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Öğe Additive effect of propofol for attenuation of hypertension in a patient with undiagnosed phaeochromocytoma(Lippincott Williams & Wilkins, 2007) Isik, A.; Taydas, E.; Ulukaya, S.; Balcioglu, T.; Aydin, U.; Kilic, M.Öğe Additive effect of propofol for attenuation of hypertension in a patient with undiagnosed phaeochromocytoma - Reply(Lippincott Williams & Wilkins, 2008) Alper, I.; Taydas, E.; Ulukaya, S.; Balcioglu, T.; Aydin, U.; Kilic, M.Öğe COVID-19 Infection, Vaccination, and Antibody Levels: Investigating Correlations through a Cohort Study(Multidisciplinary Digital Publishing Institute (MDPI), 2023) Kayalı, G.A.; Durmaz, S.; Şahin, I.N.; Akkul, B.; Durusoy, R.; Akarca, F.K.; Ulukaya, S.Aim: The objective of this study was to explore the potential correlation between COVID-19 infection or vaccination and levels of anti-nucleocapsid (anti-N) and anti-spike (anti-S) antibodies. Methods: Among 6050 healthcare workers at the Ege University Hospital, a cohort study with 162 participants divided into three arms with 54 participants each was conducted. The three groups were selected as follows: those diagnosed with COVID-19 and not vaccinated (group 1), those diagnosed with COVID-19 and subsequently vaccinated with CoronaVac (group 2), and those not diagnosed with COVID-19 but vaccinated with two doses of CoronaVac (group 3). Antibody levels measured at the sixth month of follow-up were defined as the primary outcome. Results: At the sixth month, all serum samples tested positive for anti-S. Anti-S levels were found to be significantly higher in group 2 than in the other groups (p < 0.001). There were no differences in antibody levels between groups 1 and 3 (p = 0.080). Average antibody levels were found to be lower in office workers and males. Anti-N antibodies were found to be positive in 85.1% of subjects at the sixth month. In group 2, anti-N antibodies were detected in all samples at the sixth month. Anti-N antibody levels were not significantly different between groups 1 and 2 (p = 0.165). Groups 1 and 2 had significantly higher antibody levels than group 3 (p < 0.001). Conclusions: Vaccination or infection provide protection for at least 6 months. Those who have previously been diagnosed with COVID-19 do not need to be vaccinated in the early period before their antibody levels decrease. © 2023 by the authors.Öğe Effects of Cardiac Valve Dysfunction on Perioperative Management of Liver Transplantation(Elsevier Science Inc, 2009) Alper, I.; Ulukaya, S.; Demir, F.; Kilic, M.Objective. Our aim was to investigate the effects of cardiac valve dysfunction on perioperative management of orthotopic liver transplantation (OLT) among a retrospective cohort. Patients and Methods. Three hundred forty-six patients underwent echocardiographic (ECHO) examination prior to OLT. Data of patients with valvular dysfunctions were compared to subjects with normal ECHO. We evaluated patient characteristics, operation variables, hemodynamic course, blood products, fluid and drug requirements, extubation, and mortality rates. Results. Ninety-five patients (27.5%) with cardiac valve dysfunction were classified as mitral valve insufficiency (MVI; n = 32), tricuspid valve insufficiency (TVI; n = 23), or both MVI and TVI (n = 40). One hundred fifty-two patients displayed normal ECHO examinations (control). Ninety-nine patients with other pathologies were excluded from the study. Systemic vascular resistance was significantly lower among the MVI group, and cardiac output (CO) significantly higher in the MVI and both MVI and TVI groups compared with controls. More MVI and both MVI and TVI patients required epinephrine compared with controls. The number of patients who required blood transfusion was higher in the MVI than the control group (P < .05). Patient characteristics, end-stage liver failure scores, duration of operations, hemodynamic variables, incidence of postreperfusion syndrome, mean doses of ephedrine and epinephrine, red blood cells, fresh frozen plasma and fluid requirements, number of patients extubated immediately after surgery, and mortality rates were not different between the groups. Conclusions. Our study demonstrated that cardiac valve dysfunction may be associated with end-stage liver disease among patients undergoing OLT. Patients with MVI or both MVI and TVI required more care in perioperative management.Öğe Effects of ozone treatment to the levels of neurodegeneration biomarkers after rotenone induced rat model of Parkinson's disease(Elsevier Ireland Ltd, 2023) Kaplan, Algin, A.; Tomruk, C.; Gözde, Aslan, Ç.; Saban, Akkurt, S.; Mehtap, Çinar, G.; Ulukaya, S.; Uyanıkgil, Y.The study investigated the effects of ozone treatment on the neurodegeneration of stereotaxic rotenone-induced parkinson's disease (PD) model. The model was confirmed using the apomorphine rotation test. ?-synuclein, amyloid-?, Tau, phosphorylated Tau, as well as tyrosine hydroxylase(+), nNOS(+), and glial cell counts were used to evaluate neurodegeneration in the substantia nigra pars compacta and ventral tegmental area. The experiment involved 48 Sprague-Dawley rats divided into four groups: dimethyl sulfoxide (DMSO), DMSO with ozone (O), DMSO/rotenone (R), and D/R/O. Ozone treatment significantly improved tissue ?