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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 Emergency Department Visits Secondary to Amusement Park Injury(Emergency Medicine Physicians Assoc Turkey, 2010) Deniz, Turgut; Kandis, Hayati; Ulger, Huseyin; Agalar, FatihFunfairs are entertainment centers which draws mostly children's and also all other age groups' attention both in our country and in the world. Fun center equipments should be controlled regularly. Equipments that are not renewed in proper intervals and don't have appropriate security measures should be banned. Otherwise, funfair accidents that can cause really serious results can ocur. It is aimed in this study to present three cases who came to emergency room after a fall accident from the fun equipment that is called 'octopus'.Öğe The evaluation of abstracts presented at the 5th Congress of National Trauma and Emergency Surgery(Turkish Assoc Trauma Emergency Surgery, 2008) Deniz, Turgut; Saygun, Meral; Sahiner, Tayfun; Agalar, Fatih; Taviloglu, Korhan; Yorganci, Kaya; Ertekin, CemalettinBACKGROUND The aim of this study was to evaluate demographics, methodological data and writing style of abstracts presented at the 5th Congress of National Trauma and Emergency Surgery. METHODS Study design, institutions and number of authors, appropriateness of the title, use of a structured abstract, word count, fluency, accuracy of the statistical evaluation, and conclusion-abstract accordance were assessed in 451 abstracts. RESULTS Nearly 49% of abstracts were retrospective and 29% were case reports in design. 33%, 26%, and 24% of abstracts were related to isolated organ, single system and multi-system injuries, respectively. Approximately two-fifths of presentations were university-based. Approximately one-third of presentations were multidisciplinary in origin. The mean number of authors was 5.6 +/- 1.8, and a statistical significance was found between abstract contributions from university versus other hospitals (p=0.001). Three-fourths of the abstracts had an appropriate title and 91% were structured. Word count was 100-250 in 57% and 250-500 in 42% of abstracts. Statistical analysis was used in only 19% of abstracts. Most of the abstracts were fluent. Conclusion-abstract accordance was present in 71% of the abstracts. CONCLUSION Our results indicate there are some deficiencies in the abstract writing process. The use of a structured abstract may intensify fluency and compliance to abstract writing guidelines. Clinical studies regarding multi-traumatized patient groups and experimental studies should be encouraged.Öğe The evaluation of academic emergency department design(Turkish Assoc Trauma Emergency Surgery, 2007) Deniz, Turgut; Aydinuraz, Kuzey; Oktay, Cem; Saygun, Meral; Agalar, FatihBACKGROUND In our study which was based upon a questionnaire, the inner and outer architectural designs of emergency services of Emergency Medicine Departments were investigated. METHODS In this descriptive study, a standard questionnaire was sent to 26 Emergency Medicine Departments which were operating at that time. In the questionnnaire, the internal, external architectural and functional features were questioned. Answers of 22 Emergency Medicine Departments were analysed. Two Emergency Medicine Departments that were not operating at that time were not included in the study. RESULTS The analysis of the replies revealed that only 59% (n=13) of the Emergency Medicine Departments were designed as an emergency service prior to the construction. The ambulance parking areas were not suitable in 77% of the emergency units while only 54.5% (n=12) had protection against adverse weather conditions. In only 59% (n=13) of the emergency units, a triage unit was present and in only one of the in only one (4.5%), a decontamination room was available. It was understood that only 32% (n=8) of the emergency units were appropriate in enlarging their capacity taking the local risk factors into consideration. There was a toilette for disabled patients in only 18% (n=4) of the units as well. Considering a 12-year of history of the Emergency Medicine in Turkey, the presence of a lecture room is still 68% (n=15) in emergency departments which reflects that academical efforts in this field is emerging in challenging physical conditions. CONCLUSION The results of our study revelaed that emergency service architecture was neglected in Turkey and medical care given was precluded by the insufficient architecture. The design of emergency services has to be accomplished under guidance of scientific data and rules taking advices of architects who have knowledge and experience on this field.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 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 Similar effects of general and spinal anaesthesia on perioperative stress response in patients undergoing haemorrhoidectomy(Hindawi Ltd, 2006) Büyükkoçak, Ünase; Cağlayan, Osman; Daphan, Cağatay; Aydinuraz, Kuzey; Saygun, Oral; Kaya, Tahsin; Agalar, FatihSurgery induces release of neuroendocrine hormones (cortisol), cytokines (interleukin-6: IL-6, tumour necrosis factor-alpha: TNF-alpha), acute phase proteins (C-reactive protein: CRP, leptin). We studied the effects of general and spinal anaesthesia on stress response to haemorrhoidectomy. Patients were assigned to general and spinal anaesthesia groups (n = 7). Blood samples were drawn before induction and 24 hours after surgery. Perioperative levels of IL-6, TNF-alpha, CRP, cortisol, and leptin were comparable among the groups. Twenty four hours after surgery, TNF-alpha and cortisol did not change; IL-6 and CRP increased significantly in all patients. Significant increase in leptin levels was found in patients undergoing spinal anaesthesia. Except for the increase in leptin levels, there was no significant difference related to the effects of general and spinal anaesthesia. Copyright (c) 2006 Unase Buyukkocak et al.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.
