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    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.
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    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.
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    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.
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    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.