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Öğe Comparison of Effects of Somatostatine and Octreotide in the Treatment of Acute Pancreatitis(2001) Şahin, Mustafa; Avşar, Fatih Mehmet; Vatansev, Hüsamettin; Tekin, Şakir; Gürbilek, Mehmet; Karademir, Mehmet; Yılmaz, OsmanAkut pankreatit ciddi bir hastalıktır ve tedavi seçeneklerinin yararları tartışılmaya devam etmektedir. Akut pankreatitte octreotid ve somatostatin 'in etkilerini araştırmaktadır. Çalışmaya 48 adet Spraque-Dawley raflar alındı. Raflar 4 gruba ayrıldı Her grupta ana biliopankreatit duktusbağlanarak akut pankreatit oluşturuldu. Grup I; kontrol grubu, Grup II; 35 mcg/kg/4 st somotostatin kuyruk veninden yapıldı, Grup III; 1.3 mcg/kg/8 st oktreotid subkutan yapıldı, Grup IV; her iki ürün birlikte aynı doz ve aralıklarla uygulandı. Ameliyat öncesi vepost-op 48.saatte serolojik, hematolojik ve gazometrik ölçümler için kan örnekleri alındı. Katlar çalışmanın 48. saatinde sakrifiye edildiler. Pankreas, karaciğer ve akciğerden doku örnekleri alındı.Toplam 15 rat öldü ve gruplararası mortalite oranları arasında anlamlı farklılık bulundu (p0.05). Ameliyat öncesi alınan kanda çalışılan serolojik, hematolojik ve gazometrik parametreler bütün gruplarda benzerdi. Post-op 48 saat sonra, 1. grupta 8, 2. grupta 5, 3. grupta 4 ve 4. grupta 5 parametre, preoperatif sonuçlara kıyasla daha kötü bulundu. Her grupta interstisyel ödem ve iltihabi hücre infiltrasyonu gözlendi., fakat sadece 1. grupta kanama alanları görüldü. Sonuç olarak, akut pankreatitin erken döneminde tedavi amacıyla kullanıldıkları zaman somatostatin ve oktreotid'in etkili olabilecekleri kanaatindeyiz.Öğe The effects of anti-adhesion materials in preventing postoperative adhesion in abdominal cavity (Anti-Adhesion materials for postoperative adhesions)(SPRINGER/PLENUM PUBLISHERS, 2007) Şahin, Mustafa; Çakır, Murat; Avşar, Fatih Mehmet; Tekin, Ahmet; Küçükkartallar, Tevfik; Aköz, MehmetPurpose. The purpose of this study was to compare the effects of anti-adhesion materials in postoperative adhesions. Materials and Methods. Rats were assigned to five groups: Group 1: Control. Group 2: chitin layers were used. Group 3: Na- hyaluronate / carboxymethylcellulose layers were used. Group 4: Na-hyaluronate gel was poured into the abdomen. Group 5: methylprednisolone was injected. The adhesion frequency and grade were scored according to Granat. Blood was taken for Hb, AST, BUN and albumin levels determination. Findings. The adhesion frequencies (right and left) and grades were as follow in Groups; I: 82%, 91%, 2.63 +/- 1.22; II: 8.3%, 25%, 0.58 +/- 0.66; III: 17%, 33%, 1.08 +/- 1.08; IV: 50%, 58%, 1.41 +/- 1.44; V: 50%, 42%, 1.41 +/- 1.50. The adhesion phase in all study groups was found significantly low compared to control group, p < 0.05. No difference was observed among serologic and hematological parameters in all groups. Conclusion. All the materials used significantly lowered the adhesion frequency and grade.Öğe The Effects of Different Suture Techniques on Wound Healing in Abdomibnal Wall Closure(2001) Şahin, Mustafa; Karademir, Mehmet; Özer, Şükrü; Avşar, Fatih Mehmet; Çağlayan, Osman; Aksoy, Faruk; Aktan, MuratPurpose: The aim this study was to investigate the effects of different suture techniques on the healing of abdominal wall wound. Materials and Methods: 24 male Wistar albino rats were included in this study. The rats were divided into two groups. A 4 cm midline laparatomy was performed after ketamine HCl anesthesia. In Group I, the incision was sutured with 4/0 polypropylene interruptedly and in Group II, the wound was closed with 4/0 polypropylene continuously. The skin was sutured with an interrupted 4/0 silk suture. Then 2 cc of blood was withdrawn for biochemical and hematological tests by cardiac puncture. All the rats were killed on the 7th postoperative day. Tensile strength were measured and tissue samples were taken for hydroxyproline measurements and histopathological evaluation. Meanwhile intraabdominal adhesions were recorded. Results: Tensile strength was 751±31 g in Group I and 622±28 g in Group II. The difference was significant (p<0.05). Hydroxyproline levels were 3.13±0.15 µg/mg tissue in Group I and 2.81±0.15 µg/mg tissue in Group II. The difference was significant (p<0.05). Intraabdominal adhesions were found in 3 rats in Group I and in 6 rats in Group II. There was a significant difference between the two groups regarding tissue fibroblast numbers (p<0.05). There was no significant difference between serological and hematological tests in the two groups. Conclusion: Closing the abdominal wall wound with the interrupted suture technique gave better results than with the continuous suture technique.