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    A suspicious reason for Raynaud’s phenomenon: Intrauterine device
    (SAGE Publications Ltd, 2015) Diken, Adem İlkay; Yalçınkaya, Adnan; Aksoy, Eray; Yılmaz, Seyhan; Çağlı, Kerim
    Primary Raynaud’s phenomenon may be insistent in patients under medical therapy, and intrauterine devices may be an unnoticed reason in these patients. Fluctuations in female sex hormone status were reported to be associated with the emergence of primary Raynaud’s phenomenon symptoms. The use of intrauterine devices was not reported to be associated with Raynaud’s phenomenon previously. Intrauterine device may stimulate vascular hyperactivity regarding hormonal or unknown mechanisms that result in Raynaud’s phenomenon. We present a postmenopausal patient who complained of primary Raynaud’s phenomenon symptoms and had recovery after the removal of her copper intrauterine device. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav
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    Alt ekstremite venöz yetmezliği tedavisinde kompresyon çorapları ve kullanımını etkileyen faktörler
    (2015) Yılmaz, Seyhan; Yaylacı, Songül; Diken, Adem İlkay; Yalçınkaya, Adnan; Aksoy, Eray
    ÖZET Amaç: Kronik venöz yetmezlik 2000 yılı aşkın süreden beri bilinmekte olan klinik bir sorun-dur. Alt ekstremite venöz sistemindeki yetersizlikler sonucunda venöz staz ve venöz hipertan-siyon gelişir. Kronik venöz yetmezliğin tedavisinde hastalığın her aşamasında kullanılabilen kompresyon çorapları Virchows triadı’nın ikinci noktası olan ‘staz’ tedavisi için uygulanmak-tadır, ve hastalığın tedavisinde ve proflakside etkilidir. Bu çalışmanın amacı, bölgemizdeki basınçlı kompresyon çorabı kulanım endikas- yonları ve kullanım sırasında hastaların yaşadıkları zorlukların belirlenmesidir. Gereç ve Y öntemler: Ça- lışmamızda daha önce alt ekstremite kronik venöz yetmezliği nedeniyle kompresyon çorabı önerilmiş hastalar fizik muayene, anamnez ve şikayetlerine yönelik bir anketle prospektif olarak değerlendirildiler. Bulg u lar: Çalışmaya alınan 200 hastada (%68 kadın ve %32 erkek) ortalama yaş erkekler için 43,8±10,8 yıl, kadınlar için 42,4±10,2 yıl olarak saptandı. Hastaların varis çorabını ilk olarak kullanmaya başladıkları ta- rihten itibaren geçen ortalama süre 23,8 aydı (1 ay-10 yıl). Hastaların çoğunun çorabın zor giyilmesinden ve bacağı sıkmasından kaynaklanan şikayetler dile getirdikleri gözlendi. Sonuç: Araştırmamız Çorum ilin- deki kronik venöz yetmezlikli hastala-rın tedavilerinde basınçlı elastik kompresyon çorabı kullanımı ve kullanma sıklığı açısından önemli veriler sunmaktadır, ve bu veriler kronik venöz yetmezlik tedavisi için kompresyon çorabı tedavisi öneren hekimler tarafından dikkate alınmalıdır. Anahtar Keli meler: Venöz yetmezlik; varis; kompresyon çorabı
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    Angina severity predicts worse sleep quality after coronary artery bypass grafting
    (SAGE Publications Ltd, 2016) Yılmaz, Seyhan; Aksoy, Eray; Doğan, Tolga; Diken, Adem İlkay; Yalçınkaya, Adnan; Özşen, Kelime
    Objective: We sought to reveal whether the severity of angina pectoris affects sleep quality after elective coronary artery bypass grafting. Material and methods: Patients scheduled to undergo isolated coronary artery bypass grafting were divided into two groups, having a recent myocardial infarction (Group 1, n=22, mean age 59.40±7.79 years) or not having a recent myocardial infarction (Group 2, n=30, mean age 59.73±7.72 years). The assessment included the Canadian Cardiovascular Society Angina Score, the visual analogue scale for postoperative pain and the Pittsburgh Sleep Quality Index (PSQI). Results: The two groups were similar in regard to baseline characteristics. Cross-clamp time was significantly higher (p=0.007) and the use of inotropes was significantly more common (p=0.01) in those patients with recent myocardial infarction compared to those without. Mean Canadian Cardiovascular Society scores were also higher in patients with recent myocardial infarction (p=0.02). Total Pittsburgh Sleep Quality Index score was significantly higher in patients with recent myocardial infarction (8.45±3.50 vs. 5.03±2.32, respectively, p<0.001). In multivariate