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Öğe Effect of a 50-Hz sinusoidal electromagnetic field on the integrity of experimental colonic anastomoses covered with fibrin glue(2009) Girgin S.; Ozturk H.; Gedik E.; Akpolat V.; Kale E.; Ozturk H.Background. Low-frequency magnetic fields have been shown to affect biological In this article the effects of 50-Hz sinusoidal magnetic field (MF) stimulation and application of fibrin glue on the healing of experimental colonic anastomoses were investigated. Material and Methods. Twenty-eight rats were divided into four groups. Group 1 underwent 2-cm left colonic resection and primary anastomosis. Group 2 underwent normal resection anastomosis and the area was covered with fibrin glue. Group 3 underwent normal resection anastomosis and the rats were exposed to a 50-Hz sinusoidal MF. Group 4 underwent normal resection anastomosis, the anastomosis area was covered with fibrin glue, and the rats were exposed to a 50-Hz sinusoidal MF. Investigations included bursting pressure measurement, hydroxypro-line content, and histopathological changes. Results. Tissue hydroxyproline levels and anastomotic bursting pressures of groups 2, 3, and 4 were significantly higher than in group 1. Collagen deposition and fibroblast infiltration in groups 2, 3, and 4 had higher scores than in group 1. Furthermore, these results were significantly higher in group 4 rats than in the other groups. Histopathological examination of the anastomosis revealed significantly better healing patterns for group 4 than for groups 1, 2, and 3. Conclusions. A 50-Hz sinusoidal MF stimulation and application of fibrin glue provided a significant gain in anastomotic healing in the large intestine. A combination of a 50-Hz sinusoidal MF and fibrin glue has significantly favorable effects on healing of experimental colon anastomosis. © Copyright by Wroclaw Medical University.Öğe The effects of prophylactic antibiotics on the bacterial translocation due to pringle maneuver(Turkish Surgical Society, 2002) Girgin S.; Aldemir M.; Taçyildiz I.-B.; Geyik M.F.This study was undertaken to investigate the effectiveness of prophylactic antibiotics (Cefotaxime and Ceftazidime) on the bacterial translocation related to PM in rats. Bacterial translocation may occur in humans and is associated with an increased incidence of septic morbidity. It has been consistently demonstrated in a number of experimental models, including burns, trauma, shock, and surgery. It has been previously determined that the PM causes bacterial translocation. The prophylactic antibiotics may reduce this translocation. Thirty male Sprague-Dawley rats weighed in at 250-300 gr were divided into 3 groups each were containing 10 rats. After being anaesthetized by intramuscularly injection of Ketamine, midline laparotomy was performed to all rats under sterile conditions. In group 1 (Control), the hepatoduodenal ligament was clamped for 40 min. In group 2 (Cefotaxime), following intramuscularly application of Cefotaxime (30 mg/kg) 30 minutes before the surgical procedures, the PM was performed for 40 min. In group 3 (Ceftazidime), Ceftazidime (30 mg/kg) was applied instead of Cefotaxime before the PM. 1 ml of blood sample was obtained from the portal vein for blood culture. The MLN biopsy and splenectomy were performed for culture. The positive bacterial cultures, obtained from MLN, spleen and blood, were determined most frequently in group 1. It was found that the positive cultures of group 1 (56.7%) were significantly higher than those of group 2 (6.7%) and group 3 (6.7%) (p=0.006, p=0.006, p=0.001, respectively). Microorganisms, obtained from MLN and spleen,were E. coli, C.pneumonia, Mikst, Candida and E.fecalis (respectively, 61.9%, 14.3%, 9.5%, 9.5%, 4.8%). In both cultures of MLN and spleen, the CFU of the group 1 was significantly higher than CFU of group 2 and 3 (p=0.001, p=0.003). In our study, we determined that PM significantly increased bacterial translocation in MLNs, spleen and blood, and prophylactic application of Cefotaxime and Ceftazidime had preventive effect on this translocation.