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Öğe Anesthesia for a child with Walker-Warburg syndrome(Elsevier Science Inc, 2014) Kose, Emine Arzu; Bakar, Bulent; Ates, Gokay; Aliefendioglu, Didem; Apan, AlpaslanBackground and objectives: Walker-Warburg Syndrome is a rare, autosomal recessive con-genital muscular dystrophy manifested by central nervous system, eye malformations andpossible multisystem involvement. The diagnosis is established by the presence of four crite-ria: congenital muscular dystrophy, type II lissencephaly, cerebellar malformation, and retinalmalformation. Most of the syndromic children die in the first three years of life because ofrespiratory failure, pneumonia, seizures, hyperthermia and ventricular fibrillation. Case Report : The anesthetic management of a two-months-old male child listed for electiveventriculo-peritoneal shunt operation was discussed. Conclusions : A careful anesthetic management is necessary due to the multisysteminvolvement. We reported anesthetic management of a two-months-old male child withWalker-Warburg Syndrome who was listed for elective ventriculo-peritoneal shunt operation. (C) 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rightsreserved.Öğe Anesthetic Risks Associated With Antley-Bixler Syndrome(Lippincott Williams & Wilkins, 2013) Gencay, Isin; Vargel, Ibrahim; Buyukkocak, Unase; Yazici, Ilker; Apan, AlpaslanAntley-Bixler syndrome is an autosomal recessive disorder characterized by multiple bone and cartilaginous abnormalities. The main features of this syndrome include brachycephaly, midface hypoplasia, dysplasia of ears and nose, radiohumeral synostosis, choanal stenosis, or atresia. Distinctive features are based on craniofacial deformity and humeroradial synostosis. In this report, we describe the anesthesia management of a 20-year-old Antley-Bixler syndrome patient who underwent maxillary advancement via Le Fort I osteotomy. During surgical management of craniofacial syndrome patients, particularly Antley-Bixler syndrome, the whole surgical team should be aware of possible deformities involving the airway, which may be underestimated or nondetected prior to surgery. These deformities including choanal atresia/stenosis may lead to failure of nasotracheal intubation and mask ventilation, therefore jeopardizing the surgical procedure and/or patient safety. Accurate preoperative preparation and being aware of the components of this syndrome is vital to eliminate respiratory complications and enable uneventful anesthetic and surgical management.Öğe Antibacterial activity of remifentanil and mixtures of remifentanil and propofol(Elsevier Science Inc, 2007) Apan, Teornan Zafer; Apan, Alpaslan; Sahin, Saziye; Cakirca, MehmetStudy Objective: To investigate the antibacterial activity of glycine, which is contained in remifentanil, when combined with propofol. Design: Prospective study. Setting: Departments of anesthesiology and microbiology of a university hospital. Measurements: Growth of the microorganisms Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Candida albicans in propofol 1%; saline dilutions of remifentanil at one-, 10-, and 100-,mu g/mL concentrations; and 1:1 mixtures of propofol with remifentanil solutions was determined. Main Results: Remifentanil inhibits bacterial growth in a concentration-dependent manner. The antibacterial effects were more pronounced with Staphylococcus aureus and Pseudomonas aeruginosa at cultures obtained at the fifth hour. The inhibition of bacterial growth was less influenced with Escherichia coli and Candida albicans. Conclusions: Propofol and remifentanil mixtures decreased bacterial growth, and combinations may reduce the infectious complications from accidentally contaminated propofol. Crown Copyright (c) 2007 Published by Elsevier Inc. All rights reserved.Öğe Can skin surface pressure under a cast, reveal intracompartmental pressure? An experimental study(1998) Uslu, M. Murad; Apan, Alpaslan; Güney, ŞefikALÇI İÇİNDEKİ CİLT BASINCI, KOMPARTMAN BASINCINI YANSITABİLİRMİ? DENEYSEL BİR ÇALIŞMA Ekstremite travmaları nedeniyle alçı tedavisi gören hastalarda kompartman basıncın değerlendirilmesi çoğu zaman mümkün olamamaktadır. Bu çalışmanın amacı; alçı içindeki cilt basıncının, kompartman basıncını yansıtıp yansıtmayacağının, oluşturulan ön kol modelinde araştırılmasıdır. Volar ve dorsal kompartmanları olan bir ön kol modeli oluşturularak, alçı uygulandı. Alçı ve model arasından farklı bölgelerden alınan basınç değerleri, kompartman basıncı ile karşılaştırıldı. Yapılan ölçümler sonucu alçı içi cilt basıncı ile kompartman basıncı arasında tüm lokalizasyonlarda korelasyon saptandı. Ortalama korelasyon katsayısı .995 (P000), (Std dev: .002, Minimum .992, Maksimum .999) olarak saptandı. Alçı içi cilt basıncı, kompartman basıncının moniterizasyonunda kullanılabilecek bir seçenektir. Bu konuda yapılacak klinik çalışmalar sonucunda alçı içi cilt basıncı moniterizasyonunun, ileride günlük kullanıma girmesi, hekime ve alçı tedavisi gören hastalara takip konusunda yardımcı olması beklenebilir.