analysis, higher angina score (OR: 3.27, 95% CI, 1.20-8.90, p=0.02) and longer time of intensive care unit stay (OR: 6.15, 95% CI, 1.49-25.35, p=0.01) were found to be independent predictors of poor sleep quality. The Canadian Cardiovascular Society angina score showed a significant positive correlation with poor sleep duration score (<0.001), sleep disturbance score (p=0.02), day dysfunction due to sleepiness score (p=0.001), sleep efficiency score (p=0.003), overall sleep quality score (0.03) and total PSQI score (p=0.004). Conclusion: The severity of angina pectoris in the preoperative period is independently associated with worse sleep quality after elective isolated coronary artery bypass surgery. © The Author(s) 2016.
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    Autologous platelet-rich plasma in treatment of chronic venous leg ulcers: A prospective case series
    (SAGE Publications Ltd, 2015) Yılmaz, Seyhan; Aksoy, Eray; Doğancı, Suat; Yalçınkaya, Adnan; Diken, Adem İlkay; Çağlı, Kerim
    Study: We report our results on a case series of 19 patients receiving platelet-rich plasma application in treatment of patients with chronic unhealing venous leg ulcers. Material and methods: There were 16 males and three females with a mean age of 38.55 ± 16.46 years. Planimetric size measurements were performed and pain was tested throughout the treatment period. Follow-up was made in seven-day periods. Patients received 5 ml of platelet-rich plasma for each 5 cm2 of the wound surface with half of the amount being injected 1–2 mm deep into the wound and the wound surface was covered with the remaining half. Results: Complete wound healing occurred in 18 of 19 patients (94.7%) within a mean of 4.82 ± 2.16 week. There were significant reductions in wound area among all consecutive measurements except for first week. A significant reduction in wound volume was apparent even in first week and sustained among consecutive measurements. Conclusion: Platelet-rich plasma seems effective in terms of promoting healing of venous leg ulcers. Improvement in wound depth was slightly more prominent than that in wound area, indicating a potential role of platelet-rich plasma especially in deep venous ulcers. © 2014, © The Author(s) 2014.
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    Dopamine administration is a risk factor for delirium in patients undergoing coronary artery bypass surgery
    (Elsevier Ltd, 2016) Yılmaz, Seyhan; Aksoy, Eray; Diken, Adem İlkay; Yalçınkaya, Adnan; Erol, Mehmet Emir; Çağlı, Kerim
    Background: Delirium is an important morbidity following heart surgery. We sought to determine whether dopamine infusion is associated with increased risk of delirium in patients undergoing coronary artery bypass grafting. Methods: A total of 137 patients (mean age; 61.02±7.83, 105 males) were included in the study. Patients undergoing isolated coronary artery bypass grafting were considered eligible and those with preoperative neurological deficit or significant neurocognitive disorders, dementia or psychiatric disorders were excluded. Primary outcome measure was occurrence of delirium within 72 hours after operation. The diagnosis of delirium was made using confusion assessment method for the intensive care unit questionnaire. Both administration of dopamine as a dichotomised variable and the total amount of dopamine per kg body-weight were included in two different logistic regression models. Results: Delirium occurred in 18 (13.1%) patients. Age adjusted Mantel-Haenszel relative risk for delirium with receiving dopamine was 4.62. Relative risk was 2.37 (0.18 to 31.28, 95% CI, p=0.51) in total doses over 10 mg whereas it was 3.55 (1.16 to 10.89 95% CI, p=0.02) in total doses over 30 mg per kg body-weight. Older age (p=0.03), dopamine administration (OR: 9.227 95% CI, 2.688-32.022, p<0.001) and the amount of dopamine administered (OR: 1.072, 95% CI, 1.032-1.115, p<0.001) were independent predictors for delirium 72 hours after surgery. Conclusion: Along with older age, dopamine infusion - even in low doses but more probably in higher doses - emerged as an independent risk factor for delirium in patients undergoing CABG. Further study is needed to confirm the validity of results presented. © 2015.
