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Öğe The effect of N-acetyl cysteine on serum glutathione, TNF-alpha and tissue malondialdehyde levels in the treatment of sepsis(TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2011) Gul, Mehmet; Ayan, Murat; Seydanoglu, Abdusselam; Cander, Basar; Girisgin, Sadik; Erayman, Ibrahim; Erdem, SamiBACKGROUND The aim of this study was to investigate the effects of N-acetyl cysteine (NAC) on the levels of reactive oxygen species in sepsis. METHODS In this study, 30 Sprague-Dawley female rats weighing 180-200 g were used. Rats were randomized into three groups, each containing 10 rats, as follows: Group I: Sham, Group II: Sepsis and Group III: Sepsis+NAC. Group I underwent only laparotomy. In Groups II and III, sepsis was induced by cecal ligation and perforation (CLP) technique. NAC (20 mg/kg/day) was administered orally to Group III at 0, 8 and 16 hours. At the 24th hour, tissue and blood samples were taken for erythrocyte glutathione (GSH) and serum tumor necrosis factor (TNF)-alpha levels, histopathological determination, and lung, liver and kidney tissue malondialdehyde (MDA) analyses. RESULTS Group III was significantly different from the other groups with respect to erythrocyte glutathione, serum TNF-alpha and kidney MDA levels (p<0.05). There was no significant difference between the groups regarding liver MDA levels and histopathological parameters for lung, liver and kidney (p>0.05). CONCLUSION NAC treatment had beneficial effects on erythrocyte GSH, serum TNF-alpha, lung function, and kidney MDA levels in sepsis-induced rats. However, this beneficial effect was not confirmed as histopathological improvement. Further research is needed to prove the effect of NAC in sepsis treatment.Öğe The effectiveness of various doses of octreotide for sulfonylurea-induced hypoglycemia after overdose(HEALTH COMMUNICATIONS INC, 2006) Gul, Mehmet; Candler, Basar; Girisgin, Sadik; Ayan, Murat; Kocak, Sedat; Unlu, AliThis study was conducted to investigate the effectiveness of various doses of octreotide in reducing hypoglycemic attacks and the need for dextrose in patients with refractory and recurrent hypoglycemia related to sulfonylurea toxicity. This study was carried out at the Center of Experimental Research of Selcuk University Merann School of Medicine in Konya, Turkey. A total of 40 New Zealand rabbits of both sexes, weighing between 2500 and 3000 g, were used in this experiment. Rabbits were randomly divided into 4 groups, each of which consisted of 10 animals. All animals were given oral glidazide 100 mg. For the treatment of hypoglycemic attacks in group 1, only 15 mL of 50% dextrose (7.5 g) was given intravenously; in groups II, III, and IV, octreotide was given in doses of 25 mu g, 50 mu g, and 100 mu g, respectively. Octreotide was given to groups II, III, and IV at the 8th hour (when hypoglycemic attacks were induced), along with an intravenous infusion of an additional 15 mL of 50% dextrose (7.5 g) for each hypoglycemic attack that occurred. After the toxic dose was given, the rabbits were given the amount of dextrose used before and after octreotide administration, and the numbers of hypoglycemic attacks were recorded. The values of blood glucose for all animals were read every hour on the hour from the beginning of the study, and the study ended at the 24th hour, when hypoglycemic attacks stopped. A significant difference was observed between groups I, II, and IV in numbers of hypoglycemic attacks that occurred and dextrose doses given between 9 and 24 h (P=.001). The findings of this study suggest that a single dose of octreotide 100 mu g may be used to reduce the number of refractory and recurrent hypoglycemic attacks that occur because of sulfonylurea overdose; large prospective studies are needed to validate these findings.Öğe Prediction of prognosis in patients with epidural hematoma by a new stereological method(TOHOKU UNIV MEDICAL PRESS, 2007) Kalkan, Erdal; Cander, Basar; Gul, Mehmet; Girisgin, Sadik; Karabagli, Hakan; Sahin, BunyaminEpidural hematoma (EH) is a serious clinical event observed in 2% of head trauma patients. Studies regarding the effects of epidural hematoma volume (EHV) on prognosis are not sufficient. In this study, we applied the volume fraction approach of the stereological method to estimate the hematoma to brain volume fraction (HBVF), and investigated the relation between the HBVF and prognosis. Fifty-nine EH patients (46 male and 13 female subjects, with average age of 21 years) admitted to the emergency clinic were