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Öğe Comparison of the therapeutic efficiency of verapamil, captopril and GBE, in prevention of the warm ischemia-reperfusion injury of kidneys(2000) Otçu S.; Özer M.; Öztürk H.; Dokucu A.I.; Gezici A.; Yücesan S.Injury related to warm ischemia is a problem in renal transplantation. In this study the therapeutic efficiency of verapamil, captopril and Ginkgo-Biloba-Extract (GBE) in prevention of the warm ischemia reperfusion injury is investigated. Fifty Sprague-Dawley rats were divided in 5 groups. Right nephrectomy was performed in the sham group while a right nephrectomy and a 30 minute ischemia and 60 minute reperfusion was applied to the left kidney in the remaining groups. Among the remaining 4 groups verapamil, captopril and GBE were administered before the ischemia while the fourth group formed the control group. All rats had a left nephrectomy on the 8th postoperative day after having a Tc 99m DMSA scintigraphy and blood urea, creatinine sampling. Kidneys were histopathologically investigated. In the three treatment groups, blood urea and creatinine levels were significantly lower than the control group and radioisotope uptake was significantly higher. When treatment groups are compared among each other, although there is no significant change in the blood urea and creatinine levels (p>O.05), radioisotope uptake is significantly higher in the GBE group and the results are statistically significant (p<0.05). Histopathologically the control group revealed gross necrosis while the captopril and verapamil group had less necrosis and glomeruli and distal tubules were preserved in the GBE group. As a conclusion, all three agents are effective in preventing warm ischemia of the kidney. GBE has a more potent effect in the prevention mechanism.Öğe Hirschsprung's disease: An 18-years experience(2002) Öztürk H.; Otçu S.; Önen A.; Dokucu A.I.; Gedik Ş.; Yücesan S.Aim: In this study, we aimed to analyse the diagnostic and therapeutic features, morbidity, mortality and long-term functional results of patients with Hirschsprung's disease, whom the majority were treated hy Duhamel-Martin procedure. Method: A total of 64 Hirschsprung's disease cases were diagnosed and treated in the department between June 1983 and February 2001. We reviewed the charts of these retrospectively and evaluated the age, sex, symptoms and signs, associated anomalies, the length of bowel involved, type of pull-through performed, functional results of treatment, morbidity and mortality of these patients. Results: There were 52 boys and 12 girls. Thirty seven percent of the cases were diagnosed below the age of one month. The most frequent presenting symptom was abdominal distention (34%). Thirteen of the cases had associated anomalies (20%). The most frequent site of aganglionosis was at the rectosigmoid (82%). A decompressing enterestomy was performed in 56 patients. Soave-Boley's and Duhamel-Martin's technique with protective colostomy were performed in 7 and 41 patients respectively. Postoperative complications were seen in 25 % of the patients. In 4 cases a Duhamed-Martin's procedure was performed without a colostomy. In the postoperative period 16 cases (25%) developed a complication. The most frequent complication was intestinal obstruction due to adhesions (33%). Preoperative and postoperative enterocolotis was found in three (2%) and 5 (9%) patients respectively. Eight children (12%) died, one related to associated anomalies and six due to sepsis one patient died from enterocolitis after the definitive procedure. In the 10 to 15 year age and the greater than 15 year age groups, functional scores were significantly increased when compared to the 5 to 10 year age group (p<0.05). A significant correlation was not found between the functional score and age of the patients. Conclusion. As a conclusion, we have used Duhamel-Martin procedure in majority of patients with Hirschsprung's disease. Long-term fonctional evaluations have shown an improvement in functional score in children older than 10 year in comparison with younger ones.Öğe The role of L-Arginine, a nitric oxide precursor, on deteriorating cardio-respiratory effects in experimentally produced traumatic diaphragmatic injury(2002) Öztürk H.; Gezici A.; Otçu S.; Dokucu A.I.; Kaya S.; Kirbaş G.; Yücesan S.Aim: In this study we aimed to in vestigate the protective effects of L-Arginine on cardio-respiratory complications in a diaphragmatig rupture model. Method: 40 Sprague-Dawley rats were used in this study. In Group I, only thoracotomy was performed. In Group II, III and IV, following left thoracotomy, the stomach was pulled into thorax and the intraabdominal pressure was increased by an insufflator. L-Arginine (L-Arg) was given in GIII and L-NAME was given in GIV at the 45th minute of the study, The parameters such as arterial blood pressure (BP), heart rate (HR), arterial blood gases analysis (pO2, pCO2, pH) and pulmonary scintigraphy were measured at the baseline, 30th, 45th and 60th minutes of the study. The left lungs were extracted for histopathological examination. Results: In the values of blood gases analysis following the performing herniation model the pO2 and pH values decreased and pCO2 values increased in GII in comparison with GI. The mean values of blood gases analysis in GIII following L-Arg infusion at the 60th minute of the study were found to be increased for pO2 and pH values and to be decreased for pCO2 values in comparison with the values of GII. Following L-NAME administration to the GIV, there was no difference found between GII and GIV. Pulmonary uptake decreased in GII, GIII and GIV when compared with GI, whereas pulmonary uptake in GIII was significantly increased in comparison with GII and GIV. Conclusion: The use of the precursor of nitric oxide, L-Arginine, may provide protective effects on cardio-respiratory complications related to organ herniation in the acute period of traumatic diaphragmatic rupture.Öğe The role of prenatal steroid and TRH treatment in rats with nitrofen induced diaphragmatic hernia(2000) Çi?dem M.K.; Dokucu A.I.; Önen A.; Otçu S.; Öztürk H.; Deveci E.; Yücesan S.The mortality of congenital diaphragmatic hernia (CDH) is high due to associated pulmonary hypoplasia and pulmonary hypertension. Thus studies aiming to prevent pulmonary hypoplasia in the prenatal period are gaining importance. In this study the role of glucocorticoids and "Thyroid releasing hormone" (TRH) on lung maturation in rats with nitrofen induced CDH is investigated. Ten pregnant Wistar-Albino female rats received nitrofen (100 mg) in two groups on their 9.5 day of pregnancy, while the control group had olive oil administered. In one nitrofen group additionally starting on day 16, glucocorticoids (0, 25 mg/kg betametazon) and TRH (25 ?g/kg) was administered for 5 days. Fetuses were delivered by ceaserean section on the 21st day of gestation and the fetal lungs were histopathologically investigated and DNA analysis and maturation were obtained. Nine fetuses in the control, 14 in the nitrofen and 7 in the treatment group could be investigated. No significant difference was identified in the morphologic evaluation and DNA analysis of the nitrofen and treatment groups. Histopathology revealed hypoplasia that was more prominent in the left lung in both groups. In conclusion the prenatal administration of TRH and glucocorticoids in prevention of nitrofen induced CDH has not been found effective. We believe this may be related to the initiation of treatment on day 16 of gestation.