Öğe Comparison of Effects of Dexmedetomidine-ketamine and Dexmedetomidine-midazolam Combinations in Transurethral Procedures(Elsevier Science Inc, 2012) Köse, Emine Arzu; Honca, Mehtap; Yılmaz, Erdal; Batislam, Ertan; Apan, AlpaslanOBJECTIVE To compare the effects of dexmedetomidine-ketamine and dexmedetomidine-midazolam combinations on the recovery time, hemodynamic and respiratory variables, and side effects in patients undergoing transurethral procedures. METHODS Sixty patients scheduled for elective outpatient transurethral procedure were randomized into 2 groups. In the group K, a ketamine-dexmedetomidine combination was administered, and in the group M, midazolam-dexmedetomidine was administered, to provide sedation/analgesia. Pain and sedation levels were assessed using visual analog score (VAS) and Ramsey Sedation Scale, respectively. The recovery time was assessed with the scale of Aldrete. Time was measured and recorded to the moment at which patient responses brought the Aldrete score to 10 points. Time to eye opening and length of stay in the recovery room were recorded. RESULTS Group M showed significantly lower mean arterial pressure (MAP) values at 5 and 10 minutes during the procedure when compared with group K (P = .02 and P = .01, respectively). Visual analogue scale scores were greater in group M than in group K at 5 and 10 minutes for the transurethral procedure (P = .039 and P = .028, respectively). Sedation scores were similar between groups during the procedure. Time to eye opening and length of recovery room stay were shorter (P < .001 and P < .001, respectively), and Aldrete scores were greater in group K than group M. CONCLUSION Both combinations provided satisfactory sedation levels, but the dexmedetomidine-ketamine combination provided better analgesia and hemodynamic stability, with less nausea and vomiting and shorter recovery time, than the dexmedetomidine-midazolam combination. UROLOGY 79: 1214-1219, 2012. (c) 2012 Elsevier Inc.Öğe Distortion Product Otoacoustic Emissions in Infant, Pregnant and Non-pregnant Adult Rabbits: Comparison for Different Stimulus Levels(Aves, 2011) Muluk, Nuray Bayar; Budak, Gurer G.; Budak, Bilgehan; Apan, Alpaslan; Ozturk, Goknur Guler; Seyhan, NesrinObjectives: In the present study, we investigated Distortion Product Otoacoustic Emissions in pregnant (Group 1); non-pregnat adult female rabbits (Group 2) and infant rabbits (Group 3). We assessed Distortion Product Otoacoustic Emission amplitudes in both stimulus levels of F2/F1=1.22 and 1.14; and analyzed the amplitude differences in different groups. Methods: Thirty-six New Zealand White rabbits were included into the study. They were divided into three groups. Group 1 consisted of 9 each 13-month-old, adult, pregnant female rabbits. Group 2 consisted of 9 each 13-month-old, adult, nonpregnant female rabbits. Group 3 consisted of 18 each one-month-old, infant rabbits (Nine of them, male; and nine of them, female). In all groups, cochlear functions were assessed by Distortion Product Otoacoustic Emissions at 1.0-8.0 kHz. Stimulus parameters were used as F2/F1=1.22 in the first recording; and 1.14, in the second recording for each of the ears. Results: In all groups (1 to 3), Distortion Product Otoacoustic Emission amplitudes were found as higher with F2/F1:1.22 measurements than F2/F1:1.14 measurements. In F2/F1:1.22; and F2/F1:1.14 measurements seperately; at each Distortion Product Otoacoustic Emission frequencies (1.0-8.0 kHz), the difference between Distortion Product Otoacoustic Emission amplitudes of Group1-3 were analyzed by "Kruskal Wallis Variance Analysis": The statistically significant difference were present at frequencies of 1.5-2.0 kHz and 8.0 kHz for F2/F1:1.22 measurements; and 1.0-2.0 kHz and 4.0-8.0 kHz for F2/F1:1.14 measurements. In F2/F1:1.22 measurements, at 1.5 kHz, the mean value of Group 1 (Pregnant rabbits) was significantly higher than that of Group 3 (Infant rabbits). In F2/F1:1,14 measurements, at 1.0, 4.0 and 8.0 khz, the mean values of Group 1 (Pregnant rabbits) was significantly higher than those of Group 3 (Infant rabbits); and at 1.0, 2.0 and 4.0 kHz, the mean values of Group 2 (Non-pregnant rabbits) were significantly higher than those of