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Öğe Antimicrobial activity of cefazolin-impregnated mesh grafts(Blackwell Publishing, 2007) Kılıç, Dilek; Agalar, Canan; Öztürk, Eylem; Denkbaş, Emir B.; Cime, Abdullah; Agalar, FatihBackground: The aim of this study is the preparation and characterization of cefazolin-impregnated meshes (Surgipro; Tyco Healthcare USSC, Norwalk, CT, USA) to be used as antimicrobial devices. Method: During the impregnation, poly(DL-lactide-co-glycolide) solution with cephazolin in dichloromethane was used as coating material. In vitro release experiment was carried out first; later cefazolin-impregnated meshes were evaluated for the characteristics of antimicrobial efficacy and in the last part of the study native and cefazolin-impregnated meshes were implanted in the rats. Cefazolin content was proposed as the effective parameter to control the cefazolin release rate and it was concluded that the higher amounts of initial cefazolin content caused higher release rates. In all cases (or with different cefazolin content for each mesh), the release rates were very rapid in the first 24 h and in the following periods rather slow release rates were obtained. Results: Antimicrobial activity was increased in the case of cefazolin-impregnated form and this efficiency was also increased by the higher amount of cefazolin in certain mesh pieces. Similar antimicrobial activities were observed in the in vitro studies. Conclusion: In this study, almost all of the cefazolin-impregnated mesh grafts showed very high antimicrobial activity compared with the bare mesh (or mesh without cefazolin).Öğe The Effect of Hypothermia on Splanchnic Flows and Lung in a Two-Hit Hemorrhagic Shock Model(Academic Press Inc Elsevier Science, 2010) Deniz, Turgut; Agalar, Canan; Agalar, Fatih; Comu, Faruk M.; Caglayan, Osman; Alpay, Yesim; Saygun, OralBackground. To evaluate the effect of hypothermia on bacterial translocation, splanchnic vascular flow, lung tissue weight, and levels of malondialdehyde (MDA) and nitric oxide (NO) in a two-hit model of hemorrhagic shock. Methods. Thirty rats were randomly allocated into three groups of 10 rats each. In the control group (group C), rats were treated without hemorrhage, and normothermia (37 degrees C) was maintained. In the mild hypothermia group (group MH), rats were subjected to volume-controlled hemorrhage (2 mL/100g) and a rectal temperature of 34 degrees C was maintained. In the normothermic group (group NT), rats were treated as in group MH, except for hypothermia. Seventy-two hours after hemorrhagic shock (first insult), Pseudomonas aeuruginosa was administered intratracheally as a second insult. Finally, mesenteric vascular flow patterns were recorded. Bacterial translocation was studied from tissue samples of spleen, liver, and mesenteric lymph nodes. Blood samples were obtained to evaluate the possible presence of bacteria in the bloodstream. Lung tissue weight ratio, MDA, and NO levels in lung tissue were assessed. Results. Renal, mesenteric, and portal venous flow rates were found to be lower in groups Mill and NT in comparison with group C. Blood flow profiles were lower in group NT than in group MH (P < 0.05). Bacterial translocation was not observed in group C, and it was detected more often in group NT than in group MH. Lung weight ratio was found to be higher in group NT compared with groups MH and C. Although it did not reach the level of statistical significance, MDA level in the control group was lower than that in the NT group (P = 0.085). Conclusion. Hypothermia corrected mesenteric blood flow and decreased the occurrence of bacterial translocation in the two-hit model of hemorrhagic shock and tracheal inoculaton of P. aeruginosa (C) 2010 Elsevier Inc. All rights reserved.