Sebnem Atici - Academia.edu (original) (raw)
Papers by Sebnem Atici
European Journal of Anaesthesiology, 2006
Annals of Cardiac Anaesthesia, 2008
European Journal of Anaesthesiology, 2004
European Journal of Anaesthesiology, 2005
European Journal of Anaesthesiology, 2004
Tracheostomy is done mostly in critically ill patients, many of whom may not survive. We still do... more Tracheostomy is done mostly in critically ill patients, many of whom may not survive. We still do not know the long term complications of tracheostomy itself; tracheal and subglottic stenosis, and tracheomalacia. To compare the complications of surgical tracheostomy (ST) versus percutaneous dilatational tracheostomy (PDT) by means of MRI control up to 1 month after closed tracheostomy. There was no death related to tracheostomy. In both groups there were two preoperative complications: one minor hemorrhage and one subcutaneous empysema in the ST group, and one minor bleeding and one puncture ofendotracheal tube cuff in the PDT group. When the early and the late postoperative complications of the two groups were compared, it was observed that in the ST group, five early (one minor bleeding, three stomal infections and one accidental decannulation), and two late (one peristomal granuloma and one persistent stoma) postoperative complications had occurred. In the PDT group, four early (minor bleeding) and two late postoperative complications (two minor bleeding) were observed. MRI of two patients in the PDT group demonstrated tracheal stenosis. PDT is as safe and as effective as ST. Although the early and late postoperative complication rates were not significant in the PDT group, we believe that further investigations with larger groups are necessary to find long-term outcome following PDT. MRI scanning provides an excellent non-invasive method of assessing the tracheal lumen.
European Journal of Anaesthesiology, 2005
Turkish Journal of Thoracic and Cardiovascular Surgery, 2014
European Journal of Anaesthesiology, 2005
Intrathecal morphine has been used in hopes of providing long-lasting postoperative analgesia in ... more Intrathecal morphine has been used in hopes of providing long-lasting postoperative analgesia in patients after cardiac surgery. The aim of this study was to evaluate the effects of 7 micro/kg intrathecal morphine administration in coronary bypass surgery in the postoperative period. We conducted a prospective, randomized, blinded, and controlled study. Twenty-three patients, who underwent primary elective coronary bypass surgery, were randomly allocated to receive morphine 7 micro/kg intrathecally, before the induction of general anesthesia (Group M, n = 12) or no intrathecal injection (Group C, n = 11). Pain scores, determined by visual analogue scale (VAS), were recorded immediately after extubation upon admission to the intensive care unit (ICU), at the 2nd, 4th, 6th, and 18th hour after extubation. Pethidine was administered if the patient's VAS > or = 4 and consumption was recorded. Extubation time and ICU length of stay were also recorded. VAS scores were lower in the Group M at each measured time than the control group (p = 0.016, 0.023, 0.004, 0.0001, and 0.001, respectively). According to the VAS scores, pethidine requirement was lower in the Group M than the control (p = 0.001). Extubation time (3.58 +/- 1.57 vs. 4.86 +/- 1.38 hours, p = 0.045) and ICU length of stay (16.25 +/- 2.70 vs. 19.30 +/- 2.45 hours, p = 0.014) were also significantly shorter in the Group M than the control group. No significant complications were seen in this group of patients. Intrathecal morphine provided effective analgesia, earlier tracheal extubation and less ICU length stay after on-pump coronary bypass surgery. The influence on ICU length of stay requires further evaluations.