Öğe The Effects of Different Suture Techniques on Wound Healing in Abdominal Wall Closure(2001) Şahin, Mustafa; Karademir, Mehmet; Özer, Şükrü; Avşar, Fatih Mehmet; Çağlayan, Osman; Aksoy, Faruk; Aktan, MuratPurpose: The aim this study was to investigate the effects of different suture techniques on the healing of abdominal wall wound. Materials and Methods: 24 male Wistar albino rats were included in this study. The rats were divided into two groups. A 4 cm midline laparatomy was performed after ketamine HCl anesthesia. In Group I, the incision was sutured with 4/0 polypropylene interruptedly and in Group II, the wound was closed with 4/0 polypropylene continuously. The skin was sutured with an interrupted 4/0 silk suture. Then 2 cc of blood was withdrawn for biochemical and hematological tests by cardiac puncture. All the rats were killed on the 7th postoperative day. Tensile strength were measured and tissue samples were taken for hydroxyproline measurements and histopathological evaluation. Meanwhile intraabdominal adhesions were recorded. Results: Tensile strength was 751±31 g in Group I and 622±28 g in Group II. The difference was significant (p<0.05). Hydroxyproline levels were 3.13±0.15 ?g/mg tissue in Group I and 2.81±0.15 ?g/mg tissue in Group II. The difference was significant (p<0.05). Intraabdominal adhesions were found in 3 rats in Group I and in 6 rats in Group II. There was a significant difference between the two groups regarding tissue fibroblast numbers (p<O.05). There was no significant difference between serological and hematological tests in the two groups. Conclusion: Closing the abdominal wall wound with the interrupted suture technique gave better results than with the continuous suture technique.Öğe Effects of Diphenhydramine Hc1 and Methylprednisolone in the Prevention of Abdominal Adhesions(EXCERPTA MEDICA INC, 2001) Avşar, Fatih Mehmet; Şahin, Mustafa; Aksoy, Faruk; Avşar, A. Filiz; Aköz, Mehmet; Hengirmen, Süleyman; Bilici, SamiObjective: The purpose of this study was to determine the effects of diphenhydramine hydrochloride and methylprednisolone in peritoneal adhesions. Materials and methods: Forty-eight male rats were used in the study. The rats were anesthetized by 5 mg/kg ketamine hydrochloride. After opening the abdomen, 10 longitudinal incisions of 2 to 3 cm in length were made on the right parietal peritoneum, and a 2 cm(2) peritoneal layer was excised from the left abdominal wall. The abdomen was closed with 3/0 silk suture. Group I was the control group. group II was given 10 mg/kg diphenhydramine intravenously, group III was given 20 mg/kg methylprednisolone intravenously, and group IV was administered both of the drugs in the above doses. A blood sample of 2 mL was taken from the rats on the 14th day after the operation. The animals were then sacrificed. The abdomen was opened and abdominal adhesions were examined. A tissue sample of 1 g was taken from the abdominal incision line, Albumin. zinc, and hemoglobin levels and leucocyte counts in the blood were determined as well as hydroxyproline levels in the tissue. Results: Numbers of adhesions were as follows: 9 in group 1, 3 in group II and 2 in group III. No adhesion was observed in group IV. Albumin, zinc, and hemoglobin levels and leucocyte counts were found to be similar in all groups. Hydroxyproline levels in the tissue were significantly lower in groups III and IV than in groups I and II (P < 0.05). Conclusions: Diphenhydramine and methylpredrisolone reduced postoperative adhesions significantly in rats. Further investigations are needed in order to use these drugs as antiadhesive agents in humans.