Öğe The effect of thymoquinone coating on adhesive properties of polypropylene mesh(Bmc, 2017) Aydin, Oktay; Aydinuraz, Kuzey; Agalar, Fatih; Sahiner, I. Tayfun; Agalar, Canan; Bayram, Cem; Atasoy, PinarBackground: An incisional hernia is a common complication following abdominal surgery. Polypropylene mesh is frequently used in the repair of such defects and has nearly become the standard surgical treatment modality. Though they are very effective in reducing recurrence, mesh materials exhibit a strong stimulating effect for intraabdominal adhesion. The thymoquinone (TQ) extracted from Nigella sativa seeds has potential medical properties. TQ has antiinflammatory, antioxidant and antibacterial properties. The aim of this study is to coat polypropylene mesh with TQ in order to investigate the effect of surface modification on intraabdominal adhesions. Methods: TQ-coated polypropylene mesh material was tested for cytotoxicity, contact angle, surface spectroscopy, TQ content, sterility, and electron microscopic surface properties. An experimental incisional hernia model was created in study groups, each consisting of 12 female Wistar rats. The defect was closed with uncoated mesh in control group, with polylactic acid (PLA)coated mesh and PLA-TQ coated mesh in study groups. Adhesion scores and histopathologic properties were evaluated after sacrifice on postoperative 21th day. Results: Granuloma formation, lymphocyte and polymorphonuclear leukocyte infiltration, histiocyte fibroblast and giant cell formation, capillary infiltration, collagen content were significantly reduced in the PLA-TQ coated mesh group (p < 0.05). Though not statistically significant, likely due to the limited number of study animals, adhesion formation was also reduced in the PLA-TQ coated mesh group (p: 0.067). Conclusion: TQ coated mesh is shown to reduce adhesion formation and TQ is a promising coating material for mesh surface modification.Öğe In Vitro S. epidermidis and S. aureus Adherence to Composite and Lightweight Polypropylene Grafts(Academic Press Inc Elsevier Science, 2009) Aydinuraz, Kuzey; Agalar, Canan; Agalar, Fatih; Ceken, Sabahat; Duruyurek, Nihal; Vural, TayfunBackground. Despite the significant risk of infection, prosthetic graft materials have become indispensable for incisional hernia repair. Composite and lightweight grafts have been developed to overcome adhesion and rigidity. The aim of this study was to evaluate in vitro S. epidermidis and S. aureus adherence to these new generation grafts, which have modified composition and textile properties. Materials and Methods. In this experimental study, sterile samples of multifilament polypropylene, multifilament lightweight composite, monofilament composite, and monofilament polypropylene grafts were incubated with slime positive S. epidermidis and S. aureus strains for 24 h. The grafts were washed and vortexed in saline. The saline was passaged to blood agar and incubated for 24 h. The colonies were counted. Naive and incubated graft materials were examined by scanning electron microscopy to reveal both textile properties and biofilm formation. Physicochemical properties were evaluated. Wilcoxon signed ranks test and Friedman test were used for statistical analysis. Results. S. epidermidis showed a significantly decreased adherence to monofilament polypropylene graft, and increased adherence to multifilament polypropylene graft (P<0.05). S. aureus showed a significant affinity for monofilament composite graft (P<0.05). SEM studies showed that biofilm formation was present on multifilament polypropylene graft. Conclusions. Both S. epidermidis and S. aureus had significantly less adherence to multifilament lightweight composite than multifilament polypropylene graft. S. epidermidis showed a greater affinity to monofilament composite graft compared with monofilament polypropylene graft. Overall S. epidermidis adherence for multifilament lightweight composite and monofilament composite was less than multifilament polypropylene and higher than monofilament polypropylene. S. epidermidis and S. aureus showed different adherence for each graft. Changes in material composition and textile properties may well influence bacterial adherence. (C) 2009 Elsevier Inc. All rights reserved.