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    Characteristics of penetrating abdominal firearm injuries in children
    (Hippokrates Verlag Gmbh, 2000) Dokucu, AI; Otcu, S; Öztürk, H; Önen, A; Özer, M; Bükte, Y; Özates, M
    Penetrating injuries of the abdomen which occur primarily from gunshots and stabbing become increasingly prevalent in children. Our purpose is to assess the presentation, management and outcome of children with penetrating abdominal firearm injuries (PAFI) and to evaluate the value of Injury Severity Score (ISS) for predicting injury severity and eventual morbidity and mortality in children with PAFI. Between 1985 and 1997, 69 children less than or equal to 15 years of age with PAFI were hospitalized at our institution. Their hospital records were reviewed retrospectively. Of the 69 children with PAFI, 53 were boys and 16 were girls. The mean age was 9.6. The causes of PAFI were explosives (44%), gunshot (39%) and shotgun injuries (17%). The most common organ injured was the small bowel followed by colon and liver respectively. Postoperative complications were seen in 12 children. The mean value of ISS was 16.8: 41 children had an ISS value of greater than or equal to 16. The value of ISS was significantly higher in children with complication than in those without complication. The children with ISS value greater than or equal to 16 were hospitalized significantly longer than those with less than or equal to 15 of ISS. Particularly shotgun injuries were commonly associated with severe morbidity. ISS can be useful for predicting the severity of injury and the occurrence of morbidity.
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    Esophageal, tracheal and pulmonary parenchymal alterations in experimental esophageal atresia and tracheoesophageal fistula - A histological and morphometric study
    (Karger, 2002) Otcu, S; Kaya, M; Ozturk, H; Buyukbayram, H; Dokucu, AI; Onen, A; Yucesan, S
    Pulmonary complications are among the most important causes of morbidity and mortality in neonates with esophageal atresia and tracheofistula. We aimed to investigate the possible causes of respiratory complications encountered in esophageal atresia (EA) and tracheoesophageal fistula (TEF) in an experimental model. Sprague-Dawley fetal rats treated with adriamycin were used for the experiment. Time mated pregnant rats were given 1.75 mg/kg of adriamicyn intraperitoneally on days 6-9 of gestation. The fetuses were sacrified on day 21, weighed, and dissected under the surgical microscope. The animals were divided into four groups: (1) control group; (2) saline-injected group; (3) adriamycin-induced EA group, and (4) adriamycin administered but without development of EA. The lungs, esophagus, and trachea were excised and underwent histological examination. The mucosa of distal esophagus was thickened (p < 0.05); the submucosa was thinner (p < 0.05); and the muscular layer was thickened (p < 0.05) in fetuses with EA and TEF. In adriamycin-treated rats, in which EA and TEF developed, tracheal cartilage was loosened and formed into a D or C shape. The cartilage was fragmented into several segments on transverse sections in most fetuses. Alveolar septa were thin in lungs of fetus with EA and TEF (p < 0.05), without any fibrosis or evidence of parenchymal abnormality microscopically. Our findings suggest that respiratory complications may contribute to structural lesions in the trachea and particularly in the distal esophagus but not in the pulmonary parenchyma itself. Copyright (C) 2002 S. Karger AG, Basel.
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    Influence of the platelet-activating factor receptor antagonist BB-882 on intra-abdominal adhesion formation in rats
    (Karger, 2003) Otcu, S; Ozturk, H; Aldemir, M; Kilinc, N; Dokucu, AI
    Postoperative intra-abdominal adhesion formation is a major clinical problem. We aimed to examine the preventive effect of treatment with the platelet-activating factor (PAF) antagonist (lexipafant, BB-882) on experimentally induced intra-abdominal adhesion formation in rats. Twenty male Sprague-Dawley rats weighing 250 and 290 g were studied. Generation of adhesions in rats by brushing a 1-cm(2) area of the cecum and the peritoneum on the right side of the abdominal wall was followed by intra-abdominal administration of saline and 5 mg/kg in a volume of 0.2 ml PAF receptor antagonist BB-882. After 45 days, formation of adhesions was graded and histological evaluation was processed. The severity of adhesions was significantly less in the BB-882 group than in the control group (p < 0.001, p < 0.05). The average adhesion scores in the control and BB-882 groups were 3.2 +/- 0.6 and 0.6 +/- 0.6, respectively, and the difference between both groups was found to be significant (p < 0.0001). The number of polymorphonuclear leukocytes and fibrotic areas was significantly decreased in the BB-882 group when compared to the control group (p < 0.001, p < 0.002). In conclusion, this study confirms the efficacy of BB-882 in the prevention of postoperative intra-abdominal adhesions in a rat model. Copyright (C) 2003 S. Karger AG, Basel.
