Journal of Clinical and Experimental Investigations, 2014
Objective: Accurate, reliable laboratory reference ranges are essential for effective clinical ev... more Objective: Accurate, reliable laboratory reference ranges are essential for effective clinical evaluation and monitoring. We present robust reference ranges established for hematology parameters using the Sysmex XT2000i analyzer. Methods: Blood samples were taken from 17409 healthy adults (19 to 49 years, 51.4% men and 48.6% women) and routine hematology analysis performed. Patients were assessed as healthy on the basis of a medical history and routine medical examinations. Serum hematinic assays (vitamin B12, folate, iron and ferritin) were also analyzed in order to exclude the potential anemia existence. Results: There was a statistically significant difference (p<0.001) between men and women, with the former showing higher CBC values, except WBC, neutrophil and platelet counts compared to females. Several differences were observed when compared to previously established values from Turkey, most notably in leucocytes and platelets. Our findings for CBC parameters, except leucocyte count and MCV are in general agreement with previously published data from more limited trials undertaken in other countries. Conclusions: In spite of the uncontrolled factors influencing hematological values, this study permitted to establish the new hematological reference values in Turkey, especially living near sea level. In the absence of previously detailed investigated hematological reference values in Turkey, we offered to use these results for clinical management of Turkish patients and interpretations of laboratory data for research purpose.
Severely atherosclerotic (porcelain) ascending aorta is associated with increased morbidity and m... more Severely atherosclerotic (porcelain) ascending aorta is associated with increased morbidity and mortality during coronary artery bypass grafting (CABG) due to the increased risk of perioperative atheroembolism. Three maneuvers during CABG can cause atheromatous embolism from the diseased ascending aorta: 1) cannulation of the ascending aorta; 2) cross- clamping; 3) partial clamping for the construction of the proximal anastomosis. In our hospital, extra-anatomic CABG was performed in 8 patients with heavily calcified ascending aorta: 6 patients were men and 2 women. Operations were performed on the beating heart in 5 patients, 2 patients operated on beating heart and another patient on fibrillating heart with supportive cardiopulmonary bypass (CPB). Arterial cannulation was done through the right femoral artery on these patients. Apart from internal mammary artery (IMA) grafts, proximal anastomotic sites were the right axillary, right subclavian and innominate arteries. One patient ...
Repair of atrial septal defect (ASD) via minimal access has been the preferred method to improve ... more Repair of atrial septal defect (ASD) via minimal access has been the preferred method to improve cosmesis and fast rehabilitation. A 2-stage single venous cannula introduced via the femoral route allows better vision of the surgical field and improves surgical acts through a limited incision. From February 1999 to December 2001 a minithoracotomy approach was used for closure of secundum type ASD by using single bicaval venous cannula in 17 adult patients. A 6 to 7 cm anterior minithoracotomy (submammary) approach with femoral arterial and 2-stage single venous cannula were utilized. Defects were closed primarily by running suture in 14 and with a patch in 3 patients. Calculated flow levels were maintained with a single venous cannula without assisted venous drainage in all patients. The postoperative course was uneventful in all patients except 1 who required revision for bleeding which was done through the same incision. Extension of the thoracotomy or shifting to the classic stern...
The decline in infections in childhood may contribute to the rising severity and prevalence of at... more The decline in infections in childhood may contribute to the rising severity and prevalence of atopic disorders in developed countries. Support for this hypothesis has been obtained from findings of an inverse association between tuberculin responses and atopy and from findings of high prevalence of asthma in certain islands with low prevalence of respiratory infections. With this regard, we investigated the association between serum anti-streptolysin-O (ASO) titers and the frequency of exacerbations of asthma in childhood. Thirty atopic asthmatic children who has no sign of upper respiratory tract infection at the time of presentation or during the previous two months were included in the study. Serum ASO titer was measured as an indicator of past streptococcal upper respiratory tract infections. ASO titer > or = 200 Todd units was accepted as positive. A statistically significant association is found between high anti-streptolysin-O titers and decreased number of exacerbations ...
utilizing multiple firings of an endo-GIA stapling device (Fig 2). The medial portion and thus th... more utilizing multiple firings of an endo-GIA stapling device (Fig 2). The medial portion and thus the upper lobe were subsequently freed for resection. After this maneuver, venous tributaries, arterial branches, and the bronchus were dissected out and ligated in the standard fashion. Pathology revealed a 3.5-cm squamous cell carcinoma with negative bronchial, pulmonary artery, and pulmonary vein margins. The stapled medial margin of the specimen was also negative for malignancy. The patient's recovery was unremarkable. Comment Preserving the integrity of a previous LIMA pedicle is of utmost importance during future surgical procedures. Thoracic surgeons are often confronted with this challenge during noncardiac thoracic procedures, especially those occurring in the left chest. Although one option is to tediously dissect free the entire LIMA pedicle, the consequences of an error could be lethal. We have presented a straightforward approach to leaving a portion of the left upper lobe attached to the LIMA pedicle without jeopardizing the previous coronary revascularization. This alternative is safe and with only minimal oncologic compromise. In the author's experience, this method has been utilized in 5 patients without any complications of infection or tumor recurrence.
Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology, 2006
Myocardial bridge (MB) is a congenital abnormality of the coronary arteries characterized by the ... more Myocardial bridge (MB) is a congenital abnormality of the coronary arteries characterized by the decrease in the coronary blood flow during systole due to the compression of the myocardial fibrils surrounding the epicardial coronary artery in a certain segment. Although usually asymptomatic, medical therapy, percutaneous transluminal coronary angioplasty (PTCA), and rarely surgery may be necessary to relieve symptoms.
Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology, 2002
BACKGROUND Repetitive procedures usually take place in the natural course of coronary heart disea... more BACKGROUND Repetitive procedures usually take place in the natural course of coronary heart disease. The aim of this study was to evaluate the risk factors, which affect coronary bypass reoperations, and to compare them with the postoperative results of the coronary first operations and the reoperations. METHODS Between January 1995 and January 2000, coronary reoperations were performed in 104 cases (Coronary reoperations group) by the same surgical team. Ninety-nine of them were the first, 3 were the second and 2 were the third reoperations in this group. At the same period of time, 3609 patients underwent coronary bypass procedure as the first operation (Coronary 1. operation group). Eighty-seven patients were male (83.65%), 17 were female (16.35%) and the mean age was 60.82 +/- 9.49 in reoperation group; while among 2916 patients 2223 were male (80.8%), 693 were female (19.2%) and the mean age was 60.37 +/- 9.58 in the first operation group. RESULTS Incidence of prolonged ventila...
Since 1985 many authors have reported complications of percutaneous transluminal angioplasty (PTC... more Since 1985 many authors have reported complications of percutaneous transluminal angioplasty (PTCA) (1-12). Myocardial infarction is the major complication (6, 7), but we believe that guidewire fractures are also not so rare and such cases are underreported. Cardiologists developed percutaneous intravascular methods to extract the broken portion of the guidewire by special catheters but these may not always permit a successful salvage operation. Although it is believed that wire in the coronary artery may cause intravascular thrombus formation (4) or coronary narrowing (10), some authors preferred to let the wire stay in place (10) and followed-up with no ischemic events, while others removed it by urgent or elective surgery (2, 4, 6, 8, 9).
In this study we have determined the serum tumor necrosis factor-alpha (TNF-alpha), soluble CD8 (... more In this study we have determined the serum tumor necrosis factor-alpha (TNF-alpha), soluble CD8 (sCD8) and soluble interleukin-2 receptor (sIL-2R) levels in children with active pulmonary tuberculosis (n = 66) and healthy controls (n = 20). Measurable serum TNF-alpha levels were detected in nine of 86 children (10.5%), all of whom belonged to the group with active disease. Serum sCD8 and sIL-2R determinations revealed a significant difference between the group with active pulmonary tuberculosis and the controls (p < 0.05). Deeper insight into the involvement of cytokines and T cells will provide a better understanding
Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology, 2001
The age of the patients referred for coronary bypass surgery is getting older progressively. Earl... more The age of the patients referred for coronary bypass surgery is getting older progressively. Early and late postoperative outcome of octogenarians were evaluated and compared with younger age group in this study. Records of 55 patients aged 80 years or older (mean age 82.7 +/- 2.8) among 3834 patients, who had coronary bypass graft procedure, operated between 1995 and 2001 were reviewed retrospectively. There were 39 men (70.9%) and 16 women (29.1%). Three patients had aortic valve replacement, 1 had left ventricular aneurysm repair, 1 had carotid endarterectomy additionally. Atrial fibrillation (21.8%), renal dysfunction (16.4%), and prolonged ventilation (10.9%) were the prominent complications. The hospital mortality rate was 7.27% (4 patients). Kaplan Meier Survival Analysis estimated that at the end of 5 years 83.1 + 5.2% of patients were still alive. Coronary bypass operations can be performed in octogenarians with slightly increased but acceptable hospital mortality and longe...