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    Early and Midterm Clinical Experience of 3-Dimensional Saddle Shape Rigid Annuloplasty Ring in Mitral Valve Repair
    (Elsevier Science Inc, 2013) Sarikaya, Sabit; Aksoy, Eray; Yerlikhan, Ozge Altas; Dedemoglu, Mehmet; Arslan, Akin; Elibol, Ahmet; Kirali, Kaan
    [Abstract Not Available]
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    Early mortality and long-term survival after repair of post-infarction ventricular septal rupture: An institutional report of experience
    (Elsevier Ltd, 2016) Yalçınkaya, Adnan; Lafçı, Gökhan; Diken, Adem İlkay; Aksoy, Eray; Çiçek, Ömer Faruk; Lafçı, Ayşe; Korkmaz, Kemal; Çağlı, Kerim
    Background: To determine predictors of mortality after surgical management of post-infarction ventricular septal rupture repair. Methods: A total of 63 patients (73.2%, mean age 67.22±7.71 years, male:female ratio; 35:28) underwent open heart surgery for post-infarction ventricular septal rupture repair. Patient demographics, operative data and postoperative parameters were analysed to reveal predictors of early mortality and long-term survival. Results: In-hospital mortality was 54.0% (34/63). Time from myocardial infarction to operation ? 14 days (OR: 4.10, 95% CI 1.16-14.46, p=0.02), systolic pulmonary artery pressure > 45 mmHg (OR: 4.14, 95% CI 1.110-15.496, p=0.03) and age (years) (OR: 1.09, 95% CI 1.002-1.194, p=0.04) were found to be independent predictors of in-hospital mortality. In multivariate Cox regression analysis, presence of pulmonary oedema on admission (HR: 4.95, 95% CI 1.58-15.54, p=0.006), age (years) (HR: 1.09, 95% CI 1.009-1.180, p= 0.02) and cross-clamp time <60 min (HR: 3.93, 95% CI 1.13-13.64, p=0.03) were found to be independent predictors of long-term survival. Within a follow-up of a median of 60.0 months, five-year survival rate was 67±9.0%. Conclusion: In line with the previous studies, our study demonstrated the benefits of delaying the repair for post-infarction ventricular septal rupture to allow adequate myocardial healing if haemodynamic status of the patient allows. © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).
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    Effect of left atrial reduction on restoration and maintenance of sinus rhythm in patients undergoing mitral valve replacement: A pilot study
    (Georg Thieme Verlag, 2016) Yalçınkaya, Adnan; Diken, Adem İlkay; Aksoy, Eray; Lafçı, Gökhan; Çiçek, Ömer Faruk; Kadiroğulları, Ersin; Uluşar, Ümit Deniz; Çağlı, Kerim
    Background This pilot study aimed to evaluate the effectiveness of posterior left atrial wall plication (T-plasty) in patients with persistent atrial fibrillation (AF) (> 7 days) undergoing mitral valve surgery. Materials and Methods A total of 60 patients who were scheduled for mitral valve replacement were randomly allocated into two groups: one would receive (Group 1; n = 32, mean age; 49.37 ± 9.00) and one would not receive (Group 2; n = 28; mean age 48.64 ± 8.6) left atrial size reduction using T-plasty technique. Patients with a clear indication for combined procedures other than tricuspid valve disease, aortic valve disease, and coronary artery stenosis were not included. Follow-up was performed at 6th, 12th, and 18th months after the operation. Results After the operation, 21 patients (65.6%) in Group 1 and 13 patients (46.4%) in Group 2 regained sinus rhythm (p = 0.13). Mortality did not occur. AF recurrence rates were not significantly different between the groups in three follow-ups. Restoration of sinus rhythm was significantly more common in Group 1 patients than in Group 2 patients during follow-up. Patients in Group 1 had lower left atrial volume indexes than those in Group 2 at the 6th and 12th months, whereas the difference at the 18th month was at the limit of significance. Conclusion We achieved satisfactory results using the T-plasty technique for left atrial size reduction in terms of mid-term restoration and preservation of normal sinus rhythm in patients undergoing mitral valve surgery. Further study may be justified to reveal the prognostic importance of the technique described herein. © Georg Thieme Verlag Stuttgart. New York.
