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    Acute-Phase Changes in Children Recovering from Minor Surgery
    (SPRINGER, 1998) Günel, E.; Çağlayan, O.; Çağlayan, F.; Şahin, T. K.
    The metabolic response to surgical stress is a nonspecific increase in hepatic synthesis of some specialized acute-phase proteins and a decrease in plasma concentrations of visceral proteins following surgical trauma. This study was undertaken determine which specific proteins were the better clinical indices in monitoring the metabolic response to surgical stress in children recovering from minor surgery. Forty-four patients undergoing elective inguinal surgical procedures under general anesthesia were studied. Blood samples were collected preoperatively (-1) and at 1(+1) and 5(+5) days postoperatively to determine albumin (AL), Prealbumin (PA), C-reactive protein (CRP), and al-acid glycoprotein (AGP) values, and to calculate the prognostic inflammatory and nutritional index (PINI). Mean AL values were the same on all days. Mean PA +1 was significantly lower than PA -1 and PA +5 (P < 0.001). Median CRP +1 and mean AGP +1 values were significantly higher than median CRP -1 and mean AGP -1 (P < 0.0001), respectively. Although there was a decrease after postoperative day i, median CRP + 5 and mean AGP + 5 values were still significantly higher than preoperative values (P < 0.01 and P < 0.0001). Moreover, the median PINI + 1 was also greater than PINI -1 and PINI +5 (P < 0.0001), but the median PINI+5 was significantly higher than PINI -1 (P < 0.01). Median percent changes of PINI values were significantly higher than those of the other parameters from both preoperatively to postoperative day I and preoperatively to postoperative day 5. Although several specific proteins (AL, PA, CRP, and AGP) have been evaluated as indicators of the acute metabolic response, we suggest that the PINI is more valuable for reflecting the response to surgical stress in patients recovering from minor surgery.
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    Gastrointestinal Malignitelerde Fukoz ve Fukozidaz
    (1997) Çağlayan, O.; Ersöz, B.; Menteş, G.; Osmanoğlu, N.
    Amaç: Serum glikoproteinlerindeki değişimler malignitelerde karakteristiktir. Son zamanlarda protein bağlı karbonhidratlar kanserde glikoprotein seviyesinin bir göstergesi olarak incelenmektedir. Bu çalışmada, gastrointestinal malignitelerde, L-fukoz ile onun enzimi a-L-fukozidaz’daki değişimleri incelemek amaçlanmıştır. Yöntem: Kontrol (n20), siroz (n20) ve gastrointestinal malignite (n20) gruplarının Proteine bağlı fukoz (PBF) değerleri Dische ve Shettles’in yöntemiyle tayin edildi. M fraksiyonu için Tatsumura’nın ekstraksiyon yöntemi uygulandı. G fraksiyonu totalden M çıkarılarak hesaplandı. a-L-fukozidaz aktivitesi 37 oC’de 1 saatte parçalanan p-nitrofenil a-L-fukozid’in 1 ml’de nanomol cinsinden miktarı şeklinde belirlendi. Total protein biüret yöntemiyle ölçüldü. Bulgular: PBF değerleri kontrol, siroz ve malignite gruplarında sırasıyla 7.331.36, 13.162.88 ve 14.533.25 mg/dl; a-L-fukozidaz değerleri 319.299.5, 463.6215.9 ve 528.5347.3 nmol/ml/saat idi. Total fukoz, G ve M fraksiyonları, fukoz/protein oranı ve a-L-fukozidaz malign grupta, kontrol grubuna göre anlamlı şekilde yüksekti (fukozidaz için p0.02, diğerleri için p0.001). Fakat malign-siroz karşılaştırmasında yalnız total fukoz/protein oranı anlamlı şekilde yüksekti (p0.05). Sensitivite, spesifite ve teşhis doğruluğu yönünden (% 70’in üzerinde) olumlu sonuçlar elde edildi. Sonuç: a-L-fukozidaz ve özellikle fukozun gastrointestinal malignitelerde ümit vaat eden tümör belirteçleri olduğunu tesbit ettik. Bu bulgular malignitede fukoz metabolizmasının daha ileri araştırılması yönünde teşvik edicidir.