Journal of Clinical and Experimental Investigations, 2014
Objective: Accurate, reliable laboratory reference ranges are essential for effective clinical ev... more Objective: Accurate, reliable laboratory reference ranges are essential for effective clinical evaluation and monitoring. We present robust reference ranges established for hematology parameters using the Sysmex XT2000i analyzer. Methods: Blood samples were taken from 17409 healthy adults (19 to 49 years, 51.4% men and 48.6% women) and routine hematology analysis performed. Patients were assessed as healthy on the basis of a medical history and routine medical examinations. Serum hematinic assays (vitamin B12, folate, iron and ferritin) were also analyzed in order to exclude the potential anemia existence. Results: There was a statistically significant difference (p<0.001) between men and women, with the former showing higher CBC values, except WBC, neutrophil and platelet counts compared to females. Several differences were observed when compared to previously established values from Turkey, most notably in leucocytes and platelets. Our findings for CBC parameters, except leucocyte count and MCV are in general agreement with previously published data from more limited trials undertaken in other countries. Conclusions: In spite of the uncontrolled factors influencing hematological values, this study permitted to establish the new hematological reference values in Turkey, especially living near sea level. In the absence of previously detailed investigated hematological reference values in Turkey, we offered to use these results for clinical management of Turkish patients and interpretations of laboratory data for research purpose.
Severely atherosclerotic (porcelain) ascending aorta is associated with increased morbidity and m... more Severely atherosclerotic (porcelain) ascending aorta is associated with increased morbidity and mortality during coronary artery bypass grafting (CABG) due to the increased risk of perioperative atheroembolism. Three maneuvers during CABG can cause atheromatous embolism from the diseased ascending aorta: 1) cannulation of the ascending aorta; 2) cross- clamping; 3) partial clamping for the construction of the proximal anastomosis. In our hospital, extra-anatomic CABG was performed in 8 patients with heavily calcified ascending aorta: 6 patients were men and 2 women. Operations were performed on the beating heart in 5 patients, 2 patients operated on beating heart and another patient on fibrillating heart with supportive cardiopulmonary bypass (CPB). Arterial cannulation was done through the right femoral artery on these patients. Apart from internal mammary artery (IMA) grafts, proximal anastomotic sites were the right axillary, right subclavian and innominate arteries. One patient ...
Repair of atrial septal defect (ASD) via minimal access has been the preferred method to improve ... more Repair of atrial septal defect (ASD) via minimal access has been the preferred method to improve cosmesis and fast rehabilitation. A 2-stage single venous cannula introduced via the femoral route allows better vision of the surgical field and improves surgical acts through a limited incision. From February 1999 to December 2001 a minithoracotomy approach was used for closure of secundum type ASD by using single bicaval venous cannula in 17 adult patients. A 6 to 7 cm anterior minithoracotomy (submammary) approach with femoral arterial and 2-stage single venous cannula were utilized. Defects were closed primarily by running suture in 14 and with a patch in 3 patients. Calculated flow levels were maintained with a single venous cannula without assisted venous drainage in all patients. The postoperative course was uneventful in all patients except 1 who required revision for bleeding which was done through the same incision. Extension of the thoracotomy or shifting to the classic stern...
The decline in infections in childhood may contribute to the rising severity and prevalence of at... more The decline in infections in childhood may contribute to the rising severity and prevalence of atopic disorders in developed countries. Support for this hypothesis has been obtained from findings of an inverse association between tuberculin responses and atopy and from findings of high prevalence of asthma in certain islands with low prevalence of respiratory infections. With this regard, we investigated the association between serum anti-streptolysin-O (ASO) titers and the frequency of exacerbations of asthma in childhood. Thirty atopic asthmatic children who has no sign of upper respiratory tract infection at the time of presentation or during the previous two months were included in the study. Serum ASO titer was measured as an indicator of past streptococcal upper respiratory tract infections. ASO titer > or = 200 Todd units was accepted as positive. A statistically significant association is found between high anti-streptolysin-O titers and decreased number of exacerbations ...
utilizing multiple firings of an endo-GIA stapling device (Fig 2). The medial portion and thus th... more utilizing multiple firings of an endo-GIA stapling device (Fig 2). The medial portion and thus the upper lobe were subsequently freed for resection. After this maneuver, venous tributaries, arterial branches, and the bronchus were dissected out and ligated in the standard fashion. Pathology revealed a 3.5-cm squamous cell carcinoma with negative bronchial, pulmonary artery, and pulmonary vein margins. The stapled medial margin of the specimen was also negative for malignancy. The patient's recovery was unremarkable. Comment Preserving the integrity of a previous LIMA pedicle is of utmost importance during future surgical procedures. Thoracic surgeons are often confronted with this challenge during noncardiac thoracic procedures, especially those occurring in the left chest. Although one option is to tediously dissect free the entire LIMA pedicle, the consequences of an error could be lethal. We have presented a straightforward approach to leaving a portion of the left upper lobe attached to the LIMA pedicle without jeopardizing the previous coronary revascularization. This alternative is safe and with only minimal oncologic compromise. In the author's experience, this method has been utilized in 5 patients without any complications of infection or tumor recurrence.
Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology, 2006
Myocardial bridge (MB) is a congenital abnormality of the coronary arteries characterized by the ... more Myocardial bridge (MB) is a congenital abnormality of the coronary arteries characterized by the decrease in the coronary blood flow during systole due to the compression of the myocardial fibrils surrounding the epicardial coronary artery in a certain segment. Although usually asymptomatic, medical therapy, percutaneous transluminal coronary angioplasty (PTCA), and rarely surgery may be necessary to relieve symptoms.
Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology, 2002
BACKGROUND Repetitive procedures usually take place in the natural course of coronary heart disea... more BACKGROUND Repetitive procedures usually take place in the natural course of coronary heart disease. The aim of this study was to evaluate the risk factors, which affect coronary bypass reoperations, and to compare them with the postoperative results of the coronary first operations and the reoperations. METHODS Between January 1995 and January 2000, coronary reoperations were performed in 104 cases (Coronary reoperations group) by the same surgical team. Ninety-nine of them were the first, 3 were the second and 2 were the third reoperations in this group. At the same period of time, 3609 patients underwent coronary bypass procedure as the first operation (Coronary 1. operation group). Eighty-seven patients were male (83.65%), 17 were female (16.35%) and the mean age was 60.82 +/- 9.49 in reoperation group; while among 2916 patients 2223 were male (80.8%), 693 were female (19.2%) and the mean age was 60.37 +/- 9.58 in the first operation group. RESULTS Incidence of prolonged ventila...
Since 1985 many authors have reported complications of percutaneous transluminal angioplasty (PTC... more Since 1985 many authors have reported complications of percutaneous transluminal angioplasty (PTCA) (1-12). Myocardial infarction is the major complication (6, 7), but we believe that guidewire fractures are also not so rare and such cases are underreported. Cardiologists developed percutaneous intravascular methods to extract the broken portion of the guidewire by special catheters but these may not always permit a successful salvage operation. Although it is believed that wire in the coronary artery may cause intravascular thrombus formation (4) or coronary narrowing (10), some authors preferred to let the wire stay in place (10) and followed-up with no ischemic events, while others removed it by urgent or elective surgery (2, 4, 6, 8, 9).
In this study we have determined the serum tumor necrosis factor-alpha (TNF-alpha), soluble CD8 (... more In this study we have determined the serum tumor necrosis factor-alpha (TNF-alpha), soluble CD8 (sCD8) and soluble interleukin-2 receptor (sIL-2R) levels in children with active pulmonary tuberculosis (n = 66) and healthy controls (n = 20). Measurable serum TNF-alpha levels were detected in nine of 86 children (10.5%), all of whom belonged to the group with active disease. Serum sCD8 and sIL-2R determinations revealed a significant difference between the group with active pulmonary tuberculosis and the controls (p < 0.05). Deeper insight into the involvement of cytokines and T cells will provide a better understanding
Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology, 2001
The age of the patients referred for coronary bypass surgery is getting older progressively. Earl... more The age of the patients referred for coronary bypass surgery is getting older progressively. Early and late postoperative outcome of octogenarians were evaluated and compared with younger age group in this study. Records of 55 patients aged 80 years or older (mean age 82.7 +/- 2.8) among 3834 patients, who had coronary bypass graft procedure, operated between 1995 and 2001 were reviewed retrospectively. There were 39 men (70.9%) and 16 women (29.1%). Three patients had aortic valve replacement, 1 had left ventricular aneurysm repair, 1 had carotid endarterectomy additionally. Atrial fibrillation (21.8%), renal dysfunction (16.4%), and prolonged ventilation (10.9%) were the prominent complications. The hospital mortality rate was 7.27% (4 patients). Kaplan Meier Survival Analysis estimated that at the end of 5 years 83.1 + 5.2% of patients were still alive. Coronary bypass operations can be performed in octogenarians with slightly increased but acceptable hospital mortality and longe...
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