Group 3 (Infant rabbits) Conclusion: Our study demonstrated that, in pregnant rabbits, higher corticosteroid levels may cause higher DPOAE amplitudes than infant rabbits by F2/F1:1.14 measurements. In all rabbits and especially in infant rabbits, Distortion Product Otoacoustic Emissions could be taken by F2/F1:1.22 measurements with higher amplitudes. The importance of our study is, when Distortion Product Otoacoustic Emission measurement is planned, measurements should be done using F2/F1: 1.22 to get healthy and accurate results in experimental studies. In measurements made by F2/F1: 1.14, amplitudes can be observed as lower than F2/F1: 1.22 measurements. This decline is evident especially in infant rabbit groups. Water containing medium in the middle ear of infant rabbits may cause the reduce in Distortion Product Otoacoustic Emission amplitudes than adult rabbits at both F2/F1:1.22 and 1.14 measurements.Öğe Düşük akım ve yüksek akımla uygulanan desfluran anestezisinde hemodinamik etkilerin torasik elektriksel biyoempedans monitorizasyon ile karşılaştırılması(2007) Kaymak, Çetin; Başar, Hülya; Tekin, Özlem; Sert, Özgür; Apan, AlpaslanAmaç: Expiratuar CO2 uzaklaştırıldıktan sonra ekspire edilen gazın % 50 veya daha fazlasının yeniden solutulması düşük akımlı anestezi ile mümkündür. Bu çalışmanın amacı, hemodinamik monitorizasyon amacıyla noninvaziv torasik elektriksel biyoempedans (TEB) metodu kullanılarak, düşük ve yüksek akımlı desfluran anestezisinin karşılaştırılmasıdır. Gereç ve Yöntem: Hastane etik kurul onayı alındıktan sonra, ASA I-II sınıfındaki elektif cerrahi planlanan 40 olgu dahil edildi. Tüm hastaların anestezi indüksiyonu 5-7 mg kg-1 tiopental ve 1,5 µg kg-1 fentanil ile yapıldı. 0.1 mg kg-1 veküronyum iv ardından trakeal entübasyon gerçekleştirildi. Hastalar, % 4-6 desfluran anestezisi altında düşük akım (Grup I, 1 L dk-1 % 50 N2OO2) ve yüksek akım (Grup II, 4 L dk-1 % 50 N2OO2) olmak üzere randomize edilerek iki gruba ayrıldı. Noninvaziv TEB kullanılarak ejeksiyon fraksiyonu (EF), end-diastolik indeks (EDI), kardiyak indeks (CI) ve strok volüm indeks (SVI) bazal, indüksiyon, entübasyon ve 15 dk. aralıklarla kaydedildi. Anestezinin derinliği, BIS değerleri 40-60 arasında hedeflenerek şekilde, desfluran konsantrasyonlarıyla ayarlandı. Postoperatif dönemde Aldrete Derlenme Skoru (ARS) kaydedildi. İstatistiksel analiz için student-t testi ve tekrarlayan ölçümlerde varyans analizi kullanıldı. p0.05 istatistiksel olarak anlamlı kabul edildi. Bulgular: End-tidal desfluran konsantrasyonları, Grup II'de, 45. ve 60. dk. değerlerinde, Grup I'e göre anlamlı olarak yüksekti (p0.05). Grup I'deki 45. ve 60. dk. EDI, Grup II'ye göre anlamlı olarak yüksekti (p0.05). CI, SVI ve EF değerleri, her iki grup arasında benzer bulundu. Grup I'de 5. ve 10. dakikalardaki ARS anlamlı olarak yüksekti. Sonuç: Desfluran ile düşük ve yüksek akımlı anestezi tekniğinde, TEB metodu kullanılarak benzer hemodinamik etkiler olduğu sonucuna vardık.Öğe The effects of dexmedetomidine on renal injury induced by intra-abdominal hypertension in rats(Allied Acad, 2016) Yaman, Ferda; Boybeyi, Ozlem; Kose, Emine Arzu; Balci, Mahi; Kisa, Ucler; Apan, AlpaslanIntroduction: Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are potentially life-threatening conditions in critically ill patients. Laparascopic surgery is the gold standard and has been widely performed for many procedures since its inception in the early 1980s. Pneumoperitoneum is essential for laparascopic surgery. Dexmedetomidine is a potent and highly selective alpha-2 adrenoceptor agonist with sympatholytic, sedative, amnestic and analgesic properties without respiratory depression. There is increasing evidence of its organ protective effects against ischemic and hypoxic injury, including neuroprotection, cardioprotection and renoprotection. The aim of this experimental study was to investigate the effects of the a-2 adrenoceptor agonist, dexmedetomidine on IAH induced by renal injury. Materials and methods: A total of 24 male Wistar-albino rats were randomly separated into 4 groups as the control group (CG, n=6), sham group (SG, n=6), low-dose group (DXLD, n=6) and high-dose group (DXHD, n=6). In CG, no intervention was made. IAH was obtained by insufflating atmospheric air with percutaneous intraperitoneal needle using a manual insufflator of manometer up to 15 mmHg. At the 60th min, in SG, 1.5 ml/100 gr/hr saline was infused. In DXLD, 0.5 mu g/kg/hr, and in DXHD, 1 mu g/kg/hr dexmedetomidine (Precedex, 100 mu g/ml; Abbott, Istanbul, Turkey) was infused intravenously. At the 90th min, a midline incision was made and the left kidney was harvested by median laparatomy for the measurement of tissue nitric oxide (NO), malondialdehyde (MDA) level and histopathological examination for proximal tubule injury by light microscopy. Results: No significant difference was determined between the groups either biochemically or histopathologically (p>0.05). Conclusion: Dexmedetomidine may not provide renoprotective effects within the clinical infusion doses of 0.5 mu g/kg/hr, and 1 mu g/kg/hr.