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Öğe A fatal complication after repair of post-infarction ventricular septal rupture: heparin-induced thrombocytopenia with thrombosis(Clinics Cardive Publ Pty Ltd, 2015) Nazli, Yunus; Colak, Necmettin; Demircelik, Bora; Alpay, Mehmet Fatih; Cakir, Omer; Cagli, KerimHeparin-induced thrombocytopenia (HIT) is a rare but potentially devastating and life-threatening complication from using heparin. HIT not only causes thrombocytopenia, but it also carries an increased risk for fatal thrombotic complications. In this report, we describe the case of a patient in whom fatal HIT developed after successful surgical repair of a posterior post-infarction ventricular septal rupture with cardiopulmonary bypass.Öğe Adropin: A New Marker for Predicting Late Saphenous Vein Graft Disease after Coronary Artery Bypass Grafting(Canadian Soc Clinical Investigation, 2014) Demircelik, Bora; Cakmak, Muzaffer; Nazli, Yunus; Gurel, Ozgul M.; Akkaya, Nermin; Cetin, Mustafa; Cetin, ZehraPurpose: Saphenous vein graft disease (SVGD), defined as an occlusion of 50% or more of the SVG excluding distal anastomotic occlusion, is an important predictor of morbidity after coronary artery bypass grafting (CABG). Late graft occlusion is a serious complication that often limits the use of the saphenous vein as a coronary bypass graft. Late graft occlusion is particularly common in old, degenerated venous grafts with advanced atherosclerotic plaques. Adropin has been implicated in the homeostatic control of metabolism. The purpose of this study was to investigate whether serum adropin levels are associated with late SVGD following CABG. Methods: Thirty-eight patients with SVGD involving at least one graft (occluded group; 14 females, 24 males) and 42 patients with a patent saphenous vein graft (patent group; 15 females, 27 males) were enrolled in this study. Venous blood samples were taken from all of the participants to measure plasma adropin levels using an enzyme-linked immunsorbent assay kit. Results: The mean adropin level was significantly lower in the occluded group than in the patent group (3.2 +/- 0.71 vs. 4.9 +/- 1.51 ng/ mL, p < 0.001). Multivariate regression analysis showed that the adropin level was the independent predictor of late saphenous vein graft occlusion. Conclusions: Adropin levels are lower in patients with late saphenous vein graft occlusion and these reduced adropin levels, together with other factors, may lead to saphenous vein graft occlusion. Larger and prospective studies are needed to determine if adropin plays a role in the pathogenesis of SVGD.Öğe Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA) in an Adult(Derman Medical Publ, 2013) Nazli, Yunus; Aksoy, Omer Nuri; Korkmaz, Kemal; Akkaya, Ismail Olgun; Colak, NecmettinAnomalous origin of the left main coronary artery from the pulmonary artery (ALCAPA), also known as Garland-Bland-White syndrome, is an extremely rare but potentially fatal congenital cardiovascular anomaly and it often exists as an isolated condition. We report an unusual case of a 32 years-old patient with ALCAPA presenting with chest pain and dyspnea who underwent surgical correction of this rare anomaly. This anomaly was simply repaired by the combination of LMCA ligation and coronary artery bypass grafting.Öğe Assessment of the efficacy of Ankaferd blood stopper on the prevention of postoperative pericardial adhesions(Clinics Cardive Publ Pty Ltd, 2014) Nazli, Yunus; Colak, Necmettin; Alpay, Mehmet Fatih; Haltas, Hacer; Aksoy, Omer Nuri; Akkaya, Ismail Olgun; Cakir, OmerObjectives: Ankaferd has been used as a blood-stopping agent and it may also have an anti-inflammatory effect. We investigated the efficacy of Ankaferd in preventing postoperative pericardial adhesions in an experimental rabbit model. Methods: Sixteen New Zealand white rabbits were used and categorised into two groups: an Ankaferd and a control group. The Ankaferd group of rabbits was treated with a sponge impregnated with Ankaferd solution, which was applied over the abraded epicardium. A sponge impregnated with 0.9% isotonic NaCl solution was applied to the control group using the same protocol. Scores for adhesion and visibility of coronary vessels were graded by macroscopic examination, and pericardial tissues were analysed microscopically in terms of inflammation and fibrosis. Results: In the Ankaferd group, the adhesion scores were significantly higher than in the control group (p = 0.007). When the groups were compared according to the prevalence of fibrosis and degree of inflammation, the Ankaferd group was found to be statistically significantly different from the control group in terms of prevalence of fibrosis (p = 0.028). Conclusion: Topical application of Ankaferd to prevent postoperative pericardial adhesions increased adhesion and fibrosis scores.Öğe Cilostazol Attenuates Spinal Cord Ischemia-Reperfusion Injury in Rabbits(W B Saunders Co-Elsevier Inc, 2015) Nazli, Yunus; Colak, Necmettin; Namuslu, Mehmet; Erdannar, Husamettin; Haltas, Hacer; Alpay, Mehmet Fatih; Aksoy, Omer NuriObjective: The aim of this study was to evaluate the pretreatment effect of cilostazol on spinal cord ischemia-reperfusion injury. Design: Prospective, interventional study. Setting: Research laboratory, single institution. Participants: Twenty-four New Zealand white rabbits. Interventions: Twenty-four rabbits were divided into 3 equal groups: group I (sham), group II (ischemia-reperfusion, control group), and group III (cilostazol, administered orally 30 mg/kg/day for 3 days before the surgery). Spinal cord ischemia was induced by clamping the aorta both below the left renal artery and above the iliac bifurcation for 30 minutes. Seventy-two hours postoperatively, the motor function of the lower limbs was evaluated in each animal according to the modified Tarlov score. Spinal cord and blood samples were taken for histopathologic and biochemical analyses at the 72nd hour of reperfusion. Measurements and Main Results: All rabbits in the ischemia-reperfusion group (group