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Öğe Augmentation of shoulder contour using a calf implant(Springer-Verlag, 2000) Saray, A; Eskandari, M; Oztuna, VSprengel deformity is a rare orthopedic condition that is associated with functional and cosmetic impairment. Results of orthopedic procedures are usually inconsistent and cosmetic results are far from satisfactory in these patients. A silicone-gel-filled calf prosthesis was used to correct the shoulder contour in a patient with Sprengel deformity. Cosmetically the deformity can be restored by using a calf implant for patients in whom orthopedic procedures are not likely to yield a satisfactory outcome.Öğe Effect of chronic and short-term erythropoietin treatment on random flap survival in rats: An experimental study(Lippincott Williams & Wilkins, 2003) Saray, A; Ozakpinar, R; Koc, C; Serel, S; Sen, Z; Can, ZObjective: The use of perioperative erythropoietin (EPO) therapy is gaining popularity to avoid blood transfusion and correct anemia in head and neck cancer surgery. The purpose of the study was to determine the effect of various doses and durations of EPO treatment on random flap survival. Study Design: A McFarlane type random and musculocutaneous (3 X 10 cm) flap were elevated on the dorsum of each rat. Methods. Eighty-four male Albino rats were randomly assigned into seven groups (2 animals in each group): group 1, control animals receiving placebo; group 11, chronic EPO injections (50 U/kg); group 111, chronic EPO injections (100 mg/kg); group IV, chronic EPO injections (150 mg/kg); group V, short-term EPO injections (50 mg/kg); group VI, short-term EPO injections (100 mg/kg); and group VII, short-term EPO injections (150 mg/kg). Rats in groups 11 to IV began to receive EPO 3 weeks (thrice weekly) before the construction of flaps, and rats in groups V to VII received EPO after flap elevation for 1 week (thrice) subcutaneously. Following 7 days of recovery, the area of flap survival was measured. Hematocrit and systolic blood pressure were followed weekly in all groups. Results. Erythropoietin increased the hematocrit levels and systolic blood pressure in all groups, but significant increases were noted only in the long-term treatment groups. There was a significant increase in distal necrosis of random skin flaps after long-term EPO treatment (P <.05). However, short-term low and therapeutic doses of EPO improved flap survival significantly (P <.05). Conclusions. Long-term EPO treatment might have impaired flap survival because of direct or prostaglandin-mediated vasoconstriction, endothelin-induced hypertension, increased peripheral vascular resistance, hyperviscosity, and increased thrombosis. However, EPO might have enhanced flap survival because of its antioxidant effect and modulation of nitric oxide levels. Effects of EPO are controversial, and further research is necessary to delineate the dose and duration relationship and the exact mechanism of action on flap viability.Öğe Effects of obstructive jaundice on the peripheral nerve: An ultrastructural study in rats(Karger, 2004) Can, B; Saray, A; Caglikulekci, M; Saran, YObstructive jaundice (OJ) and hepatic disorders have been shown to be associated with peripheral neuropathy in several clinical studies. The study evaluated the effect of OJ on the ultrastructure of the rat sciatic nerve. In the OJ group, jaundice was created by ligation of common bile duct in Wistar-Albino rats. In the sham-operated control group the same procedure was performed without ligation of the bile duct. On day 7, all rats were re-operated and sciatic nerves were explored to harvest 2-cm-long nerve segments for quantitative and qualitative histopathological analysis by light and electron microscopy. Bilirubin was measured on serum samples. Bilirubin levels were significantly higher in jaundiced rats compared with that of controls (8.46+/-0.45 vs. 0.80+/-0.14 mmol/l, means+/-SD, p<.01). Control nerves did not show anything other than the normal histology. In the OJ group, degenerative changes such as irregularities, thinning, ruffling and invaginations, irregular-shaped bodies, vacuolizations and focal segmental demyelination were observed in the myelin sheath. Myelin clusters were noted in the axoplasm. A varying degree of swelling was noted in the nucleus and cytoplasm of the Schwann cells. Morphometric analysis of specimens obtained from sciatic nerves showed that myelin injury (370.9 +/- 51.3 vs. 11.6 +/- 0.5 axons), axonal edema (142.1 +/- 24.2 vs. 10.6 +/- 0.5 edematous axons) and Schwann cell degeneration (50.3 +/- 11.6 vs. 3.2 +/- 0.2 Schwann cells) was significantly higher in the jaundiced rats than in the control group (p<0.01). The ultrastructural alterations spotted in the rat peripheral nerve were attributed to hyperbilirubinemia and increased concentrations of several neurotoxic substances released from the Kupffer cells in OJ. Neuropathy in jaundiced patients seems to result from accompanying degenerative changes in the peripheral nervous system. However, the exact nature and initiating factors of this nerve injury remains to be unveiled. Copyright (C) 2004 S. Karger AG, Basel.