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Öğe Determination of operation time in colorectal diseases: Preoperative chemotherapy application(ACADEMIC PRESS INC ELSEVIER SCIENCE, 2005) Sahin, M; Erikoglu, M; Ozer, S; Tekin, A; Boz, S; Golcuk, M; Avunduk, MCBackground. Our aim was to determine the time it takes for wound healing to return to normal in cases where patients have undergone preoperative chemotherapy. Materials and methods. Eighty-four Wistar-albino rats were included in the study. Twelve of them were placed in the control group (Group 1), with no further drug administration. Another 12 rats were placed in a sham group (Group 11) and were peritoneally injected with 1 cc of isotonic saline solution 5 days a month, for a period of 6 months. The remaining 60 rats were placed in five chemotherapy groups (Groups III-VII) and were administered 20 mg/kg 5-fluorouracil through peritoneal injection, 5 days a month for a period of 6 months. At the end of the sixth cure, 12 rats from the control (Group 1), sham (Group II), and chemotherapy groups (Group III) were operated on, and an intestinal transsection. was applied to the rectosigmoid junction, followed by one-by-one anastomosis using 5/0 vicryl. Other groups (Groups IV-VI) with chemotherapy treatment were operated on at 1-week intervals and subjected to the same procedure. The subjects were reoperated on on the eleventh day. A full-layer 4 x 4 cm piece was removed from the abdominal wall containing the previous incision line at the middle, for tensile strength pressure measurements. In addition, a 4 cm colon segment was removed for bursting pressure measurements. Plasma albumin and tissue hydroxyproline levels were measured, and fibroblast numbers were counted in the sections prepared from the abdominal wall. Results. The control and sham groups were found to be similar to each other with respect to all parameters measured (P > 0.05). Significant reductions were observed in all parameters in the early chemotherapy groups compared with the control and sham groups (P <0.05). All parameters measured in Groups V, VI, and VII were found to be similar to those in the control and sham groups (P <0.05). Conclusion. Wound healing is impaired in rats with chemotherapy, but following the second week after the chemotherapy, disrupted parameters return to their normal levels. (C) 2005 Elsevier Inc. All rights reserved.Öğe Effects of gender on the severity of sepsis(SPRINGER, 2005) Erikoglu, M; Sahin, M; Ozer, S; Avunduk, MCPurpose. To investigate the differences between male and female rats and the effects of sex hormones on tissue changes in the lung and liver in a sepsis model. Methods. Sixty Sprague-Dawley rats were divided into six groups of ten. Groups 1 and 2 were the control male and female groups, respectively, subjected only to sepsis; groups 3 and 4 were the male and female groups, respectively, subjected to sepsis, then given 0.04 mg/kg estrogen + progesterone (E-P) intramuscularly (i.m.); and groups 5 and 6 were the male and female groups, respectively, subjected to sepsis, then given 0.5 mg/kg testosterone ( T) i.m. The rats were killed and the histopathological changes in the lung and liver were examined, and plasma endotoxin levels were measured. Results. Histopathological examination revealed less congestion, portal inflammation, and focal necrosis of the liver, and less congestion, edema, and emphysematous and inflammatory changes in the lung in the E-P groups than in the other groups. Moreover, signs of systemic endotoxemia in plasma were proportionally less in the female rats and in the E-P groups than in the male rats and the T groups. Conclusion. Female rats subjected to sepsis showed less liver and lung tissue damage and less systemic endotoxemia than male rats, because of the effects of female sex hormones.Öğe The effects of serum estrogen levels on hypoxemia and blood nitric oxide levels in experimental hepatopulmonary syndrome(WILEY, 2005) Yol, S; Erikoglu, M; Toprak, SS; Tavli, S; Tavli, LBackground: Hepatopulmonary syndrome (HPS) is a well-defined cause of hypoxemia in patients who have liver disease due to abnormal intrapulmonary vascular dilatation. The pulmonary symptoms of HPS are the result of oxygenation defects that occur as a result of acquired dilatations of the pulmonary blood vessels. In this study, we investigated the effects of estrogen and nitric oxide (NO) in experimental HPS, especially in intrapulmonary vascular dilatation. Methods: Fifty female Sprague-Dawley rats were used in this study. The