Öğe Effects of extremely low frequency electromagnetic fields on distortion product otoacoustic emissions in rabbits(Elsevier Sci Ltd, 2009) Budak, Bilgehan; Budak, Gürer G.; Öztürk, Göknur Güler; Muluk, Nuray Bayar; Apan, Alpaslan; Seyhan, NesrinObjective: Humans are continuously exposed to extremely low frequency (ELF), electromagnetic fields (EMF), transmitted from the common Sources like power stations, electric transmission lines, communication and radio-television signal transmission units. The present study aimed to assess the effects of 50 Hz ELF-EMF of 5.068 and 10.182 kV/m electric fields, which refer to the lower and upper intensity limits beyond which hazardous effects can be observed, on the auditory functions of rabbits via Distortion Product Otoacoustic Emission (DPOAE) recordings. Methods: The study was performed on 20 healthy adult female New Zealand White rabbits randomly divided into two groups and applied 50 Hz ELF-EMF with either 5.068 kV/m (Group 1) or 10.182 kV/m (Group 2) of electric field for 3 h/day during 14 days. DPOAE responses recorded on the 0th day before exposure (B-EMF) and on the 6th (A-EMF-6th) and 14th (A-EMF-14th) days after exposure (AE). Mean stimulus intensity and emission amplitudes at 1.0-8.0 kHz were analyzed. Results: In Group 2 rabbits, on 6th and 14th days, the DPOAE amplitudes were observed as increased at 1.5-4.0 kHz (at 2.0 and 4.0 kHz significantly) than B-EMF values. At 6.0 kHz, A-EMF-14th amplitudes were significantly lower than A-EMF values. Conclusion: These results suggest that ELF EMFs might affect hearing functions by frequency dependent manner. Higher ELF EMFs exposure caused increase of cochlear activity. Ototoxic effect of 10.182 kV/m ELF EMFs may begin at the basal turn of the cochlea by reducing DPOAEs at high frequencies. (C) 2008 Elsevier Ireland Ltd. All rights reserved.Öğe Effects of GSM-like radiofrequency on distortion product otoacoustic emissions in pregnant adult rabbits(Canadian Soc Clinical Investigation, 2009) Budak, Gürer G.; Muluk, Nuray Bayar; Öztürk, Göknur Güler; Budak, Bilgehan; Apan, Alpaslan; Seyhan, Nesrin; Şanlı, CihatObjectives: To determine the effects of 1800 MHz GSM-like Radiofrequency (RFR) on the cochlear functions of pregnant adult rabbits by Distortion Product Otoacoustic Emissions (DPOAEs). Methods: Eighteen 13-month-old pregnant and eighteen 13-month-old non-pregnant New Zealand White rabbits were studied. They were randomly divided into four groups. Nine pregnant rabbits (Group 2) and nine nonpregnant rabbits (Group 4) were exposed to 1800 MHz GSM-like RFR 15 min daily for 7 days. Nine pregnant (Group 1) and nine non-pregnant rabbits (Group 3) were not exposed to GSM like RFR. Cochlear functions were assessed by DPOAEs at 1.0-8.0 kHz. Results: In all pregnant groups except 2.0 kHz, DPOAE amplitudes were not different in Group 2 and Group1. In Group 4, DPOAE amplitudes at 1.0-4.0 kHz (-1.68 dB SPL at 1.0 kHz, 3.05 dB SPL at 1.5 kHz, 2.96 dB SPL at 2.0 kHz, 1.30 dB SPL at 3.0 kHz and 12.22 dB SPL at 4.0 kHz) were lower than Group 3 (8.67 dB SPL at 1.0 kHz, 17.67 dB SPL at 1.5 kHz, 26.10 dB SPL at 2.0 kHz, 18.10 dB SPL at 3.0 kHz and 35.13 dB SPL at 4.0 kHz) (P<0.0125). In the pregnant group, harmful effects of GSM-like RFR were less than in the non-pregnant group. Conclusion: GSM-like RFR caused decreases in DPOAE amplitudes mainly in non-pregnant adult rabbits. Prolonged exposure may affect the DPOAE amplitude. Recommendations are given to prevent the potential hazardous effects of RF in humans.