Journal of Cardiac Surgery, 2008
Background: Intrathecal morphine has been used in hopes of providing long-lasting postoperative a... more Background: Intrathecal morphine has been used in hopes of providing long-lasting postoperative analgesia in patients after cardiac surgery. The aim of this study was to evaluate the effects of 7 µ/kg intrathecal morphine administration in coronary bypass surgery in the postoperative period. Methods: We conducted a prospective, randomized, blinded, and controlled study. Twenty-three patients, who underwent primary elective coronary bypass surgery, were randomly allocated to receive morphine 7 µ/kg intrathecally, before the induction of general anesthesia (Group M, n = 12) or no intrathecal injection (Group C, n = 11). Pain scores, determined by visual analogue scale (VAS), were recorded immediately after extubation upon admission to the intensive care unit (ICU), at the 2nd, 4th, 6th, and 18th hour after extubation. Pethidine was administered if the patient's VAS ≥ 4 and consumption was recorded. Extubation time and ICU length of stay were also recorded. Results: VAS scores were lower in the Group M at each measured time than the control . According to the VAS scores, pethidine requirement was lower in the Group M than the control (p = 0.001). Extubation time (3.58 ± 1.57 vs. 4.86 ± 1.38 hours, p = 0.045) and ICU length of stay (16.25 ± 2.70 vs. 19.30 ± 2.45 hours, p = 0.014) were also significantly shorter in the Group M than the control group. No significant complications were seen in this group of patients. Conclusions: Intrathecal morphine provided effective analgesia, earlier tracheal extubation and less ICU length stay after on-pump coronary bypass surgery. The influence on ICU length of stay requires further evaluations.
Urologia Internationalis, 2004
To examine in a prospective, randomized, double-blind, placebo-controlled study the analgesic eff... more To examine in a prospective, randomized, double-blind, placebo-controlled study the analgesic effect of periprostatic nerve block and/or intravenous synthetic opioid administration during a 12-core prostate biopsy. Patients were prospectively randomized to receive unilateral periprostatic lidocaine administration and/or intravenous synthetic opioid (meperidine or tramadol) administration. Placebo groups received sterile normal saline. Unilateral infiltration was performed and biopsy was begun on this side. The degree of pain was recorded using the visual analog scale/numeric analog scale (VAS/NAS) score before the procedure, during probe introduction into the rectum, during unilateral periprostatic nerve blockade, during the first 6-core biopsy and during the second 6-core biopsy, and 30 min after biopsy completion. Most of the patients had mild or moderate pain (VAS/NAS <6) during the actual biopsy procedure. However, no significant differences existed between the groups with regard to the pain scores at any time (p > 0.05). Compared with pain scores, no significant differences existed between the first 6-core (blocked side) and second 6-core biopsies (p > 0.05). Periprostatic lidocaine infiltration and/or intravenous synthetic opioid analgesics are not beneficial in significantly reducing pain during biopsy. We think that most of the patients do have pain during biopsy, however the intensity of pain is tolerable and does not require analgesics.
European Journal of Anaesthesiology, 2004
Pediatric Surgery International, 2007
Recently, most studies reported magnesium as a N-methyl-D-aspartate receptor antagonist and its a... more Recently, most studies reported magnesium as a N-methyl-D-aspartate receptor antagonist and its analgesic and perioperative anaesthetic effects have been discussed with central desensitization pathway. We investigated the effects of caudal ropivacaine plus magnesium and compared with ropivacaine alone on postoperative analgesia requirements. After hospital ethic committee's consent, 60 patients (ASA I-II, 2-10 years old) who had lower abdominal or penoscrotal surgery were enrolled in the study. After general anaesthesia induction, caudal blockage was applied. Patients were randomly assigned in two groups. Ropivacaine 0.25% was administered to Group R (n = 37), ropivacaine 0.25% plus 50 mg magnesium to Group RM (n = 23) in 0.5 ml kg -1 volume. Postoperative analgesia level was recorded at 15 min and 1, 2, 3, 4, 6 h by using Paediatric Objective Pain Scale (POPS) and The Children's Hospital of Eastern Ontoria Pain Scale (CHEOPS). Postoperative motor blocks were evaluated with Modified Bromage Motor Block Scale. According to demographic characteristics, there were no significant differences between the two groups (P > 0.05). POPS, CHEOPS, Bromage Motor Scales, analgesia duration and adverse effects were similar in Group R and Group RM. It has been shown that addition of magnesium as an adjuvant agent to local anaesthetics for caudal analgesia has no effect on postoperative pain and analgesic need.
