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Öğe Continuous infusion of small-volume fluid resuscitation in the treatment of combined uncontrolled hemorrhagic shock and head injury(2007) Ozturk H.; Yagmur Y.; Tas A.; Topcu S.; Orak M.Objective: To determine the effect of continuous limited fluid resuscitation on the hemodynamic response and survival in rats in a model of uncontrolled hemorrhage shock due to Massive Splenic Injury (MSI) and Head Injury (HI). Design: An experimental study. Place and Duration of Study: Dicle University Animal Research Laboratory, Turkey, between January and February 2005. Subjects and Methods: Seventy Sprague-Dawley rats were used in this study. Group 1 rats (n=10) was sham-operated. In group 2 (n=10), only Massive Splenic Injury (MSI) was performed and untreated. In group 3 (n=10), only head injury (HI) was performed and untreated. In group 4 (n=10), HI and MSI were performed and were untreated. In group 5 (n=10), HI and MSI were performed and 15 minutes later treated with 7.5% NaCl. In group 6 (n=10), HI and MSI were performed, and rats were treated with Ringer's Lactate (RL) solution. In group 7 (n=10), HI and MSI were performed, rats were treated with 0.9 % NaCl. In groups 2,4,5,6 and 7 midline incision was reopened and splenectomy was performed at 45 minutes. Results: In group 4 rats, Mean Arterial Pressure (MAP) was decreased from 104 ± 6.1 mmHg to 75 ± 19.5 mmHg at 15 minutes; heart rate decreased from 357 ± 24.9 beats/min to 321 ± 62.1 beats/min and hernatocrit decreased from 46 ± 1.3 % to 43 ± 2.5% (p<0.01). Similar early changes in MAP, heart rate and hematocrit were observed in groups 5, 6, and 7, at 15 minutes. At 45,60 and 120 minutes, in fluid resuscitated rats (group 5,6,7) MAP, heart rate and hematocrit values were measured higher than group 2 and 4 (p<0.01 for all). At 120 min, in group 6, hematocrit was higher than group 4, 5 and 7, in group 6, total blood loss after splenectomy was calculated at 20 ± 2.4% of blood volume and was the best value compared to other fluid resuscitated group 5 and 7 (28% and 27% of blood volume) (p<0.01). Mortality was lower in all fluid resuscitated groups when compared to group 3 and 4 (p<0.05). The median survival time was again higher in fluid resuscitated groups. Conclusion: Continuous infusion of 7.5% NaCl, RL and 0.9 % NaCl following uncontrolled hemorrhagic shock with massive splenic injury and combined head injury resulted in better survival and RL did not increase abdominal bleeding before splenectomy was performed.Öğe Diaphragmatic injuries in childhood(2000) Dokucu A.I.; Ozturk H.; Otcu S.; Onen A.; Bukte Y.; Yucesan S.Injury to the diaphragm is rare in children. From 1983 to 1998, 23 children were treated for diaphragmatic injury at our institution and they were reevaluated for etiologic, diagnostic, therapeutic and prognostic factors. There were 20 boys and 3 girls, ranging in age between 3 to 15 years. Fifteen patients sustained penetrating trauma and eighth patients sustained blunt trauma. Rupture was diagnosed preoperatively in 11 patients. All patients underwent exploratory laparotomy with repair of the diaphragm. Diaphragmatic injury was found in 14 patients at left side and in 9 patients at right side. Isolated diaphragm injury was found in only 3 patients. Twenty patients had associated injuries, most commonly involving the liver, followed by spleen and stomach. Mean Injury Severity Score (ISS) value was measured as 38 in the study. There were two deaths, both unrelated to the diaphragmatic trauma. Diaphragmatic injury must be considered in any child suffering from blunt or penetrating thoracoabdominal trauma. Associated intraabdominal organ injuries are frequent in diaphragmatic rupture and therefore they should be treated by laparotomy. Morbidity and mortality can be minimized by a high index of suspicion, prompt recognition and surgical repair of even in the smallest diaphragmatic injury.Öğe Differential expression of CD34, S100, and c-Kit in interstitial cells of Cajal in infantile hypertrophic pyloric stenosis - Immunochemical study(2009) Ozturk H.; Ozturk H.; Yilmaz F.; Okur H.; Otcu S.; Dokucu A.I.Background. The pathogenesis of infantile hypertrophic pyloric stenosis (IHPS) is poorly understood although many hypotheses have been proposed. Objectives. Assessment whether the differential expression of c-Kit, CD34, and S100 may be involved in the development of IHPS. Material and Methods. Specimens from 14 infants with IHPS and seven control subjects were immunohisto-chemically stained for c-Kit, CD34, and S 100. The numbers of CD34+, S 100+, and c-Kit+ cells in five random fields per specimen were compared via light microscopy (x200). Results. In normal pyloric tissue, specific and intense c-Kit immunoreactivity was observed in the muscle layers and moderate staining was observed around the myenteric plexus. In IHPS patients, c-Kit+ cells were either absent or markedly reduced around the myenteric plexus. In control and IHPS patients, CD34+ cells were not observed around the myenteric plexus. In the vascular endothelium, moderate CD34 staining was observed in specimens from control subjects, whereas intense staining was observed for IHPS patients. In normal pyloric tissue, moderate S 100 immunoreactivity was observed in the muscle layers and intense staining was observed in the myenteric plexus. In IHPS patients, few S100+ cells were observed in the pyloric muscle layers and S100 immunoreactivity decreased markedly around the myenteric plexus. Conclusions. These results suggest that the numbers of c-Kit+ and S100+ cells are markedly decreased in the pyloric muscle layers and around the myenteric plexus in IHPS patients. Thus a lack of c-Kit and S100, but not CD34, expression may be a critical factor in the pathogenesis of IHPS and may serve as a useful prognostic tool in the treatment of this disease. © Copyright by Wroclaw Medical University.