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    A 52-year-old man with no known history of hand trauma presenting to the clinic with a pulsatile mass in his right palm
    (K FAISAL SPEC HOSP RES CENTRE, 2011) Ugurlucan, Murat; Karademir, Hudaverdi; Filik, Muslum Ercument; Aslan, Nuray; Filizcan, Ugur; Fedakar, Ali; Oksuze, Sukru
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    Effects of Lower Extremity Revascularization on the Endothelial Functions Measured With Noninvasive Brachial Artery Flow-Mediated Dilatation
    (ELSEVIER SCIENCE INC, 2011) Unal, Orcun; Karatepe, Oguzhan; Ugurlucan, Murat; Koc, Bora; Filizcan, Ugur; Aksoy, Murat
    Background: Endothelial function is best measured with the noninvasive brachial artery flow-mediated dilatation (FMD) method. Peripheral arterial diseases and systemic cardiovascular diseases have FMD-lowering effect. The effects of lower extremity ischemia are associated with muscle inflammation and claudication, which may further lead to arterial stress. Our aim in this study was to investigate the effects of peripheral arterial revascularization on the endothelial functions through noninvasive brachial artery FMD. Methods: Between January 2007 and February 2008, 54 patients diagnosed with lower extremity arterial disease undergoing revascularization were included in the study. Endothelial function is measured preoperatively and at the fourth week postoperatively using the brachial artery FMD method. Blood samples were collected at the same intervals for the measurement of interleukin-6, leukocyte count, tumor necrosis factor-alpha, and nitric oxide values. Results: Femoropopliteal bypass grafting was performed in all patients with a synthetic graft. The mean ankle-brachial index in the preoperative period was 0.29 +/- 0.083, and after the operation, dorsalis pedis and/or posterior tibial artery became palpable in all patients. The nitric oxide, interleukin-6, high-sensitivity C-reactive protein, and tumor necrosis factor-alpha levels decreased significantly after 4 weeks postoperatively as compared with the preoperative levels (p < 0.05). Postoperative Doppler ultrasonography FMD of brachial artery increased from preoperative value of 9.2 +/- 2.1 to 16.2 +/- 4.5 (p < 0.01) at postoperative week 4. Conclusions: Systemic inflammation and muscle ischemia lead to reduced endothelial functions. After successful lower extremity revascularization, endothelial functions improve dramatically, which may be easily detected with the noninvasive brachial artery FMD method.
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    Pressure-Controlled Mechanical Ventilation Is More Advantageous in the Follow-up of Patients with Chronic Obstructive Pulmonary Disease after Open Heart Surgery
    (FORUM MULTIMEDIA PUBLISHING, LLC, 2014) Ugurlucan, Murat; Basaran, Murat; Erdim, Filiz; Selimoglu, Ozer; Caglar, Ilker Murat; Zencirci, Ertugrul; Filizcan, Ugur; Ogus, Noyan Temucin; Yildiz, Yahya; Tireli, Emin; Isik, Omer; Dayioglu, Enver
    Objective: Cardiopulmonary bypass deteriorates pulmonary functions to a certain extent. Patients with chronic obstructive pulmonary disease (COPD) are associated with increased mortality and morbidity risks in the postoperative period of open-heart surgery. In this study we compared 2 different mechanical ventilation modes, pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV), in this particular patient population. Patients and Methods: Forty patients with severe COPD were assigned to 1 of 2 groups and enrolled to receive PCV or VCV in the postoperative period. Arterial blood gases, respiratory parameters, and intensive care unit and hospital stays were compared between the 2 groups. Results: Maximum airway pressure was higher in the VCV group. Pulmonary compliance was lower in the VCV group and minute ventilation was significantly lower in the group ventilated with PCV mode. The respiratory index was increased in the PCV group compared with the VCV group and with preoperative findings. Duration of mechanical ventilation was significantly shorter with PCV; however, intensive care unit and hospital stays did not differ. Conclusion: There is not a single widely accepted and established mode of ventilation for patients with COPD undergoing open-heart surgery. Our modest experience indicated promising results with PCV mode; however, further studies are warranted.
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    Rapid Ischemic Preconditioning with a Short Reperfusion Time Prevents Delayed Paraplegia in a Rabbit Model
    (FORUM MULTIMEDIA PUBLISHING, LLC, 2011) Ozkokeli, Mehmet; Es, Mehmet Ugur; Filizcan, Ugur; Ugurlucan, Murat; Sasmazel, Ahmet; Tataroglu, Cenk
    Background: Surgery for thoracic and thoracoabdominal aortic aneurysms can be complicated by a significant incidence of neurogenic deficits due to spinal cord ischemia. In this study, we investigated whether ischemic preconditioning (IPC) improves neurologic outcome in a rabbit model. Methods: Forty rabbits underwent infrarenal aortic occlusion. The IPC group (n = 20) had 10 minutes of aortic occlusion to induce spinal cord ischemia, 40 minutes of reperfusion, and 30 minutes of ischemia, whereas the control group (n = 20) had only 30 minutes of ischemia. Tarlov scoring (0, paraplegia; 4, normal) was used to evaluate neurologic functions 7 days later, and spinal cord segments (L4-L6) were stained with hematoxylin and eosin for histologic evaluation. Results: Complete paraplegia (grade 0) occurred in 15 (75%) of the 20 control animals, whereas in the IPC group, 13 (65%) of 20 animals were completely normal (grade 4) (P < .05). Conclusion: IPC is beneficial for protecting against neurologic damage after transient aortic occlusion in a rabbit model; however, the protective mechanisms are not clear.