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    High hemodialysis vascular access flow and impaired right ventricular function in chronic hemodialysis patients
    (Medknow Publications, 2016) Yılmaz, Seyhan; Yetim, Mücahit; Yılmaz, Behice Kaniye; Doğan, Tolga; Aksoy, Eray; Yüksel, N.; Doğan, İbrahim
    There are limited data showing right ventricular preload increase due to high-flow arteriovenous fistulas (AVFs). This cross-sectional study investigated whether high AVF flow had an impact on right ventricular function in patients undergoing hemodialysis. Sixty-four patients aged between 18 and 85 years who were on routine hemodialysis with >2 hemodialysis sessions per week for at least 3 months via an AVF were studied. Patients with inadequate flow fistulas, severe chronic obstructive pulmonary disease, history of pulmonary embolism, primary pulmonary hypertension, severe mitral, aortic or pulmonary regurgitation, and/or stenosis were excluded. After an initial evaluation, 44 patients (mean age: 58.50 ± 16.84, male:female = 23:21) were considered eligible. Right ventricular function was assessed by tricuspid annular plane systolic excursion (TAPSE). AVF blood flow was measured with duplex ultrasound. There were 15 patients (34.1%) with a TAPSE of <16 mm. AVF blood flow was significantly higher in patients with impaired versus normal right ventricular function (1631.53 ± 738.17 vs. 1060.55 ± 539.92 min/ml, respectively, P = 0.003). Low left ventricular ejection fraction (odds ratio [OR]: 1.15, 95% confidence intervals [CI]: 1.007-1.334, P = 0.04), high interventricular septum thickness (OR: 1.64, 95% CI: 1.104-2.464, P = 0.01), and high AVF blood flow (OR: 1.00, 95% CI: 1.000-1.003, P = 0.03) were independent predictors of impaired right ventricular function. In addition to known risk factors that predominantly increase right ventricular afterload, excessive AVF blood flow was found to be independently associated with impaired right ventricular function, possibly by increasing right ventricular preload. © 2016 Indian Journal of Nephrology l Published by Wolters Kluwer - Medknow.
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    Hitit Üniversitesi Tıp Fakültesi Çorum Eğitim ve Araştırma Hastanesi’nde kalp cerrahisi sonuçlarımız: ilk yılın değerlendirmesi
    (Derman Medical Publishing, 2015) Diken, Adem İlkay; Yalçınkaya, Adnan; Yılmaz, Seyhan; Aksoy, Eray; Ereren, Emrah; Höbek Aydın, Yasemin; Paç, Mustafa; Çağlı, Kerim
    Amaç: Hitit Üniversitesi Çorum Eğitim ve Araştırma Hastanesi'nde yeni uygulanmaya başlanan kalp cerrahisi sonuçlarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Kasım 2012 ile Kasım 2013 tarihleri arasında 110 açık kalp ameliyatı gerçekleştirildi. 10 hasta (%9.1) ST elevasyonlu miyokard enfarktüsü nedeniyle acil olarak ameliyata alındı. 31'i (%29.2) atan kalpte ve 75'i (%70.8) kardiyopulmoner baypas ile olmak üzere toplam 106 hastaya koroner arter baypas greftleme yapılırken, 1 mitral onarım, 1 Bentall prosedürü, 1 triküspit kapak onarımı, 1 mitral kapak replasmanı, 1 root genişletmeyle birlikte aort kapak replasmanı ve 1 suprakoroner greft implantasyonu uygulandı. Bulgular: Bir (%0.9) hastada hastane mortalitesi görüldü. İkili antiagregan kullanmakta olan 4 (%3.6) hastaya ameliyat günü içerisinde kanama nedeniyle revizyon yapıldı. 3 (%2.7) hastada morbidite yaşandı. 11 (%10) hastada atriyal fibrilasyon gözlendi ve amiadoron tedavisi ile normal sinüs ritmi sağlandı. 5 (%4.5) hastada intraaortik balon pompası kullanıldı. Tartışma: Yaygın bir kırsal nüfusa hizmet veren Hitit Üniversitesi Çorum Eğitim ve Araştırma Hastanesi'nde yeni kurulan kalp cerrahisi merkezi düşük mortalite ve morbiditeyle hizmet vermektedir.