Öğe Effects of GSM-like Radiofrequency on distortion product otoacoustic emissions of rabbits: Comparison of infants versus adults(Elsevier Ireland Ltd, 2009) Budak, Gürer G.; Muluk, Nuray Bayar; Budak, Bilgehan; Öztürk, Göknur Güler; Apan, Alpaslan; Seyhan, Nesrinobjectives: The aim of this study is to investigate the potential hazardous effects of 1800 MHz Global System for Mobile Communications-like (GSM-like) Radiofrequency (RF) exposure on the cochlear functions of female infant and adult rabbits by measuring Distortion Product Otoacoustic Emission (DPOAE) response amplitudes. Methods: Eighteen each one-month-old New Zealand White female rabbits and eighteen each 13-month-old adult rabbits were included into the study. They were randomly divided into four groups. Nine infant rabbits (Group 1) were not exposed to 1800 MHz GSM-like RF (Infant Control, C-In). Nine infant rabbits (Group 2) were exposed to 1800 MHz GSM-like RF, 15 min daily for 7 days after they reached one-month of age (Infant RF, RF-In). Nine adult rabbits were not exposed to 1800 MHz GSM-like RF, 15 min daily for 7 (Adult Control, C-Ad). Nine adult rabbits were exposed to 1800 MHz GSM-like RF, 15 min daily for 7 days (Adult RF, RF-Ad). Cochlear functions were assessed by DPOAEs at 1.0-8.0 kHz. Results: At 1.0-2.0 and 6.0 kHz, the mean DPOAE values of Group 2 were significantly higher than that of Group 1. At 3.0-8.0 kHz, the mean DPOAE values of Group 4 were significantly lower than that of Group 1. At 6.0-8.0 kHz, the mean DPOAE values of Group 2 were significantly higher than that of Group 3. At 1.0-8.0 kHz, the mean DPOAE values of Group 4 were significantly lower than that of Group 2. At 1.08.0 kHz, the mean DPOAE values of Group 4 were significantly lower than that of Group 3. Conclusion: Harmful effects of GSM-like 1800 MHz RF exposure was detected more in the adult female rabbits than infant female rabbits by DPOAE measurement. Prolonged exposure and hyperthermia related to the power density of applied RFR, increasing the temperature in the ear canal, may decrease the DPOAE amplitudes. Water containing medium in the middle ear of infant rabbits may play the protective role **from the RF damage. (C) 2009 Elsevier Ireland Ltd. All rights reserved.Öğe Effects of Intracisternal and Intravenous Dexmedetomidine on Ischemia-Induced Brain Inj ury in Rat: A Comparative study(2013) Köse, Emine Arzu; Bakar, Bülent; Kasımcan, Mustafa Ömür; Atilla, Pergin; Kılınç, Kamer; Müftüoğlu, Sevda Fatma; Apan, AlpaslanAMAÇ: Sıçanlarda inkomplet serebral iskemisi üzerine intrasisternal yolla verilen deksmedetomidinin etkilerinin intravenöz yolla verilen deksmedetomidinin etkileriyle karşılaştırılması amaçlandı. YÖNTEM ve GEREÇLER: Ortak sağ karotid arter oklüzyonu ve hemoraj ik hipotansiyon ile 30 dakika süreyle serebral iskemi oluşturuldu. İntrasisternal gruplarda, iskemiden 30 dakika önce sisterna magna içine 0,1 ml % 0.9 NaCl (Grup SIC, n6) veya 9 µg/kg deksmedetomidin (Grup DIC, n6) verildi.İntravenöz gruplarda ise 9 µg/kg deksmedetomidin (Grup DIV, n6) veya % 0,9 NaCl (Grup CONTROL, n6) 5 ml/kg/h hızla 2 saat süreyle infüze edildi. Yirmi dört saat sonra beyin dokusunda ve plazmada lipid peroksidasyon seviyeleri ölçüldü. Histopatoloj ik incelemeler için hipokampal yapı kullanıldı. BULGULAR: İntravenöz deksmedetomidin ortalama arteriyel basınç ve plazma glukoz seviyelerinde bazale göre bir düşüşe neden oldu. Grup DIV ile Grup DIC, Grup SIC ve CONTROL grupları arasında beyin dokusu lipid peroksidasyon seviyeleri ve piknotik hücre sayıları bakımından anlamlı farklılık vardı (sırasıyla; p0,001, p0,001, p0,001 ve p0,001, p0,01, p0,009). Grup DIV için ortalama plazma lipid peroksidasyon seviyeleri Grup DICınkinden farklı bulundu (p0,003). SONUÇ: İskeminin indüklediği nöronal hasarda sistemik yolla verilen deksmedetomidinin nöroprotektif etkisi varken santral yolla verilen deksmedetomidinin nöroprotektif etkisi yoktur.Öğe Effects of Intracisternal and Intravenous Dexmedetomidine on Ischemia-Induced Brain Injury in Rat: A Comparative Study(Turkish Neurosurgical Soc, 2013) Köse, Emine Arzu; Bakar, Bülent; Kasımcan, Ömür; Atilla, Pergin; Kılınç, Kamer; Muftuoğlu, Sevda; Apan, AlpaslanAIM: To compare the effect of dexmedetomidine administered by intracisternal route with by intravenous route on brain tissue of rat after incomplete cerebral ischemia. MATERIAL and METHODS: Cerebral ischemia was produced by the combination of right common carotid artery occlusion and hemorrhagic hypotension during 30 minutes. Thirty minutes before the ischemia, 0.1 ml 0.9% NaCl (Group SIC, n=6) or 9 mu g/kg dexmedetomidine (Group DIC, n=6) was administered into the cisterna magna. For the intravenous groups, 9 mu g/kg dexmedetomidine (Group DIV, n=6) or 0.9% NaCl (Group CONTROL, n=6) 5 ml/kg/h was given in 2 hours. After 24 hours, the lipid peroxidation levels were measured in the brain tissue and plasma. Hippocampal formations were used for histopathological examination. RESULTS: Intravenous dexmedetomidine produced a decrease in baseline mean arterial blood pressure and plasma glucose concentrations. There was a significant difference between the DIV group and DIC, SIC, CONTROL groups regarding the brain lipid peroxidation levels (p<0.001, p<0.001, p=0.001, respectively), and regarding the picnotic neuronal cell count (p<0.001, p=0.01, p=0.009, respectively). Mean plasma lipid peroxidation levels of the DIV group was different from the DIC group (p=0.003). CONCLUSION: Systemically administered dexmedetomidine had neuroprotective effect in ischemia-induced neuronal damage, but centrally administered dexmedetomidine did not.