Browsing by Author "Vural, Ahmet Hakan"
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Item Dekortikasyon uygulanan hastaların özellikleri(Uludağ Üniversitesi, 2017-04-05) Yalçınkaya, Serhat; Erdolu, Burak; Vural, Ahmet Hakan; Özyazıcıoğlu, Ahmet FatihDrene edilmemiş plevral effüzyon sonucunda kalınlaşan fibröz plevral kabukların cerrahi olarak soyulması işlemi dekortikasyon olarak adlandırılmaktadır. Bu işlem akciğerin yaklaşık olarak yarısına yakın bir alanının tutulması, tekrarlayan torasentez ve aspirasyonlarla sıvı toplanması önlenemeyen ve 3-6 aylık tedaviye rağmen iyileşmeyen hastalarda gereklidir. Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi Göğüs Cerrahisi Servisi’nde 2002-2013 yılları arasında 37 hastaya torakotomi ile dekortikasyon işlemi uygulandı. Ortalama yaş 37,8±13,7 yıldı (aralık 17-65 yıl). Hastaların 33 ü erkek (%89,2), kalan 4 ü kadındı. Hastaların 20 sinde (%54,1) sol, kalanında sağ torakotomiyle total dekortikasyon uygulandı. Ortalama hastanede kalış süresi 10,9±5,7 gün olarak (aralık 5-30 gün) bulundu. Yapılan histopatolojik inceleme sonucunda en sık etiyolojik neden olarak 21 (%56,8) hastada nonspesifik enfeksiyon tespit edildi. Uygun zamanda planlanan dekortikasyon işleminin kalın fibröz dokunun uzaklaştırılması ve akciğerlerin normal fonksiyonlarına yeniden kavuşması için tercih edilebilecek bir yöntem olduğu kanısındayız.Item Effect of the P2Y12 antagonist ticagrelor on neointimal hyperplasia in a rabbit carotid anastomosis model(Oxford University, 2014-08) Sürer, Süleyman; Toktaş, Faruk; Ay, Derih; Eriş, Cüneyt; Yavuz, Şenol; Türk, Tamer; Vural, Ahmet Hakan; Göncü, Tuğrul; Gül, Nihal Yaşar; Yalçınkaya, Ulviye; Uludağ Üniversitesi/Veterinerlik Fakültesi/Klinik Bilimler Bölümü.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Patoloji Anabilim Dalı.; AAH-8924-2021; 55899103700; 6508300295OBJECTIVES: In the present study, we aimed to deterimine the dose-related effects of ticagrelor, the first reversible inhibitor of the P2Y(12) receptor, found in smooth muscle cells as well as platelets, during neointimal hyperplasia in a rabbit carotid anastomosis model. METHODS: This study was an experimental, prospective, randomized controlled study including 20 New Zealand white female rabbits (6-months old; weighing 2300 +/- 300 g). Under general anaesthesia, the rabbits underwent transection of the right carotid artery and subsequent anastomosis of both ends. The study animals were divided into the following 4 groups: T1 (ticagrelor 5 mg/kg, orally, daily), T2 (ticagrelor 10 mg/kg, orally, daily), T3 (ticagrelor 20 mg/kg, orally, daily) and control (no ticagrelor treatment). The single oral doses were administered in phosphate-buffered saline. The control group received sterile phosphate-buffered saline (2 ml/kg/day, orally) for 3 weeks postoperatively. At the end of the study, the animals were killed, and the anastomosed segment of the right carotid artery and part of the left carotid artery were excised from each animal. Antibodies against transforming growth factor-beta were used in staining of arterial sections, which was followed by histomorphological and immunohistochemical studies. RESULTS: The median intimal thickness (2.0 +/- 0.14 m left vs 73.4 +/- 35.8 m anastomosed right arteries; P <0.05), the median medial thickness (70.8 +/- 5.6 m left vs 92.3 +/- 4.5 m anastomosed right arteries; P <0.05) and the index ratio of intimal thickness to medial thickness (0.03 +/- 0.00 left vs 0.8 +/- 0.35 anastomosed control right arteries; P <0.05) increased significantly in the anastomosed right arteries compared with the left carotid arteries in the control group. In the treatment groups, the intimal thickness (73.4 +/- 35.8 m in control group vs T1 32.7 +/- 19; 1 m, T2 1.9 +/- 0.09 m and T3 2.2 +/- 0.5 m; P = 0.047, P = 0.009 and P = 0.009, respectively), carotid artery intima/media ratio (0.8 +/- 0.35 in control group vs T1 0.4 +/- 0.2, T2 0.03 +/- 0.01 and T3 0.03 +/- 0.01 in ticagrelor groups; P = 0.028, P = 0.009 and P = 0.009, respectively) and medial thickness (92.3 +/- 4.5 m in control group vs T2 65.6 +/- 7.1 and T3 66.1 +/- 7.6 m; P = 0.009 and P = 0.009, respectively) decreased significantly in the anastomosed right arteries. CONCLUSIONS: This study indicates that effective doses (10 and 20 mg/kg, daily) of the antiplatelet agent ticagrelor in a rabbit model may be beneficial in prevention of intimal hyperplasia. Restenosis due to intimal hyperplasia has been high. Ticagrelor has also been linked to inhibition of smooth muscle cell proliferation and, hence, reduced intimal hyperplasia.Item Effects of hyperbaric oxygen therapy combined with platelet-rich plasma on diabetic wounds: An experimental rat model(Termedia Publishing House, 2015-01-24) Yümün, Gündüz; Kahraman, Cüneyt; Kahraman, Nail; Akçılar, Aydın; Akgül, Engin; Vural, Ahmet Hakan; Yalçınkaya, Ulviye; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; AAH-8924-2021; 6508300295Introduction: Hyperbaric oxygen and platelet-rich plasma are used in the treatment of diabetic wounds. The