Öğe Effects of Oral L-Glutamine, Insulin and Laxative on Bacterial Translocation in Acute Pancreatitis(2001) Avşar, Fatih Mehmet; Özel, İ. Hakan; Baykan, Mahmut; Saygun, Oral; Şahin, Mustafa; Hengirmen, Süleyman; Ertuğrul, Ömür; Gürbilek, Mehmet; Aydın, S. NeşeAim: To investigate the effects of oral L-glutamine, insulin and laxative on the bacterial population of intestinal lumen and on bacterial translocation in acute pancreatitis. Materials and Methods: Forty Sprague-Dawley adult male rats were divided into 4 groups. Experimental pancreatitis was induced by ligating the main biliopancreatic duct. All groups were given the standard rat diet and tap water. In addition. Group II was given. 15 mg/kg/day of L-glutamine via a catheter enterally, Group III was given 3 ml of laxative via a catheter enterally, and Group IV was given 3 IU/kg/day of NPH insulin via a catheter enterally. The rats were sacrificed 96 hours after the induction of pancreatitis. Blood samples for biochemical analyses and blood culture, and culture samples from mesenteric lymph nodes, liver and spleen and from cecal content were taken. Aerobic and anaerobic cultures were prepared. Findings: Amylase levels in all the groups after the procedure increased significantly. Bacterial translocation was observed in 6 rats in the control group, in 5 rats in the insulin group, in 3 rats in the laxative group and in 2 rats in the L-glutamine group. A significant decrease in the number of luminal bacteria was observed in the laxative and L-glutamine groups. Conclusion: L-glutamine, administered in enteral solutions in rats with induced acute pancreatitis, may reduce septic complications by decreasing the bacterial translocation rate. Similar effects are also produced by laxatives through reduction in the luminal bacterial population.Öğe Effects of Oral L-Glutamine, Insulin and Laxative on the Severity of Acute Pancreatitis(2001) Avşar, Fatih Mehmet; Şahin, Mustafa; Saygun, Oral; Özel, İ. Hakan; Hengirmen, Süleyman; Vatansev, Hüsamettin; Kafalı, Ertuğrul; Yılmaz, OsmanAim: To investigate the effects of oral L-glutamine, insulin and laxative on the severity of acute pancreatitis. Materials and Methods: Forty adult male Sprague-Dawley rats were divided into 4 groups. Experimental pancreatitis was induced by ligating the main biliopancreatic duct. All groups were given standard rat pellets and tap water. In addition Group II was given 15 mg/kg/day of L-glutamine via a catheter enterally, Group III was given a 3 ml/day fleet enema via a catheter enterally, and Group IV was given 3 IU/kg/day of NPH insulin via a catheter enterally. The rats were sacrificed 96 hours after the induction of pancreatitis. Blood samples for biochemical analyses, and tissue samples from the lung and pancreas for histopathological evaluation were taken. Findings: Significant increases in amylase levels were observed after the procedure. Five parameters in the L-glutamine group (BUN, glucose, leukocyte, pO2 and SGOT), 5 parameters in the laxative group (Amylase, BUN, glucose, LDH and SGOT), and 2 parameters in the insulin group (BUN and SGOT) were better than those in the control group. While necrosis was observed in 3 rats in the control group, 3 in the insulin group and in 1 in the laxative group in the histopathological evaluation of pancreas tissue, no rats in the L-glutamine group exhibited necrosis. More severe pancreatitis was observed in the control and insulin groups (p<0.05). Conclusion: L-glutamine, administered in enteral solutions in subjects with acute pancreatitis, will not increase the severity of pancreatitis, but will aid in meeting the energy demand of the subject. Laxative may also be employed in the removal of fecal mass during the early period of the disease.