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Öğe 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.Öğe 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.Öğe Isolated Bowel Segment Created by Omentoenteropexy: Histologic Findings(SPRINGER VERLAG, 1997) Günel, E.; Tavlı, L.; Çağlayan, F.; Gündoğan, A. H.An isolated bowel segment (IBS) is a viable loop of bowel that is completely free of its mesenteric attachments. In this study, omentoenteropexy (OEP) was performed in 5-cm-long IBS of rats in order to provide neovascularization. Thirty-two rats were divided into four groups. After OEP, mesenteric division of the IBSs was performed at successive 1 week intervals in each group (3-6 weeks). The bowel-wall structures were histologically examined 2 days after division of the mesentery. Ischemic changes were observed in the group in which the interval was shorter than 4 weeks. In the IBSs that were supplied by the pediculated omental flap for 4 or more weeks no ischemic changes were noted in the mucosa, muscle layers, or intramural ganglia. We conclude that an IBS that preserves normal bowel structures can safely be created in the rat when its mesentery is divided 4 weeks after OEP. Physiological studies of motility and absorption can be performed and longitudinal tubularization may enable such an IBS to be used in short-bowel syndrome.Öğe Nonadrenergic, Noncholinergic Responses of the Human Colon Smooth Muscle and the Role of K+ Channels in These Responses(PROUS SCIENCE, SA, 2001) Şahin, A. S.; Atalık, K. E.; Günel, E.; Doğan, N.The aim of the present study was to investigate the possible role of notric oxide (NO) as a nonadrenergic, noncholinergic (NANC) mediator in human colon smooth muscle in vitro and to examine its possible interactions with K+ channels. In the presence of atropine (10(-6) M) and guanethidine (10(-5)M).. electrical field stimulation (EFS, 1-10 Hz, 0.3 msec, 50V) for 10 sec induced relaxations which were inhibited by tetrodotoxin (10(-6) M). in the presence of N-G-nitro-L-arginine methyl ester (L-NAME, 10(-4) M), relaxations induced by EFS at 1, 2, 4, 8 and 10 Hz were reduced by 38.7 +/- 4.3, 31.5 +/-3.8, 54.3 +/-5.4, 59.8 +/- 4.5 and 68.6 +/- 5.3% respectively. THe relaxations inhibited by L-NAME were restored by the preincubation of L-argarinine (L-ARG, 10(-3) M) at all frequencies tested. D-Arginine (D-ARG, 10(-3) M) had no effect. Tetraethylammonium (TEA, 10(-4) M) or glibenclamidine (10(-6) M) significantly decreased the relaxations induced induced by EFS. Exogenously applied sodium nitroprusside caused concentration-dependent relaxation with prusside. In conclusion, our data indicate that NO is involved in NANC nerve-mediated relaxation in the human calcium-dependent and ATP-sensitive K+ channels.Öğe 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.Öğe Surgical Procedures and Outcome in High or Intermediate Risk Neuroblastoma: Preliminary Report(JOHN WILEY & SONS LTD, 2010) Köksal, Y.; Günel, E.[Abstract not Available]Öğe Ultrasound-Guided Percutaneous Drainage in the Treatment of Children with Hepatic Hydatid Disease(SPRINGER VERLAG, 1997) Dilsiz, A.; Açıkgözoğlu, Saim; Günel, E.; Dağdönderen, L.; Köseoğlu, B.; Gündoğan, A. H.The present study was designed to establish the safety and efficacy of ultrasound-guided percutaneous drainage in the treatment of hepatic hydatid cysts In children. A total of 14 cysts in eight patients were drained under aseptic conditions and continuous ultra sound guidance. An 18-G needle was used for puncture and silver nitrate solution as the scolecoidal agent. All procedures were successful. During follow-up, repeated ultrasound examinations revealed a progressive decrease in cyst size and an alteration in the cyst echopattern. None of the patients had a rise in hydatid antibody titer. There were no immediate or late complications. We conclude that the safety and efficacy of ultrasound-guided percutaneous drainage are satisfactory for the treatment of hepatic hydatid cysts in children.Öğe An Unusual Case Of Testicular Ectopia(SPRINGER VERLAG, 1996) Günel, E.; Gündoğan, A. H.A testis is termed ectopic when it lies outside the normal line of descent. A case of testicular ectopia in which the testicle was located cranial and lateral to the internal ring dorsal to the external oblique muscle is reported in a 2-month-old boy. This highly aberrant ectopic testis was treated succesfully by orchiopexy; as far as we know, this is the second such case in the literature.
