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Öğe Acute Mesenteric Ischemia: Clinical Experience(Aves, 2009) Aslan, Ahmet; Temiz, Muhyittin; Semerci, Ersan; Ozkan, Orhan Veli; Yetim, Ibrahim; Fansa, Iyad; Beyaz, FikretBACKGROUND: Acute mesenteric ischemia (AMI) is a life threatening vascular emergency which requires prompt diagnosis and treatment. The prevention of this cause of high mortality and morbidity depends on early clinical suspicion end timely intervention. In the present study we aimed to analyze the acute mesenteric ischemia cases treated in Mustafa Kemal University Department of General Surgery between January 2004 and December 2008. MATERIAL/METHODS: The clinic records of all the patients who underwent surgical treatment for AMI between January 1, 2004, and December 2008, were retrospectively reviewed. The data from operative records, postoperative complications, mortality, and hospital stay were recorded. RESULTS: The study group included 18 patients. Mean age was 69. There was comorbidity in all patients and cardiac disease and hypertension were the most common ones. The most common laboratory abnormalities were leukocytes, hypoalbuminemia, hyperamylasemia. There was superiorly vascular necrosis in 16 patients; inferior vascular necrosis in one patient. One patient had non occlusive mesenteric ischemia. Segmentery resection was performed to 13 patients. Abdominoperineal resection was performed to the patient with inferior mesenter artery occlusion. We performed duodenotransversostomy on two patients and only laparotomy on two patients. Re-operation was required in 5 patients. Causes of death were multiorgan insufficiency in 7 cases, cardiac death in 2 cases. One patient died due to short intestine syndrome. CONCLUSION: Acute mesenteric ischemia is highly mortal emergency which should always be suspected in elderly patients with cardiac disease suffering from abdominal pain.Öğe The Beneficial Effects of Tadalafil on Renal Ischemia-Reperfusion Injury in Rats(Karger, 2011) Guzeloglu, Mehmet; Yalcinkaya, Fatih; Atmaca, Soner; Bagriyanik, Alper; Oktar, Suleyman; Yuksel, Oguz; Fansa, IyadAcute renal failure due to ischemia-reperfusion (I/R) injury is a common complication in cardiovascular surgery. We determined the influence of tadalafil on renal injury in a renal I/R model in rats. For this purpose, 21 male Wistar albino rats were separated into 3 groups: sham, placebo and tadalafil. A right nephrectomy was performed, and the left renal pedicles were occluded for 60 min and reperfused for 60 min in the placebo and tadalafil groups. A single dose of tadalafil (10 mg/kg) through an orogastric tube was administered to the tadalafil group. Tubular atrophy with acute inflammation in renal histology, total oxidant status (TOS) and total antioxidant status (TAS) were determined in tissue homogenates. Compared to the tadalafil group, tubular atrophy and acute inflammation was significant in the placebo group. TAS levels were significantly higher in the tadalafil group compared to the placebo (p = 0.01) and sham groups (p = 0.04). While TOS levels were significantly higher in the placebo group (p = 0.03), tadalafil did not significantly alter the TOS levels. The beneficial effects of tadalafil can be attributed to its protective effects on renal tubular cells and inhibition of leukocyte infiltration in renal tissue. We think that tadalafil treatment has an important role in reducing renal injury resulting from renal I/R. Copyright (c) 2010 S. Karger AG, BaselÖğe Dancing: More than a therapy for patients with venous insufficiency(Sage Publications Ltd, 2020) Dogru-Huzmeli, Esra; Fansa, Iyad; Cetisli-Korkmaz, Nilufer; Oznur-Karabicak, Gul; Lale, Cem; Gokcek, Ozden; Cam, YagmurObjective This study aims to figure out the effects of dance therapy on patients with chronic venous insufficiency disease. Methods Forty subjects with chronic venous insufficiency were recruited to either the control group or the dance therapy group. As the severity of chronic venous insufficiency was defined with the Venous Clinical Severity Scores (VCSS), patients in control group received only medical treatment. Twenty patients with chronic venous insufficiency in dance therapy group received three times a week, for five weeks, totally 15 sessions of dance therapy in addition to medical treatment. Results There was no significant difference in pre- and post-treatment results of Rivermead Index, VCSS parameters constipation complaint, assistive breath muscle activity, lower limb circumference, strength and range of motion between groups (p > 0.05). The remarkable result of this study was obtaining that the post-treatment quality of life scale's bodily pain score was significantly higher in the dance therapy group than the control group (p < 0.05). Conclusions It was concluded that dance therapy has positive effects on quality of life. There were no barriers to chronic venous insufficiency patients in this form of gentle exercise, showing that it is to meliorate the cardiovascular, physical and psychological benefits of an activity that is enhancing of the self-esteem in addition to the quality of life. Treatment of chronic venous insufficiency should consist of methods that support the patient mentally, physically and psychologically, in addition to the medical treatment. Dance therapy might be a potential exercise intervention for improvements in chronic venous insufficiency patients, so clinicians focusing on them could recommend this form of gentle exercise in addition to the medical treatment.