II) showed severe neurologic deficits. The median (IQR) Tarlov scores postoperatively at 72 hours in groups I, II, and III were 5.0(-), 2.0(1.0), and 4.5(1.0), respectively. Administration of cilostazol resulted in a significant reduction in motor dysfunction when compared with the ischemia-reperfusion group (p < 0.001). In the ischemia-reperfusion group, serum and tissue glutathione peroxidase and superoxide dismutase activity were significantly less compared with the sham group (group I) (p < 0.05). Serum and tissue glutathione peroxidase and superoxide dismutase levels in the cilostazol-treated group (group III) were higher compared with the ischemia-reperfusion group (p < 0.05). In the cilostazoltreated group, serum and tissue malondialdehyde levels were lower compared with the ischemia-reperfusion group (p < 0.05). Histopathologic analysis found decreased neuronal injury in the cilostazol group when compared with the ischemia-reperfusion group (p < 0.05). Conclusions: This study showed that pretreatment with cilostazol significantly ameliorated neurologic functional outcome and attenuated neuronal histopathologic injury after transient aortic occlusion in rabbits. (C) 2015 Elsevier Inc. All rights reserved.Öğe Effects of multimedia nursing education on disease-related depression and anxiety in patients staying in a coronary intensive care unit(W B Saunders Co-Elsevier Inc, 2016) Demircelik, Muhammed Bora; Cakmak, Muzaffer; Nazli, Yunus; Sentepe, Esra; Yigit, Derya; Keklik, Mevlude; Arslan, MuzeyyenAim: We evaluated the effectiveness of an accessibility-enhanced multimedia informational educational program in reducing depression and anxiety increasing satisfaction with the information and materials received by patients in coronary care unit. Methods: We selected 100 patients from among the patients who stayed at or who underwent surgery at one of two ICUs for any reason who satisfied the eligibility criteria, and agreed to participate in the research. The participants were included in the control or experimental group by random selection. The patients completed the Hospital Anxiety Depression Scale during ICU admission and 1 week after hospital discharge. Results: The difference in HADSA score was significantly greater in patients who received education than in patients who did not receive multimedia nursing education (42 +/- 0.58 vs. 0.6 +/- 0.42; p < .01). Additionally, the difference in HADSD score was significantly greater in patients who received multimedia nursing education (2.2 +/- 0.53 vs. 0.64 +/- 0.46; p < .01). Conclusion: This study showed that anxiety and depression associated with hospital can be reduced with multimedia nursing education. (C) 2015 Elsevier Inc. All rights reserved.Öğe Neuroprotective effect of atorvastatin in spinal cord ischemia-reperfusion injury(Hospital Clinicas, Univ Sao Paulo, 2015) Nazli, Yunus; Colak, Necmettin; Alpay, Mehmet Fatih; Uysal, Sema; Uzunlar, Ali Kemal; Cakir, OmerOBJECTIVES: Prevention of the development of paraplegia during the repair of the damage caused by descending thoracic and thoracoabdominal aneurysms remains an important issue. Therefore, we investigated the protective effect of atorvastatin on ischemia-induced spinal cord injury in a rabbit model. METHOD: Thirty-two rabbits were divided into the following four equally sized groups: group I (control), group II (ischemia-reperfusion), group III (atorvastatin treatment) and group IV (atorvastatin withdrawal). Spinal cord ischemia was induced by clamping the aorta both below the left renal artery and above the iliac bifurcation. Seventy-two hours postoperatively, the motor function of the lower limbs of each animal was evaluated according to the Tarlov score. Spinal cord and blood samples were obtained for histopathological and biochemical analyses. RESULTS: All of the rabbits in group II exhibited severe neurological deficits. Atorvastatin treatment (groups III and IV) significantly reduced the level of motor dysfunction. No significant differences were observed between the motor function scores of groups III and IV at the evaluated time points. Light microscopic examination of spinal cord tissue samples obtained at the 72nd hour of reperfusion indicated greater tissue preservation in groups III and IV than in group II. CONCLUSION: This study demonstrates the considerable neuroprotective effect of atorvastatin on the neurological, biochemical and histopathological status of rabbits with ischemia-induced spinal cord injury. Moreover, the acute withdrawal of atorvastatin therapy following the induction of spinal cord ischemia did not increase the neuronal damage in this rabbit model.Öğe Pharmacomechanical Thrombectomy in the Management of Deep Vein Thrombosis Using the Cleaner Device: An Initial Single-Center Experience(Elsevier Science Inc, 2015) Bozkurt, Alper; Kirbas, Ismail; Kosehan, Dilek; Demircelik, Bora; Nazli, YunusBackground: Pharmacomechanical thrombectomy (PMT) has appeared as an effective treatment modality for deep venous thrombosis (DVT). The study aimed to assess the efficacy of the Cleaner(TM) thrombectomy device for acute DVT. Methods: Sixteen consecutive patients presenting with extensive iliofemoral and/or femoropopliteal acute DVT and managed at our institution between February 2013 and May 2014 were retrospectively reviewed. The patients underwent PMT with the Cleaner device after insertion of vena caval filters. For underlying stenotic lesions, balloon angioplasty and/or stent placement was performed. Results: PMT with the Cleaner device was successful in 14 patients with complete restoration of flow. No clinical signs of pulmonary thromboembolism was recorded after the procedure. Thrombectomy failed in 2 patients. For the rest of the patients, balloon angioplasty was performed to relieve underlying stenotic lesions. Nine of them underwent additional stenting. Conclusions: Our initial experience suggests that the Cleaner device can be used in acute DVT. However, further studies involving larger patient populations are warranted to determine long-term results.