Öğe Mild Hypothermia Improves Survival During Hemorrhagic Shock Without Affecting Bacterial Translocation(Taylor & Francis Inc, 2009) Deniz, Turgut; Agalar, Canan; Özdoğan, Mehmet; Edremitlioglu, Mustafa; Eryılmaz, Mehmet; Devay, Seda Duygulu; Ağalar, FatihBackground: Accidental hypothermia in patients with hemorrhagic shock (HS) is associated with increased mortality. However, experimental mild and moderate hypothermia has beneficial effects. The mechanisms for beneficial effects of hypothermia have not been completely understood. Therefore, the aim of this study was to investigate the effect of hypothermia on survival, bacterial translocation (BT), and remote pulmonary injury in a controlled HS model in rats. Methods: HS was achieved by blood withdrawal through femoral vein. Rats in the normothermia group (group I) were maintained at 37C. Mild hypothermia group (group II) was observed at 32C that was spontaneously induced by exposure to ambient temperature. Moderate hypothermia of 28C was actively induced by external cooling in group III for 90 min. Survival and neurological deficit scores (NDS) were recorded at 24th hr. Mesenteric lymph nodes, liver and spleen samples were collected. Myeloperoxidase (MPO) and malondialdehyde (MDA) levels were measured in lung tissue. Results: Blood pressure significantly increased in hypothermia groups. Mild hypothermia significantly increased survival. No difference was found in BT rates in groups. Hypothermia was found to significantly decrease the NDS points in group III, compared to group I. There was no difference in lung tissue MPO levels among groups. Lung tissue MDA levels increased significantly in groups II and III. Conclusions: Mild hypothermia improved blood pressure, survival, and neurological outcome with a possible detrimental effect on pulmonary ROS production during HS in rats. These effects of hypothermia are not associated with BT.Öğe Oral carbohydrate solution ameliorates endotoxemia-induced splanchnic ischemia(Springer, 2007) Deniz, Turgut; Agalar, Canan; Özdogan, Mehmet; Çomu, Faruk; Emirdoğan, Mustafa; Taşkın, Seda; Agalar, FatihThe purpose of this study was to investigate the effect of oral administration of a simple carbohydrate solution on splanchnic circulation and bacterial translocation in endotoxemia. Group 1 was sham control; group 2 was starved for 24 hours; in group 3, endotoxin was administrated at the end of starvation; in group 4, carbohydrate solution was administrated via orogastric route for 24 hours; and in group 5, carbohydrate solution was given and endotoxin was administrated at the end of 24 hours. Splanchnic blood flows were recorded and tissue samples were collected for microbiological analyses. There was a significant increase (P <.05) in the incidence of bacterial translocation in starvation. Endotoxemia decreased distal (P=.021) and midmesenteric (P=.046) flow in starved animals. Oral carbohydrate significantly increased ileal blood flow in starvation (P=.036) and endotoxemia (P=.008). In conclusion, oral carbohydrate solution prevents bacterial translocation during starvation and endotoxemia. The possible mechanism is the improvement in the mesenteric blood flow.Öğe Patient Satisfaction 18 months After a Two-day Quadruple Therapy for Helicobacter Pylori(Medi+World Int, 2005) Aydin, Serpil; Koseoglu, Tankut; Agalar, CananObjectives: Because the Helicobacter pylori (Hp) infection has been the most seen infection in the world, many research studies have been conducted to find an effective therapy regimen for eradication. Long-term regimens are being replaced by short term regimens as the long-term therapies cause more side effects and patient adjustment is not easy. Our aim was to determine the efficacy of a short-term therapy regimen and patient satisfaction by conducting a telephone survey 18 months after completion of the therapy regimen. Materials and Methods: The patients with upper gastrointestinal system complaints who had presented to the gastroenterology day clinic in Ankara Numune Hospital were chosen for this study. They were evaluated, taking into account their historical, physical, laboratory, endoscopic, and histopathological findings. Patients who were found with Helicobacter pylori, but had no other symptoms or disorders, were given a two-day amoxicillin, ornidazole, and tribismuthsubcitrate therapy after a five-day lansoprazole therapy. The evaluation was repeated one month after the regimen. In addition, a telephone survey was conducted 18 months after eradication, and the patients whose upper gastrointestinal system complaints were completely eradicated were