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Item Interrelation of RDW and coronary flow reserve in patient with idiopathic dilated cardiomyopathy(2014) Ozulku, Mehmet; Caliskan, Mustafa; Gullu, Hakan; Erdogan, Dogan; Caliskan, Zuhal; Muderrisoglu, HaldunObjective: Idiopathic dilated cardiomyopathy (IDC) impairs and reduces coronary flow reserve (CFR). High level of red cell distribution width (RDW) is an independent risk factor for cardiovascular diseases. Therefore, in this observational case-control study we have aimed to determine whether RDW level is associated with CFR impairment in patients with IDC. Methods: We examined 36 patients with IDC and 35 healthy subjects formed as a control group. In addition to this, patients with IDC were divided into two subgroups according to their CFR levels [normal CFR group (CFR value >= 2) and lower CFR group (CFR value<2)]. Control and patients groups were compared using the student t-test for multiple comparisons. The subgroups were compared using the Mann-Whitney U test for continuous variables and chi-square for categorical variables. The Pearson's and Spearman correlation analysis was used to test the possible associations between CFR and the study variables as appropriate. The receiver-operating characteristic (ROC) curve was determined to evaluate the predictive performance of RDW to detect low CFR. Results: There were no significantly differences between the lower and higher CFR groups' clinical data, baseline hemodynamic, medication and biochemical data except RDW and high-sensitivity C-reactive protein (hsCRP) levels. We found that RDW level was a good predictor of low CFR at the receiver-operating characteristic curve. The area under the curve (AUC) was 73% (95% confidence interval between 0.56-0.90 is 95%, p:0.018) After adjusting potential confounders include age, body-mass index, blood pressure, lipid and glucose, RDW independently associated with CFR level (Beta:-0.374; p=0.015) and hsCRP value (Beta:-0.520; p=0.001) were the independent predictors of lower CFR. Conclusion: Results showed that there was an independent correlation between RDW level and CFR level in patients with IDC.Item Effect of using pump on postoperative pleural effusion in the patients that underwent CABG(2015) Ozulku, Mehmet; Aygun, Fatih; 27163421Objective: The present study investigated effect of using pump on postoperative pleural effusion in patients who underwent coronary artery bypass grafting. Methods: A total of 256 patients who underwent isolated coronary artery bypass grafting surgery in the Cardiovascular Surgery clinic were enrolled in the study. Jostra-Cobe (Model 043213 105, VLC 865, Sweden) heart-lung machine was used in on-pump coronary artery bypass grafting. Off-pump coronary artery bypass grafting was performed using Octopus and Starfish. Proximal anastomoses to the aorta in both on-pump and off-pump techniques were performed by side clamps. The patients were discharged from the hospital between postoperative day 6 and day 11. Results: The incidence of postoperative right pleural effusion and bilateral pleural effusion was found to be higher as a count in Group 1 (on-pump) as compared to Group 2 (off-pump). But the difference was not statistically significant [P>0.05 for right pleural effusion (P=0.893), P>0.05 for bilateral pleural effusion (P=0.780)]. Left pleural effusion was encountered to be lower in Group 2 (off-pump). The difference was found to be statistically significant (P<0.05, P=0.006). Conclusion: Under the light of these results, it can be said that left pleural effusion is less prevalent in the patients that underwent off-pump coronary artery bypass grafting when compared to the patients that underwent on-pump coronary artery bypass grafting.Item Effect of LIMA Harvesting Technique on Postoperative Drainage in Off-Pump CABG(2016) Ozulku, Mehmet; Aygun, Fatih; 27556310Objective: We investigated the effects of pedicled and semiskeletonized left internal mammary artery (LIMA) harvesting techniques on postoperative drainage in patients subjected to off-pump CABG, ignoring other advantages or disadvantages of those techniques. Methods: The present study comprises a total of 160 subjects