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    The prognostic importance of trauma scoring systems for morbidity in children with penetrating abdominal wounds
    (W B Saunders Co, 2002) Öztürk, H; Dokucu, AI; Otcu, S; Onen, A
    Background/Purpose: Risk factors that may independently predict morbidity in children with penetrating abdominal wounds (PAW) have not been elucidated fully. The aim of this study was to identify not only correlated risk factors for morbidity in children with PAW, but also to evaluate the independent predictive value of 3 different trauma scoring systems: the Injury Severity Score (ISS), the Penetrating Abdominal Trauma Index (PATI), and the Pediatric Trauma Score (PTS). Methods: Between January 1983 and November 2000, 119 children (99 boys, 20 girls) presenting with PAW were reevaluated by an analysis of the relationship between overall morbidity and potential risk factors. Results: Wounds were caused by firearm trauma in 85 children and stabbing in 34. Univariate analysis found that age greater than 10 years, trauma mechanism, number of intraabdominal organs injured (NOI) greater than 2, presence of penetrating injury, and ISS and PATI score were associated with greater than 3-fold increased incidence of morbidity (P<.05). The relative risk of a postoperative septic complication was higher than 2 for the following risk factors: age greater than 10 years, shotgun injury, number of organs injured greater than 2, presence of colon injury, ISS greater than 15, and PATI score greater than 15. Multivariate analysis showed that only ISS (P=.02), and PATI score (P=.03) were independently significant in predicting morbidity. Conclusion: ISS and PATI score were the most important indicators found to be independently associated with morbidity. J Pediatr Surg 37.93-98. Copyright (C) 2002 by WB. Saunders Company.
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    Renal effects on a solitary kidney of specific inhibition of cyclooxygenease-2 after 24 h of complete ureteric obstruction in rats
    (Springer-Verlag, 2002) Öztürk, H; Ozdemir, E; Otcu, S; Büyükbayram, H; Dokucu, AI
    The purpose of this study is to show whether selective (celecoxib) and non-selective (piroxicam) inhibitors of COX-2 can alter the morphological and functional changes after the release of a 24 h complete ureteric obstruction in tissue from solitary rat kidney. Forty male Sprague-Dawley rats weighing 225-250 g were used. The animals were divided into four groups. In group I rats (control, n = 10), only right nephrectomy was performed. Group 2 rats (untreated, n = 10) underwent right nephrectomy and the left ureter was completely obstructed. In group 3 rats (celecoxib), the same operation was performed as described for group 2 and than celecoxib was administered by gavage for a period of 24 h. Group 4 rats (piroxicam) underwent the same operation as described for group 2, then piroxicam was administered intramuscularly at least I h before the release of the for 24 h complete ureteric obstruction. All animals were then prepared for functional and histopathological studies. The administration of celecoxib produced a significant decrease in blood urea nitrogen levels when compared to the animals receiving piroxicam and the animals with no treatment. Moreover, celecoxib caused a significant decreased in creatinine levels when compared to the untreated group. Urine volume and the urinary sodium values were increased in the celecoxib group when compared with the other groups. The administration of celecoxib and piroxicam caused a significant decrease in the number of interstitial macrophages when compared to the untreated group. The Bowman space was significantly increased in the untreated group when compared with the celecoxib and the piroxicam groups. These studies indicate that celecoxib may be an important factor affecting renal morphological and functional changes after the release of a 24 h complete ureteric obstruction.