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    Hyponatremia due to escitalopram and thiazide use after cardiac surgery
    (Blackwell Publishing Inc., 2016) Diken, Adem İlkay; Yalçınkaya, Adnan; Erçen Diken, Özlem; Aksoy, Eray; Doğan, İbrahim; Yılmaz, Seyhan; Çağlı, Kerim
    Depression and mood disorders occur commonly following emergent cardiac surgery. Selective serotonin reuptake inhibitors are commonly used antidepressants. We report the development of severe hyponatremia leading to adverse clinical effects due to escitalopram and thiazide diuretic use concomitantly in a patient with depression after emergency coronary artery bypass grafting. © 2015 Wiley Periodicals, Inc.
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    Popülasyonumuzda alt ekstremite variköz venleri ve venöz yetmezliği ile varikosel-vulvar variköz venler arasındaki ilişkinin değerlendirilmesi
    (Endovasküler Cerrahi Derneği ve Fleboloji Derneği, 2013) Yılmaz, Seyhan; Aksoy, Eray; Yaylacı, Songül
    Amaç: Bireylerin yaşam kalitelerini olumsuz yönde etkileyen Kronik Venöz Yetmezlik, Amerika Birleşik Devletlerinde yetişkin nüfusun yaklaşık %10-35’inde görülen ve komplikasyonları nedeniyle önemli miktarda sağlık harcamalarına neden olan önemli bir sağlık sorunudur. Bu sağlık sorunu birçok farklı klinik görünümde izlenebilmekte olup erkeklerde önemli bir infertilite nedeni olan varikosel ve kadınlardaki vulvar varislerle ilişkili olabileceğine dair literatürde bazı yayınlar mevcuttur. Çalışmamızda İç Anadolu bölgesindeki iki ilimizde polikliniğimize başvuran alt ekstremite varisi mevcut olan hastalarda varikosel veya vulvo-perineal varis birlikteliğini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Çalışmaya alt ekstremite variköz venleri mevcut olan ve bu nedenle cerrahi geçirmemiş 236 hasta çalışma grubu olarak ve alt ekstremite venöz yetmezliği bulgusu olmayan 100 hasta kontrol grubu olarak dahil edildi. Verilerin istatistiksel analizinde Minitab 16 statistical software paket istatistik programını kullandık. Bulgular: Çalışma grubunun yaş ortalaması 39,42±10.8, kontrol grubunun yaş ortalaması ise 39,68±10,9 yıl idi. Çalışma ve kontrol grubundaki erkek hastalarda sırasıyla %18,42 ve %6,81 oranında varikosel gözlendi ve yine çalışma ve kontrol grubundaki kadın hastalarda sırasıyla %10,00 ve %7,14oranlarında vulvar varis tespit edildi. Sonuç: Alt ekstremite varisleri ve venöz yetmezliği mevcut olan hastalarda varikosel veya vulvoperineal varis birlikteliği istatistiksel ve oransal olarak artmakta olup, alt ekstremite varisleri olan hastalarda varikosel veya vulvo-perineal varis yönünden muayene yapılmasının hastalar ve sağlıkla ilgili veri tabanlarımız açısından faydalı sonuçlar vereceğini düşündük.