that underwent coronary artery bypass surgery in our clinic. Data were collected consecutively and retrospectively. An attempt was made to have similar groups in terms of demographic characteristics. Patients that underwent off-pump coronary artery bypass surgery by two surgical teams which differed only in LIMA harvesting technique were dichotomized and compared according to these techniques. The first group (Group 1) consisted of patients in whom LIMA was harvested with surrounding tissues using the pedicled technique. The second group (Group 2) consisted of patients in whom LIMA was harvested using the semiskeletonized technique, with the veins separated from surrounding connective tissues. Results: The mean amount of drainage in the first 24 hours was 706.1 +/- 234.2 ml vs. 591 +/- 258.8 ml (Group 1 vs. Group 2; P=0.005), the mean amount of drainage in the second 24 hours was 270 +/- 133.6 ml vs. 189.4 +/- 140.4 ml (Group 1 vs. Group 2; P < 0.001), and the mean amount of total drainage was determined to be 976.1 +/- 306.9 ml vs. 781.2 +/- 335.5 ml (Group 1 vs. Group 2; P < 0.001). Conclusion: It was observed that semiskeletonized LIMA presents reduced amount of postoperative drainage in the first and second 24-hour periods and total amount of drainage than pedicled LIMA, independent of pleural integrity.Item IS THERE A REAL CORRELATION BETWEEN RED CELL DISTRIBUTION WIDTH AND PERIPHERAL ARTERIAL DISEASE?(2017) Duman, Enes; Kulaksizoglu, Sevsen; Cifci, Egemen; Ozulku, Mehmet; 0000-0002-7613-2240; 30581327; AAI-8932-2021Background: Few data is available concerning the association between peripheral arterial disease (PAD) and red cell distribution width (RDW). In this study, we analyzed the relationship between RDW and atherosclerosis of the vessels other than coronary arteries in patients who had undergone digital substraction angiography (DSA). Methods: This study included 730 patients who had undergone DSA. Patients were divided into two groups according to their angiographic images. The association between RDW and atherosclerosis of peripheral arteries was analyzed. The relationship between atherosclerosis and smoking, hypertension (HT), diabetes mellitus (DM), hs-CRP, hemoglobin, white blood cell (WBC), triglyceride, total cholesterol, HDL and LDL cholesterol levels was assessed. Results: Atherosclerosis was observed more common in male and patients with older age, HT, DM and smoking (p< 0.001). hs-CRP and WBC levels were both in significantly positive association with atherosclerosis (p< 0.05). However, there were no significant differences in the RDW levels, hemoglobin, triglyceride, total cholesterol, LDL and HDL cholesterol levels in the groups (p> 0.05). Conclusions: Our results seem to demonstrate that older age, male gender, HT, DM and smoking are powerful risk factors for PAD. In contrast to the previous reports, RDW levels are found not to be associated with atherosclerosis of peripheral arteries.Item Recurrence of Primary Vascular Leiomyosarcoma Five Years after Initial Diagnosis in the Lower Extremity(2018) Erinanc, Hilal; Ozulku, Mehmet; Terzi, Aysen; 0000-0003-1401-6356; 0000-0002-1225-1320; 29971175; AAL-1268-2021; F-7546-2013Primary leiomyosarcomas of vascular origin are rare tumors. They frequently arise within the inferior vena cava; however, the peripheral vein was also affected. To date, only a few hundred cases have been reported in the world literature. Although it is an extremely aggressive tumor, the symptoms may be unspecific, especially in the lower extremities. In this report, we present a case of primary vascular leiomyosarcoma, arising from the short saphenous vein, with symptoms mimicking thrombus in the initial diagnosis. The diagnosis of leiomyosarcomas was confirmed by standard H&E staining and immunohistochemical staining. Recurrence of the tumor has been observed five years after surgical treatment. Due to its rarity, experience in the management of this type of tumor is limited. The mainstay of treatment for these tumors is complete surgical resection. The purpose of the presented case is to discuss the clinicopathological features and management options of this tumor, under the light of the most recent literatures.