asked if they had any additional upper gastrointestinal system complaints during this 18-month interval. Results: We applied the eradication therapy to 36 people. Complete eradication was obtained in 31 of the 36 patients. For the follow up telephone survey, we could not reach five of the patients due to changes in their address and/or telephone numbers; 15 patients indicated that they had not taken any drug; and 12 patients had no complaints during this 18-month period. Six patients received H2 receptor blocker irregularly, and five patients had taken our regimen once again on their own. All of the patients reached during the 18-month follow-up stated that they were satisfied with the therapy. Conclusion: Our regimen appears to relieve symptoms for a long time and it is considered to be effective from our patients' viewpoints.Öğe Prognostic significance of transforming growth factor-beta-1 in chronic hepatitis C virus infection(Academic Journals, 2012) Deveci, Ozcan; Agalar, Canan; Demirdal, Tuna; Demirturk, Nese; Yula, Erkan; Tekin, Alicem; Kilic, DilekInterferon treatment in hepatitis C virus (HCV) infection is expensive and has various adverse effects. Some markers may help in making decision to stop or maintain the treatment. The aim of this study was to evaluate the effectiveness of serum transforming growth factor beta-1 (TGF-beta 1) in assessing outcome of interferon treatment in patients with HCV infection. Twelve patients with chronic HCV infections included in the study as treatment group [Treatment group: anti-HCV (+), HCV RNA (+)] and 12 patients with anti-HCV positive, HCV-RNA negative and normal liver function tests included as control group. All patients in the treatment group were administered with peginterferon and ribavirin for 24 weeks. HCV-RNA levels were determined by realtime-PCR and TGF-beta 1 levels were measured with ELISA methods, at the beginning and 24th week of the treatment. Mann-Whitney U Test and Wilcoxon Test were used to compare variables within and between groups. Median age and male/female ratios were 46 years and 5/7, and 45 years and 3/9 for treatment groups and control group, respectively. Although no difference was found in TGF-beta 1 levels at the beginning of the treatment between groups (p>0.05), significantly decreased TGF-beta 1 levels were observed following 24 weeks of interferon treatment in treatment group (p=0.015). Despite limited number of patients, our data suggested that, TGF-beta 1 levels may be used as a prognostic marker for effectiveness of interferon treatment in patients with hepatitis C virus infection.Öğe The value of CRP, IL-6, leptin, cortisol, and peritoneal caspase-3 monitoring in the operative strategy of secondary peritonitis(Turkish Assoc Trauma Emergency Surgery, 2011) Pehlivanli, Faruk; Agalar, Fatih; Agalar, Canan; Saygun, Oral; Daphan, Cagatay; Aydinuraz, Kuzey; Sahiner, TayfunBACKGROUND We aimed to investigate the impact of C-reactive protein (CRP), interleukin (IL)-6, leptin, cortisol, and caspase-3 on the decision of terminating planned abdominal repair in secondary peritonitis. METHODS Fifteen patients with peritonitis were enrolled into the study. Serum CRP, IL-6, leptin, cortisol, and peritoneal caspase-3 activities were measured. RESULTS APACHE II scores at 48 hours (h) and age were significantly higher in non-survivors. A significant decrease was observed in caspase-3 activities of patients in whom <= 4 laparotomies were performed when compared with those who underwent >4 laparotomies. For patients who underwent <= 4 laparotomies, there was a significant difference in caspase-3 levels between 0 and 72 h. There was no significant difference in caspase-3 levels in non-survivors; caspase-3 levels were significantly lower in the survivors at 48 and 72 h. Changes in CRP, IL-6, leptin, and cortisol levels were not statistically significant. CONCLUSION CRP, IL-6, leptin, cortisol, and caspase-3 are not valuable in discriminating the number of planned operations, even though there is a significant decrease in caspase-3 "within" survivors. The discriminative value of caspase-3 for closure should be evaluated in studies in which caspase-3 is monitored for a longer duration in a large number of patients.