-synuclein level and TH+, nNOS+, and glial cell counts compared to the rotenone-only group. The study suggests that ozone treatment may have beneficial effects on PD biomarkers in the rotenone model. Further studies on ozone dosage, duration, and administration methods in humans could provide more evidence for its potential use in Parkinson's disease treatment. © 2023 Elsevier B.V.Öğe Effects of Perioperative Hypothermia on Extubation, Recovery Time, and Postoperative Shivering in Breast Surgery(Mary Ann Liebert Inc., 2023) Huniler, H.C.; Deniz, M.N.; Günişen, İ.; Yakut, Özdemir, I.; Tetik, A.; Ulukaya, S.Women undergoing breast surgery seem to be under the risk for hypothermia (central body temperature <36°) due to the uncertainty caused by the preoperative preparation time and the variety of operations, leading to neglect of warming precautions. The study examines the perioperative hypothermia (PH) in breast surgery and the relationships between the depth of decrease in body temperature and individual or clinical variables. This prospective, cross-sectional, observational study includes 120 female patients 18-65 years of age who were given general anesthesia for breast surgery. The incidence of hypothermia was 68.1%. The given patients were discriminated as body temperature <36°, hypothermia was significantly related with lower weight, body mass index, American Society of Anesthesiology (ASA) score, baseline body temperatures, higher extubation, and recovery times. When patients' temperature decreases by >1 or 1.5°, lower age and longer durations of operation and anesthesia were also significant variables. The incidence of shivering is quite high at temperatures below 36°C or at 1 and 1.5°C reductions from baseline (72.7%, 84%, 94.1%, respectively). Body temperature changes of the patients had no effect on nausea-vomiting and pain scores. It turned out that the incidence of PH and shivering is high in women who underwent breast surgery. We think that the depth of decrease in body temperature should be taken into account when evaluating the predictors or clinical consequences of hypothermia, except for the 36°C limit for body temperature. Copyright 2023, Mary Ann Liebert, Inc., publishers.Öğe Evaluation of the Brain Cellular Damage during Liver Transplantations(Wolters Kluwer Medknow Publications, 2023) Deniz, M. N.; Sezer, E.; Tetik, A.; Ulukaya, S.Background:Neuroinflammation in patients undergoing major surgery can lead to neuronal damage, and neuronal damage can be detected through the measurement of biochemical markers of brain damage. S100 beta (S100 & beta;), neuron-specific enolase (NSE), and glial fibrillary acidic protein (GFAP) levels are considered good biomarkers to detect brain damage that emerged with neurotoxicity. Aim:To evaluate neuronal damage during liver transplantations. Materials and Methods:After approval of the ethics committee and patient consents, preoperative and postoperative cognitive functions of 33 patients undergoing liver transplantation were measured using the Mini Mental State Examination (MMSE), whereas simultaneous neuronal damage was evaluated through the measurement of S100 & beta;, NSE, and GFAP levels. Results:There was no statistically significant difference between preoperative and postoperative MMSE. There was a statistically significant decrease in postoperative GFAP (P < 0.05) and a statistically significant increase in NSE (P < 0.05) compared to preoperative values. The decrease in S100 & beta; (P > 0.05) level was statistically insignificant. Conclusions:Neuroprotective approaches in anesthesia protocol protect patients from brain damage during liver transplantation and prevent the development of postoperative cognitive dysfunction. Since the significant increase in NSE levels during liver transplantations was deemed to have been associated with causes other than neuronal damage, NSE should not be evaluated as a marker of brain damage in these operations.Öğe Successful resuscitation of cardiac arrest due to postreperfusion syndrome during orthotopic liver transplantation: A case report(Elsevier Science Inc, 2007) Ulukaya, S.; Alper, I.; Aydin, U.; Kilic, M.A patient with alcohol induced end-stage liver disease developed cardiac arrest immediately after reperfusion during orthotopic liver transplantation. In our case, advanced age of the patient, alcohol-related severe liver disease with high ASA score, and myocardial dysfunction, combined with acute metabolic and hemodynamic changes throughout the surgery may have contributed to the development of postreperfusion syndrome resulting in cardiac arrest. Our patient required a total of 5 mg epinephrine, 200 mg lidocaine, 100 mEq NaHCO3, and 40 mEq calcium gluconate together with direct cardiac compressions and ventilation enriched 100% oxygen to regain sinusoidal rhythm. In conclusion, during severe postreperfusion syndrome, the collaboration between the surgical and anesthesia teams is crucial to overcome cardiac arrest. In an open abdomen, direct cardiac compressions through the transdiaphragmatic pericardial window instead of chest compressions were important to restore effective circulation during advanced life support.
