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    Circulating leptin, zinc, and copper levels after extracorporeal circulation
    (MAGHIRA & MAAS PUBLICATIONS, 2005) Gormus, ZI; Gormus, N; Baltaci, AK; Halifeoglu, I; Mogulkoc, R
    OBJECTIVE: The role of leptin in the acute stress response to extracorporeal circulation has been well documented, however, the relationship between leptin and zinc has not been investigated previously. We aimed to research the circulating leptin, zinc, and copper levels before, during, and after the extracorporeal circulation, and effect of preoperative zinc administration to these. METHODS: Twenty patients who were taken to elective coronary artery bypass grafting operations using extracorporeal circulation were taken to this research and divided into two equal groups (n(1), n(2)). In both groups blood samples were taken just before the operation (T0), at the end of operation (T1), and at the first postoperative day (T2). In the second group (n(2)) oral zinc (50 mg, once a day) was administered to patients for 5 days, preoperatively. The serum leptin, zinc, and copper levels were studied. RESULTS: In group n(1) circulating leptin levels were significantly increased at T2 when compared to T0 and T1 (p < 0.05); zinc levels were decreased at T2 when compared to T0 and T1 (p < 0.05); copper levels were decreased at T2 when compared to T0 (p < 0.05), and decreased at T1 when compared to T0 (p < 0.05). In group n(2) circulating leptin levels were significantly increased at T2 when compared to T0 and T1 (p < 0.05); zinc levels were decreased at T2 when compared to T0 and T1 (p < 0.05); copper levels were increased at T2 when compared to T1 (p < 0.05). CONCLUSIONS: These results indicate that circulating leptin levels increase after the extracorporeal circulation as an acute response, while zinc and copper levels decrease at the same period. Preoperative zinc administration does not prevent the leptin response after extracorporeal circulation.
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    Methylprednisolone prevents inflammatory reaction occurring during cardiopulmonary bypass: effects on TNF-alpha, IL-6, IL-8, IL-10
    (SAGE PUBLICATIONS LTD, 2004) Celik, JB; Gormus, N; Okesli, S; Gormus, ZI; Solak, H
    Objective: This study examined the correlation between tumour necrosis factor-alfa (TNF-alpha), interleukin (IL)-6 and IL-8, IL-10 and methylprednisolone pretreatment. Methods: This is a prospective, randomized and double-blinded study. Sixty patients undergoing coronary artery bypass grafting (CABG) were randomized to receive either intravenous methylprednisolone (n = 30, Group M) or intravenous placebo (n = 30, Group S). The patients received intravenously either 30 mg/kg methylprednisolone ( Group M) or placebo (Group S) 10 min before and after cardiopulmonary bypass (CPB). In an intensive care unit (ICU), four additional doses were given at 6-hourly intervals. Blood samples for the measurements of TNF-alpha, IL-6, IL-8 and IL-10 were obtained before induction of anaesthesia (T0 = control value), after induction (T1), before starting CPB (T2), after aortic declamping (T3), at the end of CPB (T4) and 6 hours (T5), 12 hours (T6) and 24 hours (T7) after skin closure. Creatine kinase (CK) and creatine kinase isoenzyme MB (CK-MB) were evaluated at the following intervals: T0, T5, T6 and T7. Results: When compared with the control value, TNF-alpha, IL-6 and IL-8 significantly increased in Group S and Group M (p < 0.05), but these values were significantly greater in Group S than in Group M (p < 0.05). In comparison with the control value, IL-10 increased in both groups (p < 0.05), but was significantly greater in Group M than in Group S (p < 0.05). CK and CK-MB were increased in both groups in postoperative values compared to control values. In Group S, CK and CK-MB levels were significantly lower than in Group M (p < 0.05). Conclusion: In this study, we have found that pre-operative administration of methylprednisolone has decreased TNF-alpha, IL-6 and IL-8 release, and increased the perfusing IL-10 levels after CPB. Thus, methylprednisolone may decrease the inflammatory response during the CPB procedure.
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    Preoperative analgesia management with rofecoxib in thoracotomy patients
    (W B SAUNDERS CO, 2005) Celik, JB; Gormus, N; Gormus, ZI; Okesli, S; Solak, H
    Objective: Pain management after thoracotomy is significant because pain reduces the postoperative respiratory performance. In this study, the analgesic efficacy and safety of rofecoxib in thoracotomy patients were evaluated. Design: A prospective, randomized, double-blind, and placebo-controlled study. Setting: This study was performed in the Meram Medical School of Selcuk University Departments of Cardiovascular Surgery and Anesthesiology. Participants: Sixty patients undergoing elective thoracic surgery via thoracotomy were randomized to receive either oral placebo or rofecoxib, 50 mg, 1 hour before surgery. Interventions: All patients received a standard anesthetic. Pain scores, sedation scores, heart rate, mean arterial pressure, respiratory rate, analgesic requirements, and side effects were noted 2, 4, 8,12, 18, 24, 32, 40, and 48 hours after operation. Measurements and Main Results:There were no significant differences between the 2 study groups with respect to demographics, sedation score, intraoperative blood loss, and postoperative drainage. Compared with placebo, morphine consumption and pain scores at rest and during coughing were significantly lower with rofecoxib. Conclusions: The preoperative administration of rofecoxib, 50 mg, provides significant analgesia for postoperative pain relief and decreases additional opioid requirements after thoracotomy. (C) 2005 Elsevier Inc. All rights reserved.