animals were divided into five groups of 10. Group I (the control group): the common bile duct (CBD) was dissected but not ligated. Group 2 (the cirrhosis group): the CBD was ligated. Group 3 (the cirrhosis + oophorectornized group): the CBD was ligated and a bilateral oophorectomy performed. Group 4 (the cirrhosis + estrogen group): the CBD was ligated and exogenous estrogen (5000 U/kg) given. Group 5 (the control+ estrogen group): the CBD was dissected, but not ligated and exogenous estrogen (5000 U/kg) given. A 5-week waiting period was observed for the development of cirrhosis and the rats' lungs and liver were taken for histopathological examination. Pulmonary vessel diameters were measured. The total bifirubin, direct bilirubin, alkaline phosphatase (ALP), estrogen and serum nitric oxide (NO) levels were measured. Results: The mean perialveolar vessel diameters were significantly higher in the cirrhotic rats (Groups 2, 3, and 4) than the control and control + estrogen administered groups. Again, when we compared the cirrhosis + oophorectornized group and the cirrhosis + estrogen group, the mean perialveolar vessel diameter was significantly lower in the cirrhosis + oophorectornized group than the cirrhosis + estrogen administered group (p = 0.001). The mean perialveolar vessel diameter in the cirrhosis + oophorectornized group was significantly lower than the cirrhosis group (p = 0.01). When we compared the cirrhotic rats (Groups 2, 3, and 4) and the control group, the plasma NO levels were significantly higher in the cirrhotic rats than the control group (p < 0.001). Among the cirrhotic rats, the plasma NO levels were 47.2 +/- 0.7 and 70.9 +/- 1.5 mu mol/l in the cirrhosis + oophorectomized group and the cirrhosis + estrogen administered group, respectively (P = 0.004). Conclusions: We consider that raised levels of estrogen have a potential role in intrapulmonary vascular dilatation and hypoxemia in HPS. Also, we consider that this effect of estrogen is due to increased levels of NO. Antiestrogenic surgical therapy may decrease the serum estrogen and NO levels, and may decrease the diameter of perialveolar vessels in order to relieve hypoxia in cirrhotic cases. (c) 2005 Elsevier B.V. All rights reserved.Öğe Electron-microscopic alterations of the peritoneum after both cold and heated carbon dioxide pneumoperitoneum(ACADEMIC PRESS INC ELSEVIER SCIENCE, 2005) Erikoglu, M; Yol, S; Avunduk, MC; Erdemli, E; Can, ABackground. Carbon-dioxide (CO2) is used universally as an insufflation agent to create a laparoscopic pneumoperitoneum. In this study, we aimed to examine the electron and light microscopic alterations of the peritoneum after both cold-dry and heated-humidified CO, pneumoperitoneum. Materials and methods. Thirty male Sprague-Dawley rats were used in this study. The rats were separated into three groups each comprising 10 rats. Group-I: (Control group): Gas insufflation was not applied to these animals. Group-II: These animals received standard cold-dry (21 degrees C, 2% relative humidity) CO2. Group-III: These animals received heated-humidified (40 degrees C, 98% relative humidity) CO2. In groups II and III, peritoneal gas was emptied 2 h after pneumoperitoneum. application. All rats were killed after 12 h. Peritoneal samples were examined both by scanning electron and light microscopy by two different pathologists who were not aware of the groups. Results. According to light microscopic examination; in group II and III, cellular response (increased lymphocyte) was significantly higher than the control group (P < 0.01). Similarly, in group II cellular response was significantly higher than group Ill. (P < 0.01). There was no difference in increased capillarity among all groups. (P > 0.05). According to scanning electron microscopic examination, in group I, normal peritoneum was covered by a sheet of flat mesothelial cells densely covered with microvilli. No intercellulary clefts and no free basal lamina were detected. In group II, drastic alterations of the surface layer were seen. The mesothelial cells had extreme desquamation, and the basal membrane was clearly visible. In group III, the mesothelial cells had bulged up to the surface layer and retracted. Intercellulary clefts become visible, but the basal lamina was not seen. Conclusions. Electron and light microscopic examination revealed that heated-humidified CO results in less peritoneal alteration than cold-dry CO2. Accordingly, we believe that heated-humidified CO2 is more suitable for pneumoperitoneum. application in laparoscopic surgery especially in selected cases. (c) 2005 EIsevier Inc. All rights reserved.