Objective To examine the effects of short-term cyclic stretch on apoptosis in alveolar type II ce... more Objective To examine the effects of short-term cyclic stretch on apoptosis in alveolar type II cells (A549). To study in vitro the direct influence of alveolar type II cells on mechanical stretch. Methods A549 were treated with different doses of lipopolysaccharide (LPS), 0 ng/ml, 1 ng/ml, 10 ng/ml, 100 ng/ml, 1000 ng/ml, and then A549 were lengthened 5%, 15%, 30% using a FLEXCELL tension unit 4000, a vacuum-driven device that applies strain to cells, which were cultured in six-well plates coated with collagen-I, and 12 cycles/min for 4 hours. Apoptosis was measured using the flow cytometry method that measures annexin V and propidium iodide (PI) staining. The morphological changes of apoptotic cells were observed by transmission electron microscope. Results Apoptosis could be induced in alveolar type II cells (A549) by mechanical stretch. The percentage of annexin V + PI cells increased after being treated with cyclic stretch for 4 hours by 5%, 15%, 30% in all groups. The morphological features of apoptotic cells demonstrated by transmission electron microscope were as follows: shrinkage of the cell, chromatin condensation and aggregation under the nuclear membrane as a crescent or lump, membrane-encapsulated nuclear fragment or cell organ formed by invagination of the cell membrane, and apoptotic body formation followed by vacuolization. Conclusion Apoptosis induced by mechanical stretch and LPS is dose dependent. Mechanical stretch aggravates apoptosis especially in cells treated with LPS. Annexin V and PI double staining is a specific, sensitive, and quantitative method for analyzing apoptotic cells. It is also helpful to clarify the protective mechanism of low-volume ventilation in ARDS. PaO 2 /FiO 2 430 [421; 440] # 380 [349; 397] 165 [68; 289] # C (ml/cmH 2 O) 28 [24; 32]* 18 [16; 21]* 12 [8; 17]* R i (cmH 2 O/l/s) 4.1 [3.9; 4.5] 4.5 [4.3; 5.1] 5.1 [3.7; 7.9] # P < 0.05 control vs 24-hour peritonitis, *P < 0.05 control vs 12-hour and 24-hour peritonitis.
Journal of Anesthesia, 2008
−1 propofol, 0.1 mg fentanil, and 0.1 mg·kg −1 vecuronium bromide i.v. Tracheal intubation was ac... more −1 propofol, 0.1 mg fentanil, and 0.1 mg·kg −1 vecuronium bromide i.v. Tracheal intubation was achieved with a size 7.5-mm ETT (Well Lead Medical Instruments, Jinhu Industrial Estate Hualong, Panyu Guangzhou, P. R. China). Chest auscultation revealed clear, bilaterally equal breath sounds. The lungs were ventilated at 6 l·min −1 and 17-mmHg peak airway pressure. While we were fi xing the ETT with tape, a moving particle was noticed in the lumen of the ETT. The ETT was immediately disconnected from the ventilator, and a tiny particle was noted in the distal part of the tube connector (Fig. 1). The connector was changed immediately and ventilation was maintained with no problem during the operation. Inspection of the connector revealed that the presence of the particle was caused by a manufacturing defect. Neither atelectasis nor a foreign body was seen on chest radiograph taken at the end of the operation. The postoperative course was uneventful. Problems associated with an ETT defect, if not corrected immediately, would lead to failure in ventilating the lungs, hypoxemia, and serious complications [2,3]. It is recommended that the use of transparent tubes and a pre-use check might allow visualization of the lumen and hence prevent problems [3]. However, some problems may still occur even with high-quality, pre-packed single-use transparent plastic ETTs [3]. In our patient, the foreign body moved with ventilation, and then it could be seen only in the lumen of the tube. If it had not been noticed, a possible problem would have been the inward migration of the particle, possibly leading to serious complications. There has been no previous report of this type of structural defect in an ETT. We suggest that an internal visual check of the lumen should be performed routinely, because the opaque nature of the connector makes visual
Journal of Parenteral and Enteral Nutrition, 2005