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    Potential role of electrostimulation in augmentation of venous blood flow after total knee replacement: A pilot study
    (SAGE Publications Ltd, 2016) Yılmaz, Seyhan; Çalbıyık, Murat; Yılmaz, Behice Kaniye; Aksoy, Eray
    Aim: To investigate the potential role of a novel electrostimulation device in augmenting the femoral vein venous blood flow following total knee replacement surgery. Material and methods: A total of 30 consecutive patients undergoing total knee replacement were allocated to receive either peroneal nerve electrostimulation plus low molecular weight heparin and below-knee compression stockings (Group 1, electrostimulation group, n = 15, mean age: 63.40 ± 5.91 years, male: female ratio 9:6) or low molecular weight heparin and below-knee compression stockings alone (Group 2, control group, n = 15, mean age: 63.86 ± 7.47 years, male: female ratio 8:7). Electrostimulation was performed for 1 h in every 4 h after the operation. Peak blood velocity in the femoral vein was evaluated with Duplex ultrasonongraphy in supine position. Presence of leg edema and calf diameter was also taken into consideration as outcome measures, which were recorded both before surgery and at the time of discharge from hospital. Results: Postoperative peak blood flow velocity in the femoral vein was significantly higher in electrostimulation group compared to control group (17.46 ± 2.86 cm/s vs. 13.84 ± 3.58 cm/s, p < 0.02). Electrostimulation group achieved a significant increase in peak blood flow velocity in the femoral vein after the operation (mean increase 67.48 ± 17.38%, p < 0.001). Conclusion: Electrostimulation of the common peroneal nerve enhanced venous flow in the lower limb and may potentially be of use as a supplementary technique in deep venous prophylaxis following lower limb orthopedic operations. © 2015, © The Author(s) 2015.
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    Prevalence, presentation and occupational risk factors of chronic venous disease in nurses
    (SAGE Publications Ltd, 2016) Diken, Adem İlkay; Yalçınkaya, Adnan; Aksoy, Eray; Yılmaz, Seyhan; Özşen, Kelime; Sarak, Taner; Çağlı, Kerim
    Objective: In this study involving a group of nurses employed in a number of different medical services with relatively well-defined working conditions, the presence and symptoms of chronic venous insufficiency were screened and their association with work burden and physical working conditions was explored. Methods: Of the 294 actively employed nurses during the study period, 232 (79%) were recruited on the basis of their willingness for participation and fulfilment of the inclusion criteria. Results: Among the study subjects, 62.9% had at least one symptom of chronic venous insufficiency, and 50.4% were found to have chronic venous insufficiency according to Clinical–Etiology–Anatomy–Pathophysiology classification criteria. A significant association was found between the diurnal ankle circumference difference in the left–right ankles and the mean duration of hospital stay. Conclusions: Our results have shown that the average duration of hospital stay, which is among the variables used to estimate the work burden of nurses, is associated with an increased frequency of the signs and symptoms of chronic venous insufficiency. © 2015, © The Author(s) 2015.
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    Radio-medyan cubital arteriovenous fistula creation for hemodialysis access
    (Bayçınar Medical Publishing, 2015) Yılmaz, Seyhan; Aksoy, Eray; Günaydın, Serdar
    Background: This study aims to present our institutional experience regarding radio-median cubital arteriovenous fistula (AVF) creation in patients unsuitable for standard radiocephalic fistula creation. Methods: R adio-median c ubital AVF w as c reated i n 6 6 patients (31 males, 35 females; mean age 49.6 years; range 22 to 77 years) who were unsuitable for standard radiocephalic fistula creation. The study was performed in a prospective manner. All patients were analyzed with duplex Doppler ultrasonography at postoperative 15th day and sixth month. Results: Early postoperative complications -within postoperative 15 days- were observed in 10 patients (15.1%). At first follow-up on 15th day, 64 in 66 patients (97.0%) had patent AVF. At sixth month follow-up, 56 in 61 patients (91.8%) had patent AVF. Three patients (5.0%) with patent AVFs were not initiated on hemodialysis within six months. None of the patients had signs of steal syndrome within postoperative six months. Conclusion: We achieved satisfactory results using radio-median cubital AVF creation technique in patients unsuitable for standard radiocephalic fistula creation. This technique may be a good alternative for patients with poor venous or arterial structure at the level of wrist.