included. The HBVF was estimated on the printed films of cranial computed tomography scans. For this purpose, common point counting grids were superimposed over the scan frames. According to the clinical results, patients were divided into three groups as complete recovery (43), disability (8) and exitus (8). The HBVF was compared with the clinical results. HBVF was determined as 4.6% in the patients with recovery, 8.1% in disability, and 7.6% in exitus patients. The HBVF values were lowest in recovery patients, and the difference between the recovery and the other two groups was statistically significant (p = 0.007). However, there was no statistically significant difference in HBVF between disability and exitus patients (p > 0.05). In conclusion, the HBVF can be an important tool to determine prognosis, and it can be measured using the volume fraction approach of stereological methods as developed in the present study.Öğe Prognostic value of serum zinc levels in critically ill patients(W B SAUNDERS CO-ELSEVIER INC, 2011) Cander, Basar; Dundar, Zerrin Defne; Gul, Mehmet; Girisgin, SadikPurpose: We investigated the hypothesis that a decline in serum zinc concentrations among critically ill patients is related to mortality, length of stay in the intensive care unit, and Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment (SOFA) scores. Materials and Methods: All the patients (>= 18 years old) presenting to the intensive care unit from September 2009 through November 2009 were enrolled the study. Patients' demographic characteristics and Acute Physiology and Chronic Health Evaluation and SOFA scores were recorded. Blood samples were collected within 24 hours after admission and analyzed for serum zinc, copper, C-reactive protein, and albumin levels. Patients were followed up for mortality and length of stay in the intensive care unit for 28 days. Results: A total of 36 patients, with a median age of 70.5 years (range, 18-87 years), were enrolled during the study period. Serum zinc levels were found to be inversely correlated with SOFA scores (r = -0.41, P < .01). Patients with SOFA scores of 8 or higher had significantly lower serum zinc levels compared with patients with SOFA scores lower than 8 (6.74 +/- 1.63 and 9.17 +/- 2.76 mu mol/L, respectively; P < .01). Conclusion: The result of this study supports the fact that organ failure and critical illness lead to a decline in serum zinc concentrations and that administration of zinc may be beneficial for critically ill patients. (C) 2011 Elsevier Inc. All rights reserved.Öğe The prognostic value of trauma scoring systems for gunshot injuries(PROFESSIONAL MEDICAL PUBLICATIONS, 2011) Bozdemir, Mehmet Nuri; Cander, Basar; Dur, Ali; Kocak, Sedat; Dundar, Defne Zerrin; Uyar, Mehmet; Girisgin, SadikObjective: We aimed to evaluate the trauma scoring systems on gunshot injured patients to predict trauma severity. Methodology: All patients with gunshot injury admitted to the emergency department (ED) from January 2007 through January 2009 were enrolled in the study. The demographic characteristics of patients such as age, gender, cause of the injury, type of the weapon used, the injured body parts, Glasgow Coma Scale (GCS), Shock Index (SI), the length of stay in the hospital and mortality were recorded from the patient charts. Injury Severity Score (ISS), Revised Trauma Score (RTS) and Trauma and Injury Severity Score (TRISS) have been calculated. The differences between the groups for these parameters were compared using the Mann-Whitney U test. Results: The mean age of patients was 33.2 +/- 16.1 and 79 of 87 patients were mate. The causes of GSIs were homicidal in 73.6% and bullet cartridge in 51.7%. Calculated GCS, ISS, RTS, TRISS and SI were 13.8 +/- 2.9, 13.0 +/- 9.3, 7.38 +/- 1.1, 93.9 +/- 14.9% and 1.9 +/- 0.9 respectively. GCS, RTS and TRISS scores for survivors were significantly higher than non-survivors (p<0.001). ISS score and SI for survivors were significantly lower than non-survivors (p<0.001). There were no statistically significant differences between the groups in terms of the length of stay in hospital (p>0.05). There was no statistically significant correlation of the length of stay in hospital with GCS, RTS and TRISS (p>0.05). The length of stay in hospital was found to correlate with ISS and SI positively (p<0.001). Conclusion: It is concluded that Gun Shot Injury (GSI) is much more likely in young males than the other types of trauma in the population. We recommend that trauma scoring systems should be used to show trauma severity and mortality.