Low muscle glutamine levels during sepsis are associated with reduced protein synthesis and eleva... more Low muscle glutamine levels during sepsis are associated with reduced protein synthesis and elevated protein breakdown, in particular myofibrillar protein breakdown. Thus, in a cecal ligation and puncture (CLP)-induced sepsis model in the rat, we hypothesized that glutamine pretreatment would protect the diaphragm muscle function. Eighty-four male Wistar rats weighing between 180 g and 200 g received standard amino acid solution 1.2 g kg(-1) per day intraperitoneally (IP) or standard amino acid solution 1.2 g kg(-1) per day plus alanyl-glutamine (GLN) 0.25 g kg(-1) per day (IP) during the first 6 days of the experiment. On the seventh day, CLP or sham procedures were applied. The sham and CLP groups were equally divided into 3 subgroups according to the termination of the experiment, which took place at either the 24th hour, 48th hour, or 72nd hour. After the compound muscle action potentials (CMAP) were recorded from the diaphragms of the rats at these selected times, they were decapitated under ketamine/xylazine anesthesia, and diaphragms were harvested for biochemical and histopathological examination. The mean area and amplitude of CMAP were significantly larger in sham+GLN groups when compared with CLP and CLP+GLN groups at all times (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). Diaphragm Ca+2 -ATPase levels were found to be significantly decreased in CLP group at all times compared to sham groups (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). Diaphragm reduced glutathione levels were significantly higher in sham+GLN groups when compared with CLP and CLP+GLN groups at all times (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). In histopathologic assessment, moderate neutrophil infiltration, which was observed in CLP48, was significantly reduced with alanyl-glutamine supplementation in CLP+GLN48 group (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). This study showed that glutamine pretreatment did not improve diaphragm muscle function, but prevented the biochemical and histopathological changes in diaphragmatic muscle in CLP-induced sepsis. However, further studies are needed to clarify whether a higher dose of glutamine supplementation might protect the diaphragmatic muscle functions.
… IN CLINICAL AND …, 2005
All 20 subjects showed similar changes with 2 different doses of remifentanil. Before anesthesia,... more All 20 subjects showed similar changes with 2 different doses of remifentanil. Before anesthesia, visual analysis of EEG and QEEG analysis had no significant changes between the groups. In the first group, absolute fre-quency of delta significantly increased ...
International urology and nephrology, 2001
The aim of this study was to investigate the hormonal and hemodynamic changes during percutaneous... more The aim of this study was to investigate the hormonal and hemodynamic changes during percutaneous nephrolithotomy (PCNL) procedure. Twenty-one patients between 15-65 years of age were included in the study. Invasive blood pressure and heart rate were monitored during PCNL. Serum sodium, potassium, BUN and creatinine levels were measured before and after the operation. Sodium and potassium levels were also measured during the operation. Arterial blood gases, renin, aldosterone and adrenocorticotrophic hormone (ACTH) levels were measured before and during irrigation. The mean systolic and diastolic blood pressure levels were significantly higher (p < 0.05) during PCNL compared to post-procedure levels while heart rate remained constant. Serum sodium, potassium bicarbonate and base-excess levels were decreased during the operation compared to the baseline levels (p < 0.001). BUN and creatinine levels remained unchanged during the study (p > 0.05). In conclusion, a tendency to ...
Ağrı - The Journal of The Turkish Society of Algology, 2015
Spinal myoclonus following regional anaesthesia is extremely rare. We report a patient who develo... more Spinal myoclonus following regional anaesthesia is extremely rare. We report a patient who developed spinal myoclonus after an epidural infusion of levobupivacaine.