Öğe Deep vein thrombosis in pregnant women with heterozygous factor-V Leiden mutation: a case report(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2009) Fansa, Iyad; Gungoren, Arif; Hakverdi, Ali Ulvi; Zeteroglu, Sahin; Yetim, CagcilDeep vein thrombosis during pregnancy is an important risk factor increasing maternal morbidity and mortality. Factor V Leiden mutation is the most frequent one among many hereditary and acquired thrombophilic risk factors during pregnancy. In a 23-year-old woman who had been pregnant for 11 weeks and applied to hospital with sudden onset pain, swelling, and erythema in her left lower extremity, a thrombus from left main iliac to superficial femoral veins was detected via Doppler ultrasonography. She was hospitalized and low molecular-weight heparin (enoxaprine sodium) was initiated with a dosage of 12000 IU/day. She showed a rapid healing clinically and was followed up with enoxaprine and varsity sock until delivery. After labor, the dosage of enoxaprine was halved and withdrawn after six weeks, and oral warfarin sodium was started. The patient is still continued to be followed up without any problems.Öğe Does somatostatin decrease hemorrhage from injured liver in rats?(2009) Akçora, Bülent; Altug, Enes M.; Fansa, Iyad; Nisanoglu, VedatIn portal hypertensive patients, somatostatin (SMT) and octreotide have been widely used to decrease variceal bleeding because of its splanchnic hypoperfusion effect. The aim of this study was to explore the effects of somatostatin treatment for decreasing blood loss of uncontrolled liver hemorrhage model in rats.Twenty-one male rats were divided into 3 groups including group 1; nontreatment, group 2; isotonic saline infusion and group 3; isotonic saline plus SMT infusion. Intra-abdominal bleeding was induced by transection of median lobe of liver. Mean arterial pressures (MAP), amount of intra-peritoneal blood collection and hematocrit (Hct) changes were evaluated for 60 minutes.There was no difference in the MAP changes between the groups until 25th minute. Thereafter, MAP remained similar in the group 1 while gradually increased (P < 0.05) in the group 2 and 3. There was no statistically significant difference between the groups 2 and 3. End of study, the highest Hct value was determined in the nontreatment group (41.0 ± 3.26 %) and it significantly different from other two groups. We found increase of Htc value in the group 3 (32.3 ± 2.75 %) when compared with group 2 (29.7 ± 4.19 %), but it was not statistically significant. The highest intra-peritoneal blood volume was determined in group 2. We found decrease of the hemorrhage in the group 3 when compared with the group 2, but it was not statistically significant. Somatostatin using has a tendency, although not statistically significant, to decrease of intraperitoneal hemorrhage from liver in the rat model. © 2009 OMU All rights reserved.Öğe Early Outcomes of Radial Artery Use in All-Arterial Grafting of the Coronary Arteries in Patients 65 Years and Older(Texas Heart Inst, 2010) Erdil, Nevzat; Nisanoglu, Vedat; Eroglu, Tamer; Fansa, Iyad; Cihan, Hasan Berat; Battaloglu, BektasWe retrospectively evaluated early clinical results of coronary revascularization using none but arterial grafts in patients aged 65 years and older. The cases of 449 consecutive patients who had undergone isolated myocardial revascularization were divided into 2 groups: the arterial conduit group (n=107) received a left internal mammary artery (LIMA) graft and 1 or both radial arteries (RAs), while the mixed-conduit group (n=342) received a LIMA graft and 1 or more saphenous vein grafts (SVGs), with or without an RA. There was no significant difference between the groups' rates of mortality The arterial conduit group had a significantly shorter overall postoperative hospital stay than did the mixed-conduit group (mean, 6.6 +/- 0.9 vs 7.2 +/- 5 days; P=0.04). Linear regression analysis revealed that the presence of hypertension (beta=0.13; 95% confidence interval [CI], 0.054-0.759; P=0.02) and high EuroSCORE (beta=0.24; 95% CI, 0.053-0.283; P=0.004) were the major predicting factors for long hospital stay Graft-harvest-site infection was statistically more frequent in the mixed-conduit group than in the arterial conduit group (6.4% vs 0, respectively; P=0.007). Angiography was performed postoperatively (mean, 24.9 +/- 16.3 mo; range, 17-65 mo) in 21 patients. In these patients, all LIMA grafts were patent, as were 86.9% of the SVGs and 90.9% of the RA grafts. Myocardial revascularization