Öğe Endoscopic balloon dissection for removal of lipomas via transaxillary route(Springer-Verlag, 2001) Saray, A; Ocal, K; Berberoglu, MMinimally invasive techniques and newer endoscopic surgical techniques are being introduced to aesthetic and reconstructive procedures at an accelerating pace. A new and modified technique of endoscopic excision of large encapsulated lipomas is presented and the versatility of creation of an optical cavity and incorporation of balloon dissection is discussed in two cases. Large encapsulated lipomas were removed endoscopically via transaxillary incisions and no immediate or late complication was observed. Endoscopic removal of lipomas offers several advantages over conventional direct excision and liposuction such as avoiding blind manipulation and fragmentation of lipoma mass, and unsightly scars. One drawback of this technique can be lengthy operation times, which have been near two hours for the presented cases. We conclude that endoscopic removal of tumors from a relatively remote site is beneficial in treating such encapsulated tumors and we speculate that endoscopy will prevent unsightly scarring in important areas while decreasing the operating time as experience is gained.Öğe Free radical-induced damage in experimental peripheral nerve injection injury(Thieme Medical Publ Inc, 2003) Saray, A; Apan, A; Kisa, UPeripheral nerve injury secondary to injection of therapeutic agents is well-documented. Until recently, the precise mechanism of injury has been obscure; even today, the treatment of these nerve injection injuries remains controversial. The aim of this study was to determine the involvement of ischemia-reperfusion injury in the development of peripheral nerve injection injury. Wistar rats were randomized into three groups. Sciatic nerve was used as the standardized nerve injection injury model. Two commonly used agents, lidocaine HCl 1 percent and phenol 5 percent, were tested for their comparative effects on the sciatic nerve. Lidocaine and phenol were injected,into the sciatic nerves of the rats in Groups 1 and 2, respectively. Physiologic saline was used in the controls (Group 3). All the agents were injected intrafascicularly. The effects of nerve injection injury were assessed by measuring thiobarbituric acid reactive substance (TBARS) levels and obtaining walking-track analyses (WTA). Nerve injection caused significant increases in TBARS levels, which were correlated with the severity of the injury. The TBARS levels were related to the severity of injury caused by the tested agents; TBARS levels in phenol-injected nerves were significantly higher than those of lidocaine-injected nerves. Patterns of alterations in TBARS levels also paralleled the changes in print-length factor. Injection of lidocaine and phenol resulted in near-normal walking tracks at 8 and 12 weeks, respectively, while saline injection caused only transient impairment in walking tracks. These findings indicate that reactive oxygen species are involved in the pathogenesis of experimental peripheral nerve injection injury. Indices of free oxygen radical damage correlate with the progression of functional alterations after nerve injection injury.Öğe Frontalis sling operation with deep temporal fascial graft in blepharoptosis repair(Lippincott Williams & Wilkins, 2002) Tellioglu, AT; Saray, A; Ergin, A…Öğe Fungal growth inside saline-filled implants and the role of injection ports in fungal translocation: In vitro study(Lippincott Williams & Wilkins, 2004) Saray, A; Kilic, D; Kaygusuz, S; Boyunaga, H; Ozluk, OInfection is a serious complication of breast. augmentation and tissue expansion with inflatable devices. Several reports have shown that fungi may be able to survive, colonize, and even cause infection in saline-filled devices. The mechanism of how them, penetrate, spread, and colonize inside the inflatable implants is not exactly understood. The authors assessed both the expander membrane and the port in terms of leakage and penetration of Candida albicans and Aspergillus niger in an in vitro model. Thirty saline-filled expanders connected to the injection port were placed in sterile containers filled with tryptic soy broth culture medium to simulate the clinical situation in phases I and II. Intactand multipunctured ports were used in the first and second phases of the study, respectivelv. Either the container or the implant was inoculated with one of these fungi, and six implants in containers without fungal inoculation served as controls. As a third phase, intraluminal survival of fungi was investigated in saline-filled containers (n = 12) in 21 clays. The silicone membrane, with its intact connecting tube and port, was impermeable to these fungi, whereas both fungi were able to diffuse inside-out or outside-in through the punctured ports. C. albicans did not Survive beyond 18 days in saline, whereas A. niger continued to multiply at day 21. Chemical analyses of the implant fluids revealed that the contents of the culture medium diffused into the implants in phases I and II. The data show that an intact. silicone membrane is impermeable to fungi, and punctured ports allow translocation of fungi into the implants. Fungi can grow and reproduce in a saline-only environment, and their survival periods differ among the species. Furthermore, their Survival maybe enhanced by the influx of substances through the implant shell.