Öğe The effects of topical hypothermia, methylprednisolone and BN 52021 on hepatic ischemia/reperfusion injury(Turkish Surgical Society, 2002) Taçyildiz I.; Aldemir M.; Girgin S.; Büyükbayram H.; Baç B.This study was undertaken to investigate the effectiveness of topical hypothermia, methylprednisolone and BN 52021 on ischemia/reperfusion induced liver injury. The liver is one of the organs most vulnerable to ischemia because of its high metabolic state. Occlusion of the portal triad is often required in complex hepatic surgery in order to decrease parenchymal bleeding. Liver failure due to ischemia-reperfusion injury is a serious problem during liver surgery. Fifty male Sprague-Dawley rats (200-225 gr) were divided into 5 groups each containing 10 rats. Midline laparatomy was fulfilled on all the rats under ketamine anesthesia. In group 1 (Sham), the hepatoduodenal ligament was dissected without any drug administration. In group 2 (İ/R), the ischemia (for 45 min)/ reperfusion (for 45 min) was performed and received no further treatment. In group 3 (Hypothermia), the ischemia plus topical cooling (for 45 min) and reperfusion (for 45 min) was fulfilled. In the group 4 (Steroid), the İ/R was performed and methylprednisolone (30 mg/kg) was administered. In group 5 (BN 52021), the İ/R was performed and BN 52021 (100 mg/kg) was given before ischemia. Liver, ileum and blood samples (for MDA, ALT, AST, LDH and ileal mucosal injury score) were obtained. The levels of ALT,AST, LDH, MDA(ileal, hepatic) and ileal injury score in group İ/R were significantly higher than those of group sham (p>0.0001). When group İ/R was compared with group hipothermia, there were no significant differences with regard to AST, ileal MDA and ileal injury score (p>0.05), whereas levels of ALT, LDH and hepatic MDA were significantly higher (p<0.0001, 0.0001, <0.0001, respectively). When group İ/Rwas compared with group steroid and group BN 52021, it was determined that those agents had significant protective effects on hepatic and ileal injuries (p<0.0001). It was determined that topical hypothermia decreased hepatic İ/R injury, however had no protective effect on ileal injury. We determined that Methylprednisolone and BN 52021 decreased both hepatic İ/R and ileal injury due to splanchnic congestion.Öğe Epidemiological characteristics of electrical injuries of patients applied to the emergency department(2006) Al B.; Aldemir M.; Güloğlu C.; Kara I.H.; Girgin S.BACKGROUND: In this study, we planned to determine the factors affecting the mortality, and morbidity of electrical injuries. METHODS; Medical records of 165 patients (126 males; 39 females; mean age 21.1 years; range 2.5 to 62 years), who were admitted to the Emergency Department of Dicle University School of Medicine for electrical injuries, between January 2003 and April 2004, were retrospectively reviewed. RESULTS: Among these patients, 60 (36.4%) were children, under 12 years old; 95 (57.6%) were adolescents and adults, and 10 (6%) were aged. Of the victims of electrical accidents, 29 (17.6%) were illiterate and 36 (21.8 %) were educated. Ninety-seven (58.8 %) patients were either graduates or still students of elementary, secondary or high school. The cause of exposure to electricity was accident in 99 (60%), and carelessness and parents' negligence in 66 (40%). Sixty-nine (41.8%) patients were exposed to high voltage, and 96 (58.2 %) to low voltage. Because of electrical injury 16 patients had first degree, 96 patients had second degree, and 86 patients had third degree burns. The most frequent complications were contractures of extremities (10.9%) and compartment syndrome (3.6%). Mortality rate was 9.1% (n=15). Eighty percent of the deaths were due to exposure to high voltage. A positive correlation was demonstrated between mortality and complications (p<0.001). Escarotomy was performed in 10 patients, fasciotomy in 16, and amputation in 9. Two of 5 patients who had intraabdominal hemorrhage underwent surgery. CONCLUSION: A serious education of the society with respect to conscious use of of electricity is the most efficient method to decrease electrical accidents.