using all arterial grafts (at least 50% RAs) in patients aged 65 years and older is safe and reliable, produces short-term results equal to those of saphenous vein grafting, and can reduce graft-harvest-site infections. (Tex Heart Inst J 2010; 37(3):301-6)Öğe Is Surgery the Only Fate of the Patient with Leriche Syndrome ? Our Endovascular Therapy Results Early Follow-Up Outcomes(Forum Multimedia Publishing, Llc, 2022) Beyaz, Metin Onur; Urfali, Senem; Kaya, Sefer; Oruc, Dilan; Fansa, IyadAim: In this research, we aimed to present early follow-up results of the endovascular treatment in patients with Leriche syndrome at our single center.Methods and materials: Between October 2020 and January 2022, 14 patients with Leriche syndrome (12 men, two women) who underwent endovascular treatment at our center retrospectively were evaluated. Before the treatment, the ankle-brachial index (ABI) was found 0.50 +/- 0.11 on the right leg and 0.45 +/- 0.09 on the left leg.Results: All of the patients with Leriche syndrome applied to our clinic for the first time. In five patients, the fully occluded lesion length was over 3 cm (ranging between 3.5-7.2 cm), hence they were treated with aortic and bilat-eral iliac bare metallic stents. Although in one patient, the aortic occluding lesion was below 3 cm; it was treated with a bare aortic and bilateral bare iliac stent application because the lesion in the aorta was too calcific. In eight patients, the lesion length was less than 3 cm, bilateral iliac metal bare stents were applied in a kissing stent way.Conclusion: Endovascular therapy for chronic aorto-iliac occlusive disease has an early high technical success with pri-mary and secondary patency rates. Especially in patients with high risk factors, it may be considered as a good alternative to conventional surgery.Öğe Left sinus of Valsalva aneurysm with rupture into the right atrium(Elsevier Science Bv, 2006) Tufekcioglu, Omac; Fansa, Iyad; Maden, Orhan; Hizarci, Mustafa; Kutsal, Ali; Cobanoglu, AdnanHerein, we present the echocardiographic diagnosis of a case of left sinus of Valsalva aneurysm with rupture into the right atrium. (C) 2005 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.Öğe The relationship between acute coronary artery diseases with c-reactive protein +1059 G/C and angiotensin-converting enzyme I/D gene polymorphisms(E-Century Publishing Corporation, 2016) Duran, Gulay Gulbol; Fansa, Iyad; Duran, Nizami; Jenedi, Kemal; Onlen, Cansu; Miraloglu, Meral; Yigin, AkinObjective: The purpose of this study was to evaluate the presence of an association between the CRP +1059 G/C and ACE I/D gene polymorphisms and patients who were diagnosed to have acute coronary syndrome and underwent coronary angiography. Methods: A total of 126 patients (mean age: 60.0±12.9) and 144 healthy individuals (mean age: 52.1±13.0) were included to this study. The presence of CRP +1059 G/C and ACE I/D gene polymorphisms were analyzed using the RFLP method. Results: When the patient and control groups were evaluated in terms of ACE I/D gene polymorphism, no statistically significant difference was found in the frequency of ACE DD and ACE ID between the two groups (P>0.05), while the percentage of ACE II genotype was statistically significantly higher in the patient group compared with the control group (P<0.032). For the distribution of CRP G/C genotype; CRP GG, CRP GC and CRP CC genotype frequencies were similar in the patient and control groups (P>0.05). When the presence of the ACE I/D genotype and CRP G/C genotype was compared in patients with vessel disease (one vessel, two vessels and three vessels) among the patients with coronary artery diseases with the control group, statistically significant differences were found between the two groups (P<0.05). In addition, the frequency of the ACE I/D genotype in hypertensive patients with coronary artery disease was statistically significantly higher (P<0.033). Also, the frequency of the CRP +1059 G/C genotype was found to be statistically significantly higher in the patient group (P<0.026). Conclusion: This study demonstrated that CRP +1059 G/C and ACE I/D gene polymorphisms may be a genetic marker associated with coronary artery disease in patients diagnosed with ACS. © 2016, E-Century Publishing Corporation. All rights reserved.