European Journal of Anaesthesiology, 2006
Annals of Cardiac Anaesthesia, 2008
European Journal of Anaesthesiology, 2004
European Journal of Anaesthesiology, 2005
European Journal of Anaesthesiology, 2004
Tracheostomy is done mostly in critically ill patients, many of whom may not survive. We still do... more Tracheostomy is done mostly in critically ill patients, many of whom may not survive. We still do not know the long term complications of tracheostomy itself; tracheal and subglottic stenosis, and tracheomalacia. To compare the complications of surgical tracheostomy (ST) versus percutaneous dilatational tracheostomy (PDT) by means of MRI control up to 1 month after closed tracheostomy. There was no death related to tracheostomy. In both groups there were two preoperative complications: one minor hemorrhage and one subcutaneous empysema in the ST group, and one minor bleeding and one puncture ofendotracheal tube cuff in the PDT group. When the early and the late postoperative complications of the two groups were compared, it was observed that in the ST group, five early (one minor bleeding, three stomal infections and one accidental decannulation), and two late (one peristomal granuloma and one persistent stoma) postoperative complications had occurred. In the PDT group, four early (minor bleeding) and two late postoperative complications (two minor bleeding) were observed. MRI of two patients in the PDT group demonstrated tracheal stenosis. PDT is as safe and as effective as ST. Although the early and late postoperative complication rates were not significant in the PDT group, we believe that further investigations with larger groups are necessary to find long-term outcome following PDT. MRI scanning provides an excellent non-invasive method of assessing the tracheal lumen.
European Journal of Anaesthesiology, 2005
Turkish Journal of Thoracic and Cardiovascular Surgery, 2014
European Journal of Anaesthesiology, 2005
Intrathecal morphine has been used in hopes of providing long-lasting postoperative analgesia in ... more Intrathecal morphine has been used in hopes of providing long-lasting postoperative analgesia in patients after cardiac surgery. The aim of this study was to evaluate the effects of 7 micro/kg intrathecal morphine administration in coronary bypass surgery in the postoperative period. We conducted a prospective, randomized, blinded, and controlled study. Twenty-three patients, who underwent primary elective coronary bypass surgery, were randomly allocated to receive morphine 7 micro/kg intrathecally, before the induction of general anesthesia (Group M, n = 12) or no intrathecal injection (Group C, n = 11). Pain scores, determined by visual analogue scale (VAS), were recorded immediately after extubation upon admission to the intensive care unit (ICU), at the 2nd, 4th, 6th, and 18th hour after extubation. Pethidine was administered if the patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s VAS &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 4 and consumption was recorded. Extubation time and ICU length of stay were also recorded. VAS scores were lower in the Group M at each measured time than the control group (p = 0.016, 0.023, 0.004, 0.0001, and 0.001, respectively). According to the VAS scores, pethidine requirement was lower in the Group M than the control (p = 0.001). Extubation time (3.58 +/- 1.57 vs. 4.86 +/- 1.38 hours, p = 0.045) and ICU length of stay (16.25 +/- 2.70 vs. 19.30 +/- 2.45 hours, p = 0.014) were also significantly shorter in the Group M than the control group. No significant complications were seen in this group of patients. Intrathecal morphine provided effective analgesia, earlier tracheal extubation and less ICU length stay after on-pump coronary bypass surgery. The influence on ICU length of stay requires further evaluations.