Öğe Etiology, diagnosis and treatment of anal fissure(2007) Girgin S.; Gedik E.; Aldemir M.Anal fissure is a painful ulcer, which is lying longitudinally to dentate line within the anal channel. It is a common illness, which causes morbidity in the healthy population, especially among the young people. Aetiopathogenesis, and the treatment of this illness is contentious, although it was identified long time ago. The treatment of the chronic form of this illness generally requires surgical intervention whereas acute form of the illness responses to medical treatment. Numerous medicines (Botilismus toxin, goniatoxin, glyceril trinitrate, etc), which are aimed to decrease tonus of the internal anal sphincters, which play an important role in the chronic anal fissure's etiopathogenesis and applied surgical methods are currently debatable. In this study we aimed to discuss the diagnostic methods of the anal fissure's aetiopathogenesis, medical, and surgical treatment methods.Öğe Evaluation of surgical methods in patients with blunt liver trauma(2006) Girgin S.; Gedik E.; Taçyildiz I.H.BACKGROUND: We evaluated the surgical methods, morbidity and mortality in patients who had surgery for blunt liver trauma. METHODS: We retrospectively reviewed 159 patients (116 males, 43 females; mean age 33.6; range 15 to 67 years) with blunt hepatic trauma regarding the cause and severity of liver injury, diagnostic procedures, associated injuries, management, morbidity, and mortality. Simple hepatorrhaphy was done in minor liver injuries (Grade I, II). To manage severe liver trauma (Grade III-V), debridement, selective hepatic artery ligation and omentum packing of the laceration (DSO) in 40; resectional debridement (RD) with direct control of bleeding vessels within the liver by the Pringle maneuver in 12; deep matress suture (DMS) in 23; and perihepatic packing (PP) in 9 patients were performed. RESULTS: The causes of trauma were motor vehicle accidents in 102, falls from height in 43 and violence induced blunt trauma in 14 patients. Among 159 patients, 84 had severe liver injuries and 75 had minor liver injuries. Associated organ injuries were present in 104 patients and splenic injury was the most common. Mean units of blood transfusions in DSO, DMS, RD and PP were 4.3, 6.2, 5.5 and 9.5 respectively. Mean time for liver surgery in DSO, RD, DMS and PP were 34.7, 38.1, 26 and 18.2 minutes respectively. Morbidity rate was higher in DMS group than in DSO and RD groups, and the difference was statistically significant (p<0.001). Twenty-five patients (29.4%) died of severe liver injuries and 9 (12%) died of minor liver injuries. The overall mortality rate was 21.3%. CONCLUSION: DSO, and RD methods don't increase operation time and amount of blood transfusion. They cause less morbidity and mortality when compared to DMS.Öğe Granulomatous peritonitis due to Ascaris lumbricoides(2000) Aldemir M.; Yilmaz G.; Girgin S.; Akgün Y.Ascaris lumbricoides is one of the most common and most widespread helminthic infections of humans. Infection with ascaris appears to be asymptomatic in the vast majority of cases, but may produce serious pulmonary disease or obstruction of biliary or intestinal tract in a small proportion of infected people. We examined under the light of literature this case which caused the granulomatous peritonitis by ascaris, the adult worm, without any evidence of intestinal perforation.Öğe The metabolic and hormonal effects of perioperative ibuprofen treatment on surgical stress(2002) Aydin O.; Aldemir M.; Taçyildiz I.; Girgin S.; Sen T.; Baç B.BACKGROUND: Surgical stress induces hormonal and cytokine responses proportional to the extent of the injury. Perioperative administration of cyclo-oxygenase inhibitors reduces cytokine production and nitrogen losses. The objective of this study is to evaluate clinically the metabolic and hormonal effects of ibuprofen which is cyclo-oxygenase inhibitor on surgical stress. METHODS: A prospective clinic study was performed in 20 patients who undergone thyroidectomy. Patients were randomly divided two groups as ibuprofen group (n = 10) and control group (n = 10). In the ibuprofen group, pills containing ibuprofen (400 mg) were administered orally 12 and 2 hours before surgery, and every 8 hours until the third postoperative day. In the both groups, blood samples were collected 24 and 2 hours before surgery and 1, 4, 6, 24, 48, and 72 hours after skin incision for glucose, CRP, leukocytes, ACTH, cortisol determinations. RESULTS: When preoperative