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    Helicobacter Pylori and Hypergastrinemia in Children with Recurrent Abdominal Pain
    (SPRINGER VERLAG, 1998) Günel, E.; Fındık, D.; Çağlayan, O.; Çağlayan, F.; Topgaç, Z.
    Recurrent abdominal pain (RAP) is a significant problem in the pediatric population, and there has been much recent interest in the role that Helicobacter pylori (Hp) might play in this disorder. In this case control study, the authors aimed to determine whether Hp is an agent responsible for RAP, and to assess fasting gastrin concentrations in children with and without RAP in the Hp-positive and -negative groups. The study was conducted in 42 patients with RAP and 50 healthy children attending routine day-case surgery as a control group, aged 3 to 15 years, over a 12-month period. Of the 42 children with RAP, 30 were seropositive (71.4%) for Hp IgG, and of 50 children in the control group, 32 were seropositive (64%) for Hp IgG (P > 0.05). We found that Hp infection was as high in healthy children as in children with RAP. The mean fasting gastrin levels in 62 Hp-seropositive children (60.4 ng/l) were not different from those in 30 Hp-seronegative children (57.3 ng/l) and those in 42 children with RAP (58.2 ng/l) were also not significantly different from those in 50 healthy children (62.9 ng/l). Thus, no association between childhood Hp infection, hypergastrinemia, and RAP was found in our Turkish population.
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    Serum D-Lactate Levels as a Predictor of Intestinal Ischemia-Reperfusion Injury
    (SPRINGER VERLAG, 1998) Günel, E.; Çağlayan, O.; Çağlayan, F.
    Currently, no serum marker has proved helpful in diagnosing intestinal ischemia and reperfusion (I/R) injury. An experimental study was conducted to determine the value of serum D-lactate in detecting intestinal I/R injury. Thirty New Zealand White rabbits were divided into three groups of 10 animals each: sham-operation controls (S); I/R; and I/R plus mannitol treatment (M). Serum samples were obtained before operation (T-0), at the end of the ischemic period (T-1), after the first 30 min of reperfusion (T-2), and at the end of the reperfusion period (T-3) In Group S, mean D-lactate levels for T-0, T-1, and T-2 were 0 mu g/dl, while T-3 was 5.8 +/- 4.7 mu g/dl. Before the operation (T-0), Serum mean D-lactate levels were 0 mu g/dl in all groups (S, I/R, M). Levels increased after 1 h of ischemia (T-1) in groups I/R (83.5 +/- 25.6 mu g/dl) and M (89.8 +/- 19.9 mu g/dl), but not in group S (0 mu g/dl). The mean T-2 level in group I/R (231.6 +/- 78.6 mu g/dl) was statistically higher than in group M (140.1 +/- 53.5 mu g/dl) (P = 0.007). At the end of the reperfusion period, the mean T-3 level in group I/R (698.4 +/- 360.4 mu g/dl) was significantly higher than in group M (158.7 +/- 61.4 mu g/dl)(P = 0.000). In group I/R, mean D-lactate levels changed significantly at each time point (T-1 vs T-2, P = 0.001; T-2 VS T-3, P = 0.004). However, in group M the increase from T-1 to T-2 was significant (P = 0.012), but that from T-2 to T-3 was not (P = 0.293). As a result, the mean T-3 level was significantly higher than the T-2 level in group I/R (P = 0.004), but not in group M. This study confirmed a significance rise in D-lactate levels in animals with I/R injury compared to sham-operated and I/R injury plus M treatment. We suggest that serum D-lactate levels could be a useful marker of intestinal I/R injury before laparatomy.