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    The Effect of Whole Gut Irrigation on Contractile Responses of Guinea Pig Gallbladder, Ileum, and Tissue Cholecystokinin Levels
    (Georg Thieme Verlag Kg, 2014) Turkmen, Feyza; Soyer, Tutku; Keskil, Zuhal; Kisa, Ucler; Aslan, Mustafa; Senyucel, Mine; Cakmak, Murat
    Aim An experimental study was performed to evaluate the effect of whole gut irrigation (WGI) solutions on contractile responses of the gallbladder and ileum and also on tissue cholecystokinin (CCK) levels. Materials and Methods Thirty guinea pigs were enrolled into five groups including control group (CG) and WGI group (saline physiologic [SP], Ringer lactated [RL], polyethylene glycol [PEG], and dibasic sodium phosphate [DNP]). After median laparotomy, the distal esophagus was ligated and SP, PEG, RL, and DNP infusions (2 mL/kg/min) were performed via gastric catheter until rectal discharge became clear in WGI groups. Ileum and gallbladder samples were obtained for in vitro and biochemical studies without irrigation in CG and after irrigation with different WGI solutions. Isolated ileum and gallbladder preparations were suspended in organ baths for contractile responses of carbachol and CCK. Also, biochemical analysis of tissue CCK levels was performed in ileum and gallbladder samples. Results In PEG group, gallbladder and ileum CCK levels were significantly higher than CG (p < 0.05). Also, DNP irrigation caused increased CCK levels in gallbladder samples (p < 0.05). In lower carbachol concentrations, PEG group showed increased contraction responses in gallbladder samples when compared with controls (p < 0.05). However, ileal responses to carbachol did not show any significant difference between groups, contraction responses to CCK was decreased in PEG group when compared with CG (p < 0.05). Conclusion Among WGI solutions, PEG caused the highest CCK levels in gallbladder and ileum samples. Different WGI solutions affected the contractile responses of gallbladder and ileum smooth muscles divergently. Increased levels of CCK in PEG group support the decreased contractile responses in ileum. Therefore, our results confirm that the effect of WGI on gallbladder and ileum contractility may be CCK related.
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    Quantitative Software Analysis of Ultrasonographic Textures in Experimental Testicular Torsion
    (Georg Thieme Verlag Kg, 2013) Aslan, Mustafa; Küçükaslan, İbrahim; Mulazimoğlu, Serkan; Soyer, Tutku; Şenyücel, Mine; Çakmak, Murat; Aslan, Selim
    Aim Ultrasonography (US) has high diagnostic value in testicular torsion but is vulnerable to several potential errors, especially in the early period. Echotexture (ETX) analysis software provides a numerical expression of B-mode images and allows quantitative evaluation of blood flow due to ischemic damage using power Doppler US (PDUS) analysis. Our aim in this study was to determine the diagnostic value and effective parameters of EXT analysis software in the early period of torsion using B-mode and PDUS images. Materials and Methods In this study, eight rats were used. Following anesthesia, the right testis was rotated to a 1080-degree counterclockwise position whereas the left testis was left in place to have a control group. B-mode and PDUS images of both sides were recorded with a portable US device immediately (0 hour) and 1 and 2 hours after torsion. The B-mode images were analyzed in terms of gradient, homogeneity, and contrast using the BS200pro software (BAB Digital Imaging System 2007, Ankara, Turkey). Intensity (I)-red and area (A)-red values were measured on PDUS images with the Pixelflux (Version 1.0, Chameleon-Software, Leipzig, Germany). The data were evaluated by the Mann-Whitney U and Wilcoxon tests. Results Data from B-mode US image EXT analysis showed no significant difference between the right and left testicles in 0 to 2 hours (p > 0.05). The values obtained from PDUS analysis (I-red and A-red) significantly decreased at the testicular torsion side at the end of the second hour (p < 0.05). I-red and A-red values at 0 to 1 hour of torsion indicated similar blood flow alterations (p > 0.05) whereas the flow was significantly lower at 2 hours (p < 0.05). Conclusion In experimental testicular torsion, ischemic changes can be detected by PDUS power/angiomode using blood flow alterations as early as the second hour. Tissue damage cannot be evaluated within the first 2 hours of torsion with B-mode ETX analysis.
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    Öğe
    Results of Multichannel Intraluminal Impedance pH Metry in Symptomathic Children with Normal pH Metry Findings
    (Georg Thieme Verlag Kg, 2014) Soyer, Tutku; Gulerman, Fulya; Boybeyi, Ozlem; Aslan, Mustafa; Gunal, Yasemin
    AimA retrospective study was performed to evaluate the results of multichannel intraluminal impedance (MII) pH metry in symptomatic children with normal pH monitoring (PM) findings. Patients and MethodsChildren who have reflux index (RI) less than 4% in PM and recurrent symptoms were included. All children underwent MII. Children who received antireflux treatment with normal PM findings were excluded from the study. MII results were evaluated for RI, content of reflux (acid, weak acid, and alkaline) number and type of impedance events, esophageal bolus clearance time and proximal extent of reflux (PER). ResultsEight patients (age range: 5-13 years) were included to the study. The male female ratio was 5:3. The recurrent symptoms were related with gastrointestinal (n=5) and upper respiratory system (n=3). One of the patients was operated for esophageal atresia and one was followed for corrosive esophageal disease. Four of the patients had RI higher than 4% in MII. Patients with normal RI in MII, had weak acid reflux (n: 1), alkaline reflux (n=1) and no reflux (n=2). When number of impedance events evaluated, four patients had abnormal reflux episodes (70 or more reflux episodes). Impedance event recordings were correlated in 75% of PM findings. The content of impedance events were mixed and gas in nature. Prolonged esophageal clearance time and PER were detected in patients with chest pain and operated esophageal atresia. ConclusionMII can be considered as a superior diagnostic tool to detect weak acid and alkaline reflux in patients who had recurrent symptoms with normal PM studies. MII also provides information about bolus clearance time and extent of reflux.