values were compared with postoperative values, surgical stress caused significantly changes on the all parameters in the both groups. The highest levels of ACTH and cortisol were at 1st and 6th hours respectively. In both groups, plasma cortisol levels remained elevated for 3 days, whereas plasma ACTH levels returned to the basal level at 1 day. In the ibuprofen group, the levels of ACTH and cortisol were significantly less than those of control group (p < 0.001 and p < 0.001). In the ibuprofen group glucose level (p < 0.001) and count leukocyte (p < 0.001) increased mildly. The level of CRP increased gradually after first day and were high until 3rd days (p < 0.01). In the ibuprofen group the fever increased smaller (p < 0.01). CONCLUSIONS: In conclusion, in perioperative period pretreatment with ibuprofen is able to reduce the neuroendocrine and humoral responses, but it can not completely suppress. Our present study suggests that ibuprofen may be useful in decreasing the surgical stress response in the serious patients.Öğe Quality of life, depression and anxiety among patients who have undergone permanent or temporary ostomy(2008) Yaşan A.; Ünal S.; Gedik E.; Girgin S.Objective: The aim of this study is to compare quality of life, depression and anxiety after ostomy among patients who have undergone permanent or temporary ostomy. Methods: Twenty two patients who were undergone permanent and thirty one patients who were undergone temporary ostomy were included in the study. Sociodemographic and ostomy information form, quality of life scale which had 20 questions and developed for patients with ostomy, the section of SCID-I which was deal with depression and anxiety, Hamilton Depression Rating Scale and State-Trait Anxiety Inventory were applied to those patients. The results determined in the two groups, permanent and temporary ostomy were compared. Results: Depression and anxiety diagnosing rates were 35.85%, and 56.60% among all our patients respectively. Permanent and temporary ostomy groups were compared and a difference was obtained in the answers of these groups to four questions, which was about encountered problem, or anxiety, of quality of life test. On the other hand, any difference was not found in the rates of depression and anxiety. Hamilton Depression Rating Scale and trait anxiety average score were not found between the two groups. But state anxiety average score of temporary ostomy group was obtained higher than permanent ostomy group. Discussion: The presence of ostomy -temporary or permanent- clearly affects the quality of life of patients physically, sociological, and psychologically without regarding temporary or permanent. Also it commonly leading to psychiatric disorders of depression and anxiety. Patients should be routinely screened for these disorders in order to provide early intervention and treatment.Öğe Trocar-site hernias after laparoscopic cholecystectomy(Duzce University Medical School, 2011) Kapan M.; Önder A.; Gümüş M.; Böyük A.; Girgin S.Introduction: Trocar-site hernia (TH) development after laparoscopic cholecystectomy (LC) is a rare complication. In this study, we aimed to investigate the TH after LC in the light of current literature. Methods: Between January 2007 and June 2010, the records of the patients with TH in 515 patients performed LC analyzed retrospectively in terms of age, sex, location, size, performed previous operation and risk factors. Results: TH was determined in 3 (0.58%) patients among patients underwent LC. The average age was 49.67±5.77 and all of them were women. The 10-mm trocars entry site related to TH appeared at umbilical region for 2 patients and at epigastric region for patient. The average time from LC to TH formation was 18.33±10.97 months. The diameter of the hernia defects were 1.33±0.29 cm. The average of body mass index was 30.3 ± 3.1. During the LC, 2 cm in diameter gallstone in 1 patient and multiple gallstones smaller than 1 cm in the others were detected. Wound infection at the umbilical trocar region in one patient was detected after LC. Conclusion: Although the risk of TH after LC is rare, 10 mm or larger diameter trocar sites should be sutured especially in the patients including risk factors. © 2011 Düzce Medical Journal.
