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    Intestinal ischemia-reperfusion and plasma enzyme levels
    (Springer-Verlag, 2002) Çağlayan, F.; Çağlayan, O.; Günel, E.; Elcuman, Y.; Çakmak, M.
    Determination of blood levels of intracellular enzymes is an appropriate method to evaluate tissue an organ damage. To show systemic tissue damage resulting from intestinal ischemia-reperfusion, New Zealand rabbits underwent 60 min intestinal ischemia and 60 min reperfusion. Plasma samples were obtained before and at 55, 70, and 120 min after operation and enzyme levels were determined. Plasma aspartate aminotransferase (AST) showed a significant increase during reperfusion while lactate dehydrogenase (LDH) and creatine kinase (CK) levels were significantly increased at the end of ischemia and continued to be so throughout reperfusion. It is difficult to claim that enzymes arise from the intestine, but an increase of CK, LDH. and later of AST without any increase in alanine aminotransferase levels during ischemia suggests that their primary source is the injured intestine. Increased levels of plasma enzymes do not provide exact information about the location, but do reveal the presence of an injury.
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    Plasma D-lactate levels in diagnosis of appendicitis
    (Taylor & Francis Inc, 2003) Çağlayan, F.; Cakmak, M.; Çağlayan, O.; Cavusoglu, T.
    We investigated the possible use of D -lactate as a predictor in the diagnosis of appendicitis. C-reactive protein level (CRP) and leukocyte counts were also evaluated. Venous blood D -lactate, CRP, and leukocyte counts were measured preoperatively in 53 patients undergoing surgery for appendicitis, as well as in 20 healthy subjects. Levels of all three parameters in the surgical patients were significantly higher than in the control group ( p < .05). Previous studies have shown that venous D -lactate is more specific to the intestine than CPR or leukocyte count. Based on our data, venous D -lactate, which had the lowest false-negative rate among these laboratory parameters, may be a useful diagnostic marker for appendicitis. None of these parameters were helpful in identifying the type of the appendicitis.
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    Tourniquet application and epinephrine injection to penile skin: is it safe?
    (Springer-Verlag, 2002) Çakmak, M.; Çağlayan, F.; Kısa, Ü.; Bozdoğan, Ö.; Saray, A.; Cağlayan, O.
    Although a tourniquet is frequently used in penile surgery there is still no consensus on safe application time. The aim of the present study is to investigate the effect of malondialdehyde (MDA) levels and histological changes in skin flaps after penile tourniquet application and epinephrine injection. A total of 36 male white New Zealand rabbits were randomly divided into six groups each containing six animals. A Mathieu-like flap was raised in all of the groups and a tourniquet was applied and the penis was subjected to ischemia for 10, 20 and 40 min in groups 1, 2 and 3. respectively. The flaps were then allowed to reperfuse for 5 min. Biopsies for MDA measurement were harvested in these groups. Subcutaneous 1/200,000 epinephrine was injected into penile skin in group 4 and 5 rabbits and biopsies for MDA measurement were harvested 10 and 40 min after injection. The control group was anesthetized without tourniquet usage or epinephrine injection. Specimens taken from the harvested flaps of all groups were submitted for histological evaluation. The mean MDA levels in all experimental groups were higher than in the control group and the difference was statistically significant. Edema, congestion and extravasation were observed in groups 1, 2 and 3. Minimal congestion and edema were observed in group 4 and severe edema and extravasation in group 5. Tourniquet usage for a duration of less than 10 min is clearly safer than prolonged usage. Epinephrine injection to penile skin may show a deleterious effect on wound healing.