Öğe Effects of Intracisternal Dexmedetomidine on Cerebral Neuronal Cells in Rat: A Preliminary Study(Turkish Neurosurgical Soc, 2013) Kose, Emine Arzu; Bakar, Bulent; Kasimcan, Omur; Atilla, Pergin; Kilinc, Kamer; Muftuoglu, Sevda; Apan, AlpaslanAIM:The aim was to investigate whether dexmedetomidine had a toxic effect on cerebral neurons when it was administered centrally into the cerebrospinal fluid by the intracisternal route. MATERIAL and METHODS: Eighteen rats were anesthetized and the right femoral artery was cannulated. Mean arterial pressures, heart rates, arterial carbon dioxide tension, arterial oxygen tension, and blood pH were recorded. When the free cerebrospinal fluid flow was seen, 0.1 ml normal saline (Group SIC, n=6) or 9 mu g/kg diluted dexmedetomidine in 0.1 ml volume (Group DIC, n=6) was administered into the cisterna magna of rats. After 24 hours, the whole body blood was collected for measurement of plasma lipid peroxidation (LPO) levels. The hippocampal formations used for histopathological examination and measurement of tissue LPO levels. RESULTS: There was a statistically significant difference between the DIC/SIC groups and DIC/CONTROL groups regarding the brain LPO levels (p=0.002, p<0.001, respectively). Plasma LPO levels were statistically different between the CONTROL/DIC groups, CONTROL/SIC groups, DIC/ SIC groups (p=0.002, p=0.047, p=0.025, respectively),The picnotic neuron counts were different between the CONTROL/SIC groups, CONTROL/ DIC groups, DIC/SIC groups (p<0.001, p=0.001, p=0.024, respectively). CONCLUSION: In conclusion, dexmedetomidine had a toxic effect on cerebral neurons when it was administered centrally into the cerebrospinal fluid by the intracisternal route.Öğe Effects of intrauterine and extrauterine GSM-like radiofrequency on distortion product otoacoustic emissions in infant female rabbits(2009) Budak, Gurer G.; Muluk, Nuray Bayar; Budak, Bilgehan; Ozturk, Goknur Guler; Apan, Alpaslan; Seyhan, NesrinObjective: We investigated the effects of 1,800 MHz GSM-like Radiofrequency (RF) on the cochlear functions of female infant rabbits by Distortion Product Otoacoustic Emission (DPOAE) recordings upon intrauterine (IU) and/or extrauterine (EU) exposure. Materials and Methods: Thirty-six infant female New Zealand White rabbits, each one-month-old, were randomly divided into four groups, Groups 1-4, each having 9 rabbits. Group 1 animals were remained untreated (Control), whereas other groups were treated by virtue of extrauterine (Group 2, EU), intrauterine (Group 3, IU), or both type of exposure (Group 4, IU and EU) to 1800 MHz GSM-like Radiofrequency (RF). EU exposure started after they reached to one-month of age, and IU was at intrauterine period which was in between 15th to 22nd days of gestation. The duration for exposures was 7 days with 15 minutes per day protocol. Cochlear functions were assessed by DPOAEs at 1.0-8.0 kHz. Results: DPOAE amplitudes for EU-RF group at 1.0 and 1.5 kHz was found higher with respect to control. At 2.0 kHz, the recordings for EU-RF group were higher than control and IU-RF groups. At 6.0 kHz, EU-RF group were higher than control, IU-RF, and (IU+EU)-RF groups. At 8.0 kHz, EU-RF group were higher than IU-RF and (IU+EU)-RF groups. Conclusions: We conclude that if the anatomical growth of exposed animate is completed and the extrauterine GSM-like RF exposure is not prolonged, there will not be much harmful effects on inner ear of female rabbits, measured by DPOAEs. The observed increase in DPOAE amplitudes at 1.0-2.0 kHz shows the increase in cochlear activity and outer hair cell electromotility. Prolonged exposure and hyperthermia related to the power density of applied RFR, increasing the temperature in the ear canal, may affect the DPOAE amplitudes especially during intrauterine period. When pregnant women use earphone or even carry their mobile phones in their bags or pockets, foetus may expose to GSM-like RF from the very short distance with the exposure level higher than the standard limits, which may cause ear toxicity with decreased DPOAEs. Copyright 2005 © The Mediterranean Society of Otology and Audiology.