Öğe Distal ileal perforation secondary to ingested foreign bodies(2009) Yagmur Y.; Ozturk H.; Ozturk H.A 22-year-old man was admitted with abdominal pain, nausea and vomiting secondary to ingestion of multiple foreign bodies. He was found to be in increasing distress with an increase in abdominal pain and distention and no passage of foreign bodies. Patient underwent a laparotomy. Foreign bodies removed from perforated distal ileum included 8 big size (10 cm) plastic clothes pegs, a 10 cm pencil, couple of stones, a 10 cm wood nail, nail scissors and a small size battery. In case of foreign body ingestion, especially in mentally-ill patients, the patient should be carefully examined because of the potential risk of obstruction and bowel perforation, more so, if the foreign body is a battery which can puncture causing corrosive injury as well.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 nitric oxide on esophageal alkali burns(Turkish Society of Gastroenterology, 1999) Yagmur Y.; Ozturk H.; Kara I.H.; Kiraz M.The aim of this experimental study was to evaluate the effects of nitric oxide on esophageal alkali burns. Thirty Spraque-Dawley rats weighting between 225 and 250 gram were used. Rats were randomly divided into three groups. In Group I rats (control), the esophageal lumen was washed with normal saline, in Group 2 the distal esophagus was burned with 50% NaOH solution as described by Gehanno and in Group 3 the esophageal lumen was washed with L-Arginine Methyl Ester (10 mg/kg) following esophageal burning. All rats were killed at 21 days and histopathologically evaluated for submucosal collagen increase, muscularis mucosa and tunica muscularis damage. There was no submucosal collagen increase, muscularis mucosa or tunica muscularis damage in Group 1. There was a significant difference for in submucosal collagen increase, muscularis mucosa and tunica muscularis damage when Group 2 was compared with Group 1 (p<0.0001, p<0.0001, p<0.0001) and when Group 3 was compared to Group 1 (p<0.001, p<0.05, p=0.05), There were also significant differences in the three parameters when Group 2 was compared with Group 3 (p<0.003, p<0.05, p<0.001). Nitric oxide may reduce submucosal collagen synthesis, muscularis mucosa and tunica muscularis damage in esophageal alkali burns but its effect in the prevention of stricture is not known.Öğe Intestinal ischemia, bacterial translocation, and oxygen free-radical production in abdominal compartment syndrome(2009) Yagmur Y.; Ozturk H.; Guloglu C.; Geyik M.F.; Ozturk H.; Mete F.Objectives. The aim of this experimental study was to evaluate the consequences of increased intra-abdominal pressure on the small bowel and whether this pressure creates intestinal ischemia leading to oxygen free-radical production and bacterial translocation. Material and Methods. Twenty Sprague-Dawley rats weighing 275-300 g were used. Group 1 rats (n = 10) were subjected to 20-mm Hg pneumoperitoneum pressure for 60 minutes. In group 2 rats (n = 10, controls) the intra-abdominal pressure was not increased. In all rats the following parameters were investigated: mean arterial pressure after carotid catheterization, histopathological examination of the intestinal mucosa evaluated with a scoring system, malondialdehyde production in the liver and small bowel, and bacterial translocation towards the mesenteric lymph nodes, liver, and spleen 24 hours after pneumoperitoneum deflation. Results. The mean arterial pressure exhibited no alterations. Histological analysis mainly showed extensive epithelial separations from the lamina propria down the sides of the villi and ulceration at the villus tips in the rats with increased intra-abdominal pressure. Bacterial translocation occurred to the mesenteric lymph nodes, spleen, and liver after 60 minutes of increased intra-abdominal pressure of 20 mm Hg (p < 0.05). Malondialdehyde increased in the liver and small bowel mucosa (p < 0.05 for both). Conclusions. Increased intra-abdominal pressure in rats leads to intestinal ischemia and mild histological changes in the small bowel and to oxygen free-radical production and bacterial translocation. © Copyright by Wroclaw Medical University.Öğe Isolated complete transection of the common bile duct following blunt abdominal trauma(1999) Dokucu A.I.; Ozturk H.; Bukte Y.; Otcu S.; Onen A.; Yucesan S.Isolated complete transection of the common bile duct following blunt trauma in children is extremely rare. Clinical findings in the early and late period of trauma are different. Here, we presented a 3-year-old girl who had a delayed admission to hospital for blunt abdominal trauma and was diagnosed to have an isolated complete transection of the common bile duct during laparotomy. The diagnostic difficulties of this rare injury were discussed.Öğe A rare cause of acute abdomen in childhood: primary omental torsion(2002) Ozturk H.; Kaya M.; Otcu S.; Kilinc N.We examined the fact that 12 years old obese girl who applied to our clinic with acute abdomen symptoms and we determined primer omental torsion (POT) at laparotomy in this case. This disease is rare in childhood and imitates the signs of acute appendicitis. Obesity and anatomic variations ofthe omentum are predisposingfactorsfor POI ln this study we wanted to share our experiences in diagnosis and treatment ofPOIÖğe An unusual cause of acute abdominal pain in children: Biliary ascariasis(1999) Dokucu A.I.; Ozturk H.; Bukte Y.; Ece A.; Otcu S.; Yucesan S.Ascariasis is one of the most common worldwide helminthic disease that may cause various complications. The presence of this worm in the biliary tree, however, is a rare condition, especially in children. We describe a child with biliary ascariasis who was presenting clinical symptoms mimicking surgical acute abdomen. The diagnosis was made by ultrasound. The child was successfully treated with mebendazole and antispasmolytic. Biliary ascariasis should be added to the differential diagnosis of acute abdominal pain in patients, even in children, from endemic areas.
