released from neutrophil aggregates. Fucoidin, a potent inhibitor of L-selectin function, reduces the aggregation of neutrophils. The aim of this study was to evaluate the effect of fucoidin on tissue damage in rat electrical burn injury model. Methods: Forty-two male Wistar albino rats (250-300 g) were divided into 3 groups (Group A (n = 6), control group without electrical burn injury; Groups B (n = 18) and C (n = 18), electrical burn injury groups without and with fucoidin therapy, respectively). Three separate analyses were performed at different time points on 6 out of 18 mice from Group B and C at each time point. Biochemistry (myeloperoxidase and malondialdehyde levels) and histopathology (number of neutrophils) of the skin and muscle biopsies at 1st hour; tissue edema (ratio of wet weight/dry weight of extremities) at 24th hour; and necrotic areas at 7th day after electrical injury were evaluated. The electrical burn was induced by exposing rats to 220 V AC between their left upper extremity and right lower extremity for 10 s. Fucoidin was administered as 25 mg/kg intravenous bolus injection at 15 mm after electrical burn injury. Results: Myeloperoxidase and malondialdehyde levels, number of neutrophils, tissue edema, and necrotic area were significantly less in fucoidin-applied rats than the group without fucoidin therapy. Conclusions: Fucoidin inhibits tissue damage induced by electrical burn injury in rats by reducing necrotic area, edema and number of neutrophils. (C) 2011 Elsevier Ltd and ISBI. All rights reserved.
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    Microvascular anastomosis with minimal suture and arista: An experimental study
    (Thieme Medical Publ Inc, 2007) Benlier, Erol; Top, Husamettin; Aygit, A. Cernal; Usta, Ufuk; Unal, Yasin
    Background: The conventional technique of microvascular anastomosis may cause trauma to the vessel wall. In addition, the technique is difficult for beginners and is time consuming. The duration of ischemia is an important limiting factor for muscle transfer. In the case of multiple-digit replantations, fatigue developed in the surgeon may also result in suboptimal results. This study was performed to establish an easier and shorter method of microvascular anastomosis using the Arista hemostatic agent. Methods: In this study, 20 carotid arteries obtained from rats were equally divided into two groups. The arteries were then divided and repaired using three simple interrupted stay sutures with Arista powder. Evaluations were performed using the following three methods: (1) clamping time during the vessel anastomosis, (2) patency test (after 1 hour, 24 hours, and 28 days), and (3) light microscopic findings. Results: The clamping time in the conventional suture anastomosis group was 21 4 minutes, whereas that of the minimal suture in the Arista group was 12 2 minutes; the difference between the two groups was statistically significant (P <.001). There was no significant difference between the patency rates of the two groups (P=.474). It was observed that the Arista group showed qualitatively less perivascular foreign-body giant cell reaction than the control group. There was no evidence of vascular mural fibrinold necrosis, indicating that Arista was nontoxic for the vessel walls. Conclusions: The Arista-assisted microvascular anastomosis is an alternative to the conventional suture only method because it reduces the anastomosis time significantly and does not cause narrowing of the vessel wall. We believe that this technique has the potential for improving the performance of microvascular anastomosis in clinical practice.
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    Predictive value of 99mTc-sestamibi scintigraphy for healing of extremity amputation
    (Springer, 2006) Sarikaya, Ali; Top, Husamettin; Aygit, A. Cemal; Benlier, Erol; Unal, Yasin
    Purpose: Although various non-invasive procedures have been proposed to determine the optimal level of amputation of limbs in patients who have vascular disease, currently there are no consistent criteria that can be applied before surgery. The purpose of this study was to determine whether Tc-99m-sestamibi imaging can accurately predict the healing of amputation sites. Methods: In a prospective study in 26 patients ( 21 men, 5 women; age range 23 - 94 years) presenting with ulcers or gangrene of the foot and hand, Tc-99m-sestamibi imaging was performed preoperatively. The indications for amputation included gangrene ( 23 patients), electrical injury ( 2 patients) and trauma ( 1 patient) of extremities. Although the amputation levels were chosen according to clinical criteria and scintigraphic results, the final amputation level was defined by scintigraphic results. Two below-knee, one above-knee, 12 toe, 11 transmetatarsal, two phalanx, one finger and one thumb amputations and one shoulder disarticulation were performed. In four cases, the amputation defect was not suitable for coverage using a local dermal flap; rather, it was covered with free tissue transfer. Patients had clinical follow-up for 6 - 36 months ( mean 11.69 months) to assess healing of the stump. Scan results were compared with clinical outcome to assess prediction of healing. Results: There was healing in all amputations at the end of the follow-up period. When evaluated regarding preoperative Tc-99m-sestamibi uptake pattern, there was no perfusion to the lesion site in 21 patients and perfusion to an area smaller than the extent of skin necrosis in four patients; thus, in these 25 patients, Tc-99m-sestamibi scintigraphy suggested non-viable tissue in the extremities with clear-cut edges of perfused muscle tissue. Diffusely decreased uptake was seen below the left knee in one case. How scintigraphy changed management was analysed. The amputation levels proposed before scintigraphy were divided into two groups, definite (n=14) and indefinite ( n= 12), based on visual examination and Doppler findings. In nine patients in the definite group, the proposed amputation level before scintigraphy was not altered by the scintigraphic data. However, Tc-99m-sestamibi scan enabled unnecessarily high amputation levels to be avoided in 12 patients in the indefinite group and in five patients in the definite group. Therefore, there was change in management of 65% of cases based on scintigraphic findings. Conclusion: Since healing of the stump was seen in all cases, outcome was correctly predicted by scintigraphy. This preliminary study supports the use of Tc-99m-sestamibi scan in selecting the optimal amputation level consistent with subsequent stump healing.