Öğe Effects of Intrauterine and Extrauterine GSM-like Radiofrequency on Distortion Product Otoacoustic Emissions in Infant Female Rabbits(Aves, 2009) Budak, Gürer G.; Muluk, Nuray Bayar; Budak, Bilgehan; Öztürk, Göknur Güler; Apan, Alpaslan; Seyhan, NesrinObjective: We investigated the effects of 1,800 MHz GSM-like Radiofrequency (RF) on the cochlear functions of female infant rabbits by Distortion Product Otoacoustic Emission (DPOAE) recordings upon intrauterine (IU) and/or extrauterine (EU) exposure. Materials and Methods: Thirty-six infant female New Zealand White rabbits, each one-month-old, were randomly divided into four groups, Groups 1-4, each having 9 rabbits. Group 1 animals were remained untreated (Control), whereas other groups were treated by virtue of extrauterine (Group 2, EU), intrauterine (Group 3, IU), or both type of exposure (Group 4, IU and EU) to 1800 MHz GSM-like Radiofrequency (RF). EU exposure started after they reached to one-month of age, and IU was at intrauterine period which was in between 15th to 22nd days of gestation. The duration for exposures was 7 days with 15 minutes per day protocol. Cochlear functions were assessed by DPOAEs at 1.0-8.0 kHz. Results: DPOAE amplitudes for EU-RF group at 1.0 and 1.5 kHz was found higher with respect to control. At 2.0 kHz, the recordings for EU-RF group were higher than control and IU-RF groups. At 6.0 kHz, EU-RF group were higher than control, IU-RF, and (IU+EU)-RF groups. At 8.0 kHz, EU-RF group were higher than IU-RF and (IU+EU)-RF groups. Conclusions: We conclude that if the anatomical growth of exposed animate is completed and the extrauterine GSM-like RF exposure is not prolonged, there will not be much harmful effects on inner ear of female rabbits, measured by DPOAEs. The observed increase in DPOAE amplitudes at 1.0-2.0 kHz shows the increase in cochlear activity and outer hair cell electromotility. Prolonged exposure and hyperthermia related to the power density of applied RFR, increasing the temperature in the ear canal, may affect the DPOAE amplitudes especially during intrauterine period. When pregnant women use earphone or even carry their mobile phones in their bags or pockets, foetus may expose to GSM-like RF from the very short distance with the exposure level higher than the standard limits, which may cause ear toxicity with decreased DPOAEs.Öğe Effects of Intrauterine and Extrauterine GSM-like Radiofrequency on Distortion Product Otoacoustic Emissions in Infant Female Rabbits(Aves, 2009) Budak, Gurer G.; Muluk, Nuray Bayar; Budak, Bilgehan; Ozturk, Goknur Guler; Apan, Alpaslan; Seyhan, NesrinObjective: We investigated the effects of 1,800 MHz GSM-like Radiofrequency (RF) on the cochlear functions of female infant rabbits by Distortion Product Otoacoustic Emission (DPOAE) recordings upon intrauterine (IU) and/or extrauterine (EU) exposure. Materials and Methods: Thirty-six infant female New Zealand White rabbits, each one-month-old, were randomly divided into four groups, Groups 1-4, each having 9 rabbits. Group 1 animals were remained untreated (Control), whereas other groups were treated by virtue of extrauterine (Group 2, EU), intrauterine (Group 3, IU), or both type of exposure (Group 4, IU and EU) to 1800 MHz GSM-like Radiofrequency (RF). EU exposure started after they reached to one-month of age, and IU was at intrauterine period which was in between 15th to 22nd days of gestation. The duration for exposures was 7 days with 15 minutes per day protocol. Cochlear functions were assessed by DPOAEs at 1.0-8.0 kHz. Results: DPOAE amplitudes for EU-RF group at 1.0 and 1.5 kHz was found higher with respect to control. At 2.0 kHz, the recordings for EU-RF group were higher than control and IU-RF groups. At 6.0 kHz, EU-RF group were higher than control, IU-RF, and (IU+EU)-RF groups. At 8.0 kHz, EU-RF group were higher than IU-RF and (IU+EU)-RF groups. Conclusions: We conclude that if the anatomical growth of exposed animate is completed and the extrauterine GSM-like RF exposure is not prolonged, there will not be much harmful effects on inner ear of female rabbits, measured by DPOAEs. The observed increase in DPOAE amplitudes at 1.0-2.0 kHz shows the increase in cochlear activity and outer hair cell electromotility. Prolonged exposure and hyperthermia related to the power density of applied RFR, increasing the temperature in the ear canal, may affect the DPOAE amplitudes especially during intrauterine period. When pregnant women use earphone or even carry their mobile phones in their bags or pockets, foetus may expose to GSM-like RF from the very short distance with the exposure level higher than the standard limits, which may cause ear toxicity with decreased DPOAEs.