Öğe The relationship between acute coronary artery diseases with c-reactive protein+1059 G/C and angiotensin-converting enzyme I/D gene polymorphisms(E-Century Publishing Corp, 2016) Duran, Gulay Gulbol; Fansa, Iyad; Duran, Nizami; Jenedi, Kemal; Onlen, Cansu; Miraloglu, Meral; Yigin, AkinObjective: The purpose of this study was to evaluate the presence of an association between the CRP + 1059 G/C and ACE I/D gene polymorphisms and patients who were diagnosed to have acute coronary syndrome and underwent coronary angiography. Methods: A total of 126 patients (mean age: 60.0 +/- 12.9) and 144 healthy individuals (mean age: 52.1 +/- 13.0) were included to this study. The presence of CRP + 1059 G/C and ACE I/D gene polymorphisms were analyzed using the RFLP method. Results: When the patient and control groups were evaluated in terms of ACE I/D gene polymorphism, no statistically significant difference was found in the frequency of ACE DD and ACE ID between the two groups (P>0.05), while the percentage of ACE II genotype was statistically significantly higher in the patient group compared with the control group (P<0.032). For the distribution of CRP G/C genotype; CRP GG, CRP GC and CRP CC genotype frequencies were similar in the patient and control groups (P>0.05). When the presence of the ACE I/D genotype and CRP G/C genotype was compared in patients with vessel disease (one vessel, two vessels and three vessels) among the patients with coronary artery diseases with the control group, statistically significant differences were found between the two groups (P<0.05). In addition, the frequency of the ACE I/D genotype in hypertensive patients with coronary artery disease was statistically significantly higher (P<0.033). Also, the frequency of the CRP + 1059 G/C genotype was found to be statistically significantly higher in the patient group (P<0.026). Conclusion: This study demonstrated that CRP + 1059 G/C and ACE I/D gene polymorphisms may be a genetic marker associated with coronary artery disease in patients diagnosed with ACS.Öğe Results of Prompt Surgical Intervention in Hemodialysis Radiocephalic Fistula Secondary Dysfunction(Int College Of Surgeons, 2019) Fansa, Iyad; Kosem, Mesut; Karatepe, Celalettin; Sezen, Adem; Karatepe, Hilal Kuscu; Goksel, Onur SelcukRadiocephalic fistula (RCF) dysfunction is a common problem due to low maturation and patency rates of these fistulas. The most common procedure in such cases is to place a temporary catheter for the dialysis. Temporary catheter placement and undergoing dialysis with this catheter cause complications, reduce the chance for fistula, and deteriorate the quality of life. The aim of this study was to demonstrate that immediate intervention in RCF dysfunctions can increase fistula success for the patient and can reduce the need for a catheter. Furthermore, the hemodialysis treatment can continue without affecting the quality of life. A total of 295 patients who were admitted for RCF dysfunction and who underwent early surgical intervention without any catheter placement were evaluated for postoperative complications, patency rates, and rates and durations of temporary catheter use over a mean time of 47 months of follow-up (range: 4-79 months). Of the patients, 77.2% (n = 228) underwent new proximal anastomosis (NEO; the radial artery and cephalic vein were reached with an incision created proximal to the previous anastomosis), 14.2% (n = 42) underwent brachiocephalic arteriovenous fistula (AVF), 8.4% (n = 25) underwent side-to-side brachiobasilic AVF thorn super-ficialization of the basilic vein. In 88.8% (n = 262) of the patients, successful cannulations were performed within the first 24 to 48 hours without any catheter requirement or complications. Temporary catheter was used for 15.1 6 10.7 days in 11.2% (n = 33) of the patients. In RCF dysfunctions, early surgical interventions performed in the forearm and elbow provide early cannulation and thus decrease the catheter requirement, also prevent the complications of temporary catheters (infection, decreasing the fistula success, vascular injuries, etc.), increase the autogenous fistula success, and allow for the continuation of dialysis without disturbing the quality of life.Öğe A Successful Treatment of a Patient with Inferior Vena Cava Injuries Due to Gunshot(Derman Medical Publ, 2014) Fansa, Iyad; Lale, Cem; Ugur, Mustafa; Akkucuk, SeckinInjuries of inferior vena cava are usually seen with multiple organ and system injuries. The rapid occurrence of hemodynamic instability due to massive hemorrhage leads to high rate of mortality. Concordant and fast approach of multidisciplinary surgical units to perform damage control surgery and efficient intensive care to provide hemodynamic stability are the most important points. We represented a successful treatment of a patient who transferred after laparotomy in another medical center to our hospital due to inferior vena cava and multiple organ injuries.Öğe True popliteal aneurysm presenting with acute limb ischemia and deep venous thrombosis: Report of a case(Int Scientific Literature, Inc, 2008) Erdil, Nevzat; Nisanoglu, Vedat; Eroglu, Tamer; Fansa, Iyad; Cihan, Hasan Berat; Battaloglu, BektasBackground: True popliteal aneurysm complicated with distal arterial embolization and popliteal vein thrombosis is rare. Case Report: We report a case of a 26-year-old male with popliteal artery aneurysm who presented with two major complication related to the aneurysm; distal arterial embolization and popliteal vein thrombosis. He was treated successfully by vein graft interposition and anticoagulation therapy. Conclusions: This case suggests popliteal aneurysm may cause concurrent limb-threatening complications such as acute leg ischemia and deep venous thrombosis.