Öğe Ethical and economical appreciation of living nonrelated donors renal transplantation from outside Turkey(ELSEVIER SCIENCE INC, 2004) Erikoglu, M; Tavli, S; Tonbul, ZFor patients with chronic renal failure organ demand has increased all over the world. Serious ethical problems have appeared with attempts to increase the number of organs from both living and cadaveric donors. The demand for transplantable organs is greater than the supply. The increasing number of patients waiting for transplantation has forced them to illegally obtain organs from living nonrelated donors (LNRD). This effort can result in serious complications for both recipient and donor. According to our regulations, commercial transplantation has been prohibited in Turkey, because of the possibility of abuse by an organ trade. In this study, we examine the complication, economics, and ethics concerning six patients operated outside our country.Öğe Fournier's gangrene after renal transplantation(OXFORD UNIV PRESS, 2005) Erikoglu, M; Tavil, S; Turk, S[Abstract not Available]Öğe Intraoperative determination of intestinal viability: A comparison with transserosal pulse oximetry and histopathological examination(ACADEMIC PRESS INC ELSEVIER SCIENCE, 2005) Erikoglu, M; Kaynak, A; Beyath, EA; Toy, HBackground. In this study, we aimed to measure the O-2 saturation of ischemic intestinal segments and the relationship between these measures and concomitant pathological gradings. Materials and methods. We used 14 New Zealand White rabbits, anesthetized with a combination of 80 mg/kg (i.m.) Ketamine hydrochloride and 10 mg/kg Acepromazine (i.m.). The superior mesenteric artery (SMA) was explored, and O-2 saturation was measured by pulse oximetry 5 cm proximal to the ileocecal valve at the 0th hour. At the same time a 0.5-cm. full-thickness wedge biopsy was taken from the same region. Thereafter, the SMA was ligated and the abdomen was closed. All rabbits were undertaken relaparotomy at the 4th hour; O-2 saturation was measured by pulse oximetry at 5 cm away from the region of the first biopsy and a 0.5-cm. full-thickness wedge biopsy was taken. The abdomen was then closed. The same procedure was performed at the 8th and the 12th hour. Mucosal hemorrhage, transmural congestion, mucosal necrosis, and transmural necrosis were examined in the specimens. Results. Pathologically, transmural necrosis was concomitant with 64% O-2 saturation (sensitivity: 100%; specificity: 86%). Mucosal necrosis was concomitant with 76% O-2 saturation values (sensitivity: 100%; specificity: 75%). Transmural congestion was concomitant with 81% O-2 saturation values (sensitivity: 89%; specificity: 58%). Mucosal hemorrhage was concomitant with 91% O-2 saturation (sensitivity: 100%; specificity: 31%). Conclusion. O-2 saturation measures > 76% may indicate reversible changes as mucosal necrosis, transmural congestion, or mucosal hemorrhage, and O-2 saturation measures < 64% may indicate permanent transmural necrosis. As a result, intraoperative evaluation of intestinal viability by pulse oximetry may give us an idea about the degree of pathological changes and subsequently might reduce the number of second-look operations. (c) 2005 Elsevier Inc. All rights reserved.Öğe Primary echinococcus infestation of the bone and muscles(LIPPINCOTT WILLIAMS & WILKINS, 2005) Arazi, M; Erikoglu, M; Odev, K; Memik, R; Ozdemir, MHydatid diseases of the bone and muscles are rare, generally are incurable, and have a high level of recurrence. We attempted to ascertain whether the recurrence rate decreased in patients with hydatid disease infestation of the bone and skeletal muscle who were treated with current surgical techniques and antihelminthic chemotherapy, and whether the outcomes for bone infestation were different when compared with outcomes for muscular infestation. We retrospectively reviewed 15 patients with hydatid disease of the bone (eight patients) and muscle (seven patients). The average followup was 30 months (range, 6-69 months). Recurrence was observed in four patients with bone involvement. No patient with muscle involvement had a recurrence after excision. Hydatid disease of the bone often is recurrent and progressive despite using advanced diagnostic studies, improved surgical techniques, and newly developed antihelminthic drugs. The disease status also was not as good as for patients with bone lesions when compared with patients with muscular lesions.