Öğe The effects of perioperative low- moderate doses of dexmedetomidine infusion on hemodynamic and neuroendocrine parameters(2008) Kaymak, Çetin; Başar, Hülya; Doğancı, Nur; Sert, Özgür; Apan, AlpaslanAmaç: Bu çalışmanın amacı elektif transuretral cerrahi yapılan hastalarda, orta ve düşük doz dexmedetomidin infüzyonunun, hemodinamik ve nöroendokrin parametrelere olan etkisinin incelenmesidir. Yöntem ve Gereç: Randomize olarak 50 hasta, anestezi indüksiyonundan 10 dakika önce 0.45 (Grup 1) veya 0.6 ug/kg/saat (Grup 2) dexmedetomidin infüzyonu aldılar. Kalp hızı, kan basıncı, end-tidal CO2, oksijen satürasyonu, ve noninvaziv kardiyak output parametreleri monitorize edildi. Ölçümler, bazal (I), dexmedetomidin infüzyonu sonrası (II), tiyopental sonrası (III), entübasyon sonrası (IV) ve desfluran anestezi uygulaması boyunca her 10 dakikada bir gerçekleştirildi. Anestezi idamesi (2L dak"1, % 50 N2002), BİS değeri 40-60 olacak şekilde, % 4-6 desfluran kullanılarak sağlandı. Plazma adrenalin ve noradrenalin seviyelerinin belirlenmesi için venöz kan örnekleri, entübasyondan önce (I), intraoperatif dönemin 30. dakikasında (II) ve ekstübasyondan sonra (III) alındı. İstatistiksel analizde Chi- Square, Student-t test ve tekrarlı ölçümlerde varyans analizi kullanıldı. Bulgular: Her iki dexmedetomidin infüzyonu benzer hemodinamik değişiklikler oluşturdu. Kardiyovasküler ve nöroendokrin değereler ise, Grup 2'de; Grup l'den daha fazla baskılandı. Sonuç: Bu bulgularla, intraoperatif 0.45 ve 0.6 ug kg"1 saat"1 doz dexmedetomidin benzer hemodinamik yanıt oluşturmuştur. Kardiyovasküler ve nöroendokrin parametreler, orta doz dexmedetomidin ile daha fazla hastalanmaktadır.Öğe The effects of preanesthetic, single-dose dexmedetomidine on induction, hemodynamic, and cardiovascular parameters(Elsevier Science Inc, 2008) Basar, Hülya; Akpinar, Serpil; Doganci, Nur; Buyukkocak, Unase; Kaymak, Cetin; Sert, Ozgur; Apan, AlpaslanStudy Objectives: To investigate the hemodynamic, cardiovascular, and recovery effects of dexmedetomidine used as a single preanesthetic dose. Design: Randomized, prospective, double-blind study. Setting: University Hospital of Kirikkale, Kirikkale, Turkey. Patients: 40 ASA physical status I and II patients, aged 20 to 60 years, who were scheduled for elective cholecystectomy. Interventions: Patients were randomly divided into two groups to receive 0.5 mu g kg(-1) dexmedetomidine (group D, n = 20) or saline solution (group C, n = 20). Anesthesia was induced with thiopental sodium and vecuronium, and anesthesia was maintained with 4% to 6% desflurane. Measurements: Mean arterial pressure (MAP), heart rate (HR), (ejection fraction (EF), end-diastolic index (EDI), cardiac index (CI), and stroke volume index (SVI) were recorded at 10-minute intervals. The times for patients to "open eyes on verbal command" and postoperative Aldrete recovery scores were also recorded. Main Results: In group C, an increase in HR and MAP occurred after endotracheal intubation. In group D, HR significantly decreased after dexmedetomidine was given. The EDI, Cl, SVI, and EF values were similar in groups D and C. The modified Aldrete recovery scores of patients in the recovery room were similar in groups C and D at the 15th minute. Conclusions: A single dose of dexmedetomidine given before induction of anesthesia decreased thiopental requirements without serious hemodynamic effects or any effect on recovery time. Crown Copyright (C) 2008 Published by Elsevier Inc. All rights reserved.Öğe The effects of pressure-controlled and volume-controlled ventilation modes on the nasal mucociliary activity during general anaesthesia.(Allied Acad, 2017) Yaman, Ferda; Arslan, Bengi; Kose, Emine Arzu; Kilic, Rahmi; Apan, AlpaslanThe aim of this prospective randomized, double-blind study was to investigate the effects of pressure controlled and volume controlled ventilation on mucociliary clearance under general anaesthesia maintained with total intravenous anaesthesia. After approval by the Ethics Committee, 60 patients scheduled for tympanoplasty or tympanomasteidectomy under general anaesthesia were enrolled in the study. In Group I (n=30), the lungs of the patients were ventilated using volume-controlled mode with 8 ml/kg tidal volume. In Group II (n=30) pressure controlled ventilation mode was used with 10 cm H2O pressure support. Mucociliary clearance was assessed by in vivo saccharine transit time in preoperative and postoperative periods. The groups showed no significant differences regarding age, height, body mass index, peak and plateau airway pressures. Saccharine transit time values did not differ significantly between the groups. In conclusion, volume-controlled and pressure-controlled ventilation modes have no significant impact on nasal saccharine transit time.