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    Saphenous nerve injury after endovenous laser ablation of incompetent greater saphenous vein: An electroneuromyography study
    (SAGE Publications Ltd, 2016) Yılmaz, Seyhan; Delikan, Okan; Aksoy, Eray
    Aim: To determine whether endovenous laser ablation of incompetent greater saphenous vein causes a detectable impairment in saphenous nerve conduction. Material and methods: Thirty-five patients (mean age: 44.78 ± 8.6, male/female ratio: 16/19) who were operated on for incompetent greater saphenous veins, underwent electroneuromyography before and two weeks after the operation. Dysesthesia was questioned as to whether having unpleasant abnormal sensation after the operation. Positive electroneuromyography findings for saphenous nerve injury included a sensory nerve action potential amplitude <2 µV or a nerve conduction velocity <48.0 m/s or a latency onset >5.0 ms. Results: Thirty-four patients were available at two-week follow-up. All patients achieved complete proximal closure. Three patients (8.8%) had dysesthesia at two weeks. Mean electroneuromyography values were not significantly different between preoperative and postoperative period. Postoperatively, none of the patients had abnormal sensory nerve action potential or latency onset, whereas nerve conduction velocity decreased below the lower limit in two patients. These two patients were not among those having dysesthesia and they had no other complaints. Conclusion: Injury to saphenous nerve seems not likely during endovenous laser ablation of incompetent greater saphenous veins, as evidenced by normal electroneuromyography values found after the operation. © 2015, © The Author(s) 2015.
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    Yakın Mesafeden Av Tüfeği ile Yaralanmalarda Ekstremite Koruyucu Distal Alt Ekstremite Revaskülarizasyonu
    (2014) Diken, Adem İlkay; Yalçınkaya, Adnan; Aksoy, Eray; Yılmaz, Seyhan; Başaran, Teoman; Karakuş, Osman; Çağlı, Kerim
    Amaç: Dokudaki tahribatın ciddiyetine bağlı olarak, yakın mesafeden av tüfeğiyle yaralanan ekstremitede amputasyon çoğunlukla kaçınılmazdır. Bu çalışmada yakın mesafeden maruz kalınan diz altı av tüfeği yaralanmalarında ekstremitenin kurtarılması amacıyla ameliyat edilen hastaların cerrahi sonuçlarının tartışılması amaçlanmıştır. Gereç ve Yöntemler: Çalışma Mayıs 2012 ile Ekim 2013 tarihleri arasmda gerçekleştirilmiştir. Hastalara (9 hasta) ait demografik veriler, operatif pa-- rametreler ve postoperatif döneme ait sonuçlar prospektif olarak kayıt altına alınmıştır. Bulgular: Tüm hastalarda parçalı tibia kırığı mevcutken, hastada ek olarak fibula kırığı bulunmaktaydı. Pos-- terior tibial arter en çok (8 hastada) yaralanan damardı. Beş hastada diz altı iki arterde, ve hastada ise üç arterde de yaralanma mevcuttu. Dört hastaya primer tamir uygulanırken, 3'üne otolog safen ven ile greft interpozisyonu, hastaya da popliteal arterden kan getirmek üzere distal baypas uy-- gulandı. Viabilitesini yitiren dokular rezeke edildi. Kemik kırıklarına sıklıkla eksternal fiksasyon uy-- gulandı. Sinir yaralanmaları primer tamir edildi. Medyan hastane kalış süresi 11 gündü (8-15 gün). Dört hastada ekstremite fonksiyonlarında düzelme gözlenirken, kalan hastada takipte kalıcı nörolojik etkilenme olduğu saptandı. Sonuç: Ciddi kemik kırığı ve yumuşak doku hasarı mevcudi-- yetinde, av tüfeği yaralanmaları alt ekstremitede yüksek amputasyon riskini beraberinde getir-- mektedir. H1211 tani ve erken rekonstruktif cerrahi amputasyon oranını azaltmada ve fonksiyonel düzelmeyi sağlamada önem arz etmektedir. Amputasyona gitmesi muhtemel vakalarda rekons-- truktif cerrahi başarılı sonuçlar sağlayabilmektedir.