Journal of Cardiac Surgery, 2008
Background: Intrathecal morphine has been used in hopes of providing long-lasting postoperative a... more Background: Intrathecal morphine has been used in hopes of providing long-lasting postoperative analgesia in patients after cardiac surgery. The aim of this study was to evaluate the effects of 7 µ/kg intrathecal morphine administration in coronary bypass surgery in the postoperative period. Methods: We conducted a prospective, randomized, blinded, and controlled study. Twenty-three patients, who underwent primary elective coronary bypass surgery, were randomly allocated to receive morphine 7 µ/kg intrathecally, before the induction of general anesthesia (Group M, n = 12) or no intrathecal injection (Group C, n = 11). Pain scores, determined by visual analogue scale (VAS), were recorded immediately after extubation upon admission to the intensive care unit (ICU), at the 2nd, 4th, 6th, and 18th hour after extubation. Pethidine was administered if the patient's VAS ≥ 4 and consumption was recorded. Extubation time and ICU length of stay were also recorded. Results: VAS scores were lower in the Group M at each measured time than the control . According to the VAS scores, pethidine requirement was lower in the Group M than the control (p = 0.001). Extubation time (3.58 ± 1.57 vs. 4.86 ± 1.38 hours, p = 0.045) and ICU length of stay (16.25 ± 2.70 vs. 19.30 ± 2.45 hours, p = 0.014) were also significantly shorter in the Group M than the control group. No significant complications were seen in this group of patients. Conclusions: Intrathecal morphine provided effective analgesia, earlier tracheal extubation and less ICU length stay after on-pump coronary bypass surgery. The influence on ICU length of stay requires further evaluations.
Urologia Internationalis, 2004
To examine in a prospective, randomized, double-blind, placebo-controlled study the analgesic eff... more To examine in a prospective, randomized, double-blind, placebo-controlled study the analgesic effect of periprostatic nerve block and/or intravenous synthetic opioid administration during a 12-core prostate biopsy. Patients were prospectively randomized to receive unilateral periprostatic lidocaine administration and/or intravenous synthetic opioid (meperidine or tramadol) administration. Placebo groups received sterile normal saline. Unilateral infiltration was performed and biopsy was begun on this side. The degree of pain was recorded using the visual analog scale/numeric analog scale (VAS/NAS) score before the procedure, during probe introduction into the rectum, during unilateral periprostatic nerve blockade, during the first 6-core biopsy and during the second 6-core biopsy, and 30 min after biopsy completion. Most of the patients had mild or moderate pain (VAS/NAS &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;6) during the actual biopsy procedure. However, no significant differences existed between the groups with regard to the pain scores at any time (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). Compared with pain scores, no significant differences existed between the first 6-core (blocked side) and second 6-core biopsies (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). Periprostatic lidocaine infiltration and/or intravenous synthetic opioid analgesics are not beneficial in significantly reducing pain during biopsy. We think that most of the patients do have pain during biopsy, however the intensity of pain is tolerable and does not require analgesics.
European Journal of Anaesthesiology, 2004
Pediatric Surgery International, 2007
Recently, most studies reported magnesium as a N-methyl-D-aspartate receptor antagonist and its a... more Recently, most studies reported magnesium as a N-methyl-D-aspartate receptor antagonist and its analgesic and perioperative anaesthetic effects have been discussed with central desensitization pathway. We investigated the effects of caudal ropivacaine plus magnesium and compared with ropivacaine alone on postoperative analgesia requirements. After hospital ethic committee's consent, 60 patients (ASA I-II, 2-10 years old) who had lower abdominal or penoscrotal surgery were enrolled in the study. After general anaesthesia induction, caudal blockage was applied. Patients were randomly assigned in two groups. Ropivacaine 0.25% was administered to Group R (n = 37), ropivacaine 0.25% plus 50 mg magnesium to Group RM (n = 23) in 0.5 ml kg -1 volume. Postoperative analgesia level was recorded at 15 min and 1, 2, 3, 4, 6 h by using Paediatric Objective Pain Scale (POPS) and The Children's Hospital of Eastern Ontoria Pain Scale (CHEOPS). Postoperative motor blocks were evaluated with Modified Bromage Motor Block Scale. According to demographic characteristics, there were no significant differences between the two groups (P > 0.05). POPS, CHEOPS, Bromage Motor Scales, analgesia duration and adverse effects were similar in Group R and Group RM. It has been shown that addition of magnesium as an adjuvant agent to local anaesthetics for caudal analgesia has no effect on postoperative pain and analgesic need.