Öğe Erken Postpartum Dönemde İleri Evre Hemoroid Prevalansı(2001) Avşar, Filiz; Avşar, Fatih Mehmet; Şahin, MustafaAmaç: Kronik venöz yetmezlik sonucu gelişen hemoroidlerin erken postpartum dönemde prevalansını tespit etmek. Yöntem: Vajinal yol ile doğum yapmış 1003 hastada postpartum ilk 24 saat içinde 3. ve 4. derecedeki hemoroidler ve hastaların gravidite, parite sayısı, varis olup olmadığı, kabızlık, obezite, meslek, travay süresi ve bebek kiloları tespit edildi. Bulgular: 1003 kadında 125'inde (% 12.4) 3. ve 4. derecede hemoroid tespit edildi. Ortalama yaş 26 (17-43), gravidite 2.18, parite 1, hemoroid ve varisin birlikte görülme oranı % 7.2 (n9), kabızlık % 40 (n50), obezite % 8.8 (n11), ortalama bebek ağırlığı 3312 g, % 96'sı ev hanımı, ortalama eylem süresi 4 saat bulundu. Sonuç: Gebelerde postpartum ileri evre hemoroid prevalansı yüksek olup bu dönemde önemli bir morbidite sebebi olduğu için takip, tedavi ve profilaksisi önem arzetmektedir.Öğe Meme karsinomlarında S-100, vimentin, sitokeratin ve HMB-45 ekspresyonu(2004) Hücümenoğlu, Sema; Avşar, Fatih Mehmet; Kafalı, M. Ertuğrul; Öztürk, Evrim; Erdem, Gülben; Yılmaz, Şinasi; Yalçın, ŞenayAmaç: Bu çalışmada meme karsinomu olgularında; immün belirleyicilerin ekspresyonu ile tümörlerde histolojik derece ve aksiller lenf nodu metastazı arasındaki korelasyonu araştırmak amaçlanmıştır. Yöntem: 32. invaziv duktal karsinom, 1. invaziv papiller karsinom, 1 invaziv lobüler karsinom ve 1 atipik medüller karsinom olmak üzere toplam 35 meme karsinomu olgusu incelenmiştir. Formalinle fikse edilmiş ve parafine gömülmüş dokulardan alınan kesitlere S-100, vimentin, sitokeratin (56 ve 64Kd molekül ağırlığında poliklonal), HMB-45 immünoperoksidaz yöntemi ile immünohistokimyasal boyama yapılmıştır. Bulgular: Olgularımızda immünohistokimyasal sonuçların dağılımı şöyledir. S-100 16 olguda (% 45.7), Vimentin 13 olguda ( % 37) , Sitokeratin 12 olguda ( % 34), HMB-45 12 olguda (% 34) pozitif olarak tespit edilmiştir. Vimentin ekspresyonu ile histolojik derece ve aksiler lenf nodu metastazı arasında korelasyon izlenmemiştir. Sitokeratin ve S-100 pozitifliği ile histolojik dereceler arasında anlamlı bir fark bulunmazken, bu olgularda lenf nodu metastazının daha az olduğu gözlenmiştir (P0.005). HMB45 ve – olgularda tümörlerin histolojik dereceleri arasında anlamlı bir fark olmadığı fakat olgularda aksiller lenf nodu metastazının daha yüksek oranda gözlendiği tespit edilmiştir (P0.005). Sonuç: Vimentin ve S-100 ile ilgili sonuçlarımız literatürle uyumlu olurken , HMB-45 ekspresyonu daha önce bildirilen çalışmalara göre belirgin olarak yüksek bulunmuştur.Öğe The Possibility of Nervus Ilioinguinalis and Nervus Iliohypogastricus Injury in Lower Abdominal Incisions and Effects on Hernia Formation(Academic Press Inc Elsevier Science, 2002) Avşar, Fatih Mehmet; Şahin, Mustafa; Arıkan, Bülent Ümit; Avşar, A. Filiz; Demirci, Salim; Elhan, AlaiddinAim. The aim of this study was to determine the distances of nervus ilioinguinalis and nervus iliohypo-gastricus to McBurney's and paramedian incisions. Materials and methods. This study was performed on 12 adult cadavers. Right and left inguinal regions of the cadavers were dissected by inguinal incision. The points where the nerves perforated the internal obliquus muscles were determined, and the distances of these points to the Spina iliaca anterior superior (SIAS) and to the umbilicus were measured. These distances were marked over a diagram, and distances of the nerves to McBurney's and paramedian incisions were measured by illustrating these incisions on the same diagram. Findings. While the distance of the iliohypogastric nerve from the SIAS was 1.5-8 cm on the right and 2.3-3.6 cm on the left, the distance of the ilioinguinal nerve from the SIAS was 3-6.4 cm on the right and 2-5 cm on the left. The distance of the ilioinguinal nerve from McBurney's incision was 0.2-6.1 cm on the right and 1.8-7.5 cm on the left, and that of the iliohypogastric nerve was 2.2-6.9 cm on the right and 2.9-6.2 cm on the left. The distances of the nerves from paramedian incision were found to be 4.6-10 cm on the right and 6.4-11.2 cm on the left for the ilioinguinal nerve and 5-11.2 cm on the right and 7.4-11.6 cm on the left for the iliohypogastric nerve. Conclusion. Both nerves perforate the musculus obliquus internus, scattered in a wide area. Considering the distances, the paramedian incision seems to be more reliable with respect to the risk of nerve injury. Incisions performed in the lower abdomen carry the risk of injury to the ilioinguinal and iliohypogastric nerves.