aim of this study is to evaluate the effects of hyperbaric oxygen therapy and autologous platelet concentrates in healing diabetic wounds. Material and methods: Thirty-six female Wistar albino rats were used in this study. Diabetes mellitus was induced chemically with an intraperitoneal injection of streptozotocin. The rats were divided into a control group, a hyperbaric oxygen group, a platelet-rich plasma group, and a combined therapy group. Platelet-rich plasma was applied just after the creation of the wound; hyperbaric oxygen treatment was carried out daily over 7 days. Wound healing was evaluated according to four parameters: ulcerations, epidermal thickness, density of dermal collagen fibers, and proliferation of dermal blood vessels. Results: The number of active ulcers in the combined therapy group was fewer than in the control group (p = 0.039), and the wound area was greatest in controls (p < 0.001). The epidermal thickness in platelet-rich plasma and combined therapy groups was non-significantly greater than in the control group (p = 0.097 and p = 0.074, respectively). The amount of fibrous collagen in these two groups was greater than in the control group (p = 0.002). Conclusions: Combined hyperbaric oxygen and platelet-rich plasma therapy was found to be successful in diabetic wound healing. The combination therapy had no additive effect in terms of angiogenesis and the development of new collagen fibers.Item Histological results of sclerotherapy, phototherapy, and pulsed 980-nm laser irradiation of the dorsal rabbit ear vein(Mary Ann Liebert, 2008-10) Vural, Ahmet Hakan; Koçoğulları, Cevdet Uǧur; Özcan, Ayhan; Yalçınkaya, Serhat; Bayer, Ahmet; Özyazıcıoğlu, Ahmet Fatih; Göncü, Tuğrul; Özyazıcıoğlu, Nurcan; Uludağ Üniversitesi/Sağlık Bilimleri Fakültesi/Hemşirelik Bölüm.; AAI-6835-2021; 23486367700Objective: To compare the histological changes occurring after three different treatment modalities for telangiectasias. Materials and Methods: Thirty 16-week-old New Zealand white rabbits weighing 2.4-3.1 kg were enrolled in the study. The rabbits were divided into three groups. The group 1 received sclerotherapy, he group 2 received phototherapy, and group 3 received high-power diode laser treatments. All animals were treated on the right dorsal marginal ear vein. Biopsies were taken on days 1, 2, 7, and 30 post-treatment, and histopathogical evaluation was performed. Results: Clinical and histological thrombosis occurred between days 1 and 7 in all groups. Superficial necrosis, neutrophil infiltration, and recanalization were mostly seen in group 3, whereas thrombosis was prominent in groups 1 and 2. Conclusions: All of the methods tested appear to have similar mechanisms of action, but had differing clinical and histological results. Phototherapy and laser treatment are non-invasive and do not require an exact, pinpoint technique, in contrast to sclerotherapy. However, sclerotherapy and phototherapy showed better results, especially with regard to recanalization.Item Intracoronary shunt versus bulldog clamp in off-pump bypass surgery. Endothelial trauma: Shunt versus clamp(Elsevier, 2008-12) Vural, Ahmet Hakan; Yalçınkaya, Serhat; Türk, Tamer; Yümün, Gündüz; Özyazıcıoğlu, Ahmet Fatih; Gül, Nihal Yaşar; Yalçınkaya, Ülviye; Kaya, Metin; Uludağ Üniversitesi/Veteriner Fakültesi/Cerrahi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; AAH-8924-2021; 55899103700; 6508300295; 55417963000Background. During off-pump coronary bypass grafting, local vascular control of the target vessel and a bloodless field are crucial. The aim of this study is to asses the histopathological outcomes of intracoronary shunts and bulldog clamping on the beating heart in a canine model. Methods. Twelve healthy adult mongrel dogs weighing between 15 to 25 kg were included in the study. Following left thoracotomy, proximal left anterior descending artery segment 1 cm to distal of diagonal branch was marked. Arteriotomy at this site was performed and a shunt was inserted for 10 min in the shunt group. The bulldog clamp was applied 3 cm distal to the mark for 10 min after heparinization in the bulldog group. Thirty days after the procedure, the specimens of left anterior descending artery from both regions were collected and were examined. Vascular damage, presence of intimal hyperplasia, and denudation were noted. Results. Only intimal denudation was found significantly higher in the shunt group (P < 0.05). In this group, only one case had grade 0 endothelial damage. In the bulldog group, all cases had endothelial damage of various grades. Conclusion. The proven advantages of temporary intracoronary shunts are well-known, e.g., preserving the ventricular functions. Despite these advantages, our study revealed an ultimate bad result for an off-pump coronary by pass patient: intimal denudation. We conclude that further studies with a larger number of subjects are needed to decide whether routine shunt insertion into coronary arteries during off-pump coronary bypass surgery is appropriate or not.