Objective To examine the effects of short-term cyclic stretch on apoptosis in alveolar type II ce... more Objective To examine the effects of short-term cyclic stretch on apoptosis in alveolar type II cells (A549). To study in vitro the direct influence of alveolar type II cells on mechanical stretch. Methods A549 were treated with different doses of lipopolysaccharide (LPS), 0 ng/ml, 1 ng/ml, 10 ng/ml, 100 ng/ml, 1000 ng/ml, and then A549 were lengthened 5%, 15%, 30% using a FLEXCELL tension unit 4000, a vacuum-driven device that applies strain to cells, which were cultured in six-well plates coated with collagen-I, and 12 cycles/min for 4 hours. Apoptosis was measured using the flow cytometry method that measures annexin V and propidium iodide (PI) staining. The morphological changes of apoptotic cells were observed by transmission electron microscope. Results Apoptosis could be induced in alveolar type II cells (A549) by mechanical stretch. The percentage of annexin V + PI cells increased after being treated with cyclic stretch for 4 hours by 5%, 15%, 30% in all groups. The morphological features of apoptotic cells demonstrated by transmission electron microscope were as follows: shrinkage of the cell, chromatin condensation and aggregation under the nuclear membrane as a crescent or lump, membrane-encapsulated nuclear fragment or cell organ formed by invagination of the cell membrane, and apoptotic body formation followed by vacuolization. Conclusion Apoptosis induced by mechanical stretch and LPS is dose dependent. Mechanical stretch aggravates apoptosis especially in cells treated with LPS. Annexin V and PI double staining is a specific, sensitive, and quantitative method for analyzing apoptotic cells. It is also helpful to clarify the protective mechanism of low-volume ventilation in ARDS. PaO 2 /FiO 2 430 [421; 440] # 380 [349; 397] 165 [68; 289] # C (ml/cmH 2 O) 28 [24; 32]* 18 [16; 21]* 12 [8; 17]* R i (cmH 2 O/l/s) 4.1 [3.9; 4.5] 4.5 [4.3; 5.1] 5.1 [3.7; 7.9] # P < 0.05 control vs 24-hour peritonitis, *P < 0.05 control vs 12-hour and 24-hour peritonitis.
Journal of Anesthesia, 2008
−1 propofol, 0.1 mg fentanil, and 0.1 mg·kg −1 vecuronium bromide i.v. Tracheal intubation was ac... more −1 propofol, 0.1 mg fentanil, and 0.1 mg·kg −1 vecuronium bromide i.v. Tracheal intubation was achieved with a size 7.5-mm ETT (Well Lead Medical Instruments, Jinhu Industrial Estate Hualong, Panyu Guangzhou, P. R. China). Chest auscultation revealed clear, bilaterally equal breath sounds. The lungs were ventilated at 6 l·min −1 and 17-mmHg peak airway pressure. While we were fi xing the ETT with tape, a moving particle was noticed in the lumen of the ETT. The ETT was immediately disconnected from the ventilator, and a tiny particle was noted in the distal part of the tube connector (Fig. 1). The connector was changed immediately and ventilation was maintained with no problem during the operation. Inspection of the connector revealed that the presence of the particle was caused by a manufacturing defect. Neither atelectasis nor a foreign body was seen on chest radiograph taken at the end of the operation. The postoperative course was uneventful. Problems associated with an ETT defect, if not corrected immediately, would lead to failure in ventilating the lungs, hypoxemia, and serious complications [2,3]. It is recommended that the use of transparent tubes and a pre-use check might allow visualization of the lumen and hence prevent problems [3]. However, some problems may still occur even with high-quality, pre-packed single-use transparent plastic ETTs [3]. In our patient, the foreign body moved with ventilation, and then it could be seen only in the lumen of the tube. If it had not been noticed, a possible problem would have been the inward migration of the particle, possibly leading to serious complications. There has been no previous report of this type of structural defect in an ETT. We suggest that an internal visual check of the lumen should be performed routinely, because the opaque nature of the connector makes visual
Journal of Parenteral and Enteral Nutrition, 2005
Low muscle glutamine levels during sepsis are associated with reduced protein synthesis and eleva... more Low muscle glutamine levels during sepsis are associated with reduced protein synthesis and elevated protein breakdown, in particular myofibrillar protein breakdown. Thus, in a cecal ligation and puncture (CLP)-induced sepsis model in the rat, we hypothesized that glutamine pretreatment would protect the diaphragm muscle function. Eighty-four male Wistar rats weighing between 180 g and 200 g received standard amino acid solution 1.2 g kg(-1) per day intraperitoneally (IP) or standard amino acid solution 1.2 g kg(-1) per day plus alanyl-glutamine (GLN) 0.25 g kg(-1) per day (IP) during the first 6 days of the experiment. On the seventh day, CLP or sham procedures were applied. The sham and CLP groups were equally divided into 3 subgroups according to the termination of the experiment, which took place at either the 24th hour, 48th hour, or 72nd hour. After the compound muscle action potentials (CMAP) were recorded from the diaphragms of the rats at these selected times, they were decapitated under ketamine/xylazine anesthesia, and diaphragms were harvested for biochemical and histopathological examination. The mean area and amplitude of CMAP were significantly larger in sham+GLN groups when compared with CLP and CLP+GLN groups at all times (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). Diaphragm Ca+2 -ATPase levels were found to be significantly decreased in CLP group at all times compared to sham groups (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). Diaphragm reduced glutathione levels were significantly higher in sham+GLN groups when compared with CLP and CLP+GLN groups at all times (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). In histopathologic assessment, moderate neutrophil infiltration, which was observed in CLP48, was significantly reduced with alanyl-glutamine supplementation in CLP+GLN48 group (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). This study showed that glutamine pretreatment did not improve diaphragm muscle function, but prevented the biochemical and histopathological changes in diaphragmatic muscle in CLP-induced sepsis. However, further studies are needed to clarify whether a higher dose of glutamine supplementation might protect the diaphragmatic muscle functions.
… IN CLINICAL AND …, 2005
All 20 subjects showed similar changes with 2 different doses of remifentanil. Before anesthesia,... more All 20 subjects showed similar changes with 2 different doses of remifentanil. Before anesthesia, visual analysis of EEG and QEEG analysis had no significant changes between the groups. In the first group, absolute fre-quency of delta significantly increased ...
International urology and nephrology, 2001
The aim of this study was to investigate the hormonal and hemodynamic changes during percutaneous... more The aim of this study was to investigate the hormonal and hemodynamic changes during percutaneous nephrolithotomy (PCNL) procedure. Twenty-one patients between 15-65 years of age were included in the study. Invasive blood pressure and heart rate were monitored during PCNL. Serum sodium, potassium, BUN and creatinine levels were measured before and after the operation. Sodium and potassium levels were also measured during the operation. Arterial blood gases, renin, aldosterone and adrenocorticotrophic hormone (ACTH) levels were measured before and during irrigation. The mean systolic and diastolic blood pressure levels were significantly higher (p < 0.05) during PCNL compared to post-procedure levels while heart rate remained constant. Serum sodium, potassium bicarbonate and base-excess levels were decreased during the operation compared to the baseline levels (p < 0.001). BUN and creatinine levels remained unchanged during the study (p > 0.05). In conclusion, a tendency to ...
Ağrı - The Journal of The Turkish Society of Algology, 2015
Spinal myoclonus following regional anaesthesia is extremely rare. We report a patient who develo... more Spinal myoclonus following regional anaesthesia is extremely rare. We report a patient who developed spinal myoclonus after an epidural infusion of levobupivacaine.